bluuebunny/crossref_metadata_2025 huggingface dataset:
Infection Control Recommendations for Patients With Cystic Fibrosis: Microbiology, Important Pathogens, and Infection Control Practices to Prevent Patient-to-Patient Transmission
Authors: Saiman Lisa , Siegel Jane ,   Cystic Fibrosis Foundation Consensus Conference on Infection Control Participants
Published: March 2006

Infection Control Recommendations for Patients With Cystic Fibrosis: Microbiology, Important Pathogens, and Infection Control Practices to Prevent Patient-to-Patient Transmissionupdates, expands, and replaces the consensus statement,Microbiology and Infectious Disease in Cystic Fibrosispublished in 1994. This consensus document presents background data and evidence-based recommendations for practices that are intended to decrease the risk of transmission of respiratory pathogens among CF patients from contaminated respiratory therapy equipment or the contaminated environment and thereby reduce the burden of respiratory illness. Included are recommendations applicable in the acute care hospital, ambulatory, home care, and selected non-healthcare settings. The target audience includes all healthcare workers who provide care to CF patients. Antimicrobial management is beyond the scope of this document.
Minimally Invasive Thyroidectomy: Basic and Advanced Techniques
Authors: Terris David J. , Gourin Christine G. , Chin Edward
Published: March 2006

Objective: Minimal access surgery in the thyroid compartment has evolved considerably over the past 10 years and now takes many forms. We advocate at least two distinct approaches, depending on the disease process and multiple patient factors. The technical aspects are explored in depth with liberal use of videographic demonstration.

Methods: The authors conducted a comparison of two distinct surgical techniques with photographic and videographic documentation of two distinct minimal access approaches to the thyroid compartment termed minimally invasive thyroidectomy (MITh) and minimally invasive video‐assisted thyroidectomy (MIVAT). Both historic and previously unpublished data (age, gender, pathology, incision length, and complications) are systematically analyzed.

Results: Patients who underwent minimally invasive thyroidectomy (n = 31) had a mean age of 39.4 ± 10.7 years; seven were male and 24 were female. The most common diagnosis was follicular or Hürthle cell adenoma (29%), followed by papillary or follicular cancer (26%). The mean incision length was 4.9 ± 1.0 cm. One patient developed a hypertrophic scar and one patient developed thrombophlebitis of the anterior jugular vein. There were 14 patients in the MIVAT group with a mean age of 43.7 ± 11.4 years; one was male and 13 were female. The majority of patients had follicular adenoma (42.9%) or papillary carcinoma (21.4%) as their primary diagnosis. The mean incision length was 25 ± 4.3 mm (range, 20–30 mm), and there were no complications.

Conclusions: Two distinct approaches to minimal access thyroid surgery are now available. The choice of approach depends on a number of patient and disease factors. Careful patient selection will result in continued safe and satisfactory performance of minimally invasive thyroid surgery.
Heme Oxygenase (HO)‐1 Is Upregulated in the Nasal Mucosa With Allergic Rhinitis
Authors: Elhini Ahmed , Abdelwahab Soha , Ikeda Katsuhisa
Published: March 2006

Background: Heme oxygenase (HO) is considered to be an antioxidant enzyme that catabolizes heme to produce carbon monoxide (CO) and biliverdin. Three isoforms of HO have been discovered. Recently, HO‐1 has been found to be upregulated after allergic inflammations of the lower airway.

Objective: The objective of this study was to address the expression of HO isoenzymes 1 and 2 in the nasal mucosa of patients with allergic rhinitis as well as normal control subjects.

Methods: Nasal mucosa from 30 patients with persistent allergic rhinitis as well as from 10 normal volunteers was used in this study. We used immunofluorescent technique, Western blotting, and real‐time quantitative polymerase chain reaction to localize and quantify the expression of these isoenzymes in normal and allergic human nasal tissues.

Results: We found that HO‐1 is expressed in the epithelial cells of seromucinous glands and macrophages with significant upregulation of its glandular expression in allergic rhinitis but with no difference in its macrophage expression between the study groups in contrast to HO‐2 that is expressed in the vascular endothelial lining cells as well as macrophages with no marked difference between the study groups.

Conclusion: We demonstrated that expression of HO‐1, but not HO‐2, was upregulated within the nasal tissues in allergic rhinitis inflammation, and understanding the induction of HO‐1 expression may provide for better management of allergic rhinitis that involves oxidative stress.
Factors Associated with Long‐Term Complications after Repair of Mandibular Fractures
Authors: Furr Andrea Marie , Schweinfurth John M. , May Warren L.
Published: March 2006

Educational Objective: At the conclusion of this paper, the participants should be able to identify, compare, and discuss the natural history of complications of mandible fractures and repair.

Objectives: To analyze factors affecting the incidence of long‐term complications after the repair of mandible fractures. To determine whether the use of antibiotics at any time in the course of treatment impacted the development of complications.

Study Design: Retrospective medical record review.

Methods: Medical records for patients with mandibular fractures treated surgically over a 5 year period were reviewed for demographics, history of substance abuse, etiology, location of fracture, any associated facial injury, type and timing of repair, pre‐, peri‐, and postoperative antibiotic treatment, length of hospitalization, and lag time to repair. The development of infectious and other complications after surgery, specifically, the development of abscesses, fistulae, mal/nonunion, hardware exposure, or extrusion, were recorded.

Results: Of 273 subjects, 56 fractures were repaired using open reduction internal fixation (ORIF) alone, 112 mandibulomaxillary fixation (MMF), and 105 with a combination of MMF and ORIF. Eighteen (6.6%) patients developed an infectious or related long‐term complication. These included abscess (n = 4), infected hardware (n = 1), mal/nonunion (n = 8), and hardware exposure/extrusion (n = 9). Smoking and alcohol abuse (P = .021) and the use of plating techniques (P = .04) correlated with a higher incidence of long‐term complications. Patient age, sex, location and etiology of fracture, associated facial injury, lag time to repair, length of hospitalization, and the use of antibiotics at any time after injury or repair were unrelated to the development of complications.

Conclusions: The development of infection, nonunion, and related complications after the repair of mandibular fractures correlates with a history of tobacco and alcohol use and ORIF of multiple fractures, but there were no statistically significant relationships to patient demographics, fracture site, lag time to repair, length of hospitalization, or the use of antibiotics. In this series, antibiotic therapy appears to have had no impact on the development of postoperative complications.
Olfactory Dysfunction in Leprosy
Authors: Mishra Anupam , Saito Kenji , Barbash Scott E. , Mishra Nimisha , Doty Richard L.
Published: March 2006

Leprosy (Hansen's disease) is associated with a high incidence of nasal pathology. Despite this fact, the influence of this disorder on the sense of smell is poorly understood. In this study, we administered a standardized 12‐item odor identification test to 77 patients with three types of leprosy: tuberculoid (n = 9), borderline (n = 42), and lepromatous (n = 26). All three types exhibited significantly lower test scores than their respective age‐, sex‐, and smoking–habit‐matched controls. Patients with lepromatous leprosy exhibited significantly lower test scores than those with the other two types. Only patients with lepromatous leprosy exhibited meaningful improvement in smell function after treatment. No association between disease duration, per se, and the severity of the olfactory deficit was present. Overall, 100% of the patients exhibited olfactory dysfunction, suggesting that earlier prevalence estimates based on nonstandardized olfactory testing have underestimated the prevalence of this problem.
Cyclin D1 and D3 Expression in Vestibular Schwannomas
Authors: Neff Brian A. , Oberstien Elly , Lorenz Mark , Chaudhury Abhik R. , Welling D Bradley , Chang Long‐Sheng
Published: March 2006

Objectives: The G1 regulators of the cell cycle, cyclin D1 and D3, have been implicated in the regulation of Schwann cell proliferation and differentiation. The purpose of this study is to evaluate cyclin D1 and D3 protein expression and the corresponding clinical characteristics of vestibular schwannomas.

Study Design and Methods: Tissue sections of 15 sporadic vestibular schwannomas were prepared. Immunohistochemical analysis of the vestibular schwannomas was performed with anticyclin D1 and anticyclin D3 antibodies. The immunoreactivity was evaluated in comparison with adjacent vestibular nerves. Tissue sections of breast carcinoma and prostate carcinoma were used as positive controls for cyclin D1 and D3 staining, respectively. Patient demographics, tumor characteristics, and cyclin D expression were reviewed, and statistical analysis was performed.

Results: While the breast carcinoma control expressed abundant cyclin D1 protein, none of the 15 vestibular schwannomas showed detectable cyclin D1 staining. In contrast, seven of 15 vestibular schwannomas stained positive for the cyclin D3 protein. Cyclin D3 staining was taken up in the nucleus of schwannoma tumor cells in greater proportion than Schwann cells of adjacent vestibular nerve. Although sample size was small, no significant difference in the average age of presentation, tumor size, and male to female ratios for the cyclin D3+ or cyclin D3− groups was found.

Conclusion: The Cyclin D1 protein does not appear to play a prominent role in promoting cell cycle progression in vestibular schwannomas. In contrast, cyclin D3 expression was seen in nearly half of the tumors examined, suggesting that it may have a growth‐promoting role in some schwannomas. Further studies are needed to define its cellular mechanism.
Up‐Regulation of MUC5AC and MUC5B Mucin Genes in Nasopharyngeal Respiratory Mucosa and Selective Up‐Regulation of MUC5B in Middle Ear in Pediatric Otitis Media with Effusion
Authors: Elsheikh Mohamed Nasser , Mahfouz Magdy ElSayed
Published: March 2006

Objectives: Mucins are the major component responsible for the gel‐like properties of mucus secretion. Currently, little is known about the regulation of mucins in otitis media with effusion (OME). We investigated the expression of MUC5AC and MUC5B mucin gene messenger (m)RNAs in middle ear effusions as well as in tissue biopsies of the respiratory mucosa of the nasopharynx by means of reverse‐transcription polymerase chain reaction (RT‐PCR).

Study Design: A prospective, controlled, clinical trial.

Methods: The study group consisted of 25 children with a diagnosis of OME who were to undergo bilateral ventilation tube insertion with adenoidectomy. A sample of middle ear effusion (n = 50) as well as tissue biopsy from nasopharyngeal respiratory mucosa (n = 25) were obtained from each patient. For the nasopharyngeal mucosal biopsies, two control groups were made up from 30 children with healthy ears who underwent tonsillectomy ± adenoidectomy operation; control A, 15 children with adenoid hypertrophy, and control B, 15 children with healthy nasopharynx. RNAs were extracted from effusion and tissue samples, and semiquantitative RT‐PCR was performed for MUC5AC and MUC5B to investigate their expression.

Results: In the middle ear effusions, MUC5B mRNA expression was detected in 48 (96%), whereas MUC5AC mRNA was detected in 8 (16%). On semiquantitative analysis, MUC5AC/glyceraldehyde 3‐phosphate dehydrogenase (GAPDH) and MUC5B/GAPDH mRNA ratios in the study group were significantly increased compared with those in both control groups (P < .05).

Conclusions: The results suggest that the middle ear has a unique mucin gene expression pattern when compared with that of the nasopharynx. Up‐regulation of MUC5B in the ear may play an important role in the pathogenesis of middle ear effusions.
Treatment of Contralateral N0 Neck in Early Squamous Cell Carcinoma of the Oral Tongue: Elective Neck Dissection versus Observation
Authors: Lim Young Chang , Lee Jin Seok , Koo Bon Seok , Kim Se‐Heon , Kim Young‐Ho , Choi Eun Chang
Published: March 2006

Objectives/Hypothesis: Prophylactic treatment of contralateral N0 neck in early squamous cell carcinoma (SCC) of the oral tongue is a controversial issue. The aim of this study was to analyze the rates of occult metastases and their prognostic effects in stage I and stage II SCC of the oral tongue, and to compare the results of elective neck dissection to observation of the contralateral N0 neck in the treatment of these patients.

Study Design: Retrospective review.

Methods: We reviewed the medical records of 54 patients who were treated at Severance Hospital from 1992 to 2003 and had been diagnosed with stage I or stage II SCC of the oral tongue and had not received prior treatment. All patients underwent an ipsilateral elective neck dissection simultaneously with the primary lesion. The management of the contralateral N0 necks involved “watchful waiting” in 29 patients and elective neck dissection in 25 patients. Surgical treatment was followed by radiotherapy in 20 patients. Of these, seven patients belonged to the “observation” group who did not receive contralateral elective neck dissection. The follow‐up period ranged from 3 to 110 months, with a mean of 56.3 months. Data were analyzed using the Kaplan‐Meier method, the log‐rank test, and the ξ2 test.

Results: Fifteen patients (28%, 15 of 54) had occult metastases. Of these, 14 patients (26%, 14 of 54) had ipsilateral pathologic metastases. The remaining case (4%, 1 of 25) had the only contralateral level II occult neck metastasis without ipsilateral metastasis. Disease recurred in 17 of 54 patients (31%). Of these, eight cases (47%, 8 of 17) had regional recurrences. All regional recurrences developed in the ipsilateral neck; there were no cases of contralateral neck recurrence. The 5‐year actuarial disease‐free survival rates were 82% for the “observation” group and 68% for the elective neck dissection group. This difference was not statistically significant (P = .182). The 5‐year actuarial disease‐free survival rates were 83% for the “observation” group when those patients who underwent radiotherapy were excluded (n = 22) and 68% for the elective supraomohyoid neck dissection group (n = 25), which showed no statistically significant difference (P = .127).

Conclusions: This study showed that ipsilateral elective neck management is indicated for stage I and II SCC of the oral tongue. On the other hand, our series suggests that contralateral occult lymph node metastasis was unlikely in early‐stage oral tongue SCC, and that there was no survival benefit for patients who underwent elective neck dissection in place of observation. Thus, it may not harmful to observe the contralateral N0 neck in the treatment of early oral tongue cancer.
Acoustic Analysis of Snoring Sounds by a Multidimensional Voice Program
Authors: Hara Hirotaka , Murakami Naoko , Miyauchi Yuji , Yamashita Hiroshi
Published: March 2006

Objectives: This prospective study aimed to determine whether the acoustic characteristics of snoring sounds differed between simple snorers and patients with obstructive sleep apnea syndrome (OSAS) by using a multidimensional voice program (MDVP) that analyzes various aspects of voice.

Methods: Fifty‐eight patients (48 men, 10 women) with a history of snoring were included in the study. All patients underwent conventional polysomnography (PSG). Twelve subjects were diagnosed as simple snorers and 46 subjects were diagnosed with OSAS. The mean body mass index (BMI) of simple snorers was 24.7 kg/m2 and that of patients with OSAS was 25.8 kg/m2. Natural overnight snoring was recorded from each subject while they slept during PSG. Using the multiple token protocols of MDVP, 30 snores from each subject were analyzed automatically. For data analysis, four markers were used: peak frequency, soft phonation index (SPI), noise to harmonics ratio (NHR), and power ratio.

Results: The Mann‐Whitney U test revealed significant differences between the SPI, NHR, and power ratio of simple snorers and patients with OSAS. Simple snorers had a high SPI value. OSAS‐related snorers demonstrated a high NHR and low power ratio.

Conclusions: MDVP can be used for snoring sound analysis as a noninvasive examination of sleep‐related breathing disorders for differential diagnosis. However, a suitable option that is rapid and has an easy‐to‐use interface would be more advantageous for analyzing snoring sounds.
Breath Actuated Device Improves Delivery to Target Sites Beyond the Nasal Valve
Authors: Djupesland Per Gisle , Skretting Arne , Winderen Mette , Holand Trond
Published: March 2006

Objectives: The objective was to compare nasal deposition patterns achieved with a conventional hand actuated spray pump and a novel breath actuated bidirectional prototype device housing the same spray pump (OptiMist™, OptiNose AS, Oslo, Norway).

Study Design and Methods: The bidirectional delivery device exploits the posterior connection between the nasal passages persisting when the velum automatically closes during oral exhalation. The deposition and clearance patterns achieved with the two devices were compared in nine healthy subjects by scintigraphy after administration of 99mTc‐aerosols.

Results: Compared with traditional spray pump delivery, the OptiMist device provided significantly (P < .004) larger initial and cumulative deposition (area under the deposition vs. time curve) in the upper posterior segment of the nasal passage, housing the sinus ostia and the olfactory region, and significantly lower deposition (P < .004) in the anterior segment, lined by nonciliated squamous epithelium. Furthermore, intersubject reproducibility of the initial and cumulative deposition was higher for the OptiMist™ device both in the upper posterior segment and the entire nose.

Conclusions: Compared with a spray pump, the novel breath actuated bidirectional device provides significantly larger deposition in the clinically important regions beyond the nasal valve and reduced anterior deposition. These striking differences provide new opportunities for improved therapy of chronic rhinosinusitis and polyposis as well as extended use of the nose for delivery of drugs from the nose into the brain.
Sublingual Gland Resection in Squamous Cell Carcinoma of the Floor of Mouth: is it Necessary?
Authors: Clark Jonathan R. , Franklin Jason H. , Naranjo Natalie , Odell Michael J. , Gullane Patrick J.
Published: March 2006

Objectives Little evidence exists to guide surgeons in the management of the sublingual glands (SLG) not macroscopically involved by squamous cell carcinoma of the floor of mouth and oral tongue. This study aims to determine the frequency with which the SLG is invaded, to identify variables predicting for SLG invasion and the morbidity associated with it's resection in entirety.

Study design: Retrospective cohort study.

Methods: A review of 164 patients treated for oral cavity cancer at a tertiary institution with a large volume of head and neck malignancy was performed. Demographic data, rates of surgical complications and follow up information was recorded. Pathologic review of resected material in this group yielded 134 specimens in the region of the SLG. A detailed analysis of 63 specimens in which the SLG was included was carried out.

Results: The median age was 58 years, mean follow up was 2.2 years, and there were 44 males and 19 females. Seventeen cases (27%) demonstrated histopathological SLG invasion. In patients with SLG involvement, this was evident at the time of surgery in 15 patients (88%). Microscopic SLG invasion, without macroscopic evidence at surgery, was present in only 4.2% of patients undergoing SLG resection. Clinical and pathological T stage (p = 0.023 and 0.005) and tumor thickness (p = 0.015) predicted for SLG invasion. Total SLG resection significantly increased the post‐operative wound complication rate from 14% in patients without SLG resection to 25% (p = 0.05).

Conclusion: Total SLG resection in early stage and thin squamous cell carcinoma of the floor of mouth and oral tongue provides minimal oncologic benefit and is associated with increased perioperative morbidity due to neck wound complications.
Operative Management of a Posterior Semicircular Canal Dehiscence
Authors: Mikulec Anthony A. , Poe Dennis S.
Published: March 2006

Objective: The objective of this study was to describe the operative management of posterior canal dehiscence.

Methods: A transmastoid approach to and plugging of the posterior canal was performed for posterior semicircular canal dehiscence (PSCD).

Results: Postoperatively, the patient exhibited improvement in conductive hearing loss and vestibular symptoms.

Conclusions: PSCD can cause symptoms identical to that of superior semicircular canal dehiscence. Successful PSCD plugging can be performed without visualization of the actual area of dehiscence.
Enteric‐Coated Pancreatic Enzyme with Bicarbonate Is Equal to Standard Enteric‐Coated Enzyme in Treating Malabsorption in Cystic Fibrosis
Authors: Kalnins Daina , Ellis Lynda , Corey Mary , Pencharz Paul B. , Stewart Cynthia , Tullis Elizabeth , Durie Peter R.
Published: March 2006

Objectives:

To compare the efficacy of an enteric‐coated buffered pancreatic enzyme (EC buffered PE) containing 1.5 mEq of bicarbonate per capsule with a conventional enteric‐coated enzyme (EC‐PE) capsule in cystic fibrosis patients with signs or symptoms of moderate to severe malabsorption.

Methods:

In a double‐blind crossover study, subjects were randomly assigned to two consecutive, 2‐week phases using an EC buffered PE product and conventional EC‐PE product. Seventy‐two hour stool collections from each phase were analyzed for energy, fat, and nitrogen content and expressed as percent of estimated intake.

Results:

Twenty‐one patients with cystic fibrosis and pancreatic insufficiency (14 female, mean age 20.6 ± 11.5 years, range 8.8‐41.9) completed the study. There was no significant difference in percent malabsorption of energy (19.4% vs. 19.0%), fat (20.7% vs. 20.2%), or nitrogen (10.4% vs. 10.7%) between the EC buffered PE product and the conventional EC‐PE product. However, patients taking the EC buffered PE product received less enzyme based on actual enzyme activity measured in vitro (3,468 ± 1,434 U lipase/g fat vs. 3,978 ± 1,474 U lipase/g fat, P < 0.02).

Conclusions:

In the doses used, nutrient absorption of patients taking EC buffered PE preparation offers no advantage over a conventional EC‐PE preparation.
Meticillin-resistant Staphylococcus aureus infection in diabetic mice enhanced inflammation and coagulation
Authors: Tsao Shyh-Ming , Hsu Cheng-Chin , Yin Mei-Chin
Published: March 2006

BALB/cA mice were used to study the interaction of diabetes and meticillin-resistantStaphylococcus aureus(MRSA) infection on pathogen distribution, cytokine profile and inflammatory and endothelial-injury markers, as well as coagulation and anticoagulation factors. Meticillin-susceptibleS. aureus(MSSA) infection did not cause death within the experimental period. MRSA-infected nondiabetic and diabetic mice died on 19·1±1·4 and 10·6±0·7 days post-infection (p.i.), respectively. MRSA and MSSA infection in diabetic mice did not result in symptomatic bacteraemia; however, MRSA infection in diabetic mice significantly reduced glucose levels (P<0·05). Diabetic mice showed significantly higher levels of C-reactive protein, fibrinogen, fibronectin and von Willebrand factor than nondiabetic mice (P<0·05), and MRSA infection further elevated the plasma levels of these inflammatory and endothelial markers (P<0·05). Before infection, diabetic mice had significantly higher plasminogen activator inhibitor-1 (PAI-1) activity, lower antithrombin III (AT-III) and protein C activities (P<0·05), and MRSA infection significantly increased PAI-1 activity further and reduced the activity of AT-III and protein C (P<0·05). MRSA infection increased the production of three Th1 cytokines, interleukin 2 (IL-2), tumour necrosis factor alpha and gamma interferon, in diabetic mice (P<0·05); however, three Th2 cytokines, IL-4, IL-6, IL-10, were elevated at 2 and 4 days p.i., and then dropped gradually. MRSA infection in diabetic mice accelerated the inflammation process, endothelial injury and blood coagulation in diabetic mice. Therefore, the development of proper infection diagnosis and timely use of effective treatments for MRSA-infected diabetic individuals is important and necessary.
DNA vaccines expressing pneumococcal surface protein A (PspA) elicit protection levels comparable to recombinant protein
Authors: Ferreira Daniela M. , Miyaji Eliane N. , Oliveira Maria Leonor S. , Darrieux Michelle , Arêas Ana Paula M. , Ho Paulo L. , Leite Luciana C. C.
Published: March 2006

Pneumococcal surface protein A (PspA) is a promising candidate for the development of cost-effective vaccines againstStreptococcus pneumoniae. In the present study, BALB/c mice were immunized with DNA vaccine vectors expressing the N-terminal region of PspA. Animals immunized with a vector expressing secreted PspA developed higher levels of antibody than mice immunized with the vector expressing the antigen in the cytosol. However, both immunogens elicited similar levels of protection against intraperitoneal challenge. Furthermore, immunization with exactly the same fragment in the form of a recombinant protein, with aluminium hydroxide as an adjuvant, elicited even higher antibody levels, but this increased humoral response did not correlate with enhanced protection. These results show that DNA vaccines expressing PspA are able to elicit protection levels comparable to recombinant protein, even though total anti-PspA IgG response is considerably lower.
In vitro properties of antimicrobial bromotyrosine alkaloids
Authors: Pick Neora , Rawat Mamta , Arad Dorit , Lan Jiong , Fan Junfa , Kende Andrew S. , Av-Gay Yossef
Published: March 2006

A bromotyrosine alkaloid family of antimicrobial agents was synthesized using the known structure of a natural inhibitor of the mycobacterial mycothiolS-conjugate amidase (MCA) as a template. This series of compounds represents a novel class of anti-infective agents against Gram-positive pathogens, including mycobacteria and meticillin- and vancomycin-resistantStaphylococcus aureus. The fact that these compounds are active against mycobacterial strains in which the MCA gene is deleted and against Gram-positive bacteria lacking mycothiol suggests the existence of an alternative target for these compounds. One member of this family, EXEG1706, was identified as the lead compound possessing low MICs (2·5–25 μg ml−1) for several clinical isolates, whilst having low toxicity for THP-1 monocytes and macrophages.
Sexual genotype markers absent from small numbers of male New Zealand Oncorhynchus tshawytscha
Authors: Metcalf V. J. , Gemmell N. J.
Published: March 2006

In New Zealand chinook salmon Oncorhynchus tshawytscha, sexual genotype did not correspond to phenotype in 1·6% of male fish, contrasting starkly with North American chinook populations, where inconsistencies between female genotype and phenotype have been observed at frequencies up to 84%.
Phylogeography of the Turkish brown troutSalmo truttaL.: mitochondrial DNA PCR‐RFLP variation
Authors: Bardakci F. , Degerli N. , Ozdemir O. , Basibuyuk H. H.
Published: March 2006

In the present study, mitochondrial DNA polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) assay was used to assess the phylogenetic and phylogeographic relationships among 27 brown troutSalmo truttapopulations from Turkey. The complete NADH 5/6 region and a second segment comprising the cytochromebgene and D‐loop of mtDNA amplified by PCR were digested with six and five restriction enzymes, respectively. A total of 27 haplotypes were observed and divided into three major phylogenetic assemblages, namely Danubian (DA), Adriatic (AD) and a newly proposed Tigris (TI) lineage. The timing of the net nucleotide divergence between the major lineages along with the geological history of Turkey suggested pre‐Pleistocene isolation of the Turkish brown trout and provided evidence that Turkey could be considered as a centre of diversification for these lineages. The average haplotype diversity (0·1397) and the nucleotide diversity (0·000416) within populations were low in comparison to the observed interpopulation nucleotide diversity (0·021266). PCR‐RFLP analysis showed that most of the mtDNA sequence variation found in the Turkish brown trout populations was imputable to differences among lineages. On the other hand, there was also an obvious relationship between geographical distribution of the populations and their clustering. The present study showed that brown trout populations from Turkey are highly divergent and mainly have a unique genetic profile that could be used for conservation and management purposes.
Occurrence of the scalloped ribbonfish Zu cristatus(Lampridiformes) in coastal waters of the central Tyrrhenian Sea, Italy
Authors: Bianco P. G. , Zupo V. , Ketmaier V.
Published: March 2006

The occurrence of two individuals of Zu cristatus at 2 m depth in coastal waters of the Gulf of Castellamare (Tyrrhenian Sea, Italy) together with records of this rare pan‐Oceanic mesopelagic species is reported. Analyses of two mitochondrial genes (12 s and 16 s; 936 bp) revealed a 2·6% sequence divergence between Mediterranean and Pacific (Japanese) samples of the species.
Evidence for independent origin of two spring‐spawning ciscoes (Salmoniformes: Coregonidae) in Germany
Authors: Schulz M. , Freyhof J. , Saint‐Laurent R. , Østbye K. , Mehner T. , Bernatchez L.
Published: March 2006

Combined analyses of mitochondrial DNA (mtDNA) and microsatellite loci were performed to assess the genetic differentiation of two spring‐spawning ciscoes from each other and from sympatric Coregonus albula in two German lakes. Polymorphism was screened at six microsatellite loci and mtDNA for a total of 247 and 94 ciscoes, respectively. Microsatellite data showed a weak differentiation between spring‐spawning Coregonus fontanae and sympatric C. albula in Lake Stechlin (FST = 0–0·008), whereas a significant differentiation was observed between spring‐spawning Coregonus lucinensis and sympatric C. albula in Lake Breiter Luzin (FST = 0·013–0·039). A more pronounced genetic difference was observed between both spring‐spawning species (FST = 0·05–0·128). Shared mtDNA haplotypes among sympatric species within both Lake Stechlin and Lake Breiter Luzin were observed, whereas no haplotype was shared between C. fontanae and C. lucinensis. These results suggest an independent origin for spring‐spawning ciscoes in each lake. Evidence is also provided for mtDNA introgression of Coregonus sardinella into C. lucinensis and C. albula in Lake Breiter Luzin. Postglacially, this species or at least a population which showed mtDNA introgression has colonized the Baltic Sea basin up to the glacial margin that was located between Lakes Stechlin and Breiter Luzin.
Measuring Efficiency: A Comparison of Multilevel Modelling and Data Envelopment Analysis in the Context of Higher Education
Authors: Johnes Jill
Published: March 2006

Data envelopment analysis (DEA) and multilevel modelling (MLM) are applied to a data set of 54,564 graduates from UK universities in 1993 to assess whether the choice of technique affects the measurement of universities’ performance. A methodology developed by Thanassoulis and Portela (2002; Education Economics, 10(2), pp. 183–207) allows each individual's DEA efficiency score to be decomposed into two components: one attributable to the university at which the student studied and the other attributable to the individual student. From the former component, a measure of each institution's teaching efficiency is derived and compared to the university effects from various multilevel models. The comparisons are made within four broad subjects: pure science, applied science, social science and arts. The results show that the rankings of universities derived from the DEA efficiencies which measure the universities’ own performance (i.e., having excluded the efforts of the individuals) are not strongly correlated with the university rankings derived from the university effects of the multilevel models. The data were also used to perform a university‐level DEA. The university efficiency scores derived from these DEAs are largely unrelated to the scores from the individual‐level DEAs, confirming a result from a smaller data set (Johnes, 2006a; European Journal of Operational Research, forthcoming). However, the university‐level DEAs provide efficiency scores which are generally strongly related to the university effects of the multilevel models.
MTA1 overexpression correlates significantly with tumor grade and angiogenesis in human breast cancers
Authors: Jang Ki‐Seok , Paik Seung Sam , Chung Heekyoung , Oh Young‐Ha , Kong Gu
Published: March 2006

Metastasis associated antigen 1 (MTA1) is a recently identified candidate metastasis‐associated gene that plays an important role in tumorigenesis and tumor aggressiveness, especially tumor invasiveness and metastasis. We analyzed the relationship between MTA1 expression and variable clinicopathological features and characterized its role in tumor angiogenesis in human breast cancers. Two hundred and sixty‐three breast cancer cases that successfully underwent surgery at Hanyang University Hospital (Seoul, Korea) between January 1989 and December 1997 were enrolled. MTA1 expression was observed by immunohistochemical staining and correlated with intratumoral microvessel density (MVD) and other clinicopathological parameters. MTA1 overexpression correlated significantly with higher tumor grade (grades 1 and 2 vs grade 3, P = 0.009). However, MTA1 expression did not correlate with tumor stage, status of estrogen and progesterone receptors, or axillary lymph node metastasis. Interestingly, MTA1 expression was found to correlate significantly with tumor MVD (P = 0.002). Survival analysis did not show a significant difference between MTA1 overexpression and poorer survival. In conclusion, MTA1 overexpression was found to be closely associated with higher tumor grade and increased tumor angiogenesis. These findings suggest MTA1 as a predictor of aggressive phenotype and a possible target molecule for anti‐angiogenic drugs in breast cancer treatment. (Cancer Sci 2006)
Phase I/II adenoviral p53 gene therapy for chemoradiation resistant advanced esophageal squamous cell carcinoma
Authors: Shimada Hideaki , Matsubara Hisahiro , Shiratori Tooru , Shimizu Takanori , Miyazaki Shinichi , Okazumi Shinichi , Nabeya Yoshihiro , Shuto Kiyohiko , Hayashi Hideki , Tanizawa Tooru , Nakatani Yukio , Nakasa Hiromitsu , Kitada Mitsukazu , Ochiai Takenori
Published: March 2006

We investigated the feasibility, safety, biological activity and therapeutic efficacy of adenovirus‐mediated p53 gene transfer in patients with chemoradiation resistant advanced esophageal carcinoma. Eligible patients were not surgical candidates and had measurable, advanced squamous cell carcinoma of the esophagus that was resistant to chemoradiation therapy. On a 28‐day cycle, intratumoral injections of Ad5CMV‐p53 (INGN 201; ADVEXIN®) were administered on days 1 and 3 at four dose levels (10 × 1011 particles to 25 × 1011 particles) and treated for up to five cycles. Ten patients received a total of 26 cycles with no dose‐limiting toxicity. Administration of multiple courses was feasible and well‐tolerated. Local tumor responses revealed stable disease in nine cases and progressive disease in one case. The overall responses were stable in six and progressive in four cases. Using polymerase chain reaction (PCR) analyses, gene transfer and p53 specific transgene expression were detected in tumor biopsy tissue from all patients. mRNA levels of p53, p21 and MDM2 increased in all but one case. Three patients showed absence of disease upon repeat biopsies. Substantial improvement in swallowing was observed in one patient with stenotic lesions. Intratumoral injection of Ad5CMV‐p53 is safe, feasible and biologically active when administered in multiple doses to patients with esophageal cancer. Observations from this study indicate that this treatment results in local antitumor effects in chemoradiation resistant esophageal squamous cell carcinoma. (Cancer Sci 2006; 97)
Evaluation of a diclofenac transdermal patch for the attenuation of venous cannulation pain: a prospective, randomised, double‐blind, placebo‐controlled study
Authors: Agarwal A. , Dhiraaj S. , Kumar A. , Singhal V. , Singh U.
Published: March 2006

Venous cannulation, although a minor procedure, is often painful. The present study was planned to evaluate the efficacy of a diclofenac transdermal patch placed over the venepuncture site in decreasing the pain of cannulation. Seventy‐two adults undergoing elective surgery were included in this randomised, prospective, double‐blind, placebo‐controlled study. Patients were divided into three equal groups. The Control group had a placebo adhesive patch placed on the both the dorsum of hand and the buttock; the Diclofenac‐Buttock group had a placebo patch placed on the dorsum of the hand and a diclofenac transdermal patch on the buttock; the Diclofenac‐Hand group had a diclofenac transdermal patch placed on the dorsum of hand and a placebo patch on the buttock. The patches were applied 1 h before cannulation. An 18G cannula was used for all venous cannulations. Pain during cannulation was assessed on a non‐graduated 10‐cm visual analogue scale. Median [interquartile range] pain scores were 3.0 [2.0–4.0] in the Diclofenac‐Hand group, 5.0 [4.3–7.8] in the Diclofenac‐Buttock group and 6.5 [4.5–7.0] in the Control group, p < 0.05. The numbers needed to treat were six and two in the Diclofenac‐Buttock and Diclofenac‐Hand groups, respectively. The application of a diclofenac transdermal patch at the cannulation site appears to be effective in decreasing cannulation pain.
A national survey of obstetric anaesthetic handovers*
Authors: Sabir N. , Yentis S. M. , Holdcroft A.
Published: March 2006

The handover of patient information between shifts enables continuity of care and increases patient safety. We surveyed UK practice during handovers in obstetric anaesthesia. A questionnaire was sent to 239 lead consultant obstetric anaesthetists to record routine practice in their unit and individual opinion about handover procedures. Responses were received from 168 anaesthetists, a 70% response rate. Handover policies were available in 10% of units. Most (76%) responding units had an allocated time for handover. In most units (76%), the duration of handover was reported as being < 15 min but the actual duration and depth of any discussion involved were not specified. Handovers were rarely documented in writing (7%). Consultant anaesthetists were most likely to be present at the morning handover and few handovers were multidisciplinary. Four percent of units reported critical incidents following inadequate handovers in the past 12 months. We identify features in handover procedures that could be improved.
Evaluation of a new effect‐site controlled, patient‐maintained sedation system in dental patients*
Authors: Chapman R. M. , Anderson K. , Green J. , Leitch J. A. , Gambhir S. , Kenny G. N. C.
Published: March 2006

We have designed a new effect‐site controlled, patient‐maintained sedation system for delivering propofol. In the previous systems we developed, the patients retained the use of the handset throughout the procedure and were able to increase the level of sedation. However, it was found that this could potentially lead to oversedation. In the present system, the patients were able to increase their level of sedation until a level was reached that was judged by the patients as being adequate to allow them to tolerate the injection of dental local anaesthetic. The handset was then taken from the patients and the effect site concentration of propofol was maintained at that level for the remainder of the procedure. To assess its safety and efficacy, the system was used to sedate 40 patients presenting for dental procedures under sedation. The system was used successfully and treatment was completed in 39 patients. The system was found to be safe. Both surgeon and patient approval scores were high. Although this study demonstrates the efficacy of effect‐site controlled, patient‐maintained propofol sedation in this group of patients, further work is required to confirm its safety.
Chest pain in the early postoperative period after laparoscopic adjustable gastric banding: four case reports
Authors: Tan C. P. , Chia C. H. , Leese T.
Published: March 2006

Laparoscopic adjustable gastric banding (LAGB) is gaining popularity as a technique for achieving effective weight loss in the severely obese population. It is a minimally invasive procedure and the reported early morbidity is low. However, we have observed at our institution that occasional patients complain of central chest pain, mimicking angina (verbal pain score of > 7 out of 10), within 2 h after the procedure. This is a worrying symptom because obesity is known to be a major risk factor for developing cardiovascular complications. We have now performed 250 LAGB operations at our hospital. The following four case reports document our patients who presented with early chest pain postoperatively. Common characteristics of male gender, morbid obesity and some degree of obstructive sleep apnoea were identified among the cases. The aetiology of the chest pain is uncertain; nevertheless, close monitoring is vital to exclude pathological events such as acute coronary syndrome.
Early induction of TGF‐β1 through a fasting–re‐feeding regimen promotes liver carcinogenesis by a sub‐initiating dose of diethylnitrosamine
Authors: Tessitore L. , Bollito E.
Published: March 2006

Abstract.  We previously reported that a subnecrogenic dose (20 mg/kg) of diethylnitrosamine (DENA) can induce the development of liver cancer when rats undergo a fasting–re‐feeding regimen. The present study was undertaken to establish whether fasting followed by re‐feeding builds up mechanisms able to trigger liver fibrosis, eventually leading to cirrhosis and cancer. Adult male rats, for fasted 4 days, were given 20 mg/kg of DENA after 1 day of re‐feeding; in parallel, consistently fed animals receiving 20 mg/kg (subnecrogenic) or 200 mg/kg (necrogenic dose) of DENA were used as negative and positive controls, respectively. All three groups were then subjected to the 2‐acetylaminofluorene/carbon tetrachloride promoting regimen. Fasting induced moderate apoptosis in liver tissue, as evidenced by increased levels of transforming growth factor‐β1 (TGF‐β1) and Bax proteins and by a dramatic drop in the level of Bcl‐2. Subsequent re‐feeding caused all changes to revert except TGF‐β1 up‐regulation. Histological findings of inflammation and fibrosis were consistently associated with increased production of TGF‐β1, the inflammatory cytokine with the most pronounced profibrogenic action. Thus, up‐regulation of TGF‐β1 expression appears as a major mechanism by which the fasting–re‐feeding regimen predisposes to initiation and promotion of liver carcinogenesis in rats. Avoiding fasting–re‐feeding could be considered in the nutritional status of patients with liver fibrosis.
Proliferation and pluripotency potential of ectomesenchymal cells derived from first branchial arch
Authors: Lin Yunfeng , Yan Zhengbin , Liu Lei , Qiao Ju , Jing Wei , Wu Ling , Chen Xizhe , Li Zhiyong , Tang Wei , Zheng Xiaohui , Tian Weidong
Published: March 2006

Abstract.  Cranial neural crest‐derived ectomesenchymal cells are multipotential progenitors that contribute to various tissue types during embryogenesis. Their potential to be expanded in culture as a monolayer and to be induced into different cell lineages in vitro has not been previously reported in detail. In this study, the ectomesenchymal cells in the first branchial arch were enzymatically isolated from the mandibular processes of BALB/c mice and were maintained in an intact state in a medium containing leukaemia inhibitory factor. Here, we first evaluated the proliferative activity of the cells after the third passage, using bromodeoxyuridine labelling and in situ hybridization of telomerase mRNA. Positive staining for expression of HNK‐1, S‐100 and vimentin confirmed that the population of stem cells originated from the ectomesenchyme, which did not express cytokeratin. Then we investigated the molecular and cellular characteristics of the ectomesenchymal cells during their differentiation towards neurogenic, endothelial, myogenic and odontogenic lineages. Expression of multiple lineage‐specific genes and proteins was detected by utilizing a range of molecular and biochemical approaches when the cells were transferred to inductive medium. Histological and immunohistochemical analysis of the induced cells at various intervals indicated obvious phenotypic alteration and presence of specific proteins for the differentiated lineages, for example nestin, factor VIII, α‐SMA and dentin sialophosphoprotein (DSPP), respectively. Correlatively, results of reverse transcription–PCR corroborated at mRNA level the expression of the characteristic molecules during differentiation. Therefore, it is suggested that the ectomesenchymal cells derived from the first branchial arch may represent a novel source of multipotential stem cells capable of undergoing expansion and variant differentiation in vitro.
Not only insulin stimulates mitochondriogenesis in muscle cells, but mitochondria are also essential for insulin‐mediated myogenesis
Authors: Pawlikowska Patrycja , Gajkowska Barbara , Hocquette Jean‐François , Orzechowski Arkadiusz
Published: March 2006

Abstract.  Viability and myogenesis from C2C12 muscle cells and L6 rat myoblasts were dose‐dependently stimulated by insulin. The metabolic inhibitors of phosphatidyl‐inositol‐3‐kinase (PI‐3K, LY294002) and of MAPKK/ERK kinase (MEK, PD98059) differently affected insulin‐stimulated myogenesis of the cells. After LY294002 and PD98059 treatment, viability deteriorated and apparently an additive effect of both metabolic inhibitors was observed, irrespective of the method of measurement (neutral red or MTT assay). These inhibitors were antagonistic in myogenesis. Our results confirm that insulin regulates cell viability by at least two distinct pathways, namely by PI‐3K‐ and MEK‐dependent signalling cascades. Both pathways are agonistic in cell viability, whereas PI‐3K rather than MEK supports insulin‐mediated myogenicity. Accordingly, inhibition of insulin action by LY294002, but not PD98059, was accompanied with a reduced level of Ser473‐phosphorylated Akt with additional loss of myogenin protein. Besides, repression of insulin signalling by either PI‐3K or MEK inhibitor diminished expression of selected subunits of the mitochondrial oxidative phosphorylation enzymes (OXPHOS). In turn, insulin raised and accelerated protein expression of subunits I and IV of mitochondrial cytochrome‐c oxidase (COX). In addition, the level of myogenin, the molecular marker of terminal and general muscle differentiation indices decreased if selected OXPHOS enzymes were individually blocked by rotenone, myxothiazol or oligomycin. Summing up, our results pointed to mitochondria as an essential organelle for insulin‐dependent myogenesis. Insulin positively affects mitochondrial function by induction of OXPHOS enzymes, which provide energy indispensable for the anabolic effect of insulin.