bluuebunny/crossref_metadata_2025 huggingface dataset:
A centromere-specific retroviral element associated with breaks of synteny in macropodine marsupials
Authors: Ferreri G.C. , Marzelli M. , Rens W. , O’Neill R.J.
Published: August 2004

Studies of chromosome evolution have focused heavily on the evolution of conserved syntenic, gene-rich domains. It is obvious, however, that the centromere plays an equally important role in chromosome evolution, through its involvement in fissions, centric fusions, translocations, inversions and centric shifts. It is unclear how the centromere, either as a functioning unit of the chromosome or as a DNA sequence motif, has been involved in these processes. Marsupials of the family Macropodidae (kangaroos, wallabies, rat kangaroos and potoroos) offer unique insights into current theories expositing centromere emergence during karyotypic diversification and speciation. Tracing the genomic distribution of centromeric sequences in a model macropodine (subfamily Macropodinae: kangaroos and wallabies) species, Macropus eugenii (tammar wallaby), indicates these sequences have played an important role in chromosome evolution through possible segmental duplications associated with phylogenetically conserved breaks of synteny, pericentromeric and subtelomeric regions. Hybrids between different kangaroo species provide evidence that the centromere is unstable within this group of mammals and is involved in a large number of chromosome aberrations. A better understanding of the genetic and epigenetic factors that define centromeres and how centromeres may mediate changes in chromosome architecture are critical not only to our understanding of basic cellular functioning but also to our understanding of the process of speciation.
Chromosomal localization of the major satellite DNA family (FA-SAT) in the domestic cat
Authors: Santos S. , Chaves R. , Guedes-Pinto H.
Published: August 2004

A major satellite DNA sequence was isolated from the cat genome and its sequencing data revealed homology to the FA-SAT family. In situ hybridization of the cat satellite DNA and telomeric sequences to cat chromosomes, together with staining of constitutive heterochromatin, allowed the physical mapping of the FA-SAT sequences, and also an overall constitutive heterochromatin study in cat chromosomes.
Characterization and chromosome localization of a processed pseudogene related to the bovine laminin receptor gene family
Authors: Germerodt M. , Knorr C. , Beck J. , Drögemüller C. , Williams J.L. , Habermann F. , Fries R. , Brenig B.
Published: August 2004

A bovine BAC clone containing a processed laminin receptor pseudogene (LAMR1P) has been isolated and characterized. A 2,901-bp sequence was produced from the clone, of which 1,187 bp represented seven identifiable exon-like domains, but no intervening sequences. The pseudogene sequence reveals several transversions and transitions, as well as insertions and deletions. A premature stop codon motif is present at nucleotide position 115 located in the exon-2-like domain. Physical mapping of the gene was performed by FISH and RH panel mapping and assigned LAMR1P to BTA4q24→q26 with the closest linkage to BM6458 (19 cR, LOD score of 11.6). The functional laminin receptor putatively plays an important role in the transmission of bovine spongiform encephalopathy (BSE). In this process, the receptor supposedly acts as the binding site for prion proteins to enter mammalian cells. Considering the existence of several human laminin receptor pseudogenes forming a complex family, any knowledge of even pseudogene sequences might be helpful to isolate the functional bovine laminin receptor gene.
An evolutionary change in telomere sequence motif within the plant section Asparagales had significance for telomere nucleoprotein complexes
Authors: Rotková G. , Skleničková M. , Dvořáčková M. , Sýkorová E. , Leitch A.R. , Fajkus J.
Published: August 2004

In association with a phylogenetic tree of Asparagales, our previous results showed that a distinct clade included plant species where the ancestral, Arabidopsis-type of telomeric repeats (TTTAGGG)n had been partially, or fully, replaced by the human-type telomeric sequence (TTAGGG)n. Telomerases of these species synthesize human repeats with a high error rate in vitro. Here we further characterize the structure of telomeres in these plants by analyzing the overall arrangement of major and minor variants of telomeric repeats using fluorescence in situ hybridization on extended DNA strand(s). Whilst the telomeric array is predominantly composed of the human variant of the repeat, the ancestral, Arabidopsis-type of telomeric repeats was ubiquitously observed at one of the ends and/or at intercalary positions of extended telomeric DNAs. Another variant of the repeat typical of Tetrahymena was observed interspersed in about 20% of telomerics. Micrococcal nuclease digestions indicated that Asparagales plants with a human-type of telomere have telomeric DNA organised into nucleosomes. However, unexpectedly, the periodicity of the nucleosomes is not significantly shorter than bulk chromatin as is typical of telomeric chromatin. Using electrophoretic mobility shift assays we detected in Asparagales plants with a human type of telomere a 40-kDa protein that forms complexes with both Arabidopsis- and human-type G-rich telomeric strands. However, the protein shows a higher affinity to the ancestral Arabidopsis-type sequence. Two further proteins were found, a 25-kDa protein that binds specifically to the ancestral sequence and a 15-kDa protein that binds to the human-type telomeric repeat. We discuss how the organisation of the telomere repeats in Asparagales may have arisen and stabilised the new telomere at the point of mutation.
Doppler Ultrasound as an Additional Parameter for the Evaluation of Myomas and the Indication of Myomectomy during Pregnancy
Authors: Gojnic M. , Pervulov M. , Mostic T. , Petkovic S.
Published: August 2004

Objective: Pregnancies with myomas are known to have an increased risk for complications such as abruptio placentae, dysfunctional labor, growth of the tumor, necrosis and delivery problems, but prediction is still difficult based on clinical and real-time ultrasound evaluations alone. Methods: We evaluated 15 patients with submucosal, intramural and subserous myomas, respectively. Results: We found that in the submucosal myomas, the resistance index in the spiral and radial arteries decreased from 0.80–0.95 to 0.60–0.75 when choriogonadin and aspirin were given. In 3 cases in whom the resistance index increased before delivery, intrauterine growth retardation and the need for surgical delivery occurred. In 9 cases with intramural myomas, a normal decrease in the resistance indexes was seen, but 6 cases had a sharper drop related to necrosis. In 3 of the 5 cases with myomectomies, there were not only signs of necrosis but also of sarcomatous degenerations on histology. The cases with subserous myomas had no complications and the classical physiologic conversion pattern on Doppler evaluations. Conclusion: We feel that the Doppler results helped us with the management issues and gave insights into the typical pathophysiologic sequences, but the clinical role of Doppler flow analysis in pregnancies with myomas needs to be further evaluated.
No Role for Prostacyclin IP Receptors in Duodenal HCO3– Secretion Induced by Mucosal Acidification in Mice – Comparison with Capsaicin-Induced Response
Authors: Nakashima Masato , Aoi Masako , Aihara Eitaro , Takeuchi Koji
Published: August 2004

Background/Aim: We investigated the role of prostacyclin (PGI2) IP receptors in the acid-induced secretion of HCO3– using IP receptor knockout [IP (–/–)] mice, in comparison with capsaicin-induced secretion. Methods: Male C57/BL6 mice, both wild-type [WT] and [IP (–/–)], fasted for 18 h were used. Under urethane anesthesia, a proximal duodenal loop was perfused with saline, and the secretion of HCO3– was measured at pH 7.0 using a pH-stat method and by adding 2 mM HCl. The secretion was stimulated by exposure of the loop to 10 mM HCl, capsaicin, PGE2 or cicaprost (a PGI2 agonist) for 10 min. Results: PGE2 stimulated HCO3– secretion in both WT and IP (–/–) mice, while cicaprost increased it in WT but not IP (–/–) mice. Luminal acidification increased the mucosal level of PGE2 as well as 6-keto-PGF1α, yet stimulated HCO3–secretion in both WT and IP (–/–) mice, in an indomethacin-inhibitable and sensory neuron-dependent manners. Perfusion of the duodenum with 20 mM HCl for 4 h caused severe damage in WT mice pretreated with indomethacin, but not in control WT or IP (–/–) mice. Capsaicin increased duodenal HCO3–secretion in WT mice, in an indomethacin-sensitive manner, yet no such response was observed in the animals lacking IP receptors. Conclusion: The presence of IP receptors is not essential for acid-induced HCO3– secretion and mucosal defense against acid injury in the duodenum, although activation of IP receptors results in stimulation of HCO3–secretion. Although duodenal HCO3– secretion induced by both acid and capsaicin depends on afferent neurons, it seems that the mode of interaction with the afferent neurons differs regarding dependency on the PGI2/IP receptors.
Inflammatory Bowel Disease-Specific Autoantibodies in HLA-B27-Associated Spondyloarthropathies: Increased Prevalence of ASCA and pANCA
Authors: Török H.-P. , Glas J. , Gruber R. , Brumberger V. , Strasser C. , Kellner H. , Märker-Hermann E. , Folwaczny C.
Published: August 2004

Aims: An association between inflammatory bowel disease (IBD) and spondyloarthropathies (SpA) has repeatedly been reported. The aim of the present study was to investigate whether serologic markers of IBD, e.g. antibodies against Saccharomyces cerevisiae (ASCA), antibodies against exocrine pancreas (PAB) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) are present in HLA-B27-associated SpA. Methods: 87 patients with HLA-B27-positive SpA and 145 controls were tested for ASCA, PAB and pANCA employing ELISA or indirect immunofluorescence, respectively. Antibody-positive patients were interviewed regarding IBD-related symptoms using a standardized questionnaire. Results/Conclusion: When compared to the controls, ASCA IgA but not ASCA IgG levels were significantly increased in patients with SpA, in particular in ankylosing spondylitis (AS) and undifferentiated SpA (uSpA). pANCA were found in increased frequency in patients with SpA whereas PAB were not detected. The existence of autoantibodies was not associated with gastrointestinal symptoms but sustains the presence of a pathophysiological link between bowel inflammation and SpA.
Angiotensin II Induces Hypoxia-Inducible Factor-1α in PC 12 Cells through a Posttranscriptional Mechanism: Role of AT2 Receptors
Authors: Wolf Gunter , Schroeder Regine , Stahl Rolf A.K.
Published: August 2004

Background: Angiotensin II (ANG II) inhibits proliferation and induces differentiation in PC 12 cells via AT2 receptor activation. Using differential display analysis, we previously isolated SM-20/PHD3 as a key factor, which is downregulated by ANG II treatment. Subsequently, it turned out that SM-20/PHD3 is a rat homologue of PHD3, a key prolyl hydroxylase involved in the initial steps fostering the degradation of hypoxia-inducible factor (HIF). The present study was undertaken to investigate whether the ANG-II-mediated suppression of SM-20/PHD3/PHD3 may be associated with an increase in HIF-1α. Methods: HIF-1α protein expression was assessed by Western blots. mRNA levels for HIF-1α were measured by real-time PCR and for SM-20/PHD3 by Northern blots. Binding of HIF-1α to consensus oligonucleotides in vitro was determined with gel shift analysis. SM-20/PHD3 was transiently overexpressed in PC 12 cells using an inducible expression system. Results: ANG II stimulated HIF-1α protein expression. This effect was already detected after 30 min and peaked at 6 h, but was not detectable anymore after 24– 48 h of stimulation. PD 123177, but not losartan, antagonized this effect, indicating transduction through AT2 receptors. Real-time PCR failed to show a significant increase in HIF-1α transcripts after ANG II challenge at any time point. Gel shift analysis revealed that ANG-II-induced nuclear HIF-1α protein binds to consensus sites. A reduction in SM-20/PHD3 mRNA expression paralleled the increase in HIF-1α. Overexpression of SM-20/PHD3 transiently resulted in a decrease in HIF-1α protein concentrations under basal conditions as well as after stimulation with ANG II. Conclusion: ANG II stimulates HIF-1α expression by a posttranscriptional mechanism via AT2 receptors. This increase is likely caused by a downregulation of SM-20/PHD3. The ANG-II-mediated increase in HIF-1α expression could be potentially involved in physiological as well as pathophysiological processes such as differentiation, growth inhibition, and remodeling.
Achieving K/DOQI Laboratory Target Values for Bone and Mineral Metabolism: An Uphill Battle
Authors: Al Aly Ziyad , González Esther A. , Martin Kevin J. , Gellens Mary E.
Published: August 2004

Background: The National Kidney Foundation has recently published the Kidney Disease Outcomes Quality Initiative (K/DOQI) Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease (CKD). According to these guidelines, in patients with stage 5 CKD, the adjusted calcium level should be 8.4– 9.5 mg/dl, the serum phosphate should be 3.5–5.5 mg/dl, the calcium phosphorous product should be <55 mg2/dl2 and the intact parathyroid hormone (PTH) level should be 150–300 pg/ml. Methods: In order to evaluate our ability to meet these targets, we reviewed laboratory parameters of bone and mineral metabolism of 140 patients over a 6-month period in an inner city hemodialysis unit. Serum calcium and phosphate levels were determined using standard assays and PTH levels were determined using the Nichols Intact PTH assay. Results: We found that the levels of serum calcium and serum phosphorus fell within the range recommended by the K/DOQI guidelines 49 and 36% of the time respectively. 57% of the determinations for calcium × phosphorus product were <55 mg2/dl2. PTH levels were within the recommended values in 20% of the determinations. Only 7% of the determinations met all four criteria simultaneously in spite of meeting other K/DOQI targets such as hematocrit and dialysis adequacy. Conclusion: These data indicate that current practice for the management of bone and mineral metabolism in hemodialysis falls far short of meeting the K/DOQI guidelines.
Insight in Psychosis: A Systematic Review of Treatment Interventions
Authors: Henry Charles , Ghaemi S. Nassir
Published: August 2004

Insight into illness is often impaired in psychosis and associated with poor prognosis, yet little is known about how to improve insight. After an examination of the conceptual background of insight, we review the limited empirical studies of this topic. Six studies of psychoeducation are mixed, though suggesting a possible benefit, especially with individualized interventions. In 2 studies of psychoanalytically oriented psychotherapy, and 1 of cognitive-behavioral psychotherapy, no beneficial effect on insight was notable. Two studies each of videotaped self-observation and antipsychotic medication reported improvement in insight. The possibility that atypical antipsychotics may be especially beneficial compared to traditional antipsychotics deserves further examination. We conclude that this literature suggests potentially useful options for clinicians, but further research is needed with better validated insight scales.
Exploring the Relations between Depression, Somatization, Dissociation and Alexithymia – Overlapping or Independent Constructs?
Authors: Lipsanen Tapio , Saarijärvi Simo , Lauerma Hannu
Published: August 2004

Background: The aim of this study was to extend our knowledge of associations among the constructs of alexithymia, depression, somatization and dissociation. Sampling and Methods: 924 nonclinical subjects answered questions about depression (21-item Beck Depression Inventory), somatization (13-item somatization part of Symptom Check List-90), dissociation (28-item Dissociative Experiences Scale) and alexithymia (20-item Toronto Alexithymia Scale). In addition, a 12-item General Health Questionnaire (GHQ-12) was administered to detect psychiatric distress among subjects. Results: The results suggested that there was a significant clinical correlation between somatization, dissociation, depression and alexithymia (rho varied from 0.31 to 0.56). The principal component analysis revealed the presence of four components: depression, somatization, dissociation and alexithymia. The use of factor scores diminished the covariance between measures (rho varied from –0.10 to 0.01 between the factor scores). There was almost no correlation between the dissociation factor (rho = 0.06) and alexithymia factor (rho = 0.09) scores and general distress (GHQ-12). Conclusions: This study suggests that while somatization, dissociation, depression and alexithymia are distinct constructs, they correlate to a considerable extent. The use of factor analysis and factor scores should be considered to diminish covariance between the above constructs. Comparing results between factored and unfactored results may prove illuminating. As a case in point, the results suggest that the part of dissociation that coincides with other constructs (overlaps) is associated with distress, whereas the distinct part of dissociation (no shared covariance) is not associated with distress. The same applies to the alexithymia construct. Longitudinal studies are needed to show whether there is a trait such as a relatively stable dissociation component and also whether a separate state-dependent dissociation component exists that is associated with coincident distress, somatization and depression.
Significant Increase in the Number of the SMN2 Gene Copies in an Adult-Onset Type III Spinal Muscular Atrophy Patient with Homozygous Deletion of the NAIP Gene
Authors: Yamashita Mariko , Nishio Hisahide , Harada Yosuke , Matsuo Masafumi , Yamamoto Toru
Published: August 2004

The patient was a 57-year-old Japanese man who gradually developed muscle atrophy and weakness in the trunk and limbs since the age of 20 years and was wheelchair bound at the age of 56 years. The gene copy number assay confirmed the combined homozygous deletion of the survival motor neuron (SMN) 1 and neuronal apoptosis inhibitory protein (NAIP) genes and showed the presence of 4 copies of the SMN2 gene. In this patient, the significant increase in the number of the SMN2 gene copies should compensate for the homozygous deletion of the SMN1 gene and make his disease milder despite the absence of the NAIP gene. Taken together with our previous data, we may reasonably hypothesize that the SMN2 gene copy number is more critical in determining the severity of the disease compared to the NAIP genotype.
Influence of Cytokine Gene Polymorphisms on Focal Segmental Glomerulosclerosis
Authors: Bantis Christos , Heering Peter J. , Luther Yvonne , Aker Sendogan , Kuhr Nicola , Grabensee Bernd , Ivens Katrin
Published: August 2004

Background: Recently, polymorphisms of cytokine genes have been associated with modified gene expression and increased cytokine production. We evaluated the influence of TGF-β1 gene Arg25→Pro, TNFα gene G-308A and IL-6 gene G-174C polymorphisms on the clinical manifestations of focal segmental glomerulosclerosis (FSGS). Methods: The clinical course of 71 patients with biopsy-proven primary FSGS followed up for 6.0 ± 4.4 years was studied. Patients were classified according to the slope of reciprocal serum creatinine into slow (n = 49) and fast (n = 22) progressors. One hundred healthy volunteers were analysed as controls. Genetic polymorphisms were determined by PCR amplification. Results: The genotype distribution of the studied polymorphisms was similar in patients and controls (n.s.). Age, initial renal function, proteinuria and blood pressure did not differ significantly between patients with different genotypes (n.s.). The investigated polymorphisms were not associated with the progression of FSGS as shown by the similar genotype frequencies among slow and fast progressors (n.s.) and the renal survival in the Kaplan-Meier analysis (n.s.). Conclusion: Our results indicate that TGF-β1 gene Arg25→Pro, TNFα gene G-308A and IL-6 gene G-174C polymorphisms are not risk factors or markers of progression in focal segmental glomerulosclerosis.
Effect of Spontaneous Closure of Arteriovenous Fistula Access on Cardiac Structure and Function in Renal Transplant Patients
Authors: Sheashaa Hussein , Hassan Nabil , Osman Yasser , Sabry Alaa , Sobh Mohamed
Published: August 2004

Background/Aim: The effect of spontaneous closure of arteriovenous fistula (AVF) used for hemodialysis on the heart is not adequately studied. The aim of this study was to assess the effect of spontaneous AVF closure in the early period after renal transplantation on the patient’s outcome. Methods: Seventeen patients (13 males, 4 females) who had their AVF thrombosed within the first month after transplantation were retrospectively compared to another well-matched and persistent AVF group of patients comprising of 34 patients (27 males, 7 females). Echocardiographic assessment was done before transplantation and at 1 year after transplantation. Results: In the thrombosed fistula group, there was a trend towards lower values of left ventricular end-systolic andend-diastolic diameters as well as end-systolic and end-diastolic volumes of the left ventricle, but it did not reach statistical significance. The persistent AVF group had significantly higher estimates for cardiac output and cardiac index (p < 0.05). Both groups were comparable for left ventricular mass, left ventricular mass index, and left ventricular systolic and diastolic functions. There was no difference regarding patient and graft survival in both groups. Conclusion: Spontaneous AVF thrombosis did not offer a cardiac beneficial effect and routine fistula closure is not warranted.
Microarray Analysis of Focal Segmental Glomerulosclerosis
Authors: Schwab Kristopher , Witte David P. , Aronow Bruce J. , Devarajan Prasad , Potter S. Steven , Patterson Larry T.
Published: August 2004

Background: Focal segmental glomerulosclerosis (FSGS) is a leading cause of chronic renal failure in children. Recent studies have begun to define the molecular pathogenesis of this heterogeneous condition. Here we use oligonucleotide microarrays to obtain a global gene expression profile of kidney biopsy specimens from patients with FSGS in order to better understand the pathogenesis of this disease. Methods: We extracted RNA from renal biopsy samples of 10 patients with the diagnosis of FSGS and from 5 control kidney samples, and produced labeled cRNA for hybridization to Affymetrix human U133A microarrays. Results: We identified a gene expression fingerprint for FSGS that contained 429 of 22,283 possible genes, each with a p < 0.01, using RMA normalization, Welch t test, and at least a 1.8-fold change in 5 of the 10 patients examined. We also found gene expression differences in samples from subsets of patients who had either nephrotic syndrome or renal insufficiency. This screen identified many genes and genetic pathways that have already been implicated in the pathogenesis of FSGS. In addition, we found changes in gene expression in genetic pathways that have not been studied in FSGS. Conclusions: Oligonucleotide DNA microarray analysis of renal biopsy specimens identified a gene expression fingerprint in samples from a heterogeneous population of patients with FSGS. The genes and genetic pathways identified in this study can be compared to results of similar studies of other diseases to examine specificity and used to study the pathogenesis of FSGS.
How Often Are Endometrial Polyps Malignant?
Authors: Shushan Asher , Revel Ariel , Rojansky Nathan
Published: August 2004

Objective: Endometrial polyps are a frequent pathology encountered during pelvic sonography and diagnostic hysteroscopies. The true incidence of malignant endometrial polyps is unknown. The estimations range from 0.5 to 4.8%. The objective of this study was to investigate the frequency of malignant endometrial polyps, and to characterize the hysteroscopic image of these polyps. Methods: The study included 300 consecutive women with endometrial polyps who underwent hysteroscopic polypectomy. Patients’ characteristics, operative findings, and pathology reports were analyzed. Results: Four of the 300 endometrial polyps removed by operative hysteroscopy were malignant (1.3%). Patients with malignant polyps were symptomatic peri- or postmenopausal women. All asymptomatic polyps in this series were found to be benign. We could not identify any distinct hysteroscopic feature of malignancy. Conclusions: Our study shows that about 1.5% of endometrial polyps may be malignant. This finding reinforces the indication for removal of symptomatic endometrial polyps, preferably by a hysteroscopic procedure. The significance of asymptomatic uterine polyps has still to be determined.
Impact of Volume and Specialization for Cancer Surgery
Authors: Weitz Jürgen , Koch Moritz , Friess Helmut , Büchler Markus W.
Published: August 2004

Background/Aims: The so-called volume/outcome relationship postulates that a higher caseload and specialization results in an improved outcome. The existence of such a relationship, however, is still debated in the literature. The objective of this review is to discuss the available data on this relationship in surgical oncology. Methods: A Medline analysis was performed using the following terms: volume, outcome, cancer, and surgery. The bibliography of each relevant article was screened for further studies. Results: For most malignancies a volume/outcome relationship was demonstrated in recent years. Components of this improved outcome are decreased perioperative morbidity and mortality, higher quality of life after surgery, improved economic outcome, and a better long-term prognosis for patients with cancer. The magnitude of this relationship, however, varies greatly among different malignancies. The exact reason for the volume/outcome relationship is still unknown. Conclusion: Concentrating high-risk procedures in high-volume hospitals might prevent thousands of perioperative deaths per year. This concept seems feasible for rare and high-risk diseases; however, it is unclear what threshold should be used for the definition of a high-volume provider. For common and low-risk diagnoses, it seems more realistic to educate the medical community in order to improve the outcome for the patients.
Surgical Treatment of Pancreatic Fistula
Authors: Alexakis N. , Sutton R. , Neoptolemos J.P.
Published: August 2004

Background: Pancreatic fistula remains a significant problem in pancreatic disease, trauma and surgery. Whilst improved diagnostic and treatment techniques, including endoscopic approaches, have resulted in considerably improved outcomes, surgical intervention remains an important aspect of treatment but has been relatively poorly documented. Aims: The aims were to review the recent world literature on the relative incidence of pancreatic fistula and the results of surgical treatment. Results: The pancreatic fistula rate following partial pancreato-duodenectomy was 421 (12.9%) in 3,268 patients in 13 large series; 80 (13.0%) in 671 patients after left pancreatectomy in 6 large series, and 28 (11.9%) in 243 patients after pancreatic trauma in 4 recent series. The success rate of surgical procedures for external pancreatic fistulae was 101 (90.2%) in 112 patients with an overall mortality of 7 (6.3%) reported in 9 series. For internal pancreatic fistulae the success rate of surgical treatment was 61 (92%) in 66 patients with an overall mortality of 6 (9%) reported in 7 series. Conclusions: The treatment of established pancreatic fistula remains challenging. Although surgical treatment is reserved for patients who have failed all other treatments, the success rate is 90–92% but with a mortality of 6–9%.
Morbidity of Temporary Loop Ileostomies
Authors: Bakx R. , Busch O.R.C. , Bemelman W.A. , Veldink G.J. , Slors J.F.M. , van Lanschot J.J.B.
Published: August 2004

Background/Aims: A temporary loop ileostomy is constructed to protect a distal colonic anastomosis. Closure is usually performed not earlier than 8–12 weeks after the primary operation. During this period, stoma-related complications can occur and enhance the adverse effect on quality of life. The aim of this study was to evaluate the length of time between ileostomy construction and closure, to quantify stoma-related morbidity and to examine the potential advantages of early ileostomy closure. Methods: Sixty-nine patients with a temporary, protective loop ileostomy (constructed between January 1996 and December 2000) were retrospectively analysed. The analysis was done by reviewing the medical records and the notes of the stoma care nurse. Results: Sixty ileostomies (87%) were closed after a median period of 24 weeks (range 2–124 weeks). Stoma-related complications occurred in 29 of the 69 patients (42%), and 11 patients (18%) had complications after ileostomy closure. Conclusion: The length of time between ileostomy construction and closure was substantially longer than initially planned. Earlier ileostomy closure (preferably even during the initial admission) could reduce the frequently occurring stoma-related morbidity in these patients and thus improve quality of life.
Minimally Invasive Treatment for Obstructive Tumors of the Left Colon: Endoluminal Self-Expanding Metal Stent and Laparoscopic Colectomy
Authors: Balagué Carmen , Targarona Eduardo Mª , Sainz Sergio , Montero Olga , Bendahat Galit , Kobus Christian , Garriga Jordi , Gonzalez Dolores , Pujol Juan , Trias Manuel
Published: August 2004

Background: Obstruction of the left colon may be the first manifestation of colorectal cancer. Resection of the colonic segment involved and the construction of an end colostomy (Hartman’s procedure) is the most frequent treatment. Alternatives to the placement of a stoma are subtotal colectomy or intraoperative lavage of the colon and primary anastomosis, but their application depends on intraoperative findings and the availability of a skilled surgeon. The use of an expandable stent (SEMS) can enhance the feasibility of laparoscopic colectomy, avoiding the need for a colostomy and offering the advantages of a combination of two minimally invasive procedures. Study Design: Between 1997 and 2004, an SEMS was placed in 11 cases of left colonic obstruction due to cancer, the obstruction being successfully resolved in each case. Seven patients were approached by laparoscopy to attempt the definitive colectomy. We evaluated the location and pathological characteristics of the tumor, effectiveness and complications of SEMS insertion, time interval between the insertion of SEMS and laparoscopic surgery, and postoperative data. Results: The tumors were situated in the recto-sigma (1 case), sigma (3 cases) and descending colon (3 cases). Immediate relief of the obstruction was achieved in all cases after SEMS insertion of the stent, and oral diet was started at 24 h. The 7 patients were operated on an average of 8 days (range 6–14) after insertion of the stent. Conversion to open surgery was necessary in one case for reasons not related to the stent. Conclusions: Preliminary results of the combination of SEMS and elective laparoscopic surgery demonstrate that the procedure is feasible and that it presents all the clinical advantages of a minimally invasive approach. The procedure is a valid alternative to traditional major urgent surgery.
Surgical Management of Large Sessile Villous and Tubulovillous Adenomas of the Lower Rectum
Authors: Renzulli Pietro , Maurer Christoph A. , Netzer Peter , Büchler Markus W.
Published: August 2004

Background: Large sessile adenomas of the rectum are premalignant lesions necessitating complete removal. Methods: We reviewed the data on 20 consecutive patients with large (≧2 cm) sessile villous and tubulovillous adenomas of the lower two thirds of the rectum (≤11 cm from the anal verge). Median (range) adenoma diameter and distance from the anal verge were 5 (2–8) and 7 (4–11) cm, respectively. All 11 patients with an adenomatous circumferential involvement of ≧50% or an endosonographic staging of ≧uT2 underwent a low anterior resection of the rectum. The remaining 9 patients underwent a posterior full-thickness local bowel wall resection (modified Mason procedure). The median (range) follow-up period was 3.8 (0.7–8.2) years. Results: Preoperative biopsy examination successfully excluded invasive carcinoma. Overstaging, however, occurred in 9 of 12 patients (75%) undergoing endosonography, resulting in surgical overtreatment of 4 patients. A curative resection (R0) was always achieved. Five patients had complications, but there was no in-hospital mortality and no cases of local recurrence. 4 out of 19 patients complained of minor stool incontinence, and 3 patients reported incomplete rectal emptying or constipation. Fourteen patients described the operative result as excellent (n = 7) or good (n = 7). Conclusions: Endosonography may lead to overstaging and overtreatment. An individualized approach based on the degree of adenomatous circumferential involvement and endosonographic staging showed no mortality, low morbidity, no local recurrence, and good functional medium-term results.
Role of Contrast CT in Acute Lower Gastrointestinal Bleeding
Authors: Rajan Ramesh , Dhar Puneet , Praseedom Raaj Kumar , Sudhindran S. , Moorthy Sreekanth
Published: August 2004

Objective: To evaluate the role of CT abdomen in the localization of acute lower gastrointestinal bleeding. Summary Background Data: The source of bleed in acute lower gastrointestinal bleeding is often difficult to localize. The role of CT in the evaluation of this group of patients has not been clearly addressed. Methods: A retrospective review of all patients with acute lower gastrointestinal bleeding over a 3-year period was carried out. When endoscopy failed to localize the source and bleeding continued, angiography and/or scintigraphy were carried out. In contrast, those who had normal endoscopies and had clinically stopped bleeding, underwent CT abdomen. Results: CT done in 7 patients with no evidence of active bleed identified a lesion in 6 (86%). Conclusions: CT may be useful in acute lower gastrointestinal bleeding where endoscopy fails to localize a lesion and bleeding has stopped temporarily.
Prevalence of Coronary Artery Disease Using Thallium-201 Single Photon Emission Computed Tomography among Patients Newly Undergoing Chronic Peritoneal Dialysis and Its Association with Mortality
Authors: Kim Soon Bae , Lee Sang Koo , Park Jung Sik , Moon Dae Hyuk
Published: August 2004

Background: Previous data about the prevalence of coronary artery disease in dialysis patients were mainly based on history or electrocardiogram. Methods: We evaluated the prevalence of coronary artery disease using routine thallium-201 single photon emission computed tomography (SPECT) in 227 patients at the start of chronic peritoneal dialysis between January 1996 and October 2003. We also analyzed its association with mortality. Results: Fifty-one patients (22.5%) were positive on thallium SPECT. There were significant differences in age, underlying diabetic nephropathy, and C-reactive protein (CRP), serum albumin, total cholesterol, and prealbumin levels among patients positive and negative on thallium SPECT. Multivariate logistic regression analysis showed that age (≧60 years), underlying diabetic nephropathy, and CRP (≧0.5 mg/dl) were independent predictors of positive thallium SPECT, with the patients positive for all three factors having a probability for positive thallium SPECT of 43%, whereas patients negative for all three factors had a probability of only 4%. Ninety patients died, and 137 survived during the median follow-up period of 34 (range 3–99) months. Kaplan-Meier survival analysis revealed that age, underlying diabetic nephropathy, serum albumin, prealbumin, and CRP levels, positive thallium SPECT, and smoking affected survival. Survival was not different according to gender, presence of hypertension, body mass index, total cholesterol, or lipoprotein(a). Cox regression analysis showed that only underlying diabetic nephropathy and age (≧60 years) were independent predictors of mortality. Conclusions: We found that 22.5% of the patients who started chronic peritoneal dialysis had a positive thallium SPECT. Age, underlying diabetic nephropathy, and CRP were independent predictors of a positive thallium SPECT. Underlying diabetic nephropathy and age, but not positive thallium SPECT, were independent predictors of mortality.
Staging Prisons: Performance, Activism, and Social Bodies
Authors: Caster Peter
Published: August 2004

“Staged activism” is social protest using the tactics of performance, while “activist performance” is conventional stage drama deliberately performed as part of a particular political project. What are the advantages and drawbacks of each?
“Far Away, So Close”: Psychosocial and Theatre Activities with Serbian Refugees
Authors: Schininá Guglielmo
Published: August 2004

Making creative activities for children, adolescents, and elderly refugees living in the collective centers of war-torn southern Serbia proved to be no easy task.
Whose Play Is It?: The Issue of Authorship/Ownership in Israeli Community-Based Theatre
Authors: Lev-Aladgem Shulamith
Published: August 2004

Community-based theatre in Israel is a means for individual and social empowerment. But who really owns these theatrical means of production—the community, the artists, or the sponsors?
Badal Sircar: Scripting a Movement
Authors: Mitra Shayoni
Published: August 2004

A pioneer of Indian street theatre, environmental theatre, and poor theatre continues his work in and around Kolkata. Mitra considers Sircar's life-path from the 1960s into the new century.
Why “Social Theatre”?
Authors: Thompson James , Schechner Richard
Published: August 2004

Deploying social theatre in TDR is performative—as likely to bring about as it is to describe. Social theatre is not a meeting of two distinct unrelated wholes. It is the dynamic meeting of theatre and social work, an interaction that can change both disciplines.
Social Theatre in Bangladesh
Authors: Ahsan Nazmul
Published: August 2004

Using improvisation based on the Bengali popular indigenous performance forms of jatra and khaner gan, the theatre group LOSAUK of Bangladesh raises social awareness and advocates change.
Retinoic acid regulates C/EBP homologous protein expression (CHOP), which negatively regulates myeloid target genes
Authors: Gery Sigal , Park Dorothy J. , Vuong Peter T. , Chih Doris Y. , Lemp Nathan , Koeffler H. Phillip
Published: August 2004

Retinoic acid (RA) promotes granulocytic differentiation of normal hematopoietic cells and acute promyelocytic leukemia (APL) blasts by transcriptional modulation of myeloid regulatory genes. In this study, we have identified the C/EBP homologous protein (CHOP) as a novel retinoid-responsive gene using a polymerase chain reaction (PCR)-based cDNA subtraction method. All-trans retinoic acid (ATRA) induced a biphasic expression of CHOP mRNA in the NB4 and HL60 AML cell lines. Levels of CHOP expression increased within 1 hour of exposure to ATRA. ATRA expression became nearly absent between 6 and 24 hours, and a second phase of induction occurred after 48 hours. Retinoid-dependent regulation of CHOP expression was also observed in normal human neutrophils but not in peripheral blood mononuclear cells. In addition, retinoid-dependent regulation of CHOP expression was not observed in retinoid-nonresponsive cell lines HL60R and NB4-R2. CHOP expression was regulated at the transcriptional level and was independent of new protein synthesis. CHOP heterodimerized with C/EBPϵ and negatively regulated the myeloid-specific gene lactoferrin. Furthermore, CHOP transcriptionally inhibited C/EBPα- and C/EBPϵ-dependent induction of secondary granule gene expression. RA signaling in granulocytic differentiation involves regulated expression of CHOP and C/EBPϵ in a coordinated fashion. (Blood. 2004;104:3911-3917)
A genome-wide screen identifies a single β-defensin gene cluster in the chicken: implications for the origin and evolution of mammalian defensins
Authors: Xiao Yanjing , Hughes Austin L , Ando Junko , Matsuda Yoichi , Cheng Jan-Fang , Skinner-Noble Donald , Zhang Guolong
Published: August 2004

Background

Defensins comprise a large family of cationic antimicrobial peptides that are characterized by the presence of a conserved cysteine-rich defensin motif. Based on the spacing pattern of cysteines, these defensins are broadly divided into five groups, namely plant, invertebrate, α-, β-, and θ-defensins, with the last three groups being mostly found in mammalian species. However, the evolutionary relationships among these five groups of defensins remain controversial.

Results

Following a comprehensive screen, here we report that the chicken genome encodes a total of 13 different β-defensins but with no other groups of defensins being discovered. These chicken β-defensin genes, designated as Gallinacin 1–13, are clustered densely within a 86-Kb distance on the chromosome 3q3.5-q3.7. The deduced peptides vary from 63 to 104 amino acid residues in length sharing the characteristic defensin motif. Based on the tissue expression pattern, 13 β-defensin genes can be divided into two subgroups with Gallinacin 1–7 being predominantly expressed in bone marrow and the respiratory tract and the remaining genes being restricted to liver and the urogenital tract. Comparative analysis of the defensin clusters among chicken, mouse, and human suggested that vertebrate defensins have evolved from a single β-defensin-like gene, which has undergone rapid duplication, diversification, and translocation in various vertebrate lineages during evolution.

Conclusions

We conclude that the chicken genome encodes only β-defensin sequences and that all mammalian defensins are evolved from a common β-defensin-like ancestor. The α-defensins arose from β-defensins by gene duplication, which may have occurred after the divergence of mammals from other vertebrates, and θ-defensins have arisen from α-defensins specific to the primate lineage. Further analysis of these defensins in different vertebrate lineages will shed light on the mechanisms of host defense and evolution of innate immunity.
Ancestry reported by white adults with cutaneous melanoma and control subjects in central Alabama
Authors: Acton Ronald T , Barton Ellen H , Hollowell William W , Dreibelbis Amy L , Go Rodney CP , Barton James C
Published: August 2004

Background

We sought to evaluate the hypothesis that the high incidence of cutaneous melanoma in white persons in central Alabama is associated with a predominance of Irish and Scots descent.

Methods

Frequencies of country of ancestry reports were tabulated. The reports were also converted to scores that reflect proportional countries of ancestry in individuals. Using the scores, we computed aggregate country of ancestry indices as estimates of group ancestry composition. HLA-DRB1*04 allele frequencies and relationships to countries of ancestry were compared in probands and controls. Results were compared to those of European populations with HLA-DRB1*04 frequencies.

Results

Ninety evaluable adult white cutaneous melanoma probands and 324 adult white controls reported countries of ancestry of their grandparents. The respective frequencies of Ireland, and Scotland and "British Isles" reported countries of ancestry were significantly greater in probands than in controls. The respective frequencies of Wales, France, Italy and Poland were significantly greater in controls. 16.7% of melanoma probands and 23.8% of controls reported "Native American" ancestry; the corresponding "Native American" country of ancestry index was not significantly different in probands and controls. The frequency of HLA-DRB1*04 was significantly greater in probands, but was not significantly associated with individual or aggregate countries of ancestry. The frequency of DRB1*04 observed in Alabama was compared to DRB1*04 frequencies reported from England, Wales, Ireland, Orkney Island, France, Germany, and Australia.

Conclusion

White adults with cutaneous melanoma in central Alabama have a predominance of Irish, Scots, and "British Isles" ancestry and HLA-DRB1*04 that likely contributes to their high incidence of cutaneous melanoma.
Rates of influenza vaccination in older adults and factors associated with vaccine use: A secondary analysis of the Canadian Study of Health and Aging
Authors: Andrew Melissa K , McNeil Shelly , Merry Heather , Rockwood Kenneth
Published: August 2004

Background

Influenza vaccination has been shown to reduce morbidity and mortality in the older adult population. In Canada, vaccination rates remain suboptimal. We identified factors predictive of influenza vaccination, in order to determine which segments of the older adult population might be targeted to increase coverage in influenza vaccination programs.

Methods

The Canadian Study of Health and Aging (CSHA) is a population-based national cohort study of 10263 older adults (≥ 65) conducted in 1991. We used data from the 5007 community-dwelling participants in the CSHA without dementia for whom self-reported influenza vaccination status is known.

Results

Of 5007 respondents, 2763 (55.2%) reported having received an influenza vaccination within the previous 2 years. The largest predictive factors for flu vaccination included: being married (57.4 vs. 52.6%, p = 0.0007), having attained a higher education (11.0 vs. 10.3 years, p < 0.0001), smoking (57.1% vs. 52.9%, p = 0.0032), more alcohol use (57.9% of those who drank more vs. 53.2% of those who drank less, p = 0.001), poorer self-rated health (54.1% of those with good self-rated health vs. 60.6% of those with poor self-rated health, p = 0.0006), regular exercise (56.8% vs. 52.0%, p = 0.001), and urban living (55.8% vs. 51.0%, p = 0.03).

While many other differences were statistically significant, most were small (e.g. mean age 75.1 vs. 74.6 years for immunized vs. unimmunized older adults, p = 0.006, higher Modified Mini Mental Status Examination score (89.9 vs. 89.1, p < 0.0001), higher comorbidity (2.7 vs. 2.3 comorbidities, p < 0.0001).

Residents of Ontario were more likely (64.6%) to report vaccination (p < 0.0001), while those living in Quebec were less likely to do so (48.2%, p < 0.0001). Factors retaining significance in a multivariate analysis included older age, higher education, married status, drinking alcohol, smoking, engaging in regular exercise, and having higher comorbidity.

Conclusions

The vaccination rate in this sample, in whom influenza vaccination is indicated, was low (55.2%). Even in a publicly administered health care setting, influenza vaccination did not reach an important proportion of the elderly population. Whether these differences reflect patient preference or access remains to be determined.