bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapamycin inhibits lung metastasis of B16 melanoma cells through down‐regulating alphav integrin expression and up‐regulating apoptosis signaling
Authors: Yang Zhuoshun , Lei Zhang , Li Bo , Zhou Yu , Zhang Gui‐Mei , Feng Zuo‐Hua , Zhang Biao , Shen Guan‐Xin , Huang Bo
Published: October 2009

Currently available data indicate the potential application of rapamycin and its analogues in the clinic as anticancer therapeutic agents through inhibiting tumor cell growth and tumor angiogenesis. However, whether rapamycin can directly suppress tumor metastasis remains unclear. In the present study, we demonstrated that rapamycin treatment results in reduced formation of metastatic nodules in the lung by B16 cells. This is due to two mechanisms. First, the expression of αv integrin is down‐regulated by rapamycin treatment, and subsequently, the phosphorylation of focal adhesion kinase (FAK) is reduced. Second, rapamycin promotes apoptosis by up‐regulating the proapoptotic molecules Bid and Bax and down‐regulating Bcl‐xL. Blocking the apoptosis pathway by pan‐caspase inhibitor zVAD partially reversed the suppression of rapamycin in B16 metastasis. Interestingly, rapamycin up‐regulates Bax and Bid in B16 cells via the S6K1 pathway and down‐regulates the expression of αv integrin via other pathway(s). In addition, our data showed that autophagy was not involved in the mechanisms of rapamycin‐mediated metastasis suppression. Our findings demonstrate a potential anti‐metastatic effect of rapamycin via down‐regulating αv integrin expression and up‐regulating apoptosis signaling, suggesting that rapamycin might be worthy of clinical evaluation as an antimetastatic agent. (Cancer Sci 2009)
An assessment of the validity of SOFA score based triage in H1N1 critically ill patients during an influenza pandemic
Authors: Khan Z. , Hulme J. , Sherwood N.
Published: October 2009

Sequential Organ Failure Assessment (SOFA) score based triage of influenza A H1N1 critically ill patients has been proposed for surge capacity management as a guide for clinical decision making. We conducted a retrospective records review and SOFA scoring of critically ill patients with influenza A H1N1 in a mixed medical‐surgical intensive care unit in an urban hospital. Eight critically ill patients with influenza A H1N1 were admitted to the intensive care unit. Their mean (range) age was 39 (26–52) years with a length of stay of 11 (3–17) days. All patients met SOFA score based triage admission criteria with a modal SOFA score of five. Five patients required invasive ventilation for a mean (range) of 5 (4–11) days. Five patients would have been considered for withdrawal of treatment using SOFA scoring guidelines at 48 h. All patients survived. We conclude that SOFA score based triage could lead to withdrawal of life support in critically ill patients who could survive with an acceptably low length of stay in the intensive care unit.
Risk of pulmonary aspiration with laryngeal mask airway and tracheal tube: analysis on 65 712 procedures with positive pressure ventilation
Authors: Bernardini A. , Natalini G.
Published: October 2009

We compared the risk of pulmonary aspiration in patients whose lungs were mechanically ventilated through a laryngeal mask airway (35 630 procedures) or tracheal tube (30 082 procedures). Three cases of pulmonary aspiration occurred with the laryngeal mask airway and seven with the tracheal tube. There were no deaths related to pulmonary aspiration. The incidence and outcome of pulmonary aspiration detected in this study were similar to those previously reported. The adjusted odds ratio (OR) for pulmonary aspiration with the laryngeal mask airway was 1.06 (95% CI 0.20–5.62). Unplanned surgery (OR 30.5, 95% CI 8.6–108.9) and male sex (OR 8.6, 95% CI 1.1–68) were associated with an increased risk of aspiration and age < 14 years with a reduced risk (OR 0.21, 95% CI 0.07–0.64). There were contraindications and exclusions to the use of the laryngeal mask airway but in this selected population the use of an laryngeal mask airway was not associated with an increased risk of pulmonary aspiration compared with a tracheal tube.
Ontogeny of haematopoiesis: recent advances and open questions
Authors: Ottersbach Katrin , Smith Aileen , Wood Andrew , Göttgens Berthold
Published: October 2009

Unravelling the embryonic origins of the haematopoietic system has been the subject of sustained research for more than a century. Nevertheless, many important questions are still either unanswered or remain a matter of intense debate. Recent progress in mouse and embryonic stem cell model systems as well as imaging and post‐genomic technologies has provided new insights into many of these open questions. Here we place into context recent reports on the anatomical site of blood stem cell emergence and, using red blood cells as an example, illustrate how the development of stem cells and the other blood lineages is both temporally and spatially decoupled. In addition, we outline how embryonic stem cell assays are increasingly used as a powerful surrogate for studying lineage relationships and developmental potential of early embryonic blood progenitors. Finally, we review how recent progress in the reconstruction of transcriptional regulatory networks is beginning to define the connectivity between key regulators that control early blood development. In light of these rapid recent advances, research into the embryonic origins of the haematopoietic system should remain one of the most vibrant disciplines within the wider field of haematology for the foreseeable future.
Do antineutrophil cytoplasmic antibodies (ANCA) play a key role in neutrophilic dermatoses? A case of propylthiouracil-induced neutrophilic dermatosis with positive perinuclear ANCA
Authors: Darné S. , Natarajan S. , Blasdale C.
Published: October 2009

We report a case of neutrophilic dermatosis caused by propylthiouracil (PTU), with positive perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). PTU is well known to cause vasculitis associated with positive ANCA titres, and this typically occurs late in the treatment (after months to years). PTU rarely causes neutrophilic dermatoses (three case reports). In the three cases described, ANCA was positive at the outset. Our patient’s initial ANCA testing was negative and her positive p-ANCA evolved. This may be because PTU binds to myeloperoxidase (MPO) inside neutrophils, altering its configuration and thus causing antibody formation to this abnormal MPO–PTU configuration, which would not be detected by standard laboratory techniques. ANCA has been implicated in spreading neutrophil activation and thus its pathogenic effect and clinical significance may extend beyond the realm of vasculitis alone.
Generalized eruptive lentiginosis induced by chemotherapy
Authors: De D. , Dogra S. , Kanwar A. J. , Saikia U. N.
Published: October 2009

Lentigines are characterized by brown macules developing due to increased proliferation of melanocytes in the dermoepidermal junction. Many drugs, including immunosuppressants and immunomodulators, have been shown to cause generalized lentiginosis. We describe a case of lentiginosis induced by cancer chemotherapy, an extremely rare occurrence.
Combined effects of ocean acidification and solar UV radiation on photosynthesis, growth, pigmentation and calcification of the coralline alga Corallina sessilis (Rhodophyta)
Authors: GAO KUNSHAN , ZHENG YANGQIAO
Published: October 2009

Previous studies have shown that increasing atmospheric CO2 concentrations affect calcification in some planktonic and macroalgal calcifiers due to the changed carbonate chemistry of seawater. However, little is known regarding how calcifying algae respond to solar UV radiation (UVR, UVA+UVB, 280–400 nm). UVR may act synergistically, antagonistically or independently with ocean acidification (high CO2/low pH of seawater) to affect their calcification processes. We cultured the articulated coralline alga Corallina sessilis Yendo at 380 ppmv (low) and 1000 ppmv (high) CO2 levels while exposing the alga to solar radiation treatments with or without UVR. The presence of UVR inhibited the growth, photosynthetic O2 evolution and calcification rates by13%, 6% and 3% in the low and by 47%, 20% and 8% in the high CO2 concentrations, respectively, reflecting a synergistic effect of CO2 enrichment with UVR. UVR induced significant decline of pH in the CO2‐enriched cultures. The contents of key photosynthetic pigments, chlorophyll a and phycobiliproteins decreased, while UV‐absorptivity increased under the high pCO2/low pH condition. Nevertheless, UV‐induced inhibition of photosynthesis increased when the ratio of particulate inorganic carbon/particulate organic carbon decreased under the influence of CO2‐acidified seawater, suggesting that the calcified layer played a UV‐protective role. Both UVA and UVB negatively impacted photosynthesis and calcification, but the inhibition caused by UVB was about 2.5–2.6 times that caused by UVA. The results imply that coralline algae suffer from more damage caused by UVB as they calcify less and less with progressing ocean acidification.
Role of the aquatic pathway in the carbon and greenhouse gas budgets of a peatland catchment
Authors: DINSMORE KERRY J. , BILLETT MICHAEL F. , SKIBA UTE M. , REES ROBERT M. , DREWER JULIA , HELFTER CAROLE
Published: October 2009

Peatland streams have repeatedly been shown to be highly supersaturated in both CO2 and CH4 with respect to the atmosphere, and in combination with dissolved (DOC) and particulate organic carbon (POC) represent a potentially important pathway for catchment greenhouse gas (GHG) and carbon (C) losses. The aim of this study was to create a complete C and GHG (CO2, CH4, N2O) budget for Auchencorth Moss, an ombrotrophic peatland in southern Scotland, by combining flux tower, static chamber and aquatic flux measurements from 2 consecutive years. The sink/source strength of the catchment in terms of both C and GHGs was compared to assess the relative importance of the aquatic pathway. During the study period (2007–2008) the catchment functioned as a net sink for GHGs (352 g CO2‐Eq m−2 yr−1) and C (69.5 g C m−2 yr−1). The greatest flux in both the GHG and C budget was net ecosystem exchange (NEE). Terrestrial emissions of CH4 and N2O combined returned only 4% of CO2 equivalents captured by NEE to the atmosphere, whereas evasion of GHGs from the stream surface returned 12%. DOC represented a loss of 24% of NEE C uptake, which if processed and evaded downstream, outside of the catchment, may lead to a significant underestimation of the actual catchment‐derived GHG losses. The budgets clearly show the importance of aquatic fluxes at Auchencorth Moss and highlight the need to consider both the C and GHG budgets simultaneously.
BmHrp28 is a RNA‐binding protein that binds to the female‐specific exon 4 of Bombyx mori dsx pre‐mRNA
Authors: Wang Z. , Zhao M. , Li D. , Zha X. , Xia Q. , Xiang Z. , He N.
Published: October 2009

The Bombyx mori sex determination gene Bmdsx is alternatively spliced in the male and female to produce the male‐ and female‐specific proteins. In an effort to better understand the mechanism of the alternative splicing regulation of Bmdsx, we conducted a gel‐shift assay followed by LC‐MS/MS analysis to identify the putative proteins bound to the cis‐element CE1+6 in the exon 4 of Bmdsx. A protein named as BmHrp28 which is homologous to the Drosophila Hrp48, a member of the hnRNPA/B family, was identified and expressed in Escherichia coli for testing RNA‐protein binding in vitro. All of the results showed that BmHrp28 specifically bound to the CE1+6 RNA probe. BmHrp28 has two RNA recognition motifs at the N‐terminal and a glycine‐rich motif at the C‐terminal. It might be one of the factors involved in the male‐specific splicing of Bmdsx.
Eight years of entomological surveillance in Italy show no evidence ofCulicoides imicolageographical range expansion
Authors: Conte A. , Gilbert M. , Goffredo M.
Published: October 2009

1.Assessing changes in species range is based on identifying new occurrences in areas where absence has been inferred due to lack of previous records. This technique depends on creating a consistent observational dataset, based on comparable detection methods.

2.In Mediterranean countries, the midgeCulicoides imicolais the principal vector of bluetongue virus (BTV) that causes an infectious disease of domestic and wild ruminants. Over the last 10 years, BTV has invaded Mediterranean countries (1998) and much of Northern Europe (2006); this unprecedented spread is reported to be a possible consequence of climate change. In southern Europe, based on recent observations found in northern latitudes, BTV spread has been attributed in part to changes inC. imicoladistribution. However, current sampling ofCulicoidesspp. is far more intensive and targeted than that undertaken before the first BTV epidemics; this obviously results in new information from areas in which collections would have had little chance of positive identification in the past.

3.Since 2001, a national surveillance programme based on permanent traps was established in Italy to followC. imicolapopulation dynamics in space and time. Based on data from 2000 to 2001 cross‐sectional studies, Italy was divided into three zones (I: endemicity; II: transition; III: absence) in which longitudinal data onC. imicolapresence and abundance were analysed as a function of time between 2002 and 2007 through linear and quantile regressions.

4.The results from the surveillance programme demonstrate no detectable range expansion of theC. imicolapopulation in Italy between 2002 and 2007.

5.Synthesis and applications. This study provides strong evidence that there has been no measurable range expansion between 2002 and 2007 in a species previously described as moving northwards as a result of climate change. For any reliable conclusions to be drawn on the range distribution ofC. imicolaor other similar vector species in Southern Europe,theCulicoidessurveillance system across all European countries should be designed to provide comparable data based on a constant detection probability over time.
Role of genetic testing in arrhythmogenic right ventricular cardiomyopathy/dysplasia
Authors: Barahona‐Dussault C , Benito B , Campuzano O , Iglesias A , Leung TL , Robb L , Talajic M , Brugada R
Published: October 2009

Barahona‐Dussault C, Benito B, Campuzano O, Iglesias A, Leung TL, Robb L, Talajic M, Brugada R. Role of genetic testing in arrhythmogenic right ventricular cardiomyopathy/dysplasia.

In a cohort of patients with confirmed or suspected arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), genetic testing is useful in confirming the diagnosis, particularly in individuals who do not completely fulfil Task Force criteria for the disease, thereby also enabling the adoption of preventive measures in family members. Due to the high percentage of novel mutations that are expected to be identified in ARVC/D, the use of genetic screening technology based on the identification of known mutations seems to have very restricted value. Our results support that the presence of certain genetic variations could play a role in the final phenotype of patients with ARVC/D, where single and compound mutation carriers would have more symptomatic forms of the disease and the polymorphism P366L could be associated to a more benign phenotype.
Multiple spinal ganglioneuromas in a patient harboring a pathogenic NF1 mutation
Authors: Bacci C , Sestini R , Ammannati F , Bianchini E , Palladino T , Carella M , Melchionda S , Zelante L , Papi L
Published: October 2009

Bacci C, Sestini R, Ammannati F, Bianchini E, Palladino T, Carella M, Melchionda S, Zelante L, Papi L. Multiple spinal ganglioneuromas in a patient harboring a pathogenic NF1 mutation.

Ganglioneuroma is a rare benign tumor originating from autonomic ganglia and is considered the benign counterpart of neuroblastoma. Ganglioneuromas may be present as an isolated finding and, rarely, in association with neurofibromatosis type 1 (NF1). However, ganglioneuromas of the cervical spine with intradural extension and multiple locations are extremely rare. We describe a 32‐year‐old woman with multiple ganglioneuromas of the cervical, dorsal and lumbar spine associated with a few café‐au‐lait spots and subcutaneous nodules. The patient lacked other NF1 stigmata, such as freckling, Lisch nodules and cutaneous neurofibromas. Although our patient did not fulfill the NF1 diagnostic criteria, molecular diagnosis revealed a pathogenic mutation in the NF1 gene. Approximately 30 patients affected by NF1 and ganglioneuromas have been reported: in all these individuals, NF1 diagnosis was made according to the clinical diagnostic criteria and no patients have molecular diagnosis. Therefore, this is the first case with multiple spinal ganglioneuromas associated with a pathogenic NF1 mutation.
Functional and anatomic assessments for transobturator vaginal tape inside‐out operation for urodynamic stress incontinence
Authors: Huang Wen‐Chu , Su Tsung‐Hsien , Lin Tzu‐Yin , Hsieh Ching‐Hung , Chen Shwu‐Shiuang , Lee Mei‐Yu
Published: October 2009

Aim:  The aim of the present study was to assess by urodynamic study and chain urethrocystography the functional and anatomic changes before and after transobturator vaginal tape inside‐out (TVT‐O) operation.

Methods:  From January 2005 to February 2006, 35 women were enrolled who had urodynamic stress incontinence, with or without intrinsic sphincter deficiency, and had undergone TVT‐O with regular follow‐up. Investigations, including pelvic examination, pad test, urodynamic study, chain urethrocystography and questionnaire with short forms of Urogenital Distress Inventory and Incontinence Impact Questionnaire, were performed pre‐ and postoperatively.

Results:  The mean follow‐up period was 12.8 months. The subjective and objective cure rates were 80 and 71.4%, respectively. The maximal urethral pressure was significantly decreased (from 67.0 to 58.9 cmH2O) after surgery and bladder neck mobility was reduced. Quality of life assessment revealed significant improvement after TVT‐O.

Conclusion:  TVT‐O is an effective operation for female urodynamic stress incontinence. Improved postoperative bladder neck mobility showed anatomic correction, indicating a hammock effect. The decreased maximal urethral pressure may reflect neurogenic damage during surgery; thus, minimal dissection and avoidance of unnecessary dissection to prevent periurethral damage are advised.
Primary chemotherapy patterns for ovarian cancer treatment in Japan
Authors: Shirai Takako , Imanaka Yuichi , Sekimoto Miho , Ishizaki Tatsuro ,   QIP Ovarian Cancer Expert Group
Published: October 2009

Aims:  Evidence‐based clinical practices can improve patient outcomes, especially in the area of chemotherapy. In Japan, it is not known how well physicians adhere to evidence‐based chemotherapy guidelines. This study aimed to assess physician compliance with national guidelines for ovarian cancer primary chemotherapy in Japan.

Methods:  Using an administrative database, we analyzed 209 cases of surgical laparotomy without neoadjuvant chemotherapy as the primary intervention for adnexal cancer. Cases were identified across seven teaching hospitals between 2003 and 2006.

Results:  Of the 136 patients receiving inpatient chemotherapy, 101 cases (74%) were treated with platinum–taxane therapy. In five hospitals, platinum–taxane therapy was used in more than 75% of patients, compared to 56% and 32% in the other two hospitals, respectively. The proportion of patients receiving paclitaxel and carboplatin concomitant therapy (TC therapy) was 67%, although significant variation was noted between hospitals (range 32% to 94%, P < 0.001). Of the 91 patients receiving TC therapy, 59 (65%) were given full‐dose monthly regimens, while 32 cases (35%) were treated with divided doses weekly. Weekly TC therapy was more frequently provided in hospitals with a low volume of patients receiving TC therapy. Patients under the age of 65 receiving inpatient chemotherapy were more likely to receive full‐dose regimens than patients 65 or older (68% vs 43%, P = 0.005). Publication of national treatment guidelines did not appear to substantially impact chemotherapy practice patterns.

Conclusions:  Adherence to standardized chemotherapy was comparable to rates in European countries, although rates among hospitals differed significantly. Elderly patients were more likely to receive divided‐dose regimens.
Transvaginal cystocele correction: Midterm results with a transobturator tension‐free technique using a combined bovine pericardium/polypropylene mesh
Authors: Araco Francesco , Gravante Gianpiero , Overton John , Araco Placido , Dati Stefano
Published: October 2009

Aims:  To describe the benefits and complications of a combined bovine/pericardium polypropylene mesh for severe vaginal wall prolapse at midterm follow up.

Methods:  Retrospective analysis of patients with stages 3 and 4 pelvic prolapse undergoing cystocele repair using the combined mesh.

Results:  Between June 2004 and April 2006 36 patients were treated. The median follow up was 35 months. Two patients experienced de novo urgency (5.6%). Resolution of prolapse was achieved in 91.7% of patients. Ten percent of those with urinary incontinence continued to suffer from incontinence after surgery. There was a significant improvement in the quality of life in cases with associated urinary incontinence, and in the sexual lives and constipation of all patients. Two cases of vaginal perforation (5.6%) and three cases of vaginal erosion (8.3%) were described.

Conclusions:  The use of a composite bovine pericardium/polypropylene mesh for cystocele correction is feasible and safe, yielding good results at midterm follow up.
Free peritoneal cyst with histologic properties of amniotic epithelium observed in a woman pregnant with twins
Authors: Horikoshi Tsuguhiro , Kikuchi Akihiko , Ono Kyoko , Kita Mariko , Takagi Kimiyo , Ogiso Yoshifumi
Published: October 2009

We report an interesting case of a free peritoneal cyst in a woman pregnant with twins. As far as we know, a cyst with histologic properties similar to the metaplastic stratified squamous epithelium of the amnion has not been reported. A 20‐year‐old Japanese woman pregnant with twins underwent cesarean section at 29 weeks of gestation. A simple serous cyst 5 cm in diameter was found at excavatio vesicouterina. The cyst was not attached to the surrounding organs, and was located independent of any other tissues in the patient's abdominal cavity. Histologic examination revealed that the cyst wall was composed of three major layers (epithelium, mesenchyme and mesothelium) with no vessels. Immunohistochemical staining with human chorionic gonadotropin (HCG), cytokeratins, vimentin, placental alkaline phosphatase (PAP) and cluster of differentiation (CD) 31, showed that the cyst wall had characteristic features of the amniotic membrane. Alleles of the patient's husband were not identified when the cyst was genotyped. Some of the patient's loci were deleted and others showed a structurally heterogeneous pattern. These findings suggest that the cyst was derived not from the ovum parthenogenesis, but from the patient's somatic cells and could have been incubated by ascites.
Increased interaction between heat shock protein 27 and mitogen‐activated protein kinase (p38 and extracellular signal‐regulated kinase) in pre‐eclamptic placentas
Authors: Shin Jeong‐Kyu , Jeong Young‐Taek , Jo Hyun‐Cheol , Kang Min‐Young , Chang In‐Suk , Baek Jong‐Chul , Park Ji‐Kwon , Lee Soon‐Ae , Lee Jong‐Hak , Choi Wan‐Sung , Paik Won‐Young
Published: October 2009

Aims:  Heat shock protein 27 (Hsp27) is a well‐known stress response protein that is characterized by its phosphorylative capacity. Hsp27 becomes phosphorylated in response to various stimuli through interaction with several different kinases. The purpose of this study was to evaluate the interaction between Hsp27 and mitogen‐activated protein kinase (MAPK) (p38, extracellular signal‐regulated kinase [ERK], and c‐Jun N‐terminal kinase) in the human placenta derived from patients with pre‐eclampsia.

Methods:  Western blot analysis was used to examine the levels of expression of Hsp27 and MAPK (p38, ERK, and c‐Jun N‐terminal kinase). Immunoprecipitation analysis was used to determine the interaction between Hsp27 and MAPK (p38 and ERK).

Results:  Western blotting analysis and immunohistochemistry showed that the expression of Hsp27 and p‐Hsp27 in the placental tissues of the pre‐eclampsia group were significantly higher than that in the normal pregnancy group. Immunoprecipitation analysis showed that the interaction between Hsp27 and MAPK (p38 and ERK) was significantly increased in the pre‐eclamptic placenta tissues.

Conclusion:  The interaction between Hsp27 and MAPK was increased, suggesting that phosphorylation of Hsp27 might be induced by p38 and ERK in placentas from patients with pre‐eclampsia.
Extranodal Rosai–Dorfman disease involving bilateral ovaries in a patient with a ventriculoperitoneal shunt
Authors: Yamaguchi Masayuki , Yahata Tetsuro , Fujita Kazuyuki , Sakurada Junko , Hasegawa Go , Umezu Hajime , Naito Makoto , Tanaka Kenichi
Published: October 2009

Rosai–Dorfman disease (RDD) is a rare condition of unknown etiology, and female genital tract involvement in RDD is uncommon. We describe the first case of RDD with bilateral ovarian involvement in a patient implanted with a ventriculoperitoneal (VP) shunt. The patient was a 17‐year‐old Japanese woman who had undergone radiotherapy, surgery for extranodal RDD involving the brain, and VP shunt insertion at age 12. Bilateral pelvic masses were incidentally detected on a computed tomography scan. She underwent laparotomy for lesion extirpation. On abdominal washing cytology, histiocytes showing emperipolesis were identified. Bilateral salpingo‐oophorectomy was performed instead of extirpation, as it was difficult to identify the lesion margins. At 24 months after surgery, the patient is well and has not developed local recurrence. Thus, RDD can recur because of implantation of lesion cells into the abdominal cavity through a VP shunt, as is observed in the case of cerebral neoplasms.
Does breastfeeding induce spontaneous abortion?
Authors: Ishii Hiroshige
Published: October 2009

Aim:  To verify the hypothesis that even if breastfeeding is continued during pregnancy, there are no harmful effects on pregnancy.

Methods:  The outcomes of pregnancies in mothers who continued breastfeeding during pregnancy were studied. One hundred and ten pregnant women were recruited who had one full‐term baby, no experience of premature birth or abortion, and who continued to breastfeed at diagnosis of pregnancy. Age and pregnancy history matched 774 pregnant women were selected as a control group. All of the control women stopped breastfeeding at least 3 months before becoming pregnant. We reviewed the outcome of each pregnancy retrospectively from patient records. Statistical analysis was conducted using the χ2 test.

Results:  Eight of 110 pregnancies (7.3%) resulted in spontaneous abortion in the breastfeeding group, and 65 of 774 pregnancies (8.4%) in the control group. There were no statistically significant differences between the two groups (P > 0.05).

Conclusion:  Even if the mother is pregnant, breastfeeding should be continued until natural weaning occurs. Further study is required to conclude safety of breastfeeding and premature birth.
Oncostatin M as a target biological molecule of preeclampsia
Authors: Lee Guisera , Kil Gichul , Kwon Jiyoung , Kim Sajin , Yoo Jinyoug , Shin Jongchul
Published: October 2009

Aim:  Given the presence of the cytokinetic effects of Oncostatin M (OSM), we hypothesized that placental expression of OSM and serum OSM levels are elevated in preeclampsia. To verify this hypothesis, we determined the expression of OSM in placenta and levels of OSM in plasma form women with preeclampsia and normal pregnant women.

Methods:  Sixteen women with severe preeclampsia and 16 normal pregnancy women were studied. Placental tissues were immediately frozen and stored at −80°C until extraction of total RNA. Total RNA was extracted and real‐time quantitative PCR was carried out. Placental tissues fixed in 4% paraformaldehyde were reacted with antibodies against OSM. An independent pathologist who was blind to the origins of the samples reviewed these stained slides. The maternal serum and umbilical venous concentration of OSM were determined by commercially available ELISA analysis.

Results:  The mRNA expression level of OSM in preeclamptic placenta was increased by 3.91 times which was significantly higher than those of the normal group (P = 0.028). OSM immunoreactivity was significantly higher in placentas of patients with preeclampsia than placentas from the normal group. The significantly greater OSM expressions were noted in cytotrophoblasts, syncytotrophoblasts and endothelium of preeclamptic placentas as compared to normal placentas (respectively, P = 0.004, 0.001 and 0.04). OSM concentration of preeclamptic women's serum was significantly higher than that of normal women's plasma (P = 0.016). However, OSM level of umbilical venous serum was not significantly different between two groups (P = 0.243)

Conclusion:  OSM may play a biological marker for severe preeclampsia, and its action may be predominantly on the trophoblasts and endothelium of placenta villi in preeclampsia.
An acute pain service improves postoperative pain management for children undergoing selective dorsal rhizotomy
Authors: FRIGON CHANTAL , LOETWIRIYAKUL WITTHAYA , RANGER MANON , OTIS ANNIK
Published: October 2009

Background:  A continuous epidural infusion of morphine is the pain treatment modality for children undergoing selective dorsal rhizotomy (SDR) in our institution. The aim of the study was to evaluate the impact of having an organized acute pain service (APS) on postoperative pain management of these children.

Methods:  We conducted a retrospective cohort study using anesthetic records and the APS database to compare the postoperative pain management of children undergoing SDR before and after the introduction of the APS at the Montreal Children’s Hospital in April 2001. Ninety‐two consecutive children who had their surgery between January 1997 and July 2006 were included. We collected data regarding postoperative pain, opioid‐induced side effects, complications (sedation, desaturations < 92%), and hospital length of stay.

Results:  Pain scores were documented more frequently after the implementation of the APS (61% vs 48.5%). Sedation scores were documented only after the implementation of the APS. Postoperative desaturation was significantly more frequent in the pre‐APS group compared to the APS group (45.5% vs 6.8%, P < 0.001). Despite the fact that the epidural catheter was in place for the same duration for both groups [median of 3 days (3–3 25–75%ile)], the duration of hospitalization was 1 day shorter in the APS group compared to the pre‐APS group [median of 5 (5–5 25–75%ile) vs 6 (5–6 25–75%ile) days, P < 0.001].

Conclusions:  Although we recognize that it is possible that there were changes in care not related specifically to the introduction of a dedicated APS that occurred in our institution that resulted in improvements in general postoperative care and in length of stay, our study did show that having an organized APS allowed to significantly decrease the incidence of postoperative oxygen desaturation and to decrease the hospital length of stay by 1 day.
Longevity and fecundity of Eulophus pennicornis, an ectoparasitoid of the tomato moth Lacanobia oleracea, is affected by nutritional state and diet quality
Authors: Wakefield Maureen E. , Bell Howard A. , Gatehouse Angharad M. R.
Published: October 2009

Adult female Eulophus pennicornis require a source of nutrition, provided by sources such as pollen, nectar and honeydew or by host feeding, to promote longevity and facilitate egg production. There is potential for parasitoids to be exposed directly to contaminants, including gene products in transgenic crops, through feeding on plant materials, honeydew or hosts. Among such potential contaminants are lectins such as Galanthus nivalis agglutinin (GNA) and concanavalin agglutinin (Con A).

The effect of direct exposure to honey diets containing GNA and Con A on the longevity and fecundity of E. pennicornis was examined. These lectins have been expressed in a number of plant species for the control for various insect pests. Both GNA and Con A significantly reduced longevity and fecundity at the highest concentration used (0.5% w/v). The effect on fecundity was shown to be related to a reduction in longevity.

Examination of the gustatory response of adult female E. pennicornis to honey diet containing 1% w/v GNA or Con A revealed no significant differences in consumption rate on first exposure. A significant reduction in the time spent feeding on diet containing 1% Con A was found on the second exposure to the diet. This could have been the result of either a conditioned aversion response or the intoxication of the insect. The effect of Con A on longevity and fecundity could have been, in part, a result of reduced food intake.

Studies on nutrition and egg resorption demonstrated that the availability of honey solution prolongs the longevity of E. pennicornis and the lack of a source of nutrition promotes oosorption.

A greater understanding of feeding behaviour and ovigeny is required to understand fully the potential ecological consequence of transgenic crops on parasitoid species through routes of direct exposure to transgene products.
Erythroneura lawsoniabundance and feeding injury levels are influenced by foliar nutrient status in intensively managed American sycamore
Authors: Coyle David Robert , Aubrey Doug Patrick , Bentz Jo‐Ann
Published: October 2009

Abundance and feeding injury of the leafhopperErythroneura lawsoniRobinson was measured in an intensively‐managed American sycamorePlatanus occidentalisL. plantation. Trees were planted in spring 2000 in a randomized complete block design, and received one of three annual treatments: (i) fertilization (120 kg N/ha/year); (ii) irrigation (3.0 cm/week); (iii) fertilization + irrigation; or (iv) control (no treatment).

Foliar nutrient concentrations were significantly influenced by the treatments because only sulphur and manganese levels were not statistically greater in trees receiving fertilization.

Over 116 000E. lawsoniwere captured on sticky traps during the study. Leafhopper abundance was highest on nonfertilized trees for the majority of the season, and was positively correlated with foliar nutrient concentrations. Significant temporal variation inE. lawsoniabundance occurred, suggesting five discrete generations in South Carolina.

Significant temporal variation occurred inE. lawsonifoliar injury levels, with the highest injury ratings occurring in late June and August. Foliar injury was negatively correlated with foliar nutrient content, and higher levels of injury occurred more frequently on nonfertilized trees.

The results obtained in the present study indicated that increasedE. lawsoniabundance occurred on trees that did not receive fertilization. Nonfertilized trees experienced greater foliar injury, suggesting that lower foliar nutrient status may have led to increased levels of compensatory feeding.
The indication and surgical results of local excision following radiotherapy for low rectal cancer
Authors: Han S.‐L. , Zeng Q.‐Q. , Shen X. , Zheng X.‐F. , Guo S.‐C. , Yan J.‐Y.
Published: October 2009

Aim  Radical surgery of rectal cancer is associated with significant morbidity, and some patients with low‐lying lesions must accept a permanent colostomy. The objective of this study was to evaluate the outcome of local excision followed by adjuvant radiotherapy for rectal cancer for curative purposes.

Method  One hundred and seven patients with rectal carcinoma performed with local excision were analysed retrospectively.

Results  The procedures of local excision were trans‐anal resection in 83 patients, trans‐sacral resection in 16, trans‐sphincteric local resection in five, and trans‐vaginal resection in three. The overall disease‐free survival rate was 80.4% (86/107), including 90.0% (54/60) for T1 and 72.3% (34/47) for T2 tumours, respectively. Eighty‐two of 107 patients underwent adjuvant postoperative radiotherapy after local excision, and 25 did not, and the DFS rates between radiation and nonradiation group were significantly different for T2 [81.6% (31/38) vs 33.3% (3/9), P < 0.05], but not for T1 tumours (90.9%vs 87.5%, P > 0.05). The rates of local recurrence and distant metastasis were 13.1% (14/107) and 4.7% (5/106), respectively, and the median time to relapse was 15 months (range: 10–53) for local recurrence and 30 months (21–65) for distant recurrence. The risk factors for local recurrence were large tumour (≥3 cm), poorly differentiated adenocarcinoma and T2 tumour.

Conclusions  Local excision followed adjuvant radiotherapy is an alternative and feasible technique for small T1 rectal cancer in selected cases.
Workfare–Warfare: Neoliberalism, “Active” Welfare and the New American Way of War
Authors: MacLeavy Julie , Peoples Columba
Published: October 2009

Abstract:  In recent decades, welfare reform in the USA has increasingly been based on a political imperative to reduce the number of people on welfare. This has in large part taken place through the establishment of a “workfare” state, in which the receipt of state benefits requires a paid labor input. Designed to reduce expenditure on civil social services, welfare‐to‐work programs have been introduced. At the same time, the restructuring of US defense provision has seen the “military–industrial complex” emerge as a key beneficiary of state expenditure. Both of these trends can be characterized, this paper argues, as manifestations of neoliberal thinking—whether in the form of the “workfarism” that is undertaken to bolster the US economy, or the “defense transformation” that has been intended to enhance US war‐making capacity. While these two aspects have been analyzed in detail independently, the aim of this paper is to probe the similarities, connections and overlaps between the workfare state and the recent American emphasis on high‐technology warfare—the so‐called “Revolution in Military Affairs”—and “defense transformation”. There are, the paper argues, strong homologies to be drawn between the restructuring of the American defense and welfare infrastructures. Furthermore there are also instances where warfare and welfare are being melded together into a hybrid form “workfare–warfare”, in which military service is increasingly positioned as a means of gaining welfare and, conversely, traditionally military industries are becoming involved in the area of welfare provision. The result, it is argued, is an emergent form of workfare–warfare state in the USA.
A nationwide retrospective analysis on the effect of immune therapies in patients with chronic inflammatory demyelinating polyradiculoneuropathy
Authors: Cocito D. , Paolasso I. , Antonini G. , Benedetti L. , Briani C. , Comi C. , Fazio R. , Jann S. , Matà S. , Mazzeo A. , Sabatelli M. , Nobile‐Orazio E. ,   on behalf of The Italian Network for CIDP Register
Published: October 2009

Background and purpose:  The guidelines for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) therapy suggest to use immunoglobulins (IVIg) and steroid as first‐line therapies. Patients who do not respond to one of the two drugs should be switched to the other drug. We collected therapeutic outcome data in patients followed at 11 centres in order to document the clinical practice in Italy.

Methods:  Clinical and electrophysiological data of patients with CIDP were entered into a central database. The clinical outcome (Rankin Scale) and drug side effects (SE) for first‐ and second‐line therapies were recorded.

Results:  A total of 267 patients were included. The percentage of responders (R) to first‐line therapy [steroid or IVIg or plasma exchange (PE)] was 69%; this number increased to 81% when patients who switched to different therapies were included. Overall, the percentage of R to IVIg was similar to R to steroids (P = 0.07) and higher than R to PE (P < 0.001). Of the main therapies, PE frequently caused SE (19%), followed by steroids (12.5%) and IVIg (4%).

Conclusions:  Switching between traditional therapies increases the number of responder patients. IVIg was confirmed to be a therapy with low SE.
Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis
Authors: Mori F. , Codecà C. , Kusayanagi H. , Monteleone F. , Boffa L. , Rimano A. , Bernardi G. , Koch G. , Centonze D.
Published: October 2009

Background and purpose:  Spasticity is a common disorder and a major cause of long‐term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients.

Methods:  Twenty MS patients were pseudorandomized to undergo a 2‐week daily sessions of real or sham iTBS protocol. The H/M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols.

Results:  Patients receiving real iTBS showed a significant reduction of H/M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation.

Conclusions:  These results show that iTBS, a safe, non‐invasive, well‐tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.
Multiple sclerosis survival: a population‐based study in Sicily
Authors: Ragonese P. , Aridon P. , Mazzola M. A. , Callari G. , Palmeri B. , Famoso G. , Terruso V. , Salemi G. , D’Amelio M. , Savettieri G.
Published: October 2009

Background and purpose:  There are few population‐based surveys on multiple sclerosis (MS) survival. To investigate MS survival in MS patients recruited during surveys conducted in Sicily.

Methods:  Multiple sclerosis patients identified during previous surveys were randomly matched to two referent subjects by residence, year of birth, and gender. Living status was obtained by municipality records (end of follow‐up June, 30th 2007) and, for the deceased, date and causes of death were searched. Kaplan‐Meier plots were used to calculate differences in mortality between MS patients and referent subjects. MS risks for mortality with 95% confidence intervals (CI) were also calculated.

Results:  We included 194 MS patients and 388 matched persons. Thirty MS patients (15.5%) and 28 referents (7.2%) had died until the end of follow‐up. Mean survival from onset of the disease to death was 20.6 years. Mean age at death was 55.5 for MS patients and 64.8 for the referents. Adjusted Hazard Ratios for mortality in MS was 1.81 (95% CI 1.36–2.40). Kaplan‐Meier estimates showed a higher mortality amongst patients compared to referent subjects (P < 0.001).

Conclusions:  The present study confirms the higher mortality risk in MS patients with no significant gender difference. Causes of death are related to complications of high disability and to increasing age.
Molecular trait indicators: moving beyond phylogeny in arbuscular mycorrhizal ecology
Authors: Gamper Hannes A. , van der Heijden Marcel G. A. , Kowalchuk George A.
Published: October 2009

Arbuscular mycorrhizal (AM) fungi form symbiotic associations with the roots of most plants, thereby mediating nutrient and carbon fluxes, plant performance, and ecosystem dynamics. Although considerable effort has been expended to understand the keystone ecological position of AM symbioses, most studies have been limited in scope to recording organism occurrences and identities, as determined from morphological characters and (mainly) ribosomal sequence markers. In order to overcome these restrictions and circumvent the shortcomings of culture‐ and phylogeny‐based approaches, we propose a shift toward plant and fungal protein‐encoding genes as more immediate indicators of mycorrhizal contributions to ecological processes. A number of candidate target genes, involved in the uptake of phosphorus and nitrogen, carbon cycling, and overall metabolic activity, are proposed. We discuss the advantages and disadvantages of future protein‐encoding gene marker and current (phylo‐) taxonomic approaches for studying the impact of AM fungi on plant growth and ecosystem functioning. Approaches based on protein‐encoding genes are expected to open opportunities to advance the mechanistic understanding of ecological roles of mycorrhizas in natural and managed ecosystems.
Hand movements at 3 months predict later hemiplegia in term infants with neonatal cerebral infarction
Authors: GUZZETTA ANDREA , PIZZARDI ALESSANDRA , BELMONTI VITTORIO , BOLDRINI ANTONIO , CAROTENUTO MARCO , D’ACUNTO GIULIA , FERRARI FABRIZIO , FIORI SIMONA , GALLO CLAUDIO , GHIRRI PAOLO , MERCURI EUGENIO , ROMEO DOMENICO , ROVERSI MARIA FEDERICA , CIONI GIOVANNI
Published: October 2009

Aim  The aim of this study was to explore the predictive value of quantitative assessment of hand movements in 3‐month‐old infants after neonatal stroke.

Method  Thirteen infants born at term (five females, eight males; mean gestational age 39.4wks, SD 1.19, range 37–41wks; mean birthweight 3240g, SD 203, range 2900–3570g) with neonatal arterial ischaemic cerebral infarction, and 13 healthy infants (mean gestational age 39.1wks, range 37–41wks, SD 1.26; mean birthweight 3190g, SD 259, range 2680–3490g) were enrolled in the study. The absolute frequency and the asymmetry of global hand opening and closing, wrist segmental movements, and independent digit movements were assessed from videotapes recorded at around 12 weeks. Neurological outcome was assessed when the infants were at least 18 months old using Touwen’s neurological examination.

Results  Five of the 13 infants with neonatal stroke had normal neurological development, and eight had hemiplegia. Asymmetry of wrist segmental movements and the absolute frequency of independent digit movements were significantly different between infants with and without hemiplegia (p=0.006 and p=0.008, respectively). No differences were found in global hand movements.

Interpretation  We propose that the observed abnormalities of hand movements are the result of two different mechanisms: direct disruption of the corticospinal projection to the spinal cord, and altered modulation of the central pattern generators of general movements.