bluuebunny/crossref_metadata_2025 huggingface dataset:
The Results of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children
Authors: LEE PI‐CHANG , HWANG BETAU , CHEN SHIH‐ANN , TAI CHIN G‐TAI , CHEN YI‐JEN , CHIANG CHERN‐EN , MENG C.C. LAURA
Published: May 2007

Backgrounds:

Radiofrequency (RF) catheter ablation represents a major advance in the management of children with cardiac arrhythmias and has rapidly become the standard of care for the first‐ling therapy of supraventricular tachycardias (SVTs). The purpose of this study was to investigate the results of the RF catheter ablation of SVTs in pediatric patients.

Methods:

From December 1989 to August 2005, a total of 228 pediatric patients (age: 9 ± 7 years, range: 5–18 years; male:female = 117:111) with clinically documented SVT underwent an electrophysiologic study and RF catheter ablation at our institution.

Results:

The arrhythmias included atrioventricular reentrant tachycardia (AVRT; n = 140, 61%), atrioventricular nodal reentrant tachycardia (AVNRT; n = 66, 29%), atrial tachycardia (AT; n = 11, 5%), and atrial flutter (AFL; n = 11, 5%). The success rate of the RF catheter ablation was 92% for AVRT, 97% for AVNRT, 82% for AT, and 91% for AFL, respectively. Procedure‐related complications were infrequent (8.7%; major complications: high grade AV block (2/231, 0.9%); minor complications: first degree AV block (6/231, 2.6%), reversible brachial plexus injury (2/231, 0.9%), and local hematomas or bruises (10/231, 4.3%)). The recurrence rate was 4.7% (10/212) during a follow‐up period of 86 ± 38 months (0.5–185 months).

Conclusions:

The RF catheter ablation was a safe and effective method to manage children with paroxysmal and incessant tachycardia. The substrates of the arrhythmias differed between the pediatric and adult patients. However, the success rate of the ablation, complications, and recurrence during childhood were similar to those of adults.
Idiopathic Ventricular Fibrillation Successfully Terminated by Radiofrequency Ablation of the Distal Purkinje Fibers
Authors: KOHSAKA SHUN , RAZAVI MEHDI , MASSUMI ALI
Published: May 2007

A 21‐year‐old woman was admitted for evaluation of recurrent episodes of syncope. She had several spontaneous and abrupt loss of consciousness episodes while at the emergency department, caused by sustained and nonsustained ventricular fibrillation episodes. Each episode was initiated by a certain premature ventricular complex, which remained the same in subsequent ventricular fibrillation episodes. She had a total of eight more episodes of ventricular fibrillation during her admission, despite administration of intravenous antiarrhythmic agents. A diagnosis of idiopathic ventricular fibrillation was made. Radiofrequency catheter ablation was performed, targeting the distal Purkinje system. Ventricular fibrillation was noninducible after the procedure, and the patient has been symptom‐free for the past 1 year.
A Very Narrow Preexisting Isthmus in a Case with Typical Atrial Flutter
Authors: YAMADA TAKUMI , MURAKAMI YOSHIMASA , PLUMB VANCE J. , KAY G. NEAL
Published: May 2007

A 61‐year‐old woman with typical atrial flutter underwent an electrophysiologic study and radiofrequency catheter ablation. The electroanatomic mapping revealed two contiguous lines of distinct double potentials (DPs) extending anteriorly/posteriorly from the coronary sinus ostium to the inferior vena cava (IVC) border. A large part of the anterior line of the DPs was close and parallel to the tricuspid annulus (TA). An initial discrete radiofrequency application at the very narrow preexisting isthmus between the TA and anterior line of the DPs completed the IVC‐TA isthmus conduction block.
“Backdoor” Alternative Approach to Stenting of a Post‐Anastomotic Coronary Artery Lesion via a Chronically Obstructed Right Coronary Artery after Failure to Stent through a Tortuous Free Internal Mammary Graft
Authors: CHAN RICHARD Y.J. , GUNALINGAM BRENDAN
Published: May 2007

We describe the case of a patient who previously had coronary artery bypass grafting including a free right internal mammary artery graft anastomosed to a chronic totally occluded right coronary artery (RCA) proximally and distally and who presented with a high‐risk acute coronary syndrome. Coronary angiography revealed the graft to be patent with a distal post‐anastomotic culprit lesion within the posterolateral branch of the native RCA. Because of technical challenges, PCI could not be performed through the graft and the lesion was stented via the chronically occluded RCA instead, in a “backdoor” approach with a good final result.
Acute Myocardial Infarction Without Disrupted Yellow Plaque in Young Patients Below 50 Years Old
Authors: UEDA YASUNORI , OKADA KATSUKI , OGASAWARA NOBUYUKI , OYABU JOTA , HIRAYAMA ATSUSHI , KODAMA KAZUHISA
Published: May 2007

Objective: Thrombosis caused by disrupted yellow plaque is regarded as a cause of acute myocardial infarction (MI). However, it has not been clarified if young patients have the same pathophysiology as older ones. Therefore, we elucidated clinical and angioscopic characteristics of young patients.

Methods: Among a series of patients (n = 893) who received catheterization for acute MI, clinical characteristics were compared between patients <50 years (n = 66) and the rest of patients. Angioscopic appearance of culprit lesions was evaluated in 20 young patients in whom angioscopic examination was successfully performed. It was determined if culprit lesions had disrupted yellow plaque with thrombus (DYP&T).

Results: Patients <50 years had higher prevalence of smoking (68% vs. 48%, P = 0.001), obesity (42% vs. 15%, P < 0.0001), and hypercholesterolemia (56% vs. 35%, P = 0.0005) than those ≥50 years. DYP&T was detected at culprit lesions in 14 (70%) patients. Prevalence of DYP&T was lower in patients <40 years (44% vs. 91%, P = 0.02) than those between 40 and 50 years. Patients <40 years had a trend for higher prevalence of smoking (88% vs. 62%, P = 0.05) than those between 40 and 50 years.

Conclusions: Patients with acute MI < 50 years, especially <40 years, had lower prevalence of DYP&T but higher prevalence of smoking, obesity, and hypercholesterolemia. Smoking may play an important role for thrombotic occlusion at lesions with relatively low thrombogenic potential.
Semiparametric Regression of Multidimensional Genetic Pathway Data: Least‐Squares Kernel Machines and Linear Mixed Models
Authors: Liu Dawei , Lin Xihong , Ghosh Debashis
Published: May 2007

Summary We consider a semiparametric regression model that relates a normal outcome to covariates and a genetic pathway, where the covariate effects are modeled parametrically and the pathway effect of multiple gene expressions is modeled parametrically or nonparametrically using least‐squares kernel machines (LSKMs). This unified framework allows a flexible function for the joint effect of multiple genes within a pathway by specifying a kernel function and allows for the possibility that each gene expression effect might be nonlinear and the genes within the same pathway are likely to interact with each other in a complicated way. This semiparametric model also makes it possible to test for the overall genetic pathway effect. We show that the LSKM semiparametric regression can be formulated using a linear mixed model. Estimation and inference hence can proceed within the linear mixed model framework using standard mixed model software. Both the regression coefficients of the covariate effects and the LSKM estimator of the genetic pathway effect can be obtained using the best linear unbiased predictor in the corresponding linear mixed model formulation. The smoothing parameter and the kernel parameter can be estimated as variance components using restricted maximum likelihood. A score test is developed to test for the genetic pathway effect. Model/variable selection within the LSKM framework is discussed. The methods are illustrated using a prostate cancer data set and evaluated using simulations.
Refractory Diborides of Zirconium and Hafnium
Authors: Fahrenholtz William G. , Hilmas Gregory E. , Talmy Inna G. , Zaykoski James A.
Published: May 2007

This paper reviews the crystal chemistry, synthesis, densification, microstructure, mechanical properties, and oxidation behavior of zirconium diboride (ZrB2) and hafnium diboride (HfB2) ceramics. The refractory diborides exhibit partial or complete solid solution with other transition metal diborides, which allows compositional tailoring of properties such as thermal expansion coefficient and hardness. Carbothermal reduction is the typical synthesis route, but reactive processes, solution methods, and pre‐ceramic polymers can also be used. Typically, diborides are densified by hot pressing, but recently solid state and liquid phase sintering routes have been developed. Fine‐grained ZrB2 and HfB2 have strengths of a few hundred MPa, which can increase to over 1 GPa with the addition of SiC. Pure diborides exhibit parabolic oxidation kinetics at temperatures below 1100°C, but B2O3 volatility leads to rapid, linear oxidation kinetics above that temperature. The addition of silica scale formers such as SiC or MoSi2 improves the oxidation behavior above 1100°C. Based on their unique combination of properties, ZrB2 and HfB2 ceramics are candidates for use in the extreme environments associated with hypersonic flight, atmospheric re‐entry, and rocket propulsion.
HOXC6 and HOXC11 increase transcription of S100β gene in BrdU‐induced in vitro differentiation of GOTO neuroblastoma cells into Schwannian cells
Authors: Zhang Xiuru , Hamada Jun‐ichi , Nishimoto Arata , Takahashi Yoko , Murai Taichi , Tada Mitsuhiro , Moriuchi Tetsuya
Published: May 2007

HOX genes encode transcription factors that play a key role in morphogenesis and cell differentiation during embryogenesis of animals. Human neuroblastoma cells are known to be chemically induced to differentiate into neuronal or Schwannian cells. In the present study, we investigated the roles of HOX genes in differentiation of GOTO neuroblastoma cells into Schwannian cells.When GOTO cells were grown in the presence of 5‐bromo‐2′‐deoxyuridine (BrdU), they increased the expressions of two HOX genes (HOXC6 and HOXC11) and marker genes for Schwannian cells (S100β and myelin basic protein). Forced expression of HOXC11 alone or both HOXC6 isoform 1 and HOXC11 induced the expression of S100β in GOTO cells. In transient transfection experiments, the overexpression of HOXC6 and HOXC11 transactivated the S100β promoter‐reporter construct. Taken together, our results suggest that HOXC6 and HOXC11 are associated with differentiation of GOTO cells into Schwannian cells through the transcriptional activation of S100β gene.
Structural genomics and drug discovery
Authors: Lundstrom K.
Published: May 2007

Background to drug discovery

Structure determination and drug discovery

Expression systems

Protein purification

Structure determination

Conclusions and future prospects

Structure determination has already proven useful for lead optimization and direct drug design. The number of high‐resolution structures available in public databases today exceeds 30,000 and will definitely aid in structure‐based drug design. Structural genomics approaches covering whole genomes, topologically similar proteins or gene families are great assets for further progress in the development of new drugs. However, membrane proteins representing 70% of current drug targets are poorly characterized structurally. The problems have been related to difficulties in obtaining large amount of recombinant membrane proteins as well as their purification and structure determination. Structural genomics has proven successful in developing new methods in areas from expression to structure determination by studying a large number of target proteins in parallel.
Pathogenesis of colorectal carcinoma and therapeutic implications: the roles of the ubiquitin–proteasome system and Cox‐2
Authors: Voutsadakis Ioannis A.
Published: May 2007

Introduction

APC and the Wnt pathway

K‐ras initiated pathways

The TGF‐β pathway

P53 and its functional regulation and dysregulation in colorectal cancer

The ubiquitin‐proteasome system (UPS)

The ubiquitin‐proteasome system in apoptosis and the cell cycle

Proteasome inhibition in colorectal carcinoma

Cox‐2 in colorectal cancer

Cox‐2 and lipid metabolism in colorectal cancer

Cox‐independent anti‐carcinogenic effects of Cox inhibitors

Combined Cox and proteasome inhibition in colorectal cancer

Pathways of the molecular pathogenesis of colorectal carcinoma have been extensively studied and molecular lesions during the development of the disease have been revealed. High up in the list of colorectal cancer lesions are APC (adenomatous polyposis coli), K‐ras, Smad4 (or DPC4‐deleted in pancreatic cancer 4) and p53 genes. All these molecules are part of important pathways for the regulation of cell proliferation and apoptosis and as a result perturbation of these processes lead to carcinogenesis. The ubiquitin–proteasome system (UPS) is comprised of a multi‐unit cellular protease system that regulates several dozens of cell proteins after their ligation with the protein ubiquitin. Given that among these proteins are regulators of the cell cycle, apoptosis, angiogenesis, adhesion and cell signalling, this system plays a significant role in cell fate and carcinogenesis. UPS inhibition has been found to be a pre‐requisite for apoptosis and is already clinically exploited with the proteasome inhibitor bortezomib in multiple myeloma. Cyclooxygenase‐2 (Cox‐2) is the inducible form of the enzyme that metabolizes the lipid arachidonic acid to prostaglandin H2, the first step of prostaglandins production. This enzyme is up‐regulated in colorectal cancer and in several other cancers. Inhibition of Cox‐2 by aspirin and other non‐steroidal anti‐inflammatory drugs (NSAIDs) has been found to inhibit proliferation of colorectal cancer cells and in epidemiologic studies has been shown to reduce colon polyp formation in genetically predisposed populations and in the general population. NSAIDs have also Cox‐independent anti‐proliferative effects. Targeted therapies, the result of increasingly understanding carcinogenesis in the molecular level, have entered the field of anti‐neoplastic treatment and are used by themselves and in combination with chemotherapy drugs. Combinations of targeted drugs have started also to be investigated. This article reviews the molecular pathogenesis of colorectal cancer, the roles of UPS and Cox‐2 in it and puts forward a rational for their combined inhibition in colorectal cancer treatment.
The Cellular Trafficking of the Secretory Proprotein Convertase PCSK9 and Its Dependence on the LDLR
Authors: Nassoury Nasha , Blasiole Daniel A. , Tebon Oler Angie , Benjannet Suzanne , Hamelin Josée , Poupon Vivianne , McPherson Peter S. , Attie Alan D. , Prat Annik , Seidah Nabil G.
Published: May 2007

Mutations in the proprotein convertase PCSK9 gene are associated with autosomal dominant familial hyper‐ or hypocholesterolemia. These phenotypes are caused by a gain or loss of function of proprotein convertase subtilisin kexin 9 (PCSK9) to elicit the degradation of the low‐density lipoprotein receptor (LDLR) protein. Herein, we asked whether the subcellular localization of wild‐type PCSK9 or mutants of PCSK9 and the LDLR would provide insight into the mechanism of PCSK9‐dependent LDLR degradation. We show that the LDLR is the dominant partner in regulating the cellular trafficking of PCSK9. In cells lacking the LDLR, PCSK9 localized in the endoplasmic reticulum (ER). In cells expressing the LDLR, PCSK9 sorted to post‐ER compartments (i.e. endosomes in cell lines and Golgi apparatus in primary hepatocytes), where it colocalized with the LDLR. In cell lines, PCSK9 also colocalized with the LDLR at the cell surface, requiring the presence of the C‐terminal Cys/His‐rich domain of PCSK9. We provide evidence that PCSK9 promotes the degradation of the LDLR by an endocytic mechanism, as small interfering RNA‐mediated knockdown of the clathrin heavy chain reduced the functional activity of PCSK9. We also compared the subcellular localization of natural mutants of PCSK9 with that of the wild‐type enzyme in human hepatic (HuH7) cells. Whereas the mutants associated with hypercholesterolemia (S127R, F216L and R218S) localized to endosomes/lysosomes, those associated with hypocholesterolemia did not reach this compartment. We conclude that the sorting of PCSK9 to the cell surface and endosomes is required for PCSK9 to fully promote LDLR degradation and that retention in the ER prevents this activity. Mutations that affect this transport can lead to hyper‐ or hypocholesterolemia.
Professional oral health care by dental hygienists reduced respiratory infections in elderly persons requiring nursing care
Authors: Adachi M , Ishihara K , Abe S , Okuda K
Published: May 2007

Abstract:  Objectives: Respiratory infection is a major cause of death in the elderly. We have evaluated the role of professional oral health care (POHC) by dental hygienists in reducing respiratory infections in elderly persons requiring nursing care. Methods: Two populations of elderly persons, one receiving POHC and one not, were examined to determine numbers of microorganisms, potent pathogens of respiratory infection, enzymatic activity in saliva, fevers, prevalence of fatal aspiration pneumonia and prevalence of influenza. Results: In the first population, we found a high prevalence of potent respiratory pathogens such as Staphylococcus species, Pseudomonas aeruginosa and Candida albicans. Patients who received POHC showed a lower prevalence for these pathogens than those who did not. The ratio of fatal aspiration pneumonia in POHC patients was significantly lower than that in patients without POHC (non‐POHC) over a 24‐month period (P < 0.05). The prevalence of a fever of 37.8°C or more in POHC patients was significantly lower than that in the non‐POHC group (P < 0.05). In the second study population, we investigated the effects of POHC on infection with influenza over a 6‐month period. In the POHC group, neuraminidase and trypsin‐like protease activities decreased, and one of 98 patients was diagnosed with influenza; whereas, in the non‐POHC group, nine of 92 patients were diagnosed with influenza. The relative risk of developing influenza while under POHC was 0.1 (95% CI 0.01–0.81, P = 0.008). Conclusion: These results suggest that POHC by dental hygienists is effective in preventing respiratory infections in elderly persons requiring nursing care.
Gene expression waves
Authors: Tsuchyia Masa , Wong Sum T. , Yeo Zhen X. , Colosimo Alfredo , Palumbo Maria C. , Farina Lorenzo , Crescenzi Marco , Mazzola Alessia , Negri Rodolfo , Bianchi Michele M. , Selvarajoo Kumar , Tomita Masaru , Giuliani Alessandro
Published: May 2007

The ergodic hypothesis, which assumes the independence of each cell of the ensemble from all the others, is a necessary prerequisite to attach single cell based explanations to the grand averages taken from population data. This was the prevailing view about the interpretation of cellular biology experiments that typically are performed on colonies of billions of cells. By analysing gene expression data of different cells going from yeast to mammalian cell cultures, we demonstrate that cell cultures display a sort of ‘ecology‐in‐a‐plate’ giving rise to a rich dynamics of gene expression that are independent from reproductive cycles, hence contradicting simple ergodic assumptions The aspecific character of the observed coordinated gene expression activity inhibits any simple mechanistic hypothesis and highlights the need to consider population effects in the interpretation of data coming from cell cultures.
Low Toxicity of Diphenyl Diselenide in Rabbits: A Long‐Term Study
Authors: De Bem Andreza Fabro , Portella Rafael de Lima , Farina Marcelo , Perottoni Juliano , Paixão Márcio Weber , Nogueira Cristina Wayne , Rocha João Batista Teixeira
Published: May 2007

Abstract:  Selenium compounds, like diphenyl diselenide (Ph2Se2), possess glutathione peroxidase (GSHPx)‐like activities and other antioxidant properties. The aim of this study was to evaluate the effects of a long‐term oral supplementation with Ph2Se2 on various toxicological parameters in rabbits. Adult New Zealand male rabbits were divided into four groups: Group I served as control; Groups II, III and IV received 0.3, 3.0 and 30 p.p.m. of Ph2Se2 pulverized in the chow for 8 months. A number of toxicological parameters were examined in liver, kidney, cerebral cortex and hippocampus, such as δ‐aminolaevulinic acid dehydratase (δ‐ALA‐D), catalase (CAT), GSHPx activities, non‐protein thiol (–SH), lipid peroxidation and ascorbic acid levels. The results indicated that supplementation 30 p.p.m. Ph2Se2 significantly increased δ‐ALA‐D activity in liver and in cerebral cortex. Non‐protein –SH levels were significantly increased in liver but not in kidney, cerebral cortex and hippocampus of rabbits. Ascorbic acid content was significantly lower in the liver and cerebral cortex after supplementation with 30 p.p.m. Ph2Se2. Conversely, no alterations in GSHPx and CAT activities, nor in thiobarbituric acid reactive substances levels were observed in rabbit tissues. These results indicate that oral supplementation with Ph2Se2 is relatively secure in rabbits after 8 months of exposure. The findings encourage further experiments on the potential therapeutic effects of such compound.
Protective Effect of Protopine on the Focal Cerebral Ischaemic Injury in Rats
Authors: Xiao Xianghua , Liu Juntian , Hu Jingwen , Li Tianxia , Zhang Yuanhui
Published: May 2007

Abstract:  Protopine, an isoquinoline alkaloidis, is known to produce many effects such as vasodilation, down‐regulation of glutamate levels in brain and decrease of intracellular calcium. However, so far there is no report on the effect of protopine in cerebral ischaemia. In this study, the effect of protopine on the focal cerebral ischaemia was investigated in rats. Male Sprague–Dawley rats were divided into five groups: sham‐operated group, vehicle‐treated group and three doses of protopine‐treated groups (0.98, 1.96 and 3.92 mg/kg). Protopine was intraperitoneally administered to rats once daily for 3 days prior to the ischaemia and 0.9% normal saline to rats in the vehicle‐treated group in the same pattern. Rats in the sham‐operated group were given 0.9% normal saline without the ischaemia. The focal cerebral ischaemia was induced by the middle cerebral artery occlusion for 24 hr via the intraluminal filament technique. The results showed that pre‐treatment with protopine reduced the cerebral infarction ratio and serum lactate dehydrogenase activity, and improved the ischaemia‐induced neurological deficit score and histological changes of brain in a dose‐dependent manner. The further studies demonstrated that protopine increased superoxide dismutase activity in serum, and decreased total calcium and terminal deoxynucleotidyl transferase‐mediated dUTP nick end labelling (TUNEL)‐positive cells in the ischaemic brain tissue in the middle cerebral artery occlusion rats. The results indicate that protopine is able to produce an effective protection on the injury caused by the focal cerebral ischaemia in rats possibly through the multiple effects of calcium antagonism, antioxidation and depression of cell apoptosis.
Penile Rehabilitation After Radical Prostatectomy: Where Do We Stand and Where are We Going?
Authors: Wang Run
Published: May 2007

Introduction

Postprostatectomy erectile dysfunction (ED) remains a serious quality-of-life issue. Recent advances in the understanding of the mechanism of postprostatectomy ED have stimulated great attention toward penile rehabilitation.

Aim

This review presents and analyzes a contemporary series of the recent medical literature pertaining to penile rehabilitation therapy after radical prostatectomy (RP).

Main Outcome Measures

The laboratory and clinical studies related to penile rehabilitation are analyzed. The validity of the methodology and the conclusion of the findings from each study are determined.

Methods

The published and presented reports dealing with penile rehabilitation following RP in human and cavernous nerve injury in animal models are reviewed.

Results

Exciting scientific discoveries have improved our understanding of postprostatectomy ED at the molecular level. The rationale for postprostatectomy penile rehabilitation appears to be logical according to animal studies. However, clinical studies have not consistently replicated the beneficial effects found in the laboratory studies. Currently available clinical studies are flawed due to short-term follow-up, small number of patients in the studies, studies with retrospective nature, or prospective studies without control. Rehabilitation programs are also facing a challenge with the compliance, which is critical for success for any rehabilitation program. At the present time, we do not have concrete evidence to recommend what, when, how long, and how often a particular penile rehabilitative therapy can be used effectively.

Conclusions

Large prospective, multicentered, placebo-controlled trials with adequate follow-up are necessary to determine the cost-effective and therapeutic benefits of particular penile rehabilitative therapy or therapies in patients following the treatment of clinically localized prostate cancer. Until such evidence is available, it is difficult to recommend any particular penile rehabilitation program as a standard of practice.
Heart insufficiency in traumatic arteriovenous fistulas
Authors: Ilijevski Nenad , Otasevic Petar , Milosavljevic Bratislav , Jovovic Ljiljana , Sagic Dragan , Radak Djordje
Published: May 2007

Objective:  To analyse the incidence, clinical presentation, and outcome of heart insufficiency in patients with chronic arteriovenous fistulas (AVF).

Methodology:  From 1991 to 2000 we treated 49 patients with traumatic AVF. The present study included 19 patients with AVF present for 6 months or longer, as it was presumed that these AVF will have an impact on cardiac overload. There were 16 male and three female patients with a mean age of 36 years (17–59). The time from injury to admission varied from 6 months to 33 years. Cardiological examination checked for dyspnoea and palpitation. ECG, chest X‐ray and ECHO‐cardiography were also performed. All AVF were deleted, magistral vessels reconstructed, non‐magistral obliterated, either surgically or by percutaneous embolization.

Results:  Mean follow up was 44.2 months (3–93). Serious heart insufficiency was seen in two patients only, with AVF in the subclavial vessels. Both suffered from serious heart disease prior to the therapeutic procedures that resulted in iatrogenic AVF, so it was difficult to connect heart insufficiency to the AVF alone. Despite surgical closure of AVF and intensive medical treatment, signs of heart insufficiency remained in both patients. Signs of cardiac overload were seen in six patients with long‐standing AVF in major vessels. Except for one patient who refused surgical closure of femoral AVF, the remaining five were symptom free for cardiac overload during the follow‐up period.

Conclusion:  In our series, heart insufficiency was an infrequent complication in long‐standing AVF, even when major vessels were involved.
Obscure traumatic cardiac lesion after a penetrating chest injury: Review of the literature
Authors: Chok Kenneth Siu‐Ho , Tong Daniel King‐Hung , Yuen Wai‐Key , Au Timmy Wing‐Kuk , Cheung David Lik‐Ching
Published: May 2007

We report a young man who sustained a penetrating chest injury after an assault. He was immediately transferred from a regional hospital to Queen Mary Hospital for definitive treatment after initial stabilization. Emergent thoracotomy was done in the operating theatre and primary repair of a cardiac laceration was performed. Postoperative transoesophageal echocardiography showed a large residual ventricular septal laceration with significant left to right intracardiac shunting. He had an open repair in a cardiac surgery centre the next day. A 1.5 cm laceration was found at the ventricular septum and repair was performed. Postoperative transoesophageal echocardiography showed no further ventricular septal defect. He underwent uneventful recovery and was discharged on day 6 postoperation. Follow up at 1 month postoperation did not show any abnormalities and he subsequently defaulted further follow up.
6 PROSPECTIVE SERIES OF ENDO‐ULTRASONOGRAPHY WITH MINIPROBE STAGING FOR EARLY COLORECTAL TUMOUR
Authors: Day W. , Lau P.Y.Y. , Meng W.C.S. , Yip A.W.C.
Published: May 2007

Background:  Endo‐ultrasonography (EUS) with miniprobe ultrasound provides another means of preoperative staging of colorectal tumour. Unlike rigid transrectal ultrasonography, the miniprobe examines the tumour in its natural anatomy without direct contact and compression onto the index tumour. Second, it can reach lesions beyond the rectum. Furthermore, it can serve as a complementary investigation along with our usual colonoscopy.

Aim:  To examine the accuracy of EUS with miniprobe in the staging of early colorectal tumour.

Methods:  Patients’ early sessile colorectal tumours were assessed preoperatively with EUS and miniprobe. The ultrasonographic tumour staging (uTx) of lesions was correlated with pathological staging (pTx).

Results:  Between June 2005 and November 2006, 17 patients with early sessile colorectal lesions were examined. The lesion was located in the rectum in 12 patients. The mean polyp size for uT0 lesion was 2.4 cm and the overall accuracy for uT0 staging was 92%.

Conclusions:  Endo‐ultrasonography with miniprobe is accurate in preoperative T‐staging in early sessile colorectal tumours.
7 PROSPECTIVE STUDY OF QUALITY OF LIFE AMONG HONG KONG CHINESE PATIENTS WITH RECTAL CANCER UNDERGOING CURATIVE LAPAROSCOPIC RESECTION
Authors: Leung W.W. , Ng S.S.M. , Lee J.F.Y.
Published: May 2007

Aim:  This study aimed to evaluate the quality of life (QoL) among Hong Kong Chinese patients with rectal cancer undergoing curative laparoscopic resection.

Methods:  Consecutive patients with rectal cancer undergoing curative laparoscopic resection were recruited into this prospective study. Their QoL was assessed using the validated Chinese version of two specific questionnaires (QLQ‐C30 and QLQ‐CR38) developed by the European Organization for Research and Treatment of Cancer; these were completed before surgery and at 4, 8, and 12 months after surgery. The preoperative and postoperative QoL scores were compared, and potential factors affecting the QoL were analysed.

Results:  Forty‐six patients (32 male) recruited between September 2005 and March 2006 had completed the 8th‐month questionnaires. Longitudinally, there were no significant differences between the preoperative QoL and the QoL at 4 and 8 months after surgery. However, patients who underwent abdominoperineal resection had significantly worse QoL than patients who underwent sphincter‐saving surgery at 4 months (P = 0.012) and 8 months (P = 0.032). Patients who received adjuvant therapy had worse role functioning (P = 0.004) and cognitive functioning (P = 0.031) than patients who had no adjuvant therapy at 4 months onward until 8 months after surgery. Young patients (age < 65) had significantly better postoperative QoL (P = 0.015) and emotional functioning (P = 0.03) than older patients.

Conclusions:  Although there are no major differences between the overall preoperative and postoperative QoL scores among Hong Kong Chinese patients with rectal cancer undergoing curative laparoscopic resection, factors such as old age, abdominoperineal resection, and adjuvant therapy can adversely affect the postoperative QoL.
8 LAPAROSCOPIC REVERSAL OF HARTMANN'S PROCEDURE: REPORT OF AN INITIAL EXPERIENCE
Authors: Wong H.H. , Cheung H.Y.S. , Wong J.C.H. , Yau K.K. , Chung C.C. , Li M.K.W.
Published: May 2007

Background:  Restoration of bowel continuity after Hartmann's procedure is a major surgical undertaking which usually requires a long midline laparotomy. It carries significant morbidities including high risks of wound infection and incisional hernia. For this reason, we would like to review the results of laparoscopic reversal of Hartmann's procedure performed in our department.

Methods:  During the study period we have performed four consecutive cases of laparoscopic reversal of Hartmann's operation. Data regarding demographic and clinical characteristics, surgical details, and postoperative course were recorded prospectively. Operative time, conversion, surgical complications and hospital stay were assessed.

Results:  The median operating time was 90 min and median blood loss was 30 mL. The median time for ambulation was 4 days while that for discharge was 9 days. There was one case of anastomotic bleeding. No conversion and wound‐related complications occurred. No bowel incontinence was noticed postoperatively.

Conclusion:  Laparoscopic reversal of Hartmann's operation is technically feasible and safe. It allows patients with previous Hartmann's operation to enjoy the benefits of minimally invasive surgery.
Foramen of Winslow hernia
Authors: Koh Cherry E. , Woods Simon D.S. , Usatoff Val
Published: May 2007

Foramen of Winslow hernia is a rare surgical condition that is notoriously difficult to diagnose and most patients are diagnosed only at the time of surgery. As such, a high index of suspicion is necessary to avoid potentially life‐threatening complications. The present paper describes two such cases. In the first case, a freely suspending gall bladder herniated into the lesser sac via the foramen of Winslow. This was diagnosed during a scheduled laparoscopic cholecystectomy. In the second case, the caecum herniated into the foramen of Winslow causing small bowel obstruction and ischaemic hepatitis. Diagnostic dilemma and treatment of the condition is also described.
Rapid He ii→He i recombination and radiation arising from this process
Authors: Kholupenko E. E. , Ivanchik A. V. , Varshalovich D. A.
Published: May 2007

Recombination of the primordial helium plasma (He ii → He i, z≃ 1500–3000) is considered. This process has an effect on the cosmic microwave background radiation (CMBR) anisotropy and CMBR spectrum distortion. In this work the influence of neutral hydrogen on the kinetics of He ii → He i recombination is investigated in the framework of the standard cosmological model. It is shown that a small amount of neutral hydrogen (a fraction 10−5–10−2 of the total number of hydrogen ions and atoms) leads to the acceleration of He ii → He i recombination at z≲ 2000, and at z≲ 1600 quasi-equilibrium He ii → He i recombination (according to the Saha formula) becomes valid.
Estimation of Recharge from Floods in Disconnected Stream‐Aquifer Systems
Authors: Vázquez‐Suñé E. , Capino B. , Abarca E. , Carrera J.
Published: May 2007

Stream‐aquifer interaction has been the subject of much research for cases of good hydraulic connection (continuous saturated zone) between a river and an aquifer. Under these conditions, floods do not represent a very large net input to the aquifer because most of the water that enters the aquifer during the flood returns to the river when its stage recedes. The situation is different in disconnected stream‐aquifer systems, where the streambed lies above the water level in the aquifer, thus preventing return flow from the aquifer. Under these conditions, floods may represent large, but hard to quantify, water inputs. Here, we present a methodology to estimate recharge from floods for disconnected stream‐aquifer systems. Recharge is estimated as the product of a flood time function (dependent on the streamflow) and an unknown factor, which is obtained from calibrating a ground water flow model to aquifer heads. The approach can also benefit from concentration data, which can be very informative when river water concentrations vary over time. This methodology is applied to a field situation where recharge from river flooding is found to amount to nearly 15 million m3/year on the average, which represents 40% of the total aquifer inputs. Recharge from flooding helps explain major head recoveries, suggesting that basin water management programs should allow some floods to occur.
Dynamics and Stable Isotope Composition of Gaseous and Dissolved Oxygen
Authors: Wassenaar L. I. , Hendry M. J.
Published: May 2007

The vadose zone and ground water environments are a sink for atmospheric O2. The pathways and rates of O2 consumption are primarily related to the availability and rate of oxidation of key reductants (e.g., organics, sulfides), through a combination of biological or abiotic reactions. The range in δ18O of O2 in the subsurface is large, from +20‰ to +39‰ (Vienna Standard Mean Ocean Water) in the vadose zone and from +12‰ to +46‰ in ground water. The aggregated O2 isotope fractionation by consumption (αk) was found to range from 0.970 to 1.300 and 0.980 to 1.030 in vadose zones and aquifers, respectively. These data suggest the δ18O patterns in both unsaturated zones and aquifers can be attributed to microbially mediated reactions (αk= range from 0.975 to 1.000), but there are apparently other inverse isotope fractionating processes (αk > 1.000). Circumstantial evidence suggested O2 processed during the sulfide oxidation and precipitation of Fe‐oxyhydroxides process (or other unidentified processes) could be the cause of the significant 18O depletions. Overall, δ18O data from vadose zones and ground water revealed that isotope fractionation by consumption of gaseous and dissolved O2 in the subsurface and ground water environments is more complicated than what has classically been attributed solely to geomicrobial respiration. Given the questions and inexplicable data arising from this study, further detailed research on O2 consuming processes in the Earth’s subsurface and ground water is warranted.
Fracture Control of Ground Water Flow and Water Chemistry in a Rock Aquitard
Authors: Eaton Timothy T. , Anderson Mary P. , Bradbury Kenneth R.
Published: May 2007

There are few studies on the hydrogeology of sedimentary rock aquitards although they are important controls in regional ground water flow systems. We formulate and test a three‐dimensional (3D) conceptual model of ground water flow and hydrochemistry in a fractured sedimentary rock aquitard to show that flow dynamics within the aquitard are more complex than previously believed. Similar conceptual models, based on regional observations and recently emerging principles of mechanical stratigraphy in heterogeneous sedimentary rocks, have previously been applied only to aquifers, but we show that they are potentially applicable to aquitards. The major elements of this conceptual model, which is based on detailed information from two sites in the Maquoketa Formation in southeastern Wisconsin, include orders of magnitude contrast between hydraulic diffusivity (K/Ss) of fractured zones and relatively intact aquitard rock matrix, laterally extensive bedding‐plane fracture zones extending over distances of over 10 km, very low vertical hydraulic conductivity of thick shale‐rich intervals of the aquitard, and a vertical hydraulic head profile controlled by a lateral boundary at the aquitard subcrop, where numerous surface water bodies dominate the shallow aquifer system. Results from a 3D numerical flow model based on this conceptual model are consistent with field observations, which did not fit the typical conceptual model of strictly vertical flow through an aquitard. The 3D flow through an aquitard has implications for predicting ground water flow and for planning and protecting water supplies.
Weight Loss Counseling in Primary Care
Authors: RN Elaine Rosenblatt
Published: May 2007

Caring for the overweight client requires a multifaceted approach. The nurse practitioner can help clients lose weight by providing them with strategies for reducing calorie intake, maintaining a healthy, balanced diet, exercising more, and developing positive behavioral and attitudinal changes. Weight reduction programs need to be individualized and clients should be periodically reassessed for changes in behaviors, eating patterns, and goals. Success in weight loss and maintenance requires a lifelong commitment to behavioral and nutritional changes. The goal of this article is to improve the clinician's understanding of the overweight person and to assist health care providers in counseling clients in weight reduction and maintenance.
Synthesis and In Vitro Evaluation of Substituted Phenyl‐Piperazinyl‐Phenyl Oxazolidinones Against Gram‐positive Bacteria
Authors: Liu Jidong , He Baoyuan , Yu Aizhen , Zhou Weicheng
Published: May 2007

With the incidence of linezolid‐resistant Enterococcus faecalis, E. faecium and Staphylococcus aureus, modification of linezolid at the 5‐ and/or 3‐positions led to the development of a series of 3‐(methoxyl‐phenyl)‐piperazinyl‐phenyl oxazolidinone analogues. These compounds were tested in vitro against six gram‐positive standard organisms (S. aureus, S. epidermidis, S. pneumoniae, S. albus, Streptococcus enteridis and S. nonhemolyticus). 5‐acetylaminomethyl oxazolidinones bearing fluorine at 3′‐position of phenyl ring showed activities against several gram‐positive bacteria (MIC: 3.13–6.25 μg/mL). The position of methoxyl group on the phenyl ring of piperazine group affected antibacterial spectrum. 3‐(4′‐ (para‐methoxyl‐phenyl)‐piperazinyl)‐(3′‐fluoro)‐phenyl‐5‐acetylaminomethyl oxazolidinone was found active against 5 gram‐positive organisms except S. nonhemolyticus, whereas 3‐(4′‐(ortho‐methoxyl‐phenyl)‐piperazinyl)‐(3′‐fluoro)‐phenyl‐5‐acetylaminomethyl oxazolidinone was found active only against 2 gram‐positive organisms, namely S. albus, S. enteridis.
Ab Initio Study of Non‐Peptidic Antihypertensives
Authors: Jain Swati , Yadav Arpita
Published: May 2007

In this study, the authors report ab initio molecular orbital calculations on natural hormone angiotensin II (ANG II) that induces activity at AT1 receptor leading to vasoconstriction and subsequent hypertension. Optimized conformations and charge distributions of various conformers of natural hormone and AT1 antagonists have been studied. The major pharmacophoric features have been deduced. The charge environment of ANG II and drugs guided us in exploring the two possibilities: substrate inhibition and competitive inhibition. The results indicate that more potent drugs avoid ‘wastage’ in substrate inhibition and undergo strong competitive antagonism at the receptor. Specific binding interactions are essential for competitive antagonism. Slight differences in conformation may effect to differences in interactions with the receptor, hence modulating the antagonistic properties of the drug.
Uncertainty in Thermal Process Calculations due to Variability in First‐Order and Weibull Kinetic Parameters
Authors: Halder A. , Datta A.K. , Geedipalli S.S.R.
Published: May 2007

ABSTRACT:  Alternatives to first‐order model of death kinetics of microorganisms have been proposed as improvements in the calculation of lethality for a thermal process. Although such models can potentially improve predictions for many situations, this article tries to answer the question of whether the added complexities of these models are a worthwhile investment once we include the effect of uncertainties in various microbiological and process parameters. Monte Carlo technique is used to include variability in kinetic parameters in lethality calculation for a number of heating processes, for both first‐order and Weibull kinetics models. It is shown that uncertainties represented by coefficient of variation in kinetic parameters lead to a wide range of final log‐reduction prediction. With the same percent variability in kinetic parameters, uncertainty in the final log reduction for Weibull kinetics was smaller or equal to that for first‐order kinetics. Due to the large effect of variability in the input parameters on the final log reduction, the effort to move toward more accurate kinetic models needs to be weighed against inclusion of variability.
Effects and Prooxidant Mechanisms of Oxidized α‐Tocopherol on the Oxidative Stability of Soybean Oil
Authors: Kim H.J. , Lee H.O. , Min D.B.
Published: May 2007

ABSTRACT:  α‐Tocopherol was oxidized in methanol containing methylene blue for 30 h under light. The effects of 0, 250, 500, 1000, and 1500 ppm of oxidized α‐tocopherol on the oxidative stability of purified soybean oil in the dark at 55 °C were studied by measuring the peroxide values and headspace oxygen contents in sample bottles. As the concentrations of oxidized α‐tocopherol increased, the peroxide values increased and the headspace oxygen contents decreased during the 6 d of storage. The oxidized α‐tocopherol compounds acted as prooxidant on the peroxide values and headspace oxygen contents of purified soybean oil. Tukey's test showed that oxidized α‐tocopherol had a significant effect on the peroxide value and headspace oxygen disappearance of oil at P < 0.05. The prooxidant mechanisms of oxidized α‐tocopherol may be due to α‐tocopherol peroxy radical, α‐tocopherol oxy radical, hydroxy radical, and singlet oxygen formed from the α‐tocopherol. The oxidized α‐tocopherol containing polar and nonpolar groups in the same molecule may reduce the surface tension of oil to increase the transfer of headspace oxygen to oil and accelerate the oil oxidation.
Rapid and high‐resolution detection of IgH gene rearrangements using PCR and melting curve analysis
Authors: UEMURA A. , MORI S. , SUGAHARA K. , AKAMATSU N. , TSURUDA K. , TSUKASAKI K. , HIRAKATA Y. , ATOGAMI S. , HASEGAWA H. , YAMADA Y. , KAMIHIRA SHIMERU
Published: May 2007

The analytical methods of Southern blot hybridization (SBH) and the polymerase chain reaction (PCR) for complementarity determining region‐3 (CDR3) are fundamental for detecting IgH gene rearrangement. However, there are problems stemming from the characteristics of both methods; especially, the long turn around time (TAT) because of the complex process in the SBH, and the low analytical sensitivity for amplicons in the PCR. Thus, to improve the PCR procedure, we investigated the application of detecting the clonal amplicons based on the different melting Temperature (Tm) in internal melting domains corresponding to the CDR3 hypervariable region. Our new protocol is based on the combination of a LightCycler Technology with high‐speed amplification, and Idaho‐Technology with rapid and high‐resolution melting curve analysis (MCA), designated PCR‐MCA. This method can provide the results within 3 h with an analytical sensitivity of 10−3. The diagnostic sensitivity and specificity relative to the results documented with the SBH analysis were 89.2% and 100%, respectively. This indicates that the new protocol of PCR‐MCA is acceptable for clinical testing; especially, PCR‐MCA is relevant in terms of the rapid and sensitive detection of IgH clonality within amplicons.
EDTA‐dependent lymphoagglutination in a patient with non‐Hodgkin lymphoma
Authors: LESESVE J.‐F. , FEDIUK T. , MERSEILLE J.‐M. , BRAUN F.
Published: May 2007

Lymphoagglutination is a rare EDTA‐dependent phenomenon far less frequent than neutrophil agglutination. It usually involves normal lymphocytes, but has also been reported in lymphoproliferative disorders. We report the case of a woman who developed artifactual agglutination of both normal and lymphoma cells in the context of an unusual primary cutaneous leg type B‐cell non‐Hodgkin's malignancy, raising the potential of misdiagnosis.