bluuebunny/crossref_metadata_2025 huggingface dataset:
Delayed diagnosis of Gorlin's syndrome in a renal transplant recipient
Authors: Mackenzie Katarzyna A , Maurice Paul DL
Published: April 2009

A 35‐year‐old woman was referred to the dedicated dermatology clinic for RTR. She underwent her first renal transplant at 18 years of age due to chronic renal failure following reflux nephropathy of the single right kidney (left kidney agenesis). She has since then had two further transplants. During clinical examination she was noted to have at least 16 basal cell carcinomas (BCC) and there are records in the case notes of 10 BCC having being excised and confirmed histologically in the past. By contrast, she had only had two squamous cell carcinomas (SCC) excised. She was also noted to have distinctive facial features, a kyphoscoliosis and palmar pits, and a diagnosis of Gorlin's (naevoid BCC) syndrome (GS) was made. Although immunosuppression may have contributed to the multiplicity of her BCC, the contrasting very small number of SCC is unusual in an organ transplant recipient and this alerted the authors to the diagnosis of GS.
Unusual presentation of GLUT‐1 positive infantile haemangioma
Authors: Koh Clare , Sugo Ella , Wargon Orli
Published: April 2009

Infantile haemangiomas are usually not present at birth. This is a case of a female infant with an atypical congenital vascular tumour present at birth which ulcerated in the first few days of life, involuted over several months and showed histopathological features in keeping with either an involuting GLUT‐1 positive infantile haemangioma or a reticular haemangioma of infancy. The initial clinical presentation was atypical for an infantile haemangiomas and for a congenital haemangioma, however the histopathology and immunohistochemistry assisted with confirmation of the diagnosis. Vacuum‐assisted closure (VAC) therapy aided in the complete healing of the ulcerated infantile haemangioma which was not achievable with conventional dressings.
Liver metabolism of porphyrins and haem
Authors: BLOOMER JOSEPH R
Published: April 2009

The liver is an active site for the biosynthesis of haem and porphyrinogens/porphyrins, which are intermediates of the haem biosynthetic pathway, because haem is required for functional activity of the cytochrome P 450 system and other critical hepatic haemoproteins. The production of hepatic haem is regulated primarily through the activity of aminolaevulinic acid synthase which is the ﬁrst and normally rate‐limiting enzyme of the pathway. This is, in turn, controlled by a putative regulatory haem pool. Hepatic haem can be repleted by the intravenous administration of haem, which is the basis for haem therapy in patients with acute porphyric attacks. The liver catabolizes haem to bilirubin through microsomal haem oxygenase activity and excretes haem into bile along with porphyrins. Biliary excretion of porphyrins increases signiﬁcantly in patients with some types of porphyria. In protoporphyria this may cause liver damage as a result of protoporphyrin toxicity. The delineation of the pathway for protoporphyrin excretion into bile should facilitate therapy in protoporphyria by identifying ways in which protoporphyrin excretion can be enhanced.
Augmented levels of gastric mucosal leucocyte activation by infection with cagA gene‐positive Helicobacter pylori
Authors: SUZUKI HIDEKAZU , SUZUKI MASAYUKI , MORI MIKIJI , KITAHORA TETSUJI , YOKOYAMA HIROKAZU , MIURA SOICHIRO , HIBI TOSHIFUMI , ISHII HIROMASA
Published: April 2009

The possession of the cytotoxin‐associated gene (cagA) of Helicobacter pylori is thought to be highly associated with peptic ulcer disease. However, the pathogenic role of cagA is still unknown. We have emphasized the importance of the interrelationship between H. pylori‐derived ammonia and oxygen radicals from inﬁltrated leucocytes. The aim of the present study was to explore the relationship between oxygen radical production and H. pylori strain diversity based on cagA possession. An endoscopic examination and gastric mucosal biopsy were performed in 30 H. pylori‐infected patients with gastric ulcer. Myeloperoxidase (MPO) content and the luminol‐dependent chemiluminescence value in the biopsied gastric specimens were measured as an index for leucocyte inﬁltration and oxygen radical production. From the precipitates of cultured bacterial isolates of biopsied specimens, bacterial DNA was puriﬁed and analysed by polymerase chain reaction to characterize the possession of cagA. While all patients had ureC‐positive strains, 22 had cagA‐positive and eight had cagA‐negative strains. In patients with cagA‐positive strains, MPO contents as well as chemiluminescence values in the gastric corpus were signiﬁcantly higher than those in patients with cagA‐negative strains. Gastric mucosal leucocyte recruitment and activation are suggested to be enhanced by cagA gene‐positive H. pylori infection.
Expression of Sonic hedgehog signaling molecules in normal, hyperplastic and carcinomatous endometrium
Authors: Kim Kyung Hee , Kim Jin Man , Choi Yoon‐La , Shin Young Kee , Lee Ho‐chang , Seong In Ock , Kim Bum Kyung , Chae Seoung Wan , Chung Yun‐Shin , Kim Seok‐Hyung
Published: April 2009

The aim of the present study was to determine the expression profile of the hedgehog (Hh) signaling molecules in normal, hyperplastic, and carcinomatous uterine endometrium. For this purpose, 271 endometrial tissue samples, (62 of normal endometrium, 127 of endometrial hyperplasias, and 82 endometrial adenocarcinomas) were studied using antibodies recognizing Hh‐related signaling proteins, such as, sonic hedgehog (Shh), Patched (PTCH), Smoothened (Smo), Suppressor of fused [Su(Fu)], Gli‐1, Gli‐2, and Gli‐3 by immunohistochemistry. The mRNA expression of these molecules was also assessed on reverse transcription–polymerase chain reaction. In the normal endometrium, the expression of Hh signaling molecules was generally downregulated except for Su(Fu), Gli‐2, and Shh. In particular, the expression of both PTCH and Smo was very low or almost absent. Overall expression of Hh signaling molecules increased in hyperplastic endometrium; in particular, PTCH and Smo were significantly highly expressed in complex and atypical hyperplasia. In carcinoma samples extensive alterations were observed in the expression pattern of the signaling molecules. Nuclear Gli‐2, cytoplasmic Gli‐3, and Su(Fu) were overexpressed, whereas Shh, PTCH, and Smo expression were significantly reduced compared with the hyperplastic endometrium. The results suggest that the alteration of Hh signaling may be implicated in tumorigenesis of the endometrium.
Peroxisome proliferator‐activated receptor gamma in human prostate carcinoma
Authors: Nakamura Yasuhiro , Suzuki Takashi , Sugawara Akira , Arai Yoichi , Sasano Hironobu
Published: April 2009

Peroxisome proliferator‐activated receptor (PPAR) is a member of the nuclear hormone receptor superfamily of transcription factors. Peroxisome proliferator‐activated receptor gamma (PPARγ) plays an important role in the regulation of lipid homeostasis, adipogenesis, insulin resistance, and development of various organs. Agonists of PPARγ have been also reported to inhibit proliferation of prostate carcinoma cells as in other human malignancies, and these synthetic ligands have been used in differentiation‐mediated therapy of various human carcinomas associated with high levels of PPARγ. The significance of PPARγ expression, however, was unknown in human prostate carcinoma tissues. The purpose of the present study was therefore to examine the immunolocalization of PPARγ in human prostate cancer tissues (40 cases) and correlate the findings with clinicopathological features of the patients in order to evaluate its possible biological significance. Twenty‐nine patients were positive for PPARγ immunoreactivity (73%) and a significant inverse correlation was detected between PPARγ immunoreactivity, pT stage (P = 0.036), and serum concentration of prostate‐specific antigen (P = 0.0004). In conclusion, PPARγ immunoreactivity is considered to be a new clinicopathological parameter of human prostate cancer.
Gastric leiomyosarcoma manifesting peculiar findings: Radiological–pathological correlation
Authors: Masuzawa Naoko , Kishimoto Mitsuo , Nishimura Ayako , Ichiba Noriatsu , Aoki Etsuo , Yanagibashi Ken , Hirota Seiichi , Yanagisawa Akio
Published: April 2009

Reported herein is a gastric leiomyosarcoma, which, nowadays, is extremely rare. Attention was focused not only on pathological findings but also on the histological basis of magnetic resonance imaging (MRI) findings. The patient was a 29‐year‐old Japanese woman. Preoperative T2‐weighted MRI showed a large high‐intensity gastric tumor with isointense streaks. The tumor was a broad‐based large polypoid lesion and histologically consisted of fascicles of spindled cells having eosinophilic cytoplasm and cigar‐shaped nuclei. Immunoreactivity for several smooth muscle markers including desmin on tumor cells, low amplification of both c‐kit and PDGFRA cDNA on polymerase chain reaction, and absence of c‐kit gene mutation in exons 9 and 11 strongly suggested that the tumor was not a gastrointestinal stromal tumor but a true leiomyosarcoma. In vitro MRI of the fresh tumor was obtained to explain the radiological findings on a morphological basis. In vitro MRI clearly depicted the very high‐intensity areas separated by radially extended isointense lines. This radiological finding corresponded best to the most characteristic histological feature, that is, linearly extended fascicles of the tumor cells often with myxedematous change separated by radially elongated thin fibrovascular stroma: in other words, spouting appearance.
Urothelial carcinoma of the renal pelvis with rhabdoid features
Authors: Fukumura Yuki , Fujii Hiroaki , Mitani Keiko , Sakamoto Yoshiro , Matsumoto Toshiharu , Suda Koichi , Yao Takashi
Published: April 2009

Reported herein is the case of a 70‐year‐old man with high grade urothelial carcinoma (UC) with rhabdoid features of the renal pelvis. For the most part, the tumor was composed of pleomorphic, non‐cohesive round tumor cells with abundant cytoplasm. In situ high‐grade UC composed of cohesive tumor cells was seen only in a small portion. Pleomorphic dyscohesive tumor cells often showed rhabdoid features, containing eosinophilic inclusions. These pleomorphic/rhabdoid tumor cells were immunohistochemically positive for vimentin but negative for cytokeratins, CD45, CD20, CD79a, CD3, CD45RO, CD38, and CD138. Loss of heterozygosity (LOH) analysis demonstrated identical allelic losses as well as additional allelic losses for the dyscohesive and cohesive UC lesion, indicating that these two lesions originated from a single clonal lesion.
Professional portfolios and Australian registered nurses' requirements for licensure: Developing an essential tool
Authors: Mills Jane
Published: April 2009

A requirement of many nurses in the process of licensing for practice each year is a declaration of continuing competence to practice. In Australia, each state and territory currently has its own regulatory authority for nurses and midwives, whose main role is to protect public safety. Like many other registering authorities in the Asia‐Pacific region, Australian regulatory authorities undertake the random auditing of nurses and midwives in order to assess their competence to practice. Professional portfolios commonly are considered to be a tool that nurses can use to demonstrate to regulatory authorities, employers, and others how they meet the required competencies. This article examines the different types of portfolios that fall under the umbrella term, professional portfolio, and recommends that nurses explore the strategies that identify evidence of their continuing competence to practice for inclusion in such a document.
Longitudinal study of a health education program for Japanese women in menopause
Authors: Ueda Masumi , Matsuda Masako , Okano Kozue , Suenaga Hiromi
Published: April 2009

In this longitudinal intervention study, a 6 week health education program consisting of lectures and exercises was implemented for 39 Japanese menopausal women. The effects of the program were assessed by measuring their exercise participation, climacteric symptoms, and quality of life immediately before, 6 weeks after, and 1 year after the program. The Simplified Menopausal Index was used to assess the climacteric symptoms and the Medical Outcomes Study 36‐Item Short‐Form Health (SF‐36) Survey was used to assess the quality of life. Significant improvements were observed in the subscale score for general health perception and the summary score for the physical component summary in the SF‐36 Survey. Favorable results also were found for women without a previous exercise habit before the program but who participated in regular exercise 1 year after the program. No improvements were observed in the climacteric symptoms. We concluded that our program was effective for menopausal women in spite of the intervention period being relatively short.
DNAzymes and their therapeutic possibilities
Authors: Chan C. W. S. , Khachigian L. M.
Published: April 2009

Our increasing understanding of the regulatory mechanisms involved in the pathogenesis of disease is opening up opportunities for therapeutic intervention. To tackle the unmet disease burden, the last decade has seen the emergence of gene‐targeting small‐molecule nucleic acid‐based strategies, such as antisense oligodeoxynucleotides, ribozymes, small interfering RNA and DNAzymes. DNAzymes represent promising candidates for drug therapy in a wide range of diseases, such as cancer and cardiovascular disorders. This brief review will discuss recent developments in DNAzymes and their therapeutic potential.
Methotrexate: long‐term safety and efficacy in an Australian consultant rheumatology practice
Authors: Varatharajan N. , Lim I. G. S. , Anandacoomarasamy A. , Russo R. , Byth K. , Spencer D. G. , Manolios N. , Howe G. B.
Published: April 2009

Background: The aim of this study was to evaluate the rate and cause of methotrexate (MTX) termination in clinical practice, describe the types of toxicities noted, assess the incidence of achieving remission in rheumatoid arthritis (RA) patients and review the appropriateness of current clinical guidelines for monitoring MTX treatment.

Methods: A retrospective, case review of patients seen in a private rheumatology practice attached to a major Sydney Teaching Hospital was undertaken over an 18‐year period. The primary outcome was time to cessation of MTX.

Results: Seven hundred and ninety patients satisfied the inclusion criteria. MTX was terminated in 272 patients (34.4%). Toxicity‐related discontinuation occurred in 93 patients (11.8%) and due to non‐adverse reactions in 179 patients. The median duration of therapy in these two groups was 2.0 and 2.9 years, respectively. There was no difference in the average maximum weekly dose of MTX. Of patients with RA, 47.5% were in remission at last follow up. Cox proportional hazards analyses showed that those of the female sex remained on treatment significantly longer than the male sex (hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.57–0.96; P = 0.014); patients with RA remained on treatment significantly longer than patients with seronegative arthritis (HR 0.56, 95%CI 0.42–0.74; P < 0.001). Being of the male sex aged more than 60 years and having a non‐RA diagnosis predisposed to stopping MTX earlier.

Conclusion: MTX is a safe and effective medication. Notable remission rates are achievable in patients with RA with current conventional treatment protocols. MTX has a low toxicity profile and this study stresses the need to re‐evaluate and revise the current monitoring guidelines.
Delayed adverse reactions to total‐dose intravenous iron polymaltose
Authors: Haines M. L. , Gibson P. R.
Published: April 2009

The rate of infusion reactions to total‐dose intravenous iron polymaltose is very low, but the frequency and severity of adverse reactions following the infusion are unknown. In 50 consecutive patients, adverse reactions developed up to 2 days after the infusion in 26% and lasted 1–8 days (median 4). Severe systemic reactions occurred in 8%. Patients should be warned of the chance of delayed reactions and an alternative iron preparation should be considered if parenteral iron is again indicated.
A randomized study of a new landmark‐guided vs traditional para‐carotid approach in internal jugular venous cannulation in infants
Authors: XIAO WENJING , YAN FUXIA , JI HONGWEN , LIU MINGZHENG , LI LIHUAN
Published: April 2009

Background:  Central venous catheterization is more difficult in infants than in adults. Ultrasound‐guided internal jugular venous cannulation may improve the accuracy of localization of the internal jugular vein (IJV), but ultrasound equipment is not universally available. The landmark technique remains essential in daily practice.

Methods:  One hundred and forty infants, aged 3–12 months, who were scheduled to undergo surgery for congenital heart disease, were randomly assigned to a new landmark‐guided group or traditional para‐carotid group. In the new landmark‐guided group, at the level of the cricoid cartilage, the carotid artery was marked, and the apex of the triangle formed by the two heads of the sternocleidomastoid muscle and the clavicle was also marked. The needle was inserted at the midpoint of the two marked points and advanced in the direction of the ipsilateral nipple. Seven cardiac anesthesia fellows participated in this study, and each fellow performed 10 central catheterizations in each group. The times to successful catheterization of the IJV were measured. Attempts at needle punctures for successful catheterization and procedural complications were counted.

Results:  The IJV was successfully punctured within three attempts in 74% of infants in the para‐carotid group, compared with 94% in the new landmark‐guided group (P = 0.001). The time to successful catheterization was significantly shorter in the new landmark‐guided group (P < 0.01). The incidence of arterial punctures in the para‐carotid group was 11%, compared with 3% in the new landmark‐guided group (P < 0.05).

Conclusions:  Compared with traditional para‐carotid approach, the new landmark‐guided approach for access of the IJV during teaching central catheterization significantly reduced carotid arterial puncture, provided a higher success rate and minimized procedure time in infants aged 3–12 months.
The thermal benefit of prewarming in children
Authors: Cassey J.G. , King R.A.R. , Armstrong P.
Published: April 2009

Background:  It has been suggested that warming patients before induction of anaesthesia (prewarming) reduces the drop in core temperature (Tcore) normally associated with the induction of anaesthesia [1]. It may also reduce the incidence of surgical wound infection [2, 3]. Neither the ideal ambient temperature (Tambient), nor the duration necessary to achieve these aims, is established for adults or children. Since drops in Tcore can take some time to reverse with intra‐operative heating [4], there may be benefit in starting off at a higher Tcore. We therefore conducted a prospective randomized clinical study to assess the impact of prewarming on Tcore behaviour after induction of anaesthesia in children.

Aims:  We aimed to quantify the impact of prewarming vs standard ambient temperature on core temperature behaviour after induction of anaesthesia in children.

Methods:  Prospective clinical study with randomization to either 26°C or 21°C ambient temperature. Well children scheduled for elective surgery where presurgical anaesthetic duration exceeded 20 mins. Continuous oesophageal temperature monitoring until operative procedure commenced.

Results:  There were 30 children in each group. Those in the prewarmed group had significantly higher initial Tcore, a reduced drop in their Tcore and a longer time to reach the same fall in Tcore.

Conclusions:  The demonstrated differences are considered clinically insignificant. When the surgical procedure is short or when convective heating is available and will last for at least 45 mins, there is no clinically important ‘thermal advantage’ in prewarming. This is independent of age, weight, height and body surface area.

References

1 Sessler DI, McGuire J, Moayeri A, Hynson JM. Isoflurane‐induced vasodilation minimally increases cutaneous heat loss. Anesthesiology 1991; 74: 226–232.

2 Melling AC, Baqar A, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial The Lancet 2001; 358(15): 876–880.

3 Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical‐wound infection and shorten hospitalization. New Engl J Med 1996; 334: 1209–1215.

4 Cassey J, Armstrong P, Smith GE, Farrell PT. The safety and effectiveness of a modified convection heating system for children during anesthesia. Pediatr Anesth 2006; 16: 654–662.
Pain post neurosurgery in the paediatric population: a cohort study (Accepted as a poster)
Authors: Toe J.H. , Palmer G. , Davidson A.
Published: April 2009

Aims:  This audit was to determine the incidence and severity of post neurosurgical pain, analgesic use and predictors of significant pain following paediatric neurosurgery.

Background:  Research in the adult population has evaluated incidence and severity [1–5] of post neurosurgical pain, and effectiveness of different post neurosurgical analgesic regimens. In contrast there are few studies describing the incidence or management of pain after paediatric neurosurgery.

Method:  A prospective audit of patients who underwent elective or emergency intra‐cranial procedures at the Royal Children's Hospital was performed from September 2007 to April 2008. Pain scores were obtained from nursing documentation and bi‐daily by the auditor using pain measurement tools. Use of analgesia was also noted. Details of surgical procedure and intra‐operative anaesthesia management were recorded. Multivariate regression was used to identify factors associated with use of parenteral opioids >24 hr or unacceptable pain (pain scores ≥ 3).

Results:  Eighty‐eight patients (48 male, 40 female) were included. Low median pain scores over 72 postoperative hours were reported from nursing documentation [0.79 (IQR: 0.3–1.53)] and auditor scores [1.33 (IQR: 0.17–3.08)]. Fifty (56.8%) patients required parenteral opioids, 34.1% as infusion and 22.7% as PCA, and 34.1% used parenteral morphine for >24 hr. A multivariate regression revealed younger age and longer surgical duration as factors associated with postoperative parenteral morphine use > 24 hr (P < 0.05). The only factor associated with pain scores ≥ 3 in a regression analysis of patients of all procedural types was older age (P < 0.05).

Conclusion:  This audit reported that the majority of paediatric neurosurgical patients received postoperative parenteral opioids. The majority also experienced relatively little pain. The low pain scores observed indicated effective postoperative pain management.

References

1 de Gray LC, Mata BF. Acute and chronic pain following craniotomy: a review. Anaesthesia 2005; 60: 693–704.

2 Gottschalk A, Barlow LC, Stevens RD, Mir ski M, Thompson RE, White ED, Weingarten JD, Long DM, Yester M. Prospective evaluation of pain and analgesic use following major elective intracranial surgery. Journal of Neurosurgery 2007; 106: 210–216.

3 Ire fin SA, Schubert A, Bloomfield EL, DeBeers GE, Mache EJ, Abraham ZY. The effect of craniotomy location on postoperative pain and nausea. Journal of Anesthesia 2003; 17: 227–231.

4 Kilmer M, Ruben JF, Amman J, Burner U, Klein J, Verbrugge SJ. Pain in neurosurgically treated patients: a prospective observational study. J Neurosurg 2006; 104: 350–359.

5 Quiney N, Cooper R, Stoneham M, Walters F. Pain after craniotomy. A time for reappraisal? British Journal of Neurosurgery 1996; 10: 295–299.
History or ecology? Substrate type as a major driver of patial genetic structure in Alpine plants
Authors: Alvarez Nadir , Thiel‐Egenter Conny , Tribsch Andreas , Holderegger Rolf , Manel Stéphanie , Schönswetter Peter , Taberlet Pierre , Brodbeck Sabine , Gaudeul Myriam , Gielly Ludovic , Küpfer Philippe , Mansion Guilhem , Negrini Riccardo , Paun Ovidiu , Pellecchia Marco , Rioux Delphine , Schüpfer Fanny , Van Loo Marcela , Winkler Manuela , Gugerli Felix ,   IntraBioDiv Consortium
Published: April 2009

Climatic history and ecology are considered the most important factors moulding the spatial pattern of genetic diversity. With the advent of molecular markers, species’ historical fates have been widely explored. However, it has remained speculative what role ecological factors have played in shaping spatial genetic structures within species. With an unprecedented, dense large‐scale sampling and genome‐screening, we tested how ecological factors have influenced the spatial genetic structures in Alpine plants. Here, we show that species growing on similar substrate types, largely determined by the nature of bedrock, displayed highly congruent spatial genetic structures. As the heterogeneous and disjunctive distribution of bedrock types in the Alps, decisive for refugial survival during the ice ages, is temporally stable, concerted post‐glacial migration routes emerged. Our multispecies study demonstrates the relevance of particular ecological factors in shaping genetic patterns, which should be considered when modelling species projective distributions under climate change scenarios.
The use of motivational enhancement strategies for the maintenance of weight loss among obese individuals: a preliminary investigation
Authors: Rieger E. , Dean H. Y. , Steinbeck K. S. , Caterson I. D. , Manson E.
Published: April 2009

Aim:  To investigate the efficacy of motivational enhancement strategies integrated within a standard lifestyle modification program for the maintenance of weight loss and improved psychosocial functioning of obese adults.

Methods:  Twenty‐two obese adults completed 20 sessions of a motivationally informed cognitive behavioural treatment for weight loss and maintenance. Treatment outcome measures included anthropometrics, obesity‐specific quality of life, impulsive eating tendencies, body dissatisfaction, mood disturbance and maladaptive cognitions.

Results:  At post‐treatment, there was a significant decrease in body weight (123.04 ± 22.06 vs. 116.84 ± 23.53, p < 0.001) with no significant change by the 12‐month follow‐up. Patients also reported significant improvements in obesity‐related quality of life, impulsive eating tendencies, body dissatisfaction and maladaptive cognitions at post‐treatment that were maintained at the 1‐year follow‐up.

Conclusions:  The implementation of motivational enhancement strategies within a cognitive behavioural program results in sustained weight loss that compares favourably to previous lifestyle modification programs.
Three‐dimensional study on the effect of organophosphate pesticide ‘monocrotophos’ on lens of fish and its recovery
Authors: Ravneet  , Johal M. S. , Sharma M. L.
Published: April 2009

The present studies are based on the feedback provided by fish farmers practicing composite fish culture of carps. According to them, fish habitats are affected by pesticides draining from agricultural fields into their catchments, especially during the rainy season. The lenses of most of the cultured fish became opaque, resulting in poor overall growth. In the literature, there was mounting evidence of pesticide toxicity involving multiple tissues. However, the fish visual system has never been investigated particularly from the toxicological perspective. In this regard, we carried out comparative toxicological studies on the lens of Cyprinus carpio communis using three different sublethal concentrations (0.038, 0.062 and 0.126 p.p.m.) of monocrotophos along with untreated controls for 30 days. Lenses from all the groups were extracted and preserved in gluteraldehyde and osmium tetraoxide and dehydrated in increasing grades of acetone. After dehydration, tissues were conducted with gold to observe under SEM. The fish exposed to monocrotophos developed cataract. Furthermore, when fish from the monocrotophos‐treated tanks were transferred to normal environmental conditions for the next 60 days, progressive lens degeneration was noted. To conclude, monocrotophos induces irreversible cataractous changes in the lens of C. carpio communis. The fish visual system has many similarities to mammals and may serve as a good model for comparative toxicologic and ophthalmologic studies.
The use of canine models of inherited retinal degeneration to test novel therapeutic approaches
Authors: Beltran William A.
Published: April 2009

Inherited retinal degenerations (RDs) are a common cause of blindness in dogs and in humans. Over the past two decades numerous genes causally associated with these diseases have been identified and several canine models have been used to improve our understanding of the molecular mechanisms of RDs, as well as to test the proof of principle and safety of novel therapies. This review briefly summarizes the drug delivery approaches and therapeutic strategies that have been and are currently tested in dogs, with a particular emphasis on corrective gene therapy, and retinal neuroprotection.
Bilateral orbital and nasal aspergillosis in a cat
Authors: Barachetti Laura , Mortellaro Carlo M. , Di Giancamillo Mauro , Giudice Chiara , Martino Pieranna , Travetti Olga , Miller Paul E.
Published: April 2009

A 12‐year‐old, 4 kg, castrated male Persian cat was referred with a 2‐month history of sneezing and bilateral mucopurulent nasal discharge. Rhinoscopically acquired nasal biopsies at this time revealed bilateral lymphoplasmacytic rhinitis. A tapering dose of oral prednisone caused the complete remission of the clinical signs, but 2 months after discontinuation of the therapy, the rhinitis recurred and the OD became exophthalmic. Computed tomography showed a soft tissue mass in both sides of the nasal cavity, both frontal sinuses, the right orbit, and to a lesser extent the left orbit. A fine needle aspirate of the right orbit revealed pyogranulomatous inflammation andAspergillusspp. hyphae. Repeat nasal biopsy demonstrated multi‐focal necrosis and a mixed inflammatory cell process which now included macrophages and scattered septate fungal hyphae. A few days later the cat became bilaterally blind and a contrast enhancing lesion involving the optic chiasm was found on magnetic resonance imaging. Despite a poor prognosis, therapy consisted of exenteration of the right orbit and trephination of both frontal sinuses before the planned initiation of medical antifungal therapy. Unfortunately, the cat died of cardiac arrest intraoperatively.Aspergillus fumigatuswas cultured from both orbits at necropsy. Orbital aspergillosis has been rarely reported in cats and its relationship with lymphoplasmacytic rhinitis is unclear. In this patient lymphoplasmacytic rhinitis or previous antibiotic/corticosteroid therapy may have allowed secondary fungal invasion of the nasal mucosa and subsequently both orbits and the brain. Alternatively,Aspergillusinfection may have preceded the lymphoplasmacytic rhinitis.
Laparoscopic vs open radical nephroureterectomy for upper urinary tract urothelial cancer: oncological outcomes and 5‐year follow‐up
Authors: Greco Francesco , Wagner Sigrid , Hoda Rashid M. , Hamza Amir , Fornara Paolo
Published: April 2009

OBJECTIVE

To compare the oncological outcomes of laparoscopic radical nephroureterectomy (LNU) vs open NU (ONU) for upper urinary tract transitional cell carcinoma (TCC).

PATIENTS AND METHODS

Between July 1999 and January 2003, we performed 70 LNUs and 70 ONUs for TCC of the upper urinary tract. ONU was reserved for patients with previous abdominal surgery or with severe cardiac and/or pulmonary problems. Demographic data, tumour staging and histological grading and rates of metastasis were recorded and compared.

RESULTS

For LNU and ONU the mean operative durations were 240 min and 190 min, respectively. The definitive pathology showed a high incidence of tumour stage pT2 G2 in both LNU and ONU groups. The median follow‐up was 60 months. In the LNU group, the 5‐year disease‐free survival (DFS) was 75%: 100% for pTa, 88% for pT1, 78% for pT2, and 35% for pT3 (P < 0.001). In the ONU group, the 5‐year DFS was 73% (LNU vs ONU, P = 0.037): 100% for pTa, 89% for pT1, 75% for pT2 and 31% for pT3 (P < 0.001).

CONCLUSION

The results of our long‐term controlled study support the use of LNU as an effective alternative to ONU in the therapy of upper urinary tract urothelial cancer.
The Latin American Consortium of Studies in Obesity (LASO)
Authors: Bautista L. E. , Casas J. P. , Herrera V. M. , Miranda J. J. , Perel P. , Pichardo R. , González A. , Sanchez J. R. , Ferreccio C. , Aguilera X. , Silva E. , Oróstegui M. , Gómez L. F. , Chirinos J. A. , Medina‐Lezama J. , Pérez C. M. , Suárez E. , Ortiz A. P. , Rosero L. , Schapochnik N. , Ortiz Z. , Ferrante D. ,   on behalf of the investigators of the Latin‐American Consortium of Studies in Obesity (LASO)
Published: April 2009

Current, high‐quality data are needed to evaluate the health impact of the epidemic of obesity in Latin America. The Latin American Consortium of Studies of Obesity (LASO) has been established, with the objectives of (i) Accurately estimating the prevalence of obesity and its distribution by sociodemographic characteristics; (ii) Identifying ethnic, socioeconomic and behavioural determinants of obesity; (iii) Estimating the association between various anthropometric indicators or obesity and major cardiovascular risk factors and (iv) Quantifying the validity of standard definitions of the various indexes of obesity in Latin American population. To achieve these objectives, LASO makes use of individual data from existing studies. To date, the LASO consortium includes data from 11 studies from eight countries (Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Peru, Puerto Rico and Venezuela), including a total of 32 462 subjects. This article describes the overall organization of LASO, the individual studies involved and the overall strategy for data analysis. LASO will foster the development of collaborative obesity research among Latin American investigators. More important, results from LASO will be instrumental to inform health policies aiming to curtail the epidemic of obesity in the region.
Minorities and the National Ethos
Authors: Etzioni Amitai
Published: April 2009

This essay focuses on the question of how to curb the tension between the rights of members of minorities and the particularistic values of the national community. The essay first examines a radical multicultural treatment of this issue and shows it to be unattainable and inadvisable. The essay then proposes an alternative treatment, Diversity Within Unity, a societal design that combines the nurturing communities of minorities and of the majority and is more conducive to human flourishing. Diversity Within Unity assumes that all citizens will embrace a core of values while being welcomed to follow their own subcultures on other matters.
Terrorist Finance: Asking the Right Questions
Authors: Wittig Timothy
Published: April 2009

An emerging critical literature from within and outside academia argues that existing understandings of the financing of terrorism are at best severely dysfunctional, and at worst malignantly so. This article argues that at the root of this dysfunction is a failure to ask the ‘right’ questions about terrorist financing. The right questions, the article finds, are only tangentially related to the supposed mystery of ‘who finances and how they do it’, and instead revolve around, first, specifying how financial activity influences terrorist behaviour and, second, assessing what such activity tells us about the place terrorists truly occupy in today's global system.
I'll Know What You're Like When I See How You Feel
Authors: Ames Daniel R. , Johar Gita V.
Published: April 2009

Accumulating evidence suggests that targets' displays of emotion shape perceivers' impression of those targets. Prior research has highlighted generalization effects, such as an angry display prompting an impression of hostility. In two studies, we went beyond generalization to examine the interaction of displays and behaviors, finding new evidence of augmenting effects (behavior-correspondent inferences are stronger when behavior is accompanied by positive affect) and discounting effects (such inferences are weaker when behavior is accompanied by negative affect). Thus, the same display can have different effects on impressions depending on the behavior it accompanies. We found evidence that these effects are mediated by ascribed intentions and that they have a boundary: When behaviors and affective displays are repeated, the augmenting and discounting power of displays appears to wane.
Simpson's Paradox in Survival Models
Authors: DI SERIO CLELIA , RINOTT YOSEF , SCARSINI MARCO
Published: April 2009

Abstract. In the context of survival analysis it is possible that increasing the value of a covariateXhas a beneficial effect on a failure time, but this effect is reversed when conditioning on any possible value of another covariateY. When studying causal effects and influence of covariates on a failure time, this state of affairs appears paradoxical and raises questions about the real effect ofX. Situations of this kind may be seen as a version of Simpson's paradox. In this paper, we study this phenomenon in terms of the linear transformation model. The introduction of a time variable makes the paradox more interesting and intricate: it may hold conditionally on a certain survival time, i.e. on an event of the type {T>t} for some but not allt, and it may hold only for some range of survival times.
DUALISM IN JOB STABILITY OF THE KOREAN LABOUR MARKET: THE IMPACT OF THE 1997 FINANCIAL CRISIS
Authors: Cho Joonmo , Keum Jaeho
Published: April 2009

Abstract.  This paper measures the dynamic changes in job stability in the Korean labour market during the period between the 1997 financial crisis and the recovery. Drawing on the Korean Labor and Income Panel Study data, our empirical research shows that the sharp decline in job stability experienced by Korean workers during the 1997 financial crisis never bounced back to the previous level. The recovery process was much slower for irregular, short‐tenured or less educated workers than the other comparison groups, aggravating the polarization of job stability.
MARKET EFFICIENCY: EVIDENCE FROM A NO‐BUBBLE ASSET MARKET EXPERIMENT
Authors: Lei Vivian , Vesely Filip
Published: April 2009

Abstract.  We report the results of an experiment that demonstrates that market experience is not necessary to eliminate bubbles in the type of asset markets studied in Smith et al. (1988). We introduce a pre‐market phase in which subjects experience a dividend flow themselves by literally observing and receiving dividends for 12 periods. The robust bubble–crash phenomenon never occurs in our experiment. Our results provide strong evidence that so long as a majority of the subjects have full understanding of the structure of the dividend, market efficiency can be ensured.
ESTIMATED DYNAMIC STOCHASTIC GENERAL EQUILIBRIUM MODEL OF THE TAIWANESE ECONOMY
Authors: Teo Wing Leong
Published: April 2009

Abstract. I develop a small open economy dynamic stochastic general equilibrium model to study monetary policy and the business cycle in Taiwan. Several versions of the model with different representations of Taiwanese monetary policy are estimated using Bayesian techniques. The major findings are that: (i) monetary policy in Taiwan is best described by a money supply growth rate rule; (ii) the Taiwanese economy is more flexible than the Euro area economy; and (iii) export price mark‐up and investment‐specific technology shocks are the main driving forces of output growth fluctuations in Taiwan.
OPTIMAL UNEMPLOYMENT INSURANCE, WITH HUMAN CAPITAL DEPRECIATION, AND DURATION DEPENDENCE*
Authors: Pavoni Nicola
Published: April 2009

This article introduces the possibility of a deterioration in job opportunities during unemployment into the standard optimal unemployment insurance (UI) design framework and characterizes the efficient UI scheme. The optimal program may display two novel features, which cannot be present in stationary models. First, UI transfers are bounded below by a minimal assistance level that arises endogenously in the efficient contract. Second, the optimal scheme implies a wage subsidy for long‐term unemployed workers. Numerical simulations based on the Spanish and U.S. economies suggest that both assistance transfers and wage subsidies should be part of the UI scheme in these countries.
TECHNOLOGICAL PROGRESS UNDER LEARNING BY IMITATION*
Authors: Kelly Morgan
Published: April 2009

I analyze technological progress when knowledge has a large tacit component so that transmission of knowledge takes place through direct personal imitation. It is shown that the rate of technological progress depends on the number of innovators in the same knowledge network. Assuming the diffusion of knowledge to mirror the geographical pattern of trade—the greater the trade between two sites, the greater the probability that technical knowledge flows between them—I show that a gradual expansion of trade causes a sudden rise in the rate of technological progress.
POPULATION POLICY THROUGH TRADABLE PROCREATION ENTITLEMENTS*
Authors: De La Croix David , Gosseries Axel
Published: April 2009

One of the first tradable rights proposal is Boulding's (The Meaning of the Twentieth Century, London: George Allen and Unwin Ltd, 1964), dealing with overpopulation. We discuss both tradable procreation allowances and exemptions domestically and globally, to address underpopulation as well. We focus on three effects. Notably, the rights' tradability entails that whereas exemptions or expensive enough allowances benefit the poor, cheap allowances benefit the rich. A natalist policy also worsens the average education level of the next generation, whereas population control enhances it. Also, if procreation rights are grandfathered to countries, the scheme redistributes further. Our analysis suggests that procreation entitlements may be efficient in controlling population, without being necessarily anti‐redistributive.
NONLINEAR INCOME TAXATION AND MATCHING GRANTS IN A FEDERATION WITH DECENTRALIZED IN‐KIND TRANSFERS*
Authors: Blomquist Sören , Micheletto Luca
Published: April 2009

We extend to a fiscal federalism setting the literature on redistributive in‐kind transfers in the presence of nonlinear income taxation. Local governments have a cost advantage, motivating decentralization of the in‐kind transfer. The cost structure varies across regions, and the central government cannot observe which region is which. We show that decentralized in‐kind transfers can, in this setting, be an even more important instrument for relaxing self‐selection constraints, thus, helping redistribution, than in single‐government models. We characterize the optimal marginal tax rates and matching grants. The grants have a very different structure than the one derived in earlier studies.
Communication and Empowerment: A Place for Rich and Multiple Media?
Authors: Bunning Karen , Heath Becky , Minnion Andy
Published: April 2009

Background  Project @pple (Access & Participation for People with intellectual disability in Learning Environments)1 was about exploring the terms on which young people with intellectual disability access and participate with e‐Learning and the Web. The current study is one of a number of related studies. It explores the culture of information and communication technology (ICT) and the potential to support communication and empowerment.

Materials and Methods  Semi‐structured interviews were carried out with 20 young people with intellectual disability. The interviews involved a low‐technology, augmentative communication method called Talking Mats (Murphy & Cameron 2002).

Findings  Information and communication technology and rich and multiple media featured in the participants’ narratives and contributed to self‐concept and inclusive communication. Positive value was attributed to ICT options by many, although some difficulties were expressed with regard to operational aspects of the technology.

Conclusions  The lives of young people with intellectual disability provide a fertile culture for developments in this area, offering some new opportunities for communication and empowerment.
Monitoring changes and predicting loss of ambulation in Duchenne muscular dystrophy with the Motor Function Measure
Authors: VUILLEROT CAROLE , GIRARDOT FRANÇOISE , PAYAN CHRISTINE , FERMANIAN JACQUES , IWAZ JEAN , DE LATTRE CAPUCINE , BERARD CAROLE
Published: April 2009

Aim  To assess changes in motor function in patients with Duchenne muscular dystrophy using the Motor Function Measure (MFM).

Method  Three studies were performed. Two studies included only physiotherapy‐treated patients, with 13 patients (males mean age 11y 7mo, SD 1y 10mo, range 8–14y) in the 3‐month study and 41 patients (males mean age 14y 1mo, SD 5y 5mo, range 6–32y) in the 1‐year study. A third study compared 12 patients treated with steroids with 12 age‐ and motor‐function‐matched untreated patients (males mean age of treated patients 10y 2mo, SD 2y 2mo range 6–14) over a 12‐month period.

Results  Over 3 months, the MFM D1 subscore (standing and transfers) decreased significantly (−4.7%; p<0.01). Over 1 year, all MFM subscores decreased significantly: −4.9% for D1 (p<0.01); −7.7% for D2 (axial and proximal motor capacity; p<0.01); −4.3% for D3 (distal motor capacity; p=0.03); and −5.8% for the total score (p<0.01). A threshold value for loss of ambulation and a predictive value 1 year before loss were estimated (total score 70% and D1 subscore 40%). Compared with the controls, patients treated with steroids had more stable total scores (−0.59 vs −5.87; p=0.02) and D2 subscores (0.98 vs −8.50; p<0.01).

Interpretation  These results support the use of the MFM in everyday patient management to prepare for loss of ambulation and in clinical trials to follow up patients receiving various treatments.
Choice and birth method: mixed‐method study of caesarean delivery for maternal request
Authors: Kingdon C , Neilson J , Singleton V , Gyte G , Hart A , Gabbay M , Lavender T
Published: April 2009

Objective  To explore whether women view decision‐making surrounding vaginal or caesarean birth as their choice.

Design  Longitudinal cohort study utilising quantitative (questionnaire, routinely collected data) and qualitative (in‐depth interviews) methods simultaneously.

Setting  A large hospital providing National Health Service maternity care in the UK.

Sample  Four‐hundred and fifty‐four primigravid women.

Methods  Women completed up to three questionnaires between their antenatal booking appointment and delivery. Amongst these women, 153 were interviewed at least once during pregnancy (between 24 and 36 weeks) and/or after 12 moths after birth. Data were also obtained from women’s hospital delivery records. Descriptive statistical analysis was performed (survey and delivery data). Interview data were analysed using a seven‐stage sequential form of qualitative analysis.

Results  Whilst many women supported the principle of choice, they identified how, in practice their autonomy was limited by individual circumstance and available care provision. All women felt that concerns about their baby’s or their own health should take precedence over personal preference. Moreover, expressing a preference for either vaginal or caesarean birth was inherently problematic as choice until the time of delivery was neither static nor final. Women did not have autonomous choice over their actual birth method, but neither did they necessarily want it.

Conclusions  The results of this large exploratory study suggest that choice may not be the best concept through which to approach the current arrangements for birth in the UK. Moreover, they challenge the notion of choice that currently prevails in international debates about caesarean delivery for maternal request.