bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanism for the development of pyothorax‐associated lymphoma
Authors: Kanno Hiruyuki , Aozasa Katsuyuki
Published: December 2008

Malignant lymphomas frequently develop in the pleural cavity of patients with long‐standing pyothorax. Thus, the term pyothorax‐associated lymphoma (PAL) has been proposed for this type of tumor. Most PAL are of the type diffuse lymphoma of B cell and contain Epstein‐Barr virus (EBV) DNA. This article reviews the mechanism for the development of PAL. The possible contribution of EBV infection, inflammatory cytokines and other genetic lesions, including the p53 gene, towards the growth advantage of neoplastic cells is described. Although the presence of EBV is focused in PAL cells, the contribution of EBV‐mediated growth promotion in PAL Is limited. Another important Characteristic of PAL is that the virus antigen‐positive lymphoma develops in patients with pyothorax, in whom the systemic immunodeficiency is unlikely to be present. Therefore, in the course of the development of PAL, the mechanism for the evading host immune survelliance must be obvious. In this context, the production of an immunosuppressive cytokine from PAL cells, human histocompatibility leukocyte antigen class 1 alleles of patients with PAL, and the mutations of cytotoxic T lymphocyte epitopes in an EBV‐latent antigen are described. These mechanisms could be involved in the development of PAL, an EBV‐positive lymphoma developing in an immunocompetent host, and also shed light on the tumorigenesis of other EBV‐positive neoplasms and on the lymphomagenesis of other inflammatory lesions.
Expression of cytotoxic molecule TIA‐1 in malignant lymphomas mimicking fulminant hepatitis
Authors: Sadahira Yoshito , Ohmoto Kenji , Yamamoto Shinichiroh , Nishihara Hiroji , Wads Hideho , Yawata Yoshihito , Manabe Toshiaki
Published: December 2008

Involvement of malignant lymphoma in the liver inducing fuiminant hepatic failure has rarely been reported. There fore, a close association between some lymphoma types with severe liver damage and the mechanism underlying the liver damage is intriguing. Three malignant lymphoma cases, which were clinically diagnosed as fulminant hepatitis, were collected from the autopsy records of Kawasaki Medical School (Kurashiki, Japan). All three cases were characterized by the presence of hepatosplenomegaly without superficial lymph node swelling, high elevation of transaminase and lactate dehydrogenase (LDH; especially LDH‐2), and a quite aggressive clinical course. Immuno‐histochemlcally, the tumor cells in all three cases were positive for T cell intracellular antlgen VIA‐l), which is a cytolytic protein in cytotoxic T and natural klller (NK) cells. The lymphomas were CD8+perlpheral T cell lymphoma (case l), CD56+T/NK cell lymphoma (case 2), and T cell lymphoma in a patient with mosquito hypersensitivity (case 3). Epstein‐Barr virus infection was demonstrated on the tumor cells of cases 2 and 3 using anin situhybridization method and those cases showed high titers of serum interferon‐γ and Fas. Frequent apoptosis of liver cells, where the lymphoma cells had infiltrated, was revealed by a terminal deoxyribosyl transferase‐mediated deoxyuridine nick end‐labeling (TUNEL) method. The findings in this study suggest that fulminant hepatic injury is closely associated with cytotoxic molecule TIA‐1 expression of the lymphoma cells and that some specific mechanism may be involved In liver damage.
The 5D4 antibody (anti‐cyclin D1/D2) related antigen: Cytoplasmic staining is correlated to the progression of gastric cancer
Authors: Yasogawa Yohei , Takano Yasuo , Okayasu Isao , Kakita Akira
Published: December 2008

In order to clarify the relationship between cyclin D1 and 02 (CD1/CD2) overexpression and progression, 191 gastric cancer cases (81 early and 110 advanced cancers) were investigated using the 504 monoclonal antibody for both CD1/CD2 in immunohistochemistry. 5D4 immunoreactlvity was noted in 68 (35.6%) cases, staining being restricted to the nucleus In 27 (14.1%) cases, the cytoplasm in 34 (17.8%) cases, and its presence in both the nucleus and cytoplasm in seven (3.7%). Cases demonstrating cytoplasmic positiv‐ity, including both positive cases, were significantly more frequent in advanced cancers (P = 0.010), those having lymph node metastasis (P = 0.004) and cases showing cancer invasion of vessels (P = 0.00S), although no relatlon to histological malignant grading was apparent. In contrast, cases of nuclear positivity behaved no differently from 5D4‐negative cases. Statistics showed a trend where survival in patients was worse in the cytoplasm‐positive cases than the cytoplasm‐negative group. However, multivariate analysis revealed no Independent statlstical significance in the cytoplasmic positivity of prognosis. Additional studies using DCS‐6 antlbody for CD1 and 617 antibody for CD2, suggest that nuclear staining of 5D4 indicates the presence of CD1 but cytoplasmic staining is derived from an antigen that is related to CD2. In conclusion, the present results indicate that the accumulation of CD2 in the cytoplasm may play some role In the progression of gastric cancers but not prognosis; however, CD1 overexpression is not linked to either.
Small cell (oat cell) carcinoma of the breast
Authors: Fukunaga Masaharo , Ushigome Shinichiro
Published: December 2008

A case of small cell (oat cell) carcinoma, which represents both the most dlstlnctlve and the least common type of mast carcinoma wtth neuroendocrine dlfterentiation and usually shows the most aggressive behavior, is described. Radlcal mastectomy was performed on a Wyearold female for a 10 cm tumor located in the outer part of the right breast with cutaneous ulceration Microscoplcally, the tumor predominantly consisted of a diffuse proliteration of small, round to ovoid cells with hyperchromatlc nuclei and ill‐defined, scant cytoplasm that was reminiscent of oat cell carclnoma of the lung. There were foci of invasive ductal carcinoma and ductal carcinoma in situ. Small cell carcinoma areas constituted approximately 90% of the neoplasm. The patlent had axlllary lymph node metastasis. The small tumor cells were argyrophlllc and positive for CAM5.2, carclnoembryonic antigen, neuron‐specific enolase, Leu‐7, chromogranln A and synaptophysin. Flow cytometric analysis showed an aneuplold DNA content. The patient was alive and well without disease 4 years after surgery. Small cell carcinomas of the breast may exhibkt a spectrum of malignancy that is comparable to similar tumors at better known primary sites.
Oxyphilic cell variant of endometrioid adenocarcinoma
Authors: Fukuoka Keiko , Hirokawa Mitsuyoshi , Shimizu Michio , Fujiwara Keiichi , Kohno Ichiro , Shintaku Masayukl , Manabe Toshiaki
Published: December 2008

A case of oxyphllk cell variant of endometrlold adenocarclnorna is presented. To the best of our knowledge, there have been only three such cases reported in the English literature. The patient was a 35‐yearold Japanese female (gravida 0, para 0). She was sllghtly obese with profuse vaginal bleeding. Histologlcal examlnation of the resected uterus revealed endometrlold adenocarcinoma with an exclusive oxyphllic cell component. There was no evidence of myornetrial Invasion nor lymph node metastases. Reported cases of oxyphilic cell varlant of endometrioid admocamlnoma, lncludlng the present case, were stages 0–1 and grades 1–2. Although further study is necessary to evaluate this variant, oxyphllk cell variant seems to be an early stage of ademcarcinoma and should be differentiated from eosinophllk mgtaplasia and other types of adenocarcinoma of the endometrium.
Neural representations of auditory input accommodate to the context in a dynamically changing acoustic environment
Authors: Rahne Torsten , Sussman Elyse
Published: December 2008

The auditory scene is dynamic, changing from 1 min to the next as sound sources enter and leave our space. How does the brain resolve the problem of maintaining neural representations of the distinct yet changing sound sources? We used an auditory streaming paradigm to test the dynamics of multiple sound source representation, when switching between integrated and segregated sound streams. The mismatch negativity (MMN) component of event‐related potentials was used as index of change detection to observe stimulus‐driven modulation of the ongoing sound organization. Probe tones were presented randomly within ambiguously organized sound sequences to reveal whether the neurophysiological representation of the sounds was integrated (no MMN) or segregated (MMN). The pattern of results demonstrated context‐dependent responses to a single tone that was modulated in dynamic fashion as the auditory environment rapidly changed from integrated to segregated sounds. This suggests a rapid form of auditory plasticity in which the longer‐term sound context influences the current state of neural activity when it is ambiguous. These results demonstrate stimulus‐driven modulation of neural activity that accommodates to the dynamically changing acoustic environment.
The H‐current secures action potential transmission at high frequencies in rat cerebellar parallel fibers
Authors: Baginskas Armantas , Palani Damodharan , Chiu Kenneth , Raastad Morten
Published: December 2008

Most axons in the mammalian brain are unmyelinated and thin with pre‐synaptic specializations (boutons) along their entire paths. The parallel fibers in the cerebellum are examples of such axons. Unlike most thin axons they have only one branch point. The granule cell soma, where they originate, can fire bursts of action potentials with spike intervals of about 2 ms. An important question is whether the axons are able to propagate spikes with similarly short intervals. By using extracellular single‐unit and population‐recording methods we showed that parallel fibers faithfully conduct spikes at high frequencies over long distances. However, when adding 20 μm ZD7288 or 1 mm Cs+, or reducing the temperature from 35 to 24°C, the action potentials often failed even when successfully initiated. Ba2+(1 mm), which blocks Kir channels, did not reproduce these effects. The conduction velocity was reduced by ZD7288 but not by Ba2+. This suggests that the parallel fibers have an H‐current that is active at rest and that is important for their frequency‐following properties. Interestingly, failures occurred only when the action potential had to traverse the axonal branch point, suggesting that the branch point is the weakest point in these axons.
Switching of the transmitters that mediate hindbrain correlated activity in the chick embryo
Authors: Mochida Hiraku , Sato Katsushige , Momose‐Sato Yoko
Published: December 2008

Widely propagating correlated neuronal activity is a hallmark of the developing nervous system. The activity is usually mediated by multiple transmitters, and the contribution of gap junctions has also been suggested in several systems. In some structures, such as the retina and spinal cord, it has been shown that the dominant transmitter mediating the correlated wave switches from acetylcholine to glutamate during development, although the functional significance of this phenomenon has not been clarified. An important question is whether such a transmitter switch occurs in other systems, especially in the brain. In the present study, we demonstrate that the major transmitter mediating correlated wave activity in the embryonic chick hindbrain changes from acetylcholine/γ‐aminobutyric acid (GABA)/glycine to glutamate/GABA as development proceeds. The results show for the first time that the dominant transmitter switches from acetylcholine to glutamate in a region other than the retina and spinal cord. This finding sheds more light on the role of nicotinic acetylcholine receptors in the generation of correlated wave activity, which is considered to regulate the development of the nervous system.
Functional cross‐kingdom conservation of mammalian and moss (Physcomitrella patens) transcription, translation and secretion machineries
Authors: Gitzinger Marc , Parsons Juliana , Reski Ralf , Fussenegger Martin
Published: December 2008

Plants and mammals are separated by a huge evolutionary distance. Consequently, biotechnology and genetics have traditionally been divided into ‘green’ and ‘red’. Here, we provide comprehensive evidence that key components of the mammalian transcription, translation and secretion machineries are functional in the model plant Physcomitrella patens. Cross‐kingdom compatibility of different expression modalities originally designed for mammalian cells, such as native and synthetic promoters and polyadenylation sites, viral and cellular internal ribosome entry sites, secretion signal peptides and secreted product proteins, and synthetic transactivators and transrepressors, was established. This mammalian expression portfolio enabled constitutive, conditional and autoregulated expression of different product genes in a multicistronic expression format, optionally adjusted by various trigger molecules, such as butyrolactones, macrolide antibiotics and ethanol. Capitalizing on a cross‐kingdom‐compatible expression platform, we pioneered a prototype biopharmaceutical manufacturing scenario using microencapsulated transgenic P. patens protoplasts cultivated in a Wave Bioreactor. Vascular endothelial growth factor 121 (VEGF121) titres matched those typically achieved by standard protonema populations grown in stirred‐tank bioreactors. The full compatibility of mammalian expression systems in P. patens further promotes the use of moss as a cost‐effective alternative for the manufacture of complex biopharmaceuticals, and as a valuable host system to advance synthetic biology in plants.
Future of Economic Growth for South Korea*
Authors: Kim Byung Woo
Published: December 2008

More than 80 percent of US growth between 1950 and 1993 can be attributed to transition dynamics (increases in R&D intensity and educational attainment), with less than 20 percent of growth deriving from population growth. Similarly, growth accounting shows that 80 percent of economic growth in Korea can be attributed to transition dynamics. However, the specific factors that have moved Korea far from its steady state are significantly different from the factors that have done so for the USA. In addition to the growth rates of the two countries, we also analyzed the (steady‐state) level of output per worker to determine where the Korean economy is headed relative to the USA. In 1960, Korea was characterized as poor (0.111) relative to its own steady state (0.765), and incomes were at 11.1 percent of those in the USA. Since then, however, Korea has been growing more rapidly than the USA. In our analysis, we also consider the extreme case where total factor productivity levels converge completely. Interestingly, in this case, the USA and Korea exhibit unconditional convergence similar to what is generally observed in the OECD. As the economy approaches the steady‐state income level, however, the growth rate of output per capita will decline.
Does Allocation of Public Spending Matter in Poverty Reduction? Evidence from Thailand*
Authors: Fan Shenggen , Yu Bingxin , Jitsuchon Somchai
Published: December 2008

The present paper uses a panel dataset to estimate the marginal returns to different types of government expenditure on agricultural growth and rural poverty reduction in Thailand. The study finds that additional government spending on agricultural research provides the largest return in terms of agricultural productivity and has the second largest impact on rural poverty reduction. Increased investment in rural electrification has the largest poverty reduction impact, mainly through improved nonfarm employment. Rural education has the third largest impact on both productivity and poverty reduction. Irrigation has a positive impact on agricultural productivity, but regional variation is considerable. Government spending on rural roads has no significant impact on agricultural productivity and its poverty reduction impact ranks last among all investment alternatives considered. Additional investment in the Northeast Region has a greater impact on poverty reduction than in other regions.
LIFE‐CENTERED ETHICS, AND THE HUMAN FUTURE IN SPACE
Authors: MAUTNER MICHAEL N.
Published: December 2008

In the future, human destiny may depend on our ethics. In particular, biotechnology and expansion in space can transform life, raising profound questions. Guidance may be found in Life‐centered ethics, as biotic ethics that value the basic patterns of organic gene/protein life, and as panbiotic ethics that always seek to expand life. These life‐centered principles can be based on scientific insights into the unique place of life in nature, and the biological unity of all life. Belonging to life then implies a human purpose: to safeguard and propagate life. Expansion in space will advance this purpose but will also raise basic questions. Should we expand all life or only intelligent life? Should we aim to create populations of trillions? Should we seed other solar systems? How far can we change but still preserve the human species, and life itself? The future of all life may be in our hands, and it can depend on our guiding ethics whether life will fulfil its full potentials. Given such profound powers, life‐centered ethics can best secure future generations. Our descendants may then understand nature more deeply, and seek to extend life indefinitely. In that future, our human existence can find a cosmic purpose.
A Platform for Visualizing and Experimenting with Measures of Semantic Similarity in Ontologies and Concept Maps
Authors: Gahegan Mark , Agrawal Ritesh , Jaiswal Anuj , Luo Junyan , Soon Kean‐Huat
Published: December 2008

This article describes research in the ongoing search for better semantic similarity tools: such methods are important when attempting to reconcile or integrate knowledge, or knowledge‐related resources such as ontologies and database schemas. We describe an extensible, open platform for experimenting with different measures of similarity for ontologies and concept maps. The platform is based around three different types of similarity, that we ground in cognitive principles and provide a taxonomy and structure by which new similarity methods can be integrated and used. The platform supports a variety of specific similarity methods, to which researchers can add others of their own. It also provides flexible ways to combine the results from multiple methods, and some graphic tools for visualizing and communicating multi‐part similarity scores. Details of the system, which forms part of the ConceptVista open codebase, are described, along with associated details of the interfaces by which users can add new methods, choose which methods are used and select how multiple similarity scores are aggregated. We offer this as a community resource, since many similarity methods have been proposed but there is still much confusion about which one(s) might work well for different geographical problems; hence a test environment that all can access and extend would seem to be of practical use. We also provide some examples of the platform in use.
Structural Alignment Methods with Applications to Geospatial Ontologies
Authors: Cruz Isabel F , Sunna William
Published: December 2008

We consider the problem of enabling interoperability and information sharing among geospatial applications that use ontologies to describe their concepts and the relationships among them. We present two fully automatic alignment methods that use the graph structures of a pair of ontologies to establish their alignment, that is, the semantic correspondences between their concepts. We have tested our methods on geospatial ontologies pertaining to wetlands and four other pairs that belong to a repository that has been used in the Ontology Alignment Evaluation Initiative (OAEI). Using these ontologies, we have compared the effectiveness (precision and recall) of our methods against the Similarity Flooding Algorithm that was proposed by others and show that for each of the tested ontologies one of our methods is at least as effective as their method. We have tuned the performance of our methods by introducing a greedy approach that reduces the number of concepts that get compared. This approach reduces runtime by approximately 30% with a minor compromise to the effectiveness of the results. To further validate our approach, we participated in the OAEI competition to align a pair of ontologies, each with a few thousand concepts.
The Unfolding Trends and Consequences of Expanding Higher Education in Ethiopia: Massive Universities, Massive Challenges
Authors: Tessema Kedir Assefa
Published: December 2008

There have been significant increases in the number of universities and student enrollments in the last fifteen years in Ethiopia. The numerical gains have brought about improved access to higher education for students. The expansion has also diversified fields of study and opened opportunities to pursue higher degrees to a significant number of students. Furthermore, the opportunity created for the university staff includes increased university job security, positions in the university leadership and scholarships for PhD degrees. On the other hand, the downside effects of the massification have worsened the conditions of university teaching staff. Among others, it has resulted in increasing work load and extended work schedules for academic staff. A managerialist culture has evolved that measures teaching against instrumental outcomes. There is a sense of deprofessionalisation and deskilling among staff manifested in practices that are disconnections from professional knowledge, skills and attitudes. As staff are increasingly over‐engaged, by taking more weekly class hours and managerial responsibilities, less ‘down time’ is available to keeping with developments in their fields of specialisation and practice
Towards ‘Lisbon objectives’: Economic Determinants of Participation Rates in University Education: An empirical analysis in 14 European Countries
Authors: Agasisti Tommaso
Published: December 2008

Participation rates in higher education are an important indicator to pursue one of the main European policy objectives, which is to increase the proportion of population attending higher education. A model used to detect the determinants of participation rates is proposed in this paper, and it is empirically tested for 14 European countries through a five‐year panel regression. The model considers the potential explanatory factors as follows: the country's socio‐economic conditions, the human capital stock, the organisation of the higher education sector, the higher education expenditure.

The results show the important role of financial resources devoted to higher education; but also, as expected, the influence of other factors. More specifically, there is a role for the variables related to higher education organisation and structure, also confirming that higher entry rates are influenced both by an improvement in public investments in the sector and by organisational elements. These findings are relevant for policy purposes, since they suggest some possible solutions for improving participation rates. Although future research would need to explore the impact of income inequality, the overall level of spending is the key element that influences entry rates. Therefore, in periods of public finance pressure, the best way to resolve this problem could be to improve private resources.
Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre‐eclampsia
Authors: Khalil AA , Cooper DJ , Harrington KF
Published: December 2008

Objective  To investigate whether first‐trimester arterial pulse wave analysis (PWA) can predict pre‐eclampsia.

Design  This was a prospective screening study.

Setting  The Homerton University Hospital, a London teaching hospital.

Population  Two hundred and ten low‐risk women with a singleton pregnancy were analysed.

Methods  Radial artery pulse waveforms were measured between the 11+0 and 13+6 weeks of gestation and the aortic waveform derived by applying a generalised transfer function. Augmentation pressure (AP) and augmentation index at heart rate of 75 beats per minute (AIx‐75), measures of arterial stiffness, were calculated. The multiple of the gestation‐specific median in controls for AP and AIx‐75 were calculated. Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve.

Main outcome measures  Prediction of pre‐eclampsia by AIx‐75.

Results  Fourteen (6.7%) women developed pre‐eclampsia, and 196 remained normotensive. Eight of the 14 women developed pre‐eclampsia before 34 weeks of gestation (early‐onset pre‐eclampsia). For a false‐positive rate of 11%, AIx‐75 had a detection rate of 79% for all cases of pre‐eclampsia and 88% for early‐onset pre‐eclampsia.

Conclusion  First‐trimester arterial PWA can play a significant role in understanding the pathophysiology of pre‐eclampsia and may play a role in early screening.
Estimation of population‐based incidence of pregnancy‐related illness and mortality (PRIAM) in two districts in West Java, Indonesia
Authors: Ronsmans C , Scott S , Adisasmita A , Deviany P , Nandiaty F
Published: December 2008

Objective  We introduce a new and untested approach for the measurement of life‐threatening maternal morbidity in populations where not all women give birth in a health facility. By defining complications at the very extreme end of the severity spectrum, we postulate that its count in hospitals can be used to represent the incidence in the general population.

Design  We counted all cases of life‐threatening obstetric morbidity in hospitals and all maternal deaths in the population. Using these data, we describe the incidence of life‐threatening morbidity in the total population, examine its variation across geographical areas and investigate its relationship with maternal mortality.

Setting  Serang and Pandeglang district in West Java, Indonesia.

Population or sample  All women residing in the two districts.

Methods  Cross‐sectional study of maternal morbidity and mortality.

Main outcome measures  Pregnancy‐related illness and mortality (PRIAM), consisting of life‐threatening maternal morbidity (defined using the concepts of near miss and met need for life‐saving surgery) and maternal mortality.

Results  The incidence of maternal mortality and life‐threatening complications at the population level was 421 and 1416 per 100 000 births, respectively, resulting in an overall ratio of PRIAM of 1837 per 100 000. The overall incidence of PRIAM was much lower in rural than in urban areas (1529 and 2880 per 100 000, respectively, P < 0.001), and it was lowest in rural Serang (1304 per 100 000).

Conclusions  The approach tested in this study—relying on conditions that are ‘absolutely’ life‐threatening such that their count in hospitals can be used to represent the incidence in the general population—is promising but needs further testing in populations with varied disease epidemiology and access to care. Continued investments in hospital‐based audits of life‐threatening morbidity may ultimately improve the quality and reliability of information on obstetric complications and facilitate the development of rigorous and standard criteria for the definition of life‐threatening morbidity.
The effect of recurrent miscarriage and infertility on the risk of pre‐eclampsia
Authors: Trogstad L , Magnus P , Moffett A , Stoltenberg C
Published: December 2008

Objective  Pre‐eclampsia, recurrent miscarriage and infertility may all partly be caused by unsuccessful placentation early in pregnancy. If so, one will expect these disorders to be associated in population studies. The aim of the present investigation was to estimate the risk of pre‐eclampsia in women with recurrent miscarriage and infertility.

Design  Cohort study.

Setting  The Norwegian Mother and Child Cohort Study (MoBa), a large population‐based pregnancy cohort.

Sample  The sample consisted of 20 846 singleton pregnancies to nulliparous women participating in the MoBa, 1999–2005.

Methods  Information on miscarriage, infertility and potential confounders was self‐reported in postal questionnaires, whereas the diagnosis of pre‐eclampsia was retrieved from the Medical Birth Registry of Norway. Risk estimation and confounder control was performed with multiple logistic regression.

Main outcome measures  Pre‐eclampsia according to history of miscarriage and infertility.

Results  An increased risk of pre‐eclampsia, although not statistically significant, was found for women with recurrent miscarriages (adjusted OR 1.51, 95% CI 0.80–2.83). Women who had ever been treated for infertility also had increased risk (adjusted OR 1.29, 95% CI 1.05–1.60). When these two risk factors were combined, the adjusted odds ratio for pre‐eclampsia was 2.40 (95% CI 1.11–5.18).

Conclusions  The study supports the hypothesis that infertility, recurrent miscarriage and pre‐eclampsia share elements of the same aetiological factors.
An overview of proteomic and metabolomic technologies and their application to pregnancy research
Authors: Horgan RP , Clancy OH , Myers JE , Baker PN
Published: December 2008

‘Omic’ technologies represent a strategy towards high‐throughput, simultaneous analysis of thousands of biological molecules. Their development has been accelerated in the post‐genomic era since these molecules represent the interaction of genes and environment or the ‘functional genome’. Omic domains are of particular interest in the search for predictive disease biomarkers and have additional relevance in understanding pathophysiology and the development of molecularly targeted therapeutics. This review examines the fields of proteomics and metabolomics in the context of obstetrics and gynaecology, including a discussion of methodology, challenges, potential applications and current research.
Fetal mesenchymal stem cells: isolation, properties and potential use in perinatology and regenerative medicine
Authors: Gucciardo L , Lories R , Ochsenbein‐Kölble N , Done’ E , Zwijsen A , Deprest J
Published: December 2008

The fetus is a source of nonembryonic stem cells (SC), with potential applications in perinatal medicine. Cells derived from the placenta, membranes, amniotic fluid or fetal tissues are higher in number, expansion potential and differentiation abilities compared with SC from adult tissues. Although some obstacles keep SC biology at distance from clinical application, the feasibility of using (homologous) SC for tissue engineering for the fetus with a congenital birth defect has been demonstrated. Also, other pathologies may benefit from SC technology.
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives
Authors: Rousian M , Verwoerd‐Dikkeboom CM , Koning AHJ , Hop WC , van der Spek PJ , Exalto N , Steegers EAP
Published: December 2008

Objective  To investigate accuracy and reliability of four different ultrasound‐related volume‐measuring methods.

Design  Observational study.

Setting  Both in vitro and in vivo.

Population or Sample  Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.

Methods  Three‐dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed‐Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V‐Scope. V‐Scope is a newly developed 3D volume visualisation application using a Barco I‐Space virtual reality system. Intra‐ and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).

Main outcome measure  Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).

Results  In the in vitro study, volume measurements by VOCAL, inversion mode and V‐Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra‐ and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).

Conclusions  We demonstrated that VOCAL, inversion mode and V‐Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V‐Scope application proved to be accurate and reliable.
Noninvasive prenatal detection of fetal chromosomal aneuploidies by maternal plasma nucleic acid analysis: a review of the current state of the art
Authors: Lo YMD
Published: December 2008

Fetal nucleic acids in maternal plasma have opened up new possibilities for noninvasive prenatal diagnosis of chromosomal aneuploidies. One approach is based on the measurement of the allelic ratio of single nucleotide polymorphisms in the coding region of placental mRNA. Another approach is through the analysis of DNA fragments with different patterns of DNA methylation between fetal and maternal DNA. One other alternative is to enrich the fractional concentration of fetal DNA in maternal plasma using physical or chemical methods. Finally, the development of more precise digital polymerase chain reaction‐based methods for fetal nucleic acid analysis might further catalyse the developments in this area. It is hoped that plasma‐based molecular prenatal diagnosis might ultimately make prenatal testing safer for pregnant women and their fetuses.
Prediction of time to spontaneous onset of labour with lactate concentration in vaginal fluid in women with suspected preterm prelabour rupture of the membranes
Authors: Wiberg‐Itzel E , Pettersson H , Cnattingius S , Nordstrom L
Published: December 2008

Objective  To assess whether lactate determination in vaginal fluid is associated with and can predict onset of labour for women with suspected preterm prelabour rupture of membranes (PPROMs).

Design  Prospective observational study.

Setting  Labour ward at South General Hospital, Stockholm, Sweden.

Population/participants  Women with suspected PPROMs at 20–36 completed weeks of gestation (n = 81).

Methods  All women underwent a speculum examination and a test for determining lactate concentration in vaginal fluid. We used logistic regression to estimate the association between lactate concentration in vaginal fluid and time to onset of labour.

Main outcome measure  Time from examination to spontaneous onset of labour (cervix ≥4 cm).

Results  The median time between examination and onset of labour was 13.6 hours for those with a high (≥4.5 mmol/l) lactate concentration and 1152 hours (i.e. 48 days) for those with a low (<4.5 mmol/l) lactate concentration. For a lactate threshold of 4.5 mmol/l, the likelihood ratio for positive test (LR+) was 12.6, and LR− was 0.14 for the outcome of spontaneous onset of labour within 48 hours.

Conclusions  A high lactate concentration in vaginal fluid is strongly associated with whether a woman with suspected PPROM will commence onset of labour within 48 hours. If confirmed, use of lactate (‘LAC test’) as a predictive test for onset of preterm labour may be an attractive tool in bedside obstetrics.
Distal Digital Embolization from a Thrombosed Aneurysmal Hemodialysis Arteriovenous Fistula: The Benefit of a Hybrid Approach
Authors: Simosa Hector F. , Mudumbi Sravani V. , Pomposelli Frank B. , Schermerhorn Marc L.
Published: December 2008

Aneurysmal degeneration of a hemodialysis arteriovenous fistula (AVF) is common; however, distal digital embolization from an AVF is extremely rare. Even though the ultimate fate of all arteriovenous hemodialysis access is thrombosis with minimal consequences, dislodgement of thrombus at the proximal anastomosis could lead to ischemia of the distal arterial circulation. We here present a case of a renal transplant patient with a thrombosed aneurysmal AVF who presented with acute digital ischemia successfully treated with combination catheter‐directed thrombolysis and open repair. No similar report was found describing this entity treated with this approach.
Stent Migration and Folding in the Subclavian Vein during Subclavian Hemodialysis Catheter Placement
Authors: Adulla Madhurima , Chan Micah R. , Hermsen Joshua L. , Tefera Girma , Yevzlin Alexander S.
Published: December 2008

The role of stent placement in hemodialysis (HD) access intervention continues to evolve. As more stents are placed, new and unusual complications are coming to light. We describe a case in which an unsuccessful attempt to place a left subclavian dialysis catheter resulted in the inadvertent migration and folding of a previously deployed subclavian stent. Attempts to remove the stent with a snare were unsuccessful. Patency was restored to the access circuit by placing a new stent through the struts of the folded one. Clinical vascular practice guidelines for vascular access on the use of fluoroscopy for temporary HD catheter placement may need to be re‐evaluated with the reported increase in stent placement in the US HD population.
Editorial: Intersecting Guidelines: Administering Erythropoiesis‐Stimulating Agents to Chronic Kidney Disease Patients with Cancer
Authors: Bennett Charles L. , Becker Pamela S. , Kraut Eric H. , Samaras Athena T. , West Dennis P.
Published: December 2008

There has been a dramatic sea change in the use of erythropoiesis‐stimulating agents (ESAs) for anemic persons with chronic kidney disease (CKD) or cancer patients undergoing chemotherapy. An important area that has not been addressed previously is a CKD patient who also has a malignancy. Clinical guidelines exist that outline recommended treatments for each disease, but the intersection of the two disease processes presents difficult decisions for patients and physicians. Herein, we review the background underlying recent revisions in clinical alerts and guidelines for ESAs, and provide guidance for treating anemia among CKD patients who are receiving no therapy, chemotherapy with curative intent, or chemotherapy with palliative intent. The guiding principle is that comprehensive assessment of risks and benefits in the relevant clinical setting is imperative.
Successful Treatment of Severe Iatrogenic Calcinosis Cutis with Intravenous Sodium Thiosulfate in a Child Affected by T‐Acute Lymphoblastic Leukemia
Authors: Raffaella Colombatti , Annapaola Calò , Tullio Iacopetti , Angelo Rosolen , Giuseppe Lombardi , Simone Cesaro
Published: December 2008

Abstract:  Sodium thiosulfate has been successfully used to treat calcyphilaxis in adults and children, but its effect on iatrogenic calcinosis cutis secondary to extravasation of calcium solutions is less known. We describe a 5‐year‐old boy with acute lymphoblastic leukemia who developed severe calcinosis cutis in the right forearm and hand, and in the left leg and foot after extravasation of calcium gluconate during treatment for tumor‐lysis‐syndrome‐related hypocalcaemia. Surgical debridement, local wound care, hyperbaric oxygen therapy, and sodium thiosulfate infusion achieved a complete healing of all lesions in an eight‐month period with a short discontinuation of chemotherapy. No functional or sensitive impairment remained.
Hair Shaft Videodermoscopy in Netherton Syndrome
Authors: Rakowska Adriana , Kowalska‐Oledzka Elzbieta , Slowinska Monika , Rosinska Danuta , Rudnicka Lidia
Published: December 2008

Abstract:  Netherton syndrome is an autosomal recessive disorder, characterized by ichthyosis, atopic manifestations, and hair shaft abnormalities (trichorrhexis invaginata). The diagnosis of Netherton syndrome may be established on the basis of just one abnormal hair, but it is often difficult to find a hair with pathognomonic features on light microscopic examination. Every attempt requires pulling new hairs. We present the case of an 11‐year‐old female patient with Netherton syndrome in whom hair and scalp videodermoscopy (trichoscopy) was used to visualize typical bamboo hairs and hairs with golf tee type endings in the scalp hairs and eyebrows. Trichoscopy is a method, which allows noninvasive viewing of hair shafts in many‐fold magnification without the need of pulling hair for diagnostic purposes. This case shows that trichoscopy may be employed to significantly improve the chance of establishing the diagnosis of Netherton syndrome in patients.
A New Approach to Hazardous Materials Transportation Risk Analysis: Decision Modeling to Identify Critical Variables
Authors: Clark Renee M. , Besterfield‐Sacre Mary E.
Published: December 2008

We take a novel approach to analyzing hazardous materials transportation risk in this research. Previous studies analyzed this risk from an operations research (OR) or quantitative risk assessment (QRA) perspective by minimizing or calculating risk along a transport route. Further, even though the majority of incidents occur when containers are unloaded, the research has not focused on transportation‐related activities, including container loading and unloading. In this work, we developed a decision model of a hazardous materials release during unloading using actual data and an exploratory data modeling approach. Previous studies have had a theoretical perspective in terms of identifying and advancing the key variables related to this risk, and there has not been a focus on probability and statistics‐based approaches for doing this. Our decision model empirically identifies the critical variables using an exploratory methodology for a large, highly categorical database involving latent class analysis (LCA), loglinear modeling, and Bayesian networking. Our model identified the most influential variables and countermeasures for two consequences of a hazmat incident, dollar loss and release quantity, and is one of the first models to do this. The most influential variables were found to be related to the failure of the container. In addition to analyzing hazmat risk, our methodology can be used to develop data‐driven models for strategic decision making in other domains involving risk.
Are populations of European earwigs, Forficula auricularia, density dependent?
Authors: Moerkens R. , Leirs H. , Peusens G. , Gobin B.
Published: December 2008

Biocontrol using naturally occurring predators is often limited by population parameters of those predators. Earwigs, Forficula auricularia L. (Dermaptera: Forficulidae), are important predators in fruit orchards. They are capable of suppressing outbreaks of pest species, such as pear psyllid and various apple aphid species. Earwigs therefore play an important role in integrated pest management in fruit orchards and are essential in organic top fruit cultures. However, earwig populations are very unstable, showing large between‐year variation in densities, which limits their practical use. Extensive knowledge of regulating processes of populations is therefore crucial for efficient orchard management. A 2‐year phenological study in several apple and pear orchards in Belgium showed a significant displacement of third instars during the second brood in relation to the presence of adults. We also observed a yearly population crash at the time of moulting into adults. This population decrease was correlated with earwig numbers at peak density. The crash occurred at lower earwig densities in apple orchards than in pear orchards. Six possible regulating mechanisms for this density‐dependent decrease are discussed: (1) migration, (2) pesticides or orchard management, (3) starvation, (4) pathogens, (5) parasites and parasitoids, and (6) predation or cannibalism. If we can identify these regulating processes, specific management activities could be developed to prevent the population crash, hereby increasing population densities in the orchards.
Simvastatin therapy in cyclosporine A‐induced alveolar bone loss in rats
Authors: Nassar P. O. , Nassar C. A. , Guimarães M. R. , Aquino S. G. , Andia D. C. , Muscara M. N. , Spolidorio D. M. P. , Rossa Jr C. , Spolidorio L. C.
Published: December 2008

Background and Objective:  Cyclosporine A treatment is important in the therapy of a number of medical conditions; however, alveolar bone loss is an important negative side‐effect of this drug. As such, we evaluated whether concomitant administration of simvastatin would minimize cyclosporine A‐associated alveolar bone loss in rats subjected, or not, to experimental periodontal disease.

Material and Methods:  Groups of 10 rats each were treated with cyclosporine A (10 mg/kg/day), simvastatin (20 mg/kg/day), cyclosporine A and simvastatin concurrently (cyclosporine A/simvastatin) or vehicle for 30 days. Four other groups of 10 rats each received a cotton ligature around the lower first molar and were treated similarly with cyclosporine A, simvastatin, cyclosporine A/simvastatin or vehicle. Calcium (Ca2+), phosphorus and alkaline phosphatase levels were evaluated in serum. Expression levels of interleukin‐1β, prostaglandin E2 and inducible nitric oxide synthase were evaluated in the gingivomucosal tissues. Bone volume and numbers of osteoblasts and osteoclasts were also analyzed.

Results:  Treatment with cyclosporine A in rats, with or without ligature, was associated with bone loss, represented by a lower bone volume and an increase in the number of osteoclasts. Treatment with cyclosporine A was associated with bone resorption, whereas simvastatin treatment improved cyclosporine A‐associated alveolar bone loss in all parameters studied. In addition, simvastatin, in the presence of inflammation, can act as an anti‐inflammatory agent.

Conclusion:  This study shows that simvastatin therapy leads to a reversal of the cyclosporine A‐induced bone loss, which may be mediated by downregulation of interleukin‐1β and prostaglandin E2 production.