bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant transformation of vaginal endometriosis treated with neoadjuvant chemotherapy and surgery
Authors: Fruscio Robert , Padula Francesco , Mancini Emanuela , Pellegrino Antonio , De Nictolis Michele
Published: September 2008

Malignant transformation of extragonadal endometriosis is a described. A 40‐year‐old multiparous woman presented with dyspareunia and dysmenorrhea. Physical examination revealed a 3 × 3.5 cm vaginal nodule. The histological examination of a bioptic sample revealed a moderately differentiated endometrioid adenocarcinoma. The patient was treated with neoadjuvant chemotherapy followed by surgery and is free from disease after 24 months. The frequency of malignant transformation of vaginal endometriosis is unknown. Obesity, hyperestrogenism, and exposure to unopposed estrogen are known risk factors, but were not present in the medical history of the present patient. In our case, preoperative chemotherapy allowed a complete resection without a vaginal demolitive surgery. This therapeutic option may be considered in order to reduce surgical resection and to preserve sexual function. However, because of the rarity of this disease, it is difficult to establish a standard treatment.
Extensive pelvic calcification in association with ovarian serous cystadenofibroma
Authors: Hayes Stephen J. , Misfar Nasira , Slade Richard , Mamtora Hari , Wilson Godfrey
Published: September 2008

We describe the first reported case of extensive calcification seen in association with serous cystadenofibroma of the ovary, illustrating that calcification in the female genital tract may be extensive in nature, presenting in a fashion that is not entirely typical of dystrophic or metastatic calcification. This case demonstrates that extensive calcification within the pelvis should be interpreted with caution, as it may not represent disseminated malignancy.
Primary uterine rhabdomyosarcoma in a patient with a history of breast cancer and gastrointestinal stromal tumor
Authors: Gottwald Leszek , Gora Ewa , Korczynski Jerzy , Piekarski Janusz H. , Morawiec Zbigniew , Jesionek‐Kupnicka Dorota , Sowa Piotr , Cialkowska‐Rysz Aleksandra , Bienkiewicz Andrzej
Published: September 2008

We describe a unique case of a 67‐year‐old patient with primary uterine rhabdomyosarcoma with a history of breast cancer and gastrointestinal stromal tumor of the stomach. Uterine rhabdomyosarcoma was diagnosed in our patient during adjuvant treatment of breast cancer with anastrozole. To the best of our knowledge, the development of primary uterine rhabdomyosarcoma has never been described in patients treated with anastrozole. Due to the suggested causative role of tamoxifen in the development of uterine sarcomas, it is interesting to analyze whether the new drug, anastrozole, exerts any pathogenic effect on the development of uterine sarocomas.
Ovarian large cell neuroendocrine carcinoma
Authors: Tsuji Takahiro , Togami Shinichi , Shintomo Nao , Fukamachi Nobuyuki , Douchi Tsutomu , Taguchi Shuuhei
Published: September 2008

Ovarian large cell neuroendocrine carcinoma (LCNC) is a rare disease that is commonly associated with a surface epithelial and germ cell neoplasm component. A 46‐year‐old woman presented with a pelvic mass measuring 15 cm in diameter. She underwent an exploratory laparotomy with resection of the pelvic mass. Diffuse and nodular intra‐abdominal disseminations were observed. Stage III LCNC associated with squamous differentiation alone of the right ovary was diagnosed. The patient died of progressive disease 4 months postoperatively despite paclitaxel and carboplatin therapy. Ovarian LCNC associated with squamous differentiation component alone has never been reported, but its prognosis may be poor.
Late solitary metastasis of cutaneous malignant melanoma presenting as abnormal uterine bleeding
Authors: Fambrini Massimiliano , Andersson Karin Louise , Buccoliero Anna Maria , Pieralli Annalisa , Livi Lorenzo , Marchionni Mauro
Published: September 2008

We present the case of a 52‐year‐old woman with a history of excised cutaneous malignant melanoma complaining of abnormal uterine bleeding 11 years after initial diagnosis. Hysteroscopic examination showed an endometrial lesion with polypoid shape and endometrial biopsy was suggestive for melanoma. After a complete clinical work‐up ruling out other metastatic sites, the patient underwent total abdominal hysterectomy with bilateral salpingo‐oophorectomy and pelvic lymphadenectomy. Final histopathological and immunohistochemical analysis confirmed the diagnosis of endometrial melanoma with initial myometrial invasion. After a 6‐month follow‐up period, the patient was disease free. Even after many years of negative follow up, gynecologists should be aware of the possibility that abnormal uterine bleeding could represent the clinical expression of metastatic melanoma in order to offer a prompt diagnosis and a personalized strategy of treatment.
Endometrial carcinoma in a patient having 45,X Turner syndrome with gonadal mosaicism
Authors: Park Ji Kwon , Lee Jae Ik , Kim Dong Chul , Jo Hyun cheol , Shin Jeong Kyu , Lee Soon Ae , Lee Jong Hak , Paik Won Young
Published: September 2008

Only three cases of endometrial carcinoma in women with possibly pure 45,X Turner syndrome without previous unopposed estrogen therapy have been reported. A 46‐year‐old single nulligravid woman with Turner syndrome phenotype, spontaneous menstruation, and well‐differentiated adenocarcinoma of the endometrium was diagnosed as having the 45,X karyotype from peripheral blood, skin, buccal cells, and endometrium, which was confirmed using fluorescence in situ hybridization (FISH). Analysis of the ovarian tissue using FISH confirmed 45,X/46,XX mosaicism. Gonadal mosaicism may help to interpret spontaneous menstruation and endometrial carcinoma in possibly pure 45,X Turner syndrome. We conclude that a molecular analysis of lymphocytes and various tissues is necessary for detecting low‐level mosaicism in apparently homogeneous 45,X women.
Primary non‐Hodgkin's lymphoma of the uterus, cervix and parametrium treated by combined immunochemotherapy
Authors: Su Chi‐Feng , Tsai Horng‐Jyh , Kuo Chih , Chen Gin‐Den , Lin Long‐Yau , Huang Che‐Cheng , Luo Kan‐Hung
Published: September 2008

Primary malignant lymphoma of the female genital tract is extremely rare and no standard treatment has been established. The present patient is menopausal with diffuse large B‐cell lymphoma of the uterine body, endocervix and parametrium. She underwent a simple total abdominal hysterectomy and bilateral salpingo‐oophorectomy, followed by treatment with a new regimen, combined immunochemotherapy with rituximab (monoclonal antibody), cyclophosphamide vincristine, and prednisolone. The patient had complete remission in the follow‐up 3 years after this therapy. We suggest this treatment is a useful therapy for a patient with primary malignant lymphoma of the uterine body.
Heterotopic triplet pregnancy (twin tubal) in a natural cycle with tubal rupture: Case report and review of the literature
Authors: Simsek Tayup , Dogan Askın , Simsek Mehmet , Pestereli Elif
Published: September 2008

The incidence of heterotopic/ectopic pregnancy has risen in recent years, largely due to more frequent use of ovulatory medicine and increased incidence of pelvic inflammatory disease. In a natural cycle, it is a very rare event. Most heterotopic/ectopic pregnancies are localized in the uterine tube and, usually, it is diagnosed when symptoms develop. We report the case of a 37 year‐old, gravida 2, para 0, abortion 1 woman with no known risk factors for heterotopic pregnancy. The patient attended the emergency department because of acute abdominal pain. She was evaluated in our department and a heterotopic twin pregnancy in the tube was diagnosed by transvaginal sonography. Intrauterine pregnancy with positive fetal cardiac activity at 9 weeks of gestation according to crown‐rump length measurement was detected. Laparotomy was carried out because of acute abdominal syndrome. Right ruptured tubal ectopic/heterotopic pregnancy and hemoperitoneum were diagnosed. Right salpingectomy was carried out. Pathology revealed monochorionic twin tubal pregnancy. In a review of the literature, this is first case of twin tubal pregnancy in one uterine tube. In conclusion, heterotopic pregnancy in twin form in the uterine tube is possible in natural cycles. Intrauterine pregnancy does not exclude extrauterine pregnancy in natural cycles.
Role of menaquinone biosynthesis genes in selenate reduction by Enterobacter cloacae SLD1a‐1 and Escherichia coli K12
Authors: Ma Jincai , Kobayashi Donald Y. , Yee Nathan
Published: September 2008

In this study, we investigated the role of menaquinone biosynthesis genes in selenate reduction by Enterobacter cloacae SLD1a‐1 and Escherichia coli K12. A mini‐Tn5 transposon mutant of E. cloacae SLD1a‐1, designated as 4E6, was isolated that had lost the ability to reduce Se(VI) to Se(0). Genetic analysis of mutant strain 4E6 showed that the transposon was inserted within a menD gene among a menFDHBCE gene cluster that encodes for proteins required for menaquinone biosynthesis. A group of E. coli K12 strains with single mutations in the menF, menD, menC and menE genes were tested for loss of selenate reduction activity. The results showed that E. coli K12 carrying a deletion of either the menD, menC or menE gene was unable to reduce selenate. Complementation using wild‐type sequences of the E.  cloacae SLD1a‐1 menFDHBCE sequence successfully restored the selenate reduction activity in mutant strain 4E6, and E. coli K12 menD and menE mutants. Selenate reduction activity in 4E6 was also restored by chemical complementation using the menaquinone precursor compound 1,4‐dihydroxy‐2‐nathphoic acid. The results of this work suggest that menaquinones are an important source of electrons for the selenate reductase, and are required for selenate reduction activity in E. cloacae SLD1a‐1 and E. coli K12.
Anaerobic degradation of naphthalene and 2‐methylnaphthalene by strains of marine sulfate‐reducing bacteria
Authors: Musat Florin , Galushko Alexander , Jacob Jacob , Widdel Friedrich , Kube Michael , Reinhardt Richard , Wilkes Heinz , Schink Bernhard , Rabus Ralf
Published: September 2008

The anaerobic biodegradation of naphthalene, an aromatic hydrocarbon in tar and petroleum, has been repeatedly observed in environments but scarcely in pure cultures. To further explore the relationships and physiology of anaerobic naphthalene‐degrading microorganisms, sulfate‐reducing bacteria (SRB) were enriched from a Mediterranean sediment with added naphthalene. Two strains (NaphS3, NaphS6) with oval cells were isolated which showed naphthalene‐dependent sulfate reduction. According to 16S rRNA gene sequences, both strains were Deltaproteobacteria and closely related to each other and to a previously described naphthalene‐degrading sulfate‐reducing strain (NaphS2) from a North Sea habitat. Other close relatives were SRB able to degrade alkylbenzenes, and phylotypes enriched anaerobically with benzene. If in adaptation experiments the three naphthalene‐grown strains were exposed to 2‐methylnaphthalene, this compound was utilized after a pronounced lag phase, indicating that naphthalene did not induce the capacity for 2‐methylnaphthalene degradation. Comparative denaturing gel electrophoresis of cells grown with naphthalene or 2‐methylnaphthalene revealed a striking protein band which was only present upon growth with the latter substrate. Peptide sequences from this band perfectly matched those of a protein predicted from genomic libraries of the strains. Sequence similarity (50% identity) of the predicted protein to the large subunit of the toluene‐activating enzyme (benzylsuccinate synthase) from other anaerobic bacteria indicated that the detected protein is part of an analogous 2‐methylnaphthalene‐activating enzyme. The absence of this protein in naphthalene‐grown cells together with the adaptation experiments as well as isotopic metabolite differentiation upon growth with a mixture of d8‐naphthalene and unlabelled 2‐methylnaphthalene suggest that the marine strains do not metabolize naphthalene by initial methylation via 2‐methylnaphthalene, a previously suggested mechanism. The inability to utilize 1‐naphthol or 2‐naphthol also excludes these compounds as free intermediates. Results leave open the possibility of naphthalene carboxylation, another previously suggested activation mechanism.
Dynamic secondary ion mass spectrometry imaging of microbial populations utilizing 13C‐labelled substrates in pure culture and in soil
Authors: Pumphrey Graham M. , Hanson Buck T. , Chandra Subhash , Madsen Eugene L.
Published: September 2008

We demonstrate that dynamic secondary ion mass spectrometry (SIMS)‐based ion microscopy can provide a means of measuring 13C assimilation into individual bacterial cells grown on 13C‐labelled organic compounds in the laboratory and in field soil. We grew pure cultures of Pseudomonas putida NCIB 9816‐4 in minimal media with known mixtures of 12C‐ and 13C‐glucose and analysed individual cells via SIMS imaging. Individual cells yielded signals of masses 12, 13, 24, 25, 26 and 27 as negative secondary ions indicating the presence of 12C–, 13C–, 24(12C2)–, 25(12C13C)–, 26(12C14N)– and 27(13C14N)– ions respectively. We verified that ratios of signals taken from the same cells only changed minimally during a ∼4.5 min period of primary O2+ beam sputtering by the dynamic SIMS instrument in microscope detection mode. There was a clear relationship between mass 27 and mass 26 signals in Psuedomonas putida cells grown in media containing varying proportions of 12C‐ to 13C‐glucose: a standard curve was generated to predict 13C‐enrichment in unknown samples. We then used two strains of Pseudomonas putida able to grow on either all or only a part of a mixture of 13C‐labelled and unlabelled carbon sources to verify that differential 13C signals measured by SIMS were due to 13C assimilation into cell biomass. Finally, we made three key observations after applying SIMS ion microscopy to soil samples from a field experiment receiving 12C‐ or 13C‐phenol: (i) cells enriched in 13C were heterogeneously distributed among soil populations; (ii) 13C‐labelled cells were detected in soil that was dosed a single time with 13C‐phenol; and (iii) in soil that received 12 doses of 13C‐phenol, 27% of the cells in the total community were more than 90% 13C‐labelled.
The Decision to Persist with Underperforming Alliances: The Role of Trust and Control
Authors: Patzelt Holger , Shepherd Dean A.
Published: September 2008

abstract  We draw on theories of persistence to develop a model of alliance managers' decisions towards persisting in underperforming alliances based on their concomitant consideration of the control and trust in those alliances. We test the model using experimental data based on 2,816 decisions nested within 88 alliance managers. We find that output, behavioural and social control, competence and goodwill trust, and interactions between trust and control variables significantly explain alliance managers' decisions to persist in underperforming alliances. We discuss the implications of these findings for the control, trust and strategic alliance literatures.
Do Foreign Greenfields Outperform Foreign Acquisitions or Vice Versa? An Institutional Perspective
Authors: Slangen Arjen H. L. , Hennart Jean‐François
Published: September 2008

abstract  Prior studies of the comparative performance of greenfields and acquisitions have advanced competing arguments, with some arguing that greenfields should outperform acquisitions because acquisitions are costlier to integrate, and others that acquisitions should outperform greenfields because greenfields suffer from a liability of newness. Moreover, while the costs of integration and the liability of newness are at their greatest during a subsidiary's first years, prior studies have tested their competing arguments on samples containing older subsidiaries. We extend these prior studies by (1) developing an institutional theory‐based framework that simultaneously considers the costs of integration and the liability of newness, (2) recognizing that both types of costs vary with the level of subsidiary integration, and (3) focusing on the stage of their life during which subsidiaries predominantly incur these costs. To measure subsidiary performance, we ask managers of Dutch multinationals how their ex ante performance expectations compare to the subsidiary's ex post performance during its first two years. Analysing a sample of 191 foreign subsidiaries and controlling for entry mode self‐selection and other factors, we find that acquisitions outperform greenfields at low and intermediate levels of subsidiary integration, but that greenfields outperform acquisitions at higher integration levels.
Exaggerating Character Motions Using Sub‐Joint Hierarchy
Authors: Kwon Ji‐yong , Lee In‐Kwon
Published: September 2008

Motion capture cannot generate cartoon‐style animation directly. We emulate the rubber‐like exaggerations common in traditional character animation as a means of converting motion capture data into cartoon‐like movement. We achieve this using trajectory‐based motion exaggeration while allowing the violation of link‐length constraints. We extend this technique to obtain smooth, rubber‐like motion by dividing the original links into shorter sub‐links and computing the positions of joints using Bézier curve interpolation and a mass‐spring simulation. This method is fast enough to be used in real time.
CHASING SHADOWS? PERFORMANCE MEASUREMENT OF POLICY ADVICE IN NEW ZEALAND GOVERNMENT DEPARTMENTS
Authors: GREGORY ROBERT , LONTI ZSUZSANNA
Published: September 2008

Performance measurement is an integral part of the New Zealand model of public management, as it is for many other modern systems of governmental administration. This article examines data on performance indicators for the policy advice function in five government departments, for the years 1992 to 2005, to determine which types of indicators are used, and to gauge the extent to which they offer meaningful information about the quality of policy advice. As part of its managerialist drive in the early 1990s, the government developed conceptual material designed to improve policy advice and management in departments. In general, our findings indicate that these initiatives did not lead over time to the further development of genuinely meaningful measures of the quality of policy advice, and that the indicators that have been used meet narrow managerial rather than broader political needs.
ORCHESTRATING EMERGENT CHANGE: THE ‘HOSPITALIST MOVEMENT’ IN US HEALTHCARE
Authors: WALLACE MIKE , SCHNELLER EUGENE
Published: September 2008

The metaphor of ‘orchestration’ is applied to an emergent change whereby developing different versions of a resource to solve local problems with managing hospitalized patient care in the USA became conceived as a nationwide innovation. A pluralistic framework incorporates Abbott’s conception of a system of professions, a cultural and political perspective on interaction and the notion of ‘orchestration’ which is distinguished from leadership and management. Small‐scale research in diverse settings shows how key stakeholders including academic medical researchers orchestrated the coalescence of disparate practices into a unified movement, although working in a relatively decentralized healthcare system featuring a complex mix of public, private and voluntary sectors. Sufficient confluence between diverse interests was nurtured for widespread acceptance of a new ‘hospitalist’ role coordinating inpatient treatment. It is suggested that the metaphor of orchestration may have wider potential as a heuristic for understanding emergent change that becomes more complex as it spreads.
LOOKING DIFFERENT, ACTING DIFFERENT: STRUGGLES FOR EQUALITY WITHIN THE SOUTH AFRICAN POLICE SERVICE
Authors: MARKS MONIQUE
Published: September 2008

This descriptive paper tells the story of the daily difficulties that members of the Public Order Police (POP) unit in South Africa experienced in their attempts to create a more diverse (in terms of race and gender) and representative police organization. This story is told through recordings of observations and conversations that span a 4‐year ethnographic journal. The paper demonstrates that despite affirmative action and equity legislation and programmes, Durban POP by the year 2001, six years after the transformation process within the unit began, was still plagued by deep racial and gender divisions. These divisions were reinforced by the structural make‐up of the unit and the inability of middle management to challenge entrenched practices, as well as deep‐seated assumptions, schemas and values associated with race, ethnicity and gender. By means of a ethnographic journal I was able to discover some of the daily dilemmas of the police in their change efforts and also the difficulties of getting police practice to meet new policy agendas.
OBSERVATION, THE POLICE AND PUBLIC ADMINISTRATION: INTRODUCTION
Authors: FLEMING JENNY
Published: September 2008

This conversation about the merits of ethnography in police studies began at the ‘Ethnography in Policing’ panel at the Political Studies Association Conference held in Leeds in 2005. Subsequent correspondence and occasional one‐to‐one meetings led to this symposium.
PERFECT VICTIMS, PERFECT POLICING? IMPROVING RAPE COMPLAINANTS’ EXPERIENCES OF POLICE INVESTIGATIONS
Authors: JORDAN JAN
Published: September 2008

Despite recent reforms internationally, significant criticism has been levelled at police departments regarding their service delivery to crime victims, and particularly for the disbelieving and insensitive attitudes officers may display towards women reporting rape and sexual assault. Police responses are frequently influenced by negative judgements regarding the victim’s dress, behaviour, and demeanour. These are flawed and ‘imperfect’ women – what right have they to expect ‘perfect’ treatment? This paper approaches this issue from the other end of the lens by considering the positive lessons to be learned from how ‘perfect victims’ were policed.

The material presented is based on interviews conducted with 14 of the women attacked by the same serial rapist, supplemented by interviews with police investigators. The paper aims to identify what contributed most to victim satisfaction with police performance, and to present this as evidence of ‘best practice’ to inform future developments in adult sexual assault investigations.
Multilevel Modelling of Refusal and Non-Contact in Household Surveys: Evidence From Six UK Government Surveys
Authors: Durrant Gabriele B. , Steele Fiona
Published: September 2008

We analyse household unit non-response in six major UK Government surveys by using a multilevel multinomial modelling approach. The models are guided by current conceptual frameworks and theories of survey participation. One key feature of the analysis is the investigation of the extent to which effects of household characteristics are survey specific. The analysis is based on the 2001 UK Census Link Study, which is a unique source of data containing an unusually rich set of auxiliary variables. The study contains the response outcome of six surveys, linked to census data and interviewer observations for both respondents and non-respondents.
Friendship Ties and Geographical Mobility: Evidence from Great Britain
Authors: Belot Michèle , Ermisch John
Published: September 2008

A common finding in analyses of geographic mobility is a strong association between past movement and current mobility. We argue that one of the driving forces behind this pattern is the strength of local social ties outside the household. We use data from the British Household Panel Survey on the location of the three closest friends and the frequency of meetings with them. We estimate the processes of friendship formation and residential mobility jointly, allowing for correlation between the two processes. Our results show that a larger number of close friends living nearby substantially reduces movement of 20 miles or more.
LIQUIDATION OF A LARGE BLOCK OF STOCK WITH REGIME SWITCHING
Authors: Pemy Moustapha , Zhang Qing , Yin G. George
Published: September 2008

In the literature, stock‐selling rules are mainly concerned with liquidation of the security within a short period of time. In practice, this is feasible only when a relatively smaller number of shares of a stock is involved. Selling a large position in a market place normally depresses the market if sold in a short period of time, which would result in poor filling prices. Comparing to the existing results in the literature, this work has two distinct features. First, the underlying stock price is modeled using a geometric Brownian motion formulation with regime switching in which the jump rate depends on the selling intensity. A larger selling intensity makes the regime more likely to change from a higher return mode to a lower one or forces the return mode to stay in the lower one longer. Secondly, we consider the liquidation strategy for selling a large block of stock by selling much smaller number of shares over a longer period of time. By using a fluid model, in which the number of shares is treated as fluid (continuous), we treat the selling rule problem where the corresponding liquidation is dictated by the rate of selling over time. Our objective is to maximize the expected overall return. Thus it may be formulated as a stochastic control problem with state constraints. Method viscosity solution is used to characterize the dynamics governing the optimal reward function and the associated boundary conditions. Numerical examples are reported to illustrate the results.
School Vouchers and the New Politics of the Welfare State
Authors: KLITGAARD MICHAEL BAGGESEN
Published: September 2008

School vouchers might seem a natural feature of the liberal welfare model of the U.S. and American society generally. However, for social democratic welfare states in Scandinavia, school vouchers would seem to be a contradiction. Nevertheless, school vouchers have faced severe resistance in the USA, and the program has so far not been adopted as a national educational reform, although sporadic and limited state‐level developments can be observed. In Sweden, however, the social democratic welfare state adopted a national, universal public voucher scheme in the early 1990s. The goal of this article is to explain this counter‐theoretical empirical puzzle. It is argued that the varying output from political processes on school vouchers in the USA and Sweden is to be explained by the different ways in which political institutions affect political decision making in the two countries.
Public Provision for Urban Water: Getting Prices and Governance Right
Authors: ARARAL, JR EDUARDO
Published: September 2008

Public sector monopolies are often associated with inefficiencies and inability to meet rising demand. Scholars attribute this to fundamental problems associated with public provision: (1) a tradition of below‐cost pricing due to populist pressures, (2) owner–regulator conflicts of interest, and (3) perverse organizational incentives arising from non‐credible threat of bankruptcy, weak competition, rigidities, and agency and performance measurement problems. Many governments worldwide have shifted to private provision, but recent experience in urban water utilities in developing countries has shown their limitations because of weak regulatory regimes compounded by inherent problems of information, incentives, and commitment. This article examines the paradoxical case of the Phnom Penh Water Supply in Cambodia to illustrate how public provision of urban water can be substantially improved by getting prices and governance right. Findings have implications for the search for solutions to provide one billion people worldwide with better access to potable water.
Ripples Not Waves: A Policy Configuration Approach to Reform in the Wake of the 1998 Sydney Water Crisis
Authors: MCCONNELL ALLAN
Published: September 2008

The aim of this article is to understand why, in the aftermath of the 1998 Sydney water contamination crisis, policy and institutional reform was comparatively minor—despite intense scrutiny and criticism of the framework of water policy in New South Wales (NSW). The article should be of serious interest to scholars interested in crisis and policy change, rather than simply those with a particular interest in water policy in Australia. It frames the Sydney case as a disconfirming one but finds that an understanding of the stability/change relationship in NSW water policy can only partially be understood through applying key contemporary institutional, actor, and interest‐centered explanations. Therefore, it probes the plausibility of an additional explanation and develops the rudiments of a new “policy configuration” approach to help explain policy stability and change. It concludes by suggesting that there is potential for a policy configuration perspective to be tested against other cases.
Policy Entrepreneurship, Policy Opportunism, and EU Conditionality: The AKP and TÜSİAD Experience in Turkey
Authors: UGUR MEHMET , YANKAYA DILEK
Published: September 2008

This article examines the relationship between European Union (EU) conditionality for membership and policy entrepreneurship in a candidate country. In Turkey, EU conditionality opened a window of opportunity for policy reform by lowering the political costs of controversial reforms. The study demonstrates that the Justice and Development Party (AKP) and the Turkish Industrialists' and Businessmen's Association (TÜSİAD) responded to a window of opportunity by advocating a series of reforms that represented a bold challenge to the traditionally reform‐averse and Euro‐skeptic political culture in Turkey. The study finds a difference in the duration of both actors' commitment to reforms. To explain this difference, we distinguish between policy entrepreneurs, who are actors with a long time horizon, and policy opportunists, who are actors with a short time horizon. The policy implication of this finding is that the European Commission's expectations of the AKP government to deliver the necessary reforms may be too optimistic.
Do We Need a ‘Naughty Step’? Rethinking the Parenting Order After Ten Years
Authors: BURNEY ELIZABETH , GELSTHORPE LORAINE
Published: September 2008

Abstract: This article takes a critical look at the ideology and functioning of the parenting order, tracing its political and legislative history and reasons for its geographically varied and largely limited use. It questions the need for mandated parental training which is, anyway, unlikely to prevent offending by children aged over ten years.
The uncertain future of human security in the UN
Authors: Owen Taylor
Published: September 2008

Since its original articulation in the 1994 Human Development Report, the concept of human security has been widely used to understand and address post‐Cold War threats to international peace and security. However, a review of policy documents using the concept in the United Nations (UN) system finds that human security is at risk of disappearing from the organisational landscape. I argue that this is a result of three interrelated problems with the way human security has been used–the failure to distinguish clearly between the concept and practice of human development and of human security, a lack of differentiation between human rights and human security and a lack of attention to the perils of conceptual overstretch. Two possible solutions are discussed. First, a narrow definition of human security as freedom from organised violence is reviewed and critiqued. Second, a threshold‐based conceptualisation of threats to human security is defined and used to address the three problems with the use of human security in the UN system. The chapter concludes that the narrow definition of human security is unnecessarily restrictive, leaving out too many relevant threats, and that the UN system is uniquely positioned to actualise a broad threshold‐based conceptualisation.
Oral isotretinoin in photoaging: clinical and histopathological evidence of efficacy of an off‐label indication
Authors: Rabello‐Fonseca RM , Azulay DR , Luiz RR , Mandarim‐de‐Lacerda CA , Cuzzi T , Manela‐Azulay M
Published: September 2008

Background  Despite evidences of the beneficial clinical effects of oral isotretinoin in the treatment of cutaneous photoaging, scientific evidences are still scarce, mainly supported by histopathological and morphometric studies.

Objectives  To analyse possible clinical and morphological changes resulting from the treatment of photoaging with oral isotretinoin.

Methods  Thirty female patients, aged 40 to 55 years, phototypes II to IV, with moderate to severe photoaging were randomly assigned to two groups of 15 each. Group I (G I) patients were treated with 10 mg of isotretinoin and group II (G II) with 20 mg of oral isotretinoin thrice a week for 3 months. Skin biopsies were performed before and after the end of therapy, and the various sections were submitted to specific staining for collagen and elastic fibres. To analyse the changes, morphometric studies were performed, and the results obtained were analysed by Student's t‐test (paired and non‐paired). Clinical results of therapy regarding texture, colouring and aspect of the wrinkles were assessed by both physician and patient.

Results  The increase in the amount of collagen fibres was statistically significant with both dosage regimens (mean, 37.8%, increasing to 44.4%; P = 0.029 with the 10‐mg dosage; and mean, 36.6%, increasing to 41.9%; P = 0.01 with the 20‐mg dosage). A pattern pointing toward a decrease in the number of elastic fibres was found (mean, 15.3–12%; P = 0.014 with the 10‐mg dosage; mean, 15.5–14%; P = 0.125 with the 20‐mg dosage). Additionally, there was improvement in the general aspect of the skin, regarding texture, wrinkles depth and skin coloration.

Limitations  Despite ethical considerations, a lack of a control group using placebo may render the results less accurate.

Conclusion  Low dosages of oral isotretinoin seem to be an effective therapeutic option for cutaneous photoaging.

Conflicts of interest

None declared
Extracellular matrix protein SC1/hevin in the hippocampus following pilocarpine‐induced status epilepticus
Authors: Lively Starlee , Brown Ian R.
Published: September 2008

Pilocarpine‐induced status epilepticus (SE) mimics many features of temporal lobe epilepsy and is a useful model to study neural changes that result from prolonged seizure activity. In this study, distribution of the anti‐adhesive extracellular matrix protein SC1 was examined in the rat hippocampus following SE. Western blotting showed decreased levels of SC1 protein in the week following SE. Immunohistochemistry demonstrated that the decrease in overall SC1 protein levels was reflected by a reduction of SC1 signal in granule cells of the dentate gyrus. Interestingly, levels of SC1 protein in neurons of the seizure‐resistant CA2 sector of the hippocampus did not change throughout the seizure time course. However, at 1 day post‐SE, a subset of neurons of the hippocampal CA1, CA3, and hilar regions, which are noted for extensive neuronal degeneration after SE, exhibited a transient increase in SC1 signal. Neurons exhibiting enhanced SC1 signal were not detected at 7 days post‐SE. The cellular stress response was also examined. A prominent induction of heat‐shock protein (Hsp70) and Hsp27 was detected following SE, while levels of constitutively expressed Hsp40, Hsp90, Hsp110, and Hsc70 showed little change at the time points examined. The subset of neurons that demonstrated a transient increase in SC1 colocalized with the cellular stress marker Hsp70, the degeneration marker Fluoro‐Jade B, and the neuron activity marker activity‐regulated cytoskeleton‐associated protein (Arc). Taken together, these findings suggest that SC1 may be a component of the ‘matrix response’ involved in remodeling events associated with neuronal degeneration following neural injury.
New pharmacological strategies against metastatic spread
Authors: Perret G.Y. , Crépin M.
Published: September 2008

Although metastatic spread is the most frequent cause of death in cancer patients, there are very few drugs specifically targeting this process. Bases for a new antimetastatic drug discovery strategy are weak because a great number of unknowns characterize the complete understanding of the metastatic cascade mechanisms. Moreover, the current experimental models are too simplistic and do not account for the complexity of the phenomenon. Some targets have been identified but too few are validated. Among them, the metastasis suppressor genes seem to be the most promising. In spite of this, during recent years, a dozen of molecules, which fulfil the definition of a specific metastatic drug that inhibits the metastases without altering the growth of the primary tumour (which can be eradicated by surgery), have been identified and assessed for the proof of the concept. The continuation of this effort would benefit in terms of efficiency, if the objectives were defined more precisely. It is particularly important to distinguish molecules that prevent spread of the metastatic cells of the early‐stage primary tumour from the ones which induce a regression of the established metastases or to inhibit the transition from disseminated occult tumour cells to dormant micrometastasis. This second goal is a priori more relevant in the current clinical setting where the detection of early metastatic spread is very difficult, and therefore would call for greater effort on the part of the scientific community.
Relaxing and contracting effects of theophylline’s metabolites on the rabbit upper gastrointestinal tract
Authors: Psarra Theophano A. , Batzias Georgios C. , Peeters Theo L. , Koutsoviti‐Papadopoulou Maria
Published: September 2008

The present study, aimed to clarify whether the gastrointestinal adverse effects following administration of the bronchodilator theophylline are owing to the action of the drug itself or its metabolites, investigates the pharmacodymanic effects of theophylline’s metabolites on the spontaneous contractility in the rabbit upper gastrointestinal tract. Comparative examination reveals that while two of the metabolites, namely 1‐methylxanthine (1‐MX) and 3‐methylxanthine (3‐MX), cause a similar, but less pronounced than the parent drug, concentration‐dependent relaxation on the isolated oesophagus, lower oesophageal sphincter (LOS), fundus, antrum and pylorus, the remaining two metabolites, 1,3‐dimethyluric acid (1,3‐DMU) and 1‐methyluric acid (1‐MU), produce either a weak stimulating effect, or an even weaker relaxation. The relaxation which is muscle‐mediated, non‐adrenergic non‐cholinergic (NANC) and nitric oxide (NO)‐independent is probably mediated via inhibition of the metabolites on phosphodiesterases (PDEs), while a presynaptic cholinergic pathway is involved in the weak stimulating effect. The effects of all substances are additive. As a consequence, the net result of the cumulative action of all metabolites in the oesophagus, LOS, antrum and pylorus is, at 10−3 m, comparable with that of theophylline, but in the fundus it is lower than that of the parent drug, because in the latter tissue the stimulating effect of 1,3‐DMU and 1‐MU counteracts the relaxing effect of the other two metabolites. However, combination of the parent drug with its metabolites leads to a considerable relaxation in all the gastrointestinal regions extending from the oesophagus to pylorus. Conclusively, upper gastrointestinal adverse effects following theophylline’s administration are also because of theophylline’s metabolites.
Investigation of the anti‐inflammatory and analgesic effects from an extract ofAplysina caissara, a marine sponge
Authors: Azevedo Luciana Gutterres , Peraza Gianni Goulart , Lerner Clea , Soares Andrea , Murcia Nícolas , Muccillo‐Baisch Ana Luiza
Published: September 2008

A variety of biologically active compounds with pharmacological applications has been reported to occur in marine sponges. The present study was undertaken to provide a set of data about an extract fromAplysina caissara, a Brazilian marine sponge. The antinociceptive and anti‐inflammatory effects were investigated against different experimental models in mice. When evaluated against writhing test intraperitoneally (60 and 90 mg/kg), the extract significantly inhibited abdominal constriction by 33.7% and 41.4% respectively. In the formalin test (60 and 90 mg/kg), the extract of sponge inhibited 43.6% and 51.6% in the first phase and 98.2% and 97.2% in the second phase respectively. When evaluated against the hot plate test, both doses demonstrated activity. An increase in the hot plate latency was observed after 60 min. The anti‐inflammatory effect was evaluated by formalin‐induced mice paw edema. Extract fromA. caissara(60 and 90 mg/kg) significantly reduced hind paw swelling. Mortality increased with increasing doses, with LD50of 212.2 mg/kg for intraperitoneal administration. These results demonstrated that the extract of the marine spongeA. caissarapossesses antinociceptive and anti‐edematogenic effects.
A potent and selective inhibitor of endocannabinoid uptake, UCM707, potentiates antinociception induced by cholestasis
Authors: Hasanein Parisa , Javanmardi Kazem
Published: September 2008

Cholestasis is associated with changes including analgesia. The endocannabinoid system can reduce pain sensitivity. Considering the interaction between the endogenous opioid and endocannabinoid systems in nociception processing, we studied the effect of UCM707 as a potent and selective inhibitor of endocannabinoid uptake on modulation of nociception in a model of elevated endogenous opioid tone, cholestasis. Cholestasis was induced in male Sprague–Dawley rats by ligation of the main bile duct using two ligatures and transecting the duct at the midpoint between them. Seven days later, tail‐flick latencies were measured 10 min after injection of UCM707 (0.1, 1 and 10 mg/kg, i.p.) alone or with co‐administration of a CB1receptor antagonist, AM251 (1 mg/kg, i.p.), with UCM707 (10 mg/kg, i.p.) in experimental groups. A significant increase (P < 0.01) in tail‐flick latency was observed in cholestatic rats compared with rats belonging to unoperated and sham groups. Administration of UCM707 (1 and 10 mg/kg) to cholestatic animals significantly increased tail‐flick latency compared with the vehicle‐treated cholestatic group (P < 0.05 andP < 0.001, respectively). UCM707 injection in unoperated and sham groups did not alter baseline tail‐flick latency compared with vehicle‐treated groups. The effect of UCM707 in the cholestatic group was blocked by co‐administration of AM251 (1 mg/kg, i.p.) with UCM707. These data showed that the endocannabinoid system is involved in nociception processing during cholestasis and that the effects of UCM707 on the pain threshold in cholestatic rats may be a result of CB1receptor activation by the increased extracellular levels of endocannabinoids.
Which parameters differ in very old patients with chronic atrial fibrillation treated by anticoagulant or aspirin?
Authors: Doucet Jean , Gréboval‐Furstenfeld Emmanuelle , Tavildari Alain , M’bello Luc , Delaunay Olympe , Pesqué Thierry , Moirot P. , Mouton‐Schleifer Dominique
Published: September 2008

The objective was to determine the main parameters taken into account for the decision of antithrombotic treatment of atrial fibrillation (AF) by vitamin K antagonist or aspirin. This was a prospective clinical study of four clinical services of geriatric medicine. Two hundred and nine inpatients, 84.7 ± 7 years (women 60.8%), with chronic AF were included. The patients were distributed into two groups (anticoagulant or aspirin) according to medical decision. All the decision criteria for treatment were recorded: cardiopathy, conditions of life, clinical examination (nutrition and autonomy, mini‐mental state examination (MMSE), walking evaluation, comorbidity), subjective evaluation of risk of falls and glomerular filtration rate. The thromboembolic risk and the bleeding risk, evaluated subjectively for each patient, were compared with two scores of thrombo‐embolic risk and bleeding risk. The evolution of the patients was recorded after 3 months. Student’s t‐test and chi‐squared tests were used for statistical analysis. One hundred and two patients (48.8%) received anticoagulant and 107 patients received aspirin. Patients in the aspirin group were significantly older (86.5 ± 6.5 vs. 82.9 ± 7.1 years), with more frequent social isolation, higher systolic blood pressure, and had more important subjective bleeding risk and risk of falls. Patients in the anticoagulant group had significantly more valvulopathies and a more important subjective thromboembolic risk. Thrombo‐phlebitis antecedents, dementia, denutrition and walking alterations were only slightly more frequent in patients in the aspirin group. Physicians underestimated thromboembolic risk (one‐third of patients) and they overestimated bleeding risk (half of the patients). After 3 months, the two groups did not significantly differ for death, bleeding or ischaemic events. In common practice, the decision of antithrombotic treatment for AF should take into account not only cardiovascular but also geriatric criteria.
Differential effects of neuromuscular blockers on twitches and tetani in the isolated rat muscle: a multiple comparison study using simultaneous confidence intervals
Authors: Ching L.H. , Serra C.S.M. , Nascimento D.C. , De Oliveira M.J. , Oliveira A.C.
Published: September 2008

In the present work a comparative quantitative evaluation of the differential effects of neuromuscular blockers on twitches and tetani was performed, encompassing: atracurium, cisatracurium, mivacurium, pancuronium, rocuronium and vecuronium. The sciatic nerve‐extensor digitorum longus muscle of the rat was used, in vitro. Twitches were evoked at 0.1 Hz and tetani at 50 Hz. The differential effects of the studied compounds on twitches and tetani were statistically compared using simultaneous confidence intervals for the ratios between mean IC50for the block of twitches and mean IC50for the block of tetani. The results of ratios of mean IC50together with their corresponding 95% simultaneous confidence intervals were: vecuronium: 2.5 (1.8–3.5); mivacurium: 3.8 (3.0–4.9); pancuronium: 3.9 (2.0–7.6); rocuronium: 6.1 (3.8–9.9); atracurium: 9.0 (6.4–12.6); cisatracurium: 13.1 (6.0–28.4). Using the criteria that neuromuscular blockers displaying disjunct confidence intervals for the ratios of mean IC50differ statistically with regard to differential effects on twitches and tetani, significant differences in ratios of IC50were detected in the following cases: vecuronium vs. rocuronium, vs. atracurium and vs. cisatracurium and mivacurium vs: cisatracurium and vs. atracurium. The results show that the magnitude of the differential effects of neuromuscular blockers on twitches and tetani, as evaluated in the present work in the form of ratios of mean IC50, does not depend on the chemical structure (comparing steroidal and isoquinolinic compounds), but seems to depend on differential pre‐ and post‐synaptic effects of the compounds. It is also suggested that the greater the ability of a compound to block twitches and tetani in a differential manner, the safer is the compound from the clinical anesthesiology viewpoint.