bluuebunny/crossref_metadata_2025 huggingface dataset:
FEIBA®in treatment of acute bleeding episodes in patients with haemophilia A and factor VIII inhibitors: a retrospective survey in regional haemophilia centre
Authors: SMEJKAL P. , BRABEC P. , MATYSKOVA M. , BULIKOVA A. , SLECHTOVA M. , KISSOVA J. , CHLUPOVA G. , MUZIK J. , PENKA M.
Published: March 2009

Summary. FEIBA®(factor eight inhibitor by‐passing activity) is used to achieve haemostasis in haemophiliacs with inhibitor. The aim of this study was to evaluate efficacy and consumption of the product in treatment of haemorrhages in haemophiliacs with factor VIII inhibitor, and determine factors that can influence the results of treatment. We used data from our haemophilia centre from years 2000–2008. Six haemophiliacs with factor VIII inhibitor were treated on demand with FEIBA®for 61 bleeding episodes (45 haemarthroses, six muscle bleeds, six other sites bleeds and four multiple sites bleeds). The median cumulative dose of FEIBA®per bleeding episode was 205 U kg−1. Bleeding was stopped in 96.7% (59 of 61) of events but re‐bleeding occurred in 3 events (4.9%) within 48 h after cessation of bleeding. In home treatment (20 of 61) bleeding stopped in 90% (18 of 20) without recurrence and the median consumption per event was reduced to 153 U kg−1. Without the use of home treatment the median consumption was 250 U kg−1per event and bleeding ceased definitely in 92.7% (38 of 41) of cases. The cumulative dose of FEIBA®was lower for three episodes with re‐bleeding: median 96 U kg−1but not in the two cases of ineffective treatment: 361 U kg−1. FEIBA®in management of bleeding episodes completely resolved the haemorrhage in 91.8% of events and in a further 4.9% if treatment was restarted. Using home treatment saved expenditure due to the lower cumulative dose needed for treatment of haemorrhage.
Gallbladder cancer: a morphological and molecular update
Authors: Goldin Robert David , Roa Juan Carlos
Published: March 2009

Gallbladder cancer (GBC) shows a marked geographical variation in its incidence, with the highest figures being seen in India and Chile and relatively low levels in many Western countries. Risk factors for its development include the presence of gallstones, infection and the presence of an anomalous pancreatobiliary ductal junction. It can arise from either a pathway involving metaplasia or dysplasia or one in which there is a pre‐existing adenoma. The former is the more common and, because it is often not associated with a macroscopically recognizable lesion, leads to the recommendation that all gallbladders need to be examined microscopically. Accurate staging of invasive cancers is essential to determine prognosis and treatment, and this requires extensive tumour sampling. A number of genetic alterations have been identified in the preinvasive and invasive stages of GBC and they support the morphological evidence of there being two pathways by which tumours develop. Some of these genetic changes are associated with particular risk factors. For example, cases with anomalous pancreatobiliary ductal junction show a higher frequency of K‐ras mutations. Some changes are associated with differences in prognosis. For example, cancers without expression of p21 but with expression for p27 have a better prognosis, whereas those that express c‐erb‐B2 have a worse one. Work has also been done on identifying clinical, imaging and other factors that indicate that patients have a higher risk of having GBC. This is particularly important in high‐incidence areas in which GBC is a significant public health problem.
Landscape genetics of California mule deer (Odocoileus hemionus): the roles of ecological and historical factors in generating differentiation
Authors: PEASE KATHERINE M. , FREEDMAN ADAM H. , POLLINGER JOHN P. , MCCORMACK JOHN E. , BUERMANN WOLFGANG , RODZEN JEFF , BANKS JIM , MEREDITH ERIN , BLEICH VERNON C. , SCHAEFER ROBERT J. , JONES KEN , WAYNE ROBERT K.
Published: March 2009

Landscape genetics is an emerging discipline that utilizes environmental and historical data to understand geographic patterns of genetic diversity. Niche modelling has added a new dimension to such efforts by allowing species–environmental associations to be projected into the past so that hypotheses about historical vicariance can be generated and tested independently with genetic data. However, previous approaches have primarily utilized DNA sequence data to test inferences about historical isolation and may have missed very recent episodes of environmentally mediated divergence. We type 15 microsatellite loci in California mule deer and identify five genetic groupings through a Structure analysis that are also well predicted by environmental data. We project the niches of these five deer ecotypes to the last glacial maximum (LGM) and show they overlap to a much greater extent than today, suggesting that vicariance associated with the LGM cannot explain the present‐day genetic patterns. Further, we analyse mitochondrial DNA (mtDNA) sequence trees to search for evidence of historical vicariance and find only two well‐supported clades. A coalescence‐based analysis of mtDNA data shows that the genetic divergence of the mule deer genetic clusters in California is recent and appears to be mediated by ecological factors. The importance of environmental factors in explaining the genetic diversity of California mule deer is unexpected given that they are highly mobile species and have a broad habitat distribution. Geographic differences in the timing of reproduction and peak vegetation as well as habitat choice reflecting natal origin may explain the persistence of genetic subdivision.
IL1β‐ and LPS‐induced serotonin secretion is increased in EC cells derived from Crohn’s disease
Authors: Kidd M. , Gustafsson B. I. , Drozdov I. , Modlin I. M.
Published: March 2009

Abstract  Gut mucosal enterochromaffin (EC) cells are regarded as key regulators of intestinal motility and fluid secretion via secretion of serotonin (5HT), are increased in numbers in mucosal inflammation and located in close proximity to immune cells. We examined whether interleukin (IL)1β and Escherichia coli lipopolysaccharide (LPS) induced EC cell 5HT release through Toll‐like/IL‐1 (TIL) receptor activation, nuclear factor kappa B (NFκB) and mitogen‐activated protein kinase (MAPK) phosphorylation and evaluated whether somatostatin could inhibit this phenomenon. Pure (>98%) human intestinal EC cells were isolated by fluorescent activated cell sorting from preparations of normal (n = 5) and Crohn’s colitis (n = 6) mucosa. 5HT release was measured (ELISA), and NFκB and ERK phosphorylation quantitated (ELISA) in response to IL1β and LPS. 5HT secretion was increased by both E. coli LPS (EC50 = 5 ng mL−1) and IL1β (EC50 = 0.05 pmol L−1) >2‐fold (P < 0.05) in Crohn’s EC cells compared with normal EC cells. Secretion was reversible by the TLR4 antagonist, E. coli K12 LPS (IC50 = 12 ng mL−1) and the IL1β receptor antagonist (ILRA; IC50 = 3.4 ng mL−1). IL1β caused significant (P < 0.05) NFκB and MAPK phosphorylation (40–55%). The somatostatin analogue, lanreotide inhibited IL1β‐stimulated secretion in Crohn’s (IC50 = 0.61 nmol L−1) and normal EC cells (IC50 = 1.8 nmol L−1). Interleukins (IL1β) and bacterial products (E. coli LPS) stimulated 5HT secretion from Crohn’s EC cells via TIL receptor activation (TLR4 and IL1β). Immune‐mediated alterations in EC cell secretion of 5HT may represent a component of the pathogenesis of abnormal bowel function in Crohn’s disease. Inhibition of EC cell‐mediated 5HT secretion may be an alternative therapeutic strategy in the amelioration of inflammatory bowel disease symptomatology.
A1and A2areceptors mediate inhibitory effects of adenosine on the motor activity of human colon
Authors: Fornai M. , Antonioli L. , Colucci R. , Ghisu N. , Buccianti P. , Marioni A. , Chiarugi M. , Tuccori M. , Blandizzi C. , Del Tacca M.
Published: March 2009

Abstract Experimental evidence in animal models suggests that adenosine is involved in the regulation of digestive functions. This study examines the influence of adenosine on the contractile activity of human colon. Reverse transcription‐polymerase chain reaction revealed A1and A2areceptor expression in colonic neuromuscular layers. Circular muscle preparations were connected to isotonic transducers to determine the effects of 8‐cyclopentyl‐1,3‐dipropylxanthine (DPCPX; A1receptor antagonist), ZM 241385 (A2areceptor antagonist), CCPA (A1receptor agonist) and 2‐[(p‐2‐carboxyethyl)‐phenethylamino]‐5′‐N‐ethyl‐carboxamide‐adenosine (CGS 21680; A2areceptor agonist) on motor responses evoked by electrical stimulation or carbachol. Electrically evoked contractions were enhanced by DPCPX and ZM 241385, and reduced by CCPA and CGS 21680. Similar effects were observed when colonic preparations were incubated with guanethidine (noradrenergic blocker), L‐732,138, GR‐159897 and SB‐218795 (NK receptor antagonists). However, in the presence of guanethidine, NK receptor antagonists and Nω‐propyl‐l‐arginine (NPA; neuronal nitric oxide synthase inhibitor), the effects of DPCPX and CCPA were still evident, while those of ZM 241385 and CGS 21680 no longer occurred. Carbachol‐induced contractions were unaffected by A2areceptor ligands, but they were enhanced or reduced by DPCPX and CCPA, respectively. When colonic preparations were incubated with guanethidine, NK antagonists and atropine, electrically induced relaxations were partly reduced by ZM 241385 or NPA, but unaffected by DPCPX. Dipyridamole or application of exogenous adenosine reduced electrically and carbachol‐evoked contractions, whereas adenosine deaminase enhanced such motor responses. In conclusion, adenosine exerts an inhibitory control on human colonic motility. A1receptors mediate direct modulating actions on smooth muscle, whereas A2areceptors operate through inhibitory nitrergic nerve pathways.
Pharmacogenetics of low dose clonidine in irritable bowel syndrome
Authors: Camilleri M. , Busciglio I. , Carlson P. , Mckinzie S. , Burton D. , Baxter K. , Ryks M. , Zinsmeister A. R.
Published: March 2009

Abstract  Adrenergic and serotonergic (ADR‐SER) mechanisms alter gut (gastrointestinal, GI) sensorimotor functions. We aimed to determine whether candidate ADR‐SER genes affect GI responses to low dose clonidine (CLO) in humans. Forty healthy and 120 irritable bowel syndrome (IBS) participants received CLO, 0.1 mg or 0.15 mg b.i.d., for 6 days. At baseline and post‐CLO, we measured: gastric volume (GV); satiation volume; rectal compliance, sensation thresholds and ratings with distensions. Genetic variations tested were: α2A (C‐1291G), α2C (Del 322‐325), GNβ3 (C825T) and solute carrier family 6 (neurotransmitter transporter, serotonin), member 4 (SLC6A4) (serotonin transporter linked polymorphic region). CLO reduced volume to satiation (P = 0.002), postprandial GV (P < 0.001), sensation threshold for pain (<0.001); CLO increased rectal compliance (P = 0.024). There were significant associations between post‐CLO responses and gene variations for ΔGV (α2A and SLC6A4), rectal sensation of gas (α2A, GNβ3), urgency (α2A); and pain (GNβ3 and SLC6A4); and rectal compliance (SLC6A4). α2A, GNβ3 and SLC6A4 genotypes significantly modify responses to CLO on sensory and motor GI functions in health and IBS.
Oxytocin receptor expressed on the smooth muscle mediates the excitatory effect of oxytocin on gastric motility in rats
Authors: Qin J. , Feng M. , Wang C. , Ye Y. , Wang P. S. , Liu C.
Published: March 2009

Abstract  The aim of this study was to localize oxytocin receptor (OTR) in the stomach and to investigate the effect of OT on gastric motility in rats. Western blot and immunohistochemistry methods were used to localize OTR in stomach. The motility of stomach was recorded in vivo (recording of the intragastric pressure), in vitro (recording of the contraction of muscle strips) and on isolated smooth muscle cells. OTR was expressed on cells of both circular and longitudinal muscle of stomach. Systemic administration of OT induced an early transient decrease and a subsequent increase on intragastric pressure. Devazepide (1 mg kg−1, i.v.), a cholecystokinin‐1 (CCK1) receptor antagonist, completely abolished the transient response but did not influence the subsequent one. OT (10−9–10−6 mol L−1) dose‐dependently increased the contraction of the muscle strips of gastric body, antrum, and pyloric sphincter, and decreased the average cell length of isolated smooth muscle cells. Tetrodotoxin and atropine did not influence the effect of OT on muscle strips. Pretreatment with atosiban, an OTR antagonist, inhibited the spontaneous contraction of muscle strips and abolished the excitatory effect of OT on the muscle strips and the isolated cells. These results suggest that the OTR is expressed on the smooth muscle of the stomach and mediates excitatory effect of OT on gastric motility.
Community health insurance in sub‐Saharan Africa: what operational difficulties hamper its successful development?
Authors: De Allegri Manuela , Sauerborn Rainer , Kouyaté Bocar , Flessa Steffen
Published: March 2009

In recent years, a number of reviews have generated evidence on the potential of community health insurance (CHI) to increase access to care and offer financial protection against the cost of illness for poor people excluded from formal insurance systems. Field experience, however, shows that in sub‐Saharan Africa (SSA), a series of operational difficulties still hampers the successful development of CHI, yielding negative effects on potential progress towards increased access to care and improved financial protection. Through a careful assessment of the existing literature, including peer‐reviewed articles, books, consultancy reports, and manuscripts from international organizations, we produce an analytical review of such difficulties. Our aim is to provide policy makers with the necessary knowledge on the problems at stake and with policy propositions to offset such problems, strengthening CHI and enhancing its role within SSA health systems. Our review of the literature reveals that the major difficulties currently faced by CHI in SSA are operational in nature and cluster around five areas: (i) lack of clear legislative and regulatory framework; (ii) low enrolment rates; (iii) insufficient risk management measures; (iv) weak managerial capacity; and (v) high overhead costs. Consequently, our review calls for appropriate policy interventions, specifically: (i) greater commitment towards the development of adequate legislation in support of CHI; (ii) increasing uptake of measures to expand equitable enrolment; (iii) the adoption of adequate risk management measures in all schemes; (iv) substantial investments from host countries as well as from sponsoring agencies to improve managerial capacity; and (v) collective efforts to contain overhead costs.
Important research questions in allergy and related diseases: 3‐chronic rhinosinusitis and nasal polyposis – a GA2LEN study
Authors: Bachert C. , Van Bruaene N. , Toskala E. , Zhang N. , Olze H. , Scadding G. , Van Drunen C. M. , Mullol J. , Cardell L. , Gevaert P. , Van Zele T. , Claeys S. , Halldén C. , Kostamo K. , Foerster U. , Kowalski M. , Bieniek K. , Olszewska‐Ziaber A. , Nizankowska‐Mogilnicka E. , Szczeklik A. , Swierczynska M. , Arcimowicz M. , Lund V. , Fokkens W. , Zuberbier T. , Akdis C. , Canonica G. , Van Cauwenberge P. , Burney P. , Bousquet J.
Published: March 2009

Chronic rhinosinusitis is one of the most common health care challenges, with significant direct medical costs and severe impact on lower airway disease and general health outcomes. The diagnosis of chronic rhinosinusitis (CRS) currently is based on clinical signs, nasal endoscopy and CT scanning, and therapeutic recommendations are focussing on 2 classes of drugs, corticosteroids and antibiotics. A better understanding of the pathogenesis and the factors amplifying mucosal inflammation therefore seems to be crucial for the development of new diagnostic and therapeutic tools. In an effort to extend knowledge in this area, the WP 2.7.2 of the GA2LEN network of excellence currently collects data and samples of 1000 CRS patients and 250 control subjects. The main objective of this project is to characterize patients with upper airway disease on the basis of clinical parameters, infectious agents, inflammatory mechanisms and remodeling processes. This collaborative research will result in better knowledge on patient phenotypes, pathomechanisms, and subtypes in chronic rhinosinusitis. This review summarizes the state of the art on chronic rhinosinusitis and nasal polyposis in different aspects of the disease. It defines potential gaps in the current research, and points to future research perspectives and targets.
Intrathecal neostigmine with bupivacaine for infants undergoing lower abdominal and urogenital procedures: dose response
Authors: BATRA Y. K. , RAJEEV S. , PANDA N. B. , LOKESH V. C. , RAO K. L. N.
Published: March 2009

Background: Intrathecal (IT) neostigmine produces dose‐dependent analgesia in adults. However, the dose of spinal neostigmine has not been investigated in infants. The purpose of this study was to assess spinal anesthesia (SA) duration provided by four doses of spinal neostigmine added to bupivacaine for lower abdominal and urogenital procedures in infants.

Methods: Seventy‐five infants were randomized into five groups. The control group B received IT plain 0.5% hyperbaric bupivacaine. Groups BN.25, BN.50, BN.75, and BN1.0 received bupivacaine with 0.25, 0.5, 0.75, and 1 μg/kg of neostigmine, respectively. The primary variable was the duration of anesthesia assessed by recovery of hip flexion. Postoperative pain with facial expression, leg activity, arm activity, crying and consolability scale score,and rescue analgesic requirements were the secondary variables measured, and the side effects were noted.

Results: Seventy‐three infants completed the study. There was a significant linear increase in SA duration with IT neostigmine to 65.2 (4.3) min with 0.5 μg/kg (P<0.01), 88.2 (5.1) with 0.75 μg/kg (P<0.001) and 92 (4.3) with 1 μg/kg (P<0.001) from 52.4 (4.3) min with bupivacaine alone. SA duration showed no significant difference between plain bupivacaine and BN.25 (P=0.100) or between groups BN.75 and BN1.0 (P=0.451). Groups BN.75 and BN1.0 had significantly reduced pain scores, and the median duration before the first dose rescue analgesic was requested prolonged significantly (P<0.001) compared with the other three groups.

Conclusions: IT neostigmine at a dose of 0.75 μg/kg added to bupivacaine significantly prolonged SA duration with reduced postoperative pain scores and rescue analgesic requirements in infants undergoing lower abdominal and urogenital procedures. No additional benefits were provided on increasing it to 1 μg/kg.
Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized‐controlled trial
Authors: CLAUDIUS C. , SKOVGAARD L. T. , VIBY‐MOGENSEN J.
Published: March 2009

Background: Acceleromyography (AMG) is increasingly being used in neuromuscular research, including in studies establishing the potency of neuromuscular blocking and reversal agents. However, AMG is insufficiently validated for use interchangeably with the gold standard, mechanomyography (MMG) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose–response relationship and potency, using rocuronium as an example.

Methods: We included 40 adult patients in this randomized‐controlled single‐dose response study. Anaesthesia was induced and maintained with propofol and opioid. Neuromuscular blockade was induced with rocuronium 100, 150, 200 or 250 μg/kg. Neuromuscular monitoring was performed with AMG (TOF‐Watch® SX) with pre‐load (Hand Adapter) at one arm and MMG (modified TOF‐Watch® SX) on the other, using 0.1 Hz single twitch stimulation. Dose–response relationships were determined for both recording methods using log (dose) against probit (maximum block). The obtained slopes of the regression lines, ED50, ED95 and the maximum block were compared.

Results: The ED50 and ED95 [95% confidence interval (CI)] for AMG were 185 μg/kg (167–205 μg/kg) and 368 μg/kg (288–470 μg/kg), compared with 174 μg/kg (159–191 μg/kg) and 338 μg/kg (273–418 μg/kg) for MMG. There were no statistically significant biases in maximum block, ED50, ED95 or slopes obtained with the two methods.

Conclusion: Our results indicate that any possible difference between AMG and MMG is so small that it justifies AMG to be used for establishing the potency of neuromuscular blocking agents. However, the wide CIs show that we cannot rule out a 13% higher ED50 and a 26% higher ED95 for AMG.
Attenuation of a rocuronium‐induced neuromuscular block in patients receiving prednisolone
Authors: SOLTÉSZ S. , MENCKE T. , STUNZ M. , DIEFENBACH C. , ZIEGELER S. , MOLTER G. P.
Published: March 2009

Background: This study tested the influence of continuous medication (more than 4 weeks) with prednisolone on a rocuronium‐induced neuromuscular block.

Methods: The time course of a rocuronium‐induced neuromuscular blockade (0.3 mg/kg) was investigated in 40 patients with chronic inflammatory bowel disease undergoing elective abdominal surgery. The primary end point was the time from the start of injection of rocuronium until recovery of the TOF ratio to 0.9. Twenty patients received continuous medication with prednisolone (group A), and 20 were without glucocorticoid medication (group B). Additionally, another 20 patients without inflammatory bowel disease and without glucocorticoid medication served as control (group C).

Results: The onset time was prolonged in group A [253 (51.2) s] compared with group B [187 (61.3) s]. Twitch height at the onset of the block was higher in group A [16.5 (0–61)%] than that in group B [5.0 (0–33)%]. The duration to 25% twitch height was shorter in group A [12.6 (0–20.7) min] compared with group B [16.7 (0–25.3) min] and group C [16.9 (0–29.3) min]. The recovery to a train‐of‐four ratio of 0.9 was reduced in group A [25.7 (23–34.3) min] compared with group B [34.7 (32.7–44.2) min] and group C [36.5 (31.7–42.3) min].

Conclusions: Prednisolone treatment in patients with inflammatory bowel disease is associated with a delayed onset and a shorter duration of action of rocuronium. The presence of an inflammatory bowel disease did not influence the neuromuscular block.
Rapid thawing of fresh‐frozen plasma with radio wave‐based thawing technology and effects on coagulation factors during prolonged storage at 4°C
Authors: Boström F. , Ekemar L. , Olsson D. , Egberg N. , Lundahl J.
Published: March 2009

Background and Objectives  With traditional techniques the thawing time for fresh‐frozen plasma (FFP) is about 20–30 min. A new technology using radio waves, radio wave thawing device (RTD), was applied for thawing FFP. With this technology the thawing time can substantially be reduced. The new technique was compared to an established method using Heated Air Technology (HAT). Variables subjected to assessment were temperature after thawing and analysis of factor V (FV), factor VIII (FVIII), protein S.

Materials and Methods  Plasma was collected from 20 plasma donors. Each donation was aliquoted into two equal units of approximately 250 ml. The plasma units were frozen and stored below –75°C. The thawing time was pre‐set to two time periods, one for each group, 23 min for HAT and 7·5 min for RTD. Thawed plasma was stored at 4 ± 2°C as liquid plasma. Samples were collected before freezing, after thawing, 1 week and 2 weeks after thawing.

Results  The FV and FVIII levels were over 90% direct after thawing compared to before freezing values in both groups. At 2 weeks of storage the levels of FV and FVIII were approximately 70% and 50%, respectively, compared to before freezing values. Protein S levels decreased slightly during storage. No significant differences in the decline of quality were observed between the two groups.

Conclusion  The new radio wave technology for thawing of FFP has a significant reduction of thawing time. The impact of thawing and storage on FV, FVIII, protein S does not significantly differ between HAT and RTD.
Ecology of Armillaria species in managed forests and plantations in Serbia
Authors: Keča N. , Karadžić D. , Woodward S.
Published: March 2009

The distribution of Armillaria species was investigated in Serbian forest ecosystems, in relation to the main host species attacked, forest‐types, geography and altitude. In total, 388 isolates were identified from 36 host species in 47 sites. Armillaria gallica was the most commonly observed species with the widest distribution and with an altitudinal range of 70–1450 m, it was the dominating Armillaria species in lowland alluvial forests and in Quercus and Fagus forests at higher elevations. Armillaria mellea occurred in Quercus spp. – dominated forests in the north and central regions at 70–1050 m. Sixty‐eight per cent of the A. mellea isolates were collected from living hosts, most commonly in declining conifer plantations. Armillaria ostoyae was distributed in the cooler coniferous forest types and plantations in the Dinaric Alps in the south of Serbia, at 850–1820 m. Armillaria cepistipes was found in the eastern and southern hilly and mountainous regions of the country, at 600–1900 m. Most isolates were obtained from conifers and rhizomorphs in the soil around decaying stumps. Armillaria tabescens was found only on dead oak material in the northern and eastern regions of the country at altitudes lower than 600 m.
Turkish Heterobasidion abietinum is pathogenic to inoculated Abies nordmanniana ssp. nordmanniana and ssp. bornmülleriana
Authors: Lehtijärvi A. , Aday A. G. , Doğmuş‐Lehtijärvi H. T.
Published: March 2009

Four‐year‐old seedlings of Abies nordmanniana ssp. bornmülleriana and 5‐year‐old seedlings of Abies nordmanniana ssp. nordmanniana were inoculated on the lower stem with 28 Heterobasidion abietinum isolates originating from four different regions of Turkey. Replicate seedlings were incubated in greenhouse and growth chamber. After 7 weeks, infection incidence, mortality, lesion length in the inner bark and fungal growth in the sapwood were examined. Infection incidence in different host–incubation combinations ranged between 70.5 and 79.5% and the average mortality rate was 4.2%. Average lesion lengths varied between 8.4 and 33.9 mm, and average fungal growth between 18.7 and 34.8 mm. There was a significant positive correlation between lesion length in the inner bark and fungal growth in sapwood on both hosts and conditions. Clear differences in virulence between H. abietinum isolates originating from different regions were not found. The results indicate that H. abietinum is pathogenic on both investigated subspecies of A. nordmanniana. Both lesion length and fungal growth were greater on ssp. bornmülleriana, indicating that it would be more susceptible than ssp. nordmanniana.
Quantitative evaluation of corneal epithelial oedema by confocal microscopy
Authors: Morishige Naoyuki , Takahashi Norihisa , Chikamoto Nobuhiko , Nishida Teruo
Published: March 2009

Abstract

Background:  To develop a novel quantitative index for evaluation of corneal epithelial oedema, the pixel intensity of confocal microscopic images was measured derived from the basal cell layer (BCL) of the corneal epithelium in normal eyes, eyes before and after cataract surgery, and eyes affected by bullous keratopathy.

Methods:  Five eyes of five normal volunteers, 14 eyes of 11 cataract patients and 12 eyes of 12 bullous keratopathy patients were examined by confocal microscopy. The cataract patients underwent cataract surgery, and they were examined by confocal microscopy, corneal pachymetry, and anterior fluorometry both before and at various times after surgery. The pixel intensity of BCL images obtained by confocal microscopy was measured and expressed as the BCL index.

Results:  The coefficient of variation for repeated (five times) measurement of the BCL index in each of the five normal eyes was 3.4%. The BCL index was 54.8 ± 5.3 (mean ± SD) before surgery, increased significantly to 65.2 ± 10.0 on the day after surgery, and gradually decreased thereafter in the cataract patients. The time‐course of the BCL index coincided well with that of corneal thickness and anterior fluorometry value. The BCL index in eyes affected by bullous keratopathy was significantly increased at 95.0 ± 6.4.

Conclusion:  The BCL index was increased after cataract surgery and in eyes affected by bullous keratopathy, conditions associated with corneal epithelial oedema. This quantitative measure obtained by confocal microscopy may prove useful in the clinical evaluation of corneal epithelial oedema.
CASE OF A CLOSED CHOLEDOCHOCELE WITH BILIARY AND PANCREATIC DRAINAGE VIA THE ACCESSORY DUCT CAUSING ACUTE PANCREATITIS
Authors: Gordon Stuart R. , Levenick John M. , Rath Daniel L. , Gardner Timothy B.
Published: March 2009

Type III choledochal cysts, also called choledochoceles, are rare cystic dilatations of the terminal biliary tree. We report the case of a ‘closed choledochocele’, in which the bile and ventral pancreatic ducts emptied into the cyst, but because there was no outlet into the duodenum, drainage was retrograde via the accessory duct. This type of choledochocele variant has never previously been described in the medical literature.
CASE OF INFLAMMATORY FIBROID POLYP OF THE ESOPHAGOGASTRIC JUNCTION
Authors: Yamane Tateki , Uchiyama Kan , Ishii Takayuki , Ishii Hironori , Takizawa Reo , Omura Mitsuhiro , Fujise Kiyotaka , Tajiri Hisao
Published: March 2009

Upper gastrointestinal endoscopy of a 25‐year‐old man with heartburn revealed an elevated lesion in the esophagogastric junction (EGJ). Piecemeal endoscopic mucosal resection (EMR) followed by histopathological examination led to a diagnosis of inflammatory fibroid polyp (IFP). After EMR, the heartburn persisted despite giving a proton pump inhibitor (PPI), and the residual lesion gradually enlarged and a transverse mucosal break developed on the esophageal side of it. However, the combined administration of the PPI and an H2 receptor antagonist reduced the heartburn, and led to endoscopic regression of the lesion and disappearance of the transverse mucosal break. IFP of the esophagogastric junction is extremely rare, and this case is interesting in that potent inhibition of gastric acid secretion resulted in the regression of the lesion.
SMALL BOWEL PSEUDOMELANOSIS AND ORAL IRON THERAPY
Authors: Almeida Nuno , Figueiredo Pedro , Lopes Sandra , Freire Paulo , Sousa Vítor , Lérias Clotilde , Gouveia Hermano , Leitão Maximino C.
Published: March 2009

Small bowel pseudomelanosis is a rarely reported clinical entity characterized by brown pigmentation of small bowel mucosa. The authors describe two cases, both with iron deficiency anemia, one of an 81‐year‐old female patient submitted for capsule endoscopy that revealed a brown pigmentation of all small bowel mucosa and another of an 81‐year‐old male whose retrograde double‐balloon enteroscopy revealed a diffuse brown pattern of small bowel mucosa. Ileal biopsies confirmed intense iron deposition in the macrophages of the lamina propria. Both patients were on oral iron therapy and the second one had a previous double‐balloon enteroscopy, 2 years earlier, which revealed only ileal angiodysplasias. These two cases demonstrate the importance of two new endoscopic methods for diagnosis of small bowel pseudomelanosis, the rarity of such an entity and its close relation with oral iron therapy.
URGENT CAPSULE ENDOSCOPY IS USEFUL IN SEVERE OBSCURE‐OVERT GASTROINTESTINAL BLEEDING
Authors: Almeida Nuno , Figueiredo Pedro , Lopes Sandra , Freire Paulo , Lérias Clotilde , Gouveia Hermano , Leitão Maximino C.
Published: March 2009

Aim:  With capsule endoscopy (CE) it is possible to examine the entire small bowel. The present study assessed the diagnostic yield of CE in severe obscure‐overt gastrointestinal bleeding (OOGIB).

Methods:  During a 3‐year period, 15 capsule examinations (4.5% of all CE in a single institution) were carried out in 15 patients (11 men; mean age 69.9 ± 20.1 years) with severe ongoing bleeding, defined as persistent melena and/or hematochezia, with hemodynamic instability and the need for significant red blood cell transfusion. CE was carried out after non‐diagnostic standard upper and lower endoscopy. The mean time from admission until CE was 4.1 ± 4.4 days (0–15 days).

Results:  CE revealed active bleeding in seven patients and signs of recent bleeding in four. Etiology of bleeding was correctly diagnosed in 11 patients (73.3%) (portal hypertension enteropathy, three patients; subepithelial ulcerated lesion, two patients; angiodysplasia, two patients; jejunal ulcer with visible vessel, one patient; multiple small bowel ulcers, one patient; jejunal tumor, one patient; jejunal mucosa irregularity with adherent clot, one patient). One patient (6.7%) had active bleeding but no visible lesion. As a consequence of the capsule findings, specific therapeutic measures were undertaken in 11 patients (73.3%) with five managed conservatively, four endoscopically and two surgically. Two patients experienced bleeding recurrence. One of them, with a probable small bowel tumor, refused any other interventions.

Conclusions:  CE is useful in patients with severe OOGIB by providing positive findings in the majority of patients, with subsequent impact on therapeutic procedures.
NOVEL TECHNIQUE OF ENDOSCOPIC SUBMUCOSAL DISSECTION USING AN EXTERNAL GRASPING FORCEPS FOR SUPERFICIAL GASTRIC NEOPLASIA
Authors: Imaeda Hiroyuki , Hosoe Naoki , Ida Yosuke , Kashiwagi Kazuhiro , Morohoshi Yuichi , Suganuma Kazuhiro , Nagakubo Shuichi , Komatsu Koichi , Suzuki Hidekazu , Saito Yoshimasa , Aiura Koichi , Ogata Haruhiko , Iwao Yasushi , Kumai Koichiro , Kitagawa Yuko , Hibi Toshifumi
Published: March 2009

Endoscopic submucosal dissection (ESD) for early stage gastric cancer (EGC) has improved the success rate of en bloc resection but results in perforation more often than does endoscopic mucosal resection. We report a novel technique of ESD using an external grasping forceps. A total of 265 lesions with EGC or gastric adenoma were enrolled in this study. Sixteen lesions were located in the upper third portion of the stomach, 114 in the middle third portion, and 135 in the lower third portion. After submucosal injection followed by circumcision of the lesions with a flex knife, the external grasping forceps was introduced with the help of a second grasping forceps and anchored at the margin of the lesion. Oral traction applied with this forceps could elevate the lesion and make the submucosal layer wider and more visible, thereby facilitating dissection of the submucosal layer under direct vision. The mean lesion size was 15.0 mm (range: 5–50 mm). All but 11 lesions (95.8%) could be resected en bloc with free margins. Mean procedure time was 45 min (range: 20–180 min). It was difficult to carry out this procedure when the lesions were located in the cardia, lesser curvature, or posterior wall of the upper third of the gastric body. Bleeding after ESD occurred in 10 patients (3.8%) and perforation occurred in one patient (0.4%). The endoscopic submucosal dissection using an external grasping forceps for superficial gastric neoplasia is efficacious and safe.
Dental and radiographic findings as predictors of osteoporosis in postmenopausal women
Authors: Erdogan Özgür , Incki Kuntay Kerim , Benlidayı Mehmet Emre , Şeydaoglu Gülşah , Kelekci Sefa
Published: March 2009

Aim:  The objective of this study was to evaluate the relationship between dental findings and osteoporosis in postmenopausal women.

Methods:  One hundred and eight postmenopausal women were recruited for the study. All participants underwent dual X‐ray absorptiometry (DXA). The number of remaining teeth, clinical attachment loss, pocket depth and mobility of each tooth were determined. Radiodensitometric analyses were performed on digital periapical radiographs utilizing an aluminum stepwedge technique. The appearance of inferior mandibular cortex posterior of the mental foramina region was scored according to the classification by Klemetti.

Results:  The number of remaining teeth, attachment loss values, Klemetti Index scores and the radiodensitometric scores showed a significant relationship with skeletal bone density.

Conclusion:  Tooth loss, an increased clinical attachment level, reduced density on digital periapical radiographs and an eroded appearance of the inferior mandibular cortex in panoramic radiographs are associated with low‐skeletal bone mineral density.
Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance
Authors: SURESH SANTHANAM , CHAN VINCENT W.S.
Published: March 2009

The transversus abdominis plane block (TAP) has been described recently for pain management following abdominal surgery. Although many techniques have been described using anatomical landmarks, a simple ultrasound (US) guidance technique for the block has not been described in children. An article published by Hebbard and colleagues on the use of US‐guidance for TAP blocks described the technique with the probe positioned at the midaxillary line with a needle insertion that is located further medial on the abdominal wall. This technique, although feasible in adults is not possible in children due to the need for obtaining a more thorough spread of the local anesthetic solution. We describe in this article, a user‐friendly approach to the placement of a TAP block in infants, children and adolescents. Further pharmacokinetic data has to be obtained for actual dosing for these blocks in infants and children.
Macroecological analyses reveal historical factors influencing seed dispersal strategies in Brazilian Araucaria forests
Authors: Duarte Leandro da S. , Carlucci Marcos B. , Pillar Valério D.
Published: March 2009

Aim  Our objective was to evaluate the influence of distinct macroecological factors (space, floristics and environment) on the variation in seed dispersal strategies of shrubs and trees in the Araucaria forest biome in the southern and south‐eastern Brazilian highlands. We hypothesize that history‐related factors (space, floristics) are major determinants of the proportion of endo‐ and syn‐zoochorous species in Araucaria forests, despite the current gradients in environmental conditions.

Location  Araucaria forest is the main forest biome in southern Brazil, at altitudes above 500 m a.s.l. (latitude ≤ 30° S). Their northern limit in Brazil is at latitude 20° S, where forests occur at elevations above 1000 m a.s.l.

Methods  We compiled information from 27 floristic checklists comprising shrub and tree species distributed along the geographical range of the Brazilian Araucaria forest biome. We classified species as zoochorous and non‐zoochorous, based on morphological attributes of their diaspores. Sites were described by geographical coordinates (latitude, longitude) and five environmental variables. We evaluated separately the influence of floristic, spatial and environmental variables on zoochory using correspondence analysis and linear regressions. Further, we evaluated causal connections between these variable groups using Mantel tests and path analysis.

Results  Zoochory increased with both latitude and longitude. Regression analysis showed that rainfall seasonality was the only environmental variable explaining the variation in the proportion of zoochorous species. All pairwise Mantel correlations between space, rainfall seasonality, floristics and zoochory were significant. Path analysis showed that rainfall seasonality was strongly determined by spatial distances between sites, and floristics was directly determined by rainfall seasonality. Further zoochory was mostly determined by floristics.

Main conclusions  Taking into account historical factors in the interpretation of macroecological patterns improves our understanding of biodiversity gradients. Hypotheses based on long‐term dynamics of distinct floristic groups provide some useful insights into patterns shown by studies elsewhere. Here we offer an analytical solution to incorporate history‐related factors into macroecological analyses. While history‐based hypotheses do not replace any other ideas concerning macroecological patterns, they are likely to improve our understanding on factors determining present‐day ecological patterns.
Targeted single nucleotide polymorphism (SNP) discovery in a highly polyploid plant species using 454 sequencing
Authors: Bundock Peter C. , Eliott Frances G. , Ablett Gary , Benson Adam D. , Casu Rosanne E. , Aitken Karen S. , Henry Robert J.
Published: March 2009

Discovering single nucleotide polymorphisms (SNPs) in specific genes in a heterozygous polyploid plant species, such as sugarcane, is challenging because of the presence of a large number of homologues. To discover SNPs for mapping genes of interest, 454 sequencing of 307 polymerase chain reaction (PCR) amplicons (> 59 kb of sequence) was undertaken. One region of a four‐gasket sequencing run, on a 454 Genome Sequencer FLX, was used for pooled PCR products amplified from each parent of a quantitative trait locus (QTL) mapping population (IJ76‐514 × Q165). The sequencing yielded 96 755 (IJ76‐514) and 86 241 (Q165) sequences with perfect matches to a PCR primer used in amplification, with an average sequence depth of approximately 300 and an average read length of 220 bases. Further analysis was carried out on amplicons whose sequences clustered into a single contig using an identity of 80% with the program cap3. In the more polymorphic sugarcane parent (Q165), 94% of amplicons (227/242) had evidence of a reliable SNP – an average of one every 35 bases. Significantly fewer SNPs were found in the pure Saccharum officinarum parent – with one SNP every 58 bases and SNPs in 86% (213/247) of amplicons. Using automatic SNP detection, 1632 SNPs were detected in Q165 sequences and 1013 in IJ76‐514. From 225 candidate SNP sites tested, 209 (93%) were validated as polymorphic using the Sequenom MassARRAY system. Amplicon re‐sequencing using the 454 system enables cost‐effective SNP discovery that can be targeted to genes of interest and is able to perform in the highly challenging area of polyploid genomes.
Discovering genetic polymorphisms in next‐generation sequencing data
Authors: Imelfort Michael , Duran Chris , Batley Jacqueline , Edwards David
Published: March 2009

The ongoing revolution in DNA sequencing technology now enables the reading of thousands of millions of nucleotide bases in a single instrument run. However, this data quantity is often compromised by poor confidence in the read quality. The identification of genetic polymorphisms from this data is therefore problematic and, combined with the vast quantity of data, poses a major bioinformatics challenge. However, once these difficulties have been addressed, next‐generation sequencing will offer a means to identify and characterize the wealth of genetic polymorphisms underlying the vast phenotypic variation in biological systems. We describe the recent advances in next‐generation sequencing technology, together with preliminary approaches that can be applied for single nucleotide polymorphism discovery in plant species.
A genome‐wide analysis of single nucleotide polymorphism diversity in the world's major cereal crops
Authors: Barker Gary L. A. , Edwards Keith J.
Published: March 2009

Over 3.5 million expressed sequence tags from the major cereal taxa were used to electronically mine over 176 000 putative single nucleotide polymorphisms (SNPs). The density, distribution and degree of linkage between these SNPs were compared among the different taxa. The frequency of sequence polymorphism was lowest in diploid taxa (rice, barley and sorghum), intermediate in tetraploid maize and highest in allohexaploid wheat and octoploid sugarcane. SNPs were further categorized as either intravarietal (differences between gene family members and homoeologues) or varietal (differences between two varieties), and as either co‐segregating or non‐co‐segregating with neighbouring polymorphisms. Varietal co‐segregating SNPs represent the best candidates for molecular markers as they show variation between varieties and have a high probability of being validated, as sequencing errors are unlikely to co‐segregate with one another. This elite class of SNPs was most abundant in barley and least abundant in wheat and rice. Despite the large number of observed sequence polymorphisms in allohexaploid wheat, only a fraction of those available are likely to make good molecular markers. In addition, we found that rice SNPs up to 10 kb apart were in linkage disequilibrium (LD), but that high levels of LD attributable to population structure confounded the tracking of LD over greater distances.
Livestock Disease Indemnity Design When Moral Hazard Is Followed by Adverse Selection
Authors: Gramig Benjamin M. , Horan Richard D. , Wolf Christopher A.
Published: March 2009

Averting or limiting the outbreak of infectious disease in domestic livestock herds is an economic and potential human health issue that involves the government and individual livestock producers. Producers have private information about preventive biosecurity measures they adopt on their farms prior to outbreak (ex ante moral hazard), and following outbreak they possess private information about whether or not their herd is infected (ex post adverse selection). We investigate how indemnity payments can be designed to provide incentives to producers to invest in biosecurity and report infection to the government in the presence of asymmetric information. We compare the relative magnitude of the first‐ and second‐best levels of biosecurity investment and indemnity payments to demonstrate the tradeoff between risk sharing and efficiency, and we discuss the implications for status quo U.S. policy.
Role of Education in Cigarette Smoking: An Analysis of Malaysian Household Survey Data*
Authors: Tan Andrew K.G. , Yen Steven T. , Nayga, Jr. Rodolfo M.
Published: March 2009

Heckman's sample selection model is used to examine the role of education on household purchase decisions and expenditures of tobacco products in Malaysia. Results of the marginal effects of education, segmented by ethnic and gender groups, suggest that education decreases the probability, conditional levels and unconditional levels of tobacco expenditures amongst Malaysian households. Specifically, an additional year of education of the household head, irrespective of ethnic or gender considerations, decreases smoking probability by 1.5 percent. However, the negative effect of education seems to be higher for Chinese (US$1.07) than Malay (US$0.26) households in terms of conditional expenditures. Furthermore, education significantly decreases conditional tobacco expenditures within male‐headed households.
Poverty and Governance: The Contest for Aid
Authors: Epstein Gil S. , Gang Ira N.
Published: March 2009

Countries compete with one another for funds distributed by non‐government organizations (NGOs). The authors consider a competition over poverty and governance conducted by a non‐government organization trying to allocate its funds among potential recipient countries. In its decision‐making the NGO also takes into account the initial conditions each potential recipient faces, including the current quality of governance and wealth (poverty). For example, all else being equal the poorer country will have a higher probability of obtaining funds; or, the better the applicant's governance, the more its gains. Moreover, the maximum aid a country can obtain depends on its wealth. Investment in good governance, the wealth/poverty status of the applicant, and its current quality of governance will, together, determine the funds potential recipients expect to obtain. The authors also consider recent changes in the levels of these factors. They want to understand the roles these factors play in the competition for aid and the outcome for the quality of governance.