bluuebunny/crossref_metadata_2025 huggingface dataset:
Design of UWB Filter with WLAN Notch
Authors: Kumar Harish , Upadhayay MD.
Published: April 2012

UWB technology- (operating in broad frequency range of 3.1–10.6 GHz) based filter with WLAN notch has shown great achievement for high-speed wireless communications. To satisfy the UWB system requirements, a band pass filter with a broad pass band width, low insertion loss, and high stop-band suppression are needed. UWB filter with wireless local area network (WLAN) notch at 5.6 GHz and 3 dB fractional bandwidth of 109.5% using a microstrip structure is presented. Initially a two-transmission-pole UWB band pass filter in the frequency range 3.1–10.6 GHz is achieved by designing a parallel-coupled microstrip line with defective ground plane structure using GML 1000 substrate with specifications: dielectric constant 3.2 and thickness 0.762 mm at centre frequency 6.85 GHz. In this structure aλ/4 open-circuited stub is introduced to achieve the notch at 5.6 GHz to avoid the interference with WLAN frequency which lies in the desired UWB band. The design structure was simulated on electromagnetic circuit simulation software and fabricated by microwave integrated circuit technique. The measured VNA results show the close agreement with simulated results.
Efficacy and Safety of Low-Dose Everolimus as Maintenance Immunosuppression in Cardiac Transplant Recipients
Authors: Fuchs Uwe , Zittermann Armin , Schulz Uwe , Gummert Jan F.
Published: April 2012

For cardiac transplant (CTx) recipients, the recommended everolimus (EVL) dose is 0.75 mg bid or 1.5 mg bid and the target trough blood level is 3–8μg/L. We studied a cohort of 56 CTx patients with chronic kidney disease receiving 0.75 mg bid EVL to maintain blood levels of 5–8 ug/L (designated RD group) and a cohort of 51 CTx patients with chronic kidney disease receiving 0.5 mg bid to maintain blood levels of 3–5 ug/L (designated LD group). The primary endpoint was a composite of death, rejection and premature EVL discontinuation up to 1 year after introduction of EVL. The primary endpoint was reached by 32% of patients in the LD group and by 41.1% of patients in the RD group (). Biochemical safety parameters were comparable in both groups. Our results indicate that low-dose EVL may be as effective and safe as regular dose EVL.
A Seropositive Nodular Rheumatoid Polyarthritis without Arthritis: Does It Exist?
Authors: Ben Fredj Ismail Fatma , Rezgui Amel , Karmani Monia , Ben Abdallah Olfa , Azzebi Samira , Laouani Kechrid Chedia
Published: April 2012

The rheumatoid polyarthritis is the most frequent chronic polyarthritis. It affects essentially the woman between 40 and 60 years. Rheumatic subcutaneous nodules and tenosynovitis are usually associated with seropositive symptomatic rheumatoid polyarthritis. It is, however, rare that they constitute the essential clinical expression of the disease. In this case, it makes dispute another exceptional form of rheumatoid arthritis such as rheumatoid nodulosis. A 60-year-old woman was hospitalized for tumefaction of the dorsal face of the right hand evolving two months before. The clinical examination found subcutaneous nodules from which the exploration ended in rheumatoid nodules with tenosynovitis. The evolution after four years was favourable under corticosteroid therapy, methotrexate, and colchicine.
Antibody Targeting of Cell-Bound MUC1 SEA Domain Kills Tumor Cells
Authors: Pichinuk Edward , Benhar Itai , Jacobi Oded , Chalik Michael , Weiss Lotem , Ziv Ravit , Sympson Carolyn , Karwa Amolkumar , Smorodinsky Nechama I. , Rubinstein Daniel B. , Wreschner Daniel H.
Published: April 2012

The cell-surface glycoprotein MUC1 is a particularly appealing target for antibody targeting, being selectively overexpressed in many types of cancers and a high proportion of cancer stem–like cells. However the occurrence of MUC1 cleavage, which leads to the release of the extracellular α subunit into the circulation where it can sequester many anti-MUC1 antibodies, renders the target problematic to some degree. To address this issue, we generated a set of unique MUC1 monoclonal antibodies that target a region termed the SEA domain that remains tethered to the cell surface after MUC1 cleavage. In breast cancer cell populations, these antibodies bound the cancer cells with high picomolar affinity. Starting with a partially humanized antibody, DMB5F3, we created a recombinant chimeric antibody that bound a panel of MUC1+ cancer cells with higher affinities relative to cetuximab (anti-EGFR1) or tratuzumab (anti-erbB2) control antibodies. DMB5F3 internalization from the cell surface occurred in an efficient temperature-dependent manner. Linkage to toxin rendered these DMB5F3 antibodies to be cytotoxic against MUC1+ cancer cells at low picomolar concentrations. Our findings show that high-affinity antibodies to cell-bound MUC1 SEA domain exert specific cytotoxicity against cancer cells, and they point to the SEA domain as a potential immunogen to generate MUC1 vaccines. Cancer Res; 72(13); 3324–36. ©2012 AACR.
Serum Cholesterol and mTOR Inhibitors: Surrogate Biomarker or Epiphenomenon?
Authors: Cho Daniel C. , Atkins Michael B.
Published: April 2012

Lee and colleagues report that increase in serum cholesterol is associated with improved clinical outcomes in patients with renal cell carcinoma treated with temsirolimus. Although these findings must be validated prospectively, it should also be determined if this marker is a true mechanism-based toxicity or an epiphenomenon associated with therapy. Clin Cancer Res; 18(11); 2999–3001. ©2012 AACR.
XIAP Inhibition and Generation of Reactive Oxygen Species Enhances TRAIL Sensitivity in Inflammatory Breast Cancer Cells
Authors: Allensworth Jennifer L. , Aird Katherine M. , Aldrich Amy J. , Batinic-Haberle Ines , Devi Gayathri R.
Published: April 2012

We recently identified superoxide dismutase (SOD) overexpression and decreased induction of reactive oxygen species (ROS)-mediated apoptosis in models of inflammatory breast cancer (IBC) cells with acquired therapeutic resistance. This population of cells has high expression of X-linked inhibitor of apoptosis protein (XIAP), which inhibits both extrinsic and intrinsic apoptosis pathways. We therefore wanted to evaluate the effect of classical apoptosis-inducing agent TRAIL, a proapoptotic receptor agonist that selectively triggers death receptor (DR)-mediated apoptosis in cancer cells, in the IBC acquired resistance model. XIAP levels and subsequent inhibition of caspase activity inversely correlated with TRAIL sensitivity in our models of IBC. These include SUM149, a basal-type cell line isolated from primary IBC tumors and isogenic SUM149-derived lines rSUM149 and SUM149 wtXIAP, models of acquired therapeutic resistance with endogenous and exogenous XIAP overexpression, respectively. Inhibition of XIAP function using embelin, a plant-derived cell permeable small molecule, in combination with TRAIL caused a synergistic decrease in cell viability. Embelin treatment resulted in activation of extracellular signal–regulated kinase (ERK)1/2 and ROS accumulation, which correlated with downregulation of antioxidant protein SOD1 and consumption of redox modulator reduced glutathione in the XIAP-overexpressing cells. Simultaneous treatment with an SOD mimic, which protects against ROS accumulation, reversed the decrease in cell viability caused by embelin + TRAIL treatment. Embelin primes IBC cells for TRAIL-mediated apoptosis by its direct action on the anti-caspase activity of XIAP and by shifting the cellular redox balance toward oxidative stress–mediated apoptosis. Thus, ROS modulators represent a novel approach to enhance efficacy of TRAIL-based treatment protocols in IBC. Mol Cancer Ther; 11(7); 1518–27. ©2012 AACR.
Epidemiology of Group B Streptococcus ST-17 Clone in Pregnant Women of South Taiwan
Authors: Ma Yen-Ying , Hsu Te-Yao , Shen Shu-Yun , Huang Tsi-Shu , Moh Jau-Sung , Liu Cheng-Min , Ou Chia-Yu , Lin Hao
Published: April 2012

Objectives: We aimed to utilize a simple molecular assay to simultaneously detect both group B Streptococcus (GBS) and virulent ST-17 rectovaginal colonization. We also attempted to estimate the prevalence of maternal GBS and ST-17 carriers and to evaluate their seasonal association. Subjects and Methods: We used an optimized multiplex PCR method employing scp-B and ST-17 primers to analyze DNA extracted from rectovaginal swabs of 3,064 cases collected over 3 years. The incidence trends, seasonal variations, and temperature preference were analyzed. Results: The overall prevalence of maternal colonization for GBS and ST-17 clone were 13.25 and 2.48%, respectively. The ST-17 to GBS ratio was 18.72%. The occurrence of ST-17 colonization was significantly associated with seasonal variations with a preference for lower temperatures. Conclusions: We developed a novel multiplex PCR method suitable for the simultaneous detection of GBS and ST-17 clone. The phenomenon of lower temperature preference for ST-17 clone necessitates further investigation. The epidemiological data for GBS and ST-17 incidence are especially important to establish a public policy for universal GBS screening in the future.
Fahr’s Disease with Oral Manifestations: Report of a Rare Case
Authors: Aditya Amita , Lele Shailesh , Aditya Priyam
Published: April 2012

Objective: The purpose of this article is to discuss the general and oral findings in a patient with Fahr’s disease, an uncommon disorder. Clinical Presentation and Intervention: A patient presented with the complaint of partial anodontia, but further clinical and radiographic investigations showed a myriad of findings including stunted growth, osteoporosis and pathological calcifications. Oral findings included oligodontia and advanced periodontitis in relation to the present teeth. Full-mouth rehabilitation was eventually planned for the patient. Conclusion: This case shows the necessity for dentists to be aware of symptoms associated with Fahr’s syndrome in order to make appropriate referrals and to enable diagnosis and treatment.
Signaling Pathways Mediating Chemokine Induction in Keratinocytes by Cathelicidin LL-37 and Flagellin
Authors: Nijnik Anastasia , Pistolic Jelena , Filewod Niall C.J. , Hancock Robert E.W.
Published: April 2012

Cathelicidin LL-37 is a multifunctional immunomodulatory and antimicrobial host defense peptide that has an important role in the immune defenses of the skin and other epithelial barriers. We have previously demonstrated that at physiological concentrations LL-37 synergistically augments the production of immune mediators in response to microbial compounds in human primary keratinocytes. Here we define the signaling mechanisms responsible for this activity. We demonstrate that inhibition of Src family kinases (SFKs) strongly inhibited the synergistic chemokine production in response to LL-37 and flagellin in keratinocytes. SFK activation was induced by LL-37 stimulation and was required for the downstream activation of Akt (protein kinase B) and the transcription factors CREB and ATF1. In cells stimulated with LL-37 and flagellin together, Akt activation was primarily induced by LL-37, while both flagellin and LL-37 contributed to the activation of CREB and ATF1 and consequently chemokine induction. The purinergic receptor P2X7 was identified as the receptor upstream of SFK activation in LL-37-stimulated keratinocytes. Overall, these findings established the P2X7–SFK–Akt–CREB/ATF1 signaling pathway activated by LL-37 in primary keratinocytes. These signaling mechanisms mediated the synergistic effects of LL-37 on chemokine production in flagellin-stimulated keratinocytes, and thus might have a role in the immune defenses of the skin and possibly other epithelial barriers.
Hysteroscopic Resection of Uterine Septum and Reproductive Outcome in Women with Unexplained Infertility
Authors: Bakas Panagiotis , Gregoriou Odyseas , Hassiakos Dimitrios , Liapis Angelos , Creatsas Maria , Konidaris Sokratis
Published: April 2012

Background/Aims: To investigate the reproductive outcome after hysteroscopic resection of uterine septum in women with septate uterus and otherwise idiopathic primary infertility. Methods: Sixty-eight patients with septate uterus and idiopathic primary infertility were included in this prospective observational study. All patients underwent hysteroscopic metroplasty with scissors under general anesthesia. Main outcome measures were clinical pregnancy rate, live birth and abortion rate at 12 months’ follow-up and at mean follow-up time. Results: At 12 months’ follow-up, the clinical pregnancy rate, the live birth rate and the abortion rate were 44% (30/68), 36.8% (25/68) and 16.6% (5/30), respectively. At total follow-up time, the overall pregnancy rate, the live birth rate and the abortion rate were 53.8% (35/65), 41.5% and 14.2% (7/35), respectively, while the stillbirth rate was 2.8% (1/35). Conclusion: Hysteroscopic metroplasty in women with septate uterus and unexplained infertility could improve clinical pregnancy rate and live birth rate in patients with otherwise unexplained infertility. If such a patient is looking for a spontaneous pregnancy, this is more likely to occur during the first 15 months following the procedure.
Assessment of Maternal Heart-Rate Variability during Labor Using Wavelet-Based Power Spectral Analysis
Authors: Suzuki Noritsugu , Sugawara Junichi , Kimura Yoshitaka , Nagase Satoru , Okamura Kunihiro , Yaegashi Nobuo
Published: April 2012

Objective: Changes in the maternal cardiac autonomic nervous system were assessed in the presence and absence of uterine contractions by analyzing maternal heart-rate variability during labor using wavelet-based power spectral analysis. Methods: We assessed the heart-rate variability in 20 pregnant women during labor and in 15 pregnant women with threatened premature labor with the use of wavelet-based power spectral analysis. Results: There was no significant difference in high-frequency components between the uterine contraction and non-contraction periods. The intensities of the low-frequency and very-low-frequency components during uterine contractions were significantly stronger than the corresponding intensities between uterine contractions. Conclusion: Maternal sympathetic activity was upregulated during uterine contractions, and influenced the very-low-frequency components. This method of analysis may represent a novel means of identifying uterine contractions.
Efficacy of Electrosurgical Bipolar Vessel Sealing for Abdominal Hysterectomy with Uterine Myomas More than 14 Weeks in Size: A Randomized Controlled Trial
Authors: Aydin Cetin , Yildiz Askin , Kasap Burcu , Yetimalar Hakan , Kucuk Ismail , Soylu Ferit
Published: April 2012

Objective: To compare electrosurgical bipolar vessel sealing with conventional suturing during abdominal hysterectomy. Methods: This was a randomized controlled prospective study. A total of 88 patients with myoma uteri larger than 14 weeks in size were divided into two groups: group A (44 patients who were administered the LigaSure vessel sealing system during surgery) and group B (44 patients who were administered conventional sutures during surgery). Total abdominal hysterectomy was performed in all patients. Hemoglobin reduction, operation time, hospital stay and visual analogue scale parameters of patients in both groups were compared. SPSS 16.0 was utilized in statistical analyses. The outcomes with a 95% confidence interval and a p value of less than 0.05 were regarded as significant. Results: When the two groups were compared, it was observed that the LigaSure device significantly reduced the operation time (p < 0.05). Nevertheless, no statistically significant difference was determined in hemoglobin reduction, hospital stay and visual analogue scale parameters between the two groups. Conclusion: In myoma uteri cases larger than 14 weeks in size, LigaSure vessel sealing is a secure and comfortable method for surgeons to achieve shorter operation times in abdominal hysterectomy.
Gene Polymorphisms and High-Altitude Pulmonary Edema Susceptibility: A 2011 Update
Authors: Luo Yongjun , Zou Yanlong , Gao Yuqi
Published: April 2012

High-altitude pulmonary edema (HAPE) is a severe disease caused by high-altitude hypoxia. Since some individuals are more susceptible to high altitude than others, the incidence is variable and cannot be predicted. Furthermore, multiple genes can contribute to the occurrence of HAPE, making it even more difficult to predict. The genes associated with HAPE include those in the renin-angiotensin-aldosterone system pathway, the nitric oxide pathway and the hypoxia-inducible factor pathway. Other genes associated with HAPE include tyrosine hydroxylase (TH), vascular endothelial growth factor (VEGF), pulmonary surfactant proteins and β2-adrenergic receptor. The association of the polymorphisms of these genes with HAPE susceptibility has previously been investigated. Among the genes evaluated, polymorphisms of NOS3, ACE, CYP11B2, Hsp70 and endothelin-1 and pulmonary surfactant proteins A1 and A2 were shown to be associated with HAPE incidence, while associations between TH, VEGF and HAPE remain to be fully elucidated. Novel technological approaches, including genome-wide association studies and next-generation sequencing, are currently being used to identify new HAPE susceptibility genes. The goal of this review article is to summarize the current literature and to define the outstanding areas of research that need to be explored to advance our ability to predict when HAPE will occur.
Cerebral Venous Sinus Thrombosis Associated with Spontaneous Intermittent Cerebrospinal Fluid Rhinorrhea: A Case Report
Authors: Utku Uygar , Gokce Mustafa , Senoglu Mehmet
Published: April 2012

Objectives: To present a rare case of cerebral venous sinus thrombosis (CVST). Clinical Presentation and Intervention: A 43-year-old woman presented with coma and was diagnosed as a case of CVST. She recovered in a few days with heparin treatment. Many possible risk factors for CSVT were negative in the patient but intermittent cerebrospinal fluid (CSF) rhinorrhea was accidentally noticed. Cerebral computed tomography and magnetic resonance imaging were done. The patient was diagnosed as having spontaneous intermittent CSF rhinorrhea due to a defect in the base of the skull. Conclusions: This case showed the importance of being aware that a defect in the base of the skull may lead to intermittent CSF rhinorrhea in patients with CVST.
Visual Changes after Encircling Band Removal
Authors: Liao Xin , Liu Xiao-qiang , Li Hui , Xu Chong , Wang Fang
Published: April 2012

Aims: Visual changes over 1 year in 40 eyes were studied in 40 patients after removing scleral encircling bands. Methods: Encircling bands in 20 eyes were cut and removed. The fellow eyes of the above patients and the eyes of another 20 patients with encircling bands that were not removed over the same period served as controls. Intraocular pressure, best-corrected visual acuity, axial length, microperimetry and corneal topography were evaluated preoperatively and at 1 week and 1, 3 and 6 months postoperatively. Results: Both best-corrected visual acuity and astigmatism were significantly improved at 6 months postoperatively (p < 0.05 for each). Microperimetry examination showed that 2° fixation stability increased by 52.6% (p < 0.01), 4° fixation stability increased by 17.65% (p < 0.01) and 10° mean sensitivity increased by 30% (p < 0.05). However, the pre- and postoperative axial length showed no significant difference. Conclusion: These results suggest that removing scleral encircling bands within the desired time postoperatively may give better visual outcomes due to decreased corneal astigmatism and improved average macular retinal light sensitivity. Removal of the encircling band is a safe, simple and feasible operation.
Choroidal Thickness in Open-Angle Glaucoma Measured by Spectral-Domain Scanning Laser Ophthalmoscopy/Optical Coherence Tomography
Authors: Cennamo Gilda , Finelli Marialuisa , Iaccarino Gennarfrancesco , de Crecchio Giuseppe , Cennamo Giovanni
Published: April 2012

Aims: To measure macular choroidal thickness in healthy and glaucomatous eyes using spectral-domain scanning laser ophthalmoscopy/optical coherence tomography. Methods: Choroidal thickness was measured in 21 healthy eyes and 16 glaucomatous eyes. Choroidal thickness was measured under the fovea and at 500-µm intervals from the foveal center to 4 mm in the nasal and temporal directions. Vessels were counted in a macular area of 8,000 µm2. Only choroidal vessels with a horizontal diameter of at least 155 µm and a vertical diameter of at least 50 µm were considered. Results: The mean choroidal thickness was greatest below the fovea, i.e. 343.8 µm (SD ±29.06) in controls and 411.56 µm (SD ±33.60; p < 0.001) in the glaucomatous group. The mean vertical diameter was significantly greater (p = 0.008) in glaucomatous eyes (112.18 ± 37.64 µm) than in healthy eyes (103.98 ± 25.67 µm), whereas the luminal area of vessels was significantly larger (p = 0.3) in glaucomatous eyes (39,157.34 ± 21,657.23 µm2) than in healthy eyes (43,779.84 ± 22,874.87 µm2). Conclusions: We show that choroidal thickness is increased in glaucomatous eyes due to an increase in both the vertical diameter and the luminal area of the vessels. This seems to implicate the choroid in the pathogenesis of open-angle glaucoma.
Pathology Associated with Optical Coherence Tomography Macular Bending due to either Dome-Shaped Macula or Inferior Staphyloma in Myopic Patients
Authors: Coco Rosa M. , Sanabria M. Rosa , Alegría Javier
Published: April 2012

Purpose: To evaluate the prevalence of and describe the pathology associated with macular bending (MB) defined as a smooth macular elevation found in optical coherence tomography (OCT) of patients with high myopia related to either dome-shaped macula (DSM) or the border of an inferior staphyloma. Procedures: We reviewed the 330 files of all highly myopic patients in our database that had had an OCT performed in the last 5 years. Main outcome measures were MB prevalence and its associated pathology. Results: Sixty-eight eyes from 45 patients (13.63%) presented MB; 23 bilateral, 40 in a posterior pole or macular staphyloma and 21 in an inferior staphyloma. Eighteen eyes presented choroidal neovascularization (CNV), 7 subretinal fluid without CNV, 11 retinoschisis and 3 a macular hole which had been stable for years. No differences were found in the rate of complications between patients with DSM or inferior staphyloma. Conclusions: MB is not an uncommon clinical feature. Associated pathology prevalence in MB was elevated and similar in posterior and inferior staphylomas.
Hepatic Arterial Embolization versus Chemoembolization in the Treatment of Liver Metastases from Well-Differentiated Midgut Endocrine Tumors: A Prospective Randomized Study
Authors: Maire Frédérique , Lombard-Bohas Catherine , O’Toole Dermot , Vullierme Marie-Pierre , Rebours Vinciane , Couvelard Anne , Pelletier Anne Laure , Zappa Magaly , Pilleul Frank , Hentic Olivia , Hammel Pascal , Ruszniewski Philippe
Published: April 2012

Background: Liver surgery is the best treatment for endocrine liver metastases, but it is often impossible due to diffuse disease. Systemic chemotherapy is poorly effective. Hepatic arterial embolization (HAE) and chemoembolization (HACE) have shown efficacy but have never been compared. Patients and Methods: Patients with progressive unresectable liver metastases from midgut endocrine tumors were randomly assigned to receive HAE or HACE (two procedures at 3-month interval). The primary end point was the 2-year progression-free survival (PFS) rate. Secondary end points were response rates, overall survival, and safety. Results: Twelve patients were assigned to receive HACE and 14 to receive HAE. The patient characteristics were well matched across the treatment arms. The 2-year PFS rates were 38 and 44% in the HACE and HAE arms, respectively (p = 0.90). Age, gender, previous resection of the primary tumor or liver metastases, extent of liver involvement, and concomitant treatment with somatostatin analogues were not associated with changes in PFS, whereas elevated baseline urinary 5-HIAA and serum chromogranin A levels were associated with shorter PFS. The 2-year overall survival rates were 80 and 100% in the HACE and HAE arms, respectively (p = 0.16). The disease control rate on CT scan was 95%. Grade 3 toxicity occurred in 19% of patients, with no treatment-related deaths and no differences in the treatment arms. Conclusion: HACE and HAE are safe and permit tumor control in 95% of patients with progressive liver metastases from midgut endocrine tumors. The 2-year PFS was not higher among patients receiving HACE, not favoring the hypothesis of an additive efficacy of arterial chemotherapy or embolization alone.
Lymph Node Macrophages
Authors: Gray Elizabeth E. , Cyster Jason G.
Published: April 2012

Lymph node (LN) macrophages have long been known for their efficient uptake of lymph-borne antigens. A convergence of studies on innate and adaptive immune responses has led to exciting recent advances in understanding their more specialized properties: presenting antigens to B cells, dendritic cells and T cells, producing trophic factors and cytokines, and, remarkably, being permissive for viral infection, a property critical for mounting anti-viral responses. LN macrophages have been traditionally divided into subsets based on their subcapsular sinus and medullary locations. Here, we classify LN macrophages into three subsets: subcapsular sinus macrophages, medullary sinus macrophages and medullary cord macrophages. We review the literature regarding the roles of these cells in innate and adaptive immune responses and requirements for their development. We also discuss challenges associated with their purification as well as the existence of additional heterogeneity among LN macrophages.
Can We Rely on PET in the Follow-Up of Advanced Seminoma Patients?
Authors: Siekiera Jerzy , Małkowski Bogdan , Jóźwicki Wojciech , Jasiński Miłosz , Wronczewski Andrzej , Pietrzak Tomasz , Chmielowska Ewa , Petrus Andrzej , Kamecki Krzysztof , Mikołajczak Witold , Kraśnicki Krzysztof , Chłosta Piotr , Drewa Tomasz
Published: April 2012

The management of residuals after completion of chemotherapy in advanced seminoma is controversial. It has been proposed that fluorodeoxyglucose-positron emission tomography (FDG-PET) can be used as a follow-up. In this study we investigated FDG-PET as a follow-up tool in advanced seminoma patients treated previously with chemotherapy or radiotherapy. Thirty-seven patients assigned to an advanced seminoma group based on CT and/or FDG-PET/CT and then treated with chemotherapy were included in the study. All these patients underwent FDG-PET/CT examination as a part of the follow-up scheme. Patients underwent retroperitoneal lymph node dissection (RPLND), radiotherapy, or were followed clinically by CT and/or PET/CT every 6 months. In 8 cases FDG-PET was positive: 5 of them underwent RPLND and 3 radiotherapy. Two patients with negative FDG-PET but positive CT also underwent RPLND. The remaining patients with negative FDG-PET results were followed up. FDG-PET/CT was false positive in one case >3 cm and one <3 cm, in 6 cases >3 cm it was true negative. While FDG-PET can find a viable tumor, there also is an important question of false positive results. It was clinically proven that a negative FDG-PET was correlated with stable disease, but we were unable to examine specimens in these cases.
Simultaneous Treatment of Renal Cysts and Stones with Single-Session Retroperitoneoscopic Renal Cyst Decortication and Retroperitoneoscopy-Assisted Percutaneous Nephrolithotomy
Authors: Qiu Jianguang , Wang Dejuan , Chen Xihui , Fang Youqiang , Lei Hua , Yan Xiaoxu , Gao Xin
Published: April 2012

Introduction: To determine the safety and efficacy of single-session retroperitoneoscopic renal cyst decortication in conjunction with retroperitoneoscopy-assisted percutaneous nephrolithotomy (PCNL) for simultaneous treatment of renal cysts and stones. Patients and Methods: We enrolled 15 patients (10 men and 5 women, mean age 41 years), who underwent one-stage retroperitoneoscopic renal cyst decortication and retroperitoneoscopy-assisted PCNL between January 2008 and May 2009 for symptomatic renal cysts and concomitant large kidney stones (mean stone area 6.6 cm2). Intraoperative blood loss, duration of operation, and postoperative complications were evaluated. Median follow-up time was 22 months (range 12–26). Results: Average total operative time was 83 ± 12 min and mean duration of PCNL was 45 ± 5 min. Mean estimated blood loss was 80 ± 21 ml. A plain abdominal radiograph revealed an absence of residual stones in all cases. No cyst recurrence occurred within the follow-up period. The mean pre- and postoperative pain score was 7.3 ± 0.8 and 2.8 ± 0.6, respectively. All patients resumed ambulatory activities on the first postoperative day. No severe complications related to the procedure were encountered. Conclusion: The combined laparoscopic approach for simultaneous treatment of renal cysts and stones is safe and feasible. These results encourage further studies to determine long-term outcomes of this combined surgery.
Prognostic Value of Synaptophysin and Chromogranin A Expression in Patients Receiving Palliative Chemotherapy for Advanced Non-Small-Cell Lung Cancer
Authors: Kowalski Dariusz M. , Krzakowski Maciej , Jaśkiewicz Piotr , Olszewski Włodzimierz , Janowicz-Żebrowska Anna , Wojas-Krawczyk Kamila , Krawczyk Paweł
Published: April 2012

Background: Chemotherapy is the principal treatment method for patients with advanced non-small-cell lung cancer (NSCLC). Treatment with platinum-based and novel chemotherapeutic regimens, compared to monotherapy, slightly increases the response rates to 20-40%. The predictive and prognostic values of molecular factors are highly variable; however, data on clinical-demographic factors are still burdened by significant limitations. Objectives: The aim of this study was to assess the prognostic value of synaptophysin and chromogranin A protein expression in patients receiving palliative chemotherapy for advanced NSCLC. Methods: The study population consisted of 23 women and 116 men. The median age was 57.3 years. Expression of synaptophysin and chromogranin was assessed using a two-step model of immunohistochemical staining. Level 0 represented lack of activity, while level 1 represented its expression. Results: Expression of synaptophysin and chromogranin A was observed in 12 (8.6%) and 5 (3.6%) patients, respectively. The risk of death was significantly lower in patients with expression of synaptophysin (p = 0.008) and chromogranin A (p = 0.014). The 12- and 24-month survival rate of patients with synaptophysin expression was 64% (95% CI 0.35-0.93), while for patients without expression it was 46% (95% CI 0.36-0.56) and 16% (95% CI 0.07-0.25), respectively. The 12- and 24-month survival rate of patients with chromogranin expression was 80% (95% CI 0.44-1.00), while for chromogranin A-negative patients it was 47% (95% CI 0.37-0.57) and 19% (95% CI 0.10-0.28), respectively. We did not observe associations between expression of synaptophysin and chromogranin A and the other typical prognostic factors. Conclusions: Expression of synaptophysin and chromogranin A was associated with a longer median overall survival and might have prognostic value. These results should be confirmed in a prospective study.
From Furuncle to Axillary Web Syndrome: Shedding Light on Histopathology and Pathogenesis
Authors: Rashtak Shadi , Gamble Gail L. , Gibson Lawrence E. , Pittelkow Mark R.
Published: April 2012

Axillary web syndrome (AWS) is defined as a cord-like structure extending from the axilla to the medial arm following axillary surgery in women with breast cancer. There is only limited literature on the pathogenesis of this syndrome and the etiology of the cord. A 57-year-old man presented with a band-like skin depression and tightness over the medial aspect of his arm extending from the axilla to the antecubital fossa following development of a furuncle in the ipsilateral axilla. Histopathologic examination of the ‘band’ revealed fibroblastic proliferation surrounding the lymphatic vessel which was identified by presence of an obvious valve as well as positive staining for D2-40, a specific marker for lymphatic endothelium. This is the first report of AWS following axillary furunculosis. This case adds to the limited data on the histopathology of AWS, further confirming the etiology of the ‘cord’ to be of lymphatic origin.
Determinants of Pancreatic Islet Development in Mice and Men: A Focus on the Role of Transcription Factors
Authors: Lin Chia-Lei Vivian , Vuguin Patricia Myriam
Published: April 2012

The development of the endocrine pancreas is regulated by several cell-matrix interactions that generate a diverse array of intracellular signals determining the progression of a multipotent progenitor to a mature endocrine cell. This process involves interactions between the epithelium, mesenchyma, and endothelial cells. Later in development, coordinated signaling contributes to the maintenance of the differentiated endocrine cell phenotype. It has been demonstrated that key factors as well as the sequence of events involved in mouse pancreatic development is conserved in humans. This review will discuss our current knowledge in mouse as well as human pancreatic development and highlights some important transcription factors associated with human disease.
Retinal Vascular Calibre, Geometry and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus
Authors: Crosby-Nwaobi Roxanne , Heng Ling Zhi , Sivaprasad Sobha
Published: April 2012

Purpose: To determine whether changes in retinal vascular calibre and geometry are associated with progression of diabetic retinopathy in type 2 diabetes (T2D). Procedures: The retinal vascular calibre and geometry of 30 subjects with more than 20 years of diagnosed T2D with no retinopathy (NR) were compared to 30 subjects that progressed to proliferative diabetic retinopathy (PDR). The images of PDR subjects included in this study were those obtained before the onset of retinopathy. The diameter of retinal arterioles (CRAE), retinal venules (CRVE), tortuosity of retinal vessels, junctional exponent deviation (JEa) and fractal dimension (Df) were measured using Singapore I Vessel Assessment (SIVA 3.0) software and compared using Mann-Whitney U test. Results: The median CRAE and the median CRVE were significantly wider in PDR subjects compared to NR subjects (p = 0.014 and 0.016), respectively. Curvature tortuosity of the retinal arteries and veins and Df were significantly decreased in the PDR subjects compared to NR subjects (p = 0.015, 0.016 and 0.03, respectively). The JEa was significantly increased in PDR subjects (p = 0.01). Conclusions: Retinal vessel calibre and geometry of the retinal vasculature may be important risk factors for the progression to PDR. More longitudinal prospective studies will be needed to further explore the findings of this study.
Assessment of Incompletely Excised Basal Cell Carcinomas in Six Facial Areas: Influence of Elastosis
Authors: Husein-ElAhmed H. , Aneiros-Fernandez J. , Gutierrez-Salmeron M.T. , Aneiros-Cachaza J. , Naranjo-Sintes R.
Published: April 2012

Background: Incomplete excision of non-melanoma skin cancer is a clinical indicator of surgical care. With most basal cell carcinomas arising on the face and considering the cosmetic and functional structures involved, it is interesting to identify what are the areas within the face with more likelihood of incomplete excision and the factors implicated. The aim of this study was to identify those areas and possible predictive factors. Six anatomical regions were considered and studied selectively. Method: A monocentric study was performed reviewing all facial basal cell carcinomas excised at our center during 2010. Data were analyzed using SPSS software. Results: 202 lesions from 202 subjects were studied. The percentage of incomplete excision was 17.07%. Conclusion: Lesions located in the orbitopalpebral and auricular areas and those with moderate to severe grade of associated elastosis are more likely to be incompletely excised. Wider surgical margins are observed in frontal, malar and labial areas which are distant from functional structures. The following tumor features were found to be a risk factor for incomplete resection: morpheic or superficial histology, large lesions (>20 mm) and thick lesions (>6 mm).
Aging and Human Sexual Behavior: Biocultural Perspectives – A Mini-Review
Authors: Gray Peter B. , Garcia Justin R.
Published: April 2012

In this mini-review, we consider an evolutionary biocultural perspective on human aging and sexuality. An evolutionary approach to senescence highlights the energetic trade-offs between fertility and mortality. By comparing humans to other primates, we situate human senescence as an evolutionary process, with shifts in postreproductive sexual behavior in this light. Age-related declines in sexual behavior are typical for humans but also highly contingent on the sociocultural context within which aging individuals express their sexuality. We briefly review some of the most comprehensive studies of aging and sexual behavior, both from the USA and cross-culturally. We frame these patterns with respect to the long-term relationships within which human sexual behavior typically occurs. Because sexuality is typically expressed within pair-bonds, sexual behavior sometimes declines in both members of a couple with age, but also exhibits sex-specific effects that have their roots in evolved sex differences.
Risk Factors in Patients with Hereditary Gallstones in Chinese Pedigrees
Authors: Cui Yunfeng , Li Zhonglian , Zhao Erpeng , Cui Naiqiang
Published: April 2012

Objective: We aimed to define the risk factors and to evaluate the impact of family background on the prevalence of gallstones in China. Subjects and Methods: Thirty-eight gallstone pedigrees were collected and a case-control study was conducted. This study consisted of 272 first-degree relatives and 201 non-first-degree relatives of index patients. The participants completed a questionnaire and underwent physical and ultrasonographic examinations. The risk factors examined included age, sex, body mass index (BMI), smoking status, alcohol consumption, pregnancy, fat content in dietary meat, history of gastrointestinal surgery, hypertension, hyperlipidemia, fatty liver, coronary heart disease and diabetes. Results: The prevalence of gallstones in first-degree and non-first-degree relatives of index patients was 38.2 and 10.9%, respectively. Age, pregnancy and BMI significantly differed between cases and controls (p < 0.05). The relative risks were: consumption of meat with a high fat content 1.4 (95% CI 1.1–1.8); hyperlipidemia 2.4 (95% CI 1.3–4.6); diabetes 1.9 (95% CI 1.1–3.2); fatty liver 4.9 (95% CI 1.0–24); coronary heart disease 2.5 (95% CI 1.7–3.9). Conclusion: Data showed that age, overweight, more consumption of high-fat food, high frequency of pregnancy, fatty liver, hyperlipidemia, coronary heart disease and diabetes could increase the risk of gallstones in the first-degree relatives of index patients.
Pityriasis Rubra Pilaris: Treatment with Biologics – A New Promising Therapy?
Authors: Ivanova Katja , Itin Peter , Haeusermann Peter
Published: April 2012

Pityriasis rubra pilaris (PRP) includes a spectrum of rare chronic inflammatory disorders with papulosquamous eruptions of unknown cause. Different etiologies have been proposed such as vitamin A metabolism dysfunction, association with autoimmune disorders, infection or malignancies. However, PRP seems to be a polygenic skin disorder. Classical systemic treatment is empirical and includes retinoids and methotrexate; however, only few series on treatments exist. Recently there has been an increasing number of reports documenting that new biologicals and in particular TNF-α blockers are safe and effective.
Identification of a New Mutation (L46P) in the Human NOG Gene in an Italian Patient with Symphalangism Syndrome
Authors: Athanasakis E. , Biarnés X. , Bonati M.T. , Gasparini P. , Faletra F.
Published: April 2012

Proximal symphalangism (SYM1) is a joint morphogenesis disorder characterized by stapes ankylosis, proximal interphalangeal joint fusion, skeletal anomalies and conductive hearing loss. Noggin is a bone morphogenetic protein (BMP) antagonist essential for normal bone and joint development in humans and mice. Autosomal dominant mutations have been described in the NOG gene, encoding the noggin protein. We analyzed an Italian sporadic patient with SYM1 due to a novel NOG mutation (L46P) based on a c.137T>C transition. A different pathogenic mutation in the same codon (L46D) has been previously described in an in vivo chicken model. An in silico model shows a decreased binding affinity between noggin and BMP7 for both L46D and L46P compared to the wild type. Therefore, this codon should play an important role in BMP7 binding activity of the noggin protein and consequently to the joint morphogenesis.
Most Important Papers in Intravascular Imaging
Authors:   The Editors
Published: April 2012

The following are highlights from the series
Circulation: Cardiovascular Interventions
Topic Review. This series summarizes the most important manuscripts, as selected by the editors, that have published in the
Circulation
portfolio. The studies included in this article represent the most noteworthy research in the area of intravascular imaging.
Left Ventricular Failure Produces Profound Lung Remodeling and Pulmonary Hypertension in Mice
Authors: Chen Yingjie , Guo Haipeng , Xu Dachun , Xu Xin , Wang Huan , Hu Xinli , Lu Zhongbing , Kwak Dongmin , Xu Yawei , Gunther Roland , Huo Yuqing , Weir E. Kenneth
Published: April 2012

Chronic left ventricular failure causes pulmonary congestion with increased lung weight and type 2 pulmonary hypertension. Understanding the molecular mechanisms for type 2 pulmonary hypertension and the development of novel treatments for this condition requires a robust experimental animal model and a good understanding of the nature of the resultant pulmonary remodeling. Here we demonstrate that chronic transverse aortic constriction causes massive pulmonary fibrosis and remodeling, as well as type 2 pulmonary hypertension, in mice. Thus, aortic constriction-induced left ventricular dysfunction and increased left ventricular end-diastolic pressure are associated with a ≤5.3-fold increase in lung wet weight and dry weight, pulmonary hypertension, and right ventricular hypertrophy. Interestingly, the aortic constriction-induced increase in lung weight was not associated with pulmonary edema but resulted from profound pulmonary remodeling with a dramatic increase in the percentage of fully muscularized lung vessels, marked vascular and lung fibrosis, myofibroblast proliferation, and leukocyte infiltration. The aortic constriction-induced left ventricular dysfunction was also associated with right ventricular hypertrophy, increased right ventricular end-diastolic pressure, and right atrial hypertrophy. The massive lung fibrosis, leukocyte infiltration, and pulmonary hypertension in mice after transverse aortic constriction clearly indicate that congestive heart failure also causes severe lung disease. The lung fibrosis and leukocyte infiltration may be important mechanisms in the poor clinical outcome in patients with end-stage heart failure. Thus, the effective treatment of left ventricular failure may require additional efforts to reduce lung fibrosis and the inflammatory response.
Low-Dose Spironolactone Prevents Apoptosis Repressor With Caspase Recruitment Domain Degradation During Myocardial Infarction
Authors: Loan Le Thi Yen , Mardini Mahidi , Howell Viive M. , Funder John W. , Ashton Anthony W. , Mihailidou Anastasia S.
Published: April 2012

Low-dose mineralocorticoid receptor antagonists reduce morbidity and mortality in patients with heart failure and myocardial infarction, despite normal plasma aldosterone levels. Since apoptosis plays an important role in heart failure and postinfarction left ventricular remodeling, we examined whether low-dose mineralocorticoid receptor antagonists modulate cardiomyocyte death by regulating the apoptosis repressor protein apoptosis repressor with caspase recruitment domain to lessen the extent of apoptosis. Hearts from adult male Sprague-Dawley rats were subjected to regional ischemia followed by reperfusion ex vivo, with mineralocorticoid receptor antagonists added to perfusates before ischemia. Low-dose spironolactone (10 nmol/L) or eplerenone (100 nmol/L) significantly reduced infarct size. Spironolactone also prevented cleavage of the apoptotic chromatin condensation inducer in the nucleus and of the inhibitor of caspase-activated DNAse induced by ischemia-reperfusion, thereby abolishing chromatin condensation and internucleosomal cleavage. Ischemia-reperfusion–induced activation of caspases 2, 3, and 9, but not caspase 8, was prevented by spironolactone, suggesting targeted regulation of the intrinsic pathway. Low-dose spironolactone and eplerenone prevented loss of the apoptosis repressor with the caspase recruitment domain and reduced myocyte death. In H9c2 cells, mineralocorticoid receptor activation by aldosterone resulted in apoptosis repressor with caspase recruitment domain degradation and enhanced apoptosis; these actions were prevented by coadministration of spironolactone. Using a triple lysine mutant we identified that aldosterone enhances posttranscriptional degradation of the apoptosis repressor with a caspase recruitment domain via the ubiquitin-proteasomal pathway. Our data demonstrate that low-dose mineralocorticoid receptor antagonists reduce infarct size and apoptosis in the reperfused myocardium by preventing the apoptosis repressor with caspase recruitment domain degradation.
Cardioprotective Effects Mediated by Angiotensin II Type 1 Receptor Blockade and Enhancing Angiotensin 1-7 in Experimental Heart Failure in Angiotensin-Converting Enzyme 2–Null Mice
Authors: Patel Vaibhav B. , Bodiga Sreedhar , Fan Dong , Das Subhash K. , Wang Zuocheng , Wang Wang , Basu Ratnadeep , Zhong JiuChang , Kassiri Zamaneh , Oudit Gavin Y.
Published: April 2012

Loss of angiotensin (Ang)-converting enzyme 2 (ACE2) and inability to metabolize Ang II to Ang 1-7 perpetuate the actions of Ang II after biomechanical stress and exacerbate early adverse myocardial remodeling. Ang receptor blockers are known to antagonize the effect of Ang II by blocking Ang II type 1 receptor (AT
1
R) and also by upregulating the ACE2 expression. We directly compare the benefits of AT
1
R blockade versus enhancing Ang 1-7 action in pressure-overload–induced heart failure in ACE2 knockout mice. AT
1
R blockade and Ang 1-7 both resulted in marked recovery of systolic dysfunction in pressure-overloaded ACE2-null mice. Similarly, both therapies attenuated the increase in NADPH oxidase activation by downregulating the expression of Nox2 and p47
phox
subunits and also by limiting the p47
phox
phosphorylation. Biomechanical stress-induced increase in protein kinase C-α expression and phosphorylation of extracellular signal–regulated kinase 1/2, signal transducer and activator of transcription 3, Akt, and glycogen synthase kinase 3β were normalized by irbesartan and Ang 1-7. Ang receptor blocker and Ang 1-7 effectively reduced matrix metalloproteinase 2 activation and matrix metalloproteinase 9 levels. Ang II–mediated cellular effects in cultured adult cardiomyocytes and cardiofibrolasts isolated from pressure-overloaded ACE2-null hearts were inhibited to similar degree by AT
1
R blockade and stimulation with Ang 1-7. Thus, treatment with the AT
1
R blocker irbesartan and Ang 1-7 prevented the cardiac hypertrophy and improved cardiac remodeling in pressure-overloaded ACE2-null mice by suppressing NADPH oxidase and normalizing pathological signaling pathways.