bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary bifurcation stenting: state of the art
Authors: Louvard Yves , Lefèvre Thierry
Published: January 2012

The difference between a coronary bifurcation lesion and an ordinary lesion lies in the presence of a side branch (SB). Such branches are particularly instrumental in the development of atheroma because of local blood flow patterns and are also a predictive factor of peri-procedural myocardial infarction (MI) when percutaneous coronary angioplasty (PCI) is performed.

The clinical importance of a SB depends on its diameter which is strongly correlated with its flow and the muscular mass that it vascularizes; the diameter of the SB, main branch (MB), and of proximal segment of the MB are indeed interdependent as evidenced by Murray’s law. Therefore, a coronary bifurcation should be divided into three segments, each with its own reference diameter.

Before the advent of coronary stenting, and later with bare-metal stents (BMS), PCI of coronary bifurcation lesions was associated with a lower success rate, a higher risk of complications, and a higher restenosis rate compared to non-bifurcation lesions. Although the use of drug-eluting stents (DES) has resulted in reduced restenosis rates and reintervention, coronary bifurcation lesions remain a higher risk setting especially when the bifurcation is proximal.

Over the past few years, the subject of many debates has been the identification of optimal BMS or DES strategies for improving angiographic success, reducing the risk of peri-procedural complications, and decreasing the rate of restenosis and reintervention. The vast majority of registry studies (BMS and DES) and randomized studies (DES) have demonstrated that the systematic stenting of both branches is not superior to the strategy of ‘provisional side-branch stenting’. Indications for systematic double stenting as well as the type of strategy to be implemented are still being debated because of heterogeneous studies with respect to lesion type, and of the multiplicity of inadequately described or applied techniques.

Adapting the technique to the lesion, as reported by several recent randomized studies, is complicated by the emergence of a new prognostic factor, namely the angle or angles of the bifurcation, which are still very difficult to measure precisely.

Various types of ‘dedicated’ stents specifically designed for bifurcation lesions have been included in debates about the adaptation of the technique (or stent) to the type of bifurcation lesion to be treated.

Finally, stenting of bifurcation lesions has been shown to be a risk factor of acute, late, or very late stent thrombosis and the influence of the technique or its imperfect implementation, has not been adequately assessed.

The purpose of the present chapter is to provide an overview of coronary bifurcation lesions and their current treatment and address the fundamental as well as practical issues inherent in this setting.
Percutaneous coronary intervention for unprotected and protected left main stem disease
Authors: Hughes Christine , Farah Bruno , Fajadet Jean
Published: January 2012

Significant unprotected left main coronary artery (ULMCA) disease occurs in 5–7% of patients undergoing coronary angiography (and patients with ULMCA disease treated medically have a 3-year mortality rate of 50%. Several studies have shown a significant benefit following treatment of left main (LM) stenosis with coronary bypass grafting compared with medical treatment. Until recently coronary bypass grafting has been the gold standard therapy for LM disease. However, advances in percutaneous intervention techniques and stent technology have allowed re-evaluation of the role of percutaneous coronary intervention (PCI) for LM disease. Recent studies have focused on the safety and efficacy of stenting the left main coronary artery (LMCA) to determine if it does provide a true alternative to coronary artery bypass grafting (CABG). So should we stent the LM?
Chronic total occlusions
Authors: Kukreja Neville , Tyczynski Pawel , di Mario Carlo
Published: January 2012

Chronic total occlusions (CTOs) remain the most technically challenging and time-consuming subset of coronary artery lesions to treat with percutaneous intervention (PCI). Particular difficulties may be encountered in crossing and dilating the lesion, whilst the rates of restenosis are higher than other lesions even after successful PCI. The presence of a CTO frequently prevents complete percutaneous revascularization, and may therefore provide justification for either revascularizing patients by means of coronary artery bypass grafting (CABG) or denying revascularization in favour of a more conservative approach. CTOs can cause severe disabling angina and lead to an impairment of regional and global left ventricular function. This explains why opening CTOs may provide a benefit exceeding the recognized ability of PCI to improve symptoms, and favourably impact upon long-term prognosis. This chapter aims to provide a comprehensive review of the literature on indications and results of CTO treatment as well as providing a modern practical technical guide to planning and executing CTO revascularization.
Revascularization in diabetes mellitus
Authors: Kapur Akhil , Qureshi Ayesha
Published: January 2012

Diabetes is occurring in epidemic proportions. In the general population in the developed world, approximately 8% of adults have diabetes. The prevalence of diabetes will double over the next 15 years or so to an estimated 300 million people by the year 2025. This is due almost totally to an increase in type 2 diabetes mellitus (T2DM). These figures are likely to understate the size of the problem as it has been estimated that up to one-half of affected patients in the general population remain undiagnosed. In addition up to double the number of patients who have diabetes have insulin resistance syndrome with a heightened risk of developing T2DM. This increase will be due mainly to an increasing prevalence of obesity, decreasing rates of physical activity, an increasing consumption of high calorie diets, and an ageing population.
Current status of oral antiplatelet therapies
Authors: Hobson Alex , Curzen Nick
Published: January 2012

This chapter summarizes the current guidelines for antiplatelet drugs in the context of percutaneous coronary intervention (PCI); medications at our disposal, and we will attempt to answer these questions using the evidence that is currently available. We highlight some of these issues by discussing our management of a complex clinical case. In addition we will consider to what extent technologies, pharmaceuticals, and management strategies may alter in the near future.
The contemporary use of antiplatelet therapy in interventional cardiology
Authors: Myat Aung , Gershlick Tony
Published: January 2012

Accepting that the adhesion, activation, and aggregation of platelets plays a central role in the initial formation and subsequent propagation of intracoronary thrombi, antiplatelet therapy (APT) has become central to the management of a number of manifestations of cardiovascular (CV) disease; not least in preventing the deleterious effects of stent thrombosis (ST) that can follow percutaneous coronary intervention (PCI) with stent deployment. PCI causes significant local trauma to the vessel wall leading to exposure of the subendothelium and release of its thrombogenic constituents into the intravascular environment resulting in an increased risk of vaso-occlusive complications. Exposure of the stent struts can further stimulate platelet adherence to the non-endothelialized vessel wall and accelerate activation and aggregation. Furthermore, PCI can also potentiate the release of vasoactive agents from the platelet-rich thrombus. This may be of particular importance when PCI is undertaken in those presenting with acute coronary syndromes (ACS) where plaque disruption has already locally activated platelets by exposing the flowing blood constituents to thrombogenic plaque contents.
The role of bivalirudin in percutaneous coronary intervention
Authors: Massberg Steffen , Mehilli Julinda , Kastrati Adnan
Published: January 2012

Rapid progress has been made in interventional cardiology over the past years, and many patients with coronary artery disease, even those with complex lesions, are nowadays being treated with percutaneous coronary interventions (PCI). As a result, a major focus of current cardiovascular research is on reducing negative peri-procedural clinical events associated with PCI, particularly in high-risk patients. Among the most dangerous peri-procedural events are thrombotic complications, leading to recurrent myocardial or cerebral ischaemia, often with fatal outcome. Anticoagulant and antithrombotic treatment, therefore, is an integral part of current PCI strategies. It is needless to say that prevention of procedural thrombotic events with the use of anticoagulants occurs at the expense of severe bleeding complications. Hence, there has been a strong effort over recent years to develop and validate novel anticoagulant regimens that provide protection against thrombotic complications, but have only minor effects on normal haemostasis.

Until recently, the standard anticoagulation therapy during PCI consisted in either unfractionated (UFH) or low-molecular-weight heparin (LMWH) that prevent coagulation indirectly by activation of antithrombin (AT). Once activated, AT inactivates thrombin and other proteases involved in blood clotting. However, only recently direct thrombin inhibitors (DTI) have been introduced as an alternative anticoagulant strategy in patients undergoing PCI. Bivalirudin is the most prominent member of the DTI class, directly inhibiting free- and clot-bound thrombin. Use of bivalirudin has recently been shown to result in a significant reduction of bleeding without an increase in thrombotic or ischaemic endpoints compared to heparin and glycoprotein (GP) IIb/IIIa inhibitors in patients presenting with acute coronary syndromes (ACS).

This chapter will give an overview of the pharmacology and mechanism of action of bivalirudin and summarize results from recent clinical trials evaluating the use of bivalirudin in patients undergoing PCI.
Optimal medical therapy in percutaneous coronary intervention patients: statins and ACE inhibitors as disease-modifying agents
Authors: Corbett Simon J. , Fox Kim F.
Published: January 2012

The majority of this textbook is concerned with the indications for, and applications of, the numerous techniques that interventional cardiologists have at their disposal to assess and treat significant coronary stenoses. However, it is well recognized that atherosclerosis is far from being a discrete pathological process, such that by the time a person presents with clinically apparent coronary artery disease (CAD), they will often have widespread atheroma throughout their coronary tree. Combined with the reproducible observation that the majority of acute coronary syndromes arise from lesions that were not previously flow-limiting, much research effort has been directed at identifying treatment strategies that will favourably modify all of the patient’s atherosclerotic burden, not just that which can be targeted by percutaneous or surgical revascularization. In this chapter, we focus on the rationale and evidence base supporting the use of statins and renin–angiotensin–aldosterone system (RAAS) inhibition in patients with CAD.
In-stent restenosis in the drug-eluting stent era
Authors: Caixeta Adriano , Généreux Philippe , Dangas George , Mehran Roxana
Published: January 2012

For the last two decades, restenosis has been considered the most significant problem in interventional cardiology. Drug-eluting stents (DES) have reduced rates of restenosis and target lesion revascularization (TLR) by 50–90% compared with bare-metal stents (BMS) across all lesion and patient subsets. However, a small number of patients have in-stent restenosis (ISR) after DES treatment. DES efficacy has been limited by suboptimal polymer biocompatibility, suitability of pharmacological agents, suboptimal in vivo pharmacokinetic properties, and local drug resistance and toxicity. The first two DES (sirolimus-eluting stents [SES] and paclitaxel- eluting stents [PES]) have the longest clinical follow- up, whereas the zotarolimus-eluting stents [ZES], everolimus-eluting stents [EES], and biolimus-eluting stents [BES] have only recently been introduced in daily practice. Although the low frequency of ISR events with DES makes it difficult to fully investigate this syndrome, many studies have been conducted or are ongoing to find the mechanism, incidence, predictors, and optimal treatment of DES restenosis. This review discusses the data relevant to DES restenosis and the perspective on the current treatment of this condition.
Stent thrombosis
Authors: Vasa-Nicotera Mariuca , Gershlick Tony
Published: January 2012

Over the past three decades, new strategies have rapidly evolved to achieve coronary reperfusion of ischaemic myocardium in patients with coronary artery disease (CAD). Studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) have shown that the long-term rates of death and/or myocardial infarction (MI) are substantially the same, justifying the increasing and widespread use of PCI. PCI is the dominant reperfusion therapy for such patients with the ratio of numbers of PCIs undertaken to CABG performed being 4:1 in the United Kingdom and up to 8:1 in other parts of Europe. A recurrent issue during the evolution of PCI has been the difference between PCI and CABG in the percentage of patients requiring a repeat procedure (reintervention). To date, the need of reintervention has been less with CABG and this is due to the development of in-stent restenosis that occurs after PCI. Restenosis is the re-narrowing of the vessel, which requires a repeat procedure. The rate of restenosis with early balloon angioplasty has been high. The implantation of bare metal stents (BMS) and then drug-eluting stents (DES) has reduced significantly the incidence of restenosis. While such improved overall clinical outcomes with DES has supported the use of these in preference to BMS, another long-term complication has somewhat tempered the enthusiasm for their use: the possibility that implantation of DES would result in an excess of occlusive stent thrombosis (ST).

This chapter will analyse the data on the incidence, causes, and clinical consequences of ST, and will outline the ongoing and future preventive and therapeutic initiatives. Finally, the risk/benefit of DES will be addressed.
Stent loss and retrieval
Authors: de Belder Adam , Saha Mrinal
Published: January 2012

In the right hands, percutaneous coronary intervention (PCI) is a relatively straightforward technique that is rewarding for both the operator and the patient. Success rates are high, and complications of PCI are unusual. Meticulous technique generally avoids problems. When complications occur, the consequences can be significant and understanding how to deal with them in order to secure satisfactory outcomes is key. One such complication is stent loss, whereby a stent becomes dislodged from the delivery balloon platform. Fortunately the phenomenon is rare. The methods used to manage stent loss can potentially be associated with significant morbidity. This chapter addresses the incidence, classification, and management of stent loss.
Rotational atherectomy
Authors: de Belder Adam , Thomas Martyn
Published: January 2012

Since 1979, plain old balloon angioplasty (POBA) has provided relief of angina for many patients. Recurrent symptoms due to restenosis diminished with bare-metal stent and, more recently, drug-eluting technology. A limitation to achieving good results with POBA and stenting is calcification within the artery which not only can prevent passage of balloons and stents into a lesion but also may prevent adequate lumen expansion. Rotational atherectomy or rotablation (RA) can treat highly resistant calcified plaque within coronary arteries to allow adequate vessel expansion and ensure optimal stent deployment. The concept of using a high-speed diamond-tipped drill spinning at 150 000rpm driven by compressed air to clear an artery that is 3mm in diameter is challenging, yet this technique has been available for use in coronary arteries since 1989 when M.E. Bertrand (Lille, France) and R. Erbel (Essen, Germany) first used it in humans.
Thrombus extraction in the contemporary management of ST-segment elevation myocardial infarction
Authors: Gu Youlan L. , Zijlstra Felix
Published: January 2012

ST-segment elevation myocardial infarction (STEMI) is primarily caused by an acute thrombotic event resulting in total occlusion of a coronary artery. The precipitating factor for acute thrombosis is generally the rupture of a coronary atherosclerotic plaque, responsible for approximately 75% of all coronary thrombi leading to myocardial infarction (MI) or death. After rupture of the atherosclerotic plaque, fragments of its lipid-rich core are exposed to the arterial lumen. This highly thrombogenic material induces local platelet aggregation, resulting in an early mural thrombus that partially occludes the artery. In time, the formation of a fibrin network causes consolidation of the thrombus. This can be followed by stabilization of the plaque without clinical sequelae, but additional thrombus formation may progress until eventually the whole lumen can be occluded. If occlusion continues for several hours, the ischaemic myocardium becomes irreversibly damaged. The longer this coronary occlusion persists, the worse the clinical outcomes are.
Transcatheter aortic valve replacement
Authors: Webb John G. , Nietlispach Fabian
Published: January 2012

Aortic stenosis (AS) is the most common valvular heart disease for which patients undergo valve replacement. Although the condition may develop in mid-life in association with a congenitally bicuspid valve, AS is for the most part a disease of the elderly, as demonstrated by a recent community-based study in the United States which reported a prevalence in those older than 75 years of age of 4.6%. Medically treated severe symptomatic AS has been associated with predictable clinical deterioration and a poor survival, reportedly averaging 2–3 years after the onset of symptoms.
Mitral balloon valvuloplasty
Authors: Vahanian Alec , Himbert Dominique , Brochet Eric , Ducrocq Grégory , Iung Bernard
Published: January 2012

Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. The treatment of MS has been revolutionized since the development of balloon mitral valvuloplasty (BMV). Until the first publication by Inoue in 1984, surgery was the only treatment for patients with mitral stenosis. Since then, the technique has evolved considerably. A large number of patients with varied conditions have now been treated worldwide, enabling us to assess the efficacy and risk of the technique, and long-term results make us better able to select the most appropriate candidates for treatment using this method.
Analysis of Diversity inPythium aphanidermatumPopulations from a Single Greenhouse Reveals Phenotypic and Genotypic Changes over 2006 to 2011
Authors: Al-Sadi A. M. , Al-Ghaithi A. G. , Al-Balushi Z. M. , Al-Jabri A. H.
Published: January 2012

A study was conducted to investigate phenotypic and genotypic changes within Pythium aphanidermatum populations during the period 2006 to 2011. In total, 92 isolates of P. aphanidermatum (59 in 2006 and 33 in 2011) were obtained from different planting sites (soil) of cucumber from a single greenhouse. Generated sequences of the internal transcribed spacer (ITS) ribosomal DNA showed that all, except one isolate, share an identical sequence of the ITS region. Most (89%) P. aphanidermatum isolates were found to be aggressive on cucumber seedlings, with no significant differences in the aggressiveness level between populations obtained from different planting rows or different years. Sensitivity to metalaxyl among populations of P. aphanidermatum increased significantly from concentration resulting in 50% growth inhibition levels of 0.070 to 1.823 (average 0.824 μg ml–1) in 2006 to 0.002 to 0.564 (average 0.160 μg ml–1) in 2011. Amplified fragment length polymorphism analysis of the 92 isolates produced 92 different genotypes and 985 polymorphic loci. P. aphanidermatum populations from 2006 and 2011 were found to have low levels of genetic diversity (H = 0.1425), which implies introduction of the isolates into the greenhouse via common sources. Results from analysis of molecular variance (FST= 0.0307 in 2006 and 0.0222 in 2011) provided evidence for frequent exchange of Pythium inoculum between different planting locations within the same year. However, the analysis showed moderate levels (FST= 0.1731) of genetic differentiation among populations from the 2 years. This was supported by unweighted pair group method with arithmetic means analysis, which showed clustering of many of the 2006 isolates in separate clusters. The change in the metalaxyl sensitivity of the populations from 2006 to 2011 accompanied by the genetic differences among these two populations may suggest that many of the isolates from 2006 were lost and were replaced by new and highly sensitive P. aphanidermatum isolates by 2011.
First Report of Tulip virus X on Tulip in Poland
Authors: Sochacki D. , Komorowska B.
Published: January 2012

Tulip virus X (TVX) was first isolated from tulips in Scotland (3). TVX is now found in all tulip-growing areas throughout the Netherlands, and other countries including Japan and New Zealand (2). In Poland, tulips are grown for bulb production in an estimated area of 450 ha. Since tulips are very popular during the winter season, bulbs are imported for forcing from the Netherlands. In spring 2011, symptoms typical of TVX infection were observed in field-grown ‘Strong Gold’ tulips in two farms in Mazovia Province. Leaves showed chlorotic and white, elongated streaks and spots, which are typical symptoms of TVX infection. Symptomatic leaves of four tulip plants tested positive by using TVX polyclonal antiserum in a double-antibody sandwich-ELISA assay (Bulb Quality Support B.V., Lisse, The Netherlands), whereas two plants were also infected with Tulip breaking virus. Total RNA was extracted from leaves of the same four symptomatic tulips with a silica capture method (1) and the extracts were used in a reverse transcription-PCR. Primers for the detection of TVX as well as cycling conditions were as previously reported (4). Primer pairs TVX1F-TVX1R and TVX2F-TVX2R are specific for a 219-bp fragment of the RNA-dependent RNA polymerase gene and a 189-bp fragment of the triple gene block gene-1, respectively. Amplified PCR products of the expected sizes were purified and sequenced (Genomed S.A., Warsaw, Poland). Sequence analyses showed that both fragments had 99.5 to 100% sequence identities at the nucleotide level with Genbank Accession No. AB066288. Two of the 219-bp amplicon sequences, varied by one nucleotide resulting in an amino acid substitution, were deposited in GenBank under Accession Nos. JN411683 and JN411684. To our knowledge, this is the first report of TVX in tulip in Poland. The occurrence of this virus could be important for bulb and flower production, particularly in the case of further spread because the virus can cause severe symptoms that make flowers unmarketable.

References: (1) R. Boom et al. J. Clin. Microbiol. 28:495,1990. (2) P. J. M. Knippels. Acta Hortic. (ISHS) 886:147, 2011. (3) W. P. Mowat. Ann. Appl. Biol. 101:51, 1982. (4) I. E. Tzanetakis et al. Plant Pathol. 54:562, 2005.
A Destructive New Disease of Citrus in China Caused by Cryptosporiopsis citricarpa sp. nov.
Authors: Zhu Li , Wang Xinghong , Huang Feng , Zhang Jinze , Li Hongye , Ding Dekuan , Hyde Kevin D.
Published: January 2012

Defoliation, dieback and mortality of Satsuma mandarin (Citrus unshiu), as well as kumquat (Fortunella margarita), in Chenggu County, Shaanxi Province, China was first noticed in 2006 and caused substantial economic losses to citrus production. The incidence of leaves infected approached 100% in some badly infected orchards. The disease prevailed only in late winter and early spring, where early symptoms were rounded and target-like spots on leaves. The disease was named target spot. Black conidiomata were observed on the upper surface of the leaves. A Cryptosporiopsis species was consistently recovered from the infected leaves, shoots, and branches. Koch's postulates were fulfilled by inoculating the conidial suspension of Cryptosporiopsis sp. onto the leaves of Satsuma mandarin. Phylogenetic analysis based on LSU sequence data indicated that this taxon clustered in Cryptosporiopsis (teleomorph: Neofabraea, Dermateaceae). Phylogenetic analysis based on ITS, SSU, and TUB indicated that the isolates of Cryptosporiopsis sp. constituted a distinct clade. Further study also demonstrated that this taxon was morphologically distinct from other species of Cryptosporiopsis, thus suggesting it might belong to an undescribed species. The name Cryptosporiopsis citricarpa sp. nov. is given to accommodate the fungal pathogen in this study.
Inhibitory Effects of Essential Oils for Controlling Phytophthora capsici
Authors: Bi Yang , Jiang He , Hausbeck Mary K. , Hao Jianjun J.
Published: January 2012

Essential oils (EOs) were studied in vitro and in vivo for inhibiting Phytophthora capsici. Mycelial growth of P. capsici was examined on EO-amended media or after exposing it to EO volatiles. The efficacy of EOs was determined by estimating the effective concentration for 50% inhibition of P. capsici mycelial growth (EC50). Among 14 tested commercial products, oregano, palmarosa, and red thyme EOs had the lowest EC50 values (<0.15 μg/ml) for inhibiting the production and germination of sporangia and zoospores, and mycelial growth of P. capsici. The EOs had the same range of effect on inhibiting some mutant P. capsici isolates resistant to fluopicolide and zoxamide. P. capsici population in soil was reduced by the three EOs. Zucchini (Cucurbita pepo) fruit were protected against P. capsici infection when they were sprayed with red thyme (0.1 μg/ml) or oregano and palmarosa (0.2 μg/ml) EOs. Zucchini seedling emergence was affected by oregano, but not by red thyme. Zucchini seedlings survived in P. capsici–infested soil treated with red thyme at 0.1 μg/ml, while all of the nontreated seedlings died. These results taken together suggest that oregano, red thyme, and palmarosa EOs may be potential components for integrated management of P. capsici.
A Diagnostic Guide for Fusarium Wilt of Watermelon
Authors: Kleczewski Nathan M. , Egel Daniel S.
Published: January 2012

Fusarium wilt causes major losses in watermelon production areas worldwide. Here we provide a diagnostic guide that describes general methods for disease recognition, pathogen isolation, and pathogen identification. Methods for storage and pathogenicity screens are also discussed.

Accepted for publication 26 October 2011. Published 29 November 2011.
Field Evaluation of Trichoderma spp. for Control of Armillaria Root Rot of Peach
Authors: Schnabel G. , Rollins A. P. , Henderson G. W.
Published: January 2012

Management of Armillaria root rot (ARR) of perennial crops is challenging and requires an integrated approach. In this study, Trichoderma asperellum and T. gamsii formulated as Remedier WP were drenched onto peach trees 3 to 12 days after planting (2007), and biannually thereafter in spring and fall for a total of three years in two commercial replant sites of South Carolina. All trees were planted in spots where a tree had declined from ARR the previous season to maximize disease pressure. Tree survival and trunk diameter were determined each year in the control and Remedier WP treatments. Four years after planting (2011), about 50% of all control trees and Remedier WP-treated trees had died from ARR in both locations. There was no statistical significance in survival between the treatments in either location. However, three and four years after planting, surviving Remedier WP-treated trees had significantly larger tree trunks compared to control trees in the Campobello location. Not enough trees survived in the other location for meaningful analysis of tree trunk diameter data. Our results show that in soils with heavy ARR inoculum levels, biannual drenches of Trichoderma spp. formulated as Remedier WP starting at planting are ineffective for ARR control of peach.

Accepted for publication 27 October 2011. Published 29 November 2011.
Foliar Nematodes: A Summary of Biology and Control with a Compilation of Host Range
Authors: Kohl Lisa M.
Published: January 2012

Foliar nematodes (Aphelenchoides fragariae, A. ritzemabosi, and A. besseyi) are pathogens of ornamental crops in greenhouse and nursery production, and may infect some field crops as well. Foliar nematodes migrate over plant surfaces through films of water to enter the stomates of leaves, causing vein-delimited lesions on leaf tissue. This review covers research on the identification, biology, epidemiology, and management of foliar nematodes, and also provides a new compilation of plant hosts that includes over 700 different plant species.

Accepted for publication 11 October 2011. Published 29 November 2011.
Carbon dioxide and the uneasy interactions of trees and savannah grasses
Authors: Bond William J. , Midgley Guy F.
Published: January 2012

Savannahs are a mixture of trees and grasses often occurring as alternate states to closed forests. Savannah fires are frequent where grass productivity is high in the wet season. Fires help maintain grassy vegetation where the climate is suitable for woodlands or forests. Saplings in savannahs are particularly vulnerable to topkill of above-ground biomass. Larger trees are more fire-resistant and suffer little damage when burnt. Recruitment to large mature tree size classes depends on sapling growth rates to fire-resistant sizes and the time between fires. Carbon dioxide (CO2) can influence the growth rate of juvenile plants, thereby affecting tree recruitment and the conversion of open savannahs to woodlands. Trees have increased in many savannahs throughout the world, whereas some humid savannahs are being invaded by forests. CO2has been implicated in this woody increase but attribution to global drivers has been controversial where changes in grazing and fire have also occurred. We report on diverse tests of the magnitude of CO2effects on both ancient and modern ecosystems with a particular focus on African savannahs. Large increases in trees of mesic savannahs in the region cannot easily be explained by land use change but are consistent with experimental and simulation studies of CO2effects. Changes in arid savannahs seem less obviously linked to CO2effects and may be driven more by overgrazing. Large-scale shifts in the tree–grass balance in the past and the future need to be better understood. They not only have major impacts on the ecology of grassy ecosystems but also on Earth–atmosphere linkages and the global carbon cycle in ways that are still being discovered.
A timeline for terrestrialization: consequences for the carbon cycle in the Palaeozoic
Authors: Kenrick Paul , Wellman Charles H. , Schneider Harald , Edgecombe Gregory D.
Published: January 2012

The geochemical carbon cycle is strongly influenced by life on land, principally through the effects of carbon sequestration and the weathering of calcium and magnesium silicates in surface rocks and soils. Knowing the time of origin of land plants and animals and also of key organ systems (e.g. plant vasculature, roots, wood) is crucial to understand the development of the carbon cycle and its effects on other Earth systems. Here, we compare evidence from fossils with calibrated molecular phylogenetic trees (timetrees) of living plants and arthropods. We show that different perspectives conflict in terms of the relative timing of events, the organisms involved and the pattern of diversification of various groups. Focusing on the fossil record, we highlight a number of key biases that underpin some of these conflicts, the most pervasive and far-reaching being the extent and nature of major facies changes in the rock record. These effects probably mask an earlier origin of life on land than is evident from certain classes of fossil data. If correct, this would have major implications in understanding the carbon cycle during the Early Palaeozoic.
Interactive effects of approach motivational intensity and alcohol cues on the scope of perceptual attention
Authors: Hicks Joshua A. , Friedman Ronald S. , Gable Philip A. , Davis William E.
Published: January 2012

Aims  Many theoretical perspectives suggest that alcohol‐related stimuli bear on attentional processes. Building upon these ideas and recent advances regarding the attention‐constricting impact of approach motivational states, we predicted that mere exposure to alcohol‐related images would suffice to reduce the breadth of attention among individuals who possessed a strong motivation to consume alcohol.

Design  Two studies exposed participants to alcohol and neutral cues prior to assessing attention structure. In both studies, measures of alcohol use, negative alcohol expectancies, trait approach motivation and alcohol‐related approach motivation were assessed.

Setting and participants  Study 1 comprised 102 undergraduates and study 2 comprised 161 undergraduates. Studies were conducted at Texas A&M University, College Station, Texas.

Measurements  In both studies, participants were briefly exposed to pictures of various stimuli (alcohol versus neutral pictures). After each picture was displayed, participants completed a trial assessing attentional focus.

Findings  After controlling for relevant covariates, both studies demonstrated that exposure to alcohol‐related pictures led to a narrowing of attentional focus among individuals who possessed a strong motivation to use alcohol. Exposure to neutral pictures, however, did not interact with alcohol‐related motivation to influence attentional focus.

Conclusions  Alcohol cues narrow attentional breadth for individuals who are motivated to consume alcohol, suggesting a non‐pharmacological means in which alcohol produces a narrow mindset. Alcohol cues may contribute to cognitive and behavioral deficits, as well as drinking behaviors, in part, because they lead to the inability to process a broad range of information in the environment.
Early serum HBsAg level as a strong predictor of sustained response to peginterferon alfa‐2a in HBeAg‐negative chronic hepatitis B
Authors: Peng C.‐Y. , Lai H.‐C. , Li Y.‐F. , Su W.‐P. , Chuang P.‐H. , Kao J.‐T.
Published: January 2012

Background

The roles remain unclear of early on‐treatment quantitative serum HBsAg and hepatitis B virus (HBV) DNA levels in the prediction of a sustained response (SR) to peginterferon alfa‐2a therapy in HBeAg‐negative chronic hepatitis B (CHB) patients infected with genotype B or C.

Aims

To determine their roles in HBeAg‐negative CHB patients infected with genotype B or C.

Methods

Sixty‐one patients were treated with peginterferon alfa‐2a for 48 weeks. Serum HBsAg levels were quantified using the Abbott Architect HBsAg QT assay throughout treatment. Multiple regression analyses were performed to identify independent predictors of SR.

Results

Nineteen patients (31%) achieved SR with serum HBV DNA levels <312 copies/mL at 24 weeks post‐treatment. Serum HBsAg levels at 12 (OR 31.9; 95% CI 4.8–209.6; P = 0.0003) and 24 weeks of therapy (OR 8.8; 95% CI 2.0–38.0; P = 0.0035), and HBV DNA levels at baseline (OR 7.0; 95% CI 1.3–36.2; P = 0.0203), 12 (OR 7.9; 95% CI 1.2–48.4; P = 0.0249) and 24 weeks of therapy (OR 22.3; 95% CI 2.2–224.0; P = 0.0083) were early independent predictors of SR. A serum HBsAg cut‐off of 150 IU/mL at week 12 had an AUC, sensitivity, specificity and positive and negative predictive values of 0.75, 63%, 95%, 86% and 85% with respect to predicting SR respectively.

Conclusions

A quantitative serum HBsAg level at 12 weeks of therapy can be used for the early prediction of SR to peginterferon therapy in HBeAg‐negative CHB patients infected with genotype B or C.
Early relapse and refractory disease remain risk factors in the anthracycline and autologous transplant era for patients with relapsed/refractory classical Hodgkin lymphoma: a single centre intention‐to‐treat analysis
Authors: Greaves Paul , Wilson Andrew , Matthews Janet , Brown Daniel L. P. , Auer Rebecca , Montoto Silvia , Lister T. Andrew , Gribben John G
Published: January 2012

An intention‐to‐treat (ITT) analysis was performed in 103 unselected patients with relapsed/refractory classical Hodgkin lymphoma (CHL) comparing early relapse (<12 months) or failure of first‐line therapy (ER/FTF) with late relapses (LR). Seventy one percentage proceeded to high‐dose therapy/autologous stem cell rescue (HDT/ASCR) following salvage treatment. By ITT, 5‐year overall survival (OS) was 50% for ER/FTF compared to 73% for LR patients (P = 0·012). However OS was equivalent for both groups if salvage treatment response was adequate to proceed to HDT/ASCR. ER/FTF patients remain a high‐risk group largely due to a failure of salvage therapy: a point at which novel interventions could impact survival.
Acute splenic sequestration crisis in sickle cell disease: cohort study of 190 paediatric patients
Authors: Brousse Valentine , Elie Caroline , Benkerrou Malika , Odièvre Marie‐Hélène , Lesprit Emmanuelle , Bernaudin Francoise , Grimaud Marion , Guitton Corinne , Quinet Béatrice , Dangiolo Silvana , de Montalembert Mariane
Published: January 2012

Acute splenic sequestration crisis (ASSC) is an unpredictable life‐threatening complication of sickle cell disease (SCD) in infants. Here, our objective was to update available clinical information on ASSC. We retrospectively studied the 190 patients who were diagnosed at birth with SS or Sbeta0 in the Paris conurbation between 2000 and 2009 and who experienced ASSC. They had 437 ASSC episodes (0·06/patient‐year). Median age at the first episode was 1·4 years (0·1–7) and 67% of patients had more than one episode. Age was the only factor predicting recurrence: the risk was lower when the first episode occurred after 2 years versus before 1 year of age (hazard ratio, 0·60; 95% confidence interval, 0·41–0·88; P = 0·025). A concomitant clinical event was found in 57% of episodes. The mortality rate was 0·53%. The treatment consisted in watchful waiting without prophylactic blood transfusions or splenectomy in 103 (54%) patients and in a blood transfusion programme in 55 (29%) patients. Overall, splenectomy was performed in 71 (37%) patients, at a median age of 4·5 years (range, 1·9–9·4). In conclusion, aggressive treatment may be warranted in patients experiencing ASSC before 2 years of age. Randomized controlled trials are needed to define the best treatment modalities.
Monoclonal B‐cell lymphocytosis is closely related to chronic lymphocytic leukaemia and may be better classified as early‐stage CLL
Authors: Kern Wolfgang , Bacher Ulrike , Haferlach Claudia , Dicker Frank , Alpermann Tamara , Schnittger Susanne , Haferlach Torsten
Published: January 2012

The World Health Organization classification uses a cut‐off point of 5·0 × 109/l cells with a chronic lymphocytic leukaemia (CLL)‐phenotype in peripheral blood to discriminate between monoclonal B‐lymphocytosis (MBL) and B‐CLL. This study analysed 298 MBL patients by multi‐parameter flow cytometry, chromosome banding analysis (CBA)/fluorescence in situ hybridization (FISH), and IGHV mutation status and compared them with 356 CLL patients. In MBL, CBA more frequently revealed a normal karyotype and FISH identified less frequently del(6q), del(13q) (as sole alterations), and del(17)(p13). Within the MBL cohort, a shorter time to treatment (TTT) was found for ZAP‐70‐positivity, 14q32/IGH‐translocations (CBA), del(11)(q22·3) (FISH) and unmutated IGHV status. Higher CD38 and ZAP‐70 expression, del(11)(q22·3) (FISH), trisomy 12 (FISH), and 14q32/IGH‐translocations (CBA) were correlated with a shorter TTT in the combined cohort (MBL + CLL); a sole del(13)(q14) (FISH) correlated with longer TTT. Regarding overall survival, unmutated IGHV status and ‘other’ alterations (CBA) had an adverse impact. There was no correlation between the concentration of CLL‐cells and TTT or overall survival. Multivariate analysis confirmed a negative impact on TTT for del(11)(q22·3)/ATM, trisomy 12 (both by FISH), and 14q32/IGH‐translocations by CBA. These data emphasize a close relationship between MBL and CLL regarding clinically relevant parameters and provide no evidence to strictly separate these entities by a distinct threshold of clonal B‐cells.
Induction of GITRL expression in human keratinocytes by Th2 cytokines and TNF‐α: implications for atopic dermatitis
Authors: Byrne A. M. , Goleva E. , Chouiali F. , Kaplan M. H. , Hamid Q. A. , Leung D. Y.M.
Published: January 2012

Background

Glucocorticoid‐induced TNF receptor‐related protein ligand (GITRL), a ligand for the T cell co‐stimulatory molecule GITR, is expressed by keratinocytes and involved in chemokine production. The expression of GITRL in skin inflammation remains unknown.

Objectives

This study investigated cytokine regulation of keratinocyte GITRL expression.

Methods

Glucocorticoid‐induced TNF receptor expression was evaluated in cytokine‐treated human epidermal keratinocytes (HEK)s, murine PAM 212 cell line, murine and human skin explants by real time PCR, flow cytometry and immunostaining. Functional responses to GITR fusion protein were examined by real time PCR and ELISA. GITRL expression in AD and psoriasis was studied by immunohistochemistry.

Results

Skin biopsies from STAT6VT transgenic mice, which develop spontaneous atopic skin inflammation, were found by immunofluoresence, to have increased keratinocyte GITRL expression. Exposure to Th2 cytokines augmented GITRL mRNA expression in the murine PAM 212 keratinocytic cell line and murine skin explants. In contrast, GITRL mRNA and protein expression was only increased in HEKs and human skin explants in the presence of the combination of TNF‐α and Th2 cytokines. A synergistic effect of Th2 cytokines and GITR fusion protein on production of CCL17, the Th2 chemokine, by murine keratinocytes was demonstrated. Immunohistochemical staining showed that acute AD lesions have increased expression of GITRL compared with normal skin, chronic AD lesions and psoriatic plaques.

Conclusions and Clinical Relevance

Our studies demonstrate that GITRL expression is augmented by Th2 cytokines and TNF‐α in keratinocytes. Increased GITRL expression in acute AD skin lesions is shown. This observation suggests a link between cytokine‐regulated keratinocyte GITRL expression and its role in inflammatory responses in AD.
Priority effects among young‐of‐the‐year fish: reduced growth of bluegill sunfish (Lepomis macrochirus) caused by yellow perch (Perca flavescens)?
Authors: KAEMINGK MARK A. , JOLLEY JEFFREY C. , WILLIS DAVID W. , CHIPPS STEVEN R.
Published: January 2012

1. When available, Daphnia spp. are often preferred by age‐0 yellow perch and bluegill sunfish because of energetic profitability. We hypothesised that predation by age‐0 yellow perch could lead to a midsummer decline (MSD) of Daphnia spp. and that priority effects may favour yellow perch because they hatch before bluegill, allowing them to capitalise on Daphnia spp. prior to bluegill emergence.

2. Data were collected from 2004 to 2010 in Pelican Lake, Nebraska, U.S.A. The lake experienced a prolonged MSD in all but 1 year (2005), generally occurring within the first 2 weeks of June except in 2008 and 2010 when it occurred at the end of June. MSD timing is not solely related to seasonal patterns of age‐0 yellow perch consumption. Nevertheless, when Daphnia spp. biomass was low during 2004 and 2006–2010 (<4 mg wet weight L−1), predation by age‐0 yellow perch seems to have suppressed Daphnia spp. biomass (i.e. <1.0 mg wet weight L−1). The exception was 2005 when age‐0 yellow perch were absent.

3. Growth of age‐0 bluegill was significantly faster in 2005, when Daphnia spp. were available in greater densities (>4 mg wet weight L−1) compared with the other years (<0.2 mg wet weight L−1).

4. We conclude that age‐0 yellow perch are capable of reducing Daphnia biomass prior to the arrival of age‐0 bluegill, ultimately slowing bluegill growth. Thus, priority effects favour age‐0 yellow perch when competing with age‐0 bluegill for Daphnia. However, these effects may be minimised if there is a shorter time between hatching of the two species, higher Daphnia spp. densities or lower age‐0 yellow perch densities.
Prevalence of malignancies among U.S. male patients with haemophilia: a review of the Haemophilia Surveillance System
Authors: DUNN A. L. , AUSTIN H. , MICHAEL SOUCIE J.
Published: January 2012

Summary.  The prevalence of malignancies in US male patients with haemophilia, with or without concomitant viral infections, remains unknown. To estimate the prevalence of malignancy in US male patients with haemophilia. We investigated the prevalence of malignancies among male patients with haemophilia using data from a six‐state haemophilia surveillance project. Case patients with malignancies were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes abstracted from hospital records and death certificates during the surveillance period. Cancer prevalence rates were calculated for each year during the surveillance and compared with age‐ and race‐specific prevalence rates among the U.S. male population obtained from the Surveillance, Epidemiology and End Results (SEER) Program. A total of 7 cases of leukaemia, 23 cases of lymphoma and 56 classifiable solid malignancies were identified among 3510 case patients during a total of 15 330 annual data abstraction collections. The rates of leukaemia, lymphoma and liver cancer among case patients were significantly higher than the rates among U.S. males as judged by prevalence ratios of 3.1 [95% confidence interval (CI) = 1.4–7.0] and 2.9 (95% CI = 1.8–4.6), respectively. In contrast, the prevalence ratio of prostate cancer was lower than expected at 0.49 (95% CI = 0.31–0.77). Overall the prevalence of most cancers among case patients was similar to that of the U.S. male population. However, patients with haemophilia who have unexplained symptoms should be evaluated for malignancy.
Tooth bioengineering leads the next generation of dentistry
Authors: WANG YING , PRESTON BRIAN , GUAN GUOQIANG
Published: January 2012

International Journal of Paediatric Dentistry 2012; 22: 406–418

Background.  As a result of numerous rapid and exciting developments in tissue engineering technology, scientists are able to regenerate a fully functional tooth in animal models, from a bioengineered tooth germ. Advances in technology, together with our understanding of the mechanisms of tooth development and studies dealing with dentally derived stem cells, have led to significant progress in the field of tooth regeneration.

Aim and design.  This review focuses on some of the recent advances in tooth bioengineering technology, the signalling pathways in tooth development, and in dental stem cell biology. These factors are highlighted in respect of our current knowledge of tooth regeneration.

Results and conclusion.  An understanding of these new approaches in tooth regeneration should help to prepare clinicians to use this new and somewhat revolutionary therapy while also enabling them to partake in future clinical trials. Tooth bioengineering promises to be at the forefront of the next generation of dental treatments.