bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensor Tendon Rupture Associated with Osteoarthritis of the Distal Radioulnar Joint
Authors: YAMAZAKI H. , UCHIYAMA S. , HATA Y. , MURAKAMI N. , KATO H.
Published: August 2008

Non-rheumatoid osteoarthritis of the distal radioulnar joint can cause extensor tendon rupture. We analysed the radiographic morphology of the distal radioulnar joint to identify the risk factors for this complication. Forty-one wrist X-rays of 37 patients with extensor tendon rupture caused by distal radioulnar joint osteoarthritis were evaluated retrospectively for the severity of osteoarthritis by the Kellgren/Lawrence scoring system. Measurements were obtained from posteroanterior views. All but one wrist had severe osteoarthritic changes exceeding grade 3. The radiographic features that were different from those of the contralateral wrists included deepening and widening of the sigmoid notch, radial shift of the ulnar head and dorsal inclination of the sigmoid notch. There was no significant association between tendon rupture and the morphology of the ulnar head or ulnar variance. The scallop sign, dorsal inclination of the sigmoid notch and radial shift of the ulnar head are radiological risk factors for extensor tendon ruptures.
Combined Fractures of the Distal Radius and Scaphoid
Authors: RUTGERS M. , MUDGAL C. S. , SHIN R.
Published: August 2008

Combined fractures of the distal radius and scaphoid are uncommon, are usually the result of a high-energy trauma and there is no consensus regarding their optimal management. We present a retrospective study of ten patients, out of whom nine underwent internal fixation of their fractures. Open reduction and internal fixation were performed in six of the eight intraarticular fractures of the distal radius. After a mean follow-up of 40 months, eight patients reported no pain and the mean range of wrist motion was 55° flexion and 71° extension. Our current management protocol is outlined. Emphasis on treatment of this combined fracture should be placed on the management of the distal radius fracture. Internal fixation of both fractures, followed by early rehabilitation, optimises outcomes. Cast treatment is indicated only in patients with completely undisplaced fractures of both the radius and the scaphoid.
Extrapleural Apical Fluid Collection: An Important Sign on Plain X-ray Suggesting a Pre-ganglionic Brachial Plexus Injury
Authors: MCCAUL J. , SHARMA H. , HEMS T. E.
Published: August 2008

Forty of 136 consecutive patients referred for management of brachial plexus injuries had closed supraclavicular injuries. The results of the initial chest X-rays were available for 29 patients. Nine had avulsion of the C8 and T1 nerve roots from the spinal cord. Eight cases had MR confirmation of lower root avulsion, six of these cases were confirmed surgically and none had any long-term clinical recovery. Twenty had partial brachial plexus injuries without avulsion of these roots. Seven of nine patients with avulsion of C8 and T1 had an extrapleural apical fluid collection. One of these had a fractured first rib. Two of 20 without avulsion had an extrapleural apical fluid collection. Both had fractured the first rib. The difference in incidence of extrapleural apical fluid collection between the two groups, excluding those cases with first rib fractures, was statistically significant. Without a first rib fracture, an ipsilateral extrapleural apical haematoma on a plain chest X-ray of patients with brachial plexus injury strongly suggests pre-ganglionic injury to the lower roots.
General Concepts of Wrist Biomechanics and a View from Other Species
Authors: TANG J. B.
Published: August 2008

The carpus is one of the most complex joints in the extremities both in respect of its structure and its mechanics. In this article, an overview of the structural and biomechanical characteristics of the human carpus is presented first, followed by the author’s observations on the structural characteristics of the carpal equivalents of a variety of animal species compared with those of the human carpus. Finally, the implications of these observations for the functional reconstruction of the hand are outlined.
Zone 2 Flexor Tendon Repair in Young Children: A Comparative Study of Four-Strand Versus Two-Strand Repair
Authors: NAVALI A. M. , ROUHANI A.
Published: August 2008

This study compares the active ranges of finger motion and rupture rates of two-strand and four-strand repairs in zone 2 flexor tendon lacerations in young children. A total of 29 patients (under the age of 4 years) with 32 flexor tendon lacerations in zone 2 were evaluated. The injured tendons were randomly repaired with either two-strand or four-strand modified Strickland techniques. At a mean follow-up period of 11 months, the mean total active motion of interphalangeal joints was 156° in the two-strand and 158° in the four-strand group. According to the Strickland original method, this means an average of 89% (range 57–100%) of normal function in the two-strand and 90% (range 60–100%) in the four-strand group. There were no ruptures of the four-strand repairs, but one two-strand repair failed within 3 weeks of the repair. Statistically, we were not able to show any significant difference in the active ranges of finger motion achieved with two-strand and four-strand repairs.
The Oprah Factor: The Effects of a Celebrity Endorsement in a Presidential Primary Campaign
Authors: Pease Andrew , Brewer Paul R.
Published: August 2008

In 2007, popular daytime talk show host Oprah Winfrey endorsed Barack Obama, a candidate for the 2008 Democratic presidential nomination. This study uses data from an experiment to examine the impact of news about her endorsement. Exposure to such news did not influence the extent to which participants held favorable opinions toward Obama or the extent to which they saw him as likable. On the other hand, reading about the endorsement did lead participants to see Obama as more likely to win the nomination and to say that they would be more likely to vote for him. These findings suggest that research on celebrity endorsements should consider not only effects on candidate support but also subtler effects, such as those on viability assessments.
Overnight transduction with foamyviral vectors restores the long-term repopulating activity of Fancc−/− stem cells
Authors: Si Yue , Pulliam Anna C. , Linka Yvonne , Ciccone Samantha , Leurs Cordula , Yuan Jin , Eckermann Olaf , Fruehauf Stefan , Mooney Sean , Hanenberg Helmut , Clapp D. Wade
Published: August 2008

Fanconi anemia (FA) is a complex genetic disorder characterized by congenital abnormalities, bone marrow failure, and myeloid malignancies. Identification of 13 FA genes has been instrumental to explore gene transfer technologies aimed at correction of autologous FA-deficient stem cells. To date, 3 human FA stem cell gene therapy trials with standard 4-day transduction protocols using gammaretroviral vectors failed to provide clinical benefit. In addition, 2- to 4 day ex vivo manipulation of bone marrow from mice containing a disruption of the homologue of human FANCC (Fancc) results in a time-dependent increase in apoptosis and a risk for malignant transformation of hematopoietic cells. Here, we show that a 14-hour transduction period allows a foamyviral vector construct expressing the human FANCC cDNA to efficiently transduce murine FA stem cells with 1 to 2 proviral integrations per genome. Functionally, the repopulating activity of Fancc−/− stem cells from reconstituted mice expressing the recombinant FANCC transgene was comparable with wild-type controls. Collectively, these data provide evidence that short-term transduction of c-kit+ cells with a foamyviral vector is sufficient for functional correction of a stem cell phenotype in a murine FA model. These data could have implications for future gene therapy trials for FA patients.
Point mutation in the gene encoding p300 suppresses thrombocytopenia in Mpl−/− mice
Authors: Kauppi Maria , Murphy James M. , de Graaf Carolyn A. , Hyland Craig D. , Greig Kylie T. , Metcalf Donald , Hilton Adrienne A. , Nicola Nicos A. , Kile Benjamin T. , Hilton Douglas J. , Alexander Warren S.
Published: August 2008

In an N-nitroso-N-ethylurea (ENU) mutagenesis screen using Mpl−/− mice, we isolated a semidominant suppressor of thrombocytopenia, termed Plt6. The gene mutated in Plt6 mice encodes the transcriptional coregulator p300, and the mutation, a tyrosine to asparagine substitution at amino acid 630 (Y630N), disrupts the interaction between p300 and c-Myb. Mpl−/−p300Plt6/+ mice displayed elevated platelet counts relative to Mpl−/−p300+/+ controls, whereas mice homozygous for the Plt6 mutation produced supraphysiological levels of circulating platelets. On a wild-type genetic background, mice homozygous for the p300Plt6 mutation, or recipients of Mpl+/+p300Plt6/Plt6 bone marrow, also exhibited thrombocytosis as well as deficiencies in B-lymphoid cells. Increased platelet numbers in Plt6 mutant mice were accompanied by significant increases in megakaryocyte progenitor cells within the bone marrow and spleen with concomitantly elevated numbers of megakaryocytes. The expansion of megakaryocytopoiesis and suppression of Mpl−/− thrombocytopenia in Plt6 mutants is highly reminiscent of that observed in mice with mutations affecting the p300 partner protein c-Myb, suggesting an indispensable repressive role for the c-Myb/p300 transcriptional regulatory complex in megakaryocyte develop-ment, the inhibition of which allows substantial thrombopoietin (TPO)–independent platelet production.
Aberrant expression of the Th2 cytokine IL-21 in Hodgkin lymphoma cells regulates STAT3 signaling and attracts Treg cells via regulation of MIP-3α
Authors: Lamprecht Björn , Kreher Stephan , Anagnostopoulos Ioannis , Jöhrens Korinna , Monteleone Giovanni , Jundt Franziska , Stein Harald , Janz Martin , Dörken Bernd , Mathas Stephan
Published: August 2008

The malignant Hodgkin/Reed-Sternberg (HRS) cells of classical Hodgkin lymphoma (HL) are derived from mature B cells, but have lost a considerable part of the B cell–specific gene expression pattern. Consequences of such a lineage infidelity for lymphoma pathogenesis are currently not defined. Here, we report that HRS cells aberrantly express the common cytokine-receptor γ-chain (γc) cytokine IL-21, which is usually restricted to a subset of CD4+ T cells, and the corresponding IL-21 receptor. We demonstrate that IL-21 activates STAT3 in HRS cells, up-regulates STAT3 target genes, and protects HRS cells from CD95 death receptor–induced apoptosis. Furthermore, IL-21 is involved in up-regulation of the CC chemokine macrophage-inflammatory protein-3α (MIP-3α) in HRS cells. MIP-3α in turn attracts CCR6+CD4+CD25+FoxP3+CD127lo regulatory T cells toward HRS cells, which might favor their immune escape. Together, these data support the concept that aberrant expression of B lineage–inappropriate genes plays an important role for the biology of HL tumor cells.
Cell signaling directing the formation and function of hemogenic endothelium during murine embryogenesis
Authors: Goldie Lauren C. , Lucitti Jennifer L. , Dickinson Mary E. , Hirschi Karen K.
Published: August 2008

During developmental hematopoiesis, multilineage hematopoietic progenitors are thought to derive from a subset of vascular endothelium. Herein, we define the phenotype of such hemogenic endothelial cells and demonstrate, on a clonal level, that they exhibit multilineage hematopoietic potential. Furthermore, we have begun to define the molecular signals that regulate their development. We found that the formation of yolk sac hemogenic endothelium and its hematopoietic potential were significantly impaired in the absence of retinoic acid (RA) signaling, and could be restored in RA-deficient (Raldh2−/−) embryos by provision of exogenous RA in utero. Thus, we identify a novel, critical role for RA signaling in the development of hemogenic endothelium that contributes to definitive hematopoiesis.
Leukemic challenge unmasks a requirement for PI3Kδ in NK cell–mediated tumor surveillance
Authors: Zebedin Eva , Simma Olivia , Schuster Christian , Putz Eva Maria , Fajmann Sabine , Warsch Wolfgang , Eckelhart Eva , Stoiber Dagmar , Weisz Eva , Schmid Johannes A. , Pickl Winfried F. , Baumgartner Christian , Valent Peter , Piekorz Roland P. , Freissmuth Michael , Sexl Veronika
Published: August 2008

Specific inhibitors of PI3K isoforms are currently evaluated for their therapeutic potential in leukemia. We found that BCR/ABL+ human leukemic cells express PI3Kδ and therefore explored its impact on leukemia development. Using PI3Kδ-deficient mice, we define a dual role of PI3Kδ in leukemia. We observed a growth-promoting effect in tumor cells and an essential function in natural killer (NK) cell–mediated tumor surveillance: Abelson-transformed PI3Kδ-deficient cells induced leukemia in RAG2-deficient mice with an increased latency, indicating that PI3Kδ accelerated leukemia progression in vivo. However, the absence of PI3Kδ also affected NK cell–mediated tumor surveillance. PI3Kδ-deficient NK cells failed to lyse a large variety of target cells because of defective degranulation, as also documented by capacitance recordings. Accordingly, transplanted leukemic cells killed PI3Kδ-deficient animals more rapidly. As a net effect, no difference in disease latency in vivo was detected if both leukemic cells and NK cells lack PI3Kδ. Other tumor models confirmed that PI3Kδ-deficient mice succumbed more rapidly when challenged with T- or B-lymphoid leukemic or B16 melanoma cells. Thus, the action of PI3Kδ in the NK compartment is as relevant to survival of the mice as the delayed tumor progression. This dual function must be taken into account when using PI3Kδ inhibitors as antileukemic agents in clinical trials.
HMG-CoA reductase inhibition induces IL-1β release through Rac1/PI3K/PKB-dependent caspase-1 activation
Authors: Kuijk Loes M. , Beekman Jeffrey M. , Koster Janet , Waterham Hans R. , Frenkel Joost , Coffer Paul J.
Published: August 2008

Mevalonate kinase deficiency (MKD) is an autoinflammatory disorder characterized by recurring fever episodes and results from disturbed isoprenoid biosynthesis. Lipopolysaccharide-stimulated peripheral blood mononuclear cells from MKD patients secrete high levels of interleukin-1β (IL-1β) because of the presence of hyperactive caspase-1, and this has been proposed to be the primary cause of recurring inflammation. Here we show that inhibition of HMG-CoA reductase by simvastatin treatment, mimicking MKD, results in increased IL-1β secretion in a Rac1/PI3K-dependent manner. Simvastatin treatment was found to activate protein kinase B (PKB)/c-akt, a primary effector of PI3K, and ectopic expression of constitutively active PKB was sufficient to induce IL-1β release. The small GTPase Rac1 was activated by simvastatin, and this was required for both PKB activation and IL-1β secretion. IL-1β release is mediated by caspase-1, and simvastatin treatment resulted in increased caspase-1 activity in a Rac1/PI3K-dependent manner. These data suggest that, in MKD, dysregulated isoprenoid biosynthesis activates Rac1/PI3K/PKB, resulting in caspase-1 activation with increased IL-1β release. Importantly, inhibition of Rac1 in peripheral blood mononuclear cells isolated from MKD patients resulted in a dramatic reduction in IL-1β release. These data suggest that pharmacologic inhibition of Rac1 could provide a novel therapeutic strategy for treatment of MKD.
Megakaryocyte endomitosis is a failure of late cytokinesis related to defects in the contractile ring and Rho/Rock signaling
Authors: Lordier Larissa , Jalil Abdelali , Aurade Fréderic , Larbret Fréderic , Larghero Jerôme , Debili Najet , Vainchenker William , Chang Yunhua
Published: August 2008

Megakaryocyte (MK) is the naturally polyploid cell that gives rise to platelets. Polyploidization occurs by endomitosis, which was a process considered to be an incomplete mitosis aborted in anaphase. Here, we used time-lapse confocal video microscopy to visualize the endomitotic process of primary human megakaryocytes. Our results show that the switch from mitosis to endomitosis corresponds to a late failure of cytokinesis accompanied by a backward movement of the 2 daughter cells. No abnormality was observed in the central spindle of endomitotic MKs. A furrow formation was present, but the contractile ring was abnormal because accumulation of nonmuscle myosin IIA was lacking. In addition, a defect in cell elongation was observed in dipolar endomitotic MKs during telophase. RhoA and F-actin were partially concentrated at the site of furrowing. Inhibition of the Rho/Rock pathway caused the disappearance of F-actin at midzone and increased MK ploidy level. This inhibition was associated with a more pronounced defect in furrow formation as well as in spindle elongation. Our results suggest that the late failure of cytokinesis responsible for the endomitotic process is related to a partial defect in the Rho/Rock pathway activation.
Ligation of erythrocyte CR1 induces its clustering in complex with scaffolding protein FAP-1
Authors: Ghiran Ionita , Glodek Aleksandra M. , Weaver Gregory , Klickstein Lloyd B. , Nicholson-Weller Anne
Published: August 2008

The primary identified function of complement receptor 1 (CR1/CD35) on primate erythrocytes is to bind complement-tagged inflammatory particles including microbes and immune complexes. When erythrocytes circulate through liver and spleen, sinusoidal phagocytes remove CR1-adherent particles and erythrocytes return to the circulation. This process of immune adherence clearance is important for host defense and prevention of autoimmunity. CR1 was previously described as clustered in the human erythrocyte membrane, which was thought to be necessary for binding complement-opsonized particles. In contrast, we demonstrate that on erythrocytes CR1 is not clustered, but dispersed, and able to bind complement-tagged particles. When fresh erythrocytes are solubilized by nonionic detergent, CR1 partitions to the cytoskeleton fraction. Using a PDZ-peptide array, CR1's cytoplasmic tail, which contains 2 PDZ-motifs, binds PDZ domains 2, 3, and 5 of Fas-associated phosphatase 1 (FAP-1), a scaffolding protein. We show that FAP-1, not previously recognized as an erythroid protein, is expressed on circulating erythrocytes. CR1 and FAP-1 coimmunoprecipitate, which confirms their molecular association. Disperse CR1 on erythrocytes may be advantageous for capturing immune-complexes, while ligation-induced CR1 clustering may prevent ingestion of the erythrocyte during the immune-complex transfer to the macrophages by keeping the opsonic stimulus localized thus preventing phagocyosis.
Prevalence and risk factors of airflow obstruction in an elderly Chinese population
Authors: Ko F. W. S. , Woo J. , Tam W. , Lai C. K. W. , Ngai J. , Kwok T. , Hui D. S. C.
Published: August 2008

It is common practice to use a forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) ratio of <70% as evidence of airflow obstruction. As the FEV1/FVC ratio falls with age, the lower limit of normal range (LLN), defined as the bottom 5% in a health reference population, of FEV1/FVC ratio has been suggested as a better index to reduce over-diagnosis of chronic obstructive pulmonary disease (COPD), particularly in the elderly. However, there are no large scale studies that focus on the diagnosis of COPD in the elderly based on these definitions. The present prospective epidemiological study involved 1,149 elderly subjects aged ≥60 yrs in the community. Detailed questionnaires, pre- and post-bronchodilator spirometry were performed.

In total, 1,008 subjects (mean age 74.2±6.4 yrs; 271 males) completed satisfactory spirometry testing. Airflow obstruction was present in 25.9% as defined by the post-bronchodilator FEV1/FVC ratio of <70% and in 12.4% defined by the LLN of FEV1/FVC ratio. Moderate COPD, at least, was found in 14.0% of patients according to the post-bronchodilator FEV1/FVC ratio of <70% and in 8.5% of patients according to LLN of FEV1/FVC ratio.

In the present elderly Chinese population (mostly females, with low education level and previous exposure to biomass during formative years), the prevalence of chronic obstructive pulmonary disease varied markedly depending on definitions adopted. Further longitudinal studies are needed to determine the precise definition of chronic obstructive pulmonary disease.
Genome-wide analyses reveal lineage specific contributions of positive selection and recombination to the evolution of Listeria monocytogenes
Authors: Orsi Renato H , Sun Qi , Wiedmann Martin
Published: August 2008

Background

The genusListeriaincludes two closely related pathogenic and non-pathogenic species,L. monocytogenesandL. innocua.L. monocytogenesis an opportunistic human foodborne and animal pathogen that includes two common lineages. While lineage I is more commonly found among human listeriosis cases, lineage II appears to be overrepresented among isolates from foods and environmental sources. This study used the genome sequences for oneL. innocuastrain and fourL. monocytogenesstrains representing lineages I and II, to characterize the contributions of positive selection and recombination to the evolution of theL. innocua/L. monocytogenescore genome.

Results

Among the 2267 genes in theL. monocytogenes/L. innocuacore genome, 1097 genes showed evidence for recombination and 36 genes showed evidence for positive selection. Positive selection was strongly associated with recombination. Specifically, 29 of the 36 genes under positive selection also showed evidence for recombination. Recombination was more common among isolates in lineage II than lineage I; this trend was confirmed by sequencing five genes in a larger isolate set. Positive selection was more abundant in the ancestral branch of lineage II (20 genes) as compared to the ancestral branch of lineage I (9 genes). Additional genes under positive selection were identified in the branch separating the two species; for this branch, genes in the role category "Cell wall and membrane biogenesis" were significantly more likely to have evidence for positive selection. Positive selection of three genes was confirmed in a larger isolate set, which also revealed occurrence of multiple premature stop codons in one positively selected gene involved in flagellar motility (flaR).

Conclusion

While recombination and positive selection both contribute to evolution ofL. monocytogenes, the relative contributions of these evolutionary forces seem to differ byL. monocytogeneslineages and appear to be more important in the evolution of lineage II, which seems to be found in a broader range of environments, as compared to the apparently more host adapted lineage I. Diversification of cell wall and membrane biogenesis and motility-related genes may play a particularly important role in the evolution ofL. monocytogenes.
The incidence and prevalence of diabetes in patients with serious mental illness in North West Wales: Two cohorts, 1875–1924 & 1994–2006 compared
Authors: Le Noury Joanna , Khan Afshan , Harris Margaret , Wong Winnie , Williams Dawn , Roberts Tony , Tranter Richard , Healy David
Published: August 2008

Background

Against a background of interest in rates of diabetes in schizophrenia and related psychoses and claims that data from historical periods demonstrate a link that antedates modern antipsychotics, we sought to establish the rate of diabetes in first onset psychosis and subsequent prevalence in historical and contemporary cohorts.

Methods

Analysis of two epidemiologically complete databases of individuals admitted for mental illness. 3170 individuals admitted to the North Wales Asylum between 1875–1924 and tracked over 18,486 patient years and 394 North West Wales first admissions for schizophrenia and related psychoses between 1994 and 2006 and tracked after treatment.

Results

The prevalence of Type 2 diabetes among patients with psychoses at time of first admission in both historical and contemporary samples was 0%. The incidence of diabetes remained 0% in the historical sample throughout 15 years of follow-up but rose in the contemporary sample after 3, 5 and 6 years of treatment with an incidence rate double the expected population rate so that the 15 year prevalence is likely to be over 8%.

Conclusion

No association was found between diabetes and serious mental illness, but there may be an association between diabetes and treatment.
Sugar-added beverages consumption among kindergarten children of Crete: effects on nutritional status and risk of obesity
Authors: Linardakis Manolis , Sarri Katerina , Pateraki Maria-Styliani , Sbokos Manolis , Kafatos Anthony
Published: August 2008

Objective

To assess the intake of sugar-added beverages such as soft drinks and commercially available fruit juices in kindergarten children, and to examine its association with obesity indices, physical activity levels and dietary habits.

Methods

A total of 856 children aged 4–7 years living in Crete, Greece in 2004–5 were included in this cross-sectional study. Nutrient and food intake was assessed with the use of 3-day weighed food records. Body measurements were used in order to assess BMI and waist circumference, and moderate-to-vigorous physical activity was calculated with the use of a questionnaire.

Results

Approximately 59.8% of all children consumed sugar-added beverages on a daily basis. High intake of sugar-added beverages (> 250 g/day) was associated with low intakes of calcium (p < 0.001), vitamin A and E (p < 0.010), fruits and vegetables (p = 0.007), and milk and yogurt (p = 0.048). Compared to non or low consumers, high consumers of sugar-added beverages (> 250 g/day) had higher BMI levels and two times greater risk of being overweight and/or obese (OR:2.35, p = 0.023).

Conclusion

High intake of sugar-added beverages in kindergarten children is associated with poor eating habits and inadequate nutrient intake, as well as increased risk for developing childhood obesity.
Patient's dissatisfaction with the public and private laboratory services in conducting HIV related testing in Tanzania
Authors: Mfinanga SG , Kahwa A , Kimaro G , Kilale A , Kivuyo S , Senkoro M , Ngowi B , Mtandu R , Mutayoba B , Ngadaya E , Mashoto K
Published: August 2008

Background

Patient's satisfaction with both private and public laboratory services is important for the improvement of the health care delivery in any country.

Methods

A cross-sectional survey was conducted in 24 randomly selected health facilities with laboratories that are conducting HIV related testing, in Mainland Tanzania. The study assessed patient's satisfaction with the laboratory services where by a total of 295 patients were interviewed.

Results

Of data analyzed for a varying totals from 224 to 294 patients, the percentage of dissatisfaction with both public and private laboratory services, ranged from 4.3% to 34.8%, with most of variables being more than 15%. Patients who sought private laboratory services were less dissatisfied with the cleanness (3/72, 4.2%) and the privacy (10/72, 13.9%) than those sought public laboratory service for the same services of cleanness (41/222, 18.5%) and privacy (61/222, 27.5%), and proportional differences were statistically significant (X2= 8.7, p = 0.003 and X2= 5.5, p = 0.01, respectively). Patients with higher education were more likely to be dissatisfied with privacy (OR = 1.8, 95% CI: 1.1–3.1) and waiting time (OR = 2.5, 95% CI: 1.5 – 4.2) in both private and public facilities. Patients with secondary education were more likely to be dissatisfied with the waiting time (OR = 5.2; 95%CI: 2.2–12.2) and result notification (OR = 5.1 95%CI (2.2–12.2) than those with lower education.

Conclusion

About 15.0% to 34.8% of patients were not satisfied with waiting time, privacy, results notification cleanness and timely instructions. Patients visited private facilities were less dissatisfied with cleanness and privacy of laboratory services than those visited public facilities. Patients with higher education were more likely to be dissatisfied with privacy and waiting time in both private and public facilities.
High cell density media for Escherichia coli are generally designed for aerobic cultivations – consequences for large-scale bioprocesses and shake flask cultures
Authors: Soini Jaakko , Ukkonen Kaisa , Neubauer Peter
Published: August 2008

Background

For the cultivation of Escherichia coli in bioreactors trace element solutions are generally designed for optimal growth under aerobic conditions. They do normally not contain selenium and nickel. Molybdenum is only contained in few of them. These elements are part of the formate hydrogen lyase (FHL) complex which is induced under anaerobic conditions. As it is generally known that oxygen limitation appears in shake flask cultures and locally in large-scale bioreactors, function of the FHL complex may influence the process behaviour. Formate has been described to accumulate in large-scale cultures and may have toxic effects on E. coli.

Although the anaerobic metabolism of E. coli is well studied, reference data which estimate the impact of the FHL complex on bioprocesses of E. coli with oxygen limitation have so far not been published, but are important for a better process understanding.

Results

Two sets of fed-batch cultures with conditions triggering oxygen limitation and formate accumulation were performed. Permanent oxygen limitation which is typical for shake flask cultures was caused in a bioreactor by reduction of the agitation rate. Transient oxygen limitation, which has been described to eventually occur in the feed-zone of large-scale bioreactors, was mimicked in a two-compartment scale-down bioreactor consisting of a stirred tank reactor and a plug flow reactor (PFR) with continuous glucose feeding into the PFR.

In both models formate accumulated up to about 20 mM in the culture medium without addition of selenium, molybdenum and nickel. By addition of these trace elements the formate accumulation decreased below the level observed in well-mixed laboratory-scale cultures. Interestingly, addition of the extra trace elements caused accumulation of large amounts of lactate and reduced biomass yield in the simulator with permanent oxygen limitation, but not in the scale-down two-compartment bioreactor.

Conclusion

The accumulation of formate in oxygen limited cultivations of E. coli can be fully prevented by addition of the trace elements selenium, nickel and molybdenum, necessary for the function of FHL complex. For large-scale cultivations, if glucose gradients are likely, the results from the two-compartment scale-down bioreactor indicate that the addition of the extra trace elements is beneficial. No negative effects on the biomass yield or on any other bioprocess parameters could be observed in cultures with the extra trace elements if the cells were repeatedly exposed to transient oxygen limitation.
Occupational exposures and non-Hodgkin's lymphoma: Canadian case-control study
Authors: Karunanayake Chandima P , McDuffie Helen H , Dosman James A , Spinelli John J , Pahwa Punam
Published: August 2008

Background

The objective was to study the association between Non-Hodgkin's Lymphoma (NHL) and occupational exposures related to long held occupations among males in six provinces of Canada.

Methods

A population based case-control study was conducted from 1991 to 1994. Males with newly diagnosed NHL (ICD-10) were stratified by province of residence and age group. A total of 513 incident cases and 1506 population based controls were included in the analysis. Conditional logistic regression was conducted to fit statistical models.

Results

Based on conditional logistic regression modeling, the following factors independently increased the risk of NHL: farmer and machinist as long held occupations; constant exposure to diesel exhaust fumes; constant exposure to ionizing radiation (radium); and personal history of another cancer. Men who had worked for 20 years or more as farmer and machinist were the most likely to develop NHL.

Conclusion

An increased risk of developing NHL is associated with the following: long held occupations of faer and machinist; exposure to diesel fumes; and exposure to ionizing radiation (radium). The risk of NHL increased with the duration of employment as a farmer or machinist.
Evaluation of prognostic markers for canine mast cell tumors treated with vinblastine and prednisone
Authors: Webster Joshua D , Yuzbasiyan-Gurkan Vilma , Thamm Douglas H , Hamilton Elizabeth , Kiupel Matti
Published: August 2008

Background

Canine cutaneous mast cell tumor (MCT) is a common neoplastic disease associated with a variable biologic behavior. Surgery remains the primary treatment for canine MCT; however, radiation therapy (RT) and chemotherapy are commonly used to treat aggressive MCT. The goals of this study were to evaluate the prognostic utility of histologic grade, c-KIT mutations, KIT staining patterns, and the proliferation markers Ki67 and AgNORs in dogs postoperatively treated with vinblastine and prednisone +/- RT, and to compare the outcome of dogs treated with post-operative chemotherapy +/- RT to that of a prognostically matched group treated with surgery alone. Associations between prognostic markers and survival were evaluated. Disease-free intervals (DFI) and overall survival times (OS) of dogs with similar pretreatment prognostic indices postoperatively treated with chemotherapy were compared to dogs treated with surgery alone.

Results

Histologic grade 3 MCTs, MCTs with c-KIT mutations, MCTs with increased cytoplasmic KIT, and MCTs with increased Ki67 and AgNOR values were associated with decreased DFI and OS. Dogs with histologic grade 3 MCT had significantly increased DFI and OS when treated with chemotherapy vs. surgery alone. Although not statistically significant due to small sample sizes, MCTs with c-KIT mutations had increased DFI and OS when treated with chemotherapy vs. surgery alone.

Conclusion and clinical importance

This study confirms the prognostic value of histologic grade, c-KIT mutations, KIT staining patterns, and proliferation analyses for canine MCT. Additionally, the results of this study further define the benefit of postoperative vinblastine and prednisone for histologic grade 3 MCTs.
The genome-scale metabolic model iIN800 of Saccharomyces cerevisiae and its validation: a scaffold to query lipid metabolism
Authors: Nookaew Intawat , Jewett Michael C , Meechai Asawin , Thammarongtham Chinae , Laoteng Kobkul , Cheevadhanarak Supapon , Nielsen Jens , Bhumiratana Sakarindr
Published: August 2008

Background

Up to now, there have been three published versions of a yeast genome-scale metabolic model:iFF708,iND750andiLL672. All three models, however, lack a detailed description of lipid metabolism and thus are unable to be used as integrated scaffolds for gaining insights into lipid metabolism from multilevel omic measurement technologies (e.g. genome-wide mRNA levels). To overcome this limitation, we reconstructed a new version of theSaccharomyces cerevisiaegenome-scale model,iIN800that includes a more rigorous and detailed description of lipid metabolism.

Results

The reconstructed metabolic model comprises 1446 reactions and 1013 metabolites. Beyond incorporating new reactions involved in lipid metabolism, we also present new biomass equations that improve the predictive power of flux balance analysis simulations. Predictions of both growth capability and large scalein silicosingle gene deletions byiIN800were consistent with experimental data. In addition,13C-labeling experiments validated the new biomass equations and calculated intracellular fluxes. To demonstrate the applicability ofiIN800, we show that the model can be used as a scaffold to reveal the regulatory importance of lipid metabolism precursors and intermediates that would have been missed in previous models from transcriptome datasets.

Conclusion

Performing integrated analyses usingiIN800as a network scaffold is shown to be a valuable tool for elucidating the behavior of complex metabolic networks, particularly for identifying regulatory targets in lipid metabolism that can be used for industrial applications or for understanding lipid disease states.
Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter‐observer agreement between a podiatrist and a radiologist
Authors: Bowen Catherine J , Dewbury Keith , Sampson Madeline , Sawyer Sally , Burridge Jane , Edwards Christopher J , Arden Nigel K
Published: August 2008

Background

The use of musculoskeletal ultrasound (MSUS) in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter‐observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis.

Methods

A consecutive sample of thirty‐two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS.

Results

Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p < 0.01) and erosions (kappa 0.636; p < 0.01) and fair agreement for synovitis (kappa 0.216; p < 0.05) during the primary assessments. Following a further training session, substantial agreement (kappa 0.702) between the two investigators was recorded. The sensitivity of the podiatrist using MSUS was 82.4% for detection of bursitis, 83.0% for detection of erosion and 84.0% for detection of synovitis. Specificity of the podiatrist using MSUS was 88.9% for detection of bursitis, 80.7% for detection of erosion and 35.9% for detection of synovitis.

Conclusion

This study demonstrated good inter‐observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.
Influence of early antioxidant supplements on clinical evolution and organ function in critically ill cardiac surgery, major trauma, and subarachnoid hemorrhage patients
Authors: Berger Mette M , Soguel Ludivine , Shenkin Alan , Revelly Jean-Pierre , Pinget Christophe , Baines Malcolm , Chioléro René L
Published: August 2008

Introduction

Oxidative stress is involved in the development of secondary tissue damage and organ failure. Micronutrients contributing to the antioxidant (AOX) defense exhibit low plasma levels during critical illness. The aim of this study was to investigate the impact of early AOX micronutrients on clinical outcome in intensive care unit (ICU) patients with conditions characterized by oxidative stress.

Methods

We conducted a prospective, randomized, double-blind, placebo-controlled, single-center trial in patients admitted to a university hospital ICU with organ failure after complicated cardiac surgery, major trauma, or subarachnoid hemorrhage. Stratification by diagnosis was performed before randomization. The intervention was intravenous supplements for 5 days (selenium 270 μg, zinc 30 mg, vitamin C 1.1 g, and vitamin B1 100 mg) with a double-loading dose on days 1 and 2 or placebo.

Results

Two hundred patients were included (102 AOX and 98 placebo). While age and gender did not differ, brain injury was more severe in the AOX trauma group (P = 0.019). Organ function endpoints did not differ: incidence of acute kidney failure and sequential organ failure assessment score decrease were similar (-3.2 ± 3.2 versus -4.2 ± 2.3 over the course of 5 days). Plasma concentrations of selenium, zinc, and glutathione peroxidase, low on admission, increased significantly to within normal values in the AOX group. C-reactive protein decreased faster in the AOX group (P = 0.039). Infectious complications did not differ. Length of hospital stay did not differ (16.5 versus 20 days), being shorter only in surviving AOX trauma patients (-10 days; P = 0.045).

Conclusion

The AOX intervention did not reduce early organ dysfunction but significantly reduced the inflammatory response in cardiac surgery and trauma patients, which may prove beneficial in conditions with an intense inflammation.

Trials Registration

Clinical Trials.gov RCT Register: NCT00515736.
Erythrocyte-derived ectosomes have immunosuppressive properties
Authors: Sadallah Salima , Eken Ceylan , Schifferli Jürg A
Published: August 2008

Several clinical studies have suggested that blood transfusions are immunosuppressive. Whereas there have been reports describing immunosuppression induced by leukocytes or fragments thereof, the possibility that microparticles, released by erythrocytes during storage, are also involved was not investigated. We present evidence here that such microparticles have all the properties of ectosomes including size, the presence of a lipid membrane, and the specific sorting of proteins. These erythrocyte-derived ectosomes (E-ecto) fixed C1q, which was followed by activation of the classical pathway of complement with binding of C3 fragments. Similarly to ectosomes released by PMN, they express phosphatidylserine on their surface membrane, suggesting that they may react with and down-regulate cells of the immune system. In vitro, they were taken up by macrophages, and they significantly inhibited the activation of these macrophages by zymosan A and LPS, as shown by a significant drop in TNF-α and IL-8 release (respectively, 80% and 76% inhibitions). In addition, the effect of E-ecto was not transient but lasted for at least 24 h. In sum, E-ecto may interfere with the innate immune system/inflammatory reaction. Therefore, E-ecto transfused with erythrocytes may account for some of the immunosuppressive properties attributed to blood transfusions.
Mood Disorder Following Cerebrovascular Accident
Authors: Eastwood M. R. , Rifat S. L. , Nobbs H. , Ruderman J.
Published: August 2008

Depression appears to be common after stroke, and therefore may have a bearing upon rehabilitation. To examine whether the depression is due to a specific brain lesion, or is reactive to the consequent disability, this study looked at the frequency and associations of depressed mood in a stroke rehabilitation unit in-patient population, unselected for site of lesion. Depression affected 50% of the patients; history of previous psychiatric disorder and cerebrovascular accident appeared to be important risk factors. There were hemispheric differences in the relationships between measures, with both the site-of-lesion and reactive viewpoints being upheld.
The Initial Onset of Schizophrenia and Family Expressed Emotion
Authors: Mintz Lois Imber , Nuechterlein Keith H. , Goldstein Michael J. , Mintz Jim , Snyder Karen S.
Published: August 2008

The relationships between duration of schizophrenic illness before first hospital admission, expressed emotion in key relatives, and illness course have yielded conflicting reports. This study examined the issue from a methodological perspective in a sample of first-episode schizophrenic patients. A ‘best estimate’ of illness onset, based on a compilation of all sources, was compared with an estimate based on parental report. Parental estimates suggested that the children of high-EE parents had been ill for significantly longer, but this difference was not confirmed by the best estimate. In most cases, the ill children of high-EE parents were living at home before hospital admission and their parents' estimates of duration were quite accurate. In the few cases in which the child was living away from home, high-EE parents strikingly overestimated duration. Children of low-EE families were more likely to be living away from home, but this factor did not explain the consistent underestimates of duration made by their parents. Although duration of illness did not relate to EE, successful engagement in out-patient before in-patient treatment was more common among children from low-EE families.
Organic Reaction in AIDS
Authors: Milner G. L.
Published: August 2008

A case of organic brain syndrome in a patient with AIDS is described. The implications for medical and psychiatric services are discussed and problems highlighted.
Bipolar Affective Disorder: Causes and Prevention of Relapse
Authors: Silverstone Trevor , Romans-Clarkson Sarah
Published: August 2008

The majority of patients with bipolar affective disorder relapse at least once during their lifetime, most several times, often with disastrous consequences. In this review we examine those factors which appear to play a facilitatory and in some cases, a causal role in determining whether a relapse will occur and, if so, when. Such factors include: the season of the year, with most admissions for mania in the British Isles occurring in the summer months; change in endocrine status, as after childbirth or when there is impaired thyroid function; treatment with drugs affecting central monoamine, particularly dopamine, neurotransmission; untoward life events. We evaluate the relative efficacy of treatments for the prevention of relapse, such as lithium, carbamazepine and antipsychotics, in the context of social and psychological support systems.
The Question of Therapists' Differential Effectiveness
Authors: Shapiro David A. , Firth-Cozens Jenny , Stiles William B.
Published: August 2008

Further analysis of outcome data from the Sheffield Psychotherapy Project suggested that one of the principal therapists was responsible for most of the reported advantage of Prescriptive over Exploratory treatment.
Life Events and Hostility in Self-Poisoning
Authors: Farmer Roger , Creed Francis
Published: August 2008

Life events in 82 self-poisoning subjects were studied using the Bedford College LEDS to see whether there was a difference between those who had a clear depressive syndrome (according to the Present State Examination) and the remainder. Equally high levels of severely threatening events were found in the depressed and non-depressed groups, but the former were older, had experienced more chronic difficulties and had been treated more often in the past for depression. Greatest numbers of life events were found in those with high levels of extrapunitiveness (recorded on the HDHQ), whereas those who had not experienced a severe life event showed predominance of intropunitiveness. Suicidal intent was not related to experience of life events, but has previously been shown to be associated with high intropunitiveness. The findings are discussed in the light of current theories linking life events, depression and parasuicide, and emphasise the need for longitudinal studies to examine these factors in relation to repeated parasuicide.
Seclusion
Authors: Angold Adrian
Published: August 2008

Seclusion is a commonly used management technique in some areas of psychiatric practice. However, its theoretical and empirical underpinnings are greatly wanting in many respects. This paper reviews the present state of our knowledge and ignorance about seclusion, and suggests some strategies for much-needed research.
A Rating Scale for Drug-Induced Akathisia
Authors: Barnes Thomas R. E.
Published: August 2008

A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's x) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic inpatients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.