bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatotoxicity in HIV-infected children and adolescents on antiretroviral therapy
Authors: Gil Ana Cecília Montes , Lorenzetti Raquel , Mendes Gun Bergsten , Morcillo André Moreno , Toro Adyléia Aparecida Dalbo Contrera , Silva Marcos Tadeu Nolasco da , Vilela Maria Marluce dos Santos
Published: November 2007

CONTEXT AND OBJECTIVE: Adverse drug reactions are a significant problem in patients on antiretroviral therapy (ART). We determined liver enzyme elevation frequencies in HIV-infected children and adolescents receiving ART, and their association with risk factors. DESIGN AND SETTING: Cross-sectional study, at the Pediatrics Immunodeficiency Division, University Hospital, Universidade Estadual de Campinas. METHODS: Medical records of 152 children and adolescents (54.6% male; median age 7.48 years) were analyzed, with a mean of 2.6 liver enzyme determinations per patient. Clinically, patients were classified in categories N (6), A (29), B (78) and C (39). Serum levels of aspartate aminotransferase and alanine aminotransferase were evaluated. Hepatotoxicity was scored as grade 1 (1.1-4.9 times upper limit of normality, ULN), grade 2 (5.0-9.9 times ULN), grade 3 (10.0-15.0 times ULN) and grade 4 (> 15.0 times ULN). To assess hepatotoxicity risk factors, odds ratios (OR) and adjusted odds ratios (aOR) for age, gender, TCD4+ cell count, viral load and medication usage were calculated. RESULTS: We observed grade 1 hepatotoxicity in 19.7 % (30/152) patients. No cases of grade 2, 3 or 4 were detected. There was a significant association between hepatotoxicity and use of sulfonamides (OR, 3.61; 95% confidence interval (CI), 1.50-8.70; aOR, 3.58; 95% CI, 1.44-8.85) and antituberculous agents (OR, 9.23; 95% CI, 1.60-53.08; aOR, 9.05; 95% CI, 1.48-55.25). No toxicity was associated with ART. CONCLUSIONS: One fifth of patients experienced mild hepatotoxicity, attributed to antituberculous agents and sulfonamides. Our results suggest that ART was well tolerated.
Kidney weight and volume among living donors in Brazil
Authors: Vasconcelos Vladimir Tonello de , Katayama Rafael Cauê , Ribeiro Maria Flavia de Lima , Medina-Pestana José Osmar , Baptista-Silva José Carlos Costa
Published: November 2007

CONTEXT AND OBJECTIVE: The present study was performed to measure kidney weight and volume among living donors of both sexes in Brazil. DESIGN AND SETTING: This was a cross-sectional survey carried out between December 2001 and August 2004. METHODS: Kidney transplantations from 219 living donors were analyzed for this study. The kidneys were weighed in grams on a single-pan digital balance just after drainage of the perfusion fluid and removal of the perirenal fat. The kidney volume was determined in milliliters by water displacement. RESULTS: The mean age at nephroureterectomy was 44 ± 9.5. The donor organs came from the left side in 172 cases and from the right side in 47 cases. The weights and volumes of the right and left kidneys were, respectively, 169.83 ± 29.91 g and 157.38 ± 31.84 ml; and 173.00 ± 33.52 g and 160.34 ± 34.40 ml. The differences between the sides were not significant. CONCLUSIONS: According to the present study, kidney weight cannot be the only factor determining the side on which nephroureterectomy is performed, because of the lack of statistical significance between the two sides. On average, females donate lower nephron doses than males do, which could in some transplants result in allograft damage.
Tissue microarrays for testing basal biomarkers in familial breast cancer cases
Authors: Dufloth Rozany Mucha , Matos Irina , Schmitt Fernando , Zeferino Luiz Carlos
Published: November 2007

CONTEXT AND OBJECTIVE: The proteins p63, p-cadherin and CK5 are consistently expressed by the basal and myoepithelial cells of the breast, although their expression in sporadic and familial breast cancer cases has yet to be fully defined. The aim here was to study the basal immunopro-file of a breast cancer case series using tissue microarray technology. DESIGN AND SETTING: This was a cross-sectional study at Universidade Estadual de Campinas, Brazil, and the Institute of Pathology and Mo-lecular Immunology, Porto, Portugal. METHODS: Immunohistochemistry using the antibodies p63, CK5 and p-cadherin, and also estrogen receptor (ER) and Human Epidermal Receptor Growth Factor 2 (HER2), was per-formed on 168 samples from a breast cancer case series. The criteria for identifying women at high risk were based on those of the Breast Cancer Linkage Consortium. RESULTS: Familial tumors were more frequently positive for the p-cadherin (p = 0.0004), p63 (p < 0.0001) and CK5 (p < 0.0001) than was sporadic cancer. Moreover, familial tumors had coexpression of the basal biomarkers CK5+/ p63+, grouped two by two (OR = 34.34), while absence of coexpression (OR = 0.13) was associ-ated with the sporadic cancer phenotype. CONCLUSION: Familial breast cancer was found to be associated with basal biomarkers, using tissue microarray technology. Therefore, characterization of the familial breast cancer phenotype will improve the understanding of breast carcinogenesis.
Early dexamethasone treatment for septic shock patients: a prospective randomized clinical trial
Authors: Cicarelli Domingos Dias , Vieira Joaquim Edson , Benseñor Fábio Ely Martins
Published: November 2007

CONTEXT AND OBJECTIVE: Sepsis and septic shock are very common conditions among critically ill patients that lead to multiple organ dysfunction syndrome (MODS) and death. Our purpose was to investigate the efficacy of early administration of dexamethasone for patients with septic shock, with the aim of halting the progression towards MODS and death. DESIGN AND SETTING: Prospective, randomized, double-blind, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: The study involved 29 patients with septic shock. All eligible patients were prospectively randomized to receive either a dose of 0.2 mg/kg of dexamethasone (group D) or placebo (group P), given three times at intervals of 36 hours. The patients were monitored over a seven-day period by means of the sequential organ failure assessment score. RESULTS: Patients treated with dexamethasone did not require vasopressor therapy for as much time over the seven-day period as did the placebo group (p = 0.043). Seven-day mortality was 67% in group P (10 out of 15) and 21% in group D (3 out of 14) (relative risk = 0.31, 95% confidence interval 0.11 to 0.88). Dexamethasone enhanced the effects of vasopressor drugs. CONCLUSIONS: Early treatment with dexamethasone reduced the seven-day mortality among septic shock patients and showed a trend towards reduction of 28-day mortality.
Does the use of paclitaxel or rapamycin-eluting stent decrease further need for coronary-artery bypass grafting when compared with bare-metal stent?
Authors: Lemos Júnior Hernani Pinto de , Atallah Álvaro Nagib
Published: November 2007

CONTEXT AND OBJECTIVE: The safety and efficacy of drug-eluting stents reduce the need for surgical revascularization. The objective of the present study was to investigate whether paclitaxel or rapamycin-eluting stent are effective in avoiding the need for coronary-artery bypass grafting. METHODS: This was a systematic review of the literature using the methodology of the Cochrane Collaboration. The type of study considered was controlled randomized trials; the type of intervention was drug-eluting or bare-metal stents; and the main outcome investigated was coronary-artery bypass grafting. RESULTS: The ten studies included in this systematic review did not show any statistically significant difference between the drug-eluting stents and the bare-metal stents with regard to the outcome of coronary-artery bypass grafting (confidence interval: 0.31 to 1.42). CONCLUSION: The surgical revascularization rate was not reduced by the use of drug-eluting stents.
Genetic control on the performance of common bean differential cultivars to Colletotrichum lindemuthianum races
Authors: Gonçalves-Vidigal Maria Celeste , Bonett Lucimar Pereira , Vidigal Filho Pedro Soares , Gonela Adriana , Ribeiro Aliny Simony
Published: November 2007

The aim of this work was to perform genetic control on differential cultivars Michelite, Michigan Dark Red Kidney, Perry Marrow, Cornell 49-242, PI 207262, AB 136 and G 2333 and its diallel hybrids by using Hayman's methodology. The entire F1s populations were evaluated in relation to race 89, whereas the race 31, the diallel scheme did not include the cultivar G 2333. The results showed that the additive effects were predominant for the 31 race, while non-additive effects were more important for race 89. The results demonstrated a high coefficient of genetic determination for the race 31. The G 2333, AB 136 and PI 207262 cultivars should be recommended obtaining cultivar resistant to anthracnose by backcross programs because theyshowed the highest proportion of resistant dominant alleles for the races 31 and 89.
Genes involved in brassinosteroids's metabolism and signal transduction pathways
Authors: Pereira-Netto Adaucto Bellarmino
Published: November 2007

Brassinosteroids (BRs) are plant steroids essential for the normal growth and development, which carry an oxygen moiety at C-3 and additional ones at one or more of the C-2, C-6, C-22 and C-23 carbon atoms. In the past few years, application of molecular genetics allowed significant progress on the understanding of the BRs biosynthetic pathway regulation and on the identification of several components of their signal transduction pathway, as well. Search in eletronic databases show dozens of records for brassinosteroid-related genes for the last twelve months, demonstrating the big efforts being carried out in this field. This review highlights the recent advances on the characterization of genes and mutations that are helping to unravel the molecular mechanisms involved in the BRs synthesis/metabolism, perception and response, with especial emphasis on their role in plant cell elongation. Aspects of the involvement of BRs on the regulation of cell cycle-controlling proteins are discussed as well.
Quantification of iodine in porous hydroxyapatite matrices for application as radioactive sources in brachytherapy
Authors: Lacerda Kássio André , Lameiras Fernando Soares , Silva Viviane Viana
Published: November 2007

In this study, non-radioactive iodine was incorporated in two types of biodegradable hydroxyapatite-based porous matrices (HA and HACL) through impregnation process from sodium iodine aqueous solutions with varying concentrations (0.5 and 1.0 mol/L) . The results revealed that both systems presented a high capacity of incorporating iodine into their matrices. The quantity of incorporated iodine was measured through Neutron Activation Analysis (NAA). The porous ceramic matrices based on hydroxyapatite demonstrated a great potential for uses in low dose rate (LDR) brachytherapy.
What not to do in medical statistics
Authors: Alexander Neal
Published: November 2007

There have been major efforts to improve the application of statistical methods in medical research, although some errors and misconceptions persist. In this paper I will review some of the topics which most often cause problems: a) comparison of two methods of clinical measurement; b) comparison of baseline values between arms of a randomized trial; c) absence of evidence as opposed to evidence of absence; and d) regression to the mean. I will also revisit a statistical error in one of my own publications. I review some causes of the continuing misuse of statistics, and make some suggestions for modifying the education of statistical and non-statistical medical researchers in order to alleviate this.
Avaliação da DL50 e edema pulmonar induzido pelo veneno de Tityus serrulatus (Scorpiones; Buthidae) procedente da Bahia, Brasil
Authors: Silva Tiago F. , Casais-e-Silva Luciana L. , Lira-da-Silva Rejâne M.
Published: November 2007

O escorpião Tityus serrulatus é conhecido como a espécie mais importante, do ponto de vista médico, pois é o que causa os acidentes mais graves registrados para o território brasileiro. Este trabalho trata da caracterização do veneno do escorpião T. serrulatus, através da obtenção da DL50 e determinação da capacidade em induzir edema pulmonar, em ratos. O veneno foi obtido através de estímulo elétrico. A toxicidade foi determinada através da avaliação da DL50, pelo método de Finney (1971). Os valores demonstraram a baixa toxicidade do veneno (96,16 mg/camundongo), que corresponde a 3 - 7 vezes menos tóxico que venenos de espécimes de outras regiões do Brasil. O veneno testado também não induziu edema pulmonar, avaliado através da diferença entre o peso do pulmão de animais experimentais e controle. Estes resultados demonstram uma variação do veneno de T. serrulatus e poderia explicar a ausência de óbitos e do registro de edema pulmonar nos pacientes picados nestas regiões do Estado da Bahia, Brasil.
Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia
Authors: Souza-Machado Adelmir , Souza-Machado Carolina , Silva Daisy Freitas , Ponte Eduardo Vieira , Cruz Alvaro A.
Published: November 2007

OBJETIVO: Descrever características demográficas e clínicas de asmáticos que apresentaram como desfecho a morte e relatar as condições que concorreram para o óbito entre admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia (ProAR). MÉTODOS: Estudo observacional retrospectivo e descritivo. Foram coletadas informações de atestados de óbitos e prontuários médicos de 16 dos 930 portadores de asma grave acompanhados no ambulatório Central de Referência do ProAR entre dezembro de 2003 e junho de 2006. RESULTADOS: Foram identificadas 16 (1,72%) mortes em asmáticos do ProAR. Destes, 10 pacientes eram do sexo masculino; as idades variaram de 39 a 74 anos (mediana, 55 anos), sendo 12 (75%) pacientes do grupo racial negróide. A duração da doença diagnosticada pelo médico foi de 1 a 68 anos (mediana, 30 anos). História pessoal e familiar de atopia foi observada em 43,8 e 53,8% destes casos, respectivamente. História familiar de atopia não foi relatada em 3 casos. Tabagismo (<10 maços/ano) no passado foi identificado em 37,5% dos casos. As causas registradas em atestados de óbito foram: asma ou crise de asma em 8 (50%); insuficiência respiratória em 3 (18,75%); infarto agudo do miocárdio em 2 (12,5%); hepatite em 1 (6,25%); choque hipovolêmico em 1 (6,25%); e parada cardiorrespiratória em 1 (6,25%). Dos 16 óbitos, 13 (81,25%) ocorreram dentro de uma unidade hospitalar. CONCLUSÃO: A maioria dos óbitos dos asmáticos graves foi atribuída a asfixia e doenças cardiovasculares, em ambiente hospitalar; sexo masculino, idade avançada, tempo prolongado de doença e obstrução fixa aos fluxos aéreos foram características comuns nos pacientes estudados.
Capacidade inspiratória, limitação ao exercício, e preditores de gravidade e prognóstico, em doença pulmonar obstrutiva crônica
Authors: Freitas Clarice Guimarães de , Pereira Carlos Alberto de Castro , Viegas Carlos Alberto de Assis
Published: November 2007

OBJETIVO: Correlacionar a capacidade inspiratória (CI), % do previsto, pós-broncodilatador (pós-BD), com outras variáveis indicativas de gravidade e prognóstico, na doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Oitenta pacientes estáveis com DPOC realizaram manobras de capacidade vital forçada, capacidade vital lenta, e teste de caminhada de 6 min, antes e após salbutamol spray (400 µg). Foram divididos em quatro grupos, segundo o volume expiratório forçado no primeiro segundo pós-BD. Diversas variáveis foram testadas, por análise univariada e multivariada, com a distância caminhada pós-BD, % do previsto. A CI pós-BD foi correlacionada com o estadiamento Global Initiative for Chronic Obstructive Lung Disease (GOLD) e o índice Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE). RESULTADOS: Por análise de regressão multivariada, a CI pós BD, % do previsto, (p = 0,001), o uso de oxigênio a longo prazo (p = 0,014), e o número de medicamentos usados (p = 0,044), mantiveram associação significativa com a distância caminhada, % do previsto. A CI < 70% foi observada em 56% dos pacientes em estágios GOLD 3 ou 4 comparado a 20% em estágios GOLD 1 ou 2 ( p < 0,001). A CI < 70% foi observada em 60% dos pacientes com escore BODE 3 ou 4 vs. 33% com BODE 1 ou 2 (p = 0,02). CONCLUSÃO: A CI, % do previsto, pós-BD é o melhor preditor funcional da distância caminhada, associando-se significativamente com o escore GOLD e o índice BODE. Por isso, propomos que a CI seja incluída na rotina de avaliação dos portadores de DPOC.
Modificação da técnica de alotransplante pulmonar unilateral em ratos*
Authors: Sánchez Pablo Gerardo , Martins Lucas Krieger , Martins Frederico Krieger , Schimer Ricardo , Cardoso Paulo Francisco Guerreiro , Andrade Cristiano Feijó
Published: November 2007

A crescente demanda de pesquisa em transplantes requer modelos eficientes e baratos que permitam resultados confiáveis para que, posteriormente, possam ser reproduzidos em animais de grande porte e, finalmente, aplicados clinicamente. O modelo de transplante pulmonar unilateral esquerdo em ratos tem demonstrado ser uma alternativa útil para estes propósitos. Apresentamos uma nova variante para esta técnica, a qual consiste no isolamento e ligadura da artéria pulmonar contralateral, permitindo a circulação do sangue somente no pulmão transplantado. Este modelo é exeqüível e reprodutível; no entanto, o tempo de sobrevida é relativamente curto, não permitindo avaliação do pulmão transplantado por períodos superiores a três horas.
Avaliação quantitativa das fibras elásticas na doença pulmonar obstrutiva crônica
Authors: Rufino Rogerio , Madi Kalil , Souza Heitor Siffert Pereira de , Costa Cláudia Henrique da , Saito Eduardo Haruo , Silva José Roberto Lapa e
Published: November 2007

OBJETIVO: Quantificar fibras elásticas (FE), músculo liso (ML) e linfócitos T CD4+ e CD8+ na doença pulmonar obstrutiva crônica (DPOC) estável. MÉTODOS: Biópsias cirúrgicas foram obtidas de 15 pacientes com DPOC, 18 tabagistas sem limitação do fluxo aéreo e 14 não tabagistas. FE, ML e células T CD4+ e CD8+ foram quantificados através de métodos histológicos e imuno-histoquímicos. RESULTADOS: Não foi observada diferença estatisticamente significativa das FE nos três grupos (p > 0,05). Tanto a quantidade de FE por unidade de área pulmonar (mm²), quanto o percentual destas fibras por tecido pulmonar foram semelhantes nos três grupos. Foi encontrado aumento da quantidade de ML em pacientes com DPOC quando comparados a tabagistas (p = 0,003) e não tabagistas (p = 0,009). Houve tendência de aumento das células T CD8+ nos pacientes com DPOC. O total de células T CD4+ estava diminuído nos pacientes com DPOC quando comparados aos tabagistas (p = 0,015) e não tabagistas (p = 0,003). Observou-se fraca correlação entre estas células e a relação entre o volume expiratório forçado no primeiro segundo e a capacidade vital forçada (r² = 0,003). CONCLUSÕES: A quantidade de FE foi semelhante nos três grupos estudados. A hipertrofia/hiperplasia muscular da parede das vias aéreas foi encontrada tanto em pacientes com DPOC quanto em tabagistas, indicando que o remodelamento ocorra também nos tabagistas sem limitação do fluxo aéreo. Houve diminuição da relação CD4/CD8 em pacientes com DPOC.
Perfil celular do escarro induzido e sangue periférico na doença pulmonar obstrutiva crônica
Authors: Rufino Rogerio , Costa Cláudia Henrique da , Souza Heitor Siffert Pereira de , Madi Kalil , Silva José Roberto Lapa e
Published: November 2007

OBJETIVO: Determinar o perfil celular e subgrupos linfocitários CD4+ e CD8+ no escarro induzido (EI) e sangue venoso periférico (SVP) de pacientes com doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Foram quantificadas as celularidades total e específica, incluindo subgrupos linfocitários T CD4+ e CD8+, do EI e SVP de 85 pessoas (38 pacientes com DPOC sem agudização, 29 tabagistas sem obstrução e 18 não-tabagistas). Os testes não-paramétricos de Mann-Whitney e Spearman foram usados na análise estatística, considerando como significante o p < 0,05. RESULTADOS: Os neutrófilos, eosinófilos e linfócitos T CD8+ do EI estavam aumentados (p = 0,005, p < 0,05 e p < 0,05) e o percentual de macrófagos encontrava-se reduzido (p = 0,003) nos pacientes com DPOC, em relação aos não-tabagistas. A correlação linear de cada tipo celular do EI com o volume expiratório forçado no primeiro segundo (VEF1), a capacidade vital forçada (CVF), e VEF1/CVF foi fraca (r² < 0,1). Os eosinófilos e os linfócitos T CD8+ também estavam aumentados no SVP (p = 0,04 e p = 0,02). CONCLUSÕES: Em pacientes com DPOC estável, as células T CD8+ estavam aumentadas no SVP, embora a leucometria total tenha se mantido em valores semelhantes aos dos outros dois grupos estudados, indicando possível envolvimento inflamatório sistêmico. A contagem dos linfócitos T CD8+ no sangue pode ser útil como marcador de inflamação sistêmica e auxiliar na identificação de tabagistas que já possuem padrão inflamatório de DPOC.
Microlitíase alveolar pulmonar: achados na tomografia computadorizada de alta resolução do tórax em 10 pacientes
Authors: Marchiori Edson , Gonçalves Carolina Marinho , Escuissato Dante Luiz , Teixeira Kim-Ir-Sen Santos , Rodrigues Rosana , Barreto Miriam Menna , Esteves Mauro
Published: November 2007

OBJETIVO: Apresentar os achados na tomografia computadorizada de alta resolução (TCAR) do tórax da microlitíase alveolar pulmonar. MÉTODOS: Foram estudadas, retrospectivamente, as tomografias de dez pacientes adultos, sete mulheres e três homens, com idade média de 38,7 anos. Os exames foram analisados por dois radiologistas, de forma independente, e as decisões finais foram obtidas por consenso. RESULTADOS: Os achados mais freqüentes foram as opacidades em vidro fosco e as calcificações subpleurais, ambas presentes em 90% dos pacientes estudados. Os outros achados de maior relevância foram pequenos nódulos parenquimatosos, calcificação ao longo dos septos interlobulares, cissuras nodulares, nódulos subpleurais, cistos subpleurais, consolidações densas e padrão de pavimentação em mosaico. CONCLUSÕES: A microlitíase alveolar pulmonar apresenta aspectos na TCAR que são altamente sugestivos da doença, na maior parte dos casos dispensando a realização de biópsias pulmonares.
Variáveis relacionadas à iniciação do tabagismo entre estudantes do ensino médio de escola pública e particular na cidade de Belém - PA
Authors: Pinto Denise da Silva , Ribeiro Sandra Aparecida
Published: November 2007

OBJETIVO: Analisar as variáveis relacionadas à iniciação do tabagismo entre adolescentes estudantes de nível médio de uma escola particular e outra pública, na cidade de Belém-PA, em 2005. MÉTODOS: Para a coleta de dados, foi utilizado um questionário não identificado, de autopreenchimento, com 27 questões fechadas, sobre experimentação de cigarro, fumo habitual, acesso à compra de cigarros, motivo para a experimentação do fumo, autopercepção sobre o seu rendimento escolar, diálogo sobre tabagismo no ambiente familiar e nível sócio-econômico. Participaram do estudo 1520 estudantes, sendo 724 (47,6%) da rede particular e 796 (52,4%) da rede pública. RESULTADOS: A média de idade dos estudantes foi de 16,5 anos. Dos 1520 estudantes, 669 (44%) referiram ter experimentado cigarro e 11% faziam uso habitual de cigarros. A proporção de experimentadores na escola pública foi de 51,2% e na particular foi de 36,7% (p = 0); a de fumantes habituais foi 14,6% na escola pública e de 7% na particular (p = 0). As associações encontradas para iniciação e uso atual de cigarro em ambas as escolas foram: curiosidade, presença de pessoas fumantes no convívio social do adolescente, não ter sido elogiado por não fumar, e se considerar um aluno regular ou ruim. Não houve associação entre experimentação e fumo atual com classes sociais nas duas escolas, exceto para experimentadores das classes A e B na escola particular. CONCLUSÕES: A variável mais importante para fumo entre os estudantes foi a curiosidade. A experimentação e uso habitual de cigarro foram mais freqüentes na escola pública que na particular.
Dynamic Regulation of Mitotic Arrest in Fetal Male Germ Cells
Authors: Western Patrick S. , Miles Denise C. , van den Bergen Jocelyn A. , Burton Matt , Sinclair Andrew H.
Published: November 2007

During fetal mouse development, germ cells enter the developing gonad at embryonic day (E) 10–11. In response to signaling from the male or female gonad, the germ cells commit either to spermatogenesis at E12.5 and enter mitotic arrest or to oogenesis and enter meiotic arrest at E13.5. It is unclear whether male commitment of the germ line and mitotic arrest are directly associated or whether they are developmentally separate. In addition, the published data describing the timing of mitotic arrest are inconsistent, and the molecular processes underlying the control of the cell cycle during mitotic arrest also remain unknown. Using flow cytometric techniques, 5-bromo-2′-deoxyuridine labeling, and immunofluorescent analysis of cell proliferation, we have determined that germ cells in the embryonic mouse testis arrest in G0 during E12.5 and E14.5. This process is gradual and occurs in an unsynchronized manner. We have also purified germ cells and analyzed molecular changes in male germ cells as they exit the cell cycle. This has allowed us to identify a series of molecular events, including activation of p27Kip1, p15INK4b, and p16INK4a; the dephosphorylation and degradation of retinoblastoma protein; and the suppression of CyclinE, which lead to mitotic arrest. For the first time, the data presented here accurately define the mitotic arrest of male germ cells by directly combining the analysis of cell cycle changes with the examination of functionally defined cell cycle regulators.

Disclosure of potential conflicts of interest is found at the end of this article.
Maintaining Financial Independence in Advanced Age
Authors: Barber Ann
Published: November 2007

In an attempt to personalize Nobel Prize–winning financial literature, this article seeks to show how individuals can take responsibility for their own finances. For instance, before Markowitz’s work, pension funds shied away from risky investments. Then, Markowitz proved that the safest portfolios are those that are diversified over many asset classes, including risky investments. More recently, Kahneman’s psychological experiments proved that during uncertainty, people tend to generalize from a small number of representatives to the larger group. He warns us to collect data before drawing conclusions. Using such insights, this article shows how persons in advanced age can develop Investment Policy Statements (IPS) that tailor their financial resources to serve their life goals. This is accomplished safely and successfully by following some guidelines, based on lessons from the financial literature. These guidelines are as follows: (a) update IPS annually, (b) diversify annually by rebalancing, (c) match new liabilities to specific assets, (d) be aware of common errors, such as loss aversion, and (e) measure success by whether one’s goals have been met.
Determinants of Resident Autonomy in Assisted Living Facilities: A Review of the Literature
Authors: Sikorska-Simmons Elzbieta , Wright James D.
Published: November 2007

Assisted living (AL) stresses the importance of resident autonomy in the provision of good quality care. Resident autonomy has been linked to better resident well-being, less reliance on supportive services, and greater participation in social activities. Little is known, however, about factors that foster resident autonomy in AL. This article reviews what is currently known about organizational determinants of resident autonomy in AL. The open-natural systems approach to organizational effectiveness, which views organizations in relation to their environment, provides a broad conceptual framework for this analysis. Factors that influence resident autonomy in AL are classified into two categories: (a) external environmental conditions (e.g., ownership status, chain membership, regulatory environment) and (b) internal organizational structures and processes (e.g., facility size, residents’ functional ability, resident social resources, and staff work environment). Environmental conditions represent the most antecedent set of factors that influence resident autonomy, indirectly through their effects on internal organizational structures and processes. Internal organizational factors influence resident autonomy through their impact on policies that enable resident choice and control in the facility. More research is needed to better understand the complex mechanism(s) through which organizational factors influence resident autonomy.
Constrictive/restrictive cardiac physiology: Pericarditis or right ventricular infarction?
Authors: Gavrila Dan , Horwitz Phillip A.
Published: November 2007

Here we report on the case of a 71 year old man who presented with signs and symptoms suggestive of right heart failure and was diagnosed with and successfully treated for constrictive pericarditis. Radiographic, hemodynamic, and intra‐operative pathological findings typical of constrictive pericarditis are presented. The potential for right ventricular infarction which can mimic the hemodynamic findings in constrictive pericarditis is also discussed. Pericardiectomy was recommended and was successful in improving the patient's systemic vascular congestion and symptoms. © 2007 Wiley‐Liss, Inc.
Salvage therapy in relapsed squamous cell carcinoma of the oral cavity: How and when?
Authors: Liao Chun‐Ta , Chang Joseph Tung‐Chieh , Wang Hung‐Ming , Ng Shu‐Hang , Hsueh Chuen , Lee Li‐Yu , Lin Chih‐Hung , Chen I‐How , Huang Shiang‐Fu , Cheng Ann‐Joy , Yen Tzu‐Chen
Published: November 2007

BACKGROUND.

Relapse of tumors in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a poor prognosis. In addition, salvage therapy may be a significant source of morbidity in patients with relapsing OSCC. The objective of the current study was to determine prognostic factors that predict which patients may benefit from such treatment.

METHODS.

From 953 patients who underwent primary radical surgery between 1996 and 2005, 272 patients with early‐relapsed OSCC (n = 161) or late‐relapsed OSCC (n = 111) were identified. The optimum cutoff point for relapse was chosen on the basis of 5‐year disease‐specific survival (DSS) and overall survival (OS).

RESULTS.

The optimal cutoff value for relapse was 10 months. Late relapses were associated with a better prognosis than relapses that occurred within the first 10 months (P < .0001 for both 5‐year DSS and 5‐year OS). Among patients with early‐relapsed OSCC, a primary tumor depth <10 mm was associated significantly and independently with a better 5‐year DSS (P = .014) and OS (P = .011). Among patients with late‐relapsed OSCC, neck recurrence was a significant risk factor for adverse outcomes (P < .001 for both 5‐year DSS and 5‐year OS).

CONCLUSIONS.

A late relapse was associated with better survival than a relapse that occurred within the first 10 months. Patients with late‐relapsed OSCC may benefit from salvage therapy, especially those who have a local recurrence. Among patients with early‐relapsed OSCC, salvage therapy should be considered for those who have a primary tumor depth <10 mm. Cancer 2008. © 2007 American Cancer Society.
Multiple risk markers for atherogenesis associated with chronic inflammation are detectable in patients with renal stones
Authors: Tsao Kuo‐Chien , Wu Tsu‐Lan , Chang Pi‐Yueh , Sun Chien‐Feng , Wu Lily L. , Wu James T.
Published: November 2007

Patients with renal stones are known to be at risk of clinical complications such as cardiovascular disease (CVD), nephropathy, and cancer. Recently, it has been realized that almost all risk markers for CVD, nephropathy, etc. are all markers associated with the sequence of reactions of chronic inflammation. It has been reported that chronic inflammation is involved not only in the pathogenesis of nephrolithiasis but also contributes to the development of clinical complications in this condition; therefore, we decided to find out whether these multiple markers are detectable in patients with renal stones so that they can be used to predict the risk of clinical complications in these patients. There were 33 patients with nephrolithiasis included in this study. We found that almost all major markers of chronic inflammation were elevated in patients with renal stones, including proinflammatory cytokine, acute inflammation markers, adhesion molecules, urinary microalbumin (uMA), myeloperoxidase (MPO), 8‐hydroxydeoxyguanosine (8‐OHdG), 3‐nitrotyrosine (3NT), and monocyte chemoattractant protein. It appears that it is possible to assess the risk of clinical complications by monitoring these markers in patients with renal stones. J. Clin. Lab. Anal. 21:426–431, 2007. © 2007 Wiley‐Liss, Inc.
Enhanced Monoclonal Antibody Production in Hybridoma Cells by LPS and Anti‐mIgG
Authors: Martín‐López Alicia , García‐Camacho Francisco , Contreras‐Gómez Antonio , Molina‐Grima Emilio
Published: November 2007

This paper reports on a methodology for increasing proliferation and monoclonal antibody (mAb) production in hybridoma cultures. The 55–6 murine B cell hybridoma line (CD40 and CD19‐deficient expression) was treated with increasing concentrations of lipopolysaccharide (LPS). Expression of CD69, CD40, and CD19 surface antigens on 55–6 cells did not show significant changes from untreated cells. The specific growth rate decreased at higher concentrations of LPS, but the monoclonal antibody production rate was highest at the highest LPS concentration assayed. These data are in agreement with the lowest growth rate found at this concentration of LPS. Furthermore, cells were cultured with anti‐mouse surface immunoglobulin G antibody (anti‐mIgG) plus LPS to find out whether LPS‐derived signals and anti‐mIgG stimuli are synergistic. CD69, CD40, and CD19 expression was greater than for either untreated cells (control culture) or cells stimulated with LPS alone. Moreover, LPS stimulation in combination with anti‐mIgG enhanced both the growth rate and IgG2a production over the control culture and cells stimulated with LPS alone. Maximum antibody concentration increased almost 500% compared to the control and about 100% with respect to culture stimulated with LPS alone. The maximum specific IgG2a production rate was about 300% higher than in the control culture and about 30% higher than in culture stimulated only with LPS.
How individual species structure diversity in tropical forests
Authors: Wiegand Thorsten , Gunatilleke C. V. Savitri , Gunatilleke I. A. U. Nimal , Huth Andreas
Published: November 2007

A persistent challenge in ecology is to explain the high diversity of tree species in tropical forests. Although the role of species characteristics in maintaining tree diversity in tropical forests has been the subject of theory and debate for decades, spatial patterns in local diversity have not been analyzed from the viewpoint of individual species. To measure scale-dependent local diversity structures around individual species, we propose individual species–area relationships (ISAR), a spatial statistic that marries common species–area relationships with Ripley's
K
to measure the expected α diversity in circular neighborhoods with variable radius around an arbitrary individual of a target species. We use ISAR to investigate if and at which spatial scales individual species increase in tropical forests' local diversity (accumulators), decrease local diversity (repellers), or behave neutrally. Our analyses of data from Barro Colorado Island (Panama) and Sinharaja (Sri Lanka) reveal that individual species leave identifiable signatures on spatial diversity, but only on small spatial scales. Most species showed neutral behavior outside neighborhoods of 20 m. At short scales (<20 m), we observed, depending on the forest type, two strongly different roles of species: diversity repellers dominated at Barro Colorado Island and accumulators at Sinharaja. Nevertheless, we find that the two tropical forests lacked any key species structuring species diversity at larger scales, suggesting that “balanced” species–species interactions may be a characteristic of these species-rich forests. We anticipate our analysis method will be a starting point for more powerful investigations of spatial structures in diversity to promote a better understanding of biodiversity in tropical forests.
Complexity of rice-water stool from patients with
Vibrio cholerae
plays a role in the transmission of infectious diarrhea
Authors: Nelson Eric J. , Chowdhury Ashrafuzzaman , Harris Jason B. , Begum Yasmin A. , Chowdhury Fahima , Khan Ashraful I. , LaRocque Regina C. , Bishop Anne L. , Ryan Edward T. , Camilli Andrew , Qadri Firdausi , Calderwood Stephen B.
Published: November 2007

At the International Centre for Diarrhoeal Disease Research, Bangladesh, one-half of the rice-water stool samples that were culture-positive for
Vibrio cholerae
did not contain motile
V. cholerae
by standard darkfield microscopy and were defined as darkfield-negative (DF
−
). We evaluated the host and microbial factors associated with DF status, as well as the impact of DF status on transmission. Viable counts of
V. cholerae
in DF
−
stools were three logs lower than in DF
+
stools, although DF
−
and DF
+
stools had similar direct counts of
V. cholerae
by microscopy. In DF
−
samples, non-
V. cholerae
bacteria outnumbered
V. cholerae
10:1. Lytic
V. cholerae
bacteriophage were present in 90% of DF
−
samples compared with 35% of DF
+
samples, suggesting that bacteriophage may limit culture-positive patients from producing DF
+
stools.
V. cholerae
in DF
−
and DF
+
samples were found both planktonically and in distinct nonplanktonic populations; the distribution of organisms between these compartments did not differ appreciably between DF
−
and DF
+
stools. This biology may impact transmission because epidemiological data suggested that household contacts of a DF
+
index case were at greater risk of infection with
V. cholerae
. We propose a model in which
V. cholerae
multiply in the small intestine to produce a fluid niche that is dominated by
V. cholerae
. If lytic phage are present, viable counts of
V. cholerae
drop, stools become DF
−
, other microorganisms bloom, and cholera transmission is reduced.
Formation of unprecedented actinidecarbon triple bonds in uranium methylidyne molecules
Authors: Lyon Jonathan T. , Hu Han-Shi , Andrews Lester , Li Jun
Published: November 2007

Chemistry of the actinide elements represents a challenging yet vital scientific frontier. Development of actinide chemistry requires fundamental understanding of the relative roles of actinide valence-region orbitals and the nature of their chemical bonding. We report here an experimental and theoretical investigation of the uranium methylidyne molecules X
3
U

CH (X = F, Cl, Br), F
2
ClU

CH, and F
3
U

CF formed through reactions of laser-ablated uranium atoms and trihalomethanes or carbon tetrafluoride in excess argon. By using matrix infrared spectroscopy and relativistic quantum chemistry calculations, we have shown that these actinide complexes possess relatively strong U

C triple bonds between the U
6d-5f
hybrid orbitals and carbon
2s-2p
orbitals. Electron-withdrawing ligands are critical in stabilizing the U(VI) oxidation state and sustaining the formation of uranium multiple bonds. These unique U

C-bearing molecules are examples of the long-sought actinide-alkylidynes. This discovery opens the door to the rational synthesis of triple-bonded actinide

carbon compounds.
Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation
Authors: Shaw P. , Eckstrand K. , Sharp W. , Blumenthal J. , Lerch J. P. , Greenstein D. , Clasen L. , Evans A. , Giedd J. , Rapoport J. L.
Published: November 2007

There is controversy over the nature of the disturbance in brain development that underpins attention-deficit/hyperactivity disorder (ADHD). In particular, it is unclear whether the disorder results from a delay in brain maturation or whether it represents a complete deviation from the template of typical development. Using computational neuroanatomic techniques, we estimated cortical thickness at >40,000 cerebral points from 824 magnetic resonance scans acquired prospectively on 223 children with ADHD and 223 typically developing controls. With this sample size, we could define the growth trajectory of each cortical point, delineating a phase of childhood increase followed by adolescent decrease in cortical thickness (a quadratic growth model). From these trajectories, the age of attaining peak cortical thickness was derived and used as an index of cortical maturation. We found maturation to progress in a similar manner regionally in both children with and without ADHD, with primary sensory areas attaining peak cortical thickness before polymodal, high-order association areas. However, there was a marked delay in ADHD in attaining peak thickness throughout most of the cerebrum: the median age by which 50% of the cortical points attained peak thickness for this group was 10.5 years (SE 0.01), which was significantly later than the median age of 7.5 years (SE 0.02) for typically developing controls (log rank test χ(
1
)
2
= 5,609,
P
< 1.0 × 10
−20
). The delay was most prominent in prefrontal regions important for control of cognitive processes including attention and motor planning. Neuroanatomic documentation of a delay in regional cortical maturation in ADHD has not been previously reported.
Chemical and archaeological evidence for the earliest cacao beverages
Authors: Henderson John S. , Joyce Rosemary A. , Hall Gretchen R. , Hurst W. Jeffrey , McGovern Patrick E.
Published: November 2007

Chemical analyses of residues extracted from pottery vessels from Puerto Escondido in what is now Honduras show that cacao beverages were being made there before 1000 B.C., extending the confirmed use of cacao back at least 500 years. The famous chocolate beverage served on special occasions in later times in Mesoamerica, especially by elites, was made from cacao seeds. The earliest cacao beverages consumed at Puerto Escondido were likely produced by fermenting the sweet pulp surrounding the seeds.
Prevalence of polyhydramnios at a Danish hospital – a population‐based study
Authors: BUNDGAARD ANNE , RISTORP ANDERSEN BETINA , RODE LINE , LEBECH MORTEN , TABOR ANN
Published: November 2007

Background. The purpose of this study was to determine the incidence of polyhydramnios, the related maternal and perinatal morbidity, and to estimate the association between perinatal outcome and the degree of polyhydramnios in a Danish population. Methods. The study population consisted of 168 women with singleton pregnancies and polyhydramnios diagnosed by ultrasound as a largest two‐diameter pocket of >50 cm2. Mild polyhydramnios defined a s>50 and <100 cm2, and severe polyhydramnios defined as ≥100 cm2. The background population consisted of 8,347 pregnant women from the same hospital. Outcome measures were compared using φ2 test or Fisher's exact test. Results. The incidence of polyhydramnios was 2%, with 66.7% of cases mild, and 33.3% were severe polyhydramnios. The study population had an increased risk of emergency (19 versus 10.5%, p<0.001) and elective (11.3 versus 5.0%, p<0.001) caesarean section, as well as perinatal death (1.2 versus 0.3%, p<0.05) compared to the background population. In cases of severe polyhydramnios, there was an increased risk of caesarean section (44.6 versus 23.1%, p<0.005), birth weight >4,000 g (28.6 versus 14.3%, p<0.05), and need for neonatal care (8.9 versus 0.9%, p<0.01) compared to mild cases. Apgar score <7, perinatal death and structural malformations only occurred in women with severe polyhydramnios. Conclusion. It is reasonable to distinguish between mild and severe polyhydramnios regarding special attention and follow‐up, as caesarean section and perinatal morbidity and mortality are related to the degree of polyhydramnios. A two‐diameter pocket≥100 cm2 could be used to separate mild from severe cases.
Organisation and quality of primary surgical intervention for ovarian cancer in Denmark
Authors: MARX CHARLOTTE , BENDIXEN ANETTE , HØGDALL CLAUS , OTTOSEN CHRISTIAN , KEHLET HENRIK , OTTESEN BENT
Published: November 2007

Background. The positive effect on survival of maximal primary cytoreductive surgery for ovarian cancer is well established, and the highest rates of optimal cytoreduction are achieved by gynecological oncologists. Danish women have not only one of the highest incidences of ovarian cancer, but also the highest mortality rate. From 1981 to 1989, the overall Danish optimal debulking rate was 25% in patients with stage III and IV tumors. The primary aim of the present study was, therefore, to evaluate the organisation and quality of current primary surgical intervention for ovarian cancer in Denmark. Methods. All women diagnosed with epithelial ovarian carcinoma (DC56) were identified through the Danish National Patient Registry during the study period from 1 July 2002 to 31 December 2003, and surgical notes and histopathology were evaluated by a board of 7 gynecological‐oncologists, focusing on maximal cytoreduction. Results. For stage III, the nationwide optimal debulking rate was 39%, significantly higher in the major hospitals (49%) versus other hospitals (29%) (p<0.005). In 19% of cases, there was insufficient information to evaluate debulking from the surgical notes, significantly less at the major hospitals versus other hospitals (12 versus 25%, p<0.001). Conclusions. In Denmark, the quality of the primary surgical intervention for ovarian cancer is not optimal. In order to enhance survival, compliance with international guidelines and improved registration of the surgical procedures in clinical databases are mandatory.
Maternal anxiety about first trimester nuchal translucency screening and impact of positive screening results
Authors: CHUEH HO‐YEN , CHENG PO‐JEN , SHAW SHENG‐WEN , LIN CHENG‐TAO , HSU JENN‐JEIH , HSIEH T'SANG‐T'ANG
Published: November 2007

Background. To assess pre‐ and post‐procedural maternal anxiety about nuchal translucency thickness screening for Down syndrome in the first trimester of pregnancy, and the psychological impact of positive screening results. Methods. A total of 172 women whose screens were positive for excess fetal nuchal translucency thickness, and 180 women whose screens were within normal limits (controls) were recruited. Anxiety levels were measured with the Spielberger State‐Trait Anxiety Inventory just before screening, 1 week after screening, at 22 weeks’ gestation, and 6 weeks after delivery. After delivery, all women were asked to respond using a Likert‐type scale regarding their attitudes toward fetal nuchal translucency screening. Results. Women with positive screening results reported significantly greater psychological distress on state‐anxiety scores after the full report was received. The trait‐ and state‐anxiety scores before screening, at 22 weeks’ gestation, and after delivery did not differ between groups. Both groups of women were strongly positive about nuchal translucency screening, both in the current pregnancy and in future pregnancies. Conclusion. Women with positive screening results did not have a sustained increase in anxiety and remained supportive about the value of screening. Clinician concerns about causing maternal anxiety should not be an impediment to screening.