bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycosis fungoides – analysis of the duration of disease stages in patients who progress and the time point of high‐grade transformation
Authors: Kamarashev Jivko , Theler Barbara , Dummer Reinhard , Burg Günter
Published: September 2007

Background  Mycosis fungoides (MF) is a low‐grade malignant primary cutaneous T‐cell lymphoma which, in its evolution, passes through five distinct stages (patch, plaque, and tumor stages, lymph node infiltration, and, finally, multiple organ infiltration). Furthermore, a blast transformation into a high‐grade malignant lymphoma can occur. In order to better understand the dynamics of the disease and the prognostic implications in patients who progress, we studied the duration of each stage and the time at which blast transformation occurred.

Methods  We reviewed the records of 48 MF patients who had been followed in the lymphoma clinic of the Department of Dermatology, University Hospital Zurich, Zurich, Switzerland for a median of 10 years. Forty‐two cases were eligible for evaluation.

Results  Our study showed that MF in patients who progress is a disease which, after an initial patch stage with an average duration of 7.2 years, a plaque stage lasting for an average of 2.3 years, and a tumor stage with an average duration of 1.8 years, leads to a stage of lymph node infiltration with an average duration of 0.6 years, internal organ infiltration lasting for an average of 0.5 years and, finally, a fatal outcome. Consequently, the overall average disease duration in progressing patients is 12.4 years. Blast transformation occurs in 85% of all cases in the tumor stage.

Conclusions  The course of progressing MF is chronic and advancing. The progression is initially slow and later accelerates. Important prognostic factors are the stage of disease and the presence of blast transformation. The prognosis is better in the early stage and when blast transformation is absent.
Fatal malignant melanoma in a child with neurofibromatosis type 1
Authors: Bin Amer Yousef , Al‐Khenaizan Sultan
Published: September 2007

Neurofibromatosis type 1 is an autosomal dominant disease and is considered one of the most commonly inherited diseases in humans. Malignant melanoma has been reported in up to 5% of patients with neurofibromatosis type 1. We report a young Saudi boy with neurofibromatosis type 1 who developed fatal metastatic malignant melanoma arising from giant melanocytic nevi within speckled lentiginous nevus (SLN).
Precalcaneal congenital fibrolipomatous hamartoma: a discussion of two cases
Authors: Corella F. , Dalmau Joan , García Muret M. P. , Baselga E. , Alomar A.
Published: September 2007

Case 1  A 3‐month‐old boy presented with two nodular lesions distributed symmetrically on the medial plantar surface of both heels, present since birth. The nodules were approximately 1 cm in diameter, pink in color, soft, mobile, and nonpainful to the touch (Fig. 1). The mother was a primigravida, with no previous medical history of interest or history of drug intake during pregnancy. The pregnancy passed without incident with normal delivery at term without complications, and the newborn was of appropriate weight for the gestational age. There was no family history of similar lesions. At 12 months of age, the lesions remained stable and asymptomatic.

Bilateral nodular lesions on the medial internal plantar heel surface in a 3‐month‐old boy

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Case 2  A 7‐month‐old girl presented with two symmetrical nodules of 1.2 cm in diameter located on the medial plantar surface of each heel, present since birth. The nodules were of a normal skin color, soft, mobile, and painless (Fig. 2). The mother was a secundigravida and the only medical history of note was hepatitis C virus infection 3 years earlier. The pregnancy progressed without incident with a normal delivery at term, and the newborn was of an appropriate weight for the gestational age. Significant in the family history was the presence of similar lesions in both the aunt and maternal grandfather; the mother herself denied having had similar lesions during childhood. In the case of the maternal aunt, the lesions had diminished in size to the point of completely disappearing at the age of 3 years. In the case of the maternal grandfather, the outcome was unknown. The lesions had reduced in size to approximately 1 cm in diameter in our patient at 12 months of age. Presently aged 12 months, she continues to be monitored periodically in our department; the lesions persist but no morphological changes or associated functional alterations have been observed.

Bilateral nodular lesions on the medial internal plantar heel surface in a 7‐month‐old girl

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Poikilodermatous mycosis fungoides
Authors: Mataix Javier , Bañuls José , Lucas Ana , Belinchón Isabel , Betlloch Isabel
Published: September 2007

A 60‐year‐old woman presented with a 10‐year history of pruritic patch lesions that had originated on her breast and progressed over the years to involve the lower part of the abdomen. Different cutaneous biopsies were obtained during this period revealing a superficial chronic dermatitis. She had been treated previously with intermittent cycles of medium‐strength topical steroids. This regimen was of only temporary benefit and progression of the skin lesions had occurred over the last year. The patient's medical history was otherwise unremarkable.

Physical examination revealed atrophic red–brown skin with telangiectasia predominantly located on the breast (Fig. 1). Clinical examination also revealed various red‐to‐brown scaly plaques affecting the lower part of the abdomen.

Representative clinical appearance with reticulate pigmentation, atrophy, scaling, and telangiectasia

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Two skin biopsies were obtained from the breast and the abdomen. Routine hematoxylin and eosin staining of the breast area revealed an atrophic epidermis covered by a scale of hyperkeratosis and parakeratosis. Scattered intraepidermal atypical lymphocytes were observed. In the dermis, there was a superficial band‐like infiltrate of atypical lymphocytes sparing the dermo‐epidermal interface. Pigmentary incontinence and dilated capillaries were present within the superficial dermis (Fig. 2). All of these findings were compatible with the poikilodermatous variant of cutaneous T‐cell lymphoma (CTCL). Plaques affecting the lower part of the abdomen showed clinical features of classic mycosis fungoides (MF), and histology revealed an epidermis with acanthosis, a dense band‐like infiltrate within the upper dermis, and a prominent epidermotropism with intraepidermal collections of lymphocytes. Immunohistochemical analysis of both biopsies identified the cells as CD2+, CD3+, CD4+, CD8–. Further detailed examination did not reveal any visceral or lymph node involvement.

Biopsy specimen of the breast. (A) Atrophic epidermis and a superficial band‐like infiltrate (hematoxylin and eosin; original magnification, ×40). (B) Scattered intraepidermal atypical lymphocytes and melanophages within the superficial dermis (hematoxylin and eosin; original magnification, ×200)

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When topical mechlorethamine had no significant effect, psoralen plus UV‐A (PUVA) phototherapy was started at 0.5 J/cm2 twice weekly. After 20 treatments (cumulative dose, 143.5 J/cm2), the lesions had disappeared, leaving slight postinflammatory hyperpigmentation. No maintenance treatment was required and the patient remained in complete remission during a 14‐month follow‐up period.
Postoperative electron beam radiotherapy for keloids: objective findings and patient satisfaction in self‐assessment
Authors: Bischof Marc , Krempien Robert , Debus Juergen , Treiber Martina
Published: September 2007

Aim  To evaluate the role of postoperative radiotherapy in the management of keloids.

Methods  Forty‐seven patients with a combined total of 60 keloids were treated with 6‐MeV electron beam radiotherapy after surgical excision of the keloids. Mean daily fractions of 4 Gy (range, 3–5 Gy) were administered up to a total dose of 16 Gy (range, 12–18 Gy). The median follow‐up was 70 months. Patients were asked to complete a questionnaire addressing their satisfaction with the treatment results. This self‐assessment was compared with the clinical outcome.

Results  Four keloids (7%) relapsed completely, and five recurrences (8%) were classified as limited relapses. All recurrences were observed at sites of high stretch–tension. Keloid‐associated symptoms, e.g. itching and pain, were improved in 81%. Hypopigmentation was observed in 29 patients (62%), a mild redness of the scar in eight patients (17%), and grade 1 telangiectasias in two patients (4%). No severe complications or secondary malignancies were observed. Self‐assessments did not fully correspond to the clinical examination and recurrence status. Twelve patients were not satisfied with the treatment result, but only two of these relapsed completely. Three relapsed patients described the result of therapy as excellent or good.

Conclusion  Postoperative electron radiotherapy is well tolerated and very effective in preventing keloid recurrence. To avoid an overestimation of cosmetic outcome, patients should be informed about achievable results before therapy starts.
Serological and genetic factors in early recurrence of IgA nephropathy after renal transplantation
Authors: Coppo Rosanna , Amore Alessandro , Chiesa Monica , Lombardo Federica , Cirina Paola , Andrulli Simeone , Passerini Patrizia , Conti Giovanni , Peruzzi Licia , Giraudi Roberta , Messina Maria , Segoloni Giuseppe , Ponticelli Claudio
Published: September 2007

Abstract:  Background:  The relative role of IgA anomalies and genetic factors in IgA nephropathy (IgAN) recurrence after transplantation has never been investigated in a single cohort.

Methods:  Sixty‐one transplanted patients who had IgAN as an original disease (30 with biopsy‐proved early recurrence, median 2.9 yr post‐transplant), and 120 controls, were investigated for aberrantly glycosylated IgA1, IgA binding to mesangial matrix, macromolecular IgA (IgA/fibronectin and uteroglobulin/IgA/fibronectin complexes), and polymorphisms of cytokines [tumor necrosis factor alpha (TNFα), interleukin 10 (IL‐10), IL‐6, interferon gamma and transforming growth factor beta 1] and renin‐angiotensin system (angiotensinogen converting enzyme, angiotensin II receptor 1, and angiotensinogen) genes.

Results:  At multivariate logistic regression analysis, recurrence showed a border‐line association with aberrantly glycosylated IgA1 [odds ratio (OR) 8.172, p = 0.077], and was significantly less frequent in carriers of ‐308 AG/AA TNF‐α“high producer” genotype (OR 0.125, p = 0.036) and ‐1082, ‐819, ‐592 ACC/ATA IL‐10 “low producer” (OR 0.038, p = 0.009) genotypes.

Conclusion:  High levels of aberrantly glycosylated IgA1 do not appear to play a strong crucial role in recurrence of IgAN. Polymorphisms of TNFα and IL‐10 known to condition Th1 prevalence were associated with protection from early recurrence of IgAN.
Quality and impact of occupational therapy journals: Authors’ perspectives
Authors: Rodger Sylvia , McKenna Kryss , Brown Ted
Published: September 2007

Background/aim:  With increasing pressure for academic accountability, there is a need for the profession to consider the quality and impact of its journals. This seems even more pressing because few occupational therapy journals have an impact factor, which has become synonymous with quality. By surveying authors of papers in occupational therapy journals, this study aimed to determine their perceptions of indicators of journal quality and ratings of 19 occupational therapy journals on these indicators and to have them provide a global rating for non‐occupational therapy journals.

Methods:  Authors of papers in peer‐reviewed occupational therapy journals between 2003 and 2005 were invited to complete an online survey. Of 554 authors, 184 (33%) responded. Most respondents were female (91%); over 40 years of age (78%); from the USA (29%), Canada (17%), Australia (16%), UK (16%) or Sweden (10%); had PhDs or professional doctorates (55%); and were academics (53%). The majority (63%) had published between 0 and two papers per year over the previous 3 years.

Results:  The top five quality indicators rated as very important were reputation/prestige of the journal, availability, rigour and quality of the manuscript review process, timeliness of review and publication, and impact on policy/practice. Six journals were rated high by respondents across most quality indicators (American Journal of Occupational Therapy, Australian Occupational Therapy Journal, British Journal of Occupational Therapy, Canadian Journal of Occupational Therapy, OTJR: Occupation, Participation and Health, and Scandinavian Journal of Occupational Therapy).

Conclusions:  The results are discussed in terms of promoting research and scholarship within academic institutions that are influenced by measures of research productivity and quality. Limitations of the study and recommendations for future research are included.
Constructing an occupational therapy role in situ using Organisational Role Analysis: A case study
Authors: French Glenys , Hughes Patricia
Published: September 2007

Background and Aims:  A developing international literature on population‐based occupational intervention provides limited evidence of the ways in which the associated occupational therapy roles are developed among entry‐level practitioners. This paper aims to explore the development of an occupational therapy role in a fieldwork placement from the perspective of a student and the off‐site supervisor and to explore the use of Organisational Role Analysis in this process.

Methods:  Systems psychodynamics and an occupational perspective of health provided the theoretical framework for this participant observation case study. Data from the reflective diaries of a fourth‐year student and her supervisor were analysed with respect to role development in an organisation where occupational therapy was welcome, but not completely understood.

Results:  This study provides insight into the challenges for students and supervisors in the development of an occupationally oriented role where the client is an organisation. Organisational Role Analysis was perceived to be helpful in focusing attention on the organisational context of role development.

Conclusions:  The application of the Organisational Role Analysis as an approach to student supervision in other settings, with more than one student and to facilitate professionally development warrants further investigation.
Self‐identified goals and the ability to set realistic goals following acquired brain injury: A classification framework
Authors: Turner Benjamin J. , Ownsworth Tamara L. , Turpin Merrill , Fleming Jennifer M. , Griffin Janelle
Published: September 2007

Objective:  To develop a framework for classifying the nature of goals identified by people with acquired brain injury (ABI) and explore the extent to which goals and the ability to set realistic goals vary over time and according to stage of recovery.

Methods:  Participants included 60 people with ABI comprising two subgroups: a post‐acute subgroup (n = 28, mean time since injury = 1.1 years, SD = 0.5) and a long‐term subgroup (n = 32, mean time since injury = 4.9 years, SD = 3.0). Participants completed the Self‐Awareness of Deficits Interview, which includes a goal‐setting component, at an initial assessment and at 12‐month follow‐up assessment. Data generated from the interviewing process were analysed using a combination of qualitative and quantitative methods.

Results:  Through an inductive analysis, a classification framework was developed consisting of the following goal categories: ‘relationships’, ‘work and education’, ‘injury/rehabilitation’, ‘health and leisure’, ‘daily life management’ and ‘general life/personal goals’. Each of these categories comprised several subcategories of goals. Overall, the post‐acute subgroup identified more goals in the improve function/rehabilitation subcategory than the long‐term subgroup (P = 0.002), whereas the nature of other life goals remained consistent over time. The ability to set realistic goals improved over time for the entire sample (P = 0.013).

Conclusion:  The findings provide therapists with greater insight into the goals most commonly identified by individuals with ABI. The classification framework may assist therapists to elicit client goals and tailor rehabilitation accordingly.
Evidence‐based practice in everyday clinical practice: Strategies for change in a tertiary occupational therapy department
Authors: Caldwell Elizabeth , Whitehead Mary , Fleming Jennifer , Moes Lara
Published: September 2007

Evidence‐based practice is an approach that has gained recognition for facilitating the transfer of evidence into quality clinical practice. While occupational therapy clinicians have a professional responsibility to ensure that their practice is effective, managers also have a responsibility to implement structures and systems that will support therapists in doing so. A review of the literature demonstrated limited evidence of specific organisational models of practice to facilitate the transfer of knowledge into occupational therapy practice. This paper outlines the steps undertaken by occupational therapists in a large tertiary teaching hospital to develop and implement a model of research utilisation. The resulting Research and Evidence in Practice model and the enabling strategies for its implementation are presented. A challenge for the future is to conduct a formal evaluation of the model.
Neurohydatidosis
Authors: Kovoor JME , Thomas RD , Chandrashekhar HS , Jayakumar PN , Pillai S , Shankar SK
Published: September 2007

Early and non‐invasive evaluation of hydatid infestation of brain and spine is of paramount importance, especially in endemic areas. We present a spectrum of imaging findings in neurohydatidosis with a brief review of literature.
Percutaneous radiofrequency ablation of renal tumours: Case series of 11 tumours and review of published work
Authors: Watkins TW , Parkinson R
Published: September 2007

Detection of renal cell carcinoma (RCC) is increasing with the greater use of cross‐sectional imaging and up to two‐thirds of RCCs are discovered incidentally in asymptomatic patients. The traditional option of nephrectomy or partial nephrectomy may not always be appropriate. A minimally invasive treatment alternative is radiofrequency ablation (RFA). We retrospectively reviewed the RFA cases for renal tumours at our institution between January 2004 and June 2006. Thirteen RFA treatment sessions were conducted for 11 neoplasms in 11 patients. Mean patient age was 74.4 years (61–88 years). Imaging was carried out after ablation with a mean follow up of 8.0 months (2–26 months). No residual tumour was observed after the first RFA treatment in 82% of patients (nine of 11). Two patients required a second RFA treatment for residual (one) or recurrent tumour (one). RFA is emerging as a useful technique for treatment of small renal tumour. A number of short‐term studies reflect this, however, long‐term findings are still lacking.
Evolving standards of practice for cervical spine imaging in trauma: A retrospective review
Authors: Jones C , Jazayeri F
Published: September 2007

Recently published works on radiology and emergency medicine suggest an increasing role for primary CT imaging of the cervical spine (C‐spine) in trauma, rather than plain X‐rays. This observational retrospective study of 406 patients was undertaken to examine current practice in a metropolitan teaching hospital setting and to define factors affecting the use of primary imaging for suspected C‐spine fracture. This study supports the increasing recognition of the limited accuracy and adequacy of plain films, especially among the more severely injured patients. It is suggested that intubated patients, patients with severe trauma or patients with Glasgow Coma Scale <13 have CT as a primary screening examination for suspected C‐spine fracture rather than X‐ray. Patients having head CT for suspected intracranial injury may also benefit from included C‐spine CT. The increasing usage of primary CT will increase overall imaging costs and resource utilization.
MRI: Imaging of stomach
Authors: Lam WWM , Lee JSW , Ho G
Published: September 2007

The study is to determine the optimal MRI bowel preparation regime for visualization of the stomach anatomy. Eight healthy volunteers were asked to take water, 75% barium and blueberry juice. The image quality and tolerance of different stomach distension regime were evaluated. Blueberry juice gave the best distension, but the signal intensity was not very homogeneous. Taking into account the image quality, tolerability and adverse effects, it is concluded that water is the most desirable oral contrast for MR stomach imaging.
Discrepancy between computed tomography coronary angiography and selective coronary angiography in the pre‐stenting assessment of coronary lesion length
Authors: Soon KH , Farouque HMO , Chaitowitz I , Cox N , Selvanayagam JB , Zakhem B , Bell KW , Lim YL
Published: September 2007

We aimed to compare the lesion length measured on computed tomography coronary angiography (CT‐CA) with the selective coronary angiography (SCA) lesion length measured on quantitative coronary angiography (QCA). Compared with SCA, CT‐CA has the advantage of showing the lumen and the atherosclerotic plaque in the arterial wall. This prospective observational study involved 44 coronary lesions. Computed tomography coronary angiography was carried out with an electrocardiogram‐gated 16‐slice CT before percutaneous coronary intervention. A cardiologist and a radiologist measured CT lesion lengths in consensus, whereas an interventional cardiologist carried out QCA to obtain SCA lesion lengths independently. The median difference of (CT lesion length − SCA lesion length) was 9.84 mm (95%CI: [7.26, 13.34]). The median difference of (stent length − SCA lesion length) was 7.68 mm (95%CI: [6.29, 9.26]); the median difference of (stent length − CT length) was −2.63 mm (95%CI: [−5.80, 0.05]). The mean ratio of stent length to SCA lesion length was 2.07 (95%CI: [1.83, 2.30]). The mean ratio of stent length to CT‐CA lesion length was 0.97 (95%CI: [0.83, 1.11]). In the subgroup of drug‐eluting stents (17 lesions), the median difference of (stent length − SCA lesion length) was 9.76 mm (95%CI: [6.59, 13.28]); the median difference of (stent length − CT length) was −5.2 mm (95%CI: [−11, 0.5]). The mean ratio of stent length to CT‐CA lesion length was 0.93 (95%CI: [0.68, 1.17]). Computed tomography lesion length was substantially longer than SCA lesion length measured by QCA. Routine practice of choosing stent length based on QCA may underestimate the actual length of target lesion. This may lead to incomplete coverage of the target lesion, particularly when drug‐eluting stents are used.
Short duration of skin‐to‐skin contact: Effects on growth and breastfeeding
Authors: Boo Nem‐Yun , Jamli Faizah Mohamed
Published: September 2007

Aim:  To compare weight gain and head growth in very‐low‐birthweight (VLBW, <1501 g) infants with or without exposure to short duration of skin‐to‐skin contact (STSC) during their stay in a neonatal intensive care unit.

Methods:  Stable VLBW infants were randomised into either STSC or control group. Parents of the STSC group were encouraged to provide STSC for at least 1 h daily.

Results:  One hundred and forty‐six infants were randomised, but only 126 were enrolled (STSC group: n = 64; Controls: n = 62). Infants in the STSC group had better mean weekly increase in head circumference (1.0 cm (SD = 0.3) vs. 0.7 cm (SD = 0.3); P < 0.0001) and higher breastfeeding rate at discharge (29.7% vs. 14.5%; P = 0.04). Although the mean duration of maternal education was longer in STSC (13.0 vs. 12.1 years; P = 0.04) than in controls, linear regression analysis showed that the significant predictors associated with weekly head growth were exposure to STSC (unstandardised coefficient: 0.2; 95% confidence intervals (CI): 0.1, 0.3; P < 0.0001) and head circumference of infants at the time of enrolment (unstandardised coefficient: −0.05; 95% CI: −08, −0.03; P < 0.0001); the number of years of maternal education was not a significant predictor. Logistic regression analysis showed that the only significant predictors of successful breastfeeding at discharge were receiving expressed breast milk at enrolment (adjusted OR: 4.1; 95% CI: 1.4, 11.7; P = 0.009) and receiving expressed breast milk during intervention period (adjusted OR: 8.3; 95% CI: 2.8, 24.4; P < 0.0001); exposure to STSC and maternal education were not significant predictors.

Conclusion:  Exposure to short duration of STSC may promote head growth in VLBW infants.
Neonatal circumcision: Effects on breastfeeding and outcomes associated with breastfeeding
Authors: Fergusson David M , Boden Joseph M , Horwood L John
Published: September 2007

Aim:  There have been recurrent claims made that neonatal circumcision disrupts the development and maintenance of breastfeeding in infants. The aim of the current study was to use a longitudinal birth cohort study to examine the associations between neonatal circumcision status and both breastfeeding outcomes, and health and cognitive ability outcomes associated with breastfeeding.

Method:  Data were obtained from the Christchurch Health and Development Study, a longitudinal study of over 1000 individuals born in Christchurch New Zealand in mid 1977. Data were obtained for male cohort members (n = 635) on circumcision status, breastfeeding outcomes, health outcomes in infancy and cognitive ability outcomes later in life.

Results:  Circumcision status was not significantly associated (P > 0.05) with breastfeeding outcomes in infancy, even following adjustment for covariate factors, including maternal age, family socio‐economic status, ethnicity and birthweight. Also, circumcision status was not significantly associated (P > 0.05) with health in infancy and cognitive ability outcomes in later childhood, even after adjustment for covariate factors.

Conclusions:  There was no evidence of an association between neonatal circumcision status and breastfeeding outcomes, or between circumcision status and health and cognitive ability outcomes associated with breastfeeding, and the findings do not support the view that neonatal circumcision disrupts breastfeeding.
Use of the motor performance checklist to study motor outcomes in 5‐year‐olds
Authors: Liljestrand Petra , Jeremy Rita J , Wu Yvonne W , Ferriero Donna M , Escobar Gabriel J , Newman Thomas B
Published: September 2007

Aim:  To report findings about the Motor Performance Checklist (MPC) for 5‐year‐olds, a simple 12‐item instrument for assessing gross and fine motor skills, in a research study of neurodevelopmental outcomes after neonatal events.

Methods:  We trained 10 examiners to use the MPC in a study of the outcomes of neonatal jaundice and dehydration in 339 5‐year‐old children. We compared MPC scores with those on the Wechsler Preschool and Primary Scale of Intelligence‐Revised (WPPSI‐R), the Beery–Buktenica Developmental Test of Visual‐Motor Integration‐Fourth Edition (VMI‐4), and a standard neurological examination, and compared failure rates on each MPC item across examiners. Parent concerns about their child’s development were addressed using the Parent Evaluation of Developmental Status (PEDS).

Results:  Children who ‘failed’ the MPC had 7–10 points lower mean scores on the WPPSI‐R subscales (P = 0.001), 9–10 points lower mean scores on the VMI‐4 subscales (P = 0.001), and were almost twice as likely to have a ‘questionable’ neurological examination score (adjusted OR 1.86, 95% CI 1.00–3.53, P = 0.005). On the PEDS, only the concern about the use of arms and hands was significantly associated with MPC failure. We found significant sex differences on four of the 12 MPC items. We also found differences in failure rates by different examiners.

Conclusions:  MPC scores correlated with other measures of neurodevelopment. Because of different failure rates across examiners, examiner terms need to be included if it is used in research studies.
Identification and quantification of apoptosis in the kidney using morphology, biochemical and molecular markers
Authors: HUGHES JEREMY , GOBE GLENDA
Published: September 2007

SUMMARY:  Renal cell apoptosis is important in both physiological conditions such as normal renal development and pathological processes affecting the glomerular, vascular or tubulointerstitial compartments. Apoptosis may result in the detrimental loss of cells following many renal diseases or damaging changes, with significant loss of function. In contrast, apoptosis may control and limit inflammatory processes in both the acute and chronic phases of renal disease. Investigators interested in the presence of apoptotic cells in different forms of renal disease and development need methods to accurately determine the level of apoptosis within the kidney. Apoptosis is a gene‐driven mode of cell death that may be identified by distinct morphological features, endonuclease‐initiated DNA degradation, and by the involvement of specific apoptosis‐regulating proteins. Many research papers that analyse the presence of apoptosis use the in situ terminal deoxyribonucleotidyl transferase‐mediated deoxyuridine triphosphate nick end labelling (TUNEL) assay that detects DNA strand breaks in situ in tissue sections. Localization of activated caspase‐3 is now seen as an alternative to TUNEL. This review will discuss some methods of identifying apoptosis in the kidney, using both morphological and biochemical or molecular characteristics, and also discuss some of the pitfalls of entire reliance on biochemical means of apoptotic cell identification without some morphological checks and balances. Although there are some caveats to the methods for identifying apoptotic cells in renal disease, those investigators who take the time to undertake such analysis often gain insightful data that provide explanations for the disease or condition being studied.
Polypoidal choroidal vasculopathy examined with en face optical coherence tomography
Authors: Kameda Takanori , Tsujikawa Akitaka , Otani Atsushi , Sasahara Manabu , Gotoh Norimoto , Tamura Hiroshi , Yoshimura Nagahisa
Published: September 2007

Abstract

Background:  To study the morphologic features of polypoidal choroidal vasculopathy (PCV) with the use of en face optical coherence tomography (OCT).

Methods:  We reviewed retrospectively 57 eyes of 57 patients with PCV. The macular region was examined with OCT en face planes scanned at different sequential depths, following which detailed scanning was performed of arbitrarily selected longitudinal planes.

Results:  In 48 of the cases (84.2%), en face OCT allowed us to detect round protrusions of the retinal pigment epithelium (RPE) that corresponded to the polypoidal lesions seen on indocyanine green angiography (ICGA); the branching vascular networks seen on ICGA often induced slight elevation of the overlying RPE, which typically assumed a geographical shape. In 30 cases (52.6%), branching vascular networks were detected as elevations of the RPE. With en face OCT, serous pigment epithelial detachments, most of which were seen as round protrusions of the RPE, were often accompanied by adjacent smaller round protrusions of the RPE, consistent with polypoidal lesions. These protrusions of the RPE were often fused and typically appeared as a ‘snowman’. Subsequent longitudinal examination revealed the polypoidal lesions to be sharp protrusions of the RPE with moderate inner reflectivity. Consistent with the location of the branching vascular network, a highly reflective line was seen often just beneath the slightly elevated reflective line of RPE.

Conclusions:  En face examination using OCT has an advantage in screening lesions of PCV and in examination of the detailed relationship of each component of these lesions.
Distance refractive error among Aboriginal people attending eye clinics in remote South Australia
Authors: Durkin Shane R , Tan Edwin WH , Casson Robert J , Selva Dinesh , Newland Henry S
Published: September 2007

Abstract

Purpose:  To determine the prevalence of distance refractive error among Aboriginal people attending eye clinics in remote South Australia.

Methods:  A clinic‐based cross‐sectional study was conducted that involved opportunistic sampling of Aboriginal people attending eye clinics in remote South Australia. There were 189 individuals who were invited to participate in the study all of whom underwent ophthalmic examination. This examination included measurement of pinhole‐corrected visual acuity and non‐cycloplegic autorefraction.

Results:  Automated refractive error examinations were performed on 148 people within this sample. The mean age was 44.8 ± 14.5 years and women comprised 57.7% of the sample. The overall mean refractive error was −0.01 ± 1.8 D (SD). The prevalence of myopia (spherical equivalent (SE) < −0.5 D), high myopia (SE less than or equal to −6.0 D), hypermetropia (SE > 0.5 D), astigmatism (cylinder at least −0.5 D) and anisometropia (difference in SE of >0.5 D) was 31.1%, 0.7%, 33.1%, 55.8% and 45.9%, respectively. Further analyses revealed significant age‐related trends with both myopia and hypermetropia. There were no gender associations with any form of refractive error. Of those people with clinically significant refractive error, 51/148 (34%), only four people owned distance spectacles.

Conclusions:  There continues to be a level of uncorrected distance refractive error within these patients. This represents a need to screen for refractive error among Aboriginal people in remote locations and to provide them with appropriate spectacle correction.
Medical treatment of cataract
Authors: Toh Tze'Yo , Morton Jim , Coxon Jim , Elder Mark J
Published: September 2007

Abstract

The incidence of cataract continues to increase with the ageing of the population. Surgical treatment with phacoemulsification and intraocular lens implantation remains the only proven treatment. This, however, is associated with significant cost and is not readily available especially in the developing countries where the prevalence of cataract is the highest. Medical treatment of cataract is therefore a highly desired alternative. Since the last major review of medical treatment of cataract the search for an anti‐cataract agent has advanced on many fronts. Some anti‐cataract drugs, such as carnosine, have now reached clinical trials and showed encouraging results that warrant further investigation. The discovery of an effective medical treatment for cataract is likely to make global impact on eye health. The aims of this paper are to review the literature on the drug therapy of cataract and provide updates of the latest development.
A statistical theory for sampling species abundances
Authors: Green Jessica L. , Plotkin Joshua B.
Published: September 2007

The pattern of species abundances is central to ecology. But direct measurements of species abundances at ecologically relevant scales are typically unfeasible. This limitation has motivated a long‐standing interest in the relationship between the abundance distribution in a large, regional community and the distribution observed in a small sample from the community. Here, we develop a statistical sampling theory to describe how observed patterns of species abundances are influenced by the spatial distributions of populations. For a wide range of regional‐scale abundance distributions we derive exact expressions for the sampled abundance distributions, as a function of sample size and the degree of conspecific spatial aggregation. We show that if populations are randomly distributed in space then the sampled and regional‐scale species‐abundance distribution typically have the same functional form: sampling can be expressed by a simple scaling relationship. In the case of aggregated spatial distributions, however, the shape of a sampled species‐abundance distribution diverges from the regional‐scale distribution. Conspecific aggregation results in sampled distributions that are skewed towards both rare and common species. We discuss our findings in light of recent results from neutral community theory, and in the context of estimating biodiversity.
A statistical approach to quasi‐extinction forecasting
Authors: Holmes Elizabeth Eli , Sabo John L. , Viscido Steven Vincent , Fagan William Fredric
Published: September 2007

Forecasting population decline to a certain critical threshold (the quasi‐extinction risk) is one of the central objectives of population viability analysis (PVA), and such predictions figure prominently in the decisions of major conservation organizations. In this paper, we argue that accurate forecasting of a population's quasi‐extinction risk does not necessarily require knowledge of the underlying biological mechanisms. Because of the stochastic and multiplicative nature of population growth, the ensemble behaviour of population trajectories converges to common statistical forms across a wide variety of stochastic population processes. This paper provides a theoretical basis for this argument. We show that the quasi‐extinction surfaces of a variety of complex stochastic population processes (including age‐structured, density‐dependent and spatially structured populations) can be modelled by a simple stochastic approximation: the stochastic exponential growth process overlaid with Gaussian errors. Using simulated and real data, we show that this model can be estimated with 20–30 years of data and can provide relatively unbiased quasi‐extinction risk with confidence intervals considerably smaller than (0,1). This was found to be true even for simulated data derived from some of the noisiest population processes (density‐dependent feedback, species interactions and strong age‐structure cycling). A key advantage of statistical models is that their parameters and the uncertainty of those parameters can be estimated from time series data using standard statistical methods. In contrast for most species of conservation concern, biologically realistic models must often be specified rather than estimated because of the limited data available for all the various parameters. Biologically realistic models will always have a prominent place in PVA for evaluating specific management options which affect a single segment of a population, a single demographic rate, or different geographic areas. However, for forecasting quasi‐extinction risk, statistical models that are based on the convergent statistical properties of population processes offer many advantages over biologically realistic models.
Diversity and quorum‐sensing signal production of Proteobacteria associated with marine sponges
Authors: Mohamed Naglaa M. , Cicirelli Elisha M. , Kan Jinjun , Chen Feng , Fuqua Clay , Hill Russell T.
Published: September 2007

Marine sponges are hosts to diverse and dense bacterial communities and thus provide a potential environment for quorum sensing. Quorum sensing, a key factor in cell–cell communication and bacterial colonization of higher animals, might be involved in the symbiotic interactions between bacteria and their sponge hosts. Given that marine Proteobacteria are known to produce N‐acyl homoserine lactone (AHL) signal molecules, we tested the production of AHLs by Alpha‐ and Gammaproteobacteria isolated from marine sponges Mycale laxissima and Ircinia strobilina and the surrounding water column. We used three different AHL biodetection systems in diffusion assays: Chromobacterium violaceum, Agrobacterium tumefaciens and Sinorhizobium meliloti with optimal sensitivity to short‐chain (C4–C6), moderate‐chain (C8–C12) and long‐chain (≥ C14) AHLs respectively. Thirteen of 23 isolates from M. laxissima and five of 25 isolates from I. strobilina were found to produce AHLs. Signals were detected from two of eight proteobacterial strains from the water column. Thin‐layer chromatographic assays based on the A. tumefaciens reporter system were utilized to determine the AHL profiles of the positive isolates. The types and amounts of AHLs synthesized varied considerably among the strains. Small ribosomal rRNA gene sequencing revealed that the AHL‐producing alphaproteobacterial isolates were mainly from the Silicibacter–Ruegeria subgroup of the Roseobacter clade. Two‐dimensional gel electrophoresis (2DGE)‐based proteomic analyses were congruent with phylogenetic relationships but provided higher resolution to differentiate these closely related AHL‐producing strains.
Faecal dimeric M2 pyruvate kinase in colorectal cancer and polyps correlates with tumour staging and surgical intervention
Authors: Koss K. , Maxton D. , Jankowski J. A. Z.
Published: September 2007

Objective & Method  A dimeric form of pyruvate kinase isoenzyme (tumour M2‐PK) is predominantly found in highly proliferating cells. Sandwich ELISA with monoclonal antibodies against dimeric (tumour) M2‐PK was used to measure faecal tumour M2‐PK in; 13 controls, 10 patients with colonic polyps and 32 patients with colorectal cancer.

Results  Levels of faecal tumour M2‐PK were higher in patients with colorectal cancer (median 11.72 U/ml; range 0.9–146.95 U/ml, P = 0.0001) and polyps greater than 10 mm (median 2.54 U/ml; range 0.9–29.46 U/ml, P = 0.041) when compared with controls (median 1.75 U/ml; range 0.9–3.41 U/ml). Furthermore, levels were higher in stages Duke's B (P = 0.013) and Duke's C (P = 0.43) than in Duke's A. Six months postsurgery faecal tumour M2‐PK levels fell significantly to 3.46 U/ml (range 1.03–9.05 U/ml, P = 0.001). The sensitivity of a positive faecal tumour M2‐PK test, defined as a level above 3.33 U/ml, was 91% for colorectal cancer, 60% for >10 mm and 20% for <10 mm polyps, with a specificity of 92%.

Conclusion  Faecal tumour M2‐PK is a highly sensitive marker for colorectal cancer and larger polyps. It also correlates with more advanced stages of colorectal cancer and its reduction is associated with successful surgical intervention.
Morphological vs. molecular evolution: ecology and phylogeny both shape the mandible of rodents
Authors: Renaud Sabrina , Chevret Pascale , Michaux Jacques
Published: September 2007

What actually is the expected pattern relating to molecular and morphological divergence? A phylogenetic correlation is expected; however, natural selection may force morphological evolution away from this expected correlation. To assess this relationship and the way it is modulated by selection, we investigated the radiation of the murine rodents, also called as Old World rats and mice. Regarding their diet, they are diversified as they include many omnivorous as well as specialist taxa. The size and shape of the mandible, a morphological character involved in the feeding process, was quantified and compared with an estimate of molecular divergence based on interphotoreceptor retinoid binding protein (IRBP) sequences. Size and shape of the mandible appeared to be related by an allometric relationship whatever the ecology of the taxa. Small size characterizes most murines, causing a dominance of low size distances; still, the frequency of important size differentiation increases with molecular distances. Regarding shape changes, the pattern is much contrasted between omnivores and specialists. A pattern of phenotypic drift characterizes the mandible evolution of taxa sharing an omnivorous diet. Little saturation occurs over more than 10 million years with regard to the shape of the mandible that appears as a valuable marker of phylogenetic history in this context. In contrast, important morphological distances can occur when specialist taxa are involved, even when the molecular divergence is small. Ecological specialization thus triggers an uncoupling of molecular and phenotypic evolution, and the departure from a phenotypic drift pattern.
Total phalloplasty using a musculocutaneous latissimus dorsi flap
Authors: Perovic Sava V. , Djinovic Rados , Bumbasirevic Marko , Djordjevic Miroslav , Vukovic Petar
Published: September 2007

Authors from Serbia describe their experience of total phalloplasty in children and adults using a musculocutaneous latissimus dorsi free flap, finding that this method successfully allowed the creation of a neophallus, facilitating subsequent urethroplasty and the safe insertion of a penile prosthesis.

In the second article in this section, authors from Finland present the findings in 54 patients relating to skeletal health after intestinal bladder augmentation.

OBJECTIVE

To present total phalloplasty in children and adults using a musculocutaneous latissimus dorsi (MLD) free flap to create a large neophallus, that allows easy urethroplasty and implantation of a prosthesis.

PATIENTS AND METHODS

From April 1999 to January 2006, 16 patients (mean age 24 years, range 10–34) had a total phalloplasty; the indications were congenital anomalies of the penis in 12, iatrogenic in two and accidental penile trauma in two. The MLD flap is mobilized on a subscapular artery and vein, and a thoracodorsal nerve. The neophallus is created on‐site and after dividing the neurovascular pedicle, transferred to the pubic region, where it is anastomosed with the femoral artery, saphenous vein and ilio‐inguinal nerve. The donor site was closed directly in 15 patients while in one a split‐thickness skin graft was used to cover the defect. In the following stages, two‐ or three‐stage buccal mucosa urethroplasty was used in 11 patients; a penile prosthesis was implanted in seven.

RESULTS

The mean (range) follow‐up was 31 (12–74) months; the penis was 14–18 cm long and 11–15 cm in circumference. There was no partial or total flap necrosis; the donor site healed satisfactorily in 13 patients while in the remaining three there was moderate scarring. The patency of the urethra was good in all patients. Two urethrocutaneous fistulae developed; one closed spontaneously and the other was successfully treated with minor surgery. The function of the implanted penile prostheses was satisfactory in all patients.

CONCLUSIONS

The MLD flap allows the creation of a neophallus of good size and with a good aesthetic appearance; it allows urethroplasty and safe implantation of a penile prosthesis, and it can also be used in children.
Preliminary results of the Prostacox phase II trial in hormonal refractory prostate cancer
Authors: Albouy Baptiste , Tourani Jean‐Marc , Allain Patrick , Rolland Frederic , Staerman Frederic , Eschwege Pascal , Pfister Christian
Published: September 2007

OBJECTIVES

To assess in a phase II open multicentre study the efficacy and tolerance of docetaxel administered every 14 days combined with celecoxib, in patients with hormone‐refractory prostate cancer (HRPC), and to test the hypothesis that this therapeutic combination would improve overall survival.

PATIENTS AND METHODS

In all, 48 patients were included with a mean age of 70.4 years and Gleason score of 7.5, all had a satisfactory Karnofsky performance‐status score of 92% and a metastatic bone site was measurable in 77%. The mean delay between initial diagnosis and docetaxel administration was 45 months, with a median PSA level increase of 54.8 ng/mL. The therapeutic schedule was: docetaxel (50 mg/m2) administered every 14 days (one cycle of two injections at 2 week intervals (Day 1 = Day 28) with a total of six cycles) and simultaneously a daily oral fixed dose of celecoxib (800 mg).

RESULTS

In all, 237 cycles of docetaxel were administered with a dose reduction in 23 patients at the beginning of a cycle (day 1) and 36 in the middle of a cycle (day 14). The haematological toxicity included anaemia grade 1–2 (78%) and only 10% neutropenia grade 3–4. However, there was only a 15% improvement of pain intensity. The response rate for the total PSA level was 45.5 (30.4–61.1)%, the mean time to progression was 9.3 months and the tumour‐response rate was 26.3%. In all, 75% of patients had an overall survival of >14.6 months.

CONCLUSION

Our results confirm the usefulness of docetaxel for HRPC treatment and show a significant reduction of haematological toxicity with bi‐weekly docetaxel administration combined with celecoxib.