bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel autoantigens in autoimmune hypophysitis
Authors: Lupi Isabella , Broman Karl W. , Tzou Shey‐Cherng , Gutenberg Angelika , Martino Enio , Caturegli Patrizio
Published: July 2008

Background  Pituitary autoantibodies are found in autoimmune hypophysitis and other conditions. They are a marker of pituitary autoimmunity but currently have limited clinical value. The methods used for their detection lack adequate sensitivity and specificity, mainly because the pathogenic pituitary autoantigen(s) are not known and therefore antigen‐based immunoassays have not been developed.

Objectives  This study aimed to identify novel pituitary autoantigens using sera as probes in proteomic assays. We also compared immunoblotting and immunofluorescence methods for their accuracy in diagnosing autoimmune hypophysitis.

Study design and subjects  Twenty‐eight sera from autoimmune hypophysitis cases (14 histologically proven and 14 clinically suspected) were compared to 98 sera from controls, which included 14 patients with pituitary adenomas, 48 with autoimmune thyroiditis (15 Graves’ disease and 33 Hashimoto's thyroiditis) and 36 healthy subjects.

Methods  All sera were tested against human pituitary cytosolic proteins separated by one‐dimensional (1D) gel electrophoresis. The band recognition was analysed statistically to detect molecular weight regions preferentially recognized by hypophysitis sera. 2D gel immunoblotting and mass spectrometry were then used to sequence the protein spots of interest. Sera were also tested by immunofluorescence for their recognition of Macaca mulatta pituitary sections.

Results  A single region in the 25–27‐kDa range was recognized more often by hypophysitis cases than healthy subjects (P = 0·004) or patients with pituitary adenomas (P = 0·044). This region contained two novel candidate autoantigens: chromosome 14 open reading frame 166 (C14orf166) and chorionic somatomammotrophin. Immunoblotting positivity for the 25–27‐kDa region yielded greater sensitivity (64%vs. 57%) and specificity (86%vs. 76%) than immunofluorescence in predicting histologically proven hypophysitis, although the performance was still inadequate to make immunoblotting a clinically useful test.

Conclusion  The study reports two novel proteins that could act as autoantigens in autoimmune hypophysitis. Further studies are needed to validate their pathogenic role and diagnostic utility.
Amelioration of cardiovascular risk factors with partial biochemical control of acromegaly
Authors: Delaroudis Sideris P. , Efstathiadou Zoe A. , Koukoulis George N. , Kita Marina D. , Farmakiotis Dimitrios , Dara Ourania G. , Goulis Dimitrios G. , Makedou Areti , Makris Pantelis , Slavakis Aris , Avramides Avraam I.
Published: July 2008

Objective Complete remission of acromegaly is associated with favourable changes in cardiovascular risk parameters. We evaluated the effects of suboptimal therapy on haemodynamic, metabolic, inflammatory and coagulation cardiovascular risk indices.

Design and methods Eighteen acromegalic patients on somatostatin analogues, with incomplete biochemical control, were evaluated at diagnosis and 6 months after treatment and compared to 15 healthy age‐ and body mass index (BMI)‐matched controls. Measurements of blood pressure, GH, IGF‐I, glucose, insulin, glycated haemoglobin (HbA1c), lipids, apolipoprotein A1 (apoA1), apoB, high‐sensitivity C‐reactive protein (hs‐CRP), fibrinogen, plasminogen activator inhibitor 1 (PAI‐1), tissue plasminogen activator (tPA) and circulating thrombomodulin were performed in all study participants, followed by an oral glucose tolerance test (OGTT). Insulin sensitivity (IS) was expressed by the Matsuda index (OGTTISI).

Results Partial control of acromegaly resulted in a significant reduction in systolic and diastolic blood pressure, glucose, insulin, HbA1c, total (T‐C) and low density lipoprotein cholesterol (LDL‐C) and triglyceride levels, and a significant increase in apoA1, high density lipoprotein cholesterol (HDL‐C) and OGTTISIcompared to pretreatment levels. Plasma fibrinogen and PAI‐1 levels fell significantly [respectively (mean ± SEM), 11·04 ± 0·41vs.10·12 ± 0·34 µmol/l,P = 0·003 and 9·6 ± 1·97vs.6·55 ± 1·89 µg/l,P < 0·001]. However, a marked reduction in tPA [median (IQR) 5·1 (2·5–15)vs.3·4 (2·4–8·6) µg/l,P = 0·031] and an increase in hs‐CRP [median (IQR) 0·05 (0·03–0·11)vs.0·1 (0·06–0·23) mg/l,P < 0·001] were also noted. On treatment, acromegalic patients were comparable to controls, except for OGTTISI, lipoprotein(a) [Lp(a)], fibrinogen and tPA and HDL‐C levels. Thrombomodulin and apoB levels were not affected by treatment.

Conclusions Partial control in disease activity following somatostatin analogues results in significant improvement in a considerable number of cardiovascular risk markers in acromegaly.
Obesity: a new disaster for haemophilic patients? A nationwide survey
Authors: HOFSTEDE F. G. , FIJNVANDRAAT K. , PLUG I. , KAMPHUISEN P. W. , ROSENDAAL F. R. , PETERS M.
Published: July 2008

Summary.  The prevalence of obesity, an important risk factor for both cardiovascular disease and arthropathy, is strongly increasing in the general population, but data for the haemophilia population are scarce. Obesity may have a more profound effect on arthropathy and on cardiovascular disease in patients with haemophilia. To assess the prevalence of obesity in haemophilia patients and install adequate measures, if necessary. We performed a nationwide postal survey to measure the prevalence of overweight and obesity in Dutch haemophilia patients in 1992 (n = 980) and 2001 (n = 1066). A random sample of the Dutch male population served as the control group. In adult haemophiliacs, the prevalence of overweight (BMI 25–30 kg m−2) increased from 27% to 35% (95% CI 31.1–38.0) and the prevalence of obesity (BMI ≥30 kg m−2) doubled from 4% to 8% (95% CI 6.0–10.1), which was comparable with the general population. The increased prevalence of obesity in boys with haemophiliacs, which tripled in 10 years, is alarming. The increased prevalence of overweight and obesity in patients with haemophilia may have a profound effect on morbidity and quality of life of haemophilia patients by aggravating pre‐existing arthropathy and predisposing aged patients to cardiovascular disease. Measures to prevent overweight in haemophiliacs are therefore urgently needed.
Do allelopathic compounds in invasive Solidago canadensis s.l. restrain the native European flora?
Authors: Abhilasha Dipti , Quintana Naira , Vivanco Jorge , Joshi Jasmin
Published: July 2008

One mechanism explaining the success of invasive weeds may be the production and release of allelopathic compounds by the invader that, due to a lack of co‐evolutionary history, have harmful effects on plant neighbours in the introduced range.

We partially tested this hypothesis by growing seven competing native European plant species either with the introduced Solidago canadensis s.l., one of the most successful invasive plants in Europe or on soil pre‐cultivated with S. canadensis. We added activated carbon to the soil to neutralize organic chemical compounds with putative allelopathic effects. Furthermore, we added unsterilized soil inocula from the introduced (Switzerland) or native (USA) range to the soil to test potential confounding effects of soil microbes on invasion success. Untreated sterilized soil served as control.

Five out of the seven native species were more competitive against the invasive species in soils with activated carbon than without, supporting the allelopathy hypothesis. However, competitive outcomes were also influenced by the two sources of soil inoculum and by interactive effects of soil inoculum and Solidago origin suggesting that soil microbes alter allelopathic effects.

Achillea millefolium, the species least affected by the presence of S. canadensis and with no response to the activated carbon treatment is the only species used in this experiment reported to grow within Solidago stands in Europe, whereas the other European species tested tend to grow at the periphery of invasive Solidago stands.

Chemical analysis by LC‐MS of Solidago root extracts revealed four main secondary chemical compounds with potential allelopathic effects. Root exudates of Solidago showed a significant inhibitory effect on growth of the model plant species Arabidopsis thaliana. The magnitude of inhibition increased with increasing concentration of the extract.

Synthesis. Levels of the four compounds were lower in Solidago populations from the invasive range than in populations of the same ploidy level from the native range. This suggests lower investment of invasive plants into these secondary compounds, possibly because of a higher susceptibility of plant competitors in the invasive range to these substances.
A study of specialist dietetic input for patients requiring surgical resection for an oesophageal or gastric malignancy
Authors: Roberts H.
Published: July 2008

Background:  Anorexia, weight loss and dysphagia are common symptoms in patients diagnosed with upper gastrointestinal (UGI) cancers. Research has shown that 80% of patients with UGI cancers will have a significant weight loss at the time of their diagnosis (Bruera, 1997). Actual dietetic input for this patient group has not been previously audited locally. The aim of this study was to compare the dietetic input received by patients with an oesophageal or gastric malignancy before and after appointment of a specialist upper gastrointestinal oncology (SUGO) dietitian.

Methods:  A retrospective survey examined the dietetic input for all patients requiring surgical resection for an oesophageal or gastric malignancy. Information was collected from dietetic record cards for patients that were seen by a dietitian between 1st October 2005 and 30th September 2006, the year before the SUGO dietitian was appointed. Information was collected by the same method from 1st November 2006 until 31st October 2007 for the first year the SUGO dietitian was in post. This last group of patients was asked to complete a patient satisfaction questionnaire approximately 8 weeks after surgery.

Results:  The effect of intervention by a SUGO dietitian is shown in Table 1. Pre and post operative weight loss in these patients was reduced after consultation with a SUGO dietiatin.

 A summary of the main differences in patient management before and after appointment of a SUGO dietitian

1 year pre‐appointment of SUGO dietitian
1 year post‐appointment of SUGO dietitian

Pre‐operative weight loss
7.3 (%) (average time 3.5 months)
3.2 (%) (average time 5.5 months)

Number of patients seen by a dietitian prior to having a tumour resection (2–12 weeks before surgery)
1 (2.6%)
42 (67.7%)

Post‐operative weight loss
14.4 (%) (average time 5.1 months)
7.6 (%) (average time 3.3 months)

Percentage of patients who received dietary advice for home
60 (%)
100 (%)

Percentage of patients seen as an inpatient by a dietitian following tumour resection
86 (%)
100 (%)

Percentage of patients reviewed by a dietitian following discharge for a tumour resection
17.5 (%)
100 (%)

Discussion:  Appointing a SUGO dietitian has contributed to a 115% increase in the number of referrals for this patient group. Dietetic input with a SUGO dietitian before and after tumour resection has reduced percentage weight loss. This input included advice on a high energy and high protein diet, use of supplements and jejunostomy feeding. A SUGO dietitian helped to coordinate the dietetic input ensuring all patients receive the appropriate dietary advice.

Conclusions:  This showed that since appointing a SUGO dietitian patients with an oesophageal or gastric malignancy have better access to a specialist dietitian as well as the appropriate dietary advice throughout their treatment pathway.

Reference  Bruera, E. (1997) ABC of palliative care: anorexia, cachexia and nutrition. BMJ315, 1219–1222.
An audit to evaluate the effect of staff training on the use of Malnutrition Universal Screening Tool
Authors: Wong S. , Gandy J.
Published: July 2008

Background:  Malnutrition is common in hospitalized adults and it is associated with adverse hospital outcomes. Patients admitted to hospital should be routinely screened and monitored regularly (NICE, 2006). The Malnutrition Universal Screening Tool (MUST) (Elia, 2003) has been used for nutrition screening since 2004. A survey conducted 2005 showed that 54% of patient's records contained a completed MUST form. As a result regular training on nutritional screening for ward staff by dietitians was introduced. The aims of the present audit were to assess the current use of MUST in district general hospitals and to evaluate the effect of regular training for clinical staff on the use of the MUST tool.

Methods:  This audit was conducted during May and June 2007, at three hospital sites. The medical and dietetic notes of 432 patients, who had been admitted not <72 h previously, on 30 adult wards from all specialties, apart from a spinal injuries unit, were examined by dietitians and the presence of a correctly completed MUST form recorded. A Chi‐squared test was used to compare the number of completed tools in 2005 with the number completed in 2007.

Results:  A completed MUST form was present in 67% (288) of patient's records. This was a significant (P < 0.001) increase compared with the audit conducted in 2005. The audit in 2005 found that 54% (212/392) of patient's records had a correctly completed MUST form.

Discussion:  There has been a significant improvementin the use of the MUST tool for malnutrition screening on adult wards in this trust. The introduction of training on the use of MUST for all clinical staff appears to have been effective in increasing the use of the MUST tool. Training is now included as a part of the trust mandatory training.

Conclusions:  Training of clinical staff in the use of the MUST tool is an effective method of increasing the tool's use.

References  Elia, M. (2003) Screening for Malnutrition: A multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (MUST) for adults. BAPEN.

NICE. (2006) Nutrition Support in Adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. Available at http://www.nice.nhs.uk (accessed on 17 January 2008).
Does taking vitamin, mineral and fatty acid supplements prevent cognitive decline? A systematic review of randomized controlled trials
Authors: Jia X. , McNeill G. , Avenell A.
Published: July 2008

Background  Observational studies have shown associations between nutritional status and cognition in later life but evidence from intervention studies is unclear. The present study systematically reviewed the evidence on the effect of nutrient supplementation on cognitive function in people aged ≥65 years.

Methods  Databases including MEDLINE and EMBASE were searched up to 1 September 2006. Randomized controlled trials using at least one kind of vitamin, mineral or omega‐3 fatty acid, evaluating standardized neuropsychological test(s), were included. There were no restrictions on participants’ baseline nutritional status or cognitive function. Quality assessment and data abstraction were conducted by one author and checked by another.

Results  Of 4229 articles retrieved, 22 trials (3442 participants) were identified. Many were small, short duration and of poor methodology. Only 16 out of 122 cognitive tests were significantly different between groups. A meta‐analysis showed no significant effect of taking B vitamins or antioxidant vitamins on global cognitive function. There was insufficient evidence to evaluate the effect of omega‐3 fatty acids on any cognitive domains.

Conclusion  There was little evidence of a beneficial effect from taking B vitamins or antioxidant supplements on global cognitive function in later life. Larger‐scale randomized controlled trials of longer duration in selected age groups are needed.
The Spx paralogue MgsR (YqgZ) controls a subregulon within the general stress response of Bacillus subtilis
Authors: Reder Alexander , Höper Dirk , Weinberg Christin , Gerth Ulf , Fraunholz Martin , Hecker Michael
Published: July 2008

The alternative sigma factor σB of Bacillus subtilis is responsible for the induction of the large general stress regulon comprising approximately 150–200 genes. YqgZ, a member of the σB regulon, resembles the global regulator Spx of the diamide stress regulon in B. subtilis. In this work we conducted a comprehensive transcriptome and proteome analysis of the B. subtilis wild‐type 168 and its isogenic ΔsigB and ΔyqgZ mutants following exposure to 4% (v/v) ethanol stress, which led to the characterization of a ‘subregulon’ within the general stress response that is regulated by YqgZ. Activation and induction of σB are necessary but not sufficient for a full expression of all general stress genes. Expression of 53 genes was found to be positively regulated and the expression of 18 genes was negatively affected by YqgZ. The identification of the negatively regulated group represents a so far uncharacterized regulatory phenomenon observed in the ΔsigB mutant background that can now be attributed to the function of YqgZ. Due to the strict σB‐dependent expression of YqgZ it was renamed to MgsR (modulator of the general stress response).
Positive association of HLA‐DRB1*15 with Dupuytren’s disease in Caucasians
Authors: Brown J. J. , Ollier W. , Thomson W. , Bayat A.
Published: July 2008

Dupuytren’s disease (DD) is a permanent nodular condition affecting the palms and digits of the hands, leading to progressive shortening and contractures of the digits often resulting in diminished function and severe deformity. DD is thought to be one of the most common hereditary connective tissue disorders in Caucasians. To elucidate further the aetiology of DD, we compared the HLA‐DRB1 phenotype frequencies of DD patients (n = 67) against the HLA‐DRB1 phenotype frequencies observed in a control population (n = 537). HLA‐DRB1*15 phenotype frequency was higher in DD positive Caucasoids (37.3%) when compared with control data (20.9%) (corrected P = 0.029): we conclude that in Caucasoids of European origin, HLA‐DRB1*15 is associated with risk of developing DD.
Sequence‐based typing reveals the novel HLA‐DRB1*1467 allele in a Chinese individual
Authors: Yan L.‐N. , Li S.‐Y. , Dong Z , Dong L. , Xie J.‐H. , An S.‐P. , Yuan Y.‐H.
Published: July 2008

We report here a novel DRB1*1467 allele identified by sequence‐based typing in a Chinese individual. The novel DRB1*1467 is identical to DRB1*140301 with an exception of one base substitution at position 186 (C>A) of exon 2 resulting in codon 67 changed from CTC (Leu) to ATC (Ile).
Serum α‐NH2‐butyric acid may predict spontaneous survival in pediatric acute liver failure
Authors: Rudnick David A. , Dietzen Dennis J. , Turmelle Yumirle P. , Shepherd Ross , Zhang Song , Belle Steven H. , Squires Rob ,   the Pediatric Acute Liver Failure Study Group
Published: July 2008

Abstract:  ALF is a serious, often fatal condition. Up to half of PALF patients do not survive without liver transplantation; however, early identification of those least likely to survive spontaneously remains difficult. Clinical experience suggests that recovery from ALF depends on the ability of the liver to regenerate. Based on this, we hypothesized that bio‐markers of hepatic regeneration could have utility as predictors of recovery from PALF. In the studies reported here, we used comprehensive amino acid analysis to search for novel metabolomic markers of liver regeneration in mice subjected to partial hepatectomy. This analysis identified α‐NH2‐adipic acid and α‐NH2‐butyric acid as significantly increased in liver and plasma samples from mice subjected to partial hepatectomy compared to controls. Next, we tested whether serum levels of these markers were associated with clinical outcomes in PALF patients. This examination, performed on the initially collected serum samples from 40 randomly selected patients enrolled in the PALF Study Group, showed increased α‐NH2‐butyric‐acid (Aab) and Aab:leucine (Aab:Leu) ratio in patients who survived without transplantation compared to those who were transplanted or died. These data indicate that Aab and the Aab:Leu ratio may predict clinical outcomes in PALF.
Calbindin D‐28k, Parvalbumin and Calcitonin Gene‐Related Peptide Immunoreactivity in the Canine Spinal Cord
Authors: Chang I. Y. , Kim S. W. , Lee K. J. , Yoon S. P.
Published: July 2008

This study was conducted as a comparative analysis of the immunohistochemical localization of calbindin D‐28k, parvalbumin and the calcitonin gene‐related peptide (CGRP) in the cervical through the sacral spinal cord of mongrel dogs, to reveal any distinct patterns of distribution and possible involvement in spinal processing. In laminae I and II of the substantia gelatinosa, both calbindin D‐28k and CGRP showed strong immunoreactivity, with calbindin D‐28k being positive in both cells and fibres, while CGRP was positive in fibres only. Parvalbumin and CGRP immunoreactive cells were widely distributed in various nuclei and lower motor neurones in the ventromedial horn. In addition, the lower motor neurones expressed CGRP as well as parvalbumin, but not calbindin D‐28k. These results are generally consistent with previous reports, and the co‐localization of parvalbumin and CGRP may explain the functional improvement of lower motor neuron disease.
Identification of 30‐kDa heat shock protein gene inTrichophyton rubrum
Authors: Behzadi Elham , Behzadi Payam , Sirmatel Fatma
Published: July 2008

Small heat shock proteins (sHSPs) are chaperones that are crucial in the heat shock response but also have important non‐stress roles within the cell. HSP70 inTrichophyton rubrumis already detected and carefully characterised; however, no study was carried out for HSP30 in this pathogenic fungus. In the present study,T. rubrumwas obtained from patients with dermatophytosis and cultured in appropriate conditions. High‐molecular‐weight DNA was extracted using standard extraction methods. Pairs of 21 nt primers were designed from highly conserved regions of the similar genes in other eukaryotic cells. Mentioned primers were utilised in PCR using isolated genomic DNA and extracted RNA templates ofT. rubrum. The PCR fragments were then sequenced and 415 nucleotides of HSP30 in this pathogenic fungus were detected; the open reading frame had 156 nucleotides and was coding 51 amino acids. This gene (calledTrHSP30) is registered in GenBank at National Center for Biotechnology Information (NIH, USA) database. Detection ofTrHSP30gene may open the way to determination of its possible role in the pathogenesis of dermatophyte infections due toT. rubrum.
Rapid detection of common pathogenic Aspergillus species by a novel real‐time PCR approach
Authors: Faber Joerg , Moritz Nikola , Henninger Nicole , Zepp Fred , Knuf Markus
Published: July 2008

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised and critically ill patients. Standard culture based methods for the diagnosis of Aspergillus infections have limited sensitivity and specificity and are time consuming. The recent availability of novel molecular based diagnostic techniques offers the potential of rapid, highly sensitive and specific pathogen detection. In this study, we aimed to develop a diagnostic assay to detect simultaneously common pathogenic Aspergillus species including Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger and Aspergillus terreus in whole blood specimen. A real‐time PCR/probe set assay was designed to amplify the 18sRNA genomic region of Aspergillus. In addition to a previously probe set validated for the detection of A. fumigatus (‘Asp.fum’), two other probe sets (‘Asp.ter’; ‘Asp.nig’) were synthesised with 100% sequence homology to A. terreus or A. niger. Specificity testing demonstrated amplification of Aspergillus DNA, but not DNA from a panel of other common pathogenic fungi and bacteria and/or human DNA. Sensitivity testing in serial dilution assays revealed a lower detection limit of 1–5 CFU ml−1 whole blood. However, no single probe set was most sensitive for all Aspergillus species tested and a combination of all three probe sets was necessary to achieve maximal overall assay sensitivity. Furthermore, inclusion of a subsequent probe melting temperature (Tm) analysis demonstrated species‐specific Tm‐patterns, useful to differentiate simultaneously between the different Aspergillus species detected. We describe a highly specific and sensitive real‐time PCR approach to detect and differentiate the most common pathogenic Aspergillus species in a rapid ‘same day’ assay.
Persisting onychomycosis caused by Fusarium solani in an immunocompetent patient
Authors: Brasch J. , Köppl G.
Published: July 2008

We present a patient with a Fusarium solani infection of both distal thumbnails. She suffered from Basedow’s disease but had no signs of reduced immunity. The patient declined antimycotic treatment and the infection was still verifiable after 5 years. Our observation shows that a superficial F. solani infection may persist in immunocompetent patients without causing noteworthy discomfort. Because a superficial F. solani infection may give origin to a systemic infection it should always be treated if host defence is reduced.
Successful therapy with ABLC, surgery and posaconazole for Rhizopus microsporus var. rhizopodiformis liver eumycetoma in a child with acute leukaemia
Authors: Sedlacek Petr , Vavra Vladimir , Masova Ivana , Codl Daniel , Laznickova Tana , Malaskova Ludmila , Nyc Otakar , Stary Jan
Published: July 2008

Invasive fungal infection negatively influences the morbidity and mortality in heavily immuno‐incompetent patients. Diagnosis of non‐Aspergillus mould infections remains challenging despite application of a wide spectrum of non‐culture‐based microbiological techniques. Invasive diagnostic procedures are often essential. In this article, we present the case of a 15‐month‐old boy diagnosed with Rhizopus microsporus var. rhizopodiformis liver mycetoma during induction chemotherapy for acute promyelocytic leukaemia. Following surgery, he was effectively treated with a combination of ABLC and posaconazole during ongoing intensive chemotherapy. Posaconazole was also used as long‐term secondary prophylaxis.
Automated versus manual blood pressure measurement: A randomized crossover trial
Authors: Heinemann Megan , Sellick Ken , Rickard Claire , Reynolds Pam , McGrail Matthew
Published: July 2008

This study evaluated the accuracy and reliability of the Dinamap 8100 automated blood pressure machine against three internationally recognized criteria. Systolic and diastolic blood pressures were taken concurrently by two nurses using the automated machine and a manual sphygmomanometer. Results demonstrated agreement between automated and manual readings on one set of criteria for both systolic and diastolic pressures, and support for systolic readings only on one other criterion. Comparison of mean differences between automated and manual measures showed the automated machine consistently under‐read both systolic and diastolic blood pressures. The conclusion from this study was that the Dinamap 8100 machine can be used with some degree of confidence to assess systolic blood pressures in a general population of adult hospital inpatients, but with caution when taking diastolic readings.
Lifestyle risk factors for intrahepatic stone: Findings from a case–control study in an endemic area, Taiwan
Authors: Momiyama Masato , Wakai Kenji , Oda Koji , Kamiya Junichi , Ohno Yoshiyuki , Hamaguchi Michinari , Nakanuma Yasuni , Hsieh Ling‐Ling , Yeh Ta‐Sen , Chen Tse‐Ching , Jan Yi‐Yi , Chen Miin‐Fu , Nimura Yuji
Published: July 2008

Background and Aim:  To examine associations between lifestyle risk factors and intrahepatic stone (IHS), we conducted a case–control study in Taiwan, which has the highest incidence of IHS in the world.

Methods:  Study subjects were 151 patients newly diagnosed with IHS at Chang Gung Memorial Hospital between January 1999 and December 2001. Two control subjects per case were selected randomly from patients who underwent minor surgery at the same hospital and from family members or neighbors of the hospital staff. Controls were matched to each case by age and gender. Information on lifestyle factors was collected using a self‐administered questionnaire. Strength of associations was assessed using odds ratios derived from conditional logistic models.

Results:  Female patients were significantly shorter than female controls. Compared to subjects with two or fewer children, odds ratios for those with six or more children were 20.4 in men (95% confidence interval, 1.89–221) and 2.82 (0.97–8.22) in women. Increasing level of education lowered the risk of intrahepatic stone (trend P = 0.004 for men and < 0.0001 for women). Women who had consumed ground‐surface water for a long period had a somewhat increased risk (trend P = 0.05).

Conclusion:  Lower socioeconomic status and poor hygiene may be involved in the development of intrahepatic stones.
Anatomic variations in intrahepatic bile ducts in a north Indian population
Authors: Sharma Vijay , Saraswat Vivek Anand , Baijal Sanjay Saran , Choudhuri Gourdas
Published: July 2008

Background and Aim: In the present study, we described the anatomical variations in the branching patterns of intrahepatic bile ducts (IHD) and determined the frequency of each variation in north Indian patients. There are no data from India.

Methods: The study group consisted of 253 consecutive patients (131 women) undergoing endoscopic retrograde cholangiograms for different indications. Anatomical variations in IHD were classified according to the branching pattern of the right anterior segmental duct (RASD) and the right posterior segmental duct (RPSD), presence or absence of first‐order branch of left hepatic duct (LHD) and of an accessory hepatic duct.

Results: Anatomy of the IHD was typical in 52.9% of cases (n = 134), showing triple confluence in 11.46% (n = 29), anomalous drainage of the RPSD into the LHD in 18.2% (n = 46), anomalous drainage of the RPSD into the common hepatic duct (CHD) in 7.1% (n = 18), drainage of the right hepatic duct (RHD) into the cystic duct 0.4% (n = 1), presence of an accessory duct leading to the CHD or RHD in 4.7% (n = 12), individual drainage of the LHD into the RHD or CHD in 2.4% (n = 6), and unclassified or complex variations in 2.7% (n = 7). None had anomalous drainage of RPSD into the cystic duct

Conclusion: The branching pattern of IHD was atypical in 47% patients. The two most common variations were drainage of the RPSD into the LHD (18.2%) and triple confluence of the RASD, RPSD, and LHD (11.5%).
Decline and potential recovery of Yellow‐footed Antechinus in parts of south‐eastern Australia: A perspective with implications for management
Authors: Lada Hania , Mac Nally Ralph
Published: July 2008

Summary  The extent and intensity of European‐induced changes to ecosystems in south‐eastern Australia mean that remaining habitats, despite being degraded, are of high conservation value. Given the extinction of several species of native mammals in the last 160 years in the area, and conservation concerns regarding others, it is important to provide conservation managers with sufficient information to prevent further extinctions and maintain evolutionary potential of the species. A native, carnivorous marsupial, the Yellow‐footed Antechinus (Antechinus flavipes) exists within these massively altered landscapes. We present conceptual models, derived from the literature, of persistence of populations of Yellow‐footed Antechinus both before European colonization and in the 21st century. We conclude that preservation of large trees, restoration of fallen‐timber volumes, spring flooding of floodplains and presence of vegetation corridors between forests should be undertaken to prevent local extinctions of Yellow‐footed Antechinus. From historic and current gene flow, we identify remnant woodland and forest groupings that we consider should be managed as coherent units.
Motor cortex stroke impairs individual digit movement in skilled reaching by the rat
Authors: Alaverdashvili Mariam , Whishaw Ian Q.
Published: July 2008

Over 30 years ago, Castro [(1972) Brain Res., 37, 173–185] proposed that motor cortex (MtCx) ablation produced deficits in digital usage that contributed to the rat’s impairments in a reach‐to‐eat task, but the impairment was not directly documented. The present study examined digit use in control rats and rats with MtCx lesions using high‐speed (1000 f/s) video recording. Temporal and spatial characteristics of individual digits were evaluated by digitizing the tip of the digits and digital joints using the motion measurement system Peak Motus. Control rats displayed differential digital use during grasping actions and MtCx damage reduced individual digit movement, both as the paw was pre‐shaped for grasping and in the grasping action itself. The findings show that although grasping is retained following MtCx damage, MtCx is essential for dexterous movement. The results are discussed in relation to the idea that rodent MtCx is not only necessary for rotatory movements of the limb, but also for digital control and in relation to the similarities of rodent digit use to that described for primates.
Corticotropin‐releasing factor in the dorsal raphe nucleus increases medial prefrontal cortical serotonin via type 2 receptors and median raphe nucleus activity
Authors: Forster Gina L. , Pringle Ronald B. , Mouw Nicholas J. , Vuong Shawn M. , Watt Michael J. , Burke Andrew R. , Lowry Christopher A. , Summers Cliff H. , Renner Kenneth J.
Published: July 2008

Interactions between central corticotropin‐releasing factor (CRF) and serotonergic systems are believed to be important for mediating fear and anxiety behaviors. Recently we demonstrated that infusions of CRF into the rat dorsal raphe nucleus result in a delayed increase in serotonin release within the medial prefrontal cortex that coincided with a reduction in fear behavior. The current studies were designed to study the CRF receptor mechanisms and pathways involved in this serotonergic response. Infusions of CRF (0.5 μg/0.5 μL) were made into the dorsal raphe nucleus of urethane‐anesthetized rats following either inactivation of the median raphe nucleus by muscimol (25 ng/0.25 μL) or antagonism of CRF receptor type 1 or CRF receptor type 2 in the dorsal raphe nucleus with antalarmin (25–50 ng/0.5 μL) or antisauvagine‐30 (2 μg/0.5 μL), respectively. Medial prefrontal cortex serotonin levels were measured using in‐vivo microdialysis and high‐performance liquid chromatography with electrochemical detection. Increased medial prefrontal cortex serotonin release elicited by CRF infusion into the dorsal raphe nucleus was abolished by inactivation of the median raphe nucleus. Furthermore, antagonism of CRF receptor type 2 but not CRF receptor type 1 in the dorsal raphe nucleus abolished CRF‐induced increases in medial prefrontal cortex serotonin. Follow‐up studies involved electrical stimulation of the central nucleus of the amygdala, a source of CRF afferents to the dorsal raphe nucleus. Activation of the central nucleus increased medial prefrontal cortex serotonin release. This response was blocked by CRF receptor type 2 antagonism in the dorsal raphe. Overall, these results highlight complex CRF modulation of medial prefrontal cortex serotonergic activity at the level of the raphe nuclei.
Rewarding and aversive effects of nicotine are segregated within the nucleus accumbens
Authors: Sellings Laurie H. L. , Baharnouri Golriz , McQuade Lindsey E. , Clarke Paul B. S.
Published: July 2008

Forebrain dopamine plays a critical role in motivated behavior. According to the classic view, mesolimbic dopamine selectively guides behavior motivated by positive reinforcers. However, this has been challenged in favor of a wider role encompassing aversively motivated behavior. This controversy is particularly striking in the case of nicotine, with opposing claims that either the rewarding or the aversive effect of nicotine is critically dependent on mesolimbic dopamine transmission. In the present study, the effects of 6‐hydroxydopamine lesions of nucleus accumbens core vs. medial shell on intravenous nicotine conditioned place preference and conditioned taste aversion were examined in male adult rats. Dopaminergic denervation in accumbens medial shell was associated with decreased nicotine conditioned place preference. Conversely, denervation in accumbens core was associated with an increase in conditioned place preference. In addition, dopaminergic denervation of accumbens core but not medial shell abolished conditioned taste aversion for nicotine. We conclude that nucleus accumbens core and medial shell dopaminergic innervation exert segregated effects on rewarding and aversive effects of nicotine. More generally, our findings indicate that dopaminergic transmission may mediate or enable opposing motivational processes within functionally distinct domains of the accumbens.
Environmental distribution and population biology of Candidatus Accumulibacter, a primary agent of biological phosphorus removal
Authors: Peterson S. Brook , Warnecke Falk , Madejska Julita , McMahon Katherine D. , Hugenholtz Philip
Published: July 2008

Members of the uncultured bacterial genus Candidatus Accumulibacter are capable of intracellular accumulation of inorganic phosphate in activated sludge wastewater treatment plants (WWTPs) performing enhanced biological phosphorus removal, but were also recently shown to inhabit freshwater and estuarine sediments. Additionally, metagenomic sequencing of two bioreactor cultures enriched in Candidatus Accumulibacter, but housed on separate continents, revealed the potential for global dispersal of particular Candidatus Accumulibacter strains, which we hypothesize is facilitated by the ability of Candidatus Accumulibacter to persist in environmental habitats. In the current study, we used sequencing of a phylogenetic marker, the ppk1 gene, to characterize Candidatus Accumulibacter populations in diverse environments, at varying distances from WWTPs. We discovered several new lineages of Candidatus Accumulibacter which had not previously been detected in WWTPs, and also uncovered new diversity and structure within previously detected lineages. Habitat characteristics were found to be a key determinant of Candidatus Accumulibacter lineage distribution while, as predicted, geographic distance played little role in limiting dispersal on a regional scale. However, on a local scale, enrichment of particular Candidatus Accumulibacter lineages in WWTP appeared to impact local environmental populations. These results provide evidence of ecological differences among Candidatus Accumulibacter lineages.
Abdominosacral resection is not related to the risk of neurological complications in patients with low‐rectal cancer
Authors: Bębenek M.
Published: July 2008

Objective  Some authors claim that the risk of sacrectomy‐related neurological complications is a serious limitation of abdominosacral resection (ASR). We determined the incidence of neurological complications in patients with a low‐rectal cancer who were treated by ASR.

Method  The clinical records of 54 consecutive patients with low‐rectal cancer who were operated on by ASR were analysed. The occurrence of neurological complications in these patients was compared with that of 140 consecutive patients with cancer of the mid‐ and upper rectum who underwent anterior resection (AR) during the same period. Neurological complications were defined as bowel, bladder or sexual dysfunction, gait abnormalities and local parasthesiae persisting for more than 6 months following surgery.

Results  There were no persisting neurological complications after either AR or ASR. At the end of hospitalization, the 16 of 140 and 12 of 54 of those treated with AR and ASR had neurological complications, which fell to five of 140 and three of 53 at 3 months, respectively; at 6 months, no one treated had any complications.

Conclusion  Neurological complications after AR and ASR were similar but recovery was complete at 6 months following surgery.
Treatment of left‐sided colonic emergencies: a comparison of US and UK surgical practices
Authors: Engledow A. H. , Bond‐Smith G. , Motson R. W. , Jenkinson A.
Published: July 2008

Background  Surgeons are increasingly considering resection and primary anastomosis when treating left‐sided colonic obstruction or perforation in preference to the more traditional staged procedures. Previous studies in the United Kingdom (UK) and United States of America (USA) have suggested a greater interest in single‐staged procedures amongst UK surgeons. This study was aimed to directly compare the treatment preferences between UK and US surgeons.

Method  A questionnaire, designed to determine the procedure of choice when faced with left‐sided colonic emergencies in patients with good and poor anaesthetic risk, was sent to 500 surgeons in the UK and 500 surgeons in the USA.

Results  UK surgeons were more likely to perform resection, primary anastomosis and on‐table colonic lavage in patients with sigmoid obstruction (good anaesthetic risk: P < 0.0001; poor risk: P < 0.01) and sigmoid perforation (good risk: P < 0.0001). In good‐risk patients with sigmoid obstruction, US surgeons were more likely than UK to choose Hartmann’s procedure (P < 0.0001). US surgeons performing primary anastomosis were less likely to perform on‐table lavage.

Conclusion  Single‐stage procedures are widely accepted as viable treatment options in both the UK and the USA when dealing with left‐sided colonic emergencies. British surgeons are more likely to favour single‐staged procedures, particularly with on‐table colonic lavage, when compared with US surgeons.
Microsatellite and chromosomal stable colorectal cancers demonstrate poor immunogenicity and early disease recurrence
Authors: Banerjea A. , Hands R. E. , Powar M. P. , Bustin S. A. , Dorudi S.
Published: July 2008

Objective  Colorectal cancers may demonstrate chromosomal instability (CSI) or microsatellite instability (MSI‐H). A third group of microsatellite and chromosome stable (MACS) colorectal cancer has been described more recently. Patients with MSI‐H colorectal cancers demonstrate improved outcome and a pronounced inflammatory infiltrate. Enhanced host immune response and increased immunogenicity might explain these observations. This study aims to further characterize colorectal cancer immunogenicity.

Method  Microsatellite stability status was determined in resected tumour samples. Microsatellite stable (MSS) tumour samples were stratified by DNA ploidy status, as determined by flow cytometry into aneuploid MSS (CSI) and diploid MSS (MACS) cancers. Lymphocyte proliferation, quantified by bromodeoxyuridine incorporation assays assessed tumour protein immunogenicity and ELISA assays quantified inflammatory cytokine release. Kaplan–Meier survival curves and multivariate analyses were used to determine prognostic value.

Results  Patients with MSI‐H colorectal cancer had improved outcome but those with MACS cancers undergoing curative surgery had significantly poorer disease‐free survival (P = 0.002). The MACS phenotype was an independent predictor of poor outcome (HR = 2.44, 1.33–4.47, P = 0.004). Lymphocyte proliferation assays confirmed enhanced immunogenicity of MSI‐H proteins and reduced immunogenicity of MACS proteins (P < 0.0001). In vitro levels of IFN‐γ (P = 0.004) and IL‐18 (P < 0.0001) mirrored these differences in lymphocyte activity.

Conclusions  Stratification of colorectal cancer by MSI and ploidy status may have prognostic value in patients undergoing curative surgery. MSI‐H cancers display enhanced immunogenic properties but the immune response to MACS cancers appears to be absent and this may contribute to their poor prognosis.
V‐Y Bilateral gluteus maximus myocutaneous advancement flap in the reconstruction of large perineal defects after resection of pelvic malignancies
Authors: Di Mauro D. , D’Hoore A. , Penninckx F. , De Wever I. , Vergote I. , Hierner R.
Published: July 2008

Objective  To evaluate the role of the V‐Y bilateral gluteus maximus myocutaneous flap (GLM) in the reconstruction of large perineal defects after wide surgical resections for pelvic malignancies.

Method  Twelve consecutive patients (seven females and five males), of mean age 59 years (36–78), with primary or recurrent pelvic malignancies (rectal, anal and vulvar carcinoma), underwent either abdomino‐perineal rectum excision with partial sacrectomy or total pelvic exenteration. The perineal defect was reconstructed by means of a GLM flap. Intra‐operative blood loss, operative time, hospital stay, postoperative complications and long‐term outcome were retrospectively assessed.

Results  One patient died postoperatively. All the remaining patients had at least one early and/or late complication. After a mean follow‐up of 31.2 months, seven patients were alive. No major functional impairment in daily activities was observed. Five patients experienced a slight discomfort in either walking, sitting or cycling.

Conclusion  Gluteus maximus myocutaneus flap is a useful technique for the repair of perineo‐pelvic defects after abdomino‐perineal rectum excision with partial sacrectomy.
Molecular phylogenetic analysis of all members of the genus Elminia confirms their presence within the Stenostiridae clade
Authors: Nguembock Billy , Fjeldså Jon , Cruaud Corinne , Pasquet Eric
Published: July 2008

The genus Elminia has had a jumbled taxonomic history, being placed among ‘old world flycatchers’ or ‘monarch flycatchers’, where it was for a long time lumped with Trochocercus. It was recently suggested that it might represent a deep clade in the large sylvioid radiation. Using one mitochondrial protein‐coding gene (ND2, 1041 bp) and one nuclear intron (myoglobin intron 2, 700 bp) DNA sequences, we obtained robust evidence for the phylogenetic placement of Elminia in the new family Stenostiridae, which is strongly supported by a synapomorphic insertion of one base in the nuclear myoglobin intron 2 sequence. Our analyses confirm the monophyly of Elminia and resolve relationships within this genus, but cannot confidently identify its sister‐taxon within the stenostirid clade. Two clades were strongly supported within the genus Elminia: one with the two fairy blue flycatchers and another with the three white‐tailed crested‐flycatchers. Within the first clade, Elminia longicauda appears non‐monophyletic but remains strongly related to E. albicauda. In the second clade, E. albiventris is sister to E. albonotata while the Dusky Crested Flycatcher (E. nigromitrata) appears in a basal position within this clade. According to our molecular dating, several geological events in western Africa and the Albertine Rift area seem to be related to the historical distribution of Elminia. Thus, the differentiation between E. albonotata and E. albiventris could be directly related to the tectonic history of these two regions. According to our molecular dating, at least one intercontinental dispersal event involving Culicicapa took place within the Stenostiridae clade at a time when the Middle East was forested.