bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting Mineral N Release during Decomposition of Organic Wastes in Soil by Use of the SOILN_NO Model
Authors: Sogn Trine A. , Haugen Lars Egil
Published: May 2011

In order to predict the mineral N release associated with the use of organic waste as fertilizer in agricultural plant production, the adequacy of the SOILN_NO model has been evaluated. The original thought was that the model calibrated to data from simple incubation experiments could predict the mineral N release from organic waste products used as N fertilizer on agricultural land. First, the model was calibrated to mineral N data achieved in a laboratory experiment where different organic wastes were added to soil and incubated at 15°C for 8 weeks. Secondly, the calibrated model was tested by use of NO3 −leaching data from soil columns with barley growing in 4 different soil types, added organic waste and exposed to natural climatic conditions during three growing seasons. The SOILN_NO model reproduced relatively well the NO3 −leaching from some of the soils included in the outdoor experiment, but failed to reproduce others. Use of the calibrated model often induced underestimation of the observed NO3 −leaching. To achieve a satisfactory simulation of the NO3 −leaching, recalibration of the model had to be carried out. Thus, SOILN_NO calibrated to data from simple incubation experiments in the laboratory could not directly be used as a tool to predict the N-leaching following organic waste application in more natural agronomic plant production systems. The results emphasised the need for site- and system-specific data for model calibration before using a model for predictive purposes related to fertilizer N value of organic wastes applied to agricultural land.
Estimating Nitrogen Availability of Heat-Dried Biosolids
Authors: Cogger Craig G. , Bary Andy I. , Myhre Elizabeth A.
Published: May 2011

As heat-dried biosolids become more widely produced and marketed, it is important to improve estimates of N availability from these materials. Objectives were to compare plant-available N among three different heat-dried biosolids and determine if current guidelines were adequate for estimating application rates. Heat-dried biosolids were surface applied to tall fescue (Festuca arundinaceaSchreb.) in Washington State, USA, and forage yield and N uptake measured for two growing seasons following application. Three rates of urea and a zero-N control were used to calculate N fertilizer efficiency regressions. Application year plant-available N (estimated as urea N equivalent) for two biosolids exceeded 60% of total N applied, while urea N equivalent for the third biosolids was 45%. Residual (second-year) urea N equivalent ranged from 5 to 10%. Guidelines for the Pacific Northwest USA recommend mineralization estimates of 35 to 40% for heat-dried biosolids, but this research shows that some heat-dried materials fall well above that range.
Epidemiology of Dissociative Disorders: An Overview
Authors: Sar Vedat
Published: May 2011

General psychiatric assessment instruments do not cover DSM-IV dissociative disorders. Many large-scale epidemiological studies led to biased results due to this deficit in their methodology. Nevertheless, screening studies using diagnostic tools designed to assess dissociative disorders yielded lifetime prevalence rates around 10% in clinical populations and in the community. Special populations such as psychiatric emergency ward applicants, drug addicts, and women in prostitution demonstrated the highest rates. Data derived from epidemiological studies also support clinical findings about the relationship between childhood adverse experiences and dissociative disorders. Thus, dissociative disorders constitute a hidden and neglected public health problem. Better and early recognition of dissociative disorders would increase awareness about childhood traumata in the community and support prevention of them alongside their clinical consequences.
Antiasthmatic Effects of Hesperidin, a Potential Th2 Cytokine Antagonist, in a Mouse Model of Allergic Asthma
Authors: Kim Seung-Hyung , Kim Bok-Kyu , Lee Young-Cheol
Published: May 2011

Background and Objective. The features of asthma are airway inflammation, reversible airflow obstruction, and an increased sensitivity to bronchoconstricting agents, termed airway hyperresponsiveness (AHR), excess production of Th2 cytokines, and eosinophil accumulation in the lungs. To investigate the antiasthmatic potential of hesperidin as well as the underlying mechanism involved, we studied the inhibitory effect and anti-inflammatory effect of hesperidin (HPN) on the production of Th2 cytokines, eotaxin, IL-17, -OVA-specific IgEin vivoasthma model mice.Methods. In this paper, BALB/c mice were systemically sensitized to ovalbumin (OVA) followed intratracheally, intraperitoneally, and by aerosol allergen challenges. We investigated the effect of HPN on airway hyperresponsiveness, pulmonary eosinophilic infiltration, various immune cell phenotypes, Th2 cytokine production and OVA-specific IgE production in a mouse model of asthma.Results. In BALB/c mice, we found that HPN-treated groups had suppressed eosinophil infiltration, allergic airway inflammation, and AHR, and these occurred by suppressing the production of IL-5, IL-17, and OVA-specific IgE.Conclusions. Our data suggest that the therapeutic mechanism by which HPN effectively treats asthma is based on reductions of Th2 cytokines (IL-5), eotaxin, OVA-specific IgE production, and eosinophil infiltration via inhibition of GATA-3 transcription factor.
Recent Advances in the Pathogenesis and Management of Cast Nephropathy (Myeloma Kidney)
Authors: Stringer Stephanie , Basnayake Kolitha , Hutchison Colin , Cockwell Paul
Published: May 2011

Multiple myeloma is an incurable plasma cell malignancy that is often accompanied by renal failure; there are a number of potential causes of this, of which cast nephropathy is the most important. Renal failure is highly significant in myeloma, as patient survival can be stratified by the severity of the renal impairment. Consequently, there is an ongoing focus on the pathological basis of cast nephropathy and the optimal treatment regimens in this setting, including effective chemotherapy regimens to reduce light chain production and emerging extracorporeal techniques to remove circulating light chains. This paper bridges recent advances in the pathogenesis and management of cast nephropathy in multiple myeloma.
Role of Polysaccharides on Mechanical and Adhesion Properties of Flax Fibres in Flax/PLA Biocomposite
Authors: Raj Gijo , Balnois Eric , Baley Christophe , Grohens Yves
Published: May 2011

The effect of alkali and enzymatic treatments on flax fibre morphology, mechanical, and adhesion properties was investigated. The multilength scale analysis allows for the correlation of the fibre's morphological changes induced by the treatments with mechanical properties to better explain the adherence properties between flax and PLA. The atomic force microscopy (AFM) images revealed the removal of primary layers, upon treatments, down to cellulose microfibrils present in the secondary layers. The variation in mechanical properties was found to be dependent, apart from the crystalline content, on interaction between cellulose microfibrils and encrusting polysaccharides, pectins and hemicelluloses, in the secondary layers. Finally, microbond tests between the modified fibres and PLA emphasize the important role of the outer fibre's surface on the overall composite properties. It was observed here that gentle treatments of the fibres, down to the oriented microfibrils, are favourable to a better adherence with a PLA drop. This paper highlights the important role of amorphous polymers, hemicellulose and pectin, in the optimisation of the adhesion and mechanical properties of flax fibres in the biocomposite.
Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
Authors: Manganoni A. M. , Farfaglia R. , Sereni E. , Farisoglio C. , Pizzocaro C. , Marocolo D. , Gavazzoni F. , Pavoni L. , Calzavara-Pinton P.
Published: May 2011

Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy.Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS) has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs) in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB) in 480 patients.Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm.Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.
Membrane Fusion Induced by Small Molecules and Ions
Authors: Mondal Roy Sutapa , Sarkar Munna
Published: May 2011

Membrane fusion is a key event in many biological processes. These processes are controlled by various fusogenic agents of which proteins and peptides from the principal group. The fusion process is characterized by three major steps, namely, inter membrane contact, lipid mixing forming the intermediate step, pore opening and finally mixing of inner contents of the cells/vesicles. These steps are governed by energy barriers, which need to be overcome to complete fusion. Structural reorganization of big molecules like proteins/peptides, supplies the required driving force to overcome the energy barrier of the different intermediate steps. Small molecules/ions do not share this advantage. Hence fusion induced by small molecules/ions is expected to be different from that induced by proteins/peptides. Although several reviews exist on membrane fusion, no recent review is devoted solely to small moleculs/ions induced membrane fusion. Here we intend to present, how a variety of small molecules/ions act as independent fusogens. The detailed mechanism of some are well understood but for many it is still an unanswered question. Clearer understanding of how a particular small molecule can control fusion will open up a vista to use these moleucles instead of proteins/peptides to induce fusion both in vivo and in vitro fusion processes.
Acute Disruption of Bone Marrow B Lymphopoiesis and Apoptosis of Transitional and Marginal Zone B Cells in the Spleen following a Blood-StagePlasmodium chabaudiInfection in Mice
Authors: Bockstal Viki , Geurts Nathalie , Magez Stefan
Published: May 2011

B cells and antibodies are essential for the protective immune response against a blood-stagePlasmodiuminfection. Although extensive research has focused on memory as well as plasma B-cell responses during infection, little is known about how malaria affects B-cell development and splenic maturation into marginal zone B (MZB) and follicular B (FoB) cells. In this study, we show that acutePlasmodium chabaudiAS infection in C57Bl/6 mice causes severe disruption of B lymphopoiesis in the bone marrow, affecting in particular pro-, pre-, and immature B cells as well as the expression of the bone marrow B-cell retention chemokine CXCL12. In addition, elevated apoptosis of transitional T2 and marginal zone (MZ) B cells was observed during and subsequent to the control of the first wave of parasitemia. In contrast, Folllicular (Fo) B cells levels were retained in the spleen throughout the infection, suggesting that these are essential for parasite clearance and proper infection control.
Intergraded Applied Methodology for the Treatment of Heavy Polluted Waste Waters from Olive Oil Industries
Authors: Zorpas Antonis A. , Inglezakis Vassilis J.
Published: May 2011

The annual olive oil production in Cyprus is in the range of 2700–3100 t y−1, resulting in the generation of significant amount of waste. The cocomposting of the olive oil solid residue (OOSR) and the treated wastewaters (with Fenton) from the olive oil production process with the application of reed beds has been studied as an integrated method for the treatment of wastewater containing high organic and toxic pollutants under warm climate conditions. The experimental results indicated that the olive mill wastewater (OMW) is detoxified at the end of the Fenton process. Specifically, COD is reduced up to 65% (minimum 54.32%) by the application of Fenton and another 10–28% by the application of red beds as a third stage. The final cocomposted material of OOSR with the treated olive mile wastewater (TOMW) presents optimum characteristics and is suitable for agricultural purpose.
Generalized Timelike Mannheim Curves in Minkowski Space‐Time E14
Authors: Akyig~it M. , Ersoy S. , Özgür İ. , Tosun M.
Published: May 2011

We give the definition of generalized timelike Mannheim curve in Minkowski space‐time . The necessary and sufficient conditions for the generalized timelike Mannheim curve are obtained. We show some characterizations of generalized Mannheim curve.
Reconfigurable Integrated Optoelectronics
Authors: Soref Richard
Published: May 2011

Integrated optics today is based upon chips of Si and InP. The future of this chip industry is probably contained in the thrust towards optoelectronic integrated circuits (OEICs) and photonic integrated circuits (PICs) manufactured in a high-volume foundry. We believe that reconfigurable OEICs and PICs, known as ROEICs and RPICs, constitute the ultimate embodiment of integrated photonics. This paper shows that any ROEIC-on-a-chip can be decomposed into photonic modules, some of them fixed and some of them changeable in function. Reconfiguration is provided by electrical control signals to the electro-optical building blocks. We illustrate these modules in detail and discuss 3D ROEIC chips for the highest-performance signal processing. We present examples of our module theory for RPIC optical lattice filters already constructed, and we propose new ROEICs for directed optical logic, large-scale matrix switching, and 2D beamsteering of a phased-array microwave antenna. In general, large-scale-integrated ROEICs will enable significant applications in computing, quantum computing, communications, learning, imaging, telepresence, sensing, RF/microwave photonics, information storage, cryptography, and data mining.
Mesoporous In2O3: Effect of Material Structure on the Gas Sensing
Authors: Cheng Z. X. , Ren X. H. , Xu J. Q. , Pan Q. Y.
Published: May 2011

We present a semiconductor gas sensor based on mesoporous In2O3(m-In2O3). The m-In2O3was successfully fabricated by a simple sol-gel process, using block copolymer PE6800 as a soft template. The results of gas sensing reveal that the m-In2O3prepared at room temperature shows higher resistance, which plays the key role in its greater sensitivity. The pore structure of material has an influence on gas adsorption on the material surface, which further affects response-recovery time of gas sensor.
On the Perturbation of the Three‐Dimensional Stokes Flow of Micropolar Fluids by a Constant Uniform Magnetic Field in a Circular Cylinder
Authors: Vafeas Panayiotis , Papadopoulos Polycarpos K. , Hatzikonstantinou Pavlos M.
Published: May 2011

Modern engineering technology involves the micropolar magnetohydrodynamic flow of magnetic fluids. Here, we consider a colloidal suspension of non‐conductive ferromagnetic material, which consists of small spherical particles that behave as rigid magnetic dipoles, in a carrier liquid of approximately zero conductivity and low‐Reynolds number properties. The interaction of a 3D constant uniform magnetic field with the three‐dimensional steady creeping motion (Stokes flow) of a viscous incompressible micropolar fluid in a circular cylinder is investigated, where the magnetization of the ferrofluid has been taken into account and the magnetic Stokes partial differential equations have been presented. Our goal is to apply the proper boundary conditions, so as to obtain the flow fields in a closed analytical form via the potential representation theory, and to study several characteristics of the flow. In view of this aim, we make use of an improved new complete and unique differential representation of magnetic Stokes flow, valid for non‐axisymmetric geometries, which provides the velocity and total pressure fields in terms of easy‐to‐find potentials. We use these results to simulate the creeping flow of a magnetic fluid inside a circular duct and to obtain the flow fields associated with this kind of flow.
Comparison of Different Forms for the “Spin” and “Orbital” Components of the Angular Momentum of Light
Authors: Stewart A. M.
Published: May 2011

We compare three attempts that have been made to decompose the angular momentum of the electromagnetic field into components of an “orbital” and “spin” nature. All three expressions are different, and there seems to be no reason to prefer one to another. It appears, on the basis of classical electrodynamics, that there is no unique way of decomposing the angular momentum of the electromagnetic field into orbital and spin components, even in a fixed inertial frame.
On CR‐Lightlike Product of an Indefinite Kaehler Manifold
Authors: Kumar Rakesh , Kaur Jasleen , Nagaich R. K.
Published: May 2011

We have studied mixed foliate CR‐lightlike submanifolds and
CR‐lightlike product of an indefinite Kaehler manifold and also obtained relationship
between them. Mixed foliate CR‐lightlike submanifold of indefinite
complex space form has also been discussed and showed that the indefinite
Kaehler manifold becomes the complex semi‐Euclidean space.
Design and Analysis of a New Carbon Nanotube Full Adder Cell
Authors: Ghadiry M. H. , Abd Manaf Asrulnizam , Ahmadi M. T. , Sadeghi Hatef , Senejani M. Nadi
Published: May 2011

A novel full adder circuit is presented. The main aim is to reduce power delay product (PDP) in the presented full adder cell. A new method is used in order to design a full-swing full adder cell with low number of transistors. The proposed full adder is implemented in MOSFET-like carbon nanotube technology and the layout is provided based on standard 32 nm technology from MOSIS. The simulation results using HSPICE show that there are substantial improvements in both power and performance of the proposed circuit compared to the latest designs. In addition, the proposed circuit has been implemented in conventional 32 nm process to compare the benefits of using MOSFET-like carbon nanotubes in arithmetic circuits over conventional CMOS technology. The proposed circuit can be applied in very high performance and ultra-low-power applications.
Metformin, Independent of AMPK, Induces mTOR Inhibition and Cell-Cycle Arrest through REDD1
Authors: Ben Sahra Isaam , Regazzetti Claire , Robert Guillaume , Laurent Kathiane , Le Marchand-Brustel Yannick , Auberger Patrick , Tanti Jean-François , Giorgetti-Peraldi Sophie , Bost Frédéric
Published: May 2011

Metformin is a widely prescribed antidiabetic drug associated with a reduced risk of cancer. Many studies show that metformin inhibits cancer cell viability through the inhibition of mTOR. We recently showed that antiproliferative action of metformin in prostate cancer cell lines is not mediated by AMP-activated protein kinase (AMPK). We identified REDD1 (also known as DDIT4 and RTP801), a negative regulator of mTOR, as a new molecular target of metformin. We show that metformin increases REDD1 expression in a p53-dependent manner. REDD1 invalidation, using siRNA or REDD1−/− cells, abrogates metformin inhibition of mTOR. Importantly, inhibition of REDD1 reverses metformin-induced cell-cycle arrest and significantly protects from the deleterious effects of metformin on cell transformation. Finally, we show the contribution of p53 in mediating metformin action in prostate cancer cells. These results highlight the p53/REDD1 axis as a new molecular target in anticancer therapy in response to metformin treatment. Cancer Res; 71(13);4366–72. ©2011 AACR.
Evidence That Serum Levels of the Soluble Receptor for Advanced Glycation End Products Are Inversely Associated with Pancreatic Cancer Risk: A Prospective Study
Authors: Jiao Li , Weinstein Stephanie J. , Albanes Demetrius , Taylor Philip R. , Graubard Barry I. , Virtamo Jarmo , Stolzenberg-Solomon Rachael Z.
Published: May 2011

Cigarette smoking, obesity, type 2 diabetes, and, to a lesser extent, meat cooked at high temperatures are associated with pancreatic cancer. Cigarette smoke and foods cooked at higher temperatures are major environmental sources of advanced glycation end products (AGE). AGEs accumulate during hyperglycemia and elicit oxidative stress and inflammation through interaction with the receptor for AGEs (RAGE). Soluble RAGE (sRAGE) acts as an anti-inflammatory factor to neutralize AGEs and block the effects mediated by RAGE. In this study, we investigated the associations of prediagnostic measures of Nϵ-(carboxymethyl)-lysine (CML)-AGE and sRAGE with pancreatic cancer in a case–cohort study within a cohort of 29,133 Finnish male smokers. Serum samples and exposure information were collected at baseline (1985–1988). We measured CML-AGE, sRAGE, glucose, and insulin concentrations in fasting serum from 255 incident pancreatic cancer cases that arose through April 2005 and from 485 randomly sampled subcohort participants. Weighted Cox proportional hazard regression models were used to calculate relative risks (RR) and 95% CI, adjusted for age, years of smoking, and body mass index. CML-AGE and sRAGE were mutually adjusted. CML-AGE levels were not associated with pancreatic cancer [fifth compared with first quintile, RR (95% CI): 0.68 (0.38–1.22), Ptrend = 0.27]. In contrast, sRAGE levels were inversely associated with pancreatic cancer [fifth compared with first quintile, RR (95% CI): 0.46 (0.23–0.73), Ptrend = 0.002]. Further adjustment for glucose or insulin levels did not change the observed associations. Our findings suggest that sRAGE is inversely associated with pancreatic cancer risk among Finnish male smokers. Cancer Res; 71(10); 3582–9. ©2011 AACR.
mTOR Kinase Inhibitor AZD8055 Enhances the Immunotherapeutic Activity of an Agonist CD40 Antibody in Cancer Treatment
Authors: Jiang Qun , Weiss Jonathan M. , Back Timothy , Chan Tim , Ortaldo John R. , Guichard Sylvie , Wiltrout Robert H.
Published: May 2011

mTOR is a central mediator of cancer cell growth, but it also directs immune cell differentiation and function. On this basis, we had explored the hypothesis that mTOR inhibition can enhance cancer immunotherapy. Here, we report that a combination of αCD40 agonistic antibody and the ATP-competitive mTOR kinase inhibitory drug AZD8055 elicited synergistic antitumor responses in a model of metastatic renal cell carcinoma. In contrast to the well-established mTOR inhibitor rapamycin, AZD8055 increased the infiltration, activation, and proliferation of CD8+ T cells and natural killer cells in liver metastatic foci when combined with the CD40 agonist. AZD8055/αCD40-treated mice also display an increased incidence of matured macrophages and dendritic cells compared with that achieved in mice by αCD40 or AZD8055 treatment alone. We found that the combination treatment also increased macrophage production of TNFα, which played an indispensable role in activation of the observed antitumor immune response. Levels of Th1 cytokines, including interleukin 12, IFN-γ, TNFα, and the Th1-associated chemokines RANTES, MIG, and IP-10 were each elevated significantly in the livers of mice treated with the combinatorial therapy versus individual treatments. Notably, the AZD8055/αCD40-induced antitumor response was abolished in IFN-γ−/− and CD40−/− mice, establishing the reliance of the combination therapy on host IFN-γ and CD40 expression. Our findings offer a preclinical proof of concept that, unlike rapamycin, the ATP-competitive mTOR kinase inhibitor AZD8055 can contribute with αCD40 treatment to trigger a restructuring of the tumor immune microenvironment to trigger regressions of an established metastatic cancer. Cancer Res; 71(12); 4074–84. ©2011 AACR.
Mitochondrial Subversion in Cancer
Authors: Chatterjee Aditi , Dasgupta Santanu , Sidransky David
Published: May 2011

Mitochondria control essential cellular activities including generation of ATP via oxidative phosphorylation. Mitochondrial DNA (mtDNA) mutations in the regulatory D-loop region and somatic mtDNA mutations are common in primary human cancers. The biological impact of a given mutation may vary, depending on the nature of the mutation and the proportion of mutant mtDNAs carried by the cell. Identification of mtDNA mutations in precancerous lesions supports their early contribution to cell transformation and cancer progression. Introduction of mtDNA mutations in transformed cells has been associated with increased ROS production and tumor growth. Studies reveal that increased and altered mtDNA plays a role in the development of cancer but further work is required to establish the functional significance of specific mitochondrial mutations in cancer and disease progression. This review offers some insight into the extent of mtDNA mutations, their functional consequences in tumorigenesis, mitochondrial therapeutics, and future clinical application. Cancer Prev Res; 4(5); 638–54. ©2011 AACR.
A Randomized Placebo-Controlled Prevention Trial of Aspirin and/or Resistant Starch in Young People with Familial Adenomatous Polyposis
Authors: Burn John , Bishop D. Timothy , Chapman Pamela D. , Elliott Faye , Bertario Lucio , Dunlop Malcolm G. , Eccles Diana , Ellis Anthony , Evans D. Gareth , Fodde Riccardo , Maher Eamonn R. , Möslein Gabriela , Vasen Hans F. A. , Coaker Julie , Phillips Robin K. S. , Bülow Steffen , Mathers John C.
Published: May 2011

Evidence supporting aspirin and resistant starch (RS) for colorectal cancer prevention comes from epidemiologic and laboratory studies (aspirin and RS) and randomized controlled clinical trials (aspirin). Familial adenomatous polyposis (FAP) strikes young people and, untreated, confers virtually a 100% risk of colorectal cancer and early death. We conducted an international, multicenter, randomized, placebo-controlled trial of aspirin (600 mg/d) and/or RS (30 g/d) for from 1 to 12 years to prevent disease progression in FAP patients from 10 to 21 years of age. In a 2 × 2 factorial design, patients were randomly assigned to the following four study arms: aspirin plus RS placebo; RS plus aspirin placebo; aspirin plus RS; RS placebo plus aspirin placebo; they were followed with standard annual clinical examinations including endoscopy. The primary endpoint was polyp number in the rectum and sigmoid colon (at the end of intervention), and the major secondary endpoint was size of the largest polyp. A total of 206 randomized FAP patients commenced intervention, of whom 133 had at least one follow-up endoscopy and were therefore included in the primary analysis. Neither intervention significantly reduced polyp count in the rectum and sigmoid colon: aspirin relative risk = 0.77 (95% CI, 0.54–1.10; versus nonaspirin arms); RS relative risk = 1.05 (95% CI, 0.73–1.49; versus non-RS arms). There was a trend toward a smaller size of largest polyp in patients treated with aspirin versus nonaspirin—mean 3.8 mm versus 5.5 mm for patients treated 1 or more years (adjusted P = 0.09) and mean 3.0 mm versus 6.0 mm for patients treated more than 1 year (P = 0.02); there were similar weaker trends with RS versus non-RS. Exploratory translational endpoints included crypt length (which was significantly shorter in normal-appearing mucosa in the RS group over time) and laboratory measures of proliferation (including Ki67). This clinical trial is the largest ever conducted in the setting of FAP and found a trend of reduced polyp load (number and size) with 600 mg of aspirin daily. RS had no clinical effect on adenomas. Cancer Prev Res; 4(5); 655–65. ©2011 AACR.
Back to the Future: Mechanism-Based, Mutation-Specific Combination Chemoprevention with a Synthetic Lethality Approach
Authors: Meyskens Frank L. , Gerner Eugene W.
Published: May 2011

There is an increasing recognition that the mutations accompanying carcinogenesis may provide a window of therapeutic advantage designated synthetic lethality, an example of which is reported in this issue of the journal by Huang and colleagues (beginning on page 666). First discovered and studied in yeast, synthetic lethality has basic principles that have encouraged its development for treatment and now prevention in animal models of human cancer, especially malignancies refractory to standard approaches. The pros and cons of this approach and challenges in implementing it clinically are discussed. Cancer Prev Res; 4(5); 628–32. ©2011 AACR.
Surgical Management of Benign and Indeterminate Hepatic Lesions in the Era of Laparoscopic Liver Surgery
Authors: Abu Hilal Mohammed , Di Fabio Francesco , Teng Mabel Joey , Godfrey Dean Anthony , Primrose John Neil , Pearce Neil William
Published: May 2011

Background/Aims: The expansion of the laparoscopic approach for the management of benign liver lesions has raised concerns regarding the risk of widening surgical indications and compromising safety. Large single-centre series focusing on laparoscopic management of benign liver lesions are sporadic. Methods: We reviewed a prospectively collected database of patients undergoing pure laparoscopic liver resection (LLR) for benign liver lesions. All cases were individually discussed at a multidisciplinary team meeting. Results: Forty-six patients underwent 50 LLRs for benign disease. Indications for surgery were: symptomatic lesions, preoperative diagnosis of adenoma or cystadenoma, and lesions with an indeterminate diagnosis. The preoperative diagnosis was uncertain in 11 cases. Of these, histological diagnosis was hepatocellular carcinoma in one (9%) and benign lesion in 10 patients (91%). Thirteen patients (28%) required major hepatectomy. Three patients (7%) developed postoperative complications. Mortality was nil. The median postoperative hospital stay following major and minor hepatectomy was 4 and 3 days, respectively. Conclusion: The laparoscopic approach represents a safe option for the management of benign and indeterminate liver lesions, even when major hepatectomy is required. LLR should be only performed in specialized centres to ensure safety and strict adherence to orthodox surgical indication.
Laparoscopy-Assisted Percutaneous Gastrostomy Tube Placement along with Laparoscopic Gastropexy
Authors: Tsujimoto Hironori , Yaguchi Yoshihisa , Kumano Isao , Matsumoto Yusuke , Yoshida Kazumichi , Hase Kazuo
Published: May 2011

Background: Percutaneous endoscopic gastrostomy (PEG) has gained wide acceptance for patients suffering malnutrition. However, the PEG technique is not always feasible in cases in which endoscopic passage is not possible due to an obstruction in the esophagus. Methods: Under general anesthesia, a 2.0 nylon suture with a straight needle was inserted into the peritoneal cavity approximately 1 cm cranial to the planned gastrostomy. After this straight needle was held with the laparoscopic needle holder, the layers of the anterior gastric wall were sutured, and then the needle was put through the abdominal wall. The same procedures were performed at 2 cm on the caudal side of the first suture. A trocar with a peel-away sheath was used to penetrate the gastric wall. The peel-away sheath was removed and a balloon catheter was placed between the two gastropexy sutures. Results: This surgical procedure was performed in 6 cases. The mean operation time was 46.7 ± 10.0 min, the postoperative courses were uneventful, and feeding was started on postoperative day 1 in all cases. Conclusions: This laparoscopic gastrostomy procedure should be especially useful in patients in whom endoscopic passage is not possible due to a neck or esophageal stenosis.
Nasogastric Decompression for Radical Gastrectomy for Gastric Cancer: A Prospective Randomized Controlled Study
Authors: Li Chen , Mei Jia Wei , Yan Min , Chen Ming Min , Yao Xue Xin , Yang Qiu Meng , Zhou Rui , Zhu Zheng Gang
Published: May 2011

Background: The purpose of this study was to evaluate the necessity of a nasogastric decompression in radical gastrectomy for gastric cancer patients by a prospective randomized controlled trial. Methods: From 2007 to 2009, 161 gastric cancer patients who underwent radical gastrectomy were randomly selected and entered into three groups: tube group (TG), intra-operative tube group (ITG), and no-tube group (NTG). The variables studied among the groups were demographic characteristics, surgical characteristics, postoperative recovery and complications. Results: With respect to demographic and surgical characteristics, there were no significant differences among the 3 groups. The time of the first passage of flatus, tolerance of water intake, liquid diet and semiliquid diet were similar among TG, ITG and NTG. Postoperative hospital stay was increased in patients from TG compared to NTG (11.3 vs. 10.2 days, p = 0.031). The incidence of nausea was significantly higher in TG than in ITG or NTG (64 vs. 36.8 and 29.6%). The overall postoperative complication rate was not significantly different among these groups (20, 15.8 and 20.4% in TG, ITG and NTG, respectively, p = 0.612). Conclusions: Radical gastrectomy can be performed safely without nasogastric decompression for gastric cancer patients. The routine prophylactic nasogastric decompression is unnecessary.
Management of Liver Adenomatosis by Radiofrequency Ablation
Authors: van Aalten Susanna M. , Terkivatan Turkan , van der Linden Edwin , Verheij Joanne , de Man Rob A. , IJzermans Jan N.M.
Published: May 2011

Traditionally, surgical resection has been the treatment of choice in many patients with hepatocellular adenoma because of the risk of rupture, hemorrhage and malignant transformation. However, some patients are not amenable for surgery due to the extensive involvement of the liver, as in patients with liver adenomatosis. We report 2 cases with liver adenomatosis in which we combined surgery with open and percutaneous radiofrequency ablation for lesions located in both lobes of the liver. Minimal invasive treatment including radiofrequency ablation may offer new perspectives in the treatment of patients with liver adenomatosis.
Risk Factors and Management of Postoperative Bile Leakage after Hepatectomy without Bilioenteric Anastomosis
Authors: Ishii Hiromichi , Ochiai Toshiya , Murayama Yasutoshi , Komatsu Shuhei , Shiozaki Atsushi , Kuriu Yoshiaki , Ikoma Hisashi , Nakanishi Masayoshi , Ichikawa Daisuke , Fujiwara Hitoshi , Okamoto Kazuma , Kokuba Yukihito , Sonoyama Teruhisa , Otsuji Eigo
Published: May 2011

Background/Aims: Bile leakage frequently causes major complications after hepatic resection. We investigated perioperative risk factors and management of postoperative bile leakage after hepatic resection without extrahepatic biliary resection and reconstruction. Methods: We included 247 consecutive patients who underwent elective hepatic resection without bilioenteric anastomosis at our institution between 2002 and 2009. Perioperative risk factors, including patient and surgical variables, were evaluated using univariate and logistic regression analyses. Results: Postoperative bile leakage occurred in 26 patients (10.5%). The surgical drain was retained in 6 patients (23%); 9 (35%) underwent drain salvage and 11 (42%) underwent percutaneous puncture under computed tomography or ultrasound guidance. Eight patients underwent endoscopic nasobiliary drainage (ENBD) for postoperative bile leakage, and bile leakage healed at a median interval of 19.5 days after ENBD. By univariate analysis, postoperative bile leakage was associated with central bisectionectomy, surgical time and intraoperative blood loss. Logistic regression analysis identified central bisectionectomy as an independent risk factor for postoperative bile leakage (p = 0.0003, odds ratio 16.724). Conclusion: Meticulous procedures are necessary during parenchymal hepatic resection, especially during central bisectionectomy. Drain management should be precise in the case of postoperative bile leakage. We believe ENBD may rapidly cure postoperative major bile leakage.
Mild and Severe Anal Incontinence after Lateral Internal Sphincterotomy: Risk Factors, Postoperative Anatomical Findings and Quality of Life
Authors: Kement M. , Karabulut M. , Gezen F.C. , Demirbas S. , Vural S. , Oncel M.
Published: May 2011

Aim: This study aims to evaluate the risk factors for incontinence after lateral internal sphincterotomy (LIS) and assess quality of life in different levels of incontinence. Methods: All consecutive patients (n = 253) with chronic anal fissure who underwent LIS between 2003 and 2006 were retrospectively reviewed. All patients were questioned for possible anal incontinence according to the Wexner Incontinence Score (WIS). Demographics, vaginal delivery history, additional procedures and surgeon’s experience were evaluated as risk factors. Endoanal ultrasound (EUS) was performed in incontinent patients to assess the thickness of the remaining internal sphincter and to evaluate any injury in the external sphincter. Quality of life was questioned with SF-36. Results: Twenty-eight (11.7%) patients suffered from incontinence (mean WIS = 3.6 ± 2.5). The search for a risk factor was unsuccessful when continent and incontinent groups were compared. In subgroup analyses, patients were found to be suffering from mild (WIS <5, n = 19) or severe (WIS >5, n = 9) incontinence. Vaginal delivery history was found more often in the severely incontinent subgroup than in the continent group (p < 0.05). Also, vaginal delivery history and the additional procedures were more frequently observed in the severely incontinent subgroup than in the mildly incontinent subgroup. EUS did not find any external sphincter injury in these cases. WIS had negative correlations with the physical and mental component scores of SF-36. Conclusion: In our opinion, the threat for incontinence is unpredictable; however, vaginal delivery history may increase the risk of severe incontinence.
Intracameral Injection of Bevacizumab for the Treatment of Neovascular Glaucoma
Authors: Wolf Armin , von Jagow Burkhard , Ulbig Michael , Haritoglou Christos
Published: May 2011

Purpose: To assess the duration of the effect of intracameral bevacizumab in patients presenting with rubeosis iridis and neovascular glaucoma (NVG). Methods: Retrospective analysis of 24 consecutive eyes of 24 patients with decompensated NVG (>21 mm Hg) treated with a single intracameral injection of bevacizumab over a minimum follow-up of 6 months. The endpoint of the study was the need for retreatment due to recurrence of raised intraocular pressure (IOP). Secondary outcome was the course of visual acuity (VA) and IOP over 6 months. Results: A Kaplan-Meier calculation revealed a mean duration of the treatment effect of 23 ± 4.4 days. Compared to mean IOP before treatment (26.3 mm Hg), decreases to 17.5 mm Hg at 1 week after treatment (p < 0.002) and to 17.1 mm Hg (p < 0.005) at 6 months following a single injection were seen. At 6 months, additional treatment was performed in 87.5% (n = 21) of eyes. VA remained stable or improved in 75% (n = 18) of all cases. Conclusion: The IOP-lowering effect of intracameral bevacizumab can be seen 1 week after the injection, but is limited to a period of approximately 3 weeks. However, the fast and effective response to intracameral bevacizumab injection opens a time window for additional treatments, which are often necessary.
Gestational Dermatosis Shortly after Implantation Associated with Parental Class II HLA Compatibility and Maternal Immune Activation: Preliminary Report of a Prospective Case Series
Authors: Gleicher Norbert , Barad David H.
Published: May 2011

Background: Pregnancy represents a semiallograft, subject to similar immune responses as allogeneic organ transplants. Tolerance of pregnancy appears best with maximal class II HLA heterogeneity between mother and father, while compatibilities are associated with increased pregnancy loss and maternal autoimmunity. Tolerance abnormalities often involve skin reactions. Abnormalities in tolerance of the fetal graft may do the same. Objective: To define the characteristics of a newly described dermatosis in very early pregnancy. Methods: Prospective case series of 7 couples/12 clinical episodes. Results: The dermatosis was observed in 7 out of 285 women undergoing in vitro fertilization (IVF; 2.5%; 95% CI 0.66–4.26%) and in 12 out of 277 total IVF cycles reaching embryo transfer (4.3%; 95% CI 1.93–6.73%). Prior to IVF all women reported autoimmune clinically significant allergies. All but 1 couple demonstrated class II HLA compatibility. Two of 4 pregnancies miscarried. All rashes erupted within days from embryo implantation. Conclusions: The ‘implantation rash’ reported here is uncommon but not rare. It may be the consequence of abnormal maternal immune responses to embryo implantation in women with prior immune activation, associated with class II HLA compatibility between parents. Further prospective studies are required to better define this condition.
Evolving Pattern with Age of Cutaneous Signs in Neurofibromatosis Type 1: A Cross-Sectional Study of 728 Patients
Authors: Duong T.A. , Bastuji-Garin S. , Valeyrie-Allanore L. , Sbidian E. , Ferkal S. , Wolkenstein P.
Published: May 2011

Background: Neurofibromatosis type 1 is fully penetrant by the age of 8 years, and 3 criteria of diagnosis are dermatological: café-au-lait spots (CLS), intertriginous freckling and neurofibromas (NF). Objectives: The aim of our study was to determine the evolving pattern of cutaneous manifestations during adulthood. Methods: Phenotypic data of patients seen in our center between March 2003 and December 2009 were studied. Patients were classified in 10-year groups. Following clinical characteristics, the number of CLS and the number of cutaneous and subcutaneous NF were compared according to age. Results: 728 subjects, 404 females and 324 males (mean age of 32.4 years, range 6–80 years) were studied. Four hundred eighty-nine patients were over 20 years old (67%). The number of CLS (small or large) was significantly decreased with age while the number of cutaneous and subcutaneous NF was strongly increased (p < 0.001). Conclusions: The decrease in CLS with age has not been previously reported while an increase in the number of NF is well described during puberty and pregnancy and with age.
Feasibility of Delayed Hyperthermic Intraperitoneal Chemotherapy in Case of Unforeseen Complications
Authors: Mohr Z. , Hirche C. , Liebeskind U. , Rau B. , Hünerbein M.
Published: May 2011

Background: Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) can improve the prognosis of selected patients with peritoneal surface malignancy (PSM). Usually, treatment is performed as an extensive one-step approach. We investigated the feasibility of delayed HIPEC, if the one-step procedure was interrupted precociously. Methods: 42 patients with PSM who underwent CRS and delayed HIPEC from 2006–2008 were studied. HIPEC was performed 5 days after treatment with mitomycin, cisplatin and hyperthermia. Perioperative complications and toxicity were analyzed. Results: Delayed HIPEC was successfully completed in 40 of the 42 patients. In 2 cases, HIPEC was omitted because of complications during chemotherapy (anastomotic leakage and retroperitoneal edema). Minor and major surgical complications occurred in 18 and 9 of the 40 patients treated with HIPEC (45 vs. 22.5%), respectively. Toxicity grade II–IV (WHO criteria) was observed in 4 of them (10%). Median stay in the intensive care unit was 9 days (range 2–31) while the mean hospitalization time was 24 days (range 14–59). In this series, there was no mortality. Conclusion: Postponement of HIPEC after CRS (two-step approach) is feasible. Analysis of morbidity and mortality showed no significant difference to the one-step approach reported in the literature and no disadvantages for the patient. The two-step approach is an alternative option for patients who had to discontinue the one-step approach due to unpredictable intraoperative complications.
Surgical Treatment of 26 Patients with Necrotizing Pneumonia
Authors: Tsai Y.-F. , Tsai Y.-T. , Ku Y.-H.
Published: May 2011

Background: This study aimed to review the outcome of patients treated with surgical resection for necrotizing lung infection with various co-morbidities and complications. Methods: The records of 26 patients treated with pulmonary resection for necrotizing pneumonia between July 2004 and January 2010 were retrospectively reviewed. Surgical procedures included large wedge resection (n = 1), lobectomy (n = 19) and bilobectomy (n = 6). Results: The study cohort consisted of 21 men and 5 women aged 35–85 years (mean 64.7 ± 15.0 years). Twenty-three (88.5%) patients had underlying risk factors. At surgical consultation, 17 patients presented with progressive respiratory distress; 6 required ventilatory support; 12 had empyema, and in 5 patients the conditions were complicated by bronchopleural fistula. Four patients had septic shock requiring vasopressor support. Three patients developed hemoptysis. Two patients had bilateral diffuse pneumonia. Klebsiella pneumoniaeand Streptococcusviridans were the most common pathogens. The right lower (n = 13) and right middle lobes (n = 10) were the most frequently affected. Four deaths (15.4%) occurred: 3 due to perioperative progressing pulmonary infection/inflammation and 1 due to hepatorenal failure. Postoperative empyema occurred in 3 patients. One patient became ventilator dependent. Conclusion: Pulmonaryresection for necrotizing pneumonia is a feasible treatment option in patients with progressive pulmonary sepsis.
Quadruple Therapy Leads to a Sustained Improvement of Vision in Patients with Wet Age-Related Macular Degeneration
Authors: Koss Michael J. , Lewicka-Chomont Aneta , Schramm Katharina , Rejdak Robert , Ohrloff Christian , Koch Frank H.
Published: May 2011

Aim: To investigate the efficacy of a combined intravitreal therapy with prior photodynamic therapy (PDT) in patients with wet age-related macular degeneration. Methods: Fifty-two patients (mean age: 72.7 years) with predominantly classic choroidal neovascularization received low-fluence PDT (42 J/cm2 for 72 s), followed 24 h later by a 0.4-ml core pars plana vitrectomy with intravitreal injection of dexamethasone (0.8 mg) and bevacizumab (1.25 mg). The best-corrected visual acuity (BCVA; 6 m Snellen), central macular thickness (optical coherence tomography), intraocular pressure and the need for retreatment were assessed. Results: BCVA changed significantly (vs. baseline) at 3 months (+0.11), 9 months (+0.19) and 14 months (+0.16). At the end of the follow-up period, BCVA had improved by >0.1 in the majority of the patients (72.9%), and the mean central retinal thickness had decreased by –44.3% (–211 µm). The retreatment rate was 25%. No increase in intraocular pressure or other adverse event was reported. Conclusions: The pharmacological effects of the drugs, the low-fluence PDT, and the physiological effects of the therapy may have contributed to the sustainability of the therapeutic benefits.