bluuebunny/crossref_metadata_2025 huggingface dataset:
Male university students' views, attitudes and behaviors towards family planning and emergency contraception in Turkey
Authors: Sahin Nevin Hotun
Published: June 2008

Aim:  To determine male university students' views, attitudes and behavior towards family planning and emergency contraception as an important aspect of reproductive health.

Methods:  This descriptive study was carried out with 278 men who were chosen using the convenience sampling method at several universities in Istanbul during the spring semester of 2005. Data were obtained through interviews with men by means of a 32 item self‐administered questionnaire. Data analyses were made with the Statistical Package for the Social Sciences (SPSS).

Results:  Almost all of the men (96.6%) were single. Students' (n = 200) average age at their first sexual intercourse experience was 17.4 years. Seventy‐three percent of the students used a family planning (FP) method in their first sexual experiences (69.5% used a condom). The male condom is the most well known (95.8%) and commonly used (70.1%) FP method. The number of students taking a shared responsibility for FP was 79.4%. One third of the students had negative attitudes towards vasectomy and 1/5 of them were against the use of condoms. The percentage of the students who had heard about emergency contraception (EC) was 14.5%.

Conclusion:  Male university students who are sexually active generally do not have enough knowledge about FP and EC. They tend to engage in high‐risk behavior. It is imperative that education and counseling in reproductive and sexual health must be offered to all young men. In addition, men's attitudes toward contraceptive methods should be evaluated in other cultures and useful comparisons made with Turkey.
ER, PR and Ki‐67 expression status in granulomatous and chronic non‐specific endometritis
Authors: Mishra Kiran , Wadhwa Neelam , Guleria Kiran , Agarwal Sarla
Published: June 2008

Aim:  To study the changes in the histological pattern, distribution and intensity of sex steroid receptors (estrogen and progesterone) and cell proliferation by Ki‐67 expression by semi‐quantitative scores in granulomatous and chronic non‐specific endometritis in the premenstrual phase.

Methods:  A retrospective study was conducted on 20 cases of granulomatous endometritis, 10 of chronic non‐specific endometritis and 30 age matched (±2 years) controls with no endometrial lesions. Morphological changes were noted on histological examination and semi‐quantitative scoring of Estrogen Receptor (ER), Progesterone Receptor (PR) and Ki‐67 expression was done by immunohistochemistry.

Results:  There was significantly higher ER, PR and Ki‐67 expression in endometrial glandular and stromal cells in inflamed endometria as compared with the controls (all P‐values < 0.02) regardless of the character of the inflammation. The cases with morphology not conforming to the secretory phase at which biopsy was taken had significantly higher ER, PR and Ki‐67 expression in both endometrial and stromal cells indicating a lag in the endometrial maturation (all P‐values < 0.02). Interestingly, all parameters except PR expression in glandular cells had a significantly higher expression even in cases with secretory morphology indicating disturbances in local milieu.

Conclusion:  Endometrial inflammation interferes with local expression of ER, PR and Ki‐67. This may contribute to infertility regardless of other factors and other endometrial dysfunctional states.
Kiwi Omnicup versus Malmstrom metal cup in vacuum assisted delivery: A randomized comparative trial
Authors: Ismail Nor Azlin M. , Saharan Wan Shahrul L. , Zaleha Mahdy A. , Jaafar Rohana , Muhammad Jamil A. , Razi Zainul Rashid M.
Published: June 2008

Aim:  To compare the success, clinical outcomes, and maternal and neonatal complications between the Kiwi Omnicup and the Malmstrom metal cup in vacuum assisted delivery.

Methods:  This was a prospective randomized comparative trial. Women who required vacuum assisted vaginal delivery were randomized into the Kiwi Omnicup (KO) group and the Malmstrom metal cup (MM) group. The vacuum assisted deliveries were conducted according to hospital protocol. Details of the procedure and delivery outcomes including success and complications were analyzed.

Results:  One hundred and sixty‐four women were recruited – 85 were assigned to vacuum assisted delivery using the KO and 79 the MM. One hundred percent delivery success was achieved with no significant differences between the two instruments in terms of maternal morbidity (P = 0.66). Six women in the MM group sustained post delivery complications in comparison to five in the KO group. Three babies were diagnosed with birth asphyxia in each group. More babies in the MM group were admitted to the Neonatal Intensive Care Unit (NICU) (10 babies versus 5 babies) and suffered complications (14 versus 12 babies), compared to the KO group, although the difference was not statistically significant. There were no intrapartum or neonatal deaths and of those admitted to the NICU, all were discharged within a week without any serious consequences.

Conclusion:  Kiwi Omnicup is an effective alternative to the currently available Malmstrom metal cup for vacuum assisted delivery with no increase in maternal or neonatal morbidity or mortality.
Rectovestibular fistula as neovagina in congenital cervico‐vaginal agenesis associated with imperforate anus
Authors: Matignas Anna Lynn A. , Delos Reyes Rey H.
Published: June 2008

An 18‐year‐old female presented with primary amenorrhea and progressive cyclic abdominal pain, which prompted emergency exploratory laparotomy. Intraoperative findings revealed absent cervix and vagina, partial bicornuate uterus, hematometra, left tubal endometriosis, ruptured left endometrioma and left renal agenesis. Left salpingectomy, left oophorocystectomy, hysterotomy, evacuation of menstrual blood and transverse loop colostomy were performed. Depo‐medroxyprogesterone acetate was administered to suppress menses. On re‐exploration, utero‐rectovestibular fistula anastomosis was described with the distal rectovestibular fistula functioning as a neovagina. Cyclic menses occurred thereafter. Endorectal pull‐through with anoplasty was performed after the fistulous tract healed. To the best of our knowledge, this is the first reported case of cervico‐vaginal agenesis associated with imperforate anus and rectovestibular fistula. Early diagnosis and surgery are necessary to avoid complications such as endometriosis. The aim was to preserve fertility with conservative management.
Evisceration 5 years post abdominal hysterectomy
Authors: Rajesh Sreebha , Kalu Emmanuel , Bong Jin , Wales Nicholas
Published: June 2008

This report describes a case of a 55‐year old woman presenting with evisceration of small bowel through the vagina, five years after a Total abdominal hysterectomy and bilateral salpingoopherectomy for irregular bleeding and a benign ovarian cyst. Examination under anesthesia revealed a 70 cm loop of bowel prolapsing through a 5 cm defect in the vaginal vault. She underwent an exploratory laparotomy and repair of vaginal vault defect. Small bowel prolapse through vaginal vault defect is a rare complication after abdominal hysterectomy. Appropriate management includes prompt recognition, thorough assessment of the herniated viscus and surgical repair of the vaginal defect. Combining abdominal and vaginal approaches as in our case may facilitate repair and avoid further morbidity.
Difficulty of the surgical management of a case with placenta percreta invading towards parametrium
Authors: Borekci Bunyamin , Ingec Metin , Kumtepe Yakup , Gundogdu Cemal , Kadanali Sedat
Published: June 2008

A 37‐year‐old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral internal iliac artery ligation and supracervical hysterectomy could not prevent bleeding. A right radical parametrectomy was necessary to remove invaded parametrium and to control bleeding. The placenta percreta invading parametrium may need an extended hysterectomy procedure. Excess bleeding may be prevented by leaving the placenta in situ during surgery if the placenta percreta is diagnosed before termination of pregnancy, A classical incision may help leaving placenta is situ during operation.
Migration of a Hodge pessary into the abdominal cavity; a rare complications
Authors: Lim Boon K. , Collaris Ronald R. J.
Published: June 2008

A 62‐year old para 4 with a history of a radical hysterectomy followed by radiotherapy for endometrial carcinoma was seen shortly after insertion of a pessary for a total vault prolapse. On follow‐up the pessary couldn't be retrieved. An abdominal X‐ray revealed the pessary in the abdominal cavity and it had to be removed by means of a laparotomy. Fistula and defects have been reported both in longstanding pessary use and as long‐term complication in radical surgery with radiotherapy. In view of potential – though rare – serious complications, adequate follow‐up in pessary use is therefore mandatory. Adequate diagnostic investigations are essential in deciding on an appropriate approach for rare cases like these.
Are patients with positive screening but negative diagnostic test for gestational diabetes under risk for adverse pregnancy outcome?
Authors: Gumus Ilknur I. , Turhan Nilgün O.
Published: June 2008

Objective:  Our aim was to determine the obstetrics outcomes of patients with positive 1‐h glucose challenge test (GCT), but negative diagnostic test for gestational diabetes.

Methods:  Pregnancy records of 409 pregnants were reviewed. Patients were screened for gestational diabetes mellitus (GDM) with one‐hour 50 g glucose challenge test (GCT) at 24–28 weeks of gestation. Patients with glucose challenge tests values ≥ 130 mg/dL were refered for the 3 h, 100‐g oral glucose tolerance test (OGTT). Positive GCT but negative for OGTT group (Group A) were compared retrospectively with the group of negative GCT (Group B) for obstetrics outcomes.

Result:  GDM and impared glucose tolerance (IGT) were diagnosed in 33 (7.6%) and 46 (10.5%) patients, respectively. We identified 141 (34.4%) patients with positive GCT but negative for OGTT (Group A) and 189 (46.2%) patients with negative GCT (Group B). Gestational weight gain, polyhydramnios, family history of diabetes mellitus were significantly higher in group A than group B (P < 0.05). Prevalance of preterm labor, hypertension, cesarean delivery, mean birthweight, proportion of babies admitted to neonatal intensive care unit were similar in both groups.

Conclusion:  There are some differences for pregnancy outcomes between pregnants with positive GCT but negative for OGTT and negative GCT. These patients should be followed up carefully during the antepartum and intrapartum period.
A comparison between the effect of oxytocin only and oxtocin plus propranolol on the labor (A double blind randomized trial)
Authors: Kashanian Maryam , Fekrat Mohsen , Zarrin Zahra , Ansari Narges S.
Published: June 2008

Objective: The comparison between the effect of oxytocin alone or in combination with propranolol on labor.

Methods: A double blind randomized controlled trial was performed on 150 nulliparas with a gestational age of 39–41 weeks of pregnancy and a Bishop score of ≤5. In the first group (oxytocin group = 75), oxytocin alone was used for induction of labor. In the second group (propranolol group = 75 cases), before the beginning of oxytocin, 2 mg propranolol was slowly injected intravenously then the oxytocin was initiated.

Results: The number of patients who delivered in the first day showed no difference between the two groups. The mean duration for obtaining good contractions was shorter in the propranolol group in both the first and second day of induction The mean interval between the beginning of induction until the beginning of active phase at the first day of induction was shorter in the propranolol group. The mean interval between the beginning of induction until delivery at the first day of induction was shorter in the propranolol group. The amount of necessary oxytocin for the first day of induction was less in the propranolol group.

Conclusion: Propranolol may shorten the induction duration and labor and reduce the amount of necessary oxytocin.
The role of gamma‐synuclein in cocaine‐induced behaviour in rats
Authors: Boyer Frederic , Dreyer Jean‐Luc
Published: June 2008

The aim of this study was to investigate the role of γ‐synuclein in the rewarding effects of chronic cocaine administration and its putative interaction with the dopamine transporter (DAT). For this purpose, regulatable lentiviruses driving overexpression of the rat γ‐synuclein or DAT have been prepared, as well as lentiviruses expressing siRNAs, aimed at silencing either DAT or γ‐synuclein mRNA expression. Overexpression of DAT in the nucleus accumbens (NAc) induced a 35% decrease in locomotor activity, which could be abolished when the same animal was fed doxycycline. Furthermore, local inhibition of DAT in the NAc, using lentiviruses expressing siRNAs targeted against DAT, resulted in significant hyperlocomotion activity (72% increase over controls). By contrast, overexpression of γ‐synuclein in the NAc alone had no effect, while local silencing lead to a significant decrease in cocaine‐induced locomotor activity (47% decrease compared with controls). Surprisingly, coinjection lentiviruses expressing DAT and γ‐synuclein − leading to overexpression of both proteins in the NAc − resulted in a strong increase in cocaine‐induced rat locomotor activity (52% increase compared with controls), which was abolished upon locally silencing these genes, suggesting a synergetic role of both proteins, possibly mediated through a direct interaction.
Interactions between drebrin and Ras regulate dendritic spine plasticity
Authors: Biou Virginie , Brinkhaus Heike , Malenka Robert C. , Matus Andrew
Published: June 2008

Dendritic spines are major sites of morphological plasticity in the CNS, but the molecular mechanisms that regulate their dynamics remain poorly understood. Here we show that the association of drebrin with actin filaments plays a major role in regulating dendritic spine stability and plasticity. Overexpressing drebrin or the internal actin‐binding site of drebrin in rat hippocampal neurons destabilized mature dendritic spines so that they lost synaptic contacts and came to resemble immature dendritic filopodia. Drebrin‐induced spine destabilization was dependent on Ras activation: expression of constitutively active Ras destabilized spine morphology whereas drebrin‐induced spine destabilization was rescued by co‐expressing dominant negative Ras. Conversely, RNAi‐mediated drebrin knockdown prevented Ras‐induced destabilization and promoted spine maturation in developing neurons. Together these data demonstrate a novel mechanism in which the balance between stability and plasticity in dendritic spines depends on binding of drebrin to actin filaments in a manner that is regulated by Ras.
Conditional, genetic disruption of ciliary neurotrophic factor receptors reveals a role in adult motor neuron survival
Authors: Lee Nancy , Robitz Rachel , Zurbrugg Rebekah J. , Karpman Adam M. , Mahler Ashley M. , Cronier Samantha A. , Vesey Rachel , Spearry Rachel P. , Zolotukhin Sergei , MacLennan A. John
Published: June 2008

Indirect evidence suggests that endogenous ciliary neurotrophic factor (CNTF) receptor signaling can promote motor neuron (MN) survival in the adult. If so, proper targeting of this signaling may selectively counteract the effects of adult MN diseases. However, direct evidence for CNTF receptor involvement in adult MN survival is lacking, presumably because the unconditional blockade of the mouse CNTF receptor in vivo [through genetic disruption of the essential CNTF receptor α (CNTFRα) gene] leads to uniform perinatal death of the mice. To overcome this limitation, we have developed a method to selectively disrupt CNTF receptor function in a targeted subset of adult MNs that are not required for survival. A ‘floxed CNTFRα’ mouse line was generated and characterized. In addition, an adeno‐associated virus (AAV) vector that drives Cre recombinase (Cre) expression was constructed and shown, with reporter mouse lines, to selectively excise floxed genes in facial MNs following its stereotaxic injection into the facial motor nucleus. Adult floxed CNTFRα mice were then injected with the AAV‐Cre vector to excise the CNTFRα gene in the targeted MNs. The resulting data indicate that adult CNTF receptor signaling, likely by the MNs themselves, can play an essential role in MN survival. The data further indicate that this role is independent of any developmental contributions CNTF receptor signaling makes to MN survival or function.
Pharmacological activation of CB1 and D2 receptors in rats: predominant role of CB1 in the increase of alcohol relapse
Authors: Alen Francisco , Moreno‐Sanz Guillermo , Isabel de Tena Ana , Brooks Rayna D. , López‐Jimenez Alejandro , Navarro Miguel , López‐Moreno José Antonio
Published: June 2008

The classical dopamine D2 receptor has been widely studied in alcoholism. Recently, different studies have explored the role of the CB1 receptor in alcohol‐related behavior. In alcohol addiction, relapse is one of the central features. In light of this, we investigated the functional roles of and interactions between CB1 and D2 receptors in alcohol relapse. We used the learned task of alcohol operant self‐administration in Wistar rats. In order to evaluate alcohol relapse, we set up a protocol essentially based on the alcohol deprivation effect. We found that subchronic activation of CB1 (WIN 55,212–2, 2 mg/kg), but not D2 receptors (quinpirole, 1 mg/kg), during a period of alcohol deprivation increased long‐lasting alcohol relapse. The cannabinoid‐induced potentiation of alcohol relapse was mediated by a motivational and appetitive component, and not merely by alcohol consumption. This potentiation was prevented by the pharmacological inactivation of D2 receptors (raclopride, 0.1–0.3 mg/kg). Together, these results essentially demonstrate that activation of CB1 receptors plays a key role in the increase of alcohol relapse, whereas inactivation of D2 receptors modulates this aberrant behavior. We suggest that there exists a functional and interactive relationship between both receptor systems, which controls alcohol relapse and alcohol‐learned tasks.
Mechanisms of neurodegeneration in Huntington’s disease
Authors: Gil Joana M. , Rego Ana Cristina
Published: June 2008

Huntington’s disease (HD) is caused by an expansion of cytosine–adenine–guanine (CAG) repeats in the huntingtin gene, which leads to neuronal loss in the striatum and cortex and to the appearance of neuronal intranuclear inclusions of mutant huntingtin. Huntingtin plays a role in protein trafficking, vesicle transport, postsynaptic signaling, transcriptional regulation, and apoptosis. Thus, a loss of function of the normal protein and a toxic gain of function of the mutant huntingtin contribute to the disruption of multiple intracellular pathways. Furthermore, excitotoxicity, dopamine toxicity, metabolic impairment, mitochondrial dysfunction, oxidative stress, apoptosis, and autophagy have been implicated in the progressive degeneration observed in HD. Nevertheless, despite the efforts of a multidisciplinary scientific community, there is no cure for this devastating neurodegenerative disorder. This review presents an overview of the mechanisms that may contribute for HD pathogenesis. Ultimately, a better understanding of these mechanisms will lead to the development of more effective therapeutic targets.
Going Global: Cultural Values and Perceptions of Selection Procedures
Authors: Ryan Ann Marie , Boyce Anthony S. , Ghumman Sonia , Jundt Dustin , Schmidt Gordon , Gibby Robert
Published: June 2008

The role of cultural values in perceptions of selection tools is a concern of multinational corporations seeking to standardise staffing practices. Data from 1,199 individuals across 21 countries were gathered to examine the role of cultural values (independent and interdependent self‐construals, achievement and ascription orientations) in perceptions of eight selection tools. Tool perceptions were mostly similar across individuals holding different cultural values, suggesting that multinational corporations may be able to construct tools with wide acceptability across cultures.

Le rôle des valeurs culturelles dans l’appréhension des outils de sélection est une préoccupation des entreprises multinationales qui essaient de standardiser la gestion de leur personnel. On a rassemblé des données auprès de 1199 individus répartis sur 21 pays pour analyser le rôle des valeurs culturelles (conception de soi indépendante ou interdépendante, accomplissement et attributions) dans la représentation de huit outils de sélection. La perception de ces outils était le plus souvent analogue chez des personnes représentant des valeurs culturelles différentes, ce qui suppose que les multinationales sont à même d’élaborer des instruments utilisables quelle que soit la culture.
Peripheral neural lesion‐induced stress urinary incontinence in anaesthetized female cats
Authors: Bernabé Jacques , Julia‐Guilloteau Véronique , Denys Pierre , Chartier‐Kastler Emmanuel , Alexandre Laurent , Peeters Magali , Giuliano François
Published: June 2008

OBJECTIVES

To characterize the effect of acute unilateral and bilateral lesion of the pelvic and pudendal nerves, and nerves innervating the iliococcygeous and pubococcygeous muscles during sneezing in anaesthetized female cats, on intravesical pressure (IVP), urethral pressure (UPs) and external urethral sphincter (EUS) activity.

MATERIALS AND METHODS

In seven anaesthetized female cats UPs along the urethra (UPs1–4) and IVPs were recorded in the emptied bladder during sneezing before and after unilateral and then bilateral peripheral neural lesions. UPs were measured using microtip transducer catheters with UP4 positioned in the distal urethra where the EUS is located. Urine leakage was also noted, after urethral catheter removal and bladder filling.

RESULTS

During sneezing, in intact cats, the magnitude of UP4 was larger than those of IVP and UPs1–3. The area under the curve of both anal sphincter and EUS electromyography was increased. There was no urine leakage. After unilateral neural lesions, the mean magnitude of response was similar all along the urethra and in the bladder. The distal UP response was significantly lower than that recorded in intact cats. In addition, there was urine leakage in six of the seven cats. Bilateral neural lesions caused permanent urine leakage and significant decreases in all the UP responses.

CONCLUSION

In female cats, during sneezing, neurally driven reflex contractions of EUS leading to an increase in distal UP contribute to active urethral closure mechanisms and ensure urinary continence.
ETHICAL REVIEW ISSUES IN COLLABORATIVE RESEARCH BETWEEN US AND LOW – MIDDLE INCOME COUNTRY PARTNERS: A CASE EXAMPLE
Authors: MCINTOSH SCOTT , SIERRA ESSIE , DOZIER ANN , DIAZ SERGIO , QUIÑONES ZAHIRA , PRIMACK ARON , CHADWICK GARY , OSSIP‐KLEIN DEBORAH J.
Published: June 2008

The current ethical structure for collaborative international health research stems largely from developed countries’ standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country.
One‐Dimensional Model for Multi‐Barge Flotillas Impacting Bridge Piers
Authors: Yuan Peng , Harik Issam E.
Published: June 2008

Abstract:  The serious consequence of barge‐bridge collisions necessitates the study of barge impact loadings on bridges. This article introduces an elastoplastic spring‐mass model for the analysis of multi‐barge flotillas colliding with bridge piers at zero angle of attack. The model accounts for the essential factors pertaining to barge/flotilla impacts, such as pier geometry and stiffness, and dynamic interaction between barges. A method to identify the elastoplastic behavior of barge crushing is also presented. The proposed method generates impact force time‐histories for a multitude of flotilla configurations in a matter of minutes, which is especially valuable in probabilistic analysis requiring many collision simulations. The results from this study are compatible with the respective impact time‐histories produced by exhaustive finite element simulations. A bridge pier impacted by a three‐barge and a 15‐barge flotilla is studied.
GOVERNANCE‐BASED ACQUISITIONS AND RISK TAKING IN BANKING*
Authors: BARRIOS VÍCTOR E. , GRANERO LUIS M.
Published: June 2008

We examine the market for corporate control in banking when strategic acquisitions are driven by the different governance structures of commercial and savings banks. In contrast to profit‐maximizing entities, we show that savings institutions can have acquisition incentives from their peculiar governance and ownership structure. Governance‐based acquisition incentives, which interact with the specifics of the loan market in affecting bank risk taking, can arise when acquisitions take place sequentially or simultaneously, and also when financial intermediaries affect risk taking directly through the target return of investments or indirectly through the loan interest rate.
R&D COOPERATION AND COLLUSION: THE CASE OF JOINT LABS*
Authors: CABON‐DHERSIN MARIE‐LAURE
Published: June 2008

In the standard two‐stage framework of R&D/product market competition, the present note compares the performance of full cooperation (firms conduct R&D in a joint lab and collude in the product market) and full competition (firms compete in R&D as well as in the product market). The paper shows that (i) full cooperation leads to better results in terms of R&D efforts compared with non‐cooperation; (ii) collusion at the production stage may increase both producers' and consumers' surplus especially when the degree of spillovers is not too high and the products are not homogeneous; (iii) the gains in terms of social welfare from full cooperation increase when the efficiency of R&D decreases.
TRANSITIONAL DYNAMICS OF AN ENDOGENOUS GROWTH MODEL WITH AN EROSION EFFECT*
Authors: SEQUEIRA TIAGO NEVES
Published: June 2008

The convergence features of an endogenous growth model with physical capital, human capital and R&D have been studied. We add an erosion effect (supported by empirical evidence) to this model, and fully characterize its convergence properties. The dynamics is described by a fourth‐order system of differential equations. We show that the model converges along a one‐dimensional stable manifold and that its equilibrium is saddle‐path stable, for most plausible values for the parameters. We also argue that one of the implications of considering this ‘erosion effect’ is the increase in the adherence of the model to data.
PATENT LICENSING BY MEANS OF AN AUCTION: INTERNAL VERSUS EXTERNAL PATENTEE*
Authors: SANDONÍS JOEL , FAULÍ‐OLLER RAMON
Published: June 2008

An independent research laboratory owns a patented process innovation that can be licensed by means of an auction to two Cournot duopolists producing differentiated goods. For large innovations and close enough substitute goods the patentee auctions off only one licence, preventing the full diffusion of the innovation. For this range of parameters, however, if the laboratory merged with one of the firms in the industry, full technology diffusion would be implemented as the merged entity would always license the innovation to the rival firm. This explains that, in this context, a vertical merger is both profitable and welfare improving.
Trends of mortality and causes of death among HIV‐infected patients in Taiwan, 1984–2005
Authors: Yang C‐H , Huang Y‐F , Hsiao C‐F , Yeh Y‐L , Liou H‐R , Hung C‐C , Yang S‐Y
Published: June 2008

Background

The aim of this study was to analyse the trends of mortality and causes of death among HIV‐infected patients in Taiwan from 1984 to 2005.

Methods

Registered data and death certificates for HIV‐infected patients from Taiwan Centers for Disease Control were reviewed. Mortality rate and causes of deaths were compared among patients whose HIV diagnosis was made in three different study periods: before the introduction of highly active antiretroviral therapy (HAART) (pre‐HAART: from 1 January 1984 to 31 March 1997), in the early HAART period (from 1 April 1997 to 31 December 2001), and in the late HAART period (from 1 January 2002 to 31 December 2005). A subgroup of 1161 HIV‐infected patients (11.4%) followed at a university hospital were analysed to investigate the trends of and risk factors for mortality.

Results

For 10 162 HIV‐infected patients with a mean follow‐up of 1.97 years, the mortality rate of HIV‐infected patients declined from 10.2 deaths per 100 person‐years (PY) in the pre‐HAART period to 6.5 deaths and 3.7 deaths per 100 PY in the early and late HAART periods, respectively (P<0.0001). For the 1161 patients followed at a university hospital (66.8% with CD4 count <200 cells/μL), HAART reduced mortality by 89% in multivariate analysis, and the adjusted hazard ratio for death was 0.28 (95% confidence interval 0.24, 0.33) in patients enrolled in the late HAART period compared with those in the pre‐HAART period. Seventy‐six per cent of the deaths in the pre‐HAART period were attributable to AIDS‐defining conditions, compared with 36% in the late HAART period (P<0.0001). The leading causes of non‐AIDS‐related deaths were sepsis (14.7%) and accidental death (8.3%), both of which increased significantly throughout the three study periods. Compared with patients acquiring HIV infection through sexual contact, injecting drug users were more likely to die from non‐AIDS‐related causes.

Conclusions

The mortality of HIV‐infected patients declined significantly after the introduction of HAART in Taiwan. In the HAART era, AIDS‐related deaths decreased significantly while deaths from non‐AIDS‐related conditions increased.
How has electrophysiology changed the management of cervical spondylotic myelopathy?
Authors: Lo Y. L.
Published: June 2008

Cervical spondylosis occurs universally, with cervical spondylotic myelopathy (CSM) as its most serious consequence. The electrical property of the spinal cord and its susceptibility to injury renders electrophysiology relevant to the management of CSM, as addressed in this review. Somatosensory‐evoked potentials evaluate spinal cord integrity with regards to posterior column functions exclusively. Although motor‐evoked potentials may be more sensitive than the former and may be utilized intraoperatively, they are susceptible to interference by inhalational anaesthetics. Electromyography may play a role in minimizing C5 root damage and spinal cord‐evoked potentials can localize spinal conduction block during CSM surgery. Critically reviewing the available evidence, electrophysiology cannot be universally recommended as mandatory in the management of CSM at present. It may, however, play emergent, isolated roles in the diagnosis, follow‐up and treatment of this common disorder.
Founder Effect and Estimation of the Age of the c.892C>T (p.Arg298Cys) Mutation in LMNA Associated to Charcot‐Marie‐Tooth Subtype CMT2B1 in Families from North Western Africa
Authors: Hamadouche T. , Poitelon Y. , Genin E. , Chaouch M. , Tazir M. , Kassouri N. , Nouioua S. , Chaouch A. , Boccaccio I. , Benhassine T. , De Sandre‐Giovannoli A. , Grid D. , Lévy N. , Delague V.
Published: June 2008

CMT2B1, an axonal subtype (MIM 605588) of the Charcot‐Marie‐Tooth disease, is an autosomal recessive motor and sensory neuropathy characterized by progressive muscular and sensory loss in the distal extremities with chronic distal weakness. The genetic defect associated with the disease is, to date, a unique homozygous missense mutation, p.Arg298Cys (c.892C>T), in the LMNA gene. So far, this mutation has only been found in affected individuals originating from a restricted region of North Western Africa (northwest of Algeria and east of Morocco), strongly suggesting a founder effect. In order to address this hypothesis, genotyping of both STRs and intragenic SNPs was performed at the LMNA locus, at chromosome 1q21.2‐q21.3, in 42 individuals affected with CMT2B1 from 25 Algerian families. Our results indicate that the affected individuals share a common ancestral haplotype in a region of about 1.0 Mb (1 cM) and that the most recent common ancestor would have lived about 800–900 years ago (95% confidence interval: 550 to 1300 years).
Live imaging of altered period1 expression in the suprachiasmatic nuclei of Vipr2−/− mice1
Authors: Hughes Alun T. L. , Guilding Clare , Lennox Laura , Samuels Rayna E. , McMahon Douglas G. , Piggins Hugh D.
Published: June 2008

Vasoactive intestinal polypeptide and its receptor, VPAC2, play important roles in the functioning of the brain’s circadian clock in the suprachiasmatic nuclei (SCN). Mice lacking VPAC2 receptors (Vipr2−/−) show altered circadian rhythms in locomotor behavior, neuronal firing rate, and clock gene expression, however, the nature of molecular oscillations in individual cells is unclear. Here, we used real‐time confocal imaging of a destabilized green fluorescent protein (GFP) reporter to track the expression of the core clock gene Per1 in live SCN‐containing brain slices from wild‐type (WT) and Vipr2−/− mice. Rhythms in Per1‐driven GFP were detected in WT and Vipr2−/− cells, though a significantly lower number and proportion of cells in Vipr2−/− slices expressed detectable rhythms. Further, Vipr2−/− cells expressed significantly lower amplitude oscillations than WT cells. Within each slice, the phases of WT cells were synchronized whereas cells in Vipr2−/− slices were poorly synchronized. Most GFP‐expressing cells, from both genotypes, expressed neither vasopressin nor vasoactive intestinal polypeptide. Pharmacological blockade of VPAC2 receptors in WT SCN slices partially mimicked the Vipr2−/− phenotype. These data demonstrate that intercellular communication via the VPAC2 receptor is important for SCN neurons to sustain robust, synchronous oscillations in clock gene expression.
Moderate caloric restriction initiated in rodents during adulthood sustains function of the female reproductive axis into advanced chronological age
Authors: Selesniemi Kaisa , Lee Ho‐Joon , Tilly Jonathan L.
Published: June 2008

Age‐related ovarian failure in women heralds the transition into postmenopausal life, which is characterized by a loss of fertility and increased risk for cardiovascular disease, osteoporosis and cognitive dysfunction. Unfortunately, there are no options available for delaying loss of ovarian function with age in humans. Rodent studies have shown that caloric restriction (CR) can extend female fertile lifespan; however, much of this work initiated CR at weaning, which causes stunted adolescent growth and a delayed onset of sexual maturation. Herein we tested in mice if CR initiated in adulthood could delay reproductive aging. After 4 months of CR, the ovarian follicle reserve was doubled compared to ad libitum (AL)‐fed age‐matched controls, which in mating trials exhibited a loss of fertility by 15.5 months of age. In CR females returned to AL feeding at 15.5 months of age, approximately one‐half remained fertile for 6 additional months and one‐third continued to deliver offspring through 23 months of age. Notably, fecundity of CR‐then‐AL‐fed females and postnatal offspring survival rates were dramatically improved compared with aging AL‐fed controls. For example, between 10 and 23 months of age, only 22% of the 54 offspring delivered by AL‐fed females survived. In contrast, over 73% of the 94 pups delivered by 15.5‐ to 23‐month‐old CR‐then‐AL‐fed mice survived without any overt complications. These data indicate that in mice adult‐onset CR maintains function of the female reproductive axis into advanced age and dramatically improves postnatal survival of offspring delivered by aged females.
COMPOSITIONAL VARIATION IN ROMAN COLOURLESS GLASS OBJECTS FROM THE BOCHOLTZ BURIAL (THE NETHERLANDS)*
Authors: HUISMAN D. J. , GROOT T. DE , POLS S. , VAN OS B. J. H. , DEGRYSE P.
Published: June 2008

We investigated the major and trace element composition and Pb and Sr isotope characteristics of a series of about 20 colourless glass objects from a single high‐status Roman burial from the Netherlands (Bocholtz). The major elements show a relatively homogeneous group, with one outlier. This is corroborated by the Sr isotopes. Based on the Sb and Pb content, three major groups can be discerned, with two other outliers. This grouping is corroborated by the contents of the trace elements Bi, Sn, Ag, As and Mo, and by variations in lead isotopic ratios. On the basis of these results, we conclude that the glass of all objects was probably made with sand and lime from the same source. The variation in trace elements and lead isotope composition is most likely the result of variations in the composition of the sulphidic antimony ore(s) that were used to decolourize the glass. The composition of the Bocholtz glass is compared with that of other Roman glass, and implications for production models, trade and use of colourless glass objects are discussed. On the basis of isotopic and major element variation, we conclude that the antimony ore presumably originated from different mines.
Sudden Death in a Young Man with Catecholaminergic Polymorphic Ventricular Tachycardia and Paroxysmal Atrial Fibrillation
Authors: PIZZALE STEPHEN , GOLLOB MICHAEL H , GOW ROBERT , BIRNIE DAVID H
Published: June 2008

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a familial condition that presents with exercise‐induced syncope or sudden death in children or young adults. In most cases the disease is caused by a mutation in the cardiac ryanodine receptor (RyR2) gene. Current evidence suggests that primary therapy for CPVT is beta blockade and implantable cardioverter defibrillator (ICD) placement. There is a recent report of a patient with CPVT who died despite appropriate ICD therapies, and we report a similar case. Our patient died after probably initially receiving inappropriate ICD shocks for atrial fibrillation. We recommend that utmost efforts should be made to prevent shocks including repeated exercise testing to confirm suppression of PVT.
Implant Venoplasty: Dilation of Subclavian and Coronary Veins to Facilitate Device Implantation: Indications, Frequency, Methods, and Complications
Authors: WORLEY SETH J.
Published: June 2008

Subclavian vein (SV) obstruction occurs in 13–35% of patients with prior leads, resulting in use of proximal venous access, the other vein, laser lead extraction, or surgery. Surgery is required for optimal left ventricle lead placement in 10–15% of cardiac resynchronization therapy candidates because of small or stenotic veins. Published data describe the safe and successful balloon dilation of both subclavian and coronary veins (CV); however, implant venoplasty is rarely performed because many implanting physicians are not familiar with the use of balloons. This article outlines how we use venoplasty to facilitate implantation in our laboratory. The indications, frequency, observed and potential complications that have evolved with our experience are also discussed.
The L‐Type Ca2+ and KATP Channels May Contribute to Pacing‐Induced Protection Against Anoxia‐Reoxygenation in the Embryonic Heart Model
Authors: BRUCHEZ PHILIPPE , SARRE ALEXANDRE , KAPPENBERGER LUKAS , RADDATZ ERIC
Published: June 2008

Aims:
The L‐type Ca2+ channel, the sarcolemmal (sarcKATP), and mitochondrial KATP (mitoKATP) channels are involved in myocardial preconditioning. We aimed at determining to what extent these channels can also participate in pacing‐induced cardioprotection.

Methods:
Hearts of 4‐day‐old chick embryos were paced in ovo during 12 hour using asynchronous intermittent ventricular stimulation at 110% of the intrinsic rate. Sham operated and paced hearts were then submitted in vitro to anoxia (30 minutes) and reoxygenation (60 minutes). These hearts were exposed to L‐type Ca2+ channel agonist Bay‐K‐8644 (BAY‐K) or blocker verapamil, nonselective KATP channel antagonist glibenclamide (GLIB), mitoKATP channel agonist diazoxide (DIAZO), or antagonist 5‐hydroxydecanoate. Electrocardiogram, electromechanical delay (EMD) reflecting excitation‐contraction (E‐C) coupling, and contractility were determined.

Results:
Under normoxia, heart rate, QT duration, conduction, EMD, and ventricular shortening were similar in sham and paced hearts. During reoxygenation, arrhythmias ceased earlier and ventricular EMD recovered faster in paced hearts than in sham hearts. In sham hearts, BAY‐K (but not verapamil), DIAZO (but not 5‐hydroxydecanoate) or GLIB accelerated recovery of ventricular EMD, reproducing the pacing‐induced protection. By contrast, none of these agents further ameliorated recovery of the paced hearts.

Conclusion:
The protective effect of chronic asynchronous pacing at near physiological rate on ventricular E‐C coupling appears to be associated with subtle activation of L‐type Ca2+ channel, inhibition of sarcKATP channel, and/or opening of mitoKATP channel.
Are Women with Severely Symptomatic Brugada Syndrome Different from Men?
Authors: SACHER FRÉDÉRIC , MEREGALLI PAOLA , VELTMANN CHRISTIAN , FIELD MICHAEL E , SOLNON AUDE , BRU PAUL , ABBEY SÉLIM , JAÏS PIERRE , TAN HANNO L , WOLPERT CHRISTIAN , LANDE GILLES , BERTAULT VALÉRIE , DERVAL NICOLAS , BABUTY DOMINIQUE , LACROIX DOMINIQUE , BOVEDA SERGE , MAURY PHILIPPE , HOCINI MÉLÈZE , CLÉMENTY JACQUES , MABO PHILIPPE , LEMAREC HERVÉ , MANSOURATI JACQUES , BORGGREFE MARTIN , WILDE ARTHUR , HAÏSSAGUERRE MICHEL , PROBST VINCENT
Published: June 2008

Introduction: Spontaneous type‐1 ECG has been recognized as a risk factor for sudden cardiac death (SCD) in Brugada syndrome (BrS), but studied populations predominantly consisted of men. We sought to investigate whether a spontaneous type‐1 ECG pattern was also associated in women with severely symptomatic BrS. Other known risk factors were also examined for gender specificity.

Methods: Patients with severely symptomatic BrS, defined as resuscitated SCD and/or appropriate implantable cardioverter‐defibrillator (ICD) shock, were included from 11 European centers. Clinical data, investigation of family history, 12‐lead ECG, and results of electrophysiological study (EPS) were collected. The average follow‐up was 4 ± 3 years.

Results: Fifty‐eight patients fulfilled the inclusion criteria (mean age 47 ± 11 years, 8 women). Thirty‐six men (72%) but only two women (25%) had a spontaneous type‐1 ECG at baseline (P = 0.02). Maximal ST elevation before or after drug challenge was 3.7 ± 1.3 mm in men versus 2.4 ± 0.7 mm in women (P = 0.007). The proportion of patients with a family history of SCD or an SCN5A mutation was not significantly different between both groups. Of those patients with high‐risk BrS who underwent EPS, 76%(12/25) of men and 50%(2/4) of women had a positive study.

Conclusion: In contrast to men, most women with BrS and resuscitated SCD or appropriate ICD shock do not have a spontaneous type‐1 ECG pattern. In addition, the degree of ST elevation is less pronounced in women than men. While women represent a lower‐risk group overall, risk factors established from a predominantly male population may not be helpful in identifying high‐risk females.
Diagnostic Value of Endomyocardial Biopsy Guided by Electroanatomic Voltage Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
Authors: AVELLA ANDREA , D'AMATI GIULIA , PAPPALARDO AUGUSTO , RE FEDERICA , SILENZI PAOLA FRANCESCA , LAURENZI FRANCESCO , DE GIROLAMO PIERGIUSEPPE , PELARGONIO GEMMA , RUSSO ANTONIO DELLO , BARATTA PASQUALE , MESSINA GIUSEPPE , ZECCHI PAOLO , ZACHARA ELISABETTA , TONDO CLAUDIO
Published: June 2008

Introduction:
To improve the endomyocardial biopsy (EMB) diagnostic sensitivity for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), we hypothesized a biopsy sampling focused on selected right ventricle (RV) low‐voltage areas identified by electroanatomic voltage mapping.

Methods and Results:
The study population (22 patients, 10 men; mean age 34 ± 10 years) included 11 patients with overt ARVC/D (group A) and 11 patients with suspected ARVC/D (group B), according to both arrhythmic profile and standardized noninvasive diagnostic criteria. In all 22 patients, an RV bipolar voltage mapping was performed with CARTO™ system sampling multiple endocardial sites (262 ± 61), during sinus rhythm, with a 0.5–1.5 mV color range setting of voltage display. All 11 (100%) group A patients and 8 of the 11 (73%) group B patients (P = nonsignificant [NS]) presented RV low‐voltage areas (<0.5 mV). In 8 group A patients and in all 8 group B patients with a pathological RV voltage map, an EMB focused on the low‐voltage areas was performed. In 6 (75%) group A patients and in 7 (87%) group B patients (P = NS), voltage mapping‐guided EMB was diagnostic for ARVC/D. In the remaining 3 patients, only nonspecific histological findings were observed.

Conclusions:
The results of our study (1) confirm the high diagnostic sensitivity of RV voltage mapping in patients with overt ARVC/D, (2) document a high prevalence of RV low‐voltage areas even in patients with suspected ARVC/D, and (3) demonstrate that in patients with clinical evidence or suspicion for ARVC/D, presenting RV low‐voltage areas, EMB guided by voltage mapping may provide ARVC/D diagnosis confirmation.
Making Nanostructured Ceramics from Micrometer‐Sized Powders via Grain Refinement During SPS Sintering
Authors: Chen Kepi , Zhang Xiaowen , Wang Hui , Zhang Ligong , Zhu Jing , Yang Fuqian , An Linan
Published: June 2008

In this paper, we have demonstrated that dense bulk nanostructured ceramics can be synthesized from micrometer‐sized powders by using an electrical field‐activated sintering process. A dense Pb(Mg1/3Nb2/3)O3‐PbTiO3 ceramic with grain sizes of 20–100 nm was obtained from the starting powder of 1 to 10 μm. Structural and property analysis confirmed that the entire specimen is composed of nano‐sized grains. The significant microstructural refining is attributed to a pulsed electric field‐induced thermo‐mechanical fatigue process, which in situ“shattered” the large particles into nano‐sized grains during sintering. An advantage of this technique over the previous ones is that it avoids the usage of ultrafine nanometer‐sized powders, which are difficult to process and mass produce in an economic and consistent way. In principle, the process demonstrated here can be applied to other material systems.
Preparation of Fluorine‐Containing Indium Tin Oxide Sputtering Targets using Spark Plasma Sintering Process
Authors: Takeuchi Tomonari , Kageyama Hiroyuki , Nakazawa Hiromi , Atsumi Toshiyuki , Tamura Shigeharu , Kamijo Nagao , Takeuchi Akihisa , Suzuki Yoshio
Published: June 2008

Fluorine‐containing indium tin oxide (F‐ITO) sputtering targets were prepared using spark‐plasma‐sintering (SPS) process. The initial powder, which was prepared by reacting ITO with HF, was sintered to the 10 cm‐disks with nearly 90% of the theoretical density by the SPS process. The resulting disks were consisted of ITO and InOF, and the fluorine content was about 4 at.%. Using the F‐ITO disks as sputtering target, thin films were deposited on the glass substrates. The electrical conductivity and optical transmission of the deposited films were comparable to those of the conventional ITO films, while the surface roughness of the films was much improved.