bluuebunny/crossref_metadata_2025 huggingface dataset:
An Algorithm Informed by the Parathyroid Hormone Level Reduces Hypocalcemic Complications of Thyroidectomy
Authors: Wiseman James E. , Mossanen Matthew , Ituarte Philip H. G. , Bath Jonathan M. T. , Yeh Michael W.
Published: January 2010

Background

Measurement of the parathyroid hormone (PTH) level following total thyroidectomy (TTx) may allow prediction of postoperative hypocalcemia. We present an algorithmic method of managing hypocalcemia pre‐emptively, based on the PTH level 1 h after operation.

Materials and methods

We examined 423 consecutive patients undergoing TTx at a single institution. A subset of patients were managed using an algorithm involving routine postoperative oral calcium administration and the early addition of oral calcitriol in patients with a low 1‐h postoperative PTH level. Algorithm patients were compared to a concurrent, conventionally managed group. Outcomes measured included serum calcium levels, symptoms of hypocalcemia, postoperative complications, and receipt of intravenous (IV) calcium.

Results

The algorithm was applied in 135 patients, and 288 patients were managed conventionally. Critically low calcium levels (total calcium <7.5 mg/dl [1.88 mmol/l] or ionized calcium <0.94 mmol/l) were less common in algorithm patients (10.6% vs. 25.3%; p < 0.005). Much of this difference was attributable to the protective impact of the algorithm on patients undergoing TTx for cancer, 30% of whom developed critically low calcium levels when managed conventionally. Among patients requiring IV calcium, algorithm patients received fewer doses (1.29 vs. 1.86; p < 0.05). Low 1‐h PTH levels were found in 21% (28/133) of algorithm patients, but these did not correlate with low calcium levels, suggesting that the algorithm compensated adequately for temporary hypoparathyroidism. No patients developed hypercalcemia.

Conclusions

An algorithmic approach incorporating early postoperative PTH levels and routine administration of oral calcium reduces the risk of severe hypocalcemia after total thyroidectomy.
Complications Analysis with Postoperative Choledochoscopy for Residual Bile Duct Stones
Authors: Kong Jing , Wu Shuo‐Dong , Xian Guo‐Zhe , Yang Su
Published: January 2010

Background

This study was designed to review the experience of this department with the treatment of post‐common bile duct exploration residual stones using choledochoscopy and to analyze the complications of choledochoscopy and explore effective methods of prevention.

Methods

A choledochoscope (PENTAX fibercholedochoscope and electronic choledochoscope PENTAX ECN‐1530) was used. A total of 2,882 postoperative percutaneous choledochoscopy (POC) sessions were performed on 986 patients with residual bile duct stones from 1980 to 2008 (408 men, 578 women; ages range, 21–82 years). Forty‐five of these had undergone laparoscopic common bile duct exploration (LCBDE); the rest had open bile duct exploration. Seventy‐six participants had choledochoscopy examination (for diagnosis only), and in 910 patients it was performed for both diagnosis and therapy (calculi extraction). In 68 cases, plasma shock wave lithotripsy (PSWL) was performed for larger stones before choledochoscopy extraction.

Results

The mean duration of choledochoscopy was 25 min (range, 10 min to 2 h), with a mean frequency of 2.85 times (range, 1–11). No mortalities occurred. The procedure was unsuccessful in 28 cases in which stones were not accessible because they were embedded in distal hepatic ducts or because they were in proximal ducts that were severely stenosed. Complications resulted in 13 cases and included perforated sinus, biliary peritonitis, sinus hypoplasia, destruction of the T‐tube system leading to obstruction, basket incarceration, bleeding, and intestinal fistular. Choledochoscopic stone clearance was achieved in 95.5% of the cases.

Conclusions

Choledochoscopy is an important treatment option for hepatolithus. It has a high efficiency for stone extraction and fewer complications. However, it should be noted that some of its complications are potentially life‐threatening.
A Systematic Review of Cases Reporting Needle Tract Seeding Following Thyroid Fine Needle Biopsy
Authors: Polyzos Stergios A. , Anastasilakis Athanasios D.
Published: January 2010

Background

Because of its accuracy and cost‐effectiveness, thyroid fine needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules. Needle tract seeding (NTS) has been a concern since the earliest days of FNB, contributing to the delayed acceptance of FNB as a safe procedure. In this review we tried to systematically record all reports of NTS after diagnostic thyroid FNB and provide useful hints to minimize the risk of NTS.

Methods

Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher Medline) electronic database. The search was not limited by publication time or English language.

Results

Ten relevant articles were found: eight case reports, one case in a surgical series, and one retrospective observational study.

Conclusions

Despite initial concerns about the risk of NTS, FNB is now considered to be a safe procedure. Although proper FNB technique can reduce its risk, NTS is an unavoidable complication of FNB, which clinicians should be aware of. However, the incidence of NTS is low and it doesn’t seem to affect the prognosis because the seedings can be surgically removed without recurrence. The management of the thyroid nodules is to‐date based on FNB, and the benefits from FNB (elimination of needless imaging and surgery) far outweigh the potential risk for NTS.
A Time‐Saving Technique for Specimen Extraction in Sleeve Gastrectomy
Authors: Casella Giovanni , Soricelli Emanuele , Fantini Aldo , Basso Nicola
Published: January 2010

Background

Laparoscopic sleeve gastrectomy (LSG), first intended as the first step of biliopancreatic diversion with duodenal switch (BPD‐DS), is gaining popularity as a per‐se procedure because of its effectiveness on weight loss and comorbidity resolution. The extraction of the gastrectomy specimen could be challenging and time‐consuming. Different techniques have been described for specimen withdrawal. In this article we report the technique adopted in more than 250 LSGs performed in our department.

Methods

In the first 90 LSGs performed in our department from October 2002, the specimen was extracted in a retrieval bag using an endoloop. In the following 160 cases the technique has been simplified: the grasped specimen is withdrawn through the 15‐mm trocar site without any additional device.

Results

We registered only two cases of wound infection (1.2%) with the simplified technique, both occurring in the initial cases. There were no cases of trocar site hernia formation.

Conclusion

The technique described does not require any special devices and seems to be simpler, saves time, and is cost effective if compared with other techniques previously reported.
T‐tube Duodenocholangiostomy for the Management of Duodenal Fistulae
Authors: Paluszkiewicz Piotr , Dudek Wojciech , Daulatzai Najib , Stanislawek Andrzej , Hart Colin
Published: January 2010

Background

The tube decompression of the duodenum through an additional point of access of the duodenal wall or occasionally via the leak site decreases morbidity and mortality in patients with duodenal fistula. The objective of this paper is to present the detailed technique and clinical benefits of simplified duodenal and biliary decompression achieved by transampullary insertion of a T‐tube with one‐step duodenal closure for the prevention and/or treatment of duodenal leak.

Methods

The duodenocholangiostomy using T‐tube with laterally perforated long duodenal limb was performed preventively in 4 patients and as a secondary procedure for septic duodenal leak in another selected 12. The mean output from the fistula, length of hospital stay, incidence of pancreatitis, as well as any postoperative septic events was recorded. The nutritional schedule during the in early postoperative period also was analyzed.

Results

The outcome was favorable for all patients. The mean length of hospital stay was 19 days. Septic events, such as wound or urinary tract infections, were observed in 30% of patients. Serum amylase and lipase activity was increased in two patients without a clinical picture of pancreatitis. Mean volume of T‐tube duodenocholangiostomy drainage was approximately 500 ml per day during the first postoperative week. Enteral feeding was commenced 10–52 (mean, 21) hours after surgery and was followed by the initiation of normal diet on average 5 days postoperatively.

Conclusions

Duodenocholangiostomy performed for duodenal decompression may be a promising alternative to classical tube duodenostomy for selected patients; however, further studies should be made to evaluate fully its practical value.
Fatty acid oxidation disorders: outcome and long‐term prognosis
Authors: Wilcken Bridget
Published: January 2010

Assessing the outcome of fatty acid oxidation disorders is difficult, as most are rare. For diagnosis by newborn screening, the situation is compounded: far more cases are diagnosed by screening than by clinical presentation, representing a somewhat different cohort. The literature on outcome was reviewed. For disorders other than medium‐chain acyl‐coenzyme A (CoA) dehydrogenase (MCAD) deficiency there was insufficient evidence to make many firm statements. In MCAD deficiency, risk of death in the first 72 h is around 4%, with a further approximately 5–7% fatality rate in the first 6 years but very low subsequent risk in previously undiagnosed patients. The risk of death after diagnosis is very low at any age, with good management. The long‐term outcome is good nowadays. Very‐long‐chain acyl‐CoA dehydrogenase deficiency poses a risk of death in early infancy, but the condition is generally treatable, with a good outcome after diagnosis. Approximately 10–20% of patients diagnosed by newborn screening and treated nevertheless suffer episodic rhabdomyolysis. Some patients never become symptomatic. Isolated long‐chain 3‐hydroxyacyl‐CoA dehydrogenase deficiency is treatable, but most patients suffer episodic hypoketotic hypoglycaemia and rhabdomyolysis. Generalised mitochondrial tri‐functional protein deficiency has high early mortality rate. A more insidious presentation also occurs, with symptoms sometimes confined to progressive axonal neuropathy. Among carnitine cycle disorders, carnitine transporter deficiency, potentially lethal, is uniformly successfully treated orally with carnitine. Carnitine‐acylcarnitine translocase and early‐onset carnitine palmitoyl transferase type II (CPT II) deficiencies have an extremely high neonatal mortality rate. Late‐onset CPT II is characterised only by episodic rhabdomyolysis on severe exercise. CPT type IA deficiency may often be benign, although early presentation with hypoketotic hypoglycaemia certainly occurs.
Study of inborn errors of metabolism in urine from patients with unexplained mental retardation
Authors: Sempere Angela , Arias Angela , Farré Guillermo , García‐Villoria Judith , Rodríguez‐Pombo Pilar , Desviat Lurdes R. , Merinero Begoña , García‐Cazorla Angels , Vilaseca Maria A. , Ribes Antonia , Artuch Rafael , Campistol Jaume
Published: January 2010

Mental retardation (MR) is a common disorder frequently of unknown origin. Because there are few studies regarding MR and inborn errors of metabolism (IEM), we aimed to identify patients with IEM from a cohort of 944 patients with unexplained MR. Biochemical examinations such as determination of creatine (Cr) metabolites, acylcarnitines, purine, and pyrimidines in urine were applied. We found seven patients with IEM [three with cerebral Cr deficiency syndromes (CCDS)], one with adenylosuccinate lyase (ADSL) deficiency, and three, born before the neonatal metabolic screening program in Catalonia, with phenylketonuria (PKU). All told, they represent 0.8% of the whole cohort. All of them had additional symptoms such as epilepsy, movement disorders, autism, and other psychiatric disturbances. In conclusion, in patients with MR, it is essential to perform a thorough appraisal of the associated signs and symptoms, and in most disorders, it is necessary to apply specific analyses. In some cases, it is important to achieve an early diagnosis and therapy, which may reduce the morbimortality, and to offer genetic counselling.
Perinatal hypophosphatasia presenting as neonatal epileptic encephalopathy with abnormal neurotransmitter metabolism secondary to reduced co‐factor pyridoxal‐5′‐phosphate availability
Authors: Balasubramaniam Shanti , Bowling Frank , Carpenter Kevin , Earl John , Chaitow Jeffrey , Pitt James , Mornet Etienne , Sillence David , Ellaway Carolyn
Published: January 2010

We describe two neonates presenting with perinatal hypophosphatasia and severe epileptic encephalopathy resulting in death. Both had increased levels of urinary vanillactate, indicating functional deficiency of aromatic amino acid decarboxylase, a pyridoxal‐5‐phosphate (PLP)‐dependent enzyme required for dopamine and serotonin biosynthesis. Clinical findings and results of subsequent metabolic investigations were consistent with secondary pyridoxine‐deficient encephalopathy. These patients highlight the importance of tissue non‐specific alkaline phosphatase in the neuronal PLP‐dependent metabolism of neurotransmitters. In addition, the disturbance of PLP metabolism appears to underlie the predominant neurological presentation in our patients. We recommend the measurement of serum alkaline phosphatase (ALP) during the assessment of perinatal seizures.
Disease severity in sibling pairs with type 1 Gaucher disease
Authors: Elstein Deborah , Gellman Ayelet , Altarescu Gheona , Abrahamov Aya , Hadas‐Halpern Irith , Phillips Mici , Margalit Maya , Lebel Ehud , Itzchaki Menachem , Zimran Ari
Published: January 2010

The only prognostic markers in Gaucher disease, the most common lysosomal storage disorder, are young age at first symptom/sign and the presence of null/severe mutations, both being predictive of more severe phenotypes. Therefore, it would be helpful to know whether siblings with the same genotype can be expected to experience comparable phenotypic expression. All non‐neuronopathic sibling pairs in our referral clinic (1993–2008) with the same genotype were included. For each pair, gender, date of birth, severity score index at presentation, age at diagnosis and first symptom/sign, presence of bone involvement, spleen status, and use of enzyme replacement therapy were tabulated. There were 90 pairs of siblings: two sets of identical twins; 24 pairs of brothers, 24 pairs of sisters, and 42 pairs of mixed gender. For all measures of disease severity used, only in sibling pairs with an older sister and a younger brother were phenotypes significantly different between siblings. Thus, this large cohort of sibling pairs with type 1 Gaucher disease confirmed that, in general, the phenotypic expression in the younger sibling will be similar enough to that of an older affected sibling that genetic counseling may use those findings in a prognostic way.
Explaining Mendelian Inheritance in Genetic Consultations: An IPR Study of Counselor and Counselee Experiences
Authors: Gale Theodora , Pasalodos‐Sanchez Sara , Kerzin‐Storrar Lauren , Hall Georgina , MacLeod Rhona
Published: January 2010

The explanation of Mendelian inheritance is a key component of most genetic counselling consultations, yet no evidence base exists for this area of practice. This qualitative study used Interpersonal Process Recall (IPR) to explore how information about X‐linked inheritance is provided and received in genetic counseling. Twelve consultations involving two senior genetic counselors and 21 counselees were videotaped. Section(s) of videotape featuring the explanation were subsequently played back separately to both counselees and counselors and their responses and reflections recorded. All interviews were fully transcribed and analysed using the constant comparison method. A personalised diagram, drawn “live” by the counselor during the consultation was recalled by counselees as being central to their understanding of the “bottom line”. This helped bridge the gap between scientific information and their family experience and did not appear to require a baseline understanding of genetic concepts such as genes or chromosomes. Counselors reflected on the diagram's positive impact on the way they sequenced, paced and tailored the explanation. A positive counselor‐counselee relationship was vital even during this educative exchange: for counselees to feel at ease discussing complex genetic information and to help gauge counselee understanding.
CLASSICAL NATURAL LAW THEORY, PROPERTY RIGHTS, AND TAXATION
Authors: Feser Edward
Published: January 2010

Classical natural law theory derives moral conclusions from the essentialist and teleological understanding of nature enshrined in classical metaphysics. The paper argues that this understanding of nature is as defensible today as it was in the days of Plato, Aristotle, Augustine, and Aquinas. It then shows how a natural law theory of the grounds and content of our moral obligations follows from this understanding of nature, and how a doctrine of natural rights follows in turn from the theory of natural law. With this background in place, the implications of the theory for questions about property rights and taxation are explored. It is argued that classical natural law theory entails the existence of a natural right of private property, and that this right is neither so strong as to supportlaissez fairelibertarianism, nor so weak as to allow for socialism. Though the theory leaves much of the middle ground between these extremes open to empirical rather than moral evaluation, it is argued that there is a strong natural law presumption against social democratic policies and in favor of free enterprise.
THE NATURAL RIGHT OF PROPERTY
Authors: Mack Eric
Published: January 2010

The two main theses of “The Natural Right of Property” are: (i) that persons possess an original, non-acquired right not to be precluded from making extra-personal material their own (or from exercising discretionary control over what they have made their own); and (ii) that this right can and does take the form of a right that others abide by the rules of a (justifiable) practice of property which facilitates persons making extra-personal material their own (and exercising discretionary control over what they have made their own). I articulate some of the good reasons we have to affirm persons' possession of an original, non-acquired right of self-ownership and argue that the same good reasons support the ascription to persons of a natural right of property. I contrast an “inherent feature” conception of the actions through which (initial) rights over extra-personal objects arise with a “practice” conception of (initial) entitlement-generating actions. I argue that the fact that the natural right to property can and does take the form of persons' rights that others abide by the rules of a (justifiable) practice of property explains how there are many instances of (initial) entitlement generation which are not plausibly explained by those wed to the inherent feature conception of entitlement-generating actions and why there is a strong conventional dimension in the procedures through which persons acquire (initial) property rights.
PROPERTY AND RIGHTS
Authors: Narveson Jan
Published: January 2010

I present what I take to be the “classical” approach to property rights, in which property is basically a unitary concept: owners are the ones with the right to do, and prohibit others from doing, whatever there is to do with the thing owned, within the limits imposed by the rights of others totheirthings. I expound and defend the idea of “first acquisition” in more or less Lockean mode. I also point to the many difficulties of application of the general idea, leading to the need to negotiate at many points. For example, the vagueness of land ownership as we consider what goes on in the earth below or the sky above; to consideration of not just possible physical damages to others by virtue of ownership, but also aesthetic ones; and to the increasingly important area of intellectual property. I argue that the original idea continues to hold, though it underdetermines any number of specific issues.
REAL-WORLD LUCK EGALITARIANISM
Authors: Sher George
Published: January 2010

Luck egalitarians maintain that inequalities are always unjust when they are due to luck, but are not always unjust when they are due to choices for which the parties are responsible. In this paper, I argue that the two halves of this formula do not fit neatly together, and that we arrive at one version of luck egalitarianism if we begin with the notion of luck and interpret responsible choice in terms of its absence, but a very different version if we begin with the notion of responsible choice and interpret luck in terms of its absence. I argue, further, that the difference between the two versions is significant because many real-world inequalities fall precisely in the gap between them, and that attempts to adjudicate between them lead quickly to hard questions about the relation between equality and responsibility.
COERCION, OWNERSHIP, AND THE REDISTRIBUTIVE STATE: JUSTIFICATORY LIBERALISM'S CLASSICAL TILT
Authors: Gaus Gerald
Published: January 2010

Justificatory liberalism is liberal in an abstract and foundational sense: it respects each as free and equal, and so insists that coercive laws must be justified to all members of the public. In this essay I consider how this fundamental liberal principle relates to disputes within the liberal tradition on “the extent of the state.” It is widely thought today that this core liberal principle of respect requires that the state regulates the distribution of resources or well-being to conform to principles of fairness, that all citizens be assured of employment and health care, that no one be burdened by mere brute bad luck, and that citizens' economic activities must be regulated to insure that they do not endanger the “fair value” of rights to determine political outcomes. I argue in this essay: (1) a large family of liberal views are consistent with the justificatory liberals project, from classical to egalitarian formulations (but not socialist ones); (2) overall, the justificatory project tilts in the direction of classical formulations.
ADAM SMITH AND THE GREAT MIND FALLACY
Authors: Otteson James R.
Published: January 2010

Adam Smith raised a series of obstacles to effective large-scale social planning. In this paper, I draw these Smithian obstacles together to construct what I call the “Great Mind Fallacy,” or the belief that there exists some person or persons who can overcome the obstacles Smith raises. The putative scope of the Great Mind Fallacy is larger than one might initially suppose, which I demonstrate by reviewing several contemporary thinkers who would seem to commit it. I then address two ways the fallacy might be overcome, finding both wanting. I close the paper by suggesting that Smith's Great Mind Fallacy sheds interesting light on his “impartial spectator” standard of morality, including with respect to the specific issues of property and ownership.
An ocean‐atmosphere climate simulation with an embedded cloud resolving model
Authors: Stan Cristiana , Khairoutdinov Marat , DeMott Charlotte A. , Krishnamurthy V. , Straus David M. , Randall David A. , Kinter James L. , Shukla J.
Published: January 2010

Mean climate and intraseasonal to interannual variability of two versions of the Community Climate System Model (CCSM) coupled atmosphere‐ocean general circulation model (CGCM) are analyzed. The first version is the standard CCSM, in which cloud effects on the large‐scale circulation are represented via parameterizations. The second version includes “super‐parameterization” (SP) of convective processes by replacing parameterized cloud processes with a two‐dimensional (2D) cloud‐process resolving model (CRM) at each CGCM grid column. The SP‐CCSM improves several shortcomings of the CCSM simulation, including mean precipitation patterns, equatorial SST cold tongue structure and associated double intertropical convergence zone (ITCZ), the Asian monsoon, periodicity of the El Niño–Southern Oscillation, and the intraseasonal Madden‐Julian Oscillation. These improvements were obtained without the retuning of the coupled model, which is surprising in view of previous experience with other coupled models.
Resurfacing events on Venus: Implications on plume dynamics and surface topography
Authors: Stein C. , Fahl A. , Hansen U.
Published: January 2010

Global resurfacing events explain the relatively young and uniformly aged surface of Venus. In numerical models featuring these events a variety of plume classes occur ranging from strong, stable to smaller, wind‐driven upwellings. We investigate this plume dynamics in a 3D Cartesian geometry paying special attention to the surface topography. While the stable upwellings of the stagnant‐lid phase correlate with an elevation of the surface, the wind‐driven upwellings of the resurfacing phase do not necessarily correlate with a positive topography signal. We rather observe that a thick plate can dominate the topography above upwellings.
An observational and modeling strategy to investigate the impact of remote sources on local air quality: A Houston, Texas, case study from the Second Texas Air Quality Study (TexAQS II)
Authors: McMillan W. W. , Pierce R. B. , Sparling L. C. , Osterman G. , McCann K. , Fischer M. L. , Rappenglück B. , Newsom R. , Turner D. , Kittaka C. , Evans K. , Biraud S. , Lefer B. , Andrews A. , Oltmans S.
Published: January 2010

Quantifying the impacts of remote sources on individual air quality exceedances remains a significant challenge for air quality forecasting. One goal of the 2006 Second Texas Air Quality Study (TexAQS II) was to assess the impact of distant sources on air quality in east Texas. From 23 to 30 August 2006, retrievals of tropospheric carbon monoxide (CO) from NASA's Atmospheric InfraRed Sounder (AIRS) reveal the transport of CO from fires in the United States Pacific Northwest to Houston, Texas. This transport occurred behind a cold front and contributed to the worst ozone exceedance period of the summer in the Houston area. We present supporting satellite observations from the NASA A‐Train constellation of the vertical distribution of smoke aerosols and CO. Ground‐based in situ CO measurements in Oklahoma and Texas track the CO plume as it moves south and indicate mixing of the aloft plume to the surface by turbulence in the nocturnal boundary layer and convection during the day. Ground‐based aerosol speciation and lidar observations do not find appreciable smoke aerosol transport for this case. However, MODIS aerosol optical depths and model simulations indicate some smoke aerosols were transported from the Pacific Northwest through Texas to the Gulf of Mexico. Chemical transport and forward trajectory models confirm the three major observations: (1) the AIRS envisioned CO transport, (2) the satellite determined smoke plume height, and (3) the timing of the observed surface CO increases. Further, the forward trajectory simulations find two of the largest Pacific Northwest fires likely had the most significant impact.
Expression profiling and proteomic analysis of isolated photosynthetic cells of the non-Kranz C4 species Bienertia sinuspersici
Authors: Park Joonho , Okita Thomas W. , Edwards Gerald E.
Published: January 2010

Bienertia sinuspersici Akhani represents one form of C4 photosynthesis that occurs without Kranz anatomy in family Chenopodiaceae. Analysis of transcript profiles and proteomics were made to gain information on this single-cell C4 photosynthetic mechanism. Chlorenchyma cells were isolated and purified from mature leaves. From these cells, a cDNA library was made from which sequences were obtained on 2385 clones using conventional methods. To obtain a protein profile, the multi dimensional protein identification technique was used, resulting in identification of 322 unique proteins in chlorenchyma cells. After analysing datasets from the EST library and proteomics, genes and proteins were classified into 23 and 17 categories according to types of biological processes, respectively. These include photosynthesis and photorespiration, other biosynthetic and metabolic processes, cell wall modification, defence response, DNA repair, electron transport, other cellular and developmental processes, protein folding, protein targeting, protein modification, proteolysis, redox and ion homeostasis, response to biotic and abiotic stresses, RNA modification, transcription, translation, transport and unknowns. Sequence and phylogenetic analyses were made of C4 cycle enzymes to characterise the relationship between homologues found in Bienertia with public gene sequences from other chenopods and representative C3 and C4 species from other families. Identified photosynthetic genes and proteins are discussed with respect to the proposed function of an NAD-ME type C4 cycle in this single-cell C4 system.
Correlative changes in proteases and protease inhibitors during mobilisation of protein from potato (Solanum tuberosum) seed tubers
Authors: Weeda Sarah M. , Kumar G. N. Mohan , Knowles N. Richard
Published: January 2010

Potato tubers (Solanum tuberosum L.) contain protease inhibitors that function in plant defence and as storage proteins. A multi-domain cysteine protease inhibitor, potato multicystatin (PMC), has also been implicated in regulating protein accumulation in developing tubers by inhibiting proteases. Unlike developing tubers, sprouting tubers mobilise protein reserves to support growth of developing plants and, therefore, show an increase in protease activity. Using single-eye containing cores (seedcores) from seed tubers, we characterised the relative changes in patatin, PMC, proteases and serine (Ser) protease inhibitors, as a prerequisite to further research on their potential roles in protein mobilisation from tubers during plant establishment. Approximately 63% of seedcore dry matter was mobilised over a 29-day period of plant establishment (1.7 mg seedcore dry matter mobilised for every mg increase in plant dry matter). The gelatinolytic protease isoforms induced in seedcores during plant establishment differed from those characterised previously in developing tubers. Total protease activity increased progressively in seedcores and reached a maximum 23 days after planting. Conversely, seedcore soluble protein content declined, with patatin accounting for the greatest decrease in the soluble protein fraction during plant establishment. PMC also decreased 44% and Ser (trypsin) protease inhibitors decreased to levels barely detectable in seedcores over the 29-day growth interval. Moreover, the temporal changes in PMC, protease activity and patatin content were highly correlated. As PMC decreased from 6 to 4 ng core–1, protease activity increased 9-fold, patatin decreased 2.6-fold and total soluble protein decreased by 58%. These results suggest that catabolism of protease inhibitors may facilitate protein mobilisation from seed tubers. Further work to define unequivocally the role of protease inhibitors in modulating the activity of proteases during protein mobilisation from tubers is warranted.
Ultrasonographic characterisation of prenatal development in European brown hares (Lepus europaeus PALLAS, 1778): an evolutionary approach
Authors: Roellig Kathleen , Goeritz Frank , Hildebrandt Thomas B.
Published: January 2010

The European brown hare is one species in which reproduction appears to be particularly complex. Therefore, we studied the reproductive tract and prenatal development using high-resolution ultrasound of 159 pregnancies in 45 captive female hares. Consecutive examination of live hares was particularly useful in evaluating the very early stages of gestation. As such, it was possible to detect corpora lutea by Day 3 and embryonic vesicles, representing the earliest uterine embryonic stages, by Day 6. On Day 11, the heart beat of the embryo was detectable for the first time. We defined ultrasonographic milestones that were characteristic of the different stages of pregnancy. We also calculated growth models using eight different morphological parameters, including development of the corpus luteum. On the basis of these results, it is now possible to estimate the gestational age of a pregnant doe without knowing the date of conception. In contrast with the European rabbit, a distant relative, European hares give birth to precocial young. A comparison of the prenatal growth rate of both species suggests that the precocial state of the hare neonate is a more recently derived evolutionary characteristic, whereas the altricial condition of rabbits represents the ancestral mode.
Spermatocyte apoptosis, which involves both intrinsic and extrinsic pathways, explains the sterility of Graomys griseoflavus × Graomys centralis male hybrids
Authors: Rodriguez Valeria , Diaz de Barboza Gabriela , Ponce Ruben , Merico Valeria , Garagna Silvia , Tolosa de Talamoni Nori
Published: January 2010

Spermatogenic impairment and the apoptotic pathways involved in establishing sterility of male hybrids obtained from crossing Graomys griseoflavus females with Graomys centralis males were studied. Testes from G. centralis, G. griseoflavus and hybrids were compared at different ages. Terminal transferase-mediated dUTP nick-end labelling assay (TUNEL), Fas, Bax and cytochrome c labelling were used for apoptosis evaluation, and calbindin D28k staining as an anti-apoptotic molecule. In 1-month-old animals, spermatocytes were positive for all apoptotic markers, but moderate TUNEL (+) spermatocyte frequency was only found in G. centralis. At subsequent ages, the apoptotic markers were downregulated in testes from parental cytotypes, but not in hybrid testes. TUNEL (+) spermatocytes were present at 78% and 44% per tubule cross-section in 2- and 3-month-old hybrid animals, respectively. Pachytene spermatocyte death in adult hybrids occurs via apoptosis, as revealed by high caspase-3 expression. Calbindin was highly expressed in spermatocytes of adult hybrids, in which massive cell death occurs via apoptosis. Calbindin co-localisation with TUNEL or Fas, Bax and cytochrome c was very limited, suggesting an inverse regulation of calbindin and apoptotic markers. Hybrid sterility is due to breakdown of spermatogenesis at the pachytene spermatocyte stage. Both extrinsic and intrinsic pathways are involved in apoptosis of spermatocytes, which are the most sensitive cell type to apoptotic stimuli.
Developmental kinetics and gene expression in male and female bovine embryos produced in vitro with sex-sorted spermatozoa
Authors: Bermejo-Álvarez Pablo , Lonergan Patrick , Rath Detlef , Gutiérrez-Adan Alfonso , Rizos Dimitrios
Published: January 2010

Using bovine embryos generated in vitro from IVF with X-sorted, Y-sorted and unsorted spermatozoa, we compared the kinetics of male and female embryo development and gene expression between male and female blastocysts. Bovine in vitro-matured oocytes (n = 8858) were fertilised with spermatozoa from each of three different bulls (X-sorted, Y-sorted or unsorted spermatozoa depending on the experiment). The cleavage rate was assessed 24, 27, 30, 33, 36, 40, 44 and 48 h post insemination (h.p.i.) and blastocyst development was recorded on Days 6–9. The relative mRNA abundance of nine genes (GSTM3, DNTM3A, PGRMC1, TP53, BAX, COX2, IGF2R, AKR1B1 and PLAC8) was analysed in male and female Day 7 blastocysts produced with sorted and unsorted spermatozoa from one bull. Cumulative cleavage rate and blastocyst yield were significantly higher in the unsorted group compared with the X- or Y-sorted group from the same bull (P ≤ 0.05). Although differences existed between bulls in terms of cleavage rate, no differences were observed in cleavage rate between X- and Y-sorted spermatozoa within a bull. The blastocyst yield was significantly higher only for Bull 3 when the Y-sorted spermatozoa were used (27.1+2.8 v. 19.1+1.4 for Y- and X-sorted spermatozoa, respectively; P < 0.05). There were no differences in the mRNA abundance of the nine genes analysed between embryos of the same sex produced with sorted or unsorted spermatozoa. However, significant differences in polyA mRNA abundance were observed between male and female blastocysts for three genes (GSTM3, DNMT3A and PGRMC1; P ≤ 0.05). In conclusion, the use of sorted rather than unsorted spermatozoa in IVF significantly delays the onset of first cleavage. Differences were noted between bulls, but not between X- and Y-sorted spermatozoa, and although no differences were found in terms of the mRNA abundance of the nine genes tested between sorted and unsorted spermatozoa, sex-related differences were found in the case of three genes.
Nontraumatic spinal epidural hematomas
Authors: Lövblad K O. , Baumgartner R. W. , Zambaz B. D. , Remonda L. , Ozdoba C. , Schroth G.
Published: January 2010

Purpose: Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak outcome. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH.

Material and Methods: Seven patients with nontraumatic SEH were examined by MR at 1.5 T. Two patients were under anticoagulation therapy with heparin, and 2 others were taking salicylic acid. One patient had lupus erythematodes with a marked thrombocytopenia. One patient had a spinal arteriovenous malformation.

Results: MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characteristic signal intensities of blood. Five patients underwent laminectomy and evacuation of the hematoma. In the acute phase, the hematomas appeared isointense when compared with the spinal cord on T1-weighted images and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to those of cerebrospinal fluid (CSF) on T2-weighted images

Conclusion: MR imaging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hematomas.
Time-dependency in brain lesion enhancement with gadodiamide injection
Authors: Åkeson P. , Nordström C.-H. , Holtås S.
Published: January 2010

Purpose: To determine the effective time window for MR imaging of tumors with blood-brain barrier (BBB) damage after injection of Gd-containing contrast media.

Material and Methods: Eleven patients with 15 brain lesions (metastasis, glioma, abscess) were studied with a T1-weighted spin-echo sequence repeated over periods of up to 43 min after contrast injection. A quotient was calculated between the signals in the lesion and in the gray matter, and plotted against time.

Results: All lesions reached 70% of the maximum RATIO within 3.5 min. After 25 min 12 out of 15 lesions showed persistent enhancement within 15% of the maximal RATIO.

Conclusion: The peak enhancement of BBB damage occurs around 3.5 min after injection. The effect does not change during the next 25 min. Scanning should not be started until 2–5 min after injection of the contrast medium, and there is no advantage in waiting longer as no major increase (or decline) of contrast can be expected.
Combined endovascular and surgical treatment in vertebral arteriovenous fistula
Authors: Nakstad P. H. , Haakonsen M. , Magnæs B. , Hetland S.
Published: January 2010

A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful.

She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery.

Her heart size, heart rate and blood pressure were successively normalized.
SIPAP: A new MR classification for pituitary adenomas
Authors: Edal A. L. , Skjödt K. , Nepper-Rasmussen H. J.
Published: January 2010

Purpose: To present a new MR classification for pituitary adenomas, a grading system named SIPAP.

Material and Methods: SIPAP is an acronym for the 5 juxtasellar directions of tumour extension to or penetration into adjacent structures of the sella region, using a 6-figure number for each adenoma. This retrospective study was based on 87 mid-field MR examinations of 56 patients with biochemically or surgically confirmed pituitary adenomas. Sagittal T1-weighted SE and coronal T1-weighted 3D FFE sequences before and after i.v. contrast administration were performed.

Results: The SIPAP classification was well adapted to the material. All tumours except one postoperative remnant could be classified in the grading system. The classification was useful before and after treatment, for follow-up over a longer period, and for comparing adenomas with different hormonal activity with reference to patient age and sex.

Conclusion: The SIPAP classification together with tumour size is an optimal method for the registration of pituitary adenomas.
Gadolinium-enhanced 3D time-of-flight Mr angiography
Authors: Yano T. , Kodama T. , Suzuki Y. , Watanabe K.
Published: January 2010

Purpose: To evaluate the influences of Gd-DTPA on 3D time-of-flight (TOF) MR angiography (MRA).

Material and Methods: In an experimental study using a flow phantom, contrast 3D TOF MRA was performed at varying Gd-DTPA concentrations, flow rates, TRs and flip angles. In a clinical study, cranial 3D TOF MR angiograms using Gd-DTPA were obtained in 38 patients to evaluate the efficacy of Gd-DTPA in enhancing the diagnosis of intracranial vascular lesions. Visualization of the venous system and distal arterial branches on contrast MRA was compared with those of noncontrast MRA.

Results: In the experimental study, progressive signal loss of inflowing spins due to saturation was smaller with higher concentration of Gd-DTPA. The influences of Gd-DTPA on the saturation effect were more pronounced with a slower flow rate, shorter TR and larger flip angles. In the clinical study, i.v. administration of Gd-DTPA improved the visualization of the venous system and distal arterial branches on 3D TOF MRA. The diagnostic value of MRA was enhanced by Gd-DTPA in patients with intracranial vascular lesions such as vascular malformations and large aneurysms.

Conclusion: The T1-shortening effect of Gd-DTPA reduced the signal loss of vessels with slow flow rate, and contrast MRA was particularly useful for evaluation of venous abnormalities. Compared with conventional MRA, shorter TRs and larger flip angles were considered beneficial in contrast MRA.
Evaluation of single sample clearance calculations in 902 patients
Authors: Lundqvist S. , Hietala S. O. , Groth S. , Sjödin J. G.
Published: January 2010

Purpose: To derive new formulae for the calculation of single sample clearance of the contrast medium iohexol and to compare the formulae to a selection of existing single sample clearance formulae derived for the calculation of 51Cr-EDTA and 99mTc-DTPA clearance.

Material and Methods: Glomerular filtration rate (GFR) was calculated from total plasma clearance of iohexol used for urography in 902 patients. Two plasma samples were drawn in each patient. Automated x-ray fluorescence analysis equipment was used for the plasma iodine analysis. Single and multiple sample iohexol clearance values were compared. In 77 patients the multiple sample clearance values were additionally compared to a 51Cr-EDTA clearance performed simultaneously or within 14 days.

Results: The precision of the results calculated by the existing single sample clearance formulae and the derived iohexol single sample clearance formulae were essentially the same. The most precise of the derived formulae was that based on the Bak Christensen & Groth formula. The correlation between multiple sample clearance of iohexol and 51Cr-EDTA was high (r=0.918)

Conclusion: Iohexol can substitute 51Cr-EDTA for GFR measurement. A valid GFR can be calculated from a single plasma sample determination of iohexol clearance using either the existing formulae or the new formulae derived from the present study.
Outcome of bypass surgery in patients with chronic ischemic left ventricular dysfunction
Authors: Kløw N.-E. , Smith H.J. , Gullestad L. , Seem E. , Endresen K.
Published: January 2010

Purpose: To determine the preoperative findings of MR imaging of the left ventricle (LV) that could best predict the functional outcome of the LV after surgical revascularization.

Material and Methods: Patients with angina pectoris, previous myocardial infarction, and dysfunction of the LV, and who had a preoperative cine MR, were re-evaluated after bypass surgery with MR in a study on the effects of revascularization after mean 22 months.

Results: Angina pectoris was relieved in all patients except one, but the maximum workload during the exercise test was increased in only 3 patients. Coronary angiography showed that 37 of 45 (82%) of the distal anastomoses were open. The LV ejection fraction was the same before and after operation both at angiography and MR imaging. MR showed LV end-diastolic volume to be increased from 190 ± 50 ml to 250 ± 70 ml. Compared to angiography, MR provided additional information regarding myocardial wall thickness and function, and the size of myocardial infarction. Improvement in systolic wall thickening was seen in 65% of the segments that had had an end-diastolic wall thickness (EDWT) greater than 15 mm before operation, while only 4% of the segments with EDWT <6 mm improved. In the wall thickness range of 6–15 mm, MR was unable to predict the functional outcome of the LV.

Conclusion: Preoperative MR findings of thick myocardial walls with poor function seem predictive of improved function after revascularization. When the LV wall thickness is less than 6 mm, no improvement should be expected.
Rater agreement at lung scintigraphy after consensus training
Authors: Christiansen F. , Andersson T. , Rydman H. , Måre K.
Published: January 2010

Purpose: Using the PIOPED criteria in the interpretation of lung scintigraphy, perfect agreement between experienced raters with training in consensus interpretation has been demonstrated. In a previous paper we found a kappa value of 0.54 (0.45–0.63) between experienced raters with no experience of interpretation in consensus; this is significantly lower than the perfect agreement described between consensus-trained raters. The purpose of this study was to reinvestigate the same study population with the same raters, but this time after they had undergone consensus training.

Material and Methods: Lung scintigrams of 192 patients were reviewed and categorized according to the PIOPED criteria by 2 raters after consensus training. The 2 raters reviewed a training material of 59 cases, which was not part of the study population, in order to reach a full consensus interpretation.

Results: After consensus training the kappa value was 0.57 (0.48–0.66). Three cases had a discrepancy of 2 categories (1.6%), and the remaining discrepancies were of one category.

Conclusion: Consensus training did not significantly improve the agreement rate between experienced raters from different hospitals. A substantial improvement in agreement rates between hospitals may make heavy demands on resources.