bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastrointestinal parasites of the chimpanzee population introduced onto Rubondo Island National Park, Tanzania
Authors: Petrželková Klára J. , Hasegawa Hideo , Appleton Chris C. , Huffman Michael A. , Archer Colleen E. , Moscovice Liza R. , Mapua Mwanahamissi Issa , Singh Jatinder , Kaur Taranjit
Published: December 2009

The release of any species into a novel environment can evoke transmission of parasites that do not normally parasitize the host as well as potentially introducing new parasites into the environment. Species introductions potentially incur such risks, yet little is currently known about the parasite fauna of introduced primate species over the long term. We describe the results of long‐term monitoring of the intestinal parasite fauna of an unprovisioned, reproducing population of chimpanzees introduced 40 years earlier (1966–1969) onto Rubondo Island in Lake Victoria, Tanzania, a non‐native habitat for chimpanzees. Two parasitological surveys (March 1997–October 1998 and October 2002–December 2005) identified Entamoeba spp. including E. coli, Iodamoeba buetschlii, Troglodytella abrassarti, Chilomastix mesnili, Trichuris sp., Anatrichosoma sp., Strongyloides spp., Strongylida fam. gen. sp., Enterobius anthropopitheci, Subulura sp., Ascarididae gen. sp., and Protospirura muricola. The parasite fauna of the Rubondo chimpanzees is similar to wild chimpanzees living in their natural habitats, but Rubondo chimpanzees have a lower prevalence of strongylids (9%, 3.8%) and a higher prevalence of E. anthropopitheci (8.6%, 17.9%) than reported elsewhere. Species prevalence was similar between our two surveys, with the exception of Strongyloides spp. being higher in the first survey. None of these species are considered to pose a serious health risk to chimpanzees, but continued monitoring of the population and surveys of the parasitic fauna of the two coinhabitant primate species and other animals, natural reservoir hosts of some of the same parasites, is important to better understand the dynamics of host–parasite ecology and potential long‐term implications for chimpanzees introduced into a new habitat. Am. J. Primatol. 72:307–316, 2010. © 2009 Wiley‐Liss, Inc.
Water‐related occupations and diet in two Roman coastal communities (Italy, first to third century AD): Correlation between stable carbon and nitrogen isotope values and auricular exostosis prevalence
Authors: Crowe Fiona , Sperduti Alessandra , O'Connell Tamsin C. , Craig Oliver E. , Kirsanow Karola , Germoni Paola , Macchiarelli Roberto , Garnsey Peter , Bondioli Luca
Published: December 2009

The reconstruction of dietary patterns in the two Roman imperial age coastal communities of Portus and Velia (I–III AD) by means of stable isotope analysis of bone remains has exposed a certain degree of heterogeneity between and within the two samples. Results do not correlate with any discernible mortuary practices at either site, which might have pointed to differential social status. The present study tests the hypothesis of a possible connection between dietary habits and occupational activities in the two communities. Among skeletal markers of occupation, external auricular exostosis (EAE) has proved to be very informative. Clinical and retrospective epidemiological surveys have revealed a strong positive correlation between EAE development and habitual exposure to cold water. In this study, we show that there is a high rate of occurrence of EAE among adult males in both skeletal samples (21.1% in Portus and 35.3% in Velia). Further, there is a statistically significant higher prevalence of EAE among those individuals at Velia with very high nitrogen isotopic values. This points to fishing (coastal, low‐water fishing) as the sea‐related occupation most responsible for the onset of the ear pathology. For Portus, where the consumption of foods from sea and river seems to be more widespread through the population, and where the scenario of seaport and fluvial activities was much more complex than in Velia, a close correlation between EAE and fish consumption by fishermen is less easy to establish. Am J Phys Anthropol 2010. © 2009 Wiley‐Liss, Inc.
Use of interactive sessions and e‐learning in teaching anatomy to first‐year optometry students
Authors: Choudhury Bipasha , Gouldsborough Ingrid , Gabriel Stefan
Published: December 2009

Students enrolled in the Optometry program at the University of Manchester are required to take a functional anatomy course during the first year of their studies. Low mean scores in the written examination of this unit for the past two academic years energized staff to rethink the teaching format. Interactive sessions lasting 20 minutes each were introduced during the two hour lecture sessions. In these sessions students reinforced their anatomical knowledge learned in lectures, through playing games such as anatomy bingo and solving anatomical anagrams. In addition, five e‐learning modules were also introduced for students to complete in their own time. A pre‐ and postcourse questionnaire were distributed to obtain student views on their expectations of the course and interactive sessions. Comparisons were made between written examination results from 2008 to 2009 to written examination results from the previous five academic years to see if the interactive sessions and e‐learning modules had any impact on student knowledge. In addition, comparisons were made between student performances on the functional anatomy course with their performance in all of the other assessments taken by the students during their first year of study. Analysis of the questionnaires showed that student's expectations of the course were fulfilled and the interactive sessions were well received by the majority. There was a significant increase (P ≤ 0.01) in the mean examination score in 2008–2009 after introduction of the interactive sessions and e‐learning modules compared with scores in previous years. The introduction of interactive sessions has increased student enjoyment of the module and along with the e‐learning modules have had a positive impact on student examination results. Anat Sci Educ 3:39–45, 2010. © 2009 American Association of Anatomists.
Auswirkungen des in der EnEV 2009 nun auch für Wohngebäude geforderten Nachweises des sommerlichen Wärmeschutzes nach DIN 4108‐2 auf die Notwendigkeit bauseitig bereit zu stellender Verschattungssysteme
Authors: Dietrich Udo
Published: December 2009

In DIN 4108‐2 ist ein Nachweis zum sommerlichen Wärmeschutz in Gebäuden formuliert, der seit Einführung der EnEV 2002 für den Nichtwohnungsbau gesetzlich vorgeschrieben ist. Mit der EnEV 2009 wird dieser Nachweis erstmals für neu zu errichtende Wohngebäude erforderlich. Die überwiegende Zahl der Wohnbauten in Deutschland wird derzeit bauseitig ohne Verschattungssysteme erstellt, es bleibt dem Nutzer selbst überlassen, hier ggf. nachzurüsten. Im vorliegenden Artikel wird untersucht, ob durch die EnEV 2009 hier Änderungen zu erwarten sind. Dazu wird exemplarisch eine für die Gegenwart in Grundriss und Fassadenaufteilung typische Geschosswohnung mit dem EDV‐Programm PRIMERO‐Sommer nach DIN 4108‐2 [3] bewertet und analysiert. Resultat ist, dass die Anforderungen für alle Räume zunächst so nicht erfüllt sind, also bauseitig zusätzliche Maßnahmen zum sommerlichen Wärmeschutz (Sonnenschutzverglasung, Verschattung, kleinere Fenster) notwendig sind. Die einzelnen Maßnahmen werden untersucht, sinnvolle Kombinationen entwickelt und zur Umsetzung in der Praxis vorgeschlagen.

Consequences of the required assessment of thermal insulation in summer for residential buildings according to the German EnEV 2009 and DIN 4108‐2 to the need of shading systems to be provided by building owners.

Effects of the new requirement in EnEV (German Energy Saving Ordinance) 2009 for residential buildings to show evidence of conformity as regards thermal protection in summer according to DIN 4108‐2 on the necessity to provide shading systems. Evidence of conformity as regards thermal protection in buildings in summer, which has been required by law for non‐residential buildings since the EnEV was introduced in 2002, is specified in DIN 4108‐2. EnEV 2009 extends this requirement to new residential buildings.

At present, the overwhelming majority of residential buildings in Germany are constructed without shading systems; it is up to the building users themselves to retrofit these if necessary. This paper examines whether changes are to be expected as a result of EnEV 2009.

For this, an apartment in a block with a floor plan and façade layout typical of today is assessed and analysed according to DIN 4108‐2 [3] with the PRIMERO‐Sommer EDP program by way of example.

The result shows that the rooms as they are to begin with do not all fulfil the requirements and that the building owner must therefore adopt additional measures to provide thermal protection in summer (solar control glazing, shading, and smaller windows). The measures are examined individually, and effective combinations are developed and suggested for implementation in practice.
Über die Druckverlustberechnung, insbesondere aus Simulationsergebnissen
Authors: Fiedler Eckehard
Published: December 2009

Der Strömungswiderstand technischer Komponenten wird durch den Druckverlustbeiwert ζ beschrieben. Für die experimentelle Bestimmung existieren normierte Verfahren, bei der Bestimmung aus Simulationsdaten steckt die Tücke allerdings im Detail. Der vorliegende Artikel erläutert die Grundlagen der Druckverlustberechnung. Es wird auf die besondere Problematik der Berechnung von Druckverlusten aus Simulationsergebnissen eingegangen.

Pressure loss calculation with particular reference to simulation results.

The pressure loss coefficient describes the flow resistance of technical components ζ. Standard procedures exist for the experimental determination of the pressure drop. When determining this from simulation data however, the devil is in the detail. This paper explains the basic principles for calculating pressure loss. It examines the particular problems involved in calculating pressure loss from simulation results.
Bestimmung von feuchtetechnischen Materialparametern ausgewählter Baumaterialien für die rechnerische Bewertung von Baukonstruktionen unter den Bedingungen in der Slowakei
Authors: Vertal′ Marián , Ďurica Pavol
Published: December 2009

Für die Bewertung des Bestandes mit nichtstationären Verfahren sind genaue und umfangreiche Eingabedaten erforderlich. Neben fehlenden Klimadaten sind die unvollständigen Materialdaten häufige Ursache für die schleppende Überführung moderner Rechenverfahren in die Praxis. Es wurden Parameter für ausgewählte, im Plattenbau typische Baumaterialien bestimmt.

Determining the moisture parameters of selected building materials for the computational assessment of constructions under the conditions in Slovakia.

Accurate and extensive input data are required for assessing existing buildings, using dynamic procedures. Missing meteorological data as well as incomplete materials data are often the reason why people are slow to put modern calculation methods into practice. Parameters were determined for selected building materials typical of buildings constructed from large prefabricated concrete slabs.
Exact Tests using Two Correlated Binomial Variables in Contemporary Cancer Clinical Trials
Authors: Yu Jihnhee , Kepner James L. , Iyer Renuka
Published: December 2009

New therapy strategies for the treatment of cancer are rapidly emerging because of recent technology advances in genetics and molecular biology. Although newer targeted therapies can improve survival without measurable changes in tumor size, clinical trial conduct has remained nearly unchanged. When potentially efficacious therapies are tested, current clinical trial design and analysis methods may not be suitable for detecting therapeutic effects. We propose an exact method with respect to testing cytostatic cancer treatment using correlated bivariate binomial random variables to simultaneously assess two primary outcomes. The method is easy to implement. It does not increase the sample size over that of the univariate exact test and in most cases reduces the sample size required. Sample size calculations are provided for selected designs.
Challenges in the indirect quantitation of acyl‐glucuronide metabolites of a cardiovascular drug from complex biological mixtures in the absence of reference standards
Authors: Srinivasan Karthik , Nouri Parya , Kavetskaia Olga
Published: December 2009

This paper describes the quantitation of acyl‐glucuronide metabolites (M26 and M5) of a cardiovascular‐drug (torcetrapib) from monkey urine, in the absence of their reference standards. LC/MS/MS assays for M1 and M4 (aglycones of M26 and M5, respectively) were characterized from normal and base‐treated urine, as their respective reference standards were available. The in vivo study samples containing M26 and M5 were treated with 1 n sodium hydroxide to hydrolyze them to their respective aglycones. The study samples were assayed for M1 and M4 before and after alkaline hydrolysis and the difference in the concentrations provided an estimate of the urinary levels of M26 and M5. Prior to the main sample analysis, conditions for alkaline hydrolysis of the glucuronides were optimized by incubating pooled study samples. During incubations, a prolonged increase in M4 levels over time was observed, which is inconsistent with the base‐hydrolysis of an acyl‐glucuronide (expected to hydrolyze rapidly). Possible interference of the metabolite M9 (an ether‐glucuronide metabolite isobaric to M4) was investigated to explain this observation using chromatographic and wet‐chemistry approaches. The strategies adopted herein established that the LC/MS/MS assay and our approach were reliable. The metabolite exposure was then correlated to toxicological observations to gain initial insights into the physiological role of these metabolites. Copyright © 2009 John Wiley & Sons, Ltd.
Expert testimony and the effects of a biological approach, psychopathy, and juror attitudes in cases of insanity
Authors: Rendell Jariel A. , Huss Matthew T. , Jensen Maren L.
Published: December 2009

Amid growing psychological controversy and legal interest surrounding the uses of PCL‐R and biological evidence in the legal system, this mock jury study assessed the effects of PCL‐R and biological evidence on outcomes in an insanity defense case. A sample of 428 undergraduates read a trial transcript of an insanity defense murder case. Three variables of interest were manipulated: rebuttal illness (no mental illness, personality disorder, or psychopathy), evidentiary basis (biological or psychological), and evidentiary strength (moderately strong or moderately weak). Consistent with the hypotheses, biological evidence was more persuasive than psychological evidence, and the rebuttal was slightly more successful when the prosecution labeled the defendant as a “psychopath” than when they described him simply as “not mentally ill.” Copyright © 2009 John Wiley & Sons, Ltd.
Electrostatic chiral distinction: Tetrahedral model dimers
Authors: Garten Sarit , Biedermann P. Ulrich , Topiol Sid , Agranat Israel
Published: December 2009

Although chiral distinction plays a pervasive role in chemistry, a complete understanding of how this takes place is still lacking. In this work, we expand the earlier described minimal requirement of so called four‐point interactions (vide infra). We focus on chiral point charge model systems as a means to aid in the dissection of the underlying, operative principles. We also construct models with defined symmetry characteristics. By considering extensive constellations of diastereomeric complexes, we are able to identify emerging principles for chiral distinction. As previously postulated, all the diastereomeric complexes, regardless of their nominal contact‐points, possess a chiral distinction energy. In the comparison of complexes, we find that, contrary to chemical intuition, the magnitude of chiral distinction does not correlate with the stability of the complexes, i.e., consideration of low energy complexes may not be an effective way to evaluate chiral distinction. Similarly, we do not find a correlation between the number of contact‐points and chiral distinction. Moreover, favorable interactions and facile chiral distinction appear to be unrelated. We also see some tendency for greater chiral distinction in less symmetric systems, although this may not be general. These studies can now form the basis to fold in higher levels of complexity into the models so as to gain further insights into the nature of chiral distinction. Chirality, 2010. © 2009 Wiley‐Liss, Inc.
Polarization control of ultrashort mid‐IR laser pulses for transient vibrational circular dichroism measurements
Authors: Bonmarin Mathias , Helbing Jan
Published: December 2009

Linear dichroism and birefringence artifacts are a major source of concern in transient circular dichroism measurements. They mainly arise from interaction of an imperfectly circular polarized probe beam with a nonisotropic sample. We present in this article a procedure to generate mid‐IR pulses of highly symmetric left and right handed circular or elliptical polarization states for transient VCD measurements. An infrared femtosecond laser source is synchronized to the natural frequency of a photo elastic modulator. Residual static birefringence of the modulator and the sample cell can be largely compensated by carefully controlling the arrival time of the ultrashort probe pulses at the modulator. Chirality 21:E298–E306, 2009. © 2009 Wiley‐Liss, Inc.
Patients with Metabolic Syndrome Have Prolonged Corrected QT Interval (QTc)
Authors: Li Weiju , Bai Yongyi , Sun Kai , Xue Hao , Wang Yibo , Song Xiaodong , Fan Xiaohan , Song Huijun , Han Yunfeng , Hui Rutai
Published: December 2009

Background

Prolongation of corrected QT interval (QTc) increases morbidity and mortality and QTc has been found to be longer in patients with diabetes mellitus than in healthy controls. It is still inconclusive whether the metabolic syndrome results in QTc prolongation.

Hypothesis

We hypothesized that metabolic syndrome might contribute to risk of QTc prolongation. The hypothesis was tested in a large population.

Methods

A total of 5,815 individuals (men: 1,950, women: 3,865 aged 20–80 years) were enrolled. Metabolic syndrome was defined according to the revised third National Cholesterol Education Program Adult Treatment Panel (NCEP‐ATP III). QTc was calculated by using Bazett and Fridericia equations and the corrected JT interval (JTc) was derived by subtracting the QRS duration from the QTcB. All individuals had physical examinations, electrocardiograms, echocardiography, and blood tests.

Results

Individuals with metabolic syndrome had longer QTcs and JTc than those without metabolic syndrome (439.84 ms versus 430.90 ms in men, 456.37 ms versus 445.12 ms in women, respectively, p < 0.001 using Bazett formula). The more the number of abnormal metabolic parameters they had, the longer the QTcs and JTc they had. Trend analysis indicated that QTcB, QTcF, and JTc were significantly correlated to the number of abnormal metabolic parameters both in men and in women. After being adjusted for conventional risk factors, QTcB, QTcF, and JTc remained negatively associated with serum potassium concentration and positively associated with interventricular septal thickness.

Conclusions

Metabolic syndrome is a risk factor for prolonged QTc, which may further increase cardiovascular morbidity and mortality in the subjects with metabolic syndrome. Copyright © 2009 Wiley Periodicals, Inc.
Hemoglobin Levels Predict Exercise Performance, ST‐Segment Depression, and Outcome in Patients Referred for Routine Exercise Treadmill Testing
Authors: Lipinski Michael J. , Dewey Frederick E. , Biondi‐Zoccai Giuseppe G. , Abbate Antonio , Vetrovec George W. , Froelicher Victor F.
Published: December 2009

Background

While the role of hemoglobin in heart failure and renal disease has been investigated, little is known about its effect on clinical exercise test performance and mortality in patients referred for routine exercise treadmill testing (ETT).

Hypothesis

Patients with low hemoglobin will have poor exercise capacity and would be at increased risk of mortality and cardiovascular (CV) events.

Methods

Clinical variables, laboratory values, and exercise treadmill data were obtained for 1,799 patients referred for routine ETT from 1997 to 2004. All‐cause mortality was obtained from the United States Social Security death index and autopsy reports or clinical notes were used to determine CV events and mortality. P values < 0.05 were considered significant.

Results

Our population had a mean age of 58 ± 12 years, 16% had diabetes, 53% had hypertension, 35% had hypercholesterolemia, and 67% had a history of smoking. During follow‐up, 10.3% of patients died, 3.9% of patients died of CV causes, and 11.6% had cardiovascular events. Anemic patients (hemoglobin [Hgb] < 13 g/dL) achieved lower metabolic equivalents (METs) than nonanemic patients and had more ST‐segment depression (15.5% versus 8.6%, p < 0.004). Proportional hazard analysis demonstrated that hemoglobin was significantly associated with all‐cause mortality (p < 0.0007), CV mortality (p < 0.009), and CV events (p < 0.01). Kaplan‐Meier survival analysis demonstrated that anemic patients had significantly higher mortality and CV events.

Conclusion

Hemoglobin is significantly associated with exercise performance, ST‐segment depression during ETT, mortality, and cardiovascular events. The incorporation of hemoglobin may add diagnostic and prognostic information to ETT. Copyright © 2009 Wiley Periodicals, Inc.
Serum N‐terminal‐pro‐Brain Natriuretic Peptide Level and Its Clinical Implications in Patients with Atrial Fibrillation
Authors: Bai Mei , Yang Jiefu , Li Yingying
Published: December 2009

Background

Brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not been determined. This study investigates serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) level and its clinical implications in patients with AF.

Methods

Serum NT‐proBNP levels were measured by enzyme‐linked immunosorbent assay (ELISA) and transthoracic echocardiography was performed in 136 subjects (90 cases with AF and 46 cases with sinus rhythm [SR]). Subjects were excluded if they had a history of myocardial infarction, cardiomyopathy, rheumatic heart disease, or hyperthyroidism that preceded the onset of AF. Controls (n = 30) were from a healthy outpatient primary care population. Potential determinants of serum NT‐proBNP levels were identified by univariate and multivariate analyses.

Results

Individuals with AF had higher serum NT‐proBNP levels (689.56 ± 251.87 fmol/ml) than those with SR (456.11 ± 148.14 fmol/ml, P < 0.01) and control subjects (415.83 ± 62.02 fmol/ml, P < 0.01). Individuals with SR and control subjects did not show significant difference at serum NT‐proBNP levels (P > 0.05). The regression model of serum NT‐proBNP levels and clinical predictors showed that presence of AF, older age, and larger right atrial diameter were independently predictive of higher serum NT‐proBNP values.

Conclusions

Patients with AF were associated with increased serum NT‐proBNP levels. Examining the change of serum NT‐proBNP levels is helpful to evaluate the cardiac function in patients with AF. Copyright © 2009 Wiley Periodicals, Inc.
Clinical Implications of Defective B‐Type Natriuretic Peptide
Authors: Menon Santosh G. , Mills Roger M. , Schellenberger Ute , Saqhir Syed , Protter Andrew A.
Published: December 2009

Our understanding of the natriuretic peptide system continues to evolve rapidly. B‐type natriuretic peptide (BNP), originally thought to be a simple volume‐regulating hormone that is produced in response to cardiac stretch, has been shown to also play important roles in modulating bronchodilation, endothelial function, and cardiac remodeling. Recent data demonstrate that elevated levels of BNP in patients with heart failure do not represent a simple ratcheting up of normal production in response to increased stimulus. Instead, we now know that chronic stimulation of BNP synthesis induces a reversion to fetal gene expression, resulting in production of high molecular weight forms of BNP that are functionally deficient. Standard point‐of‐care BNP assays are immunoassays that will detect any molecule containing the target epitopes. Consequently, these assays cannot distinguish between defective, high molecular weight forms of BNP and normal, physiologically active BNP. In 2 separate evaluations, mass spectroscopy detected little, if any, normal BNP in patients with heart failure, despite the appearance of high circulating levels of immunoreactive BNP (iBNP) using commercial assays. Therefore, these commercial assays should be considered to be only an indication of myocardial stress. They do not measure physiologic BNP activity. This accounts for the “BNP paradox,” namely, that administration of exogenous recombinant human BNP (rhBNP, nesiritide) has substantial clinical and hemodynamic impact in the presence of high levels of circulating iBNP using commercial assays. In addition to its short‐term hemodynamic impact, rhBNP may have other important effects in this setting, and further investigation is warranted. Copyright © 2009 Wiley Periodicals, Inc.
Overexpression of Activated Nuclear Factor‐κ B in Aorta of Patients With Coronary Atherosclerosis
Authors: Zhang Wei , Xing Shan Shan , Sun Xue Lin , Xing Qi Chong
Published: December 2009

Background

Inflammation is an established risk factor for atherosclerosis. In an inflammatory state, nuclear factor‐κ B (NF‐κB) is frequently activated as a key transcription activator for the downstream responses.

Hypothesis

The aim of this study was to investigate the changes of NF‐κB in the aorta of patients with coronary atherosclerosis and its association with atherosclerotic risk factors.

Methods

From 2004 to 2005, we collected a small piece of ascending aorta in the bypass procedure from patients (n = 31) undergoing coronary artery bypass graft (CABG) surgery. The expression of NF‐κB was determined by immunohistochemistry, and its transcriptional activity was evaluated by electrophoretic mobility shift assay. Celiac aortic tissues from 4 subjects without known atherosclerosis through the kidney donation program were taken as control.

Results

NF‐κB was detectable in aortas from CABG patients with the transcriptional activities significantly increased. The relative level of aortic NF‐κB expression was elevated in patients who were smokers or with hypertension. Spearman correlation revealed that aortic NF‐κB expression had significant correlation with coronary severity scores (Gensini score, r = 0.608, P < .05). The NF‐κB expression was positively correlated with the levels of blood glucose, low‐density lipoprotein cholesterol, lipoprotein(a), total cholesterol, and non‐high‐density lipoprotein cholesterol (P < .05); but negatively correlated with high‐density lipoprotein cholesterol (P < .05).

Conclusions

Our study demonstrates a highly activated NF‐κB in aortas from patients with coronary atherosclerosis, which may reflect overall arterial overinflammatory status. The findings of hyperactive NF‐κB in aortas may provide a diagnostic parameter for the inflammation that is associated with and may cause atherosclerosis. Copyright © 2009 Wiley Periodicals, Inc.
Endocarditis Complicating Central Venous Catheter Bloodstream Infections: A Unique Form of Health Care Associated Endocarditis
Authors: Chrissoheris Michael P. , Libertin Claudia , Ali Ronan G. , Ghantous Andre , Bekui Amenuve , Donohue Thomas
Published: December 2009

Background

Endocarditis complicating central venous catheter blood stream infection (CVC‐BSI) is a serious complication and is being seen with increasing frequency.

Methods

All patients discharged from our institution with International Classification of Disease (ICD‐9) codes of endocarditis and CVC‐BSI were identified. The medical records of those meeting our inclusion criteria were reviewed.

Results

From October 1, 1998 until December 31, 2006, 24 patients were identified with inpatient mortality of 20.8%. Nine cases were nosocomial and 15 were non‐nosocomial. The most common comorbidities were diabetes mellitus (45.8%), chronic kidney disease (58.4%), prior valvular abnormalities (37.5%), and multiple prior hospitalizations (65.2%). There were 13 external lines, 9 tunneled lines, and 2 implantable ports. Responsible microorganisms included Staphylococcus aureus in 54.6%, coagulase‐negative staphylococci in 37.5%, Candida species (spp.) in 16.6%, and enterococci in 12.5%. Five cases were polymicrobial. The line tip was within the right atrium (RA) in 37.5%, the superior vena cava (SVC)‐RA junction in 20.8%, the SVC in 33.3%, and the pulmonary artery in 4.2% of patients. Sites of endocardial involvement were the aortic valve in 6 patients, mitral valve in 7 patients, tricuspid valve in 6 patients, right atrial wall in 11 patients, and pacemaker wire in 2 patients. Isolated right‐sided involvement occurred in 50% of cases, isolated left‐sided in 33.4%, and bilateral involvement in 16.6%. Transesophageal echocardiography (TEE) was necessary for diagnosis in 10 cases (41.6%).

Conclusions

Endocarditis complicating CVC‐BSI more often involves right‐sided structures, with catheter tips in or near the right atrium, frequently requires TEE for diagnosis, and has significant inpatient mortality. Copyright © 2009 Wiley Periodicals, Inc.
Natural History of a Giant Coronary Aneurysm With Spontaneous Dissection
Authors: Bouzas‐Mosquera Alberto , Vázquez‐González Nicolás , Álvarez‐García Nemesio , Soler Rafaela , Rodríguez Esther , Calviño‐Santos Ramón , Castro‐Beiras Alfonso
Published: December 2009

Primary spontaneous coronary artery dissection may appear in young women during the peripartum period or as a result of atherosclerosis. We present a patient with familial hypercholesterolemia who developed a giant aneurysm of the right coronary artery in the setting of atherosclerotic spontaneous coronary dissection over an 8 year period. This report illustrates the association between spontaneous coronary artery dissection and subsequent coronary aneurysm formation. Copyright © 2009 Wiley Periodicals, Inc.
Retracted: Relation of Atherosclerotic Cardiovascular Events to Progression of Aortic Stenosis in Older Men
Authors: Kamalesh Masoor , Ng Charlotte , Eckert George J.
Published: December 2009

Background

RETRACTION: Publication of the following article is being retracted by the publisher due to erroneous publication. The authors were unable to obtain internal review board permission to publish the work and requested withdrawal after acceptance of: "Relation of Atherosclerotic Cardiovascular Events to Progression of Aortic Stenosis in Older Men" by Masoor Kamalesh, Charlotte Ng, and George Eckert. This article published on EarlyView on December 14, 2009 (DOI: 10.1002/clc.20541.

Aortic stenosis (AS) is now considered to be an active disease like atherosclerosis. However, therapies such as statins have not shown benefit in AS patients when studied prospectively.

Hypothesis

We tested the hypothesis that if AS was indeed similar to atherosclerosis, then subjects with progressive AS should have a higher atherosclerosis related event rate than those without progression of AS.

Methods

Two readers independently measured the aortic valve area using a continuity equation in 164 consecutive subjects with AS between January 1997 through March 2005, referred to our laboratory for serial echocardiograms for AS. Subjects with no progression of AS were compared to subjects with progression of reduction in valve area with regards to baseline demographics, occurrence of all myocardial infarctions, stroke, unstable angina requiring hospitalization, and coronary revascularization. A χ2 test were use to compare the groups for differences in endpoints.

Results

The study cohort included 164 males age 70 ± 9 years. Age, low‐density lipoprotein level, hypertension, or diabetes status were similar among the 2 groups, while the no progression group had more smokers and fewer patients on statins (P<.05). Aortic stenosis progressed in 99 subjects (60% of total) during mean follow‐up of 2.5 years. A total of 28 patients had cardiovascular events (9 myocardial infarctions, 1 stroke, 20 coronary revascularizations, 5 unstable angina requiring hospitalization). Of these, 8 (12%) occurred in the no progression group and 20 (20%) occurred in the progression group (P = .16).

Conclusions

Progressive AS is not paralleled with increased occurrence of atherosclerotic cardiovascular events despite described similarities in risk factors for AS and atherosclerosis. Copyright © 2010 Wiley Periodicals, Inc.
Three Year Follow‐up of the Sirolimus‐Eluting Stent and the Paclitaxel‐eluting Stent in Daily Practice
Authors: Gao Zhan , Yang Yuejin , Xu Bo , Chen Jilin , Qiao Shubin , Li Jianjun , Wu Yongjian , Qin Xuewen , Yuan Jinqing , Gao Runlin
Published: December 2009

Background

Although the efficacy and safety of Cypher and Taxus stents for particular patients and lesions had been proven by random clinical trials, their long‐term comparative effect for unselected Chinese patients in daily practice is still unknown.

Methods

From April 2004 to April 2005, 682 consecutive patients who were implanted with a Cypher stent (C group: n = 456, 57.3 ± 10.8 years old) or a Taxus stent (T group: n = 226, 57.2 ± 10.2 years old) in our center were analyzed. A mean 3 year clinical and 7 month angiographic follow‐up was performed.

Results

There was no difference in major adverse cardiac events (MACE) rates in the C and T groups (16.4% vs 21.7%; P = .113), and there was also no difference in cardiac death or myocardial infarction (MI) rates in both groups (2.6% vs 1.8%; P = .598, 3.3% vs 3.5%; P = .826 respectively), but target vessel revascularization (TVR) was higher in the T group (10.5% vs 16.4%; P = .036). There was no difference in total stent thrombosis or its components in both groups (total: 3.9% vs 3.5%; P = 1.000, early: 0.2% vs 0.9%; P = .256, late: 0.7% vs 1.3%; P = .404, and very late: 3.1% vs 1.3%; P = .201 respectively). A 7 month angiographic follow‐up indicated that both in‐stent and in‐segment restenosis rate were significantly lower in the C group (11.1% vs 21.0%; P = .034 and 12.2% vs 24.0%; P = .018), and in‐stent and in‐segment late loss were significantly smaller in the C group (0.18 ± 0.08 mm vs 0.53 ± 0.38 mm; P = .000 and 0.17 ± 0.09 mm vs 0.38 ± 0.19 mm; P = .000).

Conclusion

Results from this 3 year follow‐up, single‐center study showed almost the same effective and safe profile for both Cypher and Taxus stents, except for a better reducing restenosis effect in the Cypher stent. Copyright © 2009 Wiley Periodicals, Inc.
A randomized, controlled, double‐blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL)
Authors: Ladas Elena J. , Kroll David J. , Oberlies Nicholas H. , Cheng Bin , Ndao Deborah H. , Rheingold Susan R. , Kelly Kara M.
Published: December 2009

BACKGROUND:

Despite limited preclinical and clinical investigations, milk thistle (MT) is often used for the treatment of chemotherapy‐associated hepatotoxicity. Limited treatment options exist for chemotherapy‐related hepatoxicity. Given the wide use of MT, the authors investigated MT in both the laboratory and a clinical setting.

METHODS:

In a double‐blind study, children with acute lymphoblastic leukemia (ALL) and hepatic toxicity were randomized to MT or placebo orally for 28 days. Liver function tests were evaluated during the study period. To assess MT in vitro, the authors evaluated supratherapeutic concentrations in an ALL cell line.

RESULTS:

Fifty children were enrolled. No significant differences in frequency of side effects, incidence and severity of toxicities, or infections were observed between groups. There were no significant changes in mean amino alanine transferase (ALT), aspartate amino transferase (AST), or total bilirubin (TB) at Day 28. At Day 56, the MT group had a significantly lower AST (P = .05) and a trend toward a significantly lower ALT (P = .07). Although not significantly different, chemotherapy doses were reduced in 61% of the MT group compared with 72% of the placebo group. In vitro experiments revealed no antagonistic interactions between MT and vincristine or L‐asparaginase in CCRF‐CEM cells. A modest synergistic effect with vincristine was observed.

CONCLUSIONS:

In children with ALL and liver toxicity, MT was associated with a trend toward significant reductions in liver toxicity. MT did not antagonize the effects of chemotherapy agents used for the treatment of ALL. Future study is needed to determine the most effective dose and duration of MT and its effect on hepatotoxicity and leukemia‐free survival. Cancer 2010. © 2009 American Cancer Society
Correlation between ZAP‐70, phospho‐ZAP‐70, and phospho‐Syk expression in leukemic cells from patients with CLL
Authors: Kaplan David , Meyerson Howard J. , Li Xiaofeng , Drasny Carly , Liu Fangfang , Costaldi Mark , Barr Paul , Lazarus Hillard M.
Published: December 2009

For patients with chronic lymphocytic leukemia (CLL), expression of ZAP‐70 in the leukemic cells is an indicator of poor prognosis. However, the mechanism that accounts for this effect is not known. ZAP‐70 expression has previously been associated with increased B cell antigen receptor signaling upon surface immunoglobulin ligation in vitro as shown by ZAP‐70 and Syk phosphorylation. This finding has led to the suggestion that a more aggressive clinical course is correlated with B cell antigen receptor signaling. Using high resolution immunophenotyping to analyze CLL cells ex vivo (without stimulation in vitro), we have demonstrated CLL cells from all patients express some ZAP‐70 and that increased expression of ZAP‐70 is correlated with decreased levels of phosphorylated ZAP‐70 and phosphorylated Syk measured directly ex vivo. Conversely, high levels of phosphorylated ZAP‐70 and phosphorylated Syk are found only in samples with low levels of ZAP‐70 expression, and Syk and ZAP‐70 phosphorylation appear to be mostly independent of each other. Additionally, Syk phosphorylation is directly correlated with levels of p21cip1, a cell cycle inhibitor and a p53 target. Together these findings suggest that lower levels of p21cip1 and/or a defect in p53 activity may account in part for the more aggressive disease course in patients with high levels of ZAP‐70 rather than enhanced B cell antigen receptor signaling as has been previously hypothesized. © 2009 Clinical Cytometry Society
Atypical glandular cells (AGC): ThinPrep Imaging System (TIS), manual screening (MS), and correlation with Hybrid Capture 2 (HC2) HPV DNA testing
Authors: Sireci Anthony N. , Crapanzano John P. , Mansukhani Mahesh , Wright Thomas , Babiac Anamaria , Erroll Maria , Vazquez Madeline , Saqi Anjali
Published: December 2009

Objective

The aim of the study was to determine if the ThinPrep Imaging System (T1S) improves the positive predictive value (PPV) of atypical glandular cell (AGC) diagnosis for identifying HPV‐related squamous and/or glandular lesions over manual screening (MS), and if human papilloma virus (HPV)‐DNA testing improves the diagnostic yield.

Materials and Methods

85 ThinPrep cervical cytology specimens with a diagnosis of AGC by TIS (n = 51) and MS (n = 34) were retrieved. The diagnoses were correlated with corresponding histologic follow‐up and high risk (HR)‐HPV testing results.

Results

The PPV of AGC by TIS and MS for HPV‐related squamous lesions were similar. In the MS group, more cases of glandular pathology were identified, however only three represented adenocarcinoma in‐situ (AIS), and the remaining ten were endometrial carcinomas (EMCA).

Conclusions

TIS and MS are comparable in the detection of AGC representing squamous histology and the addition of HPV DNA testing does not differentially improve performance. Although the MS group harbored more glandular pathology, the differences in the detection of AIS were not statistically significant. Diagn. Cytopathol. 2010;38:705–709. © 2009 Wiley‐Liss, Inc.
Can mobile units improve the strategies for cervical cancer prevention?
Authors: Mauad Edmundo Carvalho , Nicolau Sérgio Mancini , Gomes Uilho A. , da Costa Vieira René Aloísio , de Castro Mattos Jacó Saraiva , Longatto‐Filho Adhemar , Baracat Edmund C.
Published: December 2009

Cervical cancer is a serious public health problem in women in developing countries because of absence or ineffectiveness of screening programs. Several biases to access medical care and inequity of public health system in a continental country like Brazil limit the implementation of adequate programs to appropriately prevent the cervical cancer. Therefore, the aim of this study was to evaluate the results of applying the mobile unit (MU) for cervical cancer screening. From May 2003 to May 2004, a cervical cancer screening was offered to women aged 20–69 years, residing in 19 municipal districts of the Barretos county region, in São Paulo. Out of the 9,560 examination available, 2,964 (31%) women underwent screening. The medium distance traveled by the MU was 45 km. The medium time spent by women in the MU for completion of the questionnaire and doing the exam was 20 minutes. It was observed that 17.0% of women screened had never had the test or had not had it repeated within the last 3 years. The negative response was more common among women aged 20 to 29 years and 60 to 69 years and among women with less schooling and lower socio‐economic income (P < 0.05). MU can significantly overcome the chronic deficiency of public health system accessibility offering opportunity to these women to participate in screening programs. Diagn. Cytopathol. 2010;38:727–730. © 2009 Wiley‐Liss, Inc.
The prevalence of abnormal cervical cytology in women with infertility
Authors: AbdullGaffar Badr , Kamal Mohamed O. , Hasoub Ahmed
Published: December 2009

The aim of this study was to compare the frequency of abnormal cervical cytology in women with infertility problems with that of fertile women by using ThinPrep® liquid‐based Pap Tests™. A retrospective case–control study for over 2 years was conducted. The cases included all women with infertility problems who had Pap tests during their infertility treatment period. The cases were further subdivided into primary and secondary infertility groups. The control group included all women without infertility problems who had routine Pap tests in the same period. The age and demographic features were adjusted and matched for both groups. Statistical analysis included chi‐square test and Fischer exact test. The infertility group (n = 490) showed significantly (P < 0.05) more abnormal cervical squamous epithelial abnormalities (48 positive cases, 9.8%) than the controls (n = 7,150, 216 positive cases, 3%). Women with secondary infertility had more epithelial abnormalities and more high‐grade lesions than women with primary infertility. Women with infertility had statistically significant higher frequency of squamous intraepithelial lesions than women without infertility problems of similar age and demographic background. The data suggest that women with infertility might benefit from more frequent cervical cytology screening. Diagn. Cytopathol. 2010;38:791–794. © 2009 Wiley‐Liss, Inc.
Metastatic signet ring cell carcinoma presenting as a thyroid nodule: Report of a case with fine‐needle aspiration cytology
Authors: Wheeler Yurong Y. , Marie Stoll Lisa , Sheth Shiela , Kay Li Qing
Published: December 2009

Metastatic carcinomas to the thyroid are quite rare in daily cytology practice. However, when present they may produce a diagnostic dilemma, particularly when they share some morphologic similarities with primary thyroid lesions and when occurring in patients with occult malignant history. Herein, we report a case of metastatic gastric signet ring cell carcinoma to the thyroid. Our patient presented with an isolated right thyroid nodule, which was clinically considered to be a primary thyroid neoplasm. Fine‐needle aspiration (FNA) cytology of the nodule revealed a cellular specimen with cohesive fragments and scattered individual neoplastic cells. The neoplastic cells had enlarged nuclei, fine chromatin, and inconspicuous nucleoli. Nuclear crowding, molding, and grooving were prominent. Intranuclear inclusion‐like clearance was identified. Some tumor cells also had eccentric nuclei, creating a signet ring cell appearance. The colloid was scant. These cytological features may be seen in cases of papillary thyroid carcinoma or signet ring cell follicular adenoma; however, the presence of the signet ring cells is unusual in primary thyroid lesions and raises the possibility of a metastatic lesion to the thyroid. In our case, the tumor cells were positive for AE1/AE3, mucicarmine, and periodic acid‐Schiff, but negative for thyroglobulin and thyroid transcription factor‐1. The patient was also found to have a 3.7‐cm mass in the distal esophagus/proximal stomach. Biopsy of this mass showed an invasive signet ring cell carcinoma. The purpose of our study is to discuss the cytological features and the differential diagnosis of this unusual thyroid FNA case. Diagn. Cytopathol. 2010;38:597–602. 2009 Wiley‐Liss, Inc.
Sarcomatoid collecting duct carcinoma of kidney diagnosed with urine and renal pelvic lavage cytology
Authors: Mimura Akihiro , Sakuma Takahiko , Furuta Michiko , Tanigawa Naoto , Takamizu Ryuichi , Kawano Kiyoshi
Published: December 2009

A case of sarcomatoid collecting duct carcinoma (CDC) of kidney is presented, in which the diagnosis was made cytologically with voided urine and renal pelvis lavage. Cytology of hemorrhagic voided urine revealed highly atypical adenocarcinoma cells with reminiscent ductal structure, which suggested CDC as the most likely diagnosis. Computed tomography and magnetic resonance imaging demonstrated a left renal tumor, and selective lavage of left renal pelvis yielded spindle‐shaped, highly atypical cells that indicated sarcomatoid carcinoma. The diagnosis of renal cancer with urine cytology is challenging because of small number of tumor cells in the urine, which are often associated with degeneration. As the urinary cytologic findings of sarcomatoid CDC have not been reported, the characteristic cytologic findings of sarcomatoid CDC are described in detail, and the differential diagnoses with diagnostic pitfalls were discussed. Diagn. Cytopathol. 2010;38:603–606. 2009 Wiley‐Liss, Inc.
Thyroid follicular neoplasm: Analysis by fine needle aspiration cytology, frozen section, and histopathology
Authors: Liu Feng‐Hsuan , Liou Miaw‐Jene , Hsueh Chuen , Chao Tzu‐Chieh , Lin Jen‐Der
Published: December 2009

We performed a retrospective analysis of follicular neoplasm data obtained from frozen section examinations of thyroid nodules. A total of 5,660 patients underwent preoperative neck ultrasonography and fine‐needle aspiration cytology (FNAC), surgical treatment, and follow‐up at a medical institute. Patients with papillary thyroid microcarcinoma were excluded from this study. In 971 cases, frozen section examination was performed during the surgical treatment of follicular neoplasm that was diagnosed via FNAC. Thyroid malignancies were histologically confirmed in 25.1% of cases (244/971). Among the patients with papillary thyroid carcinoma, 45 were diagnosed with the follicular variant of papillary thyroid carcinomas (27.4%). The diagnostic sensitivity of frozen section for the nonfollicular variant of papillary thyroid carcinoma was better than that for the follicular variant of papillary thyroid carcinoma (89.1% versus 78.9%; P = 0.1023). For 12 cases the diagnosis was atypical follicular adenomas. The diagnostic accuracy of frozen section in cases of follicular neoplasm was 76.9% with a sensitivity of 84.8% and a specificity of 98.9%. In conclusion, our analysis revealed high rates of accuracy when using frozen tissue sections for early diagnosis and treatment of follicular neoplasm; thus, an early decision to extent of surgery prevents a risky follow‐up surgery. Diagn. Cytopathol. 2010;38:801‐805. © 2009 Wiley‐Liss, Inc.