bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural Competence in Health Care and Its Implications for Pharmacy
Authors: O'Connell Mary Beth , Korner Eli J. , Rickles Nathaniel M. , Sias Jeri J. ,   American College of Clinical Pharmacy
Published: June 2007

Pharmacists are caring for more individuals of diverse age, gender, race, ethnicity, socioeconomic status, religion, sexual orientation, and health beliefs than in previous decades. Not all residents of the United States equally experience long life spans and good health. Health disparities in various cultures have been documented. One critical aspect of reducing health disparities is moving health care providers, staff, administrators, and practices toward increased cultural competence and proficiency. Effective delivery of culturally and linguistically appropriate service in cross‐cultural settings is identified as cultural competence. Culture is a dynamic process, with people moving in and out of various cultures throughout their lives. The failure to understand and respect individuals and their cultures could impede pharmaceutical care. Incongruent beliefs and expectations between the patient and pharmacist could lead to misunderstandings, confusion, and ultimately to drug misadventures. Models and frameworks have been developed that provide descriptions of the process by which individuals, practice settings, and organizations can become culturally competent and proficient. This article, the first in a five‐part series, presents an overview of issues related to cultural competence in health care with an emphasis on the pharmacy profession. Also provided are definitions for cultural competence and related terms, a brief overview of health disparities and challenges to the common morality, and a discussion of models and frameworks that describe pathways to cultural competence and proficiency.
Effect of an Aluminum‐ and Magnesium‐Containing Antacid on the Bioavailability of Garenoxacin in Healthy Volunteers
Authors: Krishna Gopal , Kisicki James C. , Olsen Steven , Grasela Dennis M. , Wang Zaiqi
Published: June 2007

Study Objective. To evaluate the effect of an aluminum‐ and magnesium‐containing antacid (Al‐Mg antacid), which contains a high concentration of cations, on the pharmacokinetics of garenoxacin.

Design. Prospective, randomized, open‐label, control‐balanced, residual‐effects—design study.

Setting. Pharmaceutical company—affiliated study clinic.

Subjects. Twenty healthy volunteers who were garenoxacin naïve.

Intervention. Subjects were randomly assigned to receive three of six oral treatments, each separated by a 7‐day washout period: garenoxacin 600 mg administered alone, with concomitant Al‐Mg antacid, 2 or 4 hours before Al‐Mg antacid, or 2 or 4 hours after Al‐Mg antacid. The Al‐Mg antacid dose was 20 ml, which contained aluminum hydroxide 900 mg and magnesium hydroxide 800 mg.

Measurements and Main Results. The pharmacokinetics and safety of garenoxacin were assessed. For each treatment, serial blood samples for pharmacokinetic analysis of garenoxacin were collected before and up to 72 hours after garenoxacin dosing. Absence of effect of Al‐Mg antacid on garenoxacin area under the concentration‐time curve from time zero extrapolated to infinity (AUC0–∞) and maximum observed plasma concentration (Cmax) were concluded if the 90% confidence interval of the adjusted geometric mean ratios with and without the antacid were contained within 0.80–1.25 and 0.70–1.43, respectively. Exposure to garenoxacin measured by AUC0–∞, a parameter well correlated with efficacy, was reduced by 58% when coadministered with Al‐Mg antacid and reduced by 22% and 16% when administered 2 and 4 hours after the antacid, respectively. Administration of garenoxacin 4 hours before Al‐Mg antacid had no effect on AUC0–∞ or Cmax of garenoxacin, whereas administration 2 hours before the antacid resulted in a nonclinically relevant (12%) reduction in AUC0–∞ of garenoxacin.

Conclusion. Exposure to garenoxacin was significantly decreased when garenoxacin was coadministered with Al‐Mg antacid or within 2 hours after the antacid. The magnitude of the changes in garenoxacin exposure suggests that garenoxacin should be administered at least 2 hours before or 4 hours after administration of Al‐Mg antacid or other cation‐containing products.
Dosage and Effectiveness of Intrapleural Doxycycline for Pediatric Postcardiotomy Pleural Effusions
Authors: Hoff David S. , Gremmels David B. , Hall Karen M. , Overman David M. , Moga Francis X.
Published: June 2007

Study Objective. To determine the effectiveness of intrapleural doxycycline for the treatment of postcardiotomy pleural effusions in pediatric patients.

Design. Retrospective case series.

Setting. Intensive care unit in a pediatric tertiary care center.

Patients. Sequential sample of 12 pediatric patients who underwent cardiotomy for congenital heart disease and received doxycycline pleurodesis for persistent pleural effusion that lasted more than 7 days between December 21, 2001, and May 23, 2005.

Measurements and Main Results. Mean age of the patients was 1 year (range 2 wks—2.5 yrs). Eighteen courses of doxycycline were administered among the 12 patients. An average dose of 19.1 mg/kg/dose of parenteral doxycycline was diluted in normal saline to a final syringe concentration of 2–8 mg/ml and injected through a chest tube. The patient was rotated according to a protocol. The doxycycline dose remained in the pleural space for approximately 6 hours before being drained under suction. Treatment success was defined as achievement of 0‐ml/hour chest tube output after a doxycycline dose. The overall treatment success rate was 94% (17 of 18 courses). The mean times from dosing to treatment success and chest tube removal were 76 hours (range <1 to 140 hrs) and 130 hours (range 8–453 hrs), respectively. Seventy‐two percent of the courses (13 of 18) achieved treatment success within 96 hours and chest tube removal within 168 hours after dosing. Doxycycline concentration did not appear to be related to treatment success. Chest pain was the most common adverse effect.

Conclusion. Intrapleural doxycycline infusion is effective for postcardiotomy pleural effusion in pediatric patients with persistent chest tube drainage lasting more than 7 days.
Osteochondral Lesions of the Talus: Results of Repeat Arthroscopic Debridement
Authors: Savva Nicholas , Jabur Majid , Davies Mark , Saxby Terry
Published: June 2007

Background: Repeat arthroscopic debridement of osteochondral lesions of the talus has a poor reputation despite a paucity of evidence in the literature. Methods: We reviewed all patients who had repeat arthroscopic debridement of an osteochondral lesion performed by the senior author. They were scored using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and lesions were graded using the system described by Berndt and Harty. Results: Between 1993 and 2002, 808 consecutive ankle arthroscopies were performed by the senior author, of which 215 were to treat osteochondral lesions of the talus. Of these, 12 had repeat arthroscopies because of unresolved symptoms. AOFAS scores improved from a mean of 34.8 prior to arthroscopy to 80.5 after repeat arthroscopy at a mean followup of 5.9 years (18 months to 11 years). Two patients returned to professional sports after the second procedure. Six patients returned to their preinjury levels of sporting activity and three returned to the same sports but played to a lesser standard or less frequently. One patient had already had a cartilage transplantation procedure. Conclusions: This is the first series specifically assessing patients who have had repeat arthroscopic debridement of osteochondral lesions of the talus, using the same debridement technique by a single surgeon. Our results question the assumption that repeat arthroscopic debridement yields poor results. They also provide a baseline for the newer chondral and osteochondral transplantation techniques to compare to at the medium term.
Heel Overload Associated with Heel Cord Insufficiency
Authors: Chilvers Margaret , Malicky Eric S. , Anderson John G. , Bohay Donald R. , Manoli II Arthur
Published: June 2007

Background: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. Methods: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. Results: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. Conclusions: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.
Arthroscopic Ankle Arthrodesis
Authors: Gougoulias Nikolaos E. , Agathangelidis Filon G. , Parsons Stephen W.
Published: June 2007

Background: Arthroscopic arthrodesis has been used mainly for in situ fusion of arthritic ankles without deformity. This paper presents the application of arthroscopic arthrodesis of ankles with marked deformity. Methods: The results of 78 consecutive cases of arthroscopic ankle arthrodeses, performed in 74 patients, were retrospectively evaluated. Forty-eight ankles had minor deformity (group A), whereas 30 ankles had a varus or valgus deformity of more than 15 degrees (maximum 45 degrees) (group B). The average hospital stay was 3.8 and 3.4 days in groups A and B, respectively ( p = 0.74). Postoperative treatment included ankle immobilization for 3 months. Progressive weightbearing was initiated at 2 weeks. Mean followup was 21.1 months. Results: Fusion occurred in 47 of 48 (97.9%) ankles in group A at an average time of 13.1 ± 5.8 weeks and in 29 of 30 (96.7%) ankles at 11.6 ± 2.4 weeks in group B ( p = 0.19). Unplanned operative procedures were required in 11 ankles (14.1%). One superficial wound infection occurred. Symptomatic arthritis from the adjacent joints developed in six ankles (7.7%). Postoperative ankle alignment in the frontal plane averaged 0.7 and 0.4 degrees of valgus ( p = 0.41), whereas the sagittal plane angle averaged 106 ± 4 degrees and 104.5 ± 7 degrees in groups A and B, respectively ( p = 0.22). The outcome was graded as very good in 79.2% (38 feet) in group A and 80% (24 feet) in group B, fair in 18.8% (9 feet) in group A and 16.7% (5 feet) in group B and poor in one ankle in each group ( p = 0.68). Conclusions: The arthroscopic technique offered high fusion rates and low morbidity. Deformity correction was achieved with good results.
Incidence and Morphologic Characteristics of Benign Calcaneal Cystic Lesions on MRI
Authors: Elias Ilan , Zoga Adam C. , Raikin Steven M. , Schweitzer Mark E. , Morrison William B.
Published: June 2007

Background: Since we have frequently noted osseous cyst-like lesions within the calcaneus on MRI studies, we sought to systematically evaluate this finding to determine the incidence and morphologic characteristics on MRI. Methods: Three observers blinded to age evaluated 198 MRIs of the ankle (74 males, 124 females; mean age 47 years, range 13 to 99 years), recording the presence and size of calcaneal cyst-like foci. Statistical analysis was performed to determine if there was an association with age. Additionally, MRI of 12 ankles precontrast and postcontrast were reviewed for the presence of blood vessels in the calcaneus corresponding to the location of the cyst-like lesions and 24 ankle MR arthrograms were reviewed to evaluate communication of the cyst with the adjacent joint. Results: Of the 198 ankle MRI examinations, 81 (40%) had hyperintense foci, all within the mid-calcaneal body. The size ranged from 0.01 cm 2 to 2.47 cm 2 , with a mean size of 0.36 cm 2 (± 0.45 cm 2 ). Thirty-seven (46%) were linear or elongated, whereas 44 (54%) were ovoid or round. Seven of the 81 foci (8.6% or 3.5% of the total population) were 1 cm 2 or larger. There was no significant association of patient age and presence ( p = 0.49) or size ( p = 0.48) of the focus. Location of the cyst-like foci, which often are ovoid or linear, corresponds to penetrating microvessels on precontrast and postcontrast MRI. One MR arthrogram showed communication of a cyst-like focus and the subtalar joint. Conclusions: Calcaneal lesions are relatively common incidental findings on MRI. These lesions appear to represent intraosseous ganglion cysts that arise from the anterior margin of the posterior facet of the subtalar joint in the anatomical neighborhood where vessels penetrate the superior calcaneal cortex. The lesions can vary is size; however, there is no correlation between patient age and lesion size and no significant association between age and presence of these foci.
Milking Drylands: The Marketing of Camel Milk in North-East Somalia
Authors: Nori Michele , Kenyanjui Matthew B. , Yusuf Mohammed Ahmed , Mohammed Fadhumo Hussein
Published: June 2007

Increasing market integration appears to be an unavoidable process for most pastoral societies. Raising substitution rates between direct utilisation of animal products and consumption of cereals exchanged through markets is the most important reason for consistent population growth on rangelands (Helland 2000). To some extent, market exchanges are therefore a determinant of pastoral livelihoods, especially during the dry season when internal food production does not always satisfy households' energy requirements. While offering potential for development, market integration of pastoral economies also presents critical risk factors. Increasing interdependence on regional and global political and economic environments compound pastoral vulnerability to climatic extremes. The Milking Drylands research initiative1 addresses these issues in one particular area of the world, Somalia. In this paper, mechanisms regulating the marketing of camel milk in north-eastern Somalia (Region of Puntland) are analysed in order to provide relevant insights into a society that continues to experience a lack of central government and institutional capacities. Our preliminary research findings provide some indications that pastoral dairy marketing serves a number of economic as well as social functions, through the exchange of a number of commodities, non-commodity services and information, which aims to satisfy the needs of both pastoral and urban communities.
Landscape attributes affecting patch occupancy by howler monkeys (Alouatta palliata mexicana) at Los Tuxtlas, Mexico
Authors: Arroyo‐Rodríguez Víctor , Mandujano Salvador , Benítez‐Malvido Julieta
Published: June 2007

Understanding how forest cover is related to patch attributes such as size, shape, and isolation, and how this influences the occurrence of a species in fragmented landscapes is an important question in landscape ecology and conservation biology. To study the effects of fragmentation on patch occupancy by the critically endangered Mexican mantled howler monkey (Alouatta palliata mexicana) in the Los Tuxtlas region of Mexico, we selected three landscapes of ca. 5,000 ha, which differed in their remaining forest cover (24, 11, and 4%). For each landscape, we related patch occupancy to forest cover, patch size and shape, and four isolation parameters. Landscape attributes varied according to forest cover, and the percentage of occupation was greater in landscapes with more forest cover. The attributes affecting the probability of occupancy differed among landscapes. Occupancy was positively related to patch size in all landscapes, but in the northernmost landscape, shape irregularity had a negative effect on occupancy, whereas in the southernmost landscape, occupancy was favored by greater distances to the nearest village. The results show that not only the total amount of forest cover but also patch configuration need to be taken into consideration when designing management strategies for the conservation of the Mexican mantled howler monkey. Am. J. Primatol. 70:69–77, 2008. © 2007 Wiley‐Liss, Inc.
Synthesis, spectral, thermal, DNA interaction and antimicrobial properties of novel Cu(II) heterochelates
Authors: Pansuriya Pramod B. , Patel Mohan N.
Published: June 2007

Novel dimeric Cu(II) heterochelates were synthesized using 1‐cyclopropyl‐6‐fluoro‐4‐oxo‐7‐piperazin‐1‐yl‐1,4‐dihydro‐quinoline‐3‐carboxylic acid (Cpf) and eight different neutral bidentate ligands. All ligands were characterized by elemental analyses, melting point and IR, 1H NMR and 13C NMR spectra, while heterochelates were characterized by elemental analyses, IR spectra, reflectance spectra, magnetic measurements and thermogravimetric analyses. The DNA interaction and cleavage behaviors of the ligands and corresponding heterochelates were studied by UV–vis absorption titration and gel electrophoresis technique, respectively. The results indicate that heterochelates show larger DNA interaction and cleavage affinity than the ligands. The antimicrobial activities of heterochelates, ligands, cupric nitrate and standard drugs against six bacteria and three fungi were tested. Copyright © 2007 John Wiley & Sons, Ltd.
Highly efficient N‐Heterocyclic carbene–palladium complex‐catalyzed multicomponent carbonylative Suzuki reaction: novel practical synthesis of unsymmetric aryl ketones
Authors: Zheng ShuZhan , Xu LiWen , Xia ChunGu
Published: June 2007

Highly efficient and chemoselective N‐heterocyclic carbene palladium complexes‐catalyzed multicomponent carbonyltive Suzuki reaction with sodium tetraphenylborate used as phenylating reagent has been demonstrated in this article. Both electron‐rich and electron‐deficient aryl iodides gave unsymmetric aryl ketones in excellent yields. Copyright © 2007 John Wiley & Sons, Ltd.
Immunogenicity of candidate DNA vaccine based on subtype A of human immunodeficiency virus type 1 predominant in Russia
Authors: Murashev Boris , Kazennova Elena , Kozlov Alexander , Murasheva Irina , Dukhovlinova Elena , Galachyants Yuri , Dorofeeva Ekaterina , Dukhovlinov Ilya , Smirnova Galina , Masharsky Alexey , Klimov Nikolay , Kozlov Andrei P.
Published: June 2007

Human immunodeficiency virus (HIV)‐1 subtype A strains circulating among the majority of HIVinfected individuals in the former Soviet Union (FSU) countries demonstrate low genetic diversity. The consensus sequence of the FSU region‐specific isolate has been used for the candidate DNA vaccine development. We constructed recombinant plasmids with four viral genes: env (gp140), gag, pol (reverse transcriptase), and nef. We immunized BALB/c mice intramuscularly using equimolar mixture of four recombinant plasmids, and observed significant cytotoxic T lymphocyte response and specific CD8+ cell production against cells presenting HIV‐1 peptides. Overall, the Th1 pathway of immune response clearly dominated. Immunological properties of this candidate DNA vaccine against HIV‐1 suggest the possibility of its further study in clinical trials.
Culture of transgenic Drosophila melanogaster Schneider 2 cells in serum‐free media based on TC100 basal medium
Authors: Galesi Adriana L. L. , Pereira Carlos A. , Moraes Ângela M.
Published: June 2007

Requirements of eliminating animal proteins from cell culture have intensified in recent years, with the pressure of regulatory agencies related to biopharmaceuticals production. In this work, the substitution of fetal bovine serum by yeastolate and a soy hydrolysate (Hy Soy) for the culture of Drosophila melanogaster Schneider 2 cells transfected for the production of rabies virus G glycoprotein was evaluated. TC100 supplemented with glucose, glutamine, lipid emulsion and Pluronic F68 was employed as basal medium. Results show that yeastolate was more efficient on cell growth stimulation than Hy Soy. Cells adapted in medium formulation supplemented with 3 g/L yeastolate, 1% lipid emulsion, 10 g/L glucose, 3.5 g/L glutamine and 0.1% Pluronic F68 attained a maximum concentration of 10.7 × 106 cells/mL, with the expression of 9.4 ng/mL G glycoprotein.
Second axillary sentinel node biopsy for ipsilateral breast tumour recurrence
Authors: Intra M , Trifirò G , Galimberti V , Gentilini O , Rotmensz N , Veronesi P
Published: June 2007

Background

Sentinel lymph node biopsy (SLNB) is the standard procedure for axillary staging in patients with primary operable breast cancer and uninvolved axillary nodes. These patients increasingly have breast-conserving surgery (BCS), and 5 to 10 per cent develop ipsilateral breast tumour recurrence during follow-up. If axillary nodes remain clinically uninvolved after a previous negative SLNB the question remains whether second SLNB is a suitable option.

Methods

Between January 2000 and October 2006, 202 patients who had previously had BCS and a negative SLNB developed an ipsilateral breast tumour recurrence. Of these, 65 women with clinically negative axillary nodes were offered a second SLNB; 57 had received adjuvant radiotherapy after BCS.

Results

In 63 women, preoperative lymphoscintigraphy showed an axillary sentinel node (identification rate 97 per cent). In five, this was associated with extra-axillary migration. Sentinel node metastases were detected in seven women; in two this was the only metastasis. At a median follow-up of 45·9 months, no axillary recurrence had occurred in the women who had not had axillary dissection.

Conclusion

Second SLNB after previous BCS and negative SLNB plus adjuvant radiotherapy may be offered to selected women with ipsilateral breast tumour recurrence.
Prognostic nomogram for patients undergoing oesophagectomy for adenocarcinoma of the oesophagus or gastro-oesophageal junction
Authors: Lagarde S M , Reitsma J B , de Castro S M M , ten Kate F J W , Busch O R C , van Lanschot J J B
Published: June 2007

Background

Tumour node metastasis (TNM) staging predicts survival on the basis of the pathological extent of a tumour. The aim of this study was to develop a prognostic model with improved survival prediction after oesophagectomy.

Methods

Consecutive patients who had potentially curative oesophagectomy for adenocarcinoma of the oesophagus or gastro-oesophageal junction were included. Cox regression analyses were performed to examine the association between risk factors and time to death from oesophageal cancer. The concordance index, calculated after bootstrapping, was used to measure accuracy. A nomogram was designed for use in clinical practice.

Results

Oesophageal cancer-specific survival rates for the 364 included patients who underwent oesophagectomy between 1993 and 2003 were 75·8, 54·9 and 39·2 per cent at 1, 2 and 5 years respectively. A prognostic model using all prognostic variables outperformed TNM staging (concordance index 0·79 versus 0·68 respectively; P < 0·001). A reduced model derived after backward elimination, containing only T stage, lymph node ratio and extracapsular lymph node involvement, also outperformed TNM staging (concordance index 0·77; P < 0·001).

Conclusion

A prognostic model developed to predict disease-specific survival after oesophagectomy was superior to TNM staging. More reliable prognostic information might lead to different approaches to patient follow-up.
Enucleation of pancreatic neoplasms
Authors: Crippa S , Bassi C , Salvia R , Falconi M , Butturini G , Pederzoli P
Published: June 2007

Background

Standard resections for benign and borderline neoplasms of the pancreas are associated with a significant risk of long-term functional impairment, whereas enucleation preserves healthy parenchyma and pancreatic function. The aim of this study was to evaluate postoperative and long-term oncological and functional results after pancreatic enucleation.

Methods

Data collected prospectively from 61 consecutive patients who underwent pancreatic enucleation were analysed.

Results

There were no deaths. A clinically significant pancreatic fistula was reported in 14 patients (23 per cent), and five patients (8 per cent) had a further operation for fistula-related complications. The most common indication for surgery was endocrine neoplasm (38 patients; 62 per cent) and two patients (3 per cent) had a final histopathological diagnosis of malignant neoplasm. At a median follow-up of 61 months no patient had developed tumour recurrence or exocrine insufficiency. Two elderly patients developed non-insulin-dependent diabetes.

Conclusion

Enucleation is an effective procedure for the radical treatment of benign and borderline neoplasms of the pancreas, with good long-term outcomes.
Signal suppression/enhancement in HPLC‐ESI‐MS/MS from concomitant medications
Authors: Leverence Rachael , Avery Michael J. , Kavetskaia Olga , Bi Honggang , Hop Cornelis E. C. A. , Gusev Arkady I.
Published: June 2007

This paper presents a study of the signal suppression and enhancement effects in assays based on HPLC‐ESI‐MS/MS detection. The major focus was to investigate the effect of signal suppression/enhancement of typical co‐administered (concomitant) medications, i.e. naproxen and ibuprofen. The results demonstrate that the analyte and internal standard can experience signal enhancement up to a factor of ca 2.9 if the test analyte or internal standard co‐elute with concomitant. Experimental results also demonstrate that the analyte and internal standard signal increased by a factor of ca 2.0 in the negative ion mode at physiological relevant levels of naproxen (100 µg/mL) and by a factor of ca 1.6 in the negative ion mode at physiological relevant level of ibuprofen (10 µg/mL) in both neat and plasma samples. Signal enhancement significantly increased when concomitant medications ionized in the same ion mode as the analyte and internal standard. To overcome signal enhancement or potential suppression from concomitant medications, a comprehensive HPLC method needs to be developed with sufficient separation of concomitant medication from the analyte and internal standard. Other means to reduce signal enhancement or potential suppression include switching ionization polarity and performing comprehensive sample clean‐up to remove concomitant medications before analysis. Copyright © 2007 John Wiley & Sons, Ltd.
Simultaneous determination of 17 antiretroviral drugs in human plasma for quantitative analysis with liquid chromatography–tandem mass spectrometry
Authors: Jung Byung Hwa , Rezk Naser L. , Bridges Arlene S. , Corbett Amanda H. , Kashuba Angela D. M.
Published: June 2007

This work describes a sensitive method for the simultaneous determination of 17 antiretroviral drugs including nucleoside analog reverse transcriptase inhibitors, non‐nucleoside analog reverse transcriptase inhibitors, protease inhibitors and a nucleotide analog reverse transcriptase inhibitor in 50 µL of human plasma. This method employed high‐performance liquid chromatography–tandem mass spectrometry with electrospray ionization. The analytes were monitored in multiple reaction monitoring mode and the polarity was switched from positive to negative to positive to detect all compounds after a single injection. A combination of liquid–liquid extraction and protein precipitation was used to extract all compounds, with at least 75% recovery for all analytes. Within‐ and between‐day accuracies were at least 85% for 1–500 ng/mL for nelfinavir, indinavir and abacavir, 10–500 ng/mL for didanosine and stavudine and 5–500 ng/mL for all other compounds. This method is very effective for quantifying and screening antiretroviral drugs in clinical samples with limited (50 µL) volumes. Copyright © 2007 John Wiley & Sons, Ltd.
Capillary electrophoresis of signaling molecules
Authors: Suresh Babu C. V. , Song Eun Joo , Babar Sheikh Md. Enayetul , Yoo Young Sook
Published: June 2007

The emerging field of quantitative systems biology uses high‐throughput bioanalytical measurements to gain a deeper understanding of biological phenomena. With the advent of instrumentation platforms, capillary electrophoresis spans a very wide range of biological applications. This short article focuses on the exploitation of capillary electrophoresis for the systems‐level analysis of cell signaling molecules. Copyright © 2007 John Wiley & Sons, Ltd.
Liquid chromatography–tandem mass spectrometry method for identification and quantification of two biologically active polyisoprenylated benzophenones, isoxanthochymol and camboginol, in Garcinia species
Authors: Chattopadhyay Sunil K. , Kumar Satyanshu
Published: June 2007

A sensitive liquid chromatography/electrospray ionization tandem mass spectrometrical (LC/ESI‐MS/MS) method was developed for simultaneous identification and quantification of two polyisoprenylated benzophenones, isoxanthochymol and camboginol, in the extracts of the fruit rinds, stem bark, seed and leaves of Garcinia indica and in the fruit rinds of Garcinia cambogia. The separation of isoxanthochymol and camboginol was achieved on an RP‐8 column using the solvent system consisting of a mixture of acetonitrile–water (80:20) and methanol–acetic acid (99.0:1.0) as a mobile phase in a gradient elution mode. A multiple reaction monitoring (MRM) method was developed for quantification of isoxanthochymol and camboginol in the above extracts of Garcinia species. Based on a signal‐to‐noise ratio of 3, the limits of detection in MRM mode for isoxanthochymol and camboginol were 2.0 and 5.0 ng/mL respectively. The method was validated in terms of linearity, accuracy and precision for 6 days. The method developed was found to be useful for identification and quantification of isoxanthochymol and camboginol in the extracts of the fruit rinds, stem bark, seed and leaves of Garcinia indica and in the fruit rinds of Garcinia cambogia. Copyright © 2007 John Wiley & Sons, Ltd.
Fibularis tertius: Revisiting the anatomy
Authors: Rourke K. , Dafydd H. , Parkin I.G.
Published: June 2007

Fibularis tertius (FT) may be used during reconstructive surgery and muscle transposition with retention of function. The muscle was examined in both lower limbs of 41 cadavers. Measurements were made of muscle belly length and width, tendon length and width, and the size of the origin on the fibula. Tendon insertion, nerve and blood supplies were also examined. FT was absent in five (6.1%) lower limbs of three (7.3%) subjects. The size of its origin demonstrated inter‐ and intra‐individual variation. FT arose from the distal fibula and on average occupied (28.4 ± 9.1)% (mean ± S. D.) of the total shaft length. In all cases the tendon inserted into the dorsal surface of the shafts of both the fourth and fifth metatarsals. A small nerve branch consistently arose from the deep fibular nerve near the origin of extensor digitorum longus. The nerve ran parallel to the length of this muscle, between it and extensor hallucis longus, before piercing FT. Anatomy textbooks describe FT as inserting into the fifth metatarsal only. This study, supported by data from previous reports, suggests that the “textbook” accounts of FT should be updated to record that most commonly its tendon reaches both the fourth and fifth metatarsals. Clin. Anat. 20:946–949, 2007. © 2007 Wiley‐Liss, Inc.
Assessing macroscopic and microscopic indicators of osteoarthritis in the distal interphalangeal joints: A cadaveric study
Authors: Bentley Brian S. , Hill Robert V.
Published: June 2007

Osteoarthritis is manifested both by macroscopically visible lesions and by specific histological indicators. Although traditional views of the disease process invoke physical abrasion of joint surfaces, recent studies indicate that tissue‐level changes may precede grossly visible lesions of articular cartilage. This study investigates the association between gross and histological indicators of osteoarthritis at the manual interphalangeal joints, and examines a sequence of events that may lead to the onset of cartilage degeneration. Interphalangeal joints from the hands of nine cadavers were dissected, of which 52 joints were collected and further evaluated. Gross degradation of the proximal articular surface was graded on a scale of 0–3 (with 0 representing normal cartilage with no visible lesions). Osteoarthritic lesions were found in 86% of specimens and showed no preferential occurrence between males and females or right and left hands. Histological analysis indicated that known microscopic indicators of osteoarthritis always occur in Grade 1–3 specimens, but can also be recognized in some macroscopically normal specimens. Many macroscopically normal specimens exhibited chondrocyte clustering (28.6%) and/or tide mark irregularities (57%), indicating that these features are most likely the earliest to develop in the progression of osteoarthritis. It is possible that the initiating etiology is thickening of the subchondral bone, but this was not directly observed. Results indicate significant thinning of the cartilage as macroscopic degradation progresses. Our study supports, with slight modification, a previously proposed cascade of histological changes that may ultimately lead to the physical destruction of articular cartilage. Clin. Anat. 20:799–807, 2007. © 2007 Wiley‐Liss, Inc.
A descriptive tissue evaluation at maxillary interradicular sites: Implications for orthodontic mini‐implant placement
Authors: Lim Won Hee , Lee Soo Kyung , Wikesjö Ulf Me , Chun Youn Sic
Published: June 2007

Few studies have evaluated interradicular anatomy for hard and soft tissue thickness. Because interradicular sites are common regions for mini‐implant placement for orthodontic anchorage, the purpose of this study was to provide a guideline to indicate the best location for mini‐implants as it relates to the thickness of cortical bone and soft tissue, and to the height of the attached gingival field. CT images from 15 men and 15 women (mean age 27 years, range 23–35 years) were used to evaluate the buccal interradicular cortical bone thickness from and mesial to the central incisor to the 1st molar. To record soft tissue depth at the site of assessment for cortical bone thickness, the mucosa was pierced with a #15 endodontic K‐file until the attached rubber stop rested on the mucosa. The height of attached gingiva was measured at the mid‐aspect of each tooth using a caliper. There were no significant differences in cortical bone thickness within interradicular sites except for the 2nd premolar/1st molar site. There were also no significant differences in soft tissue thickness within interradicular sites except for the lateral incisor/canine and 2nd premolar/1st molar sites. The height of attached gingiva was greater in the anterior compared to the posterior region and was shortest in the premolar region. Given the limits of this study, mini‐implants for orthodontic anchorage may be well placed with equivalent bone‐implant contact anywhere within the zone of attached gingiva up to 6 mm apical to the alveolar crest with adequate interradicular space. Clin. Anat. 20:760–765, 2007. © 2007 Wiley‐Liss, Inc.
Superficial palmar communications between the ulnar and median nerves in Turkish cadavers
Authors: Tagil Süleyman Murat , Bozkurt Mehmet Cem , Özçakar Levent , Ersoy Mehmet , Tekdemi̇r İbrahim , Elhan Alaittin
Published: June 2007

The superficial palmar communicating branch between the ulnar and median nerves, the ramus communicans (RC), has been investigated by anatomical dissections in 30 hands of 15 cadavers in the Turkish population. A communicating branch between the ulnar and median nerves was found in 18 hands (60%). It was classified into 4 types: Type 1–RC emerging from the ulnar 4th common digital nerve (CDN) and uniting with the median 3rd CDN, Type 2–RC emerging from the median 3rd CDN and uniting with the ulnar 4th CDN, Type 3–RC extending horizontally between the 3rd and 4th CDN, Type 4–a plexiform RC formed by multiple twigs. Twelve hands (40%) showed the Type 1 arrangement, one was Type 2 (3.3%), two were Type 3 (6.7%) and three (10%) were Type 4, based on the classification devised by Meals and Shaner ([;1983] J Hand Surg Am 8:411–414) and modified by Bas and Kleinert ([1999] J Hand Surg Am 24:1171–1184). Knowledge of the anatomical characteristics of this branch is important for surgical interventions, especially in carpal tunnel release operations. Clin. Anat. 20:795–798, 2007. © 2007 Wiley‐Liss, Inc.
Structural Ramification for Acetyl‐Lysine Recognition by the Bromodomain of Human BRG1 Protein, a Central ATPase of the SWI/SNF Remodeling Complex
Authors: Singh Mahavir , Popowicz Grzegorz M. , Krajewski Marcin , Holak Tad A.
Published: June 2007

Bromodomains represent an extensive family of evolutionarily conserved domains that are found in many chromatin‐associated proteins such as histone acetyltransferases (HAT) and subunits of ATP‐dependent chromatin‐remodeling complexes. These domains are associated with acetylated lysine residues that bind both in vivo and in vitro; for example, they bind to the N‐acetylated lysines of the histone tail of nucleosomes. In this report, we determined the structure of the bromodomain from human brahma‐related gene 1 (BRG1) protein, a subunit of an ATP‐dependent switching/sucrose nonfermenting (SWI/SNF) remodeling complex, and have also characterized its in vitro interaction with N‐acetylated lysine peptides from histones. In addition to a typical all‐α‐helical fold that was observed in the bromodomains, we observed for the first time a small β‐sheet in the ZA loop region of the BRG1 protein. The BRG1 bromodomain exhibited binding, albeit weak, to acetylated peptides that were derived from histones H3 and H4. We have compared the acetyl‐lysine binding sites of BRG1 bromodomain with the yGCN5 (general control of amino acid biosynthesis). By modeling the acetylated‐lysine peptide into the BRG1 bromodomain structure, we were able to explain the weak binding of acetylated‐lysine peptides to this bromodomain.
Mutational Analysis of the Myxovirescin Biosynthetic Gene Cluster Reveals Novel Insights into the Functional Elaboration of Polyketide Backbones
Authors: Simunovic Vesna , Müller Rolf
Published: June 2007

It has been proposed that two acyl carrier proteins (ACPs)—TaB and TaE—and two 3‐hydroxy‐3‐methylglutaryl synthases (HMGSs)—TaC and TaF—could constitute two functional ACP‐HMGS pairs (TaB/TaC and TaE/TaF) responsible for the incorporation of acetate and propionate units into the myxovirescin A scaffold, leading to the formation of β‐methyl and β‐ethyl groups, respectively. It has been suggested that three more proteins—TaX and TaY, which are members of the superfamily of enoyl‐CoA hydratases (ECHs), and a variant ketosynthase (KS) TaK—are shared between two ACP‐HMGS pairs, to give the complete set of enzymes required to perform the β‐alkylations. The β‐methyl branch is presumably further hydroxylated (by TaH) and methylated to produce the methoxymethyl group observed in myxovirescin A. To substantiate this hypothesis, a series of gene‐deletion mutants were created, and the effects of these mutations on myxovirescin production were examined. As predicted, ΔtaB and ΔtaE ACP mutants revealed similar phenotypes to their associated HMGS mutants ΔtaC and ΔtaF, respectively, thus providing direct evidence for the role of TaE/TaF in the formation of the β‐ethyl branch and implying a role for TaB/TaC in the formation of the β‐methyl group. Production of myxovirescin A was dramatically reduced in a ΔtaK mutant and abolished in both the ΔtaX and the ΔtaY mutant backgrounds. Analysis of a ΔtaH mutant confirmed the role of the cytochrome P450 TaH in hydroxylation of the β‐methyl group. Taken together, these experiments support a model in which the discrete ACPs TaB and TaE are compatible only with their associated HMGSs TaC and TaF, respectively, and function in a substrate‐specific manner. Both TaB and TaC are essential for myxovirescin production, and the TaB/TaC pair can rescue antibiotic production in the absence of either TaE or TaF. Finally, the reduced level of myxovirescin production in the ΔtaE mutant, relative to the ΔtaF strain, suggests an additional function of the TaE ACP.
Export aspiration system in patients with acute coronary syndrome and visible thrombus provides no substantial benefit
Authors: v. Korn Hubertus , Ohlow Marc , Donev Stoycho , Yu Jiangtao , Huegl Burkhard , Wagner Andreas , Lauer Bernward
Published: June 2007

Objective:

A visible thrombus remains a risk factor during percutaneous coronary intervention (PCI).

Methods:

Between October 2004 and March 2005, we treated all patients who consecutively presented with acute coronary syndrome + angiographically visible thrombus using the Export Aspiration System (group 1, n = 79). We retrospectively analyzed all consecutive patients who had been treated without a thrombectomy device (group 2, n = 79).

Results:

Final TIMI flow 3 or myocardial blush grade (MBG) 3 after completing PCI in group 1 and 2 was seen in 54 patients (68.4%) versus 57 patients (72.2%, P = 0.6) and in 45 patients (57.0%) versus 44 patients (55.7%, P = 0.9), respectively. Final TIMI flow 0 or MBG 0 in group 1 and 2 was observed in eight patients (10.1%) versus four patients (5.1%, P = 0.23) and in 24 patients (30.4%) versus 16 patients (20.3%, P = 0.15), respectively.

Histologic evaluation:

Histologic evaluation revealed mostly mixed thrombotic material (83.6%). Microscopic material was seen in 91.8% of cases.

MACE:

Total MACE rate during hospital stay was 11.4% in both groups.

Conclusion:

Using the Export Aspiration System in patients presenting with acute coronary syndrome + visible thrombus provides no substantial benefit. © 2007 Wiley‐Liss, Inc.
Imaging of vulnerable coronary artery plaques
Authors: Hamdan Ashraf , Assali Abid , Fuchs Shmuel , Battler Alexander , Kornowski Ran
Published: June 2007

Advances in the identification of vulnerable plaque can be an important step in preventing myocardial infarction and sudden cardiac death. The recognition that non‐flow‐limiting plaques often produce cardiac events has led to the development of invasive and non‐invasive methods to identify such plaques prospectively. This review will present the use of noninvasive imaging modalities for identifying vulnerable plaque such as computed tomography and magnetic resonance imaging. We will also review the different invasive modalities such as intravascular magnetic resonance imaging, intravascular ultrasound, coronary angioscopy, coronary thermography, optical coherence tomography, near‐infrared spectroscopy, and palpography. © 2007 Wiley‐Liss, Inc.
Modified T‐stenting with intentional protrusion of the side‐branch stent within the main vessel stent to ensure ostial coverage and facilitate final kissing balloon: The T‐stenting and small protrusion technique (TAP‐stenting). Report of bench testing and first clinical Italian‐Korean two‐centre experience
Authors: Burzotta Francesco , Gwon Hyeon‐Cheol , Hahn Joo‐Yong , Romagnoli Enrico , Choi Jin‐Ho , Trani Carlo , Colombo Antonio
Published: June 2007

Objectives:

To describe a novel modification of the T‐stenting technique and to report the bench test as well as the first clinical results obtained.

Background:

The best technique to treat bifurcated coronary lesions has not been defined.

Methods:

This novel modification of the T‐stenting technique is based, after stenting of the main vessel (MV) and kissing balloon, on the intentional minimal protrusion of the side‐branch (SB) stent within the MV. Final kissing balloon is performed using the balloon kept uninflated into the MV before SB stenting. The technique was tested in vitro and applied in two independent series of patients undergoing elective drug‐eluting stent implantation on one bifurcated lesion. Bifurcated lesions were classified according to the Medina classification. Patients' outcome up to 9 month was prospectively assessed.

Results:

The bench test showed perfect coverage of the bifurcation with minimal stent's struts overlap at the proximal part of SB ostium and a small, single layer stent struts, neo‐carina not affecting the MV patency. Seventy‐three complex patients (67% of Medina 1,1,1 lesions; 44% of unprotected distal left main lesions) were treated with sirolimus‐, paclitaxel‐, or zotarolimus‐eluting stents using the TAP technique. Procedural success was achieved in all cases and the clinical outcome up to 9 month was characterized by a low rate of clinically‐driven target vessel revascularization (6.8%).

Conclusions:

The TAP‐stenting is a modification of the T‐stenting technique which allows full coverage of bifurcated lesions and facilitates final kissing balloon. The first clinical experience suggests that this technique may be practical, thus calling for further evaluations of the technique. © 2007 Wiley‐Liss, Inc.
Let's call it “color‐gamut rendering”
Authors: Berns Roy S.
Published: June 2007

The term “color gamut” historically has been associated with color output such as optimal color stimuli and additive and subtractive imaging systems. Recently, this term has been used with input devices such as scanners and digital cameras. It is proposed that the term “color‐gamut rendering” should be used instead of input devices. This clarifies the distinction between input (analysis) and output (synthesis) color systems in terms of the effect of an input system on defining the colorimetric properties of an output system. © 2007 Wiley Periodicals, Inc. Col Res Appl, 32, 334–335, 2007
A shade guide model based on the color distribution of natural teeth
Authors: Cho Byeong‐Hoon , Lee Yong‐Keun
Published: June 2007

The objectives were to determine the color distribution of natural teeth sorted by the parameters of Value, Chroma, and hue angle measured with a colorimeter, and to suggest a shade guide model. The color of maxillary and mandibular 12 anterior teeth was measured with a tristimulus colorimeter for 47 subjects (n = 564). The color of teeth was grouped initially by Value (CIE L*) by the interval of 3.3 units. After then, within each main group, the color of teeth was subgrouped by Chroma by the interval of 3.3 units. Chroma was calculated as C*ab = (a*2 + b*2)1/2. Since the hue angles were in the first or fourth quadrant, subgroups were further sorted by the first or fourth quadrant hue angles. Hue angle was calculated as h° = arctan (b*/a*). Mean color difference (ΔE*ab) between the color of an individual tooth and the mean color of each main group was 2.5–3.3, which was lower than acceptable limit (ΔE*ab < 3.3), and that in each subgroup was 0.9–3.1. The number of subgroups was 22, which was comparable to those of conventional shade guides. A shade guide model based on the color distribution of natural teeth sorted by Value in six main groups, three or four subgroups within each main group sorted by Chroma, and further sorted by hue angle (first or fourth quadrant values) was suggested. © 2007 Wiley Periodicals, Inc. Col Res Appl, 32, 278–283, 2007
Accurate display gamma functions based on human observation
Authors: Neumann Attila , Artusi Alessandro , Neumann László , Zotti Georg , Purgathofer Werner
Published: June 2007

This article describes an accurate method to obtain the tone reproduction curve of display devices without using a measurement device. It is an improvement of an existing technique based on human observation, solving its problem of numerical instability and resulting in functions in log—log scale which correspond better to the nature of display devices. We demonstrate the efficiency of our technique on different monitor technologies, comparing it with direct measurements using a spectrophotometer. © 2007 Wiley Periodicals, Inc. Col Res Appl, 32, 310–319, 2007