bluuebunny/crossref_metadata_2025 huggingface dataset:
Endothelial Cell Seeding to the Dog Vena Caval Prostheses Made of Different Materials and Configurations
Authors: Zhonggao Wang  , Jidong Wu  , Guandi Li
Published: November 2007

Producing an early and complete prosthetic endothelialization is one of the best methods for improving performance of venous grafts. This study investigated the effect of graft material and configuration on the prosthetic endothelialization. Forty-two mongrel dogs were randomly divided into six groups. Four animals from each group were implanted with endothelial cell (EC)-seeded prostheses and 3 with unseeded ones in the inferior vena cava (IVC). ECs were harvested from autogenous omentum by enzymatic method yielding 1.65 ±0.43x106 ECs per gram of omentum. A 5-cm-long segment of IVC was resected, and an equal-dimension prosthesis was interposed. A femoral arteriovenous fistula (AVF) was created. Prostheses were explanted at ten days following surgery. All EC-seeded knitted Dacron prostheses and 3 seeded polytetrafluoroethylene (PTFE) ones were patent with complete endothelialization. All seeded woven Dacron prostheses were patent with partial endothelialization. Only 2 seeded and one control Silk prostheses were patent, and no EC lining could be detected. Light microscopy revealed that the neointima was thinner in the patent seeded PTFE grafts than that in controls (p<0.001) and in seeded knitted Dacrons (p < 0.02) . The neointima of seeded knitted Dacron grafts was thinner than that of controls (p<0.01). No marked difference was seen among the neointima formed on Meadox porous, Vascutek porous grafts (VP1200), or Vascutek sealed Gelsoft grafts. It was concluded that: (1) Excellent and early endothelialization of EC-seeded dog caval implants can be established with Vascutek VP1200, Gelsoft, Meadox knitted Dacron, and indigenous ePTFE. (2) Knitted Dacron is superior to woven Dacron in regard to EC seeding. (3) The gelatin-impregnated Gelsoft does not interfere with prosthetic endothelialization. (4) The woven Dacron, and especially the Silk prosthesis, seem unsuitable for EC seeding in the venous circuit.
Inferior Vena Caval Tumor Thrombus from Renal Angiomyolipoma
Authors: Kawahito Koji , Ino Takashi , Adachi Hideo , Ide Hirofumi , Mizuhara Akihiro , Yamaguchi Atsushi
Published: November 2007

The authors report a case of bilateral renal angiomyolipoma with tumor thrombus from the right kidney extending to the inferior vena cava. Right nephrectomy and total thrombectomy were performed. Vena caval tumor thrombus rarely occurs in patients with angiomyolipomas. To their knowledge, only 6 cases have been reported in the literature.
Effect of Pentoxifylline on Treatment of Lower Limb Ulcers in Patients with Thalassemia Major
Authors: Angelides N.S. , Angastiniotis Ch. , Pavlides N.
Published: November 2007

The possible healing effect of deferoxamine and pentoxifylline on persisting lower limb ulcers was studied in 51 patients with thalassemia major.

The results indicated that the regular use of deferoxamine at an intravenous dose of 20 mg/kg did not affect the healing progress and the recurrence rate of these ulcers significantly On the contrary, the oral administration of pentoxifylline at a dose of 1,200 mg daily during the ulcer's healing time and at a low long-term maintenance dose of 400 mg daily during the ulcer-free intervals improved their healing ability impressively and diminished their recurrence rate significantly
A Comparative Analysis of Transcutaneous Oxygen Tension (tcPO2) During Rest and Postischemic Response Test in the Diagnosis of Patients with Mild and Moderate Arteriosclerosis Obliterans (ASO)
Authors: Qian Shuixian , Iwai Takehisa , Inoue Yoshinori , Endo Mitsuo
Published: November 2007

Transcutaneous oxygen tension (tcPO2) was measured at the foot and chest wall in 12 normal subjects and 62 patients with arteriosclerosis obliterans (ASO). The results showed that the resting tcPO2 at the foot and the chest wall was significantly lower in asymptomatic patients (p < 0.01 at the foot and p < 0.01 at the chest wall) and patients with mild and moderate intermittent claudication (p < 0.01 and p < 0.01, respectively) than in normal subjects. The postischemic response test (T½) was significantly delayed in asymptomatic patients (p < 0.05) and patients with mild and moderate intermittent claudication (p < 0.01 respectively) as compared with normal subjects.

The preliminary results of this study suggest that the measurement of resting tcPO2 is useful in the diagnosis of patients with mild and moderate ASO. Measurement of resting tcPO2 coupled to the T½ test is more useful for discrimination in the severity of the disease and may provide information concerning prognosis of the patients.
Left- and Right-Heart Assistance by Retrosternal Intermittent Cardiac Compression in Dogs
Authors: Erk M. Kamuran , Kolbakir Ferşsat , Baysal Kemal
Published: November 2007

Assistance to the circulation after experimental acute low cardiac output syndrome was provided by retrosternal intermittent cardiac compression (RICC) in dogs. The prolonged assisted circulation in support of the failing heart by RICC was demonstrated in 10 dogs (Group A) for periods longer than four hours. The control group (Group B, five dogs) was given only dobutamine HCL in adequate doses, without RICC. In these two groups signif icant differences were observed (P<0.01). RICC is a simple and effective means of assisting circulation, especially with heart failure on both sides.
Aortoduodenal Fistula Associated with Streptococcus milleri Bacteremia and a Mitral Valve Vegetation
Authors: Karban Amir , Levy Yishai , Markel Arie , Torem Shlomo , Brook J. Gerald
Published: November 2007

A sixty-five-year-old woman was admitted to the hospital complaining of weight loss and melena. She had a history of five vascular operations including aortobifemoral bypass. During hospitalization, she developed sepsis with Streptococcus milleri bacteremia. A computed tomographic scan and gastroduodenoscopy suggested aortoduodenal fistula, which was confirmed by surgical exploration. An echocardiogram showed mitral valve vegetation. This case suggests the potential role of Streptococcus milleri bacteremia and endocarditis in the pathogenesis of aortoduodenal fistula.
Quality of Life After Open Heart Surgery
Authors: Sivertssen Egil , Fjeld Nils B. , Abdelnoor Michael
Published: November 2007

Quality of life was studied at mean follow-up time of thirty months by a postal standard questionnaire, which was answered by 95% of patients.

The questionnaire included a visual analog scale (VAS) for self-evaluation of the patients' quality of life.

At the time of follow-up 90% of the patients answered that their clinical condition was much better or better than before operation. However, only 24.3% of the patients were without any cardiac symptoms at follow-up.

The results of the VAS showed that 90.8% of the patients had a higher score (better quality of life) than before operation without any difference between males and females, between age groups, or between patients who underwent coronary artery bypass surgery (the CABG subgroup) and patients who had valvular replacement (the valve subgroup).

A significant relationship was found between the degree of symptoms and VAS values and between working condition and VAS values of quality of life.
Does Immunity Play a Role in the Development of Abdominal Aortic Aneurysms?
Authors: Samy Ahmed , MacBain Gordon
Published: November 2007

It has been postulated that immune mechanisms may be involved in the pathogenesis of abdominal aortic aneurysms (AAAs). To test this hypothesis, tissue was taken from the walls of AAAs in patients undergoing corrective surgery and, with a view to comparison, from the aortic walls of patients undergoing bypass surgery, and assayed for the presence or absence of immune complexes. Blood was also taken from each group and tested for complement activity, complement activation products, and autoantibodies to smooth muscle and mitochondria. No evidence was found of immune response in either group of patients. It would seem that the immune response has no role in the development of AAA or occlusive disease of the abdominal aorta.
Reconstructive Vascular Surgery for Intestinal Angina Associated with Renovascular Hypertension and Intermittent Claudication
Authors: Hiekata Tomizo , Ogawa Noboru , Koyama Teruyuki , Takei Hiroshi
Published: November 2007

Calcified atherosclerosis producing occlusion of the suprarenal aorta with involvement of the celiac artery (CA), superior mesenteric artery (SMA), and renal artery is an extremely rare entity. The authors report a case of a fifty-five-year-old woman with this lesion who had suffered from renovascular hypertension, intestinal angina, and intermittent claudi cation of the lower extremities. Reconstructive vascular surgery was successfully performed including an aortic bypass from the lower descending thoracic aorta to the distal abdominal aorta and revascularization of the CA, SMA, and bilateral renal and external iliac arteries simultaneously.

Only a few similar cases have been reported in the literature, and all the patients were female. It appears that there is an unusual predilection for females in this particular form of arteriosclerosis.
Embolectomy-Induced Pseudoaneurysm Causing a Brachial Plexopathy
Authors: Diedrich Andrea , Dibert Steven , Donofrio Peter
Published: November 2007

Pseudoaneurysm is a rare cause of compressive brachial plexopathy. The authors describe a thirty-seven-year-old man with hypertension and renal disease who presented with a painful and weak left upper extremity. Examination revealed a cool extremity with absent pulses, profound weakness, and diminished sensation and reflexes restricted to the left upper limb. During emergency exploration, a thromboembolus was extracted from the subclavian artery by means of a brachial artery entrance site. A postoperative arteri ogram revealed persistent subclavian artery occlusion. On reexploration, a second throm boembolus was removed. Postoperatively, the patient regained pulses, and over several days his left upper limb strength improved.

On reevaluation several weeks later, the patient complained of greater weakness in the left arm, forearm, and hand, which was confirmed on physical examination. Nerve conduction studies and an electromyogram were interpreted as consistent with a severe left brachial plexopathy. Magnetic resonance imaging of the brachial plexus revealed a left axillary mass displacing the brachial plexus, which also manifested pulsatile flow artifact consistent with a pseudoaneurysm. A pseudoaneurysm arising from a branch of the axillary artery was surgically repaired, resulting in some return of strength.

Several cases of brachial plexopathy due to pseudoaneurysm have previously been reported, but none has been iatrogenically induced by embolectomy. A pseudoaneurysm should be considered in any patient who develops focal limb weakness after embolec tomy, particularly those receiving anticoagulation.
Basal or Stimulated Release?
Authors: He Guo-Wei , Yang Cheng-Qin
Published: November 2007

Many vasoconstrictor substances have been demonstrated as being vasodilators through the mechanism of endothelium-derived relaxing factor (EDRF)-nitric oxide (NO) release. The authors have hypothesized that all naturally secreted vasoconstrictor substances may potentially be vasodilators as well in order to maintain an adequate physiological vascular tone and have suggested a new term (vasoactivator) for vasoconstrictors. They have recently found that the vasoconstriction induced by a mimetic (U46619) of thromboxane A2 (TXA2), a naturally secreted vasoconstrictor substance released from platelets, may be markedly influenced by the presence of endothelium in the porcine coronary artery (PCA). This may be due to basal (spontaneous) release of EDRF (NO) or stimulated biosynthesis/release by thromboxane A2. The present study was designed to further investigate whether stimulated release of EDRF (NO) by TXA2 exists. PCA rings were mounted in organ baths under a physiologic pressure. The concentration-contraction curves to U46619 were compared in endothelium-intact (+E, n=7) and endothelium- denuded (—E, n=4) rings. At the maximal contraction induced by U46619 (-6.5 log M), NG-nitro-L-arginine (L-NNA, -4 log M) was added. In separate experiments, at resting condition, L-NNA (-4 log M) or U46619 (-7.7 log M) was added and the force changes were recorded. After twenty minutes, U46619 (-7.7 log M) or L-NNA (-4 log M) was added to study the force developed. U46619-induced contraction forces were signifi cantly higher in the -E rings at the concentrations of -9.5 to -7.5 log M and L-NNA induced further contractions in the +E (P < 0.01) but not in the -E rings. In resting conditions, L-NNA induced 0.12 g and further addition of U46619 (-7.7 log M) induced 8.8 g contraction force (P < 0.0001). On the other hand, U46619 (-7.7 log M) induced only 0.88 g contraction force whereas further addition of L-NNA induced a large force (7.43 g, P < 0.0001). The authors conclude that although basal release exists in the PCA this cannot explain the large difference between the +E arteries and the -E or L-NNA incubated arteries, and therefore, TXA2 stimulates EDRF (NO) biosynthesis/release in the porcine coronary artery.
Venous Contractile Function During and After Hypothermic Exposure
Authors: Davies Mark G. , Hopkin Mark A. , Hagen Per-Otto , Brockbank Kelvin G. M.
Published: November 2007

Hypothermia has been shown to have pathophysiological consequences on endothelial and smooth muscle cell functions. The impact of rewarming on vessels is unknown. This study examines the contractile functions of two sets of rabbit external jugular veins, the first after equilibration at 37°C and the second after cooling from 37°C to 20°C for one hour and following rewarming to 37°C. The pharmacologic parameters: Emax (the maximal response expressed as a ratio of the contraction to 60 mM KCl) and the EC50 concentration, (which produces 50% of the maximal response ) were calculated. Nonreceptor-mediated contractile responses (KCl) did not significantly change with cooling or on rewarming. The sensitivity to norepinephrine increased, whereas the Emax decreased significantly on cooling to 20°C; both parameters returned to control levels on rewarming. Both the histamine sensitivity and Emax were decreased (P<0.05) with cooling. The Emax for histamine returned to normal on rewarming. In contrast to norep inephrine, the jugular vein sensitivity to histamine did not fully recover to untreated control values on rewarming. The sensitivity to bradykinin increased (P<0.05) with cooling and remained so on rewarming. The Emax for bradykinin decreased on cooling and dropped further upon rewarming (P < 0.05) . Thus, cooling produced a mixed pattern of alterations in response to contractile agonists, and rewarming did not result in a uniform restoration of these responses. These observations may have clinical implications for organ transplantation, for hypothermic surgery, and for individuals accidentally exposed to cold environmental conditions.
Management of Large Congenital Renal Arteriovenous Malformations
Authors: Motta Joseph , Armenakas Noel A. , Miller Lawrence S. , Muecke Edward C. , Fracchia John A.
Published: November 2007

Congenital renal arteriovenous malformations (AVM) are rare, with approximately 50 cases reported in the English literature. Typically they are small (1-2 cm) and the majority present with gross hematuria. The authors report a case of a young woman with a 6 cm congenital renal AVM diagnosed during her first pregnancy when she presented with signs of hypertension. Hematuria and rupture of the AVM were not part of her clinical course and a subsequent partial nephrectomy was curative. A review of the English literature of congenital AVMs is presented.
Humoral Immunity After Splenorenal Artery Bypass
Authors: Burkhart Harold M. , Wilcox Michael G. , Sawchuk Alan P.
Published: November 2007

Splenorenal artery bypass is not an uncommon procedure for correctable renal hyper tension. Although it is well known that the removal of the spleen greatly impairs humoral immunity, no data exist regarding the humoral response after a splenorenal artery bypass. The purpose of this study was to assess the humoral response to an intravenous bolus of sheep erythrocytes in Sprague-Dawley rats after they underwent a splenorenal artery bypass.

Sixteen male, retired breeder, Sprague-Dawley rats (weight 400 to 450 g) were divided into three groups and successfully studied. The first six rats were the control group and underwent sham operations consisting of a midline laparotomy followed by primary closure. The second group (n=6) underwent splenectomies with suture ligation of the splenic artery at the hilum. A splenic artery to left renal artery bypass was performed on the rats in the last group (n=4). After recovery, the rats were given an intravenous bolus of sheep erythrocytes via direct cannulation of the femoral vein. One week later, their antibody titers were assessed by hemagglutination assays.

The antibody titers of the sham-operated rats (939 ±244.4) were significantly different than those of the splenectomized group (16 ±3.6) and the bypassed group (80 ±16.0). Furthermore, there was no significant difference between the bypassed and splenectomized rats.

The results suggest that the use of pneumococcal vaccine and early antibiotic treatment may be warranted in splenorenal artery bypass patients in order to avoid infec tious sequelae.
A Right Retroperitoneal Approach for Repair of an Abdominal Aortic Aneurysm in a Patient with a Left-Sided Inferior Vena Cava
Authors: Cottrell Earl D. , Yates G. Neil , Chino Eric S.
Published: November 2007

Anomalies of the inferior vena cava present a challenge to the performance of infrarenal aortic surgery. In the past, most of these variations were first discovered at surgery while the aorta was being exposed through traditional approaches. Preoperative testing allows the discovery and planning of a case-specific directed approach. Herein is reported a case of a right retroperitoneal exposure for repair of a left-sided inferior vena cava.
Subclavian Artery Bypass Using Superficial Femoral Vein. A Case Report
Authors: Simsir Sinan A. , Kohlman-Trigoboff Debra , Molina Hector G. , Smith Bruce M.
Published: November 2007

The authors report the use of reversed superficial femoral vein (SFV) as an interposition graft in the subclavian artery following the exclusion of an aneurysm in a patient with compression of the artery at the thoracic outlet. SFV was easy to harvest and handle and provided an ideal size match with the subclavian and axillary arteries. The patient has no complaints in the upper limb 12 months following the procedure, and there have been no complications in the donor leg. SFV appears to be an ideal conduit for subclavian artery bypass procedures. The authors conclude that the use of SFV should be extended to include subclavian artery revascularization and repair.
Early Hemodynamic Effects of Percutaneous Transluminal Angioplasty in Superficial Femoral Artery Disease
Authors: Labropoulos Nicos , Giannoukas Athanasios D. , Volteas Nicos , Al Kutoubi Aghiad , Katsamouris Asterios , Wolfe John H.N. , Mansfield Averil O. , Nicolaides Andrew N.
Published: November 2007

This study was conducted to assess the early hemodynamic effects of percutaneous trans luminal angioplasty (PTA) in patients with superficial femoral artery (SFA) atheroscle rotic disease. Seventeen patients (forty-nine to eighty-five years, median sixty-seven years), underwent PTA in the SFA, except 1 who had PTA in both the SFA and popliteal artery. Fifteen patients were claudicant whereas the other one had rest pain and ulcera tion. Ten patients had localized SFA occlusion on the angiogram (3 of them had combined stenoses in the common femoral, profunda, and popliteal arteries) and 7 had localized stenoses more than 50%. Ankle-brachial index (ABI), limb blood flow (measured by air plethysmography), peak systolic velocity (PSV) ratio across the stenosis, and the spectral waveform analysis displayed by color flow duplex imaging (CFDI) were assessed before and one day after PTA.

Before PTA, the median ABI and limb blood flow were 0.55 ±0.19 and 58.6 ±13.1 mL/min, respectively. The waveform in the poststenotic area of the SFA was monophasic in 5 patients and biphasic in the others, and the PSV was at least doubled in the stenotic area. PTA was technically successful in 16 patients and failed in 1 with an occluded SFA. After successful PTA the median ABI was 0.76 ±0.15 (P<0.00001), and the median limb blood flow was 78.1 ±11.9 mL/min (P<0.00001). The waveform in the dilated area of the SFA was biphasic in all patients with marked decrease in the PSV and forward diastolic velocity present. Postangioplasty pain-free walking distance was at least doubled in 12 patients. In the case of the failed PTA the ABI, limb blood flow, poststenotic waveform, PSV, and pain-free walking-distance were unchanged.

In conclusion, early improvement in the hemodynamic parameters occurs over the first day after a successful PTA. These hemodynamic parameters correlate well with the findings of the postangioplasty angiogram and thus can be used in the follow-up of the patients after PTA.
Coexisting Abdominal Aortic Aneurysm and Lung Cancer
Authors: Olivas Terry P. , Swanson John D. , DePalma Ralph G. , Little Alex G. , Bomberger Richard A. , Manalo Pacita B.
Published: November 2007

Virtually no guidelines exist regarding the treatment of patients with coexisting abdominal aortic aneurysm (AAA) and carcinoma of the lung. The records of 19 patients with this challenging combination presenting in the last 5 years were reviewed to determine: mode of presentation, risk factors, stage of cancer, size of AAA, treatment, and natural history. There were 15 men and four women aged 59-77 years. All had smoking histories ranging from 19.3 to 120 pack-years (mean: 74 pack-years). Ten presented with AAA primarily, six primarily with lung cancer, and in the remaining three, lung cancer and the AAA were diagnosed in the course of workup for unrelated complaints.
Extraanatomic Renal Revascularization: Surgical and Anatomic Variations
Authors: Dardik Herbert , Silvestri Fred , Alasio Teresa , Berry Silvia , Hallac Ralph , Laudito Antonio , Ibrahim Ibrahim M.
Published: November 2007

A thoracic-aorta-left renal artery bypass with polytetrafluoroethylene (PTFE) and three gastroduodenal right renal artery bypasses were constructed in four patients in whom loss of renal function and the potential for dialysis were imminent. These extraanatomic bypasses showed durable patency with preservation of renal function. Gastroduodenal- renal bypass requires an appreciation of the anatomic relationship of the right renal artery to the right renal vein. Anatomic studies were performed in 80 human cadavers to assess the anatomic relationships of the right renal artery with respect to the right renal vein. In 50% of the cadavers studied, the right renal artery was superior to the right renal vein. It was located inferior to the right renal vein in 17.5% and directly posterior in 32.5%.

Extraanatomic bypasses may be required for treatment of renal hypertension or parenchymal salvage. Gastroduodenal-renal and thoracorenal reconstructions are unusual variants of extraanatomic bypasses, and though uncommonly required, may be extremely useful methods to employ for renal revascularization.
Delayed Presentation of Renal Artery Pseudoaneurysm Following Blunt Trauma
Authors: El-Reshaid Kamel , Med Am B. , Nephrol Am B. , Walia Harinder
Published: November 2007

The authors describe a 50-year-old-man who developed renal artery pseudoaneurysm (RAP) 3 months after blunt trauma, which he sustained during a car accident. The patient presented with fever and left loin pain of 1 month's duration. Ultrasound examination of the abdomen revealed a large cystic lesion in the upper pole of the left kidney, which was separated from the nondilatated pelvis of the kidney. The patient underwent left nephrec tomy, and pathological examination confirmed the absence of infection, vasculitis, or malignancy.
Improved Postischemic Recovery After Peripheral Bypass Surgery Assessed by Near-Infrared Spectroscopy
Authors: Eiberg Jonas Peter , Secher Niels Henry , Schroeder Torben Veith
Published: November 2007

Near-infrared spectroscopy has been established as a monitoring technique for assessment of cerebral oxygenation. With the sensor placed over the gastrocnemius muscle, we studied the vascular capacity before and after infrainguinal revascularization, as well as the temporal profile of muscle oxygenation in the first 24 postoperative hours. Twenty-three patients undergoing femorodistal bypass surgery for claudication (n=10) or critical ischemia (n=13) were examined. Vascular capacity was assessed in 10 patients and expressed as the time for 95% reoxygenation (reox-T 95) of calf muscles upon 4 minutes of tourniquet-induced ischemia. Five days postoperatively, reox-T95 was reduced from 128 (105 to 183) s to 85 (61 to 109) s (p<0.005) (median, interquartile range) compared with 56 (55 to 57) s for a group of seven young and 55 (36 to 56) s for a group of seven age-matched controls (p<0.05). Thirteen patients monitored for 24 hours postoperatively demonstrated postreconstructive hyperemia with a peak in skeletal muscle oxygenation (peak-SmO2) 3 h after surgery of 21 (4 to 33) units above the preoperative level (p < 0.01 ), declining to the preoperative level after 11 h.

In conclusion, calf vascular capacity as expressed by postischemic recovery was improved markedly following peripheral bypass surgery, and near-infrared spectroscopy revealed marked hyperemia postreconstructively.
Building Effective Programs to Improve Men's Health
Authors: Whitley Elizabeth M. , Jarrett Nicole C. , Young April M. W. , Adeyemi Sherry A. , Perez Leda M.
Published: November 2007

Historically, the health care needs of poor men and men of color have been neglected in the United States, resulting in significant disparities in health and health outcomes. Dedicated resources to address the particular needs of men are necessary to eliminate the health disparities that afflict underserved men. The following article compiles and shares some of the lessons learned as experienced by three Community Voices sites that have been active in men's health. Community Voices Miami's Overtown Men's Health Study, Denver Health Men's Health Initiative, and Baltimore Men's Health Center are working to address the health needs of men in some of the most vulnerable communities in the United States. Examples of community-specific assessment of men's needs, community engagement, service delivery, service to special populations, marketing, addressing sustainability, and advances in public policy to improve men's health are presented.
Wittgenstein's Voice: Reading, Self-Understanding, and the Genre ofPhilosophical Investigations
Authors: Hagberg Garry L.
Published: November 2007

Since the time of Socrates and perhaps even that of Heraclitus, philosophical reflection has found expression in some form of autobiographical or selfinterrogative work; one of the outstanding exemplars of this mode of philosophical engagement was Augustine's Confessions. This mode and that book particularly exerted a profound influence on Ludwig Wittgenstein, and in a fairly self-contained sector of his masterpiece, Philosophical Investigations, we see a modernized version of such self-interrogation in action. In his remarks on the experience of reading—a familiar experience that we all too easily take to conform to a Cartesian model—we witness a mind confronting its own temptations to simplify, to adopt misleading philosophical “pictures” or conceptual templates, to hypothesize phantom mental events to fulfill the needs of an unwittingly adopted explanatory schema. And those pictures of reading, as we see here, generate corollary pictures of “self-reading,” of autobiographical writing. A close look at Wittgenstein's self-monitoring analysis, however, reveals the conceptual intricacies of reading and, by extension, some of the parallel intricacies of self-understanding.
Ttrap is an essential modulator of Smad3-dependent Nodal signaling during zebrafish gastrulation and left-right axis determination
Authors: Esguerra Camila V. , Nelles Luc , Vermeire Liesbeth , Ibrahimi Abdelilah , Crawford Alexander D. , Derua Rita , Janssens Els , Waelkens Etienne , Carmeliet Peter , Collen Desiré , Huylebroeck Danny
Published: November 2007

During vertebrate development, signaling by the TGFβ ligand Nodal is critical for mesoderm formation, correct positioning of the anterior-posterior axis, normal anterior and midline patterning, and left-right asymmetric development of the heart and viscera. Stimulation of Alk4/EGF-CFC receptor complexes by Nodal activates Smad2/3, leading to left-sided expression of target genes that promote asymmetric placement of certain internal organs. We identified Ttrap as a novel Alk4- and Smad3-interacting protein that controls gastrulation movements and left-right axis determination in zebrafish. Morpholino-mediated Ttrap knockdown increases Smad3 activity, leading to ectopic expression of snail1a and apparent repression of e-cadherin, thereby perturbing cell movements during convergent extension, epiboly and node formation. Thus, although the role of Smad proteins in mediating Nodal signaling is well-documented, the functional characterization of Ttrap provides insight into a novel Smad partner that plays an essential role in the fine-tuning of this signal transduction cascade.
Limits to sustained energy intake. X. Effects of fur removal on reproductive performance in laboratory mice
Authors: Król Elżbieta , Murphy Michelle , Speakman John R.
Published: November 2007

The maximum rate of sustained energy intake (SusEI) may limit reproductive effort and other aspects of animal performance. We have previously suggested that lactating mice are not limited centrally by the alimentary tract or peripherally by the mammary glands, but that the limits to SusEI are imposed by the capacity of the animal to dissipate body heat generated as a by-product of processing food and producing milk. To explore the nature of the limits to SusEI, we bred MF1 laboratory mice at 21°C and then dorsally shaved lactating females to reduce their external insulation and thereby elevate their capacity to dissipate body heat. These mice increased their food intake by 12.0% and assimilated on average 30.9 kJ day–1 more energy than unshaved animals. With nearly identical mean litter sizes (11.4 pups for shaved and 11.3 pups for unshaved mice), shaved mothers exported 15.2% (22.0 kJ day–1) more energy as milk than control individuals. The elevated milk production of shaved mice enabled them to wean litters that were 15.4% (12.2 g) heavier than offspring produced by unshaved mice. Our results argue against central, peripheral or extrinsic limits to SusEI at peak lactation and provide strong support for the heat dissipation limit hypothesis. More generally, we see many situations where heat dissipation may be a previously unrecognised factor constraining the evolution of endothermic animals – for example, the latitudinal and altitudinal trends in clutch and litter sizes and the migration patterns of birds.
The predicted growth of the low-Earth orbit space debris environment — an assessment of future risk for spacecraft
Authors: Krisko P H
Published: November 2007

Space debris is a worldwide-recognized issue concerning the safety of commercial, military, and exploration spacecraft. The space debris environment includes both naturally occuring meteoroids and objects in Earth orbit that are generated by human activity, termed orbital debris. Space agencies around the world are addressing the dangers of debris collisions to both crewed and robotic spacecraft. In the United States, the Orbital Debris Program Office at the NASA Johnson Space Center leads the effort to categorize debris, predict its growth, and formulate mitigation policy for the environment from low-Earth orbit (LEO) through geosynchronous orbit.

The current paper presents recent results derived from the NASA long-term debris environment model, LEGEND. It includes the revised NASA sodium potassium droplet model, newly corrected for a factor of two over-estimation of the droplet population. The study indicates a LEO environment that is already collisionally active among orbital debris larger than 1 cm in size. Most of the modelled collision events are non-catastrophic (i.e. they lead to a cratering of the target, but no large scale fragmentation). They take place between impactors smaller than 10 cm and targets larger than 10 cm. Given the small size of the impactor these events would likely be undetectable by present-day measurement means. The activity continues into the future as would be expected. Impact rates of about four per year are predicted by the current study within the next 30 years, with the majority of targets being abandoned intacts (spent upper stages and spacecraft). Still, operational spacecraft do showa small collisional activity that increases over time as the small fragment population increases. And such an event would be potentially mission-ending for the spacecraft.
Design and operational practices for the passivation of spacecraft and launchers at the end of life
Authors: Bonnal C
Published: November 2007

Passivating spacecraft and upper stages at the end of their operational life is a must: numerous in orbit break-ups have been encountered by all space operators due to a lack of proper passivation leading to an explosion triggered by mixture of hypergolic propellants, pressure buildup, or hyper-velocity collision with a small object.

The following paper recalls first the high level guidelines that have to be adopted at international level to achieve proper space debris mitigation, recalls the definition of passivation, then describes the most frequent solutions currently adopted. Several examples, mainly from India and China, are quoted, extracted generally from IADC presentations; they are presented in italics, unmodified. The paper then reviews briefly the main problems encountered during the process of designing the passivation system and operating it.
Test procedures to evaluate spacecraft materials ejecta upon hypervelocity impact
Authors: Siguier J-M , Mandeville J-C
Published: November 2007

A spacecraft is exposed to the risk of collision with orbital debris or meteoroids throughout its orbital lifetime. Part of small debris is produced as ejecta upon impact of particles on spacecraft outer surfaces. In order to mitigate this growing population of orbital debris and obtain a better knowledge of secondary debris production, it is proposed in this document to perform standardized tests on the various materials used for external surfaces.

The approach to assess the behaviour of materials under orbital debris or meteoroid impacts, uses an ejecta model under hypervelocity impact (HVI) to define simple parameters which are able to characterize ejecta production as total mass ejected, size partitioning, velocity, and direction. In order to get comparable results, well defined ground tests are proposed using readily available HVI ranges.

Results of ejecta production have to be implemented in a database which will help in the choice of spacecraft use materials during the design phase, in order to fulfill debris mitigation and to determine the small debris production over the total spacecraft life-time.
Papular acantholytic dyskeratosis presenting as genital warts
Authors: Browne Fiona , Keane Helen , Walsh Maureen , Maw Raymond
Published: November 2007

A 24-year-old woman presented with genital warts which did not respond to treatment. Biopsy confirmed changes in keeping with a diagnosis of Darier's disease. The patient, however, had no other manifestations of Darier's disease, i.e. family history of skin disease, nail changes or other skin site involvement. We propose that this patient has a form of Darier's disease called genital papular acantholytic dyskeratosis.
The outcome of treatment of early latent syphilis and syphilis with undetermined duration in HIV-infected and HIV-uninfected patients
Authors: Manavi K , McMillan A
Published: November 2007

The aim of the study was to compare the outcome of syphilis treatment in HIV-infected and -uninfected patients. An observational study on patients diagnosed with early syphilis in three genitourinary clinics in the UK between January 2003 and June 2005 was conducted. Failure of the initial Venereal Disease Research Laboratory (test) (VDRL) titre to decrease four-fold within 12 months in the absence of history of re-infection was considered as treatment failure. During the study period, 190 HIV-uninfected and 129 HIV-infected patients were diagnosed, and 161 (84%) HIV-uninfected and 100 (77.5%) HIV-positive patients with diagnosis of syphilis who had 24 months follow-up syphilis serology results were included in the study ( P = 0.10). There were 381 and 508 follow-up episodes for HIV-infected and -uninfected patients, respectively, within 24 months. One HIV-infected patient was diagnosed with neuro-syphilis. After 12 months, 102 (63%) HIV-uninfected and 76 (70%) HIV-infected patients were treated ( P = 0.04). On Cox proportional hazard model, successful treatment after 12 months was associated with having VDRL titre more than 1:6 (hazard ratio [HR] 1.011; 95% confidence interval [CI], 1.004–1.019; P = 0.002). Those with negative immunoglobulin M enzyme immunoassay were less likely to have been successfully treated after 12 months (HR 0.676 [95% CI 0.518–0.883]; P = 0.004). HIV sero-status, age, sex group and treatment regimen were not associated with success of treatment. In conclusion, HIV sero-status did not play a role in the outcome of syphilis treatment. Treatment failure in a proportion of HIV-infected patients is due to a slower decline in VDRL titre rather than lack of response to treatment.
The Distribution and Density of Clostridium difficile Toxin Receptors on the Intestinal Mucosa of Neonatal Pigs
Authors: Keel M. K. , Songer J. G.
Published: November 2007

Clostridium difficile is an enteric pathogen affecting a variety of mammals, but it has only recently been diagnosed as a cause of neonatal typhlocolitis in pigs. The most important virulence factors of C. difficile are 2 large exotoxins, toxin A (TcdA) and toxin B (TcdB). TcdA is a potent enterotoxin with effects on host tissues that are dependent upon receptor-mediated endocytosis of the intact toxin. TcdB is an effective cytotoxin, but it apparently does not bind receptors on intact mucosal epithelium. TcdB is much less toxic in vivo unless there is underlying damage to the mucosa, and it is not essential for the virulence of C. difficile. One hypothesis to explain the resistance of most species as neonates (e.g., humans and hamsters) is that they may lack significant numbers of TcdA receptors. The susceptibility of neonatal pigs suggests cells of the gastrointestinal mucosa express sufficient numbers of toxin receptors for lesion development. Immunohistochemical (IHC) assays documented specific binding of TcdA, but not TcdB, to the epithelium of the small and large intestine. The carbohydrate Galα1–3/β1–4GlcNAc-R has been described as an important receptor for TcdA. However, IHC indicated a distribution on cell surfaces much different from that of TcdA binding, suggesting a specific interaction of toxin with an alternative receptor.
Mammary Invasive Micropapillary Carcinoma in Cats: Clinicopathologic Features and Nuclear DNA Content
Authors: Seixas F. , Palmeira C. , Pires M. A. , Lopes C.
Published: November 2007

Invasive micropapillary carcinoma (IMC) is a variant of infiltrating ductal carcinoma of the breast associated with poor outcome. In this study, we report 16 carcinomas of the feline mammary gland displaying histologic features that correspond to IMC of the breast in women. The clinicopathologic findings, overall survival time, disease-free survival time, and nuclear DNA content of these cats were compared with 65 more common invasive mammary carcinomas (other feline mammary carcinoma [FMC]) of nonspecified type. IMC was associated with larger tumor size, higher histologic grade ( P < .0001), deeper muscle invasion ( P = .004), and more frequent lymphovascular invasion and nodal metastases ( P = .009 and P = .001, respectively) than other FMCs. The aneuploid pattern was more frequent in IMC lesions. IMCs were also associated with lower survival rates. In summary, all cases of feline IMC were associated with clinicopathologic features of high biologic aggressiveness and should be classified as independent histologic types of FMC.
Equine Multinodular Pulmonary Fibrosis: A Newly Recognized Herpesvirus-Associated Fibrotic Lung Disease
Authors: Williams K. J. , Maes R. , Del Piero F. , Lim A. , Wise A. , Bolin D. C. , Caswell J. , Jackson C. , Robinson N. E. , Derksen F. , Scott M. A. , Uhal B. D. , Li X. , Youssef S. A. , Bolin S. R.
Published: November 2007

Pulmonary fibrosis and interstitial lung disease are poorly understood in horses; the causes of such conditions are rarely identified. Equine herpesvirus 5 (EHV-5) is a γ-herpesvirus of horses that has not been associated with disease in horses. Pathologic and virologic findings from 24 horses with progressive nodular fibrotic lung disease associated with EHV-5 infection are described and compared with 23 age-matched control animals. Gross lesions consisted of multiple nodules of fibrosis throughout the lungs. Histologically, there was marked interstitial fibrosis, often with preservation of an “alveolar-like” architecture, lined by cuboidal epithelial cells. The airways contained primarily neutrophils and macrophages. Rare macrophages contained large eosinophilic intranuclear viral inclusion bodies; similar inclusion bodies were also found cytologically. The inclusions were identified as herpesviral-like particles by transmission electron microscopy in a single horse. In situ hybridization was used to detect EHV-5 nucleic acids within occasional macrophage nuclei. With polymerase chain reaction (PCR), the herpesviral DNA polymerase gene was detected in 19/24 (79.2%) of affected horses and 2/23 (8.7%) of the control horses. Virus genera–specific PCR was used to detect EHV-5 in all of the affected horses and none of the control horses. EHV-2 was detected in 8/24 (33.3%) of affected horses and 1/9 (11.1%) of the control horses. This disease has not been reported before, and the authors propose that based upon the characteristic gross and histologic findings, the disease be known as equine multinodular pulmonary fibrosis. Further, we propose that this newly described disease develops in association with infection by the equine γ-herpesvirus, EHV-5.
A Soluble Secreted Glycoprotein (eCLCA1) is Overexpressed Due to Goblet Cell Hyperplasia and Metaplasia in Horses with Recurrent Airway Obstruction
Authors: Range F. , Mundhenk L. , Gruber A. D.
Published: November 2007

The equine putative chloride channel protein eCLCA1 is thought to be critically involved in the pathogenesis of recurrent airway obstruction (RAO) via modulation of the hydration of airway mucins. A recent study revealed a strong increase of eCLCA1 messenger ribonucleic acid (mRNA) in the lungs of horses with RAO. In this study, eCLCA1 protein and mRNA expression were quantified in airway goblet cells of 9 horses affected with RAO and 9 control horses by using immunohistochemistry and laser microdissection followed by real-time quantitative reverse transcription polymerase chain reaction, respectively. Horses affected by RAO had strong goblet cell metaplasia in bronchioles and goblet cell hyperplasia in bronchi and the trachea. Expression of the eCLCA1 protein was tightly linked to all airway goblet cells in both groups. No differences were detected in the ratio of eCLCA1 mRNA copy numbers to the mRNA copy numbers of the housekeeping gene EF-1a per goblet cell between horses affected with RAO and unaffected horses, suggesting that the increase in eCLCA1 expression is because of increased numbers of goblet cells and not transcriptional upregulation of the eCLCA1 gene. In addition, biochemical analyses of the eCLCA1 protein after in vitro translation and heterologous expression in cultured cells revealed that eCLCA1 is a secreted glycoprotein and not an integral membrane protein. Taken together, the results suggest that eCLCA1 mediates its effect as a soluble constituent of airway mucins that is overexpressed in RAO airways because of goblet cell hyperplasia and metaplasia, not transcriptional upregulation.
Feline Cutaneous Viral Papilloma Associated with Human Papillomavirus Type 9
Authors: Munday J. S. , Hanlon E. M. , Howe L. , Squires R. A. , French A. F.
Published: November 2007

A 12-year-old domestic Shorthaired cat developed a multinodular exophytic mass on the dorsal surface of the nose. The skin surrounding the mass was nonpigmented, and actinic keratosis had been diagnosed in this area 3 years previously. Histologic examination revealed hyperkeratosis, epidermal hyperplasia, papillomatosis, koilocytosis, and possible intranuclear viral inclusions. Polymerase chain reaction amplified papillomaviral deoxyribonucleic acid from formalin-fixed samples of the lesion. Sequencing of the amplicon revealed 98% similarity to human papillomavirus (HPV) type 9. To the authors' knowledge, this is only the second reported feline cutaneous viral papilloma. In addition, this is the first report of a feline papilloma being associated with an HPV.
Sarcocystis neurona Encephalitis in a Dog
Authors: Cooley A. J. , Barr B. , Rejmanek D.
Published: November 2007

A 1.5–year-old male Feist dog was presented to a veterinarian for reluctance to stand on the hind legs. Treatment included dexamethasone and resulted in a favorable initial response, but posterior paresis returned and progressed to recumbency, hyperesthesia, and attempts to bite the owner. The dog was euthanized. The brain was negative for rabies by fluorescent antibody analysis. Multiple foci of encephalitis were found in the cerebrum and particularly in the cerebellum. Protozoa morphologically consistent with Sarcocystis sp. were identified at sites of intense inflammation and malacia. Additionally, multiple schizonts were identified in areas without inflammation. Immunohistochemistry using both polyclonal and monoclonal antibodies specific for Sarcocystis neurona was strongly positive. No reaction to polyclonal antisera for Toxoplasma gondii or Neospora caninum was found. Polymerase chain reaction confirmed that the protozoa were S. neurona. Additional aberrant hosts for S. neurona other than horses have been identified, but S. neurona encephalitis has not been documented previously in the dog.