bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of acne vulgaris: an evidence-based update
Authors: Ingram J. R. , Grindlay D. J. C. , Williams H. C.
Published: October 2009

This review summarizes clinically important findings from 3 systematic reviews, 1 updated guideline and a selection from the 62 randomized controlled trials (RCTs) published between February 2007 and January 2009 on the topic of acne vulgaris. Low glycaemic-load diets might reduce acne severity but this remains unproven. Written patient information leaflets have not been surpassed by other communication methods. New combination topical treatments have not shown convincing advantages over current combination products such as clindamycin/benzoyl peroxide. Topical dapsone is superior to placebo but has yet to be compared with standard topical treatments. Long-term topical tretinoin to prevent nonmelanoma skin cancer in elderly men was associated with higher all-cause mortality, but there is currently no evidence of increased mortality for topical retinoid use when treating acne. All oral tetracyclines have similar efficacy, yet minocycline is the most costly. Oral isotretinoin monotherapy remains the gold-standard treatment for severe acne. Flutamide plus the oral contraceptive pill is beneficial for acne associated with polycystic ovary syndrome. Photodynamic therapy, phototherapy and laser therapy cannot be recommended universally for acne until minimal postinflammatory pigmentation and longer-term benefit can be shown, especially with current high costs. Development of non-antibiotic therapies is preferable to minimize the risk of community antibiotic resistance. Future trials should use active comparators at optimum doses and avoid noninferiority comparisons unless appropriately powered. Trials need to shift from using multiple, unvalidated outcome measures to including patient-reported and quality-of-life outcomes, and all trials should be registered on a public clinical-trials database.
Postirradiation linear morphoea
Authors: Akay B. N. , Sanli H. , Heper A. O.
Published: October 2009

Postirradiation morphoea is an uncommon side-effect of radiotherapy. We report a 74-year-old woman who was treated with radiotherapy for endometrial carcinoma. About 3.5 years after the first dose of radiotherapy, the patient developed linear morphoea starting from the radiation port and affecting distant, nonirradiated skin. Lesions of radiation-induced morphoea are generally described as well-demarcated, indurated plaques with varying amounts of associated erythema; however, there is no previous publication of unilateral band-like distribution of morphoea associated with radiotherapy, to our knowledge.
Allergic women show reduced T helper type 1 alloresponses to fetal human leucocyte antigen mismatch during pregnancy
Authors: Prescott S L , Breckler L A , Witt C S , Smith L , Dunstan J A , Christiansen F T
Published: October 2009

Low-level alloreactivity between mother and fetus may provide stimulation for fetal T helper type 1 (Th1) cell immune maturation. This study explored the effects of human leucocyte antigen (HLA) mismatch on materno–fetal interactions detected as cytokine responses and lymphoproliferation in mixed lymphocyte reactions, and whether this was altered in allergic women (n = 62) who have a Th2 propensity compared with non-allergic women (n = 65). HLA-DRβ1 mismatch was associated with significantly increased Th1 interferon (IFN)-γ, Th2 interleukin (IL)-13 and lymphoproliferative responses by both mothers and fetuses. Allergic women showed significantly lower IFN-γ Th1 production in response to HLA-DRβ1 mismatch. The infants of these women also showed significantly lower IL-10 and lower IFN-γ production relative to IL-13. Both HLA-DRβ1 mismatch and maternal allergy had significant independent effects on maternal IFN-γ Th1 responses. Maternal allergy modifies HLA-mediated alloreactivity between the mother and the fetus, reducing Th1 activation. This may affect the cytokine milieu at the materno–fetal interface and could be implicated in the attenuated Th1 responses observed commonly in infants of atopic mothers.
Hydrological and biogeochemical controls on the timing and magnitude of nitrous oxide flux across an agricultural landscape
Authors: CASTELLANO MICHAEL J. , SCHMIDT JOHN P. , KAYE JASON P. , WALKER CHARLES , GRAHAM CHRIS B. , LIN HENRY , DELL CURTIS J.
Published: October 2009

Anticipated increases in precipitation intensity due to climate change may affect hydrological controls on soil N2O fluxes, resulting in a feedback between climate change and soil greenhouse gas emissions. We evaluated soil hydrologic controls on N2O emissions during experimental water table fluctuations in large, intact soil columns amended with 100 kg ha−1 KNO3‐N. Soil columns were collected from three landscape positions that vary in hydrological and biogeochemical properties (N= 12 columns). We flooded columns from bottom to surface to simulate water table fluctuations that are typical for this site, and expected to increase given future climate change scenarios. After the soil was saturated to the surface, we allowed the columns to drain freely while monitoring volumetric soil water content, matric potential and N2O emissions over 96 h. Across all landscape positions and replicate soil columns, there was a positive linear relationship between total soil N and the log of cumulative N2O emissions (r2= 0.47; P= 0.013). Within individual soil columns, N2O flux was a Gaussian function of water‐filled pore space (WFPS) during drainage (mean r2= 0.90). However, instantaneous maximum N2O flux rates did not occur at a consistent WFPS, ranging from 63% to 98% WFPS across landscape positions and replicate soil columns. In contrast, instantaneous maximum N2O flux rates occurred within a narrow range (−1.88 to −4.48 kPa) of soil matric potential that approximated field capacity. The relatively consistent relationship between maximum N2O flux rates and matric potential indicates that water filled pore size is an important factor affecting soil N2O fluxes. These data demonstrate that matric potential is the strongest predictor of the timing of N2O fluxes across soils that differ in texture, structure and bulk density.
Carbon bio‐sequestration within the phytoliths of economic bamboo species
Authors: PARR JEFFREY , SULLIVAN LEIGH , CHEN BIHUA , YE GONGFU , ZHENG WEIPENG
Published: October 2009

The rates of carbon bio‐sequestration within silica phytoliths of the leaf litter of 10 economically important bamboo species indicates that (a) there is considerable variation in the content of carbon occluded within the phytoliths (PhytOC) of the leaves between different bamboo species, (b) this variation does not appear to be directly related to the quantity of silica in the plant but rather the efficiency of carbon encapsulation by the silica. The PhytOC content of the species under the experimental conditions ranged from 1.6% to 4% of the leaf silica weight. The potential phytolith carbon bio‐sequestration rates in the leaf‐litter component for the bamboos ranged up to 0.7 tonnes of carbon dioxide (CO2) equivalents (t‐e‐CO2) ha−1 yr−1 for these species. Assuming a median phytolith carbon bio‐sequestration yield of 0.36 t‐e‐CO2 ha−1 yr−1, the global potential for bio‐sequestration via phytolith carbon (from bamboo and/or other similar grass crops) is estimated to be ∼1.5 billion t‐e‐CO2 yr−1, equivalent to 11% of the current increase in atmospheric CO2. The data indicate that the management of vegetation such as bamboo forests to maximize the production of PhytOC has the potential to result in considerable quantities of securely bio‐sequestered carbon.
A common haplotype of protamine 1 and 2 genes is associated with higher sperm counts
Authors: Tüttelmann F. , Křenková P. , Römer S. , Nestorovic A. R. , Ljujic M. , Štambergová A. , Macek Jr M. , Macek Sr M. , Nieschlag E. , Gromoll J. , Simoni M.
Published: October 2009

Sperm chromatin compaction in the sperm head is achieved when histones are replaced by protamines during spermatogenesis. Haploinsufficiency of the protamine 1 (PRM1) or PRM2 gene causes infertility in mice. However, the published data remain inconclusive about a role of PRM1/2 variants in male infertility and their association with semen parameters. By full sequence analysis, we assessed the frequency of sequence variations in PRM1 and PRM2 in three groups of Caucasian patients with idiopathic teratozoospermia and normal (n = 88) or reduced sperm concentration (n = 83) and in men with a high percentage of normal sperm morphology and normal concentrations (n = 77). Two rare (c.54G>A and c.102G>T) and one common SNP (c.230A>C) were identified in PRM1. In PRM2, some rare heterozygous mutations and the two common intronic SNPs 298G>C and 373C>A were detected. None of the PRM1/2 variants was associated with teratozoospermia or individually with other semen parameters. However, significant linkage disequilibrium was detected between the common SNPs of PRM1 and PRM2 which formed haplotypes. Analysis of the pooled group (n = 248) revealed that homozygous carriers of the common haplotype ACC had a twofold higher sperm concentration and count than men lacking this haplotype, with sperm counts of heterozygotes for ACC being midway between the homozygotes. This markedly decreased sperm output might either be caused by spermatozoa lacking the ACC haplotype not being viable, or subject to negative selection. In addition, a significant deviation from Hardy–Weinberg‐Equilibrium of these SNPs might indicate natural selection in favour of the ACC allele which leads to higher sperm output and therefore better fertility. In conclusion, for the first time we describe an association of a common haplotype formed by PRM1 and PRM2 with sperm output in a large group of men.
Gridded Aclar: preparation methods and use for correlative light and electron microscopy of cell monolayers, by TEM and FIB–SEM
Authors: JIMÉNEZ N. , VAN DONSELAAR E.G. , DE WINTER D.A.M. , VOCKING K. , VERKLEIJ A.J. , POST J.A.
Published: October 2009

Aclar, a copolymer film with properties very similar to those of tissue culture plastic, is a versatile substrate to grow cells for light (including fluorescence) and electron microscopic applications in combination with both chemical fixation and cryoimmobilization. In this paper, we describe complete procedures to perform correlative light and electron microscopy using Aclar as substrate for the culture of cell monolayers to be finally embedded in plastic. First, we developed straightforward, efficient and flexible ways to mark the surface of the Aclar to create substrates to locate cells first at the light microscopy and then the electron microscopy level. All the methods enable the user to self‐design gridded Aclar pieces, according to the purpose of the experiments, and create a large number of substrates in a short time. Second, we confirmed that marked Aclar supports the normal growth and morphology of cells. Third, we validated the correlative light and electron microscopy procedure using Aclar. This validation was done for the high‐resolution analysis of endothelial cells using transmission electron microscopy and focused ion beam–scanning electron microscopy in combination with the use of fluorescence, phase contrast and/or bright field microscopy to map areas of interest at low resolution. The methods that we present are diverse, easy to implement and highly reproducible, and emphasize the versatility of Aclar as a cell growth substrate for diverse microscopic applications.
Comparison of the efficacy and safety of bilastine 20 mg vs levocetirizine 5 mg for the treatment of chronic idiopathic urticaria: a multi‐centre, double‐blind, randomized, placebo‐controlled study
Authors: Zuberbier T. , Oanta A. , Bogacka E. , Medina I. , Wesel F. , Uhl P. , Antépara I. , Jáuregui I. , Valiente R. ,   The Bilastine International Working Group
Published: October 2009

To cite this article: Zuberbier T, Oanta A, Bogacka E, Medina I, Wesel F, Uhl P, Antépara I, Jáuregui I, Valiente R, the Bilastine International Working Group. Comparison of the efficacy and safety of bilastine 20 mg vs levocetirizine 5 mg for the treatment of chronic idiopathic urticaria: a multi‐centre, double‐blind, randomized, placebo‐controlled study. Allergy 2010; 65: 516–528.

Background:  Bilastine is a novel nonsedative H1‐receptor antagonist, which may be used for the symptomatic treatment of chronic idiopathic urticaria (CU). The aim of this study was to compare the clinical efficacy and safety of bilastine 20 mg vs levocetirizine 5 mg and placebo in CU patients with moderate‐to‐severe symptoms.

Methods:  Overall 525 male and female subjects aged 18–70 years were randomized to receive bilastine 20 mg, levocetirizine 5 mg or placebo, once daily for 28 days, in double‐blind manner, in 46 centres across Europe and Argentina. Patients rated symptoms of pruritus, number of wheals, and maximum size of wheals (on predefined scales) as reflective (over past 12 h) symptoms twice daily, for assessment of change from baseline in the total symptoms scores (TSS) over 28 days as the primary efficacy measure. Changes in reflective and instantaneous symptoms scores, Dermatology Life Quality Index (DLQI), and CU‐associated discomfort and sleep disturbance were assessed as secondary outcomes. Safety was assessed according to adverse events, laboratory tests and electrocardiograms.

Results:  Bilastine reduced patients’ mean reflective and instantaneous TSS from baseline to a significantly greater degree than placebo (P < 0.001); from day 2 onwards of treatment. The DLQI, general discomfort, and sleep disruption were also improved significantly in bilastine‐treated patients as compared with placebo‐treated patients (P < 0.001 for all parameters). Comparison with levocetirizine indicated both treatments to be equally efficacious as well as equally safe and well tolerated as compared with placebo.

Conclusions:  Bilastine 20 mg is a novel effective and safe treatment option for the management of CU.
Predictive models for diagnosis of pleural effusions secondary to tuberculosis or cancer
Authors: SALES Roberta K.B. , VARGAS Francisco S. , CAPELOZZI Vera Luiza , SEISCENTO Márcia , GENOFRE Eduardo H. , TEIXEIRA Lisete R. , ANTONANGELO Leila
Published: October 2009

Background and objective:  Tuberculosis (TB) and cancer are two of the main causes of pleural effusions which frequently share similar clinical features and pleural fluid profiles. This study aimed to identify diagnostic models based on clinical and laboratory variables to differentiate tuberculous from malignant pleural effusions.

Methods:  A retrospective study of 403 patients (200 with TB; 203 with cancer) was undertaken. Univariate analysis was used to select the clinical variables relevant to the models composition. Variables β coefficients were used to define a numerical score which presented a practical use. The performances of the most efficient models were tested in a sample of pleural exudates (64 new cases).

Results:  Two models are proposed for the diagnosis of effusions associated with each disease. For TB: (i) adenosine deaminase (ADA), globulins and the absence of malignant cells in the pleural fluid; and (ii) ADA, globulins and fluid appearance. For cancer: (i) patient age, fluid appearance, macrophage percentage and presence of atypical cells in the pleural fluid; and (ii) as for (i) excluding atypical cells. Application of the models to the 64 pleural effusions showed accuracy higher than 85% for all models.

Conclusions:  The proposed models were effective in suggesting pleural tuberculosis or cancer.
Severe community‐acquired Acinetobacter baumannii pneumonia: An emerging highly lethal infectious disease in the Asia–Pacific
Authors: ONG Catherine W.M. , LYE David C.B. , KHOO Kay Leong , CHUA Gerald Seng Wee , YEOH Siang Fei , LEO Yee Sin , TAMBYAH Paul Ananth , CHUA Arlene Christine
Published: October 2009

Background and objective:  Patients with community‐acquired Acinetobacter baumannii (AB) pneumonia have been reported from subtropical countries. We investigated the epidemiology, clinical and microbiological characteristics of community‐acquired pneumonia (CAP) due to AB in Singapore.

Method:  A retrospective case series was performed over a 21‐month period at two institutions.

Results:  From 1 January 2007 to 30 September 2008, eight patients were diagnosed with CAP due to AB. Seven had bacteraemia and five were sputum culture‐positive. The median age at presentation was 58.5 years (range 45–76 years). Five patients (71.4%) acquired the pneumonia in the warmer months of June to September. Presentation was acute, with a median duration of 2.5 days (range 1–7 days). The median Acute Physiology and Chronic Health Evaluation II score was 28.5 (range 6–36). Six patients presented with septic shock, lactic acidosis, acute kidney injury and respiratory failure, necessitating ICU care; five of thesepatients eventually died. All patients received empirical antibiotics, including third‐generation cephalosporins, which were inactive against the organism. All isolates were susceptible to ampicillin/sulbactam, ciprofloxacin, co‐trimoxazole, aminoglycosides and imipenem.

Conclusions:  Community‐acquired AB pneumonia have a fulminant course. In a region endemic for melioidosis and severe community‐acquired Klebsiella pneumoniae, the challenge lies in rapid identification and initiation of appropriate empirical antibiotics to improve the survival of patients with AB CAP.
The effects of antifungal therapy on severe asthma with fungal sensitization and allergic bronchopulmonary aspergillosis
Authors: PASQUALOTTO Alessandro C. , POWELL Georgina , NIVEN Robert , DENNING David W.
Published: October 2009

Background and objective:  Very little is known about the response rates to or appropriateness of treatment for patients with allergic fungal diseases of the lung. This study assessed the effect of antifungal therapy in patients with severe asthma with fungal sensitization (SAFS) and allergic bronchopulmonary aspergillosis (ABPA).

Methods:  A retrospective cohort study of 33 adult patients who fulfilled the criteria for either SAFS (n = 22) or ABPA (n = 11) was conducted. All patients had received antifungal therapy for at least 6 months. The primary study end point was the effect of antifungal therapy on patients' lung function.

Results:  Overall, total IgE values and radioallergosorbent test (RAST) for A. fumigatus markedly decreased after 6 months of therapy in both SAFS and ABPA patients (P = 0.004 and P = 0.005, respectively). Reduction was seen in the eosinophil count (P = 0.037), dose of oral steroids (P = 0.043) and courses of systemic steroids required (P = 0.041). Lung function also improved (P = 0.016). Four of 10 patients discontinued oral steroids after 6 months of therapy. Reduction in IgE levels (P = 0.015) and RAST for A. fumigatus was also observed (P = 0.006) for those patients treated for at least 1 year with antifungal drugs.

Conclusions:  Both ABPA and SAFS patients benefited from oral antifungal therapy. The antifungal therapy may act by reducing the antigenic load, interacting with corticosteroids or by a direct immunological effect.
ICU procedures of the critically ill
Authors: PHUA Ghee Chee , WAHIDI Momen M.
Published: October 2009

Intensive Care Unit (ICU) patients often require urgent, high‐risk diagnostic and therapeutic procedures. However, they are particularly vulnerable to procedural complications due to the severity and instability of their illnesses. We discuss the complications associated with bronchoscopy, percutaneous dilatational tracheostomy, pleural interventions for example thoracentesis and chest tube placement, central venous catheterization and pulmonary artery catheterization. Invasive procedures are frequently performed in critically ill patients. It is important for the operator to be familiar with the specific complications of each procedure, as well as steps to take in order to enhance safety and reduce adverse events. High standards of training and credentialing are crucial to ensure that the ICU physicians are proficient in performing these procedures.
How useful is traditional herbal medicine for pulmonary fibrosis?
Authors: YANG Jiao , CUI Ye , KOLB Martin
Published: October 2009

IPF, despite considerable advances in clinical management and understanding of its complex pathophysiology, is still a fatal disease without effective treatment. Herbal medicine has been used for more than 5000 years and is the central component of medical practice in many parts of Asia. Not surprisingly, traditional and herbal medicine is also widely applied for treatment of IPF. This review describes the most important herbal medicines that are used for IPF treatment. The relevant experimental studies investigating potential mechanisms of these drugs are discussed. The best conducted clinical studies which have reported beneficial effects of some herbal medications in the management of IPF are also evaluated. Overall, there is considerable experimental support from preclinical studies for some of these herbal medicines, but the translation into clinical practice appears difficult. The clinical trials evaluating their anti‐fibrotic potential are not fulfilling the standards expected from ‘Western’ medicines. Systematic clinical research in this field is still in its infancy, and as such, the routine use of traditional and herbal medicine cannot be recommended for patients suffering from IPF.
Treating IPF—all or nothing? A PRO‐CON debate
Authors: BEHR Jürgen , KOLB Martin , COX Gerard
Published: October 2009

The Idiopathic Pulmonary Fibrosis (IPF) is a progressive fibrotic lung disease with poor prognosis. It is distinct from other idiopathic interstitial pneumonias by its histopathological pattern of usual interstitial pneumonia which is characterized by accumulation of fibroblasts, extracellular matrix and honeycombing. Inflammation is only scarce in true IPF. The use of anti‐inflammatory therapy is still part of guidelines for IPF management, although not specifically recommended, because convincing evidence showing beneficial effects of this approach is lacking. This review provides a summary of important arguments PRO and CON using anti‐inflammatory and anti‐oxidant therapy for patients with IPF in form of a debate with a concluding statement of both positions at the end.
Game‐based peripheral biofeedback for stress assessment in children
Authors: Pop‐Jordanova Nada , Gucev Zoran
Published: October 2009

Background: Peripheral biofeedback is considered to be an efficient method for assessment and stress mitigation in children. The aim of the present study was to assess the levels of stress and stress mitigation in healthy school children (HSC), in children with cystic fibrosis (CF), general anxiety (GA) and attention‐deficit–hyperactivity disorder (ADHD).

Methods: Each investigated group (HSC, CF, GA, ADHD) consisted of 30 school‐aged children from both sexes. Psychological characteristics were evaluated on Eysenck Personality Questionnaire (EPQ). The lie scale was used to determine participant honesty. Four biofeedback games using a pulls detector were applied for assessment of the stress levels as well as to evaluate ability to relax.

Results: EPQ found more psychopathological traits (P< 0.001) and less extroversion (P< 0.001) in children with GA and ADHD. In addition, high neurotic tendencies were found in children with CF (P< 0.01) and GA (P< 0.01). Unexpectedly, the lie scale was lower in ADHD children (P< 0.01) than in all other groups (HSC, CF, GA). The Magic blocks score was significantly different in relaxation levels between control and CF children (P< 0.05). Speed in the game Canal was significantly different in relaxation levels between healthy controls and all other groups, but no changes in pulls, as a relaxation measure, were found during the game. The CF group had much more commissions stemming from impulsivity (t= 5.71,P< 0.01), while the GA and ADHD children had more inattention omissions (P< 0.05). Strong negative correlation between age and pulls (r= 0.49,P= 0.003) and strong negative correlation between age and omissions (r=−0.86,P= 0.029) were found among all groups analyzed.

Conclusions: The ability to learn stress mediation is correlated with age. All three groups of children had significantly lower relaxation levels when compared to healthy controls. Relaxation was more difficult for children with GA or ADHD, and easier for children with CF.
Reality of the G‐spot and its relation to female circumcision and vaginal surgery
Authors: Thabet Saeed Mohamad Ahmad
Published: October 2009

Aim:  To clarify the reality of the G‐spot anatomically, functionally and histologically, and to determine the possible effect of female circumcision and anterior vaginal wall surgery on the integrity and function of the G‐spot.

Methods:  A controlled descriptive and comparative cohort prospective study was conducted at Kasr El Aini School of Medicine, Cairo University, Cairo, Egypt, of 50 uncircumcised and 125 circumcised women with small to moderate anterior vaginal wall descent. Preoperative sexual examination was performed to map the site of the G‐spot and other anatomical landmarks on the anterior vaginal wa11 and to verify the associated circumcision state. Pre‐ and postoperative sexual assessment and histological examination of different mapped sites in the anterior vagina were also conducted.

Results:  Histological findings, results of the anatomical and sexual mapping of the anterior vaginal wall and sexual scores were recorded. The G‐spot was proved functionally in 144 (82.3%) of women and anatomically in 95 (65.9%). The latter appeared as two small flaccid balloon‐like masses on either side of the lower third of the urethra and were named ‘the sexual bodies of the G‐spot’. These bodies were significantly detected in all histo‐positive cases in the circumcised women and in the uncircumcised women who had small or average clitorises. The G‐spot was also proved histologically in 47.4% of all cases and was formed of epithelial, glandular and erectile tissue. Sex scores were significantly higher in the histo‐positive cases with sexual bodies but significantly dropped after anterior vaginal wall surgery. In contrast, female circumcision rarely alters the scores.

Conclusion:  The G‐spot is functional reality in 82.3% of women, an anatomical reality in 54.3% and a histological reality in 47.4%. Anterior vaginal wall surgery usually affects the G‐spot and female sexuality, but female circumcision rarely affects them.
Treatment of clomiphene citrate‐related ovarian cysts in a prospective randomized study. A single center experience
Authors: Altinkaya Sunduz Ozlem , Talas Betul Bayir , Gungor Tayfun , Gulerman Cavidan
Published: October 2009

Aim:  The present study aims to compare the effectiveness of placebo, low dose and very low dose oral contraceptives (OC) in the treatment of clomiphene citrate (CC)‐related ovarian cysts.

Methods:  A prospective randomized placebo controlled study was undertaken at the Infertility Department of Dr. Zekai Tahir Burak Women's Health Education and Research Hospital. A total of 3250 primary infertile patients were administered CC for ovulation induction because of ovulatory dysfunction and/or unexplained infertility. One hundred and eighty‐six women who were diagnosed with CC‐related ovarian cysts greater than 20 mm on the third day of the following menstrual cycle, were eligible for the study. Group 1 (n = 62) was treated with very low dose OC (100 µg levonorgestrel + 20 µg ethinyl estradiol [EE]), group 2 (n = 62) with low dose OC (150 µg desogestrel + 30 µg EE) and group 3 (n = 62) with a placebo. The first control was 4 weeks later. Women with persistent cysts (n = 57) were called in 4 weeks later to continue the same treatment.

Results:  Demographic data were similar among the groups. At the first month, the regression rates of ovarian cysts were 64.5, 61.3 and 66.1% in groups 1, 2 and 3, respectively (P = 0.849). Among the 57 women (20, 19 and 18 from groups 1, 2 and 3, respectively) with persistent cysts, the regression rates were 65.0, 63.2 and 55.6%, respectively at the second month (P = 0.821). Persistence of ovarian cysts was significantly higher in women with a longer duration of CC treatment than in women with a shorter duration (P < 0.001).

Conclusion:  Any treatment might be appropriate for patients with a CC‐related ovarian cyst. However, there is no evidence to administer OC for treating CC‐related ovarian cysts. Expectant management may also achieve similar success rates.
Constitutive activation of signal transducer and activator of transcription 3 in epithelial ovarian carcinoma
Authors: Min Hao , Wei‐hong Zhao
Published: October 2009

Aim:  To investigate the expressions of signal transducer and activator of transcription 3 (Stat3) and tyrosine‐activated Stat3 (p‐Stat3) in epithelial ovarian carcinoma (EOC) and their relationships with clinical pathological parameters or prognosis.

Methods:  Immunohistochemical methods were used to detect the expressions of Stat3 and p‐Stat3 in EOC, benign ovarian tumors and normal ovarian tissues, after which an analysis of results with clinical pathological or prognosis was given.

Results:  The expressions of Stat3 and p‐Stat3 in EOC were significantly higher than in normal ovarian epithelial tissues or benign ovarian tumor tissues (P < 0.0125) and the expression of Stat3 protein was highly correlated with the expression of p‐Stat3 protein (P < 0.01). The positive rate of Stat3 in stages of III and IV (96.9%) was significantly higher than in stages of I and II (72.2%) (P < 0.05). Meanwhile, p‐Stat3 expression was significantly correlated with disease stage, degree of differentiation and lymph node metastasis. Along with higher clinical stage (P < 0.05), p‐Stat3 expression was gradually increased. The p‐Stat3 expression was negatively correlated with the prognosis of EOC patients (P < 0.01).

Conclusion:  Overexpression and overactivation of Stat3 was found in EOC tissues, and the constitutive activation of Stat3 signaling pathway may play an important role in the invasion and prognosis of EOC.
Microarray profile of micro‐ribonucleic acid in tumor tissue from cervical squamous cell carcinoma without human papillomavirus
Authors: Zhang YanLiang , Dai Yong , Huang YuanShuai , Ma Liguo , Yin Yibing , Tang Min , Hu Chengxiao
Published: October 2009

Aims:  Micro‐ribonucleic acid (miRNA) are noncoding RNA molecules of 21 to 24 nt that regulate the expression of target genes in a post‐transcriptional manner. Evidence indicates that miRNA play essential roles in embryogenesis, cell differentiation and pathogenesis of human diseases. This study describes a comparison between the microRNA profile of human‐papillomavirus‐negative cervical squamous cell carcinoma patients and controls, in order to develop further understanding of the pathogenesis of cervical squamous cell carcinomas.

Methods:  MiRNA were isolated from tumor tissues of five human‐papillomavirus‐negative cervical squamous cell carcinoma patients and five healthy controls in order to perform miRNA microarray chip analysis. The chip results were then confirmed by northern blot analysis.

Results:  A total of 27 miRNA differentially expressed between the squamous cell carcinoma patients and the healthy controls were identified.

Conclusion:  This work indicates that these miRNA may be potential diagnosis biomarkers and probable factors involved in the pathogenesis of cervical squamous cell carcinomas.
Uterine artery flow velocity waveforms during uterine contractions: Differences between oxytocin‐induced contractions and spontaneous labor contractions
Authors: Tahara Mie , Nakai Yuichiro , Yasui Tomoyo , Nishimoto Sachiyo , Nakano Akemi , Matsumoto Makiko , Nobeyama Hiroyuki , Nishihara Rika , Iwanaga Naoko , Ishiko Osamu
Published: October 2009

Aim:  To clarify the effects on uterine arterial flow velocity waveforms of uterine contractions following oxytocin infusion and during spontaneous labor.

Methods:  Uterine arterial flow velocity waveforms were obtained by pulsed Doppler methods from 22 women during an oxytocin challenge test (OCT), 26 women during oxytocin‐induced labor, and 40 women during spontaneous labor. Mean resistance index (RI) for bilateral arteries was used for analyses. After the onset of labor, flow velocity waveforms were assessed according to cervical dilatation. During OCT, Doppler flow velocimetry was performed when three uterine contractions occurred per 10‐min period.

Results:  RI values did not differ significantly between induced and spontaneous labor during relaxations at any level of cervical dilatation. However, during contractions, RI was significantly higher for induced labor than for spontaneous labor. Absence or reversal of flow was more frequent in the OCT group than in the induced labor group (P < 0.0001). However, no significant differences were found between spontaneous and induced labor groups.

Conclusion:  Interactions between the contracting uterine body and the relaxing lower segment in oxytocin‐induced labor might be associated with differences in uterine arterial flow during contraction between oxytocin‐induced and spontaneous labor. However, changes in the intensity of uterine contractions during labor progression might differ between oxytocin‐induced and spontaneous labor.
Massive peritoneal fluid and markedly elevated serum CA125 and CA19‐9 levels associated with an ovarian endometrioma
Authors: Park Byung‐Joon , Kim Tae‐Eung , Kim Yong‐Wook
Published: October 2009

Endometriosis associated with ascites is an uncommon condition, but nevertheless important because it mimics the presentation of ovarian malignancy. We present the case of a 34‐year‐old woman who was admitted with the acute onset of abdominal pain and distension. A pelvic sonogram showed a large amount of peritoneal fluid with echogenic material and a 10‐cm complex cystic structure, which appeared to be an enlarged left ovary. The concentrations of CA125 and CA19‐9 were 548.1 and 7604 IU/mL, respectively. On the second day of admission, an exploratory laparoscopy was performed, which revealed a ruptured left ovarian cyst consistent with an endometrioma. A laparoscopic left adnexectomy was therefore performed. The histological examination of the specimen confirmed the diagnosis of an endometrioma. After a 12‐month follow‐up period, the patient showed no recurrence of the endometrioma or peritoneal fluid accumulation. In most instances, the presence of massive ascites is associated with malignancies, tuberculosis, or a perforated viscus. The information provided in the present report is important to both gynecologists and oncologists because it shows that an ovarian cyst with ascites and highly elevated CA125 and CA19‐9 levels might be benign.
Sevoflurane modulation of Ca2+regulation in skeletal muscle sarcoplasmic reticulum vesicles from young and mature rabbits
Authors: KÖNIG MATTHIAS , LIN MARINA , NELSON THOMAS E. , GROBAN LEANNE
Published: October 2009

Introduction: Developmental differences in splice variants of the two key sarcoplasmic reticulum (SR) calcium regulatory proteins, ryanodine (RyR1), and sarcoendoplasmic reticulum calcium pump (SERCA1) have been linked to various neuromuscular disorders, but not malignant hyperthermia (MH). However, it is unclear whether an age‐related difference in volatile anesthetic‐mediated SR calcium function exists that could add to our current understanding of the clinical presentation of MH syndrome and provide insight into molecular mechanisms for general anesthesia that may have other physiologic and/or pathophysiologic significance. Therefore, the effects of sevoflurane on intracellular calcium regulation in isolated SR membrane vesicles from the skeletal muscle of healthy young rabbits were compared to their adult counterpart using an establishedin vitromodel with the assumption that exposure to sevoflurane would elicit a weaker response in the young SR.

Methods: Through dual wavelength spectroscopy of Ca2+: Arsenazo III difference absorbance, the effects of sevoflurane on SR Ca2+uptake rate and release in heavy and light fraction SR membrane vesicles isolated from the white muscle of anesthetized, postweaned (age = 6 weeks,n = 5) and adult (age = 6 months,n = 5) male New Zealand rabbits were examined.

Results: The adult group showed a 50% increase in Ca2+uptake rate from control at both subclinical and clinically relevant anesthetic concentrations, whereas in the SR from the younger animals, Ca2+uptake rate was not altered by any concentration of sevoflurane. The sensitivity of both the low and high affinity Ca2+‐binding sites on RyR1 was increased by sevoflurane to the same extent in the SR vesicles from the young and mature adult rabbits. Interestingly, a greater potency of sevoflurane for the high affinity‐binding site was identified, and this was independent of age.

Conclusions: These findings suggest that the sensitivity of the SR to sevoflurane‐mediated Ca2+uptake may be increased with maturity, while an analogous developmental effect on RyR1 is less probable. Nonetheless, this study shows for the first time that a potent inhalational agent such as sevoflurane can influence the high affinity SR calcium‐binding site by lowering the extraluminal concentration of calcium necessary to trigger calcium release. While this may not be of consequence when inhaled anesthetics are administered to normal children or adults, it may have life‐threatening consequences in carriers of RyR1 mutations.
School‐aged children’s experiences of postoperative music medicine on pain, distress, and anxiety
Authors: NILSSON STEFAN , KOKINSKY EVA , NILSSON ULRICA , SIDENVALL BIRGITTA , ENSKÄR KARIN
Published: October 2009

Aim: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school‐aged children who had undergone day surgery.

Background: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure®) in children after minor surgery.

Methods: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti‐emetics were documented during postoperative recovery stay. Self‐reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State‐Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi‐structured qualitative interviews were conducted.

Results: Data were recorded from 80 children aged 7–16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children’s individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as ‘calming and relaxing.’

Conclusions: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
Wood‐feeding beetles and soil nutrient cycling in burned forests: implications of post‐fire salvage logging
Authors: Cobb Tyler P. , Hannam Kirsten D. , Kishchuk Barbara E. , Langor David W. , Quideau Sylvie A. , Spence John R.
Published: October 2009

Rising economic demands for boreal forest resources along with current and predicted increases in wildfire activity have increased salvage logging of burned forests. Currently, the ecological consequences of post‐fire salvage logging are insufficiently understood to develop effective management guidelines or to adequately inform policy decision‐makers.

We used both field and laboratory studies to examine the effects of post‐fire salvage logging on populations of the white‐spotted sawyerMonochamus scutellatus scutellatus(Say) (Coleoptera: Cerambycidae) and its ecological function in boreal forest.

Monochamus s. scutellatusadults were relatively abundant in both burned and clear‐cut logged sites but were absent from salvage logged sites.

Anin situmesocosm experiment showed that the abundance ofM. s. scutellatuslarvae in burned white spruce bolts was linked to changes in total organic nitrogen and carbon in mineral soil.

Organic nutrient inputs in the form ofM. s. scutellatusfrass increased mineral soil microbial respiration rates by more than three‐fold and altered the availability of nitrogen. Changes in nitrogen availability corresponded with decreased germination and growth ofEpilobium angustifoliumandPopulusspp. but notCalamagrostis canadensis.

Although the present study focused on local scale effects, the reported findings suggest that continued economic emphasis on post‐fire salvage logging may have implications beyond the local scale for biodiversity conservation, nutrient cycling and plant community composition in forest ecosystems recovering from wildfire.
What to do with the “Tubby Hubby”?“Obesity,” the Crisis of Masculinity, and the Nuclear Family in Early Cold War Canada
Authors: McPhail Deborah
Published: October 2009

Abstract: Despite current insistence that obesity is a new problem, obesity and fat were discussed frequently in the medical and popular presses and by state officials during the early Cold War in Canada. UsingKristeva's(1982, Powers of Horror: An Essay on Abjection) concept of abjection, I argue that Cold War anxieties about fat, and specifically the obesity of white, middle‐class men, had less to do with the growing girth of bodies than it did with a post‐war crisis in masculinity related to the collapse of the public and private spheres. Through an analysis of fitness regimes and female‐administered diets for men, I argue that anti‐obesity rhetoric served to assuage dominant worries about degenerating masculinity by reasserting both the gendered division of labour and the white, middle‐class, nuclear family as Canadian norms.
Choosing Health? Exploring Children's Eating Practices at Home and at School
Authors: Rawlins Emma
Published: October 2009

Abstract: This paper considers the influences on children's eating habits in both school and home spaces in the UK. Since 2002 the UK government has been committed to halting the increase in child obesity rates, and has sanctioned particular parental and school based practices as more “healthy” than others. This study examines this through critically questioning, in particular, the classed discourses written into health education advice and advocates a new way of thinking about health education messages. Based on qualitative research with children from one secondary school and with eight families in the North of England the paper reveals that while parents and children make decisions about their lives with reference to dominant discourses about ideal “healthy” family eating practices, their ability to realise these practices is limited in numerous ways. Moreover, the influences on children's eating habits in both home and school spaces are intricately interrelated and children's practices are clearly influenced by the spaces they inhabit. Their decisions involve balancing health education knowledge with a range of other knowledges that are bound up in the socio‐spatial relations of their everyday lives. A holistic approach to understanding children's eating habits therefore requires a critical understanding of class background, parental influences and contemporary parenting practices as well as the microgeographical relations found in the school dining room.
Steady‐state amprenavir and tenofovir pharmacokinetics after coadministration of unboosted or ritonavir‐boosted fosamprenavir with tenofovir disoproxil fumarate in healthy volunteers
Authors: Luber AD , Condoluci DV , Slowinski PD , Andrews M , Olson K , Peloquin CA , Pappa KA , Pakes GE ,   for the COL104422 Study Team
Published: October 2009

Objective

An open‐label, three‐period pharmacokinetic study was conducted to investigate the drug interaction potential between fosamprenavir (FPV) and tenofovir disoproxil fumarate (TDF).

Methods

Thirty‐six healthy subjects received TDF 300 mg once daily (qd) for 7 days (period 1), and then were randomized to 14 days of either FPV 1400 mg twice daily (bid) or FPV/ritonavir (RTV) 700/100 mg bid alone or with TDF (period 2). Subjects continued their randomized dose of FPV for 14 more days, adding or removing TDF based upon its receipt in period 2 (period 3). Twenty‐four‐hour pharmacokinetic sampling was carried out on day 7 of period 1 and on day 14 of periods 2 and 3. Steady‐state plasma amprenavir (APV) and tenofovir (TFV) pharmacokinetics were assessed by noncompartmental analysis and parameter values observed with each regimen were compared using geometric mean ratios with 90% confidence intervals.

Results

After TDF coadministration, APV geometric mean minimum concentration (Cmin), maximum concentration (Cmax), and area under the plasma concentration–time curve (AUC) increased by 31, 3 and 7% above values observed with unboosted FPV alone; they also increased by 31, 4 and 16% above values observed with FPV/RTV alone. TFV Cmin, Cmax and AUC decreased by 12, 25 and 15% after FPV coadministration and by 9, 18 and 7% after FPV/RTV coadministration. No significant changes in RTV pharmacokinetics were observed. No differences were noted in adverse events among dosing periods.

Conclusions

In this evaluation of the interaction between FPV and TDF, increases in APV exposures and modest decreases in TFV exposures were observed. These were unlikely to be clinically significant.
Somatosensory function in asymptomatic Parkin‐mutation carriers
Authors: Gierthmühlen J. , Schumacher S. , Deuschl G. , Fritzer E. , Klein C. , Baron R. , Helmchen C.
Published: October 2009

Background and purpose:  It is a matter of debate whether somatosensory abnormalities in Parkinson’s disease (PD) precede or follow PD motor signs and whether they are of central or peripheral origin. The sensory sural nerve action potential amplitude (SNAP) was previously reported to be reduced in symptomatic Parkin‐associated PD. The aim of our study was to investigate asymptomatic Parkin‐mutation carriers to elucidate whether putative somatosensory abnormalities precede motor symptoms therewith helping to determine the origin of somatosensory signs.

Methods:  Nine subjects with Parkin‐mutations and nine healthy controls were examined clinically, with quantitative sensory testing (QST) and neurography.

Results:  There was a higher frequency of cold pain threshold abnormalities and hypofunction of Aβ‐fibres/central afferent pathways in Parkin‐mutation carriers compared to controls. Neurography of Parkin‐mutation carriers did not indicate peripheral neuropathy.

Conclusions:  Sensory abnormalities of asymptomatic Parkin‐mutation carriers as obtained by QST suggest impairment of either small and large peripheral pathways or central somatosensory processing. In contrast to Parkin‐associated PD, asymptomatic Parkin‐mutation carriers do not show a reduced SNAP.