bluuebunny/crossref_metadata_2025 huggingface dataset:
Non‐invasive models for predicting histology in patients with chronic hepatitis B
Authors: Wai Chun‐Tao , Cheng Chee Leong , Wee Aileen , Dan Yock‐Young , Chan Edwin , Chua Winnie , Mak Belinda , Oo Aung Myat , Lim Seng Gee
Published: June 2006

Abstract: Background and aim: In contrast to chronic hepatitis C (CHC), few studies had been performed in assessing non‐invasive models for predicting significant fibrosis or cirrhosis in chronic hepatitis B (CHB) patients. We aimed to evaluate non‐invasive markers for diagnosing significant fibrosis/cirrhosis in patients with CHB, and to evaluate accuracy of models from CHC in CHB patients.

Patients and methods: Liver biopsies from consecutive treatment‐naïve CHB patients were evaluated histologically by a pathologist blindly, using the Ishak score. Patients were divided randomly into a training (65%) and a validation sets (35%). Markers of fibrosis were evaluated by univariate followed by multivariate analysis in the training set. Area under receiver operating characteristics curve (AUROC) was assessed and validated in the training set. AUROC of aspartate aminotransferase (AST), AST/alanine aminotransferase (ALT) ratio, and AST‐platelets ratio index (APRI) (derived from studies from CHC) in diagnosing significant fibrosis/cirrhosis were also assessed.

Results: Two‐hundred and eighteen CHB patients were evaluated: 83% male, 86% Chinese, 47% having significant fibrosis, 19% having cirrhosis. Platelets were the only factor significantly associated with significant fibrosis and cirrhosis at multivariate analysis but the AUROC was only modest at 0.63 and 0.73, respectively. Models derived from studies from CHC were even less accurate.

Conclusion: Models with non‐invasive markers in predicting histology from CHC patients were unsuitable for CHB patients. No variables consisting of simple and readily available markers were able to predict cirrhosis accurately in patients with CHB.
Molecular adsorbent recirculating system treatment for patients with liver failure: the Hong Kong experience
Authors: Chiu Alexander , Chan Lina Mun Yee , Fan Sheung Tat
Published: June 2006

Abstract: Background: The molecular adsorbent recirculating system (MARS) is an extracorporeal liver dialysis system that allows selective removal of bilirubin and other albumin‐bound toxins. We reported here our experience with the use of this technique for management of liver failure at Queen Mary Hospital, Hong Kong.

Methods: From December 2002 to 2004, a total of 74 MARS sessions were performed on 22 patients. The cause of liver failure included acute liver failure (n=2), acute on chronic liver failure (n=12), posthepatectomy liver failure (n=4), and posttransplantation allograft failure (n=4).

Results: MARS treatment showed significant reduction in total bilirubin level, serum ammonia level and blood urea, and nitrogen (P<0.001 for all three parameters). Five patients (22.7%) were able to bridge to transplantation and one patient (4.5%) made a spontaneous recovery. The 30‐day mortality rate was 72.7%.

Conclusions: Our results indicated that MARS can effectively improve serum biochemistry and is suitable for temporarily supporting patients with liver failure where transplantation is not immediately available. There is, however, no clear evidence showing that MARS can increase survival, improve the chance of transplantation or assist liver regeneration. Future studies in the form of randomized‐controlled trials are crucial to characterize the true potential of this treatment.
Characterization of blood components prepared from whole‐blood donations after a 24‐hour hold with the platelet‐rich plasma method
Authors: Thibault Louis , Beauséjour Annie , De Grandmont Marie Joëlle , Lemieux Réal , Leblanc Jean‐François
Published: June 2006

BACKGROUND: The preparation of platelet (PLT) concentrates (PCs) from PLT‐rich plasma (PRP) requires that whole blood (WB) be processed within 8 hours of collection. Increasing WB storage time to 24 hours would be logistically attractive. This study compares the in vitro quality of blood components prepared from WB stored for 8 and 24 hours at room temperature before processing with the PRP method.

STUDY DESIGN AND METHODS: WB units were collected from ABO‐matched blood donors. To reduce individual variations, paired donations were drawn in parallel, pooled, and split back in the collection bag. One unit was held for 6 to 8 hours and the other for 22 to 24 hours at 20 to 24°C. Prestorage leukoreduced components were prepared with the PRP as intermediate product and analyzed during storage.

RESULTS: RBC units prepared after an 8‐ or 24‐hour hold were comparable in terms of hemolysis, sodium, pH, and ATP levels. RBC 2,3‐ diphosphoglycerate (2,3‐DPG) was significantly lower in RBCs prepared from 24‐hour hold donations immediately after processing but not after 20 days of storage. Residual white blood cells were approximately fivefold higher (p  < 0.05) in 24‐hour RBC units. For PCs, measurements for glucose, ATP, lactate, pH, extent of shape change, hypotonic shock response, and CD62p activation were similar. No differences were observed in the von Willebrand factor, factor (F)V, FVIII, and fibrinogen content of fresh‐frozen plasma.

CONCLUSIONS: The decrease in FVIII and RBC 2,3‐DPG can be acceptable as a compromise to improve blood component logistics, but leukoreduction efficiency must be improved before considering the adoption of an overnight storage of WB before PRP processing.
In vitro and in vivo evaluation of LEUKOSEP HRC‐600‐C leukoreduction filtration system for red cells
Authors: AuBuchon James P. , Cancelas Jose A. , Herschel Louise , Roger Jill , Rugg Neeta , Pratt Patricia G. , Joines Amy , Gormas Jennifer F. , Zia Majid , Spearman Michael R.
Published: June 2006

BACKGROUND: Documentation of the benefits of leukoreduction has led to the increased use of this technique and the need for development of efficient and effective techniques for its accomplishment. This study investigated the in vitro properties and in vivo autologous radiolabeled recovery of leukoreduced red cells (RBCs) produced through a leukoreduction filtration system for RBCs (LEUKOSEP HRC‐600‐C, Hemerus Medical).

STUDY DESIGN AND METHODS: Normal subjects donated 36 units of RBCs that were leukoreduced on Days 0, 3, or 5 through a “hands‐off” technique. Biochemical studies were performed before and after filtration and at the end of 42 days of storage. Units leukoreduced on Days 0 or 5 were held until Day 42 and used for autologous radiolabeled return to determine recovery with 51Cr single‐label radiolabeling techniques.

RESULTS: Leukoreduction filtration was accomplished in 16.3 ± 2 minutes on Day 0 at room temperature or 27 to 30 minutes on Days 3 or 5 after refrigeration. Leukoreduction efficiency was 4.6 ± 0.6 log with a median residual white blood cell (WBC) content of fewer than 3.3 × 104 WBCs per unit. RBC recovery was 90 ± 2 percent. Hemolysis was 0.34 ± 0.16 percent at the end of 42 days of storage. The in vivo recovery of radiolabeled RBCs 24 hours after autologous return was 80.6 ± 4.5 percent for RBC units leukoreduced on Days 0 and 5 combined.

CONCLUSION: The LEUKOSEP HRC‐600‐C WBC reduction filtration system produced leukoreduced RBCs efficiently and effectively with acceptable poststorage biochemical measures and posttransfusion recovery after 42 days of storage.
Outliers in RhD membrane integration are explained by variantRHhaplotypes
Authors: Yu Xinjian , Wagner Franz F. , Witter Bernd , Flegel Willy A.
Published: June 2006

BACKGROUND:Variations in a multipass transmembrane protein may affect its membrane integration. To study this effect, the systematic molecular characterization of variant D antigen density is a suitable model. Unlike most other membrane proteins, the expression of the D antigen is often determined by a single allele, because it occurs frequently in hemizygous form.

STUDY DESIGN AND METHODS:The D antigen density distribution of 530 CcDee, 475 ccDEe, and 514 ccDee random samples was established by flow cytometry. The molecular bases of samples with D antigen densities outside a bell‐shaped peak was investigated.

RESULTS:The antigen densities of 499 CcDee, 437 ccDEe, and 480 ccDee samples formed bell‐shaped peaks. Three, 10, and 12 samples, respectively, had decreased antigen densities and carried variantRHDalleles. Weak D type 19,RHD(I204T); weak D type 20,RHD(F417S); and the partial D DYU (also known as DQC),RHD(R234W) were newRHDalleles. Twenty‐eight CcDee, 28 ccDEe, and 22 ccDee samples had increased antigen densities; 53 of them lacked a hybridRhesus boxand were thus predicted to beRHDhomozygous. Eight ccDee samples were predicted to be heterozygous despite a large relative dose ofRHDtoRHCEalleles in quantitative polymerase chain reaction. One of these samples was further investigated and carried anRHD‐CEhybrid transcript characteristic for a‐D‐haplotype.

CONCLUSIONS:Unusual little and large RhD protein integration into the membrane could be traced to a host of distinct protein variants. Weak expression of D antigen was invariably associated with variantRHDalleles. Larger than normal D antigen density may often be caused by the presence of two D encoding alleles, which may be located in cis, and confounding zygosity testing that is solely based on gene copy number.
The natural history of childhood‐acquired hepatitis C infection in patients with inherited bleeding disorders
Authors: Posthouwer Dirk , Fischer Kathelijn , Van Erpecum Karel J. , Mauser‐Bunschoten Eveline P.
Published: June 2006

BACKGROUND: Although many patients with inherited bleeding disorders have been infected with hepatitis C in early childhood, the natural history of infection in this patient group remains poorly defined.

STUDY DESIGN AND METHODS: A total of 212 patients with inherited bleeding disorders born between 1976 and 1992 were evaluated for hepatitis C virus (HCV) infection, spontaneous clearance, and (by noninvasive tests) progressive liver disease.

RESULTS: A total of 120 of 212 patients had been exposed to non‐HCV–inactivated clotting products, and 68 of these 120 patients (57%) were anti‐HCV–positive. Of these patients, 44 (65%) had chronic hepatitis C (HCV RNA–positive) and 24 (35%) showed spontaneous clearance (HCV RNA–negative). Five patients with hepatitis C were coinfected with hepatitis B virus and/or human immunodeficiency virus (HIV). Multivariate analysis indicated that hepatitis C infection was independently associated with longer treatment period (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.3‐1.9) and exposure to a larger number of donors (OR, 2.1; 95% CI, 1.1‐3.9). Spontaneous HCV clearance was associated with a younger age at first exposure to clotting product (p = 0.02). After a mean infection period of 21 years, evidence of cirrhosis was present in 2 patients (5%), both of whom were coinfected with HIV.

CONCLUSION: Spontaneous HCV clearance is associated with young age at infection. Despite frequent childhood‐acquired hepatitis C infection among patients with inherited bleeding disorders, progression to cirrhosis after 21 years of infection is rare. The diagnosis of cirrhosis without biopsy, however, remains challenging in this population, and new, noninvasive means must be developed to accurately identify cirrhotic patients.
Does blood donor history accurately reflect the use of prescription medications? A comparison of donor history and serum toxicologic analysis
Authors: Melanson Stacy E.F. , Stowell Christopher P. , Flood James G. , Lewandrowski Elizabeth Lee , Zak Rychard J. , Lewandrowski Kent B.
Published: June 2006

BACKGROUND: Blood donor screening is performed to accomplish several goals, including donor safety during collection and recipient safety during transfusion. Donors taking certain medications such as teratogens or platelet‐inhibiting drugs are deferred from donation. Studies investigating the accuracy of the donor history are limited and only provide data on select groups of drugs. This study compares the results of an extended serum toxicology analysis to the medication use reported on the donor questionnaire.

STUDY DESIGN AND METHODS: Whole‐blood samples were collected from 108 volunteer blood donors. A serum toxicology analysis was performed with high‐performance liquid chromatography with photodiode array detection. The results were compared to those reported on the donor history questionnaire.

RESULTS: The medication history was consistent with the reported medications in 96 (89%) donors. Serum toxicology testing detected medications that were not reported on the donor history form in 12 (11%) donors. Most of the donors who did not accurately report their medication use (8 or 67%) were taking psychotropic medications.

CONCLUSION: Eleven percent of the donors did not fully disclose their recent medication history. Although none of the omitted medications would have been grounds for deferral, the finding of underreporting questions the reliability of donor screening. Despite a negative medication history, blood donor centers cannot assume that donors are medication‐free. This study reveals a bias to omit psychotropic medications such as antidepressants and anxiolytics.
Progenitor cell recruitment during individualized high‐flow, very‐large‐volume apheresis for autologous transplantation improves collection efficiency
Authors: Fontana Stefano , Groebli Rachel , Leibundgut Kurt , Pabst Thomas , Zwicky Caroline , Taleghani Behrouz Mansouri
Published: June 2006

BACKGROUND: Individual adaptation of processed patient’s blood volume (PBV) should reduce number and/or duration of autologous peripheral blood progenitor cell (PBPC) collections.

STUDY DESIGN AND METHODS: The durations of leukapheresis procedures were adapted by means of an interim analysis of harvested CD34+ cells to obtain the intended yield of CD34+ within as few and/or short as possible leukapheresis procedures. Absolute efficiency (AE; CD34+/kg body weight) and relative efficiency (RE; total CD34+ yield of single apheresis/total number of preapheresis CD34+) were calculated, assuming an intraapheresis recruitment if RE was greater than 1, and a yield prediction models for adults was generated.

RESULTS: A total of 196 adults required a total of 266 PBPC collections. The median AE was 7.99 × 106, and the median RE was 1.76. The prediction model for AE showed a satisfactory predictive value for preapheresis CD34+ only. The prediction model for RE also showed a low predictive value (R2 = 0.36). Twenty‐eight children underwent 44 PBPC collections. The median AE was 12.13 × 106, and the median RE was 1.62. Major complications comprised bleeding episodes related to central venous catheters (n = 4) and severe thrombocytopenia of less than 10 × 109 per L (n = 16).

CONCLUSION: A CD34+ interim analysis is a suitable tool for individual adaptation of the duration of leukapheresis. During leukapheresis, a substantial recruitment of CD34+ was observed, resulting in a RE of greater than 1 in more than 75 percent of patients. The upper limit of processed PBV showing an intraapheresis CD34+ recruitment is higher than in a standard large‐volume leukapheresis. Therefore, a reduction of individually needed PBPC collections by means of a further escalation of the processed PBV seems possible.
Rapid succession of peripheral blood progenitor cell mobilization cycles in patients with chronic heart failure: effects on the hematopoietic system
Authors: Hüttmann Andreas , Gutersohn Achim , Noppeney Richard , Neumann Till , Erbel Raimund , Dührsen Ulrich
Published: June 2006

BACKGROUND: Circulating hematopoietic peripheral blood progenitor cells (PBPCs) may contribute to the regeneration of nonhematopoietic organs. An increase in circulating PBPC numbers may enhance this process. Therefore, an exploratory trial of repeated PBPC mobilization in patients with chronic heart failure was conducted. The safety and cardiovascular efficacy data have been described elsewhere. In the hematopoietic system, the trial offered an opportunity to study several new aspects of granulocyte–colony‐stimulating factor (G‐CSF) action.

STUDY DESIGN AND METHODS: Fourteen male patients with chronic heart failure were treated successively with G‐CSF (four 10‐day treatment periods interrupted by treatment‐free intervals of equal length; daily dose adjustment to maintain a white blood cell [WBC] count of 45 × 109‐50 × 109/L).

RESULTS: G‐CSF induced a rapid increase in cells of all WBC lineages with return to levels equal to (neutrophilic, eosinophilic, and basophilic granulocytes) or lower than those before treatment (monocytes, lymphocytes) during the treatment‐free intervals. Red cell counts remained unchanged, but platelet counts decreased followed by rebound thrombocytosis. The extent of CD34+ cell mobilization was highly variable. For each patient, the changes induced were identical through all cycles, but the G‐CSF dose required in the first cycle was significantly higher than in subsequent cycles. In the cohort of patients, an inverse correlation was observed between the WBC level reached and the dose of G‐CSF administered.

CONCLUSIONS: Rapid alternation between PBPC mobilization and recovery periods is feasible, with identical alterations in all treatment cycles. G‐CSF responsiveness varies among patients and is increased by pretreatment with G‐CSF.
Phrenic Nerve Injury After Catheter Ablation: Should We Worry About This Complication?
Authors: BAI RONG , PATEL DIMPI , BIASE LUIGI DI , FAHMY TAMER S. , KOZELUHOVA MARKETA , PRASAD SUBRAMANYA , SCHWEIKERT ROBERT , CUMMINGS JENNIFER , SALIBA WALID , ANDREWS‐WILLIAMS MICHELLE , THEMISTOCLAKIS SAKIS , BONSO ALDO , ROSSILLO ANTONIO , RAVIELE ANTONIO , SCHMITT CLAUS , KARCH MARTIN , URIARTE JORGE A. SALERNO , TCHOU PATRICK , ARRUDA MAURICIO , NATALE ANDREA
Published: June 2006

Introduction: Phrenic nerve injury (PNI) is a complication that can occur with catheter ablation.

Methods: Data from 17 patients with PNI following different catheter ablation techniques were reviewed. PNI was defined as decreased motility (transient) or paralysis (persistent) of the hemi‐diaphragm on fluoroscopy or chest X‐ray. Patient's recovery was monitored. Normalization of chest images and sniff test would be considered as complete clinical recovery.

Results: Out of the 17 PNI patients (16 right, 1 left), 13 (11 persistent, 2 transient) occurred after pulmonary veins isolation with or without superior vena cava ablation. Three patients had persistent PNI after sinus node modification and one other patient experienced PNI after epicardial ventricular tachycardia ablation. Ablation was performed with different energy source including radiofrequency (n = 13), cryothermal (n = 1), ultrasound (n = 2) and laser (n = 1). Patient's symptoms varied broadly from asymptomatic to dyspnea, and even to respiratory insufficiency that required temporary mechanical ventilation support. Two patients with transient PNI resolved immediately after the procedure and the other 15 persistent PNI patients resolved within a mean time of 8.3 ± 6.6 months.

Conclusions: PNI caused by catheter ablation appears to functionally recover over time regardless of the energy sources used for the procedure.
Ablation for Atrioventricular Nodal Reentrant Tachycardia with a Prolonged PR Interval During Sinus Rhythm: The Risk of Delayed Higher‐Degree Atrioventricular Block
Authors: REITHMANN CHRISTOPHER , REMP THOMAS , OVERSOHL NICO , STEINBECK GERHARD
Published: June 2006

Introduction: Delayed higher‐degree atrioventricular (AV) block can develop after slow pathway ablation for AV nodal reentrant tachycardia with a preexisting first‐degree AV block. Retrograde fast pathway ablation is considered as an alternative approach for patients with a markedly prolonged PR interval and no demonstrable anterograde fast pathway function at baseline. This study aimed to determine the long‐term reliability of AV conduction after retrograde fast pathway ablation in comparison to slow pathway ablation in patients with AV nodal reentrant tachycardia and a first‐degree AV block at baseline.

Methods and Results: Among 43 patients with AV nodal reentrant tachycardia and a prolonged PR interval (defined as ≥200 msec), 10 patients without demonstrable dual pathway physiology underwent ablation of the retrograde fast pathway, and 33 patients with dual pathway physiology underwent slow pathway ablation. Persisting intraprocedural second‐ or third‐degree AV block requiring pacemaker implantation occurred in one patient (10%) after retrograde fast pathway ablation and in one patient (3%) after slow pathway ablation. During the long‐term follow‐up of 61 ± 39 months after retrograde fast pathway ablation, no delayed second‐ or third‐degree AV block occurred, and the PR interval remained unchanged (308 ± 60 msec vs 304 ± 52 msec). During the follow‐up of 37 ± 25 months after slow pathway ablation, a delayed complete heart block developed in two patients, and a second‐degree AV block developed in two patients. Three patients aged 66, 75, and 76 years died suddenly of unknown cause 4, 16, and 48 months following slow pathway ablation, respectively.

Conclusions: Slow pathway ablation was associated with a significant risk of a delayed higher‐degree AV block in patients with AV nodal reentrant tachycardia and a prolonged PR interval at baseline. Retrograde fast pathway ablation for patients with a first‐degree AV block and no demonstrable dual pathway physiology was associated with a higher intraprocedural risk of complete AV block but did not result in the development of higher‐degree AV block during the long‐term follow‐up of up to 9 years.
Right and Left Ventricular Outflow Tract Tachycardias: Evidence for a Common Electrophysiologic Mechanism
Authors: IWAI SEI , CANTILLON DANIEL J. , KIM ROBERT J. , MARKOWITZ STEVEN M. , MITTAL SUNEET , STEIN KENNETH M. , SHAH BINDI K. , YARLAGADDA RAVI K. , CHEUNG JIM W. , TAN VIVIAN R. , LERMAN BRUCE B.
Published: June 2006

Introduction:“Idiopathic” ventricular arrhythmias most often arise from the right ventricular outflow tract (RVOT), although arrhythmias from the left ventricular outflow tract (LVOT) are also observed. While previous work has elucidated the mechanism and electropharmacologic profile of RVOT arrhythmias, it is unclear whether those from the LVOT share these properties. The purpose of this study was to characterize the electropharmacologic properties of RVOT and LVOT arrhythmias.

Methods and Results: One hundred twenty‐two consecutive patients (61 male; 50.9 ± 15.2 years) with outflow tract arrhythmias comprise this series, 100 (82%) with an RVOT origin, and 22 (18%) with an LVOT origin. The index arrhythmia was similar: sustained ventricular tachycardia (VT) (RVOT = 28%, LVOT = 36%), nonsustained VT (RVOT=40%, LVOT=23%), and premature ventricular complexes (RVOT = 32%, LVOT = 41%) (P = 0.32). Cardiac magnetic resonance imaging and microvolt T‐wave alternans results (normal/indeterminate) were also comparable. In addition, 41% with RVOT foci and 50% with LVOT foci were inducible for sustained VT (P = 0.48), and induction of VT was catecholamine dependent in a majority of patients in both groups (66% and 73%; RVOT and LVOT, respectively; P = 1.0). VT was sensitive to adenosine (88% and 78% in the RVOT and LVOT groups, respectively, P = 0.59) as well as blockade of the slow‐inward calcium current (RVOT=70%, LVOT=80%; P = 1.00) in both groups.

Conclusions: Electrophysiologic and pharmacologic properties, including sensitivity to adenosine, are similar for RVOT and LVOT arrhythmias. Despite disparate sites of origin, these data suggest a common arrhythmogenic mechanism, consistent with cyclic AMP‐mediated triggered activity. Based on these similarities, these arrhythmias should be considered as a single entity, and classified together as “outflow tract arrhythmias.”
Ankyrins and Human Disease: What the Electrophysiologist Should Know
Authors: MOHLER PETER J.
Published: June 2006

The coordinate activity of ion channels and transporters in cardiac muscle is critical for normal excitation‐contraction coupling and cardiac rhythm. In the past decade, human gene variants, which alter ion channel biophysical properties, have been linked with fatal cardiac arrhythmias. Ankyrins are a family of “adaptor” proteins, which play critical roles in the proper expression and membrane localization of ion channels and transporters in excitable and nonexcitable cells. Recent findings demonstrate a new paradigm for human cardiac arrhythmia based not on gene mutations that affect channel biophysical properties, but instead on mutations that affect ion channel/transporter localization at excitable membranes in heart. Human ANK2 mutations are associated with “ankyrin‐B syndrome” (an atypical arrhythmia syndrome with risk of sudden cardiac death). Human gene mutations, which affect ankyrin‐G‐based pathways for voltage‐gated Nav channel localization, are associated with Brugada syndrome, a second potentially fatal arrhythmia. Together, these data demonstrate the importance of the molecular events involved in the cellular organization of membrane domains in excitable cells. Moreover, these data define an exciting new field of cardiac “channelopathies” due to defects in proper channel targeting/localization.
Marshall Vein as Arrhythmogenic Source in Patients with Atrial Fibrillation: Correlation Between its Anatomy and Electrophysiological Findings
Authors: KUROTOBI TOSHIYA , ITO HIROSHI , INOUE KOICHI , IWAKURA KATSUOMI , KAWANO SHIGEO , OKAMURA ATSUNORI , DATE MOTOO , FUJII KENSHI
Published: June 2006

Background: Atrial fibrillation (AF) may originate from catecholamine‐sensitive vein of Marshall (VOM) or its ligament in addition to pulmonary veins (PVs). The anatomy of VOM and its relation to arrhythmogenic foci in the left atrium are unknown. We studied the anatomy of VOM and its relation to foci in patients with AF.

Methods: The study population consisted of 100 patients with AF (mean age, 62 years; chronic AF, n = 15). AF sources were determined at baseline and after isoproterenol administration without sedation. VOM was identified by balloon‐occluded coronary sinus (CS) angiography. We determined its anatomy in relation to left PVs.

Results: VOM was visualized in 73 patients (73%). Ninety‐seven patients had 269 arrhythmogenic foci (PV, n = 77; non‐PV, n = 48). Non‐PV foci included left atrial posterior wall (24, 9%), left lateral area (12, 4.5%), roof (6, 2.2%), superior vena cava (28, 10.4%), crista terminalis (8, 3.0%), CS (10, 3.7%), and others (10, 3.7%). The incidence of PV foci in the left superior PV (LSPV) was significantly higher in patients with well‐developed VOM than in those without (66% vs 42%, P < 0.05). Twenty‐eight patients had 30 non‐PV foci around the LSPV ostium. We successfully ablated the non‐PV foci at the distal end of VOM in 11 patients. The ends of the VOM branches were good markers to search for non‐PV foci. Seven of 11 (64%) patients with successful ablation of non‐PV foci were free from arrhythmia, whereas only 6 of 17 (35%) were free from arrhythmia in those with residual non‐PV foci.

Conclusions: To determine VOM anatomy is important to identify non‐PV foci around the ends of VOM.
The influence of polyamines on apricot ovary development and fruit set
Authors: Alburquerque N. , Egea J. , Burgos L. , MartÍnez‐Romero D. , Valero D. , Serrano M.
Published: June 2006

Polyamine (PA) concentrations of ovaries of two apricot cultivars, ‘S405‐17’ and ‘Bergeron’, collected at three stages of floral development, were analysed. The relationships between PA profiles, ovule development and fruit load between the two apricot cultivars were also determined. We show that PA levels vary with ovary development, depending on the cultivar. Higher concentrations of putrescine (PUT), spermidine and spermine were found in S405‐17 cultivar at all phenological stages. In addition, S405‐17 cultivar had more developed ovules and a higher fruit load than Bergeron. Moreover, the exogenous application of 10 mM PUT in Bergeron increased the percentage of functional ovules from 17.1% (control) to 33.3%. These results prove the effects of PAs on ovary development and indicate the possible improvement of apricot ovule development by their exogenous application. All these results define the relationship between PA content and ovule development in apricot. Further studies would confirm the use of free endogenous PA concentrations as markers of the developmental stage of the ovary, because determination of PA contents is easier and faster than serial sectioning.
ABILITY OF VARIOUS POLYPHENOLIC CLASSES FROM CRANBERRY TO INHIBIT LIPID OXIDATION IN MECHANICALLY SEPARATED TURKEY AND COOKED GROUND PORK
Authors: LEE CHEN‐HSIEN , REED JESS D. , RICHARDS MARK P.
Published: June 2006

The ability of the components of cranberry powder to inhibit lipid oxidation processes in mechanically separated turkey (MST) and cooked ground pork was assessed. Fractions (Fr.) enriched in phenolic acids (Fr. 1), anthocyanins (Fr. 2), flavonols (Fr. 3 and 4) and proanthocyanidins (Fr. 5 and 6) were prepared. Fr. 4 showed the greatest inhibitory effect on lipid oxidation in cooked pork (81% inhibition), followed by Fr. 3, 2, 5, 1 and 6 of 56, 45 ,46, 26 and 22%, respectively, during storage at 2C. Fr. 4 was also the most effective fraction in inhibiting thiobarbituric acid reactive substances (TBARS) formation in MST. Fr. 4 was found to partition into lipid phases more readily than the other fractions. Ethanol was the most effective carrier solvent of polyphenolics compared to propylene glycol and water as carriers. Quercetin, a nonglycosylated flavonol present in cranberry powder, inhibited lipid oxidation in MST at low concentrations. These results suggest that flavonol aglycones were the most effective in inhibiting lipid oxidation compared to the other classes of polyphenolics.
EFFECT OF OXYGEN CONCENTRATIONS ON BLOOMING ABILITY OF AGED BEEF LONGISSIMUS LUMBORUM STEAKS FOLLOWING ULTRALOW OXYGEN AND VACUUM STORAGE
Authors: BEGGAN M. , ALLEN P. , BUTLER F.
Published: June 2006

Effect of different oxygen concentrations on blooming ability of aged beef longissimus lumborum (LL) steaks was examined. Six LL primals were stored for 2 weeks under vacuum followed by display under 2, 5, 10 or 20% oxygen (experiment 1). In addition, six primals were cut into steaks and individually stored under an ultralow‐oxygen modified atmosphere (MA), followed by display under 5, 10 or 20% oxygen (experiment 2). Color measurements (L*, a*, b*, chroma [C*] and hue angle) were recorded at 0.5, 1, 2, 4 and 24 h of display. The steaks from experiment 1 displayed at 10 and 20% oxygen showed similar a* and C* values (P > 0.05) to aerobically displayed steaks (control), indicating that a minimum level of 10% oxygen was required for blooming. In experiment 2, similar (P > 0.05) a* and C* values were found between steaks displayed under 10 and 20% oxygen treatment and between 20% oxygen and control treatments. This finding suggests that steaks stored under ultralow‐oxygen MA required a higher level of oxygen (between 10 and 20% oxygen) for blooming compared with steaks stored under vacuum.
EFFECT OF LACTIC ACID AND LACTIC ACID BACTERIA ON GROWTH OF SPOILAGE MICROORGANISMS IN VACUUM‐PACKAGED BEEF
Authors: SIGNORINI M.L. , PONCE‐ALQUICIRA E. , GUERRERO‐LEGARRETA I.
Published: June 2006

Surface application of lactic acid and lactic acid bacteria (LAB) in meat substrates was reported as a means to control spoilage populations. The objective of this work was to determine the effect of LAB inoculation and lactic acid on development of spoilage bacteria in vacuum‐packaged beef. Finely cut meat was inoculated with Pseudomonas fluorescens, Brochothrix thermosphacta and Lactobacillus minor, and treated with a LAB inoculum (Lactobacillus carnis, Lactobacillus pentosus and Staphylococcus carnosus) and lactic acid (200 mg/100 g of meat). The samples were vacuum‐packaged and stored for 12 and 6 days at 4 and 20C, respectively. Aerobic bacteria, Enterobacteriaceae species, Pseudomonas spp., B. thermosphacta, and heterofermentative LAB counts and pH were analyzed. Lactic acid was the most efficient treatment for controlling spoilage populations. LAB should be considered only as an additional factor parallel to other preservation methods to keep spoilage populations low enough as to extend meat shelf life.
COMPARISON OF FATTY ACID AND SENSORY PROFILES OF BEEF FROM FORAGE‐FED CATTLE WITH RETAIL UNITED STATES DEPARTMENT OF AGRICULTURE CHOICE AND SELECT BEEF
Authors: BAUBLITS R.T. , POHLMAN F.W. , BROWN A.H. , RULE D.C. , JOHNSON Z.B. , ONKS D.O. , MURRIETA C.M. , SANDELIN B.A. , RICHARDS C.J. , LOVEDAY H.D. , PUGH R.B.
Published: June 2006

Over two consecutive years, steaks from cattle (n = 107) grazing three cool‐season grazing systems consisting of either orchard grass pasture or fescue pasture, each with soyhull (SH) supplementation or fescue pasture with no supplementation, were compared with retail United States Department of Agriculture (USDA) Choice and Select steaks obtained from area supermarkets for fatty acid and sensory characteristics. Steaks from all three forage treatments had greater (P < 0.05) proportions of longissimus conjugated linoleic acid (CLA; cis‐9, trans‐11) and lower (P < 0.05) n‐6–n‐3 fatty acid ratios than USDA Choice or Select steaks. Sensory evaluation revealed that steaks from the SH‐supplemented treatments had similar (P > 0.05) beef/brothy and grassy flavor intensities than retail USDA Choice and Select steaks, whereas steaks from unsupplemented forage‐fed cattle had decreased (P < 0.05) beef/brothy and increased (P < 0.05) grassy flavor intensities than USDA Choice and Select steaks. These results suggest that supplementing SHs to cattle on forage can enhance beef flavor and reduce grassy flavor characteristics similar to retail USDA Choice and Select steaks while maintaining heightened CLA proportions and a lower n‐6–n‐3 ratio.
USING FLUID WHEY IN COMMINUTED MEAT PRODUCTS: EFFECTS ON TEXTURAL PROPERTIES OF FRANKFURTER‐TYPE SAUSAGES
Authors: YETIM H. , MÜLLER W.D. , DOGAN M. , KLETTNER P.G.
Published: June 2006

The objective of this research was to determine the possibility of using fluid whey in frankfurter formulations and to observe its effects on the textural properties of frankfurter‐type sausages. For this purpose, fluid whey substituted for ice used in sausages was manufactured and their textural characteristics were measured. Results of this research showed that liquid whey could be substituted for up to 100% of the ice in frankfurter formulations. For example, similar or more desirable emulsion stability and textural and color properties were obtained in comparison with the control group that contained no whey. For example, % jelly deposit and fat separation were significantly (P < 0.05) lower in 25% whey‐replaced groups. Again, a higher chewiness and elasticity but lower brittleness and hardness values were measured in no whey‐containing control groups compared with the 50, 75 and 100% fluid whey‐substituted sausages, and the highest redness (a*) value was with the 75 and 100% whey‐replaced samples. Therefore, utilization of liquid whey in comminuted meat products offers an enormous economic advantage and potential to fortify and improve functionality of processed meat products. In this way, the drying or condensing expenses as well as environmental concerns for disposing over surplus whey could also be eliminated.
Local Heat Transfer Measurements in Microchannels Using Liquid Crystal Thermography: Methodology Development and Validation
Authors: Muwanga R. , Hassan I.
Published: June 2006

Microchannel heat transfer governs the performance of the microchannel heat sink, which is a recent technology aimed at managing the stringent thermal requirements of today’s high-end electronics. The microencapsulated form of liquid crystals has been well established for use in surface temperature mapping, while limited studies are available on the use of the un-encapsulated form. This latter form is advantageous since it offers the potential for high spatial resolution, which is necessary for microgeometries. A technique for using un-encapsulated thermochromic liquid crystals (TLCs) in order to measure the local heat transfer coefficient in microchannel geometries is shown in the present study. Measurements were made in a closed loop facility combined with a microscopic imaging system and automated data acquisition. A localized TLC calibration was used to account for a non-uniform coating and variation of lighting conditions. Three test section configurations were investigated with each subsequent configuration arising due to a shortfall in the previous. Two of these configurations are comprised of single wall heated rectangular channels, while the third is a circular tube channel. Validation results are also presented; overall, the methods developed and utilized in this study have been shown to provide the local heat transfer coefficient in microchannels.
Convective Heat Transfer in Turbulent Flow Near a Gap
Authors: Chang D. , Tavoularis S.
Published: June 2006

Convective heat transfer in a rectangular duct containing a heated rod forming a narrow gap with a plane wall has been simulated by solving the unsteady Reynolds-averaged Navier-Stokes equations with a Reynolds stress model. Of particular interest is the role of quasi-periodic coherent structures in transporting fluid and heat across the gap region. It is shown that the local instantaneous velocity and temperature vary widely because of large-scale transport by coherent vortical structures forming in pairs on either side of the rod.
Primary primitive neuroectodermal tumour of the urinary bladder: a clinico-pathological study emphasising immunohistochemical, ultrastructural and molecular analyses
Authors: Lopez-Beltran A , Pérez-Seoane C , Montironi R , Hernández-Iglesias T , Mackintosh C , de Alava E
Published: June 2006

Primary primitive neuroectodermal tumours (PNETs) of the bladder are extremely rare and aggressive neoplasms, and only six examples have been reported in the literature. The case of a 21-year-old woman, who remains disease free 3 years after tumour resection, is reported here. Morphological features were found to correspond to a small round blue cell tumour without rosette formation and with extensive areas of necrosis. Strong expression of CD99, vimentin and CD117 (c-kit), and focal reactivity to cytokeratin and S-100 protein was observed in tumour cells. Ultrastructurally, sparse neurosecretory granules were observed. Diagnosis of PNET was supported by molecular genetic analysis, showing the EWS–FLI-1 fusion transcript type 2 by RT-PCR and EWS gene rearrangement by fluorescence in situ hybridisation. A normal genetically balanced genotype was shown by comparative genomic hybridisation, which, together with the expression of c-kit, a known therapeutic target for imatinib, may have prognostic and therapeutic implications.
Prognostic significance of CDC25B expression in gliomas
Authors: Nakabayashi H , Hara M , Shimizu K
Published: June 2006

Background:CDC25B is a cell-cycle regulatory protein, which is considered to be related to tumorigenesis and progression of tumours.

Aims:To elucidate the role of CDC25B in glioma, the expression of CDC25B and the association of the CDC25B expression with the clinicopathological parameters were investigated.

Methods:Fifty seven gliomas, which included 21 low-grade astrocytomas, 17 anaplastic astrocytomas and 19 glioblastomas, were studied. Protein expressions of CDC25B were evaluated by immunohistochemical methods. Semiquantitative and real-time RT-PCR analyses for the expression of CDC25B mRNA were also carried out. Disease-free survival (DFS) data were analysed by using the Kaplan–Meier method.

Results:High expression of CDC25B was identified in 18 of the 19 glioblastomas, in 10 of the 17 anaplastic astrocytomas, but not in any of the 21 low-grade astrocytomas. The CDC25B mRNA expression increased with the rise in histological grade. Increased CDC25B expression was correlated significantly with a shorter period of DFS, as shown by multivariate analysis.

Conclusions:Patients with an unfavourable clinical outcome are characterised by the increased expression of CDC25B in their glioma samples. Useful clinical information, especially on its relevance as a prognostic indicator, is provided by the evaluation of CDC25B expression in gliomas.
What is quality in surgical pathology?
Authors: Nakhleh R E
Published: June 2006

Quality in surgical pathology may be defined as accurate, timely, and complete reports. Achieving quality requires substantial investment in the basic structure and in the people who undertake surgical pathology. Quality assurance and improvement works best when it is woven into the systems of surgical pathology with well informed, well trained, and knowledgeable staff.
Audit of laboratory mycology services for the management of patients with fungal infections in the northwest of England
Authors: Hassan I A , Critten P , Isalska B , Denning D W
Published: June 2006

Background:Fungal infection is increasingly recognised as an important cause of morbidity and mortality, especially in immunocompromised patients. Little information exists on laboratory services available and the methods used by general microbiology laboratories to diagnose these important infections.

Aim:To investigate the services microbiology laboratories in northwest England provide towards the diagnosis and management of superficial and deep fungal infections.

Methods:A questionnaire was sent to laboratories to get a holistic view of the support given to clinicians looking after patients with fungal infections. The aim was not to investigate details of each laboratory’s standard operating procedures.The completed questionnaires, which formed the basis of this report, were returned by all 21 laboratories which were recruited. This study was conducted between March 2004 and September 2004.

Results:Services were provided to District General Hospitals and to six tertiary centres, including eight teaching hospitals by 16 laboratories. Their bed capacity was 250–1300 beds. Total specimens (including bacterial and viral) processed annually were 42 000–500 000 whereas fungal ones were 560–5400.

Conclusion:In most microbiology laboratories of northwest England, clinicians were aware of the potential of fungal pathogens to cause infections especially in immunocompromised patients. Additional measures such as prolonged incubation of samples were introduced to improve fungal yield from patients at high risk. It is necessary to train and educate laboratory and medical staff about the role of serology and molecular methods in diagnosis and management of patients with fungal infection.
My approach to performing a perinatal or neonatal autopsy
Authors: Wainwright H C
Published: June 2006

An opportunity to determine the cause of death, factors that may have a role in it, and the extent and cause of malformations is provided by perinatal autopsy. The family may be assisted in finding closure after the death of their infant by the information obtained. Insight into classifying infants appearing normal into one of three groups, small, appropriate and large for gestational age, has been provided, as each group tends to have specific causes of death. In infants with congenital anomalies, patterns of malformation may lead us to the diagnosis. An accurate diagnosis is required to provide counselling for a subsequent pregnancy.
Influence of Saturated Fat and Linolenic Acid on the Association Between Intake of Dairy Products and Blood Pressure
Authors: Djoussé Luc , Pankow James S. , Hunt Steven C. , Heiss Gerardo , Province Michael A. , Kabagambe Edmond K. , Ellison R. Curtis
Published: June 2006

Data on the association between dairy consumption and blood pressure have been inconsistent. We sought to examine the relation between dairy consumption and prevalent hypertension (HTN) among 4797 participants of the National Heart, Lung, and Blood Institute Family Heart Study. We used generalized estimating equations to estimate prevalence odds ratios of HTN across categories of dairy consumption. From the lowest to the highest sex-, age-, and energy-adjusted quartile of dairy consumption, there was an inverse association between dairy intake and prevalent HTN: odds ratios (95% CIs) were 1.0 (reference), 0.82 (0.64 to 1.05), 0.68 (0.53 to 0.89), and 0.62 (0.45 to 0.84), respectively, in a model adjusting for age, sex, energy intake, field center, body mass index, dietary linolenic acid, saturated and monounsaturated fat, sodium intake, potassium, caffeine, fiber, and fruits and vegetables (
P
for trend=0.002). This association was independent of calcium intake and was mainly observed among subjects consuming fewer calories from saturated fat (
P
for interaction=0.014). Dairy consumption was inversely associated with systolic (
P
for trend=0.003) but not diastolic (
P
for trend=0.09) blood pressure. Although subjects consuming ≥2 servings per day of dairy products and higher total linolenic acid had the lowest prevalence odds of HTN, there was no evidence for interaction between linolenic acid and dairy consumption on HTN (
P
for interaction=0.65). In conclusion, our data indicate an inverse association between dairy consumption and prevalent HTN that was independent of dietary calcium, mainly among individuals consuming less saturated fat. This suggests that consumption of low-fat dairy products might be more beneficial for preventing HTN.
Renal Damage in Primary Aldosteronism
Authors: Rossi Gian Paolo , Bernini Giampaolo , Desideri Giovambattista , Fabris Bruno , Ferri Claudio , Giacchetti Gilberta , Letizia Claudio , Maccario Mauro , Mannelli Massimo , Matterello Mee-Jung , Montemurro Domenico , Palumbo Gaetana , Rizzoni Damiano , Rossi Ermanno , Pessina Achille Cesare , Mantero Franco
Published: June 2006

Primary aldosteronism (PA) has been associated with cardiovascular hypertrophy and fibrosis, in part independent of the blood pressure level, but deleterious effects on the kidneys are less clear. Likewise, it remains unknown if the kidney can be diversely involved in PA caused by aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Hence, in the Primary Aldosteronism Prevalence in Italy (PAPY) Study, a prospective survey of newly diagnosed consecutive patients referred to hypertension centers nationwide, we sought signs of renal damage in patients with PA and in comparable patients with primary hypertension (PH). Patients (n=1180) underwent a predefined screening protocol followed by tests for confirming PA and identifying the underlying adrenocortical pathology. Renal damage was assessed by 24-hour urine albumin excretion (UAE) rate and glomerular filtration rate (GFR). UAE rate was measured in 490 patients; all had a normal GFR. Of them, 31 (6.4%) had APA, 33 (6.7%) had IHA, and the rest (86.9%) had PH. UAE rate was predicted (
P
<0.001) by body mass index, age, urinary Na
+
excretion, serum K
+
, and mean blood pressure. Covariate-adjusted UAE rate was significantly higher in APA and IHA than in PH patients; there were more patients with microalbuminuria in the APA and IHA than in the PH group (
P
=0.007). Among the hypertensive patients with a preserved GFR, those with APA or IHA have a higher UAE rate than comparable PH patients. Thus, hypertension because of excess autonomous aldosterone secretion features an early and more prominent renal damage than PH.