bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifetime Physical Activity and Risk of Endometrial Cancer
Authors: John Esther M. , Koo Jocelyn , Horn-Ross Pamela L.
Published: May 2010

Background: The role of moderate physical activity and life patterns of activity in reducing endometrial cancer risk remains uncertain.

Methods: We assessed lifetime histories of activity from recreation, transportation, chores, and occupation and other risk factors in a population-based case-control study of endometrial cancer conducted in the San Francisco Bay area. The analysis was based on 472 newly diagnosed cases ascertained by the regional cancer registry and 443 controls identified by random-digit dialing who completed an in-person interview.

Results: Reduced risks associated with greater lifetime physical activity (highest versus lowest tertile) were found for both total activity [odds ratio (OR), 0.61; 95% confidence interval (95% CI), 0.43-0.87; Ptrend = 0.01] and activity of moderate intensity (OR, 0.44; 95% CI, 0.30-0.64; Ptrend < 0.0001). Compared with women with low lifetime physical activity (below median), those with greater activity throughout life had a higher reduction in risk (OR, 0.62; 95% CI, 0.44-0.88). Inverse associations were stronger in obese and overweight women, but differences were not statistically significantly different from those in normal-weight women.

Conclusion: These findings suggest that physical activity in adulthood, even of moderate intensity, may be effective in lowering the risk of endometrial cancer, particularly among those at highest risk for this disease.

Impact: The results emphasize the importance of evaluating lifetime histories of physical activity from multiple sources, including both recreational and nonrecreational activities of various intensities, to fully understand the relation between physical activity and disease risk. Cancer Epidemiol Biomarkers Prev; 19(5); 1276–83. ©2010 AACR.
Breast Cancer Incidence Patterns among California Hispanic Women: Differences by Nativity and Residence in an Enclave
Authors: Keegan Theresa H.M. , John Esther M. , Fish Kari M. , Alfaro-Velcamp Theresa , Clarke Christina A. , Gomez Scarlett L.
Published: May 2010

Background: Breast cancer incidence is higher in U.S.-born Hispanic women than foreign-born Hispanics, but no studies have examined how these rates have changed over time. To better inform cancer control efforts, we examined incidence trends by nativity and incidence patterns by neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants).

Methods: Information about all Hispanic women diagnosed with invasive breast cancer between 1988 and 2004 was obtained from the California Cancer Registry. Nativity was imputed from Social Security number for the 27% of cases with missing birthplace information. Neighborhood variables were developed from Census data.

Results: From 1988 to 2004, incidence rates for U.S.-born Hispanics were parallel but lower than those of non-Hispanic whites, showing an annual 6% decline from 2002 to 2004. Foreign-born Hispanics had an annual 4% increase in incidence rates from 1995 to 1998 and a 1.4% decline thereafter. Rates were 38% higher for U.S.- than foreign-born Hispanics, with elevations more pronounced for localized than regional/distant disease, and for women >50 years of age. Residence in higher SES and lower Hispanic enclave neighborhoods were independently associated with higher incidence, with Hispanic enclave having a stronger association than SES.

Conclusions: Compared with foreign-born, U.S.-born Hispanic women in California had higher prevalence of breast cancer risk factors, suggesting that incidence patterns largely reflect these differences in risk factors.

Impact: Further research is needed to separate the effects of individual- and neighborhood-level factors that affect incidence in this large and growing population. Cancer Epidemiol Biomarkers Prev; 19(5); 1208–18. ©2010 AACR.
First Case of a Neocentromere Formation in an Otherwise Normal Chromosome 7
Authors: Liehr T. , Kosyakova N. , Weise A. , Ziegler M. , Raabe-Meyer G.
Published: May 2010

According to cytogenetic and molecular cytogenetic characterization, an otherwise not-altered chromosome 7 formed a neocentromere in band 7q32.1 in a clinically normal female. The alpha satellite sequence D7Z1 remained in its place but was not used for formation of the primary chromosomal incision. Similar observations of centromere repositioning have been made for chromosomes 3 (2×), 4, 8 and Y (2×). Even though data is available for some neocentromeres whose positions are correlated with evolutionary new centromeres for 7q32.1, no correlation could be found for an ancestral inactivated centromere in any of the presently living primates. Overall, we report a new case of centromere repositioning at a position not known to harbor an ancestral inactivated centromere.
Spectrum of Human Foxe1/TTF2 Mutations
Authors: Castanet Mireille , Polak Michel
Published: May 2010

FOXE1 (or TTF-2) has been recognized as one of the thyroid dysgenesis (TD)-related genes based on its early expression at the thyroid bud stage and on the finding in Foxe1 knock-out mice of a sublingual or absent thyroid gland. In humans, three homozygous loss-of-function missense mutations located within the forkhead domain have been reported in 5 patients with Bamforth syndrome. This syndrome is a rare inherited condition whose main features are congenital hypothyroidism (CH) due to TD (usually athyreosis), cleft palate, and spiky hair, with or without choanal atresia and bifid epiglottis. These FOXE1 mutations were typically inherited from heterozygous carrier parents who were usually consanguineous. Recently, a novelmissense mutation was found in a patient with sporadic Bamforth syndrome, inherited via uniparental isodisomy. Altogether these observations strongly suggest that FOXE1 is involved in both familial and sporadic syndromic CH due to TD in association with cleft palate. Nevertheless, despite intensive research, FOXE1 mutations have been identified in only a minority of the affected patients. Recent data suggest that the transcription factor encoded by FOXE1 may act as a susceptibility factor for TD via variations in FOXE1 polyalanine tract length, which may modulate the risk of TD.
Analysis of Segmental Duplications, Mouse Genome Synteny and Recurrent Cancer-Associated Amplicons in Human Chromosome 6p21–p12
Authors: Martin J.W. , Yoshimoto M. , Ludkovski O. , Thorner P.S. , Zielenska M. , Squire J.A. , Nuin P.A.S.
Published: May 2010

It has been proposed that regions of microhomology in the human genome could facilitate genomic rearrangements, copy number transitions, and rapid genomic change during tumor progression. To investigate this idea, this study examines the role of repetitive sequence elements, and corresponding syntenic mouse genomic features, in targeting cancer-associated genomic instability of specific regions of the human genome. Automated database-mining algorithms designed to search for frequent copy number transitions and genomic breakpoints were applied to 2 publicly-available online databases and revealed that 6p21–p12 is one of the regions of the human genome most frequently involved in tumor-specific alterations. In these analyses, 6p21–p12 exhibited the highest frequency of genomic amplification in osteosarcomas. Analysis of repetitive elements in regions of homology between human chromosome 6p and the syntenic regions of the mouse genome revealed a strong association between the location of segmental duplications greater than 5 kilobase-pairs and the position of discontinuities at the end of the syntenic region. The presence of clusters of segmental duplications flanking these syntenic regions also correlated with a high frequency of amplification and genomic alteration. Collectively, the experimental findings, in silico analyses, and comparative genomic studies presented here suggest that segmental duplications may facilitate cancer-associated copy number transitions and rearrangements at chromosome 6p21–p12. This process may involve homology-dependent DNA recombination and/or repair, which may also contribute towards the overall plasticity of the human genome.
Coping Strategies Used by Seniors Going through the Normal Aging Process: Does Fear of Falling Matter?
Authors: Filiatrault Johanne , Desrosiers Johanne
Published: May 2010

Background: Recent studies show that fear of falling, a frequent fear of community-dwelling seniors, can have a negative impact on their health and quality of life. When fear of falling is intense, it can prompt individuals to limit or avoid certain activities. This activity restriction can lead to premature physical and functional decline and, ultimately, increase the risk for falls. Although activity avoidance/restriction is a common strategy used by seniors to cope with fear of falling, they may use other strategies as well to cope with this fear. However, these other strategies have received little attention to date. Objective: This study aimed at examining and comparing coping strategies used by seniors with and without fear of falling. It also examined if fear of falling is an independent correlate of the use of coping strategies among seniors. Methods: 288 seniors aged 65 years or over and going through the normal aging process were assessed during structured home interviews. Fear of falling was assessed through a single question (Are you afraid of falling?) and a 4-category response scale (never, occasionally, often, very often). Coping strategies used by participants were assessed with the Inventory of Coping Strategies Used by the Elderly. Results: Findings show that seniors with fear of falling use several coping strategies other than activity avoidance/restriction in their daily functioning. Compared with nonfearful seniors, they tend to use a wider range of coping strategies and use them more frequently. Results also indicate that fear of falling is an independent correlate of diversity and frequency of use of behavioral coping strategies. Conclusion: This study suggests that fall prevention practitioners and researchers should document the range and frequency of use of strategies that seniors may employ to cope with fear of falling. These data could help improve interventions and evaluative research in the domain of fall prevention.
Association of Genome-Wide Variation With the Risk of Incident Heart Failure in Adults of European and African Ancestry
Authors: Smith Nicholas L. , Felix Janine F. , Morrison Alanna C. , Demissie Serkalem , Glazer Nicole L. , Loehr Laura R. , Cupples L. Adrienne , Dehghan Abbas , Lumley Thomas , Rosamond Wayne D. , Lieb Wolfgang , Rivadeneira Fernando , Bis Joshua C. , Folsom Aaron R. , Benjamin Emelia , Aulchenko Yurii S. , Haritunians Talin , Couper David , Murabito Joanne , Wang Ying A. , Stricker Bruno H. , Gottdiener John S. , Chang Patricia P. , Wang Thomas J. , Rice Kenneth M. , Hofman Albert , Heckbert Susan R. , Fox Ervin R. , O'Donnell Christopher J. , Uitterlinden Andre G. , Rotter Jerome I. , Willerson James T. , Levy Daniel , van Duijn Cornelia M. , Psaty Bruce M. , Witteman Jacqueline C.M. , Boerwinkle Eric , Vasan Ramachandran S.
Published: May 2010

Background—

Although genetic factors contribute to the onset of heart failure (HF), no large-scale genome-wide investigation of HF risk has been published to date. We have investigated the association of 2 478 304 single-nucleotide polymorphisms with incident HF by meta-analyzing data from 4 community-based prospective cohorts: the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study.

Methods and Results—

Eligible participants for these analyses were of European or African ancestry and free of clinical HF at baseline. Each study independently conducted genome-wide scans and imputed data to the ≈2.5 million single-nucleotide polymorphisms in HapMap. Within each study, Cox proportional hazards regression models provided age- and sex-adjusted estimates of the association between each variant and time to incident HF. Fixed-effect meta-analyses combined results for each single-nucleotide polymorphism from the 4 cohorts to produce an overall association estimate and
P
value. A genome-wide significance
P
value threshold was set a priori at 5.0×10
−7
. During a mean follow-up of 11.5 years, 2526 incident HF events (12%) occurred in 20 926 European-ancestry participants. The meta-analysis identified a genome-wide significant locus at chromosomal position 15q22 (1.4×10
−8
), which was 58.8 kb from
USP3
. Among 2895 African-ancestry participants, 466 incident HF events (16%) occurred during a mean follow-up of 13.7 years. One genome-wide significant locus was identified at 12q14 (6.7×10
−8
), which was 6.3 kb from
LRIG3
.

Conclusions—

We identified 2 loci that were associated with incident HF and exceeded genome-wide significance. The findings merit replication in other community-based settings of incident HF.
“So Manifest a Signe from Heaven”: Monstrosity and Heresy in the Antinomian Controversy
Authors: Valerius Karyn
Published: May 2010

Several months after being banished from Massachusetts Bay for her antinomian beliefs, Anne Hutchinson miscarried. Heralding it as a sign from God, authorities insisted that Hutchinson's “monstrous birth” was indisputable proof of her monstrous views, evidence that inspired fear and awe and would undoubtedly return the wayward to orthdoxy's fold.
Lineage as Capital: Genealogy in Antebellum New England
Authors: Morgan Francesca
Published: May 2010

The lives of two women and three men in antebellum Massachusetts and New Hampshire demonstrate that genealogical practices buttressed class distinctions and that genealogists researched lineages that best fit their definitions of propriety. Documented seventeenth-century lineages constituted social capital. Yet genealogy showed also that class could be made as well as inherited.
Faking It: Social Bluffing and Class Difference in Howells's The Rise of Silas Lapham
Authors: Marchand Mary
Published: May 2010

In Howells's distinctive vision of the social world, there is something inimitable about upper- bourgeois culture—something that defies the aspirants' attempts to acquire or fake upper-class behaviors. In The Rise of Silas Lapham, he dramatizes for readers what none of his characters can articulate but all of them finally “feel,” namely the “fine yet impassable” differences between classes.
Trapped inside the Box? Five Questions for Ben Fine
Authors: Michael A. Lebowitz
Published: May 2010

Responding to comments by Ben Fine in relation to the concept of the degree of separation among workers, this article argues that Fine (a) confuses Marx’s levels of analysis and thus cannot distinguish between necessity and contingency; (b) fails to grasp the problematic character of Marx’s discussion of relative surplus-value once we remove the assumption of a given standard of necessity; and (c) accordingly remains trapped (like so many others) in a ‘Ricardian Box’ that Marx himself was able to escape.
Correspondence: The Foundation of the Situationist International (June 1957‐August 1960), Guy Debord, Los Angeles: Semiotext(e), 2009. All the King’s Horses, Michèle Bernstein, Los Angeles: Semiotext(e), 2008. 50 Years of Recuperation of the Situationist International, McKenzie Wark, New York: Princeton Architectural Press, 2008.
Authors: Kinkle Jeff
Published: May 2010

This review-essay looks at three texts from, or about, the early days of the Situationist International. The first volume of Guy Debord’s Correspondence reveals the SI’s internal discussions during their decisive first three years; Bernstein’s book represents an example of the continued relevance of the technique of détournement; while Wark’s text demonstrates both the breadth of the Situationist project and that, despite being continually mined by the academy, activists, the creative industries, and other more sinister recuperators, their work has not been depleted of its vitality. Taken together, the three books undermine a series of preconceptions about the SI, namely in terms of Debord’s role at the centre of the group and the SI’s engagement with the forces of the ‘spectacled’.
Multiple-Component Remediation for Developmental Reading Disabilities
Authors: Morris Robin D. , Lovett Maureen W. , Wolf Maryanne , Sevcik Rose A. , Steinbach Karen A. , Frijters Jan C. , Shapiro Marla B.
Published: May 2010

Results from a controlled evaluation of remedial reading interventions are reported: 279 young disabled readers were randomly assigned to a program according to a 2 × 2 × 2 factorial design (IQ, socioeconomic status [SES], and race). The effectiveness of two multiple-component intervention programs for children with reading disabilities (PHAB + RAVE-O; PHAB + WIST) was evaluated against alternate (CSS, MATH) and phonological control programs. Interventions were taught an hour daily for 70 days on a 1:4 ratio at three different sites. Multiple-component programs showed significant improvements relative to control programs on all basic reading skills after 70 hours and at 1-year follow-up. Equivalent gains were observed for different racial, SES, and IQ groups. These factors did not systematically interact with program. Differential outcomes for word identification, fluency, comprehension, and vocabulary were found between the multidimensional programs, although equivalent long-term outcomes and equal continued growth confirmed that different pathways exist to effective reading remediation.
Dyslexia as Disability or Handicap: When Does Vocabulary Matter?
Authors: Elbro Carsten
Published: May 2010

General cognitive ability is still a factor in current definitions of dyslexia despite two decades of research showing little or no relevance to the nature of dyslexia. This article suggests one reason why this may be so. The suggestion is based on a distinction between dyslexia as a disability (poor ability)—as it is viewed and explained by psycholinguistic and neuropsychological research—and dyslexia seen as a handicap (the consequences of a poor ability) in the educational world. While general knowledge and ability may be irrelevant to the nature of dyslexia as a disability, general knowledge and ability does relate to an ensuing handicap. Vocabulary is possibly the most closely linked subcomponent of “general knowledge and ability” to reading. It was thus hypothesized that when reading ability was controlled individuals with high vocabulary would be more likely than others would to experience a reading handicap as a function of poor reading. Conversely, vocabulary would not relate to the severity of the reading disability per se. These hypotheses were supported by results from a study of 165 adult poor readers.
Early Oral Language Markers of Poor Reading Performance in Hong Kong Chinese Children
Authors: Liu Phil D. , McBride-Chang Catherine , Wong Anita M.-Y. , Tardif Twila , Stokes Stephanie F. , Fletcher Paul , Hua Shu
Published: May 2010

This study investigated the extent to which language skills at ages 2 to 4 years could discriminate Hong Kong Chinese poor from adequate readers at age 7. Selected were 41 poor readers (age M = 87.6 months) and 41 adequate readers (age M = 88.3 months). The two groups were matched on age, parents’ education levels, and nonverbal intelligence. The following language tasks were tested at different ages: vocabulary checklist and Cantonese articulation test at age 2; nonword repetition, Cantonese articulation, and receptive grammar at age 3; and nonword repetition, receptive grammar, sentence imitation, and story comprehension at age 4. Significant differences between the poor and adequate readers were found in the age 2 vocabulary knowledge, age 3 Cantonese articulation, and age 4 receptive grammar skill, sentence imitation, and story comprehension. Among these measures, sentence imitation showed the greatest power in discriminating poor and adequate readers.
Rehabilitation Counselor Education and the New Code of Ethics
Authors: Glosoff Harriet L. , Rocco Cottone R.
Published: May 2010

The purpose of this article is to discuss recent changes in the Commission on Rehabilitation Counselor Certification Code of Professional Ethics for Rehabilitation Counselors , effective January 1, 2010, that are most relevant to rehabilitation counselor educators. The authors provide a brief overview of these key changes along with implications for ethical practice in rehabilitation counselor education.
Airport Activity and Local Development: Evidence from Italy
Authors: Percoco Marco
Published: May 2010

The role of infrastructure as a factor of growth and development of countries and regions is often considered to be crucial. Among the various types of transport infrastructure, airports are considered as particularly strategic because of the increasing importance of air transport in connecting territories. This paper studies the impact of airports on Italian provinces. To this end, it builds on the framework proposed by Brueckner, where sectoral employment is regressed on a series of controls and on airline traffic. That framework is extended to take account of selection bias due to the location choices of airports and spatial spillover effects. It is found that the elasticity of service-sector employment to airport passengers is 0.045 and that of spillover effects due to neighbouring airports is almost 0.017.
Professions, Occupational Roles and Skills in Urban Policy: A Reworking of the Debates in England and France
Authors: Goodchild Barry , Jeannot Gilles , Hickman Paul
Published: May 2010

The past few years have seen a proliferation of skills analysis in urban regeneration in England. In France, in contrast, researchers have linked questions of skills to the styles and form of public-sector work. This paper reworks the debates in the two countries to provide a comparative analysis of neighbourhood management. There are three main sections and themes: the implications of a bottom—up perspective in the study of policy implementation; the emergence in France of the chef de projet as an ideal type figure of transversal working; and finally, in relation to England, the fragmentation and diversity of policy initiatives, agencies and funding streams. This fragmentation and diversity have implied, in turn, an emphasis on flexibility and generic rather than specialist skills in urban regeneration.
When the Going Gets Tough, Does Support Get Going? Determinants of Spousal Support Provision to Type 2 Diabetic Patients
Authors: Iida Masumi , Parris Stephens Mary Ann , Rook Karen S. , Franks Melissa M. , Salem James K.
Published: May 2010

Although spousal support has been linked to positive outcomes in various health-related contexts, some research has found that the amount of social support provided to those who are chronically ill deteriorates over time. The current study refines the literature by considering multiple factors associated with spouses’ provision of emotional support to partners with Type 2 diabetes. This diary study ( N = 126 couples) examined the roles that stressor (disease severity and diabetes-specific anxiety), recipient (negative and positive affect), provider (negative and positive affect), and relationship (tension and enjoyment) factors play in spouses’ provision of emotional support. Daily disease severity, patients’ and spouses’ daily negative affect, and spouses’ daily relationship enjoyment were predictors of support provision. Wives, but not husbands, provided more support on days when patients experienced diabetes-specific anxiety. Results advance understanding of support provision in the context of a chronic stressor.
Temporal Distance and Person Memory: Thinking About the Future Changes Memory for the Past
Authors: Wyer Natalie A. , Perfect Timothy J. , Pahl Sabine
Published: May 2010

Psychological distance has been shown to influence how people construe an event such that greater distance produces high-level construal (characterized by global or holistic processing) and lesser distance produces low-level construal (characterized by detailed or feature-based processing). The present research tested the hypothesis that construal level has carryover effects on how information about an event is retrieved from memory. Two experiments manipulated temporal distance and found that greater distance (high-level construal) improves face recognition and increases retrieval of the abstract features of an event, whereas lesser distance (low-level construal) impairs face recognition and increases retrieval of the concrete details of an event. The findings have implications for transfer-inappropriate processing accounts of face recognition and event memory, and suggest potential applications in forensic settings.
Fixing Broken Doors: Strategies for Drafting Privacy Policies Young People Can Understand
Authors: Micheti Anca , Burkell Jacquelyn , Steeves Valerie
Published: May 2010

The goal of this project is to identify guidelines for privacy policies that children and teens can accurately interpret with relative ease. A three-pronged strategy was used to achieve this goal. First, an analysis of the relevant literature on reading was undertaken to identify the document features that affect comprehension. Second, focus groups were conducted to examine their experience and practices in the interpretation of privacy policies found on sites that have been identified as favorite kids’ sites. Based on the results of the literature review and focus groups, a set of potential guidelines were identified. Finally, the efficacy of these guidelines was tested in the final phase of the research project. The result of this work is a set of 14 guidelines for the drafting of privacy policies that make a difference, by improving the comprehensibility of privacy policies encountered by Canadian children and teens as they surf the Net.
Posterolateral Corner Reconstruction of the Knee
Authors: Rios Clifford G. , Leger Robin R. , Cote Mark P. , Yang Clifford , Arciero Robert A.
Published: May 2010

Background: Injuries to the posterolateral corner of the knee remain a challenging problem and have been cited frequently as a reason for failure of anterior and posterior cruciate ligament reconstructions. Although several reconstructive techniques currently exist, there are relatively few clinical outcomes data after reconstruction of the posterolateral corner.

Purpose: The study was undertaken to examine the clinical outcomes and provide objective data using arthrometry and stress radiography of a posterolateral corner reconstruction technique.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective cohort study of a consecutive series of patients who underwent posterolateral corner reconstruction of the knee was evaluated. The surgery featured dual femoral tunnels, a transfibular tunnel, and a free graft to reconstruct the posterolateral corner of the knee. All patients had concomitant reconstruction of one or both cruciate ligaments. Outcomes were assessed using the Short Form–12, Lysholm, and Tegner knee scores. A clinical examination, KT-2000 arthrometry measurements, single-legged hop quotient, and varus and posterior Telos stress radiographs were obtained and compared with results for the contralateral, uninjured knees.

Results: Twenty-four (83%) of 29 consecutive patients were evaluated at a mean 39 months postoperatively (range, 24-81 months). The mean Lysholm and Tegner knee scores were 83 and 6, respectively. The mean difference (± standard deviation) in total anterior-posterior side-to-side KT arthrometry measurements was 1.4 ± 1.3 mm. The varus stress radiographic mean side-to-side difference measured at 20° of flexion was 0.2 ± 1.9 mm. The mean radiographic posterior tibial displacement with a 15-kg stress at 90° of flexion was 3.2 ± 4.5 mm in patients undergoing posterior cruciate ligament reconstruction.

Conclusion: This reconstruction of the posterolateral corner of the knee with concomitant cruciate ligament reconstruction restores varus and rotational stability at a minimum of 2 years postoperatively.
Cerebral Folate Deficiency Presenting as Adolescent Catatonic Schizophrenia: A Case Report
Authors: Ho Albert , Michelson David , Aaen Gregory , Ashwal Stephen
Published: May 2010

Cerebral folate deficiency presents during infancy with irritability, deceleration of head growth, seizures, and progressive cognitive and motor impairment. Although low serum folate levels have been found in patients with schizophrenia, we describe the first case of cerebral folate deficiency presenting as catatonic schizophrenia. A 13-year-old previously healthy boy presented to our hospital with a 17-month history of schizophrenic symptoms with progressively worsening catatonia. On admission, he demonstrated near-complete mutism, frequent enuresis and encopresis, and severe psychomotor retardation. Our initial diagnostic evaluations, including brain magnetic resonance imaging, electroencephalogram, and routine metabolic tests, were normal. A lumbar puncture done to look for neurotransmitter defects or cerebral folate deficiency revealed low levels of 5-methyltetrahydrofolate (31 nmol/L; reference range, 40-150 nmol/L). He also had elevated titers of folate receptor-blocking antibodies. He was treated for the next 9 months with 5-formyltetrahydrofolate (folinic acid), but his catatonia was unchanged.
Extracorporeal Removal Techniques for the Poisoned Patient: A Review for the Intensivist
Authors: Fertel Baruch S. , Nelson Lewis S. , Goldfarb David S.
Published: May 2010

The kidney is able to rapidly eliminate many water-soluble xenobiotics (exogenous chemicals). However, in the face of extraordinary serum concentrations of these xenobiotics or renal dysfunction, alternative elimination techniques often become necessary. Extracorporeal removal (ECR) techniques are used to increase the clearance of xenobiotics. These techniques include hemodialysis (HD), charcoal hemoperfusion (HP), and modalities grouped under the heading of continuous renal replacement therapy (CRRT): continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodiafiltration (CVVHDF). Extracorporeal removal is limited to patients with significant or potentially significant clinical poisoning because the resources required to perform ECR are great. Therefore, most patients who are treated with these techniques are being cared for in intensive care units (ICUs). Our goal in this review is to discuss the properties that make xenobiotics amenable to removal by ECR and the advantages and disadvantages of the individual techniques. We discuss xenobiotics that constitute clear indications for ECR, including the toxic alcohols, salicylates, and lithium. We review the use of CRRT, a modality for which clear indications for treatment of poisonings are currently lacking.
The Utility of Tissue Doppler Imaging for the Noninvasive Determination of Left Ventricular Filling Pressures in Patients With Septic Shock
Authors: Mousavi Negareh , Czarnecki Andrew , Ahmadie Roien , Tielan Fang  , Kumar Kanwal , Lytwyn Matthew , Kumar Anand , Jassal Davinder S.
Published: May 2010

Background: Pulmonary artery wedge pressure (PAWP) is an important indicator of volume status in septic patients. Although it requires invasive pulmonary artery catheterization (PAC), a noninvasive method to assess PAWP would be clinically useful in this select patient population. Diastolic indices using transthoracic echocardiography (TTE) may provide an accurate estimate of PAWP. Objective: To determine whether echocardiographic Doppler assessment is accurate in estimating PAWP in patients with septic shock. Methods: A retrospective chart review was performed of 320 patients admitted with a diagnosis of septic shock from 2007-2008. Of the total patient population, 40 patients fulfilled the inclusion criteria, having undergone both TTE and PAC within 4 hours. Spectral Doppler indices including peak early (E) and late (A) transmitral velocities, E/A ratio, and E-wave deceleration time were measured. Tissue Doppler indices including S’, E’ and A’ velocities were determined. Pulmonary artery wedge pressure values measured invasively were compared to the dimensionless index of E/E’ in each patient. Results: The mean age was 68 ± 12 years with 28 males (70%). On echo assessment, 28% of patients had evidence of mild left ventricular diastolic dysfunction while 17% of patients had moderate diastolic dysfunction. Pulmonary artery wedge pressures ranged from 7 to 31 mm Hg with a mean of 18 ± 5 mm Hg. The mean E/E’ was 11 ± 8. Linear regression analysis between PAWP and E/E7apos; demonstrated a strong correlation (r = .84, P < .05). Conclusion: Tissue Doppler indices using TTE is a feasible and strong predictor of PAWP in patients with septic shock.
Myxoid Adrenal Cortical Carcinoma Presenting as Primary Hyperaldosteronism
Authors: Hsieh Min-Shu , Chen Jun-Herng , Lin Long-Wei
Published: May 2010

The authors report a case of myxoid adrenal cortical carcinoma (ACC) clinically manifesting as primary hyperaldosteronism. The 82-year-old female patient had a history of hypertension and was sent to the emergency room because of change in consciousness. Ventricular fibrillation occurred, and severe hypokalemia was found. Increased renal loss of potassium, high serum aldosterone level, low renin activity, and a huge tumor in the left suprarenal area were revealed when tests were conducted to determine the cause of her hypokalemia. Left adrenalectomy was performed. The tumor measured 13 cm in diameter and showed a heterogeneous cut surface with gelatinous material. Microscopically, the lesion was composed of polygonal cells with eosinophilic cytoplasm and arranged in arborizing cords in a myxoid background. Capsular and vascular invasion were observed. The tumor stained positive for synaptophysin, melan-A, vimentin, and α-inhibin but negative for cytokeratin. A primary myxoid ACC was diagnosed, which is a rare histological variant. The authors review 13 other reported cases. Most of these were functional tumors causing Cushing syndrome, and only 2 cases presented as primary hyperaldosteronism. All cases had similar microscopic and immunohistochemical features. Distal metastases and local recurrence were not uncommon. Close clinical follow-up is imperative.
CDX2 and LI-Cadherin Expression in Esophageal Mucosa: Use of Both Markers Can Facilitate the Histologic Diagnosis of Barrett’s Esophagus and Carcinoma
Authors: Weimann Andreas , Zimmermann Mathias , Gross Monica , Slevogt Hortense , Rieger Anja , Morawietz Lars
Published: May 2010

Background: Barrett’s mucosa is a risk factor for esophageal adenocarcinoma and should be detected at an early stage. CDX2 and liver—intestine (LI)-cadherin are intestine-specific markers.Aberrant CDX2 expression has been demonstrated in Barrett’s metaplasia, esophagitis, and intestinal metaplasia of the stomach. Methods: The relationship between CDX2 and LI-cadherin expression was investigated in normal gastroesophageal (n = 24) and in Barrett’s (n = 20) mucosa, in low-grade (n = 15) and high-grade (n = 13) intraepithelial neoplasia (IEN) as well as in esophageal adenocarcinoma (n = 16), using immunohistochemistry. Results: Nuclear positivity for CDX2 coupled with membranous expression of LI-cadherin was observed in about 70% of the epithelial cells of Barrett’s mucosa. The intensity of staining and the percentage of positive cells increased within the sequential steps of low-grade to high-grade IEN, whereas the normal cylindric epithelium lacked the expression of both. In adenocarcinoma, the expression of LI-cadherin and CDX2 was significantly weaker or absent. Conclusions: CDX2 and LI-cadherin are sensitive markers of intestinal metaplasia with or without dysplasia in the upper gastrointestinal tract. Both can be helpful for the early histologic diagnosis of Barrett’s esophagus and its subsequent lesions; however, they do not significantly discern between different grades of dysplasia.
Fibrolamellar Hepatocellular Carcinoma: An Immunohistochemical Comparison With Conventional Hepatocellular Carcinoma
Authors: Abdul-Al Hala M. , Guanghua Wang  , Makhlouf Hala R. , Goodman Zachary D.
Published: May 2010

The fibrolamellar variant of hepatocellular carcinoma (FLC) differs from conventional hepatocellular carcinoma (HCC) in some clinical and pathological features. The authors investigated possible differences in reactivity between FLCs and HCCs using glypican-3 (GPC3), an oncofetal protein, and survivin, an antiapoptotic protein. They also compared staining of FLC and HCC with antibodies to cytokeratins 7 (CK7) and 19 (CK19) and CD34. GPC3 was significantly more often and more strongly expressed in HCCs (72%) than in FLCs (17%). Survivin nuclear translocation in tumor cells did not differ between HCCs (10%) and FLCs (9%). There was more abundant expression of CK7 in FLCs (92%) than in HCCs (33%), whereas CK19 was more often found in HCCs (20%) than in FLCs (5%). All tumors had CD34-positive sinusoids. This study shows that FLCs and HCCs differ in the expression of GPC3, CK7, and CK19 and that there is a lack of difference as regards survivin and CD34.
Intraductal Carcinoma of the Prostate in the Ejaculatory Duct
Authors: Sanchez-Salazar Alma J. , Basler Joseph W. , Nicolas Marlo M.
Published: May 2010

Intraductal carcinoma of the prostate (IDCP) involving prostatic ducts and acini is a well-known phenomenon typically seen in a background of high-grade invasive prostatic adenocarcinoma. The current case of prostatic adenocarcinoma with Gleason score of 9 (4 + 5) invades the ejaculatory ducts, left seminal vesicle, and extraprostatic tissue. The tumor involving the left ejaculatory duct spans the lumen with preservation of native duct architecture, including basal cells, similar features described in IDCP involving prostatic ducts and acini.
Review Article: The Familial Counterparts of Follicular Cell—Derived Thyroid Tumors
Authors: Prazeres Hugo , Torres Joana , Soares Paula , Sobrinho-Simões Manuel
Published: May 2010

The follicular cell—derived thyroid cancers (termed nonmedullary thyroid cancers—NMTCs) occur mostly sporadically, but intriguingly, NMTC has the highest familial risk among all cancer sites. This epidemiological observation is strengthened by the clinical occurrence of NMTC in familial aggregation (FNMTC) and by the detection of chromosomal loci in linkage with the disease phenotype. FNMTC loci have been proposed at 14q, 1q21, 19p13.2, 2q21, 8p23, 8q24, 1q21, and 6q22, but to date, no causative mutations have been linked to FNMTCs. In this review, the authors focus on the clinical, morphological, and molecular aspects that characterize familial tumors. Some morphological patterns may alert for a familial disease. FNMTCs share several of the somatic molecular changes associated with sporadic tumors. New genes affected by somatic changes have been disclosed within regions harboring FNMTC loci.
Final Amended Report of the Safety Assessment of Toluene-2,5-Diamine, Toluene-2,5-Diamine Sulfate, and Toluene-3,4-Diamine as Used in Cosmetics
Authors: Burnett Christina L. , Bergfeld Wilma F. , Belsito Donald V. , Klaassen Curtis D. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Andersen F. Alan
Published: May 2010

Toluene-2,5-diamine, toluene-2,5-diamine sulfate, and toluene-3,4-diamine are diaminotoluenes used as colorants in permanent hair dyes and tints. Toluene-2,5-diamine is used in 79 products at concentrations up to 3%; toluene-2,5-diamine sulfate is used in 168 products at concentrations up to 4%. Toluene-3,4-diamine does not appear to be in current use. Previously, the Cosmetic Ingredient Review Expert Panel determined that all 3 ingredients were safe for use as hair dyes. New data suggest that differences in toxicity, especially with respect to carcinogenicity, may exist as a function of placement of amine groups around the benzene ring. The Expert Panel concluded that toluene-2,5-diamine and toluene-2,5-diamine sulfate and are safe as hair dye ingredients in the present practices of use and concentrations but that there are insufficient data supporting the safety of toluene-3,4-diamine.
Final Report of the Amended Safety Assessment of Quaternium-15 as Used in Cosmetics
Authors: Becker Lillian C. , Bergfeld Wilma F. , Belsito Donald V. , Klaassen Curtis D. , Hill Ronald , Leibler Daniel , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Andersen F. Alan
Published: May 2010

Quaternium-15 is an antimicrobial agent used in cosmetics as a cosmetic preservative and antistatic agent. Little systemic toxicity was reported in most single-dose or repeated-dose animal studies. Quaternium-15 was an oral teratogen, but not a dermal teratogen, in rats at doses that exceeded the expected cumulative exposure from cosmetics. The frequency of sensitization increased in North America but not in Europe, where Quaternium-15 is used less often. In almost all animal and human studies, Quaternium-15 at 0.2% was not a sensitizer. The weight of evidence suggested that a 0.2% concentration is not a sensitizer and that cosmetic products containing Quaternium-15 up to that level are safe.
Increased Urinary Excretion of Carnitine and Acylcarnitine by Mercuric Chloride Is Reversed by 2,3-Dimercapto-1-Propanesulfonic Acid in Rats
Authors: Al-Madani Waleed A. , Siddiqi Nikhat J. , Alhomida Abdullah S. , Khan Haseeb A. , Arif Ibrahim A. , Kishore Uday
Published: May 2010

This investigation was aimed to study the effect of 2,3-dimercapto-1-propanesulfonic acid (DMPS) on mercuric chloride (HgCl2)-induced alterations in urinary excretion of various carnitine fractions including free carnitine (FC), acylcarnitine (AC), and total carnitine (TC). Different groups of Wistar male rats were treated with HgCl2 at the doses of 0.1, 0.5, 1.0, 2.0, and 3.0 mg/kg body weight, and the animals were sacrificed at 24 hours following HgCl2 injection. A separate batch of animals received HgCl2 (2 mg/kg) with or without DMPS (100 mg/kg) and sacrificed at 24 or 48 hours after dosing. Administration of HgCl2 resulted in statistically significant and dose-dependent increase in the urinary excretion of FC, AC, and TC in rats. However, the ratio of urinary AC:FC was significantly decreased by HgCl2. Pretreatment with DMPS offered statistically significant protection against HgCl2-induced alterations in various urinary carnitine fractions in rats.
Effect of Allyl Isothiocyanate (AITC) in Both Nitrite- and Nitrosamine-Induced Cell Death, Production of Reactive Oxygen Species, and DNA Damage by the Single-Cell Gel Electrophoresis (SCGE): Does It Have Any Protective Effect on HepG2 Cells?
Authors: Erkekoğlu Pınar , Baydar Terken
Published: May 2010

The current study was designed to investigate possible protective effect of allyl isothiocyanate (AITC) in nitrite- and nitrosamine-treated human hepatoma cells (HepG2) with the evaluation by cytotoxic effects and genotoxic effects determined by the single-cell gel electrophoresis (SCGE). Allyl isothiocyanate treatment enhanced cell viability and reduced intracellular reactive oxygen species (ROS) production in both nitrite- and nitrosamine-treated cells significantly. In SCGE, when compared to untreated control cells, all of the treated groups caused increases in the tail intensity (%) such as nitrite at 17%, N-nitrosodimethylamine (NDMA) at 279%, N-nitrosodiethylamine (NDEA) at 324%, and N-nitrosomorpholine (NMOR) at 288%. Allyl isothiocyanate reduced the tail intensity caused by nitrite 36%, by NDMA 36%, by NDEA 49%, and by NMOR 32%, respectively, when compared to each individual toxic compound–treated group. In conclusion, AITC protected HepG2 cells against cytotoxic and genotoxic effects caused by nitrite and the nitrosamines.
Comparative Effects of Microtubules Disruption on Glucocorticoid Receptor Functions in Proliferating and Quiescent Cells
Authors: Vrzal Radim , Gerbal-Chaloin Sabine , Maurel Patrick , Dvořák Zdeněk
Published: May 2010

We have recently demonstrated that the alkaloid colchicine (COL) inhibits glucocorticoid receptor (GR) transcriptional activity. In addition, we described proteasome-mediated degradation of GR in COL-treated HeLa cells. While these effects were previously attributed to cell cycle arrest in G2/M phase, this explanation is not applicable for nonproliferating cells such as human hepatocytes (HH). In the current study, we compared COL-mediated microtubule disruption and cell cycle arrest with selected GR functions in HeLa cells and HH as models of proliferating and quiescent cells, respectively. Microtubule disruption led to irreversible decrease in GR binding capacity and protein level in HeLa cells. None of the parameters was restored 24 hours after COL withdrawal. In contrast, dexamethasone (DEX) binding was increased in HH at the beginning of the treatment, with following transient activation of extracellular signal-regulated kinase (ERK). The findings of these investigations emphasize the GR-signaling differences between primary and transformed cells.
Protective Effect of Quercetin on Hydrogen Peroxide–Induced Tight Junction Disruption
Authors: Chuenkitiyanon Somrudee , Pengsuparp Thitima , Jianmongkol Suree
Published: May 2010

Tight junction is a crucial structure in the control of paracellular transport across epithelial/endothelial barriers. This study investigated the protective effect of quercetin against hydrogen peroxide (H2O2)-induced tight junction disruption and hyperpermeability in ECV304 monolayers. Nonlethal concentration of H2O2 (100 µmol/L; 4 hours) decreased expression of the tight junction proteins zonular occudens (ZO)-1 and occludin as well as disrupted the junction structure at the cell border. Concurrently, the increased activities of extracellular signal-regulated kinase (ERK)1/2 and p38 mitogen-activated protein kinase (MAPK) were observed. Pretreatment with quercetin (10 µmol/L; 30 minutes) prior to H2O2 prevented the loss of ZO-1 and occludin. In addition, the level of phosphorylated p38 MAPK, but not that of the phosphorylated ERK1/2, decreased in quercetin-pretreated group. These findings suggested that the protective effect of quercetin involved the inhibition of phosphorylated p38 MAP activity. Furthermore, quercetin could also preserve the functional integrity of ECV304 monolayers from H2O2 exposure.
The functional and psychological impact of hand osteoarthritis
Authors: Hill Susan , Dziedzic Krysia S. , Bie Nio Ong
Published: May 2010

Objectives: Studies suggest that hand osteoarthritis (OA) can result in impairment of hand function and participation restriction. The objective of the current study was to investigate the impact of functional impairments caused by hand OA on everyday life.

Methods: Semi-structured interviews with primary care (n = 15; mean age 62.4 years; M : F ratio 1 : 4) and secondary care (n = 14; mean age 63.6 years; M : F ratio 1 : 13) patients aged 50 years and over were conducted. Data were analysed using thematic analysis and the constant comparison method.

Results: Individuals reported impact across day-to-day activities. Perceptions of dependence and independence were important. They reported embarrassment due to the appearance of their hands and their inability to carry out ‘normal’ tasks. Work status had been affected for two of the participants. Negative emotional responses were captured. Participants utilized cognitive, behavioural and avoidance forms of coping.

Conclusion: We have captured the impact of functional impairment on everyday life and related psychological effects. With a retirement age increasing, the study raises the potential issue of future employment restriction for those with hand OA. Individuals utilising ‘temporal’ comparison as a form of coping may be less well adjusted to their hand problem, which could have implications for future management.