bluuebunny/crossref_metadata_2025 huggingface dataset:
WALL SLIP EFFECTS MEASURING THE RHEOLOGICAL BEHAVIOR OF ELECTRORHEOLOGICAL (ER) SUSPENSIONS
Authors: SCHNEIDER STEFFEN
Published: August 2011

In this work, a new method to determine the wall shear stress was developed step by step. To determine the wall shear stress, methods of the suspension rheology are being used for the first time to characterize ER fluids. This work focuses on investigations of the flow behavior of electrorheological suspensions in flow channels with different geometries at different electrical field strengths. Careful interpretation of the results with respect to different gap geometries has shown that the measured flow curves should undergo a combination of corrections. As a result it can be shown that wall slip effects can be measured under application like conditions on a hydraulic test bench.
INTERACTION FORCE BETWEEN POLYDISPERSE STAR POLYMERS IN A Θ-SOLVENT
Authors: HIMMI M. , MOHAMMADI L.
Published: August 2011

We consider a dilute solution of very small spherical particles clothed each by f end-grafted flexible polymer chains, we regard as star-polymers, and immersed in a Θ-solvent. The presence of a Θ-solvent induces an effective force between adjacent star-polymers. We are interested in the investigation of the polydispersity effects on this interaction force. This work is a natural extension of that where we have considered the same system but in the presence of a good solvent. Consequently we use the same theoretical approach to determine the structure of our system, and particularly the extension of polydisperse star-polymer in a Θ-solvent. We assume that the lengths of the f grafted chains are randomly distributed, with a distribution [Formula: see text]. The latter is the number of chains having more than n monomers and which generally is related to the probability to have a grafted chain of n monomers. To make explicit calculation of the expected force, FΘ(h), as a function of the interparticle-distance h we choose the particular form for the distribution [Formula: see text] used in the good solvent case. This distribution is a power law in the n-variable that is, [Formula: see text], if n < N, and [Formula: see text], if n > N. Here, 1 ≤ α < 2 is the polydispersity exponent and N is the polymerization degree of the longest grafted chain. To obtain the force expression, we use some method developed by Witten and Pincus for monodisperse star-polymers in a good solvent. We show that the computation of the force depends on the polymerization degree N compared with the typical number Nc ~ f1/(α-1).
ARTIFICIAL MICRO WORLDS PART IV: MODELS OF COMPLEX SELF-REPRODUCERS
Authors: BILOTTA ELEONORA , PANTANO PIETRO
Published: August 2011

As Wolfram classification of cellular automata, we have divided a taxonomy of Artificial Micro Worlds (AMWs) into four classes. In previous work, we have presented many examples of self-reproducers belonging to Class 1. In this paper, we present a series of AMWs, belonging to Class 2 (complex AMWs which contain complex species of self-reproducers); Class 3 (which contains species of self-reproducers with chaotic behavior) and Class 4 (which contains species with hyper complex self-reproducers). In particular, we introduce an AMW, belonging to Class 2 (a loop-shaped system); several AMWs, belonging to Class 3 (species with a linear and chaotic behavior) and a series of AMWs, belonging to Class 4 (with species which show very different behaviors). Particular attention will be dedicated to a new type of AMW, which contains a species that has an incorporated developmental program.
MOUFANG LOOPS OF ODD ORDER p3q3
Authors: RAJAH ANDREW , CHEE WING LOON
Published: August 2011

It was shown that for odd primes p1< ⋯ < pm< q < r1< ⋯ < rn, all Moufang loops of order [Formula: see text] are associative if and only if q ≢ 1 ( mod pi) for each i. In this paper, we extend this result to Moufang loops of odd order p3q3.
A NONVANISHING LEMMA FOR CERTAIN PADÉ APPROXIMATIONS OF THE SECOND KIND
Authors: MERILÄ VILLE
Published: August 2011

We prove the nonvanishing lemma for explicit second kind Padé approximations to generalized hypergeometric and q-hypergeometric functions. The proof is based on an evaluation of a generalized Vandermonde determinant. Also, some immediate applications to the Diophantine approximation is given in the form of sharp linear independence measures for hypergeometric E- and G-functions in algebraic number fields with different valuations.
ON LOGARITHMIC DERIVATIVES OF ZETA FUNCTIONS IN FAMILIES OF GLOBAL FIELDS
Authors: LEBACQUE PHILIPPE , ZYKIN ALEXEY
Published: August 2011

We prove a formula for the limit of logarithmic derivatives of zeta functions in families of global fields with an explicit error term. This can be regarded as a rather far reaching generalization of the explicit Brauer–Siegel theorem both for number fields and function fields.
A p-ADIC VIEW OF MULTIPLE SUMS OF POWERS
Authors: KIM MIN-SOO , HU SU
Published: August 2011

Washington [p-Adic L-functions and sums of powers, J. Number Theory69 (1998) 50–61] gave an explicit p-adic expansion of [Formula: see text] as a power series in m. The coefficients are values of p-adic L-functions. Let q = 4 if p = 2 and q = p otherwise. In this paper, we prove an explicit p-adic expansion of the multiple sums of powers [Formula: see text] as a p-adic power series in m. The coefficients are values of multiple two-variable p-adic L-functions. Washington's formula is a special case of the formula given in this paper when n = 1 and t = 0.
INDUCTIVE FORMULAS FOR SOME ARITHMETIC FUNCTIONS
Authors: EL BACHRAOUI MOHAMED
Published: August 2011

We prove recursive formulas involving sums of divisors and sums of triangular numbers and give a variety of identities relating arithmetic functions to divisor functions providing inductive identities for such arithmetic functions.
Credit Risky Securities Valuation under a Contagion Model with Interacting Intensities
Authors: Wang Anjiao , Ye Zhongxing
Published: August 2011

We study a three‐firm contagion model with counterparty risk and apply this model
to price defaultable bonds and credit default swap (CDS). This model assumes that default intensities are driven by external common factors as well as other defaults in the system. Using the “total hazard” approach, default times can be generated and the joint density function is obtained. We represent the pricing method of defaultable bonds and obtain the closed‐form pricing formulas. By the approach of “change of measure,” analytical solutions of CDS
swap rate (swap premuim) are derived in the continuous time framework and the discrete time framework, respectively.
Pelvic Lymphadenectomy in the Treatment of Invasive Bladder Cancer: Literature Review
Authors: Elzayat Ehab A. , Al-Zahrani Ali A.
Published: August 2011

The standard surgical treatment of invasive bladder cancer is the radical cystectomy and pelvic lymph node dissection (PLND). Up to one-third of patients with invasive bladder cancer have lymph node metastasis. Thus, PLND has important therapeutic and prognostic benefits. The number of lymph nodes that should be removed and the extent of the PLND are still a controversial issue. Recently, the trend of PLND increased toward more extended PLND. Several prognostic factors related to PLND were reported in the literature. In this paper, we will discuss the different PLND templates, number of lymph nodes that should be resected, lymph node density, lymphovascular invasion, tumor burden, extracapsular extension, and the aggregate lymph node metastasis diameter.
The Role of FRMD7 in Idiopathic Infantile Nystagmus
Authors: Watkins Rachel J. , Thomas Mervyn G. , Talbot Chris J. , Gottlob Irene , Shackleton Sue
Published: August 2011

Idiopathic infantile nystagmus (IIN) is an inherited disorder in which the nystagmus arises independently of any other symptoms, leading to the speculation that the disorder represents a primary defect in the area of the brain responsible for ocular motor control. The inheritance patterns are heterogeneous, however the most common form is X-linked.FRMD7resides at Xq26-27 and approximately 50% of X-linked IIN families map to this region. Currently 45 mutations withinFRMD7have been associated with IIN, confirming the importance ofFRMD7in the pathogenesis of the disease. Although mutations inFRMD7are known to cause IIN, very little is known about the function of the protein. FRMD7 contains a conserved N-terminal FERM domain suggesting that it may provide a link between the plasma membrane and actin cytoskeleton. Limited studies together with the knowledge of the function of other FERM domain containing proteins, suggest that FRMD7 may play a role in membrane extension during neuronal development through remodeling of the actin cytoskeleton.
Not All Brains Are Made the Same: New Views on Brain Scaling in Evolution
Authors: Herculano-Houzel Suzana
Published: August 2011

Evolution has generated mammalian brains that vary by a factor of over 100,000 in mass. Despite such tremendous diversity, brain scaling in mammalian evolution has tacitly been considered a homogeneous phenomenon in terms of numbers of neurons, neuronal density, and the ratio between glial and neuronal cells, with brains of different sizes viewed as similarly scaled-up or scaled-down versions of a shared basic plan. According to this traditional view, larger brains would have more neurons, smaller neuronal densities (and, hence, larger neurons), and larger glia/neuron ratios than smaller brains. Larger brains would also have a cerebellum that maintains its relative size constant and a cerebral cortex that becomes relatively larger to the point that brain evolution is often equated with cerebral cortical expansion. Here I review our recent data on the numbers of neuronal and nonneuronal cells that compose the brains of 28 mammalian species belonging to 3 large clades (Eulipotyphla, Glires, and Primata, plus the related Scandentia) and show that, contrary to the traditional notion of shared brain scaling, both the cerebral cortex and the cerebellum scale in size as clade-specific functions of their numbers of neurons. As a consequence, neuronal density and the glia/neuron ratio do not scale universally with structure mass and, most importantly, mammalian brains of a similar size can hold very different numbers of neurons. Remarkably, the increased relative size of the cerebral cortex in larger brains does not reflect an increased relative concentration of neurons in the structure. Instead, the cerebral cortex and cerebellum appear to gain neurons coordinately across mammalian species. Brain scaling in evolution, hence, should no longer be equated with an increasing dominance of the cerebral cortex but rather with the concerted addition of neurons to both the cerebral cortex and the cerebellum. Strikingly, all brains appear to gain nonneuronal cells in a similar fashion, with relatively constant nonneuronal cell densities. As a result, while brain size can no longer be considered a proxy for the number of brain neurons across mammalian brains in general, it is actually a very good proxy for the number of nonneuronal cells in the brain. Together, these data point to developmental mechanisms that underlie evolutionary changes in brain size in mammals: while the rules that determine how neurons are added to the brain during development have been largely free to vary in mammalian evolution across clades, the rules that determine how other cells are added in development have been mostly constrained and to this day remain largely similar both across brain structures and across mammalian groups.
Variability in Neuron Densities across the Cortical Sheet in Primates
Authors: Collins Christine E.
Published: August 2011

The function of any area of the brain is a product of its unique population of neurons and nonneurons and their local and long-range connectional architecture. At the present time, we have inadequate data about numbers of neurons and the distribution patterns of neurons in the cortex and other parts of the brain. Numbers and densities of neurons and nonneurons provide the foundation for the assembly of a cortical and whole-brain neuronal network, yet the majority of studies reporting neuron densities for the primate cortex estimate the number of neurons in the cortex as a whole or in specific areas for comparisons between treatment groups or species. While this is valuable information for studies of scaling or comparative studies of specific pathways or functions, a more detailed examination of cell and neuron number distribution across the entire cortical expanse is needed. Two studies reviewed here use the isotropic fractionator method for the determination of cell and neuron numbers to investigate the distribution of cells and neurons across the entire cortical sheet of 4 primate species, taking into consideration cortical areal boundaries. Neuron and total cell numbers were found to vary as much as 5 times between different functional areas across the cortical sheet. Numbers were also variable across representational zones within cortical areas like V1 and S1. The overall distribution of cells and neurons appears to be conserved across the species examined, suggesting a common plan for cell distribution in primates, with more areas of high neuron density in macaques and baboons compared to the smaller and less differentiated cortex of prosimian galagos and the New World owl monkey.
All Rodents Are Not the Same: A Modern Synthesis of Cortical Organization
Authors: Krubitzer Leah , Campi Katharine L. , Cooke Dylan F.
Published: August 2011

Rodents are a major order of mammals that is highly diverse in distribution and lifestyle. Five suborders, 34 families, and 2,277 species within this order occupy a number of different niches and vary along several lifestyle dimensions such as diel pattern (diurnal vs. nocturnal), terrain niche, and diet. For example, the terrain niche of rodents includes arboreal, aerial, terrestrial, semi-aquatic, burrowing, and rock dwelling. Not surprisingly, the behaviors associated with particular lifestyles are also highly variable and thus the neocortex, which generates these behaviors, has undergone corresponding alterations across species. Studies of cortical organization in species that vary along several dimensions such as terrain niche, diel pattern, and rearing conditions demonstrate that the size and number of cortical fields can be highly variable within this order. The internal organization of a cortical field also reflects lifestyle differences between species and exaggerates behaviorally relevant effectors such as vibrissae, teeth, or lips. Finally, at a cellular level, neuronal number and density varies for the same cortical field in different species and is even different for the same species reared in different conditions (laboratory vs. wild-caught). These very large differences across and within rodent species indicate that there is no generic rodent model. Rather, there are rodent models suited for specific questions regarding the development, function, and evolution of the neocortex.
Adsorptive Modulation of Inflammatory Mediators Dampens Endothelial Cell Activation
Authors: Schildberger Anita , Buchacher Tanja , Weber Viktoria , Falkenhagen Dieter
Published: August 2011

Aim: In this study, the effect of specific or selective adsorption of inflammatory mediators on endothelial activation was assessed. Methods: Conditioned medium was obtained by stimulation of monocytic THP-1 cells with lipopolysaccharide and treated either with an adsorbent specific for tumour necrosis factor-α or with an albumin-coated polystyrene-divinylbenzene copolymer which selectively binds a range of cytokines. Thereafter, the conditioned medium was applied to endothelial cells in culture. Results: Adsorption of inflammatory mediators resulted in significantly decreased endothelial cell activation, as shown by reduced interleukin (IL)-6 and IL-8 secretion from endothelial cells as well as reduced surface expression of the adhesion molecules intercellular adhesion molecule-1 and E-selectin. The effect was more pronounced the earlier the mediator modulation was performed. Conclusion: Adsorptive modulation of inflammatory mediators dampens endothelial cell activation and may thus be beneficial as supportive therapy in sepsis.
A Missense Mutation in the Death Domain of EDAR Abolishes the Interaction with EDARADD and Underlies Hypohidrotic Ectodermal Dysplasia
Authors: Masui Yukiko , Farooq Muhammad , Sato Nobuyuki , Fujimoto Atsushi , Fujikawa Hiroki , Ito Masaaki , Shimomura Yutaka
Published: August 2011

Background: Hypohidrotic ectodermal dysplasia (HED) is a rare condition characterized by hypotrichosis, hypohidrosis and hypodontia. The disease shows X-linked recessive, autosomal-dominant or autosomal-recessive inheritance trait. X-linked form of HED is caused by mutations in the EDA gene, while autosomal forms are caused by mutations in either EDAR or EDARADD genes. Methods: We analyzed the DNA from a Japanese patient with HED through direct sequencing, and also performed functional studies for the mutation. Results: We identified a homozygous missense mutation c.1073G>A (p.R358Q) in the EDAR gene of the patient, which was a nonconservative amino acid substitution within the death domain of EDAR protein. We demonstrated that the p.R358Q mutant EDAR protein lost its affinity to EDARADD, leading to reduced activation of the downstream NF-ĸB. Conclusion: Our data further suggest the crucial role of the EDAR signaling in development of hair, teeth, and sweat gland in humans.
Characterization of Patient-Reported Outcomes in Moderate to Severe Psoriasis
Authors: Krenzer Stefanie , Radtke Marc , Schmitt-Rau Karlheinz , Augustin Matthias
Published: August 2011

Background: The Patient Benefit Index (PBI) is a recently developed instrument to assess patient satisfaction with treatment. It has been applied to only a limited number of psoriasis patients. Objective: Characterization of patient-reported outcomes (PRO) in patients with moderate to severe psoriasis Methods: 1,787 patients with plaque psoriasis were documented. Psoriasis Area and Severity Index (PASI), body surface area (BSA), Dermatology Life Quality Index (DLQI) and PBI were determined. Correlations were calculated and the persistence of PBI improvement and strength of treatment effect were evaluated. A regression analysis was performed to characterize predictors of PBI and DLQI improvements. Results: Significant correlations exist between ΔPASI/ΔBSA and ΔDLQI. Also, DLQI and PBI are correlated. Improvement in the skin condition has a positive and sustainable impact on all need dimensions of the PBI. The best early predictor for PBI was PASI 75 at treatment week 8, relevant factors predicting quality of life were PBI/subscale 4, (reducing physical impairment), ΔBSA and ΔPASI. Conclusion: Improvement in skin condition correlates with improvements in quality of life in patients with plaque psoriasis. Successful treatment leads to significant and sustainable patient benefit. While PBI subscale 4 is a good predictor for quality of life, more work is necessary to identify potential predictors for patient benefit.
Pressure Bandage as an Effective Treatment for Intralymphatic Histiocytosis Associated with Rheumatoid Arthritis
Authors: Washio Ken , Nakata Kaori , Nakamura Atsuko , Horikawa Tatsuya
Published: August 2011

The patient is a 71-year-old male who has been suffering from rheumatoid arthritis for over 20 years. He first noticed the erythema on his right forearm in 2008, which got worse in 2009. Topical corticosteroids were not effective, and a skin biopsy was performed. Histopathologic examination showed aggregation of the inflammatory cells in the dermal vessels. Those cells were positive for CD68 and CD31 and all the surrounding vessels expressed D2–40 and CD31. We diagnosed him with intralymphatic histiocytosis. One week after the skin was biopsied, only the part of the erythematous lesion covered by skin tape had improved, suggesting that pressure on the lesion might improve the erythematous eruption. We therefore used a pressure bandage elbow supporter in addition to topical treatment. The lesion improved 3 months later and was totally diminished after 9 months. Combined with previously reported cases, our case suggested that intralymphatic histiocytosis is closely related to lymphostasis.
Dominant convict cichlids (Amatitlania nigrofasciata) grow faster than subordinates when fed an equal ration
Authors: Grant James W.A. , Lee Gavin , Comolli Perry
Published: August 2011

Previous studies indicate that dominant fish grow faster than subordinate fish when fed equal rations. It is unclear, however, whether this growth differential is caused by intrinsic differences related to their propensity to become dominant, or by the extrinsic effect of the social stress experienced by subordinates. We first tested whether dominant convict cichlids (Amatitlania nigrofasciata) grew faster than subordinates when fed an equal amount of food. Second, we tested whether the growth advantage of dominants occurred when only visual interactions were allowed between pairs of fish. Third, we randomly assigned social status to the fish to rule out the possibility that intrinsic differences between fish were responsible for both the establishment of dominance and the growth differences. In three separate experiments, dominant fish grew faster than size-matched subordinate convict cichlids, but the growth advantage of dominants was higher when there were direct interactions between fish compared to only visual interactions. Our results provide strong support for the hypothesis that the slower growth rate of subordinate fish was due to the physiological costs of stress.
Rapid search for genetic differentiation of populations: application to the European pond turtle
Authors: Pieau Claude , Girondot Marc , Servan Jean
Published: August 2011

A strategy has been developed to screen very rapidly many individuals and loci in one step to screen for qualitative genetic difference among different populations. Genomic DNAs of individuals are digested with a restriction enzyme and then pooled according to the phenotypic character to genetically characterize. After electrophoresis on the same gel of the different DNA pools, the DNA fragments are hybridized with synthetic oligonucleotides of 4 base repeats. The hybridization patterns obtained with the different pools of DNA are compared and are used as references to analyze the individual profiles. This strategy was used to screen the genetic structure of several breeding groups of the European pond turtle (Emys orbicularis) from department of Indre (Brenne region), and Var, both in France at 4 geographic scales. The results are concordant with those obtained using morphological and mtDNA data.
Are toad tadpoles unpalatable: evidence from the behaviour of a predatory dragonfly in South China
Authors: Karraker Nancy E.
Published: August 2011

Predators are important determinants of amphibian community structure in aquatic habitats, and larval odonates can be significant predators of amphibian larvae. Despite their toxicity as adults, the palatability of bufonid eggs and tadpoles to vertebrate and invertebrate predators remains widely debated. I tested the palatability of hatchling tadpoles of the Asian common toad (Bufo melanosticus) and four other amphibians in Hong Kong to larvae of the dragonfly Pantala flavescens. Attempted predation of Bufo melanostictus hatchling tadpoles by P. flavescens resulted in 100% mortality of hatchlings, but none were consumed. All other amphibians were palatable to P. flavescens. Development of toxins may not protect early-stage bufonids from invertebrate predators that detect prey by visual cues and then make a debilitating strike. These findings present the first report of unpalatability of bufonid tadpoles to an invertebrate predator and provide evidence that unpalatability of early stage bufonids to odonates may decrease through ontogeny.
Framing Superiority and Closeness: Bridging the Class Gap in Philippine Electoral Politics
Authors: Rutten Rosanne
Published: August 2011

Contentious politics produces diverse leadership styles that may all be salient to a country’s electorate. This article explores key cultural frames that allow politicians to project both superiority and closeness to lower-class populations, hinged on different criteria of legitimacy. In the Philippine electoral arena, the established “patronage frame” is challenged by new political contenders who put forward the “oppression frame” of class politics, the “good governance” frame of liberal reformers, and the populist frame of media celebrities-turned-politicians. Given the salience of multiple frames, ordinary people may employ seemingly contradictory criteria of superiority and legitimacy and combine these effortlessly when they choose whom to vote for. This article suggests a social logic of frame diversity.
Anti-Elites as New Elites: Complexities of Elite Performance in Baffled Bolivia
Authors: Sologuren Ximena Soruco , Salman Ton
Published: August 2011

This article argues that recent political changes in Bolivia, leading to the first indigenous president in the country’s history being inaugurated in 2006, unsettled the traditional schemes of societal stratification, as well as the traditionally accepted markers of elite-hood. As a consequence, not only have new elites come to the fore, but they also modified the material, symbolic and political parameters with which elites demonstrate and affirm their position, leading to new searches for self-positioning as elites. Some sectors of the old elites developed an egoistic, revengeful subjectivity bringing bloodshed to the country. The new elite, on the contrary, is fragmented, confused and in part reluctant to perform as elite.
Evaluation of Water Stress Impact on the Parameter Values in Stomatal Conductance Models Using Tower Flux Measurement of a Boreal Aspen Forest
Authors: Wang Shusen
Published: August 2011

The impact of water stress on plant stomatal conductance (g) has been widely studied but with little consensus as to the processes governing its responses. The photosynthesis-driven stomatal conductance models usually employ constant model parameters and attribute the decrease of g from water stress to the reduction of leaf photosynthesis. This has been challenged by studies showing that the model parameter values decrease when the plant is under water stress. In this study, the impact of plant water stress on the parameter values in stomatal conductance models is evaluated using the approach recently developed by S. Wang et al. and the tower flux measurements at a Canadian boreal aspen forest. Results show that the slope parameter (α) in the stomatal conductance models decreases substantially with the development of plant water stress. The magnitude of this reduction is dependent on how plant water stress is represented. Overall, the relative reduction of α from its maximum value is 28% when soil water content decreases from 0.38 to 0.18 m3 m−3, and is 38% when Bowen ratio increases from 0.25 to 3.5. Equations for α correction to account for water stress impacts are proposed. Further studies on different ecosystems are necessary to quantify the parameter variations with water stress among different climate regions and plant species.
Linked Data and the LOCAH project
Authors: Ruddock Bethan
Published: August 2011

The popularity of the Semantic Web has been growing in recent years. Introduced by Tim Berners-Lee in 2001, the vision of the Semantic Web is of a web of data, negotiable by machines. One of the main components of this is Linked Data, which describes things and the relationships between them using controlled ontologies and HTTP URIs. This article provides a clear explanation of the fundamentals of Linked Data, and discusses how these are being used by the JISC-funded LOCAH project, which aims to make bibliographic and archival data from the Copac and the Archives Hub available as open Linked Data. Providing data as Linked Data creates links with other data sources, and allows the development of new channels into the data. Bibliographic and archive data is especially rich in the kind of data that can enhance existing knowledge and conceptions. The author also looks at the power and the potential of Linked Data, the growth in its application, and concludes with some of the ways businesses (BBC, Vodaphone, and the oil and gas industries) are beginning to use Linked Data.
Research and information services
Authors: King Emma
Published: August 2011

Research and information services in corporate business are facing challenges to their value and relevance. The key to continued existence lies in ensuring that the research service is offering what the business needs and then demonstrating that value to the business. This requires research services to respond to the constantly changing demands of businesses who themselves are seeking to survive. It is a continuing cycle of assessing the service offering against the business needs; defining the remit of the research service based on those needs; demonstrating that the research service is commercially valuable because it understands what the business research needs are and delivers against these needs. The results can provide a powerful message to stakeholders and can counter the view that a research service is an unnecessary cost. The aim of any research service is to be, and to be seen as, a necessary resource, rather than one that is nice to have. This article is written from the experiences of the author from various research roles in consultancies and professional services where the author has worked and also established research services that focus on delivering value-added, commercially relevant research support, direct to staff who are undertaking work for clients.
General population low-count CLL-like MBL persists over time without clinical progression, although carrying the same cytogenetic abnormalities of CLL
Authors: Fazi Claudia , Scarfò Lydia , Pecciarini Lorenza , Cottini Francesca , Dagklis Antonis , Janus Agnieszka , Talarico Anna , Scielzo Cristina , Sala Cinzia , Toniolo Daniela , Caligaris-Cappio Federico , Ghia Paolo
Published: August 2011

Monoclonal B-cell lymphocytosis (MBL) is classified as chronic lymphocytic leukemia (CLL)–like, atypical CLL, and CD5− MBL. The number of B cells per microliter divides CLL-like MBL into MBL associated with lymphocytosis (usually detected in a clinical setting) and low-count MBL detected in the general population (usually identified during population screening). After a median follow-up of 34 months we reevaluated 76 low-count MBLs with 5-color flow cytometry: 90% of CLL-like MBL but only 44.4% atypical CLL and 66.7% CD5− MBL persisted over time. Population-screening CLL-like MBL had no relevant cell count change, and none developed an overt leukemia. In 50% of the cases FISH showed CLL-related chromosomal abnormalities, including monoallelic or biallelic 13q deletions (43.8%), trisomy 12 (1 case), and 17p deletions (2 cases). The analysis of the T-cell receptor β (TRBV) chains repertoire showed the presence of monoclonal T-cell clones, especially among CD4highCD8low, CD8highCD4low T cells. TRBV2 and TRBV8 were the most frequently expressed genes. This study indicates that (1) the risk of progression into CLL for low-count population-screening CLL-like MBL is exceedingly rare and definitely lower than that of clinical MBL and (2) chromosomal abnormalities occur early in the natural history and are possibly associated with the appearance of the typical phenotype.
The surgical treatment of knee stiffness following anterior cruciate ligament reconstruction
Authors: Robertson G A , Coleman S G , Keating J F
Published: August 2011

Knee stiffness following anterior cruciate ligament (ACL) reconstruction remains a common complication, which can substantially impair knee function. The aim of this study was to assess the effectiveness of arthroscopic arthrolysis, in conjunction with manipulation under anaesthetic (MUA), in treating stiffness post-ACL reconstruction. We reviewed the records of 18 patients who underwent arthroscopic arthrolysis to treat established stiffness following primary isolated ACL reconstruction. Eight of these patients underwent concomitant MUA at time of arthrolysis. The median time between reconstruction and arthrolysis was nine months. Seven patients had arthrolysis performed within eight months of reconstruction, while 11 patients underwent arthrolysis greater than eight months postreconstruction. Following arthrolysis, the mean extension loss improved from 7° to 1°. In patients with mild extension stiffness (prearthrolysis extension deficits <10°), the mean improvement to extension was 3°. In patients with severe extension stiffness (prearthrolysis extension deficit ≥10°), the mean improvement to extension was 10°. Arthroscopic arthrolysis was significantly more effective in restoring extension loss if carried out within eight months of the primary reconstruction ( P < 0.03). In the patients who underwent MUA at time of arthrolysis, the mean flexion loss improved from 16° to 4°. In conclusion, arthroscopic arthrolysis, in conjunction with MUA, is an effective treatment for knee stiffness post-ACL reconstruction but ideally should be carried out within eight months.
A rare case of ovarian carcinoid causing heart failure
Authors: Mordi I R , Bridges A
Published: August 2011

Carcinoid tumours are rare tumours of the neuro-endocrine system. They most commonly present in the gut; however, they can present in other organs. In all, 0.3% of carcinoid tumours are ovarian in origin. Subsequently, very few cases of ovarian carcinoid affecting the heart have been reported and this case adds to the literature on this. There are very few reports in the literature of ovarian carcinoid and even fewer on cardiac failure due to carcinoid. Generally, carcinoid heart disease only affects the right-sided valves, sparing the mitral and aortic valves. We present the case of a patient who had an ovarian carcinoid tumour excised successfully and had been asymptomatic for 14 years prior to an incidental finding of right valvular signs on echocardiography, before subsequently right heart failure deemed to be secondary to ovarian carcinoid heart disease. The diagnosis is generally made on the findings of right-sided heart failure and the valvular abnormalities on echocardiogram (isolated pulmonary and tricuspid involvement). If the tumour is present at the same time as the development of heart failure, cardiac function can improve with timely tumour resection; however, cardiac disease can occur despite tumour removal.
Dental hyponatraemia
Authors: Simpson R M
Published: August 2011

A 14-year-old girl developed dental pain and was treated for acute infected pulpitis of her right upper lateral incisor with drilling and filling. The pain continued and was helped by analgesia, sucking ice cubes and drinking cold water. Forty-eight hours later, she became confused and disoriented. She started to vomit and complained of headache. Investigations revealed hyponatraemia with normal serum potassium levels and initially normal urinary sodium excretion. Over the next 24 hours, she passed 5.45 L of urine and her serum sodium rose from 125 to 143 mmol/L. Self-induced water intoxication has been described during drinking games and initiation ceremonies, but this would appear to an unusual cause. Conservative management proved successful in allowing this girl to recover without sequelae.
The conservative management of primary pyomyositis abscess in children: case series and review of the literature
Authors: Miller N J K , Duncan R D D , Huntley J S
Published: August 2011

Pyomyositis is a primary pyogenic infection in skeletal muscle, often progressing to abscess formation. It is rare in temperate climates and generally deep-seated within the pelvis with nonspecific clinical features, making diagnosis difficult. Magnetic resonance imaging (MRI) is highly sensitive for muscle inflammation and fluid collection, and with its increasing availability is now the investigation of choice. Treatment of pyomyositis abscess has traditionally been with incision and drainage or guided aspiration followed by a prolonged course of antibiotics, although there are sporadic reports of cases treated successfully with antibiotics alone. Our aim was to describe our own experience with the treatment of pyomyositis abscess in children. From our 20-year database of over 16,000 paediatric orthopaedic admissions, we identified only three cases with MRI-confirmed pyomyositis abscess. These were all in boys (aged 2-12 years) and affected the gluteal, piriformis and adductor muscles. Despite the organisms not being identified, each patient was treated successfully with a short (4-7 days) course of intravenous antibiotics followed by 2-6 weeks of oral therapy. There were no recurrences or complications and all made a full recovery. In conclusion, we propose that uncomplicated pyomyositis abscess in children may usually be managed conservatively without the need for open or percutaneous drainage.
Often atypical? The distribution of sensory disturbance in carpal tunnel syndrome
Authors: Clark D , Amirfeyz R , Leslie I , Bannister G
Published: August 2011

This study aimed to examine the disturbance of hand sensation in patients with carpal tunnel syndrome (CTS) and assess the usefulness of objective and subjective measures. The study included 64 patients with CTS confirmed by electrophysiological testing. Sensory assessment was made by objective (pressure aesthesiometry) and subjective (hand symptom diagram) measures in different anatomical areas. The results of the subjective and objective testing were correlated with nerve conduction studies by a kappa analysis. Sensory disturbance occurred more frequently in areas innervated by the median nerve (index finger, 94%) but also with great frequency in other areas (little finger, 39%). Pain occurred frequently in anticipated areas (wrist crease, 33%) but also in other areas (little finger, 11%). There was very poor correlation between objective measures and electrophysiological testing or subjective measures. This study does therefore not support the use of objective sensory assessment for the initial diagnosis of CTS. An atypical distribution of symptoms is a common occurrence and should not discourage diagnosis of CTS. The patient's description of symptoms remains the most important tool in diagnosis.
Management of boys with abnormal appearance of meatus at circumcision for balanitis xerotica obliterans
Authors: Holbrook C , Tsang T
Published: August 2011

INTRODUCTION

The aim of this study was to develop a standardised management plan for boys with abnormal appearance of meatus at circumcision for balanitis xerotica obliterans (BXO).

METHODS

Between 1995 and 2008, 107 boys underwent circumcision for BXO (confirmed on histology). Of these, 23 had abnormal appearance of the meatus at operation; their case notes were reviewed for age, presenting symptoms, management, outcome and follow up.

RESULTS

The age range at operation was 3–15 years (mean: 9 years). Patients commonly presented with phimosis and balanitis. Seven patients had an additional procedure at circumcision: six had meatotomy, one had meatal dilatation. Thirteen were treated with topical steroid cream post-operatively. Eight of these (62%) subsequently required meatotomy. Three patients were observed and did not require further intervention. Meatotomy was required in 9 patients, 6–29 months after circumcision (mean: 11 months). Two patients required dilatation, including one with a previous intraoperative meatotomy, who required multiple dilatations.

CONCLUSIONS

We propose the following standardised management plan: 1. With clinical evidence of BXO at circumcision, prepuce should be sent for histology. 2. If BXO is confirmed but the meatus appears normal, patients should be seen once post-operatively to give information about meatal stenosis. 3. When the meatus appears scarred with a narrowed lumen at operation, a meatotomy should be performed, with follow up for at least two years. 4. If the lumen is scarred but adequate, patients should be followed up in clinic for the same period for possible development of stenosis. 5. Topical steroid cream can be considered for voiding discomfort without decreased urine stream.
The management of oesophageal soft food bolus obstruction: a systematic review
Authors: Leopard D , Fishpool S , Winter S
Published: August 2011

INTRODUCTION

Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO.

METHODS

Relevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. A systematic review was performed on 8 November 2010.

RESULTS

This systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a ‘watch and wait’ policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction.

CONCLUSIONS

There is a need for large double-blind, randomised, placebo controlled trials of drugs used in the medical management of OSFBO. Until the results from such trials are available, the treatment of OSFBO will remain based on inconsistent clinical judgement.
Maintaining surgical professionalism
Authors: Taylor Irving
Published: August 2011

The Royal College of Physicians working party on medical professionalism defined it as 'a set of values, behaviours and relationships that underpins the trust the public has in doctors.' In essence professionalism incorporates competence, consistency, autonomy, honesty and integrity. It should be reflected in actions, work, speech, dress and behaviour.
The RCS ESOS Course: What Have We Learned and What Have We to Offer Other Course Organisers?
Authors: Davies ML , Teli M , Collins R , Morris-Stiff G , Lewis MH
Published: August 2011

Previous surgical training provided a long and wide exposure to general surgery but the combination of subspecialisation and reduced training time means that current trainees and consultants are no longer exposed to the same variety and number of surgical cases. Although this may not be a problem in the day-to-day running of a surgical firm, both trainee and consultant surgeons in the emergency setting can feel concerned and stressed by a condition encountered infrequently. Furthermore, with the rapid change in technology, operations are often rapidly superseded and leave surgeons at risk of criticism if they are not 'up to date' in a condition outside their specialty. It is therefore important that trainees and consultants alike keep abreast of advances in the management of a broad range of emergency conditions while continuing to develop their own subspecialty interest.
Pressure and the media – inevitable companions
Authors: Williams Norman
Published: August 2011

I was elected to the presidency on 14 April and installed in office on 7 July. The interregnum was a whirlwind of activity as I gradually reduced my responsibilities at Barts and The London and took office here at the College – and what a learning experience this has been. Despite being heavily involved in various aspects of College life beforehand and also being cognisant of the President's responsibilities, it was nevertheless somewhat surprising to realise the enormous breadth of activity in which the College is now engaged.
An unusual cause of dysuria
Authors: Kwak Hye-Chung , Tan Garry , Rickers Lisa , Leeder Paul , Larvin Mike
Published: August 2011

Laparoscopic adjustable gastric band (LAGB) insertion has become an increasingly common treatment for severe obesity worldwide. As a consequence, LAGB complications are reported in increasing numbers and usually present to acute surgical units. This report describes the development of lower abdominal pain and dysuria in a patient who had undergone LAGB surgery 20 months previously. Repeated symptomatic treatment for a possible urinary tract infection in the community setting had been unsuccessful. The cause was found to be a fracture in the tubing connecting the LAGB device with its subcutaneous adjusting port, which was causing persistent bladder irritation. It is recommended that when LAGB patients present with acute lower abdominal pain, consideration should be made as to whether a tubing disconnection has occurred. Such a complication may be visualised by abdominal radiography. Advice can be sought on this and other complications of bariatric surgery by contacting the regional bariatric surgical centre where definitive management would be undertaken.
Carcinoid tumour metastasis to the submandibular gland: a case report
Authors: Gulati Aakshay , Ramchandani Parkash L , King Emma Victoria
Published: August 2011

Carcinoid tumours are slow growing tumours of neuroendocrine origin that primarily affect the gastrointestinal tract and pulmonary system. They can behave aggressively, with regional and distant metastases, although metastases to the head and neck region are uncommon. We present a rare case of carcinoid metastasis to the submandibular gland, which to the best of our knowledge has not been previously reported in the literature.
Small bowel perforation following capsule endoscopy: a case report
Authors: Palmer JS , Marenah K , El Madani F , Jain K , Gupta S
Published: August 2011

Small bowel perforation following a capsule endoscopy (CE) is a rare but dreadful complication. We report a CE induced small bowel perforation in a patient with Crohn’s disease where preoperative investigations failed to reveal any strictures.
Infective aneurysm of the inferior pancreaticoduodenal artery
Authors: Williamson JML , Cook JL , Jackson JE , Hocken DB
Published: August 2011

Introduction

Pancreaticoduodenal (PD) artery aneurysms account for less than 2% of all splanchnic aneurysms. A mycotic aetiology is extremely uncommon. Two weeks following an episode of sepsis related to a prostatic biopsy, a 59-year-old man presented with abdominal pain and anaemia. Ultrasonography and computed tomography revealed an inferior PD artery pseudoaneurysm with an associated mesenteric root haematoma. This was treated successfully by transcatheter embolisation. Infective pseudoaneurysms of the PD artery are rare but can be associated with rupture into the gastrointestinal tract or retroperitoneum. Transcatheter embolisation remains the most effective therapy as it is associated with low morbidity and mortality rates and recurrence is very unlikely provided the aneurysm is completely excluded from the circulation.