bluuebunny/crossref_metadata_2025 huggingface dataset:
Big‐bubble deep anterior lamellar keratoplasty for post‐keratitis and post‐traumatic corneal stromal scars
Authors: Venkataratnam Sathyamurthy , Ganekal Sunil , Dorairaj Syril , Kolhatkar Tripti , Jhanji Vishal
Published: December 2011

Abstract

Background:  Evaluation of outcomes of big‐bubble deep anterior lamellar keratoplasty in cases with post‐keratitis and post‐traumatic corneal scars.

Design:  Interventional case series.

Participants:  Patients with corneal stromal scarring secondary to healed infectious keratitis or trauma were recruited from the Corneal Clinic of the M. M. Joshi Eye Institute, Karnataka, India between August 2007 and December 2009.

Methods:  All patients underwent big‐bubble deep anterior lamellar keratoplasty surgery.

Main Outcome Measures:  Best‐corrected visual acuity, as well as intra‐ and postoperative complications.

Results:  Big‐bubble deep anterior lamellar keratoplasty was performed in 36 patients (25 males, 11 females) with post‐infectious keratitis (n = 22) and post‐traumatic (n = 14) corneal stromal scars sparing the Descemet's membrane and endothelium. Mean age was 39.7 ± 11.3 years (range: 22–58 years). Although a big bubble was achieved in all eyes (100%), intraoperative perforation of the Descemet's membrane occurred in six eyes (16%) during stromal dissection. Two cases required conversion to penetrating keratoplasty. A double anterior chamber occurred in the immediate postoperative period in three cases (8.3%). Raised intraocular pressure was seen in one eye. Mean preoperative best‐corrected visual acuity (0.03 ± 0.04) improved significantly at the end of 6 months follow‐up postoperatively (0.43 ± 0.20; P < 0.01, Wilcoxon signed‐ranks test). Corneal stromal graft rejection was noted in two cases (5.5%) during the first 3 months after surgery. Graft failure occurred in two cases (5.5%).

Conclusions:  Deep anterior lamellar keratoplasty using the big‐bubble technique is a viable option in cases with post‐infectious keratitis and post‐traumatic corneal stromal scarring with normal Descemet's membrane and endothelium.
Impact of gender on first eye cataract surgery and motor vehicle crash risk for older drivers
Authors: Meuleners Lynn B , Ng Jonathon Q , Fraser Michelle , Hendrie Delia , Morlet Nigel
Published: December 2011

Abstract

Background:  No study to date has examined gender differences in crash risk after cataract surgery. Therefore, this study aimed to determine gender‐related differences in the effectiveness of first eye cataract surgery in reducing crash risk for older drivers.

Design:  This retrospective before and after study used whole population linked data to compare the frequency of police reported crashes 1 year before and 1 year after first eye cataract surgery for the years 1997–2006.

Participants:  All patients aged 60–85 years who had first eye cataract surgery between 1997 and 2006 in Western Australia and were involved in a motor vehicle crash 12 months before and/ or after surgery.

Methods:  Two separate generalized estimating equation Poisson models were undertaken for males and females to compare crash frequency before and after surgery.

Main Outcome Measures:  Police‐reported crashes before and after cataract surgery.

Results:  A large proportion of the cohort involved in a crash either 1 year before or 1 year after first eye cataract surgery were male (n = 1091, 63.6%) compared with female (n = 624, 36.3%). Results from the generalized estimating equation Poisson models showed a significant reduction of 15.3% (P = 0.040) in all police reported crash frequency for males 1 year after cataract surgery. However, there was no significant change in crash frequency after surgery for females.

Conclusions:  The results of this study suggest that clinicians may need to take gender into account when advising patients on driving safety before and after cataract surgery.
Current medical students' understanding of Surgical Education and Training
Authors: Farah Sam , Winter Matthew , Smith Julian A.
Published: December 2011

Background:  The current Surgical Education and Training (SET) programme in Australia and New Zealand has been implemented to streamline surgical training. As applications to the SET programme can occur as early as the 2nd post‐graduate year, early preparation is vital to ensure a successful outcome in gaining a SET position. We wish to demonstrate to what degree medical students are aware of the SET structure and application requirements to determine if further assistance to future SET candidates is required.

Methods:  A standardized questionnaire was delivered to students of an Australian Medical School via an online medium. Ethics approval was granted, and all surveys were completed anonymously and voluntarily. One hundred eighty‐two completed surveys were received.

Results:  Eighteen percent of surveyed participants felt they had a good understanding of the SET programme, with 82% stating they had minimal or no understanding of the programme. Fourteen percent felt they had the information needed to pursue a career in surgery. Fifty‐three percent were unaware that the College outlined areas of core competencies required in their training, with 75% unable to name any core competencies.

Conclusion:  There are a large proportion of medical students potentially considering a career in surgery. However, only a small number feel that they have been adequately equipped throughout their medical course to understand the steps needed to build a strong application for SET.
Gum chewing during pre‐anesthetic fasting
Authors: Poulton Thomas J.
Published: December 2011

Many ad hoc fasting guidelines for pre‐anesthetic patients prohibit gum chewing. We find no evidence that gum chewing during pre‐anesthetic fasting increases the volume or acidity of gastric juice in a manner that increases risk, nor that the occasional associated unreported swallowing of gum risks subsequent aspiration. On the contrary, there is evidence that gum chewing promotes gastrointestinal motility and physiologic gastric emptying. Recommendations against pre‐anesthetic gum chewing do not withstand scrutiny and miss an opportunity to enhance comfort and sense of wellbeing for patients awaiting anesthesia. Gum chewing during the pre‐anesthetic nil per os (NPO) period would also permit the development of gum‐delivered premedications and should be permitted in children old enough to chew gum safely. Gum chewing should cease when sedatives are given and all patients should be instructed to remove any chewing gum from the mouth immediately prior to anesthetic induction.
A comparison of inhalational inductions for children in the operating room vs the induction room
Authors: Varughese Anna M. , Hagerman Nancy , Patino Mario , Wittkugel Eric , Schnell Beverly , Salisbury Shelia , Kurth Dean
Published: December 2011

Background:  There has been debate about the use of an induction room (IR) compared with an operating room (OR) for inhalational induction in children. The quality of the anesthesia induction between these two physical environments has not been studied previously. We sought to compare child distress, OR utilization and efficiency, and parental satisfaction and safety, between an IR and an OR.

Methods:  In a prospective observational study, we studied 501 developmentally appropriate children ages 1–14 years, American Society of Anesthesiologists (ASA) physical status I–III, presenting for the inhalational induction of anesthesia, undergoing outpatient or outpatient‐admit ENT surgery. Inductions were performed in an IR (IR group) or OR (OR group) with parent(s) present. Child behavioral compliance was assessed using the Induction Compliance Checklist (ICC), a validated observational scale from 0 to 10 consisting of 10 behaviors; an ICC score ≥4 was considered poor behavioral compliance. Times for transport, anesthesia start, ready for surgery, surgery finish, out of OR, and total case process times were recorded. OR utilization and OR efficiency was derived using these times. Data on number and experience of clinical providers were also collected. Parent satisfaction with the induction was measured using a satisfaction survey. Safety was measured by recording respiratory complications during induction. The chi‐squared test was conducted to determine whether induction location was associated with level of behavioral compliance. A multivariable proportional odds model was used to control for risk factors. OR utilization and efficiency were analyzed using the Wilcoxon–Mann–Whitney test.

Results:  There were no significant differences in ICC scores between the groups (P‐value = 0.12). Anesthesia, nonoperative, and transport time were statistically less in the OR group when compared with the IR group, although total case process times were similar in both groups. While OR efficiency was significantly higher for the OR group (P‐value = 0.0096), OR utilization did not differ between groups (P‐value = 0.288). The OR group had a significantly higher number of anesthesia providers and a more experienced surgical team. Parents in the two groups were equally satisfied with their experience during induction, and none of the subjects had respiratory complications during the anesthesia induction.

Conclusions:  We found no differences in child distress, parent satisfaction, and respiratory complications between inductions conducted in the IR vs the OR. Differences in utilization, efficiency, and turnover were minimal and not operationally significant. Capital equipment, space, and staffing strategies should be key drivers in considerations for the use of IRs, and in the design of ORs with IRs.
A secretion of the mollusc Cryptomphalus aspersa promotes proliferation, migration and survival of keratinocytes and dermal fibroblasts in vitro
Authors: Iglesias‐de la Cruz M. C. , Sanz‐Rodríguez F. , Zamarrón A. , Reyes E. , Carrasco E. , González S. , Juarranz A.
Published: December 2011

Synopsis

Regenerative properties of skin decrease with age, and thus, the search for substances that minimize cutaneous ageing has increased in the last few years. The secretion of the mollusc Cryptomphalus Aspersa (SCA) is a natural product that bears regenerative properties when applied topically. The purpose of this work is to study the in vitro effects of SCA on cell proliferation and migration, as well as on cell–cell (E‐cadherin and β‐catenin) and cell–substrate (vinculin and β1‐integrin) adhesion proteins expression, using a human keratinocyte cell line (HaCaT cells) and primary dermal fibroblasts (HF). We tested the effects of SCA on cell proliferation using a colorimetric assay. In addition, SCA‐induced changes on cell migration were studied by wound‐healing assays. Besides, Western blot and immunofluorescence microscopy were carried out to test the expression of different cell adhesion proteins. We found that SCA promotes proliferation and migration of HaCaT cells in a time‐ and dose‐dependent manner. Moreover, treatment with SCA increases the migratory behaviour and the expression of adhesion molecules in both HaCaT and HF. Finally, SCA also improves cell survival and promotes phosphorylation of FAK and nuclear localization of β‐catenin. These results shed light on the molecular mechanisms underlying the regenerative properties of SCA, based on its promoting effect on skin cell migration, proliferation and survival. Moreover, these results support future clinical uses of SCA in the regeneration of wounded tissues.
Geometric morphometrics shows differences and similarities in skull shape between the red and giant pandas
Authors: Figueirido B. , Serrano‐Alarcón F. J. , Palmqvist P.
Published: December 2011

A morphometric analysis of the skull of the red or lesser panda, Aiulurus fulgens (Ailuridae), and the giant panda, Ailuropoda melanoleuca (Ursidae), was performed for evaluating the importance of natural selection and phylogenetic constraints in shaping the convergent morphological adaptations of these peculiar carnivores for feeding on bamboo. Principal components and discriminant analyses of landmark data was used in a comparative study across the families Procyonidae, Ursidae and Ailuridae. Skull morphospaces show that major patterns of morphological variation among these arctoid carnivorans correlate with differences in their feeding behavior. More specifically, this study has shown an extreme convergence in skull shape between the two bamboo specialists. Following the most recent molecular and morphological phylogenies, as well as the poor evidence from the fossil record, it seems highly improbable that homology could explain the shared morphology of the giant and red pandas, which lineages diverged ∼40 million years ago. On the contrary, most phylogenetic and paleontological data suggest that convergent or parallel evolution (homoplasy) would be the evolutionary process shaping the common morphological traits of these unusual carnivorans. Therefore, the overall resemblance in skull shape between the giant and red pandas was probably driven by extrinsic factors (natural selection and adaptation for feeding on bamboo) as well as by intrinsic ones (the shared developmental pathway of the carnivoran skull, which posed some biomechanical constraints on the direction of the evolution of pandas).
Integrity of the inferior longitudinal fasciculus and impaired object recognition in children: a diffusion tensor imaging study
Authors: ORTIBUS ELS , VERHOEVEN JUDITH , SUNAERT STEFAN , CASTEELS INGELE , DE COCK PAUL , LAGAE LIEVEN
Published: December 2011

Aim  In this study, we explored the integrity of the inferior longitudinal fasciculus (ILF) by means of diffusion tensor imaging tractography in children with visual perceptual impairment, and more specifically, object recognition deficits, compared with typically developing children.

Methods  Eleven individuals (nine males, two females; mean age 7y 8mo; range 3y 5mo–13y) were assessed with the L94 visual perceptual battery after assessment of performance age. In all participants, an ophthalmological evaluation was carried out. Diffusion tensor imaging tractography of the ILF was performed. The mean fractional anisotropy was determined for every child and compared with data for 11 age‐ and sex‐matched typically developing children.

Results  The mean fractional anisotropy value in the left ILF was consistently lower in the study participants than in the comparison group. The five children with L94 impairment showed a significantly lower ILF fractional anisotropy on the left as well as on the right side. Furthermore, the decrease in ILF fractional anisotropy was correlated with the number of impaired subtests.

Interpretation  The results suggest an association between ILF integrity loss and object recognition deficits. Moreover, the severity of clinical impairment is reflected in the degree of ILF integrity loss. Therefore, the ILF plays a potential role in object recognition.
‘THERE'S NO PLACE LIKE HOME’—NO ISOTOPIC EVIDENCE FOR MOBILITY AT THE EARLY BRONZE AGE CEMETERY OF SINGEN, GERMANY
Authors: OELZE V. M. , NEHLICH O. , RICHARDS M. P.
Published: December 2011

The Early Bronze Age necropolis of Singen (Hohentwiel), located near Lake Constance, represents a population from a period of technological transition in southwestern Germany. The site contains several graves with metal artefacts that originated in other parts of Central and Western Europe, and therefore these could be interpreted as being the graves of non‐local individuals. The purpose of this study was to investigate this possibility through the application of isotopic analysis. The ratios of strontium and oxygen isotopes in human enamel reflect the geological origin of food and drinking water consumed during enamel formation in early life stages. Additionally, the ratio of sulphur isotopes from bone collagen reflects the origin of foods consumed during the last 10–20 years of life of an adult individual. We used these three isotope systems to attempt to identify local and non‐local individuals at the site. We found that the isotope ratios of Sr, O and S of the humans were relatively homogeneous and generally correspond to the isotope signature of the local geology, climate and environment. We conclude that the sampled population is of local origin and does not show patterns of individual mobility, even though there is evidence for long‐distance trade and exchange of the metal artefacts at this site.
THE SUPPLY OF CAMPANIAN‐MADE SIGILLATA TO THE CITY OF POMPEII
Authors: MCKENZIE‐CLARK J.
Published: December 2011

Pompeii is an important temporal reference in the study of Roman ceramics, yet until now the origins of red slip tableware or sigillata found in the city have largely been classified by visual evaluations of the pottery. This investigation employs petrographic and elemental analyses to establish the provenance of sigillata found in two pre–ad 79 contexts of Pompeii. In contrast to previous studies, the results suggest that pottery workshops in the vicinity of Somma‐Vesuvius played a vital role in the supply of sigillata to the city.
Decomposing Racial and Ethnic Disparities in the Use of Postacute Rehabilitation Care
Authors: Holmes George M. , Freburger Janet K. , Ku Li‐Jung E.
Published: December 2011

Objective

To determine the degree to which racial and ethnic disparities in the use of postacute rehabilitation care (PARC) are explained by observed characteristics.

Data Sources

State inpatient databases (SIDs) for 2005 and 2006 from four diverse states were used to identify patients with stays for joint replacement, stroke, or hip fracture.

Study Design

Our primary outcomes were use of institutional PARC (versus discharge home) and, conditional on discharge to an institution, skilled nursing facility (versus inpatient rehabilitation facility) care. We modified the Oaxaca–Blinder decomposition method to account for the dichotomous outcome and multilevel nature of the data.

Data Collection/Extraction Methods

Discharges from the four SIDs were included if the principal diagnosis (stroke, hip fracture) or procedure (joint replacement) was in the sample inclusion criteria.

Principal Findings

Observed characteristics explained roughly half of the unadjusted differences in use of institutional PARC. Patient‐level factors (clinical, age) were more explanatory of disparities in institutional PARC use, while hospital‐level factors were more explanatory of skilled nursing facility versus inpatient rehabilitation facility care.

Conclusions

Adjustment for characteristics influencing PARC use both mitigated and exacerbated racial/ethnic disparities in use. The degree to which the characteristics explained the disparity varied across conditions and outcomes.
No Evidence‐Based Restoration Without a Sound Evidence Base: A Reply to Guldemond et al.
Authors: Ntshotsho Phumza , Reyers Belinda , Esler Karen J.
Published: December 2011

Evidence‐based practice is not possible without an evidence base. Guldemond et al. confuse our attempt at assessing the status of the evidence base of restoration programs in South Africa with attempting to assess whether restoration is evidence‐based. While we fully agree with them that there is a need to assess whether practitioners use evidence in their decision‐making, we assert that use of evidence is the last step in the evidence‐based approach. It is preceded by the generation (and documentation) of evidence through baseline condition assessment, proper goal setting, sound monitoring of the impacts of the chosen intervention as well as effective dissemination of resulting evidence. To answer the question whether restoration is evidence‐based would require the assessment of all stages from generation to use. We chose to start at the beginning, a logical place to start.
miR‐210: The Master Hypoxamir
Authors: CHAN YUK C. , BANERJEE JAIDEEP , CHOI SANG YONG , SEN CHANDAN K.
Published: December 2011

Please cite this paper as: Chan YC, Banerjee J, Choi SY, Sen CK. miR‐210: The master hypoxamir. Microcirculation19: 215–223, 2012.

MicroRNAs are small non‐coding RNAs implicated mainly in post‐transcriptional gene silencing by interacting with the untranslated region of the transcript. miR‐210 represents major hypoxia‐inducible miRs, also known as hypoxamirs, which is ubiquitously expressed in a wide range of cells, serving versatile functions. This review article summarizes the current progress on biogenesis of miR‐210 and its physiological roles including arrest of cell proliferation, repression of mitochondrial respiration, arrest of DNA repair, vascular biology, and angiogenesis. Given the fact that miR‐210 is aberrantly expressed in a number of diseases such as tumor progression, myocardial infarction and cutaneous ischemic wounds, miR‐210 could serve as an excellent candidate for prognostic purposes and therapeutic intervention. With the advancement of computational prediction, high‐throughput target validation methodology, sequencing, proteomic analysis, and microarray, it is anticipated that more down‐stream targets of miR‐210 and its associated biological consequences under hypoxia will be unveiled establishing miR‐210 as a major hub in the biology of hypoxia‐response.
Evaluation of multi‐professional obstetric skills training for postpartum hemorrhage
Authors: MARKOVA VERONIKA , SØRENSEN JETTE LED , HOLM CHARLOTTE , NØRGAARD ASTRID , LANGHOFF‐ROOS JENS
Published: December 2011

Objective. To evaluate the effect of multi‐professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training. Design. A database audit. Setting. University hospital, Rigshospitalet, Copenhagen, Denmark. Population. Women receiving red blood cell (RBC) transfusion up to seven days postpartum before (2003), during (2005), and after (2007) the introduction of training. Methods. Linkage of the Danish Medical Birth Registry and the local transfusion database, followed by audit of medical records. We identified 148 women with RBC transfusion for PPH in 10 461 deliveries and assessed the cause of PPH, surgical interventions and transfusion data. Main outcome measures. RBC transfusion. Delay to surgical intervention. Results. RBC transfusion rates for PPH were 1.5% (2003), 1.6% (2005), and 1.2% (2007) (not statistically significant). The transfusion rates did not change after vaginal delivery but decreased after cesarean section [2.4, 2.1 and 0.7% (p<0.01)]. Transfusion requirements and pre‐transfusion hemoglobin values did not change. The median time from delivery to manual removal of the placenta increased non‐significantly (64, 70 and 75 minutes). The median time from decision to manual removal of the placenta remained unchanged (30 minutes). Conclusion. There was no effect of multi‐professional obstetric skills training on the rate of RBC transfusion for PPH. The unchanged long delay in handling a retained placenta indicates a need for multi‐disciplinary training in collaboration with staff from anesthesiology and the operation theater.
Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans
Authors: Tosta Mauro , Cortes Arthur R. G. , Corrêa Luciana , Pinto Décio dos S. , Tumenas Isabel , Katchburian Eduardo
Published: December 2011

Objective

The present study investigated the efficacy of a biphasic calcium phosphate as a bone grafting material for maxillary sinus augmentation in humans.

Materials and methods

Half of the thirty patients selected for sinus augmentation were grafted with biphasic calcium phosphate, whereas the other half were grafted with autogenous bone chips harvested intraorally. After 9 months of healing, bone cores were retrieved from implant sites for histologic and histomorphometric evaluation.

Results

The areas augmented with autogenous bone chips showed newly formed bone with a pattern very similar to that of the native area. Histomorphometry demonstrated that the amount of newly formed bone in the autogenous bone group was significantly greater than in the biphasic calcium phosphate group (P < 0.05). In the biphasic calcium phosphate group, less bone formation was observed in the area further away from native bone interface than in the area closer to native bone interface (P < 0.05), whereas no significant differences were observed between both areas in the autogenous group. In both groups, the implant survival rate was 100% with a minimum 1‐year follow‐up.

Conclusion

The data presented in this work confirm the osteoconductive properties of biphasic calcium phosphate, as well as its use in association with maxillary sinus floor augmentation procedures with successful outcomes.
Cutaneous leishmaniasis mimicking inflammatory and neoplastic processes: a clinical, histopathological and molecular study of 57 cases
Authors: Saab Jad , Fedda Faysal , Khattab Ruba , Yahya Lamis , Loya Asif , Satti Mohamed , Kibbi Abdul‐Ghani , Houreih Mohammad Adib , Raslan Wasim , El‐Sabban Marwan , Khalifeh Ibrahim
Published: December 2011

Background: Cutaneous leishmaniasis displays considerable variation in its histopathological and clinical presentation. Clinically, it progresses from a papule into a painless ulcerated and crusted nodule/papule. Microscopically, it progresses from sheets of amastigote‐filled histiocytes to granulomatous inflammation.

Methods: The study was conducted on 145 skin biopsies from untreated patients with histopathological and/or clinical suspicion of cutaneous leishmaniasis in Lebanon, Syria and Saudi Arabia (1992–2010). The pre‐biopsy clinical diagnosis and demographic data were collected. Biopsies were evaluated for the major microscopic pattern, and the parasitic index (PI) was also determined. Diagnosis was confirmed by polymerase chain reaction (PCR) followed by molecular sub‐speciation.

Results: Of the 145 patients, 125 were confirmed as cutaneous leishmaniasis by PCR. Eighteen cases presented with a pre‐biopsy clinical diagnosis other than cutaneous leishmaniasis that ranged from dermatitis to neoplasm. Of the 125 cases, 57 showed a major histopathological pattern other than cutaneous leishmaniasis. Identification of amastigotes was equivocal (PI ≤1) in 38 of the 57 cases. Of interest, all the 18 cases with a pre‐biopsy clinical diagnosis other than cutaneous leishmaniasis also showed atypical histopathology for cutaneous leishmaniasis.

Conclusions: The manifestations of cutaneous leishmaniasis are broad and may mimic other inflammatory and neoplastic diseases. Pathologists and dermatologists should be aware of such pitfalls and can utilize PCR to confirm the diagnosis of leishmaniasis.

Saab J, Fedda F, Khattab R, Yahya L, Loya A, Satti M, A‐G Kibbi, Houreih MA, Raslan W, El‐Sabban M, Khalifeh I. Cutaneous leishmaniasis mimicking inflammatory and neoplastic processes: a clinical, histopathological and molecular study of 57 cases.
The yin yang of bacterial polysaccharides: lessons learned from B. fragilis PSA
Authors: Surana Neeraj K. , Kasper Dennis L.
Published: December 2011

Summary:  Over the past several years, there have been remarkable advances in our understanding of how commensal organisms shape host immunity. Although the full cast of immunogenic bacteria and their immunomodulatory molecules remains to be elucidated, lessons learned from the interactions between bacterial zwitterionic polysaccharides (ZPSs) and the host immune system represent an integral step toward better understanding how the intestinal microbiota effect immunologic changes. Somewhat paradoxically, ZPSs, which are found in numerous commensal organisms, are able to elicit both proinflammatory and immunoregulatory responses; both these outcomes involve fine‐tuning the balance between T‐helper 17 cells and interleukin‐10‐producing regulatory T cells. In this review, we discuss the immunomodulatory effects of the archetypal ZPS, Bacteroides fragilis PSA. In addition, we highlight some of the opportunities and challenges in applying these lessons in clinical settings.
Molecular mimicry as an inducing trigger for CNS autoimmune demyelinating disease
Authors: Chastain Emily M. L. , Miller Stephen D.
Published: December 2011

Summary:  Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) that affects about 0.1% of the worldwide population. This deleterious disease is marked by infiltration of myelin‐specific T cells that attack the protective myelin sheath that surrounds CNS nerve axons. Upon demyelination, saltatory nerve conduction is disrupted, and patients experience neurologic deficiencies. The exact cause for MS remains unknown, although most evidence supports the hypothesis that both genetic and environmental factors contribute to disease development. Epidemiologic evidence supports a role for environmental pathogens, such as viruses, as potentially key contributors to MS induction. Pathogens can induce autoimmunity via several well‐studied mechanisms with the most postulated being molecular mimicry. Molecular mimicry occurs when T cells specific for peptide epitopes derived from pathogens cross‐react with self‐epitopes, leading to autoimmune tissue destruction. In this review, we discuss an in vivo virus‐induced mouse model of MS developed in our laboratory, which has contributed greatly to our understanding of the mechanisms underlying molecular mimicry‐induced CNS autoimmunity.
Microbes and microbial effector molecules in treatment of inflammatory disorders
Authors: Kelly Denise , Delday Margaret I , Mulder Imke
Published: December 2011

Summary:  The healthy gut tolerates very large numbers of diverse bacterial species belonging mainly to the Bacteroidetes and Firmicutes phyla. These bacteria normally coexist peacefully with the gut and help maintain immune homeostasis and tolerance. The mechanisms promoting tolerance affect various cell populations, including the epithelial cells lining the gut, resident dendritic cells (DCs), and gut‐homing T cells. Gut bacteria also influence multiple signaling pathways from Toll‐like receptors to nuclear factor κB and regulate the functionality of DCs and T cells. Several bacterial species have been identified that promote T‐cell differentiation, in particular T‐helper 17 and T‐regulatory cells. Insight into the molecular mechanisms by which bacteria mediate these effects will be very important in identifying new ways of treating intestinal and extra‐intestinal immune‐mediated diseases. These diseases are increasing dramatically in the human population and require new treatments. It may be possible in the future to identify specific bacterial species or strains that can correct for T‐cell imbalances in the gut and promote immune homeostasis, both locally and systemically. In addition, new information describing microbial genomes affords the opportunity to mine for functional genes that may lead to new generation drugs relevant to a range of inflammatory disease conditions.
Microbial influences on epithelial integrity and immune function as a basis for inflammatory diseases
Authors: Macia Laurence , Thorburn Alison N. , Binge Lauren C. , Marino Eliana , Rogers Kate E. , Maslowski Kendle M. , Vieira Angélica T. , Kranich Jan , Mackay Charles R.
Published: December 2011

Summary:  Certain autoimmune diseases as well as asthma have increased in recent decades, particularly in developed countries. The hygiene hypothesis has been the prevailing model to account for this increase; however, epidemiology studies also support the contribution of diet and obesity to inflammatory diseases. Diet affects the composition of the gut microbiota, and recent studies have identified various molecules and mechanisms that connect diet, the gut microbiota, and immune responses. Herein, we discuss the effects of microbial metabolites, such as short chain fatty acids, on epithelial integrity as well as immune cell function. We propose that dysbiosis contributes to compromised epithelial integrity and disrupted immune tolerance. In addition, dietary molecules affect the function of immune cells directly, particularly through lipid G‐protein coupled receptors such as GPR43.
REFERENCE RANGES AND RELIABILITY OF TRANSABDOMINAL ULTRASONOGRAPHIC RENAL DIMENSIONS IN THOROUGHBRED HORSES
Authors: Draper Alexandra C. E. , Bowen I. Mark , Hallowell Gayle D.
Published: December 2011

The aims of this study were to establish a normal reference range (mean ± 2SD) and assess reliability of renal dimensions obtained using transabdominal ultrasonography inThoroughbred horses (n= 7). A minimum of three ultrasonographic cineloops were obtained from each intercostal space and the left paralumbar fossa by two observers daily for three consecutive days. Renal length, width, and thickness and cortex, medulla, and pelvic dimensions were obtained. Measurements were undertaken by both observers, who were unaware of prior measurements, to assess reproducibility and measured on three separate occasions to evaluate short‐term measurement repeatability. Measurements from images obtained by both operators were compared to evaluate image repeatability. The left kidney was consistently identified in the left 15th–17th intercostal space and the paralumbar fossa with maximal length in the 16th intercostal space (12.7 ± 2.0 cm) and maximal width in the paralumbar fossa (7.9 ± 1.1 cm). The right kidney was consistently identified in the right 15th–17th intercostal space with maximal length and maximal width in the 15th intercostal space (16.0 ± 0.7 cm and 7.9 ± 1.0 cm). Reproducibility, image repeatability, measurement repeatability were good to excellent, although were less good for the smaller structures. There were no differences in renal dimensions between horses. Overall renal ultrasonography was reliable and a normal reference range forThoroughbred horses was established. Renal dimensions vary between rib spaces. As repeatability and reproducibility were excellent for renal length and width, it may be prudent to use those measurements in rib spaces where parameters were maximal.
Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: secondary data analysis of Demographic Health Survey 2007
Authors: Kabir Iqbal , Khanam Mansura , Agho Kingsley E. , Mihrshahi Seema , Dibley Michael J. , Roy Swapan K.
Published: December 2011

Suboptimal and inappropriate complementary feeding practices are one of the major causes of child undernutrition in the first 2 years of life in South Asian countries including Bangladesh. The aim of this study was to use the newly developed World Health Organization infant feeding indicators to identify the potential risk factors associated with inappropriate complementary feeding practices. We used data for 1728 children aged 6–23 months obtained from nationally representative data from the 2007 Bangladesh Demographic and Health Survey to assess the association between complementary feeding and other characteristics using multivariate models. Only 71% of infants were consuming soft, semi‐solid and solid food by 6–8 months of age. In the multivariate analysis, mothers who had no education had a higher risk for not introducing timely complementary feeds [adjusted odds ratio (AOR) = 2.14; 95% confidence interval (CI): 1.08–4.23, P = 0.03], not meeting the minimum dietary diversity (AOR = 1.69; 95% CI: 1.14–2.54, P = 0.01), minimum acceptable diet (AOR = 1.70, 95% CI: 1.09–2.67, P = 0.02) and minimum meal frequency (AOR = 1.73; 95% CI: 1.20–2.49, P = 0.003) than the mothers who had secondary or higher education. Infants born in Sylhet, Chittagong and Barisal division had higher risks for not meeting minimum dietary diversity, meal frequency and acceptable diet (P < 0.001). The poorest two quintiles had poor levels of minimum meal frequency but dietary quality improved with age. In Bangladesh addressing the fourth Millennium Development Goal (MDG) target will require substantial improvement in complementary feeding practices. Appropriate Infant and Young Child feeding massages should to be development and delivered through existing health system.
Determinants of inappropriate timing of introducing solid, semi‐solid or soft food to infants in Pakistan: Secondary data analysis of Demographic and Health Survey 2006–2007
Authors: Hazir Tabish , Senarath Upul , Agho Kingsley , Akram Dure‐Samin , Kazmi Narjis , Abbasi Saleem , Dibley Michael J.
Published: December 2011

Inappropriate timing of introducing complementary food deprives the infant of optimum nutrition, leading to undernutrition, and increased mortality and morbidity. The aim of this analysis was to identify determinants of inappropriate timing of introduction of solid, semi‐solid and soft foods in Pakistan.

Data on 941 infants 3.00 to 8.99 months were obtained from the Pakistan Demographic and Health Survey 2006–2007. The prevalence of introduction of foods among infants aged 3.00–5.99 months and 6.00–8.99 months was examined against a set of individual, household and community level variables using univariate analysis. Adjusted odds ratio (AOR) for early introduction in age 3.00–5.99 months and non‐introduction in 6.00–8.99 months of age were calculated using backward stepwise logistic regression models. The prevalence of early introduction of complementary foods among 3.00‐ to 5.99‐month‐old and timely introduction among 6.00‐ to 8.99‐month‐old infants were 10.6% and 39.2%, respectively. Multivariate analyses revealed that mothers who had four or more antenatal clinic visits (AOR = 2.68) and who lived in the provinces of Sindh (AOR = 2.89) and Baluchistan (AOR = 6.75) were more likely to introduce complementary foods early. Mothers from middle‐level households (AOR = 7.82), poorer households (AOR = 4.84) and poorest households (AOR = 5.72) were significantly more likely to delay introduction of complementary foods. In conclusion more than half (60.8%) of Pakistani infants do not receive complementary foods at recommended time. Public health interventions to improve the timing of introduction of complementary food are needed at national level with special focus on high risk groups.
Prevalence of immune disease in patients with wounds presenting to a tertiary wound healing centre
Authors: Shanmugam Victoria K , Schilling Amber , Germinario Anthony , Mete Mihriye , Kim Paul , Steinberg John , Attinger Christopher E
Published: December 2011

Chronic leg ulcers are a significant cause of morbidity and mortality and account for considerable healthcare and socioeconomic costs. Leg ulcers are a recognised complication of immune disease, and the purpose of this study was to establish the prevalence of immune disease in a cohort of patients with chronic wounds, and to compare wound outcomes in the subjects with and without immune disease.

Retrospective chart review was completed on consecutive patients scheduled with the plastic surgeon in the Georgetown University Center for Wound Healing between 1 January 2009 and 31 March 2009. Of the 520 patients scheduled for appointments, 340 were eligible for inclusion. The prevalence of immune disease was higher than expected with 78 of 340 patients (23%) having associated immune disease. At presentation, wounds in patients with immune disease had a significantly larger mean surface area [33·4 cm2 (69·05) compared to 22·5 cm2 (63·65), P = 0·02]. Split thickness skin graft (STSG) and bioengineered alternative tissue (BAT) graft data was available on 177 grafts from 55 subjects. There was a significantly lower response rate to STSG in subjects with immune disease (50% compared to 97%, P = 0·0002), but response rates to BAT were not different.

The association between immune diseases and chronic wounds may provide unique insights into pathways of wound healing, and warrants further study.
Evaluation of autologous bone marrow in wound healing in animal model: a possible application of autologous stem cells
Authors: Akela Ashok , Nandi Samit Kumar , Banerjee Dibyajyoti , Das Partha , Roy Subhasis , Joardar Siddhartha Narayan , Mandal Mohan , Das Pradip Kumar , Pradhan Nisith Ranjan
Published: December 2011

A study was conducted to evaluate the potential of autologous bone marrow‐derived cells in comparison with buffy coat of autologous blood for rapid cutaneous wound healing in rabbit model. Three square full‐thickness skin excisional wounds were created in 15 selected experimental animals (rabbit) divided randomly into three groups. The wound was treated with autologous bone marrow cells in plasma (group 1), buffy coat of blood in plasma (group 2) and autologous plasma as control (group 3). Wounds were observed for 30 days for granulation tissue formation, biochemical, histomorphological and histochemical evaluation. In this study, granulation tissue appeared significantly lesser in wounds of group 3 animals followed by group 2 and 1 animals. Neovascularisation, granulation tissue formation, denser, thicker and better arranged collagen fibres, reticulin fibres and elastin fibres formation was more in group 1 as compared with other groups. It was concluded that the application of bone marrow‐derived nucleated cells into the wound margins resulted in early and significantly faster rate of complete healing as compared with buffy coat of autologous blood and autologous plasma (control). This approach may be beneficial in various surface wounds that heal at a slower rate and recommended for healing of various complicated wound in future.
EXPRESSION OF VIRULENCE GENES OF LISTERIA MONOCYTOGENES IN FOOD
Authors: RANTSIOU KALLIOPI , MATARAGAS MARIOS , ALESSANDRIA VALENTINA , COCOLIN LUCA
Published: December 2011

In the present study, the development of reverse transcription‐quantitative polymerase chain reaction protocols for three virulence genes (plcA, iap and hly) and the sigB stress response gene that may be applied for the determination of the virulence gene expression of Listeria monocytogenes in situ was reported. When applied to L. monocytogenes strains of different origin (#3, isolated from meat; National Collection of Type Cultures 10527, a collection strain; and #162, isolated from cheese) and to four different food matrices (fermented sausage, soft cheese, ultrahigh temperature milk and minced meat), stored at 4 and 12C, significant heterogeneity in their expression was recorded. By statistical analysis of the data, it was possible to determine a significant effect on the gene expression by the food matrix, especially for the strain #162. This work showed that environmental factors may influence the virulence expression of L. monocytogenes providing better insights to the physiology of the microorganism grown in foods.

PRACTICAL APPLICATIONS

The ability to rapidly determine the virulence potential of Listeria monocytogenes in food is a challenge. This study adds new information regarding the heterogeneity within this species. Moreover, it highlights the need to better understand the influence of the different food matrices on the expression of virulence and stress response genes in L. monocytogenes. The reverse transcription‐quantitative polymerase chain reaction approach developed and exploited in this study has the potentials to be applied in the field of food safety in order to provide additional insights regarding the virulence of L. monocytogenes. Such information could be useful in implementing control strategies.
Measuring intranodal pressure and lymph viscosity to elucidate mechanisms of arthritic flare and therapeutic outcomes
Authors: Bouta Echoe M. , Wood Ronald W. , Perry Seth W. , Brown Edward B. , Ritchlin Christopher T. , Xing Lianping , Schwarz Edward M.
Published: December 2011

Rheumatoid arthritis (RA) is a chronic autoimmune disease with episodic flares in affected joints; the etiology of RA is largely unknown. Recent studies in mice demonstrated that alterations in lymphatics from affected joints precede flares. Thus, we aimed to develop novel methods for measuring lymph node pressure and lymph viscosity in limbs of mice. Pressure measurements were performed by inserting a glass micropipette connected to a pressure transducer into popliteal lymph nodes (PLN) or axillary lymph nodes (ALN) of mice; subsequently, we determined that the lymphatic pressures of water were 9 and 12 cm, respectively. We are also developing methods for measuring lymph viscosity in lymphatic vessels afferent to PLN, which can be measured by multiphoton fluorescence recovery after photobleaching (MP‐FRAP) of fluorescein isothiocyanate–labeled bovine serum albumin (FITC‐BSA) injected into the hind footpad. These results demonstrate the potential of lymph node pressure and lymph viscosity measurements, and future studies to test these outcomes as biomarkers of arthritic flare are warranted.
The osteoclast and its unique cytoskeleton
Authors: Teitelbaum Steven L.
Published: December 2011

The osteoclast cytoskeleton is a unique structure that polarizes the cell's resorptive machinery to the bone–cell interface where it creates an isolated resorptive microenvironment consisting of an actin ring surrounding a ruffled border. This polarization process occurs under the aegis of the αvβ3 integrin in collaboration with the M‐CSF receptor, c‐Fms. When occupied, αvβ3 activates a canonical signaling complex consisting of c‐Src, Syk, Dap12, Slp76, Vav 3, and Rac that permits the cell to spread and form actin rings. Generation of the ruffled border, the cell's resorptive organelle, is an exocytic process wherein synaptotagmin VII mediates fusion of secretory lysosomes to the bone‐apposed plasma membrane. Absence of any component of this signaling pathway compromises osteoclast cytoskeletal organization and abridges bone resorption.
Skeletal receptors for steroid‐family regulating glycoprotein hormones
Authors: Blair Harry C. , Robinson Lisa J. , Sun Li , Isales Carlos , Davies Terry F. , Zaidi Mone
Published: December 2011

Pituitary glycoprotein hormone receptors, including ACTH‐R, TSH‐R, and FSH‐R, occur in bone. Their skeletal expression reflects that central endocrine control is evolutionarily recent. ACTH receptors, in osteoblasts or the adrenal cortex, drive VEGF synthesis. VEGF is essential to maintain vasculature. In bone, ACTH suppression by glucocorticoids can cause osteonecrosis. TSH receptors occur on osteoblasts and osteoclasts, in both cases reducing activity. Thus, TSH directly reduces skeletal turnover, consistent with evolutionary adaptation to stress. FSH receptors accelerate bone resorption, whereas estrogen promotes bone formation, the forces usually balancing. With ovarian failure, low estrogen with high FSH causes rapid bone loss. The skeletal FSH effect in the menopause seems paradoxical, but it is a logical adaptation in lactation, where prolonged FSH elevation also occurs. In addition to receptors, there is some synthesis of pituitary glycoproteins at distributed sites; this is not well studied, but it may further modify the paradigm of central endocrine regulation.
Mechanotransduction and cartilage integrity
Authors: Leong Daniel J. , Hardin John A. , Cobelli Neil J. , Sun Hui B.
Published: December 2011

Osteoarthritis (OA) is characterized by the breakdown of articular cartilage that is mediated in part by increased production of matrix metalloproteinases (MMPs) and aggrecanases (ADAMTS), enzymes that degrade components of the cartilage extracellular matrix. Efforts to design synthetic inhibitors of MMPs/ADAMTS have only led to limited clinical success. In addition to pharmacologic therapies, physiologic joint loading is widely recommended as a nonpharmacologic approach to improve joint function in osteoarthritis. Clinical trials report that moderate levels of exercise exert beneficial effects, such as improvements in pain and physical function. Experimental studies demonstrate that mechanical loading mitigates joint destruction through the downregulation of MMPs/ADAMTS. However, the molecular mechanisms underlying these effects of physiologic loading on arthritic joints are not well understood. We review here the recent progress on mechanotransduction in articular joints, highlighting the mediators and pathways in the maintenance of cartilage integrity, especially in the prevention of cartilage degradation in OA.