bluuebunny/crossref_metadata_2025 huggingface dataset:
Factor VIII and thrombin generation assays: relevance to pharmacokinetic studies in haemophilia A
Authors: BARROWCLIFFE T. W.
Published: September 2006

Summary.  This article reviews the problems associated with traditional Factor VIII (FVIII) assays in pharmacokinetic studies, and the advantages, disadvantages, and technical aspects of thrombin generation assays as a replacement or additional tool.
Pharmacokinetics of recombinant factor VIII (Kogenate‐FS®) in children and causes of inter‐patient pharmacokinetic variability
Authors: BARNES C. , LILLICRAP D. , PAZMINO‐CANIZARES J. , BLANCHETTE V. S. , STAIN A. M. , CLARK D. , HENSMEN C. , CARCAO M.
Published: September 2006

Summary.  Understanding the pharmacokinetics (PK) of factor VIII (FVIII) is important in the management of patients with haemophilia A. We studied the PK of FVIII in order to determine aetiological factors contributing to PK variability of FVIII in children.

Twenty children with haemophilia A (mean age 12.8 years) were administered a single bolus of 50 U kg−1 of recombinant FVIII (rFVIII; Kogenate‐FS®, Bayer).

The mean incremental FVIII recovery was 1.87 (U mL−1)/(U kg−1) (range: 1.25–2.76) and the mean FVIII half‐life was 10.7 h (range: 7.8–15.3). FVIII recovery was positively correlated with body surface area (BSA; P = 0.04). FVIII half‐life was positively correlated with preinfusion levels of von Willebrand factor antigen (VWF:Ag) (P = 0.0001) and was reduced in patients (n = 6) with very low FVIII inhibitor titres (<0.5 BU) vs. those (n = 14) with negative inhibitor titres (P = 0.06).

These observations suggest that (i) young children with haemophilia in comparison with adults have a low recovery of FVIII and that this might be explained by differences in body composition (BSA, plasma volume), (ii) levels of VWF:Ag may explain some of the differences in the half‐life and clearance of FVIII and (iii) very low inhibitor titres, previously regarded as clinically insignificant, may actually be significant and should be evaluated in the context of PK studies.
Determination of minimal sampling time points for reliable pharmacokinetic evaluation of recombinant factor VIII – an exploratory population pharmacokinetic analysis in paediatric patients suffering from severe haemophilia
Authors: STASS H.
Published: September 2006

Summary.  Data obtained from 19 paediatric patients (mean age, range: 12.8, 4.3–12 years) with haemophilia A from one clinical trial (see Barnes et al in these proceedings) were used to develop a population model of the pharmacokinetics (PK) of intravenous recombinant Factor VIII (rFVIII) given as a single bolus infusion of 50 IU kg−1 body weight. Eleven plasma samples per patient were drawn and assayed using the one stage coagulation assay. These data and the patient covariables were modelled by iterative two step analysis, thus generating PK parameter values for both individuals and the overall study population. The partial derivatives method of analysis (from WinNonlin®) was used to identify the optimal sampling times (OST). Minimization of the sampling schedule was validated by comparison of parameter estimates obtained by OST with data calculated from the full (11 samples/patient) data set using compartmental and non‐compartmental PK approaches and sensitivity analysis with respect to patients’ covariables. The PK parameters were best described by a two compartment model with an IV input‐function to the central compartment. Base line FVIII levels were built into the model as a continuous constant rate delivery function. Lean body mass (LBM) had a moderate influence on clearance and central volume of distribution (∼2.5% per kg LBM). Inter‐subject variability on both parameters was moderate (Cl: 27.2%, V: 15.5%) residual error was low (5.7%). Base line estimates were generally below 1% for all subjects in accordance with their severe state of disease. Five OST (end of infusion, 2.5–3.5, 8–10, 22–26 and 46–50 h) provided maximum information and allowed PK parameter values to be estimated by both compartmental and non‐compartmental methods with comparable accuracy as that obtained using the full sampling schedule. Additionally, a predose sample may be added to get an improved base line estimate. Our results indicate that even after substantial reduction of the number of samples (from 11 to 5) adequate rFVIII PK data can be obtained using OST schedules in severe haemophiliacs. PK studies conducting using the much fewer sampling time points are less burdensome to patients, particularly very young patients, and thus may be easier to implement into routine haemophilia care.
Pharmacoeconomics of factor dosing in the haemophilia population
Authors: BERNTORP E.
Published: September 2006

Summary.  Treatment of haemophilia is extremely costly due to the short biological half‐life of infused factor and pricing issues. This paper examines the impact of different dosing schedules on factor consumption, via a review of literature on dosing regimens used for prophylaxis with a focus on pharmacokinetics (PK).

Pharmacokinetics were found to have an important role for pharmacoeconomics in factor dosing both for assessment of the treatment and for developing new treatment protocols but the clinical response to treatment must always guide the dosing schedule. In order to better understand pharmacoeconomics during prophylaxis, controlled prospective studies are needed but much can also be learned from studies of existing cohorts that have been treated for decades.
Interstitial lung disease—the new synergy between radiology and pathology
Authors: Quigley M , Hansell D M , Nicholson A G
Published: September 2006

In the last 30 years, high‐resolution computed tomography (HRCT) has been the major advance in diagnosis of diffuse parenchymal lung disease (DPLD). We review the diagnostic accuracy of HRCT and discuss how the gold standard in diagnosis of DPLD has shifted from histopathological diagnosis in isolation to a multidisciplinary approach. This latter process is now accepted as providing the highest levels of diagnostic accuracy in patients with DPLD and lung biopsy is primarily reserved for cases with atypical clinical or radiological presentations.
Service users’ experiences of ‘as needed’ psychotropic medications in acute mental healthcare settings
Authors: Baker J. A. , Lovell K. , Easton K. , Harris N.
Published: September 2006

Aims.  This paper reports a study which aimed to explore service users’ views and experiences of the processes associated with the prescription and administration of ‘as needed’ (p.r.n.) psychotropic medications in acute mental health settings.

Background.  Few studies have explored the use of ‘as needed’ medication in acute mental healthcare settings. Such medication is frequently requested by service users, but the literature is unclear about the reasons for these requests or service users’ experiences of this treatment.

Method.  A convenience sample of 22 inpatients participated in face‐to‐face semi‐structured interviews exploring their treatment experiences of ‘as needed’ psychotropic medication in acute mental health settings in a large city in the United Kingdom in 2005. Thematic content analysis was carried out.

Results.  Interviewees highlighted the value of ‘as needed’ medications. However, the process associated with their use was perceived as confusing and stigmatizing. Service users had limited understanding of and felt unsupported in attempts to use alternatives approaches. Additionally, the decision‐making and information‐giving processes were unclear to them, which raises issues of power and control in acute mental health settings.

Conclusions.  Nurses should take account of the issues of power and control when administering ‘as needed’ medication. The provision of adequate treatment information should be a priority to enable informed choices to be made about this form of medication.
ORIGINAL ARTICLE: How many species of shore fishes are there in the Tropical Eastern Pacific?
Authors: Zapata Fernando A. , Ross Robertson D.
Published: September 2006

Aim To assess whether the total richness of the shore‐fish fauna of a discrete biogeographical region can be predicted, and to estimate how long it is likely to take to enumerate that fauna.

Location The Tropical Eastern Pacific (TEP), an isolated biogeographical region with a high level of endemism (72%) among its modestly rich, known fauna of shore fishes (1222 named + 58 known undescribed shallow‐water species).

Methods We used patterns in the long‐term dynamics and accumulation curves of descriptions of new species, which began in 1758, correlates of these patterns, and the body size–frequency distributions of various ecological groups of the fauna to (1) try to predict the total richness of that fauna, (2) estimate how many species might be missing and what biological characteristics they might have, and (3) estimate how long their discovery and description will take to complete.

Results Accumulation curves for the entire fauna, for all TEP endemics or for reef and soft‐bottom species (77.5% of the fauna) are not approaching asymptotes, and their description rates have remained fairly stable over the past century. However, curves for pelagic and multi‐habitat species (22.5% of the fauna) may be nearing asymptotes, perhaps because these species are relatively accessible to collection. These curves clearly indicate that the total TEP fauna is substantially richer than the presently known fauna, but do not allow reliable prediction of its richness. Extrapolations from frequency distributions of the body size of different ecological groups of TEP fishes indicate that the entire fauna is at least 12–15% larger than the currently known fauna.

Main conclusions From recent description trends, undiscovered species will tend to be small, have limited geographic and depth ranges, and live in deeper water. Poorly known, priority areas for taxonomic investigation in the TEP include deeper reef habitats, two isolated island groups, and several continental areas with unusual environments. At current levels of traditional taxonomic activity, the description of known unnamed species will takec.15 years, and assessment of the richness of unknown species, which probably number in the hundreds, will take decades.
ORIGINAL ARTICLE: Taxonomy and diversity of Afroalpine Chironomidae (Insecta: Diptera) on Mount Kenya and the Rwenzori Mountains, East Africa
Authors: Eggermont Hilde , Verschuren Dirk
Published: September 2006

Aim Anthropogenic climate change is expected to result in the complete loss of glaciers from the high mountains of tropical Africa, with profound impacts on the hydrology and ecology of unique tropical cold‐water lakes located downstream from them. This study examines the biodiversity of Chironomidae (Insecta: Diptera) communities in these scarce Afroalpine lake systems, in order to determine their uniqueness in relation to lowland African lakes and alpine lakes in temperate regions, and to evaluate the potential of Afroalpine Chironomidae as biological indicators to monitor future changes in the ecological integrity of their habitat.

Location Mount Kenya (Kenya) and Rwenzori Mountains (Uganda).

Methods The species composition of Afroalpine chironomid communities was assessed using recent larval death assemblages extracted from the surface sediments of 11 high‐mountain lakes between 2900 and 4575 m. Results were compared with similar faunal data from 68 East African lakes at low and middle elevation (750–2760 m), and with literature records of Chironomidae species distribution in sub‐Saharan Africa, the Palaearctic region and elsewhere. All recovered taxa were fully described and illustrated.

Results The 11‐lake analysis yielded 1744 subfossil chironomid larvae belonging to 16 distinct taxa of full‐grown larvae, and three taxa of less differentiated juveniles. Eleven of these 16 are not known to occur in African lakes at lower elevation, and eight taxa (or 50% of total species richness) appear restricted to the specific habitat of cold lakes above 3900 m, where night‐time freezing is frequent year‐round. The faunal transition zone coincides broadly with the Ericaceous zone of terrestrial vegetation (c. 3000–4000 m). Snowline depression during the Quaternary ice ages must have facilitated dispersion of cold‐stenothermous species among the high mountains of equatorial East Africa, but less so from or to the Palaearctic region via the Ethiopian highlands.

Main conclusions Chironomid communities in glacier‐fed lakes on Africa's highest mountains are highly distinct from those of lowland African lakes, and potentially unique on a continental scale. By virtue of excellent preservation and their spatial and temporal integration of local community dynamics, chironomid larval death assemblages extracted from surface sediments are powerful biological indicators for monitoring the hydrological and ecological changes associated with the current retreat and loss of Africa's glaciers.
Effect of temperature and leaf wetness duration on infection of sweet oranges by Asiatic citrus canker
Authors: Dalla Pria M. , Christiano R. C. S. , Furtado E. L. , Amorim L. , Bergamin Filho A.
Published: September 2006

Asiatic citrus canker, caused by Xanthomonas smithii ssp. citri, formerly X. axonopodis pv. citri, is one of the most serious phytosanitary problems in Brazilian citrus crops. Experiments were conducted under controlled conditions to assess the influence of temperature and leaf wetness duration on infection and subsequent symptom development of citrus canker in sweet orange cvs Hamlin, Natal, Pera and Valencia. The quantified variables were incubation period, disease incidence, disease severity, mean lesion density and mean lesion size at temperatures of 12, 15, 20, 25, 30, 35, 40 and 42°C, and leaf wetness durations of 0, 4, 8, 12, 16, 20 and 24 h. Symptoms did not develop at 42°C. A generalized beta function showed a good fit to the temperature data, severity being highest in the range 30–35°C. The relationship between citrus canker severity and leaf wetness duration was explained by a monomolecular model, with the greatest severity occurring at 24 h of leaf wetness, with 4 h of wetness being the minimum duration sufficient to cause 100% incidence at optimal temperatures of 25–35°C. Mean lesion density behaved similarly to disease severity in relation to temperature variation and leaf wetness duration. A combined monomolecular‐beta generalized model fitted disease severity, mean lesion density or lesion size as a function of both temperature and duration of leaf wetness. The estimated minimum and maximum temperatures for the occurrence of disease were 12°C and 40°C, respectively.
Usefulness of nonhost plants in managing Plasmodiophora brassicae
Authors: Friberg H. , Lagerlöf J. , Rämert B.
Published: September 2006

Germination of resting spores of Plasmodiophora brassicae, causal agent of clubroot in crucifers, may be stimulated by certain nonhost plants. Without a host plant to infect, such germination would lead to a reduced persistence of resting spores in the soil. The effect of four nonhost plants on P. brassicae was investigated in a 3‐year field experiment and a 14‐month glasshouse experiment. Three of the plant species used, leek (Allium porrum), winter rye (Secale cereale) and perennial ryegrass (Lolium perenne), have been reported to stimulate resting spore germination, while the fourth, red clover (Trifolium pratense), does not. In the field experiment, none of the plant species reduced the concentration of P. brassicae in soils when tested with bioassay plants (Chinese cabbage, Brassica rapa var. pekinensis). In the glasshouse experiment, there was a lower disease level in all plant treatments compared with the plant‐free control following incorporation and decomposition of plant roots. At this time, pH in the soils with plant treatments was higher than that in the control soil. There were no indications of a species‐specific interaction between any of the nonhost plants investigated and P. brassicae, and it cannot be concluded that any of them would be useful in the sanitation of P. brassicae‐infested soils within short time periods.
Is there a signal transduction pathway that links events at the plasma membrane to the phosphorylation state of the mitochondrial pyruvate dehydrogenase complex?
Authors: Miernyk Jan A. , Szurmak Blanka , Tovar‐Mendez Alejandro , Randall Douglas D. , Muszynska Grazyna
Published: September 2006

Monoclonal antibodies against the E1α subunit of pyruvate dehydrogenase (PDH) were used to quantify the mitochondrial pyruvate dehydrogenase complex (mtPDC) by enzyme‐linked immunosorbent assay (ELISA). Recombinant Arabidopsis thaliana PDH (E1) was used to calibrate the ELISA. Antibodies against a synthetic phosphopeptide corresponding to phosphorylation site one of E1α were used in an ELISA to quantify phospho‐PDC (P‐PDC). For calibration of the second ELISA, recombinant E1 was phosphorylated in vitro with recombinant A. thaliana E1‐kinase. The two ELISA were used to quantify mitochondrial total‐ and P‐PDC in clarified homogenates from Nicotiana tabacum BY‐2 suspension cells. The level of mtPDC remained constant throughout the 7‐day growth cycle at 25.1 g−1 FW. During the lag (days 0–2) and stationary (day 7) stages of the growth cycle, the mtPDC was completely phosphorylated (inactive), whereas during the log‐growth stage it was completely dephosphorylated (active). Exposure of 3‐ or 7‐day posttransfer suspension cells to osmotic stress significantly decreased proportion of P‐PDC. A series of pharmacological studies were undertaken to gain insight into the signal transduction pathways coupling osmotic stress perception with control of mitochondrial respiration. Results from these studies indicate a signal transduction pathway linking stress perception to control of mitochondrial respiration that includes protein kinases and phosphoprotein phosphatases.
The multifarious roles of PPR proteins in plant mitochondrial gene expression
Authors: Andrés Charles , Lurin Claire , Small Ian D.
Published: September 2006

With a few rare exceptions, genes encoding pentatricopeptide (PPR) proteins are present in all sequenced eukaryotic genomes but absent from prokaryotic and archaeal genomes. The family has greatly expanded in plants, to more than 400 genes in each species. So far, the evidence indicates that PPR proteins are generally involved in regulation of organelle genome expression, in other words they are eukaryotic proteins selected for the control of genomes of prokaryotic origin. PPR proteins are localised in both plastids and mitochondria, and appear to have similar roles in both cases. They have been implicated in almost all stages of gene expression, including messenger RNA (mRNA) transcription, splicing, processing, editing, translation and stability. The most probable hypothesis for explaining these diverse roles is that PPR proteins are sequence‐specific RNA‐binding adaptors capable of directing effector enzymes to defined sites on mRNAs. Much of the recent interest in the role of PPR proteins in mitochondria has been driven by the discovery that most cytoplasmic male sterility systems comprise fertility restorer genes that are members of this fascinating family.
Plant mitochondrial pathway leading to programmed cell death
Authors: Vianello Angelo , Zancani Marco , Peresson Carlo , Petrussa Elisa , Casolo Valentino , Krajňáková Jana , Patui Sonia , Braidot Enrico , Macrì Francesco
Published: September 2006

Programmed cell death (PCD) is a finely tuned process of multicellular organisms. In higher plants, PCD regulates many developmental processes and the response of host plants to incompatible pathogens (hypersensitive response). Four types of PCD have been described in plants, mainly associated to vacuole rupture, that is followed by the appearance of the typical PCD hallmarks (i.e. nuclear DNA fragmentation and cell shrinkage). However, in some cases vacuole collapse is preceded by an early alteration of other subcellular organelles, such as mitochondria. In particular, the central role played by mitochondria in PCD has been largely recognised in animal cells. This review deals with the involvement of mitochondria in the manifestation of plant PCD, in comparison to that described in animal PCD. The main hallmark, connecting animal and plant PCD via mitochondria, is represented by the release of cytochrome c and possibly other chemicals such as nucleases, which may be accomplished by different mechanisms, involving both swelling and non‐swelling of the organelles.
The genetic architecture of male colour differences between a sympatric Lake Malawi cichlid species pair
Authors: BARSON N. J. , KNIGHT M. E. , TURNER G. F.
Published: September 2006

The genetic basis of traits involved in reproductive isolation is a key parameter in models of sympatric speciation by sexual selection, a potential mechanism driving the explosive radiation of East African cichlids. Analysis of hybrid crosses between two sympatric Lake Malawi cichlid species, representing the extremes of the extant colour distribution, generated Castle–Wright estimates of four to seven loci controlling colour differences. Segregation patterns deviated from a purely additive model with a significant contribution from dominance, and possibly also epistasis. Evidence was found for a strong influence of autosomal loci. As departures from simple additive variation could effect the operation of models of sympatric speciation, dominance and epistasis should not be neglected.
Senescence in relation to latitude and migration in birds
Authors: MØLLER A. P.
Published: September 2006

Senescence is the age‐related deterioration of the phenotype, explained by accumulation of mutations, antagonistic pleiotropy, free radicals or other mechanisms. I investigated patterns of actuarial senescence in a sample of 169 species of birds in relation to latitude and migration, by analysing longevity records adjusted for sampling effort, survival rate and body mass. Senescence might decrease at low latitudes because of elevated adult survival rates and generally slow life histories. Alternatively, the rate of senescence might increase at low latitudes because of the greater impact of biological interactions such as parasitism, predation and competition on fitness through differential effects of age‐specific mortality (e.g. because immunologically naïve young individuals and immuno‐senescent old individuals might die more frequently than individuals belonging to intermediate age classes). Bird migration entails extensive exercise twice annually, with migrants spending more time in benign environments with little abiotic mortality than residents, migrants having higher adult survival rate and lower annual fecundity than residents, and migrants suffering more from the consequences of oxidative stress than residents. The rate of senescence increased with latitude, as expected because of slow life histories at low latitudes. Independently, rate of senescence decreased with increasing migration distance. These findings were robust to control for potentially confounding effects of body mass, age of first reproduction and phenotypic similarity among species because of common descent.
Pulmonary embolism: Accuracy and safety of a negative CT pulmonary angiogram and value of a negative D‐dimer assay to exclude CT pulmonary angiogram‐detectable pulmonary embolism*
Authors: Subramaniam RM , Chou T , Swarbrick M , Karalus N
Published: September 2006

This is a retrospective study to determine the accuracy and safety of a negative CT pulmonary angiogram (CTPA) based on clinical outcome and to determine the usefulness of a negative D‐dimer assay before CTPA. A total of 483 patients with a negative CTPA study were followed up for 3 months, with the aim of detecting episodes of venous thromboembolism and mortality. Three hundred and forty‐nine patients had an immunochromatographic D‐dimer assay called ‘Simplify', carried out before a CTPA examination. Seventy‐eight patients had a negative D‐dimer assay and a negative CTPA. Three patients had a negative D‐dimer assay and a positive CTPA. All three patients had a moderate pretest clinical probability. Of the 483 patients who had a negative CTPA and a 3‐month follow up, 444 (92%) were alive and 39 (8%) had died. Of the 444 patients who were alive, none had any further suspected episode of thromboembolism or had received anticoagulation therapy within the follow‐up period. Of those who died, none of the deaths was thought to be as a result of pulmonary embolism (PE). Single‐detector helical CT can be used safely as the primary diagnostic test to evaluate PE. Negative Simplify D‐dimer assay and low pretest clinical probability exclude CTPA‐detectable PE, and a CTPA is unnecessary in this cohort of patients.
Normal obstetric ultrasound reduces the risk of Down syndrome in fetuses of older mothers
Authors: Anderson NG , Luehr B , Ng R
Published: September 2006

The objective of this study is to determine whether a normal fetal morphology ultrasound scan in women older than 35 years reduces the risk of aneuploidy. We reviewed the results of amniocentesis and second trimester sonogram in all women older than 35 years from 1991 to 1995. None had prior screening. We excluded fetuses with structural anomalies. We determined the sensitivity and specificity of minor markers in detecting Down syndrome and also determined the reduction in risk of a normal sonogram. Among the 2060 women older than 35 years giving birth during the study period, 16 (0.78%) delivered an infant with Down syndrome. Of the 16 fetuses, two had no prenatal testing or ultrasound, two had invasive testing but no second trimester sonogram, five had a normal sonogram and seven had one or more sonographic markers of Down syndrome. At least 17% of women older than 35 years did not participate in prenatal testing or ultrasound. Ultrasound detected Down syndrome with a sensitivity of 59% (95% confidence interval: 45–72%), a false‐positive rate of 10.6% (9.4–11.8%) and a positive predictor value of 1 in 9. The likelihood of having normal karyotype if the sonogram was normal was 0.46 (0.31–0.61). In women older than 35 years, a normal second trimester sonogram reduces the risk of Down syndrome by more than 50%. At least 17% of women older than 35 years do not participate in prenatal testing or ultrasound.
Patient satisfaction in radiation oncology
Authors: Zissiadis Y , Provis A , Harper E , Kearney E , McDonald L , Dhaliwal S
Published: September 2006

As part of a quality improvement exercise at the Perth Radiation Oncology Centre, a survey was undertaken to ascertain the current level of patient satisfaction with the information they were receiving from their treating radiation oncologist. In addition, the effect of radiation on patients’ anxiety levels was investigated. Two questionnaires were given to patients having radical radiotherapy for malignancy. The first questionnaire consisted of the Information Satisfaction Questionnaire and the State Trait Anxiety Index. It was given to patients before the commencement of their course of radiotherapy. The second questionnaire consisted of the State Trait Anxiety Index and was given at the completion of their radiotherapy. A total of 120 patients completed both the questionnaires. The majority of patients were satisfied/very satisfied with the explanation of their illness and radiation toxicities. Fewer patients were satisfied with the explanation of lifestyle (e.g. diet, exercise, smoking) and practical issues such as parking and treatment costs. The patients showed a statistically significant reduction in both their State and Trait Anxiety scores following radiotherapy. Following this study, we have developed new information booklets addressing lifestyle and practical issues, which were not being adequately addressed as shown in this study. Our next study will assess the effect of these new information booklets.
Ovarian vascular pedicle sign in ovarian metastasis arising from gall bladder carcinoma
Authors: Taranto AJ , Lourie R , Lau WFE
Published: September 2006

A case of a large mass in the pelvis confirmed to be a rare ovarian metastasis arising from a primary adenocarcinoma of the gall bladder is presented. The value of the recently described ovarian pedicle sign in confirming the organ of origin of the pelvic mass is emphasized.
Spontaneous intracranial hypotension: A study of six cases with MR findings and literature review
Authors: Sainani NI , Lawande MA , Pungavkar SA , Desai M , Patkar DP , Mohanty PH
Published: September 2006

Spontaneous intracranial hypotension is clinically characterized by orthostatic headache and other symptoms caused by low cerebrospinal fluid pressure due to leakage of cerebrospinal fluid from dural punctures or other medical causes. The other symptoms are mainly due to traction of the cranial and spinal nerves owing to descent of the brain caused by low cerebrospinal fluid pressure. Magnetic resonance imaging is very useful in the diagnosis because of its characteristic findings. We describe the MRI findings in six cases that had variable clinical presentation.
Posttransplant lymphoproliferative disorder: A pictorial review
Authors: Burney K , Bradley M , Buckley A , Lyburn I , Rye A , Hopkins R
Published: September 2006

Posttransplant lymphoproliferative disorder (PTLD) is a serious and potentially fatal complication after solid organ and haemopoietic stem cell transplantation. The frequency of PTLD varies with the type of organ transplant but overall it affects 2–10% of all solid organ transplant recipients. Most cases develop within 1 year after the transplant, although occasional cases present 5–10 years later. Posttransplant lymphoproliferative disorder is clinically and pathologically heterogeneous – the majority are of the non–Hodgkin’s lymphoma type, whereas Hodgkin’s lymphoma arising after transplantation is rare. We have retrospectively reviewed patients with a histological diagnosis of PTLD after a solid organ transplant. We present the imaging features and a clinical review of this condition. Early diagnosis of PTLD may alter the management and outcome of the disease. The radiologist can play a vital role in establishing the diagnosis by imaging features supplemented with percutaneous biopsy and also in monitoring the disease response to treatment.
Radiology curriculum for medical students: Clinicians’ perspectives
Authors: Subramaniam RM , Sherriff J , Holmes K , Chan MC , Shadbolt B
Published: September 2006

This study was conducted to establish clinicians’ perspectives of a set of radiology curriculum topics for medical student teaching, which were held to be important by radiologists. A questionnaire was sent to clinicians in all specialties. Forty‐six clinicians (51.1%) out of 90 returned the questionnaires. All curriculum topics were scored above an average of 4 (agree). The five highest ranking curriculum topics in order of importance were: developing a system for viewing chest radiographs (5.59), developing a system for viewing abdominal radiographs (5.56), developing a system for viewing bone and joint radiographs (5.33), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.33) and identifying gross bone or joint abnormalities in skeletal radiographs (5.22). Correlative analysis between speciality groups showed surgical and medical specialities were significantly different in their responses of two learning outcomes: basic knowledge about the contrast media benefits and risks (P= 0.01) and ability to select the most appropriate and the most cost‐effective methods of radiological investigations for clinical situations (P= 0.03). Acute specialities were not significantly different from the other two groups for these two learning outcomes. There was no statistically significant difference for other learning outcomes between the three speciality groups.
Alternative technique for transjugular intrahepatic portosystemic shunt in a young child
Authors: Fasulakis S , Rerksuppaphol S , Hardikar W , Vrazas J , Brooks M
Published: September 2006

Liver transplantation is safer, more readily available and is increasingly being carried out in younger patients. Therapeutic bridging procedures such as transjugular intrahepatic portosystemic shunt have therefore become more relevant to paediatrics, especially in the group of patients who are too unstable for surgery or in whom a liver graft is not available. We describe a transjugular intrahepatic portosystemic shunt procedure in a 4‐year‐old child with life‐threatening variceal bleeding in whom the conventional procedure had failed. This technique may provide an alternative to conventional transjugular intrahepatic portosystemic shunt in this group.
Comparison of non‐coplanar and coplanar irradiation techniques to treat cancer of the pancreas
Authors: Osborne C , Bydder SA , Ebert MA , Spry NA
Published: September 2006

We compared two different techniques of pancreatic irradiation using measures associated with normal tissue complications. Seven consecutive patients with pancreatic cancer were planned for both coplanar and non‐coplanar (NCP) external beam radiation treatments, using the same defined anatomical volumes for each patient, in each case. Each pair of plans was then compared using a range of objective criteria. Individual normal tissues were assessed against traditional tolerance limits. Selected dose‐points, normal tissue complication probability (NTCP) and equivalent uniform doses (EUD) were also compared, as were indices combining information from individual tissues – total NTCP and total weighted EUD. All individual normal tissues doses were within established tolerance limits. For NCP relative to coplanar planning, NTCP and EUD were lower for all individual tissues in four cases and one case, respectively, i.e. in most cases a benefit to one tissue was offset by detriment to others. Summary measures demonstrated overall benefits for NCP techniques, with the total NTCP in six patients, and with the total weighted EUD in all patients. NCP techniques show potentially useful benefits. We present a new objective measure, the total weighted EUD, which may be particularly useful comparing plans where there are multiple critical tissues.
Outcome of post‐prostatectomy radiotherapy in one institution
Authors: Borg M , Sutherland P , Stapleton A , Bolt J , Steele D , Landers B , Porter A , Buxton S , Heilbornn C , Wong H‐Z
Published: September 2006

We present a retrospective study to evaluate the outcome of postoperative radiotherapy for biochemical or clinical recurrent prostate cancer. Twenty‐six patients (median age 60 years) underwent radiotherapy after radical prostatectomy between January 1997 and January 2004. Seven patients received adjuvant radiotherapy and 19 received salvage radiotherapy. The median prostate‐specific antigen at diagnosis was 8.6 (0.9–89) and most (23 patients) presented with T3N0 disease. The median follow up was 19.5 months (5–84 months). All patients received a dose of 61.2 Gy at 1.8 Gy per fraction, 20 initially receiving 45 Gy to the lesser pelvis. The median dose to the bladder, rectum and left femoral head were 55.6, 57.5 and 33.8 Gy, respectively. All patients were managed radiotherapeutically by the first author. Twenty‐four patients are alive. Two patients have died, one from oesophageal cancer and the second from metastatic prostate cancer. Two other patients also developed metastatic disease. Four asymptomatic patients with a rising prostate‐specific antigen are under observation. None of the 26 patients has developed a local recurrence. Seven patients have developed grade 1 late bowel effects and three a grade 2 late effect. Eight patients suffer from grade 1 late genitourinary effects and two from grade 2 effects. One patient developed impotence, whereas 23 patients were rendered impotent postoperatively. There were no grade 3/4 late effects. Postoperative radiotherapy is well tolerated and provides effective local control.
Cholecystocolonic fistula diagnosed with CT‐intravenous cholangiography
Authors: Gaillard F , Stella D , Gibson R
Published: September 2006

Cholecystoenteric fistulas are often not diagnosed preoperatively and delineation of fistula can have an influence on surgical planning. We report a case of cholecystocolonic fistula diagnosed preoperatively using CT‐i.v. cholangiography and review the published reports.
Non‐cavernomatous superior mesenteric thrombosis successfully recanalized with interventional radiological procedures carried out with a combination transmesenteric and transjugular approaches
Authors: Yamagami T , Takeuchi Y , Sonoyama T , Nakao N , Kato T , Ochiai T , Ichikawa D , Yamagishi H , Nishimura T
Published: September 2006

This is the study of a 52‐year‐old man with oesophageal, rectal and anal varices caused by portal hypertension with complete obstruction of the superior mesenteric vein. Treatment by two sessions of interventional radiological procedures was successful. The first was a catheter‐directed thrombolysis using the transmesenteric approach. The second was percutaneous transluminal angioplasty and stent implantation for the obstructed segment of the superior mesenteric vein and the creation of a transjugular intrahepatic portosystemic shunt. In the second session, devices were advanced over a guidewire inserted from the right jugular vein and pulled out of the ileocolic vein using the pull‐through technique.
Laparoscopic scar: A mimicker of Sister Mary Joseph’s nodule on positron emission tomography/CT
Authors: Setty B , Blake MA , Holalkere NS , Blaszkowsky LS , Fischman A
Published: September 2006

Positron emission tomography/CT is an established imaging method in the diagnosis and staging of cancers. 18F‐fluoro‐2‐deoxy‐d‐glucose (FDG) is the most commonly used radiotracer in positron emission tomography/CT. It is a tumour viability agent and usually its uptake within a lesion reflects the presence of a viable tumour tissue. However, false‐positive FDG uptake is known to occur in benign processes of either inflammatory or infectious aetiology. We describe FDG uptake at the site of laparoscopic scar that mimicked Sister Mary Joseph’s nodule in a patient with gastric adenocarcinoma. Here, the knowledge of the patient’s history and subtle imaging findings helped in accurate staging of the patient. In this case report, we emphasize the value of the knowledge of the patient history and awareness of different pitfalls of FDG to achieve a correct diagnosis on positron emission tomography/CT.
Endoscopic ultrasound‐guided fine needle aspiration biopsy: Equipment and technique
Authors: Vilmann Peter , Săftoiu Adrian
Published: September 2006

Endoscopic ultrasound‐guided fine needle aspiration biopsy (EUS‐FNA) is currently performed on a routine basis at many endoscopic centers and it is evident that this procedure has a major impact on the therapeutic management of patients by obtaining a definite tissue diagnosis from lesions outlined by endosonography. The reported yield of EUS‐FNA is about 90–95%, with an overall sensitivity and specificity of 90% and 100%, respectively. Moreover, even minute lesions down to a size of 5 mm may be imaged and consequently biopsied. This Review describes the technique of EUS‐FNA in detail, based on a literature review and the authors’ extensive experience with this method. The endoscopes and needle systems available on the market are presented in detail. The biopsy procedure is carefully explained, as well as the preparation of the cytology smears. Finally, the limitations and complications of the procedure are reviewed in brief, stressing the low rate of complications (below 1–2%), most of them being minor and self‐limiting. Currently endosonography has strengthened its position as a diagnostic and staging method, especially after establishing the method of FNA biopsy. Thus, EUS‐FNA is very useful to establish an initial tissue diagnosis of malignancy, but also to accurately stage the patients preoperatively, influencing the decision‐making process and reducing the morbidity and mortality that accompanies inappropriate surgical interventions in patients with advanced cancer.
Phytoplankton primary production, chlorophyll‐a and nutrient concentrations in the water column of mountainous Lake Phewa, Nepal
Authors: Gurung Tek Bahadur , Dhakal Ram Prasad , Bista Jay Dev
Published: September 2006

The seasonal patterns of phytoplankton primary production, chlorophyll‐a concentration, cell number and several other limnological variables in Lake Phewa, located in the active monsoon zone in Central Himalaya, Nepal, were studied for a year beginning in April 2001. During the study period, the gross primary production and chlorophyll‐a concentrations were relatively low during the monsoon season. The phytoplankton cell number, represented by 24 genera, also fluctuated seasonally, but tended to increase in the pre‐ and post‐monsoon period. These results suggest that the monsoon plays a crucial role in the primary production and phytoplankton dynamics for Lake Phewa. Among the phytoplankton species, Microcystis aeruginosa, a representative species for eutrophic lakes, was the dominant phytoplankton. At the same time, however, it is clear that the lake is not yet heavily eutrophic. The present study suggests that the exchange of lake water during the monsoon season contributes to maintaining the health of the lake against further degradation. Nevertheless, the silt carried in the monsoon rain run‐off from the lake's catchment area suggests increasingly serious degradation problems for this small mountainous lake.
Influence of influent tributaries on water quality changes in Lake Mogan, Turkey
Authors: Taşeli Başak K.
Published: September 2006

Lake Mogan, located in the steppes of central Anatolia, is a vital Turkish ecological system, in terms of its water resources, flora and fauna. The lake also is a unique recreational area for Ankara, the capital of Turkey. However, the lake is currently threatened by severe pollution, being under the risk of serious degradation because of (i) uncontrolled urbanization; (ii) point and non‐point source pollution; (iii) inefficient sewerage systems; (iv) sediment transportation and pollution via influent creeks to the lake; (v) uncontrolled soil erosion in its drainage basin; (vi) inappropriate flood control measures; and (vii) severe degradation of the natural wetlands within its drainage basin. This study evaluates the influence of its influent creeks on the water quality of Lake Mogan, mainly because the creeks are believed to be responsible for the major pollutant load reaching the lake, and because the extensive database documenting this situation has not previously been critically evaluated. Accordingly, this study reviews (i) change in the water quality of Lake Mogan between 1993 and 2002; (ii) the water quality classification of the major influent creeks feeding Lake Mogan; and (iii) the influence of the influent creeks on the water quality of the lake between 1993 and 2004.
Planning for integrated lake management in Uganda: Lessons for sustainable and effective planning processes
Authors: Nunan Fiona
Published: September 2006

The international consensus on the need for integrated approaches for managing water resources has led to a plethora of integrated frameworks and strategies. The development of management plans for lakes and their drainage basins is part of the ‘integrated management’ agenda. Challenging questions, however, arise in regard to what integration actually means within the context of planning processes and systems, and for the management plans themselves. The limited literature on lake management planning emphasizes the need for a lead agency for planning and implementation. A relevant question is how does lake management planning relate to planning by local governments, national government departments and other stakeholder groups. The integrated lake management efforts in Uganda have led to the development of lake management plans that build on, and complement, existing local government processes and plans. Lessons from early lake management experiences indicate that establishing clear linkages in the planning processes, and within the plans themselves between lake management structures and local government, is essential for sustainability, coordination and resource mobilization. The development of lake management plans also strengthens existing local government planning systems, by providing a forum for sharing information, ideas and lessons. The lake management planning also supports the introduction of local governments to participatory, community‐based planning, as well as promoting intersectoral coordination.
Induction of parkin expression in the presence of oxidative stress
Authors: Yang Yan Xiang , Muqit Miratul M. K. , Latchman David S.
Published: September 2006

Parkinson's disease (PD) is one of the most common neurodegenerative disorders. Gene mutations have been found in rare familial forms of PD, with mutations in parkin being the most common cause. Oxidative stresses have also been implicated as an important contributing factor in the pathogenesis of PD. Currently, there is accumulating evidence that parkin may play a role in maintaining mitochondrial function and preventing oxidative stress. We demonstrated here that parkin is up‐regulated when SH‐SY5Y dopaminergic neuroblastoma cells are exposed to the oxidant dopamine.The up‐regulation of parkin appeared to be due to transcriptional activation as luciferase assays confirmed that specific parkin promoter constructs could confer enhanced transcriptional activation in response to dopamine. Moreover, this effect was also seen when SH‐SY5Y cells were subjected to another oxidative stress, 1‐methyl‐4‐phenylpyridinium. In parallel with these studies, we also observed similar transcriptional activation of the parkin coregulated gene by oxidative stress. This is the first demonstration that parkin expression is up‐regulated by oxidative stresses and may suggest that this might be a general neuroprotective response of parkin to oxidative stresses.
Dynamic role of kallikrein 6 in traumatic spinal cord injury
Authors: Scarisbrick I. A. , Sabharwal P. , Cruz H. , Larsen N. , Vandell A. G. , Blaber S. I. , Ameenuddin S. , Papke L. M. , Fehlings M. G. , Reeves R. K. , Blaber M. , Windebank A. J. , Rodriguez M.
Published: September 2006

Kallikrein 6 (K6) is a member of the kallikrein gene family that comprises 15 structurally and functionally related serine proteases. In prior studies we showed that, while this trypsin‐like enzyme is preferentially expressed in neurons and oligodendroglia of the adult central nervous system (CNS), it is up‐regulated at sites of injury due to expression by infiltrating immune and resident CNS cells. Given this background we hypothesized that K6 is a key contributor to the pathophysiology of traumatic spinal cord injury (SCI), influencing neural repair and regeneration. Examination of K6 expression following contusion injury to the adult rat cord, and in cases of human traumatic SCI, indicated significant elevations at acute and chronic time points, not only at the injury site but also in cord segments above and below. Elevations in K6 were particularly prominent in macrophages, microglia and reactive astrocytes. To determine potential effects of elevated K6 on the regeneration environment, the ability of neurons to adhere to and extend processes on substrata which had been exposed to recombinant K6 was examined. Limited (1 h) or excess (24 h) K6‐mediated proteolytic digestion of a growth‐facilitatory substrate, laminin, significantly decreased neurite outgrowth. By contrast, similar hydrolysis of a growth‐inhibitory substrate, aggrecan, significantly increased neurite extension and cell adherence. These data support the hypothesis that K6 enzymatic cascades mediate events secondary to spinal cord trauma, including dynamic modification of the capacity for axon outgrowth.