bluuebunny/crossref_metadata_2025 huggingface dataset:
Blast-Resistant Improvement of Sandwich Armor Structure with Aluminum Foam Composite
Authors: Yang Shu , Qi Chang
Published: September 2013

Sandwich armor structures with aluminum foam can be utilized to protect a military vehicle from harmful blast load such as a landmine explosion. In this paper, a system-level dynamic finite element model is developed to simulate the blast event and to evaluate the blast-resistant performance of the sandwich armor structure. It is found that a sandwich armor structure with only aluminum foam is capable of mitigating crew injuries under a moderate blast load. However, a severe blast load causes force enhancement and results in much worse crew injury. An isolating layer between the aluminum foam and the vehicle floor is introduced to remediate this drawback. The results show that the blast-resistant capability of the innovative sandwich armor structure with the isolating layer increases remarkably.
General Iterative Methods for System of Equilibrium Problems and Constrained Convex Minimization Problem in Hilbert Spaces
Authors: Duan Peichao
Published: September 2013

We propose an implicit iterative scheme and an explicit iterative scheme for finding a common element of the set of solutions of system of equilibrium problems and a constrained convex minimization problem by the general iterative methods. In the setting of real Hilbert spaces, strong convergence theorems are proved. Our results improve and extend the corresponding results reported by Tian and Liu (2012) and many others. Furthermore, we give numerical example to demonstrate the effectiveness of our iterative scheme.
Assessment of Lead and Cadmium Levels in Frequently Used Cosmetic Products in Iran
Authors: Nourmoradi H. , Foroghi M. , Farhadkhani M. , Vahid Dastjerdi M.
Published: September 2013

This study aims to investigate the content of lead and cadmium in most frequently used brands of cosmetic products (lipstick and eye shadow) in Iran. Fifty samples of lipstick (5 colors in 7 brands) and eye shadow (3 colors in 5 brands) were selected taken from large cosmetic stores in Isfahan (Iran) and lead and cadmium of them were analyzed. The results showed that the concentration of lead and cadmium in the lipsticks was within the range of 0.08–5.2 µg/g and 4.08–60.20 µg/g, respectively. The eye shadow samples had a lead level of 0.85–6.90 µg/g and a cadmium level of 1.54–55.59 µg/g. The content range of the heavy metals in the eye shadows was higher than that of the lipsticks. There was significant difference between the average of the lead content in the different brands of the lipsticks and eye shadows. Thus, the continuous use of these cosmetics can increase the absorption of heavy metals, especially Cd and Pb, in the body when swallowing lipsticks or through dermal cosmetic absorption. The effects of heavy metals such as lead can be harmful, especially for pregnant women and children. Therefore, effort must be made to inform the users and the general public about the harmful consequences of cosmetics.
Ectopic Teeth in Ovarian Teratoma: A Rare Appearance
Authors: Ingale Yashwant , Shankar Akhil A. , Routray Samapika , Agrawal Manoj , Kadam Ajit , Patil Tushar
Published: September 2013

Teratoma consists of tissues derived from all the three germ layers, and there may be presence of appendages as a representation of these germ layers as well. Teratomas of the ovary are known to occur in a fairly large number of women. These may be present clinically at a much later stage, permitting a limited treatment plan. Newer diagnostic techniques are always welcome in identifying these lesions. This case report discusses the case of a 40-year-old woman with a large teratoma in the right ovary and its diagnostic and surgical modalities.
A Study on the Thermodynamics of Grain Growth in R.F. Magnetron Sputtered NiO Thin Films
Authors: Dhanya I. , Sasi B.
Published: September 2013

Postdeposition annealing of thin nickel films synthesized using R.F. magnetron sputtering technique is carried in this study. The XRD analysis indicates that annealing of the nickel films leads to the formation of nickel oxide with a preferential growth along (200) plane. The oxidation mechanism is observed with a phase transformation and results in polycrystalline NiO films. The surface morphology of the thin films was investigated by scanning electron microscopy (SEM) and atomic force microscopy (AFM) as a function of annealing temperature. The studies indicate the formation of well-defined grain boundaries due to agglomeration of nanocrystallites. The films annealed in the range 573–773 K are found to be porous. The optical transmission spectra of the films annealed at 773 K exhibit interference effects for photon energies below the fundamental absorption edge. The optical studies indicate the existence of direct interband transition across a bandgap of 3.7 eV in confirmation with earlier band structure calculations.
Glomerular Function Time Trends in Long-Term Survivors of Childhood Cancer: A Longitudinal Study
Authors: Mulder Renée L. , Knijnenburg Sebastiaan L. , Geskus Ronald B. , van Dalen Elvira C. , van der Pal Helena J.H. , Koning Caro C.E. , Bouts Antonia H. , Caron Huib N. , Kremer Leontien C.M.
Published: September 2013

Background: Impaired glomerular function is one of the health problems affecting childhood cancer survivors (CCS). It is unclear whether glomerular function deteriorates or recovers. We investigated time trends and predictors of glomerular function in CCS.

Methods: We evaluated repeated observations of estimated glomerular filtration rate (GFR) and glomerular dysfunction (GFR <90 mL/min/1.73 m2) among adult five-year CCS treated in the EKZ/AMC between 1966 and 2003. Ifosfamide, cisplatin, carboplatin, high-dose (HD) methotrexate, HD-cyclophosphamide, radiotherapy to the kidney region, and nephrectomy (i.e., potentially nephrotoxic therapy) were investigated as predictors of glomerular function patterns over time in multivariable longitudinal analyses.

Results: At a median follow-up of 21 years after diagnosis, glomerular function was assessed in 1,122 CCS aged ≥18 years. CCS treated with potentially nephrotoxic therapy had a significantly lower GFR and higher glomerular dysfunction probability up to 35 years after cancer diagnosis compared with CCS treated without nephrotoxic therapy (P < 0.001). Especially ifosfamide, cisplatin, and nephrectomy were associated with worse glomerular function that persisted during the entire follow-up period (P < 0.001). Glomerular function deteriorated over time in all CCS (P < 0.001). CCS treated with higher doses of cisplatin seem to have a higher deterioration rate as compared with other CCS (P < 0.005).

Conclusions: The loss in glomerular function starts early, especially for CCS treated with ifosfamide, higher doses of cisplatin, and nephrectomy, and seems to be persistent. We have an indication that CCS treated with higher doses of cisplatin experience faster decline than other CCS.

Impact: As glomerular function continues to deteriorate, CCS are at risk for premature chronic renal failure. Cancer Epidemiol Biomarkers Prev; 22(10); 1736–46. ©2013 AACR.
The Novel ATP-Competitive Inhibitor of the MET Hepatocyte Growth Factor Receptor EMD1214063 Displays Inhibitory Activity against Selected MET-Mutated Variants
Authors: Medová Michaela , Pochon Benoît , Streit Bruno , Blank-Liss Wieslawa , Francica Paola , Stroka Deborah , Keogh Adrian , Aebersold Daniel M. , Blaukat Andree , Bladt Friedhelm , Zimmer Yitzhak
Published: September 2013

The receptor tyrosine kinase MET is a prime target in clinical oncology due to its aberrant activation and involvement in the pathogenesis of a broad spectrum of malignancies. Similar to other targeted kinases, primary and secondary mutations seem to represent an important resistance mechanism to MET inhibitors. Here, we report the biologic activity of a novel MET inhibitor, EMD1214063, on cells that ectopically express the mutated MET variants M1268T, Y1248H, H1112Y, L1213V, H1112L, V1110I, V1206L, and V1238I. Our results show a dose-dependent decrease in MET autophosphorylation in response to EMD1214063 in five of the eight cell lines (IC50 2–43 nmol/L). Blockade of MET by EMD1214063 was accompanied by a reduced activation of downstream effectors in cells expressing EMD1214063-sensitive mutants. In all sensitive mutant-expressing lines, EMD1214063 altered cell-cycle distribution, primarily with an increase in G1 phase. EMD1214063 strongly influenced MET-driven biologic functions, such as cellular morphology, MET-dependent cell motility, and anchorage-independent growth. To assess the in vivo efficacy of EMD1214063, we used a xenograft tumor model in immunocompromised mice bearing NIH3T3 cells expressing sensitive and resistant MET-mutated variants. Animals were randomized for the treatment with EMD1214063 (50 mg/kg/d) or vehicle only. Remarkably, five days of EMD1214063 treatment resulted in a complete regression of the sensitive H1112L-derived tumors, whereas tumor growth remained unaffected in mice with L1213V tumors and in vehicle-treated animals. Collectively, the current data identifies EMD1214063 as a potent MET small-molecule inhibitor with selective activity towards mutated MET variants. Mol Cancer Ther; 12(11); 2415–24. ©2013 AACR.
Cloning and Heterologous Expression of Serine Protease SL41 Related to Biocontrol in Trichoderma harzianum
Authors: Liu Yan , Yang Qian
Published: September 2013

Serine proteases are highly conserved among fungi and considered to play a key role in different aspects of fungal biology. These proteases are involved in fungal growth and have been related to biocontrol processes. To assess the functional role of serine proteases from Trichoderma harzianum T88, an effective biocontrol agent, on inhibition of phytopathogenic fungi, a gene (SL41) encoding a serine protease was isolated by 5′ and 3′ RACE (rapid amplification of cDNA ends). Northern blot analysis indicated that SL41 was induced in response to cell walls of different fungi. This protease gene was expressed in Saccharomyces cerevisiae under the control of the galactose-inducible GAL1 promoter. After induction, the enzyme activity was culminated (16.2 units ml-1) at 60 h of cultivation. The optimal enzyme reaction temperature was 40°C and optimal pH was 10.5. Northern blot analysis indicated that the amount of the transcripts increased with the culture time in agreement with the measured enzyme activity. Antifungal activity of serine protease against five phytopathogens was investigated in vitro. It can inhibit the mycelial growth of phytopathogenic fungi and exerted broad spectrum antifungal activity against phytopathogenic fungi. This is the first time that the different regulation of serine protease in T. harzianum response to five phytopathogenic fungi was shown, the protease was functionally expressed in a heterologous host, and its antagonistic activity was evaluated in vitro.
High-Frequency Oscillatory Ventilation with Low Oscillatory Frequency in Pulmonary Interstitial Emphysema
Authors: Squires Katharine A.G. , De Paoli Antonio G. , Williams Christopher , Dargaville Peter A.
Published: September 2013

Background: Pulmonary interstitial emphysema (PIE) is a common respiratory illness in preterm infants associated with significant morbidity and mortality for which the ventilatory management is imperfect. Objectives: To evaluate the impact of high-frequency oscillatory ventilation (HFOV) with a low oscillatory frequency and thus prolonged expiratory time in preterm infants with severe PIE. Methods: In a retrospective cohort study, preterm infants ≤30 weeks' gestation with radiological findings of severe PIE, and either high FiO2 or persistent respiratory acidosis were studied if managed on HFOV with a low frequency (5-6 Hz, inspiratory time 30%) for >24 h. Trends in physiological and ventilatory parameters were examined over the first 72 h, radiological changes noted, and in-hospital outcomes ascertained. Results: 19 cases were identified and analysed in two groups: 14 with bilateral and 5 with predominantly unilateral disease. After transition to low-frequency HFOV, physiological responses were seen in both groups, in particular a rapid and sustained improvement in oxygenation in the bilateral group (mean (SD) alveolar-arterial oxygen difference at baseline: 404 ± 206 mm Hg; 4 h post-transition: 262 ± 181 mm Hg; 72 h: 155 ± 74 mm Hg; p = 0.0003). This occurred following a reduction in mean airway pressure (mean (SD) baseline: 14 ± 3.9 cm H2O; 72 h: 12 ± 2.9 cm H2O; p = 0.011). In the unilateral group, radiological resolution of PIE was observed on re-inflation following collapse of the affected lung. Overall, 15 infants survived, including 10 of the bilateral cases (71%), and all of the unilateral cases. Conclusion: HFOV with a low oscillatory frequency may afford benefit in preterm babies with severe PIE.
Ultrastructural Findings in Noncompaction Prevail with Neuromuscular Disorders
Authors: Finsterer Josef , Stöllberger Claudia
Published: September 2013

Objectives: Little is known about the ultrastructural abnormalities of left ventricular hypertrabeculation/noncompaction (LVHT). This literature review aimed to summarize and discuss ultrastructural abnormalities described in LVHT so far. Methods: The literature search was conducted via MEDLINE using the search terms ‘non-compaction', ‘noncompaction', ‘left ventricular hypertrabeculation', ‘spongy myocardium' in combination with the terms ‘ultra-structural', or ‘electron microscopy'. Results: Altogether, 11 studies reporting ultrastructural investigations of LVHT were retrieved. In these 11 studies, data on 13 patients with LVHT were presented. Ultrastructural abnormalities found in these study patients were generally nonspecific and included an increase in the number of mitochondria (n = 3), abnormally shaped mitochondria (n = 2), distorted cristae (n = 3), sarcomeric derangement (n = 3), immature cardiomyocytes (n = 1), lipid-like inclusions (n = 1), enlarged interstitial spaces (n = 1), increased interstitial collagen (n = 1), or increased glycogen (n = 1). The morphological abnormalities were most prominent in patients with a neuromuscular disorder like Barth syndrome or mitochondrial myopathy. Conclusions: Only in few patients with LVHT, ultrastructural investigations have been performed so far. Ultrastructural abnormalities in LVHT are nonspecific and most prominent in patients with a neuromuscular disorder. There is a strong need to carry out thorough ultrastructural investigations of LVHT to contribute to the understanding of this still unexplained myocardial abnormality.
Chromosomal Organization of Repetitive DNA in Sorubim lima (Teleostei; Pimelodidae)
Authors: Sczepanski T.S. , Vicari M.R. , de Almeida M.C. , Nogaroto V. , Artoni R.F.
Published: September 2013

Interspaced repetitive DNA elements and segmental duplications have been extensively analyzed in fishes through physical chromosome mapping methods, providing a better comprehension of the structure and organization of the genome of this group. In order to contribute to this scenario, a sequence integration study of different classes of repetitive DNA with high resolution physical chromosome mapping was performed in Sorubim lima. Fluorescence in situ hybridization (FISH) and fiber-FISH with probes for 18S and 5S rRNA genes, TTAGGGn sequence and non-LTR retrotransposon family members Rex1, Rex3 and Rex6 showed that non-LTR elements may be dispersed in the chromosome set with relative concentration in heterochromatic regions, as shown by Rex1, or may even intercalate in 45S rDNA and the telomeric sequence, as found for Rex3 and Rex6. These results reinforce the presence of preferential regions of retroelement accumulation and contribute to a better understanding of the genomic organization of some repetitive DNA classes in fishes.
Perfusion Index as a Diagnostic Tool for Patent Ductus Arteriosus in Preterm Infants
Authors: Khositseth Anant , Muangyod Natthachai , Nuntnarumit Pracha
Published: September 2013

Background: Perfusion index (PI) could reflect peripheral flow. Preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) will have left-to-right shunt across PDA causing less blood flow to the lower legs. Objective: To evaluate pre- and postductal PI differences (ΔPI) in hsPDA. Methods: Preterm infants with gestational age <34 weeks were assessed for ΔPI on days 1, 3, and 7 of life with simultaneous echocardiography. Based on echocardiography, each infant was categorized into hsPDA, non-hsPDA, and no PDA. Results: Thirty infants (16 males), median age 31 weeks (interquartile range, IQR, 29-32) and weight 1,490 g (IQR 1,100-1,670) were enrolled. On days 1 and 3 of life, the ΔPI of infants with hsPDA (1.57%, IQR 0.28-2.32, n = 14, and 1.32%, IQR 0.28-1.83, n = 10) were significantly higher than those without hsPDA (0.14%, IQR -0.03 to 0.30, n = 16, and 0.08%, IQR -0.07 to 0.26, n = 20), p = 0.009 and 0.005, respectively. At all time points (days 1, 3, and 7 of life, n = 84), ΔPI >1.05% had sensitivity, specificity, positive predictive value, and negative predictive value of 66.7, 100, 100, and 86.4%, respectively, to detect hsPDA. Conclusion: The pre- and postductal PI differences were significantly related to the hemodynamic changes of PDA and might be useful to detect hemodynamically significant PDA.
The Medial Based Bi- or Trilobed Flap for Repair of Distal Alar Defects
Authors: Skaria A.M.
Published: September 2013

Background: Reconstruction of defects of the lateral nasal ala might be challenging. Reconstruction with a bi- or trilobed flap is common. The laterally based bi- or trilobed flap for defects of the distal ala or lateral tip of the nose produces mostly tissue protrusion in the nasal groove which is aesthetically unpleasant. Why not use more the medially based bi- or trilobed flap? Objective: To describe the utility of bilobed and trilobed flaps for alar defects insisting on the design of medially based flaps. Methods: To show the technique and practical application for this kind of reconstruction. Results: The bi- and trilobed flaps are useful for defect repair between the lateral nasal tip and the distal ala. We observed that in most cases the flap based medially respects anatomical subunits better than the laterally based flap for medium-sized defects of the distal ala of the nose. Conclusion: I suggest that the bi- and trilobed flaps for repair of the lateral tip/distal ala should more often be medially based. This flap has a specific indication and precise advantage compared to other reconstructions, especially to the laterally based multilobed flaps in this specific indication.
Cognitive Interventions in Mild Alzheimer's Disease: A Therapy-Evaluation Study on the Interaction of Medication and Cognitive Treatment
Authors: Schecker M. , Pirnay-Dummer P. , Schmidtke K. , Hentrich-Hesse T. , Borchardt D.
Published: September 2013

Background/Aims: Many studies have shown that not only pharmacological treatment but also cognitive stimulation in the early stages of Alzheimer's disease (AD) improves language processing and (other) cognitive functions, stabilizes Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) functions and increases the subjective quality of life (wherein a combination of pharmacological intervention and cognitive stimulation could provide greater relief of clinical symptoms than either intervention given alone). Today, it is no longer the question of whether cognitive stimulation helps but rather what kind of stimulation helps more than others. Methods: A sample of 42 subjects with mild AD (all medicated with an acetylcholinesterase inhibitor and well adjusted) underwent clinical and cognitive evaluation and participated in a 6-month study with 2 experimental groups (i.e. ‘client-centered' global stimulation vs. cognitive training) and a control group. Since the test performance also depends on the individual test, we used a wide variety of tests; we z-transformed the results and then calculated the mean value for the global cognitive status (using the Mini-Mental State Examination) as well as for the single functional areas. Results: Between-group differences were found, they were overall in favor of the experimental groups. Different functional areas led to different treatment and test patterns. Client-centered, global, cognitive therapy stimulated many cognitive functions and thus led to a better performance in language processing and ADL/IADL. The subjective quality of life increased as well. The cognitive training (of working memory) improved only the ADL/IADL performance (more, however, than client-centered, global, cognitive stimulation) and stabilized the level of performance in the other three functional areas.
Intravenous Zoledronic Acid Given Every 6 Months in Childhood Osteoporosis
Authors: Ooi Hooi Leng , Briody Julie , Biggin Andrew , Cowell Chris T. , Munns Craig F.
Published: September 2013

Aim: To evaluate the safety and efficacy of 12 months of zoledronic acid (ZA) administered every 6 months to children with osteoporosis. Methods: Retrospective cohort study of 27 patients (16 male, 11 female) treated with ZA (0.05 mg/kg/dose) every 6 months for 1 year. 20 were immobile, 4 steroid-induced osteoporosis, 2 idiopathic osteoporosis and 1 neurofibromatosis type 1. 16 had long bone fractures and 12 had vertebral wedging at baseline. Mineral homeostasis, bone mineral density (BMD) and vertebral morphometry were evaluated at baseline and 12 months. Results were compared to published data on 3-monthly ZA treatment. Results: Median age at ZA start was 10.5 years (range 6.2-13.3). Following the first infusion, 2 developed asymptomatic hypocalcemic, 14 developed temperature >38°C, 13 aches/pain and 6 nausea. At 12 months, there was reduction in bone turnover and improvement in BMD and vertebral shape. No patient fractured after starting ZA. Growth was normal. Outcomes were similar to 3-monthly ZA. Conclusion: ZA administered 6-monthly was associated with acute phase reaction to the first dose and improvement in BMD, reduction in bone turnover and improved vertebral shape at 12 months.
A Surgical Technique for Homogenous Renal Distribution of Substances in Rats
Authors: Monteiro Carvalho Mori da Cunha Marina Gabriela , Beckmann Diego Vilibaldo , Carlon Marianne Sylvia , Zia Silvia , Pippi Ney Luis , Mazzanti Alexandre , Van der Perren Anke , Deprest Jan , Toelen Jaan
Published: September 2013

Intra-arterial injection of mesenchymal stem cells has been proven to result in a superior nephroprotection compared to intravenous injection. This avoids initial passage through filter organs such as the lung, liver and spleen. The aim of the present study was to investigate whether suprarenal aortic delivery results in a homogenous distribution to both kidneys. Chinese ink was used to evaluate the renal distribution pattern for the comparison of two retrograde intra-aortic injection methods. In the first, the aorta caudal to the renal branches was temporarily clamped and Chinese ink was injected at the level of the renal arteries. In the second, a distal aortic clamp was combined with alternated clamping of the contralateral arteries. Immediately after injection, kidneys were harvested for histological analysis. Amniotic fluid stem cells labeled with LacZ were injected in the aorta by alternated clamping of the renal arteries in order to track the cells in a rat ischemia/reperfusion model. Without renal artery clamping, intra-aortic administration resulted in a delivery of the ink into the right kidney, whereas administration with alternated clamping of the contralateral renal artery, together with distal aortic artery clamping, resulted in a more homogenous distribution of the ink in both kidneys. Moreover, LacZ-positive cells were found in both kidneys after 6 h of injection. In conclusion, the retrograde administration of Chinese ink in two steps is a fast and reproducible technique, which results in a more homogenous distribution of the stain in both kidneys than a single administration combined by only clamping the aorta.
Effects of the Thioredoxin-1 Inhibitor PX-12 on Blood-Brain Barrier Permeability in the Early Stage of Focal Cerebral Ischemia
Authors: Chi Oak Z. , Barsoum Sylviana , Grayson Jeremy , Liu Xia , Weiss Harvey R.
Published: September 2013

Background/Aims: Since a thioredoxin-1 (Trx-1) inhibitor, 1-methylpropyl-2-imidazolyl disulfide (PX-12) which is an antitumor agent, significantly decreased vascular permeability in tumor xenografts within a few hours of treatment, we tested whether PX-12 would attenuate blood-brain barrier (BBB) disruption in the early stage of focal cerebral ischemia and whether its action could be affected by vascular endothelial growth factor (VEGF) which interacts with the Trx-1 system. Methods: In rats, 40 min after intravenous infusion of either 25 mg/kg of PX-12 (PX-12 group) or normal saline (control group), a middle cerebral artery (MCA) was occluded. In half of each group, VEGF (10-10 mol/l) was applied topically in the ischemic cortex (IC). Ninety minutes after MCA occlusion, the transfer coefficient (Ki) of 14C-α-aminoisobutyric acid and the volume of 3H-dextran distribution were determined to measure the degree of BBB disruption. VEGF protein levels were determined using Western blot analysis. Results: MCA occlusion increased the Ki in the control (+196%) as well as in the PX-12-treated rats (+90%), but the Ki of the IC of the PX-12 group was lower (-42%) than that of the control rats. VEGF protein levels were decreased in both the IC (-9.5%) and the contralateral cortex (CC; -10.2%) with PX-12 treatment. In the VEGF-treated rats, PX-12 also attenuated (-41%) the Ki of the IC. The difference in the volume of dextran distribution between the IC and the CC became insignificant with PX-12 treatment with or without VEGF application. Conclusion: Our data demonstrated that PX-12 was effective in decreasing BBB disruption in the early stage of focal cerebral ischemia and that VEGF is not an important factor involved in the action of PX-12 on BBB permeability.
α-Synuclein in Parkinson's Disease: Pathogenic Function and Translation into Animal Models
Authors: Eschbach Judith , Danzer Karin M.
Published: September 2013

Parkinson's disease is a common neurodegenerative disease characterised by the loss of dopaminergic neurons in the substantia nigra pars compacta and the formation of α-synuclein aggregates found in Lewy bodies throughout the brain. Several α-synuclein transgenic mouse models have been generated, as well as viral-mediated overexpression of wild-type and mutated α-synuclein to mimic the disease and to delineate the pathogenic pathway of α-synuclein-mediated toxicity and neurodegeneration. In this review, we will recapitulate what we have learned about the function of α-synuclein and α-synuclein-mediated toxicity through studies of transgenic animal models, inducible animal models and viral-based models.
Is Laparoscopy-Assisted Total Gastrectomy Feasible for the Treatment of Gastric Cancer? A Case-Matched Study
Authors: Kim Ki Han , Kim Yoo Min , Kim Min Chan , Jung Ghap Joong
Published: September 2013

Background: The aim of this study was to clarify the short- and long-term outcomes of laparoscopy-assisted total gastrectomy (LATG) for gastric cancer compared to conventional open total gastrectomy (COTG) with a case-control study. Methods: Between January 2002 and December 2010, a series of 264 patients with gastric cancer underwent R0 total gastrectomy (61 LATG patients and 203 COTG patients). Age, gender, and pathological stage were matched by propensity scoring, and 120 patients (60 LATG and 60 COTG) were selected for analysis. Results: There were no significant differences in the clinicopathological features between the two groups. Regarding postoperative outcomes, first flatus time was significantly shorter in the LATG group than in the COTG group (p < 0.001), while operation time was significantly longer in the LATG group than in the COTG group (p < 0.001). Postoperative complications occurred in 5 cases (8.3%) of the LATG group and in 11 cases (18.3%) of the COTG group (p = 0.178). There were two recurrences in the LATG group and three recurrences in the COTG group. There was no significant difference in the 5-year survival rate between the two groups (p = 0.667). Conclusions: LATG for gastric cancer may be both feasible and efficient compared to COTG for experienced laparoscopic surgeons. This study is valuable for a prospective randomized controlled trial of LATG for gastric cancer in a larger number of patients.
Late Recovery of Cranial Diabetes Insipidus following Pituitary Surgery
Authors: Glynn Nigel , O'Brien Donncha , Agha Amar
Published: September 2013

Background: Diabetes insipidus (DI) is common following surgery for a pituitary/sellar lesion. Postoperative DI persisting beyond a few weeks is usually regarded as permanent, requiring lifelong desmopressin therapy. Case Presentation: A 16-year-old girl underwent pituitary decompression following a pituitary tumour apoplexy. She developed DI with thirst and hypotonic polyuria in the immediate post-operative period, which was controlled with parenteral DDAVP. Her symptoms persisted and she was discharged on oral desmopressin. Subsequently, she commenced growth hormone replacement. A water deprivation test 6 weeks postoperatively confirmed persistent DI with failure to concentrate urine after 8 hours of dehydration. She was maintained on desmopressin and reported intense thirst and polyuria every time she delayed taking the medication up until 1 year postoperatively. After 1 year, she complained of bloating and stopped taking desmopressin but her symptoms did not recur. A repeat water deprivation test confirmed very late resolution of DI with normal urinary concentration. She has remained asymptomatic ever since. Conclusion: Delayed recovery of normal posterior pituitary function is exceptionally rare. We hypothesise that the underlying mechanism may be the revascularisation and regeneration of the posterior pituitary tissues or of the axons terminating in the posterior pituitary.
Baseline Inhibin B Levels for Diagnosis of Central Precocious Puberty in Girls
Authors: De Filippo Gianpaolo , Rendina Domenico , Nazzaro Alfredo , Lonardo Fortunato , Bouvattier Claire , Strazzullo Pasquale
Published: September 2013

Aim: To evaluate the use of baseline inhibin B (INHB) levels to differentiate the progressive form (PF) from the non-progressive form (NPF) of central precocious puberty (CPP). Methods: A total of 62 girls were enrolled, 31 with PF and 31 with NPF. Using receiver operating characteristic (ROC) curves, we analysed the diagnostic performance of INHB in addition to other diagnostic tools used to differentiate the 2 forms of CPP. Results: INHB levels were higher in PF versus NPF (29.1 vs. 13.1 pg/ml; p < 0.001). The ROC area under the curve (AUC) was greatest for luteinizing hormone [LH; 0.807, standard error (SE) 0.069], followed by INHB (0.800, SE 0.067), ovarian volume (OV; 0.782, SE 0.070) and uterine volume (0.723, SE 0.076). In ROCs relative to a combination of such parameters, the AUC was greater for LH + INHB (0.972, SE 0.010), followed by OV + LH (0.841, SE 0.084) and OV + INHB (0.836, SE 0.075). The combination of INHB and LH (with cut-offs of 20 pg/ml and 0.2 IU/l, respectively) results in 98% sensitivity and specificity. Conclusion: Our results suggest that the addition of basal INHB values to baseline LH levels provides a reliable method to identify PF. Further replication studies are needed to definitively prove or disprove the utility and advantages of INHB levels as part of the work-up of CPP.
Chromosomal Mapping of Repetitive DNA and Cytochrome C Oxidase I Sequence Analysis Reveal Differentiation among Sympatric Samples of Astyanaxfasciatus (Characiformes, Characidae)
Authors: Pansonato-Alves J.C. , Hilsdorf A.W.S. , Utsunomia R. , Silva D.M.Z.A. , Oliveira C. , Foresti F.
Published: September 2013

The genus Astyanax is a specious Neotropical fish group, occurring from the south area of the United States to Argentina. During the past few years, intensive studies on representatives of this group have been performed, broadening the genetic, taxonomic and biogeographical knowledge considerably. However, phylogenetic relationships among many species remain uncertain. Significant karyotypic variations occur in A. bimaculatus, A. scabripinnis and A. fasciatus, suggesting the existence of species complexes. Samples with different diploid numbers may be found in A. fasciatus and, in some cases, morphological differentiation among them is not easily verified due to the absence of clear diagnostic characteristics. In the present study, the organization of the A. fasciatus genome from the Tietê River, Mogi das Cruzes, SP, Brazil, was analyzed, describing the karyotype structure and the chromosomal mapping of 18S and 5S ribosomal DNA (rDNA), H1 and H3 histones genes, telomeric DNA, and Rex3 transposable element. Sequencing of the cytochrome c oxidase I (COI) gene was also performed. Chromosomal analyses highlighted the occurrence of 2 distinct karyomorphs in the referred population, one with 2n = 46 and the other with 2n = 48 chromosomes. Furthermore, physical mapping of the repetitive sequences and nucleotide analysis of the COI gene reinforce the genomic differentiation between those karyomorphs and corroborate the existence of 2 different lineages morphologically similar to A. fasciatus living in sympatry.
Residual β-Cell Mass Influences Growth of Prepubertal Children With Type 1 Diabetes
Authors: Bizzarri Carla , Benevento Danila , Patera Ippolita Patrizia , Bongiovanni Marzia , Boiani Arianna , Fusco Concetta , Cianfarani Stefano , Cappa Marco
Published: September 2013

Background: The growth deceleration observed in children with type 1 diabetes (T1D) has been related to poor glycemic control. It is unclear whether growth impairment persists despite the optimization of therapy. We analyzed the effects of intensive insulin treatment on prepubertal growth. Methods: One hundred and four T1D children were evaluated from T1D diagnosis up to puberty onset. Height, weight, insulin requirement and glycated hemoglobin (HbA1c) were recorded at 3- to 6-month intervals. Residual β-cell mass was estimated by fasting C-peptide at T1D onset. Results: Age at T1D onset was 5.91 ± 1.9 years. Follow-up duration was 4.84 ± 1.58 years. Height velocity standard deviation score (SDS) was -0.14 ± 1.84. Height SDS changed from 0.52 ± 1.04 at T1D onset, to 0.36 ± 1.10 at the end of follow-up (p = 0.04). BMI SDS increased from -0.04 ± 1.48 to 0.32 ± 1.03 (p = 0.01). Multivariate analysis showed that height velocity was directly affected by C-peptide (p = 0.03) and insulin requirement (p = 0.004) and inversely related to HbA1c (p = 0.006). BMI gain was negatively influenced by HbA1c (p = 0.01) and positively related to T1D duration (p = 0.01). Conclusion: Despite insulin intensive therapy, T1D still negatively affects growth. Residual β-cell mass has a direct positive impact on growth, independently from the quality of glycemic control.
Are Thiazide Diuretics Safe and Effective Antihypertensive Therapy in Kidney Transplant Recipients?
Authors: Taber David J. , Srinivas Titte M. , Pilch Nicole A. , Meadows Holly B. , Fleming James N. , McGillicuddy John W. , Bratton Charles F. , Thomas Beje , Chavin Kenneth D. , Baliga Prabhakar K. , Egede Leonard E.
Published: September 2013

Background/Aims: There are no published studies assessing the safety and efficacy of thiazides as antihypertensives in kidney transplantation (KTX). Methods: This was a longitudinal retrospective cohort study conducted in adult KTX recipients. Patients were grouped based on receiving thiazides following KTX. Safety and efficacy comparisons were made between thiazide recipients and unexposed patients, as well as change in blood pressure (BP) within thiazide patients. Results: 1,093 patients were included (thiazide group: 108, unexposed group: 985). Mean follow-up was 7.3 ± 4.5 years. Thiazide recipients were older (53 ± 11 vs. 48 ± 13 years, p < 0.001) and more likely to be female (52 vs. 41%, p = 0.023) and have pre-KTX hypertension (97 vs. 88%, p = 0.004) or diabetes (36 vs. 27%, p = 0.035). After controlling for baseline differences, safety analysis revealed thiazide recipients were not more likely to be readmitted to the hospital, but were at higher risk to develop hyperkalemia (56 vs. 38%, p < 0.001) or hypokalemia (28 vs. 18%, p = 0.010), with similar rates of hypotension, decreased estimated glomerular filtration rate, graft loss and death. Efficacy analysis demonstrated systolic (147 ± 17 to 139 ± 18 mm Hg, p < 0.001) and diastolic (79 ± 9 to 77 ± 11 mm Hg, p < 0.001) BPs were significantly reduced after thiazide initiation. Compared to unexposed patients, thiazide recipients had higher mean BPs during the entire follow-up (142/78 vs. 136/77, p < 0.001), with similar BPs while on thiazides and comparable rates of goal BPs (<130/80 mm Hg, 32 vs. 36%, p = 0.219). Conclusions: In KTX, based on long-term outcomes, thiazides appear to be safe and effective antihypertensives; in the short-term, thiazides may increase the risk of developing potassium disturbances.
Malignant Transformation from Endometriosis to Atypical Endometriosis and Finally to Endometrioid Adenocarcinoma within 10 Years
Authors: Tanase Yasuhito , Furukawa Naoto , Kobayashi Hiroshi , Matsumoto Takashi
Published: September 2013

Atypical endometriosis is reported to possess a precancerous potential attributed to premalignant changes characterized by cytological atypia and architecture proliferation. Moreover, the coexistence of atypical endometriosis and neoplasms had been reported. However, cases of atypical endometriosis transformation to carcinoma are rarely reported. We describe the case of a 33-year-old woman who had a long therapeutic history of endometriosis. Three laparoscopic surgeries were performed to treat endometriosis. After the third surgery, she was diagnosed as having grade 1 endometrioid adenocarcinoma. The histological review of the previous surgery confirmed the diagnosis of atypical endometriosis based on the second specimen. The patient's disease progressed from a benign endometriotic cyst to atypical endometriosis and finally to endometrioid adenocarcinoma within 10 years. When we encounter cases of atypical endometriosis, it is necessary to consider the possibility of ovarian cancer and carefully follow the patients for long periods.
Pattern Dystrophy of the Macula in a Case of Steinert Disease
Authors: Esteves Filipe , Dolz-Marco Rosa , Hernández-Martínez Pablo , Díaz-Llopis Manuel , Gallego-Pinazo Roberto
Published: September 2013

Introduction: Myotonic dystrophies are typically associated with ocular complications like ptosis, weakness of the ocular muscle and cataracts, but also with less recognized retinal changes. Case Report: A 41-year-old female with type 1 myotonic dystrophy complained of progressive vision loss. Slit lamp examination revealed the presence of typical bilateral polychromatic cataract with posterior subcapsular component. Dilated fundus examination was remarkable for bilateral macular depigmented changes. Multimodal imaging analysis of the macula suggested the presence of a butterfly-shaped pattern dystrophy. Discussion: In cases of myotonic dystrophies it is of great relevance to analyze the presence of retinal changes that might limit the visual improvement following cataract extraction.
Cyclophilin D Modulates Mitochondrial Acetylome
Authors: Nguyen Tiffany Tuyen M. , Wong Renee , Menazza Sara , Sun Junhui , Chen Yong , Wang Guanghui , Gucek Marjan , Steenbergen Charles , Sack Michael N. , Murphy Elizabeth
Published: September 2013

Rationale:

Mice lacking cyclophilin D (CypD
−/−
), a mitochondrial chaperone protein, have altered cardiac metabolism. As acetylation has been shown to regulate metabolism, we tested whether changes in protein acetylation might play a role in these metabolic changes in CypD
−/−
hearts.

Objective:

Our aim was to test the hypothesis that loss of CypD alters the cardiac mitochondrial acetylome.

Methods and Results:

To identify changes in lysine-acetylated proteins and to map acetylation sites after ablation of CypD, we subjected tryptic digests of isolated cardiac mitochondria from wild-type and CypD
−/−
mice to immunoprecipitation using agarose beads coupled to antiacetyl lysine antibodies followed by mass spectrometry. We used label-free analysis for the relative quantification of the 875 common peptides that were acetylated in wild-type and CypD
−/−
samples and found 11 peptides (10 proteins) decreased and 96 peptides (48 proteins) increased in CypD
−/−
samples. We found increased acetylation of proteins in fatty acid oxidation and branched-chain amino acid metabolism. To evaluate whether this increase in acetylation might play a role in the inhibition of fatty acid oxidation that was previously reported in CypD
−/−
hearts, we measured the activity of
l
-3-hydroxyacyl-CoA dehydrogenase, which was acetylated in the CypD
−/−
hearts. Consistent with the hypothesis,
l
-3-hydroxyacyl-CoA dehydrogenase activity was inhibited by ≈50% compared with the wild-type mitochondria.

Conclusions:

These results implicate a role for CypD in modulating protein acetylation. Taken together, these results suggest that ablation of CypD leads to changes in the mitochondrial acetylome, which may contribute to altered mitochondrial metabolism in CypD
−/−
mice.
Validation of Contrast-Enhanced Magnetic Resonance Imaging to Monitor Regenerative Efficacy After Cell Therapy in a Porcine Model of Convalescent Myocardial Infarction
Authors: Malliaras Konstantinos , Smith Rachel R. , Kanazawa Hideaki , Yee Kristine , Seinfeld Jeffrey , Tseliou Eleni , Dawkins James F. , Kreke Michelle , Cheng Ke , Luthringer Daniel , Ho Chak-Sum , Blusztajn Agnieszka , Valle Ileana , Chowdhury Supurna , Makkar Raj R. , Dharmakumar Rohan , Li Debiao , Marbán Linda , Marbán Eduardo
Published: September 2013

Background—

Magnetic resonance imaging (MRI) in the CArdiosphere-Derived aUtologous stem CElls to reverse ventricUlar dySfunction (CADUCEUS) trial revealed that cardiosphere-derived cells (CDCs) decrease scar size and increase viable myocardium after myocardial infarction (MI), but MRI has not been validated as an index of regeneration after cell therapy. We tested the validity of contrast-enhanced MRI in quantifying scarred and viable myocardium after cell therapy in a porcine model of convalescent MI.

Methods and Results—

Yucatan minipigs underwent induction of MI and 2–3 weeks later were randomized to receive intracoronary infusion of 12.5×10
6
mismatched allogeneic CDCs or vehicle. Allogeneic CDCs induced mild local mononuclear infiltration but no systemic immunogenicity. MRI revealed that allogeneic CDCs attenuated remodeling, improved global and regional function, decreased scar size, and increased viable myocardium compared with placebo 2 months post-treatment. Extensive histological analysis validated quantitatively the MRI measurements of scar size, scar mass, and viable mass. CDCs neither altered gadolinium contrast myocardial kinetics nor induced changes in vascular density or architecture in viable and scarred myocardium. Histology demonstrated that CDCs lead to cardiomyocyte hyperplasia in the border zone, consistent with the observed stimulation of endogenous regenerative mechanisms (cardiomyocyte cycling, upregulation of endogenous progenitors, angiogenesis).

Conclusions—

Contrast-enhanced MRI accurately measures scarred and viable myocardium after cell therapy in a porcine model of convalescent MI. MRI represents a useful tool for assessing dynamic changes in the infarct and monitoring regenerative efficacy.
In-Hospital Complications Associated With Catheter Ablation of Atrial Fibrillation in the United States Between 2000 and 2010
Authors: Deshmukh Abhishek , Patel Nileshkumar J. , Pant Sadip , Shah Neeraj , Chothani Ankit , Mehta Kathan , Grover Peeyush , Singh Vikas , Vallurupalli Srikanth , Savani Ghanshyambhai T. , Badheka Apurva , Tuliani Tushar , Dabhadkar Kaustubh , Dibu George , Reddy Y. Madhu , Sewani Asif , Kowalski Marcin , Mitrani Raul , Paydak Hakan , Viles-Gonzalez Juan F.
Published: September 2013

Background—

Atrial fibrillation ablation has made tremendous progress with respect to innovation, efficacy, and safety. However, limited data exist regarding the burden and trends in adverse outcomes arising from this procedure. The aim of our study was to examine the frequency of adverse events attributable to atrial fibrillation (AF) ablation and the influence of operator and hospital volume on outcomes.

Methods and Results—

With the use of the Nationwide Inpatient Sample, we identified AF patients treated with catheter ablation. We investigated common complications including cardiac perforation and tamponade, pneumothorax, stroke, transient ischemic attack, vascular access complications (hemorrhage/hematoma, vascular complications requiring surgical repair, and accidental arterial puncture), and in-hospital death described with AF ablation, and we defined these complications by using validated
International Classification of Diseases, Ninth Revision, Clinical Modification
diagnosis codes. An estimated 93 801 AF ablations were performed from 2000 to 2010. The overall frequency of complications was 6.29% with combined cardiac complications (2.54%) being the most frequent. Cardiac complications were followed by vascular complications (1.53%), respiratory complications (1.3%), and neurological complications (1.02%). The in-hospital mortality was 0.46%. Annual operator (<25 procedures) and hospital volume (<50 procedures) were significantly associated with adverse outcomes. There was a small (nonsignificant) rise in overall complication rates.

Conclusions—

The overall complication rate was 6.29% in patients undergoing AF ablation. There was a significant association between operator and hospital volume and adverse outcomes. This suggests a need for future research into identifying the safety measures in AF ablations and instituting appropriate interventions to improve overall AF ablation outcomes.
Arterial Stiffening Precedes Systolic Hypertension in Diet-Induced Obesity
Authors: Weisbrod Robert M. , Shiang Tina , Al Sayah Leona , Fry Jessica L. , Bajpai Saumendra , Reinhart-King Cynthia A. , Lob Heinrich E. , Santhanam Lakshmi , Mitchell Gary , Cohen Richard A. , Seta Francesca
Published: September 2013

Stiffening of conduit arteries is a risk factor for cardiovascular morbidity. Aortic wall stiffening increases pulsatile hemodynamic forces that are detrimental to the microcirculation in highly perfused organs, such as the heart, brain, and kidney. Arterial stiffness is associated with hypertension but presumed to be due to an adaptive response to increased hemodynamic load. In contrast, a recent clinical study found that stiffness precedes and may contribute to the development of hypertension although the mechanisms underlying hypertension are unknown. Here, we report that in a diet-induced model of obesity, arterial stiffness, measured in vivo, develops within 1 month of the initiation of the diet and precedes the development of hypertension by 5 months. Diet-induced obese mice recapitulate the metabolic syndrome and are characterized by inflammation in visceral fat and aorta. Normalization of the metabolic state by weight loss resulted in return of arterial stiffness and blood pressure to normal. Our findings support the hypothesis that arterial stiffness is a cause rather than a consequence of hypertension.