bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosome release of β-catenin: a novel mechanism that antagonizes Wnt signaling
Authors: Chairoungdua Arthit , Smith Danielle L. , Pochard Pierre , Hull Michael , Caplan Michael J.
Published: September 2010

CD82 and CD9 are tetraspanin membrane proteins that can function as suppressors of tumor metastasis. Expression of CD9 and CD82 in transfected cells strongly suppresses β-catenin–mediated Wnt signaling activity and induces a significant decrease in β-catenin protein levels. Inhibition of Wnt/β-catenin signaling is independent of glycogen synthase kinase-3β and of the proteasome- and lysosome-mediated protein degradation pathways. CD82 and CD9 expression induces β-catenin export via exosomes, which is blocked by a sphingomyelinase inhibitor, GW4869. CD82 fails to induce exosome release of β-catenin in cells that express low levels of E-cadherin. Exosome release from dendritic cells generated from CD9 knockout mice is reduced compared with that from wild-type dendritic cells. These results suggest that CD82 and CD9 down-regulate the Wnt signaling pathway through the exosomal discharge of β-catenin. Thus, exosomal packaging and release of cytosolic proteins can modulate the activity of cellular signaling pathways.
Effect of Soybean Cyst Nematode on Growth of Dry Bean in the Field
Authors: Poromarto Susilo H. , Nelson Berlin D. , Goswami Rubella S.
Published: September 2010

Phaseolus vulgaris is a host of soybean cyst nematode (SCN; Heterodera glycines), but the effects of SCN on growth of dry bean plants are poorly understood. To study the effects of SCN (HG type 0) on dry bean, the cultivars GTS-900 (pinto bean), Montcalm (kidney bean), and Mayflower (navy bean) were evaluated in eight field experiments at four locations between 2007 and 2009. Plants were grown in a pasteurized Arveson loam soil that was infested with SCN eggs at densities ranging from 0 to 10,000 eggs/100 cm3 soil. Soil was placed in 14.6-liter plastic pots that were buried in the field with the bottoms removed. SCN reproduced on all three dry bean cultivars with reproduction factors (RF = number of eggs in the soil at harvest divided by number of eggs at planting) ranging from 6.1 to1.2. RFs were higher for dry bean plants growing at lower egg densities compared to higher densities. Pod number (PN), pod weight (PW), seed number (SN), and seed weight (SW) of GTS-900 were significantly less at 5,000 and 10,000 eggs/100 cm3 soil compared with the control. Averaged over those two egg densities, PN, PW, SN, and SW were reduced by 44 to 56% over the 2 years compared with the control. For Montcalm, significant reductions of 31 to 35% in PW, SN, SW, and total dry weight (TDW) in treatments of 2,500 and 5,000 eggs/100 cm3 soil were recorded in 2009, but not in 2008. For Mayflower, significant reductions of 27 to 41% in PH, PW, SN, SW, and TDW in treatments of 2,500 and 5,000 eggs/100 cm3 soil compared with the control were recorded in one out of two experiments in 2009. The reproduction of SCN on roots and the reduction in plant growth and seed yield on three different bean classes under field conditions indicates SCN is a potential threat to the large dry bean industry in the North Dakota–northern Minnesota region.
An Assessment of Mixed-Modeling Approaches for Characterizing Profiles of Time-Varying Response and Predictor Variables
Authors: Madden L. V. , Paul P. A.
Published: September 2010

A general statistical modeling approach was tested for characterizing the relationship between pathogen inoculum density (or other biological response variables) and environmental variables when the data are collected as temporal profiles of observations within multiple locations or years. The approach, based on the use of linear mixed models, simultaneously accounts for serial correlations of the observations within each time profile, the random effects of location–year (or other grouping factors), and the cross-correlation of the environmental variables, and is appropriate when the environmental effects on the response variable or its transformation (Y) are distributed over several times (e.g., days). Stability and precision of parameter estimates for environmental effects over multiple time lags were achieved through the use of polynomial constraints within a likelihood-based full mixed-model fit; from the parameter estimates, marginal effects of environmental variables and weights for individual time lags were determined. The mixed model was directly expanded, through the incorporation of smoothing functions, to potentially account for possible longer-term trends in the temporal profiles unrelated to the environmental variables being considered. The new approach described here (with or without a smoothing function) generalizes a previously used—and computationally less demanding—two-stage (composite) approach. In the previous approach, constrained parameter estimates and associated weights were first determined without consideration of serial correlation, cross-correlation of environmental variables, and the random effects of location–year; then, a mixed-model fit was accomplished using the fixed time-lag weights derived in the first step. Using data for inoculum density of Gibberella zeae on wheat spikes from 27 location–years, similar results were achieved with the full mixed model and the two-stage approaches, in terms of both the calculated parameters and predictions of Y. With the use of smoothing functions, the precision of the predictions was improved but the general conclusions regarding environmental effects on Y were not affected. Thus, in the particular example data set, previously derived conclusions regarding environmental effects on inoculum density were robust in terms of the statistical methodology used in analysis; most researchers will find the two-stage approach much easier to implement for the analysis of multiple profiles of time-varying observations.
Cpkk1, MAPKK of Cryphonectria parasitica, Is Necessary for Virulence on Chestnut
Authors: Rostagno Laura , Prodi Antonio , Turina Massimo
Published: September 2010

The role of Cpkk1, a mitogen-activated protein kinase from Cryphonectria parasitica, was investigated by generating a number of mutant strains that overexpress, under the control of the cryparin promoter, both the wild-type protein and its allele with an extensive deletion in the catalytic domain. Furthermore, a hairpin construct was built and expressed to cause specific silencing of Cpkk1 mRNA transcripts. Specific mRNA silencing or overexpression was confirmed on both Northern and Western blot analysis. Selected C. parasitica strains with Cpkk1 either silenced or overexpressed were evaluated for their biological characteristics, including virulence on European chestnut, growth on different substrates, conidial sporulation, and resistance to cell-wall-degrading enzymes. Silencing of Cpkk1 and the overexpression of a defective Cpkk1 correlated with a marked reduction in virulence on 3-year-old chestnut trees, with no statistically significant effect on fungal growth in the various conditions tested.
Two Independent Quantitative Trait Loci Are Responsible for Novel Resistance to Beet curly top virus in Common Bean Landrace G122
Authors: Larsen Richard C. , Kurowski Chester J. , Miklas Phillip N.
Published: September 2010

Beet curly top virus, often referred to as Curly top virus (CTV), is an important virus disease of common bean in the semiarid regions of the United States, Canada, and Mexico and the only effective control is genetic resistance. Our objective was to determine if dry bean landrace G122, which lacks the Bct gene for resistance to CTV, contains novel resistance to the virus. Two populations, GT-A and GT-B, consisting of 98 F5:7 recombinant inbred lines (RILs) in total were derived from a cross between G122 and the susceptible variety Taylor Horticultural and evaluated for phenotypic response to natural CTV field infection. Genetic analyses revealed random amplified polymorphism DNA (RAPD) markers associated with a major-effect quantitative trait loci (QTL) from G122 which exhibited stable expression across 3 years in both populations. Phenotypic variation explained by the QTL in GT-A (37.6%) was greater than in GT-B (20.4%). RAPD marker Q14.973 was converted to a sequence-characterized amplified region (SCAR) and designated SQ14.973. The SCAR was used to locate the QTL on linkage group 6 of the Phaseolus core map. A survey of 74 common bean cultivars and breeding lines revealed SQ14.973 would be widely useful for marker-assisted selection of the QTL. An additional minor-effect QTL from G122 was detected on linkage group 7. G122 was determined to possess novel resistance to CTV conditioned by at least two genes, one with major the other minor effect.
5′–3′-UTR interactions regulate p53 mRNA translation and provide a target for modulating p53 induction after DNA damage
Authors: Chen Jing , Kastan Michael B.
Published: September 2010

Optimal induction of p53 protein after DNA damage requires RPL26-mediated increases in p53 mRNA translation. We report here the existence of a dsRNA region containing complementary sequences of the 5′- and 3′-untranslated regions (UTRs) of human p53 mRNA that is critical for its translational regulation by RPL26. Mutating as few as 3 bases in either of the two complementary UTR sequences abrogates the ability of RPL26 to bind to p53 mRNA and stimulate p53 translation, while compensatory mutations restore this binding and regulation. Short, single-strand oligonucleotides that target this 5′–3′-UTR base-pairing region blunt the binding of RPL26 to p53 mRNA in cells and reduce p53 induction and p53-mediated cell death after several different types of DNA damage and cellular stress. The ability to reduce stress induction of p53 with oligonucleotides or other small molecules has numerous potential therapeutic uses.
MICROANOMIE: THE COGNITIVE FOUNDATIONS OF THE RELATIONSHIP BETWEEN ANOMIE AND DEVIANCE*
Authors: KONTY MARK
Published: September 2010

Emile Durkheim and Robert Merton spawned a century of research on the effects of anomie on rule‐breaking behavior. During that time “strain” emerged as the social psychological mechanism producing deviant behavior from the effects of anomie. This research challenges the primacy of the affective strain mechanism, arguing that anomie produces a cognitive state—referred to as microanomie—where self‐enhancing values are higher priority than self‐transcending values. Data from a sample of university students support the association between dominant self‐enhancing values and deviant behavior. These data also demonstrate how the microanomie condition can explain gender differences in offending. A synthesis with the affective strain mechanism is suggested.
CRIMINAL PROPENSITY, DEVIANT SEXUAL INTERESTS AND CRIMINAL ACTIVITY OF SEXUAL AGGRESSORS AGAINST WOMEN: A COMPARISON OF EXPLANATORY MODELS*
Authors: LUSSIER PATRICK , PROULX JEAN , LEBLANC MARC
Published: September 2010

Three hypotheses have been used to describe the male propensity for sexual aggression towards women: a general propensity to offend, a specific propensity to sexually offend and a combination of both. In this paper, using structural equation modeling, we compared the relative utility of these three hypotheses in explaining criminal activity in adulthood of sexual aggressors of women. In total, 209 adult males who were convicted of at least one sexual offence were included in the study. Results indicate that a propensity model emphasizing the role of an early and persistent general propensity to act in an antisocial manner during childhood and adolescence is most adequate to explain sexual aggressors' criminal activity. After controlling for the role of this propensity, a specific propensity characterized by high sexualization and deviant sexual interests explained only a modest proportion of variance of the sexual criminal activity.
THE LOCOMOTION OF THE LORISES, WITH SPECIAL REFERENCE TO THE POTTO
Authors: Walker Alan
Published: September 2010

The stealthy locomotion of the lorises is seen to be directly related to catching prey such as insects and roosting birds. The method of stalking prey contrasts strongly with the quick leaping method of food‐catching presented by the galagos. The lorises, by virtue of their food‐catching habits, are restricted to true forest, whereas some of the galagos, by the same token, have colonized more open country. This throws some light on the nature of the post‐Miocene link between Africa and Asia and is suggested as a reason why the galagos are restricted to Africa whereas the lorises are found in both Africa and Asia.
GROWTH IN WEIGHT OF THE FEMALE AFRICAN ELEPHANT IN ZAMBIA
Authors: Hanks J.
Published: September 2010

Weights of 173 non‐pregnant female elephants whose ages were estimated from the degree of molar tooth wear (Laws, 1966) were used to construct a growth curve. This differed from the growth curves described by Laws (1966) and Laws and Parker (1968), and reasons are suggested for this discrepancy.
THE FATE OF BLACK RHINOCEROSES RELEASED IN NAIROBI NATIONAL PARK
Authors: Hamilton P. H. , King J. M.
Published: September 2010

Information on the black rhinoceros population of Nairobi National Park has been obtained from two‐month surveys in 1967 and 1968 backed by data collected at random over the past few years. It proved impossible to identify some of the rhinoceroses whose presence was indicated by spoor and unidentified sightings, and an estimate of the total number present at the end of 1968 must vary between 27 and 33 animals. Twenty‐two rhinoceroses have been brought into the Park by the Game Department Capture Unit since November 1966. The fate of these animals has been: two dead, two not seen and 18 identified in the Park 3–33 months after release. The newcomers have produced only one serious conflict with a resident rhinoceros and two collisions with motor vehicles. Despite the small size of the Park, the inadequacy of its boundaries and the legendary intolerance of the species, it would appear that the translocation operations have been a success.
THE GROWTH AND NUTRITION OF THE AFRICAN ELEPHANT II. The chemical nature of the diet
Authors: McCullagh K.
Published: September 2010

The stomach contents of 148 elephants, cropped at different times of the year, were analysed chemically as part of a programme of elephant research taking place in 1966 and 1967.

On average these samples contained 8.4 g of protein, 1.5 g of fat, 43.5 g of carbohydrate, 35.7 g of fibre and 11.0 g of mineral material in 100 g of their dry matter. The percentage of protein during the dry season was less than half its value during the wet season and calculations suggest that these animals may be deficient in protein at this time.

Calculations suggest that the intake of calcium is higher during the dry season than during the wet season, although it is argued that this is not a factor in inducing damage to trees.

Analysis of the quality of the dietary fat showed it to contain relatively small amounts of essential poly‐unsaturated fatty acids.
Evaluation of a transportable capnometer for monitoring end‐tidal carbon dioxide
Authors: Hildebrandt T. , Espelund M. , Olsen K. S.
Published: September 2010

We compared a small and transportable Capnometer (EMMA™) with a reference capnometer, the Siesta i TS Anaesthesia. During air‐breathing through a facemask, both the EMMA (nine modules) and reference capnometer sampled expired gas simultaneously. A wide range of end‐tidal carbon dioxide values were obtained during inhalation of carbon dioxide and voluntary hyperventilation. The median IQR [range] difference between all sets of carbon dioxide values (EMMA – reference) was −0.3 (−0.6 to 0.0 [−1.7 to 1.6] kPa; n = 297) using new batteries, which was statistically significant (p = 0.04) and located to two of the nine EMMAs tested. Using batteries with reduced voltage did not influence the measurements. The 95% CI of the medians of the differences were −0.4 to −0.2. We conclude that the EMMA can slightly under‐read the end‐tidal carbon dioxide but is generally comparable with a free‐standing monitor. The precision of the EMMAs was similar whether new batteries or batteries with reduced voltage were used.
Evaluation of a morphine maturation model for the prediction of morphine clearance in children: how accurate is the predictive performance of the model?
Authors: Mahmood Iftekhar
Published: September 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

The pharmacokinetics of morphine are well known in pre‐term and term neonates, infants, younger and older children, as well as in adults. There are circumstances when a pharmacokinetic study may not be possible in children (especially neonates and infants), and as a result one would like to predict drug clearance in children. Several methods, such as allometric scaling and prediction based on incorporation of physiological parameters, have been suggested. Recently a morphine maturation model has been proposed to predict morphine clearance in the paediatric population.

WHAT THIS STUDY ADDS

The current study evaluates the predictive performance of the morphine maturation model for the prediction of morphine clearance in pre‐term, term, infants and children up to 5 years of age. The results of the study highlight the shortcomings of the model to predict morphine clearance in children in aforementioned age groups.

AIMS Recently, a maturation model that incorporates a sigmoidal Emax type model has been proposed for the estimation of morphine clearance in paediatric patients. The primary objective of this report is to evaluate the predictive performance of the morphine maturation model for the prediction of morphine clearance in children of different ages. The secondary objective of this report is to evaluate the predictive performance of exponent 0.75 on bodyweight in the absence of the sigmoidal part of the morphine maturation model.

METHODS In order to evaluate the predictive performance of the morphine maturation model, the clearance values of morphine for individual children (preterm neonates to 5‐year‐old children; n= 147) were obtained from the literature. The predicted clearance of morphine in an individual child, obtained from the maturation model as well as from the fixed exponent 0.75 was compared with the observed clearance in that individual child.

RESULTS The morphine maturation model's predictive power in neonates, infants and younger children is poor and the inclusion of the sigmoidal part in the model only helps in reducing the substantial error introduced in the prediction due to the application of exponent 0.75 on bodyweight. Furthermore, the real benefit of the sigmoidal Emax part of the model disappears by 1 year of age.

CONCLUSIONS The morphine maturation model has a poor predictive power of morphine clearance in preterm and term neonates, infants and very young children and may not be of any practical value for the prediction of morphine clearance in this age group.
The role of food allergy in the atopic march
Authors: Allen K. J. , Dharmage S. C.
Published: September 2010

Cite this as: K. J. Allen and S. C. Dharmage, Clinical & Experimental Allergy, 2010 (40) 1439–1441.
CD23/FcεRII: molecular multi-tasking
Authors: Acharya M , Borland G , Edkins A L , MacLellan L M , Matheson J , Ozanne B W , Cushley W
Published: September 2010

CD23 is the low-affinity receptor for immunoglobulin (Ig)E and plays important roles in the regulation of IgE responses. CD23 can be cleaved from cell surfaces to yield a range of soluble CD23 (sCD23) proteins that have pleiotropic cytokine-like activities. The regions of CD23 responsible for interaction with many of its known ligands, including IgE, CD21, major histocompatibility complex (MHC) class II and integrins, have been identified and help to explain the structure–function relationships within the CD23 protein. Translational studies of CD23 underline its credibility as a target for therapeutic intervention strategies and illustrate its involvement in mediating therapeutic effects of antibodies directed at other targets.
Management of Women With A Cervical Smear Showing A Mild Degree of Dyskaryosis: A Review of Policy
Authors: COOPER P. , KIRBY A. J. , SPIEGELHALTER D. J. , WHITEHEAD A. L. , PATTERSON A.
Published: September 2010

Three hundred and thirty‐seven women who presented for the first time with a cervical smear showing a mild degree of dyskaryosis were followed for a minimum period of 3 years and 9 months. of the 305 women with complete cytological and histological records, 178 were biopsied and 127 remained on cytological follow up. In the biopsied group one case of microinvasive squamous cell carcinoma was diagnosed within 1 year of the patient's first abnormal smear. A further 24% showed cervical intraepithelial neoplasia (CIN) I, 17% showed CIN II and 29% showed CIN III. the overall regression rate for the group of 305 women was 34%. Our results indicate that cytological surveillance is acceptable provided that biopsy is advised when dyskaryosis persists. No major modifications to laboratory policy are indicated and in approximately 34% of cases an unnecessary hospital referral would be avoided.
Inbreeding depression and its effect on intrinsic population dynamics in engraver beetles
Authors: DOMINGUE MICHAEL J. , TEALE STEPHEN A.
Published: September 2010

Abstract1. Phloem‐feeding bark beetles (Coleoptera: Curculionidae, Scolytinae) generally disperse before mating, leading to expectations of outbreeding. New York and British Columbia populations of engraver beetles (Ips pini) were tested for inbreeding depression using different methods. Among several traits measured, only the number of offspring surviving to adulthood was strongly reduced by inbreeding.

2. There was no evidence of avoidance of inbreeding depression in two possible mechanisms considered: differential male and female emergence times within full sib broods, and early termination of brood construction in forced sib mating.

3. Sib‐mated females lay more eggs and have longer galleries than those in outbred crosses, despite a low rate of survival to adulthood for such eggs. This difference may be due to the ability of engraver beetles to assess crowding in broods as larvae begin to feed, and allows partial compensation for the effects of inbreed depression.

4. Population models assuming density‐dependent generational effects were modified to account for inbreeding depression. Inbreeding depression makes populations less prone to cyclical behaviour, particularly at lower carrying capacities.

5. Inbreeding depression has not been previously measured in scolytids, nor has inbreeding‐related behaviour been explicitly considered outside of exclusively inbreeding tribes.
Limiting the success of stem borers (Prodoxus quinquepunctellus) in yuccas: indirect effects of ants, aphids, and fruit position
Authors: SNELL R. S. , ADDICOTT J. F.
Published: September 2010

Abstract 1. Although the moth–yucca mutualism is often studied as a pairwise interaction, yucca plants are also the sole host for a variety of other visitors. One of these additional visitors is a stem‐boring moth, Prodoxus quinquepunctellus.

2. In this study, it is shown how the reproductive success of Prodoxus indirectly depends on the interactions between yuccas and their pollinators (Tegeticula, Prodoxidae) as well as the indirect effects of ants and aphids.

3. Aggressive wood ants foraging on yuccas will attack adult Prodoxus moths while attempting to oviposit. This reduces the number of eggs laid in yucca stalks, leading to fewer larvae feeding in the stalks.

4. Once in the stalk, the survival of Prodoxus eggs/larvae depends upon the rate at which the flowering stalks dry out during fruit maturation. Portions of the stalk above the highest fruit dry out quickly and survivorship approaches zero in these dry sections, while larvae in green sections of the flowering stalk have significantly higher survival rates. The presence of aphids feeding on the stalk slows down the rate of stalk drying and could lead to increased survival of Prodoxus larvae.

5. Overall, ants have strong indirect effects on P. quinquepunctellus by controlling how many eggs are laid in the stalk and by influencing the distribution of aphids. However, it is primarily the presence and position of the fruit that can affect larval survivorship, and fruit position is a function of pollinator visits and resource limitation. These complex interactions illustrate the importance of studying the yucca–moth mutualism in a community context.
Observations on the Soil‐borne Wheat Mosaic Virus in Italy1
Authors: Corino L. , Grancini P.
Published: September 2010

Observations are presented regarding the presence, symptomatology and transmission of the soil‐borne wheat mosaic virus in Italy.
Reduction of the acute bioavailability of metformin by the α‐glucosidase inhibitor acarbose in normal man
Authors: SCHEEN A. J. , FERREIRA ALVES de MAGALHAES A. C. , SALVATORE T. , LEFEBVRE P. J.
Published: September 2010

In a double‐blind cross‐over study, we investigated a possible influence of the α‐glucosidase inhibitor acarbose on the bioavailability of the biguanide compound metformin. Each of the six healthy young male volunteers was randomly allocated during two consecutive 7 day periods to either acarbose (days 1–3: 3 times 50mg day−1; days 4–7: 3 times 100 mg day−1) or placebo. At day 7 and 14 of the study, the overnight‐fasted subjects ingested 1000mg metformin with the first bite of a standardized breakfast (500kcal; 60 g carbohydrates) and together with either placebo or 100 mg acarbose. Acarbose significantly (P < 0·05) reduced the meal‐induced increase in blood glucose and plasma insulin levels. Acarbose induced a significant (P < 0·05) reduction in early (90, 120, 180min) serum levels, peak concentrations (Cmax: 1·22 ± 0·14 vs. 1·87 ± 0·60 mgl−1) and area under the curve of metformin (AUC 0–540min: 423±55 vs. 652±55 mg minl−1), but did not diminish its 24 h urinary excretion. In conclusion, acarbose significantly reduces the acute bioavailability of metformin in normal subjects.
Mutations in connexin genes and disease
Authors: Pfenniger Anna , Wohlwend Annelise , Kwak Brenda R.
Published: September 2010

Eur J Clin Invest 2010; 41 (1): 103–116

Background  Connexins are a family of transmembrane proteins that are widely expressed in the human body. Connexins play an important role in cell‐cell communication and homeostasis in various tissues by forming gap junction channels, which enable a direct passage of ions or metabolites from one cell to another. Twenty‐one different connexins are expressed in humans, each having distinct expression patterns and regulation properties. Knowledge on this family of proteins can be gained by making an inventory of mutations and associated diseases in human.

Design  PubMed and other relevant databases were searched. In addition, key review articles were screened for relevant original publications. Sections of representative organs were photographed and annotated.

Results  The crucial role of connexins is highlighted by the discovery of mutations in connexin genes which cause a variety of disorders such as myelin‐related diseases, skin disorders, hearing loss, congenital cataract, or more complex syndromes such as the oculodendrodigital dysplasia. This review systematically addresses current knowledge on mutations in connexin genes and disease, focusing on the correlation between genetic defects, cellular phenotypes and clinical manifestations.

Conclusions  The review of diseases caused by mutations in connexin genes highlights the essential nature of connexin function and intercellular communication in tissue homeostasis.
Three sisters in the same dress: cryptic speciation in African odonates
Authors: CORDERO‐RIVERA A. , LORENZO‐CARBALLA M. O.
Published: September 2010

The discovery of cryptic species (i.e. two or more distinct but morphologically undistinguishable species) has grown exponentially in the last two decades, due mainly to the increasing availability of DNA sequences. This suggests that hidden in the known species, many of which have been described based solely on morphological information, there might be a high number of species waiting to be discovered. In this issue Damm et al. (2010) use a combination of genetic, morphological and ecological evidence to identify the first cryptic species complex found within dragonflies (insect order Odonata). Their findings add more evidence for the importance of combining information from different disciplines to new species’ discovery (DeSalle et al. 2005).
Hermann Friedberg's case report: an early description of CLOVES syndrome
Authors: Alomari AI , Thiex R , Mulliken JB
Published: September 2010

Alomari AI, Thiex R, Mulliken JB. Hermann Friedberg's case report: an early description of CLOVES syndrome.

CLOVES syndrome is a recently described overgrowth disorder with complex vascular anomalies. Careful analysis of the case report by the German physician Hermann Friedberg “gigantism of the right lower limb” published in 1867 revealed that the report probably represents one of the first written accounts of CLOVES syndrome.
Larger tidal volume increases sevoflurane uptake in blood: a randomized clinical study
Authors: ENEKVIST B. , Bodelsson M. , STURESSON L. W. , JOHANSSON A.
Published: September 2010

Background: The rate of uptake of volatile anesthetics is dependent on alveolar concentration and ventilation, blood solubility and cardiac output. We wanted to determine whether increased tidal volume (VT), with unchanged end‐tidal carbon dioxide partial pressure (PETCO2), could affect the arterial concentration of sevoflurane.

Methods: Prospective, randomized, clinical study. ASA physical status 2 and II patients scheduled for elective surgery of the lower abdomen were randomly assigned to one of the two groups with 10 patients in each: one group with normal VT (NVT) and one group with increased VT (IVT) achieved by increasing the inspired plateau pressure 0.04 cmH2O/kg above the initial plateau pressure. A corrugated tube added extra apparatus dead space to maintain PETCO2 at 4.5 kPa. The respiratory rate was set at 15 min−1, and sevoflurane was delivered to the fresh gas by a vaporizer set at 3%. Arterial sevoflurane tensions (Pasevo), Fisevo, PETsevo, PETCO2, PaCO2, VT and airway pressure were measured.

Results: The two groups of patients were similar with regard to gender, age, weight, height and body mass index. The mean PETsevo did not differ between the groups. Throughout the observation time, arterial sevoflurane tension (mean±SE) was significantly higher in the IVT group compared with the NVT group, e.g. 1.9±0.23 vs. 1.6±0.25 kPa after 60 min of anesthesia (P<0.05).

Conclusion: Ventilation with larger tidal volumes with isocapnia maintained with added dead‐space volume increases the tension of sevoflurane in arterial blood.
Maize‐ or potato‐derived hydroxyethyl starches: is there any thromboelastometric difference?
Authors: GODIER A. , DURAND M. , SMADJA D. , JEANDEL T. , EMMERICH J. , SAMAMA C. M.
Published: September 2010

Background: Hydroxyethyl starches (HES) could differ with regard to the origin, and the influence on the coagulation of the raw material is unknown. This study compared the effects of a new potato‐derived HES with a maize‐derived HES and two crystalloid solutions.

Methods: Whole blood from 10 healthy individuals was diluted by 20% and 40% using either non‐balanced potato‐derived HES 130/0.42/6 : 1, non‐balanced maize‐derived HES 130/0.4/9 : 1, isotonic saline or Ringer's lactate solution. Samples were analysed by thromboelastometry ROTEM®: Coagulation was initiated by acid ellagic [intrinsic thromboelastometry (INTEM)] or tissue factor (extrinsic thromboelastometry) with and without cytochalasin to determine the functional component of fibrinogen [cytochalasin‐d‐modified thromboelastometry (FIBTEM)]. Platelet count and fibrinogen activity were measured.

Results: No effect of raw material was found as no difference was detected among the HES solutions. Whatever the solution, progressive haemodilution impaired haemostasis in a dose‐dependant manner: For INTEM, the clot formation time was increased up to 308% and the maximum clot firmness (MCF) was decreased down to 49%. As dilution increased, initiation of coagulation was also impaired. Thromboelastometric alterations were more severe with HES than with crystalloids, especially regarding fibrin polymerization explorations: MCF of FIBTEM was considerably reduced from 12[10–14] to 2[2–3] mm (P<0.05). Fibrinogen activity and platelet count were reduced by dilution in a dose‐dependant manner and decreased similarly in all groups.

Conclusion: Maize‐ and potato‐derived HES have similar effects on coagulation. Both the starch preparations tested lead to more severe haemostatic defects than crystalloids, and impairment of fibrin polymerization appears to be a leading determinant of this coagulopathy.
Histopathological aspects of cardiac biopsy in pediatric patients with dilated cardiomyopathy
Authors: Nishikawa Toshio , Uto Kenta , Kanai Saeko , Oda Hideaki , Kawamura Shunji , Nakanishi Toshio , Hagiwara Nobuhisa , Morimoto Shin‐ichiro
Published: September 2010

Background:  Dilated cardiomyopathy (DCM) is a heart muscle disease with cardiac dysfunction and a heterogenous disorder. This disease may show various histopathological aspects of the myocardium, but little is known about these in children.

Methods:  Histopathological findings of endomyocardial biopsy from 20 pediatric patients with DCM were analyzed and compared with those in adult patients.

Results:  Advanced histopathology, including myocytolysis and/or fragmentation of muscle bundles, was frequently observed in patients with poor prognosis. Patchy fibrosis was predominantly demonstrated in the pediatric patients, whereas perivascular fibrosis was mostly observed in the older adults. The myocarditic index, assessed in terms of the findings of fibrosis, size variation of myocytes, disarrangement of muscle bundles and mononuclear cell infiltration was higher in the pediatric patients than in the older adults (P < 0.05). Bizarre myocardial hypertrophy with disorganization, which tends to be frequently demonstrated in hypertrophic cardiomyopathy, was revealed in 30% of the pediatric patients, whereas it was disclosed in none of the older adult patients (P < 0.05).

Conclusion:  These results suggest that the major pathogenetic factors of DCM in children may be different from those in adults.
Challenges and opportunities for discovery of disease biomarkers using urine proteomics
Authors: Kentsis Alex
Published: September 2010

Modern medicine has experienced a tremendous explosion in knowledge about disease pathophysiology, gained largely from understanding the molecular biology of human disease. Recent advances in mass spectrometry and proteomics now allow for simultaneous identification and quantification of thousands of unique proteins and peptides in complex biological tissues and fluids. In particular, proteomic studies of urine benefit from urine's less complex composition as compared to serum and tissues, and have been used successfully to discover novel markers of a variety of infectious, autoimmune, oncological, and surgical conditions. This perspective discusses the challenges of such studies that stem from the compositional variability and complexity of human urine, as well as instrumental sampling limitations and the effects of noise and selection bias. Strategies for the design of observational clinical trials, physical and chemical fractionation of urine specimens, mass spectrometry analysis, and functional data annotation are outlined. Rigorous translational investigations using urine proteomics are likely to discover novel and accurate markers of both rare and common diseases. This should aid the diagnosis, improve stratification of therapy, and identify novel therapeutic targets for a variety of childhood and adult diseases, all of which will be essential for the development of personalized and predictive medicine of the future.
FUTURE PERSPECTIVES OF GASTROINTESTINAL ENDOSCOPY AND JOINT ACADEMIC–INDUSTRIAL RESEARCH FOLLOWING TECHNOLOGICAL INNOVATION IN MEDICAL AND BIOLOGICAL ENGINEERING
Authors: Tajiri Hisao
Published: September 2010

Screening surveys conducted to predict the future of gastrointestinal endoscopy, have revealed a tendency towards emphasis on the development of endoscopes of smaller diameters, to reduce the pain and discomfort caused to patients. It appears that the efforts to develop newer endoscopes with a focus on further reducing the diameter of the tip of the endoscopes, while preserving the visualizing and manipulating capabilities of endoscopes, are moving towards development of wireless capsule endoscopes. Regarding improvement in the diagnostic capabilities of endoscopes, it is expected that high‐definition (HD)‐TV technology‐compatible endoscopy systems and so on, will be developed in the near future, with the improved resolution of images and improved image analysis systems, accompanied by the development of new endoscope‐linked devices, such as endoscopic ultrasonography, a fluorescent endoscope, and an ultra‐magnifying endoscope. These developments may eventually lead to the age of ‘bioendoscopy’, in which endoscopes would be used for not only morphological diagnosis, like conventional endoscopes, but also for evaluation of the pathophysiology of individual diseases through combining cell‐level diagnosis with functional diagnosis using an ultra‐magnifying endoscope. This paper will also summarize the current status and problems pertaining to joint academic‐industrial research for the development of new diagnostic imaging devices from an international perspective, placing emphasis on the ideal mode of academic–industry collaboration, improvements in education and personnel development, strengthening of collaboration among the medical, engineering and pharmaceutical fields, and promotion of clinical trials on new medical devices.
SUBTLE VILLOUS CHANGES DETECTED AT ENDOSCOPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Authors: Hamamoto Norihiro , Rubio Carlos , Befrits Ragnar , Toyoda Hideki , Ceballos Jorge , Jaramillo Edgar
Published: September 2010

Dysplastic areas in flat mucosa in patients with inflammatory bowel disease (IBD) are difficult to detect at endoscopic examination. We describe the endoscopic and clinicopathological characteristics of colorectal mucosa with subtle villous changes (SVC) detected by endoscopy and chromoscopy in patients with IBD. The present study consists of 18 IBD patients. The age at onset of the disease, duration and extent of disease, endoscopic features, and clinical follow up were noted. Of the 18 patients, 12 had ulcerative colitis and six had Crohn's colitis. The mean duration from onset of disease to the detection of SVC was 25.4 years (range 4–50 years). All patients had extensive colitis. All SVC areas were present in colorectal segments having absent vascular pattern and decrease or loss of normal folds. Mucosal redness was frequently observed. Following indigo carmine dye spraying the SVC were characterized by a subtle villous surface resembling small intestinal mucosa. Biopsies taken from SVC areas showed dysplasia in nine of the 18 patients (50.0%): LGD in seven and HGD in two. SVC can be identified with endoscopy and chromoscopy. The endoscopic identification of SVC areas may increase the accuracy in detecting epithelial dysplasia in biopsies from patients with IBD.
MAGNIFICATION ENDOSCOPY IN THE UPPER GI TRACT
Authors: Singh Shailender , Sharma Prateek
Published: September 2010

Magnification endoscopy in conjunction with chromoendoscopy provides additional valuable and detailed information with respect to mucosal morphology. The most promising indications include the depiction and staging of squamous cell cancer of the esophagus, the potential to identify neoplasia within Barrett's esophagus, and the demarcation of early gastric cancer. However, the exact role of magnification endoscopy for routine clinical practice is not yet determined and is currently under investigation
PERORAL CHOLANGIOSCOPY: AN IMPROVED PROCEDURE
Authors: Kubota Yoshitsugu , Yamamoto Shin , Okazaki Kazuichi
Published: September 2010

Cholangioscopy provides direct visual assessment of the bile ducts, tissue sampling, and therapeutic interventions. Delineation of intraductal lesions equivocal with direct cholangiography, differentiation between malignant and benign biliary strictures, and assessment of longitudinal extent of cholangiocarcinoma are major indicators for diagnostic cholangioscopy. Peroral cholangioscopy is readily performed at an initial endoscopic retrograde cholangiopancreatography. Owing to substantial refinement in terms of image quality and technical feasibility achieved with the development of a new video cholangioscope, peroral cholangioscopy has become a powerful tool. However, compared with percutaneous cholangioscopy, there remain several disadvantages in peroral cholangioscopy: less favorable maneuverability, small instrumental channel, and limited therapeutic instrumentations. With further advances in endoscopic functions and increasing availability of suitable instruments, peroral cholangioscopy, because of its less invasiveness, will become mandatory for diagnostic and therapeutic biliary endoscopy.
RAPUNZEL SYNDROME WITH GASTRIC PERFORATION IN AN ADULT
Authors: Bhandarwar Ajay H , Bakhshi Girish D , Nandu Bharat
Published: September 2010

Rapunzel syndrome is a rare condition of gastric trichobezoar with contiguous extension in the intestines found commonly in pediatric and teenage patients, mostly females, with underlying psychological disorders. We report the case of a 37‐year‐old widow who presented with epigastric pain, fullness and early satiety of 6 months duration. Investigations revealed a trichobezoar extending from the stomach through the duodenum into the jejunum. Psychiatric analysis revealed depressive symptoms. She was posted for elective surgery; however, 2 days prior to the surgery she presented with acute abdomen with plain X‐ray of the chest and abdomen showing free gas under the diaphragm. Urgent laparotomy was carried out which confirmed the diagnosis of gastric perforation due to Rapunzel syndrome. The perforation was closed primarily along with removal of the trichobezoar en masse by anterior gastrotomy. This is the first case of Rapunzel syndrome with gastric perforation that has presented in the fourth decade of life. Here we discuss the etiology, pathogenesis, diagnosis and treatment of this unusual syndrome.
FEASIBILITY OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR ELDERLY PATIENTS WITH EARLY GASTRIC CANCERS AND ADENOMAS
Authors: Onozato Yasuhiro , Kakizaki Satoru , Ishihara Hiroshi , Iizuka Haruhisa , Sohara Naondo , Okamura Shinichi , Mori Masatomo
Published: September 2010

Background:  Endoscopic submucosal dissection (ESD) has the advantage of permitting en bloc and histologically complete resection for early gastric cancer. Elderly patients often have surgical operative risks due to disease, and the feasibility of this treatment for such patients will improve the quality of life. The aim of the present study is to evaluate the efficacy and safety of ESD in elderly patients.

Methods:  We reviewed patients who underwent ESD for gastric lesions at Maebashi Red Cross Hospital. Among 251 gastric lesions treated by ESD from 2002 to 2006, 110 lesions were discovered in 93 elderly patients who were 75 years of age or older. The one‐piece resection with tumor‐free margin rate and the complications were assessed in comparison with younger patients under 75 years old.

Results:  The average age of the elderly patients was 79.8 years (range 75–92 years). The one‐piece resection with tumor‐free margin rate was 96.4% (106/110). Immediate bleeding occurred in one lesion (0.9%) and delayed bleeding requiring emergency endoscopy occurred in five lesions (4.5%). Perforation during ESD occurred in two patients (1.8%), and was immediately closed with endoclips and managed by conservative medical treatment. One case (0.9%) complicated with delayed perforation was managed by conservative medical treatment. The one‐piece resection with tumor‐free margin rate and the complication rate in elderly patients were not significantly different from those of younger patients.

Conclusion:  The present study shows the technical feasibility of ESD for gastric neoplasms in elderly patients.
TRANSECTION OF METAL STENTS USING ARGON PLASMA COAGULATION
Authors: Tai Mayumi , Ichii Osamu , Watanabe Tatsuyuki , Ejiri Yutaka , Otsuki Makoto
Published: September 2010

Background:  Placement of self‐expandable metallic stents has become the preferred palliative treatment for patients with unresectable malignant biliary obstruction. Metallic stents provide longer patency compared with plastic stents. Distal malposition or migration of metallic stents sometimes occurs, but it is often difficult to remove them. We evaluated the efficacy and safety of argon plasma coagulation (APC), and the optimum conditions for cutting metallic stents (Wallstent).

Methods:  We wrapped porcine small intestines around a metallic Wallstent with and without silicon lining membrane (Permulume®), leaving the distal portion unwrapped to resemble the protrusion of the biliary metallic stent from the ampulla of Vater. APC irradiation was applied to the metallic stent at 1 cm from the edge of the wrapped small intestine at 30, 60 and 99 watts (W) for 3 or 6 s.

Results:  Metallic Wallstent with the silicone‐based membrane Permalume® was cut at 30 W power, whereas more than 60 W power was required to cut the bare metallic wire. The irradiation of APC (flow rate at 2.0 L/min) at 30 W to the covered metallic stent transected the metallic mesh stent not only under dry but also under wet conditions (moisturized stent). Irradiation of APC caused no gross damage to the small intestines irrespective of the power applied and duration of irradiation.

Conclusions:  Our results suggest that APC is efficacious and safe for endoscopic sectioning of wire mesh stents at low power (30 W) without gross damage to the surrounding pancreaticobiliary tissues.
PEDUNCULATED GASTRIC SIGNET RING CELL CARCINOMA
Authors: Oku Takatomi , Maeda Masahiro , Ono Kaoru , Nagamachi Yasuhiro , Fujii Shigeyuki , Fujita Miri , Misu Kenjiro , Senmaru Naoto , Suzuki Yasuhiro , Nagashima Kazuo , Niitsu Yoshiro
Published: September 2010

Signet ring cell carcinoma (SRCC) is characterized by poor ductal formation and a diffuse progression pattern and generally presents as a depressed lesion in the majority of cases. We describe here an extremely rare case of gastric SRCC that presented as a pedunculated lesion. We hypothesize that the major factor responsible for the elevation of this lesion was proliferation of signet ring cells that did not lose their mutual connections. Among the two cases of early elevated‐type gastric SRCC that have been reported in the literature, this is the first case of pedunculated intramucosal SRCC. Pathological examination revealed no cancer cells in the basal part of the elevated lesion. The cellular morphology was consistent with SRCC, although the ductal structure was well preserved and more similar to well‐differentiated adenocarcinoma. Endoscopic examination showed a smooth‐surfaced lesion with no depressed region around the basal part of the elevated lesion. Because these findings differ significantly from previous reports of elevated SRCC, this report provides further insight into the nature of SRCC.