bluuebunny/crossref_metadata_2025 huggingface dataset:
The dynamic nature of bud dormancy in trees: environmental control and molecular mechanisms
Authors: COOKE JANICE E. K. , ERIKSSON MARIA E. , JUNTTILA OLAVI
Published: June 2012

In tree species native to temperate and boreal regions, the activity‐dormancy cycle is an important adaptive trait both for survival and growth. We discuss recent research on mechanisms controlling the overlapping developmental processes that define the activity‐dormancy cycle, including cessation of apical growth, bud development, induction, maintenance and release of dormancy, and bud burst. The cycle involves an extensive reconfiguration of metabolism. Environmental control of the activity‐dormancy cycle is based on perception of photoperiodic and temperature signals, reflecting adaptation to prevailing climatic conditions. Several molecular actors for control of growth cessation have been identified, with the CO/FT regulatory network and circadian clock having important coordinating roles in control of growth and dormancy. Other candidate regulators of bud set, dormancy and bud burst have been identified, such as dormancy‐associated MADS‐box factors, but their exact roles remain to be discovered. Epigenetic mechanisms also appear to factor in control of the activity‐dormancy cycle. Despite evidence for gibberellins as negative regulators in growth cessation, and ABA and ethylene in bud formation, understanding of the roles that plant growth regulators play in controlling the activity‐dormancy cycle is still very fragmentary. Finally, some of the challenges for further research in bud dormancy are discussed.
Atopic dermatitis: a candidate for disease‐modifying strategy
Authors: Bieber T. , Cork M. , Reitamo S.
Published: June 2012

The concept of disease modification has been introduced to define the therapeutic strategies aimed to break, stop, or reverse the natural course of a chronic invalidating disease. This strategy is tightly related to the biomarker‐based stratification of affected patients using genetic and other biological markers. With regard to the progress in understanding the genetic background of atopic dermatitis (AD), its natural history and its pivotal role in the emergence of allergic asthma, the time is mature to foster the research field of biomarkers in AD and to consider the elaboration of disease‐modifying strategies in the management of AD with the goal to stop or even reverse the atopic march.
T cells producing the anti‐inflammatory cytokine IL‐10 regulate allergen‐specific Th2 responses in human airways
Authors: Faith A. , Singh N. , Farooque S. , Dimeloe S. , Richards D. F. , Lu H. , Roberts D. , Chevretton E. , Lee T. H. , Corrigan C. J. , Hawrylowicz C. M.
Published: June 2012

Background

Murine models suggest a critical functional role for the anti‐inflammatory cytokine IL‐10 in local regulation of allergic airways inflammation. There is little corresponding information on human airway cells. This study aimed to investigate whether local IL‐10 production regulates responses by respiratory mucosal leucocytes isolated from nasal polyps.

Materials and Methods

Nasal polyp tissue was harvested from 24 patients sensitised to aeroallergens with chronic rhinitis and polyposis undergoing routine polypectomy. Cells were isolated by matrix proteolysis. Cytokine production by polyp cells was determined by cytometric bead array (CBA) and intracellular cytokine analysis. Surface marker expression by polyp cells was determined by flow cytometry.

Results

Allergen stimulation significantly enhanced production of IL‐10, but not IL‐5 or IFN‐γ by nasal polyp cell suspensions. Under the same conditions, neutralisation of IL‐10 significantly increased allergen‐specific IL‐5 and IFN‐γ production by nasal polyp cells. Cell depletion experiments showed that T cells themselves were primarily responsible for IL‐10 production or for inducing its production by other cells. Intracellular cytokine staining confirmed production of IL‐10 in the absence of IL‐2 production by T cells in response to allergen.

Conclusion

T cells within the human respiratory mucosa produce IL‐10, which is capable of inhibiting pro‐inflammatory Th2 and Th1 cytokine production in an antigen‐specific fashion.
Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients
Authors: Lim Wai H. , Chadban Steve J. , Clayton Philip , Budgeon Charley A. , Murray Kevin , Campbell Scott B. , Cohney Solomon , Russ Graeme R. , McDonald Stephen P.
Published: June 2012

Human leukocyte antigen (HLA) mismatches have been shown to adversely affect renal allograft outcomes and remain an important component of the allocation of deceased donor (DD) kidneys. The ongoing importance of HLA mismatches on transplant outcomes in the era of more potent immunosuppression remains debatable. Using Australia and New Zealand Dialysis and Transplant Registry, live and DD renal transplant recipients between 1998 and 2009 were examined. The association between the number of HLA mismatches and HLA‐loci mismatches and outcomes were examined. Of the 8036 renal transplant recipients, 59% had between 2 and 4 HLA mismatches. Compared with 0 HLA mismatch, increasing HLA mismatches were associated with a higher risk of graft failure and patient death in the adjusted models. HLA mismatches were associated with an incremental risk of rejection although the relative risk was higher for live donor kidney transplants. Increasing HLA‐AB and HLA‐DR mismatches were associated with a greater risk of acute rejection, graft failure, death‐censored graft failure, and/or death. There was no consistent association between initial immunosuppressive regimen and outcomes. Our results corroborate and extend the previous registry analyses demonstrating that HLA mismatches are associated with poorer transplant outcomes independent of immunosuppression and transplant era.
Diaphragmatic hernia in infants following living donor liver transplantation: Report of three cases and a review of the literature
Authors: Shigeta Takanobu , Sakamoto Seisuke , Kanazawa Hiroyuki , Fukuda Akinari , Kakiuchi Toshihiko , Karaki Chiaki , Uchida Hajime , Matsuno Naoto , Tanaka Hideaki , Kasahara Mureo
Published: June 2012

Shigeta T, Sakamoto S, Kanazawa H, Fukuda A, Kakiuchi T, Karaki C, Uchida H, Matsuno N, Tanaka H, Kasahara M. Diaphragmatic hernia in infants following living donor liver transplantation: Report of three cases and a review of the literature.

Abstract:  DH is a rare complication following LT. This report presents three cases of right‐sided DH after LT using a left‐sided graft. All of the patients were younger than one yr of age, and they were critically ill owing to their original disease, characterized by biliary atresia, progressive familiar intrahepatic cholestasis, and acute liver failure. DH occurred with sudden onset within three months after LT. All of the cases were promptly diagnosed and treated. A literature review of 24 cases of DH identified four factors associated with DH: left‐sided graft, right‐sided DH, relatively delayed onset of DH, and age‐specific chief complaint. DH following LT should be considered as a potential surgical complication when a left‐sided graft is used, especially in small infants with coagulopathy and malnutrition.
Immunohistochemical phenotyping of the inflammatory infiltrate in de novo autoimmune hepatitis after liver transplantation in children
Authors: Hadžić Nedim , Quaglia Alberto , Cotoi Corina , Hussain Munther J. , Brown Nigel , Vergani Diego , Mieli‐Vergani Giorgina
Published: June 2012

Hadžić N, Quaglia A, Cotoi C, Hussain MJ, Brown N, Vergani D, Mieli‐Vergani G. Immunohistochemical phenotyping of the inflammatory infiltrate in de novo autoimmune hepatitis after liver transplantation in children.

Abstract:  We have investigated the inflammatory infiltrate in post‐transplant dn‐AIH, a form of late insidious graft rejection, focusing on transcription factors defining effector and T‐regs, using an antigen retrieval immunohistochemical method on archived liver tissue, and compared it with ACR and classical AIH. Paraffin‐embedded liver biopsies from pediatric patients with dn‐AIH (n = 10), ACR (n = 10), and AIH (n = 13) were selected randomly and stained using antibodies directed to CD4, CD8, T‐bet (marker of Th1 polarization), GATA‐3 (marker of Th2 polarization), FOXP3 (marker for T regulatory cells), IL‐17, CD56 (NK cells), and perforin. Portal and lobular lymphocytic infiltrate was assessed semi‐quantitatively. Prominent CD4, CD8, and T‐bet positivity were present in both the lobular and portal infiltrate of all three conditions. Overall T‐bet score of lobular inflammation in the dn‐AIH group was lower than in the ACR and AIH groups (p = 0.02). In contrast, most samples showed absent or minimal GATA‐3 positivity. FOXP3, CD56, IL‐17, and perforin staining of mild to moderate severity were present in all three groups in both the portal and lobular infiltrate. A Th1 polarization of the inflammatory infiltrate characterizes dn‐AIH, but also ACR and AIH.
Living donor liver transplantation in children: A single North American center experience over two decades
Authors: Karnsakul W. , Intihar P. , Konewko R. , Roy A. , Colombani P. M. , Lau H. , Schwarz K. B.
Published: June 2012

Karnsakul W, Intihar P, Konewko R, Roy A, Colombani PM, Lau H, Schwarz KB. Living donor liver transplantation in children: A single North American center experience over two decades.

Abstract:  Little data concerning hospital charges and long‐term outcomes of LDLT in North American children according to transplant indications have been published. To compare outcomes of patient and graft survival and healthcare charges for LDLT for those with BA vs. other diagnoses (non‐BA). A retrospective review of 52 children receiving 53 LDLT (38 BA and 14 non‐BA) from 1992 to 2010 at our institution was performed. One‐, five‐, and 10‐yr patient and graft survival data were comparable to national figures reported to UNOS. Average one‐yr charges for recipients and donors were $242 849 for BA patients and $183 614 for non‐BA (p = 0.074). BA patients were 1.23 ± 1.20 yr of age vs. 4.25 ± 5.02 for non‐BA, p = 0.045. Examination of the total population of patients who were alive in 2010 in five chronological groupings showed that the crude five‐yr survival rates were 1992–1995: 9/11 (82%); 1995–1997: 6/10 (60%); 1997–1999: 8/10 (80%); 1999–2001: 9/10 (90%); and 2001–2003: 7/7 (100%). Thus, examination of the clinical and financial data together over the entire period of the transplant program suggests that the dramatic improvement in patient survival was accomplished without a dramatic increase in indexed charges. All 53 donors survived, and only 10% had complications requiring hospitalization. LDLT in children results in excellent outcomes for patients and donors. Ways to lower costs and maximize graft outcome should be investigated.
Effects of Exogenous Testosterone on Parental Care Behaviours in Male Bluegill Sunfish (Lepomis macrochirus)
Authors: Rodgers Chandra M. C. , Neff Bryan D. , Knapp Rosemary
Published: June 2012

Androgens are known to mediate aggressive and defensive behaviour in many vertebrate species. However, high concentrations of androgens might also conflict with the expression of nurturing behaviours and therefore a trade‐off can exist between aggressive and nurturing behaviours during parental care. We explored the role of testosterone in paternal care in bluegill sunfish (Lepomis macrochirus), where males provide both sole defence of the young from predators and sole nurturing behaviour such as fanning of the eggs. At the onset of parental care, we manipulated testosterone levels in males using testosterone propionate implants. We then observed the frequency of nurturing and aggressive behaviours displayed by the males over 6 d of parental care. Testosterone‐implanted fish were more aggressive when presented with a brood predator, performing more bites, opercular flares and lateral displays than control males. Testosterone‐implanted males, however, were not less nurturing than control fish, performing similar levels of fanning and nest‐cleaning behaviours. Thus, our results support a positive relationship between testosterone and paternal aggression but no testosterone‐mediated trade‐off between paternal nurturing and aggression.
Testes Investment along a Vertical Depth Gradient in an Herbivorous Fish
Authors: Ota Kazutaka , Hori Michio , Kohda Masanori
Published: June 2012

Males are expected to adjust testes investment according to the varying level of sperm competition that they experience. Spatial and temporal variation in population density likely influences sperm competition. In herbivorous aquatic organisms, densities often decrease along a vertical depth gradient, because their food is photosynthetic and thus becomes less abundant in deeper regions where less light penetrates. This decrease should be dramatic on a steep slope, which allows testing of the association between density and testes investment at the within‐population level. We tested the effect in the socially monogamous herbivorous cichlid fish
Variabilichromis moorii living on a steep slope in Lake Tanganyika. We examined competitor density and food abundance as ecological factors, territory defense behaviors and phenotypic traits (testes investment and somatic investment), and compared them between shallow (4–6 m depth) and deep habitats (10–13 m depth) separated by several dozen meters. We found that food availability drastically decreased with increasing depth and that
V
. moorii was much more abundant in shallower habitats. Males in shallower habitats were in better physical condition (based on fat and liver mass) despite experiencing greater costs in terms of territory defense. Testes investment differed in areas with different competitor density and food abundance along a vertical depth gradient, but competitor density was the most explanatory factor of the difference. This suggests that this herbivorous fish would change testes investment in response to population density.
Pecking but Accepting the Parasitic Eggs may not Reflect Ejection Failure: The Role of Motivation
Authors: Soler Manuel , Fernández‐Morante Jacob , Espinosa Francisco , Martín‐Vivaldi Manuel
Published: June 2012

The common cuckoo, Cuculus canorus, is an evictor brood parasite that generally reduces host fitness to zero, exerting strong selective pressure on hosts to evolve egg recognition and rejection. However, a great deal of variation in egg‐rejection efficiency exists, egg‐rejection behaviour being considered a flexible conditional response against parasitic eggs. Recently, it has been shown that some of the individuals that recognized (pecked) the parasitic egg finally accepted it. Here, we present the results of two egg‐recognition experiments made in two populations of rufous‐tailed scrub robins, Cercotrichas galactotes, in which one plaster model or a real house sparrow's egg, respectively, was experimentally introduced into their nests. The hosts' response was video recorded, allowing us to quantify the number of pecks, pecking strength, and ejection behaviour. We have found that rufous‐tailed scrub robin females ejected the model egg easily by grasping it after weakly pecking it; however, sometimes (55%) females pecked the experimental egg but did not eject it. This acceptance after pecking is not the consequence of a failure at puncture ejection, given that when confronted with real eggs (soft and easily punctured) in the second experiment, only 20% of pecked eggs were ejected, signifying that females that pecked at eggs without ejecting them had a low motivation to eject. We also discuss the effect of clutch inspection and the function of pecking strength. Finally, based on our own and previous research demonstrating pecking not followed by rejection, we propose a stepwise discrimination process in which accumulating motivation plays a key role in determining behavioural pathways shaping host response to parasitic eggs.
Pathogenicity and virulence of Armillaria sinapina and host response to infection in Douglas‐fir, western hemlock and western redcedar in the southern Interior of British Columbia
Authors: Cleary M. R. , van der Kamp B. J. , Morrison D. J.
Published: June 2012

The frequency of infection, lesion characteristics and anatomical changes in phloem and cambial tissues caused by Armillaria sinapina were studied on inoculated trees of Douglas‐fir, western hemlock and western redcedar and compared with results of A. ostoyae inoculations previously reported on the same host species. Similar percentages of inoculations resulting in infection of roots on the three hosts indicate that A. sinapina and A. ostoyae are equally pathogenic. Armillaria ostoyae was more virulent than A. sinapina as demonstrated by fungal exudates from A. ostoyae inoculum blocks, which appeared to cause lesions on roots; the higher frequency at which lignified impervious tissue (IT) and necrophylactic periderm (NP) developed in bark and following cambial invasion, compartmentalization; the large proportion of roots that showed no visible host response; the large zones of IT formed under continuous stimulation by A. ostoyae advancing in inner bark; and the high frequency of breaching of NP barriers. Spread of A. sinapina mycelium in host species appeared slower than that of A. ostoyae, particularly in Douglas‐fir and western hemlock. In western redcedar, A. ostoyae induced stronger host responses than those following invasion by A. sinapina, which included further expansion of the induced rhytidome response, traumatic phloem resin duct formation and higher numbers of polyphenolic parenchyma comprising its barrier zone. Where damage by A. sinapina ensued, it was always associated with high inoculum potential. The ecology of virulent and less virulent species of Armillaria in natural forests is discussed.
Root‐colonizing ophiostomatoid fungi associated with dying and dead young Scots pine in Poland
Authors: Jankowiak R. , Bilański P. , Kolařík M. , Wasiuta D.
Published: June 2012

Ophiostomatoid fungi are carried by various bark beetles. However, very little is known about the role of these fungi in conifer roots. We studied ophiostomatoid fungi in roots of dying and dead Pinus sylvestris trees and tested the potential phytotoxicity of some isolates using a sensitive bioassay with Lepidium sativum in Poland. Fungi were identified based on their morphology and DNA sequencing. Three ophiostomatoid fungi, Leptographium procerum, Sporothrix inflata and Ophiostoma pallidulum, were isolated from the roots. The most abundant soil‐borne fungus, S. inflata, and relatively rare O. pallidulum were isolated for the first time from roots of dying and dead pine trees. The frequency of S. inflata and O. pallidulum correlated with tree decline. The fungi were isolated more frequently from roots of dead than dying trees. Sporothrix inflata and O. pallidulum slightly reduced the stem and root growth of L. sativum. Leptographium procerum reduced more significantly root than stem growth. This species reduced root elongation 32–54% after 10–17 days of incubation.
Concurrence of lichen striatus and localised pityriasis rosea: Cutaneous mosaicism
Authors: Verma Prashant , Singal Archana , Yadav Pravesh , Sharma Reena
Published: June 2012

Cutaneous mosaicism has always been an intriguing subject. A 15‐year‐old boy presented to us with a unilateral band of lesions of pityriasis rosea and lichen striatus. The case is discussed in the light of the concept of genetic mosaicism.
Effect of captopril on infantile haemangiomas: A retrospective case series
Authors: Christou Elizabeth M , Wargon Orli
Published: June 2012

The mechanism of action of beta adrenergic blockers in the involution of infantile haemangioma (IH) remains unclear. It has been proposed that the renin‐angiotensin pathway may play a role. We present a retrospective case series of 17 patients with IH who were treated with oral corticosteroid therapy and developed hypertension requiring treatment with the angiotensin converting enzyme inhibitor, captopril. All patients, with written documentation, demonstrated an improvement in their lesion at the start of oral corticosteroid therapy (n = 14). Captopril alone did not sustain the corticosteroid‐induced involution with a documented worsening of infantile haemangioma in seven out of 12 patients (58%).
Neuropathologic analysis of Lewy‐related α‐synucleinopathy in olfactory mucosa
Authors: Funabe Sayaka , Takao Masaki , Saito Yuko , Hatsuta Hiroyuki , Sugiyama Mikiko , Ito Shinji , Kanemaru Kazutomi , Sawabe Motoji , Arai Tomio , Mochizuki Hideki , Hattori Nobutaka , Murayama Shigeo
Published: June 2012

We analyzed the incidence and extent of Lewy‐related α‐synucleinopathy (LBAS) in the olfactory mucosa, as well as the central and peripheral nervous systems of consecutive autopsy cases from a general geriatric hospital. The brain and olfactory mucosa were immunohistochemically examined using antibodies raised against phosphorylated α‐synuclein. Thirty‐nine out of 105 patients (37.1%) showed LBAS in the central or peripheral nervous systems. Seven patients presented LBAS (Lewy neurites) in the olfactory lamina propria mucosa. One out of the seven cases also showed a Lewy neurite in a bundle of axons in the cribriform plate, but α‐synuclein deposits were not detected in the olfactory receptor neurons. In particular, high incidence of α‐synuclein immunopositive LBAS in the olfactory mucosa was present in the individuals with clinically as well as neuropathologically confirmed Parkinson's disease and dementia with Lewy bodies (6/8 cases, 75%). However, this pathologic alteration was rare in the cases with incidental or subclinical Lewy body diseases (LBD) (one out of 31 cases, 3.2%). In the olfactory bulb, the LBAS was usually present in the glomeruli and granular cells of most symptomatic and asymptomatic cases with LBD. Our studies further confirmed importance of the olfactory entry zone in propagation of LBAS in the human aging nervous system.
Clinicopathological and genetic characteristics of extraventricular neurocytomas
Authors: Myung Jae Kyung , Cho Hwa Jin , Park Chul‐Kee , Chung Chun Kee , Choi Seung Hong , Kim Seung‐Ki , Park Sung‐Hye
Published: June 2012

Extraventricular neurocytoma (EVN) shares histological features with central neurocytoma, but has a wide morphological spectrum. Little is known regarding its clinicopathologic nature, biological behavior and genetic abnormalities. The aim of this study is to examine the diagnostic criteria, genetic abnormalities and biological behavior of EVN. Clinicopathological and molecular genetic studies were performed in seven EVNs. Among them, three cases showed atypical histology. Immunohistochemically, synaptophysin was robustly positive, but neuronal muclear antigen was positive in only half the cases (4/7cases). Isocitrate dehydrogenase enzyme isoform 1 (IDH1) (H09 immunostaining), α–internexin and p53 were negative in all cases. One case was positive for galectin‐3. None of the cases showed IDH1 R132 and IDH2 R172 mutation by direct sequencing. One case showed high polysomy of the epidermal growth factor receptor (EGFR) gene; however, O6‐methylguanine‐DNA methyltransferase (MGMT) promoter methylation and 1p/19q co‐deletion were not detected. Array‐based comparative genomic hybridization (CGH) study was performed in two cases, revealing different profiles, with loss and gain of multiple chromosomal loci. Two children (18%) had tumor recurrence after initial surgery, and one of them showed worse histology at recurrence and EGFR high polysomy. One patient died from the disease at 18.5 months after surgery. From our study, we concluded that EVNs were characterized by the absence of p53 overexpression, α‐internexin positivity, MGMT promotor methylation and IDH1/IDH2 mutation. Oligodendrocyte transcription factor 2 expression was seen in a scattered positive pattern but quite large numbers of tumor cells were negative. EVN is a WHO grade II tumor but some cases (2/7 cases in our series) can show late recurrence but mortality is low (1/7 cases in our series). CGH study suggested genetic heterogeneity of EVNs and unknown subclassification, which requires verification in more cases.
Practice of breast self‐examination and knowledge of breast cancer among female university students in Korea
Authors: Shin Kyung Rim , Park Hyo Jung , Kim Mijung
Published: June 2012

This study examined the practice of breast self‐examination and knowledge of breast cancer among female university students in Korea. This was a cross‐sectional descriptive study. The participants were 2186 female university students in Korea. The Breast Cancer and Heredity Knowledge Scale was used. The collected data were analyzed through descriptive statistics, χ2‐test, t‐test, ANOVA, and logistic regression. Twenty‐seven percent of students reported engaging in breast self‐examination. The participants displayed a medium‐level score (total score: 5.33 ± 2.70, range: 0–11) on knowledge about breast cancer. Predictors for breast self‐examination were age (odds ratio = 1.15, P < 0.001), major (odds ratio = 1.80, P < 0.001), and knowledge of breast cancer (odds ratio = 1.16, P < 0.001). This study was the sole nationwide‐scale research that examined the practice of breast self‐examination, related factors, and knowledge of breast cancer among female university students, as a representative sample of young Korean women. The results are valuable in developing educational programs that can increase knowledge related to breast cancer, as well as the practice of breast self‐examination, to support health promotion among young women.
One‐step, simultaneous triple endoscopic nasobiliary drainage for hilar biliary stricture
Authors: Kawakubo Kazumichi , Isayama Hiroyuki , Mizuno Suguru , Hirano Kenji , Yamamoto Natsuyo , Takahara Naminatsu , Miyabayashi Koji , Mohri Dai , Sasaki Takashi , Kogure Hirofumi , Sasahira Naoki , Tada Minoru , Koike Kazuhiko
Published: June 2012

The management of advanced hilar malignant and benign biliary strictures remains difficult regardless of the advances in endoscopic biliary stenting. Endoscopic nasobiliary drainage (ENBD) is suitable for the management, but the number of ENBD tubes is limited by the diameter of the accessory channel of the duodenoscope. In the present study,we demonstrated the feasibility and safety of one‐step simultaneous triple ENBD insertion to manage hilar biliary strictures. A therapeutic duodenoscope with a 4.2‐mm accessory channel was advanced into the duodenum. Three guidewires were advanced into three different intrahepatic bile ducts, none of which communicated with the others.Then, the three 5‐Fr ENBD tubes were simultaneously inserted alongguidewire, one at a time. Three patients with hilar biliary stricture who suffered from acute cholangitis due to stent occlusion were successfully managed by one‐step, simultaneous triple ENBD insertion.There were no procedure‐related complications. One‐step simultaneous triple ENBD is the most suitable drainage method for patients with advanced hilar biliary obstruction, especially in the setting of acute cholangitis due to occlusion of the previously placed stent.
Animal feasibility study of an innovated splash‐needle for endoscopic submucosal dissection in the upper gastrointestinal tract
Authors: Fujishiro Mitsuhiro , Sugita Noriyuki
Published: June 2012

Background and aim

The high frequency of complications accompanying endoscopic submucosal dissection (ESD) and its complex processes suggest that the process requires improvement. The objective of the present study was to investigate the feasibility of an innovated splash‐needle for ESD.

Methods

An animal feasibility study with a living pig was conducted. Six resections per portion (esophagus and upper, middle, and lower thirds of the stomach) in a total of 24 resections were carried out by using an original splash‐needle or an innovated splash‐needle. Major innovations were a thicker part in the middle of the knife and a metal plate on the tip of the sheath to obtain more coagulation ability. Injection solution in the submucosal layer was also changed due to possible influence on the outcomes. Main outcome measurements were entire procedure time, cutting speed, and frequency of bleeding during ESD.

Results

All the 24 resections were completed without complications. Among the obtained data, only mean cutting speeds were significantly influenced by location of the simulated lesion, which revealed that ESD at the upper third was significantly quicker than that at the lower third (P = 0.01), and ESD at the esophagus was significantly slower than that at the three parts of the stomach (P < 0.01). There was no significant difference between the different knives in each variable.

Conclusions

The innovated splash‐needle will be feasible for human use, although the safety and advantages in clinical settings must be elucidated by proper comparative studies with existing knives in humans.
Topical anesthesia for transnasal esophagogastroduodenoscopy: Spray, applicator, or both?
Authors: Moriyama Tomohiko , Matsumoto Takayuki , Esaki Motohiro , Nakamura Shotaro , Kimura Hiroshi
Published: June 2012

Background and Aim

Transnasal esophagogastroduodenoscopy (EGD) has become widely accepted in Japan. Better performance and compliance for the procedure are expected with appropriate nasal anesthesia.We aimed to elucidate the effectiveness, the safety and the compliance of nasal anesthesia for transnasal EGD.

Methods

Subjects were 372 asymptomatic patients examined by transnasal EGD for gastric cancer screening. They were pretreated with topical anesthesia either with a nasal spray method (Spr group, n = 127), cotton‐tipped applicator method (Cot group, n = 115), or both (Com group, n = 130). Lidocaine (4%) was applied with atomizer in the Spr method, whereas a cotton‐tipped applicator soaked in 4% lidocaine was placed in the nasal cavity for 5 min in the Cot method. After transnasal EGD, each subject rated procedure‐related discomfort according to visual analogue scales. In subjects who had prior experience oftransoral EGD, tolerance against EGD was compared between transnasal and transoral routes.

Results

There were no severe adverse events related to topical anesthesia.Transnasal EGD was completed in 94.9% of the patients.Age, gender or insertion failure rate were not different among Spr, Cot and Com groups. Pain scores for anesthesia and examination were significantly lower in the Spr group, whereas the pain score for insertion was not different among the three groups.The rate of patients who deemed transnasal EGD to be more tolerable than transoral EGD was highest in the Spr group.

Conclusions

Topical nasal spray seems to be appropriate for topical anesthesia in transnasal EGD.
Testing postural control among various osteoporotic patient groups: A literature review
Authors: de Groot Maartje H , van der Jagt‐Willems Hanna C , van Campen Jos PCM , Lems Willem F , Lamoth Claudine JC
Published: June 2012

Aim:  Osteoporosis can cause vertebral fractures, which might lead to a flexed posture, impaired postural control and consequently increased fall risk. Therefore, the aim of the present review was to examine whether postural control of patients with osteoporosis, vertebral fractures, thoracic kyphosis and flexed posture is affected. Furthermore, instruments measuring postural control were evaluated and examined for sensitivity and easy clinical use.

Methods:  Until February 2011, electronic databases were systematically searched for cross‐sectional studies. Methodological quality was assessed with a modified Downs & Black scale.

Results:  Of the 518 found studies, 18 studies were included. Postural control was generally affected for patients with vertebral fractures, thoracic kyphosis and flexed posture. Patients with osteoporosis had impaired postural control when assessed with computerized instruments. Easy performance‐based tests did not show any impairments.

Conclusions:  There is evidence for an impaired postural control in all patient groups included. Impaired postural control is an important risk factor for falls. Functional performance tests are not sensitive and specific enough to detect affected postural control in patients with osteoporosis. To detect impaired postural control among osteoporotic patients and to obtain more insight into the underlying mechanisms of postural control, computerized instruments are recommended, such as easy‐to‐use ambulant motion‐sensing (accelerometry) technology. Geriatr Gerontol Int 2012; ••: ••–••.
Comprehensive geriatric functional analysis of elderly populations in four categories of the long‐term care insurance system in a rural, depopulated and aging town in Japan
Authors: Chen Wenling , Fukutomi Eriko , Wada Taizo , Ishimoto Yasuko , Kimura Yumi , Kasahara Yoriko , Sakamoto Ryota , Okumiya Kiyohito , Matsubayashi Kozo
Published: June 2012

Aim:  The aim of this study was to show which dimensions of functions differ among community‐dwelling elderly participants in four different certification levels of the current long‐term care insurance system (LTCI) in a rural, depopulated and aging town in Japan, with special consideration for strengths and weaknesses of the LTCI.

Methods:  The study population consisted of 1077 community‐dwelling elderly participants aged 65 years and older, with LTCI certification comprising 542 uncertified elderly (Ippan‐Koureisya), 437 specified elderly (Tokutei‐Koreisha), 57 support‐level elderly (Youshien‐Koureisha) and 41 care‐level elderly (Youkaigo‐Ninteisha). Each participant was rated regarding their health status, with question topics including basic activities of daily living (ADL), the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG‐IC), the 15‐item Geriatric Depression Scale (GDS‐15), 21‐item Fall Risk Index (FRI‐21), the quantitative subjective quality of life (QOL), current medical situation, past medical histories and social backgrounds.

Results:  The scores in basic ADL, each item of the TMIG‐IC and five items of the quantitative subjective QOL were significantly lower, and the scores in GDS‐15 and in FRI‐21 were significantly higher according to certification level, in order of uncertified, specified, support‐level and care‐level elderly in a dose–response manner. Exercise and drinking habits were significantly less common in support‐ or care‐level elderly than in specified or uncertified elderly. The prevalence of taking antihypertensive, antihyperlipidemia, antidepressant or sleeping medications was significantly higher in the support‐ or care‐level elderly than in uncertified or specified elderly people. Support‐ or care‐level elderly also had a significantly higher prevalence of past medical histories of stroke, bone fractures, osteoarthropathy, heart disease and cancer than uncertified or specified elderly people.

Conclusion:  Actual standardized quantitative and qualitative geriatric functions of the elderly among four categories in newly revised LTCI system were shown in a depopulated and aging town in Japan. Based on the actual situation of functions of the elderly, the strengths and weaknesses of the current LTCI system were reconsidered. Further research on the measures to prevent future dependency among the specified and support‐level elderly is required. Geriatr Gerontol Int 2013; 13: 63–69.
Structure‐oriented review of 14‐3‐3 protein isoforms in geriatric neuroscience
Authors: Umahara Takahiko , Uchihara Toshiki , Iwamoto Toshihiko
Published: June 2012

This review focuses on the possible relevance of 14‐3‐3 proteins in geriatric neuroscience. 14‐3‐3 proteins are mainly localized in the synapses and neuronal cytoplasm. These proteins regulate intracellular signal cascades for differentiation, development, growth, apoptosis and survival. Seven isoforms have so far been identified in mammals. The binding motifs and potential functions of 14‐3‐3 proteins are now recognized to have a wide range of functional relevance. First, we provide a brief summary of the molecular structure and multiple functions of 14‐3‐3 proteins. Second, we review the involvement of 14‐3‐3 proteins in common diseases of geriatric neurology, such as Alzheimer's disease and tauopathies, Parkinson's disease and α‐synucleinopathies, Huntington's disease and polyglutamine diseases, Creutzfeldt–Jakob disease and prion diseases, cerebral infarction, and atherosclerosis. Finally, we discuss the immunohistochemical localization of 14‐3‐3 proteins and its isoforms during the postnatal development of rat brains as a basis for understanding adult neurogenesis. The elucidation of the isoform‐dependent functions of 14‐3‐3 proteins with regard to brain development might be promising for the future development of novel therapeutic interventions for common diseases of geriatric neurology. Geriatr Gerontol Int 2012; ••: ••–••.
Effects of health literacy to self‐efficacy and preventive care utilization among older adults
Authors: Chen Ji‐Zhen , Hsu Hui‐Chuan , Tung Ho‐Jui , Pan Ling‐Yen
Published: June 2012

Aim:  This study examined the relationships between health literacy, self‐efficacy and preventive care utilization among older adults in Taiwan.

Methods:  The data were from a longitudinal survey, “Taiwan Longitudinal Study in Aging” in 2003 and 2007. A total of 3479 participants who completed both two waves were included for analysis. Health literacy first was constructed through education, cognitive function and disease knowledge through structural equation modeling (SEM); then, the associations of health literacy to later self‐efficacy and preventive care were examined.

Results:  The model fit of SEM was good, indicating that the construct of health literacy was appropriate. Healthy literacy showed a moderate positive effect on self‐efficacy and a small positive effect on preventive care utilization.

Conclusions:  Health literacy increases self‐efficacy and utilization of preventive care. Promoting people's health knowledge and health literacy is suggested. Geriatr Gerontol Int 2013; 13: 70–76.
Effects of cilostazol on cognition and regional cerebral blood flow in patients with Alzheimer's disease and cerebrovascular disease: A pilot study
Authors: Sakurai Hirofumi , Hanyu Haruo , Sato Tomohiko , Kume Kazumasa , Hirao Kentaro , Kanetaka Hidekazu , Iwamoto Toshihiko
Published: June 2012

Aim:  It remains unknown whether antiplatelet agents have a preventive effect on cognitive decline in patients with Alzheimer's disease (AD). We investigated the effects of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, on cognition and regional cerebral blood flow (rCBF) in elderly patients with AD and cerebrovascular disease (CVD).

Methods:  A total of 20 patients with AD and CVD were randomly assigned to a cilostazol group (n = 11, 100 mg daily) or control group (n = 9, aspirin 100 mg or clopidogrel 50 mg–75 mg daily) for 6 months.

Results:  The cilostazol group did not show any statistically significant changes in cognitive function test scores, whereas the control group showed statistically significant cognitive decline on the Alzheimer's Disease Assessment Scale‐Cognitive Subscale (Japanese version), Revised Wechsler Memory Scale (logical memory‐I) and Trail Making Test‐A. Analysis of covariance of treatment effect revealed that the cilostazol group showed increased rCBF in the right anterior cingulate lobe compared with baseline, whereas the control group showed decreased rCBF in the left middle temporal gyrus compared with baseline.

Conclusion:  These findings suggest that cilostazol might have a preventive effect on cognitive decline in patients with AD and CVD. Geriatr Gerontol Int 2013; 13: 90–97.
Analysis of the normative conditions of oral health, depression and serotonin‐transporter‐linked promoter region polymorphisms in an elderly population
Authors: Mendes Danilo Cangussu , Silva Thiago Fonseca , Barros Lucas de Oliveira , de Oliveira Marcos Vinícius Macêdo , Vieira Leonardo Tadeu , Haikal Desirée Sant'Ana , Guimarães André Luiz Sena , De Paula Alfredo Maurício Batista
Published: June 2012

Aim:  To investigate the association between depression, the normative conditions of oral health and serotonin‐transporter‐linked promoter region (5‐HTTLPR) polymorphisms in a community‐dwelling elderly sample.

Methods:  Elderly adults living in a community (n = 200) were submitted to an oral clinical examination. Depression was assessed using the 15‐item Geriatric Depression Scale. The 5‐HTTLPR was analyzed by polymerase chain reaction‐restriction fragment length polymorphism. Associations between the biomarkers and clinical covariates were assessed by bivariate and multivariate statistical tests. Statistical significance was set at P < 0.05.

Results:  The prevalence of dental caries, periodontal disease, edentulism and oral mucosal lesions was 51.2%, 20.8%, 58.0% and 21.5%, respectively. The prevalence of depression was 21.5%. A higher frequency of the S allele was recorded in older individuals with depression (P = 0.017). The present findings showed no significant association between depression and the normative conditions of oral health. The observed allelic polymorphisms were 44% S and 56% L, respectively. Genotypic variants were 33.5% LL, 45.0% SL and 21.5% SS. Individuals carrying the SS genotype showed a significantly high prevalence of periodontal disease (prevalence ratio = 3.077, CI 95% = 1.008–9.393, P = 0.048).

Conclusion:  The present findings suggest that depressive community‐dwelling older individuals did not show any association with alterations of oral health normative conditions. However, the SS genotypic polymorphic variant of 5‐HTTLPR seems to contribute to the occurrence of periodontal disease in the elderly. Geriatr Gerontol Int 2013; 13: 98–106.
Synergistic impact of low serum albumin on intensive care unit admission and high blood urea nitrogen during intensive care unit stay on post‐intensive care unit mortality in critically ill elderly patients requiring mechanical ventilation
Authors: Pan Sheng‐Wei , Kao Hsin‐Kuo , Yu Wen‐Kuang , Lien Te‐Cheng , Chen Yen‐Wen , Wang Jia‐Horng , Kou Yu Ru
Published: June 2012

Aims:  To identify intensive care unit (ICU) risk factors for post‐ICU 6‐month (PI6M) mortality in critically ill elderly patients requiring mechanical ventilation (MV).

Methods:  The present study was a retrospective observational study carried out in a respiratory ICU from December 2008 to December 2009. Medical records of patients aged ≥70 years and receiving MV were reviewed. Risk factors of PI6M mortality were assessed by multivariate Cox regression.

Results:  Of 120 patients enrolled, 46 (38%) died in the PI6M period. As compared with survivors, non‐survivors had lower serum albumin levels on ICU admission, lower estimated glomerular filtration rate, higher peak blood urea nitrogen (BUN) levels during ICU stay (ICU‐peak BUN), a higher ratio of prolonged steroid use and longer MV length in ICU. Independent risk factors of PI6M mortality were low albumin on admission (hazard ratio [HR] 3.53 per g/dL decrease, 95% CI [1.97–6.33], P < 0.001) and high ICU‐peak BUN (HR 1.11 per 10‐mg/dL increase, [1.04–1.18], P = 0.001). The HR for PI6M mortality was 7.88 [2.97–20.91] for patients with both risk factors (albumin ≤2.8 g/dL and ICU‐peak BUN >72 mg/dL) as compared with those without. For patients with high ICU‐peak BUN (>72 mg/dL), PI6M survival was better for those with a reduction in BUN level to ≤72 mg/dL at ICU discharge than those without.

Conclusions:  Low serum albumin level on ICU admission and high BUN level during ICU stay are two independent risk factors, especially their combination, of PI6M mortality in critically ill elderly patients requiring MV. Furthermore, patients with a reduction in high BUN have a better PI6M survival. Geriatr Gerontol Int 2013; 13: 107–115.
Using phonocardiography to investigate maternal cardiac reserve function in gestational hypertension and pre‐eclampsia
Authors: Shao Yong , Zhang Ying‐hong , Liu Ou Mamie
Published: June 2012

Aim:  This study used phonocardiography to investigate maternal cardiac reserve function in gestational hypertension and pre‐eclampsia.

Method:  Ninety‐nine pregnant women with gestational hypertension (50 cases) and pre‐eclampsia (49 cases) were included in the study; 99 normotensive pregnant women acted as controls. Using phonocardiography, cardiac reserve function parameters for all participants were recorded: heart rate, the ratio of the first heart sound magnitude to the second heart sound magnitude (S1/S2) and the ratio of the diastolic duration to the systolic duration (D/S).

Results:  The average values for S1/S2 in the pre‐eclampsia and gestational hypertension groups were 4.3 ± 2.2 and 2.2 ± 1.1 respectively. The average D/S of the pre‐eclampsia and gestational hypertension groups were 1.1 ± 0.3 and 1.4 ± 0.3 respectively. Cases of postnatal adverse maternal outcomes were only observed in the pre‐eclampsia group. A small proportion (2 out of 28) suffered cardiac‐related complications, with one of these two patients dying from cardiac failure. Both these cases had notably poor cardiac reserve function (S1/S2 > 5.00 and D/S < 1) before delivery. The index S1/S2 increases and the index D/S decreases with increasing severity of hypertension‐complicated pregnancies.

Conclusions:  Our findings indicate that cardiac reserve function declines with the increasing severity of hypertension during pregnancy. Phonocardiography is a useful, convenient and clinically worthwhile technique to monitor cardiac reserve function parameters of pregnant women with pre‐eclampsia.
Serial magnetic resonance imaging of placenta percreta with bladder involvement during pregnancy and postpartum: A case report
Authors: Ueda Yusuke , Kondoh Eiji , Kakui Kazuyo , Hamanishi Junzo , Ueda Masashi , Nishikawa Ai , Tatsumi Keiji , Konishi Ikuo
Published: June 2012

Whether to manage placenta previa percreta surgically or conservatively has been a controversial issue. A 30‐year‐old woman with placenta percreta with bladder involvement was treated conservatively. A planned cesarean section was performed at 33 weeks' gestation. A 1768‐g female infant was delivered through a transverse fundal uterine incision with the placenta left inside the uterus. The following morning, a massive postpartum hemorrhage occurred, and was successfully treated with transarterial embolization. The placenta was never expelled and spontaneously disappeared 4 months after surgery. We demonstrate serial magnetic resonance imaging of the placenta percreta during pregnancy and the postpartum period.
Can measurement of maternal anti‐cytomegalovirus immunoglobulin‐M antibody levels be used to screen for cytomegalovirus infection in embryos and fetuses?
Authors: Yoshida Masashi , Matsuda Hideo , Yoshinaga Yosuke , Asai Kazuhiko , Kawashima Akihiro , Sei Kiguna , Furuya Kenichi
Published: June 2012

Aims:  Our study aims to estimate whether measurement of maternal anti‐cytomegalovirus immunoglobulin‐M antibody (CMV‐IgM) levels are useful as a screening method for achieving early detection of congenital CMV infection.

Material and Methods:  Levels of maternal CMV‐IgM were measured by enzyme immunoassay in all (n = 2865) pregnant women who visited our hospital in the first trimester during the period from January 2005 to December 2009.

Results:  Among them, 21 individuals (0.73%) had a CMV‐IgM titer of ≥0.08 and were judged to be CMV‐IgM‐positive. Informed consent was obtained from all 21 individuals to perform the confirmation test that quantifies the levels of cytomegalovirus DNA (CMV‐DNA) in amniotic fluid by real‐time polymerase chain reaction. However, only one (0.03%) of the 21 individuals was CMV‐DNA‐positive (CMV‐DNA concentration, 1.0 × 104 copies/ml).

Conclusion:  In order to detect congenital CMV infection in early pregnancy, it is considered appropriate to use ultrasound for close examination of embryo or fetal symptoms indicative of CMV instead of performing serological screening based on CMV‐IgM.