bluuebunny/crossref_metadata_2025 huggingface dataset:
Truncated tau expression levels determine life span of a rat model of tauopathy without causing neuronal loss or correlating with terminal neurofibrillary tangle load
Authors: Koson Peter , Zilka Norbert , Kovac Andrej , Kovacech Branislav , Korenova Miroslava , Filipcik Peter , Novak Michal
Published: July 2008

We have previously demonstrated in a transgenic rat model of tauopathy that human misfolded truncated tau derived from Alzheimer’s disease suffices to drive neurofibrillary degeneration in vivo. We employed this model to investigate the impact of truncated tau expression levels on life span, neuronal loss and the final load of neurofibrillary tangles (NFTs) in transgenic rats. Two independent transgenic lines (SHR72, SHR318), that display different expression levels of truncated tau, were utilized in this study. We found that transgene expression levels in the brain of SHR72 rats were 44% higher than in SHR318 rats and that truncated tau protein levels determined the survival rate of transgenic rats. The line with higher expression levels of truncated tau (SHR72) showed decreased median survival (222.5 days) when compared with the line with lower expression (SHR318; 294.5 days). Interestingly, NFT loads (total NFT/total neurons) were very similar in terminal stages of disease in both transgenic lines (SHR72 – 10.9%; SHR318 – 11.6%), despite significantly different expression levels of truncated tau. Moreover, mean neuron numbers in the hippocampus (CA1–3) and brain stem (gigantocellular reticular nucleus) in the two transgenic rat strains in the terminal stages of disease were similar, and did not differ significantly from those observed in age‐matched non‐transgenic controls. These findings suggest that the expression levels of misfolded truncated tau determine the life span in a transgenic rat model of tauopathy without causing neuronal loss or correlating with terminal NFT load.
Transcranial Doppler ultrasound during galvanic labyrinth polarization depicts central vestibular processing, demonstrating bilateral vestibular projection
Authors: Schlosser Hans‐Georg , Guldin Wolfgang , Fritzsche Danny , Clarke Andrew H.
Published: July 2008

The combination of galvanic labyrinth polarization and transcranial Doppler ultrasound was employed to depict the neurovascular coupling in the cerebral vestibular areas. For galvanic stimulation, surface electrodes were attached to the right and left mastoid and two further electrodes were fixed near to each shoulder blade. Thus, each pair of electrodes (mastoid to shoulder) facilitated unilateral stimulation of the ipsilateral vestibular labyrinth. Blood flow in the middle cerebral artery and the internal carotid artery in both hemispheres was measured by means of Doppler ultrasound. The transcranial Doppler ultrasound system was head‐fixed and allowed continuous monitoring of the blood flow throughout the trials. Using a series of different stimulation modes (bilateral, unilateral left, unilateral right and sham), the changes in mean blood flow velocity were evaluated by comparing baseline blood flow under resting conditions to blood flow during stimulation. A total of 18 trials were performed with each of seven volunteer subjects. Galvanic labyrinth polarization elicited a clear sensation of pendular body movement in all subjects. Significant blood flow increase (P < 0.05) in both hemispheres was observed during bilateral stimulation. Of more interest is that unilateral stimulation also elicited a significant increase in flow in both the ipsilateral and the contralateral hemispheres, demonstrating the existence of bilateral projections from each vestibular labyrinth. The combination of galvanic labyrinth polarization with transcranial Doppler ultrasound blood flow measurement provides a novel approach to the functional assessment of the vestibular system (deep cerebral structures and cortical areas). This novel technique provides a useful tool for clinical examinations.
Polymorphisms in the FKBP5 gene region modulate recovery from psychosocial stress in healthy controls
Authors: Ising Marcus , Depping Anna‐Mareike , Siebertz Anna , Lucae Susanne , Unschuld Paul G. , Kloiber Stefan , Horstmann Sonja , Uhr Manfred , Müller‐Myhsok Bertram , Holsboer Florian
Published: July 2008

Mood and anxiety disorders are considered stress‐related diseases characterized by an impaired function of mineralocorticoid and glucocorticoid receptors (MR and GR, respectively), the major regulatory elements of the hypothalamus–pituitary–adrenocortical (HPA) axis. A number of so‐called chaperone proteins moderate the function of these receptors. Genetic variations in one of these chaperones, FKBP5, were associated with antidepressant treatment response in depression and with a major risk‐factor for the development of posttraumatic stress disorder. To further investigate the effect of FKPB5 polymorphisms on corticosteroid receptor‐mediated HPA axis regulation we conducted the Trier Social Stress test, a standardized procedure to evaluate psychosocial stress response, in 64 healthy volunteers. We genotyped rs4713916, rs1360780 and rs3800737, the three single nucleotide polymorphisms (SNPs) in the FKBP5 region which had shown the strongest effect in previous studies. In addition, we evaluated the effects of the GR polymorphisms Bcl1 and N363S as well as the MR polymorphism I180V. Subjects homozygous for any of the FKBP5 variants displayed an incomplete normalization of the stress‐elicited cortisol secretion. This was also observed following a second test additionally accompanied by an increased self‐reported anxiety. Regarding GR and MR, only carriers of the Bcl1 variant displayed an altered cortisol response in the prognosticated direction. While Bcl1 was predominantly associated with anticipatory cortisol, homozygous carriers of the FKBP5 minor allele showed insufficient cortisol recovery and increased self‐reported anxiety after psychosocial stress. This reaction pattern suggests that subjects carrying these variants are at risk of displaying chronically elevated cortisol levels after repeated stress constituting a risk factor for stress‐related diseases.
Interhemispheric motor inhibition: its role in controlling electromyographic mirror activity
Authors: Hübers Annemarie , Orekhov Yuriy , Ziemann Ulf
Published: July 2008

Electromyographic mirror activity (MA) refers to involuntary activation of the non‐active limb during intended strictly unilateral movements of the other limb. MA occurs in the majority of healthy adults but little is known about its neurophysiological foundation. Here we examined in healthy adults the hypothesis that transcallosal interhemispheric inhibition (IHI) between the primary motor cortices determines the extent to which MA occurs. IHI was tested by an established paired transcranial magnetic stimulation protocol [A. Ferbert et al. (1992) J. Physiol. (Lond.), 453, 525–546]. In a first experiment we found that the magnitudes of IHI and MA were inversely correlated. In a second experiment we sought to establish a more causative relation by exploring the changes induced by low‐frequency repetitive transcranial magnetic stimulation of primary motor cortex on IHI and MA. These changes were also significantly inversely correlated, i.e. a repetitive transcranial magnetic stimulation‐induced increase in IHI was associated with a decrease in MA, and a decrease in IHI was associated with an increase in MA. These results provide strong and consistent evidence that transcallosal inhibitory interhemispheric interaction provides a significant route by which unwanted MA during intended unimanual motor tasks can be controlled.
Reduced error monitoring in children with autism spectrum disorder: an ERP study
Authors: Vlamings Petra H. J. M. , Jonkman Lisa M. , Hoeksma Marco R. , Van Engeland Herman , Kemner Chantal
Published: July 2008

This study investigated self‐monitoring in children with autism spectrum disorder (ASD) with event‐related potentials looking at both the error‐related negativity (ERN) and error‐related positivity (Pe). The ERN is related to early error/conflict detection, and the Pe has been associated with conscious error evaluation or attention allocation. In addition, post‐error slowing in reaction times (RTs) was measured. Children with ASD and age‐ and IQ‐ matched controls were administered an easy and a hard version of an auditory decision task. Results showed that the ERN was smaller in children with ASD but localized in the anterior cingulate cortex (ACC) in both groups. In addition we found a negativity on correct trials (CRN) that did not differ between the groups. Furthermore, a reduced Pe and a lack of post‐error slowing in RTs were found in children with ASD. The reduced ERN in children with ASD, in the presence of an intact CRN, might suggest a specific insensitivity to detect situations in which the chance of making errors is enhanced. This might in turn lead to reduced error awareness/attention allocation to the erroneous event (reduced Pe) and eventually in a failure in change of strategy to deal with a situation, as becomes evident from the lack of post‐error slowing in the ASD group. This relates well to the perseverative behaviour that is seen in children with ASD. We discuss these results in terms of a general deficit in self‐monitoring, underlying social disturbance in ASD and the involvement of the ACC.
Induction mechanisms and modulation of bidirectional burst stimulation‐induced synaptic plasticity in the hippocampus
Authors: Clark Kristin , Normann Claus
Published: July 2008

Spike bursting is an important physiological mode of the hippocampus. Whereas the rules of spike timing‐dependent synaptic plasticity are well defined for pairs of single action potentials (APs) and excitatory postsynaptic potentials (EPSPs), long‐term modification of synaptic responses is much less understood for more complex pre‐ and postsynaptic spike patterns. We induced a burst stimulation (BS)‐associated form of synaptic plasticity in rat CA1 hippocampal slices by repeatedly pairing three EPSPs with a burst of APs induced by postsynaptic current injection. In distinct groups of cells, this induction paradigm resulted in long‐term potentiation (LTP), long‐term depression (LTD) or no change in synaptic strength. LTP was N‐methyl‐d‐aspartate receptor‐dependent, whereas LTD could be blocked by a metabotropic glutamate receptor antagonist or inhibition of Ca2+ influx through voltage‐activated Ca2+ channels. LTP was predicted by a more depolarized membrane potential and a higher initial AP frequency. LTD was facilitated by a larger time interval between the last EPSP and its preceding AP. We conclude from these findings that associative BS induces a bidirectional form of long‐term synaptic plasticity that cannot be fully explained by spike timing rules. Postsynaptic membrane potential and Ca2+ influx further influence the sign and magnitude of synaptic modification. LTP and LTD have distinct mechanisms and can be selectively modulated. This supports the concept of two independent coincidence detectors for LTP and LTD, and extends the physiological options to modulate synaptic plasticity and maintain a putative balance between potentiation and depression in synaptic networks.
Relationship between afterhyperpolarization profiles and the regularity of spontaneous firings in rat medial vestibular nucleus neurons
Authors: Saito Yasuhiko , Takazawa Tomonori , Ozawa Seiji
Published: July 2008

Our previous in vivo and in vitro whole‐cell patch‐clamp recording studies demonstrated that neurons in the medial vestibular nucleus (MVN) could be characterized on the basis of three electrophysiological properties: afterhyperpolarization (AHP) profile; firing pattern; and response pattern to hyperpolarizing current pulses. In the present study, to clarify which types of the classified MVN neurons correspond to neurons with regular or irregular firing, we investigated their spike discharge patterns using whole‐cell patch‐clamp recording in both in vivo and in vitro preparations. The discharge regularity was related to AHP profiles, and we found that: (i) the coefficient of variation (CV) of interspike intervals during spike discharges was smaller in neurons exhibiting AHP with a slow component [AHP(s+)] than in those without a slow component [AHP(s−)], or with a slow AHP component preceded by afterdepolarization (ADP) [AHP(s+) with ADP]; (ii) the blockade of Ca2+‐dependent K+ channels by 100 nm apamin abolished the slow component and increased the CV in neurons exhibiting AHP(s+); and (iii) the modulation of firing (firing gain) in response to ramp current was larger in neurons exhibiting AHP(s−) than in the other two neuronal types. These results suggest that neurons exhibiting AHP(s+) are regularly discharging neurons with small firing gains to stimulus, neurons exhibiting AHP(s+) with ADP are irregularly discharging neurons with small firing gains, and neurons exhibiting AHP(s−) are irregularly discharging neurons with large firing gains. The regular firing of neurons exhibiting AHP(s+) is attributed to the activation of apamin‐sensitive Ca2+‐dependent K+ channels.
Olfactory deficits in mice overexpressing human wildtype α‐synuclein
Authors: Fleming Sheila M. , Tetreault Nicole A. , Mulligan Caitlin K. , Hutson Ché B. , Masliah Eliezer , Chesselet Marie‐Françoise
Published: July 2008

Accumulation of α‐synuclein in neurons of the central and peripheral nervous system is a hallmark of sporadic Parkinson’s disease (PD) and mutations that increase α‐synuclein levels cause familial PD. Transgenic mice overexpressing α‐synuclein under the Thy1 promoter (Thy1‐aSyn) have high levels of α‐synuclein expression throughout the brain but no loss of nigrostriatal dopamine neurons up to 8 months, suggesting that they may be useful to model pre‐clinical stages of PD. Olfactory dysfunction often precedes the onset of the cardinal motor symptoms of PD by several years and includes deficits in odor detection, discrimination and identification. In the present study, we measured olfactory function in 3‐ and 9‐month‐old male Thy1‐aSyn mice with a buried pellet test based on latency to find an exposed or hidden odorant, a block test based on exposure to self and non‐self odors, and a habituation/dishabituation test based on exposure to non‐social odors. In a separate group of mice, α‐synuclein immunoreactivity was assessed in the olfactory bulb. Compared with wildtype littermates, Thy1‐aSyn mice could still detect and habituate to odors but showed olfactory impairments in aspects of all three testing paradigms. Thy1‐aSyn mice also displayed proteinase K‐resistant α‐synuclein inclusions throughout the olfactory bulb. These data indicate that overexpression of α‐synuclein is sufficient to cause olfactory deficits in mice similar to that observed in patients with PD. Furthermore, the buried pellet and block tests provided sufficient power for the detection of a 50% drug effect, indicating their usefulness for testing novel neuroprotective therapies.
Biodiversity of amoebae and amoebae‐resisting bacteria in a drinking water treatment plant
Authors: Thomas Vincent , Loret Jean‐François , Jousset Michel , Greub Gilbert
Published: July 2008

The complex ecology of free‐living amoebae (FLA) and their role in spreading pathogenic microorganisms through water systems have recently raised considerable interest. In this study, we investigated the presence of FLA and amoebae‐resisting bacteria (ARB) at various stages of a drinking water plant fed with river water. We isolated various amoebal species from the river and from several points within the plant, mostly at early steps of water treatment. Echinamoeba‐ and Hartmannella‐related amoebae were mainly recovered in the drinking water plant whereas Acanthamoeba‐ and Naegleria‐related amoebae were recovered from the river water and the sand filtration units. Some FLA isolates were recovered immediately after the ozonation step, thus suggesting resistance of these microorganisms to this disinfection procedure. A bacterial isolate related to Mycobacterium mucogenicum was recovered from an Echinamoeba‐related amoeba isolated from ozone‐treated water. Various other ARB were recovered using co‐culture with axenic Acanthamoeba castellanii, including mycobacteria, legionella, Chlamydia‐like organisms and various proteobacteria. Noteworthy, a new Parachlamydia acanthamoebae strain was recovered from river water and from granular activated carbon (GAC) biofilm. As amoebae mainly multiply in sand and GAC filters, optimization of filter backwash procedures probably offers a possibility to better control these protists and the risk associated with their intracellular hosts.
Tailored surgery for internal and external rectal prolapse: functional results of 268 patients operated upon by a single surgeon over a 21‐year period*
Authors: Pescatori M. , Zbar A. P.
Published: July 2008

Objective  Many procedures are used to treat internal (IRP) and external rectal prolapse (ERP). We report the outcome of surgery tailored in accordance with an evolving Unit algorithm over a 21‐year period.

Method  Two hundred and sixty‐eight patients (151 IRP and 117 ERP) are reported. Perineal procedures (Delorme’s mucosectomy, Altemeier’s perineal rectosigmoidectomy) were used in frail elderly patients with ERP with abdominal sacrorectopexy or the Frykman‐Goldberg procedure in fit patients. In IRP, prolapsectomy was most common with anterior hemi‐Delorme’s procedures for rectocele and levatorplasty for coincident faecal incontinence. Clinical and functional outcome was assessed over a median of 61 months (range 4–184 months).

Results  Postoperative mortality was 0.4%. For ERP, a perineal procedure was carried out in 75 (61.4%) cases with a 7.2% complication rate, postoperative incontinence in 20 (26.7%), constipation in four (5.3%) and recurrence in 12 (16%). For 42 abdominal procedures, the complication rate was 5% with incontinence in 7.1%, constipation in eight (19%) and recurrence in five (11.9%). A perineal operation was used in 89.4% of patients with IRP with incontinence in 10.6%, persistent constipation in 48 (52.7%) and recurrence in 25 (27.5%). The overall incontinence rate was 11% following abdominal and 24% following perineal procedures (P < 0.05). Recurrence of ERP was significantly higher following a perineal operation (P < 0.05).

Conclusion  Tailored surgery for ERP achieves satisfactory results in terms of recurrence and functional outcome. For patients with IRP, perineal procedures are associated with a high incidence of recurrence and residual evacuatory difficulty.
Efficacy of the anal fistula plug in complex anorectal fistulae
Authors: Thekkinkattil D. K. , Botterill I. , Ambrose N. S. , Lundby L. , Sagar P. M. , Buntzen S. , Finan P. J.
Published: July 2008

Objective  The treatment of complex anorectal and rectovaginal fistulae remains a difficult problem. The options are fistulotomy, setons, fibrin glue and a variety of flap procedures. Recently, there have been several reports of a new plug; the Surgisis® AFP™ plug. Reports from various centres do not give consistent results. The aim of this study was to assess the efficacy of the Surgisis® AFP™ fistula plug in a wide spectrum of patients with anorectal, rectovaginal and pouch vaginal fistulae.

Method  Between March 2006 and September 2007, patients with a variety of anal fistulae were selected for fistula plug insertion in the coloproctology units at Leeds, UK, and Aarhus, Denmark. Demographic and fistulae details were obtained. Postoperatively, all patients had a course of oral antibiotics.

Results  Forty‐three patients with a median age of 45 (range 18–65) years underwent a total of 45 procedures. Seventy‐five per cent (n = 32) had a fistula secondary to cryptoglandular abscess. Median follow up was 47 (range 12–77) weeks. The success rate for complete healing was 44%. Dislodgement caused failure on 10 (22%) occasions.

Conclusion  Our study shows a moderate success rate for treatment with fistula plugs. The complex nature of the fistulae selected may be the reason for the low success rate.
The impact of pre‐ or postoperative radiochemotherapy on complication following anterior resection with en bloc excision of female genitalia for T4 rectal cancer
Authors: Szynglarewicz B. , Matkowski R. , Gisterek I. , Forgacz J. , Lacko A. , Pudelko M. , Kornafel J.
Published: July 2008

Objective  The aim of the study was to assess the mortality and morbidity following extended anterior resection with excision of internal female genitalia combined with pre‐ or postoperative chemoradiotherapy in women with extensive rectal cancer.

Method  The study included a consecutive series of 21 women with T4 adenocarcinoma of the rectum infiltrating the reproductive organs treated with curative intent between 1997 and 2003. All patients had an extended anterior sphincter preserving resection of the rectum (total mesorectal excision) and hysterectomy with or without posterior vaginal wall excision. In all patients, surgery was combined with adjuvant radiochemotherapy. Ten patients received preoperative radiotherapy (50.4 Gy) concurrently with two courses of chemotherapy [fluorouracil with folinic acid (FA)] followed by surgery within 6–8 weeks and subsequently four courses of postoperative chemotherapy. Eleven received postoperative chemoradiotherapy (50.4 Gy plus fluorouracil with FA).

Results  There was no postoperative mortality. Postoperative complications were observed in 57% patients (early in 14% and late in 52%). These included: anterior resection syndrome with anorectal dysfunction in 52% (requiring proximal diversion in 5%), urinary complications in 24% (complete incontinence requiring a permanent catheter in 5%). In addition, postoperative acute bleeding requiring relaparotomy, delayed wound healing caused by superficial infection, anastomotic leakage, prolonged bowel paralysis, benign rectovaginal fistula and anastomotic stricture occurred (5% each). The risk of postoperative morbidity (52%) was similar for patients with or without preoperative radiochemotherapy.

Conclusion  Despite this aggressive therapeutic approach, most postoperative complications were transient or could be treated. Preoperative radiochemotherapy did not increase the risk of morbidity.
To determine the efficacy of anal fistula plug in the treatment of high fistula‐in‐ano: an initial experience
Authors: Garg P.
Published: July 2008

Objective The aim of this study was to determine the efficacy of the anal fistula plug in the treatment of high fistula‐in‐ano.

Method Twenty‐three patients with high cryptoglandular fistula‐in‐ano were prospectively studied over 1 year. The number of tracks, number of previous procedures and co‐morbid conditions that could potentially affect outcome were noted. A seton was used to guide the AFP™ into the fistula track which was anchored at the primary opening.

Results Two patients were lost to follow‐up. Twenty‐one patients (mean age was 49.8 years) were followed from 192 to 543 days (median = 292 days). Thirteen patients had single track, eight had multiple tracks and 14 had a recurrent fistula. Success, defined by closure of all fistula tracks occurred in 71.4% (15/21). The success rate was 84.6% in patients with a single fistula track (11/13) compared with 50% in patients with multiple tracks (4/8) (P = 0.14, Fisher’s exact test). Recurrent [10/14 (71.4%)]vsnonrecurrent fistulae [5/7 (71.4%)] had no bearing on the outcome (P = 1.0). Two patients experienced healing despite extrusion of the plug in the early postoperative period. The procedure was safe and well tolerated.

Conclusion The Surgisis® AFP™ was successful in 71.4% of patients. Plug extrusion does not necessarily mean failure.
Value of sacral nerve stimulation in the treatment of severe faecal incontinence: a comparison to the artificial bowel sphincter
Authors: Meurette G. , La Torre M. , Regenet N. , Robert‐Yap J. , Lehur P. A.
Published: July 2008

Objective  Sacral nerve stimulation (SNS) is a recent treatment option in the management of severe faecal incontinence (FI) that offers promising results. The aim of this study was to compare SNS to artificial bowel sphincter (ABS) implanted patients to assess the rationale of this approach in achieving satisfying functional results and improved quality of life (QoL).

Method  Among 27 patients tested (December 2001 and April 2004), 15 patients were successfully managed with SNS. They were compared to 15 matched patients implanted with ABS in a previous period (control group). Assessment of continence level (Cleveland Clinic score), constipation score (Knowles, Eccersley, Scott Score) and QoL (Short‐Form 36) were prospectively collected.

Results  Both groups were comparable for clinical parameters (age, gender, anal testing and aetiology of incontinence) and anal physiology. The mean postoperative continence score was significantly higher in the SNS group [9.4 (±3.3) vs 5.7 (±3.9), P < 0.01]; however, the mean constipation score was higher in the ABS group (6.3 ± 6.3 vs 12.8 ± 5.7, P < 0.01). The mean QoL score was similar in both groups. The mean follow‐up after implantation was 15 (±9) months in the SNS group, and 43 (±33) months in the ABS group.

Conclusion  In this study, SNS offers satisfying results in terms of QoL, similar to that of ABS. Although it seems to be less effective in restoring continence level, symptoms of outlet obstruction are more frequent after ABS. This SNS approach should be proposed as a first‐line treatment of FI in selected patients. ABS should remain an option that can improve function.
Preoperative neo‐adjuvant therapy for curable rectal cancer – reaching a consensus 2008
Authors: Scott N. A. , Susnerwala S. , Gollins S. , Sun Myint A. , Levine E.
Published: July 2008

Objective  Our aim was to determine the range of neo‐adjuvant therapy the multidisciplinary team (MDT) currently offers patients with curable (M0) rectal cancer.

Method  A senior oncologist from each of the four oncology centres in north Wales and the north‐west of England (approximate target population 8 million – Glan Clwyd, Clatterbridge, Christie and Preston) reviewed his/her understanding of the current evidence of neo‐adjuvant therapy in rectal cancer. Then a representative from each centre was asked to identify which of three neo‐adjuvant options (no neo‐adjuvant therapy, short‐course radiotherapy 25 Gy over five fractions and long‐course chemoradiotherapy) he/she would use for a rectal cancer in the upper, middle or lower third of the rectum staged by magnetic resonance imaging as being T2–T4 and/or N0–N2.

Results  In all cases of locally advanced rectal cancer (T3a N1–T4), oncologists from the four oncology centres recommended long‐course chemoradiotherapy before rectal resection. This consensus was maintained for cases of lower third T3a N0 cancers. Thereafter, the majority of patients with rectal cancer are offered adjuvant short‐course radiotherapy.

Conclusion  Neo‐adjuvant therapy is less likely to be offered if the tumour is early (T2, N0) and/or situated in the upper third of the rectum.
Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review
Authors: Burch J. , Epstein D. , Baba‐Akbari Sari A. , Weatherly H. , Jayne D. , Fox D. , Woolacott N.
Published: July 2008

Objective  This systematic review aimed to evaluate the short‐ and long‐term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy.

Method  We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.

Results  Twenty‐seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.

Conclusion  Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.
Rectal cancer: involved circumferential resection margin – a root cause analysis
Authors: Youssef H. , Collantes E. C. , Rashid S. H. , Wong L. S. , Baragwanath P.
Published: July 2008

Introduction  An involved circumferential resection margin (CRM) following surgery for rectal cancer is the strongest predictor of local recurrence and may represent a failure of the multidisciplinary team (MDT) process.

Aim of study  The study analyses the causes of positive CRM in patients undergoing elective surgery for rectal cancer with respect to the decision‐making process of the MDT, preoperative rectal cancer staging and surgical technique.

Method  From March 2002 to September 2005, data were collected prospectively on all patients undergoing elective rectal cancer surgery with curative intent. The data on all patients identified with positive CRM were analysed.

Results  Of 158 patients (male:female = 2.2:1) who underwent potentially curative surgery, 16 (10%) patients had a positive CRM on postoperative histology. Four were due to failure of the pelvic magnetic resonance imaging (MRI) staging scans to predict an involved margin, two with an equivocal CRM on MRI did not have preoperative radiotherapy, one had an inaccurate assessment of the site of primary tumour and in one intra‐operative difficulty was encountered. No failure of staging or surgery was identified in the remaining eight of the 16 patients. Abdominoperineal resection (APR) was associated with a 26% positive CRM, compared with 5% for anterior resection.

Conclusion  No single consistent cause was found for a positive CRM. The current MDT process and/or surgical technique may be inadequate for low rectal tumours requiring APR.
Preservation of sexual and bladder function after laparoscopic rectal surgery
Authors: Jones O. M. , Stevenson A. R. L. , Stitz R. W. , Lumley J. W.
Published: July 2008

Background  There have recently been reports of higher levels of bladder and sexual dysfunction in men after laparoscopic rectal surgery when compared with those undergoing open surgery. This has led some surgeons to question the role of the laparoscopic approach to rectal surgery.

Method  This study represents a retrospective analysis of a prospectively collected database for a single unit, comprising 2406 patients undergoing laparoscopic colorectal surgery. Bladder function, potency and ejaculation were assessed at postoperative clinic visits for men undergoing laparoscopic low or ultra‐low anterior resection and abdominoperineal excision of the rectum.

Results  A total of 101 males were identified (median age 62 years: range 20–90 years). Urinary dysfunction was reported by six (6%) patients. Six (6%) patients had sexual dysfunction, manifesting as retrograde ejaculation in four patients and erectile dysfunction in a further two patients.

Conclusions  The low rates of sexual dysfunction in this unit may be attributable to pelvic dissection only being undertaken by experienced, dedicated laparoscopic colorectal surgeons. Laparoscopic restorative surgery for rectal cancer has been performed here only since 2001 after considerable experience accrued in operating on benign rectal disease and colon cancer. Studies from elsewhere reporting poorer functional outcomes have probably included a significant number of patients on the surgeons’‘learning curve’.
Comparison of preoperative whole‐body positron emission tomography with MDCT in patients with primary colorectal cancer
Authors: Akiyoshi T. , Oya M. , Fujimoto Y. , Kuroyanagi H. , Ueno M. , Yamaguchi T. , Koyama M. , Tanaka H. , Matsueda K. , Muto T.
Published: July 2008

Objective  Preoperative use of emission tomography with18F‐fluorodeoxyglucose (FDG‐PET) in patients with primary colorectal cancer remains controversial. This study evaluated the additional value of FDG‐PET in comparison with routine multidetector row computed tomography (MDCT) in patients with primary colorectal cancer.

Method  Retrospective analysis was performed in 65 patients with colorectal cancer who underwent whole‐body FDG‐PET. Results of FDG‐PET were compared with routine preoperative evaluation by MDCT regarding detection of primary tumour, lymph node involvement and distant metastases. All images were evaluated before surgery.

Results  Tumour detection rate was 100% (63/63) for MDCT and 98% (62/63) for FDG‐PET. Lymph node involvement was pathologically confirmed in 35 patients. MDCT and FDG‐PET displayed sensitivities of 89% (31/35; 95% CI: 73–97%) and 43% (15/35; 95% CI: 26–61%) and specificities of 52% (11/21; 95% CI: 30–74%) and 95% (20/21; 95% CI: 76–100%), respectively. Liver metastases were present in 22 patients. MDCT and FDG‐PET showed accuracies of 98% (64/65; 95% CI: 92–100%) and 97% (63/65; 95% CI: 89–100%), respectively. FDG‐PET detected additional extrahepatic metastatic lesions and affected treatment plan compared with MDCT in 10 patients.

Conclusion  Preoperative FDG‐PET is not superior to MDCT for detection of primary tumour, lymph node involvement or liver metastases, but may have potential clinical value in patients with advanced colorectal cancer by detecting extrahepatic distant metastases.
Application of the BSG guidelines to a colonoscopy waiting list
Authors: Clements D. , Tawfiq S. , Harries B. , Sheridan W.
Published: July 2008

Objective  Currently priority for colonoscopy is given to diagnostic and therapeutic procedures. Surveillance colonoscopies place a significant demand on the service. These are held on a separate waiting list in our institution, which is currently several years behind. The purpose of this study was to apply the BSG guidelines to this waiting list in our institution in order to ascertain whether patients are appropriately listed.

Method  This was a retrospective review. The patients on the waiting list whose procedures were due in 2004 and 2005 formed the study group. Information on demographics, previous colonoscopies, and indication was taken from the case notes. Results were analysed using Microsoft Excel.

Results  A total of 172 patients were overdue their colonoscopies. If the BSG guidelines were strictly adhered to, 49% of these patients were inappropriately listed. If applied less rigidly, 42% of patients should not have been on the list. The reasons for removal from the list were as follows: Thirty‐nine patients were older than the upper age limit, 23 had had clear colonoscopies after adenomatous polyp follow up, four were listed for diverticular disease follow up, four for metaplastic polyps, one for constipation and one for per rectum (PR) bleed follow up.

Conclusion  With strict application of the BSG guidelines to a surveillance colonoscopy waiting list, 49% of the patients on the list do not need the procedure. It is recommended that consultant led education and control of the waiting list be used to reduce unnecessary investigations.
The ideal lateral internal sphincterotomy: clinical and endosonographic evaluation following open and closed internal anal sphincterotomy
Authors: García‐Granero E. , Sanahuja A. , García‐Botello S. A. , Faiz O. , Esclápez P. , Espí A. , Flor B. , Minguez M. , Lledó S.
Published: July 2008

Objective  To evaluate the relationship between extent of internal sphincter division following open and closed sphincterotomy, as assessed by anal endosonography, with fissure persistence/recurrence and faecal incontinence.

Method  A total of 140 consecutive patients undergoing lateral internal sphincterotomy (LIS) for idiopathic chronic anal fissure were prospectively studied. Preoperative clinical assessment was performed together with a postoperative clinical and endosonographic examination. Three zones of the internal sphincter, identifiable by endosonography, were used to describe the uppermost extent of LIS. Primary end‐points were fissure persistence/recurrence and faecal incontinence.

Results  A total of 140 patients, median age 49.5 years (IQR: 38–56 years) were included. Seventy‐five (53.6%) and 65(46.4%) patients underwent percutaneous LIS (PLIS) and open LIS (OLIS) respectively. Median follow‐up was 21 months (IQR: 14–29 months). Persistence and recurrence rates were 2.9% (4/140) and 5.7% (8/140) respectively. 7.9% (11/140) patients scored > 3 on the Jorge and Wexner Faecal Incontinence scale. PLIS was associated with a trend towards higher fissure persistence/recurrence rates than OLIS (12.0%vs 4.6%, P = 0.141). OLIS was significantly associated with a higher proportion of complete sphincterotomies (CS) than PLIS (56/65 vs 48/75, P = 0.003). A CS was associated with a lower fissure persistence or recurrence rate (1/104 vs 11/36, P < 0.001) but higher incontinence scores (11/104 vs 0/36 cases with Wexner scores > 3, P = 0.042) than following incomplete sphincterotomy. There was a strongly significant increase in incontinence scores (P < 0.001) and decrease in recurrence rates (P < 0.001) with increasing length of sphincterotomy.

Conclusion  We recommend a short and CS using either PLIS or OLIS for the treatment of idiopathic anal fissure.
Comparison of the short‐term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients
Authors: Ersoy E. , Devay A. O. , Aktimur R. , Doganay B. , Özdoğan M. , Gündoğdu R. H.
Published: July 2008

Objective  The study was designed to compare the early postoperative results of the commonly used two surgical flap procedures in pilonidal disease: Karydakis and Limberg.

Method  One hundred patients were randomized into two groups and standard Limberg or Karydakis procedures were performed. All had primary sinus orifices. Infected cases and the ones with secondary orifices over 2 cm distant from primary were excluded. Data were recorded concerning complications, need for analgesia and wound dressing, periods of time off work and off driving. Patients were asked to classify their first defecation manner after the operation and also pain according to a Visual Analogue Scale with range of 1–10.

Results  There was a significantly higher wound infection rate in the Karydakis group than in the Limberg group (13/50 and 4/50 respectively). This also resulted in significantly higher values for wound dressings and need for analgesia. The time off work and off driving and also the Visual Analogue Scale scores were not significantly different between the two groups.

Conclusion  Both procedures can be safely performed in pilonidal disease with a standard length of stay in hospital and a similar loss of productive power. However, the Karydakis flap seems to have a significant higher infection rate and this probably increases the cost.
Congruency as a Nonspecific Perceptual Property Contributing to Newborns’ Face Preference
Authors: Macchi Cassia Viola , Valenza Eloisa , Simion Francesca , Leo Irene
Published: July 2008

Past research has shown that top‐heaviness is a perceptual property that plays a crucial role in triggering newborns’ preference toward faces. The present study examined the contribution of a second configural property, congruency, to newborns’ face preference. Experiments 1 and 2 demonstrated that when embedded in nonfacelike stimuli, congruency induces a preference of the same strength as that induced by facedness. Experiments 3 and 4 demonstrated that the attentional biases toward facedness and congruency produce a cumulative effect on newborns’ visual preferences according to an additive model. These findings were extended by those of Experiment 5, showing that the additive model holds true when congruency is added to top‐heaviness in nonfacelike stimuli displaying more elements in the upper portion.
Grownups Are Not Afraid of Scary Stuff, but Kids Are: Young Children’s and Adults’ Reasoning About Children’s, Infants’, and Adults’ Fears
Authors: Sayfan Liat , Lagattuta Kristin Hansen
Published: July 2008

Three‐, 5‐, and 7‐year‐olds and adults (N= 64) listened to stories depicting 2 protagonists of different ages (infant and child or child and grownup) that encounter an entity that looks like a real (e.g., a snake) or an imaginary (e.g., a ghost) fear‐inducing creature. Participants predicted and explained each protagonist’s intensity of fear. Results showed significant age‐related increases in knowledge that infants and adults would experience less intense fears than young children and that people’s fears are causally linked to their cognitive mental states. Across age, stories involving imaginary beings elicited more frequent mental explanations for fear than stories about real creatures. Results are discussed in relation to children’s developing awareness of the mind as mediating between situations and emotions.
Gender and Patterns of Concerned Responsiveness in Representations of the Mother–Daughter and Mother–Son Relationship
Authors: Butler Ruth , Shalit‐Naggar Rachel
Published: July 2008

Given that girls show more interpersonal concern than boys, it was predicted that more mother–daughter than mother–son dyads would develop a relationship of mutual concerned responsiveness (CR). Two hundred and twenty‐six Israeli children (7–8 years old) and 91 mother–child pairs provided narratives of mother–child interactions. At high levels of socioeconomic status (SES), descriptions of child but not maternal concern differed by gender; therefore, more mother–daughter narratives described mutual CR and more mother–son narratives described a nonreciprocal pattern of maternal CR. In a low‐SES sample, most mother–daughter narratives described mutual CR, but many mothers and sons described little concern by either partner. Results provided clear evidence of gender differences in mother–child reciprocity and confirmed the importance of examining gender influences in different social groups.
Development of Feedforward Control in a Dynamic Manual Tracking Task
Authors: Van Roon Dominique , Caeyenberghs Karen , Swinnen Stephan P. , Smits‐Engelsman Bouwien C. M.
Published: July 2008

To examine the development of feedforward control during manual tracking, 117 participants in 5 age groups (6 to 7, 8 to 9, 10 to 11, 12 to 14, and 15 to 17 years) tracked an accelerating dot presented on a monitor by moving an electronic pen on a digitizer. To remain successful at higher target velocities, they had to create a predictive model of the target’s motion. The ability to track the target at higher velocities increased, and the application of a feedback‐based step‐and‐hold strategy decreased with age, as shown by increases in maximum target velocity and decreases in number of stops between ages 6–7 and 8–9 and between ages 8–9 and 10–11. The ability to exploit feedforward control in a dynamic tracking task improves significantly with age.
Social and Cognitive Correlates of Children’s Lying Behavior
Authors: Talwar Victoria , Lee Kang
Published: July 2008

The relation between children’s lie‐telling and their social and cognitive development was examined. Children (3–8 years) were told not to peek at a toy. Most children peeked and later lied about peeking. Children’s subsequent verbal statements were not always consistent with their initial denial and leaked critical information revealing their deceit. Children’s conceptual moral understanding of lies, executive functioning, and theory‐of‐mind understanding were also assessed. Children’s initial false denials were related to their first‐order belief understanding and their inhibitory control. Children’s ability to maintain their lies was related to their second‐order belief understanding. Children’s lying was related to their moral evaluations. These findings suggest that social and cognitive factors may play an important role in children’s lie‐telling abilities.
Moral Development in a Violent Society: Colombian Children’s Judgments in the Context of Survival and Revenge
Authors: Posada Roberto , Wainryb Cecilia
Published: July 2008

Ninety‐six Colombian children (mean age = 7.7 years) and adolescents (mean age = 14.6 years) made judgments about stealing and physical harm in the abstract and in the context of survival and revenge. All participants judged it wrong to steal or hurt others because of considerations with justice and welfare, and most also judged it wrong to engage in such actions even when they can aid in survival. Their judgments in the context of revenge were more mixed, with a sizable proportion endorsing stealing and hurting in that condition. Furthermore, the majority expected that people would steal and hurt others in most situations. Significant age differences were also found. The consequences of political violence for moral development are discussed.
Pathways to Literacy: A Study of Invented Spelling and Its Role in Learning to Read
Authors: Ouellette Gene , Sénéchal Monique
Published: July 2008

This intervention study tested whether invented spelling plays a causal role in learning to read. Three groups of kindergarten children (mean age = 5 years 7 months) participated in a 4‐week intervention. Children in the invented‐spelling group spelled words as best they could and received developmentally appropriate feedback. Children in the 2 comparison groups were trained in phonological awareness or drew pictures. Invented‐spelling training benefited phonological and orthographic awareness and reading of words used in the intervention. Importantly, the invented‐spelling group learned to read more words in a learn‐to‐read task than the other groups. The finding are in accord with the view that invented spelling coupled with feedback encourages an analytical approach and facilitates the integration of phonological and orthographic knowledge, hence facilitating the acquisition of reading.
Coaching, Truth Induction, and Young Maltreated Children’s False Allegations and False Denials
Authors: Lyon Thomas D. , Malloy Lindsay C. , Quas Jodi A. , Talwar Victoria A.
Published: July 2008

This study examined the effects of coaching (encouragement and rehearsal of false reports) and truth induction (a child‐friendly version of the oath or general reassurance about the consequences of disclosure) on 4‐ to 7‐year‐old maltreated children’s reports (N = 198). Children were questioned using free recall, repeated yes–no questions, and highly suggestive suppositional questions. Coaching impaired children’s accuracy. For free‐recall and repeated yes–no questions, the oath exhibited some positive effects, but this effect diminished in the face of highly suggestive questions. Reassurance had few positive effects and no ill effects. Neither age nor understanding of the meaning and negative consequences of lying consistently predicted accuracy. The results support the utility of truth induction in enhancing the accuracy of child witnesses’ reports.
A Developmental Perspective on Full‐ Versus Part‐Day Kindergarten and Children’s Academic Trajectories Through Fifth Grade
Authors: Votruba‐Drzal Elizabeth , Li‐Grining Christine P. , Maldonado‐Carreño Carolina
Published: July 2008

Children’s kindergarten experiences are increasingly taking place in full‐ versus part‐day programs, yet important questions remain about whether there are significant and meaningful benefits to full‐day kindergarten. Using the Early Childhood Longitudinal Study’s Kindergarten Cohort (N= 13,776), this study takes a developmental approach to examining associations between kindergarten program type and academic trajectories from kindergarten (ages 4–6 years) through 5th grade (ages 9–12 years). Full‐day kindergarten was associated with greater growth of reading and math skills from fall until spring of kindergarten. Initial academic benefits diminished soon after kindergarten. The fade‐out of the full‐day advantage is in part explained by differences in the children who attend part‐ and full‐day kindergarten as well as school characteristics.