bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of lower urinary tract symptoms with sexual dysfunction: a cross‐cultural study between Japanese and American men with localized prostate cancer
Authors: Namiki Shunichi , Litwin Mark S. , Kwan Lorna , Kagawa‐Singer Marjorie , Ishidoya Shigeto , Saito Seiichi , Arai Yoichi
Published: June 2009

OBJECTIVE

To assess the association of lower urinary tract symptoms (LUTS) with sexual function, and estimate the correlates of LUTS among Japanese and American men with localized prostate cancer.

PATIENTS AND METHODS

In all, 343 Japanese men and 307 American men with prostate cancer were enrolled in the study. Sexual function and sexual bother were measured separately with the University of California‐Los Angeles Prostate Cancer Index and obstructive/irritative voiding symptoms were measured with the American Urological Association Symptom Index (AUA SI).

RESULTS

Japanese men had worse sexual function scores than the American men before treatment, whereas no differences were reported between Japanese and American men in sexual bother scores. Japanese and American men also did not differ meaningfully in AUA SI. However, those with moderate to severe LUTS reported significantly worse sexual bother scores than those with mild symptoms in both Japanese and American men (P = 0.004 and <0.001, respectively). The Japanese men were more likely to have LUTS than were American men (odds ratio 1.60, P = 0.029). Age and sexual function were highly associated with LUTS (odds ratio 1.35, P = 0.027; and 0.652, P = 0.001, respectively). The comorbidity count was independently associated with worse urinary symptoms (odds ratio 1.23, P = 0.015).

CONCLUSIONS

We posit that cultural differences in the meaning or salience of sexual functioning, and the interpretation of the questionnaire in quality‐of‐life surveys, might explain the different profiles in the association of LUTS with sexual activity in Japanese and American men with localized prostate cancer.
Learning objects and engagement of students in Australian and New Zealand schools
Authors: Lowe Kate , Lee Libby , Schibeci Renato , Cummings Rick , Phillips Rob , Lake David
Published: June 2009

This paper reports on a completed field study that examined the usability and effectiveness of learning objects designed for Australian and New Zealand primary and secondary schools. It focuses on student engagement by observing the ways students interacted with learning objects and by listening to what they said about them. Questions that guided the field study included the following: Could the students use the learning objects easily? Did they enjoy the experience? Did they engage with the intended learning? These questions are examined with reference to students at different levels of schooling, and examples drawn from the fieldwork illustrate that, while some learning objects achieved their potential as engaging multimedia educational resources, others fell short. The paper provides a detailed examination of two learning objects to reveal what worked and what created barriers or subverted the intended learning. In particular, it explores interest, challenge and importance as elements that contributed to engagement and socially constructed learning.
Gender Logic and (Un)doing Gender at Work
Authors: Kelan Elisabeth K.
Published: June 2009

Doing gender is a popular concept in studies on work and organizations that is used to show how gender is constructed through interactions in organizations. Recently researchers have also started looking at how gender can be undone. This article elucidates two understandings of doing gender based on ethnomethodological and poststructural and discursive approaches and shows how these theoretical approaches lead to diverging ways of undoing gender. These two approaches are critically explored by drawing on qualitative research with information communication technology workers. The article thereby examines how gender might be undone within both ethnomethodological and poststructural and discursive traditions. It makes a contribution towards understanding (un)doing gender approaches at work by highlighting the implications for research on gender, work and organization.
Antimicrobial susceptibility and biochemical patterns of Neisseria gonorrhoeae strains in Vejle area, Denmark
Authors: Lis‐Tønder J , Cybulski Z
Published: June 2009

Background  Strains of Neisseria gonorrhoeae resistant to penicillin and ciprofloxacin have been isolated worldwide. Increasing number of N. gonorrhoeae that lack the enzyme proline aminopeptidase (proA‐negative N. gonorrhoeae) have been detected in many countries all over the world.

Objectives  This study aims to assess the resistance profiles of N. gonorrhoeae isolates sent to the Department of Clinical Microbiology in Vejle, Denmark, between 2003 and 2007, and to analyse their biochemical patterns.

Methods  Sixty‐two strains of N. gonorrhoeae were retrospectively analysed for their susceptibility to penicillin, ciprofloxacin and ceftriaxone. The identification of isolated strains was confirmed using both biochemical and immunological tests.

Results  Twenty‐one (33.9%) N. gonorrhoeae isolates were resistant to penicillin and 30 (48.4%) were resistant to ciprofloxacin. All strains were susceptible to ceftriaxone. Fifty‐six (90.3%) N. gonorrhoeae strains showed API NH biochemical code 10 010 (produced acid from glucose and proline aminopeptidase). Six strains showed code 10 000 that lack the enzyme proline aminopeptidase (proA‐negative N. gonorrhoeae).

Conclusions  Ceftriaxone should be used as the first‐line treatment of gonorrhoea in Vejle community area, Denmark, both for infections with proA‐producing and proA‐negative N. gonorrhoeae isolates, which circulate in the region.
A survey of vitiligo management among dermatologists in Saudi Arabia
Authors: AlGhamdi KM
Published: June 2009

Background  There are concerns that there is no uniform approach towards the management of vitiligo.

Objectives  To explore attitudes and strategies for the management of vitiligo among dermatologists.

Methods  A self‐administered questionnaire containing 22 questions was distributed to 160 dermatologists attending a national dermatology conference in 2007.

Results  One hundred and twelve dermatologists responded to the questionnaire (70% response rate). We had 105 completed questionnaires (seven were excluded due to incompleteness). Active treatment of vitiligo was recommended by 96% in more than half of patients, while 79% recommended treatment at non‐visible sites. Repigmentation was regarded as main treatment goal by 54%. Mid‐potent topical steroids were widely prescribed for focal vitiligo (72% in children and 65% in adults). Use of tacrolimus and pimecrolimus was limited. The most common used phototherapy was ‘narrowband ultraviolet B’ (NBUVB; 36% and 40% for generaliased vitiligo in children and adults, respectively). The use of oral psoralen plus UVA (PUVA) was limited (8% for generalized vitiligo in adults). Few respondents (1–8% for different types of vitiligo) prescribed outdoor topical PUVA. Vitiligo surgery was advised mainly for segmental type (18% in adults and 5% in children). Depigmentation was the first option for universal vitiligo by 50% and 30% in adults and children, respectively.

Conclusions  Most dermatologists are enthusiastic about active treatment of vitiligo even in hidden sites. Overall, the most two common treatment modalities were topical steroids and NBUVB. Vitiligo surgery is underutilized. Development of national practice guidelines is needed.
Expression of p53 and p16 in actinic keratosis, bowenoid actinic keratosis and Bowen's disease
Authors: Bagazgoitia L , Cuevas J , Juarranz Á
Published: June 2009

Introduction  Bowen's disease (BD) and bowenoid actinic keratosis (bAK) have traditionally been differentiated according to the presence or absence of dysplasia in the follicular epithelium. p16 has been suggested to be a useful tool to make the differential diagnosis between BD and AK and as a marker of bad prognosis.

Materials  Five biopsies of BD, five of AK and five of bAK where stained for p53 and p16.

Results  All lesions showed positive immunostaining of p53, affecting to the lower two thirdss of the epidermis in BD and bAK, and only the basal layer in non‐bAK. All the BD and bAK cases were positive for p16, showing a similar immunostaining pattern, whereas no staining was observed in non‐bAK.

Discussion and conclusion  These findings suggest a common pathogenic mechanism for BD and bAK. bAK might have worse prognosis than AK. p16 might not be useful as a tool for differential diagnosis between AK and BD because bAK and BD show an extremely similar immunohistochemical pattern.
Remittances and inequality in Cape Verde: the impact of changing family organization
Authors: ÅKESSON LISA
Published: June 2009

There is a risk that remittances exacerbate socio‐economic inequality among the recipients. In this case study of a Cape Verdean community I explore how variations in family organization interact with the distribution of remittances and their effects on local social stratification. Formerly, the typical migrant was male and directed the main part of his remittances to a nuclear household he had left behind. Households that included a male migrant were able to raise their standard of living over that of households without a migrant member. Today, relationships between women and men have become increasingly unstable and long‐lasting transnational family ties are now rarely based on a conjugal relationship. Both women and men migrate and they often start up a new family abroad. Consequently, when migrants send remittances to Cape Verde they do not invest in their own future lives as they did in the past. Instead, they try to support ageing parents and young children left behind. This means that migrants often have economic obligations to several households and that they are therefore only able to send limited amounts of money to each. This implies, first, that many households are recipients of remittances and, second, that they normally only receive small sums. In conclusion, it may be said that these changes in family organization have reduced the risk that remittances will exacerbate inequality.
The D3dopamine receptor inhibits dopamine release in PC‐12/hD3 cells by autoreceptor signaling via PP‐2B, CK1, and Cdk‐5
Authors: Chen Pei‐Chun , Lao Chu‐Lan , Chen Jin‐Chung
Published: June 2009

The function of the D3dopamine (DA) receptor remains ambiguous largely because of the lack of selective D3receptor ligands. To investigate the function and intracellular signaling of D3receptors, we established a PC‐12/hD3 clone, which expresses the human D3DA receptor in a DA producing cell line. In this model, we find that the D3receptor functions as an autoreceptor controlling neurotransmitter secretion. Pre‐treatment with 3,6a,11, 14‐tetrahydro‐9‐methoxy‐2 methyl‐(12H)‐isoquino[1,2‐b] pyrrolo[3,2‐f][1,3] benzoxanzine‐1‐carboxylic acid, a D3receptor preferring agonist, dose‐dependently suppressed K+‐evoked [3H]DA release in PC‐12/hD3 cells but not in the control cell line. This effect was prevented by D3receptor preferring antagonists GR103691 and SB277011‐A. Furthermore, activation of D3receptors significantly inhibits forskolin‐induced cAMP accumulation and leads to transient increases in phosphorylation of cyclin‐dependent kinase 5 (Cdk5), dopamine and cAMP‐regulated phosphoprotein of Mr32 000 and Akt. Because we observed differences in Cdk5 phosphorylation as well as Akt phosphorylation after DA stimulation, we probed the ability of Cdk5 and phosphatidylinositol‐3 kinase (PI3K) to influence DA release. Cdk5 inhibitors, roscovitine, or olomoucine, but not the PI3K inhibitor wortmannin, blocked the D3receptor inhibition of DA release. In a complimentary experiment, over‐expression of Cdk5 potentiated D3receptor suppression of DA release. Pertussis toxin, 3‐[(2,4,6‐trimethoxyphenyl)methylidenyl]‐indolin‐2‐one and cyclosporine A also attenuated D3receptor‐mediated inhibition of DA release indicating that this phenomenon acts through Gi/oα and casein kinase 1, and phosphatase protein phosphatase 2B (calcineurin), respectively. In support of previous data that D3DA receptors reduce transmitter release from nerve terminals, the current results demonstrate that D3DA receptors function as autoreceptors to inhibit DA release and that a signaling pathway involving Cdk5 is essential to this regulation.
Retinoic acid selectively inhibits death of basal vomeronasal neurons during late stage of neural circuit formation
Authors: Hörnberg Maria , Gussing Fredrik , Berghard Anna , Bohm Staffan
Published: June 2009

In mouse, sexual, aggressive, and social behaviors are influenced by G protein‐coupled vomeronasal receptor signaling in two distinct subsets of vomeronasal sensory neurons (VSNs): apical and basal VSNs. In addition, G protein‐signaling by these receptors inhibits developmental death of VSNs. We show that cells of the vomeronasal nerve express the retinoic acid (RA) synthesizing enzyme retinal dehydrogenase 2. Analyses of transgenic mice with VSNs expressing a dominant‐negative RA receptor indicate that basal VSNs differ from apical VSNs with regard to a transient wave of RA‐regulated and caspase 3‐mediated cell death during the first postnatal week. Analyses of G‐protein subunit deficient mice indicate that RA and vomeronasal receptor signaling combine to regulate postnatal expression of Kirrel‐2 (Kin of IRRE‐like), a cell adhesion molecule regulating neural activity‐dependent formation of precise axonal projections in the main olfactory system. Collectively, the results indicate a novel connection between pre‐synaptic RA receptor signaling and neural activity‐dependent events that together regulate neuronal survival and maintenance of synaptic contacts.
μ‐Opioid receptor‐stimulated synthesis of reactive oxygen species is mediated via phospholipase D2
Authors: Koch Thomas , Seifert Anja , Wu Dai‐Fei , Rankovic Marija , Kraus Jürgen , Börner Christine , Brandenburg Lars‐Ove , Schröder Helmut , Höllt Volker
Published: June 2009

We have recently shown that the activation of the rat μ‐opioid receptor (MOPr, also termed MOR1) by the μ‐agonist [d‐Ala2, Me Phe4, Glyol5]enkephalin (DAMGO) leads to an increase in phospholipase D2 (PLD2) activity and an induction of receptor endocytosis, whereas the agonist morphine which does not induce opioid receptor endocytosis fails to activate PLD2. We report here that MOPr‐mediated activation of PLD2 stimulates production of reactive oxygen molecules via NADH/NADPH oxidase. Oxidative stress was measured with the fluorescent probe dichlorodihydrofluorescein diacetate and the role of PLD2 was assessed by the PLD inhibitor d‐erythro‐sphingosine (sphinganine) and by PLD2‐small interfering RNA transfection. To determine whether NADH/NADPH oxidase contributes to opioid‐induced production of reactive oxygen species, μ‐agonist‐stimulated cells were pre‐treated with the flavoprotein inhibitor, diphenylene iodonium, or the specific NADPH oxidase inhibitor, apocynin. Our results demonstrate that receptor‐internalizing agonists (like DAMGO, β‐endorphin, methadone, piritramide, fentanyl, sufentanil, and etonitazene) strongly induce NADH/NADPH‐mediated ROS synthesis via PLD‐dependent signaling pathways, whereas agonists that do not induce MOPr endocytosis and PLD2 activation (like morphine, buprenorphine, hydromorphone, and oxycodone) failed to activate ROS synthesis in transfected human embryonic kidney 293 cells. These findings indicate that the agonist‐selective PLD2 activation plays a key role in the regulation of NADH/NADPH‐mediated ROS formation by opioids.
The Difficulty of Justifying European Integration as a Consequence of Depoliticization: Evidence from the 2005 French Referendum
Authors: Glencross Andrew
Published: June 2009

This article analyses the 2005 French referendum debate on the EU Constitutional Treaty as an instance of depoliticization. Particular emphasis is placed on the argumentative strategy of President Chirac as, despite the treaty's focus on institutional reform, he eventually chose to justify the document in terms of social policy: an ultimately unconvincing strategy because voters believed it was contradicted by current EU policy priorities. On this evidence,paceGlyn Morgan, prioritizing a justification of EU finality over that of institutions and policies does not seem appropriate. Rather, the priority for integration is to overcome elites' strategies of depoliticization during referendum campaigns.
Morbidity and mortality following coronary artery bypass graft surgery in patients with cirrhosis: a population‐based study
Authors: Shaheen Abdel Aziz M. , Kaplan Gilaad G. , Hubbard James N. , Myers Robert P.
Published: June 2009

Background: The risk of cardiac surgery in patients with cirrhosis is poorly defined. Our objective was to describe outcomes of coronary artery bypass graft (CABG) surgery in cirrhotic patients from a population‐based perspective.

Methods: We analysed the 1998–2004 Nationwide In‐patient Sample to identify patients hospitalized for CABG surgery. The effect of cirrhosis on mortality, complications, length of stay (LOS) and charges was evaluated using logistic regression models.

Results: Between 1998 and 2004, there were 403 094 CABG admissions; 711 patients (0.2%) had cirrhosis. The average annual number of surgeries increased 4.2% [95% confidence interval (CI) 0.7–7.8] in cirrhotic patients, but decreased 5.5% (3.4–7.5) in non‐cirrhotic patients. Patients with cirrhosis had an increased risk of mortality [17 vs. 3%; adjusted odds ratio (OR) 6.67; 95% CI 5.31–8.31], complications [43 vs. 28%; OR 1.99 (95% CI 1.72–2.30)] and greater LOS and charges (P<0.0001). Predictors of mortality included age over 60 (OR 2.21; 95% CI 1.31–3.73), female gender (OR 1.92; 95% CI 1.08–3.41), ascites (OR 3.80; 95% CI 1.95–7.39) and congestive heart failure (OR 1.75; 95% CI 1.08–2.84). Hospital volume and off‐pump CABG did not affect mortality.

Conclusions: Patients with cirrhosis have an increased risk of morbidity and mortality following CABG surgery. Additional studies are necessary to refine risk stratification in this high‐risk patient population.
Acral Peeling Skin Syndrome: A Case of Two Brothers
Authors: Wakade Oojwala , Adams Beth , Shwayder Tor
Published: June 2009

Abstract:  We report two brothers of Middle Eastern descent with consanguineous parents who present with numerous fragile, flaccid blisters on the hands and feet. In addition to spontaneous peeling, they can manually peel skin from acral areas without pain. The symptoms worsen with warm temperatures, excessive water exposure, and perspiration. Two biopsies from flaccid blisters on the feet were taken from the older brother, which revealed cleavage at the level of the stratum corneum. A diagnosis of acral peeling skin syndrome was made.
Case Report: Vulvar Lichen Sclerosus in a Premenarchal Girl with a Complicated Biopsy
Authors: YOUSEFI MORVARID , PRIDE HOWARD , ELSTON DIRK
Published: June 2009

Abstract:  Lichen sclerosus is a T‐lymphocyte mediated chronic cutaneous disorder with predilection for the vulva. In prepubertal girls, lichen sclerosus presents as vulvar discomfort, pruritus, bruising/bleeding, discharge, dysuria, or painful defecation. Diagnosis and treatment of lichen sclerosus is of utmost importance in the prevention of complications such as scarring, adhesions, atrophy, or long‐term sexual dysfunction. We discuss a case of a 4‐year‐old female with an atypical presentation of genital lichen sclerosus and a complicated biopsy.
Normolipemic Papuloeruptive Xanthomatosis in a Child
Authors: HUANG HUNG‐YI , LIANG CHER‐WEI , HU SHU‐LING , CHENG CHUNG‐CHIN
Published: June 2009

Abstract:  Normolipemic papuloeruptive xanthomatosis is a very rare skin disorder. We report a child with yellowish papular eruptions on the face that rapidly merged into confluent plaques. Serum lipid profiles showed normolipemia. A diagnosis of normolipemic papuloeruptive xanthomatosis with no associated systemic disorders was made. The skin lesions involuted spontaneously during follow‐up.
The Role of Allergic Contact Dermatitis in Diaper Dermatitis
Authors: SMITH WILEY J. , JACOB SHARON E.
Published: June 2009

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, and must not exceed two pages of text including references. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Seizure‐related injuries are underreported in pharmacoresistant localization‐related epilepsy
Authors: Friedman David E. , Gilliam Frank G.
Published: June 2009

Purpose:  To investigate and compare injury rates, associated risk factors, circumstances, and medical record documentation in patients with pharmacoresistant temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE).

Methods:  The study cohort consisted of fifty‐two consecutive adults with treatment‐resistant epilepsy and seizure classification confirmed by video‐electrocardiography (EEG) (28 with TLE and 24 with ETLE) who consented to participate. All subjects had their seizures classified with prior video‐EEG monitoring, were followed in a tertiary‐care center in northwest New York City, and received a semistructured phone interview regarding injuries experienced since being diagnosed with epilepsy.

Results:  Injuries were reported in 16 (57%) of the patients with TLE and 4 (17%) of the patients with ETLE (p = 0.004 after controlling for duration of epilepsy and seizure burden); 83% of all injuries were designated by patients as seizure‐related. Most injuries (22 of 41; 54%) were classified as moderate or greater in severity. In addition, one motor vehicle accident (MVA) was reported in the TLE group and one episode of sudden unexpected death (SUDEP) was identified in the ETLE group. More than half (55%) of the injuries were not documented as seizure‐related in medical records.

Conclusion:  A substantial number of potentially serious injuries are not documented as seizure related, even in a tertiary‐care setting. Patients with pharmacoresistant TLE may be at higher risk for experiencing an injury than patients with pharmacoresistant ETLE.
Beer‐Induced Pancreatic Enzyme Secretion: Characterization of Some Signaling Pathways and of the Responsible Nonalcoholic Compounds
Authors: Gerloff Andreas , Singer Manfred V. , Feick Peter
Published: June 2009

Background:  Various alcoholic beverages have different effects on pancreatic enzyme secretion in vivo and in vitro. Recently we demonstrated that beer dose‐dependently induces amylase release of rat pancreatic acinar cells, whereas pure ethanol and other alcoholic beverages have no effect. The aims of this study were to: (1) investigate the involved signaling pathways in the beer‐induced enzyme secretion of rat pancreatic acinar cells and (2) characterize the responsible nonalcoholic compounds from beer.

Methods:  Rat pancreatic AR4‐2J cells were differentiated by dexamethasone treatment for 72 hours. After incubation of cells with 1 to 10% (v/v) beer (containing 4.7% v/v ethanol) in the absence or presence of the maximal effective concentration of cholecystokinin (CCK) (100 nM) for 60 minutes, protein secretion was measured using amylase activity assay. To study the involved signaling pathways, cells were pretreated with selective inhibitors or the fluorescent dye Fura2/AM for 15 and 30 minutes, respectively. To characterize the responsible compounds, beer was distilled, lyophilized, dialyzed, or treated with proteases prior stimulation of the cells. Extract of barley was prepared by boiling the crop and subsequent filtration.

Results:  Stimulation with 5% and 10% beer (v/v) significantly (p < 0.001) increased maximally CCK‐induced amylase by 55 ± 25% and 56 ± 37%, respectively. By using selective antagonists, we found that inhibition of phospholipase C (PLC) and inositol 1,4,5‐trisphosphate‐receptor binding reduced beer‐induced amylase release, whereas inhibition of protein kinase C, adenylate cyclase, and protein kinase A had no significant effect. Using the fluorescent Ca2+ indicator Fura‐2/AM revealed that beer induces an increase of cytosolic free Ca2+ concentration. Stimulation of AR4‐2J cells with preproducts of beer and fermented glucose indicated that the stimulatory substances from beer derived from barley and are not produced during alcoholic fermentation. Furthermore, the stimulants from beer are thermostable, nonvolatile substances with a molecular weight higher than 15 kDa.

Conclusions:  Beer‐induced enzyme secretion of AR4‐2J cells is, at least in part, mediated by the activation of PLC and subsequent Ca2+ release from internal stores. However, the additive effect of beer on CCK‐induced amylase release suggests that additional signaling pathways are involved. The yet unknown stimulants of pancreatic enzyme secretion originate from barley and their stimulatory potential is maintained during the process of malting and brewing.
Weight Prejudice and Medical Policy: Support for an Ambiguously Discriminatory Policy Is Influenced by Prejudice‐Colored Glasses
Authors: Brochu Paula M. , Esses Victoria M.
Published: June 2009

This study examined the influence of affectively‐based weight prejudice versus weight control beliefs on perceptions of and support for an ambiguously discriminatory medical policy: denying surgery to overweight patients. Participants read a news article describing a new policy in the United Kingdom of denying surgery to overweight patients, and reported their reactions to the policy. Results revealed that participants who scored higher on an affectively‐based measure of weight prejudice that was completed 3–4 weeks before the main session were less likely to perceive the medical policy as discriminatory, more likely to agree with the policy and to support adoption of a similar policy in their own country, and recommended lower body mass index (BMI) cutoff values for denying surgery to overweight patients, whereas weight control beliefs had less of a role to play. In addition, perceptions of the policy as (non)discriminatory mediated the effects of weight prejudice on policy agreement, support, and recommended BMI cutoff. These results indicate that affective prejudice influences individuals' support for an ambiguously discriminatory medical policy, which has important implications for policy makers and researchers.
Intraoperative dialysis during liver transplantation with citrate dialysate
Authors: WINROW Robert M. , DAVIS Connie , HALLDORSON Jeffrey B. , AHMAD Suhail
Published: June 2009

Liver transplantation for acutely ill patients with fulminant liver failure carries high intraoperative and immediate postoperative risks. These are increased with the presence of concomitant acute kidney injury (AKI) and intraoperative dialysis is sometimes required to allow the transplant to proceed. The derangements in the procoagulant and anticoagulant pathways during fulminant liver failure can lead to difficulties with anticoagulation during dialysis, especially when continued in the operating room. Systemic anticoagulation is unsafe and regional citrate anticoagulation in the absence of a functional liver carries the risk of citrate toxicity. Citrate dialysate, a new dialysate with citric acid can be used for anticoagulation in patients who cannot tolerate heparin or regional citrate. We report a case of a 40‐year‐old female with acetaminophen‐induced fulminant liver failure with associated AKI who underwent intraoperative dialytic support during liver transplantation anticoagulated with citrate dialysate during the entire procedure. The patient tolerated the procedure well without any signs of citrate toxicity and maintained adequate anticoagulation for patency of the dialysis circuit. Citrate dialysate is a safe alternative for intradialytic support of liver transplantation in fulminant liver failure.
Densification of Powder Compact Containing Large and Small Pores
Authors: Pan Jingzhe , Cocks Alan , Rödel Jürgen , Huang Ruoyu , Ch'ng Heok Ngee
Published: June 2009

A classical sintering theory predicts that a pore with high coordination number grows instead of shrinking during sintering. This has led to the proposition that grain growth may be beneficial to densification. Pan and colleagues argue against this theory using computer simulations, while Flinn and colleagues have provided direct experimental evidence showing that very large pores shrink despite their high coordination number. The current paper brings the analytical and experimental work together. In particular, further computer simulation evidence is provided to support the argument and an analytical model is developed to predict the densification rate of powder compacts containing large and small pores. The analytical model shows that there is a sudden reduction in the shrinking rate of the large pores when the small pores are eliminated.
Nickel–Boron Nanolayer‐Coated Boron Carbide Pressureless Sintering
Authors: Lu Kathy , Zhu Xiaojing , Nagarathnam Karthik
Published: June 2009

Sintering of pure B4C and Ni2B nanolayer‐coated B4C was studied from 1300° to 1600°C, with the holding time at the peak temperatures being 2 or 10 h. Compacts were made by uniaxial die compaction and combustion‐driven compaction. Pure B4C sample shows less sintering at all conditions. Ni2B‐coated B4C sample shows more extensive densification, neck formation, and grain shape accommodation. The combustion driven compaction process accelerates sintering by offering higher green density to start with. The Ni2B species on the B4C particle surfaces melts into a nickel–boron‐containing liquid phase during heating, remains as liquid during sintering, and then transforms into Ni4B3 and NiB during cooling. High‐resolution composition analysis shows that there is no nickel diffusion into bulk B4C during the sintering process. However, there is boron diffusion into the Ni2B coating layer. Carbon diffusion cannot be directly measured but is believed to be a simultaneous process as boron diffusion. A multievent sintering process has been proposed to explain the observations.
Acellular dermal matrix as a barrier in guided bone regeneration: a clinical, radiographic and histomorphometric study in dogs
Authors: Borges Germana Jayme , Novaes Arthur Belém , De Moraes Grisi Márcio Fernando , Palioto Daniela Bazan , Taba Mário , De Souza Sérgio Luís Scombatti
Published: June 2009

Objectives: The purpose of this study was to evaluate the effectiveness of the acellular dermal matrix (ADM) as a membrane for guided bone regeneration (GBR), in comparison with a bioabsorbable membrane.

Material and methods: In seven dogs, the mandibular pre‐molars were extracted. After 8 weeks, one bone defect was surgically created bilaterally and the GBR was performed. Each side was randomly assigned to the control group (CG: bioabsorbable membrane made of glycolide and lactide copolymer) or the test group (TG: ADM as a membrane). Immediately following GBR, standardized digital X‐ray radiographs were taken, and were repeated at 8 and 16 weeks post‐operatively. Before the GBR and euthanasia, clinical measurements of the width and thickness of the keratinized tissue (WKT and TKT, respectively) were performed. One animal was excluded from the study due to complications in the TG during wound healing; therefore, six dogs remained in the sample. The dogs were sacrificed 16 weeks following GBR, and a histomorphometric analysis was performed. Area measurements of new tissue and new bone, and linear measurements of bone height were performed.

Results: Post‐operative healing of the CG was uneventful. In the TG membrane was exposed in two animals, and one of them was excluded from the sample. There were no statistically significant differences between the groups for any histomorphometric measurement. Clinically, both groups showed an increase in the TKT and a reduction in the WKT. Radiographically, an image suggestive of new bone formation could be observed in both groups at 8 and 16 weeks following GBR.

Conclusion: ADM acted as a barrier in GBR, with clinical, radiographic and histomorphometric results similar to those obtained with the bioabsorbable membrane.
Sinus augmentation analysis revised: the gradient of graft consolidation
Authors: Busenlechner Dieter , Huber Christian D. , Vasak Christoph , Dobsak Antonia , Gruber Reinhard , Watzek Georg
Published: June 2009

Objective: Graft consolidation follows a gradient that reflects the properties of bone substitutes at sites of sinus augmentation. Here we present an analytical method to investigate the process of graft consolidation taking the distance from the maxillary host bone into account.

Material and methods: We therefore evaluated histological specimens, 6 and 12 weeks after the sinus of minipigs was augmented with Bio‐Oss®, a deproteinized bovine bone mineral, and Ostim®, an aqueous paste of synthetic nanoparticular hydroxyapatite. A curve was drawn that represents the changes in histomorphometric parameters within a given distance from the maxillary host bone.

Results: Based on this curve, three regions of interest were defined: R1 (0–1 mm) the bridging distance where new bone is laid onto the host bone, R2 (2–3 mm) a region of osteoconduction where new bone exclusively grows on the biomaterial, R3 (4–5 mm) and a region of osteoconduction where bone formation has reached its maximal extension. Qualitative and quantitative analysis of the three regions can reveal differences in graft consolidation, depending on the bone substitutes and the observation period [Bone volume (BV) per tissue volume after 6 weeks: R1: 19±8.4% for Bio‐Oss® and 42.9±13.2% for Ostim® (P=0.03), R2: 3±2.4% for Bio‐Oss® and 14.7±9.5% for Ostim® (P=0.03), R3: 5±4.1% for Bio‐Oss® and 5.3±5.3% for Ostim® (P=0.86). BV per tissue volume after 12 weeks: R1: 38.0±13.3% for Bio‐Oss® and 53.3±6.6 for Ostim® (P=0.04), R2: 14±12.2 for Bio‐Oss® and 26.4±11 for Ostim® (P=0.18), R3: 6.6±7 for Bio‐Oss® and 10.7±5.8 for Ostim® (P=0.32) after 12 weeks].

Conclusion: Based on the graft consolidation gradient, the impact of bone substitutes to modulate the process of bone formation and the kinetic of degradation within a distinct region of the augmented sinus can be investigated.
Oral health disparities and food insecurity in working poor Canadians
Authors: Muirhead Vanessa , Quiñonez Carlos , Figueiredo Rafael , Locker David
Published: June 2009

Abstract – 

Objectives:  This study explored oral health disparities associated with food insecurity in working poor Canadians.

Methods:  We used a cross‐sectional stratified study design and telephone survey methodology to obtain data from 1049 working poor persons aged between 18 and 64 years. The survey instrument contained sociodemographic items, self‐reported oral health measures, access to dental care indicators (dental visiting behaviour and insurance coverage) and questions about competing financial demands. Food‐insecure persons gave ‘often’ or ‘sometimes’ responses to any of the three food insecurity indicators used in the Canadian Community Health Survey (2003) assessing ‘worry’ about not having enough food, not eating enough food and not having the desired quality of food because of insufficient finances in the previous 12 months.

Results:  Food‐insecure working poor persons had poor oral health compared with food‐secure working poor persons indicated by a higher percentage of denture wearers (P < 0.001) and a higher prevalence of toothache, pain and functional impacts related to chewing, speaking, sleeping and work difficulties (P < 0.001). Fewer food‐insecure persons rated their oral health as good or very good (P < 0.001). Logistic regression analyses showed that oral health disparities between food‐insecure and food‐secure persons related to denture wearing, having a toothache, reporting poor/very poor self‐rated oral health or experiencing an oral health impact persisted after adjusting for sociodemographic factors and access to dental care factors (P < 0.05). Food‐insecure working poor persons reported relinquishing goods or services in order to pay for necessary dental care.

Conclusions:  This study identified oral health disparities within an already marginalized group not alleviated by access to professional dental care. Working poor persons regarded professional dental care as a competing financial demand.
A case report of inflammatory nonscarring alopecia associated with the epidermal growth factor receptor inhibitor erlotinib
Authors: Pongpudpunth Marinya , Demierre Marie France , Goldberg Lynne J.
Published: June 2009

Epidermal growth factor receptor inhibitors (EGFRIs) are new anticancer agents that act by inhibiting EGFR signaling transduction pathways, thus decreasing tumor growth. In more than 30 countries, EGFRIs are currently used in the treatment of a number of solid tumors, and other indications are being sought. In the United States, select EGFRIs have been approved in certain patients with non‐small cell lung cancer, metastatic colorectal carcinoma, and advanced squamous cell carcinoma of the head and neck. Various cutaneous side effects of EGFRIs have been reported, including acneiform eruptions, chronic paronychia, xerosis, a seborrheic dermatitis‐like eruption, changes in hair texture, and nonscarring alopecia. We present a 60‐year‐old woman with non‐small cell lung cancer who developed a persistent generalized itchy eruption and progressive nonscarring alopecia shortly after initiation of erlotinib (Tarceva). Scalp biopsy showed near‐equal number of anagen and catagen/telogen hair follicles, and a superficial and deep perivascular lymphoplasmocytic infiltration. These changes are typical of the nonscarring alopecia induced by EGFRIs. Because it is likely that EGFRIs will be increasingly used, dermatopathologists are likely to see more reactions from these agents. Familiarity with their side effects is essential to accurate diagnosis and effective patient management.
Bortezomib plus dexamethasone is highly effective in relapsed and refractory myeloma patients but responses are short‐lived
Authors: Corso Alessandro , Varettoni Marzia , Mangiacavalli Silvia , Zappasodi Patrizia , Pica Gian Matteo , Algarotti Alessandra , Pascutto Cristiana , Lazzarino Mario
Published: June 2009

Objectives:  Bortezomib has proven to be effective as single agent in myeloma patients. Aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with dexamethasone in a cohort of multiple myeloma (MM) relapsed/refractory patients treated in a single center.

Patients and Methods:  In this single center study, 70 patients were treated with bortezomib alone (9) or in combination with dexamethasone (61).

Results:  Forty‐one patients (59%) achieved at least a partial response (PR), including 7% complete response (CR), 36% very good partial response (VGPR) reaching the best response within four cycles. The duration of response was significantly longer for patients achieving CR/VGPR than for those achieving PR (7.3 vs. 3.8 months, P = 0.03). Likewise, time to progression, time to alternative treatment, and treatment free interval were significantly better for patients obtaining CR/VGPR (6.8, 9.4, 6.5 months respectively) as compared with PR (4.9, 6.3, 2 months respectively). The only dose‐limiting toxicity was peripheral neuropathy (PN), which occurred in 38/70 patients (55%) and was of grade 3–4 in 12 (17%). PN led to a dose reduction or treatment discontinuation in 17 (24%) patients. Complete resolution or improvement of PN occurred in 29/38 (76%) after a median time of 100 d (range: 17–202).

Conclusions:  Bortezomib in combination with dexamethasone is highly effective in relapsed/refractory MM producing an impressive rate of CR/VGPR, but responses are short‐lived.
Use of various models for in vitro percutaneous absorption studies of ultraviolet filters
Authors: Huong Srei Pisei , Bun Hot , Fourneron Jean‐Dominique , Reynier Jean‐Pierre , Andrieu Véronique
Published: June 2009

Background: The percutaneous absorption test aims to estimate the passage of a substance across the skin. The absorption process can be described in three steps: (a) penetration of a substance into the skin layer, followed by (b) penetration from one layer into another (permeation) and finally (c) resorption into the vascular system. In vivo and in vitro models are available but owing to ethical reasons as well as the latter providing greater feasibility, in vitro models are preferred.

Aims: This present study reviews the natural membranes (human skin and animal models: pig, rabbit, rat, hairless mouse, guinea‐pig and mouse), artificial skin equivalents and synthetic membranes that are currently being used for in vitro percutaneous absorption studies of UV filters, in order to provide the researcher with a greater insight when selecting membrane models for given experimental conditions.
ORIGINAL ARTICLE: Activating Killer Cell Immunoglobulin‐Like Receptor Genes’ Association with Recurrent Miscarriage
Authors: Vargas Rafael Gustavo , Bompeixe Eni Picchioni , França Patrícia Pinhode , Moraes Marcio Marques de , Bicalho Maria da Graça
Published: June 2009

Problem  Natural killer (NK) cells are regulated through NK cell receptors such as killer cell immunoglobulin‐like receptors (KIRs). KIRs are suspected of being involved in the causes of recurrent miscarriage (RM) as a higher proportion of activated NK cells were observed in women with RM when compared with that in controls. The aim of this study was to investigate if KIR genes coding for receptors known to have as ligands HLA class I molecules are correlated with RM.

Method of study  A matched case–control study was carried out in 68 south Brazilian Caucasian patient couples with RM and 68 control fertile couples. KIR genes were typed by PCR‐Reverse SSO method.

Results The rate of possession of an elevated number of activating KIR genes (positive for five or six activating KIR genes out of six different activating KIR genes analyzed) in RM patient women was significantly higher (P = 0.0201) when compared with that in control fertile women. These data suggest that women carrying a high content of activating KIR genes have about threefold increased probability to develop RM [OR = 2.71; 95% CI (1.23–6.01)].

Conclusion  Our results indicate that RM could be associated with NK cell activation mediated by a profile rich in activating KIR genes.
REVIEW ARTICLE: Toll‐Like Receptors, Inflammation and Tumor in the Human Female Reproductive Tract
Authors: Yu Li , Wang Liantang , Chen Shangwu
Published: June 2009

Abstract  Toll‐like receptors are an important family of pattern recognition receptors. They recognize microbial conserved components and trigger protective responses to the invading pathogens, which constitute a major part of the innate immune system. Toll‐like receptors are mainly expressed in immune cells. The current evidences demonstrate that Toll‐like receptors are present in some epithelial cells and epithelium derived tumor cells. The expression of Toll‐like receptors in these cells is related to infection and inflammation, and tumor progression as well. Genital mucosal epithelium is the first line in defense of microorganism invasion in the female reproductive tract. Toll‐like receptors expressed in the genital tract have been implicated in many aspects of reproductive physiology and pathology in the female. In the current review, we will focus on the expression of Toll‐like receptors in the female genital mucosa and its association with anti‐infection immunity and tumorigenesis.
ORIGINAL ARTICLE: CCL20/MIP3α is a Novel Anti‐HIV‐1 Molecule of the Human Female Reproductive Tract
Authors: Ghosh Mimi , Shen Zheng , Schaefer Todd M. , Fahey John V. , Gupta Phalguni , Wira Charles R.
Published: June 2009

Problem  CCL20/MIP3α is a chemokine for immature dendritic cells as well as an antibacterial against gram‐positive and gram‐negative bacteria. The role of CCL20/MIP3α as an antiviral is unknown. In this study, we have examined the production of CCL20/MIP3α by epithelial cells from the upper female reproductive tract as well as its activity as an antiviral molecule.

Method of study  Primary uterine and Fallopian tube epithelial cells were treated with Poly(I:C) and CCL20/MIP3α mRNA and protein was measured by Realtime RT‐PCR and ELISA assays. Anti‐HIV activity was determined using an indicator cell line TZM‐bl and quantified by using a luminometer.

Results  Primary uterine and Fallopian tube epithelial cells produce CCL20/MIP3α constitutively and the production is enhanced following stimulation with viral double‐stranded RNA mimic Poly(I:C). Recombinant CCL20/MIP3α was able to inhibit both T‐cell‐tropic X4/IIIB and macrophage‐tropic R5/BaL HIV‐1 when virus was directly incubated with CCL20/MIP3α but not when CCL20/MIP3α was added to cells either prior to infection or post‐infection. This suggests that the mechanism of inhibition is likely to be a direct interaction between HIV‐1 and CCL20/MIP3α.

Conclusion  This study demonstrates that CCL20/MIP3α is an important endogenous anti‐HIV‐1 microbicide of the female reproductive tract.
Treatment of aggressive external root resorption with calcium hydroxide medicaments: a case report
Authors: Öktem Zeynep Başak , Çetinbaş Tuğba , Özer Levent , Sönmez Hayriye
Published: June 2009

Abstract –  Intrusive luxation is an injury involving the axial displacement of a tooth into the alveolar socket. This paper describes apexification using calcium hydroxide medicaments of an immature permanent central incisor in which spontaneous re‐eruption as well as severe inflammatory external root resorption was observed following traumatic intrusion. A 10‐year‐old boy was referred to the Department of Pediatric Dentistry 3 days after having fallen at school. Intraoral examination revealed intrusive luxation and an enamel‐dentin crown fracture of the maxillary left central incisor (Tooth 21). The tooth was not sensitive to percussion and responded positively to electric pulp test. Radiographic examination indicated that the tooth had an open apex and had been intruded approximately 3–4 mm relative to the cemento‐enamel junction of the adjacent right central incisor. The tooth was left for possible spontaneous re‐eruption. The crown fracture was temporarily restored using glass ionomer cement, and the patient was scheduled for recall in 2 weeks, at which time intraoral examination revealed spontaneous re‐eruption of the tooth. However, radiographic examination also showed inflammatory external root resorption. The root canal was accessed and filled with a calcium hydroxide paste; however, follow‐up examination indicated continuing resorption after 1 month. Calcium hydroxide plus points (CHPP) was chosen as an alternative treatment. At the end of 6 months of CHPP treatment, examination showed no further progression of external resorption and complete apexification of the tooth. After a 24‐month follow‐up period, no signs of pathosis were observed.