bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Potential of Ginger against Renal Injury Induced by Carbon Tetrachloride in Rats
Authors: Hamed Manal A. , Ali Sanaa A. , Saba El-Rigal Nagy
Published: April 2012

The objective of this study was to evaluate the potential of successive ginger extracts (petroleum ether, chloroform, and ethanol) against nephrotoxicity induced by CCl4in rats. The evaluation was done through measuring kidney antioxidant parameters: glutathione (GSH), lipid peroxides (LPO), and superoxide dismutase (SOD). Renal function test: urea, creatinine and serum protein values, were also evaluated. The work was extended to examine tissue inflammatory mediators, prostaglandin-E2(PGE2), collagen content and the kidney histopathology. Severe alterations in all biomarkers were observed after injury with CCl4. Treatment with ginger extracts resulted in markedly decreased levels of LPO, PGE2, collagen and kidney function tests, while increased levels of GSH, SOD and serum protein were observed. In conclusion, extracts of ginger, particularly the ethanol, resulted in an attractive candidate for the treatment of nephropathy induced by CCl4through scavenging free radicals, improved kidney functions, inhibition of inflammatory mediators, and normalizing the kidney histopathological architecture. Further studies are required in order to identify the molecules responsible of the pharmacological activity.
Effects of Amelogenin on Proliferation, Differentiation, and Mineralization of Rat Bone Marrow Mesenchymal Stem CellsIn Vitro
Authors: Izumikawa Masanobu , Hayashi Keijiro , Polan Mohammad Ali Akbor , Tang Jia , Saito Takashi
Published: April 2012

The aim of this study was to clarify the function of amelogenin, the major protein of enamel matrix derivative, on the proliferation, differentiation, and mineralization of cultured rat bone marrow stem cells (BMSCs), toward the establishment of future bone regenerative therapies. No differences in the morphology of BMSCs or in cell numbers were found between amelogenin addition and additive-free groups. The promotion of ALPase activity and the formation of mineralized nodules were detected at an early stage in amelogenin addition group. In quantitative real-time RT-PCR, mRNA expression of osteopontin, osteonectin, and type I collagen was promoted for 0.5 hours and 24 hours by addition of amelogenin. The mRNA expression of osteocalcin and DMP-1 was also stimulated for 24 hours and 0.5 hours, respectively, in amelogenin addition group. These findings clearly indicate that amelogenin promoted the differentiation and mineralization of rat BMSCs but did not affect cell proliferation or cell morphology.
Potential Long-Term Complications of Endovascular Stent Grafting for Blunt Thoracic Aortic Injury
Authors: Miller Larry E.
Published: April 2012

Blunt thoracic aortic injury (BTAI) is a rare, but lethal, consequence of rapid deceleration events. Most victims of BTAI die at the scene of the accident. Of those who arrive to the hospital alive, expedient aortic intervention significantly improves survival. Thoracic endovascular aortic repair (TEVAR) has been accepted as the standard of care for BTAI at many centers, primarily due to the convincing evidence of lower mortality and morbidity in comparison to open surgery. However, less attention has been given to potential long-term complications of TEVAR for BTAI. This paper focuses on these complications, which include progressive aortic expansion with aging, inadequate stent graft characteristics, device durability concerns, long-term radiation exposure concerns from follow-up computed tomography scans, and the potential for (Victims of Modern Imaging Technology) VOMIT.
Deformable Image Registration with Inclusion of Autodetected Homologous Tissue Features
Authors: Zhu Qingsong , Gu Jia , Xie Yaoqin
Published: April 2012

A novel deformable registration algorithm is proposed in the application of radiation therapy. The algorithm starts with autodetection of a number of points with distinct tissue features. The feature points are then matched by using the scale invariance features transform (SIFT) method. The associated feature point pairs are served as landmarks for the subsequent thin plate spline (TPS) interpolation. Several registration experiments using both digital phantom and clinical data demonstrate the accuracy and efficiency of the method. For the 3D phantom case, markers with error less than 2 mm are over 85% of total test markers, and it takes only 2-3 minutes for 3D feature points association. The proposed method provides a clinically practical solution and should be valuable for various image-guided radiation therapy (IGRT) applications.
Evolution of the C-Type Lectin-Like Receptor Genes of the DECTIN-1 Cluster in the NK Gene Complex
Authors: Sattler Susanne , Ghadially Hormas , Hofer Erhard
Published: April 2012

Pattern recognition receptors are crucial in initiating and shaping innate and adaptive immune responses and often belong to families of structurally and evolutionarily related proteins. The human C-type lectin-like receptors encoded in the DECTIN-1 cluster within the NK gene complex contain prominent receptors with pattern recognition function, such as DECTIN-1 and LOX-1. All members of this cluster share significant homology and are considered to have arisen from subsequent gene duplications. Recent developments in sequencing and the availability of comprehensive sequence data comprising many species showed that the receptors of the DECTIN-1 cluster are not only homologous to each other but also highly conserved between species. Even inCaenorhabditis elegans, genes displaying homology to the mammalian C-type lectin-like receptors have been detected. In this paper, we conduct a comprehensive phylogenetic survey and give an up-to-date overview of the currently available data on the evolutionary emergence of the DECTIN-1 cluster genes.
Self-Harm and Suicidal Behaviors in Hong Kong Adolescents: Prevalence and Psychosocial Correlates
Authors: Shek Daniel T. L. , Yu Lu
Published: April 2012

The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH) and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal behavior than did adolescent boys. Having remarried parents was related to an increased likelihood of DSH and suicide. While high levels of family functioning, overall positive youth development, and academic and school performance predicted low rates of DSH and suicidal behavior, cognitive and behavioral competencies were unexpectedly found to be positively associated with DSH and suicidal behavior. Theoretical and practical implications of the findings are discussed.
Expression and Clinical Significance of Antiapoptotic Gene (Survivin) in NB4 and Acute Promyelocytic Leukemia Cells
Authors: Xue Jun , Xie Xiao-Jing , Lin Mao-Fang
Published: April 2012

To study survivin gene expression in APL cells and to explore its correlation with clinical manifestations. PML/RARα and survivin mRNA expression were analysed using RT-PCR. By treatment of ATRA, the survivin mRNA expression in NB4 cells gradually decreased with time and was almost undetectable in the 72th hour. Survivin was expressed in 67% of the 36 APL cases (de novo and relapse patients) with PML/RARα fusion gene expression. However, in 22 cases of remission stage patients without PML/RARα fusion gene expression, survivin was expressed in 36%. The survivin mRNA expression positive rate in de novo and relapse groups, and PML/RARα fusion gene L-type positive groups, was obviously higher than those in remission period groups and was significantly lower than those in acute leukemia groups. In 36 cases of de novo and relapse APL patients, all cases could obtain complete remission, irrespective of the survivin expression. APL patients expressed with survivin mRNA had DIC and serious infection (one patient died). The clinical symptom included slight skin or mucosa bleeding, fever, and asthenic for patients without the survivin mRNA expression. Later, two cases of APL patients with the survivin mRNA expression were treated by ATRA, induction differentiation sign in their peripheral blood and bone marrow figure was not obvious. It was concluded that the survive gene expression was lower in APL than those in any other types of leukemia, thus closely associated with clinical manifestation.
Characteristics of Disease Spectrum in relation to Species, Serogroups, and Adhesion Ability of Motile Aeromonads in Fish
Authors: Kozińska Alicja , Pękala Agnieszka
Published: April 2012

An attempt was made to delineate the relationship between ofAeromonasspecies and/or serogroups and specific disease symptoms in common carpCyprinus carpioL. and rainbow troutOncorhynchus mykissWalbaum. The adhesion ofAeromonasstrains to various tissues in relation to disease spectrum was also tested. All strains ofA. hydrophilacaused skin ulcers as well as septicaemia in both carp and trout while the other strains were able to cause only skin ulcers or some specific internal lesions with or without septicaemia depending on which species and/or serogroup they represented. Disease symptoms depended also on fish species. It was found that adhesion intensity ofAeromonasstrains tested was significantly higher to tissues, which were susceptible to infection with these strains. The results indicate that adhesion to various cells of the fish organism is principal marker to detect virulentAeromonasstrains. The findings presented in this study may be helpful in the appraisal of aeromonads disease risk and kind of the infection in particular fish farms by epizootiological studies or/and during routine fish examinations. They will also be useful to improve and facilitate diagnosis of bacterial fish disease.
Footprinting of Inhibitor Interactions ofIn SilicoIdentified Inhibitors of Trypanothione Reductase ofLeishmaniaParasite
Authors: Venkatesan Santhosh K. , Dubey Vikash Kumar
Published: April 2012

Structure-based virtual screening of NCI Diversity set II compounds was performed to indentify novel inhibitor scaffolds of trypanothione reductase (TR) fromLeishmania infantum. The top 50 ranked hits were clustered using the AuPoSOM tool. Majority of the top-ranked compounds were Tricyclic. Clustering of hits yielded four major clusters each comprising varying number of subclusters differing in their mode of binding and orientation in the active site. Moreover, for the first time, we report selected alkaloids and dibenzothiazepines as inhibitors ofLeishmania infantumTR. The mode of binding observed among the clusters also potentiates the probablein vitroinhibition kinetics and aids in defining key interaction which might contribute to the inhibition of enzymatic reduction of T[S] 2. The method provides scope for automation and integration into the virtual screening process employing docking softwares, for clustering the small molecule inhibitors based upon protein-ligand interactions.
Supercooling Agent Icilin Blocks a Warmth-Sensing Ion Channel TRPV3
Authors: Sherkheli Muhammad Azhar , Gisselmann Guenter , Hatt Hanns
Published: April 2012

Transient receptor potential vanilloid subtype 3 (TRPV3) is a thermosensitive ion channel expressed in a variety of neural cells and in keratinocytes. It is activated by warmth (33–39°C), and its responsiveness is dramatically increased at nociceptive temperatures greater than 40°C. Monoterpenoids and 2-APB are chemical activators of TRPV3 channels. We found that Icilin, a known cooling substance and putative ligand of TRPM8, reversibly inhibits TRPV3 activity at nanomolar concentrations in expression systems likeXenopus laevesoocytes, HEK-293 cells, and in cultured human keratinocytes. Our data show that icilin's antagonistic effects for the warm-sensitive TRPV3 ion channel occurs at very low concentrations. Therefore, the cooling effect evoked by icilin may at least in part be due to TRPV3 inhibition in addition to TRPM8 potentiation. Blockade of TRPV3 activity by icilin at such low concentrations might have important implications for overall cooling sensations detected by keratinocytes and free nerve endings in skin. We hypothesize that blockage of TRPV3 might be a signal for cool-sensing systems (like TRPM8) to beat up the basal activity resulting in increased cold perception when warmth sensors (like TRPV3) are shut off.
Beneficial Effects of Montelukast Against Methotrexate-Induced Liver Toxicity: A Biochemical and Histological Study
Authors: Kose Evren , Sapmaz Hilal Irmak , Sarihan Ediz , Vardi Nigar , Turkoz Yusuf , Ekinci Nihat
Published: April 2012

The effects of montelukast against methotrexate-induced liver damage were investigated. 35 Wistar albino female rats were divided into 5 groups as follows: group I: control; group II: montelukast (ML); group III: methotrexate (Mtx); group IV: montelukast treatment after methotrexate application (Mtx + ML); group V: montelukast treatment before methotrexate application (ML + Mtx). At the end of the experiment, the liver tissues of rats were removed. Malondialdehyde (MDA), myeloperoxidase (MPO), and reduced glutathione levels were determined from liver tissues. In addition, the liver tissues were examined histologically. MDA and MPO levels of Mtx group were significantly increased when compared to control group. In Mtx + ML group, these parameters were decreased as compared to Mtx group. Mtx injection exhibited major histological alterations such as eosinophilic staining and swelling of hepatocytes. The glycogen storage in hepatocytes was observed as decreased by periodic acid schiff staining in Mtx group as compared to controls. ML treatment did not completely ameliorate the lesions and milder degenerative alterations as loss of the glycogen content was still present. It was showed that montelukast treatment after methotrexate application could reduce methotrexate-induced experimental liver damage.
Dicer‐1 is a key enzyme in the regulation of oogenesis in panoistic ovaries
Authors: Donato Tanaka Erica , Piulachs Maria‐Dolors
Published: April 2012

Background information

In insects, the action of microRNAs (miRNAs) on oogenesis has been explored only in dipterans, which possess meroistic ovaries, a highly modified ovarian type. Here we study miRNA function in the most primitive, panoistic type of ovaries using the phylogenetically basal insect Blattella germanica (Dictyoptera, Blattellidae) as model.

Results

Dicer‐1 (Dcr1), a key enzyme in miRNA biogenesis, was depleted using RNAi. Females treated with double‐stranded RNA targeting Dicer‐1, exhibited deep alterations in oocyte development; among them, the follicular epithelia of the basal oocytes did not develop, thus resulting in sterile females.

Conclusions

These effects derived from the absence of Dicer‐1 suggest that miRNAs are crucial for the regulation of oogenesis in panoistic ovaries, the most primitive insect ovarian type.
ROCK1 and ROCK2 regulate epithelial polarisation and geometric cell shape
Authors: Kalaji Ruba , Wheeler Ann P. , Erasmus Jennifer C. , Lee Sang Y. , Endres Robert G. , Cramer Louise P. , Braga Vania M.M.
Published: April 2012

Background information

Cell–cell adhesion and contraction play an essential role in the maintenance of geometric shape and polarisation of epithelial cells. However, the molecular regulation of contraction during cell elongation leading to epithelial polarisation and acquisition of geometric cell shape is not clear.

Results

Upon induction of cell–cell adhesion, we find that human keratinocytes acquire specific geometric shapes favouring hexagons, by re‐modelling junction length/orientation and thus neighbour allocation. Acquisition of geometric shape correlates temporally with epithelial polarisation, as shown by an increase in lateral height. ROCK1 and ROCK2 are important regulators of myosin II contraction, but their specific role in epithelial cell shape has not been addressed. Depletion of ROCK proteins interferes with the correct proportion of hexagonal cell shapes and full elongation of lateral domain. Interestingly, ROCK proteins are not essential for maintenance of circumferential thin bundles, the main contractile epithelial F‐actin pool. Instead, ROCK1 or ROCK2 regulates thin bundle contraction and positioning along the lateral domain, an important event for the stabilisation of the elongating lateral domain. Mechanistically, E‐cadherin clustering specifically leads to ROCK1/ROCK2‐dependent inactivation of myosin phosphatase and phosphorylation of myosin regulatory light chain. These events correlate temporally with the increase in lateral height and thin bundle compaction towards junctions.

Conclusion

We conclude that ROCK proteins are necessary for acquisition of elongated and geometric cell shape, two key events for epithelial differentiation.
Development and evaluation of a real‐time PCR seed lot screening method for Fusarium circinatum, causal agent of pitch canker disease
Authors: Dreaden T. J. , Smith J. A. , Barnard E. L. , Blakeslee G.
Published: April 2012

Fusarium circinatum is a serious pathogen of Pinus spp. worldwide, causing pitch canker disease. F. circinatum can contaminate seeds both internally and externally and is readily disseminated via contaminated seed. Many countries require screening of pine seeds for F. circinatum before they can be imported. The currently accepted screening method is based on culturing the pathogen on a semi‐selective medium and identifying it using morphological traits. This method is time‐consuming and does not allow for accurate identification of the pathogen to the species level. A bulk DNA extraction and real‐time PCR procedure to screen seeds for the presence of F. circinatum were developed in this study. The real‐time PCR method resulted in the detection of F. circinatum in 5 of 6 commercial seed lots tested and has a lower detection limit of 1 × 10−5 ng of F. circinatum DNA per PCR. The culture‐based method detected Fusarium spp. in four of six of the same seed lots. The real‐time PCR method can be used to screen multiple seed lots in 2 days, whereas the culture‐based method requires a minimum of 1–2 weeks. This new real‐time PCR seed screening method allows for fast, sensitive and accurate screening and can be adapted to handle larger volumes of seeds.
The Sustainability of Quinoa Production in Southern Bolivia: from Misrepresentations to Questionable Solutions. Comments on Jacobsen (2011, J. Agron. Crop Sci. 197: 390–399)
Authors: Winkel T. , Bertero H. D. , Bommel P. , Bourliaud J. , Chevarría Lazo M. , Cortes G. , Gasselin P. , Geerts S. , Joffre R. , Léger F. , Martinez Avisa B. , Rambal S. , Rivière G. , Tichit M. , Tourrand J. F. , Vassas Toral A. , Vacher J. J. , Vieira Pak M.
Published: April 2012

Reviewing the situation of quinoa production in southern Bolivia, Jacobsen (2011, J. Agron. Crop Sci. 197: 390) argues that the booming export market has a negative effect on the environment and on the home consumption of quinoa, thereby leading to an environmental disaster in the region. In view of the scarcity of scientific knowledge on the rapid social and environmental dynamics in the region, we consider that Jacobsen’s review misrepresents the situation of quinoa production in southern Bolivia. Specifically, we argue that (i) the data presented by Jacobsen (2011, J. Agron. Crop Sci. 197: 390) do not support any drop in quinoa crop yield supposed to reflect soil degradation and (ii) his demonstration regarding home consumption of quinoa is ill‐founded from both a nutritional and a cultural point of view. We suggest that the diffusion of the arguments exposed by Jacobsen (2011, J. Agron. Crop Sci. 197: 390), because of their flaws, might have strong negative impacts on those concerned with sustainable food production and fair‐trade with developing countries. We conclude that, rather than reinforced agro‐technical controls on local farmers, the rising competition in the international quinoa market requires a shift towards an ethical economy and ethical research cooperation with quinoa producers.
Independent and Combined Effects of Soil Warming and Drought Stress During Anthesis on Seed Set and Grain Yield in Two Spring Wheat Varieties
Authors: Weldearegay D. F. , Yan F. , Jiang D. , Liu F.
Published: April 2012

Increase in soil temperature together with decrease in soil moisture during anthesis of spring wheat (Triticum aestivum L) crops is predicted to occur more frequently in a future climate in Denmark. The objective of this study was to investigate the responses of two Danish spring wheat varieties (Trappe and Alora) to soil warming (H), drought (D) and both (HD) during anthesis. The plants were grown in pots in a climate‐controlled glasshouse. In H, the soil temperature was increased by 3 °C compared with the control (C). In both D and HD treatments, the plants were drought‐stressed by withholding irrigation until all of the transpirable soil water had been depleted in the pots. Results showed that, particularly under D treatment, Alora depleted soil water faster than Trappe. In both varieties, flag leaf relative water content (RWC) was significantly lowered, while spikelet abscisic acid (ABA) concentration was significantly increased by D and HD treatments. Compared with the C plants, D and HD treatments significantly reduced ear number, ear to tiller ratio, shoot biomass, grain yield, harvest index and seed set but hardly affected tiller number and 1000‐kernel weight, whereas H treatment alone only decreased shoot biomass and reduced seed set. When analysed across the varieties and the treatments, it was found that the reduction in seed set was closely correlated with the increase in spikelet ABA concentration, indicating that D and HD treatments induced greater spikelet ABA concentrations might have caused seed abortion. It was concluded that the grain yield reduction under D and HD treatments during anthesis in spring wheat is ascribed mainly to a lowered seed set and wheat varieties (i.e. Alora) with more dramatic increase in spikelet ABA concentration are more susceptible to D and HD treatment.
Neural correlates of socioeconomic status in the developing human brain
Authors: Noble Kimberly G. , Houston Suzanne M. , Kan Eric , Sowell Elizabeth R.
Published: April 2012

Socioeconomic disparities in childhood are associated with remarkable differences in cognitive and socio‐emotional development during a time when dramatic changes are occurring in the brain. Yet, the neurobiological pathways through which socioeconomic status (SES) shapes development remain poorly understood. Behavioral evidence suggests that language, memory, social‐emotional processing, and cognitive control exhibit relatively large differences across SES. Here we investigated whether volumetric differences could be observed across SES in several neural regions that support these skills. In a sample of 60 socioeconomically diverse children, highly significant SES differences in regional brain volume were observed in the hippocampus and the amygdala. In addition, SES × age interactions were observed in the left superior temporal gyrus and left inferior frontal gyrus, suggesting increasing SES differences with age in these regions. These results were not explained by differences in gender, race or IQ. Likely mechanisms include differences in the home linguistic environment and exposure to stress, which may serve as targets for intervention at a time of high neural plasticity.
Rapid recognition at 10 months as a predictor of language development
Authors: Junge Caroline , Kooijman Valesca , Hagoort Peter , Cutler Anne
Published: April 2012

Infants’ ability to recognize words in continuous speech is vital for building a vocabulary. We here examined the amount and type of exposure needed for 10‐month‐olds to recognize words. Infants first heard a word, either embedded within an utterance or in isolation, then recognition was assessed by comparing event‐related potentials to this word versus a word that they had not heard directly before. Although all 10‐month‐olds showed recognition responses to words first heard in isolation, not all infants showed such responses to words they had first heard within an utterance. Those that did succeed in the latter, harder, task, however, understood more words and utterances when re‐tested at 12 months, and understood more words and produced more words at 24 months, compared with those who had shown no such recognition response at 10 months. The ability to rapidly recognize the words in continuous utterances is clearly linked to future language development.
Characterisation of Human Skin Impedance at Acupuncture Point Pc4 Ximen and pericardium meridian using the four-electrode method
Authors: Rezaei Shima , Khorsand Ali , Jamali Jamshid
Published: April 2012

Introduction

Traditional Chinese medicine offers several theories to explain the mechanism of acupuncture. One of these theories proposes that acupuncture points and meridians have unique electrical properties and their electrical skin impedance is lower than surrounding areas. The aim of this study was to evaluate the differences in electrical skin impedance between PC4 and the pericardium meridian compared with the surrounding areas.

Methods

Eighteen healthy subjects (10 women) were recruited to participate in the study. An impedance meter based on the four-electrode technique was designed specifically for the study. Twenty-five points were marked on the skin: one on the point PC4, four others on the pericardium meridian and 20 points around it. The electrical impedance of each point was measured with the four-electrode device.

Results

The mean electrical skin impedance at PC4 was significantly different from the 20 of the surrounding points but not significantly different from the four adjacent points. The mean skin impedance of the five points over the pericardium meridian was significantly different from that of parallel rows of points using repeated measures analysis of variance (p<0.001)

Conclusion

Within the possible limits of this measurement technique, skin impedance along the pericardium meridian is lower than surrounding areas, supporting the idea of different properties of the pericardium meridian compared with the control areas. Evidence on skin impedance at PC4 is inconclusive and further studies are needed.
Is There Any Difference in Human Pupillary Reaction to Acupuncture between Light- and Dark-Adaptive Conditions?
Authors: Mori Hidetoshi , Kuge Hiroshi , Tanaka Tim Hideaki , Kikuchi Yuya , Nakajo Hiroshi , Yamashita Kazuhiko , Nishijo Kazushi
Published: April 2012

Objectives

To determine if acupuncture stimulation elicits a pupillary response under light adaptation and whether there is any difference in the pupillary response between light and dark adaptation environments during acupuncture stimulation.

Methods

The participants consisted of 55 healthy individuals who had no known eye diseases or pupil abnormalities. Experiment 1 compared pupillary responses between acupuncture stimulation and no-stimulation groups under light adaptation. Experiment 2 compared pupillary responses to acupuncture between two conditions (dark and light adaptation) with a two-period repeated measurement crossover design. For both experiments the pupil diameter was continuously measured for 3 min before stimulation, during stimulation and for 3 min after stimulation. For all acupuncture stimulation interventions an acupuncture needle was inserted superficially at the TE5 acupuncture point followed by gentle tapping stimulation for 90 s.

Results

In experiment 1 the pupil diameter was significantly decreased during (p<0.01) and after stimulation (p<0.0001) compared with the pupil diameter before stimulation under light adaptation. No significant difference was noted in the serial changes in pupil diameter in the no-stimulation group. In experiment 2 the pupil diameter was significantly decreased 90 s after stimulation (p<0.05) and 150 s after stimulation (p<0.05) under light adaptation conditions. Furthermore, the pupil diameter was significantly decreased 120 s after stimulation (p<0.05) and 150 s after stimulation (p<0.01) under dark adaptation conditions. No significant difference in the serial changes in pupil diameter was noted between the groups.

Conclusions

This study shows that pupil constriction occurs following acupuncture stimulation under light adaptation and this response is no different from that seen under dark adaptation.
Why clinicians should embrace individual budgets
Authors: Duffy Simon John
Published: April 2012

The use of individual budgets in healthcare marks the beginning of a new set of opportunities for clinicians to collaborate with their patients and use approaches that are not limited to traditional medical treatments. Individual budgets will be particularly valuable in areas of healthcare where increased patient control, responsiveness, creativity or personalisation are useful. Individual budgets are likely to be particularly useful for people with chronic health conditions or mental health needs and for those people who are at the end of life.
Introducing the Palliative Performance Scale to clinicians: the Grampian experience
Authors: Linklater Gordon , Lawton Sally , Fielding Shona , Macaulay Lisa , Carroll David , Pang Dong
Published: April 2012

Objectives

The Palliative Performance Scale (PPS) was introduced across NHS Grampian. Our aim was to determine how practical and useful the PPS was for clinicians looking after palliative patients in a variety of settings.

Methods

A prospective audit approach was used in primary, secondary and nursing home care settings who. Demographic and assessment data were gathered for 3 months; feedback was gathered at the end of the data collection phase. Patient follow-up status was determined at 12 months.

Results

Fifteen clinical sites participated and feedback was obtained from all clinical areas (n=30). Most respondents found the PPS easy to use and that it helped recognise disease progression in cancer patients, but not in patients with dementia/frailty. Assessment data were gathered on 666 patients. Sixty per cent had a malignant diagnosis and 62.5% of the sample died within 12 months. Lower PPS scores at initial assessment indicated poorer prognosis. Median survival figures differed from previously published data. Falling PPS scores increased the risk of death compared with patients whose PPS scores remained static or improved.

Conclusion

Clinicians found the PPS to be a quick, useful way of assessing and reviewing functional changes in palliative patients. However, it may not identify the subtle changes in individuals with advanced dementia. The survival figures confirm that caution is needed in generalising survival data across different settings and populations. Further work is needed to examine changing functional status in patients with non-malignant diseases or dementia/frailty.
Improving end of life care for people with dementia: a rapid participatory appraisal
Authors: Sampson Elizabeth , Mandal Uttara , Holman Amanda , Greenish Wendy , Dening Karen Harrison , Jones Louise
Published: April 2012

Objectives

People with dementia and their carers may experience poor end of life care, often having to navigate complex health and social care systems. The objectives of this study were to identify: (1) barriers for people with dementia and their carers in accessing good quality end of life care and (2) cost-effective ways of enabling improvements.

Methods

Rapid participatory appraisal gains information from different sources across a single locality. Participants were carers of people who had died of dementia, health and social care staff. Care pathways were modelled. Barriers identified from qualitative work were triangulated with detailed case audit and economic analysis. Results were presented to the stakeholder group who generated feasible solutions.

Results

Nine cases were audited (predominantly white British male subjects, 64–84 years with advanced dementia). Six resided at home, one in a care home and two in continuing care wards. Five died in their place of residence and four in the acute hospital. Care costs over the 6 months before death were higher in care homes or continuing care (£37 029) than for those living at home (£19 854). Synthesis of qualitative and quantitative data generated areas for improvement: patient pathway, impact of acute hospitalisation, economic costs, advance care planning, impact on carers, skills and training of health and social care staff.

Conclusions

This method provided evidence for stimulating change in the health and social care system. Following the patient journey and identifying barriers to care allowed local context to be considered. Service providers generated solutions enabling ‘ownership’ of changes to service delivery.
From Cork to Budapest by Skype: living and dying
Authors: Battley Jodie E , Balding Lucy , Gilligan Oonagh , O'Connell Catherine , O'Brien Tony
Published: April 2012

Effective communication is a prerequisite to the delivery of good palliative care. The increasing use of web-based technologies and social media challenges us to reassess traditional communication styles and to define appropriate applications of evolving technologies. The use of Skype, blogging and webcams by patients in our hospitals and hospices is increasing. As illustrated in this case, the availability of such technology enables patients and families to communicate across wide geographical boundaries. This has particular advantages in situations where family members cannot routinely attend at the hospital because of other commitments or distance. The authors report on the varying use of Skype video-telephony over the course of a cancer patient's illness from the initial treatment phase through to the final days and hours of life. The benefits and challenges of using such technologies in a hospital setting and particularly in end-of-life circumstances are discussed.
DYNAMICAL F(R) GRAVITIES
Authors: DZHUNUSHALIEV VLADIMIR
Published: April 2012

It is offered that F(R) modified gravities can be considered as nonperturbative quantum effects arising from Einstein gravity. It is assumed that nonperturbative quantum effects gives rise to the fact that the connection becomes incompatible with the metric, the metric factors and the square of the connection in Einstein–Hilbert Lagrangian have nonperturbative additions. In the simplest approximation both additions can be considered as functions of one scalar field. The scalar field can be excluded from the Lagrangian obtaining F(R) gravity. The essence of quantum correction to the affine connection as a torsion is discussed.
Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran
Authors: Emami Mohammad Hassan , Kouhestani Soheila , Karimi Somayeh , Baghaei Abdolmahdi , Janghorbani Mohsen , Jamali Nahid , Gholamrezaei Ali
Published: April 2012

Aim. Atypical presentations of celiac disease (CD) have now been shown to be much more common than classical (typical) form. We evaluated the frequency of CD among adult patients with typical or atypical symptoms of CD.Materials and Methods. Patients referred to two outpatient gastroenterology clinics in Isfahan (IRAN) were categorized into those with typical or atypical symptoms of CD. IgA antitissue transglutaminase antibody was assessed and followed by duodenal biopsy. In patients for whom endoscopy was indicated (independent of the serology), duodenal biopsy was taken. Histopathological changes were assessed according to the Marsh classification.Results. During the study period, 151 and 173 patients with typical and atypical symptoms were evaluated (mean age =32.8±12.6and35.8±14.8years, 47.0% and 56.0% female, resp.). Frequency of CD in patients with typical and atypical symptoms was calculated, respectively, as 5.9% (9/151) and 1.25% (3/173) based on positive serology and pathology. The overall frequency was estimated as at least 9.2% (14/151) and 4.0% (7/173) when data of seronegative patients were also considered.Conclusions. CD is more frequent among patients with typical symptoms of malabsorption and these patients should undergo duodenal biopsy, irrespective of the serology. In patients with atypical symptoms, serological tests should be performed followed by endoscopic biopsy, and routine duodenal biopsy is recommended when endoscopic evaluation is indicated because of symptoms.
A Bilobed Schwannoma in Roof of Orbit: A Rare Case Report
Authors: Dulani Somya , Diagavane Sachin , Lele Seema , Gaurkhede Harshal
Published: April 2012

In this paper, we report a case of bilobed schwannoma, presented in the roof of orbit arising from supraorbital nerve. A 62-year male presented with a nontender mass in superior part of orbit and eccentric proptosis. Visual acuity and rest of ocular examination were normal. CT scan and MRI orbit revealed an extraconal homogenous bilobed mass, of size 3.5 to 2.5 cms in roof of orbit. Fine needle aspiration cytology was done, which was suggestive of schwannoma a peripheral nerve tumor. Successful surgical excision of intact bilobed schwannoma was done with careful separation and preservation of supraorbital nerve from which it was originated. Postoperative period was uneventful though rare, less than 1%, schwannoma can present as painless mass in the orbit and proptosis. Treatment of choice is surgical excision of intact tumor to prevent recurrence and preservation of peripheral nerve from which it arises.
Infantile Hemangiomas Masquerading as Other Periocular Disorders
Authors: Hsu Jennifer , Mohney Brian G.
Published: April 2012

Periocular tumors are common in infancy. The most common periocular tumors are capillary hemangiomas, which are present in 1-2% of newborns and develop in 10%–12% of children by the age of 1 year old. Deep capillary hemangiomas may be more challenging to diagnose than superficial capillary hemangiomas and can be confused with other orbital lesions. Deep orbital hemangiomas can mimic teratoma, lymphangioma, rhabdomyosarcoma, metastatic neuroblastoma, and granulocytic sarcoma. In this paper, we describe 2 pediatric cases where previously diagnosed dermoid cyst and dacrocystocele were found to be capillary hemangiomas upon biopsy. Approaches to distinguish capillary hemangiomas from other periocular tumors are further discussed. To our knowledge, this is the first case report of periocular hemangiomas imitating a dermoid cyst and a dacrocystocele. These cases emphasize the importance of including infantile hemangiomas in the differential diagnosis of subcutaneous periocular abnormalities.
In VivoClearance of Alpha-1 Acid Glycoprotein Is Influenced by the Extent of Its N-Linked Glycosylation and by Its Interaction with the Vessel Wall
Authors: McCurdy Teresa R. , Bhakta Varsha , Eltringham-Smith Louise J. , Gataiance Sharon , Fox-Robichaud Alison E. , Sheffield William P.
Published: April 2012

Alpha-1 acid glycoprotein (AGP) is a highly glycosylated plasma protein that exerts vasoprotective effects. We hypothesized that AGP’s N-linked glycans govern its rate of clearance from the circulation, and followed the disappearance of different forms of radiolabeled human AGP from the plasma of rabbits and mice. Enzymatic deglycosylation of human plasma-derived AGP (pdAGP) by Peptide: N-Glycosidase F yielded a mixture of differentially deglycosylated forms (PNGase-AGP), while the introduction of five Asn to Gln mutations in recombinantPichia pastoris-derived AGP (rAGP-N(5)Q) eliminated N-linked glycosylation. PNGase-AGP was cleared from the rabbit circulation 9-fold, and rAGP-N(5)Q, 46-fold more rapidly than pdAGP, primarily via a renal route.Pichia pastoris-derived wild-type rAGP differed from pdAGP in expressing mannose-terminated glycans, and, like neuraminidase-treated pdAGP, was more rapidly removed from the rabbit circulation than rAGP-N(5)Q. Systemic hyaluronidase treatment of mice transiently decreased pdAGP clearance. AGP administration to mice reduced vascular binding of hyaluronic acid binding protein in the liver microcirculation and increased its plasma levels. Our results support a critical role of N-linked glycosylation of AGP in regulating itsin vivoclearance and an influence of a hyaluronidase-sensitive component of the vessel wall on its transendothelial passage.
Determination ofRETSequence Variation in an MEN2 Unaffected Cohort Using Multiple-Sample Pooling and Next-Generation Sequencing
Authors: Margraf R. L. , Durtschi J. D. , Stephens J. E. , Perez M. , Voelkerding K. V.
Published: April 2012

Multisample, nonindexed pooling combined with next-generation sequencing (NGS) was used to discoverRETproto-oncogene sequence variation within a cohort known to be unaffected by multiple endocrine neoplasia type 2 (MEN2). DNA samples (113 Caucasians, 23 persons of other ethnicities) were amplified forRETintron 9 to intron 16 and then divided into 5 pools of <30 samples each before library prep and NGS. Two controls were included in this study, a single sample and a pool of 50 samples that had been previously sequenced by the same NGS methods. All 59 variants previously detected in the 50-pool control were present. Of the 61 variants detected in the unaffected cohort, 20 variants were novel changes. Several variants were validated by high-resolution melting analysis and Sanger sequencing, and their allelic frequencies correlated well with those determined by NGS. The results from this unaffected cohort will be added to theRETMEN2 database.
Myelofibrosis Associated with Romiplostim Treatment in a Patient with Immune Thrombocytopenia
Authors: Gonzalez Maria Fernanda , Freeman Jonathan King
Published: April 2012

Immune thrombocytopenia is characterized by antibody-mediated platelet destruction and insufficient platelet production resulting in isolated thrombocytopenia in the absence of underlying cause. Despite many treatment options, low-to-intermediate rates of remission and high rates of resistance to treatment are seen. Approximately 20% of patients do not attain a hemostatic platelet count after splenectomy or after first- and second-line medical approaches. A new option in these cases is treatment withromiplostim. Bone marrow (BM) fibrosis has been reported in clinical trials with romiplostim. We report a case with marked reticulin fibrosis of the BM, worsening of cytopenias and dyserythropoiesis, and atypical megakaryocytes, which did not reverse following cessation of the drug. Although this could represent idiopathic myelofibrosis, unrelated to therapy, the pretreatment biopsy demonstrating no fibrosis combined with the concordant timing of the drug and fibrosis suggests the treatment with romiplostim may be causative.
Age of 40 Years or Younger Is an Independent Risk Factor for Locoregional Failure in Early Breast Cancer: A Single-Institutional Analysis in Saudi Arabia
Authors: Rudat Volker , El-Sweilmeen Hamdan , Fadel Elias , Brune-Erber Iris , Ahmad Nour Alaa , Bushnag Zinaida , Masri Nidal , Altuwaijri Saleh
Published: April 2012

Background. This study was undertaken to evaluate the impact of prognostic factors on the locoregional failure-free survival of early breast cancer patients.Methods. In this single-institutional study, 213 breast cancer patients were retrospectively analysed. Fifty-five of 213 patients were ≤40 years of age at diagnosis. The impact of patient- or treatment-related factors on the locoregional failure-free survival was assessed using the Kaplan-Meier method. The simultaneous impact of factors on the locoregional failure-free survival was assessed using the Cox proportional hazards regression analysis.Results. The median follow-up time of the censored patients was 22 months (mean 28 months, range 3–92 months). On univariate analysis, statistically significant factors for the locoregional failure-free survival were the age (≤40 versus >40 years), T stage (Tis, T0–2 versus T3-4), molecular tumor type (luminal A versus luminal B, Her2neu overexpression, or triple negative), and lymphovascular status (LV0 versus LV1). On multivariate analysis, age and T stage remained statistically significant.Conclusions. Being 40 years or younger has a statistically significant independent adverse impact on the locoregional failure-free survival of patients with early breast cancer.
Alternative Mechanisms to Initiate Translation in Eukaryotic mRNAs
Authors: Martínez-Salas Encarnación , Piñeiro David , Fernández Noemí
Published: April 2012

The composition of the cellular proteome is under the control of multiple processes, one of the most important being translation initiation. The majority of eukaryotic cellular mRNAs initiates translation by the cap-dependent or scanning mode of translation initiation, a mechanism that depends on the recognition of the m7G(5′)ppp(5′)N, known as the cap. However, mRNAs encoding proteins required for cell survival under stress bypass conditions inhibitory to cap-dependent translation; these mRNAs often harbor internal ribosome entry site (IRES) elements in their 5′UTRs that mediate internal initiation of translation. This mechanism is also exploited by mRNAs expressed from the genome of viruses infecting eukaryotic cells. In this paper we discuss recent advances in understanding alternative ways to initiate translation across eukaryotic organisms.
Successful Treatment of Fanconi Anemia and T-Cell Acute Lymphoblastic Leukemia
Authors: Flatt Terrie , Neville Kathleen , Lewing Karen , Dalal Jignesh
Published: April 2012

Fanconi anemia is associated with an increased risk of malignancy. Patients are sensitive to the toxic effects of chemotherapy. We report the case of a patient with Fanconi anemia who developed T-cell acute lymphoblastic leukemia. He experienced chemotherapy-related complications including prolonged neutropenia, grade IV vincristine neuropathy, and disseminated aspergillosis. He was successfully treated with modified dosing of cytarabine and intrathecal methotrexate followed by allogeneic bone marrow transplant. The aspergillosis was treated with systemic antifungal treatment and surgical resection. Now 30 months after bone marrow transplant the patient is without evidence of aspergillosis or leukemia.
Electrical Muscle Stimulation: An Effective Form of Exercise and Early Mobilization to Preserve Muscle Strength in Critically Ill Patients
Authors: Karatzanos Eleftherios , Gerovasili Vasiliki , Zervakis Dimitrios , Tripodaki Elli-Sophia , Apostolou Kleovoulos , Vasileiadis Ioannis , Papadopoulos Emmanouil , Mitsiou Georgios , Tsimpouki Dimitra , Routsi Christina , Nanas Serafim
Published: April 2012

Purpose. This is a secondary analysis of previously published data to investigate the effects of electrical muscle stimulation (EMS) on strength of various muscle groups in critically ill patients.Methods. One hundred forty-two consecutive patients, with APACHE IIscore≥13, were randomly assigned to the EMS or the control group. EMS sessions were applied daily on vastus lateralis, vastus medialis, and peroneus longus of both lower extremities. Various muscle groups were evaluated with the Medical Research Council (MRC) scale for muscle strength. Handgrip strength assessment was also employed.Results. Twenty four patients in the EMS group and 28 patients in the control group were finally evaluated. EMS patients achieved higher MRC scores than controls (P≤0.05) in wrist flexion, hip flexion, knee extension, and ankle dorsiflexion. Collectively, the EMS group performed higher (P<0.01) in the legs and overall. Handgrip strength correlated (P≤0.01) with the upper and lower extremities’ muscle strength and the overall MRC scores.Conclusions. EMS has beneficial effects on the strength of critically ill patients mainly affecting muscle groups stimulated, while it may also affect muscle groups not involved presenting itself as a potential effective means of muscle strength preservation and early mobilization in this patient population.