bluuebunny/crossref_metadata_2025 huggingface dataset:
The anti‐condyloma acuminatum effects of interferon‐inducible protein 10 in vitro
Authors: Li Huijuan , Yi Tao , Zhao Shuyun , Chen Pin , Cheng Chenxian , Wei Yuquan , Zhao Xia
Published: January 2009

Background  Interferon‐inducible protein 10 (IP‐10) has been reported to show an effective antiviral and antineoplastic role in various murine models.

Aim  To investigate the anti‐condyloma acuminatum effect and human papillomavirus (HPV)‐inhibiting efficacy of a recombinant plasmid encoding IP‐10 in vitro.

Methods  A recombinant plasmid DNA carrying IP‐10 cDNA was constructed. Condyloma acuminatum tissue particles were transfected with IP‐10 and examined for apoptosis by terminal deoxynucleotidyl transferase‐mediated dUTP nick end labeling (TUNEL) staining and flow cytometry techniques. Relative real‐time polymerase chain reaction (PCR) was used to validate the HPV inhibited level of the treatment groups. Immunohistochemistry was used to determine the IP‐10 expression on condyloma acuminatum tissues.

Results  Transfected IP‐10 was expressed mainly in the cytoplasm of the condyloma acuminatum tissues. Plentiful apoptosis was observed in condyloma acuminatum tissues transfected with IP‐10. In addition, HPV expression was lower in IP‐10‐treated tissues than in control tissues.

Conclusions  These observations suggest that IP‐10 has strong anti‐condyloma acuminatum effects, inducing apoptosis and inhibiting HPV, and therefore may be a novel and potentially effective therapy for condyloma acuminatum.
Cutaneous squamous cell carcinoma developing in lupus vulgaris exfoliativus persistent for 40 years
Authors: Zawirska Agnieszka , Adamski Zygmunt , Stawicka Ewa , Schwartz Robert A.
Published: January 2009

Background  A 65‐year‐old man is described with a 40‐year history of lupus vulgaris exfoliativus, a form of cutaneous tuberculosis that resembles psoriasis. He had been misdiagnosed as having psoriasis vulgaris for many years. A cutaneous squamous cell carcinoma developed within a plaque of lupus vulgaris exfoliativus.

Methods  A skin biopsy provided the correct diagnoses.

Results  The patient was successfully treated with medication for tuberculosis and had his skin cancer cured by surgical excision.

Conclusions  With an increasing worldwide incidence of tuberculosis, one needs to be aware of its cutaneous forms and variants, as well as its complications, in particular skin cancer. Lupus vulgaris exfoliativus may resemble psoriasis vulgaris.
Atypical forms of lupus vulgaris – a case series
Authors: Saritha Mohanan , Parveen Basheer Ahamed , Anandan Venkatesan , Priyavathani Malathy R. , Tharini Karuvelan G.
Published: January 2009

Atypical presentations of cutaneous tuberculosis are not so uncommon and are frequently overlooked in clinical practice, leading to late diagnosis and increased morbidity. We report three cases of lupus vulgaris with atypical presentations. The cases mimicked other chronic skin lesions like actinomycosis, mycetoma, and so on. Strong clinical suspicion, histopathology, and response to antituberculous treatment led to the diagnosis and all three had excellent response to treatment. Today, when tuberculosis threatens to burst into pandemics again, early diagnosis and treatment are more important than ever for control and prevention of morbidity.
Alopecia in congenital hidrotic ectodermal dysplasia responding to treatment with a combination of topical minoxidil and tretinoin
Authors: Melkote Shubha , Dhurat Rachita S. , Palav Anjali , Jerajani Hemangi R.
Published: January 2009

Clouston's syndrome is an ectodermal dysplasia characterized by dystrophic nails, alopecia, and palmoplantar hyperkeratosis. Alopecia is due to decrease in number and degree of maturation of the hair follicles. Tretinoin is a mitogen by itself and also enhances the absorption of minoxidil which acts by enlarging the miniaturized hair follicles. We report a case of alopecia in Clouston's syndrome who responded to treatment with topical minoxidil and tretinoin.
Atypical X‐linked ichthyosis in a patient with a large deletion involving the steroid sulfatase (STS) gene
Authors: Gonzalez‐Huerta Luz , Mendiola‐Jimenez Jaime , Del Moral‐Stevenel Maria , Rivera‐Vega Maria , Cuevas‐Covarrubias Sergio
Published: January 2009

A 70‐year‐old male presented with very large, thick, tightly adherent, dark‐brown scales on the front of his lower extremities. His face, neck, back, abdomen, upper extremities, flexural areas, palms and soles as well as hair and nails were not involved. Family history was negative for similar lesions. Otherwise, the patient had a normal development. Onset of symptoms occurred during childhood with scales on lower extremities with no more additional features. Treatment included emollients exclusively with partial and temporary remission of cutaneous lesions. Recently, the patient had not received topical or systemic medical treatment. Laboratory investigations were within normal limits.

The patient had undetectable levels of STS activity when compared with normal control (0.00 pmol mg‐1 protein h‐1) which confirmed the diagnosis of X‐linked ichthyosis (XLI) . PCR analysis showed deletion of the STS gene, markers DXS1139 and DXF22S1and the 5′ end of the VCX3A gene.

The patient had scales present on lower extremities only with no medical treatment that corresponded to an unusual clinical manifestation of XLI. Clinical manifestations of XLI are due to a great variety of environmental, genetic and individual factors that should be considered in XLI diagnosis.
The most common challenges in melanoma diagnosis and how to avoid them
Authors: Marghoob Ashfaq A , Changchien Lily , DeFazio Jennifer , Dessio Whitney C , Malvehy Josep , Zalaudek Iris , Halpern Allan C , Scope Alon
Published: January 2009

Due to its particularly lethal nature and tendency to affect relatively young individuals, the timely diagnosis of melanoma remains of paramount importance for clinicians and their patients. Unfortunately, melanomas can mimic benign lesions that are overwhelmingly more common in the population than are melanomas, and misdiagnosis or delay in diagnosis of melanoma can occur. Misdiagnosis of melanoma serves as one of the most common causes for malpractice litigation brought against medical practitioners. In this review we describe seven clinical scenarios that represent challenges in melanoma diagnosis and discuss potential strategies for avoiding the errors that commonly give rise to those scenarios.
Perioperative management and the associated rate of adverse events in dermatological procedures performed by dermatologists in New Zealand
Authors: Chan Bob CY , Patel Denesh C
Published: January 2009

Dermatological surgery performed in an outpatient setting is common and generally perceived as safe, but the potential for serious adverse events does exist. Furthermore, there is a current lack of guidelines regarding preoperative and intraoperative monitoring of such patients. This is a retrospective study that involved a written questionnaire sent to current practising New Zealand dermatologists. Aspects investigated include their practice relating to preoperative assessments and intraoperative monitoring during standard dermatological procedures, and the resulting rate of adverse events. We found that most respondents performed dermatological procedures in dedicated theatres in outpatient clinics. The majority of survey respondents would screen for and optimize risk factors prior to surgery. Most respondents would not record vital sign measurements either preoperatively or intraoperatively. Antibiotic prophylaxis was generally only prescribed if clinically indicated, and anticoagulation and antiplatelet therapies were in the majority of cases never withheld prior to surgery. Infection (<3.5%) and bleeding (<2%) were the most common postoperative complications, with other serious adverse events being extremely rare. Although dermatological surgery continues to be safely performed in the outpatient setting, attempts should still be made to identify patients who are at higher risk for surgery and extra precautions should be applied to these selected patients.
Leprosy: Not always an easy diagnosis and often a management challenge
Authors: Manifold Rachel , Marshman Gillian
Published: January 2009

Leprosy is rare in Australia, particularly in the southern states. We report two cases of leprosy in southern Australia that presented to the dermatology outpatients' department within a 4‐month period. The presentation of the first case was complex, making the correct diagnosis difficult. Both cases involved immigrants from South‐East Asia, were classified as multi‐bacillary leprosy as defined by the World Health Organization, and were commenced on the recommended multiple drug therapy. The ensuing clinical course was complicated, with both cases developing Type 1 leprosy reactions. The first case also developed the rare but serious dapsone‐induced delayed hypersensitivity reaction.
Leukaemia cutis in a patient treated for breast cancer
Authors: Weinel Sarah , Malone Janine , Jain Dharamvir , Callen Jeffrey P
Published: January 2009

A 47‐year‐old woman with a history of breast cancer presented with eruptive cutaneous nodules on the trunk and extremities. Treatment for her breast cancer had included surgery, radiation and chemotherapy with doxorubicin and cyclophosphamide. Biopsy of the skin lesions revealed leukaemia cutis, which led to the discovery of acute myelogenous leukaemia. This was felt to be primarily induced by doxorubicin. Treatment included induction chemotherapy in preparation for a bone marrow transplant, which resulted in the disappearance of the cutaneous lesions. However, the patient later succumbed to her leukaemia.
Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin
Authors: De Zwaan Sally E , Iland Harry J , Damian Diona L
Published: January 2009

We report a patient with pyoderma gangrenosum successfully treated with intravenous immunoglobulin. He had previously been treated for 4 years with high‐dose corticosteroids and had developed insulin‐dependent diabetes mellitus. Multiple corticosteroid‐sparing agents had failed or were contraindicated. He developed no adverse effects from intravenous immunoglobulin, which allowed reduction of his prednisone to 3 mg/day, and his ulcer has completely healed.
Giant basal cell carcinoma masquerading as an osteogenic sarcoma
Authors: Cherian Paul , Kumarasinghe Prasad
Published: January 2009

An 88‐year‐old man presented to the dermatology outpatient clinic with an 11‐month history of a rapidly growing mass overlying a clavicular fracture site. The lesion was 8 × 6 cm, painful, fixed to deeper structures and ulcerated. Superficial and deep biopsies yielded invasive basal cell carcinoma. Imaging demonstrated extensive soft tissue invasion into muscle, bone and potentially into the lung parenchyma. Due to complications arising from subsequent diagnostic procedures, the patient declined further invasive tests. The cutaneous lesion was treated with palliative radiotherapy. We explore the literature regarding the tumorigenic effects of peri‐fracture cytokines on the biological behaviour of basal cell neoplasms.
‘Knowing what makes them tick’: Motivating cognitively impaired older adults to participate in restorative care
Authors: Galik Elizabeth M. , Resnick Barbara , Pretzer‐Aboff Ingrid
Published: January 2009

Nursing home residents with dementia represent a majority of the most functionally impaired individuals residing in nursing homes. Although many perceive this population as having little restorative potential, maintaining resident functional abilities for as long as possible helps to optimize quality of life and decrease caregiver burden. This study used a qualitative design with a focus group methodology to explore facilitators and barriers to engaging cognitively impaired residents in functional activities and exercise. A purposive sample of seven geriatric nursing assistants who were experts in dementia care participated in the study. Twenty‐seven codes were reduced to three themes: (i) knowing what makes them tick and move; (ii) teamwork and utilizing resources; and (iii) barriers to restorative care. The study findings were used to revise the Restorative Care for the Cognitively Impaired Intervention and could direct future implementation of programmes in nursing home settings.
Challenges for professional care of advanced dementia
Authors: Chang Esther , Daly John , Johnson Amanda , Harrison Kathleen , Easterbrook Sally , Bidewell John , Stewart Heather , Noel Michael , Hancock Karen
Published: January 2009

Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers. Data collection was via five focus groups (total n = 24) and 20 follow‐up individual interviews. Participants included palliative care, aged care and dementia specialist nurses, medical specialists from an area health service, residential aged care staff and general medical practitioners. Responses emphasized the need for improved knowledge and skills, and clearer policy. Concerns included accurate assessment, especially of pain, owing to the inability of people with advanced dementia to communicate their symptoms. Assessment, managing physical and behavioural symptoms, and communicating with family presented as further challenges. Conclusions are that the need for a palliative approach to care in advanced dementia should be recognized. Aged care staff can deliver palliative care to people with advanced dementia only if the staff receive relevant education and training beyond their generalist competencies.
Use of oxygen in the resuscitation of preterm infants: Current opinion and practice in Australia and New Zealand
Authors: Clark Rowena L , Lui Kei , Oei Ju Lee
Published: January 2009

Aim:  The aim of this paper was to explore the opinions and practices of tertiary health‐care professionals in Australia and New Zealand regarding air and oxygen blending (OB) for the resuscitation of preterm infants.

Methods:  Structured questionnaires were sent to the directors of 25 tertiary perinatal units, with instructions to distribute the questionnaires to 15 pertinent clinical staff.

Results:  Response rate was 72% (n = 271); medical‐staff response was 25%. Sixteen (64%) perinatal units had OB resuscitation equipment. Among respondents, 114 (42%) had access to OB and 73 (27%) had OB for all resuscitations. Pulse oximetry was available to 160 (59%) of respondents. The majority (173, 64%) would initiate resuscitation with Fractional inspired oxygen (FiO2) ranging from 0.3 to 0.9 (mean 0.5), with 15% and 21% preferring air and 100% oxygen, respectively. There were large variations in managing FiO2 changes thereafter. Half of the respondents were either unsure (39%) or not convinced (15%) that 100% oxygen during resuscitation would cause harm. Conversely, 42% suggested that OB might improve outcome with bronchopulmonary dysplasia and retinopathy of prematurity being the most important considerations. Most (92%) would advocate for OB in the delivery suite. Set‐up cost (50%) and lack of guided experience (38%) ranked highest as barriers to change.

Conclusions:  Two‐thirds of the tertiary centres have at least some OB equipment in the delivery suite, but the ways and opinions in which OB is utilised differ widely. Most practitioners would advocate for a change. There is an urgent need for further research to achieve a consistent and meaningful clinical management for OB resuscitation of preterm infants.
Bile and acid reflux in the pathogenesis of reflux oesophagitis in children
Authors: Jiang Mizu , Chen Jie , Chen Feibo , Yu Jindan , Liang Jianfeng , Zhang Yanyi , Ou Biyou
Published: January 2009

Aim:  The aim of this study was to investigate the role of bile and acid reflux in the pathogenesis of reflux oesophagitis (RE) in children.

Methods:  A total of 44 patients aged 5–17 years with gastro‐oesophageal reflux symptoms were enrolled. Simultaneous 24‐h oesophageal Bilitec 2000 (Medtronic Instruments, Minneapolis, MN, USA) bilirubin monitoring and pH monitoring, in biopsy of oesophageal mucosa by gastro‐endoscopy, were performed in all patients.

Results:  According to the diagnostic criteria of pathological acid reflux and pathological bile reflux, 10 of 44 cases (22.7%) had acid reflux, 10 (22.7%) had isolated bile reflux, 16 (36.4%) had mixed acid and bile reflux, and the other eight (18.2%) had no reflux. Significant difference was observed in the ratio of different patterns of reflux between the RE group (26 cases) and the non‐erosive reflux disease (NERD) group (18 cases) (χ2 = 9.096, P < 0.01). All the parameters of acid reflux in the RE group were higher significantly than that in the NERD group (P < 0.05 or P < 0.01). A total of 20 out of 26 cases (76.9%) with RE had oesophageal acid reflux as against six out of 18 cases (33.3%) in patients with NERD (P < 0.01). The difference of each parameter of bile reflux had not reached significance between the two groups.

Conclusions:  Mixed reflux is the predominant form of reflux in the causation of oesophageal mucosal injury in children. Isolated bile reflux also plays a role in the development of RE, although only in patients without acid reflux.
DPP‐IV inhibition enhances the antilipolytic action of NPY in human adipose tissue
Authors: Kos K. , Baker A. R. , Jernas M. , Harte A. L. , Clapham J. C. , O’Hare J. P. , Carlsson L. , Kumar S. , McTernan P. G.
Published: January 2009

Context:  Dipeptidyl peptidase IV (DPP‐IV) inactivates the incretin hormone glucagon‐like peptide. It can also affect the orexigenic hormone neuropeptide Y (NPY1–36) which is truncated by DPP‐IV to NPY3–36, as a consequence NPY’s affinity changes from receptor Y1, which mediates the antilipolytic function of NPY, to other NPY receptors. Little is known whether DPP‐IV inhibitors for the treatment of type 2 diabetic (T2DM) patients could influence these pathways.

Aims:  To investigate the in vitro effects of NPY with DPP‐IV inhibition in isolated abdominal subcutaneous (AbdSc) adipocytes on fat metabolism, and assessment of NPY receptor and DPP‐IV expression in adipose tissue (AT).

Methods:  Ex vivo human AT was taken from women undergoing elective surgery (body mass index: 27.5 (mean ± s.d.) ± 5 kg/m2, age: 43.7 ± 10 years, n = 36). Isolated AbdSc adipocytes were treated with human recombinant (rh)NPY (1–100 nM) with and without DPP‐IV inhibitor (1 M); glycerol release and tissue distribution of DPP‐IV, Y1 and Y5 messenger RNA (mRNA) were measured and compared between lean and obese subjects.

Results and conclusion:  rhNPY reduced glycerol release, an effect that was further enhanced by co‐incubation with a DPP‐IV inhibitor [control: 224 (mean ± s.e.) ± 37 μmol/l; NPY, 100 nM: 161 ± 27 μmol/l**; NPY 100 nM/DPP‐IV inhibitor, 1 M: 127 ± 14 μmol/l**; **p < 0.01, n = 14]. DPP‐IV was expressed in AbdSc AT and omental AT with relative DPP‐IV mRNA expression lower in AbdSc AT taken from obese [77 ± 6 signal units (SU)] vs. lean subjects (186 ± 29 SU*, n = 10). Y1 was predominantly expressed in fat and present in all fat depots but higher in obese subjects, particularly the AbdSc AT‐depot (obese: 1944 ± 111 SU vs. lean: 711 ± 112 SU**, n = 10). NPY appears to be regulated by AT‐derived DPP‐IV. DPP‐IV inhibitors augment the antilipolytic effect of NPY in AT. Further studies are required to show whether this explains the lack of weight loss in T2DM patients treated with DPP‐IV inhibitors.
Preliminary evaluation of a novel side‐fire diode laser emitting light at 940 nm, for the potential treatment of benign prostatic hyperplasia: ex‐vivo and in‐vivo investigations
Authors: Seitz Michael , Bayer Thomas , Ruszat Robin , Tilki Derya , Bachmann Alexander , Gratzke Christian , Schlenker Boris , Stief Christian , Sroka Ronald , Reich Oliver
Published: January 2009

OBJECTIVES

To evaluate, ex vivo and in vivo, the tissue‐removal capacity and coagulation properties of a diode laser emitting light at 940 nm, as in the search for potential therapeutic strategies for benign prostatic hyperplasia that cause less morbidity than transurethral resection of the prostate (TURP), various types of lasers have been tested.

MATERIALS AND METHODS

A diode laser system (prototype; wavelength 940 nm, Dornier MedTech, Wessling, Germany) was evaluated in an isolated, blood‐perfused ex‐vivo porcine kidney model at 10–60 W (five kidneys). An in‐vivo beagle model was used to investigate the effects on six prostate lobes at a generator output power level of 200 W. After the laser treatment tissue were examined histologically to compare the depth of coagulation and vaporization.

RESULTS

With increasing generator output power levels there was an increasing vaporization and coagulation ability for the diode laser at 940 nm in the ex‐vivo model. At 60 W the mean (sd) vaporization depth was 1.72 (0.47) mm with a coagulation zone of 9.56 (0.26) mm. In vivo, the diode laser caused rapid ablation with no intraoperative haemorrhage. Histologically, the zone of coagulation had a mean (sd) depth of 4.25 (0.15) mm at 200 W. The tissue removal capacity was estimated at 0.874–1.583 g/min in vivo.

CONCLUSIONS

Our findings indicate that diode‐laser vaporization at 940 nm is feasible and might be effective for acutely relieving bladder outlet obstruction in an in‐vivo setting. Due to its mean coagulation zone of 4.25 mm the diode laser seems to have effective haemostatic properties.
A pilot phase‐II prospective study to test the ‘efficacy’ and tolerability of a penile‐extender device in the treatment of ‘short penis’
Authors: Gontero Paolo , Di Marco Massimiliano , Giubilei Gianluca , Bartoletti Riccardo , Pappagallo Giovanni , Tizzani Alessandro , Mondaini Nicola
Published: January 2009

OBJECTIVE

To assess a commonly marketed brand of penile extender, the Andro‐Penis® (Andromedical, Madrid, Spain), widely used devices which aim to increase penile size, in a phase II single‐arm study powered to detect significant changes in penile size, as despite their widespread use, there is little scientific evidence to support their potential clinical utility in the treatment of patients with inadequate penile dimensions.

PATIENTS AND METHODS

Fifteen patients were required to test the efficacy of the device, assuming an effect size of >0.8. Eligible patients were counselled how to use the penile extender for at least 4 h/day for 6 months. Penile dimensions were measured at baseline and after 1, 3, 6 and 12 months (end of study). The erectile function (EF) domain of the International Index of EF was administered at baseline and at the end of the study. Treatment satisfaction was assessed using an institutional unvalidated five‐item questionnaire.

RESULTS

After 6 months the mean gain in length was significant, meeting the goals of the effect size, at 2.3 and 1.7 cm for the flaccid and stretched penis, respectively. No significant changes in penile girth were detected. The EF domain scores improved significantly at the end of study. Treatment satisfaction scores were consistent with acceptable to good improvement in all items, except for penile girth, where the score was either ‘no change’ or ‘mild improvement’.

CONCLUSIONS

Penile extenders should be regarded as a minimally invasive and effective treatment option to elongate the penile shaft in patients seeking treatment for a short penis.
Biodegradable braided poly(lactic‐co‐glycolic acid) urethral stent combined with dutasteride in the treatment of acute urinary retention due to benign prostatic enlargement: a pilot study
Authors: Kotsar Andres , Isotalo Taina , Juuti Hanne , Mikkonen Joonas , Leppiniemi Jenni , Hänninen Venla , Kellomäki Minna , Talja Martti , Tammela Teuvo L.J.
Published: January 2009

OBJECTIVE

To evaluate, in a pilot study, the efficacy and safety of combining a braided poly(lactic‐co‐glycolic acid) (PLGA, a copolymer of l‐lactide and glycolide) urethral stent and dutasteride in the treatment of acute urinary retention (AUR) due to benign prostatic enlargement (BPE).

PATIENTS AND METHODS

Ten men with AUR due to BPE were treated as outpatients. A biodegradable braided PLGA urethral stent was inserted into the prostatic urethra, using a specially designed insertion device under visual control. Dutasteride treatment was started and the patients were followed up for 3 months after insertion of the stents.

RESULTS

In all patients the stents were placed successfully with the new insertion device. All men were able to void after inserting the stent. At 1 month five patients voided freely with a low residual urine volume (<150 mL), two voided but had a high residual urine volume and a suprapubic catheter was placed, and three needed a suprapubic or an indwelling catheter before 1 month, due to AUR or comorbidities. At 3 months five patients were voiding with no problems.

CONCLUSIONS

We have developed a new and effective insertion device for biodegradable braided prostatic stents. The new braided‐pattern stent overcomes the earlier problems of migration and sudden breakage into large particles associated with biodegradable spiral stents. However, the mechanical properties of the new stent need to be improved and tested in a longer follow‐up. We consider that this new biodegradable braided‐pattern urethral stent could provide a new option in the future treatment of AUR.
Health‐related quality of life 3 years after high‐dose intensity‐modulated radiotherapy with gold fiducial marker‐based position verification
Authors: Lips Irene M. , Van Gils Carla H. , Van Der Heide Uulke A. , Kruger Arto E. Boeken , Van Vulpen Marco
Published: January 2009

OBJECTIVE

To evaluate the change in quality of life (QoL) 3 years after high‐dose intensity‐modulated radiotherapy (IMRT) using gold fiducial marker‐based position verification in patients with locally advanced prostate cancer.

PATIENTS AND METHODS

Between October 2003 and November 2004, 95 patients with locally advanced prostate cancer were treated with 76 Gy IMRT with gold‐fiducial marker‐based position verification. Before treatment (baseline) and 1, 6 and 36 months after RT the QoL was measured using the RAND‐36, the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ‐C30(+3)) and the prostate tumour‐specific module (EORTC QLQ‐PR25). Changes in QoL with time of ≥10 points were considered clinically relevant.

RESULTS

After 3 years there was a statistically significant improvement in QoL for emotional role restriction and functioning, change in health, mental health and insomnia, compared with baseline. Emotional role restriction increased by >10 points and was therefore clinically relevant, while all other differences were of <10 points. There was a statistically significant deterioration of QoL after 3 years in physical and cognitive functioning, bowel symptoms/function and sexual activity. Only the sexual activity QoL score changed by 12 points and was therefore the only meaningful deterioration in QoL at 3 years after treatment.

CONCLUSION

IMRT and accurate position verification provide the possibility to deliver a high irradiation dose to the prostate without clinically relevant deterioration in long‐term QoL, except for a persistent decrease in sexual activity score.
Independent prognostic value of tumour diameter and tumour necrosis in upper urinary tract urothelial carcinoma
Authors: Simone Giuseppe , Papalia Rocco , Loreto Andrea , Leonardo Costantino , Sentinelli Steno , Gallucci Michele
Published: January 2009

OBJECTIVE

To identify significant prognostic indicators of upper urinary tract (UUT) urothelial carcinoma (UC) and to assess a risk stratification of patients.

PATIENTS AND METHODS

We retrospectively analysed data from 162 patients with non‐metastatic UC primarily occurring in UUT treated with open nephroureterectomy. Variables assessed included age, gender, pT, tumour grade, tumour necrosis extension, pN, tumour location, multifocal location, tumour diameter, and subsequent development of a bladder tumour. Tumour necrosis was measured using commercial software (Eureka interface system, version 4.0.22, HESP technology, Menarini Diagnostics, Italy) and was classified as none, focal (<10% of tumour area) or extensive, ≥10% of tumour area). The prognostic significance of each variable on metastasis‐free survival (MFS) and disease‐free survival (DFS) was tested in univariable analysis with the log‐rank test. Variables with significance levels of P < 0.05 according to the univariable analyses were entered into a multivariable forward‐stepwise Cox regression model.

RESULTS

At a mean follow‐up of 66 months, 20 cancer‐related deaths (12.3%) were censored. In multivariable analysis, tumour diameter, pT stage and tumour necrosis were independent predictors of MFS and DFS. All events occurred in patients with extensive tumour necrosis and a tumour diameter of ≥3 cm. The median survival of patients with advanced‐stage tumours, extensive necrosis and a tumour diameter of ≥3 cm were significantly impaired by increasing pT stage(P < 0.001).

CONCLUSION

Tumour necrosis and tumour diameter are compelling prognostic factors that deserve further study in a prospective setting to determine if their use in combination with more traditional variables, such as pT stage, might better determine prognosis and guide the follow‐up and treatment of patients.
Localization of renal oxidative stress and inflammatory response after lithotripsy
Authors: Clark Daniel L. , Connors Bret A. , Evan Andrew P. , Willis Lynn R. , Handa Rajash K. , Gao Sujuan
Published: January 2009

OBJECTIVE

To determine if the acute renal oxidative stress and inflammation after extracorporeal shock wave lithotripsy (ESWL), thought to be mediated by ischaemia, is most severe in the portion of the kidney within the focal zone of the lithotripter, and if these effects result primarily from ischaemic injury.

MATERIALS AND METHODS

Pigs (7–8‐weeks old) received either 2000 shock waves at 24 kV to the lower‐pole calyx of one kidney or unilateral renal ischaemia for 1 h. A third group (sham) received no treatment. Timed urine and blood samples were taken for analysis of lipid peroxidation and the inflammatory cytokines, tumour necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6). At 4 h after treatment, kidneys were removed and samples of cortex and medulla were frozen for analysis of cytokines and heme oxygenase‐1 (HO‐1).

RESULTS

ESWL did not affect urinary excretion of malondialdehyde, but did elicit an eight‐fold induction of HO‐1 in the portion of the renal medulla within the focal zone of the lithotripter (F2), while remaining unchanged elsewhere in the treated kidney. There was no induction of HO‐1 in renal tissue after ischaemia‐reperfusion. Urinary excretion of TNF‐α increased from the lithotripsy‐treated kidney by 1 h after treatment, but was unaffected by ischaemia‐reperfusion. As with the HO‐1 response after lithotripsy, IL‐6 increased only in the renal medulla at F2. By contrast, ischaemia‐reperfusion increased IL‐6 in all samples from the treated kidney.

CONCLUSION

These findings show that the acute oxidative stress and inflammatory responses to ESWL are localized to the renal medulla at F2. Furthermore, the differing patterns of markers of injury for ESWL and ischaemia‐reperfusion suggest that ischaemia is not the principal cause of the injury response after ESWL.
Cultural variations in pre‐emptive effort downplaying
Authors: Pualengco Reinier P. , Chiu Chi‐yue , Kim Young‐Hoon
Published: January 2009

Pre‐emptive effort downplaying (PED) occurs when people publicly downplay their effort expenditure on test preparation prior to taking a test for the sake of managing the social evaluation of the self in the face of a challenging performance task. Thirty Asian Americans and 29 European Americans had two opportunities to publicly report their effort expenditure on a practice exercise. They also completed measures of self‐evaluations and concern for performance before working on the practice exercise, and the self‐evaluation measure again at the completion of the actual test. Only European Americans showed PED. Additionally, concern for performance was positively associated with and mediated cultural variations in PED. The implications of these results are discussed.
Development and validation of the brief Relational, Individual and Collective (brief RIC) Self‐Aspects scale
Authors: Hardie Elizabeth A.
Published: January 2009

A brief nine‐item context‐free version of the 30‐item Relational, Individual and Collective (RIC) Self‐Aspects scale was developed for use in short surveys and time‐constrained telephone interviews. Two monocultural studies were conducted using Australian samples. In Study 1 (N = 175 university students) the Brief RIC demonstrated internal reliability, factorial validity and convergent construct validity with the original RIC. In Study 2 (N = 1000 adults) the three‐factor structure was replicated and demographic correlates of self‐aspects revealed new directions for future exploration. The Brief RIC will benefit from further validation, particularly in cross‐cultural samples, but appears to be suitable for research purposes which require brevity.
Valence Politics in Scotland: Towards an Explanation of the 2007 Election
Authors: Johns Robert , Mitchell James , Denver David , Pattie Charles
Published: January 2009

In this article we use evidence from the Scottish Election Study 2007 to build an explanation for the narrow SNP victory in the Holyrood election. The theoretical focus is on valence models of voting, which are increasingly important in Scotland following dealignment and ideological convergence in the party system, and as Scottish governments flex their executive muscle. Exploring the valence battleground reveals mixed but overall negative evaluations of Labour's performance in government, and suggests advantages for the SNP on issue competence, leadership and party image. Modelling party choice at the individual level shows that key valence variables – performance evaluations, economic competence and party image – have strong and significant effects, unlike hitherto prominent factors like religion, class and national identity. Constitutional preferences are important too, but their effects suggest a further valence link: the SNP's strong showing among voters seeking further devolution but opposed to independence is due in large part to its credentials as a battler for Scottish interests. In contrast, Labour's stand against ‘more powers’ may have tarnished its own reputation on that score. We conclude that the SNP edged home by persuading enough voters that it had a positive agenda for governing Scotland within the current constitutional arrangements, and that it could deliver on that agenda.
Antiviral activity and safety of aplaviroc, a CCR5 antagonist, in combination with lopinavir/ritonavir in HIV‐infected, therapy‐naïve patients: results of the EPIC study (CCR100136)*
Authors: Yeni P , LaMarca A , Berger D , Cimoch P , Lazzarin A , Salvato P , Smaill FM , Teofilo E , Madison SJ , Nichols WG , Adkison KK , Bonny T , Millard J , McCarty D ,   the EPIC (CCR100136) study team
Published: January 2009

Background

This phase IIb study explored the antiviral activity and safety of the investigational CC chemokine receptor 5 (CCR5) antagonist aplaviroc (APL) in antiretroviral‐naïve patients harbouring R5‐ or R5X4‐tropic virus.

Methods

A total of 191 patients were randomized 2:2:2:1 to one of three APL dosing regimens or to lamivudine (3TC)/zidovudine (ZDV) twice daily (bid), each in combination with lopinavir/ritonavir (LPV/r) 400 mg/100 mg bid. Efficacy, safety and pharmacokinetic parameters were assessed.

Results

This study was terminated prematurely because of APL‐associated idiosyncratic hepatotoxicity. A total of 141 patients initiated treatment early enough to have been able to complete 12 weeks on treatment [modified intent‐to‐treat (M‐ITT) population]; of these, 133 completed the 12‐week treatment phase. The proportion of subjects in the M‐ITT population with HIV‐1 RNA <400 copies/mL at week 12 was 50, 48, 54 and 75% in the APL 200 mg bid, APL 400 mg bid, APL 800 mg once a day (qd) and 3TC/ZDV arms, respectively. Similar responses were seen in the few subjects harbouring R5X4‐tropic virus (n=17). Common clinical adverse events (AEs) were diarrhoea, nausea, fatigue and headache. APL demonstrated nonlinear pharmacokinetics with high interpatient variability.

Conclusions

While target plasma concentrations of APL were achieved, the antiviral activity of APL+LPV/r did not appear to be comparable to that of 3TC/ZDV+LPV/r.
What is Systematic Theology?
Authors: HEALY NICHOLAS M.
Published: January 2009

Three types of systematic theology are distinguished, each with its own form, function, interests and location: ‘official’, produced by the institutional church; ‘ordinary’ theological reflection, engaged in by virtually all believers; professional‐academic systematic theology. Viewed in the context of the theology of the church, official theology would benefit from a more realistic understanding of ordinary theologies. Academic systematic theology mediates between the other two, critically and constructively, and engages university disciplines likewise. It belongs within the sphere of the church but at some distance from the institution, and thus is usefully (though necessarily uneasily) located within the university.
Principles of Systematic Theology
Authors: WEBSTER JOHN
Published: January 2009

The Holy Trinity is the ontological principle of Christian systematic theology. Its external or objective cognitive principle is the divine Word, by which, through the prophets and apostles and with the illumination of the Spirit, God's incommunicable self‐knowledge is accommodated to the saints. The internal or subjective cognitive principle is the redeemed intelligence of the saints. Systematic theology is thus ectypal knowledge (derived from God's disclosure of his archetypal self‐knowledge), and a subaltern or subordinate science. Its matter is twofold: God, and all things in God. Accordingly, it is best arranged as a treatment of God in himself, followed by a treatment of the outer works of God, with a theology of the divine missions as the hinge between the two. This arrangement offers a synthetic and conceptual transposition of the primary language of Scripture.
Weichselian and Holocene palaeoenvironmental history of the Bol'shoy Lyakhovsky Island, New Siberian Archipelago, Arctic Siberia
Authors: ANDREEV ANDREI A. , GROSSE GUIDO , SCHIRRMEISTER LUTZ , KUZNETSOVA TATIANA V. , KUZMINA SVETLANA A. , BOBROV ANATOLY A. , TARASOV PAVEL E. , NOVENKO ELENA Y. , MEYER HANNO , DEREVYAGIN ALEKSANDR Y. , KIENAST FRANK , BRYANTSEVA ANNA , KUNITSKY VIKTOR V.
Published: January 2009

Cryolithological, ground ice and fossil bioindicator (pollen, diatoms, plant macrofossils, rhizopods, insects, mammal bones) records from Bol'shoy Lyakhovsky Island permafrost sequences (73°20′N, 141°30′E) document the environmental history in the region for the past c. 115 kyr. Vegetation similar to modern subarctic tundra communities prevailed during the Eemian/Early Weichselian transition with a climate warmer than the present. Sparse tundra‐like vegetation and harsher climate conditions were predominant during the Early Weichselian. The Middle Weichselian deposits contain peat and peaty soil horizons with bioindicators documenting climate amelioration. Although dwarf willows grew in more protected places, tundra and steppe vegetation prevailed. Climate conditions became colder and drier c. 30 kyr BP. No sediments dated between c. 28.5 and 12.05 14C kyr BP were found, which may reflect active erosion during that time. Herb and shrubby vegetation were predominant 11.6–11.3 14C kyr BP. Summer temperatures were c. 4 °C higher than today. Typical arctic environments prevailed around 10.5 14C kyr BP. Shrub alder and dwarf birch tundra were predominant between c. 9 and 7.6 kyr BP. Reconstructed summer temperatures were at least 4 °C higher than present. However, insect remains reflect that steppe‐like habitats existed until c. 8 kyr BP. After 7.6 kyr BP, shrubs gradually disappeared and the vegetation cover became similar to that of modern tundra. Pollen and beetles indicate a severe arctic environment c. 3.7 kyr BP. However, Betula nana, absent on the island today, was still present. Together with our previous study on Bol'shoy Lyakhovsky Island covering the period between about 200 and 115 kyr, a comprehensive terrestrial palaeoenvironmental data set from this area in western Beringia is now available for the past two glacial–interglacial cycles.
Late Wisconsinan glacial landsystems on Atlantic Canadian shelves: New evidence from multibeam and single‐beam sonar data
Authors: SHAW JOHN , TODD BRIAN J. , BRUSHETT DENISE , PARROTT D. RUSSELL , BELL TREVOR
Published: January 2009

Multibeam sonar surveys in the past decade, augmented by single‐beam data from the OLEX charting system, reveal landsystems on Atlantic Canadian shelves that are diagnostic of Late Wisconsinan ice‐sheet dynamics. Four landsystems are described. (1) The Bay of Fundy landsystem comprises two contrasting sets of bedforms, and is interpreted as evidence of topographically controlled fast‐flowing ice adjacent to slower‐moving ice. (2) The German Bank landsystem off southwest Nova Scotia is comprised of glacially fluted terrain overprinted by De Geer moraines and arcuate recessional moraines. We infer that a flow of grounded glacial ice out of the Bay of Fundy was followed by steady retreat, punctuated by at least one major re‐advance. (3) The Placentia Bay landsystem consists of a convergent field of streamlined landforms with superimposed De Geer moraines, overprinted in one area by flutings. We infer that this landsystem was formed in the onset zone of fast‐flowing ice, and that overprinting was due to a re‐advance of ice from offshore. (4) The south coast of Newfoundland landsystem, which includes arcuate, fjord‐mouth moraines and a coast‐parallel, fluted moraine, indicates strong topographic control on a retreating marine ice margin as it reached a fjord coastline. These submarine glacial landsystems are not inconsistent with a conceptual model showing Late Wisconsinan ice advance to shelf edges, rapid calving retreat along deepwater channels and slower retreat of ice margins grounded in shallow water. The re‐advances documented two of the study areas have parallels in the Last British Ice Sheet, confirming that the reorganization of marine‐based ice sheets, caused by calving in embayments, led to internally forced re‐advances.
Holocene peat growth and decay dynamics in sub‐arctic peat plateaus, west‐central Canada
Authors: SANNEL A. BRITTA K. , KUHRY PETER
Published: January 2009

Peat and net carbon accumulation rates in two sub‐arctic peat plateaus of west‐central Canada have been studied through geochemical analyses and accelerator mass spectrometry (AMS) radiocarbon dating. The peatland sites started to develop around 6600–5900 cal. yr BP and the peat plateau stages are characterized by Sphagnum fuscum peat alternating with rootlet layers. The long‐term peat and net carbon accumulation rates for both profiles are 0.30–0.31 mm/yr and 12.5–12.7 gC/m2yr, respectively. These values reflect very slow peat accumulation (0.04–0.09 mm/yr) and net carbon accumulation (3.7–5.2 gC/m2yr) in the top rootlet layers. Extensive AMS radiocarbon dating of one profile shows that accumulation rates are variable depending on peat plateau stage. Peat accumulation rates are up to six times higher and net carbon accumulation rates up to four times higher in S. fuscum than in rootlet stages. Local fires represented by charcoal remains in some of the rootlet layers result in very low accumulation rates. High C/N ratios throughout most of the peat profiles suggest low degrees of decomposition due to stable permafrost conditions. Hence, original peat accretion has remained largely unaltered, except in the initial stages of peatland development when permafrost was not yet present.
Changes in Gene Expression During the Formation of Bioengineered Heart Muscle
Authors: Khait Luda , Birla Ravi K.
Published: January 2009

A three‐dimensional bioengineered heart muscle (BEHM) construct model had been previously developed, exhibiting contractile forces up to 800 µN. The interest of this study was to determine gene expression levels of biologic markers involved in calcium‐handling between BEHM, cell monolayer, and neonatal heart. Cardiac cells were isolated from one litter of F344 rats and organized into groups (n = 5): 4‐, 7‐, 10‐day BEHM and cell monolayer; BEHM was evaluated for cell viability and contractility. Groups were then analyzed for mRNA expression of calcium‐handling proteins: myosin heavy chain (MHC) α and β, Sarcoplasmic reticulum Ca++ ATPase (SERCA) 2, phospholamban (PBL), and ryanodine receptor. BEHM exhibited electrically stimulated active force (208 ± 12 µN day 4, 361 ± 22 µN day 7, and 344 ± 29 µN day 10) and no decrease in cell number. Real‐time polymerase chain reaction (PCR) showed an increase in gene expression of all calcium‐handling proteins in BEHM at 7 and 10 days compared with monolayers, for example, comparing BEHM to monolayer (7 and 10 days, respectively), MHC‐α: 2600‐fold increase and a 100‐fold increase; MHC‐β: 70‐fold increase at 10 days; ryanodine receptor: 74‐fold increase at 10 days; SERCA: 19‐fold increase and sixfold increase; PBL: 158‐fold increase and 24‐fold increase. It was concluded that a three‐dimensional environment is a better culturing condition of cardiac cells than a monolayer. Also, BEHM constructs demonstrated a high similarity to a native myocardium, and is, thus, a good starting foundation for engineered heart muscle.
Photocrosslinkable Chitosan Hydrogel Can Prevent Bone Formation in Both Rat Skull and Fibula Bone Defects
Authors: Tsuda Yoshifumi , Ishihara Masayuki , Amako Masatoshi , Arino Hiroshi , Hattori Hidemi , Kanatani Yasuhiro , Yura Hirofumi , Nemoto Koichi
Published: January 2009

UV light irradiation to a photocrosslinkable chitosan (Az‐CH‐LA) resulted in an insoluble and flexible hydrogel within 30 s. The purpose of this study was to evaluate the ability of the photocrosslinkable chitosan to inhibit bone formation in the bone defects. A 5‐mm‐diameter defect was made in the rat calvarium, and then photocrosslinkable chitosan was implanted and irradiated with UV for 30 s. Furthermore, a 2‐mm defect was made in the fibula of a rat hind leg, and then photocrosslinkable chitosan was implanted and irradiated with UV. Bone formations in the rat skull and fibula defects with photocrosslinkable chitosan hydrogel were significantly prevented for 8 weeks. Thus, the chitosan hydrogel has an inhibitory effect on bone formation.