bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural features in the C‐terminal region of the Sinorhizobium meliloti RmInt1 group II intron‐encoded protein contribute to its maturase and intron DNA‐insertion function
Authors: Molina‐Sánchez María D. , Martínez‐Abarca Francisco , Toro Nicolás
Published: November 2009

Group II introns are both catalytic RNAs and mobile retroelements that move through a process catalyzed by a RNP complex consisting of an intron‐encoded protein and the spliced intron lariat RNA. Group II intron‐encoded proteins are multifunctional and contain an N‐terminal reverse transcriptase domain, followed by a putative RNA‐binding domain (domain X) associated with RNA splicing or maturase activity and a C‐terminal DNA binding/DNA endonuclease region. The intron‐encoded protein encoded by the mobile group II intron RmInt1, which lacks the DNA binding/DNA endonuclease region, has only a short C‐terminal extension (C‐tail) after a typical domain X, apparently unrelated to the C‐terminal regions of other group II intron‐encoded proteins. Multiple sequence alignments identified features of the C‐terminal portion of the RmInt1 intron‐encoded protein that are conserved throughout evolution in the bacterial ORF class D, suggesting a group‐specific functionally important protein region. The functional importance of these features was demonstrated by analyses of deletions and mutations affecting conserved amino acid residues. We found that the C‐tail of the RmInt1 intron‐encoded protein contributes to the maturase function of this reverse transcriptase protein. Furthermore, within the C‐terminal region, we identified, in a predicted α‐helical region and downstream, conserved residues that are specifically required for the insertion of the intron into DNA targets in the orientation that would make it possible to use the nascent leading strand as a primer. These findings suggest that these group II intron intron‐encoded proteins may have adapted to function in mobility by different mechanisms to make use of either leading or lagging‐oriented targets in the absence of an endonuclease domain.
The sigma factors of Mycobacterium tuberculosis: regulation of the regulators
Authors: Sachdeva Preeti , Misra Richa , Tyagi Anil K. , Singh Yogendra
Published: November 2009

One of the important determinants of virulence of Mycobacterium tuberculosis is adaptation to adverse conditions encountered in the host cells. The ability of Mycobacterium to successfully adapt to stress conditions is brought about by the expression of specific regulons effected by a repertoire of σ factors. The induction and availability of σ factors in response to specific stimuli is governed by a complex regulatory network comprising a number of proteins, including σ factors themselves. A serine–threonine protein kinase‐mediated signaling pathway adds another dimension to the mycobacterial σ factor regulatory network. This review highlights the recent advances in understanding mycobacterial σ factors, their regulation and contribution to bacterial pathogenesis.
Quantitative measure of evolution of bright cluster galaxies at moderate redshifts
Authors: Vikram Vinu , Wadadekar Yogesh , Kembhavi Ajit K. , Vijayagovindan G. V.
Published: November 2009

Using archival data from the Hubble Space Telescope, we study the quantitative morphological evolution of spectroscopically confirmed bright galaxies in the core regions of nine clusters ranging in redshift from z = 0.31 to 0.84. We use morphological parameters derived from two-dimensional bulge–disc decomposition to study the evolution. We find an increase in the mean bulge-to-total luminosity ratio as the Universe evolves. We also find a corresponding increase in the fraction of early-type galaxies and in the mean Sérsic index. We discuss these results and their implications to physical mechanisms for evolution of galaxy morphology.
Protein kinase C mRNA and protein expressions in hypobaric hypoxia‐induced cardiac hypertrophy in rats
Authors: Uenoyama M. , Ogata S. , Nakanishi K. , Kanazawa F. , Hiroi S. , Tominaga S. , Seo A. , Matsui T. , Kawai T. , Suzuki S.
Published: November 2009

Aim:  Protein kinase C (PKC), cloned as a serine/threonine kinase, plays key roles in diverse intracellular signalling processes and in cardiovascular remodelling during pressure overload or volume overload. We looked for correlations between changes in PKC isoforms (levels and/or subcellular distributions) and cardiac remodelling during experimental hypobaric hypoxic environment (HHE)‐induced pulmonary hypertension.

Methods:  To study the PKC system in the heart during HHE, 148 male Wistar rats were housed for up to 21 days in a chamber at the equivalent of 5500 m altitude level (10% O2).

Results:  At 14 or more days of exposure to HHE, pulmonary arterial pressure (PAP) was significantly increased. In the right ventricle (RV): (1) the expression of PKC‐α protein in the cytosolic and membrane fractions was increased at 3–14 days and at 5–7 days of exposure respectively; (ii) the cytosolic expression of PKC‐δ protein was increased at 1–5, 14 and 21 days of exposure; (3) the membrane expressions of the proteins were decreased at 14–21 (PKC‐βII), 14–21 (PKC‐γ), and 0.5–5 and 21 (PKC‐ε) days of exposure; (4) the expression of the active form of PKC‐α protein on the plasma membrane was increased at 3 days of exposure (based on semiquantitative analysis of the immunohistochemistry). In the left ventricle, the expressions of the PKC mRNAs, and of their cytosolic and membrane proteins, were almost unchanged. The above changes in PKC‐α, which were strongly evident in the RV, occurred alongside the increase in PAP.

Conclusion:  PKC‐α may help to modulate the right ventricular hypertrophy caused by pulmonary hypertension in HHE.
The Impact of Self‐Affirmation on Health Cognition, Health Behaviour and Other Health‐Related Responses: A Narrative Review
Authors: Harris Peter R. , Epton Tracy
Published: November 2009

There is growing evidence that self‐affirmation – the process of reflecting upon cherished values or attributes – may have implications for health. Postulated effects range from reducing the defensive resistance to unwelcome health‐risk information to ameliorating the physiological response to stress. In this, the first detailed review of the literature on self‐affirmation and health, we summarise what is known. Self‐affirming can increase acceptance of unwelcome health‐risk information, especially among those at greatest risk. Self‐affirmed participants typically also report more intention to change behaviour postmessage. There is evidence that certain effects of self‐affirming may endure. Self‐affirmation has also been shown to have beneficial effects on the response to stress. There is, however, currently only limited evidence of actual health‐behaviour change following self‐affirmation. We discuss reasons for this and consider key research questions for the next phase of research.
The Concept of Situations
Authors: Yang Yu , Read Stephen J. , Miller Lynn C.
Published: November 2009

The concept of situations has a long past, but the conceptualization of situations only has a short history. This article provides a survey of the concept of situations. Based upon Milgram’s [Human Relations 18 (1965), 57] vision toward ‘a compelling theory of situations,’ the authors examine the concept of situations in three specific literatures: definitions of situations, taxonomies of situations, and interrelationships among persons, situations, and behaviors. To further integrate the literature, the authors propose that the essence of a situation is its affordance of human goals, and that situations are largely characterized by two specific principles of goal processes (what happened, is happening, or might happen to people’s goals) and goal contents (the specific goals afforded in the situation).
Skeletal changes mimicking intrathoracic disease on chest radiographs
Authors: Van Gelderen WFC
Published: November 2009

Various chest radiographs are illustrated to demonstrate features where bony changes may mimic intrathoracic disease. To confirm the skeletal origin and nature, further conventional radiographs often suffice, and the need for CT or scintigraphy may therefore be obviated. At the time of presentation for radiography of the chest, further pertinent clinical details can be obtained from the patient by the department staff, as required. All previous radiographs and radiological reports should be readily available. In order to add to the educational value of the 13 cases illustrated, all are presented in quiz format, with the answers and further images included in the text.
Locally invasive nodular lymphoid hyperplasia: Radiological findings in a case of pulmonary and sinus disease
Authors: Siemienowicz M , Simkin P , Straub A , House R
Published: November 2009

Nodular lymphoid hyperplasia is a rare, benign, lymphoproliferative disease usually found in the gastrointestinal tract. It has never been reported in the sinuses. We present an unusual case of pulmonary nodular lymphoid hyperplasia with locally invasive sinus involvement and describe the CT, MRI and positron emission tomography findings.
Photodynamic therapy for chronic central serous chorioretinopathy
Authors: Ruiz‐Moreno José M. , Lugo Francisco L. , Armadá Felix , Silva Rufino , Montero Javier A. , Arevalo J. Fernando , Arias Luis , Gómez‐Ulla Francisco
Published: November 2009

Purpose:  This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC).

Methods:  We describe a non‐randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators.

Results:  Mean follow‐up was 12 ± 10 months and mean age was 46 ± 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student’s t‐test for paired data). Mean BCVA at the end of follow‐up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 μm (SD 95), to 229 μm (SD 70) at 1 month after PDT, 206 μm (SD 68) at 3 months, and 202 μm (SD 76) at 6 months (all p < 0.0001, Student’s t‐test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT.

Conclusions:  Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow‐up are needed to assess the real role of this treatment in chronic CSC.
Rat small intestine expresses the reelin–Disabled‐1 signalling pathway
Authors: García‐Miranda P. , Peral M. J. , Ilundain A. A.
Published: November 2009

Expression of reelin, reelin receptors [apolipoprotein E receptor 2 (ApoER2) and very low density lipoprotein receptor (VldlR)] and the Disabled‐1 (Dab1) protein was investigated in rat intestinal mucosa. Intestinal reelin and Dab1 mRNA levels were maximal in the early stages of life, reaching adult levels in 1‐month‐old rats. Expression of reelin mRNA was restricted to fibroblasts, whereas mRNAs of Dab1, ApoER2, VldlR and integrins α3 and β1 were observed in enterocytes, crypts and fibroblasts. Reelin protein was only observed in isolated intestinal fibroblasts and in a cell layer subjacent to the villus epithelium, which seems to be composed of myofibroblasts because it also reacted to α‐smooth muscle actin. The Disabled‐1 and VldlR protein signals were detected in the crypt and villus cells, and they were particularly abundant in the terminal web domain of the enterocytes. The ApoER2 protein signal was detected in the upper half of the villi but not in the crypts. This is the first report showing that rat intestinal mucosa expresses the reelin–Disabled‐1 signalling system.
Cell Signaling in Space and Time: Where Proteins Come Together and When They’re Apart
Authors: Scott John D. , Pawson Tony
Published: November 2009

Signal transduction can be defined as the coordinated relay of messages derived from extracellular cues to intracellular effectors. More simply put, information received on the cell surface is processed across the plasma membrane and transmitted to intracellular targets. This requires that the activators, effectors, enzymes, and substrates that respond to cellular signals come together when they need to.
No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports
Authors: Bahr R
Published: November 2009

Overuse injuries may represent as much of a problem as do acute injuries in many sports. This paper reviews key concepts related to the methodology for recording overuse symptoms. Results from the FIVB Volleyball Injury Study were used to compare two different recording methods. The aim of this paper was to provide recommendations on how standardised methodology can be developed to quantify overuse injuries in surveillance studies. Using beach volleyball data, a “traditional” cohort study approach using a time-loss injury definition suggested that injury risk was very low. In contrast, the data from a survey of past and present pain problems in the shoulder, knees and low back demonstrated that these were prevalent. The following recommendations are made: (1) studies should be prospective, with continuous or serial measurements of symptoms; (2) valid and sensitive scoring instruments need to be developed to measure pain and other relevant symptoms; (3) prevalence and not incidence should be used to report injury risk; (4) severity should be measured based on functional level and not time loss from sports. In conclusion, new approaches are needed to develop more appropriate methodology to quantify overuse injuries in studies.
Paediatric and adolescent sport injury in the wilderness
Authors: Heggie T W
Published: November 2009

Participation in backcountry wilderness recreation has increased in recent years with children and adolescents making up an increasing number of participants visiting wilderness destinations. Engaging in wilderness activity involves the risk of injury, illness and even death. Unfortunately, there is very little research investigating the health challenges facing children and adolescents in the wilderness. With the intent of increasing awareness among the sports medicine community, this review examines reported paediatric and adolescent wilderness injuries reported in the state of Washington and in US National Parks, injuries reported during outdoor wilderness programmes and global youth expeditions, and health challenges in wilderness settings where the threat of acute mountain sickness is elevated. Future studies addressing the challenges of establishing numerator data linked to suitable denominator data and monitoring injured and non-injured children and adolescents in the wilderness are recommended.
Injuries about the shoulder in skiing and snowboarding
Authors: McCall D , Safran M R
Published: November 2009

There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities.
Hamartomas, papillomas and adenocarcinomas of the sinonasal tract and nasopharynx
Authors: Perez-Ordoñez B
Published: November 2009

Lesions of the sinonasal tract are uncommon, with most of the specimens seen by surgical pathologists consisting primarily of fragments of inflamed sinonasal mucosa or inflammatory polyps from patients with chronic rhinosinusitis, and the occasional squamous cell carcinoma. Other lesions such as hamartomas, various types of Schneiderian papillomas and adenocarcinomas are seen only rarely by most histopathologists; therefore a biopsy or surgical resection specimen from a patient with one of these processes may represent a diagnostic challenge. The aim of this review is to present the pathological features of a group of infrequent epithelial surface and glandular lesions of the sinonasal tract which includes respiratory epithelial adenomatoid hamartoma, glandular (seromucinous) hamartoma, exophytic papilloma, inverted papilloma, cylindrical cell (oncocytic) papilloma, low-grade sinonasal adenocarcinoma and intestinal-type sinonasal adenocarcinoma.
Detection and characterisation of β-globin gene cluster deletions in Chinese using multiplex ligation-dependent probe amplification
Authors: So C C , So A C Y , Chan A Y Y , Tsang S T Y , Ma E S K , Chan L C
Published: November 2009

Background:

Deletions in the β-globin cluster causing thalassaemia and hereditary persistence of fetal haemoglobin (HPFH) are uncommon and difficult to detect. Data in Chinese are very scarce.

Aims:

To use a recently available technique to investigate the frequencies and nature of β-globin cluster deletions in Chinese.

Methods:

106 subjects with phenotypes of thalassaemia or HPFH and suspected to have deletions in the β-globin cluster were studied. A commercially available kit employing multiplex ligation-dependent probe amplification (MLPA) was used to screen for deletions. Gap PCR and direct nucleotide sequencing were used to characterise deletions detected.

Results:

17 deletions in the β-globin cluster were found in 17 patients: 8 of Chinese (Aγδβ)0thalassaemia, 7 of Southeast Asian (Vietnamese) deletion and 2 of Thai (Aγδβ)0thalassaemia. The only type of deletion detected in δβ-thalassaemia was Chinese (Aγδβ)0thalassaemia. The deletional form of HPFH was rarely seen in only 1 case of Thai (Aγδβ)0thalassaemia. Deletions presenting as β-thalassaemia trait and raised HbF were all of the Southeast Asian (Vietnamese) deletion type. When these deletions were co-inherited with classical β-thalassaemia mutations in compound heterozygous states, the phenotypes could be very variable.

Conclusions:

In the Chinese population, there are only relatively few types of deletions seen in the β-globin cluster. MLPA is a fast and effective way of screening for these deletions. Characterisation of these deletions allows the development of simpler and more specific PCR-based tests for routine diagnostic use. Accurate prediction of phenotype is not always feasible. The molecular defects in many cases of HPFH still await discovery.
CD24 shows early upregulation and nuclear expression but is not a prognostic marker in colorectal cancer
Authors: Ahmed M A H , Al-Attar A , Kim J , Watson N F S , Scholefield J H , Durrant L G , Ilyas M
Published: November 2009

Background and aims:

The putative stem cell marker CD24 is a small, heavily glycosylated, cell surface molecule which was originally associated with tumour metastasis. Recently it has been reported to be upregulated and of prognostic importance in colorectal tumours. The study aims to study the prognostic value of CD24 in a large series of colorectal cancer (CRC).

Methods:

CD24 protein expression was examined by immunohistochemistry. A total of 10 whole tissue sections (WTS) of adenoma and 345 CRCs arranged as tissue microarrays (TMAs) were evaluated. For comparison with non-neoplastic tissue, 10 WTS containing tumour with associated non-neoplastic tissue were also studied.

Results:

None of the samples of normal tissue (adjacent to tumour) showed CD24 expression. In the tumours, CD24 expression was seen on the luminal surface of the cells, within the cytoplasm and, unexpectedly, also within the nucleus. Positive immunostaining was seen in 9/10 (90%) adenomas and 313/345 (91%) of CRCs. Weak statistical associations were found between CD24 expression and some clinicopathological features. In contrast to other published studies, however, the analysis did not show any association between CD24 expression and poor prognosis—if anything it was found that loss of CD24 expression appeared to be more related to poor outcome.

Conclusion:

Upregulation of CD24 is an early and common event during the development of CRC and it may be expressed in any cellular compartment, including the nucleus. CD24 is not, however, a good prognostic marker in CRC.
The Impact of Chronic Inflammation on the Growing Skeleton: Lessons from Interleukin-6 Transgenic Mice
Authors: De Benedetti F.
Published: November 2009

Background: Chronic inflammatory diseases in children are associated with impairment of linear growth and bone mineral accrual. In addition to poor nutrition, reduced mobility and glucocorticoid treatment, several observations in patients suggest that inflammation itself may have a direct detrimental effect on the growing skeletal system. Among the various inflammatory cytokines produced during the inflammatory response, data in animals suggest that interleukin-6 (IL-6) may mediate the effects of inflammation on the developing skeleton. Mice overexpressing IL-6 during the prepubertal stage show stunted growth, abnormalities of the insulin-like growth factor I system, defective growth plates, delayed development of ossification centres, uncoupling of osteoblast and osteoclast activity and defective ossification. These changes appear to mirror the features observed in children with chronic inflammatory diseases. Conclusions: The tissue, cellular and molecular abnormalities reviewed provide a rationale for therapeutic approaches aimed at correcting the detrimental effects of inflammation on the developing skeletal system.
Effects of Growth Hormone Treatment on Growth in Children with Juvenile Idiopathic Arthritis
Authors: Simon D. , Bechtold S.
Published: November 2009

Background: Several therapeutic trials have been conducted over the past decade to evaluate the role of exogenous growth hormone (GH) as a means of correcting the growth deficiency seen in children with juvenile idiopathic arthritis (JIA). Early studies showed the benefit of GH treatment with respect to final height in patients with JIA. Of 13 patients receiving GH, 84% (11 patients) achieved a final height within their target range compared with only 22% (4 of 18 patients) of untreated patients. There are, however, factors that may limit the statural gains achieved with GH therapy including severe inflammation, severe statural deficiency at GH therapy initiation, long disease duration and delayed puberty. Data on the efficacy of GH replacement therapy in children with JIA and factors that influence the statural growth response will be reviewed. Conclusions: Results from therapeutic trials show that treatment with GH can decrease the statural deficit that occurs during the active phase of JIA, producing an adult height that is close to the genetically determined target height.
Effect of Amnioinfusion on the Umbilical Doppler Flow Velocity Waveform: A Case Report
Authors: van den Wijngaard J.A.G.W. , Pijpers L. , Reuss A. , Wladimiroff J.W.
Published: November 2009

A case of intrauterine growth retardation with marked oligohydramnios is presented in which, following amnioinfusion of 200 ml of a 5% glucose solution, the diagnosis of bilateral renal agenesis was established. Doppler flow study in the umbilical artery revealed a high resistance flow velocity waveform which became normal following amnioinfusion, suggesting cord compression rather than poor uteroplacental perfusion. Abnormal Doppler flow velocity waveforms in the umbilical artery in the presence of severe oligohydramnios should be interpreted with caution.
Fetal Therapy: Ethical and Legal Implications of Prenatal Intervention and Clinical Application
Authors: Brodner Robert A. , Shuster Evelyne
Published: November 2009

Recent advances in antenatal diagnosis have stimulated interest in the development of techniques for in utero treatment of fetal abnormalities. This article identifies and discusses the ethical and legal problems which emerge from fetal therapy. Is a fetus a patient? Does the fetus have rights? Who should give consent for the unborn? Does the fetus have redress if it is injured? Could a pregnant woman be forced to undergo treatment which could endanger her life and health for the benefit of the fetus? Answers to these questions are not clear and create in themselves additional queries. Until fetal therapy becomes an accepted medical practice, the resolution of the ethical and legal issues that it provokes will probably remain inconclusive and a matter of concern.
Abnormal Fetal Cerebral Blood Flow Velocity Waveforms as a Sign of an Aneurysm of the Vein of Galen
Authors: Rizzo Giuseppe , Arduini Domenico , Colosimo, Jr. Cesare , Boccolini Maria Rita , Mancuso Salvatore
Published: November 2009

A cerebral midline cystic lesion was detected by real-time ultrasound in utero in the absence of other congenital abnormalities. Pulsed Doppler ultrasound assessment of fetal circulation demonstrated normal peripheral and intracardiac hemodynamics associated with decreased cerebral vascular resistance. Furthermore, a markedly turbulent flow pattern was evidenced within the cerebral lesion. The presence of a cerebral arteriovenous malformation with an aneurysm of the vein of Galen was suggested and the provisional diagnosis was later confirmed by computed tomography and carotid angiography performed after birth.
Ultrasonic Assessment of Fetal Colon by Comparing Ratios of Colon Circumference to Abdominal Circumference in Normal Pregnancy and Two Abnormal Cases
Authors: Tepper Ron , Schoenfeld Alex , Ovadia Jardena
Published: November 2009

Fetal gastrointestinal malformations occur with an incidence of approximately 6/1,000 births and can often be diagnosed in utero by ultrasound. Antenatal knowledge of these abnormalities can potentially decrease fetal and neonatal morbidity and mortality because the appropriate preparations can be made in advance of delivery. Changes in ultrasonic images of the fetal colon were measured by comparing ratios of colon circumference to abdominal circumference in 136 normal pregnancies. Normal values of these parameters are given for gestational age. Two abnormal case reports are included to exemplify the clinical applications.
Development of Behavioral States in Hydrocephalic Fetuses
Authors: Arduini Domenico , Rizzo Giuseppe , Caforio Leonardo , Mancuso Salvatore
Published: November 2009

Behavioral states observations were carried out in 12 hydrocephalic fetuses by means of a computerized system. Recordings of behavioral parameters, including fetal heart rate, gross body movements, breathing movements and eye movements, were performed at 2-week intervals from 30 weeks of gestation onwards. The hydrocephalic fetuses showed quantitative and qualitative differences in their motor behavior in comparison to healthy fetuses of equivalent gestational age. Similarly the appearance of behavioral states was delayed in hydrocephalic fetuses. Furthermore, an increased discordance between the behavioral parameters was evidenced. The degree of discordance seems to be related to the severity of neonatal outcome suggesting a possible estimation of CNS dysfunction by means of behavioral state analysis.
Intraperitoneal Fetal Transfusion: Paralysis Inhibits Red Cell Absorption
Authors: Menticoglou Savas M. , Harman Chris R. , Manning Frank A. , Bowman John M.
Published: November 2009

This study was undertaken to determine whether differences in fetal activity could account for the unpredictability of absorption of red blood cells from the peritoneal cavity of fetuses with alloimmune hydrops. The absorption of red cells from the peritoneal cavity of fetal lambs was studied in 7 pregnant ewes. In 3 nonparalyzed fetuses, uptake of donor red cells was complete by 80 h. In 4 fetuses given pancuronium for 4 days to abolish breathing and body movements, the absorption of red cells was markedly diminished at 92 h, but was complete 3–4 days after fetal movement resumed. This study demonstrates that fetal movements are essential in ensuring the normal absorption of red cells from the peritoneal cavity. Variability in fetal movements, particularly fetal breathing movements, may explain the unpredictability of absorption of red cells from the peritoneal cavity in fetuses with hydrops fetalis.
Ethical Guidelines in Fetal Medicine
Authors: Crawfurd M.d’A.
Published: November 2009

The ethical guidelines in the clinical practice of fetal medicine are discussed, largely from the point of view of early prenatal diagnosis. The discussion concentrates on several specific aspects including counselling, good procedure, prenatal screening, disclosure of results including fetal sex, experimentation and assessment of new technologies and health education. The emphasis is placed on the importance of informed consent, choice and understanding on the part of the patient, and the professional competence of the doctor and other professionals she may meet.
Fetal Echocardiography: A Review of Six Years Experience
Authors: Stewart P.A. , Wladimiroff J.W. , Reuss A. , Sachs E.S.
Published: November 2009

Between January 1982 and January 1988, 2,060 pregnant patients were scanned for congenital heart defects (CHD). In 76.5% of these patients, there was an increased risk of CHDs in their offspring. In this group there were 27 CHDs, 17 of which were correctly diagnosed prenatally. In the remaining 23.5% of the patients, the indication for cardiac studies was fetal pathology in the present pregnancy (fetal cardiac arrhythmia, polyhydramnios, severe intrauterine growth retardation, fetal ascites and suspected structural anomalies). In this group there were 82 CHDs, 79 of which were correctly diagnosed prenatally. The incidence of abnormal karyotype was 35%. When a CHD is diagnosed, a realistic prognosis can be given and appropriate obstetric measures taken according to the degree of disease. In cases with a good prognosis careful follow-up may be offered resulting in the delivery of an infant in optimal condition. Reassurance can be given to patients when abnormalities are excluded.
Gene Therapy
Authors: Drugan Arie , Miller Orlando J. , Evans Mark I.
Published: November 2009

Severe genetic disorders are potentially correctable by the addition of a normal gene into tissues. Although the technical problems involving integration, stable expression, and insertional damage to the treated cell are not yet fully solved, enough scientific progress has already been made to consider somatic cell gene therapy acceptable from both the ethical and scientific viewpoints. The resolutions to problems evolving from somatic cell gene therapy will help to overcome the technical difficulties encountered presently with germ line gene manipulation. This procedure would then become morally permissible as it will cause, in time, a reduction in the pool of abnormal genes in the population. Enhancement genetic engineering is technically feasible but morally unacceptable. Eugenic genetic engineering is not technically possible or ethically permissible in the foreseeable future.
Development of a Program for Planned Cesarean Delivery and Immediate Pediatric Surgical Repair of Ventral Wall Defects
Authors: Evans Mark I. , Drugan Arie , Greenholz Stephen K. , Hauff Nancy , Jewell Marvin R. , Klein Michael D.
Published: November 2009

The development of a program for timed elective delivery and immediate repair of ventral wall defects is described. Our experience with 3 cases of immediate surgical repair of gastroschisis shows that this program can be applied in tertiary care centers to shorten pre-and postoperative stay and to present the neonate to surgery in optimal condition.
A Reassessment of Pregnancy Staging
Authors: Pringle K.C.
Published: November 2009

A system of staging pregnancy that is directly related to normal development is proposed to replace the currently used ‘trimester’ system. If accepted, this concept of staging could be applied across species without the likelihood of a grossly incorrect assessment of the stage of development. In contrast to this, the division of a pregnancy into trimesters is based upon an accident of mathematics and bears no relationship to human development. The proposal is to divide pregnancy into three stages, termed ‘horizons’. First is the ‘embryonic horizon’ from fertilisation until the end of the 8th week from fertilisation, i.e. 10 weeks from the first day of the last menstrual period (LMP). The ‘early fetal horizon’ extends from the end of the embryonic phase to the 25th week of gestation (i.e 25 weeks from the first day of the LMP). This horizon is divided into the ‘primitive phase’ (up to the 15th week of gestation) and the ‘transitional phase’ (from the 15th to the 25th week of gestation). The ‘late fetal horizon’ extends from 25 weeks to beyond term and is divided into the ‘premature phase’ (from 25 weeks to 36 weeks of gestation), the ‘mature phase’ (36 weeks to term) and the ‘post-mature phase’ which extends from term to about 45 weeks of gestation. The importance of this phase is the fact that perinatal morbidity and mortality is proportional to the length of time the gestation continues beyond maturity. It must be stressed that the terms ‘horizon’ and ‘phase’ are intentionally imprecise. This is to emphasise that human development is a continuum and not a series of steps.
SDS-PAGE as an Additional Test to Determine Fetal Kidney Function prior to Intrauterine Diversion of Urinary Tract Obstruction
Authors: Holzgreve Wolfgang , Lison Arno , Bulla Monika
Published: November 2009

The analysis of urine obtained from fetuses with hydronephrosis, seen on ultrasound, can give a misleading assessment of residual renal function. Additional parameters for assessment of fetal renal function would be helpful. We have used SDS-polyacrylamide gel electrophoresis to separate urinary proteins from a fetus with obstructive uropathy and severe oligohydramnios, already present at 18 weeks of gestation. The dilated urinary bladder of the fetus was successfully shunted in utero with a double pigtail catheter which worked for 17 weeks, and a boy without renal or pulmonary insufficiency was born at 36 weeks. In this case the prenatal protein analysis by electrophoresis was a better indicator of the ultimate good pregnancy outcome than the evaluation of urinary electrolytes and osmolarity alone. We therefore suggest the addition of this test to the profile of renal function studies performed on fetal urine.
Computer-Assisted Analysis of Fetal Behavior in Fetal Abnormalities
Authors: Shinozuka Norio , Masuda Haruo , Okai Takashi , Kuwabara Yoshinori , Mizuno Masahiko
Published: November 2009

Fetal behavior was studied in 17 cases of fetal abnormalities including nonimmune hydrops fetalis and in 11 cases of intrauterine growth retardation (IUGR) in comparison to 30 healthy fetuses. Breathing movements, rapid eye movements and trunk movements were observed ultrasonically and analyzed using a computer-assisted system. The cases with central nervous system anomalies showed a markedly different behavioral pattern. In the fetal abnormalities without chromosomal anomalies, the cases without major behavioral disorders were cured by neonatal treatment. IUGR cases with decreased trunk, breathing and REM period were finally diagnosed as having fetal distress by fetal heart rate monitoring. The findings on fetal behavior hint at the possibility of diagnosing abnormalities in neural development as well as in well-being.
Symmetrical Intrauterine Growth Retardation Is Not Symmetrical: Organ-Specific Gravimetric Deficits in Midtrimester and Neonatal Trisomy 18
Authors: Johnson Mark Paul , Barr, Jr. Mason , Qureshi Faisal , Drugan Arie , Evans Mark I.
Published: November 2009

Models to predict normal fetal growth have been of limited accuracy. Abnormal growth is even more problematic. We have developed a mathematical modeling system based on observed body and brain weights to study fetal growth patterns in midgestational trisomy 18 fetuses. Third-degree polynomial-based analysis using observed fetal body and brain weights to generate predicted weights for various organ systems allows for the comparative study of growth patterns at various fetal weights and gestational ages. Our data suggest that what has been previously called symmetrical intrauterine growth retardation associated with aneuploid fetuses is really an asymmetrical pattern that is dynamic in nature and may change through the course of pregnancy.
Reevaluation of Nonstress Test by Umbilical Venous Blood Profile Using Cordocentesis
Authors: Okamura Kunihiro , Endoh Hidetaka , Watanabe Takanori , Tanigawara Shingo , Iwamoto Mitsuru , Murotsuki Jun , Yajima Akira
Published: November 2009

Fetal blood sampling by cordocentesis was performed in 85 cases of fetuses with either nonimmune hydrops fetalis, anomalies, intrauterine growth retardation, maternal immunological disorders, Rh incompatibility, hydronephrosis, polyhydramnios, maternal preeclampsia or fetal tumor. Fetal heart rate monitoring was also recorded before cordocentesis. We evaluated the usefulness of the nonstress test (NST) with regard to fetal hematologic gas profiles including pH, pO2 and pCO2. When the acceleration was classified into reactive and nonreactive group, pH and pO2 were significantly higher in the reactive group than in the nonreactive group. pCO2 was significantly lower in the former than the latter. However, the sensitivity and specificity of the reactive NST predicting fetal umbilical venous pO2 over 20 mm Hg was 79.7 and 68.7%, respectively. The false-positive rate of nonreactive NST predicting hypoxemia below 20 mm Hg pO2 was 44%. As a consequence, we cannot always rely on the NST, and should perform fetal blood sampling to assess fetal condition for further management.
Amniotic Fluid Alpha-Fetoprotein Levels in the Differential Diagnosis of Cystic Hygroma
Authors: Sorokin Yoram , Johnson Mark Paul , Drugan Arie , Koppitch III Frederick C. , Evans Mark I.
Published: November 2009

In 7 second trimester pregnancies ultrasound (US) demonstrated cystic hygroma colli (CHC); amniocentesis was performed in 6 patients. In the 7th patient, because of oli-gohydramnios, the fluid for karyotype was aspirated from the CHC. Five pregnancies had been referred secondary to abnormalities on US and 2 others because of low maternal serum alpha-fetoprotein (MSAFP). Four karyotypes were abnormal (45, X; 47, XX+21; 47.XY+21; 46, XX/45, X), and 3 had normal karyotypes. Amniotic fluid alpha-fetoprotein (AFAFP) was normal in 4 pregnancies and low in 2 (0.09 MOM, 0.41 MOM). Of 2 pregnancies with trisomy 21 one had been referred for low MSAFP. In 2 pregnancies with normal karyotypes, US findings at early gestational age (14–17 weeks) of small, nonseptated, bilateral CHC disappeared during pregnancy; these women delivered normal, term babies. Most prenatally diagnosed CHC are not in fetuses with Turner syndrome. With a normal karyotype and CHC as the only finding on early US in utero, normal neonatal survival is possible. AFAFP is not elevated in pregnancies with CHC. If AFAFP is elevated with a positive acetylcholinesterase, such results may suggest that the CHC was inadvertently aspirated.
Tryptophan Availability and Fetal Behavioral States
Authors: Romanini Carlo , Valensise Herbert , Ciotti Giuseppina , Arduini Domenico , Giorgi Pierhigi
Published: November 2009

Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance liquid chromatography in 20 growth-retarded fetuses due to pregnancy-induced hypertension (PIH) and 20 normal pregnancies as control group. The fetomaternal ratio of tryptophan is significantly higher in normal fetuses than in PIH growth-retarded fetuses (p < 0.001). Behavioral states have been determined 1 week and just before cesarean section. Values of IF, 2F, 3F and 4F differ in the 2 groups (p < 0.001). A higher percentage of non-coincidences (p < 0.001) and state interruptions (p < 0.001) is found in PIH fetuses. A significant correlation is demonstrated between the increase of non-coincidences and decrease in the fetomaternal Trp ratio (p < 0.001).
Neural Tube Defects: Considerations on the Pathogenesis and Correlation with Myelodysplasia in Man
Authors: Di Rocco Concezio , Rende Mario
Published: November 2009

In this first part, a brief review of some of the general embryological, pathogenetical and experimental aspects of neural tube defects is made. In particular, the importance of the extracellular matrix and glycosaminoglycans is discussed in relation with neural tube defects.
Collection and Use of Fetal Central Nervous System Tissue
Authors: Seiger Åke
Published: November 2009

A recent promising development in the field of central nervous system (CNS) tissue transplantation has suggested the use of human fetal CNS tissue from first trimester abortions for xenografting/explantation. Such experiments would certainly expand our knowledge of the normal developmental mechanisms in the human CNS, and allow studies of various indices of maturation and CNS function. However, the suggestion is looked upon with hesitance for ethical, legal and perhaps even for scientific reasons. The initial experiments have been very valuable, though, for our understanding of the structural and functional development of the human CNS, and several legal and ethical concerns have been addressed in working out the procedures for retrieving such tissue. This article tries to put our present knowledge in the right perspective of scientific achievements and potential, legal restrictions and ethical concerns.
Built on Shifting Sands: Changes in Employers’ Use of Contingent Labour in the UK Construction Sector
Authors: Forde Chris , MacKenzie Robert , Robinson Andrew
Published: November 2009

There has been widespread interest across various national contexts in employers’ use of contingent forms of labour. The tendency to conflate different contract types into catch-all categories has increasingly given way to recognition of the differences between forms of labour. Despite this, systematic comparisons of employers’ attitudes to different forms of labour remain an underdeveloped area of research. Drawing on an original survey of the UK construction sector this paper offers new insight into employers’ attitudes to different forms of contingent labour and tracks changes in their use. Uniquely, the analysis of movement between different forms of labour goes beyond approaches that focus on the dichotomy between direct and contingent labour to trace a more complex pattern of movement between the different contingent forms. This more nuanced picture of changing patterns of employers’ use of contingent labour suggests an area for development in future research.
Contrasting Management and Employment-Relations Strategies in European Airlines
Authors: Bamber Greg J. , Hoffer Gittell Jody , Kochan Thomas A. , von Nordenflycht Andrew
Published: November 2009

We discuss deregulation (liberalization) and some of the international institutions that influence the management of people in airlines. As a point of departure, we summarize contrasting models from successful ‘new entrant’ airlines: Ryanair and Southwest. We consider examples of various categories of airlines in different ‘ideal types’ of institutional context: liberal-market economies and coordinated-market economies. These are two varieties of advanced capitalism. The former include the USA, Britain, Ireland (and Australia). The latter include the Germanic and Scandinavian countries. We classify airlines according to which strategies dominate their efforts at cost reduction. Alongside these differences in strategies, we analyse differences in two aspects of employment-relations strategies. First, employers can focus on controlling employee behaviour or seeking their commitment to the goals of the airline. Second, employers can seek to avoid, accommodate or partner with unions. We show that, in terms of employment relations, the variety of capitalism context helps to influence employers’ strategies, but airlines (and other enterprises) still have some scope for exercising strategic choice, in spite of their institutional and regulatory context.
Why Are State Policy Makers Still Proponents of Enterprise Zones? What Explains Their Action in the Face of a Preponderance of the Research?
Authors: Greenbaum Robert T. , Landers Jim
Published: November 2009

The vast majority of states have implemented some version of enterprise zone (EZ) programs, which geographically target economic development efforts to revitalize distressed areas. While EZs have been studied extensively, there is little evidence that they have succeeded. Despite this, the number of programs, the number of EZs designated, and the land area covered by these zones have grown over time. This essay reviews the research on state EZ programs and explores why it has not had a greater influence on policy. One explanation we discuss is that the research has not been made accessible enough to policy makers and their staffs. Another explanation we posit is that political decision making that guides policy on EZ programs is influenced by many actors and sources of information not just the academic research literature. The essay discusses how the establishment or expansion of EZ programs may be encouraged by EZ businesses and landlords engaging in rent seeking behavior. The essay concludes by providing some recommendations regarding how the research community can make its work more relevant for state and local policy makers and how policy makers can become better consumers of evaluative research when implementing and refining programs.