bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracellular Trafficking in the Trypanosomatids
Authors: Field Mark C. , Natesan Senthil Kumar A. , Gabernet‐Castello Carme , Lila Koumandou V.
Published: May 2007

Trypanosomes are members of the kinetoplastida, a group of divergent protozoan parasites responsible for considerable morbidity and mortality worldwide. These organisms have highly complex life cycles requiring modification of their cell surface together with engagement of immune evasion systems to effect survival; both processes intimately involve the membrane trafficking system. The completion of three trypanosomatid and several additional protist genomes in the last few years is providing an exciting opportunity to evaluate, at the molecular level, the evolution and diversity of membrane trafficking across deep evolutionary time as well as to analyse in unprecedented detail the membrane trafficking systems of trypanosomes.
Nup53p is a Target of Two Mitotic Kinases, Cdk1p and Hrr25p
Authors: Lusk C. Patrick , Waller Daniel D , Makhnevych Taras , Dienemann Axel , Whiteway Malcolm , Thomas David Y , Wozniak Richard W.
Published: May 2007

Nuclear pore complexes (NPCs) form channels across the nuclear envelope and provide the sole sites of molecular exchange between the cytoplasm and nucleoplasm. The NPC is a target of a number of post‐translational modifications, including phosphorylation, yet the functions of these modifications are ill defined. Here, we have investigated the mitotic specific phosphorylation of a yeast nucleoporin Nup53p. Two kinases were identified that phosphorylate Nup53p: the mitotic kinase Cdk1p/Cdc2p/Cdc28p and the casein kinase Hrr25p. Hrr25p was identified by screening 119 yeast kinases for their ability to phosphorylate Nup53p in vitro. Conditional alleles of Hrr25p support the conclusion that Hrr25p phosphorylates Nup53p in vivo. We further demonstrated using solution binding and affinity purification assays, that Hrr25p directly binds Nup53p in an interaction that is destabilized by the phosphorylation of Nup53p. Consistent with this observation, we observed that Hrr25p moves between distinct locations in the cell during the cell cycle including the nucleus, the cortex of the emerging bud and the spindle pole bodies. Cdk1p also contributes to Nup53p phosphorylation as specific inhibition of Cdk1p or mutation of Cdk1p consensus sites partially blocked its phosphorylation. The ability of nup53 alleles containing Cdk1p site mutations to complement synthetic defects of nup53Δnup170Δ strains is linked to a function for Nup53p in the spindle assembly checkpoint.
The Peroxin PEX14 of Neurospora crassa is Essential for the Biogenesis of Both Glyoxysomes and Woronin Bodies
Authors: Managadze David , Würtz Christian , Sichting Martin , Niehaus Gerd , Veenhuis Marten , Rottensteiner Hanspeter
Published: May 2007

In the filamentous fungus Neurospora crassa, glyoxysomes and Woronin bodies coexist in the same cell. Because several glyoxysomal matrix proteins and also HEX1, the dominant protein of Woronin bodies, possess typical peroxisomal targeting signals, the question arises as to how protein targeting to these distinct yet related types of microbodies is achieved. Here we analyzed the function of the Neurospora ortholog of PEX14, an essential component of the peroxisomal import machinery. PEX14 interacted with both targeting signal receptors and was localized to glyoxysomes but was virtually absent from Woronin bodies. Nonetheless, a pex14Δ mutant not only failed to grow on fatty acids because of a defect in glyoxysomal β‐oxidation but also suffered from cytoplasmic bleeding, indicative of a defect in Woronin body‐dependent septal pore plugging. Inspection of pex14Δ mutant hyphae by fluorescence and electron microscopy indeed revealed the absence of Woronin bodies. When these cells were subjected to subcellular fractionation, HEX1 was completely mislocalized to the cytosol. Expression of GFP‐HEX1 in wild‐type mycelia caused the staining of Woronin bodies and also of glyoxysomes in a targeting signal‐dependent manner. Our data support the view that Woronin bodies emerge from glyoxysomes through import of HEX1 and subsequent fission.
Nuclear Functions of the Arf Guanine Nucleotide Exchange Factor BRAG2
Authors: Dunphy Jillian L. , Ye Keqiang , Casanova James E.
Published: May 2007

BRAG2 is a guanine nucleotide exchange factor for the GTPase Arf6 that cycles between the cytoplasm and nucleus in a CRM1/exportin1‐dependent manner. Despite its presence in the nucleus, nuclear functions have not previously been described. Here, we show that depletion of endogenous BRAG2 by RNAi leads to an increased number of Cajal bodies (CBs), and altered structure of nucleoli, as indicated by less focal fibrillarin staining. This result was surprising given that nuclear BRAG2 is diffusely distributed throughout the nucleoplasm and is not concentrated within nucleoli at steady state. However, we found that ectopic expression of the nuclear GTPase PIKE/AGAP2 causes both BRAG2 and the CB marker coilin to accumulate in nucleoli. Neither the GTPase activity of PIKE nor the nucleotide exchange activity of BRAG2 is required for this nucleolar concentration. Increased levels of exogenous BRAG2 in nucleoli result in a redistribution of fibrillarin to the nucleolar periphery, supporting a role for BRAG2 in regulating nucleolar architecture. These observations suggest that, in addition to its role in endocytic regulation at the plasma membrane, BRAG2 also functions within the nucleus.
Cholesterol‐Sensitive Cdc42 Activation Regulates Actin Polymerization for Endocytosis via the GEEC Pathway
Authors: Chadda Rahul , Howes Mark T. , Plowman Sarah J. , Hancock John F. , Parton Robert G. , Mayor Satyajit
Published: May 2007

Glycosyl‐phosphatidylinositol (GPI)‐anchored proteins (GPI‐APs) are present at the surface of living cells in cholesterol dependent nanoscale clusters. These clusters appear to act as sorting signals for the selective endocytosis of GPI‐APs via a Cdc42‐regulated, dynamin and clathrin‐independent pinocytic pathway called the GPI‐AP‐enriched early endosomal compartments (GEECs) pathway. Here we show that endocytosis via the GEECs pathway is inhibited by mild depletion of cholesterol, perturbation of actin polymerization or overexpression of the Cdc42/Rac‐interactive‐binding (CRIB) motif of neural Wiskott−Aldrich syndrome protein (N‐WASP). Consistent with the involvement of Cdc42‐based actin nanomachinery, nascent endocytic vesicles containing cargo for the GEEC pathway co‐localize with fluorescent protein‐tagged isoforms of Cdc42, CRIB domain, N‐WASP and actin; high‐resolution electron microscopy on plasma membrane sheets reveals Cdc42‐labelled regions rich in green fluorescent protein–GPI. Using total internal reflection fluorescence microscopy at the single‐molecule scale, we find that mild cholesterol depletion alters the dynamics of actin polymerization at the cell surface by inhibiting Cdc42 activation and consequently its stabilization at the cell surface. These results suggest that endocytosis into GEECs occurs through a cholesterol‐sensitive, Cdc42‐based recruitment of the actin polymerization machinery.
Repeated Spontaneous Abortion. Cooperative Effects of ADA and ACP1 Genetic Polymorphisms
Authors: Nicotra M. , Bottini N. , La Torre M. , Amante A. , Bottini E. , Gloria‐Bottini F.
Published: May 2007

Problem

In consideration of the effect of adenosine deaminase (ADA) and ACP1 (a low‐molecular‐weight protein tyrosine phosphatase) on T‐cell receptor activity, we have analysed the joint distribution of these polymorphisms in a sample of women with primary repeated spontaneous abortion (RSA) to search for possible interactive effects on susceptibility to RSA.

Method of study

ACP1 and ADA phenotypes were determined in 170 women with primary RSA in 79 healthy consecutive puerperae and in 160 female newborns from the Caucasian population of Rome and in 357 healthy consecutive puerperae from the Caucasian population of Penne. Chi‐square test of independence and three way contingency table analysis by a log‐linear model were performed.

Results

Women with low‐ADA activity and high‐ACP1 activity show the lowest susceptibility to RSA. Women with high‐ADA activity and low‐ACP1 activity, on the contrary, show the highest susceptibility to RSA and also the highest incidence of auto antibodies and of A blood group incompatibility.

Conclusion

The data are in agreement with those expected on the basis of the effects of ACP1 and ADA genetic variability on T‐cell receptor activity and suggest a cooperative effect of the two polymorphic systems in the susceptibility/resistance to repeated spontaneous abortion.
Attitudes to dental hygienists: evaluation of the Dental Hygienist Beliefs Survey in a Swedish population of patients and students
Authors: Abrahamsson KH , Stenman J , Öhrn K , Hakeberg M
Published: May 2007

Abstract:  Objectives:The aim was to evaluate and test the psychometric properties of the Dental Hygienist Beliefs Survey (DHBS) in a Swedish sample of different patient groups and students. It was hypothesized that negative dental hygienist beliefs would discriminate between fearful and non‐fearful study groups. The DHBS was distributed together with the revised Dental Beliefs Survey (DBS‐R) and the Dental Anxiety Scale (DAS). The study sample included 394 subjects (130 students, 144 general dental patients, 90 periodontal patients and 30 patients on a waiting list for dental fear treatment). The results verified that the DHBS discriminates well between dentally fearful and non‐fearful study groups. The DHBS had high internal consistency (Cronbach's α = 0.96−0.98) in all the groups. The correlation between the DHBS and the DBS‐R was high (ρ = 0.82, P < 0.001). Furthermore, the DHBS correlated significantly with the DAS, as well as with a low but significant correlation to age (more negative attitudes in younger age groups) and gender (more negative attitudes amongst women). Regression analysis showed that gender and the DHBS items: 23, 16 and 28, i.e. items related to feeling helpless, worries/fears not being taken seriously and fear about ‘bad news’ possibly preventing treatment, were the most important predictors of dental fear. The results suggest that the DHBS may be a valid and reliable scale to use in order to assess patient's specific attitudes to dental hygienists. However, the psychometric properties including test–retest analysis and the underlying factor structure of the DHBS need to be further explored.
Antimicrobial activity of garlic against oral streptococci
Authors: Groppo FC , Ramacciato JC , Motta RHL , Ferraresi PM , Sartoratto A
Published: May 2007

Abstract:  The antimicrobial activity of two garlic clones’ (1: purple and 2: white) crude extracts against oral microbiota was evaluated in vitro (study 1) and in vivo (study 2). Study 1 consisted of the evaluation of minimum inhibitory (MIC) and bactericidal (MBC) concentrations against nine streptococci strains. In study 2, a 2.5% garlic (clone 2) solution was used as a mouthwash in a 5‐week study by 30 subjects. Blood agar and Mitis Salivarius Bacitracin agar were inoculated with subjects’ saliva to quantify oral microorganisms and mutans streptococci. Study 1 showed MIC ranging from 0.5 to 32.0 mg ml−1 for clone 2 and from 8 to 64.0 mg ml−1 for clone 1. MBC ranged from 1.0 to 128.0 mg ml−1 and from 8.0 to 128.0 mg ml−1 regarding clones 2 and 1 respectively. Study 2 showed that 2.5% garlic mouthwash solution had good antimicrobial activity against mutans streptococci and oral microorganisms. Maintenance of reduced salivary levels of streptococci was observed after 2 weeks at the end of mouthwash use. Unpleasant taste (100%), halitosis (90%) and nausea (30%) were reported by subjects after the end of the study. It was concluded that the garlic clones have antimicrobial properties in vitro against streptococci and anticariogenic properties against oral microorganism in spite of its adverse effects.
Self‐reported oral problems, compared with clinical assessment in an epidemiological study
Authors: Airila‐Månsson S , Bjurshammar N , Yakob M , Söder B
Published: May 2007

Abstract:  Objectives: To study self‐reported oral problems in relation to periodontal clinical findings in an epidemiological investigation. Materials and methods: 1676 individuals, 828 men and 848 women, participated. The clinical examination comprised the number of remaining teeth excluding third molars, plaque index (PLI), gingival index (GI), bleeding on probing (BOP%), calculus index (CI) and the number of teeth with pocket depth (PD) ≥5 mm. Participants answered a questionnaire concerning smoking and snuffing habits and described in their own words any oral problems present. Analysis of variance (anova), unpaired t‐test and chi‐squared test were the statistical methods used. Results: The questionnaire was completed by 99.4% of participants. Problems of the teeth and mouth were reported by 28.9% of respondents comprising 31.8% females and 26.2% males. The difference between the sexes was statistically significant (P < 0.05). Of the reported oral problems, 57.4% was of periodontal origin. The differences between subjects with and without self‐reported mobile teeth showed significant clinical outcome in PLI (P < 0.001), CI (P < 0.01), GI (P < 0.001), BOP% (P < 0.01), the number of teeth with PD ≥ 5 mm (P < 0.001) and the number of remaining teeth (P < 0.001). The differences between subjects with and without self‐reported periodontal disease and with and without bleeding gingiva also showed significant differences in CI (P < 0.05), GI (P < 0.05) and the number of teeth with PD ≥ 5 mm (P < 0.05) and in PLI (0.001), CI (P < 0.01), GI (P < 0.001) and BOP% (P < 0.001) respectively. Conclusions: Present study clearly shows that self‐reported periodontal problems were confirmed by clinical assessments.
Legionella in the dental office
Authors: Bodrumlu E , Alaçam T , Bayraktar A
Published: May 2007

Abstract:  Objective: This study aimed to assess the microbiology of dental unit water and municipal water in terms of Legionella species and total bacteria levels.Methods: The presence of Legionella species was investigated using the culture method, direct fluorescent antibody and polymerase chain reaction techniques in collected dental unit water and municipal water samples from 71 dental offices in Ankara, Turkey. In addition, total bacterial counts were assessed using the culture method.Results: In 27% of the dental unit water samples and in 13% of municipal water samples, the number of colony‐forming units (cfu ml−1) significantly exceeded acceptable values for high‐risk group patients. No Legionella spp. was found in the dental unit water samples. Legionella SG3 was found in only one municipal water sample.Conclusion: The dental unit water systems examined in this study did not include Legionella spp., but other bacteria at high numbers were determined. This is a potential threat, especially for elderly people, the medically compromised patients receiving regular dental treatment and the dental clinic staff.
Comparison of manual versus sonic and ultrasonic toothbrushes: a review
Authors: Costa MR , Marcantonio RAC , Cirelli JA
Published: May 2007

Purpose: This review of the literature intends to evaluate the effect of brushes with high frequency motion when compared with manual toothbrushes regarding the indices of plaque and gingival bleeding. Methods: Patients presenting gingivitis and/or chronic periodontitis were evaluated in addition to patients having osseointegrated implants and fixed orthodontic appliances. Pertinent literature was reviewed to select articles according to previously defined inclusion criteria. Results: In the assessed studies results showed significant decreases in plaque and gingival indices by utilization of both types of brushes. However, in the selected studies where sonic brushes were tested in orthodontic and dental implant patients there was a more significant decrease in the indices. Furthermore, there was no indication of gingival recession attributed to product use. Conclusion: Future studies with a more homogeneous methodology and better experiment designs will be needed.
A predictive study on the role and function of the dental hygienist in Taiwan*
Authors: Cheng Y‐A , Huang S‐T , Hsieh S‐T
Published: May 2007

Abstract:  Objectives: The purpose of this study was to achieve a consensus on the work roles and scope of practice of dental hygienists in Taiwan and to rank the results according to their importance.Methods: A modified Delphi technique was used to enquire how experts view their role and function as a dental hygienist in Taiwan. Three groups of 105 experts (dentists, officials and scholars) were surveyed. Responses were analysed using qualitative statistics.Results: Fifty‐one topics, which were included in the categories of the research agenda, were identified through the first phase of the study. The return rate of 87.62% and 68.48% was achieved from the two rounds of surveys. Afterwards, a consensus was reached on 38 out of the 51 topics. In the aspect of service, the most desired roles and functions were those of a friendly receptionist and of an employee effective in scheduling appointments. In the aspect of administration, the most important roles and functions were billing of health insurance, and book keeping on payments, as well as administering materials. In the aspects of technical efficiency, dental hygienists were most frequently seen as serving in four‐ or six‐handed assisting and in infection control. In the area of oral health, an oral health educator and an oral health promoter were viewed as having the most important roles and functions.Conclusions: The experts concluded that the role and function of a dental hygienist should shift from a patient treatment orientation to that of an oral health promoter. The role expectations need to change to reflect what hygienists actually learn and do.
Peri‐implant maintenance of immediate function implants: a pilot study comparing hyaluronic acid and chlorhexidine
Authors: De Araújo Nobre M , Cintra N , Maló P
Published: May 2007

Abstract:  Introduction: In implants, maintenance assumes an important role. The role of chlorhexidine (CHX) is well known in maintenance, while only limited evidence exists on the practical use of hyaluronic acid (HA). The objective of this study was to compare the health status of the peri‐implant complex (hard and soft tissues surrounding the implant) during the healing period of immediate function implants, using HA or CHX gels in the patient's maintenance protocol.Study population and methodology: Thirty complete edentulous patients, with four immediate function Brånemark System implants placed in the mandible (total of 120 implants), were randomly assigned to two groups (HA and CHX) using only these two chemicals in their daily implant self‐care. Both groups were followed up for 6 months, with clinical observations on the 10th day, 2 months, 4 months and 6 months post‐surgically.Results: During the course of the study, HA and CHX produced good results in maintaining a healthy peri‐implant complex in immediate function implants for complete rehabilitations in the edentulous mandible. Statistically significant differences were found in favour of the HA group in the modified bleeding index on the second observation (P = 0.003). The difference was more marked in the axial implants placed in the fifth sextant (P = 0.05). Correlation coefficient between plaque and bleeding index revealed a potentially better result for CHX at 6 months.Conclusion: The findings point out the importance of a maintenance protocol in immediate function implants. Both chemicals are valid tools for implant maintenance. The authors suggest that it might be advantageous to administer HA in the first 2 months and CHX between 2 and 6 months.
Cardiovascular Profile of the Canine Torsades de Pointes Arrhythmia Model Assessed by Echocardiographic and Haemodynamic Methods
Authors: Takahara Akira , Sugiyama Atsushi , Satoh Yoshioki , Iwasaki Hiroshi , Nakamura Yuji , Hashimoto Keitaro
Published: May 2007

Abstract:  Chronic atrioventricular block dogs have been established as an in vivo model of drug‐induced torsades de pointes arrhythmias. We compared the cardiovascular profile of the canine model with that of sham‐operated animals using echocardiographic and haemodynamic methods. In the echocardiographic study, the larger diameters of the left atria, inferior vena cava and left ventricle in end‐diastole in addition to greater fractional shortening, end‐diastolic volume, stroke volume and ejection fraction were more often detected in the chronic atrioventricular block dogs than in the sham‐operated animals. During haemodynamic examination, lower cardiac output and higher pulmonary capillary wedge pressure were detected in chronic atrioventricular block dogs more than in sham‐operated animals; however, these changes were within the physiological limits, and the results suggest that the chronic atrioventricular block dogs have a pathophysiological profile of chronic compensated heart failure.
Confirmatory Factor Analysis of the German Version of the International Index of Erectile Function (IIEF): A Comparison of Four Models
Authors: Kriston Levente , Günzler Cindy , Harms Anja , Berner Michael
Published: May 2007

Introduction

The International Index of Erectile Function (IIEF) is the most widely used instrument to assess erectile function in research and clinical practice. However, there are heterogeneous results concerning the factor structure of this questionnaire. The original model assumes five factors (erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction). Others suggested four factors (composite domain of erectile dysfunction and intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction) or only two factors (sexual function and sexual desire). Because of the high intercorrelation between the different domains, a one-factor model is also plausible.

Aims

This study assesses and compares these four models of the German version of the IIEF.

Methods

It was examined which of the models fit best our data from 261 German men in cardiovascular rehabilitation participating in the SPARK study (Sexuality of Patients in the Rehabilitation of Cardiovascular Diseases). Contrary to the former exploratory studies, we used confirmatory factor analysis.

Main Outcome Measures

Local and global goodness-of-fit measures were calculated.

Results

The results show that two items (ability to maintain erection and intercourse frequency) could not be represented sufficiently through any of the four models. Based on the global goodness-of-fit indexes, our data proved to be fairly congruent with the original five-factor model and were acceptably represented by a four-factor model as well.

Conclusions

The original five-factor structure could be confirmed. Due to high intercorrelations, the different domains cannot optimally be discriminated and should be interpreted with caution. Further research is needed to clarify the association between the domains of male sexual function.
Effects of Aloe vera on colonic anastomoses of rats
Authors: İnan Aydın , Şen Meral , Koca Cemile , Ergin Metin , Dener Cenap
Published: May 2007

Background:  Aloe vera is a cactus‐like plant that grows in hot, dry regions. Aloe vera has been known and used in traditional medicine and also in the modern world. Aloe vera has some pharmacological actions including wound healing, anti‐inflammatory and immunostimulatory effects. We have studied the possible effects of Aloe vera gel on the healing of colonic anastomoses of rats.

Material and Methods:  In this study, Sprague–Dawley rats were used. Aloe vera group received 2 mL/kg per day Aloe vera, and the control group received the same amount of water. Animals underwent resection and anastomosis of the distal colon. Bursting pressures of anastomoses and hydroxyproline contents of perianastomotic region were determined on the third and seventh days. Mann–Whitney U‐test was used to compare bursting pressures and hydroxyproline levels between groups.

Results:  There was no difference between groups in mortality. Mean bursting pressures and mean hydroxyproline levels were lower in the control group than in the Aloe vera group both on the third and seventh days.

Conclusion:  Aloe vera has multiple pharmacologically active compounds. It stimulates phagocyte formation and its activity induces nitric oxide production, it has angiogenic activity, increases synthesis, maturation and cross‐linking of collagen, stimulates cell proliferation, stimulates fibroblast functions and proliferation, inhibits arachidonic acid oxidation, has anti‐inflammatory effects, reduces tumour necrosis factor‐α levels, and has antioxidant activity. Thus, according to our findings, Aloe vera has positive effects on the colonic anastomotic healing of rats.
Omental torsion in adults: A clinical twister
Authors: Sammour Khalil Y. , Abburu Rao S. , Sammour Tarik
Published: May 2007

Background:  Omental torsion is usually diagnosed intraoperatively and resected. Recent literature supports conservative management after diagnosis of omental torsion using radiological imaging. We present the experience of a single institution.

Methods:  Retrospective review of clinical, laboratory, radiological and operative data were collected from patient case notes.

Results:  Six patients were identified as cases of omental torsion between January 2003 and May 2005. Abdominal ultrasound was performed in all patients. The abnormality was described in two patients as vaguely defined focal hyperdense mass‐like lesion in the hypochondrium and right iliac fossa. In another two patients, localized small fluid collections were noted. The remaining two studies were reported as normal. Computed tomography scan of the abdomen performed in five patients accurately identified the abnormality as an ill‐defined, relatively hyperdense fatty mass with a typical whorled appearance centred on engorged blood vessels. Four patients underwent surgery and two were successfully managed conservatively.

Conclusion:  Awareness and careful evaluation of clinical and laboratory findings, coupled with ultrasound and/or computed tomography studies of the abdomen, can make a reliable diagnosis of omental torsion, affording the option of conservative management in some cases.
Pattern and factors affecting management outcome of neonatal emergency surgery in Ile‐Ife, Nigeria
Authors: Sowande Oludayo A. , Ogundoyin Olakayode O. , Adejuyigbe Olusanya
Published: May 2007

Objective:  To determine the pattern and various factors that can affect the outcome of emergency surgical management of the neonate in a developing country.

Methods:  A retrospective study of all neonates who had emergency surgery over a 10‐year period at Obafemi Awolowo University Teaching Hospital, Ile‐Ife, Nigeria.

Results:  There were 72 males and 38 females. The age at presentation ranged between 2 h to 30 days (mean ± SD: 6.62 ± 7.14 days). The weight at presentation was 1.3 to 3.9 kg (mean ± SD: 2.62 ± 0.53 kg). The mean birthweight of the survivors (mean ± SD: 2.84 ± 0.44 kg) was significantly higher than those that died (mean ± SD: 2.26 ± 0.49 kg) (P < 0.01). The mean interval to surgery from onset of symptoms in the survivors (mean ± SD: 42.720 ± 41.769 h) compared well to those that died (mean ± SD: 51.85 ± 65.52 h) (P = 0.424). The admission weight, duration of operation, level of gastrointestinal obstruction and type of operation significantly influenced the outcome. Closure of ruptured exomphalos, thoracostomy with oesophageal anastomosis, and intestinal resection with anastomosis are associated with high mortality. Sepsis/septicaemia was the commonest postoperative complications accounting for 16 deaths. Overall, there were 59 deaths (53.6%).

Conclusion:  The morbidity and mortality following emergency surgical management of the neonate is still very high in this environment. Lower admission weight, long duration of operation, type of operation performed and presence of upper gastrointestinal obstruction are significantly associated with increased neonatal surgical mortality in our hospital
Simultaneous laparoscopic abdominal and transanal excision for low rectal tumours
Authors: Wong Dennis Chung‐Tak , Chung Chi‐Chiu , Cheung Hester Yui‐Shan , Wong James Cheuk‐Hoo , Yau Kwok‐Kay , Li Michael Ka‐Wah
Published: May 2007

Aim:  In performing laparoscopic sphincter‐preserving total mesorectal excision, one of the technical challenges is to obtain an adequate distal mural margin of 2 cm in the case of low rectal tumours. Herein we describe a technique, known as simultaneous laparoscopic abdominal and transanal excision, where an adequate distal margin can be safely achieved at the beginning of the operation.

Methods and Results:  As the specimen is delivered per anum, the patient can enjoy the full benefits of minimally invasive surgery. Additionally, the simultaneous approach helps to shorten the operating time. The technique was attempted in five patients with radiological T2 or T3 disease, with two patients having received neoadjuvant chemoirradiation. The outcomes of these five patients are presented.

Conclusion:  As treatment of rectal cancer is increasingly stage dependent, the simultaneous laparoscopic abdominal and transanal excision procedure offers a clear alternative for treating patients with low rectal tumours in this laparoscopic era.
Mucinous adenocarcinoma arising from chronic perianal fistula
Authors: Hisham Raja B. , Rahman Sabariah Abd , Gul Yunus A.
Published: May 2007

Perianal mucinous adenocarcinoma is a rare tumour which may be associated with long‐standing chronic perianal sepsis. Early diagnosis is challenging and is based on a high index of clinical suspicion and specific histological features. Definitive treatment is surgical, in the form of an abdomino‐perineal resection. We hereby describe a case of a perianal mucinous adenocarcinoma arising from long‐standing recurrent perianal fistula and complement this with a brief review of the literature pertaining in particular to the management of this condition.
Acute appendicitis perforating into the bladder mimicking cystitis
Authors: Papadopoulos Vasileios N. , Michalopoulos Antonios , Tzeveleki Ioanna , Basdanis George
Published: May 2007

Perforation of the appendix can lead to periappendiceal abscess or diffuse peritonitis. The major reason for appendiceal perforation is delay in diagnosis and treatment. We report this rare case of perforated appendix into the bladder, which caused acute abdomen. We also present a review of the literature. The patient underwent an emergency operation in which the appendicitis was found to have perforated into the bladder and produced symptoms that mimicked cystitis. The terminal ileum and the cecum were seriously inflamed. The patient underwent a limited right hemicolectomy, closure of the bladder with a serosal patch, closure of the transverse colon and an end‐ileostomy. Differential diagnosis of acute appendicitis especially in women is very difficult because the surgeon must always consider and look for many other conditions that can mimic appendicitis. From a management viewpoint, the various diagnoses can be divided into those that require surgery and those that do not. The present case was an uncommon case of acute appendicitis where, unfortunately, its primary symptoms and laboratory data had led to the wrong diagnosis of cystitis, which did not require surgery.
1 ADJUVANT RADIOTHERAPY IS AN INDEPENDENT RISK FACTOR FOR SMALL BOWEL OBSTRUCTION AFTER CURATIVE RECTAL CANCER SURGERY
Authors: Hon S.S.F. , Leung W.W. , Ng S.S.M. , Lee J.F.Y.
Published: May 2007

Aim:  Small bowel obstruction (SBO) as a complication is not uncommon after curative rectal cancer surgery; adjuvant radiotherapy (RT) may have a contributory role. This study aimed at determining the prevalence and risk factors for this complication.

Methods:  The medical records of 260 consecutive patients with rectal cancer (excluding rectosigmoid cancer) who underwent curative surgery at our institution between January 1995 and December 2000 were retrospectively reviewed to determine the prevalence of SBO requiring hospitalization and intervention. Possible risk factors for SBO were recorded and analysed using univariate and multivariate analysis.

Results:  The median duration of follow up was 76.1 months (range, 3.3–141.8 months). Forty‐four patients (16.9%) developed SBO and 19 of them required surgical intervention. Three patients (6.8%) died as a consequence of SBO. Seventy‐eight patients (30%) received adjuvant RT with a median dose of 50 Gy (range 30–64 Gy). Patients receiving RT were more likely to develop SBO (25.6% vs 13.2%, P = 0.014). The median duration between adjuvant RT and the first episode of SBO was 23.5 months (range, 5.7–99.4 months). Multivariate analysis showed that adjuvant RT was the only independent risk factor for SBO (OR = 2.27, 95% CI = 1.17–4.42, P = 0.016). Gender, operative approach (open vs laparoscopic), abdominoperineal resection, perioperative blood transfusion, postoperative intra‐abdominal sepsis, tumour stage, and disease recurrence were not associated with the development of SBO.

Conclusion:  Adjuvant RT is the only independent risk factor for SBO after curative surgery for rectal cancer. Patients should be well informed of this potential complication when they are offered adjuvant RT.
2 TOWARDS PAINLESS COLONOSCOPY: A DOUBLE BLIND RANDOMIZED CONTROLLED TRIAL ON CARBON DIOXIDE INSUFFLATION COLONOSCOPY
Authors: Wong J.C.H. , Yau K.K. , Cheung H.Y.S. , Wong D.C.T. , Chung C.C. , Li M.K.W.
Published: May 2007

Background:  Colonoscopy is a useful screening and diagnostic tool. Yet, many patients fear it because of pain. Carbon dioxide (CO2) insufflation during examination was reported to result in reduced pain. However, data on CO2 insufflation colonoscopy are still limited.

Objective:  The current study is a randomized controlled trial aiming to assess the safety and potential benefits of CO2 insufflating colonoscopy.

Methods:  From January to April 2006, adult patients undergoing elective colonoscopy were recruited and randomized into CO2 insufflation (CO2i) or air insufflation (AIRi) groups. All examinations were performed by either one of the two designated endoscopists. Pain scores during examination and 30 min, 1 h and 2 h after were recorded using a visual analogue scale (VAS). Other outcomes measured included the caecal intubation rate, complication and caecal intubation time, defined as the time required to reach the caecum. By means of questionnaire, patient's satisfaction and acceptance of the endoscopic examination were assessed after the procedure.

Results:  Over a 4‐month period, 96 patients were recruited and randomized. The age and gender ratio of the groups were matched. The caecal intubation rate was 96% and 98% in the CO2i group and the AIRi group, respectively. No complication occurred in the CO2i group whereas one patient from the AIRi group developed secondary haemorrhage after polypectomy. Patients in the CO2i group had a significantly lower pain score during (P < 0.01) and 30 min after (P = 0.02) the examination. Compared to the AIRi group, significantly more patients in the CO2i group reported the examination as painless (VAS 0) during the procedure (45% vs 14%, P < 0.01) and 30 min after (70% vs 51%, P = 0.05). In both groups, high satisfaction scores were recorded. Most of the patients (93% for the CO2 group and 98% for the air group) would accept another colonoscopy if indicated. Again, most of the patients (89% for the CO2 group and 96% from the air group) would recommend others to have colonoscopy as the method for colonic evaluation.

Conclusion:  Our data suggest CO2 that insufflation colonoscopy is safe. Most importantly, compared to conventional air insufflation colonoscopy, it results in significantly less pain during the examination. CO2 insufflation colonoscopy holds the potential to be a painless screening tool in the community.
3 LONG‐TERM FOLLOW UP OF THE EFFICACY OF A MULTIDISCIPLINARY APPROACH TO THE MANAGEMENT OF CHRONIC CONSTIPATION
Authors: Leung R.W.C. , Meng W.C.S. , Fung B.K.Y. , Lee W.S. , Chan D. , Lau P.Y.Y. , Yip W.C.
Published: May 2007

Introduction:  Standard measures for the management of constipation include adequate dietary fibre and fluid intake, regular exercise, and biofeedback training. However, there is no documentation on the effects of the above in Hong Kong.

Purpose:  To evaluate the long‐term efficacy of the rehabilitative programme in the management of constipation in Hong Kong.

Methods:  Patients diagnosed with chronic constipation using the Rome II criteria were recruited. A clinician, dietitian and physiotherapist assessed the patients. Anorectal physiology investigations and defecation proctography were performed prior to and after the treatment programme. The treatment programme involved consultation by the dietitian, postural re‐education, and pelvic floor re‐education on a proper defecation pattern. Patients were followed up in alternate weeks for the first 3 months and monthly for another 3 months. Telephone follow up was followed 3 years after the programme.

Results:  24 patients completed the program in the years 2002 and 2003. The mean age was 48.1 ± 12.8 years. There were five males and 19 females, with a median follow up of 46 months (36–48). On completion of the programme, there was significant improvement in average straining time, median bowel frequency per week, Bristol score and fibre intake.

Pretreatment
Post‐treatment

Average straining time (min)
14.8 ± 2.2
10.6 ± 2.2
P = 0.029

Median bowel frequency per week
2.0 (0–42)
6.0 (0–42)
P = 0.027

Bristol score
2.0 ± 0.5
2.9 ± 0.4
P = 0.006

Fibre intake (g)
10.5 ± 4.0
15.5 ± 7.4
P = 0.007

Post‐treatment
Post‐treatment 3 years

Average straining time
10.6 ± 2.2
10.0 ± 2.6
P = 0.633

Median bowel frequency per week
6.0 (0–42)
4.5 (0–26)
P = 0.016

Bristol score
2.9 ± 0.4
3.4 ± 0.8
P = 1.000

Fibre intake
15.5 ± 7.4
8.46 ± 3.2
P = 0.001

Subjective improvement
45.2%
43.0%
P = 0.615

Conclusions:  Rehabilitative programme for constipation can significantly improve the symptoms of constipation including straining time, bowel frequency and Bristol score. This was a long‐term effect and the decrease in average straining time was persistent at 3 years post‐treatment. Change of lifestyle was more difficult. Hence, there was a tendency for patients to have decreased fibre intake again after the therapy and this contributed to the subsequent decrease in bowel frequency. Fortunately, the overall subjective improvement in constipation was persistent on long‐term follow up.
4 EMERGENCY LAPAROSCOPIC‐ASSISTED VERSUS OPEN RIGHT HEMICOLECTOMY FOR COMPLICATED CAECAL DIVERTICULITIS: A COMPARATIVE STUDY OF SHORT‐TERM OUTCOMES
Authors: Li J.C.M. , Ng S.S.M. , Lee J.F.Y. , Yiu R.Y.C. , Leung K.L.
Published: May 2007

Aim:  The aim of this study was to compare the operative and short‐term clinical outcomes of emergency laparoscopic‐assisted versus open right hemicolectomy for complicated caecal diverticulitis.

Methods:  Between September 2001 and June 2006, 18 consecutive patients with complicated caecal diverticulitis underwent emergency right hemicolectomy at out institution, six with the laparoscopic‐assisted approach and 12 with the open approach. Clinical data were prospectively recorded and compared between the two groups.

Results:  There were no significant differences between the two groups with respect to age, gender, comorbidities, duration of symptoms, and Hinchey staging. There was no conversion in the laparoscopic‐assisted group. Compared to the open group, the laparoscopic‐assisted group had a slightly longer operative time (167.5 vs 150 min, P = 0.083) but significantly less blood loss (35 vs 100 mL, P = 0.041). Although the median time to first bowel motion was significantly shorter in the laparoscopic‐assisted group (3 vs 5 days, P = 0.041), the time to full ambulation and the duration of hospital stay were similar between the two groups. The postoperative complication rates (50% vs 33.3%), as well as the hospital readmission rates for complications (33% vs 0%), were higher in the open group than the laparoscopic‐assisted group, but the differences did not reach statistical significance.

Conclusion:  Emergency laparoscopic‐assisted right hemicolectomy for complicated caecal diverticulitis is feasible and safe in the hands of experienced surgeons. Compared with the open approach, the laparoscopic‐assisted approach is associated with less blood loss and earlier return of gastrointestinal function.
5 LAPAROSCOPIC RESECTION FOR COLORECTAL CANCER IN OCTOGENARIANS: RESULTS OF A DECADE
Authors: Ling Y.H. , Cheung H.Y.S. , Wong J.C.H. , Yau K.K. , Chung C.C. , Li M.K.W.
Published: May 2007

Objectives:  To evaluate the results of laparoscopic resection for colorectal cancer in octogenarians.

Patients and method:  Patients aged 80 years or above who had undergone elective laparoscopic resection for colorectal cancer from 1 July 1996 to 30 June 2006 were recruited with the following exceptions: (i) patients who did not give informed consent; (ii) unfit for operation; (iii) surgical emergencies; (iv) multiple abdominal operations; or (v) locally advanced tumours. Main outcomes measures: operating data, length of hospital stay, mortality, morbidities, recurrence and survival.

Results:  Over a 10‐year period, laparoscopic colorectal cancer resection was attempted in 101 octogenarians. The median age was 83 (range: 81–85) years. The median operating time was 110 (range: 87–130) min, with a median blood loss of 50 (range: 20–100) mL. Conversion was required in one case with a leakage rate of 3.3%. The overall morbidity and operative mortality rates were 17% and 3%, respectively. With a median follow up of 24 (range: 12–48) months, 24 patients developed recurrence. The overall 4‐year survival is 51%.

Conclusions:  Laparoscopic colorectal cancer resection in selected octogenarians is safe and feasible. An aggressive attitude in treating octogenarians with colorectal cancer is justified and laparoscopic approach is the technique of choice.
In Silico Prediction of SARS Protease Inhibitors by Virtual High Throughput Screening
Authors: Plewczynski Dariusz , Hoffmann Marcin , Von Grotthuss Marcin , Ginalski Krzysztof , Rychewski Leszek
Published: May 2007

A structure‐based in silico virtual drug discovery procedure was assessed with severe acute respiratory syndrome coronavirus main protease serving as a case study. First, potential compounds were extracted from protein–ligand complexes selected from Protein Data Bank database based on structural similarity to the target protein. Later, the set of compounds was ranked by docking scores using a Electronic High‐Throughput Screening flexible docking procedure to select the most promising molecules. The set of best performing compounds was then used for similarity search over the 1 million entries in the Ligand.Info Meta‐Database. Selected molecules having close structural relationship to a 2‐methyl‐2,4‐pentanediol may provide candidate lead compounds toward the development of novel allosteric severe acute respiratory syndrome protease inhibitors.
α1‐Adrenergic Receptor Stimulation of Cell Motility Requires Phospholipase D‐Mediated Extracellular Signal‐Regulated Kinase Activation
Authors: Sang Rachel L. , Johnson Jessica F. , Taves Jennifer , Nguyen Callie , Wallert Mark A. , Provost Joseph J.
Published: May 2007

Phospholipase D is suspected to play a role in tumorigenesis, and the inhibition of phospholipase D has been associated with changes in several cellular events including invasion and migration. We report here that the specific α1‐adrenergic receptor agonist, phenylepherine, signals to a growth factor pathway in a manner that requires phospholipase D activity in CCL39 fibroblasts. Phenylepherine increased extracellular signal‐regulated kinase phosphorylation eightfold and promoted stress fiber formation threefold. Stress fiber formation was blocked when extracellular signal‐regulated kinase activation was inhibited. Stimulation of CCL39 fibroblasts by phenylepherine increased the rate of wound healing fourfold in a wounding assay, while treatment with the MEK inhibitor, PD98059 reduced the closure of phenylepherine‐induced wound healing to control levels. Addition of 1‐butanol but not 2‐butanol inhibited extracellular signal‐regulated kinase activation by phenylepherine, presumably by blocking the formation of phosphatidic acid. Exogenously added cell permeable phosphatidic acid increased extracellular signal‐regulated kinase activation in a time‐ and dose‐dependent manner as well as stimulated the formation of stress fibers. 1‐butanol also significantly inhibited the ability of phenylepherine to stimulate stress fiber formation and wound healing. Taken together, these results indicate a novel role for phospholipase D in the activation of the extracellular signal‐regulated kinase growth factor pathway to stimulate early cellular events induced by phenylepherine.
In vitro evaluation of the accuracy of five different electronic apex locators for determining the working length of endodontically retreated teeth
Authors: Ebrahim Aqeel Khalil , Wadachi Reiko , Suda Hideaki
Published: May 2007

The aim of this study was to evaluate the accuracy of five electronic apex locators (EALs) in determining the working length (WL) of teeth after removal of the root canal obturation materials. A total of 32 extracted straight, single‐rooted teeth were used. The actual canal length (AL) was determined and the WL was established by subtracting 0.5 mm from the AL. The root canals were instrumented and divided into two groups. One group (n = 6) served as control, while the other group (n = 26) was the experimental group. In the experimental group, the root canals were obturated using vertically compacted gutta‐percha with AH 26 sealer. In both groups, the access cavities were restored with a provisional restoration and stored for 15 days at 37°C and 100% humidity. The root canal obturation material was removed, and the teeth were then mounted in an experimental apparatus. Five EALs were used: Dentaport ZXTM®, ProPex, Foramatron D10, Apex NRG and Apit 7. For the electronic measurement of canal length, a size 25 K‐file was used. During measurement, the canal was irrigated with 2.5% sodium hypochlorite. The difference (D) between the AL and the electronically determined length (EDL), AL–EDL, was calculated and recorded for each measurement. Data were analysed by two‐way anova and Fisher’s PLSD test. In both groups, statistically significant differences were found among the EALs (P < 0.01). In conclusion, the Dentaport ZXTM®, ProPex and Foramatron D10 were more accurate than the other two EALs in determining the WL in teeth after removal of the root canal obturation materials. However, the Apex NRG and Apit 7 were also reliable for determination of the WL in the majority of the cases.
Endodontic treatment of mandibular incisors with two root canals: Report of two cases
Authors: Kabak Yury S. , Abbott Paul V.
Published: May 2007

The root canal anatomy of mandibular incisors can present a number of variations, including multiple canals. Two case reports are presented to illustrate the serendipitous discovery and successful non‐surgical endodontic management of complex canal systems in mandibular incisors. In both cases, all four mandibular incisors had two canals each.
The Debittering of Navel Orange Juice Using Polymeric Films
Authors: Fayoux Stéphane C. , Hernandez Ruben J. , Holland Robert V.
Published: May 2007

ABSTRACT:  In order to better understand and optimize the sorption of limonin (the major navel orange juice bitter principle) by various plasticized polymeric films, a sorption and plasticizer migration study was carried out using high‐performance liquid chromatography (HPLC) and gas chromatography (GC). Low molecular weight (LMW) poly (vinyl chloride) (PVC) plasticized with dioctyl adipate (DOA) gave the best results for both limonin sorption and low DOA migration. Thick films did not significantly sorb more limonin than thin films in the timeframe of our experiments, as the absorption involved rapid surface sorption followed by slow bulk diffusion. The debittering efficiency was a 1000‐fold greater than that obtained with current polystyrene divinylbenzene resin beads, with potential for industrial scale debittering.