bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular coherence tomography in acute posterior multifocal placoid pigment epitheliopathy
Authors: Lim Lyndell L , Watzke Robert C , Lauer Andreas K , Smith Justine R
Published: October 2006

Abstract

The authors report a case of typical acute posterior multifocal placoid pigment epitheliopathy in which an ocular coherence tomographic scan was performed through an acute lesion and then repeated through the same lesion 12 months later. The initial ocular coherence tomographic scan showed marked anterior displacement of both neuroretina and outer reflective band. A subsequent ocular coherence tomographic scan revealed resolution of the prior displacement, increased reflectance of the outer reflective band and mild disruption of the outer retinal layers. These findings are consistent with a primary choroiditis.
Investigation of the safety of tenecteplase to the outer retina
Authors: McAllister Ian L , Vijayasekaran Sarojini , Khong Chee Hong , Yu Dao‐Yi
Published: October 2006

Abstract

Purpose:  To investigate the safety of the thrombolytic agent, tenecteplase to the outer retina in pig eyes.

Methods:  Tenecteplase (50 µg) was injected into the subretinal space in one eye while the fellow eye received balanced salt solution. At 24 h, 1 week and 9 weeks the eyes were examined by indirect ophthalmoscopy and photographed. Animals were killed at 9 weeks, eyes enucleated and processed for light and transmission electron microscopy. Three locations within the area of the injection bleb were analysed.

Results:  Retinal pigment epithelial defects, which appeared to be iatrogenic and confined to the injection site, were seen in most of the treated and control eyes. There was no significant difference in the degree of retinal damage between the two groups of eyes at the three sites examined (P > 0.05).

Conclusion:  Fifty micrograms of tenecteplase appears to be a safe dose with no evidence of toxicity to the outer retina and may have a potential role in the treatment of submacular haemorrhage.
Anti‐social anthropology? Objectivity, objection, and the ethnography of public policy and professional communities*
Authors: Mosse David
Published: October 2006

One legacy of Malinowski's ethnographic method is the separation of ‘field’ and ‘desk’. What anthropologists know is inseparable from their relationship with those they study – the epistemology is relational – but ethnographic writing breaks fieldwork relations, cuts the network, and erects boundaries: it is necessarily anti‐social. As anthropologists turn their interest in what people believe, say, and do (and the inconsistencies between these) to the inter‐connected institutions that comprise the modern world, to policy and professional communities of which they may also be members, their method of entering and exiting social worlds becomes more difficult. Arguing for the particular importance of an ethnographic perspective on the practices of powerful institutions, this article uses recent research on international aid and development to show how influential informants object to ethnographic accounts, resist anthropological boundary‐making, and attempt to unpack academic knowledge back into relationships.
Deconstructing Deliberation in the Appraisal of Medical Technologies: NICEly Does it?
Authors: Syrett Keith
Published: October 2006

Appraisals of medical technologies undertaken by the National Institute for Health and Clinical Excellence (NICE) have significant implications for the setting of priorities for health care expenditure in the NHS in England and Wales. NICE has been characterised as a deliberative body, an evaluation which reflects the recent attention paid by those working within the health policy community to the establishment of mechanisms which deliver procedural justice, in the absence of societal consensus upon the substantive values which should underpin distributive choices in health care. This article critically interrogates the assessment of NICE as deliberative in character. It also considers the relationship between legitimacy and deliberation in this policy context, in light of the claim that ‘thickening proceduralisation’ by establishing and enhancing deliberative structures and processes is a useful strategy for addressing regulatory problems.
Transthyretin oligomers induce calcium influx via voltage‐gated calcium channels
Authors: Hou Xu , Parkington Helena C. , Coleman Harold A. , Mechler Adam , Martin Lisandra L. , Aguilar Marie‐Isabel , Small David H.
Published: October 2006

The deposition of transthyretin (TTR) amyloid in the PNS is a major pathological feature of familial amyloidotic polyneuropathy. The aim of the present study was to examine whether TTR could disrupt cytoplasmic Ca2+ homeostasis and to determine the role of TTR aggregation in this process. The aggregation of amyloidogenic TTR was examined by solution turbidity, dynamic light scattering and atomic force microscopy. A nucleation‐dependent polymerization process was observed in which TTR formed low molecular weight aggregates (oligomers < 100 nm in diameter) before the appearance of mature fibrils. TTR rapidly induced an increase in the concentration of intracellular Ca2+ ([Ca2+]i) when applied to SH‐SY5Y human neuroblastoma cells. The greatest effect on [Ca2+]i was induced by a preparation that contained the highest concentration of TTR oligomers. The TTR‐induced increase in [Ca2+]i was due to an influx of extracellular Ca2+, mainly via L‐ and N‐type voltage‐gated calcium channels (VGCCs). These results suggest that increasing [Ca2+]i via VGCCs may be an important early event which contributes to TTR‐induced cytotoxicity, and that TTR oligomers, rather than mature fibrils, may be the major cytotoxic form of TTR.
Brain‐type Natriuretic Peptide Secretion Following Febrile and Afebrile Seizures—A New Marker in Childhood Epilepsy?
Authors: Rauchenzauner Markus , Haberlandt Edda , Foerster Stefanie , Ulmer Hanno , Laimer Markus , Ebenbichler Christoph F. , Joannidis Michael , Zimmerhackl Lothar‐Bernd , Stein Jörg , Luef Gerhard
Published: October 2006

Summary:  Purpose: Markers for epileptic seizures are rare and their use has not been established in the evaluation of seizures and febrile convulsions (FC). Brain‐type natriuretic peptide (BNP) is a natriuretic, diuretic, and vasodilator compound first discovered in the hypothalamus but mainly synthesized in the myocardium. The aim of this study was to assess whether epileptic seizures or FC are related to increased secretion of the N‐terminal fragment of BNP (NT‐proBNP).

Methods: Sixty‐five postictal children (43 boys, 22 girls) and 31 children with epilepsy (20 boys, 11 girls) after a seizure‐free period for at least 2 months serving as controls were enrolled. Postictal NT‐proBNP levels were analyzed and controlled 24–48 h thereafter.

Results: Plasma concentration of NT‐proBNP was significantly higher 4 h postictal compared to 24–48 h postictal (p < 0.001). Subgroup analysis revealed increased NT‐proBNP levels in children with tonic–clonic seizures and FC compared to children with partial motor seizures (p < 0.001), syncope (SYN; p < 0.01), or control population (p < 0.001).

Conclusions: Our results suggest that elevated plasma NT‐proBNP levels are not specific for cardiac dysfunction. Postictal measurement of plasma NT‐proBNP seems to be useful in discriminating different types of epilepsy, FC, and SYN in childhood.
Altered Glutamate Receptor—Transporter Expression and Spontaneous Seizures in Rats Exposed to Methylazoxymethanol in Utero
Authors: Harrington Emily P. , Möddel Gabriel , Najm Imad M. , Baraban Scott C.
Published: October 2006

Summary:  Purpose: Brain malformations are a common cause of intractable epilepsy and cognitive dysfunction in children. Prenatal exposure to the teratogen methylazoxymethanol (MAM) is a rodent model of brain malformation featuring loss of lamination, clusters of displaced hippocampal cells, and pharmaco‐resistance to antiepileptic drugs. In a normotopic hippocampus, expression of postsynaptic glutamate receptors and the transporters regulating neurotransmitter reuptake are critical factors modulating excitation and synaptic communication. Alterations in this system can have profound effects on overall excitability, cognitive function, and seizure thresholds.

Methods: Immunohistochemical techniques were used to analyze the expression of N‐methyl‐d‐aspartate (NMDA) and α‐amino‐3‐hydroxy‐5 methylisoxazole‐4‐proprionic acid (AMPA) receptor subunits in rats exposed to MAM in utero (25 mg/kg, intraperitoneal injection). We also examined the expression of several glutamate transporters (EAAC1, vGLUT1, and vGLUT2). A video‐electroencephalographic (video‐EEG) system was used for long‐term monitoring of adult MAM‐exposed rats.

Results: Heterotopic hippocampal neurons exhibited striking reductions in GluR1 and EAAC1 expression; vGlut2 expression was prominent in these regions. Spontaneous electrographic seizures were verified in two animals.

Conclusions: We conclude that glutamate receptor subunit and transporter expression are altered in animals exposed to MAM in utero. Further studies in the MAM model may provide greater insight into the potential disruptions in excitatory synaptic neurotransmission that can occur in a malformed brain.
Inhibition of Glutamate Transporters Results in a “Suppression‐Burst” Pattern and Partial Seizures in the Newborn Rat
Authors: Milh Mathieu , Becq Hélène , Villeneuve Nathalie , Ben‐Ari Yehezkel , Aniksztejn Laurent
Published: October 2006

Summary:  Purpose: To determine the electrophysiological pattern and propose a clinical relevance of a deficient glutamate transport in the developing brain.

Methods: (a) Surface EEG‐video monitoring in freely moving pups; (b) intracortical multiple unit activity (MUA) and local field potential recordings in 5‐ to 7‐day‐old rats after pharmacological inhibition of the glutamate transporters by DL‐TBOA.

Results: Glutamate transporters inhibition alters the background cortical electrical activity inducing a dominant and persistent pattern of bilateral recurrent paroxysmal bursts alternating with periods of hypoactivity and also partial seizures. Intracortical local field recordings show that paroxysmal bursts are associated with multiunits and gamma oscillations separated by periods of silence. This cortical activity involves the activation of ionotropic glutamate receptors and was not observed after kainate and pilocarpine administration.

Conclusions: We show that a dysfunction of glutamate transporters in immature rats leads to a singular cortical activity that is reminiscent of a “suppression‐burst” pattern. We propose that an early deficiency of glutamate transport may underlie some early onset epilepsies.
Methylenetetrahydrofolate Reductase C677T‐Polymorphism and Its Association With Alcohol Withdrawal Seizure
Authors: Lutz Ulrich C. , Batra Anil , Kolb Werner , Machicao Fausto , Maurer Sandra , Köhnke Michael D.
Published: October 2006

Background: Elevated homocysteine plasma levels are considered as a risk factor for the occurrence of seizures during alcohol withdrawal. Homocysteine plasma concentrations seem to be influenced by the methylenetetrahydrofolate reductase (MTHFR) C677T‐polymorphism. It was investigated whether the T‐allele of the MTHFR C677T‐polymorphism is associated with alcohol dependence, alcohol withdrawal seizure (WS), or the daily amount of alcohol consumption.

Methods: A group of 102 healthy controls and 221 alcoholic patients, including 97 patients with a history of mild withdrawal symptoms (MWS) and 70 patients with a history of alcohol WS, were genotyped, and personal data were collected for statistical evaluation in a case–control design.

Results: The T‐allele is significantly associated with WS by comparing alcoholic patients with a history of WS (T‐allele frequency: 0.39) and healthy controls (T‐allele frequency: 0.28) (p=0.03). Although there was no significant difference between alcoholic patients with only MWS and alcoholic patients with a history of WS, a trend for the T‐allele frequency among the analyzed subgroups was noticed: T‐allele frequency increased from f(T)=0.28 in healthy controls to f(T)=0.33 in alcoholic patients with MWS up to f(T)=0.40 in alcohol‐dependent men having a WS. Differences between healthy male controls and male alcoholic patients concerning the T‐allele frequency also turned out to be significant [f(T)=0.27 vs f(T)=0.37; p=0.03]. Daily alcohol intake was independent of T‐allele carrier status in alcohol‐dependent patients.

Conclusion: The present study suggests an influence of the MTHFR C677T‐polymorphism on the etiology of alcohol WS and alcohol dependence in men in a western European population. An influence of MTHFR C677T on the daily amount of alcohol intake before admission among alcohol‐dependent patients could not be shown.
Perception of Sleep in Recovering Alcohol‐Dependent Patients With Insomnia: Relationship With Future Drinking
Authors: Conroy Deirdre A. , Todd Arnedt J. , Brower Kirk J. , Strobbe Stephen , Consens Flavia , Hoffmann Robert , Armitage Roseanne
Published: October 2006

Background: Subjective and objective measures of poor sleep in alcoholic insomniacs predict relapse to drinking. Nonalcoholic insomniacs underestimate their total sleep time (TST) and overestimate their sleep onset latency (SOL) and wake time after sleep onset (WASO) compared with polysomnography (PSG). This study evaluated 3 hypotheses: (1) subjective SOL would predict frequency of future drinking; (2) participants would overestimate SOL and WASO and underestimate TST; and (3) higher amounts of over‐ and underestimates of sleep at baseline would predict worse drinking outcomes prospectively.

Methods: Participants (N=18), mean age 44.6 years (±13.2), underwent an adaptation night and then 2 nights of PSG 3 weeks apart. They also provided morning estimates of SOL, WASO, TST, and sleep efficiency (SE). Following the baseline PSG, participants were followed over 12 weeks. A 2‐way ANOVA (night × method of measuring sleep) compared results and regression analyses predicted drinking. Drinking outcomes were defined as number of days drinking (DD) and number of heavy‐drinking days (HDD) during 2 consecutive 6‐week follow‐up periods.

Results: Most participants (72%) overestimated SOL by a mean of 21.3 (±36) minutes compared with PSG [F(1, 14)=7.1, p<0.03]. Unexpectedly, 89% underestimated WASO by a mean difference of 48.7 (±49) minutes [F(1, 14)=15.6, p<0.01]. Drinking during the first 6‐week study period was predicted by both subjective estimates of WASO and their accuracy, whereas drinking during the second 6‐week period was predicted by both subjective estimations of sleep and rapid eye movement sleep latency.

Conclusion: Greater subjective accuracy of wakefulness at night provided by the patient predicted drinking during the study. Unlike nonalcoholic insomniacs, this alcoholic sample significantly underestimated WASO compared with PSG values. The predictive ability of sleep parameters depended on the selected measure of drinking outcomes and when outcomes were measured. Subjective sleep measures were better predictors of future drinking than corresponding PSG measures.
Infant Stress Reactivity and Prenatal Alcohol Exposure
Authors: Haley David W. , Handmaker Nancy S. , Lowe Jean
Published: October 2006

Background: Animal studies have shown that prenatal alcohol exposure (PAE) is linked to alterations in the stress response systems. To date, little is known about the impact of PAE on stress systems in human infants. The current study examined PAE effects on the stress response, as evidenced by the activation of the limbic–hypothalamic–pituitary–adrenal (L‐HPA) axis and autonomic system and changes in negative affect during a social‐emotional challenge in human infants. We also examined whether the effects of PAE on infant responsiveness differed in boys and girls.

Methods: Measures of cortisol, heart rate, and negative affect were obtained during a modified version of Tronick's still‐face procedure, a standardized developmental paradigm used to study emotion and stress regulation. Our sample included fifty‐five 5‐ to 7‐month‐old infants whose mothers were enrolled in an alcohol intervention study. Measures of maternal alcohol consumption during pregnancy and after delivery were obtained using Timeline Followback interviewing methods. Relationships between prenatal alcohol consumption and infant outcomes were examined. In addition, mothers were divided into high and low‐frequency drinkers, based on the mean percent of prenatal drinking days (PDD) to facilitate between‐group comparisons of infant stress measures.

Results: Mothers enrolled in our study reported significant reductions in alcohol consumption after learning of their pregnancies. Nevertheless, PDD from conception to pregnancy recognition was related to increases in cortisol reactivity, elevated heart rate, and negative affect in their infants. The effects of PAE on infant responsiveness were significant after controlling for the effects of maternal depression and annual income. In addition, the effects of PAE on cortisol reactivity differed for boys and girls.

Conclusions: Greater PAE was related to greater activation of stress response systems. Our findings suggest that PAE affects the development of infant stress systems and that these effects differ in boys and girls. This work supports the possibility that PAE is related to alterations in infant stress systems, which could underlie problems in cognitive and social–emotional functioning that are common among persons exposed prenatally to alcohol.
Long-Term Outcomes of Childhood Epilepsy: “The Truth is Rarely Pure and Never Simple”1
Authors: Miller John W.
Published: October 2006

Natural History of Treated Childhood-Onset Epilepsy: Prospective, Long-Term Population-Based Study

Sillanpää M, Schmidt D

Brain 2006;129(Pt 3):617–624

It is not well known how often drug resistance, a major clinical problem, occurs early or late in the course of epilepsy and how often epilepsy follows a continuous, remitting or relapsing-remitting pattern. To provide evidence if, in fact, different patterns of evolution of drug resistance and remission exist, a prospective, long-term population-based study of 144 patients followed on the average for 37.0 years (SD 7.1, median 40.0, range 11–42) since their first seizure before the age of 16 years was performed. At the end of follow-up, 67% of 144 patients were in terminal remission, on or off antiepileptic drugs. Early remission, starting within the first year of treatment, was seen in 45 patients (31%). In 23 (16%) of them, first remission continued, uninterrupted by relapse, to terminal remission. Late remission with a mean delay of 9 years was achieved by a further 72 patients (50%), including 46 (32%) patients who achieved terminal remission without any relapse and suggested, together with 23 patients, a remitting course. Following a relapse after early or late remission, 28 (19%) patients achieved terminal remission, suggesting a remitting-relapsing pattern. Altogether 20 patients (14%) did not re-enter remission, indicating a worsening course of epilepsy. Twenty-seven (19%) patients were drug-resistant from the start to the end of follow-up. In conclusion, half the patients with childhood-onset epilepsy will eventually enter terminal remission without relapse and a fifth after relapse. One-third will have a poor long-term outcome in terms of persistent seizures after remission or without any remission ever.
Treatment of New Onset Seizures: Predicting Long-Term Outcome
Authors: Ben-Menachem E.
Published: October 2006

Prediction of Risk of Seizure Recurrence after a Single Seizure and Early Epilepsy: Further Results from the MESS Trial

Kim LG, Johnson TL, Marson AG, Chadwick DW; MRC MESS Study group

Lancet Neurol 2006;5:317–322. Erratum in: Lancet Neurol 2006;5:383

Background

The MRC Multicentre trial for Early Epilepsy and Single Seizures (MESS) showed a reduced risk of further seizures in patients, for whom treatment with antiepileptic drugs was uncertain, who were randomly assigned immediate treatment compared with delayed treatment. However, there was no evidence of long-term remission rates. This study was undertaken to assess the role of patient characteristics and treatment in the prediction of seizure recurrence. This will enable decision making on the basis of the perceived risk of treatment compared with the benefit of reducing the risk of further seizures in the initial years after diagnosis.

Methods

A prognostic model was developed based on individual patient data from MESS to enable identification of patients at low, medium, or high risk of seizure recurrence. A split-sample approach was used in which the model was developed on a subsample of the full data and validated on the remainder of the sample. Distinction of the prognostic groups and predictive accuracy of the model were assessed.

Findings

Number of seizures of all types at presentation, presence of a neurological disorder, and an abnormal electroencephalogram (EEG) were significant factors in indicating future seizures. Individuals with two or three seizures, a neurological disorder, or an abnormal EEG were identified as the medium-risk group, those with two of these features or more than three seizures as the high-risk group, and those with a single seizure only as the low-risk group.

Interpretation

The model shows that there is little benefit to immediate treatment in patients at low risk of seizure recurrence, but potentially worthwhile benefits are seen in those at medium and high risk.
Is Mesial Temporal Sclerosis a Necessary Component of Temporal Lobe Epilepsy?
Authors: Kapur Jaideep
Published: October 2006

Temporal Lobe Epilepsy after Experimental Prolonged Febrile Seizures: Prospective Analysis

Dube C, Richichi C, Bender RA, Chung G, Litt B, Baram TZ

Brain 2006;129(Pt 4):911–922

Experimental prolonged febrile seizures (FS) lead to structural and molecular changes that promote hippocampal hyperexcitability and reduce seizure threshold to further convulsants. However, whether these seizures provoke later-onset epilepsy, as has been suspected in humans, has remained unclear. Previously, intermittent EEGs with behavioural observations for motor seizures failed to demonstrate spontaneous seizures in adult rats subjected to experimental prolonged FS during infancy. Because limbic seizures may be behaviourally subtle, here we determined the presence of spontaneous limbic seizures using chronic video monitoring with concurrent hippocampal and cortical EEGs, in adult rats (starting around 3 months of age) that had sustained experimental FS on postnatal day 10. These subjects were compared with groups that had undergone hyperthermia but in whom seizures had been prevented (hyperthermic controls), as well as with normothermic controls. Only events that fulfilled both EEG and behavioural criteria, i.e. electro-clinical events, were considered spontaneous seizures. EEGs (over 400 recorded hours) were normal in all normothermic and hyperthermic control rats, and none of these animals developed spontaneous seizures. In contrast, prolonged early-life FS evoked spontaneous electro-clinical seizures in 6 out of 17 experimental rats (35.2%). These seizures consisted of sudden freezing (altered consciousness) and typical limbic automatisms that were coupled with polyspike/sharp-wave trains with increasing amplitude and slowing frequency on EEG. In addition, interictal epileptiform discharges were recorded in 15 (88.2%) of the experimental FS group and in none of the controls. The large majority of hippocampally-recorded seizures were heralded by diminished amplitude of cortical EEG, that commenced half a minute prior to the hippocampal ictus and persisted after seizure termination. This suggests a substantial perturbation of normal cortical neuronal activity by these limbic spontaneous seizures. In summary, prolonged experimental FS lead to later-onset limbic (temporal lobe) epilepsy in a significant proportion of rats, and to interictal epileptifom EEG abnormalities in most others, and thus represent a model that may be useful to study the relationship between FS and human temporal lobe epilepsy.
Development of a GC‐MS Method for the Simultaneous Analysis of Latent Fingerprint Components*
Authors: Croxton Ruth S. , Baron Mark G. , Butler David , Kent Terry , Sears Vaughn G.
Published: October 2006

ABSTRACT: Latent fingerprint residue is a complex mixture of organic and inorganic compounds. A full understanding of the composition of this mixture and how it changes after deposition is lacking. Three solvent systems were compared for the simultaneous extraction and derivatization with ethyl chloroformate of selected amino and fatty acids from a nonporous substrate (Mylar®) for subsequent analysis by gas chromatography‐mass spectrometry. A solvent system comprised of sodium hydroxide, ethanol, and pyridine was found to be the most effective. This method was applied to the analysis of latent fingerprint residue deposited on Mylar® and preliminary data are presented. Twelve amino acids (e.g., serine, glycine, and aspartic acid) and 10 fatty acids (e.g., tetradecanoic, hexadecanoic, and octadecanoic acids) were identified. The potential application of this method to further the understanding of latent fingerprint chemistry has been demonstrated.
Sensitivity and specificity of immunoglobulin G titer for the diagnosis of mumps virus in infected patients depending on vaccination status
Authors: SANZ JUAN CARLOS , DEL MAR MOSQUERA MARÍA , ECHEVARRÍA JUAN EMILIO , FERNÁNDEZ MARISA , HERRANZ NIEVES , PALACIOS GUSTAVO , DE ORY FERNANDO
Published: October 2006

The aim of the study was to evaluate the usefulness of serological detection of mumps IgM and titration of IgG in patients with acute parotitis according to their vaccination status. The detection of mumps virus RNA in saliva by RT‐PCR was used as reference. 116 patients (109 of them previously vaccinated) with mumps RT‐PCR‐negative results and 21 (19 vaccinated) with mumps RT‐PCR‐positive results were studied. Mumps‐specific IgM and IgG were assayed by EIA (Enzygnost, Dade Behring, Germany). IgM results were expressed as positive or negative. For IgG, several cut‐offs were calculated using receiver operating characteristic (ROC) curves. Seven RT‐PCR‐positive and five RT‐PCR‐negative patients showed IgM‐positive results (sensitivity 33.3% and specificity 95.7%). Among vaccinated patients, the sensitivity and specificity of IgM were 26.3% (5/19) and 99.1% (108/109). For IgG, a titer of 5,000 in all the patients showed a sensitivity of 76.2% (16/21) and a specificity of 83.6% (97/116). In vaccinated patients, the corresponding figures for this cut‐off were 84.2% (16/19) and 83.5% (91/109), respectively. Although IgM detection against mumps is highly specific, its sensitivity is very low in immunized subjects. In this group, the titration of IgG could serve as an additional diagnostic tool.
Use of DNA hybridization test for diagnosing bacterial vaginosis in women with symptoms suggestive of infection
Authors: GAZI HORU , DEGERLI KENAN , KURT OZGUR , TEKER ASLI , UYAR YILDIZ , CAGLAR HUSNU , KURUTEPE SEMRA , SURUCUOGLU SUHEYLA
Published: October 2006

The purpose of this study was to evaluate a DNA hybridization test (Affirm VPIII) as an alternative to Gram stain for the rapid diagnosis of bacterial vaginosis in women with clinical signs of vaginal infection. Vaginal specimens were collected from 321 symptomatic women, and analyzed for bacterial vaginosis by both Gram stain using Nugent criteria and DNA hybridization test. Sensitivity, specificity, positive predictive value, and negative predictive value of the DNA hybridization test were determined using the Gram staining as the standard for diagnosis of bacterial vaginosis. Of the 321 patients, 115 (35.8%) were Gram positive for bacterial vaginosis and 126 (39.2%) were negative. 80 patients (25.0%) demonstrated intermediate Gram staining that was also considered negative. The Affirm system detected G. vaginalis in 107 (93.0%) of 115 vaginal specimens positive for bacterial vaginosis diagnosed by Gram stain. Compared to the Gram stain, DNA hybridization test had a sensitivity of 87.7% and a specificity of 96.0%. Positive and negative predictive values of the DNA hybridization test were 93.0% and 92.7%, respectively. In conclusion, Affirm VPIII hybridization test correlated well with Gram stain and may be used as a rapid diagnostic tool to exclude bacterial vaginosis in women with genital complaints.
Atypical neurothekeoma: a new case and review of the literature
Authors: Campanati Anna , Brandozzi Giuliano , Sisti Stefano , Bernardini Maria Luisa , Offidani Anna Maria
Published: October 2006

Background:  Neurothekeoma is a rare neoplasm ascribed into the broad category of benign peripheral nerve sheath tumors. The atypical cellular variant of this neoplasm, showing a peculiar histological pattern, has been very rarely reported in literature.

Methods:  The clinical, histopathological and immunohistochemical profile of a new case of atypical cellular neurothekeoma in a 32‐year‐old woman is reported.

Results:  The described neoplasm showed the histological features of atypical variant of cellular neurothekeoma with high‐rate mitotic activity and deep penetration into subcutaneous fat.

Conclusions:  Because only few cases of atypical neurothekeoma have been reported in literature, clinical and morphological available data on this neoplasm are very few, and its prognosis remains uncertain; anyway, dermatologists should be aware of histological features of this neoplasm for which a complete surgical excision is recommended.
Expression of the corticotropin‐releasing hormone–proopiomelanocortin axis in the various clinical types of psoriasis
Authors: Kim Jung Eun , Cho Dae Ho , Kim Hei Sung , Kim Hee Jung , Lee Jun Young , Cho Baik Kee , Park Hyun Jeong
Published: October 2006

Abstract:  Psychological stress is known to aggravate inflammatory skin diseases such as atopic dermatitis, psoriasis and contact sensitivity by altering the cellular constituents of the immune system. The skin appendages function dually as prominent targets and sources of the peripheral corticotropin‐releasing hormone–proopiomelanocortin (CRH‐POMC) axis. In this study, we examined the expression level of CRH‐POMC axis constituents in psoriasis, a well‐known stress‐related inflammatory skin disease. The 15 psoriasis patients and six normal controls were retrospectively selected after extensive review of their clinical records and skin biopsy specimens. We immunohistochemically analysed the expressivity of CRH, adrenocorticotrophic hormone (ACTH) and α‐melanocyte‐stimulating hormone (α‐MSH) in various types of psoriatic lesions and control skin. A significant increase of CRH expression was observed in psoriatic lesions, which involved the entire epidermis (upper layer in particular), hair follicles and sweat glands compared with controls. Expression of ACTH and α‐MSH was clearly stimulated in a subset of psoriasis patients compared with controls, but on the whole, lacked statistical significance. The immunoreactivity of CRH, ACTH and α‐MSH in psoriasis was not dependent on its clinical subtype, duration or number of previous treatments. Compared with the definite increase of CRH expression in psoriasis, the expression of the POMC peptides was heterogenous with no overall significance. From the findings, we suggest that CRH, a key stress hormone, may play an important role in the pathomechanism of psoriasis.
Characterization of a multifunctional protein disulfide oxidoreductase from Sulfolobus solfataricus
Authors: Pedone Emilia , Limauro Danila , D'Alterio Romina , Rossi Mosè , Bartolucci Simonetta
Published: October 2006

A potential role in disulfide bond formation in the intracellular proteins of thermophilic organisms has recently been ascribed to a new family of protein disulfide oxidoreductases (PDOs). We report on the characterization of SsPDO, isolated from the hyperthermophilic archaeon Sulfolobus solfataricus. SsPDO was cloned and expressed in Escherichia coli. We revealed that SsPDO is the substrate of a thioredoxin reductase in S. solfataricus (KM 0.3 µm) and not thioredoxins (TrxA1 and TrxA2). SsPDO/S. solfataricus thioredoxin reductase constitute a new thioredoxin system in aerobic thermophilic archaea. While redox (reductase, oxidative and isomerase) activities of SsPDO point to its central role in the biochemistry of cytoplasmic disulfide bonds, chaperone activities also on an endogenous substrate suggest a potential role in the stabilization of intracellular proteins. Northern and western analysis have been performed in order to analyze the response to the oxidative stress.
The answer is blowing in the wind: simulating the interaction of jets with dynamic cluster atmospheres
Authors: Heinz S. , Brüggen M. , Young A. , Levesque E.
Published: October 2006

We present numerical simulations investigating the interaction of active galactic nucleus jets with galaxy clusters, for the first time taking into account the dynamic nature of the cluster gas and detailed cluster physics. The simulations successfully reproduce the observed morphologies of radio sources in clusters. We find that cluster inhomogeneities and large-scale flows have a significant impact on the morphology of the radio source and cannot be ignored a priori when investigating radio source dynamics. Morphological comparison suggests that the gas in the centres of clusters like Virgo and Abell 4059 shows significant shear and/or rotation. We find that shear and rotation in the intracluster medium move large amounts of cold material back into the path of the jet, ensuring that subsequent jet outbursts encounter a sufficient column density of gas to couple with the inner cluster gas, thus alleviating the problem of evacuated channels discussed in the recent literature. The same effects redistribute the excess energy ΔE deposited by the jet, making the distribution of ΔE at late times consistent with being isotropic.
Growing supermassive black holes by chaotic accretion
Authors: King A. R. , Pringle J. E.
Published: October 2006

We consider the problem of growing the largest supermassive black holes from stellar mass seeds at high redshift. Rapid growth without violating the Eddington limit requires that most mass is gained while the hole has a low spin and thus a low radiative accretion efficiency. If, as was formerly thought, the black hole spin aligns very rapidly with the accretion flow, even a randomly oriented sequence of accretion events would all spin up the hole and prevent rapid mass growth. However, using the recent result that the Bardeen–Petterson effect causes counteralignment of hole and disc spins under certain conditions, we show that holes can grow rapidly in mass if they acquire most of it in a sequence of randomly oriented accretion episodes whose angular momenta Jd are no larger than the angular momentum of the hole, Jh. Ultimately the hole has total angular momentum comparable with the last accretion episode. This points to a picture in which the accretion is chaotic on a lengthscale of order the disc size, that is, ≲0.1 pc.
Infrared observations of the 2006 outburst of the recurrent nova RS Ophiuchi: the early phase
Authors: Evans A. , Kerr T. , Yang Bin , Matsuoka Y. , Tsuzuki Y. , Bode M. F. , Eyres S. P. S. , Geballe T. R. , Woodward C. E. , Gehrz R. D. , Lynch D. K. , Rudy R. J. , Russell R. W. , O'Brien T. J. , Starrfield S. G. , Davis R. J. , Ness J.-U. , Drake J. , Osborne J. P. , Page K. L. , Adamson A. , Schwarz G. , Krautter J.
Published: October 2006

We present infrared spectroscopy of the recurrent nova RS Ophiuchi, obtained 11.81, 20.75 and 55.71 d following its 2006 eruption. The spectra are dominated by hydrogen recombination lines, together with He i, O i and O ii lines; the electron temperature of ∼104 K implied by the recombination spectrum suggests that we are seeing primarily the wind of the red giant, ionized by the ultraviolet flash when RS Oph erupted. However, strong coronal emission lines (i.e. emission from fine structure transitions in ions having high ionization potential) are present in the last spectrum. These imply a temperature of 930 000 K for the coronal gas; this is in line with X-ray observations of the 2006 eruption. The emission linewidths decrease with time in a way that is consistent with the shock model for the X-ray emission.
Efficacy of the Kampo Medicine Xiong-Gui-Jiao-Ai-Tang, a Traditional Herbal Medicine, in the Treatment of Threatened Abortion in Early Pregnancy
Authors: Ushiroyama Takahisa , Araki Ryoji , Sakuma Kou , Nosaka Sakura , Yamashita Yoshiki , Kamegai Hideki
Published: October 2006

This study was carried out to evaluate the clinical efficacy of Xiong-gui-jiao-ai-tang (Kyuki-kyogai-to), a traditional Chinese herbal medicine, in the treatment of threatened abortion in early pregnancy. We enrolled 72 women diagnosed with threatened abortion at Osaka Medical College Hospital and assigned them at random to the following two groups: a group of 36 women who received Xiong-gui-jiao-ai-tang at a dose of 7.5 g/day and another group of 36 women who received human chorionic gonadotropin (hCG)(control group). We found that in the Xiong-gui-jiao-ai-tang group (2.9 ± 3.5 days), the number of days required before hemostasis was reached in the uterus was significantly shorter than in the control group (10.8 ± 8.2 days, p < 0.0001). Furthermore, the number of days required for retroplacental hematoma in the vicinity of the gestational sac to disappear was significantly shorter in the Xiong-gui-jiao-ai-tang group (9.9 ± 7.1 days) than in the control group (23.2 ± 12.8 days) ( p < 0.0001). In retroplacental hematoma size, significant rates of reduction were obtained in both major and minor axis measurements at the 7th day of treatment for the Xiong-gui-jiao-ai-tang group compared to the control group (control vs Xiong-gui-jiao-ai-tang: major axis: 7.5 ± 3.8% vs 42.3 ± 10.5%; minor axis: 15.3 ± 16.8% vs 71.5 ± 48.2%)( p < 0.0001, each case). The results of this study demonstrated the beneficial effects of Xiong-gui-jiao-ai-tang in stabilizing early pregnancy.

Xiong-gui-jiao-ai-tang can be expected to improve unstable early pregnancy with uterine bleeding and to prevent abortion.
A Comparison Between Directional and Proportional Methods in Locating Acupuncture Points Using Dual-Energy X-ray Absorptiometry in Korean Women
Authors: Park Hi-Joon , Chae Younbyoung , Song Mi-Yeon , Choe Il-Hwan , Park Jongbae , Lee Hyejung , Lim Sabina
Published: October 2006

The cun measurement system, an essential and convenient method for locating acupoints, has been widely used in the practice of acupuncture. However, the traditional cun measurement methods have been criticized for their lack of reliability. In addition, new technology has become available to measure the soft tissue and bone mass independently. The present study was conducted in order to determine if one cun, measured by the directional method, is consistent with proportional methods and to investigate whether both methods can be used to locate acupoints. The lengths of bone from several parts of the body in 47 Korean women were measured using Dual-Energy X-ray Absorptiometry. The lengths of each part of the body were compared with 3 cun measured by proportional methods, and the width of all four fingers measured at the level of the proximal inter-phalangeal joint used in the directional method. The results showed that one cun measured by the directional method was significantly different from one cun by proportional methods. The directional method is likely less dependable in locating acupoints than the proportional method.
A Study on the Clinical Effects of Physical Therapy and Acupuncture to Treat Spontaneous Frozen Shoulder
Authors: Ma Tsochiang , Kao Mu-Jung , Lin I-hsin , Chiu Yen-Lin , Chien Chingwen , Ho Tsung-Jung , Chu Bow-Ching , Chang Yung-Hsien
Published: October 2006

The integration of traditional Chinese and Western medicine and their clinical effects have been widely evaluated. Many studies have shown that using a combination of these two remedies has resulted in better outcomes than using only one of them. Acupuncture is a traditional Chinese medical technique, which plays an important role in enforcing pain control, prevention and functional improvement. In 1979, the World Health Organization (WHO) journal introduced acupuncture as a remedy for 43 diseases, including frozen shoulder. This study aims to assess the therapeutic outcomes of combining acupuncture and physical therapy to treat frozen shoulder, and hopes to establish an evidence-based study of the integration of acupuncture and western medicine in the future.

A total of 75 frozen shoulder patients treated in a medical center were recruited for the study between January 2002 and December 2002. The average age of these patients was 54.8 years. The average duration of the condition was 25.8 weeks before treatment. Of the 75 patients, 30 were treated by physical therapy, 30 by acupuncture and 15 by both remedies. Before the treatment began, all patients were evaluated by assessing static pain scale, motion pain scale, active and passive ROM (range of motion) and quality of life scale sheet SF-36 (Short Form-36). The outcome was evaluated by follow-up assessments conducted at the 2nd week and 4th week of treatment sessions.

All patients showed improvement in quality of life (Short Form-36). Pain was controlled better by acupuncture while ROM improved following physical therapy. However, patients treated by both methods had the best outcome.

The integration of acupuncture and physical therapy to treat frozen shoulder leads to a better outcome than using only one method. The author suggests that an evidence-based foundation of the integration of Chinese and Western medicine should be established in the future, to encourage the integration of Chinese and Western medicine.
Ginkgo bilobaLeaf Extract (EGb761) Combined with Neuroprotective Agents Reduces the Infarct Volumes of Gerbil Ischemic Brain
Authors: Chung Shu-Ying , Cheng Fu-Chou , Lee Ming-Shih , Lin Jing-Ying , Lin Ming-Cheng , Wang Ming-Fu
Published: October 2006

Ginkgo biloba exerts many pharmacological actions. It possesses antioxidant properties, the ability of neurotransmitter/receptor modulation and antiplatelet activation factor. This research is designed to investigate the neuroprotective effects of long-term treatment with EGb761 (a standard form of the extract of Ginkgo biloba leaf) in combination with MgSO4, FK506, or MK-801 on the infarct volume of male gerbils' brain induced by unilateral middle cerebral artery occlusion (MCAO). Thirty-five gerbils fed a standard diet were intragastrically given water or EGb761 (100 mg/kg/day) for one week. Five randomized groups were established: control ( n = 7), EGb 761 ( n = 8), EGb 761 + MgSO4( n = 7), EGb 761 + FK 506 ( n = 7), and EGb 761 + MK -801 ( n = 6). The three drug-combination groups were injected with MgSO4(90 mg/kg), FK506 (0.5 mg/kg), or MK-801 (1 mg/kg), respectively 30 min before MCAO. Gerbils were anesthetized and craniectomized to expose the right middle cerebral artery (MCA). The right MCA was constricted with an 8-0 suture to produce a permanent ligation for 24 hours. Postmortem infarct volumes were determined by quantitative image analysis of 2,3,5-triphenyltetrazolium chloride (TTC)-stained brain sections. Results showed that the total infarct volumes of the four treated groups either EGb761 alone or in combination with drugs were lower than the control group by 36.1% (EGb761 alone), 40.3% ( EGb 761 + MgSO4), 35.3% ( EGb 761 + FK 506), and 56.4% ( EGb 761 + MK -801), respectively ( p < 0.01). The main affected areas of the brain in the four treated groups were significantly focused between 4 and 6 mm from the frontal pole, when compared to the control group ( p < 0.01). All animals in the five groups had infarctions in both cortex and subcortex. These results indicate that long-term pre-treatment of EGb761 administered either alone or in combination with drugs significantly effective neuroprotection on infarct volume in gerbil ischemic brains.
MORBIDITY OF HAND AND WRIST GANGLIA
Authors: Tomlinson P. J. , Field J.
Published: October 2006

Pain and disability caused by ganglia of the hand and wrist were assessed using a patient-rated wrist evaluation questionnaire in 75 patients. Dorsal wrist ganglia were the most painful and disabling. However, the majority of ganglia cause little pain or disability. Consequently, referral by General Practitioners should be confined to those with pain, disability or failure of conservative management.
LIMITED WRIST ARTHRODESIS VERSUS RADIAL OSTEOTOMY FOR ADVANCED KIENBÖCK'S DISEASE — FOR A FRAGMENTED LUNATE
Authors: Tatebe Masahiro , Hirata Hitoshi , Iwata Yoshihisa , Hattori Tatsuya , Nakamura Ryogo
Published: October 2006

Thirty-eight patients with advanced Kienböck's disease treated by limited wrist arthrodesis (LWA: n = 10) or radial osteotomy (RO: n = 28) for a fragmented lunate were retrospectively examined after an average of 47.9 and 68.1 months, respectively. Compared with pre-operative values, the active flexion-extension range of motion decreased by about 16.0° in LWA and increased approximately 9.7° in RO and the grip strength improved by approximately 7.5 kg in LWA and 8.0 kg in RO. In both groups, radiographs showed no significant progression of carpal collapse. Although LWA caused some decrease in wrist flexion-extension, both procedures are appropriate for surgical treatment of advanced Kienböck's disease. Most patients experienced a reduction in pain and were able to return to work.
SIMULTANEOUS FRACTURES OF DISTAL AND PROXIMAL PHALANGES OF THE THUMB, TRAPEZIUM AND CARPAL SCAPHOID OF THE IPSILATERAL HAND: A CASE OF VERY UNUSUAL COMBINATION OF FRACTURES
Authors: Sakamoto Kazuaki , Kozuki Kenso , Shakya Iswar Man
Published: October 2006

Simultaneous multiple injuries of the thumb ray are rare. An unusual case of a simultaneous fracture of proximal and distal phalanges, trapezium and scaphoid is reported. The patient had an acceptable result six months after injury. This type of injury of the thumb ray may be a specific form of injury pattern caused by the mobile phone.
LOCKING OF THE METACARPOPHALANGEAL JOINT OF THE THUMB BY A LOOSE BODY: A CASE REPORT
Authors: Ueda Daisuke , Ikeda Masayoshi , Oka Yoshinori
Published: October 2006

We report a case with locking of the metacarpophalangeal (MP) joint of the thumb in a 15-year-old high school baseball catcher, which was caused by an intra-articular loose body arising from osteochondritis dissecans. The loose body was removed arthroscopically, enabling early return to full MP joint function.
DIGITAL PAPILLARY ADENOCARCINOMA: A CASE REPORT
Authors: Mangrulkar Vaibhav H. , Gould Elaine S. , Miller Frederick
Published: October 2006

Digital papillary adenocarcinoma (DPAc) is a relatively rare neoplasm arising from the sweat glands with a predilection for the hand. A case of DPAc in the third finger at the level of the proximal phalanx in a 55-year-old male is presented. Our paper recommends specific consideration of DPAc in evaluating digital soft tissue masses, particularly those that present with an aggressive nature.
ACUTE RUPTURE OF EXTENSOR POLLICIS LONGUS TENDON DUE TO AVULSED FRACTURE OF THE SECOND METACARPAL BASE: A CASE REPORT
Authors: Ishida Kazunari , Fujioka Hiroyuki , Doi Ryoichi
Published: October 2006

Acute tendon rupture of the extensor pollicis longus (EPL) is rare. We present acute EPL tendon rupture associated with avulsed fracture of the second metacarpal at the insertion of extensor carpi radialis longus. Tendon rupture of the EPL was repaired with end-to-end suture and avulsed fracture of the second metacarpal base was treated with open reduction and internal fixation.