bluuebunny/crossref_metadata_2025 huggingface dataset:
Compression Stockings for Treating Venous Leg Ulcers
Authors: Benigni J. P. , Deman A. L. , Uhl J. F.
Published: February 2013

Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle). Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI)) and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit). In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.
Joint Optimal Pricing and Inventory Control for Deteriorating Items under Inflation and Customer Returns
Authors: Ghoreishi Maryam , Arshsadi khamseh Alireza , Mirzazadeh Abolfazl
Published: February 2013

This paper studies the effect of inflation and customer returns on joint pricing and inventory control for deteriorating items. We adopt a price and time dependent demand function, also the customer returns are considered as a function of both price and demand. Shortage is allowed and partially backlogged. The main objective is determining the optimal selling price, the optimal replenishment cycles, and the order quantity simultaneously such that the present value of total profit in a finite time horizon is maximized. An algorithm has been presented to find the optimal solution. Finally, we solve a numerical example to illustrate the solution procedure and the algorithm.
Flow Cytometry in the Detection of Neonatal Sepsis
Authors: Umlauf Volker N. , Dreschers Stephan , Orlikowsky Thorsten W.
Published: February 2013

Neonatal sepsis remains a burden problem by showing minimal initial symptoms of subtle character, nonspecific manifestation, and diagnostic pitfalls. The clinical course can be fulminant and fatal if treatment is not commenced promptly. It is therefore crucial to establish early diagnosis and initiate adequate therapy. Besides clinical symptoms, the most reliable laboratory markers in establishing diagnosis is currently the combined measurement of CRP and a cytokine (IL-6 and IL-8). Due to their different kinetics, a diagnostic gap might occur and thus withholding antimicrobial therapy in clinical suspicion of infection is not acceptable. We therefore need parameters which unerringly differentiate between infants in need for antimicrobial therapy and those who are not. Flow cytometry promises to be a useful tool in this field, allowing the determination of different cellular, dissolved, and functional pathophysiological components of sepsis. Despite technical and methodical advances in flow cytometry, its use in clinical routine is still limited. Advantages and disadvantages of promising new parameters in diagnosis of sepsis performed by flow cytometry, particularly CD64, HLA-DR, and apoptosis, are reviewed here. The necessity of tests to be used as an “ideal” parameter is presented.
Carbon Nanotube‐Epoxy Nanocomposites: Correlation and Integration of Dynamic Impedance, Dielectric, and Mechanical Analyses
Authors: Moudam O. , Andrews T. , Lekakou C. , Watts J. F. , Reed G.
Published: February 2013

This study focuses on the characterization of MWNT‐epoxy composites for different MWNT concentrations of 0–7 wt% by correlating different dynamic analysis techniques, including DMA, impedance, and DEA. An optimum composition was established at 0.1 wt% MWNTs corresponding to the best MWNT dispersion which resulted in the formation of an optimum MWNT network. The addition of this low fraction of MWNTs in epoxy resulted in stiffening the molecular structure and suppressing certain molecular transitions, raising the dielectric constant especially in the low‐to‐medium frequency range, raising the electrical conductivity especially at the high frequencies, and increasing the electromagnetic shielding effectiveness. The 0.1% MWNT‐epoxy nanocomposite switched the electromagnetic shielding behaviour from being a very effective absorber at low frequencies to being an effective reflector at high frequencies. Finally, the Nyquist plot derived from the dynamic impedance spectroscopy proved most useful at providing evidence of multiple size distribution of MWNT agglomerates.
Perioperative Management of Type 2N Von Willebrand’s Disease with Recombinant Factor VIII in a Patient Undergoing Knee-Replacement Surgery
Authors: Dukka Srivasavi , Allsup David John
Published: February 2013

Type 2N Von Willebrand's disease (2N VWD) is a rare, recessively inherited bleeding disorder, comprising 1-2% of all VWD patients, usually manifesting as a mild bleeding diathesis. Treatment includes desmopressin (DDAVP) or intermediate purity plasma-derived FVIII concentrates containing residual VWF. We present a case of a 75-year-old gentleman, incidentally diagnosed with type 2N VWD in 2002 on routine blood testing before surgery with an ISTH bleeding score of 1-2, who was treated with recombinant FVIII preoperatively.
Targeted Metabolomics of Serum Acylcarnitines Evaluates Hepatoprotective Effect of Wuzhi Tablet (Schisandra sphenantheraExtract) against Acute Acetaminophen Toxicity
Authors: Bi Huichang , Li Fei , Krausz Kristopher W. , Qu Aijuan , Johnson Caroline H. , Gonzalez Frank J.
Published: February 2013

Possible prevention and therapeutic intervention strategies to counteract acetaminophen (APAP) hepatotoxicity would be of great value. Wuzhi tablet (WZ, extract ofSchisandrae sphenanthera) possesses hepatoprotective effects against hepatitis and the hepatic dysfunction induced by various chemical hepatotoxins. In this study, the protective effect of WZ on APAP-induced hepatic injury was evaluated and targeted metabolomics by LC-MS-based metabolomics was used to examine whether WZ influences hepatic metabolism. The results demonstrated significant hepatoprotection of WZ against APAP-induced liver injury; pretreatment with WZ prior to APAP administration blocks the increase in serum palmitoylcarnitine and oleoylcarnitine and thus restores the APAP-impaired fatty acidβ-oxidation to normal levels. These studies further revealed a significant and prolonged upregulation of the PPARαtarget genesCpt1andAcot1by WZ mainly contributing to the maintenance of normal fatty acid metabolism and thus potentially contributing to the hepatic protection of WZ against APAP-induced hepatic toxicity. Taken together, the current study provides new insights into understanding the hepatoprotective effect of WZ against APAP-induced liver toxicity.
Dynamical Analyses for Developmental Science: A Primer for Intrigued Scientists
Authors: DiDonato Matthew D. , England Dawn , Martin Carol Lynn , Amazeen Polemnia G.
Published: February 2013

Dynamical systems theory is becoming more popular in social and developmental science. However, unfamiliarity with dynamical analysis techniques remains an obstacle for developmentalists who would like to quantitatively apply dynamics in their own research. The goal of this article is to address this issue by clearly and simply presenting several analytical techniques for the study of dynamics. We placed emphasis on the use of dynamical analysis techniques for the examination of social and developmental phenomena. We present descriptions of five techniques, which include examples of how they have been or can be used in developmental research, with reference to seminal and approachable resources when appropriate.
Microgenetic Learning Analysis: A Methodology for Studying Knowledge in Transition
Authors: Parnafes Orit , diSessa Andrea A.
Published: February 2013

This paper introduces and exemplifies a qualitative method for studying learning, microgenetic learning analysis (MLA), which is aimed jointly at developing theory and at establishing useful empirical results. Among modern methodologies, the focus on theory is somewhat distinctive. We use two strategies to describe MLA. First, we develop a framework for comparing the focus and means of different methods, particularly qualitative methods, aimed at studying learning. Using the framework, we compare and contrast MLA with two better-known methods, microgenetic analysis and grounded theory. Second, we aim to schematize elements of MLA – from large-scale patterns of work to detailed analytical strategies – and to exemplify some of them in a case study using data collected some years prior to this elaboration of MLA.
Why Mob? Reassessing the Costs and Benefits of Primate Predator Harassment
Authors: Crofoot Margaret C.
Published: February 2013

While some primate species attempt to avoid predators by fleeing, hiding or producing alarm calls, others actually approach, harass and sometimes attack potential threats, a behavior known as ‘mobbing’. Why individuals risk their safety to mob potential predators remains poorly understood. Here, I review reports of predator harassment by primates to (1) determine the distribution of this behavior across taxa, (2) assess what is known about the costs of mobbing, and (3) evaluate hypotheses about its function. Mobbing is taxonomically widespread and is used against a wide range of predator species. However, inconsistent use of the term ‘mobbing’ within the primate literature, the lack of systematic studies of primate mobbing, and the likelihood of systematic biases in the existing data pose significant obstacles to understanding this puzzling behavior. Although difficult to quantify, the costs associated with harassing predators appear nontrivial. Many benefits that have been proposed to explain mobbing in birds may also be important in primate systems. There are puzzling aspects of primate mobbing, however, that existing hypotheses cannot explain. Future research should consider the within-group signaling potential of this costly behavior, as well as the ability of behavioral syndromes to explain the distribution of mobbing in primates.
Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios
Authors: Hall Thomas C. , Pattenden Clare , Hollobone Chloe , Pollard Cristina , Dennison Ashley R.
Published: February 2013

Objective: Preoperative over-ordering of blood is common and leads to the wastage of blood bank resources. The preoperative blood ordering and transfusion practices for common elective general surgical procedures were evaluated in our university hospital to formulate a maximum surgical blood order schedule (MSBOS) for those procedures where a cross-match appears necessary. Methods: We evaluated blood ordering practices retrospectively in all elective general surgical procedures in our institution over a 6-month period. Cross-match-to-transfusion ratios (C:T) were calculated and compared to current trust and the British Society of Haematology (BSH) guidelines. The adjusted C:T ratio was also calculated and was defined as the C:T ratio when only cross-matched blood used intraoperatively was included in the calculation. Results: 541 patients were identified during the 6-month period. There were 314 minor and 227 major surgeries carried out. 99.6% (n = 226) of the patients who underwent major surgery and 95.5% (n = 300) of the patients having minor surgery had at least a group and save (G and S) test preoperatively. A total of 507 units of blood were cross-matched and 238 units were used. The overall C:T ratio was therefore 2.1:1, which corresponds to a 46.9% red cell usage. There was considerable variation in the C:T ratio, depending on the type of surgery performed. The adjusted C:T ratio varied between 3.75 and 37. Conclusions: Compliance with transfusion policies is poor and over-ordering of blood products commonplace. Implementation of the updated recommended MSBOS and introduction of G and S for eligible surgical procedures is a safe, effective and cost-effective method to prevent preoperative over-ordering of blood in elective general surgery. Savings of GBP 8,596.00 per annum are achievable with the incorporation of updated evidence-based guidelines in our university hospital.
No Detection of the Retrovirus Xenotropic Murine Leukemia Virus-Related Virus in Individuals with Hemophilia
Authors: Schüttrumpf Jörg , Hourfar M.Kai , Alesci Sonja , Miesbach Wolfgang , Seifried Erhard , Schmidt Michael
Published: February 2013

Background: Xenotropic murine leukemia virus-related virus (XMRV) is a retrovirus that has recently been related to prostate cancers and chronic fatigue syndrome. Since other human-pathogenic retroviruses, such as HIV, human T-lymphotropic virus type I (HTLV-I) and –II, are known blood-transmitted pathogens, XMRV might present another hazard associated with products derived from in vitro cultures of human or animal origin, or blood component-based therapeutics. Here, we investigated whether XMRV was transmitted to individuals with hemophilia and frequent exposure to plasma-derived or recombinant clotting factors. Methods: We used highly sensitive real-time PCR to test plasma samples from 127 consecutive individuals with hemophilia who consulted our hemophilia center either for treatment or for a standard check-up. Results: From the 127 hemophiliacs, 80 had prior contact to persons with either hepatitis B (n = 30), hepatitis C (n = 74) and/or HIV (n = 21), and 30 were currently being treated with plasma-derived and 97 with recombinant factor concentrates. None of the individuals tested positive for XMRV. Conclusions: Independent of the ongoing discussion on whether the positive XMRV testing in initial reports was a result of reagent, sample, or tissue contamination, and whether XMRV is a real threat or a testing artifact, our data suggest that XMRV might not play an important role for hemophiliacs.
An Open-Labelled, Randomized Cross-Over Study of the Effect of Electromechanical Pumps versus Conventional Gravity Flow on Platelet Transfusion in Adult Haematology Patients
Authors: Khalafallah Alhossain A. , Al-Barzan Abdul Majeed , Camino Annette , Robertson Iain K. , Bates Gerald , Richardson Dawn , Austen Catherine , Seaton David , Heller Wolfgang , Brain Terry
Published: February 2013

Background: Only few data are available regarding the effect of the method of platelet transfusion on the platelet increment. Although administering platelets via either a free-flowing gravity or an electromechanical pump is common practice, there are no randomized trials addressing differences between these techniques. Objectives: Our study aimed to determine whether infusion methods influence the platelet increment. Methods: We studied the effect of 3 different electromechanical pumps that are used routinely for transfusion at our hospital; the Graseby 3000, Imed Gemini PC-1, and the Baxter Colleague in comparison to the free-flow gravity method. Between January 2007 and January 2011, we prospectively randomized the platelet transfusion method for 35 patients, in total 171 transfusion episodes. Most of the patients received platelets by each of the 4 different techniques. Patients with factors that may have influenced platelet recovery, such as infection, coagulopathy, platelet or HLA antibodies, were excluded. Results: The Baxter Colleague pump method was associated with the highest platelet increment at 1 h after transfusion (p = 0.03). This effect vanished after 24 h. The Gemini and Graseby pumps gave results similar to those of the gravity flow method. Conclusion: None of the different infusion pumps were inferior to the gravity flow method. Further studies to confirm these findings are warranted.
Transfusion-Related Acute Lung Injury: The Work of DAMPs*
Authors: Land Walter G.
Published: February 2013

Current notions in immunology hold that not only pathogen-mediated tissue injury but any injury activates the innate immune system. In principle, this evolutionarily highly conserved, rapid first-line defense system responds to pathogen-induced injury with the creation of infectious inflammation, and non-pathogen-induced tissue injury with ‘sterile’ tissue inflammation. In this review, evidence has been collected in support of the notion that the transfusion-related acute lung injury induces a ‘sterile’ inflammation in the lung of transfused patients in terms of an acute innate inflammatory disease. The inflammatory response is mediated by the patient’s innate immune cells including lung-passing neutrophils and pulmonary endothelial cells, which are equipped with pattern recognition receptors. These receptors are able to sense injury-induced, damage-associated molecular patterns (DAMPs) generated during collection, processing, and storage of blood/blood components. The recognition process leads to activation of these innate cells. A critical role for a protein complex known as the NLRP3 inflammasome has been suggested to be at the center of such a scenario. This complex undergoes an initial ‘priming’ step mediated by 1 class of DAMPs and then an ‘activating’ step mediated by another class of DAMPs to activate interleukin-1beta and interleukin-18. These 2 cytokines then promote, via transactivation, the formation of lung inflammation.
An Unusual Cytogenetic Rearrangement Originating from Two Different Abnormalities in Chromosome 6 in a Child with Acute Promyelocytic Leukemia
Authors: Matos R.R.C. , Mkrtchyan H. , Amaral B.A.S. , Liehr T. , de Souza M.T. , Ney-Garcia D.R. , Santos N. , Marques-Salles T.J. , Ribeiro R.C. , Figueiredo A.F. , Silva M.L.M.
Published: February 2013

Acute promyelocytic leukemia (APL) is usually associated with a favorable outcome, but about 10% of patients tend to relapse. The genetic hallmark of APL is a balanced translocation involving chromosomes 15 and 17, and the PML-RARa gene fusion is found in more than 90% of these cases. Other chromosomal abnormalities are commonly found in APL, but their clinical significance has yet to be determined. Here we report a case of childhood APL that was studied by conventional cytogenetics along with molecular cytogenetic techniques. The patient showed a complex karyotype with an unusual cytogenetic rearrangement originating from two different abnormalities in a single chromosome 6. Our case is an exceptional example of a cryptic cytogenetic anomaly in APL and underscores the importance of detailed genetic characterization.
Cell-Free Circulating DNA: A New Biomarker for the Acute Coronary Syndrome
Authors: Cui Ming , Fan Mengkang , Jing Rongrong , Wang Huimin , Qin Jingfeng , Sheng Hongzhuan , Wang Yueguo , Wu Xinhua , Zhang Lurong , Zhu Jianhua , Ju Shaoqing
Published: February 2013

Background: In recent studies, concentrations of cell-free circulating DNA (cf-DNA) have been correlated with clinical characteristics and prognosis in several diseases. The relationship between cf-DNA concentrations and the acute coronary syndrome (ACS) remains unknown. Moreover, no data are available for the detection cf-DNA in ACS by a branched DNA (bDNA)-based Alu assay. The aim of the present study was to investigate cf-DNA concentrations in ACS and their relationship with clinical features. Methods: Plasma cf-DNA concentrations of 137 ACS patients at diagnosis, of 60 healthy individuals and of 13 patients with stable angina (SA) were determined using a bDNA-based Alu assay. Results: ACS patients (median 2,285.0, interquartile range 916.4–4,857.3 ng/ml), especially in ST-segment elevation myocardial infarction patients (median 5,745.4, interquartile range 4,013.5–8,643.9 ng/ml), showed a signiﬁcant increase in plasma cf-DNA concentrations compared with controls (healthy controls: median 118.3, interquartile range 81.1–221.1 ng/ml; SA patients: median 202.3, interquartile range 112.7–256.1 ng/ml) using a bDNA-based Alu assay. Moreover, we found positive correlations between cf-DNA and Gensini scoring and GRACE (Global Registry of Acute Coronary Events) scoring in ACS. Conclusion: cf-DNA may be a valuable marker for diagnosing and predicting the severity of coronary artery lesions and risk stratification in ACS.
Optimal Dose Period for Indisetron Tablets for Preventing Chemotherapy-Induced Nausea and Vomiting with Modified FOLFOX6: A Randomized Pilot Study
Authors: Nakatsumi Hiroshi , Komatsu Yoshito , Yuki Satoshi , Sogabe Susumu , Tateyama Miki , Muto Shuichi , Kudo Mineo , Kato Kanji , Miyagishima Takuto , Uebayashi Minoru , Meguro Takashi , Oba Koji , Asaka Masahiro
Published: February 2013

Background: Indisetron is a serotonin (5-hydroxytryptamine type 3) receptor antagonist that also antagonizes 5-hydroxytryptamine type 4 receptors. We designed a pilot study in order to explore the optimal dosing period for indisetron during modified FOLFOX6 (mFOLFOX6). Patients and Methods: Forty-two chemotherapy-naive patients with advanced colorectal cancer scheduled to receive mFOLFOX6 were randomly assigned to either a 1- or 3-day indisetron regimen arm. The primary endpoint was complete protection from vomiting. Results: Proportions of patients with complete protection from vomiting were 85.7% [95% confidence interval (CI) 63.7–97.0] with the 3-day regimen and 81.0% (95% CI 58.1–94.6) with the 1-day regimen. Proportions of patients with complete protection from nausea were 47.6% in each arm (95% CI 25.7–70.2). No rescue therapy rates were 66.7% (95% CI 43.0–85.4) versus 57.1% (95% CI 34.0–78.2). No severe adverse events were observed in either arm. Conclusion: Both 1- and 3-day indisetron regimens were feasible for preventing nausea and vomiting induced by mFOLFOX6.
Stratified Cancer Screening: The Practicalities of Implementation
Authors: Dent T. , Jbilou J. , Rafi I. , Segnan N. , Törnberg S. , Chowdhury S. , Hall A. , Lyratzopoulos G. , Eeles R. , Eccles D. , Hallowell N. , Pashayan N. , Pharoah P. , Burton H.
Published: February 2013

Background: Improving understanding of the genetic basis of disease susceptibility enables us to estimate individuals' risk of developing cancer and offer them disease prevention, including screening, stratified to reflect that risk. Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that would arise in delivering such tailored approaches to prevention in practice. Results: Issues analysed include the organisational context within which implementation of stratified prevention would occur, how the offer of screening would be made, making sure consent is adequately informed, how individuals' risk would be assessed, the age at which risk estimation should occur, and the potential use of genetic data for other purposes. The review also considers how management might differ depending on individuals' risk, how their results would be communicated and their follow-up arranged, and the different issues raised by modification of an existing screening programme, such as that for breast cancer, and the establishment of a new one, for example for prostate cancer. Conclusion: Stratified screening based on genetic testing is a radically new approach to prevention. Various organisational issues would need to be considered before it could be introduced, and a number of questions require further research.
Exocytosis of Neutrophil Granule Subsets and Activation of Prolyl Isomerase 1 Are Required for Respiratory Burst Priming
Authors: McLeish Kenneth R. , Uriarte Silvia M. , Tandon Shweta , Creed Timothy M. , Le Junyi , Ward Richard A.
Published: February 2013

This study tested the hypothesis that priming the neutrophil respiratory burst requires both granule exocytosis and activation of the prolyl isomerase Pin1. Fusion proteins containing the TAT cell permeability sequence and either the SNARE domain of syntaxin-4 or the N-terminal SNARE domain of SNAP-23 were used to examine the role of granule subsets in TNF-mediated respiratory burst priming using human neutrophils. Concentration-inhibition curves for exocytosis of individual granule subsets and for priming of fMLF-stimulated superoxide release and phagocytosis-stimulated H2O2 production were generated. Maximal inhibition of priming ranged from 72 to 88%. Linear regression lines for inhibition of priming versus inhibition of exocytosis did not differ from the line of identity for secretory vesicles and gelatinase granules, while the slopes or the y-intercepts were different from the line of identity for specific and azurophilic granules. Inhibition of Pin1 reduced priming by 56%, while exocytosis of secretory vesicles and specific granules was not affected. These findings indicate that exocytosis of secretory vesicles and gelatinase granules and activation of Pin1 are independent events required for TNF-mediated priming of neutrophil respiratory burst.
Personality Traits and Behavioural and Psychological Symptoms in Patients with Mild Cognitive Impairment
Authors: Mendez Rubio Montserrat , Antonietti J.P. , Donati A. , Rossier J. , von Gunten A.
Published: February 2013

Background and Aims: Both personality changes and behavioural and psychological symptoms (BPS) may be associated with mild cognitive impairment (MCI) in later life and help identify incipient dementia. We wished to investigate the links between personality and BPS in MCI. Method: We studied premorbid personality traits as estimated 5 years back and their changes in 83 control subjects and 52 MCI patients using the revised NEO Personality Inventory for the Five-Factor Model completed by a proxy. Information on BPS was obtained using the Neuropsychiatric Inventory (NPI). Analyses were controlled for current depression and anxiety. Results: Premorbid neuroticism and openness to experience were associated with the total NPI score. The changes in neuroticism, extraversion, openness to experiences, and conscientiousness were associated with apathy and affective symptoms. Conclusions: Personality changes and BPS occur in MCI. The occurrence of affective BPS and apathy is associated with both premorbid personality traits and their changes.
Progress in the Molecular Genetics of Hypertrophic Cardiomyopathy: A Mini-Review
Authors: Tian Tao , Liu Yaxin , Zhou Xianliang , Song Lei
Published: February 2013

Background: Hypertrophic cardiomyopathy (HCM), which is characterized by unexplained and asymmetric left ventricular hypertrophy in the absence of other cardiac or systemic diseases, is an inherited cardiovascular disease and presents rising penetrance with aging. Objective: The purpose of this review is to offer an outline of recent progress in the molecular genetics of HCM and to discuss characteristics of elderly HCM patients. Methods: Studies were analyzed which included disease genes related to HCM, relationships between genotype and phenotype, potential pathogenesis of HCM, and the features of elderly patients with HCM. Results: HCM is caused by mutations in genes encoding myofilament proteins of the sarcomere, Z-disc proteins, Ca2+-handling proteins, and other proteins related to the sarcomere. Phenotypic manifestations of HCM are not just determined by these genes; modifying genes and epigenetic factors also contribute to the complexity of the HCM phenotype. The potential pathogenesis of HCM involves dominant negative function, an imbalance of myocardial energetic metabolism, and haploinsufficiency. Late-onset HCM presents its own features in the distribution of causal genes. Mutations in MYBPC3 may be the most common cause of delayed expression of HCM, and the sarcomere gene screen is most likely to be negative in elderly HCM patients. Conclusions: Despite progress in the identification of genetic causes and pathogenesis of HCM, there are still some questions that need to be better understood. It remains a great challenge to identify the cause of 50% of HCM cases in patients without an identified mutation. The application of a new genetic study technology may completely uncover the genetic background of these cases. In addition, the influences of causal mutations on the function and signaling of cardiocytes are expected to be elucidated further.
Pseudonormalization of Negative T Wave during Stress Test in Asymptomatic Patients without Ischemic Heart Disease: A Clue to Apical Hypertrophic Cardiomyopathy?
Authors: Kang Seungcheol , Choi Won-Ho
Published: February 2013

Introduction: Generally, apical hypertrophic cardiomyopathy (ApHCM) shows a negative T wave on an electrocardiogram (ECG), which waxes and wanes during the clinical course. However, some patients with ApHCM just have negative T waves and show no obvious diagnostic evidence on their echocardiography, so the diagnosis of ApHCM cannot be confirmed or is delayed for several years in many cases. Case Report: In our study, 2 males in their 50s showed negative T waves on their ECG precordial leads, but no diagnosis was confirmed for over 10 years, despite all efforts. Both patients showed pseudonormalization of the negative T wave during a stress test using a treadmill and dobutamine. They were finally diagnosed with ApHCM confirmed by cardiac magnetic resonance (MR). Discussion: Pseudonormalization of the negative T wave during a stress test is a quite rare phenomenon, particularly in the general population, and cardiac MR is very costly and inaccessible. Thus, when such an ECG pattern is observed without evidence of other pathology, the possibility of ApHCM should be kept in mind and the performance of cardiac MR may be considered. Furthermore, this pseudonormalization pattern could also be one possible explanation for the waxing and waning of the negative T wave during the course of ApHCM.
Isolated Sinonasal Posttransplantation Lymphoproliferative Disorder: A Clinical and Radiographic Invasive Fungal Sinusitis Look-a-Like
Authors: Hatten Kyle M. , Loevner Laurie A. , Palmer James N. , Adappa Nithin D.
Published: February 2013

Posttransplantation lymphoproliferative disorder (PTLD) is a known complication of solid organ transplantation with chronic immunosuppression. We present a unique case that illustrates PTLD mimicking invasive fungal sinusitis both clinically and radiographically. This report addresses the critical diagnostic evaluation and management of PTLD arising from the paranasal sinuses.
Febrile Ulceronecrotic Mucha-Habermann Disease: Treatment with Infliximab and Intravenous Immunoglobulins and Review of the Literature
Authors: Meziane L. , Caudron A. , Dhaille F. , Jourdan M. , Dadban A. , Lok C. , Chaby G.
Published: February 2013

Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare subtype of pityriasis lichenoides et varioliformis acuta, characterized by an acute onset of ulceronecrotic papules, rapidly coalescing into large ulcers with necrotic crusts, associated with high fever and severe systemic symptoms. We report a case of a 65-year-old woman with a resistant form of FUMHD successfully treated with a tumor necrosis factor-α (TNFα) inhibitor (infliximab). After 1 year of treatment, because of the recurrence of lesions and -occurrence of severe sepsis, we decided to change the therapeutic procedure by introducing intravenous immunoglobulin witch induced a spectacular improvement. Only few cases of FUMHD treated with intravenous immunoglobulin have been reported to date. In our case, we describe the first utilization of TNFα inhibitors in the treatment of FUMHD: TNFα inhibitors may be useful, particularly in resistant cases. Further reports are required to confirm this potential therapeutic option.
Dermoscopy of Desmoplastic Trichoepithelioma Reveals Other Criteria to Distinguish It from Basal Cell Carcinoma
Authors: Khelifa Elhem , Masouyé Isabelle , Kaya Gürkan , Le Gal Frédérique-Anne
Published: February 2013

Background: Desmoplastic trichoepithelioma (DT) is a rare benign adnexal neoplasm considered to have follicular differentiation. It usually presents as an asymptomatic, firm, annular plaque with a raised border. The diagnosis of DT is based on clinical and histological features which can be similar to those of morpheiform basal cell carcinoma. Taking this into consideration, the use of another diagnostic technique would be very useful. Dermoscopy is a noninvasive diagnostic technique allowing a more accurate diagnosis. Objectives: To differentiate DT and morpheiform basal cell carcinoma by means of dermoscopy. Methods: Here, we describe the dermoscopic features of a case of DT, and make a direct clinicopathological correlation by using the horizontally cut slides provided by Mohs micrographic surgery. Results: On dermoscopy, DT shows well-defined borders and an ivory-white color, as well as prominent arborizing telangiectasias in the central area and on the right side. There are no leaf-like structures and no ovoid nests. This observation confirms and completes the first dermoscopic analysis of DT reported in the literature so far.
Prediction of Three-Year Outcome of Renal Transplantation from Optimal Donors versus Expanded Criteria Donors
Authors: La Manna Gaetano , Comai Giorgia , Cappuccilli Maria L. , Liviano D’Arcangelo Giovanni , Fabbrizio Benedetta , Valentini Chiara , Carretta Elisa , Ravaioli Matteo , Scolari Maria P. , Ridolfi Lorenza , Feliciangeli Giorgio , Grigioni Franco W. , Pinna Antonio D. , Stefoni Sergio
Published: February 2013

Background/Aims: The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski’s histological score on 3-year graft function in renal transplant. Ex-post classification using Nyberg’s score was carried out to assess the reliability of a purely clinical score and its applicability for organ allocation. Methods: We evaluated 407 deceased donors (251 optimal and 156 ECD) for renal transplants performed between 2001 and 2006. The differences in creatinine levels and MDRD-GFR at transplant and 1, 2 and 3 years post-transplant between optimal donors and ECD were recorded. Amongst ECD organs, the effect of different Karpinski score classes (0–1, 2, 3, 4, double transplants) on 3-year graft outcomes was analyzed. We then compared renal function over time across the Nyberg grades (A, B, C, and D). Results: Karpinski scores 0–1 and 2 and double transplants were associated with improved graft function compared to scores 3 and 4. Nyberg’s clinical score shows a good fit with medium-term outcome and Karpinski’s score, but among the donors with a high Nyberg grade (C and D), it fails to differentiate between allocable or non-allocable organs (due to Karpinski’s score ≥7). Conclusions: Our data demonstrate a correlation of histological damage at the time of transplant with 3-year graft function, but at present we are unable to provide any supposition on the possible outcome of the discarded kidneys.
Diabetes Mellitus and Elevated Copeptin Levels in Middle Age Predict Low Cognitive Speed after Long-Term Follow-Up
Authors: Tufvesson Eva , Melander Olle , Minthon Lennart , Persson Margaretha , Nilsson Peter M. , Struck Joachim , Nägga Katarina
Published: February 2013

Background/Aims: We examined the potential impact of vascular risk factors including copeptin – a robust surrogate marker of arginine vasopressin associated with the metabolic syndrome and diabetes risk – on future cognitive abilities in a population-based cohort. Methods: Participants (n = 933) were investigated using baseline data, including copeptin levels, and data collected 16 years later using the Mini-Mental State Examination (MMSE) and A Quick Test of Cognitive Speed (AQT). Results: Logistic regression showed that diabetes (OR, 1.86; p < 0.05) and higher copeptin levels (OR, 1.19; p < 0.05) were independently associated with an increased risk of low AQT performance. Conclusion: Prevalence of diabetes mellitus and elevated copeptin levels in middle age predict lower cognitive speed after long-term follow-up.
[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography Imaging in Oncology: Initial Staging and Evaluation of Cancer Therapy
Authors: Pauwels Ernest K.J. , Coumou Annette W. , Kostkiewicz Magdalena , Kairemo Kalevi
Published: February 2013

Positron emission tomography (PET) with [18F]fluoro-2-deoxy-D-glucose (FDG) has proven to be a valuable diagnostic modality in various diseases. Its accuracy has been improved with the hybrid PET/computed tomography (CT) technique because of precise anatomic location of areas of abnormal FDG accumulation. This integrated PET/CT modality has been widely adopted, particularly in oncology. This paper reviews the role of FDG-PET/CT imaging in breast cancer, non-small-cell lung cancer, colorectal cancer, head and neck cancer as well as lymphoma on the basis of recent key articles. Special attention is paid to preoperative diagnostic workup, evaluation of treatment response and survival prognosis. Experience from specialized centers indicates that there is strong evidence for the clinical effectiveness of FDG-PET/CT in staging, restaging and the prediction of response to therapy in the above-mentioned malignancies. It is concluded that this imaging modality contributes considerably to improved patient management and paves the way to personalize cancer treatment in a cost-effective way.
Where Did I Put My Keys? - A ‘We' Intervention to Promote Memory in Healthy Older Adults: A Controlled Pilot Study
Authors: Mammarella Nicola , Fairfield Beth
Published: February 2013

Background: Numerous behavioural studies have shown that older adults have more difficulty in binding things together and have underlined the corresponding importance of this function in everyday memory tasks. Objective: This study was designed to test a new brief inter-dependent self-knowledge intervention on memory functions in aging. Methods: Before engaging in a working memory task based on binding objects and their locations, half of the participants read a series of paragraphs that focused on the individual self and were written in the first person singular ‘I' (in-dependent self-knowledge), whereas the other half read paragraphs that focused on the relational self and were written in the first person plural ‘We' (inter-dependent self-knowledge). Results: Results showed that older adults who were trained with ‘We' passages were more successful in remembering objects and their location compared to the group of participants who were trained with ‘I' passages. Conclusion: These findings are discussed in terms of the role that social factors may have in favouring memory functions in aging and delineate a new cognitive clinical protocol based on an inter-dependent self-knowledge approach.
BRCA1 and BRCA2 Mutations in the Ovarian Cancer Population across Race and Ethnicity: Special Reference to Asia
Authors: Shanmughapriya Santhanam , Nachiappan Vasanthi , Natarajaseenivasan Kalimuthusamy
Published: February 2013

Objective: To evaluate the prevalence and spectrum of BRCA mutations among ovarian carcinoma patients of different races and ethnicity with special reference to Asia. Methods: A systematic review of the literature was undertaken to evaluate the prevalence of BRCA mutations among people belonging to different races. The electronic search strategy was developed specifically for the different databases concerned and via cross-referencing. Results: The frequency of BRCA1 and BRCA2 mutations ranged from 1.1 to 39.7 and from 0 to 13.9, respectively. BRCA1 mutations are more common among ovarian cancer cases than BRCA2 mutations, although the ratio of BRCA1 to BRCA2 varies between populations. The Swedish and Indian populations showed 12 and 7 times as many BRCA1 as BRCA2 mutations, respectively, whilst in a study from Iceland the ratio was 0.5:1. These wide-ranging estimates of the mutation prevalence suggest genetic heterogeneity between different populations. Conclusion: The ability to identify BRCA1/2 mutations was found to be successful in the clinical management of ovarian cancer. Given the implications for clinical care and for advances in cancer prevention, identifying racial difference in genetic or lifestyle factors, which may modify the cancer risk due to BRCA1/2 mutations, is a high priority for future research.
Phase II Trial of Alternating mFOLFOX6 and FOLFIRI Regimens in the First-Line Treatment for Unresectable or Metastatic Colorectal Cancer (KSCC0701)
Authors: Oki Eiji , Emi Yasunori , Akagi Yoshito , Tokunaga Shoji , Sadanaga Noriaki , Tanaka Takaho , Ogata Yutaka , Saeki Hiroshi , Kakeji Yoshihiro , Baba Hideo , Nishimaki Tadashi , Natsugoe Shoji , Shirouzu Kazuo , Maehara Yoshihiko ,   Kyushu Study Group of Clinical Cancer
Published: February 2013

Objective: This phase II study examined the efficacy and safety of alternating regimens of mFOLFOX6 and FOLFIRI as a first-line treatment for unresectable or metastatic colorectal cancer. Patients and Methods: Forty-eight patients were enrolled in this study. Patients received an alternating regimen of 4 cycles of mFOLFOX6 followed by 4 cycles of FOLFIRI. Results: The characteristics of the study population were as follows: males/females 34/12, median age 66 years (range 43–75) and Eastern Cooperative Oncology Group performance status 0/1/2 in 37/9/0 patients. The overall response rate was 58.7% [95% confidence interval (CI) 43.9–73.5]. The median progression-free survival was 10.3 months (95% CI 7.5–11.9), and the median overall survival was 28.4 months (95% CI 22.5–35.7). Among the 47 patients evaluated for toxicity, the most common grade 3–4 adverse events were leukopenia (26%), neutropenia (55%), anemia (4%), neurotoxicity (0%), diarrhea (2%), febrile neutropenia (4%), nausea (4%), vomiting (2%), and hypersensitivity (0%). Conclusions: The results of this phase II study indicate that this alternating schedule is effective and well tolerated as a first-line treatment for unresectable or metastatic colorectal cancer. The low rate of grade 3 neurotoxicity is also promising.
Treatment with the Radiolabelled Somatostatin Analog 177Lu-DOTATATE for Advanced Pancreatic Neuroendocrine Tumors
Authors: Sansovini Maddalena , Severi Stefano , Ambrosetti Alice , Monti Manuela , Nanni Oriana , Sarnelli Anna , Bodei Lisa , Garaboldi Lucia , Bartolomei Mirco , Paganelli Giovanni
Published: February 2013

Background: We evaluated the activity and safety profile of 177Lu-DOTATATE peptide receptor radionuclide therapy (Lu-PRRT) in patients with advanced G1-G2 pancreatic neuroendocrine tumors. Patients and Methods: Fifty-two consecutive patients were treated at two different therapeutic dosages of 18.5 or 27.8 GBq in five cycles, according to the patient's kidney function and bone marrow reserve, which are known to be the critical organs in PRRT. Results: Twenty-six patients received a mean full dosage (FD) of 25.5 GBq (range 20.7-27.8) and 26 a mean reduced dosage (RD) of 17.8 GBq (range 11.1-19.9). Both therapeutic dosages resulted in antitumor activity (disease control rate in the entire case series 81%), with 12% complete response, 27% partial response and 46% stable disease in the FD group, whereas we observed 4% complete response, 15% partial response and 58% stable disease in the RD group. Median progression-free survival was not reached in the FD group and was 20 months in the RD group. No major acute or delayed hematological toxicity occurred. Conclusion:177Lu-DOTATATE peptide receptor radionuclide therapy showed antitumor activity in advanced pancreatic neuroendocrine tumors even at a reduced total activity of 18.5 GBq. However, progression-free survival was significantly longer (p = 0.05) after a total activity of 27.8 GBq, which can thus be considered the recommended dosage in eligible patients.
Publishing large DNA sequence data in reduced spaces and lasting formats, in paper or PDF
Authors: AGUIAR ALEXANDRE PIRES
Published: February 2013

Scientific publications carry a practical moral duty: they must last. Along that line of thinking, some methods are proposed to allow economically and structurally viable publication of DNA sequence data of any size in printed matter and PDFs. The proposal is primarily aimed at contributing for preserving information for the future, while allowing authors to avoid information splitting and complement storage ex situ, that is, in server machines, outside the publication proper. The technique may also help to solve the impasse between the ICZN Code requirement that a new nomen be associated to diagnostic characters for the taxon vs. the phylogenetic definition of taxa, based on cladograms only: sequence data are characters, and can now be easily and comfortably included in taxonomic publications, with direct textual mention to their diagnostic sections. The compression level achieved allows the inclusion of all wanted DNA or RNA sequences in the same printed matter or PDF publications where the sequences are cited and discussed. Reduced font sizes, invisible fonts, and original 2D black & white and color barcodes are illustrated and briefly discussed. The level of data compression achieved can allow each full page of sequence data, or about 5000 characters, to be precisely coded into a color barcode as small as a square of 1.5 mm. A practical example is provided with Taeniogonalos woodorum Smith (Hymenoptera, Trigonalidae). Free software to generate publishable barcodes from txt or FASTA files is provided at www.systaxon.ufes.br/dna.
Biases in Expendable Bathythermograph Data: A New View Based on Historical Side-by-Side Comparisons
Authors: Cowley Rebecca , Wijffels Susan , Cheng Lijing , Boyer Tim , Kizu Shoichi
Published: February 2013

Because they make up 56% of ocean temperature profile data between 1967 and 2001, quantifying the biases in expendable bathythermograph (XBT) data is fundamental to understanding the evolution of the planetary energy and sea level budgets over recent decades. The nature and time history of these biases remain in dispute and dominate differences in analyses of the history of ocean warming. A database of over 4100 side-by-side deployments of XBTs and conductivity–temperature–depth (CTD) data has been assembled, and this unique resource is used to characterize and separate out the pure temperature bias from depth error in a way that was not previously possible. Two independent methods of bias extraction confirm that the results are robust to bias model and fitting method. It was found that there is a pure temperature bias in Sippican probes of ~0.05°C, independent of depth. The temperature bias has a time dependency, being larger (~0.1°C) in the earlier analog acquisition era and being likely due to changes in recorder type. Large depth errors are found in the 1970s–80s in shallower-measuring Sippican T4/T6 probe types, but the deeper-measuring Sippican T7/Deep Blue (DB) types have no error during this time. The Sippican T7/DB fall rate slows from ~1990 onward. It is found that year-to-year variations in fall rate have a bigger effect on corrections to the global XBT database than do any small effects of ocean temperature on fall rate. This study has large implications for the future development of better schemes to correct the global historical XBT archive.