bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of faecal pollution and relative algal abundances in Lakes Oconee and Sinclair, Georgia, USA
Authors: Bachoon Dave S. , Nichols Todd W. , Manoylov Kalina M. , Oetter Doug R.
Published: June 2009

Water quality was assessed for five subregions of Lake Oconee and Lake Sinclair in Georgia, USA. The areas were chosen for their levels of human impact, including: (i) suburban development >30 years old; (ii) modern suburban development; (iii) industry; (iv) agriculture; and (v) an area of low human activity. The measured temperature, pH, dissolved oxygen concentration and turbidity values were normal for oligotrophic lakes. Faecal pollution in the lakes was determined using the membrane filtration method (Method 1600) on mEI plates for enterococci. There was a positive correlation between turbidity and the number of faecal enterococci in the lakes. The faecal pollution level was higher for the old suburban and agricultural areas. Faecal pollution in the agricultural region of Lake Oconee exceeded EPA regulatory standards. The faecal pollution source was identified using polymerase chain reaction detection, with Bifidobacterium adolescentis being a marker of human faecal pollution, and bovine‐associated Bacteroides (BoBac) as a marker of cattle faecal pollution. Human faecal pollution was detected in the agricultural, old suburban and industrial areas of the lakes. In contrast, bovine faecal pollution was detected only in the agricultural area of Lake Oconee. Measurements of chlorophyll‐a and relative algal community abundance indicated the least‐impacted and modern suburban areas had significantly lower numbers of primary producers, being dominated by diatoms.
Physicochemical parameters and magnetic speciation of Iron in Nakivubo Channel and Lake Victoria waters
Authors: Bbosa Naziriwo Betty , Oyoo Wandiga Shem , Vicent Madadi Odongo , Atieno Abongo Debra
Published: June 2009

Magnetic speciation technique was used for the determination of iron species in Nakivubo Channel and Lake Victoria waters. The method consisted of a column of supported Dowex 1‐X18, 20–50 US mesh (Cl) surrounded by movable permanent magnets. Dowex was supported by a porous material to permit adequate passage of the eluent through the column. In the presence of an external magnetic field, enhanced capacity for adsorption of iron III was observed. The enhanced capacity is primarily due to the magnetic field produced and ion exchange sorption mechanism. The results show that, most of the Iron in Nakivubo Channel waters is in reduced ferrous form while, in the Lake Victoria waters, it exists in the oxidized ferric form. Physicochemical parameters for the field samples are discussed in this study. Turbidity levels in catchments with substantial vegetation were significantly lower than those without. pH values up to 13 was observed for some of the point source. The physicochemical parameters along Nakivubo Channel waters were relatively higher than the Lake Victoria waters indicating slow increasing pollution load along the Nakivubo Channel.
Bile ductular cell reaction with senescent hepatocytes in chronic viral hepatitis is lost during hepatocarcinogenesis
Authors: Ikeda Hiroko , Sasaki Motoko , Sato Yasunori , Harada Kenichi , Zen Yoh , Mitsui Takeshi , Nakanuma Yasuni
Published: June 2009

Cellular senescence is defined as irreversible cell arrest and could work as a safeguard against tumorigenesis. This mechanism was examined in chronic viral hepatitis‐related hepatocarcinogenesis. By using surgical resected or wedge biopsied liver specimens from 87 chronic viral hepatitis patients in whom 35 neoplastic nodules (dysplastic nodules and hepatocellular carcinoma) were complicated, P21 expression and senescence‐associated β galactosidase activity, a marker of senescence, were examined. All of these neoplastic nodules harbored portal tracts within the tumors. Hepatocytes expressing senescence markers and cytokeratin (CK)7‐positive bile ductules including hepatic progenitor‐like cells were increased in periseptal areas in cirrhosis. Interestingly, these cells appeared to form an anatomical complex that was completely lost in the periportal areas within the neoplastic nodules. In one‐third of the neoplastic nodules, CK7‐positive small neoplastic hepatocytes resembling hepatic progenitor cells proliferated zonally around the portal tracts. In conclusion, loss of a complex of senescent hepatocytes and ductular cell including hepatic progenitor‐like cells in the periportal or periseptal areas may be associated with emergence of neoplastic hepatocytes and their proliferation followed by neoplastic nodules arising in liver cirrhosis. Zonal proliferation of CK7‐positive small neoplastic hepatocytes resembling hepatic progenitor cells may develop during early hepatocarcinogenesis.
Adult‐onset renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusion with smooth muscle stroma and abnormal vessels
Authors: Kuroda Naoto , Tamura Masato , Tanaka Yukichi , Hes Ondrej , Michal Michal , Inoue Kaori , Ohara Masahiko , Mizuno Keiko , Lee Gang‐Hong
Published: June 2009

Renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion has been recently identified. Herein is presented a case of RCC with Xp11.2 translocations/TFE3 gene fusions with unusual histological findings. A 68‐year‐old Japanese woman was incidentally found to have a renal mass on CT. Histological examination showed clear cell neoplasm with alveolar and papillary growth patterns. The nuclear atypia corresponded to Fuhrman grade 3. Additionally, smooth muscle stroma was observed and abnormal vessels showing a heterogeniety in thickness were also identified. On immunohistochemistry, neoplastic cells were diffusely positive for transcription factor E3 (TFE3) and Melan A, and focally positive for CD10 and RCC marker. The smooth muscle stroma was positive for α‐smooth muscle actin and h‐caldesmon, but reverse transcription–polymerase chain reaction of the tumor using frozen material could not detect any previously reported chimeric transcripts including ASPL‐TFE3, PRCC‐TFE3, CLTC‐TFE3, PSF‐TFE3 or NoNo‐TFE3. G‐band karyotype was unsuccessful. Pathologists should pay attention to the afore‐described unusual stromal reaction of adult‐onset RCC associated with Xp11.2 translocations/TFE3 gene fusions.
Hepatocellular carcinoma occurring in a young Crohn's disease patient
Authors: Murakami Ayumi , Tanaka Yukichi , Ueda Michio , Nagano Yasuhiko , Kunisaki Reiko , Morimoto Manabu , Enaka Makiko , Tanabe Mikiko , Kawachi Kae , Sasaki Takeshi , Nozawa Akinori
Published: June 2009

Reported herein is a case of hepatocellular carcinoma (HCC) occurring in a 25‐year‐old Japanese man who was diagnosed with Crohn's disease (CD) at 14 years of age; treatment included predonisolone, azathioprine, and infliximab. The tumor was located in right upper lobe and the size was 8 cm in diameter; histology was poorly differentiated HCC with pleomorphic cellular changes. Adjacent normal liver showed no evidence of cirrhosis or viral hepatitis. Until now, only six cases of HCC arising in patients with CD have been reported in the English‐language literature. Most of these patients had early onset of CD and HCC: none had cirrhosis or virus hepatitis. Most patients had a long disease history of CD and were being medicated with several immunosuppressive agents. Some factors associated with CD might indirectly or directly be related to the development of HCC in CD patients, although the possibility that these HCC occurred coincidentally in CD patients, including the present patient, cannot be ruled out. Accumulation of cases is necessary to evaluate the relationship between CD and HCC precisely.
Hypohidrosis‐related symptoms in pediatric epileptic patients with topiramate
Authors: Kim Soon Chul , Seol In Joon , Kim Sun Jun
Published: June 2009

Background:  Topiramate is one of the most commonly prescribed newer antiepileptic drugs. However, we have encountered quite a few cases of pediatric epileptic patients on topiramate complaining about the symptoms related to hypohidrosis. The aim of this study was to determine the incidence and define the clinical characteristics of hypohidrosis‐related symptoms with topiramate in pediatric patients.

Methods:  Data was collected prospectively on 264 patients diagnosed as having epilepsy and treated with topiramate at the Department of Pediatrics, Chonbuk National University Hospital between July 2004 and July 2006. The data were collected by direct interview after at least 3 months had elapsed from the initiation of the medication.

Results:  The study group was composed of 70 boys and 81 girls, with a mean age of 33.1 ± 43.2 months. The mean duration of topiramate treatment was 13.4 ± 15.0 months; 52 patients (34.4%) were treated with topiramate only and 99 patients (65.6%) were on polytherapy including topiramate; 59 out of 151 patients (39.1%) experienced hypohidrosis‐related symptoms: such as facial flushing, lethargy, itching sensation, irritability with hyperthermia, heat sensation or heat intolerance. However, there were no patients complaining of hypohidrosis‐related symptoms among those who were taking antiepileptic drugs other than topiramate.

Conclusions:  Our results suggest that topiramate induces hypohidrosis‐related symptoms more often than we expected, especially in pediatric patients. We recommend that pediatric epileptic patients taking topiramate should be warned to avoid hot and humid environments, especially during the hot summer season.
Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome
Authors: Homma Yukio , Ueda Tomohiro , Tomoe Hikaru , Lin Alex TL , Kuo Hann‐Chorng , Lee Ming‐Huei , Lee Jeong Gu , Kim Duk Yoon , Lee Kyu‐Sung ,   The interstitial cystitis guideline committee
Published: June 2009

A clinical guideline and algorism for interstitial cystitis and hypersensitive bladder syndrome has been developed by a group of East Asian urologists as a revised form of the Japanese guideline for interstitial cystitis. The guideline defines interstitial cystitis (IC) as a disease of the urinary bladder diagnosed by 3 requirements; 1) a characteristic complex of lower urinary tract symptoms, 2) bladder pathology such as Hunner's ulcer and bladder bleeding after overdistension, and 3) exclusions of confusable diseases. The characteristic symptom complex is termed as hypersensitive bladder syndrome (HBS), which is defined as bladder hypersensitivity, usually associated with urinary frequency, with or without bladder pain. For the definite diagnosis of IC, cytoscopy or hydrodistension is crutial; HBS is the diagnosis when IC is suspected but not confirmed by the 3 requirements. Numerous therapeutic options are available; however, most of them lack in high level of evidence, leaving a few as recommended therapies. Etiology of IC are multifactorial; the interaction among nervous, immune and endocrine factors forms a vicious cycle, provocating and maintaining inflammatory reactions in the bladder. The inclusion and efficacy criteria for clinical trials should be standardized to enhance the clinical research for this disabling disease, which has proved to be more prevalent than previously believed.
Intubation in routine dacryocystorhinostomy: why we do what we do
Authors: Madge Simon N , Selva Dinesh
Published: June 2009

Abstract

The role of intubation in routine dacryocystorhinostomy (DCR) surgery is unclear, with there being little evidence in favour of this practice, which appears to have largely come about as a result of history, anecdote and the evolution of DCR surgery. In this paper, a brief history of intubation in DCR surgery is presented and the evidence base is analysed.
Trachoma, cataracts and uncorrected refractive error are still important contributors to visual morbidity in two remote indigenous communities of the Northern Territory, Australia
Authors: Wright Heathcote R , Keeffe Jill E , Taylor Hugh R
Published: June 2009

Abstract

Purpose:  To assess the contribution of trachoma, cataract and refractive error to visual morbidity among Indigenous adults living in two remote communities of the Northern Territory.

Design, Setting and Participants:  Cross‐sectional survey of all adults aged 40 and over within a desert and coastal community.

Main outcome measures:  Visual acuity, clinical signs of trachoma using the simplified WHO grading system and assessment of cataract through a non‐dilated pupil.

Results:  Two hundred and sixty individuals over the age of 40 years participated in the study. The prevalence of visual impairment (<6/12) was 17%. The prevalence of blindness (<3/60) was 2%, 40‐fold higher than seen in an urban Australian population when adjusted for age. In total, 78% of adults who grew up in a desert community had trachomatous scarring compared with 26% of those who grew up in a coastal community (P ≤ 0.001). In the desert community the prevalence of trachomatous trichiasis was 10% and corneal opacity was 6%. No trachomatous trichiasis or corneal opacity was seen in the coastal community.

Conclusions:  Trachoma, cataract and uncorrected refractive error remain significant contributors to visual morbidity in at least two remote indigenous communities. A wider survey is required to determine if these findings represent a more widespread pattern and existing eye care services may need to be re‐assessed to determine the cause of this unmet need.
Patterns of species turnover in plant‐pollinator communities along a precipitation gradient in Patagonia (Argentina)
Authors: DEVOTO MARIANO , MEDAN DIEGO , ROIG‐ALSINA ARTURO , MONTALDO NORBERTO H.
Published: June 2009

Recent studies have assessed the influence of different types of gradients (e.g. altitudinal, latitudinal and temporal, among others) on the structure and function of community‐level plant‐pollinator webs. Although the importance of humidity as a major driver of species‐richness gradients worldwide has been stressed by recent reviews, no studies have been specifically designed to address the influence of precipitation gradients on pollination webs. In the present paper we describe for the first time the turnover of species of plants and their associated flower visitors between eight communities located along a steep precipitation gradient in north‐west Patagonia, Argentina. Our results show that: (i) there is a high spatial turnover of plant communities and their associated pollinators; (ii) this turnover is strongly related to precipitation changes across the region; and (iii) the turnover rate is similar for plants and pollinators. Our results support the view that the precipitation gradient is a significant factor associated with the regional turnover of plants and their pollinators in the temperate forests of southern South America.
Toe‐bud clipping of juvenile small marsupials for ecological field research: No detectable negative effects on growth or survival
Authors: FISHER D. O. , BLOMBERG S. P.
Published: June 2009

Toe clipping is widely used to permanently mark many species of small vertebrates including marsupials, particularly didelphids and dasyurids. Small marsupials are marked as juveniles, by removing the tip of developing toe buds. It has recently been shown that survival and/or recapture probability decreases with increasing number of toes clipped in frogs. Because of this and other animal welfare concerns, toe clipping of adult vertebrates is increasingly being discouraged. The short‐ and long‐term effects of toe‐bud clipping have not been evaluated in marsupials. We used an experiment to test if marking more toes results in slower growth or higher mortality in the brown antechinus (Antechinus stuartii, Dasyuridae) in the short or long term. We found no harmful effects of toe‐bud clipping. There were no infections associated with clipping, marking more toes did not reduce growth in young or adults, and did not affect survival of young in captivity, survival of independent animals in the wild, or recapture probability. Toe‐bud clipping is done at an extremely immature stage, when the area cut is tiny and perception and memory of pain is unlikely to be a problem. We suggest that toe‐bud clipping is a humane and benign method of permanently marking antechinuses, and probably also the young of other morphologically similar small marsupials.
Identification of the food sources of sympatric ghost shrimp (Trypaea australiensis) and soldier crab (Mictyris longicarpus) populations using a lipid biomarker, dual stable isotope approach
Authors: SPILMONT NICOLAS , MEZIANE TARIK , SEURONT LAURENT , WELSH DAVID T.
Published: June 2009

Fatty acids (FAs) profiles and stable isotope signatures of the ghost shrimp, Trypaea australiensis and the soldier crab, Mictyris longicarpus were determined at an unvegetated sandbank of Southport (Gold Coast, Queensland, Australia), in November 2005 and February 2006. Additionally, the FAs composition of the faeces and feeding pellets of M. longicarpus and the surface sediment at the study site were also analysed. Trypaea australiensis was found to selectively feed principally on benthic diatoms, as revealed by the high contribution of the marker lipid (20:5 (n‐3)) to tissue total FAs and the δ13C and δ15N isotopic signatures of shrimp tissues. Although the diet of T. australiensis did not change between the two sampling periods, the shrimps appeared to reduce their feeding activity in summer, presumably in relation to a restricted metabolism, as revealed by a decrease in the contribution of the microalgal markers in their tissues. The FAs composition of the tissues of the soldier crab indicated that bacteria and diatoms constituted the base of its diet (contributions of branched 15:0 and 17:0, 18:1 (n‐7) and 20:5 (n‐3)). However, the isotopic signatures of the crabs suggested that meiofauna may represent an intermediate link between the crab and these micro‐organisms.
Lolium multiflorumdensity responses under ozone and herbicide stress
Authors: MARTÍNEZ‐GHERSA M. ALEJANDRA , RADOSEVICH STEVEN R.
Published: June 2009

Adaptations to overcrowding of individual plants result in density dependant control of growth and development. There is little information on how anthropogenic stresses modify these responses. We investigated whether combinations of diclofop‐methyl herbicide and tropospheric ozone alter the pattern of expected growth compensation with density changes resulting from intraspecific competition inLolium multiforumLam (Poacea) plants. Individual plant vegetative parameters and total seed production were assessed for plants growing under various densities and different herbicide rates and ozone treatments. The stressors differently changed the frequency distribution for average individual plant weight resulting from increasing densities. Only herbicide affected seedling mortality. Plants were able to compensate during grain filling maintaining similar seed production – density relationships in all treatments. Our findings contribute to the understanding of the impact of stress factors on the demographic changes in plant populations. Important ecological implications arise: (i) contrasting responses to ozone and herbicide, alone and in combination of individual plants resulted in different biomass – density relationships; (ii) stress effects on plant populations could not be predicted from individual responses; and (iii) changes in competitive outcome by single or combined stress factors may alter the expected genotype frequency in a crowded population with few dominant individuals.
Diversity and salt tolerance of native Acacia rhizobia isolated from saline and non‐saline soils
Authors: THRALL PETER H. , BROADHURST LINDA M. , HOQUE MOHAMED S. , BAGNALL DAVID J.
Published: June 2009

Re‐establishing native vegetation in stressed soils is of considerable importance in many parts of the world, leading to significant interest in using plant–soil symbiont interactions to increase the cost‐effectiveness of large‐scale restoration. However, effective use of soil microbes in revegetation requires knowledge of how microbe communities vary along environmental stress gradients, as well as how such variation relates to symbiont effectiveness. In Australia, shrubby legumes dominate many ecosystems where dryland salinity is a major issue, and improving plant establishment in saline soils is a priority of regional management agencies. In this study, strains of rhizobial bacteria were isolated from a range of Acacia spp. growing in saline and non‐saline soils. Replicates of each strain were grown under several salinity levels in liquid culture and characterized for growth and salt tolerance. Genetic characterization of rhizobia showed considerable variation among strains, with salt tolerance and growth generally higher in rhizobial populations derived from more saline soils. These strains showed markedly different genetic profiles and generic affiliations to those from more temperate soils, suggesting community differentiation in relation to salt stress. The identification of novel genomic species from saline soils suggests that the diversity of rhizobia associated with Australian Acacia spp. is significantly greater than previously described. Overall, the ability of some symbiotically effective strains to tolerate high salinity is promising with regard to improving host plant re‐establishment in these soils.
Influence of temporal fluctuations in seed abundance on the diet of harvester ants (Pogonomyrmexspp.) in the central Monte desert, Argentina
Authors: PIRK GABRIELA I. , DE CASENAVE JAVIER LOPEZ , POL RODRIGO G. , MARONE LUIS , MILESI FERNANDO A.
Published: June 2009

Harvester ants usually go through temporal fluctuations in environmental seed abundance and composition which could influence their behaviour and ecology. The aim of this study was to evaluate how these fluctuations influence the diet ofPogonomyrmex rastratus,P. pronotalisandP. inermis(Hymenoptera, Formicidae) in the central Monte desert during three consecutive growing seasons. Although seeds were the main item in the diet, these ants turned more generalist when seed abundance of the most consumed species (grassesAristidaspp.,Trichloris crinita,Pappophorumspp.,Digitaria californicaandStipa ichu) was low. Accordingly, diversity of items in the diet decreased with seed abundance in a logarithmical fashion, showing higher foraging efficiency for seeds at higher seed abundance. Seed diversity, however, was not related to seed abundance as ants always included several species in their diet, with alternating prevalence. The proportion of the most consumed species increased logarithmically in the diet ofP. rastratusandP. pronotalisalong with their abundance in the environment probably as a consequence of diet switching (from forb and shrub seeds to grass seeds) and by an increase in foraging efficiency at higher seed densities. In contrast, foraging activity ofP. inermiswas very low at low seed abundance and its diet included only the five grasses. Among the most consumed species, proportion in the diet was not associated with relative abundance in the environment.Aristidaspp.,Pappophorumspp. andD. californicawere overall highly selected. However, the flexibility in the diet ofP. pronotalisandP. rastratusand the low foraging activity ofP. inermisduring periods of low resource abundance could attenuate potential top‐down effects in the central Monte desert. This study shows that bottom‐up effects are important in ant‐seed interactions and should be considered when predicting and evaluating ants' effects on seed resources.
EVALUATION OF PERORAL VIDEOCHOLANGIOSCOPY USING NARROW‐BAND IMAGING FOR DIAGNOSIS OF INTRADUCTAL PAPILLARY NEOPLASM OF THE BILE DUCT
Authors: Itoi Takao , Sofuni Atsushi , Itokawa Fumihide , Tsuchiya Takayoshi , Kurihara Toshio
Published: June 2009

Background:  It is very important for intraductal papillary neoplasm of the bile duct (IPNB) to determine the extension of the neoplasms because of substantial differences in the approach to treatment strategy. Peroral videocholangioscopy (PVCS) has been developed as a new diagnostic tool for high resolution imaging of biliary disorders. Recently, narrow‐band imaging (NBI) has made it possible to emphasize the imaging of certain features, such as mucosal structures and capillary vessels. The aim of this study is to evaluate the clinical usefulness of PVCS using NBI for the diagnosis of IPNB.

Patients and Methods:  Four patients (3 men and 1 woman) were eligible for this study as they were scheduled for PVCS for evaluation of IPNB between August 2005 and September 2008 at Tokyo Medical University Hospital. We evaluated endoscopic imaging of white light imaging (WLI) and NBI for IPNB lesions, and ability of removing mucin in the bile duct by PVCS. The quality of the visualization was evaluated. : (i) poor, (ii) fair, and (iii) excellent, compared to WLI and the feasibility of irrigation: (i) poor, (ii) fair, and (iii) excellent, compared to those in patients with non‐mucin‐producing biliary tract diseases.

Results:  After sufficient removal of mucin by balloon catheter, conventional cholangioscopy could detect the papillary lesion, and revealed the range of tumor spread in all cases. Interestingly, another papillary lesion far from the main tumor was detected only by PVCS. In the ability to detect the fine mucosal structure, NBI was predisposed to be better than conventional imaging while only one case was “poor” by NBI observation because we could not eliminate the influence of bile.

Conclusion:  Our results presented here suggest that the depiction ability of the margin of lesions by NBI observation is superior to conventional observation if abundant mucin can be removed sufficiently. Although further cases should be accumulated, choledochoscopy using NBI may be helpful for the observation of fine mucosal structures, resulting in diagnosis of tumor spread in patients with IPNB.
DIAGNOSTIC VIDEOCHOLANGIOSCOPY USING NARROW‐BAND IMAGING AND RECANALIZATION BY RENDEZVOUS TECHNIQUE FOR DIFFICULT BENIGN BILIARY STRICTURE
Authors: Itoi Takao , Ishii Kentaro , Tsuji Shujiro , Ikeuchi Nobuhito , Yamada Kouta
Published: June 2009

A 51‐year‐old man was hospitalized because of close examination for liver dysfunction. drip infusion cholangiography‐computed tomography (DIC‐CT) revealed a stricture located at the middle bile duct but normal biliary scintigraphy. Endoscopic retrograde cholangiopancreatography (ERCP) showed obstruction of bile duct. Although we tried to pass the stricture using several kinds of guidewire under direct vision of peroral cholangioscopy, recanalization could not be achieved. Then percutaneous transhepatic biliary drainage (PTBD) was conducted. Cholangioscopy using narrow band imaging showed no tumor vessel or irregular mucosa. The biopsy specimens obtained from both distal and proximal sides of stricture showed no malignancy. Eventually, a rendezvous technique was tried using guidewire under percutaneous transhepatic cholangioscopy (PTCS) direct vision. Fortunately, since a guidewire could advance into a tiny hole at the center of a scar and an endoscopic nasobiliary drainage (ENBD) tube could be placed across the biliary stricture. One week after placement of ENBD tube, a 10 Fr plastic stent was inserted and the PTBD tube was removed without procedure‐related complication. Eight months later, the stent was removed and the chief complaint disappeared without liver dysfunction.
EUS‐GUIDED PANCREATIC PSEUDOCYST DRAINAGE: SIMULTANEOUS PLACEMENT OF STENTS AND NASOCYSTIC CATHETER USING DOUBLE‐GUIDEWIRE TECHNIQUE
Authors: Itoi Takao , Itokawa Fumihide , Tsuchiya Takayoshi , Kawai Takashi , Moriyasu Fuminori
Published: June 2009

Background:  Endoscopic ultrasonography (EUS)‐guided pancreatic pseudocyst drainage has become the standard and safety procedure in many centers for nonsurgical treatment. If multiple stents or another nasocystic catheter are used, the pseudocyst is recannulated using a catheter and guidewire. To avoid the cumbersome issue of recannulating the pseudocyst, we, and some endoscopists, have advocated the concept of a double‐wire technique. The aim of this study is to evaluate EUS‐guided simultaneous placement of stent and nasocystic catheter for pancreatic pseudocyst.

Patients and Methods:  Thirteen patients (9 men, mean age 55.7 years) underwent EUS‐guided pancreatic pseudocyst drainage by simultaneous placement of stent and nasocystic catheter. Mean size of cyst was 81.3 ± 63.1 (range; 35–280 cm). The symptoms that indicated a requirement for drainage in the 13 patients were abdominal pain (n = 8), fever (n = 4), and biliary obstruction (n = 1).

Results:  Transgastric and transduodenal approach were conducted in 10 cases and 3 cases, respectively. The procedure was technically successful in 12 of 13 patients (92%). At a median follow‐up of 785 days, the treatment was successful in 13 of 13 patients (100%). No pseudocyst recurrence was observed. Decrease of cyst was seen in 8 cases (61.5%). Pseudocyst disappeared completely in 5 cases. There was no procedure‐related complication.

Conclusion:  Although more experience is required to determine whether this method is more effective, we believe that stent placement in combination with nasocystic catheter using double‐wire technique will be of great value for patients with pancreatic pseudocysts without pancreatic necrosis.
TRANS‐GASTRIC ENDOSCOPIC DRAINAGE USING A LARGE BALLOON FOR PANCREATIC NECROSIS AND ABSCESS – TWO CASE REPORTS
Authors: Okabe Yoshinobu , Kaji Ryohei , Ishida Yusuke , Sakamoto Teruo , Maeda Akira , Kikuma Kanta , Tsuruta Osamu , Sata Michio
Published: June 2009

Reports on endoscopic treatment for pancreatic necrosis and pancreatic abscess have occasionally been published in recent years. Single treatments using endoscopic transpapillary or transumural drainage were originally used, but these were frequently changed to surgical therapy. In recent years, attempts have been made, such as the use of a combination of transmural and transpapillary approaches, the balloon dilatation of the cystgastrostoma, and a daily endoscopic necrosectomy and saline solution lavage, and the treatment results have thus been improved, even though the number of cases is low. We performed transmural endoscopic ultrasonography (EUS)‐guided drainage without a necrosectomy in two cases with pancreatic necrosis and abscess, and treated cases in which a continuous closed lavage using a tube with a large diameter was effective, and we herein report our findings.
TOWARD THE GLOBAL STANDARDIZATION OF ENDOSCOPIC SUBMUCOSAL DISSECTION PROPOSAL FOR 10 YEARS FROM NOW – PRESENT AND FUTURE VIEW OF KOREA
Authors: Cho Joo Young , Cho Won Young
Published: June 2009

Endoscopic submucosal dissection (ESD) is the main treatment of early gastric cancer in Korea. The Korean Society of Gastrointestinal Endoscopy (KSGE) has organized an ESD research group and made several plans to standardize pathologic and therapeutic points of view. This article is to introduce the present and future view of ESD in Korea.
ENDOSCOPIC PIECEMEAL RESECTION IS A PRACTICAL OPTION TO CURE COLORECTAL TUMORS
Authors: Fujiya Mikihiro , Moriichi Kentaro , Saitoh Yusuke , Watari Jiro , Kohgo Yutaka
Published: June 2009

Endoscopic mucosal resection (EMR) and endoscopic piecemeal resection (EPMR) are therapeutic options widely accepted for the treatment of colon adenoma, intramucosal cancer and minimally invasive submucosal cancer. Our retrospective investigation revealed that single EMR or EPMR with 2‐channel procedure cured 913 (96.6%) of 945 flat and depressed tumors, verifying the significant role of certain procedures in the therapeutic strategy for colorectal neoplasm. Predicting the invasion depth and fibrotic change before resection are proposed to be necessary for improving complete resection rate of first EMR or EPMR. Hood, 2‐channel method and the combination of EMR and circumferential mucosal incision are regarded to be practical procedures on EPMR.
ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE COLORECTUM: PRESENT STATUS AND FUTURE PROSPECTS
Authors: Uraoka Toshio , Kawahara Yoshiro , Kato Jun , Saito Yutaka , Yamamoto Kazuhide
Published: June 2009

Endoscopic submucosal dissection (ESD) can successfully resect early stage gastrointestinal tumors, but colorectal ESDs are not widely performed, even by Japanese endoscopists, because of several negative factors. Besides being considerably more difficult in terms of technical demands, colorectal ESDs involve a longer procedure time and have a higher complication rate compared to gastric ESDs. In addition, most colorectal lesions are adenomas or intramucosal cancers that despite their large size that can be curatively treated by endoscopic mucosal resection including piecemeal resection.

There is, however, no doubt about ESD having a major therapeutic advantage in being able to achieve a higher en‐bloc resection rate resulting in enhanced curability and more accurate histopathological assessment. Continued improvement in the technical skills of endoscopists, further refinement of such devices as electrical surgical knives and a special colonoscope as well as the development of more effective submucosal injection solutions and new traction systems are expected to facilitate easier, faster and safer colorectal ESD procedures in the relatively near future.
EARLY DIAGNOSIS OF SMALL PANCREATIC CANCER: ROLE OF ENDOSCOPIC ULTRASONOGRAPHY
Authors: Irisawa Atsushi , Sato Ai , Sato Masaki , Ikeda Tsunehiko , Suzuki Rei , Ohira Hiromasa
Published: June 2009

Advanced pancreatic cancer is a major cause of cancer‐related death. However, if surgery achieves clear margins and negative lymph nodes, the prognosis for survival can be prolonged. Therefore, early diagnosis – as early as possible – is important for improving overall survival and quality of life in patients with pancreatic cancer. Because of higher imaging resolution near the pancreas through the gastroduodenal wall, endoscopic ultrasonography enables detection of subtle pancreatic abnormalities. In fact, many investigators have reported the high ability of EUS not only for detection of small lesions but also recognition of chronic pancreatitis, which is the risky status of pancreatic cancer. As a tool for early diagnosis of pancreatic cancer, EUS is a highly anticipated modality.
PRESENT STATUS AND FUTURE PERSPECTIVE OF EUS‐GUIDED DRAINAGE
Authors: Kitano Masayuki , Sakamoto Hiroki , Komaki Takamitsu , Kudo Masatoshi
Published: June 2009

Development of the curved linear (convex) array echoendoscope has enabled procedures that utilize interventional endoscopic ultrasonography (EUS), such as EUS‐guided drainage. EUS‐guided pseudocyst drainage creates a fistula between the pseudocyst and the gastric or duodenal lumen. This treatment is superior to conventional endoscopic transmural drainage with respect to prevention from complications such as bleeding, because ultrasonographic observation permits easy visualization of the interposing vessels and real‐time visualization of needle procedure. Endoscopic ultrasonography‐guided drainage can also be applied to pancreatobiliary drainage. In cases where endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful in the treatment of obstructive jaundice and chronic obstructive pancreatitis, transmural drainage of bile and pancreatic juice under EUS guidance may supplant the percutaneous transhepatic biliary drainage and the surgical treatment.
THE NEW RESOURCES OF TREATMENT FOR EARLY STAGE COLORECTAL TUMORS: EMR WITH SMALL INCISION AND SIMPLIFIED ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: Toyonaga Takashi , Man‐I Mariko , Morita Yoshinori , Sanuki Tsuyoshi , Yoshida Masaru , Kutsumi Hiromu , Inokuchi Hideto , Azuma Takeshi
Published: June 2009

Introduction:  Early stage colorectal tumors can be removed by endoscopic mucosal resection (EMR) but larger tumors (≧20 mm) may require piecemeal resection. The development of endoscopic submucosal dissection (ESD) has enabled en‐bloc resection of lesions regardless of size and shape. However ESD of colorectal tumor is technically difficult. As the resources, we perform EMR with small incision (EMR with SI) for more reliable EMR, and also ESD with snaring (simplified ESD) for easier and safer ESD.

Aim & Methods:  The aim of the study was to retrospectively compare the treatment results of the following 3 methods (EMR with SI/ simplified ESD/ ESD). We treated 24/44/468 colorectal tumors, and examined the tumor size, resected specimen size, procedure time, en‐bloc resection rate, complication rate.

Result:  The median tumor size (mm) (EMR with SI/simplified EMR/ESD) was 20/17/30 (EMR with SI vs simplified ESD: P = n.s, simplified ESD vs ESD: P < 0.0001). The median resected specimen size (mm) was 22.5/26/41 (EMR with SI vs simplified ESD: P = 0.0018, simplified ESD vs ESD: P < 0.0001). The procedure time (min.) was 19/27/60 (EMR with SI vs simplified ESD: P = n.s, simplified ESD vs ESD: P < 0.0001) The en‐bloc resection rate (%) was 83.3/90.9/98.9. The complication rate (post‐operative bleeding rate/perforation rate) was 0/0, 2.3/4.5, 1.5/1.5 (simplified ESD vs ESD: P = n.s).

Conclusion:  Endoscopic mucosal resection with small incision (EMR with SI) and ESD with snaring (simplified ESD) are a good option to fill the differences between conventional EMR and ESD, and also considered to become nice steps to the introduction of ESD.
Comprehensive geriatric assessment of elderly highlanders in Qinghai, China IV: Comparison of food diversity and its relation to health of Han and Tibetan elderly
Authors: Kimura Yumi , Okumiya Kiyohito , Sakamoto Ryota , Ishine Masayuki , Wada Taizo , Kosaka Yasuyuki , Wada Chizu , Ishimoto Yasuko , Hirosaki Mayumi , Kasahara Yoriko , Konno Akiko , Chen Wingling , Otsuka Kuniaki , Fujisawa Michiko , Nakatsuka Masahiro , Nakashima Michiro , Wang Hongxin , Dai Qingxiang , Yang Airong , Gao Jidong , Li Zhanquan , Qiao Haisheng , Zhang Yongshou , Ge Ri‐Li , Matsubayashi Kozo
Published: June 2009

Aim:  To examine the association between food diversity and health status of Han and Tibetan elderly highlanders in Qinghai Plateau, China.

Methods:  The study population consisted of 240 community‐dwelling elderly subjects aged 60 years or more (176 Han elderly subjects, 64 Tibetan ones). Food diversity was determined using an 11‐item Food Diversity Score Kyoto (FDSK‐11). Subjects were interviewed on health status including activities of daily living (ADL), screening‐based depression and quality of life (QOL). Blood chemical investigation was carried out in association with food diversity.

Results:  ADL was significantly lower in both Han and Tibetan elderly with lower food diversity than those with higher diversity. In Han elderly with lower food diversity, QOL was significantly lower in the items of subjective sense of health, relationship with family and subjective happiness, but not significant in Tibetan elderly. A close association was found between lower food diversity and lower financial satisfaction in both Han and Tibetan subjects. No association was found between food diversity and age or body mass index. Higher food diversity was associated with lower blood glucose level in Han elderly subjects, but the opposite association was found in Tibetan ones.

Conclusion:  Food diversity was associated with ADL and QOL in highlanders in Qinghai, China. Food assessment is very important as a useful indicator to establish the actual condition of diet and its relation to health status of community‐dwelling elderly as well as the change of economic background in the Qinghai highlands.
Influences of flux‐cored arc welding consumables on dynamic fracture toughness (J1d) of armour grade Q&T steel joints
Authors: MAGUDEESWARAN G. , SATHYANARAYANAN S. , REDDY G. MADHUSUDHAN , BALASUBRAMANIAN V. , MOITRA A. , VENUGOPAL S. , SASIKALA G.
Published: June 2009

Quenched and tempered (Q&T) steels are prone to hydrogen‐induced cracking in the HAZ after welding. Austenitic stainless steel (ASS) welding consumables are traditionally used for welding of high hardness Q&T steels as they have higher solubility for hydrogen. The use of stainless steel consumables for a non‐stainless steel base metal is not economical. In recent years, the developments of low hydrogen ferritic steel (LHF) consumables that contain no hygroscopic compounds are utilized for welding of Q&T steels The use of ASS and LHF consumables for armour grade Q&T steel will lead to formation of distinct microstructures in their respective welds. This microstructural heterogeneity will have a drastic influence in the dynamic fracture toughness of the armour grade Q&T steel welds. Hence, an attempt was made in this paper to study the influence of flux‐cored arc welding consumables on dynamic fracture toughness (J1d) of armour grade Q&T steel joints. The flux‐cored arc welding consumables have a significant effect on the dynamic fracture toughness of the armour grade Q&T steel welds. The joints fabricated using ASS flux‐cored wires showed superior J1d values than the joints fabricated using LHF consumables and the base metal.
Ecological limits and diversification rate: alternative paradigms to explain the variation in species richness among clades and regions
Authors: Rabosky Daniel L.
Published: June 2009

Diversification rate is one of the most important metrics in macroecological and macroevolutionary studies. Here I demonstrate that diversification analyses can be misleading when researchers assume that diversity increases unbounded through time, as is typical in molecular phylogenetic studies. If clade diversity is regulated by ecological factors, then species richness may be independent of clade age and it may not be possible to infer the rate at which diversity arose. This has substantial consequences for the interpretation of many studies that have contrasted rates of diversification among clades and regions. Often, it is possible to estimate the total diversification experienced by a clade but not diversification rate itself. I show that the evidence for ecological limits on diversity in higher taxa is widespread. Finally, I explore the implications of ecological limits for a variety of ecological and evolutionary questions that involve inferences about speciation and extinction rates from phylogenetic data.
Evaluation of gadolinium‐enhanced T1‐weighted magnetic resonance imaging in the preoperative assessment of local staging in rectal cancer
Authors: Jao S.‐Y. , Yang B.‐Y. , Weng H.‐H. , Yeh C.‐H. , Lee L.‐W.
Published: June 2009

Aim  The aim of this study was to determine whether gadolinium‐enhanced T1‐weighted magnetic resonance (MR) sequence is beneficial in the preoperative assessment of tumour and nodal staging in patients with primary rectal cancer.

Method  Eighty‐eight patients with primary rectal cancer underwent preoperative MR imaging, followed by surgical resection. Two radiologists independently reviewed (i) T2‐weighted MR images (T2WI); (ii) gadolinium‐enhanced T1‐weighted MR images (T1 + Gd); (iii) MR combined with T2WI and T1 + Gd for the prediction of tumour and nodal stage compared with histopathologic findings as the end point. Differences in the diagnostic performance of T2WI only, T1 + Gd image only and combined T2WI and T1 + Gd MR images were analyzed by comparing areas under receiver operating characteristic curves (Az) for each reader. Interobserver agreement was also calculated.

Results  There was no significant difference in the Az values of T2WI only, T1 + Gd image only and combined T2WI and T1 + Gd images for the prediction of tumour staging (Az of T2WI, T1 + Gd and combined MR images for reader 1, 0.80, 0.76 and 0.85; reader 2, 0.83, 0.82 and 0.87) and nodal staging (Az for reader 1, 0.73, 0.73 and 0.81; reader 2, 0.79, 0.80 and 0.83). Interobserver agreement for the prediction of tumour staging was moderate to substantial, while only fair agreement was noted for the prediction of nodal staging.

Conclusion  Gadolinium‐enhanced T1‐weighted MRI did not increase the diagnostic yield for tumour and nodal staging, and may be omitted in the MR protocol for preoperative assessment of primary rectal cancer.
The use of molecular and morphological characters to resolve the taxonomic identity of cryptic species: the case of Miniopterus manavi (Chiroptera, Miniopteridae)
Authors: Goodman Steven M. , Maminirina Claudette P. , Weyeneth Nicole , Bradman Helen M. , Christidis Les , Ruedi Manuel , Appleton Belinda
Published: June 2009

Based on recent molecular phylogenetic studies, the Old World bat family Miniopteridae, composed of species in the genus Miniopterus, has been shown to contain complex paraphyletic species, many of which are cryptic based on convergent morphological characters. Herein we resolve the phylogenetic relationships and taxonomy of the species complex M. manavi on Madagascar and in the Comoro Archipelago, where these animals occur in different bioclimatic zones. First using mitochondrial cytochrome‐b sequence data to define clades and then morphology to corroborate the molecular data, including comparisons to type specimens, we demonstrate that animals identified as this taxon are a minimum of three species: M. manavi sensu stricto occurs in at least the central portion of the Central Highlands; M. griveaudi has a broad distribution in lowland northern and central western Madagascar and the Comoros (Anjouan and Grande Comore), and M. aelleni sp. n. has been found in northern and western Madagascar and the Comoros (Anjouan). In each case, these three clades were genetically divergent and monophyletic and the taxa are diagnosable based on different external and craniodental characters. One aspect that helped to define the systematics of this group was isolation of DNA from one of the paratypes of M. manavi collected in 1896 and new topotypic material. Miniopterus manavi is most closely allied to a recently described species, M. petersoni. At several localities, M. griveaudi and M. aelleni have been found in strict sympatry, and together with M. manavi sensu stricto show considerable convergence in morphological characters, but are not immediate sister taxa. In defining and resolving the systematics of cryptic species, such as miniopterid bats, the process of defining clades with molecular tools, segregating the specimens accordingly, and identifying corroborative morphological characters has been notably efficient.
Does the presence of significant risk factors affect perioperative outcomes after robot‐assisted radical cystectomy?
Authors: Butt Zubair M. , Fazili Anees , Tan Wei , Wilding Gregory E. , Filadora Victor , Kim Hyung L. , Mohler James L. , O’Leary Kathleen A. , Guru Khurshid A.
Published: June 2009

OBJECTIVE

To evaluate the effect of preoperative risk factors on perioperative outcomes up to 3 months after robot‐assisted radical cystectomy (RARC), as RC continues to be associated with a high rate of morbidity and mortality.

PATIENTS AND METHODS

From 2005 to 2007, 66 consecutive patients had RARC at Roswell Park Cancer Institute. Patient demographics, preoperative risk factors and complications up to 3 months after RARC were reviewed from a prospective quality‐assurance database. Patients were stratified into high‐ and low risk groups based on age, previous abdominal surgery, chronic obstructive pulmonary disease (COPD), body mass index (BMI), Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiologists (ASA) score.

RESULTS

Age, previous abdominal surgery, COPD, BMI, RCRI score and ASA score did not significantly influence complications during or up to 3 months following RARC (P > 0.05). Advanced age was associated with a higher RCRI score (P = 0.014) and an increased likelihood of admission to the Intensive Care Unit (P = 0.007). A higher ASA score was associated with an increased overall hospital stay (P = 0.039). Previous abdominal surgery was associated with more frequent unscheduled postoperative clinic visits (P = 0.014). Operative duration did not significantly influence complication rates (P > 0.05). Fifteen of 62 patients (24%) had a major complication, while 15 (24%) had minor complications within 3 months of surgery. The reoperation rate was 11% and the overall mortality rate was 1.6%.

CONCLUSIONS

RARC appears to be well tolerated, independent of comorbid risk factors such as age, BMI, RCRI and ASA score.