bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual presentation of eosinophilic fasciitis: two case reports and a review of the literature
Authors: Danis Ramazan , Akbulut Sami , Altintas Abdullah , Ozmen Sehmus , Ozmen Cihan Akgul
Published: February 2010

Introduction

Eosinophilic fasciitis is an uncommon disorder with unknown etiology and a poorly understood pathogenesis. We present the cases of two patients with eosinophilic fasciitis with unusual presentation, and describe the clinical characteristics and laboratory findings related to them.

Case presentation

The first case involves a 29-year-old Turkish man admitted with pain, edema and induration of his right-upper and left-lower limbs. Unilateral edema and stiffness with prominent pretibial edema was noted upon physical examination. A high eosinophil count was found on the peripheral smear. The second case involves a 63-year-old Turkish man who had pain, edema, erythema, and itching on his upper and lower extremities, which developed after strenuous physical activity. He had cervical lymphadenopathy and polyarthritis upon physical examination, and rheumatoid factor and antinuclear antibody upon laboratory examination.

Conclusion

Eosinophilic fasciitis can present with various symptoms. When patients exhibit eosinophilia, arthralgia and myalgia, eosinophilic fasciitis should be considered as a possible diagnosis.
Acute myocardial infarction as the first presentation of thyrotoxicosis in a 31-year old woman - case report
Authors: Lewandowski Krzysztof C , Rechciński Tomasz , Krzemińska-Pakuła Maria , Lewiński Andrzej
Published: February 2010

A 31-year old woman, previously fit & well was admitted with pressing retrosternal chest pain and palpitations of sudden onset. Her body weight was normal (BMI 20.5 kg/m2) and there was no significant family history of cardiac disease. She smoked, however, about 15 cigarettes a day and she had been taking combined oral contraceptive pill (Cilest®) for about three years. On admission she appeared sweaty and in pain, blood pressure 130/70 mmHg, heart rate about 110/min, mild lid-lag sign. Heart sounds were normal and chest was clear. ECG revealed 2-3 mm ST segment elevations in II, III, aVF as well as V2 to V5. Troponin I was raised and she was qualified to an emergency coronary angiography. This revealed a massive spasm of left anterior descending (LAD) coronary artery that responded to intracoronary glyceryl trinitrite administration, however, with the presence of critical narrowing of the LAD apical segment with possible superimposed thrombus. Cardiac ultrasound revealed akinesis of 1/2 of apical area consistent with myocardial infarction

Treatment and progress

She was started on Aspirin, Simvastatin, and Diltiazem, but continued to have persistent tachycardia and tremor. Thyroid function tests were ordered and showed thyrotoxicosis [free T4-46.9 pmol/l (ref. range 9-25), free T3-11.9 pmol/l (2-5), TSH - 0.02 mIU/l (0.27-4.2)]. She was referred for an endocrine opinion and started on Thiamazole. Other investigations revealed elevated anti-TPO and anti-TSH receptor antibodies consistent with Graves' disease. Thrombophilia screen was negative. She had remained euthyroid on a "block & replace" regimen (Thiamazole plus L-Thyroxine) that was discontinued after 18 months. She denies any anginal symptoms, but continues to smoke against medical advice.

Conclusions

Our case highlights the possibility of development of an acute myocardial infarction in a young subject with thyrotoxicosis. We speculate that patient's smoking habit combined with subtle thyrotoxicosis-induced prothrombotic state and/or coronary-artery spasm had lead to the above-mentioned acute coronary event.
Regulation of microsomal prostaglandin E2synthase-1 and 5-lipoxygenase-activating protein/5-lipoxygenase by 4-hydroxynonenal in human osteoarthritic chondrocytes
Authors: Chen Shu-Huang , Fahmi Hassan , Shi Qin , Benderdour Mohamed
Published: February 2010

Introduction

This study aimed to investigate whether hydroxynonenal (HNE) depletion is responsible for the switch from cyclooxygenase-2 (COX-2) and microsomal prostaglandin E2 synthase-1 (mPGES-1) to 5-lipoxygenase-activating protein (FLAP) and 5-lipoxygenase (5-LOX).

Methods

For COX-2 and mPGES-1 studies, human osteoarthritic chondrocytes were stimulated at different incubation times (up to 24 hours) with a single or repetitive addition of 10 μM HNE to the cultures at 2-hour intervals, up to 14 hours. For 5-LOX and FLAP studies, cells were treated with a single addition of 10 μM HNE for 24 hours, 48 hours, and 72 hours in the presence or absence of naproxen (a nonspecific COX-2 inhibitor) or antibody anti-transforming growth factor-beta 1 (TGF-β1). The protein levels of COX-2, mPGES-1 and early growth response factor-1 (Egr-1) transcription factor were evaluated by western blot, and those of prostaglandin E2 (PGE2), leukotriene B4 (LTB4) and TGF-β1 were determined with commercial kits. The levels of mPGES-1, FLAP and 5-LOX mRNA were measured by real-time RT-PCR. Transient transfection was performed to determine promoter activities of mPGES-1 and 5-LOX.

Results

Single addition of 10 μM HNE to cultured chondrocytes induced PGE2 release as well as COX-2 and mPGES-1 expression at the protein and mRNA levels, with a plateau reached respectively at 8 and 16 hours of incubation, followed by a subsequent decline. However, repeated treatments with HNE prevented the decline of COX-2 and mPGES-1 expression that occurred with a single aldehyde addition. HNE induced mPGES-1 promoter activity, possibly through transcription factor Egr-1 activation. After 48 hours, when COX-2 expression decreased, the LTB4 level rose through 5-LOX and FLAP upregulation. The addition of naproxen to cultured chondrocytes revealed that FLAP and 5-LOX regulation by HNE required PGE2 production. Furthermore, our data showed that HNE significantly induced TGF-β1 production. The addition of anti-TGF-β1 antibody reduced HNE-induced 5-LOX and FLAP expression by 40%, indicating the partial involvement of a TGF-β1-dependent mechanism.

Conclusions

Our data demonstrate that the shunt to the FLAP and 5-LOX pathway in HNE-induced human osteoarthritic chondrocytes is attributed to COX-2 and mPGES-1 inhibition, probably due to HNE depletion. PGE2 and TGF-β1 are suggested to be involved in this regulation.
Universal Poor Survival in Children With Medulloblastoma Harboring Somatic TP53 Mutations
Authors: Tabori Uri , Baskin Berivan , Shago Mary , Alon Noa , Taylor Michael D. , Ray Peter N. , Bouffet Eric , Malkin David , Hawkins Cynthia
Published: February 2010

Purpose

Medulloblastoma is the prototype of treatment success in modern pediatric neuro-oncology. Unfortunately, 20% to 30% of tumors recur despite maximal resection and multimodal therapy. Multiple biologic prognostic markers have been investigated to predict recurrences, but controversy remains regarding their clinical utility. Because p53 immunopositivity is an adverse prognostic marker in pediatric medulloblastoma and TP53 mutations are associated with chemotherapy and radiation therapy resistance, we aimed to determine the extent and role of TP53 mutations in pediatric medulloblastoma treatment failure.

Patients and Methods

One hundred eight of 111 consecutive patients diagnosed with medulloblastoma in our institution from 1995 to 2007 were included. Median follow-up time was 5.3 years in survivors. All samples were immunostained for p53 and erbB-2. Histologic grade and immunostaining were scored by two blinded reviewers. For 49 patients, frozen material was available for TP53 sequencing. The main outcome measures were overall and progression-free survival.

Results

Sixteen percent of sequenced medulloblastomas harbored a TP53 mutation. As a screening test, p53 immunohistochemistry was 100% sensitive and 83% specific for a TP53 mutation. Strikingly, all mutated tumors recurred early, and 5-year survival for average-risk patients was 0% for TP53-mutated medulloblastoma compared with 74% ± 8% for wild-type medulloblastoma (P < .0001). Furthermore, 75% of recurrences in average-risk patients were associated with TP53 mutations. On multivariate analysis, TP53 mutation status was the strongest adverse prognostic factor (hazard ratio = 10.4, P = .003).

Conclusion

Lack of long-term survival in TP53-mutated medulloblastomas highlights the role of TP53 mutations in medulloblastoma resistance to conventional therapies and the need for alternative treatments, and prospective validation of these findings is needed.
Cellular Histone Modification Patterns Predict Prognosis and Treatment Response in Resectable Pancreatic Adenocarcinoma: Results From RTOG 9704
Authors: Manuyakorn Ananya , Paulus Rebecca , Farrell James , Dawson Nicole A. , Tze Sheila , Cheung-Lau Gardenia , Hines Oscar Joe , Reber Howard , Seligson David B. , Horvath Steve , Kurdistani Siavash K. , Guha Chandhan , Dawson David W.
Published: February 2010

Purpose

Differences in cellular levels of histone modifications have predicted clinical outcome in certain cancers. Here, we studied the prognostic and predictive value of three histone modifications in pancreatic adenocarcinoma.

Methods

Tissue microarrays (TMAs) from two pancreatic adenocarcinoma cohorts were examined, including those from a 195-patient cohort from Radiation Therapy Oncology Group trial RTOG 9704, a multicenter, phase III, randomized treatment trial comparing adjuvant gemcitabine with fluorouracil and a 140-patient cohort of patients with stage I or II cancer from University of California, Los Angeles Medical Center. Immunohistochemistry was performed for histone H3 lysine 4 dimethylation (H3K4me2), histone H3 lysine 9 dimethylation (H3K9me2), and histone H3 lysine 18 acetylation (H3K18ac). Positive tumor cell staining for each histone modification was used to classify patients into low- and high-staining groups, which were related to clinicopathologic parameters and clinical outcome measures.

Results

Low cellular levels of H3K4me2, H3K9me2, or H3K18ac were each significant and independent predictors of poor survival in univariate and multivariate models, and combined low levels of H3K4me2 and/or H3K18ac were the most significant predictor of overall survival (hazard ratio, 2.93; 95% CI, 1.78 to 4.82) in the University of California, Los Angeles cohort. In subgroup analyses, histone levels were predictive of survival specifically for those patients with node-negative cancer or for those patients receiving adjuvant fluorouracil, but not gemcitabine, in RTOG 9704.

Conclusion

Cellular levels of histone modifications define previously unrecognized subsets of patients with pancreatic adenocarcinoma with distinct epigenetic phenotypes and clinical outcomes and represent prognostic and predictive biomarkers that could inform clinical decisions, including the use of fluorouracil chemotherapy.
Cost Effectiveness of Positron Emission Tomography in Patients With Hodgkin's Lymphoma in Unconfirmed Complete Remission or Partial Remission After First-Line Therapy
Authors: Cerci Juliano J. , Trindade Evelinda , Pracchia Luís F. , Pitella Felipe A. , Linardi Camila C.G. , Soares José , Delbeke Dominique , Topfer Leigh-Ann , Buccheri Valeria , Meneghetti José C.
Published: February 2010

Purpose

To assess the cost effectiveness of fluorine-18–fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with Hodgkin's lymphoma (HL) with unconfirmed complete remission (CRu) or partial remission (PR) after first-line treatment.

Patients and Methods

One hundred thirty patients with HL were prospectively studied. After treatment, all patients with CRu/PR were evaluated with FDG-PET. In addition, PET-negative patients were evaluated with standard follow-up, and PET-positive patients were evaluated with biopsies of the positive lesions. Local unit costs of procedures and tests were evaluated. Cost effectiveness was determined by evaluating projected annual economic impact of strategies without and with FDG-PET on HL management.

Results

After treatment, CRu/PR was observed in 50 (40.0%) of the 127 patients; the sensitivity, specificity, and positive and negative predictive values of FDG-PET were 100%, 92.0%, 92.3%, and 100%, respectively (accuracy of 95.9%). Local restaging costs without PET were $350,050 compared with $283,262 with PET, a 19% decrease. The incremental cost-effectiveness ratio is −$3,268 to detect one true case. PET costs represented 1% of total costs of HL treatment. Simulated costs in the 974 patients registered in the 2008 Brazilian public health care database showed that the strategy including restaging PET would have a total program cost of $56,498,314, which is $516,942 less than without restaging PET, resulting in a 1% cost saving.

Conclusion

FDG-PET demonstrated 95.9% accuracy in restaging for patients with HL with CRu/PR after first-line therapy. Given the observed probabilities, FDG-PET is highly cost effective and would reduce costs for the public health care program in Brazil.
Sustained Molecular Response With Interferon Alfa Maintenance After Induction Therapy With Imatinib Plus Interferon Alfa in Patients With Chronic Myeloid Leukemia
Authors: Burchert Andreas , Müller Martin C. , Kostrewa Philippe , Erben Philipp , Bostel Tilman , Liebler Simone , Hehlmann Rüdiger , Neubauer Andreas , Hochhaus Andreas
Published: February 2010

Purpose

Imatinib induces sustained remissions in patients with chronic myelogenous leukemia (CML), but fails to eradicate CML stem cells. This is of major concern regarding the issues of cure, long-term imatinib tolerability, and imatinib resistance. We therefore asked whether interferon alfa-2a (IFN) alone could maintain molecular remissions achieved by a prior combination therapy with imatinib and IFN.

Patients and Methods

Imatinib therapy was stopped in 20 patients who had concomitantly been pretreated with imatinib and IFN for a median of 2.4 years (range, 0.2 to 4.8 years) and 2.5 years (range, 0.2 to 4.9 years), respectively. After imatinib discontinuation, remission status was monitored monthly by quantitative analysis of the peripheral-blood BCR-ABL mRNA levels using real-time polymerase chain reaction. Proteinase-3 expression and proteinase-3–specific cytotoxic T cells (CTLs) were longitudinally measured to assess putative markers of IFN response.

Results

With a median time of 2.4 years after imatinib withdrawal (range, 0.5 to 4.0 years), 15 (75%) of 20 patients remained in remission. The number of patients in complete molecular remission increased under IFN from two patients at baseline to five patients after 2 years. Relapses occurred in five patients within 0.4 years (range, 0.2 to 0.8 years), but patients underwent rescue treatment with imatinib, re-establishing molecular remission. IFN therapy was associated with an increase in the expression of leukemia-associated antigen proteinase 3 and induction of proteinase-3–specific CTLs.

Conclusion

Treatment with IFN enables discontinuation of imatinib in most patients after prior imatinib/IFN combination therapy and may result in improved molecular response. Induction of a proteinase-3–specific CTL response by IFN may contribute to this effect.
Deficient forward transduction and enhanced reverse transduction in the alpha tectorin C1509G human hearing loss mutation
Authors: Xia Anping , Gao Simon S. , Yuan Tao , Osborn Alexander , Bress Andreas , Pfister Markus , Maricich Stephen M. , Pereira Fred A. , Oghalai John S.
Published: February 2010

Most forms of hearing loss are associated with loss of cochlear outer hair cells (OHCs). OHCs require the tectorial membrane (TM) for stereociliary bundle stimulation (forward transduction) and active feedback (reverse transduction). Alpha tectorin is a protein constituent of the TM and the C1509G mutation in alpha tectorin in humans results in autosomal dominant hearing loss. We engineered and validated this mutation in mice and found that the TM was shortened in heterozygous TectaC1509G/+ mice, reaching only the first row of OHCs. Thus, deficient forward transduction renders OHCs within the second and third rows non-functional, producing partial hearing loss. Surprisingly, both TectaC1509G/+ and TectaC1509G/C1509G mice were found to have increased reverse transduction as assessed by sound- and electrically-evoked otoacoustic emissions. We show that an increase in prestin, a protein necessary for electromotility, in all three rows of OHCs underlies this phenomenon. This mouse model demonstrates a human hearing loss mutation in which OHC function is altered through a non-cell-autonomous variation in prestin.
Flagellar and ciliary beating: the proven and the possible
Authors: Lindemann Charles B. , Lesich Kathleen A.
Published: February 2010

The working mechanism of the eukaryotic flagellar axoneme remains one of nature's most enduring puzzles. The basic mechanical operation of the axoneme is now a story that is fairly complete; however, the mechanism for coordinating the action of the dynein motor proteins to produce beating is still controversial. Although a full grasp of the dynein switching mechanism remains elusive, recent experimental reports provide new insights that might finally disclose the secrets of the beating mechanism: the special role of the inner dynein arms, especially dynein I1 and the dynein regulatory complex, the importance of the dynein microtubule-binding affinity at the stalk, and the role of bending in the selection of the active dynein group have all been implicated by major new evidence. This Commentary considers this new evidence in the context of various hypotheses of how axonemal dynein coordination might work.
The perennial organelle: assembly and disassembly of the primary cilium
Authors: Seeley E. Scott , Nachury Maxence V.
Published: February 2010

Primary cilia contain signaling receptors of diverse classes, and ciliary dysfunction results in a variety of developmental defects. Thus, primary cilia are thought to have an important role in sensing and transducing cellular signals. Although there is clear evidence demonstrating that these organelles are assembled and disassembled dynamically as cells progress through the cell cycle, the mechanisms by which the cell cycle controls the assembly and disassembly of the primary cilium remain poorly understood. In this Commentary, we review the basic cellular mechanisms that underlie the early stages of cilium assembly and discuss how the cell cycle communicates with the ciliation program. A commonly held view is that ciliation occurs exclusively in cells that have exited the cell cycle and entered quiescence or differentiation. However, this concept is at odds with the finding that, during development, many actively proliferating cells require cilia-mediated signaling pathways to instruct their developmental fate. Here, we reassess the quiescence-centric view of ciliation by reviewing historic and current literature. We discuss ample evidence that cilia are in fact present on many proliferating cells, and that a transient peak of ciliation before the G1-S transition might be tightly coupled to entry into the DNA replication phase. Finally, we touch on the relationship between the ciliation and cell-division cycles and the tissue distribution of primary cilia in order to highlight potential roles for the primary cilium in restraining cells from the hyperproliferative state that contributes to cancer.
Sensory reception is an attribute of both primary cilia and motile cilia
Authors: Bloodgood Robert A.
Published: February 2010

A recent cluster of papers has shown that motile cilia in the respiratory and reproductive tracts of humans and other mammals can exhibit sensory functions, a function previously attributed primarily to non-motile primary cilia. This leads to a new paradigm that all cilia and flagella (both motile and primary) can mediate sensory functions. However, examination of the literature shows that evidence of sensory functions of motile cilia and flagella is widespread in studies of invertebrates, and extends as back as far as 1899. In this Opinion article, I review the recent and historical findings that motile cilia have a variety of sensory functions, and discuss how this concept has in fact been evolving for the past century.
Convergent origins and rapid evolution of spliced leader trans-splicing in Metazoa: Insights from the Ctenophora and Hydrozoa
Authors: Derelle Romain , Momose Tsuyoshi , Manuel Michael , Da Silva Corinne , Wincker Patrick , Houliston Evelyn
Published: February 2010

Replacement of mRNA 5′ UTR sequences by short sequences trans-spliced from specialized, noncoding, spliced leader (SL) RNAs is an enigmatic phenomenon, occurring in a set of distantly related animal groups including urochordates, nematodes, flatworms, and hydra, as well as in Euglenozoa and dinoflagellates. Whether SL trans-splicing has a common evolutionary origin and biological function among different organisms remains unclear. We have undertaken a systematic identification of SL exons in cDNA sequence data sets from non-bilaterian metazoan species and their closest unicellular relatives. SL exons were identified in ctenophores and in hydrozoan cnidarians, but not in other cnidarians, placozoans, or sponges, or in animal unicellular relatives. Mapping of SL absence/presence obtained from this and previous studies onto current phylogenetic trees favors an evolutionary scenario involving multiple origins for SLs during eumetazoan evolution rather than loss from a common ancestor. In both ctenophore and hydrozoan species, multiple SL sequences were identified, showing high sequence diversity. Detailed analysis of a large data set generated for the hydrozoan Clytia hemisphaerica revealed trans-splicing of given mRNAs by multiple alternative SLs. No evidence was found for a common identity of trans-spliced mRNAs between different hydrozoans. One feature found specifically to characterize SL-spliced mRNAs in hydrozoans, however, was a marked adenosine enrichment immediately 3′ of the SL acceptor splice site. Our findings of high sequence divergence and apparently indiscriminate use of SLs in hydrozoans, along with recent findings in other taxa, indicate that SL genes have evolved rapidly in parallel in diverse animal groups, with constraint on SL exon sequence evolution being apparently rare.
A collection of micrographs: where science and art meet
Authors: Uskokovi Vuk
Published: February 2010

Micrographs obtained using different instrumental techniques are presented with the purpose of demonstrating their artistic qualities. The quality of uniformity currently dominates the aesthetic assessment in scientific practice and is discussed in relation to the classical appreciation
of the interplay between symmetry and asymmetry in arts. It is argued that scientific and artistic qualities have converged and inspired each other throughout millennia. With scientific discoveries and inventions enriching the world of communication, broadening the space for artistic creativity
and making artistic products more accessible than ever, science inevitably influences artistic creativity. On the other hand, the importance of aesthetic principles in guiding scientific conduct has been appreciated by some of the most creative scientific minds. Science and arts can be thus
considered as parallel rails of a single railroad track. Only when precisely coordinated is the passing of the train of human knowledge enabled. The presented micrographs, occupying the central part of this discourse, are displayed with the purpose of showing the rich aesthetic character of
even the most ordinary scientific images. The inherent aesthetic nature of scientific imagery and the artistic nature of scientific conduct have thus been offered as the conclusion.
Internet Mediated Super-Consciousness: Cleansing the Central Nervous System of Collective Consciousness
Authors: Drewry Ben
Published: February 2010

This article explores the expanding dimensions of Internet-based communication in connection with the potential up flowing of super-consciousness within virtual worlds. The presence of an Enlightened Master is highlighted as a necessary catalyst precipitating Internet mediated super-consciousness.
The virtual world Second Life is cited as a model for addressing present day potentials for such a transformative process. A proposal is outlined for experimenting with the communicative potentials of virtual worlds. The Internet is illustrated as an emerging nervous system of collective consciousness
ready to undergo a cleansing process similar to that of an individual nervous system. A vision of future potentials is also considered.
Exploring Cross-National Differences in Organizational Buyers’ Normative Expectations of Supplier Performance
Authors: Steward Michelle D. , Morgan Felicia N. , Crosby Lawrence A. , Kumar Ajith
Published: February 2010

The authors analyze data from two cross-national studies to explore differences in organizational buyers’ normative expectations of supplier performance. These normative expectations encompass what buyers perceive as business standards or norms, regardless of product/service, supplier, or industry. The first study (four countries) pinpoints the normative expectations that help explain why managers across countries may evaluate the same supplier performance differently. The second study provides an illustrative example of these differences in a separate sample drawn from the same four countries. The inclusion of such normative expectations of supplier performance has the potential to add explanatory power to models of performance evaluation in international business-to-business relationships. The findings suggest that if differences in normative expectations of supplier performance are not taken into account, performance ratings may be distorted indicators of actual performance.
The Effect of Collectivism on the Importance of Relationship Quality and Service Quality for Behavioral Intentions: A Cross-National and Cross-Contextual Analysis
Authors: Ozdemir V. Emre , Hewett Kelly
Published: February 2010

The authors explore when and how collectivism influences the importance of service quality and relationship quality for behavioral intentions. Using goal and action identification theories, they argue that collectivist tendencies become salient depending on a buyer's particular goal in a given service context and that when collectivist characteristics are salient, they can influence the importance of service or relationship quality. In the first study, the authors demonstrate the moderation effect of collectivism in a high-social-interaction context, in which they argue that collectivist tendencies are salient, using data collected in countries characterized as high and low in collectivism, and find that collectivism increases the importance of relationship and service quality (contrary to the hypothesized negative effect) for behavioral intentions. In the second study, the authors find that collectivism does not moderate the aforementioned relationships in contexts in which social interaction is expected to be low. The cross-national and cross-contextual findings provide multinational retailers guidance in designing the customer retail experience on the basis of the collectivist tendencies of consumers in various markets.
Drivers and Performance Outcomes of Relationship Learning for Suppliers in Cross-Border Customer–Supplier Relationships: The Role of Communication Culture
Authors: Jean Ruey-Jer “Bryan” , Sinkovics Rudolf R. , Kim Daekwan
Published: February 2010

Recently, relationship learning between supply chain members has drawn a great deal of attention in the literature. In the context of the international electronics supply chain, which is characterized by cultural differences and complexity of products, relationship learning is difficult to achieve and relies largely on close collaboration between partners. The authors build on the resource-based view of the firm and adopt a communication culture theory to examine drivers and performance outcomes of relationship learning in cross-border relationships in the electronics industry. They propose a research framework in which a firm's innovativeness orientation, trust, information technology advancement, and technological uncertainty are determinants of relationship learning. In the framework, they introduce the communication cultures of the supplier and buyer as a moderator. Using 246 electronics suppliers in relationships with international original equipment manufacturer customers, the authors empirically show that innovativeness orientation, trust, and technological uncertainty affect relationship learning positively. Furthermore, the communication cultures of the supplier and buyer moderate the effects of innovativeness orientation and technological uncertainty. The authors conclude with a discussion of the implications.
Exporting Services Successfully: Antecedents and Performance Implications of Customer Relationships
Authors: Sichtmann Christina , von Selasinsky Maren
Published: February 2010

This research is among the first to present a study of the drivers of service export performance. The authors develop and empirically test a theoretical framework of the antecedent and performance implications of cross-border customer relationships (CCRs) in the context of service exports. Survey data from 142 business-to-business service providers show that valuable CCRs have positive impacts on the export performance of services, but there is no influence derived from the number of cross-border relationships. The results also indicate a positive link between relationship marketing activities and the cross-cultural skills of service employees on the one side with valuable and numerous CCRs on the other. That is, relationship marketing activities receive positive influences from export commitment, customer orientation, and managers’ cross-cultural skills.
Establishing an Evaluation Model for Emerging Industry Credit Ability for the Banking Sector
Authors: Lin Chin-Tsai , Chen Yi-Shan
Published: February 2010

The banking industry plays an intermediary role in the entire range of economic activities in which institutions use their own credit to absorb idle funds from governments, enterprises, families, and individuals, lend funds to those in need, and inject funds into production and non-production activities in order to boost overall economic development. In this paper, we propose an evaluation model for emerging industry credit ability. First, we present an evaluation framework using the modified Delphi method. Next, the relative weights of evaluation criteria are determined using the analytic hierarchy process (AHP) model. Thereafter, a case study is presented for demonstrating the proposed evaluation model. Using the AHP-based decision-making method to construct an evaluation model can serve as a valuable reference for decision-makers or bank administrators for evaluating emerging industry credit ability, thereby enabling them to identify firms for bank loans risk management, which involves irrecoverable loans or credits. Therefore, the model will be highly applicable for academic and commercial purposes.
Dexamethasone suppression test predicts later development of an impaired adrenal function after a 14-day course of prednisone in healthy volunteers
Authors: Neidert Stefanie , Schuetz Philipp , Mueller Beat , Christ-Crain Mirjam
Published: February 2010

Background

Suppression of the adrenal function after glucocorticoid treatment is common, potentially dangerous, and unpredictable. Identification of patients at risk is of clinical importance. We hypothesized that the dexamethasone suppression test predicts the development of corticosteroid-induced impaired adrenal function.

Methods

We included 39 healthy male volunteers. After a 1-μg ACTH test, all participants underwent an overnight 0.5-mg dexamethasone suppression test. Participants then took prednisone, 0.5 mg/kg body weight, for 14-day. After the withdrawal of prednisone, a 1-μg ACTH test was performed and a clinical score was assessed on days 1, 3, 7, and 21.

Results

On days 1, 3, 7, and 21, 100, 50, 26.5 and 32.4% of the participants had a suppressed adrenal function. The risk of developing suppressed adrenal function decreased from 44 to 0% in patients with cortisol levels after the administration of dexamethasone in the lowest and highest quartiles respectively. Receiver operating curve (ROC) analysis performed to predict a suppressed adrenal function on day 7 after the withdrawal of prednisone showed an area under the curve (AUC) of 0.76 (95% confidence interval (CI) 0.58–0.89) for cortisol after the administration of dexamethasone, which was in the range of the AUC of 0.78 (95% CI 0.6–0.9) for pre-intervention cortisol after the administration of ACTH. Basal cortisol before intake of prednisone (AUC 0.62 (95% CI 0.44–0.78)) and the clinical score (AUC 0.64 (95% CI 0.45–0.79)) had significantly lower AUCs.

Conclusion

Circulating cortisol levels after a dexamethasone suppression test and a pre-intervention-stimulated cortisol level are predictive of later development of a suppressed adrenal function after a 14-day course of prednisone, and are superior to a clinical score or basal cortisol levels. This may allow a more targeted concept for the need of stress prophylaxis after cessation of steroid therapy.
Diagnostic accuracy of free and total metanephrines in plasma and fractionated metanephrines in urine of patients with pheochromocytoma
Authors: Grouzmann Eric , Drouard-Troalen Laurence , Baudin Eric , Plouin Pierre-François , Muller Beat , Grand Daniela , Buclin Thierry
Published: February 2010

Background

Plasma free and urinary metanephrines are recognized biomarkers for the assessment of pheochromocytoma. Plasma total metanephrines with a long half-life may represent another useful biomarker.

Objective

The aim of this study is to evaluate the diagnostic performances of plasma total metanephrines alone or combined with free metanephrines and fractionated 24-h urinary metanephrines.

Methods

A retrospective, case–control diagnostic test study was conducted between 1999 and 2007 in two university hospitals in Switzerland and two institutions in France. The patients included 46 cases with histologically proven pheochromocytoma, and 181 controls suspected of tumor with negative investigations and 3-year follow-up. None had renal dysfunction. Sensitivity and specificity were compared after expressing each measurement result as a ratio over its upper reference limit, adding the ratios of normetanephrine and metanephrine, and defining cut-off values of 1 or 2 for this sum.

Results

Applying a cut-off value of 1, plasma free and total metanephrines and urinary fractionated metanephrines had similar sensitivities of 96% (95% confidence interval, 86–99%), 95% (85–99%), and 95% (84–99%) along with similar specificities of 89% (83–94%), 91% (84–95%), and 86% (80–91%). A cut-off of 2 for the sum of ratios over reference limit improves the specificity, and it can be used for a confirmation test based on another biomarker taken among the three biomarkers.

Conclusion

All three metanephrine-based tests perform equivalently for diagnosing pheochromocytoma in the absence of renal insufficiency, and can be conveniently associated two by two for confirming/excluding tumor.
Impact of Initial Pathogen Density on Resistance and Tolerance in a Polymorphic Disease Resistance Gene System in Arabidopsis thaliana
Authors: Roux Fabrice , Gao Liping , Bergelson Joy
Published: February 2010

The evolution of natural enemy defense shapes evolutionary trajectories of natural populations. Although the intensity of selection imposed by enemies clearly varies among natural populations, little is known about the reaction norm of genotypes under a gradient of selective pressure. In this study, we measure the quantitative responses of disease symptoms and plant fitness to a gradient of infection, focusing on the gene-for-gene interaction between the Rpm1 resistance gene in Arabidopsis thaliana and the AvrRpm1 avirulence gene in the bacterial pathogen Pseudomonas syringae. Two complementary sets of plant material were used: resistant (R) and susceptible (S) isogenic lines and a set of six natural accessions, three of which are Rpm1 resistant (R) and three of which are rpm1 susceptible (S). Nine initial pathogen densities were applied to each plant line. Using isogenic lines allows any differences between R and S lines to be attributed directly to the Rpm1 gene, whereas using natural accessions allows the natural variation of resistance and tolerance over a gradient of infection dosages within R and S accessions to be described. For both sets of plant material, increased infection dosage results in more extensive disease symptoms, with a subsequent decrease in seed production. The severity of disease symptoms was reduced in R relative to S subgroups, and the presence of the Rpm1 allele led to an increase in plant fitness. Tolerance, defined as the ability to sustain infection without a reduction in fitness, was directly affected by Rpm1, providing a novel demonstration of an R gene affecting tolerance. Genetic variation for tolerance was also found within the S and R natural accessions, suggesting the potential for selection to act upon this important trait.
Childhood Language Skills and Adult Literacy: A 29-Year Follow-up Study
Authors: Schoon Ingrid , Parsons Samantha , Rush Robert , Law James
Published: February 2010

OBJECTIVE:

Our aim was to assess the longitudinal trajectory of childhood receptive language skills and early influences on the course of language development.

METHODS:

Drawing on data collected for a nationally representative British birth cohort, the 1970 British Cohort Study, we examined the relationship between directly assessed early receptive language ability, family background, housing conditions, early literacy environment, and adult literacy skills. A sample of 11349 cohort members who completed the English Picture Vocabulary Test at 5 years of age were studied again at 34 years of age, when they completed a direct assessment of their basic literacy skills. We contrasted experiences of individuals with language problems at age 5 against the experiences of those with normal language skills at that age, assessing the role of socioeconomic family background and early literacy environment in influencing the longitudinal course of developmental language problems. Statistical comparisons of rates with χ2 tests at P values of .001, .01, and .05 were made, as well as multivariate logistic regressions.

RESULTS:

Cohort members with receptive language problems at age 5 had a relatively disadvantaged home life in childhood, both in terms of socioeconomic resources and the education level of their parents, but also regarding their exposure to a stimulating early literacy environment. Although there is significant risk for poor adult literacy among children with early language problems, the majority of these children develop competent functional literacy levels by the age of 34. Factors that reduce the risk for persistent language problems include the child being born into a working family, parental education beyond minimum school-leaving age, advantageous housing conditions, and preschool attendance.

CONCLUSION:

Effective literacy-promoting interventions provided by pediatric primary care providers should target both children and parents.
Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine
Authors: Middleman Amy B. , Anding Roberta , Tung Celestine
Published: February 2010

OBJECTIVE:

Several studies have noted that obese adolescents and adults achieve lower titers of antibody in response to vaccines such as hepatitis B virus (HBV) vaccine. The objective of this study was to determine whether use of a longer (1.5-in) rather than a standard (1-in) needle to penetrate the thicker deltoid fat pad among obese youth would result in higher antibody titers after immunization against HBV.

METHODS:

Obese adolescents from a large metropolitan area who had not previously received the HBV vaccine were randomly assigned to be immunized with HBV vaccine by using either a 1-inch or a 1.5-inch needle.

RESULTS:

Those who were immunized with a 1.5-inch needle achieved significantly higher antibody titers to hepatitis B surface antigen (median titers: 1-inch = 189.8 mIU/mL, 1.5-inch = 345.4 mIU/mL; P = .03).

CONCLUSIONS:

This finding supports the hypothesis that needle length accounts for a significant portion of the discrepancy in immune response to HBV vaccine that is seen among those with obesity.
Weight and Age as Predictors for Passing the Infant Car Seat Challenge
Authors: DeGrazia Michele , Guo Chao-Yu , Wilkinson Ashley Anne , Rhein Lawrence
Published: February 2010

OBJECTIVE:

The American Academy of Pediatrics recommends observation of preterm and at-risk infants in their car seat before hospital discharge to screen for breathing problems. This observation period, which we refer to as the infant car seat challenge (ICSC), is used to determine readiness for travel in a car seat. Infants who fail the ICSC are recommended to travel in a car bed. Limited data exist to identify risk factors for failing the ICSC, and no guidelines are available to facilitate transition from car beds to car seats. The purpose of this study was to determine whether weight and age are predictors for passing the ICSC.

METHODS:

This retrospective study evaluated 43 infants referred to the Children's Hospital Boston Center for Healthy Infant Lung Development for a repeat ICSC after initial failure and 37 infants who passed or failed their initial ICSC at the Caritas Saint Elizabeth's Medical Center. Gender, birth weight, gestational age (GA), weight (ICSC weight), corrected GA, and chronological age at time of ICSC were extracted, and logistic regression analysis was performed.

RESULTS:

The average GA at birth of infants referred was 35 weeks 2 days (±2 weeks 3 days), and almost equal numbers of boys and girls were referred. A majority of infants passed their initial rechallenge (38 [88%] of 43). Infants who failed the repeat challenge were slightly smaller (3327 ± 927 vs 3913 ± 936 g) and younger at time of retesting (CGA 40 weeks 5 days vs 42 weeks 5 days; chronological age 39.2 vs 52.2 days). Neither weight nor age at initial or repeat ICSC predicted passing the ICSC.

CONCLUSIONS:

This study suggests that ICSC screenings remain the safest method for transitioning preterm infants from a car bed to a car seat.
Standard and Emerging Therapies for Metastatic Differentiated Thyroid Cancer
Authors: O'Neill Christine J. , Oucharek Jennifer , Learoyd Diana , Sidhu Stan B.
Published: February 2010

Learning Objectives

After completing this course, the reader will be able to: Describe the role and limitations of traditional treatments for metastatic differentiated thyroid cancer.Discuss the molecular basis of and clinical evidence for novel and emerging treatments for metastatic differentiated thyroid cancer.Identify suitable candidates for clinical trials among your patients with radioactive iodine refractory, metastatic differentiated thyroid cancer and enroll them.

This article is available for continuing medical education credit at CME.TheOncologist.com

Differentiated thyroid cancer accounts for >90% of cases of thyroid cancer, with most patients having an excellent prognosis. Distant metastases occur in 10%–15% of patients, decreasing the overall 10-year survival rate in this group to 40%. Radioactive iodine has been the mainstay of treatment for distant metastases, with good results when lesions retain the ability to take up iodine. For patients with metastatic disease resistant to radioactive iodine, treatment options are few and survival is poor. Chemotherapy and external beam radiotherapy have been used in these patients, but with disappointing results. In recent years, our understanding of the molecular pathways involved in thyroid cancer has increased and a number of molecular targets have been identified. These targets include the proto-oncogenes BRAF and RET, known to be common mutations in thyroid cancer; vascular endothelial growth factor receptor and platelet-derived growth factor receptor, associated with angiogenesis; and the sodium-iodide symporter, with the aim of restoring its expression and hence radioactive iodine uptake. There are now multiple trials of tyrosine kinase inhibitors, angiogenesis inhibitors, and other novel agents available to patients with metastatic thyroid cancer. This review discusses both traditional and novel treatments for metastatic differentiated thyroid cancer with a particular focus on emerging treatments for patients with radioactive iodine–refractory disease.
Sorafenib Therapy for Hepatocellular Carcinoma in an HIV–HCV Coinfected Patient: A Case Report
Authors: Perboni Giorgio , Costa Paolo , Fibbia Giovanni Carlo , Morandini Barbara , Scalzini Alfredo , Tagliani Alberto , Cengarle Rita , Aitini Enrico
Published: February 2010

Background/Aims.

HIV and hepatitis C virus (HCV) share common modes of transmission, resulting in about 33% incidence of coinfection among people infected with HIV. The survival benefit from highly effective antiretroviral therapy (HAART) for HIV infection is resulting in an increased incidence of hepatocellular carcinoma (HCC) in this population. There are no reports to date regarding the coadministration of HAART and sorafenib for hepatocellular carcinoma.

Methods.

We report the case of a 42-year-old male patient coinfected with HIV and HCV who developed advanced HCC not amenable to curative therapy. The patient was treated with sorafenib, an oral multikinase inhibitor shown to lead to a longer median survival time and time to progression in patients with advanced HCC. Antiretroviral therapy was continued during sorafenib therapy.

Results.

The patient achieved a partial tumor response after 3 months and continued to respond at subsequent assessments. His serum α-fetoprotein normalized from 2,172 IU/ml to 2 IU/ml. He had durable stable disease after 23 months of therapy. Antiretroviral therapy was efficacious (CD4+ lymphocyte count, 377/μl; HIV viremia, <50 copies/ml). The simultaneous administration of these therapies was well tolerated. No grade 3 or 4 toxicities were observed. Exacerbation of pre-existing hypertension, grade 2 diarrhea, and grade 1 skin reaction were observed.

Conclusions.

This is the first report in which sorafenib has been successfully used to treat HCC in a patient with HIV–HCV coinfection.
Behaviour of latex-modified concrete under cyclic loading
Authors: Prasad B. K. , Gupta U. , Choubey U. B.
Published: February 2010

A series of uniaxial cyclic tests were conducted on cylindrical specimens of latex-modified concrete. Cylindrical specimens were cast using normal concrete mix of 30 N/mm2 strength with three different percentages of styrene butadiene rubber latex, namely 5, 10 and 15% by weight of cement. With increase in latex, the water/cement (w/c) ratio was decreased to ensure the same consistency for all the mixes. The parameters considered for the study were latex dispersion, w/c ratio and the concrete strength. The focus of the study was to investigate the stress–strain behaviour of latex-modified concrete and to develop a non-dimensional model with the observed deformation response. The tests included stress–strain envelope curves, common point curves, stability point curves and plastic strain curves. Analytical expressions are established to represent these curves. It is found that the permissible stress level depends on the plastic strain present in the material. The behaviour of latex-modified concrete under cyclic loading is very similar to that of plain concrete