bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Ischaemic Postconditioning on Recovery of Left Ventricular Contractile Function after Acute Myocardial Infarction
Authors: Zhao Cm , Yang Xj , Yang Jh , Cheng Xj , Zhao X , Zhou By , Xu Sd , Wang Hf
Published: February 2013

OBJECTIVE: This study investigated whether ischaemic postconditioning can improve recovery of myocardial contractile function in acute myocardial infarction patients 1 week and 6 months after angioplasty. METHODS: A total of 62 patients undergoing direct percutaneous coronary intervention after acute myocardial infarction were randomly assigned to receive four episodes of inflation and deflation of the angioplasty balloon in the early reperfusion period (postconditioned group, n = 32), or no additional intervention (control group, n = 30). Two-dimensional size and left ventricular (LV) global and regional contractile functions were then evaluated by echocardiography at 1 week and 6 months after angioplasty. RESULTS: At 1 week, there were no significant differences in left atrial diameter, LV end-diastolic diameter, LV end-diastolic volume, cardiac output, LV ejection fraction or wall motion score index between the two groups. At 6 months, LV ejection fraction was significantly increased and the wall motion score index significantly reduced in the postconditioned group compared with the control group. CONCLUSION: Ischaemic postconditioning can improve long-term LV contractile function 6 months after reperfusion following acute myocardial infarction.
Addition of Adrenaline to Chloroprocaine Provides a Moderate Duration Time for Epidural Anaesthesia in Elective Caesarean Section
Authors: Feng Sw , Cao Y , Wang Wg , Liu Ys , Shen Xf
Published: February 2013

OBJECTIVE: Epidural anaesthesia using chloroprocaine with or without adrenaline and lidocaine with adrenaline were compared. METHODS: Sixty parturients undergoing elective caesarean section under epidural anaesthesia were randomized to receive 3% chloroprocaine (group C), 3% chloroprocaine with adrenaline (group CA) or 2% lidocaine with adrenaline (group LA). Onset time, duration time and various maternal, fetal and neonatal parameters were monitored. Pain was assessed using a visual analogue scale. RESULTS: The onset time of analgesia in group CA was similar to that in group C but was shorter than that in group LA. Duration of analgesia, loss of cold sensation and motor blockade in group CA were prolonged compared with group C, but were shorter than those in group LA. No differences in maternal, fetal or neonatal effects were seen. A higher pain score was reported in group C than in groups CA or LA at the end of surgery. CONCLUSIONS: Epidural anaesthesia using chloroprocaine with adrenaline has a quick onset and moderate duration and is an attractive alternative to lidocaine and adrenaline or chloroprocaine alone for caesarean section.
Age Interactions in Breast Cancer: An Analysis of a 10-Year Multicentre Study in China
Authors: Yang Hj , Yu Xf , He Xm , Fan Jh , Li J , Xu F , Zhang Bn , Tang Zh , Zheng S , Qiao Yl
Published: February 2013

OBJECTIVES: The effects of age at diagnosis on the clinical characteristics of breast cancer and trends over time were investigated in Chinese women. METHODS: Data from 4211 women with pathologically confirmed primary breast cancer collected between 1999 and 2008 for a multicentre retrospective study were analysed according to age at diagnosis. RESULTS: Age at diagnosis ranged from 21 to 86 years, with a mean of 48.7 years, and was shown to be significantly related to tumour size, lymph node status, hormone receptor status and human growth factor receptor-2 status, but not to pathological type or tumour, node, metastasis stage. The age-corrected proportion of patients aged 50 – 64 years at diagnosis increased significantly between 1999 and 2008. There was a significant difference in the age-corrected distribution of age at diagnosis in China compared with Western countries. CONCLUSIONS: Age at diagnosis is related to the clinical and pathological characteristics of breast cancer. The age at diagnosis in China increased over the decade from 1999 to 2008, but is still lower than in Western countries.
The Effect of Locoregional Transarterial Infusion Chemotherapy on Liver Metastasis after Gastric Cancer Resection
Authors: Wang Yy , Zhang W , Qian S , Liu R , Kan Zx , Wang J-H
Published: February 2013

OBJECTIVE: A retrospective clinical study to evaluate the effect of transarterial infusion (TAI) chemotherapy and transarterial chemoembolization (TACE) on liver metastasis after gastric cancer resection. METHODS: The study recruited patients who underwent surgical resection for stage T2N2M0 gastric adenocarcinoma without liver metastasis. Patients chose to receive either TAI or systemic chemotherapy, based on the advantages and disadvantages of each regimen as explained by physicians. Both regimens comprised 100 mg/m2 oxaliplatin and 500 mg/m2 fluorodeoxyuridine, administered via TAI or a peripheral vein, commencing 30 days postsurgery. Patients who developed liver metastasis during the 3-year follow-up period were offered TACE. RESULTS: Mean time from gastric cancer diagnosis to liver metastasis was significantly longer in the TAI group ( n = 13) than in the systemic chemotherapy group ( n = 29); 944 ± 231 days versus 506 ± 77 days. Patients who received TACE ( n = 32) had a partial remission rate of 46.9% and a median survival of 14.7 months after diagnosis of liver metastasis. CONCLUSIONS: Locoregional TAI chemotherapy was more effective in reducing liver metastasis after gastric cancer resection than conventional systemic chemotherapy. TACE is an effective treatment for liver metastasis.
Primary Melanoma of the Cervical Spine with Cerebral Metastases: Case Report and Review of the Literature
Authors: Yu J , Zhao D-D , Chen S , Zhang J-M , Xu J
Published: February 2013

Primary spinal melanoma is a very rare condition: to date < 60 cases have been reported in the literature. A 48-year-old man presented with a 6-month history of upper- and lower-extremity numbness. Spinal magnetic resonance imaging (MRI) revealed a space-occupying lesion at the C2 – C6 level. This was confirmed as a melanoma by immunohistochemistry. Cerebral MRI showed multiple lesions with the same signal characteristics as those seen in the spinal lesion on MRI. Complete skin, mucosal and retinal examination failed to show any primary lesion, therefore a diagnosis of primary cervical melanoma with brain metastases was made. To our knowledge this is the first report of a primary melanoma of the cervical spine with cerebral metastases at the time of diagnosis. This article presents pertinent reported literature and discusses the aetiology, diagnosis, treatment and prognosis of this unusual condition.
Elevated Lysosome-Associated Protein Transmembrane-4β-35 is an Independent Prognostic Marker in Pancreatic Carcinoma
Authors: Zhang G , Liang Y , Huang Y , Chen Y , Zhou R
Published: February 2013

OBJECTIVES: To investigate the relationship between lysosome-associated protein transmembrane-4β-35 (LAPTM4B-35) and the clinicopathological features and prognosis of pancreatic carcinoma. METHODS: The level of LAPTM4B-35 protein was determined by semiquantitative immunohistochemistry in pancreatic carcinoma specimens. The relationship between LAPTM4B-35 level and prognosis was determined using univariate and multivariate analyses. RESULTS: A total of 98 patient samples were included. The presence of LAPTM4B-35 protein was confirmed in 77/98 (78.6%) patients and was significantly associated with tumour stage, degree of differentiation and pathological staging of pancreatic carcinoma after primary surgery. Patients with high LAPTM4B-35 levels had a poorer overall survival compared with patients with lower levels. Multivariate analysis showed that LAPTM4B-35 was an independent prognostic factor for overall survival. CONCLUSIONS: LAPTM4B-35 was found to be present at high levels in a large proportion of patients with pancreatic carcinoma, and was closely related to disease progression and poor prognosis. LAPTM4B-35 may represent a new molecular target for the clinical evaluation and treatment of pancreatic carcinoma.
Relationship between Fasting and 2-Hour Postprandial Plasma Glucose Levels and Vascular Complications in Patients with Type 2 Diabetes Mellitus
Authors: Tanaka M
Published: February 2013

OBJECTIVE: To investigate the relationship between fasting and 2-h postprandial plasma glucose concentrations and vascular complications in type 2 diabetes. METHODS: Consecutive patients with type 2 diabetes admitted for blood glucose control were grouped according to their fasting and 2-h postprandial plasma glucose levels. Frequency and severity of diabetic retinopathy and nephropathy, number of carotid artery plaques, coefficient of variation of R—R intervals (CVRR), brachial—ankle pulse wave velocity (baPWV), intima—media thickness, brain natriuretic peptide level, ankle—brachial index, and high-sensitivity C-reactive protein levels were compared. RESULTS: In the 206 patients studied, mean ± SD age, glycosylated haemoglobin and duration of diabetes were 63.4 ± 13.7 years, 9.8 ± 1.8% and 13.4 ± 8.9 years, respectively. Patients with high fasting plasma glucose levels had a higher frequency of proliferative retinopathy than those with low fasting levels. Patients with medium or high 2-h postprandial plasma glucose levels had higher baPWV and lower CVRR, respectively, than those with low 2-h levels. There was an inverse correlation between baPWV and CVRR. CONCLUSION: Elevated fasting and postprandial plasma glucose levels are risk factors for vascular complications in type 2 diabetes mellitus.
Intact versus Fragmented 99mTc-Monoclonal Antibody Imaging of Infection in Patients with Septically Loosened Total Knee Arthroplasty
Authors: Gratz S , Reize P , Pfestroff A , Höffken H
Published: February 2013

OBJECTIVE: This prospective study compared the diagnostic accuracy of imaging using an intact murine antigranulocyte antibody 99mTc-besilesomab, and a murine antibody Fab' fragment 99mTc-sulesomab, in patients with suspected septically loosened total knee arthroplasty. METHODS: Images from 20 patients who underwent three-phase bone scintigraphy followed by imaging using 99mTc-besilesomab ( n = 10) or 99mTc-sulesomab ( n = 10) were evaluated and compared. Final diagnosis was determined by microbiological evaluation of aspirated synovial fluid, intraoperative samples through the clinical course, or by long-term follow-up. RESULTS: Prosthesis infection was shown in 18 patients. At 4 and 24 h after intravenous injection, absolute uptake of 99mTc-besilesomab was significantly higher than 99mTc-sulesomab in infected knee joints. Infected-to-healthy knee activity ratios were similar at 4 and 24 h for 99mTc-besilesomab and 99mTc-sulesomab. CONCLUSIONS: Both 99mTc-besilesomab and 99mTc-sulesomab had similar diagnostic accuracy for the detection of septic arthroplasty. If repeated use of immunoscintigraphy is needed for follow-up, 99mTc-sulesomab should be preferred over 99mTc-besilesomab since it is known to be well tolerated and without side effects or incompatibility reactions.
Comparison of a Paraspinal Approach with a Percutaneous Approach in the Treatment of Thoracolumbar Burst Fractures with Posterior Ligamentous Complex Injury: A Prospective Randomized Controlled Trial
Authors: Jiang Xz , Tian W , Liu B , Li Q , Zhang Gl , Hu L , Li Zy , He D
Published: February 2013

OBJECTIVE: This prospective randomized controlled study compared the efficacy and safety of two paraspinal muscle-sparing surgical approaches for the management of neurologically intact patients with thoracolumbar burst fractures and posterior ligamentous complex injuries. METHODS: Patients were randomized to undergo either percutaneous ( n = 31) or paraspinal ( n = 30) fluoroscopically-guided pedicle screw—rod fixation, and were followed for ≥ 3 years. Preoperative postural reduction was attempted in all patients. RESULTS: The percutaneous approach was associated with significantly less intraoperative blood loss and shorter duration of surgery and hospitalization, as well as less pain and better functional recovery at 3 months after surgery compared with the paraspinal approach. Paraspinal surgery resulted in significantly better correction of kyphosis and restoration of vertebral height compared with percutaneous surgery. There were no differences in long-term clinical outcomes between the two groups. CONCLUSIONS: The minimally invasive percutaneous approach appears to be better in cases of successful postural reduction. The paraspinal approach results in better surgical correction and is, therefore, recommended for patients without successful postural reduction.
Dexmedetomidine versus Midazolam for Conscious Sedation in Postoperative Patients Undergoing Flexible Bronchoscopy: A Randomized Study
Authors: Liao W , Ma G , Su Qg , Fang Y , Gu Bc , Zou Xm
Published: February 2013

OBJECTIVE: This prospective randomized study evaluated the efficacy and patient tolerance of dexmedetomidine compared with midazolam for sedation in postoperative patients undergoing flexible bronchoscopy. METHODS: A total of 198 postoperative patients were randomized to receive dexmedetomidine ( n = 99) or midazolam ( n = 99) to produce conscious sedation for bronchoscopy. Peripheral oxygen saturation, heart rate and systolic and diastolic arterial pressures were recorded before, during and after the procedure. Patient tolerance was recorded using various visual analogue scales. RESULTS: The mean lowest peripheral oxygen saturation was significantly lower in the midazolam group than in the dexmedetomidine group. Heart rate and systolic arterial pressure were both significantly higher during bronchoscopy in the midazolam group than in the dexmedetomidine group. Bronchoscopy was well tolerated in both groups; there was no between-group difference in patient discomfort scores or in the percentage of patients who would accept repeat bronchoscopy. CONCLUSIONS: Compared with midazolam, dexmedetomidine provided better oxygen saturation and was equally well tolerated for conscious sedation in postoperative patients undergoing bronchoscopy.
High Anxiety, Young Age and Long Waits Increase the Need for Preoperative Sedatives in Children
Authors: Kim Je , Jo By , Oh Hm , Choi Hs , Lee Y
Published: February 2013

OBJECTIVE: This prospective, observational study aimed to identify children likely to require sedation preoperatively by measuring anxiety levels using the modified Yale Preoperative Anxiety Scale (mYPAS). Other possible predictive factors for preoperative sedation were also investigated. METHODS: A total of 455 patients aged 2 – 12 years scheduled for surgery requiring general anaesthesia were enrolled in the study. Patients' anxiety levels were measured using the mYPAS in a preoperative holding area just before patients were separated from their parents or guardians and entered the operating theatre. Anaesthetists blinded to the mYPAS assessments judged whether the child could be separated and enter the operating theatre without a sedative. The ability of the mYPAS to predict the need for preoperative sedation was analysed by receiver operating characteristic (ROC) curve analysis. RESULTS: The optimum mYPAS cut-off for requiring sedatives was 41.7 according to ROC curve analysis. Multivariate logistic regression analysis showed that age, mYPAS > 40 and waiting time were independent predictors of the requirement for sedative administration. CONCLUSIONS: High anxiety levels, young age and long waits contributed to the need for preoperative sedation in children.
Clinical Evaluation of Extraperitoneal Colostomy without Damaging the Muscle Layer of the Abdominal Wall
Authors: Dong L-R , Zhu Y-M , Xu Q , Cao C-X , Zhang B-Z
Published: February 2013

OBJECTIVE: This study investigated whether extraperitoneal colostomy without damaging the muscle layer of the abdominal wall is an improved surgical procedure compared with conventional sigmoid colostomy in patients undergoing abdominoperineal resection. METHODS: Patients with rectal cancer undergoing abdominoperineal resection were selected and randomly divided into two groups: the study group received extraperitoneal colostomy without damaging the muscle layer of the abdominal wall and the control group received conventional colostomy. Clinical data from both groups were analysed. RESULTS: A total of 128 patients were included: 66 received extraperitoneal colostomy without damaging the muscle layer of the abdominal wall and 62 received conventional colostomy. Significant differences between the two groups were found in relation to colostomy operating time, defaecation sensation, bowel control and overall stoma-related complications. Duration of postoperative hospital stay was also significantly different between the study groups. CONCLUSIONS: Extraperitoneal colostomy without damaging the muscle layer of the abdominal wall was found to be an improved procedure compared with conventional sigmoid colostomy in abdominoperineal resection, and may reduce colostomy-related complications, shorten operating time and postoperative hospital stay, and potentially improve patients' quality of life.
Switching to an L/N-Type Calcium Channel Blocker Shows Renoprotective Effects in Patients with Chronic Kidney Disease: The Kyoto Cilnidipine Study
Authors: Hatta T , Takeda K , Shiotsu Y , Sugishita C , Adachi T , Kimura T , Sonomura K , Kusaba T , Kishimioto N , Narumiya H , Tanda S , Tamagaki K , Yamada K , Kameyama H , Kido H , Harada S , Bito Y , Moriguchi J , Morimoto S , Okigaki M , Itoh H , Mori Y , Nakata T , Maki K , Sasaki S , Sawada K , Matsubara H
Published: February 2013

OBJECTIVE: This open-label, randomized controlled trial investigated the effects of cilnidipine, an L/N-type calcium channel blocker (CCB), in patients with chronic kidney disease (CKD). METHODS: Sixty patients with CKD and well-controlled hypertension being treated with a renin—angiotensin system (RAS) inhibitor and an L-type CCB (L-CCB) were randomly assigned either to switch from the L-CCB to cilnidipine after a 4-week observation period or to continue with L-CCB treatment. Blood pressure, heart rate and renal function were monitored for 12 months. Data were available for analysis from 50 patients: 24 from the cilnidipine group and 26 from the L-CCB group. RESULTS: Blood pressure was well controlled in both groups. After 12 months, proteinuria and heart rate were significantly decreased in the cilnidipine group, but proteinuria increased and heart rate remained unchanged in the L-CCB group. There was a significant positive correlation between the percentage changes in proteinuria and heart rate. CONCLUSIONS: Cilnidipine has antihypertensive effects equivalent to those of L-CCBs. In patients with CKD, proteinuria can be decreased by switching from an L-CCB to cilnidipine, thereby improving renal function.
Noninvasive Evaluation of the Chronic Influence of Local Air Velocity from an Air Conditioner Using Salivary Cortisol and Skin Caspase-14 as Biomarkers of Psychosomatic and Environmental Stress
Authors: Yamaguchi M , Nishimiya H
Published: February 2013

OBJECTIVE: To demonstrate the possibility of evaluating the chronic influence of local air velocity from an air conditioner using noninvasive biomarkers. METHODS: Over a consecutive 5-day period, 16 healthy young male adults were exposed to air flow from a whole ceiling-type air conditioner (low local air velocity) and from a commercial concentrated exhaust air conditioner (high local air velocity). Salivary cortisol was used as an index of the psychological effects and caspase-14, collected from the stratum corneum, was used as a marker of environmental stress on the skin. RESULTS: Local air velocity generated from the whole ceiling-type air conditioner where the subject's head was positioned was one-seventh that of the exhaust air conditioner. After exposure to the exhaust air conditioner for 5 days, salivary cortisol decreased significantly from morning to evening and skin caspase-14 gradually increased during the day. A significant increase in hydration index from the morning to the evening was found with the whole ceiling-type air conditioner. CONCLUSION: The effects of chronic exposure to air movement generated by an air conditioner may be quantified by measurement of salivary cortisol and skin caspase-14.
Naloxone Inhibition of Lipopolysaccharide-Induced Activation of Retinal Microglia is Partly Mediated via the p38 Mitogen Activated Protein Kinase Signalling Pathway
Authors: Xu Yf , Fu Ll , Jiang Ch , Qin Yw , Ni Yq , Fan Jw
Published: February 2013

OBJECTIVES: To investigate the effects and underlying mechanism of action of naloxone on lipopolysaccharide (LPS)-induced activation of retinal microglia in vitro. METHODS: Rat retinal microglia primary cultures were divided into four treatment groups: untreated; 1 μg/ml LPS for 12 h; 0.5, 1.0 or 2.0 μM naloxone for 30 min before LPS; 2.5 or 5.0 μM SB203580 for 12 h before LPS and naloxone. Levels of tumour necrosis factor (TNF)-α and interleukin (IL)-1β were determined by enzyme-linked immuno sorbent assay. Western blot analysis and double immunofluorescence were used to examine activation of the mitogen activated protein kinase (MAPK) signalling pathway. RESULTS: LPS induced an increase in TNF-α and IL-1β in culture supernatants, which was dose-dependently inhibited by naloxone. Naloxone also dose-dependently inhibited LPS-induced increases in phosphorylated p38 MAPK. Pretreatment of cells with SB203580 attenuated the inhibitory effect of naloxone on TNF-α and IL-1β production. CONCLUSIONS: Naloxone suppressed LPS-induced activation of cultured retinal microglia and this suppression appeared to occur partly through the p38 MAPK signalling pathway. Naloxone may have therapeutic potential in neurodegenerative diseases characterized by the activation of microglia.
A Mathematical Model for Predicting Outcome in Preterm Labour
Authors: Takagi K , Satoh K , Muraoka M , Takagi K , Seki H , Nakabayashi M , Takeda S , Yoshida K , Nishioka N , Ikenoue T , Kanayama N , Kanzaki T , Sagawa T , Matsuda Y
Published: February 2013

OBJECTIVE: This study aimed to develop a model for predicting the outcome and evaluating the treatment of patients with threatened of preterm labour. METHODS: Clinical data from 236 patients at < 32 weeks gestation who were in preterm labour were analysed to develop a discriminant function using multiple logistic regression to identify significant risk factors. The function was validated retrospectively in a further 501 patients and prospectively in 63 patients with premature labour. RESULTS: Factors that increased the risk of preterm birth were premature rupture of the membranes, intrauterine infection, dilatation of the cervix and uterine bleeding. Factors that decreased the risk of preterm birth were hospital admission after 28 weeks of gestation and intravenous administration of ritodrine. The predictive accuracy of the function was 75.4% in the 236 patients analysed, 84.8% in the further 501 retrospectively studied patients and 85.7% in the prospective group. CONCLUSIONS: The discriminant function described was clinically useful for predicting the outcome of threatened preterm labour before initiating treatment and for determining the medical care of patients, including maternal transfer to a high-level perinatal care centre.
Atypical Antipsychotics Do Not Reverse Prepulse Inhibition Deficits in Acutely Psychotic Schizophrenia
Authors: Xue Y-Y , Wang H-N , Xue F , Tan Q-R
Published: February 2013

OBJECTIVES: To investigate the effects of atypical antipsychotics on prepulse inhibition, startle response and habituation in acutely psychotic patients with schizophrenia, and investigate whether prepulse inhibition deficit improvements are a result of the direct impact of atypical antipsychotics or improvements in antipsychotic-related symptoms. METHODS: Prepulse inhibition, habituation and acoustic startle response were evaluated in healthy control subjects and patients with schizophrenia (either unmedicated with antipsychotics at the time of hospitalization or medicated with atypical antipsychotics for ≥ 1 month before hospitalization). RESULTS: Data were analysed for 26 patients in the unmedicated group, 20 patients in the medicated group and 31 control subjects. Compared with controls, both medicated and unmedicated patients showed prepulse inhibition deficits; however, there were no significant differences between the two patient groups. Lower prepulse inhibition levels were correlated with higher levels of positive, negative, general and total scores on the Positive and Negative Syndrome Scale. CONCLUSIONS: These results suggest that effects of atypical antipsychotics on prepulse inhibition may not be evident when patients with schizophrenia are acutely symptomatic, and do not directly influence prepulse inhibition.
Blood—Brain Barrier Disruption is More Severe in Neuromyelitis Optica than in Multiple Sclerosis and Correlates with Clinical Disability
Authors: Tomizawa Y , Yokoyama K , Saiki S , Takahashi T , Matsuoka J , Hattori N
Published: February 2013

OBJECTIVES: This study evaluated blood— brain barrier (BBB) integrity, using blood and cerebrospinal fluid (CSF) markers, and assessed the practicality of these markers in the differential diagnosis of neuromyelitis optica (NMO) and multiple sclerosis (MS). METHODS: This was a retrospective observational study of consecutive patients presenting with acute phase NMO or MS (first attack or relapse). Haematological tests (including antiaquaporin-4 antibody levels) and CSF parameters (using primary component analyses) were undertaken; the correlation between BBB permeability and disease severity (by Expanded Disability Status Scale [EDSS] score) was examined. RESULTS: Levels of several markers of BBB permeability were higher in patients with NMO ( n = 21) than in those with MS ( n = 52). The CSF: serum albumin ratio (AR) was the one of the main differentiators of NMO and MS. Additionally, there was a significant correlation between AR and clinical severity for NMO but not for MS. CONCLUSIONS: Markers of BBB permeability were significantly higher in NMO patients than in MS patients. AR was the best marker for differentiating NMO and MS. Thus, measurement of BBB disruption markers (such as AR) might help to differentiate the diagnosis of NMO and MS in acute clinical settings.
Gender-Specific Normal Levels of Myocardial Metabolites Determined by Localized 1H-Magnetic Resonance Spectroscopy
Authors: Wu J , Yang L , Yang J , Yang Ch , Zhang Xh
Published: February 2013

OBJECTIVE: Gender-specific normal concentrations of myocardial metabolites and the differences that might exist between healthy males and females were measured in vivo using 1H-magnetic resonance spectroscopy (1H-MRS). METHODS: A total of 100 healthy individuals (57 males, 43 females) were studied. Cardiac magnetic resonance imaging and localized 1H-MRS were used to localize the voxels and quantify myocardial metabolite concentrations, respectively, for each gender. RESULTS: A total of 14 participants were excluded because of motion and poor spectra, which meant that 86 participants (46 males, 40 females) were included in the final analysis. Spectral peaks were identified with chemical shifts corresponding to water, choline, creatine and triglyceride. Myocardial choline and creatine levels showed no statistically significant differences between males and females. Females had a significantly lower body mass index and body surface area compared with males, and a significantly higher concentration of myocardial triglycerides. CONCLUSIONS: Myocardial triglyceride concentration was shown to be related to gender, whereas myocardial creatine and choline concentrations were not gender-related.
Optimal Bent Length of Lightwand for Intubation in Adults: A Randomized, Prospective, Comparative Study
Authors: Chen J , Luo W , Wang E , Lu K
Published: February 2013

OBJECTIVE: To evaluate the effect on intubation success of different bent lengths of a lightwand (a malleable illuminating stylet used for intubation), based on the patient's thyroid prominence-to-mandibular angle distance (TMD), thyroid prominence-to-incisor distance (TID) and gender. METHODS: This prospective, randomized, blinded study included patients undergoing elective surgery. In group A, the bent length was determined based on the patient's gender. In groups B and C, the bent length was calculated according to the patient's TMD or TID, respectively. Intubation success rate, time required for intubation, haemodynamics and complications postintubation were documented. RESULTS: A total of 246 patients were recruited and randomly assigned to one of the study groups. There were no significant differences in number of intubation attempts and success rate among the three groups. The mean time required for intubation was significantly shorter in group A than in the other groups. There were no major complications in any group. CONCLUSIONS: Gender-determined bent length was more suitable for lightwand-guided intubation than TID or TMD. For most patients, the optimal bent length was in the range of 6.0 – 6.9 cm.
Primary Paraganglioma of the Lung: A Case Report and Literature Review
Authors: Zhang J-J , Liu T , Peng F
Published: February 2013

Only 22 cases of primary pulmonary paraganglioma have been reported previously. This report presents a case of paraganglioma that arose in the lung of a 38-year-old woman who presented with chest pain and paroxysmal cough with little sputum. Positron emission tomography—computed tomography scan demonstrated two homogeneous masses in the left lower lobe accompanied by multiple mediastinal lymph node metastases. After resection, gross pathological examination confirmed two solid masses, which had a yellow—grey complexion and decreased blood supply and that invaded the mediastinum. Immunohistochemical analysis confirmed the presence of several biological tumour markers. This is the first known report to describe the computed tomography imaging characteristics of a paraganglioma, thereby improving understanding of its morphological features and helping in the differential diagnosis of lung tumours.
“Dolphins Are Just Gay Sharks”
Authors: Marwick Alice , Gray Mary L. , Ananny Mike
Published: February 2013

The FOX television series Glee has been lauded for its progressive portrayals of gay characters and criticized for trafficking in stereotypes. We position Glee within a transmedia framework, using textual analysis of program storylines, ethnographic fieldwork, and messages about Glee circulated on the microblogging site Twitter, to examine fan responses to and uses of Glee. We find that young adults experience and deploy Glee in two ways. First, they use Glee as a text to interpret their own life experiences, and imagine how they might articulate queer desires and acceptance of them. Second, as a malleable and mobile symbolic object, Glee acts as a strategic device used to signal identifications with and levels of awareness and acceptance of lesbian, gay, bisexual, transgender (LGBT)–identifying people. Although some of the engagement with Glee on social media echoed textual themes, we also find devoted fan engagement that diverges from that of our ethnographic observations.
Outcomes of treatment with pyrimine 60 in Thai myasthenia gravis patients
Authors: Tiamkao Somsak , Tiamkao Siriporn , Sawanyawisuth Kittisak
Published: February 2013

Myasthenia gravis is a neurological disease that causes poor quality of life. Mestinon® is the drug of choice. However, using the original medication may lead to high costs particularly in developing countries. We did a pilot study in previously diagnosed, stable generalized myasthenia gravis patients by switching Mestinon® to pyrimine 60, a generic form. After we enrolled 13 patients, 6 patients responded, 4 patients did not respond, and 4 patients had severe dry mouth and throat from pyrimine 60. Clinical characters, SF-36 scores, and composite scores in those who responded, did not response, and had side effects were compared. No patients had serious side effects or myasthenic crisis. In conclusion, pyrimine 60 may be as effective as mestinon® with minor side effects.
The Future of Emotion Regulation Research
Authors: Aldao Amelia
Published: February 2013

Emotion regulation has been conceptualized as a process by which individuals modify their emotional experiences, expressions, and physiology and the situations eliciting such emotions in order to produce appropriate responses to the ever-changing demands posed by the environment. Thus, context plays a central role in emotion regulation. This is particularly relevant to the work on emotion regulation in psychopathology, because psychological disorders are characterized by rigid responses to the environment. However, this recognition of the importance of context has appeared primarily in the theoretical realm, with the empirical work lagging behind. In this review, the author proposes an approach to systematically evaluate the contextual factors shaping emotion regulation. Such an approach consists of specifying the components that characterize emotion regulation and then systematically evaluating deviations within each of these components and their underlying dimensions. Initial guidelines for how to combine such dimensions and components in order to capture substantial and meaningful contextual influences are presented. This approach is offered to inspire theoretical and empirical work that it is hoped will result in the development of a more nuanced and sophisticated understanding of the relationship between context and emotion regulation.
Overcoming the Barriers to Self-Knowledge
Authors: Carlson Erika N.
Published: February 2013

People’s beliefs about their personality, or how they typically think, feel, and behave, correspond somewhat to objective accuracy criteria. Yet recent research has highlighted the fact that there are many blind spots in self-knowledge and that these blind spots can have fairly negative consequences. What can people do to improve self-knowledge? The current article suggests that the construct of mindfulness, defined as paying attention to one’s current experience in a nonevaluative way, may serve as a path to self-knowledge. Specifically, mindfulness appears to directly address the two major barriers to self-knowledge: informational barriers (i.e., the quantity and quality of information people have about themselves) and motivational barriers (i.e., ego-protective motives that affect how people process information about themselves). This article reviews the available evidence supporting the hypothesis that mindfulness improves self-knowledge and outlines promising future directions that might firmly establish an empirical link between mindfulness and self-knowledge.
School Rankings, Department Rankings, and Individual Accomplishments
Authors: Stenstrom Douglas M. , Curtis Mathew , Iyer Ravi
Published: February 2013

The outcome of a graduate student’s hunt for employment is often attributed to the student’s own accomplishments, the reputation of the department, and the reputation of the university. In 2007, a national survey of psychology graduate students was conducted to assess accomplishments and experiences in graduate school, part of which was an assessment of employment after completion of the doctorate (PhD). Five hundred and fifty-one respondents who had applied for employment reported whether they had obtained employment and in what capacity. Survey results were then integrated with the National Research Council’s most recent official ranking system of academic departments. The strongest predictor of employment was department-level rankings even while controlling for individual accomplishments, such as publications, posters, and teaching experience. Equally accomplished applicants for an employment position were not equal, apparently, if they graduated from differently ranked departments. The results also show the degree to which school-level rankings, department-level rankings, and individual accomplishments uniquely predict the various types of employment, including jobs at PhD-granting institutions, master’s-granting institutions, liberal arts colleges, 2-year schools, outside academia, or no employment at all.
Navigating Into the Future or Driven by the Past
Authors: Seligman Martin E. P. , Railton Peter , Baumeister Roy F. , Sripada Chandra
Published: February 2013

Prospection (Gilbert & Wilson, 2007), the representation of possible futures, is a ubiquitous feature of the human mind. Much psychological theory and practice, in contrast, has understood human action as determined by the past and viewed any such teleology (selection of action in light of goals) as a violation of natural law because the future cannot act on the present. Prospection involves no backward causation; rather, it is guidance not by the future itself but by present, evaluative representations of possible future states. These representations can be understood minimally as “If X, then Y” conditionals, and the process of prospection can be understood as the generation and evaluation of these conditionals. We review the history of the attempt to cast teleology out of science, culminating in the failures of behaviorism and psychoanalysis to account adequately for action without teleology. A wide range of evidence suggests that prospection is a central organizing feature of perception, cognition, affect, memory, motivation, and action. The authors speculate that prospection casts new light on why subjectivity is part of consciousness, what is “free” and “willing” in “free will,” and on mental disorders and their treatment. Viewing behavior as driven by the past was a powerful framework that helped create scientific psychology, but accumulating evidence in a wide range of areas of research suggests a shift in framework, in which navigation into the future is seen as a core organizing principle of animal and human behavior.
Behavioral Influences in the Present Tense
Authors: Dunning David , Fetchenhauer Detlef
Published: February 2013

Seligman and colleagues importantly ask when behavior is produced by the past or the future, but in doing so forget that it can also be guided by the present. We discuss the distinction between expressive influences (i.e., those that attach to behavioral choices in the present) and instrumental ones (i.e., those attached to potential future outcomes of those choices). We argue that expressive influences play a larger role in decision-making, particularly social decisions about trust, than economists and psychologists recognize. As such, any discussion of the influence of past and future on behavior must also include a treatment of influences that exist in the immediate here and now.
Reply to Comments
Authors: Sripada Chandra , Railton Peter , Baumeister Roy F. , Seligman Martin E. P.
Published: February 2013

Evidence of prospective processes is increasingly common in psychological research, which suggests the fruitfulness of a theoretical framework for mind and brain built around future orientation. No metaphysics of determinism or indeterminism is presupposed by this framework, nor do considerations of scientific method require determinism—successful scientific theories in the natural sciences all involve probabilistic elements. We speculate that expressive behavior and moral decision making use prospective processes parallel to those used in nonmoral decisions.
Sticky Cultures: Memory Publics and Communal Pasts in Competitive Chess
Authors: Fine Gary Alan
Published: February 2013

Although examinations of social memory have largely focused on societies and large populations, much remembrance occurs within bounded publics. This memory, especially when it is held in common, ties individuals to their chosen groups, establishing an ongoing reality of affiliation. I term this form of memory work as sticky culture, recognizing the centrality of the linkage of selves and groups. To examine how sticky culture operates, I examine the social world of competitive chess with its deep history and rich literature. More specifically, I examine forms through which chess publics are cemented through remembrances of the past, focusing on the hero, the critical moment, and validated styles. Champions, memorable games, and recognized strategies establish a lasting public.
Health resource utilization and multidisciplinary impact of endoscopic ultrasonography in a tertiary referral medical center
Authors: Sodikoff Jamie B. , Garud Sagar S. , Keilin Steven A. , Bharmal Sheila J. , Lewis Melinda M. , Cai Qiang , Willingham Field F.
Published: February 2013

Background:

Endoscopic ultrasound (EUS) is a resource-intensive endoscopic procedure, but may result in high downstream health resource utilization and multispecialty impact. Our aim was to examine the downstream impact of EUS by specialty and by indication.

Methods:

A retrospective chart review was performed at an academic medical center for patients for whom EUS represented the first point of contact at the study institution within a 20-month period.

Results:

A total of 552 EUS procedures were reviewed and 208 represented the first point of contact. The most common principle indication involved the pancreas ( n = 117, 56%). Downstream health utilization was calculated for an average of 313 days postprocedure (range: 35–632 days). Following unique referral for endoscopic ultrasound, 52% of the patients in the study were retained within the institution for further management and, of these, 34% had a major intervention in the form of surgery or chemoradiotherapy. Compared with other indications, patients presenting with a pancreatic mass were significantly more likely to remain in the study institution for further management (62% versus 39%, p = 0.005), were more likely to have a downstream surgery (29% versus 14%, p = 0.020) and were more likely to have downstream chemo-radiotherapy (11% versus 3%, p = 0.012).

Conclusions:

EUS represents a unique portal of entry into tertiary referral medical centers. First point of contact EUS referrals are associated with major downstream health resource utilization and significantly increased utilization for mass lesions of the pancreas.
Improving Diagnostic Data Communication Processes for Better Patient Care and Hospital Efficiency
Authors: Balmforth Colin
Published: February 2013

When physicians order tests, the ability to ensure that they and their patients see the results in a timely manner can have a dramatic effect on patient care and satisfaction. Not only are delays inefficient for practitioners and health care organizations, but they can also be dangerous for patients. Relying on traditional delivery methods and recordkeeping practices no longer satisfies the demands of today’s regulatory requirements or of modern health care standards. Technology solutions available today can enable test results or alerts to be delivered quickly and completely to mobile or other communications devices. In most instances, complete test and image detail can be provided. The practitioner can then order treatment, initiate further consultations or tests, and even approve patient discharges from wherever he or she may be located. These systems also create a comprehensive audit trail, tracking receipt of test results and the response to the information. This article will discuss recent developments in mobile health care information technology, including how this communications technology works in theory and in practice. It also provides a case study of one health care organization’s successful adoption of the technology.
Facets of Self in Schizophrenia
Authors: Klein Stanley B. , Altinyazar Vesile , Metz Molly A.
Published: February 2013

Disturbance of self is a core feature of schizophrenia. In this article, we argue that a nuanced appreciation of self is necessary to understand the relation between the self and its disruption. After discussing evidence for the fractionation of self into several functionally independent yet normally interacting systems of knowledge, we focus on a specific self-system: trait self-knowledge. This system has proven robust in the presence of a host of cognitive and neural impairments rendering other systems of self dysfunctional. Little, however, is known about how this system is affected by schizophrenia. Our findings indicate that, in accord with previous investigations demonstrating the resilience of trait self-knowledge, schizophrenic patients maintain both highly reliable and moderately accurate trait self-knowledge.
Religion and HIV/AIDS Stigma in Puerto Rico
Authors: Varas-Díaz Nelson , Neilands Torsten B. , Cintrón-Bou Francheska , Santos-Figueroa Axel , Marzán-Rodríguez Melissa , Marques Domingo
Published: February 2013

HIV/AIDS stigma continues to be a challenge for HIV prevention and treatment. When health professionals manifest stigma it can limit access to quality treatment. With an ever-growing epidemic among Latinos, including Puerto Ricans living on the Caribbean Island, the social and structural factors that foster HIV/AIDS stigma need to be understood. In this study, we documented the association of religion with HIV/AIDS stigma in a sample of medical students in Puerto Rico. Findings suggest that importance placed on religion, and participation in religious activities, is associated with HIV/AIDS stigma for this population.
Law and Pediatric HIV Testing
Authors: Verani Andre R. , Orago Alloys S. S. , Kariuki Charles N. , Muraguri Nicholas , Koros Dan , Marston Barbara , De Cock Kevin M.
Published: February 2013

Realization of the right to health occurs along a continuum including national ratification of international treaties such as the Convention on the Rights of the Child, passage of domestic laws and policies that may specify modes of implementation and enforcement such as Kenya’s Constitution and HIV and AIDS Prevention and Control Act, and actual implementation of domestic laws and policies such as through the regulation and delivery of health services. The stages heuristic theoretical framework describes the public policy continuum as consisting of marked stages: agenda setting, policy formulation, policy implementation, and evaluation. This case study illustrates the continuum in Kenya with regard to pediatric HIV testing. Kenya has made progress applying law, policy, and science to reduce vertical transmission of HIV and increase HIV testing of infants, although several challenges remain. Progress in policy implementation may reduce mother-to-child transmission and increase pediatric HIV testing.
Murine dendritic cell rapamycin-resistant and rictor-independent mTOR controls IL-10, B7-H1, and regulatory T-cell induction
Authors: Rosborough Brian R. , Raïch-Regué Dàlia , Matta Benjamin M. , Lee Keunwook , Gan Boyi , DePinho Ronald A. , Hackstein Holger , Boothby Mark , Turnquist Hēth R. , Thomson Angus W.
Published: February 2013

Key Points

RAPA-resistant mTOR negatively regulates DC B7-H1 expression through signal transducer and activator of transcription 3 and suppressor of cytokine signaling 3. Adenosine triphosphate–competitive mTOR inhibition promotes B7-H1–dependent DC induction of Tregs.
Erk1 and Erk2 are required for maintenance of hematopoietic stem cells and adult hematopoiesis
Authors: Chan Gordon , Gu Shengqing , Neel Benjamin G.
Published: February 2013

Key Points

Erk1/2 are required for the maintenance of hematopoietic stem cells and immature progenitors in vivo.