bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful management by recombinant activated factor VII in a case of disseminated intravascular coagulopathy caused by obstetric hemorrhage
Authors: Nohira Tomoyoshi , Osakabe Yumi , Suda Shingo , Takahashi Chie , Tanaka Asashi , Ikeda Kazumi , Ikeda Toshiaki , Okabe Kazuhiro
Published: September 2008

Postpartum hemorrhage (PPH) is a life‐threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta. The patient was a 33‐year‐old woman with placental previa. Cesarean section (CS) was performed at gestational week 35. During CS, there was massive hemorrhage due to placenta accreta. After CS, disseminated intravascular coagulopathy and hypovolemic shock were diagnosed. The PPH was not controlled by transfusion therapy. On the fourth day after CS, rFVIIa (90 µg/kg × 2) was given because of the persistent PPH. Bleeding decreased and no further transfusion was required from 2 days after administration. rFVIIa was useful in the treatment of this case of obstetric hemorrhage.
Prenatal diagnosis of congenital cystic adenomatoid malformation using three‐dimensional inversion rendering: A case report
Authors: Sanz‐Cortés Magdalena , Raga Francisco , Bonilla‐Musoles Fernando
Published: September 2008

We report a case of a congenital cystic adenomatoid malformation of the lung (CCAM). At 12 weeks of gestation, an echogenic lung associated to a hydrothorax was detected. Despite the results of the combined test that informed of a high risk of chromosomopathy, normal karyotype was confirmed after an amniocentesis. The three‐dimensional ultrasound inversion mode depicted all the cysts within the fetal lungs as opaque areas that were seen concurrently together, which was compatible with CCAM. After parental counseling, the patient opted to terminate the pregnancy at 18 weeks. Pathological analysis of the lungs confirmed the diagnosis of a CCAM type II. The recent advent of the three‐dimensional ultrasound inversion mode opens many diagnostic options until now unavailable or difficult to attain sonographically and therefore it may help us to increase the sonographic detection rates of congenital cystic adenomatoid malformation.
Longitudinal follow up of delayed eclampsia using cerebroangiography
Authors: Negishi Yasuyuki , Otsubo Yasuo
Published: September 2008

A 33‐year‐old primigravida experienced a delayed eclamptic convulsion. Following the convulsion, an i.v. administration of magnesium sulfate was utilized in response to cerebroarterial vasospasms, which were seen before and 1 week after the convulsion. Our findings confirm that the appropriate use of magnesium sulfate is necessary in such cases.
Triplet pregnancy with partial hydatidiform mole coexisting with two fetuses: A case report
Authors: Kim Cheol Hong , Kim Yoon Ha , Kim Jong Woon , Kim Ki Min , Cho Moon Kyoung , Kim Seok Mo , Nam Jong Hee , Song Tae‐Bok
Published: September 2008

Hydatidiform mole with a coexistent fetus is rare, but this condition has recently shown an increased incidence because of assisted reproduction technology. Herein, we report on a case of triplet pregnancy with a partial hydatidiform mole coexisting with two fetuses. It was diagnosed by p57kip2 immunohistochemical staining which is helpful in determining histologically equivocal cases. After termination of pregnancy, the patient was diagnosed with persistent gestational trophoblastic disease. Six courses of methotrexate chemotherapy were performed. Her β‐human chorionic gonadotrophin titers then fell to a normal level.
Efficacy of array comparative genomic hybridization in a fetus with an inherited apparently balanced translocation: A case report
Authors: Park Ji Kwon , Lee Jae Ik , Jo Hyun Cheol , Shin Jeong Kyu , Lee Soon Ae , Lee Jong Hak , Paik Won Young
Published: September 2008

When one parent is discovered to have the same apparently balanced genetic rearrangement as that identified at prenatal diagnosis, many couples are advised to seek a more precise prenatal diagnosis for reassurance. A 25‐year‐old translocation carrier, who carried a fetus with partial trisomy 3q and partial monosomy 9p with omphalocele in a previous pregnancy, showed the same apparently balanced translocation at chorionic villus sampling. A truly balanced translocation without cryptic imbalances for the fetus was detected using array comparative genomic hybridization. For cryptic unbalanced defects, in which an apparently balanced translocation has been transmitted from a normal parent to a child with a phenotypic abnormality, the use of array comparative genomic hybridization to assess the presence of cryptic aberrations in the fetus combines the speed of DNA analysis with a comprehensive scan for submicroscopic genomic abnormalities.
Concurrent sigmoid volvulus and herniation through broad ligament defect during pregnancy: Case report and literature review
Authors: Vo Thi M. , Gyaneshwar Rajat , Mayer Christiane
Published: September 2008

Sigmoid volvulus in pregnancy is a rare complication. The combination of sigmoid volvulus and sigmoid herniation through a broad ligament together with placental abruption in pregnancy is a most unusual obstetrical emergency. We report the case of a previously well 32‐year‐old Mexican woman who was transferred to our institution at 28 weeks gestation with threatened preterm labor. We considered the possibility of appendicitis. While awaiting a surgical consult, an emergency cesarean section was carried out for a prolonged deceleration of the fetal heart. A routine transverse suprapubic abdominal entry revealed a large loop of ischemic bowel. This was confirmed to be a sigmoid volvulus which had herniated through a left broad ligament defect. The deceleration was attributed to a large placental abruption. No previous case with a combination of a sigmoid volvulus and placental abruption was found in the literature.
Adnexal torsion during pregnancy: Report of four cases and review of the literature
Authors: Hasiakos Dimitris , Papakonstantinou Katerina , Kontoravdis Antonios , Gogas Lazaros , Aravantinos Leon , Vitoratos Nikolaos
Published: September 2008

Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. It is frequently associated with ovarian stimulation for in vitro fertilization (IVF) or with ovarian masses, mainly of functional origin. The clinical, laboratory and imaging findings are non‐specific. The authors present four cases with adnexal torsion diagnosed during the first trimester of pregnancy. The clinical picture, the mode of diagnosis, and the therapeutic approach are discussed. In two cases, the adnexa was removed, because there was extensive hemorrhage and ischemia. In the other two cases, unwinding of the adnexa was carried out and the ovary was preserved. The diagnosis of adnexal torsion is difficult, especially during pregnancy, and occasionally remains a diagnostic dilemma. It necessitates a prompt surgical intervention, because any delay leads to irreversible ovarian necrosis, so that adnexectomy is ultimately required.
Uterine rupture at scar of prior laparoscopic cornuostomy after vaginal delivery of a full‐term healthy infant
Authors: Su Chi Feng , Tsai Horng Jyh , Chen Gin Den , Shih Yang Tse , Lee Maw Sheng
Published: September 2008

A 30‐year‐old, gravida 2, para 0 woman who had a history of a laparoscopic cornuostomy for a left interstitial pregnancy was admitted for a vaginal delivery due to labor pains at 40 weeks gestation. A prolonged placental delivery, persistent abdominal pain, and hemorrhagic shock were noted after the delivery of the infant. An emergency laparotomy was carried out, and the diagnosis of a uterine rupture at the scar of a prior cornuostomy was confirmed. The entire placenta extruded through the rupture wound into the abdominal cavity. A Medline computer search revealed that a similar case of a uterine rupture after full‐term vaginal delivery has yet to be reported. In order to prevent a uterine rupture, we suggest that a planned cesarean delivery, before the onset of labor in a subsequent pregnancy, may be safer for a patient with a scarred uterus from a prior cornuostomy for an interstitial pregnancy.
Transitional cell carcinoma of the ovary: Unusual presentation as metastatic cervical lymph node
Authors: Keepanasseril Anish , Suri Vanita , Gupta Nalini , Ghoshal Sushmita
Published: September 2008

Transitional cell carcinoma (TCC) of the ovary is a rare and recently recognized subtype of ovarian surface epithelial cancer. We present a case that presented with metastatic cervical lymph nodes which is an extremely rare presentation of an ovarian carcinoma.
First case of liposarcoma arising from the fallopian tube: Case report and review of the literature
Authors: Oishi Hitomi , Moriyama Shingo , Kotera Kouhei , Miura Kiyonori , Masuzaki Hideaki
Published: September 2008

Liposarcoma is the most common soft tissue sarcoma in adults, and it typically occurs in either the retroperitoneum or the extremities. However, this malignant tumor is very rare in the female reproductive system. A 58‐year‐old woman presented with acute abdominal pain, and computed tomography (CT) scan detected multiple masses measuring 4–6 cm in size with a fatty density in her adnexal region. Laparoscopic evaluation revealed tumors of the left fallopian tube with a normal left ovary. Histopathological evaluation of the resected pelvic tumors showed lipocytes and lipoblasts of various sizes, leading to diagnosis of well‐differentiated liposarcoma of the left adnexal region. This is the first known case of a liposarcoma arising from the fallopian tube. When a pelvic mass with fatty density that does not show typical findings of a mature cystic teratoma is detected by either CT or magnetic resonance imaging, the possibility of a liposarcoma should be considered.
Leiomyosarcoma of the uterine cervix in a young woman
Authors: Sahu Latika , Bupathy A. , Badhe Bhavana A.
Published: September 2008

Primary leiomyosarcoma of the uterine cervix is an exceedingly rare tumor. Probably, this is first case to be reported in a young woman. A 25‐year‐old south Indian woman presented with excessive white discharge per vaginum. On examination, a growth in the cervix infiltrating to the anterior vaginal wall was present. Biopsy showed leiomyosarcoma. Two cycles of chemotherapy with cisplatin, doxorubicin and cyclophosphamide were given and then a total hysterectomy with bilateral salpingo‐oophorectomy was carried out, followed by local radiation to the anterior vaginal wall. The patient developed extensive metastasis within 6 months of surgery. Because the number of reported cases is very small, the optimal mode of treatment is yet to be established. Additional cases are needed to establish the optimal mode of management and to predict the prognosis.
Pelvic inflammatory disease with Tc‐99m Ciprofloxacin imaging
Authors: Im Moon Whan , Choe Wonsick , Hwang Sung Ook , Song Eun‐Seop , Lee Woo Young
Published: September 2008

The clinical diagnosis of pelvic inflammatory disease (PID) is inexact. There are multiple potential symptoms and signs ascribable to PID as predicted by areas of inflammatory involvement. No symptoms or signs are pathognomonic for PID. The authors describe single photon emission computed tomography (SPECT) images of technetium‐99m (99mTc) ciprofloxacin imaging of patients with PID that showed foci of significantly increased uptake in the regions corresponding to the areas of clinical symptoms. We report two such cases of PID. We undertook physical exams, complete blood count, erythrocyte sedimentation rate, C‐reactive protein, Gram stains, wet smears, cultures, Mycoplasma genetic studies, Chlamydia cultures, and SPECT before treatment. During treatment we took laparoscopies, hysteroscopies, biopsies, and cultures. After the treatment, we repeated the same exams. 99mTc ciprofloxacin imaging is considered valuable in persons with symptoms of PID in whom diagnosis is difficult.
Two cases of epidural anesthesia‐associated postoperative decubitus
Authors: Takahashi Eri , Isonishi Seiji , Suzuki Michiko , Ogura Asako , Kunito Shiro , Hirama Masanori , Shoji Hirokazu , Ochiai Kazuhiko , Tanaka Tadao
Published: September 2008

Very few cases of postoperative decubitus have been reported. We report two cases of hip decubitus after myomectomy. Case 1 is a 32‐year‐old Japanese woman who underwent an uncomplicated myomectomy under the combination of general and epidural anesthesia. Twelve hours after surgery, a palpable soft tissue mass developed in the sacral region. On day 3, the soft tissue mass had disappeared and the patient was discharged on day 8. Case 2 is a 33‐year‐old woman. Under a combination of spinal and epidural anesthesia, a myomectomy was carried out. On day 1 after surgery, a hard mass with redness was detected. On day 8, decubitus improved and she was discharged. We evaluated the temporal changes in anesthetic level in four independent cases. Eighteen hours after surgery, the anesthetic effect still continued below the L2 level. We conclude that the extended effect of epidural anesthesia might be one of the mechanisms causing postoperative decubitus.
INFORMATION‐SHARING AND CONFIDENTIALITY IN SOCIAL POLICY: REGULATING MULTI‐AGENCY WORKING
Authors: BELLAMY CHRISTINE , 6 PERRI , RAAB CHARLES , WARREN ADAM , HEENEY CATHERINE
Published: September 2008

In recent years, there has been growing concern in the UK that local services aimed at risky or vulnerable people are ineffective, because of agencies’ persistent failure to share information about their clients. Despite considerable national policy effort to encourage better information‐sharing, previous research indicates that there are many cases where information is still not shared when it should be, or where it is shared when it should not be, with potentially devastating results. This article uses data from the largest empirical study of local information‐sharing yet undertaken to examine four policy sectors where multi‐agency working has come to the fore. It shows that variations in their information‐sharing and confidentiality practices can be explained by neo‐Durkheimian institutional theory and uses insights from this theory to argue that current policy tools, which emphasize formal regulation, are unlikely to lead to consistent and acceptable outcomes, not least because of unresolved conflicts in values and aims.
RETHINKING POLICY OPTIONS FOR INDUSTRY: APPROPRIATENESS IN POLICIES FOR INDUSTRY AND UK FARMING AND FOOD
Authors: COX ANDREW , CHICKSAND DANIEL
Published: September 2008

This article assesses the appropriateness of lean supply and partnership relationship management policies as a means of invigorating industry, using the example of the UK pig and beef industry. The analysis assesses the extent to which it is operationally feasible, and with what commercial consequences, in UK pig and beef supply chains and markets. The analysis demonstrates that the lean and partnering approach is not always operationally feasible. Furthermore, when itisoperationally feasible dominant players only – such as multiple retailers – appear to benefit commercially from its adoption. Given this, alternative policy options may be required in the future for such reinvigoration of industry. A framework to guide policy selection is provided.
ELECTED MAYORS: LESSON DRAWING FROM FOUR COUNTRIES
Authors: ELCOCK HOWARD
Published: September 2008

Countries can and sometimes do copy the institutions and practices of other countries in order to address problems and issues that they have in common with them. The office of directly elected mayor has become an increasingly common feature of local government throughout the developed democracies, spreading from its largely American origins to a range of European states. This paper develops a matrix for the analysis of elected mayors in different countries using as its horizontal axis the formal, informal and individual attributes of elected mayors and, on the vertical axis, their governmental, governance and allegiance roles. The matrix is then applied to analyse studies of elected mayors in four countries: the United States, England, Germany and Greece, in an attempt to derive comparative lessons applicable to the countries included in the analysis, as well as to countries considering or in the process of developing directly elected executive mayors. The issues examined include improving the internal co‐ordination of local authorities’ departments, the need for network management in increasingly fragmented or ‘hollowed out’ local government systems and the ways in which mayors attempt to secure their political survival and that of the offices they hold, by securing and retaining the allegiance of voters and stakeholders. It also explores the benefits and dangers of concentrating much formal power and informal influence in a single pair of hands. Its conclusions are offered both to demonstrate ways in which comparative studies of political institutions can be developed and in the hope that they may be of use to mayors and those concerned with the development and reform of local government and governance.
DIXON OF DOCK GREEN GOT SHOT! POLICING IDENTITY WORK AND ORGANIZATIONAL CHANGE
Authors: DAVIES ANNETTE , THOMAS ROBYN
Published: September 2008

Drawing on a small‐scale ethnographic study in one UK police force, the paper offers insights into how different individuals and groups legitimate particular definitions of policing performance through invoking contrasting constructions of community policing. In doing so, the paper focuses on the discursive analysis of change defined in two interrelated ways: firstly with regard to the intentions and implementation of a new discursive template; and, secondly, as ongoing situated human agency in context. Findings from the study show how ‘Dixon of Dock Green’– an archaic stereotype of the slow‐witted but endearing ‘PC Plod’ character – is used as a discursive resource to both acknowledge and resist the legitimacy of community work in the definition of ‘real policing’. Despite attempts over the last two decades to underpin policing priorities, as well as roles and cultures, with a collaborative, community focused approach, the study suggests a marginal impact on policing processes, performance and work identities.
MANAGING THE DIARY: WHAT DOES A POLICE COMMISSIONER DO?
Authors: FLEMING JENNY
Published: September 2008

What do we know about the work of a Police Commissioner? Using the example of Australia, this article provides a perspective of the working environment within which a Police Commissioner operates. The emphasis is on the Commissioner’s office and how that office manages a constantly changing diary in an unpredictable and uncertain environment both internally and externally. Through an analysis of a workplace diary spanning five years, interviews and non‐participation observation notes, the article reflects on the working life of an Australian Police Commissioner. It demonstrates that this Police Commissioner divides her time between management duties and representing the Office of Commissioner in the wider community. It also highlights the importance of external leadership and the importance of working with communities and connecting with external constituencies. The article shows that qualitative analysis in the form of interviews and non‐participant observation can provide a stronger interpretation and understanding of quantitative data.
PRIVATE POLICING: A VIEW FROM THE MALL
Authors: WAKEFIELD ALISON
Published: September 2008

In many Western democratic societies the primacy of the police has begun to diminish with a proliferation of alternative service providers, particularly within the private security sector. This raises questions about how such bodies can best be mobilized and integrated within policing. This paper reports findings from three ethnographic case studies of private security teams operating within areas of semi‐public space, to advance understanding of their nature and operations. It shows how the character of security work is determined by vastly differing structural arrangements to those of the police, but by a similar heterogeneity of function. While private security is seen to have a valid place within the ‘extended police family’, it is depicted as a low status sector whose authority in undertaking policing derives from the autonomy of other more powerful players. Future ethnographies, it is therefore argued, need to focus on the corporate users that govern its activities.
Joint Generalized Estimating Equations for Multivariate Longitudinal Binary Outcomes with Missing Data: An Application to Acquired Immune Deficiency Syndrome Data
Authors: Lipsitz Stuart R. , Fitzmaurice Garrett M. , Ibrahim Joseph G. , Sinha Debajyoti , Parzen Michael , Lipshultz Steven
Published: September 2008

In a large, prospective longitudinal study designed to monitor cardiac abnormalities in children born to women who are infected with the human immunodeficiency virus, instead of a single outcome variable, there are multiple binary outcomes (e.g. abnormal heart rate, abnormal blood pressure and abnormal heart wall thickness) considered as joint measures of heart function over time. In the presence of missing responses at some time points, longitudinal marginal models for these multiple outcomes can be estimated by using generalized estimating equations (GEEs), and consistent estimates can be obtained under the assumption of a missingness completely at random mechanism. When the missing data mechanism is missingness at random, i.e. the probability of missing a particular outcome at a time point depends on observed values of that outcome and the remaining outcomes at other time points, we propose joint estimation of the marginal models by using a single modified GEE based on an EM-type algorithm. The method proposed is motivated by the longitudinal study of cardiac abnormalities in children who were born to women infected with the human immunodeficiency virus, and analyses of these data are presented to illustrate the application of the method. Further, in an asymptotic study of bias, we show that, under a missingness at random mechanism in which missingness depends on all observed outcome variables, our joint estimation via the modified GEE produces almost unbiased estimates, provided that the correlation model has been correctly specified, whereas estimates from standard GEEs can lead to substantial bias.
Sir Godfrey Thomson: A Statistical Pioneer
Authors: Bartholomew David J. , Deary Ian J. , Lawn Martin
Published: September 2008

Godfrey Thomson (1881–1955) was a leading figure in intelligence testing who made his name in that field first at Armstrong College, Newcastle, and then at the University of Edinburgh. In the course of his practical work he identified many theoretical problems which were essentially statistical in character. In particular, he used maximum likelihood estimation as early as 1919 and his statistical work largely set the course of modern factor analysis and related techniques. His statistical abilities were recognized, at different stages of his career, by both Karl Pearson and Sir Ronald Fisher. His key insight was to recognize the importance of Fisherian inference for the future of that subject.
Another Look into the Effect of Premarital Cohabitation on Duration of Marriage: An Approach Based on Matching
Authors: Mazzuco Stefano
Published: September 2008

The paper proposes an alternative approach to studying the effect of premarital cohabitation on subsequent duration of marriage on the basis of a strong ignorability assumption. The approach is called propensity score matching and consists of computing survival functions conditional on a function of observed variables (the propensity score), thus eliminating any selection that is derived from these variables. In this way, it is possible to identify a time varying effect of cohabitation without making any assumption either regarding its shape or the functional form of covariate effects. The output of the matching method is the difference between the survival functions of treated and untreated individuals at each time point. Results show that the cohabitation effect on duration of marriage is indeed time varying, being close to zero for the first 2–3 years and rising considerably in the following years.
The Transformation of Higher Education in Israel since the 1990s: The Role of Ideas and Policy Paradigms
Authors: MENAHEM GILA
Published: September 2008

This article examines the transformation of Israel's higher education system since the 1990s. During that period, the system underwent expansion, diversification, privatization, and internationalization in a series of pathbreaking reforms. The main argument is that while external factors—such as demographic trends—exerted pressure for change, the trajectory and policy options preferred were shaped by ideational factors. Policy entrepreneurs played a crucial role in advancing pathbreaking institutional change when they reframed policies through linking cognitive ideas of “what has to be done” with the normative ideas that granted legitimacy to the proposals for reform.
They Hug Hoodies, Don't They? Responsibility, Irresponsibility and Responsibilisation in Conservative Crime Policy
Authors: BENNETT JAMIE
Published: September 2008

Abstract: After ten years of Labour government, their penal policies have been extensively examined and reviewed. Recent months have seen the resurgence in popularity of the Conservative Party, but their penal policies have not been the subject of critical analysis. This article aims to provide such a review of Conservative Party policy. It explores the published statements and documents produced on penal policy and identifies that rather than presenting a new approach, the policies mix neo‐conservative or New Right economic policies from the 1980s including the creation of a small State with marketised public services and promoting punitive criminal justice policies that have been staples of the party for more than a decade, with the deployment of neo‐liberal strategies in the social field, particularly responsibilisation. The article argues that whilst there is some mixing and matching of policies and strategies, there is an underlying neo‐conservative ideology. The social consequences of Cameron's policies are discussed, including the expansion of the criminal justice and penal system, the redefinition of the socially excluded as the ‘undeserving poor’ and the creation of a minimalist State.
Optical coherence tomography imaging of bullous diseases
Authors: Mogensen M , Morsy HA , Nurnberg BM , Jemec GBE
Published: September 2008

Background  Optical coherence tomography (OCT) is a non‐invasive optical imaging technique with a micrometer resolution that may potentially offer real‐time bedside imaging of sufficient detail to allow for morphological discrimination between different types of bullae.

Objective  To explore the potential of OCT in bullous skin disorders by looking at a set of patients with skin blisters of known origin and study the OCT images for possible hallmarks of the blistering level.

Materials and methods  OCT provides cross‐sectional, tomographic images of the skin. A consecutive series of patients were recruited and their lesions imaged by OCT: 3 patients with bullous pemphigoid (BP), 1 patient with extensive bullae following burns, 1 patient with pemphigus, 1 patient with subcorneal pustular dermatosis, and a patient with Dariers disease. The latter two were included due to similarity to pemphigus with respect to the level of defect cell adhesion.

Results  In OCT images, BP bullae are easily depicted as dark, ovoid to round well‐demarquated areas, and BP bulla morphology is clearly different from the burn blisters and the pemphigus‐like disease with respect to the blistering level.

Discussion  Differentiation of epidermal and subepidermal blisters is demonstrated using OCT. The variation within pemphigoid lesions and pemphigus‐like diseases is however too subtle to allow for differential diagnosis; this may be ascribed to limited resolution. Enhanced resolution of OCT may overcome this obstacle.
Expression of mutant SOD1G93A in astrocytes induces functional deficits in motoneuron mitochondria
Authors: Bilsland Lynsey G. , Nirmalananthan Niranjanan , Yip Jing , Greensmith Linda , Duchen Michael R.
Published: September 2008

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by motoneuron degeneration resulting in paralysis and eventual death. ALS is regarded as a motoneuron‐specific disorder but increasing evidence indicates non‐neuronal cells play a significant role in disease pathogenesis. Although the precise aetiology of ALS remains unclear, mutations in the superoxide dismutase (SOD1) gene are known to account for approximately 20% of familial ALS. We examined the influence of SOD1G93A expression in astrocytes on mitochondrial homeostasis in motoneurons in a primary astrocyte : motoneuron co‐culture model. SOD1G93A expression in astrocytes induced changes in mitochondrial function of both SOD1G93A and wild‐type motoneurons. In the presence of SOD1G93A astrocytes, mitochondrial redox state of both wild‐type and SOD1G93A motoneurons was more reduced and mitochondrial membrane potential decreased. While intra‐mitochondrial calcium levels [Ca2+]m were elevated in SOD1G93A motoneurons, changes in mitochondrial function did not correlate with [Ca2+]m. Thus, expression of SOD1G93A in astrocytes directly alters mitochondrial function even in embryonic motoneurons, irrespective of genotype. These early deficits in mitochondrial function induced by surrounding astrocytes may increase the vulnerability of motoneurons to other neurotoxic mechanisms involved in ALS pathogenesis.
Dose–response effect of ferulic acid against nicotine‐induced tissue damage and altered lipid levels in experimental rats: a pathohistological evaluation
Authors: Adluri Ram Sudheer , Nagarajan Devipriya , Periyaswamy Vishwanathan , Venugopal Padmanabhan Menon
Published: September 2008

In the present study, ferulic acid (FA), a naturally occurring nutritional compound, was investigated for its protective effect against nicotine‐induced toxicity in a dose dependent manner. The toxicity was induced by subcutaneous injection of nicotine at a dose of 2.5 mg/kg body weight (b.w.) for 22 weeks in female albino Wister rats. Simultaneously, rats were treated with FA at three different doses (10, 20 and 40 mg/kg b.w.) via intragastric intubations for 22 weeks. At the end of the experiment, circulatory marker enzymes (i.e. lactate dehydrogenase and alkaline phosphatase) and tissue (lung, liver and kidney) lipid levels (i.e. cholesterol, free fatty acids, triglycerides and phospholipids) were analysed, which were significantly increased in the nicotine‐treated group, whereas FA treatment positively modulated these levels. FA at a dose of 20 mg/kg b.w. was found to be more effective when compared with the other two doses. The lung, liver and kidney excised from the different groups were fixed and stained to perform histological assessments. The protective effect of FA on histological observations confirms that 20 mg/kg b.w. of FA modulates the deleterious effects of nicotine. The results suggest that FA exerts its inhibitory action against nicotine‐induced tissue damage through its antioxidant and antihyperlipidemic properties.
The urokinase receptor (u‐PAR)—a link between tumor cell dormancy and minimal residual disease in bone marrow?
Authors: ALLGAYER HEIKE , AGUIRRE‐GHISO JULIO A.
Published: September 2008

Minimal residual disease (MRD) is hypothesized to be the major cause of tumor recurrence and metastasis even years and decades after primary cancer diagnosis and curative solid tumor resection. In these patients disseminated tumor cells reflecting MRD can be detected in the bone marrow years after treatment. It is to be assumed that genetic determinants and a complex interplay between the disseminated tumor cells and their microenvironment in the bone marrow are responsible for tumor cell dormancy and the final reactivation towards metastasis. The urokinase receptor (u‐PAR), a critical regulator of invasion, intravasation, and metastasis, is found to be a key player in regulating the shift between single cell tumor dormancy and proliferation. This has mainly been attributed to a regulation by u‐PAR of integrins, and the ability of the latter to propagate signals from fibronectin through the EGF‐receptor, ERK, and p38 signaling. Interestingly, u‐PAR is found in disseminated tumor cells in the bone marrow of solid cancer patients, and is associated with the expansion of these cells and clinical prognosis. Here we summarize and discuss findings on disseminated tumor cells in the bone marrow, MRD and the role of u‐PAR in tumor biology, especially focusing on its specific role in providing a switch between tumor cell proliferation and dormancy. Finally, we discuss the hypothesis that u‐PAR might be an essential molecule in bone marrow disseminated tumor cells for long‐term survival during dormancy, and/or reactivation of their proliferation years after primary treatment.
Integrins in breast cancer dormancy
Authors: PONTIER STEPHANIE M. , MULLER WILLIAM J.
Published: September 2008

Among breast cancer patients, 20% to 45% develop malignant lesions following their initial treatment. This relapse may occur after an apparent remission period that can range from years to several decades. Clinical observations suggest that breast‐derived malignant cells have the ability to survive subclinically for a very long period of time before eventually resuming proliferation and forming detectable lesions. While the precise molecular events that correspond to this dormant phenotype remain poorly understood, data published during the last 10 years have underlined an important role of integrin proteins in the regulation of this phenomenon.
In vivo real‐time imaging of nuclear‐cytoplasmic dynamics of dormancy, proliferation and death of cancer cells
Authors: HOFFMAN ROBERT M.
Published: September 2008

The in vivo visualization of dormancy, proliferation, as well as cell death is of great importance in understanding the cellular pathology of cancer. We describe here the use of fluorescent proteins to differentially label cells in the nucleus and cytoplasm, and high‐powered imaging technology to visualize the nuclear‐cytoplasmic dynamics of these phenomena of cancer in vivo. The implications of this technology for discovery of new visible targets at the cellular level for treatment of cancer are discussed.
Tumor cell dormancy: implications for the biology and treatment of breast cancer
Authors: FEHM T. , MUELLER V. , MARCHES R. , KLEIN G. , GUECKEL B. , NEUBAUER H. , SOLOMAYER E. , BECKER S.
Published: September 2008

Despite progress made in the therapy of solid tumors such as breast cancer, the prognosis of patients even with small primary tumors is still limited by metastatic relapse often long after removal of the primary tumor. Therefore, it has been hypothesized that primary tumors shed tumor cells already at an early stage into the blood circulation. A subset of these disseminated tumor cells may persist in a state of so‐called “dormancy”. Based on cell culture and animal models, dormancy can occur at two different stages. Single dormant cells are defined as cells with a lack of proliferation and apoptosis with the cells undergoing cell cycle arrest. The micrometastasis model defines tumor cell dormancy as a state of balanced apoptosis and proliferation of micrometastasis resulting in no net increase of tumor mass. Mechanisms leading to a growth activation of dormant tumor cells and the outgrowth of manifest metastases are not completely understood. Genetic predisposition of the dormant cells as well as immunological and angiogenetic influences of the surrounding environment may contribute to this phenomenon. In this review, we summarize findings on different factors for tumor cell dormancy and potential therapeutic implications that should help to reduce metastatic relapse in cancer patients.
Vascular determinants of cancer stem cell dormancy—do age and coagulation system play a role?
Authors: RAK JANUSZ , MILSOM CHLOE , YU JOANNE
Published: September 2008

The inability of tumour‐initiating cancer stem cells (CSCs) to bring about a net increase in tumour mass could be described as a source of tumour dormancy. While CSCs may be intrinsically capable of driving malignant growth, to do so they require compatible surroundings of supportive cells, growth factors, adhesion molecules and energy sources (e.g. glucose and oxygen), all of which constitute what may be referred to as a ‘permissive' CSC niche. However, in some circumstances, the configuration of these factors could be incompatible with CSC growth (a ‘non‐permissive' niche) and lead to their death or dormancy. CSCs and their niches may also differ between adult and paediatric cancers. In this regard the various facets of the tumour‐vascular interface could serve as elements of the CSC niche. Indeed, transformed cells with an increased tumour‐initiating capability may preferentially reside in specific zones adjacent to tumour blood vessels, or alternatively originate from poorly perfused and hypoxic areas, to which they have adapted. CSCs themselves may produce increased amounts of angiogenic factors, or rely for this on their progeny or activated host stromal cells. It is likely that ‘vascular' properties of tumour‐initiating cells and those of their niches may diversify and evolve with tumour progression. The emerging themes in this area include the role of vascular (and bone marrow) aging, vascular and metabolic comorbidities (e.g. atherosclerosis) and the effects of the coagulation system (both at the local and systemic levels), all of which could impact the functionality of CSCs and their niches and affect tumour growth, dormancy and formation of occult as well as overt metastases. In this article we will discuss some of the vascular properties of CSCs relevant to tumour dormancy and progression, including: (i) the role of CSCs in regulating tumour vascular supply, i.e the onset and maintenance of tumour angiogenesis; (ii) the consequences of changing vascular demand (vascular dependence) of CSC and their progeny; (iii) the interplay between CSCs and the vascular system during the process of metastasis, and especially (iv) the impact of the coagulation system on the properties of CSC and their niches. We will use the oncogene‐driven expression of tissue factor (TF) in cancer cells as a paradigm in this regard, as TF represents a common denominator of several vascular processes that commonly occur in cancer, most notably coagulation and angiogenesis. In so doing we will explore the therapeutic implications of targeting TF and the coagulation system to modulate the dynamics of tumour growth and tumour dormancy.
Regulation of tumor dormancy as a function of tumor‐mediated paracrine regulation of stromal Tsp‐1 and VEGF expression
Authors: KANG SOO‐YOUNG , WATNICK RANDOLPH S.
Published: September 2008

Tumor dormancy is a critical yet poorly understood phenomenon affecting both the diagnosis and treatment of human cancers. This is due in large part to the lack of model systems available to study dormant tumor cells and the length of time needed to adequately examine the models that do exist. It has been demonstrated in several types of human cancer that tumor dormancy is a function of an impairment in angiogenesis. The intracellular signaling pathways regulating the expression of several pro‐ and anti‐angiogenic proteins have been well characterized in human cancer cells. The intercellular signaling that takes place between tumor cells and the surrounding tumor‐associated stroma has not been as extensively studied with regard to the regulation of angiogenesis, and as a result dormancy. In this review we define the key players in the regulation of angiogenesis and examine how their expression is regulated in the tumor‐associated stroma. The resulting analysis is often seemingly paradoxical, underscoring the complexity of intercellular signaling within tumors and the need to better understand the environmental context underlying these signaling mechanisms.
Tumor‐vascular interactions and tumor dormancy
Authors: NAUMOV GEORGE N. , FOLKMAN JUDAH , STRAUME ODDBJORN , AKSLEN LARS A.
Published: September 2008

Tumor progression is dependent on a number of sequential steps, including initial tumor‐vascular interactions and recruitment of blood vessels (i.e., the angiogenic switch), as well as tumor cells interacting with the surrounding microenvironment and its different components. Failure of a microscopic tumor to complete one or more of these early stages may lead to delayed clinical manifestation of the cancer and a state of stable non‐progressing disease (i.e., tumor dormancy). In this review, some of the clinical and experimental evidence is summarized, suggesting that microscopic human cancers, either primary, recurrent or metastatic, can remain in an asymptomatic, non‐detectable, and occult state for a long period of time. We also review current experimental human tumor dormancy models which closely recapitulate clinically observed delay in tumor progress.
Dental anxiety and quality of life: the effect of dental treatment
Authors: Vermaire J. H. , De Jongh Ad , Aartman Irene H. A.
Published: September 2008

Abstract –  Objective:  The aim of the present study was to determine the association between dental anxiety and quality of life (QoL) and to test the hypothesis that treatment of highly anxious patients would significantly enhance QoL.

Material and methods:  Subjects were 35 highly anxious dental patients of a Dutch dental fear clinic who were assessed on dental trait anxiety (DAS and S‐DAI) and QoL (oral health‐related QoL with the use of OHIP‐14, dental anxiety‐related QoL with the SADAS, and general aspects of QoL using Global Assessment of Functioning, while five different aspects of life satisfaction were quantified on a VAS‐scale) both prior to and after treatment (an average of six sessions of 45–60 minutes each). Also, both objective (DMFT and dentists’ judgement) and subjective (patients’ judgement) indices of oral health status were recorded.

Results:  Higher dental anxiety was significantly associated with lower OH‐QoL as indexed by the OHIP‐14 (r = 0.51–0.56, P < 0.01). Treatment was associated with marked improvement on oral health status, reduction of dental anxiety, and improvements regarding a variety of aspects of QoL (all Ps < 0.001). Reduction of dental anxiety, rather than improved oral health, was found to predict enhanced OH‐QoL.

Conclusion:  The results underline the importance of applying effective treatment methods for dentally anxious patients, not only with the purpose to alleviate their dental anxiety and to improve their oral health, but also because it contributes to an enhancement of their QoL.
Parsimonious prediction model for the prevalence of dental visits
Authors: Seirawan Hazem
Published: September 2008

Abstract –  Objectives:  To analyze the prevalence of dental visits within the last year in the Behavioral Risk Factor Surveillance System or BRFSS (2003) national database by simple sociodemographic factors, and to predict prevalence in States that have not participated in BRFSS 2003.

Methods:  Behavioral Risk Factor Surveillance System is a cross‐sectional telephone survey conducted by the state‐level authorities in the United States and based on a standardized questionnaire to determine the distribution of risk behaviors and health practices among noninstitutionalized adults. A multivariable logistic regression model considers the complex sample design of the BRFSS was used to predict the prevalence of dental visits based on four nonclinic parsimonious variables.

Results:  White race, high income (≥$35 000), education above high school, and marital status were associated with an annual dental visit with odds ratios of 1.38, 2.09, 1.61, and 1.18, respectively. Utah had the highest percentage (78%) of estimated annual users, while ‘Virgin Islands’ had the lowest percentage (59%). The model’s correct classification rate was 61.5%.

Conclusions:  State and local governments, health promotion organizations, insurance companies, and organizations that administer public health programs (such as Medicare and Medicaid in the U.S.) will benefit by applying this model to the available nonclinical databases, and will be able to improve planning of dental health services and required dental workforce.
Palestinian experience with sewage sludge utilizing reed beds
Authors: Nassar Abdel Majid , Smith Mike , Afifi Samir
Published: September 2008

Management of sewage sludge is one of the main environmental problems in Palestine. More than 400 m3/day of aerobic sludge and 5000 m3/year of anaerobic sludge are disposed of randomly in the Gaza Strip, creating several environmental and health problems. Because of the political–economic situation, a low cost system for sludge treatment has to be adopted. The results of a pilot project using a reed bed system in the Gaza Strip are promising. Sludge that accumulated in a reed bed system over a 3‐year period was found to be well mineralized and composted, and suitable for land application. The water that drained from the reed bed was found to contain very low concentrations of suspended solids (SS) and chemical oxygen demand (COD). This paper presents the results of a 3‐year project using a reed bed for sewage sludge treatment in Gaza – Palestine. The quality of drained water and the quality and quantity of accumulated sludge were monitored in two drying beds, one planted with reeds and the other left as a conventional drying bed.
How will a room service delivery system affect dietary intake, food costs, food waste and patient satisfaction in a paediatric hospital? A pilot study
Authors: Kuperberg Karen , Caruso Angelina , Dello Susan , Mager Diana
Published: September 2008

The current meal delivery system at The Hospital for Sick Children is a cold‐plating tray delivery system. Our goal was to determine the effect of a room service model on satisfaction, food costs/waste and macronutrient intake in an inpatient paediatric setting. A prospective cross‐sectional study of inpatients (n = 54) was studied over 6 days, 3 days under the current system and 3 days under the pilot model. A satisfaction questionnaire was used to assess satisfaction, and tray tickets were used to assess food costs/waste and dietary intake. With room service, satisfaction increased (P < 0.05), food costs decreased at breakfast and lunch (P < 0.05), and reductions in waste occurred at all meals (P < 0.05). There was an increase in energy, protein, carbohydrate and fat intake (P < 0.05) during lunch. Piloting a room service model in an acute‐care paediatric centre resulted in increased satisfaction, improved dietary intake and reduced food costs and waste, resulting in hospital‐wide implementation.
Thermal death time of Salmonella Typhimurium in oyster meat: establishment and application in a heat‐treated ceviche recipe
Authors: Plaza Ina Isabel B. , Gabriel Alonzo A.
Published: September 2008

The absence of heating processes in the preparation of oyster ceviche makes the dish a potential cause of foodborne illnesses. Hence, this study was conducted to establish the thermal death time at 60°C (D60°C) of the pathogen Salmonella Typhimurium in oyster meat so that it may be applied in the preparation of a heat‐treated oyster ceviche recipe. The established D60°C was used to calculate a heating protocol capable of deactivating 99.999% of the pathogen. Results showed that the heat treatment significantly (P ≤ 0.05) reduced the microbial populations in the oyster meats. Penetrometer and colorimeter measurements of the softness and color characteristics revealed that the heating process significantly influenced these characteristics. However, sensory analyses showed that test panelists did not detect significant differences between the color and texture of control and treatment oyster meats. Only some specific descriptors related to oyster appearance and aroma were given significantly different sensory evaluation scores.