bluuebunny/crossref_metadata_2025 huggingface dataset:
Low plasma antibodies specific for phosphatidylethanol in alcohol abusers and patients with alcoholic pancreatitis
Authors: Nissinen Antti E. , Laitinen L. Maria , Kakko Sakari , Helander Anders , Savolainen Markku J. , Hörkkö Sohvi
Published: February 2011

Phosphatidylethanol (PEth) is a group of alcohol‐modified phospholipids present in cell membranes after heavy drinking. Our aim was to demonstrate the presence of human plasma antibodies binding to PEth and to address their specificity and value in detecting subjects engaged in heavy alcohol consumption. Antibodies to PEth were analyzed in plasma from heavy drinkers (n = 20), patients with alcoholic pancreatitis (n = 58) and control subjects (n = 24), using chemiluminescent immunoassay. Heavy drinkers and patients with alcoholic pancreatitis demonstrated significantly lower levels of plasma IgG, IgA and IgM titers to PEth compared with controls (P < 0.001). The specificity of the antibodies to PEth was demonstrated with competitive liquid phase immunoassays and flow cytometry. The plasma IgG, but not IgA or IgM, titers to PEth in heavy drinkers correlated with the whole blood PEth concentration determined by liquid chromatography‐mass spectrometry (r = 0.655, P = 0.002). Compared with traditional markers for alcohol abuse (aspartate aminotransferase, gamma‐glutamyl transpeptidase and mean corpuscular volume), receiver operating characteristic curve analysis showed that a low plasma IgA to PEth had the highest area under the curve (AUC 0.940, P < 0.001). In conclusion, plasma IgG, IgA and IgM antibodies binding specifically to PEth were found in subjects of all study groups. Subjects with heavy alcohol consumption showed markedly lower plasma immunoglobulin levels to PEth, potentially making them useful as a biomarker to distinguish heavy from moderate alcohol use.
Relationship between vulnerability to reinforcing effects of morphine and activity of the endogenous cholecystokinin system in Lewis and Fischer rats
Authors: Noble Florence , Benturquia Nadia , Crete Dominique , Canestrelli Corinne , Mas Nieto Magdalena , Wilson Jodie , Roques Bernard P.
Published: February 2011

A great number of studies have shown the presence of physiological interactions between brain neurotransmitter systems in behavioural responses. This is the case for opioid, cholecystokinin (CCK) and dopamine systems. However, so far the role that the CCK system may play in vulnerability to consumption of drugs of abuse is not clear. This was investigated in this study using Lewis rats that are more sensitive to the reinforcing properties of drugs of abuse than Fischer rats. The extraneuronal CCK8 levels and brain CCK2 receptors were found higher in Fischer than in Lewis rats in the nucleus accumbens, one of the most important structures involved in drug consumption. Moreover, pharmacological modulation of the CCK system by administration of a selective CCK2 agonist blocked, in the conditioned place preference, the reinforcing effects of morphine in Lewis rats, whereas a selective CCK2 antagonist revealed reinforcing effects of the alkaloid in Fischer rats. These results obtained following systemic administrations of the CCK ligands were confirmed following microinjection into the nucleus accumbens. Thus, a low level of CCK efflux in the nucleus accumbens could be one of the many factors involved in drug reinforcing effects, whereas a high level of CCK efflux could attenuate it.
Effect of morphine on conditioned place preference in rhesus monkeys
Authors: Wang JianHong , Wu XuJing , Li ChuanYu , Wei JingKuang , Jiang HuiHui , Liu CiRong , Yu ChengYang , Carlson Synnöve , Hu XinTian , Ma Hua , Duan Wei , Ma YuanYe
Published: February 2011

In rodents, a conditioned place preference (CPP) can be induced by morphine. In the current study, we designed a biased place conditioning paradigm to test the rewarding effects of morphine in freely moving rhesus monkeys. Five monkeys were first placed in three serial rooms with the doors open between them for three days. After this habituation period, during which baseline preference for each of the two end rooms was measured, CPP conditioning occurred when the monkeys were injected intramuscularly with morphine at an increasing dose (1.5, 3, 4.5 mg/kg) before they entered the non‐preferred room and on alternate days, with saline before they entered the preferred room. Morphine and saline treatment lasted for six days, respectively. CPP was tested 24 hours after the end of CPP training. The result showed that in all five monkeys, CPP was induced by the morphine treatment. The preference lasted for at least 15.3 ± 1.7 months.
The delta opioid receptor antagonist, SoRI‐9409, decreases yohimbine stress‐induced reinstatement of ethanol‐seeking
Authors: Nielsen Carsten K. , Simms Jeffrey A. , Bito‐Onon Jade J. , Li Rui , Ananthan Subramaniam , Bartlett Selena E.
Published: February 2011

A major problem in treating alcohol use disorders (AUDs) is the high rate of relapse due to stress and re‐exposure to cues or an environment previously associated with alcohol use. Stressors can induce relapse to alcohol‐seeking in humans or reinstatement in rodents. Delta opioid peptide receptors (DOP‐Rs) play a role in cue‐induced reinstatement of ethanol‐seeking; however, their role in stress‐induced reinstatement of ethanol‐seeking is not known. The objective of this study was to determine the role of DOP‐Rs in yohimbine‐stress‐induced reinstatement of ethanol‐seeking. Male, Long‐Evans rats were trained to self‐administer 10% ethanol in daily 30‐minute operant self‐administration sessions using a FR3 schedule of reinforcement, followed by extinction training. Once extinction criteria were met, we examined the effects of the DOP‐R antagonist, SoRI‐9409 (0–5 mg/kg, i.p.) on yohimbine (2 mg/kg, i.p.) stress‐induced reinstatement. Additionally, DOP‐R‐stimulated [35S]GTPγS binding was measured in brain membranes and plasma levels of corticosterone (CORT) were determined. Pre‐treatment with SoRI‐9409 decreased yohimbine stress‐induced reinstatement of ethanol‐seeking but did not affect yohimbine‐induced increases in plasma CORT levels. Additionally, yohimbine increased DOP‐R‐stimulated 35[S]GTPγS binding in brain membranes of ethanol‐trained rats, an effect that was inhibited by SoRI‐9409. This suggests that the DOP‐R plays an important role in yohimbine‐stress‐induced reinstatement of ethanol‐seeking behavior, and DOP‐R antagonists may be promising candidates for further development as a treatment for AUDs.
Innate difference in the endocannabinoid signaling and its modulation by alcohol consumption in alcohol‐preferring sP rats
Authors: Vinod K. Yaragudri , Maccioni Paola , Garcia‐Gutierrez Maria Salud , Femenia Teresa , Xie Shan , Carai Mauro A. M. , Manzanares Jorge , Cooper Thomas B. , Hungund Basalingappa L. , Colombo Giancarlo
Published: February 2011

The present study was undertaken to examine whether genetically predetermined differences in components of the endocannabinoid system were present in the brain of Sardinian alcohol‐preferring (sP) and Sardinian alcohol‐non‐preferring (sNP) rats, a pair of rat lines selectively bred for opposite alcohol preference. The effects of acquisition and maintenance of alcohol drinking, alcohol withdrawal, and alcohol re‐exposure on the endocannabinoid system was also assessed in the striatum of sP rats. The findings revealed significantly higher density of the CB1 receptors and levels of CB1 receptor mRNA, CB1 receptor‐mediated G‐protein coupling, and endocannabinoids in the cerebral cortex, hippocampus and striatum of alcohol‐naive sP rats than sNP rats. A significantly lower expression of mFAAH enzyme was evident in the hippocampus of alcohol‐naive sP rats. Alcohol drinking (during both acquisition and maintenance phases) in sP rats resulted in a significant reduction in striatal CB1 receptor‐mediated G‐protein coupling whereas alcohol withdrawal attenuated this effect. Alcohol consumption was also associated with markedly increased levels of endocannabinoids in the striatum. Co‐administration of the CB1 receptor antagonist, rimonabant (SR141716A) reduced alcohol intake, and reversed alcohol‐induced changes in CB1 receptor‐mediated G‐protein activation. These findings provided a new insight into a potential genetic basis of excessive alcohol consumption, suggesting innate differences in the endocannabinoid system might be associated with higher alcohol preference in sP rats. The data also indicate a modulation of CB1 receptor‐mediated signaling following alcohol consumption, and further strengthen the potential of the endocannabinoid system as a target for the treatment of alcohol related behaviors.
Donor and recipient ACE I/D genotype are associated with loss of renal function in children following renal transplantation
Authors: Büscher Rainer , Nagel Dominik , Finkelberg Ilja , Büscher Anja K. , Wingen Anne‐Margret , Kranz Birgitta , Vester Udo , Hoyer Peter F.
Published: February 2011

Büscher R, Nagel D, Finkelberg I, Büscher AK, Wingen A‐M, Kranz B, Vester U, Hoyer PF. Donor and recipient ACE I/D genotype are associated with loss of renal function in children following renal transplantation. Pediatr Transplantation 2011: 15:214–220. © 2010 John Wiley & Sons A/S.

Abstract:  Genetic polymorphisms of the RAS correlate with allograft function. We therefore analyzed common RAS polymorphisms in kidney donors and in children following RTx to determine the relationship between genotype and decline in GFR, blood pressure, and LVM. A total of 107 children who underwent RTx were included: 70 male, 37 female, mean age 8.8 ± 4.9 yr, mean follow up 5.4 yr. The following RAS polymorphisms were studied in all 107 recipients, 48 donors, and 120 healthy controls: Renin (Renin Mbol 18G/A), ACE I/D; angiotensinogen (AGT M235T), and angiotensin II receptor type‐1 (AT1R A1166C). Only patients homozygous for the ACE D allele had a significantly steeper decline in GFR compared with homozygous carriers of the ACE I allele (slope DD: −4.3 ± 0.8 vs. II: −1.3 ± 1.1 mL/min/1.73 m2 per yr; p = 0.035). In four cases, a DD recipient received a kidney from a DD donor, and these patients showed a more pronounced decline in GFR (−5.2 ± 0.5 mL/min/1.73 m2 per yr; p = 0.002). MABP was not different before vs. after RTx and was independent of ACE I/D genotype. LVMI increased significantly in the majority of patients (36.6 ± 13.9 g/m2.7 six months before RTx vs. 46.4 ± 15.3 g/m2.7 12 months after RTx, p = 0.015). However, this difference disappeared after stratification by ACE I/D genotype. The ACE DD genotype is a potential marker for identifying patients at high risk of poor allograft outcome.
A Personal Perception of the History of Blood and Transfusion
Authors: Heier Hans Erik
Published: February 2011

This paper presents a personal attempt to understand the historical roots of modern transfusion systems and the clinical practice of transfusion. The author is a blood banker and not a professional historian.

The unremitting succession of medical breakthroughs, their twists and turns, and the working life story of people who initiated, enhanced or hampered the progress, are convincing evidence in support of the classical historian's view that learning about the historical and gestational development of knowledge might be as important a source of intellectual stimulation, culture and progress as the knowledge itself‐ (Bahman Habibi, 2000)
Effects of pollen reward removal on fecundity in a self‐incompatible hermaphrodite plant
Authors: Duffy K. J. , Johnson S. D.
Published: February 2011

The pollen of hermaphrodite plants is often utilised by flower‐visiting animals. While pollen production has obvious benefits for plant male fitness, its consequences for plant female fitness, especially in self‐incompatible hermaphrodite species, are less certain. Pollen production could either enhance seed production though increased pollinator attraction, or reduce it if ovules are discounted by deposition of self pollen, as can occur in species with late‐acting self‐incompatibility. To test the effects of pollen reward provision on female fitness, we artificially emasculated flowers in two populations of the succulentAloe maculata(Asphodelaceae), which has a late‐acting self‐incompatibility system, over the course of its flowering period. Flowers of this species are visited by sunbirds (for nectar) and native bees (for pollen and nectar). We measured floral visitation rates, floral rejection rates, pollen deposition on stigmas and fruit and seed set in both emasculated and non‐emasculated plants. We found that flowers of emasculated plants suffered reduced visitation and increased rejection (arrival without visitation) by bees, but not by sunbirds; had fewer pollen grains deposited on stigmas and showed an overall decrease in fruit set and seed set. Rates of seed abortion were, however, greatly reduced in emasculated flowers. This study shows that pollen rewards can be important for seed set, even in self‐incompatible plants, which have been assumed to rely on nectar rewards for pollinator attraction. Seed abortion was, however, increased by pollen production, a result that highlights the complexity of selection on pollen production in hermaphrodite flowers.
Identification of an Arabidopsis solute carrier critical for intracellular transport and inter‐organ allocation of molybdate
Authors: Gasber A. , Klaumann S. , Trentmann O. , Trampczynska A. , Clemens S. , Schneider S. , Sauer N. , Feifer I. , Bittner F. , Mendel R. R. , Neuhaus H. E.
Published: February 2011

Plants represent an important source of molybdenum in the human diet. Recently, MOT1 has been identified as a transport protein responsible for molybdate import in Arabidopsis thaliana L.; however, the function of the homologous protein MOT2 has not been resolved. Interestingly, MOT2‐GFP analysis indicated a vacuolar location of this carrier protein. By site directed mutagenesis at the N‐terminal end of MOT2, we identified a di‐leucine motif that is essential for driving the protein into the vacuolar membrane. Molybdate quantification in isolated vacuoles showed that this organelle serves as an important molybdate store in Arabidopsis cells. When grown on soil, leaves from mot2 T‐DNA mutants contained more molybdate, whereas mot2 seeds contained significantly less molybdate than corresponding wild‐type (Wt) tissues. Remarkably, MOT2 mRNA accumulates in senescing leaves and mot2 leaves from plants that had finished their life cycle had 15‐fold higher molybdate levels than Wt leaves. Reintroduction of the endogenous MOT2 gene led to a Wt molybdate phenotype. Thus, mot2 mutants exhibit impaired inter‐organ molybdate allocation. As total concentrations of the molybdenum cofactor (Moco) and its precursor MPT correlates with leaf molybdate levels, we present novel evidence for an adjustment of Moco biosynthesis in response to cellular MoO42− levels. We conclude that MOT2 is important for vacuolar molybdate export, an N‐terminal di‐leucine motif is critical for correct subcellular localisation of MOT2 and activity of this carrier is required for accumulation of molybdate in Arabidopsis seeds. MOT2 is a novel element in inter‐organ translocation of an essential metal ion.
Predictors of medication adherence in children receiving psychotropic medication
Authors: Dean Angela J , Wragg Jillian , Draper Judith , McDermott Brett M
Published: February 2011

Aim:  Medication adherence is poor in many young people with chronic illness. However, little research has examined medication adherence in clinic samples of young people receiving psychotropic medication, and whether factors such as disorder or drug type influence adherence. This study aimed to examine medication adherence in children and adolescents receiving psychotropic medication.

Methods:  Young people receiving psychotropic medication and their caregivers were recruited from pharmacy and mental health services within a large metropolitan hospital. A brief cross‐sectional survey examined medication history, missed doses within the previous week and other clinical information. Multiple regression analysis examined whether child characteristics, drug type and regimen characteristics were associated with medication adherence.

Results:  Poor adherence was associated with lack of parental involvement in medication routines (P < 0.05), use of complementary medicines (P < 0.01) and difficulty remembering doses (P < 0.01). Developmental diagnoses (P < 0.05), use of antipsychotics (P < 0.05) and use of concomitant non‐psychotropic medication (P < 0.05) were predictors of good adherence.

Conclusion:  Encouraging parental involvement in medication routines may be a practical target for clinicians aiming to improve medication adherence in young people. Use of complementary medicines may indicate a group with a higher risk of poorer adherence.
Impact of an oral health intervention on pre‐school children <3 years of age in a rural setting in Australia
Authors: Neumann Ana S , Lee Katherine J , Gussy Mark G , Waters Elizabeth B , Carlin John B , Riggs Elisha , Kilpatrick Nicky M
Published: February 2011

Aim:  Australian pre‐school children living in rural areas experience higher levels of dental caries than those in metropolitan areas. This may be because of a lack of community water fluoridation. The aim of this study was to evaluate the effectiveness of a community‐based intervention to improve the oral health of children in non‐fluoridated rural Victoria, Australia.

Methods:  The study was conducted across three local government areas in Victoria, with two receiving the intervention and one remaining with standard care. Although multifaceted, the primary strategy of the intervention was the promotion of early exposure to fluoridated toothpaste, including the distribution, by maternal and child health nurses (MCHNs), of an oral health starter kit including toothpaste, toothbrush and information to parents at their child's 7–8‐month health check. Children were followed up annually to the age of three.

Results:  Infants in the intervention arm experienced less caries (cavitated and pre‐cavitated lesions included) than infants in the control arm at the first and second examinations (3.1% with caries in the intervention vs. 6.9% in the control group at exam 1 (adjusted P= 0.07) and 10.8% vs. 19.5% at exam 2 (adjusted P= 0.11), respectively). However potential benefits disappeared at the third examination (29.5% vs. 28.9%, adjusted P= 0.67).

Conclusions:  This study suggests that an oral health promotion intervention delivered via local MCHNs promoting early exposure to fluoride may be successful in reducing caries in the second year of life but less so in older children when participants have less contact with MCHNs.
Low defaecation frequency in Taiwanese adolescents: Association with dietary intake, physical activity and sedentary behaviour
Authors: Chien Li‐Yin , Liou Yiing Mei , Chang Polun
Published: February 2011

Aim:  The objectives of this study were to estimate the prevalence of constipation, defined as less than three defaecations per week, in Taiwanese adolescents and to examine its association with the intake of vegetables, fruits and fluids; time spent on sedentary behaviour; and time spent on moderate and vigorous physical activity.

Methods:  This study used a questionnaire survey. The study participants were 14 626 adolescents in grades 7–12. Physical activity was measured using the International Physical Activity Questionnaire‐Youth Show Card Version. Time spent on sedentary activity included studying, reading, sitting in vehicles and screen time. Consumption of fluid, fruits and vegetables was measured by asking participants to describe the average consumption of each type of food in the past 7 days.

Results:  The prevalence of defaecation frequency of <3 times a week was 9.3%. Multivariate logistic regression analysis showed that female sex (odds ratio (OR) = 2.2), worse health status (OR = 1.3), not being overweight/obese (OR = 0.7 and 0.3 for overweight and obesity), more time spent on sedentary activity (OR = 1.0) and low intake of fluids (<1.8 L/day; OR = 1.2), fruits (<1 portion; OR = 1.6), vegetables (<1 portion or 100 g; OR = 1.4) and whole‐grain products (OR = 1.2) were independently associated with increased risk of low defaecation frequency.

Conclusions:  The prevalence of low defaecation frequency was high in Taiwanese adolescents. Decreasing sedentary behaviour and increasing the intake of fluids, vegetables, fruits and whole‐grain products among those adolescents with very low intake levels could be helpful in preventing and managing constipation, irrespective of body size and health status.
Parents' attitudes towards the influenza vaccine and influencing factors
Authors: Cooper Robbins Spring Chenoa , Leask Julie , Booy Robert
Published: February 2011

Aim:  To determine what factors are associated with parents' attitudes towards accepting the influenza vaccine for their child.

Methods:  Parents' attitudes were measured as part of a pilot randomised controlled trial of influenza vaccination in children attending day care in 2007. Parents and their children were recruited to the study upon a doctor's visit to the day care. A questionnaire elicited beliefs and attitudes towards influenza and vaccination. Descriptive analyses and χ2 were calculated to determine factors associated with parental attitudes towards the influenza vaccine and with vaccination status.

Results:  One hundred sixty‐nine care givers were interviewed. The following factors were identified as preventive by parents: washing hands (81%); eating a healthy diet (75%); immunisation (74%); keeping their child out of child care when flu is around (54%); disinfecting household surfaces (53%); and breastfeeding for 6 months (48%). Only 5.9% of parents generally or strongly opposed influenza vaccination for their children, and only 1.8% thought that there was a high risk associated with their child having the vaccination. Parents with stronger support for the vaccine tended to view it as safer than other parents and also tended to know more about preventing influenza than other parents. Level of support for the vaccine and perceived safety of the vaccine were both significantly correlated with parents' acceptance of the offer for child influenza vaccination.

Conclusions:  There were small numbers of our sample that did not support influenza vaccination; thought that it was unsafe; and/or had low levels of knowledge about prevention of influenza but still vaccinated their child against influenza. There is a need for strong and well‐justified recommendations for parents to accept seasonal influenza vaccination for their children.
High prevalence of rheumatic heart disease in Fiji detected by echocardiography screening
Authors: Reeves Ben M , Kado Joseph , Brook Monica
Published: February 2011

Aim:  Rheumatic heart disease poses a huge burden for developing countries, with Pacific Island nations having among the highest prevalence reported in the world. It is recognised that echocardiography is much more sensitive than clinical examination for detection of rheumatic heart disease, but resource and cost limitations are delaying implementation of screening programmes in developing nations. Rapid echocardiography using low‐cost portable machines and a non‐expert operator may be a useful compromise, allowing widespread screening and control of rheumatic heart disease in developing countries.

Methods:  In‐school echocardiography and clinical examination was carried out on primary school children (aged five to 14) in Lautoka, Fiji. All of the children with abnormal findings were then recalled for complete in‐hospital clinical and echocardiographic assessment by a paediatrician with expertise in rheumatic heart disease and echocardiography.

Results:  Using screening echocardiography averaging less than 4 min per patient, the prevalence of definite rheumatic heart disease detected by echocardiogram screening was 55.2 per 1000 compared with 11 per 1000 detected by clinical examination (P < 0.001). It was demonstrated that echocardiography is five times more sensitive at detecting rheumatic heart disease compared with clinical examination. A comprehensive screening programme is estimated to cost less than US$40 per patient detected.

Conclusion:  This study confirms that Fiji has the highest documented prevalence of rheumatic heart disease in the world. Rapid echocardiography has the potential to screen large numbers of patients by non‐specialist operators, which encourages its use in larger scale screening and prevention strategies in developing countries.
Clinicopathological characteristics of ovarian tumours according to menarchal status in Korean girls
Authors: Lee Hongjue , Lee Wonmoo , Cho Samhyeon , Roh Jaesook
Published: February 2011

Aim:  To evaluate our experience with ovarian tumours in young girls and to identify specific characteristics in relation to their menarchal status that might assist in the early diagnosis and prompt management.

Methods:  Girls younger than 18 years of age who had an adnexal tumour confirmed at surgery from 1985 to 2008 were identified from the pathology database of Hanyang University Medical Centre. Clinicopathological characteristics such as patient's age, age at menarche, presenting symptoms, operative findings and final histological diagnosis were analysed.

Results:  Twenty‐four of the 90 patients operated on for an ovarian tumour were pre‐menarchal and 66 were post‐menarchal. Most tumours were of germ cell origin: 83% of tumours in pre‐menarchal and 53% in post‐menarchal girls. Most of the patients complained of abdominal pain (∼70%), although a palpable mass was identified in only 17% of pre‐menarchal and 30% of post‐menarchal patients. Vomiting was a major complaint in pre‐menarchal patients (30%) but was uncommon in post‐menarchal patients (<5%). The frequency of torsion was significantly higher in pre‐menarchal (50%) than in post‐menarchal (17%) patients, and more than 90% of the torsion in pre‐menarchal patients occurred in tumours of germ cell origin.

Conclusions:  The incidence of ovarian tumour and torsion is rare, especially in pre‐menarchal girls. However, we found a higher prevalence of torsion in pre‐menarchal girls with an ovarian tumour. A high level of suspicion for torsion should be considered when treating pre‐menarchal girls with an ovarian tumour, irrespective of the tumour size to preserve adnexal tissue.
Children's consumption of beverages in Singapore: Knowledge, attitudes and practice
Authors: Goh Danial Yam Thiam , Jacob Anna
Published: February 2011

Aim:  To examine the beverage consumption habits of Singaporean children and to investigate knowledge and attitudes of parents and children with regard to beverage consumption.

Methods:  A total of 800 respondents were randomly surveyed using face‐to‐face household interviews conducted between 10 March and 23 April 2009. The survey included mothers aged 25 to 44 years, of 400 children aged three to six years and 400 children aged seven to 10 years.

Results:  Children aged three to six and seven to 10 years typically consume milk on a daily basis. Younger children consume a greater number of servings of milk, whereas a significantly greater proportion of children aged seven to 10 years consume malted energy drinks and non‐gassy and gassy soft drinks (P ≤ 0.005 for all). In older children, a decline in the proportion consuming milk on a typical weekday (69% vs. 92% for three‐ to six‐year‐olds) is accompanied by a reduction in mean calcium intake (733 mg vs. 1032 mg for three‐ to six‐year‐olds). On a typical weekday, 26% of children aged three to six years did not meet the recommended daily dietary allowance (RDDA) of 600 mg of calcium. Of children aged seven to 10 years, 61% also did not meet the age‐appropriate RDDA of 700 g mg of calcium.

Conclusions:  Milk consumption decreases with age while the consumption of beverages such as malted energy drinks, gassy and non‐gassy soft drinks and syrups increases markedly. Educational programmes may aid in the selection of appropriate nutrient‐dense beverages and other calcium‐rich foods to ensure that children achieve the recommended daily dietary nutrient intake.
A case of granulocyte colony‐stimulating factor and interleukin 6 receptor‐producing mediastinal mature cystic teratoma with somatic‐type malignancy
Authors: Masunaga Atsuko , Sato Yuichi , Kadofuku Tsuyoki , Iwamoto Sanju , Masuda Mikio , Suzuki Shuichi , Suzuki Takashi , Miyazaki Akira , Mitsuya Toshiyuki
Published: February 2011

Mediastinal germ cell tumor with somatic‐type malignancy is a rare neoplasm. We describe one such case in a 49‐year‐old Japanese man who had shown an elevated serum concentration of granulocyte colony‐stimulating factor (GCSF) and leukocytosis without a shift to the left. Histologically, the tumor formed a teratomatous cyst whose wall contained benign epithelial components, well‐differentiated tubular and mucinous adenocarcinoma, and poorly‐differentiated pleomorphic carcinoma. Immunohistochemically, both the well differentiated adenocarcinoma and poorly differentiated pleomorphic carcinoma expressed GCSF. Immunohistochemistry and molecular analysis revealed that both components also produced interleukin 6 receptor (IL6R). We diagnosed this tumor as a GCSF‐ and IL6R‐producing mediastinal mature cystic teratoma with somatic‐type malignancy. The tumor showed immunohistochemical expression of activated signal transducer and activator of transcription 3. The patient died 6 months after developing systemic symptoms. For a GCSF‐producing tumor, complete resection appears to offer the best outcome at present. For any patient presenting with leukocytosis without a shift to the left, a thorough analysis should be conducted, and the tumor diagnosed as early as possible.
Compliance of Cypriot nurses with Standard Precautions to avoid exposure to pathogens
Authors: Efstathiou Georgios , Papastavrou Evridiki , Raftopoulos Vasilios , Merkouris Anastasios
Published: February 2011

Standard Precautions have been introduced as a means to protect health professionals from exposure to pathogens. This study examines the extent of Cypriot nurses' compliance with the main aspects of Standard Precautions and explores the possible associations with the nurses' characteristics. Self‐completed questionnaires that examined the frequency of the implementation of Standard Precautions were distributed to a convenience sample of 668 nurses. The response rate was 89.37%. The results showed inadequate compliance with Standard Precautions. Full compliance with all the main aspects of Standard Precautions was reported by only 9.1% of the participants. Male nurses and those who had not been exposed previously to pathogens reported better compliance, in comparison to female nurses and those who had been exposed previously. Nurses who had participated previously in an educational program about Standard Precautions reported a higher frequency of implementing them than those who had not participated. The nurses' age and frequency of the implementation of Standard Precautions were found to be significantly and positively correlated. The results can be used to enhance nurses' safety by focusing on areas of non‐compliance.
Enhancing patient adherence: Outcomes of medication alliance training on therapeutic alliance, insight, adherence, and psychopathology with mental health patients
Authors: Byrne Mitchell K. , Deane Frank P.
Published: February 2011

The results of interventions to enhance patient adherence to medication have been inconsistent. This research investigated the utility of an enhanced adherence training programme to ascertain its effectiveness and the possible mechanisms of that effect. Forty‐six clinicians were trained in ‘medication alliance’, and data were collected from 51 patients matched to the clinician. Data on clinician changes in skills, knowledge, and attitudes, in relation to enhancing patient adherence and patient changes in adherence, insight, and psychopathology were collected at baseline and at 6 and 12 months. The quality of the therapeutic relationship between the clinician and the patient was also assessed. The results indicated significant improvements in both clinician and patient measures, the majority of which were maintained over time. The quality of the therapeutic relationship was also enhanced. A hypothesized explanatory model accounting for the data was supported. It was concluded that clinician training to support improved patient adherence should include strategies that also enhance the therapeutic alliance.
Retrospective analysis on coexisting ovarian cancer in 976 patients with clinical stage I endometrial carcinoma
Authors: Pan Zimin , Wang Xinyu , Zhang Xiaofei , Chen Xiaoduan , Xie Xing
Published: February 2011

Aim:  To evaluate the safety of ovarian preservation at the time of operation in clinical stage I endometrial carcinoma.

Material and Methods:  The data of patients with and without coexisting ovarian cancers were retrospectively collected and clinic‐pathologic parameters were analyzed.

Results:  In total, 20 (2.05%) were histologically diagnosed as coexisting ovarian cancer, including 17 (1.74%) ovarian metastases and three (0.31%) synchronous ovarian primary cancers in 976 patients. Fifty percent (10 of 20) were microscopic ovarian involvements. Ovarian involvement was significantly associated with histological type, depth of myometrial invasion, cervical invasion, uterine serosa extension, fallopian tube involvement, retroperitoneal lymph node metastasis, positive peritoneal cytology and CA125 level by univariate analysis (all P < 0.05); while cervical invasion, uterine serosa extension, and fallopian tube involvement were independent high‐risk factors by multivariate analysis (both P < 0.05).

Conclusion:  The incidence of coexisting ovarian cancer in clinical stage I endometrial carcinoma is low, but the decision for ovary preservation at the time of operation still needs to be made with caution because of occult ovarian metastasis, especially for patients with high‐risk factors.
Failure of epidural analgesia converted to epidural anesthesia for cesarean delivery in a patient with bronchial atresia in labor
Authors: Jung Hyun Ju , Kim Jong Bun , Im Kyong Shil , Kim Duk Ju , Lee Jae Myeong
Published: February 2011

Bronchial atresia is a rare anomaly characterized generally by obstruction in the bronchial system, mucus accumulation, emphysematous changes and bulla formation in the peripheral lung. Regional anesthesia is the choice for cesarean delivery in a parturient patient with this anomaly. We report a patient with a diagnosis of bronchial atresia in whom the conversion of epidural analgesia to epidural anesthesia for cesarean delivery failed during labor, needing the application of general anesthesia for a successful delivery.
Studies of the dynamic expression of the Xenorhabdus FliAZ regulon reveal atypical iron‐dependent regulation of the flagellin and haemolysin genes during insect infection
Authors: Jubelin Grégory , Pagès Sylvie , Lanois Anne , Boyer Marie‐Hélène , Gaudriault Sophie , Ferdy Jean‐Baptiste , Givaudan Alain
Published: February 2011

Xenorhabdus nematophila engages in complex interactions with invertebrates, through its symbiosis with soil nematodes and its pathogenicity to a broad range of insect larvae. Among the regulatory proteins of Xenorhabdus involved in host interactions, the sigma factor FliA and the regulator FliZ, expressed from the fliAZ operon, play a key role in mediating the production of exoenzymes, motility and full virulence in insects (Lanois et al., 2008). In this study, we investigated the dynamics of the FliA‐dependent flagellin gene fliC and FliZ‐dependent haemolysin genes xaxAB during insect infection and nematode association by carrying out real‐time expression analysis using an unstable GFP monitoring system. We showed that expression of the FliAZ‐dependent genes in infected insects is not restricted to a specific tissue but increases significantly just prior to host death and reaches a maximal level in larvae cadaver. Using an iron availability reporter construct, we also showed that iron starvation conditions inhibit expression of FliAZ‐dependent genes in vitro, as well as during the first steps of the infectious process. These findings shed further light on the role of the FliAZ regulon in the Xenorhabdus life cycle and suggest that iron may constitute a signal governing Xenorhabdus adaptation to shifting host environments.
Virtual cavernoscopy: a novel diagnostic tool for use in the corpus cavernosal lumen in patients with erectile dysfunction
Authors: Izumi Kazuyoshi , Kawanishi Yasuo , Muguruma Hiroshi , Kusuhara Yoshihito , Komori Masatsugu , Yamanaka Masahito , Yamamoto Akira , Numata Akira , Kishimoto Tomoteru , Kanayama Hiro‐omi
Published: February 2011

Study Type – Diagnostic (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

In visualizing the artery in patients with ED, digital subtraction angiography, CT angiography and color Doppler ultrasonography has been performed.

There were difficulties with the previous methods in visualizing the stenotic lesion, or parts beyond the obstruction of the artery. Virtual cavernoscopy can visualize an artery independently of blood flow. We therefore believe that this new imaging technology will contribute to better ED practice.

OBJECTIVE

• To evaluate virtual cavernoscopy as a diagnostic tool in erectile dysfunction.

PATIENTS AND METHODS

• Forty patients who visited our hospital for investigation of erectile dysfunction underwent cavernosography using three‐dimensional (3D)‐computed tomography (CT).

• Virtual cavernoscopic images were reconstructed from 3D‐CT data.

RESULTS

• Virtual cavernoscopic images were obtained from all patients.

• Virtual cavernoscopy visualized the corpus cavernosal lumen surrounded by the tunica albuginea, the septum of the cavernosum, the outlets of the veins, and cavernous arteries.

• The visualization of each structure depended on the window level (WL). At WL 400, the virtual cavernoscopy visualized only a fibrous structure. At this WL, the internal view of the corpus cavernosum was expressed as a hollow space. At WL 1600, the virtual cavernoscopy visualized the cavernous artery as a filling defect.

• Out of 80 lumens in the 40 subjects, arteries in 14 lumens were detected by both virtual cavernoscopy and CT angiography, while arteries in 50 lumens were detected only by virtual cavernoscopy. Arteries in two lumens could not be visualized by either method and those in 14 lumens were visualized only by CT angiography.

CONCLUSION

• In visualizing the artery, conventional imaging techniques depend on blood flow, whereas using virtual cavernoscopy an artery can be visualized independently of blood flow. Virtual cavernoscopy is unique in this regard and we therefore believe that this new imaging technology will contribute to better ED practice.
The application of pelvic osteotomy in adult female patients with exstrophy: applications and outcomes
Authors: Ansari Mohd S. , Gearhart John P. , Cervellione Raimondo Maximilian , Sponseller Paul D.
Published: February 2011

Study Type – Therapy (case series)

Level of Evidence 4

OBJECTIVE

• To apply the technique of pelvic osteotomy to a select group of adult female patients with exstrophy, in view of the low complication rate and acceptable success rate of the technique.

PATIENTS AND METHODS

• We applied this technique as an adjunct to uterovaginal suspension and abdominal wall repair after our prior success in treating patients with extreme pelvic diastasis.

• Bilateral innominate (transverse) and vertical iliac osteotomies were done from an anterior approach and an external fixator was placed. The fixator and pelvic bones were gradually cranked together over a period of 2–3 weeks until the diastasis was less than 4 cm.

• Then sacrocolpopexy was performed with revision of the abdominal wall and revision genitoplasty along with the placement of an intrasymphyseal titanium plate.

RESULTS

• Six patients presented with uterine/vaginal prolapse and concerns about the appearance of their abdominal wall and genitalia. Three patients had undergone uterine suspension before and one patient had had five prior attempts at suspension, which failed. The mean (range) age was 22.3 (18–26) years.

• All the patients underwent staged reduction of pubic diastasis and sacrocolpopexy along with revision of the abdominal wall and in four cases revision genitoplasty was also performed. The mean (range) diastasis was 12.8 (8–18) cm and 2.8 (3–4) cm before and after staged reduction respectively.

• Complications included transient femoral nerve palsy (two) and foot drop secondary to sciatic nerve stretch (one), which resolved with time. The symphyseal plate needed to be removed in three patients: secondary to persistent pain at the site (one), persistent discharge from the lower abdominal wound (one) and erosion into the anterior wall of the vagina (one).

• At a mean (range) follow‐up of 60.7 (2–137) months the cosmetic and functional outcome of the abdominal wall reconstruction and genitoplasty was good with all the patients being satisfied. Five patients are currently sexually active and none has had a recurrence of their prolapse. None has become pregnant yet.

CONCLUSIONS

• Although the morbidity of this procedure in the adult is not insignificant, it is a valuable adjunct to pelvic floor reconstruction in young women of childbearing age even in those who have had prior suspension procedures.

• In addition, it allows the movement of lateral previously unoperated skin into the midline, allowing scar and skin replacement with healthier more vascularized tissue.
Co‐administration of intravesical bacillus Calmette‐Guérin and interferon α‐2B as first line in treating superficial transitional cell carcinoma of the urinary bladdera
Authors: Bazarbashi Shouki , Soudy Hussein , Abdelsalam Mahmoud , Al‐Jubran Ali , Akhtar Saad , Memon Muhammad , Aslam Muhammad , Kattan Said , Shoukri Mohamed
Published: February 2011

Study Type – Therapy (individual cohort)

Level of Evidence 2b

What’s known on the subject? and What does the study add?

BCG is the standard treatment for superficial bladder cancer. The combination of BCG and interferon‐alfa may be more effective and less toxic than BCG alone.

With long term follow up the efficacy and toxicity of combined intravesical BCG and interferon‐α and BCG alone seems to be equal in treatment of superficial bladder cancer.

OBJECTIVE

• To evaluate the efficacy and toxicity of the combination of bacillus Calmette‐Guérin (BCG) and interferon α‐2B (IFNα‐2B) in treating superficial bladder cancer (SBC). The mentioned combination has shown synergism in pre‐clinical studies.

PATIENTS AND METHODS

• The present study is a single‐arm, open‐label, single‐institution prospective trial. Patients with Ta, T1 or in situ carcinoma and no previous intravesical therapy were included between July 2002 and June 2009.

• Patients were treated with weekly intravesical instillation of 27 mg of BCG mixed with 10 million units (MU) of IFNα‐2B for six consecutive weeks followed by 3‐weekly booster instillations at 3 months if there was no recurrence.

• The primary endpoint was disease recurrence. Secondary endpoints were disease progression and toxicity.

• Patients were followed‐up with cystoscopy and urine cytology every 3 months.

RESULTS

• In all, 50 patients were included.

• At a median follow‐up of 55.8 months, 31 (62%) patients were recurrence‐free.

• Progression to muscle invasion occurred in two (4%) and metastasis occurred in two (4%) patients.

• Treatment was well tolerated, with grade III dysuria and frequency occurring in 18 and 14% of patients, respectively, and with 74% of patients being able to complete the maintenance dosage.

CONCLUSION

• The combination of BCG and IFNα‐2B in the patient population with SBC has similar efficacy and toxicity to BCG monotherapy.
Transperineal bulbo‐prostatic anastomosis for posterior urethral stricture associated with false passage: a single‐centre experience
Authors: Fu Qiang , Zhang Jiong , Sa Ying‐long , Jin San‐bao , Xu Yue‐min
Published: February 2011

Study Type – Therapy (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

The emergency treatment of patients with PFUDD in developing countries is not currently codified and the majority of these patients have been treated using incorrect procedures that add iatrogenic damage to the trauma. Sometimes urethral dilatation gruffly and repeatedly wound lead to formation of urethral false passage which results in infection and incontinence. The treatment of urethral false passage is still a major challenge for urologists. False passage can lead to prolonged unhealed infections, increase the scar around the urethra, increasing stricture significantly. If preoperative examination was careless, it leads to identify false passage difficultly intra‐operative, the variation of direction when the curved sound was used as internal guidance, anastomosis between distal urethra and bladder wall near the orificium urethrae internum, leading to surgical failure.

Cystourethrogram, flexible cystocopy pre‐operatively and dissect urethral bulb carefully are key points of urethroplasty for posterior urethral stricture with false passage. Then to pass a curved sound via the suprapubic tract into the posterior urethra to act as a guide for subsequent excision of all scar tissue.

OBJECTIVE

• To evaluate the management of traumatic posterior urethral stricture associated with false passage, as this remains a challenge for urologists.

PATIENTS AND METHODS

• From January 2000 to February 2010, 19 patients (mean (range) age 34 [25–52] years) with traumatic posterior urethral obliteration associated with false passage were evaluated and treated at our centre.

• All patients underwent perineal excision and primary anastomotic urethroplasty using cystoscopy by the suprapubic route to insert a guidewire into the original bladder neck, allowing exposure of the normal posterior urethra.

• Patients underwent voiding cysto‐urethrography 1 month after the procedure. When symptoms of decreased force of stream were present and uroflowmetry was <15 mL/s, urethrography and urethroscopy were repeated.

• Clinical outcome was considered a failure when any postoperative instrumentation was needed, including dilatation.

RESULTS

• The mean (range) follow‐up was 12 (9–14) months. The overall success rate was 84%.

• Three patients (16%) with persistent voiding difficulty developed a short anastomotic stricture 1–3 months after surgery.

• The mean maximum urinary flow rate after surgery was 20.01 mL/s and no patient had urinary incontinence.

CONCLUSION

• The preoperative use of flexible cystoscopy via the suprapubic route represented a successful key point of urethroplasty for posterior urethral stricture associated with false passage.
Optimization of the expression of the HIV fusion inhibitor cyanovirin‐N from the tobacco plastid genome
Authors: Elghabi Zouhair , Karcher Daniel , Zhou Fei , Ruf Stephanie , Bock Ralph
Published: February 2011

Plants with transgenic plastid (chloroplast) genomes represent a promising production platform in molecular farming, mainly because of the plastids’ potential to accumulate foreign proteins to very high levels and the increased biosafety conferred by the maternal mode of plastid inheritance. Although some transgenes can be expressed to extraordinarily high levels, the expression of others has been unsuccessful. Lack of detectable transgene expression is usually attributable to either RNA instability or protein instability. Here, we have investigated the possibilities to improve the production of a pharmaceutical protein that is difficult to express in chloroplasts: the HIV‐1 fusion inhibitor cyanovirin‐N (CV‐N). Testing various N‐terminal and C‐terminal fusions to peptide sequences from two proteins known to accumulate to high levels in transgenic plastids (GFP and the protein antibiotic PlyGBS), we show that both low mRNA stability and low protein stability contribute to the lack of detectable CV‐N expression in chloroplasts. Both problems can be alleviated by N‐terminal fusions to the CV‐N coding region, thus highlighting a suitable strategy for optimization of plastid transgene expression.