bluuebunny/crossref_metadata_2025 huggingface dataset:
Asymmetrical male-mediated gene flow between harbor seal (Phoca vitulina) populations in Alaska
Authors: Herreman J. K. , Blundell G. M. , McDonald D. B. , Ben-David M.
Published: June 2009

Harbor seals ( Phoca vitulina richardii (Gray, 1864)) in Alaska are currently treated as three distinct management stocks. Previous genetic analyses using mitochondrial DNA suggested that these stocks are differentiated genetically. We studied populations in Glacier Bay (GB; Southeast Alaska Stock), where harbor seals are declining, and Prince William Sound (PWS; Gulf of Alaska Stock), where the population has recently stabilized. Using six pairs of hypervariable microsatellite primers, we determined that these populations are a single panmictic unit with estimated migration rates of 22 animals/generation (PWS to GB) and 63 animals/generation (GB to PWS). The asymmetrical gene flow between GB and PWS is likely driven in part by a recent increase in competitors and predators of seals in GB. In contrast with males, emigration of females from PWS to GB (8.3 seals/generation) is higher than emigration of females from GB to PWS (3.3 seals/generation), likely because females use glacial ice as pupping habitat. Despite the high gene flow, the number of migrants per year (0.02% of the Gulf of Alaska population) is likely too low to influence the demographics of harbor seals in PWS, and the two populations may best be managed as separate stocks.
Foraging behavior and predation success of the sand viper (Cerastes vipera)
Authors: Subach Aziz , Scharf Inon , Ovadia Ofer
Published: June 2009

Activity levels and foraging success of ectotherms are dependent both on extrinsic factors (e.g., ambient temperature) and intrinsic factors (e.g., hunger level). We focus here on activity and foraging of sand vipers ( Cerastes vipera (L., 1758)) (Squamata: Viperidae) in the northwestern Negev desert of Israel. Viper activity is bounded by a specific thermal range, but within this range, temperature does not affect the distance moved. Movement distances are, however, positively correlated with relative humidity. The capture success of lizards, the main prey of this viper, is strongly related both to movement distances of the snake and to the number of the lizard burrows scanned. Body size and shape have a direct effect on the number of burrows scanned and on the number of lizards captured. The increase in capture success with size is probably due to the consequent increase in the range of prey items the sand viper can subdue or handle. Vipers are larger and have a higher mass to length ratio in one of the three study sites, characterized by higher mean annual rainfall and vegetation cover. Finally, females tend to have a higher mass to length ratio than males, which may provide some space within the female body for reproductive materials such as eggs.
Phylogeography of the longnose dace (Rhinichthys cataractae) species group in northwestern North America — the origin and evolution of the Umpqua and Millicoma dace
Authors: McPhail J. D. , Taylor E. B.
Published: June 2009

The Umpqua and Millicoma dace are small cyprinid fishes endemic, respectively, to the Umpqua and Coos rivers on the central coast of Oregon. The origins and relationships of these dace are unclear; however, two hypotheses have been postulated that assume these dace had evolved from a longnose dace ( Rhinichthys cataractae (Valenciennes, 1842)) like ancestor, but from different modes of origin. The direct origin hypothesis postulates that each of these dace originated directly, but independently, from a common ancestor. In contrast, the indirect origin hypothesis postulates that the Umpqua dace originated from a R. cataractae like ancestor and that the Millicoma dace evolved from the Umpqua dace. We used mitochondrial (cytochrome b and control region) sequences to test the two hypotheses. Our maximum likelihood analysis supports the indirect origin hypothesis and argues that together the Umpqua and Millicoma dace form a distinctive Oregon coastal clade within the R. cataractae species group. We also attempt to reconcile this result with the observation that the geographic distribution of the morphologically divergent Umpqua dace is sandwiched between the geographic ranges of the morphologically similar Millicoma dace and longnose dace.
Flexibility in the colouration of the meninx (brain covering) in the guppy (Poecilia reticulata): investigations of potential function
Authors: Gibson R. , Burns J. G. , Rodd F. H.
Published: June 2009

Many organisms can change the apparent colour of their bodies by altering the aggregation of pigment in chromatophores in a process known as physiological colour change. In this study, we investigate a previously unstudied example of physiological colour change, from clear to black, of a brain covering, or meninx, in the guppy ( Poecilia reticulata Peters, 1859). UV protection in bright light was our primary hypothesis for the function of the meningeal colour, with a cost of increased conspicuousness to avian predators selecting for plasticity in the trait. An alternate hypothesis was that this flexible trait could be a physiological by-product of stress. Thus, we investigated the response of meningeal colour to light, stress, and simulated predator attacks, and also whether the black meninx affected conspicuousness to potential predators. Meningeal response to higher light levels did not differ from baseline responses. However, we did find that stress induced a sex-biased, rapid darkening of the meninx; this darkening then declined over time. These results suggest that meningeal blackness could be used as a novel, noninvasive indicator of stress level in guppies. We found no evidence for a role of predation in meningeal colour: meninx colour did not respond to the presence of a predator model and human “predators” detected similar numbers of guppies with black meninges and guppies with clear meninges.
Effect of age on energy storage during prehibernation swarming in little brown bats (Myotis lucifugus)
Authors: McGuire L. P. , Fenton M. B. , Guglielmo C. G.
Published: June 2009

At temperate latitudes insectivorous bats face substantial nutritional demands prior to hibernation. As temperature decreases and availability of insect prey declines, bats must deposit nutrient stores for hibernation. The use of torpor allows bats to limit energy expenditures resulting in a net energy gain despite decreased energy intake. However, subadult bats have lower initial fat stores than adults and may have greater difficulty depositing sufficient nutrient stores to survive the winter. We used plasma metabolite analysis to determine the fueling performance of little brown bats ( Myotis lucifugus (LeConte, 1831)) during swarming to see if subadults compensated for the increased challenges by increased feeding throughout the swarming period. During the period of our study (August and September), adult bats gained mass, while subadults lost mass. There was, however, no difference in nutrient intake of the age groups as indicated by plasma metabolite concentrations. The number of bats using torpor while roosting in the hibernaculum by day increased exponentially coincident with the onset of mating and a decrease in nutrient intake. The results are consistent with wild bats using torpor to minimize energy expenditure and compensate for lower nutrient intake. The difference in mass change for adults and subadults despite the same nutrient intake indicates that subadults incur greater energetic costs.
Activity-based computing for medical work in hospitals
Authors: Bardram Jakob E.
Published: June 2009

Studies have revealed that people organize and think of their work in terms of activities that are carried out in pursuit of some overall objective, often in collaboration with others. Nevertheless, modern computer systems are typically single-user oriented, that is, designed to support individual tasks such as word processing while sitting at a desk. This article presents the concept of Activity-Based Computing (ABC), which seeks to create computational support for human activities. The ABC approach has been designed to address activity-based computing support for clinical work in hospitals. In a hospital, the challenges arising from the management of parallel activities and interruptions are amplified because multitasking is now combined with a high degree of mobility, collaboration, and urgency. The article presents the empirical and theoretical background for activity-based computing, its principles, the Java-based implementation of the ABC Framework, and an experimental evaluation together with a group of hospital clinicians. The article contributes to the growing research on support for human activities, mobility, collaboration, and context-aware computing. The ABC Framework presents a unifying perspective on activity-based support for human-computer interaction.
Go with the flow
Authors: Xu Guoqing , Arnold Matthew , Mitchell Nick , Rountev Atanas , Sevitsky Gary
Published: June 2009

Many large-scale Java applications suffer from runtime bloat. They execute large volumes of methods, and create many temporary objects, all to execute relatively simple operations. There are large opportunities for performance optimizations in these applications, but most are being missed by existing optimization and tooling technology. While JIT optimizations struggle for a few percent, performance experts analyze deployed applications and regularly find gains of 2x or more.

Finding such big gains is difficult, for both humans and compilers, because of the diffuse nature of runtime bloat. Time is spread thinly across calling contexts, making it difficult to judge how to improve performance. Bloat results from a pile-up of seemingly harmless decisions. Each adds temporary objects and method calls, and often copies values between those temporary objects. While data copies are not the entirety of bloat, we have observed that they are excellent indicators of regions of excessive activity. By optimizing copies, one is likely to remove the objects that carry copied values, and the method calls that allocate and populate them.

We introduce
copy profiling
, a technique that summarizes runtime activity in terms of chains of data copies. A flat copy profile counts copies by method. We show how flat profiles alone can be helpful. In many cases, diagnosing a problem requires data flow context. Tracking and making sense of raw copy chains does not scale, so we introduce a summarizing abstraction called the
copy graph
. We implement three clients analyses that, using the copy graph, expose common patterns of bloat, such as finding hot copy chains and discovering temporary data structures. We demonstrate, with examples from a large-scale commercial application and several benchmarks, that copy profiling can be used by a programmer to quickly find opportunities for large performance gains.
Dietary Protein, Weight Loss, and Weight Maintenance
Authors: Westerterp-Plantenga M.S. , Nieuwenhuizen A. , Tomé D. , Soenen S. , Westerterp K.R.
Published: June 2009

The role of dietary protein in weight loss and weight maintenance encompasses influences on crucial targets for body weight regulation, namely satiety, thermogenesis, energy efficiency, and body composition. Protein-induced satiety may be mainly due to oxidation of amino acids fed in excess, especially in diets with “incomplete” proteins. Protein-induced energy expenditure may be due to protein and urea synthesis and to gluconeogenesis; “complete” proteins having all essential amino acids show larger increases in energy expenditure than do lower-quality proteins. With respect to adverse effects, no protein-induced effects are observed on net bone balance or on calcium balance in young adults and elderly persons. Dietary protein even increases bone mineral mass and reduces incidence of osteoporotic fracture. During weight loss, nitrogen intake positively affects calcium balance and consequent preservation of bone mineral content. Sulphur-containing amino acids cause a blood pressure–raising effect by loss of nephron mass. Subjects with obesity, metabolic syndrome, and type 2 diabetes are particularly susceptible groups. This review provides an overview of how sustaining absolute protein intake affects metabolic targets for weight loss and weight maintenance during negative energy balance, i.e., sustaining satiety and energy expenditure and sparing fat-free mass, resulting in energy inefficiency. However, the long-term relationship between net protein synthesis and sparing fat-free mass remains to be elucidated.
Is There a Fatty Acid Taste?
Authors: Mattes Richard D.
Published: June 2009

Taste is a chemical sense that aids in the detection of nutrients and guides food choice. A limited number of primary qualities comprise taste. Accumulating evidence has raised a question about whether fat should be among them. Most evidence indicates triacylglycerol is not an effective taste stimulus, though it clearly contributes sensory properties to foods by carrying flavor compounds and altering texture. However, there is increasing anatomical, electrophysiological, animal behavior, imaging, metabolic, and psychophysical evidence that free fatty acids are detectable when non-taste cues are minimized. Free fatty acids varying in saturation and chain length are detectable, suggesting the presence of multiple transduction mechanisms and/or a nonspecific mechanism in the oral cavity. However, confirmation of “fatty” as a taste primary will require additional studies that verify these observations are taste specific. Oral exposure to free fatty acids likely serves as a warning signal to discourage intake and influences lipid metabolism.
Functional Significance of Zinc-Related Signaling Pathways in Immune Cells
Authors: Haase Hajo , Rink Lothar
Published: June 2009

Recent years have brought a paradigm shift for the role of the essential trace element zinc in immunity. Although its function as a structural component of many enzymes has been known for decades, current experimental evidence points to an additional function of the concentration of free or loosely bound zinc ions as an intracellular signal. The activity of virtually all immune cells is modulated by zinc in vitro and in vivo. In this review, we discuss the interactions of zinc with major signaling pathways that regulate immune cell activity, and the implications of zinc deficiency or supplementation on zinc signaling as the molecular basis for an effect of zinc on immune cell function.
Nutrient Biofortification of Food Crops
Authors: Hirschi Kendal D.
Published: June 2009

Plant-based foods offer an array of nutrients that are essential for human nutrition and promote good health. However, the major staple crops of the world are often deficient in some of these nutrients. Traditional agricultural approaches can marginally enhance the nutritional value of some foods, but the advances in molecular biology are rapidly being exploited to engineer crops with enhanced key nutrients. Nutritional targets include elevated mineral content, improved fatty acid composition, increased amino acid levels, and heightened antioxidant levels. Unfortunately, in many cases the benefits of these “biofortified” crops to human nutrition have not been demonstrated.
Management of the Metabolic Syndrome and Type 2 Diabetes Through Lifestyle Modification
Authors: Magkos Faidon , Yannakoulia Mary , Chan Jean L. , Mantzoros Christos S.
Published: June 2009

Sustainable lifestyle modifications in diet and physical activity are the initial, and often the primary, component in the management of diabetes and the metabolic syndrome. An energy-prudent diet, coupled with moderate levels of physical activity, favorably affects several parameters of the metabolic syndrome and delays the onset of diabetic complications. Weight loss, albeit not an absolute prerequisite for improvement, is a major determinant and maximizes effectiveness. Adopting a healthy lifestyle pattern requires a series of long-term behavioral changes, but evidence to date indicates low long-term adherence to diet and physical activity recommendations. This calls for greater research and public health efforts focusing on strategies to facilitate behavior modification.
Vitamin D Gene Pathway Polymorphisms and Risk of Colorectal, Breast, and Prostate Cancer
Authors: McCullough Marjorie L. , Bostick Roberd M. , Mayo Tinisha L.
Published: June 2009

Higher vitamin D exposure is hypothesized to prevent several cancers, possibly through genomic effects modulated by the vitamin D receptor (VDR), and autocrine/paracrine metabolism of the VDR's ligand, 1α,25-(OH)2-vitamin D. Herein we review the background and evidence to date on associations between polymorphisms in VDR and selected genes in the vitamin D pathway in relation to colorectal, breast, and prostate cancer. Although most studies to date have examined only a few VDR polymorphisms, more are beginning to comprehensively investigate polymorphisms in the VDR as well as in other vitamin D pathway genes, such as the vitamin D–binding protein gene (Gc) and CYP27B1 and CYP24A1, which code for enzymes that, respectively, synthesize and degrade 1α,25-(OH)2-vitamin D. Currently, there is no strong, consistent epidemiologic evidence for substantial influences of single variants in vitamin D pathway genes on risk for colorectal, breast, or prostate cancer, but promising leads are developing.
Vascular cell adhesion molecule-1 expression in human intestinal microvascular endothelial cells is regulated by PI 3-kinase/Akt/MAPK/NF-κB: inhibitory role of curcumin
Authors: Binion David G. , Heidemann Jan , Li Mona S. , Nelson Victoria M. , Otterson Mary F. , Rafiee Parvaneh
Published: June 2009

Endothelial activation and surface expression of cell adhesion molecules (CAMs) is critical for binding and recruitment of circulating leukocytes in tissues during the inflammatory response. Endothelial CAM expression plays a critical role in the intestinal microvasculature in inflammatory bowel disease (IBD), as blockade of leukocyte α4-integrin binding by gut endothelial CAM ligands has therapeutic benefit in IBD. Mechanisms underlying expression of vascular cell adhesion molecule (VCAM)-1, a ligand for α4-integrin in primary cultures of human intestinal microvascular endothelial cells (HIMEC) has not been defined. We investigated the effect of curcumin, phosphatidylinositol 3-kinase (PI 3-kinase)/protein kinase B (Akt), and mitogen-activated protein kinase (MAPK) inhibitors on VCAM-1 expression and function in HIMEC. CAM expression was assessed and HIMEC-leukocyte adhesion was visualized under static and flow conditions. Western blotting and in vitro kinase assays were used to assess Akt and MAPK activation. Nuclear factor-κB (NF-κB) activation and nuclear translocation of its p65 subunit were determined. Tumor necrosis factor (TNF)-α/lipopolysaccharide (LPS)-induced VCAM-1 expression in HIMEC was suppressed by Akt small-interfering RNA, curcumin, and inhibitors of NF-κB (SN-50), p38 MAPK (SB-203580) and PI 3-kinase/Akt (LY-294002). VCAM-1 induction was partially suppressed by p44/42 MAPK (PD-098059) but unaffected by c-Jun NH2-terminal kinase (SP-600125) inhibition. Curcumin inhibited Akt/MAPK/NF-κB activity and prevented nuclear translocation of the p65 NF-κB subunit following TNF-α/LPS. At physiological shear stress, curcumin attenuated leukocyte adhesion to TNF-α/LPS-activated HIMEC monolayers. In conclusion, curcumin inhibited the expression of VCAM-1 in HIMECs through blockade of Akt, p38 MAPK, and NF-κB. Curcumin may represent a novel therapeutic agent targeting endothelial activation in IBD.
Progress and future challenges in stem cell-derived liver technologies
Authors: Dalgetty Donna M. , Medine Claire N. , Iredale John P. , Hay David C.
Published: June 2009

The emergence of regenerative medicine has led to significant advances in the identification and understanding of human stem cells and adult progenitor cells. Both cell populations exhibit plasticity and theoretically offer a potential source of somatic cells in large numbers. Such a resource has an important role to play in the understanding of human development, in modeling human disease and drug toxicity, and in the generation of somatic cells in large numbers for cell-based therapies. Presently, liver transplantation is the only effective treatment for end-stage liver disease. Although this procedure can be carried out with high levels of success, the routine transplant of livers is severely limited by organ donor availability. As a result, attention has focused on the ability to restore liver mass and function by alternative approaches ranging from the bioartificial device to transplantation of human hepatocytes. In this review we will focus on the generation of human hepatic endoderm from different stem/progenitor cell populations with a view to its utility in regenerative medicine.
Stimulation of incretin secretion by dietary lipid: is it dose dependent?
Authors: Yoder Stephanie M. , Yang Qing , Kindel Tammy L. , Tso Patrick
Published: June 2009

After the ingestion of nutrients, secretion of the incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) by the enteroendocrine cells increases rapidly. Previous studies have shown that oral ingestion of fat stimulates secretion of both incretins; however, it is unclear whether there is a dose-dependent relationship between the amount of lipid ingested and the secretion of the hormones in vivo. Recently, we found a higher concentration of the incretin hormones in intestinal lymph than in peripheral or portal plasma. We therefore used the lymph fistula rat model to test for a dose-dependent relationship between the secretion of GIP and GLP-1 and dietary lipid. Under isoflurane anesthesia, the major mesenteric lymphatic duct of male Sprague-Dawley rats was cannulated. Each animal received a single, intraduodenal bolus of saline or varying amounts of the fat emulsion Liposyn II (0.275, 0.55, 1.1, 2.2, and 4.4 kcal). Lymph was continuously collected for 3 h and analyzed for triglyceride, GIP, and GLP-1 content. In response to increasing lipid calories, secretion of triglyceride, GIP, and GLP-1 into lymph increased dose dependently. Interestingly, the response to changes in intraluminal lipid content was greater in GLP-1- than in GIP-secreting cells. The different sensitivities of the two cell types to changes in intestinal lipid support the concept that separate mechanisms may underlie lipid-induced GIP and GLP-1 secretion. Furthermore, we speculate that the increased sensitivity of GLP-1 to intestinal lipid content reflects the hormone's role in the ileal brake reflex. As lipid reaches the distal portion of the gut, GLP-1 is secreted in a dose-dependent manner to reduce intestinal motility and enhance proximal fat absorption.
The effect of denervation on protein synthesis and degradation in adult rat diaphragm muscle
Authors: Argadine Heather M. , Hellyer Nathan J. , Mantilla Carlos B. , Zhan Wen-Zhi , Sieck Gary C.
Published: June 2009

Previous studies showed that unilateral denervation (DNV) of the rat diaphragm muscle (DIAm) results in loss of myosin heavy chain protein by 1 day after DNV. We hypothesize that DNV decreases net protein balance as a result of activation of the ubiquitin-proteasome pathway. In DIAm strips, protein synthesis was measured by incorporation of3H-Tyr, and protein degradation was measured by Tyr release at 1, 3, 5, 7, and 14 days after DNV. Total protein ubiquitination, caspase-3 expression/activity, and actin fragmentation were analyzed by Western analysis. We found that, at 3 days after DNV, protein synthesis increased by 77% relative to sham controls. Protein synthesis remained elevated at 5 (85%), 7 (53%), and 14 days (123%) after DNV. At 5 days after DNV, protein degradation increased by 43% relative to sham controls and remained elevated at 7 (49%) and 14 days (74%) after DNV. Thus, by 5 days after DNV, net protein balance decreased by 43% compared with sham controls and was decreased compared with sham at 7 (49%) and 14 days (72%) after DNV. Protein ubiquitination increased at 5 days after DNV and remained elevated. DNV had no effect on caspase-3 activity or actin fragmentation, suggesting that the ubiquitin-proteasome pathway rather than caspase-3 activation is important in the DIAm response to DNV. Early loss of contractile proteins, such as myosin heavy chain, is likely the result of selective protein degradation rather than generalized protein breakdown. Future studies should evaluate this selective effect of DNV.
Laparoskopische Lymphonodektomie: Technik und Ergebnisse
Authors: Fleisch Markus C. , Rein Daniel T.
Published: June 2009

Seit etwa 20 Jahren erfährt die Technik der laparoskopischen pelvinen und paraaortalen Lymphonodektomie eine zunehmende Popularität als Bestandteil minimalinvasiver operativer Behandlungskonzepte von Patientinnen mit gynäkologischen Tumorerkrankungen. Insbesondere Patientinnen mit frühem Zervix- und Endometriumkarzinom können unter der Voraussetzung gleicher chirurgischer Radikalität die bekannten Vorteile eines minimalinvasiven Behandlungsmodus in Anspruch nehmen. Die publizierten Machbarkeits- und Fall-Kontroll-Studien suggerieren vergleichbare Radikalitätskenngrössen, wie z.B. die Zahl entfernter Lymphknoten, zeigen aber auch potenzielle Vorteile wie einen geringeren intraoperativen Blutverlust, eine geringere stationäre Verweildauer und postoperative Komplikationsrate gegenüber dem konventionellen Verfahren auf. Verlässliche Daten zum Langzeitüberleben aus prospektiv randomisierten Studien stehen noch aus, sind aber für die nahe Zukunft zu erwarten.
Stellenwert der Laparoskopie in der gynäkologischen Onkologie: Grenzen bei Adnexbefunden
Authors: Wimberger Pauline , Kimmig Rainer
Published: June 2009

In den letzten Jahrzehnten haben Bedeutung und Einsatz der operativen Laparoskopie (LSK) bei benignen Adnextumoren rasant zugenommen. Die operative Entfernung von Ovarialmalignomen im Frühstadium per LSK bleibt allerdings umstritten. Diese Übersichtsarbeit soll die Datenlage zur Wertigkeit der LSK in der Adnexchirurgie und im Speziellen bei Malignomen evaluieren. Die Morbidität der LSK ist sicherlich geringer, das Risiko besteht in einem möglicherweise eingeschränkteren Staging, der Eröffnung des Tumors und dem Auftreten von Portmetastasen. Die Analyse zeigte, dass der Standardzugangsweg bei Ovarialmalignomen auch weiterhin die Laparotomie per Längsschnitt ist, da die Datenlage für die LSK sehr spärlich ist und prospektive, randomisierte Studien für die Frühstadien eines Ovarialkarzinoms fehlen. Ein laparoskopisches Staging ist technisch möglich, aber es gibt bislang keinen Beleg der Sicherheit.
Refractory Epilepsy: A Clinically Oriented Review
Authors: Beleza Pedro
Published: June 2009

About one third of patients with newly diagnosed epilepsy do not achieve seizure control despite medical therapy and should be assessed in detail to confirm the diagnosis, to determine the epilepsy syndrome and to plan treatment strategy. Refractory epilepsy is established when there is inadequate seizure control despite using potentially effective antiepileptic drugs (AEDs) at tolerable levels for 1–2 years, and excluding nonepileptic events and poor compliance. An overview of patient management in everyday clinical practice is given. Risk factors for refractoriness include (1) generalized epilepsy with lesions; (2) focal epilepsy with hippocampal sclerosis, cortical dysplasia or hemorrhages; (3) early epilepsy onset; (4) high seizure frequency; (5) absence of response to the first 2 AEDs; (6) high frequency of interictal spikes, and (7) multifocal spikes. The efficacy of surgery ranges from curative (resection) to palliative (vagus nerve stimulation, callosotomy, multiple subpial transections) depending on the epilepsy syndrome and etiology. Using a new antiepileptic drug benefits about one third of patients. Refractoriness is constitutive in most patients and shows a progressive or remission-relapse course in others. As the transporter and target hypotheses do not entirely explain refractoriness, other hypotheses are emerging. New treatments under investigation are described.
Characteristics and the Fate of Intraluminal Thrombus of the Intracranial and Extracranial Cerebral Arteries in Acute Ischemic Stroke Patients
Authors: Choi Hye-Yeon , Ye Byoung Suk , Ahn Seong Hwan , Cho Hyun Ji , Kim Dong-Joon , Kim Seung Min , Heo Ji Hoe
Published: June 2009

Background: The characteristics and fate of intraluminal thrombus (IT), which may incidentally be detected in acute stroke patients, are not well known and the optimal treatment strategy for IT remains controversial. Methods: We have identified patients with IT in either the extracranial or intracranial artery and followed up on their clinical courses and imaging findings. We categorized it based on its morphology and investigated clinical outcomes and fate of IT in those patients. Results: Among 495 patients with acute ischemic stroke, 9 (1.9%, 8 men, age range of 61–84 years) were identified with IT. Patients with IT could be categorized into three groups: a filling defect (4) during digital subtraction angiography (DSA), a stenosis-mimic lesion on DSA (3), and a mobile mass on carotid duplex (2). All patients had follow-up vascular imaging studies. Complete or partial resolution of IT was seen in 8 patients. Four patients developed transient or minor ischemic symptoms, which were potentially related to IT. Stenosis-mimic lesions and IT adjacent to atherosclerotic plaques appeared to be associated with unstable clinical courses. Conclusions: IT can be categorized according to its morphological features. The outcome may depend on the morphology and location of the IT.
Coping Strategy and Anxiety Evolution in Multiple Sclerosis Patients Initiating Interferon-Beta Treatment
Authors: Moreau Thibault , Schmidt Nicolas , Joyeux Olivier , Bungener Catherine , Souvignet Véronique
Published: June 2009

This study (ACSEPT) aimed to assess anxiety evolution according to coping strategy in patients with multiple sclerosis (MS) during their first months of treatment with interferon (IFN)-β1a. Recently diagnosed relapsing-remitting MS (RRMS) patients (n = 255) were included and received standardized information on MS. At inclusion, the preferred coping mode was determined using the Coping Inventory for Stressful Situations (CISS). Anxiety and depression were assessed at inclusion and after 3 months using the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory, respectively. At inclusion, the preferred coping strategy was task-oriented for most patients (53%), 51% were considered as anxious, and the mean Beck depression score was low. Emotion-oriented patients were more anxious and more depressed than the 2 other coping groups (task- and avoidance-oriented). During the first 3 months of IFN treatment, the anxiety level slightly decreased in the total population, more intensively in the emotion-oriented group, and there were no clinically significant changes in the Beck depression score. Anxiety and depression remained stable or decreased during the first 3 months of IFN treatment, depending on coping strategy. Identifying these coping strategies during therapy initiation may allow customized support and improve treatment adherence.
Is There an Association between the Level of High-Sensitivity C-Reactive Protein and Idiopathic Parkinson’s Disease? A Comparison of Parkinson’s Disease Patients, Disease Controls and Healthy Individuals
Authors: Song In-Uk , Kim Joong-Seok , Chung Sung-Woo , Lee Kwang-Soo
Published: June 2009

Background: High-sensitivity C-reactive protein (hs-CRP) is a sensitive systemic marker of inflammation, and increased levels of hs-CRP are associated with inflammatory reactions. Microglia-mediated neuroinflammation has been hypothesized to play an important role in the pathogenesis of idiopathic Parkinson’s disease (PD). However, the clinical value of hs-CRP in PD is poorly defined. Therefore, we conducted this study to investigate the clinical value of hs-CRP in patients with PD. Methods: We examined 212 patients with de novo PD, 253 patients with acute ischemic cerebrovascular disease and 119 healthy subjects and investigated the differences in hs-CRP among these 3 groups. The PD group was classified into 4 subgroups according to the Hoehn and Yahr stage to investigate the relationship between hs-CRP and symptom severity. Results: There was no significant difference in the hs-CRP value between the PD and the ischemic cerebrovascular disease groups, but the subjects in the 2 disease groups demonstrated higher hs-CRP levels than those in the normal control group. A post-hoc analysis of the 4 PD subgroups showed no significant differences in hs-CRP values. In addition, this study demonstrated that the odds ratio of the PD group by hs-CRP was 2.037 (95% CI 1.180–3.517; p = 0.011). Conclusion: We suggest that our results could support the hypothesis that neuroinflammation contributed to the pathogenesis of PD and cautiously assume that elevated hs-CRP might have a clinical value as a risk factor for PD.
Impact of Subthalamic Stimulation and Medication on Proximal and Distal Bradykinesia in Parkinson’s Disease
Authors: Pötter-Nerger M. , Wenzelburger R. , Deuschl G. , Volkmann J.
Published: June 2009

Objective: To evaluate the usefulness of a new instrument for bedside testing of proximal arm and distal finger tapping performance in patients with Parkinson’s disease (PD). Methods: Twenty healthy controls and 25 PD patients with subthalamic nucleus deep brain stimulation were investigated in different treatment conditions using three different tapping paradigms: (1) the standard tapping task of the CAPSIT-PD-protocol; (2) alternate pressing of two buttons on the new board by moving the arm at the elbow and shoulder (proximal tapping), and (3) alternate pressing of two closely collocated buttons on the new board by moving only the index finger (distal tapping) for 30 s. Results: The new tapping board was as sensitive as the standard board to distinguish untreated PD patients from controls. The relative improvements in tapping scores from the off treatment condition were largest for the proximal tapping task. The treatment effects of high frequency stimulation of the subthalamic nucleus or medication alone were comparable, whereas the combined treatment induced significantly higher tapping scores. Conclusion: The new tapping board represents a quick and easy to use bedside test, which may be routinely used to probe the efficacy of treatments on different aspects of motor control.
Temperament and Melancholic Type: Path Analysis of a Prospective Study of Depressive Mood Change in a Nonclinical Population
Authors: Sakai Yoshie , Akiyama Tsuyoshi , Kawamura Yoshiya , Matsumoto Satoko , Tominaga Maki , Kurabayashi Lumie , Miyake Yuko , Akiskal Kareen , Akiskal Hagop
Published: June 2009

Background: Recent studies suggest that mood-disorder-related personality traits predict depressive mood changes (DMC) in nonclinical populations. Sampling and Methods: In this study we examined the predictability of DMC in a nonclinical sample consisting of 351 Japanese company employees, with temperament and melancholic type personality as measured by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego and the Munich Personality Test. We also analyzed the mediating roles of dysfunctional attitudes and coping styles. Subjects were assessed for depressive mood, temperament and personality traits in May 2002 (time 1) and May 2004 (time 2), and dysfunctional attitudes and coping styles at time 2. Results and Conclusion: Results of hierarchical multiple regressions showed that depressive, cyclothymic and hyperthymic temperaments and melancholic type at time 1 significantly predicted DMC from time 1 to time 2, after controlling for demographic variables and the level of depressive mood at time 1. Path analysis results showed that depressive, cyclothymic and hyperthymic temperaments and melancholic type significantly predicted DMC, a certain part of the influence of depressive, cyclothymic and hyperthymic temperaments and melancholic type was significantly mediated via coping styles and that the influence of melancholic type was also mediated via dysfunctional attitudes. These findings provide clues for the targeting of interventions.
Gender Differences in Axis I and Axis II Comorbidity in Patients with Borderline Personality Disorder
Authors: Tadić André , Wagner Stefanie , Hoch Julia , Başkaya Ömür , von Cube Robert , Skaletz Christian , Lieb Klaus , Dahmen Norbert
Published: June 2009

Background/Aims: Differences in the clinical presentation of men and women with borderline personality disorder (BPD) are of potential interest for investigations into the neurobiology, genetics, natural history, and treatment response of BPD. The purpose of this study was to investigate gender differences in axis I and axis II comorbidity and in diagnostic criteria in BPD patients. Methods: 110 women and 49 men with BPD were assessed with the computer-based version of the Munich-Composite International Diagnostic Interview and the Structured Clinical Interview for DSM-IV Personality Disorders. Gender differences were investigated for the following outcomes: (a) lifetime, 12-month and 4-week prevalence of axis I disorders; (b) axis II disorders, and (c) DSM-IV BPD diagnostic criteria. Results: With regard to lifetime prevalence of axis I disorders, men more often displayed a substance use disorder, in particular alcohol dependency (65 vs. 43%); on the other hand, women more frequently had an affective (94 vs. 82%), anxiety (92 vs. 80%) or eating disorder (35 vs. 18%), in particular anorexia nervosa (21 vs. 4%). Regarding the 12-month prevalence, we found significantly more women suffering from anorexia nervosa (13 vs. 0%). Considering the 4-week prevalence, there were no significant gender differences. With regard to axis II disorders, men had a higher frequency of antisocial personality disorder (57 vs. 26%). Regarding the BPD diagnostic criteria, men more often displayed ‘intensive anger’ (74 vs. 49%), whereas women more frequently showed ‘affective instability’ (94 vs. 82%). Conclusion: In this German study, we could replicate and extend the findings from previous US studies, where men and women with BPD showed important differences in their pattern of psychiatric comorbidity. The implications for clinicians and researchers are discussed.
Formal Thought Disorder, Neuropsychology and Insight in Schizophrenia
Authors: Barrera Álvaro , McKenna Peter J. , Berrios German E.
Published: June 2009

Background: Information provided by patients with schizophrenia and their respective carers is used to study the descriptive psychopathology and neuropsychology of formal thought disorder (FTD). Sampling and Methods: Relatively intellectually preserved schizophrenia patients (n = 31) exhibiting from no to severe positive FTD completed a self-report scale of FTD, a scale of insight as well as several tests of executive and semantic function. The patients’ carers completed another scale of FTD to assess the patients’ speech. Results: FTD as self-reported by patients was significantly associated with the synonyms test performance and severity of the reality distortion dimension. FTD as assessed by a clinician and by the patients’ carers was significantly associated with executive test performance and performance in a test of associative semantics. Overall insight was significantly associated with severity of the reality distortion dimension and graded naming test performance, but was not associated with self-reported FTD or severity of FTD as assessed by the clinician or carers. Conclusions: The self-reported experience of FTD has different clinical and neuropsychological correlates from those of FTD as assessed by clinicians and carers. The assessment of FTD by patients and carers used along with the clinician’s assessment may further the study of this group of symptoms.
Validation of a German Version of the Confusion Assessment Method for Delirium Detection in a Sample of Acute Geriatric Patients with a High Prevalence of Dementia
Authors: Hestermann Ute , Backenstrass Matthias , Gekle Irene , Hack Markus , Mundt Christoph , Oster Peter , Thomas Christine
Published: June 2009

Objectives: To assess validity and interrater reliability of an operationalized German version of the Confusion Assessment Method (CAM) in geriatric patients with comorbid dementia and high delirium risk. Design: Prospective cross-sectional cohort study with double CAM assessment by a medical and nonmedical rater. Setting: Random sample of frail, cognitively impaired elderly with acute disease requiring hospital care. Participants: A total of 39 frail elderly, mean age 83 ± 7 years, 72% (n = 28) female, with cognitive impairments, a high prevalence of dementia (86%, n = 33) and a significant risk of delirium. Of these, 13 revealed delirium, which was superimposed on dementia in 11. Measurements: A translated and operationalized version of the CAM was validated against a neuropsychiatric and geriatric consensus reference standard based on DSM-IV. Additional measures included the Short Portable Mental Status Questionnaire, the Mini-Mental State Examination and the Delirium Index for cognitive impairment severity, the Informant Questionnaire on Cognitive Decline for dementia diagnosis and the Barthel Index, illness severity (Cumulative Illness Rating Scale) and medication. Results: Delirium was correctly detected by CAM algorithm in 10 out of 13 delirious patients resulting in a high sensitivity of 0.77 and a specificity of 0.96–1.00 for both raters. Likelihood ratio revealed an almost 20-fold risk of delirium with positive CAM testing. Interrater reliability was excellent with a Cohen’s ĸ of 0.95 (CI 0.74–1.0) for the algorithm, single items’ ĸ values varied between 0.5 and 1. Conclusions: The German CAM is a reliable and valid measure of delirium, even in frail, acutely diseased elderly with concomitant dementia.
A Case Report of Intraventricular Gliofibroma
Authors: Sarkar Rajashree , Yong William H. , Lazareff Jorge A.
Published: June 2009

Gliofibroma is a rare tumor with biphasic morphology. We report a case of a 3-month-old girl presenting with increasing head circumference. CT and MRI showed the presence of a large heterogeneous, nonenhancing tumor filling the atria and bodies of the lateral ventricles with caudal extension into the third ventricle. Hydrocephalus was noted. A biopsy was performed and pathology showed the presence of glial and collagenous tissue consistent with the diagnosis of gliofibroma. However, no mitosis or necrosis was seen. Immunohistochemistry was positive for glial fibrillary acid protein, Masson trichrome and reticulin. The patient was followed up for a period of 10 years. Recent MRI showed stable appearance of the tumor and clinically the patient is neurologically intact with normal cognitive development. Our case report has the longest follow-up so far reported in the literature, of 10 years. As evident from our case report, we recommend a conservative treatment approach for gliofibroma with benign histology.
Hearing Loss Attributable to a Cerebellopontine-Angle Arachnoid Cyst in a Child
Authors: Messerer Mahmoud , Nouri Mustapha , Diabira Sylma , Morandi Xavier , Hamlat Abderrahmane
Published: June 2009

Although hearing loss in newborns and infants is predominantly due to malformations and infections, there are other situations which may compromise hearing quality in later stages, including posterior-fossa arachnoid cysts (ACs). We report the case of an 8-year-old girl who presented with hearing loss linked to a pontocerebellar-angle AC which had been diagnosed and treated when she was 14 months old. The pathophysiology of this late AC complication is discussed. This case reminds us that a close follow-up with audiologic monitoring and/or brain stem auditory evoked response is necessary in children with posterior-fossa AC because modern neuroradiological imaging methods do not inform about cerebral and nerve functions, although they provide excellent morphological details of ACs and have improved the ease and accuracy of their early diagnosis. Therefore, surgery should be performed before complete hearing loss occurs; however, in hearing-impaired patients, it remains unclear which surgical treatment is most appropriate.
Few Isolated Neurons in Hypothalamic Hamartomas May Cause Gelastic Seizures
Authors: Waldau Ben , McLendon Roger E. , Fuchs Herbert E. , George Timothy M. , Grant Gerald A.
Published: June 2009

Hypothalamic hamartomas (HHs) are congenital, benign masses in the hypothalamus and tuber cinereum that may cause central precocious puberty and gelastic seizures. Nodules of small neurons are thought to be a universal feature of the microarchitecture of HH lesions associated with epilepsy. Here we describe the case of a 5-year-old boy with gelastic seizures who underwent resection of a HH that contained nodules of glial cells, but only few, randomly distributed neurons. HHs that contain few or no neurons have only been reported thus far in cases associated with precocious puberty. This case demonstrates that few solitary neurons in HHs can drive the development of gelastic seizures, and nodules of small neurons may not be a universal feature of HHs associated with epilepsy. This finding is clinically important since hypothalamic hamartomas with rare neurons can easily be misdiagnosed as pilocytic astrocytomas or subependymomas if their presence is overlooked. A neuronal stain is helpful in making the correct diagnosis in these cases.
Primary Disseminated Intradural Malignant Peripheral Nerve Sheath Tumor of the Spine in a Child: Case Report and Review of the Literature
Authors: Chamoun Roukoz B. , Whitehead William E. , Dauser Robert C. , Luerssen Thomas G. , Okcu M. Fatih , Adesina Adekunle M. , Jea Andrew
Published: June 2009

The authors report a rare case of primary disseminated intradural malignant peripheral nerve sheath tumor (MPNST) of the spine in a 5-year-old child without neurofibromatosis type I (NF-I). This child presented with abdominal pain and gait disturbance. MRI revealed a large intradural extramedullary tumor at C4–5 with dissemination to the thoracic spine, cauda equina and leptomeninges. Following a 2-level cervical laminectomy, the tumor was biopsied and debulked. Based on pathological and immunohistological findings, the tumor was diagnosed as an MPNST. Because of the rarity of this pathological entity, a review of the literature was performed. The reported clinical outcomes for adult and pediatric patients with intradural MPNST are very poor. No established standard for the treatment of these tumors exists. We report the first pediatric case – without or with NF-I – of disseminated intradural MPNST primarily localized proximal to the conus medullaris. It must always be considered in the differential diagnosis for intradural extramedullary tumors of the pediatric spine, along with neurofibromas and schwannomas, even in children without NF-I.
Malignant Rhabdoid Tumor of the Spine in an Infant: Case Report and Review of the Literature
Authors: Fridley Jared S. , Chamoun Roukoz B. , Whitehead William E. , Curry Daniel J. , Luerssen Thomas G. , Adesina Adekunle , Jea Andrew
Published: June 2009

Malignant rhabdoid tumors of the spine are rare pediatric neoplasms that have a poor prognosis. The histological, ultrastructural, and immunohistochemical features are essential elements used in their diagnosis. We report the case of a malignant rhabdoid tumor of the cervical spine in a 13-month-old infant. Tumor cells were vimentin positive with prominent nucleoli indented by eosinophilic cytoplasmic inclusions containing intermediate filaments. INI1 immunostaining was negative. This patient was operated on twice for symptomatic spinal cord compression. Despite chemotherapy, she developed worsening leptomeningeal dissemination, lower cranial nerve dysfunction, and hydrocephalus that did not respond to CSF diversion. She died 4 months after initial diagnosis. We review the literature on spinal malignant rhabdoid tumor and discuss the nomenclature, pathology, radiology, treatment, and outcomes of this rare entity.