bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective, split face, single‐blinded study looking at the use of an infrared device with contact cooling in the treatment of skin laxity in asians
Authors: Chan Henry H. , Yu C.S. , Shek S. , Yeung C.K. , Kono T. , Wei W.I.
Published: February 2008

Background

Although monopolar radiofrequency treatment is effective in the improvement of skin laxity, the pain and cost that are associated with this method suggest the need for alternative treatment options. Recently, an infrared device with contact cooling has been shown to be effective in the treatment of skin laxity, with ultrastructural changes observed that are similar to those that are observed following treatment with a monopolar radiofrequency device. However, no control was included in previous studies.

Objective

To conduct a prospective, split‐face, single‐blinded study to look at the efficacy and complications among Asians of treatment for skin tightening with an infrared device with contact cooling.

Method

Thirteen Chinese women were treated. An infrared device with contact cooling (Titan, Cutera, Brisbane, CA) was used to treat one side of the face and the untreated side served as the control. The treatment was performed twice with a 4‐week interval between the treatments and the patients were followed up by subjective assessment using a structured questionnaire 1 and 3 months after the second (and last) treatment. In all cases, pre‐ and post‐treatment clinical photographs were taken. Two independent observers assessed the photographs.

Results

Twenty‐three percentage of patients reported mild improvement, 15% reported moderate improvement, and 54% reported significant improvement 3 months after their second (and last) treatment. In terms of objective assessment, 41% of patients were identified to have some degree of improvement of the treated side 3 months after their second treatment. Compared with the untreated side, the treated side improved significantly (P = 0.031) at 1 and 3 months after the second treatment. Blistering occurred in one patient, which had resolved completely by the 3‐month follow‐up visit.

Conclusion

An infrared device with contact cooling can be used effectively and safely for the treatment of skin laxity, especially in smaller anatomical areas. Lesers Surg. Med. 40:146–152, 2008. © 2008 Wiley‐Liss, Inc.
Combined use of intense pulsed light and Q‐switched ruby laser for complex dyspigmentation among asian patients
Authors: Park Jong Min , Tsao Hensin , Tsao Sandy
Published: February 2008

Background

Dyspigmentation is a common cosmetic concern among Asians. Many individuals exhibit mixed pigmentary entities including melasma, flat/small seborrheic keratoses, ephelides, solar lentigines and acquired bilateral nevus‐of‐Ota‐like macules (ABNOM). We term this phenomenon complex dyspigmentation (CD) and suggest that a combination strategy may be more efficacious than any singular modality.

Objective

To determine the effectiveness of combined intense‐pulsed light (IPL) for global photorejuvenation along with Q‐switched ruby laser (QSRL) for targeted pigment dissolution.

Study Design/Materials and Methods

Twenty‐five Korean women with CD (defined as >2 types of facial pigmentary disorders) were initially treated with IPL followed by repeat treatments every 3–4 weeks as needed. The QSRL treatments, set at low fluence, were added either during the same session or within 1 week of the IPL treatment. Improvement was assessed by the patient, the treating physician and a blinded evaluation of pre‐ and post‐treatment photographs.

Results

Using a 4‐point scale (1 = poor, 2 = fair, 3 = good, 4 = excellent), 19/25 patients (76%) reporting good‐to‐excellent response (score “3” or “4”). Two independent physician assessment revealed that 15/25 patients (60%) showed 76–100% improvement while 19/25 patients (76%) showed at least 50% improvement. Side‐effects were minimal: 3 patients had transient post‐inflammatory hyperpigmentation (12%) and 1 patient (4%) had linear hypopigmentation.

Conclusions

Combination treatment with IPL and QSRL is an effective and safe treatment for CD among Asian patients. Lesers Surg. Med. 40:128–133, 2008. © 2008 Wiley‐Liss, Inc.
Treatment of resistant tattoos using a new generation Q‐switched Nd:YAG laser: Influence of beam profile and spot size on clearance success
Authors: Karsai Syrus , Pfirrmann Gudrun , Hammes Stefan , Raulin Christian
Published: February 2008

Background and Objectives

Multiple treatments of resistant tattoos often result in fibrosis and visible textural changes that lessen response to subsequent treatments. The aim of this study is to evaluate the influence of beam profile and spot size on clearance rates and side effects in the setting of resistant tattoos.

Study Design/Material and Methods

Thirty‐six professional, black tattoos (32 patients) were treated unsuccessfully with a Q‐switched Nd:YAG laser (MedLite™ C3, HoyaConBio Inc., Fremont, CA). Because of therapy resistance all tattoos were re‐treated using a new generation Nd:YAG laser (MedLite™ C6, HoyaConBio Inc.). Maximum energy fluence (E
max), mean energy fluence, mean spot size, level of clearance, side effects and beam profile (irradiance distribution) of both laser systems were assessed and evaluated in a retrospective study.

Results

All tattoos were previously treated with the C3 laser at 1,064 nm using a mean Emax of 5.8±0.8 J/cm2 (range 3.8–7.5 J/cm2) as compared with a mean Emax of 6.4±1.6 J/cm2 (range 3.2–9.0 J/cm2) during the C6 treatment course. Corresponding spot sizes were larger during C6 treatments as compared with C3 (5.0±0.9 and 3.6±0.2 mm, respectively). The C6 laser had a “flat top” and homogenous profile regardless of the spot size. For the C3 laser the beam shape was “Gaussian,” and the homogeneity was reduced by numerous micro‐spikes and micro‐nadirs.

After the C6 treatment course 33.3% of the tattoos showed clearance of grade 1 (0–25%), 16.7% of grade 2 (26–50%), 16.7% of grade 3 (51–75%), 30.5% of grade 4 (76–95%), 2.8% of grade 5 (96–100%). The total rate of side effects due to C6 treatment was 8.3% in all tattoos (hyperpigmentation 5.6%, hypopigmentation 2.7%, textural changes/scars 0%).

Conclusion

This clinical study documents for the first time the impact of a 1,064‐nm Nd:YAG laser with a more homogenous beam profile and a larger spot size on the management of resistant tattoos. Only a few treatment sessions were necessary to achieve an additional clearance with a low rate of side effects. Lesers Surg. Med. 40:139–145, 2008. © 2008 Wiley‐Liss, Inc.
Combination of Er:YAG laser and photodynamic therapy in the treatment of nodular basal cell carcinoma
Authors: Šmucler Roman , Vlk Marek
Published: February 2008

Backgrounds and Objectives

Photodynamic therapy (PDT), via topical aminolevulinic acid (ALA) is an effective treatment for basal cell carcinomas not exceeding a depth of 2 mm. This limits the treatment of basal cell carcinoma (non‐melanoma skin cancer) to superficial forms and nodular therapy (only in aesthetically desired locations). This paper addresses the effectiveness of reducing tumor mass via initial Er:YAG laser ablation to depths that are therapeutically responsive to PDT with ALA.

Study Design/Materials and Methods

This study compared three methods for the treatment of recurring nodular basal cell carcinomas (r nBCC). Method A utilized PDT with topical application of ALA methyl ester, method B with solitary Er:YAG laser ablation, and method C combined Er:YAG laser ablation reducing tumor size below 2 mm (method B) with subsequent ALA methyl ester PDT (method A). All three methods were used to treat to each patient, all subjects presenting with three or more basal cell carcinomas in order to eliminate differences in patient responsiveness to treatment. Patients were monitored and interviewed at 3, 6, and 12 month intervals to examine the progress of tumor elimination, aesthetic results as well as the patient's preference of treatment method. In all, 286 patients were treated, of whom 194 were checked at the prescribed intervals and then evaluated.

Results

Statistically, the combination therapy demonstrated the most effective treatment at all time intervals, with a final efficacy of 98.97% versus 94.85% (PDT only) and 91.75% (Er:YAG laser only). The combined method also provided the best aesthetic results (scale: 1—best; 4—worst) of 1.23±1.23, compared to 1.67±0.76 (PDT only) and 1.83±0.95 (Er:YAG laser only).

Conclusions

Although 67% patients preferred solitary Er:YAG laser treatment over the PDT method (20%) and the combined treatment (13%), because of the simplicity of the treatment, the combination therapy has proven to be both clinically and aesthetically superior. Solitary Er:YAG laser ablation will remain however a fast, effective, and economical treatment alternative for simple manifestations of superficial basal cell carcinoma and has replaced PDT for uncomplicated cases at our facility. The combination of Er:YAG laser ablation and ALA–PDT aspires to be therapy of choice for BCC. Lesers Surg. Med. 40:153–158, 2008. © 2008 Wiley‐Liss, Inc.
LED photoprevention: Reduced MED response following multiple LED exposures
Authors: Barolet Daniel , Boucher Annie
Published: February 2008

Background and Objectives

As photoprotection with traditional sunscreen presents some limitations, the use of non‐traditional treatments to increase skin resistance to ultraviolet (UV) induced damage would prove particularly appealing. The purpose of this pilot study was to test the potential of non‐thermal pulsed light‐emitting diode (LED) treatments (660 nm) prior to UV exposure in the induction of a state of cellular resistance against UV‐induced erythema.

Study Design/Materials and Methods

Thirteen healthy subjects and two patients with polymorphous light eruption (PLE) were exposed to 5, 6, or 10 LED treatments (660 nm) on an EXPERIMENTAL anterior thigh region. Individual baseline minimal erythema doses (MED) were then determined. UV radiation was thereafter performed on the LED EXPERIMENTAL and CONTROL anterior thigh areas. Finally, 24 hours post‐UV irradiation, LED pre‐treated MED responses were compared to the non‐treated sites.

Results

Reduction of erythema was considered significant when erythema was reduced by >50% on the LED‐treated side as opposed to CONTROL side. A significant LED treatment reduction in UV‐B induced erythema reaction was observed in at least one occasion in 85% of subjects, including patients suffering from PLE. Moreover, there was evidence of a dose‐related pattern in results. Finally, a sun protection factor SPF‐15‐like effect and a reduction in post‐inflammatory hyperpigmentation were observed on the LED pre‐treated side.

Conclusions

Results suggest that LED based therapy prior to UV exposure provided significant protection against UV‐B induced erythema. The induction of cellular resistance to UV insults may possibly be explained by the induction of a state a natural resistance to the skin via specific cell signaling pathways and without the drawbacks and limitations of traditional sunscreens. These results represent an encouraging step towards expanding the potential applications of LED therapy and could be useful in the treatment of patients with anomalous reactions to sunlight. Lesers Surg. Med. 40:106–112, 2008. © 2008 Wiley‐Liss, Inc.
Experimental and Computational Approaches on the Isospecific Role of Monoester‐Type Internal Electron Donor for TiCl4/MgCl2 Ziegler‐Natta Catalysts
Authors: Liu Boping , Cheng Ruihua , Liu Zhen , Qiu Pengyuan , Zhang Shiliang , Taniike Toshiaki , Terano Minoru , Tashino Kunihiko , Fujita Takashi
Published: February 2008

In this work, a combination of experimental and computational approaches on the isospecific role of monoester‐type internal electron donors (ED) such as phenylpropionate (PhP), ethylheptanoate (EH), methylbenzoate (MB), ethylbenzoate (EB) for TiCl4/ED/MgCl2 Ziegler‐Natta catalysts had been performed. The propylene polymerization results revealed that the isospecificity of catalysts increases in the following order: PhP < EH < MB < EB. The subsequent molecular modeling on the electronic properties of the donors and two kinds of cluster model catalysts: TiCl4/ED/MgCl2 and TiCl4/ED/(MgCl2)4 based on density functional theory (DFT) method was carried out. Two kinds of ED coordination on MgCl2 clusters through either O or O within the monoester‐type ED had been disclosed. A perfect correlation between the dipole moment of ED, the coordination bond length of O … Mg, the competitive coordination from O with Mg ion and the isospecificity of the catalysts had been established.
Natural abundance 43Ca solid‐state NMR characterisation of hydroxyapatite: identification of the two calcium sites
Authors: Laurencin Danielle , Wong Alan , Dupree Ray , Smith Mark E.
Published: February 2008

Natural abundance 43Ca solid‐state NMR of hydroxyapatite (Ca10(PO4)6(OH)2) was performed at three different fields (8.45, 14.1 and 18.8 T). The two crystallographically distinct calcium sites of the apatite structure were spectroscopically resolved at 18.8 T. The 43Ca NMR interaction parameters (δiso, CQ and etaQ) of each site were determined by multiple magnetic‐field simulations. The peaks with δiso = 11.2 ± 0.8 and − 1.8 ± 0.8 ppm, both with CQ = 2.6 ± 0.4 MHz, were assigned to the Ca(II) and Ca(I) sites, respectively, on the basis of their relative intensities. Copyright © 2008 John Wiley & Sons, Ltd.
A solid‐state 23Na NMR study of monovalent cation binding to double‐stranded DNA at low relative humidity
Authors: Wong Alan , Yan Zhimin , Huang Yining , Wu Gang
Published: February 2008

We report a solid‐state 23Na NMR study of monovalent cation (Li+, Na+, K+, Rb+, Cs+ and NH4+) binding to double‐stranded calf thymus DNA (CT DNA) at low relative humidity, ca 0–10%. Results from 23Na31P rotational echo double resonance (REDOR) NMR experiments firmly establish that, at low relative humidity, monovalent cations are directly bound to the phosphate group of CT DNA and are partially dehydrated. On the basis of solid‐state 23Na NMR titration experiments, we obtain quantitative thermodynamic parameters concerning the cation‐binding affinity for the phosphate group of CT DNA. The free energy difference (ΔG° ) between M+ and Na+ ions is as follows: Li+ (−1.0 kcal mol−1), K+ (7.2 kcal mol−1), NH4+ (1.0 kcal mol−1), Rb+ (4.5 kcal mol−1) and Cs+ (1.5 kcal mol−1). These results suggest that, at low relative humidity, the binding affinity of monovalent cations for the phosphate group of CT DNA follows the order: Li+ > Na+ > NH4+ > Cs+ > Rb+ > K+. This sequence is drastically different from that observed for CT DNA in solution. This discrepancy is attributed to the different modes of cation binding in dry and wet states of DNA. In the wet state of DNA, cations are fully hydrated. Our results suggest that the free energy balance between direct cation–phosphate contact and dehydration interactions is important. The reported experimental results on relative ion‐binding affinity for the DNA backbone may be used for testing theoretical treatment of cation‐phosphate interactions in DNA. Copyright © 2008 John Wiley & Sons, Ltd.
Kinetics of 1H → 31P NMR cross‐polarization in bone apatite and its mineral standards
Authors: Kaflak Agnieszka , Kolodziejski Waclaw
Published: February 2008

Kinetics of NMR cross‐polarization (CP) from protons to phosphorus‐31 nuclei was studied in the following samples: mineral of whole human bone, apatite prepared from bone, natural brushite, synthetic hydroxyapatite (hydrated and calcined), and synthetic carbonatoapatite of type B with 9 wt% of CO32−. In order to avoid an effect of magic angle spinning on CP and relaxation, the experiments were carried out on static samples. Parameters of the CP kinetics were discussed for trabecular and cortical bone tissue from adult subjects in comparison to the synthetic mineral standards. It was found that carbonatoapatite shows similar CP behavior to the bone mineral. Both materials undergo two‐component CP kinetics. The fast‐relaxing classical component is from the surface of apatite crystals and the slow‐relaxing nonclassical component comes from the crystal interior. The components have been unambiguously assigned using inverse CP from phosphorus‐31 to protons. The study provides information on a structured water layer, which covers crystal surface of carbonato‐ and bone apatite. The layer encompasses ca 40% of apatite phosphorus and its thickness is more than ca 2 nm. Copyright © 2008 John Wiley & Sons, Ltd.
Variable resolution reconstruction for cartesian data acquired with nonconstant sampling density in phase‐encoding direction
Authors: Rasche Volker , Bornstedt Axel , Hombach Vinzenz
Published: February 2008

The variable‐kernel extent technique is applied for providing local high‐resolution images from k‐space data sampled on a Cartesian sampling grid with gradually decreasing sampling density in the phase‐encoding direction. The approach is based on a variable spatial resolution reconstruction technique providing gradually decreasing resolution in the phase‐encoding direction with increasing distance to the image center, while preserving full spatial resolution in a narrow slab centered in spatial domain. Reconstruction is performed by a variable convolution kernel gridding technique. The convolution kernel width is chosen proportional to the k‐space sampling spacing to utilize the respective apodization in the image for reduction of the aliasing artifacts. Application of this technique to carotid artery wall imaging shows the potential of the technique for a significant reduction of image acquisition time without sacrificing image quality in the region of the carotid arteries. Magn Reson Med 59:661–666, 2008. © 2008 Wiley‐Liss, Inc.
The six sigma initiative at Mount Sinai Medical Center
Authors: Chassin Robert
Published: February 2008

Lean Six Sigma, in various forms, has been used widely in many Fortune 500 companies. Motorola, General Electric, Sony, American Express, and Bechtel all use Six Sigma to improve quality and performance. While the impact of this methodology has been documented extensively by the press in manufacturing and transactional settings, less evidence is available regarding its utility in health care environments. Mount Sinai Medical Center initiated a Six Sigma program in 2000 to determine its applicability and value in a large academic medical center. This article discusses Mount Sinai Medical Center's experience adapting this methodology to improve both patient care and business processes and outcomes. We present an overview of Six Sigma, and offer examples of projects undertaken using this data‐driven approach to performance improvement. Lastly, the article provides insights and lessons learned regarding this organization‐wide experience. Mt Sinai J Med 75:45–52, 2008. © 2008 Mount Sinai School of Medicine
The logistic–exponential survival distribution
Authors: Lan Yingjie , Leemis Lawrence M.
Published: February 2008

For various parameter combinations, the logistic–exponential survival distribution belongs to four common classes of survival distributions: increasing failure rate, decreasing failure rate, bathtub‐shaped failure rate, and upside‐down bathtub‐shaped failure rate. Graphical comparison of this new distribution with other common survival distributions is seen in a plot of the skewness versus the coefficient of variation. The distribution can be used as a survival model or as a device to determine the distribution class from which a particular data set is drawn. As the three‐parameter version is less mathematically tractable, our major results concern the two‐parameter version. Boundaries for the maximum likelihood estimators of the parameters are derived in this article. Also, a fixed‐point method to find the maximum likelihood estimators for complete and censored data sets has been developed. The two‐parameter and the three‐parameter versions of the logistic–exponential distribution are applied to two real‐life data sets. © 2008 Wiley Periodicals, Inc. Naval Research Logistics, 2008
Differential diagnosis of a calcified object from a 4th–5th century AD burial in Aqaba, Jordan
Authors: Perry M. , Newnam J. , Gilliland M.
Published: February 2008

In 1997 a calcified object was recovered from the pelvic region of an adult male excavated from an ancient cemetery in Aqaba, Jordan. The cemetery (n = 48) dates to the middle 4th to early 5th century AD and is associated with the Byzantine‐period marine trading centre of Aila located on the Gulf of Aqaba in the Red Sea. The oblong calcification consisted of linearly aligned tubules within a thin shell. Twenty‐eight conditions potentially resulting in calcification within the pelvic region were considered. Of these, five were retained as possible diagnoses due to the object's location and size and the presence of a thin shell and fully calcified tubules. In the end, the object appears to be a calcified, but unidentified, parasite. Copyright © 2008 John Wiley & Sons, Ltd.
Study on cross‐linking reaction between acrylic resin and epoxy derivative in over coating layer materials for TFT panel
Authors: Takahashi Shuichi , Hayashida Mika , Ogata Tomonari , Nonaka Takamasa , Kurihara Seiji
Published: February 2008

A photoactive over coating layer (OCL) material was prepared by mixing methacrylate copolymer resin, epoxy, and photoactive compounds, separately. The OCL material was found to show long shelf life at room temperature. However, serious lowering of the transparency of the OCL material was caused by post‐baking after alkali development. Microscopic and near infrared spectroscopic studies revealed that the phase separation between the hydrophilic copolymer resin and hydrophobic epoxy compound brought about the formation of wrinkly surface during the post‐baking after the alkali development, and consequently the transparency was lowered by light scattering due to the wrinkly surface. The carboxylic acid derivatives with long alkyl groups were effective for improvement of the transparency without shortening of the shelf life. Copyright © 2008 John Wiley & Sons, Ltd.
Stable second‐order nonlinear optical poly(amide–imide)/inorganic materials via simultaneous sequential self‐repetitive reaction and sol–gel process
Authors: Lin Hsun‐Lien , Chao Tsung‐Yi , Shih Yeng‐Fong , Dai Shenghong A. , Su Wen‐Chiung , Jeng Ru‐Jong
Published: February 2008

A series of thermally stable organic/inorganic second‐order nonlinear optical (NLO) composites via sequential self‐repetitive reaction (SSRR) and sol–gel process has been developed. This SSRR is based on carbodiimide (CDI) chemistry. The difunctional azo chromophores (2,4‐diamino‐4′‐(4‐ nitrophenyl‐diazenyl)azobenzene (DNDA)) was reacted with excessive amount of 4, 4′‐methylene‐ diphenylisocyanate (MDI) to form poly‐CDI, and subsequently trimellitic anhydride (TMA) was added to obtain poly(N‐acylurea). The organic/inorganic composites containing prepolymer of phenyltriethoxysilane (PTEOS) and poly(N‐acylurea) in different weight ratios (10:90, 30:70, 50:50, 70:30, 90:10 wt%) were prepared, respectively. The moderate glass transition temperature (Tg) characteristic of the poly(N‐acylurea) allows the NLO‐active polymer to achieve high poling efficiency. After in situ poling and curing process, the Tgs of the composites were elevated, and higher than that of the pristine poly(amide–imide) sample. Electro‐optical (EO) coefficients (r33) of about 5.5 ∼ 18.0 pm/V at 830 nm were obtained. Excellent temporal stability at 100°C, and waveguide characteristics (3.1–4.2 dB/cm at 830 nm) were also obtained for these composites. Copyright © 2008 John Wiley & Sons, Ltd.
Monitoring of epithelial cell caspase activation via detection of durable keratin fragment formation
Authors: Tao G‐Z , Li DH , Zhou Q , Toivola DM , Strnad P , Sandesara N , Cheung RC , Hong A , Omary MB
Published: February 2008

Keratins 18 and 19 (K18/K19) are epithelial‐specific intermediate filament proteins. Apoptosis induces caspase cleavage at the highly conserved K18 or K19 Asp237, which in K18 is preceded by cleavage at Asp396. We characterized the keratin N‐terminal fragments that are generated upon caspase digestion of K18/K19 at Asp237 in order to study keratin dynamics during apoptosis. This was carried out by generating and characterizing antibodies selective to K18/K19 Asp237. K18 or K19 peptides that expose Asp237 in 234VEVD were used for rabbit immunization. The generated antibodies recognized cleaved but not intact K18/K19, exclusively, as determined by blotting or immunofluorescence staining of apoptotic human HT29 cells or livers isolated from Fas‐Ab‐injected mice. Antibodies to K18/K19 Asp237 recognized the common VEVD‐motif as determined by immunoblotting of cells transfected with K18, K19 or K20. The K18/K19 VEVD‐directed antibodies demonstrated sequential Asp396 then Asp237 K18 cleavage during apoptosis. Specific‐keratin selectivity of the anti‐Asp237 antibodies was confirmed by their inability to recognize K14 after UV‐induced apoptosis in transfected cells. The Asp237‐containing apoptotic keratin fragments are secreted into the medium of cultured HT29 cells and are stable up to 96 h after inducing apoptosis. Furthermore, the generated antibodies recognize keratin apoptotic fragments in sera of mice undergoing hepatocyte apoptosis and sera of patients with cirrhosis, and also recognize apoptotic cells in various epithelial human tumours. Therefore, the N‐terminal caspase‐generated K18 fragment is stable in tissues and biological fluids. The Asp237‐directed antibodies provide a powerful tool to study apoptosis in human and mouse tissues, cells and serum, using a broad range of detection modalities. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Proton versus photon radiotherapy for common pediatric brain tumors: Comparison of models of dose characteristics and their relationship to cognitive function
Authors: Merchant Thomas E. , Hua Chia‐ho , Shukla Hemant , Ying Xiaofei , Nill Simeon , Oelfke Uwe
Published: February 2008

Background

To determine whether proton radiotherapy has clinical advantages over photon radiotherapy, we modeled the dose characteristics of both to critical normal tissue volumes using data from patients with four types of childhood brain tumors.

Procedures

Three‐dimensional imaging and treatment planning data, including targeted tumor and normal tissues contours, were acquired for 40 patients, 10 each with optic pathway glioma (OPG), craniopharyngioma (CR), infratentorial ependymoma (EP), or medulloblastoma (MB). Dose–volume data were collected for the entire brain, temporal lobes, cochlea, and hypothalamus from each patient. The data were averaged and compared based on treatment modality (protons vs. photons) using dose‐cognitive effects models. Outcomes were estimated over 5 years.

Results

Relatively small critical normal tissue volumes such as the cochlea and hypothalamus may be spared from radiation exposure when not adjacent to the primary tumor volume. Larger normal tissue volumes such as the supratentorial brain or temporal lobes receive less of the low and intermediate doses. When applied to longitudinal models of radiation dose‐cognitive effects, these differences resulted in clinically significant higher IQ scores for patients with MB and CR and academic reading scores in patients with OPG. Extreme differences between proton and photon dose distributions precluded meaningful comparison of protons and photons for patients with EP.

Conclusions

Differences in the overall dose distributions, as indicated by modeling changes in cognitive function, showed that a reduction in the lower‐dose volumes or mean dose would have long‐term, clinical advantages for children with MB, CR, and OPG. Pediatr Blood Cancer 2008;51:110–117. © 2008 Wiley‐Liss, Inc.
Appendicitis in immunosuppressed children: Still a diagnostic and therapeutic dilemma?
Authors: Chui Chan‐Hon , Chan Mei‐Yoke , Tan Ah‐Moy , Low Yee , Yap Te‐Lu , Jacobsen Anette S.
Published: February 2008

Acute appendicitis in the immunosuppressed patients are often difficult to diagnose and are associated with increased morbidity and mortality. Recent debates on primary appendicitis and typhlitis‐associated appendicitis have contributed to the diagnostic and therapeutic dilemma. We retrospectively reviewed all our immunosuppressed patients with appendicitis. The most frequent presenting symptom was fever followed by non‐specific intermittent abdominal pain. The median delay in diagnosis was 4 days. CT scan was useful in making the diagnosis, but the presence of adjacent bowel thickening has contributed to the dilemma in diagnosis and treatment. Pediatr Blood Cancer 2008;50:1282–1283. © 2008 Wiley‐Liss, Inc.
Current status of prenatal diagnosis, operative management and outcome of esophageal atresia/tracheo‐esophageal fistula
Authors: Houben C. H. , Curry J. I.
Published: February 2008

Ultrasonographic features suggestive of esophageal atresia with or without tracheo‐esophageal fistula (EA/TEF) are only in a small minority of fetuses with EA/TEF (<10%) identifiable on prenatal scans.

The prenatal diagnosis of EA/TEF relies in principle, on two nonspecific signs: polyhydramnios and absent or small stomach bubble. Polyhydramnios is associated with a wide range of fetal abnormalities, but most commonly it pursues a benign course. Similarly the sonographic absence of a stomach bubble may point to a variety of fetal anomalies.

The combination of polyhydramnios and absent stomach bubble in two small series offers a modest positive predictive value of 44 and 56% respectively. Prenatal scanning for EA/TEF identifies a larger proportion of fetuses with Edwards syndrome; there is also a higher proportion of isolated EA in comparison to postnatal studies.

Current ultrasound technology does not allow for a definite diagnosis of EA/TEF and therefore, counseling of parents should be guarded.

Postnatal diagnosis of EA is confirmed by the failure to pass a firm nasogastric tube into the stomach; on chest X‐ray, the tube is seen curling in the upper esophageal pouch. Corrective surgery for EA/TEF is well established and survival rates of over 90% can be expected. Copyright © 2008 John Wiley & Sons, Ltd.
First‐trimester combined screening for Down syndrome: prediction of low birth weight, small for gestational age and pre‐term delivery in a cohort of non‐selected women
Authors: Pihl Kasper , Sørensen Tina Lindvig , Nørgaard‐Pedersen Bent , Larsen Severin Olesen , Nguyen Tri Huu , Krebs Lone , Larsen Torben , Christiansen Michael
Published: February 2008

Objective

To establish the relationship between the first‐trimester screening markers [pregnancy‐associated plasma protein A (PAPP‐A), free human chorionic gonadotrophin‐β (β‐hCG), nuchal translucency (NT)], the Down syndrome (DS) risk estimate, and the adverse outcomes such as low birth weight, small for gestational age (SGA) and pre‐term delivery.

Methods

A retrospective cohort study including 1734 non‐selected singleton pregnancies consecutively enrolled into the programme of first‐trimester combined screening for DS in a 12‐month period at a single centre. Data from the Prenatal Patient Registry in ASTRAIA were combined with the Danish National Newborn Screening Registry and Danish Birth Registry.

Results

There was a significant relation between low PAPP‐A MoM, low β‐hCG MoM, increased risk estimate for DS and low birth weight and SGA. Low PAPP‐A MoM and increased NT showed a significant relation to pre‐term and spontaneous pre‐term delivery. Low PAPP‐A MoM showed a significant relation to early pre‐term delivery.

Conclusion

First‐trimester screening markers exhibited a significant relation to low birth weight, SGA and to some extent, to pre‐term and early pre‐term delivery. The screening performance of individual markers was poor. Copyright © 2008 John Wiley & Sons, Ltd.
Onset of acute myocardial infarction after use of non‐steroidal anti‐inflammatory drugs
Authors: Hammad Tarek A. , Graham David J. , Staffa Judy A. , Kornegay Cynthia J. , Dal Pan Gerald J.
Published: February 2008

Purpose

To examine the association between cyclooxygenase‐2 (COX‐2) selective and traditional nonsteroidal anti‐inflammatory drugs (NSAIDs) and incident acute myocardial infarction (AMI), and to address unanswered questions regarding the contour of risk over time.

Methods

A cohort of new NSAID users aged 40–84 years was followed for the occurrence of first AMI. Data were collected within the General Practice Research Database (GPRD) from 1 January 1997 to 31 December 2004.

Results

The study population included 1185 AMI events (889 probable and 296 possible) from a cohort of 283 136 patients. After adjustment for demographic and cardiovascular risk factors, the hazard ratio (HR) for AMI was significantly increased for both coxib (2.11, 95% confidence interval (CI) 1.04–4.26) and non‐coxib (2.24, 95%CI 1.13–4.42) COX‐2 selective NSAIDs when compared to remote exposure to NSAIDs, but was not increased for traditional NSAIDs. Stratifying exposure into the first month of use versus use beyond 1 month, the risk of AMI was increased during the first month of COX‐2 selective NSAIDs use, but not later (3.43, 95%CI 1.66–7.07 and 1.88, 95%CI 0.82–4.31, respectively p‐value for interaction = 0.6).

Conclusions

The results suggest that the use of coxib and non‐coxib COX‐2 selective NSAIDs was associated with an elevated risk of AMI within the first month of exposure. Recent past exposure to NSAID was not associated with a similar increase in risk. Copyright © 2008 John Wiley & Sons, Ltd.
Young adolescents' use of medicine for headache: sources of supply, availability and accessibility at home
Authors: Holstein Bjørn E. , Andersen Anette , Krølner Rikke , Due Pernille , Hansen Ebba Holme
Published: February 2008

Objective

Use of medicines for headache is common among young adolescents but little is known about their sources of supply and access to medicines. The purpose was to describe sources of supply, availability and accessibility at home and to examine if supply, availability and accessibility were associated with medicine use.

Methods

Cross‐sectional study in eight schools where all fifth and seventh grade students (11‐ and 13‐year‐olds) answered a questionnaire about socio‐demographic factors, health and medicine use. Response rate: 84.0%, n = 595.

Results

The reported prevalence of headache at least monthly was 45.0%, and 42.5% had used medicines for headache during the past month. 68.2% reported that medicines for headache were always available at home, and 22.2% were allowed to use these without asking for permission. Most pupils received medicine from their parents (73.1%) and physicians (25.4%). Smaller proportions had received medicine from school nurses, teachers, friends and others; 11.6% mentioned at least three sources of supply. Pupils with frequent episodes of headache reported more sources of supply and higher availability and accessibility at home. OR for medicine use among children who mentioned three or more sources of supply was 4.53 (95% CI 2.63–7.83) in a multivariate model controlled for sex, age and prevalence of headache. Use of medicine was also associated with availability at home (OR = 1.51, 1.01–2.27) and accessibility (OR = 2.49, 1.57–3.93).

Conclusion

Medicine use for headache among children and young adolescents is common and control of access may be the key issue for safe medicine use. Copyright © 2008 John Wiley & Sons, Ltd.
Dispensed volumes of anti‐asthmatic drugs related to the prevalence of asthma and COPD in Sweden
Authors: Haupt Dan , Wettermark Björn , Nilsson J. Lars G.
Published: February 2008

Purpose

To explore the possibility of using dispensed volumes asthma/COPD drugs as a proxy for the combined prevalence of asthma plus COPD.

Methods

The proportions of the Swedish population with inhalation drugs for asthma/COPD 2004 were obtained using three different databases. A pharmacy record database gave the volumes of dispensed drugs (defined daily doses, DDDs of R03A + R03B drugs) for each patient, 20 years and older. The X‐plain database of Apoteket AB gave drug sales data for Sweden and Swedish population data were obtained from Swedish statistics.

Results

The sales volumes of asthma/COPD drugs were much higher for older than for younger people. The volumes increased from 18 DDD/TID for the 20–29 year group up to 124 DDD/TID for patients 70–79 years, or about seven times. The average volumes per patient in the different age groups corresponded to one DDD/day in only three of the age groups (50–79 years). In the youngest group the average drug volume per patient corresponded to one DDD every second day, which may indicate undermedication. The percentages of the Swedish population with asthma/COPD drugs increased from 4.0% for 20–29 years old to 14.5% for 80+ years old, or 3.6 times. When head‐to‐head comparisons could be made between reported prevalence data of asthma and COPD and our data the two sets of data were in a reasonable agreement.

Conclusion

The prevalence of drug treatment, i.e. the proportion of the population with dispensed asthma/COPD drugs, could function as a proxy for the disease prevalence of asthma plus COPD. Copyright © 2008 John Wiley & Sons, Ltd.
COMT genotypes and use of antipsychotic medication: linking population‐based prescription database to the HUNT study
Authors: Hagen Knut , Stovner Lars Jacob , Skorpen Frank , Pettersen Elin , Zwart John‐Anker
Published: February 2008

Purpose

The aim of this prospective study was to evaluate the impact of codon 158 polymorphism at the catechol‐O‐methyltransferase (COMT) gene on prescription of antipsychotic medication in a general population.

Methods

The sample comprised 2623 non‐diabetic individuals who participated in the Nord‐Trøndelag Health Study (HUNT) in the period 1995–97 and who were alive 1 January 2004. The subjects were followed up with respect to prescription of antipsychotic medication based on data obtained from the Norwegian prescription database.

Results

Among the group of 76 individuals who had been prescribed antipsychotic medication the distribution did not differ between genotypes and alleles when compared to a control group. For 47 individuals with at least three prescriptions a correlation between median total defined daily doses (DDDs) and genotype groups was found (Spearman's rho, −0.40,p = 0.01), being highest for the Met/Met genotype (250), intermediate for the Met/Val genotype (126) and lowest for the Val/Val genotype (47) (p = 0.03).

Conclusion

In this population‐based cohort of 2623 adults, the Val158Met polymorphism at theCOMTgene had no major impact on number of individuals who had been prescribed antipsychotic medication. However, linkage to the prescription database may in an indirect way indicate an association between theCOMTVal158Met polymorphism and treatment response or dose requirements of antipsychotic medication. Copyright © 2008 John Wiley & Sons, Ltd.
Shedding & shaving: Disclosure of proteomic expressions on a bacterial face
Authors: Tjalsma Harold , Lambooy Lambert , Hermans Peter W. , Swinkels Dorine W.
Published: February 2008

Bacterial surface proteins are critically important in determining the success of bacterial strains in their competition for survival, which makes comprehensive knowledge of the microbial ‘face’ of high relevance to understand bacterial physiology. Therefore, the aim of this study was to inventorize the proteomic composition of a bacterial surface by gel‐free approaches using Bacillus subtilis as a model organism. To this purpose, intact bacteria were incubated with trypsin to cleave surface proteins, after which these ‘shaved’ proteins were identified by LC‐MS/MS analysis of tryptic peptides that were released into the incubation buffer. In parallel, proteins that were released from bacterial cells without trypsin treatment were inventorized and defined as ‘shed’ proteins. The results showed that peptides of 41 proteins, comprising transmembrane proteins, secretory and lipoproteins, known ‘anchorless’ surface proteins and ribosomal proteins, were specifically released by shaving. Some of these proteins were also cleaved by trypsin‐beads, which are unable to penetrate the bacterial cell wall, indicating a genuine surface‐exposed localization. Together this shows that these combined gel‐free approaches can reveal novel proteomic decorations on a bacterial face and may provide leads for future studies on protein sorting in B. subtilis and other Gram‐positive bacteria.
Determining the protein repertoire of Cryptosporidium parvum sporozoites
Authors: Sanderson Sanya J. , Xia Dong , Prieto Helena , Yates John , Heiges Mark , Kissinger Jessica C. , Bromley Elizabeth , Lal Kalpana , Sinden Robert E. , Tomley Fiona , Wastling Jonathan M.
Published: February 2008

The genome of the intracellular parasite Cryptosporidium parvum has recently been sequenced, but protein expression data for the invasive stages of this important zoonotic gastrointestinal pathogen are limited. In this paper a comprehensive analysis of the expressed protein repertoire of an excysted oocyst/sporozoite preparation of C. parvum is presented. Three independent proteome platforms were employed which yielded more than 4800 individual protein identifications representing 1237 nonredundant proteins, corresponding to ∼30% of the predicted proteome. Peptide data were mapped to the corresponding locations on the C. parvum genome and a publicly accessible interface for proteome data was developed for data‐mining and visualisation at CryptoDB (http://cryptodb.org). These data provide a timely and valuable resource for improved annotation of the genome, verification of predicted hypothetical proteins and identification of proteins not predicted by current gene models. The data indicated the expression of proteins likely to be important to the invasion and intracellular establishment of the parasite, including surface proteins, constituents of the remnant mitochondrion and apical organelles. Comparison of the expressed proteome with existing transcriptional data indicated only a weak correlation. For approximately half the proteome there was limited functional and structural information, highlighting the limitations in the current understanding of Cryptosporidium biology.
Time‐of‐flight secondary ion mass spectrometric analysis of the interface between bone and titanium implants
Authors: Eriksson Cecilia , Malmberg Per , Nygren Håkan
Published: February 2008

Implant healing into bone tissue is a process where the mature bone grows towards and eventually fuses with the implant. In this study we investigated implant healing during 4 weeks with focus on the implant‐tissue interface. Our main interest was to study the mineralization process around the implant. Titanium discs were implanted in rat tibia for 2 and 4 weeks. After implantation cross sections of bone and implant were made using a low‐speed saw equipped with a diamond wafering blade. One section from each sample was stained with basic fuchsin and micrographed by light microscopy (LM). The other section was analyzed with imaging time‐of‐flight secondary ion mass spectrometry (TOF‐SIMS) using a Bi cluster ion source. This ion source has recently been shown to enable identification of high‐mass hydroxyapatite (HA) fragment ions (m/z 291–653) in bone samples. The LM images were used to identify areas suitable for TOF‐SIMS analysis. Three areas were selected for mass spectral analysis, corresponding to interface region, bone and soft tissue, from which positive ion spectra were recorded. In the areas identified as bone, high‐mass HA fragments ions were found after both 2 and 4 weeks. In the soft tissue area, no high‐mass ions were found after 4 weeks. However, after 2 weeks HA‐related ions were identified in mineralized spots in areas defined as soft tissue. After 4 but not after 2 weeks, high‐mass HA fragment ions were found in the interface region. In conclusion, differences were observed regarding mineralization between 2 and 4 weeks of implantation and between different regions surrounding the implants. Imaging TOF‐SIMS analysis using a Bi cluster as ion source enables identification of high‐mass HA fragment ions at implant‐tissue interfaces in bone. This technique might therefore be useful for biocompatibility assessment and for studying the mineralization process at implant surfaces. Copyright © 2008 John Wiley & Sons, Ltd.
Monitoring the channel process of a stream restoration project in an urbanizing watershed: a case study of Kelley Creek, Oregon, USA
Authors: Levell A. P. , Chang H.
Published: February 2008

Pacific Northwest (PNW) streams in the United States were impacted by the 20th century development, when removal of instream structure and channelization degraded an aquatic habitat. The lower Kelley Creek in southeast Portland, USA was channelized during the 1930's Works Progress Administration (WPA) projects. Stream restoration reintroduced pool‐riffle sequences and heterogeneous substrates to protect salmonids while mitigating impacts from flooding. We investigated whether the restored pool‐riffle morphology changed substantially following effective discharge events. We examined channel forms for four reaches representing three time periods—pre‐development (two reference reaches), development and restoration. We conducted thalweg profiles, cross‐sections and pebble counts along the reaches to examine how channel geometry, residual pool dimensions and particle size distribution changed following effective discharge events. The effective discharge flows altered the restoration reach more substantially than the reference reaches. The restoration reach decreased in median particle size, and its cross‐sectional geometry aggraded near its margins. However, the residual pool morphology remained in equilibrium. Richardson Creek's reference reach degraded at the substrate level, while Kelley Creek's reference reach remained in equilibrium. The restoration reach's aggradation may have resulted from sedimentation along the nearby Johnson Creek. In contrast, Richardson Creek's degradation occurred as upstream land use may have augmented flows. Stream channels with low gradient pool‐riffle morphologies are ideal for salmonid spawning and rearing and should be protected and restored within urban corridors. The findings of our study suggest that the connectivity of streams and the dynamic fluvial geomorphology of stream channels should be considered for stream restoration projects in humid temperate climates. Copyright © 2008 John Wiley & Sons, Ltd.
An experimental assessment of the effectiveness of gravel cleaning operations in improving hyporheic water quality in potential salmonid spawning areas
Authors: Meyer E. I. , Niepagenkemper O. , Molls F. , Spänhoff B.
Published: February 2008

Dissolved oxygen (DO) conditions within the hyporheic zone were investigated in a gravel stream (River Sieg) in North Rhine Westphalia, Germany, populated in the spawning season by recurring migratory fish species, like Atlantic salmon (Salmo salar L.) and sea trout (Salmo trutta trutta L.). The gravel bed was cleaned at three sites in an area of approximately 150 m2 to a depth of 50 cm, reducing the quantity of grains <2 mm to below 0.2%. DO concentrations in cleaned and uncleaned sediments were monitored in situ at 10, 20 and 30 cm sediment depth from the end of November 2001 to the end of April 2002. DO showed only minor fluctuations at the cleaned sites and steadily decreased at all uncleaned sites over time. Fine sediment accumulation over 5 months in the cleaned sites was comparable to the proportion of material within the bed prior to the experimental cleaning and probably influenced the DO concentrations of the hyporheic water. Decreasing DO concentrations at all sites coincided with increasing water temperatures towards the end of the study period. The cleaning operation significantly improved the conditions of DO in the hyporheic zone of the three study sites. Copyright © 2008 John Wiley & Sons, Ltd.