bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful endovascular and surgical treatment of spinal extradural metameric arteriovenous malformation
Authors: Fairhall Jacob M. , Reddy Rajesh , Sears William , Wenderoth Jason D. , Stoodley Marcus A.
Published: December 2010

A report of successful combined endovascular and surgical management of an unusual case of metameric (juvenile) spinal arteriovenous malformation (AVM) is presented. The malformation had extradural and paraspinal components, but no intradural elements. It had caused rapid neurological deterioration to near-complete paraplegia prior to treatment (American Spinal Injury Association [ASIA] Grade C). A combination of endovascular occlusion of major feeding vessels and excision of the malformation resulted in a complete neurological recovery (ASIA Grade E). The authors conclude that selected metameric AVMs can be successfully treated with multimodal therapy. This case further illustrates the fact that not all spinal vascular malformations are easily categorized.
A look at Mayan artificial cranial deformation practices: morphological and cultural aspects [RETRACTED]
Authors: Romero-Vargas Samuel , Ruiz-Sandoval José Luis , Sotomayor-González Arturo , Revuelta-Gutiérrez Rogelio , Celis-López Miguel Angel , Gómez-Amador Juan Luis , García-González Ulises , López-Serna Raul , García-Navarro Victor , Mendez-Rosito Diego , Correa-Correa Victor , Gómez-Llata Sergio
Published: December 2010

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.
History of the Kleeblattschädel deformity: origin of concepts and evolution of management in the past 50 years
Authors: Manjila Sunil , Chim Harvey , Eisele Sylvia , Chowdhry Shakeel A. , Gosain Arun K. , Cohen Alan R.
Published: December 2010

The history and evolution of surgical strategies for the treatment of Kleeblattschädel deformity are not well described in the medical literature. Kleeblattschädel anomaly is one of the most formidable of the craniosynostoses, requiring a multidisciplinary team for surgical treatment. The initial descriptions of this cloverleaf deformity and the evolution of surgical treatment are detailed in the present report. Two illustrative cases of Kleeblattschädel deformity, syndromic and nonsyndromic craniosynostoses treated by the senior authors, are also described along with insights into operative strategies.
The value of preoperative and intraoperative electromyography in the management of obstetric brachial plexus injury
Authors: Chin Kuen F. , Di Mascio Livio , Holmes Karen , Misra V. Peter , Sinisi Marco M.
Published: December 2010

The treatment of obstetric brachial plexus palsy (OBPP) with neuroma-in-continuity is controversial. The recent literature advocates excision of neuroma-in-continuity in OBPP and repair with nerve graft irrespective of its neurophysiological conductivity. This approach risks sacrificing the regenerating axons, and the result has not yet been proven to be superior to neurolysis alone. In this case report, the authors aim to outline their strategy of using the combination of preoperative and intraoperative clinical and neurophysiological findings to aid their decision making.

The lack of upper trunk recovery and the unfavorable preoperative neurophysiological findings in a child with Narakas Group 4 OBPP at 5 months of age prompted an urgent exploration with the intention of performing neurotization. This procedure was abandoned and neurolysis was performed due to the favorable intraoperative neurophysiological findings. At 4 years of age, the child scored 12 of 15 on Mallet classification and has an excellent range of movement. No secondary operation was needed. The authors hope to highlight the idea that the surgical option for neurolysis alone should be kept open and that intraoperative electromyography can be a valuable tool to add to the surgeon's armamentarium.
Intramedullary spinal immature teratoma: resolution of quadriplegia following resection in a 4-week-old infant
Authors: Nickols Hilary Highfield , Chambless Lola B. , Carson Robert P. , Coffin Cheryl M. , Pearson Matthew M. , Abel Ty W.
Published: December 2010

Intramedullary spinal cord teratomas are rare entities in infants. Management of these lesions is primarily surgical, with outcome dependent on rapid surgical decompression and complete gross-total tumor resection. The lesions are typically of the mature type, with immature teratomas displaying unique pathological features. The authors report a case of an extensive intramedullary immature teratoma in an infant with resolution of quadriplegia following grosstotal radical resection. At the 1-year follow-up, there was radiographic evidence of tumor, and surgical reexploration yielded portions of immature teratoma and extensive gliosis.
Minimally invasive endoscopic transventricular hemispherotomy for medically intractable epilepsy: a new approach and cadaveric demonstration
Authors: Bahuleyan Biji , Manjila Sunil , Robinson Shenandoah , Cohen Alan R.
Published: December 2010

Object

Surgery for medically intractable epilepsy secondary to unihemispheric pathology has evolved from more aggressive hemispherectomy to less aggressive variations of hemispherotomy. The authors propose a novel minimally invasive endoscopic hemispherotomy that should give results comparable to conventional open craniotomy and microsurgery.

Methods

Endoscopic transventricular hemispherotomy was performed in 5 silicon-injected cadaveric heads in the authors' minimally invasive neurosurgery laboratory. The lateral ventricle was accessed endoscopically through a frontal and occipital bur hole. White matter disconnections were performed to unroof the temporal horn and to disconnect the frontobasal region, corpus callosum, and fornix.

Results

Using an endoscopic transventricular approach, all white matter disconnections were successfully performed in all 5 cadavers.

Conclusions

The authors have demonstrated the feasibility of endoscopic transventricular hemispherotomy in a cadaveric model. The technique is simple and could be useful in a subgroup of patients with parenchymal volume loss and ventriculomegaly.
Cerebral paragonimiasis that manifested as intracranial hemorrhage
Authors: Chen Jingyu , Chen Zhi , Li Fei , Lin Jiangkai , Meng Hui , Feng Hua
Published: December 2010

Object

The purpose of this study was to review 14 rare cases of cerebral paragonimiasis that first manifested as intracranial hemorrhage (ICH), and to investigate the characteristics of clinical manifestation, diagnosis, and treatment of the disease.

Methods

The authors have encountered 14 cases of cerebral paragonimiasis in patients between the ages of 6 and 16 years (mean age 11.5 years) who presented with sudden headache, nausea, and vomiting. Three of them were affected with varying degrees of limb hemiplegia, and in 1 this was combined with high fever; the blood eosinophil count and enzyme-linked immunosorbent assay showed positive results too. The ICHs were observed with cranial CT and MR imaging, and lung lesions were also detected in 5 cases on chest CT scans. Ten of the diagnosed cases were treated with oral praziquantel. Three of these patients were given carbamazepine from the beginning of parasiticidal treatment to prevent seizures; 4 of the remaining 7 patients experienced epileptic seizures during the treatment process. Four patients needed surgery to remove the lesions, and these individuals received praziquantel treatment right after the surgery.

Results

Pathological examinations demonstrated eosinophilic granuloma in these patients. There was no disease recurrence or epilepsy in 11–40 months of follow-up; however, mild hemiplegia could still be observed in 2 cases after 12 months and 17 months of follow-up.

Conclusions

The possibility of cerebral paragonimiasis should be considered when ICH is detected in young patients who are either from an endemic area or have recently visited such an area; the relatively small amount of hemorrhage in cerebral paragonimiasis is often represented as small lesions surrounded by disproportionately larger edema on the imaging study. Preventive antiepileptic drugs should be used along with the administration of parasiticide.
Maternal Socioeconomic and Nutritional Determinants of Low Birth Weight in Urban area of Bangladesh
Authors: Matin A , Azimul SK , Matiur AKM , Shamianaz S , Shabnam JH , Islam T
Published: December 2010

Objectives: Globally about 15.5% of all births are born with low birth weight (LBW) and in Bangladesh, LBW rate is quite high. The present study was conducted to determine the socioeconomic and nutritional factors affecting LBW in urban community of Bangladesh.Methods: This case control study was done at Department of Obstetrics & Gynaecology of Shaheed Suhrawardy Medical College Hospital, Dhaka. Normally delivered singleton live births babies from January 2003 to January 2005 were selected purposively and after enrollment all newborns birth weight was measured. Then from the total (N=583) study populations childmother pairs formed and were divided in LBW group (n=135) and NBW group (n=448). Data were collected regarding maternal socioeconomic and nutritional factors by interviewing the mothers and family members. Variables were analyzed to find out significant maternal factors affecting LBW.Results: The LBW incidences in this study was found 23.2%. And 51.1% of the LBW came from the mother of <20year of age group, 50% mothers of LBW were found illiterate, socioeconomic status was significantly more poor, maternal anaemia was found significantly more common in LBW and iron & vitamin supplementation during pregnancy were found significantly less among the mothers of LBW babies in comparison to NBW. Significant relationship was found between early maternal age, poor educational and socioeconomic status, anaemia, iron & vitamin supplementation during pregnancy with LBW. No relationship was found between LBW and maternal height but significant relationship was found with maternal weight and BMI.Conclusion: These findings suggest that selectively targeted interventions such as delay age at first pregnancy (at >20 year of age), improving maternal education and nutrition, iron and vitamin supplementation can prevent LBW in Bangladesh.. Key words: LBW (Low Birth Weight); NBW (Normal Birth Weight); IUGR(intrauterine growth retardation). DOI: 10.3329/jdmc.v17i2.6588J Dhaka Med Coll. 2008; 17(2) : 83-87
Role of Crush Cytology for the Detection of Helicobacter Pylori in Gastroduodenal Diseases
Authors: Ahsan K , Hossain MZ , Uddin MR
Published: December 2010

Context: A cross-sectional study was carried out at the Department of Pathology, Dhaka Medical Collage, Dhaka and Immunology Laboratory, Laboratory Sciences Division of ICDDR,B, Dhaka during a period of 1 year from July, 2007 to June, 2008 to determine the efficacy of endoscopic crush cytology in the detection of Helicobacter pylori infection in gastroduodenal diseases. Clinically suspected cases of gastro-duodenal lesions and who had not taken antibiotics, omeprazole or bismuth salts for at least three weeks prior to endoscopy were selected. Patients who were clinically and endoscopically suspected of having malignancy were excluded from the study. A total of 110 such subjects were consecutively included in the study. The statistics used to analyze the data were descriptive statistics and components of accuracy test.Results: The sensitivity of crush cytology in correctly diagnosing H. pylori of those who had the disease was 89.3%, while the specificity of the test in correctly differentiating those who did not have H. pylori was 92.6% when compared against histopathological examination using Giemsa stain. However, a slightly low sensitivity (86.2%) without compromising with specificity (92.3%) was obtained when the crush cytology diagnosis was compared against histopathological examination using haematoxylin-eosin (H & E) stain.Conclusion: The study concludes that the diagnostic accuracy of crush smear cytology (sensitivity and specificity) for detection of Helicobacter pylori in gastric biopsy material is comparable to histopathology. Moreover, the technique is very simple, less expensive and less time consuming which gives clinicians added advantage in making a quicker decision.Key words: Cytology; Helicobacter pylori; Gastroduodenal disease. DOI: 10.3329/jdmc.v17i2.6589J Dhaka Med Coll. 2008; 17(2) : 88-93
Problems Faced By Kith & Kin in Dealing with Their Parents
Authors: Chowdhury SA , Jabeen S
Published: December 2010

Objectives: This study was conducted to find out the problems faced by the kith and kin (children) to deal with their aged parents.Methodology: This cross-sectional descriptive study was conducted among the rural people of Dhamrai, who had either one or both living parents. Data was collected from January to March, 2008.Results: Three hundred respondents were interviewed; the mean age was 33.73 (S.D ±7.27) years. Most of the respondents were Muslims (92%) and male (86%). Majority were day labourer (37.3%), agriculture worker (26%) and businessman (19.3%). Rests were service holders (11.3%) and housewives (9%). The educational levels of the respondents were SSC and above (41%) while 8.6% were illiterate. Mean family size was 5.5 members with mean average monthly income 4173(S.D ±2007.77) taka. Majority of the respondents (58.3%) had their parents living with them and 92% parents were dependant upon them for their living. More than half (56%) respondents had problems due to the presence of their parents in their families. Among them, majority (63%) had financial constrain, others were too busy with occupation (18%), limited space in their houses (10%), due to pressure from family members family members (9%). More financial support (32%), more attention (31%), more honour (20%) were the main expectations from their kith and kin by the parents.Conclusion: The main problems found among the majority (56%) of the respondents were, financial constraint (63%), busy with occupation (18%), limited space at home(10%), and non co-operation from other family members(9%). Key Words: Kith & Kin; Caregivers; Elderly DOI: 10.3329/jdmc.v17i2.6592J Dhaka Med Coll. 2008; 17(2) : 106-110
Multidrug Resistant Typhoid Fever in Children: A Review
Authors: Rahman AKMM , Ahmed M , Begum RS , Ghosh AK , Hossain MZ
Published: December 2010

DOI: 10.3329/jdmc.v17i2.6595J Dhaka Med Coll. 2008; 17(2) : 121-126
Oral Antidiabetic Agents in Gestational Diabetes Mellitus- Shifting of Paradigm?
Authors: Amin MR , Hossain MZ , Miah MT , Yasmin R , Chowdhury MFI , Hoque MA
Published: December 2010

Diabetes mellitus is one of the most common medical complications of pregnancy; gestational diabetes mellitus (GDM) accounts for approximately 90-95% of all cases. The incidence of gestational diabetes is increasing. It has been demonstrated that good metabolic control maintained throughout pregnancy can reduce maternal and fetal complications in diabetes Traditionally, insulin therapy has been considered the gold standard for management There has been a traditional reluctance to recommend oral antidiabetic drugs for the management of hyperglycaemia in gestational diabetes mellitus. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have given a glimse of hope for woman who likes to avoid insulin and prefer oral agents. The current short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst shortterm data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm. This controversy related article gives an overview of the rationale for use of oral antidiabetic agents in the treatment of gestational diabetes. DOI: 10.3329/jdmc.v17i2.6596J Dhaka Med Coll. 2008; 17(2) : 127-130
Endovascular Treatment of Subarachnoid Haemorrhage, First Time at Dhaka Medical College Hospital
Authors: Khan SU , Siddiqui MR , Rahman KM , Hoque MA , Mondol MBA , Daisy S , Habib M , Husain S , Mohammad QD
Published: December 2010

Subarachnoid hemorrhage (SAH) due to rupture aneurysm is a neurologic catastrophe with a very high risk of rebleeding if the aneurysm is not treated. Endovascular coiling has becoming common and has replaced neurosurgical clipping as the treatment of choice. A 48-year-old man came to us with the history of SAH from ruptured cerebral arterial aneurysm and for the first time in the history of Dhaka Medical College Hospital, we had successfully treated by Endovascular coiling. Key words: Subarachnoid haemorrhage (SAH); cerebral DSA; surgical clipping; endovascular coiling. DOI: 10.3329/jdmc.v17i2.6597J Dhaka Med Coll. 2008; 17(2) : 131-133
Jejunogastric Intussusception - Case Series Reporting
Authors: Sarkar MAR
Published: December 2010

Jejunogastric Intussusception is rare but potentially serious complication of gatrojejunostomy or gastrectomy requiring early diagnosis and prompt surgical intervention in acute form of the complication. Upper GI Endoscopy by a familiar person with this rare condition is diagnostic. The clinical picture of acute intestinal obstruction with haematemesis in the back ground of gastrectomy or gastrojejunostomy may make the illusive diagnosis definite and demand surgery to reduce morbidity and mortality of the patients. In our all the 4 cases Upper G I Endoscopy found to be diagnostic. Keywords: Jejunogastric Intussusception; Upper GI Endoscopy; Acute intestinal obstruction. DOI: 10.3329/jdmc.v17i2.6598J Dhaka Med Coll. 2008; 17(2) : 134-137
On Dancing and Fishing: Joy and the Celebration of Fertility Among the Punu of Congo-Brazzaville
Authors: Plancke Carine
Published: December 2010

Among the Punu of Congo-Brazzavilleikokudancing is perceived through the concept of joy. In line with the privileging of the emotional experience, this article intends to consider the dance as an emotive institution – that is, a socially organized activity that creates culturally meaningful forms of emotion within which an understanding of self, as well as social identities and relations, are shaped. Inikoku, a succession of dance sessions, embarked on with shame-banishing pride and performed individually or as a couple, awakens a shared joy. Through the dance patterns and idiom, this joyful dancing is connected to the fecundating sexual encounter and to the activity of fishing, linking the dance world to the life-bearing water spirit world. The joining of sexual differentiation and maternal containment that in this way is enacted and deeply experienced by the participants – if the event succeeds in awakening joy – supports basic structures of Punu rural society characterized by the tension between conjugal relations based on a patri-virilocal principle and matriclanic belonging. The emphasis that our analysis places on the dance form itself, and on the shared joy in dawning fertility it evokes, also proves to be fruitful in understanding howikokudancing persists in changing contexts – and even in urban ones.
Volumetrical Characterization of Sheet Molding Compounds
Authors: Calvimontes Alfredo , Grundke Karina , Müller Anett
Published: December 2010

For a comprehensive study of Sheet Molding Compound (SMC) surfaces, topographical data obtained by chromatic confocal imaging were submitted systematically for the development of a profile model to understand the formation of cavities on the surface. In order to qualify SMC surfaces and to predict their coatability, a characterization of cavities is applied. To quantify the effect of surface modification treatments, a new parameter (Surface Relative Smooth) is presented, applied and probed. The parameter proposed can be used for any surface modification of any solid material.
Novel Cytotoxic Vectors Based on Adeno-Associated Virus
Authors: Kohlschütter Johannes , Michelfelder Stefan , Trepel Martin
Published: December 2010

Vectors based on adeno-associated virus (AAV) are promising tools for gene therapy. The production of strongly toxic vectors, for example for cancer-directed gene transfer, is often unfeasible due to uncontrolled expression of toxic genes in vector-producing cells. Using an approach based on transcriptional repression, we have created novel AAV vectors carrying the genes coding for diphtheria toxin A (DTA) and the pro-apoptotic PUMA protein. The DTA vector had a significant toxic effect on a panel of tumor cell lines, and abrogation of protein synthesis could be shown. The PUMA vector had a toxic effect on HeLa and RPMI 8226 cells, and sensitized transduced cells to doxorubicin. To permit targeted gene transfer, we incorporated the DTA gene into a genetically modified AAV-2 capsid previously developed by our group that mediates enhanced transduction of murine breast cancer cells in vitro. This vector had a stronger cytotoxic effect on breast cancer cells than DTA vectors with wildtype AAV capsid or vectors with a random capsid modification. The vector production and application system presented here allows for easy exchange of promotors, transgenes and capsid specificity for certain target cells. It will therefore be of great possible value in a broad range of applications in cytotoxic gene therapy and significantly broadens the spectrum of available tools for AAV-based gene therapy.
Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-Analysis of Randomized Controlled Trials
Authors: Qi Hualin , Xu Chen , Yan Haidong , Ma Jun
Published: December 2010

Background

Icodextrin is widely used in peritoneal dialysis (PD); however, the safety and efficacy of icodextrin are unclear. In the present study, we performed a systematic review of randomized controlled trials (RCTs) that compared icodextrin and glucose for the once-daily long dwell in PD.

Methods

Electronic searches were performed in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to select all eligible studies. Eligible studies, as determined by consensus using predefined criteria, were reviewed, and data were extracted onto a standard form.

Results

In the 9 RCTs that were identified, patients using icodextrin were found to have much greater net ultrafiltration (UF) and a lower incidence of negative net UF compared to patients using 1.5%, 2.5%, and 4.25% glucose solutions. Additionally, icodextrin has a markedly increased UF efficiency ratio and peritoneal clearance of creatinine and urea nitrogen, but residual renal function was not different from patients using glucose solutions for PD. No significant differences were observed between icodextrin and glucose groups with respect to risk of mortality, peritonitis, and total adverse events. Although rashes occurred significantly more often in icodextrin groups, few differences were noted between icodextrin and glucose groups when withdrawal rates secondary to adverse events were compared.

Conclusions

This meta-analysis suggests that icodextrin provides patients with greater fluid removal and small solute clearance and does not cause any damage to residual renal function. Icodextrin is particularly appropriate for use in patients with high peritoneal transport status.
Miniemulsion polymerization as a versatile tool for the synthesis of functionalized polymers
Authors: Crespy Daniel , Landfester Katharina
Published: December 2010

The miniemulsion technique is a particular case in the family of heterophase polymerizations, which allows the formation of functionalized polymers by polymerization or modification of polymers in stable nanodroplets. We present here an overview of the different polymer syntheses within the miniemulsion droplets as reported in the literature, and of the current trends in the field.
Prologue: 2009 Joint Meeting of Spondyloarthritis Research and Therapy Network (SPARTAN) and International Genetics of Ankylosing Spondylitis (IGAS)
Authors: REVEILLE JOHN D. , CLEGG DANIEL O.
Published: December 2010

In July 2009, a 3-day conference was held in Houston, Texas, USA, by members of several groups: the Spondyloarthritis Research and Therapy Network (SPARTAN); the International Genetics of Ankylosing Spondylitis (IGAS); and interested members of the Pan American League of Associations of Rheumatology (PANLAR). The purpose of this meeting was to bring together physician scientists, clinicians, and educators from around the world who are working together to improve their understanding of spondyloarthritis (SpA). In addition to the annual educational and Fellows sessions for SPARTAN members, the conference included a one-day international meeting dedicated to the role of HLA-B27, along with a series of sessions that summarized advances among various collaborative groups and defined opportunities for future genetic initiatives. This supplement provides a review of the SPARTAN and IGAS meetings.
Current Controversies in Spondyloarthritis: SPARTAN
Authors: WEISMAN MICHAEL , LEARCH THOMAS J. , BARALIAKOS XENOFON , CHANDRAN VINOD , GLADMAN DAFNA D. , RAYCHAUDHURI SIBA P. , XU HUJI , COLLANTES-ESTÉVEZ EDUARDO , VÁZQUEZ-MELLADO JANITZIA , MEASE PHILIP J. , SIEPER JOACHIM , DEODHAR ATUL A. , COLBERT ROBERT A. , CLEGG DANIEL O.
Published: December 2010

The Spondyloarthritis Research and Therapy Network (SPARTAN), founded in 2003 to promote research, education, and treatment of ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA), held its 7th Annual Research and Education Meeting in July 2009 in Houston, Texas. Current controversies in SpA discussed during the meeting included an update on the epidemiology of AS, axial SpA, and inflammatory back pain; the adequacy of the mSASS to assess radiographic involvement; the helpfulness of magnetic resonance imaging in assessing disease progression; the reliability of metrology in assessing damage; and whether biologic agents alter the course of AS. Presentations also were made on psoriasis in the SCID mouse model; the challenges and opportunities of SpA in China; a discussion of the special needs in managing SpA in Ibero-America, and the SPARK Survey in Europe and North America.
Epidemiology of Ankylosing Spondylitis: IGAS 2009: Table 1.
Authors: REVEILLE JOHN D. , BROWN MATTHEW A.
Published: December 2010

The International Genetics of Ankylosing Spondylitis (IGAS) meeting was held in Houston, Texas, July 25, 2009. Sixteen investigators from Asia, Australia, Europe, and North and South America presented the status of their respective cohorts of patients with ankylosing spondylitis (AS). They also reviewed a proposal to examine their patients by single-nucleotide polymorphism (SNP) genotyping on an Illumina Infinium microarray SNP genotyping chip in a case-control cohort exceeding 12,000 samples. This chip will type 200,000 SNP selected from the most strongly associated variants identified in genome-wide association studies of inflammatory diseases, including inflammatory bowel disease, psoriasis, and ankylosing spondylitis.
Ablation to Treat Atrial Fibrillation: Beyond Rhythm Control
Authors: Zak Jody
Published: December 2010

Care before, during, and after ablation is discussed in this article.
Critical Care Transport in a Combat Environment: Building Tactical Trauma Transport Teams Before and During Deployment
Authors: Hudson Timothy L. , Morton Richard
Published: December 2010

The critical care transport practice within the combat arena is rarely seen in civilian health care.
Monsters in the Closet: Munchausen Syndrome by Proxy
Authors: Criddle Laura
Published: December 2010

This syndrome is associated with a high incidence of recidivism, morbidity, and mortality.
Immunoprotective Effect of Seabuckthorn (Hippophae rhamnoides) and Glucomannan on T-2 Toxin-Induced Immunodepression in Poultry
Authors: Ramasamy T. , Varshneya C. , Katoch V. C.
Published: December 2010

The present investigation was undertaken to study the immunoprotective effect of seabuckthorn berries and glucomannan against T-2 toxin-induced immunodepression in 15-day-old chicks. T-2 toxin was produced in the laboratory by growingFusarium sporotrichioidesMTCC 2081 on wheat. T-2 toxin was fed to birds at 1 ppm level of the diet. The powdered seabuckthorn berries were added at 400 and 800 ppm levels, and glucomannan added at 1 g/kg of feed. All the treatments were continued up to 28 days. The immunoprotective effects of seabuckthorn and glucomannan were assessed by evaluating humoral immune reaction against NCD vaccine (haemagglutination test and immunoglobulin estimation), serum immunoglobulin levels, phagocytic index, and DTH reaction against DNFB between day 25 and day 28 of experiment. There was significant (P<.05) decrease in non-specific immunity in T-2 toxin-treated group as evidenced by a reduction in phagocytic index, DTH reaction, HI titer, and total serum Ig compared to the healthy control group. A significant increase (P<.05) in HI titer and total serum Ig was seen in seabuckthorn and glucomannan fed group. A significant (P<.05) increase in DTH reaction and non-specific immune response was seen in seabuckthorn and glucomannan fed birds. The present investigation revealed that the seabuckthorn alone protected the immunosuppressant action of T-2 toxin, but seabuckthorn and glucomannan in combination provided an additive protection against T-2 toxicity.
Rev1, Rev3, or Rev7 siRNA Abolishes Ultraviolet Light‐Induced Translesion Replication in HeLa Cells: A Comprehensive Study Using Alkaline Sucrose Density Gradient Sedimentation
Authors: Takezawa Jun , Ishimi Yukio , Aiba Naomi , Yamada Kouichi
Published: December 2010

When a replicative DNA polymerase stalls upon encountering a lesion on the template strand, it is relieved by other low‐processivity polymerase(s), which insert nucleotide(s) opposite the lesion, extend by a few nucleotides, and dissociate from the 3′‐OH. The replicative polymerase then resumes DNA synthesis. This process, termed translesion replication (TLS) or replicative bypass, may involve at least five different polymerases in mammals, although the participating polymerases and their roles have not been entirely characterized. Using siRNAs originally designed and an alkaline sucrose density gradient sedimentation technique, we verified the involvement of several polymerases in ultraviolet (UV) light‐induced TLS in HeLa cells. First, siRNAs to Rev3 or Rev7 largely abolished UV‐TLS, suggesting that these 2 gene products, which comprise Polζ, play a main role in mutagenic TLS. Second, Rev1‐targeted siRNA also abrogated UV‐TLS, indicating that Rev1 is also indispensable to mutagenic TLS. Third, Polη‐targeted siRNA also prevented TLS to a greater extent than our expectations. Forth, although siRNA to Polι had no detectable effect, that to Polκ delayed UV‐TLS. To our knowledge, this is the first study reporting apparent evidence for the participation of Polκ in UV‐TLS.
Pleomorphic Lobular Carcinoma in a Male Breast: A Rare Occurrence
Authors: Rohini Bhatia , Singh P. A. , Vatsala Misra , Vishal Dhingra , Mitali Singhal , Nishant Sharma
Published: December 2010

Carcinoma of male breast is uncommon as it accounts for 0.7% of total breast cancer. The pathology of male breast cancer is remarkably similar to that of cancers seen in women. The same histological subtypes of invasive cancer are present, although papillary carcinomas (both invasive and in situ) are more common and lobular carcinomas are less common. The predominant histological type, in males, as in females, reported in large series has been infiltrating ductal carcinoma with scattered reports of infiltrating lobular carcinoma, all of them of classical type except for a single case of pleomorphic infiltrating lobular carcinoma. Herein, we describe a case of pleomorphic lobular carcinoma occurring in male breast.
A Case of Isolated Left Ventricular Noncompaction with Basal ECG-Tracing Strongly Suggestive for Type-2 Brugada Syndrome
Authors: Banci Maria , Martinoli Roberta , Dofcaci Alessandro , Piccirilli Stefano , Papetti Federica , Sansoni Ilaria , Saccucci Patrizia
Published: December 2010

Isolated left ventricular noncompaction (ILVNC) is a cardiomyopathy caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. ILVNC is clinically accompanied by depressed ventricular function, arrhythmias, and systemic embolization. We reported a case of ILVNC with basal ECG-tracing strongly suggestive for type-2 Brugada syndrome (BrS). Up to now, this is the first report investigating the association between ILVNC and this particular ECG pattern.
Vascular Guidance: Microstructural Scaffold Patterning for Inductive Neovascularization
Authors: Muller Daniel , Chim Harvey , Bader Augustinus , Whiteman Matthew , Schantz Jan-Thorsten
Published: December 2010

Current tissue engineering techniques are limited by inadequate vascularisation and perfusion of cell-scaffold constructs. Microstructural patterning through biomimetic vascular channels within a polymer scaffold might induce neovascularization, allowing fabrication of large engineered constructs. The network of vascular channels within a frontal-parietal defect in a patient, originating from the anterior branch of the middle meningeal artery, was modeled using computer-aided design (CAD) techniques and subsequently incorporated into polycaprolactone (PCL) scaffolds fabricated using fused deposition modeling (FDM). Bone marrow-derived mesenchymal stem cells (MSCs) were seeded onto the scaffolds and implanted into a rat model, with an arteriovenous bundle inserted at the proximal extent of the vascular network. After 3 weeks, scaffolds were elevated as a prefabricated composite tissue-polymer flap and transferred using microsurgical technique. Histological examination of explanted scaffolds revealed vascular ingrowth along patterned channels, with abundant capillary and connective tissue formation throughout experimental scaffolds, while control scaffolds showed only granulation tissue. All prefabricated constructs transferred as free flaps survived and were viable. We term this concept “vascular guidance,” whereby neovascularization is guided through customized channels in a scaffold. Our technique might potentially allow fabrication of much larger tissue-engineered constructs than current technologies allow, as well as allowing tailored construct fabrication with a patient-specific vessel network based on CT scan data and CAD technology.
Molecular Mechanisms Underlying Hypothermia-Induced Neuroprotection
Authors: Shintani Yasushi , Terao Yasuko , Ohta Hiroyuki
Published: December 2010

Stroke is a dynamic event in the brain involving heterogeneous cells. There is now compelling clinical evidence that prolonged, moderate cerebral hypothermia initiated within a few hours after severe ischemia can reduce subsequent neuronal death and improve behavioral recovery. The neuroprotective role of hypothermia is also well established in experimental animals. However, the mechanism of hypothermic neuroprotection remains unclear, although, presumably involves the ability of hypothermia to suppress a broad range of injurious factors. In this paper, we addressed this issue by utilizing comprehensive gene and protein expression analyses of ischemic rat brains. To predict precise target molecules, we took advantage of the therapeutic time window and duration of hypothermia necessary to exert neuroprotective effects. We proposed that hypothermia contributes to protect neuroinflammation, and identified candidate molecules such as MIP-3α and Hsp70 that warrant further investigation as targets for therapeutic drugs acting as “hypothermia-like neuroprotectants.”
Liquid Chromatographic Investigation of Spontaneous Oscillatory In Vitro Chiral Conversion and Spontaneous Oscillatory Condensation of Simple Carboxylic Acids in Aqueous and Nonaqueous Media
Authors: Sajewicz Mieczyslaw , Kowalska Teresa
Published: December 2010

Oscillatory reactions are a narrow reaction type among the entity of chemical reactions and those involving purely organic compounds make a small contribution to an overall number of all known oscillatory reactions. The most abundant type is purely inorganic and mixed inorganic-organic oxidation-reduction reactions, basically because monitoring them is relatively easy (e.g., with use of potentiometric measurements). Investigation of the organic reactions can be more demanding, and then chromatography is an analytical technique of choice. In this paper, we provide an overview of chromatographic evidence with oscillatory reactions discovered in our laboratory in the course of the last several years that involve the low-molecular-weight carboxylic acids (profen drugs, amino acids, and hydroxy acids). The investigated processes comprise the oscillatory chiral conversion and the oscillatory condensation, spontaneously running in the aqueous and nonaqueous abiotic media, and they were traced with use of TLC and HPLC coupled with different detector types.
A Review of Medication Reconciliation Issues and Experiences with Clinical Staff and Information Systems
Authors: Waitman L.R. , Brown S.H. , Porcelli P.J.
Published: December 2010

Medication reconciliation was developed to reduce medical mistakes and injuries through a process of creating and comparing a current medication list from independent patient information sources, and resolving discrepancies. The structure and clinician assignments of medication reconciliation varies between institutions, but usually includes physicians, nurses and pharmacists. The Joint Commission has recognized the value of medication reconciliation and mandated implementation in 2006; however, a variety of issues have prevented simple, easy, and universal implementation. This review references issues related to the development and the implementation of medication reconciliation including: – the need of a system or standard for accurate drug identification to create a definitive ‘gold standard’ patient medication list, – identifying stakeholders of medication reconciliation within the institution and contrasting staff interest and participation with institutional resources, – observations and opportunities of integrating medication reconciliation with the electronic patient health record, and – summarizing a series of institutions experiences developing and implementing medication reconciliation. Last, as medication reconciliation becomes a regular process within medical centers, key concepts for effective implementation are discussed.
Hyperventilation in men claiming compensation for benign asbestos-related diseases
Authors: Crompton GK
Published: December 2010

The observation that hyperventilation was common in men involved in civil court actions compared with my non-medico-legal practice stimulated me to carefully assess 100 consecutively seen men with non-malignant asbestosrelated disease(s). A diagnosis of hyperventilation was made in 33 and probable hyperventilation in 12. The development of anxiety symptoms in these men could, in part at least, be prevented or greatly decreased if more emphasis was placed on the education of ex-asbestos workers by solicitors and organisations responsible for the initiation of civil actions.
The prevalence of proteinuria in patients presenting with fluid retention due to heart failure
Authors: Peeroo K , Clark A
Published: December 2010

The prevalence of proteinuria in patients presenting acutely with oedema due to heart failure has not been studied extensively. Recent evidence from the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) trial suggests that there is a high prevalence of albuminuria in chronic heart failure patients. We set out to investigate the prevalence of proteinuria in patients presenting with fluid retention secondary to heart failure. A random collection of urine albumin–creatinine ratios (ACRs) in successive patients was used to quantify proteinuria. Out of a sample of 19 patients, seven had no detectable albuminuria, eight had microalbuminuria and four had macroalbuminuria. We did not find any relation between urine ACR and age, serum urea or serum creatinine. Moreover, we did not find a higher prevalence of albuminuria with increasing age or the presence of diabetes mellitus. In conclusion, the clinical significance of this common finding in patients presenting with fluid retention is not clear, and further research is warranted to clarify its prognostic value.
The evolution of advanced techniques for the management of symptomatic aortic stenosis in the elderly population: conventional surgical management vs transcatheter valve implantation
Authors: Jahangiri M , Kappetein AP , van Geldorp M , Bogers AJ
Published: December 2010

The shifting age demographic of the adult population has affected every area of contemporary medical and surgical practice. Many more people are living well, not just into their 70s but into their 80s and beyond. Their expectations of treatment for every illness have shifted markedly upwards at the same time. Despite the decline in cases of rheumatic fever in Westernised populations in recent times, the ageing population has led to no decline in the prevalence of valvular aortic stenosis. This is now realised to be an active pro-inflammatory disease, rather than a degenerative process. Thus the condition has remained in the mainstream and continues to be responsible for considerable morbidity, hospitalisation and mortality among the elderly and very elderly.

Management has always been based on the triage of cases for direct intervention to the valve by surgery. Just as expectations have risen from patients, the techniques, application and monitoring of cardiac surgery have also made huge strides forward to meet this aspiration. More and more, surgeons are routinely asked to consider procedures in frailer, more elderly patients with more severe disease and co-morbidity. Managing the stenosis is rarely the only issue confronting the operating surgeon. Attempts to provide alternatives to open valve replacement surgery on cardiopulmonary bypass have now emerged. These are based around the transcutaneous placement of a valve prosthesis. While these technologies were initially highly selective in their application, they have now reached a stage to be compared with contemporary standards of cardiac surgical practice. In this debate we have invited two international experts from the fields of cardiac surgery (Professor Jahangiri) and interventional cardiology (Professor Kappetein and colleagues) to take deliberately opposing positions on the evolving management of valvular aortic stenosis in the very elderly. We have asked them to try to consider the strengths of each route. Both approaches provide options for patients who only a few years ago might have been regarded as essentially untreatable.
Breast cancer
Authors: Barrett SV
Published: December 2010

Breast cancer is now the most common cancer of women in the UK and incidence is increasing. Because of major treatment advances and earlier diagnosis over the past 40 years, survival rates have been improving gradually and women diagnosed with breast cancer today are almost twice as likely to survive for 10 years or longer as women 40 years ago. However, breast cancer remains a major contributor to cancer morbidity and mortality in the UK. The majority of patients present with potentially curative disease and surgery is the mainstay of treatment. Many patients receive adjuvant (post-operative) therapy, which reduces the risk of loco-regional and distant disease recurrence. Treatment options include radiotherapy, chemotherapy, endocrine therapy and biological agents, with treatment increasingly tailored to the individual tumour and patient, aiming to provide maximum survival benefit with minimum toxicity. Many patients participate in clinical trials of radiotherapy, new agents, drug combinations or novel dosing regimens. Patients with metastatic disease can rarely be offered curative treatment, but improved quality of life and prolonged survival may be achieved with palliative treatment, including hormones, chemotherapy, radiotherapy, trastuzumab and bisphosphonates. This overview aims to summarise current knowledge and recent developments in the management of breast cancer.
Head and neck cancer
Authors: Casasola RJ
Published: December 2010

Head and neck cancer is traditionally thought of as being a disease associated with alcohol and tobacco abuse and deprivation. It was the fourth most common cancer in males in Scotland in 2000 and just over 1,000 cases were diagnosed in 2007. As smoking becomes less prevalent, a fall in the incidence of head and neck cancer could be anticipated; however, increasing evidence of other aetiological factors contributing to the diagnosis of head and neck cancer, particularly oropharyngeal cancer in non-smoking, little-drinking populations, is impacting on that perception. This review will aim to look at current aetiological factors for head and neck cancer, along with current therapeutic modalities in treatment of this disease.
Impact of biomass burning on ocean water quality in Southeast Asia through atmospheric deposition: eutrophication modeling
Authors: Sundarambal P. , Tkalich P. , Balasubramanian R.
Published: December 2010

Abstract. Atmospheric deposition of nutrients (N and P species) can intensify anthropogenic eutrophication of coastal waters. It was found that the atmospheric wet and dry depositions of nutrients was remarkable in the Southeast Asian region during the course of smoke haze events, as discussed in a companion paper on field observations (Sundarambal et al., 2010b). The importance of atmospheric deposition of nutrients in terms of their biological responses in the coastal waters of the Singapore region was investigated during hazy days in relation to non-hazy days. The influence of atmospherically-derived, bio-available nutrients (both inorganic and organic nitrogen and phosphorus species) on the coastal water quality between hazy and non-hazy days was studied. A numerical modeling approach was employed to provide qualitative and quantitative understanding of the relative importance of atmospheric and ocean nutrient fluxes in this region. A 3-D eutrophication model, NEUTRO, was used with enhanced features to simulate the spatial distribution and temporal variations of nutrients, plankton and dissolved oxygen due to atmospheric nutrient loadings. The percentage increase of the concentration of coastal water nutrients relative to the baseline due to atmospheric deposition was estimated between hazy and non-hazy days. Model computations showed that atmospheric deposition fluxes of nutrients might account for up to 17 to 88% and 4 to 24% of total mass of nitrite + nitrate-nitrogen in the water column, during hazy days and non-hazy days, respectively. The results obtained from the modeling study could be used for a better understanding of the energy flow in the coastal zone system, exploring various possible scenarios concerning the atmospheric deposition of nutrients onto the coastal zone and studying their impacts on water quality.