bluuebunny/crossref_metadata_2025 huggingface dataset:
Libman-Sacks Endocarditis with Unusual Features
Authors: Tahir Mohammad Z , Rustom Majd , Al-Ebrahim Khalid
Published: May 2013

Systemic lupus erythematosus is an autoimmune inflammatory disorder that affects many organs including the cardiovascular system. It involves pericardium, myocardium, endocardium, cardiac valves, and coronary vessels. Several autopsy series have shown an incidence of cardiac lesions of 48% to 74% but documentation of such lesions during life is rare. With increasing use of two-dimensional echocardiography and the Doppler technique, cardiac lesions are increasingly being detected in the living population with systemic lupus erythematosus. A higher association has been seen between antibodies against phospholipids and cardiac valvular abnormalities but there are few prospective data on their role in the development of cardiovascular abnormalities.
Left Atrial Myxoma: Experience with Different Approaches Including Superior Transseptal Approach
Authors: Magotra Ratna , Mukadam Majid , Agrawal Nandkishore , Khandeparkan Jagdish , Tendolkar Anil
Published: May 2013

Forty-nine patients underwent surgical excision of left atrial myxomas during a period of 14 years (1982 to 1995). There were 25 male and 24 female patients. In all cases, the diagnosis was based on clinical examination and echocardiography; cardiac catheterization was performed in 9 patients. We considered the diagnosis of myxoma as an indication for early surgery. The myxoma was excised using various approaches: right atrial transseptal incision (38), biatrial incision (9) and superior transseptal approach (2). The latter approach has not been utilized for excision of myxoma before. One patient died in the early postoperative period. New cardiac arrhythmias were observed in 4 patients while the others had an uneventful recovery. Forty-two patients returned for follow-up over a period ranging from 0.4 to 13.6 years. They were evaluated clinically and echocardiographically. All have recovered well and we conclude that left atrial myxoma can be treated with low mortality and morbidity.
Chemodectomas of the Neck
Authors: Matta Rekha , Neelakandhan Kurur Sankaran
Published: May 2013

We report the clinical features and surgical management of 7 cases of cervical chemodectoma. Six patients with unilateral sporadic carotid body tumors and 1 with a unilateral tumor of the glomus jugulare were operated on between 1990 and 1994, without cerebrovascular accidents, mortality, or recurrence. Preoperative tumor embolization was employed in 2 cases. Angiography confirmed the diagnosis in all patients.
Transcervical Vagotomy for Hypertrophic Pulmonary Osteoarthropathy
Authors: Sing Wong Poo , Goldstraw Peter
Published: May 2013

Six patients (5 male and 1 female) aged 55 to 65 years, with right-sided bronchial tumors, presented with severe pain due to hypertrophic pulmonary osteoarthropathy. The diagnosis was confirmed at mediastinoscopy, which also demonstrated extensive mediastinal node involvement. As lung resection in these circumstances is not advisable, we took the opportunity of performing vagotomy through the mediastinoscope. There was immediate relief of pain following transcervical vagotomy in all patients. Two patients were pain free until time of death, 5 and 9 months respectively. One patient underwent radiotherapy to the primary lung tumor after mediastinoscopy and vagotomy, and was pain free until her death 14 months later. However, in 3 patients this benefit was short-lived and the pain recurred within 4 weeks. Following radiotherapy to the bronchial tumor, the pain was relieved. Mean follow-up time was 18 months (range, 5 to 36 months). These findings cast an interesting light on the function of the vagus nerve and the nature of hypertrophic pulmonary osteoarthropathy, and the technique affords a means of relieving the persistent and distressing pain, albeit temporary.
Management of Tricuspid Valve Disease in Patients Undergoing Double Valve Replacement
Authors: Song Cao , Kun Qiu Zhao , Li Gu Wei
Published: May 2013

The management of mild tricuspid valve disease associated with left-sided valve lesions remains controversial. Between January 1985 and September 1995, 87 patients underwent combined double (aortic and mitral) valve replacement and tricuspid valve repair at the Shanghai Chest Hospital. The early mortality was 16.1%. Predictors of early mortality were found to be New York Heart Association functional class IV and right ventricular systolic pressure of 65 mm Hg or more, by multivariable regression analysis. The mean follow-up was 4.6 years. Cumulative 3-year and 5-year survival rates in patients discharged from hospital were 80% ± 4% and 63% ± 7%. Late mortality was due to sudden death (18.7%), myocardial infarction (6.5%), and cerebral embolism or hemorrhage (31.2%). Of 48 patients still alive, 45 are in New York Heart Association functional class I or II. None of them has mild or moderate tricuspid regurgitation. Based on these results, we recommend early surgical treatment prior to the appearance of severe hemodynamic deterioration and we propose a policy of liberal indication for tricuspid annuloplasty for mild functional tricuspid insufficiency at the initial double valve replacement.
Thrombolytic Therapy for Acute Ischemic Stroke: What Cardiac Physicians Need to Know
Authors: White Roger L
Published: May 2013

The current status of thrombolytic therapy for acute ischemic stroke is reviewed in relation to early work and to the use of thrombolytic agents in acute myocardial infarction. The case of a patient treated with recombinant tissue plasminogen activator for acute ischemic stroke is described to illustrate the improvement in outcome that can be achieved with this therapy in selected patients. A number of recommendations are included for cardiologists on the use of plasminogen activator in acute ischemic stroke regarding the timing, dosage, selection, and monitoring of patients.
Ten Years Experience with Pericardiectomy
Authors: Mavitaş Binali , Yamak Birol , Katircioğlu Fehmi , Uluş Tulğa , Saritaş Ahmet , Taşdemir Oğuz , Bayazit Kemal
Published: May 2013

A retrospective analysis was made of the records of 62 patients who underwent pericardiectomy over a ten year period (1985 to 1996) in our department. Primarily, 43 patients (69.4%) had tuberculosis, 16 patients (25.8%) were diagnosed as idiopathic or viral infection, 2 patients (3.2%) had a previous cardiac operation and 1 patient (1.6%) had a neoplasm. Eight patients were in New York Heart Association functional class I, 22 in class II, 24 in class III, and 8 in class IV. Pericardiectomy was performed through midline sternotomy in all cases; 2 required cardiopulmonary bypass. Subtotal pericardiectomy was performed, in which the phrenic nerves define the posterior extent of pericardial resection. Low cardiac output was present in 8 patients. The early mortality rate was 6.45% (4 patients). During the follow-up period, ranging from 1 to 7 years (mean 3.8 ± 1.42 years), there were 2 late deaths due to the right heart failure. One patient who underwent pericardiectomy after an open-heart operation showed recurrent pericardial constriction. We conclude that pericardiectomy using midline sternotomy with or without cardiopulmonary bypass can be performed with low mortality and can result in good long-term survival and improved functional capacity.
Pulmonary Hypertensive Crisis following Pediatric Cardiac Surgery
Authors: Das Tanmoy , Basu Rahul , Dixit Mahadev Damodar , Shetty Devi Prasad , Muralidhar Kanchi
Published: May 2013

In this clinical study, 146 high risk neonates and infants of less than 5 years of age were monitored to identify and characterize pulmonary hypertensive crises following surgery for congenital heart defects. Monitoring included pulse oximetry and catheter measurements of pulmonary arterial and left atrial pressure. Fifty-one patients had one or more hypertensive crises, from which 11 ultimately died and 40 survived with aggressive vasodilator therapy. Each crisis was associated with a stress event. Crises were difficult to attenuate if not treated rapidly and multiple crises would often follow an initial event. Phenoxybenzamine, oxygen, and nitrates were the most frequently used vasodilators. Postoperative management must be individualized on the basis of the monitored response of the pulmonary circulation.
Comparison of Normothermic Cardiopulmonary Bypass with Conventional Hypothermic Bypass
Authors: Chauhan Sandeep , Ramesh Gaurishankar , Saxena Nita , Choudhary Shiv Kumar , Kumar Lokendra , Kumar Arkalgud Sampath
Published: May 2013

In a prospective randomized study from October to December 1996 at the All India Institute of Medical Sciences, we compared normothermic cardiopulmonary bypass with conventional hypothermic bypass. Sixty patients undergoing open-heart surgery for valvular heart disorders were assigned to undergo either normothermic bypass (35°C to 37°C, n = 30) or moderate hypothermic bypass (28°C, n = 30). Bypass time, pump flow, urine output, need for vasopressors, arterial blood gases on bypass, duration of cardioplegia, need for defibrillation, postoperative blood loss, rewarming time to a peripheral (toe) temperature above 35°C, awakening time, and neurologic outcome were studied. Mean bypass time in the normothermic patients (67.33 ± 23.5 minutes) was 23% less (p < 0.05) than in the hypothermic group (89.6 ± 49.26 minutes). Higher flows were required initially in the normothermic group due to low systemic vascular resistance. Early return of sinus node electrical activity in patients (70%) in the normothermic group required more frequent use of topical ice slush and cardioplegia administration. Postoperative blood loss was similar in both groups but fluid and blood requirements in the normothermic group (514 ± 220 mL·m−2) was significantly less (p < 0.05) than in the hypothermic group (722.3 ± 383 mLm−2). Normothermic patients rewarmed earlier (4.25 ± 1.79 hours) to peripheral (toe) temperatures above 35 °C and awoke earlier compared with the hypothermic group, which took a mean time of 6.1 ± 2.3 hours to rewarm. We concluded that normothermic bypass is more physiologic and significantly reduces bypass time while avoiding the deleterious effects of hypothermia.
Mitral Valvuloplasty with Carpentier's Techniques
Authors: Van Phan Nguyen , Phuong Phan Kim , Vinh Pham Nguyen , Yen Dang Thi Bach , Trung Dao Huu , Hiep Chu Trong , Quy Nguyen Thi , Hào Nguyen Tiên , Deloche Alain , Carpentier Alain
Published: May 2013

From January 1992 to January 1997, 586 patients with mitral incompetence were treated by Carpentier's techniques in the Heart Institute of Ho Chi Minh City, Vietnam. Ages ranged from 6 to 60 years (mean, 26.4 ± 9.9 years) and 124 patients were younger than 15 years of age. Mitral valve incompetence was classified into three types according to leaflet pliability: type I, normal leaflet motion, 7 cases (1.2%); type II, leaflet prolapse, 185 cases (31.6%); type III, restricted leaflet motion, 394 cases (67.2%). Associated tricuspid valvular disease was present in 337 cases (57.5%). Mitral valve prosthetic ring annuloplasty was used in 532 cases (90.8%). The operative mortality rate was 1.9% (11/586). According to the New York Heart Association functional classification, 3.9% (23/586) of the patients were in class I, 52% (305/586) were in class II, 42.3% (248/586) were in class III, and 1.7% (10/586) were in class IV. Mitral valve disease was due to rheumatic fever in 96.7% of the patients. Follow-up data were available in 572 patients from 1 year to 5 years (mean, 38 months). The late mortality rate was 0.7% (4/572). Morbidity comprised endocarditis in 2 patients, one patient had a cerebral hemorrhage, and 16 patients underwent reoperation for recurrent mitral incompetence (incorrect operative indication). There were 2 incidents of thromboembolism. Patient selection was based on valvular disease rather than age, physical condition, or cause of valvular disease. The low mortality and complication rates in this series confirm that mitral valve reconstruction by Carpentier's techniques was appropriate for the patients with mitral incompetence, particularly for children.
Mitral Valve Replacement and Preservation of Subvalvular Apparatus Using Cox's Maze Operation
Authors: Hioki Masafumi , Iedokoro Yoshio , Yamagishi Shigeki , Yamashita Yasuo , Orii Kouan , Hirano Shigeyuki , Hirata Tomomi , Kutukata Noriyoshi , Masuda Sakae , Hisayoshi Takao , Tanaka Shigeo
Published: May 2013

A 58-year-old female with mitral stenosis and atrial fibrillation underwent mitral valve replacement. The subvalvular apparatus was successfully preserved by the Cox's maze operation. The postoperative course was uneventful. One year postoperatively, she is doing well and remains in sinus rhythm. The combined operative techniques are discussed.
One-Stage Repair of Aortic Coarctation, Aneurysm, and Calcified Stenosis
Authors: Yokoyama Taro , Capouya Eli R , Gheissari Ali , Platin Ilana
Published: May 2013

A 74-year-old female presented with severe proximal hypertension. She was found to have coarctation of the aorta, calcified aortic stenosis, and an ascending aortic aneurysm. Surgery was performed through a median sternotomy to insert a 25-mm aortic valve composite graft and a 20-mm woven Dacron graft. A Bentall procedure was carried out on the 25-mm aortic valve graft. The proximal portion of the 20-mm graft was anastomosed to the lateral portion of the replaced ascending aorta and the distal portion was anastomosed to an aortotomy in the descending thoracic aorta through the pericardial space. After 2 years of follow-up, the patient is well.
Thyroid Hormone and Myocardial Metabolism after Heart Surgery in Dogs
Authors: Murai Noriyuki , Katayama Yasushi , Yamada Takashi , Imazeki Takao , Irie Yoshihito , Kiyama Hiroshi , Sato Yasuhiro , Hata Ikkoku , Yoshida Hirotugu , Mukouyama Mikaya
Published: May 2013

Recent studies have demonstrated that thyroid hormone improves hemodynamics following open-heart surgery, through unknown mechanisms. The effect of triiodothyronine on myocardial metabolism was studied in dogs undergoing normothermic crystalloid cardioplegic arrest. Seven animals in group 0 served as controls, 8 in group 1 received 0.1μg·kg−1·min−1 triiodothyronine intravenously after aortic cross-clamping, and 3 dogs in group 2 received triiodothyronine 150 μg per day orally for 7 days preoperatively and intravenously (0.1 μg·kg−1·min−1) after aortic cross-clamping. Myocardial carbon dioxide production and the uptake of oxygen, lactate, glucose, and free fatty acids were determined before aortic cross-clamping and at 10, 30, 60, and 120 minutes after declamping. After aortic cross-clamping, increased myocardial uptake of oxygen, lactate, and glucose were observed in group 1 compared with group 0. Myocardial free fatty acid uptake decreased in all groups. Carbon dioxide production correlated with myocardial oxygen uptake. These findings suggest that intraoperative triiodothyronine supplementation improves myocardial metabolism but preoperative administration is ineffective.
Transmyocardial Laser Revascularization as Sole Therapy in Coronary Disease
Authors: Li Zhi , Ren Li Jie , Wang Bing , Xu Wen Ting , Li Guang Ying
Published: May 2013

This prospective study evaluated the medium-term efficacy of transmyocardial laser revascularization as the sole therapy in patients with ischemic heart disease. A carbon dioxide laser was used to create channels through ischemic areas of the myocardium in 33 patients with a mean age of 58.8 ± 10.4 years. The mean left ventricular ejection fraction determined by echocardiography was 44.8% ± 14%. Preoperatively, the patients underwent coronary artery angiography, single photon emission computed tomography perfusion scans, and positron emission tomography metabolism scans to determine the extent and severity of ischemia and myocardial viability. Total follow-up of 327 patient-months was obtained for 26 patients with a mean follow-up of 12.6 ± 9 months. The scans were repeated at 3, 6, 12, and 24 months postoperatively. The perioperative mortality was 9% due to ventricular fibrillation. Morbidity was minimal. The number of perfusion defects decreased significantly after treatment and there was a significant increase in myocardial viability in the treated left ventricular free wall. The success rate, defined as a decrease of 2 angina classes, was approximately 80% during the follow-up, reflected in a significant decrease in the number of admissions for angina in the year after the procedure (mean, 0.5 ± 0.4) compared with the previous year (mean, 2 ± 1.1) and in decreased use of antianginal medications.
Reoperation for Essential Hyperhidrosis
Authors: Yoon Yong Han , Lee Doo Yun , Kim Hae Kyoon , Cho Hyun Min
Published: May 2013

Palmar hyperhidrosis has a recurrence rate of 0% to 5% after thoracic sympathectomy. From January 1992 to October 1997, thoracic sympathectomy was performed by video-assisted thoracoscopic surgery for hyperhidrosis in 490 patients of whom 5 (2 male and 3 female with a mean age of 20 years) experienced recurrent hyperhidrosis in the early (< 7 days) or late (up to 6 months) postoperative period. All patients had moderate to severe pleural adhesions in the previous sympathectomy sites but no operative complications or crossover to thoracotomy occurred. Surgery resulted in satisfactory outcomes showing that video-assisted thoracoscopic sympathectomy was effective in treating recurrent hyperhidrosis. Prevention of recurrence requires the identification and resection of the second thoracic sympathetic ganglion as well as the Kuntz fibers.
Profile of Chest Trauma in a Referral Hospital: A Five-Year Experience
Authors: Iyer Raju S , Manoj Padmanabhan , Jain Rajnish , Venkatesh Prasad , Dilip Dronamraju
Published: May 2013

From April 1993 to March 1998, 90 patients with chest injuries were retrospectively assessed for the incidence, presentation, and outcome of thoracic trauma. The majority (55.6%) were less than 40 years of age and 83 (92%) were male. The mode and extent of injury, specific intrathoracic organ injuries, associated injuries, flail chest, ventilatory requirements, management, morbidity, and mortality were analyzed. Blunt injuries were seen in 56 (62.2%) and penetrating injuries in 34 (37.7%). Multiple rib fractures with hemopneumothorax was the most frequent presentation with orthopedic and head injuries being most commonly associated. Patients with tachypnea, cyanosis, lung contusion, partial pressure of aterial oxygen less than 60 mm Hg, and those with more than 6 rib fractures most often required ventilation but the majority (54.4%) were treated with a chest drain only. Emergency or delayed thoracotomy was required in 24.4%. The mortality rate was 6.7%, mainly due to respiratory insufficiency. Subcutaneous emphysema requiring releasing incisions accounted for most of the morbidity. Mean hospital stay was 9.5 days. Chest injuries were of major concern in multisystem trauma patients and early planned management is recommended in a mostly vulnerable section of our population in an age of violence and vehicular accidents.
Intussusception of Left Atrial Appendage through the Mitral Valve
Authors: Dhaded Sanjay B , Pathare Hemant P , Ghotkar Sanjay , Khandeparkar Jagdish , Magotra Ratna A , Deshpande Jaya , Sivaraman Ammu , Vaideeswar Pradeep
Published: May 2013

A 4-month-old male infant underwent elective repair of a large subaortic ventricular septal defect. Although it was an uneventful surgical procedure, he required inotropic support during weaning from cardiopulmonary bypass. He presented with sudden-onset low cardiac output syndrome in the immediate postoperative period and could not be revived. Autopsy revealed intussusception of the left atrial appendage projecting through the mitral valve orifice.
Is Surgery Justifiable for Treatment of Small Abdominal Aortic Aneurysms?
Authors: Bayazit Murat , Göl M Kamil , Işcan H Zafer , Ulus Tulga , Taşdemir Oğuz , Bayazit Kemal
Published: May 2013

Patients who underwent elective surgery for abdominal aortic aneurysms between January 1990 and December 1996 were evaluated retrospectively. Forty-six patients (group 1) with aneurysms of less than 5 cm in diameter were compared with 121 patients (group 2) with larger aneurysms. There were no differences in age, sex, or associated pathology between the two groups. Hypertension, coronary artery disease, and chronic obstructive lung disease were the most frequently associated conditions. Hospital mortality was not significantly different; 4.3% for group 1 and 2.5% for group 2. At 7 years, the cumulative long-term survival rates for group 1 and group 2 were 97% and 90% respectively (p > 0.05). For any infrarenal aortic aneurysm, indication for surgery should be based on the rate of aneurysm expansion, development of increased aneurysm-related symptoms or complications, and patient anxiety.
Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy
Authors: Eid Hossam Eldin
Published: May 2013

Intraaortic balloon counterpulsation has become a prerequisite for surgical repair of a left ventricular aneurysm. From October 1991 to October 1996, 60 consecutive patients underwent left ventricular endoaneurysmorrhaphy. Most had associated procedures, mainly coronary artery bypass grafting. Twenty-two patients (36.7%) were in New York Heart Association functional class III or IV preoperatively. These included 16 (26.7%) who had low cardiac output requiring an intraaortic balloon pump in the perioperative period. Pharmacological inotropic support alone was inadequate in 13 of these patients, one required a balloon pump for 5 days preoperatively due to severe low cardiac output, and 2 needed mechanical support postoperatively for ventricular arrhythmia and low cardiac output. The other 44 patients (73.3%) recovered without mechanical support. This study highlights the important role of intraaortic balloon counterpulsation in the surgical treatment of postinfarction left ventricular aneurysm.
A Great Family of Sovereign Men: Democratic Discourse in Nineteenth-Century Spain
Authors: Peyrou Florencia
Published: May 2013

The article analyses how nineteenth-century Spanish Democrats understood democracy, what were the issues at stake, how they were debated, and how political and social discourses evolved. It focuses on Democrats’ conceptions of citizenship, freedom, equality, sovereignty, political activity and the nation, as well as on their ideas on the most convenient form of government and organization of the State. It traces the process through which their original idea of democracy as an active and immediate exercise of power evolved into another centred on the control and limitation of power and the promotion of individual autonomy. It finally points out their holistic vision of society and their difficulty accepting a plurality of interests and parties, which had considerable influence on their political practice and their attempts at self-organization.
Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong
Authors: Cheng Vincent CC , Tai Josepha WM , Wong Zoie SY , Chen Jonathan HK , Pan Kris BQ , Hai Yizhen , Ng Wing-Chun , Chow Denise MK , Yau Miranda CY , Chan Jasper FW , Wong Sally CY , Tse Herman , Chan Sophia SC , Tsui Kwok-Leung , Chan Felix HW , Ho Pak-Leung , Yuen Kwok-Yung
Published: May 2013

Background

The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.

Methods

Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.

Results

In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as ‘MRSA-positive’. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p < 0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation −0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.

Conclusions

Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.
Physical activity in older people: a systematic review
Authors: Sun Fei , Norman Ian J , While Alison E
Published: May 2013

Background

Physical activity (PA) in older people is critically important in the prevention of disease, maintenance of independence and improvement of quality of life. Little is known about the physical activity of the older adults or their compliance with current physical activity guidelines.

Methods

A systematic literature search of the published literature was conducted. Included were published reports of original research that independently reported: the PA level of non-institutional older adults (aged 60 years and over); and the proportion of older adults in the different samples who met PA recommendations or guidelines. The review was restricted to studies published since 2000 to provide a current picture of older adults’ PA levels.

Results

Fifty three papers were included in the review. The percentage of older adults meeting recommended physical activity ranged from 2.4 – 83.0% across the studies. Definitions of “recommended” physical activity in older adults varied across the studies as did approaches to measurement which posed methodological challenges to data analysis. Older age groups were less likely than the reference group to be regularly active, and women were less likely than men to achieve regular physical activity, especially leisure time physical activity, when measured by both subjective and objective criteria.

Conclusion

The review highlights the need for studies which recruit representative random samples of community based older people and employ validated measurement methods consistently to enable comparison of PA levels over time and between countries.
Data coverage of a cancer registry in southern Iran before and after implementation of a population-based reporting system: a 10-year trend study
Authors: Lankarani Kamran Bagheri , Khosravizadegan Zahra , Rezaianzadeh Abbas , Honarvar Behnam , Moghadami Mohsen , Faramarzi Hossein , Mahmoodi Mojtaba , Farahmand Mahin , Masoompour Seyed Masoom , Nazemzadegan Bahman
Published: May 2013

Background

Cancer registries help to decrease the burden of cancers by collecting accurate and complete data. We aimed to measure the completeness of coverage of information recorded between 2000 and 2009 in a cancer registry program in Fars province, southern Iran.

Methods

The cancer registry program run by Shiraz University of Medical Sciences was investigated in two periods: pathology-based data from 2000 to 2007 and population-based data from 2007 to 2009. Completeness of yearly coverage was measured as the number of reported cases of cancer in each year divided by estimated cases based on 107.3 new cases per 100 000 individuals. The percentage of complete data registration (patient’s name, age, gender, address, phone number and father’s name) and correct cancer encoding was calculated for each year and compared to the maximum acceptable error rate for each item.

Results

A total of 29 277 non-duplicate cancer records were studied. Completeness of coverage varied from 22.68% in 2000 to 118.7% in 2008. Deficiencies in patients’ demographic data were highest for name in 2002 (0.09%), age in 2006 (2.36%), gender in 2001 (0.06%) and father’s name in 2001 (52.5%). Incomplete address (99.7%) and missing phone number (100%) were most frequent in 2000, and deficiencies in encoding information were highest in 2008 (6.36%).

Conclusions

The cancer registry program in Fars province (southern Iran) was considered satisfactory in terms of completeness of coverage and information about age. However, it was deficient in recording patients’ phone number and address, and father’s name. The error level for cancer encoding was unacceptably high. Enhancing hardware and software resources, education and motivation in all public and private sectors involved in the cancer registry program, and greater attention to epidemiological research are needed to increase the quality of the cancer registry program, including its completeness.
Eosinophils affect functions of in vitro-activated human CD3-CD4+ T cells
Authors: Harfi Issam , Schandené Liliane , Dremier Sarah , Roufosse Florence
Published: May 2013

Background

The recent development of eosinophil-targeting agents has raised enthusiasm for management of patients with hypereosinophilic syndromes. Roughly half of anti-IL-5-treated patients with corticosteroid-responsive lymphocytic (L-HES) and idiopathic disease variants can be tapered off corticosteroids. Potential consequences of corticosteroid-withdrawal on clonal expansion of pre-malignant CD3-CD4+T-cells associated with L-HES are a subject of concern. Indeed, corticosteroid treatment inhibits T-cell activation and may lower blood CD3-CD4+cell counts. On the other hand, previous studies have shown that eosinophils support CD4 T-cell activation, suggesting that targeted eosinophil depletion may negatively regulate these cells.

Objectives

Effects of eosinophils on CD4 T-cell activation in vitro were investigated as an indirect means of exploring whether treatment-induced eosinophil depletion may affect pathogenic T-cells driving L-HES.

Methods

Helper (CD4) T-cells and CD3-CD4+cells from healthy controls and L-HES patients, respectively, were cultured in vitro in presence of anti-CD3/CD28 or dendritic cells. Effects of eosinophils on T-cell proliferation and cytokine production were investigated.

Results

Eosinophils enhanced CD3-driven proliferation of CD4 T-cells from healthy subjects in vitro, while inhibiting TCR-independent proliferation and IL-5 production by CD3-CD4+T-cells.

Conclusions

While this study confirms previous work showing that eosinophils support activation of normal helper T-cells, our in vitro findings with CD3-CD4+T-cells suggest that eosinophil-depletion may favor activation and expansion of this pathogenic lymphocyte subset. With the ongoing development of eosinophil-targeted therapy for various eosinophilic conditions, the indirect consequences of treatment on the underlying immune mechanisms of disease should be investigated in detail in the setting of translational research programs.
PEP-1-CAT protects hypoxia/reoxygenation-induced cardiomyocyte apoptosis through multiple sigaling pathways
Authors: Zhang Lei , Wei Shuang , Tang Jun-Ming , Guo Ling-Yun , Zheng Fei , Yang Jian-Ye , Kong Xia , Huang Yong-Zhang , Chen Shi-You , Wang Jia-Ning
Published: May 2013

Background

Catalase (CAT) breaks down H2O2 into H2O and O2 to protects cells from oxidative damage. However, its translational potential is limited because exogenous CAT cannot enter living cells automatically. This study is aimed to investigate if PEP-1-CAT fusion protein can effectively protect cardiomyocytes from oxidative stress due to hypoxia/reoxygenation (H/R)-induced injury.

Methods

H9c2 cardomyocytes were pretreated with catalase (CAT) or PEP-1-CAT fusion protein followed by culturing in a hypoxia and re-oxygenation condition. Cell apoptosis were measured by Annexin V and PI double staining and Flow cytometry. Intracellular superoxide anion level was determined, and mitochondrial membrane potential was measured. Expression of apoptosis-related proteins including Bcl-2, Bax, Caspase-3, PARP, p38 and phospho-p38 was analyzed by western blotting.

Results

PEP-1-CAT protected H9c2 from H/R-induced morphological alteration and reduced the release of lactate dehydrogenase (LDH) and malondialdehyde content. Superoxide anion production was also decreased. In addition, PEP-1-CAT inhibited H9c2 apoptosis and blocked the expression of apoptosis stimulator Bax while increased the expression of Bcl-2, leading to an increased mitochondrial membrane potential. Mechanistically, PEP-1-CAT inhibited p38 MAPK while activating PI3K/Akt and Erk1/2 signaling pathways, resulting in blockade of Bcl2/Bax/mitochondrial apoptotic pathway.

Conclusion

Our study has revealed a novel mechanism by which PEP-1-CAT protects cardiomyocyte from H/R-induced injury. PEP-1-CAT blocks Bcl2/Bax/mitochondrial apoptotic pathway by inhibiting p38 MAPK while activating PI3K/Akt and Erk1/2 signaling pathways.
Nuclear β-catenin accumulation is associated with increased expression of Nanog protein and predicts poor prognosis of non-small cell lung cancer
Authors: Li Xi-Qing , Yang Xing-Long , Zhang Gong , Wu Si-Pei , Deng Xu-Bing , Xiao Sheng-Jun , Liu Qiu-Zhen , Yao Kai-Tai , Xiao Guang-Hui
Published: May 2013

Background

Although the prognostic roles of β-catenin expression in non-small cell lung cancer (NSCLC) have been reported in several immunohistochemical (IHC) studies, the results were not consistent because some studies lack sufficient number of the positive cases or did not evaluate the subcellular localization features of the protein.

Method

In this study, we have evaluated the expression levels and subcellular localization of β-catenin and Nanog proteins IHC staining in tissue specimens from 309 patients with NSCLC, and explored their association with clinicopathological features and patient outcome.

Results

We showed that patients with negative expression of membranous beta-catenin had a trend towards shorter survival (p=0.064) than those with positive expression. In contrast to previous studies, we found that increased expression of either cytoplasmic or nuclear β-catenin was strongly associated with poor prognosis and was an independent prognosticator for overall survival (p <0.01). We further found that NSCLC cells frequently exhibited an abundance of nuclear Nanog protein which was significantly correlated with nuclear β-catenin expression (p <0.01) and poor prognosis (p <0.01). Interestingly, immunofluorescent staining results revealed that increased expression of Nanog and nuclear translocation of β-catenin occurred concomitantly in response to epidermal growth factor receptor(EGFR) signaling in A549 and H23 cells. Furthermore, western blot analysis show that nuclear β-catenin rather than cytoplasmic β-catenin expression in the A549 and H23 cells can be enhanced by adding EGF, Nanog expression in the A549 and H23 cells with knockdown of β-catenin can not be obviously enhanced by adding EGF.

Conclusion

We propose that evaluation of subcellular localization of β-catenin and Nanog expression is of clinical significance for patients with NSCLC.
Patterns of failure in patients with locally advanced rectal cancer receiving pre-operative or post-operative chemoradiotherapy
Authors: Yeo Seung-Gu , Kim Min-Jeong , Kim Dae Yong , Chang Hee Jin , Kim Min Ju , Baek Ji Yeon , Kim Sun Young , Kim Tae Hyun , Park Ji Won , Oh Jae Hwan
Published: May 2013

Background

We investigated patterns of failure in patients with locally advanced rectal cancer (LARC) according to chemoradiotherapy (CRT) timing: pre-operative versus post-operative. Also, patterns of failure, particularly distant metastasis (DM), were analyzed according to tumor location within the rectum.

Methods

In total, 872 patients with LARC who had undergone concurrent CRT and radical surgery between 2001 and 2007 were analyzed retrospectively. Concurrent CRT was administered pre-operatively (cT3–4) or post-operatively (pT3–4 or pN+) in 550 (63.1%) and 322 (36.9%) patients, respectively. Median follow-up period was 86 (range, 12–133) months for 673 living patients. Local recurrence (LR) was defined as any disease recurrence within the pelvis, and any failure outside the pelvis was classified as a DM. Only the first site of recurrence was scored.

Results

In total, 226 (25.9%) patients developed disease recurrence. In the pre-operative CRT group, the incidences of isolated LR, combined LR and DM, and isolated DM were 17, 21, and 89 patients, respectively. In the post-operative CRT group, these incidences were 8, 15, and 76 patients, respectively. LR within 2 years constituted 44.7% and 60.9% of all LRs in the pre-operative and post-operative CRT groups, respectively. Late (> 5 years) LR comprised 13.2% and 4.3% of all LRs in the pre-operative and post-operative CRT groups, respectively. The lung was the most common DM site (108/249, 43.4%). Lung or para-aortic lymph node metastasis developed more commonly from low-to-mid rectal tumors while liver metastasis developed more commonly from upper rectal tumors. Lung metastasis occurred later than liver metastasis (n = 54; 22.6 ± 15.6 vs. 17.4 ± 12.1 months; P = 0.035).

Conclusions

This study showed that LARC patients receiving pre-operative CRT tended to develop late LR more often than those receiving post-operative CRT. Further extended follow-up than is conventional may be necessary in LARC patients who are managed with optimized multimodal treatments, and the follow-up strategy may need to be individualized according to tumor location within the rectum.
Investing in Preschool Programs
Authors: Duncan Greg J , Magnuson Katherine
Published: May 2013

We summarize the available evidence on the extent to which expenditures on early childhood education programs constitute worthy social investments in the human capital of children. We provide an overview of existing early childhood education programs, and then summarize results from a substantial body of methodologically sound evaluations of the impacts of early childhood education. The evidence supports few unqualified conclusions. Many early childhood education programs appear to boost cognitive ability and early school achievement in the short run. However, most of them show smaller impacts than those generated by the best-known programs, and their cognitive impacts largely disappear within a few years. Despite this fade-out, long-run follow-ups from a handful of well-known programs show lasting positive effects on such outcomes as greater educational attainment, higher earnings, and lower rates of crime. It is uncertain what skills, behaviors, or developmental processes are particularly important in producing these longer-run impacts. Our review also describes different models of human development used by social scientists, examines heterogeneous results across groups, and tries to identify the ingredients of early childhood education programs that are most likely to improve the performance of these programs.
The Investment Strategies of Sovereign Wealth Funds
Authors: Bernstein Shai , Lerner Josh , Schoar Antoinette
Published: May 2013

Sovereign wealth funds have emerged as major investors in corporate and real resources worldwide. After an overview of their magnitude, we consider the institutional arrangements under which many of the sovereign wealth funds operate. We focus on a specific set of agency problems that is of first-order importance for these funds: that is, the direct involvement of political leaders in the management process. We show that sovereign wealth funds with greater involvement of political leaders in fund management are associated with investment strategies that seem to favor short-term economic policy goals in their respective countries at the expense of longer-term maximization of returns. Sovereign wealth funds face several other issues, like how best to cope with demands for transparency, which can allow others to copy their investment strategies, and how to address the problems that arise with sheer size, like the difficulties of scaling up investment strategies that only work with a smaller value of assets under investment. In the conclusion, we discuss how various approaches cultivated by effective institutional investors worldwide—from investing in the best people to pioneering new asset classes to compartmentalizing investment activities—may provide clues as to how sovereign wealth funds might address these issues.
Finance: Function Matters, Not Size
Authors: Cochrane John H
Published: May 2013

It's fun to pass judgment on waste, size, usefulness, complexity, and excessive compensation. But as economists, we have an analytical structure for thinking about these questions. “I don't understand it” doesn't mean “it's bad,” or “regulation will improve it.” That attitude pervades policy analysis in general and financial regulation in particular, and economists do the world a disservice if we echo it. I will not offer a competing black box [to explain the size of the finance industry]. I don't claim to estimate the socially optimal “size of finance” at, say, 8.267 percent of GDP. It's just the wrong question. Hayek and the failure of planning should teach us a little modesty: Pronouncing on socially optimal industry size is a waste of time. Is the finance industry functioning well? Are there identifiable market or government distortions? Will proposed regulations help or make matters worse? These are useful questions.
The Growth of Finance
Authors: Greenwood Robin , Scharfstein David
Published: May 2013

The US financial services industry grew from 4.9 percent of GDP in 1980 to 7.9 percent of GDP in 2007. A sizeable portion of the growth can be explained by rising asset management fees, which in turn were driven by increases in the valuation of tradable assets, particularly equity. Another important factor was growth in fees associated with an expansion in household credit, particularly fees associated with residential mortgages. This expansion was fueled by the development of nonbank credit intermediation (or “shadow banking”). We offer a preliminary assessment of whether the growth of active asset management, household credit, and shadow banking—the main areas of growth in the financial sector—has been socially beneficial.
Life Experiences of Instability and Sexual Risk Behaviors Among High‐Risk Adolescent Females
Authors: Secor‐Turner Molly , McMorris Barbara , Sieving Renee , Bearinger Linda H.
Published: May 2013

Context

Understanding the interplay of multiple contexts of adolescents’ sexual risk behaviors is essential to helping them avoid pregnancy and STDs. Although a body of research has identified multiple individual‐ and family‐level variables associated with adolescents’ sexual risk behaviors, relatively few studies have examined relationships between these behaviors and latent indicators of unstable, chaotic environments.

Methods

In 2007–2008, a sample of 241 sexually active adolescent females who were at high risk for pregnancy and STDs were recruited through two school‐based clinics and two community clinics in Minneapolis and St. Paul. Confirmatory factor analysis was used with baseline data to specify latent constructs of individual risk and family disengagement. Structural equation models examined longitudinal relationships between baseline measures of these constructs and sexual risk behaviors assessed six months later.

Results

The latent construct of individual risk encompassed substance use, violence perpetration, violence victimization and having witnessed violence; that of family disengagement included family disconnection, poor family communication and perceived lack of safety at home. Baseline level of individual risk was positively associated with number of male sex partners six months later (path coefficient, 0.2); it was not associated with consistent condom use at follow‐up. Level of family disengagement was negatively associated with condom use consistency six months later (−0.3), but was not associated with number of male sex partners.

Conclusions

To meet the health needs of vulnerable adolescents, health systems should incorporate coordinated and interdisciplinary services that acknowledge adolescents’ relevant familial and social contexts.
From exceptional collections to motivic decompositions via noncommutative motives
Authors: Marcolli Matilde , Tabuada Gonçalo
Published: May 2013

Making use of noncommutative motives we relate exceptional collections (and more generally semi-orthogonal decompositions) to motivic decompositions. On one hand we prove that the Chow motive M(𝒳)ℚ of every smooth and proper Deligne–Mumford stack 𝒳, whose bounded derived category 𝒟
b
(𝒳) of coherent schemes admits a full exceptional collection, decomposes into a direct sum of tensor powers of the Lefschetz motive. Examples include projective spaces, quadrics, toric varieties, homogeneous spaces, Fano threefolds, and moduli spaces. On the other hand we prove that if M(𝒳)ℚ decomposes into a direct sum of tensor powers of the Lefschetz motive and moreover 𝒟
b
(𝒳) admits a semi-orthogonal decomposition, then the noncommutative motive of each one of the pieces of the semi-orthogonal decomposition is a direct sum of ⊗-units. As an application we obtain a simplification of Dubrovin's conjecture.
Combination of neutron imaging (NI) and digital image correlation (DIC) to determine intra-ring moisture variation in Norway spruce
Authors: Lanvermann Christian , Sanabria Sergio J. , Mannes David , Niemz Peter
Published: May 2013

The hygroscopic behavior of wood has a strong influence on its mechanical performance, yet the moisture gradients within the growth ring structure have not been sufficiently investigated. The main challenge is that moisture variations are coupled with strong sample deformation, which complicates the spatial referencing of moist and dry states. In this work, neutron imaging (NI) for the detection of water and digital image correlation (DIC) for the detection of local deformation were combined to calculate the local gravimetric moisture content (MCgrav) and the volumetric moisture content (MCvol) within single growth rings. Specimens of Norway spruce [Picea abies (L.) Karst.] were exposed to an adsorption-desorption cycle, with relative humidity (RH) steps varying from 0% (oven dry) up to 95% RH. After each acclimatization step, neutron transmission and DIC images were acquired. The local deformations determined by DIC were used to assign the corresponding dry density in the undeformed state to the compartment in a moist state and thus to calculate its MC by NI. No significant MC gradients could be found between earlywood (EW) and latewood (LW) within ±0.5% accuracy. However, strong density gradients between EW and LW can be directly correlated with MCvol. It appears that the MC in the cell wall is constant regardless of the particular growth ring position.
Is yoga an effective treatment in the management of patients with chronic low back pain compared with other care modalities – a systematic review
Authors: Hill Christopher
Published: May 2013

Objective: The aim of the study was to assess randomized-control trials (RCTs) to ascertain whether yoga is an effective treatment in the management of patients with chronic low back pain (cLBP) compared with other care modalities.

Methods: A search strategy was formulated with key concepts identified using the PICO process. Four databases were searched in June 2012. Appropriate eligibility criteria were set and implemented.

Results: Four randomized control trials met the inclusion criteria. All four papers found that yoga lead to a significant improvement in back function, and three demonstrated a significant improvement in back pain when compared with certain care modalities. All papers had significant limitations identified, however.

Conclusions: Given the limitations identified within the studies, the conclusions drawn must be considered conservatively. Although early results appear promising, but further well-designed RCTs are warranted, with multiple, specified comparator care modalities before firm conclusions can be gained.