bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Inguinal Approach for Tube Cystostomy
Authors: BRAY JONATHAN P. , DOYLE RONAN S. , BURTON CAROLYN A.
Published: April 2009

Objective—To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony.

Study Design—Case series.

Animals—Dogs (n=9) and cats (6).

Methods—Medical records (January 2004–January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred.

Results—Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration.

Conclusions—An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur.

Clinical Relevance—An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.
Oral and Intravenous Amiodarone for Atrial Fibrillation‐Flutter
Authors: STRASBERG BORIS , SCLAROVSKX SAMUEL , KUSNIEC JAIRO , AGMON JACOB
Published: April 2009

Amiodrone is a benytfuran derivative with class III anti arrhythmic effects. It has also been reported to convert atrial fibrillation and flutter to sinus rhythm and is highly effective for the prevention of atrial fibrillation (especially of the paroxysmal form) with an overall efficacy in the range of 70–50%. This high degree of efficacy was obtained in a majority of patients who had already failed various conventional anti arrhythmic agents. The mechanism of arrhythmia termination by intravenous amiodarone is not clear. The slowing in ventricular response, which most probably improves cardiac hemodynamics, has an indirect salutary effect. Despite the fact that none of the published reports on intravenous amiodarone used a placebo control group, these studies suggest that intravenous amiodarone has an important role in the acute treatment of atrial fibrilation with fast ventricular response.
Mexiletine for the Management of Ventricular Arrhythmias in Ischemic Heart Disease
Authors: HALINEN MATTI O.
Published: April 2009

Mexiletine, a type IB anti arrhythmic agent, has recently been released in the United States for use in the oral treatment of ventricular arrhythmias. It is as effective as other group IB and LA drugs, and less effective than group 1C agents such as propafawne, flecainide, and amiodarone; however, it has the advantage of being associated with fewer serious adverse effects. Mexiletine will control ventricular tachycardia in patients with drug‐resistant arrhythmias in 20–30% of cases; in unselected populations it may abolish VT in 50–96%. It is recommended that mexiletine be combined with beta blockers and/or group IA drugs for treating resistant arrhythmias. Efficacy may be increased and adverse side effects reduced through use of smaller dosages and combination therapy.
Second Degree SA Block and Escape‐Capture Bigeminy Diagnosed by Esophageal Electrocardiography
Authors: CAMPANALE GIOVANNI , CIOCIOLA GIULIANO , SCARCIA ANTONIO , SALIANI RITA , SIVO ADRIANO , GIRARDI FRANCESCO
Published: April 2009

We report a case of escape‐capture bigeminy, a rare form of arrhythmia, occurring after treatment of wide‐QRS tachycardia and diagnosed by esophageal electrocardiography recording of atrial activity which was not evident on the surface electrocardiogram.
Role of Propafenone in the Treatment of Ventricular Premature Beats
Authors: HODGES MORRISON
Published: April 2009

The effectiveness of propafenone versus quinidine for the therapy of ventricular premature beats was evaluated in a placebo‐controlled double‐blind parallel study. A total of 105 patients was entered; 53 patients were randomly assigned to receive propafenone (600 mg/day and 900 mg/day during low‐and high‐dose weeks, respectively) and 52 patients were randomly assigned to receive quinidine (800 mg/day and 1,600 mg/day, respectively). Both drugs significantly reduced ventricular ectopy at both dose levels; there was no statistically significant difference between the two drugs in effectiveness, although a higher percentage of patients responded to propafenone. Side effects resulting in discontinuation of therapy were more common with quinidine. This study confirms the effectiveness of propafenone in the therapy of ventricular premature beats.
Propafenone Therapy in Patients with Serious Ventricular Arrhythmia ‐ Noninvasive Evaluation of Efficacy
Authors: CUENI LAWRENCE , PODRID PHILIP J.
Published: April 2009

Propafenone is a newv IC antiarrhythmic agent that is effective for suppression of spontaneously occurring ventricular arrhythmia as evauated with monitoring and exercise testing. The incidence of nonserious, but disturbing side effects is low and the drug infrequently is discontinued because of adverse reactions. Serious side effects are primarily cardiac and include arrhythmia aggravation, CHF exacerbation, and conduction abnormalities. These complications occur primarily in those with severe underlying heart disease in whom this drug, like other antiarrhythmic agents, must be used cautiously. If the drug is effective and well tolerated, arrhythmia recurrence can be prevented.
A Low Incidence of Proarrhythmia Using Low‐Dose Amiodarone
Authors: KERIN NICHOLAS Z. , BLEVINS ROGER D. , KERNER NATHAN , FAITEL KATHY , FRUMIN HOWARD , MACIEJKO JAMES J. , RUBENFIRE MELVYN
Published: April 2009

The incidence of proarrhythmia with antiarrhythmic agents is reported to be 2%‐23%, depending on the agent, definition of proarrhythmia, method of assessment, and severity of underlying rhythm disturbance. Several case reports of amiodarone‐induced proarrhythmia have appeared; however, its prevalence and clinical significance have not been adequately defined. In our series of 107 patients with potentially lethal ventricular arrhythmias, amiodarone was administered as a 5‐mg/kg bolus infusion, followed by 600–800 mg/day for 7–10 days. A mean daily maintenance dose of 270 mg/day was given for an average of 15 months (range <57). Proarrhythmia was defined by the method of Morganroth as: (1) a three‐ to tenfold increase in VPC frequency, (2) a marked increase in VT rate, or (3) the development of new sustained VT/VF or torsade de pointes. Bradyarrhythmias, conduction delays, and out‐of‐hospital sudden death were not included by definition. Baseline 24‐hour‐Holter monitoring revealed 449 ± 685 VPCs/hr, 740 ± 584 couplets/24 hr, and 61 ± 685 episodes of nonsustained VT/24 hr. Proarrhythmia occurred in three patients (2.8%). Two of these episodes occurred during the first week of treatment and resolved without dosage adjustment. These episodes included a 4.7‐ and 5.1‐fold increase in VPC frequency. The other proarrhythmic event was a case of torsade de pointes that occurred after 12 months of treatment and required acute intervention and withdrawal of amiodarone. In conclusion, low‐dose amiodarone appears to have a low potential for proarrhythmia and compares favorably with other agents in this regard, perhaps owing to its unique electrophysiologic properties.
Bundle‐Branch Reentrant Ventricular Tachycardia: A Possible Mechanism of Flecainide Proarrhythmic Effect
Authors: SAOUDI N. , GALTIER M. , HIDDEN F. , GERBER L. , LETAC B.
Published: April 2009

A 42‐year‐old male with cardiomyopathy and paroxysmal at atrial fibrillation was on chronic oral amiodarone therapy (200 mg/day) and received an additional 400 mg of flecainide per day because his nondocumented palpitations recurred. Ten syncopes occurred in the two following months and the patient was referred for electrophysiologic study. The basic H#V interval was prolonged (80 msec) and QRS slightly prolonged (110 msec). Programmed ventricular stimulation consistently found a critical SH delay (260 msec) that was followed by a left bundle‐branch block type of QRS. The latter was always preceded by a His deflection (H), thereby evoking His‐Purkinje reentry. Three premature beats induced a rapid (cycle length 270 msec), sustained, poorly tolerated ventricular tachycardia (VT) with a QRS morphology identical to the bundle‐branch reentrant phenomenon.

Each ventricular electrogram was preceded by an H, H‐V varying from 100 to 130 msec. Three weeks after flecainide withdrawal, the H‐V interval was 60 msec and no VT was inducible. This observation is representative of a proarrhythmic effect of flecainide in association with amiodarone.

Bundle‐branch reentry ventricular tachycardia is the most likely mechanism of arrhythmia‐aggravation in this observation. It could have been induced because of intraventricular depression of conduction.
Catheter Ablation in the Canine Coronary Sinus Using Radiofrequency Energy
Authors: GROGAN E. WAYNE , SUBRAMANIAN RAMIAH , WHITESELL LARRY E. , NELLIS STEPHEN H.
Published: April 2009

This study was performed to evaluate the effects of radiofrequency catheter ablation in the coronary sinus as a potential means of eliminating conduction over left‐sided accessory pathways in humans. Radiofrequency current at a frequency of 500 kHz was delivered by electrode catheter to two sites in the coronary sinus of each often dogs. Left coronary arteriography with venous phase visualization of the coronary sinus was performed before, immediately after, and 2 weeks following ablation. Unipolar electrograms from the ablating electrode were recorded before and immediately after ablation. Coronary arteriography revealed no evidence of damage to the adjacent left circumflex coronary artery or its branches as a result of ablation. Contrast visualization of the coronary sinus showed persistent contrast staining following ablation at two of the ablated sites. Angiographically apparent stenosis of the coronary sinus was seen both acutely and chronically in two cases. Unipolar electrogram recordings from the ablating electrode showed an increase in atrial repolarization voltage (atrial current of injury) of 1.53 ± 1.03 mV (P = 0.00004), and an increase in ventricular repolarization voltage of 0.73 ± 0.84 mV (P = 0.005). There was a 23% decrease in amplitude of atrial electrograms (P = 0.006) and a 7% decrease in amplitude of ventricular electrograms (P = 0.02) recorded from the ablating electrode following ablation. Lesions could be identified grossly and microscopically at 16 of the 20 ablated sites. Perforation of the coronary sinus did not occur. Microscopical observation showed normal healing with granulation tissue and fat necrosis extending outward from the coronary sinus involving the atrial epicardium in 13 lesions, the ventricular epicardium in 5 lesions, and the adventitia of the left circumflex coronary artery in 5 lesions. No medial or intimal involvement of the coronary artery was seen. The coronary sinus itself showed luminal organized thrombus in 4 lesions, with near occlusion of the lumen in 1 case. Radiofrequency ablation in the coronary sinus thus results in lesions of a size and extent that would be expected to successfully ablate some left‐sided accessory pathways if delivered in humans. Monitoring of the unipolar electrogram provides insight into the extent of injury during ablation. In some cases, thrombosis of the coronary sinus occurs, the long‐term effects of which are not known.
Spatiotemporal food web dynamics along a desert riparian–upland transition
Authors: Soykan Candan U. , Sabo John L.
Published: April 2009

Increased awareness of spatiotemporal variation in species interactions has motivated the study of temporally‐resolved food web dynamics at the landscape level. Empiricists have focused attention on cross‐habitat flows of materials, nutrients, and prey, largely ignoring the movement of predators between habitats that differ in productivity (and how predators integrate pulses in resource availability over time). We set out to study seasonal variation in food web interactions between mammalian carnivores and their rodent prey along a riparian–upland gradient in semi‐arid southeastern Arizona which features both spatial and temporal heterogeneity in resource availability. Specifically, we tested whether mammalian carnivores spill over from productive, near‐river habitats into adjacent, desert‐scrub habitats; and if they do, to document the effects of this spillover on rodent communities. Furthermore, we examined seasonal variation in top‐down effects by measuring changes in carnivore diet and distribution patterns and rodent populations over time. The results indicate that carnivores track seasonally‐abundant resources across the landscape, varying both their diet and movement patterns. In turn, desert‐scrub rodent population dynamics track seasonal shifts in carnivore habitat use but not resource availability, suggesting that predation plays a role in structuring rodent communities along the San Pedro River. Further evidence comes from data on rodent community composition, which differs between desert‐scrub habitats near and far from the river, despite similarities in resource availability. Our data also suggest that seasonal omnivory helps predators survive lean times, increasing their effects on prey populations. Taken together, these results underscore the importance of spatiotemporal variation in species interactions, highlighting the complexity of natural systems and the need for further detailed studies of food web dynamics.
A periplasmic aldehyde oxidoreductase represents the first molybdopterin cytosine dinucleotide cofactor containing molybdo‐flavoenzyme from Escherichia coli
Authors: Neumann Meina , Mittelstädt Gerd , Iobbi‐Nivol Chantal , Saggu Miguel , Lendzian Friedhelm , Hildebrandt Peter , Leimkühler Silke
Published: April 2009

Three DNA regions carrying genes encoding putative homologs of xanthine dehydrogenases were identified in Escherichia coli, named xdhABC, xdhD, and yagTSRQ. Here, we describe the purification and characterization of gene products of the yagTSRQ operon, a molybdenum‐containing iron–sulfur flavoprotein from E. coli, which is located in the periplasm. The 135 kDa enzyme comprised a noncovalent (αβγ) heterotrimer with a large (78.1 kDa) molybdenum cofactor (Moco)‐containing YagR subunit, a medium (33.9 kDa) FAD‐containing YagS subunit, and a small (21.0 kDa) 2 × [2Fe2S]‐containing YagT subunit. YagQ is not a subunit of the mature enzyme, and the protein is expected to be involved in Moco modification and insertion into YagTSR. Analysis of the form of Moco present in YagTSR revealed the presence of the molybdopterin cytosine dinucleotide cofactor. Two different [2Fe2S] clusters, typical for this class of enzyme, were identified by EPR. YagTSR represents the first example of a molybdopterin cytosine dinucleotide‐containing protein in E. coli. Kinetic characterization of the enzyme revealed that YagTSR converts a broad spectrum of aldehydes, with a preference for aromatic aldehydes. Ferredoxin instead of NAD+ or molecular oxygen was used as terminal electron acceptor. Complete growth inhibition of E. coli cells devoid of genes from the yagTSRQ operon was observed by the addition of cinnamaldehyde to a low‐pH medium. This finding shows that YagTSR might have a role in the detoxification of aromatic aldehydes for E. coli under certain growth conditions.
Sotalol as Adjunctive Therapy to Implantable Cardioverter‐Defibrillators in Heart Failure Patients
Authors: Chaki Amber L. , Caines Amitra E. , Miller Alan B.
Published: April 2009

The number of heart failure patients with implantable cardioverter‐defibrillators is rising. Common issues encountered in this population are high defibrillation thresholds and inappropriate shocks. In order to resolve these problems, the addition of a class III antiarrhythmic such as sotalol is often considered. Given the emerging issue of polypharmacy and medication compliance in the heart failure population, the question of the efficacy of sotalol in reducing inappropriate shocks, defibrillation thresholds, and its ability to replace conventional β‐blockers is often raised. Current literature review suggests that sotalol is a useful adjunct to the contemporary heart failure regimen. It has the ability to reduce inappropriate shocks and defibrillation thresholds, but appears not to fully reproduce the pleiotropic beneficial effects of the β‐blockers more commonly employed for their mortality/remodeling benefits in heart failure patients.
Influence of Egg Characteristics on Survival, Growth and Feeding in Larval Walleye (Stizostedion vitreum)
Authors: Moodie G. E. E. , Loadman N. L. , Wiegand M. D. , Mathias J. A.
Published: April 2009

A subsample of eggs from 109 walleye (Stizostedion vitreum) from Crean Lake, Saskatchewan, was sieved soon after fertilization to yield four groups of eggs ranging in size from 4.86 to 5.62 mm3. Overall egg size tended to correspond to yolk and oil volumes. At hatching, larvae from the eggs with the least yolk and oil were significantly shorter than larvae from all other egg groups. At the end of the experiment, 13 d after hatching, the larvae from the eggs with the most yolk were significantly larger than larvae from the other egg groups. Differences in the mean amount of food ingested by larvae were related to initial egg size. The yolk of the smallest eggs was deficient in the (n-3) series of polyunsaturated fatty acids. Larvae from these small eggs had a high level of major body deformities and a mortality rate which reached 100% by day 10. Small egg size in itself did not appear disadvantageous; larvae from a different stock (Lake of the Prairies, Manitoba) which produced eggs with a mean size less than that of the smallest sieved eggs, had survival and growth rates comparable with those of the larger Crean Lake eggs.
CONNECTION OF SINGLE-WALLED CARBON NANOTUBES BY BANDAGING WITH A BIGGER RADIUS SINGLE-WALLED CARBON NANOTUBE
Authors: SONG HAI-YANG , HU MING-LIANG , ZHA XIN-WEI
Published: April 2009

We report molecular dynamics studies of single-walled carbon nanotubes (SWCNT) as a bandage to connect separated SWCNTs for getting structures of random length. The mechanical properties of the connected SWCNT strands with different joint length under axial loads are investigated using the classical molecular dynamics simulations method. The interaction between atoms is modeled using the second-generation of reactive empirical bond-order (REBO) potential coupled with the Lennard–Jones (L–J) potential. The mechanical properties, such as Young's modulus, tensile strength, critical buckling strains and critical buckling loads are determined and presented for SWCNT and connected SWCNT strands. The results indicates that the joints made in this way have relatively high mechanical properties corresponding to that of the ideal SWCNTs.
Neonatal Intermittent Hypoxia Leads to Long-Lasting Facilitation of Acute Hypoxia-Evoked Catecholamine Secretion From Rat Chromaffin Cells
Authors: Souvannakitti Dangjai , Kumar Ganesh K. , Fox Aaron , Prabhakar Nanduri R.
Published: April 2009

The objective of the present study was to examine the effects of intermittent hypoxia (IH) and sustained hypoxia (SH) on hypoxia-evoked catecholamine (CA) secretion from chromaffin cells in neonatal rats and assess the underlying mechanism(s). Experiments were performed on rat pups exposed to either IH (15-s hypoxia/5-min normoxia; 8 h/day) or SH (hypobaric hypoxia, 0.4 atm) or normoxia (controls) from P0 to P5. IH treatment facilitated hypoxia-evoked CA secretion and elevations in the intracellular calcium ion concentration ([Ca2+]i) and these responses were attenuated, but not abolished, by treatments designed to eliminate Ca2+ flux into cells (Ca2+-free medium or Cd2+), indicating that intracellular Ca2+ stores were augmented by IH. Norepinephrine (NE) and epinephrine (E) levels of adrenal medullae were elevated in IH-treated pups. IH treatment increased reactive oxygen species (ROS) production in adrenal medullae and antioxidant treatment prevented IH-induced facilitation of CA secretion, elevations in [Ca2+]i by hypoxia, and the up-regulation of NE and E. The effects of neonatal IH treatment on hypoxia-induced CA secretion and elevation in [Ca2+]i, CA, and ROS levels persisted in rats reared under normoxia for >30 days. In striking contrast, chromaffin cells from SH-treated animals exhibited attenuated hypoxia-evoked CA secretion. In SH-treated cells hypoxia-evoked elevations in [Ca2+]i, NE and E contents, and ROS levels were comparable with controls. These observations demonstrate that: 1) neonatal IH and SH evoke opposite effects on hypoxia-evoked CA secretion from chromaffin cells, 2) ROS signaling mediates the faciltatory effects of IH, and 3) the effects of neonatal IH on chromaffin cells persist into adult life.
Plasma Protein Carbonyls and Breast Cancer Risk in Sisters Discordant for Breast Cancer from the New York Site of the Breast Cancer Family Registry
Authors: Zipprich Jennifer , Terry Mary Beth , Liao Yuyan , Agrawal Meenakshi , Gurvich Irina , Senie Ruby , Santella Regina M.
Published: April 2009

Reactive oxygen species are important in the pathogenesis of many diseases, including breast cancer. Several population-based case-control studies have shown that various biomarkers of oxidative stress are associated with an increase in breast cancer risk. We selected sisters discordant for breast cancer (n = 645) from the New York site of the Breast Cancer Family Registry to explore factors that contribute to variation in plasma protein carbonyls, and to determine whether this biomarker is associated with an increase in breast cancer risk among those with a family history. Late age at menarche, hormone replacement therapy use, and Hispanic race were significantly associated with lower plasma protein carbonyl levels in unaffected sisters. Plasma protein carbonyls were associated with an increase in breast cancer risk [Q2 odds ratio (OR), 1.4; 95% confidence interval (CI), 0.8–2.7; Q3 OR, 2.4; 95% CI, 1.1–4.9; Q4 OR, 1.9; 95% CI, 0.8–4.2], although not in a dose-dependent manner. These data suggest that oxidative damage is a risk factor for breast cancer in high-risk women. [Cancer Res 2009;69(7):2966–72]
ABT-510 Is an Effective Chemopreventive Agent in the Mouse 4-Nitroquinoline 1-Oxide Model of Oral Carcinogenesis
Authors: Hasina Rifat , Martin Leslie E. , Kasza Kristen , Jones Colleen L. , Jalil Asif , Lingen Mark W.
Published: April 2009

Despite numerous advances, the 5-year survival rate for head and neck squamous cell cancer (HNSCC) has remained largely unchanged. This poor outcome is due to several variables, including the development of multiple primary tumors. Therefore, it is essential to supplement early detection with preventive strategies. Using the 4-nitroquinoline 1-oxide (4-NQO) mouse model, we sought to define an appropriate dose and duration of administration that would predict the histologic timeline of HNSCC progression. Additionally, we sought to determine the timing of the onset of the angiogenic phenotype. Finally, using ABT-510 as a proof-of-principle drug, we tested the hypothesis that inhibitors of angiogenesis can slow/delay the development of HNSCC. We determined that 8 weeks of 100 μg/mL 4-NQO in the drinking water was the optimal dosage and duration to cause a sufficient incidence of hyperkeratoses, dysplasias, and HNSCC over a period of 32 weeks with minimal morbidity and mortality. Increased microvessel density and vascular endothelial growth factor expression in hyperkeratotic lesions provided evidence that the initiation of the angiogenic phenotype occurred before the development of dysplasia. Importantly, ABT-510 significantly decreased the overall incidence of HNSCC from 37.3% to 20.3% (P = 0.021) as well as the combined incidence of dysplasia and HNSCC from 82.7% to 50.6% (P < 0.001). These findings suggest that our refinement of the 4-NQO model allows for the investigation of the histologic, molecular, and biological alterations that occur during the premalignant phase of HNSCC. In addition, these data support the hypothesis that inhibitors of angiogenesis may be promising chemopreventive agents.
Observations of Entry and Exit of Potential Vorticity at the Sea Surface
Authors: Czaja Arnaud , Hausmann Ute
Published: April 2009

Although potential vorticity (PV) is central to many theories of the oceanic circulation, the entry–exit of PV at the sea surface has not been thoroughly discussed from an observational perspective. After clarifying the notion of “PV entry and exit,” and the mechanisms responsible for it, a climatology of this quantity for the Northern Hemisphere is presented.

It is found that surface PV loss over western boundary current regions and their interior extension is a robust feature over the North Pacific and Atlantic basins. At high latitudes, mechanical and diabatic effects act in concert in the North Atlantic to drive the net PV exit. In the Pacific, however, these effects oppose each other and the net entry–exit of PV is more uncertain. At low latitudes, surface winds are found to be particularly important in setting the surface PV exit in the Pacific, equatorward of the intertropical convergence zone.
Clinical Research: Benefits of a Nutrition Support Service in an HMO Setting
Authors: Meyer Julie , Lund Diane , Smith James
Published: April 2009

In an effort to improve long‐term follow‐up and to provide an integrated approach to the care of patients receiving home parenteral nutrition (HPN), a home nutrition support service (HNSS) was formed in 1993 at a large not‐for‐profit Midwest Health Maintenance Organization (HMO). Because the coordination of care for these patients is managed within the HMO setting, rather than contracting this service out, continuity of care is maintained and provides ease of communication with the physicians and access to patient information. By using a case management approach with the HPN patients, the average cost of HPN per day has decreased by 54% over the past six years. The home nutrition support service in the HMO setting has been cost effective and provides a unique setting for comprehensive patient care.
Appropriateness of Adult Parenteral Nutrition Use in a Large Hospital
Authors: Fessler Theresa A.
Published: April 2009

The purpose of this study was to assess the appropriateness of parenteral nutrition (PN) therapy used in clinical practice. A prospective, nonrandomized survey that compared patient characteristics with established guidelines for PN use was conducted in a 686‐bed tertiary and teaching hospital over a 6‐month period. Registered dietitians collected data from patient charts for the following variables: diagnoses, physicians' reasons for ordering PN, duration of PN therapies, and indicators of gastrointestinal (GI) function. American Society for Parenteral and Enteral Nutrition guidelines and indicators of GI function were used to assess the appropriateness of PN. Of 145 initial orders for total parenteral nutrition, 65% were appropriate, 27% were inappropriate, and 8% questionable. Of 87 initial orders for peripheral parenteral nutrition, 54% were appropriate, 32% inappropriate, and 14% questionable. These results indicate a need for better education and awareness of health care professionals on the proper use of nutrition support.
Impact of Customized Parenteral Nutrition in a Pediatric Hospital
Authors: Stettler Nicolas , Sentongo Timothy A. , Carroll Mimi , Schears Gregory J. , Mascarenhas Maria R.
Published: April 2009

In pediatric hospitals, several factors interfere with the delivery of parenteral nutrition (PN). The purpose of this study was to assess the impact of a customized system of PN ordering on PN delivery, using a retrospective chart review before (n = 40) and after (n = 43) implementation of the system. No difference was observed in the proportions of children who did not receive the ordered amount of dextrose and amino acids (30% versus 23%, p = .49). Before customization, the subjects were more likely to receive intralipids (42% versus 19%, p = .02), and micronutrients (67% versus 9%, p < .0001) out of range. These results remained unchanged after adjustment for age, hospital unit, other fluids, and presence of a central line. Our findings highlight the discrepancy between ordered and received PN in pediatric patients. Customized PN ordering was associated with improved delivery of intralipids and micronutrients.
Skin‐Level Gastrostomy Using a Novel Balloon‐Type Device—Long‐Term Results in Oncological Patients
Authors: Dormann Arno J. , Wejda Bernd , Huchzermeyer Hans , Malfertheiner Peter
Published: April 2009

Objective: The usefulness of skin level gastrostomy tubes (button systems) for maintaining nutrition support after primary insertion of percutaneous endoscopic gastrostomy (PEG) is widely accepted. Technical and usability problems have forced the development of new systems. The experience with a newly developed skin‐level gastrostomy system (Freka‐Button Gastrostomy) in oncological patients is described. Methods: In a cohort study we prospectively evaluated for ease of use, complications, and time to failure, a modified balloon button system based on the MIC‐Key type. It differs from other systems by its application mode and balloon design. Since February 1998, 18 systems were applied in 15 patients (median age 56 years, 42 to 72 years, 14 men, 1 woman). Results: Correct application of the 18 buttons in 15 individuals was easy and fast to perform (median intervention time 10.8 minutes). During follow‐up (median 201, range 2 to 590 days) 1 button was removed because of the patient's decision, 2 others had to be renewed because of technical problems, and no major complication occurred. Conclusions: The new Freka‐button system provides an easy‐to‐use, safe, and feasible alternative for long‐term use of skin‐level gastrostomy tubes in oncological patients.
Can Intravenous Feeding as the Sole Means of Nutrition Support Growth in the Child and Restore Weight Loss in an Adult? An Affirmative Answer
Authors: Miller Sarah J.
Published: April 2009

SUMMARY FROM ORIGINAL ARTICLE: Continuous infusion into the superior vena cava of hypertonic nutrient solutions containing large amounts of nitrogen, calories, and vitamins and required amounts of electrolytes can be accomplished safely for long periods of time with meticulous attention to preparation and administration of the solution. With the exclusive use of parenteral hyperalimentation, weight gain, positive nitrogen balance, growth, and development have been regularly achieved. This technique allows adequate metabolic support of patients with severe nutritional debility or prolonged disability of the gastrointestinal tract and adds a valuable tool to the repertoire of the surgeon and investigator. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Ann Surg 169:974–984, 1969.
Techniques and Procedures: Using Needleless Intravenous Access Devices for Administering Total Parenteral Nutrition (TPN): Practice Update
Authors: Bliss Donna Zimmaro , Dysart Mary
Published: April 2009

Needleless intravenous (IV) access devices have been introduced into many clinical settings for administering TPN and other IV fluids to decrease the risks of needle‐stick injury and transmission of bloodborne pathogens. However, reports of outbreaks of bloodstream infections in patients receiving needleless devices illustrated a lack of infection‐control guidelines for use of these devices, their components, and variable staff practices. Revised practice standards from the IV Nurses Society recommend rigorous infection‐control practices. All components of the IV system used in administering TPN, including the needleless components, should be considered a closed system that is manipulated aseptically and changed daily.
Clinical Dilemmas: Gastric Residuals in Tube Feeding: How Much Is Too Much?
Authors: Murphy Lynne M. , Bickford Virginia
Published: April 2009

Measurement of specific amounts of gastric residual volumes in tube‐fed patients often precludes the objective of the therapy: to provide nutrition. There is no agreement in the literature regarding the exact amount of residual volumes necessary to stop or maintain feeding. Measurements of gastric residual volumes should be used in conjunction with sound clinical judgment before decisions are made to stop enteral nutrition.
Endogenous κ Opioid Activation Mediates Stress-Induced Deficits in Learning and Memory
Authors: Carey Amanda N. , Lyons Angela M. , Shay Christopher F. , Dunton Ocean , McLaughlin Jay P.
Published: April 2009

We hypothesized that mice subjected to prolonged stress would demonstrate decreased performance in a learning and memory task attributable to the endogenous activation of the κ opioid receptor (KOR). C57BL/6J mice were tested using the novel object recognition (NOR) assay at various time points after exposure to repeated forced swim stress (FSS). Unstressed mice demonstrated recognition of the novel object at the end of a procedure using three 10-min object interaction phases, with a recognition index (RI) for the novel object of 71.7 ± 3.4%. However, 1 h after exposure to FSS, vehicle-pretreated mice displayed a significant deficit in performance (RI = 58.2 ± 4.1%) compared with unstressed animals. NOR was still significantly reduced 4 but not 24 h after FSS. Treatment with the KOR-selective antagonist norbinaltorphimine (10 mg/kg, i.p.) prevented the decline in learning and memory performance. Moreover, direct activation of the KOR induced performance deficits in NOR, as exogenous administration of the KOR agonist U50,488 [(±)-trans-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]-benzeneacetamide] (0.3 mg/kg, i.p.) suppressed NOR (RI = 56.0 ± 3.9%). The effect of FSS on NOR performance was further examined in mice lacking the gene for the endogenous KOR agonist dynorphin (Dyn). Dyn gene-disrupted mice exposed to FSS did not show the subsequent learning and memory deficits (RI = 66.8 ± 3.8%) demonstrated by their wild-type littermates (RI = 49.7 ± 2.9%). Overall, these results suggest that stress-induced activation of the KOR may be both necessary and sufficient to produce subsequent deficits in novel object recognition.
Retraction Notice: Protein Identification in Sub Proteome Fractions of Breast Cancer Cells by OFFGEL-IEF and iTRAQ Labeling
Authors: Chandramouli K.H. , Agrawal Pushpa , Thimmaiah K.N.
Published: April 2009

THIS ARTICLE HAS BEEN RETRACTED
Cryosectioning
Authors: Watkins Simon
Published: April 2009

This unit describes sample preparation and sectioning methods for frozen tissue. Sections of this type are used in a variety of light microscopic procedures including in situ hybridization, immunohistochemistry, and enzyme histochemistry. Curr. Protocol. Cytom. 48:12.15.1‐12.15.7. © 2009 by John Wiley & Sons, Inc.
Multiplexed Analysis of Peptide Antigen‐Specific Antibodies
Authors: Drummond James E.
Published: April 2009

Many experiments require the simultaneous measurement of more than one parameter at a time. These protocols describe a multiplex method that can be used to detect two or more analytes simultaneously in the same sample preparation. Our example detects antibodies directed against peptide antigens but is amenable to most typical EIA format configurations to allow measurement of alternative analytes. We chose to use the LumAvidin bead‐based assay system due to the simplicity of coupling synthesized biotin‐peptides to the spectrally distinct bead types. The coupled beads were stored at 4°C. Using unlabeled beads as a negative control posed a significant risk of antigen migration from other labeled beads in the multiplex format. Therefore, labeled beads should be mixed immediately prior to performing the assay. Peptide‐specific units were assigned to a polyclonal standard control allowing for quantitation of sample responses. The assay has proven to be quite robust. Curr. Protocol. Cytom. 48:13.10.1‐13.10.7. © 2009 by John Wiley & Sons, Inc.
Precision Polymers: Monodisperse, Monomer‐Sequence‐Defined Segments to Target Future Demands of Polymers in Medicine
Authors: Hartmann L. , Börner H. G.
Published: April 2009

The established technology platforms of solid‐phase‐supported oligopeptide and oligonucleotide synthesis can be expanded to access fully synthetic macromolecules, preserving both the monodisperse character and the defined monomer sequence. Precision polymers are sequentially assembled from a library of functional building blocks, enabling one to program interaction capabilities or generate functions by sequence‐specific positioning of functionalities. Examples are provided, showing that these monodisperse macromolecules can be conjugated to oligonucleotides, oligopeptides, or poly(ethylene glycol)s. The resulting model systems can contribute to the understanding of complex biomedical‐related processes. Due to the absence of chemical and molecular‐weight distributions in these multifunctional segments, exact correlation of the monomer sequence and (bio)properties is attainable. This is demonstrated by the design of carrier systems that exhibit fine‐tuned interactions with plasmid DNA, actively controlling important steps in DNA delivery and transfection, such as polyplex formation, DNA compression, and release of the cargo.
Marketing preferences of small‐scale farmers in the context of new agrifood systems: a stated choice model
Authors: Blandon Jose , Henson Spencer , Islam Towhidul
Published: April 2009

Considering the dynamic changes in agrifood systems in developing countries, this study uses a stated choice model to explore the marketing preferences of small‐scale producers of fresh fruits and vegetables in Honduras. Eight attributes, proposed in hypothetical contracts to farmers, are evaluated. The results suggest that farmers have strong marketing preferences associated with new supply chains, such as prearranging prices and quantities with buyers, but have remaining preferences for some attributes of traditional spot markets, such as the lack of grading produce, receiving cash payments, lack of delivery schedules, ability to sell at the farm gate, and ability to sell individually. Further, farmers prefer market channels that do not require major upfront investments. The results suggest that the traditional marketing preferences of farmers could impede participation of small‐holders in emerging supply chains and take advantage of the potential opportunities that new agrifood supply chains can offer. [JEL Code: Q13 O14]. © 2009 Wiley Periodicals, Inc.
The effect of low intensity ultraviolet‐C light on monoclonal antibodies
Authors: Lorenz Christopher M. , Wolk Bradley M. , Quan Cynthia P. , Alcala Emily W. , Eng Marian , McDonald Daniel J. , Matthews Timothy C.
Published: April 2009

As part of an investigation to identify potential new viral reduction strategies, ultraviolet‐C (UV‐C) light was examined. Although this technology has been known for decades to possess excellent virus inactivation capabilities, UV‐C light can also introduce significant unwanted damage to proteins. To study the effect on monoclonal antibodies, three different antibodies were subjected to varying levels of UV‐C light using a novel dosing device from Bayer Technology Services GmbH. The range of fluencies (or doses) covered was between 0 and 300 J/m2 at a wavelength of 254 nm. Product quality data generated from the processed pools showed only minimal damage done to the antibodies. Aggregate formation was low for two of the three antibodies tested. Acidic and basic variants increased for all three antibodies, with the basic species increasing more than the acidic species. Peptide maps made for the three sets of pools showed no damage to two of the three antibody backbones, whereas the third antibody had very low levels of methionine oxidation evident. Samples held at 2–8°C for 33 days showed no increase in aggregates or charge variants, indicating that the proteins did not degrade and were not damaged further by reactive or catalytic species that may have been created on exposure to UV‐C light. Overall, UV‐C light was shown to induce very little damage to monoclonal antibodies at lower fluencies and appears to be a viable option for viral inactivation in biotechnology applications. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2009
Red blood cell quantification microfluidic chip using polyelectrolytic gel electrodes
Authors: Kim Kwang Bok , Chun Honggu , Kim Hee Chan , Chung Taek Dong
Published: April 2009

This paper reports on a novel microfluidic chip with polyelectrolytic gel electrodes (PGEs) used to rapidly count the number of red blood cells (RBCs) in diluted whole blood. The proposed microdevice is based on the principle that the impedance across a microchannel between two PGEs varies sensitively as RBCs pass through it. The number and amplitude of impedance peaks provide the information about the number and size of RBCs, respectively. This system features a low‐voltage dc detection method and non‐contact condition between cells and metal electrodes. Major advantages include stable detection under varying cellular flow rate and position in the microchannel, little chance of cell damage due to high electric field gradient and no surface fouling of the metal electrodes. The performance of this PGEs‐based system was evaluated in three steps. First, in order to observe the size‐only dependence of the impedance signal, three different sizes of fluorescent microbeads (7.2, 10.0, and 15.0 μm; Bangs laboratories, USA) were used in the experiment. Second, the cell counting performance was evaluated by using 7.2 μm fluorescent microbeads, similar in size to RBCs, in various concentrations and comparing the results with an animal hematoanalyzer (MS 9‐5; Melet schloesing laboratories, France). Finally, in human blood sample tests, intravenously collected whole blood was just diluted in a PBS without centrifuge or other pretreatments. The PGE‐based system produced almost identical number of RBCs in over 800‐fold diluted samples to the results from a commercialized human hematoanalyzer (HST‐N402XE; Sysmex, Japan).
Box‐spread arbitrage efficiency of Nifty index options: The Indian evidence
Authors: Vipul
Published: April 2009

This study examines the market efficiency for the European style Nifty index options using the box‐spread strategy. Time‐stamped transactions data are used to identify the mispricing and arbitrage opportunities for options with this modelfree approach. Profit opportunities, after accounting for the transaction costs, are quite frequent, but do not persist even for two minutes. The mispricing is higher for the contracts with higher liquidity (immediacy) risk captured by the moneyness (the difference between the strike prices and the spot price) and the volatility of the underlying. © 2009 Wiley Periodicals, Inc. Jrl Fut Mark 29:544–562, 2009
Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity
Authors: Shrime Mark G. , Ma Clement , Gullane Patrick J. , Gilbert Ralph W. , Irish Jonathan C. , Brown Dale H. , Goldstein David P.
Published: April 2009

Background

The association between nodal ratio and survival has not been assessed in squamous cell carcinomas of the head and neck.

Methods

This is a population‐based analysis, using the Surveillance, Epidemiology, and End‐Results database, to determine whether nodal ratio impacts survival in patients with oral cavity squamous cell carcinoma.

Results

Between 1988 and 2005, 2955 new diagnoses of N1 or N2 squamous cell carcinoma of the oral cavity were identified. The mean nodal ratio was 16.9%. Nodal ratio was found to be strongly statistically associated with overall survival in both univariate and multivariate analyses. Patients could be stratified into low‐ (0% to 6%), moderate‐ (6% to 12.5%), and high‐risk (>12.5%) groups based on nodal ratio.

Conclusions

In patients with squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified based on nodal ratio. © 2009 Wiley Periodicals, Inc. Head Neck, 2009
Integrating hydrometeorological information for rainfall‐runoff modelling by artificial neural networks
Authors: Chiang Yen‐Ming , Chang Fi‐John
Published: April 2009

The major purpose of this study is to effectively construct artificial neural networks‐based multistep ahead flood forecasting by using hydrometeorological and numerical weather prediction (NWP) information. To achieve this goal, we first compare three mean areal precipitation forecasts: radar/NWP multisource‐derived forecasts (Pr), NWP precipitation forecasts (Pn), and improved precipitation forecasts (Pm) by merging Pr and Pn. The analysis shows that the accuracy of Pm is higher than that of Pr and Pn. The analysis also indicates that the NWP precipitation forecasts do provide relative effectiveness to the merging procedure, particularly for forecast lead time of 4–6 h. In sum, the merged products performed well and captured the main tendency of rainfall pattern. Subsequently, a recurrent neural network (RNN)‐based multistep ahead flood forecasting techniques is produced by feeding in the merged precipitation. The evaluation of 1–6‐h flood forecasting schemes strongly shows that the proposed hydrological model provides accurate and stable flood forecasts in comparison with a conventional case, and significantly improves the peak flow forecasts and the time‐lag problem. An important finding is the hydrologic model responses which do not seem to be sensitive to precipitation predictions in lead times of 1–3 h, whereas the runoff forecasts are highly dependent on predicted precipitation information for longer lead times (4–6 h). Overall, the results demonstrate that accurate and consistent multistep ahead flood forecasting can be obtained by integrating predicted precipitation information into ANNs modelling. Copyright © 2009 John Wiley & Sons, Ltd.