bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining FIB milling and conventional Argon ion milling techniques to prepare high‐quality site‐specific TEM samples for quantitative EELS analysis of oxygen in molten iron
Authors: MIYAJIMA N. , HOLZAPFEL C. , ASAHARA Y. , DUBROVINSKY L. , FROST D.J. , RUBIE D.C. , DRECHSLER M. , NIWA K. , ICHIHARA M. , YAGI T.
Published: October 2009

This paper reports a procedure to combine the focused ion beam micro‐sampling method with conventional Ar‐milling to prepare high‐quality site‐specific transmission electron microscopy cross‐section samples. The advantage is to enable chemical and structural evaluations of oxygen dissolved in a molten iron sample to be made after quenching and recovery from high‐pressure experiments in a laser‐heated diamond anvil cell. The evaluations were performed by using electron energy‐loss spectroscopy and high‐resolution transmission electron microscopy. The high signal to noise ratios of electron energy‐loss spectroscopy core‐loss spectra from the transmission electron microscopy thin foil, re‐thinned down to 40 nm in thickness by conventional Argon ion milling, provided us with oxygen quantitative analyses of the quenched molten iron phase. In addition, we could obtain lattice‐fringe images using high‐resolution transmission electron microscopy. The electron energy‐loss spectroscopy analysis of oxygen in Fe0.94O has been carried out with a relative accuracy of 2%, using an analytical procedure proposed for foils thinner than 80 nm. Oxygen K‐edge energy‐loss near‐edge structure also allows us to identify the specific phase that results from quenching and its electronic structure by the technique of fingerprinting of the spectrum with reference spectra in the Fe‐O system.
Assessing the contribution of off‐fault deformation to slip‐rate estimates within the Taupo Rift, New Zealand, using 3‐D ground‐penetrating radar surveying and trenching
Authors: McClymont Alastair Fergus , Villamor Pilar , Green Alan G.
Published: October 2009

We demonstrate that conventional palaeoseismic trenching and mapping techniques that do not account for the effects of off‐fault deformation can significantly underestimate a fault’s slip rate. Using combined interpretations of 3‐D ground‐penetrating radar (GPR) and palaeoseismic trench data, we show that drag folding and hangingwall and footwall horizontal‐axis rotations have accommodated up to 41% of total extension across a normal fault within the Taupo Rift, New Zealand, over the past 24.6 ± 1.0 cal. ka BP. Our results may explain why geologically determined fault‐slip rates for the central and southern Taupo Rift are anomalously low when compared with geodetic estimates. We suggest that a combination of GPR surveying and palaeoseismic trenching may help resolve differences between geodetically and geologically determined strain rates observed across active extensional regimes worldwide.
On the uniformity of anthropogenic Venice uplift
Authors: Gambolati Giuseppe , Teatini Pietro , Ferronato Massimiliano , Strozzi Tazio , Tosi Luigi , Putti Mario
Published: October 2009

A programme of Venice uplift because of seawater injection into a 600–800 m deep brackish aquifer underlying the lagoon has recently been advanced. As the actual spatial variability of the hydro‐geological parameters is to a large extent unknown, a controversial issue concerns the 25–30 cm heave prediction with the possible generation of differential displacements that might jeopardize the integrity of the architectural patrimony. It is shown that significant differential displacements have occurred in Venice in the past and are still presently occurring as evidenced by SAR interferometry. The results of a stochastic analysis addressing the variability of the hydraulic conductivity of the injected formation indicate that even a highly uneven aquifer expansion does not migrate to ground surface because of the smoothing effect exerted by the overburden. The predicted differential displacements are well below the values Venice is experiencing. Any a priori alarmism appears to be unfounded and unjustified.
Novel PORCN mutations in focal dermal hypoplasia
Authors: Froyen G , Govaerts K , Van Esch H , Verbeeck J , Tuomi M‐L , Heikkilä H , Torniainen S , Devriendt K , Fryns J‐P , Marynen P , Järvelä I , Ala‐Mello S
Published: October 2009

Focal dermal hypoplasia (FDH), Goltz or Goltz–Gorlin syndrome, is an X‐linked dominant multisystem disorder characterized primarily by involvement of the skin, skeletal system and eyes. We screened for mutations in the PORCN gene in eight patients of Belgian and Finnish origin with firm clinical suspicion of FDH. First, we performed quantitative PCR (qPCR) analysis to define the copy number at this locus. Next, we sequenced the coding regions and flanking intronic sequences of the PORCN gene. Three de novo mutations were identified in our patients with FDH: a 150‐kb deletion removing six genes including PORCN, as defined by qPCR and X‐array‐CGH, and two heterozygous missense mutations; c.992T>G (p.L331R) in exon 11 and c.1094G>A (p.R365Q) in exon 13 of the gene. Both point mutations changed highly conserved amino acids and were not found in 300 control X chromosomes. The three patients in whom mutations were identified all present with characteristic dermal findings together with limb manifestations, which were not seen in our mutation‐negative patients. The clinical characteristics of our patients with PORCN mutations were compared with the previously reported mutation‐positive cases. In this report, we summarize the literature on PORCN mutations and associated phenotypes.
Detailed molecular and clinical characterization of three patients with 21q deletions
Authors: Lindstrand A , Malmgren H , Sahlén S , Schoumans J , Nordgren A , Ergander U , Holm E , Anderlid BM , Blennow E
Published: October 2009

Lindstrand A, Malmgren H, Sahlén S, Schoumans J, Nordgren A, Ergander U, Holm E, Anderlid BM,Blennow E. Detailed molecular and clinical characterization of three patients with 21q deletions.

We have investigated three patients with 21q deletions, two with developmental delay, dysmorphic features and internal organ malformations, and one with cognitive function within the normal range but with some deficits in gross and fine motor development. All aberrations were characterized by array‐comparative genomic hybridization (array‐CGH). In addition, extensive fluorescence in situ hybridization (FISH) mapping on metaphase chromosomes and mechanically stretched chromosomes was performed on patient 1 who had an extremely complex intrachromosomal rearrangement with 16 breakpoints, four deletions and four duplications. Patients 2 and 3 had interstitial deletions comprising 21q21.1‐21q22.11 and 21q11.2‐21q21.3, respectively. Partial deletions of 21q are rare and these patients display a highly variable phenotype depending on the size and position of the deletion. A review of the literature identified 38 cases with pure 21q deletions. Twenty‐three of these had reliable mapping data. The combined information of present and previous cases suggests that the ITSN1 gene is involved in severe mental retardation in patients with 21q deletion. In addition, a critical region of 0.56 Mb containing four genes, KCNE1, DSCR1, CLIC6 and RUNX1, is associated with severe congenital heart defects, and deletions of the most proximal 15–17 Mb of 21q is associated with mild or no cognitive impairment, but may lead to problems with balance and motor function.
Partial splenic embolization and peg‐IFN plus RBV in liver transplanted patients with hepatitis C recurrence: safety, efficacy and long‐term outcome
Authors: Bárcena Rafael , Moreno Ana , Foruny José R , Blázquez Javier , Graus Javier , Riesco José M , Blesa Carlos , García‐Hoz Fernando , Sánchez Juan , Gil‐Grande Luis , Nuño Javier , Fortún Jesús , Rodriguez‐Sagrado Miguel A , Moreno Alberto
Published: October 2009

Bárcena R, Moreno A, Foruny JR, Blázquez J, Graus J, Riesco JM, Blesa C, García‐Hoz F, Sánchez J, Gil‐Grande L, Nuño J, Fortún J, Rodriguez‐Sagrado MA, Moreno A. Partial splenic embolization and peg‐IFN plus RBV in liver transplanted patients with hepatitis C recurrence: safety, efficacy and long‐term outcome. Clin Transplant 2010: 24: 366–374. © 2009 John Wiley & Sons A/S.

Abstract: Background:  There is limited information on the long‐term outcome in liver transplant (LT) subjects undergoing partial splenic embolization (PSE) prior to full dose pegylated interferon/ribavirin (peg‐IFN/RBV).

Methods:  Retrospective review of eight LT subjects after PSE and antiviral therapy.

Results:  Baseline platelets and neutrophils were <50 000 cells/mL and <1000 cells/mL in 75% and 50%. Mean splenic infarction volume was 85 ± 13%. PSE produced major complications in three (37.5%): recurrent sterile netrophilic ascites and renal insufficiency (n = 2), and splenic abscess (n = 1). Full‐dose peg‐IFN/RBV was started in seven (87.5%), with two early withdrawals (28.6%) despite early virological response (toxicity and infection); both subjects died. Anemia led to RBV dose‐adjustment in six (86%), with human recombinant erythropoietin (EPO) use in four (57%). No peg‐IFN adjustments or granulocyte‐colonies stimulating factor were needed. Two patients reached sustained virological response (SVR) (28.6%). Two non‐responders maintained prolonged therapy with biochemical/histological improvement. After a median follow‐up of 151 wk, we observed significant improvements in hematological parameters, aspartate aminotransferase, alanine aminotransferase, international normalized ratio, and prothrombin activity.

Conclusions:  Extensive PSE after LT produced significant morbidity (37.5%). Peg‐IFN/RBV was completed in five out of seven (71%), with SVR in two (28.6%). RBV adjustement due to anemia was high despite EPO use. Only patients able to complete or maintain antiviral therapy survived, with long‐term significant benefits in hematological parameters and liver function tests.
Putative function of cytochrome b559 as a plastoquinol oxidase
Authors: Bondarava Natallia , Gross Christine M. , Mubarakshina Maria , Golecki Jochen R. , Johnson Giles N. , Krieger‐Liszkay Anja
Published: October 2009

The function of cytochrome b559 (cyt b559) in photosystem II (PSII) was studied in a tobacco mutant in which the conserved phenylalanine at position 26 in the β‐subunit was changed to serine. Young leaves of the mutant showed no significant difference in chloroplast ultra structure or in the amount and activity of PSII, while in mature leaves the size of the grana stacks and the amount of PSII were significantly reduced. Mature leaves of the mutant showed a higher susceptibility to photoinhibition and a higher production of singlet oxygen, as shown by spin trapping electron paramagnetic resonance (EPR) spectroscopy. Oxygen consumption and superoxide production were studied in thylakoid membranes in which the Mn cluster was removed to ensure that all the cyt b559 was present in its low potential form. In thylakoid membranes, from wild‐type plants, the larger fraction of superoxide production was 3‐(3,4‐dichlorophenyl)‐1,1‐dimethylurea‐sensitive. This type of superoxide formation was absent in thylakoid membranes from the mutant. The physiological importance of the plastoquinol oxidation by cyt b559 for photosynthesis is discussed.
ROS in plant development
Authors: Swanson Sarah , Gilroy Simon
Published: October 2009

Reactive oxygen species (ROS) are now recognized as important regulators of plant developmental programs and recent work on tip‐growing systems has revealed a central role for the NADPH oxidases in generating such developmentally important ROS. Tip‐growing cells have also shown that the functions of cytosolic ROS, acting as regulators of activities such as ion channel gating, are closely linked to those of ROS produced to the apoplast, where they act to modulate cell wall properties. Thus, coordination of ROS production and their activities between compartments is emerging as an important theme in our understanding of how growth and developmental programs are integrated.
Differential accumulation of volatile terpene and terpene synthase mRNAs during lavender (Lavandula angustifolia and L. x intermedia) inflorescence development
Authors: Guitton Yann , Nicolè Florence , Moja Sandrine , Valot Nadine , Legrand Sylvain , Jullien Frédéric , Legendre Laurent
Published: October 2009

Despite the commercial importance of Lavandula angustifolia Mill. and L. x intermedia Emeric ex Loisel floral essential oils (EOs), no information is currently available on potential changes in individual volatile organic compound (VOC) content during inflorescence development. Calyces were found to be the main sites of VOC accumulation. The 20 most abundant VOCs could be separated into three sub‐groups according to their patterns of change in concentration The three groups of VOCs sequentially dominated the global scent bouquet of inflorescences, the transition between the first and second groups occurring around the opening of the first flower of the inflorescence and the one between the second and third groups at the start of seed set. Changes in calyx VOC accumulation were linked to the developmental stage of individual flowers. Leaves accumulated a smaller number of VOCs which were a subset of those seen in preflowering inflorescences. Their nature and content remained constant during the growing season. Quantitative real time polymerase chain reaction assessments of the expression of two terpene synthase (TPS) genes, LaLIMS and LaLINS, revealed similar trends between their patterns of expression and those of their VOC products. Molecular and chemical analyses suggest that changes in TPS expression occur during lavender inflorescence development and lead to changes in EO composition. Both molecular data and terpene analysis support the findings that changes in biosynthesis of terpene occurred during inflorescence development.
Boost of mucosal secretory immunoglobulin A response by clarithromycin in paediatric influenza
Authors: SAWABUCHI Takako , SUZUKI Satoshi , IWASE Kazuhiro , ITO Chika , MIZUNO Dai , TOGARI Hajime , WATANABE Isamu , TALUKDER Sadiqur R. , CHIDA Junji , KIDO Hiroshi
Published: October 2009

Background and objective: The antiviral neuraminidase inhibitor oseltamivir (OSV) is used to treat influenza. The macrolide clarithromycin (CAM) is used to treat bacterial infections and has anti‐inflammatory and immunomodulatory activities. This retrospective study investigated the immunomodulatory effects of CAM in children presenting with influenza A.

Methods: The study recruited 40 children with acute influenza, and grouped them according to the treatment received: 5‐day treatment with OSV (n = 14), CAM (n = 8), OSV + CAM (n = 12) and untreated (n = 6). The before and after treatment comparisons were made of the level of secretory IgA (sIgA) against influenza A virus (H3N2) and (H1N1), total sIgA, viral RNA copy numbers in nasopharyngeal aspirates and disease symptoms.

Results: Infection induced anti‐viral mucosal sIgA in the nasopharyngeal aspirates of most patients of all treatment groups. Particularly prominent increases in the levels were found in the CAM and OSV + CAM groups. Low induction of anti‐viral sIgA was observed in the OSV group, but the addition of CAM to OSV augmented sIgA production and restored local mucosal sIgA levels. The frequency of residual cough in the OSV + CAM group was significantly lower than in the other groups including the group treated with OSV.

Conclusions: CAM boosted the nasopharyngeal mucosal immune response in children presenting with influenza A, even in those treated with OSV who had low production of mucosal anti‐viral sIgA, and alleviated the symptoms of influenza.
Black Saturday: The personal recollection of a doctor working during the worst bushfire in Australian history
Authors: Moloney John
Published: October 2009

The date, 7 February 2009, will be known forever in Victoria, Australia as “Black Saturday”. In the worst bushfires in Australian history, 173 lives were lost. Townships were razed. Over 1800 homes were destroyed, resulting in > 7000 people being made homeless. The provision of health care to the injured, and then to the displaced communities, was provided by a range of health professionals, including paramedics, nurses, and doctors. This is a personal recollection of the related events.
Early psychosocial interventions after disasters, terrorism, and other shocking events: Guideline development
Authors: Te Brake Hans , Dückers Michel , De Vries Maaike , Van Duin Daniëlle , Rooze Magda , Spreeuwenberg Cor
Published: October 2009

Although most victims of disasters, terrorism, or other shocking events recover on their own, a sizable amount of these victims develops long‐term disaster‐related problems. These victims should receive timely and appropriate psychosocial help. This article describes the development of guidelines on psychosocial interventions during the first 6 weeks after a major incident. Scientific literature, expert opinions, and consensus among relevant parties in the clinical field were used to formulate the recommendations. Early screening, a supportive context, early preventive and curative psychosocial interventions, and the organization of interventions are covered. The implications for the clinical field and future research are discussed. It is concluded that the international knowledge base provides valuable input for the development of national guidelines. However, the successful implementation of such guidelines can take place only if they are legitimated and accepted by local key actors and operational target groups. Their involvement during the development process is vital.
Moyamoya‐disease‐related ischemic stroke in the postpartum period
Authors: Miyakoshi Kei , Matsuoka Misugi , Yasutomi Daisuke , Tanaka Mamoru , Yakubo Kazumi , Fukuiya Tatsuro , Yoshimura Yasunori
Published: October 2009

Stroke during pregnancy or the puerperium is an extremely rare yet serious cause of perinatal morbidity and mortality. Moyamoya disease, a cerebrovascular occlusive pathology with a female predominance, may become symptomatic for the first time in association with pregnancy. A 36‐year‐old woman with postpartum pre‐eclampsia suddenly developed hemiparesis in the left arm with dysarthria after the initiation of antihypertensive measures. Cranial magnetic resonance imaging and angiography revealed acute ischemic lesions in the right hemisphere along with the steno‐occlusive lesions of bilateral terminal portions of the internal carotid artery, indicating Moyamoya disease. With anti‐platelet medication, the patient recovered gradually and was diagnosed as having Moyamoya disease using conventional angiography 3 months postpartum. In this case, the fluctuations in blood pressure in association with pre‐eclampsia appear to have exacerbated the clinical symptoms of Moyamoya disease. As such, Moyamoya disease should be considered as an underlying disease of ischemic stroke associated with pregnancy.
A survey of the knowledge and attitudes of pregnant Thai women towards Down syndrome screening
Authors: Pruksanusak Ninlapa , Suwanrath Chitkasaem , Kor‐anantakul Ounjai , Prasartwanakit Visit , Leetanaporn Roengsak , Suntharasaj Thitima , Hanprasertpong Tharangrut
Published: October 2009

Aim:  To determine the knowledge and attitudes of pregnant Thai women towards Down syndrome screening.

Methods:  A total of 714 pregnant women were recruited attending antenatal clinics in Songklanagarind Hospital from February through June 2007. Their knowledge and attitudes concerning Down syndrome screening were evaluated through self‐administered questionnaires. The data were analyzed using SPSS version 12.0.

Results:  The mean age of the respondents was 29.9 ± 6.4 years. Regarding their knowledge of Down syndrome and its screening test, the mean scores were 43.6% and 20.6%, respectively. Most pregnant women (77.6%) had a positive attitude to Down syndrome screening. In addition, 92.2% of cases would accept a Down syndrome screening test. Multivariate logistic regression analysis showed that levels of education and types of health insurance were factors associated with knowledge of Down syndrome screening. Maternal age was the only factor affecting attitudes.

Conclusion:  Most pregnant women had inadequate knowledge of Down syndrome and the screening test. However, they did have a positive attitude and were willing to accept the test. Providing knowledge on Down syndrome and the screening test for pregnant women should be implemented in our antenatal care services and community.
Maternal plasma soluble fms‐like tyrosine kinase‐1 and placental growth factor levels as biochemical markers of gestational hypertension for Malaysian mothers
Authors: Nadarajah Vishna D. , Min Richard G. L. Y. , Judson John P. , Jegasothy Ravindran , Ling Elena H. P.
Published: October 2009

Aims:  To establish baseline levels of maternal plasma soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) among normotensive Malaysian mothers and to compare the marker levels between normotensives and mothers with gestational hypertension (GH).

Methods:  Plasma sFlt‐1 and PlGF were measured by enzyme‐linked immunosorbent assay in an unmatched, case–control study. The results were subjected to normality testing and analyzed by Mann–Whitney U‐tests.

Results:  Among normotensive mothers, both sFlt‐1and PlGF showed a general increase in levels from the 24th to 32nd weeks of pregnancy. PlGF levels in normotensive mothers with gestational diabetes mellitus were reduced compared to those without the disease, while levels of sFlt‐1 were elevated. Mothers with GH had reduced levels of PlGF with increased levels of sFlt‐1 when compared to normotensive mothers. Among the normotensive mothers followed up until delivery, the inversed pattern of reduced PlGF and increased sFlt‐1 marker levels was found in 40% of those who developed GH later in pregnancy.

Conclusions:  Plasma levels of sFlt‐1and PlGF in normotensive mothers may be influenced by gestational diabetes mellitus and GH. GH mothers show an inversed pattern of marker levels compared to normotensive mothers.
Two cases of reversal of twin‐twin transfusion syndrome diagnosed by measuring hourly fetal urine production
Authors: Sumie Masahiro , Nakata Masahiko , Murata Susumu , Miwa Ichiro , Sugino Norihiro
Published: October 2009

Reversal of twin‐twin transfusion syndrome (TTTS) is a rare complication of monochorionic pregnancy. Diagnostic criteria and satisfactory therapeutic options have not been reported. We make a suggestion of diagnosis and therapy for reversal of TTTS. We report two cases of reversal of TTTS. Measurement of the fetal urine production rate was useful for management and better comprehension of the cases. In case 1, double intrauterine fetal demise occurred before the criteria for TTTS were fulfilled, in which each fetal urine production rate reversed prior to the change of amniotic fluid volume. In case 2, elevated urine production was noted prior to progressive polyhydroamnios and congestive heart failure in the new recipient and the fetoscopic laser photocoagulation of the placental communicating vessels was performed successfully before the criteria for TTTS were fulfilled. Both infants required intensive care, but developed normally and showed no neurologic complications at 2 years after birth. Hourly fetal urine production rate was useful for immediate diagnosis of reversal of TTTS, and laser photocoagulation of the placental communicating vessels is thus a method for the correction of the fetal blood flow imbalance in cases of reversal of the donor‐recipient phenotype in TTTS.
Oral hydration therapy in oligohydramnios
Authors: Ghafarnejad Marzieh , Tehrani Mehrnaz Barzi , Anaraki Fatemeh Baradaran , Mood Narges Izadi , Nasehi Leyla
Published: October 2009

Aim:  Oligohydramnios is a threatening condition to fetal health, for which some treatments are available, or are under evaluation. We aimed to assess the effect of acute oral hydration on maternal amniotic fluid index (AFI).

Methods:  An randomized controlled trial was conducted on 44 pregnant women diagnosed by sonography to have oligohydramnios (2.1 < AFI < 6 cm).

Results:  The mean AFI before intervention was 50.8 in the intervention group and 52.1 in the control group. After intervention, the mean AFI was 67.2 and 52.5 in the intervention and control groups, respectively, (P < 0.001, t‐test = 3.827). The mean urinary specific gravity (USG) change was 13.4 after oral hydration in the intervention group and 1.68 in the control group (P < 0.001, t‐test = 3.954).

Conclusion:  Acute oral hydration is a noninvasive, easily accessible and cheap intervention, and an effective way of increasing AFI.
Luteoma‐induced fetal virilization
Authors: Ugaki Hiromi , Enomoto Takayuki , Tokugawa Yoshihiro , Kimura Tadashi
Published: October 2009

A pregnancy luteoma represents an unusual response of ovarian stromal cells to the altered hormonal levels of pregnancy. It is a distinctive non‐neoplastic lesion characterized by solid proliferations of luteinized cells resulting in a tumor‐like ovarian enlargement. Most patients are asymptomatic; the ovarian enlargement is usually discovered incidentally at cesarean section or during postpartum tubal ligation. We report a typical case that we found at cesarean section to be associated with a virilized infant who manifested clitoromegaly and labial fusion. We detected an increased level of testosterone in the maternal patient. We concluded that the ovarian luteoma induced the fetal virilization.
Effect of human chorionic gonadotrophin on in vitro contractions of stimulated detrusor muscle strips of female rats
Authors: Rizk Diaa E. E. , Osman Nawal A. , Shafiullah Mohammed M. , Nagelkerke Nicolaas J. D. , Fahim Mohammed A.
Published: October 2009

Aims:  We studied the effect of human chorionic gonadotrophin (hCG) on the in vitro detrusor muscle contractions in female rats.

Methods:  Two adjacent detrusor muscle strips from the bladder dome of 18 female Wistar rats (230–250 gm) were mounted in an organ bath for the recording of isometric tension. Carbachol (10−9–10−3 M), α,β methylene adenosine 5′‐triphosphate (ATP) (10−9–10−3 M) and potassium chloride (KCl) (10−4–10−3 M) were applied (n = 6 × 3 groups). Concentration‐response curves, before and after the addition of hCG (100 iu/mL) or oxybutynin (10−5 M) to either muscle strip, were compared.

Results:  All curves were displaced to the right by hCG in a concentration‐dependent manner with significant inhibition of contractions induced by carbachol (P < 0.001) and KCl (P = 0.016) but not those induced by α,β‐methylene ATP (P = 0.4). Estimated order of potency of inhibition was carbachol>KCl>α,β‐methylene ATP. The overall inhibitory effect of hCG was significantly less than oxybutynin (P < 0.001).

Conclusions:  hCG significantly inhibited in vitro detrusor contractions induced by depolarization (KCl) and cholinergic (carbachol) but not purinergic (α,β‐methylene ATP) stimulation in a dose‐dependent manner in female rats.
Relevance of declines in serum human chorionic gonadotropin levels to the management of persistent ectopic pregnancy
Authors: Abe Takashi , Akira Shigeo , Negishi Yasuyuki , Ichikawa Masao , Nakai Akihito , Takeshita Toshiyuki
Published: October 2009

Aim:  To evaluate postoperative declines in serum human chorionic gonadotropin (hCG) levels (percentages of preoperative hCG levels) to rule out persistent ectopic pregnancy (PEP).

Methods:  A retrospective study was conducted on 50 patients who underwent laparoscopic salpingotomy between April 1995 and March 2008. The postoperative course was divided into four periods: (period A: days 1–2; period B: days 3–4; period C: days 5–6; and period D: days 7–8), and the postoperative serum hCG declines in the PEP and control groups (successfully treated patients) were compared. A cutoff value of serum hCG decline to rule out PEP was established by receiver operating characteristic (ROC) analysis.

Results:  Ten of the 50 patients (20%) were diagnosed with PEP. There were no differences in clinical findings or preoperative serum hCG levels between the two groups. From period C, the serum hCG decline in the control group was significantly greater than in the PEP group, and all individual serum hCG declines in the PEP group were outside the 95% confidence interval of the control group. Furthermore, analysis by ROC using a 14% decline in postoperative serum hCG as a cutoff revealed that the specificity and sensitivity of the test were equal to 100% from period C.

Conclusion:  Declines in serum hCG during period C (days 5–6) constitute an important marker of the presence or absence of PEP. Decisions regarding a second intervention for PEP should be made by this time postoperatively.
The prevalence of hereditary breast/ovarian cancer risk in patients with a history of breast or ovarian cancer in Japanese subjects
Authors: Komata Dai , Yahata Tetsuro , Kodama Shoji , Koyama Yu , Takeda Nobuo , Tajima Kenzo , Makino Haruhiko , Sato Nobuaki , Muto Ichiro , Hatakeyama Katsuyoshi , Tanaka Kenichi
Published: October 2009

Aim:  Women at high risk for hereditary breast/ovarian cancer require specific management strategies for cancer prevention and early detection. The authors sought to determine the prevalence of family histories suggestive of a hereditary breast/ovarian cancer syndrome in patients with a personal history of breast or ovarian cancer in Japanese women.

Methods:  Family history (first‐ and second‐degree relatives) data were collected by a self‐administered questionnaire for women with a history of breast or ovarian cancer in six major cancer treating hospitals in Niigata prefecture, Japan.

Results:  Data were obtained from 1463 women: 626 women with a history of breast cancer, 289 women with a history of ovarian cancer and 548 women without a history of any cancer as controls. Women with a family history of breast and/or ovarian cancer had OR of breast cancer of 2.3 (95% confidential interval [CI] 1.5–3.7) and ovarian cancer of 2.2 (95% CI 1.3–3.8). The risk was higher when the proband was younger or when two or more relatives were affected. Among women with a history of breast or ovarian cancer, 7.5% met the criteria for a 10% risk of a BRCA1 or BRCA2 mutation according to the Myriad model.

Conclusion:  Obtaining a detailed breast and ovarian cancer family history and the application of the Myriad model is useful for identifying women at an elevated genetic risk of breast and ovarian cancer. The estimation for the prevalence of hereditary breast/ovarian cancer syndrome has significant implications for a patient's management, as well as for the capacity for risk assessment and testing.
Reduced‐dose rocuronium for day‐case tonsillectomy in children where volatile anaesthetics are not used: operating room time saving
Authors: BARTOLEK DUBRAVKA , JAKOBOVIĆ JASMINKA , BARTOLEK FRANJO , FINCI DIJANA , MUNJIZA ALEKSANDRA
Published: October 2009

Objectives:  Mivacurium, rocuronium, and vecuronium are neuromuscular blocking agents (NMB) commonly used in pediatric day‐case anesthesia. Mivacurium is the most appropriate NMB for short surgical procedures where NMB drugs were required but is not available in all countries.

Aim:  We evaluated the operating room time minimization after reduced‐dose rocuronium (0.45 mg·kg−1) during elective day‐case tonsillectomy in children.

Methods/Materials:  One hundred and five children (6–9 years, ASA I/II status) scheduled for day‐case tonsillectomy were included in prospective, double blind clinical study. Children were randomly divided in three equal groups. All children were premedicated (midazolam 0.25 mg·kg−1 orally, EMLA). Anesthesia was induced (2.5 mg·kg−1) and maintained (0.1 mg·kg−1·min−2) by propofol and alfentanil (0.0015 mg·kg−1·min−1) and supplemented by inhalation mixture of 50% of O2/Air. Neuromuscular block was achieved by vecuronium (0.1 mg·kg−1) (V) or rocuronium in standard (0.6 mg·kg−1) (R) or reduced dose (0.45 mg·kg−1) (LD). Neuromuscular transmission was monitored by acceleromyography. Time analysis of NMB drugs action was performed.

Results:  Time difference from the end of tonsillectomy to T90 neuromuscular block recovery was significantly shorter in LD Group (7.3 ± 0.41 min), (V = 15.9 ± 1.06, R = 16.0 ± 1.7 min) (P = 0.0011). The onset time of neuromuscular block was prolonged in LD Group (LD=3.1 ± 0.4, R = 1.3 ± 0.4, V = 2.2 ± 0.2 min) (P = 0.0039) without changing the intubating conditions. The maximum operation room time saving per each tonsillectomy was 37% in LD Group (Group V 21%, Group R 17%) (P = 0.0001). Low incidence of postoperative nausea and vomiting (PONV) 3–6% (0.4577) and good visual analog scale (VAS) score (≤2) (0.5969) were found in all study groups 12 h after surgery.

Conclusions:  Reduced‐dose rocuronium in addition with propofol and alfentanil in children where volatile anesthetics are not used effectively saves the operating room time during short elective surgical procedures, avoids delays in patient recovery, allows high level of acceptable intubating conditions, and improves the optimal surgical work. Low incidences of PONV as VAS score may achieved successfully.
The comparative prevalence and demographic impact of two pathogens in swarming Ips typographus adults: a quantitative analysis of long term trapping data
Authors: Wegensteiner Rudolf , Dedryver Charles‐Antoine , Pierre Jean‐Sébastien
Published: October 2009

Adult Ips typographus were collected using pheromone traps at a locality in the eastern part of Austria between 1995 and 2004. The occurrence of two pathogens, Gregarina typographi and Chytridiopsis typographi, was determined throughout the period of beetle swarming activities. Weekly and annual data sets were then analysed by smoothing statistical techniques and epidemiological models.

The pathogens spread differently within the beetle population with respect to their biological characteristics: infectious forms of C. typographi were immediately available after their development in the insect's gut, but not those of G. typographi.

Both of the pathogens had a low prevalence in swarming beetles, especially C. typographi, and there was no evidence of a between‐year or within‐year epidemiological process. Conversely, it was shown that G. typographi has a positive effect on the rate of increase of trapped beetles.

Fitting a nonlinear model to the data suggested that: (i) this was due to a higher catch ability of beetles infected with G. typographi than of healthy beetles; (ii) when this effect is taken into account, G. typographi induces a specific within‐year low mortality in beetle populations; and (iii) beetle populations increase naturally within a year, despite their infection by both pathogens. No clear effect of C. typographi was detected in the trapped data set when the prevalence of this species was high in beetle populations collected from trees.

It is hypothesized that both pathogens induce different behavioural effects on their host, resulting in: (i) favouring the trapping of G. typographi‐infected beetles and (ii) hindering the capture of C. typographi‐infected individuals. This could be the result of both of the pathogens having an opposite effect on the flight abilities of beetles and/or on the beetles' response to the aggregation pheromones used in the traps.
−509C>T polymorphism in the TGF‐β1 gene promoter is not associated with susceptibility to and progression of colorectal cancer in Chinese
Authors: Qi P. , Ruan C.‐P. , Wang H. , Zhou F.‐G. , Zhao Y.‐P. , Gu X. , Gao C.‐F.
Published: October 2009

Aim  Colorectal cancer is common, accounting for nearly 10% of all cancers. Transforming growth factor‐β1 (TGF‐β1) is a pleiotropic cytokine that has been implicated in the pathogenesis of colorectal neoplasia. The most studied −509C>T polymorphism of TGF‐β1 gene has been associated with various kinds of cancer. This study investigated the association between this genetic variant and the risk and/or progression of colorectal cancer.

Method  A case–control study was carried out of 150 colorectal cancer cases and 503 healthy controls. DNA was extracted from blood cell nuclear materials, and −509C>T polymorphism in the TGF‐β1 gene promoter was genotyped by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Colorectal cancer tissues (n = 70) were obtained from the studied cases for measurement of TGF‐β1 mRNA expression levels. We also assessed the plasma TGF‐β1 levels of cases (n = 88) and healthy subjects (n = 120).

Results  The TGF‐β1 producer genotype, −509TT, was not associated with an increased risk of colorectal cancer compared with other genotypes. Colorectal cancer patients especially those with a more aggressive disease behaviour were more frequently associated with C allele.

Conclusion  The results suggest that TGF‐β1 −509C>T polymorphism is not associated with either an increased risk or progression of colorectal cancer.
Association between interleukin‐4R and TGF‐β1 gene polymorphisms and the risk of colorectal cancer in a Korean population
Authors: Lee Y. S. , Choi H. B. , Lee I. K. , Kim T. G. , Oh S. T.
Published: October 2009

Aim  Colorectal cancer is associated with inflammatory bowel disease. The mechanisms of how different genetic make‐ups of cytokines might influence the individual susceptibility to develop particular types of tumours are still unknown. The authors analysed the association between genetic polymorphisms in cytokine/cytokine receptor genes and the risk of colorectal cancer in a Korean population.

Method  The authors assessed polymorphisms of the interleukin: IL‐1, IL‐1R, IL‐2, IL‐4, IL‐4R, IL‐10, transforming growth factor (TGF)‐β1, IFN‐γ genes in Korean patients with colorectal cancer (n = 170) and in a normal healthy control group (n = 130) to investigate the association between theses cytokine gene polymorphisms and the risk of colorectal cancer.

Results  The IL‐4R 1902*T allele was found to be associated with an increased risk of colon cancer (P < 0.01, OR = 2.0) and rectal cancer (P < 0.05, OR = 1.8). The IL‐4R 1902*C allele was associated with a decreased risk of both colon cancer (P < 0.01, OR = 0.51) and rectal cancer (P < 0.05, OR = 0.5). The TFG‐β1 10*T allele was found to be associated with an increased risk of colon cancer (P < 0.00, OR = 2.3) and the TFG‐β1 10*C allele with a decreased risk of colon cancer (P < 0.00, OR = 0.43).

Conclusion  These results suggest that the genetic polymorphisms of IL‐4R and TGF‐β1 are associated with the risk of colorectal cancer in a Korean population.
Hygiene and urinary tract infections after cystectomy in 452 Swedish survivors of bladder cancer
Authors: Thulin Helena , Steineck Gunnar , Kreicbergs Ulrika , Onelöv Erik , Ahlstrand Christer , Carringer Malcolm , Holmäng Sten , Ljungberg Börje , Malmström Per‐Uno , Robinsson David , Wijkström Hans , Wiklund N. Peter , Henningsohn Lars
Published: October 2009

Study Type – Symptom prevalence (retrospective cohort) Level of Evidence 2b

OBJECTIVES

To determine whether or not an improved hygiene can lessen the incidence of symptomatic urinary tract infections (UTIs) in patients treated by cystectomy for urinary bladder cancer.

PATIENTS AND METHODS

We attempted to contact during their follow‐up all men and women aged 30–80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified hygienic measures and included them in a study‐specific questionnaire. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results presented as relative risks (RR) with 95% confidence interval.

RESULTS

We received the questionnaire from 452 (92%) of 491 identified patients. The proportion of patients who had a symptomatic UTI in the previous year was 22% for orthotopic neobladder and cutaneous continent reservoir, and 23% for non‐continent urostomy diversion. The RR for a UTI was 1.1 (0.5–2.5) for ‘never washing hands’ before handling with catheters or ostomy material. Patients with diabetes mellitus had a RR of 2.1 (1.4–3.2) for having a symptomatic UTI.

CONCLUSIONS

We could not confirm lack of hygiene measures as a cause of UTI for men and women who had a cystectomy with urinary diversion. Patients with diabetes mellitus have a greater risk of contracting a UTI.
Activity of ketoconazole after taxane‐based chemotherapy in castration‐resistant prostate cancer
Authors: Nakabayashi Mari , Oh William K. , Jacobus Susanna , Regan Meredith M. , Taplin Mary‐Ellen , Kantoff Philip W. , Rosenberg Jonathan E.
Published: October 2009

Study Type – Therapy (case series)Level of Evidence 4

OBJECTIVE

To assess the efficacy of the androgen‐synthesis inhibitor ketoconazole as a secondary hormonal therapy in patients with castration‐resistant prostate cancer (CRPC) previously treated with chemotherapy, as persistent androgens appear to play a role in the development and maintenance of CRPC.

PATIENTS AND METHODS

We retrospectively identified 34 patients with CRPC who were treated with ketoconazole as a secondary hormonal therapy after paclitaxel‐ or docetaxel‐based chemotherapy for CRPC. They were treated with ketoconazole 200–400 mg three times daily with or without hydrocortisone. Patients with previous use of ketoconazole were excluded. Half the patients had received estramustine as part of their chemotherapy regimen. The primary endpoint was the proportion of patients with a decline of ≥50% in their prostate‐specific antigen (PSA) level. PSA progression was defined by the PSA Working Group 1 Criteria.

RESULTS

Eight of the 32 evaluable patients (25%) had a PSA decline of ≥50%. The median time to progression (TTP) was 3 months (95% confidence interval, 1.2–5.4). A history of previous response to taxane‐based chemotherapy was not associated with the response to ketoconazole. However, previous use of oestrogens for CRPC was significantly associated with a shorter TTP on ketoconazole (1.5 vs 10.2 months; P = 0.03).

CONCLUSIONS

Ketoconazole has moderate activity as secondary hormonal therapy in patients with CRPC previously treated with taxane‐based chemotherapy, although the TTP was short. Previous treatment with oestrogenic therapy is associated with a shorter TTP.
The Disappearance of the State from “Livable” Urban Spaces
Authors: Hankins Katherine B. , Powers Emily M.
Published: October 2009

Abstract:  This paper examines the absence of the state from the discourses and practices of “livable” urban spaces. Drawing from an ethnography of Atlantic Station, the USA's largest new urbanist infill development, we argue that “livable” urban spaces are increasingly arenas for luxury, theater, and consumption, and that the state, while an important actor in the creation of urban spaces such as Atlantic Station, has largely been made invisible. We see this in the absence of public institutions, such as schools, parks, and libraries, and in the absence of a collective political identity among Atlantic Station patrons. The disappearance of the state in the material spaces of the city suggests that the neoliberal project of individualism and consumerism is transforming the very notion of livability and the democratic possibilities of what makes urban space “livable”.
Acts of Aid: Neoliberalism in a War Zone
Authors: Hyndman Jennifer
Published: October 2009

Abstract:  International aid is a dynamic bundle of geographical relationships at the intersection of war, neoliberalism, nature, and fear. The nexus between development and security warrants further conceptualization and empirical grounding beyond the instrumentalist and alarmist discourses that underwrite foreign aid. This article examines two such discourses, that of “aid effectiveness” and securitization, that serve to frame an analysis of aid to Sri Lanka. Since 1977, neoliberal policies of international assistance have shaped the country's economy and polity, and, since 1983, government troops and militant rebels have been at war. International aid focuses on economic development and support for peace negotiations, but little attention has been paid to the ways in which these agendas intersect to shape donor behavior and aid delivery. Drawing from research on international aid agencies operating in Sri Lanka, in particular the Canadian International Development Agency, the geopolitics of aid are analyzed.
Breeding Influenza: The Political Virology of Offshore Farming
Authors: Wallace Robert G.
Published: October 2009

Abstract:  The geographic extent, xenospecificity, and clinical course of influenza A (H5N1), the bird flu strain, suggest the virus is an excellent candidate for a pandemic infection. Much attention has been paid to the virus's virology, pathogenesis and spread. In contrast, little effort has been aimed at identifying influenza's social origins. In this article, I review H5N1's phylogeographic properties, including mechanisms for its evolving virulence. The novel contribution here is the attempt to integrate these with the political economies of agribusiness and global finance. Particular effort is made to explain why H5N1 emerged in southern China in 1997. It appears the region's reservoir of near‐human‐specific recombinants was subjected to a phase change in opportunity structure brought about by China's newly liberalized economy. Influenza, 200 nm long, seems able to integrate selection pressures imposed by human production across continental distances, an integration any analysis of the virus should assimilate in turn.
Labour Migration, Neoliberalism and Ethno‐politics in the New Europe: The Latvian Case
Authors: Woolfson Charles
Published: October 2009

Abstract:  The accession of the new European Union (EU) member states of Eastern Europe has highlighted ambivalence towards migration within the older member states. That same ambivalence has been less frequently discussed in the new. The former Soviet republic of Latvia serves as a case study of a new member state facing intensified pressure to accept inward migration to meet labour shortages, in part, a consequence of EU accession. Confounding appropriate political and policy responses is the sensitive issue of “ethnic balance”, a troubled “legacy” of Latvian history. This has been characterised as comprising a “regime of discrimination” against the Russian‐speaking minority. In the context of changes in the global migratory landscape, the potential for a renewed of regime of discrimination is emerging, based on an ethno‐politics that has wider European resonance.
Tibet and the Problem of Radical Reductionism
Authors: Yeh Emily T.
Published: October 2009

Abstract:  This article takes issue with a mode of argumentation advanced by a number of left‐leaning, radical scholars, including those associated with China's New Left, about the causes of the Tibetan unrest in China in spring 2008. According to this stance, the Tibetan protests were the result of external manipulation by neoconservative, reactionary forces, ranging from the CIA to the Dalai Lama. The unstated premise of this response is that taking a critical stance against western imperialism and neoliberal globalization necessitates a defense of China's policies in Tibet. Such arguments take the form of unfavorable comparisons between Tibetans and Palestinians especially because the former are often romanticized, suggestions that Tibetans are unfortunate ideological victims of US‐funded propaganda, and claims that they should be grateful for Chinese state‐funded development. This response renders Tibetans incapable of being authentic political subjects. A radical stance on Western imperialism and capitalism should reject such reductionism.