bluuebunny/crossref_metadata_2025 huggingface dataset:
T cell lymphoblastic leukaemia/lymphoma associated with a microenvironment of thymic asteroid B cells in the bone marrow
Authors: Naresh Kikkeri N , May Philippa C , Reid Alistair G , Marks Alexandra J , Macdonald Donald , Kanfer Ed
Published: September 2010

Naresh K N, May P C, Reid A G, Marks A J, Macdonald D & Kanfer E (2010) Histopathology 57, 549–554 T cell lymphoblastic leukaemia/lymphoma associated with a microenvironment of thymic asteroid B cells in the bone marrow

Aims:  Asteroid B cells are a component of normal thymus. It is currently unclear whether these cells are identifiable in T cell lymphoblastic leukaemia/lymphoma (T‐ALL/LBL) of the thymus. The aim of this study was to identify asteroid B cells both in thymic and extrathymic tissue involved by T‐ALL/LBL.

Methods and results:  Thymic, lymph node (LN) and bone marrow trephine biopsy (BMTB) samples from eight patients with T‐ALL/LBL were reviewed. All had been investigated by immunohistochemistry and one by fluorescent in situ hybridization (FISH). The BMTB samples of two of eight T‐ALL/LBLs and LN sample in one of them showed the presence of asteroid‐shaped B cells with dendritic cytoplasmic processes. These B cells also expressed CD23 and the features were akin to the unique thymic asteroid B cells. Both patients had aggressive/resistant disease. Cytogenetic analysis in one showed a complex translocation involving the T cell receptor beta (TCRB) gene at 7q35 and a distal region of 9q known to harbour the NOTCH1 gene.

Conclusion:  This is the first report of T‐ALL/LBL documenting the presence of an asteroid B cell‐rich microenvironment at bone marrow and LN sites. In this small subset, T‐ALL/LBL cells are possibly dependent upon asteroid B cells, and whether targeting of asteroid B cells with anti‐CD20 monoclonal antibody in such cases will result in clinical benefit remains to be determined.
Seeking harmony in the provision of care to the stroke‐impaired: views of Chinese family caregivers
Authors: Lee Regina LT , Mok Esther SB
Published: September 2010

Aims.  To explore the coping strategies of Chinese family caregivers of stroke‐impaired older relatives.

Background.  Many stroke‐impaired patients rely heavily on support from their families, and the daily lives of such family caregivers are severely impacted. However, services and support for family caregivers of stroke‐impaired relatives in the home setting have received little attention. Appropriate and relevant information and support to family caregivers are important in facilitating the care‐giving task. It is, therefore, necessary to understand the nature and demands of care‐giving before planning specific educational and support programmes.

Design.  Grounded theory.

Methods.  Fifteen Chinese family caregivers of stroke‐impaired older relatives were recruited and interviewed in 2003 and 2004. Theoretical sampling and constant comparative analysis were used to recruit the sample and perform data analysis.

Results.  Seeking harmony to provide care for the stroke‐impaired was the core category for describing and guiding the family care‐giving process, with five main stages: (1) living with ambiguity, (2) monitoring the recovery progress, (3) accepting the downfalls, (4) meeting family obligations and (5) reconciling with harmony. These issues were seldom discussed openly with health professionals.

Conclusions.  The findings indicated that Chinese family caregivers determine their own needs by seeking harmony to continue to provide care without thinking about getting help from others or their own health problems. These findings help to define some of the complex dynamics that have an impact on the development of partnership care and might challenge nurses practising in the community.

Relevance to clinical practice.  Community nurses should assess and understand the coping strategies of family caregivers and assist them to engage in stress‐reducing practices. This is an important partnership to be formed in stroke care for family caregivers in the community. The study findings will guide further development of family care‐giving aspects in nursing practice.
An evaluation of a managed clinical network for personality disorder: breaking new ground or top dressing?
Authors: Hogard Elaine , Ellis Roger
Published: September 2010

Rationale, aims and objectives  This article describes an evaluation of an innovative managed clinical network in the UK. The purpose of the network was to establish a better‐coordinated service for those with personality disorder. The network was evaluated with regard to the extent it met its stated and implied outcomes; the process whereby it was established and operated; and the views of the various stakeholders involved. Managed clinical networks are briefly reviewed.

Methods  Methods to gather evaluation data included documentary analysis, the use of specially devised tools to assess partnership, staff development needs and record keeping, and interviews.

Results  While the network had achieved its objectives to establish new operational structures and communication networks and staff showed a high level of commitment, it was unclear whether the network had maintained or improved the clinical service. Record keeping for assessment and clinical intervention was at an early stage and there was a need for more systematic use of assessment instruments and data management systems. The creation of a new category of staff – the Network coordinator – raised problems of delivery and staff development.

Conclusions  On the basis of this evaluation and at this stage of one network's development it is concluded that the benefits of a managed clinical network remain theoretical rather than proven.
Cost‐effectiveness of screening for hepatocellular carcinoma among subjects at different levels of risk
Authors: Chang Yaojen , Lairson David R. , Chan Wenyaw , Lu Sheng‐Nan , Aoki Noriaki
Published: September 2010

Objective  The American Association for the Study of Liver Diseases 2005 practice guidelines for management of hepatocellular carcinoma (HCC) recommends that various high‐risk groups of people undergo HCC surveillance. Our study aimed to investigate whether screening for HCC among subjects with early‐stage cirrhosis is more cost‐effective than screening among chronic hepatitis B virus (HBV) carriers without cirrhosis.

Method  Markov‐based decision models were constructed to simulate development and progression of cirrhosis and HCC in the following 2 cohorts: subjects with early‐stage cirrhosis and subjects who are chronic HBV carriers but do not have cirrhosis. The models also were used to estimate the incremental cost‐effectiveness ratio (ICER) for each cohort over a time horizon of 25 years.

Results  The average cost per person was less and the average effect was greater for the cohort of chronic HBV carriers without cirrhosis than for the cohort of subjects with cirrhosis. The incremental effects for use of the screening strategy and the non‐screening strategy in the 2 cohorts were 0.28 years and 0.86 years, respectively. The ICERs for the 2 cohorts were $25 578 and $15 191, respectively. The cohort of chronic HBV carriers had a greater ICER with respect to the HCC screening programme because of the smaller incremental effect. The sensitivity analyses revealed that HCC incidence and the probability of accidental diagnosis of HCC were critical parameters in the model.

Conclusion  Screening for HCC among subjects with early‐stage cirrhosis is more cost‐effective than screening among chronic HBV carriers who do not have cirrhosis.
Taking decisions on expenditure for high‐cost drugs at the regional level: a model for evaluating the overall impact of Trastuzumab in the Veneto Region of Italy
Authors: Buja Alessandra , Perissinotto Egle , Compostella Antonio , Tramarin Andrea , Rebba Vincenzo , Pastorelli Davide , Grigoletto Francesco , Gallo Costantino , Rausa Giuseppe , Gregori Dario
Published: September 2010

Introduction  Cost‐effectiveness analysis provides a ratio that indicates the value created per unit of money by a given therapy but says nothing about the total expected costs or net health and social impact of this therapy in a particular population of interest.

Objective  The main objective of this study is to define a methodology to calculate the effects of interventions from a local perspective. This will help determine parameters that provide information about resource planning and management to local decision makers.

Methods  The described methodology calculates four indicators using local demographic and epidemiological data and a Markovian decision tree approach.

Results  The method was applied to evaluate the economic, health and social impact of introducing a new cancer drug, Trastuzumab, for the early treatment of breast cancer in the Veneto Region of Italy.

Discussion  The indicators described in this study allow public policy makers to clearly understand the benefits and costs of a particular health intervention in a local population and to compare it with other strategies.
Invasion genetics of the Ciona intestinalis species complex: from regional endemism to global homogeneity
Authors: ZHAN AIBIN , MACISAAC HUGH J. , CRISTESCU MELANIA E.
Published: September 2010

Determining the degree of population connectivity and investigating factors driving genetic exchange at various geographical scales are essential to understanding population dynamics and spread potential of invasive species. Here, we explore these issues in the highly invasive vase tunicate, Ciona intestinalis, a species whose invasion history has been obscured by its poorly understood taxonomy and population genetics. Recent phylogenetic and comparative genomic studies suggest that C. intestinalis is a cryptic species complex consisting of at least three species. We reconstructed phylogenies based on both mitochondrial (cytochrome c oxidase subunit 3—NADH dehydrogenase subunit 1 region and NADH dehydrogenase subunit 4 gene) and nuclear (internal transcribed spacer 1) sequences, results of which support four major phylogroups corresponding to the previously reported spA, spB and Ciona spp. (spC) as well as an undescribed cryptic species (spD). While spC and spD remain restricted to their native ranges in the Mediterranean Sea and Black Sea, respectively, the highly invasive species (spA and spB) have disjunct global distributions. Despite extensive interspecific divergences, we identified low phylogeographical structure within these two invasive species. Haplotype network analyses revealed comparatively limited mutation steps among haplotypes within each species. Population genetic analyses based on two mtDNA fragments and eight unlinked microsatellites illustrated relatively low population differentiation and high population connectivity at both regional and continental scales in the two invasive species. Human‐mediated dispersal coupled with a high potential for natural dispersal is probably responsible for the observed genetic homogeneity.
Transcriptome analysis of nitrate assimilation in Aspergillus nidulans reveals connections to nitric oxide metabolism
Authors: Schinko Thorsten , Berger Harald , Lee Wanseon , Gallmetzer Andreas , Pirker Katharina , Pachlinger Robert , Buchner Ingrid , Reichenauer Thomas , Güldener Ulrich , Strauss Joseph
Published: September 2010

Nitrate is a dominant form of inorganic nitrogen (N) in soils and can be efficiently assimilated by bacteria, fungi and plants. We studied here the transcriptome of the short‐term nitrate response using assimilating and non‐assimilating strains of the model ascomycete Aspergillus nidulans. Among the 72 genes positively responding to nitrate, only 18 genes carry binding sites for the pathway‐specific activator NirA. Forty‐five genes were repressed by nitrate metabolism. Because nirA‐ strains are N‐starved at nitrate induction conditions, we also compared the nitrate transcriptome with N‐deprived conditions and found a partial overlap of differentially regulated genes between these conditions. Nitric oxide (NO)‐metabolizing flavohaemoglobins were found to be co‐regulated with nitrate assimilatory genes. Subsequent molecular characterization revealed that the strongly inducible FhbA is required for full activity of nitrate and nitrite reductase enzymes. The co‐regulation of NO‐detoxifying and nitrate/nitrite assimilating systems may represent a conserved mechanism, which serves to neutralize nitrosative stress imposed by an external NO source in saprophytic and pathogenic fungi. Our analysis using membrane‐permeable NO donors suggests that signalling for NirA activation only indirectly depends on the nitrate transporters NrtA (CrnA) and NrtB (CrnB).
Genetics of diapause in the comma butterfly Polygonia c‐album
Authors: SÖDERLIND LINA , NYLIN SÖREN
Published: September 2010

The processes of local adaptation and ecological speciation can be better understood by studying the genetic background of life‐history decisions. The sex chromosomes host genes for many population differences in the Lepidoptera and therefore the inheritance of diapause determination in the butterfly Polygonia c‐album may be hypothesized to be sex‐linked. In the present study, Polygonia c‐album (L.) from Spain and Sweden and hybrid offspring are raised under an LD 17 : 7 h photocycle that induces most pure Swedish individuals to develop into the diapausing dark morph and most pure Spanish individuals into the light and directly‐developing morph. If inheritance of the daylength threshold for diapause is X‐linked, as is known to be the case for host‐plant preferences, females should follow the developmental path of their male parents' populations. However, female hybrids instead have a diapause propensity intermediate to that of their parental stocks and, consequentially, diapause determination is not X‐linked. However, male hybrids eclose as the diapausing morph to a higher extent than females and, moreover, this pattern is more pronounced in the Spanish female × Swedish male cross than in the reciprocal cross. Hence, it is concluded that the genetic determination of the critical daylength for diapause is mainly autosomal but with some influence of sex‐linked genes and/or parental effects, possibly as an effect of the importance of protandry for males. Such sex effects could provide a starting point for the evolution of population differences inherited on the sex chromosomes.
Effects of temperature, photoperiod and soil humidity on induction of pseudopupal diapause in the bean blister beetle Epicauta gorhami
Authors: SHINTANI YOSHINORI , HIROSE YUZURU , TERAO MISATO
Published: September 2010

Larvae of the bean blister beetle Epicauta gorhami Marseul (Coleoptera: Meloidae) feed on grasshopper eggs in soil and undergo hypermetamorphosis. This beetle undergoes larval diapause in the fifth instar as a pseudopupa, a form characteristic of hypermetamorphosis in meloid beetles. The effects of temperature, photoperiod and soil humidity on larval development of E. gorhami are examined in a population in Miyazaki, Japan, using egg pods of Locusta migratoria L. as food. At lower temperatures (20 and 22.5 °C), all larvae become pseudopupae, regardless of the photoperiod. By contrast, at higher temperatures (27.5 and 30 °C), almost all larvae pupate at the end of the fourth instar, again regardless of the photoperiod. A long‐day photoperiodic response occurs only at an intermediate temperature (25 °C): under an LD 12 : 12 h photocycle, all larvae enter diapause, although the diapause incidence tends to decrease as the day length becomes longer. Pseudopupae are immobile and remain in diapause for ≥120 days when they are kept under the same conditions, except that diapause terminates within a relatively short time at 30 °C. Although lower soil humidity retards post‐feeding development, soil humidity has no effect on the diapause incidence. On the basis of the short developmental period and diapause avoidance under summer conditions, it is suggested that this beetle partially produces two generations a year in southwestern Japan.
Selective weed suppression by cover crop residues: effects of seed mass and timing of species’ sensitivity
Authors: KRUIDHOF H M , GALLANDT E R , HARAMOTO E R , BASTIAANS L
Published: September 2010

Kruidhof HM, Gallandt ER, Haramoto ER & Bastiaans L (2011). Selective weed suppression by cover crop residues: effects of seed mass and timing of species’ sensitivity. Weed Research51, 177–186.

Laboratory bioassays have shown that large‐seeded species better tolerate cover crop residue–mediated stress than small‐seeded species. This provides the potential for selective suppression of small‐seeded weeds in large‐seeded crops. We conducted two field experiments in which seedling emergence of a range of crop and weed species was monitored in soil without cover crop residues and soil with recently incorporated lucerne, winter oilseed rape or winter rye residues. A positive relationship was found between seed mass and tolerance to winter oilseed rape and lucerne residues in both experiments, whereas winter rye residues did not inhibit seedling emergence. Both the gradual reduction in residue‐mediated inhibitory potential with time in the first experiment, as well as the sudden increase in lucerne residue–mediated inhibitory potential following a severe rainfall event in the second experiment, illustrated the importance of temporal dynamics. Therefore, we hypothesised that time between residue incorporation and receptor plant emergence could serve as an additional variable for explaining the variation in inhibition of seedling emergence among receptor plant species. Re‐analysis of data from two previously published field experiments revealed that seed mass and time of emergence only contributed significantly to explaining variance in receptor plant emergence when both these factors were included in the analysis. Our findings suggest that considering temporal synchrony of receptor species’ sensitivity and potential residue effects in field studies provides a valuable framework for analysing crop residue‐mediated effects.
Intertriginous lymphomatoid drug eruption
Authors: Wolf Ronni , Barzilai Aviv , Davidovici Batya
Published: September 2010

A 76‐year‐old man developed a maculopapular purpuric eruption confined to the intertriginous areas (i.e. the inguinal, gluteal, and axillary folds). Two days before the eruption appeared, he had received a second course of chemotherapy consisting of cisplatinum 40 mg and gemcitabine (Gemzar) 1700 mg for the treatment of squamous cell carcinoma of the lung stage III B. The histologic picture was of either lymphomatoid drug eruption or lymphomatoid papulosis. The antineoplastic therapy was changed to once‐weekly intravenous vinorelbine (Navelbine) 50 mg, a Vinca alkaloid, and the eruption resolved completely within two weeks without any further therapy. These circumstantial evidences support the diagnosis of intertriginous drug eruption. Our case is interesting and unusual in that it demonstrated a rare clinical presentation of drug eruption, namely, intertriginous drug eruption or baboon syndrome, with a histologic picture of a lymphomatoid drug eruption that can mimic lymphoma. We are unaware of any earlier reported case of baboon syndrome with a histologic picture of lymphomatoid drug eruption. The pathomechanisms of both types of drug eruption, i.e. baboon syndrome and lymphomatoid drug eruption, are not fully understood.
Beliefs and perceptions of Arab vitiligo patients regarding their condition
Authors: AlGhamdi Khalid M.
Published: September 2010

Background  Patients’ beliefs about their illness can result in positive and/or negative implications for the management of their disease. To examine the beliefs held by vitiligo patients about their condition and to explore the potential factors that might influence such beliefs.

Methods  The illness perception questionnaire (IPQ) was translated into the particular regional language (Arabic) and administered to adult vitiligo patients visiting our Dermatology Department, from 2006 to 2008. Demographic and illness details were obtained.

Results  We recruited 164 vitiligo patients (91 male subjects). The mean age was 27 years (SD = 13, range 15–57 years). It was believed that stress, altered immunity, and heredity were the cause of vitiligo by 33%, 26%, and 24% of the respondents respectively. Eighty‐four percent and 28% believed in fate and evil eye as a cause of their illness respectively. Forty‐two percent believed that their illness had a major effect on their lives and 44% believed that vitiligo had strongly affected the way others see them. For both beliefs, this was independent of the gender. Thirty‐seven percent reported that they do not understand their illness. Six percent believed that their disease was contagious while 12% were not sure. Fifty‐four and 57% reported feeling depressed and anxious respectively, because of their disease. This was more common in female patients (P = 0.019 and 0.031 respectively).

Conclusion  Misconceptions and negative attitudes are widespread among vitiligo patients. The lack of disease‐related understanding and the existence of anxiety and depression require targeted health education and psychosocial support.
Tamoxifen vs. non‐tamoxifen treatment for advanced melanoma: a meta‐analysis
Authors: Beguerie Julieta Ruiz , Xingzhong Jin , Valdez Raúl P.
Published: September 2010

Although tamoxifen (TAM) is routinely used in advanced melanoma, it is still uncertain whether evidence exists to support this practice. This review assesses the benefits and harms of systemic therapy with TAM vs. without TAM on response and mortality in patients with advanced melanoma. MEDLINE, The Cochrane Database of Systemic Reviews, The Cochrane Central Register of Controlled Trials, EMBASE and LILACS were searched for randomized controlled trials comparing chemotherapy using and not using TAM in any dose, in patients of any age with advanced melanoma. References lists, databases of ongoing trials and conference proceedings were hand‐searched. All included trials were evaluated for quality assessment. Primary outcomes were response and mortality. Secondary outcomes were hematologic and non hematologic toxicity, treatment‐related mortality and quality of life. A meta‐analysis was performed and results were presented as relative risk with 95% confidence interval. Nine randomized controlled trials met the inclusion criteria. Patients treated with TAM were more likely to respond, with a relative risk 1.36 (95% CI: 1.04–1.77, P = 0.02). However, there was no improvement in 1‐year mortality. The incidence of hematologic toxicity was higher in the TAM group. Subgroup analyses showed that female patients were more likely to respond. Chemotherapies with TAM improve overall and partial response, but do not improve mortality in 1 year in advanced melanoma. Further use of TAM in melanoma should be done only in the context of clinical trials.
Circulating CD4+ CD25highFoxP3+ T cells vary in different clinical forms of leprosy
Authors: Attia Enas A. S. , Abdallah Marwa , Saad Abeer A. , Afifi Ashraf , El Tabbakh Alaa , El‐Shennawy Dina , Ali Hala B.
Published: September 2010

Background  CD4+ CD25highFoxP3+  regulatory T cells (T‐regs) were reported to increase in chronic infections. We aimed at studying their frequency in leprosy to investigate their role during Mycobacterium leprae infection.

Methods  Using flow cytometry, the frequency and FoxP3 expression of circulating T‐regs was assessed in 38 leprosy patients and 38 healthy controls. Patients were divided into; group I tuberculoid (TT), group II borderline cases [borderline tuberculoid (BT), borderline (BB), and borderline lepromatous (BL)], group III lepromatous (LL), and group IV erythema nodosum leprosum (ENL).

Results  Mean T‐regs% and FoxP3 expression were significantly elevated in patients (particularly TT) compared to controls (3.8 ± 2.5% vs. 2.5 ± 0.8% and 78.8 ± 56.2% vs. 55.8 ± 15.7%, respectively) (P < 0.05). Comparing the four disease groups, T‐regs% was significantly different (median 5.3% in group I, 3.4% in group II, 2.8% in group III, and 1.2% in group IV; P = 0.005). FoxP3% on T‐regs was not significantly different between them [median 71.5% in TT, 62.3% in borderline categories, 67.75% in LL, and 85.75% in ENL; P = 0.149). Notably FoxP3 expression was significantly higher in ENL than controls (P = 0.011).

Conclusion  The frequency and suppressive marker of circulating T‐regs are elevated in TT patients. Patients with LL and ENL express significantly lower frequency of T‐regs and higher FoxP3 expression (in ENL), consistent with disease progression and immune hyper‐activation in these disease categories. Thus, rather than being detrimental to immunity, intact T‐regs activity may be beneficial to leprosy patients.
Familial cases of atypical clinical features genetically diagnosed as LEOPARD syndrome (multiple lentigines syndrome)
Authors: Kato Harunosuke , Yoshida Rie , Tsukamoto Katsuhiko , Suga Hirotaka , Eto Hitomi , Higashino Takuya , Araki Jun , Ogata Tsutomu , Yoshimura Kotaro
Published: September 2010

Five familial cases exhibited ephelides‐like multiple lentigines, and we examined three of them, a mother and two sons. All three patients presented with small dark‐brown maculae on the face and neck and electrocardiographic abnormalities. These findings sufficed to fulfill the criteria for LEOPARD syndrome (multiple lentigines syndrome), although they lacked five of seven major clinical features. However, the family members presented with a webbed neck and pectus excavatum, which are more frequently seen in Turner or Noonan syndrome. Histological examination of the lentigines revealed slightly elongated rete ridges, a hyperpigmented basal layer, and melanophages in the papillary dermis. Direct sequencing of the patients’ genomic DNA revealed that all three had a consistent missense mutation [c.1403C > T (p.T468M)] in the PTPN11 gene, confirming LEOPARD syndrome with an atypical phenotype. It was suggested that LEOPARD syndrome shows a diverse phenotype but its diagnosis can be verified by mutation analysis.
Sex‐specific effects of inbreeding in wild‐caught Drosophila melanogaster under benign and stressful conditions
Authors: ENDERS L. S. , NUNNEY L.
Published: September 2010

In animal populations, sib mating is often the primary source of inbreeding depression (ID). We used recently wild‐caught Drosophila melanogaster to test whether such ID is amplified by environmental stress and, in males, by sexual selection. We also investigated whether increased ID because of stress (increased larval competition) persisted beyond the stressed stage and whether the effects of stress and sexual selection interacted. Sib mating resulted in substantial cumulative fitness losses (egg to adult reproduction) of 50% (benign) and 73% (stressed). Stress increased ID during the larval period (23% vs. 63%), but not during post‐stress reproductive stages (36% vs. 31%), indicating larval stress may have purged some adult genetic load (although ID was uncorrelated across stages). Sexual selection exacerbated inbreeding depression, with inbred male offspring suffering a higher reproductive cost than females, independent of stress (57% vs. 14% benign, 49% vs. 11% stress).
Effects of polyandry on male phenotypic diversity
Authors: BARBOSA M. , DORNELAS M. , MAGURRAN A. E.
Published: September 2010

Polyandry has the potential to affect the distribution of phenotypes and to shape the direction of sexual selection. Here, we explore this potential using Trinidadian guppies as a model system and ask whether polyandry leads to directional and/or diversifying selection of male phenotypic traits. In this study, we compare the phenotypic diversity of offspring from multiply and singly sired broods. To quantify phenotypic diversity, we first combine phenotypic traits using multivariate methods, and then take the dispersion of individuals in multivariate space as our measure of diversity. We show that, when each trait is examined separately, polyandry generates offspring with a higher proportion of bright coloration, indicating directional selection. However, our multivariate approach reveals that this directionality is accompanied by an increase in phenotypic diversity. These results suggest that polyandry (i) selects for the production of sons with the preferred brighter colour phenotypes whereas (ii) enhancing the diversity of male sexual traits. Promoting phenotypic diversity may be advantageous in coping with environmental and reproductive variability by increasing long‐term fitness.
Association betweenFOXP2gene and speech sound disorder in Chinese population
Authors: Zhao Yunjing , Ma Hongwei , Wang Yueping , Gao Hong , Xi Chunyan , Hua Tainyi , Zhao Yaru , Qiu Guangrong
Published: September 2010

Aim: FOXP2was described as the first gene relevant to human speech and language disorders. The main objective of this study was to compare the distribution ofFOXP2gene polymorphisms between patients with speech sound disorder and healthy controls.

Methods: FiveFOXP2polymorphisms, rs923875, rs2396722, rs1852469, rs17137124 and rs1456031, were analyzed in 150 patients with speech sound disorder according to DSM‐IV, as well as in 140 healthy controls. Coding exons for key domains ofFOXP2were also sequenced in all the patients.

Results: Significant differences in the genotype (P = 0.001) and allele (P = 0.0025) frequencies of rs1852469 (located 5′ upstream of the ATG initiator codon) were found between patients and controls. The excess of the T allele in the patients group remained significant after Bonferroni correction (P = 0.0126). Further investigations revealed a risk haplotype: rs2396722T/+rs1852469T. Our screening of key domains did not detect any point mutations in this sample. But we detected heterozygous triplet deletion of the glutamine‐encoding region of exon 5 that alterFOXP2protein sequence in five probands. These changes are predicted to yield a polyglutamine tract reduction from 40 to 39 consecutive glutamines.

Conclusions: Our data support a possible role ofFOXP2in the vulnerability to speech sound disorder, which adds further evidence to implicate this gene in speech and language functions.
Impact of biopsychosocial factors on psychiatric training in Japan and overseas: Are psychiatrists oriented to mind, brain, or sociocultural issues?
Authors: Kato Takahiro A. , Tateno Masaru , Umene‐Nakano Wakako , Balhara Yatan P. S. , Teo Alan R. , Fujisawa Daisuke , Sasaki Ryuji , Ishida Tetsuya , Kanba Shigenobu
Published: September 2010

Aim:  To clarify the impact of biopsychosocial factors on psychiatric training under the new and traditional postgraduate medical education system in Japan and to compare them with young psychiatrists from other countries.

Methods:  Psychiatric residents and early‐career psychiatrists were recruited in Japan and other countries. Using mail‐based and web‐based self‐administered questionnaires, we evaluated participants' demographic information, motivation to become psychiatrists, interest and commitment to various aspects of psychiatry, and reactions to a case vignette, focusing on biopsychosocial factors.

Results:  A total of 137 responses, 81 from Japan and 56 from other countries, were collected. Before starting psychiatric training, Japanese participants showed a strong interest in ‘mind’ and less interest in ‘brain’ and ‘environmental factors’, while the interest in ‘brain’ and ‘environmental factors’ is presently as high as that in ‘mind.’ Japanese participants reported less commitment to their training toward ICD/DSM‐based diagnosis, interview, pharmacotherapy, psychosocial treatment and epidemiology, compared with participants from other countries. In particular, Japanese participants showed less commitment to their training in suicide prevention, despite their perception of its high importance due to a high suicide rate in Japan. Suicide risk of a case vignette proved to be differently assessed according to participants' commitment levels to each aspect of psychiatry.

Conclusion:  Our results suggest that young psychiatrists' attitudes concerning the biopsychosocial model generally become well‐balanced with psychiatric training, however sociocultural factors do not seem to be well represented in the Japanese psychiatric training system. Additional training on sociocultural issues, such as suicide in Japan, should be considered.
Effects of osmotic‐release methylphenidate in attention‐deficit/hyperactivity disorder as measured by event‐related potentials
Authors: Sawada Masayuki , Iida Junzo , Ota Toyosaku , Negoro Hideki , Tanaka Shohei , Sadamatsu Miyuki , Kishimoto Toshifumi
Published: September 2010

Aim:  Attention‐deficit/hyperactivity disorder (ADHD) is a relatively common central nervous system disorder in school‐age children, which may involve a specific disorder in cognition and/or information processing. Event‐related potentials (ERP) are commonly used as physiological measures of cognitive function as they are easily measured and non‐invasive. Thus, in the present study, we examined the effects of osmotic‐release methylphenidate (MPH) (Concerta), a common treatment for childhood attention‐deficit/hyperactivity disorder (ADHD), in ADHD children as measured by ERP.

Methods:  Ten ADHD children participated after giving consent. Based on the guidelines for evoked potential measurement, mismatch negativity (MMN) and P300 were obtained by auditory odd‐ball tasks. We measured both MMN and P300 in the drug‐naive condition and after intake of osmotic‐release MPH.

Results:  The MMN amplitudes after intake of osmotic‐release MPH were significantly greater than those in the drug‐naive situation at Pz and C4. The P300 amplitudes after intake of osmotic‐release MPH were significantly greater than those in the drug‐naive situation at Cz and Pz.

Conclusion:  MMN and P300 are sensitive tools for measuring the pharmacological effects of osmotic‐release MPH in ADHD children.
Interface between hypothalamic‐pituitary‐adrenal axis and brain‐derived neurotrophic factor in depression
Authors: Kunugi Hiroshi , Hori Hiroaki , Adachi Naoki , Numakawa Tadahiro
Published: September 2010

Although the pathophysiology of depressive disorder remains elusive, two hypothetical frameworks seem to be promising: the involvement of hypothalamic pituitary‐adrenal (HPA) axis abnormalities and brain‐derived neurotrophic factor (BDNF) in the pathogenesis and in the mechanism of action of antidepressant treatments. In this review, we focused on research based on these two frameworks in relation to depression and related conditions and tried to formulate an integrated theory of the disorder. Hormonal challenge tests, such as the dexamethasone/corticotropin‐releasing hormone test, have revealed elevated HPA activity (hypercortisolism) in at least a portion of patients with depression, although growing evidence has suggested that abnormally low HPA axis (hypocortisolism) has also been implicated in a variety of stress‐related conditions. Several lines of evidence from postmortem studies, animal studies, blood levels, and genetic studies have suggested that BDNF is involved in the pathogenesis of depression and in the mechanism of action of biological treatments for depression. Considerable evidence has suggested that stress reduces the expression of BDNF and that antidepressant treatments increase it. Moreover, the glucocorticoid receptor interacts with the specific receptor of BDNF, TrkB, and excessive glucocorticoid interferes with BDNF signaling. Altered BDNF function is involved in the structural changes and possibly impaired neurogenesis in the brain of depressed patients. Based on these findings, an integrated schema of the pathological and recovery processes of depression is illustrated.
Impact of spatial disjunction within biophysical classes on plant species composition: implications for conservation planning
Authors: ADAMS MATTHEW P. , SMITH PETER L. , BEATTIE ANDREW J.
Published: September 2010

The use of surrogates for biodiversity is a practical tool to improve the cost effectiveness of regional conservation planning. However, there is still much uncertainty about the biological representativeness of surrogates. Using a biophysical classification system known as the Mitchell Landscapes, we compare plant species composition in contiguous versus disjunct units of nine Landscape types and hence the ability of this surrogate to capture patterns of plant species composition. We found that plant species homogeneity was higher within a contiguous Landscape than between non‐contiguous units of the same Landscape. Overall, the dissimilarity between non‐contiguous units and their contiguous counterparts was significant (P = 0.004). Biophysical classes with very high dissimilarities between non‐contiguous units of the same region may be of limited utility.
Behavioural responses of native predators to an invasive toxic prey species
Authors: NELSON DAVID W. M. , CROSSLAND MICHAEL R. , SHINE RICHARD
Published: September 2010

One important impact of invasive species may be to modify the behaviour of native taxa. For example, the invasion of highly toxic cane toads (Bufo marinus) kills many anurophagous native predators, but other predators learn to recognize and avoid the toxic invader. We exposed native fish (northern trout gudgeons, Mogurnda mogurnda) and Dahl's aquatic frogs (Litoria dahlii) to cane toad tadpoles, then monitored the predator's responses during subsequent trials. Both the frogs and fish initially attacked toad tadpoles, but rapidly learned not to do so. Fish and adult frogs retained their aversion for at least a week, whereas recently metamorphosed frogs did not. Clearly, the spread of cane toads through tropical Australia can modify feeding responses of native aquatic predators. For predators capable of rapid avoidance learning, the primary impact of cane toads may be on foraging behaviour rather than mortality.
PARTIAL REGRESSION OF DUODENAL LESIONS OF INTESTINAL FOLLICULAR LYMPHOMA AFTER ANTIBIOTIC TREATMENT
Authors: Yaguchi Tomonori , Imaeda Hiroyuki , Kizaki Masahiro , Hosoe Naoki , Suzuki Hidekazu , Ogata Haruhiko , Iwao Yasushi , Kameyama Kaori , Ikeda Yasuo , Hibi Toshifumi
Published: September 2010

A 51‐year‐old man was referred to our hospital because of duodenal lesions of lymphoma. Endoscopy showed multiple tiny smooth whitish granules in the second portion of the duodenum including the papilla of Vater. Biopsy specimens showed medium‐sized centrocyte‐like cells forming lymphoid follicles, and immunohistology showed positive staining for bcl‐2 and CD10. A small bowel series showed multiple granular lesions extending from the second portion of the duodenum to the proximal jejunum and the proximal ileum. On the basis of these findings, the tumor was diagnosed as stage I follicular lymphoma (FL). Although the patient was negative for Helicobacter pylori, he underwent antibiotic treatment. The lesions improved 3 months after antibiotic treatment, but biopsy specimens showed residual lymphoma cells. The patient therefore received combination chemotherapy with rituximab. Endoscopy 4 months later showed regression of FL, and there was no evidence of recurrence during 3 years of follow up. The partial regression of duodenal lesions of intestinal FL may be due to the effect of antibiotic treatment.
EOSINOPHILIC GASTROENTERITIS ASSOCIATED WITH GIANT FOLDS
Authors: Ishido Kenji , Tanabe Satoshi , Higuchi Katsuhiko , Sasaki Tohru , Katada Chikatoshi , Azuma Mizutomo , Koizumi Wasaburo , Saigenji Katsunori , Niiyama Shiro , Mikami Tetsuo
Published: September 2010

We describe a 54‐year‐old man who presented with right subcostal pain. Minocycline had been prescribed to treat pruritus, and the symptoms resolved. Subsequently, the patient consulted a local physician because of right subcostal pain. Giant folds were found in the greater curvature of the gastric body, and he was referred to the Department of Gastroenterology, Kitasato University East Hospital. Upper gastrointestinal endoscopy revealed markedly enlarged folds in the greater curvature of the stomach, with redness and edematous mucosa in the lesser curvature. Biopsy showed marked inflammatory cell infiltration (mainly eosinophils), but no atypical cells. Blood tests showed marked eosinophilia and elevated immunoglobulin E levels in the serum. The results of various allergic examinations were negative, but the clinical course suggested drug‐induced eosinophilic gastroenteritis, and treatment was started. Minocycline was withdrawn without adequate resolution of symptoms. Because the leukocyte and eosinophil counts continued to increase, the patient was given suplatast, an anti‐allergic agent. The symptoms and hematological values improved promptly. The patient recovered uneventfully, with no recurrence.
CURRENT STATUS IN THE OCCURRENCE OF POSTOPERATIVE BLEEDING, PERFORATION AND RESIDUAL/LOCAL RECURRENCE DURING COLONOSCOPIC TREATMENT IN JAPAN
Authors: Oka Shiro , Tanaka Shinji , Kanao Hiroyuki , Ishikawa Hideki , Watanabe Toshiaki , Igarashi Masahiro , Saito Yutaka , Ikematsu Hiroaki , Kobayashi Kiyonori , Inoue Yuji , Yahagi Naohisa , Tsuda Sumio , Simizu Seiji , Iishi Hiroyasu , Yamano Hiroo , Kudo Shin‐Ei , Tsuruta Osamu , Tamura Satoshi , Saito Yusuke , Cho Eisai , Fujii Takahiro , Sano Yasushi , Nakamura Hisashi , Sugihara Kenichi , Muto Tetsuichiro
Published: September 2010

Bleeding, perforation, and residual/local recurrence are the main complications associated with colonoscopic treatment of colorectal tumor. However, current status regarding the average incidence of these complications in Japan is not available. We conducted a questionnaire survey, prepared by the Colorectal Endoscopic Resection Standardization Implementation Working Group, Japanese Society for Cancer of the Colon and Rectum (JSCCR), to clarify the incidence of postoperative bleeding, perforation, and residual/local recurrence associated with colonoscopic treatment. The total incidence of postoperative bleeding was 1.2% and the incidence was 0.26% with hot biopsy, 1.3% with polypectomy, 1.4% with endoscopic mucosal resection (EMR), and 1.7% with endoscopic submucosal dissection (ESD). The total incidence of perforation was 0.74% (0.01% with the hot biopsy, 0.17% with polypectomy, 0.91% with EMR, and 3.3% with ESD). The total incidence of residual/local recurrence was 0.73% (0.007% with hot biopsy, 0.34% with polypectomy, 1.4% with EMR, and 2.3% with ESD). Colonoscopic examination was used as a surveillance method for detecting residual/local recurrence in all hospitals. The surveillance period differed among the hospitals; however, most of the hospitals reported a surveillance period of 3–6 months with mainly transabdominal ultrasonography and computed tomography in combination with the colonoscopic examination.
ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL NEOPLASIA
Authors: Honma Kiyoaki , Kobayashi Makoto , Watanabe Hidetaka , Suga Toshihiro , Tominaga Keiichi , Yamagata Michiko , Hiraishi Hideyuki
Published: September 2010

Aim:  Endoscopic submucosal dissection (ESD) has been positively applied to and gradually standardized for early gastric cancer; however, it is not widely used in the colorectum because of its technical difficulty.

Methods:  To increase the safety and ease of carrying out colon ESD, we developed a new scissors‐type device that we call the stag beetle knife (SBK). Here we report on our efforts to assess the efficacy and safety of colon ESD using the SBK.

Results:  ESD was carried out using SBK in 25 patients with colorectal neoplasia. All lesions were treated safety and easily, without any unexpected incisions. No delayed hemorrhage and perforation occurred. An en‐bloc resection and a negative resection margin were obtained in all cases.

Conclusion:  ESD using the SBK can be carried out with greater ease and safety for colorectal neoplasia.
DIAGNOSTIC YIELD OF DOUBLE‐BALLOON ENTEROSCOPY WITH INTESTINAL JUICE ANALYSIS FOR INTESTINAL STRONGYLOIDIASIS
Authors: Nakamura Naohiro , Matsushita Mitsunobu , Tahashi Yoshiya , Shimatani Masaaki , Aoi Kazunori , Yanagawa Masato , Okazaki Kazuichi
Published: September 2010

Strongyloidiasis is relatively common in tropical and subtropical areas. Most patients with Strongyloides stercoralis hyperinfection are immunocompromised, most commonly from corticosteroids or human T‐cell lymphoma virus type 1 (HTLV‐1) infection. We encountered a patient with HTLV‐1 infection accompanied by paralytic ileus, in whom strongyloidiasis in the duodenum and jejunum was disclosed by esophagogastroduodenoscopy (EGD) and double‐balloon enteroscopy (DBE). Until the age of 7 years, he lived on Amami‐Oshima Island, Japan, where both S. stercoralis and HTLV‐1 are endemic. EGD and peroral DBE disclosed white villi, edematous mucosa, and the disappearance of folds in the duodenum and jejunum. Biopsy specimens from the white villi in the duodenum and jejunum revealed S. stercoralis larvae. In both duodenal and jejunal juice, the rhabditiform larvae moved around. Because the larvae invade the lymph vessels, resulting in lymphangiectasia in edematous enteritis, the appearance of white villi may reflect villous atrophy/destruction and mucosal edema. Although our patient revealed no eosinophilia and negative stool specimens for parasites or ova, EGD and DBE with multiple biopsies and intestinal juice analysis are valuable diagnostic tools for strongyloidiasis.
RECTAL GRANULAR‐CELL TUMOR DIFFICULT TO DISTINGUISH FROM CARCINOID TUMOR
Authors: Nakanome Teppei , Yokoyama Kaoru , Takeuchi Hitomi , Haruki Satomi , Sada Miwa , Kobayashi Kiyonori , Saigenji Katsunori , Katsumata Tomoe , Hara Atsuko , Okayasu Isao
Published: September 2010

A 60‐year‐old man had a positive fecal occult‐blood test on a medical check‐up. Colonoscopy revealed a yellowish‐white submucosal tumor 8 mm in diameter in the rectum. Endoscopic ultrasonography showed a well‐demarcated mass with a homogeneous, low‐level, internal echo in the second to third layers of the rectal wall. A carcinoid tumor was suspected, and the mass was resected endoscopically. Histopathological examination revealed a granular‐cell tumor. Gastrointestinal granular‐cell tumors rarely arise in the rectum, and the preoperative diagnosis of small lesions is often difficult. In our patient, granular‐cell tumor was difficult to differentially diagnose because the endoscopic and endoscopic ultrasonographic findings closely resembled those of carcinoid tumor. Interestingly, the endoscopic characteristics of the rectal granular‐cell tumor in our patient resembled those of a carcinoid tumor.
SUCCESSFUL ENDOSCOPIC HEMOSTASIS FOR RUPTURED DUODENAL VARICES AFTER BALLOON‐OCCLUDED RETROGRADE TRANSVENOUS OBLITERATION
Authors: Soga Koichi , Tomikashi Koichi , Fukumoto Kohei , Miyawaki Ki‐ichirou , Okuda Kotaro , Konishi Hideyuki , Yagi Nobuaki , Wakabayashi Naoki , Kokura Satoshi , Naito Yuji , Yoshikawa Toshikazu
Published: September 2010

A 75‐year‐old man with general malaise and appetite loss was transferred to our hospital for assessment and treatment of liver failure. Laboratory findings on admission showed anemia, and gastroduodenoscopy (GDS) revealed linear esophageal varices and tensive duodenal varices (DV) in the second portion of the duodenum. Systemic examinations did not reveal any significant lesion capable of explaining his anemia, except for DV. Balloon‐occluded retrograde transvenous obliteration was carried out to prevent DV bleeding. Good pooling of sclerosant was observed using two balloon catheters. However, contrast‐enhanced computed tomography after the procedure revealed no thrombosis in DV, and the patient complained of tarry stools before additional therapy. Emergent GDS revealed ruptured DV with fresh blood and erosions on the surface. Emergent endoscopic obliteration using the tissue adhesive N‐butyl‐2‐cyanoacrylate was carried out and complete hemostasis was achieved. Although no rebleeding episodes were observed after emergent obliteration, the patient died of sepsis following spontaneous bacterial peritonitis 53 days after admission. Autopsy revealed that DV dropped out, and the deep vein was replaced by granulation tissue. No signs of thrombi were detected, except varices. This autopsy case revealed the difficulty in DV management.