bluuebunny/crossref_metadata_2025 huggingface dataset:
Voice Complaints, Risk Factors for Voice Problems and History of Voice Problems in Relation to Puberty in Female Student Teachers
Authors: Thomas G. , de Jong F.I.C.R.S. , Kooijman P.G.C. , Donders A.R.T. , Cremers C.W.R.J.
Published: September 2006

The aim of the study was to estimate voice complaints, risk factors for voice complaints and history of voice problems in student teachers before they embarked on their professional teaching career. A cross-sectional questionnaire survey was performed among female student teachers. The response rate was 72% and 457 questionnaires were analyzed. Voice complaints at the moment and/or during the past year were reported by 39.6% subjects. Subjects with voice complaints had significantly higher VHI scores than subjects without voice complaints. In comparison to subjects without voice complaints, overall, subjects with voice complaints reported more frequently that vocal loading factors, physical factors, environmental factors and psychological factors had a negative influence on their voice. Subjects with voice complaints reported more frequently a history of voice complaints during puberty and before puberty in comparison to subjects without voice complaints. Voice complaints in student teachers apparently had a multifactorial genesis and with roots during puberty or before puberty. Logistic regression analysis revealed that intensive voice use, emotions and history of voice complaints during puberty were the most discriminating set of risk factors for voice complaints. Subjects with voice complaints in comparison to those without voice complaints reported more frequently that they would develop a voice problem due to future teaching and that future teaching would have a negative influence on their voice. Around three quarters of subjects with and without voice complaints reported that attention paid to their voice during their training was sufficient. However, subjects with voice complaints were observed to report the need for a refresher course on voice use more frequently than those without voice complaints. The findings call for more intensive voice training for student teachers to cope with the vocal, physical and psychological demands of the teaching profession. Authorities should take responsibility to monitor and improve working conditions of student teachers and teachers.
Fundamental Frequency as a Perceptual Cue for Vowel Identification in Speakers with Parkinson’s Disease
Authors: Bunton Kate
Published: September 2006

This study investigates the importance of fundamental frequency (F0) as a perceptual cue for identification of vowel targets produced by speakers with Parkinson’s disease (PD). It has been suggested in the literature that F0 is a redundant cue for vowel identification in highly intelligible speech. For speakers with dysarthria who are having difficulty with segmental and suprasegmental aspects of production which result in ambiguous or conflicting cues in the acoustic signal, F0 may have increased perceptual importance for accurate identification of vowel targets. In the present study, F0 contours for single-word targets produced in sentence level material by 20 speakers with PD and 20 control speakers were synthetically modified in several different ways (i.e., flattened and enhanced). Listener identification of vowel targets across the F0 conditions was recorded. The accuracy of vowel identification for the control group was not affected by the flattening of the F0 contour. For the speakers with PD, however, modification of the F0 contour (flattening or enhancing) affected the accuracy with which listeners identified certain vowels. Differences in vowel identification were found primarily for the front vowels /I, Ε, æ/ along a high-low continuum.
Prenatal Diagnosis of a Fibrosarcoma of the Thigh: A Case Report
Authors: Durin Luc , Jeanne-Pasquier Corinne , Bailleul Patrick , Eboué Cyril , Aicardi Stéphanie , Herlicoviez Michel , Dreyfus Michel
Published: September 2006

We report a rare case of fibrosarcoma of the thigh suspected prenatally. At 27 weeks of gestation a voluminous, vascularised mass was discovered at ultrasound on the foetus’ left leg, suggestive of haemangioma or a fibrosarcoma. There were no signs of heart failure. A rapid increase in the tumour mass was noted and a caesarean section was carried out at 39 weeks because of abnormal foetal heart rate. Postnatal ultrasound examination was comparable to that carried out prenatally; pathological examination of the mass biopsied and immunohistochemical investigation provided a diagnosis of congenital fibrosarcoma. After neoadjuvant chemotherapy and surgery the infant is now in complete remission without amputation.
Prenatal Management of Placental Chorioangioma: Value of the Middle Cerebral Artery Peak Systolic Velocity
Authors: Escribano D. , Galindo A. , Arbués J. , Puente J.M. , De la Fuente P.
Published: September 2006

Placental chorioangiomas are benign tumors of the placenta. Large chorioangiomas may cause severe complications such as fetal anemia, hydrops and fetal death. We report the use of sonographic findings and peak systolic velocity in the middle cerebral artery in the diagnosis and management of fetal anemia without the occurrence of hydrops fetalis in a pregnant woman with a large placental chorioangioma. Successful intrauterine blood transfusion was performed at 26 weeks. Spontaneous thrombosis of the main supplying blood vessel of the chorioangioma was detected at 33 weeks. The child was delivered at 39 weeks of pregnancy in normal clinical condition.
Amnion Cells Engineering: A New Perspective in Fetal Membrane Healing after Intrauterine Surgery?
Authors: Papadopulos Nikolaos A. , Klotz Susanne , Raith Andreas , Foehn Matthias , Schillinger Ulrike , Henke Julia , Kovacs Laszlo , Horch Raymund E. , Biemer Edgar
Published: September 2006

In this study we aimed to set up an in vitro culture of the rabbit amnion in order to support in vivo fetal membrane healing capacity following fetoscopy. Fetal membranes were collected from a mid-gestational rabbit, and cultured on collagen support material for 14 days. 34 rabbits at 22–23 days gestational age (GA) underwent fetoscopy. The entry site was randomly allocated to 4 closure technique study groups: group I, human amnion membrane (n = 23); group II, collagen foil (n = 16); group III, collagen plug (n = 19), and group IV, collagen plug with cultured amnion cells (n = 19). In all groups membrane access sites were additionally sealed with fibrin sealant, and the myometrium was closed with sutures. Fetal survival, amnion membrane integrity, and the presence of amniotic fluid were evaluated at 30 days GA. Cultures showed good survival in the collagen support material. Increased cellularity, survival and proliferations were observed. The amnion at the access site resealed in 58–64% of cases in groups II–IV, but none of the tested techniques was significantly better than the other. Histological examination indirectly revealed the anatomic repair of the membranes, since no entrapment of the membranes could be demonstrated in the myometrial wound.
Non-Invasive Prenatal Detection of Paternal Origin Hb Lepore in a Male Fetus at the 7th Week of Gestation
Authors: Lazaros Leandros , Hatzi Elisabeth , Bouba Ioanna , Paraskevaidis Evangelos , Georgiou Ioannis
Published: September 2006

Objective: To perform a reliable non-invasive prenatal detection of the Hb Lepore paternal mutation and determine the fetal gender in the first trimester of pregnancy. Methods: DNAwas extracted from a serum sample obtained from a pregnant womanat the mid first trimester of gestation. Hb Lepore-specific, mutant and normal, primers as well as Y-chromosome-specific STSs were used to carry out the analysis. Results: Paternal Hb Lepore and the DYS14 and DYZ1 gene-specific sequences were detected in the serum sample obtained at the 7th week of pregnancy. None of the above sequences was detectable in the maternal peripheral blood cell DNA. Conclusion: Conventional polymerase chain reaction analysis of cell-free fetal DNA can be used to determinefetal gender and paternal Hb Lepore as early as the 7th week of pregnancy.
Prenatally Diagnosable Differences in the Cellular Immunity of Fetuses with Down’s and Edwards’ Syndrome
Authors: Zizka Zdenek , Calda Pavel , Fait Tomas , Haakova Lucia , Kvasnicka Jan , Viskova Hana
Published: September 2006

Introduction: Lymphocyte subpopulations are identified by the uniform CD classification (Cluster of Differentiation) and can be accurately differentiated with monoclonal antibodies using the method of flow cytometry. With the aid of cordocentesis it is possible to perform studies on the status and development of cellular immunity as early as in the second trimester of pregnancy. Objective: To compare lymphocyte subpopulations present in fetuses with chromosomal abnormalities (Down’s syndrome (DS), Edwards’ syndrome (ES)) and fetuses with normal karyotype. Study Design: Prospective observational study. Methods: We examined a total of 61 pregnant women with an average age of 31.5 years (20– 46 years). Results: In fetuses with DS we found a significant decrease in B lymphocytes (CD19),a decrease in the subpopulations of multi-reactive B-cells (CD5+CD19+, B-CLL),and a decrease in the index of CD4/CD8 and class II HLA-DR. In contrast, the representation of NK cells expressing /CD3-CD (16 + 56)+/ was greatly increased. In ES we found a decrease in T lymphocytes (CD3), a decrease in T-helper lymphocytes (monocytes CD4), a decreased index of CD4/CD8 and a greater representation of NK cells /CD3-CD (16 + 56)+/. Conclusion: We determined the normal values of lymphocyte subpopulations in physiological fetuses. We demonstrated that the immunological defect of the affected fetuses is already present antenatally, and can be reliably diagnosed in the second trimester of pregnancy.
Follow-Up Analysis of Pregnancies Complicated by HELLP Syndrome
Authors: Hupuczi Petronella , Rigó Barbara , Sziller István , Szabó Gábor , Szigeti Zsanett , Papp Zoltán
Published: September 2006

Aim: In this study, we investigated the course of subsequent pregnancies in patients with HELLP syndrome and the development of chronic maternal diseases. Results: The study population consisted of 50 patients who were treated for HELLP syndrome at 1st Department of Obstetrics and Gynecology, Semmelweis University between January 1, 1995 and December 31, 2004. There were 35 subsequent pregnancies in 25 patients. Of these there were seven miscarriages, one mid-trimester loss. The incidence of premature birth was 40.7%, and neonatal mortality 7.4%. Preeclampsia recurred in twelve pregnancies; it was mild in eight and severe in four cases. HELLP syndrome re-occurred four times in three patients (14.28%). Recurrent hypertension was observed in 24% of the pregnancies. Conclusions: Pregnancies after a previous pregnancy complicated by HELLP syndrome carry not only an increased chance for HELLP syndrome but also the development of other pathological obstetric conditions and chronic maternal diseases. Hypertension was found to be a maternal disease of increased incidence (24%) in subsequent pregnancies.
Automated Microscopy of Amniotic Fluid Cells: Detection of FISH Signals Using the FastFISH® Imaging System
Authors: Evans Mark I. , Sharp Michael , Tepperberg James , Kilpatrick Michael W. , Tsipouras Petros , Tafas Triantafyllos
Published: September 2006

Objective: FISH (fluorescence in situ hybridization) analysis is a valuable adjunct to cytogenetics that provides a rapid screen for common abnormalities. However, FISH is expensive, labor-intensive, and requires a high skill level and subjective signal interpretation. A fully automated system for FISH analysis could improve laboratory efficiency and potentially reduce errors and costs. Methods: In this study we blindly compared automated FISH signal acquisition and display against standard FISH analysis. A total of 62 amniocentesis samples were prepared using the AneuVysion® multicolor DNA probe kit and probed for chromosomes 13, 18, 21, X, and Y. Two sets of slides were produced from each sample. Fifty cells were scored in each slide. One set was evaluated using standard manual microscopy and the other using the automated image acquisition and display capabilities of the Ikoniscope® fastFISH® amnio Test System. This system uses epifluorescence optics, along with optimized slide management to process slides automatically. Results: A 100% concordance was observed between the results obtained using manual microscopy and the automated system. There was also 100% concordance between the FISH results and those obtained by conventional karyotyping. Conclusion: Our data suggest that the automated system is capable of providing accurate and rapid identification and display of cells and FISH signals.
The Effectiveness of Adrenocorticotropin Repeated Doses in High Risk Pregnancies
Authors: Klimek M.
Published: September 2006

Objective: The aim of this study was to assess the effect of two kinds of adrenocorticotropin (ACTH)-depot repeated doses administered to pregnant women who underwent infertility treatment. Material and Methods: The study population included 424 pregnant women with singletons. Two hundred and forty-two women received repeated 0.5 mg doses of ACTH, whereas 182 women also were treated for infertility but did not receive any therapy. The ACTH-treated patients were subdivided into two subgroups: (1) 142 patients received only series of three 0.5 g ACTH-depot injections every other day in the first and/or second trimester with occasionally single ACTH-depot doses in the third trimester, (2) 100 patients received only single 0.5 mg ACTH-depot doses for the entire duration of pregnancy. Clinical symptoms of threatened abortion and preterm delivery as well as very low or decreasing levels of serum oxytocinases were indications for the hormonal therapy. Low oxytocinase serum levels, recurrent abortion and preterm delivery characterize pregnant women with hypothalamic insufficiency. Results: Women who received only single doses of the ACTH-therapy for the entire duration of pregnancy had a statistically significant longer gestation, and higher newborn mass and length than patients who received a series of three hormonal injections as well as control women who had no clinical or laboratory indication for such therapy. Conclusions: ACTH-depot injection results in the oxytocinase increased serum level, a decreased number of abortion and preterm deliveries and prolonged duration of pregnancy. Single repeated doses of the ACTH-depot therapy had statistically significant better results in the prolongation of pregnancy, newborn mass and length than a serial hormonal dosage.
Intrauterine Shunt for Obstructive Hydrocephalus – Still Not Ready
Authors: Bruner Joseph P. , Davis George , Tulipan Noel
Published: September 2006

Objective: To determine the safety and efficacy of ventriculoamniotic shunt placement through a hysterotomy in the second trimester of pregnancy as treatment for isolated obstructive hydrocephalus. Methods: Between 1999 and 2003, four pregnancies with isolated fetal obstructive hydrocephalus in the second trimester were treated at Vanderbilt University Medical Center. Preoperatively, all fetuses underwent serial ultrasonographic examinations and an ultrafast magnetic resonance imaging to confirm isolated aqueductal stenosis. A normal fetal karyotype and negative polymerase chain reaction or culture of the amniotic fluid for cytomegalovirus and toxoplasmosis were obtained. Serial enlargement of the lateral ventricles >1.5 mm/week and fetal macrocephaly were documented. Using epidural and GETA, a standard ultrasmall ventricular catheter and valve were inserted via a hysterotomy. The distal catheter, rather than being inserted into the fetal peritoneum, exited between the fetal scapulae. Patients were discharged home from the hospital, and the remainder of their prenatal care was provided by their local obstetrician. After delivery, the distal drain was converted to a ventriculoperitoneal shunt. Results: Cases were performed at 23 6/7, 25 5/7, 26 4/7, and 26 5/7 weeks. Shunts performed well during pregnancy, and were intact at delivery. Deliveries occurred at 34 1/7, 27 1/7, 28, and 32 4/7 weeks. Birthweights were 2,010, 907, 1,200, and 2,220 g. All Apgar scores were normal. Case 1 developed a neonatal shunt infection, and is now developmentally delayed, with swallowing dysfunction, hearing deficits and a poor pupillary response. Case 2 developed neonatal sepsis and is now developmentally delayed. Case 3 delivered preterm due to chorioamnionitis, and neonatal death occurred from sepsis. Case 4 is developmentally delayed. Conclusions: Ventriculoamniotic shunt can be placed through a hysterotomy, overcoming many of the technical difficulties of earlier percutaneous shunts. However, recent developments in fetal imaging and molecular genetics have not improved case selection. Unless new breakthroughs occur, fetal shunting cannot reasonably be expected to improve perinatal outcome.
Diagnosis of Pentalogy of Cantrell by Three-Dimensional Ultrasound in Third Trimester of Pregnancy
Authors: Araujo Júnior Edward , Zanforlin Filho Sebastião Marques , Guimarães Filho Hélio Antonio , Pires Cláudio Rodrigues , Nardozza Luciano Marcondes Machado , Moron Antonio Fernandes
Published: September 2006

The Pentalogy of Cantrell is a rare congenital anomaly characterized by defects in the closing of the supraumbilical abdominal wall, in the anterior portion of the diaphragm, in the diaphragmatic pericardium, ectopia cordis, and intracardiac defects. It may be associated to other anomalies determining the variants of this syndrome. The prenatal ultrasound diagnosis is extremely important for detecting structural malformations and for postnatal surgical planning, when possible. We present a case of Pentalogy of Cantrell diagnosed in the 34th week of gestation, showing the main findings by two-dimensional ultrasound and emphasizing the importance of three-dimensional ultrasound on the assessment of structural malformations and on the better understanding of the origins of the pathology.
Raised Plasma Aldosterone and Natriuretic Peptides in Atrial Fibrillation
Authors: Dixen Ulrik , Ravn Lasse , Soeby-Rasmussen Christian , Paulsen Anders Wallin , Parner Jan , Frandsen Erik , Jensen Gorm B.
Published: September 2006

Background and Aims: During atrial fibrillation (AF), the renin-angiotensin-aldosterone system (RAAS) may be activated.In this study, our aim was to evaluate at a long-term follow-up visit the levels of plasma aldosterone and natriuretic peptides as markers of neurohormonal remodeling in patients with earlier, documented AF in relation to present heart rhythm, clinical data, and the left ventricular ejection fraction (LVEF). We hypothesized that increased levels of aldosterone and natriuretic peptides were significantly associated with present AF as markers of RAAS activation during the arrhythmia. Methods: We studied 158 patients with earlier ECG-documented AF followed by restored sinus rhythm (SR) attending a follow-up visit 2.6 years (mean) after primary inclusion. Results: At follow-up, 93 patients had SR. Heart rhythm at follow-up visit (SR/AF), plasma aldosterone, plasma N-terminal pro Brain Natriuretic Peptide (Nt- proBNP), plasma N-terminal pro Atrial Natriuretic Peptide (Nt-proANP), LVEF, medication, and clinical characteristics were recorded. Standard linear multiple regression analysis including age, sex, weight, hypertension, congestive heart failure, ischemic heart disease, present AF at follow-up, total duration of AF disease, ongoing medication, and the LVEF as explanatory variables showed that only ongoing treatment with diuretics was significantly associated (likelihood ratio test, p = 0.0057) with a raised log-transformed plasma aldosterone, although present AF at follow-up was related to a high aldosterone level (p = 0.09). For the natriuretic peptides, present AF at follow-up (p < 0.0001), age (p < 0.0001), female gender (p = 0.0047), ischemic heart disease (p = 0.0154), and ongoing treatment with sotalol (p = 0.0003) were all independently associated with high log-transformed plasma Nt-proANP. Likewise, present AF at follow-up (p = 0.0008) as well as age (p < 0.0001) were associated with high log-transformed plasma Nt-proBNP. Conclusions: In patients with earlier AF, AF at long-term follow-up visit was independently associated with raised levels of Nt-proANP and Nt-proBNP and to some extent with plasma aldosterone indicating neurohormonal activation during arrhythmia.
Symptomatic Treatment of Multiple Sclerosis
Authors: Henze T. , Rieckmann P. , Toyka K.V.
Published: September 2006

Besides immunomodulation and immunosuppression, the specific treatment of symptoms is an essential component of the overall management of multiple sclerosis (MS). Symptomatic treatment is aimed at the elimination or reduction of symptoms impairing the functional abilities and quality of life of the affected patients. Moreover, with symptomatic treatment the development of a secondary physical impairment due to an existing one may be avoided. Many therapeutic techniques as well as different drugs are used for the treatment of MS symptoms, but only a few of them have been investigated, especially in MS patients, and are approved by the national health authorities. Despite an overwhelming number of publications, only a few evidence-based studies exist and consensus reports are very rare, too. Therefore, it seemed necessary to develop a consensus statement on symptomatic treatment of MS comprising existing evidence-based literature as well as therapeutic experience of neurologists who have dealt with these problems over a long time. This consensus paper contains proposals for the treatment of the most common MS symptoms: disorders of motor function and coordination, of cranial nerve function, of autonomic, cognitive, and psychological functions as well as MS-related pain syndromes and epileptic seizures.
Analysis of the Association between Apolipoprotein D and Schizophrenia
Authors: Zhang Xiaoju , Li Dawei , Duan Shiwei , Duan Yun , Chen Qingying , Li Xingwang , Liu Zhuangjun , Feng Guoyin , He Lin
Published: September 2006

Schizophrenia is a severe, chronic and common complex debilitating mental illness with a large genetic component. Evidence to date suggests that apolipoprotein D protein may be closely related to schizophrenia. To investigate the role of the APOD gene in the etiology of schizophrenia, we genotyped three genetic polymorphisms (rs7659, rs2280520 and rs4677695) in a case-control study using subjects from the Chinese population, and altogether 425 cases and 473 controls were analyzed in the study. However, we found no significant discrepancies in allele and genotype frequencies of the three polymorphisms nor in the haplotype distribution between the cases and the controls. Our data indicate no direct evidence of association between schizophrenia and the APOD gene, and the results suggest that the three genetic polymorphisms within the APOD gene are unlikely to confer increased susceptibility to the illness in the Chinese population.
Association of a Functional Polymorphism in the Serotonin Transporter Gene with Personality Traits in Females in a Polish Population
Authors: Dragan Wojciech Ł. , Oniszczenko Włodzimierz
Published: September 2006

The aim of our study was to determine whether the 5-HTTLPR polymorphism is related to temperamental traits measured using the Formal Characteristics of Behavior – Temperament Inventory (FCB-TI) and personality traits assessed by the NEO Five-Factor Inventory (NEO-FFI) questionnaire. The sample comprised 200 unrelated females, aged 18–29 years. DNA of the subjects was isolated from buccal epithelial cells, and 5-HTTLPR polymorphism was genotyped using PCR. The subjects were divided into SS, SL and LL groups according to their genotype. The differences in results on the endurance scale (F = 11.29, p = 0.001), measured using FCB-TI and neuroticism measured using NEO-FFI (F = 15.32, p = 0.000) between the S group (short-form allele; genotypes SS and SL) and the L group (long-form allele; genotype LL) were statistically significant. Additionally, statistically significant differences between the LL and SS groups, and between the SL and SS groups with respect to ‘activity’ (FCB-TI) were found (F = 4.5, p = 0.012). These findings support a role of the 5-HTTLPR polymorphism in the modulation of personality and temperamental traits.
Brain Activation during Mental Maze Solving
Authors: Kirsch Peter , Lis Stefanie , Esslinger Christine , Gruppe Harald , Danos Peter , Broll Jochen , Wiltink Jörg , Gallhofer Bernd
Published: September 2006

Background: So-called Porteus mazes are used to investigate prefrontal cortex (PFC) functioning in normal subjects and patients with different neuropsychiatric disorders. Here we present data confirming the involvement of the PFC for the first time by means of functional magnetic resonance imaging (fMRI). To minimize motor-related activation, mental mazes were used. Methods: Mazes as well as pseudo-mazes without any bifurcations were presented to 49 healthy participants during fMRI scans. Results: Both, mazes as well as pseudo-mazes, activated a large network from visual to parietal regions, reflecting the dorsal stream of visual information processing. Mazes but not pseudo-mazes also activated bilateral areas of the PFC indicating their special role in decision processes. In addition, although no motor response was required during maze performance, both tasks activated subcortical and cortical motor areas. Conclusions: These tasks are suitable for investigating and specifying PFC functioning and its impairment in psychiatric disorders such as schizophrenia. In addition, mental mazes might be a suitable task for the investigation of patients with motor disturbances.
Caregiver Burden, Health-Related Quality of Life and Coping in Dementia Caregivers: A Comparison of Frontotemporal Dementia and Alzheimer’s Disease
Authors: Riedijk S.R. , De Vugt M.E. , Duivenvoorden H.J. , Niermeijer M.F. , van Swieten J.C. , Verhey F.R.J. , Tibben A.
Published: September 2006

Frontotemporal dementia (FTD) is the second most prevalent dementia after Alzheimer’s disease (AD). We compared 29 FTD and 90 AD caregivers with respect to burden, health-related quality of life (HQoL) and coping. FTD caregivers were more burdened than AD caregivers, and caregivers of patients who were demented for shorter duration had lower HQoL. We furthermore compared the 29 FTD caregivers with 34 caregivers of institutionalized FTD patients to understand their specific caregiver issues. Caregivers of FTD patients institutionalized after shorter dementia duration were most burdened and affected in their HQoL. Overall, passive coping strategies were associated with increased burden and decreased HQoL. We recommend that FTD caregivers be offered more support than AD caregivers. Furthermore, we suggest that interventions target passive coping strategies.
Serum Fetuin-A Levels Link Inflammation and Cardiovascular Calcification in Hemodialysis Patients
Authors: Cozzolino Mario , Galassi Andrea , Biondi Maria Luisa , Turri Olivia , Papagni Sergio , Mongelli Nicola , Civita Luigi , Gallieni Maurizio , Brancaccio Diego
Published: September 2006

Background: Cardiovascular disease (CVD) is the leading cause of mortality in hemodialysis (HD). An elevated incidence of cardiovascular calcifications (CVC) is observed in HD. Fetuin-A is an important inhibitor of CVC. Reduced fetuin-A levels associate with inflammation and increased cardiovascular (CV) mortality in HD. In this study we investigated the association of fetuin-A levels and CVC. Method: We evaluated a cohort of 115 patients (67 males), aged 63 ± 16 years with a HD vintage ≧9 months. Presence of CVC was assessed by ultrasound imaging of the abdominal aorta, common carotid arteries, bilateral ilio-femoral axis, aortic and mitral cardiac valves. The presence of CVC was analyzed as a CVC score (CVCS) (0–7) according to the number of CVC sites. Patients were arbitrary stratified in three groups: group I (CVCS = 0), group II (0 < CVCS < 6) and group III (CVCS ≧ 6). Patients without CVC were younger, non-diabetic and with a negative history for CV events. Results: Patients with evidence of CVC in more than 5 sites had lower serum fetuin-A levels (0.41 ± 0.22 g/l) compared to patients with CVCS = 0 (0.51 ± 0.17 g/l, p = 0.048). In addition a worse CVCS was associated with higher serum levels of C-reactive protein (p = 0.002) and fibrinogen (p < 0.001). Serum fetuin-A levels lower than 0.290 g/l were associated with higher risk of a worse CVCS, independently from traditional risk factors. Conclusion: Chronic inflammation in HD patients leads to lower serum fetuin-A levels. The present study confirms the independent and significant association between reduced serum fetuin-A levels and multi-site CVC in HD.
Functional Expression of the TRPM4 Cationic Current in Ventricular Cardiomyocytes From Spontaneously Hypertensive Rats
Authors: Guinamard Romain , Demion Marie , Magaud Christophe , Potreau Daniel , Bois Patrick
Published: September 2006

Cardiac hypertrophy is associated with electrophysiological modifications, including modification of action potential shape that can give rise to arrhythmias. We report here a higher detection of a calcium-activated nonselective cation current in cardiomyocytes of spontaneously hypertensive rats (SHRs), a model of hypertension and heart hypertrophy when compared with Wistar-Kyoto (WKY) rat, its normotensive equivalent. Freshly isolated cells from the left ventricles of 3- to 6-month-old WKY rats or SHRs were used for patch-clamp recordings. In inside-out patches, the channel presented a linear conductance of 25±0.5 pS, did not discriminate Na
+
over K
+
, and was not permeable to Ca
2+
. Open probability was increased by depolarization and a rise in [Ca
2+
]
i
(dissociation constant=10±5.4 μmol/L) but reduced by 0.5 mmol/L [ATP]
i
, 10 μmol/L glibenclamide, or flufenamic acid (IC
50
=5.5±1.7 μmol/L). Thus, it owns the fingerprint of the TRPM4 current. Although rarely detected in WKY cardiomyocytes, the current was present in >50% of patches from SHR cardiomyocytes. Moreover, by performing RT-PCR from ventricular samples, we observed that TRPM4 mRNA detection was higher in SHRs than in WKY rats. We propose that a TRPM4 current is expressed in ventricular cardiomyocytes from SHRs. According to its properties, this channel may contribute to the transient inward current implicated in delayed-after-depolarizations observed during [Ca
2+
] overload of cardiomyocytes.
Central Action of Increased Osmolality to Support Blood Pressure in Deoxycorticosterone Acetate–Salt Rats
Authors: O’Donaughy Theresa L. , Qi Yue , Brooks Virginia L.
Published: September 2006

To test the hypothesis that increased osmolality contributes to hypertension in deoxycorticosterone acetate (DOCA)-salt–hypertensive rats by acting in the brain, DOCA-salt and Sham-salt rats were instrumented with bilateral, nonoccluding intracarotid and femoral catheters. Two weeks prior, rats were uninephrectomized and received subcutaneous implants with or without DOCA (65 mg) and began drinking salt water (1% NaCl and 0.2% KCl). DOCA-salt rats (n=28) exhibited elevated blood pressure (159±4 mm Hg;
P
<0.05) and heart rate (392±10 bpm;
P
<0.05) compared with Sham-salt animals (n=5; blood pressure: 107±5 mm Hg; heart rate: 355±10 bpm). Bilateral intracarotid infusion of hypotonic fluid (osmolality: ≈40 mOsm/L), which lowers osmolality of blood to the brain by ≈2%, rapidly decreased blood pressure in DOCA-salt rats (−22±4 mm Hg after 15 minutes;
P
<0.05; n=7) but not Sham-salt rats (2±2 mm Hg; n=5). Hypotonic fluid infused intravenously did not lower blood pressure (0±2 mm Hg) in DOCA-salt rats (n=7). In DOCA-salt rats pretreated with a V
1
vasopressin antagonist (Manning compound, 5 μg, IV), intracarotid hypotonic infusion still decreased blood pressure (−10±3 mm Hg;
P
<0.05; n=9), but the response was smaller (
P
<0.05). Finally, in DOCA-salt rats (n=4) pretreated with the V
1
antagonist and the ganglionic blocker hexamethonium, decreasing osmolality of blood to the brain did not reduce blood pressure. These data indicate that, in DOCA-salt rats, hypertonicity acts in the brain to support blood pressure, in part by stimulating vasopressin secretion and in part by stimulating another rapidly reversible mechanism, likely the sympathetic nervous system.
Cost-Effectiveness of Coronary Artery Bypass Grafts Versus Percutaneous Coronary Intervention for Revascularization of High-Risk Patients
Authors: Stroupe Kevin T. , Morrison Douglass A. , Hlatky Mark A. , Barnett Paul G. , Cao Lishan , Lyttle Christopher , Hynes Denise M. , Henderson William G.
Published: September 2006

Background—

A Department of Veterans Affairs Cooperative Study randomized high-risk patients with medically refractory myocardial ischemia, a group largely excluded from previous trials, to urgent revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The present study examined the cost-effectiveness of PCI versus CABG for these high-risk patients.

Methods and Results—

Of 454 patients at 16 Department of Veterans Affairs medical centers, 445 were available for the economic analysis (218 PCI and 227 CABG patients). Total costs were assessed at 3 and 5 years from the third-party payer’s perspective, and effectiveness was measured by survival. After 3 years, average total costs were $63 896 for PCI versus $84 364 for CABG patients, a difference of $20 468 (95% confidence interval [CI] $13 918 to $27 569). CIs were estimated by bootstrapping. Survival at 3 years was 0.82 for PCI versus 0.79 for CABG patients (
P
=0.34). Precision of the cost-effectiveness estimates were assessed by bootstrapping. PCI was less costly and more effective at 3 years in 92.6% of the bootstrap replications. After 5 years, average total costs were $81 790 for PCI versus $100 522 for CABG patients, a difference of $18 732 (95% CI $9873 to $27 831), whereas survival at 5 years was 0.75 for PCI patients versus 0.70 for CABG patients (
P
=0.21). At 5 years, PCI remained less costly and more effective in 89.4% of the bootstrap replications.

Conclusions—

PCI was less costly and at least as effective for the urgent revascularization of medically refractory, high-risk patients over 5 years.
Strategy for Safe Performance of Extrathoracic Magnetic Resonance Imaging at 1.5 Tesla in the Presence of Cardiac Pacemakers in Non–Pacemaker-Dependent Patients
Authors: Sommer Torsten , Naehle Claas P. , Yang Alexander , Zeijlemaker Volkert , Hackenbroch Matthias , Schmiedel Alexandra , Meyer Carsten , Strach Katharina , Skowasch Dirk , Vahlhaus Christian , Litt Harold , Schild Hans
Published: September 2006

Background—

The purpose of the present study was to evaluate a strategy for safe performance of extrathoracic magnetic resonance imaging (MRI) in non–pacemaker-dependent patients with cardiac pacemakers.

Methods and Results—

Inclusion criteria were presence of a cardiac pacemaker and urgent clinical need for an MRI examination. Pacemaker-dependent patients and those requiring examinations of the thoracic region were excluded. The study group consisted of 82 pacemaker patients who underwent a total of 115 MRI examinations at 1.5T. To minimize radiofrequency-related lead heating, the specific absorption rate was limited to 1.5 W/kg. All pacemakers were reprogrammed before MRI: If heart rate was <60 bpm, the asynchronous mode was programmed to avoid magnetic resonance (MR)–induced inhibition; if heart rate was >60 bpm, sense-only mode was used to avoid MR-induced competitive pacing and potential proarrhythmia. Patients were monitored with ECG and pulse oximetry. All pacemakers were interrogated immediately before and after the MRI examination and after 3 months, including measurement of pacing capture threshold (PCT) and serum troponin I levels. All MR examinations were completed safely. Inhibition of pacemaker output or induction of arrhythmias was not observed. PCT increased significantly from pre- to post-MRI (
P
=0.017). In 2 of 195 leads, an increase in PCT was only detected at follow-up. In 4 of 114 examinations, troponin increased from a normal baseline value to above normal after MRI, and in 1 case (troponin pre-MRI 0.02 ng/mL, post-MRI 0.16 ng/mL), this increase was associated with a significant increase in PCT.

Conclusions—

Extrathoracic MRI of non–pacemaker-dependent patients can be performed with an acceptable risk-benefit ratio under controlled conditions and by taking both MR- and pacemaker-related precautions.
The Effect of a Multicomponent Professional Development Training on the Beliefs and Behaviors of Community Health Educators Concerning Food Irradiation
Authors: Thompson Britta M. , Knight Stephanie L.
Published: September 2006

Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponentprofessional development training on food irradiation could change their beliefs and behaviors. This study compared the food irradiation beliefs and educational programmingof educators who participated in a professional development training with thosewhodidnot.Results indicatedthat the trainingsignificantlyimproved the foodirradiationbeliefs ofparticipants. In addition, the number of participants who provided food irradiation education significantly improved compared with educators who had not attended the training. These results suggest that this type of professional development training format can significantly affect beliefs and could increase the amount of food irradiation information available to consumers through community health educators.
A Qualitative Evaluation of a Faith-Based Breast and Cervical Cancer Screening Intervention for African American Women
Authors: Matthews Alicia K. , Berrios Nerida , Darnell Julie S. , Calhoun Elizabeth
Published: September 2006

This article presents a formative evaluation of a CDC Racial and Ethnic Approaches to Community Health (REACH) 2010 faith-based breast and cervical cancer early detection and prevention intervention for African American women living in urban communities. Focus groups were conducted with a sample of women ( N = 94) recruited from each church participating in the intervention. One focus group was conducted in each of the nine participating churches following completion of the 6-month REACH 2010 intervention. Transcribed data were coded to identify relevant themes. Key findings included (a) the acceptability of receiving cancer education within the context of a faith community, (b) the importance of pastoral input, (c) the effectiveness of personal testimonies and lay health advocates, (d) the saliency of biblical scripture in reinforcing health messages, (e) the effectiveness of multimodal learning aids, and (f) the relationship between cervical cancer and social stigma. Study findings have implications for enhancing faith-based breast and cervical cancer prevention efforts in African American communities.
Use of Computer Kiosks for Breast Cancer Education in Five Community Settings
Authors: Kreuter Matthew W. , Black Wynona J. , Friend LaBraunna , Booker Angela C. , Klump Paula , Bobra Sonal , Holt Cheryl L.
Published: September 2006

Finding ways to bring effective computer-based behavioral interventions to those with limited access to technology is a continuing challenge for health educators. Computer kiosks placed in community settings may help reach such populations. The Reflections of You kiosk generates individually tailored magazines on breast cancer and mammography and was adapted from an evidence-based intervention that increased mammography use in African American women. This usage study tracked patterns of use and characteristics of kiosk users in beauty salons, churches, neighborhood health centers, Laundromats, and social service agencies in St. Louis. Kiosks were used 4,527 times in 470 kiosk days at 40 different host sites. Highly significant differences among community settings were found in rates and patterns of kiosk use as well as user characteristics, breast cancer knowledge, and use of mammography. Findings inform strategic decision making about technology dissemination and community outreach to women needing information about breast cancer and mammography.
Health Behaviors and Breast Cancer: Experiences of Urban African American Women
Authors: Stolley Melinda R. , Sharp Lisa K. , Wells Anita M. , Simon Nolanna , Schiffer Linda
Published: September 2006

Breast-cancer survival rates are lower among African American women compared to White women. Obesity may contribute to this disparity. More than 77% of African American women are overweight or obese. Adopting health behaviors that promote a healthy weight status may be beneficial because obesity increases risk for recurrence. Studies among White breast-cancer survivors indicate that many make health behavior changes after diagnosis. This cross-sectional pilot study collected quantitative and qualitative data on the attitudes, beliefs, barriers, and facilitators related to health behavior changes in 27 overweight/obese African American breast-cancer survivors. Results indicated that most participants reported making dietary changes since their diagnosis, and some had increased their physical activity. Focus groups provided rich details on the barriers and facilitators for behavior change. These results begin to address the significant gap in our knowledge of African American breast-cancer survivors' health behaviors and underscore the need for culturally competent health behavior interventions.
Building an MMO With Mass Appeal
Authors: Ducheneaut Nicolas , Yee Nick , Nickell Eric , Moore Robert J.
Published: September 2006

World of Warcraft (WoW) is one of the most popular massively multiplayer games (MMOs) to date, with more than 6 million subscribers worldwide. This article uses data collected over 8 months with automated “bots” to explore how WoW functions as a game. The focus is on metrics reflecting a player’s gaming experience: how long they play, the classes and races they prefer, and so on. The authors then discuss why and how players remain committed to this game, how WoW’s design partitions players into groups with varying backgrounds and aspirations, and finally how players “consume” the game’s content, with a particular focus on the endgame at Level 60 and the impact of player-versus-player-combat. The data illustrate how WoW refined a formula inherited from preceding MMOs. In several places, it also raises questions about WoW’s future growth and more generally about the ability of MMOs to evolve beyond their familiar template.
From Tree House to Barracks
Authors: Williams Dmitri , Ducheneaut Nicolas , Xiong Li , Zhang Yuanyuan , Yee Nick , Nickell Eric
Published: September 2006

A representative sample of players of a popular massively multiplayer online game (World of Warcraft) was interviewed to map out the social dynamics of guilds. An initial survey and network mapping of players and guilds helped form a baseline. Next, the resulting interview transcripts were reviewed to explore player behaviors, attitudes, and opinions; the meanings they make; the social capital they derive; and the networks they form and to develop a typology of players and guilds. In keeping with current Internet research findings, players were found to use the game to extend real-life relationships, meet new people, form relationships of varying strength, and also use others merely as a backdrop. The key moderator of these outcomes appears to be the game's mechanic, which encourages some kinds of interactions while discouraging others. The findings are discussed with respect to the growing role of code in shaping social interactions.
Storyline, Dance/Music, or PvP?
Authors: Lowood Henry
Published: September 2006

Player-created game movies have been an outlet for creative expression by World of Warcraft (WoW) players since the beta version of the game. The proliferation of players, clans, Web sites, and community forums for creating, consuming, and commenting on WoW movies is remarkable. Linking multiplayer game communities and the making of animated movies is not unprecedented. It has been a characteristic of machinima for more than a decade. In this article however, the author hopes to show that the context, content, and consumption of game movies based on massively multiplayer games raises new questions about contributions game-based performances make to player communities. The author connects the brief history of WoW movies to the history of machinima and other game movies, illustrates the variety of impulses behind WoW movies through three quickly recounted examples, and gathers together salient themes around one movie in particular: Tristan Pope's Not Just Another Love Story.
Regulation of the Arf tumor suppressor in Eμ-Myc transgenic mice: longitudinal study of Myc-induced lymphomagenesis
Authors: Bertwistle David , Sherr Charles J.
Published: September 2006

Lymphomagenesis in Eμ-Myc mice is opposed by the Arf tumor suppressor, whose inactivation compromises p53 function and accelerates disease. Finding nascent Eμ-Myc–induced tumors in which p19Arf causes cell-cycle arrest or apoptosis is problematic, since such cells will be eliminated until Arf or p53 function is lost. Knock-in mice expressing a green fluorescent protein (GFP) in lieu of Arf coding sequences allow analysis of Arfpromoter regulation uncoupled from p19Arf action. Prior to frank lymphoma development, unexpectedly low levels of Eμ-Myc–induced p19Arf or GFP were expressed. However, as lymphomas arose in Arf+/GFP heterozygotes, additional oncogenic events synergized with Eμ-Myc to further induce the functionally null Arf-Gfp allele. Concomitant up-regulation of p19Arf was not observed; instead, the wild-type allele was inactivated. We infer that very low levels of Arf are tumor suppressive, and that further induction provides the selective pressure for the emergence of tumors that have inactivated the gene.
Genome-wide DNA polymorphism analyses using VariScan
Authors: Hutter Stephan , Vilella Albert J , Rozas Julio
Published: September 2006

Background

DNA sequence polymorphisms analysis can provide valuable information on the evolutionary forces shaping nucleotide variation, and provides an insight into the functional significance of genomic regions. The recent ongoing genome projects will radically improve our capabilities to detect specific genomic regions shaped by natural selection. Current available methods and software, however, are unsatisfactory for such genome-wide analysis.

Results

We have developed methods for the analysis of DNA sequence polymorphisms at the genome-wide scale. These methods, which have been tested on a coalescent-simulated and actual data files from mouse and human, have been implemented in the VariScan software package version 2.0. Additionally, we have also incorporated a graphical-user interface. The main features of this software are: i) exhaustive population-genetic analyses including those based on the coalescent theory; ii) analysis adapted to the shallow data generated by the high-throughput genome projects; iii) use of genome annotations to conduct a comprehensive analyses separately for different functional regions; iv) identification of relevant genomic regions by the sliding-window and wavelet-multiresolution approaches; v) visualization of the results integrated with current genome annotations in commonly available genome browsers.

Conclusion

VariScan is a powerful and flexible suite of software for the analysis of DNA polymorphisms. The current version implements new algorithms, methods, and capabilities, providing an important tool for an exhaustive exploratory analysis of genome-wide DNA polymorphism data.