bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the Initial Presentation of Patients with Implantable Defibrillator Influence the Outcome?
Authors: MENZ VOLKER , SCHWARTZMAN DAVID , NALLAMOTHU NASARAIAH , GRIMM WOLFRAM , HOFFMANN JÜRGEN , CALLANS DAVID J. , GOTTLIEB CHARLES D. , MARCHLINSKI FRANCIS E.
Published: June 2006

The influence of the clinical presentation on the long‐term outcome in 213 consecutive patients with ICDs, ECG storage capability, and nonthoracotomy leads, was analyzed. Sixty‐six patients presented with cardiac arrest (CA), 81 patients with hemodynamically stable VT, and 66 patients with syncope (SY). Patient characteristics were: mean age CA 62, VT 61, SY 61 years; mean ejection fraction CA 31%, VT 29%, SY 30%; coronary artery disease CA 71%, VT 71%, SY 64% (all P > 0.05 Fisher's exact test); female gender CA 40%, VT 14%, SY 19% (CA vs VT and SY, P < 0.005); inducibility by programmed stimulation CA 50%, VT 84%, SY61 % (VT vs CA and SY, P < 0.001, CA vs SY, P > 0.05). During a mean follow‐up of 14.5 months, 29 patients died; CA 12%, VT 14%, SY 9% (P > 0.05). Comparing Kaplan‐Meier curves, no difference in the time course of overall mortality was found (log‐rank P > 0.05). In the CA, VT, and SY groups, 543, 1,630, and 189 ICD therapies (including antitachycardia pacing, low energy cardioversion, and defibrillation) were observed, respectively. Actuarial analysis showed a shorter interval between implantation and first ICD therapy for VT versus CA and SY (log‐rank P < 0.005). Patients presenting with VT experienced earlier and more frequent ICD therapies than patients with CA or SY independent of age, ejection fraction, and heart disease. No difference in overall mortality and time course of fatal events was observed among the three groups.
Rounded Biphasic Waveform Reduces Energy Requirements for Transvenous Catheter Cardioversion of Atrial Fibrillation and Flutter
Authors: HARBINSON M.T. , ALLEN J.D. , IMAM ZAFAR , DEMPSEY G. , ANDERSON J. McC , AYERS G.M. , ADGEY A.A.J.
Published: June 2006

We postulated that reducing peak leading edge shock voltage and its rate of rise (waveform rounding) would reduce energy requirements for cardioversion of AF and AFI, and may therefore reduce patient discomfort. Transvenous defibrillating catheters (In‐Control Inc.) were placed in the RAA (active fixation) and the CS of six anesthetized sheep. AF or AFI was induced by electrical stimulation (100 Hz, 2 V; Grass stimulator). A standard trapezoidal biphasic (S) waveform (3‐ms duration each phase) was compared with a similar waveform that had the first phase rounded (R). Cardioversion was attempted after 30 seconds of arrhythmia, using a Ventritex HVS‐O2 defibrillator modified to allow waveform rounding. Each waveform was randomly tested several times at 100‐, 150‐, and 200‐V leading edges, and percentage cardioversion success calculated. Shock energy was calculated from delivered current and voltage using Flukeview (Fluke, Inc.) software. At 100‐V leading edge R (64% success) and S (59%), shocks were similarly efficacious (P = 0.37). However. R delivered less current, voltage, and energy than the comparable S shock (means 1.30 A, 65.0 V, 0.33 J R vs 1.92 A, 94.2 V, 0.47 J S; P = 0.0001). Both waveforms were equally successful at 150 V (88% vs 100%; P = NS) and 200 V(100% vs 100%), but again R delivered less current, voltage, and energy (2.05 A, 102.5 V, 0.82 J R vs 2.78 A, 142.3 V, 1.11 J S at 150 V; 2.76 A, 141.2 V, 1.58 J R vs 3.77 A, 189.4 V, 2.03 J S at 200 V; both P = 0.0001). No arrhythmic or other complications occurred in the 174 shocks delivered. Waveform rounding reduces delivered peak voltage, current, and energy without reducing defibrillation efficacy. To determine if these changes are associated with a reduction in discomfort, patients with AF are currently being cardioverted with these waveforms during electrophysiological studies.
Pain Threshold for Low Energy Intracardiac Cardioversion of Atrial Fibrillation with Low or No Sedation
Authors: AMMER RICHARD , ALT ECKHARD , AYERS GREGORY , SCHMITT CLAUS , PASQUANTONIO JAY , SCHMIDT MATTHIAS , PÜTTER KATJA , SCHÖMIG ALBERT
Published: June 2006

Recent studies have shown that internal cardioversion of atrial fibrillation is safe and effective. In this randomized prospective study, we have tried to evaluate the influence of different waveforms on the perception of pain during internal cardioversion in patients with chronic atrial fibrillation. Methods: Internal cardioversion was performed with minimal or no sedation in 31 consecutive patients, R wave triggered, biphasic shocks of 6 ms/6 ms or 3 ms/3 ms duration (randomly selected) and approximately 65% tilt were used starting with a 50‐V test shock. The shock intensity was increased in 40‐V steps up to a maximum voltage of 520 V. Shocks were applied via two custom‐made catheters (Elecath, Rahway, NJ). In 16 patients (3 females, age 61 ± 11 years, left atrium diameter 58 ± 5 mm, duration of atrial fibrillation 4 ± 4 months), 6/6 waveforms were used, and in 15 patients (1 female, age 62 ± 5 years, left atrium diameter 59 ± 4 mm, duration of atrial fibrillation 5 ± 2 months), 3/3 waveforms were used. After cardioversion, each patient was asked to quantify their pain on a scale from 0–10 (0 = no pain, 10 = intolerable). Fourteen of the 15 patients in the 3/3 ms and 15 of the 16 patients in the 6/6 ms group were successfully cardioverted. Patients from the 6/6 waveform group were cardioverted with a lower mean voltage of 254/92 versus 355/127 V (P < 0.02), at lower pain score 1.8 ± 1.3 versus 4.2 ± 2.2 (P < 0.05) with equivalent energy (6.8 ± 2.8 versus 6.2 ± 1.5 J, n.s.) and required lower doses of midazolam of 2.2 ± 1.9 versus 4.0 ± 1.8 mg IV (P < 0.02). The waveform used in internal cardioversion seems to have a major impact on the patients’ perception of pain. These results imply that energy determines the success of a shock, but voltage determines the pain perceived by the patient. The use of waveforms that deliver greater energy at lower peak voltages offers the possibility of internal cardioversion with less sedation and greater patient tolerance.
A Randomized, Prospective Comparison of Anterior and Posterior Approaches to Atrioventricular Junction Modification of Medically Refractory Atrial Fibrillation
Authors: LEE SHIH‐HUANG , CHENG JUN‐JACK , CHEN SHIH‐ANN
Published: June 2006

To compare the safety and efficacy of anterior versus posterior approach for atrioventricular (AV) junction modification, 40 patients with medically refractory paroxysmal (PAF) or chronic atrial fibrillation (AF) were randomly assigned to receive AV junction modification with an anterior or posterior approach. If the ablation session had taken more than 1 hour without success, the alternative ablation approach was attempted. Among the 18 patients assigned to receive the anterior approach, 14 (78%) had a primary success. One (5%) patient had complete A V block after ablation. Three patients crossed over to the posterior approach and had a successful outcome. Fourteen (64%) of 22 patients initially treated with the posterior approach had primary success. One (4%) patient developed complete AV block. Seven patients crossed over to the anterior approach and had a successful outcome. The primary success rate (14/18 vs 14/22, P = NS), incidence of transient AV block (3/18 vs 3/22, P = NS), and complete AV block (1/18 vs 1/22, P = NS) were similar between the anterior approach and posterior approach. The major differences between the two groups showed more radiofrequency pulses (10 ± 4 vs 6 ± 3 pulses, P < 0.01), longer procedure duration (50 ± 24 vs 28 ± 18 minutes, P < 0.01), and longer fluoroscopy exposure time (28 ± 17 vs 16 ± 8 minutes, P < 0.01) in the patients who had primary success with the posterior approach. In conclusion, this study demonstrated that (1) the two techniques had similar efficacies; (2) if one approach was ineffective, switching to the other approach might be safe; (3) combining these two approaches resulted in overall improvement in the success rate of this procedure, and (4) the posterior approach needed more radiofrequency pulses, longer procedural time, and longer fluoroscopy exposure time.
Assessment of Autonomic Nervous System Functions in Patients with Vitamin B12 Deficiency by Power Spectral Analysis of Heart Rate Variability
Authors: AYTEMIR KUDRET , AKSÖYEK SERDAR , BÜYÜKASIK YAHYA , HAZNEDAROĞCLU IBRAHIM , AT ALAR ENVER , ÖZER NECLA , ÖVÜNÇ KENAN , ÖZMEN FERHAN , OTO ALI
Published: June 2006

The purpose of this study was to test the autonomic nervous system function of patients with vitamin B12 deficiency (megaloblastic anemia) by measuring heart rate variability (HRV). The study population consisted of 17 vitamin B12 deficient patients and 15 age‐ and sex‐matched normal volunteers. HRV was measured by power spectral analysis from which power of the low frequency (LF) peak (0.04–0.15 Hz), normalized units of the LF peak (LFNU), power of the high frequency (HF) peak (0.15–0.4 Hz), normalized units of the HF (HFNU), and ratio of power of LF to power of HF (LF:HF) were calculated. Vitamin B12 deficient patients had lower LF, LFNU, HF, HFNU, and LF:HF ratio than normal volunteers (P < 0.05). Decreases in sympathetic indices (LF and LFNU) were greater than those measured in parasympathetic indices (HF and HFNU). All HRV parameters correlated positively with the level of vitamin B12 (P < 0.001) and negatively with the duration of disease (P < 0.001). After vitamin B12 replacement the HEV parameters of patients and controls became comparable (P > 0.05). Our data suggest that autonomic sympathetic and parasympathetic nervous activities are decreased in patients with vitamin B12 deficiency, an abnormality that can be corrected by vitamin B12 replacement therapy.
Safety of Pacemaker Implantation Prior to Radiofrequency Ablation of Atrioventricular Junction in a Single Session Procedure
Authors: PROCLEMER ALESSANDRO , FACCHIN DOMENICO , PAGNUTTI CATIA , FIORETTI PAOLO , DE MICHELE CARLO
Published: June 2006

RF current delivery may cause acute and chronic dysfunction of previously implanted pacemakers. The aim of this study was to assess prospectively the effects of RF energy on Thera I and Kappa pacemakers in 70 consecutive patients (mean age 70 ± 11 years, mean left ventricular ejection fraction 48 ± 15%) who underwent RF ablation of the AV junction for antiarrhythmic drug refractory atrial fibrillation (permanent in 42 patients, paroxysmal in 28). These pacing systems incorporate protection elements to avoid electromagnetic interference. The pacemakers (Thera DR 7960 I in 20 patients, Thera SR 8960 1 in 30, Kappa DR 600–601 in 8, Kappa SR 700–701 in 12) were implanted prior to RF ablation in a single session procedure and were transiently programmed to VVI mode at a rate of 30 beats/min. Capsure SP and Z unibipolar leads were used. During RF application there was continuous monitoring of three ECG leads, endocavitary electrograms, and event markers. Complete AV block was achieved in all cases after 3.6 ± 2.9 RF pulses and 100 ± 75 seconds of RF energy delivery. The mean time of pacemaker implantation and RF ablation was 60 ± 20 minutes. Transient or permanent pacemaker dysfunction including under/oversensing, reversion to a “noise‐mode” pacing, pacing inhibition, reprogramming, or recycling were not observed. Leads impedance, sensing, and pacing thresholds remained in the normal range in the acute and long‐term phase (average follow‐up 18 ± 12 months). In conclusion, Thera I and Kappa pacemakers exhibit excellent protection against interference produced by RF current. The functional integrity of the pacemakers and Capsure leads was observed in the acute and chronic phases. Thus, the implantation of these pacing systems prior to RF ablation of the AV junction can be recommended.
Failure of Coronary Sinus Pacing in Reducing Local Atrial Conduction Delay in Patients with Atrial Fibrillation After Successful Internal Cardioversion
Authors: TSE HUNG‐FAT , LAU CHU‐PAK , AYERS GREGORY M.
Published: June 2006

Recent studies suggested that distal coronary sinus (CS) pacing may prevent atrial fibrillation (AF) by reducing site dependent intraatrial conduction delay. The aim of this study was to investigate the effect of high right atriai (HRA) and distal CS pacing on local conduction delay in patients with AF. The study population consisted of 10 patients with persistent AF after transvenous atriai defibrillation and 10 control subjects. The local conduction delays along the anterolateral right atrium (RA), in the CS. and at the right atriai septum (RAS), and the incidence of AF in response to an atriai extrastimulus during HRA and distal CS pacing at a drive cycle length of 400, 500, and 600 ms were evaluated. In patients with AF, distal CS and HRA pacing are associated with more prominent and simitar extent of conduction delay within the atria, without any significant difference in the dispersion of conduction delay and susceptibility to AF induction (70% vs 60%, P = 0.9). In normal controls, distal CS pacing reduces the conduction delay at the RAS and CS ostium and decreases the dispersion of conduction delay and the propensity for AF induction (0% vs 50%, P = 0.03) compared to HRA pacing. The pacing drive cycle length has no significant effect on conduction delay in patients with AF and normal controls (P > 0.05). Compared to normal controls, patients with AF have significantly longer conduction delay at the RAS and along the anterolateral RA during HRA and distal CS pacing. The result of this study demonstrates that the effect of HRA and distal CS pacing on the local atriai conduction delay in patients with and without AF differ significantly. These patients with AF may have more diffuse atriai anisotropv causing the changes in conduction, and pacing from distal CS in these patients dose not reduce the propensity for AF.
False‐Positive Exercise Stress Electrocardiogram Due to Accessory Pathway in the Absence of Manifest Preexcitation
Authors: SHAH PRASAD P. , NAIR MOHAN , DHALL ANIL , VERMA K.K. , MIDHA K.K. , MOHAN J.C. , KAUL U.A. , ARORA R.
Published: June 2006

False‐positive exercise testing in patients with an accessory pathway has been described only in patients with manifest preexcitation during exercise. We describe a patient in whom marked ST‐segment changes were seen during an exercise test in the absence of any preexcitation of the QRS complexes. The role of the accessory pathway in producing the ST changes was reaffirmed by absence of this abnormality following catheter ablation of the accessory pathway.
Inappropriate Shock Delivery by Implantable Defibrillators with Dual Chamber Pacing During Nonsustained Ventricular Tachycardia in Patients with Heart Block
Authors: SRA JASBIR , AKHTAR MASOOD
Published: June 2006

Transvenous implantable cardioverter defibrillators (ICDs) have improved the management of patients with ventricular tachycardia/ventricular fibrillation (VT/VF).1–5 Many patients with sustained VT/VF have bradyarrhythmias and nonsustained VT.6–9 Shock delivery due to nonsustained VT would be an undesirable feature. Abortive shock capability (noncommitted shocks) is a feature available in devices to prevent delivery of shocks for nonsustained VT.6–8 Recently, the availability of dual chamber pacing capability has improved the efficacy of ICDs by obviating the need of separate pacemaker implantation in patients with VT/VF and concomitant bradyarrhythmias.10 However, interaction between bradyarrhythmias and VT/VF has not been described and has important clinical implications. We report a case in which a patient with complete atrioventricular (AV) block and ventricular arrhythmias received an inappropriate shock following spontaneous termination of nonsustained VT, showing an important shortcoming of devices with these features.
Diagnosis of Myocardial Ischemia During Ventricular Pacing
Authors: BAROLD S. SERGE
Published: June 2006

Discordant ST elevation >5 mm was recently described as an electrocardiographic sign with good specificity and moderate sensitivity for the diagnosis of acute myocardial infarction during right ventricular pacing. This report shows that the same sign may occur transiently during myocardial ischemia and also serve as a diagnostic marker.
Situational assessment and strategies for strengthening nursing and midwifery in the Western Pacific region
Authors: FRITSCH Kathleen
Published: June 2006

A situational assessment of the World Health Organization’s (WHO) Western Pacific region illustrates the area’s geographical, topographical, political, socioeconomic, and cultural diversity, as well as its human resource and health system challenges, including limited capacities in evidence‐based policies, planning and management. The poor repair of facilities, lack of essential drugs and equipment, low salaries, and lack of ongoing supervision are linked to lowered productivity and morale and deficient service delivery to vulnerable populations, particularly those in rural and remote areas. The situation analysis lays the foundation for the Regional Human Resources for Health strategy. The core strategies and activities of the WHO Western Pacific regional human resources for health and nursing area of work are highlighted, with attention given to workforce planning tools and guidelines and policy option support in relation to: the migration of skilled health workers; poverty, gender, and health publications; building workforce capacity in relation to priority health problems; and strengthening networking and partnerships to support leadership capacity‐building and good governance in relation to health service planning and policy‐making. Future WHO support to member states emphasizes workforce planning and management, leadership development, networking, and partnerships.
The current state of the center for the creation and dissemination of new Japanese nursing science: The 21st century Center of Excellence at Chiba University School of Nursing
Authors: ISHIGAKI Kazuko , MASAKI Harue , NAKAMURA Nobue , MIYAZAKI Misako , YAMAMOTO‐MITANI Noriko
Published: June 2006

Aim:  The Center of Excellence for the Creation and Dissemination of a New Japanese Nursing Science at Chiba University School of Nursing is now in its third year of operation. This center aims to develop nursing science that is appropriate for Japanese culture and to internationally disseminate the importance of culturally based care. Our project seeks to systematically transform the art of nursing practise into a nursing science.

Method:  To date, multiple frameworks have been created through the qualitative meta‐synthesis of research on effective nursing care. To create a nursing science, these frameworks derived from meta‐synthesis must be verified and internalized in nursing practise.

Results:  After three years of research, the following findings are emerging: professional care relationships in nursing practise in Japan are characterized by the bidirectional process between the nurse and the client, in which both gradually undergo a transformation in order to establish a collaborative, therapeutic relationship; Japanese nurses emphasize the importance of understanding adolescent clients’ subjective understanding of their own life with self‐care, as well as social support; and the priority for community health nurses in Japan is to create support systems in the community, regardless of whether the intended client is an individual, a family, a specific group, or the community as a whole.

Conclusions:  Our future efforts will focus on verifying our findings through interdisciplinary and international comparative research and by integrating various frameworks in order to create a new Japanese nursing science.
TO WHAT EXTENT DOES THE SELF-CONSISTENT MEAN-FIELD EXIST?
Authors: GUO LU , SAKATA FUMIHIKO , ZHAO EN-GUANG , MARUHN J. A.
Published: June 2006

A non-convergent difficulty near level-repulsive region is discussed within the self-consistent mean-field theory. It is shown by numerical and analytic studies that the mean-field is not realized in the many-fermion system when quantum fluctuations coming from two-body residual interaction and quadrupole deformation are larger than an energy difference between two avoided crossing orbits. An analytic condition indicating a limitation of the mean-field concept is derived for the first time.
DECREASE OF THE SPIN-ORBIT INTERACTION IN DRIP-LINE NUCLEI, USING RELATIVISTIC MEAN FIELD MODELS
Authors: MEHTA M. S. , SHARMA B. K. , PATRA S. K. , GUPTA RAJ K. , GREINER W.
Published: June 2006

The spin-orbit potential and the energy splitting of spin-orbit partners in nuclei towards the neutron drip-line are found to show the decreasing behavior with the increase of neutron number, in both the spherical and deformed versions of the standard relativistic mean field model, the SRMF and DRMF, and its extended version for spherical case, the effective field theory motivated relativistic mean field model, the E-RMF. The calculations are presented for nuclei in different mass regions, which include the isotopes of F , Mg , Sb , Pb and Bi nuclei.
Food and Memory
Authors: Holtzman Jon D.
Published: June 2006

Much of the burgeoning literature on food in anthropology and related fields implicitly engages with issues of memory. Although only a relatively small but growing number of food-centered studies frame themselves as directly concerned with memory—for instance, in regard to embodied forms of memory—many more engage with its varying forms and manifestations, such as in a diverse range of studies in which food becomes a significant site implicated in social change, the now-voluminous body relating food to ethnic or other forms of identity, and invented food traditions in nationalism and consumer capitalism. Such studies are of interest not only because of what they may tell us about food, but moreover because particular facets of food and food-centered memory offer more general insights into the phenomenon of memory and approaches to its study in anthropology and related fields.
Limited role for SREBP-1c in defective glucose-induced insulin secretion from Zucker diabetic fatty rat islets: a functional and gene profiling analysis
Authors: Parton Laura E. , McMillen Patrick J. , Shen Yingnian , Docherty Elizabeth , Sharpe Erin , Diraison Frédérique , Briscoe Celia P. , Rutter Guy A.
Published: June 2006

Accumulation of intracellular lipid may contribute to defective insulin secretion in type 2 diabetes. Although Zucker diabetic fatty (ZDF; fa/fa) rat islets are fat-laden and overexpress the lipogenic master gene, sterol regulatory element binding protein 1c (SREBP-1c), the contribution of SREBP-1c to the secretory defects observed in this model remains unclear. Here we compare the gene expression profile of lean control ( fa/+) and ZDF rat islets in the absence or presence of dominant-negative SREBP-1c (SREBP-1c DN). ZDF islets displayed elevated basal insulin secretion at 3 mmol/l glucose but a severely depressed response to 17 mmol/l glucose. While SREBP-1c DN reduced basal insulin secretion from ZDF islets, glucose-stimulated insulin secretion was not improved. Of 57 genes differentially regulated in ZDF islets and implicated in glucose metabolism, vesicle trafficking, ion fluxes, and/or exocytosis, 21 were upregulated and 5 were suppressed by SREBP-1c DN. Genes underrepresented in ZDF islets were either unaffected ( Glut-2, Kir6.2, Rab3), stimulated (voltage-dependent Ca2+channel subunit α1D, CPT2, SUR2, rab9, syt13), or inhibited ( syntaxin 7, secretogranin-2) by SREBP-1c inhibition. Correspondingly, SREBP-1c DN largely corrected decreases in the expression of the transcription factors Pdx-1 and MafA but did not affect the abnormalities in Pax6, Arx, hepatic nuclear factor-1α (HNF1α), HNF3β/Forkhead box-a2 (Foxa2), inducible cyclic AMP early repressor (ICER), or transcription factor 7-like 2 (TCF7L2) expression observed in ZDF islets. We conclude that upregulation of SREBP-1c and mild increases in triglyceride content do not explain defective glucose-stimulated insulin secretion from ZDF rats. However, overexpression of SREBP-1c may contribute to enhanced basal insulin secretion in this model.
Precerebellar Hindbrain Neurons Encoding Eye Velocity During Vestibular and Optokinetic Behavior in the Goldfish
Authors: Beck James C. , Rothnie Paul , Straka Hans , Wearne Susan L. , Baker Robert
Published: June 2006

Elucidating the causal role of head and eye movement signaling during cerebellar-dependent oculomotor behavior and plasticity is contingent on knowledge of precerebellar structure and function. To address this question, single-unit extracellular recordings were made from hindbrain Area II neurons that provide a major mossy fiber projection to the goldfish vestibulolateral cerebellum. During spontaneous behavior, Area II neurons exhibited minimal eye position and saccadic sensitivity. Sinusoidal visual and vestibular stimulation over a broad frequency range (0.1–4.0 Hz) demonstrated that firing rate mirrored the amplitude and phase of eye or head velocity, respectively. Table frequencies >1.0 Hz resulted in decreased firing rate relative to eye velocity gain, while phase was unchanged. During visual steps, neuronal discharge paralleled eye velocity latency (∼90 ms) and matched both the build-up and the time course of the decay (∼19 s) in eye velocity storage. Latency of neuronal discharge to table steps (40 ms) was significantly longer than for eye movement (17 ms), but firing rate rose faster than eye velocity to steady-state levels. The velocity sensitivity of Area II neurons was shown to equal (±10%) the sum of eye- and head-velocity firing rates as has been observed in cerebellar Purkinje cells. These results demonstrate that Area II neuronal firing closely emulates oculomotor performance. Conjoint signaling of head and eye velocity together with the termination pattern of each Area II neuron in the vestibulolateral lobe presents a unique eye-velocity brain stem-cerebellar pathway, eliminating the conceptual requirement of motor error signaling.
Association of Polymorphisms in the Paraoxonase 1 Gene with Breast Cancer Incidence in the CPS-II Nutrition Cohort
Authors: Stevens Victoria L. , Rodriguez Carmen , Pavluck Alexandre L. , Thun Michael J. , Calle Eugenia E.
Published: June 2006

Paraoxonase 1 (PON1) plays an important role in the high-density lipoprotein–mediated prevention of low-density lipoprotein oxidation and the metabolism of lipid-soluble radicals. In this study, we investigated the association of two common, nonsynonymous polymorphisms in the PON1 gene (Q192R and L55M) with breast cancer risk in postmenopausal women through a nested case-control study within the American Cancer Society Cancer Prevention Study II Nutrition Cohort. Using conditional logistic regression of genotyping results from 502 cases and 502 cancer-free controls matched on age, race/ethnicity, and date of blood draw, we found that the L55M single nucleotide polymorphism (SNP) was associated with an increased risk of breast cancer [odds ratio (OR), 1.58; 95% confidence interval (95% CI), 1.05-2.37 for MM]. No association was found for the Q192R SNP. The L55M association with breast cancer was modified by nonsteroidal anti-inflammatory drug (NSAID) use. The association was limited to women who took NSAIDs and was somewhat stronger among women who reported regular (≥15 times per month) NSAID use (OR, 3.24; 95% CI, 1.17-9.00) than in those who reported any NSAID use (OR, 2.46; 95% CI, 1.39-4.36). These results suggest that genetic variation in PON1, particularly at the L55M SNP, may be associated with increased risk of breast cancer in postmenopausal women. Furthermore, NSAID use seems to modify this risk. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1226–8)
Specific Infections, Infection-Related Behavior, and Risk of Non-Hodgkin Lymphoma in Adults
Authors: Vajdic Claire M. , Grulich Andrew E. , Kaldor John M. , Fritschi Lin , Benke Geza , Hughes Ann Maree , Kricker Anne , Turner Jennifer J. , Milliken Sam , Armstrong Bruce K.
Published: June 2006

Infections were examined as possible risk factors for non-Hodgkin lymphoma in a population-based case-control study in New South Wales and the Australian Capital Territory, Australia. Incident cases (n = 694) had no history of HIV infection or transplantation. Controls (n = 694) were randomly selected from electoral rolls and frequency matched to cases by age, sex, and area of residence. A postal questionnaire and telephone interview measured history of specific infections, occupational exposures, and behavioral and other risk factors for infection. Blood samples were tested for antibodies to human T-lymphotrophic virus type I and hepatitis C virus. Logistic regression models included the three matching variables and ethnicity. There was no association between risk of non-Hodgkin lymphoma and any of the variables analyzed, including sexually transmitted infections, sexual behavior, blood transfusions, influenza, acne, and either occupational or domestic exposure to zoonotic infections. Non-Hodgkin lymphoma risk was nonsignificantly elevated (odds ratio, 2.99; 95% confidence interval, 0.78-11.51) for those with a history of injecting drug use. Three cases and two controls (odds ratio, 1.32; 95% confidence interval, 0.22-7.98) tested positive to hepatitis C virus infection and none tested positive to human T-lymphotrophic virus type I/II infection. This study provides consistent evidence that sexually transmitted infections and zoonoses are not risk factors for non-Hodgkin lymphoma. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1102–8)
Evolution of Thrombin Formation and Fibrinolysis Markers, Including Thrombin-Activatable Fibrinolysis Inhibitor, during Severe Meningococcemia
Authors: Fouassier Marc , Moreau Delphine , Thiollière Fabrice , Frère Corinne , Marquès-Verdier Alain , Souweine Bertrand
Published: June 2006

A 17-year-old girl presented with Neisseria meningitidis sepsis, with evidence of disseminated intravascular coagulation. Substitution therapy with both antithrombin and protein C concentrates was initiated, leading to clinical and biological improvement. Sequential dosages were performed for biological markers including thrombin-activatable fibrinolysis inhibitor (TAFI). Substitution therapy with both antithrombin and protein C concentrates led to a clinical and biological improvement. Biological markers showed a decrease in thrombin generation and in plasminogen activator inhibitor 1 (PAI-1) and a return of TAFI to a normal value. Discontinuation of substitutive treatment was marked by a clinical relapse at 24 h, with thrombin generation and increase in PAI-1, while TAFI remained unchanged. This report shows the evolution of hemostasis markers during septic shock and provides new data concerning the effects of a substitutive therapy.
Prevalence of Multiple Sclerosis Door-to-Door Survey in Maltepe, Istanbul, Turkey
Authors: Türk Börü Ülkü , Alp Recep , Sur Haydar , Gül Levent
Published: June 2006

Background: The prevalence of multiple sclerosis (MS) in Istanbul, Turkey, is unknown. We investigated the prevalence of MS in the district of Maltepe, Istanbul, Turkey. Methods: This was a cross-sectional field research study using door-to-door sampling. Maltepe is a district of Istanbul beside the sea of Marmara (population 359,298 from 2000 census). The two-phase study screened 32,531 subjects using the Poser criteria for clinical diagnosis. The χ2 test was used for analyses of frequency distributions. Results: 33 of 32,531 people were diagnosed with MS. Their average age was 41 ± 12.0 years (43 ± 12.7 years for females and 37 ± 9.6 years for males). The prevalence of MS in Maltepe was 101.4/100,000 within the total population (118.7/100,000 in the female and 76.0/100,000 in the male populations). Conclusions: The prevalence rates of MS in the Turkish population living in a district of Istanbul are considerably higher than we thought. And the prevalence rate is much higher than neighboring countries. They are similar to those recently recorded in Sicily and Germany. These figures suggest that the prevalence rate of MS is not totally dependent upon geographical variation. However, the research of our results needs to be confirmed with further investigations in order to determine the prevalence of MS in Turkey with confidence.
Counseling Psychology in the Era of Genetic Testing
Authors: Kaut Kevin P.
Published: June 2006

The field of genetics and the process of testing for genetic disorders have advanced considerably over the past half century, ushering in significant improvements in certain areas of medical diagnosis and disease prediction. However, genetic discoveries are accompanied by many social, emotional, and psychological implications, and counseling psychologists may be uniquely equipped to help clients deal with these issues. The present overview is intended to raise awareness of the multidimensional issues inherent in situations where clients seek genetic testing to diagnose or predict various medical conditions. Initially, the author presents a framework to help counseling psychologists identify and organize information within a genetic-testing context, followed by suggestions for addressing the various psychological, social, and multicultural issues potentially affecting client decision making, mental health, and behavior. Finally, the author raises considerations for training, continuing education, and professional practice to foster continued discussion among counseling psychologists preparing for, or presently working in, research and applied settings involving clients with genetic concerns.
From Equality to Opportunity
Authors: Miguel Luis Felipe
Published: June 2006

Brazil’s 2002 presidential elections brought to power Luiz Inácio Lula da Silva, the leader of the Partido dos Trabalhadores (Worker’s party—PT) and a former union leader with a markedly leftist political trajectory. An examination of the PT’s discourse throughout the 2002 campaign, as evidenced in the free political advertising programs that represent the main form of contact between candidates and voters in Brazil, reveals the “professionalization” of Lula’s communication. An integral part of the “practical” shift of his political strategy, this professionalization punctuated a long process of accommodating the political establishment, in effect burying the radical novelty that the PT had stood for. In its origins, the party discourse fed on the lived experience of workers and the daily battles of social movements. This is the feature that was lost in 2002, when the discourse of Lula and the PT was molded to the dominant political discourse in both form and content.
Teaching End-of-Life Issues in US Medical Schools: 1975 to 2005
Authors: Dickinson George E.
Published: June 2006

This study examined medical school offerings on end-of-life issues between 1975 and 2005. Seven national surveys of US medical schools were conducted in 1975, 1980, 1985, 1990, 1995, 2000, and 2005 (response rates in percentages of 95, 96, 90, 90, 93, 92, and 81, respectively). Results revealed that between 1975 and 2005, the overall offerings in death and dying increased so that 100% of US medical schools, beginning in 2000, offered something on death and dying. A multidisciplinary-team approach continued over the 30-year period. Palliative care is offered in 94% of US medical schools, to some extent, and about a fourth of the schools offer students an opportunity to have a continuing relationship for several weeks with a terminally ill patient. Numerous end-of-life topics are currently covered in the curriculum. This increased attention to end-of-life issues in medical schools should enhance each medical student’s relationship with terminally ill patients and their families.
Schistosoma mansoni infection in eosinophil lineage–ablated mice
Authors: Swartz Jonathan M. , Dyer Kimberly D. , Cheever Allen W. , Ramalingam Thirumalai , Pesnicak Lesley , Domachowske Joseph B. , Lee James J. , Lee Nancy A. , Foster Paul S. , Wynn Thomas A. , Rosenberg Helene F.
Published: June 2006

We explore the controversial issue of the role of eosinophils in host defense against helminthic parasites using the established Schistosoma mansoni infection model in 2 novel mouse models of eosinophil lineage ablation (ΔdblGATA and TgPHIL). No eosinophils were detected in bone marrow of infected ΔdblGATA or TgPHIL mice, despite the fact that serum IL-5 levels in these infected mice exceeded those in infected wild type by approximately 4-fold. Liver granulomata from infected ΔdblGATA and TgPHIL mice were likewise depleted of eosinophils compared with those from their respective wild types. No eosinophil-dependent differences in granuloma number, size, or fibrosis were detected at weeks 8 or 12 of infection, and differential accumulation of mast cells was observed among the ΔdblGATA mice only at week 12. Likewise, serum levels of liver transaminases, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) increased in all mice in response to S mansoni infection, with no eosinophil-dependent differences in hepatocellular damage observed. Finally, eosinophil ablation had no effect on worm burden or on egg deposition. Overall, our data indicate that eosinophil ablation has no impact on traditional measures of disease in the S mansoni infection model in mice. However, eosinophils may have unexplored immunomodulatory contributions to this disease process.
17q22–24 Chromosomal Losses and Alterations of Protein Kinase A Subunit Expression and Activity in Adrenocorticotropin-Independent Macronodular Adrenal Hyperplasia
Authors: Bourdeau Isabelle , Matyakhina Ludmila , Stergiopoulos Sotirios G. , Sandrini Fabiano , Boikos Sosipatros , Stratakis Constantine A.
Published: June 2006

Context: Primary adrenocortical hyperplasias leading to Cushing syndrome include primary pigmented nodular adrenocortical disease and ACTH-independent macronodular adrenal hyperplasia (AIMAH). Inactivating mutations of the 17q22–24-located PRKAR1A gene, coding for the type 1A regulatory subunit of protein kinase A (PKA), cause primary pigmented nodular adrenocortical disease and the multiple endocrine neoplasia syndrome Carney complex. PRKAR1A mutations and 17q22–24 chromosomal losses have been found in sporadic adrenal tumors and are associated with aberrant PKA signaling.

Objective: The objective of the study was to examine whether somatic 17q22–24 changes, PRKAR1A mutations, and/or PKA abnormalities are present in AIMAH.

Patients: We studied fourteen patients with Cushing syndrome due to AIMAH.

Methods: Fluorescent in situ hybridization with a PRKAR1A-specific probe was used for investigating chromosome 17 allelic losses. The PRKAR1A gene was sequenced in all samples, and tissue was studied for PKA activity, cAMP responsiveness, and PKA subunit expression.

Results: We found 17q22–24 allelic losses in 73% of the samples. There were no PRKAR1A-coding sequence mutations. The RIIβ PKA subunit was overexpressed by mRNA, whereas the RIα, RIβ, RIIα, and Cα PKA subunits were underexpressed. These findings were confirmed by immunohistochemistry. Total PKA activity and free PKA activity were higher in AIMAH than normal adrenal glands, consistent with the up-regulation of the RIIβ PKA subunit.

Conclusions: PRKAR1A mutations are not found in AIMAH. Somatic losses of the 17q22–24 region and PKA subunit and enzymatic activity changes show that PKA signaling is altered in AIMAH in a way that is similar to that of other adrenal tumors with 17q losses or PRKAR1A mutations.
Immunodetection of human telomerase reverse-transcriptase (hTERT) re-appraised: nucleolin and telomerase cross paths
Authors: Wu Ying-Li , Dudognon Charles , Nguyen Eric , Hillion Josette , Pendino Frédéric , Tarkanyi Ilona , Aradi Janos , Lanotte Michel , Tong Jian-Hua , Chen Guo-Qiang , Ségal-Bendirdjian Evelyne
Published: June 2006

The involvement of telomerase in cellular immortalization and senescence has often been assessed by means of telomerase expression at the RNA level and quantification of telomerase activity by the telomeric repeat amplification protocol assay. However, these methods either neglected the existence of various telomerase splice variants, or ignored the nonconventional functions of telomerase independent of its ability to elongate and maintain telomere length. Immunodetection of telomerase is now being recognized as a necessary approach to precisely elucidate its roles in oncogenesis and senescence. A few antibodies directed against the catalytic subunit of the human telomerase (hTERT) are currently used but their specificity is not always demonstrated. A survey of the literature showed inconsistencies and led us to comparatively re-evaluate the most frequently used antibodies. Surprisingly, mass spectrometry, two-dimensional gel analysis and immunofluorescent experiments revealed that the most frequently used hTERT immunoprobe, a mouse monoclonal antibody that was claimed to be directed against an hTERT protein epitope, in fact recognizes nucleolin rather than telomerase. Our findings have interesting implications regarding the biology of nucleolin and telomerase in the context of pathophysiological investigations recently carried out.
Disruption of the plasma membrane stimulates rearrangement of microtubules and lipid traffic toward the wound site
Authors: Togo Tatsuru
Published: June 2006

Resealing of a disrupted plasma membrane requires Ca2+-regulated exocytosis. Repeated disruptions reseal more quickly than the initial wound. This facilitated response requires both Ca2+ and protein kinase C (PKC), and is sensitive to brefeldin A. There is also evidence that this response is polarized to the site where the cell membrane had previously been disrupted. Observations of GFP-tagged α-tubulin and end-binding protein 1 (EB1) revealed that membrane disruption initially induced disassembly of microtubules around the wound site, followed by elongation of microtubules toward the wound site. Recruitment of EB1 to microtubules required Ca2+ influx, but was independent of PKC. NBD C6-ceramide, a probe for the Golgi apparatus and Golgi-derived lipids, initially stained the perinuclear region, and a portion of the probe was translocated to the wound site 5 minutes after wounding. Translocation of the lipids required microtubules and PKC activity, and was suppressed by low temperature. On the other hand, constitutive traffic of the lipid was still normal in the presence of a PKC inhibitor. These findings suggest that membrane disruption stimulates regulated vesicle traffic from the region of the trans-Golgi network to the wound site along rearranged microtubules in a PKC-dependent manner.
Rac1 and Rac2 regulate macrophage morphology but are not essential for migration
Authors: Wheeler Ann P. , Wells Claire M. , Smith Stephen D. , Vega Francisco M. , Henderson Robert B. , Tybulewicz Victor L. , Ridley Anne J.
Published: June 2006

Rac GTPases are believed to contribute to migration in leukocytes by transducing signals from cell surface receptors to the actin and microtubule cytoskeletons. Mammals have three closely related Rac isoforms, Rac1, Rac2 and Rac3, and it is widely assumed that cell migration requires the activity of these Rac GTPases. We have previously shown that Rac1-null mouse macrophages have altered cell shape and reduced membrane ruffling but normal migration speed. Here we investigate the behaviour of macrophages lacking Rac2 (Rac2–/–) or Rac1 and Rac2 (Rac1/2–/–). Rac2–/– macrophages have reduced F-actin levels and lack podosomes, which are integrin-based adhesion sites, and their migration speed is similar to or slightly slower than wild-type macrophages, depending on the substrate. Unexpectedly, Rac1/2–/– macrophages, which do not express Rac1, Rac2 or Rac3, migrate at a similar speed to wild-type macrophages on a variety of substrates and perform chemotaxis normally, although their morphology and mode of migration is altered. However, Rac1–/– and Rac1/2–/– but not Rac2–/– macrophages are impaired in their ability to invade through Matrigel. Together, these data show that Rac1 and Rac2 have distinct roles in regulating cell morphology, migration and invasion, but are not essential for macrophage migration or chemotaxis.
Microsoft-ova kampanja legalizacije software-a
Authors: Zecevic Aleksandra
Published: June 2006

All software producers give license for their products. Last July the most famous software producer - Microsoft -launched a serious and systematic licensing campaign for using their products in the territory of Yugoslavia. The paper gives a review of software licensing procedures as well as possibilities for being allowed certain discounts by Microsoft. .
The transition process: Stimulating free entrepreneurship
Authors: Stojanovic Bozo
Published: June 2006

The text consists of two parts. In the first we expound the thesis that transition is actually a process of creation of institutional preconditions for development of private entrepreneurship at a given moment and under the inherited circumstances. To create an environment that stimulates free entrepreneurship and enables a successful transition requires a lot of knowledge, creativity and pragmatism (there is no general model). The rest remains on the entrepreneurs. In the second part we analyse the experience of FRY before and after the change of regime. During the former regime FRY was an example of degenerative connection between politics and economy geared to prevent reforms. The task of the new government is to make a radical break with the earlier practice. If the reform is not radical and not aiming to create an institutional environment that fully stimulates competition and private entrepreneurship (which has not been the case so far), it has no good prospects to succeed.
Inequality and development
Authors: Jovanovic-Gavrilovic Biljana
Published: June 2006

Inequality can be analyzed from various aspects. In this paper our attention is drawn to economic inequality, most frequently manifested through income and wealth. The measurement of economic inequality is a complex task. The Lorenz curve and a number of numerical indices are applied, and let us mention the following ones: the Gini coefficient, the coefficient of variation, the Theil index and the Atkinson measure. These indices do satisfy the criteria (principles) presenting, according to general consent an appropriate measure of economic inequality: anonymity (symmetry) principle, population principle, relative income principle and the Dalton principle of transfer. In recent times, the problem of inequality has been attracting a lot of attention. The explanation should be sought in the widening of income differences (within individual countries and between them) and also in new knowledge about the relationship between inequality and development. The attitude to inequality being determined mainly by the economic development level (as presented in the Kuznets hypothesis) is gradually being replaced by the attitude to inequality being the determinant of income and its growth. Contrary to previous beliefs about the stronger income inequalities being favorable to the economic growth, more recent research has pointed to the fact that a more equal distribution of income through various channels, can possibly act as an efficient stimulus of growth.