bluuebunny/crossref_metadata_2025 huggingface dataset:
Endosonography for Rectal Carcinoma: Preoperative TNM Staging Compared to Histology
Authors: Tio TL , Coene PPLO
Published: April 2016

Transreccal endosonography was performed preoperatively in 58 patients with rectal carcinoma. The results of endosonography were compared to the histology of resected specimens according to the new (1987) TNM (tumour, nodes, metastases) classification. Endosonography was accurate in the staging of tumour categories except with T2 carcinomas because of concomitant peritoneal abscesses, inflammation or tissue changes after irradiation therapy. The overall accuracy of endosonography was 81 %. Overstaging occurred in 17% and understaging in 2%. The accuracy of endosonography for staging regional lymph nodes was 74%, sensitivity was 95% and specificity 61 %. Endosonography was not accurate in the staging of distant metastases due to the limited penetration depth of ultrasound used. In conclusion, endosonography will become the standard for staging rectal carcinoma.
Inflammatory Bowel Disease Incidence and Prevalence in Southern Alberta
Authors: Davis Faith G , Grace Michael G , Hershfield Noel
Published: April 2016

Incidence and prevalence rates of inflammatory bowel disease
were estimated for 1976‐81 in southern Alberta. Cases were identified using
hospital and physician records and membership lists of the Canadian Foundation
for Ileitis and Colitis. A mail survey was conducted to obtain demographic data.
Population data were obtained from Statistics Canada. The overall prevalence
rate of IBO in men was 69.1 per 105 and 97.6 per 105 in women. Incidence rates
of IBD were 6.0 per 105 per year in men and 9.2 per 105 per year in women.
These six differences were due to Crohn′s disease as female incidence rates were
twice that of male rates 6.3 per 105 per year versus 3. L per LOS per year. A bimodal
age distribution and female predominance in the younger age groups was apparent
for Crohn′s disease.
Role of Intestinal Microflora in Initiation and Perpetuation of Inflammatory Bowel Disease
Authors: Sartor RB
Published: April 2016

Ulcerative colitis and Crohn's disease occur in regions of the intestine colonized by the highest concentrations of normal flora bacteria and resemble certain chronic bacterial, viral or parasitic infections. However, the role of endogenous and pathogenic bacteria in the induction and perpetuation of chronic idiopathic intestinal inflammation remains controversial. No convincing evidence incriminates a single bacterial, mycobacterial or viral agent as the cause of a high percentage of cases of idiopathic inflammatory bowel disease (IBD). Subtle alterations of luminal microbial flora are nearly impossible to detect, but concentrations of certain anaerobic bacteria, including Bacteroides vulgatus, are increased in active Crohn's disease and correlate with disease activity. Recent investigations suggest mechanisms which bacteria may induce an autoimmune response through molecular mimicry or alterations in host antigens or immunoregulation. Intestinal bacteria contain formylated peptides and cell wall polymers ( endotoxin and peptidoglycan-polysaccharide complexes) which have potent and well characterized inflammatory and immunoregulatory properties and can produce acute and chronic intestinal and systemic inflammation in experimental animals. These proinflammatory molecules are probably absorbed more readily in IBO due ro increased mucosa! permeability during active and perhaps quiescent phases of disease. While the primary mechanisms of intestinal injury remain unknown, it is likely that commensal bacteria and their products amplify and perpetuate the inflammatory response of IBO and may be responsible for extraintestinal manifestations in addition to the frequent septic complications of these diseases.
Hepatic Hemangioma: An Unusual Cause of Fever of Unknown Origin
Authors: Hopkins Kathleen , Bailey Robert J
Published: April 2016

A patient with a giant cavernous hemangioma of the liver presented with fever of unknown origin. Extensive investigation revealed no other source of temperature. Following surgical resection of the Lesion the fever resolved. Pathology of the benign cavernous hemangioma showed only areas of thrombosis.
Overtubes and Foreign Bodies
Authors: Marcon Norman E
Published: April 2016

The most common article ingested in adults is food or food products such as nuts, shells, pits and bones. Poorly chewed steak causing bolus obstruction occurs especially in the elderly, while coins are most common in the pediatric group. New techniques of flexible endoscopy have altered and improved management, decreasing the need for surgery. A foreign body in the esophagus mandates prompt removal to avoid perforation. At least 80% of foreign, bodies reaching the stomach pass spontaneously. Once the foreign body is beyond the distal duodenum, it should be followed with serial x-rays. Techniques of removal of meat, bones, shells, bezoars, glass, bottle tops, sharps, pencils, pens, wires, thermometers, gastrostomy tubes, obesity balloons, safety pins, razor blades, button batteries and cocaine packets are described. Complications related to foreign body removal are rare.
The University Endoscopy Unit: The Standard of Care?
Authors: Golubov Jordan , Adams Paul C
Published: April 2016

In an attempt to investigate practice patterns of the modern gastrointestinal endoscopy unit, a survey was undertaken in 10 university-affiliated endoscopy units in three Ontario cities. The results showed that there was a wide range of premedications used, a nd that there was variation tn the extent of patient monitoring, the method of endoscope sterilization and the degree of safety precautions. This survey provides information on the 'standard of care' in the university endoscopy unit and provides a framework for discussion for the establishment of guidelines for the modern gastrointestinal endoscopy unit.
Severe Sepsis Associated with Lemierre’s Syndrome: A Rare but Life-Threatening Disease
Authors: Tawa Audrey , Larmet Raphaëlle , Malledant Yannick , Seguin Philippe
Published: April 2016

Background.The incidence of Lemierre’s syndrome has increased in the past decade. This posttonsillitis complication may be life threatening.Case Presentation.A 19-year-old patient was admitted to Surgical Intensive Care Unit of a French University Hospital for high fever, low blood pressure, and haemoptysis following a sore throat episode. Blood analysis revealed a thrombopenia, an acute renal failure, and an elevated lactate serum.Fusobacterium necrophorumwas found in blood cultures. Computed tomography of the neck and lungs confirmed the diagnosis of Lemierre’s syndrome: pleural effusions, bilateral lung infiltrates, and an internal jugular vein thrombosis. Fluid administration and antibiotic treatment were quickly initiated. Patient left the unit four days after his admission without any organ dysfunction.Conclusion.Lemierre’s syndrome may lead to multiorgan dysfunction and should be rapidly identified.
Curcumin Downregulates Phosphate Carrier and Protects against Doxorubicin Induced Cardiomyocyte Apoptosis
Authors: Junkun Lu , Erfu Chu , Tony Hasahya , Xin Li , Sudeep K. C. , Mingliang Zhang , Yanqin Wang , XiangQian Qi
Published: April 2016

Aim. To explore the effects of curcumin on phosphate carrier (PiC) and its role in protection against doxorubicin induced myocyte toxicity.Methods. Using H9c2 cell line, the cardiotoxic effect of doxorubicin and its mitigation by curcumin were studied. H9c2 cells were cultured with doxorubicin and/or curcumin at various concentrations. Analysis for apoptosis of H9c2 was done using flow cytometry. Confocal laser scanning microscopy was used to record the fluorescence intensity ratios and to determine the mitochondrial permeability transition pore (MPTP) opening state. Oxidative stress was measured using glutathione level, superoxide dismutase activities, and malondialdehyde content. The effect of doxorubicin and curcumin on PiC gene expression was measured by real-time PCR.Results. Curcumin decreased mRNA of PiC and was partly protective against oxidative stress, loss of mitochondrial transmembrane potential, and apoptosis induced by doxorubicin. Interestingly, the effect was not clearly dose dependent and the concentration of 12 mg/L was more efficient than 15 and 10 mg/L.Conclusion. Curcumin downregulates PiC and partly protects against doxorubicin induced oxidative stress and myocyte apoptosis.
Laryngeal Langerhans Cell Histiocytosis Presenting with Neck Mass in an Adult Woman
Authors: Jahandideh Hesam , Nasoori Yasser , Rostami Sara , Safdarian Mahdi
Published: April 2016

Langerhans cell histiocytosis (LCH) is a very rare condition that commonly affects the head and neck region. There are very few cases of isolated laryngeal involvement by LCH, mostly reported in pediatric patients. Here, we report a case of laryngeal LCH in a 62-year-old woman presenting with a neck mass several weeks ago. The clinical and histopathological findings are reported with a brief discussion about the disease.
Mathematical Model of Three Age-Structured Transmission Dynamics of Chikungunya Virus
Authors: Agusto Folashade B. , Easley Shamise , Freeman Kenneth , Thomas Madison
Published: April 2016

We developed a new age-structured deterministic model for the transmission dynamics of chikungunya virus. The model is analyzed to gain insights into the qualitative features of its associated equilibria. Some of the theoretical and epidemiological findings indicate that the stable disease-free equilibrium is globally asymptotically stable when the associated reproduction number is less than unity. Furthermore, the model undergoes, in the presence of disease induced mortality, the phenomenon of backward bifurcation, where the stable disease-free equilibrium of the model coexists with a stable endemic equilibrium when the associated reproduction number is less than unity. Further analysis of the model indicates that the qualitative dynamics of the model are not altered by the inclusion of age structure. This is further emphasized by the sensitivity analysis results, which shows that the dominant parameters of the model are not altered by the inclusion of age structure. However, the numerical simulations show the flaw of the exclusion of age in the transmission dynamics of chikungunya with regard to control implementations. The exclusion of age structure fails to show the age distribution needed for an effective age based control strategy, leading to a one size fits all blanket control for the entire population.
Acute Pyelonephritis with Bacteremia Caused byEnterococcus hirae: A Rare Infection in Humans
Authors: Pãosinho Ana , Azevedo Telma , Alves João V. , Costa Isabel A. , Carvalho Gustavo , Peres Susana R. , Baptista Teresa , Borges Fernando , Mansinho Kamal
Published: April 2016

Enterococci are one of the usual residents of the microflora in humans. In the last decade this genus has been reported as the third most common cause of bacteremia. We present the case of a 78-year-old female who was admitted to the emergency room because of nausea, lipothymia, and weakness. She was diagnosed with a pyelonephritis with bacteremia, with the isolation in blood and urine cultures ofEscherichia coliandEnterococcus hirae. This last microorganism is a rarely isolated pathogen in humans. Currently it is estimated to represent 1–3% of all enterococcal species isolated in clinical practice.
Predicting Geotechnical Investigation Using the Knowledge Based System
Authors: Žlender Bojan , Jelušič Primož
Published: April 2016

The purpose of this paper is to evaluate the optimal number of investigation points and each field test and laboratory test for a proper description of a building site. These optimal numbers are defined based on their minimum and maximum number and with the equivalent investigation ratio. The total increments of minimum and maximum number of investigation points for different building site conditions were determined. To facilitate the decision-making process for a number of investigation points, an Adaptive Network Fuzzy Inference System (ANFIS) was proposed. The obtained fuzzy inference system considers the influence of several entry parameters and computes the equivalent investigation ratio. The developed model (ANFIS-SI) can be applied to characterize any building site. The ANFIS-SI model takes into account project factors which are evaluated with a rating from 1 to 10. The model ANFIS-SI, with integrated recommendations can be used as a systematic decision support tool for engineers to evaluate the number of investigation points, field tests, and laboratory tests for a proper description of a building site. The determination of the optimal number of investigative points and the optimal number of each field test and laboratory test is presented on reference case.
Hair Mercury Levels Detection in Fishermen from Sicily (Italy) by ICP-MS Method after Microwave-Assisted Digestion
Authors: Giangrosso Giuseppe , Cammilleri Gaetano , Macaluso Andrea , Vella Antonio , D’Orazio Nicolantonio , Graci Stefania , Lo Dico Gianluigi Maria , Galvano Fabio , Giangrosso Margherita , Ferrantelli Vincenzo
Published: April 2016

A number of ninety-six hair samples from Sicilian fishermen were examined for total mercury detection by an Inductively Coupled Plasma Mass Spectrometry (ICP-MS) method. The mercury levels obtained were compared with mercury levels of 96 hair samples from a control group, in order to assess potential exposure to heavy metals of Sicilian fishermen due to fish consumption and closeness to industrial activities. Furthermore, the mercury levels obtained from hair samples were sorted by sampling area in order to verify the possible risks linked to the different locations. The overall mean concentration in the hair of the population of fishermen was6.45±7.03 μg g−1, with a highest value in a fisherman of Sciacca (16.48 μg g−1). Hair mercury concentration in fishermen group was significantly higher than in control group (p<0.01). There was no significant difference in hair total mercury concentrations between sampling areas (p>0.05). The results of this study indicate a greater risk of exposure to mercury in Sicilian fishermen, in comparison to the control population, due to the high consumption of fish and the close relationship with sources of exposure (ports, dumps, etc.).
Review of theTrifolium amabileComplex in Peru, with the Description of a New Species
Authors: Molinari-Novoa Eduardo Antonio
Published: April 2016

Here, we describeTrifolium absconditumsp. nov., a new species of theT. amabilecomplex from South America. It differs from other PeruvianTrifoliaof the complex by having smaller stipules, leaves, inflorescences, and floral pieces. A key for Peruvian species of the complex is presented, and typifications for them are made when necessary and material is available in Peruvian herbaria. Thus, the number of Peruvian species in the complex is elevated to three:T. amabile,T. absconditum, and a resurrectedT. peruvianum. Finally, it is suggested that Chile must be excluded from the distribution of this complex.
Automatic Tissue Differentiation Based on Confocal Endomicroscopic Images for Intraoperative Guidance in Neurosurgery
Authors: Kamen Ali , Sun Shanhui , Wan Shaohua , Kluckner Stefan , Chen Terrence , Gigler Alexander M. , Simon Elfriede , Fleischer Maximilian , Javed Mehreen , Daali Samira , Igressa Alhadi , Charalampaki Patra
Published: April 2016

Diagnosis of tumor and definition of tumor borders intraoperatively using fast histopathology is often not sufficiently informative primarily due to tissue architecture alteration during sample preparation step. Confocal laser microscopy (CLE) provides microscopic information of tissue in real-time on cellular and subcellular levels, where tissue characterization is possible. One major challenge is to categorize these images reliably during the surgery as quickly as possible. To address this, we propose an automated tissue differentiation algorithm based on the machine learning concept. During a training phase, a large number of image frames with known tissue types are analyzed and the most discriminant image-based signatures for various tissue types are identified. During the procedure, the algorithm uses the learnt image features to assign a proper tissue type to the acquired image frame. We have verified this method on the example of two types of brain tumors: glioblastoma and meningioma. The algorithm was trained using 117 image sequences containing over 27 thousand images captured from more than 20 patients. We achieved an average cross validation accuracy of better than 83%. We believe this algorithm could be a useful component to an intraoperative pathology system for guiding the resection procedure based on cellular level information.
Macro/Microtesting and Damage and Degradation of Sandstones under Dry-Wet Cycles
Authors: Liu Xinrong , Wang Zijuan , Fu Yan , Yuan Wen , Miao Luli
Published: April 2016

In terms of the degradation of mechanical parameters of rock mass in the hydrofluctuation belt of a reservoir bank slope arising from rainfall and the reservoir level fluctuation, the moderately weathered sandstone in a side slope of the Three Gorges Reservoir Region is selected as a research object to carry out “drying-saturation-drying” tests for disks with two thicknesses (h=25 mm,h=50 mm) in different cycles; a spiral CT machine, an ultrasonic velocity meter, and a light Schmidt hammer are utilzed to conduct nondestructive testing on dry-wet cycles; through the Brazilian splitting test, the uniaxial tensile strength of “dry” and “saturated” sandstones under different dry-wet cycles is obtained. The research shows that, with the increase of the dry-wet circles (n), the longitudinal wave velocity and the rebound strength of sandstones are linearly decreased withn; the uniaxial tensile strength of sandstones and the mean CT number of cross sections are logarithmically decreased withn; the fitting equation of macro/micromechanical parameters and dry-wet cycles (n) of sandstones is raised, which is provided as a reference basis for the weathering process of sandstones under dry-wet cycles.
Study on Roll Instability Mechanism and Stability Index of Articulated Steering Vehicles
Authors: Li Xuefei , Wu Ya , Zhou Wei , Yao Zongwei
Published: April 2016

This study examines the roll instability mechanism and stability index of articulated steering vehicles (ASVs) by taking wheel loaders as the research object. A seven-degree-of-freedom nonlinear dynamics model of the ASVs is built on the basis of multibody dynamics. A physical prototype model of an ASV is designed and manufactured to validate the dynamic model. Test results reasonably agree with the simulation results, which indicates that the established dynamic model can reasonably describe ASV movements. Detailed analysis of the rollover stability of the wheel loader is performed with the use of the established dynamic model. Analysis results show that rollover will occur when the roll angular velocity exceeds a critical threshold, which is affected by lateral acceleration and slope angle. On this basis, a dynamic stability index applicable to the ASVs is presented.
Phase Characterization of Cucumber Growth: A Chemical Gel Model
Authors: Li Bo , Liu Xuejing , Zhang Junshi
Published: April 2016

Cucumber grows with complex phenomena by changing its volume and shape, which is not fully investigated and challenges agriculture and food safety industry. In order to understand the mechanism and to characterize the growth process, the cucumber is modeled as a hydrogel in swelling and its development is studied in both preharvest and postharvest stages. Based on thermodynamics, constitutive equations, incorporating biological quantities, are established. The growth behavior of cucumber follows the classic theory of continuous or discontinuous phase transition. The mechanism of bulged tail in cucumber is interpreted by phase coexistence and characterized by critical conditions. Conclusions are given for advances in food engineering and novel fabrication techniques in mechanical biology.
Measurement of Circulating 1,25-Dihydroxyvitamin D: Comparison of an Automated Method with a Liquid Chromatography Tandem Mass Spectrometry Method
Authors: Zittermann Armin , Ernst Jana B. , Becker Tobias , Dreier Jens , Knabbe Cornelius , Gummert Jan F. , Kuhn Joachim
Published: April 2016

Background. The clinical relevance of circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) is probably underappreciated, but variations in the measurement of this difficult analyte between different methods limit comparison of results.Methods. In 129 clinical samples, we compared a new automated assay with a commercially available liquid chromatography tandem mass spectrometry (LC-MS/MS) kit.Results. Median (interquartile range) 1,25(OH)2D concentrations with the automated assay and the LC-MS/MS method were 26.6 pg/mL (18.5–39.0 pg/mL) and 23.6 pg/mL (16.1–31.3 pg/mL), respectively (P=0.001). Using the method-specific cut-offs for deficient 1,25(OH)2D levels (<20 pg/mL for the automated assay and <17 pg/mL for the LC-MS/MS method), the percentage of patients classified as 1,25(OH)2D deficient was 28.7% and 27.1%, respectively. However, concordance between the two methods for deficient levels was only 62% and the concordance correlation coefficient was poor (0.534). The regression equation resulted in an intercept of −1.99 (95% CI: −7.33–1.31) and a slope of 1.27 (95% CI: 1.04–1.52) for the automated assay. The mean bias with respect to the mean of the two methods was −3.8 (1.96 SD: −28.3–20.8) pg/mL for the LC-MS/MS method minus the automated assay.Conclusions. The two methods show only modest correlation and further standardization is required to improve reliability and comparability of 1,25(OH)2D test procedures.
Reversible Fluindione-Induced Chronic Interstitial Nephritis
Authors: Crepin Thomas , Bamoulid Jamal , Courivaud Cécile , Dahmani Omar , Felix Sophie , Ducloux Didier
Published: April 2016

Fluindione is well known to induce acute drug-induced interstitial nephritis (IN). Most cases occurred soon after the onset of treatment. We report a unique case of severe subacute fluindione-induced IN diagnosed 2 years after the treatment was begun. Renal function dramatically improved after fluindione withdrawal and steroid therapy.
Elevated Levels of Urinary PGE-M Are Found in Tobacco Users and Indicate a Poor Prognosis for Oral Squamous Cell Carcinoma Patients
Authors: Kekatpure Vikram D. , BS Naveen , Wang Hanhan , Zhou Xi Kathy , Kandasamy Chandramohan , Sunny Sumsum P. , Suresh Amritha , Milne Ginger L. , Kuriakose Moni Abraham , Dannenberg Andrew J.
Published: April 2016

Cyclooxygenase-2 (COX-2)–derived prostaglandin E2 (PGE2) plays a role in the development and progression of epithelial malignancies. Measurements of urinary PGE-M, a stable metabolite of PGE2, reflect systemic PGE2 levels. Here, we investigated whether urinary PGE-M levels were elevated in healthy tobacco users and in patients with oral squamous cell carcinoma (OSCC). Median urinary PGE-M levels were increased in healthy tobacco quid chewers [21.3 ng/mg creatinine (Cr); n = 33; P = 0.03] and smokers (32.1 ng/mg Cr; n = 31; P < 0.001) compared with never tobacco quid chewers-never smokers (18.8 ng/mg Cr; n = 30). Urinary PGE-M levels were also compared in OSCC patients versus healthy tobacco users. An approximately 1-fold increase in median urinary PGE-M level was found in OSCC patients (48.7 ng/mg Cr, n = 78) versus healthy controls (24.5 ng/mg Cr, n = 64; P < 0.001). We further determined whether baseline urinary PGE-M levels were prognostic in OSCC patients who underwent treatment with curative intent. A nearly 1-fold increase in baseline urinary PGE-M levels (64.7 vs. 33.8 ng/mg Cr, P < 0.001) was found in the group of OSCC patients who progressed (n = 37) compared with the group that remained progression free (n = 41). Patients with high baseline levels of urinary PGE-M had both worse disease-specific survival [HR, 1.01 per unit increase; 95% confidence interval (CI), 1.01–1.02; P < 0.001] and overall survival (HR, 1.01 per unit increase; 95% CI, 1.00–1.02; P = 0.03). Taken together, our findings raise the possibility that NSAIDs, prototypic inhibitors of PGE2 synthesis, may be beneficial for reducing the risk of tobacco-related aerodigestive malignancies or treating OSCC patients with high urinary PGE-M levels. Cancer Prev Res; 9(6); 428–36. ©2016 AACR.
Antibody-Mediated Phosphatidylserine Blockade Enhances the Antitumor Responses to CTLA-4 and PD-1 Antibodies in Melanoma
Authors: Freimark Bruce D. , Gong Jian , Ye Dan , Gray Michael J. , Nguyen Van , Yin Shen , Hatch Michaela M.S. , Hughes Christopher C.W. , Schroit Alan J. , Hutchins Jeff T. , Brekken Rolf A. , Huang Xianming
Published: April 2016

In tumor-bearing animals, the membrane phospholipid phosphatidylserine (PS) suppresses immune responses, suggesting that PS signaling could counteract the antitumor effect of antibody-driven immune checkpoint blockade. Here, we show that treating melanoma-bearing mice with a PS-targeting antibody enhances the antitumor activity of downstream checkpoint inhibition. Combining PS-targeting antibodies with CTLA-4 or PD-1 blockade resulted in significantly greater inhibition of tumor growth than did single-agent therapy. Moreover, combination therapy enhanced CD4+ and CD8+ tumor-infiltrating lymphocyte numbers; elevated the fraction of cells expressing the proinflammatory cytokines IL2, IFNγ, and TNFα; and increased the ratio of CD8 T cells to myeloid-derived suppressor cells and regulatory T cells in tumors. Similar changes in immune cell profiles were observed in splenocytes. Taken together, these data show that antibody-mediated PS blockade enhances the antitumor efficacy of immune checkpoint inhibition. Cancer Immunol Res; 4(6); 531–40. ©2016 AACR.
Environmental and Genetic Activation of Hypothalamic BDNF Modulates T-cell Immunity to Exert an Anticancer Phenotype
Authors: Xiao Run , Bergin Stephen M. , Huang Wei , Slater Andrew M. , Liu Xianglan , Judd Ryan T. , Lin En-Ju D. , Widstrom Kyle J. , Scoville Steven D. , Yu Jianhua , Caligiuri Michael A. , Cao Lei
Published: April 2016

Macroenvironmental factors, including a patient's physical and social environment, play a role in cancer risk and progression. Our previous studies show that living in an enriched environment (EE) providing complex stimuli confers an anticancer phenotype in mice mediated, in part by a specific neuroendocrine axis, with brain-derived neurotrophic factor (BDNF) as the key brain mediator. Here, we investigated how an EE modulated T-cell immunity and its role in the EE-induced anticancer effects. Our data demonstrated that CD8 T cells were required to mediate the anticancer effects of an EE in an orthotropic model of melanoma. In secondary lymphoid tissue (SLT), an EE induced early changes in the phenotype of T-cell populations, characterized by a decrease in the ratio of CD4 T helper to CD8 cytotoxic T lymphocytes (CTL). Overexpression of hypothalamic BDNF reproduced EE-induced T-cell phenotypes in SLT, whereas knockdown of hypothalamic BDNF inhibited EE-induced immune modulation in SLT. Both propranolol and mifepristone blocked the EE-associated modulation of CTLs in SLT, suggesting that both the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis were involved. Our results demonstrated that enhanced anticancer effect of an EE was mediated at least in part through modulation of T-cell immunity and provided support to the emerging concept of manipulating a single gene in the brain to improve cancer immunotherapy. Cancer Immunol Res; 4(6); 488–97. ©2016 AACR.
Personality-Related Determinants of Subtle Cognitive Decline in Old Age: A Population-Based Study
Authors: Rodriguez Cristelle , Albanese Emiliano , Pegna Alan , Toma Simona , Ackermann Marine , Tombeur Eline , Herrmann Francois R. , Giannakopoulos Panteleimon
Published: April 2016

Background/Aims: Recent studies of cases with mild cognitive impairment (MCI) suggested that besides Alzheimer disease (AD)-related biomarkers, some personality dimensions are associated with progression to AD. To date, there are no studies addressing the psychological determinants of subtle cognitive decline in healthy elderly controls. Methods: 488 community-dwelling healthy controls were assessed with a detailed neuropsychological battery at baseline and an 18-month follow-up. Personality factors and facets were investigated at baseline using the NEO-Personality Inventory-Revised (NEO-PI-R). Upon follow-up, there were 264 stable controls (sCON) and 224 deteriorating controls (dCON). Their personality data were compared to those of the 102 MCI cases using one-way analysis of variance and logistic regression models. Results: Significantly higher scores of Openness factor (as well as Aesthetics, Ideas and Values facets) were found in sCON than in both dCON and MCI cases. The three groups did not differ in the other NEO-PI-R factor and facet scores. Openess factor (and the same facets) was associated with cognitive preservation in healthy controls (OR: 0.72, 95% CI: 0.59, 0.87). Lower scores in the same factor and facets conferred higher risk to have MCI (OR: 0.61, 95% CI: 0.46, 0.79). Conclusion: Higher openness to new experiences and thoughts may be a protective factor against early cognitive decline in brain aging.
The Proportion of Signet Ring Cell Component in Patients with Localized Gastric Adenocarcinoma Correlates with the Degree of Response to Pre-Operative Chemoradiation
Authors: Charalampakis Nikolaos , Nogueras González Graciela M. , Elimova Elena , Wadhwa Roopma , Shiozaki Hironori , Shimodaira Yusuke , Blum Mariela A. , Rogers Jane E. , Harada Kazuto , Matamoros Jr. Aurelio , Sagebiel Tara , Das Prajnan , Minsky Bruce D. , Lee Jeffrey H. , Weston Brian , Bhutani Manoop S. , Estrella Jeannelyn S. , Badgwell Brian D. , Ajani Jaffer A.
Published: April 2016

Background: Patients with localized gastric adenocarcinoma (LGAC), who get pre-operative therapy, have heterogeneous/unpredictable outcomes. Predictive clinical variables/biomarkers are not established. Methods: We analyzed 107 LGAC patients who had chemoradiation and surgery. LGACs were grouped for (1) presence/absence of signet ring cell histology (SRC) and (2) histologic grade: G2 or G3. %SRC was assessed (0, 1-10, 11-49, and 50-100%) and correlated with pathologic complete response (pathCR) or <pathCR in the resected specimens. Results: Most patients were men (60%), had stage cIII LGAC (50%), and received chemotherapy before chemoradiation (93%). Most had G3 tumors (78%) and SRC (58%). Presence of SRC was associated with a lower rate of pathCR (11 vs. 36%, p = 0.004), and the association remained significant even with a low percentage of SRC (1-10%; p = 0.014). The higher the fraction of SRC, the lower was the probability of pathCR (p = 0.03). G3 and SRC led to a shorter overall survival (OS) (p = 0.046 and p = 0.038, respectively). yp stage independently prognosticated OS and recurrence-free survival (p < 0.001). Conclusion: Our novel findings suggest that LGACs with SRC are relatively chemoradiation resistant compared to LGACs without SRC. A higher fraction of SRC is associated with higher resistance. Upon validation/biomarker(s) evaluation, reporting of the fraction of SRC may be warranted.
Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study
Authors: Minig Lucas , Patrono Maria Guadalupe , Cárdenas-Rebollo Jose Miguel , Martin Marfil Pedro , Rodriguez-Tabares Virginia , Chuang Linus
Published: April 2016

Objective: To describe the incidence of symptomatic lymphocele (SLC) after an aggressive tumor debulking surgery and lymphadenectomy in patients with ovarian cancer and peritoneal carcinomatosis with or without TachoSil®. Material and Methods: A pilot retrospective comparative observational study was performed between patients with advanced ovarian cancer International Federation of Gynecology and Obstetrics stages III-IV who underwent complete debulking surgery and radical retroperitoneal lymphadenectomy. In 18 patients, 4 TachoSil® patches were placed in the retroperitoneal area, since January 2014-October 2014. This group was compared with other 18 consecutive patients matched by age, International Federation of Gynecology and Obstetrics stage, surgical complexity, American Society of Anesthesiologists score, comorbidity, and BMI without the use of TachoSil®. Results: Baseline characteristics were similar between groups. There were no statistically significant differences in terms of surgical complexity, surgical time, estimated blood loss, node removed, length of hospital stay, and complications between groups. SLC was diagnosed in 7 patients (38.8%) without TachoSil®, and in 2 patients (11.1%) with TachoSil® (p = 0.121). The use of TachoSil® was associated with a statistically significant lower re-admission rate (p = 0.041) and with a significantly shorter time to adjuvant chemotherapy (p = 0.02). Conclusions: Using TachoSil® in women with advanced stage ovarian cancer who underwent radical debulking with retroperitoneal lymph node dissection is associated with a non-statistically significant reduction in the incidence of SLC. A larger-scale randomized controlled study should be conducted to confirm our preliminary results.
Role of Multi-Parametric Magnetic Resonance Image and PIRADS Score in Patients with Prostate Cancer Eligible for Active Surveillance According PRIAS Criteria
Authors: Almeida Gilberto Laurino , Petralia Giuseppe , Ferro Matteo , Ribas Carmen Austrália Paredes Marcondes , Detti Serena , Jereczek-Fossa Barbara Alicja , Tagliabue Elena , Matei Deliu Victor , Coman Ioan , De Cobelli Ottavio
Published: April 2016

Objective: To evaluate the prognostic role of multiparametric-MRI (mp-MRI) in patients with clinically localized prostate cancer (PCa) eligible for active surveillance (AS) according to Prostate Cancer Research International: Active Surveillance (PRIAS) criteria. Patients and Methods: We analyzed prospectively 73 patients with PCa and PRIAS criteria for low-risk disease. All patients fitted criteria for AS but optioned surgery treatment. The mp-MRI was performed to define the likelihood of malignancy according to the Prostate Imaging Reporting and Data System (PIRADS) score (1-5). Patients were divided in 2 groups: non-visible cancer lesion on MRI (PIRADS 2-3) and visible cancer (PIRADS 4-5). Preoperative clinical data (age, body mass index, prostate specific antigen (PSA) level, positive core biopsy, PSA density (PSAD)) and definitive pathological findings (staging, upgrading, unfavorable disease) were compared between groups. PIRADS score was correlated with pathological data to evaluate the prognostic role of mp-MRI; and preoperative variables and definitive pathology (upgrading, upstaging and unfavorable disease) were also assessed. Results: PSAD (p = 0.04) and pathological stage (p = 0.03) were significantly associated with the presence of visible disease. Visible disease was significantly associated with upstaging (p = 0.03). Correlation between PIRADS 5 and unfavorable disease was statistically significant (p = 0.02). The mp-MRI had adequate sensibility in detecting upstaging (92%), intermediate for upgrading (76%) and unfavorable disease (76%). Negative predictive value was higher for upstaging than for upgrading or unfavorable disease (96 vs. 68% and 64%). Multivariate logistic regression revealed that PIRADS 5 was a significant predictor of upstaging (p = 0.05, OR 16.12) and unfavorable disease (p = 0.01, OR 6.53). Conclusion: A visible lesion on mp-MRI strongly predicts significant PCa in patients eligible for AS according to PRIAS criteria, based on upstaging and unfavorable disease. We believe that mp-MRI is an important tool and should be added to clinical selection criteria for AS.
Long-Term Effect of Anti-VEGF Agents on Intraocular Pressure in Age-Related Macular Degeneration
Authors: Beato João , Pedrosa Ana Catarina , Pinheiro-Costa João , Freitas-da-Costa Paulo , Falcão Manuel S. , Melo António , Estrela-Silva Sérgio , Falcão-Reis Fernando , Carneiro Ângela M.
Published: April 2016

Purpose: To analyze the effect of anti-vascular endothelial growth factor (VEGF) agents on intraocular pressure (IOP) in patients with neovascular age-related macular degeneration (AMD). Materials andMethods: This is a retrospective study that included 72 patients treated unilaterally with anti-VEGF agents according to a pro re nata regimen. Fellow noninjected eyes (n = 72) were used as controls. IOP variation and the development of sustained ocular hypertension (OHT) were assessed both in the injected and in the fellow eyes. Results: While the final IOP was not significantly different between the 2 groups, sustained OHT developed in 4.2% of the injected eyes and 1.4% of the controls. In the study group, no significant IOP variation was noted during follow-up in patients receiving ≤20 injections, but there was a significant increase in IOP with time in more frequently treated patients (p = 0.041). Comparison of both subgroups demonstrated that patients receiving >20 injections suffered significantly greater IOP variation (p = 0.034) during follow-up, and that these patients tended to require IOP-lowering treatment more frequently (p = 0.090). Conclusion: Multiple anti-VEGF injections lead to an increase in IOP, although this variation is not sufficient to cause development of OHT in the majority of patients.
The Impact of Enrolment in Methadone Maintenance Therapy on Initiation of Heavy Drinking among People Who Use Heroin
Authors: Klimas Jan , Wood Evan , Nguyen Paul , Dong Huiru , Milloy Michael John , Kerr Thomas , Hayashi Kanna
Published: April 2016

Background: There is equivocal evidence regarding whether people who use heroin substitute heroin for alcohol upon entry to methadone maintenance therapy (MMT). We aimed to examine the impact of MMT enrolment on the onset of heavy drinking among people who use heroin. Methods: We derived data from prospective, community-based cohorts of people who inject drugs in Vancouver, Canada, between December 1, 2005, and May 31, 2014. Multivariable extended Cox regression analysis examined the effect of MMT enrolment on the onset of heavy drinking among people who used heroin at baseline. Results: In total, 357 people who use heroin were included in this study. Of these, 208 (58%) enrolled in MMT at some point during follow-up, and 115 (32%) reported initiating heavy drinking during follow-up for an incidence density of 7.8 events (95% CI 6.4-9.5) per 100 person-years. The incidence density of heavy drinking was significantly lower among those enrolled in MMT at some point during follow-up compared to those who did not (4.6 vs. 16.2; p < 0.001). MMT enrolment was not significantly associated with time to initiate heavy drinking (adjusted relative hazard (ARH) 1.27; 95% CI 0.78-2.07) after adjustment for relevant demographic and substance-use characteristics. Age and cannabis use were the only variables that were independently associated with the time to onset of heavy drinking (ARH 0.74; 95% CI 0.58-0.94 and ARH 2.06; 95% CI 1.32-3.19, respectively). Conclusion: In this study, MMT enrolment did not predict heavy drinking and may even appear to decrease the initiation of heavy drinking. Our findings suggest younger age and cannabis use may predict heavy drinking. These findings could help inform on-going discussions about the effects of opioid agonist therapy on alcohol consumption among people who use heroin.
TPH1 and 5-HTTLPR Genes Specifically Interact in Opiate Dependence but Not in Alcohol Dependence
Authors: Wang Tzu-Yun , Lee Sheng-Yu , Chung Yi-Lun , Chen Shiou-Lan , Li Chia-Ling , Chang Yun-Hsuan , Wang Liang-Jen , Chen Po See , Chen Shih-Heng , Chu Chun-Hsien , Huang San-Yuan , Tzeng Nian-Sheng , Hsieh Tsai-Hsin , Lee I. Hui , Chen Kao Chin , Yang Yen Kuang , Hong Jau-Shyong , Lu Ru-Band
Published: April 2016

Background: Different drug dependencies may have unique genetic vulnerabilities. Changes in serotonin availability and function have been linked to addiction. We investigated whether 2 serotonergic polymorphisms, TPH1 A218C (rs1800532) and 5-HTT-linked promoter region (5-HTTLPR) (rs25531), are differently associated with alcohol or opiate dependence. Methods: Alcohol-dependent patients (n = 292), opiate-dependent patients (n = 309), and healthy controls (n = 301) were recruited from the Han Chinese population in Taiwan. Genotypes of TPH1 A218C and 5-HTTLPR polymorphisms were analyzed using a polymerase chain reaction with restriction fragment length polymorphism. Results: The genotype frequencies of the TPH1 A218C polymorphisms were not significantly different in the 3 groups. The genotype frequencies of the 5-HTTLPR S+ (S/S, S/LG, LG/LG) polymorphisms were significantly higher in opiate-dependent patients (χ2 = 8.77, p = 0.01), but not after controlling for the covariates of age, gender, and interaction effect in logistic regression analysis. Moreover, there was a significant interaction between the TPH1 A218C A/C and 5-HTTLPR S+ gene polymorphisms in opiate-dependent (OR 2.72, p = 0.01), but not in alcohol-dependent patients. Conclusions: Our data suggested that there may be a differential genetic vulnerability in serotonergic genes for alcohol and opiate addiction. However, replications of our findings are still needed.
Executive and Attentional Disorders, Epilepsy and Porencephalic Cyst in Autosomal Recessive Cerebellar Ataxia Type 3 Due to ANO10 Mutation
Authors: Chamard Ludivine , Sylvestre Géraldine , Koenig Michel , Magnin Eloi
Published: April 2016

Background:ANO10 mutations have recently been reported in autosomal recessive cerebellar ataxia type 3 (ARCA3). The objective of this study was to describe the phenotype of 2 siblings with compound heterozygous ANO10 mutations and progressive cerebellar ataxia, epilepsy, and cognitive impairment. A porencephalic cyst was also described in one of them and a coenzyme Q10 deficiency in the other one. Methods: We performed neurological, neuropsychological, electromyographic, electroencephalic and MRI examinations in 2 siblings with compound heterozygous ANO10 mutations. Results: We reported for the first time the neuropsychological profile of 2 ARCA3 patients showing an adult-onset executive and attentional syndrome. Both presented epilepsy. One of them presented a porencephalic cyst. Conclusion: These results suggest that executive and attentional disorders are impaired in ANO10 mutation. In addition, epilepsy and porencephalic cysts were also described in our ARCA3 patients, the cyst thus expanding the clinical phenotype of ARCA3 patients due to ANO10 mutation.
Decreased Linezolid Serum Concentrations in Three Critically Ill Patients: Clinical Case Studies of a Potential Drug Interaction between Linezolid and Rifampicin
Authors: Blassmann Ute , Roehr Anka C. , Frey Otto R. , Koeberer Andreas , Briegel Josef , Huge Volker , Vetter-Kerkhoff Cornelia
Published: April 2016

Linezolid is a valuable treatment option for treating infections caused by multi-resistant gram-positive pathogens. Lack of effective linezolid levels due to the co-administration of rifampicin has been described in healthy subjects. However, the clinical significance of this potential drug interaction (DI) for critically ill patients is still unclear. This was a retrospective analysis of 3 critically ill patients with the combination therapy of linezolid and rifampicin or rifampicin pre-treatment. Despite increasing the dose of linezolid, the majority of observed linezolid trough concentrations in all 3 patients were below 2 mg/l. Furthermore, linezolid trough concentrations remained below 2 mg/l after discontinuation of rifampicin. This potential DI between linezolid and rifampicin could lead to treatment failure. Therefore, we strongly recommend that linezolid serum concentrations be monitored in patients with rifampicin co-administration or rifampicin pretreatment.
Increased Intracranial Pressure in a Boy with Gorham-Stout Disease
Authors: Patel Manisha K. , Mittelstaedt Brent R. , Valentin Frank E. , Thomas Linda P. , Carlson Christian L. , Faux Brian M. , Hsieh David T.
Published: April 2016

Gorham-Stout disease (GSD), also known as vanishing bone disease, is a rare disorder, which most commonly presents in children and young adults and is characterized by an excessive proliferation of lymphangiomatous tissue within the bones. This lymphangiomatous proliferation often affects the cranium and, due to the proximate location to the dura surrounding cerebrospinal fluid (CSF) spaces, can result in CSF leaks manifesting as intracranial hypotension with clinical symptoms to include orthostatic headache, nausea, and vertigo. We present the case of a boy with GSD and a known history of migraine headaches who presented with persistent headaches due to increased intracranial pressure. Although migraine had initially been suspected, he was eventually diagnosed with intracranial hypertension after developing ophthalmoplegia and papilledema. We describe the first known instance of successful medical treatment of increased intracranial pressure in a patient with GSD.
Apresentação
Authors: Lopes Ivã Carlos , Saraiva Américo
Published: April 2016

Apresentação do volume 11, n2.
Uma leitura semiótica de “Pais e filhos”: o plano do conteúdo da canção.
Authors: Merith-Claras Sonia
Published: April 2016

A teoria semiótica, proposta por Algirdas Julien Greimas, de linha francesa, insere-se entre as teorias que objetivam descrever e explicar como os sentidos dos textos são produzidos. Sendo assim, diferentes estudiosos estão desenvolvendo trabalhos no intuito de aliar tal teoria ao ensino de língua portuguesa. A necessidade de se encontrar outros instrumentos teórico-metodológicos no ensino deve-se, principalmente, a indicadores como Prova Brasil e SAEB (Sistema de Avaliação da Educação Básica) os quais têm apontado para índices desfavoráveis quanto à competência de leitura dos alunos avaliados. Desta forma, nosso objetivo, neste trabalho, é sugerir, por meio da análise semiótica da letra da música Pais e Filhos, interpretada pela banda Legião Urbana, um possível encaminhamento a ser seguido na leitura do gênero em pauta. Nosso intuito, com a análise, cujo foco centra-se no nível discursivo do percurso gerativo, é destacar questões em torno da manifestação linguística. Sendo assim, a ênfase será dada às escolhas feitas pelo enunciador e a depreensão de temas, os quais são recobertos pela organização figurativa. O processo de mediação do professor na construção dos sentidos dos textos é algo essencial, por isso acreditamos que as discussões empreendidas acerca da letra da música podem auxiliar o professor a eleger assuntos a serem abordados na aula de leitura.
Duas formas de representar o Feminino na literatura infantil: Narizinho, de Monteiro Lobato, e Dorothy, de L. Frank Baum
Authors: Chiovatto Ana Carolina Lazzari
Published: April 2016

Tendo em vista que a obra de Monteiro Lobato (1882-1948) foi publicada pouco depois da de L. Frank Baum (1856-1919) – de forma que podemos considerar que tais obras tiveram influências similares de seu tempo, apesar de receberem também influências diversas por conta de seu espaço –, e que as obras de literatura infantil de ambos os autores possuem grande importância no Brasil desde então, seja pelos livros em si, adotados em escolas ou leituras paradidáticas, ou pelas inúmeras adaptações que cada um recebeu (este, para o cinema, principalmente, e para o teatro; aquele, para a televisão), e se utilizam do recurso dos mundos fantásticos na figurativização de seus textos, pretende-se com este trabalho traçar uma comparação entre as protagonistas Dorothy, de O Maravilhoso Mágico de Oz (1900), e Lúcia, de Reinações de Narizinho (1931), com o fim de analisar como se dá a representação do feminino, a partir desses atores, nas obras indicadas. A importância de tal análise reside no fato de as duas personagens possuírem diversos pontos em comum, como alguns dos temas que figurativizam na narrativa, mas há outras tantas diferenças entre elas, dadas no percurso utilizado, na forma da representação e no discurso a elas atribuído.