bluuebunny/crossref_metadata_2025 huggingface dataset:
Transanal Treatment of Strictured Rectal Anastomosis with a Circular Stapler Device: Simple and Safe
Authors: Pabst M. , Giger U. , Senn M. , Gauer J.M. , Boldog B. , Schweizer W.
Published: March 2007

Background: Several methods of treatment for benign anastomotic strictures after low anterior resection have been described. We report and illustrate a simple, safe, and effective method for treating benign rectal anastomotic strictures by means of a transanal circular stapling device. Methods: Three patients with a clinically significant rectal stricture underwent transanal resection of the fibrous stenosis by a circular stapler device (CEEA stapler 29 or 31 mm calibre; Tyco Co., USA). Results: No complications occurred. Patients were discharged from the hospital on the first postoperative day. After a follow-up period of 8, 12 and 14 months respectively, no recurrence of the stricture was observed. The stool habits of all 3 patients were normal with 1–3 formed, asymptomatic fecal passages per day. Conclusion: Transanal reanastomosis by means of a circular stapler device is a simple and effective method. However, a larger number of patients need to be treated with this relatively new method to draw further conclusions.
The Role of Laparoscopy in Advanced Pancreatic Cancer Diagnosis
Authors: Butturini Giovanni , Crippa Stefano , Bassi Claudio , Salvia Roberto , Piccoli Micaela , Pederzoli Paolo
Published: March 2007

Background/Aims: Histological diagnosis between ductal and endocrine carcinoma is imperative in patients with advanced and unresectable pancreatic malignancies because of the different treatment modalities and prognoses. Whenever percutaneous and endoscopic ultrasound-guided pancreatic fine needle aspiration (FNA) fails to obtain a diagnostic specimen, a laparoscopic approach may be employed. Methods: Between October 2002 and July 2004, 19 patients with demonstrated unresectable pancreatic cancer underwent laparoscopy to obtain a cytohistological diagnosis. Results: The mean operative time was 83 min. Laparoscopy showed the presence of liver metastases in 15 patients that were correctly diagnosed by preoperative imaging in only 8 cases (53%). Overall 5 pancreatic FNA and 16 liver and peritoneal biopsies were obtained. In 1 patient the procedure was abandoned due to hypercapnia. In 16 patients (84%) a cytohistological diagnosis was obtained. There were no mortalities. Conclusions: Laparoscopic biopsy of advanced unresectable pancreatic cancer is a feasible, safe and reliable procedure to obtain a cytohistological diagnosis whenever ultrasound-guided FNA fails.
Long-Term Survival after Radical Resection for Pancreatic Head and Ampullary Cancer: A Potential Role for the EGF-R
Authors: Smeenk H.G. , Erdmann J. , van Dekken H. , van Marion R. , Hop W.C.J. , Jeekel J. , van Eijck C.H.J.
Published: March 2007

Background/Aim: Pancreatic cancer has a dismal prognosis. Ampullary cancer (defined as cancer of the ampulla of Vater or the distal common bile duct) has a better prognosis and is thought to be a biologically different tumor. The aim of this study was to find factors that could predict survival after radical (R-0) resection for pancreatic head and ampullary cancers. Methods: We analyzed clinical and pathological data from 93 patients who underwent a true R-0 resection for pancreatic head or ampullary cancer. Furthermore, we performed a tissue microarray protein expression analysis for several growth factor receptors and oncogenes: HER-2, EGF-R, ER, PR, C-myc, p53, p16, RB-1, and chromogranin A as a neuroendocrine differentiation marker. Results: Median survival (14 vs. 42 months) and time to recurrence (16 vs. 42 months)were significantly longer for ampullary than for pancreatic head cancers. Preoperative pain, perineural invasion, lymph node metastasis, and tumor differentiation grade are indicators of a poor survival. No differences in protein expression were found between groups, except for EGF-R which was expressed more in pancreatic head cancers (p = 0.026). Conclusions: Outcomes for ampullary cancers are better than for pancreatic head cancers. This different biological behavior can possibly be explained by differences in EGF-R expression.
Changes in Bowel Function following Transanal and Transvaginal Rectocele Repair
Authors: Tsujinaka Shingo , Tsujinaka Yasunobu , Matsuo Keigo , Akagi Kazunari , Hamahata Yukihiro
Published: March 2007

Aim: This study was designed to compare preoperative and postoperative bowel functions in patients with rectocele repair. Methods: Patients who underwent surgery for rectocele between October 1988 and October 2004 were enrolled. Prior to surgery, the patients were asked to complete a questionnaire regarding evacuation difficulty, itching, fecal incontinence, and the need for digitation. Surgery was performed either transanally (group I) or transvaginally (group II). At follow-up after 12 months, the same questionnaire was obtained in the outpatient clinic or by mail to evaluate preoperative and postoperative changes in bowel function. Results: There were 71 patients in group I and 40 patients in group II. The median age was 56 years in group I and 67 years in group II. The evacuation difficulty was significantly improved in both group I (p < 0.001) and group II (p < 0.001). Incontinence to flatus was slightly increased in group I (p = 0.33) and group II (p = 0.6). Incontinence to solid stool was not statistically different in either group. The need for digitation was markedly improved in group I (p < 0.001) and group II (p = 0.0017). Conclusion: Although surgery for rectocele potentially increases the risk of fecal incontinence, it may be indicated if presented with evacuation difficulty necessitating digitation.
Preoperative Polyethylene Glycol versus a Single Enema in Elective Bowel Surgery
Authors: Veenhof A.A.F.A. , Sietses C. , Giannakopoulos G.F. , van der Peet D.L. , Cuesta M.A.
Published: March 2007

Background: At the beginning of 2004, a large Dutch randomized study comparing mechanical bowel preparation with a single preoperative enema reported no differences in anastomotic leakage rates, septic complications, or mortality. On the basis of this study, this institution abandoned the routine practice of bowel preparation with polyethylene glycol and introduced a single preoperative enema. Methods: A consecutive series of 78 patients undergoing elective colorectal surgery with mechanical bowel preparation using polyethylene glycol (PG group) was compared to a consecutive series of 71 patients with a single preoperative enema (SE group). The PG group was operated between June 2003 and December 2004, the SE group between January 2005 and January 2006. Mortality, anastomotic leakage, and infectious and noninfectious complications were compared. Results: Mortality, anastomotic leakage, frequency of reoperations, and hospital stay were comparable for both groups. The overall postoperative morbidity was significantly higher in the SE group (26 vs. 9, p = 0.003). Specifically, the incidence of wound infections was significantly higher in the SE group (7 vs. 1, p = 0.041). Furthermore, a trend was observed in the incidence of intra-abdominal infections which was higher in the SE group (8 vs. 2, p = 0.070). Also a trend toward more extra-abdominal infectious complications was seen in the SE group (11 vs. 4, p = 0.086). Conclusions: Based on both the conflicting data currently available from different randomized studies and our results, the preoperative bowel preparation protocol in our institution has been changed. All left-sided colonic resections, in patients who can tolerate mechanical bowel preparation, are prepared with polyethylene glycol.
Aortoesophageal Fistula Secondary to Reflux Esophagitis
Authors: Podbielski Francis J. , Rodriguez Heron E. , Zhu Richard Y. , Worley Todd A. , Fontaine Jacques Pierre , Connolly Mark M.
Published: March 2007

Aortoenteric fistula is a rare cause of massive upper gastrointestinal bleeding and is in the overwhelming majority of cases due to erosion of a suture line of a prosthetic vascular graft into the bowel. We report the case of a massive fatal gastrointestinal hemorrhage from an aortoenteric fistula secondary to erosion from reflux esophagitis. Proper management requires expedient radiographic and endoscopic evaluation, and even with appropriate management mortality remains extremely high.
Endothelial Nox2 Overexpression Potentiates Vascular Oxidative Stress and Hemodynamic Response to Angiotensin II
Authors: Bendall Jennifer K. , Rinze Ruth , Adlam David , Tatham Amy L. , de Bono Joe , Channon Keith M.
Published: March 2007

Vascular disease states are associated with endothelial dysfunction and increased production of reactive oxygen species (ROS) derived from vascular NADPH oxidases in both vascular smooth muscle cells (VSMCs) and endothelial cells. Recent evidence suggests an important role for VSMC NADPH oxidases in vascular ROS production. However, it is unclear whether increased NADPH oxidase activity in endothelial cells alone is sufficient to alter overall vascular ROS production and hemodynamics. We sought to address these questions using transgenic mice with endothelial-targeted overexpression of the catalytic subunit of NADPH oxidase, Nox2. Aortas of Nox2 transgenic (Nox2-Tg) mice had increased total Nox2 mRNA and protein levels compared with wild-type littermates. Both p22phox mRNA and protein levels were also significantly elevated in Nox2-Tg aortas. Aortic superoxide production was significantly increased in Nox2-Tg mice compared with wild-type, but this difference was abolished by endothelial removal. Superoxide dismutase inhibition increased superoxide release and levels of Mn superoxide dismutase protein were significantly elevated in aortas from Nox2-Tg mice compared with wild type. Increased ROS production from endothelial Nox2 overexpression led to increased endothelial nitric oxide synthase protein and extracellular signal-regulated kinase 1/2 phosphorylation in transgenic aortas. Basal blood pressure was similar, however the pressor responses to both acute and chronic angiotensin II administration were significantly increased in Nox2-Tg mice compared with wild type. These results demonstrate that endothelial-targeted Nox2 overexpression is sufficient to increase vascular NADPH oxidase activity, activate downstream signaling pathways, and potentiate the hemodynamic response to angiotensin II, despite compensatory increases in vascular antioxidant enzymes. Endothelial cell Nox2-containing NADPH oxidase plays an important functional role in vascular redox signaling.
Regulation of Cardiac cAMP Synthesis and Contractility by Nucleoside Diphosphate Kinase B/G Protein βγ Dimer Complexes
Authors: Hippe Hans-Joerg , Luedde Mark , Lutz Susanne , Koehler Henrike , Eschenhagen Thomas , Frey Norbert , Katus Hugo A. , Wieland Thomas , Niroomand Feraydoon
Published: March 2007

Heterotrimeric G proteins are pivotal regulators of myocardial contractility. In addition to the receptor-induced GDP/GTP exchange, G protein α subunits can be activated by a phosphate transfer via a plasma membrane-associated complex of nucleoside diphosphate kinase B (NDPK B) and G protein βγ-dimers (Gβγ). To investigate the physiological role of this phosphate transfer in cardiomyocytes, we generated a Gβ
1
γ
2
-dimer carrying a single amino acid exchange at the intermediately phosphorylated His-266 in the β
1
subunit (Gβ
1
H266Lγ
2
). Recombinantly expressed Gβ
1
H266Lγ
2
were integrated into heterotrimeric G proteins in rat cardiomyocytes but were deficient in intermediate Gβ phosphorylation. Compared with wild-type Gβ
1
γ
2
(Gβ
1
WTγ
2
), overexpression of Gβ
1
H266Lγ
2
suppressed basal cAMP formation up to 55%. A similar decrease in basal cAMP production occurred when the formation of NDPK B/Gβγ complexes was attenuated by siRNA-mediated NDPK B knockdown. In adult rat cardiomyocytes expressing Gβ
1
H266Lγ
2
, the basal contractility was suppressed by ≈50% which correlated to similarly reduced basal cAMP levels and reduced Ser16-phosphorylation of phospholamban. In the presence of the β-adrenoceptor agonist isoproterenol, the total cAMP formation and contractility were significantly lower in Gβ
1
H266Lγ
2
than in Gβ
1
WTγ
2
expressing cardiomyocytes. However, the relative isoproterenol-induced increased was not affected by Gβ
1
H266Lγ
2
. We conclude that the receptor-independent activation of G proteins via NDPK B/Gβγ complexes requires the intermediate phosphorylation of G protein β subunits at His-266. Our results highlight the histidine kinase activity of NDPK B for Gβ and demonstrate its contribution to the receptor-independent regulation of cAMP synthesis and contractility in intact cardiomyocytes.
Inducible Nitric Oxide Synthase Deficiency Protects the Heart From Systolic Overload–Induced Ventricular Hypertrophy and Congestive Heart Failure
Authors: Zhang Ping , Xu Xin , Hu Xinli , van Deel Elza D. , Zhu Guangshuo , Chen Yingjie
Published: March 2007

Inducible nitric oxide synthase (iNOS) protein is expressed in cardiac myocytes of patients and experimental animals with congestive heart failure (CHF). Here we show that iNOS expression plays a role in pressure overload–induced myocardial chamber dilation and hypertrophy. In wild-type mice, chronic transverse aortic constriction (TAC) resulted in myocardial iNOS expression, cardiac hypertrophy, ventricular dilation and dysfunction, and fibrosis, whereas iNOS-deficient mice displayed much less hypertrophy, dilation, fibrosis, and dysfunction. Consistent with these findings, TAC resulted in marked increases of myocardial atrial natriuretic peptide 4-hydroxy-2-nonenal (a marker of lipid peroxidation) and nitrotyrosine (a marker for peroxynitrite) in wild-type mice but not in iNOS-deficient mice. In response to TAC, myocardial endothelial NO synthase and iNOS was expressed as both monomer and dimer in wild-type mice, and this was associated with increased reactive oxygen species production, suggesting that iNOS monomer was a source for the increased oxidative stress. Moreover, systolic overload–induced Akt, mammalian target of rapamycin, and ribosomal protein S6 activation was significantly attenuated in iNOS-deficient mice. Furthermore, selective iNOS inhibition with 1400W (6 mg/kg per hour) significantly attenuated TAC induced myocardial hypertrophy and pulmonary congestion. These data implicate iNOS in the maladaptative response to systolic overload and suggest that selective iNOS inhibition or attenuation of iNOS monomer content might be effective for treatment of systolic overload-induced cardiac dysfunction.
Acrolein Induces Cyclooxygenase-2 and Prostaglandin Production in Human Umbilical Vein Endothelial Cells
Authors: Park Yong Seek , Kim Jayoung , Misonou Yoshiko , Takamiya Rina , Takahashi Motoko , Freeman Michael R. , Taniguchi Naoyuki
Published: March 2007

Objective—

Acrolein, a known toxin in tobacco smoke, might be involved in atherogenesis. This study examined the effect of acrolein on expression of cyclooxygenase-2(COX-2) and prostaglandin (PG) production in endothelial cells.

Methods and Results—

Cyclooxygenase (COX)-2 induction by acrolein and signal pathways were measured using Western blots, Northern blots, immunoflouresence, ELISA, gene silencing, and promoter assay. Colocalization of COX2 and acrolein-adduct was determined by immunohistochemistry. Here we report that the levels of COX-2 mRNA and protein are increased in human umbilical vein endothelial cells (HUVECs) after acrolein exposure. COX-2 was found to colocalize with acrolein-lysine adducts in human atherosclerotic lesions. Inhibition of p38 MAPK activity abolished the induction of COX-2 protein and PGE
2
accumulation by acrolein, while suppression of extracellular signal-regulated kinase (ERK) and JNK activity had no effect on the induction of COX-2 expression in experiments using inhibitors and siRNA. Furthermore, rottlerin, an inhibitor of protein kinase Cδ (PKCδ), abrogated the upregulation of COX-2 at both protein and mRNA levels.

Conclusion—

These results provide that acrolein may play a role in progression of atherosclerosis and new information on the signaling pathways involved in COX-2 upregulation in response to acrolein and provide evidence that PKCδ and p38 MAPK are required for transcriptional activation of COX-2.
Grb2 Is Required for Atherosclerotic Lesion Formation
Authors: Proctor Brandon M. , Ren Jie , Chen Zhouji , Schneider Jochen G. , Coleman Trey , Lupu Traian S. , Semenkovich Clay F. , Muslin Anthony J.
Published: March 2007

Objective—

Grb2 is a ubiquitously expressed linker protein that couples growth factor receptor activation to downstream mitogen-activated protein kinase (MAPK) cascades. Macrophage proliferation and uptake of modified lipoproteins are critical components of atherogenesis which require MAPK activation. However, the precise role of upstream signaling factors and the interrelationship of various MAPK cascades in the pathogenesis of atherosclerosis remains uncertain. Complete deletion of Grb2 in mice results in early embryonic lethality. However, Grb2 heterozygous mice appear normal at birth. To test the role of the Grb2 adapter protein in atherosclerotic lesion formation, we generated Grb2
+/−
mice in the apoE
−/−
genetic background.

Methods and Results—

Grb2
+/−
apoE
−/−
and apoE
−/−
mice exhibited similar body weight and serum lipid profiles. However, Grb2
+/−
apoE
−/−
mice on a Western diet had reduced lesion formation compared with apoE
−/−
mice by aortic sinus and en face assays. Transplantation of apoE
−/−
mice with Grb2
+/−
apoE
−/−
or apoE
−/−
bone marrow indicated that Grb2 haploinsufficiency in blood-borne cells confers resistance to Western diet–induced atherosclerosis. Cell culture experiments with bone marrow–derived macrophages showed that Grb2 is required for oxidized low density lipoprotein (oxLDL)-induced MAPK activation and foam cell formation.

Conclusions—

Grb2 is required for atherosclerotic lesion formation and uptake of oxidized LDL by macrophages.
Endotoxemia, Immune Response to Periodontal Pathogens, and Systemic Inflammation Associate With Incident Cardiovascular Disease Events
Authors: Pussinen Pirkko J. , Tuomisto Karolina , Jousilahti Pekka , Havulinna Aki S. , Sundvall Jouko , Salomaa Veikko
Published: March 2007

Objective—

In periodontitis, overgrowth of Gram-negative bacteria may cause endotoxemia and systemic inflammation leading to cardiovascular diseases (CVD). We investigated in a prospective study the associations of serum endotoxin, antibodies to periodontal pathogens, and inflammation markers with the risk of incident CVD.

Methods and Results—

The FINRISK 1992 cohort of 6051 individuals was followed up for 10 years. We examined 185 incident CVD events and a control cohort of 320 individuals using a prospective case–cohort design. High antibody response to periodontal pathogens independently predicted incident CVD events with hazard ratios (HR, quartile 4 versus quartiles 1 to 3, 95% CI) of 1.87 (1.13 to 3.08). The subjects with a high antibody response and high CRP or interleukin (IL)-6 had multivariate-adjusted HRs of 3.01 (1.27 to 7.09) and 3.11 (1.42 to 6.83) compared with low-responders, respectively. The corresponding HRs for high endotoxin concentration were 1.82 (1.22 to 2.73, alone), 3.92 (1.99 to 7.74, with CRP), 3.54 (1.78 to 7.03, with IL-6), and 2.26 (1.13 to 4.52, with tumor necrosis factor (TNF)-α) after adjusting for age and gender. These associations were abolished after adjusting for serum lipids. High endotoxin/HDL ratio, however, had a multivariate-adjusted HR of 1.92 (1.19 to 3.08) for CVD events.

Conclusions—

Our results suggest that the exposure to periodontal pathogens or endotoxin induces systemic inflammation leading to increased risk for CVD.
Farnesyltransferase Inhibitor, Manumycin A, Prevents Atherosclerosis Development and Reduces Oxidative Stress in Apolipoprotein E-Deficient Mice
Authors: Sugita Michiko , Sugita Hiroki , Kaneki Masao
Published: March 2007

Objective—

Statins are presumed to exert their antiatherogenic effects in part via lipid-lowering–independent mechanisms. Inhibition of protein farnesylation and/or geranylgeranylation by statins has been postulated to contribute to the lipid-lowering–independent effects. However, a role for protein farnesylation in atherogenesis has not yet been studied. Therefore, we examined the effects of farnesyltransferase inhibitor, manumycin A, on the development of atherosclerosis in apolipoprotein E (apoE)-deficient mice fed a high-fat diet.

Methods and Results—

Manumycin A treatment for 22 weeks decreased Ras activity, and reduced fatty streak lesion size at the aortic sinus to 43% of that in vehicle-treated apoE-deficient mice (
P
<0.05), while plasma total cholesterol was unaltered. Moreover, manumycin A reduced α-smooth muscle actin-positive area to 29% of that in vehicle-treated apoE-deficient mice (
P
<0.01). The prevention of atherogenesis by manumycin A was accompanied by amelioration of oxidative stress, as judged by reduced ex vivo superoxide production and nitrotyrosine immunoreactivity.

Conclusions—

These results indicate that the inhibition of farnesyltransferase prevents the development of mature atherosclerosis with concomitant alleviation of oxidative stress in apoE-deficient mice. The present data highlight farnesyltransferase as a potential molecular target for preventive and/or therapeutic intervention against atherosclerosis.
c-Myb–Dependent Inositol 1,4,5-Trisphosphate Receptor Type-1 Expression in Vascular Smooth Muscle Cells
Authors: Afroze Talat , Sadi Al Muktafi , Momen M. Abdul , Gu Steven , Heximer Scott , Husain Mansoor
Published: March 2007

Objective—

The IP3 receptor-1 (IP3R1) mediates Ca
2+
signals critical to vascular smooth muscle cell (VSMC) proliferation. The cell cycle–associated transcription factor c-Myb increases Ca
2+
at the G
1
/S transition. Here we show the mechanism through which c-Myb regulates expression of IP3R1.

Methods & Results—

Ribonuclease protection confirmed transcriptional start (TS), and qRT-PCR revealed a 6-fold increase in IP3R1 mRNA as immortalized VSMC progress from G
0
to G
1
/S. A c-Myb neutralizing antibody decreased IP3R1 mRNA expression 3-fold, and abolished the 3.4-fold increase in IP3R1 protein observed at G
1
/S. Primary aortic VSMCs in culture and proliferating carotid VSMCs in vivo showed similar regulation of IP3R1 mRNA and protein. Sequence analysis of a 3.1-Kb mouse IP3R1 promoter revealed 17 putative c-Myb binding sites. Reporter assays demonstrated a 2-fold increase in promoter activity in G
1
/S- versus G
0
-synchronized VSMCs, which was abolished by functional c-Myb knockdown or deletion of promoter sequences upstream and downstream of TS. Point mutations in Myb sites-13 or -15 significantly blunted G
1
/S-specific promoter induction in both immortalized and primary VSMCs. Gel shift and ChIP confirmed binding of c-Myb to sites-13 and -15 in G
1
/S stage VSMCs.

Conclusion—

c-Myb regulates cell cycle–associated IP3R1 transcription in VSMCs via specific highly conserved Myb-binding sites in the IP3R1 promoter.
Disinhibition of the Premotor Cortex Contributes to a Maladaptive Change in the Affected Hand After Stroke
Authors: Takeuchi Naoyuki , Tada Takeo , Chuma Takayo , Matsuo Yuichiro , Ikoma Katsunori
Published: March 2007

Background and Purpose—

The mechanism of reorganization after stroke remains uncertain. Several studies that have measured reaction time (RT) delay by transcranial magnetic stimulation (TMS) have revealed some substrates responsible for the reorganization of motor recovery. In this study, we evaluated the RT delay and inhibitory functions by examining the silent period (SP) in the primary motor cortex (M1) and premotor cortex (PMC) of the affected hemisphere. Using these data, we investigated whether a change in the inhibitory system might influence motor recovery.

Methods—

This study was performed in 20 patients with chronic subcortical stroke. To evaluate the RT delay, TMS was applied to the affected hemisphere 100 ms after showing the cue that indicated paretic finger movement. The SP was induced by TMS over the affected hemisphere during voluntary contraction of the paretic hand.

Results—

The RT delays of the PMC were more prominent in patients with greater disability. The ratio of SP duration to RT delay in the PMC decreased with the decline in motor function. Moreover, upper arm function was better than hand function in patients with a decreased SP in the PMC.

Conclusions—

The inhibitory function of the PMC was disturbed in patients with poor motor function. Stroke patients with poor motor ability appeared to depend not only on the motor pathway from M1 but also on other parallel motor circuits to move the paretic side. However, this brain reorganization might result in the sacrifice of function of the affected hand.
Association Between IgM Against an Aldehyde-Modified Peptide in Apolipoprotein B-100 and Progression of Carotid Disease
Authors: Fredrikson Gunilla Nordin , Hedblad Bo , Berglund Göran , Alm Ragnar , Nilsson Jan-Åke , Schiopu Alexandru , Shah Prediman K. , Nilsson Jan
Published: March 2007

Background and Purpose—

Autoantibodies against antigens in oxidized low-density lipoprotein are common in people; experimental studies suggest that these immune responses have a functional role in the disease process. The aim of this study was to evaluate the relationship between the immune response against one defined oxidized low-density lipoprotein antigen, the aldehyde-modified peptide corresponding amino acids 3136 and 3155 (MDA-p210) in apolipoprotein (apo) B-100, and progression of carotid intima media thickness (IMT).

Methods—

IgM and IgG against MDA-p210 were determined by enzyme-linked immunosorbent assay at baseline and after 12 months of treatment with placebo, metoprolol, fluvastatin, or metoprolol/fluvastatin in 751 individuals participating in the BCAPS. Carotid IMT was assessed by ultrasonography at baseline and after 18 and 36 months of treatment.

Results—

Antibody levels did not change in response to treatment, but high baseline MDA-p210 IgM levels were associated with a more rapid progression of carotid disease both at 18 (
r
=0.09,
P
<0.05) and 36 months (
r
=0.12,
P
<0.005). At 36 months, the difference in IMT progression rate per year between those with high MDA-p210 IgM levels and those with low was 0.011 mm (95% CI=0.005 to 0.018 mm,
P
<0.0001). Treatment with fluvastatin markedly decreased the progression of IMT among subjects with high but not with low MDA-p210 IgM levels. There was no association between MDA-p210 IgG and carotid IMT progression.

Conclusions—

IgM against the aldehyde-modified peptide corresponding amino acids 3136 and 3155 in apo B-100 is common in subjects with asymptomatic carotid disease, and high levels are associated with a more rapid progression of carotid IMT. The observation that the effect of fluvastatin was restricted to subjects with high MDA-p210 IgM levels may reflect the increased rate of disease progression in this group.
Effects of Peroxisome Proliferator-Activated Receptor Ligands in Modulating Tissue Factor and Tissue Factor Pathway Inhibitor in Acutely Symptomatic Carotid Atheromas
Authors: Golledge Jonathan , Mangan Simone , Clancy Paula
Published: March 2007

Background and Purpose—

Severely stenotic, symptomatic carotid atheromas are associated with a high risk of stroke in the short term. Although carotid endarterectomy is effective in reducing this stroke risk, it is frequently not applied within the time window for significant benefit. We investigated the effect of peroxisome proliferator-activated receptor (PPAR) -α and -γ ligands in acutely modifying tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in unstable carotid atheromas.

Methods—

During a 3-year period, 64 patients who had experienced a transient ischemic attack or stroke with good recovery within 6 weeks before surgery and 12 asymptomatic patients with a >70% carotid stenosis were recruited. The expression of PPAR-α and -γ was investigated in endarterectomy samples. The effects of the PPAR-α and -γ ligands fenofibrate and rosiglitazone were investigated in cell culture experiments. Targeted biopsy specimens from endarterectomy samples (n=48) were incubated with medication for 4 days. TF and TFPI were assessed by immunohistochemistry, Western blot analysis, flow cytometry, and activity assays.

Results—

PPAR-γ1 but not -α was downregulated in atheromas removed from patients with recent symptoms and no evidence of diabetes. Fenofibrate but not rosiglitazone impaired the induction of TF in human endothelial cells and reduced resting levels of TF activity in vascular smooth muscle cells. Rosiglitazone but not fenofibrate increased TFPI secretion from human endothelial cells. Both fenofibrate (100±18.7% to 56.6±8.8%,
P
=0.005; 0.2664±0.0696 to 0.1771±0.0310,
P
=0.02) and rosiglitazone (100±22% to 88.3±20%,
P
=0.02; 0.3113±0.0729 to 0.2287±0.0415,
P
=0.04) reduced TF expression and activity, respectively, in atheroma biopsy specimens. A low expression of TFPI was found in atheroma biopsy specimens with little evidence of TFPI activity.

Conclusions—

This study suggests that both PPAR-α and -γ ligands have beneficial effects in acutely reducing TF in unstable carotid atheromas.
Filial Piety, Infidel Yale, and Memory Making in Lyman Beecher's Autobiography
Authors: Baker Thomas N.
Published: March 2007

Rampant drunkenness, a deserted chapel, schoolboy Voltaires greeting Rousseaus on the Green—this is how Lyman Beecher recalled his Yale days in his Autobiography (1864). But evidence suggests that these colorful events may have been cribbed from an unsigned 1818 memoir of, oddly enough, Yale's President Timothy Dwight.
“A Strange Medley-Book”: Lucy Larcom's An Idyl of Work
Authors: Loeffelholz Mary
Published: March 2007

Lucy Larcom's long autobiographical poem An Idyl of Work (1874) is a formally sophisticated treatment not of the material conditions of industrial labor but rather of the conditions of the Lowell mill workers' access to culture and of the agency of literary culture in the making of class.
Satan's War against the Covenant in Salem Village, 1692
Authors: Ray Benjamin C.
Published: March 2007

Using maps to plot the locations of church members, accusers, and accused witches in Salem village, the essay concludes that the belief that Satan had targeted village church members significantly influenced both accusers and magistrates and thereby produced the unprecedented number of witchcraft accusations and executions.
Images of Hope: Representations of the Death of the Virgin, East and West
Authors: Walsh Elizabeth
Published: March 2007

Christianity has existed for nearly two thousand years, yet its divergent forms and rituals almost belie its existence. Perhaps the best image to express its reality is the cross, but that too has many interpretations. Is there any image that can be said to represent all that Christianity intends? The Death of the Virgin, which was first represented in art in the tenth century, is an image which includes all of the basic elements of the Christian faith: incarnation, death, and resurrection. The story of this icon spans much of Christian history as the icon evolved through legend, liturgy, art, and theology. It is an imaginative rendition of centuries of speculation, study, discussion, prayer, and devotion. Although Christian unity is more of a desire than a reality, this image transcends the divisions and separation which have marred the religion and stands as a sign of hope and unity. In order to understand the icon, it seems necessary to trace the process of its signification. Icons of Mary's death occur in eastern and western art; thus, they represent a call to be mindful of the essential unity of the Christian faith. This article will focus especially on the categories of legend, liturgy, and art.
Shakespeare's Grand Deception: The Merchant of Venice—Anti-Semitism as "Uncanny Causality" and the Catholic-Protestant Problem
Authors: Coonradt Nicole
Published: March 2007

Considering the notion of poetry in Early Modern drama as a veil for political commentary during a perilously censorious time, this essay closely examines Shakespeare's The Merchant of Venice in its previously ignored historical context while providing a brief survey of the play's critical heritage to show how the play's anti-Judaism effects reader response. Within an emerging new vein of Dissident Theory that explores formerly overlooked historical facts in England's troubled Reformation history, this essay provides an alternate interpretation reading "otherwise" to discover how Shylock haunts our interpretations of the play, which is not, as this essay's title suggests, so much about the Jewish Question, but the Christian one as found in the Catholic-Protestant crisis, as crisis it undoubtedly was. This reading offers a measured departure from most existing scholarship by exploring the play poststructurally as the site of a metaphoric, performative conversion where Shakespeare employs the trope of anti-Semitism ironically to convey a coded message about the moral incoherence in popular Christianity—specifically concerning aroused anxieties about Christian identity as seen in forced conversions and the complete violation of the basic tenets of mercy and justice which highlight the hypocrisy in Christianity as Shakespeare saw it practiced.
Introduction to Special Focus
Authors: Kopanski Ataullah Bogdan , Idriz Mesut
Published: March 2007

During the 20th century, there have been numerous scholarly attempts in studying, analyzing and even to some extent, criticizing the issues pertaining to the contacts, impacts and relations between the Muslim world and the West. However, when dealing with these issues, the geography should not be limited to the Muslim world and the West, Europe in particular, but it should cover both Europe and Asia taken together where the earliest civilizations took place and by the 7th century, Islamic civilization flourished in the center of domain civilizations. With a wider and more positive look, the four articles by the academicians, (namely Danial M. Yosuf, Ali Çaksu, Anke Iman Bouzenita and Mesut Idriz), selected to be featured in this edition will contribute not only to this field of study but also avoid or remove the barriers and concentrate on the bridges between the Islamic world and the Eurasia. All the articles are original works and published for the first time in this volume The focus of this special edition is on the paradoxes between the Islamic and Eurasian worlds.
Davutoglu's Paradigm, Winkel's Epistemé and Political Science in Malaysia
Authors: Yusof Danial Mohd
Published: March 2007

Husserlian phenomenology and its terminology are utilised to justify the sociology of Islam and its essentialist response through the course of transcultural exchanges and sedimentation with the irreconcilable weltanshauung of the West. At the same time, the issue of structure and reliable knowledge is considered through the difficult relationship between revivalist religion and state politics where political legitimacy and the development of institutions is a feature of socio-political fact. Here, Malaysian political culture and democracy is used as an example. It makes out that sociopolitical realities, if not co-incidental with discourses of reliable knowledge and moral society, are representations of the conciliation of interests with specific value orientation with regards to alternative conceptions of moral society.
Ibn Khaldun and Hegel on Causality in History: Aristotelian Legacy Reconsidered
Authors: Çaksu Ali
Published: March 2007

There have been several attempts to identify the 'four causes' of history in Ibn Khaldun and Hegel. These attempts have been inspired by the presupposition that both Ibn Khaldun and Hegel are basically Aristotelian in their outlook, and that Aristotle's four causes, which, for him, pertained to physics and metaphysics, were simply extended to the domain of history by Ibn Khaldun and Hegel. However, it is the main thesis of this study that Ibn Khaldun's and Hegel's approaches to causality cannot be reduced to a mechanical application of Aristotelian doctrine and that in developing their philosophies of history, both Ibn Khaldun and Hegel transformed the Aristotelian doctrine of the four basic causes. Their transformations of this doctrine were so profound that it is an oversimplification and a distortion to simply impose the Aristotelian scheme on their systems.
From a Local Tradition to a Universal Practice: Ijāzah as a Muslim Educational Tradition (With Special Reference to a 19th Century Idrīs Fahmī b. Sālih's Ijāzah Issued in the Balkans and Its Annotated English Translation)
Authors: Idriz Mesut
Published: March 2007

The ijāzah tradition is recognized as having a long history in Muslim educational life. The term 'ijāzah' in Islamic pedagogy generally signifies a 'licence to teach', and more specifically refers to a certificate issued by a professor in an institution of higher learning to a student who has attended a course of lecturers to the professor's satisfaction, and who has been deemed henceforth as qualified to transmit the same subject to his own students. The ijāzah tradition developed in Muslim education life as early as the 4th century A.H. (10th century A.D.) and became a universally applied educational procedure in all Muslim lands. Originally, it was a tradition developed by Muslims under the influence of Islamic sciences, such as hadīth and tafsīr. Some two centuries later, in the second half of the 12th century, ijāzah made its appearance in the Latin West or Christian Europe. It was a licence to teach, a so-called 'licentia docendi', which is the same as ijāzah. Licentia docendi was the earliest form of certificate in the West. But throughout history, the term 'licentia docendi' has been altered, according to the university system, into certificate, diploma, degree, etc. Whereas the term ijāzah has remained almost the same since the time it was developed, from the early years of Islam up until today, with a few exceptions in some areas. The various ijāzahs in Islamic sciences and in other fields demonstrate the religious, cultural and educational unity of Muslims in the past, despite their geographical differences. In this article, we will have an attempt to study the ijāzah tradition in the Balkans by analyzing an ijāzah issued in the 19th century in the famous city of Üsküp (Skopje), then translating the same ijāzah into English.
Investigating the Link Between Validation Seeking and Lay Dispositionism
Authors: Friedman Ronald S. , Cooper M. Lynne , Chladek Michael R. , Rudy Duane
Published: March 2007

In this study, the authors investigated the relationship between validation seeking (VS; Dykman, 1998) and lay dispositionism, the use of personality traits as the basis for social inference (Chiu, Hong, & Dweck, 1997). Specifically, the authors sought to empirically address three questions: (a) Does VS predict the tendency to make dispositional inferences and, if so, do social comparison tendencies mediate this relationship? (b) Does VS mediate the association between implicit person theories and lay dispositionism? and (c) Does contingent parental regard indirectly predict lay dispositionism via its effects on VS and/or implicit person theories? Results suggest that both VS and entity person theories facilitate lay dispositionism, yet do so via distinct processes. Both processes are driven at least partly by contingent parental regard; however, their effects on lay dispositionism differ in scope and in the extent to which they entail social comparison.
Assimilation and Contrast in Persuasion
Authors: Tormala Zakary L. , Clarkson Joshua J.
Published: March 2007

The present research explores a contextual perspective on persuasion in multiple message situations. It is proposed that when people receive persuasive messages, the effects of those messages are influenced by other messages to which people recently have been exposed. In two experiments, participants received a target persuasive message from a moderately credible source. Immediately before this message, participants received another message, on a different topic, from a source with high or low credibility. In Experiment 1, participants' attitudes toward the target issue were more favorable after they had first been exposed to a different message from a low rather than high credibility source (contrast). In Experiment 2, this effect only emerged when a priming manipulation gave participants a dissimilarity mindset. When participants were primed with a similarity mindset, their attitudes toward the target issue were more favorable following a different message from a high rather than low credibility source (assimilation).
Results of Arthroscopic Medial Retinacular Release for Treatment of Medial Subluxation of the Patella
Authors: Shannon Brian D. , Keene James S.
Published: March 2007

Background

Medial subluxation of the patella is a rare, disabling condition that has iatrogenic and traumatic causation. To date, only open reconstructions have been reported for operative treatment of this condition, but these procedures have a high rate of complications, revisions, and subsequent surgery. This is the first study to present the results of arthroscopic medial retinacular release for treatment of this problem.

Hypothesis

Arthroscopic release will alleviate painful medial patellar subluxation.

Study Design

Case series; Level of evidence, 4.

Methods

Nine knees (7 patients) with painful, recurrent medial subluxation of the patella that occurred spontaneously (2 knees) or after a lateral release (5 knees) or an injury (2 knees) were treated with an arthroscopic medial retinacular release. The retinaculum was released 2 cm medial to the superior pole of the patella down to the anteromedial portal. At a mean follow-up of 2.7 years (range, 1-8 years), all knees were evaluated, and the results were graded according to the Merchant and Mercer rating scale.

Results

The mean age of the patients was 25 years (range, 15-38 years), and the mean duration of the subluxations before surgery was 28 months (range, 6-48 months). In all 7 patients (9 knees), the medial release relieved their medial subluxation and knee pain, and there were 6 excellent and 3 good results. There were no complications or further realignment surgery needed after this procedure.

Conclusion

An arthroscopic medial retinacular release will successfully treat painful medial subluxation of the patella.
Epidemiology of High School and Collegiate Football Injuries in the United States, 2005-2006
Authors: Shankar Prasad R. , Fields Sarah K. , Collins Christy L. , Dick Randall W. , Comstock R. Dawn
Published: March 2007

Background

Football, one of the most popular sports among male high school students in the United States, is a leading cause of sports-related injuries, with an injury rate almost twice that of basketball, the second most popular sport.

Hypothesis

Injury patterns will vary between competition and practice exposures and between levels of play (ie, high school vs. National Collegiate Athletic Association [NCAA]).

Study Design

Descriptive epidemiology study.

Methods

Football-related injury data were collected over the 2005-2006 school year from 100 nationally representative high schools via High School RIO™ (Reporting Information Online) and from 55 Division I, II, and III colleges via the NCAA Injury Surveillance System.

Results

Nationally, an estimated 517 726 high school football-related injuries (1881 unweighted injuries) occurred during the 2005-2006 season. The rate of injury per 1000 athlete-exposures was greater during high school competitions (12.04) than during practices (2.56). The rate of injury per 1000 athlete-exposures was also greater during collegiate competitions (40.23) than during practices (5.77). While the overall rate of injury per 1000 athlete-exposures was greater in the NCAA (8.61) than in high school (4.36), high school football players sustained a greater proportion of fractures and concussions. Running plays were the leading cause of injury, with running backs and linebackers being the positions most commonly injured.

Conclusion

Patterns of football injuries vary, especially by type of exposure and level of play. Future studies should continue to compare differences in injury patterns in high school and collegiate football, with particular emphasis placed on high-risk plays (running plays) and positions (running backs and linebackers).
Fresh Osteochondral Allografting in the Treatment of Osteochondritis Dissecans of the Femoral Condyle
Authors: Emmerson Bryan C. , Görtz Simon , Jamali Amir A. , Chung Christine , Amiel David , Bugbee William D.
Published: March 2007

Background

The treatment of osteochondritis dissecans in the adult knee can be challenging. As part of our comprehensive treatment program, fresh osteochondral allografts have been used in the surgical management of osteochondritis dissecans of the femoral condyle.

Hypothesis

Fresh osteochondral allograft transplantation will provide a successful surgical treatment for osteochondritis dissecans of the femoral condyle.

Study Design

Case series; Level of evidence, 4.

Methods

Sixty-six knees in 64 patients underwent fresh osteochondral allografting for the treatment of osteochondritis dissecans. Each patient was evaluated both preoperatively and postoperatively using an 18-point modified D'Aubigné and Postel scale. Subjective assessment was performed using a patient questionnaire. Radiographs were evaluated preoperatively and postoperatively.

Results

Mean follow-up was 7.7 years (range, 2-22 years). There were 45 men and 19 women with a mean age of 28.6 years (range, 15-54 years). All patients had undergone previous surgery. Forty-one lesions involved the medial femoral condyle, and 25 involved the lateral femoral condyle. All were osteochondritis dissecans type 3 or 4. The mean allograft size was 7.5 cm2. One knee was lost to follow-up. Of the remaining 65 knees, 47 (72%) were rated good/excellent, 7 (11%) were rated fair, and 1 (2%) was rated poor. Ten patients (15%) underwent reoperation. The mean clinical score improved from 13.0 preoperatively to 16.4 postoperatively (P < .01). Fifty-nine of 64 patients completed questionnaires. Subjective knee function improved from a mean of 3.4 to 8.4 on a 10-point scale (P < .01).

Conclusion

With greater than 70% good or excellent results, fresh osteochondral allograft transplantation is a successful surgical treatment for osteochondritis dissecans of the femoral condyle.
Lower Reinjury Rate with a Coach-Controlled Rehabilitation Program in Amateur Male Soccer
Authors: Hägglund Martin , Walden Markus , Ekstrand Jan
Published: March 2007

Background

Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury.

Hypothesis

The rate of reinjury is reduced using a coach-controlled rehabilitation program.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups.

Results

There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16-0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11-0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%).

Conclusion

The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.