bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant impact of age at diagnosis on the prognosis of Japanese patients with pT1 renal cell carcinoma following surgical resection
Authors: Sakai Iori , Miyake Hideaki , Muramaki Mototsugu , Kondo Yutaka , Kusuda Yuji , Yamada Yuji , Fujisawa Masato
Published: August 2011

Study Type – Prognosis (individual cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?

Several parameters significantly associated with the prognosis of patients with small venal cell carcinoma (RCC) have been reported; however, the outcomes described in such studies are not totally consistent, and the majority of these studies were based on the data from Western populations. Age of diagnosis is a significant predictor of disease recurrence as well as overall survivals in Japanese patients with pT1 RCC following surgical resection; therefore, intensive follow‐up of older patients is necessary even for those with pT1 RCC.

OBJECTIVE

To retrospectively review oncological outcomes following surgical resection in Japanese patients with pT1 renal cell carcinoma (RCC).

PATIENTS AND METHODS

The present study included a total of 832 consecutive Japanese patients who underwent either radical or partial nephrectomy and were subsequently diagnosed as having localized pT1 RCC.

The significance of several clinicopathological factors in their postoperative outcomes was analysed.

RESULTS

The median (range) age of the 832 patients was 66 (31–90) years. Radical and partial nephrectomies were performed for 710 patients (85.3%) and 122 patients (14.7%), respectively. Distribution of pathological stage was pT1a in 582 patients (70.0%) and pT1b in 250 patients (30.0%).

During the observation period (median 44 months, range 3–114 months), postoperative disease recurrence developed in 38 patients (4.6%) and death occurred in 34 (4.1%). The 5‐year recurrence‐free and overall survival rates were 93.6% and 94.1%, respectively.

Of several factors examined, only age at diagnosis was identified as an independent predictor of both postoperative disease recurrence and overall survival in these patients. Furthermore, there were significant differences in the recurrence‐free and overall survivals among patient groups stratified by age at diagnosis.

CONCLUSION

These findings suggest that age at diagnosis is a significant predictor of disease recurrence as well as overall survival in patients with pT1 RCC following surgical resection; therefore, intensive follow‐up of older patients is necessary even for those with pT1 RCC.
Long‐term toxicity and quality of life up to 10 years after low‐dose rate brachytherapy for prostate cancer
Authors: Emara Amr M. , Chadwick Eliot , Nobes Jenny P. , Abdelbaky Ather Mohamed , Laing Robert W. , Langley Stephen E.M.
Published: August 2011

Study Type – Therapy (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Prostate BXT is an established treatment option for low and intermediate risk localized prostate cancer. Long‐term studies have confirmed similar oncological outcomes for low risk disease compared with radical prostatectomy and external beam radiotherapy.

This study reports long‐term toxicity for a large cohort of patients who had been followed‐up after LDR BXT for up to 10 years, with a minimum follow‐up of 5 years.

Long‐term toxicity results are very encouraging and provide useful date to help clinicians and patients make informed treatment choices.

OBJECTIVE

To report on the long‐term toxicity outcome for patients with prostate cancer treated by low‐dose rate (LDR) brachytherapy (BXT).

PATIENTS AND METHODS

The study population comprised a cohort of men treated in our centre between March 1999 and April 2004 with LDR BXT for prostate cancer who had at least 5 years of follow‐up post‐implant.

Patients who had died or experienced biochemical failure were excluded.

We contacted eligible patients and asked them to complete a questionnaire to assess current urinary, erectile and bowel function.

Urinary and erectile function was compared pre‐ and post‐treatment and outcomes were assessed by treatment modality.

RESULTS

Of the 226 LDR BXT‐treated patients with >5 years of follow‐up, 174 (77.0%) responded to the questionnaire.

The mean International Prostate Symptom Score (IPSS) increased from 6.70 pre‐BXT to 7.91 at follow‐up (P= 0.003). Of the patients with mild symptoms pre‐BXT (IPSS, 0–7), 64.2% retained mild symptoms at follow‐up, 31.2% developed moderate symptoms (IPSS, 8–9) and 4.6% reported severe symptoms (IPSS, 20–35).

A good or acceptable quality of life (QoL) secondary to urinary symptoms (IPSS QoL, 0–4) was reported by 98.0% of respondents.

Of those patients potent (International Index of Erectile Function‐5 ≥11) pre‐BXT, 62.9% remained potent at follow‐up. There were no differences in the proportion of patients who were potent when analyzed by the number of years post‐implant.

At follow‐up, 51.7% and 45.4% of patients, respectively, had normal or mild bowel symptoms as indicated by the European Organisation for the Research and Treatment of Cancer questionnaire (QLQ‐C30/PR25 scores, 4–8). Moderate bowel symptoms (QLQ‐C30/PR25 scores, 9–12) were reported by 2.9% of respondents; none reported severe symptoms.

CONCLUSION

The present study shows low morbidity after LDR BXT over the long‐term for a large cohort of patients.
The species richness–productivity relationship in the herb layer of European deciduous forests
Authors: Axmanová Irena , Chytrý Milan , Zelený David , Li Ching‐Feng , Vymazalová Marie , Danihelka Jiří , Horsák Michal , Kočí Martin , Kubešová Svatava , Lososová Zdeňka , Otýpková Zdenka , Tichý Lubomír , Martynenko Vasiliy B. , Baisheva El'vira Z. , Schuster Brigitte , Diekmann Martin
Published: August 2011

Aim  In contrast to non‐forest vegetation, the species richness–productivity (SR‐P) relationship in forests still remains insufficiently explored. Several studies have focused on the diversity of the tree layer, but the species richness of temperate deciduous forests is mainly determined by their species‐rich herb layer. The factors controlling herb‐layer productivity may differ from those affecting tree layers or open herbaceous vegetation, and thus the SR‐P relationship and its underlying processes may differ. However, the few relevant studies have reported controversial results. Here we explore the SR‐P relationship in the forest herb layer across different areas from oceanic to continental Europe, and put the effect of habitat productivity on species richness into context with other key factors, namely soil pH and light availability.

Location  North‐western Germany, Czech Republic, Slovakia and southern Urals (Russia).

Methods  We measured herb‐layer species richness and biomass, soil pH and tree‐layer cover in 156 vegetation plots of 100 m2 in deciduous forests. We analysed the SR‐P relationship and the relative importance of environmental variables using regression models for particular areas and separate forest types.

Results  We found a consistent monotonic increase in the herb‐layer species richness with productivity across all study areas and all forest types. Soil pH and light availability also affected species richness, but their relative importance differed among areas.

Main conclusions  We suggest that the monotonically increasing SR‐P relationship in the forest herb layer results from the fact that herb‐layer productivity is limited by canopy shading; competition within the herb layer is therefore not strong enough to exclude many species. This differs fundamentally from open herbaceous vegetation, which is not subject to such productivity limits and consequently exhibits a unimodal SR‐P relationship. We present a conceptual model that might explain the differences in the SR‐P relationship between the forest herb layer and open herbaceous vegetation.
An analysis of the accounting and finance research productivity in Australia and New Zealand in 1991–2010
Authors: Chan Kam C. , Chang Chih‐Hsiang , Tong Jamie Y. , Zhang Feida
Published: August 2011

We assess the research productivity of the accounting and finance community in Australian and New Zealand higher education institutions (HEIs) during 1991–2010 using 48 high‐quality accounting and finance journals. Our finding suggests that the HEIs’ research output steadily increases during the 20‐year period. The University of New South Wales, the University of Sydney, Monash University, the University of Melbourne and the University of Queensland are the top‐five HEIs. We also find that it is a challenge for an academic staff member to publish multiple articles. If an author is able to manage five total appearances over a 20‐year period, he/she is in the top 15 per cent among all authors. Many highly productive authors are able to move to different jobs during the 20‐year period.
Marriage seasonality and the industrious revolution: southern Sweden, 1690–18951
Authors: DRIBE MARTIN , VAN DE PUTTE BART
Published: August 2011

In this article we study the evolution of marriage seasonality in relation to economic change, particularly connected to changes in labour supply and work intensity of the kind implied by the ‘industrious revolution’. The focus is on southern Sweden in 1685–1894, which was a period of agricultural transformation and early industrialization, when we would expect to see an increase in work intensity. The analysis is based on about 120,000 marriages from 117 different parishes. The analysis shows that the seasonality of marriage changed dramatically over time, from a classic grain production pattern, with a marriage peak in late spring and a marriage trough at harvest time, to a much more even seasonality, although with the appearance of a very strong peak in December. This change affected rural rather than urban areas, and was present regardless of differences in institutional settings, and for almost all occupational groups below the elite. The changed seasonality pattern is consistent with increasing work intensity over the year, leaving only the weeks around Christmas as a low season. In addition to the increase in work intensity, the privatization of marriage and the availability of time and resources were also important factors in the changing seasonality pattern.
Blood–brain barrier modeling with co‐cultured neural progenitor cell‐derived astrocytes and neurons
Authors: Lippmann Ethan S. , Weidenfeller Christian , Svendsen Clive N. , Shusta Eric V.
Published: August 2011

J. Neurochem. (2011) 119, 507–520.

In vitro blood–brain barrier (BBB) models often consist of brain microvascular endothelial cells (BMECs) that are co‐cultured with other cells of the neurovascular unit, such as astrocytes and neurons, to enhance BBB properties. Obtaining primary astrocytes and neurons for co‐culture models can be laborious, while yield and heterogeneity of primary isolations can also be limiting. Neural progenitor cells (NPCs), because of their self‐renewal capacity and ability to reproducibly differentiate into tunable mixtures of neurons and astrocytes, represent a facile, readily scalable alternative. To this end, differentiated rat NPCs were co‐cultured with rat BMECs and shown to induce BBB properties such as elevated trans‐endothelial electrical resistance, improved tight junction continuity, polarized p‐glycoprotein efflux, and low passive permeability at levels indistinguishable from those induced by primary rat astrocyte co‐culture. An NPC differentiation time of 12 days, with the presence of 10% fetal bovine serum, was found to be crucial for generating NPC‐derived progeny capable of inducing the optimal response. This approach could also be extended to human NPC‐derived astrocytes and neurons which similarly regulated BBB induction. The distribution of rat or human NPC‐derived progeny under these conditions was found to be a roughly 3 : 1 mixture of astrocytes to neurons with varying degrees of cellular maturity. BMEC gene expression analysis was conducted using a BBB gene panel, and it was determined that 23 of 26 genes were similarly regulated by either differentiated rat NPC or rat astrocyte co‐culture while three genes were differentially altered by the rat NPC‐derived progeny. Taken together, these results demonstrate that NPCs are an attractive alternative to primary neural cells for use in BBB co‐culture models.
Anatomical localization of protease‐activated receptor‐1 and protease‐mediated neuroglilal crosstalk on peri‐synaptic astrocytic endfeet
Authors: Shavit Efrat , Michaelson Daniel M. , Chapman Joab
Published: August 2011

J. Neurochem. (2011) 119, 460–473.

We studied the localization, activation and function of protease‐activated receptor 1 (PAR‐1) at the CNS synapse utilizing rat brain synaptosomes and slices. Confocal immunofluoresence and transmission electron microscopy in brain slices with pre‐embedding diaminobenzidine (DAB) immunostaining found PAR‐1 predominantly localized to the peri‐synaptic astrocytic endfeet. Structural confocal immunofluorescence microscopy studies of isolated synaptosomes revealed spherical structures stained with anti‐PAR‐1 antibody which co‐stained mainly for glial‐filament acidic protein compared with the neuronal markers synaptophysin and PSD‐95. Immunoblot studies of synaptosomes demonstrated an appropriate major band corresponding to PAR‐1 and activation of the receptor by a specific agonist peptide (SFLLRN) significantly modulated phosphorylated extracellular signal‐regulated kinase. A significant membrane potential depolarization was produced by thrombin (1 U/mL) and the PAR‐1 agonist (100 μM) and depolarization by high K+ elevated extracellular thrombin‐like activity in the synaptosomes preparation. The results indicate PAR‐1 localized to the peri‐synaptic astrocytic endfeet is most likely activated by synaptic proteases and induces cellular signaling and modulation of synaptic electrophysiology. A protease mediated neuron‐glia pathway may be important in both physiological and pathological regulation of the synapse.
Chronic psychosocial stress enhances long‐term depression in a subthreshold amyloid‐beta rat model of Alzheimer’s disease
Authors: Tran Trinh T. , Srivareerat Marisa , Alhaider Ibrahim A. , Alkadhi Karim A.
Published: August 2011

J. Neurochem. (2011) 119, 408–416.

In addition to genetic aspects, environmental factors such as stress may also play a critical role in the etiology of the late onset, sporadic Alzheimer’s disease (AD). The present study examined the effect of chronic psychosocial stress in a sub‐threshold Aβ (subAβ) rat model of AD on long‐term depression by two techniques: electrophysiological recordings of synaptic plasticity in anesthetized rats, and immunoblot analysis of memory‐ and AD‐related signaling molecules. Chronic psychosocial stress was induced using a rat intruder model. The subAβ rat model of AD, which was intended to represent outwardly normal individuals with a pre‐disposition to AD, was induced by continuous infusion of 160 pmol/day Aβ1‐42 via a 14‐day i.c.v. osmotic pump. Results from electrophysiological recordings showed that long‐term depression evoked in stress/subAβ animals was significantly enhanced compared with that in animals exposed to stress or subAβ infusion alone. Molecular analysis of various signaling molecules 1 h after induction of long‐term depression revealed an increase in the levels of calcineurin and phosphorylated CaMKII in groups exposed to stress compared with other groups. The levels of the brain‐derived neurotrophic factor (BDNF) were significantly decreased in stress/subAβ animals but not in stress or subAβ animals. In addition, the levels of beta‐site amyloid precursor protein cleaving enzyme were markedly increased in stress/subAβ. These findings suggest that chronic stress may accelerate the impairment of synaptic plasticity and consequently cognition in individuals ‘at‐risk’ for AD.
Steroid receptor coactivator 2 modulates steroid‐dependent male sexual behavior and neuroplasticity in Japanese quail (Coturnix japonica)
Authors: Niessen Neville‐Andrew , Balthazart Jacques , Ball Gregory F. , Charlier Thierry D.
Published: August 2011

J. Neurochem. (2011) 119, 579–593.

Steroid receptor coactivators are necessary for efficient transcriptional regulation by ligand‐bound nuclear receptors, including estrogen and androgen receptors. Steroid receptor coactivator‐2 (SRC‐2) modulates estrogen‐ and progesterone‐dependent sexual behavior in female rats but its implication in the control of male sexual behavior has not been studied to our knowledge. We cloned and sequenced the complete quail SRC‐2 transcript and showed by semi‐quantitative PCR that SRC‐2 expression is nearly ubiquitous, with high levels of expression in the kidney, cerebellum and diencephalon. Real‐time quantitative PCR did not reveal any differences between intact males and females the medial preoptic nucleus (POM), optic lobes and cerebellum. We next investigated the physiological and behavioral role of this coactivator using in vivo antisense oligonucleotide techniques. Daily injections in the third ventricle at the level of the POM of locked nucleic acid antisense targeting SRC‐2 significantly reduced the expression of testosterone‐dependent male‐typical copulatory behavior but no inhibition of one aspect of the appetitive sexual behavior was observed. The volume of POM, defined by aromatase‐immunoreactive cells, was markedly decreased in animals treated with antisense as compared with controls. These results demonstrate that SRC‐2 plays a prominent role in the control of steroid‐dependent male sexual behavior and its associated neuroplasticity in Japanese quail.
In vitro and in vivo neuroprotective activity of the cardiac glycoside oleandrin from Nerium oleander in brain slice‐based stroke models
Authors: Dunn Denise E. , He Dong Ning , Yang Peiying , Johansen Mary , Newman Robert A. , Lo Donald C.
Published: August 2011

J. Neurochem. (2011) 119, 805–814.

The principal active constituent of the botanical drug candidate PBI‐05204, a supercritical CO2 extract of Nerium oleander, is the cardiac glycoside oleandrin. PBI‐05204 shows potent anticancer activity and is currently in phase I clinical trial as a treatment for patients with solid tumors. We have previously shown that neriifolin, which is structurally related to oleandrin, provides robust neuroprotection in brain slice and whole animal models of ischemic injury. However, neriifolin itself is not a suitable drug development candidate and the FDA‐approved cardiac glycoside digoxin does not cross the blood–brain barrier. We report here that both oleandrin as well as the full PBI‐05204 extract can also provide significant neuroprotection to neural tissues damaged by oxygen and glucose deprivation as occurs in ischemic stroke. Critically, we show that the neuroprotective activity of PBI‐05204 is maintained for several hours of delay of administration after oxygen and glucose deprivation treatment. We provide evidence that the neuroprotective activity of PBI‐05204 is mediated through oleandrin and/or other cardiac glycoside constituents, but that additional, non‐cardiac glycoside components of PBI‐05204 may also contribute to the observed neuroprotective activity. Finally, we show directly that both oleandrin and the protective activity of PBI‐05204 are blood brain barrier penetrant in a novel model for in vivo neuroprotection. Together, these findings suggest clinical potential for PBI‐05204 in the treatment of ischemic stroke and prevention of associated neuronal death.
Role of vesicle pools in action potential pattern‐dependent dopamine overflow in rat striatum in vivo
Authors: Wang Shi‐Rong , Yao Wei , Huang Hong‐Ping , Zhang Bo , Zuo Pan‐Li , Sun Liang , Dou Hai‐Qiang , Li Qing , Kang Xin‐Jiang , Xu Hua‐Dong , Hu Mei‐Qin , Jin Mu , Zhang Lei , Mu Yu , Peng Ji‐Yun , Zhang Claire Xi , Ding Jiu‐Ping , Li Bao‐Ming , Zhou Zhuan
Published: August 2011

J. Neurochem. (2011) 119, 342–353.

Action potential (AP) patterns and dopamine (DA) release are known to correlate with rewarding behaviors, but how codes of AP bursts translate into DA release in vivo remains elusive. Here, a given AP pattern was defined by four codes, termed total AP number, frequency, number of AP bursts, and interburst time [N, f, b, i].. The ‘burst effect’ was calculated by the ratio (γ) of DA overflow by multiple bursts to that of a single burst when total AP number was fixed. By stimulating the medial forebrain bundle using AP codes at either physiological (20 Hz) or supraphysiological (80 Hz) frequencies, we found that DA was released from two kinetically distinct vesicle pools, the fast‐releasable pool (FRP) and prolonged‐releasable pool (PRP), in striatal dopaminergic terminals in vivo. We examined the effects of vesicle pools on AP‐pattern dependent DA overflow and found, with given ‘burst codes’ [b = 8, i = 0.5 s], a large total AP number [N = 768, f = 80 Hz] produced a facilitating burst‐effect (γ[b8/b1] = 126 ± 3%), while a small total AP number [N = 96, 80 Hz] triggered a depressing‐burst‐effect (γ[b8/b1] = 29 ± 4%). Furthermore, we found that the PRP (but not the FRP) predominantly contributed to the facilitating‐burst‐effect and the FRP played an important role in the depressing‐burst effect. Thus, our results suggest that striatal DA release captures pre‐synaptic AP pattern information through different releasable pools.
Diurnal and nocturnal ranging behaviour of Stone‐curlews Burhinus oedicnemus nesting in river habitat
Authors: CACCAMO CHIARA , POLLONARA ENRICA , EMILIO BALDACCINI NATALE , GIUNCHI DIMITRI
Published: August 2011

Studying a species under a range of conditions is essential for fully understanding its ecology and for predicting its response to human impacts on the environment. We investigated the spatial behaviour and the habitat characteristics of foraging areas of Eurasian Stone‐curlews breeding in an important but poorly investigated habitat, gravel riverbed, throughout the full 24‐h cycle. The data collected for 17 radiotagged birds nesting in the Taro River Regional Park (Parma, Italy) showed a clear split between diurnal and nocturnal spatial behaviour. Almost all diurnal fixes and about two‐thirds of nocturnal ones were located in the gravel riverbed, which not only provided suitable breeding territories but probably part of the food resources needed for reproduction. Nocturnal excursions from breeding sites to feeding areas (mostly farmland), sometimes of a few kilometres, indicated that these resources do not cover all of the birds’ needs. Night spotlight counts of foraging birds in the agricultural area indicated that Stone‐curlews preferred recently harvested crops (mainly forage and wheat) and piles of farmyard manure. These habitat preferences are closely linked to the predominant agricultural activity of the study area, which is characterized by a high density of dairy farms for the production of Parmigiano Reggiano cheese. It seems likely that the proximity of gravel riverbed and farmland habitats is one of the main causes of the high breeding density recorded in the study area. We propose that the conservation of Stone‐curlews at this site could potentially be achieved only by a synergistic management of both natural and agricultural habitats.
Eclipsed: An overshadowed goddess and the discarded image of Botticelli's Primavera
Authors: DEE JOHN
Published: August 2011

This article explores the implications of a neglected aspect of that letter to the owner of the Primavera in which Marsilio Ficino pictures the human soul as mirroring the cosmos. The lunar metaphor adopted for the ratio mobilis, middle term of the soul, is found to be an integral feature of his ontology, developed primarily in relation to Aristotelian cosmology. As template for the metaphor, the division of perceptible reality into supralunary and sublunary contrasting halves can be seen to govern the imagery of the Primavera, the contrasting halves of which are centred on a figure with a lunar amulet and inescapable overall resemblance to a lunar deity described in a recently printed and highly popular classical work. Botticelli's painting embodies a metaphysical image of the cosmos reflected in the soul, as outlined in the letter, with the planetary deity Luna as the middle term of both, mediating between the celestial and terrestrial realms of the one and – as ratio– the intellectual and sensual realms of the other. The genre of the Primavera has been obscured. It is a great Quattrocento imago mundi.
Synthesis and characterisation of microencapsulated 7‐alkyloxy‐4‐trifluoromethylcoumarin dyes
Authors: Hu Yixin , Zhong Yi , Li Jinxing , Cai Li , Li Hongqi
Published: August 2011

Five new 7‐alkyloxy‐4‐trifluoromethylcoumarin fluorescent dyes were synthesised using the Pechmann and Williamson etherification reactions. The structures of these coumarin dyes were characterised by Fourier Transform–infrared, proton and carbon nuclear magnetic resonance and mass spectra. One of the new coumarin compounds, 7‐isopropyloxy‐4‐trifluoromethylcoumarin, was microencapsulated with melamine–formaldehyde as the shell material by in situ polymerisation. The microcapsules were characterised in terms of Fourier Transform–infrared spectrum, particle size distribution and scanning electron microscopy morphology. The cotton fabric finished with the microencapsulated coumarin dye showed strong fluorescence under ultraviolet light.
Phototoxic Dermatitis Due to Chenopodium Album in a Child
Authors: Bilgili Serap G. , Akdeniz Necmettin , Akbayram Sinan , Ceylan Abdullah , Çalka Ömer , Karaman Kamuran
Published: August 2011

Abstract:  In this article, we report a 2‐year‐old girl with severe phototoxic dermatitis caused by ingestion of Chenopodium album. To the best of our knowledge, this is the first case of phototoxic dermatitis due to Chenopodiumalbum in childhood.
The Dermoscopic Features in Infantile Hemangioma
Authors: OISO NAOKI , KAWADA AKIRA
Published: August 2011

Abstract:  Dermoscopy is useful for evaluating the precise vascular structure. We recently applied dermoscopy to infantile hemangiomas without proliferation and showed polymorphous vascular structures. We now demonstrate two typical dermoscopic figures of proliferative infantile hemangiomas. One was a superficial hemangioma which showed polymorphous vascular structure without obvious red linear vessels and red dilated vessels. The other was a thicker hemangioma with a deeper component. This hemangioma had polymorphous vascular structures with red linear and red dilated vessels. These observations indicates the usefulness of dermoscopy for subclassifying infantile hemangioma.
Severe Atopic Dermatitis and Transient Hypogammaglobulinemia in Children
Authors: Wang Audrey S. , Liang Marilyn G. , Schneider Lynda C.
Published: August 2011

Abstract:  We sought to describe the clinical outcomes of eight pediatric patients diagnosed with atopic dermatitis (AD) and hypogammaglobulinemia through retrospective review of medical records. All patients presented with severe facial AD. The mean and median ages of diagnosis of hypogammaglobulinemia were 6.2 months and 6.5 months, respectively, with a mean immunoglobulin G (IgG) level of 156 mg/dL. Seven of the eight patients identified in our search demonstrated simultaneous improvement in AD and serum IgG levels within 2 years of initial presentation, suggesting a diagnosis of transient hypogammaglobulinemia. The remaining patient demonstrated normalization by age 6, but no IgG levels had been measured between initial presentation and age 6. The five patients who were tested for specific antibody response to tetanus and Haemophilus influenzae type b vaccination all produced protective responses. All eight patients initially presented with high serum IgE levels. On initial evaluation, three patients had leukocytosis (white blood cell count >18,000 cells/μL), and six had peripheral blood eosinophilia. Three patients outgrew their AD by age 5, and five had clinically good to excellent control of their AD at their last visit, coincident with normalization of IgG levels. Although severe AD and immunoglobulin deficiency may rarely be associated with complex immunodeficiency disorders, our observations suggest that, with careful immunologic monitoring and diligent skin care, most children who present with severe AD and hypogammaglobulinemia exhibit improvement in dermatitis and serum IgG levels within 2 years of onset without major complications.
Vitiligo in Children: A Clinical‐Epidemiologic Study in Jordan
Authors: AL‐REFU KHITAM
Published: August 2011

Abstract:  Two thousand consecutive children were analyzed in a 2‐year period to establish a clinical and epidemiologic profile of vitiligo in Jordan; 71 had vitiligo, with the prevalence increasing with age (0.45% <1 yr, 1% aged 1–5 yrs, 2.1% aged 5–12 yrs). Nonsegmental‐type vitiligo was seen in 67 of the patients (92.9%).
Diffuse Cutaneous Mastocytosis Masquerading as Epidermolysis Bullosa
Authors: Kleewein Kristin , Lang Roland , Diem Anja , Vogel Tobias , Pohla‐Gubo Gabriela , Bauer Johann W. , Hintner Helmut , Laimer Martin
Published: August 2011

Abstract:  A 10‐month‐old boy presented with a history of a generalized cutaneous bullous eruption since 3 months of age. Emesis, flush, pruritus, and fatigue had accompanied relapsing episodes of sometimes extensive blistering. Histopathology showed dense dermal infiltrates of mast cells on hematoxylin and eosin and corroborating immunohistochemical staining. Laboratory examination revealed a markedly high level of serum tryptase. Based on these results and after consecutive staging, the patient was diagnosed with diffuse cutaneous bullous mastocytosis (BM). Mutation analysis detected a deletion mutation (del419) in C‐Kit by direct exon sequencing. This rare entity must be considered in the differential diagnosis whenever a child presents with bullae and erosions. A crucial diagnostic hint is that rubbing of affected skin areas results in whealing (Darier’s sign). A comprehensive diagnostic approach, advanced therapeutic strategies, regular follow‐ups, and instruction of patients and relatives on prevention and prophylaxis are highly indicated.
Local Vaccine Site Reactions and Contact Allergy to Aluminum
Authors: Beveridge Mara G. , Polcari Ingrid C. , Burns Jennifer L. , Adler Amos , Hendrickson Barbara , Stein Sarah L.
Published: August 2011

Abstract:  Childhood vaccines are a routine part of pediatric care in the United States; clinicians must be able to recognize and interpret associated localized adverse reactions. Redness and induration at the site of injection are commonly reported and are considered to be the result of local inflammation or hematoma formation, although other atypical reactions can occur. We report the case of a 6‐month‐old infant who developed subcutaneous nodules at the sites of his 4‐ and 6‐month Pentacel (DTaP/Hib/IPV, diphtheria, tetanus, acellular pertussis, Haemophilus b conjugate, and inactivated poliovirus vaccine) and 6‐month Prevnar (heptavalent pneumococcal vaccine) injections. Infectious disease and immunodeficiency examinations were unremarkable. Aluminum contact allergy was considered, and contact allergy testing confirmed sensitivity to aluminum. Although rare, aluminum contact allergy after routine immunization can occur and should be considered in the differential diagnosis of persistent subcutaneous nodules after vaccination.
Early and Successful Enzymatıc Debridement Via Collagenase Application to Pinna in a Preterm Neonate
Authors: Karagol Belma Saygili , Okumus Nurullah , Dursun Arzu , Karadag Nilgun , Zencıroglu Aysegul
Published: August 2011

Abstract:  We report early and successful enzymatic debridement using collagenase application to pinna in a preterm neonate. Collagenase clostridiopeptidase A should be kept in mind not only for the removal of eschar but also for avoidance of the progression of necrotic tissue in neonates.
Postvaccination Morphea Profunda in a Child
Authors: Khaled Aida , Kharfi Monia , Zaouek Anissa , Rameh Soumaya , Zermani Rachida , Fazaa Becima , Kamoun Mohamed Ridha
Published: August 2011

Abstract:  We report a new case of postvaccination morphea profunda (MP) in a child and discuss its different clinical presentations, prognosis, and therapy and its relationship with “solitary morphea profunda.” A 2‐year‐old healthy girl presented with an induration of the anterior aspect of the left thigh of 9 months duration. The lesion had appeared 3 months after a third dose of diphtheria‐tetanus‐pertussis vaccine. Cutaneous examination showed an induration of 7 × 7 cm with an “orange peel” texture after pinching the skin. Histologic examination confirmed the diagnosis of MP. Systemic steroids (1 mg/kg/day) led to the stabilization of the lesion. After 4 months of treatment, we began the concomitant use of oral methotrexate (10 mg/wk) for 2 months. Methotrexate was then continued alone for 10 months, leading to a significant regression of the induration with no relapse.
Sole Dermatitis in Children: Patch Testing Revisited
Authors: Darling Mark I. , Horn Helen M. , McCormack Sally K.A. , Schofield Olivia M.V.
Published: August 2011

Abstract:  Although dermatoses affecting the soles of the feet in children are regularly encountered in dermatology clinics, the relationship with allergic contact dermatitis affecting this part of the foot is not well established. The aim of this study was to evaluate the relevance of patch testing children with sole dermatoses. We reviewed the results of all patch tests performed in children (<18 years) presenting with dermatoses involving the soles between 1997 and 2009 from our departmental patch test database. Forty‐one children were identified: 27 children with an inflammatory dermatitis affecting the sole and 14 children with juvenile plantar dermatosis (JPD). Seventeen (41%) children had at least one clinically relevant positive patch test reaction. Rubber additives and potassium dichromate were the most frequent allergens identified. Forty‐eight percent of children with inflammatory dermatitis affecting the sole and 29% of children with JPD had at least one relevant reaction. Of the children with relevant reactions, 76% had a personal or family history of atopy. Our results demonstrate the importance of patch testing children with dermatoses affecting the soles and indicate that a history of atopy or a diagnosis of JPD should not deter investigation.
FREQUENT CLONALITY IN FUCOIDS (FUCUS RADICANS AND FUCUS VESICULOSUS; FUCALES, PHAEOPHYCEAE) IN THE BALTIC SEA1
Authors: Johannesson Kerstin , Johansson Daniel , Larsson Karl H. , Huenchuñir Cecilia J. , Perus Jens , Forslund Helena , Kautsky Lena , Pereyra Ricardo T.
Published: August 2011

Asexual reproduction by cloning may affect the genetic structure of populations, their potential to evolve, and, among foundation species, contributions to ecosystem functions. Macroalgae of the genus Fucus are known to produce attached plants only by sexual recruitment. Recently, however, clones of attached plants recruited by asexual reproduction were observed in a few populations of Fucus radicans Bergström et L. Kautsky and F. vesiculosus L. inside the Baltic Sea. Herein we assess the distribution and prevalence of clonality in Baltic fucoids using nine polymorphic microsatellite loci and samples of F. radicans and F. vesiculosus from 13 Baltic sites. Clonality was more common in F. radicans than in F. vesiculosus, and in both species it tended to be most common in northern Baltic sites, although variation among close populations was sometimes extensive. Individual clonal lineages were mostly restricted to single or nearby locations, but one clonal lineage of F. radicans dominated five of 10 populations and was widely distributed over 550 × 100 km of coast. Populations dominated by a few clonal lineages were common in F. radicans, and these were less genetically variable than in other populations. As thalli recruited by cloning produced gametes, a possible explanation for this reduced genetic variation is that dominance of one or a few clonal lineages biases the gamete pool resulting in a decreased effective population size and thereby loss of genetic variation by genetic drift. Baltic fucoids are important habitat‐forming species, and genetic structure and presence of clonality have implications for conservation strategies.
LIGHT DEPENDENCY OF PHOTOSYNTHETIC RECOVERY DURING WETTING AND THE ACCLIMATION OF PHOTOSYNTHETIC APPARATUS TO LIGHT FLUCTUATION IN A TERRESTRIAL CYANOBACTERIUM NOSTOC COMMUNE1
Authors: Chen Zhen , Lu GaoFei , Chen Shuo , Chen XiongWen
Published: August 2011

The PSII photochemical activity in a terrestrial cyanobacterium Nostoc commune Vaucher ex Bornet et Flahault during rewetting was undetectable in the dark but was immediately recognized in the light. The maximum quantum yield of PSII (Fv/Fm) during rewetting in the light rose to 85% of the maximum within ∼30 min and slowly reached the maximum within 6 h, while with rewetting in the darkness for 6 h and then exposure to light the recovery of Fv/Fm required only ∼3 min. These results suggested that recovery of photochemical activity might depend on two processes, light dependence and light independence, and the activation of photosynthetic recovery in the initial phase was severely light dependent. The inhibitor experiments showed that the recovery of Fv/Fm was not affected by chloramphenicol (CMP), but severely inhibited by 3‐(3,4‐dichlorophenyl)‐1,1‐dimethylurea (DCMU) in the light, suggesting that the light‐dependent recovery of photochemical activity did not require de novo protein synthesis but required activation of PSII associated with electron flow to plastoquinone. Furthermore, the test indicated that the lower light intensity and the red light were of benefit to its activation of photochemical activity. In an outdoor experiment of diurnal changes of photochemical activity, our results showed that PSII photochemical activity was sensitive to light fluctuation, and the nonphotochemical quenching (NPQ) was rapidly enhanced at noon. Furthermore, the test suggested that the repair of PSII by de novo protein synthesis played an important role in the acclimation of photosynthetic apparatus to high light, and the heavily cloudy day was more beneficial for maintaining high photochemical activity.
OPTIMIZATION OF SALT CONCENTRATIONS FOR A HIGHER CAROTENOID PRODUCTION IN DUNALIELLA SALINA (CHLOROPHYCEAE)1
Authors: Farhat Nèjia , Rabhi Mokded , Falleh Hanen , Jouini Jihène , Abdelly Chedly , Smaoui Abderrazak
Published: August 2011

Dunaliella salina (Dunal) Teodor, when treated over 25 d with a wide range of NaCl salinities (0.6–4.5 M), showed its maximal growth potentialities at 1.5–3.0 M NaCl and was able to survive even at 4.5 M NaCl. Sodium concentrations increased significantly at the supraoptimal salinities, reaching up to 5 mmol · g−1 dry weight (dwt) at 4.5 M NaCl. Interestingly, ability of D. salina to take up essential mineral nutrients was not impaired by increased salinity. As for growth, chl concentrations were maximal in the 1.5–3.0 M NaCl range. Interestingly, carotenoid concentrations increased with the increasing salinity. The highest values of total antioxidant activity (5.2–6.9 mg gallic acid equivalents [GAE] · g−1 dwt), antiradical activity, and reducing power were measured at 1.5–3.0 M NaCl. As a whole, these results showed that at 1.5–3.0 M NaCl, D. salina produce appreciable antioxidant level. But, once it reaches its growth maximum, a salt addition up to 4.5 M could enhance its carotenoid yield.
How do I transfuse platelets (PLTs) to reverse anti‐PLT drug effect? (CME)
Authors: Sarode Ravi
Published: August 2011

Antiplatelet agents (APAs) are commonly used in clinical practice to either treat or prevent arterial thrombotic disorders in patients at high risk. The newer APAs are more potent with higher bleeding risk profiles. Patients who present with serious bleeds or need urgent surgical interventions while on APAs may require reversal of these agents' effect on PLTs. Currently, there are no guidelines for management of such patients. This article describes my approach to PLT transfusion or use of pharmacologic agents in such clinical scenarios based solely on personal experience and very limited published data.
Aortic Atheromas: Current Knowledge and Controversies: A Brief Review of the Literature
Authors: Sharma Umesh , Tak Tahir
Published: August 2011

Atheromatous disease of the aorta is a known marker of vascular disease and is associated with ischemic stroke, peripheral embolization, and coronary events. Transesophageal echocardiogram is routinely used to assess aortic atheromas. Discrepancies exist in the grading of aortic atheromas. Atheromas with >4 mm thickness or with plaque rupture and mobile fragments are more likely to be associated with peripheral embolic events. Antiplatelet agents, oral anticoagulants, and statins have been suggested in the management of atheromas but sufficiently powered, randomized, controlled trials are not available to guide medical management of atheromas. (Echocardiography 2011;28:1157‐1163)
Atropine Augmentation of Treadmill Exercise Stress Echocardiography
Authors: Brenden Cynthia K. , Eckman Peter M. , Bruce‐Fane Lorrie , Erlien Darryl , Herzog Charles A.
Published: August 2011

Objectives: Performance of exercise stress testing depends on adequate workload and is limited by patients’ inability to reach target heart rate due to noncardiac illness or medications such as beta‐blockers. This study aimed to assess the utility of atropine administration to augment the chronotropic response of patients undergoing treadmill exercise stress echocardiography. Methods: In a retrospective study, we assessed the utility of atropine administration to augment the chronotropic response in 1,396 patients undergoing treadmill exercise stress echocardiography between January 2004 and January 2009, compared with a historical control group with no atropine augmentation. Results: Atropine was well tolerated. The proportion of abnormal studies differed significantly between patients who underwent exercise with and without atropine augmentation (15% vs. 10%; P < 0.0001). Compared with the historical control group, the proportion of patients who achieved ≥85% of their target heart rates increased from 67% to 78% (P < 0.0001). Conclusions: While atropine augmentation is safe and feasible, further studies are required to determine whether it is an equivalent surrogate to achieving target heart rate through exercise alone. (Echocardiography 2011;28:1109‐1112)
Endothelial‐Mediated Coronary Flow Reserve and Its Relation to Mitral Annular Tissue Doppler Velocities in Offspring of Hypertensive Parents
Authors: Mahfouz Ragab A. , Dwidar Ashraf Elsaied , El Tahlawi Mohammad A.
Published: August 2011

Background: Although coronary flow reserve (CFR) is reduced in hypertensive patients, data regarding the endothelial response of coronary vasomotion and its relation to left ventricular (LV) function in their offspring is limited. Objective: To investigate the endothelial response of coronary flow, using cold pressor test (CPT), in offspring of hypertensive parents and its impact on LV diastolic function. Subjects and Methods: The study population consisted of 32 healthy young offspring (mean age 23.5 ± 7.1 years) of hypertensive parents and 26 aged matched volunteers (healthy offspring of normotensive parents) as controls. Coronary blood flow velocities were recorded in all subjects at rest and after CPT; a stimulus that can be considered totally endothelium‐dependent. CFR was calculated as the ratio of hyperemic‐to‐resting diastolic peak velocities. Doppler echocardiographic assessment was performed using both conventional and tissue Doppler assessment. Results: Coronary diastolic peak velocities at rest was comparable between the two groups (27.1 ± 6.2 vs 26.4 ± 5.8; P > 0.05); but the velocities were significantly lower after CPT in offspring of hypertensive parents (P < 0.02), with highly significant lower CFR (P < 0.0001). Conventional echo‐Doppler variables were comparable in both groups, whereas tissue Doppler assessment demonstrated significant LV diastolic dysfunction among offspring of hypertensive parents. The CPT‐CFR was significantly correlated to tissue Doppler diastolic dysfunction in this group (For Em, Am and Em/Am, r was 0.65, 0.59 and 0.61, respectively, and P < 0.001). Conclusion: Offspring of hypertensive parents have coronary endothelial dysfunction that appears in response to physiological stimuli (CPT). The coronary endothelial dysfunction is associated with latent LV diastolic dysfunction. (Echocardiography 2011;28:1113‐1118)
Myocardial Performance Index Derived from Preejection Period: A Novel and Feasible Parameter in Evaluation of Cardiac Performance in Patients with Permanent Atrial Fibrillation
Authors: Su Ho‐Ming , Lin Tsung‐Hsien , Hsu Po‐Chao , Chu Chun‐Yuan , Lee Wen‐Hsien , Lee Chee‐Siong , Lai Wen‐Ter , Sheu Sheng‐Hsiung , Voon Wen‐Chol
Published: August 2011

Background: Using tissue Doppler echocardiography, we can measure preejection period (PEPa), defined as the interval measured from the onset of QRS to the onset of the systolic mitral annular velocity pattern, isovolumic relaxation time (IVRTa), defined as the interval measured from the end of systolic mitral annular velocity pattern to the onset of diastolic mitral annular velocity pattern, and ejection time (ETa), defined as the interval measured from the onset to the end of systolic mitral annular velocity pattern on the same cardiac cycle. The aim of this study is to test the applicability of PEPa‐derived myocardial performance index (MPI), defined as the ratio of PEPa + IVRTa to ETa, as an indicator of combined left ventricular systolic and diastolic function in patients with permanent atrial fibrillation. Methods: Echocardiographic examination was performed in 54 consecutive patients with permanent atrial fibrillation. Clinical and echocardiographic parameters were compared and analyzed. Results: After a multivariate analysis, the average RR interval on the tissue Doppler image (β=−0.328, P = 0.002), left ventricular ejection fraction (β=−0.260, P = 0.024), and early diastolic mitral annular velocity (β=−0.408, P < 0.001) were the major determinants of PEPa‐derived MPI. Conclusions: PEPa‐derived MPI had a significant correlation with echocardiographic left ventricular diastolic and systolic function. It may be a novel and feasible indicator in assessment of global left ventricular function in patients with permanent atrial fibrillation. (Echocardiography 2011;28:1081‐1087)