bluuebunny/crossref_metadata_2025 huggingface dataset:
Review : Utilization of dimethyl sulfoxide for treating anthracycline extravasation
Authors: Rospond Raylene M.
Published: November 2007

Objective. To review the literature available on the use of dimethyl sulfoxide (DMSO) to treat anthracy cline extravasation.

Data Sources. English-language literature was gathered using Medline, EMBASE International Phar maceutical Abstracts, CINAHL, and references from bibliographies.

Study Selection. Studies selected for review included controlled animal studies and any available human studies, including case reports and case series. All studies must have used DMSO in the treatment of an anthracycline extravasation.

Data Extraction. Data extracted from animal studies included the animal model used; method of doxorubicin and DMSO administration; ulcer out come ; and statistical significance. Individual case re ports and case series were abstracted for the anti neoplastic agent extravasated; associated symptoms; DMSO administration; concurrent therapies; and short- and long-term results (symptoms, functional damage).

Data Synthesis. One of six animal studies indi cated a significant difference in peak lesion size and area under the curve between DMSO and control. However, local cooling resulted in less toxicity as compared with DMSO, and the time to ulcer healing was actually prolonged in the DMSO-treated group. Clinical experience with DMSO has resulted in no surgical intervention and no residual function impair ment after anthracycline extravasation.

Conclusion. The controversial animal data and the lack of controlled clinical experience with DMSO should preclude its use as the sole initial therapy of anthracycline extravasations. A comparison study be tween topical DMSO and local cooling versus local cooling alone would aid in determining the true benefit of DMSO in the treatment of anthracycline extravasation.
Ambulatory infusion of dacarbazine for metastic malignant melanoma: A clinical, pharmaceutical, and pharmacokinetic case report
Authors: Sewell Graham J , Hong Anne
Published: November 2007

Objective. This report describes the development and clinical use of a dacarbazine ambulatory infusion for palliative treatment of metastatic malignant mela noma.

Case Summary. A 39-year-old male with meta static malignant melanoma received ambulatory infu sion of dacarbazine, 2.5 mg/kg/d X 10 days (courses 1 and 2) and 5 mg/kg/d X 10 days (course 3). This was made possible by the development of a modified dacarbazine infusion formulation which increased drug stability. The first two courses were well toler ated and the patient remained independent and ac tive. A pilot pharmacokinetic study was undertaken on the third course to enable comparison of the potential exposure of tissues to dacarbazine between the prolonged infusion and conventional schedules.

Discussion. Under conditions replicating ambu latory infusion (37°C) the modified infusion of dacar bazine was stable for 24 hours (92.4% remaining) compared with a standard infusion in water for injection (89.2% remaining after 8 hours). The patient appeared to benefit from ambulatory treatment, and mild nausea was the only adverse effect recorded during the first two treatment courses. The pharma cokinetic study revealed an average steady-state plasma concentration (Cpssave ) and AUC of 243 ng · mL-1 and 58.4 μg · h·mL -1, respectively.

Conclusion. Ambulatory infusion of dacarba zine in the home setting is possible with the modified infusion formulation described in this report.
Use of EMLA as an adjunct for burning pain associated with a liposarcoma
Authors: Trinkle Randy
Published: November 2007

Objective. To report the successful use of EMLA cream (a topical anesthetic) for the relief of neuro pathic pain in a patient with a liposarcoma.

Case Summary. A 63-year-old male with a lipo sarcoma was admitted to the hospital to establish an effective pain control regimen. Despite the use of high-dose hydromorphone, dexamethasone, and in domethacin, he still complained of a burning sensa tion in the skin over the tumor site. EMLA—applied regularly every 8 hours, was started, and within 24 hours the patient reported relief from this pain.

Discussion. While there is some experience with the use of systemically administered anesthetics for the control of neuropathic pain in cancer patients, there is little reported experience of the use of topical anesthetics. EMLA has, however, been successfully used for postherpetic neuralgia. Adverse reactions from its use for reducing the pain of venipuncture are usually mild and transient, and repeated use does not appear to increase the risk of toxicity. In this case, the patient's pain was well-controlled without any observ able adverse reactions.

Summary. This patient experienced relief of burning pain when EMLA was added to his treatment regimen. EMLA cream could be considered as a treatment option for cancer patients experiencing neuropathic pain, but the patients most likely to benefit and the optimal treatment regimen have yet to be determined by a prospective study.
"C" is for costs, and cancer, and conference: Highlights of the First European Conference on the Economics of Cancer
Authors: Malfair Taylor Suzanne C.
Published: November 2007

The first European conference on the economics of cancer was held in Brussels, Belgium on November 19-21, 1997. This international meeting was organized under the European Organization for Research and Treat ment of Cancer. Approximately 300 participants from around the world, including physicians, health care econ omists, epidemiologists, pharmaceutical industry repre sentatives, pharmacists, and other researchers, clinicians, and administrators attended the sessions. This interna tional mix of professions, along with the 12 plenary sessions, 4 tutorials, and over 100 contributed oral and poster presentations, made for a very interesting and informative conference. This review will focus on out comes measurement tools, pharmacoeconomics in clini cal trials, issues regarding the improvement of the quality and usability of pharmacoeconomic evaluations, and state of the art pharmacoeconomic reviews of hematopoietic growth factors and lung cancer. Abstracts of contributed presentations have already been published.1
Benchmarking pharmaceutical care within the Alberta Cancer Board
Authors: Dobish Roxanne , Lee Gordon H.
Published: November 2007

Objective. To describe the numerous pharmacy ac tivities afforded by the seven pharmacy sites that provide various levels of pharmacy services to cancer patients in cities throughout Alberta, Canada.

Methods. A questionnaire for measuring phar maceutical care (PC) was developed and applied to each site to benchmark the level of PC that was offered at each institution. The survey was con structed based on elements of the PC model of Hepler and Strand et al and grouped along the lines of Cal Knowlton's ABCs of PC. Responses were graded according to what degree the site had fully, partially, or not yet incorporated the element surveyed.

Results. Overall, 44% of the PC elements were fully implemented, 33% were partially implemented, and 23% were not yet implemented in the newly formed Alberta Cancer Board Pharmacy Department. The traditional areas of bottling and counseling con tinue to be areas of strength, with 79% and 77% of the elements fully implemented, respectively. More em phasis is warranted in the areas of assessment and surveillance, with only 26% and 29% of the elements fully implemented, respectively.

Conclusions. The results of the survey indicate the need for continued planning to incorporate some of the elements of cognitive pharmacy services in the Alberta Cancer Board Pharmacy Department strategic plan.
Paper Cities: Visual Thinking in Urban Planning
Authors: Söderström Ola
Published: November 2007

We find instead that direct observation, far from being a mere ragpicker, is an explo ration by the form-seeking and form-imposing mind, which needs to understand but cannot unless it casts what it sees into manageable models.1
The Surgical Treatment of Mitral Insufficiency Associated with Torn Chordae Tendineae
Authors: Kay Jerome Harold , Tsuji Harold K. , Redington John V. , Mendez Adolfo M.
Published: November 2007

In 1963 Kay and Egerton 1 and in 1965 Kay, Tsuji, and Redington2 reported on the surgical treatment of mitral insufficiency associated with torn chordae tendineae.
Angioplasty in Donor Artery Complication After Renal Transplant
Authors: Vujic Ivan , Rajagopalan P.R. , Fitts Charles T.
Published: November 2007

Hypertension following renal transplantation may be caused by narrowing of either native or donor arteries or their anastomosis. A case is presented of attempted percutaneous angioplasty of a severely stenotic donor renal artery which resulted in total occlusion necessitating emergency reparative surgery. While short segments of narrowing of the native artery or anastomosis are lesions manageable by percutaneous transluminal angioplasty, lesions involv ing a donor artery should be approached with care, particularly if the segment of narrowing is longer, resembling the lesions of fibromuscular dysplasia.
Abdominal Aortic Aneurysms: Results From a Community Hospital
Authors: Chiu James S.P.
Published: November 2007

The results of the management of patients with confirmed abdominal aortic aneurysms in a community general hospital over a 5-year period were re viewed. The patients were grouped according to the presentation of their aneurysms into 3 categories: asymptomatic, symptomatic, and ruptured. Al together 64 patients were included in the study; 24 underwent surgery at the Grace General Hospital in Winnipeg, 3 were transferred to the teaching hospi tals in the city, and the remaining 37 patients did not undergo surgery. The postoperative complication rate was 80%. The operative mortality rate was nil in the asymptomatic group, 8% in the symptomatic group, and 17% in the ruptured group. The importance of clinical diagnosis in all types is emphasized, and the value of different investigative techniques to confirm the diagnosis is discussed. It is recommended that all patients with aortic aneurysms should be assessed by vascular surgeons for possible surgical treatment.
Indications for Permanent Pacemakers in Young Adults
Authors: Gould Lawrence , Gopalaswamy C. , Chandy F. , Abdou O.
Published: November 2007

The sick sinus syndrome has become the most common indication for permanent pacemaker implantation. 1 In a recent review of 50 patients with the sick sinus syndrome treated with pacemaker insertion, the mean age of the group was 71 years. 2

There are occasional reports of the sick sinus syndrome in young adults. However, many of the reported cases involve postoperative congenital heart disease.3,4

Recently Kay and his group5reported a series of 18 cases of young adults who required pacemakers. Twelve had the sick sinus syndrome and served as the basis of their report. Electrophysiologic studies were performed in only 5 of their 12 cases, and the authors stressed that the corrected sinus node recovery time was normal in their 5 patients.

We routinely perform electrophysiologic studies in all patients being considered for pacemaker implantations. We therefore reviewed our experience over 8 years with young adults who required permanent pacemaker insertions.
Popliteal Artery Injuries
Authors: Reyes David C.
Published: November 2007

It is unfortunate but true that in a world of wars, high speed travel and civilian violence, the repair of major injuries to the vascular system has become an important part of the surgeon's work. At present, injuries of the popliteal artery have the highest amputation rate of all injuries to peripheral arteries. Despite the introduction of techniques of vascular repair during the Korean Conflict, the rate of amputation remained nearly 32 percent! In the Vietnam Conflict the amputation rate has remained virtually unchanged—about 32 percent. In a civilian series, Conkle and colleagues1(1975) documented an amputation rate of about 44 percent. At our institution, we use a temporary shunt to reduce ischemic time in the operating room.
Mycotic Dissecting Aneurysm of Abdominal Aorta
Authors: Hans Sachinder S.
Published: November 2007

Atherosclerotic aortic aneurysms rarely result in dissection and it is quite uncommon to find evidence of infection in such a dissection. Recently, a mycotic dissecting atherosclerotic infrarenal aortic aneurysm was excised in a 53-year-old male and replaced with an aortic bifurcation graft. Following this surgery, the patient developed osteomyelitis of the lumbar spine, which im proved on prolonged antibiotic therapy.
Postoperative Rupture of a Middle Colic Artery Aneurysm
Authors: Mandelbaum David M. , Smead William L. , Vaccaro Patrick S.
Published: November 2007

Rupture of a middle colic artery aneurysm occurs rarely. Presented herein is the twelfth reported case of such a lesion. The etiology, diagnosis and treatment of middle colic artery aneurysms are emphasized.
Duplication of the Mitral Valve Associated with Endocardial Cushion Defect: Report of a Case with Mitral Valve Replacement
Authors: Morishita Yasuo , Taira Akira
Published: November 2007

A case of double orifice mitral valve is presented, in which the patient under went previous closure of an ostium primum defect and repair of a mitral cleft, eventually producing severe mitral regurgitation requiring prosthetic valve re placement six years later. The nature of the lesion and surgical alternatives are discussed. We conclude that valve replacement should be the treatment of choice in severe mitral regurgitation associated with double orifice mitral valve.
Cystic Adventitial Disease of the Popliteal Artery: A Case Report
Authors: Harjola Pekka-T. , Ketonen Pentti , Ala-Kulju Kari
Published: November 2007

A case of intermittent claudication in a young otherwise healthy non-smoker caused by cystic adventitial disease of the popliteal artery is presented. Other possible causes of calf claudication in a young non-smoker as well as etiology, clinical findings and modes of operative treatment are discussed.
Symptoms and Signs of Carotid Territory Transient Cerebral Ischaemia
Authors: Murie John A. , Sheldon Christopher D. , Quin Roger O.
Published: November 2007

In 400 patients referred for non-invasive vascular assessment by ultrasono graphy, 29% of 214 with transient ischaemic attacks, 25% of 44 with reversible ischaemic neurological deficits and 28% of 46 with recovered stroke had signifi cant extracranial internal carotid artery disease. For amaurosis fugax, 65% of 74 patients had significant disease. Both cerebral and ocular symptoms of simi lar laterality with respect to one carotid occurred together in 22 patients, of whom 86% had significant internal carotid disease.

Bruit was heard in 29% of carotids in 200 symptomatic patients. Only 45% of bruits were associated with significant internal carotid disease. The external carotid alone was shown to be the source of cervical murmur in a significant number of patients.
Major Contributing Role of Sclerotherapy in the Treatment of Varicose Veins
Authors: Gallagher Philip G.
Published: November 2007

Varicose veins is a common vascular problem in Western Civilization, ac counting for 24 million cases in the United States. Factors appear to be a combi nation of heredity, perhaps diet, and hormonal influences. One out of five females will have some form of varicosities with a ratio of about 20 females to 1 male. Endogenous hormones are implicated in that varicosities start after the menarche in many women, are usually symptomatic pre-menstrually, and are tremendously aggravated by pregnancy (Table I). The administration of estro gen often aggravates pre-existing varices, as does obesity, which may be related to endogenous estrogen. Sedentary life style or occupations requiring standing in one position for long periods of time play a role in aggravation of pre-existing varices, as does lack of muscle tone.1
Peripheral Pseudoaneurysms: An Eleven Year Experience
Authors: Borrero Edgar , Chang John B.
Published: November 2007

In the past two years we have operated on an increased number of patients with peripheral pseudoaneurysm. We have observed increasing numbers of in travenous drug abusers seeking medical care. This trend may be due to the fear generated by drug abusers with the acquired immunodeficiency syndrome. Be cause of the dramatic increase in the number of patients with peripheral pseu doaneurysms, due to these patients and civilian violent injuries, we were prompted to analyze the records of the last eleven years to determine the etiol ogy, sites, and types of repairs. Our eleven-year experience with 50 pseu doaneurysms is reviewed.
Noninvasive Vascular Test with the 133Xe Clearance Technique in Assessment of Hypogastric Arteries Insufficiency
Authors: Setacci C. , Vattimo A. , Campoccia G.
Published: November 2007

The 133Xenon clearance technique is a valuable method of measuring blood flow in peripheral muscles. The purpose of this study was to evaluate this technique for measuring blood flow in the vascular bed of the hypogastric arteries.

Clearance of 133Xenon injected intravascularly in the gluteal region was studied in 10 healthy subjects and in 25 patients with aortoiliac disease to measure muscular blood flow (MBF) in this vascular bed.

At rest, average MBF was higher in healthy subjects in both gluteal muscles than in the patients with arterial disease. After exercise-induced hyperemia, maximal MBF was markedly higher in healthy subjects than in the patients.

The 133Xe clearance is a simple and reliable procedure that could be especially useful for assessing the condition of the hypogastric arteries before surgical treatment of cancer in the left portion of the colon and in the rectum.
Brachial Arteriovenous Fistula After Balloon Catheter Thrombectomy: A Case Report
Authors: Hoffman Aaron , Karmeli Ron , Torem Shlomo , Hashmonai Moshe
Published: November 2007

Arteriovenous fistulas complicating the use of balloon catheters for thrombectomy and embolectomy are rare. A case is reported with such an iatrogenic complication in an as yet unpublished location: the brachial artery. The desired management is discussed.
Cranial Nerve Dysfunction Following Carotid Endarterectomy
Authors: Stanton Paul E. , Moody James A. , Murphree Stephen , Modica Louis , Vo Nghia M.
Published: November 2007

In an effort to establish the true incidence of cranial nerve dysfunction after carotid endarterectomy, 50 consecutive carotid endarterectomy procedures were assessed by careful and objective preoperative and postoperative cranial nerve evaluations, including indirect laryngoscopic examination by a trained ENT surgeon.

Of the 50 patients evaluated, 2 (4%) were found to have a postoperative cranial nerve deficit, and these were the following: 1 (2%) recurrent laryngeal, none (0%) superior laryngeal, 1 (2%) marginal mandibular nerve, and none (0%) hypoglossal nerve. In no instance was any patient who was asymptomatic found to have unsuspected objective evidence of cranial nerve injury; on the other hand, both symptomatic patients were found to have a significant cranial nerve injury by further evaluation.

Our objective data refute the literature that would support a magnitude of either symptomatic or asymptomatic cranial nerve injuries following such a procedure. Our study further fails to support a need for a more extensive exam ination that would routinely include indirect laryngoscopy and a specialist-ori ented consultation—both of which appear neither warranted nor cost effective.
Surgical Correction of Supravalvular Aortic Stenosis Following Two Previous Unsuccessful Interventions— A Case Report
Authors: Bell-Thomson John , Luber John M. , Tyras Denis H.
Published: November 2007

We present a case of supravalvular aortic stenosis in an adult who had un dergone two previous attempts at repair, the second of which exacerbated his condition. We emphasize the technique used for repair of the anomaly and ia trogenic exacerbation in a patient who recovered well and is currently asympto matic.
Carotid Endarterectomy in a Metropolitan Community: Complications in 518 Consecutive Cases
Authors: AbuRahma Ali F.
Published: November 2007

The records of 518 consecutive carotid endarterectomies done in 427 patients in one institution were evaluated for perioperative complications and catego rized according to their presenting syndrome. Of this surgery, 62.9% was done for hemispheric transient ischemic attack (TIA), 14.5% for nonhemispheric TIAs, 7.9% in patients with previous stroke, and 14.7% for asymptomatic sig nificant carotid stenosis. Each group's complication rate was then evaluated and compared with rates in comparable studies. The postoperative stroke rate and the combined stroke and death rate were 2.6% and 2.6%, respectively, for the group with asymptomatic significant carotid stenosis; 2.7% and 4%, respec tively, for the group with nonhemispheric TIA; 4% and 4.6%, respectively, for the group with hemispheric TIA; and 7.3% and 7.3%, respectively, in the group with previous stroke. The combined postoperative stroke rate for the whole series was 3.9% and the death rate was 1.4% with a combined stroke and death rate of 4.4%.

This study points out the need to categorize patients who have had carotid endarterectomy by their presenting syndrome before comparing them with pa tients in other studies.
Blunt Axillary Artery Injury in Children — Case Reports
Authors: Sullivan Cornelius A. , Berman Joel A.
Published: November 2007

The authors report 2 cases of acute axillary artery thrombosis in children with blunt trauma. The incidence and etiology of this injury are discussed, par ticularly as they relate to injury of the great vessels in blunt chest trauma. Diagnostic and therapeutic approaches are outlined for this uncommon but po tentially disabling condition.
A New Approach for Abdominal Aortic Aneurysm by a Ringed Y Graft
Authors: Kurata Satoru , Hongo Hiroshi , Misumi Kozo , Kawano Tetuya , Kuroda Yutaka , Nakayasu Kiyoshi , Harada Mikihiko , Esato Kensuke
Published: November 2007

Nonsuture technique with ringed Y graft (RYG) was applied to 5 high-risk patients with abdominal aortic aneurysm (AAA). All showed marked arterio sclerotic changes. In 3 cases, the AAA was located 1 cm below the renal artery branching. Concomitant diseases were: gastric ulcer in 3 cases, chronic bron chitis in 3, moderate renal failure in 2, thoracic aortic aneurysm in 1, and aortic valvular insufficiency in 1. The RYG method was evaluated by comparing age, size of aneurysm, operating time, blood loss, and aorta clamping time with the conventional Y graft (CYG) method (10 cases). Ages and sizes in the RYG group were nearly identical with those in the CYG group. The mean blood loss was 797 ± 86 ml in the RYG group and 1631 ± 754 ml in the CYG group (p < 0.05). Aorta clamping time was 34 ± 2.4 min in the RYG group and 62 ± 4.9 min in the CYG group (p < 0.01). Although the suprarenal aorta was clamped in 3 of 5 cases in the RYG group, proximal anastomosis took only a few minutes, and none of them required protection to the kidney.

The authors conclude that RYG can be reliably applied to high-risk patients with AAA.
Dynamic Angiography in Below-Knee Bypass Grafts
Authors: Waneck Reinhart , Jantsch Hans , Lechner Gerhard , Kretschmer Georg , Pichler Wolfgang , Polterauer Peter , Frank Wolfgang
Published: November 2007

Dynamic angiography has been performed in 60 patients with below- knee bypass grafts during a period from one month to seven years after operation.

In this particular technique the angiography is carried out in a lateral decubitus position. The films are ex posed in three different positions, with the knee straight, in an interme diate (45°), and in a maximum bended position of 90 ° . In a control group of 40 patients the dynamic Doppler index was determined.

The morphologic changes ob served in dynamic angiography were correlated with the implanted graft material (autologous vein, PTFE-by pass graft, and human umbilical vein) and compared for its early and late complications.

The results showed that the best graft material is an autologous vein interposition. There was no direct correlation between morphologic changes in angiography and Doppler index. A dynamic decrease in Dop pler index is not necessarily predic tive of early occlusion of the bypass graft. If severe morphologic changes are present, an early occlusion might be expected, even with good Doppler index.
Ectasia of the Profunda Femoris Artery: A Late, Serious Complication of Isolated Profundaplasty
Authors: Ratto G.B. , Bertoglio C. , Beretta E. , Motta G.
Published: November 2007

The merits of isolated profundaplasty remain controversial, because of many variables in patient selection and operative technique, including or not concomitant inflow procedures. This report deals with a homogeneous group of 11 male patients, aged forty-seven to seventy-two years, who underwent isolated profundaplasty for limb salvage and were thereafter available for follow-up. The check-up protocol included echographic examination of the femoral region, in order to detect any aneurysm formation of the reconstructed vessel. A fe morodistal bypass was judged unsuitable in all cases, because of severity of the atherosclerotic disease involving popliteal and tibial arteries. The cumulative limb salvage rate was 63% at two years and 54% at five and ten years. Five reconstructions failed within four years after surgery. Four patients died two to eight years following profundaplasty. An aneurysm of the reconstructed pro funda femoris artery was diagnosed in 1 patient three years after surgery. Ten months later the patient presented with a gangrenous forefoot and underwent below-knee amputation. In conclusion, isolated profundaplasty may achieve an acceptable limb salvage rate, even in patients with a poor distal vascular bed. Ectasia of the reconstructed profunda artery represents a potential, serious complication.
Aortic Wall Sepsis
Authors: Nyamekye Isaac , Beard Jonathan
Published: November 2007

The authors present a case to illustrate a possible mechanism by which gut microorgan isms may infect the aorta, and they discuss the probable etiology of the finding.
Pericardial Lymph Node Hyperplasia: Embryologic, Surgical, and Prognostic Considerations
Authors: Mingoli Andrea , Schultz Richard D. , Cisternino Silvestro , Farina Carlo , Feldhaus Richard J. , Donahue Terry
Published: November 2007

A case of intrapericardial giant lymph node hyperplasia (localized hyaline-vascular variant of Castleman's disease) is reported. The large tumor was successfully removed, and at a twelve-year follow-up there are no signs of recurrence. This is the first case reported in the literature of an intrapericardial Castleman's disease localization. Embryologic, surgical, and prognostic implications of this finding are briefly discussed.
Telford's Operation for Primary Palmar Hyperhidrosis
Authors: Gyftokostas Dimitrios , Koutsoumbelis Christos , Daskalakis Emmanuel , Bouhoutsos John
Published: November 2007

Bilateral upper dorsal sympathectomy via the supraclavicular approach was performed in 42 patients for palmar hyperhidrosis. In 16 patients (32 extremities) the effect of sympathectomy on digital circulation was evaluated objectively, in comparison with that of 15 control subjects. Mean values of finger temperature and of digital systolic pressure increased by 6.9°C and 36 mmHg respectively after operation, whereas an increase of digital blood flow and a decrease of the time of the clearance of 99mTc by approximately 60% were recorded. Differences between preoperative and postoperative values and those of controls were statistically significant. Clinical results of treatment remain satisfactory after a mean follow-up period of thirty-two months with no case of recurrence. Permanent decrease of plantar hyperhidrosis was recorded by 14 patients. The advantages of Telford's operation over other methods of upper extremity sympathetic denervation are discussed.
Protection from Cold Injury by Deferoxamine, an Iron Chelator
Authors: Maity Swapna , Lu Dan , Russel John C. , Lyengar Jaisimha , Das Dipak K.
Published: November 2007

The presence of hydroxyl radical (OH°) has been implicated in the pathogenesis of cold injury. Since iron is known to catalyze the OH° formation responsible for cellular injury, this study was designed to examine whether an iron chelator such as deferoxamine can salvage a tissue from cold injury. Cold injury was induced in the hind limbs of rabbits. The experimental group received 0.6 mM of deferoxamine through the femoral vein prior to cooling of the limbs. Deferoxamine reduced the tissue injury, as evidenced by the decreased release of lactate dehydrogenase, a nonspecific marker for cellular injury. In addition, this drug inhibited OH° formation and lipid peroxidation when examined by monitoring the formation of conjugated dienes and malonaldehyde, presumptive markers for lipid peroxidation. Rewarming of the cooled limbs was also associated with the loss of membrane phospholipids, with the corresponding accumulation of lysopho-sphoglyc erides and free fatty acids, especially linoleic and arachidonic acids. Deferoxamine prevented the loss of phospholipids and inhibited the accumulation of amphipathic lipid products. These results indicates that deferoxamine salvaged the tissue from cold injury, possibly by preventing the formation of OH° presumably by chelating iron, thus protecting the phospholipids from free radical attack.
Recombinant Tissue Plasminogen Activator (rTPA) in the Treatment of Superior-Mesenteric Vein Thrombosis
Authors: Lechner P. , Engler J.
Published: November 2007

A fifty-two-year-old woman presented with an acute abdomen. Operation revealed hemorrhagic infarction of the small intestine from the duodenojejunal flexure to the ileocecal junction, the gut being deeply blue. Weak pulses were palpable in the upper mesenteric artery, but no blood flow was detectable in the vein. Since the gut did not recover, the authors performed arteriotomy and injected 10 mg of recombinant tissue plasminogen activator as a bolus. Another 90 mg was infused over the following ninety minutes. The laparotomy wound was temporarily closed. Reopening of the abdomen twelve, thirty-six, and seventy-two hours later revealed stepwise recovery of the small intestine. The patient left the hospital twenty-two days later. From this experience the authors recommend that thrombolysis be attempted in far-reaching hemorrhagic infarc tion of the small intestine.
Primary Aortoenteric Fistula Secondary to Ulcerative Atherosclerosis
Authors: Frassinelli Paul , Gittleman Mark A. , McDonald Kenneth M.
Published: November 2007

Aortoenteric fistulae after replacement surgery of the aorta is a well-described phenom enon. Fewer than 200 cases of primary aortoenteric fistulae have, however, been reported. The vast majority of these reveal aortic or gastrointestinal pathology as etiolo gies. The authors report on the very rare occurrence of primary aortoenteric fistula caused by ulcerative atherosclerosis in the absence of aortic aneurysm.

The index of suspicion in patients with gastrointestinal bleeding of unknown etiology must be high to accurately diagnose an aortoenteric fistula. With aggressive testing and early laparotomy if indicated, the diagnosis of aortoenteric fistula can be ascertained and surgical correction can be accomplished.
An Aggressive Approach to an Aggressive Malignancy
Authors: Kashyap Ajaya , Huntly Michael , Luft William C.
Published: November 2007

Angiosarcomas are rare neoplasms of the head and neck region accounting for less than 1% of malignancies. The median survival after diagnosis varies from eleven to twenty months. The authors present a case of angiosarcoma that was difficult to diagnose at initial presentation. After initial diagnosis and treatment, the patient developed regional metastasis (parotid gland/neck) at three months, femoral head metastasis at two and one-half years, and liver metastasis at five years. These occurrences were treated aggressively. The patient is now almost seven years postpresenta- tion and apparently disease-free and working full time.
Aortic Sarcoma with Solitary Metastasis to the Right Suprarenal Region Mimicking Pheochromocytoma
Authors: Ting A.C.W. , Lam K.Y. , Cheng S.W.K.
Published: November 2007

Primary tumor of the aorta is extremely rare. The authors report a case of primary aortic sarcoma presenting with a solitary metastasis to the right suprarenal region and malignant hypertension, mimicking pheochromocytoma, with a review of the literature on this topic.
Superficial Femoral Artery Pseudoaneurysm Causing Extensive Deep Venous Thrombosis
Authors: Rishavy Thomas J. , Rivela Lucian J. , Tyndall Steven H.
Published: November 2007

This is a case report of a fifty-six-year-old, obese, corticosteroid-dependent asthmatic who presented with a pulsatile left thigh mass, left calf and foot swelling, and two block left calf claudication. Upon investigation, he was found to have a superficial femoral artery pseudoaneurysm compressing the superficial femoral vein causing a deep venous thrombosis (DVT) of the superficial femoral, popliteal, posterior tibial, and peroneal veins. The patient underwent lytic therapy for the DVT, followed by resection of the superficial femoral artery aneurysm and reconstruction of the superficial femoral artery. The cause of the superficial femoral artery pseudoaneurysm is undetermined, since he had no history of trauma, infection, or vascular intervention. Very few cases of superfi cial femoral artery aneurysm or pseudoaneurysms have been reported in the literature. This is a unique case owing to the presentation from DVT caused by compression of the surrounding venous structures.
Simultaneous Changes in Leg Arterial Pulsatile Blood Flow and Toe Laser-Doppler Perfusion Accompanying Graded Thigh Compression
Authors: Mayrovitz Harvey N.
Published: November 2007

Previous findings showed that regional ankle cuff compression and below-knee compression bandaging cause significant decreases in skin blood perfusion distal to the compressed regions. Contrastingly, with compression bandaging, as is commonly used in the treatment of venous ulcers and other conditions, an increase in leg pulsatile blood flow in compressed regions has been reported without corresponding decreases in sub-bandage skin blood perfusion. The explanation for these differential effects is unclear in part because of the fact that foot-to-knee compression bandaging has both direct sub-bandage tissue effects and effects on distal and sub-bandage venous hemodynamics. To help clarify this issue, the present study was done to determine the role of compression-induced changes in venous pressure per se on both skin microvascular and calf pulsatile blood flow. This was done using graded thigh cuff compression up to 50 mm Hg to modify lower extremity venous pressure. During these compressions mid-calf pulsatile blood flow via magnetic resonance flowmetry and toe-skin laser-Doppler blood perfusion
Jugular Venous Phlebectasia
Authors: Shuler Frederick W. , Atkins Colby , Jerius Hilde , Matsuura John , Clark Michael D. , Rosenthal David
Published: November 2007

Phlebectasia of the jugular vein is a rare entity, manifested as a compressible cystic mass in the neck that appears on straining. The authors report the postpartum presentation of jugular phlebectasia and discuss the benefit of color-flow duplex imaging in the diagnosis and follow-up of this condition.
Playing with Law: Agamben and Derrida on Postjuridical Justice
Authors: Mills Catherine
Published: November 2007

This essay examines the notion of “playing with law” that Giorgio Agamben proposes in State of Exception and, more broadly, his understanding of “play” as developed in works such as Infancy and History. In this latter text, Agamben provides his most extended discussion of play, throughout which he ties it to the necessity of a reconsideration of history and the experience of “infancy.” The first part of this essay discusses the conceptual nexus of play, experience, and history and shows its importance for the later reflections on law and politics, particularly in relation to a conception of justice that is established with the deposition of law. The second part of this essay builds on this to briefly consider the theoretical and political implications of this conceptual nexus.
The Geometrical Method in Spinoza'sEthics
Authors: Byrne Laura
Published: November 2007

While the goal of Spinoza's Ethics has strong affinities with the Aristotelian goal of eudaimonia, structurally the text itself is modeled on Euclid's Elements. Does Spinoza think that the precision and certainty of mathematics can be extended to moral philosophy? To answer this question, I discuss the relation between the geometrical method of the Ethics and its content and goal. Arguing that the deductive structure of the Ethics mirrors the causal necessity by which all of nature follows from God, I conclude that Spinoza applies the geometrical method to ethics because nothing, including human life and well-being, is exempt from this causal necessity. Furthermore, I discuss the role the geometrical method plays in an aspect of the argument of the Ethics which can best be described as dialectical, in the Aristotelian sense of the word: Spinoza hoped to persuade the members of his circle of theologically radical yet devout friends, and others intellectually similar to them, of the truth of his philosophy by beginning with Cartesian principles they would accept. Finally, I argue that certain nongeometrical portions of the Ethics are directed at the emotions of these readers.
Paying Respect
Authors: Ellingsen Tore , Johannesson Magnus
Published: November 2007

Why do people work? Economic theory generally, and the principal–agent model specifically, emphasize the role of material incentives. But many academics, for example, work diligently year after year for a nearly fixed real salary, continuing to work hard as they approach retirement, although financial incentives are usually absent. We will argue that while economists have been right to focus on incentives, they have been wrong to focus so exclusively on material incentives. While workers appreciate monetary rewards, they also get utility from what (they believe that) others think about them. We lay out a body of evidence that, taken as a whole, makes a strong case that respect matters in the workplace, above and beyond material rewards. We discuss evidence that workers respond to attention, symbolic rewards, and trust—and even that material incentives in some cases lead to less effort. Finally, we argue that many of these observations can be captured in a standard principal–agent model, once the principals and the agents are assumed to care about respect or esteem as well as money.
Retrospectives: Léon Walras and the Nobel Peace Prize
Authors: Sandmo Agnar
Published: November 2007

This paper is an account of the history of Léon Walras's attempt to be awarded the Nobel Peace Prize for 1906. It describes Walras's moves to get three of his Lausanne colleagues to nominate him for the prize, the arguments advanced in the proposal, and the reception that it received by the Norwegian Peace Prize Committee in Kristiania (Oslo). It discusses whether Walras had realistic reasons to believe that he stood a chance of winning the prize, and it evaluates the validity of the arguments on which the proposal was based.
Notification of syphilis test results by telephone: acceptability ratings in a community-based sample of Scottish gay men
Authors: Knussen Christina , Flowers Paul
Published: November 2007

Notifying patients of the results of syphilis testing by telephone can be cost-effective for clinic staff. This study compared the acceptability ratings among potential patients of three methods of learning of syphilis test results: with a call to a mobile phone; with a call to a home phone; and with the patient phoning in for results. A questionnaire was distributed to male clients of gay venues in Glasgow, Scotland, during 2005 ( n = 150). Phoning in for results was rated as significantly more acceptable than either learning of results with a call to a mobile phone, or receiving a phone call at home (both P < 0.001). Further, receiving a call on a mobile phone was rated as significantly more acceptable than receiving a call at home ( P < 0.001). It is recommended that patients be given the option of initiating the communication of test results.
Process, efficacy and sample demographics of three approaches to behavioural surveillance for gonorrhoea: case interviews, place surveys, and network studies
Authors: Ross Michael W , Berman S M , Aral S O , Courtney P E , Dennison J M , Klovdahl A S , Williams M L , St Lawrence J S
Published: November 2007

We investigated the process and time required to collect 450 interviews in a project to determine the most efficacious behavioural surveillance approaches to detect changes in gonorrhoea prevalence. In total, 150 respondents were recruited in each method. For each of place surveys (bars), gonorrhoea case interviews, and network studies based on seeds from the case and place interviews, we determined the recruitment rate and process. Urine testing for gonorrhoea and chlamydia took place in the place interviews. We present data from Houston, Texas that illustrate the sample characteristics, recruitment rates, and, where appropriate, infection rates. Data indicate that there was high uptake and a rapid recruitment rate from the place surveys, an intermediate rate from the network studies, and that the gonorrhoea case interviews were the most inefficient accrual method for behavioural surveillance. Sample characteristics and biases in each method are described, and conclusions drawn for the relative efficacy of each method for gonorrhoea behavioural surveillance.
Neonatal herpes in herpes simplex virus type 2 and HIV-seropositive pregnant patients; the role of preventive measures in the absence of clinical disease of herpes
Authors: Nasoodi A , Quah S , Dinsmore W W
Published: November 2007

There is very little knowledge about how herpes simplex virus (HSV) seropositivity of HIV-positive mothers could complicate the occurrence of neonatal herpetic disease, in the absence of genital ulcers, in this group of patients. We present a case of fatal disseminated neonatal herpes infection in a baby, born to a HIV-positive patient, and wish to discuss the potential need for changes in the management of this group of patients during pregnancy. Disseminated HSV disease is a rare, yet serious condition in newborns of HSV-infected mothers, and women with HIV infection have shown to frequently shed more HSV DNA in their genital secretions, even in the absence of active herpetic ulcers. This is the first case report of this rare association and, as a result, the evidence in support of our hypothesis has been extrapolated from other studies.
Granulomatous and Eosinophilic Rhinitis in a Cow Caused by Pseudallescheria boydii Species Complex (Anamorph Scedosporium apiospermum)
Authors: Singh K. , Boileau M. J. , Streeter R. N. , Welsh R. D. , Meier W. A. , Ritchey J. W.
Published: November 2007

A 2-year-old Hereford cow was presented to the teaching hospital for increased respiratory noise and bilateral bloody nasal discharge. A nodular rhinitis was detected clinically, and the nasal biopsy revealed a granulomatous and eosinophilic rhinitis with intralesional fungi. The cow was euthanized due to financial constraints. Grossly multifocal-to-coalescing, raised, ulcerated firm nodules were present in both nares. Histologically, the lamina propria was expanded by intense infiltrates of eosinophils, epithelioid macrophages, multinucleate giant cells, lymphocytes, and plasma cells. Associated with the inflammatory cells were variably sized, septate hyphae, 5–8 μm in diameter, admixed with numerous, terminal conidia, 6–30 μm in diameter, with a discrete outer wall identified by culture as Pseudallescheria boydii species complex (anamorph Scedosporium apiospermum). The infection was localized to the nasal cavity with no gross or microscopic evidence of a systemic dissemination.
Subcutaneous Neoplasms of the Ventral Abdomen with Features of Adrenocortical Tumors in Two Ferrets
Authors: Smith M. , Schulman F. Y.
Published: November 2007

A ventral abdominal subcutaneous mass was removed from each of 2 young adult spayed female ferrets. In both cases, the neoplasms were composed of islands of polygonal cells separated by interlacing streams of spindloid cells reminiscent of ferret adrenocortical tumors with smooth muscle proliferation. Immunohistochemically, the polygonal cells demonstrated strong cytoplasmic reactivity for inhibin and weak cytoplasmic reactivity for pancytokeratin and S-100 protein. Spindloid cells demonstrated strong cytoplasmic reactivity for alpha smooth muscle actin, muscle-specific actin, desmin, and glial fibrillary acidic protein. Ultrastructurally, the polygonal cells contained numerous intracytoplasmic clear vacuoles, mitochondria, scant rough endoplasmic reticulum, and few intermediate filaments. In one tumor, vesicular tubular mitochondria were found in polygonal cells. The spindloid cells contained numerous aggregates of parallel intermediate filaments. The histologic, immunohistochemical, and ultrastructural findings are suggestive of adrenocortical tumors with smooth muscle proliferation, but cannot be differentiated from an ovarian gonadal stromal tumor. Neither ferret had a clinically detected primary adrenal gland tumor or clinical signs of adrenal-associated endocrinopathy.
Divergence Between the Drosophila pseudoobscura and D. persimilis Genome Sequences in Relation to Chromosomal Inversions
Authors: Noor Mohamed A F , Garfield David A , Schaeffer Stephen W , Machado Carlos A
Published: November 2007

As whole-genome sequence assemblies accumulate, a challenge is to determine how these can be used to address fundamental evolutionary questions, such as inferring the process of speciation. Here, we use the sequence assemblies of Drosophila pseudoobscura and D. persimilis to test hypotheses regarding divergence with gene flow. We observe low differentiation between the two genome sequences in pericentromeric and peritelomeric regions. We interpret this result as primarily a remnant of the correlation between levels of variation and local recombination rate observed within populations. However, we also observe lower differentiation far from the fixed chromosomal inversions distinguishing these species and greater differentiation within and near these inversions. This finding is consistent with models suggesting that chromosomal inversions facilitate species divergence despite interspecies gene flow. We also document heterogeneity among the inverted regions in their degree of differentiation, suggesting temporal differences in the origin of each inverted region consistent with the inversions arising during a process of divergence with gene flow. While this study provides insights into the speciation process using two single-genome sequences, it was informed by lower throughput but more rigorous examinations of polymorphism and divergence. This reliance highlights the need for complementary genomic and population genetic approaches for tackling fundamental evolutionary questions such as speciation.