bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI in the evaluation of late bone marrow changes following bone marrow transplantation
Authors: Tanner S F , Clarke J , Leach M O , Mesbahi M H , Nicolson V , Powles R , Husband J E , Tait D
Published: July 2009

Measurements of MR spin-lattice (T  1), and spin–spin (T  2) relaxation times in lumbar vertebrae have been performed in a pilot study on six adult patients, treated for acute myeloid leukaemia (AML). All patients were treated with initial chemotherapy and then proceeded to bone marrow transplantation (BMT), conditioned with Melphalan and total body irradiation (TBI). MR measurements were made between 21 and 89 months after TBI. The relaxation times in the six patients were compared with those in six healthy age-matched volunteers to establish whether there were differences between the two groups. Average T  1 values in the vertebrae of the treated patients are significantly shorter (p<0.01) than in the healthy volunteers. This is consistent with the observation of a relatively hyperintense vertebral bone marrow in the T  1 weighted images and is likely to be a consequence of treatment induced fatty replacement of marrow. Shorter T  1 values tend to be distributed within the centre of the lumbar vertebrae compatible with observations, made by others, which suggest that the peripheral zone of the vertebral body has been repopulated with bone marrow cells whereas the central zone, around the basivertebral vein, is predominantly fat. Histogram displays of vertebral body relaxation time distributions (T  1, T  2) for both patients and healthy age-matched volunteers are similar in that both patients and volunteers give histograms that are only slightly skewed. This similarity is probably a reflection of the fact that the patients have been in remission for over a year and have generally healthy bone marrow.
CT–MRI image fusion for 3D conformal prostate radiotherapy: use in patients with altered pelvic anatomy
Authors: Lau H Y , Kagawa K , Lee W R , Hunt M A , Shaer A H , Hanks G E
Published: July 2009

We describe the application of CT–MRI fusion software for 3D conformal radiotherapy in two patients with localized prostate cancer who had significantly altered pelvic anatomy due to prior surgery. Patient A had a hemipelvectomy for fibrosarcoma and Patient B had an abdominoperineal resection (APR) for rectal carcinoma. Using the Picker AcQSIM 3D treatment planning software equipped with CT–MRI fusion capabilities, we were able to construct 3D conformal treatment plans for the two patients. The CT–MRI fusion was invaluable in the 3D conformal treatment planning of these cases with distorted pelvic anatomy. It allowed for accurate identification of the clinical target volume (CTV) and was also able to better visualize normal structures so that the radiation beams could be placed to minimize toxicity to the normal tissues.
Plain film reporting by radiographers—a feasibility study
Authors: Robinson P J A
Published: July 2009

Two specially-trained radiographers reported 561 plain film examinations on accident and emergency (A/E) patients in parallel with rota radiologists of varying seniority. The reports were concordant in 495 cases (88.2%) and discordant in 66 (11.8%). The incidence of errors (false positives and false negatives) in the reports made by the two groups of observers was not significantly different. It may be feasible to introduce suitably trained radiographers into a reporting rota for A/E examinations with no detriment to the quality of reports.
Comparison of portal imaging and megavoltage verification films for conformal pelvic irradiation
Authors: Thompson V , Bidmead M , Mubata C
Published: July 2009

This study has evaluated the use of electronic portal imaging (EPI) as a replacement for megavoltage verification films in the treatment of conformal pelvic patients. The two methods of imaging have been compared in 40 patients. Several advantages of EPI were identified, including ease of image acquisition, regular assessment of reproducibility of set-up and the possibility of on-line intervention when necessary. The findings suggest that EPI is a suitable replacement for films.
Occupational dose to the radiographer in dual X-ray absorptiometry
Authors: Patel R , Blake G M
Published: July 2009

We thank Professor Mazess for his comments on our study of the occupational dose to radiographers perfoming bone densitometry scans [1]. Our report described environmental dose measurements for Lunar DPX and Hologic QDR dual X-ray absorptiometry scanners. At the time we did not have the opportunity to perform scatter dose measurements for a Lunar EXPERT system but instead compared our data with the radiological study of the EXPERT bone densitometer published by Njeh et al [2].
Effectiveness of a Pragmatic Education Program Designed to Promote Walking Activity in Individuals With Impaired Glucose Tolerance
Authors: Yates Thomas , Davies Melanie , Gorely Trish , Bull Fiona , Khunti Kamlesh
Published: July 2009

OBJECTIVE

To investigate whether a pragmatic structured education program with and without pedometer use is effective for promoting physical activity and improving glucose tolerance in those with impaired glucose tolerance (IGT).

RESEARCH DESIGN AND METHODS

Overweight and obese individuals with IGT were recruited from ongoing screening studies at the University Hospitals of Leicester, U.K. Participants were randomly assigned to one of three groups. Group 1 received a 3-h group-based structured education program designed to promote walking activity using personalized steps-per-day goals and pedometers. Group 2 received a 3-h group-based structured education program designed to promote walking activity using generic time-based goals. Group 3 received a brief information leaflet (control condition). Outcomes included an oral glucose tolerance test, standard anthropometric measures, ambulatory activity, and psychological variables. Follow-up was conducted at 3, 6, and 12 months.

RESULTS

A total of 87 individuals (66% male, mean age 65 years) were included in this study. At 12 months, significant decreases in 2-h postchallenge glucose and fasting glucose of −1.31 mmol/l (95% CI −2.20 to −0.43) and −0.32 mmol/l (−0.59 to −0.03), respectively, were seen in the pedometer group compared with the control group. No significant improvements in glucose control were seen in those given the standard education program.

CONCLUSIONS

This study suggests that a pragmatic structured education program that incorporates pedometer use is effective for improving glucose tolerance in those with IGT. This result is likely to have important implications for future primary care–based diabetes prevention initiatives.
Effect of solvent on the viscosity changes of coal‐oil slurry under high temperature–high pressure during heating
Authors: Ren Yingjie , Song Lei , Zhang Dexiang , Gao Jinsheng , Xu Hong
Published: July 2009

Heating coal‐oil slurry is an important step in direct coal liquefaction. Some physical and chemical properties and the viscosity of coal‐oil slurry will be the changes in the heating process. A self‐manufactured rotary viscometer that can measure the viscosity of coal slurry at high‐pressure temperature was designed. Two kinds of solvents including anthracene oil, Shenhua recycled oil (the catalytic hydrogenation products of Shenhua direct coal liquefaction) and Yanzhou coal were used. The results show that the viscosity of Yanzhou coal‐anthracene oil and Shenhua recycled oil slurry decrease firstly with the decreasing of solvent viscosity, then increase with measuring temperature for the absorption and volatilization of the solvent in atmosphere. Both of them have a viscosity peak with increasing measuring temperature in atmosphere. However, the Yanzhou coal‐anthracene oil slurry has a viscosity peak at about 583 K under high pressure during heating, while the Yanzhou coal‐Shenhua recycled oil slurry does not have a viscosity peak, but coke deposits appear at 623 K and above, under high pressure. In addition, the viscosity–temperature characteristics of thermally treated coal‐oil slurry at different temperatures are the same; both have a viscosity peak with increasing heating temperature at the same measuring temperature. Copyright © 2009 Curtin University of Technology and John Wiley & Sons, Ltd.
High‐performance liquid chromatography coupled with mass spectrometry for the quantitative analysis of vinca‐alkaloids in biological matrices: a concise survey from the literature
Authors: Damen Carola W. N. , Rosing Hilde , Schellens Jan H. M. , Beijnen Jos H.
Published: July 2009

The bioanalysis of vinca‐alkaloids has been investigated extensively. High‐performance liquid chromatography coupled to ultraviolet, fluorescence or electrochemical detection have been described. During recent years liquid chromato‐graphy coupled with mass spectrometry (LC‐MS) has become the first choice for the quantitative bioanalysis of the vinca anticancer agents. This paper reviews recent methods for the bio‐analysis of vinca‐alkaloids using LC‐MS, supplemented with our own experience. We will focus on sample pre‐treatment, chromatography and MS detection and pay attention to problems which can occur during the bioanalysis of vinca‐alkaloids. These problems encounter carry‐over and absorption effects and solutions will be provided how to circumvent these problems. Copyright © 2009 John Wiley & Sons, Ltd.
Metabonomic profiling of liver metabolites by gas chromatography–mass spectrometry and its application to characterizing hyperlipidemia
Authors: Gu Shenghua , A Jiye , Wang Guangji , Zha Weibin , Yan Bei , Zhang Ying , Ren Hongcan , Cao Bei , Liu Linsheng
Published: July 2009

The measurement of metabolites in tissues is of great importance in metabonomic research in the biomedical sciences, providing more relevant information than is available from systemic biofluids. The liver is the most important organ/tissue for most biochemical reactions, and the metabolites in the liver are of great interest to scientists. To develop an optimized extraction method and comprehensive profiling technique for liver metabolites, organic solvents of various compositions were designed using design of experiments to extract metabolites from the liver, and the metabolites were profiled by gas chromatography/time‐of‐flight mass spectrometry (GC/TOF‐MS). The resolved peak areas were processed by principle components analysis, partial least‐squares projections to latent structures, and discriminant analysis. The results suggest the highest extraction efficiency was for methanol–water, which maximized the majority of GC/TOF‐MS responses. The optimal solvent was applied to extract metabolites in liver of hyperlipidemia hamster and the control. The GC/TOF‐MS profiles of liver metabolites showed obvious differences between hyperlipidemic hamsters and controls. A comparison of liver and serum data from the same animals identified common biomarkers and presented complementary information. Our results suggest that liver metabonomics is a valuable technique and that the combined analysis of systematic biofluids and local tissues is meaningful and complementary, recovering more comprehensive metabonomic data than either analysis alone. Copyright © 2009 John Wiley & Sons, Ltd.
Synthesis and Characterization of Amino‐functionalized Meso‐ porous Silicate MCM‐41 for Removal of Toxic Metal Ions
Authors: HAMID Sepehrian , SYED Waqif‐Husain , MOHAMMAD Ghannadi‐Maragheh
Published: July 2009

Amino‐functionalized MCM‐41 has been prepared by grafting amino containing functional groups onto mesoporous silicate MCM‐41 and characterized by powder X‐ray diffraction, N2 adsorption/desorption measurement, SEM, FT‐IR, thermogravimetry and elemental analysis to confirm the ordered mesoporous structure and the functionalization of the amino groups. Sorption behavior for 18 metal ions on this sorbent has been studied and discussed.
An evaluation of two‐dimensional echocardiography in the diagnosis of hypertrophic cardiomyopathy
Authors: Ballester M. , Rees S. , Rickards A. F. , Mcdonald L.
Published: July 2009

Various anatomical and functional features of hypertrophic cardiomyopathy are analyzed in view of the data provided by two‐dimensional echocardiography. Measurement of septal thickness is crucial, and is best done by a combination of M‐Mode and 2‐D echo. Two types of systolic anterior movement of the mitral valve (SAM) are observed and are related to the degree of sub‐valvular gradient. The specificity of these patterns of SAM is analyzed. The functional anatomy of the mitral valve in relation to the presence and degree of mitral regurgitation shows that although the presence and type of SAM are important, there are other causes of mitral regurgita‐tion in hypertrophic cardiomyopathy unrelated to SAM. We emphasize the fact the 2‐D echo cannot “diagnose” hypertrophic cardiomyopathy except when cardiac hypertrophy plus SAM involving the body of the mitral valve is seen; in the remaining cases, 2‐D echo confirms/suggests the clinical diagnosis.
Ruptured papillary muscle, a complication of myocardial infarction: Clinical presentation, diagnosis, and treatment
Authors: Clements S. D. , Story W. E. , Hurst J. W. , Craver J. M. , Jones E. L.
Published: July 2009

Ruptured papillary muscle due to myocardial infarction was encountered in 14 patients during the period 1975–1983. Five of the 14 patients had a history of angina pectoris and two had a history of prior myocardial infarction. Eleven patients with myocardial infarction developed additional pain due to myocardial ischemia and/or a murmur of mitral regurgitation and pulmonary edema within a week, 3 others had a prolonged course with intermittent pain due to myocardial ischemia and breathlessness for longer periods and then deteriorated. Thirteen of our 14 patients developed a murmur and all but one had pulmonary edema on the chest x‐ray. Five patients had infarction patterns on the electrocardiogram, the remainder of the patients had only ST‐ and T‐wave changes. Echocardiograms showed fine flutter and notching of the anterior mitral leaflets and vigorous contractions of the left ventricle. Only one patient was demonstrated to have a papillary muscle tip prolapsing into the left atrium on two‐dimensional echocardiography. Twelve patients underwent surgery and 8 survived. Seven patients had singlevessel coronary disease, 4 involving the circumflex system and 3 involving the right coronary system. Four of the 7 patients with single‐vessel coronary disease survived surgery. Five patients went to surgery with the intra‐aortic balloon pump in place and only 3 survived. Three others had the pump inserted intraoperatively and 2 of these survived. Six of 9 patients who had mitral valve replacement and coronary bypass survived. Ejection fraction ranged from 40 to 79%. Surgical survival did seem to be related to the extent of papillary muscle rupture, with the best results occurring in the group with a small portion of the tip ruptured. Seven patients had a stormy clinical course and required surgery within 10 days of rupture. Four of these 7 survived. It seems reasonable to believe that these patients who often have small infarction and limited coronary disease have good potential for survival. Our approach has been to move toward surgery once the diagnosis is made to avoid the sudden deterioration that frequently occurs. The surgical mortality in this group remains in the 30 to 40% range.
Inadvertent permanent ventricular pacing from the coronary vein: An electrocardiographic, roentgenographic, and echocardiographic assessment
Authors: Shettigar U.R. , Loungani R. R. , Smith C A.
Published: July 2009

The incidence of inadvertent permanent ventricular pacing from the coronary vein is not known. In a retrospective analysis of 69 patients in whom transvenous pacemakers were implanted between 1979 and 1986, 12 patients were discovered to have right bundle‐branch block pattern to the paced complexes on electrocardiogram. In this group, three patients were considered to have inadvertent placement of pacing lead in the coronary vein by two‐dimensional echocardiographic criteria. No complications were noted in follow‐up of 2–79 months. Monitoring of surface electrocardiogram, frontal and lateral fluoroscopy, and pacing threshold and sensing parameters (during implantation of pacemaker) were found to offer no absolute protection against malplacement of the lead. Placement of the lead into the lung field via the main pulmonary artery and then withdrawing with eventual positioning into the right ventricular apex will avoid malposition into the coronary vein. Two‐dimensional echocardiography is useful for the diagnosis of pacing lead malplacement and should be performed in any patient with right bundle‐branch block pattern in the surface electrocardiogram following pacemaker implantation.
Thrombosis and anticoagulation therapy in coronary ectasia
Authors: Perlman P. E. , Ridgeway N. A.
Published: July 2009

A 41‐year‐old man presenting with unstable angina was found to have diffuse coronary ectasia with a partially occluding thrombus in the proximal left anterior descending artery. Anticoagulation with heparin followed by warfarin resulted in relief of angina and resolution of thrombosis at follow‐up angiography 3.5 months later. The patient remains well after three years. Nonatherosclerotic ectatic coronary arteries are prone to thrombosis possibly because of spasm, intimal damage, and blood current eddies. We believe that chronic warfarin therapy may be indicated in many patients with coronary ectasia.
Comparative demographic analysis in contrasting environments of Magnolia dealbata: an endangered species from Mexico
Authors: Sánchez‐Velásquez Lázaro Rafael , Pineda‐López María del Rosario
Published: July 2009

The study of population regulation and demography in natural habitats is critical for the conservation of rare and endangered species. We address the impact of cattle exclusion on the demographics of Magnolia dealbata (Magnoliaceae), an endangered species according to IUCN and Federal Mexican laws. Sixteen permanent plots were established, eight of which were enclosed to livestock, in the mountain cloud forest in Coyopolan, Mexico, which has the largest population of M. deadlbata. Censuses of the plots were undertaken annually during three annual cycles to record seed number, recruitment, mortality, and growth (defined as length and diameter at breast height). The effects of two treatments (with and without livestock exclusion) on the dynamics of M. dealbata were investigated using transition matrix models and life table response experiment (LTRE) analysis. Contrary to expectations, there was no significant effect of cattle exclusion on population growth rates (λ). Furthermore, the λ, estimated from the mean transition matrix for both treatments was greater than one. The transitions with the highest elasticity values were similar between the two treatments, while reproductive stage contributed more to differences in population growth rate and were less variable than the non‐reproductive stage. LTRE analysis showed that treatment differences had little effect on λ. Livestock exclusion appears to lead more to differences in the arrangement of the values of the transition matrix than to the rate of population growth for M. dealbata.
Metabolic phenotypes of phenylketonuria. Kinetic and molecular evaluation of the Blaskovics protein loading test
Authors: Langenbeck U. , Burgard P. , Wendel U. , Lindner M. , Zschocke J. ,   German Collaborative Study on Phenylketonuria (PKU) /Hyperphenylalaninemia (HPA)
Published: July 2009

Background: As part of the German Collaborative Study of Children Treated for Phenylketonuria (PKU), a three‐day protein loading test was applied to children at 6 months of age. This load elicits three principal types of blood phenylalanine (Phe) response, with types I and III clinically corresponding to classic PKU and mild hyperphenylalaninaemia not requiring diet (MHP), respectively. An intermediate type II, clinically corresponding to mild PKU, is characterized by early decline of blood Phe from above 1200 μmol/L down to levels between 600 and 1200 μmol/L at 72 h. Aims: Unbiased classification and kinetic and molecular characterization of the intermediate Phe response; estimation of phenotypic variability of Phe disposal. Method: A kinetic model with zero‐order protein synthesis and first‐order rate of metabolic disposal of Phe is applied to 157 tests. Results: A model of exponentially saturated activation describes the acceleration of Phe disposal from day 1 to 3 in the intermediate type of response. Eleven of 14 p.Y414C functional hemizygotes and two of three p.R261Q homozygotes manifested this kinetic type. The rate estimates of Phe metabolic disposal differ widely in patients with identical PAH genotype, yet are highly correlated with the Phe level at 72 h.
Maternal Demographic and Psychosocial Factors Associated with Low Birth Weight in Eastern Taiwan
Authors: Li Yin‐Ming , Chang Tzu‐Kuei
Published: July 2009

The relationship between birth weight and maternal sociodemographic characteristics was examined in a sample from two teaching hospitals in eastern Taiwan. Using a structured questionnaire, we conducted face‐ to‐face interviews with women at antenatal clinics between 1998 and 1999 in Hualien City. One year later, we took the outcome of pregnancy from medical records and birth certificates from the Public Health Bureau of Hualien County. Of the 1,128 single live births, 6.8% had low birth weight (LBW) using the World Health Organization cut‐off of 2,500 g. LBW was more common in teenage (< 20 years), older (> 30 years), first‐time, and unmarried mothers; those with basic/intermediate educational attainment; and residents of aboriginal districts. Teenage pregnancies were more likely than those in adults to be unplanned, and such mothers had smoking or alcohol‐drinking behavior. Prevention of teenage pregnancy is crucial to lower LBW rates in eastern Taiwan. For adult mothers, basic or intermediate educational attainment, residence in an aboriginal district, and first‐term pregnancy were significant factors associated with LBW, after adjustment for other psychosocial attributes, such as psychologic distress and poor family support. Thus, we should pay more attention when caring for pregnant women with such sociodemographic characteristics, and ensure that they have adequate prenatal care and can adopt a healthy lifestyle.
Anti‐Cancer Effect of Liriodenine on Human Lung Cancer Cells
Authors: Chang Hui‐Chiu , Chang Fang‐Rong , Wu Yang‐Chang , Lai Yung‐Hsiung
Published: July 2009

Our previous work demonstrated that liriodenine, an isoquinoline alkaloid isolated from plant species of many genera, exhibits a potent cytotoxic effect on various types of human cancer cells. In this study, we investigated the effect of liriodenine on the growth and viability of human lung cancer cells and addressed the underlying mechanism of action. We found that liriodenine suppressed proliferation of A549 human lung adenocarcinoma cells in a dose‐ and time‐dependent manner. Flow cytometric analysis showed that liriodenine blocked cell cycle progression at the G2/M phase. Induction of G2/M arrest by liriodenine was accompanied by reduction of G1 cyclin (D1) and accumulation of G2 cyclin (B1). In vitro kinase activity assay demonstrated that the enzymatic activity of the cyclin B1/cyclin‐dependent kinase 1 complex was reduced in liriodenine‐treated cells. More importantly, incubation with liriodenine led to activation of caspases and apoptosis in A549 cells. The apoptosis‐inducing activity of liriodenine was more apparent when cells were cultured under serum‐free conditions. Our results indicate that liriodenine exerts potent anti‐proliferative and apoptosis‐inducing effects on human lung cancer cells.
Choosing Calcium Channel Blockers for Pregnant Women With Paroxysmal Supraventricular Tachycardia and Preterm Labor: A Case Report
Authors: Ou Kae‐Yng , Yang Cheng‐Hui , Tsai Eing‐Mei , Lai Wen‐Ter , Su Jinu‐Wang
Published: July 2009

Preterm labor is a major clinical hazard causing both maternal and neonatal morbidity and mortality. Paroxysmal supraventricular tachycardia (PSVT) complicated by preterm labor is rare. Of the many drugs used to treat PSVT, only calcium channel blockers are tocolytics. Here, we present the case of a 29‐year‐old female admitted to our ward with previously diagnosed PSVT and preterm labor at 31 weeks' gestation of her fourth pregnancy. Calcium channel blockers were administered and her uterine contractions subsided. Afterwards, no side effects were noted and she suffered no further tachycardic attacks during her pregnancy. She successfully delivered a full‐term baby and received subsequent regular follow‐up at the outpatient clinic.
Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report
Authors: Huang Ching‐Wen , Nee Chung‐Hunk , Juan Tung‐Kung , Pan Ching‐Kuen , Ker Chen‐Guo , Juan Chung‐Chou
Published: July 2009

Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra‐abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile‐ stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.
Unstable Angina with Normal Coronary Angiography in Hyperthyroidism: A Case Report
Authors: Lin Tsung‐Hsien , Su Ho‐Ming , Voon Wen‐Chol , Lai Wen‐Ter , Sheu Sheng‐Hsiung
Published: July 2009

Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58‐year‐old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laboratory data showed that the patient suffered from hyperthyroidism, for which he was successfully treated with anti‐thyroid agents. We are reminded that typical chest pain might be the first symptom of hyperthyroidism.
Spontaneous Ureteral Stent Fragmentation: A Case Report and Review of the Literature
Authors: Kilciler Mete , Erdemir Fikret , Bedir Selahattin , Coban Hidayet , Erten Koray , Guven Oguz , Topac Hasret
Published: July 2009

Ureteral stents have been widely used for more than two decades with different indications. Due to the widespread usage of ureteral stents, the number of possible complications of ureteral stents has increased, including stent migration, encrustation, stone formation, and fragmentation. Among these complications, ureteral stent fragmentation is rare. Herein, we present a case of spontaneous ureteral stent fragmentation and review the relevant literature.
Primary Pulmonary Synovial Sarcoma: A Case Report
Authors: Chen Hsin‐Hung , Huang Wan‐Ting , Kang Wan‐Yi , Huang Hsuan‐Ying , Chai Chee‐Yin
Published: July 2009

We report a rare case of primary synovial sarcoma of the lung. A 57‐year‐old man had a well‐defined tumor in the right middle lobe seen on chest computed tomography, and underwent lobectomy. Grossly, the nonencapsulated tumor measured 4.5 cm in greatest diameter, with a solid and tan‐white cut surface. Histologically, the tumor was mainly composed of a dense proliferation of spindle cells. Immunohistochemical studies were focally positive for epithelial membrane antigen, and diffusely positive for CD99 and Bcl‐2. Cytokeratin, S‐100 protein, desmin, smooth muscle actin, and CD34 were absent. SYT‐SSX1 gene fusion transcript was detected by reverse transcription‐polymerase chain reaction, which is diagnostic of primary synovial sarcoma of the lung. We also review the literature with regard to the clinicopathologic, immunohisto‐chemical, and molecular studies of primary pulmonary synovial sarcoma.
Postmalaria Neurologic Syndrome: A Case Report
Authors: Hsieh Cheng‐Fang , Shih Pang‐Ying , Lin Ruey‐Tay
Published: July 2009

Neurologic signs and symptoms are common in acute malarial infection. However, after the parasites have been cleared from the blood and patients recover full consciousness, neurologic or psychiatric symptoms may occur or recur within 2 months after the acute illness. This phenomenon is called “postmalaria neurologic syndrome” (PMNS). We present a 50‐year‐old man who returned from the Republic of Malawi and soon developed Plasmodium falciparum malaria. Cerebral malaria, renal failure, hepatic failure, diffuse intravascular coagulation with thrombocytopenia, and upper gastrointestinal bleeding were noted during the acute stage. He was admitted to the infectious diseases ward and treated for 3 weeks. He was free from clinical general symptoms and parasites in blood smear when discharged. However, 2 weeks after discharge, he began to experience severe headache, dizziness, diplopia, mild hand tremor, unsteady gait, and easy falling. When readmitted to the neurologic ward, he presented with irritability, delirium, visual hallucination, and strange behavior. Neurologic examination was normal except for mild general weakness and evident truncal ataxia when walking. Brain magnetic resonance imaging revealed no structural lesions, and electroencephalography showed diffuse cortical dysfunction. Cerebral spinal fluid profile exhibited cytoalbuminologic dissociation. Brain single photon emission computed tomography showed diffuse cerebral parenchymal disorder. Nerve conduction studies revealed early sensory predominant polyneuropathy. The unsteadiness persisted for the initial 2 weeks of hospitalization until corticosteroid was administered. Intravenous methylprednisolone (80 mg/day) was continued for 3 days, followed by oral prednisolone (45 mg/day). His unsteadiness improved gradually after medication, and he absconded from the hospital on the 9th day of corticosteroid treatment with clear consciousness and free ambulation. The manifestation of PMNS is diverse and may present as an acute confusional state or psychosis, generalized seizure, fine tremors, cerebellar syndromes, postural hypotension, or malarial polyneuritis. Although the neurologic syndrome is primarily self‐limited in most cases, corticosteroid may be beneficial in reversing PMNS.
Corneal Flap Thickness During Laser In Situ Keratomileusis
Authors: Hsu Sheng‐Yao
Published: July 2009

To analyze the actual corneal flap thickness (FT) after flap making by MK‐2000 microkeratome during laser in situ keratomileusis (LASIK), 42 females and 20 males with myopia or myopic astigmatism were enrolled in this study. FTs were created using a microkeratome with a 130 μm head. Corneal thickness was measured by ultrasonic pachymeter. The correlations between FT and central corneal thickness (CCT), keratometric power and age were analyzed. The mean age at operation for all study subjects was 27.6 ± 4.9 years. The average FT was 133.2 ± 15.4 μm. The average CCT was 540.6 ± 30.3 μm. The average keratometric power was 43.66 ± 1.32 D. There was a positive correlation between FT and CCT and no correlation between FT and keratometric power or between FT and age. We recommend that LASIK surgeons inspect the actual FT when using microkeratome.
Easy Category for Complex Congenital Cardiac Segmental Connections
Authors: Chen Huai‐Min , Chang Po‐Chih , Chiu Chao‐Chi , Lee Meng‐Shin , Wu Jin‐Ren
Published: July 2009

To clarify the variant complex congenital cardiac defects, Van Praagh introduced a system of segmental sets to classify the majority of congenital heart diseases, but the code system entails some confusion for complete understanding. We attempted to recategorize the variant sets into four subgroups according to the connection of the atrial‐ventricular and ventricular‐arterial segments. This complexity can simply be grouped into four subgroups with regularities. From a simple table so formed, we can quickly ascertain the hemodynamics and the circulatory physiology, and therefore quickly determine the treatment protocol for variant complex hearts.
Brain Abscess in Adult Cirrhotic Patients: Two Case Reports
Authors: Chung Chia‐Li , Lieu Ann‐Shung , Chen I‐Yi , Kwan Aij‐Lie , Howng Shen‐Long
Published: July 2009

Patients who have liver cirrhosis are at increased risk of bacterial infections, such as bacteremia, meningitis, pneumonia, urinary tract infections, and spontaneous bacterial peritonitis, due to immunodeficiency associated with the severity of the cirrhosis. Although bacterial infections are frequent in cirrhotic patients, only isolated cases of brain abscess have been reported. In these cirrhotic patients, the initial presentation of brain abscess may not be fever or leukocytosis, but focal neurologic deficits. In addition, for consideration of blood‐brain barrier penetration, the antibiotic choice postoperatively is also quite different from other infections outside the central nervous system. We will discuss two cases of brain abscess in cirrhotic patients with special emphasis on the clinical presentation, magnetic resonance spectroscopic findings, organism encountered, therapeutic strategy, and prognosis.
Painless Aortic Dissection with Initial Symptom of Right Upper Extremity Weakness: A Case Report
Authors: Liu Kuan‐Ting , Chan Hon‐Man , Lin Tzeng‐Jih
Published: July 2009

Thoracic aortic dissection is a dangerous disease. It usually presents as severe chest or back pain. Symptoms resulting from aortic branch involvement may also be involved. Sometimes, it presents with atypical symptoms. Here, we report a patient who came to the emergency department (ED) because of acute onset of right upper limb weakness and numbness. Brain computed tomography (CT) was performed initially because cerebral vascular disease was suspected. Subsequently, angiography was performed as artery occlusion of the limb was found. The patient suddenly collapsed in the ED. Stanford type A acute aortic dissection was found by chest CT.
Leukemoid Reaction Resulting from Granulocyte Colony‐Stimulating Factor Producing Urothelial Carcinoma of the Renal Pelvis
Authors: Lin Han‐Ching , Chai Chee‐Yin , Su Yue‐Chiu , Wu Wen‐Jeng , Huang Chun‐Hsiung
Published: July 2009

Leukemoid reaction is defined as a reactive leukocytosis in response to infection, inflammation, or therapeutic agents such as growth factors and malignancy. We report a case of leukemoid reaction resulting from granulocyte colony‐stimulating factor producing urothelial carcinoma of the renal pelvis as evidenced on immunohistochemical analysis.
Skin Grafting on the Gastric Wall Following Gastric Pull‐Up Reconstruction: A Case Report
Authors: Chang Kao‐Ping , Lai Chung‐Sheng , Lin Sin‐Daw
Published: July 2009

A simple, rapid, reliable technique to close an anterior neck defect is presented. This technique involves skin grafting directly onto the de‐serosalized stomach wall following gastric pull‐up reconstruction for a hypopharyngeal cancer.
Deliberate Self‐harm and Relationship to Alcohol Use at an Emergency Department In Eastern Taiwan
Authors: Li Yin‐Ming
Published: July 2009

Suicide incidence has increased dramatically in recent years in Taiwan. In 2004, 3,468 lives were lost due to suicide and the total mortality was 15.3/100,000. It is well known that alcohol drinking raises the risk of deliberate self‐harm (DSH), especially among psychologically distressed subjects. This study investigated the characteristics of DSH patients and their association with acute alcohol drinking. Since 2004, an injury surveillance system has been set up in a medical center, collecting the minimal information recommended by the World Health Organization. Attending nurses collected information and assessed each injured patient as to whether he/she smelled of alcohol. Medical records of DSH injuries were reviewed for confirmation of any prior DSH and any known mental disorder was checked. Of 11,837 injuries, 123 (1.0%) were DSH. Those who were first‐time DSH patients (n = 115) were studied. About half of the patients were female and 83.5% were aged between 20 and 54 years. More than half of the DSH incidents occurred at home and 80.1% cases were stabbing or cutting injuries. Injuries were defined as alcohol‐related based on the report of “alcohol odor” or “intoxicated” by the nurse or a positive blood alcohol test. In total, 55 (47.8%) DSH injuries were found to be alcohol‐related. The proportion of alcohol‐related injuries was highest (60.0%) in the age range 45–64 years. Of those patients who tested positive for alcohol (n = 21), the mean blood alcohol concentration was 211.2 mg/dL (standard deviation, 79.1). Most subjects were discharged from the emergency department (75.7%). Only 20 DSH patients (17.1%) went on to receive a psychiatric consultation. DSH is not uncommon in eastern Taiwan. Half of our cases were associated with alcohol use. Males had the same risk of injuring themselves and were more likely than females to adopt “severe” methods to injure themselves. Further studies into the causes of DSH or parasuicide attempts are needed. Psychiatric consultation is essential in caring for DSH patients and in preventing suicide. A DSH injury also offers an opportunity to recognize alcohol problems.
Management of Tracheal Deformity During Intubation: A Case Report
Authors: Wu Sheng‐Hua , Chen Kuang‐I , Lu I‐Chen , Huang Shu‐Hung , Chu Kuong‐Shing
Published: July 2009

Failure or difficulty in intubating the trachea can be either due to inability to visualize the glottis or some pathology at the level of or below the cords. This report describes a case of difficult intubation suspected of being related to neck scarring from previous surgery. Computed tomography (CT) was used to evaluate the patient's airway and revealed upper tracheal angulation. We describe a method to secure the airway in this patient with a two‐person technique by rotating an oral endotracheal tube 180° counterclockwise to adjust to the curvature of the trachea. Problems with intubation should be anticipated in patients with scarring of the neck, and equipment for aiding intubation should be on hand. Furthermore, we found that CT contributed to the assessment of the difficulty of intubation in this kind of patient.
Congenital Left Circumflex Coronary Artery Atresia Detected by 64‐Slice Computed Tomography: A Case Report
Authors: Liu Chen‐Yuan , Juan Chi‐Wen , Pai Yu‐Lin , Tseng Yung‐Zu
Published: July 2009

A variety of coronary artery disorders, including intramyocardial coronary segments and coronary artery anomalies, can result in sudden cardiac death, especially in young adults. The detection of structural coronary artery abnormalities is important in the management of patients at risk of sudden cardiac death. Coronary artery anomalies occur in about 1% of the population. Congenital absence of left circumflex coronary artery (LCX) is a very rare vascular anomaly, and few cases have been reported in the literature, with a frequency of only 0.003% in all patients who underwent coronary angiography. Although coronary catheterization is the gold standard for the evaluation of coronary arterial patency disease, noninvasive computed tomography (CT) is considered the diagnostic method of choice for the detection and evaluation of coronary artery anomaly. Herein, we report the case of a 17‐year‐old girl who presented with exertional dyspnea and chest pain and who was studied at our emergency department with the final diagnosis of LCX atresia detected by 64‐slice CT. She may be the first case of congenital LCX atresia proved by multislice CT.
The Psychosocial Consequences for Primiparas and Multiparas
Authors: Hung Chich‐Hsiu
Published: July 2009

The purpose of the study was to differentiate among various postpartum stressors and to compare women's postpartum stress, social support, and mental health status in relation to parity differences. A non‐experimental quantitative study with cross‐sectional design was carried out. A total of 435 primiparas and 426 multiparas from clinics and hospitals in southern Taiwan were recruited for the study. The Hung Postpartum Stress Scale, the Social Support Scale, and the 12‐item Chinese Health Questionnaire were used to compare the postpartum stress, social support, and mental health status of primiparous and multiparous women. Compared with multiparas, the mean scores of primiparas were higher for postpartum stress, concerns about negative body changes, concerns about maternal role attainment, as well as for measures of social support, family support, and friend support. However, multiparas had higher scores than primiparas regarding concerns about lack of social support. The mental health status of the two groups did not differ significantly by parity. The primiparous women and multiparous women experienced unique postpartum stressors. The results suggest that it is important to identify specific postpartum stressors for primiparas and multiparas when providing supportive interventions. Specifically tailored nursing interventions based on differences in parity may help reduce postpartum stress and help prevent the development of more severe mental health problems among postpartum women.
On the zero set of G-equivariant maps
Authors: BUONO P-L. , HELMER M. , LAMB J. S. W.
Published: July 2009

Let G be a finite group acting on vector spaces V and W and consider a smooth G-equivariant mapping f: V → W. This paper addresses the question of the zero set of f near a zero x with isotropy subgroup G. It is known from results of Bierstone and Field on G-transversality theory that the zero set in a neighbourhood of x is a stratified set. The purpose of this paper is to partially determine the structure of the stratified set near x using only information from the representations V and W. We define an index s(Σ) for isotropy subgroups Σ of G which is the difference of the dimension of the fixed point subspace of Σ in V and W. Our main result states that if V contains a subspace G-isomorphic to W, then for every maximal isotropy subgroup Σ satisfying s(Σ) > s(G), the zero set of f near x contains a smooth manifold of zeros with isotropy subgroup Σ of dimension s(Σ). We also present partial results in the case of group representations V and W which do not satisfy the conditions of our main theorem. The paper contains many examples and raises several questions concerning the computation of zero sets of equivariant maps. These results have application to the bifurcation theory of G-reversible equivariant vector fields.
Bending of the Bolivian orocline and growth of the central Andean plateau: Paleomagnetic and structural constraints from the Eastern Cordillera (22–24°S, NW Argentina)
Authors: Maffione Marco , Speranza Fabio , Faccenna Claudio
Published: July 2009

We report new paleomagnetic and structural data from late Cretaceous to Mio‐Pliocene continental sandy/silty sedimentary rocks from the Eastern Cordillera (central Andes). Here, N–S to NNE–SSW ridges hosting Paleozoic basement and upper Cretaceous continental red beds overthrust thick adjacent Cenozoic basins. Pretilting (and likely primary) reliable directions gathered at 15 sites document 45.9° ± 9.4, 30.1° ± 23.9°, and 15.4° ± 19.3° clockwise (CW) rotations with respect to South America occurring after the late Cretaceous (∼80 Ma), Oligo‐Miocene (20–30 Ma), and late Miocene‐Pliocene (5–10 Ma), respectively. Conversely, four upper Cretaceous sites from the walls of a N–S left‐lateral strike‐slip fault (Yavi–Abra Pampa fault) yield a null rotation. About 20 km to the west, flower structures and subvertical syntectonic strata dated at 14.26 ± 0.19 Ma are exposed along the subparallel Abra Moreta left‐lateral strike‐slip fault. Relying on data from the literature on the period when deformation began, we suggest that since Eo‐Oligocene times (30–40 Ma) the Eastern Cordillera has undergone a regional CW rotation of 40°–50°, synchronous with crustal shortening and large‐scale bending of the Andean salient. The CW rotation is possibly still active today, as documented by regional GPS data from the Andes. Since ∼15 Ma ago, the activity of N–S left‐lateral strike‐slip faults induced counterclockwise rotations along the fault zone, locally annulling the regional CW rotation. In agreement with a previous model, we speculate that mid‐Miocene strike‐slip activity accommodated the progressive southward spreading of the Altiplano‐Puna high‐altitude plateau, laterally migrating from the overthickened crustal region of the salient apex.
Effect of electric potential structures on Jovian S‐burst morphology
Authors: Hess S. , Mottez F. , Zarka P.
Published: July 2009

Jupiter's radio emissions are dominated in intensity by decametric radio emissions due to the Io‐Jupiter interaction. A significant part of these emissions consists of short radio bursts (so‐called S‐bursts) drifting in time and frequency. Previous analyses suggest that these emissions are cyclotron‐maser emissions in the flux tube connecting Io or Io's wake to Jupiter. We present simulations of these electrons under the assumption of acceleration by Alfvén waves in the Io flux tube. Near Jupiter, a loss cone and a ring distribution appear in the magnetically mirrored electron population, which can then amplify extraordinary (X) mode radio waves. The X‐mode growth rate is computed, which allows us to build theoretical dynamic spectra of the resulting Jovian radio emissions. Additional potential structures are assumed in the Jovian auroral region. We reconstruct their impact on the morphology of the emission. They match some of the time‐frequency patterns observed with Jovian S‐bursts. This provides the first evidence of bipolar electrostatic structures in the Jovian auroral region.
Magnetization field-dependences and the “exchange bias” in ferro/antiferromagnetic systems. I. Model of a bilayer ferromagnetic
Authors: Grechnev A. G. , Kovalev A. S. , Pankratova M. L.
Published: July 2009

A qualitative model explanation of the experimentally obtained field dependences of the magnetization in ferro- and antiferromagnetic media in contact with one another is proposed. In this model a thin ferromagnetic (FM) film on an antiferromagnetic (AFM) substrate consists of only two ferromagnetic layers. This is the simplest model which admits a spatially nonuniform FM state. In this exactly solvable model it shown that a range of fields exists where a stable collinear (canted) structure of the FM subsystem obtains. This structure corresponds to inclined sections of the field dependence M(H) of the magnetization which are not associated with the kinetics of the magnetization reversal process. In the model proposed, for systems with large easy-plane anisotropy the magnetization reversal process with “exchange bias” taken into account is strictly symmetric as a function of the field provided that the additional weak FM anisotropy in the easy plane is neglected. When this anisotropy in the easy plane is taken into account hysteresis appears in the magnetization curve and the field dependence M(H) becomes asymmetric.