bluuebunny/crossref_metadata_2025 huggingface dataset:
Individualized Cognition‐Action intervention to prevent behavioral disturbances and functional decline in institutionalized older adults: a randomized pilot trial
Authors: Dechamps Arnaud , Alban Rigier , Jen Joanne , Decamps Arnaud , Traissac Thalie , Dehail Patrick
Published: November 2009

Objective

To evaluate the effectiveness of an individualized Cognition‐Action (CA) intervention to reduce behavioral disturbances in severely deconditioned institutionalized old adults.

Design

12 weeks randomized pilot trial of either individualized Cognition‐Action program (n = 24) or routine medical care as control (C, n = 25).

Setting

Long‐term care (LTC) of the Geriatric Department from the University State Hospital in Bordeaux, France.

Participants

49 institutionalized old patients with at least one Neuropsychiatric symptoms ≥4.

Intervention

The CA rationale was a non‐preconceived ideas approach over the patient's abilities and discourse. Patients received short bouts of 5–15 min and accumulated 50 min of interaction per week. CA intervention used five standardized exercises as tools to enhance communication and social interactions. CA was compared to usual care.

Measurements

Primary outcomes were the Neuropsychiatric inventory (NPI) total and symptoms scores. Secondary outcomes were the BERG balance scale, the Geriatric Depression Scale (GDS), Quality of life AM‐PAC‐CAT and Muscle strength.

Results

The CA group had a clinically significant NPI total score reduction compared to C, −7, 95%CI [−10.8 to −3], $\eta _p^{\rm 2} $ = 0.24. CA group showed a risk reduction of NPI total score worsening, OR = 0.09, 95%CI [0.02–0.37]. BERG total score was clinically improved in the CA group compared to C, 4.9 95%CI [0.7–9.2], $\eta _p^{\rm 2} $ = 0.11. CA patients reduced their GDS score and improved their Quality of life and Strength.

Conclusions

The combination of tailored guidance and simple standardized exercises was an effective behavioral management approach for behavioral disturbances reduction and functional autonomy improvement in institutionalized old adult populations. Copyright © 2009 John Wiley & Sons, Ltd.
Policy process for health sector reforms: a case study of Punjab Province (Pakistan)
Authors: Tarin Ehsanullah , Green Andrew , Omar Maye , Shaw Jane
Published: November 2009

The health sector in the Punjab (Pakistan) faces many problems, and, the government introduced reforms during 1993–2000. This paper explores the policy process for the reforms. A case study method was used and, to assist this, a conceptual framework was developed. Analysis of four initiatives indicated that there were deviations from the government guidelines and that the policy processes used were weak. The progress of different reforms was affected by a variety of factors: the immaturity of the political process and civil society, which together with innate conservatism and resistance to change on the part of the bureaucracy resulted in weak strategic sectoral leadership and a lack of clear purpose underpinning the reforms. It also resulted in weaknesses in preparation of the detail of reforms leading to poor implementation. The study suggests a need for broadening the stakeholders' base, building the capacity of policy‐makers in policy analysis and strengthening the institutional basis of policymaking bodies. Copyright © 2009 John Wiley & Sons, Ltd.
Measuring sustainability as a programming tool for health sector investments: report from a pilot sustainability assessment in five Nepalese health districts
Authors: Sarriot Eric , Ricca Jim , Ryan Leo , Basnet Jagat , Arscott‐Mills Sharon
Published: November 2009

Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system—the unit of analysis of the study—was defined as the health district.

We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal, child, health, and family planning results for the five districts included in this pilot study, ranked from “no sustainability” to “beginning of sustainability.”

We conclude that systematic application of the Sustainability Framework could improve the health sector investment decisions of development agencies. It could also give districts an information base on which to build autonomy and accountability. The ability to form and test hypotheses about the sustainability of outcomes under various funding strategies—made possible by this approach—will be a prerequisite for more efficiently meeting the global health agenda. Copyright © 2009 John Wiley & Sons, Ltd.
Needs assessment of health education in health‐networks of the Isfahan province of Iran, 2005–2006
Authors: Shiri Mansoor , Farhang Fereshteh , Heidari Kamal , Afghari Afsaneh , Amini Soodabeh , Sharifirad Gholamreza , Sadri Ghollamhoosein , Hassanzadeh Akbar , Samar Parvin , Sadeghi Shahriyar , Yarmohammadian Mohammad Hossein , Masood Shahriyar
Published: November 2009

An essential element of a successful educational system is evidence concerning the core educational needs of the system. This descriptive study used the consent‐based technique of needs assessment to determine health educational needs and priorities within such education in 21 district health networks of the Isfahan province of Iran. This study was conducted in the Isfahan province from March 2005 to December 2006 among health experts of the Isfahan provincial health center and the following three groups in district health networks: health experts at headquarters; health workers delivering health services; and people in the community covered by these networks. Health education needs and priorities of the Isfahan provincial health authority at the district health networks were determined. While the first priority of headquarter experts and field workers was mental health and family planning, respectively, the first priority of people in the community in most districts was nutrition. The findings showed that in most districts there are differences in viewpoints between health workers, health experts and service users regarding health educational needs and priorities within the needs. Copyright © 2009 John Wiley & Sons, Ltd.
The long and winding road to RNA editing in plant mitochondria: The Tübingen‐Berlin chapter
Authors: Brennicke Axel
Published: November 2009

It took several independent observations of C‐to‐T differences between genomic mtDNA sequences and corresponding complementary DNA (cDNA) sequences before RNA editing in plant mitochondria was accepted as a fact by the group at Tübingen and later Berlin (Hiesel et al., Science246 (1989) 1632–1634). The first such deviating sequence runs were critically viewed in the lab as being errors of some kind, most likely cloning artifacts, which occur only too frequently. Several such cDNA‐mtDNA differences identified in independent cDNA clones in different libraries and finally CGG to TGG codon changes dispelled the skeptical view, and this phenomenon was finally recognized as plant mitochondrial RNA editing of a type similar to the apolipoprotein B RNA editing in mammals. © 2009 IUBMB IUBMB Life, 61: 1105–1109, 2009.
Enzymatic processing of β‐dystroglycan recombinant ectodomain by MMP‐9: Identification of the main cleavage site
Authors: Bozzi Manuela , Inzitari Rosanna , Sbardell Diego , Monaco Susanna , Pavoni Ernesto , Gioia Magda , Marini Stefano , Morlacchi Simona , Sciandra Francesca , Castagnola Massimo , Giardina Bruno , Brancaccio Andrea , Coletta Massimo
Published: November 2009

Dystroglycan (DG) is a membrane receptor belonging to the complex of glycoproteins associated to dystrophin. DG is formed by two subunits, α‐DG, a highly glycosylated extracellular matrix protein, and β‐DG, a transmembrane protein. The two DG subunits interact through the C‐terminal domain of α‐DG and the N‐terminal extracellular domain of β‐DG in a noncovalent way. Such interaction is crucial to maintain the integrity of the plasma membrane. In some pathological conditions, the interaction between the two DG subunits may be disrupted by the proteolytic activity of gelatinases (i.e. MMP‐9 and/or MMP‐2) that removes a portion or the whole β‐DG ectodomain producing a 30 kDa truncated form of β‐DG. However, the molecular mechanism underlying this event is still unknown. In this study, we carried out proteolysis of the recombinant extracellular domain of β‐DG, β‐DG(654‐750) with human MMP‐9, characterizing the catalytic parameters of its cleavage. Furthermore, using a combined approach based on SDS‐PAGE, MALDI‐TOF and HPLC‐ESI‐IT mass spectrometry, we were able to identify one main MMP‐9 cleavage site that is localized between the amino acids His‐715 and Leu‐716 of β‐DG, and we analysed the proteolytic fragments of β‐DG(654‐750) produced by MMP‐9 enzymatic activity. © 2009 IUBMB IUBMB Life, 61: 1143–1152, 2009
Molluscicides from some common medicinal plants of eastern Uttar Pradesh, India
Authors: Singh Sunil Kumar , Yadav Ram P. , Singh Ajay
Published: November 2009

Many aquatic snails act as intermediate hosts for the larvae of trematodes, Fasciola hepatica and Fasciola gigantica, which cause the diseases fascioliasis and schistosomiasis. The WHO has tested several thousands of synthetic compounds for the control of the snail host. Although effective, these molluscicides have so far not proved themselves to be entirely satisfactory. With a growing awareness of environmental pollution, efforts are being made to discover molluscicidal products of plant origin. Being products of biosynthesis, these are potentially biodegradable in nature. Several groups of compounds present in various plants have been found to be toxic to target organisms at acceptable doses ranging from <1 to 100 ppm. Common medicinal plants, i.e. Thevetia peruviana, Alstonia scholaris (Family; Apocynaceae), Euphorbia pulcherima and Euphorbia hirta (Family; Euphorbiaceae), have potent molluscicidal activity against freshwater snails. The toxicological actions of Thevetia peruviana may be due to the presence of apigenin‐5‐methyl ether (flavonoid) and triterpenoid glycosides, while a number of alkaloids (pseudo‐akuammigine in addition to betulin, ursolic acid and β‐sitosterol), steroids and triterpenoids are present in Alstonia scholaris and the diterpenoids, pulcherrol, β‐sitosterol, hentriacontane, ellagic acid and β‐amyrin are present in Euphorbia hirta and in Euphorbia pulcherima. Although, at present very little literature is available on the control of vector snails through plant origin pesticides, an attempt has been made in this review to assemble all the known information on molluscicidal properties of common medicinal plants of eastern Uttar Pradesh, India, which might be useful for the control of harmful snails. Copyright © 2009 John Wiley & Sons, Ltd.
Low oxygen treatment prior to cold storage decreases the incidence of bitter pit in ‘Golden Reinders’ apples
Authors: Val Jesús , Fernández Victoria , López Paola , Peiró Jose María , Blanco Alvaro
Published: November 2009

BACKGROUND: The effect of subjecting ‘Golden Reinders’ apples to a low O2 pre‐treatment (LOT; 1–2% O2) was evaluated as a strategy to decrease the rate of bitter pit (BP) incidence after standard cold storage (ST). Immediately after harvest, apples were stored for 10 days at 20 °C under low O2. Thereafter, apples were cold‐stored (0–4 °C) for 4 months and changes were monitored in terms of BP incidence, fruit quality traits and mineral element concentrations.

RESULTS: After 4 months cold storage, LOT apples presented a 2.6‐fold decrease in the rate of BP incidence (14%) versus the values obtained for standard cold‐stored fruits (37% BP incidence). LOT increased flesh firmness, total soluble solids and titratable acidity as compared to the quality traits determined for cold‐stored fruits. Lower cortex Ca and Mg concentrations as compared to ST apples were determined in association with LOT, 2 months after cold storage.

CONCLUSION: Application of a LOT prior to cold storage may be a promising strategy to reduce the incidence of BP and preserve fruit quality, which should be further investigated. Copyright © 2009 Society of Chemical Industry
Experimental evidence for the protective effects of coffee against liver fibrosis in SD rats
Authors: Shin Jang‐Woo , Wang Jing‐Hua , Kang Jong‐Koo , Son Chang‐Gue
Published: November 2009

BACKGROUND: Coffee is one of the most commonly consumed beverages worldwide. Accumulating clinical evidence has shown an inverse relationship between coffee and liver cirrhosis. We investigated the protective effect of coffee against liver fibrosis and underlying molecular mechanisms using a dimethylnitrosamine (DMN)‐induced liver fibrosis model.

RESULTS: Coffee administration significantly prevented the deterioration of body weight, organ weight, and serum biochemistry by DMN treatment. Histopathological examination revealed that necrosis/inflammation and fibrotic septa decreased significantly in coffee‐treated rats compared to those treated with DMN and water. Coffee administration also significantly inhibited the accumulation of hydroxyproline (P < 0.001) and the production of malondialdehyde (P < 0.05), as well as stellate cell activation caused by DMN injection. Coffee protected the depletion of glutathione, superoxide dismutase, and catalase in liver tissue. In addition, coffee treatment inhibited the gene expression of inducible nitric oxide synthase, transforming growth factor (TGF)‐β, tumor necrosis factor‐α, interleukin‐1, and platelet‐derived growth factor (PDGF)‐β in liver tissues, and lowered the concentration of TGF‐β and PDGF‐β in liver. Coffee inhibited NO production by macrophages.

CONCLUSION: Coffee exerts protective effects against liver fibrosis via antioxidant action and the suppression of fibrogenic cytokines, TGF‐β and PDGF‐β. Copyright © 2009 Society of Chemical Industry
Thermoplastic Vulcanizates Based on Highly Compatible Blends of Isotactic Poly(propylene) and Copolymers of Atactic Poly(propylene) and 5‐Ethylidene‐2‐norbornene
Authors: l'Abee Roy , Sablong Rafael , Goossens Han , van Duin Martin , Spoelstra Anne , Duchateau Rob
Published: November 2009

Highly compatible thermoplastic/elastomer blends were used to prepare thermoplastic vulcanizates (TPVs) with refined morphologies and improved mechanical properties. Copolymers of atactic poly(propylene) (aPP) and 5‐ethylidene‐2‐norbornene (ENB) (aPP‐co‐ENB) were prepared via metallocene catalysis. Blends of isotactic poly(propylene) (iPP) and the aPP‐co‐ENB rubbers are immiscible in the melt, but the very high compatibility leads to a refinement of the morphology in comparison to blends based on iPP and ethylene‐propylene‐ diene (EPDM) rubber. The aPP‐co‐ENB‐based blends show improved tensile properties, while the relatively high Tg of the rubber phase retards the elastic recovery at room temperature. Dilution of the TPVs with oil broadens the temperature window for applications by a signification reduction of the Tg and improves the elasticity of the TPVs. This study demonstrates that the lower limit of the rubber particle size of TPVs that is attainable via dynamic vulcanization of immiscible blends is in the order of 300–500 nm.

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Bioinspired Block Copolymers: Translating Structural Features from Proteins to Synthetic Polymers
Authors: Laschewsky André , Marsat Jean‐Noël , Skrabania Katja , von Berlepsch Hans , Böttcher Christoph
Published: November 2009

In order to mimic a key functional feature of the transport protein serum albumin that disposes of several different simultaneous binding sites, new ternary linear block copolymers were synthesized. The block copolymers are made of one non‐ionic hydrophilic block based on derivatives of poly(oligoethyleneglycol), and of two mutually immiscible hydrophobic poly(acrylate) blocks, based on hydrocarbon and fluorocarbon esters of acrylic acid, respectively. The polymers self‐organize in aqueous solution to micellar aggregates, which undergo microphase separation within the hydrophobic micellar core. The different aggregate structures were imaged by transmission electron cryo‐microscopy (cryo‐TEM). Depending on the detailed polymer architecture, either core‐shell‐corona micelles, or micelles with a true multicompartment structure were formed, that are capable of selective solubilization.

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Characterization of Low‐Molecular‐Weight PLA using HPLC
Authors: Codari Fabio , Moscatelli Davide , Storti Giuseppe , Morbidelli Massimo
Published: November 2009

HPLC is applied and assessed as an effective tool to investigate both the production of PLA by polycondensation and its corresponding degradation. A new HPLC calibration procedure, through which it is possible to fully characterize LMW PLA samples by determining the concentration of each individual oligomer, is developed. A comparison between HPLC, 1H NMR spectroscopy and non‐aqueous solution titration is also reported in order to confirm the reliability of the proposed method. Finally, the proposed analytical technique is applied to monitor the development of a polycondensation reaction performed at 150 °C and 133.3 mbar for 12 h.

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Deligne's duality for de Rham realizations of 1‐motives
Authors: Bertapelle Alessandra
Published: November 2009

Let M be a 1‐motive over a base scheme S and M ′ its Cartier dual. We show the existence of a canonical duality between the de Rham realizations of M and M ′; this generalizes a result in [5]. Furthermore, we study universal extensions of 1‐motives and their relation with ♮‐extensions (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Convergence theorems for fixed point problems and variational inequality problems in Hilbert spaces
Authors: Yao Yonghong , Liou Yeong‐Cheng , Chen Rudong
Published: November 2009

In this paper, we introduce an iterative scheme for finding a common element of the set of fixed points of a nonexpansive mapping and the set of solutions of the variational inequality for an α ‐inverse strongly monotone mapping in a Hilbert space. We show that the sequence converges strongly to a common element of two sets under some mild conditions on parameters (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Micro‐/Nanoscale Structuring of Cell‐Culture Substrates with Fluorocarbon Plasmas
Authors: Di Mundo Rosa , Gristina Roberto , Sardella Elaisa , Intranuovo Francesca , Nardulli Marina , Milella Antonella , Palumbo Fabio , d'Agostino Riccardo , Favia Pietro
Published: November 2009

We describe the tailoring of polymer surfaces with CFx composition and roughness/density of different micro‐/nanometric relieves (ribbons, petals, domes, dots) tuned independently in low pressure plasma deposition and etching processes. Similarity of outer chemical composition grants the comparison of cell culture results to analyze the impact of topographical features on cellular behavior. Such surfaces are of interest for biomedical substrates since tuning their surface composition and morphology can drive the behavior of cells in contact with them.

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Density Distributions in TATB Prepared by Various Methods
Authors: Hoffman D. Mark , Fontes Aaron T.
Published: November 2009

The density distribution of two legacy types of 1,3,5‐triamino‐2,4,6‐trinitrobenzene (TATB) particles were compared with TATB synthesized by new routes and recrystallized in several different solvents using a density gradient technique. Legacy wet (WA) and dry aminated (DA) TATB crystalline aggregates gave average densities of 1.9157 and 1.9163 g cm−3, respectively. Since the theoretical maximum density (TMD) for a perfect crystal is 1.937 g cm−3, legacy TATB crystals averaged 99% of TMD or about 1% voids. TATB synthesized from phloroglucinol (P) had comparable particle size to legacy TATBs, but significantly lower density, 1.8340 g cm−3. TATB synthesized from 3,5 dibromoanisole (BA) was very difficult to measure because it contained extremely fine particles, but had an average density of 1.8043 g cm−3 over a very broad range. Density distributions of TATB recrystallized from dimethylsulfoxide (DMSO), sulfolane, and an 80/20 mixture of DMSO with the ionic liquid 1‐ethyl‐3‐methyl‐imidazolium acetate (EMImOAc), with some exceptions, gave average densities comparable or better than the legacy TATBs.
Fusion Technique for Liver Transection with Kelly‐Clysis and Harmonic Technology
Authors: Jagannath P. , Chhabra D. G. , Sutariya K. R. , Shah R. C.
Published: November 2009

Background

Various devices are available for liver transection and comparative data on transection techniques are limited by the diversity of operative procedures. Clamp crushing (Kelly‐clysis) with a Cavitron ultrasonic surgical aspirator (CUSA—Integra Radionics) is widely used for splitting the liver parenchyma. Hemostasis is achieved by bipolar coagulation, ligatures, or hemoclips. We introduce a fusion technique (Focus‐clysis) for liver transection using a combination of Kelly‐clysis and harmonic technology.

Materials and method

A fusion technique (FT) was performed using FOCUS, a Kelly clamp like instrument attached to a Harmonic generator. Hepatic resections (nine major, nine minor) were performed with the fusion technique in 18 non‐cirrhotic patients. Variables evaluated were blood loss, transection time, biliary leak, postoperative liver function, morbidity, and cost‐effectiveness. The results were compared with 18 hepatic resections (nine major, nine minor) that were performed with our earlier technique, i.e., CUSA with bipolar cautery, ligatures, and hemoclips.

Results

The mean blood loss was 416 ml in the FT group, compared to 833 ml in the CUSA group. Two patients in the FT group needed blood transfusion in the first 48 h, whereas eight patients in the CUSA group had transfusions. No major postoperative liver dysfunction was noted with the new technique, and postoperative morbidity was lower in the FT group. Liver transection with the fusion technique was faster.

Conclusion

The fusion technique (Focus‐clysis) using Kelly‐clysis and harmonic technology is promising, easy, and effective for liver transection. Our initial results show advantages over the routinely used CUSA/bipolar combination. The fusion technique could be a new option for liver transection, especially in non‐cirrhotic patients.
Association of Increasing Surgeon Age with Decreasing In‐Hospital Mortality After Coronary Artery Bypass Graft Surgery
Authors: Chai Chiah‐Yang , Chen Chao‐Hung , Lin Hui‐Wen , Lin Herng‐Ching
Published: November 2009

Background

The aim of this study was to investigate the relation between surgeon age and in‐hospital mortality for patients who underwent a coronary artery bypass graft (CABG) using a nationwide population‐based data set.

Methods

This study used data from the 2004 Taiwan National Health Insurance Research Database. The study sample comprised 3766 patients hospitalized for CABG surgery and was divided into three equal‐sized surgeon age groups: <40, 40 to 45, and >45 years. A conditional (fixed‐effect) logistic regression was performed to examine the relation between surgeon age and in‐hospital mortality after adjusting for surgeon CABG caseload and characteristics of patients and surgeons as well as the clustering effect among surgeons.

Results

Patients who underwent CABG performed by surgeons in the <40 years age group had significantly higher in‐hospital mortality rates (5.4%) than those operated on by surgeons in the 40‐ to 45‐year age group (3.5%) and surgeons in the >45‐year age group (2.6%). Regression shows that the adjusted odds ratio of in‐hospital mortality for patients operated on by surgeons in the <40‐year age group was 1.47 (p < 0.05) times that for surgeons in the 40‐ to 45‐year age group and 1.82 (p < 0.05) times that for surgeons in the >45‐year age group.

Conclusion

We conclude that older surgeons are more likely to achieve better clinical performance with CABG surgery because of their greater clinical experience.
Quantitative Comparison of the Difficulty of Performing Laparoscopic Colectomy at Different Tumor Locations
Authors: Kuwabara Kazuaki , Matsuda Shinya , Fushimi Kiyohide , Ishikawa Koichi B. , Horiguchi Hiromasa , Fujimori Kenji
Published: November 2009

Background

Laparoscopic approaches of colectomy for colonic cancer are increasingly surpassing the mainstream open colectomy approach. Impact of disease variables, such as tumor location, has not been adequately measured in quality improvement initiatives. Quantitative analysis concerning the difficulty performing these procedures and differences in postoperative care depending on tumor site will contribute to the development of training programs and to the assessment of quality of care strategies.

Methods

A total of 3,765 cases received laparoscopic colectomy (LC). Patient demographics, weighted comorbidities, procedure‐related complications, stapling devices, operating room (OR) time, postoperative length of hospital stay (LOS), or total charges (TC) were categorized and compared based on tumor location: cecum to ascending, transverse, descending, and sigmoid colon. Multivariate analyses determined the impact of tumor location on postoperative LOS, TC, OR time, and complications.

Results

Sigmoid colon was the most frequent tumor placement (40.5%). Significant differences in age, gender, frequency of blood transfusion, use of stapling devices, OR time, and postoperative LOS were observed among tumor locations. Transverse colon was the most significant determinant of postoperative LOS and TC, whereas descending colon tumors correlated with increased OR time. Greater OR time was associated with more postoperative resource use and complications.

Conclusions

Tumor location, complications, and OR time affected postoperative resource use, whereas greater OR time signified an increased occurrence of complications. Developers of LC training programs or healthcare policy makers should consider the quantitative impact of tumor locations when attempting to improve effective skill training or to survey the quality of LC performance.
Tetralogy of Fallot: Yesterday and Today
Authors: Starr Joanne P.
Published: November 2009

Tetralogy of Fallot (TOF) is a cyanotic congenital cardiac defect that was first described by Stenson in 1672 and later named for Fallot, who in 1888 described it as a single pathological process responsible for (1) pulmonary outflow tract obstruction, (2) ventricular septal defect (VSD), (3) overriding aortic root, and (4) right ventricular hypertrophy. The surgical history of TOF began with the development of the systemic to pulmonary artery shunt (BT shunt) by Blalock, Taussig, and Thomas in 1944. Ten years later complete repair of TOF was performed by Lillehei using cross‐circulation and by Kirklin with a primitive cardiopulmonary bypass circuit. Notable contributions by several other surgeons including Bahnson, Ebert, Malm, Trusler, Barratt‐Boyes, and Castaneda would lead us into the modern era of surgery. Today, complete repair of TOF is performed before six months of age with low mortality (<2%). In select cases a modified version of the BT shunt is still performed as the initial procedure. Long‐term survival rates are excellent (85%–90%). Adult survivors with TOF are an ever‐increasing population and may require reintervention, surgically or catheter based. Promising future innovations include percutaneous pulmonary valve replacement, tissue‐engineered autologous valves and conduits, and genetic manipulation. This article presents a review of TOF, including the history of surgical treatment, present‐day approaches, and long‐term outcomes.
Papillary Carcinoma Located in the Thyroid Isthmus
Authors: Lee Yong Sang , Jeong Jong Ju , Nam Kee‐Hyun , Chung Woong Youn , Chang Hang‐Seok , Park Cheong Soo
Published: November 2009

Background

The purpose of the present study was to evaluate the clinicopathologic characteristics and short‐term outcomes of papillary thyroid carcinomas (PTC) located in the isthmus compared to tumors located in other thyroid regions, and to use those findings to establish a surgical strategy for treating these tumors.

Patients and methods

Thyroidectomy was performed in 1,973 thyroid cancer patients in our hospital between January 2006 and December 2007. The patients were analyzed in two groups; group I, patients with tumors located in the isthmus (n = 181) and group II, patients with tumors located in other thyroid regions (n = 1,792). The clinicopathologic characteristics and short‐term outcomes were compared between the two groups.

Results

The study groups were similar in terms of age and gender ratio. For groups I and II, respectively, the mean primary tumor size was 1.02 cm and 1.13 cm (p = 0.017), capsular invasion frequency was 70.2 and 60.8% (p = 0.008), and multifocality frequency was 48.6 and 39.8% (p = 0.006). In addition, central node involvement was 40.3 and 42.1% (p = 0.350), and lateral node involvement was 9.4 and 18.2% (p = 0.001). At the time of postoperative iodine‐131 remnant ablation, 34.3% of group I patients and 38.0% of group II patients showed undetectable serum thyroglobulin concentrations. There were no significant differences in surgical complications between the two groups.

Conclusions

Papillary thyroid carcinomas located in the isthmus was more likely to be associated with multiple foci in bilateral lobes and higher rates of capsular invasions than tumors in other thyroid regions. These findings indicate that total thyroidectomy is an appropriate initial surgical procedure for the isthmic PTC.
Risk Factors for Clinical Pancreatic Fistula After Distal Pancreatectomy: Analysis of Consecutive 100 Patients
Authors: Yoshioka Ryuji , Saiura Akio , Koga Rintaro , Seki Makoto , Kishi Yoji , Morimura Ryo , Yamamoto Junji , Yamaguchi Toshiharu
Published: November 2009

Background

The mortality associated with distal pancreatectomy (DP) has declined to <5% in recent years in high‐volume centers. However, morbidity remains high, ranging from 32% to 57%. Pancreatic fistula (PF) is the most common complication after DP. The aim of this study was to analyze factors associated with the occurrence of clinical PF.

Methods

A retrospective review was performed of the medical records of 100 patients who underwent DP in our institution between May 2001 and January 2009.

Results

There was no mortality, but morbidity was occurred in 65 patients (65%), with major complications occurring in 9 patients (9%). PF occurred in 50 patients (50%) and clinical PF occurred in 23 patients (23%). Multivariate analysis indicated that independent risk factors for clinical PF were: age younger than 65 years (P = 0.049; odds ratio (OR) 2.958; 95% confidence interval (CI) 1.007–8.688), not ligating the main pancreatic duct (MPD) (P = 0.02; OR 4.933; 95% CI 1.283–18.967), and extended lymphadenectomy (P = 0.008; OR 4.773; 95% CI 1.504–15.145).

Conclusions

Age < 65 years, not ligating the MPD, and extended lymphadenectomy are independent risk factors for clinical PF.
Mitochondrial Cholesterol Transporter, StAR, Inhibits Human THP‐1 Monocyte‐Derived Macrophage Apoptosis
Authors: Bai Qianming , Li Xiaobo , Ning Yanxia , Zhao Fengdi , Yin Lianhua
Published: November 2009

Steroidogenic acute regulatory protein (StAR) plays an important role in the maintenance of intracellular lipid homeostasis. Macrophages are the key cellular player in the pathophysiology of atherosclerosis. Imbalance of macrophage lipid homeostasis causes cellular apoptosis, which is the key process in the initiation of atherosclerosis. The present study has investigated the effects of StAR in the apoptotic process of human THP‐1 derived macrophages induced by serum withdrawal or Ox‐LDL. Overexpression of StAR significantly decreased the number of apoptotic macrophages by decreasing the expression of pro‐apoptotic genes Caspase‐3 and Bax mRNA and protein levels, as well as through increasing expression of anti‐apoptotic gene Bcl‐2 mRNA and protein levels in the absence and presence of Ox‐LDL. The results indicate that StAR plays an important role in macrophage and foam cell apoptotic processing, which may provide a potential method for preventing atherosclerosis.
Ring‐Opening Polymerization of Epoxidized Soybean Oil
Authors: Liu Zengshe , Erhan Sevim Z.
Published: November 2009

Ring‐opening polymerization of epoxidized soybean oil (ESO) catalyzed by boron trifluoride diethyl etherate (BF3·OEt2) in methylene chloride was conducted in an effort to develop useful biodegradable polymers. The resulting polymerized ESO (PESO) were characterized using infrared (IR) spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), 1H NMR, 13C NMR, solid state 13C NMR and gel permeation chromatography (GPC). The results indicated that PESO materials were highly crosslinked polymers. They had glass transition temperatures ranging from −16 to −48 °C. TGA results showed the PESO polymers were thermally stable at temperatures up to 220 °C. Decomposition of the polymers was found to occur at temperature greater than 340 °C. GPC results indicated the extracted soluble substances from PESO polymers were ESO dimers, trimers and polymers with low molecular weights. The resulting crosslinked polymers can be converted into hydrogels by chemical modification, such as hydrolysis. These soy based hydrogels will find applications in personal care and health care areas.
Krankheitsspezifische Hautmodelle
Authors: Eckl K.-M. , Hennies H.C.
Published: November 2009

In den letzten Jahren wurden Hautmodelle besonders für die Behandlung von Verbrennungsopfern, aber auch zur molekularen und zellbiologischen Aufklärung von dermatologischen und immunologischen Erkrankungen und Untersuchung von Kosmetika und Pharmaka entwickelt. Kommerzielle Modelle, als alternative Methode für Tierversuche in der kosmetischen und chemischen Industrie entwickelt, sind vielfältig erhältlich und entsprechend den Richtlinien von OECD (Organisation for Economic Co-operation and Development) und ECVAM (European Centre for the Validation of Alternative Methods) validiert. Hautmodelle beinhalten 2 Kompartimente, ein Dermisäquivalent, welches meist aus Typ-I-Kollagen und darin enthaltenen Fibroblasten besteht, und ein voll differenzierbares Epidermisäquivalent. Bis heute existieren nur wenige Hautmodelle, die spezifische monogene Hautkrankheiten simulieren oder in der Haut sichtbare Krankheitszeichen einer systemischen Autoimmunerkrankung darstellen. Wir haben kürzlich ein solches Modell für kongenitale Ichthyosen entwickelt, das hinsichtlich seiner physikalischen, physiologischen und zellbiologischen Eigenschaften validiert wird und zur Erprobung neuer Therapien geeignet ist.
Use of the Universal Clamp for deformity correction and as an adjunct to fusion: Preliminary results in scoliosis
Authors: Jouve Jean-Luc , de Gauzy Jérôme Sales , Blondel Benjamin , Launay Franck , Accadbled Franck , Bollini Gérard
Published: November 2009

Purpose

Evaluation of a novel instrumentation device for adolescent idiopathic scoliosis.

Methods

A new osteosynthesis implant (Universal Clamp) primarily consisting of a sublaminar band and titanium clamp was prospectively studied in 32 patients (average age, 15 years) with a major thoracic curve.

Results

The Universal Clamp was used without anterior release to reduce and maintain correction of the thoracic curve, which improved from 55.1° preoperatively to 14.5° at 3 months without neurological complication or loss of kyphosis.

Conclusions

This implant distributes stress over a larger area of the laminar cortex than sublaminar wires, patently reducing the risk of laminar fracture for equivalent reduction forces, and permits progressive reduction at several apical levels simultaneously.
An endoplasmic reticulum/plasma membrane junction: STIM1/Orai1/TRPCs
Authors: Lee Kyu Pil , Yuan Joseph P. , Hong Jeong Hee , So Insuk , Worley Paul F. , Muallem Shmuel
Published: November 2009

Ca2+ entering cells through store‐operated channels (SOCs) affects most cell functions, and excess SOC is associated with pathologies. The molecular makeup of SOCs and their mechanisms of gating were clarified with the discovery of the Orais and STIM1. Another form of SOCs are the TRPCs. STIM1 gates both Orai and TRPC channels but does so by different mechanisms. Although the STIM1 SOAR domain mediates the binding of STIM1 to both channel types, SOAR is sufficient to open the Orais but the STIM1 polylysine domain mediates opening of the TRPC channels. This short review discusses recent findings on how STIM1 gates and regulates the Orais and TRPCs, and how the STIM1/Orai1/TRPCs complexes may function in vivo to mediate SOC activity.
Acid sphingomyelinase, cell membranes and human disease: Lessons from Niemann–Pick disease
Authors: Schuchman Edward H.
Published: November 2009

Acid sphingomyelinase (ASM) plays an important role in normal membrane turnover through the hydrolysis of sphingomyelin, and is one of the key enzymes responsible for the production of ceramide. ASM activity is deficient in the genetic disorder Types A and B Niemann–Pick disease (NPD). ASM knockout (ASMKO) mice were originally constructed to study this disorder, and numerous defects in ceramide‐related signaling have been shown. Studies in these mice have further suggested that ASM may be involved in the pathogenesis of several common diseases through the reorganization of membrane microdomains. This review will focus on the role of ASM in membrane biology, with a specific emphasis on what a rare genetic disorder (NPD) has taught us about more common events.
Activation of protein kinase C‐α is essential for stimulation of cell proliferation by ceramide 1‐phosphate
Authors: Gangoiti Patricia , Granado Maria H. , Arana Lide , Ouro Alberto , Gomez-Muñoz Antonio
Published: November 2009

We previously demonstrated that ceramide‐1‐phosphate (C1P) stimulates fibroblast and macrophage proliferation, but the mechanisms involved in this action have only been partially described. Here we demonstrate that C1P induces translocation of protein kinase C‐alpha (PKC‐α) from the soluble to the membrane fraction of bone marrow‐derived macrophages. Translocation of this enzyme was accompanied by its phosphorylation on Ser 657 residue. Activation of PKC‐α was independent of prior stimulation of phosphatidylinositol‐dependent or phosphatidylcholine‐dependent phospholipase C activities, but required activation of sphingomyelin synthesis. Inhibition of PKC‐α activation also blocked C1P‐stimulated macrophage proliferation indicating that this enzyme is essential for the mitogenic effect of C1P.
Sialic acids acquired by Pseudomonas aeruginosa are involved in reduced complement deposition and siglec mediated host‐cell recognition
Authors: Khatua Biswajit , Ghoshal Angana , Bhattacharya Kaushik , Mandal Chandan , Saha Bibhuti , Crocker Paul R. , Mandal Chitra
Published: November 2009

The opportunism of Pseudomonas aeruginosa (PA) in immunocompromised hosts prompted us to explore the potential role of sialic acids (Sia) in this phenomenon. Culture of PA in the presence of exogenous Sia resulted in linkage‐specific incorporation of Sia which was associated with decreased complement deposition on the bacteria. Sia acquired by PA mediated enhanced binding of bacteria to recombinant‐CHO cells expressing human siglec‐7 or siglec‐9, as well as to human NK‐cells and monocytes naturally expressing these siglecs. Therefore, Sia may be acquired by PA in the host and contribute to bacterial pathogenicity and host‐cell interactions via reduction of complement deposition and siglec‐dependent recognition.
Dysmenorrhea in a multiethnic population of adolescent Asian girls
Authors: Wong Li Ping , Khoo Ee Ming
Published: November 2009

Objective

To determine the prevalence of dysmenorrhea, its impact, and the treatment‐seeking behavior of adolescent Asian girls.

Method

A cross‐sectional study with 1092 girls from 15 public secondary schools and 3 ethnic groups in the Federal Territory of Kuala Lumpur, Malaysia.

Results

Overall, 74.5% of the girls who had reached menarche had dysmenorrhea; 51.7% of these girls reported that it affected their concentration in class; 50.2% that it restricted their social activities; 21.5% that it caused them to miss school; and 12.0% that it caused poor school performance. Ethnicity and form at school were significantly associated with the poor concentration, absenteeism, and restriction of social and recreational activities attributed to dysmenorrhea. Only 12.0% had consulted a physician, and 53.3% did nothing about their conditions. There were ethnic differences in the prevalence, impact, and management of dysmenorrhea.

Conclusion

There is a need for culture‐specific education regarding menstruation‐related conditions in the school curriculum.
Clomiphene citrate plus tamoxifen versus laparoscopic ovarian drilling in women with clomiphene‐resistant polycystic ovary syndrome
Authors: Zakherah Mahmoud S. , Nasr Ahmed , El Saman Aly M. , Shaaban Omar M. , Shahin Ahmed Y.
Published: November 2009

Objective

To compare the efficacy of clomiphene citrate (CC) plus tamoxifen with that of laparoscopic ovarian drilling in clomiphene‐resistant women with polycystic ovary syndrome (PCOS).

Method

We randomly allocated 150 women with CC‐resistant PCOS to a combined medication group (group 1) or a laparoscopic surgery group (group 2). The primary outcome was the live birth rate in each group; secondary outcomes were the rates of ovulation, clinical pregnancy and miscarriage.

Results

There were no significant differences between the groups regarding rates of ovulation (81.3% vs 85.3%), pregnancy (53.3% vs 50.7%), or live births (49.3% vs 44.0%), but the mean endometrium thickness was significantly greater on the day of human chorionic gonadotropin administration in group 1 (P < 0.001).

Conclusion

Clomiphene citrate plus tamoxifen was as effective as laparoscopic ovarian drilling in promoting ovulation and pregnancy.
Cytology versus HPV testing for the detection of high‐grade cervical lesions in women found positive on visual inspection in Mumbai, India
Authors: Pimple Sharmila , Muwonge Richard , Amin Geetanjali , Goswami Smriti , Sankaranarayanan Rengaswamy , Shastri Surendra S.
Published: November 2009

Objective

To compare the utility of cytology and HPV testing in women from Mumbai, India, suspected of having cervical intraepithelial neoplasia (CIN) on visual inspection with acetic acid (VIA), Lugol's iodine (VILI), or both.

Method

The sensitivity, specificity, and predictive values of these tests for the detection of CIN 2 and/or 3 were evaluated in this cross‐sectional study with 756 women suspected of having CIN on visual inspection.

Results

There were 25 women with CIN 2, 20 with CIN 3, and 21 with invasive cancer. The sensitivity to detect CIN 3 lesions was 85.0% (95% CI, 62.1–96.8) and 70.0% (95% CI, 45.7–88.1) for cytology testing at the ASCUS and LSIL thresholds, respectively, and it was 89.5% (95% CI, 66.9–98.7) for HPV testing. The specificity to detect CIN 3 lesions was 94.5% (95% CI, 92.5–96.1) and 96.1% (95% CI, 94.4–97.5) for cytology testing at the ASCUS and LSIL thresholds, and it was 91.1% (95% CI, 88.5–93.2) for HPV testing.

Conclusion

Cytology and HPV testing were both found to be accurate triaging methods for women suspected of having CIN on visual inspection, especially for those with CIN 3 lesions.
Laryngeal cryptococcosis: Clinical presentation and treatment of a rare cause of hoarseness
Authors: Gordon Dan H. , Stow Nicholas W. , Yapa H. Manisha , Bova Ron , Marriott Deborah
Published: November 2009

Objective: Laryngeal cryptococcosis is rare, with few reported cases in the literature. We present current investigation and treatment recommendations for this disease.

Study Design: A structured literature review; additional cases and expert opinion are presented.

Results: Localized laryngeal cryptococcal infection most commonly presents with persisting hoarseness. Clinical suspicion of the disease is required for accurate diagnosis, with treatment based on the patient's immune status. Early microbiological advice and adequate follow‐up is recommended to ensure disease resolution.

Conclusion: Isolated laryngeal cryptococcosis is a rare presentation of fungal infection. It is easily treated and should be considered in the differential diagnosis of patients with persisting hoarseness.
Alterations in the Nasopharyngeal Bacterial Flora after Adenoidectomy in Children: A Systematic Review
Authors: Aarts Johanna W. M. , van den Aardweg Maaike T. A. , Rovers Maroeska M. , Bonten Marc J. M. , Schilder Anne G. M.
Published: November 2009

OBJECTIVE

To review the current literature on alterations in the nasopharyngeal bacterial flora in relation to adenoidectomy in children with recurrent upper respiratory tract infections (rURTIs).

DATA SOURCES

A systematic literature search of PubMed (from 1966 on) and EMBASE (from 1974 on) to May 3 2008.

REVIEW METHODS

A study was selected if it included children aged less than 18 years who had undergone adenoidectomy or adenotonsillectomy, and in whom nasopharyngeal bacterial flora was studied before and after or only after surgery. Data from eight studies were included in this review. We extracted from each study which potentially pathogenic and nonpathogenic nasopharyngeal flora were cultured before and after surgery.

RESULTS

Streptococcus pneumoniae and Haemophilus influenzae were most often detected in the nasopharynx of children with rURTI. Carriage of these bacteria decreased after adenoidectomy in the majority of studies. In contrast, carriage of bacteria belonging to the nonpathogenic nasopharyngeal flora increased after surgery.

CONCLUSION

Adenoidectomy seems to have a beneficial effect on the nasopharyngeal bacterial flora. Because the overall quality of the available evidence is low, it is important that controlled studies are initiated into the short‐ and long‐term effect of adenoidectomy on the nasopharyngeal bacterial flora and its relationship with the recurrence of URTIs in children.
Kyanite–sillimanite metamorphism of the Precambrian complexes, Transangarian region of the Yenisei Ridge
Authors: Likhanov I.I. , Reverdatto V.V. , Kozlov P.S. , Popov N.V.
Published: November 2009

Four Precambrian metamorphic complexes in the vicinity of regional faults in the Transangarian region of the Yenisei Ridge were examined. Based on geothermobarometry and P-T path calculations, our geological and petrological studies showed that the Neoproterozoic medium-pressure metamorphism of the kyanite–sillimanite type overprinted regionally metamorphosed low-pressure andalusite-bearing rocks at about 850 Ma. A positive correlation between rock ages and P-T estimates for the kyanite-sillimanite metamorphism provide evidence of the regional structural and tectonic heterogeneity. The medium-pressure metamorphism was characterized by (1) the development of deformational structures and textures, and kyanite-bearing blastocataclasites (blastomylonites) with sillimanite, garnet, and staurolite after andalusite-bearing regional metamorphic rocks; (2) insignificant apparent thickness of the zone of medium-pressure zonal metamorphism (from 2.5 to 7 km), which was localized in the vicinity of the overthrusts; (3) a low metamorphic field gradient during metamorphism (from 1–7 to 12 °C/km); and (4) a gradual increase in lithostatic pressure towards the thrust faults. These specific features are typical of collisional metamorphism during overthrusting of continental blocks and are evidence for near-isothermal loading. This event was justified within the framework of the crustal tectonic thickening model via rapid overthrusting and subsequent rapid uplifting and erosion. The results obtained allowed us to consider medium-pressure kyanite-bearing metapelites as a product of collision metamorphism, formed either by unidirectional thrusting of rock blocks from Siberian craton onto the Yenisei Ridge in the zones of regional faults (Angara, Mayakon, and Chapa areas) or by opposite movements in the zone of splay faults of higher orders (Garevka area).