bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro studies of cytokine-mediated interactions between malignant glioma and autologous peripheral blood mononuclear cells
Authors: Jachimczak Piotr , Schwulera Udo , Bogdahn Ulrich
Published: May 2009

✓ The humoral interactions between three malignant glioma early-passage cell cultures andin vitrointerleukin (IL)-1α- and IL-2-activated autologous peripheral blood mononuclear cells (PBMC's) were investigated, employing standard and modified (separated by permeable membranes) mixed lymphocyte tumor cell (MLTC) cultures. In modified MLTC's, glioma cells clearly inhibit proliferation of PBMC's (up to 60%), whereas lymphokine-activated PBMC's enhance glioma cell growth up to 12-fold, as determined by3H-thymidine incorporation assays. Glioma cells produce both stimulatory (IL-6) and inhibitory proteins (transforming growth factor-β) for PBMC's. Lymphokine-activated PBMC's secrete IL-1α, IL-2, IL-4, IL-6, interferon-γ, and tumor necrosis factor-α, which may modulate glioma cell proliferation.

None of these cytokines stimulated glioma cells as intensely as modified MLTC systems. These observations indicate thatin vitrolymphokine-activated PBMC's, although suppressed by humoral glioma-derived factors, may enhance glioma cell proliferation with soluble factors secreted into the culture medium. The authors conclude that glioma-lymphocyte growth regulatory networks include stimulatory and inhibitory factors from both cell populations, which may modulate tumor progression. These observations may have relevance for adoptive immunotherapy in patients with gliomas.
Third ventricular xanthogranulomas clinically and radiologically mimicking colloid cysts
Authors: Tatter Stephen B. , Ogilvy Christopher S. , Golden Jeffrey A. , Ojemann Robert G. , Louis David N.
Published: May 2009

✓ Two cases are reported of third ventricle masses that were clinically and radiographically indistinguishable from pure colloid cysts. A 21- and a 36-year-old man presented with 5-year and 10-day histories of headache, respectively. Magnetic resonance (MR) imaging revealed smooth, homogeneous masses in the anterior third ventricle that were iso- to hyperintense on T1-weighted MR images and hyperintense on T2-weighted images. There was little enhancement with intravenous contrast material. In both patients, craniotomies were performed and histopathological examination revealed xanthogranulomas of the choroid plexus with only microscopic foci of colloid cyst-like structures. These cases illustrate that xanthogranulomas of the third ventricle may clinically and radiologically mimic pure colloid cysts, that a range of MR imaging signals can be seen, and that craniotomy rather than stereotactic aspiration is the indicated treatment.
Coccidioidomycosis brain abscess
Authors: Mendel Ehud , Milefchik Eric N. , Amadi Jamshid , Gruen Peter
Published: May 2009

✓ Coccidioidomycosis is an infection originating in the San Joaquin Valley of southern California, but is now seen with increasing frequency throughout southern California and the southwestern United States. A central nervous system involvement is usually manifested as meningitis.

The authors present the case of a young man with pulmonary coccidioidomycosis who developed a brain lesion that proved to be a coccidioidal abscess. This manifestation may now be more frequently seen and therefore should be included in the differential diagnosis of any patient presenting with a brain mass who is from an area in which this disease is endemic.
Dural arteriovenous malformation of the skull base with intraosseous vascular nidus
Authors: Malik Ghaus M. , Mahmood Asim , Mehta Bharat A.
Published: May 2009

✓ Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discovered a small subgroup of dural AVM's in extrasinusal locations such as the skull base and tentorium. Two of the 17 patients who were studied between 1976 and 1993 had dural AVM's that were entirely intraosseous except for their venous drainage, which was via the dural venous sinuses. Although such intraosseous dural AVM's have not been previously described, the authors elected to group these malformations with dural AVM's because their venous drainage was intracranial and angiograms revealed identical features.
Acute obstructive hydrocephalus due to brain-stem edema caused by hyperosmotic insult
Authors: Fujioka Masayuki , Okuchi Kazuo , Iwanaga Hideaki , Sakaki Toshisuke
Published: May 2009

✓ The case of a 63-year-old man with acute obstructive hydrocephalus is presented. To the authors' knowledge, this is the first reported case of acute obstructive hydrocephalus associated with nonketotic hyperosmolar diabetic coma. It is believed that the plasma hyperosmolality resulted in osmotic endothelial injury leading to brain-stem edema.
Meningiomas: genetics, malignancy, and the role of radiation in induction and treatment
Authors: Wilson Charles B.
Published: May 2009

✓ The author reviews the molecular genetics, pathology, and cell kinetics of meningiomas and the role that regional multiplicity in the dura mater may play in their recurrence. Malignant and radiation-induced meningiomas are discussed, with summaries of series of 60 patients with frankly malignant lesions treated over a period of 22 years at the University of California, San Francisco, and of 10 patients with meningiomas induced by high-dose radiation therapy. Reviewing a 23-year series of 140 patients with subtotally removed meningiomas who were treated postoperatively with radiation, the author recommends that, with meticulous technique, irradiation is effective in preventing the regrowth of subtotally removed benign meningiomas and of all malignant meningiomas. Adoption of both the microscopical cytological grading system proposed by Jääskeläinen's group in Helsinki and the classification of operations proposed by Donald Simpson is also recommended. Wide removal of dura adjacent to meningioma reduces the risk of recurrence, and determination of the bromodeoxyuridine labeling index provides a valid basis for planning treatment and follow-up evaluations. Increased awareness is necessary for early recognition of radiation-induced meningiomas in patients at risk for developing such tumors. For meningiomas in such sites as the parasellar region and the posterior fossa, conservative removal of tumor followed by irradiation is advocated in preference to a radical operation that may cause neurological injury without being curative.
Preliminary experience using an optimized three-point transformation algorithm for spatial registration of coordinate systems: a method of noninvasive localization using frame-based stereotactic guidance systems
Authors: Heilbrun M. Peter , Koehler Spencer , MacDonald Paul , Siemionow Vladimir , Peters William
Published: May 2009

✓ This study describes the use of an optimized three-point transformation algorithm to spatially cross-register a volumetric computerized tomographic scan or magnetic resonance image data set with the coordinate system of a stereotactic frame. This algorithm was tested for accuracy using a scanned phantom in which calculated targets, using the Brown-Roberts-Wells (BRW) frame picket-fence algorithm as a standard, could be compared to physical targets measured using a BRW arc and phantom. These target values were then compared to target values calculated with the optimized three-point algorithm. This method was used for target localization in 21 patients. Following this noninvasive localization method, the standard BRW stereotactic system was used for guidance. The application accuracy of this frameless localization technique was within the limits of the scan slice thickness in 16 of 21 cases, with an average error of 2.11 mm in an average scan slice thickness of 3.1 mm. Intracranial targets were successfully reached in all cases without morbidity or mortality. The algorithm can be customized to cross-register image data sets with the coordinate systems of a wide variety of stereotactic guidance systems. The method increases the convenience and flexibility of frame-based stereotactic guidance by providing a means of noninvasive localization that can be accomplished electively at a separate time from the guidance part of a stereotactic operative procedure.
Clinical and radiological evaluation of long-term results of stereotactic proton beam radiosurgery in patients with cerebral arteriovenous malformations
Authors: Seifert Volker , Stolke Dietmar , Mehdorn Hubertus M. , Hoffmann Bernd
Published: May 2009

✓ Within a period of nearly 10 years, from October, 1980, to May, 1990, a total of 68 patients with a cerebral arteriovenous malformation (AVM) were referred to a radiosurgical center in the United States for stereotactic Bragg peak proton beam therapy. Radiosurgery was chosen as an alternative treatment, either because the AVM was considered to be of high surgical risk due to its size and/or location, or because the patient refused surgery. In 63 patients (92.6%), complete clinical and radiological follow-up examinations were available. Clinical and radiological long-term results were correlated to size and to the Spetzler-Martin scale of the AVM. With increasing size or higher grade on the Spetzler-Martin scale, the clinical results of proton beam therapy became progressively worse. Of 37 patients with an AVM between 3 and 6 cm in diameter, only one-third showed amelioration of their clinical symptoms, and two-thirds remained the same or even deteriorated after radiation treatment. The same results apply to patients with very large AVM's, of whom only one-third profited from proton beam therapy. Although 85.7% of the patients in Spetzler-Martin Grades I and II showed postirradiation amelioration of their clinical symptoms, this compares to only 54.2% of the patients in Grade III, and only 24% in Grade IV. In regard to the radiological results of proton beam therapy, complete obliteration during long-term observation was only detectable in 10 patients or 15.9%, which is less than one-sixth of the whole group of 63 patients. All of these obliterated AVM's were smaller than 3 cm. Almost 85% of the patients treated using stereotactic proton beam therapy did not show any angiographic change in the radiological appearance of their AVM. The results reported here indicate that radiosurgery using stereotactic proton beam therapy is ineffective for the treatment of medium- or large-sized AVM's and should not be recommended for patients harboring an AVM larger than 3 cm. If proton beam treatment is contemplated, it should be restricted to AVM's that are less than 3 cm in size and whose location makes them easily accessible only for proton beam therapy.
The identification of four protein kinase C isoforms in human glioblastoma cell lines: PKC alpha, gamma, epsilon, and zeta
Authors: Xiao Haiguang , Goldthwait David A. , Mapstone Timothy
Published: May 2009

✓ Levels of protein kinase C (PKC) isoforms in eight human glioblastoma cell lines and two normal human glial cell cultures were determined. Earlier studies identified PKC-α and PKC-γ in these cell lines but PKC-β was not present. In this study, PKC-ϵ and PKC-ζ are demonstrated immunologically in these cell lines and also in two normal human glial cell cultures. Protein kinase C-δ was not present. When levels of the four isoforms in the tumor cells were compared to levels in the normal cells, no increase was observed in PKC-α or PKC-γ, but PKC-ϵ was elevated three to 30 times in six of the eight tumors, and PKC-ζ was elevated approximately two times in all of the tumors. Incubation of cell line A172 with phorbol ester for 6 hours resulted in a 48-fold maximum increase in the nuclear PKC-ϵ and a sevenfold increase in the plasma membrane fraction with no change in the cytoplasmic fraction. A similar incubation for 4 hours produced a 0.5- to onefold increase of PKC-ζ in cytoplasmic, nuclear, and plasma membrane fractions. Other researchers have shown that overexpression of PKC-ϵ in fibroblasts results in tumorigenesis, and that blocking PKC-ζ function inhibits deoxyribonucleic acid synthesis. These data suggest that alteration in the expression of PKC-ϵ and PKC-ζ could be a factor in the conversion of normal glial cells to glioblastomas.
Effects of head elevation on intracranial hemodynamics in patients with ventriculoperitoneal shunts
Authors: Higashi Sotaro , Futami Kazuya , Matsuda Hiroshi , Yamashita Junkoh , Hashimoto Masaaki , Hasegawa Mitsuhiro , Tokuda Kazuhiko , Hassan Mahmood , Hisada Kinichi
Published: May 2009

✓ The present study was performed to investigate the effects of head elevation on intracranial hemodynamics in patients with ventriculoperitoneal (VP) shunts. The series included 35 hydrocephalic patients and five individuals without hydrocephalus who were used as controls. The hydrocephalic patients were divided into three groups: 15 patients who received VP shunts with a differential-pressure valve (DP group); 11 who received VP shunts with a variable-resistance valve (VR group), and 13 hydrocephalic patients (Hyd group) who had not received shunts (four underwent VP shunts later).

The cerebral blood flow (CBF) of patients in the supine and upright positions was measured by technetium-99m hexamethylpropylenamine oxide (HMPAO) single-photon emission computerized tomography in each patient, using the subtraction technique. Cerebral perfusion pressure (CPP) was taken as the difference between the mean arterial blood pressure and ventricular fluid pressure, both referenced to the level of the foramen of Monro. The patients' heads were elevated stepwise from supine to upright. Percent changes of the mean CBF in the upright position (%ΔmCBFupr) were 24.9% ± 4.3% (mean ± standard error of the mean) in the DP group, 6.2% ± 2.7% in the VR group, 3.5% ± 2.6% in the Hyd group, and 4.5% ± 2.2% in the control group. Patients in the DP group showed a pathological increase in CPP with head elevation, whereas those in the Hyd and VR groups showed a physiological decrease in CPP. Three patients with differential-pressure valves, whose %ΔmCBFupr was markedly high, developed low-intracranial pressure syndrome. In conclusion, shunted patients with a DP valve showed pathological intracranial hemodynamics in the upright position. This pathological hemodynamic stress in patients with long-standing differential-pressure valve implantation may induce pathological changes in the brain such as subependymal gliosis.
Management of tentorial dural arteriovenous malformations: transarterial embolization combined with stereotactic radiation or surgery
Authors: Lewis Adam I. , Tomsick Thomas A. , Tew John M.
Published: May 2009

✓ The clinical, anatomical, and radiological features of nine cases of tentorial dural arteriovenous malformations (AVM's) are presented, and 45 reported cases are reviewed. Unlike dural AVM's of the transverse sigmoid and cavernous sinuses that usually have a benign natural history, dural AVM's of the tentorium typically present with hemorrhage or progressive neurological deficit. In this series, patients ranged in age from 52 to 72 years and included five men and four women. These patients presented with subarachnoid hemorrhage, parenchymal hemorrhage, brainstem dysfunction, cerebellar signs, and obstructive hydrocephalus. Malformations were fed principally by the meningohypophyseal trunk, branches of the middle meningeal artery, and the occipital artery. Venous drainage was uniform through the cortical veins (predominantly the mesencephalic, petrosal, and cerebellar veins). Eight of the nine patients had an associated venous aneurysm(s); two had more than one venous aneurysm, and two patients had a vein of Galen aneurysm associated with the tentorial dural AVM. Eight of nine patients improved after treatment, including four patients with complete obliteration of the dural AVM. Based on our experience, we have developed a treatment protocol for tentorial dural AVM's that uses transarterial embolization followed by direct microsurgery or stereotactic radiation. These therapies, applied in a staged manner, have proven safe and relatively effective for the treatment of dural AVM's.
An experimental study of reflex variability in selective dorsal rhizotomy
Authors: Rivera Arnold D. C. , Burke Tim , Schiff Steven J. , Weiss Ira P.
Published: May 2009

✓ Significant problems regarding the measurement technique currently used to choose nerve roots for sectioning in the selective dorsal rhizotomy procedure have recently been reported. To better understand the source of these problems, a series of six experiments was performed in which the selective rhizotomy technique was applied to cats that were either intact, decerebrate, or spinalized. Measurements were made before and after partial rhizotomy. In decerebrate preparations, large, spontaneous changes in reflex threshold were observed over short periods of time, especially after partial rhizotomy was performed, and threshold changes greater than 1000% could be observed over 10-minute periods. Using constant-current stimulation of the dorsal root at threshold, the response of each ipsilateral leg muscle demonstrated frequent changes, and changes coincided with the variability in threshold estimation. In addition, very low thresholds were measured (0.1 to 0.25 mA) in half (3 of 6) of these experiments, these measurements being well below the currents customarily used for intraoperative decision making. Stimulation at twice threshold was found to consistently increase the pathological quality of the responses observed. Although intact animals never displayed contralateral responses when stimulated at threshold, such contralateral responses could readily be elicited at twice threshold. These laboratory results raise further doubts regarding the reliability of the measurement techniques now widely used for selective dorsal rhizotomy.
Archival correspondence regarding the origin of the Harvey Cushing Society: the American Association of Neurological Surgeons
Authors: Smith Frank P.
Published: May 2009

✓ Behind the scenes in the origin of the Harvey Cushing Society, now known as the American Association of Neurological Surgeons, there were many interesting political factors occurring, which appeared in correspondence and were preserved and later forwarded by William P. Van Wagenen to the Harvey Cushing Section of the Yale Medical Library. This correspondence, circa 1931, provides an interesting account of the aspirations of young neurosurgeons who wished to gain societal status, without offending the giants of the Society of Neurological Surgeons.
Characterization and pathogenicity of duck plague virus isolated from natural outbreaks in ducks of Bangladesh
Authors: Akter S , Islam MA , Hossain MT , Begum MIA , Amin MM , Sadekuzzaman M
Published: May 2009

Characterization and pathogenicity studies on Duck plague virus isolated from natural outbreaks of 170 ducks belonged to the districts of Mymensingh (n = 50), Netrokona (n = 70), and Kishoregonj (n = 50) were carried out during the period from January to June 2002. The collected samples were processed virologically for isolation and identification of Duck plague virus (DPV). Characterization and pathogenicity of the isolated DPV were studied in developing duck and chicken embryo, confluent monolayer of DEF, and experimentally induced infection in ducks. The DPV was identified by using neutralization (NT) and passive haemagglutination (PHA) tests. No remarkable differences were observed in the clinical characteristics, course of the disease and macroscopic lesions between naturally and experimentally infected ducks. The results of NT of DPV showed that all the local virus isolates (DPV-Mymensingh, DPV-Netrokona, and DPV-Kishoregonj) were neutralized by the antisera of duck plague vaccine virus (DLS, Mohakhali) which indicate that the virus isolates are homogenous and specific to the antisera to DPV. The PHA test was also found sensitive for the identification of DPV. Therefore, both the NT and PHA tests could be used for the identification of DPV. In addition, the local isolate of DPV-Netrokona was found to be more antigenic compared to other isolates which could be selected for vaccine preparation to control duck plague under field condition.Key words: duck plague virus; duck plague vaccine; neutralization test; passive haemagglutination testdoi: 10.3329/bjvm.v2i2.2540Bangl. J. Vet. Med. (2004). 2 (2): 107-111
Morphological sperm abnormalities of different breeds of AI bull and its impact on conception rate of cows in AI programme
Authors: Sarder MJU
Published: May 2009

The main objective of this study was to evaluate the effect of genetic groups of bulls on morphological characteristics of spermatozoa in relation to conception rate of first inseminated cows. For this purpose, 1390 ejaculates of semen were collected from 71 bull of six genetic groups at Central Cattle Breeding Station and Dairy Farm (CCBSDF), Savar, Dhaka; Rajabarihat Dairy Cattle Improvement Farm (RDCIF), Rajshahi, and District Artificial Insemination Centre, Rajshahi, from January 1997 to March 2002. A total of 20936 cows were inseminated by 40 technicians of different AI Sub-centre or points under the District Artificial Insemination Centre, Rajshahi, and pregnancy was confirmed on rectal palpation at 90 to 120 days after insemination. The average values of total head abnormalities, free loose head, mid-piece, tail abnormalities, proximal and distal cytoplasmic droplets, total tail abnormalities and total sperm abnormalities were 5.45%, 2.44%, 1.19%, 6.19%, 0.74%, 0.57%, 11.16% and 16.38%, respectively. Genetic groups of bull had significant (p < 0.05) effect on all the morphological characteristics of spermatozoa. The lower incidence of total sperm abnormalities (13.45%) was found in the genetic groups of 100% SL and higher (19.28%) in 75% F x 25% L bulls. The genetic groups of bulls had significant effect on first service conception rate of cows. The conception rate was higher in cows inseminated with 100% Local than those inseminated with genetic groups of 75% F x 25% L (53.13% vs 45.88%; p < 0.05). Significantly strong positive correlations were found between total head abnormalities and total sperm abnormalities (r = 0.828; p < 0.01) as well as between total tail abnormalities and total sperm abnormalities (r = 0.892; p < 0.01). It appears from the results that minimum total sperm abnormalities are found for pure breed bulls than cross-bred bulls, and 100% Local, 100% Friesian and 50% SL x 50% F bulls had better conception rates on cows.Key words: Spermatozoa; abnormalities; bull; genetic group; AI; conception ratedoi: 10.3329/bjvm.v2i2.2555Bangl. J. Vet. Med. (2004). 2 (2): 129-135
Grasses of different C4 subtypes reveal leaf traits related to drought tolerance in their natural habitats: Changes in structure, water potential, and amino acid content
Authors: Carmo‐Silva Ana E. , Francisco Ana , Powers Stephen J. , Keys Alfred J. , Ascensão Lia , Parry Martin A. J. , Arrabaça Maria Celeste
Published: May 2009

Three grasses (Poaceae) of different C4 subtypes, Paspalum dilatatum (NADP‐malic enzyme [ME]), Cynodon dactylon (NAD‐ME) and Zoysia japonica (phosphoenolpyruvate carboxykinase), occur in natural habitats that differ in annual rainfall. Their leaf characteristics were studied to identify traits related to drought tolerance. Plants were grown in pots, and water deficit was gradually induced by withholding water. Leaves of Z. japonica had the greatest and P. dilatatum the lowest relative dry matter content. Transverse sections of leaves that developed during the water deficit showed little change compared to control leaves, consistent with low phenotypic plasticity. Anatomical features distinguished the three species, with xeromorphic characteristics most strongly represented in Z. japonica. The leaf relative water content (RWC) decreased with the soil water content similarly for the three grasses. However, at 80% RWC, the leaf water potential was −3.1 MPa for Z. japonica and only −1.3 MPa for P. dilatatum and C. dactylon. Soluble amino acids, especially proline, increased as RWC decreased in leaves of C. dactylon and Z. japonica. Phenylalanine, valine, leucine, and isoleucine increased more in Z. japonica than in the other two species. The results provide evidence that C. dactylon and, especially, Z. japonica have evolved leaf traits better suited to arid habitats.
Modalités et enjeux de la communication externe des réseaux de santé : l'expérience d'un réseau d'accès aux soins
Authors: Plu Isabelle , Gignon Maxime , Emery Sophie , Purssell-François Irène , Moutel Grégoire , Hervé Christian
Published: May 2009

Résumé Les réseaux de santé dont le but est de favoriser la coordination des prises en charge doivent se faire connaître du grand public et des professionnels de santé afin de bien s’insérer dans le maillage sanitaire local. Après un rappel des obligations légales des réseaux de santé en matière de communication externe, les vecteurs de communication utilisés pour faire connaître le réseau sur son territoire sont décrits, à partir de l’exemple d’un réseau d’accès aux soins, le réseau ASDES (Accès aux Soins, accès aux Droits, Éducation à la Santé). Selon le Code de la santé publique, les premiers vecteurs de communications des réseaux sont la convention constitutive et la charte du réseau, devant être communiquées aux professionnels de santé du territoire et portées à la connaissance des patients. Le réseau ASDES a en outre informé collectivement et individuellement de ses actions les professionnels de santé du territoire, et s’est fait connaître auprès de la population lors de journées de prévention départementales et d’actions communautaires d’éducation à la santé. À partir de ce cas illustratif, s’ouvre une réflexion éthique et déontologique sur les modalités et les enjeux de la communication externe des réseaux.
Organisation sanitaire lors des opérations de déminage dans le Finistère
Authors: Saliou Philippe , Largeau Françoise
Published: May 2009

Résumé La direction départementale des affaires sanitaires et sociales (Ddass) du Finistère, en coopération avec les secouristes, les services de la mairie et de la préfecture, a mis au point une méthode pour l’évacuation sanitaire des personnes lors des opérations de déminage dans la région brestoise. Il s’agit de recenser les personnes à domicile, de déterminer les besoins en hébergements hospitaliers et d’organiser leur prise en charge par les secouristes. Cette méthode appliquée depuis 2003 s’appuie sur des outils créés par la Ddass. Elle est couramment utilisée et a fait la preuve de son efficacité jusqu’à présent.
Twelve Steps for Success in the Nursing Research Journey
Authors: Pierce Linda L.
Published: May 2009

Research is an integral part of everyday nursing practice. Clients, third-party payers, and accreditors demand clinical practice based on evidence or research findings. Who will perform this research? Nurses at all educational levels and in all practice settings can participate in the research journey. The purpose of this article is to discuss 12 steps, offered as a road map, in the research process. Nurses can learn these steps for success and increase their ability to conduct the research that supports and develops nursing science.

J Contin Educ Nurs
2009;40(4):154–162.
Antibiotic-impregnated Calcium Sulfate Use in Combat-related Open Fractures
Authors: Helgeson CPT Melvin D. , Potter MAJ Benjamin K. , Tucker CPT Christopher J. , Michael Frisch LTC H. , Shawen LTC Scott B.
Published: May 2009

This article presents our experience with the use of antibiotic-impregnated calcium sulfate in the management of comminuted open fractures with a bony defect caused by combat-related blast injuries and high-energy wounds.

Calcium sulfate was used 19 times in 15 patients (17 fractures) as a bone graft substitute and a carrier for antibiotics. The anatomic sites of the graft were as follows: 6 calcanei, 1 midfoot, 1 metatarsal, 5 tibiae, 3 femorae, and 1 humerus. The average number of procedures prior to grafting was 6.2 (range, 2–10; median, 6) with grafting performed at an average 28 days after injury (range, 9–194 days; median, 14 days). Average radiographic follow-up of 12 fractures not requiring repeat grafting or amputation was 8.5 months (range 1–19 months; median, 7 months), and all of these fractures demonstrated clinical and radiographic evidence of fracture healing and consolidation. Four patients subsequently underwent 5 transtibial amputations: 2 for persistent infection, 1 when the patient changed his mind against limb salvage acutely, and 2 for severe neurogenic pain. Including the 2 amputations for persistent infection, 4 patients (22.2%) required further surgical management of infection. Three patients (17.6%) subsequently developed heterotopic ossification at the graft site, which required surgical excision.

Antibiotic-impregnated calcium sulfate is effective in treating severe, contaminated open fractures by reducing infection and assisting with fracture union.
In Vivo Adduction and Reverse Axial Rotation (External) of the Tibial Component Can Be Minimized
Authors: Howell Stephen M. , Hodapp Esther E. , Kuznik Kyle , Hull Maury L.
Published: May 2009

Mechanical alignment with conventional total knee arthroplasty (TKA) instruments often requires collateral ligament releases, which result in a high prevalence of adduction and reverse axial rotation (external rotation) of the tibial component during knee flexion with a variety of component designs. We used a radiographic image-matching technique to determine the contact kinematics during standing and kneeling at 90° and maximum flexion in a series of 35 patients in which a new image-guided, custom cutting block system was used to kinematically align a cruciate-retaining prosthesis with the intent of restoring the 3 kinematic axes of the knee. The kinematically aligned prosthesis had a minimal prevalence of adduction (3%) and reverse axial rotation (8.5%). The anteroposterior contact positions of the lateral and medial femoral condyles did not edge load the tibial liner. The moderate association between abduction and internal rotation, the degree of knee flexion, and the contact position of the medial femoral condyle suggest that abduction was not a sign of lift-off of the medial femoral condyle, but the result of the medial femoral condyle moving up the anterior slope of the tibial liner. These more normal contact kinematics were achieved without release of the collateral ligaments or lateral retinaculum. In contrast to mechanical alignment with conventional surgical techniques, the use of kinematic alignment with custom-fit cutting guides and a cruciate-retaining, symmetric medial and lateral femoral–tibial bearing surface minimizes the undesirable consequences of adduction and reverse axial rotation (external rotation).
Delivering Ideal Employee Experiences
Authors: Weiss Marjorie D. , Tyink Steve , Kubiak Curt
Published: May 2009

Employee-centric strategies have moved from employee satisfaction and brand awareness to employee “affinity” or “attachment.” In today's marketplace, occupational health nurses understand that differentiation (i.e., the perception of uniqueness) is the direct result of superior employee interactions, which lead to better employee care, enduring employee relationships, loyal employees, and satisfied employers. What drives employees to occupational health nurse attachment? The answer is a passion for rising above the competition to create ideal employee experiences.
The Concept of Reliability in the Context of Observational Assessments
Authors: Brentnall Jennie , Bundy Anita C.
Published: May 2009

Occupational therapists are interested in clients' performance of activities of daily living in real-life contexts. To maximize the validity of inferences made from assessments, occupational therapists conduct observations in everyday environments: at home, school, and work and in the community. Although these observations in context are arguably more valid, they are potentially less controlled, which affects the reliability of the data obtained. Occupational therapists may wonder about the evidence of reliability when evaluating observational assessments for use or question reliability considerations in developing protocols. This article explores the concept of reliability in the context of observational assessments. We compare two theoretical approaches to reliability; apply the theory to the example of occupational performance, as viewed by occupational therapists; and argue the relevance of internal consistency, observer (rater) reliability, and sample reliability. Finally, the authors examine in-depth factors influencing the sample reliability of observational assessment scores, weighed against the utility of assessments and generalizability of scores.
Under‐reporting of compensable mesothelioma in Alberta
Authors: Cree Marilyn W. , Lalji Munira , Jiang Bei , Carriere Keumhee C.
Published: May 2009

Background

When combined with a history of occupational asbestos exposure, mesothelioma is often presumed work‐related. In Canada, workers diagnosed with mesothelioma caused by occupational asbestos exposure are often eligible for compensation under provincial workers' compensation boards. Although occupational asbestos exposure causes the majority of mesothelioma, Canadian research suggests less than half of workers actually apply for compensation. Alberta's mandatory reporting requirements may produce higher filing rates but this is currently unknown. This study evaluates Alberta's mesothelioma filing and compensation rates.

Methods

Demographic information on all mesothelioma patients diagnosed between 1980 and 2004 were extracted from the Alberta Cancer Board's Cancer Registry and linked to Workers' Compensation Board of Alberta claims data.

Results

Alberta recorded a total of 568 histologically confirmed mesothelioma cases between 1980 and 2004. Forty‐two percent of cases filed a claim; 83% of filed claims were accepted for compensation.

Conclusions

Patient under‐reporting of compensable mesothelioma is a problem and raises larger questions regarding under‐reporting of other asbestos‐related cancers in Alberta. Strategies should focus on increasing filing rates where appropriate. Am. J. Ind. Med. 52:526–533, 2009. © 2009 Wiley‐Liss, Inc.
Homocysteine as a predictor of cognitive decline in Alzheimer's disease
Authors: Oulhaj Abderrahim , Refsum Helga , Beaumont Helen , Williams Jonathan , King Elizabeth , Jacoby Robin , Smith A. David
Published: May 2009

Objective

Moderately elevated levels of plasma total homocysteine are associated with an increased risk of developing Alzheimer's disease. We have tested whether baseline concentrations of homocysteine relate to the subsequent rate of cognitive decline in patients with established Alzheimer's disease (AD).

Methods

In 97 patients with AD, 73 pathologically‐confirmed, we analysed the decline of global cognitive test scores (CAMCOG) over time from the first assessment for at least three 6‐monthly visits up to a maximum of 9.5 years (in total 689 assessments). Non‐linear mixed‐effects statistical models were used.

Results

Baseline homocysteine levels showed a concentration‐response relationship with the subsequent rate of decline in CAMCOG scores: the higher the homocysteine, the faster the decline. The relationship was significant in patients aged < 75 years who had not suffered a prior stroke. For example, in patients aged 65 years with a baseline homocysteine of 14 µmol/L, the decline from a CAMCOG score of 88 to a score of 44 occurred 19.2 (95% CI 6.8, 31.6) months earlier than in patients with a baseline homocysteine of 10 µmol/L.

Conclusions

Raised homocysteine concentrations within the normal range among the elderly strongly relate to the rate of global cognitive decline in patients with Alzheimer disease. Plasma homocysteine can readily be lowered by B‐vitamin treatment and trials should be carried out to see if such treatments can slow the rate of cognitive decline in relatively young patients with Alzheimer disease. Copyright © 2009 John Wiley & Sons, Ltd.
Updating the skin sensitization in vitro data assessment paradigm in 2009
Authors: Basketter David A. , Kimber Ian
Published: May 2009

Approaches to the interpretation of guinea pig skin sensitization data for both hazard identification and potency assessment have been understood for many years. More recently, the local lymph node assay has to a large extent replaced the earlier guinea pig assays, not least because it provides a more clearly defined and transparent means of identifying hazard, and the ability to measure relative skin sensitization potency. However, beginning in 2009 there will be considerable pressure replace all in vivo assays for skin sensitization with alternative approaches that do not require the use of animals (in vitro and/or in silico methods). As there is a common view that multiple assays will be needed to achieve complete replacement of the in vivo tests, a strategy for the integration of the available data will be required. There has been at least one previous attempt to develop a framework that would provide for integration of relevant information from different sources to reach informed decisions about skin sensitization potential and potency. It is timely now, in the light of recent developments and initiatives, to revisit this paradigm with a view to developing recommendations for modification and refinement. In addition to this, the need for performance standards and an agreed ‘gold standard’ dataset against which to validate both alternatives and new prediction models is discussed. Copyright © 2009 John Wiley & Sons, Ltd.
In vitro maturation of “biotube” vascular grafts induced by a 2‐day pulsatile flow loading
Authors: Huang Haiying , Zhou Yue‐Min , Ishibashi‐Ueda Hatsue , Takamizawa Keiichi , Ando Joji , Kanda Keiichi , Yaku Hitoshi , Nakayama Yasuhide
Published: May 2009

Autologous vascular tissues with a small diameter, “biotubes,” were developed in vivo using a novel concept in regenerative medicine, “in‐body tissue architecture technology.” The effect of pulsatile flow in vitro was investigated on the structural and functional properties of the biotubes. Silicone rods (diameter, 3.0 mm; length, 35.0 mm), used as molds, were embedded into dorsal subcutaneous spaces of Wister rats. After 4 weeks, the autologous tubular tissues formed around the rods were harvested. Some tissues were incubated for 2 days under pulsatile flow simulating conditions in the human arteries with small caliber (wall shear stress (WSS), 15.5–77.3 dyn/cm2; circumferential stress (CS), 0.6–4.5 × 105 dyn/cm2). Upon flow loading, the sparse, randomly oriented collagen fibers in the biotubes became dense and oriented in the regular circumferential direction. Compliances (β values) of the control (ca. 30) and flow‐loaded (ca. 20) biotubes were equivalent to that of the human coronary arteries and femoral arteries, respectively. Further, upon flow loading, the burst pressure significantly increased from ca. 1000 mmHg to ca. 1800 mmHg, along with the α‐SMA‐positive cell ratio. Pulsatile flow loading in vitro for 2 days could induce biotube maturation in terms of collagen structures and mechanical properties. © 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009
Three‐dimensional power Doppler sonography in the diagnosis of a cystic sacrococcygeal teratoma mimicking a meningomyelocele: A case report
Authors: Sugitani Maiko , Morokuma Seiichi , Hidaka Nobuhiro , Kinoshita Yoshiaki , Taguchi Tomoaki , Tsukimori Kiyomi , Wake Norio
Published: May 2009

Sacrococcygeal teratomas have been diagnosed prenatally on sonograms as masses of cystic, solid, or mixed echogenicity from the sacral area and protruding through the perineum or buttocks. However, a cystic sacrococcygeal teratoma may be misdiagnosed as an anterior sacral meningomyelocele, especially when presenting as a posterior cystic mass. We report a case in which three‐dimensional power Doppler imaging was helpful for making a correct prenatal diagnosis of a type 1 cystic sacrococcygeal teratoma, which mimicked a meningomyelocele. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009
A scanning electron microscopic study on the cephalic cuticular sensillae of different larval stages of Antheraea assamensis, an indigenous silkworm species of Northeast India
Authors: Dey Sudip , Singh Surendra , Chakraborty Rahul , Hooroo Rupa Nylla Kynta , Choudhury Sudipto
Published: May 2009

Scanning electron microscopy revealed the presence of a number of cuticular sensillae on the head of different larval stages of the “Muga” silk moth, Antheraea assamensis. These include four types of sensilla trichodea, bead‐like folded sensilla, two types of sensilla basiconica, and sensory pegs. The study seems to be the first attempt in describing the morphology and distribution pattern of the cephalic cuticular sensillae of different larval stages of the silk moth Antheraea assamensis, an indigenous species of Northeast India. The possible significance of the sensillae in searching behavior of the larval stages during feeding is discussed with the help of available literature. Microsc. Res. Tech., 2009. © 2009 Wiley‐Liss, Inc.
Visualization of wound periderm and hyphal profiles in pine stems inoculated with the pitch canker fungus Fusarium circinatum
Authors: Kim Ki Woo , Lee In Jung , Thoungchaleun Vilakon , Kim Chang Soo , Lee Don Koo , Park Eun Woo
Published: May 2009

Postpenetration behavior of Fusarium
circinatum in stems of pine species was investigated with light and transmission electron microscopy. Two‐year‐old stems of Pinus rigida and P. densiflora were wound‐inoculated with the fungal conidial suspension and subjected to 25°C for up to 30 days. It was common to observe the formation of wound periderm on each pine species, recovering wounded sites with newly formed tissues. The outermost thick layer of wound periderm was pink to red colored with the phloroglucinol‐EtOH staining, indicating heavy deposition of lignin in wound periderm. The cork layers in the wound periderm of the two pine species consisted of cells that were mostly devoid of cellular contents in cytoplasm. The cork cells showed convoluted cell walls with different electron density (lamellations), which was seemingly more prevalent in P. densiflora than P. rigida. Hyphae of F. circinatum appeared normal with typical eucaryotic cytoplasm in P. rigida on ultrathin sections. Meanwhile, hyphae in P. densiflora were found to possess highly vacuolated cytoplasm, implying hyphal weakening and disintegration. Hyphal cytoplasm appeared to be a thin layer between the vacuole and the plasma membrane surrounded by cell wall. In addition, intrahyphal hyphae and concentric bodies were observed in hyphal cytoplasm. These results suggest that the architecture of wound periderm may be responsible for different responses of pine species to the invasion of F. circinatum. Microsc. Res. Tech., 2009. © 2009 Wiley‐Liss, Inc.
Predictors of ischemic stroke after hip operation: A population‐based study
Authors: Popa Alina S. , Rabinstein Alejandro A. , Huddleston Paul M. , Larson Dirk R. , Gullerud Rachel E. , Huddleston Jeanne M.
Published: May 2009

BACKGROUND:

Hip operation (total hip arthroplasty [THA] or fracture repair) is the most common noncardiac surgical procedure performed in patients age 65 years and older.

OBJECTIVE:

To determine the predictors of ischemic stroke in patients who have undergone hip operation.

DESIGN:

Population‐based historical cohort study, in which postoperative ischemic strokes were identified from medical record review for stroke diagnostic codes and brain imaging results and were confirmed by physician review.

SETTING:

Tertiary care center in Olmsted County, Minnesota.

PATIENTS:

Residents of Olmsted County who underwent hip surgical procedure.

MEASUREMENTS:

Incidence of ischemic stroke within 1 year of hip operation.

RESULTS:

In total, 1606 patients underwent 1886 hip procedures from 1988 through 2002 and were observed for ischemic stroke for 1 year after their procedure. Sixty‐seven ischemic strokes were identified. The rate of stroke at 1 year after hip operation was 3.9%. In univariate analysis, history of atrial fibrillation (hazard ratio [HR], 2.16; P = 0.005), hip fracture repair vs. total hip arthroplasty (HR, 3.80; P < 0.001), age 75 years or older (HR, 2.20; P = 0.02), aspirin use (HR, 1.8; P = 0.01), and history of previous stroke (HR, 4.18; P < 0.001) were significantly associated with increased risk of stroke. In multivariable analysis, history of stroke (HR, 3.27; P < 0.001) and hip fracture repair (HR, 2.74; P = 0.004) were strong predictors of postoperative stroke.

CONCLUSIONS:

This population‐based historical cohort of patients with hip operation had a 3.9% cumulative probability of ischemic stroke over the first postoperative year. Hip fracture repair and history of stroke were the strongest predictors of this complication. Journal of Hospital Medicine 2009;4:298–303. © 2009 Society of Hospital Medicine.
Identification of germinal disk region derived genes potentially involved in hen fertility
Authors: Elis Sebastien , Blesbois Elisabeth , Couty Isabelle , Balzergue Sandrine , Martin‐Magniette Marie‐Laure , Batellier Florence , Govoroun Marina S.
Published: May 2009

Despite the regular decrease in fertility observed in hens, especially in “meat” lines, little is known about genes affecting fertility. We used the Affymetrix microarray to search for oocyte genes whose expression would vary in relation to fertility rate in both “laying” and “meat” line hens. We focused on oocyte genes because several of them have been found to be involved in fertility in other species. Based on microarray analysis, 54 and 84 genes were differentially expressed between germinal disc regions (GDR) of F1 maturation stage oocytes from hens exhibiting either high (100%) or low (from 22% to 80%) fertility rate from laying and meat lines respectively. Most of these differentially expressed genes were distributed between “laying” and “meat” lines indicating that mechanisms involved in the decrease in fertility rates in these two cases were independent. Real time RT‐PCR performed on the same samples which were used for microarray confirmed in several cases differences in gene expression levels detected by microarray. Moreover the correlations between gene expression levels and fertility rates were evaluated for the 10 most interesting genes at different stages of follicular maturation and early embryo development on individual GDR samples from hens exhibiting different fertility rates. In total, we identified five genes whose expression levels correlated with fertility rate in accordance with findings of microarray analysis and real time RT‐PCR: VWC2, CR407412, TAPA, FGL2, and TRAP6. The biological significance of these genes sheds light on potential mechanisms influencing fertility and could provide candidates for fertility markers in the hen. Mol. Reprod. Dev. 76: 1043–1055, 2009. © 2009 Wiley‐Liss, Inc.
Flow cytometric determination of Src phosphorylation in pediatric patients treated with dasatinib
Authors: Guerrouahen Bella S. , Wieder Eric , Blanchard Elisabeth G. , Lee Francis Y. , Aplenc Richard , Corey Seth J.
Published: May 2009

Tyrosine kinase inhibitors, such as imatinib, have dramatically improved the outcomes for patients with selected cancers. For imatinib, western blotting of phospho‐CrkL was an insensitive, indirect, and descriptive method to determine drug efficacy. Greater use of targeted therapies should involve more quantitative evaluation of the target's dose‐inhibition. The Src/Abl kinase inhibitor dasatinib has recently been approved for use in Ph+ leukemias after failure with imatinib. Src family kinases (SFK) also play a critical role in nonhematologic cancers. We have developed a flow cytometric assay to measure SFK autophosphorylation levels in blood mononuclear cells and observed a direct correlation between its inhibition and patient dosage. This method provides a sensitive, quick, and quantitative tool to assess drug efficacy. Pediatr Blood Cancer 2009;53:1132–1135. © 2009 Wiley‐Liss, Inc.