bluuebunny/crossref_metadata_2025 huggingface dataset:
Proposed categorization of pathological states of EBV‐associated T/natural killer‐cell lymphoproliferative disorder (LPD) in children and young adults: Overlap with chronic active EBV infection and infantile fulminant EBV T‐LPD
Authors: Ohshima Koichi , Kimura Hiroshi , Yoshino Tadashi , Kim Chul Woo , Ko Young H. , Lee Seung‐Suk , Peh Suat‐Cheng , Chan John K.C. ,   The CAEBV Study Group
Published: March 2008

EBV‐associated T/natural killer (NK)‐cell lymphoproliferative disorder (EBV‐T/NK LPD) of children and young adults is generally referred to with the blanket nosological term of severe chronic active EBV infection (CAEBV). This disease is rare, associated with high morbidity and mortality, and appears to be more prevalent in East Asian countries. But because there is no grading or categorization system for CAEBV, pathologists and clinicians often disagree regarding diagnosis and therapy. EBV‐T/NK LPD includes polyclonal, oligoclonal, and monoclonal proliferation of cytotoxic T and/or NK cells. Moreover, a unique disease previously described as infantile fulminant EBV‐associated T‐LPD has been identified and overlaps with EBV‐T/NK LPD. In the present review a clinicopathological categorization of EBV‐T/NK LPD is proposed, based on pathological evaluation and molecular data, as follows: (i) category A1, polymorphic LPD without clonal proliferation of EBV‐infected cells; (ii) category A2, polymorphic LPD with clonality; (iii) category A3, monomorphic LPD (T‐cell or NK cell lymphoma/leukemia) with clonality; and (iv) category B, monomorphic LPD (T‐cell lymphoma) with clonality and fulminant course. Categories A1, A2, and A3 possibly constitute a continuous spectrum and together are equivalent to CAEBV. Category B is the exact equivalent of infantile fulminant EBV‐associated T‐LPD. It is expected that this categorization system will provide a guide for the better understanding of this disorder. This proposal was approved at the third meeting of the Asian Hematopathology Association (Nagoya, 2006).
Localized malignant mesenteric mesothelioma causing small bowel obstruction
Authors: Kuroda Kishio , Ishizawa Shin , Kudo Takahiko , Uotani Hideyuki , Hosokawa Ayumu , Tanaka Tomonori , Kitano Haruhisa , Hori Takashi , Tsukada Kazuhiro , Sugiyama Toshiro , Fukuoka Junya
Published: March 2008

Malignant mesothelioma is an uncommon lethal neoplasm in the serous membrane in which peritoneal mesothelioma is a rarer form. Herein is reported a case of malignant mesothelioma presenting as a localized mass inside the mesentery causing focal luminal obstruction of the small intestine. The diagnosis of malignant mesothelioma was obtained on repeat double balloon endoscopic biopsy. Partial resection of the small intestine along with the mesentery was performed, followed by a course of chemotherapy. No relapse of the disease has been found in the 8 months' follow up radiologically. To the best of the authors' knowledge this is the first reported case of localized malignant mesothelioma arising inside the mesentery. Mesothelioma should be considered as the differential diagnosis when small bowel obstruction occurs with unknown primary neoplasm.
Ovarian undifferentiated carcinoma resembling giant cell carcinoma of the lung
Authors: Yasunaga Masafumi , Ohishi Yoshihiro , Nishimura Izumi , Tamiya Sadafumi , Iwasa Atsuko , Takagi Emi , Inoue Takafumi , Yahata Hideaki , Kobayashi Hiroaki , Wake Norio , Tsuneyoshi Masazumi
Published: March 2008

Giant cell carcinoma (GCC) is a highly aggressive variant of sarcomatoid carcinoma of the lung. To date, however, there have been no reported cases of ovarian carcinoma mainly composed of GCC. Herein is reported the case of a 54‐year‐old Japanese woman with an undifferentiated ovarian carcinoma producing granulocyte colony‐stimulating factor (G‐CSF) and an inflammatory cytokine. Histologically, the tumor was composed of cohesive nests or discohesive pleomorphic mononucleated or multinucleated tumor giant cells, accompanied by inflammatory cell infiltration and emperipolesis. Immunohistochemically, the tumor cells were focally positive for epithelial membrane antigen and cytokeratin 7. Clinically, after the initial surgery, the tumor had rapid regrowth along with the production of G‐CSF and an inflammatory cytokine. Adjuvant chemotherapy was administered but induced severe heart failure and severe neutropenia, probably due to the presence of hypercytokinemia and excess G‐CSF. Upon the appearance of these fatal side‐effects the chemotherapy was immediately discontinued and replaced with radiotherapy. The recognition of this type of ovarian tumor is important for clinical management, because adjuvant chemotherapy is the standard treatment for clinical management of epithelial ovarian cancer.
Anaplastic lymphoma kinase‐positive anaplastic large cell lymphoma presenting as a bladder neoplasm
Authors: Gómez‐Román José Javier , Cobo María Luisa Cagigal , Val‐Bernal José Fernando
Published: March 2008

Malignant lymphoma presenting in the bladder has been classified in primary cases, as the first sign of disseminated disease and as a secondary infiltration. Most of the examples in the literature have been reported as single cases. Reported herein is the case of a 45‐year‐old man with an anaplastic large cell lymphoma (anaplastic lymphoma kinase (ALK) and granzyme B positive) that presented as a bladder neoplasm. The morphological differential diagnosis was complex because the EMA‐positive immunophenotype, CD45 and CD3 negativity and the clinical manifestation simulated a transitional cell carcinoma. It is important to be aware of its existence because a poorly differentiated bladder carcinoma cannot be ruled out if CD30 and ALK immunostaining are not performed. T‐cell receptor‐γ clonal rearrangement could be also helpful in these cases. Although bladder involvement by recurrent lymphoma is a sign of widely disseminated disease and it is associated with a very poor prognosis, it seems that chemotherapeutic regimens in this kind of ALK‐positive lymphoma could be effective, given that the present patient had an impressive response to chemotherapy treatment.
ECHINOSTOMA HORTENSE ASADA INFECTION IN THE DUODENUM: INCIDENTAL FINDINGS DURING ROUTINE GASTROINTESTINAL ENDOSCOPY
Authors: Tanaka Toshiaki , Kamada Tomoari , Koga Hideki , Tanaka Aki , Manabe Noriaki , Hata Jiro , Kusunoki Hiroaki , Ishii Manabu , Sato Motonori , Tarumi Kenichi , Shiotani Akiko , Okino Tetsuya , Haruma Ken
Published: March 2008

We report herein a case of Echinostoma hortense Asada infection, which is known to derive from eating fresh frogs or loaches, which was discovered during routine gastrointestinal endoscopy. To our knowledge, this is the first report in Japan of E. hortense Asada infection observed by means of magnifying endoscopy.
RARE GASTRIC CALCIFYING FIBROUS PSEUDOTUMOR REMOVED BY ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: Sato Shun , Ooike Nobuyuki , Yamamoto Terushige , Wada Masahiro , Miyamoto Akitoshi , Matsukawa Masaaki , Morohoshi Toshio
Published: March 2008

We report a case of a calcifying fibrous pseudotumor of the stomach that we resected using endoscopic submucosal dissection (ESD). A 61‐year‐old male with a gastric submucosal tumor was admitted to our hospital for treatment. By upper gastrointestinal tract endoscopy, a smooth‐surfaced submucosal tumor measuring 2 cm in diameter was observed in the anterior wall of the middle body of the stomach. By endoscopic ultrasonography, a mass was observed in the stomach submucosa; the mass had a well‐defined boundary. Internally, the mass was heterogeneous and hypoechoic; high spots were scattered throughout the mass. Continuity between the mass and the muscularis mucosae and muscularis propria was not observed. Strongly suspecting that this mass was a gastrointestinal stromal tumor arising from the stomach, we resected the mass by ESD for total biopsy. Histopathologically, the mass consisted of proliferation of eosinophilic collagen fibers with plasma cell infiltration and lymphoid follicle proliferation. Calcification was also observed in some parts of the mass. Thus, the mass was identified as calcifying fibrous pseudotumor. Calcifying fibrous pseudotumor of the stomach is extremely rare and its histogenesis remains unclear; however, its morphology became distinct by comparing endoscopic/radiological and histopathological findings.
ENDOSCOPIC MANIPULATION OF GASTRIC PROLAPSE IN MORGAGNI HERNIA
Authors: Sunada Fumiko , Hanatsuka Kazunobu , Yoshida Tohru , Osawa Hiroyuki , Kita Hiroto , Sugano Kentaro
Published: March 2008

Laparoscopic treatment has been recommended for gastric prolapse in Morgagni hernia. We describe a 92‐year‐old woman diagnosed with gastric prolapse in Morgagni hernia. Endoscopic treatment was chosen because surgical or laparoscopic treatment was not tolerable for her. We successfully replaced gastric prolapse by aspirating air and fluid in the prolapsed antrum and subsequently advanced the endoscope to the duodenum. This new endoscopic technique is relatively simple, non‐invasive and useful as an alternative method of surgical or laparoscopic treatment, especially in patients with high risk for these invasive treatments.
NARROW BAND IMAGING IN THE DETECTION OF COLORECTAL POLYP: KOREAN EXPERIENCE
Authors: Byeon Jeong‐Sik , Kim Joo Sung , Lee Chang Kyun , Park Jae Myung , Chang Dong Kyung , Kim Young Bae , Kim Yong Sik , Lee Yong Chan , Jee Sam‐Ryong , Choi Kyu Yong
Published: March 2008

Background:  Although white light (WL) colonoscopy is a gold standard to detect colorectal polyps, substantial polyps are missed. Narrow band imaging (NBI) is a new technology that enables a more detailed visualization of the mucosal surface. The aim of the present study was to determine whether NBI can improve the detection of colorectal polyps.

Methods:  We prospectively enrolled 188 (M : F = 99:89, 21–80 years) subjects undergoing colonoscopy as a screening procedure in nine referral centers. After a careful WL examination of the whole colorectum, rectosigmoid colon (0–30 cm from the anal verge) was reobserved by NBI. Size, macroscopic morphology, and the histology of all the polyps detected during WL and NBI examination were analyzed.

Results:  WL examination detected 162 polyps in 188 subjects, of which 106 lesions were neoplastic, while NBI of rectosigmoid colon detected an additional 61 polyps of which eight lesions were neoplastic. Only 10 (6.2%) of 162 polyps discovered during WL examination were flat polyps compared to 10 (16.4%) of 61 newly detected polyps during NBI being flat type (P = 0.002). The mean polyp size detected by NBI was smaller than that found by WL colonoscopy (2.8 ± 1.0 mm vs 6.5 ± 4.5 mm, P < 0.001).

Conclusion:  Many additional colorectal polyps, especially flat type, could be detected by NBI examination for normal‐looking rectosigmoid mucosa. The role of NBI in colorectal neoplasm screening needs to be further investigated in future studies.
Imbalance between excitation and inhibition among synaptic connections of CA3 pyramidal neurons in cultured hippocampal slices
Authors: Cruz‐Martín Alberto , Schweizer Felix E.
Published: March 2008

A fundamental property of small neuronal ensembles is their ability to be selectively activated by distinct stimuli. One cellular mechanism by which neurons achieve this input selectivity is by modulating the temporal dynamics of excitation and inhibition. We explored the interplay of excitation and inhibition in synapses between pyramidal neurons of cornu ammonis field 3 of the hippocampal formation (CA3) in cultured rat hippocampal slices, where activation of a single excitatory cell can readily recruit local interneurons. Simultaneous whole‐cell recordings from pairs of CA3 pyramidal neurons revealed that the strength of connections was neither uniform nor balanced. Rather, stimulation of presynaptic neurons elicited distinct combinations of excitatory postsynaptic current–inhibitory postsynaptic current (EPSC–IPSC) amplitudes in the postsynaptic neurons. EPSC–IPSC sequences with small EPSCs had large IPSCs and sequences that contained large EPSCs had small IPSCs. In addition to differences in the amplitudes of the responses, the kinetics of the EPSCs were also different, creating distinct temporal dynamics of excitation and inhibition. Weaker EPSCs had significantly slower kinetics and were efficiently occluded by IPSCs, thereby further limiting their contribution to depolarizing the postsynaptic membrane. Our data suggest that hippocampal pyramidal cells may use an imbalance between excitation and inhibition as a filter to enhance selectivity toward preferential excitatory connections.
Halophilic Archaea determined from geothermal steam vent aerosols
Authors: Ellis Dean G. , Bizzoco Richard W. , Kelley Scott T.
Published: March 2008

Hydrothermal vents, known as ‘fumaroles’, are ubiquitous features of geothermal areas. Although their geology has been extensively characterized, little is known about the subsurface microbial ecology of fumaroles largely because of the difficulty in collecting sufficient numbers of cells from boiling steam water for DNA extraction and culture isolation. Here we describe the first collection, molecular analysis and isolation of microbes from fumarole steam waters in Russia (Kamchatka) and the USA (Hawaii, New Mexico, California and Wyoming). Surprisingly, the steam vent waters from all the fumaroles contained halophilic Archaea closely related to the Haloarcula spp. found in non‐geothermal salt mats, saline soils, brine pools and salt lakes around the world. Microscopic cell counting estimated the cell dispersal rate at approximately 1.6 × 109 cells year−1 from a single fumarole. We also managed to enrich microbes in high‐salt media from every vent sample, and to isolate Haloarcula from a Yellowstone vent in a 20% salt medium after a month‐long incubation, demonstrating both salt tolerance and viability of cells collected from high‐temperature steam. Laboratory tests determined that microbes enriched in salt media survived temperatures greater than 75°C for between 5 and 30 min during the collection process. Hawaiian fumaroles proved to contain the greatest diversity of halophilic Archaea with four new lineages that may belong to uncultured haloarchaeal genera. This high diversity may have resulted from the leaching of salts and minerals through the highly porous volcanic rock, creating a chemically complex saline subsurface.
Teaching comprehension and critical literacy: investigating guided reading in three primary classrooms
Authors: Fisher Annie
Published: March 2008

With the introduction of the National Literacy Strategy, England's primary school teachers were asked to replace “listening to children read”–a practice deeply embedded in UK pedagogy–with guided reading, a practice focused on interpretive and critical comprehension rather than accuracy and fluency. This small‐scale research project addresses the perceptions of the author's Primary B.Ed. student teachers that what goes on under the name of guided reading in the classrooms in which they undertake teaching practice does not do justice to the term. In particular, it examines the claim that fluent readers are still engaged in reading aloud, rather than being taught how to develop analytical strategies for comprehension and engage in collaborative dialogue to develop cognition and promote interpretive critical literacy. Using interpretive methodology, this small‐scale study examines episodes of guided reading in three case study classrooms. In each episode examined, although some form of group reading was conducted, there was no opportunity for children to read silently or engage in collaborative discussion, little teaching of inferential comprehension and none of evaluative strategies. The study reaches tentative rather than conclusive answers. These suggest that the effective teaching of guided reading depends both upon the understanding of its psychological underpinning, and also on the teacher's ability, through sharing responsibility for problem solving with the children, to build bridges between what is known and what is new.
Constructing a Historiography of Mexican Women and Gender
Authors: Buck Sarah A.
Published: March 2008

This article outlines the historiographical importance of the International Colloquium of Women's and Gender History in Mexico, particularly in the context of the author's own scholarship, especially her dissertation. It argues for the need for women's and gender history, and for a dialogue, by means of which these separate but related bodies of scholarship can inform the other. It includes a summary of the author's dissertation and its theoretical influences, a review of historical topics discussed at the first two conferences of the International Colloquium of Women's and Gender History, and a discussion of the historiographical implications of such developments.
Escaping the International Governance Dilemma? Incorporated Transgovernmental Networks in the European Union
Authors: EBERLEIN BURKARD , NEWMAN ABRAHAM L.
Published: March 2008

This article investigates the role of transgovernmental networks of national regulators in addressing collective action problems endemic to international cooperation. In contrast to recent work on transgovernmental actors, which emphasizes such networks as alternatives to more traditional international institutions, we examine the synergistic interaction between the two. Building on the broader premise that patterns of “dual delegation” above and below the nation‐state enhance the coordinating role of networks of national agencies in two‐level international governance, the article examines the formal incorporation of transgovernmental networks into European Union (EU) policymaking. The focus on authoritative rule‐making adds a crucial dimension to the landscape of EU governance innovations while connecting to the broader study of transgovernmental networks in international governance. The article develops an analytical framework that maps these incorporated networks across different sectors in terms of function, emergence, and effectiveness. Two case studies of data privacy and energy market regulation are presented to apply and illustrate the insights of this mapping.
Inside the Autonomous State: Programmatic Elites in the Reform of French Health Policy
Authors: GENIEYS WILLIAM , SMYRL MARC
Published: March 2008

This article combines the methods of institutionalist analysis and the sociology of elites to look inside the black box of the French state. We identify key groups of policymakers in the social policy sector and track both their policy preferences and the results of their efforts from the mid‐1980s through the late 1990s. Our conclusion is that budgetary and ideological challenges to existing policies led to the consolidation within the Ministry of Social Affairs of what we label a “programmatic elite,” whose influence derived less from the positions held by its members than from the coherence and applicability of its state‐centered policy model. The competition for legitimate authority between such programmatic elites, we conclude, is an important but often overlooked endogenous source of policy change in situations of institutional stability.
Partisan Politics, Globalization, and the Determinants of Privatization Proceeds in Advanced Democracies (1990–2000)
Authors: ZOHLNHÖFER REIMUT , OBINGER HERBERT , WOLF FRIEDER
Published: March 2008

The 1990s have witnessed unprecedented attempts at privatizing state‐owned enterprises in virtually all OECD democracies. This contribution analyzes the extent to which the partisan control of the government can account for the differences in the privatization proceeds raised by EU and OECD countries between 1990 and 2000. It turns out that privatizations are part of a process of economic liberalization in previously highly regulated economies as well as a reaction to the fiscal policy challenges imposed by European integration and the globalization of financial markets. Partisan differences only emerge if economic problems are moderate, while intense economic, particularly fiscal, problems foreclose differing partisan strategies.
Impact of fatigue on quality of life in patients with Parkinson’s disease
Authors: Havlikova E. , Rosenberger J. , Nagyova I. , Middel B. , Dubayova T. , Gdovinova Z. , Van Dijk J. P. , Groothoff J. W.
Published: March 2008

Background and purpose:  Fatigue is frequent and important in the lives of Parkinson’s disease (PD) patients. It is multidimensional, with physical and mental aspects. The aim of our study was to explore the impact of fatigue on quality of life (QoL) for PD patients.

Methods:  The sample consisted of 175 PD patients from Eastern Slovakia (52% males, mean age 68.2 ± 9.2, mean disease duration 7.4 ± 6.7). The Multidimensional Fatigue Inventory (five dimensions), the Parkinson’s Disease Quality of Life Questionnaire (eight dimensions) and the Unified Parkinson’s Disease Rating Scale were used. Demographic data were obtained in a structured interview. Fisher’s exact test, t‐test, and multiple linear regression analysis were used.

Results:  Different aspects of fatigue selectively explained different domains of QoL – physical dimensions of fatigue were connected with Mobility and Activities of daily living; mental fatigue dimensions affected Cognition, Emotional well‐being, Communication and Activities of daily living; general fatigue was related to Bodily discomfort. The explained variances varied from 5% (Social support) to 65% (Activities of daily living).

Conclusion:  Fatigue combined with worse functional status appears to be a significant contributor to poor quality of life. Its multidimensional construct can be used to develop strategies for improving specific aspects of fatigue to improve QoL for PD patients.
The fourth shift: exploring the gendered nature of sleep disruption among couples with children
Authors: Venn Susan , Arber Sara , Meadows Robert , Hislop Jenny
Published: March 2008

The study of sleep has been neglected within sociology, yet may provide insights into fundamental aspects of the nature of gender inequalities. This article examines how, for couples with children, sleep is influenced by the gendered nature of caring. A key concern is not only who gets up to care for children's physical needs at night, but whether this changes with women's increased role in the labour market. Of concern also is how changes in the nature of caring for older children, as opposed to young children, may impact on parents’ sleep.

This article analyses qualitative data from an ESRC funded multi‐disciplinary project on couples’ sleep based on in‐depth audio‐tape recorded interviews with 26 couples (aged 20–59) with younger and older children. Additionally, one week's audio sleep diaries were completed and follow up in‐depth interviews were undertaken with each partner on an individual basis.

Physical and emotional care for young children at night was largely provided by women, with a lack of explicit negotiation between partners about who provides this care, even when women return to employment. Thus, considerably more women than men continued their daytime and evening shifts, as well as undertaking an ongoing third shift of sentient activity for their family, into the night. This resulted in a fourth night‐time shift where physical caring, and sentient activities continued. As a consequence, women were more likely to subjugate their own sleep needs to those of their family. Fathers did not, in general, undertake this fourth night‐time shift. Those that did were more likely to be the fathers of young adult children who were staying out late at night, with the focus of their concerns being the safety of their children.
Our favourite melodies: musical consumption and teenage lifestyles1
Authors: Tanner Julian , Asbridge Mark , Wortley Scot
Published: March 2008

The present study explores the determinants and lifestyle correletes of musical preferences among a large sample of high school students in Toronto, Ontario. Our work is informed by theory and research on cultural stratification and adolescent subcultures. In terms of cultural stratification, we engage with Bourdieu's (1984) and Peterson's (1996) conceptualizations of elite taste, while subcultural theory encourages us to focus upon more dissenting tastes and to explore connections between musical tastes and peer group activity. Our findings suggest that racial and ethnic identity, school experiences and cultural capital are significant sources of variation in musical tastes that loosely correspond to existing typologies; they also confirm what has often been inferred – that musical tastes and peer group cultural practices are closely linked. Our findings are then discussed in the light of current debates about the nature and dimensions of listening audiences for music.
Being a pretty good citizen: an analysis and monetary valuation of formal and informal voluntary work by gender and educational attainment1
Authors: Egerton Muriel , Mullan Killian
Published: March 2008

This paper is set in the context of macrosocial/macroeconomic theories of the organization of both paid and unpaid work. The specific topic investigated is engagement in unpaid voluntary work, an activity which is thought to be important for social cohesion, civil society and citizenship. Research on the sources of social cohesion has focused on organizational membership and voluntary organization activity. There has been little investigation of informal helping of non‐resident kin, friends or acquaintances, an activity which is not measured in most social surveys but is measured in time use surveys. Previous research shows that the highly educated are more likely to engage in formal voluntary organizations and data from the UK 2000 HETUS survey confirm that the highly educated spend more time on formally organised voluntary work. However, the less qualified, particularly women, spend more time on extra‐household unpaid helping activities. Since both types of voluntary work are partly dependent on available time, these findings are modelled adjusting for time allocated to paid work, study, family and personal care. The findings remain statistically significant. Drawing on work carried out by the Office for National Statistics, a monetary value is placed on both formally organized and informal voluntary work. Although the median wage rates for formal voluntary work are greater than those for informal helping, the latter is greater in frequency and duration and therefore more economically valuable from a population perspective. This finding is discussed in the light of recent debates on citizenship and gender.
Two‐Stage Group Sequential Robust Tests in Family‐Based Association Studies: Controlling Type I Error
Authors: Yan Lihan K. , Zheng Gang , Li Zhaohai
Published: March 2008

In family‐based association studies, an optimal test statistic with asymptotic normal distribution is available when the underlying genetic model is known (e.g., recessive, additive, multiplicative, or dominant). In practice, however, genetic models for many complex diseases are usually unknown. Using a single test statistic optimal for one genetic model may lose substantial power when the model is mis‐specified. When a family of genetic models is scientifically plausible, the maximum of several tests, each optimal for a specific genetic model, is robust against the model mis‐specification. This robust test is preferred over a single optimal test. Recently, cost‐effective group sequential approaches have been introduced to genetic studies. The group sequential approach allows interim analyses and has been applied to many test statistics, but not to the maximum statistic. When the group sequential method is applied, type I error should be controlled. We propose and compare several approaches of controlling type I error rates when group sequential analysis is conducted with the maximum test for family‐based candidate‐gene association studies. For a two‐stage group sequential robust procedure with a single interim analysis, two critical values for the maximum tests are provided based on a given alpha spending function to control the desired overall type I error.
Mental health in migrant children
Authors: Stevens Gonneke W.J.M. , Vollebergh Wilma A.M.
Published: March 2008

Many factors have been identified to explain differences in mental health problems between migrant and native children: the process of migration, the ethnic minority position of migrants, their specific cultural background and the selection of migrants. In this paper, the international literature regarding mental health of migrant children is reviewed using strict selection criteria. An extensive search was carried out to locate journal articles on the subject of mental health in migrant youth published since the 1990s. Only 20 studies met all inclusion criteria. Besides the conclusion that the studies did not unequivocally find an increased risk of mental health problems in migrant children, it proved to be very difficult to draw any sound conclusions with respect to these children's risk of mental health problems, since the impact of migration on children's mental health varied with the informants used and the characteristics of the migrant group and of the host country. The lack of univocal definitions of key terms further complicated generalised conclusions in this research field. As such, this research field is in urgent need of more research using standardised research designs, methodology and definitions. A proposition for this research design is made.
Anaesthetic choice in the colposcopy clinic: a retrospective analysis of routinely collected data
Authors: Swancutt DR , Luesley DM , Eastaugh JL , Wilson S
Published: March 2008

Objectives  Current guidelines recommend that less than 20% of treatments in colposcopy clinics should be under general anaesthetic. The objective of this study was to increase the evidence base for guidelines by establishing the proportion of women receiving general anaesthesia for treatment, determining the predictors of and reasons recorded for general anaesthetic use.

Design  Retrospective analysis of routinely collected data.

Setting  NHS Trust in the West Midlands.

Participants  Colposcopy patients; January 2003 to March 2005.

Methods  Logistic regression of factors associated with general anaesthetic choice.

Main outcome measures  Proportion of women treated under general anaesthesia, factors associated with anaesthetic choice and reasons recorded for general anaesthetic use.

Results  About 5.4% (204/3777) of new appointments for colposcopy received treatment under general anaesthetic. Of women requiring treatment, 20% (204/1003) received general anaesthetic. General anaesthetic was more likely to be used when the woman required loop excision (OR = 3.63, 95% CI 2.11–6.24) and less likely when directed biopsy was performed (OR = 0.11, 95% CI 0.01–0.80), when the patient appointment date was after introduction of new guidelines (OR = 0.37, 95% CI 0.24–0.56) or when the assessment visit was with a nonconsultant status doctor rather than nurse or consultant (OR = 0.70, 95% CI 0.50–0.97). General anaesthetic use varied between colposcopists ranging from 0 to 16.5% of new patients seen. Woman’s choice was the most commonly specified reason for the use of general anaesthetic.

Conclusions  The proportion of colposcopy patients treated under general anaesthetic is 20%, within guideline limits. Substantial variation in general anaesthetic rates between colposcopists was observed, and further investigation is required to discover the reason for this.
pH‐balanced tampons: do they effectively control vaginal pH?
Authors: Melvin L , Glasier A , Elton R , Cameron ST
Published: March 2008

Objective  To determine if tampons lubricated with pH‐balanced gel are effective at maintaining normal vaginal pH.

Design  Randomised controlled trial.

Setting  Urban family planning clinic and teaching hospital.

Population  Healthy volunteers using the combined oral contraceptive pill.

Methods  Women were randomised to use an existing lubricating gel (pH 5.1) or a lactic acid‐buffered gel (pH 3.8–4.2) with regular size, non‐applicator tampons. In the preceding control cycle, women used identical tampons without gel.

Main outcome measures  Vaginal pH ≤ 4.5, microbiology (candida and bacterial vaginosis [BV]) and colposcopic appearance within 72 hours of tampon use, subject acceptability and symptoms.

Results  Eighty‐one out of 98 (83%) women completed the study. No significant difference was observed between tampons with the standard gel formulation, the pH‐balanced gel and nonlubricated tampons in terms of vaginal pH, microbiological evidence of candida or BV, or colposcopic appearance. Acceptability scores were significantly higher for lubricated tampons compared with nonlubricated tampons (P < 0.05), although there was no difference in reported symptoms.

Conclusions  Tampons lubricated with pH‐balanced gel do not control vaginal pH. There was no evidence of measurable health benefits of lubricated tampons, but women preferred tampons without lubrication.
Gender differences in final year medical students’ experience of teaching of intimate examinations: a questionnaire study
Authors: Akkad A , Bonas S , Stark P
Published: March 2008

Objectives  To examine final year medical students’ experience of being taught to conduct intimate examinations.

Design  Prospective questionnaire study.

Setting  Medical school in the UK.

Population  Medical students in the final year cohort 2005/06.

Methods  Questionnaires were distributed to students in the final week of a final year obstetrics and gynaecology course. Responses to questions about course experience were analysed using frequencies and single‐variable analyses.

Main outcome measures  Students’ experience of and satisfaction with the teaching of intimate examinations and differences between male and female students.

Results  Male and female students performed similar numbers of intimate examinations, but clinical tutors were significantly more likely to introduce female students to patients (76 versus 52%; P= 0.001) and obtain consent on their behalf (75 versus 53%; P= 0.009) when compared with male students. Male students reported a greater degree of embarrassment (mean score 2.41 ± 1.25 versus 1.69 ± 0.90; P= 0.002), and a higher number of patients refusing consent to examination (median 2; range 0–12 versus 0; range 0–6; P= 0.0001).

Conclusions  Gender discrimination in the behaviour of tutors may impact on students’ experience of intimate examinations. It is highly improbable that differences in behaviour are deliberately intended to disadvantage male students, and further research is needed to understand why tutors behave differently with them. In the meantime, tutors need to be aware of potential bias and ensure appropriate support is provided for both male and female students.
Expected day of delivery from ultrasound dating versus last menstrual period—obstetric outcome when dates mismatch
Authors: Thorsell M , Kaijser M , Almström H , Andolf E
Published: March 2008

Objective  To analyse the association between fetal size at time of dating ultrasound and risk for preterm delivery and small‐for‐gestational‐age (SGA) birth and to evaluate if timing of ultrasound, that is before 14 weeks of gestation or after 16 weeks affects this association.

Design  Retrospective cohort study.

Setting  Ultrasound departments of Ultragyn, Stockholm, Sweden.

Population  A total of 28 776 singleton pregnancies dated between 1998 and 2004.

Methods  Obstetric outcome was assessed through linkage of the cohort to the Swedish Medical Birth Register.

Main outcome measures  Risks of preterm delivery, low birthweight for gestational age, pre‐eclampsia, asphyxia, respiratory distress, instrumental delivery, caesarean section, and postterm birth were calculated for the groups dated early and late.

Results  When the expected date of delivery was postponed after ultrasound dating by 7 days or more, there was an increased risk for preterm delivery and pre‐eclampsia in the late dating group (OR 1.49, 95% CI 1.27–1.73 and OR 1.27, 95% CI 1.02–1.60, respectively) but not in the early dating group. In both dating groups, there was an increased risk for SGA birth (OR 1.77, 95% CI 1.13–2.78 and OR 2.09, 95% CI 1.59–2.73, respectively) There was no increased risk for any of the other diagnoses.

Conclusion  Our study gives further support to the notion that intrauterine growth restriction may be present as early as the first trimester. Accordingly, our study also suggests that surveillance of pregnancies with postponed estimated date of delivery may provide means for increased detection of fetal growth restriction.
Activation of P2X7 receptors decreases glutamate uptake and glutamine synthetase activity in RBA‐2 astrocytes via distinct mechanisms
Authors: Lo Jun‐Chih , Huang Wei‐Chi , Chou Yun‐Chia , Tseng Chun‐Hsien , Lee Wei‐Li , Sun Synthia H.
Published: March 2008

Glutamate clearance by astrocytes is critical for controlling excitatory neurotransmission and ATP is an important mediator for neuron‐astrocyte interaction. However, the effect of ATP on glutamate clearance has never been examined. Here we report that treatment of RBA‐2 cells, a type‐2‐like astrocyte cell line, with ATP and the P2X7 receptor selective agonist 3′‐O‐(4‐benzoylbenzoyl) adenosine 5′‐triphosphate (BzATP) decreased the Na+‐dependent [3H]glutamate uptake within minutes. Mechanistic studies revealed that the decreases were augmented by removal of extracellular Mg2+ or Ca2+, and was restored by P2X7 selective antagonist , periodate‐oxidized 2′,3′‐dialdehyde ATP (oATP), indicating that the decreases were mediated through P2X7 receptors. Furthermore, stimulation of P2X7 receptors for 2 h inhibited both activity and protein expression of glutamine synthetase (GS), and oATP abolished the inhibition. In addition, removal of extracellular Ca2+ and inhibition of protein kinase C (PKC) restored the ATP‐decreased GS expression but failed to restore the P2X7‐decreased [3H]glutamate uptake. Therefore, P2X7‐mediated intracellular signals play a role in the down‐regulation of GS activity/expression. Activation of P2X7 receptors stimulated increases in intracellular Na+ concentration ([Na+]i) suggesting that the P2X7‐induced increases in [Na+]i may affect the local Na+ gradient and decrease the Na+‐dependent [3H]glutamate uptake. These findings demonstrate that the P2X7‐mediated decreases in glutamate uptake and glutamine synthesis were mediated through distinct mechanisms in these cells.
Ectopic decorin expression up‐regulates VEGF expression in mouse cerebral endothelial cells via activation of the transcription factors Sp1, HIF1α, and Stat3
Authors: Santra Manoranjan , Santra Sutapa , Zhang Jing , Chopp Michael
Published: March 2008

We demonstrate that a proteoglycan decorin (DCN) up‐regulates the vascular endothelial growth factor (VEGF) expression with activation of VEGF regulating transcription factors Sp1, hypoxia‐inducible factor 1α (HIF1α), and signal transducer and activator of transcription 3 (Stat3) via epidermal growth factor receptor (EGFR), mitogen‐activated protein kinase extracellular signal‐regulated kinase 1/2 (ERK1/2), and protein kinase B (AKT) pathways in DCN transfected mouse cerebral endothelial (MCE) cells. Treatment with pharmacological inhibitors and small interfering RNAs reveal that induction and activation of Sp1, HIF1α, and Stat3 facilitate their nuclear localization and binding to their specific motifs of the VEGF promoter and induce VEGF expression via two independent pathways, DCN/EGFR/phosphoinositide‐3 kinase/AKT and DCN/EGFR/ERK1/2, respectively, in DCN synthesizing MCE cells. The cell type specific glycosylation protects Sp1 and HIF1α from proteosome degradation and plays an important and novel role in the regulation of VEGF in DCN transfected MCE cells. Induction of gelatinases (matrix metalloproteinase 2 and 9), the serine protease tissue plasminogen activator and plasmin by DCN transfection in MCE cells leads to extracellular proteolysis and to release of matrix‐bound VEGF and activation of angiogenesis. In this study, we demonstrate that two independent downstream signal pathways, DCN/EGFR/ERK1/2 and DCN/EGFR/phosphoinositide‐3 kinase/AKT, mediate up‐regulation and activation of transcription factors of VEGF such as HIF1α, Stat3, and Sp1 and increase VEGF transcription and angiogenesis in MCE cells.
Role of tissue plasminogen activator in the sensitization of methamphetamine‐induced dopamine release in the nucleus accumbens
Authors: Fukakusa Ayumi , Nagai Taku , Mizoguchi Hiroyuki , Otsuka Noboru , Kimura Haruhide , Kamei Hiroyuki , Kim Hyoung‐Chun , Nabeshima Toshitaka , Takuma Kazuhiro , Yamada Kiyofumi
Published: March 2008

We have previously demonstrated that repeated, but not acute, methamphetamine (METH) treatment increases tissue plasminogen activator (tPA) activity in the brain, which is associated with the development of behavioral sensitization to METH. In this study, we investigated whether the tPA‐plasmin system is involved in the development of sensitization in METH‐induced dopamine release in the nucleus accumbens (NAc). There was no difference in acute METH‐induced increase in extracellular dopamine levels in the NAc between wild‐type and tPA‐deficient (tPA−/−) mice. Repeated METH treatment resulted in a significant enhancement of METH‐ induced dopamine release in wild‐type mice, but not tPA−/− mice. Microinjection of exogenous tPA or plasmin into the NAc of wild‐type mice significantly potentiated acute METH‐ induced dopamine release. Degradation of laminin was evident in brain tissues incubated with tPA plus plasminogen or plasmin in vitro although tPA or plasminogen alone had no effect. Immunohistochemical analysis revealed that microinjection of plasmin into the NAc reduced laminin immunoreactivity without neuronal damage. Our findings suggest that the tPA‐plasmin system participates in the development of behavioral sensitization induced by repeated METH treatment, by regulating the processes underlying the sensitization of METH‐induced dopamine release in the NAc, in which degradation of laminin by plasmin may play a role.
Lysophosphatidic acid‐LPA1receptor–Rho–Rho kinase‐induced up‐regulation of Nav1.7 sodium channel mRNA and protein in adrenal chromaffin cells: enhancement of22Na+influx,45Ca2+influx and catecholamine secretion
Authors: Maruta Toyoaki , Yanagita Toshihiko , Matsuo Kiyotaka , Uezono Yasuhito , Satoh Shinya , Nemoto Takayuki , Yoshikawa Norie , Kobayashi Hideyuki , Takasaki Mayumi , Wada Akihiko
Published: March 2008

In cultured bovine adrenal chromaffin cells, chronic (≥ 24 h) treatment with lysophosphatidic acid (LPA) augmented veratridine‐induced22Na+influx via Nav1.7 by ∼22% (EC50 = 1 nmol/L), without changing nicotine‐induced22Na+influx via nicotinic receptor‐associated channel. LPA enhanced veratridine (but not nicotine)‐induced45Ca2+influx via voltage‐dependent calcium channel and catecholamine secretion. LPA shifted concentration–response curve of veratridine for22Na+influx upward, without altering the EC50of veratridine.Ptychodiscus brevistoxin‐3 allosterically enhanced veratridine‐induced22Na+influx by twofold in non‐treated and LPA‐treated cells. Whole‐cell patch‐clamp analysis showed that peak Na+current amplitude was greater by 39% in LPA (100 nmol/L for 36 h)‐treated cells; however,I–Vcurve and steady‐state inactivation/activation curves were comparable between non‐treated and LPA‐treated cells. LPA treatment (≥ 24 h) increased cell surface [3H]saxitoxin binding by ∼28%, without altering theKdvalue; the increase was prevented by cycloheximide, actinomycin D, or Ki16425, dioctylglycerol pyrophosphate 8:0 (two inhibitors of LPA1and LPA3receptors), or botulinum toxin C3 (Rho inhibitor), Y27632 (Rho kinase inhibitor), consistent with LPA1receptor expression in adrenal chromaffin cells. LPA raised Nav1.7 mRNA level by ∼37%. Thus, LPA–LPA1receptor–Rho/Rho kinase pathway up‐regulated cell surface Nav1.7 and Nav1.7 mRNA levels, enhancing veratridine‐induced Ca2+influx and catecholamine secretion.
Genetic or pharmacological blockade of noradrenaline synthesis enhances the neurochemical, behavioral, and neurotoxic effects of methamphetamine
Authors: Weinshenker David , Ferrucci Michela , Busceti Carla L. , Biagioni Francesca , Lazzeri Gloria , Liles L. Cameron , Lenzi Paola , Pasquali Livia , Murri Luigi , Paparelli Antonio , Fornai Francesco
Published: March 2008

N‐(2‐chloroethyl)‐N‐ethyl‐2‐bromobenzylamine (DSP‐4) lesions of the locus coeruleus, the major brain noradrenergic nucleus, exacerbate the damage to nigrostriatal dopamine (DA) terminals caused by the psychostimulant methamphetamine (METH). However, because noradrenergic terminals contain other neuromodulators and the noradrenaline (NA) transporter, which may act as a neuroprotective buffer, it was unclear whether this enhancement of METH neurotoxicity was caused by the loss of noradrenergic innervation or the loss of NA itself. We addressed the specific role of NA by comparing the effects of METH in mice with noradrenergic lesions (DSP‐4) and those with intact noradrenergic terminals but specifically lacking NA (genetic or acute pharmacological blockade of the NA biosynthetic enzyme dopamine β‐hydroxylase; DBH). We found that genetic deletion of DBH (DBH−/− mice) and acute treatment of wild‐type mice with a DBH inhibitor (fusaric acid) recapitulated the effects of DSP‐4 lesions on METH responses. All three methods of NA depletion enhanced striatal DA release, extracellular oxidative stress (as measured byin vivomicrodialysis of DA and 2,3‐dihydroxybenzoic acid), and behavioral stereotypies following repeated METH administration. These effects accompanied a worsening of the striatal DA neuron terminal damage and ultrastructural changes to medium spiny neurons. We conclude that NA itself is neuroprotective and plays a fundamental role in the sensitivity of striatal DA terminals to the neurochemical, behavioral, and neurotoxic effects of METH.
The newly synthesized pool of dopamine determines the severity of methamphetamine‐induced neurotoxicity
Authors: Thomas David M. , Francescutti‐Verbeem Dina M. , Kuhn Donald M.
Published: March 2008

The neurotransmitter dopamine (DA) has long been implicated as a participant in the neurotoxicity caused by methamphetamine (METH), yet, its mechanism of action in this regard is not fully understood. Treatment of mice with the tyrosine hydroxylase (TH) inhibitor α‐methyl‐p‐tyrosine (AMPT) lowers striatal cytoplasmic DA content by 55% and completely protects against METH‐induced damage to DA nerve terminals. Reserpine, by disrupting vesicle amine storage, depletes striatal DA by more than 95% and accentuates METH‐induced neurotoxicity.l‐DOPA reverses the protective effect of AMPT against METH and enhances neurotoxicity in animals with intact TH. Inhibition of MAO‐A by clorgyline increases pre‐synaptic DA content and enhances METH striatal neurotoxicity. In all conditions of altered pre‐synaptic DA homeostasis, increases or decreases in METH neurotoxicity paralleled changes in striatal microglial activation. Mice treated with AMPT,l‐DOPA, or clorgyline + METH developed hyperthermia to the same extent as animals treated with METH alone, whereas mice treated with reserpine + METH were hypothermic, suggesting that the effects of alterations in cytoplasmic DA on METH neurotoxicity were not strictly mediated by changes in core body temperature. Taken together, the present data reinforce the notion that METH‐induced release of DA from the newly synthesized pool of transmitter into the extracellular space plays an essential role in drug‐induced striatal neurotoxicity and microglial activation. Subtle alterations in intracellular DA content can lead to significant enhancement of METH neurotoxicity. Our results also suggest that reactants derived from METH‐induced oxidation of released DA may serve as neuronal signals that lead to microglial activation early in the neurotoxic process associated with METH.