bluuebunny/crossref_metadata_2025 huggingface dataset:
Regressing cutaneous malignant melanoma and vitiligo‐like depigmentation
Authors: Arpaia Nicola , Cassano Nicoletta , Vena Gino A.
Published: June 2006

Association of malignant melanoma (MM) with various clinical forms of skin depigmentation is well‐known. We report a case highlighting the importance of careful examination of patients with skin hypomelanoses, including vitiligo and halo nevi, in order to exclude the presence of MM.

A 66‐year‐old woman presented with a 6‐month history of vitiligo‐like depigmentation of the face and halo nevi. Physical examination unexpectedly revealed also the presence of a regressing MM associated with a clinically evident lymphoadenopathy. Predominant dermoscopic features of the lesion were an irregular vascular pattern and regression structures, associated with peripheral areas of irregular pigmentation without pigment network.

The literature concerning the association between leukoderma and MM is also reviewed.
Lingual traumatic ulceration (Riga–Fede disease)
Authors: Baroni Adone , Capristo Carlo , Rossiello Luigi , Faccenda Franco , Satriano Rocco Alfredo
Published: June 2006

An 11‐month‐old male infant was referred to our clinic because of a painful ulcer of approximately 5 months’ duration on the ventral surface of the tongue (Fig. 1). On physical examination, the lesion was circular (3 cm × 2 cm) with erythematous, raised, and indurated borders.

Ulcer on the tongue

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No pathologic findings emerged from the laboratory data, neurologic examination, or clinical history. The family history was also negative for developmental disorders and congenital syndromes. No biopsy was performed in view of the age of the infant, the particular site of the lesion, and the clinical evidence of diagnosis. The treatment included odontologic cream (methylvinylether/maleic acid) as a protective shield, a collutorium (chlorhexidine 0.2%), and the use of a teething ring. Complete healing of the lesion (Fig. 2) occurred within 3 weeks.

Healing of the ulcer after treatment

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Toxicodendron dermatitis in the UK
Authors: Walker S. L. , Lear J. T. , Beck M. H.
Published: June 2006

Background  We present two cases of Toxicodendron dermatitis, one acquired in the United States but presenting in the United Kingdom (UK), the other a recurrent dermatitis following importation of the plant to the UK.

Poison ivy, poison oak and poison sumac are native to North America and belong to the genus Toxicodendron. This group of plants is of interest to the dermatologist because they contain a mixture of potent sensitisers which cause a severe allergic contact dermatitis.

Conclusions  The dermatitis can present to the dermatologist in Europe after an individual has been in contact with the plant whilst visiting an endemic area. The plants have the potential to grow in Europe and it is therefore possible for an individual to be sensitised and subsequently to develop the rash without leaving the continent.
Clinical features of late‐onset Behçet's disease: Report of nine cases
Authors: Saricaoglu Hayriye , Karadogan Serap Koran , Bayazit Neval , Yucel Ali , Dilek Kamil , Tunali Sukran
Published: June 2006

Background  Behçet's disease (BD) is usually diagnosed between the second and fourth decades. Onset after 50 years of age is extremely rare. We aimed to analyze the clinical features of late‐onset patients with BD.

Method  The study was conducted from 439 patients diagnosed as BD according to criteria of the International Study Group for BD. Clinical features of patients who were asymptomatic or suffered from only recurrent aphthous stomatitis (RAS) until 50 years of age but fulfilled the diagnostic criteria of BD after this age were reviewed.

Results  The age‐of‐onset was more than 50 years in nine patients (1.56%). Two patients developed erythema nodosum, two developed pathergy positivity, one developed papulopustules, pathergy positivity and ocular symptoms, one developed papulopustules and pathergy positivity, one developed ocular symptoms, one developed papulopustules and ocular symptoms, and one developed erythema nodosum and pathergy positivity as well as oral aphthae and genital ulcerations after the age of 50 years. The neurologic system was involved in two patients. Mucocutaneous symptoms of two patients worsened after interruption of therapy. Two patients with neurologic and ocular involvement flared during the follow up.

Conclusion  Since the course of the disease is regarded to be relatively mild in mature patients, it is noteworthy that systemic manifestations such as ocular and neurologic involvement and acute flares developed after the age of 50 years in the limited number of patients with late‐onset BD in our series.
Clinical, histologic and immunologic features of pemphigus in Bangladesh
Authors: Amin Md. Nurul , Islam A. Z. M. Maidul
Published: June 2006

We studied the clinical, histologic and immunologic features of 32 pemphigus patients evaluated in Dhaka. The diagnosis was pemphigus vulgaris (PV) in 72% of cases, and pemphigus foliaceous (PF) in 28%, with male to female ratios of 1.3 : 1 and 1.25 : 1, respectively. Only 25% of PV patients had vesicles or bullae involving mucous membranes as the initial presentation. Direct (DIF) and indirect (IIF) immunofluorescence tests were positive in all 32 patients. The DIF testing of tissue demonstrated intercellular substance (ICS) deposition of IgG (59%) or IgG plus C3 (41%). Serum ICS antibody titers ranged from 1 : 20–40 in PV and from 1 : 10–20 in patients with PF. To our knowledge, this is the first report concerning the characteristics of pemphigus in Bangladesh.
Innovations du travail et syndicats de la fonction publique: un partenariat À construire
Authors: Harrisson Denis , Bellemare Guy
Published: June 2006

Résumé**:  Au cours des dix dernières années, les acteurs de l’administration publique du Québec ont expérimenté une configuration organisationnelle créative et originale constituée des Comités ministériels sur l’organisation du travail (CMOT). Peu d’études et de recherches se sont intéressées à cette forme de partenariat entre l’État, les syndicats et les associations professionnelles. Nous proposons une étude de cas de trois CMOT que nous considérons comme étant des innovations sociales dans l’administration publique. Les acteurs ont du mal à s’entendre sur les frontières délimitant la zone d’influence des CMOT au sein des ministères. Des nouvelles tensions naissent entre les gestionnaires et les représentants syndicaux. Néanmoins, une nouvelle zone de coopération se forme conduisant à un nouvel équilibre dans les relations entre les acteurs de l’administration publique. Nous proposons une analyse de la mise en place des CMOT, de sa lente évolution marquée de ruptures et de reprises. Malgré les obstacles, les acteurs s’entendent pour affirmer que le partenariat est nécessaire à la bonne marche du processus de transformation de l’administration publique.
Effects of leukotriene receptor antagonists on monocyte chemotaxis, p38 and cytoplasmic calcium
Authors: Hung Chih‐Hsing , Li Chi‐Yuan , Hua Yi‐Ming , Chen Chun‐Jung , Yang Kuender D. , Jong Yuh‐Jyh
Published: June 2006

Montelukast and zafirlukast, two cysteinyl leukotriene receptor antagonists (LTRAs), have been shown to have a beneficial effect on the clinical symptoms of asthma. LTRAs can inhibit eosinophil recruitment; however, little is known about their role in monocyte migration. We investigated whether montelukast and zafirlukast could suppress chemokine‐induced chemotaxis of monocytes and signaling. Chemotaxis of monocytes from peripheral blood mononuclear cells (PBMCs), cord blood mononuclear cells (CBMCs), and THP‐1 cells was evaluated using a 24‐well transwell microchamber. [Ca2+]i was measured with the fluorescence calcium indicator fura‐2/AM photometry system. p38 MAPK expression was measured by Western blotting. Results showed that montelukast (1–100 μm) and zafirlukast (100 μm) significantly down‐regulated monocyte chemoattractant protein‐1(MCP‐1)‐induced chemotaxis of THP‐1 cells and human primary monocytes from PBMCs and CBMCs (p < 0.05, each comparison). Montelukast also abolished MCP‐1–induced [Ca2+]i and pp38 MAPK expression in THP‐1 cells in a dose‐dependent manner. These data demonstrate that montelukast is effective in down‐regulating human monocyte chemotaxis induced by MCP‐1. This effect may involve the down‐regulation of MCP‐1‐induced [Ca2+]i and p38 MAPK expression.
Soluble CD14 at 2 yr of age: Gender‐related effects of tobacco smoke exposure, recurrent infections and atopic diseases
Authors: Lødrup Carlsen K. C. , Løvik M. , Granum B. , Mowinckel P. , Carlsen K. H.
Published: June 2006

The endotoxin receptor soluble CD14 (sCD14) has been implicated in the ‘hygiene hypothesis’ suggesting reduced allergic sensitization with bacterial stimulation. However, the relationship between early life sCD14 and allergic diseases is conflicting. We aimed to investigate whether possible risk factors for allergic diseases were associated with sCD14 levels at 2 yr of age. In the nested case–control study of the birth cohort studies ‘Environment and Childhood Asthma study in Oslo’ 411 children selected with recurrent bronchial obstruction (rBO) (n = 241) and no bronchial obstruction (n = 170) by 2 yr were investigated with skin prick test and structured parental interview at age 2 yr. Exposure to tobacco smoke, pets and infections was recorded semi‐annually by questionnaires (0–2 yr). The sCD14 was analysed from frozen, stored serum by ELISA technique. Regression analyses were performed in all subjects with complete data (n = 406, 180 girls), and in girls and in boys separately. Mean sCD14 (ng/ml) was significantly higher among girls 2035 (1973–2096) vs. 1947 (1890–2004) (boys). The sCD14 was significantly reduced among girls exposed to antenatal maternal smoking and with parental asthma, after adjusting for age, parental rhino‐conjunctivitis, pet keeping and childhood infections. Recurrent otitis media (OM) increased and common colds significantly decreased sCD14 levels in girls. Boys with atopic dermatitis and rBO had reduced sCD14. Pet exposure was not significantly associated with sCD14. We report novel gender‐related effects of sCD14 in early life and suggest that gender, tobacco smoke exposure, age and middle ear disease in particular should be accounted for when assessing the role of sCD14 in childhood allergic diseases.
Florida Scrub‐Jays Compensate for the Sentinel Behavior of Flockmates
Authors: Bednekoff Peter A. , Woolfenden Glen E.
Published: June 2006

Sentinel coordination requires that individuals react to the sentinel behavior of others. Previous work showed that Florida scrub‐jays are sentinels more often when given supplemental food. Here we measured how birds in pairs reacted when their mates were fed. Scrub‐jays were sentinels less when their mates were fed, demonstrating compensation. Indirect evidence suggests that this compensatory decrease in sentinel behavior was smaller than the increase in sentinel behavior by their mates. In addition, males in newly established groups were sentinels less often.
Habitat Quality, Social Dominance and Dawn Chorus Song Output in Black‐Capped Chickadees
Authors: Van Oort Harry , Otter Ken A. , Fort Kevin T. , Holschuh Carmen I.
Published: June 2006

Individuals that settle in poor habitats may reduce resource investments in various life history traits; for example, resources may be withheld from costly advertisement signals. There may be geographic variation in advertisement levels that correspond with habitat quality; however, this is poorly documented and it is unclear whether such habitat effects have consequences for the function of mate‐choice signals within habitats. We examined song output of male black‐capped chickadees (Poecile atricapillus) during the dawn chorus in two contrasting habitats (mature forest vs. young forest) known to differ in quality. Dominance rank is indicative of phenotypic quality in this species and was assessed during the preceding winter. We measured the song output of males participating in the dawn chorus during the nesting/egg laying period. Males living in young forest had reduced song output; however, a habitat–rank interaction term showed that dominant birds accounted for most of this difference. This suggests that signal reliability might be lost in poor habitats. We generate several hypotheses to explain these findings.
Isolation of germline cells from Drosophila embryos by flow cytometry
Authors: Shigenobu Shuji , Arita Kayo , Kitadate Yu , Noda Chiyo , Kobayashi Satoru
Published: June 2006

Primordial germ cells (PGC) are the earliest identifiable germ cells in the embryo. To understand the molecular basis of germline development, isolation of pure PGC is required. We report here the use of fluorescence‐activated cell sorting (FACS) to isolate pure populations of Drosophila pole cells, which are the presumptive primordial germ cells in flies. In order to fluorescently mark pole cells, we used an EGFP‐vasa transgenic line that expresses green fluorescent protein (GFP) specifically and continuously in the germ line throughout the life cycle. The purity of FACS‐sorted pole cells from embryos was confirmed by microscopic inspection and quantitative polymerase chain reaction. Moreover, by optimizing the sample preparation and the sorting protocol, embryonic gonads could also be isolated. This technique opens the way for genome‐wide transcriptome analysis of germline cells. In a pilot experiment, we generated a cDNA library from purified embryonic gonad and identified a novel germline‐specific gene, RpL22‐like.
Generation of insulin‐secreting cells from human embryonic stem cells
Authors: Baharvand Hossein , Jafary Hanieh , Massumi Mohammad , Ashtiani Saeid Kazemi
Published: June 2006

A growth factor‐mediated selection method was used to obtained insulin‐secreting cells from human embryonic stem cells (hESC; Royan H1). Our resultant cells were positive for dithizone, a zinc‐chelating agent known to selectively stain pancreatic β cells and immunoreactive for antibodies against insulin, glucagon, and C‐peptide. Semi‐quantitative reverse transcription–polymerase chain reaction detected expression of proinsulin, insulin and other pancreatic β‐cell‐related genes, such as Nkx6.1, Is11, Glut2, Pax4, and prohormone convertase2 (PC2). Moreover, glucagon, somatostatin, KATP‐channel genes KIR6.2 and SUR1, islet amyloid polypeptide (IAPP), PC1/3, and glucokinase (GCK) were expressed in the differentiating hESC in a developmental stage‐dependent manner. Also, the addition of glucose to the culture medium triggered insulin release from differentiated cells, but transmission electron microscopy of the differentiated cells did not show typical β‐cell granules, even though secretary granules were detected. The results showed that hESC have the ability to transcribe and process insulin, but further improvements of the current method are required to generate a sufficient source of true β cells for the treatment of diabetes mellitus.
Exogenous FGF10 can rescue an eye‐open at birth phenotype of Fgf10‐null mice by activating activin and TGFα‐EGFR signaling
Authors: Tao Hirotaka , Ono Katsuhiko , Kurose Hitomi , Noji Sumihare , Ohuchi Hideyo
Published: June 2006

Mutant mice deficient in the fibroblast growth factor 10 (Fgf10) gene exhibit an eye‐open phenotype at birth. It has previously been shown that FGF10 has a dual role in proliferation and migration during the early and later stages of eyelid development, respectively. To verify the role of FGF10 during eyelid closure, explant culture of Fgf10‐null eyelid anlagen was performed, by which it was examined whether or not exogenous FGF10 could rescue the expression of activin βB and transforming growth factor α, known to be required for eyelid closure. We found that the expression of these genes was markedly induced while that of Shh or Ptch1, Ptch2 was not. We also observed the distribution of filamentous actin (F‐actin) after FGF10 application in the mutant eyelid explant, finding that the FGF10 protein induced F‐actin accumulation. We further examined filopodia of the eyelid leading edge cells, finding the length of the filopodia was significantly reduced in the mutant. These results verify that FGF10 promotes eyelid closure through activating activin and TGFα‐EGFR signaling.
Prediction of the prognosis in patients with acute‐on‐chronic hepatitis using the MELD scoring system
Authors: Yu Jian‐Wu , Wang Gui‐Qiang , Li Shu‐Chen
Published: June 2006

Aim:  To predict prognosis in patients with acute‐on‐chronic hepatitis (AOCH) using the model for end‐stage liver disease (MELD) scoring system and to study the effects of age, sex, etiology, low serum sodium, and persistent ascites on MELD.

Methods:  The MELD scores of 300 patients with AOCH were calculated according to the original formula. The 3‐month mortality in patients was measured, and the validity of the models was determined by means of the concordance (c) statistic. The influential factors on MELD were also assessed.

Results:  The 3‐month mortality of AOCH patients with a MELD score of 20–29 was 56.0%, with a score of 30–39 it was 76.5%, and with a score over 40 it was 98.2%. The concordance (c) statistic of 3‐month mortality was 0.782. Univariate analysis showed that mortality was significantly related to age (P = 0.047), etiology (P = 0.039), serum sodium (P = 0.029) and ascites (P = 0.031) for patients with MELD scores 20–29. In multivariate analysis, in patients with MELD scores 20–29, age (P = 0.012), etiology (P = 0.024), serum sodium (P = 0.005) and ascites (P = 0.017) were independent predictors of mortality; for MELD scores above 30, only MELD score (P = 0.015) was independently predictive.

Conclusions:  The MELD scoring system is a reliable method for predicting mortality in patients with AOCH. In the group with MELD score 20–29, factors including age, etiology, presence of low serum sodium and persistent ascites may influence the MELD scoring system. The MELD score is the decisive predictor of the prognosis of patients with AOCH when the MELD score is over 30.
ENDOVASCULAR REPAIR OF POPLITEAL ARTERY ANEURYSMS: TECHNIQUES, CURRENT EVIDENCE AND RECENT EXPERIENCE
Authors: Siauw Ray , Koh Eng H. , Walker Stuart R.
Published: June 2006

Endovascular repair of popliteal artery aneurysms is a new technique, which has emerged as an alternative to open surgical bypass. However, evidence to support its use is limited. We present a review of current literature relevant to this technique. The MEDLINE search terms were popliteal artery, aneurysm, endovascular, endoluminal and stent. Fifty‐eight articles were yielded, of which 21 were studies of endovascular repair by implantation of stent or stent graft of true aneurysms of the popliteal artery. There was only one randomized study. Small numbers of endovascular interventions are reported, with variations in study design and endovascular techniques. Long‐term follow‐up data is lacking; however, early results have been promising with high rates of initial treatment success. Early thrombosis of stent grafts occurs in approximately 10%, but this does not herald limb loss. Endovascular treatment offers potential benefits over traditional surgery, but needs to be studied further with a large‐scale multicentre randomized trial.
QUALITY OF LIFE ASSESSMENT IN PATIENTS WITH INGUINAL HERNIA
Authors: Mathur Sachin , Bartlett Adam St. J. R. , Gilkison William , Krishna Govind
Published: June 2006

Background:  The natural history of untreated inguinal hernia (IH) is poorly understood. Whether a delay in operative repair of IH leads to excessive physical suffering or significant psychosocial impairment is not known. This study attempts to quantify the morbidity of patients with IH by assessing their quality of life (QOL) while on a waiting list for IH surgery.

Methods:  QOL was measured in adult patients with IH who were on the waiting list using a standardized SF‐36 questionnaire. Scores were compared with a sample of age‐, sex‐ and comorbidity‐matched controls.

Results:  A total of 143 patients were identified, of which 106 were included in the study. Patients with IH had significantly impaired QOL compared with comorbidity‐ and demographic‐matched controls across all of the domains measured. Subgroup analysis showed an inverse relationship between the size of the IH and the QOL and patients employed in manual work tended to have lower QOL compared with those with sedentary vocations.

Conclusions:  In conclusion, we showed that the SF‐36 score is a good measure of QOL in this patient group. Those patients on the elective waiting list for repair of IH have a significantly impaired QOL compared with age‐, sex‐ and comorbidity‐matched controls.
PUBLICATION BIAS IN PAPERS PRESENTED TO THE AUSTRALIAN ORTHOPAEDIC ASSOCIATION ANNUAL SCIENTIFIC MEETING
Authors: Harris Ian A. , Mourad Mohamed S. , Kadir Agus , Solomon Michael J. , Young Jane M.
Published: June 2006

Background:  The selective publication of articles based on factors, such as positive outcome, statistical significance and study size is known as publication bias. If publication bias is present, any clinical decision based on a review of the published work will also be biased. Publication bias has been shown in various specialties, based on review of publication rates for abstracts presented at major scientific meetings. This study was conducted to investigate publication bias in orthopaedics.

Methods:  Abstracts presented at the 1998 Australian Orthopaedic Association Annual Scientific Meeting were reviewed independently by two reviewers. Details of sample size, study setting, country of origin, outcome and study type were recorded for each abstract. Publication within 5 years was ascertained by electronic searching of Medline and Embase databases and direct author contact. Logistic regression analysis was used to identify predictors of publication.

Results:  The overall publication rate was 31%. Publication was more likely if the study was a laboratory study, rather than a clinical study (odds ratio (OR), 3.45; 95% confidence interval (CI) 1.69–7.01, P < 0.001). Sample size, country of origin, study type, statistical significance and positive outcome were not significantly associated with publication.

Conclusion:  According to this study, laboratory studies were significantly more likely to be published than clinical studies. In contrast to previous studies, publication bias due to the selective publication of papers with a positive outcome or those reporting statistical significance was not found.
EFFECT OF RESECTION AND OUTCOME IN PATIENTS WITH RETROPERITONEAL SARCOMA
Authors: Chiappa Antonio , Zbar Andrew P. , Biffi Roberto , Bertani Emilio , Biella Francesca , Viale Giuseppe , Pace Ugo , Pruneri Giancarlo , Orecchia Roberto , Lazzari Roberta , Poldi Davide , Andreoni Bruno
Published: June 2006

Background:  A consecutive series of 47 patients with retroperitoneal sarcoma (RPS) were resected and prospectively followed.

Method:  Between July 1994 and March 2005, 47 patients (24 men, 23 women; mean age, 56 years; range, 17–82 years) were evaluated.

Results:  A total of 23 patients had primary RPS and 24 patients had recurrent RPS. A total of 30 out of 47 patients (64%) underwent removal of contiguous intra‐abdominal organs. The peroperative mortality was nil and significant preoperative complications occurred in eight cases only (17%). High tumour grade and incomplete resection were significant variables for a worse survival in all 47 patients, both in the univariate and multivariate analyses (P = 0.008 and P = 0.016, respectively). Among 28 radically resected patients, only histological grade affected overall survival (90% 5‐year survival for low‐grade tumour vs 26% 5‐year survival for high‐grade tumour; P = 0.006) with a similar effect noted for disease‐free survival.

Conclusions:  Histological grade was the only factor that affected overall and disease‐free survival for RPS tumours. An aggressive surgical approach in both primary and recurrent RPS is associated with long‐term survival.
RECURRENT PHYLLODES TUMOURS OF THE BREAST: PATHOLOGICAL FEATURES AND CLINICAL IMPLICATIONS
Authors: Tan Ern Y. , Hoon Tan Puay , Yong Wei S. , Wong Hwee B. , Hui Ho G. , Yeo Allen W. Y. , Wong Chow Y.
Published: June 2006

Background:  Phyllodes tumours (PT) of the breast are fibro‐epithelial neoplasms that are known to recur locally in up to 19% of patients. The failure to achieve adequate surgical margins is an important risk factor for local recurrence. This, however, is a common problem as PT are clinically similar to the more common fibro‐adenoma and are therefore often locally excised without any gross surgical margins. It is still debatable as to whether it is necessary to subject the patient to repeat surgery to obtain pathologically negative margins after a diagnosis of a benign or borderline PT is made. Although the majority of recurrences are histologically similar to the initial tumour, a malignant recurrence is possible. Malignant tumours can metastasize through the haematogenous route and metastases are associated with a poor prognosis as they are poorly responsive to conventional chemotherapy.

Methods:  We retrospectively reviewed 37 women who presented with local recurrence over a 10‐year period to the Singapore General Hospital. Data, including age at the time of diagnosis, clinical presentation, histological features, type of surgery carried out, clinical progression and characteristics of locally recurrent disease, were analysed. Comparisons were made between those with benign, borderline and malignant tumours, as well as between those who developed a malignant recurrence and those who did not.

Results:  The mean age at the time of diagnosis was 39.6 ± 7.4 years and the mean tumour size was 6.0 ± 5.1 cm. A total of 22 patients were classified as having benign tumour, 9 as having borderline tumour and 6 as having malignant tumour. Tumour grade did not influence the tumour size, the adequacy of surgical margins or the time interval to local recurrence or the number of recurrences. Local recurrence occurred after a median interval of 20 months. Although malignant tumours tended to recur earlier, this was not found to be statistically significant. The majority of recurrent tumours were histologically similar to the initial tumour; however, seven patients (19%) developed a malignant recurrence from an initially benign or borderline tumour. Although these tumours were larger, recurred more frequently and within a shorter interval, no significant predictive factor was found on multivariate analysis. Distant metastasis developed only in patients with malignant tumours and accounted for all three mortalities in the study.

Conclusions:  It may be acceptable to use an expectant management towards benign and borderline tumours that are excised without adequate surgical margins. However, surgery for locally recurrent tumours, as well as malignant tumours, should aim to achieve adequate surgical margins to reduce the risk of local recurrence, particularly that of a malignant recurrence.
EFFECT OF AGE ON PROGNOSIS IN PATIENTS WITH GASTRIC CANCER
Authors: Saito Hiroaki , Osaki Tomohiro , Murakami Daiki , Sakamoto Teruhisa , Kanaji Shingo , Tatebe Shigeru , Tsujitani Shunichi , Ikeguchi Masahide
Published: June 2006

Background:  The incidence of gastric cancer among the elderly has recently been increasing; however, the prognostic value of age in patients with gastric cancer remains elusive.

Methods:  A total of 1473 patients with gastric cancer, who had undergone curative gastrectomy were reviewed to investigate the prognostic significance of age.

Results:  Blood vessel invasion and differentiated type were more frequently observed in elderly than nonelderly patients (P < 0.0001) and elderly patients underwent limited lymph node dissection compared with nonelderly patients (P < 0.001). Moreover, chemotherapy was carried out in nonelderly patients more frequently than in elderly patients (P < 0.005). Ten‐year survival rates were 70.2 and 81.4% in elderly and nonelderly patients, respectively, and the differences were statistically significant (P < 0.001). Postoperative mortality rates were 3.2 and 2.0% in elderly and nonelderly patients, respectively. Hematogenous recurrence was more frequently observed in elderly patients than nonelderly patients (P < 0.05). Multivariate analysis showed that age was an independent prognostic factor.

Conclusions:  Age clinically serves as a simple predictor of survival in patients with gastric cancer and should be taken into account along with conventional clinicopathological variables such as depth of invasion and lymph node metastasis.
OCCURRENCE AND FATE OF PALMAR TYPE OF MEDIAN ARTERY
Authors: D’Costa Sujatha , Narayana Kilarkaje , Narayan Prashanthi , Jiji  , Nayak Soubhagya R. , Madhan S. J.
Published: June 2006

Background:  The median artery represents a persistent part of the embryonic arterial axis of the upper extremity. It appears mainly as two types: an antebrachial type and a palmar type. The palmar type is of major clinical significance.

Method:  This study was undertaken to investigate the incidence and fate of the palmar type of the median artery in 19 cadavers. The occurrence was 15.8% and of this two incidences (5.2%) were on the right side and four (10.6%) were on the left side. On the right side, the artery originated from the ulnar and joined with the superficial palmar arch or anterior interosseous artery and communicated with the radial artery.

Conclusions:  This study concludes that palmar type of median artery is found at a higher incidence than the antebrachial type and that it may be involved in the pronator teres syndrome, carpal tunnel syndrome and anterior interosseous syndrome.
IS LOBECTOMY NECESSARY IN THE TREATMENT OF PULMONARY HYDATID CYSTS?
Authors: Hasdiraz Leyla , Oğuzkaya Fahri , Bilgin Mehmet
Published: June 2006

Background:  Hydatidosis is endemic in Turkey and many other areas of the world. The definitive treatment for pulmonary hydatidosis is surgical. The purpose of this study was the review of surgical therapy of our patients with pulmonary hydatid disease and the necessity of lobectomy.

Methods:  We reviewed 107 patients: 26 of whom were women and 81 were men. The median age was 30 years (range, 7–57 years). Chest roentgenogram, abdominal ultrasound and computed tomography of the chest and upper abdomen were carried out as diagnostic study. All patients underwent thoracotomy and cystotomy with or without capitonnage.

Results:  Four patients had two cysts in the same lobe and one patient had three cysts (one perforated and two intact) in the left lower lobe (4.6%). In nine patients, the cysts were >10 cm in diameter (8.4%). In 18 patients, the cysts were suppurative (16.8%). None of the patients required lobectomy. Of the 107 patients, prolonged air leaks (n = 8), atelectasis (n = 3) and empyema (n = 3; two had empyema preoperatively because of pleural perforation of cysts and the other had prolonged air leak) were observed in the postoperative period. There was no death.

Conclusion:  The effective treatment of hydatid cysts in the lung is the complete excision of the cyst with maximum preservation of lung parenchyma. We believe that the decision of lobectomy must be taken very carefully, even in the case of infected hydatid cysts, atelectasis, giant cysts and multiple cysts in the same lobe.
COMPLETE AXILLARY DISSECTION: A TECHNIQUE THAT STILL HAS RELEVANCE IN CONTEMPORARY MANAGEMENT OF BREAST CANCER
Authors: Ung Owen , Tan Mona , Chua Boon , Barraclough Bruce
Published: June 2006

Axillary lymph node status is an important prognostic indicator for women with breast cancer and axillary dissection provides accurate information regarding nodal status. In addition, local control of axillary disease and allocation of adjuvant systemic therapy are dependent on appropriate axillary surgery. The survival benefit of an axillary dissection remains controversial. We describe a technique of complete axillary clearance that includes levels I, II and III. In our experience this technique is associated with no additional morbidity to patients and incurs minimal prolongation of operative time compared with a level II dissection. Other operative descriptions of axillary surgery generally do not adequately describe a method that clearly and consistently identifies the boundaries, anatomical landmarks and neurovascular structures that traverse the axilla. This technique, with relative ease, allows the identification and preservation of these structures in their original anatomical planes and avoids the division of the pectoralis minor muscle. The assumption that routine level III axillary clearance, as opposed to level I or level II dissection, is associated with greater morbidity warrants further evaluation. No well‐conducted randomized trials have addressed this issue.
ROYAL AUSTRALASIAN COLLEGE OF SURGEONS HEAD AND NECK GROUP: THE FIRST 20 YEARS (1986–2005)*
Authors: Morton Randall P.
Published: June 2006

The Head and Neck Group of the Royal Australasian College of Surgeons had rather stormy beginnings at a time when the practice of head and neck surgery was dominated by ‘turf’ issues. It became an independent multidisciplinary group within the College and since its inception the Group has been usefully engaged in several professional issues for the College. Definite progress has been made over 20 years, but there have also been lost opportunities. The time has probably come for a review of the current status and future direction of the Group and its relations with other professional groups practising head and neck oncological surgery in Australia and New Zealand.
Preventive medicine beyond 65
Authors: Lim Lionel S. , Chutka Darryl S.
Published: June 2006

Preventive health care in adults aged 65 and older is essential to ensure that quality of life is maintained with longevity. The first half of this article will focus on the two major causes of mortality in the US adult population: cancer and cardiovascular disease. We will address current screening and chemoprevention issues pertaining to breast, cervical, colorectal, prostate and skin cancer. For cardiovascular disease prevention, we will discuss the importance of screening for and treating hypertension, hyperlipidemia, diabetes mellitus, and the use of aspirin chemoprophylaxis and angiotensin‐converting enzyme inhibition. In the latter half, we will discuss other aspects of preventive health care including fall prevention, motor vehicle safety, immunizations and screening issues. Health screening can help detect conditions like osteoporosis, subclinical thyroid disease, hearing impairment, nutritional status, and oral and dental problems. Finally, we will also address psychosocial health issues that affect older people including dementia, depression, elder abuse, lifestyle habits and advanced directives. Our recommendations are based on the latest available evidence and include the US Preventive Services Task Force and other leading health professional organizations.
Risk factors for anxiety at induction of anesthesia in children: a prospective cohort study
Authors: DAVIDSON ANDREW J. , SHRIVASTAVA PRANI P. , JAMSEN KRIS , HUANG GRACE H. , CZARNECKI CAROLINE , GIBSON MARGARET A. , STEWART STEPHANIE A. , STARGATT ROBYN
Published: June 2006

Background : In children anxiety at induction of anesthesia is a common and important aspect of the psychological impact of anesthesia and surgery. Previous studies examining risk factors for increased anxiety have found contradictory results. This may be due to using small, or highly selective population samples, or failure to adjust for confounding variables. Results may also be culturally or institutionally specific. The aim of this study was to identify possible risk factors in a large representative cohort of children.

Methods : One thousand two hundred fifty children aged 3–12 years were recruited. Anxiety at induction of anesthesia was assessed using the modified Yale preoperative anxiety scale. Children with an anxiety score of greater than 30 were classified as having high anxiety. Anesthetists were blinded to the assessment. Data recorded included age, gender, past healthcare history, family details, use of sedative premedication, anesthesia details, admission details, parental anxiety and child temperament. An unadjusted analysis was performed to identify possible risk factors for high anxiety. An adjusted regression analysis was then performed including the potential risk factors identified in the unadjusted analysis.

Results : The incidence of high anxiety at induction was 50.2%. In the adjusted analysis, younger age, behavioral problems with previous healthcare attendances, longer duration of procedure, having more than five previous hospital admissions and anxious parents at induction were all associated with high anxiety at induction. Hospital admission via the day stay ward was associated with less anxiety. Sedative premedication was associated with less anxiety in children with ASA status greater than one. However, the variability explained by factors included in the model was low (5.3%).

Conclusions : Some simple preoperative questions can help identify children at risk of heightened anxiety at induction of anesthesia; however, it remains difficult to precisely predict which child will experience high anxiety.
The effect of capsicum plaster in pain after inguinal hernia repair in children
Authors: KIM KYO S. , KIM DONG W. , YU YEON K.
Published: June 2006

Background : Capsicum plaster at a classical Chinese acupoint is an alternative to acupuncture, which has been used as a supplemental therapy to opioid analgesics for pain control during the postoperative period. We investigated the postoperative analgesic efficacy of capsicum plaster at Zusanli (ST‐36) points after pediatric hernia repair.

Methods : This double‐blind, sham‐controlled study was designed in 108 children, aged 4 month to 9 year, undergoing unilateral hernia repair, and was randomly assigned to three treatment regimens: group Zusanli (Z) = capsicum plaster at Zusanli acupoints and placebo tape on the shoulder as a nonacupoint, group Sham (S) = capsicum plaster on the shoulders and placebo tape at Zusanli acupoints, and group control (C) = placebo tape at Zusanli acupoints and on the shoulder. The postoperative pain scores and analgesic requirements during 24 h postoperatively were assessed.

Results : Total meperidine consumption was significantly lower in group Z (0.87 ± 0.35 mg·kg−1) compared with group C (1.27 ± 0.41 mg·kg−1) and S (1.22 ± 0.45 mg·kg−1) (P < 0.001). The pain scores on both the objective pain scale (OPS) and the Children Hospital of Ontario Pain Scale (CHEOPS), were significantly lower in group Z compared with the other groups at 6 and 24 h postoperatively, but not at the 10 min and 1 h postoperative time periods.

Conclusions : Placement of capsicum plaster at the Zusanli points reduces pain and postoperative opioid consumption in children undergoing inguinal hernia repair, but not in the first six postoperative hours.
Anesthesia management for the child with Sanjad–Sakati syndrome
Authors: PLATIS CARI M. , WASERSPRUNG DAVID , KACHKO LUDMYLA , TSUNZER IGOR , KATZ JACOB
Published: June 2006

Sanjad–Sakati syndrome (SSS) is a rare genetic disorder characterized by congenital hypoparathyroidism, hypocalcemia and hyperphosphatemia, seizures, severe intrauterine and postnatal growth failure, dwarfism, mental retardation, dysmorphic features including retromicrognathia and abnormal dentition and increased susceptibility to infection. It is mainly confined to children in the Middle‐East countries. We report the anesthesia management of a 12‐year‐old boy with SSS for dental treatment, and discuss the anesthesia implications of this disorder.
Revisiting the corroboration effects of earnings and dividend announcements
Authors: Cheng Louis T. W. , Leung T. Y.
Published: June 2006

Using a unique market setting in Hong Kong, where (i) all firms release earnings and dividend information in the same announcement; (ii) corporate transparency is low; (iii) dividend income is non‐taxable and (iv) corporate ownership is highly concentrated, we re‐examine the corroboration effects of earnings and dividends. We use the control firm approach to avoid the return estimation bias resulting from observation clustering. We also add in variables and use econometric procedure to control for the potential impacts of earnings management, special dividends and heteroskedasticity. Our findings show that there exists a corroboration effect between the jointly announced signals.
Financial covenants in the markets for public and private debt
Authors: Mather Paul , Peirson Graham
Published: June 2006

The public debt contracts surveyed in Whittred and Zimmer (1986) and Stokes and Tay (1988) were issued between 1962 and 1985, and there has been significant macroeconomic, institutional and regulatory change since that time. We analyse a sample of 36 recently issued Australian public debt contracts and document a considerable change in the ‘package’ of financial covenants used in public debt contracts. The covenant package is now less restrictive and the types of covenants used are more heterogenous. We also survey a sample of 41 recent Australian private debt contracts. These contracts contain a greater number, variety and, collectively, more restrictive set of financial covenants than those public debt contracts we survey, supporting theory which suggests that covenant restrictive and renegotiation–flexible contracts are more suited to borrowers contracting with financial intermediaries in private debt markets. We also note differences in accounting rules associated with financial covenants used in these private debt contracts.
Bayesian comparison of several continuous time models of the Australian short rate
Authors: Sanford Andrew D. , Martin Gael M.
Published: June 2006

This paper provides an empirical analysis of a range of alternative single‐factor continuous time models for the Australian short‐term interest rate. The models are nested in a general single‐factor diffusion process for the short rate, with each alternative model indexed by the level effect parameter for the volatility. The inferential approach adopted is Bayesian, with estimation of the models proceeding through a Markov chain Monte Carlo simulation scheme. Discrimination between the alternative models is based on Bayes factors. A data augmentation approach is used to improve the accuracy of the discrete time approximation of the continuous time models. An empirical investigation is conducted using weekly observations on the Australian 90 day interest rate from January 1990 to July 2000. The Bayes factors indicate that the square root diffusion model has the highest posterior probability of all models considered.
Constitutive expression of the pea ABA‐responsive 17 (ABR17) cDNA confers multiple stress tolerance in Arabidopsis thaliana
Authors: Srivastava Sanjeeva , Rahman Muhammad H. , Shah Salehuzzaman , Kav Nat N. V.
Published: June 2006

The constitutive expression of the pea ABR17 (abscisic acid‐responsive 17) cDNA, which is a member of the group 10 family of pathogenesis‐related proteins (PR 10), in Arabidopsis thaliana is reported. The presence of ABR17 transcripts and the protein in the three transgenic lines is demonstrated by reverse transcriptase‐polymerase chain reaction (RT‐PCR) and two‐dimensional electrophoresis followed by tandem mass spectrometry, respectively. Three independently derived transgenic lines containing ABR17 germinated better in the presence of salt, cold temperature or both. Furthermore, the transgenic plants also exhibited enhanced tolerance to freezing temperature, suggesting the potential utility of the ABR17 gene to engineer multiple stress tolerance. In order to obtain insights into the mechanism underlying ABR17‐mediated stress tolerance, we have compared the proteome of a transgenic line with that of its wild‐type counterpart. Several proteins were observed to be significantly altered in the transgenic line, including some with a role(s) in photosynthesis, stress tolerance and the regulation of gene expression. Our findings are discussed within the context of available genes to engineer multiple stress tolerance as well as the biological activities of the ABR17 protein.
The effect of prenatal hypoxia on brain development: short‐ and long‐term consequences demonstrated in rodent models
Authors: Golan Hava , Huleihel Mahmoud
Published: June 2006

Hypoxia (H) and hypoxia‐ischemia (HI) are major causes of foetal brain damage with long‐lasting behavioral implications. The effect of hypoxia has been widely studied in human and a variety of animal models. In the present review, we summarize the latest studies testing the behavioral outcomes following prenatal hypoxia/hypoxia‐ischemia in rodent models. Delayed development of sensory and motor reflexes during the first postnatal month of rodent life was observed by various groups. Impairment of motor function, learning and memory was evident in the adult animals. Activation of the signaling leading to cell death was detected as early as three hours following H/HI. An increase in the counts of apoptotic cells appeared approximately three days after the insult and peaked about seven days later. Around 14–20 days following the H/HI, the amount of cell death observed in the tissue returned to its basal levels and cell loss was apparent in the brain tissue. The study of the molecular mechanism leading to brain damage in animal models following prenatal hypoxia adds valuable insight to our knowledge of the central events that account for the morphological and functional outcomes. This understanding provides the starting point for the development and improvement of efficient treatment and intervention strategies.
Intellectual development of infants, children and adolescents with congenital heart disease
Authors: Wray Jo
Published: June 2006

Cardiac disease is the most common congenital defect in children, affecting between 3 and 10 in every 1000 live births. While significant advances in medical and surgical management have resulted in increasing numbers of survivors, it is also recognized that there is a growing population of children living with neurological impairment and lowered intellectual function. The aetiology of such impairment is multi‐factorial and hypoxia is one of the factors involved. This article provides an overview of the effects of hypoxia on the intellectual development of infants, children and adolescents with congenital heart disease.
Neurocognitive dysfunction in children with sleep disorders
Authors: Kheirandish Leila , Gozal David
Published: June 2006

It is well known that adults with sleep disturbances frequently exhibit a wide range of neurocognitive decrements, and that these deficits are potentially reversible with effective treatment. However, the consequences of respiratory sleep disturbances on neurocognitive function in children have only recently been evaluated, and suggest a strong causal association between the episodic hypoxia and sleep fragmentation that characterize the disease and the emergence of reduced memory, attention and intelligence as well as a link to problematic and hyperactive behaviours and mood disturbances. This article takes a critical look at the current literature on these issues, reviews the major findings and discusses such findings in conjunction with those derived from pertinent animal models.
Human behaviour and development under high‐altitude conditions
Authors: Virués‐Ortega Javier , Garrido Eduardo , Javierre Casimiro , Kloezeman Karen C.
Published: June 2006

Although we are far from a universally accepted pattern of impaired function at altitude, there is evidence indicating motor, perceptual, memory and behavioural deficits in adults. Even relatively low altitudes (2500 m) may delay reaction time, and impair motor function. Extreme altitude exposure (>5000 m) may result in more pronounced impairment that can persist after returning to the lowlands. Research into the effects of altitude exposure earlier in development is lacking by comparison. Un‐acclimatized children can suffer from acute mountain sickness, and, in native populations born at altitude, subtle cognitive and behavioural deficits suggest incomplete adaptation to hypoxia. The study of neurobehavioural functioning at altitude may provide important information about the effects of clinical hypoxia on the human brain and behavioural development.