bluuebunny/crossref_metadata_2025 huggingface dataset:
Pneumocystis carinii Mimicking Neonatal Lupus Erythematosus‐Related Pneumonitis
Authors: Wozniacka Anna , Robak Ewa , Sysa‐Jedrzejowska Anna , McCauliffe Daniel P.
Published: November 2004

Abstract:  Neonatal lupus erythematosus (LE) is a rare disease associated with the transplacental passage of maternal autoantibodies to infants who manifest congenital heart block, skin disease, and less commonly, hematologic and hepatic disease. Pulmonary disease is a rare manifestation of neonatal LE and has presented as transient pneumonitis. In this report we describe an infant with neonatal LE who had the classic skin and hematologic findings of the disease in addition to pulmonary disease which might be attributed to neonatal LE‐related pneumonitis, but in fact was caused by a concomitant Pneumocystis carinii infection. This case demonstrates the importance of looking for other causes of pulmonary disease in neonatal LE patients.
Genomic Abnormalities in Patients With Migraine and Chronic Migraine: Preliminary Blood Gene Expression Suggests Platelet Abnormalities
Authors: Hershey Andrew D. , Tang Yang , Powers Scott W. , Kabbouche Marielle A. , Gilbert Donald L. , Glauser Tracy A. , Sharp Frank R.
Published: November 2004

Background.—Migraine has strong genetic and environmental components and may also be a significant contributor to chronic migraine (CM). It is hypothesized that gene expression changes in peripheral blood cells can be used to detect the interaction of these influences.

Objective.—Distinct genomic expression patterns for migraine and CM will be present. These genomic profiles will help clarify the interactions of inheritance and environment. This initial study begins to examine the feasibility of peripheral blood cell genomic analysis to assist in the understanding of the pathophysiology of migraine and CM.

Methods.—Blood samples from patients were obtained either during an acute migraine or CM. Genomic expression patterns were analyzed using Affymetrix U95A microarrays.

Results.—Expression patterns of 7 migraine and 15 CM patients were compared to four distinct control groups (total patients, n = 56) including healthy subjects. A group of platelet genes were upregulated in both migraine and CM samples. Different gene expression patterns were also seen between migraine and CM. A group of immediate early genes including c‐fos and cox‐2 were expressed at higher levels in migraine, whereas specific mitochondrial genes were expressed at higher levels in CM.

Conclusions.—Increased expression of platelet genes in patients with migraine and CM suggests similar underlying pathophysiology. The differences seen between migraine and CM in other genes suggest an overlapping but not identical pathophysiology. Further genomic profiling studies will help define these relationships and provide further insights into headache pathogenesis.
Preventing Disturbing Migraine Aura With Lamotrigine: An Open Study
Authors: Pascual Julio , Caminero Ana B. , Mateos Valentín , Roig Carlos , Leira Rogelio , García‐Moncó Carlos , Laínez Miguel J
Published: November 2004

Background.—Lamotrigine has been suggested as possibly effective for preventing migraine aura.

Objective.—To describe our experience with a series of patients with disturbing migraine aura treated with lamotrigine.

Methods.—The members of the Headache Group of the Spanish Society of Neurology were sent an ad hoc questionnaire to collect patients treated with lamotrigine due to disturbing migraine aura. The main outcome parameter (“response”) was a >50% reduction in the mean frequency of migraine auras at 3 to 6 months of treatment.

Results.—A total of 47 patients had been treated with lamotrigine due to severe migraine aura. Three could not complete the protocol as a result of developing skin rashes. Thirty (68%) patients responded. These were 21 females and 9 males whose ages ranged from 19 to 71 years. Eight suffered from migraine with “prolonged” aura, 8 typical aura with migraine headache (but had frequent episodes including speech symptoms), 6 basilar‐type migraine, 6 typical aura without headache, and 2 hemiplegic migraine. Fifteen had been previously treated, without response, with other preventatives. The mean monthly frequency of migraine auras in these 30 patients changed from 4.2 (range: 1 to 15) to 0.7 (range: 0 to 6). Response was considered as excellent (>75% reduction) in 21 cases (70% of responders). Auras reappeared in 2 months in 9 out of 13 patients where lamotrigine was stopped, and ceased as soon as this drug was reintroduced.

Conclusions.—Lamotrigine should be considered in clinical practice for the preventive treatment of selected patients with disturbing migraine auras. Lamotrigine seems worthy of a controlled trial as prophylaxis of migraine aura.
Biaxial Flexural Strength and Microstructure Changes of Two Recycled Pressable Glass Ceramics
Authors: Albakry Mohammad , Guazzato Massimiliano , Vincent Swain Michael
Published: November 2004

Purpose: This study evaluated the biaxial flexural strength and identified the crystalline phases and the microstructural features of pressed and repressed materials of the glass ceramics, Empress 1 and Empress 2.

Materials and Methods: Twenty pressed and 20 repressed disc specimens measuring 14 mm × 1 mm per material were prepared following the manufacturers' recommendations. Biaxial flexure (piston on 3‐ball method) was used to assess strength. X‐ray diffraction was performed to identify the crystalline phases, and a scanning electron microscope was used to disclose microstructural features.

Results: Biaxial flexural strength, for the pressed and repressed specimens, respectively, were E1 [148 (SD 18) and 149 (SD 35)] and E2 [340 (SD 40), 325 (SD 60)] MPa. There was no significant difference in strength between the pressed and the repressed groups of either material, Empress 1 and Empress 2 (p > 0.05). Weibull modulus values results were E1: (8, 4.7) and E2: (9, 5.8) for the same groups, respectively. X‐ray diffraction revealed that leucite was the main crystalline phase for Empress 1 groups, and lithium disilicate for Empress 2 groups. No further peaks were observed in the X‐ray diffraction patterns of either material after repressing. Dispersed leucite crystals and cracks within the leucite crystals and glass matrix were features observed in Empress 1 for pressed and repressed samples. Similar microstructure features—dense lithium disilicate crystals within a glass matrix—were observed in Empress 2 pressed and repressed materials. However, the repressed material showed larger lithium disilicate crystals than the singly pressed material.

Conclusions: Second pressing had no significant effect on the biaxial flexural strength of Empress 1 or Empress 2; however, higher strength variations among the repressed samples of the materials may indicate less reliability of these materials after second pressing.
The Effects of a Commercial Aluminum Airpolishing Powder on Dental Restorative Materials
Authors: Johnson William W. , Barnes Caren M. , Covey David A. , Walker Mary P. , Ross Judith A.
Published: November 2004

Introduction: JET‐Fresh™ (Dentsply International, York, PA), a new airpolishing powder that contains aluminum trihydroxide as the abrasive agent, has been introduced for use with Prophy‐Jet™ (Dentsply International).

Purpose: The aim of this study was to investigate the surface effects of aluminum trihydroxide airpolishing powder on a series of restorative materials.

Materials and Methods: A total of 6 Class V preparations with enamel margins were created on the buccal surface of extracted human molars. The preparations were restored with Type III gold, a high copper spherical alloy amalgam, porcelain, a light‐activated hybrid composite material, a light‐activated microfilled composite material, and a light‐activated, resin‐modified glass ionomer material. The distal half of each restoration was covered with fiberglass tape and the mesial half subjected to treatment with the aluminum trihydroxide powder via the Prophy‐Jet™ for 5 seconds. After removal of the protective tape, the buccal surface of each treated tooth was replicated with impression material. Replicas were generated using epoxy resin and prepared for evaluation with scanning electron microscopy.

Results: The aluminum trihydroxide produced surface alterations that were apparent visually and when viewed by a scanning microscope of the hybrid and microfilled composites and the glass ionomer restorations. The surfaces of the amalgam and gold restorations were altered, but not to the extent that the resin‐based materials were. No disruption of the surface characterization of the porcelain was detected; however, with gold and porcelain materials, the aluminum trihydroxide removed notable amounts of the luting cements (the results are consistent with the data gathered with sodium bicarbonate powder).

Conclusion: Aluminum trihydroxide as the abrasive agent in an airpolishing system should be avoided on resin composites, resin‐modified composites, and around the margins of cemented restorations.
Implant‐Supported Rehabilitation of the Severely Atrophic Maxilla: A Clinical Report
Authors: Peñarrocha‐Diago Miguel , Uribe‐Origone Roberto , Guarinos‐Carbó Juan
Published: November 2004

Implant‐supported rehabilitation in the posterior maxillary region presents a series of challenges because of the possibility of increased pneumatization of the maxillary sinus after dental loss. In cases where significant maxillary bone resorption has occurred, efforts center on maximizing the use of the remaining bone to afford primary stability to the implants. This clinical report describes a patient with extreme maxillary atrophy for whom fixed rehabilitation supported on 8 implants was accomplished. A zygomatic implant, a pterygomaxillary implant, and 2 implants mesial and distal to both canine eminences were placed. This rehabilitation was accomplished with a less invasive technique and in a much shorter time period compared to a sinus lift procedure. One year after prosthetic loading, the clinical and radiological results remain satisfactory.
Use of an Endoscopic Suturing Device for Laparoscopic Resection of the Apex of the Bladder and Umbilical Structures in Normal Neonatal Calves
Authors: Bouré Ludovic , Foster Robert A. , Palmer Michele , Hathway Amanda
Published: November 2004

Objective—To develop a laparoscopic technique using an endoscopic suturing device for the resection of the apex of the bladder and the umbilical structures in large‐animal neonates.

Study Design—Experimental study.

Animals or Sample Population—Seven healthy male Holstein calves.

Methods—A laparoscopic technique for resection of the apex of the bladder was developed on 2 calf cadavers, then evaluated on 5 anesthetized calves. The calves were positioned in dorsal recumbency, and 4 ventral abdominal portals were used. The umbilical vessels were double‐ligated using an endoscopic suturing device and subsequently transected. The apex of the bladder was transected between a row of laparoscopic clips applied near the apex and atraumatic laparoscopic forceps applied distally; then, the edges were apposed using an endoscopic suturing device. The dissected umbilical remnants were removed from the abdomen through a small incision centered at the umbilicus. One month later, the calves were euthanatized and a second‐look laparoscopy performed; then, bladders were collected for gross and histologic examination.

Results—No major complications occurred during or after surgery. The endoscopic suturing device permitted both effective ligation of the umbilical vessels and closure of the bladder. During second‐look laparoscopy, healing of the peritoneal surface of the bladder and umbilical vessels was assessed to be excellent in 4 calves. A focal adhesion of omentum to the bladder suture line was observed in 1 calf. Focal adhesions of the omentum to the umbilical incision site occurred in 2 calves. The bladder mucosa was completely healed at the surgical sites.

Conclusion and Clinical Relevance—Resection of the apex of the bladder and umbilical vessels in calves can be accomplished laparoscopically using an endoscopic suturing device.
Effect of Focused and Radial Extracorporeal Shock Wave Therapy on Equine Bone Microdamage
Authors: Da costa Gömez Támara M. , Radtke Catherine L. , Kalscheur Vicki L. , Swain Carol A. , Scollay Mary C. , Edwards Ryland B. , Santschi Elizabeth M. , Markel Mark D. , Muir Peter
Published: November 2004

Objectives— To determine whether bone microcracks are altered after application of focused and radial extracorporeal shock wave therapy (ESWT) to the equine distal limb.

Study Design— An ex vivo experimental model.

Sample Population— A contralateral limb specimen was obtained from 11 Thoroughbred racehorses with a unilateral catastrophic injury. Distal limb specimens were also obtained from 5 non‐racing horses.

Methods— Three separate skin‐covered bone segments were obtained from the mid‐diaphysis of the metacarpus (MC3) or metatarsus (MT3). Focused (9,000 shockwaves, 0.15 mJ/mm2, 4 Hz) and radial (9,000 shockwaves, 0.175 mJ/mm2, 4 Hz) ESWT treatments were randomized to the proximal and distal segments and the middle segment was used as a treatment control for pre‐existing microcracks. After treatment, bone specimens were bulk‐stained with basic fuchsin and microcracks were quantified in transverse calcified bone sections.

Results— ESWT had small but significant effects on microcracks. Microcrack density (Cr.Dn) and microcrack surface density (Cr.S.Dn) were increased after focused ESWT, whereas Cr.Le was increased after radial ESWT. In racing Thoroughbreds, Cr.Le increased with increased number of races undertaken. Cr.Dn and Cr.S.Dn were not significantly influenced by the number of races undertaken.

Conclusion— ESWT has small but significant effects on bone microcracking ex vivo.

Clinical Relevance— These preliminary data suggest that ESWT has the potential to increase bone microcracking in equine distal limb bone in vivo. Such effects may be more pronounced in Thoroughbreds that are actively being raced, because in vivo microcracking increases with increased number of races undertaken.
Effect of Petrolatum Coating on the Rate of Occlusion of Ameroid Constrictors in the Peritoneal Cavity
Authors: Adin Christopher A. , Gregory Clare R. , Kyles Andrew E. , Griffey Stephen M. , Kendall Lon
Published: November 2004

Objective—To document rate of closure and degree of inflammation associated with petrolatum coated (PCA) and non‐coated ameroid constrictors (NCA) in the peritoneal cavity.

Study Design—Experimental study.

Animals—18 Sprague‐Dawley rats.

Methods—Thirty‐six ameroid constrictors (AC; 5 mm) were digitally scanned and luminal area measured. Rats were anesthetized, and 1 PCA and 1 NCA were inserted in the peritoneal cavity by median celiotomy. Rats were euthanatized at 2 weeks (6 rats), 4 weeks (6), or 6 weeks (6) after surgery. AC were harvested, digitally scanned, and luminal area determined. Inflammation associated with the AC was subjectively graded (1–5). The effects of petrolatum coating on luminal area measurements and inflammatory score were statistically analyzed.

Results—Closure of AC occurred most rapidly during the first 2 weeks, but luminal area decreased only 32% at 6 weeks after implantation. There was no significant difference in rate of closure for PCA compared to NCA at 2, 4, or 6 weeks. Inflammation scores were not significantly different between PCA and NCA.

Conclusions—Petrolatum coating did not slow the rate of closure of AC in the peritoneal cavity.

Clinical Relevance—The lack of closure of AC supports the conclusion that vascular attenuation is not dependent on luminal constriction alone. Petrolatum coating did not slow the rate of casein expansion and is unlikely to be clinically useful.
Scanning Electron Microscopic Examination of Third Metacarpal/Third Metatarsal Bone Failure Surfaces in Thoroughbred Racehorses with Condylar Fracture
Authors: Stepnik Matthew W. , Radtke Catherine L. , Scollay Mary C. , Oshel Philip E. , Albrecht Ralph M. , Santschi Elizabeth M. , Markel Mark D. , Muir Peter
Published: November 2004

Objective—To examine the fracture failure surfaces from Thoroughbred horses that had sustained a catastrophic condylar fracture.

Sample Population—Bone specimens from the failure surface were obtained from 12 Thoroughbred racehorses with catastrophic injury and 2 non‐racing horses with accidental long bone fracture.

Methods—Bone specimens from the failure surface of each fracture were incubated with gold microspheres to label microcracks before examination at ×50 to ×60,000 using scanning electron microscopy. Microcracking at the failure surface was assessed using a visual analog scale.

Results—Branching arrays or clusters of microcracks were seen over a range of magnifications in adapted subchondral bone in the distal end of the MC3/MT3 bone from racing Thoroughbreds with a catastrophic displaced condylar fracture. In the palmar/plantar region, microcracking was associated with the formation of an array of macroscopic cracks in the condylar groove. A different pattern of microcracking was seen in specimens of bone from distal metaphyseal and diaphyseal MC3/MT3 failure surfaces from Thoroughbred racehorses with catastrophic fracture and non‐racing horses with an accidental diaphyseal long bone fracture. Few microcracks were seen and typically did not form branching arrays.

Conclusion—These data suggest that propagation of condylar fracture in Thoroughbred racehorses is initiated by the formation of nanoscale microcracks in adapted subchondral bone that form during exercise‐induced bone adaptation.

Clinical Relevance—Accumulation and coalescence of branching microcracks into arrays or clusters appears to eventually lead to the development of macroscopic subchondral cracks in the condylar groove and initiation of a condylar fracture.
Outcomes of Cellophane Banding for Congenital Portosystemic Shunts in 106 Dogs and 5 Cats
Authors: Hunt Geraldine B. , Kummeling Anne , Tisdall Penelope L.C. , Marchevsky Andrew M. , Liptak Julius M. , Youmans K. Ruth , Goldsmid Sarah E. , Beck Jason A.
Published: November 2004

Objective— To report outcomes after cellophane banding of single congenital portosystemic shunts in dogs and cats.

Study Design— Retrospective study of sequential cases.

Animals— One hundred and six dogs and five cats.

Methods— Medical records were reviewed for breed, sex, age at surgery, shunt anatomy, results of pre‐ and postoperative biochemical analysis, development of postligation neurologic dysfunction, portal hypertension or other serious complications, and the owners' perception of their animal's response to surgery.

Results— Ninety‐five dogs and all 5 cats had extrahepatic shunts. Eleven dogs had intrahepatic shunts. Six dogs (5.5%) died as a result of surgery from portal hypertension (2 dogs), postligation neurologic dysfunction (2), splenic hemorrhage (1) and suspected narcotic overdose (1). Serious complications were more common in dogs with intrahepatic shunts than those with extrahepatic shunts (P=.002). Postligation neurologic dysfunction necessitated treatment in 10 dogs and 1 cat; 8 dogs and the cat survived. Clinical signs attributed to portosystemic shunting resolved or were substantially attenuated in all survivors. Postoperative serum bile acid concentrations or results of ammonia tolerance testing were available for 88 animals; 74 (84%) were normal and 14 (16%) were abnormal. Multiple acquired shunts were documented in two animals.

Conclusions— Cellophane banding is a safe and effective alternative to other methods of attenuation.

Clinical Relevance— Slow occlusion of portosystemic shunts using a variety of methods is being evaluated world wide. Cellophane banding is a relatively simple procedure with comparable safety and efficacy to previously reported techniques.
Laparoscopic Repair of a Small Intestinal Mesenteric Rent in a Broodmare
Authors: Sutter W. Wesley , Hardy Joanne
Published: November 2004

Objectives—To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy.

Study design—Clinical case report.

Sample population—A 6‐year‐old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent.

Methods—Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from right flank portals by approximation with hemostatic clips.

Results—Approximation of the mesoduodenal rent was achieved with laparoscopic clips. No further complications or signs of abdominal pain occurred over the following year.

Conclusions—Mesenteric rents in the mesoduodenum can be repaired by laparoscopic techniques in the standing horse.

Clinical Relevance—Use of laparoscopic techniques in the standing horse should be considered for mesoduodenal rents that are not accessible form a ventral median celiotomy.
The Distinctive and Inclusive Domain of Entrepreneurial Cognition Research
Authors: Mitchell Ronald K. , Busenitz Lowell , Lant Theresa , McDougall Patricia P. , Morse Eric A. , Smith J. Brock
Published: November 2004

Through mapping both distinctive and inclusive elements within the domain of entrepreneurial cognition research, we accomplish our task in this introductory article to Volume 2 of the Special Issue on Information Processing and Entrepreneurial Cognition: to provide a fitting backdrop that will enhance the articles you will find within. We develop and utilize a “boundaries and exchange” concept to provide a lens through which both distinctive and inclusive aspects of the entrepreneurship domain are employed to frame this special issue.
An Epicardial Subxiphoid Implantable Defibrillator Lead:
Authors: MOLINA J. ERNESTO , BENDITT DAVID G.
Published: November 2004

A single epicardial implantable lead using the subxiphoid approach is described in this article. It consists of a single halo‐shaped coil that is implanted under the inferior surface of the heart, including the right and left inferior ventricular surfaces. It has been implanted in four patients who could not be defibrillated with a transvenous system, even with the adjunct use of subcutaneous leads or left chest wall patch. Three of the patients had progressive heart failure due to ischemic myocardiopathy; the fourth patient had a dilated idiopathic myocardiopathy. The approach is simple and appears to be effective due to its ability to encompass the left and right ventricles. This vector seems to significantly lower the threshold for defibrillation, and may offer substantial benefit in the setting of high defibrillation thresholds with conventional leads, or when conventional systems are inadequate to achieve consistent defibrillation.
Effect of Amiodarone Dose on the Risk of Permanent Pacemaker Insertion
Authors: ESSEBAG VIDAL , HADJIS TOM , PLATT ROBERT W. , ABRAHAMOWICZ MICHAL , PILOTE LOUISE
Published: November 2004

Bradyarrhythmia requiring permanent pacemaker insertion has been associated with amiodarone use but the effect of amiodarone dose has not been investigated. In order to determine the effect of amiodarone dose on the risk of requiring permanent pacemaker insertion, a cohort of 15,824 subjects with atrial fibrillation (AF) and prior myocardial infarction was established. This study included 1,340 subjects who received a first prescription of amiodarone at > 65 years of age. Cox regression with daily dose and cumulative dose (weighted for recency of exposure) represented by time dependent covariates was performed, adjusting for baseline risk factors and time dependent exposure to other cardiac medications. The incidence of pacemaker insertion was 2.2% per person‐year during a mean of 1.8 ± 1.5 years of follow‐up, and 5.2% per person‐year during the first 90 days of amiodarone exposure. Amiodarone daily doses > 200 mg were associated with an increased risk during the entire follow‐up HR 2.0; 95% CI 1.0 to 4.1) as well as during the first 90 days (HR 3.1; 95% CI 1.1 to 9.0). Cumulative doses greater than the equivalent of continuous therapy with 200 mg per day were also associated with an increased risk (HR 2.8; 95% CI 1.4 to 5.5). Baseline conduction disorder or sinus node dysfunction was the only other significant predictor of pacemaker insertion. This study suggests that there is a dose dependent increased risk of permanent pacemaker insertion associated with amiodarone use that appears to be greatest during the initial months of treatment.
T Wave Oversensing by a Cardioverter Defibrillator Implanted in a Patient with the Brugada Syndrome
Authors: PORRES JOSÉ MANUEL , BRUGADA JOSEP , MARCO PILAR , GARCÍA FRANCISCO , AZCARATE BEGOÑA
Published: November 2004

Oversensing of electrical signals in recipients of ICDs is a common complication causing the delivery of inappropriate therapy. The Brugada syndrome has a characteristic ECG pattern with dynamic temporal changes in response to various physiological or environmental conditions. This case report presents a patient with the Brugada syndrome and intermittent T wave oversensing by an ICD due to changes in T wave amplitude which could not be resolved by device reprogramming and required repositioning of the electrode.
Extraction of a Defibrillator Lead Through an Inferior Vena Cava Filter
Authors: HENRIKSON CHARLES A. , BRINKER JEFFREY A.
Published: November 2004

We report an extraction of a chronic, previously cut and abandoned, active‐fixation implantable cardioverter‐defibrillator lead through an inferior vena cava filter. A long workstation sheath that crossed the filter was used, allowing the lead and all hardware to be withdrawn through a single opening in the filter.
Stress Echocardiography:
Authors: NIXDORFF UWE
Published: November 2004

Myocardial viability within the infarct zone is an important determinant for left ventricular (LV) function recovery after interventional coronary revascularization. Echocardiographic techniques are highly valuable in identifying hibernation, especially in conjunction with dobutamine titration. Low doses may detect the inotropic reserve by significant enhancement of segmental wall motion abnormalities while high doses may surpass the ischemic threshold and wall motion deteriorates (biphasic response). According to the Task Forces on Clinical Application of Echocardiography by the American Heart Association (AHA) in cooperation with the American College of Cardiology (ACC), dobutamine echocardiography (DE) is officially recommended for the purpose of clincial decision making in respect of revascularization therapies (whether during the subacute infarct period or especially in chronic LV dysfunction due to coronary artery disease (CAD)). New methods such as strain rate imaging implemented in DE are on the way to give us quantitative measures of the amount of viability.
Clinical Experiences Using Everolimus‐Eluting Stents in Patients with Coronary Artery Disease
Authors: STÖRGER HANS , GRUBE EBERHARD , HOFMANN MANFRED , SCHWARZ FRANZ , HAASE JÜRGEN
Published: November 2004

Despite the growing use of drug‐eluting stents, restenosis remains to occur especially in high risk subgroups like patients with diffuse in‐stent restenosis. This observation is supporting the search for new and potentially even more effective drug eluting stent systems. Everolimus has been used in conjuction with a new bioabsorbable polymer and gave promising results in initial clinical studies. In FUTURE I, a single‐center, single‐blinded randomized safety and feasibility study enrolling 15 patients with bare metal stents and 27 patients with everolimus‐coated stents, 30‐day MACE rate was 0% in both groups. In‐stent late loss at six months was 0.83 mm in the controll group and 0.10 mm in the everolimus group (p < 0.0001). In FUTURE II, a randomized multi‐center study, a total of 64 patients were enrolled confirming safety and feasibility. After 6 months late loss was 0.85 mm in the control group and 0.12 mm in the everolimus group (p < 0.001).
Endovascular Interventions in Iliac and Infrainguinal Occlusive Artery Disease
Authors: RUEF JOHANNES , HOFMANN MANFRED , HAASE JÜRGEN
Published: November 2004

Percutaneous endovascular procedures are increasingly applied to treat symptomatic peripheral occlusive artery disease. While the primary technical success and recanalization rates in iliac and infrainguinal interventions are high, differences in the long‐term patency rates exist with respect to the anatomic localization, separating the iliac, femoropopliteal, and infrapopliteal arterial regions. In iliac arteries, even complex lesions can be recanalized with good long‐term patency rates, especially when using self‐expanding nitinol stents. In the infrainguinal arteries the method of choice is still under debate (e.g., balloon angioplasty vs stent implantation). A high restenosis rate represents one of the major limitations in femoropopliteal and infrapopliteal interventions. Therefore, additional methods and treatment strategies for peripheral interventions with the potential for future applications are under investigation and will be discussed such as drug‐eluting stents, brachytherapy, subintimal angioplasty, laser angioplasty, atherectomy/thrombectomy, cutting balloon, polytetrafluoroethylene (PTFE)‐covered stent grafts, biodegradable stents, and cryoplasty. The increasing amount of data on successful peripheral interventions supports the necessity to adapt and reevaluate the current consensus guidelines that were put together in 2000.
The Therapeutic Alliance in Couples Therapy: Clinical Considerations
Authors: Garfield Robert
Published: November 2004

This article presents clinical considerations about the therapeutic alliance in couples therapy, stimulated by pertinent new research findings reported in this issue. A loyalty dimension of the couple's relationship is described, as well as its influence on the therapeutic alliance in couples therapy. The therapist's establishment of a “meta‐alliance” with the couple around their loyalty conflicts, avoidance of splits and disruptions, and prioritization of marital distress (versus individual symptoms) as the primary focus of treatment all serve to solidify the therapeutic alliance. In addition, identifying the partners' early family‐of‐origin distress can help predict and respond to strains in the therapeutic alliance that may occur later in therapy. Finally, the therapist helping the couple to balance their relational power differences in therapy and to address their concerns about the impact of the therapist's gender also strengthens their therapeutic alliance. A clinical case and vignettes are included to illustrate these issues.
The Evidence of Things Seen and Not Seen: The Legacy of Race and Racism
Authors: Watts‐Jones Dee
Published: November 2004

Franklin, A.J.

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2004.

Gates, H.L.

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2004.

Winston, A. (Ed.).

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2004.
A systematic review of the influence of different titanium surfaces on proliferation, differentiation and protein synthesis of osteoblast‐like MG63 cells
Authors: Bächle Maria , Kohal Ralf J.
Published: November 2004

Objectives: Titanium is the standard material for dental and orthopaedical implants. The good biocompatibility has been proven in many experimental and clinical investigations. Different titanium topographies were tested in vitro using different cell culture models. The aim of this systematic review was to evaluate and summarize the medical/dental literature to assess on which kind of titanium surface structure the osteoblast‐like osteosarcoma cells MG63 show the best proliferation and differentiation rate, and the best protein synthesis.

Methods: A systematic search was carried out using different on‐line databases (PubMed, Web of Science, Cochrane Library, International Poster Journal), supplemented by handsearch in selected journals and by examination of the bibliographies of the identified articles. Inclusion and exclusion criterias were applied when considering relevant articles. Studies which met the inclusion criteria were included and data extraction was undertaken by one reviewer.

Results: The search yielded 348 references. Nine articles referring to nine different studies were relevant to our question. Additionally 8 less relevant articles were identified. It was found that regularly textured surfaces of pure titanium with Ra values (average roughness) of around 4 μm are well‐accepted by MG63 cells.

Conclusions: The surfaces and culture conditions vary widely. Therefore it is still difficult to recommend one particular surface. It seems that there are no differences in cell proliferation and differentiation on surfaces treated by blasting and etching. Standardization in fabrication and size of the different test surfaces as well as homogeneity in culture times and plating densities should be aspects for future research.
The use of porous calcium phosphate scaffolds with transforming growth factor beta 1 as an onlay bone graft substitute
Authors: Huse Robert O. , Quinten Ruhe P. , Wolke Johannes G. C. , Jansen John A.
Published: November 2004

Objectives: Autogeneous bone grafting is regarded to be the golden standard for onlay grafts, but it requires a harvesting procedure and the remodeling pattern over time is unpredictable. New materials are constantly being sought to overcome these problems. An in vivo experiment was carried out to evaluate whether (1) porous calcium phosphate cement is a suitable biomaterial for onlay bone grafting, and (2) the addition of transforming growth factor beta 1 (TGF‐β1) accelerates de novo bone formation inside the cement porosity.

Material and methods: A carrier of porous calcium phosphate cement (Calcibon®) was designed and 16 rats received one preshaped implant each. In 8 out of 16 implants 0.75 μg TGF‐β1 was applied. The animals were killed after 4 weeks and the characteristics of tissue ingrowth into the onlay graft were evaluated.

Results: Histologic and quantitative histomorphometrical measurements demonstrated osteoid‐like tissue formation in both experimental groups. The addition of TGF‐β1 did not induce significantly more osteoid‐like tissue formation. On the other hand, in TGF‐β‐loaded implants, a higher number of pores contained an inflammatory infiltrate.

Conclusion: This study indicated that porous calcium phosphate cement is a promising material for clinical situations where bone formation has to be supported.
Bone formation following sinus grafting with autogenous bone‐derived cells and bovine bone mineral in minipigs: preliminary findings
Authors: Fuerst Gabor , Tangl Stefan , Gruber Reinhard , Gahleitner André , Sanroman Fidel , Watzek Georg
Published: November 2004

Abstract: Bone formation in a sinus grafted with a cell‐free scaffold requires the presence of local progenitor cells that differentiate into osteoblasts. The purpose of this study was to examine the effect of culture expanded autogenous bone‐derived cells (ABC) with bovine bone mineral (BBM) on bone formation after single‐stage sinus grafting in minipigs. Bone biopsies from the iliac crest were harvested 4 weeks prior to sinus grafting and ABC were culture expanded in vitro. The sinuses of five adult minipigs were grafted. In one sinus of each minipig the space between Schneider's membrane (SM) and the sinus wall was grafted with ABC (325,000 cells per sinus, on average) and BBM. In the other sinus, BBM alone was used. The animals were sacrificed after 12 weeks. One block of each grafted area was prepared by saw cutting and the amount of newly formed bone was analysed by micro‐computed tomography (μ‐CT). The addition of ABC to BBM significantly increased the amount of newly formed bone compared with BBM alone on μ‐CT analysis (ABC+BBM: 29.86±6.45% vs. BBM: 22.51±7.28% (P=0.016)). Bone formation was increased near SM (ABC+BBM: 20.7±4.5% vs. BBM: 15.43±3.62% (P=0.009)) and in the middle zone of the grafting material (ABC+BBM: 31.63±7.74% vs. BBM: 22.5±7.91% (P=0.001)), but not near the local host bone (ABC+BBM: 37.23±8.23% vs. BBM: 28.42±12.54% (P=0.15)). These preliminary findings indicate that supplementation of cell‐free grafting material with culture expanded ABC can stimulate bone formation in areas with low bone‐forming capacity.
Rupture of chordae tendineae in patients with β‐thalassemia
Authors: Farmakis Dimitrios , Deftereos Spyros , Giakoumis Anastasios , Polymeropoulos Evangelos , Aessopos Athanasios
Published: November 2004

Cardiac disease is the primary cause of mortality in β‐thalassemia patients. Except for ventricular dysfunction and pulmonary hypertension that represent the main forms of heart disease in these patients, valvular abnormalities including valvular regurgitation, endocardial thickening and calcification and mitral valve prolapse have also been described. Here we present two patients with thalassemia major and mitral chordal rupture, a previously undescribed abnormality in this population. Pathogenesis of this finding may involve thalassemia‐related pseudoxanthoma elasticum‐like syndrome, a diffuse elastic tissue defect, which is observed with a notable frequency in these patients and has been associated with numerous cardiovascular complications, including valvular ones.
Habitat use and movement of river blackfish (Gadopsis marmoratus R.) in a highly modified Victorian stream, Australia
Authors: Khan M. T. , Khan T. A. , Wilson M. E.
Published: November 2004

Abstract –  Movement and habitat use of river blackfish (Gadopsis marmoratus R.) was studied in a highly modified central Victorian stream (Birch Creek), Australia, using radio telemetry (N = 10) and mark–recapture (N = 113) between October 2001 to May 2002, and November to December 2002 respectively. Blackfish had a small home range of 10–26 m with strong affinity to a pool. However, small movements within a pool were common which resulted in relatively large cumulative movements. At a diel scale there were no significant differences in blackfish movement between day and night (Kruskal–Wallis test, P = 0.95). Six of seven blackfish translocated 40 m upstream or downstream of their original positions returned within 48 h, suggesting strong affinity not only to a pool, but also to a small region within a pool. Blackfish utilised slow flowing (0–20 cm s−1) and deep waters (40–60 cm). Blackfish were strongly associated with the instream cover habitats of undercut banks and boulders. Significant differences were recorded in instream cover and water velocity used by blackfish between day and night (Kruskal–Wallis test, P = <0.01). At night blackfish used open areas with high water velocities whereas during the day blackfish used complex undercut banks with low water velocities.
Comparative Histopathology of Grey‐Horse‐Melanoma and Human Malignant Melanoma
Authors: Seltenhammer Monika Heidemarie , Heere‐Ress Elisabeth , Brandt Sabine , Druml Thomas , Jansen Burkhard , Pehamberger Hubert , Niebauer Gert Willhelm
Published: November 2004

Equine melanoma shows striking features particularly with regard to clinical development in grey horses: in contrast to malignant melanoma in humans and in solid coloured horses that are characterized by early onset of metastasis, pigment cell tumours display almost benign clinical features in ageing grey horses. Through evolution, grey horses appear to be in a favourable position in regard to the biological behaviour of melanomas. Yet unknown factors inhibiting or retarding early melanoma metastasis may be responsible for this phenomenon. In this study, immunostaining profiles and histopathologic patterns of equine vs. human melanotic tumours were compared. In addition, the expression of melanoma markers currently used in human melanoma detection and characterization were evaluated for their applicability in equine melanoma diagnosis. Immunohistopathologic investigations revealed that benign grey horse melanomas share common features with human blue nevi and with human malignant desmoplastic melanomas, whereas their resemblance to other types of human cutaneous malignant melanomas is less pronounced. Our data equally underline that S‐100, proliferating cell nuclear antigen (PCNA), HMB‐45, Ki‐67, T‐311 and CD44 can serve as reliable markers for horse melanomas. Further investigations aiming at identifying factors retarding metastasis in affected grey horses are needed, as they may contribute to the development of novel treatment strategies for human malignant melanoma.
The Neuromelanin of Human Substantia Nigra: Physiological and Pathogenic Aspects
Authors: Zucca Fabio A. , Giaveri Giuseppe , Gallorini Mario , Albertini Alberto , Toscani Marco , Pezzoli Gianni , Lucius Ralph , Wilms Henrik , Sulzer David , Ito Shosuke , Wakamatsu Kazumasa , Zecca Luigi
Published: November 2004

Neuromelanin (NM) accumulates as a function of age in normal human substantia nigra (SN) but is relatively depleted in the SN of patients with Parkinson disease (PD). Several studies have been performed to further our understanding of the role of NM in neuronal aging and neurodegenerative mechanisms of PD. To this purpose, NM from human SN was isolated and its structure and molecular interactions were investigated. Cysteinyl‐dopamine was shown to be one precursor of NM synthesis. A striking affinity of NM for specific metals, lipids, drugs and pesticides was found in vitro, and in animal and human brain postmortem studies. Because of these affinities, NM seems to play a protective role in the human brain by blocking toxic molecules. On the other hand, experiments in cell culture indicate that NM can activate microglia, eliciting the release of cytotoxic factors that can induce neurodegeneration.
Non‐Invasive Measurements of Skin Pigmentation In Situ
Authors: Stamatas Georgios N. , Zmudzka Barbara Z. , Kollias Nikiforos , Beer Janusz Z.
Published: November 2004

Objective in situ measurements of skin pigmentation are needed for accurate documentation of pigmentation disorders, in studies of constitutive and induced skin pigmentation, for testing of the efficacy of pro‐pigmentation or de‐pigmentation agents, etc. Non‐invasive instrumental measurements of skin pigmentation have been used for many decades. All are based on the ability of melanin to attenuate light. However, hemoglobin in dermal capillaries also attenuates light and needs to be accounted for when pigmentation is assessed. The methods under consideration include: (a) single point measurements, in which light reflected from a defined skin area is collected and a pigment index is calculated representing the average pigmentation over the examined area, and (b) imaging methods that attempt to generate a concentration distribution map of melanin pigment for the skin area being imaged. In this article, we describe the potentials and the limitations of the different approaches to both single point and imaging methods.
Melatonin protects SH‐SY5Y neuroblastoma cells from calyculin A‐induced neurofilament impairment and neurotoxicity
Authors: Li Shu Peng , Deng Yan Qiu , Wang Xiao Chuan , Wang Yi Peng , Wang Jian‐Zhi
Published: November 2004

Abstract:  Hyperphosphorylation of cytoskeletal proteins seen in Alzheimer's disease is most probably the result of an imbalanced regulation in protein kinases and protein phosphatases (PP) in the affected neurons. Previous studies have revealed that PP‐2A and PP‐1 play important roles in the pathogenesis. Employing human neuroblastoma cells, we found that 10 nm calyculin A (CA), a selective inhibitor of PP‐2A and PP‐1, significantly increased phosphorylation and accumulation of neurofilament (NF) in the cells. Levels of NF‐M (middle chain) and NF‐L (light chain) mRNA decreased after CA treatment. Additionally, CA led to a decreased cell viability determined by MTT and crystal violet assay. Melatonin efficiently protects the cell from CA‐induced alterations in NF hyperphosphorylation and accumulation, suppressed NF gene expression as well as decreased cell viability. It is concluded that inhibition of PP‐2A/PP‐1 by CA induces abnormalities in NF metabolism and cell survival, and melatonin efficiently arrests the lesions.
Methodological approaches and rationale for training to prevent anterior cruciate ligament injuries in female athletes
Authors: Myer Gregory D. , Ford Kevin R. , Hewett Timothy E.
Published: November 2004

Female athletes have a four‐ to sevenfold increased risk of anterior cruciate ligament (ACL) injury compared with their male counterparts playing at similar levels in the same sports. The elevated risk of ACL injury in females coupled with the geometric increase in female sports participation in the last 30 years has led to a rapid rise in these injuries. This large increase in ACL injury incidence has fueled studies into both mechanisms of injury and interventions to prevent injury. A review of published multidisciplinary approaches demonstrates that several training protocols have utilized multiple components targeted toward injury prevention training and were able to reduce injury incidence in female athletes. Similar training techniques may also be used to gain improvements in measures of performance. The purpose of this review is to highlight training components that may reduce ACL injury risk and assess their potential for combined use in performance‐oriented protocols.
Clinical improvement after 6 weeks of eccentric exercise in patients with mid‐portion Achilles tendinopathy – a randomized trial with 1‐year follow‐up
Authors: Roos Ewa M. , Engström Mikael , Lagerquist Annika , Söderberg Bengt
Published: November 2004

Achilles tendinopathy is common and treatment with eccentric exercises seems promising. We designed a prospective randomized clinical trial to test the hypothesis that eccentric calf muscle exercises reduce pain and improve function in patients with Achilles tendinopathy. Forty‐four patients were recruited from primary care (mean age: 45 years; 23 women; 65% active in sports) and randomized to three treatment groups for 12 weeks: eccentric exercises, a night splint or a combination of both treatments. Pain and function were evaluated at 6, 12, 26 and 52 weeks by the Foot and Ankle Outcome Score. At 6 weeks, the eccentric group reported a significant pain reduction (27% compared with baseline,P=0.007) which lasted for 1 year (42%,P=0.001). The two groups treated with a night splint also reported significant but less pain reduction than the eccentric group. Differences between all the three groups were not significant. At 12 weeks, the eccentric group reported significantly less pain than the splint‐only group (P=0.04). More patients in the eccentric group than in the splint group returned to sport after 12 weeks. We conclude that eccentric exercises seem to reduce pain and improve function in patients with Achilles tendinopathy. Our results are in line with previous studies and strengthen the recommendation that patients should undergo an eccentric exercise program prior to considering other treatments such as surgery.