bluuebunny/crossref_metadata_2025 huggingface dataset:
Early-Stage Investigations of Ultrasmall Superparamagnetic Iron Oxide-Induced Signal Change After Permanent Middle Cerebral Artery Occlusion in Mice
Authors: Desestret Virginie , Brisset Jean-Christophe , Moucharrafie Samir , Devillard Emilie , Nataf Serge , Honnorat Jérôme , Nighoghossian Norbert , Berthezène Yves , Wiart Marlène
Published: March 2009

Background and Purpose—

MR signal changes after intravenous ultrasmall superparamagnetic iron oxide (USPIO) injection are related to inflammatory cells at the subacute stages after focal cerebral injury. However, at the early stages, the interpretation of USPIO-related MR signal alterations remains controversial. Here, we compared MR signal changes after intravenous USPIO injection with the histological iron and macrophage distribution during the first 24 hours in a rodent model of acute stroke.

Methods—

Multiparametric MRI at 7T and histological USPIO distribution were confronted from 6 to 24 hours after permanent middle cerebral artery occlusion in mice. Blood–brain barrier disruption was assessed using gadolinium MRI and immunoglobulin staining. Prussian blue staining was performed to depict the USPIO brain distribution. USPIO uptake by phagocytes was assessed by immunochemistry on brain tissue, peripheral blood cells, and monocyte cells derived from bone marrow culture.

Results—

After USPIO injection, 4 areas of early signal change were observed on every MRI. In all these areas, iron particles were mostly free whether detected in the vascular and cerebrospinal fluid compartments or in the interstitium. Within the first 24 hours, USPIO-loaded cells were not detected in the blood of injured mice or in cultured monocytic cells incubated with USPIO at plasmatic concentration.

Conclusions—

These results suggest that, in this model, early reproducible USPIO-related MR signal changes are mainly caused by passive diffusion of free USPIO after blood–brain barrier leakage and by intravascular trapping rather than by peripheral phagocyte infiltration.
Framingham Stroke Risk Function in a Large Population-Based Cohort of Elderly People
Authors: Bineau Sébastien , Dufouil Carole , Helmer Catherine , Ritchie Karen , Empana Jean-Philippe , Ducimetière Pierre , Alpérovitch Annick , Bousser Marie Germaine , Tzourio Christophe
Published: March 2009

Background and Purpose—

External validation of the Framingham stroke risk function has been rarely performed. We assessed its predictive ability in a population-based cohort of French elderly.

Methods—

The sample comprised 6913 subjects from the 3C Study, aged 65 to 84 at baseline, who were followed up to 6 years. Predictive accuracy of the original Framingham stroke risk function was assessed in a 3-step procedure: comparison between the Framingham and 3C cohorts of the prevalence of selected risk factors and the associated relative risks (RR) for stroke, comparison of the predicted to the observed number of stroke events (calibration), and ability to separate high-risk from low-risk participants (discrimination). We also compared predictive performances of the original Framingham, the recalibrated Framingham, and the local stroke risk functions.

Results—

During follow-up, 110 incident strokes occurred. For most risk factors, RRs were comparable between the 2 cohorts, except for age in women. The original Framingham stroke risk function applied to the 3C cohort overestimated the 6-year absolute risk for stroke by a factor of 3.7 for men and 4.4 for women. However, the recalibrated Framingham and 3C functions did not show any over- or underestimation of stroke risk. The 3 stroke risk functions (original, recalibrated, and 3C) provided acceptable discrimination with areas under the ROC curve ranging from 0.67 to 0.73.

Conclusions—

The original Framingham stroke risk function strongly overestimated the stroke risk for 3C participants. Derived Framingham stroke score sheets should not be directly used by physicians in the French elderly population.
Effective Glycemic Control With Aggressive Hyperglycemia Management Is Associated With Improved Outcome in Aneurysmal Subarachnoid Hemorrhage
Authors: Latorre Julius Gene S. , Chou Sherry Hsiang-Yi , Nogueira Raul Gomes , Singhal Aneesh B. , Carter Bob S. , Ogilvy Christopher S. , Rordorf Guy A.
Published: March 2009

Background and Purpose—

Hyperglycemia strongly predicts poor outcome in patients with aneurysmal subarachnoid hemorrhage, but the effect of hyperglycemia management on outcome is unclear. We studied the impact of glycemic control on outcome of patients with aneurysmal subarachnoid hemorrhage.

Methods—

A prospective intensive care unit database was used to identify 332 patients with hyperglycemic aneurysmal subarachnoid hemorrhage admitted between January 2000 and December 2006. Patients treated with an aggressive hyperglycemia management (AHM) protocol after 2003 (N=166) were compared with 166 patients treated using a standard hyperglycemia management before 2003. Within the AHM group, outcome was compared between patients who achieved good (mean glucose burden <1.1 mmol/L) and poor (mean glucose burden ≥1.1 mmol/L) glycemic control. Poor outcome was defined as modified Rankin scale ≥4 at 3 to 6 months. Multivariable logistic regression models correcting for temporal trend were used to quantify the effect of AHM on poor outcome.

Results—

Poor outcome in AHM-treated patients was lower (28.31% versus 40.36%) but was not statistically significant after correcting for temporal trend. However, good glycemic control significantly reduced the incidence of poor outcome (OR, 0.25; 95% CI, 0.08 to 0.80;
P
=0.02) compared with patients with poor glycemic control within the AHM group. No difference in the rate of clinical vasospasm or the development of delayed ischemic neurological deficit was seen before and after AHM protocol implementation.

Conclusion—

AHM results in good glucose control and significantly reduces the odds for poor outcome after aneurysmal subarachnoid hemorrhage in glucose-controlled patients. Further studies are needed to confirm these results.
Effects of Deferoxamine on Intracerebral Hemorrhage-Induced Brain Injury in Aged Rats
Authors: Okauchi Masanobu , Hua Ya , Keep Richard F. , Morgenstern Lewis B. , Xi Guohua
Published: March 2009

Background and Purpose—

Deferoxamine (DFX) reduces brain edema, neuronal death, and neurological deficits after intracerebral hemorrhage (ICH) in young rats. In the present study, we investigated whether DFX is effective on brain injury after ICH in aged rats and examined dose dependency.

Methods—

Male Fischer 344 rats (18 months old) had an intracaudate injection of 100 μL autologous whole blood and were treated with different doses of DFX (10, 50, and 100 mg/kg) or vehicle 2 and 6 hours post-ICH and then every 12 hours up to 7 days. Rats were euthanized at Day 3 for brain edema determination and Day 56 for brain atrophy measurement. Behavioral tests were performed during the experiments.

Results—

All 3 doses of DFX attenuated perihematomal brain edema at 3 days (eg, at dose 50 mg/kg, 80.4±0.5 versus 81.6±0.9% in the vehicle-treated group,
P
<0.01). Fifty and 100 mg/kg DFX also reduced ICH-induced ventricle enlargement, caudate atrophy, and ICH-induced neurological deficits in aged rats. However, although 10 mg/kg DFX reduced ventricle enlargement and forelimb-placing deficits, it did not reduce caudate atrophy and corner turn deficits.

Conclusions—

These results indicate that DFX can reduce ICH-induced brain injury in aged as well as young rats and that a dose >10 mg/kg is the optimal dose of DFX in this model.
Transient Focal Increase in Perihematomal Glucose Metabolism After Acute Human Intracerebral Hemorrhage
Authors: Zazulia Allyson R. , Videen Tom O. , Powers William J.
Published: March 2009

Background and Purpose—

Progressive perihematomal cell death over 3 to 4 days has been described after experimental intracerebral hemorrhage (ICH). We investigated whether progressive perihematomal damage occurs in human subjects by measuring relative changes in regional cerebral glucose metabolism with
18
F-fluorordeoxyglucose (FDG) positron emission tomography at multiple time points during the first week after ICH.

Methods—

Thirteen subjects with a median hematoma volume of 22 cm
3
were studied 1.0±0.3, 2.9±0.8, and 6.7±1.6 days after ICH. Normalized mean counts in 5 concentric annular 2-mm-thick perihematomal volumes-of-interest (VOIs) were compared to the initial study. Next, automated searches with 0.5 to 5.0 mL spherical VOIs identified maximum focal changes in normalized counts compared to the initial study.

Results—

No annular or focal decrease in perihematomal FDG uptake developed. Instead, FDG uptake significantly increased at session #2 in the first 3 2-mm annular VOIs (9.2%±14.2, 7.8%±11.3, 5.9%±9.0), returning to baseline at session #3. The VOI search identified focal regions of increased perihematomal FDG uptake relative to the contralateral control hemispheres in 6 subjects, which accounted for the annular increase.

Conclusion—

Perihematomal glucose metabolism increased transiently in a subset of patients 2 to 4 days after acute ICH. These transient focal increases in glucose metabolism occurring in the brain after acute ICH demonstrate that there are ongoing processes in response to injury that last for days. Although further studies are needed to elucidate their pathophysiology, these processes may be indicative of a prolonged window for intervention to improve neurological outcome.
Showered Calcific Emboli to the Brain, the ‘Salted Pretzel’ Sign, Originating From the Ipsilateral Internal Carotid Artery Causing Acute Cerebral Infarction
Authors: Christian Brett A. , Kirzeder Daniel J. , Boyd Jim , Laing Jeffery , Gash Judson R.
Published: March 2009

Background and Purpose—

Unenhanced head CT has become the first line imaging study in the evaluation of suspected acute cerebral ischemia. It is important to identify subtle findings of acute ischemia on this exam to direct appropriate patient management.

Summary of Case—

We report the first case of multiple pial surface distal internal carotid artery territory calcified emboli causing multifocal cerebral infarctions, likely from a carotid bifurcation source.

Conclusions—

Visualization of multiple pial surface calcifications on unenhanced head CT, the ‘salted pretzel sign’, should raise suspicion for acute infarction from showered calcific emboli.
Hyperglycemia and Incidence of Ischemic and Hemorrhagic Stroke-Comparison Between Fasting and 2-Hour Glucose Criteria
Authors: Hyvärinen Marjukka , Tuomilehto Jaakko , Mähönen Markku , Stehouwer Coen DA , Pyörälä Kalevi , Zethelius Björn , Qiao Qing
Published: March 2009

Background and Purpose—

We examined the impact of hyperglycemia on ischemic and hemorrhagic stroke incidence comparing criteria based on fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hour PG).

Methods—

Data from 9 European cohorts comprising 18 360 individuals between 25 to 90 years of age were collaboratively analyzed. The maximum length of follow-up varied between 4.9 to 36.8 years. Hazards ratios (95% confidence intervals) for stroke incidence were estimated using Cox-proportional hazards model adjusting for known risk factors.

Results—

In individuals without a prior history of diabetes, the multivariate-adjusted hazards ratio for ischemic stroke corresponding to 1 SD increase in FPG was 1.12 (1.02 to 1.22) and in 2-hour PG 1.14 (1.05 to 1.24). Adding 2-hour PG to the model with FPG significantly improved the prediction of the model for the incidence of ischemic stroke (χ
2
=4.72,
P
=0.03), whereas FPG did not improve the 2-hour PG model prediction (χ
2
=0.25,
P
=0.62). A significantly increased hazard ratio was also observed for previously diagnosed diabetes (2.26 [1.51 to 3.38]) and for screen-detected diabetes defined by FPG (1.48 [1.08 to 2.02]) and 2-hour PG (1.60 [1.18 to 2.16]). None of the criteria predicted hemorrhagic stroke.

Conclusions—

Diabetes defined by either of the criteria predicted the future risk of ischemic stroke but not the hemorrhagic stroke. The prediction is stronger for elevated 2-hour PG than for FPG levels.
Contrast of Rainfall–SST Relationships in the Western North Pacific between the ENSO-Developing and ENSO-Decaying Summers*
Authors: Wu Bo , Zhou Tianjun , Li Tim
Published: March 2009

While the overall summer rainfall–sea surface temperature (SST) relationship has a negative correlation over the western North Pacific (WNP), this relationship experiences a significant interannual variation. During the ENSO-developing (decaying) summer, the rainfall–SST correlation is significantly positive (negative). The positive correlation is attributed to interplay between the anomalous Walker circulation and the cross-equatorial flows associated with the enhanced WNP summer monsoon. The former leads to negative rainfall anomalies in the western Pacific, whereas the latter leads to a cold SST anomaly resulting from enhanced surface latent heat fluxes. The negative correlation is attributed to the maintenance of an anomalous Philippine Sea anticyclone from the El Niño peak winter to the subsequent summer. The anomalous anticyclone, on one hand, suppresses the local rainfall, and on the other hand induces a warm in situ SST anomaly through both the enhanced solar radiation (resulting from a decrease in clouds) and the reduced surface latent heat flux (resulting from the decrease of the monsoon westerly). The rainfall–SST correlation is insignificant in the remaining summers. Thus, the overall weak negative rainfall–SST correlation is attributed to the significant negative correlation during the ENSO-decaying summers.
Local Mean Bias Correction in a Regional Model Downscaling: A Case Study of the South China Sea Summer Monsoon of 1998
Authors: Wu Po-Lin , Lin Pay-Liam , Juang Hann-Ming Henry
Published: March 2009

Regional climate models used to resolve high-resolution local circulation by dynamically downscaling from a coarse-resolution analysis may have difficulty in keeping large-scale information the same as in the analysis. Such difficulty produces large-scale error or bias, mainly due to mathematically ill-posed lateral boundary conditions. To reduce this type of error, in this paper the authors propose a scheme called local mean bias correction (LMBC). LMBC has means in x and in y directions locally over the model domain, but not a single mean over the entire domain. In spectral space, local means are represented by the zero wavenumber in the x direction with all wavenumbers in the y direction, and the zero wavenumber in the y direction with all the wavenumbers in the x direction. The local mean perturbation can be removed to correct the local mean bias where the perturbation is defined as the difference between a regional field and a base field from the analysis. The LMBC constitutes a simple methodology to ameliorate the influence of the lateral boundary conditions (LBCs) on the integration of the regional climate model (RCM); using it in this study improved the regional climate simulation of the 1998 South China Sea (SCS) summer monsoon. Generally speaking, this scheme proved to have a well-simulated circulation during all periods of monsoon activities examined. Circulation errors during the SCS summer monsoon onset can be corrected using this LMBC scheme, though the rainfall amount was always underestimated as compared to the observation. This research demonstrated that shifting the domain north, east, west, and south as well as enlarging domain size produced results that are consistent in different cases over different years.
Formulary Coverage for Lipid-Lowering Drugs Recommended for Children
Authors: Yoon Esther Y. , Freed Gary L. , Davis Matthew M. , Clark Sarah J.
Published: March 2009

Objective/methods. A cross-sectional assessment to describe availability, coverage, and pediatric labeling status of lipid-lowering drugs offered by 1 private and 1 public insurance plan formularies. Results. Both insurance plans had equal medication availability of bile acid sequestrants (7), statins (10), and cholesterol-absorption blockers (CAB; 1). The private plan had 3 bile acid sequestrants and 3 statins listed as preferred drugs; the CAB was not preferred. In contrast, the public plan had 5 bile acid sequestrants, 7 statins, and the CAB as preferred drugs. For medications with pediatric labeling, the private plan covered 50% as preferred drugs whereas the public plan covered 70% as preferred drugs. Conclusions. If new recommendations of the American Academy of Pediatrics for treatment of dyslipidemia in children were implemented today, children with the public plan would have equal choice but better coverage of lipid-lowering drugs as preferred drugs, including those with FDA approval, compared with children with the private plan.
An Infant with Diffuse Lung Masses
Authors: Douvoyiannis Miltiadis , Bordy Lana , Fakioglu Esra
Published: March 2009

Chronic granulomatous disease presenting as invasive pulmonary aspergillosis in an infant is described in this report. Symptoms of chronic, intermittent respiratory distress had been previously attributed to gastroesophageal regurgitation and asthma. The isolation of an unusual pathogen even from a nonsterile site, particularly when symptoms persist, should not be considered as a contamination but prompt further investigation to exclude phagocytic or other immune deficiencies.
Effects of ethanol and ecstasy on conditioned place preference in the rat
Authors: Jones BC , Ben-Hamida S. , Pereira de Vasconcelos A. , Kelche C. , Lazarus C. , Jackisch R. , Cassel JC
Published: March 2009

The club drug ecstasy (3,4-methylenedioxymethylamphetamine or MDMA) is often taken recreationally with ethanol (EtOH). We have shown previously that EtOH potentiates the psychomotor effects of MDMA in rats. More recently, we demonstrated in striatal slices that MDMA produced preferential release of serotonin, but when combined with EtOH, the preferential release shifted to dopamine, raising the possibility that administration of EtOH may increase the reward effect of MDMA. To address this possibility, adult male Long-Evans rats were tested for conditioned place preference following treatment with saline, EtOH (0.75 g/kg), MDMA (6.6 mg/kg) or the combination. The only condition that produced a preference for the compartment associated with the drug was that of the drug combination. The current data are in line with anecdotal reports and one study in humans, indicating that EtOH alters the pharmacological effects of MDMA including self reports of enhanced or prolonged euphoria. Thus, administration of EtOH might increase the risk for compulsive use of MDMA, an issue that warrants further study.
The Restoration of a Local Energy Regime Amid Trends of Power Liberalization in East Asia
Authors: Yu Jung-Min
Published: March 2009

Since the mid-1980s, power sector liberalization has been embraced at different levels in the East Asian countries of China, Japan, South Korea and Taiwan. The dominant rationale underlying power liberalization has been a quest for efficiency improvements, to be achieved by substituting private market activity for public regulations and by opening a country's electricity system to the global economy and management techniques. However, as the power system is increasingly liberalized, the possibility of establishing a local energy system, which has the great potential to restore sustainable environment-society relations, has been diminished. As an alternative to the power liberalization strategy, this paper proposes a restoration of local energy regimes based on the model of an energy commons and a decentralization paradigm. The innovative energy-policy model of the Sustainable Energy Utility, as applied in the case of Seoul, Korea, is explored as a possible option for a local energy strategy for East Asian countries.
Delayed Vastus Medialis Obliquus to Vastus Lateralis Onset Timing Contributes to the Development of Patellofemoral Pain in Previously Healthy Men
Authors: Van Tiggelen Damien , Cowan Sallie , Coorevits Pascal , Duvigneaud Nathalie , Witvrouw Erik
Published: March 2009

Background

Delayed onset of vastus medialis obliquus activity has been described in patellofemoral pain patients. No prospective study investigating the development of patellofemoral pain has tested the onset timing of electromyographic activity of the vastus medialis obliquus and vastus lateralis muscles during a functional task.

Hypothesis

Before the development of patellofemoral pain, subjects demonstrate an altered firing order of the vastus medialis obliquus and vastus lateralis muscles compared with healthy subjects during a functional task.

Study Design

Cohort study; Level of evidence, 2.

Methods

The onset of vastus medialis obliquus and vastus lateralis activity was measured with surface electromyography during a functional task (rocking back on the heels) in 79 healthy subjects subsequently submitted to a 6-week strenuous basic military training. Afterward, these subjects were reassessed.

Results

Thirty-two percent of the recruits developed patellofemoral pain during training. Patellofemoral pain subjects demonstrated a significant delay of onset of vastus medialis obliquus electromyographic activity compared with the healthy controls ( P = .023), even before basic military training. In healthy subjects, no significant differences in electromyographic activity onset of the vastus medialis obliquus compared with the vastus lateralis could be identified before and after basic military training. A significant ( P < .001) delay could be demonstrated in the patellofemoral pain group after basic military training. A binary logistic regression could be constructed wherein the onset of the electromyographic activity of the vastus medialis obliquus and vastus lateralis was withheld in the model. The most optimal cutoff value, which is based on the receiver operating characteristic curve, is a timing difference of −0.67 milliseconds (vastus medialis obliquus – vastus lateralis). The area under the receiver operating characteristic curve is considered as fair (0.68).

Conclusion

Delayed onset of electromyographic activity of the vastus medialis obliquus–vastus lateralis is one of the contributing risk factors to the development of patellofemoral pain.
Practical Use of Exenatide and Pramlintide for the Treatment of Type 2 Diabetes
Authors: Meade Lisa T.
Published: March 2009

Type 2 diabetes is a progressive disease that affects more than 20.8 million Americans. Traditional antihyperglycemic therapy can cause weight gain and hypoglycemia in this population. Research shows that type 2 diabetic patients have low levels of glucagon-like peptide-1 and amylin. This discovery led to the creation of 2 newer agents, exenatide and pramlintide. Exenatide, a glucagon-like peptide-1 agonist, stimulates insulin secretion, suppresses glucagon secretion, and slows gastric motility. Transient nausea is the most common side effect, which can be minimized with slow titration. Weight loss associated with exenatide is between 0.9 and 2.8 kg. Hypoglycemia occurs more frequently when exenatide is used with a sulfonylurea. There are some case reports of pancreatitis in patients taking exenatide. Pramlintide, a synthetic form of amylin, inhibits the postmeal rise in glucagon, slows gastric emptying, and promotes satiety. Common side effects of pramlintide include transient nausea, headache, and modest weight loss (1.6 kg). Exenatide and pramlintide are contraindicated in patients with gastroparesis. The success of therapy with both agents is enhanced with slow titration to minimize nausea and patient counseling. Exenatide and pramlintide offer improved postprandial control with the potential for weight loss in patients with type 2 diabetes.
Evaluating Internet Interviews With Gay Men
Authors: Ayling Russel , Mewse Avril J.
Published: March 2009

In this article we describe the use of the Internet to conduct online synchronous interviews on gay men's experiences of Internet sex-seeking and barebacking, using interpretative phenomenological analysis (IPA). We then present the results of a separate IPA of the issues we encountered during the research. The analysis is focused around four superordinate themes: positive experience, technological issues, boundaries, and requests/expectations. We argue that online qualitative research is valuable in its own right, and that the advantages considerably outweigh the difficulties. This is particularly true in accessing individuals who might not participate in other types of research settings to discuss experiences that would otherwise be too difficult to talk about. Several issues that are problematic in more conventional research still apply, albeit in a different guise, but these must be situated in the context of who or what is being researched, and why, and can be largely overcome with more creative methodologies and considered preparation.
Pathologizing or Validating: Intake Workers' Discursive Constructions of Mothers
Authors: Berman Rachel C. , Wilson Leslie
Published: March 2009

We employ a feminist discursive lens to re-examine an earlier thematic-based analysis of intake workers' reports of interviews with mothers at a children's hospital. In the original study the first author focused on coping styles of parents of children with exceptionalities, whereas in the current study we demonstrate how intake workers' discursive constructions of mothers as pathological functions to dismiss mothers' views and concerns, and constructions of sets of parents as open to expert advice functions to validate them as “effective allies.” In this article, we seek to provide an example of how our analytical lens serves to produce various findings that might serve the voices of the more powerful, or of the marginalized. As an outcome of the re-analysis of the data, we recommend an approach to parent— professional interaction that involves enacting language that fosters mutual respect between professionals and parents, and in particular between intake workers and mothers.
Therapeutic Letters as Relationally Responsive Practice
Authors: Pyle Nathan R.
Published: March 2009

Therapeutic letters have become a practice adopted by many clinicians as an adjunct to therapeutic conversations. This article presents selected findings from a larger study that examined both the letter-writing practices of nine clinicians as well as the experiences of seven adult clients who received a therapeutic letter or letters during the course of individual or family therapy. A novel aspect of this study is that data from clients were gathered in the form of letters—eight letters written by the clients to the researcher about their experience of receiving a therapeutic letter or letters from their clinician. Thematic analysis guided the analysis of the data. Findings are placed within the context of relationally responsive (or relationally engaged) practice. An invitation is extended to conceptualize letters not as monologic documents but as a means of dialogically relating to clients and to the “goings-on” of therapeutic conversations.
Men Family Caregivers' Experience of Nonsupportive Interactions
Authors: Neufeld Anne , Kushner Kaysi Eastlick
Published: March 2009

Men's involvement as family caregivers has grown as the prevalence of dementia has increased. Men rely on support from others for caregiving but also experience nonsupportive interactions. The purpose of this ethnographic study of 34 men (24 spouses and 10 sons) caring for a relative with dementia, 5 assisting caregivers, and 15 professionals was to identify primary caregivers' perceptions of nonsupportive and supportive interactions in relationships with kin and friends as well as professionals. Thematic analysis of transcribed data generated from interviews, diaries, and focus group discussions revealed the nature of men's caregiving journeys, the characteristics of their social networks, and their expectations of supportive interactions. The nonsupportive interactions men caregivers experienced included a lack of orientation to the caregiving situation, an unsatisfactory linkage to support sources, insufficient support, and hurtful interactions. Information about nonsupportive interactions can sensitize kin and friends as well as professionals to the complexity of men's experience and potentially avoid unintended negative consequences of support efforts.
A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis
Authors: Barrett CL , Mann GE , Taylor PN , Strike P
Published: March 2009

Background

Functional electrical stimulation (FES), is a means of producing a contraction in a paralyzed or weak muscle to enable function through electrical excitation of the innervating nerve.

Objective

This two-group randomized trial assessed the effects of single channel common peroneal nerve stimulation on objective aspects of gait relative to exercise therapy for people with secondary progressive multiple sclerosis (SPMS).

Methods

Forty-four people with a diagnosis of SPMS and unilateral dropped foot completed the trial. Twenty patients were randomly allocated to a group receiving FES and the remaining 24 to a group receiving a physiotherapy home exercise program for a period of 18 weeks.

Results

The exercise group showed a statistically significant increase in 10 m walking speed and distance walked in 3 min, relative to the FES group who showed no significant change in walking performance without stimulation. At each stage of the trial, the FES group performed to a significantly higher level with FES than without for the same outcome measures.

Conclusion

Exercise may provide a greater training effect on walking speed and endurance than FES for people with SPMS. FES may provide an orthotic benefit when outcome is measured using the same parameters. More research is required to investigate the combined therapeutic effects of FES and exercise for this patient group.
Superoxide dismutase and catalase anti-oxidant activity in leucocyte lysates from hypertensive patients: effects of eprosartan treatment
Authors: Labiós Manuel , Martínez Marcial , Gabriel Francisco , Guiral Victoria , Dasi Francisco , Beltrán Belén , Muñoz Anna
Published: March 2009

Introduction. In an earlier study, our group reported that circulating leucocytes in hypertensive (HT) patients show a significant increase in oxidative stress compared to the control group, and this normalised after two months of treatment with eprosartan.1 It can be speculated that these facts may be attributable to a possible reduction in anti-oxidative activity in untreated HT patients, which would be corrected by eprosartan.

Materials and methods. In this observational pilot study, superoxide dismutase and catalase activities were evaluated in leucocyte lysates in a group of 21 HT patients at baseline and after two months of treatment with eprosartan (600 mg/ day). For the control group, 25 normotensive volunteers were recruited with comparable characteristics to the patients.

Results. The results obtained indicate, paradoxically, that the untreated HT patients present greater anti-oxidant enzyme activity than the control group.

Conclusion. This result could be interpreted as a cell defence mechanism against the greater oxidative stress that exists in these patients.This hypothesis is consistent with the facts reported previously by our group in which a reduction in oxidative stress was found after two months of treatment with eprosartan. 1 Upon reducing this stress, less anti-oxidative activity would be necessary, just as was observed in the present study after two months of treatment with eprosartan.
Effect of Triangular Ligament Tears on Distal Radioulnar Joint Instability and Evaluation of Three Clinical Tests: A Biomechanical Study
Authors: MORIYA T. , AOKI M. , IBA K. , OZASA Y. , WADA T. , YAMASHITA T.
Published: March 2009

Using 11 fresh/frozen cadaver specimens, instability of the distal radioulnar joint (DRUJ) during passive wrist motion was measured by motion analysis and three clinical tests (ulno-carpal stress test, piano-key test, and DRUJ ballottement test) were performed. Release of the triangular ligament from the palmar approach was performed to simulate instability of the DRUJ. Displacement of the distal radius against the ulnar head was measured at various degrees of forearm rotation. Release of the triangular ligament at the ulnar fovea and around the base of the ulnar styloid process caused various degrees of DRUJ instability during passive wrist motion. After complete triangular ligament release, only the DRUJ ballottement test demonstrated a statistically significant degree of accuracy in the evaluation of distal radioulnar joint instability.
Flexor Tendon Repair in Zone 2 Using A Six-Strand ‘Figure of Eight’ Suture
Authors: AL-QATTAN M. M. , AL-TURAIKI T. M.
Published: March 2009

The tensile strength of three different flexor tendon repair techniques were tested in vitro: the modified Kessler technique (a two-strand repair), two ‘figure of eight’ sutures (a four-strand repair) and three ‘figure of eight’ sutures (a six-strand repair). The mean breaking forces for the three techniques were 48.0 N, 73.1 N and 93.3 N, respectively, and the differences were highly significant ( p < 0.0001). In a prospective clinical study, a total of 45 patients (50 fingers) with clean-cut complete lacerations of both flexor tendons in zone 2 were included. The protocol used the three ‘figure of eight’ suture techniques for (profundus only) tendon repair, ‘venting’ of the pulleys, and post-operative immediate active range of motion that ensured full active extension of the proximal interphalangeal joint. One repair (2%) ruptured. In the remaining 49 repairs, the result was considered excellent in 39 (78%) and good in 10 (20%) using the Strickland and Glogovac grading system.
A Midterm Follow-Up Study of Bioreconstructive Polylactide Scaffold Implants in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Arthritis Patients
Authors: HONKANEN P. B. , KELLOMÄKI M. , KONTTINEN Y. T. , MÄKELÄ S. , LEHTO M. U. K.
Published: March 2009

This paper presents the results of a prospective study of 80 metacarpophalangeal joint arthroplasties, in which biodegradable polylactide 96/4 copolymer scaffolds were used. Twenty-three rheumatoid arthritis patients were assessed at an average of 59 months after operation, which exceeds the resorption time of P(L/D)LA 96/4 according to animal experiments. Palmar subluxation exceeded half of the bone thickness in 39 joints before operation and in nine at the last follow-up. Ulnar deviation decreased from 25° to 5°, extension deficit from 32° to 15° and active flexion from 76° to 63°. The results are comparable with published data on silicone implant arthroplasties. Implant resorption did not induce any significant osteolysis in the medium term and the restoration of the structure and function of the hand was maintained after implant resorption, probably as the guided fibrous tissues had replaced the dissolved implant.
The Blood Supply of the Scaphoid Bone
Authors: OEHMKE M. J. , PODRANSKI T. , KLAUS R. , KNOLLE E. , WEINDEL S. , REIN S. , OEHMKE H. J.
Published: March 2009

Scaphoid vascularisation was investigated using macroscopic and microscopic techniques in 12 uninjured, formalin fixed cadaver hands. A good blood supply of the scaphoid bone from palmar, dorsal and radial vessel groups with a variety of anastomoses was found which should provide sufficient collateral blood flow from adjacent regions in some patients. Since blood supply is available from the palmar circulation, a dorsal approach to the scaphoid bone is possible.
Modelling and simulation of bulk metallic glass production process with suction casting
Authors: Li H. Q. , Yan J. H. , Wu H. J.
Published: March 2009

An integrated model, which coupled nucleation and crystalline growth with the heat transfer process, is presented in the present paper. The temperature, temperature gradient, cooling rate and the crystalline fraction of Zr65Al7·5Cu17·5Ni10 in suction casting have been calculated with this model. The results show that the metallic glass can be obtained at the bottom and the radial boundary of the rod sample, and that the crystalline phase precipitates in the centre of the sample. The crystalline fraction reaches the highest value of 0·0128 in the centre of the sample. Comparatively lower nucleation rate, as well as the higher viscosity and the cooling rate account for the formation of the bulk metallic glass.
Study of sol–gel process for preparing cerium nano-oxide films on AA7020-T6 Al alloy
Authors: Hassannejad H. , Shahrabi T. , Aliofkhazraei M.
Published: March 2009

A design of experiment technique, the Taguchi method, has been used to optimise a coating process in order to decrease the corrosion rate and increase the passivity of the coated samples by controlling the coating process's factors. Potentiodynamic polarisation measurements were carried out to determine the corrosion rate and passivity of the coated samples. The optimised coating parameters for corrosion rate are one molar ratio for acid citric/CeCl3, 300°C for heat treatment temperature, 0·02 mol for CeCl3 concentration and 0 min for time of boiling. The optimised coating parameters for passive region are two molar ratio for acid citric/CeCl3, 300°C for heat treatment temperature, 0·001 mol for CeCl3 concentration and 60 min for time of boiling. The results showed that the acid citric/CeCl3 is the most significant factor affecting the corrosion rate while the time of boiling affects significantly on the passive region of the coatings.
The Classification of Libraries and the Image of the Librarian in Nineteenth and Early Twentieth-Century Germany
Authors: Minter Catherine J
Published: March 2009

This article examines the classification and arrangement of libraries and the image of the librarian, and explores possible links between the two, in nineteenth- and early twentieth-century Germany with particular reference to academic libraries in the period between 1850 and 1920. The first part of the article argues that the systematic classification and shelf arrangement which were the norm in German libraries during this period tended to support a particular image of the librarian in contemporary writings on library science: specifically, a view of the librarian as a congenial guide to the collection, who would selflessly serve the library and its users. The latter part of the article examines the critique of systematic arrangement in libraries in Germany in the second half of the nineteenth century, and suggests that new views of the library's arrangement and function at this time helped usher in a new conception of the librarian's role and ideal persona.
Analysis of tarantula skeletal muscle protein sequences and identification of transcriptional isoforms
Authors: Zhu Jingui , Sun Yongqiao , Zhao Fa-Qing , Yu Jun , Craig Roger , Hu Songnian
Published: March 2009

Background

Tarantula has been used as a model system for studying skeletal muscle structure and function, yet data on the genes expressed in tarantula muscle are lacking.

Results

We constructed a cDNA library from Aphonopelma sp. (Tarantula) skeletal muscle and got 2507 high-quality 5'ESTs (expressed sequence tags) from randomly picked clones. EST analysis showed 305 unigenes, among which 81 had more than 2 ESTs. Twenty abundant unigenes had matches to skeletal muscle-related genes including actin, myosin, tropomyosin, troponin-I, T and C, paramyosin, muscle LIM protein, muscle protein 20, a-actinin and tandem Ig/Fn motifs (found in giant sarcomere-related proteins). Matches to myosin light chain kinase and calponin were also identified. These results support the existence of both actin-linked and myosin-linked regulation in tarantula skeletal muscle.

We have predicted full-length as well as partial cDNA sequences both experimentally and computationally for myosin heavy and light chains, actin, tropomyosin, and troponin-I, T and C, and have deduced the putative peptides. A preliminary analysis of the structural and functional properties was also carried out. Sequence similarities suggested multiple isoforms of most myofibrillar proteins, supporting the generality of multiple isoforms known from previous muscle sequence studies. This may be related to a mix of muscle fiber types.

Conclusion

The present study serves as a basis for defining the transcriptome of tarantula skeletal muscle, for future in vitro expression of tarantula proteins, and for interpreting structural and functional observations in this model species.
Implication of scavenger receptors in the interactions between diesel exhaust particles and immature or mature dendritic cells
Authors: Taront Solenne , Dieudonné Audrey , Blanchard Simon , Jeannin Pascale , Lassalle Philippe , Delneste Yves , Gosset Philippe
Published: March 2009

Background

The exposure to pollutants such as diesel exhaust particles (DEP) is associated with an increased incidence of respiratory diseases. However, the mechanisms by which DEP have an effect on human health are not completely understood. In addition to their action on macrophages and airway epithelial cells, DEP also modulate the functions of dendritic cells (DC). These professional antigen-presenting cells are able to discriminate unmodified self from non-self thanks to pattern recognition receptors such as the Toll like Receptors (TLR) and Scavenger Receptors (SR). SR were originally identified by their ability to bind and internalize modified lipoproteins and microorganisms but also particles and TLR agonists. In this study, we assessed the implication of SR in the effects of DEP associated or not with TLR agonists on monocyte-derived DC (MDDC). For this, we studied the regulation of CD36, CXCL16, LOX-1, SR-A1 and SR-B1 expression on MDDC treated with DEP associated or not with TLR2, 3 and 4 ligands. Then, the capacity of SR ligands (dextran sulfate and maleylated-ovalbumin) to block the effects of DEP on the function of lipopolysaccharide (LPS)-activated DC has been evaluated.

Results

Our data demonstrate that TLR2 agonists mainly augmented CXCL16, LOX-1 and SR-B1 expression whereas DEP alone had only a weak effect. Interestingly, DEP modulated the action of TLR2 and TLR4 ligands on the expression of LOX-1 and SR-B1. Pretreatment with the SR ligand maleylated-ovalbumin but not dextran sulfate inhibited the endocytosis of DEP by MDDC. Moreover, this SR ligand blocked the effect by DEP at low dose (1 μg/ml) on MDDC phenotype (a decrease of CD86 and HLA-DR expression) and on the secretion of CXCL10, IL-12 and TNF-α. In contrast, the decrease of IL-12 and CXCL10 secretion and the generation of oxygen metabolite induced by DEP at 10 μg/ml was not affected by SR ligands

Conclusion

Our results show for the first time that the modulation of DC functions by DEP implicates SR. TLR agonists upregulated SR expression in contrast to DEP. Interfering with the expression and/or the function of SR might be one way to limit the impact of DEP on lung immune response.
Clinical audit of core podiatry treatment in the NHS
Authors: Farndon Lisa , Barnes Andrew , Littlewood Keith , Harle Justine , Beecroft Craig , Burnside Jaclyn , Wheeler Tracey , Morris Selwyn , Walters Stephen J
Published: March 2009

Background

Core podiatry involves treatment of the nails, corns and callus and also giving footwear and foot health advice. Though it is an integral part of current podiatric practice little evidence is available to support its efficacy in terms of research and audit data. This information is important in order to support the current NHS commissioning process where services are expected to provide data on standards including outcomes. This study aimed to increase the evidence base for this area of practice by conducting a multi‐centre audit in 8 NHS podiatry departments over a 1‐year period.

Methods

The outcome measure used in this audit was the Podiatry Health Questionnaire which is a self completed short measure of foot health including a pain visual analogue scale and a section for the podiatrist to rate an individual's foot health based on their podiatric problems. The patient questionnaire was completed by individuals prior to receiving podiatry care and then 2 weeks after treatment to assess the effect of core podiatry in terms of pain and foot health.

Results

1047 patients completed both questionnaires, with an age range from 26–95 years and a mean age of 72.9 years. The podiatrists clinical rating at baseline showed 75% of patients had either slight or moderate podiatric problems. The differences in questionnaire and visual analogue scores before and after treatment were determined according to three categories – better, same, worse and 75% of patients’ scores either remained the same or improved after core podiatry treatment. A student t‐test showed a statistical significant difference in pre and post treatment scores where P < 0.001, though the confidence interval indicated that the improvement was relatively small.

Conclusion

Core podiatry has been shown to sustain or improve foot health and pain in 75% of the patients taking part in the audit. Simple outcome measures including pain scales should be used routinely in podiatric practice to assess the affect of different aspects of treatments and improve the evidence base for podiatry.
Systemic Administration of C-Type Natriuretic Peptide as a Novel Therapeutic Strategy for Skeletal Dysplasias
Authors: Yasoda Akihiro , Kitamura Hidetomo , Fujii Toshihito , Kondo Eri , Murao Naoaki , Miura Masako , Kanamoto Naotetsu , Komatsu Yasato , Arai Hiroshi , Nakao Kazuwa
Published: March 2009

Skeletal dysplasias are a group of genetic disorders characterized by severe impairment of bone growth. Various forms of them add to produce a significant morbidity and mortality, yet no efficient drug therapy has been developed to date. We previously demonstrated that C-type natriuretic peptide (CNP), a member of the natriuretic peptide family, is a potent stimulator of endochondral bone growth. Furthermore, we exhibited that targeted overexpression of a CNP transgene in the growth plate rescued the impaired bone growth observed in a mouse model of achondroplasia (Ach), the most frequent form of human skeletal dysplasias, leading us to propose that CNP may prove to be an effective treatment for this disorder. In the present study, to elucidate whether or not the systemic administration of CNP is a novel drug therapy for skeletal dysplasias, we have investigated the effects of plasma CNP on impaired bone growth in Ach mice that specifically overexpress CNP in the liver under the control of human serum amyloid P component promoter or in those treated with a continuous CNP infusion system. Our results demonstrated that increased plasma CNP from the liver or by iv administration of synthetic CNP-22 rescued the impaired bone growth phenotype of Ach mice without significant adverse effects. These results indicate that treatment with systemic CNP is a potential therapeutic strategy for skeletal dysplasias, including Ach, in humans.