bluuebunny/crossref_metadata_2025 huggingface dataset:
Herbal Extracts Combination (WNK) Prevents Decline in Spatial Learning and Memory in APP/PS1 Mice through Improvement of Hippocampal AβPlaque Formation, Histopathology, and Ultrastructure
Authors: Cong Wei-hong , Yang Bin , Xu Li , Dong Xiao-xia , Sheng Li-song , Hou Jin-cai , Liu Jian-xun
Published: July 2012

To investigate the cognitive enhancement effect of WNK, an extracts combination ofP. ginseng,  G. biloba, andC. sativusL. and possible mechanisms, 5-month-old APP/PS1 transgenic mice were used in this study. After 3 months of administration, all mice received Morris water maze (MWM) training and a probe test. Mouse brain sections were detected by immunohistochemistry, HE staining, and transmission electron microscopy. MWM results showed significant difference between transgenic mice and nontransgenic littermates (P<0.05,P<0.01). WNK-treated mice exhibited enhanced maze performance over the training progression, especially better spatial memory retention in probe test compared to transgenic mice (P<0.05,P<0.01) and better spatial learning and memory at the fourth day of MWM test compared to EGB761- (G. bilobaextract-) treated ones (P<0.05). Hippocampal Aβplaque burden significantly differed between APP/PS1 and littermate mice (P<0.001), while decreased Aβplaque appeared in WNK- or EGB761-treated transgenic brains (P<0.05). Neurodegenerative changes were evident from light microscopic and ultrastructural observations in transgenic brains, which were improved by WNK or EGB761 treatment. These data indicate WNK can reduce the decline in spatial cognition, which might be due to its effects on reducing Aβplaque formation and ameliorating histopathology and ultrastructure in hippocampus of APP/PS1 mouse brain.
Catheter Displacement into Inferior Epigastric Vein Causing Local Phlebitis and Cellulitis
Authors: Hattori Noriko , Hattori Hidenori , Takahashi Kazushi , Suzuki Norihiro , Kishi Kazuo
Published: July 2012

Catheter insertion for intravenous hyperalimentation is a commonly and widely used clinical technique. When compared with the incidence of complications associated with insertions into the internal jugular vein or the subclavian vein, complications associated with insertions into the femoral vein are less frequent. In this paper, we describe a very rare complication of femoral vein catheter insertion—namely, catheter displacement into the inferior epigastric vein.
Tetralogy of Fallot Associated with Dysplastic Kidneys, Cloacal Anomalies, and Female Pseudohermaphroditism: A Systemic Anomaly of Septation?
Authors: Morales-Roselló José , Serrano Teresa Escudero , Almela Ana García , Santander Rafael Lázaro
Published: July 2012

A 20-week fetus was diagnosed with tetralogy of Fallot and multicystic kidneys. The postmortem study showed missing müllerian structures with small streak ovaries, external male genitalia, and an abnormal cloacal septation (imperforate anus with a sigmoid colon opening in the bladder). As the observed anomalies were related with septation, a mechanism related with the activation of specific growth factors, we discuss the possibility of a disorder in the function of the bone morphogenetic proteins as a common cause for the widespread anomalies found in this fetus.
The Role of Acupuncture in Assisted Reproductive Technology
Authors: Zheng Cui Hong , Zhang Ming Min , Huang Guang Ying , Wang Wei
Published: July 2012

The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA) techniques, on the clinical pregnancy rate (CPR) and live birth rate (LBR) of in vitro fertilization (IVF) or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants) were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.
Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department
Authors: Harvey Martyn , Cave Grant , Prince Gaynor
Published: July 2012

A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20 cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department.
Design of an Integrated Methodology for Analytical Design of Complex Supply Chains
Authors: Rashid Shahid , Weston Richard
Published: July 2012

A literature review and gap analysis indentifies key limitations of industry best practice when modelling of supply chains. To address these limitations the paper reports on the conception and development of an integrated modelling methodology designed to underpin the analytical design of complex supply chains. The methodology is based upon a systematic deployment of EM, CLD, and SM techniques; the integration of which is achieved via common modelling concepts and decomposition principles. Thereby the methodology facilitates: (i) graphical representation and description of key “processing”, “resourcing” and “work flow” properties of supply chain configurations; (ii) behavioural exploration of currently configured supply chains, to facilitate reasoning about uncertain demand impacts on supply, make, delivery, and return processes; (iii) predictive quantification about relative performances of alternative complex supply chain configurations, including risk assessments. Guidelines for the application of each step of the methodology are described. Also described are recommended data collection methods and expected modelling outcomes for each step. The methodology is being extensively case tested to quantify potential benefits & costs relative to current best industry practice. The paper reflects on preliminary benefits gained during industry based case study modelling and identifies areas of potential improvement.
Inchingorei-san (TJ-117) and Artemisiae Capillaris Herba Induced Prolonged Survival of Fully Mismatched Cardiac Allografts and Generated Regulatory Cells in Mice
Authors: Jin Xiangyuan , Uchiyama Masateru , Zhang Qi , Hirai Toshihito , Niimi Masanori
Published: July 2012

We investigated Inchingorei-san (TJ-117), a 6-component Japanese herbal medicine, on alloimmune responses in murine cardiac allograft transplantation. CBA mice underwent transplantation of a C57BL/6 (B6) heart and received oral administration of TJ-117 or each component of TJ-117 from the day of transplantation until 7 days afterward. Naive CBA mice rejected B6 cardiac grafts acutely (median survival time (MST), 7 days). CBA recipients given 1 g/kg/day of TJ-117 had prolonged B6 allograft survival (MST, 37 days). Moreover, given 1 g/kg/day of Artemisiae Capillaris Herba (ACH), one component of TJ-117, indefinitely prolonged B6 allograft survival (MST, >100 days). However, other five components of TJ-117 were less effective than TJ-117 and ACH. Secondary CBA recipients given whole splenocytes, CD4+, and CD4+CD25+cells from primary ACH-treated CBA recipients with B6 cardiac allografts 30 days after grafting had prolonged survival of B6 hearts (MSTs, 57, >100, and >100 days, resp.). Flow cytometry studies showed that the CD4+CD25+Foxp3+regulatory cell population was increased in transplant recipients given ACH. Cell proliferation, interleukin-2, and interferon-γwere suppressed in ACH-treated mice, whereas interleukin-4 and interleukin-10 were upregulated. In conclusion, ACH, one component of TJ-117, as well as TJ-117 induced hyporesponsiveness to fully allogeneic cardiac allografts and may generate CD4+CD25+Foxp3+regulatory cells.
Gender Gaps in Human Capital in Developing Countries: An Empirical Assessment
Authors: Dao Minh Quang
Published: July 2012

This paper examines the impact of various determinants on gender gaps in human capital in developing countries. We find that female primary completion is dependent on per capita GDP growth, female employment in agriculture, in industry, and in services, and the interactions between per capita GDP growth and female employment in industry and in services. We are also able to show that the ratio of girls to boys’ enrollments in primary and secondary schools is a function of the poverty rate, the fraction of the population with access to an improved water source, and maternal mortality. In addition, we observe that girls’ mortality is dependent upon the fraction of the population having access to improved sanitation and water services, and ethnic fractionalization. Finally, we find that maternal mortality is a function of the fraction of the population with access to improved water services, the fraction of births attended by skilled staff, the fraction of women receiving prenatal care, and ethnic fractionalization. These statistical results can assist developing countries identify areas that need to be improved upon in order to reduce gender gaps in human capital—specifically those concerning female mortality and education.
Characterizations of Irregular Multigenerator Gabor Frame on Periodic Subsets of ℝ
Authors: Yuan D. H. , Feng Y. , Shen Y. F. , Yang S. Z.
Published: July 2012

We consider the multigenerator system ,n ∈ ℤ, l = 0, …, r − 1} for φ0, …, φr−1 ∈ L2(𝕊) and a0, b0, …, ar−1, br−1 > 0, where the parameters b0, …, br−1 > 0 are not necessary the same. With the help of frame theory, we provide some sufficient or necessary conditions for the system to be a frame for L2(𝕊). Moreover, we present some characterizations for this system to be a Parseval frame.
The Effect of Control Strength on Lag Synchronization of Nonlinear Coupled Complex Networks
Authors: Wang Shuguo , Yao Hongxing
Published: July 2012

This paper mainly investigates the lag synchronization of nonlinear coupled complex networks using methods that are based on pinning control, where the weight configuration matrix is not necessarily symmetric or irreducible. We change the control strength into a parameter concerning time t, by using the Lyapunov direct method, some sufficient conditions of lag synchronization are obtained. To validate the proposed method, numerical simulation examples are provided to verify the correctness and effectiveness of the proposed scheme.
Synthesis and Characterization of CeO2-SiO2Nanoparticles by Microwave-Assisted Irradiation Method for Photocatalytic Oxidation of Methylene Blue Dye
Authors: Mohamed R. M. , Aazam E. S.
Published: July 2012

CeO2-SiO2nanoparticles were synthesized for the first time by a facile microwave-assisted irradiation process. The effect of irradiation time of microwave was studied. The materials were characterized by N2adsorption, XRD, UV-vis/DR, and TEM. All solids showed mesoporous textures with high surface areas, relatively small pore size diameters, and large pore volume. The X-ray diffraction results indicated that the as-synthesized nanoparticles exhibited cubic CeO2without impurities and amorphous silica. The transmission electron microscopy (TEM) images revealed that the particle size of CeO2-SiO2nanoparticles, which were prepared by microwave method for 30 min irradiation times, was around 8 nm. The photocatalytic activities were evaluated by the decomposition of methylene blue dye under UV light irradiations. The results showed that the irradiation under the microwave produced CeO2-SiO2nanoparticles, which have the best crystallinity under a shorter irradiation time. This indicates that the introduction of the microwave really can save energy and time with faster kinetics of crystallization. The sample prepared by 30 min microwave irradiation time exhibited the highest photocatalytic activity. The photocatalytic activity of CeO2-SiO2nanoparticles, which were prepared by 30 min irradiation times was found to have better performance than commercial reference P25.
Activation of the mTOR Pathway in Primary Medullary Thyroid Carcinoma and Lymph Node Metastases
Authors: Tamburrino Anna , Molinolo Alfredo A. , Salerno Paolo , Chernock Rebecca D. , Raffeld Mark , Xi Liqiang , Gutkind J. Silvio , Moley Jeffrey F. , Wells Samuel A. , Santoro Massimo
Published: July 2012

Purpose: Understanding the molecular pathogenesis of medullary thyroid carcinoma (MTC) is prerequisite to the design of targeted therapies for patients with advanced disease.

Experimental Design: We studied by immunohistochemistry the phosphorylation status of proteins of the RAS/MEK/ERK and PI3K/AKT/mTOR pathways in 53 MTC tissues (18 hereditary, 35 sporadic), including 51 primary MTCs and 2 cases with only lymph node metastases (LNM). We also studied 21 autologous LNMs, matched to 21 primary MTCs. Staining was graded on a 0 to 4 scale (S score) based on the percentage of positive cells. We also studied the functional relevance of the mTOR pathway by measuring cell viability, motility, and tumorigenicity upon mTOR chemical blockade.

Results: Phosphorylation of ribosomal protein S6 (pS6), a downstream target of mTOR, was evident (S ≥ 1) in 49 (96%) of 51 primary MTC samples. This was associated with activation of AKT (phospho-Ser473, S > 1) in 79% of cases studied. Activation of pS6 was also observed (S ≥ 1) in 7 (70%) of 10 hereditary C-cell hyperplasia specimens, possibly representing an early stage of C-cell transformation. It is noteworthy that 22 (96%) of 23 LNMs had a high pS6 positivity (S ≥ 3), which was increased compared with autologous matched primary MTCs (P = 0.024). Chemical mTOR blockade blunted viability (P < 0.01), motility (P < 0.01), and tumorigenicity (P < 0.01) of human MTC cells.

Conclusion: The AKT/mTOR pathway is activated in MTC, particularly, in LNMs. This pathway sustains malignant features of MTC cell models. These findings suggest that targeting mTOR might be efficacious in patients with advanced MTC. Clin Cancer Res; 18(13); 3532–40. ©2012 AACR.
Abiraterone Inhibits 3β-Hydroxysteroid Dehydrogenase: A Rationale for Increasing Drug Exposure in Castration-Resistant Prostate Cancer
Authors: Li Rui , Evaul Kristen , Sharma Kamalesh K. , Chang Kai-Hsiung , Yoshimoto Jennifer , Liu Jiayan , Auchus Richard J. , Sharifi Nima
Published: July 2012

Purpose: Treatment with abiraterone (abi) acetate prolongs survival in castration-resistant prostate cancer (CRPC). Resistance to abi invariably occurs, probably due in part to upregulation of steroidogenic enzymes and/or other mechanisms that sustain dihydrotestosterone (DHT) synthesis, which raises the possibility of reversing resistance by concomitant inhibition of other required steroidogenic enzymes. On the basis of the 3β-hydroxyl, Δ5-structure, we hypothesized that abi also inhibits 3β-hydroxysteroid dehydrogenase/isomerase (3βHSD), which is absolutely required for DHT synthesis in CRPC, regardless of origins or routes of synthesis.

Experimental Design: We tested the effects of abi on 3βHSD activity, androgen receptor localization, expression of androgen receptor–responsive genes, and CRPC growth in vivo.

Results: Abi inhibits recombinant 3βHSD activity in vitro and endogenous 3βHSD activity in LNCaP and LAPC4 cells, including conversion of [3H]-dehydroepiandrosterone (DHEA) to Δ4-androstenedione, androgen receptor nuclear translocation, expression of androgen receptor–responsive genes, and xenograft growth in orchiectomized mice supplemented with DHEA. Abi also blocks conversion of Δ5-androstenediol to testosterone by 3βHSD. Abi inhibits 3βHSD1 and 3βHSD2 enzymatic activity in vitro; blocks conversion from DHEA to androstenedione and DHT with an IC50 value of less than 1 μmol/L in CRPC cell lines; inhibits androgen receptor nuclear translocation; expression of TMPRSS2, prostate-specific antigen, and FKBP5; and decreases CRPC xenograft growth in DHEA-supplemented mice.

Conclusions: We conclude that abi inhibits 3βHSD-mediated conversion of DHEA to active androgens in CRPC. This second mode of action might be exploited to reverse resistance to CYP17A1 inhibition at the standard abi dose by dose-escalation or simply by administration with food to increase drug exposure. Clin Cancer Res; 18(13); 3571–9. ©2012 AACR.
Two-Year Analysis of Efficacy and Safety of Deferasirox Treatment for Transfusional Iron Overload in Sickle Cell Anemia Patients
Authors: Cancado Rodolfo , Olivato Maria Cristina A. , Bruniera Paula , Szarf Gilberto , de Moraes Bastos Roberto , Rezende Melo Murilo , Chiattone Carlos
Published: July 2012

The efficacy and safety of a 2-year treatment with deferasirox was evaluated in 31 patients with sickle cell anemia and transfusional iron overload. At 24 months, there were significant decreases from baseline in mean serum ferritin (from 2,344.6 to 1,986.3 µg/l; p = 0.040) and in mean liver iron concentration (from 13.0 ± 5.4 to 9.3 ± 5.7 mg Fe/g dry weight; p < 0.001). Myocardial T2* values were normal (>20 ms) in all patients at baseline and did not change significantly over the course of the study. However, there was a significant improvement from baseline in left ventricular ejection fraction at 24 months (62.2–64.6%; p = 0.02). Deferasirox was generally well tolerated with no progressive increases in serum creatinine or renal failure observed. These data confirm that deferasirox is effective in reducing body iron burden in patients with sickle cell anemia and transfusional iron overload.
Monogamous and Promiscuous Rodent Species Exhibit Discrete Variation in the Size of the Medial Prefrontal Cortex
Authors: Kingsbury Marcy A. , Gleason Erin D. , Ophir Alexander G. , Phelps Steven M. , Young Larry J. , Marler Catherine A.
Published: July 2012

Limbic-associated cortical areas, such as the medial prefrontal and retrosplenial cortex (mPFC and RS, respectively), are involved in the processing of emotion, motivation, and various aspects of working memory and have been implicated in mating behavior. To determine whether the independent evolution of mating systems is associated with a convergence in cortical mechanisms, we compared the size of mPFC and RS between the monogamous prairie vole (Microtus ochrogaster) and the promiscuous meadow vole (Microtus pennsylvanicus), and between the monogamous California mouse (Peromyscus californicus) and the promiscuous white-footed mouse (Peromyscus leucopus). For both promiscuous mice and voles, the mPFC occupied a significantly larger percentage of total cortex than in the monogamous species. No significant differences were observed for the RS or overall cortex size with respect to mating system, supporting the convergent evolution of mPFC size, specifically. Individual differences in the mating behavior of male prairie voles (wandering versus pair-bonding), presumably facultative tactics, were not reflected in the relative size of the mPFC, which is likely a heritable trait. Given the importance of the mPFC for complex working memory, particularly object-place and temporal order memory, we hypothesize that the relatively greater size of the mPFC in promiscuous species reflects a greater need to remember multiple individuals and the times and locations in which they have been encountered in the home range.
Effect of Fluoridated Milk on Enamel and Root Dentin Demineralization Evaluated by a Biofilm Caries Model
Authors: Giacaman R.A. , Muñoz M.J. , Ccahuana-Vasquez R.A. , Muñoz-Sandoval C. , Cury J.A.
Published: July 2012

Although some studies suggest an anticaries effect of fluoridated bovine milk (F-milk) on enamel, evidence is still considered weak. Even more uncertain, the effect of F-milk on root caries remains largely unknown. This study evaluated the effect of F-milk on enamel and on root dentin demineralization using a validated Streptococcus mutans biofilm model, simulating a high cariogenic challenge. S. mutans (UA159) biofilms were formed on bovine enamel and root dentin saliva-coated slabs after measuring initial surface microhardness (SH). Biofilms were exposed to 10% sucrose 8×/day and treated 2×/day with either: (1) 0.9% NaCl (negative control), (2) bovine milk, (3) F-milk (5.0 ppm F as NaF) or (4) NaF 0.05% (anticaries-positive control). Medium pH was monitored twice/day, as a biofilm acidogenicity indicator. After 5 days for enamel and 4 days for dentin, biofilms were recovered to analyze: biomass, soluble proteins, viable microorganisms, and extra- and intracellular polysaccharides. Enamel and dentin demineralization were estimated by percentage of SH loss. Results were compared by ANOVA and Tukey’s test. Neither acidogenicity nor biofilm composition differed among treatment groups in biofilms formed on enamel or dentin (p > 0.05). F-milk, however, significantly reduced enamel and dentin demineralization when compared with the negative control (p < 0.05). Also, F-milk was as efficient as 0.05% NaF to reduce enamel (p > 0.05), but not dentin demineralization (p < 0.05). These findings suggest that milk containing 5.0 ppm of fluoride is effective to control enamel caries and that it may be effective on root dentin caries prevention.
Changes in Gene Expression Profile in Human Subcutaneous Adipose Tissue during Significant Weight Loss
Authors: Leyvraz Céline , Verdumo Chantal , Suter Michel , Paroz Alexandre , Calmes Jean-Marie , Marques-Vidal Pedro M. , Giusti Vittorio
Published: July 2012

Objective: To analyze the expression of peroxisome proliferator-activated receptor-γ1 and 2 (PPARγ1 and 2), 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1), and leptin in adipose tissue (AT) of obese women during weight loss following Roux-en-Y gastric bypass (RYGB) and to compare these levels with those obtained in AT of nonobese subjects. Methods: Gene expression was determined by real-time RT-PCR prior to surgery and at 3, 6, and 12 months after RYGB. Results: All obese patients lost weight, reaching a mean BMI of 29.3 ± 1.0 kg/m2 at 1 year after surgery (–33.9 ± 1.5% of their initial body weight). In obese subjects leptin and 11βHSD1 were over-expressed, whereas PPARγ1 was expressed at lower levels compared to controls. After surgery, leptin and 11βHSD1 gene expression decreased, whereas PPARγ1 expression increased. At 12 months after RYGB, these 3 genes had reached levels similar to the controls. In contrast, PPARγ2 gene expression was not different between groups and types of tissue and remained unchanged during weight loss. We found a positive correlation between BMI and levels of gene expression of leptin and 11βHSD1. Conclusion: Gene expression of leptin, PPARγ1, and 11βHSD1 in AT is modified in human obesity. This default is completely corrected by RYGB.
Understanding Joshua 10:12-14 in its Context
Authors: Yu James
Published: July 2012

Joshua 10:12-14 is studied in its literary context and is to be read as an artistic stroke in a picture of YHWH’s holy war.
Exegetical Note on Matthew 25.31-46: The Parable of the Sheep and the Goats
Authors: Down Martin
Published: July 2012

Does the parable of the Sheep and the Goats teach a doctrine of salvation by works? These notes offer an examination of the meaning of the words of Jesus in Matthew 25.40.
Current and emerging therapies in multiple sclerosis: a systematic review
Authors: Castro-Borrero Wanda , Graves Donna , Frohman Teresa C. , Flores Angela Bates , Hardeman Paula , Logan Diana , Orchard Megan , Greenberg Benjamin , Frohman Elliot M.
Published: July 2012

Multiple sclerosis (MS) is a potentially disabling chronic autoimmune neurological disease that mainly affects young adults. Our understanding of the pathophysiology of MS has significantly advanced in the past quarter of a century. This has led to the development of many disease-modifying therapies (DMTs) that prevent exacerbations and new lesions in patients with relapsing remitting MS (RRMS). So far there is no drug available that can completely halt the neurodegenerative changes associated with the disease. It is the purpose of this review to provide concise information regarding mechanism of action, indications, side effects and safety of Food and Drug Administration and European Medicines Agency approved agents for MS, emerging therapies, and drugs that can be considered for off-label use in MS.
Blood pressure lowering in acute phase of stroke: latest evidence and clinical implications
Authors: Patarroyo Sully Xiomara Fuentes , Anderson Craig
Published: July 2012

Persistent controversy exists as to whether there are worthwhile beneficial effects of early, rapid lowering of elevated blood pressure (BP) in acute stroke. Elevated BP or ‘hypertension’ (i.e. systolic >140 mmHg) is common in stroke, especially in patients with pre-existing hypertension and large strokes, due to variable ‘autonomic stress’ and raised intracranial pressure. While positive associations between BP levels and poor outcomes are evident across a range of studies, very low BP levels and large reductions in BP have also been shown to predict death and dependence, more so for ischaemic stroke (IS) than intracerebral haemorrhage (ICH). Accumulating evidence indicates that early BP lowering can reduce haematoma expansion in ICH, but there is uncertainty over whether this translates into improved clinical outcomes, particularly since such an effect was not evident from haemostatic therapy in clinical trials. Guidelines generally recommend control of high systolic BP (>180 mmHg), but recent evidence indicates that even more modest elevation (>140 mmHg) increases risks of cerebral oedema and haemorrhagic transformation following thrombolysis in IS. Thus, any potential benefits of rapid BP lowering in acute stroke, particularly in IS, must be balanced against the potential risks of worsening cerebral ischaemia from altered autoregulation/perfusion. This paper explores current knowledge regarding the management of hypertension in acute stroke and introduces ongoing clinical trials aimed at resolving such a critical issue in the care of patients with acute stroke.
Management of patients with Alzheimer’s disease: pharmacological treatment and quality of life
Authors: Mossello Enrico , Ballini Elena
Published: July 2012

A methodological approach to quality of life (QoL) assessment in Alzheimer’s disease (AD) is challenging and few clinical trials have included it among outcomes, with conflicting results. In this review an indirect appraisal of evidence has been performed, searching the literature for the effect of drug treatments on determinants of QoL in AD. Among clinical factors associated with QoL, possible targets of drugs include cognition, which seems to be associated with QoL in early disease and can be positively affected by cholinesterase inhibitors (CIs) in this stage; functional decline, the risk of which can be decreased by CIs and memantine (MEM); behavioral and psychological symptoms, which can be reduced by MEM and atypical antipsychotics. Long-term observational studies have associated CIs and MEM treatment with a reduced institutionalization risk. According to the evidence, drug treatment of depression associated with AD should not be first choice from a QoL perspective, while treatment of pain can have beneficial effects on wellbeing indicators also in the late stages of the disease. Possible drug-related adverse events can affect QoL and should always be weighed against expected benefits from the patient’s perspective. For this reason antipsychotic treatment is often problematic in AD and should be limited to severe psychosis and aggression, using the lowest effective doses for the shortest possible period. Conversely titration of CIs is necessary to reach the most effective dosages, although dose-related risk of adverse events has to be taken into account. Finally, CIs and MEM have been shown to reduce caregiver burden in randomized trials, possibly affecting caregivers’ QoL.
Dexmedetomidine Controls Supraventricular Tachycardia Following Cardiac Surgery in a Child
Authors: Delwadia Sonya , Naguib Aymen , Tobias Joseph D.
Published: July 2012

Dexmedetomidine is an α2-adrenergic agonist which initially received US Food and Drug Administration (FDA) approval in the United States in 1999 for the sedation of adults during mechanical ventilation and then in 2009 for monitored anesthesia care. Although generally viewed as an adverse effect, bradycardia and the negative chronotropic effects may be beneficial in certain patient populations and have occasionally been used as a therapeutic maneuver. We present a case summary describing intraoperative and postoperative use of dexmedetomidine to treat and control supraventricular tachycardia in a 5-year-old boy undergoing surgical repair of a large atrial septal defect. The specific effects of dexmedetomidine on the cardiac conduction system are reviewed and previous reports of its use as a therapeutic agent for the treatment of perioperative tachyarrhythmias are discussed.
Controlling Oxygenation During Initiation of Cardiopulmonary Bypass
Authors: Babu Balram , Bhat Seetharam , Prabuswamy Honnur Puttaswamy , Kamalapurkar Giridhar , Kumar Honnekare Venkataiah Jayanth , Libu Gnanaseelan Kanakamma , Shilpa Suresh , Lokesh Bhuvanahalli Karigowda
Published: July 2012

Objective: Cardiopulmonary bypass (CPB) initiated with high oxygen levels may expose cyanotic children to reoxygenation injury. The ideal method of initiation of bypass to prevent this phenomenon still remains largely unproven. This study tested the hypothesis that controlling oxygenation during initiation of CPB improves early postoperative outcomes. Methods: Thirty-one cyanotic children were randomized to two treatment arms of the study. In group A (intervention), CPB was initiated with fraction of inspired oxygen (Fio2) 0.21, and after one minute of full bypass, Fio2 was increased at increments of 0.1 per minute to reach 0.6. In group B (hyperoxemic), CPB was initiated using Fio2 >0.6. Aortic cross clamp time (minutes), CPB time (minutes), creatine phosphokinase-MB (CPK-MB) levels (U/L), lactate levels (mmol/L), duration of ventilator support (hours), inotropic support (hours), and intensive care unit (ICU) stay (hours) as well as hospital mortality were measured. Results: Levels of CPK-MB (group A mean = 59.6 U/L, 95% confidence interval [CI]: 45.9-73.3; group B mean = 82.6 U/L, 95% CI: 66.1-99.1, P = .016) and ventilation time (group A median = 16.5 hours; interquartile range [IQR] = 11.25-23; group B median = 27.5 hours; IQR = 17-54, P = .045) were significantly lower in the intervention group. Other parameters showed no significant differences: CPB time (group A median = 71.5 minutes, IQR = 64-100; group B median = 95.5 minutes, IQR = 58-145, P = .71), cross clamp time (group A mean = 59.2 minutes, 95% CI: 47.6-70.8; group B mean = 66.57 minutes, 95% CI: 47.6-88.5, P =.57), lactate levels (mmol/L; group A median = 1.8, IQR = 1.48-2.59; group B median = 2.1, IQR = 1.29-2.62, P = 1), inotropic support (group A median = 47.5 hours, IQR = 36-73.75; group B median = 59.5 hours, IQR = 41.75-92.5, P = .27), ICU stay (group A median = 59.5 hours, IQR = 48.25-118.5; group B median = 85 hours, IQR = 47.75-137.50, P = .21), and mortality (group A n = 2, group B n = 2). Conclusion: A controlled oxygenation protocol was associated with significantly lower postoperative CPK-MB levels. Evaluation of other end points including ventilation times requires a study with larger sample size for validation.
Left Ventricular and Mitral Valve Function Long After Repair of Left Anomalous Coronary Artery From the Pulmonary Artery
Authors: Georgiev Stanimir G. , Lazarov Stojan D. , Mitev Ivajlo D. , Latcheva Alexandra Z. , Christov Georgi A. , Velkovski Ivan G. , Mitev Plamen D.
Published: July 2012

Background: The study evaluates the long-term results of surgery for anomalous left coronary artery from the pulmonary artery (ALCAPA) with special attention on the left ventricular (LV) function and mitral regurgitation. Methods: Twenty-one children underwent surgery for ALCAPA over 23 years (1987-2010). All patients underwent establishment of a two-coronary system, by direct reimplantation (n = 13) or by intrapulmonary tunnel technique (n = 8), with concomitant mitral valve repair in one. The follow-up echocardiograms were evaluated to assess LV function and mitral regurgitation. Results: Five patients died. The age of the nonsurvivors was lower, 4.2 ± 1.3 versus 22.7 ± 29.4 months, P = .04. All nonsurvivors had moderate or severe mitral regurgitation preoperatively and higher LV diameter z score than the survivors: 11.8 (9-14.6) versus 4.6 (1.9-13.1), P = .01. At last follow-up, all survivors were asymptomatic; the diastolic LV diameter was normal, with z scores: 0.3 (0.1-1.9) versus 7 (1.9-14.6) preoperatively, P = .001, as was the LV ejection fraction: 66% (61%-78%) versus 38% (16%-70%) preoperatively, P = .001. Fifteen patients had moderate or severe mitral regurgitation at initial presentation and it eventually regressed to insignificant in all survivors ( P = .001). No subsequent interventions on the coronary arteries or the mitral valve were needed. Four patients with intrapulmonary tunnel had mild suprapulmonary obstruction with Doppler peak gradients between 20 and 30 mm Hg. Conclusions: In our experience, establishment of a two-coronary circulation without mitral valve repair leads to normalization of LV dimension and systolic function and to improvement of mitral regurgitation in the surviving patients. Mortality is related to low age and to the associated higher degree of LV dysfunction.
Pentalogy of Cantrell
Authors: Bellotti Christopher A. , Stewart Robert D. , Golden Alex B. , Mavroudis Constantine , Vachhani Neil
Published: July 2012

Pentalogy of Cantrell is a rare diagnosis consisting of several midline defects of the sternum, abdominal wall, diaphragm, pericardium, and heart. One of the known features is ventricular diverticulum that can represent a technical challenge surgically. This is a follow-up case report of the successful simultaneous resection of a biventricular diverticulum and omphalocele repair after previous report of repair of complex intracardiac disease in the same patient.
The Curious Case of a Button Which Led to the Needle
Authors: Saileela R. , Sridhar Anuradha , Premsekar R. , Agarwal Ravi , Shankar Janani , Cherian K. M.
Published: July 2012

Foreign bodies in the heart are uncommon in children. These are often removed even if asymptomatic to prevent complications like erosion, embolization, bleeding, thrombosis, and endocarditis. We report the case of a one-and-a-half-year-old child with a hypodermic needle in the heart which was found incidentally and removed successfully by surgery.
Plastic Bronchitis in Patients With Fontan Physiology: Review of the Literature and Preliminary Experience With Fontan Conversion and Cardiac Transplantation
Authors: LaRue Madeleine , Gossett Jeffrey G. , Stewart Robert D. , Backer Carl L. , Mavroudis Constantine , Jacobs Marshall L.
Published: July 2012

Plastic bronchitis is a rare, life-threatening condition characterized by the formation of mucofibrinous casts within the pulmonary bronchi. In patients with congenital heart disease, it is most frequently observed in single ventricular anatomies after Fontan palliation. The pathophysiology of plastic bronchitis remains unknown, and a consistently effective treatment strategy has yet to be identified. We report two cases of plastic bronchitis in patients with Fontan physiology. The first was treated with Fontan conversion and, despite encouraging short-term results, experienced recurrence of cast formation seven months postoperatively. The second underwent cardiac transplantation and has been free of bronchial casts for over one year. In addition, we explore the similarities between plastic bronchitis and protein-losing enteropathy, considering theories of their pathophysiologic mechanisms and reports of mutually effective treatment strategies. We propose that bronchial cast formation may result from the confluence of genetic makeup, inflammation, and the Fontan physiology and conclude that further investigation into therapies directed at these factors is merited.
Palliative Arterial Switch Operation in the Context of Multiple Ventricular Septal Defects, Potentially Biventricular and Univentricular Hearts With Malposed Great Arteries
Authors: Katewa Ashish , Marwah Ashutosh , Singh Vishal , Sharma Rajesh
Published: July 2012

Background: This study is an examination of our unit’s experience with palliative arterial switch in univentricular and potentially biventricular hearts with transposition of the great arteries (TGA). Methods: These patients were divided into three groups based on their physiology. (a) Single ventricle physiology (n = 8), in which all the patients had univentricular hearts, TGA, and subaortic stenosis (SAS). (b) Borderline biventricular physiology (n = 4), in which the patients had TGA, ventricular septal defect (VSD), and hypoplastic right ventricle (RV). (c) Biventricular physiology (n = 3), in which the patients had TGA and multiple VSDs. Results: In all, 12 (80%) patients survived. Seven of these have undergone second stage surgery (cavopulmonary shunt, n = 5; biventricular repair, n = 2). Conclusion: Palliative arterial switch is an alternative to Norwood procedure and modifications thereof for managing SAS in single ventricle with malposed great arteries. Palliative switch with adjunctive pulmonary artery band may be a temporizing measure in TGA with multiple VSDs, where the VSDs are judged to be inaccessible through the tricuspid valve or through either of the great arteries. It may also be utilized for TGA and hypoplastic RV instead of committing them to univentricular pathway and keeping the option of biventricular repair.
Challenges in the Management of Patients With Functionally Univentricular Heart in Turkey
Authors: Sarioglu Tayyar , Yalcinbas Yusuf Kenan , Erek Ersin , Sarioglu Ayse
Published: July 2012

Management of patients with functionally univentricular heart encompasses a wide array of developments over the years in every country. This article describes our working group experiences and 30-year story of single ventricle surgery in Turkey. Diagnosis, surgical treatment, and medical treatment of this complex group of patients necessitate courageous and continuous team effort with multi-institutional collaboration.
Serum Cardiac Troponin T in Asphyxiated Term Neonates Delivered at Two Teaching Hospitals in Lagos, Nigeria
Authors: Uzodimma Chinyere C. , Okoromah Christy A. N. , Ekure Ekanem , Ezeaka Chinyere V. , Njokanma Fidelis O.
Published: July 2012

Background: Asphyxia is a leading cause of perinatal morbidity and mortality in the developing countries. All organs including the myocardium are vulnerable to ischemic injury in asphyxia. The aim of the current study was to assess myocardial injury in asphyxiated full-term neonates using their serum cardiac troponin T levels. Methods: In all, 30 term asphyxiated neonates and 30 gestational age-, birth weight-, and sex-matched controls were studied. Asphyxia was defined by double criteria of low umbilical arterial blood pH <7.20 and low five-minutes Apgar score ≤6, while the controls were term nonasphyxiated neonates with umbilical arterial blood pH ≥7.20 and five minutes Apgar score >6. The umbilical arterial pH was done soon after delivery, while the serum cardiac troponin T was done within the first 4 to 24 hours of life. Results: Participants and controls were similar in terms of mean gestational age, mode of delivery, gender, and birth weight ( P = 1.0, .07, 1.0, and 1.0, respectively). Two thirds of the asphyxiated babies had elevated serum cardiac troponin T in the high risk range (> 0.1 ng/mL). On the contrary, none of the controls had serum cardiac troponin T in that range. Serum cardiac troponin T showed negative correlation with pH ( r = −.75), five-minute Apgar score ( r = −.74), and one-minute Apgar score ( r = −0.70). Conclusion: The study identified perinatal asphyxia as a high-risk factor for elevated serum cardiac troponin T and hence for myocardial cellular injury.
Hematologic Alterations in Patients with Functionally Univentricular Hearts
Authors: Makhija Zeena , Sharma Rajesh
Published: July 2012

Coagulation factor deficiencies may predispose patients with functionally univentricular hearts to bleeding tendencies preoperatively and perioperatively. Postoperatively, this is altered to a prothrombotic predisposition in these patients. Early and late thromboembolic events secondary to a prothrombotic state following univentricular repair contribute to significant morbidity after establishment of the Fontan circulation. Anticoagulation following univentricular repair is advocated but its benefits are controversial.
Thermal expansion of alunite up to dehydroxylation and collapse of the crystal structure
Authors: Zema M. , Callegari A. M. , Tarantino S. C. , Gasparini E. , Ghigna P.
Published: July 2012

The high-temperature (HT) behaviour of a sample of natural alunite was investigated by means of in situ HT single-crystal X-ray diffraction from room temperature up to the dehydroxylation temperature and consequent collapse of the crystal structure. In the temperature range 25–500°C, alunite expands anisotropically, with most of the contribution to volume dilatation being produced by expansion in the c direction. The thermal expansion coefficients determined over the temperature range investigated are: αa = 0.61(2) × 10–5 K–1 (R2 = 0.988), αc = 4.20(7) × 10–5 K–1 (R2 = 0.996), αc/αa = 6.89, αV = 5.45(7) × 10–5 K–1 (R2 = 0.998). At ∼275–300°C, a minor discontinuity in the variation of unit-cell parameters with temperature is observed and interpreted on the basis of loss of H3O+ that partially substitutes for K+ at the monovalent A site in the alunite structure. Increasing temperature causes the Al(O,OH)6 sheets, which remain almost unaltered along the basal plane, to move further apart, and this results in an expansion of the coordination polyhedron around the intercalated potassium cation. Sulfate tetrahedra act as nearly rigid units, they contract a little in the lower temperature range to accommodate the elongation of the Al octahedra.
Retrograde strontium metasomatism in serpentinite mélange of the Kurosegawa Zone in central Kyushu, Japan
Authors: Miyazoe T. , Enami M. , Nishiyama T. , Mori Y.
Published: July 2012

Strontium-rich epidote, including epidote-(Sr) and epidote with major amounts of Sr (i.e. epidote containing up to 17.3 wt.% SrO), was found in pumpellyite schist and epidote blueschist in a tectonic block in the serpentinite mélange of the Kurosegawa Zone, central Kyushu, Japan. The tectonic block is 20 m wide and made primarily of lawsonite blueschist, with subordinate amounts of pumpellyite schist and epidote blueschist. The pumpellyite schist typically occurs at the edge of the block and is composed mainly of pumpellyite with subordinate amounts of strontium-poor epidote, albite and chlorite, and thin veins of fine-grained calcite and clinopyroxene. Epidote-(Sr) forms rims around strontium-poor epidote, fills fractures in strontium-poor epidote and also occurs interstitially between pumpellyite aggregates and along the boundaries between pumpellyite and calcite-clinopyroxene veins. The epidote blueschist is found between the pumpellyite schist and lawsonite blueschist, and consists mainly of sodic amphibole, epidote and titanite, with albite veining. Strontium-rich epidote occurs as rims, replacing Sr-poor epidote near the albite vein. The bulk strontium contents of the rocks are as follows: lawsonite blueschist (200 ppm), epidote blueschist (2800 ppm) and pumpellyite schist (~10,700 ppm). The chemical and petrological characteristics of the Sr-rich epidote-bearing metabasites suggest that the infiltration of a metamorphic fluid promoted extensive Sr metasomatism during the later stages of high-pressure metamorphism.
Genes2FANs: connecting genes through functional association networks
Authors: Dannenfelser Ruth , Clark Neil R , Ma'ayan Avi
Published: July 2012

Background

Protein-protein, cell signaling, metabolic, and transcriptional interaction networks are useful for identifying connections between lists of experimentally identified genes/proteins. However, besides physical or co-expression interactions there are many ways in which pairs of genes, or their protein products, can be associated. By systematically incorporating knowledge on shared properties of genes from diverse sources to build functional association networks (FANs), researchers may be able to identify additional functional interactions between groups of genes that are not readily apparent.

Results

Genes2FANs is a web based tool and a database that utilizes 14 carefully constructed FANs and a large-scale protein-protein interaction (PPI) network to build subnetworks that connect lists of human and mouse genes. The FANs are created from mammalian gene set libraries where mouse genes are converted to their human orthologs. The tool takes as input a list of human or mouse Entrez gene symbols to produce a subnetwork and a ranked list of intermediate genes that are used to connect the query input list. In addition, users can enter any PubMed search term and then the system automatically converts the returned results to gene lists using GeneRIF. This gene list is then used as input to generate a subnetwork from the user’s PubMed query. As a case study, we applied Genes2FANs to connect disease genes from 90 well-studied disorders. We find an inverse correlation between the counts of links connecting disease genes through PPI and links connecting diseases genes through FANs, separating diseases into two categories.

Conclusions

Genes2FANs is a useful tool for interpreting the relationships between gene/protein lists in the context of their various functions and networks. Combining functional association interactions with physical PPIs can be useful for revealing new biology and help form hypotheses for further experimentation. Our finding that disease genes in many cancers are mostly connected through PPIs whereas other complex diseases, such as autism and type-2 diabetes, are mostly connected through FANs without PPIs, can guide better strategies for disease gene discovery. Genes2FANs is available at: http://actin.pharm.mssm.edu/genes2FANs.