bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased fructosamine in non-diabetic rheumatoid arthritis patients: role of lipid peroxides and glutathione
Authors: Babu Narsimhan Prakash , Bobby Zachariah , Selvaraj Nambiar , Harish Belgode N.
Published: June 2006

Modification of proteins by non-enzymatic glycation is one of the underlying factors known to play a major role in the pathogenesis of many clinical disorders. Glycation of plasma proteins is enhanced by elevated glucose concentrations. However, increased fructosamine has been documented in rheumatoid arthritis patients without any history of diabetes. Collective evidence reveals that malondialdehyde and reduced glutathione can modulate the glycation process. This study was undertaken to unravel the possible association of malondialdehyde and glutathione with fructosamine in rheumatoid arthritis patients. A case-control study was performed on 15 rheumatoid arthritis patients and 15 control subjects. Whole blood glutathione, plasma malondialdehyde, fructosamine and fasting glucose were analyzed in both groups. Partial correlation analysis was performed to predict the independent association of malondialdehyde, glutathione and fasting glucose on fructosamine. In rheumatoid arthritis patients, while fructosamine and malondialdehyde levels were significantly increased, glutathione levels were significantly decreased compared with controls. With partial correlation analysis, fructosamine was found to have a significant positive correlation with malondialdehyde and a negative correlation with glutathione. These data suggest that plasma fructosamine levels are closely associated with malondialdehyde and glutathione in rheumatoid arthritis patients, warranting extra precaution in interpreting fructosamine as a measure of glycemic control in these patients.

Clin Chem Lab Med 2006;44:848–52.
Training Agricultural Economists for the Private Sector: Are We Meeting Their Needs?
Authors: Boland Michael , Daniel Scott
Published: June 2006

The objective is to determine occupational factors associated with price and market research analysts who have graduate degrees and are employed in private sector agribusiness firms. USDA publications and data are the primary source of information. Regression analysis, benefit/cost analysis, and present value/rate of return analysis are skills desired for either type of analyst position. Market research analysts require skills for identifying groups with similar buying habits and preparing marketing plans. Price analyst positions require traditional economics and econometrics skills such as supply and demand analysis and price forecasting. Information on salary ranges for analysts is described.
Agriculture as an Almost‐Constant‐Cost Industry: Evidence and Implications
Authors: Uhlin Hans-Erik , Olson Kent D.
Published: June 2006

Instead of a significant, positive slope, we argue that agriculture's intermediate‐run supply curve is S‐shaped with a large, nearly horizontal area in the middle. If the demand curve intersects the nearly horizontal area, farmers lack the economic signals of who should remain and who should leave. Extension and advisory services, rural social development programs, and industrial policies need to be refocused during these periods of indeterminacy and instability. Development of alternative products and resource uses would help move “horizontal resources” to better alternatives, reduce the elastic portion of the supply curve, and create a more stable demand and supply intersection.
The Economics of Bt Corn: Valuing Protection from the European Corn Borer
Authors: Hyde Jeffrey , Martin Marshall A. , Preckel Paul V. , Edwards C. Richard
Published: June 2006

Corn that carries a gene from the natural soil bacterium Bacillus thuringiensis kurstaki, or Bt, has given farmers a potentially powerful tool to protect against European corn borer (ECB) damage. European corn borers are responsible for losses of $1–$2 billion per year in the United States. This study analyzed the economic value of Bt corn under Indiana conditions. Results suggest that the value of the protection offered by Bt corn is generally lower than the current seed premiums in Indiana. The economic value of Bt corn may exceed the current premiums for farmers with higher‐than‐average yields or who have a 40% or greater probability of an ECB infestation.
The Role of Information in U.S. Grain and Oilseed Markets
Authors: Jones Eluned
Published: June 2006

Transparency of information in economic (price) signals is the crux of the debate regarding institutional guidelines for grain and oilseed markets. Federal grades and standards guide the determination and discovery of price in the competitive (public) market. However, the increasing rate of market coordination is reflective of a widening information gap, which rent‐seeking entrepreneurs are able to arbitrage into higher returns. Thus, the outcome of the debate will determine the direction and rate of change of US. grain‐market structures as well as the degree to which market prices reflect the value of desired attributes.
Evolutionary Theories and the Community Management of Local Commons: A Survey
Authors: Rupasingha Anil , Boadu Fred O.
Published: June 2006

This article examines the evolution of economic theory to explain the emergence and maintenance of cooperation among users of local commons. The conventional view that “free riding” prevents cooperative solutions to the commons dilemma is challenged under new theories rooted in evolutionary paradigm and the institutional matrix within which individuals find themselves. Contrary to the prediction of the conventional view, modern evolutionary theories provide ample empirical and theoretical evidence in support of a community's ability to self‐organize to preserve the local commons.
S-nitrosoglutathione modulates CXCR4 and ICOS expression
Authors: Yamamoto Yoshihiko , Pahwa Rajendra , Pahwa Savita
Published: June 2006

The expression of CXCR4, a membrane protein which is involved in the entry of HIV-1, is down-modulated from the cell surface by Phorbol 12-myristate 13-acetate (PMA) and the Ca+ ionophore, Ionomycin. Inducible co-stimulator (ICOS), which contributes to lymphocyte proliferation, is up-regulated by PMA/Ionomycin. We examined the influence of S-nitrosoglutathione (SNG), an inhibitor of Vacuolar H+-ATPase (V-ATPase), on the expression of CXCR4 and ICOS in PMA/Ionomycin-treated peripheral mononuclear cells (PBMC), and of CXCR4 alone in lymphoid cell lines. In this report, we show that SNG interferes with both effects of PMA/Ionomycin, namely CXCR4 down-regulation and ICOS up-regulation. These studies imply opposing roles of V-ATPase in the regulation of CXCR4 and ICOS. The influence of SNG in modulating the susceptibility of T cells to HIV-1 and on their immune responses needs further investigation.
The specific T-cell response to antigenic peptides is influenced by bystander peptides
Authors: Nowak Izabela , Pajtasz-Piasecka Elżbieta , Chmielowski Bartosz , Ignatowicz Leszek , Kuśnierczyk Piotr
Published: June 2006

T lymphocytes recognize antigens in the form of peptides presented by major histocompatibility complex (MHC) molecules on the cell surface. Only a small proportion of MHC class I and class II molecules are loaded with foreign antigenic peptides; the vast majority are loaded with thousands of different self peptides. It was suggested that MHC molecules presenting self peptides may serve either to decrease (antagonistic effect) or increase (synergistic effect) the T cell response to a specific antigen. Here, we present our finding that transfected mouse fibroblasts presenting a single antigenic peptide covalently bound to a class II MHC molecule stimulated specific mouse T cell hybridoma cells to an interleukin-2 response less efficiently than fibroblasts presenting a similar amount of antigenic peptide in the presence of class II molecules loaded with heterogenous bystander peptides.
The identification and characterization of a testis-specific cDNA during spermatogenesis
Authors: Chen Ying , Hu Jiarui , Song Ping , Gong Wuming
Published: June 2006

Using bioinformatics and experimental validation, we obtained a cDNA (named srsf) which was exclusively expressed in the mouse testes. RT-PCR analysis showed that srsf mRNA was not expressed in the gonad during the sex determination period or during embryogenesis. In developing mouse tests, srsf expression was first detected on post-natal day 10, reached its highest level on day 23, and then reduced to and remained at a moderate level throughout adulthood. In situ hybridization analysis demonstrated that srsf mRNA was expressed in pachytene spermatocytes and round spermatids in the testes. The predicted protein contains one RNA-binding domain (RBD) and a serine-arginine rich domain (RS), which are characterized by some splicing factors of SR family members. These findings indicate that srsf may play a role during spermatogenesis.
Co-involvement of the mitochondria and endoplasmic reticulum in cell death induced by the novel ertargeted protein HAP
Authors: Xu Hua , Zhou Qing , Liu Xin , Qi Yi-Peng
Published: June 2006

HAP (a homologue of the ASY/Nogo-B protein), a novel human apoptosis-inducing protein, was found to be identical to RTN3. In an earlier study, we demonstrated that HAP localized exclusively to the endoplasmic reticulum (ER) and that its overexpression could induce cell apoptosis via a depletion of endoplasmic reticulum (ER) Ca2+ stores. In this study, we show that overexpression of HAP causes the activation of caspase-12 and caspase-3. We still detected the collapse of mitochondrial membrane potential (Δωm) and the release of cytochrome c in HAP-overexpressing HeLa cells. All the results indicate that both the mitochondria and the ER are involved in apoptosis caused by HAP overexpression, and suggest that HAP overexpression may initiate an ER overload response (EOR) and bring about the downstream apoptotic events.
Regulation of Schistocerca gregaria neuroparsin transcript levels by juvenile hormone and 20‐hydroxyecdysone
Authors: Claeys Ilse , Breugelmans Bert , Simonet Gert , Franssens Vanessa , Van Soest Sofie , Broeck Jozef Vanden
Published: June 2006

Neuroparsins (NPs) are small proteins that were originally discovered in the pars intercerebralis–corpus cardiacum neurosecretory complex of the migratory locust brain. From the desert locust, Schistocerca gregaria, we recently cloned four different transcripts, each coding for a distinct NP‐related peptide. In addition to the brain, some NP‐like precursor (Scg‐NPP) transcripts also occur in a number of peripheral tissues, and their expression levels are controlled in a gender‐ and stage‐dependent manner. Previous studies revealed a close correlation between Scg‐NPP transcript levels and the gonotrophic cycle. In the present report, we demonstrate that certain Scg‐NPP transcript levels are significantly altered upon injection of juvenile hormone (JH) or 20‐hydroxyecdysone (20E) in adult gregarious desert locusts (five days after final ecdysis). While Scg‐NPP1 transcript levels did not significantly change as a result of hormone treatment (animals were analyzed 24 h after injection), Scg‐NPP2, Scg‐NPP3, and Scg‐NPP4 displayed hormone‐dependent regulation in various tissues. Scg‐NPP2 and Scg‐NPP3 transcript levels significantly increased in the brain of JH‐treated locusts. In addition, JH induction of Scg‐NPP3 and Scg‐NPP4 transcripts was observed in male fat body and in male and female gonads. Furthermore, 20E injection also induced Scg‐NPP2, Scg‐NPP3, and Scg‐NPP4 transcripts in desert locust gonads. This is the first report showing NP‐like precursor gene expression in insect ovaries. Our study indicates that the expression levels of some Scg‐NPP transcripts are regulated by developmental hormones, suggesting a close correlation between NP expression and the endocrine control of the reproductive cycle. Arch Insect Biochem Physiol 62:107–115, 2006. © 2006 Wiley‐Liss, Inc.
Comparative structure‐activity analysis of insect kinin core analogs on recombinant kinin receptors from Southern cattle tick Boophilus microplus (Acari: Ixodidae) and mosquito Aedes aegypti (Diptera: Culicidae)
Authors: Taneja‐Bageshwar Suparna , Strey Allison , Zubrzak Pawel , Pietrantonio Patricia V. , Nachman Ronald J.
Published: June 2006

The systematic analysis of structure‐activity relationships of insect kinins on two heterologous receptor‐expressing systems is described. Previously, kinin receptors from the southern cattle tick, Boophilus microplus (Canestrini) [Holmes et al., Insect Mol Biol 9:457–465 (2000); Holmes et al., Insect Mol Biol 12:27–38 (2003)], and the dengue vector, the mosquito Aedes aegypti (L.) [Pietrantonio et al., Insect Mol Biol 14:55–67 (2005)], were functionally and stably expressed in CHO‐K1 cells. In order to determine which kinin residues are critical for the peptide‐receptor interaction, kinin core analogs were synthesized as an Ala‐replacement series of the peptide FFSWGa and tested by a calcium bioluminescence plate assay. The amino acids Phe1 and Trp4 were essential for activity of the insect kinins in both receptors. It was confirmed that the pentapeptide kinin core is the minimum sequence required for activity and that the C‐terminal amide is also essential. In contrast to the tick receptor, a large increase in efficacy is observed in the mosquito receptor when the C‐terminal pentapeptide is N‐terminally extended to a hexapeptide. The aminoisobutyric acid (Aib)‐containing analog, FF[Aib]WGa, was as active as superagonist FFFSWGa on the mosquito receptor in contrast to the tick receptor where it was statistically more active than FFFSWGa by an order of magnitude. This restricted conformation Aib analog provides information on the conformation associated with the interaction of the insect kinins with these two receptors. Furthermore, the analog FF[Aib]WGa has been previously shown to resist degradation by the peptidases ACE and nephrilysin and represents an important lead in the development of biostable insect kinin analogs that ticks and mosquitoes cannot readily deactivate. Arch Insect Biochem Physiol 62:128–140, 2006. Published 2006 Wiley‐Liss, Inc.
Technical failure of lateral sphincterotomy for the treatment of chronic anal fissure: A study using endoanal ultrasonography
Authors: Farouk R , Monson J R T , Duthie G S
Published: June 2006

Long-term follow-up of outcome after lateral internal sphincterotomy for chronic anal fissure suggests that the healing rate is in excess of 95 per cent. A group of patients who continue to have symptoms following surgery has been investigated by endoanal ultrasonography to determine its value in determining why sphincterotomy has failed.
Chemical ablation of the gallbladder
Authors: Majeed A W , Reed M W R , Stephenson T J , Johnson A G
Published: June 2006

Background

Chemical ablation of the gallbladder might avoid the need for surgery in elderly, unfit patients. This study examined the efficacy of various chemicals in destroying gallbladder mucosa.

Methods

Ninety-five per cent ethanol, 3 per cent sodium tetradecyl sulphate (STD), trifluoroacetic acid (TFA) 2 mol/l, tetracycline 50 mg/ml, 30 and 50 per cent phenol, and a mucosal exfoliant solution (compound ethylene diamine tetra-acetic acid) were tested for gallbladder ablation in rabbits. Histology was obtained 8 weeks after exposure to these chemicals.

Results

Thirty per cent phenol, tetracycline, TFA and ethanol when used as single agents were moderately effective in causing complete gallbladder mucosal obliteration, 50 per cent phenol caused a macroscopic burn of the entire gallbladder. The mucosal exfoliant solution and STD on their own did not cause mucosal destruction but had significantly enhanced efficacy when combined with 95 per cent ethanol, allowing reliable mucosal destruction with a 5-min contact duration.

Conclusion

Ninety-five per cent ethanol and STD after pretreatment with a mucosal exfoliant solution may be the combination of choice for in situ gallbladder mucosal ablation.
Der chirurg
Authors: Chirurg Der
Published: June 2006

For this quarter's digest, Professor Christian Herfarth and Dr Thomas Lehnert have selected the best from the October to December 1996 issues of Der Chirurg. A digest for the BJS for the same period, written by Mr Colin Johnson, appears in the German journal.
Comparative effects of enteric-coated pancreatin microsphere therapy after conventional and pylorus-preserving pancreatoduodenectomy
Authors: Bruno M J , Borm J J J , Hoek F J , Delzenne B , Hofmann A F , de Goeij J J M , van Royen E A , van Gulikt T M , de Wit L Th , Goumat D J , van Leeuwen D J , Tytgat G N J
Published: June 2006

Background

A comparative study was performed between patients with exocrine pancreatic insufficiency after conventional pancreatoduodenectomy (Whipple′s procedure) and pylorus-preserving pancreatoduodenectomy (PPPD). In these patients the pharmacodynamics of 2-mm enteric-coated pancreatin microspheres (ECPMs) and their gastric transit time in relation to that of a solid meal were investigated. The efficacy of ECPM preparations may differ after Whipple′s procedure compared with PPPD, because the latter procedure does not include gastrectomy.

Methods

Gastric transit was assessed by double-isotope scintigraphy. A pancake meal was labelled with 99mTc. ECPMs were cold-labelled with 170Er and neutron activated shortly before ingestion to enable imaging with a δ camera. Intraluminal pancreatic enzyme activity was assessed during a 6-h period with two indirect tests: the cholesteryl [14C]octanoate breath test and the N-benzoyl-L-tyrosyl-p-aminobenzoic acid-p-aminosalicylic acid (NBT-PABA-PAS) test.

Results

In patients who had Whipple's procedure, the gastric transit time of ECPMs and of the pancake meal was not significantly different. The outcome of the indirect pancreatic function tests during enzyme supplementation was comparable, and not significantly different, from that in healthy volunteers. In patients who had PPPD, however, the gastric transit time of microspheres was greatly delayed compared with that of the pancake meal (P<0·05). Improvement in the outcome of the indirect pancreatic function tests during enzyme supplementation was much less and remained well below that of healthy volunteers (P < 0·05).

Conclusion

In cases of exocrine pancreatic insufficiency after Whipple's procedure, 2-mm ECPM treatment adequately restores pancreatic enzyme activity. Following PPPD, however, ECPM treatment is often ineffective because the microspheres are retained in the stomach. In these patients, use of conventional powdered pancreatin enzyme preparations may improve the efficacy of treatment.
Initial experience with an absorbable laparoscopic ligation clip
Authors: Darzi A , Soin B , Coleman J , Lirici N M , Angelini L
Published: June 2006

Background

Laparoscopic surgery requires secure and safe methods of ligation and haemostasis. This study evaluated the efficacy of an absorbable ligation clip with a novel compression closure mechanism.

Methods

A new compression-closure absorbable clip was compared with currently available absorbable and non-absorbable clips used in a variety of laparoscopic procedures in 12 centres worldwide.

Results

At follow-up to 3 months after the procedure, no complications specific to the use of the compression-closure clip were detected. Operator satisfaction with the clip was high, with criticism directed at its relatively large size.

Conclusion

This new clip is as safe and effective as presently available metal and absorbable clips in providing haemostasis and securing tubular structures.
Hernia repair in elderly patients
Authors: Gianetta E , De Cian F , Cuneo S , Friedman D , Vitale B , Marinari G , Baschieri G , Camerini G
Published: June 2006

Background

This study evaluates a 5-year experience of the management of the most frequent abdominal wall hernias in an elderly population.

Methods

From April 1990 to December 1995, 231 inguinal, 12 femoral and seven umbilical hernias were repaired in 221 patients (mean age 74 (range 66–93) years). Concomitant diseases were present in 157 patients, A mesh repair was performed with ‘tension-free’ or ‘plug’ techniques in all but 23 inguinal and two femora! hernia repairs, in which the Bassini or Shouldice procedures were adopted. Ten emergency hernia repairs were performed for strangulation. A total of 232 operations, including four emergency hernia repairs, were carried out under local anaesthesia.

Results

There was no perioperative mortality. Acute intestinal bleeding occurred 2 days after surgery in a patient with colonic diverticular disease. Urinary retention occurred once following emergency hernia repair under general anaesthesia and twice after elective hernia repair under local anaesthesia. Local complications included four scrotl haematomas (2 per cent), three wound infections (1 per cent) and one case of orchitis with atrophy after repair of a recurrent hernia. There was one recurrence after a Bassini repair and one after Shouldice inguinal herniorrhaphy. No recurrence was observed after mesh repair.

Conclusion

Local anaesthetic mesh hernia repair is safe and effective in elderly patients. Age should be no bar to elective hernia repair. This policy should avoid the complications of emergency operation.
Cells are present in the smoke created during laparoscopic surgery
Authors: Champault G , Taffinder N , Ziol M , Riskalla H , Catheline J M C
Published: June 2006

Background

The application of laparoscopy for malignancy has been halted in many centres because of a growing number of reports of metastases arising in port sites. The smoke created by coagulation during laparoscopic surgery appears to contain particles visible to the naked eye. This study tested the hypothesis that whole cells can be carried as an aerosol in the pneumoperitoneum during laparoscopy.

Methods

Nine patients undergoing laparoscopic surgery for benign and metastatic disease were studied. Throughout the procedure the gas of the pneumoperitoneum was allowed to escape through a filter. The filters and tubing were washed, and washing solution was centrifuged and stained immunohistochemically to identify the cells. Three of the filters were also examined with an electron microscope.

Results

Six of the nine samples contained cells. Clumps of whole cells were identified as mesothelial in origin; the electron micrographs showed many other cells stuck to the filter, which appeared to be blood and mesothelial cells but were not analysed further.

Conclusion

The presence of whole identifiable cells carried in the pneumoperitoneum raises concerns for operating staff and could be a mechanism for tumour implantation. No malignant cells were found, but ethical considerations prevented intentional coagulation of malignant tissue.
Patterns of lymphatic spread of carcinoma of the ampulla of Vater
Authors: Shirai Y , Ohtani T , Tsukada K , Hatakeyama K
Published: June 2006

Background

The pattern of lymphatic spread of ampullary cancer is poorly documented. This pattern was clarified in order to define the rational extent of radical lymphadenectomy.

Method

Thirty-nine consecutive patients who underwent pancreaticoduodenectomy with radical lymphadenectomy were included in the study. A total of 1447 lymph nodes dissected from the resected specimens was examined to detect the presence of metastatic foci.

Results

Twenty-one of the 39 patients had a total of 97 positive nodes. The sites of nodal involvement were the posterior pancreaticoduodenal (20 of 21 patients), inferior pancreaticoduodenal artery (IPDA; 12 of 21), anterior pancreaticoduodenal (three of 21), trunk of the superior mesenteric artery (three of 20), pericholedochal (three of 21), retroportal (two of 21), and para-aortic (three of five) regions. No metastases were found in the hepatic artery, cystic duct, perigastric, right coeliac, middle colic artery or right caval node groups.

Conclusion

Ampullary cancer mainly spreads to the posterior pancreaticoduodenal node group, then to the IPDA node group, and finally to the para-aortic area. The rational extent of radical lymphadenectomy should include the pancreaticoduodenal, superior mesenteric, pericholedochal, retroportal and para-aortic nodes.
Impact of preoperative radiochemotherapy on postoperative course and survival in patients with locally advanced squamous cell oesophageal carcinoma
Authors: Mariette C , Piessen G , Lamblin A , Mirabel X , Adenis A , Triboulet J P
Published: June 2006

Background

The aim of this study was to determine the effect of neoadjuvant radiochemotherapy (RCT) on postoperative complications and survival after surgery for locally advanced oesophageal squamous cell carcinoma.

Methods

Postoperative course and survival were compared in 144 patients who had neoadjuvant RCT and 80 control patients who had surgery alone for locally advanced oesophageal squamous cell carcinoma (radiological stage T3, N0 or N1, M0).

Results

The two groups were comparable in terms of American Society of Anesthesiologists grade, age, sex, weight loss, tumour location, presence of lymph node metastasis and surgical approach. Postoperative mortality rates were 6·3 and 9 per cent (P = 0·481), with morbidity rates of 40·3 and 41 per cent (P = 0·887) in the RCT and control group respectively. Complete resection (R0) rates were 74·3 and 48 per cent respectively (P < 0·001). Significant downstaging was observed in the RCT group (P < 0·001), with 16·0 per cent of patients having a complete pathological response. Median survival was 29 versus 15 months, and the 5-year survival rate 37 versus 17 per cent (P = 0·002) in RCT and control groups respectively.

Conclusion

Neoadjuvant RCT significantly enhanced R0 resection and survival rates in patients with stage T3 oesophageal squamous cell carcinoma, with no increase in postoperative mortality and morbidity rates.
Final results of the Canadian prospective phase II trial of intermittent androgen suppression for men in biochemical recurrence after radiotherapy for locally advanced prostate cancer
Authors: Bruchovsky Nicholas , Klotz Laurence , Crook Juanita , Malone Shawn , Ludgate Charles , Morris W. James , Gleave Martin E. , Goldenberg S. Larry
Published: June 2006

BACKGROUND.

This prospective Phase II study was undertaken to evaluate intermittent androgen suppression as a form of therapy in men with localized prostate cancer who failed after they received external beam irradiation.

METHODS.

Patients who demonstrated a rising serum prostate‐specific antigen (PSA) level after they received radiotherapy and who were without evidence of distant metastasis were accepted into the study. Treatment in each cycle consisted of cyproterone acetate given as lead‐in therapy for 4 weeks, followed by a combination of leuprolide acetate and cyproterone acetate, which ended after a total of 36 weeks.

RESULTS.

Of 109 patients registered, 103 patients were eligible for interruption of treatment, yielding a PSA response rate of 95%. The study continued for 6 years with a mean follow‐up of 3.7 years (median follow‐up, 4.2 years). The time off treatment averaged 53% of the total cycle time but, in absolute terms, decreased with each succeeding cycle, ranging from 63.7 weeks in Cycle 1 to 25.6 weeks in Cycle 5. Prostate volume was reduced by 40% in Cycle 1 and by 34% in Cycle 2, and there were no decreases in Cycle 3 or Cycle 4. At the end of the trial, 38.5% of patients still were receiving treatment, 23.9% of patients had failed, and 15.6% of patients had died. Only 2% of deaths were cancer‐specific.

CONCLUSIONS.

Biochemical recurrence after irradiation for localized prostate cancer was amenable to cyclic androgen withdrawal therapy and showed a high response rate. Despite progressively shorter treatment cycles, the off‐treatment interval remained appreciable, ranging from 65% in Cycle 1 to 46% in Cycle 5. Cancer 2006. © 2006 American Cancer Society.
The emergence of local norms in networks
Authors: Burke Mary A. , Fournier Gary M. , Prasad Kislaya
Published: June 2006

We develop an explanation of the emergence of local norms and the associated phenomenon of geographical variation in behavior. Individuals are assumed to interact locally with neighbors in an environment with a network externality. Although many patterns of behavior are possible, the dispersed interactive choices of agents are shown to select behavior that is locally uniform but globally diverse. The range of applications of the theory includes regional variation in the practice of medicine, technology choice, and corruption. The framework is also useful for further developing our understanding of important phenomena like lock‐in, critical thresholds, and contagion. © 2006 Wiley Periodicals, Inc. Complexity 11: 65–83, 2006
Who refuses the diagnostic assessment for dementia in primary care?
Authors: Boustani Malaz , Perkins Anthony J. , Fox Chris , Unverzagt Fred , Austrom Mary Guerriero , Fultz Bridget , Hui Siu , Callahan Christopher M. , Hendrie Hugh C.
Published: June 2006

Objective

Early screening and detection of dementia in primary care remains controversial. At least half of the patients identified as cognitively impaired by screening instruments do not meet criteria for dementia and some patients refuse further evaluation following a positive screen. The aim of this study was to identify the characteristics of patients who refuse a clinical diagnostic assessment for dementia after screening.

Design

Cross sectional study.

Setting

Seven primary care practice centers in Indianapolis.

Participants

Four hundred and thirty‐four individuals aged 65 and older who screened positive for dementia with a mean age of 74.6, 67% women, and 68% African‐American.

Main outcome measure

Patients' acceptance of undergoing a dementia diagnostic assessment that included neuropsychological testing, caregiver interview, and medical chart review.

Results

Among patients with positive screening results for dementia, approximately half (47.7%) refused further assessment to confirm their screening results. In a bivariate analysis, possible factors associated with a higher probability of refusing dementia assessment were older age and better screening score. In a multiple logistic regression model, performing well on the temporal orientation of the screening instrument was associated with a higher probability of refusing diagnostic assessment for dementia (OR = 1.37; p = 0.001). Also, African‐American patients aged 80 and older were more likely to refuse the diagnostic assessment than African‐Americans less than 80 years of age (OR = 3.1, p < 0.001), while there was no significant age association for white patients (OR = 0.9, p = 0.728).

Conclusions

Older primary care patients who perceived themselves as having no cognitive symptoms refused dementia diagnostic assessment despite their positive screening results. We must improve our understanding of the decision‐making process driving patients' beliefs and behaviors about the benefits and risks of dementia screening and diagnosis before implementing any broad‐based screening initiatives for dementia. Copyright © 2006 John Wiley & Sons, Ltd.
Complete hypopharyngeal obstruction by mucosal adhesions: A complication of intensive chemoradiation for advanced head and neck cancer
Authors: Franzmann Elizabeth J. , Lundy Donna S. , Abitbol Andre A. , Goodwin W. Jarrard
Published: June 2006

Background.

Severe swallowing dysfunction is the dominant long‐term complication observed in patients treated for head and neck squamous cell carcinoma (HNSCC) with treatment protocols using intensive concurrent chemotherapy with radiation therapy (chemo/XRT). We identified a subset of these patients, who were seen with complete obstruction of the hypopharynx distal to the site of the primary cancer, and in whom we postulate that the obstruction was caused by separable mucosal adhesions rather than obliteration by a mature fibrous stricture.

Methods.

Seven patients were referred to the senior author with a diagnosis of complete hypopharyngeal obstruction between 1992 and 2001. The diagnosis was confirmed by barium swallow imaging and/or endoscopy before referral in all patients. Patients underwent recanalization by passing a Jesberg esophagoscope under general anesthesia, followed by serial dilations and intensive swallowing therapy. Patient charts were reviewed retrospectively after institutional review board approval.

Results.

All seven patients were successfully recanalized. No patient had a perforation or other significant complication related to the recanalization procedure or subsequent dilations. Five of the seven patients showed improvement in swallowing at some point after the initial procedure, but just two patients recovered sufficiently to have their gastrostomy tube removed permanently.

Conclusions.

We conclude that complete hypopharyngeal obstruction secondary to mucosal adhesions is one cause of gastrostomy tube dependence in patients who have been treated with chemo/XRT for HNSCC. It is a difficult problem to treat, but most patients can recover useful swallowing function without undergoing laryngectomy or major surgical reconstruction. The postulated pathophysiology has implications for prevention as well as treatment. © 2006 Wiley Periodicals, Inc. Head Neck, 2006
Differential tissue and subcellular expressionof ERM proteins in normal and malignant tissues: Cytoplasmic ezrin expression has prognostic signficance for head and neck squamous cell carcinoma
Authors: Madan Rashna , Brandwein‐Gensler Margaret , Schlecht Nicolas F. , Elias Kristin , Gorbovitsky Eleanor , Belbin Thomas J. , Mahmood Radma , Breining Dwayne , Qian Hong , Childs Geoffrey , Locker Joseph , Smith Richard , Haigentz Missak , Gunn‐Moore Frank , Prystowsky Michael B.
Published: June 2006

Background.

Members of the ezrin‐radixin‐moesin (ERM) protein family regulate cellular shape, motility, and proliferation and potentially influence ability to metastasize. We investigated the correlation between ERM subcellular localization and survival in patients with squamous cell carcinoma (SCC)

Methods.

Tissue microarrays (TMAs) were constructed from paraffin‐embedded tissue. TMA sections were evaluated for ERM protein expression immunohistochemically. The results were compared across clinical and histopathologic variables

Results

ERM staining results for 47 patients showed that cytoplasmic ERM expression was prevalent in tumors (>92%). Whereas ezrin and moesin also localized to the membrane, only willin was found in the nucleus of tumors. Multivariable Cox regression analysis demonstrated that strong cytoplasmic ezrin expression was independently associated with poorer survival (p = .04, hazard ratio 1.82)

Conclusions.

Both level of expression and subcellular localization of ERM proteins may be important indicators of clinical outcome in SCC. This pilot study justifies the need for an expanded validation study of ERM proteins and clinical outcome. © 2006 Wiley Periodicals, Inc. Head Neck, 2006
The dynamics of the health labour market
Authors: Vujicic Marko , Zurn Pascal
Published: June 2006

One of the most important components of health care systems is human resources for health (HRH)—the people that deliver the services. One key challenge facing policy makers is to ensure that health care systems have sufficient HRH capacity to deliver services that improve or maintain population health. In a predominantly public system, this involves policy makers assessing the health care needs of the population, deriving the HRH requirements to meet those needs, and putting policies in place that move the current HRH employment level, skill mix, geographic distribution and productivity towards the desired level. This last step relies on understanding the labour market dynamics of the health care sector, specifically the determinants of labour demand and labour supply. We argue that traditional HRH policy in developing countries has focussed on determining the HRH requirements to address population needs and has largely ignored the labour market dynamics aspect. This is one of the reasons that HRH policies often do not achieve their objectives. We argue for the need to incorporate more explicitly the behaviour of those who supply labour—doctors, nurses and other providers—those who demand labour, and how these actors respond to incentives when formulating health workforce policy. Copyright © 2006 John Wiley & Sons, Ltd.
Physician supply, supplier‐induced demand and competition: empirical evidence from a single‐payer system
Authors: Xirasagar Sudha , Lin Herng‐Ching
Published: June 2006

We examined the earnings of 8106 office‐based (FTE) physicians in 2002 in Taiwan for evidence of supplier‐induced demand (SID). We hypothesize that SID, operating in the form of mutual cross‐specialty referral, will cause earnings to increase with total physician density (all specialties taken together), but simultaneously, decrease with increasing competition within specialties. We used multiple regression analyses controlling for high‐user population, physician demographics and practice type. The evidence supports our hypotheses. Increasing total physician density (all specialties) is positively associated with earnings. Concurrently, within specialties, increased competition is associated with reduced earnings. The medical appropriateness of increasing health care utilization with increasing physician supply cannot be directly determined from the data. However, evidence of a steady earnings increase with increasing total physician density, which precludes a saturation point (of appropriate care levels) at some optimum physician density, substantiates SID in the office‐based practice market. Empirically, our data suggest that the average market effect of physicians on one another is synergic when all specialties are considered together, but competitive within each specialty. Copyright © 2006 John Wiley & Sons, Ltd.
The importance of knowledge transfer between specialist and generic services in improving health care: a cross‐national study of dementia care in England and The Netherlands
Authors: Kümpers Susanne , Mur Ingrid , Hardy Brian , Maarse Hans , Raak Arno van
Published: June 2006

Knowledge transfer (KT) between specialist and generic services is widely seen as an important strategy for improving the quality of integrated dementia care. This article elaborates on intra‐ and inter‐organizational features associated with successful KT. A provisional conceptual framework is suggested, based on literature about inter‐organizational networks and knowledge management. Professional and organizational cultures, domain perceptions, perceived dependency and the availability of resources are suggested as significant influences upon the motivation and perceived capacity to engage in KT. Personal and organizational continuity is identified as an important process quality. Data from four local case studies in England and The Netherlands are used to develop and specify the provisional framework. A conceptual model is built to explain the relative success or failure of KT. Copyright © 2006 John Wiley & Sons, Ltd.
Patterns of simultaneous polysubstance use in drug using university students
Authors: Barrett Sean P. , Darredeau Christine , Pihl Robert O.
Published: June 2006

Simultaneous polysubstance use (SPU) is a common phenomenon, yet little is known about how various substances are used with one another. In the present study 149 drug‐using university students completed structured interviews about their use of various substances. For each substance ever used, participants provided details about the type, order and amount of all substances co‐administered during its most recent administration. Alcohol, tobacco and cannabis were frequently co‐administered with each other and with all other substances. Chi‐squared tests revealed that when alcohol was used in combination with any of cannabis, psilocybin, MDMA, cocaine, amphetamine, methylphenidate (ps < 0.01) or LSD (p < 0.05) its initial use preceded the administration of the other substance. Paired samples t‐tests revealed that when alcohol was used with cocaine (p < 0.01) or methylphenidate (p < 0.05) it was ingested in greater quantities than when used in their absence. Patterns of cannabis use were not systematically related to other substances administered. Finally, using one‐sample t‐tests, tobacco use was demonstrated to be increased relative to ‘sober’ smoking rates when used with alcohol, cannabis, psilocybin, MDMA, cocaine, amphetamine (ps < 0.001), LSD (p < 0.01) or methylphenidate (p < 0.05). Results suggest that many substances are routinely used in a SPU context and that the pattern in which a substance is used may be related to other substances co‐administered. Copyright © 2006 John Wiley & Sons, Ltd.
The role of a HSV thymidine kinase stimulating substance, scopadulciol, in improving the efficacy of cancer gene therapy
Authors: Hayashi Kyoko , Lee Jung‐Bum , Maitani Yoshie , Toyooka Naoki , Nemoto Hideo , Hayashi Toshimitsu
Published: June 2006

Background

The most extensively investigated strategy of suicide gene therapy for treatment of cancer is the transfer of the herpes simplex virus thymidine kinase (HSV‐TK) gene followed by administration of antiviral prodrugs such as acyclovir (ACV) and ganciclovir (GCV). The choice of the agent that can stimulate HSV‐TK enzymatic activity is one of the determinants of the usefulness of this strategy. Previously, we found that a diterpenoid, scopadulciol (SDC), produced a significant increase in the active metabolite of ACV. This suggests that SDC may play a role in the HSV‐TK/prodrug administration system.

Methods

The anticancer effect of SDC was evaluated in HSV‐TK‐expressing (TK+) cancer cells and nude mice bearing TK+ tumors. In vitro and in vivo enzyme assays were performed using TK+ cells and tumors. The phosphorylation of ACV monophosphate (ACV‐MP) was measured in TK− cell lysates. The pharmacokinetics of prodrugs was evaluated by calculating area‐under‐the‐concentration‐time‐curve values.

Results

SDC stimulated HSV‐TK activity in TK+ cells and tumors, and increased GCV‐TP levels, while no effect of SDC was observed on the phosphorylation of ACV‐MP to ACV‐TP by cellular kinases. The SDC/prodrug combination altered the pharmacokinetics of the prodrugs. In accord with these findings, SDC enhanced significantly the cell‐killing activity of prodrugs. The bystander effect was also significantly augmented by the combined treatment of ACV/GCV and SDC.

Conclusions

SDC was shown to be effective in the HSV‐TK/prodrug administration system and improved the efficiency of the bystander effect of ACV and GCV. The findings will be considerably valuable with respect to the use of GCV in lower doses and less toxic ACV. This novel strategy of drug combination could provide benefit to HSV‐TK/prodrug gene therapy. Copyright © 2006 John Wiley & Sons, Ltd.
Short‐term treatment using insulin‐like growth factor‐1 (IGF‐1) improves life expectancy of the delta‐sarcoglycan deficient hamster
Authors: Serose Armelle , Salmon André , Fiszman Marc Y. , Fromes Yves
Published: June 2006

Background

The hamster strain CHF147 presents a progressive dilated cardiomyopathy (DCM) due to a large deletion of the delta‐sarcoglycan gene that leads to heart failure. This cardiomyopathy induces premature death. We have previously shown that a short‐term treatment using IGF‐1 preserves cardiac structure and improves function of the CHF147 hamster.

Methods

In the current study, we measured long‐term effects of short‐term treatment with recombinant human IGF‐1 (rhIGF‐1) in CHF147 hamsters. CHF147 hamsters (7–8 months old) were implanted under the skin with an osmotic pump filled either with saline or with recombinant human IGF‐1 at a total dose of 25 µg. The osmotic pump allowed a continuous delivery of the protein for a mean duration of 19 days.

Results

We observed a significant increase in overall survival, as well as preservation of cardiac function, in the rhIGF‐1‐treated group. At the time of death, hearts of treated animals did not present any macroscopical or histological differences compared to those of sham hamsters. These results show that rhIGF‐1 treatment slows down the evolution of the DCM in the CHF147 hamster. Moreover, the low dose treatment did not increase IGF‐1 serum levels.

Conclusions

This study is the first one reporting beneficial effects of IGF‐1 treatment on survival of an animal model presenting DCM. Our results raise hopes for a new therapeutic approach of this pathology. Copyright © 2006 John Wiley & Sons, Ltd.
Anatomic study of distally based pedicle compound flaps with nutrient vessels of the cutaneous nerves and superficial veins of the forearm
Authors: Zhang Fa‐Hui , Topp Shelby G. , Zhang Wen‐Ju , Zheng He‐Ping , Zhang Feng
Published: June 2006

The purpose of this study was to describe the anatomic basis for a distally based neurovenovascular pedicle compound flap, with nutrient vessels of the cutaneous nerves and superficial veins of the forearm. In this study, the origins, branches, and anastomoses of nutrient vessels of the cutaneous nerves and superficial veins of the forearm and their relationships with the blood supply of adjacent muscle, bone, and skin were assessed in 96 adult cadavers by perfusion of red gelatin into the superior limb arteries. The results showed that the nutrient vessels of cutaneous nerves and superficial veins of the forearm were found to have multiple origins, consisting of six longitudinal vascular plexuses and one transverse vascular plexus of the forearm, as follows: 1) the anterior‐lateral vascular plexus from cutaneous branches of the radial artery; 2) the anterior‐medialis vascular plexus from cutaneous branches of the ulnar artery; 3) the dorso‐lateral vascular plexus from radial osteal and cutaneous branches; 4) the dorso‐medialis vascular plexus from ulnar osteal and cutaneous branches; 5) the radial vascular plexus from osteal and cutaneous branches of the radial artery, cutaneous branches of the radial artery in the upper wrist, recurrent branches of the styloid process of the radius, and the radialis vascular plexus of cutaneous branches of the tabatière anatomique (anatomical snuffbox); and 6) the ulnar lateral vascular plexus from cutaneous branches of the ulnar artery in the upper wrist and osteal and cutaneous branches. The transverse vascular plexus is composed of dorsal branches of the ulnar and radial arteries. These perforating branches give fascial branches, cutaneous branches, periosteal branches, and nutrient vessels of cutaneous nerves and superficial veins. These results suggest that nutrient vessels of the cutaneous nerves and superficial veins of the forearm have the same origins as those of the nutrient vessels of adjacent muscles, bones, and skin of the forearm, which can be designated as five types of distally based pedicle flaps with nutrient vessels of cutaneous nerves and superficial veins of the forearm, whose rotation point is at the wrist joint. This flap can be applied to repair tissues of distal parts of the hand. © 2006 Wiley‐Liss, Inc. Microsurgery, 2006.