bluuebunny/crossref_metadata_2025 huggingface dataset:
Embolization with Onyx in Iatrogenic Bleeding of the Gluteal Region
Authors: Hörer Tal , Toivola Asko , Larzon Thomas
Published: October 2011

We report a unique method using transcatheter Onyx embolization in a bleeding due to morphine injection in the gluteal region. A 47-year-old man with a rare blood type presented a painful gluteal hematoma due to iatrogenic injury. A computed tomographic angiography verified bleeding from a suspected branch of the deep femoral artery. Because of the unbearable pain, the hematoma was evacuated by means of computed tomography (CT)-guided puncture and the insertion of a pigtail catheter combined with the injection of a human plasminogen activation agent (t-PA). The initial result was positive. To stop the bleeding, angiographic embolization with Onyx was successfully used. Onyx can be used in small vessel bleedings and might offer the advantage of selective embolization in cases where the access to the bleeding vessel is challenging or time-consuming.
An Audit of Pain Control Pathways following Video-Assisted Thoracoscopic Surgery
Authors: Khoshbin Espeed , Al-Jilaihawi Ali N. , Scott Nicholas B. , Prakash Dhruva , Kirk Alan J. B.
Published: October 2011

Objective

To compare different modes of pain management following video-assisted thoracoscopic surgery (VATS) to our national standard.

Methods

This is an audit based on patient's experiences. One hundred consecutive patients who underwent VATS with or without pleurodesis were managed by one of the following pain relief pathways: (A) thoracic paravertebral block + morphine patient-controlled analgesia (PCA), (B) percutaneous thoracic paravertebral catheter +/– morphine PCA, (C) thoracic epidural +/– morphine PCA, (D) morphine PCA alone, and (E) intravenous or subcutaneous morphine as required. Pain score was documented up to four times per day for each patient. The incidence of severe pain was defined as visual analog scale ≥7. The results were compared with the standard set by the audit commission for postoperative pain relief in the UK. The mean daily pain scores were calculated retrospectively for all patients.

Results

There were no statistically significant differences in mean daily pain scores irrespective of having a pleurodesis. The percentage of patients experiencing severe pain was 34% [mean visual analog scale = 8 (standard deviation = 1.0)]. This was almost seven times the standard. Among these pathways, B had the least percentage incidence of severe pain (16.7%) followed by A (25.0%) D (33.3%), C (35.7%), and E (52.4%).

Conclusions

We are not compliant with the standards set by the audit commission. Pain management in theater recovery needs to be targeted. In the light of these results, we recommend the use of percutaneous thoracic paravertebral catheter +/– morphine PCA for postoperative VATS pain relief.
Use of Navigation Bronchoscopy for Biopsy and Endobronchial Fiducial Placement
Authors: Linden Philip A.
Published: October 2011

Electromagnetic navigation bronchoscopy (ENB) is a technique that can be used to biopsy pulmonary lesions beyond areas that are traditionally accessible by bronchoscopy. It can also guide biopsies of peribronchial lymph nodes and guide the placement of fiducial markers for stereotactic radiosurgery. With ENB, the patient is placed in a magnetic field and their anatomy is merged with a 3D reconstructed chest cat scan (CCT). A locatable, steerable probe is used to guide a working channel to the target, usually a peripheral tumor. Biopsies can be taken, and markers can be placed. The accuracy of this system depends largely on a small bronchus leading toward to target. The diagnostic yield is similar to CT-guided biopsies, with a false-negative rate of about 30%, although results may be improved with combined ENB and radial endoscopic ultrasound (EUS). The incidence of pneumothorax is 5% to 8% with ENB-directed biopsies compared with approximately 30% with CT-guided transthoracic biopsy.
Mediastinal Parathyroidectomy with the da Vinci Robot
Authors: Van Dessel Els , Hendriks Jeroen M. H. , Lauwers Patrick , Ysebaert Dirk , Ruyssers Natacha , Van Schil Paul E. Y.
Published: October 2011

Mediastinal parathyroid glands are often located in a position which is inaccessible through a cervical approach. Because of the significant morbidity of open surgery, the need for minimal invasive approaches is high. More recently, robotic systems have been introduced to refine the dissection and optimize the view in the mediastinal region. We present two cases. The first case is a 34-year-old woman who was diagnosed with primary hyperparathyroidism. Because a bilateral neck dissection disclosed no parathyroid adenoma, we performed a parathyroid sestamibi scan and computed tomographic scan of neck and mediastinum to look for aberrant parathyroid glands. Both showed a parathyroid adenoma in the mediastinum on the left side. The second case is a 66-year-old man. A sestamibi scan showed a parathyroid adenoma of 3 cm in the superior mediastinum which was confirmed by and computed tomographic scan. In both cases, we performed a parathyroidectomy with the da Vinci robotic system through a left-sided approach. Three thoracoports were inserted around the mammary gland for the robot and a fourth auxiliary port was positioned in between. Single-lung ventilation was installed, and the mediastinum was entered by opening the parietal pleura along the left phrenic nerve. The upper margin for dissection was the left brachiocephalic vein that was followed until the right pleura. All the tissue in front of the pericardium was dissected en bloc. The sinking test of the nodule and a preoperative frozen section analysis confirmed the diagnosis of parathyroid adenoma, which was also proven by rapid parathyroid hormone analysis. The resection of a parathyroid adenoma from the aortopulmonary window represents an ideal case for robotic surgery.
Edwards EndoVent as a Pacing Catheter for Minimally Invasive Aortic Valve Surgery a Novel Approach
Authors: Kraidin Jonathan L. , Pantin Enrique J. , Anderson Mark B. , Zhou Bo-Lu , Solina Alann R.
Published: October 2011

Objective

The placement of epicardial pacing wires before weaning from bypass during port-access heart surgery can be difficult or impossible. Sometimes, it is necessary to pacing the patient to wean from bypass, and it is problematic to exchange the Edwards pulmonary vent (EndoVent) for a pace catheter under the drapes. Our objective was to devise an effective means of pacing the patient using the pulmonary vent catheter.

Methods

All patients having aortic valve minimally invasive port-access surgery have a pacing wire deployed through the Edwards EndoVent catheter. We did a retrospective chart analysis of these cases.

Results

After reviewing the anesthesia records, we determined that we were able to reliably convert the pulmonary vent catheter, which is beneficial for the surgery, into a pacing catheter before weaning from bypass 100% of the time. The mean pacing threshold current was 1.60 mA with the wire in the right ventricular apex.

Conclusions

We found that in all 25 patients we were able to rapidly convert the vent catheter into a reliable pacing catheter without any complications.
Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease
Authors: Botero‐López Jorge E. , Araya Magdalena , Parada Alejandra , Méndez Marco A. , Pizarro Fernando , Espinosa Nelly , Canales Paulina , Alarcón Teresa
Published: October 2011

Objective:

The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD).

Patients and Methods:

A cross‐sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti‐endomysial antibodies, and anti‐tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal‐Wallis, principal component analysis, and linear discriminant analysis.

Results:

One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age ± standard deviation was 23 ± 15.8 (range 1.6–75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1–17.6) in TCD, 12.4 g/dL (10.5–14.5) in ACD, and 13.6 g/dL (11.1–16.7) in HC (P < 0.0001); serum ferritin was 17.7 μg/L (2.9–157), 10.8 μg/L (2.7–39.8), and 28.7 μg/L (4.5–127.2), respectively (P < 0.01). Cu was 105 μg/dL (60–185), 97.5 μg/dL (40–130), and 125 μg/dL (80–205), respectively (P < 0.05). Ceruloplasmin was 21.6 mg/dL (14.2–73.2), 22.6 mg/dL (0.9–34.3), and 32.1 mg/dL (5.8–72.6), respectively (P < 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P < 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%).

Conclusions:

Deficiency of micronutrients was found both in typical as well as in atypical cases.
Quality of Life and Level of Anxiety in Youths With Inflammatory Bowel Disease in Ireland
Authors: Kilroy Sarah , Nolan Elizabeth , Sarma Kiran M.
Published: October 2011

Objective:

Little is known of the psychological well‐being of youths diagnosed as having inflammatory bowel diseases (IBDs). Much of the literature available focuses on adults with IBD and those that focus on youths tend to use generic measures of health‐related quality of life (QOL). The primary aim of this research is to obtain a profile of the IBD‐related QOL and levels of anxiety of youths of ages 9 to 17 years presenting with IBD to a national hospital. It is also intended to examine the clinical utility of the IMPACT‐III questionnaire.

Patients and Methods:

A questionnaire battery containing the IMPACT‐III questionnaire and the Spence Children's Anxiety Scale (SCAS) was posted to all of the patients on the database of the gastrointestinal clinic between the ages of 9 and 17 years (n = 215), resulting in an achieved sample size of 79 (response rate of 36.7%).

Results:

It was found that 63% (n = 50) of participants had total IMPACT‐III scores below the cutoff of 143, previously established for remission. In addition, 5 participants reported being unhappy with their lives. Thirty‐nine percent (n = 31) of participants had elevated anxiety symptoms on ≥1 of the SCAS subscales. Anxiety level was found to be a significant predictor of QOL (β = −0.616, P = 0.001). Qualitative feedback highlighted the variability of physical and psychological symptoms participants experience, feelings of anger or embarrassment around the condition, and posed numerous questions, indicating that there is a lack of knowledge among patients around IBD.

Conclusions:

These findings support the utility of screening patients with IBD for psychological difficulties and estimates of QOL. Further research and group interventions are recommended.
Validation of an Instrument to Measure Quality of Life in British Children With Inflammatory Bowel Disease
Authors: Ogden C.A. , Akobeng A.K. , Abbott J. , Aggett P. , Sood M.R. , Thomas A.G.
Published: October 2011

Objective:

To validate IMPACT‐III (UK), a health‐related quality of life (HRQoL) instrument, in British children with inflammatory bowel disease (IBD).

Patients and Methods:

One hundred six children and parents were invited to participate. IMPACT‐III (UK) was validated by inspection by health professionals and children to assess face and content validity, factor analysis to determine optimum domain structure, use of Cronbach alpha coefficients to test internal reliability, ANOVA to assess discriminant validity, correlation with the Child Health Questionnaire to assess concurrent validity, and use of intraclass correlation coefficients to assess test‐retest reliability. The independent samples t test was used to measure differences between sexes and age groups, and between paper and computerised versions of IMPACT‐III (UK).

Results:

IMPACT‐III (UK) had good face and content validity. The most robust factor solution was a 5‐domain structure: body image, embarrassment, energy, IBD symptoms, and worries/concerns about IBD, all of which demonstrated good internal reliability (α = 0.74–0.88). Discriminant validity was demonstrated by significant (*P < 0.05, **P < 0.01) differences in HRQoL scores between the severe, moderate, and inactive/mild symptom severity groups for the embarrassment scale (63.7* vs 81.0 vs 81.2), IBD symptom scale (45.0** vs 64.2* vs 80.6), and the energy scale (46.4* vs 62.1* vs 77.7). Concurrent validity of IMPACT‐III (UK) with comparable domains of the Child Health Questionnaire was confirmed. Test‐retest reliability was confirmed with good intraclass correlation coefficients of 0.66 to 0.84. Paper and computer versions of IMPACT‐III (UK) collected comparable scores, and there were no differences between the sexes and age groups.

Conclusions:

IMPACT‐III (UK) appears to be a useful tool to measure HRQoL in British children with IBD.
Late Adolescent Linear Growth Pattern in Pediatric‐onset Inflammatory Bowel Disease
Authors: Hood Helen C. , Cohen Laurie E. , Lee Jessica J.
Published: October 2011

The late adolescent linear growth pattern of pediatric patients with inflammatory bowel disease (IBD) has rarely been studied. We retrospectively reviewed the height measurements of 475 patients with IBD at 16, 18, and 20 years old for girls, and 18 and 20 years old for boys. We also compared Bayley‐Pinneau bone age–predicted and –measured adult heights. Female patients had mean height‐for‐age z scores of −0.25 ± 1.0 at 16 years and −0.23 ± 1.0 at 18 years (P = 0.189); boys had z scores of −0.30 ± 1.1 at 18 years and −0.26 ± 1.0 at 20 years, respectively (P = 0.105). Bayley‐Pinneau height predictions were 1.5 and 2.4 cm greater than measured height for 18‐year‐old girls (P = 0.060) and 20‐year‐old boys (P = 0.017), respectively. Our data indicate that most patients with IBD attain adult height within normal timing for the population. Hence, early identification of growth impairment is critical to appropriate management in IBD.
Impaired Mucosal Barrier Function in the Small Intestine of the Cystic Fibrosis Mouse
Authors: De Lisle Robert C. , Mueller Racquel , Boyd Megan
Published: October 2011

Objectives:

The intestinal mucosal barrier protects the body from the large numbers of microbes that inhabit the intestines and the molecules they release. Intestinal barrier function is impaired in humans with cystic fibrosis (CF), including reduced activity of the lipopolysaccharide‐detoxifying enzyme intestinal alkaline phosphatase (IAP) and increased permeability. The objective of this study was to determine the suitability of using the CF mouse to investigate intestinal barrier function, and whether interventions that are beneficial for the CF mouse intestinal phenotype (antibiotics or laxative), would improve barrier function. Also tested were the effects of exogenous IAP administration.

Materials and Methods:

The Cftrtm1UNC mouse was used. IAP expression (encoded by the murine Akp3 gene) was measured by quantitative reverse transcription‐polymerase chain reaction and enzyme activity. Intestinal permeability was assessed by measuring rhodamine‐dextran plasma levels following gavage.

Results:

CF mice had 40% Akp3 mRNA expression and 30% IAP enzyme activity, as compared with wild‐type mice. Oral antibiotics and laxative treatments normalized Akp3 expression and IAP enzyme activity in the CF intestine. CF mice had a 5‐fold greater transfer of rhodamine‐dextran from gut lumen to blood. Antibiotic and laxative treatments reduced intestinal permeability in CF mice. Administration of exogenous purified IAP to CF mice reduced intestinal permeability to wild‐type levels and reduced small intestinal bacterial overgrowth by >80%.

Conclusions:

The CF mouse intestine has impaired mucosal barrier function, similar to human CF. Interventions that improve other aspects of the CF intestinal phenotype (antibiotics and laxative) also increase IAP activity and decrease intestinal permeability in CF mice. Exogenous IAP improve permeability and strongly reduce bacterial overgrowth in CF mice, suggesting this may be a useful therapy for CF.
Intestinal Rehabilitation and Bowel Reconstructive Surgery
Authors: Khalil Basem A. , Ba'ath Muhammad E. , Aziz Anuar , Forsythe Lynette , Gozzini Sara , Murphy Fiona , Carlson Gordon , Bianchi Adrian , Morabito Antonino
Published: October 2011

Background and Aim:

Short bowel syndrome poses a great challenge to pediatric teams. Several innovative techniques in the management of total parenteral nutrition (TPN) and bowel reconstructive surgery have improved the outcomes of these children. The authors present their experience during the last decade as a specialist unit using improved techniques and multidisciplinary approaches in the management of this condition.

Methods:

All of the children presenting with short bowel syndrome between 2000 and 2009 were identified. Diagnosis, length of residual gut, age at definitive surgery, length of gut prelengthening, length of gut postlengthening, TPN status, and survival were recorded. Median values were calculated.

Results:

Twenty‐seven children were identified (14 boys, 13 girls). Overall survival was 92%. Two children died. Nineteen children required bowel lengthening and 8 children had simple bowel reconstruction while on our protocol. Overall median age at definitive surgery was 12 months. Overall median residual gut length for these was 35.5 cm, whereas the median residual gut length for patients undergoing bowel lengthening was 25 cm. Postbowel lengthening, the median gut length was 90 cm. TPN data were unavailable for 2 patients. Overall, excluding the 2 patients who died and the 2 we have no TPN data on, of 23 patients, 21 (91%) are now off TPN.

Conclusions:

Our series shows improved results not only with survival but also in the number of patients that are off TPN. Multidisciplinary approach consisting of both medical and surgical expertise is necessary in the management of these patients. The authors advocate centralisation of short gut services to experienced centers with multidisciplinary expertise.
Benefits of a New Pediatric Triple‐Chamber Bag for Parenteral Nutrition in Preterm Infants
Authors: Rigo Jacques , Marlowe Monica L. , Bonnot Denis , Senterre Thibault , Lapillonne Alexandre , Kermorvant‐Duchemin Elsa , Hascoet Jean Michel , Desandes Roxane , Malfilâtre Geneviève , Pladys Patrick , Beuchée Alain , Colomb Virginie
Published: October 2011

Objectives:

The aim of this study was to evaluate the efficacy, safety, flexibility, and ease of handling and use of the Ped3CB‐A 300 mL, the first ready‐to‐use multichamber parenteral nutrition (PN) system, with optional lipid bag activation, specially designed for administration to preterm infants.

Materials and Methods:

In this prospective, open‐label, multicenter, noncomparative, phase III clinical trial, preterm infants were treated with Ped3CB‐A for 5 to 10 consecutive days.

Results:

A total of 113 preterm infants were enrolled in the study and 97 (birth weight 1382 ± 520 g; gestational age 31.2 ± 2.5 weeks; postnatal age administration 5.6 ± 6.1 days) were included in the per protocol analysis accounting for 854 perfusion days. Double‐chamber bag activation was used for 32 perfusion days. Macronutrient, electrolyte, and mineral supplements were primarily administered through a Y‐line or directly in the activated bag. In all, 199 additions (mainly sodium, 95%) were made to the Ped3CB‐A bags on 197 infusion days (23.1%) in 43 infants (44.3%). More than 1 of these nutrients was added to the bag on only 1 perfusion day. Mean and maximum parenteral nutrient intakes were 2.8 ± 0.7 and 3.6 ± 0.8 g amino acids per kilogram per day, and 80 ± 20 and 104 ± 22 kcal · kg−1 · day−1. Mean weight gain represented 10.0, 21.5, and 22.6 g · kg−1 · day−1 according to age at inclusion (0–3, 4–7, or >7 days of life). A visual analog scale was completed and produced positive results. No adverse events were attributable to the design of the Ped3CB‐A system.

Conclusions:

Ped3CB‐A provides easy‐to‐use, well‐balanced, and safe nutritional support. Nutritional intakes and weight gain were within the recent PN recommendations in preterm infants.
Heme Oxygenase‐1 Is Protective Against Nonsteroidal Anti‐inflammatory Drug–induced Gastric Ulcers
Authors: Uc Aliye , Zhu Xiaoyan , Wagner Brett A. , Buettner Garry R. , Berg Daniel J.
Published: October 2011

Objectives:

Nonsteroidal anti‐inflammatory drugs (NSAIDs) are widely used for the treatment of pain, fever, and inflammation. Long‐term use of these drugs is associated with significant gastric injury. Activated neutrophils and oxidative stress seem to play a significant role in NSAID‐induced gastric mucosal damage. The objective of our study is to examine the protective effects of an antioxidant and anti‐inflammatory enzyme, heme oxygenase‐1 (HO‐1), in NSAID‐induced gastric injury.

Methods:

Mice were intraperitoneally injected with indomethacin (10 mg/kg) or sham. A specific inducer of HO‐1, cobalt protoporphyrin (5 mg/kg), was given 24 hours before indomethacin to allow for the expression of HO‐1. Controls received sham treatment. Twenty‐four hours after indomethacin injection, gastric tissue damage was examined with histology. HO‐1 expression was measured with immunoblot; cytokine levels were measured with enzyme‐linked immunosorbent assay. Neutrophil infiltration was quantified with myeloperoxidase assay. Using electron paramagnetic resonance and desferrioxamine, we measured the labile iron pool in the mouse stomach as a marker of oxidative stress.

Results:

Indomethacin caused gastric inflammation and ulcers, neutrophil activation, and increased tissue expression of interleukin‐6 and tumor necrosis factor‐alpha in mice. Inducing HO‐1 with cobalt protoporphyrin reduced gastric inflammation, number of stomach ulcers, tissue neutrophil activation, and proinflammatory cytokine expression caused by indomethacin.

Conclusions:

These findings suggest that the induction of an anti‐inflammatory and cytoprotective enzyme HO‐1 may be a strategy to overcome the gastrointestinal adverse effects limiting the use of NSAIDs.
Pediatric End‐stage Liver Disease Score in Acute Liver Failure to Assess Poor Prognosis
Authors: Sanchez Maria C. , D'Agostino Daniel E.
Published: October 2011

Background and Aim:

Although establishing accurate prognosis in acute liver failure (ALF) is of paramount importance, prognostic scoring systems still fail to achieve success. The pediatric end‐stage liver disease (PELD) score has been used as a predictor of mortality in children with chronic liver disease listed for liver transplantation (LT); however, experience with the PELD score in ALF is limited. The goal of the present study was to investigate the prognostic accuracy of the PELD score in children with ALF.

Patients and Methods:

PELD score was calculated based on results of blood tests obtained at hospital admission from June 1999 to January 2009, in 40 consecutive patients younger than 18 years who presented with ALF. Poor outcome was defined as LT or death.

Results:

Mean (±SD) age of patients was 5.3 ± 4.4 years (range 6 months–17 years); 52.5% were girls (n = 21). Etiologies of ALF were hepatitis A in 42.5% (17), indeterminate in 35% (14), autoimmune hepatitis in 17.5% (type 1 12.5% [n5], type 2 5% [n2]), and toxic in 5% (2). Mean PELD score was 34.92 ± 10.48 (range 6–55). PELD scores obtained on admission were significantly higher among nonsurvivors (39.8 ± 9.5) and recipients of an LT (39 ± 7.1) compared with those who survived without LT (31.3 ± 3) (P < 0.001). A cutoff of 33 in PELD score using receiver operating characteristic curves showed 81% specificity and 86% sensitivity for poor outcome (positive predictive value 92% and negative predictive value 69%; area under curve 0.88 95% confidence interval 0.77–1.0; P < 0.0001).

Conclusions:

PELD score obtained upon admission may be of help to establish the optimal timing for LT evaluation and listing. Further validation in larger and more diverse populations is needed.
Heating‐induced Bacteriological and Biochemical Modifications in Human Donor Milk After Holder Pasteurisation
Authors: de Segura Aránzazu Gómez , Escuder Diana , Montilla Antonia , Bustos Gerardo , Pallás Carmen , Fernández Leonides , Corzo Nieves , Rodríguez Juan M.
Published: October 2011

Objectives:

The objectives of the present study were to enumerate and characterize the pathogenic potential of the Bacillus population that may survive holder pasteurisation of human milk and to evaluate the nutritional damage of this treatment using the furosine and lactulose indexes.

Materials and Methods:

Milk samples from 21 donors were heated at 62.5°C for 30 minutes. Bacterial counts, lactose, glucose, myoinositol, lactulose, and furosine were determined before and after the heat treatment. Some B cereus isolates that survived after pasteurisation were evaluated for toxigenic potential.

Results:

Nonpasteurised milk samples showed bacterial growth in most of the agar media tested. Bacterial survival after pasteurisation was observed in only 3 samples and, in these cases, the microorganisms isolated belonged to the species B cereus. Furosine could not be detected in any of the samples, whereas changes in lactose, glucose, and myoinositol concentrations after holder pasteurisation were not relevant. Lactulose was below the detection limit of the analytical method in nonpasteurised samples, whereas it was found at low levels in 62% of the samples after holder pasteurisation. The lactation period influenced myoinositol content because its concentration was significantly higher in transition milk than in mature or late lactation milk samples.

Conclusions:

Holder pasteurisation led to the destruction of bacteria present initially in donor milk samples, except for some B cereus that did not display a high virulence potential and did not modify significantly the concentration of the compounds analyzed in the present study.
Context fear learning specifically activates distinct populations of neurons in amygdala and hypothalamus
Authors: Trogrlic Lidia , Wilson Yvette M. , Newman Andrew G. , Murphy Mark
Published: October 2011

The identity and distribution of neurons that are involved in any learning or memory event is not known. In previous studies, we identified a discrete population of neurons in the lateral amygdala that show learning-specific activation of a c-fos-regulated transgene following context fear conditioning. Here, we have extended these studies to look throughout the amygdala for learning-specific activation. We identified two further neuronal populations, in the amygdalo–striatal transition area and medial amygdala, that show learning-specific activation. We also identified a population of hypothalamic neurons that show strong learning-specific activation. In addition, we asked whether these neurons are activated following recall of fear-conditioning memory. None of the populations of neurons we identified showed significant memory-recall–related activation. These findings suggest that a series of discrete populations of neurons are involved in fear learning in amygdala and hypothalamus. The lack of reactivation during memory recall suggests that these neurons either do not undergo substantial change following recall, or that c-fosis not involved in any such activation and change.
Annually recurring parthenogenesis in a zebra shark Stegostoma fasciatum
Authors: Robinson D. P. , Baverstock W. , Al‐Jaru A. , Hyland K. , Khazanehdari K. A.
Published: October 2011

A zebra shark, Stegostoma fasciatum, held in captivity at the Burj Al Arab aquarium, produced embryos and pups in the absence of a male. A total of 15 pups were produced from eggs laid within the aquarium over a period of four consecutive years commencing 2007. Parthenogenesis was confirmed through DNA analysis for three pups sampled during the first two consecutive egg cycles and is presumed to be the method of reproduction responsible thereafter.
Safety and performance of TCI pumps in a magnetic resonance imaging environment*
Authors: Adapa R. M. , Axell R. G. , Mangat J. S. , Carpenter T. A. , Absalom A. R.
Published: October 2011

Target controlled infusion (TCI) devices can be associated with significant safety concerns when used during magnetic resonance imaging (MRI). We tested the safety and compatibility of newer TCI systems in a 3‐Tesla MRI environment. Two Asena PK and two Agilia TCI pumps were used to administer TCI propofol (at target blood concentrations of 0.5 and 6.0 μg.ml−1) using the Marsh model under magnetic fields of up to 50 G with a T2‐weighted sequence. We assessed the devices for projectile risk, accuracy of drug delivery, alarm function and effects on MR image quality. Both devices did not demonstrate any significant deflection at the tested field strengths, and performed within acceptable limits (cumulative error in total delivered volume < 3%; maximum 10‐min interval error < 10%). The Asena pump caused minor artefacts on MR images. The TCI pumps tested perform well and safely implement pharmacokinetic software in a high magnetic field.
Evidence for assembly rules: limiting similarity within a saltmarsh
Authors: Wilson J. Bastow , Stubbs Wendy J.
Published: October 2011

1. We sought evidence for limiting similarity, a basic aspect of community structure, in three zones of a saltmarsh. Sampling was conducted at three spatial scales (grains), from a single point up to the scale of several square metres. Twenty‐three functional traits, related to the structure of the shoot and root systems and to nutrient status, were measured on each species present, separately in each community.

2. Patterns of association between plant species were compared with those expected under a null model, to assess whether plants with similar functional traits tended to coexist or to separate, i.e. whether there was environmental filtering or limiting similarity. A patch null model was used, a type that tends to be conservative but that avoids spurious evidence of limiting similarity caused by environmental pseudoreplication. One overall and four univariate test statistics were calculated, to capture possible patterns in trait space whilst minimising the problem of multiple testing.

3. In the Shrub community, overall evidence for even spacing of co‐occurring species in functional‐trait space, the pattern expected from the theory of limiting similarity, was seen at the area scale. In univariate tests in that community, there was evidence for even spacing in leaf lobation and leaf succulence, especially at small scales.

4. In the Rush community, there was significant evidence for limiting similarity in several traits, especially those related to canopy interactions, but also in some root characteristics. However, clustering in other traits, presumably owing to microenvironmental filtering, reduced overall tests for limiting similarity to ‘marginal significance’ (0.1 > P > 0.05).

5. In the species‐poor and salt‐stressed Salt turf, significant departures from the null model were sporadic and not consistent, although chlorophyll characters and leaf nitrogen concentration tended to be clustered.

6. Synthesis: There was evidence for niche limitation in two of the communities – Rush and Shrub – apparently based on canopy interactions in both cases and perhaps also root interactions in the latter community. Limiting similarity can be an important force in community assembly. However, in situations when it cannot be demonstrated, we do not know whether trait‐based competition is absent or whether its signal is overwhelmed by other processes.
Type 2 diabetes mellitus interacts with obesity and common variations in PLTP to affect plasma phospholipid transfer protein activity
Authors: Dullaart R. P. F. , Vergeer M. , de Vries R. , Kappelle P. J. W. H. , Dallinga‐Thie G. M.
Published: October 2011

Abstract.  Dullaart RPF, Vergeer M, de Vries R, Kappelle PJWH, Dallinga‐Thie GM (University Medical Center Groningen, University of Groningen, Groningen; and Academic Medical Center Amsterdam, Amsterdam; The Netherlands). Type 2 diabetes mellitus interacts with obesity and common variations in PLTP to affect plasma phospholipid transfer protein activity. J Intern Med 2012; 271: 490–498.

Background.  Phospholipid transfer protein (PLTP) is an emerging cardiometabolic risk marker that is important in high‐density lipoprotein (HDL) and triglyceride metabolism. Plasma PLTP activity is elevated in type 2 diabetes mellitus, whereas glucose may regulate PLTP gene transcription in vitro. Of interest, common PLTP variations that predict cardiovascular disease have been identified recently. We investigated whether the diabetic state is able to amplify relationships between obesity and PLTP gene variations with circulating PLTP levels.

Subjects and methods.  Plasma PLTP activity (using a phospholipid vesicles–HDL system), PLTP gene score [number of PLTP activity‐decreasing alleles based on two tagging polymorphisms (rs378114 and rs60‐ 65904)] and waist circumference were determined in two Dutch cohorts comprising 237 patients with type 2 diabetes and 78 control subjects.

Results.  Patients with diabetes were more obese (P < 0.001 for prevalence of increased waist circumference) and had 13% higher plasma PLTP activity (P < 0.001). PLTP gene score was not different in diabetic and control subjects (P = 0.40). PLTP activity was highest in patients with diabetes with an enlarged waist and lowest in control subjects with a normal waist circumference (P < 0.001). Multiple linear regression analysis revealed a positive interaction between diabetes status and waist circumference on PLTP activity (β = 0.200, P = 0.005). Furthermore, diabetes status (β = −0.485, P = 0.046) or HbA1c (β = −0.240, P = 0.035) interacted with PLTP gene score to affect PLTP activity.

Conclusions.  Type 2 diabetes and enlarged waist circumference interact to impact on plasma PLTP activity. Diabetes may also amplify the association between plasma PLTP activity and common PLTP gene variations. Our findings support the hypothesis that diabetes–environment and diabetes–gene interactions govern plasma PLTP activity.
Long‐term monitoring of live cell proliferation in presence of PVP‐Hypericin: a new strategy using ms pulses of LED and the fluorescent dye CFSE
Authors: PENJWEINI ROZHIN , LOEW HANS G. , HAMBLIN MICHAEL R. , KRATKY KARL W.
Published: October 2011

During fluorescent live cell imaging it is critical to keep excitation light dose as low as possible, especially in the presence of photosensitizer drugs, which generate free radicals upon photobleaching. During fluorescent imaging, stress by excitation and free radicals induces serious cell damages that may arrest the cell cycle. This limits the usefulness of the technique for drug discovery, when prolonged live cell imaging is necessary. This paper presents a strategy to provide gentle experimental conditions for dynamic monitoring of the proliferation of human lung epithelial carcinoma cells (A549) in the presence of the photosensitizer Polyvinylpyrrolidone‐Hypericin. The distinctive strategy of this paper is based on the stringent environmental control and optimizing the excitation light dose by (i) using a low‐power pulsed blue light‐emitting diode with short pulse duration of 1.29 ms and (ii) adding a nontoxic fluorescent dye called carboxyfluorescein‐diacetate‐succinimidyl‐ester (CFSE) to improve the fluorescence signals. To demonstrate the usefulness of the strategy, fluorescence signals and proliferation of dual‐marked cells, during 5‐h fluorescence imaging under pulsed excitation, were compared with those kept under continuous excitation and nonmarked reference cells. The results demonstrated 3% cell division and 2% apoptosis due to pulsed excitation compared to no division and 85% apoptosis under the continuous irradiation. Therefore, our strategy allows live cell imaging to be performed over longer time scales than with conventional continuous excitation.
Evaluation of screening methods and fruit composition in relation to anthracnose fruit rot resistance in blueberries
Authors: Miles T. D. , Hancock J. F. , Callow P. , Schilder A. M. C.
Published: October 2011

Anthracnose fruit rot is an important disease of blueberries, and losses are common in humid growing regions. Most commercial cultivars are susceptible and the disease is usually managed with fungicides. However, a few cultivars are considered resistant. The objectives of this study were to: (i) compare different inoculation techniques for anthracnose fruit rot resistance screening, (ii) screen ripe fruit from a range of blueberry cultivars using selected techniques, and (iii) investigate the role of fruit characteristics in anthracnose fruit rot resistance. The following inoculation methods were evaluated on ripe fruit of a susceptible and resistant cultivar using a conidial suspension: spray, droplet, and injection inoculation of whole fruit; and droplet inoculation of the open surface of cut fruit. All whole‐fruit inoculations yielded similar results. Despite the removal of the epidermis, resistance was also expressed in cut fruit but relatively fewer conidia were produced. The cut‐fruit assay required substantially less time and half the amount of fruit to accomplish than whole‐fruit assays. Detached ripe fruit from 24 cultivars in 2008 and 26 cultivars in 2009 were screened for resistance. Results from the cut‐fruit assay correlated best with published resistance ratings. To determine the possible role of fruit characteristics in resistance, fruit pH, titratable acidity, sugar content and firmness were regressed against various fruit rot resistance measures. Fruit rot resistance was positively correlated with sugar content. On defined media, mycelial growth was restricted as sugar concentration increased and pH decreased, suggesting that fruit composition may play a role in the resistance phenotype.
Surfaces with a long history: the Aptian top Shu’aiba Formation unconformity, Sultanate of Oman
Authors: RAMEIL NIELS , IMMENHAUSER ADRIAN , CSOMA ANITA É. , WARRLICH GEORG
Published: October 2011

Discontinuity surfaces in shallow‐marine carbonate successions may represent significant time gaps in the geological record of ancient epeiric‐neritic seas. Understanding the hidden geological information contained in major discontinuities is thus of key significance in palaeo‐environmental analysis, sequence stratigraphy, reconstructions of sea‐level change and basin evolution. In the present paper, the Aptian top Lower Shu’aiba Formation discontinuity in the Sultanate of Oman is taken as a prominent example of a regionally extensive (>100 000 km2) surface with a long (up to 10 Myr) and complex geological history. The top Shu’aiba discontinuity formed on the topographically elevated domain of the Oman platform and represents in essence the Late Aptian time interval. Coeval carbonates in the intrashelf Bab Basin and oceanic rim indicate forced regression and sequence‐wise, gradual down‐stepping. Available regional, sedimentological, sequence‐stratigraphic, petrographic, palaeontological and geochemical evidence from outcrops and cored wells in Oman is summarized, in part complemented by new data, and reviewed in a process‐oriented context. In the field, the discontinuity is expressed as a low relief, stained surface with evidence for a marine hardground stage being dominant. Indistinct features that indicate a transient meteoric precursor stage (isotope shifts, meteoric cements, circumgranular cracks, etc.) are present but their interpretation requires careful and detailed work. This feature is remarkable, as a series of relative sea‐level falls with amplitudes of up to several tens of metres from the Early to Late Aptian boundary to the end of the Aptian are reported from the Middle East and elsewhere. Despite the palaeogeographic position of the study area in the tropical climate zone, evidence of deep‐cutting karst features, characteristic for many long‐term exposure surfaces worldwide is scarce. Acknowledging the fact that the modern world offers no genuine analogues for the Lower Aptian carbonate system in Oman, morphological similarities between actualistic, wave‐eroded coastal terraces and the top Shu’aiba discontinuity are discussed critically. This discussion may imply that, during an exposure time of several million years, the top Shu’aiba discontinuity experienced repeated stages of shallow flooding and emergence, with each transgression removing portions of the underlying rock record. The data shown here exemplify the complexity of hiatal surfaces in epeiric‐neritic carbonates and may serve as a case example for other major discontinuities.
Role of corticotropin‐releasing factor in the median raphe nucleus in yohimbine‐induced reinstatement of alcohol seeking in rats
Authors: Lê A. D. , Funk Douglas , Coen Kathleen , Li Zhaoxia , Shaham Yavin
Published: October 2011

The pharmacological stressor yohimbine increases ongoing alcohol self‐administration and reinstates alcohol seeking in rats. This effect is attenuated by systemic injections of a corticotropin‐releasing factor (CRF) antagonist. The brain sites involved in CRF's role in yohimbine‐induced alcohol taking and seeking are unknown. We report that injections of the CRF receptor antagonist d‐Phe CRF into the median raphe nucleus (MRN) attenuated yohimbine‐induced reinstatement of alcohol seeking but had no effect on yohimbine‐induced increases in alcohol intake during ongoing self‐administration. Results indicate an important role of MRN CRF receptors in yohimbine‐induced reinstatement of alcohol seeking but not yohimbine‐induced increases in alcohol intake.
Glucocorticoid and polyamine interactions in the plasticity of glutamatergic synapses that contribute to ethanol‐associated dependence and neuronal injury
Authors: Prendergast Mark A. , Mulholland Patrick J.
Published: October 2011

Stress contributes to the development of ethanol dependence and is also a consequence of dependence. However, the complexity of physiological interactions between activation of the hypothalamic–pituitary–adrenal (HPA) axis and ethanol itself is not well delineated. Emerging evidence derived from examination of corticotropin‐releasing factor systems and glucocorticoid receptor systems in ethanol dependence suggests a role for pharmacological manipulation of the HPA axis in attenuating ethanol intake, though it is not clear how activation of the HPA axis may promote ethanol dependence or contribute to the neuroadaptative changes that accompany the development of dependence and the severity of ethanol withdrawal. This review examines the role that glucocorticoids, in particular, have in promoting ethanol‐associated plasticity of glutamatergic synapses by influencing expression of endogenous linear polyamines and polyamine‐sensitive polypeptide subunits of N‐methyl‐D‐aspartate (NMDA)‐type glutamate receptors. We provide evidence that interactions among glucocorticoid systems, polyamines and NMDA receptors are highly relevant to both the development of ethanol dependence and to behavioral and neuropathological sequelae associated with ethanol withdrawal. Examination of these issues is likely to be of critical importance not only in further elucidating the neurobiology of HPA axis dysregulation in ethanol dependence, but also with regard to identification of novel therapeutic targets that may be exploited in the treatment of ethanol dependence.
Serratia marcescens strains implicated in adverse transfusion reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Authors: Greco‐Stewart V. S. , Brown E. E. , Parr C. , Kalab M. , Jacobs M. R. , Yomtovian R. A. , Ramírez‐Arcos S. M.
Published: October 2011

Background and Objectives  Serratia marcescens is a Gram‐negative bacterium that has been implicated in adverse transfusion reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface‐attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system.

Materials and Methods  Seven S. marcescens strains, including biofilm‐positive and biofilm‐negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system.

Results  All strains exhibited similar growth in medium and platelets. While only the biofilm‐positive control strain formed biofilms in medium, this strain and three clinical isolates associated with transfusion reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm‐forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm‐negative strains.

Conclusion  S. marcescens strains associated with transfusion reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
Effects of transient overexpression or knockdown of cytochrome P450 reductase on reactive oxygen species generation and hypoxia reoxygenation injury in liver cells
Authors: Pillai Venkateswaran C , Snyder Russell O , Gumaste Upendra , Thekkumkara Thomas J , Mehvar Reza
Published: October 2011

1. Literature data suggest that the electron‐donating enzyme, cytochrome P450 reductase (CPR), might act as a source of reactive oxygen species (ROS). However, the role of CPR in pathophysiological conditions associated with oxidative stress is unknown. The aim of the present study was to study the role of CPR in the generation of ROS and cellular injury under basal conditions, and after simulated in vitro ischaemia–reperfusion (IR).

2. Plasmid DNA or siRNA approaches were used to transiently overexpress or knockdown the human CPR gene in rat liver epithelial (WB‐F344) or human hepatoblastoma (HepG2) cells, respectively. The generation of ROS and/or cellular injury was then studied under the basal conditions and after simulated IR (4 h of ischaemia plus 30 min of reoxygenation).

3. Under the basal conditions, transient overexpression of CPR protein in WB‐F344 cells caused a 90% increase in the CPR activity, which was associated with a 100% increase in the ROS production. In contrast, after simulated IR, a 2.5‐fold higher CPR activity did not significantly affect the magnitude of ROS generation or cell death. Similarly, although the knockdown of CPR protein resulted in a significant reduction (∼30%) in the CPR activity, the ROS production was not substantially altered after simulated IR in HepG2 cells.

4. Our data suggest that CPR plays a major role in the ROS generation by liver cells under the basal conditions. However, the role of CPR in the ROS generation during simulated in vitro IR injury in these cells is minimal, if any.