bluuebunny/crossref_metadata_2025 huggingface dataset:
In Situ Cardiomyogenic Differentiation of Implanted Bone Marrow Mononuclear Cells by Local Delivery of Transforming Growth Factor-β1
Authors: Yang Hee Seok , Bhang Suk Ho , Kim Il-Kwon , Lee Tae-Jin , Kang Jin-Muk , Lee Dae-Hee , Lee Soo-Hong , Hwang Ki-Chul , Kim Byung-Soo
Published: December 2011

Bone marrow mononuclear cells (BMMNCs) can be used to treat patients with myocardial infarction, since BMMNCs can differentiate in vitro toward cardiomyogenic lineages when treated with transforming growth factor-β1 (TGF-β1). However, the in vitro cardiomyogenic differentiation culture process is costly and laborious, and the patients should wait during the culture period. In this study, we hypothesize that BMMNCs implanted in cardiomyogenically undifferentiated state to myocardial infarction site would differentiate cardiomyogenically in situ when exogenous TGF-β1 is delivered to the cell implantation site. Heparin-conjugated poly(lactic- co-glycolic acid) nanospheres (HCPNs) suspended in fibrin gel were used as a TGF-β1 delivery system. BMMNCs were labeled with a green fluorescent dye (PKH67) and implanted into the infarction border zone of rat myocardium using fibrin gel containing HCPNs and TGF-β1. BMMNC implantation using fibrin gel and HCPNs without TGF-β1 served as a control. Four weeks after implantation, the expression of cardiomyogenic marker proteins by the implanted BMMNCs was dramatically greater in the TGF-β1 delivery group than in the control group. This method can significantly improve the stem cell therapy technology for myocardial regeneration, since it can remove in vitro cell culture step for cardiomyogenic differentiation prior to cell implantation.
Myogenic Properties of Human Mesenchymal Stem Cells Derived from Three Different Sources
Authors: De La Garza-Rodea Anabel S. , Van Der Velde-Van Dijke Ietje , Boersma Hester , Gonçalves Manuel A. F. V. , Van Bekkum Dirk W. , De Vries Antoine A. F. , Knaän-Shanzer Shoshan
Published: December 2011

Mesenchymal stem cells (MSCs) of mammals have been isolated from many tissues and are characterized by their aptitude to differentiate into bone, cartilage, and fat. Differentiation into cells of other lineages like skeletal muscle, tendon/ligament, nervous tissue, and epithelium has been attained with MSCs derived from some tissues. Whether such abilities are shared by MSCs of all tissues is unknown. We therefore compared for three human donors the myogenic properties of MSCs from adipose tissue (AT), bone marrow (BM), and synovial membrane (SM). Our data show that human MSCs derived from the three tissues differ in phenotype, proliferation capacity, and differentiation potential. The division rate of AT-derived MSCs (AT-MSCs) was distinctly higher than that of MSCs from the other two tissue sources. In addition, clear donor-specific differences in the long-term maintenance of MSC proliferation ability were observed. Although similar in their in vitro fusogenic capacity with murine myoblasts, MSCs of the three sources contributed to a different extent to skeletal muscle regeneration in vivo. Transplanting human AT-, BM-, or SM-MSCs previously transduced with a lentiviral vector encoding β-galactosidase into cardiotoxin-damaged tibialis anterior muscles (TAMs) of immunodeficient mice revealed that at 30 days after treatment the frequency of hybrid myofibers was highest in the TAMs treated with AT-MSCs. Our finding of human-specific β-spectrin and dystrophin in hybrid myofibers containing human nuclei argues for myogenic programming of MSCs in regenerating murine skeletal muscle. For the further development of MSC-based treatments of myopathies, AT-MSCs appear to be the best choice in view of their efficient contribution to myoregeneration, their high ex vivo expansion potential, and because their harvesting is less demanding than that of BM- or SM-MSCs.
Transcriptional Profiling of the Hematopoietic Support of Interleukin-Stimulated Human Umbilical Vein Endothelial Cells (HUVECs)
Authors: Bal Gürkan , Kamhieh-Milz Julian , Futschik Matthias , Häupl Thomas , Salama Abdulgabar , Moldenhauer Anja
Published: December 2011

Endothelial cells can be successfully used to maintain or increase the number of hematopoietic stem cells in vitro. Previously we identified hematopoietic progenitor cell (HPC) expansion or survival benefit induced by IL-1β-, IL-3-, and IL-6-stimulated human umbilical vein endothelial cell (HUVEC) supernatants. In order to identify molecular mechanisms that support hematopoiesis, we examined the time-dependent expression profiles of IL-1β-, IL-3-, and IL-6-stimulated HUVECs via microarray. Here, we present 24 common upregulated elements and three common downregulated elements of IL-1β- and IL-3-stimulated HUVECs, with these factors exhibiting great potential for the observed HPC expansion. Furthermore, metabolic pathway analysis resulted in the identification of nonproteinogenic factors such as prostaglandin E2 (PGE2) and nitric oxide (NO) and determined their HPC expansion potential via delta, methylcellulose, and cobblestone assays. We confirmed PGE2 and spermine as hematopoietic expansion factors. Furthermore, we identified several factors such as SSAT, extracellular matrix components, microRNA21, and a microvesicle-mediated cross-talk between the endothelium and HPCs that may play a crucial role in determining stem cell fate. Our results suggest that microarray in combination with functional annotations is a convenient method to identify novel factors with great impact on HPC proliferation and differentiation.
A Spotlight on Strategies for Increasing Safety Reporting in Nursing Education
Authors: Cooper Elizabeth E.
Published: December 2011

Health care policy changes have ripple effects that touch many different areas of the health care arena. Quality and safety are at the forefront of this discussion. In health care institutions, error reporting is expected to monitor and improve patient safety. Procedures are in place for reporting errors. However, multiple barriers lead to low use of reporting methods. Creating a reporting system that leads to transparency could positively affect the health care system. Introducing nurses to error reporting at the beginning of their educational experience could lead to a reduction in barriers to error reporting and promote error reporting. This article discusses strategies to increase error and near-miss reporting in a school of nursing.
Bilateral Ring-shaped Intrastromal Opacities After Corneal Cross-linking for Keratoconus
Authors: Camesasca Fabrizio I. , Vinciguerra Paolo , Seiler Theo
Published: December 2011

PURPOSE:

To report a case of bilateral, ring-shaped, intrastromal corneal opacities after corneal cross-linking (CXL) for progressive keratoconus.

METHODS:

A 21-year-old man with bilateral, progressive keratoconus underwent CXL with riboflavin 0.1% and ultraviolet A (UVA) light in the right eye and, 6 months later, in the left eye.

RESULTS:

One day after CXL, the right eye showed a sharply demarcated white ring in the corneal periphery. The ring involved the superficial stroma at 2 mm from the limbus, extended from 1 to 11 o’clock, and was 1.5-mm wide. Corneal topography showed marked central flattening. Six months after treatment, a residual, faint, ring-shaped opacity remained, with a decrease in corneal ectasia. Cross-linking was then performed in the left eye. Different ultraviolet devices were used in the two eyes. On postoperative day 1, the left eye also showed a white ring of stromal opacity. Scheimpflug imaging showed corneal stromal contraction in the zone of whitening. At final examination, >1 year after surgery, corrected visual acuity was 0.00 logMAR with cylinder of 2.00 diopters in both eyes.

CONCLUSIONS:

The bilateral intrastromal corneal changes were innocuous in the long-term, with preservation of good visual acuity and successful stabilization of progressive keratoconus.
Precision Analysis of Posterior Corneal Topography Measured by Visante Omni: Repeatability, Reproducibility, and Agreement With Orbscan II
Authors: Srivannaboon Sabong , Chotikavanich Suksri , Chirapapaisan Chareenun , Kasemson Sirilux , Po-ngam Wasin
Published: December 2011

PURPOSE:

To evaluate the repeatability and reproducibility of posterior corneal curvature and posterior corneal elevation best-fit sphere (BFS) obtained with the Visante Omni (Carl Zeiss Meditec) and to compare the results with the Orbscan II (Bausch & Lomb).

METHODS:

Thirty eyes from 30 healthy volunteers were included in this study. All patients were examined 5 times with the Visante Omni and Orbscan II by 2 independent operators. The posterior corneal curvature (3- and 6-mm zone) and posterior corneal elevation BFS (5- and 8-mm zone) were generated for each system. Intraoperator repeatability and interoperator reproducibility and agreement between the systems were evaluated using the intraclass correlation coefficient (ICC) and the Bland–Altman method.

RESULTS:

The repeatability of posterior corneal curvature and posterior corneal elevation BFS measured by the Visante Omni was high for all analysis zones (ICC, 0.99 to 1.00). The reproducibility also showed similar results (ICC, 0.99 to 1.00). Agreement between the Visante Omni and Orbscan II was high for posterior corneal curvature (ICC, 0.94 to 0.97) and posterior corneal elevation BFS (ICC, 0.96 to 0.98) with 95% limits of agreement at −0.26 to 0.22 diopters for posterior corneal curvature and 0.11 to 0.69 mm for posterior corneal elevation BFS.

CONCLUSIONS:

The Visante Omni provides good repeatability and reproducibility of posterior corneal topography. Overall agreement with the Orbscan II system was high.
Efficacy of Brinzolamide Ophthalmic Suspension 1% for Treatment of a Vitelliform Macular Lesion in a Patient With Desferrioxamine Retinopathy
Authors: Genead Mohamed A. , Fishman Gerald A.
Published: December 2011

A 46-year-old woman with a vitelliform macular lesion secondary to desferrioxamine retinal toxicity in the right eye was treated with brinzolamide 1% ophthalmic drops three times a day. A spectral-domain optical coherence tomography (SD-OCT) unit was used to monitor any changes in the macular lesion. Two months after starting the eye drops, the SD-OCT showed a notable improvement in the vitelliform macular lesion’s thickness. Six months later, further improvement was noted in the macular lesion thickness on SD-OCT testing in the right eye. Best-corrected visual acuity was initially 1.00 logarithm of the minimum angle of resolution (20/200 on a Snellen acuity chart) in the right eye and 0.14 logarithm of the minimum angle of resolution (20/25
−2
) in the left eye. After 6 months of treatment, visual acuity was 0.92 (20/200
+1
) in the right eye and 0.08 (20/25
+1
) in the left eye. The use of brinzolamide 1% was associated with a marked reduction in a vitelliform macular lesion on SD-OCT testing secondary to desferrioxamine retinal toxicity.
Short QT Syndrome
Authors: Giustetto Carla , Scrocco Chiara , Giachino Daniela , Antzelevitch Charles , Gaita Fiorenzo
Published: December 2011

The short QT syndrome (SQTS) is a recently described genetic arrhythmogenic disorder, characterized by abnormally short QT intervals on surface electrocardiogram (ECG) and a high incidence of sudden death (SD) during life, including the first months of life. The inheritance of SQTS is autosomal dominant, with genetic heterogeneity. Gain-of-function mutations in 3 genes encoding potassium channels have been associated to the disease: KCNH2 encoding IKr (SQT1), KCNQ1 encoding IKs (SQT2), and KCNJ2 encoding IK1 (SQT3). Loss-of-function mutations in 3 genes encoding the cardiac L-type calcium channel, CACNA1C, CACNB2b and CACNA2D1 may underlie a mixed phenotype of Brugada pattern ECG (or non-specific repolarization changes in case of CACNA2D1) and shorter than normal QT intervals. Clinical presentation is often severe, as cardiac arrest represents the first clinical presentation in most subjects. Moreover, often a noticeable family history of cardiac SD is present. Atrial fibrillation may be observed, also in young individuals. At electrophysiological study, short atrial and ventricular refractory periods are found, and atrial and ventricular fibrillation are easily induced by programmed electrical stimulation. The outcome of patients with SQTS becomes relatively safe when they are identified and treated. Currently, the suggested therapeutic strategy is an implantable cardioverter- defibrillator (ICD) in patients with personal history of aborted SD or syncope. In asymptomatic adult patients from highly symptomatic families and in newborn children pharmacological treatment with hydroquinidine, which has been shown to prolong the QT interval and reduce the inducibility of ventricular arrhythmias, may be proposed.
Sudden Infant Death Syndrome and Cardiac Channelopathies: From Mechanisms to Prevention of Avoidable Tragedies
Authors: Insolia Roberto , Ghidoni Alice , Dossena Cinzia , Mastantuono Elisa , Schwartz Peter J.
Published: December 2011

The sudden infant death syndrome (SIDS), with the load of mystery surrounding its causes and with the devastating impact on the affected families, remains the greatest contributor to post-neonatal mortality during the first year of life. Following a succinct review of the non-cardiac genetic factors, which have been associated with SIDS, we focus on the cardiac hypothesis for SIDS and specifically on those diseases produced by cardiac ion channel mutations, the so-called channelopathies. Special attention is devoted to the fact that these causes of SIDS, and especially the long QT syndrome, are preventable if diagnosed in time. This highlights the importance of neonatal ECG screening and carries a number of practical implications, including medico-legal considerations.
Recent Advances in the Genetics of Atrial Fibrillation: From Rare and Common Genetic Variants to microRNA Signaling
Authors: Sinner Moritz F. , Clauss Sebastian , Wakili Reza , Meitinger Thomas , Estner Heidi , Kääb Stefan
Published: December 2011

Besides traditional risk factors, atrial fibrillation (AF) also shares a strong genetic component. Here, we review the genetics of AF including monogenic forms of AF, heritability of AF, complex genetic risk of AF, and the role of microRNAs in AF pathophysiology. Thirtytwo mutations (17 genes) have been reported to cause familial AF. Mutations in cardiac ion channel genes or their subunits alter electrical properties and thereby lead to AF. Recently, also non-ion channel gene mutations have been identified to cause familial AF. Twin and community-based studies suggested AF to be heritable also on the population level. The AF risk in the offspring of an affected first-degree relative ranged between 2- to 5-fold, depending on the age of onset. Thereby, the risk of AF increases gradually the earlier the youngest relative of an AF patient developed the arrhythmia. African Americans bear a lesser risk of AF compared to individuals of European ancestry. Their risk rises with increasing European admixture. Genome wide association studies have revealed loci on chromosomes 4q25, 16q21 and 1q21 conferring risk of AF. Very recently, another consortial effort has identified a novel locus on chromosome 1, intronic to IL6R. IL6R encodes the a subunit of the interleukin 6 receptor. MicroRNAs were shown to regulate gene expression, and are increasingly reported to modify AF. A hallmark of AF pathophysiology is electrical and structural remodeling. MicroRNAs are involved in this process by regulating gene expression of cardiac ion channels, calcium handling proteins, transcription factors, and extracellular matrix related proteins.
Preface
Authors: Crotti Lia
Published: December 2011

On behalf of the Working Group on Cellular and Molecular Biology of the Italian Society of Cardiology, we are glad to present this special issue devoted to Channelopathies, the genetically transmitted ion channel diseases.[...]
Bacterial colonization of psoriasis plaques. Is it relevant?
Authors: Marcus Eva , Demmler Diana , Rudolph Andreas , Fischer Matthias
Published: December 2011

Bacterial colonization was investigated retrospectively in patients with plaque psoriasis (n=98 inpatient treatments, n=73 patients). At least one pathogen was found in 46% of all cases. Staphylococcus aureus was the most frequent bacterium. Bacterial colonization of psoriasis plaques could be relevant in individual cases.
Patient with giant Becker’s nevus and epidermal nevus
Authors: Issa George , Blalock Travis W. , Lesher Jack L.
Published: December 2011

Becker’s nevus is a cutaneous hamartoma that may be present at birth, but more commonly is noticed during puberty. It classically manifests unilaterally on the shoulder and upper trunk as a tan to brown patch or thin plaque. "It typically has an irregular margin, breaks up into islands at the periphery, and has an average size of 125 square centimeters. Numerous skin, soft-tissue, and bony anomalies have been reported in association with Becker’s nevus. We describe a patient with Becker’s nevus of considerable size who has a concurrent epidermal nevus.
Callosity of ankles among people with the habit of sitting with crossed legs: a cosmetic problem
Authors: Omidian Mohammad , Omidian Ehsan
Published: December 2011

Many people living in developing countries still prefer to sit on the carpet or uncarpeted floor, and many times they sit in a cross legged position. Continuous rubbing and friction of the ankles over the carpet or the plain hard surface may cause callosity of the ankles. This can cause a cosmetic problem. We describe a case series of ankle hyperkeratosis referred to our outpatient clinic in Ahwaz in the south west of Iran from 2005-2010. These patients had localized hyperkeratosis on two ankles or the front of ankles. This article aims to help the clinician become more familiar with the morphological characteristic of this problem which may occur in people of Eastern origin.
Laser therapy for Hailey-Hailey Disease: review of the literature and a case report
Authors: Ortiz Arisa E. , Zachary Christopher B.
Published: December 2011

Medical therapy for Hailey-Hailey disease (HHD) generally only provides temporary suppression. Surgical intervention has been shown to prolong remission, but may lead to significant morbidity. Laser therapy is becoming the preferred method of treatment because of its successful results and lower risk of complications compared to surgical modalities. We report a case of fractional ablative carbon dioxide (CO2) laser treatment for HHD and review the relevant literature. Fractional CO2 laser therapy was performed in our patient with a 14-year history of HHD. No recurrence was observed 5 months after laser therapy in right inframammary and axillary regions. Symptomatic recurrence was noted after treatment of inguinal areas. In conclusion, traditional laser ablation remains the treatment of choice for prolonged remission of recalcitrant plaques in HHD.
Lichenoid drug eruption due to eprosartan/hydrochlorothiacide
Authors: Ruiz-Villaverde Ricardo , Galan-Gutierrez Manuel
Published: December 2011

We report a case of a 66-year-old male who developed an itchy eruption while taking an antihypertonic drug containing eprosartan and hydrochlorothiacide after sun exposure. The lesions resembled a lichenoid appearance that was confirmed by the histological study. There are few reports in the literature of lichenoid reactions to these compounds, so we review the characteristics of themselves as a potencial cause of drug eruptions.
Eczema Herpeticum in Pregnancy
Authors: Gurvits Grigoriy E. , Nord Jill A.
Published: December 2011

Eczema Herpeticum (EH), or Kaposi’s varicelliform eruption, is a skin infection with herpes simplex type I virus (HSV-1) that occurs in patients with compromised skin integrity, such as atopic dermatitis (AD). Unrecognized, it may be fatal and viremia in pregnancy may lead to fetal demise and miscarriage. We describe a rare case of EH in pregnancy, eczema herpeticum gravidarum (EHG), which is the third published report in the literature to date.
Coexistence of reticulate acropigmentation of Kitamura and Dowling-Degos disease
Authors: Cabral Ana Rita , Santiago Felicidade , Reis José Pedro
Published: December 2011

Reticulate acropigmentation of Kitamura (RAK) and Dowling-Degos Disease (DDD) are rare genodermatosis inherited as an autosomal dominant trait with variable penetrance. They are part of a spectrum of diseases with hyperpigmented macules coalescing in a reticular pattern, facial and palmoplantar pits, breaks in dermatoglyphics, comedo-like lesions and epidermoid cysts, and a unique histological picture of hyperpigmented digitate epidermal downgrowths. The authors describe the case of a 45-year-old female with reticulate acropigmentation of the dorsa of the hands and feet, hyperpigmented macules on the axilla and around the mouth, and palmar pitting. Clinical and histological findings, together with a relevant family history, allowed the authors to consider this case an example of the rare event of an overlap RAK-DDD.
Cutaneous plasmacytosis: a case report and review of pulmonary findings
Authors: Chantachaeng Weeranut , Chularojanamontri Leena
Published: December 2011

Primary cutaneous plasmacytosis is an uncommon cutaneous disorder with multiple cutaneous nodules and plaques mainly on face and trunk. This entity is thought to be a reactive process with unknown etiology. Pulmonary involvement could be found as a part of systemic plasmacytosis whereas cutaneous plasmacytosis was also reported with other pulmonary disorders. This report presents the case of cutaneous plasmacytosis and the review of pulmonary findings reported in plasmacytosis.
Unilateral linear syringoma in a Japanese female: dermoscopic differentiation from lichen planus linearis
Authors: Hayashi Yuka , Tanaka Masaru , Nakajima Shizuka , Ozeki Masahiko , Inoue Takayuki , Ishizaki Sumiko , Fujibayashi Mariko
Published: December 2011

A dermoscopy of linear unilateral syringoma has never been described in the English literature. The authors report the case to elucidate the dermoscopic features of syringoma. Clinical, dermoscopic and pathological features of a 38-year-old Japanese female case of linear unilateral syringoma on the left upper arm were described and compared with those of lichen planus linearis. Although the clinical appearance of linearly arranged dusky erythemas in the present case was quite similar to that of lichen planus linearis, dermoscopy did not show Wickham's striae but rather homogeneous light brown pigmentation with multifocal whitish areas and a delicate pigment network at the periphery. Dermoscopy might be helpful to differentiate linear unilateral syringoma from lichen planus linearis.
Narrowband UVB-induced lichen planus pemphigoides
Authors: Chan Wai Man Mandy , Lee Joyce Siong See , Theng Colin Seng Thiam , Chua Sze Hon , Oon Hazel Hwee Boon
Published: December 2011

Lichen planus pemphigoides (LPP) is an autoimmune disease characterised by evolution of subepidermal blisters on normal and lichen planus affected skin. We describe a case of LPP in a 54-year-old Chinese woman. The patient presented with psoriasiform plaques and was diagnosed with guttate psoriasis. Narrowband ultraviolet B (NBUVB) therapy was commenced, and she experienced a generalised eruption of violaceous papules, bullae over the lower limbs, and Wickham’s striae over the buccal mucosa. Histology from a plaque revealed interface dermatitis, while a specimen from a blister showed subepidermal bulla. Direct immunofluorescence showed linear deposition of IgG and C3 along the basement membrane. A diagnosis of LPP was made on clinicopathological grounds. This is the first case report of NBUVB alone in unmasking LPP. In this case report, we describe the pathological mechanism of NBUVB in the development of LPP and key features distinguishing LPP from bullous lupus erythematosus, bullous lichen planus, bullous pemphigoid, and psoriasis.
Wegener´s granulomatosis in a young patient preceded by localized cutaneous manifestations
Authors: Smit Jesper , Poulsen Jakob Lykke , Sølling Jakob , Mikkelsen Carsten Sauer
Published: December 2011

Wegener´s granulomatosis (WG) is a rare, systemic vasculitis involving multiple organs. The clinical presentation is highly diverse, and there is considerable risk of mortality if diagnosis and treatment are delayed. We present a case illustrating that patients with WG may initially present with localized cutaneous symptoms and signs.
Resolution of Cullen’s sign in patient with metastatic melanoma responding to hypoxia-activated prodrug TH-302
Authors: Weiss Glen J. , Lewandowski Karen , Oneall Jon , Kroll Stew
Published: December 2011

Cullen’s sign, ecchymosis of the subcutaneous periumbilical tissue often described in association with non-malignant conditions such as ruptured ectopic pregnancy or acute pancreatitis, has been reported in malignancies involving the abdomen. In melanoma, hematoma-like metastasis has been observed and can resolve with an effective therapy. We observed resolution of Cullen’s sign (probably hematoma-like metastasis) in a patient with metastatic melanoma. The patient was participating in a phase I clinical trial and treated with TH-302, a hypoxia-activated prodrug. After 2 months on study, complete resolution of Cullen’s sign resolved in concert with extracranial response in lung, liver, and lymph node metastases. Based on the dramatic extracranial response to this investigational agent, additional patients with metastatic melanoma without evidence of brain metastasis were treated on study with TH-302.
Pyoderma Gangrenosum and lymph nodes tuberculosis disease: unusual association
Authors: Zaraa Ines , Hawilo Abdulmohti , Hassine Slim Ben , Chelly Inès , Haouet Slim , Mourad Mokni , Osman Amel Ben
Published: December 2011

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis with unknown etiology. PG associated with infectious disease is very unsual. We report a singular case of PG with lymph nodes tuberculosis disease.
Cystic Fibrosis-Related Liver Disease: A Single-Center Experience
Authors: Catarino Costa Paula , Barreto Celeste Canha , Pereira Luisa , Lobo Maria Luisa , Costa Maria Adília , Gouveia Lopes Ana Isabel
Published: December 2011

Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years) with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases). All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years), revealed by hepatomegaly or hepatosplenomegaly (3 cases) and/ or abnormalities of liver function tests (3 cases) changes of liver ultrasound (7 cases) with evidence of portal hypertension (2 cases). Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis), progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.
Temporary Brittle Bone Disease: Relationship Between Clinical Findings and Judicial Outcome
Authors: Paterson Colin R. , Monk Elizabeth A.
Published: December 2011

There is a wide differential diagnosis for the child with unexplained fractures including non-accidental injury, osteogenesis imperfecta and vitamin D deficiency rickets. Over the last 20 years we and others have described a self-limiting syndrome characterised by fractures in the first year of life. This has been given the provisional name temporary brittle bone disease. This work had proved controversial mostly because the fractures, including rib fractures and metaphyseal fractures, were those previously regarded as typical or even diagnostic of non-accidental injury. Some have asserted that the condition does not exist. Over the years 1985 to 2000 we investigated 87 such cases with fractures with a view to determining the future care of the children. In 85 of these the judiciary was involved. We examined the clinical and radiological findings in the 33 cases in which there was a judicial finding of abuse, the 24 cases in which the parents were exonerated and the 28 cases in which no formal judicial finding was made. The three groups of patients were similar in terms of demographics, age at fracturing and details of the fractures. The clinical similarities between the three groups of patients contrasts with the very different results of the judicial process.
Endometrial stromal sarcoma metastasis to the lumbar spine and sphenoid bone
Authors: Huang Mary I. , DeBernardo Robert L. , Rodgers Mark , Hart David J.
Published: December 2011

Endometrial stromal sarcoma (ESS) is typically associated with metastasis to the abdomen, pelvis, and lung. We found three case reports of ESS metastasis to the bone (two to the thoracic spine, and one to the parietal bone). Our objective is to review the literature on ESS spinal and intracranial metastases and, report the first case of ESS metastatic to the lumbar paraspinal region and sphenoid bone. A 53-year-old female with ESS status-post radiation, chemotherapy, and pelvic exenteration surgery presented with right hip weakness, back pain, and radicular leg pain that were explained by chemotherapy-induced neuropathy, radiation-induced lumbosacral plexopathy, and femoral nerve and obturator nerve injury during pelvic exenteration surgery. During routine positron emission tomography, we found metastasis to the L3 lumbar spinal region. L3 laminectomy and subtotal resection of the mass was performed with tumor residual in the neuroforamina and pedicles. One month later, magnetic resonance imaging (MRI) performed for persistent headaches revealed a large lesion in the sphenoid bone that was biopsied transsphenoidally with the same diagnosis, but no further surgery was performed. She is intolerant of chemotherapy and currently undergoing whole brain radiation. Delay in the diagnosis and management of lumbar paraspinal and sphenoid bone metastasis of ESS likely occurred because of the uniqueness of the location and aggressiveness of ESS metastasis. Health care providers should be aware of potentially aggressive metastasis of ESS to bone, in particular the unusual locations of the lumbar paraspinal region and sphenoid bone.
Clinical utility of chromogranin a and octreotide in large cell neuro endocrine carcinoma of the uterine corpus
Authors: Shahabi Shohreh , Pellicciotta Ilenia , Hou June , Graceffa Sarah , Huang Gloria S. , Samuelson Robert N. , Goldberg Gary L.
Published: December 2011

Primary neuroendocrine tumors of the female genital tract have been described in the cervix, ovaries and uterus. Large cell neuroendocrine carcinoma (LCNC) of the uterine corpus is the least common and appears to behave the most aggressively. We report a rare case of a large cell neuroendocrine tumor of the endometrium. These tumors are not well characterized, unlike neuroendocrine tumors of the uterine cervix. Consequently, the optimal management remains still unclear. The treatment of our case consisted of surgery, radiotherapy, chemotherapy, and octreotide. Despite the aggressive treatment, the patient died of disease progression 12 months after the initial diagnosis. We discuss the diagnosis, prognosis, and treatment options for LCNC of the genital tract, and potential future therapeutics.
Massive portal vein tumor thrombus from colorectal cancer without any metastatic nodules in the liver parenchyma
Authors: Yamamoto Naoto , Sugano Nobuhiro , Morinaga Soichiro , Kanazawa Amane , Inagaki Daisuke , Shiozawa Manabu , Rino Yasushi , Akaike Makoto
Published: December 2011

Metastatic lesions in the liver derived from colorectal cancer rarely invade the portal vein macroscopically. Portal vein tumor thrombus is commonly associated with hepatocellular carcinoma. Colorectal liver metastases are usually accompanied by microscopic tumor invasion into the intrahepatic portal vein, and the incidence of macroscopic tumor thrombus in the trunk of the portal vein is rare. Here, we provide unique appearance of metastatic colorectal cancer. To the best of our knowledge, macroscopically, the right portal vein filled with the tumor thrombus without any tumor in liver parenchyma has been quite rare.
Prakties-teologiese riglyne vir die drie kategorie� van visuele prediking
Authors: Van Tonder Barend J.
Published: December 2011

Met die verskyning van die TV-medium binne die Suid-Afrikaanse milieu in die laat sestigerjare en vroe� sewentigerjare (vgl. Barnard 2009:192), het �n nuwe wyse van kommunikasie die lig gesien. Grotendeels het dit meegebring dat die kommunikasiemedium van die woord deur die kommunikasiemedium van die beeld vervang is (vgl. Sweet 1999:200).Visuele kommunikasie het die mees ingrypende verskuiwing geword wat oor die afgelope vyf dekades plaasgevind het. Uiteraard het dit �n nuwe generasie na vore gebring, wat as die visuele generasie bekend staan, en binne die visuele taalkode kommunikeer.Visuele uitbeelding word in hierdie artikel gestel as �n legitieme vorm van homiletiese aanbieding naas die oratoriese aanbieding van die prediking. In hierdie artikel word drie kategoriee van visuele prediking word geidentifiseer, naamlik, (1) die visuele beeldpreek, (2) die visuele uitbeeldingspreek en die (3) visuele verbeeldingspreek. Praktiese riglyne vir elke vorm van visuele prediking word in hierdie artikel ontwikkel, sodat die visuele geletterdheid van die prediker kan verhoog.�
Eletroestimulação transcutânea do nervo tibial posterior para bexiga hiperativa neurogênica
Authors: Monteiro Ébe dos Santos , De Aquino Leticia Moraes , Gimenez Marcia Maria , Fukujima Marcia Maiumi , Do Prado Gilmar Fernandes
Published: December 2011

A Síndrome da bexiga urinária hiperativa neurogênica, de alta prevalência, é causada principalmente pela hiperatividade do músculo detrusor da bexiga. A patofisiologia ainda é pouco elucidada e existem algumas opções de tratamento cirúrgico e clínico. Muitas vezes são necessários tratamentos conjuntos para melhores resultados. As pesquisas sobre intervenções conservadoras têm crescido nos últimos anos, apontando para novas estratégias de manejo dos sintomas. A eletrostimulação transcutânea do nervo tibial posterior é uma delas, que tem mostrado resultados promissores, de fácil aplicação, boa adesão, baixo custo e com eficiência.
Application of Theoretical Models to Exercise Behavior among Employed Women
Authors: Marcus Bess H. , Pinto Bernardine M. , Simkin Laurey R. , Audrain Janet E. , Taylor Elaine R.
Published: December 2011

Purpose.

This study examines the utility of three theoretical models—the stages of change model, self-efficacy theory, and the decisional balance model—in understanding exercise behavior among employed women.

Design.

Data for this cross-sectional study were collected as part of a routine follow-up of a worksite-based smoking and health risk appraisal study.

Setting.

The study was conducted in three Rhode Island worksites, including one manufacturing company, one medical center, and one retail outlet.

Subjects.

Of a sample of 431 women who completed exercise questionnaires, 293 reported participation in a physical activity over the previous week. The average age of the sample was 41.1 years, and mean years of education was 12.8.

Measures.

Previously validated measures to determine stage of exercise behavior, exercise self-efficacy, exercise decisional balance, and physical activity participation were administered. Additional demographic information was also obtained.

Results.

Frequency counts revealed that 39% of the population was sedentary, 34% were participating in irregular activity, and 27% were active. MANOVAs followed by one way ANOVAs revealed that women in Precontemplation scored the lowest and those in Maintenance scored the highest on the self-efficacy, pro, and decisional-balance indices, with the trend reversed on the con scale. A chi-square test revealed that women with one or more young children in the home were more likely to be in a lower stage of exercise adoption.

Conclusions.

Most of the women in this cross-sectional study did not engage in regular activity. Presence of young children in the home was significantly related to decreased activity. The results are limited by the nonrandomized, and cross-sectional nature of the study design. Data suggest that, with multiple roles and responsibilities, women may be better served by stage-matched interventions to increase physical activity.
A Qualitative Investigation of Organizational Issues in an Alcohol Awareness Program for Blue-Collar Workers
Authors: Towers Anna M. , Kishchuk Natalie , Sylvestre Marcel , Peters Claudia , Bourgault Chantal
Published: December 2011

Purpose.

To explore sociopolitical and organizational issues in worksite alcohol health promotion. Few such programs are reported in the literature.

Design.

Qualitative data were gathered during the development and implementation phases of a program through focus groups, key informant interviews, and observations made by the research team.

Settings and Subjects.

One hundred and ninety-nine blue-collar workers from a private company (a group which was also involved in a randomized controlled trial) and 123 workers from four other organizations (nontrial groups) received the intervention. The nontrial groups were used to pilot-test the intervention and in a post-trial assessment. All companies were located in Montreal, Quebec, Canada.

Intervention.

Two worksite health promotion sessions on responsible drinking were given to small groups of workers.

Measures.

The reactions of workers, unions, and employers to the program and to the evaluation trial were observed. The viewpoints of key informants were solicited through semi-structured interviews. Analysis was accomplished through several cycles of memo writing.

Results.

Alcohol is a sensitive subject when discussed in worksite group settings. Our data suggest that there are alcohol problems in the workplace of which coworkers are clearly cognizant. In one setting the intervention led to the development of organizational rules regarding workers who reported to work inebriated, where this behavior had been previously tolerated. The sessions were better received when disease concepts were avoided. Evaluation research on alcohol requires particular care with confidentiality and ongoing communication with all stakeholders, especially unions.

Conclusions.

Worksite health promotion regarding alcohol is feasible. The complex process of negotiating, implementing, and evaluating a worksite alcohol health promotion program is discussed. More research on the sociopolitical aspects of such programs is needed.
Continental-scale enrichment of atmospheric 14CO2 from the nuclear power industry: potential impact on the estimation of fossil fuel-derived CO2
Authors: Graven H. D. , Gruber N.
Published: December 2011

Abstract. The 14C-free fossil carbon added to atmospheric CO2 by combustion dilutes the atmospheric 14C/C ratio (Δ14C), potentially providing a means to verify fossil CO2 emissions calculated using economic inventories. However, sources of 14C from nuclear power generation and spent fuel reprocessing can counteract this dilution and may bias 14C/C-based estimates of fossil fuel-derived CO2 if these nuclear influences are not correctly accounted for. Previous studies have examined nuclear influences on local scales, but the potential for continental-scale influences on Δ14C has not yet been explored. We estimate annual 14C emissions from each nuclear site in the world and conduct an Eulerian transport modeling study to investigate the continental-scale, steady-state gradients of Δ14C caused by nuclear activities and fossil fuel combustion. Over large regions of Europe, North America and East Asia, nuclear enrichment may offset at least 20% of the fossil fuel dilution in Δ14C, corresponding to potential biases of more than −0.25 ppm in the CO2 attributed to fossil fuel emissions, larger than the bias from plant and soil respiration in some areas. Model grid cells including high 14C-release reactors or fuel reprocessing sites showed much larger nuclear enrichment, despite the coarse model resolution of 1.8°×1.8°. The recent growth of nuclear 14C emissions increased the potential nuclear bias over 1985–2005, suggesting that changing nuclear activities may complicate the use of Δ14C observations to identify trends in fossil fuel emissions. The magnitude of the potential nuclear bias is largely independent of the choice of reference station in the context of continental-scale Eulerian transport and inversion studies, but could potentially be reduced by an appropriate choice of reference station in the context of local-scale assessments.
Late Holocene plant and climate evolution at Lake Yoa, northern Chad: pollen data and climate simulations
Authors: Lézine A.-M. , Zheng W. , Braconnot P. , Krinner G.
Published: December 2011

Abstract. The discovery of groundwater-fed Lake Yoa (19.03° N, 20.31° E) in the hyperarid desert of northern Chad by the German research team ACACIA headed by S. Kröpelin provides a unique, continuous sedimentary sequence of late Holocene age available in the entire Saharan desert. Here we present pollen data and climate simulations using the LMDZ atmospheric model with a module representing the climatologically-relevant thermal and hydrological processes occurring above and beneath inland water surfaces to document past environmental and climate changes during the last 6000 cal yr BP. Special attention is paid to wind strength and direction, length and amplitude of the rainy season, and dry spell occurrence, all of which are of primary importance for plant distribution and pollen transport. In addition to climate changes and their impact on the natural environment, anthropogenic changes are also discussed. Two main features can be highlighted: (1) the shift from an earlier predominantly monsoonal climate regime to one dominated by northern Mediterranean fluxes that occurred after 4000 cal yr BP. The direct consequence of this was the establishment of the modern desert environment at Yoa at 2700 cal yr BP. (2) Changes in climate parameters (simulated rainfall amount and dry spell length) between 6 and 4000 cal yr BP were comparatively minor. However, changes in the seasonal distribution of precipitation during this time interval dramatically affected the vegetation composition and were at the origin of the retreat of tropical plant communities from Lake Yoa.
Hydro-physical processes at the plunge point: an analysis using satellite and in situ data
Authors: Assireu A. T. , Alcântara E. , Novo E. M. L. M. , Roland F. , Pacheco F. S. , Stech J. L. , Lorenzzetti J. A.
Published: December 2011

Abstract. The plunge point is the main mixing point between river and epilimnetic reservoir water. Plunge point monitoring is essential for understanding the behavior of density currents and their implications for reservoir. The use of satellite imagery products from different sensors (Landsat TM band 6 thermal signatures and visible channels) for the characterization of the river-reservoir transition zone is presented in this study. It is demonstrated the feasibility of using Landsat TM band imagery to discern the subsurface river plumes and the plunge point. The spatial variability of the plunge point evident in the hydrologic data illustrates the advantages of synoptic satellite measurements over in situ point measurements alone to detect the river-reservoir transition zone. During the dry season, when the river-reservoir water temperature differences vanish and the river circulation is characterized by interflow-overflow, the river water inserts into the upper layers of the reservoir, affecting water quality. The results indicate a good agreement between hydrologic and satellite data and that the joint use of thermal and visible channel data for the operational monitoring of a plunge point is feasible. The deduced information about the density current from this study could potentially be assimilated into numerical models and hence be of significant interest for environmental and climatological research.
Trends in indices of daily precipitation extremes in Catalonia (NE Spain), 1951–2003
Authors: Turco M. , Llasat M. C.
Published: December 2011

Abstract. The aim of this paper is to quantitatively characterize the climatology of daily precipitation indices in Catalonia (northeastern Iberian Peninsula) from 1951 to 2003. This work has been performed analyzing a subset of the ETCCDI (Expert Team on Climate Change Detection and Indices) precipitation indices calculated from a new interpolated dataset of daily precipitation, namely SPAIN02, regular at 0.2° horizontal resolution (around 20 km) and from two high-quality stations: the Ebro and Fabra observatories. Using a jack-knife technique, we have found that the sampling error of the SPAIN02 regional averaged is relatively low. The trend analysis has been implemented using a Circular Block Bootstrap procedure applicable to non-normal distributions and autocorrelated series. A running trend analysis has been applied to analyze the trend persistence. No general trends at a regional scale are observed, considering the annual or the seasonal regional averaged series of all the indices for all the time windows considered. Only the consecutive dry days index (CDD) at annual scale shows a locally coherent spatial trend pattern; around 30% of the Catalonia area has experienced an increase of around 2–3 days decade−1. The Ebro and Fabra observatories show a similar CDD trend, mainly due to the summer contribution. Besides this, a significant decrease in total precipitation (around −10 mm decade−1) and in the index "highest precipitation amount in five-day period" (RX5DAY, around −5 mm decade−1), have been found in summer for the Ebro observatory.