bluuebunny/crossref_metadata_2025 huggingface dataset:
Mucosal Immunity: Induction, Dissemination, and Effector Functions
Authors: Brandtzaeg P.
Published: September 2009

Prevention of infections by vaccination remains a compelling goal to improve public health. Most infections involve the mucosae, but the development of vaccines against many of these pathogens has yet to be successful. Mucosal vaccines would make immunization procedures easier, be better suited for mass administration, and most efficiently induce immune exclusion – a term coined for non‐inflammatory antibody shielding of internal body surfaces – mediated principally by secretory immunoglobulin A (SIgA). The exported antibodies are polymeric, mainly IgA dimers (pIgA) – produced by local plasma cells stimulated by antigens that target the mucosae. SIgA was early shown to be complexed with an epithelial glycoprotein – the secretory component (SC). In 1974, a common SC‐dependent transport of pIgA and pentameric IgM was proposed. From the basolateral surface, pIg‐SC complexes are taken up by endocytosis and finally extruded into the lumen. Membrane SC is now referred to as polymeric Ig receptor (pIgR). In 1980, it was shown to be synthesized as a larger transmembrane protein – first cloned from rabbit and then from human. Mice deficient for pIgR showed that this is the only receptor responsible for epithelial transport of IgA and IgM. In the gut, induction of B cells occurs in gut‐associated lymphoid tissue, particularly the Peyer’s patches, but also in mesenteric lymph nodes. Plasma cell differentiation is accomplished in the lamina propria to which the memory/effector cells home. The airways also receive such cells from nasopharynx‐associated lymphoid tissue – but by different homing receptors. Such compartmentalization is a challenge for development of mucosal vaccines.
Differences in perceived health status between kidney transplant recipients and dialyzed patients are based mainly on the selection process
Authors: Rosenberger Jaroslav , Van Dijk Jitse P. , Prihodova Lucia , Majernikova Maria , Nagyova Iveta , Geckova Andrea Madarasova , Roland Robert , Van Den Heuvel Wim J.A. , Groothoff Johan W.
Published: September 2009

Rosenberger J, van Dijk JP, Prihodova L, Majernikova M, Nagyova I, Madarasova Geckova A, Roland R, van den Heuvel WJA, Groothoff JW. Differences in perceived health status between kidney transplant recipients and dialyzed patients are based mainly on the selection process. Clin Transplant 2010: 24: 358–365. © 2009 John Wiley & Sons A/S.

Abstract:  Kidney transplantation offers longer survival, less morbidity and lower costs than dialysis. It is also believed to improve quality of life. The aim of this study was to compare prospectively the perceived health status (PHS) of dialyzed patients on a waiting list with kidney transplant recipients after transplantation, matched for age, gender and comorbidity. The sample consisted of 93 dialyzed patients on a waiting list for deceased‐donor kidney transplantation and 87 incident transplant recipients. A total of 62 dialyzed patients were matched for age, gender and comorbidity with 62 transplant recipients. PHS was measured using the SF‐36 questionnaire. Data from baseline and after 12 months were compared between the groups. Patients on dialysis had worse physical (49 ± 21) and mental (59 ± 18) PHS than transplant recipients (56 ± 21 and 64 ± 18, p ≤ 0.05), but when matched pairs were compared, no differences in PHS were found. After 12 months, PHS did not change significantly in either group. The PHS of patients after kidney transplantation is better than that of those on dialysis. However, this fact is significantly influenced by the selection procedure, as only some dialyzed patients are put onto the waiting list while others were actually transplanted. The differences disappear with matching.
Long‐term results after conversion from calcineurin inhibitors to sirolimus in renal transplant patients
Authors: Martinez‐Mier Gustavo , Avila‐Pardo Sandro F. , Mendez‐Lopez Marco T. , Budar‐Fernandez Luis F.
Published: September 2009

Martinez‐Mier G, Avila‐Pardo SF, Mendez‐Lopez MT, Budar‐Fernandez LF. Long‐term results after conversion from calcineurin inhibitors to sirolimus in renal transplant patients. Clin Transplant 2010: 24: 467–473. © 2009 John Wiley & Sons A/S.

Abstract: Background:  Calcineurin inhibitors (CNI) toxicity is one of the contributing factors for the development and progression of chronic allograft dysfunction (CAD). Conversion to sirolimus (SRL) from CNI improves renal function kidney in transplant recipients.

Methods:  A retrospective review from patients abruptly converted from CNI to SRL over a three yr period is reported.

Results:  Thirty‐nine patients were converted 55.2 ± 58 months after renal transplantation. 24 month patient and graft survival was 100% and 92%. Acute rejection incidence was 7.6%. Overall, serum creatinine (SCr) and Cockcroft–Gault creatinine clearance (CGCrCl) improved. In responders, SCr improved from 2.48 ± 0.8 to 1.94 ± 0.8 mg/dL (p < 0.05) CGCrCl improved from 37.8 ± 17.4 to 51.9 ± 23.8 mL/min at two years. An increase in proteinuria was observed from conversion to month 12 in responders (189.4 ± 512.8 to 488.3 ± 890.6 mg/day, p < 0.05) and from conversion to month six in non‐responders (1179.4 ± 2001.1 to 2357 ± 4172.9 mg/day, p < 0.05). Low proteinuria had positive predictive value for renal response after conversion.

Conclusion:  Conversion from CNI to SRL with CAD is associated with improved renal function with an increase in proteinuria. Low proteinuria is a possible positive predictive factor for successful conversion.
Kinetics of interferon‐gamma producing cytomegalovirus (CMV)‐specific CD4+ and CD8+ T lymphocytes and the risk of subsequent CMV viremia after allogeneic hematopoietic stem cell transplantation
Authors: Eid A.J. , Brown R.A. , Hogan W.J. , Lahr B.D. , Eckel‐Passow J.E. , Litzow M.R. , Razonable R.R.
Published: September 2009

Background.Deficiencies in cytomegalovirus (CMV)‐specific T lymphocytes impair the immunologic response against CMV reactivation after allogeneic hematopoietic stem cell transplantation (HSCT).

Methods.A time‐dependent analysis was conducted to determine the association between the percentages and kinetics of interferon‐gamma‐producing CMV‐specific CD4+ and CD8+ T lymphocytes and CMV viremia among 30 allogeneic HSCT recipients.

Results.Higher percentages of CD4+ T lymphocytes activated with CMVpp65 (hazard ratio [HR]: 2.06; 95% confidence interval [95% CI]: 1.18–3.6;P=0.011) and CMV lysate (HR: 1.18; 95% CI: 0.99–1.42;P=0.072), and higher percentages of CD8+ T lymphocytes activated by CMV immediate early‐1 (HR: 1.2; 95% CI: 1.01–1.43;P=0.038) and CMVpp65 (HR: 1.12; 95% CI: 1.0–1.27;P=0.060) were associated with time‐to‐CMV viremia. Furthermore, a higher degree in the decline of CMV lysate‐activated CD4+ T lymphocytes (HR: 1.14; 95% CI: 0.96–1.36;P=0.125) and CMVpp65‐activated CD8+ T lymphocytes (HR: 1.36; 95% CI: 1.03–1.78;P=0.031) was suggestive of or significantly associated with time‐to‐CMV viremia.

Conclusions.Higher levels of CMV‐specific CD4+ and CD8+ T lymphocytes were associated with subsequent CMV viremia after HSCT. The association between CMV viremia and the degree of decline in CMV‐specific T lymphocytes suggests that severe disruption in homeostatic CMV‐specific immune environment contributes to the immunopathogenesis of CMV after allogeneic HSCT.
Brain natriuretic peptide is a good predictor for outcome in cardiac surgery
Authors: Elíasdóttir S. B. , Klemenzson G. , Torfason B. , Valsson F.
Published: September 2009

Background and aim:  The heart secretes brain natriuretic peptide (BNP) in response to myocardial stretch. The aim of this study was to determine whether adverse effects after cardiac surgery were associated with higher serum BNP levels pre‐operatively.

Methods:  One hundred and thirty‐five patients undergoing various cardiac procedures were included in the study, and N‐terminal pro‐BNP (NT‐pro‐BNP) was measured pre‐operatively. Post‐operative complications were defined as follows: (i) a post‐operative length of stay in the intensive care unit (ICU) exceeding 48 h; (ii) mortality at 28 days; (iii) the need for inotropic agents and/or intra‐aortic balloon pump (IABP); and (iv) renal failure. Serum NT‐pro‐BNP values were compared for patients with and without complications. The serum NT‐pro‐BNP level was also correlated with the euroSCORE and ejection fraction (EF).

Results:  Pre‐operative serum NT‐pro‐BNP levels were significantly higher in patients with an ICU length of stay of more than 2 days or death prior to post‐operative day 28 (3118 ng/l vs. 705 ng/l; P < 0.001). Pre‐operative serum NT‐pro‐BNP levels were also significantly higher in patients needing inotropic agents (2628 ng/l vs. 548 ng/l; P < 0.001) or IABP insertion (3705 ng/l vs. 935 ng/l; P = 0.001) or developing renal failure (2857 ng/l vs. 945 ng/l; P < 0.001) post‐operatively. The correlation between the serum NT‐pro‐BNP level and euroSCORE was good (r = 0.658; P < 0.001). The receiver operating characteristic (ROC) curves were used to assess the ability of serum NT‐pro‐BNP, euroSCORE and EF to predict outcome after cardiac surgery. This revealed an area under the ROC curve for the length of stay in the ICU or mortality at 28 days of 0.829 for serum NT‐pro‐BNP, 0.814 for euroSCORE and 0.328 for EF assessed by transesophageal echocardiography, indicating that the pre‐operative serum NT‐pro‐BNP level is a good prognostic indicator for outcome after cardiac surgery.

Conclusion:  Serum NT‐pro‐BNP is a good predictor for complications after cardiac surgery, and is as good as euroSCORE and better than EF.
Applicability of tools to assess pain in elderly patients after cardiac surgery
Authors: PESONEN A. , SUOJARANTA‐YLINEN R. , TARKKILA P. , ROSENBERG P. H.
Published: September 2009

Background: Post‐operatively, elderly patients with impaired vision and cognitive dysfunction may experience difficulties understanding standard pain assessment tools such as the 10‐cm Visual Analogue Scale (VAS) and the Verbal Rating Scale (VRS). Thus, there is a need to identify more feasible post‐operative pain assessments for elderly patients. With this goal in mind, we compared the VAS and VRS with two more expressive tools: the 50‐cm Red Wedge Scale (RWS) and the Facial Pain Scale (FPS).

Methods: Cardiac surgery patients (73 ± 5 years, mean ± SD) were allocated to an RWS (n=80) or an FPS (n=80) group. Pain was assessed at rest and after movement during the first 4 days after tracheal extubation. The RWS or FPS assessments were repeated after 10 min. All patients completed the VRS and VAS.

Results: The rates of successful pain measurement on study day 1 were: VRS 86%, VAS 62%, RWS 78%, and FPS 60%. Pain measurements with the RWS correlated with the VAS (r=0.758, P<0.001) and weaker with the VRS (r=0.666, P<0.001) measurements. Pain measurements with the FPS correlated well with the VAS (r=0.873, P<0.001) and weaker with the VRS (r=0.583, P<0.001) measurements. With all scales, success rates improved during the study period.

Conclusion: In elderly patients, immediately after cardiac surgery, the VRS is the most feasible pain scale, followed by the RWS. The traditional 10‐cm VAS is unsuitable for pain measurement in this population.
A case of unexpected difficult airway due to lingual tonsil hypertrophy
Authors: ASBJØRNSEN H. , KUWELKER M. , SØFTELAND E.
Published: September 2009

Clinical value of preoperative bedside screening tests for predicting difficult airway remains limited. Asymptomatic lingual tonsil hypertrophy is a known cause of unexpected difficult airway. We report a case as a reminder of this.
Systematic follow‐up increases incidence of anaphylaxis during adverse reactions in anesthetized patients
Authors: MALINOVSKY J.‐M. , DECAGNY S. , WESSEl F. , GUILLOUX L. , MERTES P. M.
Published: September 2009

Background: The incidence of hypersensitivity reactions during anesthesia is underestimated because clinical symptoms may vary and diagnosis is not obvious. Our aim was to investigate the consequences of a systematic follow‐up of patients on the estimated incidence of allergic reactions during anesthesia.

Methods: We conducted a prospective study over a 2‐year period (70,000 anesthesias). When patients were suspected with hypersensitivity reactions or with unexplained adverse reactions during anesthesia, blood was sampled to measure histamine and tryptase, and then skin tests were performed 4–6 weeks later.

Results: During the studied period, 39 patients were enrolled in the database. Eight were excluded because of lack of skin tests. Twenty‐two patients had clinical features compatible with immediate hypersensitivity reaction, and nine had reactions rated as ‘unexplained’ by the attending physician. Following systematic investigation, we found 22 hypersensitivity reactions (15 patients with obvious and seven with unexplained reactions) during anesthesia. This increases the estimated incidence of hypersensitivity reactions from 1 : 4667 to 1 : 3180 anesthesias. Tryptase concentrations were increased in only 50% of these patients. In our series, positive and negative predictive values of tryptase at T0 for the diagnosis of anaphylaxis were 100% and 60%, respectively. Latex was the major causative agent, followed by neuromuscular blocking agents and antibiotics.

Conclusions: Systematic follow‐up of patients with unexplained reactions during anesthesia increases the estimated incidence of IgE‐mediated hypersensitivity reactions during anesthesia by 50%.
Lateral sagittal infraclavicular block: clinical experience in 380 patients
Authors: GÜRKAN Y. , HOŞTEN T. , SOLAK M. , TOKER K.
Published: September 2009

Background: The purpose of this study was to evaluate the clinical utility and block success rate of ‘lateral sagittal infraclavicular block (LSIB)’ in a large‐scale clinical study.

Methods: Adult patients scheduled for hand, wrist and forearm surgery between March 2005 and June 2007 were prospectively included into the study. Using a nerve stimulator LSIB was performed. In the LSIB technique the puncture site is immediately adjacent to the most medial point of the coracoid process and the anterior surface of the clavicula. The needle is inserted caudally in a sagittal plane, 20° dorsally (downwards), until muscle twitches are observed in synchrony with the stimulation. A Local anesthetic mixture of either 20 ml bupivacaine 5 mg/ml or 20 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml with 5 μg/ml epinephrine (total volume 40 ml) was administered following electrolocation of the median, radial or ulnar nerve.

Results: Three‐hundred and eighty patients were included into the study. Block was successful in 341 (89.7%) patients without any need for local anesthetic supplementation. We had complete failure in 17 (4.5%) patients and these patients received general anesthesia. Twenty‐two (5.8%) patients needed either infiltration of local anesthetic at the site of skin incision or supplementation of the block at the axilla. No other complications other than vascular punctures − 25 patients (6.6%) – were observed.

Conclusions: LSIB provided a clinically acceptable success rate and our results are in agreement with other studies assessing this approach.
Contributions of myocardial ischemia and heart rate to ST segment changes in patients with or without coronary artery disease
Authors: HÄGGMARK S. , HANEY M. F. , JOHANSSON G. , REIZ S. , NÄSLUND U.
Published: September 2009

Background: ST changes related to ischemia at different heart rates (HRs) have not been well described. We aimed to analyze ST dynamic changes by vectorcardiography (VCG) during pacing‐induced HR changes for subjects with proven coronary artery disease (CAD) and without (non‐CAD).

Methods: Symptomatic CAD patients scheduled for elective surgery were enrolled along with a non‐CAD group. During anesthesia, both groups were placed at multiple ascending levels. VCG ST data, and in particular in ST change vector magnitude (STC‐VM) from baseline, along with arterial and great coronary artery vein (GCV) blood samples were collected to determine regional myocardial lactate production.

Results: A total of 35 CAD and 10 non‐CAD patients were studied over six incremental 10 beat/min HR increases. STC‐VM mean levels increased in the CAD group from 9±5 to 131±37 μV (standard deviation) compared with non‐CAD subjects with 8±3–76±34 μV. Myocardial ischemia (lactate production) was noted at higher HRs and the positive predictive value for STC‐VM to detect ischemia was 58% with the negative predictive value being 88%. STC‐VM at 54 μV showed a sensitivity of 88% and a specificity of 75% for identification of ischemia.

Conclusions: Both HR and ischemia at higher HRs contribute to VCG ST elevation. Established ST ischemia detection concerning HR levels is suboptimal, and further attention to the effects of HR on ST segments is needed to improve electrocardiographic ischemia criteria.
Intravenous remifentanil vs. epidural levobupivacaine with fentanyl for pain relief in early labour: a randomised, controlled, double‐blinded study
Authors: VOLMANEN P. , SARVELA J. , AKURAL E. I. , RAUDASKOSKI T. , KORTTILA K. , ALAHUHTA S.
Published: September 2009

Background: We hypothesised that intravenous patient‐controlled analgesia (IV PCA) with remifentanil could provide as satisfactory pain relief for labour as epidural analgesia.

Methods: Fifty‐two parturients with singleton uncomplicated pregnancies were randomised to receive either IV PCA with remifentanil or epidural analgesia with 20 ml levobupivacaine 0.625 mg/ml and fentanyl 2 μg/ml in saline. The PCA dose of remifentanil was given over 1 min with a lockout time of 1 min. The dose was increased starting from the bolus of 0.1 μg/kg and following a dose escalation scheme up until the individual‐effective dose was reached. The parturients assessed contraction pain (0–10), pain relief (0–4), sedation and nausea during 60 min.

Results: Forty‐five parturients were included in the analysis. The median cervical opening was 4 cm before the study and 7 cm after the study. The median pain scores were 7.3 and 5.2 during remifentanil and epidural analgesia, respectively (P=0.009). The median pain relief scores were 2.5 and 2.8 (P=0.17). There was no difference between the groups in the proportion of parturients who discontinued due to ineffective analgesia, nor in the proportion of parturients who would have liked to continue the given medication at the end of the study. Sedation and low haemoglobin oxygen saturation were observed more often during remifentanil analgesia. Foetal heart rate tracing abnormalities were as common in both groups.

Conclusions: In terms of pain scores, epidural analgesia is superior to that provided by IV remifentanil. However, there was no difference in the pain relief scores between the treatments.
Induction of mild hypothermia in cardiac arrest survivors presenting with cardiogenic shock syndrome
Authors: SKULEC R. , KOVARNIK T. , DOSTALOVA G. , KOLAR J. , LINHART A.
Published: September 2009

Background: Induction of mild hypothermia (MH) in patients resuscitated from cardiac arrest improves their outcome. However, benefits and risks of MH in patients who remain in cardiogenic shock after the return of spontaneous circulation (ROSC) are unclear. We analysed all cardiac arrest survivors who were treated with MH in our intensive coronary care unit (CCU) and compared the outcome of patients with cardiogenic shock syndrome (CSS) with those who were circulatory stable.

Methods: We performed retrospective analysis of all consecutive cardiac arrest survivors treated by MH in our CCU from November 2002 to August 2006. They were classified into two groups, according to whether they met the criteria for cardiogenic shock or not before MH initiation.

Results: Out of 56 consecutive patients, 28 fulfilled criteria of cardiogenic shock before MH initiation (group A) and 28 were relatively stable (group B). In‐hospital mortality was 57.1% in group A and 21.4% in group B patients (P=0.013). Favourable neurological outcome anytime during hospitalization was found in 67.9% of group A patients and in 82.1% of group B subjects (P=0.355). Favourable discharge neurological outcome was reached in 39.3% in group A and in 71.4% in group B (P=0.031). The complication rate in both groups did not differ.

Conclusion: While in‐hospital mortality in cardiac arrest survivors treated by MH was expectably higher in those with cardiogenic shock than in stable patients, the favourable neurological outcome during hospitalization was comparable in both groups. Therefore, induction of MH should be considered in cardiac arrest survivors with CSS after ROSC.
Haemodilution induced by hydroxyethyl starches 130/0.4 is similar in septic and non‐septic patients
Authors: MEYER P. , PERNET P. , HEJBLUM G. , BAUDEL J. L. , MAURY E. , OFFENSTADT G. , GUIDET B.
Published: September 2009

Background: Fluid therapy induces haemodilution related to plasma volume expansion. The aim of our study was to compare haemodilution after a single hydroxyethyl starches (HES) 130/0.4 infusion in two groups of patients, one with and one without sepsis. We hypothesized that a single HES challenge would induce similar sustained haemodilution in both groups.

Methods: In this prospective preliminary study, patients predicted to require a single further volume‐expander infusion were included immediately before receiving 500 ml of 6% HES 130/0.4 over a 15‐min period. No additional fluid was administered over the next 8 h. Haematocrit, and serum albumin and protein were determined immediately before HES infusion then after 1, 2, 3, 4, and 8 h.

Results: Twelve patients were included in each group. In both groups, all three haemodilution markers had significantly lower values after 1 h than at baseline. None of the values after 1 and 3 h differed significantly between the two groups. Neither did any of the other study variables show significant differences between the groups with and without sepsis.

Conclusion: We found that a starch‐based compound was as effective in inducing haemodilution in patients with sepsis as in controls without sepsis, suggesting that HES may remain within the intravascular space even in patients with sepsis. Haemodilution parameters such as haematocrit, serum albumin and serum protein are useful for assessing the duration of plasma volume expansion induced by fluid therapy in critically ill patients.
Induction and emergence behavior of children undergoing general anesthesia correlates with maternal salivary amylase activity before the anesthesia
Authors: ARAI Y.‐C. P. , KANDATSU N. , ITO H. , SATO Y. , SATAKE Y. , MIZUTANI M. , USHIDA T. , KOMATSU T.
Published: September 2009

Background: The parents of the children who undergo surgery experience stress during the pre‐anesthetic period. Such stress influences the mental status of their children, thereby inducing their pre‐anesthetic anxiety and problematic behavior at emergence. Recently, measurement of salivary biomarkers was evaluated as stress biomarkers. Especially, α‐amylase is utilized as an excellent index for psychological stress. In the present study, we tested whether salivary amylase activity of mothers before the surgery of their children correlates with the peri‐operative children's behaviors.

Methods: A total of 22 pairs of mothers and children were analyzed. Maternal salivary amylase activity was evaluated at the entrance of the operation room. The children underwent minor plastic surgery under general anesthesia, and induction and emergence behaviors were assessed.

Results: The higher the maternal salivary amylase activity, the severer the children's induction anxiety (rs=−0.667, n=22, P<0.0001), and the higher the maternal amylase activity, the severer the children's emergence agitation (rs=0.705, n=22, P<0.0001).

Conclusion: Induction and emergence behaviors of children undergoing general anesthesia significantly correlated with their respective maternal salivary amylase activity during the pre‐anesthetic period.
Delayed pharmacological pre‐conditioning effect of mitochondrial ATP‐sensitive potassium channel opener on neurologic injury in a rabbit model of spinal cord ischemia
Authors: KIM K. O. , CHOE G. , CHUNG S. H. , KIM C. S.
Published: September 2009

Background: Diazoxide, pharmacological openers of mitochondrial ATP‐sensitive potassium channels have been shown to induce early pre‐conditioning in the spinal cord. Here, the authors investigated whether diazoxide also induce delayed pre‐conditioning and thereby reduce neurologic complications using a rabbit model of spinal cord ischemia.

Methods: Infrarenal blood flow was interrupted for 20 min in 21 rabbits. Non‐treated control animals received no pre‐treatment. Diazoxide (5 mg/kg) were given 48 h before 20 min ischemia in the 48‐h DZ group, whereas 15‐min DZ group received diazoxide (5 mg/kg) 15 min before 20‐min ischemia. Neurological functions were evaluated using Johnson scores for 3 days after reperfusion, after which, spinal cords were procured for hematoxylin and eosin staining for cell counting.

Results: Johnson scores revealed a marked improvement in both the diazoxide‐treated groups vs. the non‐treated control group at 3, 24, 48, and 72 h after reperfusion (P<0.01). The histologic changes were proportional to the Johnson scores, with better preservation of motor neuron numbers in the animals of the 48‐h DZ and 15‐min DZ group relative to the non‐treated controls (81±12, 90±10, 50±23 motor neurons, respectively, P<0.01). No difference was found between the 48‐h DZ group and 15‐min DZ group with respect to the Johnson scores or neuron numbers.

Conclusions: The study demonstrates that pre‐treatment with diazoxide 48 h before ischemia, induce delayed pharmacological pre‐conditioning, thereby significantly improving clinical neurologic scores and histologic findings in this animal model.
Intraguild interactions and aphid predators: biological efficiency of Harmonia axyridis and Episyrphus balteatus
Authors: Alhmedi A. , Haubruge E. , Francis F.
Published: September 2009

Introductions of the harlequin ladybird Harmonia axyridis into Belgium for aphid biological control have been followed by declines in native aphid natural enemies. We first examined, in laboratory and field conditions, the impact of larval mobility of either H. axyridis or Episyrphus balteatus, the most abundant native hoverfly in central Europe, on aphid suppression. The hoverfly larvae consumed more aphids (Megoura viciae) in a short term, whereas the ladybird ones were more efficient in a long term. We second investigated the intraguild interactions between H. axyridis and E. balteatus larvae and adults. In larva pairings between the two species in laboratory microcosms containing aphid (M. viciae) infested broad bean (Vicia faba) plants, H. axyridis had an intraguild predation (IGP) advantage over the hoverfly. When conspecific larvae were paired together on aphid‐infested plants, no cannibalism between them was detected. The presence of either H. axyridis or E. balteatus larvae on aphid‐infested plants negatively influenced the ovipositional behaviour of H. axyridis and E. balteatus females; lower numbers of laid eggs were recorded compared to control treatment. Moreover, eggs laid by E. balteatus females were also dropped as victims of predation mainly by H. axyridis larvae. Our results suggest that while the exotic ladybird was more efficient in aphid biological control, larvae and eggs of the native hoverfly species face increased IGP by H. axyridis, which would contribute, as a consequence, to the decline in E. balteatus population following invasion.
Retrievable Gunther Tulip inferior vena cava filter: Experience in 317 patients
Authors: Given MF , McDonald BC , Brookfield P , Niggemeyer L , Kossmann T , Varma DK , Thomson KR , Lyon SM
Published: September 2009

The aim of our study was to assess our experience with the retrievable Gunther Tulip (GT) inferior vena cava (IVC) filter, with regard to its insertion, efficacy, ease of placement and retrieval, and associated complications. Between November 2001 and October 2005, 322 GT filters were placed in 317 patients. Insertion indications included the following: pulmonary embolus (PE) prophylaxis in trauma patients (n = 232), PE prophylaxis in perioperative patients (n = 27), PE prophylaxis in moribund intensive care unit patients (n = 22), recent PE (n = 48), extensive deep venous thrombosis (n = 66), contraindication to anticoagulation (n = 63), anticoagulation complication (n = 8) and deep venous thrombosis with failed anticoagulation (n = 8). Some patients had more than one indication for caval filter placement. Two hundred and five attempted retrievals have been carried out, with 15 failures. Our successful retrieval rate is 92%. Nineteen filters were originally inserted permanently. There have been three minor complications associated with insertion and five with retrieval. The mean time from filter insertion to attempted retrieval was 76.95 days. The ideal filter implantation time gives the patient the benefit of PE protection, while avoiding the long‐term risks associated with caval filters. Although GT retrieval times have lengthened considerably, our data suggest that this is at the expense of successful retrieval rates.
Desmoplastic fibroma in humerus
Authors: Apaydin M , Gelal F , Avci A , Adinas C , Sarsilmaz A , Varer M
Published: September 2009

Desmoplastic fibroma of the bone is a very rare benign tumour, which may be locally aggressive. We report X‐ray radiographic and MRI findings of a case of desmoplastic fibroma of the humerus in a 33‐year‐old man who presented with a slowly enlarging arm mass over years. Desmoid fibroma should be taken into consideration in case of a low T2 signal in a non‐sclerotic fibroosseous lesion.
Resuscitation skills for radiologists: A short paper
Authors: Pitman AG , Van Dijk J , Cunningham NJ
Published: September 2009

The radiologist is likely to be the first medical practitioner on the scene for contrast reactions, anaphylaxis and other common medical emergencies that occur in radiology departments and stand‐alone practices. Until 2007, the Royal Australian and New Zealand College of Radiologists (RANZCR) did not provide resuscitation training as a CPD service for fellows, and the need for such a service has not been gauged. In 2007, the authors ran the first RANZCR large‐group resuscitation refresher training workshop at the Melbourne 2007 annual scientific meeting. The workshop maximized audience participation and knowledge transfer in a constrained time, disseminated guidelines, and collected feedback on the need for further resuscitation training for radiologists. Of the 100 feedback forms, 82 were returned. All the 82 responses wanted the workshop repeated at future annual scientific meetings, and 71 wanted RANZCR to provide hands‐on refresher training. Sixty‐six responders indicated when they had their most recent resuscitation training: six in the past 12 months, 25 in the past 3 years and 35 longer than 3 years. Sixty‐nine responded on availability of resuscitation training at their workplace: 33 indicated ‘Yes’ and 36 ‘No’. There is a definite need to provide resuscitation training for radiologists in Australia. At the end of this article, we reproduce the currently applicable guidelines as a service to our readers.
Magnetic Resonance Imaging in the staging of cervical carcinoma: A pictorial review
Authors: Smith GEC , Gormly KLM
Published: September 2009

The purposes of diagnostic imaging in cervical carcinoma are to determine the size and extent of the tumour for accurate staging and to establish lymph node status. Historically, cervical tumours were staged by clinical examination and by examination under anaesthesia according to the International Federation of Gynecology and Obstetrics staging system. This system does not incorporate imaging findings or lymph node status, but it is now accepted that cross‐sectional imaging, and in particular MRI, has an important role to play in the staging of these tumours. We carried out an audit of all patients having a staging MRI for suspected cervical carcinoma in South Australia and the Northern Territory for 2 years from January 2005. This was the first time the clinicians had been offered routine MRI, and despite the strong supporting published reports, they had some reservations about its performance. Our audit covered a wide range of tumour stages and provided a good teaching resource for radiologists and clinicians alike.
Tumour and tumour‐like lesions of the intercondylar notch of the knee: A pictorial review
Authors: Li PKL , James SLJ , Davies AM
Published: September 2009

A variety of tumours and tumour‐like lesions are found in the intercondylar notch of the knee. MR imaging is the technique of choice in evaluating these conditions. Correlation with radiographs is important to identify those lesions containing calcification. This review article discusses the imaging features of tumour and tumour‐like lesions involving the intercondylar notch with an emphasis on MR imaging features that suggest a specific diagnosis.
Twisted tail: Spinal epidural lipomatosis responding to chemotherapy in a patient with non‐small‐cell lung cancer
Authors: Nasoodi A , McAleese J , Grey A , Stranex S
Published: September 2009

Spinal epidural lipomatosis is a rare condition, described in corticoadrenal hyperactivity. It is most commonly seen in association with steroid administration and occasionally with Cushing’s syndrome. This is the first case report of spinal epidural lipomatosis as presenting finding in a patient with non‐small‐cell lung carcinoma without any evidence of endogenous or exogenous hypercortisolism. The additional interesting feature is the paraneoplastic behaviour of this condition and even more interestingly its resolution following chemo‐treatment of the primary cancer. Spinal epidural lipomatosis is a benign condition, which must be considered in the differential diagnosis of spinal cord compression in this category of patients. Its pathophysiology remains to be discovered in future.
Numerical simulation of rotating bending process for U‐tubes in heat exchangers
Authors: KIM H.‐S. , JIN T.‐E. , CHANG Y.‐S. , KIM Y.‐J.
Published: September 2009

Heat exchangers comprise thousands of tubes having U‐shaped portions. Rotating bending method has been widely utilized to make U‐bends. Although this method shows an excellent performance, cracks have been frequently detected in the U‐bends due to residual stresses induced by bending. In this paper, the bending process is simulated based on elastic–plastic finite element analyses in order to investigate the magnitude and distribution of the residual stresses including the effects of operating pressure. Analyses results show that the residual stress increases as the radius of U‐bend decreases and that operating pressure has a detrimental effect in terms of stress corrosion cracking at the intrados of U‐bend. It is thought that these results can be utilized for the estimations of fracture mechanics parameters such as limit load, stress intensity factor and J‐integral, prevention of the cracking, and establishment of the optimum inspection strategy for the heat exchanger tubes.
Changes in mechanical properties of vehicle components after strengthening under low‐amplitude loads below the fatigue limit
Authors: XI L. , SONGLIN Z.
Published: September 2009

Changes in the mechanical properties of vehicle components were investigated after strengthening under low‐amplitude loads below the fatigue limit (SLAL). The strengths of vehicle components including fatigue strength, static strength and yield strength were significantly increased by SLAL. The surface hardness of the front axle, composed of a kind of low strength steel without heat treatment, was enhanced with increased strengthening and damaging. The change of surface hardness was reversed completely for the transmission gear, composed of a kind of high strength steel with surface heat treatment. The natural frequency of the transmission gear was appreciably increased by SLAL.
Instant Caching for Interactive Global Illumination
Authors: Debattista K. , Dubla P. , Banterle F. , Santos L.P. , Chalmers A.
Published: September 2009

The ability to interactively render dynamic scenes with global illumination is one of the main challenges in computer graphics. The improvement in performance of interactive ray tracing brought about by significant advances in hardware and careful exploitation of coherence has rendered the potential of interactive global illumination a reality. However, the simulation of complex light transport phenomena, such as diffuse interreflections, is still quite costly to compute in real time. In this paper we present a caching scheme, termed Instant Caching, based on a combination of irradiance caching and instant radiosity. By reutilising calculations from neighbouring computations this results in a speedup over previous instant radiosity‐based approaches. Additionally, temporal coherence is exploited by identifying which computations have been invalidated due to geometric transformations and updating only those paths. The exploitation of spatial and temporal coherence allows us to achieve superior frame rates for interactive global illumination within dynamic scenes, without any precomputation or quality loss when compared to previous methods; handling of lighting and material changes are also demonstrated.
FDI, Growth and the Asian Financial Crisis: The Experience of Selected Asian Countries
Authors: Thangavelu Shandre M. , Wei Yong Yik , Chongvilaivan Aekapol
Published: September 2009

This paper studies the trends in foreign direct investment (FDI) flows into selected South‐East Asian and East Asian economies after the Asian crisis. Empirical evidence indicates that South‐East and East Asian economies are recovering from the Asian crisis with strong output growth driven largely by export growth. However, output growth in the post‐crisis period is also accompanied by rising unemployment rates, growing government deficits, and declining FDI inflows into the South‐East Asian region. The declining FDI inflows into South‐East Asia after the crisis is of concern, as our empirical results show that FDI is important for output growth in the region. Our results also suggest that there might have been structural changes in the regional economies that could have led to a downward shift in the output growth of Asian economies in the post‐crisis period. This raises the issue of the sustainability of their output growth in the post‐crisis period.
The Economic Impacts of Turkish Accession to the European Union
Authors: Philippidis George , Karaca Orhan
Published: September 2009

Half a century has passed and Turkey is no further toward achieving EU membership. Under the mandate of the Barcelona Declaration, EU–Turkish industrial tariffs will be abolished, whilst agro‐food protectionism remains largely intact. Consequently, the direct impacts from a hypothetical EU accession scenario will be concentrated in agro‐food sectors, whilst their share of economic output in Turkey implies ‘secondary’ macro impacts.

To this end, a computable general equilibrium (CGE) framework is employed to quantitatively reassess full Turkish accession. Unlike previous CGE studies, agriculture, fishing and food sectors are disaggregated, whilst significant advancements to the ‘standard’ model code are incorporated to capture the vagaries of agricultural factor, input and product markets. In addition, a realistic ‘baseline’ scenario is constructed including ‘up to date’ trade and domestic agricultural policy reforms prior to Turkish entry to the EU.

The results show that trade‐led gains in Turkey are moderated due to tariff liberalisation prior to EU entry, whilst Turkey receives significant budgetary transfers from the CAP budget, which are ‘mirrored’ as EU‐27 costs. With additional migration effects, Turkish (EU‐27) production possibilities fall (rise), whilst real income per capita rises (falls).
A Mirror for God and for Us: Christology and Exegesis in Calvin's Doctrine of Election
Authors: GIBSON DAVID
Published: September 2009

Although John Calvin's doctrine of election is often criticized, it remains seriously under‐described in both content and form. By attending to one strand of its content (Christ and election), and one persistently unappreciated aspect of its form (exegesis), this article attempts a substantial construal of the doctrine in Calvin's theology. It aims to show that, for Calvin, Christ is the subject of election in that he is its author, and Christ is the object of election in that he mediates both election itself and the salvation which flows from election. The focus on Calvin's exegesis of election and Christology establishes contact points with some important theological concerns: Karl Barth's reading of Calvin; election and the extra Calvinisticum; and ‘christocentrism’ in Calvin's theology.
Imputation as Attribution: Union with Christ, Reification and Justification as Declarative Word
Authors: GARCIA MARK A.
Published: September 2009

Calvin's integration of the christological features of the eucharistic controversy with soteriological questions in his refutation of Andreas Osiander marks a critical development in Reformed theology. In this article, that development is extended further in reconsideration of the nature of imputation as a linguistic action. It is argued that imputation is a soteriological corollary of the christological idea of attribution. Imputation thus conceived clarifies not only how it is located within the doctrine of union with Christ, but how that union and imputation provide clarity in ongoing discussions about reification of sin and righteousness as well as the nature of justification as a declarative word.
The Market Timing Ability of UK Mutual Funds
Authors: Cuthbertson Keith , Nitzsche Dirk , O'Sullivan Niall
Published: September 2009

Abstract:  We apply a recent nonparametric methodology to test the market timing skills of UK equity and balanced mutual funds. The methodology has a number of advantages over the widely used regression based tests of Treynor‐Mazuy (1966) and Henriksson‐Merton (1981). We find a relatively small number of funds (around 1%) demonstrate positive market timing ability at a 5% significance level while around 19% of funds exhibit negative timing and on average funds miss‐time the market. However, controlling for publicly available information we find very little evidence of market timing ability based on private timing signals. In terms of investment styles, there are a small number of successful positive market timers amongst Equity Income and ‘All Company’ funds but not among either Small Stock funds or Balanced funds, although a few small stock funds are found to time a small stock index rather than a broad market index.
Single Stock Futures as a Substitute for Short Sales: Evidence from Microstructure Data
Authors: Danielsen Bartley R. , Van Ness Robert A. , Warr Richard S.
Published: September 2009

Abstract:  We examine how the introduction of single‐stock futures impacts short sale costs and short interest levels in the underlying spot market. We find that short selling in the underling securities declines, after futures are introduced, the cost of borrowing stock for short sales declines and the available unborrowed supply of lendable shares increases. These results are consistent with futures exchanges providing a low‐cost substitute market for establishing short positions. Microstructure evidence also suggests that the lower cost and greater ease of short selling via futures markets draws informed traders from the spot market.
Treatment of periorbital wrinkles by repeated medium‐depth chemical peels in dark‐skinned individuals
Authors: Kadhim K A , Al‐Waiz M
Published: September 2009

Background  The periorbital region serves as a barometer of chronological and environmental age and, as such, persons often seek its cosmetic rejuvenation.

Objective  This study was conducted to determine the efficacy and safety of repeated, medium‐depth chemical peels in the treatment of periorbital wrinkles in dark‐skinned individuals.

Subjects and methods  A total of 12 subjects (10 women and 2 men) with fine and/or medium‐sized wrinkles were included in the study, the ages ranged from 30 to 55 years with a mean of 41.25. Focal, medium‐depth peels of periorbital area including crow's foot wrinkles were performed using a combination of Jessner's solution followed by the application of 35% trichloroacetic acid (TCA). The study involved a four‐session regimen. To be included in this study, the subject completed at least two peeling sessions, 1 month apart, and returned for follow‐up according to the research schedule.

Results  Improvement occurred in 11 of 12 subjects. Marked improvement occurred in four subjects (33%), moderate improvement in three (25%), mild improvement in another three (25%), minimal improvement in one subject (8%), and no response in one subject (8%). There were seven patients with fine and five with medium periorbital wrinkles. For statistical analysis, the no and minimum response groups were categorized as nonresponders. The improvement that ranged between marked to mild occurred in 100% of subjects with fine wrinkles and 60% of subjects with medium wrinkles. Mild side effects appeared in four subjects (33%).

Conclusion  It can be concluded that fine and/or medium periorbital wrinkling responds favorably to repeated, medium‐depth chemical peels even in dark‐skinned individuals with few mild side effects.
Efficacy of a new antidandruff thermophobic foam: a randomized, controlled, investigator‐blinded trial vs. ketoconazole 2% scalp fluid
Authors: Quadri G , Cavallero W , Milani M
Published: September 2009

Background  Ketoconazole (K), zinc pyrithione (ZP), and salicylic acid (SA) are compounds active in the treatment of dandruff. A thermophobic foam formulation containing K 1%, ZP 0.5%, and SA 2% is now available.

Study aim  To compare the efficacy of thermo phobic foam with K 2% scalp fluid in the treatment of moderate to severe dandruff.

Patients and methods  In a randomized, prospective, parallel‐group, investigator‐blinded, 4‐week treatment trial, a total of 54 patients (mean age 43 ± 8 years) were enrolled. Foam (F group) (n = 37) or K 2% scalp fluid (SF group) (n = 17) was applied daily for 7 days and twice weekly for 3 weeks thereafter. Clinical assessment of the total dandruff severity score (TDSS) was performed at baseline, after 2 and 4 weeks. The TDSS was calculated using a four‐grade quantitative score (0 = no dandruff; 3 = severe dandruff) dividing the scalp area into four zones and adding the single score for each area.

Results  At baseline, TDSS was 7.1 ± 2 and 5.1 ± 1 in the F and SF groups, respectively. At the end of treatment period, beneficial effects were observed in both groups. The TDSS was reduced to 2.5 ± 1 in the F group and to 3.7 ± 1.2 in the SF group (mean difference in favor of F group: −1.2; 95% CI: –0.57 to −1.8) (P = 0.0003). A complete or nearly complete resolution of dandruff was observed in 24 out of 37 (64%: 95%CI: 48–77%) in the F group and in 7 out of 17 (41%: 95% CI: 21–64%) in the SF group (P = 0.06 between groups).

Conclusions  This new antidandruff thermophobic foam has shown to be more effective than ketoconazole 2% scalp fluid in the treatment of severe dandruff.