bluuebunny/crossref_metadata_2025 huggingface dataset:
The Spectrum of Dementia: Frequency, Causes and Clinical Profile
Authors: Shelley Bhaskara P. , Al Khabouri Jaber
Published: August 2007

Background and Objective: There is a paucity of epidemiological data on dementia in the Arabian Peninsular region, particularly Oman. To determine the spectrum, clinical profile, and the behavioral manifestations of dementia in Omani patients evaluated at a tertiary referral hospital. Methods: We retrospectively reviewed the demographic and clinical spectrum of 116 patients with probable dementia diagnosed in this center. The diagnosis of dementia was made according to DSM-IV criteria, and staged according to the Clinical Dementia Rating scale. Exclusion criteria included psychiatric disorders, cranial trauma, cerebral tumors, and mild cognitive impairment. The vascular risk patterns and behavioral data were analyzed. Results: Alzheimer’s disease was observed to be the commonest dementia subtype seen in 61 patients (52.6%), while 24.1% had vascular dementia and 9.5% constituted frontotemporal lobar degeneration. Early onset dementia was seen in 45% and potentially reversible dementia constituted 8.6%. Behavioral and psychopathological disturbances in dementia appear to be universal with certain differentiating features between the three major subtypes of dementia. Conclusions: This is the first published report of dementia from Oman. Dementia is an important health problem not only of the elderly but also of the young population in Oman.
Dietary Lutein/Zeaxanthin Partially Reduces Photoaging and Photocarcinogenesis in Chronically UVB-Irradiated Skh-1 Hairless Mice
Authors: Astner S. , Wu A. , Chen J. , Philips N. , Rius-Diaz F. , Parrado C. , Mihm M.C. , Goukassian D.A. , Pathak M.A. , González S.
Published: August 2007

Lutein and zeaxanthin are xanthophyll carotenoids with potent antioxidant properties protecting the skin from acute photodamage. This study extended the investigation to chronic photodamage and photocarcinogenesis. Mice received either a lutein/zeaxanthin-supplemented diet or a standard nonsupplemented diet. Dorsal skin of female Skh-1 hairless mice was exposed to UVB radiation with a cumulative dose of 16,000 mJ/cm2 for photoaging and 30,200 mJ/cm2 for photocarcinogenesis. Clinical evaluations were performed weekly, and the animals were sacrificed 24 h after the last UVB exposure. For photoaging experiments, skin fold thickness, suprapapillary plate thickness, mast cell counts and dermal desmosine content were evaluated. For photocarcinogenesis, samples of tumors larger than 2 mm were analyzed for histological characterization, hyperproliferation index, tumor multiplicity, total tumor volume and tumor-free survival time. Results of the photoaging experiment revealed that skin fold thickness and number of infiltrating mast cells following UVB irradiation were significantly less in lutein/zeaxanthin-treated mice when compared to irradiated animals fed the standard diet. The results of the photocarcinogenesis experiment were increased tumor-free survival time, reduced tumor multiplicity and total tumor volume in lutein/zeaxanthin-treated mice in comparison with control irradiated animals fed the standard diet. These data demonstrate that dietary lutein/zeaxanthin supplementation protects the skin against UVB-induced photoaging and photocarcinogenesis.
An Estimate of the Prevalence of Dementia among Community-Dwelling Elderly in Israel
Authors: Wertman Eli , Brodsky Jenny , King Yaron , Bentur Netta , Chekhmir Svetlana
Published: August 2007

The study goal was to identify the prevalence of dementia among elderly people aged 65 and over living in the community in Israel. The target population included 47,834 community-dwelling elderly aged 65 and over in Jerusalem. Of this population, 1,624 elderly were randomly sampled according to ten strata of sex and age groups. The study included initial screening for ‘suspected’ dementia cases followed by in-depth clinical evaluation to determine whether an individual indeed suffered from dementia. One fifth (19.2%) of the elderly aged 65 and over, living in the community in Jerusalem, were found to have dementia at varying levels of severity. When the specific rates of elderly with dementia in the community in Jerusalem by gender and age groups were applied to data on the total elderly population in the community in Israel at the end of 2002, the prevalence of dementia was an estimated 16.7%. The percentage of elderly with dementia in Israel is in the upper range of rates quoted in other studies. The health and social service systems in Israel will have to make provisions to care for a much larger number of dementia sufferers than has been previously estimated.
Symptoms of Preclinical Dementia in General Practice up to Five Years before Dementia Diagnosis
Authors: Ramakers Inez H.G.B. , Visser Pieter Jelle , Aalten Pauline , Boesten Jos H.M. , Metsemakers Job F.M. , Jolles Jelle , Verhey Frans R.J.
Published: August 2007

Objectives:To investigate which symptoms are indicative of preclinical dementia in general practice and whether subjects with preclinical dementia have an increased contact frequency with their general practitioner (GP). Methods: Individuals with preclinical dementia (n = 75) and non-demented controls (n = 125) were selected from the Dutch GP registration network (RNH). Number of visits and odds ratio for the risk of subsequent dementia of various symptoms were analysed. Analyses were done separately for each 12-month period, in the 5 years prior to the diagnosis of dementia. Results: In the 5 years prior to diagnosis, subjects with preclinical dementia visited their GP more often than controls. Gait disturbances were the earliest predictor. Cognitive complaints were predictive for dementia in the 3 years before diagnosis. All other symptoms, except vascular symptoms, were predictive in the year prior to diagnosis. Sensitivity was highest for cognitive symptoms (0.58) and gait disturbances (0.47) in the year before diagnosis. Conclusion:Preclinical dementia is associated with an increased contact frequency between patient and GP at least 5 years prior to the diagnosis of dementia. Gait disturbances and cognitive complaints are the earliest symptoms of preclinical dementia.
Left Paraduodenal Hernia Successfully Treated with Laparoscopic Surgery: A Case Report
Authors: Shoji Tuyoshi , Nishiyama Raisuke , Oba Koji , Azuma Masaki
Published: August 2007

A 60-year-old Japanese man was referred for examination of abdominal pain. Abdominal MRI exactly demonstrated paraduodenal hernia. Propylthiouracil was administered until the patient became euthyroid, because Graves’ disease was detected during the subsequent general examinations. Laparoscopic repair was then carried out. The sac collar, which had a diameter of about 30 mm, was located lateral to the ascending portion of the duodenum. Bowel incarcerated in the hernia sac was reduced and the hernia orifice closed. The postoperative course was good, and the patient was discharged 7 days after surgery. The diagnosis by MRI has made possible laparoscopic surgery for paraduodenal hernia.
Isoflurane Inhalation after Induction of Endotoxemia in Rats Attenuates the Systemic Cytokine Response
Authors: Flondor M. , Hofstetter C. , Boost K.A. , Betz C. , Homann M. , Zwissler B.
Published: August 2007

Background/Aims: Volatile anesthetics are frequently utilized in clinical routine. Isoflurane has been shown to attenuate the response to inflammatory stimuli such as lipopolysaccharide (LPS) when administered before induction of endotoxemia. We aimed therefore to evaluate the effect of isoflurane after administration of LPS on the cytokine release as a therapeutic option. Materials and Methods:21 male Sprague-Dawley rats were randomly assigned to the following groups: animals that received LPS (5 mg/kg, i.v.) without further intervention (LPS group), animals that received continuous inhalation of 1 minimum alveolar concentration (MAC) isoflurane 15 min after administration of LPS (Iso group) and no specific intervention (sham group). Four hours following LPS injection, plasma levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6 and IL-10 were determined. Furthermore, nitrite release from cultured alveolar macrophages was analyzed. Results: Inhalation of isoflurane after induction of endotoxemia attenuated the release of TNF-α (–52%, p < 0.05) and IL-1β (–39%, p < 0.05) as compared to the LPS group, while IL-6 and IL-10 levels were not significantly altered. Nitrite release was significantly increased in the Iso group as compared to the LPS group (+115%, p < 0.05). Conclusion: Inhalation of 1 MAC isoflurane after induction of endotoxemia in rats attenuates the systemic release of proinflammatory cytokines and concurrently enhances the production of nitrite in cultured alveolar macrophages.
Single-Center Experience on Liver Transplantation for Hepatocellular Carcinoma Arising in Alcoholic Cirrhosis: Results and Ethical Issues
Authors: Sotiropoulos G.C. , Beckebaum S. , Lang H. , Frilling A. , Molmenti E.P. , Cicinnati V.R. , Saner F.H. , Erim Y. , Baba H.A. , Malagó M. , Broelsch C.E.
Published: August 2007

Background: Liver transplantation is currently recognized as the optimal treatment for both early hepatocellular carcinoma in the setting of cirrhosis (HCC) as well as for alcoholic liver disease (ALD). The purpose of this study was to evaluate the outcome of patients with HCC and ALD in the absence of viral hepatitic infections. Methods: Twelve recipients were transplanted with a diagnosis of HCC and ALD in the absence of viral hepatitis during a 6-year period. Nine received deceased donor livers, and 3 live donor grafts. Our results were compared to those obtained by a search of the world literature. Results: The postoperative course was uneventful in all but one patient. All recipients experienced a good quality of life postoperatively. Three-year overall and recurrence-free survival rates were 82 and 73%, respectively. Nine patients are currently alive, after a median follow-up of 29 months. Conclusion: This is the first study to evaluate liver transplantation for HCC in ALD. Although outcomes are excellent, the evaluation of patients with ALD and HCC constitutes a challenging topic in transplantation surgery, especially when live liver donation is considered. An interdisciplinary structured approach is recommended, with special emphasis on ethical considerations.
TRPV1-Mediated Diuresis and Natriuresis Induced by Hypertonic Saline Perfusion of the Renal Pelvis
Authors: Zhu Yi , Xie Chaoqin , Wang Donna H.
Published: August 2007

Background: The transient receptor potential vanilloid type 1 (TRPV1) channel is known to be activated by multiple stimuli, albeit its role in mediating renal function is largely unknown. This study was designed to test the hypothesis that TRPV1 mediates diuresis and natriuresis induced by hypertonic saline perfusion into the pelvis. Methods: NaCl or KCl was perfused into the left renal pelvis of rats at a rate without changing renal pelvic pressure. Afferent renal nerve activity (ARNA), urine flow rate (V) and urinary sodium excretion (UNaV) in the presence or absence of selective antagonists of TRPV1, capsazepine (CAPZ), or neurokinin-1 (NK1) receptors, RP67580, were examined. Results: Unilateral renal pelvis perfusion of NaCl at 600 mM, but not 150 or 300 mM, increased ipsilateral ARNA and contralateral V and UNaV, which were blocked by ipsilateral administration of CAPZ or RP67580. In contrast, KCl perfused at 150 or 300 mM, but not 600 mM, increased ipsilateral ARNA and contralateral V and UNaV, which were insensitive to CAPZ. Conclusion: Unilateral hypertonic saline perfusion causes contralateral diuresis and natriuresis via TRPV1 or NK1 activation, indicating that these receptors may play a critical role in sensing microenvironmental changes in the renal pelvis to modulate renal function in health and disease.
A Novel Mutation of COL4A3 Presents a Different Contribution to Alport Syndrome and Thin Basement Membrane Nephropathy
Authors: Hou Ping , Chen Yuqing , Ding Jiaxiang , Li Guangtao , Zhang Hong
Published: August 2007

Background: Alport syndrome (AS) and thin basement membrane nephropathy (TBMN) are heterogeneous renal hereditary diseases. Mutations of COL4A3 and COL4A4 genes were reported to be the underlying pathogenicity in both diseases. However, the mechanism of the same mutation causing totally different clinical processes and outcomes in AS and TBMN is still not clear. Subjects and Methods: Mutations of all coding exons of COL4A3 and COL4A4 were screened in a patient with autosomal recessive Alport syndrome (ARAS) of a Chinese Han consanguineous family by means of PCR and direct sequencing. Furthermore, the identified mutation was validated by restriction endonuclease AvaII in all 20 members in his family, as well as 46 patients with TBMN, 2 patients with AS from another two families, and 50 healthy controls. Results: A novel missense mutation (3725G>A, G1242D) in exon 42 of COL4A3 was identified in the proband in the homozygous form. This pathogenic mutation was demonstrated in all carriers who presented with hematuria or mild proteinuria in the heterozygous form, whereas it was not detected in others whose urinalysis was normal within the family. In addition, 10 polymorphisms, including 1 non-glycine missense variant and 9 neutral polymorphisms, were detected in COL4A3/COL4A4. Conclusion: The novel mutation (3725G>A, G1242D) of COL4A3 was the underlying pathogenic role in the homozygous form in ARAS and in the heterozygous form in TBMN within an identical family. The result provided a potentially useful clue for the functional investigation of COL4A3 in these two hereditary glomerular disorders.
Stapes Surgery: A 32-Year Follow-Up
Authors: Karhuketo Tapio S. , Lundmark Jari , Vanhatalo Johanna , Rautiainen Markus , Sipilä Markku
Published: August 2007

Despite a widespread use of stapes surgery, little is known about the long-term durability of hearing results. The present study provides data over a long time frame (32 years) on hearing changes following surgical treatment. During a 10-year period (1965–1975) stapes surgery was performed in 322 consecutive patients in Tampere University Hospital, Finland. Postoperative evaluation was performed in the same hospital during the years 2001 and 2002 in 58 patients (41 females, 17 males). Of these 58 patients, 68 ears were operated decades ago (stapedoplasty in 67 ears and stapes mobilization in one ear). The mean follow-up time at the latest visit was 32.9 years. At the long-term follow-up, we found that the operative result was very well maintained: 37% of the patients had air-bone gap closure less than 10 dB. Most of the patients (83%) reached postoperative (6–12 months) air-bone gap closure less than 20 dB. The result was maintained by 75% of the patients. Stapes surgery gives a rise to a better social life for the hearing-impaired patient and delays the need for hearing aid in most patients.
CXCR2 Blockade Impairs Angiotensin II–Induced CC Chemokine Synthesis and Mononuclear Leukocyte Infiltration
Authors: Nabah Yafa Naim Abu , Losada Mercedes , Estellés Rossana , Mateo Teresa , Company Chantal , Piqueras Laura , Lopez-Gines Concha , Sarau Henry , Cortijo Julio , Morcillo Esteban J. , Jose Peter J. , Sanz Maria-Jesus
Published: August 2007

Objective—

Angiotensin II (Ang-II) and mononuclear leukocytes are involved in atherosclerosis. This study reports the inhibition of Ang-II–induced mononuclear cell recruitment by CXCR2 antagonism and the mechanisms involved.

Methods and Results—

Ang-II (1 nmol/L, i.p. in rats) induced CXC and CC chemokines, followed by neutrophil and mononuclear cell recruitment. Administration of the CXCR2 antagonist, SB-517785-M, inhibited the infiltration of both neutrophils (98%) and mononuclear cells (60%). SB-517785-M had no effect on the increase in CXC chemokine levels but reduced MCP-1, RANTES, and MIP-1α release by 66%, 63%, and 80%, respectively. Intravital microscopy showed that pretreatment with SB-517785-M inhibited Ang-II–induced arteriolar mononuclear leukocyte adhesion. Stimulation of human umbilical arterial endothelial cells (HUAECs) or whole blood with 1 μmol/L Ang-II induced the synthesis of chemokines. Ang-II increased HUAEC CXCR2 expression, and its blockade caused a significant reduction of MCP-1, -3, and RANTES release, as well as mononuclear cell arrest. Ang-II–induced MIP-1α release from blood cells was also inhibited.

Conclusion—

Mononuclear leukocyte recruitment induced by Ang-II is, surprisingly, largely mediated by the CXC chemokines which appear to induce the release of CC chemokines. Therefore, CXC chemokine receptor antagonists may help to prevent mononuclear cell infiltration and the progression of the atherogenic process.
Angiotensin II Receptor Blocker Inhibits Neointimal Hyperplasia Through Regulation of Smooth Muscle–Like Progenitor Cells
Authors: Yamada Takaaki , Kondo Takahisa , Numaguchi Yasushi , Tsuzuki Michitaka , Matsubara Tatsuaki , Manabe Ichiro , Sata Masataka , Nagai Ryozo , Murohara Toyoaki
Published: August 2007

Objectives—

Angiotensin II (ATII) type 1 receptor (AT1R) blocker (ARB) has been shown to inhibit neointimal formation. Bone marrow–derived mononuclear cells (BM-MNCs) give rise to smooth muscle (SM)-like cells at injured arterial wall and contribute to neointimal formation. However, role of the renin—angiotensin system in the homing process of SM-like cells during neointimal formation is unknown.

Material and Methods—

When human BM-MNCs and peripheral blood MNCs (PB-MNCs) were cultured under treatment with PDGF-BB and bFGF, these cells gave rise to SM-like cells with expression of αSMA, SMemb, and SM1 proteins. RT-PCR showed the expression of AT1R, ATII type 2 receptor (AT2R), αSMA, and SMemb mRNAs. ATII accelerated the differentiation of SM-like cells, which was inhibited by an ARB CV11974 (
P
<0.05). We then examined the effects of ATII, CV11974, and AT2R antagonist PD123319 on neointimal formation and BM-derived SM-like cell incorporation at injured arteries in vivo. BM from green fluorescence protein (GFP)-transgenic mice was transplanted to irradiated WT mice. GFP-BM chimera mice were subjected to wire injury on the left femoral artery. ATII (100 ng/kg/min) stimulated whereas CV11974 (1 mg/kg/d) inhibited neointimal formation. Number of GFP
+
αSMA
+
cells at neointima correlated with the intima/media ratio (
r
=0.69,
P
<0.05).

Conclusion—

BM-derived SM-like progenitor cells contributed to the neointimal formation after arterial injury. ATII accelerated whereas ARB suppressed this process. These are new aspects of the ARB-mediated inhibition of atherosclerotic disease progression.
Is There a Role for Fibrates in the Management of Dyslipidemia in the Metabolic Syndrome?
Authors: Barter Philip J. , Rye Kerry-Anne
Published: August 2007

The outcomes of fibrate trials have varied: positive with gemfibrozil in the primary prevention Helsinki Heart Study and the secondary prevention VA-HIT trial; positive with reservations in the primary prevention WHO trial (clofibrate); and mixed with bezafibrate in the secondary prevention BIP study and with fenofibrate in the combined primary and secondary prevention FIELD study. Overall, the mixed results, combined with potential for adverse effects when given in combination with statins, have limited the use of these fibrates as cardioprotective agents. However, post hoc analyses of several of the fibrate studies have shown that people with features of the metabolic syndrome, particularly overweight people with high plasma triglyceride levels and low levels of HDL cholesterol, derive a disproportionately large reduction in cardiovascular events when treated with these agents. Thus, there is a strong case for the use of a fibrate to reduce the cardiovascular risk in overweight people with high triglyceride and low HDL-C. However, it should be noted that such people also have their cardiovascular risk reduced by statin therapy. It remains to be determined whether the combination of a fibrate plus statin reduces the risk beyond that achieved with a statin alone.
Important Role of Nox4 Type NADPH Oxidase in Angiogenic Responses in Human Microvascular Endothelial Cells In Vitro
Authors: Datla Srinivasa Raju , Peshavariya Hitesh , Dusting Gregory J. , Mahadev Kalyankar , Goldstein Barry J. , Jiang Fan
Published: August 2007

Objective—

Redox signaling mediated by Nox2-containing NADPH oxidase has been implicated in angiogenic responses both in vitro and in vivo. Because Nox4 type NADPH oxidase is also highly expressed in endothelial cells, we studied the role of Nox4 in angiogenic responses in human endothelial cells in culture.

Methods and Results—

Inhibition of Nox4 expression by small interfering RNA reduced angiogenic responses as assessed by the tube formation and wound healing assays, in both human microvascular and umbilical vein endothelial cells. Overexpression of wild-type Nox4 enhanced, whereas expression of a dominant negative form of Nox4 suppressed the angiogenic responses in endothelial cells. These effects were mimicked by exogenous H
2
O
2
and the antioxidant compound ebselen, respectively. Overexpression of Nox4 enhanced receptor tyrosine kinase phosphorylation and the activation of extracellular signal-regulated kinase (Erk). Inhibition of the Erk pathway reduced the endothelial angiogenic responses. Nox4 expression also promotes proliferation and migration of endothelial cells, and reduced serum deprivation–induced apoptosis.

Conclusions—

Nox4 type NADPH oxidase promotes endothelial angiogenic responses, at least partly, via enhanced activation of receptor tyrosine kinases and the downstream Erk pathway.
Resequencing Genomic DNA of Patients With Severe Hypertriglyceridemia (MIM 144650)
Authors: Wang Jian , Cao Henian , Ban Matthew R. , Kennedy Brooke A. , Zhu Siqi , Anand Sonia , Yusuf Salim , Pollex Rebecca L. , Hegele Robert A.
Published: August 2007

Objective—

The genetic determinants of severe hypertriglyceridemia (HTG; MIM 144650) in adults are poorly defined. We therefore resequenced 3 candidate genes, namely
LPL
,
APOC2
, and
APOA5
, to search for accumulation of missense mutations in patients with severe HTG compared with normolipidemic subjects.

Methods and Results—

We resequenced >2 million base pairs of genomic DNA from 110 nondiabetic patients with severe HTG and determined the prevalence of coding sequence variants compared with 472 age- and sex-matched normolipidemic controls. We found: (1) heterozygous mutations (
LPL
p.Q-12E >11X, p.D25H, p.W86R, p.G188E, p.I194T and p.P207L;
APOC2
p.K19T and IVS2–30G>A) in 10.0% of severe HTG patients compared with 0.2% of controls (carrier odds ratio [OR] 52, 95% confidence interval [CI] 8.6 to 319); and (2) an association of the
APOA5
p.S19W missense variant with severe HTG (carrier OR 5.5 95% CI 3.3 to 9.1). Furthermore, either rare mutations or the
APOA5
p.S19W variant were found in 41.8% of HTG subjects compared with 8.9% of controls (carrier OR 7.4, 95% CI 4.5 to 12.0). Also, heterozygotes for rare mutations had a significantly reduced plasma triglyceride response to fibrate monotherapy.

Conclusions—

Both common and rare DNA variants in candidate genes were found in a substantial proportion of severe HTG patients. The findings underscore the value of candidate gene resequencing to understand the genetic contribution in complex lipoprotein and metabolic disorders.
Natural Killer Cells and CD4
+
T-Cells Modulate Collateral Artery Development
Authors: van Weel V. , Toes R.E.M. , Seghers L. , Deckers M.M.L. , de Vries M.R. , Eilers P.H. , Sipkens J. , Schepers A. , Eefting D. , van Hinsbergh V.W.M. , van Bockel J.H. , Quax P.H.A.
Published: August 2007

Objective—

The immune system is thought to play a crucial role in regulating collateral circulation (arteriogenesis), a vital compensatory mechanism in patients with arterial obstructive disease. Here, we studied the role of lymphocytes in a murine model of hindlimb ischemia.

Methods and Results—

Lymphocytes, detected with markers for NK1.1, CD3, and CD4, invaded the collateral vessel wall. Arteriogenesis was impaired in C57BL/6 mice depleted for Natural Killer (NK)-cells by anti-NK1.1 antibodies and in NK-cell–deficient transgenic mice. Arteriogenesis was, however, unaffected in Jα281-knockout mice that lack NK1.1
+
Natural Killer T (NKT)-cells, indicating that NK-cells, rather than NKT-cells, are involved in arteriogenesis. Furthermore, arteriogenesis was impaired in C57BL/6 mice depleted for CD4
+
T-lymphocytes by anti-CD4 antibodies, and in major histocompatibility complex (MHC)-class-II–deficient mice that more selectively lack mature peripheral CD4
+
T-lymphocytes. This impairment was even more profound in anti-NK1.1-treated MHC-class-II–deficient mice that lack both NK- and CD4
+
T-lymphocytes. Finally, collateral growth was severely reduced in BALB/c as compared with C57BL/6 mice, 2 strains with different bias in immune responsiveness.

Conclusions—

These data show that both NK-cells and CD4
+
T-cells modulate arteriogenesis. Promoting lymphocyte activation may represent a promising method to treat ischemic disease.
Cholesterol Accumulation Is Increased in Macrophages of Phospholipid Transfer Protein-Deficient Mice
Authors: Ogier Nicolas , Klein Alexis , Deckert Valérie , Athias Anne , Bessède Ginette , Le Guern Naig , Lagrost Laurent , Desrumaux Catherine
Published: August 2007

Objective—

Phospholipid transfer protein (PLTP) is a multifunctional, extracellular lipid transport protein that plays a major role in lipoprotein metabolism and atherosclerosis. Recent in vivo studies suggested that unlike systemic PLTP, macrophage-derived PLTP would be antiatherogenic. The present study aimed at characterizing the atheroprotective properties of macrophage-derived PLTP.

Methods and Results—

Peritoneal macrophages were isolated from PLTP-deficient and wild-type mice and their biochemical characteristics were compared. It is shown that macrophages isolated from PLTP-deficient mice have increased basal cholesterol content and accumulate more cholesterol in the presence of LDL compared with wild-type cells. Cholesterol parameters in macrophages of PLTP-deficient mice were normalized by dietary α-tocopherol supplementation.

Conclusions—

The antiatherogenic properties of macrophage-derived PLTP are related at least in part to its ability to reduce cholesterol accumulation in macrophages through changes in the α-tocopherol content and oxidative status of the cells.
Small Concentrations of oxLDL Induce Capillary Tube Formation From Endothelial Cells via LOX-1–Dependent Redox-Sensitive Pathway
Authors: Dandapat Abhijit , Hu Changping , Sun Liuqin , Mehta Jawahar L.
Published: August 2007

Objective—

Vascular endothelial growth factor (VEGF), a key angiogenic growth factor, stimulates angiogenesis. Low levels of reactive oxygen species (ROS) function as signaling molecules for angiogenesis. We postulated that low concentrations of oxLDL might induce low levels of ROS and initiate angiogenesis.

Methods and Results—

An in vitro model of tube formation from human coronary artery endothelial cells (HCAECs) was used. oxLDL (0.1, 1, 2, 5 μg/mL) induced VEGF expression and enhanced tube formation. oxLDL-mediated VEGF expression and tube formation were suppressed by a specific blocking anti–LOX-1 antibody. Anti–LOX-1 antibody also reduced oxLDL-induced increase in the expression of NADPH oxidase (gp91
phox
and p47
phox
subunits) and subsequent intracellular ROS generation, phosphorylation of p38 as well as p44/42MAPK, and NF-κB p65 expression. gp91
phox
siRNA had a similar effect. The expression of VEGF and NF-κB p65 induced by oxLDL was also inhibited by the specific extracellular signal-regulated kinase (ERK) 1/2 inhibitor U0126 and the p38 MAPK inhibitor SB203580. Importantly, the NADPH oxidase inhibitor apocynin, gp91
phox
siRNA, U0126, and SB203580 all reduced tube formation in response to oxLDL.

Conclusions—

These findings suggest that small concentrations of oxLDL promote capillary tube formation by inducing the expression of VEGF via LOX-1-mediated activation of NADPH oxidase- MAPKs-NF-κB pathway.
Risk Factors Related to Infections of Implanted Pacemakers and Cardioverter-Defibrillators
Authors: Klug Didier , Balde Mamadou , Pavin Dominique , Hidden-Lucet Françoise , Clementy Jacques , Sadoul Nicolas , Rey Jean Luc , Lande Gilles , Lazarus Arnaud , Victor Jacques , Barnay Claude , Grandbastien Bruno , Kacet Salem
Published: August 2007

Background—

The Prospective Evaluation of Pacemaker Lead Endocarditis study is a multicenter, prospective survey of the incidence and risk factors of infectious complications after implantation of pacemakers and cardioverter-defibrillators.

Methods and Results—

Between January 1, 2000, and December 31, 2000, 6319 consecutive recipients of implantable systems were enrolled at 44 medical centers and followed up for 12 months. All infectious complications were recorded, and their occurrence was related to the baseline demographic, clinical, and procedural characteristics. Among 5866 pacing systems, 3789 included 2 and 117 had >2 leads; among 453 implantable cardioverter-defibrillators, 178 were dual-lead systems. A total of 4461 de novo implantations occurred and 1858 pulse generator or lead replacements. Reinterventions were performed before hospital discharge in 101 patients. Single- and multiple-variable logistic regression analyses were performed to identify risk factors; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. At 12 months, device-related infections were reported in 42 patients (0.68%; 95% CI, 0.47 to 0.89). The occurrence of infection was positively correlated with fever within 24 hours before the implantation procedure (aOR, 5.83; 95% CI, 2.00 to 16.98), use of temporary pacing before the implantation procedure (aOR, 2.46; 95% CI, 1.09 to 5.13), and early reinterventions (aOR, 15.04; 95% CI, 6.7 to 33.73). Implantation of a new system (aOR, 0.46; 95% CI, 0.24 to 0.87) and antibiotic prophylaxis (aOR, 0.4; 95% CI, 0.18 to 0.86) were negatively correlated with risk of infection.

Conclusions—

This study identified several factors of risk of device infection and confirmed the efficacy of antibiotic prophylaxis in recipients of new or replacement pacemakers or implantable cardioverter-defibrillators.
Cardiac Arrest in Schools
Authors: Lotfi Katayoun , White Lindsay , Rea Tom , Cobb Leonard , Copass Michael , Yin Lihua , Becker Linda , Eisenberg Mickey
Published: August 2007

Background—

The purpose of the present study is to improve understanding of the epidemiology of cardiac arrest in the school setting, with a special focus on the role of school-based automated external defibrillators.

Methods and Results—

The investigation was a retrospective study of emergency medical service–treated, nontraumatic, out-of-hospital cardiac arrests in Seattle and King County, Washington, that occurred in schools between 1990 and 2005. Cases were identified with cardiac arrest location data from emergency medical service cardiac arrest registries. Patient characteristics, cardiac arrest characteristics, and outcome information were abstracted from the registries and incident report forms. During the study period, 97 cardiac arrests occurred in schools, accounting for 0.4% of all treated cardiac arrests and 2.6% of public location cardiac arrests. Of the 97 cases, 12 cardiac arrests were among students, 33 among faculty and staff, and 45 among adults not employed by the school (7 adults with indeterminate school association). School-based cardiac arrest occurred on average in 1 of 111 schools annually, with a greater annual incidence among colleges (1 cardiac arrest per 8 colleges) than high schools (1 per 125 high schools) or lower-level schools (1 cardiac arrest per 200 preschools through middle schools). The estimated annual incidence of cardiac arrest was 0.18 per 100 000 person-years among students and 4.51 per 100 000 person-years for school faculty and staff.

Conclusions—

The present study characterizes school-setting cardiac arrest and provides a framework within which to consider preparation efforts and outcome expectations.
Recombinant Vascular Endothelial Growth Factor 121 Attenuates Hypertension and Improves Kidney Damage in a Rat Model of Preeclampsia
Authors: Li Zhihe , Zhang Ying , Ying Ma Jing , Kapoun Ann M. , Shao Qiming , Kerr Irene , Lam Andrew , O’Young Gilbert , Sannajust Frederick , Stathis Peter , Schreiner George , Karumanchi S. Ananth , Protter Andrew A. , Pollitt N. Stephen
Published: August 2007

Inhibitors of angiogenic factors are known to be upregulated, and their levels increase in the maternal circulation before the onset of preeclampsia. We reproduced a previously characterized model of preeclampsia by adenoviral overexpression of the soluble vascular endothelial growth factor (VEGF) receptor sFlt-1 (also referred to as sVEGFR-1) in pregnant and nonpregnant Sprague-Dawley rats. Animals were treated with VEGF121 at 0, 100, 200, or 400 μg/kg once or twice daily (n=8 per group; 64 total) and compared with normal control animals (n=4 per group) by examination of systolic blood pressure, urinary albumin and creatinine, renal histopathology, and glomerular gene expression profiling. sFlt-1 expression induced hypertension with proteinuria and glomerular endotheliosis and significant changes in gene expression. VEGF121 treatment alleviated these symptoms and reversed 125 of 268 sFlt-1–induced changes in gene expression. VEGF121 had beneficial effects in this rat model of preeclampsia without apparent harm to the fetus. Further study of VEGF121 as a potential therapeutic agent for preeclampsia is warranted.
B
leeding
R
isk
A
nalysis in
S
troke
I
maging Before Thrombo
L
ysis (BRASIL)
Authors: Fiehler Jens , Albers Gregory W. , Boulanger Jean-Martin , Derex Laurent , Gass Achim , Hjort Niels , Kim Jong S. , Liebeskind David S. , Neumann-Haefelin Tobias , Pedraza Salvador , Rother Joachim , Rothwell Peter , Rovira Alex , Schellinger Peter D. , Trenkler Johannes
Published: August 2007

Background and Purpose—

There has been speculation that the risk of secondary symptomatic intracranial hemorrhage (SICH) may be increased after thrombolytic therapy in ischemic stroke patients who have cerebral microbleeds (CMBs) on T2*-weighted magnetic resonance imaging. Because of this concern, some centers withhold potentially beneficial thrombolytic therapy from these patients.

Methods—

We analyzed magnetic resonance imaging data acquired within 6 hours after symptom onset from 570 ischemic stroke patients treated with intravenous tissue plasminogen activator in 13 centers in Europe, North America, and Asia. Baseline T2*-weighted magnetic resonance images were evaluated for the presence of CMBs. The primary end point was SICH, defined as clinical deterioration with an increase in the National Institutes of Health Stroke Scale score by ≥4 points, temporally related to a parenchymal hematoma on follow-up-imaging.

Results—

A total of 242 CMBs were detected in 86 of 570 patients (15.1%). The number of CMBs ranged from 1 to 77 in the individual patient, with ≥5 CMBs in 6 of 570 patients (1.1%). Proportions of patients with SICH were 5.8% (95% CI, 1.9 to 13.0) in the presence of CMBs and 2.7% (95% CI, 1.4 to 4.5) in patients without CMBs (
P
=0.170, Fisher’s exact test), resulting in no significant absolute increase in the risk of SICH of 3.1% (95% CI, −2.0 to 8.3).

Conclusions—

The data suggest that if there is any increased risk of SICH attributable to CMBs, it is likely to be small and unlikely to exceed the benefits of thrombolytic therapy. No reliable conclusion regarding risk in the rare patient with multiple CMBs can be reached.
Iron Oxide Particle-Enhanced MRI Suggests Variability of Brain Inflammation at Early Stages After Ischemic Stroke
Authors: Saleh Andreas , Schroeter Michael , Ringelstein Adrian , Hartung Hans-Peter , Siebler Mario , Mödder Ulrich , Jander Sebastian
Published: August 2007

Background and Purpose—

Inflammation contributes to brain damage caused by ischemic stroke. Ultrasmall superparamagnetic iron oxide (USPIO)-enhanced MRI allows noninvasive monitoring of macrophage recruitment into ischemic brain lesions. In this study, we determined the extent of USPIO enhancement during early stages of ischemic stroke.

Methods—

Twelve consecutive patients with typical clinical signs of stroke underwent multimodal stroke imaging at 1.5-T within 24 hours of symptom onset. They received intravenous USPIO (ferumoxtran) infusion at 26 to 96 hours (mean, 44 hours) after stroke. A total of four follow-up MRI scans were performed 24 to 36 hours, 48 to 72 hours, 7 to 8 days, and 10 to 11 days after USPIO infusion.

Results—

Nine patients were included in the final analysis. Parenchymal USPIO enhancement occurred in 3 of 9 analyzed patients and was mainly evident on T1-weighted spin-echo images. USPIO-dependent signal changes were spatially heterogeneous, reflecting the distinct patterns of hematogenous macrophage infiltration in different lesion types.

Conclusions—

Our findings suggest a variable extent and distribution of macrophage infiltration into early ischemic stroke lesions. USPIO-enhanced MRI may help to more specifically target antiinflammatory therapy in patients with stroke.
The Impact of Ambulance Practice on Acute Stroke Care
Authors: Mosley Ian , Nicol Marcus , Donnan Geoffrey , Patrick Ian , Kerr Fergus , Dewey Helen
Published: August 2007

Background and Purpose—

Few patients with acute stroke are treated with alteplase, often due to significant prehospital delays after symptom onset. The aims of this study were to: (1) identify factors associated with rapid first medical assessment in the emergency department after a call for ambulance assistance, and (2) determine the impact of ambulance practice on times from the ambulance call to first medical assessment in the emergency department.

Methods—

During a 6-month period in 2004, all ambulance-transported patients with stroke or transient ischemic attack arriving from a geographically defined region in Melbourne, Australia (population 383 000) to one of 3 hospital emergency departments were assessed prospectively. Ambulance records including the tape recording of the call for ambulance assistance and hospital medical records, were analyzed.

Results—

One hundred ninety-eight patients were included in the study. One hundred eighty-seven ambulance patient care records were complete and available for analysis. Factors associated with first medical assessment in the emergency department <60 minutes from the ambulance call and <10 minutes from hospital arrival were: Glasgow Coma Scale <13 (
P
<0.001 and
P
=0.021) and hospital prenotification (
P
=0.04 and
P
<0.001). Paramedic stroke recognition and hospital prenotification were associated with shorter times from the ambulance call to first medical assessment (
P
=0.001 and
P
<0.001).

Conclusions—

Paramedic stroke recognition and hospital prenotification are associated with shorter prehospital times from the ambulance call to hospital arrival and in-hospital times from hospital arrival to first medical assessment. This highlights the importance of including ambulance practice in comprehensive care pathways that span the whole process of stroke care.
A Fuzzy Logic Algorithm for the Separation of Precipitating from Nonprecipitating Echoes Using Polarimetric Radar Observations
Authors: Gourley Jonathan J. , Tabary Pierre , Parent du Chatelet Jacques
Published: August 2007

A fuzzy logic algorithm has been developed for the purpose of segregating precipitating from nonprecipitating echoes using polarimetric radar observations at C band. Adequate polarimetric descriptions for each type of scatterer are required for the algorithm to be effective. An observations-based approach is presented in this study to derive membership functions and objectively weight them so that they apply directly to conditions experienced at the radar site and to the radar wavelength. Three case studies are examined and show that the algorithm successfully removes nonprecipitating echoes from rainfall accumulation maps.
Impact of Accurate Geoid Fields on Estimates of the Ocean Circulation
Authors: Stammer Detlef , Köhl Armin , Wunsch Carl
Published: August 2007

The impact of new geoid height models on estimates of the ocean circulation, now available from the Gravity Recovery and Climate Experiment (GRACE) spacecraft, is assessed, and the implications of far more accurate geoids, anticipated from the European Space Agency’s (ESA) Gravity and Ocean Circulation Explorer (GOCE) mission, are explored. The study is based on several circulation estimates obtained over the period 1992–2002 by combining most of the available ocean datasets with a global general circulation model on a 1° horizontal grid and by exchanging only the EGM96 geoid model with two different geoid models available from GRACE. As compared to the EGM96-based solution, the GRACE geoid leads to an estimate of the ocean circulation that is more consistent with the Levitus temperature and salinity climatology. While not a formal proof, this finding supports the inference of a substantially improved GRACE geoid skill. However, oceanographic implications of the GRACE model are only modest compared to what can be obtained from ocean observations alone. To understand the extent to which this is merely a consequence of a not-optimally converged solution or if a much more accurate geoid field could in principle play a profound role in the ocean estimation procedure, an additional experiment was performed in which the geoid error was artificially reduced relative to all other datasets. Adjustments occur then in all elements of the ocean circulation, including 10% changes in the meridional overturning circulation and the corresponding meridional heat transport in the Atlantic. For an optimal use of new geoid fields, improved error information is required. The error budget of existing time-mean dynamic topography estimates may now be dominated by residual errors in time-mean altimetric corrections. Both these and the model errors need to be better understood before improved geoid estimates can be fully exploited. As is commonly found, the Southern Ocean is of particular concern.
Lidar-Based Characterization of the Geometry and Structure of Water Clouds
Authors: Bissonnette Luc R. , Roy Gilles , Tremblay Grégoire
Published: August 2007

Lidar remote sensing measurements of low-level water clouds in the form of vertical soundings and instantaneous (∼1 min) azimuth-over-elevation scans are reported. Retrievals are made of the liquid water content and effective droplet diameter at the same range, time, and angular resolutions as those of the measurements. The results are presented as time–height plots and two-dimensional horizontal maps of the retrieved parameters. The cloud structure is resolved by calculating histograms, spatial autocorrelation functions, and power spectra. The distribution of the horizontal inhomogeneities is characterized over the size range from 10 to ∼1000 m. The Kolmogorov −5/3 power-law dependence is verified in all cases, but the −5/3 regime is broken into two subregimes that are separated by a sudden increase in the energy density level. The results illustrate how lidars can contribute meaningful information on cloud structure at high spatial and temporal resolutions, in near–real time, and over extended periods of time.
The Journals of Ernest Becker, 1964-1969
Authors: Kramer Robert
Published: August 2007

Written from 1964 until 1969, the year in which Ernest Becker rediscovered the writings of Otto Rank, these journals offer a poignant answer to Becker's call to all of us, and most of all to himself, in his Pulitzer Prize—winning The Denial of Death (1973)— becoming “conscious of what one is doing to earn [one's] feeling of heroism is the main self-analytic problem of life.” Reflecting on what he was doing to earn his own feeling of heroism, Becker offers in these journals glimmers of hope for the future impact of his work as well as a riveting self-analysis of his dreams and nightmares.
“The Royal We”
Authors: Humble Áine M. , Zvonkovic Anisa M. , Walker Alexis J.
Published: August 2007

Family rituals provide a rich context in which to study the relation between ideology and action. Guided by the gender perspective, this article analyzes the experiences of 21 newly married heterosexual couples who described how they planned their weddings. The interplay among gender ideology, gender display, and gender assessment differed across three types of couples: traditional ( n = 6), transitional ( n = 10), and egalitarian ( n = 5). An examination of gender assessment in transitional couples illustrates how holding competing ideologies contributes to the reproduction of hegemonic gendered work patterns within wedding planning.
Combined Proximal and Distal Realignment Procedures to Treat the Habitual Dislocation of the Patella in Adults
Authors: Shen Hsain-Chung , Chao Kuo-Hua , Huang Guo-Shu , Pan Ru-Yu , Lee Chian-Her
Published: August 2007

Background

Habitual dislocation of the patella (HDP) is a rare condition. Many surgical procedures using proximal realignment have been reported to treat HDP in children, with around 80% satisfactory results. However, few articles have addressed the treatment of HDP associated with high-grade patellofemoral chondromalacia in adults.

Hypothesis

A combination of proximal and distal realignment procedures of the patella will reduce pain and increase function in adult patients with HDP.

Study Design

Case series; Level of evidence, 4.

Methods

Twelve patients with 13 symptomatic cases of HDP of the knee underwent surgical treatment that included lateral release, medial retinaculum advancement, and the anteromedial tibial tubercle transfer procedure. The average period between dislocation and surgery was 10.8 years. One patient had an additional procedure, an open-wedge varus corrective osteotomy of the distal femur, because of a 20° valgus deformity of the knee. The patellofemoral morphology study included routine and Merchant views of the knee and a computed tomography scan at full extension and at 30° flexion of the knee, before the operation and at follow-up. Any associated intra-articular pathologic findings during the surgical procedure were addressed. Patellofemoral function was evaluated with the Kujala functional score before surgery and at the time of the final follow-up.

Results

Chondromalacia of the patella over the medial facet and central ridge was grade III in 8 knees and grade IV in 5 knees. Corresponding chondral erosion of the lateral femoral condyle was noted in every knee. All patients were followed for an average period of 67.3 months (range, 25-103 months). The average preoperative Kujala functional score was 43.9 and the average postoperative score was 88.9 (P < .05). Radiographically, there was a statistically significant improvement in the congruence angle from 62.1° ± 15.0° preoperatively to —2.7° ± 9.8° postoperatively (P < .01) and in the lateral patellofemoral angle from —40.2° ± 9.3° preoperatively to 1.4° ± 7.0° postoperatively (P < .01). No patient has reported an episode of patellar dislocation after the surgical procedures.

Conclusion

Combined proximal and distal realignments of the patella effectively treat HDP in adults with associated high-grade patellofemoral chondromalacia.