bluuebunny/crossref_metadata_2025 huggingface dataset:
Leptin Induces Phosphorylation of Neuronal Nitric Oxide Synthase in Defined Hypothalamic Neurons
Authors: Donato Jose , Frazão Renata , Fukuda Makoto , Vianna Claudia R. , Elias Carol F.
Published: September 2010

Studies have indicated that the neurotransmitter nitric oxide (NO) mediates leptin’s effects in the neuroendocrine reproductive axis. However, the neurons involved in these effects and their regulation by leptin is still unknown. We aimed to determine whether NO neurons are direct targets of leptin and by which mechanisms leptin may influence neuronal NO synthase (nNOS) activity. Nicotinamide adenine dinucleotide phosphate diaphorase activity and leptin-induced phosphorylation of signal transducer and activator of transcription-3 immunoreactivity were coexpressed in subsets of neurons of the medial preoptic area, the paraventricular nucleus of the thalamus, the arcuate nucleus (Arc), the dorsomedial nucleus of the hypothalamus (DMH), the posterior hypothalamic area, the ventral premammillary nucleus (PMV), the parabrachial nucleus, and the dorsal motor nucleus of the vagus nerve. Fasting blunted nNOS mRNA expression in the medial preoptic area, Arc, DMH, PMV, and posterior hypothalamic area, and this effect was not restored by acute leptin administration. No difference in the number of neurons expressing nNOS immunoreactivity was noticed comparing hypothalamic sections of fed (wild type and ob/ob), fasted, and fasted leptin-treated mice. However, we found that in states of low leptin levels, as in fasting, or lack of leptin, as in ob/ob mice, the number of neurons expressing the phosphorylated form of nNOS is decreased in the Arc, DMH, and PMV. Notably, acute leptin administration to fasted wild-type mice restored the number of phosphorylated form of nNOS neurons to that observed in fed wild-type mice. Herein we identified the first-order neurons potentially involved in NO-mediated effects of leptin and demonstrate that leptin regulates nNOS activity predominantly through posttranslational mechanisms.
Functional Hypothalamic Amenorrhea Due to Increased CRH Tone in Melanocortin Receptor 2-Deficient Mice
Authors: Matsuwaki Takashi , Nishihara Masugi , Sato Tsuyoshi , Yoda Tetsuya , Iwakura Yoichiro , Chida Dai
Published: September 2010

Exposure to chronic stressors results in dysregulation of the hypothalamic-pituitary-adrenal axis and a disruption in reproduction. CRH, the principal regulator of the hypothalamic-pituitary-adrenal axis induces the secretion of ACTH from the pituitary, which stimulates adrenal steroidogenesis via the specific cell-surface melanocortin 2 receptor (MC2R). Previously, we demonstrated that MC2R−/− mice had undetectable levels of corticosterone despite high ACTH levels. Here, we evaluated the reproductive functions of female MC2R−/− mice and analyzed the mechanism of the disrupted cyclicity of these mice. The expression of CRH in the paraventricular nucleus was significantly increased in MC2R−/− mice under nonstressed conditions. Although MC2R−/− females were fertile, they showed a prolonged estrous cycle. After hormonal stimulation, MC2R−/− females produced nearly-normal numbers of eggs, but slightly less than MC2R+/− females, and showed near-normal ovarian histology. During diestrus, the number of GnRH-positive cells in the medial preoptic area was significantly reduced in MC2R−/− females. CRH type 1 receptor antagonist restored estrous cyclicity in MC2R−/− females. Kisspeptin-positive areas in the arcuate nucleus were comparable, whereas kisspeptin-positive areas in the anteroventral periventricular nucleus in MC2R−/− females were significantly reduced compared with MC2R+/− females, suggesting that arcuate nucleus kisspeptin is not involved, but anteroventral periventricular nucleus kisspeptin may be involved, in the maintenance of estrous cyclicity. Our findings show that high levels of hypothalamic CRH disturb estrous cyclicity in the female animals and that the MC2R−/− female is a unique animal model of functional hypothalamic amenorrhea.
Hypothalamic Responses to Fasting Indicate Metabolic Reprogramming Away from Glycolysis Toward Lipid Oxidation
Authors: Poplawski Michal M. , Mastaitis Jason W. , Yang Xue-Jun , Mobbs Charles V.
Published: September 2010

Nutrient-sensitive hypothalamic neurons regulate energy balance and glucose homeostasis, but the molecular mechanisms mediating hypothalamic responses to nutritional state remain incompletely characterized. To address these mechanisms, the present studies used quantitative PCR to characterize the expression of a panel of genes the hypothalamic expression by nutritional status of which had been suggested by DNA microarray studies. Although these genes regulate a variety of function, the most prominent set regulate intermediary metabolism, and the overall pattern clearly indicated that a 48-h fast produced a metabolic reprogramming away from glucose metabolism and toward the utilization of alternative fuels, particularly lipid metabolism. This general reprogramming of intermediary metabolism by fasting was observed both in cortex and hypothalamus but most prominently in hypothalamus. The effect of fasting on the expression of these genes may be mediated by reduction in plasma glucose or glucose metabolism, rather than leptin, because they were generally recapitulated by hypoglycemia even in the presence of elevated insulin and in vitro by low glucose but were not recapitulated in ob/ob mice. These studies suggest that fasting reduces glucose metabolism and thus minimizes the production of hypothalamic malonyl-coenzyme A. However, because the reprogramming of glucose metabolism by fasting was also observed in cortex, this apparent substrate competition may mediate more general responses to nutritional deprivation, including those responsible for the protective effects of dietary restriction. The present studies also provide a large panel of novel glucose-regulated genes that can be used as markers of glucose action to address mechanisms mediating hypothalamic responses to nutritional state.
trpm7 Regulation of in Vivo Cation Homeostasis and Kidney Function Involves Stanniocalcin 1 and fgf23
Authors: Elizondo Michael R. , Budi Erine H. , Parichy David M.
Published: September 2010

The transient receptor potential melastatin 7 (trpm7) channel kinase is a primary regulator of magnesium homeostasis in vitro. Here we show that trpm7 is an important regulator of cation homeostasis as well as kidney function in vivo. Using zebrafish trpm7 mutants, we show that early larvae exhibit reduced levels of both total magnesium and total calcium. Accompanying these deficits, we show that trpm7 mutants express higher levels of stanniocalcin 1 (stc1), a potent regulator of calcium homeostasis. Using transgenic overexpression and morpholino oligonucleotide knockdown, we demonstrate that stc1 modulates both calcium and magnesium levels in trpm7 mutants and in the wild type and that levels of these cations are restored to normal in trpm7 mutants when stc1 activity is blocked. Consistent with defects in both calcium and phosphate homeostasis, we further show that trpm7 mutants develop kidney stones by early larval stages and exhibit increased levels of the anti-hyperphosphatemic factor, fibroblast growth factor 23 (fgf23). Finally, we demonstrate that elevated fgf23 expression contributes to kidney stone formation by morpholino knockdown of fgf23 in trpm7 mutants. Together, these analyses reveal roles for trpm7 in regulating cation homeostasis and kidney function in vivo and implicate both stc1 and fgf23 in these processes.
Why Is Androgen Replacement in Males Controversial?
Authors: Cunningham Glenn R. , Toma Shivani M.
Published: September 2010

Context: Symptoms and signs consistent with androgen deficiency and low testosterone levels are recognized frequently in clinical practice. Recent population-based epidemiological studies indicate that low testosterone levels in men are associated with increased morbidity and mortality. The clinician must be able to counsel patients to help them determine whether testosterone replacement therapy is appropriate for them.

Evidence Acquisition: The authors have conducted a literature search in PubMed, and we have reviewed references in the multiple systematic reviews and meta-analyses that have been published on this topic.

Evidence Synthesis: We have attempted to provide the reader with an appreciation of the evidence that can be used to support the diagnosis of androgen deficiency, the efficacy of treatment, the potential risks of treatment, the therapeutic options, and the recommendations for monitoring treatment.

Conclusions: We think that published clinical experience justifies testosterone replacement therapy in males who have not initiated puberty by age 14 and in males with low testosterone levels due to classical diseases of the hypothalamic-pituitary-gonadal axis. The benefit:risk ratio is less certain in older men and in those with chronic diseases associated with low testosterone levels. The decision to treat in this setting is much more controversial because there are few large clinical trials that have demonstrated efficacy and no large clinical trials that have determined potential risks of increasing the incidence of clinical prostate cancers or cardiovascular events. We provide a critical review of the evidence that supports treatment and potential risks and ways to reduce the risks if the physician and patient elect testosterone replacement.
Sedimentary Characteristics and Hydrocarbon Accumulation of Glutenite in the Fourth Member of Eogene Shahejie Formation in Shengtuo Area of Bohai Bay Basin, East China
Authors: Liu Hui , Jiang Zaixing , Cao Yingchang , Wang Yanzhong
Published: September 2010

The genetic type and hydrocarbon accumulation conditions of glutenite in Shengtuo Area have been studied based on cores, well-logs, and formation test data. During deposition of the fourth member of Eogene Shahejie Formation ( Es4), Shengtuo Area was predominated by nearshore subaqueous fan and sublacustrine fan, controlled by the Chennan Fault and the Tuo-Sheng-Yong Fault. Nearshore subaqueous fan and sublacustrine fan were respectively developed on the downthrown of the Chennan Fault and the Tuo-Sheng-Yong Fault. Both of nearshore subaqueous fan and sublacustrine fan can be subdivided into three subfacies, including inner fan, middle fan and outer fan, from proximal to distal provenance. The braided channel within the middle fan, characterized by conglomeratic sandstones and sandstones with high secondary porosity and overpressured microfissures resulted from the effect of organic acid and reservoir overpressure, is the best reservoir among these three subfacies. Inner fan subfacies, consisted of thick-bedded, poorly-sorted and matrix-supported conglomerates, has low primary and secondary porosity, is the best sealing among this depositional system. Outer fan sediments, comprised of thick dark mudstones interbedded with thin sandstones in which overpressured microfissures developed very well, accounts for the migration pathway for oil and gas to enter braided channel reservoir from source rocks. In addition, the glutenite fans were developed near the Lijin Sag and the Minfeng Sag, which deposited two sets of high quality source rocks ( Es4s (upper section of Es4) and Es4x (lower section of Es4) source rock). With regional cap rock and appropriate preservation conditions, the different subfacies in glutentite fans worked together and formed a “self-generation and self-storage” lithostratigraphic trap characterized by “migrating through outer fan, accumulating in middle fan and sealing by inner fan”.
Geochemical Surveillance of the Linnan Oil Field with Oil Fingerprinting
Authors: Chang Xiangchun , Li Zengxue
Published: September 2010

Linnan oil field is one of the main producing areas of Shengli Oil Company and fronted with the challenge of sustaining production. Technique of oil fingerprinting is conducted for the production surveillance of reservoir engineering issues. Geochemical analysis of oils in Linnan oil field continued for several years and indicates that with the course of waterflood development, oil fingerprints are varied regularly. Ratios of fingerprint peak weights show positive, negative or stable correlations with the increase of water cut, suggesting the relative displacement preferences of different fingerprints. The ratios stable in single-zone endmember oils and variable in multi-zone commingled oils with waterflood development can be selected for continuity appraisal and production allocation, while those varied with water cut can be used for distinguishing oil or water layers and defining the water flooded layer. Based on the contribution allocation of multi-zones production, development measurements are optimized and job executions are evaluated effectively in Linnan oil field. Connectivity of producing and injecting well characterized by oil fingerprints assists the detection of low grade fault in X53 fault block reservoirs, improving the contradiction between injection and production.
The Kudo 5 total elbow replacement in the treatment of the rheumatoid elbow
Authors: Qureshi F. , Draviaraj K. P. , Stanley D.
Published: September 2010

Between September 1993 and September 1996, we performed 34 Kudo 5 total elbow replacements in 31 rheumatoid patients. All 22 surviving patients were reviewed at a mean of 11.9 years (10 to 14). Their mean age was 56 years (37 to 78) at the time of operation. All had Larsen grade IV or V rheumatoid changes on X-ray. Nine (three bilateral replacements and six unilateral) had died from unrelated causes. One who had died before ten years underwent revision for dislocation.

Of the 22 total elbow replacements reviewed six had required revision, four for aseptic loosening (one humeral and three ulnar) and two for infection. Post-operatively, one patient had neuropraxia of the ulnar nerve and one of the radial nerve. Two patients had valgus tilting of the ulnar component.

With revision as the endpoint, the mean survival time for the prosthesis was 11.3 years (95% confidence interval (10 to 13) and the estimated survival of the prosthesis at 12 years according to Kaplan-Meier survival analysis was 74% (95% confidence interval 0.53 to 0.91).

Of the 16 surviving implants, ten were free from pain, four had mild pain and two moderate. The mean arc of flexion/extension of the elbow was 106° (65° to 130°) with pronation/supination of 90° (30° to 150°) with the joint at 90° of flexion. The mean Mayo elbow performance score was 82 (60 to 100) with five excellent, ten good and one fair result.

Good long-term results can be expected using the Kudo 5 total elbow replacement in patients with rheumatoid disease, with a low incidence of loosening of the components.
Uncemented computer-assisted design-computer-assisted manufacture femoral components in revision total hip replacement
Authors: Muirhead-Allwood S. , Sandiford N. A. , Skinner J. A. , Hua J. , Muirhead W. , Kabir C. , Walker P. S.
Published: September 2010

We prospectively evaluated the long-term outcome of 158 consecutive patients who underwent revision total hip replacement using uncemented computer-assisted design-computer-assisted manufacture femoral components. There were 97 men and 61 women. Their mean age was 63.1 years (34.6 to 85.9). The mean follow-up was 10.8 years (10 to 12).

The mean Oxford, Harris and Western Ontario and McMaster hip scores improved from 41.1, 44.2 and 52.4 pre-operatively to 18.2, 89.3 and 12.3, respectively (p < 0.0001, for each). Six patients required further surgery. The overall survival of the femoral component was 97% (95% confidence interval 94.5 to 99.7). These results are comparable to those of previously published reports for revision total hip replacement using either cemented or uncemented components.
Does the new generation of high-flex knee prostheses improve the post-operative range of movement?
Authors: Mehin R. , Burnett R. S. , Brasher P. M. A.
Published: September 2010

A new generation of knee prostheses has been introduced with the intention of improving post-operative knee flexion. In order to evaluate whether this goal has been achieved we performed a systematic review and meta-analysis. Systematic literature searches were conducted on MEDLINE and EMBASE from their inception to December 2007, and proceedings of scientific meetings were also searched. Only randomised, clinical trials were included in the meta-analysis. The mean difference in the maximum post-operative flexion between the ‘high-flex’ and conventional types of prosthesis was defined as the primary outcome measure. A total of five relevant articles was identified.

Analysis of these trials suggested that no clinically relevant or statistically significant improvement was obtained in flexion with the ‘high-flex’ prostheses. The weighted mean difference was 2.1° (95% confidence interval −0.2 to +4.3; p = 0.07).
Mid-term results of a metal-backed glenoid component in total shoulder replacement
Authors: Castagna A. , Randelli M. , Garofalo R. , Maradei L. , Giardella A. , Borroni M.
Published: September 2010

Total shoulder replacement is a successful procedure for degenerative or some inflammatory diseases of the shoulder. However, fixation of the glenoid seems to be the main weakness with a high rate of loosening. The results using all-polyethylene components have been better than those using metal-backed components. We describe our experience with 35 consecutive total shoulder replacements using a new metal-backed glenoid component with a mean follow-up of 75.4 months (48 to 154).

Our implant differs from others because of its mechanism of fixation. It has a convex metal-backed bone interface and the main stabilising factor is a large hollow central peg. The patients were evaulated with standard radiographs and with the Constant Score, the Simple Shoulder Test and a visual analogue scale. All the scores improved and there was no loosening, no polyethylene-glenoid disassembly and no other implant-related complications.

We conclude that a metal-backed glenoid component is a good option in total shoulder replacement with no worse results than of those using a cemented all-polyethylene prosthesis.
The use of a femoral revision stem in the treatment of primary or secondary bone tumours of the proximal femur
Authors: Bischel O. E. , Böhm P. M.
Published: September 2010

Endoprosthetic reconstruction following resection of 31 tumours of the proximal femur in 30 patients was performed using a Wagner SL femoral revision stem. The mean follow-up was 25.6 months (0.6 to 130.0). Of the 28 patients with a metastasis, 27 died within a mean follow-up period of 18.1 months (0.6 to 56.3) after the operation, and the remaining patient was excluded from the study 44.4 months post-operatively when the stem was removed. The two patients with primary bone tumours were still alive at the latest follow-up of 81.0 and 130.0 months, respectively. One stem only was removed for suspected low-grade infection 44.4 months post-operatively. The worst-case survival rate with removal of the stem for any cause and/or loss to follow-up was 80.0% (95% confidence interval 44.9 to 100) at 130.0 months. The mean Karnofsky index increased from 44.2% (20% to 70%) pre-operatively to 59.7% (0% to 100%) post-operatively, and the mean Merle d’Aubigné score improved from 4.5 (0 to 15) to 12.0 (0 to 18). The mean post-operative Musculoskeletal Tumour Society score was 62.4% (3.3% to 100%).

The Wagner SL femoral revision stem offers an alternative to special tumour prostheses for the treatment of primary and secondary tumours of the proximal femur. The mid-term results are very promising, but long-term experience is necessary.
Treatment of massive rotator-cuff tears with a polyester ligament (Dacron) augmentation
Authors: Nada A. N. , Debnath U. K. , Robinson D. A. , Jordan C.
Published: September 2010

We describe the clinical outcome of a technique of surgical augmentation of chronic massive tears of the rotator cuff using a polyester ligament (Dacron) in 21 symptomatic patients (14 men, seven women) with a mean age of 66.5 years (55.0 to 85.0). All patients had MRI and arthroscopic evidence of chronic massive tears. The clinical outcome was assessed using the Constant and Murley and patient satisfaction scores at a mean follow-up of 36 months (30 to 46).

The polyester ligament (500 mm × 10 mm) was passed into the joint via the portal of Neviaser, medial to the tear through healthy cuff. The two ends of the ligament holding the cuff were passed through tunnels made in the proximal humerus at the footprint of the insertion of the cuff. The ligament was tied with a triple knot over the humeral cortex.

All the patients remained free from pain (p < 0.001) with improvement in function (p < 0.001) and range of movement (p < 0.001). The mean pre-operative and post-operative Constant scores were 46.7 (39.0 to 61.0) and 85.4 (52.0 to 96.0), respectively (p < 0.001). The mean patient satisfaction score was 90%. There were two failures, one due to a ruptured ligament after one year and the other due to deep-seated infection. The MR scan at the final follow-up confirmed intact and thickened bands in 15 of 17 patients.

This technique of augmentation gives consistent relief from pain with improved shoulder movement in patients with symptomatic massive tears of the rotator cuff.
Outcome of surgery for recurrent patellar dislocation based on the distance of the tibial tuberosity to the trochlear groove
Authors: Tecklenburg K. , Feller J. A. , Whitehead T. S. , Webster K. E. , Elzarka A.
Published: September 2010

We evaluated the outcome in a series of patients with recurrent patellar dislocation who had either medial transfer of the tibial tuberosity and lateral release or an isolated lateral release as the primary treatment. The decision to use one or other procedure was based on a pre-operative distance between the tibial tuberosity to the trochlear groove (TTTG) of less than 10 mm to include the tibial tuberosity transfer in addition to the lateral release.

Between April 2002 and December 2006, 49 patients (63 knees) underwent one of these procedures. A total of 35 patients (46 knees) was evaluated at a mean of 38 months (13 to 71) post-operatively. Medial transfer of the tibial tuberosity was performed in 33 knees and isolated lateral release in the remaining 13. Evaluation included the International Knee Documentation Committee (IKDC), the Kujala and the Short-form 36 scores. From the tibial tuberosity group 23 knees also underwent radiological examination at follow-up.

There were further episodes of patellar dislocation in six of the 46 knees available for review. Further dislocation was noted in five of 33 knees (15.2%) in the tibial tuberosity transfer group and in one of 13 knees (7.7%) in the lateral release group. The mean subjective IKDC score was 80.4 (sd 11.6), the mean Kujala score 88 (sd 8.2) and the mean objective IKDC score was 79% normal and 21% nearly normal. The mean post-operative TTTG distance in the tibial tuberosity transfer group was 8.9 mm (3.2 to 15.7) compared with the mean pre-operative value of 16.8 mm (12.2 to 24.4).
Total knee replacement with intra-articular resection of bone after malunion of a femoral fracture
Authors: Wang J.-W. , Chen W.-S. , Lin P.-C. , Hsu C.-S. , Wang C.-J.
Published: September 2010

Intra-articular resection of bone with soft-tissue balancing and total knee replacement (TKR) has been described for the treatment of patients with severe osteoarthritis of the knee associated with an ipsilateral malunited femoral fracture. However, the extent to which deformity in the sagittal plane can be corrected has not been addressed. We treated 12 patients with severe arthritis of the knee and an extra-articular malunion of the femur by TKR with intra-articular resection of bone and soft-tissue balancing. The femora had a mean varus deformity of 16° (8° to 23°) in the coronal plane. There were seven recurvatum deformities with a mean angulation of 11° (6° to 15°) and five antecurvatum deformities with a mean angulation of 12° (6° to 15°).

The mean follow-up was 93 months (30 to 155). The median Knee Society knee and function scores improved from 18.7 (0 to 49) and 24.5 (10 to 50) points pre-operatively to 93 (83 to 100) and 90 (70 to 100) points at the time of the last follow-up, respectively. The mean mechanical axis of the knee improved from 22.6° of varus (15° to 27° pre-operatively to 1.5° of varus (3° of varus to 2° of valgus) at the last follow-up. The recurvatum deformities improved from a mean of 11° (6° to 15°) pre-operatively to 3° (0° to 6°) at the last follow-up. The antecurvatum deformities in the sagittal plane improved from a mean of 12° (6° to 16°) pre-operatively to 4.4° (0° to 8°) at the last follow-up.

Apart from varus deformities, TKR with intra-articular bone resection effectively corrected the extra-articular deformity of the femur in the presence of antecurvatum of up to 16° and recurvatum of up to 15°.
Image-guided navigation in orthopaedic trauma
Authors: Leung K. S. , Tang N. , Cheung L. W. H. , Ng E.
Published: September 2010

Fluoronavigation is an image-guided technology which uses intra-operative fluoroscopic images taken under a real-time tracking system and registration to guide surgical procedures. With the skeleton and the instrument registered, guidance under an optical tracking system is possible, allowing fixation of the fracture and insertion of an implant. This technology helps to minimise exposure to x-rays, providing multiplanar views for monitoring and accurate positioning of implants. It allows real-time interactive quantitative data for decision-making and expands the application of minimally invasive surgery. In orthopaedic trauma its use can be further enhanced by combining newer imaging technologies such as intra-operative three-dimensional fluoroscopy and optical image guidance, new advances in software for fracture reduction, and new tracking mechanisms using electromagnetic technology. The major obstacles for general and wider applications are the inability to track individual fracture fragments, no navigated real-time fracture reduction, and the lack of an objective assessment method for cost-effectiveness.

We believe that its application will go beyond the operating theatre and cover all aspects of patient management, from pre-operative planning to intra-operative guidance and postoperative rehabilitation.
Acute isolated injury of the posterior cruciate ligament treated by a dynamic anterior drawer brace
Authors: Jacobi M. , Reischl N. , Wahl P. , Gautier E. , Jakob R. P.
Published: September 2010

We investigated the role of a functional brace worn for four months in the treatment of patients with an acute isolated tear of the posterior cruciate ligament to determine whether reduction of the posterior tibial translation during the healing period would give an improved final position of the tibia. The initial and follow-up stability was tested by Rolimeter arthrometry and radiography. The clinical outcome was evaluated using the Lysholm score, the Tegner score and the International Knee Documentation Committee scoring system at follow-up at one and two years. In all, 21 patients were studied, 21 of whom had completed one-year and 17 a two-year follow-up.

The initial mean posterior sag (Rolimeter measurement) of 7.1 mm (5 to 10) was significantly reduced after 12 months to a mean of 2.3 mm (0 to 6, p < 0.001) and to a mean of 3.2 mm (2 to 7, p = 0.001) after 24 months. Radiological measurement gave similar results. The mean pre-injury Lysholm score was normal at 98 (95 to 100). At follow-up, a slight decrease in the mean values was observed to 94.0 (79 to 100, p = 0.001) at one year and 94.0 (88 to 100, p = 0.027, at two years).

We concluded that the posterior cruciate ligament has an intrinsic healing capacity and, if the posteriorly translated tibia is reduced to a physiological position, it can heal with less attentuation. The applied treatment produces a good to excellent functional result.
Chromatin regulators: weaving epigenetic nets
Authors: Hernández-Muñoz Inmaculada
Published: September 2010

In multicellular organisms differentiated cells must maintain their cellular memory, which will be faithfully inherited and maintained by their progeny. In addition, these specialized cells are exposed to specific environmental and cell-intrinsic signals and will have to appropriately respond to them. Some of these stimuli lead to changes in a subset of genes or to a genome-wide reprogramming of the cells that will remain after stimuli removal and, in some instances, will be inherited by the daughter cells. The molecular substrate that integrates cellular memory and plasticity is the chromatin, a complex of DNA and histones unique to eukaryotes. The nucleosome is the fundamental unit of the chromatin and nucleosomal organization defines different chromatin conformations. Chromatin regulators affect chromatin conformation and accessibility by covalently modifying the DNA or the histones, substituting histone variants, remodeling the nucleosome position or modulating chromatin looping and folding. These regulators frequently act in multiprotein complexes and highly specific interplays among chromatin marks and different chromatin regulators allow a remarkable array of possibilities. Therefore, chromatin regulator nets act to propagate the conformation of different chromatin regions through DNA replication and mitosis, and to remodel the chromatin fiber to regulate the accessibility of the DNA to transcription factors and to the transcription and repair machineries. Here, the state-of-the-art of the best-known chromatin regulators is reviewed.
Propeptides as modulators of functional activity of proteases
Authors: Demidyuk Ilya V. , Shubin Andrey V. , Gasanov Eugene V. , Kostrov Sergey V.
Published: September 2010

Most proteases are synthesized in the cell as precursor-containing propeptides. These structural elements can determine the folding of the cognate protein, function as an inhibitor/activator peptide, mediate enzyme sorting, and mediate the protease interaction with other molecules and supramolecular structures. The data presented in this review demonstrate modulatory activity of propeptides irrespective of the specific mechanism of action. Changes in propeptide structure, sometimes minor, can crucially alter protein function in the living organism. Modulatory activity coupled with high variation allows us to consider propeptides as specific evolutionary modules that can transform biological properties of proteases without significant changes in the highly conserved catalytic domains. As the considered properties of propeptides are not unique to proteases, propeptide-mediated evolution seems to be a universal biological mechanism.
Surgical treatment of acute pancreatitis today
Authors: Szentkereszty Zsolt , Kotán Róbert , Damjanovich László , Sápy Péter
Published: September 2010

Az enyhe akut pancreatitis kezelése alapvetően konzervatív, míg súlyos esetekben a sebészi kezelésnek jelentős szerepe van.
Módszer:
A szerzők az utóbbi 10 évben megjelent, a műtét kérdéseit taglaló közlemények alapján elemzik a sebészi kezelés indikációit, időzítését és a műtét technikai kérdéseit.
Eredmények/következtetések:
A steril pancreasnecrosis csak ritkán, a szeptikus necrosis azonban műtéti indikációt képez, ha a konzervatív kezelés eredménytelen. A terápiarezisztens sokszervi elégtelenség, a súlyos hasi kompartmentszindróma és egyéb sebészi szövődmény, mint a vérzés, perforáció is műtéti beavatkozást tesz szükségessé. Pancreatitist okozó epekövesség talaján kialakult cholestasis esetén sürgős endoszkópos sphincterotomia és később cholecystectomia javasolt. Pancreasnecrosis esetén a műtét ideális időpontja a betegség kezdetétől számított 21. nap utánra tehető, mivel a „korai” műtétek szövődmény- és halálozási aránya magas. Fontos a gondos necrectomia, amelynek a retrocolicus és retroduodenalis terekre is ki kell terjednie. A nyitott has kezelésének több a szövődménye, ezért csak válogatott esetekben javasolják. A műtétet posztoperatív bursa omentalis lavage-zsal érdemes kiegészíteni. Orv. Hetil., 2010,
41,
1697–1701.
The advancement of robotic surgery – successes, failures, challenges
Authors: Haidegger Tamás
Published: September 2010

Az első robotsebészeti eszközök több mint húsz éve jelentek meg, és azóta majdnem négyszáz különböző prototípust fejlesztettek ki. Szűk hányaduk kereskedelmi forgalomba is került, főként idegsebészeti és ortopédiai beavatkozásokhoz. Ezek közül vitathatatlanul a legsikeresebb a da Vinci műtéti rendszer, amelyet főként urológiai és hasi sebészeti beavatkozásokhoz használnak. Gyártója és fejlesztője az amerikai Intuitive Surgical Inc., amely az egyedüli profitot termelő cég a szektorban. A da Vinci széles körű elterjedésével vált világszerte ismertté a számítógéppel integrált sebészet, eredményei sorra meggyőzték a kritikusokat, és mára már százezreket operálnak vele alacsonyabb kockázattal és költséggel. A sikerhez szükség volt jól megválasztott üzletfejlesztési stratégiára, kiváló szakembergárdára, jó időzítésre és nem kevés szerencsére. A cikk bemutatja a da Vinci robot felépítését, fejlesztésének történetét, orvosi, gazdasági és pénzügyi vonatkozásait, és rávilágít, miért pont ez a robot lett sikeres. Orv. Hetil., 2010,
41,
1690–1696.
Supportive treatment with beta-erythropoietin in patients with lung cancer – Clinical data analysis of quality of life and effectiveness
Authors: Tamási Lilla , Gálffy Gabriella
Published: September 2010

Daganatos betegek körében gyakori szövődmény az anaemia, amelyet maga a betegség vagy az onkológiai kezelés okozhat. A vérszegénység rontja a betegek életminőségét, valamint a citotoxikus kezelés dóziscsökkentéséhez, illetve késleltetéséhez vezethet. A jelen retrospektív adatelemzés célja az volt, hogy elemezze 19 egymás után felvett, tüdőrákban szenvedő betegünk kemoterápia okozta anaemiájának béta-eritropoetinnel történő szupportációja során a betegek életminőségének és hemoglobinkoncentrációjának alakulását. A betegek átlagos, eritropoetinterápia előtti hemoglobinkoncentrációja 96,31±6,72 g/L volt (átlag±SD). Az anaemia szupportációjának befejezésekor az átlagos hemoglobinkoncentráció szignifikáns mértékben magasabb, 111,63±14,05 g/L volt (p<0,05). A 19 beteg kezelése során 4 esetben volt szükség transzfúzióra. A betegek eritropoetin bevezetését megelőző átlagos életminőséget jellemző teljes pontszáma 22,89±5,67 volt, és szignifikáns mértékben javult a szupportáció mellett (27,84±6,14; p<0,05). A kemoterápia okozta anaemiában szenvedő betegek életminőségének eritropoetin-béta-szupportáció mellett észlelt szignifikáns mértékű javulása megnyilvánult az alábbi részpontszámok szignifikáns mértékű javulásában: szédülést, tachycardiát, gyengeséget jellemző részpontszámok. A kis betegszám és az alkalmazott saját, csupán a betegdokumentáción alapuló kérdőív validáltságának hiánya természetesen korlátozza az adatok értékelhetőségét, az adatelemzés eredményei azonban felhívják a figyelmet az időben bevezetett erythropoeticus proteinszupportáció által biztosított jobb életminőség és alacsony transzfúziós szükséglet elérésének lehetőségére ebben az egyébként nagyon súlyos betegcsoportban. Orv. Hetil., 2010,
41,
1684–1688.
The ISO 18.104: 2003 as Integrative Model of Nursing Terminologies
Authors: Cubas Marcia Regina , Denipote Adelita Gonzalez Martinez , Malucelli Andreia , Nóbrega Maria Miriam Lima da
Published: September 2010

This paper presents the ISO 18.104:2003 as an integrative model of nursing terminology. It describes the standard, studies and experiences with its use and discusses possibilities to develop knowledge in the field. The standard has been shown to be effective in developing reference terminologies, and as a standard method for interoperability and reuse. Studies have internal limitations such as language and notations unknown to nursing. Correspondence of the model with classifications used in health services and practice is incipient, which hinders its applicability and development due to the lack of examples to be analyzed and discussed.
Self-Care Behaviors and Health Indicators in Adults with Type 2 Diabetes
Authors: Compeán Ortiz Lidia Guadalupe , Gallegos Cabriales Esther Carlota , González González José Gerardo , Gómez Meza Marco Vinicio
Published: September 2010

This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006). The results showed a low self-care behaviors index ( or = 36.94, SD=15.14). A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, p<.001), triglycerides (r s=-.208, p=.040), BMI (r s=-.248, p=.014) and body fat percentage (r s=-.221, p=.029). Multivariate analysis revealed the influence of self-care behaviors on HbA1c, BMI and body fat percentage with explained variances of 9 to 41% (p < .05). From all self-care dimensions, diet was the most predictive for health indicators, moderated by gender and understanding of diabetes contents (p< .05).
Knowledge of Patients with Mechanical Valve Prostheses Concerning Chronic Oral Anticoagulant Therapy
Authors: Rocha Helena Teixeira , Rabelo Eneida Rejane , Aliti Graziella , Souza Emiliane Nogueira de
Published: September 2010

Adherence to chronic Oral Anticoagulant Therapy (OAT) is directly related to patients' understanding of the therapy. This study verified the knowledge of patients with mechanical valve prostheses concerning OAT. This is a contemporary cross-sectional study, the sample is composed of patients with mechanical valve prostheses (MVP) in outpatient follow-up. A 10-question instrument was used; answers were ‘know' (1 point), ‘know partially' (half point), or ‘do not know' (zero). Patients were grouped according to the result obtained: ≤ 4 points was considered insufficient knowledge; > 4 ≤ 8 equated to moderate knowledge; and > 8 was considered appropriate knowledge. Of the 110 patients, 61.8% presented moderate knowledge, 40.9% were not able to name at least one factor that may alter the INR (International Normalized Ratio) and 37.3% were not able to report their INR target range. The majority of patients presented moderate knowledge concerning the treatment. Strategies to improve knowledge on the topic should be implemented to minimize risks.
Demographic Factors and Risk Indicators of Stroke: Comparison Between Inhabitants of Fortaleza Municipal District and the National Profile
Authors: Cavalcante Tahissa Frota , Moreira Rafaella Pessoa , Araujo Thelma Leite de , Lopes Marcos Venicios de Oliveira
Published: September 2010

The aim of this study was to compare the demographic factors and the risk indicators for the occurrence of the stroke in the city of Fortaleza with other cities, based on national studies. A transversal study developed with 180 patients who were diagnosed with stroke in nine different public institutions within the period from October 2007 to April 2008. For data collection, a questionnaire was applied by interviewing the patient and/or their companions. The following tests were used for the comparative analysis of epidemiological data: The Chi-Square Test for the adherence and the T-Test for the mean. The patients with stroke evaluated in Fortaleza were younger and had higher rates of hypertension than in the national profile, however, fewer were smokers or consumers of alcohol. It is necessary to increase knowledge about the health of the Brazilian population by region, since there are specific influential factors in the occurrence of stroke.
Mothers' View on Late Postoperative Pain Management by the Nursing Team in Children After Cardiac Surgery
Authors: Nascimento Lucila Castanheira , Strabelli Brisa Soldatelli , Almeida Fernanda Cristina Queiroz Gomes de , Rossato Lisabelle Mariano , Leite Adriana Moraes , Lima Regina Aparecida Garcia de
Published: September 2010

Postoperative pain management in children is a complex, multidimensional and subjective phenomenon. It represents a challenge for children, parents and health professionals. This study aimed to understand how mothers assess their children's pain management by the nursing team in the late postoperative phase of cardiac surgery. Empirical data collection was carried out through semistructured interviews with 17 mothers who accompanied their children. Data were subject to qualitative analysis, revealing that, for the mothers, taking good care results from the confidence they vest in the nursing team and from the observation of the medication interventions this team performs. Not taking good care of their children is a consequence of lack of information or inadequate communication between the team and the mothers. The results of this study permit identifying aspects that strengthen and weaken nursing care for these clients, contributing to the improvement of the delivered care.
Infusion of Hematopoietic Stem Cells: Types, Characteristics, Adverse and Transfusion Reactions and the Implications for Nursing
Authors: Curcioli Ana Carolina de Jesus Vieira , Carvalho Emilia Campos de
Published: September 2010

Hematopoietic stem cell infusion is an important procedure in Hematopoietic Stem Cell Transplantation (HSCT). This study identifies transfusion and other adverse reactions that can occur during infusion and the nursing care related to the procedure. This epidemiologic study used transplantations performed between 2006 and 2008. A total of 166 transplantations were performed: 114 were autologous, 47 allogeneic and five haploidentical. Three transfusion reactions and 96 adverse reactions were observed. Adverse reactions were related to the presence of cryoprotectant, though the infusion rate and quantity of infused cryoprotectant were not related to the occurrence of reactions. The products were fresh and infused within the recommended time when transfusion reactions occurred. In regard to cell source, lower engraftment time was found in peripheral blood. Nursing documentation is relevant for patients' safety as well to planning an infusion in order to minimize the occurrence of reactions.
Factors Related to the Quality of the Dying Process in Cancer Patients
Authors: Espinoza Venegas Maritza , Sanhueza Alvarado Olivia
Published: September 2010

This correlational and descriptive research examined the Quality of the Dying Process (QDP) in cancer patients. Data were collected from one significant person for each of the 78 patients who had died, using QDP and communication quality questionnaires. The highest QDP scores were found for social experiences related to: the moment of death, family company and their concern with the person. The lowest score was for symptoms. A statistically significant association (p<0.001) was found between a better QDP and: preparation for death, spending time with the family, concern and care for the patient, communication quality. Conclusions: patient care needs to be focused on the aspects fostering closeness and dialogue with the patient's close relatives, promoting communication in order to detect and handle the real problems, along with efficient pain management, in which humanized care is essential.
Nursing Care of Women Who Suffered Sexual Violence
Authors: Reis Maria José dos , Lopes Maria Helena Baena de Moraes , Higa Rosângela , Bedone Aloísio José
Published: September 2010

The aim of this study was to characterize the nursing care, provided to women who suffered sexual violence, treated at The Women's Hospital-CAISM/UNICAMP. A retrospective, descriptive study performed using 146 nursing care records of women attended from June 2006 to May 2007. The results showed that the majority of attendances occurred during the day period, that there was consistency between the interventions and the nursing diagnoses identified, and that women reported having received guidance in accordance with the protocol of the program. The nursing consultation time was greater at night (p=0.0227) and the women frequently understood the health risks resulting from sexual violence (p=0.0072), the use of antiretrovirals according to their daily activities (p=0.0397) and they were more focused on the purpose of the serology (p=0.0351). We concluded that the care provided was shown to be appropriate and of a better quality in the nightshift period.
Analysis of the Organizational Aspects of a Clinical Emergency Department: A Study in a General Hospital in Ribeirao Preto, SP, Brazil
Authors: Coelho Mônica Franco , Chaves Lucieli Dias Pedreschi , Anselmi Maria Luiza , Hayashida Miyeko , Santos Claudia Benedita dos
Published: September 2010

Demand for the Emergency Department (ED) has increased, making the organization of work difficult. This quantitative, descriptive and documental study identifies and analyzes the characteristics of clinical care in the ED of a General Hospital in Ribeirão Preto, SP, in 2007, according to organizational variables. The study population included all clinical care consultations registered in the Hospital Management Information System. Data were analyzed through descriptive statistics and discussed considering the theoretical framework of the Single Health System (SUS). A total of 5,285 consultations were registered in the period, which were more frequent in patients from the city itself, in January (10%), on Mondays (16%), from 12pm to 12am (67.1%). The main reason for discharge from the unit was hospitalization (63.8%) and the predominant length of stay in the unit was less than six hours (39.8%). The results support the management of human resources, materials and equipment, indicating the desirability of reorganizing emergency care in the hospital.
Sterility Maintenance Assessment of Moist/Wet Material After Steam Sterilization and 30-day Storage
Authors: Moriya Giovana Abrahão de Araújo , Graziano Kazuko Uchikawa
Published: September 2010

Moist/wet materials stored after autoclaving are considered contaminated and not recommended for use. This study evaluates the maintenance of sterility in moist/wet material after being submitted to steam sterilization and stored for a period of 30 days. Aiming to support decision-making in emergency situations, 40 surgical boxes packed in nonwoven cloth covering Spunbound, Metblouwn, Spunbound (SMS): half (the experimental group) were placed in an autoclave but the drying phase was interrupted, yielding moist/wet materials and the other half (the negative control group) underwent the complete cycle. The external parts of each surgical box were deliberately contaminated with Serratia marcescens and subsequently stored for 30 days. After this period, the boxes' contents were submitted to sterility tests and no growth was observed. The presence of moisture inside the surgical boxes did not interfere with maintaining their sterility.
Social Model: A New Approach of the Disability Theme
Authors: Bampi Luciana Neves da Silva , Guilhem Dirce , Alves Elioenai Dornelles
Published: September 2010

The experience of disability is part of the daily lives of people who have a disease, lesion or corporal limitation. Disability is still understood as personal bad luck; moreover, from the social and political points of view, the disabled are seen as a minority. The aim of this study is to contribute to the knowledge about the experience of disability. The research presents a new approach on the theme: the social model. This approach appeared as an alternative to the medical model of disability, which sees the lesion as the primary cause of social inequality and of the disadvantages experienced by the disabled, ignoring the role of social structures in their oppression and marginalization. The study permits reflecting on how the difficulties and barriers society imposed on people considered different make disability a reality and portray social injustice and the vulnerability situation lived by excluded groups.