bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of esophageal cancer related gene 4 (ECRG4), a novel tumor suppressor gene, in esophageal cancer and its inhibitory effect on the tumor growth in vitro and in vivo
Authors: Li Lin‐Wei , Yu Xi‐Ying , Yang Yang , Zhang Chun‐Peng , Guo Li‐Ping , Lu Shih‐Hsin
Published: April 2009

The ECRG4 gene was initially identified and cloned in our laboratory from human normal esophageal epithelium (GenBank accession no. AF325503). We revealed the expression of ECRG4 protein was downregulated in 68.5% (89/130) ESCC samples using tissue microarray. The low ECRG4 protein expression was significantly associated with regional lymph node metastasis, primary tumor size, and tumor stage in ESCC (p < 0.05). ECRG4 mRNA expression was downregulated in ESCC due to the hypermethylation in the gene promoter. The treatment with 5‐aza‐2′‐deoxycytidine, which is a DNA methyltransferase inhibitor restored ECRG4 mRNA expression in ESCC cells. The result indicated that promoter hypermethylation may be 1 main mechanism leading to the silencing of ECRG4. The high expression of ECRG4 in patients with ESCC was associated with longer survival compared with those with low ECRG4 expression by Kaplan‐Meier survival analysis (p < 0.05). ECRG4 protein was an independent prognostic factor for ESCC by multivariable Cox proportional hazards regression analysis (p < 0.05). The restoration of ECRG4 expression in ESCC cells inhibited cell proliferation, colony formation, anchorage‐independent growth, cell cycle progression and tumor growth in vivo (p < 0.05). The transfection of ECRG4 gene in ESCC cells inhibited the expression of NF‐κB and nuclear translocation, in addition to the expression of COX‐2, a NF‐κB target gene, was attenuated. Taken together, ECRG4 is a novel candidate tumor suppressor gene in ESCC, and ECRG4 protein is a candidate prognostic marker for ESCC. © 2009 UICC
Lidocaine: An inhibitor in the free‐radical‐induced hemolysis of erythrocytes
Authors: Tang You‐Zhi , Liu Zai‐Qun , Wu Di
Published: April 2009

Lidocaine was reported to protect erythrocytes from hemolysis induced by 2,2′‐azobis(2‐amidinopropane) dihydrochloride (AAPH). Since AAPH‐induced hemolysis was a convenient in vitro experimental system to mimic erythrocytes undergoing peroxyl radicals attack, the aim of this work was to investigate the antioxidant effect of lidocaine on AAPH‐induced hemolysis by chemical kinetics. As a result, one molecule of lidocaine can only trap 0.37 radical, much lower than melatonin. Meanwhile, lidocaine cannot protect erythrocytes from hemolysis induced by hemin, which the mechanism of hemolysis was due to the erythrocyte membrane destroyed by hemin. Accordingly, lidocaine protected erythrocytes by scavenging radicals preferentially rather than by stabilizing membrane. Moreover, the interactions of lidocaine with two radical species, including 2,2′‐azinobis(3‐ethylbenzothiazoline‐6‐sulfonate) radical cation (ABTS+•) and 2,2′‐diphenyl‐1‐picrylhydrazyl (DPPH), indicated that lidocaine can reduce ABTS+• with 260 µM as the 50% inhibition concentration (IC50) and cannot react with DPPH. Thus, lidocaine served as a reductant rather than a hydrogen donor to interact with radicals. Finally, the quantum calculation proved that, compared with the melatonin radical, the stabilization of N‐centered radical of lidocaine was higher than the amide‐type N‐centered radical but lower than the indole‐type N‐centered radical in melatonin. These results provided basic information for lidocaine to be an antiradical drug. © 2009 Wiley Periodicals, Inc. J Biochem Mol Toxicol 23:81–86, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/jbt.20267
Effect of thermochemical sludge pretreatment on sludge reduction and on performances of anoxic‐aerobic membrane bioreactor treating low strength domestic wastewater
Authors: Do Khac‐Uan , Banu J. Rajesh , Chung Ik‐Jae , Yeom Ick‐Tae
Published: April 2009

BACKGROUND: Reduction of excess sludge production has become an urgent issue. An investigation into the influence of thermochemical sludge pretreatment on sludge reduction in a bench‐scale anoxic‐aerobic membrane bioreactor was performed. Two systems were operated. In one system, part of the mixed liquid (1.5% of the influent flow rate) was pretreated thermochemically (at 80 °C, pH 11 and 3 h) and returned to the bioreactor. This study examined and evaluated the effect of thermochemical sludge pretreatment on the reduction of excess sludge and on the performance of the system.

RESULTS: The average solubilization efficiency of the pretreated sludge was found to be about 0.2. The sludge production rate of the experimental system (E‐MBR) was less than that of the control (C‐MBR) by about 33%. The total phosphorus was removed mainly by normal cell synthesis, with removal efficiencies of 38–40% and 40–42% for the E‐MBR and C‐MBR, respectively. The total nitrogen removal in the E‐MBR was slightly higher than in the C‐MBR due to supply of soluble chemical oxygen demand (SCOD) from the digested sludge solution as an external carbon source. The mixed liquor volatile suspended solids (MLVSS) and mixed liquor suspended solids (MLSS) ratios for the two systems were almost identical, in the range 74–77%, indicating that the inorganics from the disintegrated cells do not accumulate as particulates in the reactor. The TMP was maintained at less than 6 cmHg for 180 days without membrane cleaning.

CONCLUSION: Thermochemical sludge pretreatment can play an important role in reducing sludge production. The qualities of the effluent water were not significantly affected during 6 months of operation. Copyright © 2009 Society of Chemical Industry
Discourses contexts and collaboration
Authors: Jensen Povl Erik
Published: April 2009

This paper starts and ends with a discussion on whether management should draw conclusions and make decisions on the basis of information alone or also should take into account the intangible aspects of the situation and intuition. The analysis of this question focuses on how and where (productive) knowledge is created. The critical input in the production process is knowledge because knowledge is the basic source of values. All knowledge is attained and possessed by individuals. In contrast, the use of (productive) knowledge to create values is a collective process. This is so because only information, and not knowledge, can be shared and spread among the members of an organization. Thus, information must be transformed into knowledge (possessed by individuals) and back into information again that is shared among members of the organization if values are to be produced.

The aim of this paper is to explore how productive knowledge is created in the collective processes involved in the coordination and cooperation activities that individuals perform in a close working relationship. This coordination is guided by discourses (or conversations). These discourses (conversations) can be both context specific and general. Context‐specific discourses create a collective identity, that is specific to the context in question, while general discourses may also create particularized identities stemming from contexts removed from the specific context. Discourses can be evaluated “from the outside” by studying the narrative texts produced by the organization. Such a study is used in the empirical component of this paper. From discourses with texts and histories, the participants create common constructions that boost knowledge sharing among them and the company's customers. If management (and employees) can develop dense working relationships among themselves and their customers on the basis of discourses, contexts, and collaboration activities unique to them, they can rely heavily on information sharing without being exposed to the risk that the company's core capabilities are likely to be copied. Copyright © 2009 John Wiley & Sons, Ltd.
Technological and conceptual accessibility to measure the soundness of an e‐business idea
Authors: Capece Guendalina
Published: April 2009

The purpose of this paper is to present two new parameters that aim to support the selection phase of a new e‐business idea in order to evaluate its soundness and effectiveness.

The paper explains the reasons for the creation of these new parameters, the identification of the measures and the metrics to evaluate them, and presents the final results and their meaning.

This new methodology should integrate the traditional business analysis concepts through the identification of new useful measures that are specific to the e‐business field.

The parameters identified have been called “Conceptual Accessibility” and “Technological Accessibility.”

In order to tune the new parameters and to execute all the needed subjective evaluations a user panel of 100 potential users was selected and utilized. In order to assess the soundness of the identified parameters and to give a definition and a metric that will allow a quantitative evaluation of the idea the reference user panel gave evaluations on an enterprise reference group of well known e‐business ventures. All the components of the enterprise reference group are examples of successful implementation of e‐business ideas. The users in the panel were carefully selected in order to represent the expected target of the new e‐business idea to be evaluated. In the final sections of the paper we finally discuss the results and underline the advantages of this methodology. Copyright © 2009 John Wiley & Sons, Ltd.
Assessing the value of an e‐mail knowledge extraction system
Authors: Tedmori Sara , Jackson Thomas W.
Published: April 2009

This paper reviews an approach to locating knowledge holders within organizations through the use of a well‐established communication medium, E‐mail. The approach has been used to develop the E‐mail knowledge extraction (EKE) tool. EKE was then evaluated at an academic institution in the United Kingdom. This study represents the first effort to validate the viability of the E‐mail medium as a source of knowledge profiling data, to be used for finding employees who possess the required knowledge. It also looks at the socio–ethical challenges associated with EKE's adoption. The overall evaluation of EKE found it to be useful, interesting, easy and intuitive to use and of potential benefit to employees within organizations. Copyright © 2009 John Wiley & Sons, Ltd.
The organizational knowledge iceberg: An empirical investigation
Authors: Haider Sajjad
Published: April 2009

This study explores the critical success factors of implementing and running a knowledge management program. In doing so, the paper proposes and tests a conceptual model of “knowledge iceberg” inside the organization using a case study methodology. In total 89 in‐depth semi‐structured interviews were conducted over a period of 1 year in the SoftNetCo company to study success factors in the implementation of knowledge initiatives. During the research period 11 knowledge management initiatives were launched in the company which provided an excellent platform to conduct this research. The findings of the study suggest the existence of a knowledge iceberg inside organizations. It is reported that six activities can cause the knowledge iceberg to rise which is critical for the success of knowledge management initiatives. It is further argued that a holistic approach is required to manage knowledge, people, and culture and that managers have to concentrate more on managing people than the knowledge itself. Copyright © 2009 John Wiley & Sons, Ltd.
Li–Fraumeni and Li–Fraumeni‐like syndrome mutations in p53 are associated with exonic methylation and splicing regulatory elements
Authors: Kouidou Sofia , Malousi Andigoni , Maglaveras Nicos
Published: April 2009

Mutations in codon 133 of p53, which cause the loss of the Δ133 isoform(s) expression, are very frequent in the Li–Fraumeni (LF) and Li–Fraumeni‐like (LFL) syndromes. In sporadic cancers, silent p53 mutations are correlated with exonic splicing enhancers (ESEs) and exonic methylated sites. The present study shows that mutations in splice sites are also very frequent in LF/LFL syndromes, while missense mutations are less common compared to other familial or sporadic cancers (P = 0 in both cases). Furthermore, it is shown that the codons at which LF/LFL germline missense mutations occur, correlate with CpG‐containing ESEs (r = 0.181, P = 0.014) which are all methylated in p53. While both silent and LF/LFL missense mutations correlate with SC35 motifs, only the latter are associated with SRp55. On the contrary, only silent mutations in sporadic cancers correlate with SF2/ASF motifs in p53. Moreover, 12.1% of LF/LFL missense mutations involve the formation of potential splice sites of considerable splicing scores. Finally, mutations that are not at, or adjacent to CpGs (±1 codon, 34% of all LF/LFL mutated sites), introduce considerable changes of the ESE scores (>1.3 score change). The above data verify that LF/LFL missense mutations probably result also in splicing deregulation, in addition to any changes of the protein function and are mostly associated with alterations of the exonic methylation landscape. Some of the ESEs affected in LF/LFL syndromes are also genetically unstable in sporadic cancers but non‐CpG cytosine instability, which is predominantly associated with specific ESEs, is only common in sporadic cancers. Mol. Carcinog. © 2009 Wiley‐Liss, Inc.
Influence of intrinsic noise generated by a thermotesting device on thermal sensory detection and thermal pain detection thresholds
Authors: Pavlaković G. , Züchner K. , Zapf A. , Bachmann C.G. , Graf B.M. , Crozier T. A. , Pavlaković H.
Published: April 2009

Various factors can influence thermal perception threshold measurements and contribute significantly to unwanted variability of the tests. To minimize this variability, testing should be performed under strictly controlled conditions. Identifying the factors that increase the variability and eliminating their influence should increase reliability and reproducibility. Currently available thermotesting devices use a water‐cooling system that generates a continuous noise of approximately 60 dB. In order to analyze whether this noise could influence the thermal threshold measurements we compared the thresholds obtained with a silent thermotesting device to those obtained with a commercially available device. The subjects were tested with one randomly chosen device on 1 day and with the other device 7 days later. At each session, heat, heat pain, cold, and cold pain thresholds were determined with three measurements. Bland–Altman analysis was used to assess agreement in measurements obtained with different devices and it was shown that the intersubject variability of the thresholds obtained with the two devices was comparable for all four thresholds tested. In contrast, the intrasubject variability of the thresholds for heat, heat pain, and cold pain detection was significantly lower with the silent device. Our results show that thermal sensory thresholds measured with the two devices are comparable. However, our data suggest that, for studies with repeated measurements on the same subjects, a silent thermotesting device may allow detection of smaller differences in the treatment effects and/or may permit the use of a smaller number of tested subjects. Muscle Nerve 40: 257–263, 2009
Modulation of the soleus H‐reflex following galvanic vestibular stimulation and cutaneous stimulation in prone human subjects
Authors: Lowrey Catherine R. , Bent Leah R.
Published: April 2009

There is evidence to suggest that vestibular and somatosensory inputs may interact when they are processed by the central nervous system, although the nature of the individual sensory contributions to this interaction is unknown. We examined the effects of a combined vestibular and cutaneous conditioning stimulus on the motoneuron pool that supplies the soleus muscle via the Hoffman reflex (H‐reflex). We applied galvanic vestibular stimulation (GVS; bipolar, binaural, 500 ms, 2.5‐mA square‐wave pulse) and cutaneous stimulation (medial plantar nerve; 11 ms, three‐pulse train, 200 HZ) to prone human subjects and examined changes in the amplitude of the H‐reflex. GVS alone caused facilitation (approximately 20%) of the H‐reflex, whereas ipsilateral cutaneous stimulation alone caused a 26% inhibition. Paired GVS and cutaneous stimulation resulted in a linear summation of the individual conditioning effects. H‐reflex amplitudes observed after paired conditioning with GVS and cutaneous stimulation could be predicted from the amplitudes observed with individual conditioning. These results suggest that in the prone position, when the muscles are not posturally engaged, vestibular and somatosensory information appear to sum in a linear fashion to influence the reflex response of lower limb motoneurons. Muscle Nerve 40: 213–220, 2009
Bone loss in survival motor neuron (Smn−/−SMN2) genetic mouse model of spinal muscular atrophy
Authors: Shanmugarajan Srinivasan , Tsuruga Eichi , Swoboda Kathryn J , Maria Bernard L , Ries William L , Reddy Sakamuri V
Published: April 2009

Spinal muscular atrophy (SMA) is characterized by degenerating lower motor neurons and an increased incidence of congenital bone fractures. Survival motor neuron (SMN) levels are significantly reduced due to deletions/mutations in the telomeric SMN1 gene in these patients. We utilized the Smn−/− SMN2 mouse model of SMA to determine the functional role for SMN in bone remodelling. µCT analysis of lumber vertebrae, tibia and femur bones from SMA mice revealed an osteoporotic bone phenotype. Histological analysis demonstrated a thin porous cortex of cortical bone and thin trabeculae at the proximal end of the growth plate in the vertebrae of SMA mice compared to wild‐type mice. Histochemical staining of the vertebrae showed the presence of abundant activated osteoclasts on the sparse trabeculae and on the endosteal surface of the thin cortex in SMA mice. Histomorphometric analysis of vertebrae from SMA mice showed an increased number of osteoclasts. Serum TRAcP5b and urinary NTx levels were elevated, consistent with increased bone resorption in these mice. SMA mice showed a significant decrease in the levels of osteoblast differentiation markers, osteocalcin, osteopontin and osterix mRNA expression; however, there were no change in the levels of alkaline phosphatase expression compared to WT mice. SMA mouse bone marrow cultures revealed an increased rate of osteoclast formation (54%) and bone resorption capacity (46%) compared to WT mice. Pre‐osteoclast cells from SMA mice showed constitutive up‐regulation of RANK receptor signalling molecules critical for osteoclast differentiation. Our results implicate SMN function in bone remodelling and skeletal pathogenesis in SMA. Understanding basic mechanisms of SMN action in bone remodelling may uncover new therapeutic targets for preventing bone loss/fracture risk in SMA. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
A case of multisystem Langerhans cell histiocytosis with primary hypothyroidism followed by type 1 diabetes mellitus
Authors: Shima Haruko , Inokuchi Mikako , Shimada Hiroyuki
Published: April 2009

We report a case of a 13‐year‐old female with Langerhans cell histiocytosis (LCH) and primary hypothyroidism followed by type 1 diabetes mellitus (DM), both of which are rare complications. In LCH diagnosis, imaging studies showed an enlargement of the thyroid gland, suggesting the involvement of LCH cells. While the pancreas appeared normal, insulin secretion markedly deteriorated 11 months after cessation of chemotherapy. Even without direct pancreatic involvement, there is a possibility that LCH could induce DM as a part of its long‐term complications. In particular, thyroid involvement may be related to the onset of DM. Pediatr Blood Cancer 2009;53:232–234. © 2009 Wiley‐Liss, Inc.
A strategy to provide long‐term control of weedy rice while mitigating herbicide resistance transgene flow, and its potential use for other crops with related weeds
Authors: Gressel Jonathan , Valverde Bernal E
Published: April 2009

Transgenic herbicide‐resistant rice is needed to control weeds that have evolved herbicide resistance, as well as for the weedy (feral, red) rice problem, which has been exacerbated by shifting to direct seeding throughout the world—firstly in Europe and the Americas, and now in Asia, as well as in parts of Africa. Transplanting had been the major method of weedy rice control. Experience with imidazolinone‐resistant rice shows that gene flow to weedy rice is rapid, negating the utility of the technology. Transgenic technologies are available that can contain herbicide resistance within the crop (cleistogamy, male sterility, targeting to chloroplast genome, etc.), but such technologies are leaky. Mitigation technologies tandemly couple (genetically link) the gene of choice (herbicide resistance) with mitigation genes that are neutral or good for the crop, but render hybrids with weedy rice and their offspring unfit to compete. Mitigation genes confer traits such as non‐shattering, dwarfism, no secondary dormancy and herbicide sensitivity. It is proposed to use glyphosate and glufosinate resistances separately as genes of choice, and glufosinate, glyphosate and bentazone susceptibilities as mitigating genes, with a six‐season rotation where each stage kills transgenic crop volunteers and transgenic crop × weed hybrids from the previous season. Copyright © 2009 Society of Chemical Industry
Second harmonic generation in melilite‐type Ba2MgGe2O7
Authors: Bayarjargal Lkhamsuren , Becker Petra , Liebertz Josef , Bohatý Ladislav
Published: April 2009

The components of the nonlinear optical susceptibility tensor [dijk SHG] (SHG tensor) of the melilite‐type tetragonal germanate Ba2MgGe2O7, that allows phase matched second harmonic generation and sum frequency generation in a wide spectral range, were determined using the Maker fringes method. The values of the components amount about one third of d36SHG of KH2PO4 (KDP). Effective nonlinear susceptibilities for SHG phase matching directions are given for different wavelengths. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Comparison between the performances of the spin‐projected Hartree–Fock, generalized valence‐bond, and spin‐coupled approaches
Authors: Karadakov Peter B. , Cooper David L.
Published: April 2009

The total energies from spin‐projected Hartree–Fock (spin‐PHF), generalized valence‐bond with perfect‐pairing and strong orthogonality restrictions (GVB‐PP‐SO), and fully‐variational spin‐coupled (SC) calculations are compared for a series of unsaturated alternant hydrocarbons, ranging from trans buta‐1,3‐diene to naphthalene. The extent to which the spin‐PHF and GVB‐PP‐SO wavefunctions for these molecules can approximate the more general SC wavefunction can be understood by analyzing the weights of the different modes of spin coupling in the full SC treatment. The spin‐PHF wavefunction is found to display a surprising ability to capture more of the π‐space correlation effects in aromatic and antiaromatic systems than its GVB‐PP‐SO counterpart, even in the case of naphthalene, a molecule with 10 π electrons. © 2009 Wiley Periodicals, Inc. Int J Quantum Chem, 2009
Anatomy of bond formation: Insights from the analysis of domain‐averaged Fermi holes in momentum space
Authors: Cooper David L. , Ponec Robert
Published: April 2009

Alongside conventional domain‐averaged Fermi hole (DAFH) analysis in position space, we examine an alternative representation in momentum space. As examples, we consider the processes of splitting the chemical bonds in the simple diatomic molecules H2, N2, and LiH, as representatives of nonpolar single, nonpolar multiple, and polar bonding. We believe that the additional information provided by the complementary description in momentum space contributes to a better understanding of the phenomenon of chemical bonding. © 2009 Wiley Periodicals, Inc. Int J Quantum Chem, 2009
Choice and performance of governance mechanisms: matching alliance governance to asset type
Authors: Hoetker Glenn , Mellewigt Thomas
Published: April 2009

Formal and relational governance mechanisms are used in strategic alliances to coordinate resources and mitigate the risk of opportunistic behavior. While recent work has shown that these approaches are not mutually exclusive, we understand little about when one approach is superior to the other. Using data on the governance choices and subsequent performance of alliances in the German telecommunications industry, we find that the optimal configuration of formal and relational governance mechanisms depends on the assets involved in an alliance, with formal mechanisms best suited to property‐based assets and relational governance best suited to knowledge‐based assets. Furthermore, a mismatch between governance mechanisms and asset type can harm the performance of the alliance. Our findings contribute to transaction cost economics, the literature on relational governance, and recent work studying their interaction. Copyright © 2009 John Wiley & Sons, Ltd.
Nonoperative Management of Intraabdominal Hypertension and Abdominal Compartment Syndrome
Authors: Cheatham Michael L.
Published: April 2009

Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with significant morbidity and mortality. In recent years, the diagnosis and management of these syndromes has evolved tremendously, and the importance of comprehensive strategies to reduce intraabdominal pressure (IAP) has been recognized. All clinicians should be aware of the risk factors that predict the development of IAH/ACS, the appropriate measurement of IAP, and the current resuscitation options for managing these highly morbid syndromes. The nonoperative management of IAH/ACS can be summarized using five therapeutic goals: evacuate intraluminal contents, evacuate intraabdominal space‐occupying lesions, improve abdominal wall compliance, optimize fluid administration, and optimize systemic and regional tissue perfusion. Surgical intervention through open abdominal decompression should immediately be pursued for patients with progressive IAH, end‐organ dysfunction, and failure that is refractory to these nonoperative therapies. This comprehensive management strategy has been demonstrated to improve patient survival and long‐term outcome.
Influencing Factors of Symptomatic Anastomotic Leakage After Anterior Resection of the Rectum for Cancer
Authors: Cong Zhi‐jie , Fu Chuan‐gang , Wang Han‐tao , Liu Lian‐jie , Zhang Wei , Wang Hao
Published: April 2009

Background

The aim of the present study was to analyze the factors associated with anastomotic leakage after anterior resection for rectal cancer.

Methods

Retrospectively collected consecutive data of 738 rectal cancer patients who underwent anterior resection in our hospital between 2005 and 2008 were reviewed. The associations between 15 patient‐related and surgery‐related variables and anastomotic leakage were studied with both the univariate chi‐square test and multivariate logistic regression analysis.

Results

Univariate analysis showed that risk factors associated with anastomotic leakage were low rectal cancer (located 5 cm or less above the dentate line) (5.9% vs. 0.9%; P = 0.003), non‐specialized surgeon (3.9% vs. 11.3%; P = 0.031), and defunctioning transanal catheter placement (14.5% vs. 3.6%; P < 0.001). It should be noted that the mean surgeon case volumes of anterior resection of colorectal surgeons and non‐specialized general surgeons were 43 per year and 2 per year, respectively (P < 0.001). In addition, there was a tendency for colorectal surgeons to operate on a greater proportion of low rectal cancers (72.1% vs. 52.8%; P = 0.003). In the multivariate analysis, besides low rectal cancer, non‐specialized surgeon, and transanal catheter placement, three other factors were associated with anastomotic leakage: diabetes mellitus (P = 0.027), free distal margins less than 1 cm (P = 0.009), and a defunctioning stoma (P = 0.031). In a further analysis of 522 patients with low rectal cancer, the leakage rate in patients with a defunctioning stoma was significantly lower (2.9% vs. 8.5%; P = 0.007). By contrast, the leakage rate in the transanal catheter placement group was higher (15.1% vs. 4.9%; P = 0.008), because of its poor protective effect as well as the selection bias.

Conclusions

From the findings of this study, we believe that low rectal cancer, non‐specialized surgeons, and diabetes mellitus are risk factors for anastomotic leakage after rectal surgery, and that a defunctioning stoma could significantly reduce the incidence of leakage in low rectal cancer patients.
Preoperative Fasting of 2 Hours Minimizes Insulin Resistance and Organic Response to Trauma After Video‐Cholecystectomy: A Randomized, Controlled, Clinical Trial
Authors: Faria Marcelo S. M. , de Aguilar‐Nascimento José E. , Pimenta Osvânio S. , Alvarenga Luis C. , Dock‐Nascimento Diana B. , Slhessarenko Natasha
Published: April 2009

Background

Studies showing the improvement of insulin sensitivity by reducing the term of preoperative fasting are mostly done in patients undergoing major operations. More information about the role of shortened preoperative fasting in perioperative metabolism is needed for such elective minor/moderate abdominal procedures as laparoscopic cholecystectomy. We investigated the influence of a carbohydrate‐rich drink given 2 h before laparoscopic cholecystectomy on insulin resistance and the metabolic response to trauma.

Methods

A group of 21 female candidates (18–65 years old) for elective laparoscopic cholecystectomy were randomized to either an 8 h fasting group (control group: n = 10) or to a group receiving 200 ml of a carbohydrate beverage containing 12.5% (25 g, 50 kcal per 100 ml and approximately 285 mOsm) of maltodextrine 2 h before operation (CHO group: n = 11). Blood samples for various biochemical assays were collected both at induction of anesthesia and after the 10th postoperative hour. Insulin resistance was assessed by the HOMA‐IR equation (Insulin (μU/ml) × blood glucose (mg/dl)/405).

Results

There were no postoperative complications. Seventy percent (7/10) of the controls and 27.3% (3/11) of the CHO group experienced at least one episode of vomiting (RR = 2.42, 95% Confidence Interval [CI] = 0.88–6.68; P = 0.08). Biochemical analysis showed that serum glucose (P < 0.01), insulin (P < 0.01), lactate/pyruvate ratio (P = 0.03), and triglycerides (P < 0.01) for the control group were higher than for the CHO group. The value of HOMA‐IR was significantly greater (P = 0.03) in the conventionally fasted patients than in the CHO group.

Conclusions

Abbreviation of the period of preoperative fasting and administration of a carbohydrate beverage diminishes insulin resistance and the organic response to trauma.
Impact of Surgical Training on Incidence of Surgical Site Infection
Authors: Rosenthal Rachel , Weber Walter P. , Zwahlen Marcel , Misteli Heidi , Reck Stefan , Oertli Daniel , Widmer Andreas F. , Marti Walter R.
Published: April 2009

Background

Despite availability of other training forms, tutorial assistance cannot be entirely replaced in surgical education. Concerns exist that tutorial assistance may lead to an increased rate of surgical site infection (SSI). The purpose of the present study was to investigate whether the risk of SSI is higher after surgery with tutorial assistance than after surgery performed autonomously by a fully trained surgeon.

Methods

All consecutive visceral, vascular, and traumatological inpatient procedures at a Swiss University Hospital were prospectively recorded during a 24‐month period, and the patients were followed for 12 months to ascertain the occurrence of SSI. Using univariable and multivariable logistic regressions, we assessed the association of tutorial assistance surgery with SSI in 6,103 interventions.

Results

Autonomously performed surgery was associated with SSI in univariable analysis (5.36% SSI vs. 3.81% for tutorial assistance, p = 0.006). In multivariable analysis, the odds of SSI for tutorial assistance was no longer significantly lower (Odds Ratio [OR] = 0.82; 95% Confidence Interval [CI]: 0.62–1.09; p = 0.163).

Conclusions

Surgical training does not lead to higher SSI rate if trainees are adequately supervised and interventions are carefully selected. Although other forms of training are useful, tutorial assistance in the operating room continues to be the mainstay of surgical education.
Prospective Study of Routine Day‐Case Laparoscopic Modified Lind Partial Fundoplication
Authors: Agrawal S. , Shapey I. , Peacock A. , Ali A. , Super P.
Published: April 2009

Background

The aim of the present study was to prospectively assess the feasibility, safety, and acceptability of performing day‐case laparoscopic modified Lind fundoplication for gastroesophageal reflux disease on a routine basis and to determine possible implications for health care costs to the hospital.

Methods

All patients undergoing laparoscopic fundoplication between November 2005 and November 2007 under the care of one surgeon were included in the study. Inclusion criteria were American Society of Anesthesiologists (ASA) grade I and II with adequate home support. The surgical procedure was laparoscopic modified Lind fundoplication in all the cases. Patients were reviewed in the clinic at 6 weeks and were subsequently assessed through a structured postal questionnaire at a median of 1 year.

Results

Over the 25‐month period, a total of 130 laparoscopic modified Lind fundoplications were performed, of which 103 (79.2%) met the inclusion criteria for day‐case surgery. The patients were 16 to 75 years of age. Ninety (87.4%) were discharged on the same day as planned, and 11 patients were admitted overnight because of nausea. At clinic follow‐up at a median of 6 weeks all patients expressed satisfaction and were reflux free. There was a significant reduction of mean modified Visick score and visual analog scale for reflux at a median of 1 year after surgery.

Conclusions

Routine day‐case laparoscopic modified Lind fundoplication for gastroesophageal reflux disease is safe and well tolerated, with high levels of patient satisfaction and reduced costs to the hospital. Patients with ASA grade >2 and redo antireflux surgery should not be considered for day‐case surgery. Hospital readmission was required in less than 3% of patients after discharge home, but those readmissions were not related to early discharge on the same day of surgery.
Significance of Biochemical Parameters in Differentiating Uniglandular from Multiglandular Disease and Limiting Use of Intraoperative Parathormone Assay
Authors: Thakur Abhijit , Sebag Frederic , Slotema Eveline , Ippolito Giuseppe , Taïeb David , Henry Jean François
Published: April 2009

Background

We studied whether serum calcium and parathormone (PTH) levels are significantly different for uniglandular disease (UGD) and multiglandular disease (MGD) and whether intraoperative rapid intact parathormone (IOPTH) monitoring can be avoided in some cases of minimally invasive parathyroidectomy (MIP) without affecting cure rates, substantiating various previous published studies.

Method

This is a single‐referral‐center retrospective review of prospectively collected data for 281 patients with sporadic primary hyperparathyroidism (sPHPT) from January 1999 to February 2005. The calcium and PTH values were categorized using the following parameters: calcium ≥3 mmol/l = 1, <3 mmol/l = 0, PTH ≥ 100 pg/ml = 1, PTH < 100 = 1.

Results

P values for serum calcium and PTH by ANOVA were 0.0547 and 0.3936, respectively, and by the Mann‐Whitney test were 0.1606 and 0.6208, respectively. We had 118 patients with concordant technetium 99 m sestamibi scintigraphy (MIBI) and neck ultrasonography (US) and UGD was confirmed in 118 (100%) cases.

Conclusions

No significant difference between serum calcium and PTH for UGD and MGD was found. IOPTH monitoring could be avoided when there is concordant positive MIBI and neck US for single, unilateral, hyperfunctioning gland without affecting cure rates.
Treatment of Postoperative Esophagorespiratory Fistulas with Dual Self‐Expanding Metal Stents
Authors: Agustsson Thorhallur , Nilsson Magnus , Henriksson Gert , Arnelo Urban , Juto Jan E. , Lundell Lars
Published: April 2009

Background

Fistulas between the esophagus and the respiratory tract can occur as a complication to anastomotic dehiscence after esophageal resection. The traditional therapeutic approach is to deviate the proximal portion of the esophagus and transpose the conduit into the abdominal cavity. With the introduction and development of self‐expandable metal stents (SEMS), new therapeutic options have emerged for these severe complications.

Methods

One hundred sixty‐seven consecutive esophageal resections were reviewed to address the outcome of a stent‐based therapeutic strategy in cases with esophagorespiratory fistulas. The patency of each anastomosis was checked only at the time of clinical suspicion of leakage but then radiology, endoscopy, and bronchoscopy were used together.

Results

Seven patients developed esophagorespiratory fistula. All of these fistulas were diagnosed more than 1 week after the operation. Two patients (27%) died due to the fistula. Four could be successfully treated but in two of these we were forced to change strategy and either perform a colonic interposition or externalize the esophagus. One of these patients subsequently developed total respiratory failure and required extracorporal membrane oxygenation (ECMO) to recover.

Conclusions

When an esophagorespiratory fistula is diagnosed, an attempt to close the fistula tract by SEMS from both the esophageal and the respiratory side is a feasible treatment option. This strategy has to be prolonged and aggressive with a commitment to repeatedly change stents and modify sizes and designs. Thereby a majority of these patients can be managed conservatively with prospects of a successful outcome.
Tensiometry as a Decision Tool for Abdominal Wall Reconstruction with Component Separation
Authors: Dragu Adrian , Klein Peter , Unglaub Frank , Polykandriotis Elias , Kneser Ulrich , Hohenberger Werner , Horch Raymund E.
Published: April 2009

Background

The recurrence rate for incisional hernias following reconstruction depends not only on the size of the initial hernia or abdominal wall defect but also on the number of the concomitant diseases. The surgical approach chosen and the level of tension affecting the sutures both represent essential indicators of long‐term success in abdominal wall reconstruction. Several techniques have been advocated to reconstruct the abdominal wall, either with or without use of alloplastic material. A number of authors even recommended separating the lateral components of the abdominal wall to preserve innervation and blood supply of the advanced parts.

Methods

This retrospective study is based on a patient collective consisting of 23 patients. In addition to hernias or abdominal wall defects, all of them suffered several concomitant diseases and were treated at the German university hospitals in Erlangen‐Nürnberg and Freiburg. All procedures were performed between the years 2000 and 2006. In all cases, reconstruction of the abdominal wall was achieved by employing the separation of components technique by Ramirez. Some of these procedures entailed the use of alloplastic material. Use of this material was based on intraoperative tensiometry results. Surgical outcome was determined by evaluating postoperative complications and the hernia recurrence rate.

Results

We achieved complete anatomic reconstruction of the abdominal wall in 61% of cases. Alloplastic mesh was used in 39% of the cases. Results of a long‐term follow‐up (56 months) revealed that only 18% of patients experienced hernia recurrence.

Conclusions

Intraoperative tensiometry provides an additional important parameter for the surgical algorithm. Depending on the results, the appropriate surgical method for each case can be chosen. The decision on whether this procedure entails the use of alloplastic mesh can also be based on intraoperative tensiometry results.
Pharmacogenetics education in British medical schools
Authors: Higgs Jenny E. , Andrews Julie , Gurwitz David , Payne Katherine , Newman William
Published: April 2009

Pharmacogenetic tests allow medications to be tailored to individual patients to improve efficacy and reduce drug toxicity. In 2005, the International Society of Pharmacogenomics (ISP) made recommendations for undergraduate medical teaching in pharmacogenetics. We aimed to establish the quantity and scope of this in British medical schools. An electronic survey was sent to all British medical schools. Nineteen out of 34 (56%) medical schools responded. Sixteen of the 19 (84%) respondents provided pharmacogenetics teaching, usually 1–2 h in total. Only four (21%) medical schools offered the four or more hours of teaching recommended by the ISP. However, 10 of 16 (63%) schools felt the amount of pharmacogenetic teaching offered was sufficient. The quantity of undergraduate teaching of pharmacogenetics is low. However, a majority of UK medical schools teach it, covering a broad scope of elements. It is encouraging that future clinicians are being provided with the knowledge to deliver pharmacogenetics into clinical practice.
Mental health literacy and attitude towards people with mental illness: A trend analysis based on population surveys in the eastern part of Germany
Authors: Angermeyer M.C. , Holzinger A. , Matschinger H.
Published: April 2009

Background

There is growing evidence that mental health literacy has improved in western countries in recent years. The question arises as to whether this trend is paralleled by an improvement of attitudes towards people with mental illness.

Aim

To examine the development of mental health literacy and the desire for social distance towards people with schizophrenia and major depressive disorder in Eastern Germany over a time period of eight years.

Method

A trend analysis was carried out using data from two population surveys conducted in the eastern part of Germany in 1993 and 2001. By means of a fully structured interview psychiatric labelling, causal beliefs, help-seeking and treatment recommendations as well as the desire for social distance was assessed.

Results

While there was an increase in the mental health literacy of the public, the desire for social distance from people with major depression and schizophrenia remained unchanged or even increased.

Conclusions

The assumption underlying a number of anti-stigma campaigns, namely that educating people about mental disorders may automatically lead to the improvement of their attitudes towards the mentally ill, appears questionable.
Orphan nuclear receptor Nurr1 induces neuron differentiation from embryonic cortical precursor cells via an extrinsic paracrine mechanism
Authors: Bae Eun-Ji , Lee Hyun-Seob , Park Chang-Hwan , Lee Sang-Hun
Published: April 2009

Nurr1 is an orphan nuclear receptor‐type transcription factor (TF) that plays critical roles in midbrain dopamine neuron development. This study demonstrated a novel role for Nurr1 in neuronal/astrocytic differentiation of neural precursor (NP) cells isolated from rat embryonic cortices: overexpression of this TF promoted NP cell differentiation towards neurons at the expense of astrocytic differentiation. Single cell‐based lineage analyses and experiments using co‐cultures revealed that Nurr1 elicited its neurogenic role in an extrinsic paracrine manner. We defined diffusible factors and downstream neurogenic TFs responsible for the Nurr1‐mediated neuronal differentiation.
Density of numerical radius attaining operators on some reflexive spaces
Authors: Cardassi Carmen Silvia
Published: April 2009

We show that for reflexive spaces X the density of numerical radius attaining operators in L(X) is equivalent to the density of numerical radius attaining operators in L(X*). As a consequence of this fact and of a result of Berg and Sims, we prove that for uniformly smooth spaces X the numerical radius attaining operators are dense in L(X).
Generalised convexity and duality in multiple objective programming
Authors: Weir T. , Mond B.
Published: April 2009

By considering the concept of weak minima, different scalar duality results are extended to multiple objective programming problems. A number of weak, strong and converse duality theorems are given under a variety of generalised convexity conditions.
More about metric spaces on which continuous functions are uniformly continuous
Authors: Beer Gerald
Published: April 2009

An Atsuji space is a metric space X such that each continuous function form X to an arbitrary metric space Y is uniformly continuous. We here present (i) characterizations of metric spaces with Atsuji completions; (ii) Cantor-type theorems for Atsuji spaces; (iii) a fixed point theorem for self-maps of an Atsuji space.
A non-abelian automorphism group with all automorphisms central
Authors: Curran M.J.
Published: April 2009

This paper provides an example of a non-abelian 2-group with a non-abelian automorphism group in which every automorphism is central.
A determinant for rectangular matrices
Authors: Joshi V.N.
Published: April 2009

The familiar notion of the determinant is generalised to include rectangular matrices. An expression for a normalised generalised inverse of a matrix is given in terms of its determinant and a possible generalisation of the Schur complement is discussed as a simple application.
On the characteristic word of the inhomogeneous Beatty sequence
Authors: Komatsu Takao
Published: April 2009

We detail the sequence (fn) wherefn= [(n+ 1)θ + ø] − [nθ+ ø] − [θ]. This description of the inhomogeneous Beatty sequence generalises earlier work dealing with special cases in which ø is restricted to rational values.
The cohomology rings of finite groups with semi-dihedral Sylow 2-subgroups
Authors: Chin Angelina
Published: April 2009

In this paper we determine the mod-2 cohomology rings and the 2-primary part of the integral cohomology rings of finite groups with semi-dihedral Sylow 2-subgroups. The method used here is algebraic and can be considered as elementary.
A note on resonance problems with nonlinearity bounded in one direction
Authors: Ma To Fu , Sanchez Luís
Published: April 2009

We prove the existence of a solution for a semilinear boundary value problem at resonance in the first eigenvalue. The nonlinearity is assumed to be bounded below or above; no further growth restrictions are assumed.
Generic well posedness of supinf problems
Authors: Kenderov P.S. , Lucchetti R.E.
Published: April 2009

We consider two notions of well posedness for problems of the type and give conditions under which the majority (in Baire category sense) of bounded functions f defined in X × Y give rise to problems which are well posed. As a corollary we get that the problem is well posed for the majority of bounded lsc real valued functions f if, and only if, X contains a dense completely metrisable subset.
Characterisations of quasiconvex functions
Authors: Luc Dinh The
Published: April 2009

In this paper we introduce the concept of quasimonotone maps and prove that a lower semicontinuous function on an infinite dimensional space is quasiconvex if and only if its generalised subdifferential or its directional derivative is quasimonotone.
On Morita duality
Authors: Xue Weimin
Published: April 2009

Modules whose nonzero endomorphisms are epimorphisms and modules whose nonzero endomorphisms are monomorphisms are considered in this paper. We prove that these two classes of modules are dual to each other via Morita duality. We also prove that a left artinian ring R with Jacobson radical J has a Morita duality if either (1) J/J2 is a central bimodule; or (2) R is artinian right duo and R/J is commutative.
Permutation representations of the (2, 4, r) triangle groups
Authors: Everitt Brent
Published: April 2009

The abstract triangle groups Δ(2, 4, r) can be defined for any positive integer r by Δ(2, 4, r) = 〈x, y | x2 = y4 = (xy)r = 1〉. In this paper we show that for every r ≥ 6, all but finitely many of the alternating groups An can be obtained as quotients of Δ(2, 4, r).