bluuebunny/crossref_metadata_2025 huggingface dataset:
Occipital Nerve Stimulation for Refractory Occipital Pain after Occipitocervical Fusion: Expanding Indications
Authors: Ghaemi Kazem , Capelle Hans-Holger , Kinfe Thomas M. , Krauss Joachim K.
Published: November 2008

Background: Occipital nerve stimulation is being used for various pain syndromes. Here, we expand its use for the treatment of refractory occipital pain after occipitocervical fusion. Case Description: We describe a case of occipital neuralgia in a 60-year-old man following posterior occipitocervical fusion. The maximum pain intensity was rated 9/10 on the visual analogue scale (VAS). Since pain proved to be refractory to analgetic medication, two quadripolar electrodes (Resume II, Medtronic) were implanted in the occipital region to stimulate the occipital nerve bilaterally. The patient experienced a dramatic response during test stimulation for 10 days with externalized electrodes, and a pacemaker (Synergy, Medtronic) was connected to the electrodes. While on chronic stimulation (bipolar 6 V, 210 μs, 130 Hz) improvement of pain was maintained, reflected by a decrease in the VAS score to 1/10 at 12 months of follow-up. Conclusion: Occipital nerve stimulation for medical refractory occipital neuralgia after occipitocervical fusion is an effective method expanding the indications for its use.
Electron Therapy for Orbital and Periorbital Lesions Using Customized Lead Eye Shields
Authors: Hayashi Keiji , Hatsuno Kunito , Yoshimura Ryo-ichi , Iida Toshiaki , Ayukawa Fumio , Toda Kazuma , Taniguchi Hisashi , Shibuya Hitoshi
Published: November 2008

Purpose: To establish the protective efficacy against late complications of electron therapy using customized lead eye shields in cases with orbital and periorbital lesions. Methods: Between 1982 and 2006, 16 patients with 22 orbital and periorbital lesions were treated by electron therapy. Customized lead eye shields were prepared and placed in the respective patients’ eyes during each fraction of electron therapy. The toxicity and local control rates were analyzed. Results: The preparation period for the customized lead eye shields was 2 days. The shields could be used throughout the treatment period in all the patients. No evidence of radiation cataract was observed in 15 of the 16 patients. None of the patients developed corneal ulceration or evidence of lead poisoning. Conclusion: Customized lead eye shields could be made relatively quickly, and electron therapy for orbital and periorbital lesions could be undertaken safely without any late complication.
Changes in Intestinal Waste Products during the Antenatal Management of Gastroschisis by Serial Amniotic Fluid Exchange and Infusion
Authors: Lee Hee-Young , Shim Jae-Yoon , Won Hye-Sung , Lee Pil Ryang , Kim Ahm
Published: November 2008

Despite the good survival rate of fetuses with gastroschisis, the length and cost of hospitalization for surgically repaired gastroschisis are high. In gastroschisis, prolonged exposure of the intestine to amniotic fluid (AF) containing intestinal waste products results in intestinal damage, including intestinal wall thickening and fibrous peel formation. The deleterious effects of AF on gastroschisis can be prevented by lowering the concentration of intestinal waste products. We describe the treatment of a case of fetal gastroschisis by repeated AF exchange and infusion. Following repeated, successful transabdominal AF exchange and infusion, the concentrations of various intestinal waste products were decreased. AF exchange and infusion may prevent intestinal damage and improve postnatal outcome in gastroschisis by diluting the AF, probably by lowering the concentrations of intestinal waste products.
Campomelic Dysplasia: Echographic Suspicion in the First Trimester of Pregnancy and Final Diagnosis of Two Cases
Authors: Massardier J. , Roth P. , Michel-Calemard L. , Rudigoz R.C. , Bouvier R. , Dijoud F. , Arnould P. , Combourieu D. , Gaucherand P.
Published: November 2008

Objective: Campomelic dysplasia (CD) is a rare skeletal dysplasia characterized by marked femoral and tibial angulations, hypoplasic scapulae, normal upper limbs and sex reversal in 3/4 of 46,XY fetuses. Most cases are lethal in the neonatal period. Heterozygous mutations in the SOX9 gene are responsible for CD. The diagnosis is not usually made until the mid-second trimester or later. Methods: We describe 2 cases of CD suspected by ultrasonography in the first trimester. Results: The 2 cases presented with hygroma colli along with anomalies in the lower but not the upper limbs. Terminations of pregnancy were obtained at 14+3 and 20+6 gestational weeks. Fetopathological examinations confirmed sonographic findings. Conclusion: When first trimester hygroma colli is accompanied by specific findings of the lower limbs, the diagnosis of CD can be investigated through SOX9 mutation analysis.
CD4+ T Cells Have a Key Instructive Role in Educating Dendritic Cells in Allergy
Authors: Larsson Kristina , Lindstedt Malin , Lundberg Kristina , Dexlin Linda , Wingren Christer , Korsgren Magnus , Greiff Lennart , Borrebaeck Carl A.K.
Published: November 2008

Background: Dendritic cells (DCs) are central in allergy as regulators of the Th1/Th2 balance. We have recently demonstrated a unique transcriptional profile of DCs in patients with ongoing allergy compared with healthy subjects and shown that crosstalk between DCs and memory T cells affects the transcriptional profile of T cells. However, the transcriptional profile of DCs educated by T cells in allergy is unknown. Methods: In the present study, we have examined the transcriptional profiles of DCs after stimulation with grass pollen allergens, Phleum pratense and coculture with autologous CD4+ memory T cells using high-density microarray. Protein analysis was performed using flow cytometry and recombinant antibody protein microarrays. Patients with allergic rhinitis and healthy subjects were compared. Results: The results reveal a distinct T-cell-induced DC profile in atopic individuals. Accordingly, about 170 genes were upregulated and 40 genes downregulated. For example, the chemokine receptor CXCR4 and the tumor necrosis factor receptor CD30 were upregulated in DCs derived from atopic donors, and this could also be verified at the protein level. Conclusion: We conclude that crosstalk between CD4+ memory T cells and autologous DCs induces transcriptional reprogramming in DCs. This finding suggests that T cells have a key instructive role in educating DCs in Th2-type responses.
Kinetics of Regulatory T Cells in the Ovalbumin Asthma Model in the Rat
Authors: Jurawitz Marie-Charlot , Luhrmann Anke , Tschernig Thomas , Pabst Reinhard
Published: November 2008

Background: The kinetics of regulatory T cells (TReg) in allergic diseases such as asthma are only partly known. Methods: The asthma model in the Fischer rat with ovalbumin (OVA) sensitization and aerosol challenge was used. The relative and absolute numbers of leukocytes, lymphocytes and TReg subsets were determined by flow cytometry in the lung interstitium and draining bronchial lymph nodes at different time points after two challenges, and lung function was tested in parallel. Results: The progressive number of challenges resulted in increased relative and absolute numbers of lymphocytes and in particular of TReg. The TReg number was augmented with each aerosol challenge and was already significantly increased 6 h after the second challenge. The relative (%) and absolute numbers of CD4+ and CD8+ TReg and dendritic cells showed different kinetics after two challenges. The leukocyte numbers in the lung did not correlate with lung function. Conclusion: TReg increased surprisingly early after challenge in the lung tissue. Relative and absolute numbers of leukocyte subsets should always be calculated. The kinetics of different leukocyte subsets can only be determined when several time points are studied.
Prevalence of Self-Reported Allergic Rhinitis in Eleven Major Cities in China
Authors: Zhang Luo , Han Demin , Huang Dan , Wu Yangfeng , Dong Zhen , Xu Geng , Kong Weijia , Bachert Claus
Published: November 2008

Background: Allergic rhinitis (AR) is a common disease and its prevalence is increasing worldwide. Data on the current prevalence of AR in China, one of the biggest countries in the world, with a population of around 1.3 billion citizens, are scarce. The aim of this study was to investigate the prevalence of self-reported AR in Chinese citizens. Methods: In a cross-sectional, population-based study, telephone interviews were conducted in 11 major cities in China after sampling target telephone numbers through the approach of random digital dialing. The questions for the telephone interviews were based on validated questionnaires. Results: A total of 38,203 telephone interviews were conducted from September 2004 to May 2005. The response rate was 63.7%. After adjustment for age and gender, the self-reported prevalence of AR was lowest in Beijing (8.7%) and highest in Urumqi (24.1%). Among the subjects with self-reported AR, 25.6% were diagnosed with persistent AR and 74.4% suffered from intermittent AR. Less than half of the subjects with self-reported AR had presented at a health clinic. In 37.3% AR had previously been diagnosed by physicians, and 33.1% of subjects with self-reported AR had been treated. Comorbidities reported were asthma (9.2%), rhinosinusitis (13.3%) and atopic dermatitis (16.4%). Conclusions: This study demonstrates that the self-reported prevalence of AR in 11 cities across Mainland China has wide variations, ranging from <10% to >20%; 26% of the self-reported AR subjects were classified as suffering from persistent AR.
Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia
Authors: Mehrkens J.H. , Bötzel K. , Steude U. , Zeitler K. , Schnitzler A. , Sturm V. , Voges J.
Published: November 2008

Background: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) offers a very promising therapy for medically intractable dystonia. However, little is known about the long-term benefit and safety of this procedure. We therefore performed a retrospective long-term analysis of 18 patients (age 12–78 years) suffering from primary generalized (9), segmental (6) or focal (3) dystonia (minimum follow-up: 36 months). Methods: Outcome was assessed using the Burke-Fahn-Marsden (BFM) scores (generalized dystonia) and the Tsui score (focal/segmental dystonia). Follow-up ranged between 37 and 90 months (mean 60 months). Results: Patients with generalized dystonia showed a mean improvement in the BFM movement score of 39.4% (range 0–68.8%), 42.5% (range –16.0 to 81.3%) and 46.8% (range –2.7 to 83.1%) at the 3- and 12-month, and long-term follow-up, respectively. In focal/segmental dystonia, the mean reduction in the Tsui score was 36.8% (range 0–100%), 65.1% (range 16.7–100%) and 59.8% (range 16.7–100%) at the 3- and 12-month, and long-term follow-up, respectively. Local infections were noted in 2 patients and hardware problems (electrode dislocation and breakage of the extension cable) in 1 patient. Conclusion: Our data showed Gpi-DBS to offer a very effective and safe therapy for different kinds of primary dystonia, with a significant long-term benefit in the majority of cases.
Increase in Relapse Rate during Assisted Reproduction Technique in Patients with Multiple Sclerosis
Authors: Hellwig Kerstin , Schimrigk Sebastian , Beste Christian , Müller Thomas , Gold Ralf
Published: November 2008

The objective was to determine if there is an increased risk to develop exacerbations in patients with multiple sclerosis (MS) after assisted reproduction technique (ART). An increase in annual relapse rate (ARR) was described after ART in a small cohort of patients. We investigated the associations between ART and relapse rate (RR) in 23 MS patients who underwent 78 hormonal stimulations in total. There was a statistically significant increase in the RR following ART independent of the hormonal approach or the time interval between the stimulations. These results suggest that female MS patients who wish to have children should be informed that the RR may be increasing if ART is necessary.
Is There a Difference between Levodopa/ Dopa-Decarboxylase Inhibitor and Entacapone and Levodopa/Dopa-Decarboxylase Inhibitor Dose Fractionation Strategies in Parkinson’s Disease Patients Experiencing Symptom Re-Emergence due to Wearing-Off?
Authors: Destée Alain , Rérat Karin , Bourdeix Isabelle
Published: November 2008

Two strategies to manage symptom re-emergence due to wearing-off with conventional levodopa/dopa-decarboxylase inhibitor (DDCI) therapy were compared in patients with Parkinson’s disease (PD) in this randomized, open-label trial. PD patients receiving 3 daily doses of levodopa/DDCI were randomized to either levodopa/DDCI and entacapone or an increased dose frequency of levodopa/DDCI with or without an increased total daily dose (dose fractionation). After 1 month of treatment, patients were followed up for 1 year. A greater proportion of levodopa/DDCI and entacapone-treated patients had treatment success compared with dose-fractionated patients, according to investigator Clinical Global Impression of Change scores at 1 month (68 vs. 59%, respectively) and 1 year (60 vs. 51%, respectively). Mean ‘off’ time (time with symptoms) was improved in both groups at 1 month and 1 year, despite a reduction in the mean daily levodopa dose in the levodopa/DDCI and entacapone group at 1 month. The mean daily levodopa dose was increased in the dose fractionation group. At 1 month, there was a 4% reduction in patients experiencing dyskinesia with levodopa/DDCI and entacapone and a 3% increase with dose fractionation. These data suggest that levodopa/DDCI and entacapone reduces time with symptoms, the rate of motor complications and the daily levodopa dose compared with dose fractionation. However, as the observed differences were not statistically significant, further studies are required to confirm these results.
The Association of Atrial Tachyarrhythmias with Isolated Atrial Amyloid Disease: Preliminary Observations in Autopsied Heart Specimens
Authors: Ariyarajah Vignendra , Steiner Ivo , Hájková Petra , Khadem Aliasghar , Kvasnicka Jiri , Apiyasawat Sirin , Spodick David H.
Published: November 2008

Objective: Isolated atrial amyloidosis (IAA) is associated with atrial tachyarrhythmias. However, only a few studies have appraised atrial tachyarrhythmias and atrial depolarization abnormalities in connection with high-grade IAA. We conducted a collaborative retrospective study to assess this association. Methods: One hundred consecutive autopsied hearts were studied histologically for IAA. To increase the specificity for atrial depolarization abnormalities in this preliminary study, we excluded those specimens with intermediate amyloid involvement, i.e. IAA grades 1 and 2 (grade 0 = absent or trivial deposits; grade 1 = small deposits; grade 2 = moderate deposits; grade 3 = dense, large deposits). We then screened for baseline, premortem electrocardiograms (ECGs) to assess rhythm. In those with sinus rhythm, the P wave axis, duration, dispersion and terminal force in V1 were determined under magnification. Results: Of the 27 premortem ECGs corresponding to the autopsy specimens with grades 3 (sample) or 0 (controls) IAA, 9 showed sinus rhythm, 13 showed atrial fibrillation, 1 showed atrial flutter and 4 were uninterpretable. Fourteen autopsied hearts (52%) were positive for grade 3 IAA. Ten of those had atrial tachyarrhythmias (9 atrial fibrillation and 1 atrial flutter) compared to 4 of the 13 hearts with grade 0 IAA (72 vs. 31%, respectively; p = 0.03). Although there was excellent interobserver agreement using intraclass correlation coefficients, there were no significant differences in P wave measurements among the small number of patients with sinus rhythm for grade 3 versus grade 0 IAA. Conclusion: In a collaborative, preliminary, pilot assessment of autopsied hearts for which premortem ECGs were necessarily screened retrospectively, significantly more hearts with high-grade IAA were associated with atrial tachyarrhythmias compared to those with low-grade IAA. A larger study with an appropriately matched autopsy control group is needed to confirm these and previous observations.
The Canonical Wnt Pathway Regulates Retinal Stem Cells/Progenitors in Concert with Notch Signaling
Authors: Das Ani V. , Bhattacharya Sumitra , Zhao Xing , Hegde Ganapati , Mallya Kavita , Eudy James D. , Ahmad Iqbal
Published: November 2008

The canonical Wnt pathway is known to influence multiple developmental events such as patterning, cell proliferation and cell specification. Recent studies have provided evidence of the involvement of the canonical Wnt pathway in the emergence and development of the optic neuroepithelium and its derivatives, particularly the retina. However, the mechanism of its action during retinal development remains rather obscure. Here, we demonstrate that (in agreement with observations in the blood, intestine, and skin) the canonical Wnt pathway influences retinal development by maintaining stem cells/progenitors. For example, the activation of this pathway keeps the early retinal stem cells/progenitors proliferating and uncommitted, while its attenuation facilitates their differentiation into retinal ganglion cells in vitro and in vivo. In addition, we demonstrate that Wnt signaling acts in concert with Notch signaling during retinal histogenesis, where the latter calibrates the influence of the former on the differentiation status of retinal stem cells/progenitors by regulating Lef1 and sFRP2.
Basal Metabolic Rate and Body Composition in Patients with Post-Polio Syndrome
Authors: Bargieri J.V. , Quadros A.A.J. , Pereira R.D.B. , Oliveira A.J.B. , Lazaretti-Castro M. , Silva A.C.
Published: November 2008

The aim of this study was to compare basal metabolic rate (BMR) of post-polio syndrome (PPS) patients with healthy individuals and to determine its correlation to body composition. BMR (kcal/day) was determined by indirect calorimetry and body composition by dual energy X-ray absorptiometry. BMR was lower in the PPS patient group than in the control group, although it was similar in both groups when adjusted for body surface area, total body mass (TBM), lean body mass (LBM) and fat-free mass (FFM). PPS patients also showed reduced TBM, LBM and FFM in relation to controls. As muscle energy expenditure while at rest contributes only 20% to the BMR, a proportional reduction in BMR and FFM or LBM could suggest that muscle mass or other factors may interfere more than predicted. It was concluded that the prediction of BMR from the Harris-Benedict equation in PPS patients must be carefully reviewed.
Ductal Carcinoma in situ of the Breast in Israeli Women Treated by Breast-Conserving Surgery Followed by Radiation Therapy
Authors: Jiveliouk Irina , Corn Benjamin , Inbar Moshe , Merimsky Ofer
Published: November 2008

Background: Lumpectomy followed by radiation therapy (RT) has become an accepted local management strategy for patients with small, mammographically detected ductal carcinoma in situ (DCIS) of the breast. The aim of this analysis is to describe control rates and patterns of relapse in a cohort of Israeli women with mammographically detected DCIS treated at a single medical center. Patients and Methods: The files of 107 consecutive patients with DCIS were retrieved from the cancer registry of the unit of RT. All women underwent lumpectomy followed by definitive RT, administered in conventional dose fractionation regimens. Oral tamoxifen, 20 mg/ day, was prescribed to all but 2 patients with positive receptors. Results: Within a median follow-up time of 52 months, no local recurrence of any breast tumor was found. There was no correlation between event-free survival and tumor size, focality, grading, hormone receptor status, administration of adjuvant hormonal therapy, timing of RT, and RT boost delivery. The 8-year overall survival, disease-free-survival, and event-free survival were 100, 100, and 87%, respectively. Conclusions: The results reported herein are consistent with short-term and intermediate-term outcomes that are better than the reported benchmarks from prospective randomized trials. Although this could reflect selection factors at a single institution, it is also plausible that a genetically distinct disease is present in this local population.
Relationships of Insulin-Like Growth Factor-1 Receptor and Epidermal Growth Factor Receptor Expression to Clinical Outcomes in Patients with Colorectal Cancer
Authors: Takahari Daisuke , Yamada Yasuhide , Okita Natuko T. , Honda Takuya , Hirashima Yoshinori , Matsubara Junichi , Takashima Atsuo , Kato Ken , Hamaguchi Tetsuya , Shirao Kuniaki , Shimada Yasuhiro , Shimoda Tadakazu
Published: November 2008

Objectives: The present study evaluated the prognostic implications of insulin-like growth factor-1 receptor (IGF-1R), epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor (HER)-2 in patients with colorectal cancer (CRC). Methods: Our subjects were 91 patients who underwent surgery and subsequently received fluoropyrimidines. Expressions of IGF-1R, EGFR and HER-2 in primary lesions were analyzed immunohistochemically to determine the prognostic significance of these biomarkers. Results: Overexpression was found for IGF-1R in 48 tumors (53%), EGFR in 57 (63%) and HER-2 in 2 (2%). Overexpression of IGF-1R was significantly correlated with shorter survival from the start of first-line chemotherapy (p = 0.033). Overexpression of EGFR was a significant predictor of clinical response to fluoropyrimidines (p = 0.032). Multivariate analysis of potential prognostic factors showed that IGF-1R expression and worsened performance status were independent predictors of poor outcomes. Conclusions: Our results suggest that anti-IGF-1R strategies may offer a useful approach in molecular therapy for CRC, which has the potential to improve outcomes.
Nasal Saline Irrigation Facilitates Control of Allergic Rhinitis by Topical Steroid in Children
Authors: Li Huabin , Sha Quan , Zuo Kejun , Jiang Hongyan , Cheng Lei , Shi Jianbo , Xu Geng
Published: November 2008

Objective: This study was designed to determine whether nasal saline irrigation improved the symptoms and signs of allergic rhinitis (AR) and whether nasal saline irrigation could be used as a complementary management of AR in children while less steroids were used. Method: 26 children with AR were divided into three groups and were given nasal saline irrigation and/or topical steroid. Symptoms and signs of AR and mucociliary clearance (MCC) were evaluated, and concentration of soluble intercellular adhesion molecule (sICAM)-1 in nasal secretion was detected. Results: In AR children treated with nasal irrigation and tapered topical steroid at week 8 and week 12, a significant improvement in symptoms and signs was observed, and a significant decrease in the mean values of MCC and the mean concentrations of sICAM-1 in nasal secretions was also detected. Conclusion: Nasal saline irrigation can be viewed as a good adjunctive treatment option for AR. It permitted the use of less topical steroids for controlling AR in children, which will contribute to fewer side effects and less economic burden.
Transitory Increase in Middle Cerebral Artery Peak Systolic Velocity of Recipient Twins after Fetoscopic Laser Photocoagulation for Twin-Twin Transfusion Syndrome
Authors: Ishii Keisuke , Murakoshi Takeshi , Matsushita Mitsuru , Sinno Takashi , Naruse Hiroo , Torii Yuichi
Published: November 2008

Objective: It was the aim of this study to elucidate the clinical features of recipient twins with increased middle cerebral artery peak systolic velocity (MCA-PSV) after fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome. Methods: Serial Doppler velocimetry of the MCA was performed in 30 recipient twins before and after FLP. Clinical data and perinatal outcome were compared between cases with and without increased MCA-PSV. Results: Increased MCA-PSV was observed in 7 recipients (23.3%) within 14 days after FLP. MCA-PSV gradually decreased to <1.5 multiples of median in 6 recipients; however, 1 patient resulted in fetal demise subsequent to the demise of the co-twin. The incidences of fetal and neonatal demise and neurological morbidity were similar. No recipient was diagnosed as anemic at birth. Conclusions: The increase in MCA-PSV in recipients following FLP appeared to be generally transitory; this differs from twin anemia-polycythemia sequence.
Reversion of the Ballantyne Syndrome despite Fetal Hydrops Persistence
Authors: Lobato Gustavo , Nakamura-Pereira Marcos
Published: November 2008

Introduction: The Ballantyne syndrome (or mirror syndrome) is a gestational proteinuric hypertension associated with fetal hydrops. This report describes a case in which Ballantyne syndrome reversion occurred despite fetal hydrops persistence. Case Report: A 24-year-old woman showed fetoplacental hydrops at 28 2/7 gestational weeks. Severe Rh(D) alloimmunization and fetal hemolytic anemia (fetal hematocrit 15.4%) were confirmed by cordocentesis, and an intrauterine transfusion was performed. She also revealed hypertension (160/100 mm Hg), edema and proteinuria (845 mg/day). After four intrauterine transfusions, blood pressure was normalized; urinary proteinuria was not significant, and the edema vanished completely. Fetal hydrops persisted until delivery at 32 gestational weeks, but a partial reduction of placental hydrops was noted. Discussion: Total or partial reduction of the placental edema may be responsible for the reversal of the Ballantyne syndrome despite the fetal hydrops persistence.
Prenatal Diagnosis of Duodenal Obstruction Selects Cases with a Higher Risk of Maternal-Foetal Complications and Demands in utero Transfer to a Tertiary Centre
Authors: Calisti Alessandro , Oriolo Lucia , Cozzi Denis Andrew , Briganti Vito , Morini Francesco , Pacilli Maurizio , Molle Philippe , Spagnol Lorna , Mangia Giovanni , Cozzi Francesco
Published: November 2008

Objectives: It was the aim of this study to determine if prenatal diagnosis of congenital duodenal obstruction (CDO) selects high-risk pregnancies and demands special perinatal attention. Methods: Medical records of 62 neonates with intrinsic CDO, admitted since 1981 in 2 institutions, were reviewed and divided into 2 groups: 39 cases, detected in utero by a prenatal ultrasonogram (group A), and 23 diagnosed at birth (group B). Prevalence of complete CDO, mean gestational age, mean birth weight, hydramnios, as well as maternal-foetal complications requiring emergency Caesarean section and associated with premature delivery were compared in the 2 groups. Results: A complete CDO was found in 77% of patients in group A versus 48% of patients in group B (p < 0.02). Differences in mean gestational age and mean birth weight in the 2 groups were non-significant. Prenatally diagnosed patients presented a higher prevalence of hydramnios, maternal-foetal complications and premature delivery. Conclusions: Prenatal diagnosis selects patients with complete CDO and hydramnios. These pregnancies present a high incidence of maternal-foetal complications, which may require an emergency Caesarean section, and are frequently associated with premature delivery. These aspects must be considered in prenatal counselling. In utero transfer to a tertiary centre for delivery and appropriate perinatal care should be recommended.
Differential Expression of GABA Receptor Subunit Messenger Ribonucleic Acids and Immunoreactivity in the Rat Neostriatum during Postnatal Development
Authors: Lau W.K. , Zhang H.Q. , Chan Y.S. , Yung K.K.L.
Published: November 2008

γ-Aminobutyric acid (GABA) is a major inhibitory neurotransmitter in the neostriatum. Functions of GABA are mediated by GABAA and GABAB receptors in the neostriatum. In order to investigate the developmental expression of GABA receptor subunits (GABAAα1, GABAAα3 and GABAAα6; GABAAβ2 and GABAAβ3, and GABABR1 and GABABR2) in the rat neostriatum, reverse transcriptase-polymerase chain reaction (RT-PCR) and immunofluorescence were performed. Tissues were obtained from rats on postnatal day (PND) 1, PND 7 and PND 14, and from adult rats. RT-PCR indicated that GABAAα1 and GABAAα6 mRNA levels were low, but that GABAAβ2 and GABAAβ3 mRNAs levels were high during the early postnatal period. Immunofluorescence revealed that GABAAα1 immunoreactivity was only observed in striatal interneurons in PND 14 and in adult rats. Immunoreactivity for GABAAα6 was only observed in PND 14 and adult animals. GABABR1 immunoreactivity was found to be expressed by perikarya of striatal neurons at all ages examined. In contrast, GABABR2 immunoreactivity was mainly observed in choline acetyltransferase-positive striatal interneurons in PND 14 and adult rats. The present results indicate that there are differential patterns of developmental expression of GABA receptor subunits in the neostriatum, with important implications for the development of GABA systems in rat basal ganglia.
Development and Initial Validation of the Thyroid Cancer Module of the M. D. Anderson Symptom Inventory
Authors: Gning Ibrahima , Trask Peter C. , Mendoza Tito R. , Harle Margaret T. , Gutierrez Karla A. , Kitaka Sheila A. , Sherman Steven I. , Cleeland Charles S.
Published: November 2008

Objective: The M. D. Anderson Symptom Inventory (MDASI) and its modules measure common symptoms related to cancer and its treatment. We report the development and initial validation of the MDASI-Thyroid Cancer module (MDASI-THY). Methods: A list of thyroid-cancer-specific symptoms was generated through focus groups and interviews with thyroid cancer patients, clinicians and researchers. These MDASI-THY items were added to the original MDASI and administered to 60 patients with thyroid cancer. Symptom prevalence and severity were evaluated, along with the reliability and content, construct and known-group validity of the MDASI-THY. Results: Cognitive debriefing performed on a subset of patients indicated that the MDASI-THY items were clear, concise, relevant and easy to understand. Fatigue, drowsiness, sleep disturbance, distress and difficulty remembering were the 5 most prevalent and severe symptoms. Twenty-eight percent of patients had moderate to severe fatigue (≥5 on a 0–10 scale). Average severity was 1.28 and 1.29 for the symptom and interference subscales, respectively. MDASI-THY symptoms were severer for patients with poorer performance status. Cronbach α-values were 0.76, 0.85 and 0.92 for the thyroid-specific symptom items, core symptom subscale and interference subscale, respectively. Conclusions: This study demonstrates preliminary evidence for the validity and reliability of the MDASI-THY.
Chronically Administered Immunotherapy with Low-Dose IL-2 and IFN-α in Metastatic Renal Cell Carcinoma: A Feasible Option for Patients with a Good Prognostic Profile
Authors: Vaglio Augusto , Alberici Federico , Maggiore Umberto , Buti Sebastiano , Potenzoni Domenico , Passalacqua Rodolfo , Buzio Carlo
Published: November 2008

Objective: We report the results obtained using an original immunotherapy schedule featuring chronically administered low-dose interleukin-2 (IL-2) and interferon-α (IFN-α) in patients with metastatic renal cell carcinoma (mRCC), and we assess treatment efficacy according to the patients’ prognostic profiles. Methods: 138 consecutive patients were enrolled, and received IL-2 (1 million IU/m2) subcutaneously twice daily on days 1 and 2, and once daily on days 3–5 of each week, and IFN-α (1.8 million IU/m2) intramuscularly once daily on days 3 and 5. Each cycle consisted of 4 consecutive weeks and was repeated indefinitely at 4-month intervals regardless of response. The patients’ baseline risk profile was assessed using Negrier’s stratification system. Results: The overall response rate was 10.9% (95% CI 6.7–17.2), and median overall survival was 19.6 months (95% CI 14.2–28.2). Treatment-related toxicity was mostly WHO grade 2 or below. Survival in the low-, intermediate- and high-risk groups was significantly different (p for trend <0.001), with low-risk patients having a median survival of 65.1 months (95% CI 42.7–84.2). Conclusion: Chronically administered low-dose IL-2 and IFN-α may be a safe and effective option for low-risk mRCC patients.
Chronic Kidney Disease and US Healthcare Resource Utilization in a Nationally Representative Sample
Authors: Alexander Marcus , Bradbury Brian D. , Kewalramani Reshma , Barlev Arie , Mohanty Sarita A. , Globe Denise
Published: November 2008

Background: Chronic kidney disease (CKD) is a prevalent condition; however, little is known about healthcare resource utilization (HRU) by CKD patients. Methods: This analysis included NHANES participants aged ≥18 years, with serum creatinine, urine protein, and hemoglobin measurements. We assessed the association between CKD (stratified by stage) and HRU based on self-reported physician visits and hospitalizations in the year preceding the survey. Results: Of the 15,258 included in this analysis, 2,110 had early CKD (stage 1 and 2 CKD) and 1,121 had late CKD (stage 3 and 4 CKD). Mean (SE) number of annual physician visits were 3.51 (0.08), 4.43 (0.18), and 6.53 (0.38) for participants with no CKD, early CKD, and late CKD, respectively. Mean (SE) number of annual hospitalizations were 0.15 (0.01), 0.19 (0.01), and 0.42 (0.03) for participants with no CKD, early CKD, and late CKD, respectively. Participants with late CKD were more likely to have more physician visits (OR 1.81, 95% CI 1.46, 2.23) and have more hospital admissions (OR 2.12, 95% CI 1.66, 2.71) compared with participants with early CKD or no CKD. Conclusions: In this analysis, late stage CKD was associated with increased HRU, suggesting the need for early identification and treatment of CKD and its associated conditions.
A Clearly Democratic Religious-Zionist Philosophy: The Early Thought of Yeshayahu Leibowitz
Authors: Hellinger Moshe
Published: November 2008

In his early teaching, from the 1920s through the 1950s, Yeshayahu Leibowitz (1903–1994) stands out as one of the most fascinating religious Zionist thinkers. He strives to establish a Jewish democratic state whose democratic aspects will be channeled toward the establishment of an exemplary society, one that can express its religious roots within a modern democratic context.Leibowitz thus attaches enormous importance to democracy in terms of both its political components and its modern Orthodox aspirations. In this respect, he is the most radical spokesman of the Neo-Orthodox notion of Torah with Derekh Eretz, as translated into religious-Zionist terms.
Why Is Thought Linguistic? Ockham's Two Conceptions of the Intellect
Authors: Lenz Martin
Published: November 2008

One of Ockham's fundamental tenets about the human intellect is that its acts constitute a mental language. Although this language of thought shares some of the features of conventional language, thought is commonly considered as prior to conventional language. This paper tries to show that this consensus is seriously challenged in Ockham's early writings. I shall argue that, in claiming the priority of conventional language over mental language, Ockham established a novel explanation of the systematicity of thought—an explanation which anticipates the idea that thought becomes systematic through the acquisition of conventional language.
From an Outsider's Point of View: Lorenzo Valla on the Soul
Authors: Nauta Lodi
Published: November 2008

In his Repastinatio. . . Lorenzo Valla launched a heavy attack on Aristotelian-scholastic thought. While most of this book is devoted to metaphysics, language and argumentation, Valla also incorporates chapters on the soul and natural philosophy. Using as criteria good Latin, common sense and common observation, he rejected much of standard Aristotelian teaching on the soul, replacing the hylopmorphic account of the scholastics by an Augustinian one. In this article his arguments on the soul's autonomy, nobility and independency from the body are studied and analysed. His critique of Aristotle's opinions on natural phenomena as being untrue to what we observe will also be briefly studied. His arguments do not show him always to be deep or consistent thinker, but the critical review of Aristotelian philosophy proceeds from some philosophically interesting assumptions. Moreover, from a broader historical perspective his undermining of Aristotle's authority may be regarded as a contribution to the final demise of the Aristotelian paradigm, even though the humanist critique was just one factor in this process.
Recreating Fatima, Aisha and Marginalized Women in the Early Years of Islam: Assia Djebar's Far from Medina (1991)
Authors: Roded Ruth
Published: November 2008

When Francophone creative artist Assia Djebar decided to write a semi-fictional work on the early years of Islam, she brought to this endeavor her life experience in the context of Algerian history and French colonial influence. Her writing reveals changing attitudes towards Algerian women and Islam, in response to ongoing events.Far from Medina was influenced by the chain of modern biographies of the Prophet Muhammad produced in English, French and Arabic. Early Islamic feminist endeavors also informed her work. Most fascinating is the dialogue that Djebar seems to have carried out with classical Islamic texts, revealed in the format and style of the book.Djebar proposes that the death of Muhammad, and to a greater extent the death of his daughter Fatima six months later, were turning points in women's roles in Islamic society—taking the Muslims "Far From Medina," where women were strong and stood up for their rights.
The Influence of Classical Interpretation on the Law of Guarantees in the United Arab Emirates
Authors: Rahman Suhaimi Ab
Published: November 2008

During the past four decades, the world has awakened with the reassertion of Islamic law in the Muslim world. At this point, the reassertion also means the embedment of classical interpretations in modern law as they are regarded as part of Islamic law. The question that arises is how far these classical interpretations bind modern legislators and to what extent, if any, classical interpretations influence the development of modern legal principles. This article seeks to clarify these issues through the examination of the law of guarantees in the United Arab Emirates. Both classical and modern legal sources of the United Arab Emirates have been examined for the above purpose. The study demonstrates that classical interpretation has a profound influence in the development of the law of guarantees in the United Arab Emirates.
The Legal Protection of Databases: a Study of Jordanian Law
Authors: Alqudah Fayyad
Published: November 2008

This article deals with the legal protection of databases under Jordanian law. Section 1, on protection afforded under international conventions and agreements, discusses four international conventions: i.e., the Berne Convention for the Protection of Literary and Artistic Works, Trade Related Aspects of Intellectual Property Rights (TRIPS) Agreement, World Intellectual Property Organization Copyright Treaty (WCT) and Arab Convention on Copyright. Section 1.1. discusses the legal base in Jordan for such protection under international conventions. According to Jordanian law and court practice, international conventions to which Jordan is party have supremacy over the provisions of local law. In Section 1.2., the scope of protection, including exceptions and limitations, is discussed. Databases are protected under these conventions if the selection and arrangement of their content can be shown to be intellectual property. Section 1.3. is devoted to the remedies these conventions offer. It is shown that the TRIPS Agreement includes detailed provisions that afford administrative, precautionary, as well as civil and criminal protection to authors of databases. Section 2.1., on protection under Jordanian law, shows that Jordanian Copyright Law (JCL) provides a legal base for protection of databases in its provisions, as discussed in Section 1.1. The scope of protection, including exceptions and limitations, is presented in Section 2.2. In addition to protecting the author's traditional rights to the database created, JCL has introduced legal measures to protect the technology used to prevent illegal access to databases. Section 2.3. discusses the remedies afforded under local law, i.e., administrative, precautionary measures as well as civil and criminal protection. Also, Jordanian courts have upheld such protection in all areas. Thus, one may conclude that databases are protected under the Jordanian legal system to the same degree upheld in the TRIPS Agreement and in compliance with international standard.
Legal Safeguards in Egypt's Petroleum Concession Agreements
Authors: Khatchadourian Minas
Published: November 2008

This article deals with the concession contracts for the exploration and the production of oil and gas in Egypt. Such tripartite contracts are concluded between the Government of Egypt (GOE) as the host country, a National Oil Company (NOC) as the concession holder and an international oil company (IOC) as the foreign contractor who receives a part of the oil or gas production on a production sharing agreement (PSA). From an Egyptian legal perspective, this contract is qualified as a

State contract

which is supposed to give the Government some exorbitant powers towards its counterparts. However, in order to attract foreign investors into this kind of agreement and encourage international oil companies to explore natural resources, several legal safeguards are incorporated in the concession agreement. Examples of this include placing the contract in the framework of a legislative act, granting the contract a supremacy on any contrary legislation, stabilization clause, adaptation of the contract through renegotiation, arbitration clause, etc.
A Metamodeling Approach to Mechanical Characterization of Anisotropic Plates
Authors: Setiawan R. , Syngellakis S. , Hill M.
Published: November 2008

The proposed characterization method is based on the knowledge of free vibration characteristics of plate specimens. Effective laminate properties are estimated through minimization of the error between known and predicted natural frequencies. Metamodeling is used for approximating the relationship between the material properties and the corresponding natural frequencies. This results in an economical characterization process, applicable to a large number of specimens of various shapes and dimensions. The proposed strategy is first tested on a range of hypothetical composite materials with numerically simulated test results, then applied to reliable published experimental data. It is thus shown to have the potential of a fast and accurate, in-situ characterization tool.
The Effect of Sulfonation Level and Molecular Weight on the Tensile Properties of Polyoxadiazoles
Authors: Loos Marcio R. , Gomes Dominique
Published: November 2008

The tensile properties of sulfonated polyoxadiazoles were studied as a function of molecular weight and sulfonation level. All sulfonated polyoxadiazoles synthesized through a polycondensation reaction of the hydrazine sulphate salt and a dicarboxylic acid in poly(phosphoric acid) exhibit rigid-ductile behavior with high Young’s modulus (3—4 GPa) and with larger elongations at break (up to 120%). Sulfonated polyoxadiazoles with maximum reproducible tensile strength (190 ± 6.9 MPa) could be synthesized in the frame of time of 4—5 h.
Accelerated Hygrothermal and UV Aging of Thermoplastic Polyurethanes
Authors: Jana R.N. , Bhunia H.
Published: November 2008

Thermoplastic polyurethanes (PU) were prepared from 4,4'-diphenyl methane diisocyanate (MDI), polyether polyol and 1,4 butane diol with and without a hindered amine light stabilizer (Tinuvin®-123) and UV absorber (Tinuvin®-400). The accelerated hygrothermal and UV aging were performed at different humidity and aging temperatures for 720, 1440, and 2160 h of exposure, in a Thermotron environmental chamber and QUV chamber, respectively. Fourier transform infrared spectroscopy was used to evaluate the structural changes during aging. The thermal transition for PU, studied by differential scanning calorimetry showed a marginal structural damage after hygrothermal aging. After only 720 h of UV exposure, the neat PU showed a noticeable change in the chemical structure; however, the stabilized one showed almost no change. Tensile strength for the neat PU deteriorated by about 47% after 2160 h of UV exposure; however, the stabilized polyurethane maintained its almost original strength (i.e., 83% retention) after the whole exposure time. The acceleration factor was found to be 6 and the predicted life time for the stabilized polyurethane was about 6 years.
Piezoelectric Energy Harvesting using Single Crystal Pb(Mg1/3Nb2/3)O 3-xPbTiO3 (PMN-PT) Device
Authors: Chengliang Sun  , Lifeng Qin  , Fang Li  , Wang Qing-Ming
Published: November 2008

We present the analytical and experimental studies of a piezoelectric energy harvesting device that can be used as a standalone energy source for powering microsensors and electronics. Single crystal piezoelectric Pb(Mg1/3 Nb2/3)O3-xPbTiO3 (PMN-PT) with large electromechanical coupling coefficient was employed for device design and fabrication in this study. An analytical model for estimating the power-harvesting performance was derived for a cantilever-mounted aluminum alloy plate with a PMN-PT device bonded near the clamped end and a proof mass at the other end. Considering the plate was subjected to both a steady-state sinusoidal vibration and a pulse impact excitation, static, and dynamic analyses were performed for device structure to achieve efficient energy harvesting. In the static analysis, the effect of geometrical dimension of piezoelectric device on the energy harvesting performance has been discussed. In the dynamic analysis, transient response of the device subjected to a pulse impact excitation was studied using a single degree of freedom system model. The resonance characteristics and the power generation capability of the device were discussed. Based on the analytical results, a cantilever device was fabricated and evaluated with sinusoidal excitation and impact excitation. The results are applicable for the structural design of piezoelectric energy harvesting devices.
Integrated Motion Measurement for Flexible Structures using a Modal and Krylov Subspace Model Reduction Approach
Authors: Örtel Thorsten , Wagner Jörg F.
Published: November 2008

Integrated navigation for vehicle guidance is a well-known application of integrated motion measurement systems. For this, the vehicle is modeled as a single rigid body with six degrees of freedom to be determined. Stability problems with these systems occur, but can be avoided by distributing sensors over the vehicle structure. However, in this case the rigid body assumption has to be replaced to take the distributed sensors and the flexibility of the structure into account. By means of a modal approach and Krylov subspaces, appropriate models for the example of a flexible beam have been developed and tested based on simulated data.
Captain Blake versus the Highwaymen: Or, How San Francisco Won the Freeway Revolt
Authors: Johnson Katherine M.
Published: November 2008

The San Francisco freeway revolt was not just the first but the longest 1960s protest against superhighway construction in urban areas. Most accounts attribute this to the city's dramatic natural setting, which fostered an early and insistent aesthetic critique. This article identifies the critical condition in not the city but the state. In 1947, the California legislature reoriented its entire highway program from multipurpose roads to limited-access freeways designed to go directly into cities. Resituating the revolt in this context explains not just its precocity but its duration and intensity. What began as a reasonable assertion of local jurisdiction was transformed into a protracted standoff with the state by the vast new funding of the Interstate and Defense Highway Act of 1956. It also reveals how close the city came to losing the revolt, despite the legitimacy of its claims, and identifies a direct impact of this narrow victory on the emerging environmental movement.