bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing for inherited thrombophilia and consequences for antithrombotic prophylaxis in patients with venous thromboembolism and their relatives
Authors: Rossi Elena , De Stefano Valerio
Published: July 2013

The clinical penetrance of venous thromboembolism (VTE) susceptibility genes is variable, being lower in heterozygous carriers of factor V Leiden and prothrombin 20210A (mild thrombophilia), and higher in the rare carriers of deficiencies of antithrombin, protein C or S, and those with multiple or homozygous abnormalities (high-risk thrombophilia). The absolute risk of VTE is low, and the utility of laboratory investigation for inherited thrombophilia in patients with VTE and their asymptomatic relatives has been largely debated, leading to the production of several Guidelines from Scientific Societies and Working Groups. The risk for VTE largely depends on the family history of VTE. Therefore, indiscriminate search for carriers is of no utility, and targeted screening is potentially more fruitful. In patients with VTE inherited thrombophilia is not scored as a determinant of recurrence, playing a minor role in the decision of prolonging anticoagulation; indeed, a few guidelines consider testing worthwhile to identify carriers of high-risk thrombophilia, particularly those with a family history of VTE. The identification of the asymptomatic carrier relatives of the probands with VTE and thrombophilia could reduce cases of provoked VTE, offering them primary antithrombotic prophylaxis during risk situations. In most guidelines, this is considered justified only for relatives of probands with a deficiency of natural anticoagulants or multiple abnormalities. Counselling the asymptomatic female relatives of individuals with VTE and/or thrombophilia before pregnancy or the prescription of hormonal treatments should be administered with consideration of the risk driven by the type of thrombophilia and the family history of VTE.
Patient-reported treatment satisfaction with oral rivaroxaban versus standard therapy in the treatment of acute symptomatic deep-vein thrombosis
Authors: Bamber Luke , Wang Maria Y. , Prins Martin H. , Ciniglio Cathleen , Bauersachs Rupert , Lensing Anthonie W. A. , Cano Stefan J.
Published: July 2013

Rivaroxaban, an oral, direct factor Xa inhibitor, has been approved for the treatment of deep-vein thrombosis (DVT) and pulmonary embolism (PE) and the prevention of recurrent DVT and PE as a fixed-dose, single-drug regimen that does not require initial heparinisation, routine coagulation monitoring or dose adjustment. This study evaluated patient-reported treatment satisfaction in EINSTEIN DVT - a large, open-label, randomised study that compared rivaroxaban with enoxaparin/ vitamin K antagonist (VKA) therapy in patients with acute symptomatic DVT without PE. As part of EINSTEIN DVT, a total of 1,472 patients in seven countries were asked to complete a new, validated measure of treatment satisfaction - the Anti-Clot Treatment Scale (ACTS) - at scheduled visits throughout 12 months of treatment. ACTS scores were compared between study groups in the intentionto- treat population. Patients reported greater satisfaction in the rivaroxaban group compared with the enoxaparin/VKA group, with higher mean ACTS scores across visits. Mean ACTS Burdens scores were 55.2 vs 52.6 (p<0.0001) in favour of rivaroxaban, equivalent to a moderate effect size of 0.42. The treatment effect was consistent over time, with the mean score difference ranging from 2.18 (month 2) to 3.18 (month 12). Overall mean ACTS Benefits scores were 11.7 vs 11.5 in favour of rivaroxaban (p=0.006). This was associated with a small overall effect size of 0.12. The improvement in ACTS Benefits for rivaroxaban became apparent at month 2 and subsequent visits. Rivaroxaban results in improved treatment satisfaction compared with enoxaparin/VKA among patients with DVT, particularly in reducing patient-reported anticoagulation burden.
Acat1
Gene Ablation in Mice Increases Hematopoietic Progenitor Cell Proliferation in Bone Marrow and Causes Leukocytosis
Authors: Huang Li-Hao , Gui Jingang , Artinger Erika , Craig Ruth , Berwin Brent L. , Ernst Patricia A. , Chang Catherine C.Y. , Chang Ta-Yuan
Published: July 2013

Objective—

To investigate the role of acyl-CoA:cholesterol acyltransferase 1 (ACAT1) in hematopoiesis.

Approach and Results—

ACAT1 converts cellular cholesterol to cholesteryl esters for storage in multiple cell types and is a potential drug target for human diseases. In mouse models for atherosclerosis, global
Acat1
knockout causes increased lesion size; bone marrow transplantation experiments suggest that the increased lesion size might be caused by ACAT1 deficiency in macrophages. However, bone marrow contains hematopoietic stem cells that give rise to cells in myeloid and lymphoid lineages; these cell types affect atherosclerosis at various stages. Here, we test the hypothesis that global
Acat1

−/−

may affect hematopoiesis, rather than affecting macrophage function only, and show that
Acat1

−/−

mice contain significantly higher numbers of myeloid cells and other cells than wild-type mice. Detailed analysis of bone marrow cells demonstrated that
Acat1

−/−

causes a higher proportion of the stem cell–enriched Lin
−
Sca-1
+
c-Kit
+
population to proliferate, resulting in higher numbers of myeloid progenitor cells. In addition, we show that
Acat1

−/−

causes higher monocytosis in
Apoe

−/−

mouse during atherosclerosis development.

Conclusions—

ACAT1 plays important roles in hematopoiesis in normal mouse and in
Apoe

−/−

mouse during atherosclerosis development.
Review, Historical Context, and Clarifications of the NINDS rt-PA Stroke Trials Exclusion Criteria
Authors: Levine Steven R. , Khatri Pooja , Broderick Joseph P. , Grotta James C. , Kasner Scott E. , Kim Doojin , Meyer Brett C. , Panagos Peter , Romano Jose , Scott Phillip
Published: July 2013

Background and Purpose—

Since Food and Drug Administration approval of intravenous tissue-type plasminogen activator (tPA) for treatment of acute ischemic stroke in 1996, it has become clear that several criteria used for exclusion from therapy were not based on actual data or operationally defined for use in clinical practice. All eligibility criteria from the National Institute of Neurological Disorders and Stroke (NINDS) recombinant tPA Stroke Study were adopted within the alteplase package insert as contraindications/warnings. Many clinicians have expressed the need for clarification and better definition of these treatment criteria.

Methods—

A group of investigators who also practice as stroke physicians convened a collaborative endeavor to work toward developing more clinically meaningful and consensus-driven exclusion criteria for intravenous tPA. The first of these exclusion criteria chosen was rapidly improving stroke symptoms (RISS). We reviewed and clarified the historical context and intention with the original investigators, held e-mail discussions, convened an in-person RISS Summit, and obtained the understanding of experienced stroke physicians broadly.

Results—

Historically, the intent of this exclusion criterion within the NINDS recombinant tPA Stroke Trial was to avoid treatment of transient ischemic attacks—who would have recovered completely without treatment. There was unanimous consensus that, in the absence of other contraindications, patients who experience improvement of any degree, but have a persisting neurological deficit that is potentially disabling, should be treated with intravenous tPA. This statement is supported from the methods established for the original NINDS trial, on the basis of detailed discussions and interviews with the former NINDS trialists. It was agreed that improvement should only be monitored for the extent of time needed to prepare and administer the intravenous tPA bolus/infusion. An explicit operational definition of RISS was developed by consensus to guide future decision making in acute stroke. There was unanimous agreement that all neurological deficits present at the time of the treatment decision should be considered in the context of individual risk and benefit, as well as the patient’s baseline functional status.

Conclusions—

A structured framework and quantitative approach toward defining RISS emerged through expert opinion and consensus. The term, RISS, should be reserved for those who improve to a mild deficit, specifically one which is perceived to be nondisabling. This is recommended to guide decision making on intravenous tPA eligibility going forward, including the design of future studies. An additional study of patients with rapid improvement to nonmild deficits is not justified because these patients should be treated.
Analytical Philosophy and the Philosophy of Intellectual History: A Critical Comparison and Interpretation
Authors: Skodo Admir
Published: July 2013

Abstract

This article argues that the relationship between analytical philosophy and the philosophy of intellectual history is conceptually uneasy and even antagonistic once the general philosophical viewpoints, and some particular topics, of the two perspectives are drawn out and compared. The article critically compares the philosophies of Quentin Skinner and Mark Bevir with the philosophies of Ludwig Wittgenstein, J.L. Austin, W.V.O. Quine and Donald Davidson. Section I compares the way in which these two perspectives view the task of philosophy. Section II points to a critical difficulty in Bevir and Skinner’s use of analytical philosophy in their discussions on objectivity. In section III, another such critical juncture is identified in the topic of explanation. Finally, section IV suggests an interpretation for the character of the comparison.
Semantics of Historical Representation in Terms of Aspects
Authors: Zeleňák Eugen
Published: July 2013

Abstract

In his latest book, Frank Ankersmit proposes an original theory of historical representation. In this review I focus on what I take to be his most important semantic points with respect to representation, meaning, truth, and reference. First, I provide a short summary of the book. Second, I explore his semantics in terms of aspects and compare it with a different account inspired by the Fregean notion of mode of presentation. As my examination shows, Ankersmit’s analysis faces the problem of “loosing indirectness” and, moreover, there seems to exist an alternative and plausible view that does not suffer from this problem. Finally, I conclude with a couple of comments on the Copernican Revolution advocated in the book.
Two Contrasting Severe Seasonal Extremes in Tropical South America in 2012: Flood in Amazonia and Drought in Northeast Brazil
Authors: Marengo Jose A. , Alves Lincoln M. , Soares Wagner R. , Rodriguez Daniel A. , Camargo Helio , Riveros Marco Paredes , Pabló Amelia Diaz
Published: July 2013

Two simultaneous extreme events affected tropical South America to the east of the Andes during the austral summer and fall of 2012: a severe drought in Northeast Brazil and intense rainfall and floods in Amazonia, both considered records for the last 50 years. Changes in atmospheric circulation and rainfall were consistent with the notion of an active role of colder-than-normal surface waters in the equatorial Pacific, with above-normal upward motion and rainfall in western Amazonia and increased subsidence over Northeast Brazil. Atmospheric circulation and soil moisture anomalies in the region contributed to an intensified transport of Atlantic moisture into the western part of Amazonia then turning southward to the southern Amazonia region, where the Chaco low was intensified. This was favored by the intensification of subtropical high pressure over the region, associated with an anomalously intense and northward-displaced Atlantic high over a relatively colder subtropical South Atlantic Ocean. This pattern observed in 2012 was not found during other wet years in Amazonia such as 1989, 1999, and 2009. This suggests La Niña as the main cause of the abundant rainfall in western Amazonia from October to December, with wet conditions starting earlier and remaining until March 2012, mostly in northwestern Amazonia. The anomalously high river levels during the following May–July were a consequence of this early and abundant rainy season during the previous summer. In Northeast Brazil, dry conditions started to appear in December 2011 in the northern sector and then extended to the entire region by the peak of the rainy season of February–May 2012.
An Artificial Neural Network Model to Reduce False Alarms in Satellite Precipitation Products Using MODIS and CloudSat Observations
Authors: Nasrollahi Nasrin , Hsu Kuolin , Sorooshian Soroosh
Published: July 2013

The Moderate Resolution Imaging Spectroradiometer (MODIS) instrument aboard the NASA Earth Observing System (EOS) Aqua and Terra platform with 36 spectral bands provides valuable information about cloud microphysical characteristics and therefore precipitation retrievals. Additionally, CloudSat, selected as a NASA Earth Sciences Systems Pathfinder satellite mission, is equipped with a 94-GHz radar that can detect the occurrence of surface rainfall. The CloudSat radar flies in formation with Aqua with only an average of 60 s delay. The availability of surface rain presence based on CloudSat together with the multispectral capabilities of MODIS makes it possible to create a training dataset to distinguish false rain areas based on their radiances in satellite precipitation products [e.g., Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks (PERSIANN)]. The brightness temperatures of six MODIS water vapor and infrared channels are used in this study along with surface rain information from CloudSat to train an artificial neural network model for no-rain recognition. The results suggest a significant improvement in detecting nonprecipitating regions and reducing false identification of precipitation. Also, the results of the case studies of precipitation events during the summer and winter of 2007 over the United States show an accuracy of 77% no-rain identification and 93% detection accuracy, respectively.
Urbanization and Climate Change: An Examination of Nonstationarities in Urban Flooding
Authors: Yang Long , Smith James A. , Wright Daniel B. , Baeck Mary Lynn , Villarini Gabriele , Tian Fuqiang , Hu Heping
Published: July 2013

The authors examine the hydroclimatology, hydrometeorology, and hydrology of flooding in the Milwaukee metropolitan region of the upper midwestern United States. The objectives of this study are 1) to assess nonstationarities in flood frequency associated with urban transformation of land surface properties and climate change and 2) to examine how spatial heterogeneity in land surface properties and heavy rainfall climatology interact to determine floods in urbanizing areas. The authors focus on the Menomonee River basin, which drains much of the urban core of Milwaukee, and the adjacent Cedar Creek basin, where agricultural land use dominates. Results are based on analyses of bias-corrected, high-resolution (1-km2 spatial resolution and 15-min time resolution) radar rainfall fields that are developed using the Hydro-NEXRAD system, rainfall observations from a network of 21 rain gauges in the Milwaukee metropolitan region, and discharge observations from 11 U.S. Geological Survey stream gauging stations. Both annual flood peak magnitudes and annual peaks over threshold flood counts have increased for the Menomonee River basin during the past five decades, and these trends are accompanied by a transition of flood events dominated by snowmelt (March–April floods) to a regime in which warm season thunderstorms are the dominant flood-producing agents. The frequency of heavy rainfall events has increased significantly. The spatial distribution of rainfall for flood-producing storms in the Milwaukee study region exhibits striking spatial heterogeneity, with a maximum in the central portion of the Menomonee River basin. Storm event hydrologic response is determined by the interactions of spatial patterns of urbanization and rainfall distribution in the Menomonee River basin.
Improved Passive Microwave Retrievals of Rain Rate over Land and Ocean. Part II: Validation and Intercomparison
Authors: Petty Grant W. , Li Ke
Published: July 2013

A new passive microwave rainfall retrieval algorithm for the Tropical Rainfall Measuring Mission (TRMM) Microwave Imager (TMI) that relies on an a priori database derived from matchups between TMI brightness temperatures and precipitation radar (PR)-derived surface rain rates has been developed. In addition to implementing a fairly conventional Bayesian approach to precipitation estimation, it exploits a dimensional reduction technique designed to increase the effective sample density in the database and also to improve the detectability of precipitation over problem surface types. The details of the algorithm itself are described in a companion paper. In this paper, the algorithm is validated against independent PR–TMI matchups from calendar year 2002. The validation results are benchmarked against results obtained for the same scenes from the current standard (version 7) 2A12 rainfall product for TRMM.

Validation statistics considered include the biases, correlation coefficients, and root-mean-square (RMS) differences for annual precipitation totals on a 1° grid as well as two-threshold Heidke skill scores (HSS) for instantaneous (pixel level) retrievals, determined separately for each of seven surface classes, including ocean, coast, and five other basic land surface types as well as for cold (<275 K) and warm surface skin temperatures.

Overall, the University of Wisconsin (UW) algorithm exhibits markedly reduced RMS error and bias in the annual total rainfall and markedly improved instantaneous skill at delineating light rain rates, especially over land and the coast. To ensure that the improved results were not due to both the training and validation data having been taken from the same calendar year, the validation of the UW algorithm is repeated using 2005 matchup data.
Obesity Is a Risk Factor for Significant Carotid Atherosclerosis in Patients Aged 39 to 55 Years
Authors: Silva Erasmo Simão da , Giglio Pedro Nogueira , Waisberg Daniel Reis , Filho Richard Geraldo Jaqueta , Casella Ivan Benaduce , Puech-Leão Pedro
Published: July 2013

We compared the prevalence of risk factors between young and old individuals with significant carotid atherosclerosis. We retrospectively reviewed the records of patients aged 39 to 55 years (group I) and aged ≥60 years (group II) with significant atherosclerotic stenosis at the carotid bifurcation. Group I patients had significantly higher values for the following factors: weight, height, body mass index, diastolic pressure, prevalence of current smoking, total and low-density lipoprotein cholesterol and significant lower values for systolic pressure, creatinine, and prevalence of coronary artery disease. Group I patients were more symptomatic and showed higher rates of carotid occlusion and near occlusion. Atherosclerosis of the carotid bifurcation was more aggressive in the younger group, with a higher rate of occlusion and near occlusion. Obesity and smoking were significant risk factors for young patients in this sample.
Periurban Land Redevelopment in Vietnam under Market Socialism
Authors: Labbé Danielle , Musil Clement
Published: July 2013

Starting in the 1990s, the Vietnamese state sought to expand and modernise the country’s urban system after four decades of anti-urban policies. This paper examines the reworking of the socialist land regime that followed from this shift. It begins by explaining how new legislation and institutions combined market and socialist principles to lure domestic enterprises into realising the state’s new urban ambitions. It then shows how this hybrid reordering of policy triggered local experiments with periurban land redevelopment and new forms of alliances between the state and private capital. Using the case of the Land-for-Infrastructure mechanism, which uses land as in-kind payment for the building of infrastructure, it is found that this experiment undermines the implementing of official planning orientations and regulations. Finally, the paper explores the relationship between this problematic outcome and the political-economic environment within which recent land policy changes have been implemented in Vietnam.
Diacetyl Increases Sensory Innervation and Substance P Production in Rat Trachea
Authors: Goravanahally Madhusudan P. , Hubbs Ann F. , Fedan Jeffery S. , Kashon Michael L. , Battelli Lori A. , Mercer Robert R. , Goldsmith W. Travis , Jackson Mark C. , Cumpston Amy , Frazer David G. , Dey Richard D.
Published: July 2013

Inhalation of diacetyl, a butter flavoring, causes airway responses potentially mediated by sensory nerves. This study examines diacetyl-induced changes in sensory nerves of tracheal epithelium. Rats ( n = 6/group) inhaled 0-, 25-, 249-, or 346-ppm diacetyl for 6 hr. Tracheas and vagal ganglia were removed 1-day postexposure and labeled for substance P (SP) or protein gene product 9.5 (PGP9.5). Vagal ganglia neurons projecting to airway epithelium were identified by axonal transport of fluorescent microspheres intratracheally instilled 14 days before diacetyl inhalation. End points were SP and PGP9.5 nerve fiber density (NFD) in tracheal epithelium and SP-positive neurons projecting to the trachea. PGP9.5-immunoreactive NFD decreased in foci with denuded epithelium, suggesting loss of airway sensory innervation. However, in the intact epithelium adjacent to denuded foci, SP-immunoreactive NFD increased from 0.01 ± 0.002 in controls to 0.05 ± 0.01 after exposure to 346-ppm diacetyl. In vagal ganglia, SP-positive airway neurons increased from 3.3 ± 3.0% in controls to 25.5 ± 6.6% after inhaling 346-ppm diacetyl. Thus, diacetyl inhalation increases SP levels in sensory nerves of airway epithelium. Because SP release in airways promotes inflammation and activation of sensory nerves mediates reflexes, neural changes may contribute to flavorings-related lung disease pathogenesis.
Plasma Gel as a New Augmentation Material for Injection Laryngoplasty in Rabbit Model: Histologic Analysis
Authors: Hong Seok Jin , Lee Sang Hyuk , Jin Sung Min , Lee Seon Uk , Huh Se Hyung , Kim Dong Hoon , Kwon Soon Young , Woo Seung Hoon
Published: July 2013

Objectives

Currently, a variety of materials are available for the treatment of glottal insufficiency. Ideal injection materials should be inexpensive, easily obtainable, nontoxic, and biocompatible. Plasma gel has recently been developed as an injectable, autologous material used in plastic surgery. The aim of this study was to evaluate the histological changes in rabbit vocal folds (VFs) after an injection of plasma gel, compared with collagen (Artecoll) or hyaluronic acid (Reviderm Intra).

Study Design

Experimental prospective animal study.

Setting

Animal laboratory.

Subjects and Methods

Blood samples were collected from 12 New Zealand rabbits. Plasma collected from each rabbit was centrifuged and processed using a gel heating system. All rabbits received a 0.05 ml injection of plasma gel into the right VF, while an equivalent volume of Artecoll or Reviderm Intra was injected into the left VFs of each 6 rabbits randomly. The larynges were collected 2, 4, and 8 weeks after injection, and the tissues were stained for histological analysis.

Results

In comparison with left VFs injected with Artecoll or Reviderm Intra, there was significantly less inflammatory response and foreign body reaction in the plasma gel injected right VFs (P <. 05). Multinucleated foreign body type giant cells were also more prevalent in the left VFs. There were no quantitative differences in the rates of neovascularization or collagen deposition between groups.

Conclusion

Plasma gel is a biologically compatible material that may serve as a suitable augmentation material in injection laryngoplasty. Further studies that examine the long‐term effects in a larger number of subjects are needed.
ERCC1 Protein Expression Is Associated with Differential Survival in Oropharyngeal Head and Neck Squamous Cell Carcinoma
Authors: Patel Mihir R. , Zhao Ni , Ang Mei‐Kim , Stadler Michael E. , Fritchie Karen , Weissler Mark C. , Zanation Adam M. , Harris Stephen L. , Funkhouser William K. , Olshan Andrew F. , Shores Carol G. , Hayes D. Neil
Published: July 2013

Objective

To investigate ERCC1 protein expression and its relationship to clinical factors and treatment outcomes in patients with head and neck squamous cell carcinoma (HNSCC).

Design

Case series.

Setting

Tertiary care academic center.

Subjects

One hundred and seventy‐six patients diagnosed with HNSCC and treated with intent to cure between 2002 and 2008 were analyzed with respect to clinical data and tumor pathology.

Main Outcome Measures

Tissue microarrays were constructed from tumor blocks and immunohistochemical staining for ERCC1 performed. ERCC1 expression status was dichotomized into high and low using the Allred score. Clinical characteristics of patients with high versus low ERCC1 expression were compared. Distributions of overall survival (OS) and progression‐free survival (PFS) were analyzed using the Kaplan‐Meier method.

Results

Of 176 patients, ERCC1 showed baseline nuclear staining in 148 patients (84.1%). Lower staining intensity ERCC1 expression was prominent in parabasal cells in the lower half of the epithelium, while at high staining intensity, ERCC1 expression was present throughout the epithelium. The median H‐score was 50. No significant differences in age, gender, smoking status, tumor site, or stage were seen between the high and low ERCC1 expression groups. Expression of ERCC1 stratified by tumor site correlates with OS. Patients with oropharyngeal HNSCC and high ERCC1 expression (H‐score > 120) were more likely to survive (P <. 01) and remain disease free when compared to non‐oropharyngeal squamous cell carcinoma (SCCa) patients with high ERCC1 expression despite treatment modality and human papillomavirus virus (HPV) status.

Conclusion

Patients with oropharyngeal SCCa and high ERCC1 expression may have better outcomes despite HPV status.
Congenital heart surgery outcome analysis: Indian experience
Authors: Vasdev Sumit , Chauhan Sandeep , Malik Madhur , Talwar Sachin , Velayoudham Devagourou , Kiran Usha
Published: July 2013

Background

The study aimed to analyze the outcome of congenital heart surgery in a subset of Indian patients, using the Aristotle Basic Complexity score, the Risk Adjustment for Congenital Heart Surgery categories, and the Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories.

Patients and methods

1312 patients <18 years of age undergoing congenital heart surgery were assigned the 3 scores and studied for outcome indices of difficulty (cardiopulmonary bypass time or duration of surgery >120 min), morbidity (intensive care unit stay >7 days), and mortality.

Results

The overall mortality was 6.85%, with mean a Aristotle Basic Complexity score, Risk Adjustment for Congenital Heart Surgery category, and Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality category of 7.17 ± 2.04, 2.28 ± 0.78, and 2.24 ± 1.06, respectively. The mortality predictive capacity of the Risk Adjustment for Congenital Heart Surgery category (c = 0.76) was similar to that of the Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality category (c = 0.75); both were better compared to the Aristotle Basic Complexity score (c = 0.66). The Risk Adjustment for Congenital Heart Surgery category and Aristotle Basic Complexity score correlated with morbidity and difficulty outcomes.

Conclusion

The study shows that the Aristotle Basic Complexity score, the Risk Adjustment for Congenital Heart Surgery category, and the Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality category are tools of case mix stratification to analyze congenital heart surgery outcomes in a subset of the Indian population.
Advantages of upper brachial artery cannulation in aortic surgery
Authors: Yilmazkaya Bayram , Gurkahraman Sami , Yondem Omer Zuhtu , Hijazi Alaa , Algin Ibrahim H , Yesilay Aytekin
Published: July 2013

Background

The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings. The aim of this study was to investigate the local neurological and vascular complications following upper brachial cannulation.

Methods and results

This study included 44 patients who underwent procedures on the ascending aorta, aortic arch, or descending aorta with upper brachial artery cannulation for cardiopulmonary bypass at OSM Ortadogu Hospital and Cankaya Hospital between January 2009 and April 2012. The mean age of the 32 (72.7%) men and 12 (27.3%) women was 55.2 ± 12.3 years. Doppler analysis of the upper brachial artery was performed in 26 (59%) patients. Mean follow-up time for Doppler analysis was 5.7 ± 2 months. The mean antegrade cerebral perfusion time was 35 ± 16.1 min. The mean degree of hypothermia was 25.1 ℃ ± 2.0 ℃. Hospital death occurred in 4 (9.1%) patients, and 2 (4.5%) suffered local neurologic complications. Electromyelography analysis was carried out in the 2 patients who suffered local neurologic symptoms.

Conclusions

Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion.
HeartWare left ventricular assist device thrombosis in aspirin non-responder
Authors: Dalén Magnus , Sartipy Ulrik , Corbascio Matthias , Lund Lars H , Grinnemo Karl-Henrik
Published: July 2013

Patient characteristics that increase the risk of continuous-flow left ventricular assist device thrombosis have not been well established. We report a case of HeartWare thrombosis in a patient with aspirin hyporesponsiveness, and discuss the role of platelet function testing in preventing this severe complication. There is a need for clinical trials determining optimal antiplatelet therapy in patients supported with left ventricular assist devices, and consensus regarding modification of antiplatelet therapy after device thrombosis.
Direct closure of an asymptomatic right coronary sinus of Valsalva aneurysm
Authors: Tessitore Giulio , Alamanni Francesco , Ali Sarah Ghulam , Zanobini Marco
Published: July 2013

A 52-year-old man was referred for evaluation of palpitation. Transthoracic echocardiography revealed an extracardiac aneurysm of the right coronary sinus of Valsalva, and normal anatomy of the aortic valve with no regurgitation. Three-dimensional computed tomography confirmed the aneurysm with a diameter of 21 × 13.7 mm arising from the right coronary sinus of Valsalva under the right coronary artery. Surgical repair was performed without changing the normal anatomy of the aortic valve, preserving the right coronary ostium. Intraoperative and postoperative echocardiography showed complete closure of the aneurysm with normal functioning of the aortic valve.
Relationships can drive some to drink
Authors: Rodriguez Lindsey M. , Knee C. Raymond , Neighbors Clayton
Published: July 2013

How much and why individuals in romantic relationships drink alcohol may be a function of both personal and relational influences. The current research examined factors that predict vulnerability to health-related risky behavior (i.e., drinking to cope and drinking problems) in response to relationship difficulties. We consider the possibility that for individuals whose self-worth is contingently tied to the fluctuations of their relationship, feeling less satisfied may predict increased drinking problems; moreover, this may be mediated by drinking to cope. This study evaluated relationship-contingent self-esteem (RCSE) as a moderator of the association between relationship satisfaction and coping motives, which was expected to predict alcohol problems in couples. Both members in committed relationships ( N = 78 dyads) reported relationship satisfaction, RCSE, drinking to cope motives, and alcohol problems in a cross-sectional survey. Actor–Partner Interdependence Model analyses revealed significant mediated moderation among men, such that higher RCSE interacted with lower relationship satisfaction to predict stronger coping motives, in turn predicting increased drinking problems. Implications and future directions are discussed.
Corporate espionage
Authors: Vashisth Akanksha , Kumar Avinash
Published: July 2013

Espionage, whether conducted for economic or national security purposes, challenges society. Corporate espionage essentially describes illegal and unethical activities undertaken by organizations to systematically gather, analyze and manage information on competitors with the purpose of gaining a competitive edge in the market. Although the application of counter-intelligence measures can be effective, organizations often overlook the most significant and vulnerable aspect – the insider threat. This article attempts to explain espionage using a number of models demonstrating specific factors that cause individuals to engage in such acts. Corporate espionage, as unethical behaviour, is described from various perspectives such as the personality characteristics of employees, the organizational environment, the interaction between individual characteristics and the organizational environment, and the social interactions within the organization.
Expression and clinical significance of connective tissue growth factor in thyroid carcinomas
Authors: Wang Guimin , Zhang Wei , Meng Wei , Liu Jia , Wang Peisong , Lin Shan , Xu Liyan , Li Enmin , Chen Guang
Published: July 2013

Objectives

To examine expression of the connective tissue growth factor ( CTGF) gene in human thyroid cancer and establish whether a correlation exists between the presence of CTGF protein and clinicopathological parameters of the disease.

Methods

CTGF protein expression was investigated retrospectively by immunohistochemical analysis of CTGF protein levels in thyroid tumour tissue. Associations between immunohistochemical score and several clinicopathological parameters were examined.

Results

In total, 131 thyroid tissue specimens were included. High levels of CTGF protein were observed in papillary thyroid carcinoma tissue; benign thyroid tumour tissue scored negatively for CTGF protein. In papillary thyroid carcinoma, there was a significant relationship between high CTGF protein levels and Union for International Cancer Control disease stage III–IV, and presence of lymph node metastasis. In papillary thyroid carcinomas, CTGF protein levels were not significantly associated with sex or age.

Conclusions

These findings suggest that the CTGF protein level is increased in papillary thyroid carcinoma cells compared with benign thyroid tumours. CTGF expression might play a role in the development of malignant tumours in the thyroid.
Angiotensin-converting enzyme insertion/deletion gene polymorphism and risk of intracranial aneurysm in a Chinese population
Authors: Liu Yi , Li Peng , Hu Xiao , Hu Yu , Sun Hao-Gen , Ma Wei-Chao , Qiao Fei , He Min , You Chao
Published: July 2013

Objective

The relationship between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphisms and intracranial aneurysm (IA) has been studied in Caucasian and Japanese populations. The present study aimed to investigate this association in a Chinese population.

Methods

Patients with confirmed IA and age- and sex-matched control subjects without evidence of IA were enrolled. ACE I/D gene polymorphisms were analysed using polymerase chain reaction–restriction fragment length polymorphism.

Results

A total of 220 patients with IA and 220 matched controls were enrolled. In the IA group, 64, 106 and 50 patients were of the II, ID and DD genotypes, respectively, compared with 44, 99 and 77 subjects in the control group. The ACE DD genotype and D allele frequencies were significantly lower in the IA group compared with the control group. There were no statistically significant differences in the site, shape, size and Fisher Grade of aneurysms between genotypes in patients with IA.

Conclusion

The ACE DD genotype may be a protective factor for IA in a Chinese population.
Indoleamine 2,3-dioxygenase levels at the normal and recurrent spontaneous abortion fetal–maternal interface
Authors: Ban Yanli , Chang Yongchun , Dong Baihua , Kong Beihua , Qu Xun
Published: July 2013

Objectives

To localize indoleamine 2,3-dioxygenase (IDO) mRNA and protein and to undertake a functional study at the first trimester fetal–maternal interface in order to determine whether the distribution and function of IDO are related to recurrent spontaneous abortion (RSA).

Methods

Women undergoing legal pregnancy termination and women with RSA participated in this prospective study. Immunohistochemistry and real-time reverse transcription–polymerase chain reaction were used to analyse levels of IDO protein and mRNA in placenta, decidua and HTR-8/SVneo cells. Culture medium collected from trophoblast villous explant or HTR-8/SVneo cell cultures was used to measure IDO activity in response to interferon (IFN)-γ treatment.

Results

A total of 40 healthy women and 26 women with RSA provided samples of placenta and decidua. For normal pregnancies, IDO protein and mRNA was identified in placental trophoblasts, invasive extravillous trophoblasts and decidual glandular epithelium. IFN-γ significantly increased IDO activity in trophoblast villous explants and HTR-8/SVneo cells. Levels of IDO protein and mRNA in the placenta and decidua from normal pregnancies were significantly higher than in those from RSA.

Conclusions

Decreased levels of IDO protein and mRNA in the placenta and decidua from RSA suggest an important role for IDO in the maintenance of normal pregnancy.
Headache among CADASIL patients with R544C mutation: Prevalence, characteristics, and associations
Authors: Choi Jay Chol , Song Sook-Keun , Lee Jung Seok , Kang Sa-Yoon , Kang Ji-Hoon
Published: July 2013

Background and aim

There are variations of migraine prevalence in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) among different regions of the world. Previous studies on Asian CADASIL patients have not provided detailed descriptions of the characteristics of their headaches. The aims of this study were to determine prevalence and characteristics of headaches and to investigate associations between headache and other clinical symptoms or brain magnetic resonance imaging (MRI) findings among homogenous group of patients having the same R544C mutation.

Methods

In this cross-sectional study, we enrolled 53 CADASIL patients with the R544C mutation between May 2010 and April 2011. We obtained the history of headache using a structured questionnaire and detailed interview. Other clinical features and brain MRI findings were also assessed for potential associations.

Results

Overall headache prevalence was 45.3% (24 patients). Among them, 21 patients (87.5%) were classified as having tension-type headache, followed by migraine (two patients) and unclassifiable headaches (one patient). Except for alcohol consumption, no significant associations were observed between the headaches and other clinical features or brain MRI findings.

Conclusion

Migraine was found in only 3.8% of CADASIL patients with the R544C mutation. Such a low prevalence of migraine may hinder clinical detection of CADASIL among ethnically Asian patients.
Delayed Early Passive Motion Is Harmless to Shoulder Rotator Cuff Healing in a Rabbit Model
Authors: Zhang Shurong , Li Hong , Tao Hongyue , Li Hongyun , Cho Samson , Hua Yinghui , Chen Jiwu , Chen Shiyi , Li Yunxia
Published: July 2013

Background:

Postoperative passive motion is the most widely accepted rehabilitation protocol after rotator cuff repair; however, a rotator cuff retear remains a frequent surgical complication. Clinical outcomes indicate that early passive motion is harmless to rotator cuff healing, but no laboratory evidence supports this proposition.

Hypotheses:

(1) Immediate postoperative immobilization improves rotator cuff healing in rabbits. (2) Early passive motion after short-term immobilization does not harm rotator cuff healing in rabbits.

Study Design:

Controlled laboratory study.

Methods:

An injury to the supraspinatus tendon was created and repaired in 90 New Zealand White rabbits, after which they were randomly separated into 3 groups: (1) nonimmobilization (NI; n = 30), (2) continuous immobilization (IM; n = 30), and (3) immobilization with early passive motion (IP; n = 30). At 3, 6, and 12 weeks postoperatively, 5 rabbits from each group were sacrificed for histological evaluation, biomechanical testing, and magnetic resonance imaging.

Results:

The histological study demonstrated better postoperative healing in the IM and IP groups, with clusters of chondrocytes accumulated at the tendon-bone junction. Magnetic resonance imaging illustrated that the tendon-bone junction was intact in the IM and IP groups. The magnetic resonance quantification analysis showed that the signal-to-noise quotient (SNQ) of the NI group was not significantly higher than that of the immobilization groups at 3 weeks ( P = .232) or 6 weeks ( P = .117), but it was significantly different at 12 weeks (NI vs IM, P = .006; NI vs IP, P = .009). At 12 weeks, the failure load was significantly higher in the IM and IP groups than in the NI group (NI vs IM, P = .002; NI vs IP, P = .002), but no difference was found between the IM and IP groups ( P = .599).

Conclusion:

Immediate postoperative immobilization led to better tendon-bone healing than immediate postoperative mobilization, and under immobilization, early passive motion was harmless to tendon-bone healing in this study.

Clinical Relevance:

The results have an implication in supporting the rehabilitation protocol of early passive motion after rotator cuff repair.
Influence of dynamic seals on silt abrasion of the impeller ring in a centrifugal pump
Authors: Qian Zhongdong , Gao Yuanyong , Zhang Kai , Huai Wenxin , Wu Yulin
Published: July 2013

The water flow and movement of silt in a prototype double suction centrifugal pump was simulated using an Euler–Lagrange multiphase flow model. Back-blade and J-groove configurations were adopted to protect the impeller ring from silt abrasion. Four back-blades and four J-grooves were considered. The results show that the relative velocity of water around the impeller ring is too low to move silt out of the spacing between the impeller and the casing, which results in a high silt concentration around the impeller ring. The high silt concentration around the impeller ring is the major contributor to silt abrasion of the ring. Back-blade and J-groove configurations are effective in reducing the silt concentration around the ring but extra friction loss is also introduced and the pump efficiency is decreased. Optimization of the length, position and number of back-blades, and the shape and number of J-grooves, decreases losses in pump efficiency and effectively protects the impeller ring. Case 4 for the back-blade and Case 8 for the J-groove were the most effective configurations in this study.
Posterior reversible encephalopathy syndrome in Korean patients with systemic lupus erythematosus: risk factors and clinical outcome
Authors: Jung SM , Moon S-J , Kwok S-K , Ju JH , Park K-S , Park S-H , Kim H-Y
Published: July 2013

Posterior reversible encephalopathy syndrome (PRES) is an uncommon neurologic condition associated with systemic lupus erythematosus (SLE). This study aimed to demonstrate the risk factors and clinical outcome of PRES in patients with SLE.

Fifteen patients with SLE were diagnosed with PRES by characteristic clinical manifestations and magnetic resonance imaging (MRI) features from 2000 to 2012. Clinical profiles and outcomes were assessed for this study population. Additionally, 48 SLE patients with neurologic symptoms who underwent brain MRI were included for comparative analyses.

The median age and duration of SLE in patients with PRES was 27 and 6.1 years, respectively. Comparison between patients with and without PRES revealed significant differences in the presentation of hypertension and seizure, lupus nephritis with renal insufficiency, treatment with high-dose steroid and cyclophosphamide, recent transfusion, and lupus activity measured by SLE disease activity index. Renal failure was the single independent factor with a high odds ratio of 129.250 by multivariate analysis. Of 15 patients, four experienced relapse and two died of sepsis during hospitalization.

Our results suggest that lupus nephritis with renal dysfunction and other related clinical conditions can precede the occurrence of PRES in patients with SLE. It is important to perform early brain imaging for a timely diagnosis of PRES when clinically suspected.
Carcinosarcoma of the biliary system in a cat
Authors: Cavicchioli Laura , Ferro Silvia , Callegari Carolina , Auriemma Edoardo , Zini Eric , Zappulli Valentina
Published: July 2013

A 12-year-old, mixed-breed domestic cat was diagnosed with a multicystic hepatic mass via ultrasonographic examination and computer tomography scan. The tumor associated with the left medial liver lobe, and connected by a thin stalk to the hilar region, was surgically removed. The mass was firm, encapsulated, mottled white to red black, multinodular, and cystic. Histologic diagnosis was carcinosarcoma supported by positive immunohistochemistry for cytokeratins and vimentin of atypical neoplastic cell populations. On the basis of morphology, the origin was considered to be in the biliary tract. Biliary carcinosarcoma is a rare neoplasm that occurs in people. The epidemiology and risk factors have not yet been determined, and the prognosis is poor except for cases in which curative resection is performed.
Natural and experimental poisoning of goats with the pyrrolizidine alkaloid–producing plant Crotalaria retusa L.
Authors: Maia Lisanka A. , de Lucena Ricardo B. , da T. Nobre Verônica M. , Dantas Antônio F. M. , Colegate Steven M. , Riet-Correa Franklin
Published: July 2013

Crotalaria retusa L. (rattleweed), estimated to contain about 4.96% monocrotaline (MCT) in the seed, was associated with a natural poisoning outbreak in goats. The poisoning was experimentally reproduced by the administration of C. retusa seeds containing approximately 4.49% of MCT. Thus, 1 of 3 goats given a single dose of 5 g/kg bodyweight (bw) of seeds (248 mg MCT/kg bw) and 2 goats given a single dose of 347 mg MCT/kg bw showed acute clinical signs and were euthanized 10–11 days after dosing. Clinical signs and gross and histologic lesions were characteristic of acute centrilobular liver necrosis.