bluuebunny/crossref_metadata_2025 huggingface dataset:
Arxula adeninivorans Recombinant Guanine Deaminase and Its Application in the Production of Food with Low Purine Content
Authors: Trautwein-Schult Anke , Jankowska Dagmara , Cordes Arno , Hoferichter Petra , Klein Christina , Matros Andrea , Mock Hans-Peter , Baronian Keith , Bode Rüdiger , Kunze Gotthard
Published: January 2014

Purines of exogenous and endogenous sources are degraded to uric acid in human beings. Concentrations >6.8 mg uric acid/dl serum cause hyperuricemia and its symptoms. Pharmaceuticals and the reduction of the intake of purine-rich food are used to control uric acid levels. A novel approach to the latter proposition is the enzymatic reduction of the purine content of food by purine-degrading enzymes. Here we describe the production of recombinant guanine deaminase by the yeast Arxula adeninivorans LS3 and its application in food. In media supplemented with nitrogen sources hypoxanthine or adenine, guanine deaminase (AGDA) gene expression is induced and intracellular accumulation of guanine deaminase (Agdap) protein occurs. The characteristics of the guanine deaminase isolated from wild-type strain LS3 and a transgenic strain expressing the AGDA gene under control of the strong constitutive TEF1 promoter were determined and compared. Both enzymes were dimeric and had temperature optima of 55°C with high substrate specificity for guanine and localisation in both the cytoplasm and vacuole of yeast. The enzyme was demonstrated to reduce levels of guanine in food. A mixture of guanine deaminase and other purine degradation enzymes will allow the reduction of purines in purine-rich foods.
Comparison of RECIST 1.0 and RECIST 1.1 on Computed Tomography in Patients with Metastatic Colorectal Cancer
Authors: Jang H.J. , Kim B.C. , Kim H.S. , Kim J.H. , Song H.H. , Kim J.B. , Park J.J. , Yoon S.N. , Woo J.Y. , Zang D.Y.
Published: January 2014

Objective: We conducted this study to compare tumor measurement by computed tomography (CT) and tumor response assessment between Response Evaluation Criteria In Solid Tumors (RECIST) 1.0 and RECIST 1.1 in patients with metastatic colorectal cancer (CRC). Methods: We reviewed the medical records of patients with metastatic CRC who received first-line chemotherapy between January 2004 and December 2012 and compared CT tumor measurement using two RECIST versions. Results: A total of 58 patients who had target lesions according to RECIST 1.0 were included in the study. The number of target lesions recorded by RECIST 1.1 was significantly lower than that by RECIST 1.0, with a decrease experienced in 48 patients (82.7%). Six patients had no target lesions because of the new criteria of RECIST 1.1 for lymph node size. Out of 95 lymph nodes from 58 patients, only 40% were defined as target lesions according to RECIST 1.1. The overall response rate of first-line chemotherapy according to RECIST 1.0 and 1.1 was 41.5 and 40.4%, respectively. The best tumor responses showed almost perfect agreement between RECIST 1.1 and RECIST 1.0 (ĸ = 0.913). Three patients showed disagreement of the best responses between the two RECIST versions. Conclusion: RECIST 1.1 showed a highly concordant response assessment with RECIST 1.0 in metastatic CRC and its clinical impact on therapeutic decisions was minimal.
Maternal Serum Placental Growth Factor (PlGF) Isoforms 1 and 2 at 11-13 Weeks' Gestation in Normal and Pathological Pregnancies
Authors: Nucci Marta , Poon Leona C. , Demirdjian Gaiane , Darbouret Bruno , Nicolaides Kypros H.
Published: January 2014

Objective: To compare the maternal serum concentration of placental growth factor-1 (PlGF-1) and PlGF-2 at 11-13 weeks' gestation in normal pregnancies and in those complicated by preeclampsia (PE), delivery of small for gestational age (SGA) neonates and fetal trisomies 21, 18 and 13. Methods: Serum PlGF-1 and PlGF-2 were measured in 270 pathological pregnancies (PE, n = 80; SGA, n = 80; trisomy 21, n = 44; trisomy 18, n = 38; trisomy 13, n = 28) and 590 normal controls. The values were expressed as multiple of the median (MoM) after adjustment for maternal characteristics and corrected for adverse pregnancy outcomes and the median MoM values in each pathological pregnancy were compared to the normal group. Results: There were significant contributions to PlGF-1 and PlGF-2 from gestational age, smoking and racial origin. In addition, there were significant contributions to PlGF-1 from parity and method of conception. The median MoM of PlGF-1 and PlGF-2 was significantly decreased in PE (0.783 and 0.916 MoM), SGA (0.891 and 0.851 MoM), trisomy 21 (0.609 and 0.749 MoM), trisomy 18 (0.529 and 0.730 MoM) and trisomy 13 (0.373 and 0.699 MoM). Conclusions: In pathological pregnancies, except SGA, the decrease in serum PlGF-1 at 11-13 weeks' gestation is more marked than the decrease in PlGF-2.
Intraperitoneal Paclitaxel Is Useful as Adjuvant Chemotherapy for Advanced Gastric Cancer with Serosal Exposure
Authors: Kitayama Joji , Ishigami Hironori , Yamaguchi Hironori , Emoto Shigenobu , Watanabe Toshiaki
Published: January 2014

Background: Intraperitoneal administration of paclitaxel (PTX) can elicit a marked clinical response in peritoneal metastases of gastric cancer. Methods: In this study, we retrospectively analyzed the clinical outcome of 17 patients who underwent R0 resection with D2 dissection for advanced gastric cancer with macroscopic serosal exposure and received intraperitoneal PTX as adjuvant therapy. Results: A pathological study revealed that the depth of invasion of the primary tumor was pT4a or pT4b in 10 cases, and that the pN stage was more than pN2 in 8 cases. Genetic analysis of peritoneal lavage fluid was performed in 14 cases, all of which were positive for carcinoembryonic antigen mRNA. In these patients, PTX was intraperitoneally administered at 20-60 mg/m2 with oral S-1 for 3-36 months after surgery. In a median follow-up period of 66 months, recurrence occurred in the liver and peritoneum in 2 (11.7%) and 1 (5.9%) patients, respectively, and no nodal recurrence was observed. Five-year overall survival and disease-free survival were 88.2 and 82.3%, respectively. Conclusion: Since these patients are considered to be a high-risk group for peritoneal recurrence, this result strongly suggests that adjuvant chemotherapy including intraperitoneal PTX is a promising protocol to improve the outcome of patients with advanced gastric cancer with serosal exposure.
Awareness of Both Type 1 and 2 Errors in Climate Science and Assessment
Authors: Anderegg William R. L. , Callaway Elizabeth S. , Boykoff Maxwell T. , Yohe Gary , Root Terr y L.
Published: January 2014

Treatment of error and uncertainty is an essential component of science and is crucial in policy-relevant disciplines, such as climate science. We posit here that awareness of both “false positive” and “false negative” errors is particularly critical in climate science and assessments, such as those of the Intergovernmental Panel on Climate Change. Scientific and assessment practices likely focus more attention to avoiding false positives, which could lead to higher prevalence of false-negative errors. We explore here the treatment of error avoidance in two prominent case studies regarding sea level rise and Himalayan glacier melt as presented in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. While different decision rules are necessarily appropriate for different circumstances, we highlight that false-negative errors also have consequences, including impaired communication of the risks of climate change. We present recommendations for better accounting for both types of errors in the scientific process and scientific assessments.
Characterizing Channel Center Frequencies in AMSU-A and MSU Microwave Sounding Instruments
Authors: Lu Qifeng , Bell William
Published: January 2014

Passive microwave observations from the Microwave Sounding Unit (MSU) and the Advanced Microwave Sounding Unit-A (AMSU-A) have been exploited widely for numerical weather prediction (NWP), atmospheric reanalyses, and climate monitoring studies. The treatment of biases in these observations, with respect to models as well as between satellites, has been the focus of much effort in recent years. This study presents evidence that shifts, drifts, and uncertainties in pass band center frequencies are a significant contribution to these biases. Center frequencies for AMSU-A channels 6–14 and MSU channel 3 have been analyzed using NWP fields and radiative transfer models, for a series of operational satellites covering the period 1979–2012. AMSU-A channels 6 (54.40 GHz), 7 (54.94 GHz), and 8 (55.50 GHz) on several satellites exhibit significant shifts and drifts relative to nominal pass band center frequencies. No significant shifts were found for AMSU-A channels 9–14, most probably as a consequence of the active frequency locking of these channels. For MSU channel 3 (54.96 GHz) most satellites exhibit large shifts, the largest for the earliest satellites. For example, for the first MSU on the Television and Infrared Observation Satellite-N (TIROS-N), the analyzed shift is 68 MHz over the lifetime of the satellite. Taking these shifts into account in the radiative transfer modeling significantly improves the fit between model and observations, eliminates the strong seasonal cycle in the model–observation misfit, and significantly improves the bias between NWP models and observations. The study suggests that, for several channels studied, the dominant component of the model–observation bias results from these spectral errors, rather than radiometric bias due to calibration errors.
Model Wind Field Forecast Verification Using Multiple-Doppler Syntheses from a National Radar Network
Authors: Beck Jeffrey , Nuret Mathieu , Bousquet Olivier
Published: January 2014

Model verification has traditionally relied upon in situ observations, which typically exist on a sparse network, making nonsurface model forecast verification difficult. Given increasing model resolution, supplemental observational datasets are needed. Multiple-Doppler wind retrievals using a national network of radars provide an opportunity to assess the accuracy of wind forecasts at multiple levels, as well as verification within a three-dimensional domain. Wind speed and direction verification results are presented for a 9-day period of forecasts from the French Application of Research to Operations at Mesoscale-Western Mediterranean (AROME-WMED) model using multiple-Doppler retrievals from the French Application Radar à la Météorologie Infrasynoptique (ARAMIS) network. For the analyzed period, relationships were found that suggest that errors are not only linked to forecasted evolution of meteorological phenomena, but are sensitive to terrain height below the analyzed level as well as mesoscale processes. The spatial distribution of errors at initialization and forecast times shows that biases are generally independent of location and terrain height at initialization, but that the impact of terrain below the analysis level affects the forecasted wind magnitude and direction over time. These comparisons illustrate that multiple-Doppler wind retrieval measurements accurately identify model error and can serve as an invaluable dataset for model verification.
Children’s rights and school psychology: Historical perspective and implications for the profession
Authors: Hart Stuart N. , Hart Brannon W.
Published: January 2014

School psychology and children’s rights have great potential, well beyond what has been realized, for advancing the best interests of children, their communities, and societies. A child rights approach infused into school psychology can significantly contribute to the fulfillment of this potential. To respect and illuminate these factors and possibilities, a brief history of children’s rights is presented, its major components as embodied in the UN Convention on the Rights of the Child and their relevance for education and the school community are clarified, and the opportunities for school psychology to champion and deeply integrate children’s rights in policy and practice are explored. Employing this base, a proposal is made for a new social contract between school psychology and those it serves which moves beyond reactive problem oriented interventions to give primacy to proactive promotion of the well-being and full holistic development of the child, employing a prospective human development models emphasizing progressive achievement of self-stewardship for all children.
Linking regulation of practitioner school psychology and the United Nations Convention on the Rights of the Child: The need to build a bridge
Authors: Woods Kevin , Bond Caroline
Published: January 2014

In 2014, the 25th anniversary of the United Nations Convention on the Rights of the Child presents an opportunity for school psychology to evaluate its achievements relevant to the Convention, as well as its current and future strategic adherence to the Convention’s principles. With analysis of key school psychology documentation from the UK, it is shown that for school psychologists the achievements and strategy relating to the international Convention have been directly, albeit implicitly, supported from ‘top down’, by the post-ratification governance processes and structures of national level agencies which operate school psychology preparation, statutory professional regulation, and non-statutory professional quality enhancement. On account of their use of a scientist-practitioner model, school psychologists are positioned to make a unique contribution to enacting the Convention’s agenda and from recent Convention evaluations five priority areas for strategic development in relation to the Convention are identified. An account of the authors’ commissioned work following a non-accidental child death in the UK illustrates how school psychologists can make significant contributions to Convention priorities from ‘bottom up’ as a result of significant contemporaneous events at local or national level. Implications of the ‘top down’ and ‘bottom up’ linking of school psychologists’ work with the CRC agenda are discussed with reference to both the national and international school psychology communities and regulatory bodies.
Child rights as a framework for advancing professional standards for practice, ethics, and professional development in school psychology
Authors: Nastasi Bonnie Kaul , Naser Shereen
Published: January 2014

The United Nations (1989) Convention on the Rights of the Child was designed to promote and protect the survival, development, and well-being of children, thus extending human rights to individuals from birth to age 18. This article examines the consistency of the Articles of the Convention with the professional standards for school psychology, as articulated by the major organizations representing the profession in the USA––American Psychological Association, International School Psychology Association, and National Association of School Psychologists. Although the standards for ethics, practice, and training of these organizations are generally consistent with the UN Convention, the standards lack the specificity provided by the Convention’s 54 Articles. To facilitate the application of child rights’ principles in school psychology practice, we propose a model for integrating the professional standards with the Articles of the Convention. In addition, we describe a curriculum for training of school psychologists, developed through a partnership of several organizations, which is consistent with the model. In the curriculum, the school psychologist is regarded as the mesosystem in the child’s ecology, to characterize the psychologist’s central role in ensuring the promotion and protection of child rights within school, family, community, and society.
Are altered states of consciousness detrimental, neutral or helpful for the origins of symbolic cognition? A response to Hodgson and Lewis-Williams
Authors: Froese Tom , Woodward Alexander , Ikegami Takashi
Published: January 2014

We respond to the commentaries by Hodgson and Lewis-Williams by clarifying the novelty of our theory. We argue that whenever Turing instabilities of neural activity play a role in generating visual hallucinations, they do more than shape the geometric patterns. Their relatively autonomous self-organization is a source of intrinsic value related to their self-maintenance as a pattern of activity, and they would also thereby decouple “higher-level” stages of neural processing from external stimulation, thus facilitating a more abstract mode of cognition. These additional features of our proposal support Hodgson and Lewis-Williams in their respective theories about the very first origins of human artistic activity. We also evaluate the critical literature regarding the possibility of ritualized enaction of altered states of consciousness (ASC) in early prehistory. We conclude that ASC were indeed possible, and suggest that they were likely involved in facilitating the social development of more symbolic forms of life and mind.
Presbyopia: a pilot investigation of the barriers and benefits of near visual acuity correction among a rural Filipino population
Authors: Wubben Thomas J , Guerrero Christopher M , Salum Marlo , Wolfe Gregory S , Giovannelli Gerald P , Ramsey David J
Published: January 2014

Background

Presbyopia is the age-related decline in accommodation that diminishes the ability of the eye to focus on near objects. Presbyopia is common and easy to correct; however, many communities lack access to basic eye care. The purpose of this project was to assess the burden of uncorrected presbyopia in a rural Filipino population and to pilot an intervention aimed at increasing access to reading glasses in the community.

Methods

Individuals above the age of 40 who presented to a health outreach in the Philippines were invited to undergo a near vision exam to detect the presence of functional presbyopia and be fitted with ready-made, single-vision glasses. The change in stereoacuity was used as a surrogate measure of functional improvement after near vision correction. A questionnaire was administered to assess this population’s perceived barriers and benefits to correcting near vision.

Results

The average age of the participants was 57 ± 11 years, with 87.6% of participants having an uncorrected near visual acuity of <20/50. Reading glasses improved near vision to 20/40 or better in 77.7% of participants having near-vision impairment (uncorrected near visual acuity of <20/40). Over 75% of participants also showed improvement in stereoacuity. Cost, rather than availability, was perceived to be the greater barrier to the procurement of glasses, and 84% of participants reported that the glasses dispensed would greatly improve their ability to earn a living.

Conclusions

Dispensing ready-made, single-vision glasses is a simple and cost-effective intervention to improve near vision and enhance depth perception. A greater understanding of the barriers and benefits to correcting near vision will inform the design and execution of a sustainable program to correct presbyopia in developing countries.
Acute necrotizing colitis due to sigmoid colon cancer
Authors: Matsunaga Hiroki , Shida Dai , Kamesaki Makoto , Hamabe Yuichi
Published: January 2014

When obstructive colitis becomes fulminant, it is known as ‘acute necrotizing colitis’. We report a rare case of acute necrotizing colitis due to sigmoid colon cancer, in which shock status occurred within ten hours of onset. A 79-year-old female with acute abdominal pain was transported to our hospital with acute shock. Abdominal enhanced computed tomography revealed thickening of the wall of the sigmoid colon and marked dilation of the proximal colon. Emergency surgery was performed with the intraoperative findings of severe sigmoid colon stenosis and proximal dilation of the colon without perforation, and a large volume of putrid ascitic fluid. The intestine was proximally dilated and black in color, from the sigmoid colon to the ileum 60 cm proximal to the terminal ileum, suggesting acute necrosis. Total colectomy with 80 cm resection of terminal ileum and ileostomy was performed. Whereas acute necrotizing colitis is a rare condition and its etiology remains obscure, the chronic ischemic state must play some role. Our patient was of advanced age and had diabetes mellitus and hypertension. These factors might lead to a chronic ischemic state of the bowel due to arteriosclerosis. In addition to the underlying condition, massive bacterial reflux into the ileum from the colon might cause the capillary vasoconstriction of the bowel that led to her critical state.
Survival and surgical outcomes of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer
Authors: Wang Yi , Huang Chang-Ming , Wang Jia-Bin , Zheng Chao-Hui , Li Ping , Xie Jian-Wei , Lin Jian-Xian , Lu Jun
Published: January 2014

Background

Although cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. The objective of this study was designed to evaluate the prognosis of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer.

Methods

In this retrospective comparative study, clinical data and prognosis were compared in 48 patients with cardiac cancer of the remnant stomach and 96 patients with primary cardiac cancer who underwent radical resection from January 1995 to June 2007. Clinicopathologic characteristics, survival times, mortality, and complications were analyzed.

Results

The 5-year survival rate was significantly higher in patients with primary cardiac cancer than in those with cardiac cancer of the remnant stomach (28.4% vs. 16.7%, P = 0.035). Serosal invasion, lymph node metastasis and tumor location were independent prognostic factors for survival. Subgroup analysis, however, showed similar survival rates in patients with primary cardiac cancer and cardiac cancer of the remnant stomach without serosal invasion (25.0% vs. 43.8%, P = 0.214) and without lymph node metastasis (25.0% vs. 38.8%, P = 0.255), as well as similar complication rates (20.8% vs. 11.5%, P = 0.138).

Conclusion

Although the survival rates after radical resection in patients with cardiac cancer of the remnant stomach were poorer than in those with primary cardiac cancer, they were similar in survival rates when patients without serosal invasion or lymph node metastasis. Therefore, early detection is an important way to improve overall survival in cardiac cancer of the remnant stomach.
Jordan decomposition and geometric multiplicity for a class of non-symmetric Ornstein-Uhlenbeck operators
Authors: Rao Yulei , Wang Jiying , Chen Yong
Published: January 2014

In this paper, we calculate the Jordan decomposition for a class of non-symmetric Ornstein-Uhlenbeck operators with the drift coefficient matrix, being a Jordan block, and the diffusion coefficient matrix, being the identity multiplying a constant. For the 2-dimensional case, we present all the general eigenfunctions by mathematical induction. For the 3-dimensional case, we divide the calculation of the Jordan decomposition into three steps. The key step is to do the canonical projection onto the homogeneous Hermite polynomials, and then use the theory of systems of linear equations. Finally, we get the geometric multiplicity of the eigenvalue of the Ornstein-Uhlenbeck operator.
Muscle fibre type distribution of the thoracolumbar and hindlimb regions of horses: relating fibre type and functional role
Authors: Hyytiäinen Heli K , Mykkänen Anna K , Hielm-Björkman Anna K , Stubbs Narelle C , McGowan Catherine M
Published: January 2014

Background

Although the majority of equine muscles have a mixed fibre type distribution indicative of diverse functional roles, the predominance of a fibre type can indicate the primary function of a muscle. The deep epaxial musculature has an important role in core spinal stability in humans, reflected as a predominantly muscle fibre type (MFT) I or postural fibre type. The fibre type of the deep epaxial musculature has not been determined in horses. The objective of the study was to determine the MFT distribution in selected muscles of thoracolumbar and hindlimb region of horses. This included deep epaxial and hypaxial muscles that were hypothesised to have a postural stabilising role. A second objective was to examine differences in MFT distribution between horses bred for endurance (Arabian) and sprinting (Quarter horse). Muscle biopsy samples were obtained from selected thoracolumbar and hind limb muscles of 5 Quarter horses, 4 Arabians, and 2 Thoroughbreds. The myosin heavy chain distribution was determined by gel electrophoresis. Mann–Whitney rank test was used to compare the proportional MFT and differences between breeds.

Results

Mm. sacrocaudalis dorsalis medialis and diaphragm had the highest proportion of MFT-I. The remaining deep epaxial muscles and the hypaxial muscle m. psoas minor had approximately equal MFT I and II proportions. Mm. psoas major, iliocostalis, longissimus dorsi and the hind limb muscles contained mostly MFT-IIX. The fibre type distribution was similar between Arabians and Quarter horses, although Quarter horses had more MFT-IIX fibres in psoas major (P = 0.02) while Arabians had more MFT-I fibres in m. longissimus dorsi (P = 0.03).

Conclusions

The fibre type distribution of the deep epaxial muscles, mm psoas minor and diaphragm varied from approximately equal MFT-I and II proportions to predominantly MFT-I suggesting a postural stabilising role possibly important in core spinal stability. In contrast the fibre type proportions of mm psoas major, iliocostalis, longissimus dorsi and the hind limb muscles were mainly MFT-II suggesting a locomotory role. Knowledge of fibre type distribution in such a clinically important area can direct diagnosis, prevention and treatment of muscular or neuromotor dysfunction.
Basal encephalocele in an adult patient presenting with minor anomalies: a case report
Authors: Harada Naoyuki , Nemoto Masaaki , Miyazaki Chikao , Kondo Kosuke , Masuda Hiroyuki , Nomoto Jun , Sugo Nobuo , Kuroki Takao
Published: January 2014

Introduction

Basal encephalocele is rare in adults. Congenital and acquired cases have been reported with regard to the developmental mechanism, and the pathology has not been elucidated in detail.

Case presentation

We encountered an adult with basal encephalocele strongly suggesting congenital development because of the presence of minor anomalies: strabismus and ocular hypertelorism. The disease manifested as persistent spontaneous cerebrospinal fluid rhinorrhea and repeated meningitis in a 66-year-old Japanese man. On computed tomography, brain tissue protruded through a part of the ethmoid bone of his right anterior skull base, and it was diagnosed as transethmoidal-type basal encephalocele. Regarding his facial form, the distance between his bilateral eyeballs was large compared to his facial width, and his canthal index (defined as inner to outer inter canthal ratio × 100) was calculated as 38.5, based on which it was judged as ocular hypertelorism. In addition, his right eyeball showed strabismus. A right frontotemporal craniotomy was performed for spontaneous cerebrospinal fluid rhinorrhea, and the defective dura mater region was patched with temporal fascia.

Conclusions

Mild minor anomalies that require no treatment are overlooked in adults, but the presence of several anomalies increases the possibility of congenital disease. Therefore, it may be necessary to examine minor anomalies in cases of adult basal encephalocele when considering the possibility that the disease may be congenital.
Radial contrast enhancement on brain magnetic resonance imaging could be diagnostic of primary angiitis of the central nervous system: a case report and review of the literature
Authors: Ganta Kartheek , Malik Aisha Mohsin , Wood James B , Levin Michael C
Published: January 2014

Introduction

Primary angiitis of the central nervous system is a rare disease of unclear etiology. There is no single test diagnostic of primary angiitis of the central nervous system. We report an unusual pattern on brain magnetic resonance imaging that might be specific for primary angiitis of the central nervous system.

Case presentation

A 47-year-old Caucasian man developed progressive bilateral hand tremor, difficulty walking, cognitive slowing and headache. A physical examination showed bilateral hand tremor with dysmetria, hyperreflexia and abnormal gait. Magnetic resonance imaging of his brain showed bilateral, symmetrical, increased intensity on T2-weighted images concurrent with linear contrast enhancement in a radial distribution throughout his white matter, sparing subcortical regions in his centrum semiovale, corona radiata, basal ganglia and brainstem. Magnetic resonance spectroscopy demonstrated elevated choline and decreased N-acetyl aspartate. Except for elevated protein and lymphocytic pleocytosis, examination of his cerebrospinal fluid showed no abnormalities. Serological tests for rheumatologic, vasculitic, paraneoplastic, infectious and peroxisomal disorders were negative. A brain biopsy revealed primary angiitis of the central nervous system. Our patient was treated with steroids and intravenous cyclophosphamide, with improvement in signs and symptoms as well as changes on magnetic resonance imaging.

Conclusion

Bilateral, symmetrical, increased intensity on T2-weighted images concurrent with linear contrast enhancement in a radial distribution throughout the white matter on magnetic resonance imaging of the brain should be recognized as a feature of primary angiitis of the central nervous system, and might avoid the need for a brain biopsy to diagnose primary angiitis of the central nervous system.
Fulminant systemic capillary leak syndrome due to C1 inhibitor deficiency complicating acute dermatomyositis: a case report
Authors: Gradwohl-Matis Ilse , Illig Romana , Salmhofer Hermann , Neureiter Daniel , Brunauer Andreas , Dünser Martin W
Published: January 2014

Introduction

Dermatomyositis is a chronic inflammatory disorder characterized by muscular and dermatologic symptoms with variable internal organ involvement. This is the first report on a patient with acute dermatomyositis and fulminant systemic capillary leak syndrome.

Case presentation

A 69-year-old Caucasian woman with chronic dermatomyositis presented with clinical signs of severe hypovolemic shock and pronounced hemoconcentration (hematocrit, 69%). Her colloid osmotic pressure was 4.6mmHg. Following a bolus dose of prednisolone (500mg), fluid resuscitation was initiated. During volume loading, anasarca and acute respiratory distress rapidly developed. Echocardiography revealed an underfilled, hypokinetic, diastolic dysfunctional left ventricle with pericardial effusion but no signs of tamponade. Despite continued fluid resuscitation and high-dosed catecholamine therapy, the patient died from refractory shock 12 hours after intensive care unit admission. A laboratory analysis of her complement system suggested the presence of C1 inhibitor deficiency as the cause for systemic capillary leakage. The post-mortem examination revealed bilateral pleural, pericardial and peritoneal effusions as well as left ventricular hypertrophy with patchy myocardial fibrosis. Different patterns of endomysial/perimysial lymphocytic infiltrations adjacent to degenerated cardiomyocytes in her myocardium and necrotic muscle fibers in her right psoas major muscle were found in the histological examination.

Conclusions

This case report indicates that acute exacerbation of chronic dermatomyositis can result in a fulminant systemic capillary leak syndrome with intense hemoconcentration, hypovolemic shock and acute heart failure. In the presented patient, the cause for diffuse capillary leakage was most probably acquired angioedema, a condition that has been associated with both lymphoproliferative and autoimmunologic disorders.
Determination of antibiotic consumption index for animal originated foods produced in animal husbandry in Iran, 2010
Authors: Aalipour Fathollah , Mirlohi Maryam , Jalali Mohammd
Published: January 2014

The public health concerns over the long-term exposure to antibiotics have risen in different parts of the world. The purpose of this study was to investigate the antibiotic consumption pattern in livestock and poultry and to estimate the quantity of antibiotic active ingredient (mg) consumed per unit weight (Kg) of red meat, milk and egg production in Iran in 2010. A cross-sectional study was designed in charmahal - bakhtiary province-Iran. A questioner has been developed by naming 110 types of antibiotics. Twenty two veterinary clinicians and three livestock pharmaceutical distributor companies were included in the survey to determine the antibiotic prescription and distribution pattern in the farms. Veterinary organization of Iran supplied the information of the total antibiotic consumption in different dosage forms. National and international data on the livestock and poultry production were obtained from the relevant official web sites. Tetracycline class of antibiotics was the most common types of antibacterial prescribed and sold to both livestock and poultry farms. Amino glycoside, penicillin and macrolide in the cattle farms and furofenocole in broiler farms were the second most used groups of antibiotics. The quantity of antibiotic active ingredients consumed per unit weight of animal-originated food products was counted as 107.4 mg/kg for both milk and red meat and 249.5 mg/kg for broiler meat and egg. Totally, it was estimated that 133 mg antibiotic substances was used per kg of milk, meat and egg produced in 2010. In comparison to available data for other countries, consumption of antibiotics in livestock and poultry in Iran is higher than developed countries with an exception of South Korea. The findings of the present study could be alarming for the legislative authorities in food security and safety. More clear evaluation should be carried out as well as implementation of national monitoring and inspective programs in order to reach an added safety regarding animal-originated foods.
Effects of Parathyroid Hormone on Bone Mass, Bone Strength, and Bone Regeneration in Male Rats With Type 2 Diabetes Mellitus
Authors: Hamann Christine , Picke Ann-Kristin , Campbell Graeme M. , Balyura Mariya , Rauner Martina , Bernhardt Ricardo , Huber Gerd , Morlock Michael M. , Günther Klaus-Peter , Bornstein Stefan R. , Glüer Claus-C. , Ludwig Barbara , Hofbauer Lorenz C.
Published: January 2014

Type 2 diabetes mellitus (T2DM) is associated with increased skeletal fragility and impaired fracture healing. Intermittent PTH therapy increases bone strength; however, its skeletal and metabolic effects in diabetes are unclear. We assessed whether PTH improves skeletal and metabolic function in rats with T2DM. Subcritical femoral defects were created in diabetic fa/fa and nondiabetic +/+ Zucker Diabetic Fatty (ZDF) rats and internally stabilized. Vehicle or 75 μg/kg/d PTH(1–84) was sc administered over 12 weeks. Skeletal effects were evaluated by μCT, biomechanical testing, histomorphometry, and biochemical markers, and defect regeneration was analyzed by μCT. Glucose homeostasis was assessed using glucose tolerance testing and pancreas histology. In diabetic rats, bone mass was significantly lower in the distal femur and vertebrae, respectively, and increased after PTH treatment by up to 23% in nondiabetic and up to 18% in diabetic rats (P < .0001). Diabetic rats showed 23% lower ultimate strength at the spine (P < .0005), which was increased by PTH by 36% in normal and by 16% in diabetic rats (P < .05). PTH increased the bone formation rate by 3-fold in normal and by 2-fold in diabetic rats and improved defect regeneration in normal and diabetic rats (P < .01). PTH did not affect serum levels of undercarboxylated osteocalcin, glucose tolerance, and islet morphology. PTH partially reversed the adverse skeletal effects of T2DM on bone mass, bone strength, and bone defect repair in rats but did not affect energy metabolism. The positive skeletal effects were generally more pronounced in normal compared with diabetic rats.
A Facile Preparation, Characteristic Properties, and Crystal Structure of {4-[(E)-2-(3-Guaiazulenyl)diazenyl]phenyl}(3-guaiazulenyl)methylium Hexafluorophosphate
Authors: Takekuma Shin-ichi , Seki Atsuki , Minematsu Toshie
Published: January 2014

Reaction of 4-[(E)-2-(3-guaiazulenyl)diazenyl]benzene-1-carbaldehyde with guaiazulene (=7-isopropyl-1,4-dimethylazulene) in methanol in the presence of 65% hexafluorophosphoric acid at 25 °C for 2 h gives the title new monocarbenium ion compound with an equivalent of HPF6, in 97% isolated yield, which upon reduction with NaBH4 in a mixed solvent of ethanol and acetonitrile at 25 °C for 30 min affords the corresponding new H−-reduction product, {4-[(E)-2-(3-guaiazulenyl)diazenyl]phenyl}(3-guaiazulenyl)methane, in 93% isolated yield. Along with the above basic studies, the difference between the delocalized π-electron system (i.e., the formation of the resonance structures) of the title compound, possessing an (E)-diazene linkage (–N=N–), and that of the structurally related new compound, possessing an (E)-ethene linkage (–CH=CH–), i.e., {4-[(E)-2-(3-guaiazulenyl)ethenyl]phenyl}(3-guaiazulenyl)methylium hexafluorophosphate, is reported in detail.
Overconfidence and Diversification
Authors: Heller Yuval
Published: January 2014

Experimental evidence suggests that people tend to be overconfident in the sense that they overestimate the accuracy of their private information. In this paper, we show that risk-averse principals might prefer overconfident agents in various strategic interactions because these agents help diversify the aggregate risk. This may help understanding why successful analysts and entrepreneurs tend to be overconfident. In addition, a different interpretation of the model presents a novel evolutionary foundation for overconfidence, and explains various stylized facts about this bias. (JEL D81, D82)
Financing Experimentation
Authors: Drugov Mikhail , Macchiavello Rocco
Published: January 2014

Entrepreneurs must experiment to learn how good they are at a new activity. What happens when the experimentation is financed by a lender? Under common scenarios, i.e., when there is the opportunity to learn by “starting small” or when “noncompete” clauses cannot be enforced ex post, we show that financing experimentation can become harder precisely when it is more profitable, i.e., for lower values of the known arm and for more optimistic priors. Endogenous collateral requirements (like those frequently observed in microcredit schemes) are shown to be part of the optimal contract. (JEL D82, G21, G32, L25, L26)
Extension Rules or What Would the Sage Do?
Authors: Lehrer Ehud , Teper Roee
Published: January 2014

Quite often, decision makers face choices that involve new aspects and alternatives never considered before. Scenarios of this sort may arise, for instance, as a result of technological progress or from individual circumstances such as growing awareness. In such situations, simple inference rules, past experience, and knowledge about historic choice problems may prove helpful in determining what would be a reasonable action to take vis-a-vis a new problem. In the context of decision making under uncertainty, we introduce and study an extension rule that enables the decision maker to extend a preference order defined on a restricted domain. (JEL D81, D83)
Συσχέτιση της ιδιοπαθούς διατατικής μυοκαρδιοπάθειας με αυτοάνοσες παθήσεις
Authors: Ανυφαντάκης Ζαχαρίας-Αλέξανδρος
Published: January 2014

Οι μηχανισμοί της κυτταρικής και χυμικής ανοσίας, κάτω απο την καθοδήγηση γενετικών παραγόντων, φαίνεται ότι παίζουν σημαντικό ρόλο στην παθογένεια της ιδιοπαθούς διατατικής μυοκαρδιοπάθειας (ΔΜ). Στοιχεία από πειραματικές και παθολογοανατομικές μελέτες δεικνύουν το ιδιαίτερο ρόλο της ενεργοποιήσεως των Τ-λεμφοκυττάρων στην παθογένεια της νόσου. ΣΚΟΠΟΣ Στην παρούσα μελέτη διερευνήσαμε την υπόθεση ότι η ιδιοπαθής διατατική μυοκαρδιοπάθεια μοιράζεται κοίνους γενετικούς παράγοντες κινδύνου με άλλες παθήσεις, οι οποίες θεωρούνται ως αυτοανόσου αιτιολογίας και άρα τα ίδια ή οι ίδιες ομάδες γονιδίων σε συνδυασμό με την επίδραση περιβαλλοντικών παραγόντων οδηγούν σε διάφορετικές νόσους, στην παθογένεση των οποίων μετέχουν οι αυτοάνοσοι μηχανισμοί. ΜΕΘΟΔΟΣ Μελετήθηκαν 52 πάσχοντες απο ΔΜ, στους οποίους η διάγνωση είχε τεθεί με κλινικά, υπερηχοκαρδιογραφικά και αιμοδυναμικά κριτηρια, μαζί με 356 πρώτου βαθμού συγγενείς, ενώ την ομάδα ελέγχου αποτέλεσαν 50 ασθενείς με άλλη καρδιακή νόσο διάφορη της ΔΜ μαζί με 350 πρώτου βαθμού συγγενείς. Επίσης προσδιορισθηκάν τα επίπεδα του διαλυτού υποδοχέα της ιντερλευκίνης-2 (sIL-2R), ενός ευρέως αποδεκτού δείκτη ενεργοποιήσεως των Τ - λεμφοκυττάρων, στους πάσχοντες απο ΔΜ. ΑΠΟΤΕΛΕΣΜΑΤΑ Η συχνότητα, διαφόρων θεωρουμένων ως αυτοανόσου αιτιολογίας νοσημάτων, ήταν μεγαλύτερη στους συγγενείς ατομών με ΔΜ, σε σύγκριση με αυτούς της ομάδας ελέγχου, ποσοστό 15,4% σε σύγκριση με 6,3% αντίστοιχα (p<0,001, odds ratio 5,4). Το 66,7% των ασθενών με ΔΜ, που χαρακτηρίζονταν απο αυξημένα επίπεδα του sIL-2R, άνω των 800 pg/ml, είχαν θετικό οικογενειακό ιστορικό αυτοανόσων ασθενειών, συγκριτικά με το 25,8% των ασθενών με χαμηλά επίπεδα του sIL-2R, (p<0,01, σχετικός κίνδυνος 6,3). Επίσης διαπιστώθηκε στατιστικώς σημαντική διαφορά (p<0,01) στα επίπεδά sIL- 2R μεταξύ των ασθενών της ομάδος με θετικό οικογενειακό ιστορικό αυτοανόσων νοσημάτων (1044+311 pg/ml) και των ασθενών της ομαδός με αρνητικό ιστορικό (659+125 pg/ml). ΣΥΜΠΕΡΑΣΜΑ Σύμφωνα με την αρχική υπόθεση της μελέτης δείξαμε αυξημένο επιπολασμό αυτοανόσων παθήσεων στους πρώτου βαθμού συγγενείς των πασχόντων από ΔΜ. Επίσης η ενεργοποίηση των Τ-λεμφοκυττάρων, η οποία αντανακλάται στα υψηλά επίπεδα του sIL-2R, φαίνεται ότι ταυτοποιεί μία ομάδα ασθενών με ΔΜ, στους οποίους παρατηρείται συνάθροιση (clustering) αυτοανόσων παθήσεων.
Μικροβιακοί παράγοντες που απομονώνονται στα πτύελα χρόνιων αποφρακτικών ασθενιών κατά τη διάρκεια παροξύνσεων της νόσου τους και ευαισθησία τους στα κοινά αντιβιοτικά
Authors: Τσιμογιάννη Αγγελική
Published: January 2014

Σκοπός: Να εξετάσουμε τη μικροβιακή χλωρίδα των πτυέλων στις παροξύνσεις ΧΑΠ και τη σχέση της με δείκτες σοβαρότητας της υποκείμενης νόσου και δείκτες σοβαρότητας της παρόξυνσης. Μελετάμε επίσης τη λαμβανόμενη αντιβίωση και την ευαισθησία των απομονωθέντων μικροβίων σε αυτή. Tέλος εκτιμάται η έκβαση των ασθενών και συσχετίζεται με τη χλωρίδα, τη σοβαρότητα της νόσου και της παρόξυνσης. Υλικό και Μέθοδος: Κατάλληλα δείγματα πτυέλων που συλλέγησαν μέσα σε τρεις ώρες από την εισαγωγή των ασθενών συμπεριλήφθηκαν στην ανάλυση και πραγματοποιήθηκαν ποσοτικές καλλιέργειες. Η σοβαρότητα της ΧΑΠ εκτιμήθηκε με το FEV1, την κλίμακα χρόνιας δύσπνοιας Medical Research Council (MRC), την παρουσία νοσηλείας το προηγούμενο έτος, την αλβουμίνη ορού, το δείκτη μάζας σώματος (BMI) και τη χορήγηση συνεχούς κατ’οίκον οξυγονοθεραπείας (LTOT). Η σοβαρότητα της παρόξυνσης εκτιμήθηκε με τη μερική πίεση του διοξειδίου (PaCO2), την αξιολόγηση της οξείας φυσιολογίας και χρόνιας κατάστασης της υγείας (APACHE) II score και την παρουσία πυώδους απόχρεμψης. Η έκβαση των ασθενών εκτιμήθηκε με την τριετή θνητότητα και τη διάρκεια νοσηλείας (LOS). Αποτελέσματα: Στη μελέτη συμπεριλήφθησαν 103 ασθενείς που χωρίστηκαν στην: Ομάδα Α που περιλάμβανε 64 ασθενείς με φυσιολογική χλωρίδα και στην ομάδα Β που περιλάμβανε 39 ασθενείς με θετικές καλλιέργειες. Η ομάδα B χωρίστηκε εκ νέου στις υποομάδες B1 με 27 ασθενείς με παθογόνους μικροοργανισμούς εκτός P. αeruginosa και στην υποομάδα B2 με 12 ασθενείς με P. aeruginosa. FEV1 και BMI ήταν υψηλότερα και το APACHE II score χαμηλότερο στην ομάδα A από ότι στην ομάδα B (p<0.05). Λιγότεροι ασθενείς είχαν επίσης πυώδη απόχρεμψη στην ομάδα Α (p<0.05). Συγκρίσεις μεταξύ όλων των ομάδων έδειξαν ότι η υποομάδα B2 είχε το χαμηλότερο FEV1 και το υψηλότερο APACHE II score (p<0.05). Όλοι οι ασθενείς έλαβαν αντιβιοτικά στην εισαγωγή τους αν και βακτηριακή αιτιολογία της παρόξυνσης τεκμηριώθηκε στο 37.9%, εκ των οποίων οι μισοί έλαβαν κατάλληλη αγωγή. Η ενδονοσοκομειακή θνητότητα ήταν 3.9% και η θνητότητα στην τριετία 42.2%. Η διάρκεια νοσηλείας ήταν 8.91±0.55 ημέρες. Η επιβίωση συσχετιζόταν αντίστροφα με το βαθμό δύσπνοιας MRC, το PaCO2, APACHE II score, LTOT και τις νοσηλείες και θετικά με την αλβουμίνη ορού (p values< 0.05), με το βαθμό δύσπνοιας MRC να είναι ο μόνος ανεξάρτητος καθοριστικός παράγοντας της επιβίωσης (p<0.001 OR= 7.71 και 95% CI 2.36-25.212). Η επιβίωση δε συσχετιζόταν με τη μικροβιακή χλωρίδα. Αντίθετα η LOS συσχετιζόταν με τη χλωρίδα όπως και με το βαθμό δύσπνοιας MRC (p<0.05), ο οποίος ήταν ο καθοριστικός παράγοντας της LOS (p<0.05 OR= 3.09 και 95% CI 1.16-8.26). Συμπέρασμα: Βακτηριακής αιτιολογίας παροξύνσεις ΧΑΠ και ειδικά όταν ο εμπλεκόμενος μικροοργανισμός είναι η P. aeruginosa χαρακτηρίζουν ασθενείς με πιο σοβαρή υποκείμενη νόσο και πιο σοβαρή παρόξυνση. Ο βαθμός δύσπνοιας με την κλίμακα MRC είναι ο καλύτερος προγνωστικός δείκτης της διάρκειας νοσηλείας και της επιβίωσης.
Βιοχημικοί δείκτες και αντιμετώπιση των τραυματικών κακώσεων ήπατος στα παιδιά
Authors: Κεπερτής Χρυσόστομος
Published: January 2014

Σκοπός της μελέτης αυτής είναι η διερεύνηση των τραυματικών κακώσεων ήπατος, όσο αφορά το ποσοστό συμμετοχής του ήπατος, την αιτιολογία των κακώσεων ήπατος, τις συνοδές κακώσεις αλλά και την αξία των βιοχημικών δεικτών. Διακρίνουμε δύο ομάδες ασθενών: Στη πρώτη ομάδα γίνεται αναδρομική μελέτη όλων των μικρών ασθενών ηλικίας μικρότερης των 15 ετών που νοσηλεύτηκαν στην Α’ Κλινική Χειρουργικής Παίδων του Α.Π.Θ. από Ιανουάριο 1994 μέχρι Δεκέμβριο 2004. Σε σύνολο 436 παιδιών με κάκωση κοιλίας μελετήθηκαν 34 περιπτώσεις με κάκωση ήπατος. Η μέση ηλικία είναι η ηλικία των 6 ετών και τα αγόρια αφορούσαν ποσοστό 76,4%. Ο συχνότερος μηχανισμός κάκωσης αφορούσε τα τροχαία ατυχήματα (41,17%). Χειρουργική αντιμετώπιση έτυχαν 9 παιδιά (26,4%). Οι κρανιοεγκεφαλικές κακώσεις αποτελούν τις συχνότερες συνοδές κακώσεις και η θνητότητα αφορά ποσοστό 2,94%. Το ήπαρ αποτελεί το δεύτερο σε συχνότητα ενδοκοιλιακό όργανο που τραυματίζεται στη κοιλιά και η συντηρητική αντιμετώπιση σε αιμοδυναμικά σταθερούς ασθενείς αποτελεί τη θεραπεία εκλογής. Στη δεύτερη ομάδα γίνεται προοπτική μελέτη των τραυματικών κακώσεων κοιλίας από Ιανουάριο 2004 μέχρι Ιανουάριο 2008 όπου γίνεται μελέτη βιοχημικών δεικτών και σύνδεση τους με τη διάγνωση και αντιμετώπιση των τραυματικών κακώσεων ήπατος. Οι δείκτες που μελετούνται είναι τα λευκά αιμοσφαίρια και ο τύπος τους, οι τρανσαμινάσες, η γ-GT, η αμυλάση και η αλκαλική φωσφατάση. Σε σύνολο 106 ασθενών με τραυματική κάκωση κοιλίας 22 έχουν κάκωση ήπατος. 20 ασθενείς αντιμετωπίστηκαν συντηρητικά και μελετούνται οι τιμές των δεικτών με την εισαγωγή των ασθενών στη Κλινική, 12 ώρες μετά, 24 ώρες και 48 ώρες μετά. Η τρανσαμινασαιμία συνδέεται με τη κάκωση ήπατος όταν AST>200, ALT>150 και AST/ALT >1. Ο δείκτης AST/ALT μπορεί να χρησιμοποιηθεί ως δείκτης στη διάγνωση και στην ανταπόκριση του ασθενούς στη συντηρητική αντιμετώπιση.
Ανοσιακοί μηχανισμοί στις μυοκαρδιοπάθειες
Authors: Ευθυμιάδης Ιωάννης
Published: January 2014

[…] Κύριοι στόχοι της μελέτης ήταν να διερευνηθεί α) ο ρόλος των βοηθητικών Τ-λεμφοκυττάρων που εκφράζουν τον υποδοχέα της ΙL-2 (CD4+/ CD25+), β) η σημασία ορισμένων πολύ σημαντικών κυτταροκινών της Th1/Th2 ρύθμισης (IL-2, IFN-γ, IL-10), και γ) ο ρόλος της Β7/CD28 (CD14+/CD80+μονοπύρηνα, CD4+/CD28+Τ-λεμφοκύτταρα) διαμεσολαβούμενης συνδιέγερσης, ασθενών με ΔΜΚ συνολικά και ξεχωριστά σε 2 υποομάδες ασθενών, με πρόσφατης έναρξης ΔΜΚ (Δ₁-recent onset disease) και με χρόνια εγκατεστημένη νόσο (Δ₂-long lasting disease). Για τη μελέτη της λειτουργικής ικανότητας των περιφερικών μονοπυρήνων και της δυνητικής έκφρασης υποδοχέων και κυτταροκινών, πραγματοποιήθηκαν καλλιέργειες με μιτογόνο PHA μόνο ή με προσθήκη δύο διαφορετικών ποσοτήτων αντιγόνου κεκαθαρμένης ανθρώπινης καρδιακής μυοσίνης που παρασκευάσθηκε ειδικά για τον σκοπό αυτό. […]