bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of osteopontin in the induction of the CD40 ligand in Graves' disease
Authors: Qi Yicheng , Li Xiaoli , Ma Xinran , Xu Lingyan , Zhang Xiaofang , Jiang Xiaohua , Hong Jie , Cui Bin , Ning Guang , Wang Shu
Published: April 2013

Objective

Graves' disease (GD) is a common autoimmune disease involved autoantibody production. Although we previously reported that osteopontin (OPN), a proinflammatory protein, affected development of GD through NF‐κB activation, little is known about the role of OPN in regulating immunoglobulin production in GD. CD40 Ligand (CD40L) is expressed on the surface of activated CD4+T cells and costimulates CD40 on B cells, stimulating production of immunoglobulins, a process which has been reported to play a vital role in immunological signalling transduction in several autoimmune diseases. This study sought to characterize the relationship between CD40L and GD development, as well as investigating the role of OPN in modulating immunoglobulin production in GD via CD40L.

Methods

Forty incident patients with GD, twenty‐one patients with GD in remission and twenty‐seven healthy controls were recruited. Both membrane‐bound and soluble forms of CD40L were measured, and their correlations with clinical parameters were studied. In addition, correlation between OPN and CD40L level was also examined. Furthermore, we studied the regulatory effect of OPN on CD40L in CD4+T cells.

Results

We demonstrated that the CD40L levels were enhanced in patients with GD and recovered in patients with GD in remission. CD40L levels correlated with clinical GD diagnostic parameters and OPN concentration. Moreover, human recombinant OPN and plasma samples from patients with GD increased CD40L expression, which could be significantly suppressed by OPN monoclonal antibody. In addition, CD40L antibody blocked the immunoglobulin production augmented by OPN in cultured peripheral blood mononuclear cells (PBMCs), isolated from patients with GD and healthy subjects.

Conclusion

These results indicate that CD40L is induced by OPN and serves as the downstream effector of OPN for immunoglobulin production in GD development.
The classification and diagnostic algorithm for primary lymphatic dysplasia: an update from 2010 to include molecular findings
Authors: Connell FC , Gordon K , Brice G , Keeley V , Jeffery S , Mortimer PS , Mansour S , Ostergaard P
Published: April 2013

Historically, primary lymphoedema was classified into just three categories depending on the age of onset of swelling; congenital, praecox and tarda. Developments in clinical phenotyping and identification of the genetic cause of some of these conditions have demonstrated that primary lymphoedema is highly heterogenous. In 2010, we introduced a new classification and diagnostic pathway as a clinical and research tool. This algorithm has been used to delineate specific primary lymphoedema phenotypes, facilitating the discovery of new causative genes. This article reviews the latest molecular findings and provides an updated version of the classification and diagnostic pathway based on this new knowledge.
Neurofibromatosis type 1 in two siblings due to maternal germline mosaicism
Authors: Trevisson E. , Forzan M. , Salviati L. , Clementi M.
Published: April 2013

Neurofibromatosis type 1 (NF1) is caused by loss of function mutations of the NF1 gene, which are de novo in 50% of cases. Although this gene shows one of the highest mutation rates in the human genome, germline mosaicism is very rare in this condition. We describe the molecular analysis of a family in which neurofibromatosis type 1 occurred in two out of four siblings born to unaffected parents. Molecular analysis of the NF1 gene identified in both patients the same splicing mutation c.1392+1G>A, which was absent in parental lymphocytes. Microsatellite analysis showed that the two affected siblings shared the same maternal allele, however a specific PCR‐RFLP assay excluded the presence of the NF1 splicing mutation in multiple maternal tissues. Our molecular and clinical findings are consistent with a germline mosaicism for the NF1 splicing mutation. This is the first case of maternal germline mosaicism for a NF1 mutation characterized so far at the molecular level. Our data confirm that germline mosaicism is rare in neurofibromatosis 1, but it has important implications for genetic counseling.
The Myth of Failed Integration: The Case of Eastern Oslo
Authors: ANDERSEN BENGT , BISETH HEIDI
Published: April 2013

In this article we examine the dominant assumptions that immigrant youth living in the working‐class suburban areas in Oslo, Norway are marginalized and angry. We argue that there is no proof that immigrants living in the Oslo suburbs are alienated from society. Nor do we see any indications of some form of mobilization among this group. This dominant assumption is linked to a larger misperception about “ghettos” in Oslo. The idea, that there are “immigrant ghettos” in Oslo, has similarities with, and draws on public debates about “immigrants” in other European cities and a broader international scholarly discourse. In this paper we show that teenagers and young adults in the most materially deprived areas in Oslo are not socially isolated, but actively participate in crucial mainstream institutions and arenas. We show that these youths have ideals, values, and ambitions that closely duplicate those of most Norwegian teenagers and young adults. We conclude therefore, that the young people labeled as “immigrants” are not only integral members of Norwegian society, but co‐producers of it.
Narratives of Moral Order in Michigan's Foreclosure Crisis
Authors: JEFFERSON ANNA
Published: April 2013

In the United States foreclosure crisis since 2007, millions of homeowners have strived but failed to hold onto homeownership. This crisis threatens to unsettle the myth of the American dream and deep‐seated cultural beliefs about the self as a moral, political, and financial subject. On the whole, mainstream narratives blame homeowners for their predicaments or at least hold them responsible for the consequences of the housing bust. This article examines how homeowners, housing professionals, and activists in Michigan confront narratives of blame and flawed foreclosure prevention programs. Michigan has been pivotal in the formation of beliefs about the American dream, evidenced in the blue‐collar middle class, as well as being emblematic of deindustrialization and the foreclosure crisis. Confronting a multi‐layered crisis, homeowners, housing professionals, and activists in Michigan produce narratives of suicide, walking away, or strategically defaulting on the mortgage. These narratives present moral critiques of lenders, enact and challenge tropes of blame, and imagine ways to recapture (albeit constrained) agency.
Gamma‐glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer
Authors: He W.‐z. , Guo G.‐f. , Yin C.‐x. , Jiang C. , Wang F. , Qiu H.‐j. , Chen X.‐x. , Rong R.‐m. , Zhang B. , Xia L.‐p.
Published: April 2013

Aim

Biomarkers have been utilized for prognosis in colorectal cancer; however, relatively few have been identified. We compared the prognostic value of serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and gamma‐glutamyl transpeptidase (GGT) with carcinoembryonic antigen (CEA) and carbohydrate antigen 19‐9 (CA19‐9) in patients with metastatic colorectal cancer (mCRC).

Method

Blood samples were collected from 239 patients with mCRC presenting between 2005 and 2010 in the Sun Yat‐sen University Cancer Center.

Results

CEA (P < 0.001), CA19‐9 (P < 0.001), GGT (P < 0.001), ALP (P < 0.001) and LDH (P = 0.001) were statistically significant prognostic factors of overall survival (OS). CEA (P = 0.002) and GGT (P = 0.021) were validated as independent predictors. On univariate analysis, CEA (P = 0.003), CA19‐9 (P = 0.006), GGT (P < 0.001) and ALP (P = 0.001) were statistically significant predictive factors of progression‐free survival (PFS) in patients having first‐line chemotherapy. CEA (P = 0.011) and GGT (P = 0.027) were independent predictors. GGT (P = 0.001), ALP (P = 0.016) and LDH (P = 0.039) levels were correlated with the tumour response rate assessed by CT, whilst CEA (P = 0.724) and CA19‐9 (P = 0.822) were not. There was a statistically significant difference in OS (P < 0.001) and PFS (P < 0.001) among patients who had elevations of both CEA and GGT compared with those in whom only one or neither was elevated.

Conclusion

Among GGT, LDH and ALP, only GGT plays an independent role with CEA in predicting OS and PFS in mCRC. When coupled with CEA, GGT may lead to improved prognostic predictors.
Pharmacotherapy of amphetamine‐type stimulant dependence: An update
Authors: Brensilver Matthew , Heinzerling Keith G. , Shoptaw Steven
Published: April 2013

Issues.

Methamphetamine‐ or amphetamine‐type stimulants are the second most frequently used illicit drug worldwide, second only to cannabis. Behavioural treatments are efficacious, but their impact is limited underscoring the need for other treatment options, notably, pharmacotherapy.

Approach.

A review of randomised controlled trials of pharmacotherapies for methamphetamine‐ or amphetamine‐type stimulants was performed using PubMed and Google Scholar databases. Evidence for efficacy of medications is reported.

Key Findings.

Clinical trials have yielded no broadly effective pharmacotherapy. Promising signals have been observed for methylphenidate, naltrexone, bupropion and mirtazapine in subgroups of patients in reducing stimulant use (e.g. patients with less severe dependence at baseline and men who have sex with men), though none has produced an unambiguous, replicable signal of efficacy.

Implications.

Problems in Phase II trials, including high dropout rates, missing data and a lack of agreement on outcomes, complicate efforts to find a broadly effective pharmacotherapy for amphetamine‐type stimulant disorders. Efforts to address these problems include calls for better validation of pharmacological target exposure, receptor binding and functional modulation. As well, there is a need for agreement in using findings from preclinical and early phases of the medication development process for selecting better pharmacotherapy candidates.

Conclusion.

After over 20 years of efforts worldwide to develop a broadly effective medication for dependence on methamphetamine‐ or amphetamine‐type stimulants, no candidate has emerged. This highlights the need for new compounds, consistent and stringent research methods, better integration between preclinical and clinical stages of medication development, and improved collaboration between government, industry and researchers. [Brensilver M, Heinzerling KG, Shoptaw S. Pharmacotherapy of amphetamine‐type stimulant dependence: An update. Drug Alcohol Rev 2013;32:449–460]
Unilateral versus bilateral endoscopic biliary stenting for malignant hilar biliary strictures
Authors: Yasuda Ichiro , Mukai Tsuyoshi , Moriwaki Hisataka
Published: April 2013

The present review compared unilateral versus bilateral stenting in order to determine the optimal stenting strategy for malignant hilar biliary strictures based on the previous literature. The role of preoperative biliary drainage prior to liver resection for hilar cholangiocarcinoma remains under discussion. However, in Japan, endoscopic placement of single nasobiliary drainage in the future remnant hepatic lobe is currently considered the most suitable method. In most unresectable cases, unilateral stenting appears to be adequate for ameliorating jaundice. It is technically easier and less expensive than bilateral stenting, with reintervention for stent dysfunction also being considerably easier. However, contrast medium injection into undrained bile ducts is associatedwith uncontrolled cholangitis and poor prognosis. To prevent this complication, bilateral stenting may be preferred to unilateral stenting. Additionally, previous studies have demonstrated bilateral stenting to be associated with longer stent patency as compared to unilateral stenting. We consider that further large‐scale studies are required to clarify whether unilateral or bilateral stenting is a better therapeutic technique for malignant hilar biliary stricture.
Endoscopic ultrasound‐guided choledochoantrostomy as an alternative extrahepatic bile duct drainage method in pancreatic cancer with duodenal invasion
Authors: Itoi Takao , Itokawa Fumihide , Tsuchiya Takayoshi , Tsuji Shujiro , Tonozuka Ryosuke
Published: April 2013

Recently, endoscopic ultrasonography‐guided bile duct drainage (EUS‐BD) has become popular as an alternative method of biliary drainage in cases of failed endoscopic retrograde cholangiopancreatography. In terms of EUS‐guided extrahepatic bile duct drainage, recently, EUS‐guided choledochoantrostomy has been reported as a variation of EUS‐BD. We describe a case of successful choledochoantrostomy using a fully covered self‐expandable metallic stent. We conclude that EUS‐guided choledochoantrostomy should be one option for biliary decompression. Inparticular, if patients have duodenal strictures, with or without a duodenal metal stent, it seems to be an ideal alternative to choledochoduodenostomy.
Otaru consensus on biliary stenting for unresectable distal malignant biliary obstruction
Authors: Irisawa Atsushi , Katanuma Akio , Itoi Takao
Published: April 2013

Endoscopic biliary drainage with biliary stent placement is the treatment of choice for palliation in patients with malignant biliary obstruction caused by unresectable neoplasms. Various biliary stent designs have become available, but lack of a clear consensus persists on the use of covered versus uncovered metal stents in malignant distal bile duct obstructions, and plastic versus metal stents. In 2012, the European Society of Gastrointestinal Endoscopy indicated guidelines for biliary stenting. Accordingly, the consensus meeting for biliary stenting was held at the Endoscopic Forum Japan 2012, and four selected statements related to stent placement for distal malignant biliary obstruction were discussed to produce a consensus. Two of fourstatements (related to the usefulness of self‐expandable metallic stents, and reintervention after stenting) were agreed upon by almost all participants. Nevertheless, our opinions were divided on the other two statements (necessity of sphincterotomy for stenting, and covered metal stent versus uncovered metal stent). We herein report the results of the meeting, and present proposed new statements via discussion.
Locoregional and multiple distant metastases after chemoradiation therapy following endoscopic resection for rectal cancer with deep submucosal invasion
Authors: Takeuchi Yoji , Shingai Tatsushi , Ohue Masayuki , Nishiyama Kinji , Tomita Yasuhiko
Published: April 2013

A 61‐year‐old man underwent endoscopic mucosal resection for a 12‐mm flat neoplasm in the lower rectum at another hospital. Histopathology of the resected specimen indicated well‐ to moderately differentiated adenocarcinoma with deep submucosal invasion and lymphatic and venous involvement. Although the tumor was completely removed by endoscopic resection, the possibility of lymph node metastasis could not be ignored. Therefore, additional surgery with lymph node dissection was recommended, but the patient refused and visited our hospital. He instead underwent chemoradiotherapy as an alternative therapy(i.v. drip infusion of 5‐fluorouracil [250 mg/m2 per day] for 5 days × 5 weeks + 1.8 Gy/day of irradiation for 5 days × 5 weeks). However, lung and locoregional metastases were detected approximately 2 years after completion of chemoradiotherapy. He is now undergoing systemic combination chemotherapy with capecitabine, oxaliplatin, and bevacizumab once a month.
Lessons from imperfect endoscopic submucosal dissection of rectal tumor
Authors: Okamoto Koichi , Muguruma Naoki , Kitamura Shinji , Shiba Masako , Takayama Tetsuji
Published: April 2013

Endoscopic mucosal resection (EMR) is a standard endoscopic treatment for gastrointestinal tumors, but resections done in a piecemeal fashion are difficult to diagnose pathologically as curative resections, and the local recurrence rate is relatively high. Recently, endoscopic submucosal dissection (ESD) for colorectal tumors, which provides a higher complete resection rate than conventional EMR, has rapidly come into widespread use in Japan. However, colorectal ESD is still technically difficult and has complications such as perforation, and the procedure time is longer than that of conventional EMR. We report herein a case in which a rectal tumor was resected with an inappropriate specimen due to imperfect ESD. This lesion had severe fibrosis in the submucosal layer because the lesion had been injected with asolution for EMR in another hospital, which resulted in non‐lifting signs, and had been subjected to many biopsies. During the ESD in our hospital, the submucosal layer was not clearly identified, and a small injury was caused in the specimen. A precise diagnosis based on histopathological findings could not be made because of the inappropriate specimen. Thus, expertise in both the diagnostic and the therapeutic aspects is required before treating large colorectal tumors.
Biliary self‐expandable metallic stent for unresectable malignant distal biliary obstruction: Which is better: covered or uncovered?
Authors: Isayama Hiroyuki , Nakai Yousuke , Kogure Hirofumi , Yamamoto Natsuyo , Koike Kazuhiko
Published: April 2013

Self‐expandable metallic stents (SEMS) are a widely accepted biliary endoprosthesis for patients with unresectable malignant distal biliary obstruction. There are two types of SEMS: covered and uncovered. Uncovered SEMS (UCSEMS) embed into the biliary wall due to their mesh structure and self‐expandability, and are resistant to migration. However, the disadvantage of UCSEMS is occlusion due to tumor ingrowth (TI) via the stent mesh, and TI is the main cause of UCSEMS occlusion. To overcome this, covered SEMS (CSEMS) were developed and showed longer patency than UCSEMS. However, migration due to the non‐embedded stent body is the main cause of CSEMS dysfunction. There are some randomized studies comparing CSEMS and UCSEMS; however, the results are different according to each study. From one meta‐analysis, CSEMS showed longer patency than UCSEMS. A literature review revealed that covered SEMSshowed longer patency than UCSEMS. Some studies cannot clearly demonstrate the superiority of CSEMS, as the CSEMS used did not prevent TI or migration. Mechanical properties of SEMS may influence the occurrence of complications. A recent clinical study comparing the Covered Wallstent and the Covered WallFlex revealed superiority of the WallFlex for the prevention of migration. Reducing the axial force and increasing the radial force may lead to good results. Migration of CSEMS should be prevented by taking into consideration the mechanical properties of stents and development of anti‐migration systems.
Reintervention for occluded biliary metal stent for patients with malignant distal biliary stricture
Authors: Ito Kei , Ogawa Takahisa , Horaguchi Jun , Koshita Shinsuke , Fujita Naotaka
Published: April 2013

A metal stent has a longer stent patency than a plastic stent in patients with unresectable malignant distal biliary stricture. However, treatment for stent dysfunction of a metal stent remains unresolved. A review of reported articles regarding reintervention for metal stent dysfunction showed that causes of stent dysfunction included tumor ingrowth/overgrowth, stone/sludge/food impaction, and stent migration. Cleaning of the stent is associated with an early relapse of stent dysfunction. Additional placement of a covered metal stent is expected to have a longer stent patency than that of other stents such as uncovered metal stents or plastic stents. It is recommended that occludedcovered metal stents be removed if possible. Stent trimming with argon plasma coagulation is sometimes useful for the treatment of stent displacement. No strategy for occluded metal stents has been established yet. Further clinical trials regarding proper treatments are necessary.
Metachronous adenoma on ileorectal anastomosis suture line and submucosal deep invasive cancer suspected of rapid growth in rectal remnant following long‐term interval after curative surgery for advanced colon cancer
Authors: Uraoka Toshio , Horii Joichiro , Goto Osamu , Shimoda Masayuki , Yahagi Naohisa
Published: April 2013

There is general agreement as to the value of postoperative surveillance and the effectiveness of colonoscopy in the early detection of metachronous colorectal lesions. In the present case, a 56‐year‐old woman with no family history of colon cancer underwent surveillance colonoscopy in which a metachronous flat adenoma was detected following an interval of 23 years after a colectomy and 20 years subsequent to treatment for uterine cancer. A second metachronous flat lesion histopathologically determined to be a submucosal (sm) deep invasive cancer with lymphovascular involvement was detected 12 months later. This second metachronous lesion was suspected of having developed rapidly in the rectal remnant accounting for its sm deep invasion. The findings of this case suggest colonoscopy surveillance guidelines proposed for individuals at high risk should be evaluatedbased on cancer history and an analysis of possible mismatch repair gene mutations. In addition, the first metachronous lesion was located directly on the suture line of the anastomosis. Endoscopic submucosal dissection (ESD) was indicated despite severe fibrosis into the sm layer. This case also demonstrates the successful use of improved ESD instruments, sm injection agents and technique refinements in the treatment of a technically difficult lesion with a high risk of complications.
Invasive rectal cancer treated with a combination of endoscopic submucosal dissection and chemoradiation
Authors: Fu Kuang I. , Konuma Hironori , Ueyama Hiroya , Saga Taiji
Published: April 2013

A 68‐year‐old man underwent total colonoscopy because of a positive fecal occult blood test. A polypoid lesion (Is + IIa), 20 mm in size, was detected in the very lower part of the rectum. A large reddish nodule suggesting invasive carcinoma was seen on conventional view. Magnifying chromoendoscopy, however, disclosed a non‐invasive pit pattern in that part. Moreover, magnifying narrow band imaging showed a type IIIA capillary pattern. Therefore, endoscopic submucosal dissection was successfully conducted for en bloc resection. Histologically, it was a rectal submucosal invasive carcinoma deeply invading into thesubmucosal layer with vascular invasion. Although additional surgical treatment was suggested, the patient refused the proposal and received chemoradiation therapy to avoid a permanent colostomy. Periodic evaluation revealed no local or distant metastasis 3 years thereafter.
Small Barrett's adenocarcinoma, 3 mm in size, in long‐segment Barrett's esophagus detected after 4 years of follow up
Authors: Hirasawa Dai , Fujita Naotaka , Yamagata Yuki Maeda Taku , Noda Yutaka
Published: April 2013

We herein report a rare case of very small Barrett's adenocarcinoma. A 65‐year‐old man underwent surveillance esophagogastroduodenoscopy (EGD) 3 years after endoscopic submucosal dissection (ESD) for superficial Barrett's adenocarcinoma, which revealed a very small reddish area in the mucosa, 2 mm in diameter, in long‐segment Barrett's esophagus. The EGD carried out 1 year later confirmed slight enlargement of the lesion, from 2 mm to 3 mm in diameter. Macroscopic type changed from flat type to slightly depressed type. On narrow‐band imaging with magnifyingendoscopy, an irregular microstructure and irregular microvasculature became recognizable. It was resected by ESD and diagnosed as mucosal adenocarcinoma with a diameter of only 3 mm.
Barrett's adenocarcinoma in long‐segment Barrett's esophagus successfully detected by narrow‐band imaging with magnifying endoscopy
Authors: Morita Yoshinori , Tanaka Shinwa , Toyonaga Takashi , Azuma Takeshi
Published: April 2013

Conventionally, long‐segment Barrett's esophagus (LSBE) has been considered a high‐risk background for the occurrence of Barrett's adenocarcinoma in Western countries, and random biopsy has been proposed for surveillance, aiming to detect early cancer. However, accurate detection of a lesion and diagnosis of the expansion are difficult by this blind method. Herein, we report a case of early Barrett's adenocarcinoma derived from LSBE thatwas successfully detected by narrow‐band imaging with magnifying endoscopy.
What Is Social Construction?
Authors: Diaz‐Leon E.
Published: April 2013

In this paper I discuss the question of what it means to say that a property is socially constructed. I focus on an influential project that many social constructivists are engaged in, namely, arguing against the inevitability of a trait, and I examine several recent characterizations of social construction, with the aim of assessing which one is more suited to the task.
The Development of EU Case‐Law on Age Discrimination in Employment: ‘Will You Still Need Me? Will You Still Feed Me? When I'm Sixty‐Four’
Authors: Dewhurst Elaine
Published: April 2013

This article addresses the development of age discrimination law in the Court of Justice and concludes that there is a marked difference in the level of discretion given to Member States in cases relating to mandatory retirement policies. The article will critique the approach of the Court of Justice to the legitimate objective test and the proportionality test in retirement cases. It will also argue that the decisions of the Court of Justice to date have all involved cases with very similar factual scenarios, and the article hypothesises how a different conclusion might be reached in cases with different factors. It also considers the impact of the Charter of Fundamental Rights on such cases. The article concludes by arguing that mandatory retirement policies may no longer be compatible with EU law and that there is a need to move towards more flexible retirement policies.
Modelling the effects of climate change on the distribution and production of marine fishes: accounting for trophic interactions in a dynamic bioclimate envelope model
Authors: Fernandes Jose A. , Cheung William W. L. , Jennings Simon , Butenschön Momme , de Mora Lee , Frölicher Thomas L. , Barange Manuel , Grant Alastair
Published: April 2013

Climate change has already altered the distribution of marine fishes. Future predictions of fish distributions and catches based on bioclimate envelope models are available, but to date they have not considered interspecific interactions. We address this by combining the species‐based Dynamic Bioclimate Envelope Model (DBEM) with a size‐based trophic model. The new approach provides spatially and temporally resolved predictions of changes in species' size, abundance and catch potential that account for the effects of ecological interactions. Predicted latitudinal shifts are, on average, reduced by 20% when species interactions are incorporated, compared to DBEM predictions, with pelagic species showing the greatest reductions. Goodness‐of‐fit of biomass data from fish stock assessments in the North Atlantic between 1991 and 2003 is improved slightly by including species interactions. The differences between predictions from the two models may be relatively modest because, at the North Atlantic basin scale, (i) predators and competitors may respond to climate change together; (ii) existing parameterization of the DBEM might implicitly incorporate trophic interactions; and/or (iii) trophic interactions might not be the main driver of responses to climate. Future analyses using ecologically explicit models and data will improve understanding of the effects of inter‐specific interactions on responses to climate change, and better inform managers about plausible ecological and fishery consequences of a changing environment.
Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community‐dwelling elderly women
Authors: Felicio Diogo Carvalho , Pereira Daniele Sirineu , Assumpção Alexandra Miranda , de Jesus‐Moraleida Fabianna Resende , de Queiroz Barbara Zille , da Silva Juscelio Pereira , de Brito Rosa Naysa Maciel , Dias João Marcos Domingues , Pereira Leani Souza Máximo
Published: April 2013

Aim

To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community‐dwelling elderly women.

Methods

This was a cross‐sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community‐dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations.

Results

Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P < 0.05), yet poorly, correlated with handgrip strength (r < 0.30).

Conclusion

The majority of analyses did not show any correlation between variables assessed by isokinetic dynamometer and handgrip dynamometer. Caution is required when generalizing handgrip strength as a predictor of global muscle strength in community‐dwelling elderly women. Geriatr Gerontol Int 2014; 14: 185–189.
Alterations of epigenetics and microRNAin hepatocellular carcinoma
Authors: Saito Yoshimasa , Hibino Sana , Saito Hidetsugu
Published: April 2013

Studies have shown that alterations of epigenetics and microRNA(miRNA) play critical roles in the initiation and progression of hepatocellular carcinoma (HCC). Epigenetic silencing of tumor suppressor genes inHCCis generally mediated byDNAhypermethylation ofCpGisland promoters and histone modifications such as histone deacetylation, methylation of histoneH3lysine 9 (H3K9) and tri‐methylation ofH3K27. Chromatin‐modifying drugs such asDNAmethylation inhibitors and histone deacetylase inhibitors have shown clinical promise for cancer therapy. miRNAare small non‐codingRNAthat regulate expression of various target genes. SpecificmiRNAare aberrantly expressed and play roles as tumor suppressors or oncogenes during hepatocarcinogenesis. We and other groups have demonstrated that important tumor suppressormiRNAare silenced by epigenetic alterations, resulting in activation of target oncogenes in human malignancies includingHCC. Restoring the expression of tumor suppressormiRNAby inhibitors ofDNAmethylation and histone deacetylase may be a promising therapeutic strategy forHCC.
A Reconsideration of Religious Authority in Christian Theology
Authors: Carnes Natalie
Published: April 2013

As Stanley Cavell has critiqued Christianity for displacing authority from the individual to somewhere beyond critical assessment, so several Christian theologians have also turned to Wittgenstein to justify just such displacement. This article suggests that both offer theologically impoverished and historically inattentive accounts of authority. It aims instead to sketch five moments in the Christian tradition to suggest five ways of naming the intimacy of religious authority with individual critical assessment. Such intimacy is then theologically described through the doctrinal loci of creation and incarnation, which generate a picture of authority surprisingly near to one Cavell might want to celebrate.
Evaluation of culturally appropriate health counselling to prevent lifestyle‐related diseases and its modification for practical use as the new ABC model of culturally appropriate counselling for Japanese public health nurses
Authors: Marutani Miki , Tamura Sugako , Miyazaki Misako , Amamiya Yuko
Published: April 2013

This study evaluates culturally appropriate health counselling to prevent lifestyle‐related diseases and suggests modifications of the method for practical use.

Semi‐structured interviews were conducted with 13 public health nurses (PHNs) in seven cities with different cultural backgrounds. Data were analysed qualitatively with the following research questions: Do we need to add other cultural factors to the previous six categories or to improve their expression for practical use? Are the methods for using cultural factors valid and expressed in appropriate language for practical use?

The original factors were re‐categorized into three classifications—Values, Styles and Relationships—using colloquial expressions. The original methods of using cultural factors were re‐categorized and modified into five phases: Assessment, Acceptance, Awareness, Balance and Connection. The names of the methods were also modified.

Modified culturally appropriate health counselling is easily understandable by any PHN and highlights the unique Japanese culture and style of public health nurses.
Identifying structure and aspects that ‘continuing nursing care’ used in discharge support from hospital to home care in Japan
Authors: Nagae Hiroko , Tanigaki Shizuko , Okada Mari , Katayama Yoko , Norikoshi Chie , Nishina Yuko , Sakai Masako
Published: April 2013

This study investigated nursing practice in continuing nursing care with the aim of identifying the key factors in nursing practice during discharge support. A literature review of papers published in Japanese in 2000 and 2011 was conducted using ‘case management’, ‘care management’, ‘continuing nursing care’, ‘discharge support’, ‘discharge planning’ and ‘elderly person’ as key words. An analysis of 54 papers revealed the following five aspects of continuing nursing care: (i) a cyclical approach aimed at realising the lifestyle desired by the person concerned; (ii) management of medical conditions for lifestyle stability; (iii) support for the patient as someone who can live independently; (iv) support to raise the ability of families to care for themselves; and (v) team approach to achieve implementation of patient‐centred care. Understanding these aspects allows nurses to recreate the lifestyle of patients and families and facilitate the implementation of a systematic team approach.
A Comparison of 0°–0° and 45°–45° bridge‐Seeded, YBCO single grains
Authors: Shi Yunhua , Durrell John H. , Dennis Antony R. , Zhang Zhiwei , Zhai Wei , Hari Babu Nadendla , Cardwell David A.
Published: April 2013

A variety of multiseeding techniques have been investigated over the past 20 yr in an attempt to enlarge bulk (RE)BCO superconducting samples fabricated by the top‐seeded melt growth (TSMG) process for practical applications. Unfortunately, these studies have failed to establish whether technically useful values of trapped field can be achieved in multiseeded bulk samples. In this work specially designed, 0°–0° and 45°–45° bridge seeds of different lengths have been employed to produce improved alignment of the seeds during the TSMG process. The ability of these bridge‐seeded samples to trap magnetic field, which is the key superconducting property for practical applications of bulk (RE)BCO, is compared for the samples seeded using 0°–0° and 45°–45° bridge seeds of different lengths. The grain boundaries produced by these bridge seeds are analyzed in detail, and the similarities and differences between the two bridge‐seeding processes are discussed.
Salt Loading and Potassium Supplementation: Effects on Ambulatory Arterial Stiffness Index and Endothelin‐1 Levels in Normotensive and Mild Hypertensive Patients
Authors: Liu Zhendong , Peng Jie , Lu Fanghong , Zhao Yingxin , Wang Shujian , Sun Shangwen , Zhang Hua , Diao Yutao
Published: April 2013

The authors investigated effects of excessive salt intake and potassium supplementation on ambulatory arterial stiffness index (AASI) and endothelin‐1 (ET‐1) in salt‐sensitive and non–salt‐sensitive individuals. AASI and symmetric AASI (s‐AASI) were used as indicators of arterial stiffness. Plasma ET‐1 levels were used as an index of endothelial function. Chronic salt‐loading and potassium supplementation were studied in 155 normotensive to mild hypertensive patients from rural northern China. After 3 days of baseline investigation, participants were maintained sequentially for 7 days each on diets of low salt (51.3 mmol/d), high salt (307.7 mmol/d), and high salt+potassium (60 mmol/d). Ambulatory 24‐hour blood pressure (BP) and plasma ET‐1 were measured at baseline and on the last 2 days of each intervention. High‐salt intervention significantly increased BP, AASI, s‐AASI (all P<.001); potassium supplementation reversed increased plasma ET‐1 levels. High‐salt–induced changes in BP, s‐AASI, and plasma ET‐1 were greater in salt‐sensitive individuals. Potassium supplementation decreased systolic BP and ET‐1 to a significantly greater extent in salt‐sensitive vs non–salt‐sensitive individuals (P<.001). Significant correlations were identified between s‐AASI and ET‐1 change ratios in response to both high‐salt intervention and potassium supplementation (P<.001). Reducing dietary salt and increasing daily potassium improves arterial compliance and ameliorates endothelial dysfunction.
Characterization of age‐associated alterations of islet function and structure in diabetic mutant cryptochrome 1 transgenic mice
Authors: Okano Satoshi , Hayasaka Kiyoshi , Igarashi Masahiko , Togashi Yoshiyuki , Nakajima Osamu
Published: April 2013

Aims/Introduction

In earlier reports, we described that transgenic (Tg) mice ubiquitously expressing cryptochrome1 (CRY1) with a mutation in cysteine414 (CRY1‐AP Tg mice) show an early‐onset insulin‐secretory defect of diabetes mellitus resembling human maturity‐onset diabetes of the young (MODY). To clarify the yet undiscovered molecular pathogenesis of diabetes mellitus in which the mutant of CRY1 is involved, we examined age‐dependent characteristics of islets of CRY1‐AP Tg mice.

Materials and Methods

Immunohistochemical analyses of islets were carried out for 2‐, 4‐ and 19‐week‐old mice. Insulin contents in the pancreas and glucose‐stimulated insulin secretion of isolated islets of mice were measured at 4 weeks. Real‐time polymerase chain reaction analyses using pancreases of mice at 4 and 21 weeks‐of‐age were carried out.

Results

Already at a young stage, the proliferation of β‐cells was reduced in CRY1‐AP Tg mice. Insulin contents and the levels of glucose‐stimulated insulin secretion were lower than those of wild‐type controls in CRY1‐AP Tg mice at the young stage. The expression of insulin and glucose‐sensing genes was reduced at the young stage. At the mature stage, altered distribution and hyperplasia of α‐cells were observed in the islets of CRY1‐AP Tg mice.

Conclusions

Architectural abnormality in islets progressed with age in CRY1‐AP Tg mice. The reduced expression of insulin and glucose‐sensing genes, along with the lowered proliferation of β‐cells from an early stage, is a possible primary cause of early‐onset insulin‐secretory defect in CRY1‐AP Tg mice. Our results suggest that CRY1 is crucial for the maintenance of β‐cell function.
Defining criteria for the introduction of liraglutide using the glucagon stimulation test in patients with type 2 diabetes
Authors: Kondo Yoshinobu , Satoh Shinobu , Nagakura Joe , Kimura Masayo , Nezu Uru , Terauchi Yasuo
Published: April 2013

Aims/Introduction

To define a set of criteria using indices of β‐cell function, including results from the glucagon stimulation test, for liraglutide introduction in patients with type 2 diabetes.

Materials and Methods

In the present retrospective cohort study, patients were included in our analysis if their β‐cell function had been evaluated with a glucagon stimulation test and a 24‐h urinary C‐peptide (U‐CPR) excretion test before switching from insulin therapy to liraglutide monotherapy. The efficacy of liraglutide was determined by the extent to which glycemic control was achieved or if glycated hemoglobin levels were maintained at <7.0% after liraglutide monotherapy for 24 weeks.

Results

Liraglutide was effective in 36 of 77 patients. In the liraglutide‐effective cases, the following parameters were higher: fasting C‐peptide (CPR0) levels, C‐peptide levels 6 min after glucagon stimulation (CPR6), the C‐peptide index (CPI; CPR0 × 100/fasting plasma glucose) and stimulated C‐peptide index (S‐CPI; CPR6 × 100/plasma glucose 6 min after glucagon stimulation). U‐CPR did not differ between liraglutide‐effective and liraglutide‐ineffective cases. Using receiver operating characteristic analysis adjusted for baseline characteristics, the independent cut‐off value for effective liraglutide introduction was 0.72 for CPI and 1.92 for S‐CPI.

Conclusions

Evaluation of β‐cell function using the glucagon stimulation test is useful for determining the efficacy of liraglutide introduction in patients with type 2 diabetes.
Isotretinoin 5 mg daily for low‐grade adult acne vulgaris – a placebo‐controlled, randomized double‐blind study
Authors: Rademaker M. , Wishart J.M. , Birchall N.M.
Published: April 2013

Background

Despite acne persisting into adulthood in up to 50% of the population, very few therapeutic studies have been performed in this age group.

Objectives

To assess the efficacy of 5 mg/day isotretinoin in adult acne.

Methods

An investigator initiated, industry‐sponsored, randomized, double‐blind, placebo‐controlled, parallel‐group clinical study of isotretinoin 5 mg/day in the treatment of low‐grade adult acne for 16 weeks followed by an open‐label phase of 16 weeks. Group 1 received 32 weeks of 5 mg isotretinoin/day; Group 2 first received 16 weeks of placebo, followed by 16 weeks open‐label 5 mg isotretinoin/day. Patients were followed for a further 10 weeks off treatment. The primary end‐point was the difference in acne lesion count and disability score after 16 weeks isotretinoin compared to placebo. Secondary end‐points included differences in these counts/scores after 32 weeks of isotretinoin compared to baseline, and after 10 weeks off treatment, compared to end of treatment (week 32).

Results

There were highly significant differences (P < 0.0001) in acne lesion count, Dermatology Life Quality Index and self‐assessment after 16 weeks of isotretinoin, compared to placebo (both per protocol and intention to treat). Acne lesions fell significantly, within 4 weeks of 5 mg isotretinoin/day (Group 1) and continued to fall during 32 weeks of treatment [acne lesion count (mean ± SD): 11.3 ± 8.1 (baseline), 3.6 ± 5.5 (week 16), 1.3 ± 3.1 (week 32), P < 0.0001)]. There was a similar significant reduction in acne lesion count in Group 2, but only from week 20, 4 weeks after starting open‐label 5 mg isotretinoin. Adverse effects were minimal.

Conclusions

Isotretinoin 5 mg/day is effective in reducing the number of acne lesions, and improving patients dermatologic quality of life, with minimal adverse effects.
Life‐history traits of the common snookCentropomus undecimalisin a Caribbean estuary and large‐scale biogeographic patterns relevant to management
Authors: Andrade H. , Santos J. , Taylor R.
Published: April 2013

The ecology of common snookCentropomus undecimalisin Amatique Bay, a tropical estuary in eastern Guatemala, was investigated and life‐history traits were used to conduct a meta‐analysis of the species from Florida to Brazil. The reproduction cycle ofC. undecimalisin Amatique was strongly related to the precipitation cycle, with a lag of 2 months. Spawning occurred from April to November with a peak spawning after the onset of the summer rains. Protandric sex reversal occurred early in the dry season (December) before somatic recovery from spawning. The growth cycle preceded that of body condition byc. 1 month, and was out of phase with the reproductive cycle. Growth was fast, as many individuals reached >70% of the maximum observed total length (LT, 102 cm) after 3 years. Sex transition occurred within a relatively narrowLTrange (70–79 cm), but over a wide range of ages, indicating plasticity in this respect. The meta‐analysis indicated a latitudinal‐temperature gradient in life‐history traits, as well as different seasonal patterns relative to temperature and hydrographical cycles.Centropomus undecimalisfrom cooler winter waters (e.g. Florida) reach larger maximumLTandLTat sex change, as well as greater gonado‐somatic indices and longer life spans. Further, increased fishing mortality results in younger age at sex reversal and male predominance in the populations compared. Recognition of large‐scale biogeographic patterns in this important, but little studied, fish species helps in the formulation of management advice in other areas of its occurrence.
Development of a monoclonal antibody‐based flow‐through immunoassay (FTA) for detection of white spot syndrome virus (WSSV) in black tiger shrimp Penaeus monodon
Authors: Patil R , Shankar K M , Kumar B T N , Kulkarni A , Patil P , Moger N
Published: April 2013

A flow‐through immunoassay (FTA), an improved version of immunodot, was developed using a nitrocellulose membrane baked onto adsorbent pads enclosed in a plastic cassette to detect white spot syndrome virus (WSSV) in shrimp. Sharp purple dots developed with WSSV against the white background of the nitrocellulose membrane. The detection limits of WSSV by the FTA and immunodot were 0.312 and 1.2 μg mL−1 crude WSSV protein, respectively. The FTA could be completed in 8–10 min compared with 90 min for immunodot. The FTA was 100 times more sensitive than 1‐step polymerase chain reaction (PCR) and in between that of the 1‐ and 2‐step PCR protocol recommended by the Office of International Epizootics (OIE). In experimental, orally infected shrimp post‐larvae, WSSV was first detected 14, 16 and 18 h post‐infection (hpi) by FTA, immunodot and one‐step PCR, respectively. The FTA detected WSSV 2 and 4 h earlier than immunodot and one‐step PCR, respectively. The FTA was more sensitive (25/27) than one‐step PCR (23/27) and immunodot (23/27) for the detection of WSSV from white spot disease outbreak ponds. The reagent components of the FTA were stable giving expected results for 6 m at 4–8 °C. The FTA is available as a rapid test kit called ‘RapiDot’ for the early detection of WSSV under field conditions.
Neuroimaging Features in Congenital Trichomegaly: The Oliver‐McFarlane Syndrome
Authors: Pedroso José Luiz , Rivero René Leandro M. , de Miranda Victor Alexandre D. , Avelino Marcela Amaral , Dutra Lívia Almeida , Ribeiro Rodrigo Souza , Nunes Karlo Faria , Manzano Gilberto Mastrocola , Barsottini Orlando G.
Published: April 2013

A 23‐year‐old woman presented to our hospital with 9 months history of progressive ataxia, visual loss since childhood due to retinitis pigmentosa and primary amenorrhea. On examination, there were also sparse scalp hair, very long and curled upwards eyelashes and short stature. Oliver‐McFarlane syndrome was suspected. Brain MRI disclosed cerebellar atrophy and hyperintense signal in corticospinal tracts on FLAIR and T2‐weighted images. Therefore, brain imaging must be thoroughly investigated in patients with suspected Oliver‐McFarlane syndrome, in order to determinate whether cerebellar atrophy and hyperintense signal in corticospinal tracts are part of this neurological condition.