bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasmonic-Resonant Bowtie Antenna for Carbon Nanotube Photodetectors
Authors: Chen Hongzhi , Xi Ning , Lai King Wai Chiu , Chen Liangliang , Fung Carmen Kar Man , Lou Jianyong
Published: February 2012

The design of bowtie antennas for carbon nanotube (CNT) photodetectors has been investigated. CNT photodetectors have shown outstanding performance by using CNT as sensing element. However, detection wavelength is much larger than the diameter of the CNT, resulting in small fill factor. Bowtie antenna can confine light into a subwavelength volume based on plasmonic resonance, thus integrating a bowtie antenna to CNT photodetectors can highly improve photoresponse of the detectors. The electric field enhancement of bowtie antennas was calculated using the device geometry by considering fabrication difficulties and photodetector structure. It is shown that the electric field intensity enhancement increased exponentially with distance reduction between the CNT photodetector to the antenna. A redshift of the peak resonance wavelength is predicted due to the increase of tip angles of the bowtie antennas. Experimental results showed that photocurrent enhancement agreed well with theoretical calculations. Bowtie antennas may find wide applications in nanoscale photonic sensors.
Roles of Pro- and Anti-Inflammatory Cytokines in the Pathogenesis of SLE
Authors: Su Ding-Lei , Lu Zhi-Min , Shen Min-Ning , Li Xia , Sun Ling-Yun
Published: February 2012

SLE is an autoimmune inflammatory disease in which various pro- and anti-inflammatory cytokines, including TGF-β, IL-10, BAFF, IL-6, IFN-α, IFN-γ, IL-17, and IL-23, play crucial pathogenic roles. Virtually, all these cytokines can be generated by both innate and adaptive immune cells and exert different effects depending on specific local microenvironment. They can also interact with each other, forming a complex network to maintain delicate immune homeostasis. In this paper, we elaborate on the abnormal secretion and functions of these cytokines in SLE, analyze their potential pathogenic roles, and probe into the possibility of them being utilized as targets for therapy.
Pancreatic Perfusion CT in Early Stage of Severe Acute Pancreatitis
Authors: Tsuji Yoshihisa , Takahashi Naoki , Tsutomu Chiba
Published: February 2012

Early intensive care for severe acute pancreatitis is essential for improving SAP mortality rates. However, intensive therapies for SAP are often delayed because there is no ideal way to accurately evaluate severity in the early stages. Currently, perfusion CT has been shown useful to predict prognosis of SAP in the early stage. In this presented paper, we would like to review the clinical usefulness and limitations of perfusion CT for evaluation of local and systemic complications in early stage of SAP.
Macrophage Migration and Its Regulation by CSF-1
Authors: Pixley Fiona J.
Published: February 2012

Macrophages are terminally differentiated cells of the mononuclear phagocytic lineage and develop under the stimulus of their primary growth and differentiation factor, CSF-1. Although they differentiate into heterogeneous populations, depending upon their tissue of residence, motility is an important aspect of their function. To facilitate their migration through tissues, macrophages express a unique range of adhesion and cytoskeletal proteins. Notably, macrophages do not form large, stable adhesions or actin stress fibers but rely on small, short lived point contacts, focal complexes and podosomes for traction. Thus, macrophages are built to respond rapidly to migratory stimuli. As well as triggering growth and differentiation, CSF-1 is also a chemokine that regulates macrophage migration via activation the CSF-1 receptor tyrosine kinase. CSF-1R autophosphorylation of several intracellular tyrosine residues leads to association and activation of many downstream signaling molecules. However, phosphorylation of just one residue, Y721, mediates association of PI3K with the receptor to activate the major motility signaling pathways in macrophages. Dissection of these pathways will identify drug targets for the inhibition of diseases in which macrophages contribute to adverse outcomes.
Molecular Alterations Associated with Osteosarcoma Development
Authors: Ando Kosei , Mori Kanji , Verrecchia Franck , Marc Baud’huin , Rédini Françoise , Heymann Dominique
Published: February 2012

Osteosarcoma is the most frequent malignant primary bone tumor characterized by a high potency to form lung metastases which is the main cause of death. Unfortunately, the conventional chemotherapy is not fully effective on osteosarcoma metastases. The progression of a primary tumor to metastasis requires multiple processes, which are neovascularization, proliferation, invasion, survival in the bloodstream, apoptosis resistance, arrest at a distant organ, and outgrowth in secondary sites. Consequently, recent studies have revealed new insights into the molecular mechanisms of metastasis development. The understanding of the mechanism of molecular alterations can provide the identification of novel therapeutic targets and/or prognostic markers for osteosarcoma treatment to improve the clinical outcome.
Quality of Life in Iranian Patients with Acne
Authors: Safizadeh H. , Shamsi-Meymandy S. , Naeimi A.
Published: February 2012

Acne is a chronic inflammatory disease of pilosebaceous units. Although the acne isnot a life threatening disease, studies have revealed that it has significant effect on self-image and quality of life. The purpose of this paper was to investigate the health-related quality of life in patients with acne in an Iranian context. Dermatology Life Quality Index (DLQI) and Cardiff Acne Disability Index (CADI) were used for measuring quality of life, and severity of acne was measured by Global Acne Grading System (GAGS). The mean (±SD) of DLQI and CADI scores was 6.42 (±4.77) and 5.97 (±2.97), respectively. Acne influenced the quality of life in 51.8% of patients from moderate to very much, and the quality of life was affected by the severity of acne (P< 0.01). Since acne has significant effects on patient’s quality of life, the management of patients with acne requires more attention to different aspects of quality of life.
Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea
Authors: Lin Aaron C. , Koltai Peter J.
Published: February 2012

Pediatric obstructive sleep apnea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of pediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic, and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. Sleep endoscopy is a technique that can enable the surgeon to determine the level of obstruction in a sleeping child with OSA. With this knowledge, site-specific surgical therapy for persistent and complex pediatric OSA may be possible.
Multiscale Autoregressive Identification of Neuroelectrophysiological Systems
Authors: Gilmour Timothy P. , Subramanian Thyagarajan , Lagoa Constantino , Jenkins W. Kenneth
Published: February 2012

Electrical signals between connected neural nuclei are difficult to model because of the complexity and high number of paths within the brain. Simple parametric models are therefore often used. A multiscale version of the autoregressive with exogenous input (MS-ARX) model has recently been developed which allows selection of the optimal amount of filtering and decimation depending on the signal-to-noise ratio and degree of predictability. In this paper, we apply the MS-ARX model to cortical electroencephalograms and subthalamic local field potentials simultaneously recorded from anesthetized rodent brains. We demonstrate that the MS-ARX model produces better predictions than traditional ARX modeling. We also adapt the MS-ARX results to show differences in internuclei predictability between normal rats and rats with 6OHDA-induced parkinsonism, indicating that this method may have broad applicability to other neuroelectrophysiological studies.
Epigenetic Mechanisms of Genomic Imprinting: Common Themes in the Regulation of Imprinted Regions in Mammals, Plants, and Insects
Authors: MacDonald William A.
Published: February 2012

Genomic imprinting is a form of epigenetic inheritance whereby the regulation of a gene or chromosomal region is dependent on the sex of the transmitting parent. During gametogenesis, imprinted regions of DNA are differentially marked in accordance to the sex of the parent, resulting in parent-specific expression. While mice are the primary research model used to study genomic imprinting, imprinted regions have been described in a broad variety of organisms, including other mammals, plants, and insects. Each of these organisms employs multiple, interrelated, epigenetic mechanisms to maintain parent-specific expression. While imprinted genes and imprint control regions are often species and locus-specific, the same suites of epigenetic mechanisms are often used to achieve imprinted expression. This review examines some examples of the epigenetic mechanisms responsible for genomic imprinting in mammals, plants, and insects.
Program Spectra Analysis with Theory of Evidence
Authors: Hewett Rattikorn
Published: February 2012

This paper presents an approach to automatically analyzing program spectra, an execution profile of program testing results for fault localization. Using a mathematical theory of evidence for uncertainty reasoning, the proposed approach estimates the likelihood of faulty locations based on evidence from program spectra. Our approach is theoretically grounded and can be computed online. Therefore, we can predict fault locations immediately after each test execution is completed. We evaluate the approach by comparing its performance with the top three performing fault localizers using a benchmark set of real-world programs. The results show that our approach is at least as effective as others with an average effectiveness (the reduction of the amount of code examined to locate a fault) of 85.6% over 119 versions of the programs. We also study the quantity and quality impacts of program spectra on our approach where the quality refers to the spectra support in identifying that a certain unit is faulty. The results show that the effectiveness of our approach slightly improves with a larger number of failed runs but not with a larger number of passed runs. Program spectra with support quality increases from 1% to 100% improves the approach's effectiveness by 3.29%.
Principal Component Analysis of Gait Kinematics Data in Acute and Chronic Stroke Patients
Authors: Milovanović Ivana , Popović Dejan B.
Published: February 2012

We present the joint angles analysis by means of the principal component analysis (PCA). The data from twenty-seven acute and chronic hemiplegic patients were used and compared with data from five healthy subjects. The data were collected during walking along a 10-meter long path. The PCA was applied on a data set consisting of hip, knee, and ankle joint angles of the paretic and the nonparetic leg. The results point to significant differences in joint synergies between the acute and chronic hemiplegic patients that are not revealed when applying typical methods for gait assessment (clinical scores, gait speed, and gait symmetry). The results suggest that the PCA allows classification of the origin for the deficit in the gait when compared to healthy subjects; hence, the most appropriate treatment can be applied in the rehabilitation.
Headache in Pregnancy: A Nuisance or a New Sense?
Authors: Dixit Archana , Bhardwaj Manish , Sharma Bhavna
Published: February 2012

Headache is a very commonly encountered symptom in pregnancy and is usually due to primary headache disorders which are benign in nature. It can however be quite debilitating for some women who may need therapeutic treatment of which there are several options safe to use in pregnancy. It is equally important though to recognise that headache may be a sign of serious underlying pathology. This paper aims to provide a clinically useful guidance for differentiation between primary and secondary headaches in pregnancy. The primary headache disorders and their management in pregnancy are explored in depth with brief overviews of the causes for secondary headaches and their further investigation and management.
Best Constants between Equivalent Norms in Lorentz Sequence Spaces
Authors: Barza S. , Marcoci A. N. , Persson L. E.
Published: February 2012

We find the best constants in inequalities relating the standard norm, the dual norm, and the norm∥x∥(p,s):=inf⁡{∑k∥x(k)∥p,s}, where the infimum is taken over all finite representationsx=∑kx(k)in the classical Lorentz sequence spaces. A crucial point in this analysis is the concept of level sequence, which we introduce and discuss. As an application, we derive the best constant in the triangle inequality for such spaces.
A Mutual Algorithm for Optimizing Distributed Source Coding in Wireless Sensor Networks
Authors: Abughalieh Nashat , Steenhaut Kris , Lemmens Bart , Now© Ann
Published: February 2012

Wireless Sensor Networks (WSNs) are composed of small wireless nodes equipped with sensors, a processor, and a radio communication unit, all normally powered by batteries. For most WSN applications, the network is expected to function for several months or years. In the common monitoring application scenario, adjacent nodes in a WSN often sense spatially correlated data. Suppressing this correlation can significantly improve the lifetime of the network. The maximum possible network data compression can be achieved using distributed source coding (DSC) techniques when nodes encode at Slepian-Wolf rates. This paper presents contributions to the lifetime optimization problem of WSNs in the form of two algorithms: the Updated-CMAX (UCMAX) power-aware routing algorithm to optimize the routing tree and the Rate Optimization (RO) algorithm to optimize the encoding rates of the nodes. The two algorithms combined offer a solution that maximizes the lifetime of a WSN measuring spatially correlated data. Simulations show that our proposed approach may significantly extend the lifetime of multihop WSNs with nodes that are observing correlated data.
Checklist for the Structural Description of the Deep Phenotype in Disorders of Sexual Development
Authors: Wünsch L.
Published: February 2012

This paper addresses the question, how the variations of the deep phenotype in disorders of sex development (DSD) are appropriately described. This is a relevant question, because extensive phenotypic variability occurs in gonads and sex ducts. With the advance of video endoscopy and laparoscopy, fresh insight in gonadal and sex duct anatomy is emerging. So far, an attempt to standardize the diagnostic approach and, in particular, how to document these findings has not been published. We propose a standardized examination schedule for these procedures. It consists of 5 pictures of relevant anatomic features. For laparoscopy, it includes two pictures each of gonads and sex ducts on either side and an image of the retrovesical space. For endoscopy, the examination of the ureteric orifices, the posterior urethra, and the urogenital sinus derivates is recommended. Adherence of a standardized schedule and image storing enhances patient autonomy, because they can carry their examination for a second opinion without need for repeated examination. Physicians and scientists create a structured image library that facilitates the comparison of clinical outcomes, research on genotype phenotype associations and may lead to better classifications.
Evolving Trends in the Hepatitis C Virus Molecular Epidemiology Studies: From the Viral Sequences to the Human Genome
Authors: Trinks Julieta , Gadano Adrián , Argibay Pablo
Published: February 2012

Hepatitis C virus (HCV) represents a major worldwide public health problem. The search for the key molecular biomarkers that may provide insight on the basis of the differences in disease progression, severity, and response to therapy is crucial for understanding the natural history of HCV, for estimating the burden of infection and for developing preventive interventions. Initially, molecular epidemiology studies have focused on studying the viral genetic diversity (genotypes, genetic variants, specific nucleotide and amino acid substitutions). However, the clinical heterogeneities of HCV infection and the imperfect predictability of the response to treatment have suggested the need to search for host genetic biomarkers. This led to the discovery of genetic polymorphisms playing a major role in the evolution of infection, as well as in treatment response and adverse effects, such asIL-28B,ITPA, andIP-10. As a consequence, nowadays the focus of molecular epidemiology studies has turned from the viral to the human genome. This paper will cover recent reports on the subject describing the most relevant viral as well as host genetic risk factors analyzed by past and current HCV molecular epidemiology studies.
The Metabolic Syndrome among Postmenopausal Women in Gorgan
Authors: Marjani Abdoljalal , Moghasemi Sedigheh
Published: February 2012

Introduction. The present study aimed to assess the metabolic syndrome among postmenopausal women in Gorgan, Iran.Materials and Methods. The study was conducted on hundred postmenopausal women who were referred to the health centers in Gorgan. Metabolic syndrome was diagnosed using Adult Treatment Panel III (ATP III) guidelines.Results. The mean body mass index, waist circumference, hip, circumference waist-to-hip ratio, diastolic blood pressure, and triglyceride and fasting blood glucose levels were significantly high among postmenopausal women with metabolic syndrome, but the mean HDL-cholesterol was significantly low (P<0.05). Overall prevalence of metabolic syndrome was 31%. Body mass index and waist circumference had a positive correlation with a number of metabolic syndrome factors (P<0.001). Body mass index, waist circumference, and waist-to-hip ratio had a positive correlation with each other (P<0.001). BMI had relatively high correlation with WC (P<0.001).Conclusions. Our results show that postmenopausal status might be a predictor of metabolic syndrome. Low HDL-cholesterol level and high abdominal obesity are the most frequent characteristics in comparison to other metabolic components. Our study also showed some related factors of metabolic syndrome among postmenopausal women. These factors may increase cardiovascular risk among postmenopausal women with metabolic syndrome.
Susceptibilities of ESBL-Producing Enterobacteriaceae to Ertapenem, Meropenem and Piperacillin-Tazobactam with and without Clavulanic Acid
Authors: Raveh David , Yinnon Amos M. , Broide Ellen , Rudensky Bernard
Published: February 2012

Background: Faced with the extended-spectrum β-lactamase (ESBL) pandemic, we compared the susceptibilities of ESBL-producing Enterobacteriaceae to ertapenem, meropenem and piperacillin-tazobactam with and without clavulanate. Methods: 121 strains of Escherichia coli and Klebsiella were studied. 70 strains were originally reported as resistant to ceftazidime based upon disk diffusion; 51 strains were originally reported as sensitive to ceftazidime based upon previous guidelines of the National Committee for Clinical Laboratory Standards, but subsequently shown to be ESBL producers. Minimal inhibitory concentrations (MICs) of the strains towards ertapenem, meropenem and piperacillin-tazobactam were determined by Etest. The effect of adding clavulanate on the MICs was determined by performing the Etest, using plates containing 2 µg/ml of clavulanate. Results: The MIC90 of all isolates was 0.094 and 0.25 µg/ml for ertapenem, 0.032 and 0.064 µg/ml for meropenem, and 16 and 256 µg/ml for piperacillin-tazobactam with and without clavulanate, respectively. Conclusions: ESBL-producing organisms were more susceptible to meropenem than to ertapenem, although the MICs to ertapenem were well within clinically achievable levels. Piperacillin-tazobactam was ineffective in a large percentage of isolates. The presence of clavulanate resulted in a 5-fold decrease in the MIC of ertapenem and in a drastic reduction in the MIC of piperacillin-tazobactam. The decrease observed with ertapenem is unlikely to be of clinical significance. Thus, in our hospital, ertapenem could be a good meropenem-sparing agent for infections due to ESBL-producing organisms. Piperacillin-tazobactam appeared to be a poor choice, as our isolates produce ESBLs which are not successfully inhibited by tazobactam.
Bacterial Metabolism of Polychlorinated Biphenyls
Authors: Pieper Dietmar H. , Seeger Michael
Published: February 2012

Microbial metabolism is responsible for the removal of persistent organic pollutants including PCBs from the environment. Anaerobic dehalogenation of highly chlorinated congeners in aquatic sediments is an important process, and recent evidence has indicated that Dehalococcoides and related organisms are predominantly responsible for this process. Such anaerobic dehalogenation generates lower chlorinated congeners which are easily degraded aerobically by enzymes of the biphenyl upper pathway (bph). Initial biphenyl 2,3-dioxygenases are generally considered the key enzymes of this pathway which determine substrate range and extent of PCB degradation. These enzymes have been subject to different protein evolution strategies, and subsequent enzymes have been considered as crucial for metabolism. Significant advances have been made regarding the mechanistic understanding of these enzymes, which has also included elucidation of the function of BphK glutathione transferase. So far, the genomes of two important PCB-metabolizing organisms, namely Burkholderia xenovorans strain LB400 and Rhodococcus sp. strain RHA1, have been sequenced, with the rational to better understand their overall physiology and evolution. Genomic and proteomic analysis also allowed a better evaluation of PCB toxicity. Like all bph gene clusters which have been characterized in detail, particularly in strains LB400 and RHA1, these genes were localized on mobile genetic elements endowing single strains and microbial communities with a high flexibility and adaptability. However, studies show that our knowledge on enzymes and genes involved in PCB metabolism is still rather fragmentary and that the diversity of bacterial strategies is highly underestimated. Overall, metabolism of biphenyl and PCBs should not be regarded as a simple linear pathway, but as a complex interplay between different catabolic gene modules.
Temporary Percutaneous Gastric Electrical Stimulation: A Novel Technique Tested in Patients with Non-Established Indications for Gastric Electrical Stimulation
Authors: Andersson S. , Ringström G. , Elfvin A. , Simrén M. , Lönroth H. , Abrahamsson H.
Published: February 2012

Aim: To test temporary percutaneous gastric electrical stimulation (TPGES) in patients with drug-refractory nausea/vomiting and nonestablished indications for GES. Methods: 27 patients (2–81 years) underwent TPGES with electrodes implanted at gastroscopy and received stimulation for 7–21 days with low current settings (5–7 mA) either as open stimulation (n = 14) or randomized to double-blind crossover stimulation (n = 13; ON for 12–14 days, OFF for 12–14 days). Symptoms were recorded daily. Nonresponders were offered another period (14–21 days) with increased stimulation (8–10 mA). Results: Mean lead implantation time was 14 min. Leads were kept implanted for ≤60 days. 22 of 27 evaluable patients had a favorable symptom reduction, preferentially of nausea/vomiting, irrespective of delayed or normal gastric emptying rate: postsurgical gastroparesis 7/8, chronic intestinal pseudo-obstruction 2/2, idiopathic gastroparesis 1/1, functional dyspepsia 6/9, diabetes mellitus 2/2, postsurgical nausea/vomiting 2/2, malformation syndrome 1/1, intestinal neuropathy 1/1, intestinal interstitial cells of Cajal deficiency 0/1. 6 patients had a clear symptom reduction during the ON period compared with stimulation OFF. Four of 7 patients improved with increased stimulation (8–10 mA). Twenty of the 22 responders received a permanent GES implant, 90% of them still being responders at last follow-up. Conclusion: TPGES seems promising to study new indications for GES and to select responders/non-responders.
Total and Individual Coronary Artery Calcium Scores as Independent Predictors of Mortality in Hemodialysis Patients
Authors: Shantouf Ronney S. , Budoff Matthew J. , Ahmadi Naser , Ghaffari Arshia , Flores Ferdinand , Gopal Ambarish , Noori Nazanin , Jing Jennie , Kovesdy Csaba P. , Kalantar-Zadeh Kamyar
Published: February 2012

Many traditional and nontraditional risk factors contribute to vascular calcification among maintenance hemodialysis (MHD) patients. It is not clear whether coronary artery calcification (CAC) delineates a higher mortality risk independent of known risk factors. We examined 6-year (10/2001–9/2007) survival of 166 MHD patients, aged 53 ± 13 years, with baseline CAC scores. Patients were grouped into four CAC groups: 0, 1–100, 101–400, and 400+. The 101–400 and 400+ groups were associated with a significantly higher adjusted risk of death than CAC 0 with hazard ratios (HR) 8.5 (95% CI: 1.1–48.1, p = 0.02) and 13.3 (95% CI: 1.3–65.1, p = 0.01), respectively, independent of demographics, comorbidity, lipids and other cardiovascular risks, surrogates of bone disease, nutritional and inflammatory markers and dialysis dose. Total CAC [HR 6.7 (1.1–21.5, p = 0.03)] followed by the presence of CAC in the left main [4.6 (2.2–9.8, p = 0.001)] and left anterior descending artery [4.3 (2.1–14.2, p = 0.001)] were strong independent predictors of mortality even after adjusting for above covariates. Total and vessel-specific CAC predict mortality in MHD patients independent of traditional and nontraditional risk factors.
Transient Global Amnesia: Seven Years of Experience with Diffusion-Weighted Imaging in an Emergency Department
Authors: Ahn Shin , Kim Won , Lee Yoon-Seon , Kim Won Young , Lee Jae Ho , Oh Bum Jin , Lim Kyoung Soo
Published: February 2012

Background/Aims: Hippocampal lesions on diffusion-weighted imaging (DWI) are commonly described in transient global amnesia (TGA). We evaluated the utility of DWI and the presence of hippocampal lesions in the diagnosis of TGA. Methods: A total of 203 TGA episodes were diagnosed at our emergency department from January 2003 to May 2010. DWI (5-mm slice thickness) was performed using a 1.5 T scanner. Patients were divided into 2 groups based on the presence of hippocampal lesions on DWI: DWI– and DWI+. The clinical characteristics and the time interval from development of amnesia to magnetic resonance imaging (MRI) were compared. Results: 16 patients had hippocampal lesions on DWI. The DWI– and DWI+ groups had similar clinical characteristics. The overall median time interval from amnesia to MRI was 6 h, and this interval was significantly longer for the DWI+ group than the DWI– group [9 h (IQR 6.5–25) vs. 5 h (IQR 4–9), p = 0.002]. Conclusion: DWI has a low diagnostic yield when performed early in the course of TGA. Positive findings can confirm the diagnosis, but in negative results, careful interpretation is required, including the time interval from amnesia to MRI.
The Prevalence and Diagnostic Significance of Eosinophilic Pleural Effusions: A Meta-Analysis and Systematic Review
Authors: Oba Yuji , Abu-Salah Tareq
Published: February 2012

Background: Eosinophilic pleural effusion (EPE) is defined by an eosinophil count of ≧10% in the pleural fluid and often caused by air or blood in the pleural space. The diagnostic significance of EPEs is still a matter of debate. Objective: The objective of this study was to systematically review the medical literature to evaluate the diagnostic significance of EPEs. Methods: Electronic databases were searched from 1950 to April 2010 to perform a meta-analysis. Data were extracted using standardized forms, and pooled odds ratios with 95% confidence intervals were calculated. A logistic regression analysis was also performed to evaluate the association between the pleural eosinophil counts and the likelihood of underlying causes of EPEs. Results: We identified a total of 687 cases of EPE. The most common cause of EPEs was malignancy (26%) followed by idiopathic (25%) and parapneumonic (13%) effusions. The likelihood of malignancy or tuberculosis was somehow lower in EPEs than in non-EPEs, but the differences were not statistically significant. The prevalence of malignancy was significantly lower in the group of patients that required a pathologic confirmation (21 vs. 30%; p = 0.01). The likelihood of malignancy was inversely correlated with the pleural fluid eosinophil counts. The likelihood of idiopathic effusion was significantly higher in EPEs than in non-EPEs. Conclusions: Malignancy was the most common cause of EPEs. EPEs appeared to be a negative predictor of malignancy when a pleural fluid eosinophil count was extremely high. EPEs were more likely to be idiopathic as compared with non-EPEs.
Chromogranin A Is a Reliable Biomarker for Gastroenteropancreatic Neuroendocrine Tumors in an Asian Population of Patients
Authors: Chou Wen-Chi , Hung Yu-Shin , Hsu Jun-Te , Chen Jen-Shi , Lu Chang-Hsien , Hwang Tsann-Long , Rau Kun-Ming , Yeh Kun-Yun , Chen Tse-Ching , Sun Chien-Feng
Published: February 2012

Purpose: To evaluate the significance of plasma chromogranin A (CgA) levels in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET) in terms of disease status and treatment responses. Materials and Methods: Forty-four GEP-NET patients comprising 15 disease-free patients and 29 patients with active disease, as well as 26 healthy participants were enrolled in this study between April 2010 and April 2011. Clinicopathological factors were collected and serial plasma CgA levels were measured. Results: Plasma CgA levels were significantly higher in GEP-NET patients with active disease than in disease-free patients (p = 0.011) or healthy participants (p = 0.001). No difference in CgA levels was observed in terms of primary tumor location, tumor grade, and functional status in patients with active disease. CgA values at 94 U/l distinguished healthy individuals or disease-free patients from patients with active disease. Sensitivity and specificity rates were 86 and 88%, respectively. CgA levels at 110 U/l differentiated patients without recurrence from those with recurrence, with a sensitivity rate of 100% and a specificity rate of 80%. Patients (5/5, 100%) with stable disease and who showed partial response after treatment had a more than 20% decrease in CgA levels compared with the baseline values. Patients (6/6, 100%) with progressive disease showed a less than 20% decrease or increase in CgA levels. Conclusion: The plasma CgA level is a reliable biomarker for GEP-NET. We conclude that changes in CgA levels are associated with disease status and treatment responses.
Disorders of Sexual Development in the Domestic Horse, Equus caballus
Authors: Lear T.L. , McGee R.B.
Published: February 2012

Abnormalities of sexual development causing infertility in horses have been investigated since the early 1970's. Conventional cytogenetic analysis by karyotyping has been the primary tool used to investigate these horses. Abnormalities have a broad range, from a phenotypically normal mare with gonadal dysgenesis to a horse with ambiguous external genitalia and internal male and female organs. Cytogenetic analysis can determine genetic sex but cannot identify mutations or deletions of genes involved in the sex determination pathway. Molecular technologies have been developed to confirm cytogenetic results and to aid in identifying the genetic causes of abnormal sex determination in horses. In this paper, we review the historical development of methods used to understand abnormal sexual development in the horse as well as summarize cases reported over the last 40-50 years.
Airway Complications after Lung Transplantation: Long-Term Outcome of Silicone Stenting
Authors: Sundset Arve , Lund May Brit , Hansen Gunnar , Bjørtuft Øystein , Kongerud Johny , Geiran Odd Ragnar
Published: February 2012

Background: Airway complications remain a significant cause of morbidity after lung transplantation. The majority of the centres that have published their results have used metal stents. Objectives: We report the long-term outcome of silicone stenting and subsequent stent removal in lung transplant recipients with stenotic airway complications. Method: From 1990 to 2008, 279 patients received 88 single, 170 double, and 21 heart-and-lung transplantations. Of 470 anastomoses at risk, 44 airway complications developed and were treated in 35 patients. Six lesions were treated with Nd:YAG laser and balloon dilatations only. Thirty-two silicone stents of Hood or Dumont type were inserted in 27 patients. Results: Symptoms were relieved and FEV1 increased in all patients (median 0.7 litres, range 0.1-1.8 litres, p < 0.0001). In 8 patients, stents had to be repositioned or reinserted, in 19 patients only one insertion and one removal procedure were necessary. One patient suffered a serious complication with haemorrhage and pneumonectomy, 3 patients had minor airway wall injuries resolving spontaneously. Six patients died with the stents from causes not related to the airway complications. Twenty-five stents could be removed after a median of 6 months (range 1-22) in 21 patients, and 22 airways remained patent. Median FEV1 was 2.3 litres immediately after stent removal, and remained 2.3 litres after 24 months. Conclusion: Stenotic airway complications after lung transplantation can be successfully treated with silicone stents, which can ultimately be removed, leaving a patent airway.
Signaling Pathways as Specific Pharmacologic Targets for Neuroendocrine Tumor Therapy: RET, PI3K, MEK, Growth Factors, and Notch
Authors: Carter Yvette , Jaskula-Sztul Renata , Chen Herbert , Mazeh Haggi
Published: February 2012

Neuroendocrine tumors are rare tumors with a common progenitor – the neural crest cell. Included in this category are pulmonary and gastrointestinal tract carcinoid tumors and medullary thyroid cancer. The majority of these tumors are sporadic in nature, however they can be hereditary. Medullary thyroid cancers can present sporadically, with other endocrine tumors, as in the complex of multiple endocrine neoplasias 1, 2A, or 2B, or as familial medullary thyroid cancer. These tumors can become evident at later stages, with metastases already present at the time of diagnosis. Despite the small size and rare incidence of gastrointestinal neuroendocrine (carcinoid) tumors, they can be debilitating when present. Their natural history presents as early lymph node and distant metastases, as well as symptoms of the carcinoid syndrome, which result from the overproduction and secretion of serotonin and somatostatin. As a consequence of their metastases, surgical resection is non-curative and hence there is a need for novel treatment strategies to address tumor burden and symptom control. There are multiple intracellular pathways which can be targeted, either individually or in combination, to address these tumors. Here, we review some of the intracellular pathways, and identify some specific targets, which are vital to the generation and propagation of neuroendocrine tumorigenesis, and thus, can be the foci of novel drug therapies. We also elaborate on present pharmacological strategies and clinical trials involving these intracellular pathways.
Delayed Type of Asthmatic Response to Allergen Challenge and Cytokines in the Peripheral Blood
Authors: Pelikan Zdenek
Published: February 2012

Background: Patients with allergic bronchial asthma can develop various types of asthmatic response to bronchial challenge with allergens, such as immediate (IAR), late (LAR) or delayed (DYAR) response, due to different immunological mechanisms. Objective: The DYAR, beginning within 26– 32 h after the challenge, reaching its maximum between 32 and 48 h and resolving within 56 h (p < 0.001), differs from IAR and LAR regarding the clinical features, diagnostic and immunological parameters. Methods: The repeated DYAR (p < 0.001) in 28 patients was supplemented with recording of cytokine concentrations in the serum before and up to 72 h after the bronchial challenge by means of enzyme-linked immunoassay. Results: The DYAR was accompanied by a significant increase in the serum concentration (p < 0.05) of IL-2 at 24, 36 and 48 h; IL-10 at 12, 24, 36 and 48 h; IL-18 at 12 and 24 h; IFN-γ at 24, 36, 48 and 56 h; G-CSF at 1 and 12 h; TNF-α at 12, 36 and 48 h and TGF-β at 12 and 36 h, and a significant decrease in the concentration (p < 0.05) of IL-7 at 36 and 48 h and IL-12p70 at 12 h, as compared both with the prechallenge and with PBS control values. No significant changes in the serum cytokines were recorded during the PBS controls (p > 0.2). Conclusions: These results support the evidence for an active involvement of the Th1 cells, neutrophils, monocytes, macrophages, epithelial cells and endothelial cells, upon cooperation of other cell types, in the immunological mechanism(s) underlying the DYAR.
Previous Infection and Stroke: A Prospective Study
Authors: Roquer Jaume , Cuadrado-Godia Elisa , Giralt-Steinthauer Eva , Jimena Sara , Jiménez-Conde Jordi , Martínez-Rodríguez José Enrique , Ois Angel , Rodríguez-Campello Ana
Published: February 2012

Background: Previous studies have demonstrated that infections might precipitate ischemic strokes (IS). We sought to describe, in a large prospective series, the frequency of previous infection (PI) in IS and intracerebral hemorrhage (ICH), and to assess whether any relationship with stroke subtype or outcome could be identified. Methods: Between January 2005 and December 2010, we studied 1,981 patients with acute stroke. The presence of PI within the month before the stroke was prospectively assessed. PI was correlated with demographic data, vascular risk factors, stroke subtype, and 3-month outcome. Results: A total of 193 (9.7%) patients had suffered a PI, the most common being respiratory tract infections (36.8%), flu or flu-like illness (30.1%), and gastrointestinal infections (12.4%). PI was more frequent in IS cases (10.2%) than in ICH (6.8%) (p = 0.081). Among IS cases, no differences were seen between PI and TOAST subtypes (p = 0.644). For IS, patients with PI were older (p = 0.025), had worse previous functional status (p = 0.002), suffered a more severe stroke (p = 0.002), achieved poor outcome (p = 0.001), and had higher 3-month mortality (p = 0.019). Multivariate analysis showed that IS patients with PI had previous poor functional status (OR = 1.58; p = 0.026) and suffered more severe strokes (OR = 1.02, p = 0.048). After adjustment for confounders, PI has no independent influence on 3-month outcome (OR = 1.15; p = 0.564). Conclusions: PI are observed in 9.7% of stroke cases without differences according to the TOAST subtype. PI are associated with previous poor functional status and with stroke severity, but have no independent influence on the 3-month outcome.
Prediction of Requirement for Mechanical Ventilation in Community-Acquired Pneumonia with Acute Respiratory Failure: A Multicenter Prospective Study
Authors: Kohno Shigeru , Seki Masafumi , Takehara Koji , Yamada Yoshitsugu , Kubo Keishi , Ishizaka Akitoshi , Soma Kazui
Published: February 2012

Background: Several severity scoring systems for predicting mortality are established in community-acquired pneumonia (CAP). Objectives: The predictability of the aggravation such as requirement for mechanical ventilation in addition to mortality was examined in CAP patients with acute respiratory failure by using the age, dehydration, respiratory failure, orientation disturbance and blood pressure (A-DROP) scoring system which was proposed by the Japanese Respiratory Society. Methods: This study was a prospective, multicenter, observational cohort study. The severity of pneumonia was examined using A-DROP and Pneumonia Severity Index (PSI) which originated from the Infectious Disease Society of America. Requirement for mechanical ventilation and mortality were evaluated for 28 days. Results: 482 CAP patients with acute respiratory failure were enrolled in the study. The 28-day mortality and mechanical ventilation rates were 12.3 and 14.4%, respectively. There were no significant differences in the areas under the receiver-operator characteristic curves for prediction of mortality between A-DROP and PSI (χ2 test; p = 0.3613). In the subgroup analyses by severity, the A-DROP scoring system showed a severity-dependent increase of mortality (moderate 5.6%, severe 16.1%, extremely severe 27.1%, Cochran-Armitage trend test; p < 0.0001). Similar results were obtained for mechanical ventilation rate (moderate 9.8%, severe 16.7%, extremely severe 25.4%, Cochran-Armitage trend test; p = 0.0006). The compliance with scoring the A-DROP was higher than that with scoring the PSI (96.9 vs. 71.6%). Conclusions: The results of this study suggest that the A-DROP scoring system could be a simple CAP risk scoring system which could predict not only mortality, but also the requirement for mechanical ventilation.
Risk and Healthcare Costs of Chemotherapy-Induced Neutropenic Complications in Women with Metastatic Breast Cancer
Authors: Weycker Derek , Edelsberg John , Kartashov Alex , Barron Rich , Lyman Gary
Published: February 2012

Background: The burden of chemotherapy-induced neutropenic complications (CINC) in women with metastatic breast cancer (MBC) is largely unknown and may differ across cancer populations due to variation in the characteristics of patients, their disease and their treatment. Methods: This study employed a retrospective cohort design and US healthcare claims data (2003-2009). For each woman in the study database who received myelotoxic chemotherapy for MBC, the first observed course and each cycle within the course were characterized. Risk and healthcare costs of CINC - by care setting - were descriptively analyzed on an overall basis by chemotherapy cycle and chemotherapy regimen. Results: Among 2,620 study subjects, most received chemotherapy with cyclophosphamide/doxorubicin (25%), docetaxel (20%) or paclitaxel (12%). Thirty-one percent of subjects received colony-stimulating factors (CSF) prophylactically in their first chemotherapy cycle and an additional 13% first received CSF prophylaxis after cycle one. CINC developed in 11% of subjects; among these subjects, 88% required inpatient care and 45% experienced CINC in the first cycle of chemotherapy. For CINC requiring inpatient care, costs averaged USD 12,869 (95% CI: USD 12,622-13,116), and for CINC requiring outpatient care only, USD 2,030 (CI: USD 1,925-2,135). Conclusion: CINC is a clinically and economically important threat among women with MBC, and should be an important consideration in the treatment of this population.
Aloe Emodin Induces G2/M Cell Cycle Arrest and Apoptosis via Activation of Caspase-6 in Human Colon Cancer Cells
Authors: Suboj Priya , Babykutty Suboj , Srinivas Priya , Gopala Srinivas
Published: February 2012

Aloe emodin (AE), a natural anthraquinone, is reported to have antiproliferative activity in various cancer cell lines. In this study, we analyzed the molecular mechanisms involved in the growth-inhibitory activity of this hydroxyanthraquinone in colon cancer cell, WiDr. In our observation AE inhibited cell proliferation by arresting the cell cycle at the G2/M phase and inhibiting cyclin B1. AE appreciably induced cell death specifically through the induction of apoptosis and by activating caspases 9/6. Apoptotic execution was found to be solely dependent on caspase-6 rather than caspase-3 or caspase-7. This is the first study indicating that the AE induces apoptosis specifically through the activation of caspase-6.
Atorvastatin May Delay Cardiac Aging by Upregulating Peroxisome Proliferator-Activated Receptors in Rats
Authors: Han Lei , Li Minggao , Liu Yongxue , Han Chunguang , Ye Ping
Published: February 2012

Aims: To investigate the effect of atorvastatin on cardiac aging in rats. Materials: Ninety 20-month-old Wistar rats were administered oral atorvastatin (AVT; 10 or 1 mg·kg-1·day-1) or saline for 4 months. At the end of the experiment, age-related changes in hearts were measured. Results: Compared with young rats, obvious increases were found in the aging rats in left ventricle thickness, diameter of cardiocytes, collagen deposition, the ratio of type I/type III collagen, β-galactosidase and malondialdehyde (MDA), and obvious decreases were found in superoxide dismutase (SOD), catalase (CAT) and nitric oxide synthase (NOS). The treatment with AVT led to significant decreases in the thickness of the left ventricle, diameter of cardiocytes, collagen deposition, I/III collagen ratio, MDA, β-galactosidase and increases in the activity of SOD, CAT and NOS. Some aging-related inflammatory cytokines like interleukin (IL)-1β, tumour necrosis factor (TNF)-α and matrix metalloproteinase (MMP)-9 were found to be overexpressed in the aging rats. AVT treatment could inhibit the expression of IL-1β, TNF-α and MMP-9 on both the mRNA and protein levels, and increase the expression of peroxisome proliferator-activated receptors (PPAR-α/β/δ/γ). Pretreatment with PPAR inhibitors attenuated the inhibitory effect of AVT on the expression of inflammatory cytokines. Conclusion: AVT may retard the cardiac aging process by upregulating PPARs.
Involvement of Target Gene Polymorphisms in 5-Fluorouracil Toxicity: A Case Report
Authors: Scalvini Anna , Ferrari Vittorio , Bodei Serena , Arcangeli Giuseppina , Consoli Francesca , Spano PierFranco , Sigala Sandra
Published: February 2012

Personalized medicine is becoming an important tool in oncology, both in preventing disease and in optimizing the treatment of existing cancers. Here we describe the cases of 2 patients with relevant systemic toxicity following 5-fluorouracil (5-FU) therapy and we study the more frequent polymorphisms in the target genes, in particular: (1) the variability in the number of 28-base repetitions present in the 5′-untranslated sequence of the thymidine synthase gene; (2) the presence of single-nucleotide polymorphisms in the methylene tetrahydrofolate reductase gene, and (3) the presence of mRNA splicing in intron 14 of the hepatic enzyme dihydropyrimidine dehydrogenase. The 5-FU gene profile of our patients strongly suggested that the polymorphisms expressed may contribute to the adverse effects seen during the therapy. To what extent these polymorphisms induced adverse effects cannot be established at present; however, our results strengthen the relevance of the 5-FU-related pharmacogenomic profile to predict the response outcome and the chemotherapy toxicity.
Primary Spontaneous Pneumothorax: A Diffuse Disease of the Pleura
Authors: Grundy Seamus , Bentley Andrew , Tschopp Jean-Marie
Published: February 2012

Primary spontaneous pneumothorax (PSP) is by definition not associated with any underlying lung disease. However, this does not mean that there is no underlying pathological process. It has become increasingly apparent over recent years that PSP is associated with diffuse and often bilateral abnormalities within the pleura and is not simply a disease caused by ruptured blebs/bullae. The pathological process includes emphysema-like changes, pleural porosity and inflammation. In this review, we summarise the recent advances in our understanding of the pathogenesis of PSP and discuss how this relates to management strategies for patients with PSP.