bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analysis of Capsular Area in Patients with Anterior, Posterior, and Multidirectional Shoulder Instability
Authors: Dewing Christopher B. , McCormick Frank , Bell S. Josh , Solomon Daniel J. , Stanley Mark , Rooney Timothy B. , Provencher Matthew T.
Published: January 2008

Background

Although increased capsular volume has been implicated in shoulder instability, there is a paucity of clinical evidence to quantify the size of the capsule with specific instability conditions of the shoulder.

Hypothesis

Shoulder capsular area, as measured by magnetic resonance arthrography, is increased with specific patterns of shoulder instability.

Study Design

Cross-sectional study; Level of evidence, 4.

Methods

During an 8-month period, all patients with a diagnosis of anterior (n = 19), posterior (n = 14), or multidirectional (n = 13) instability of the shoulder and who were assessed with a magnetic resonance arthrogram were reviewed. A group of 10 control patients without clinical instability were also identified. The magnetic resonance arthrograms of all groups were randomly mixed, and 5 reviewers recorded measures of capsular length and area and determined labral abnormalities. The magnetic resonance arthrogram measurements were compared between groups, and interobserver agreement was determined.

Results

The cross-sectional area of the capsule was increased in patients with posterior ( P = .017) or multidirectional instability ( P = .021) versus controls, but not in patients with anterior instability. Additionally, the posteroinferior cross-sectional area was increased in patients with posterior ( P = .001), multidirectional ( P = .003), and anterior ( P = .008) instability. In patients with a posterior labral tear, the mean axial ( P = .043) and mean posteroinferior sagittal cross-sectional area ( P = .011) was increased, but there were no differences in cross-sectional area for those with an anterior labral tear. The overall interobserver reliability was very good (correlation coefficient range, 0.68–0.94).

Conclusion

Our results reinforce the concept that capsular elongation and laxity, either preexisting or acquired, play a role in certain instability conditions of the shoulder. Additional work is needed to determine how to correlate surgical decision making with the cross-sectional area measurements demonstrated in this study.
Policy Considerations for Establishing an Environmentally Sound Regional Material Flow in East Asia
Authors: Hotta Yasuhiko , Elder Mark , Mori Hideyuki , Tanaka Makiko
Published: January 2008

This article argues that waste management and recycling have become regional or international issues; they can no longer be considered only in a national context. The regionalization or internationalization of waste and recycling issues is caused in large part by the steady advance of economic integration, especially increasing trade and investment flows resulting from trade and investment liberalization. Just as economic integration has separated the location of consumption from the location of most efficient production, it has also separated the most efficient and effective location of recycling from the location of production and consumption. This makes it difficult to operate domestically oriented recycling schemes, as demonstrated by the case of Japan. Therefore, national policies, although still important, are now insufficient, and this article will propose policy recommendations to address this, including the development of national recycling systems and capacity linked to regional recycling zones, regionally coordinated extended producers responsibility, and regional certification schemes for recyclers and traders.
Quality of Frozen Turkey Crepes in Relation to Antioxidants Used and Length of Storage at 0°F.1
Authors: Payton Sharon B. , Carlin Agnes Frances
Published: January 2008

The major objective was to evaluate the quality of precooked frozen turkey crepes stored at 0°F. (−18°C.) up to 6 months. Strips of raw breast or thigh meat, treated with a solution of salt, sugar, and one of the antioxidants (polyphosphates, ascorbic acid, or a combination of the two) were made into rolls and cooked in waterproof casings to 160°F. (71°C.) in 190°F. (88°C.) water. Rolls were sliced and cubed. The cubed turkey meat in cream sauce was enclosed in a crepe. Turkey crepes were packaged four in each aluminum pan (770 g., 1.7 lbs.), and frozen. After storage at 0°F. for 0, 4, or 6 months, samples were heated at 350°F. (177°C.) to 160°F. (71°C.) and scored for quality. The light or the dark turkey meat cubes, the cream sauce, and the crepes (thin pancakes) were evaluated separately.

Evaluation by a trained taste panel revealed that the three antioxidant treatments were effective in maintaining turkey flavor and in preventing rancidity. Ascorbic acid alone was slightly less effective than polyphosphates either alone or combined with ascorbic acid. Cream sauces made with flour (1/3) and modified cornstarch (2/3) did not separate after freezing and reheating to 160°F. Cream sauces containing corn oil and crepes containing margarine were not rancid. Thus, the results indicated that the frozen turkey crepes had good eating quality after storage for 6 months at 0°F.
Power and pleasure in ethnographic home-work: producing a recognizable ethics
Authors: Youngblood Jackson Alecia
Published: January 2008

The author uses Michel Foucault's power/knowledge/pleasure combination to analyze the production of ethical practices in qualitative research. Through two data stories, the author recounts her own pleasurable acts while carrying out an ethnographic study in her hometown high school. The pleasures of conducting such home-work are analyzed to point out the ethics of constituting the experience of the self in qualitative research.
Cultural Geographies lecture
Authors: Katz Cindi
Published: January 2008

As the 21st century picks up speed and settles into place, childhood has become a spectacle — a site of accumulation, commodification, and desire — in whose name much is done. In this article, I argue that the spectacle of childhood is associated with the rise of ontological insecurity provoked by anxieties around the political—economic, geopolitical, and environmental futures. I address how this spectacle is produced and made sensible, and lay out three configurations of the child — as accumulation strategy, ornament, and waste — that it calls forth. I suggest some of the consequences of these material social practices for actual children and the cultural geographies of their everyday lives. In exploring what is accomplished politically and socially by these cultural forms and material social practices, I draw out their connections with commodification, essence, distraction, and panic.
Racialized landscapes: whiteness and the struggle over farmworker housing in Woodburn, Oregon
Authors: Nelson Lise
Published: January 2008

Through an analysis of political resistance to the construction of subsidized farmworker housing in Woodburn, Oregon between 1991 and 1996, this article explores the defense of normative whiteness in relation to a largely undocumented Mexican immigrant population residing in the community. It is argued that for many (mostly white) city leaders and residents, the construction of urban farmworker housing represented a racialized and spatial transgression that undermined the normalized geography of farmworker invisibility — the labor camp. While the racial anxieties linked to the permanent settlement of low-wage immigrant workers had percolated for many years, the public debate over farmworker housing represented a moment when the longstanding anxiety of white residents could be publicly articulated, as well as coded and expressed as something other than race. The analysis builds on work in geography examining how spatial metaphors and practices are used to police the borders of whiteness and difference.
White bread bio-politics: purity, health, and the triumph of industrial baking
Authors: Bobrow-Strain Aaron
Published: January 2008

This article traces the massive commodification and industrialization of the USA's single most important food: bread. It argues that bakers overcame serious obstacles to capitalist development during this period thanks to the construction of contingent and contested associations between industrial bread and larger discourses of purity, hygiene, and progress circulating through turn-of-the-century America. It explores two arenas in which this articulation operated: the re-making of baking as a techno-science of expert control and the visual spectacle of streamlined, white loaves. This story, in turn, offers larger lessons about the contradictory politics of food safety in our own time. Building on Michel Foucault's work on bio-politics, it shows how notions of food safety dependent on discourses of purity, contagion, hygiene, and vitality inevitably constitute lines of exclusion and social hierarchy, even as they are used to mobilize `progressive' social change.
Television's Power Relations in the Transition to Digital
Authors: Christophers Brett
Published: January 2008

This article examines the contemporary configuration of power relations in the U.K. television sector, probing, in the process, the enduring accuracy of longstanding economic arguments concerning distributor dominance in the “cultural industries” more broadly. Such arguments are important because we cannot understand the power of the media unless we understand the circulation of power within the media. The article shows that while recent developments in respect to both producer—distributor and producer—advertiser relationships have begun to enhance the leverage enjoyed by the production community, the steady inflation of the mass-market premium enjoyed by the leading distributors (the terrestrial broadcasters) in the advertising market has largely sustained their power, in relation to smaller (multichannel) distributors, to producer suppliers, and—of course— to the consuming public.
Physical and Emotional Predictors of Depression After Radical Prostatectomy
Authors: Weber Bryan A. , Roberts Beverly L. , Mills Terry L. , Chumbler Neale R. , Algood Chester B.
Published: January 2008

Radical prostatectomy commonly results in urinary, sexual, and bowel dysfunction that bothers men and may lead to depressive symptomatology (hereafter depression) that occurs at a rate 4 times greater for men with prostate cancer than healthy counterparts. The purpose of this study was to assess depressive symptoms in men shortly after radical prostatectomy and to identify associated risk factors. Seventy-two men were interviewed 6 weeks after surgery. Measured were depression (Geriatric Depression Scale), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), physical and emotional factors (UCLA Prostate Cancer Index), and social function (SF-36 subscale). Results indicate that men with high self-efficacy and less sexual bother were 45% and 55% less likely to have depressive symptoms, respectively. Findings from this study add to the limited amount of information on the complex relationship between prostate cancer treatment and depression in men.
Influence of Gang Membership on Negative Affect, Substance Use, and Antisocial Behavior Among Homeless African American Male Youth
Authors: Harper Gary W. , Davidson Jonathan , Hosek Sybil G.
Published: January 2008

The current study examined differences between gang-involved and non-gang-involved homeless African American male youth with regard to negative affect, substance use, and antisocial/violent behavior. A total of 69 homeless African American young men were recruited from community agencies and completed structured face-to-face interviews. Overall, gang members reported higher rates of negative mental and physical health outcomes than did non-gang members, with current gang members reporting higher levels of depression and anxiety, greater levels of antisocial and violent behavior, and higher levels of lifetime alcohol and marijuana use. Multiple linear regression analyses revealed that greater levels of gang involvement were associated with more frequent lifetime use of alcohol and marijuana and higher levels of participation in violent behaviors. Implications of these findings for interventions with homeless African American male youth and future research directions are discussed.
State of the Art Reviews: Using the Internet to Promote Physical Activity and Healthy Eating in Youth
Authors: Whiteley Jessica A. , Bailey Bruce W. , McInnis Kyle J.
Published: January 2008

The prevalence of overweight children and adolescents is increasing at alarming rates. Since 1980, the prevalence of overweight among children aged 6 to 11 years has more than doubled and more than tripled among adolescents aged 12 to 19. Innovative, effective weight loss strategies that effectively promote healthy eating and physical activity are needed to address this obesity epidemic. The Internet may prove to be an effective means of reaching youth to reduce overweight and, ideally, prevent weight gain. This article reviews the available literature of Internet-based interventions promoting healthy eating, physical activity, and/ or weight loss in school, home, camp, and medical settings. Findings show that few examples of well-designed trials exist in the youth literature. However, several studies show promise for the use of the Internet. It is recommended that future trials use adequate sample sizes, randomized designs, objective measures, boys and girls, health disparity youth, longer intervention periods (at least 16 weeks), long-term follow-up, theory-based skill building (eg, tracking of behavior, goal setting, feedback, increasing social support), the involvement of parents or caretakers, and improved means for sustaining interest and use in the site over time.
The Jak2V617F oncogene associated with myeloproliferative diseases requires a functional FERM domain for transformation and for expression of the Myc and Pim proto-oncogenes
Authors: Wernig Gerlinde , Gonneville Jeffrey R. , Crowley Brian J. , Rodrigues Margret S. , Reddy Mamatha M. , Hudon Heidi E. , Walz Christoph , Reiter Andreas , Podar Klaus , Royer Yohan , Constantinescu Stefan N. , Tomasson Michael H. , Griffin James D. , Gilliland D. Gary , Sattler Martin
Published: January 2008

The V617F activating point mutation in Jak2 is associated with a proportion of myeloproliferative disorders. In normal hematopoietic cells, Jak2 signals only when associated with a growth factor receptor, such as the erythropoietin receptor (EpoR). We sought to identify the molecular requirements for activation of Jak2V617F by introducing a point mutation in the FERM domain (Y114A), required for receptor binding. Whereas BaF3.EpoR cells are readily transformed by Jak2V617F to Epo independence, we found that the addition of the FERM domain mutation blocked transformation and the induction of reactive oxygen species. Further, while cells expressing Jak2V617F had constitutive activation of STAT5, cells expressing Jak2V617F/Y114A did not, suggesting that signaling is defective at a very proximal level. In addition, expression of the Myc and Pim proto-oncogenes by Jak2V617F was found to be FERM domain dependent. An inducible constitutively active STAT5 mutant expressed in BaF3 cells was sufficient to induce Myc and Pim. Finally, the FERM domain in Jak2V617F was also required for abnormal hematopoiesis in transduced primary murine fetal liver cells. Overall, our results suggest that constitutive activation of Jak2 requires an intact FERM domain for a transforming phenotype, and is necessary for activation of the major target of Jak2, STAT5.
Modulation of angiogenesis by ω-3 polyunsaturated fatty acids is mediated by cyclooxygenases
Authors: Szymczak Melissa , Murray Michael , Petrovic Nenad
Published: January 2008

The potential role of dietary fats in cancer is attracting considerable interest within the community. Both epidemiologic and experimental findings suggest that omega-3 polyunsaturated fatty acids (ω-3 PUFAs), which are almost absent from typical Western diets, exert protective effects against cancer progression, although the precise mechanism of this suppression remains unknown. One of the potential targets for ω-3 PUFAs in cancer suppression is angiogenesis, a process of new blood vessel formation within rapidly growing tumors. Here, we demonstrate that ω-6 PUFAs stimulate and ω-3 PUFAs inhibit major proangiogenic processes in human endothelial cells, including the induction of angiopoietin-2 (Ang2) and matrix metalloprotease-9, endothelial invasion, and tube formation, that are usually activated by the major ω-6 PUFA arachidonic acid. The cyclooxygenase (COX)–mediated conversion of PUFAs to prostanoid derivatives participated in modulation of the expression of Ang2. Thus, the ω-6 PUFA–derived prostaglandin E2 augmented, whereas the ω-3 PUFA–derived prostaglandin E3 suppressed the induction of Ang2 by growth factors. Our findings are consistent with the suggestion that PUFAs undergo biotransformation by COX-2 to lipid mediators that modulate tumor angiogenesis, which provides new insight into the beneficial effects of ω-3 PUFAs.
Exposure to hog barn dust alters airway epithelial ciliary beating
Authors: Wyatt T. A. , Sisson J. H. , Von Essen S. G. , Poole J. A. , Romberger D. J.
Published: January 2008

Swine confinement workers are at increased risk of airway diseases, including mucus membrane irritation syndrome, chronic rhinosinusitis and chronic bronchitis. Dust extracts from swine confinement facilities stimulate the production of pro-inflammatory cytokines in bronchial epithelial cells, including interleukin (IL)-8. As IL-8 is capable of blocking β-agonist-stimulated increases in cilia beating, which impacts on mucociliary clearance, it was hypothesised that hog barn-dust exposure might alter cilia responses to stimulation.

To test this hypothesis, ciliated bovine bronchial epithelial cell cultures were exposed to hog barn-dust extract (HDE) and ciliary beat frequency (CBF) was assayed.

An elevation in baseline CBF was observed. This effect appeared to be independent of endotoxin but dependent upon nitric oxide. HDE also stimulated nitric oxide production in bronchial epithelial cells; however, stimulation of cilia beating by a β-agonist did not occur in cells pre-exposed to HDE.

These data demonstrate that hog barn dust can alter normal stimulation of cilia, suggesting a mechanism for the abrogation of stimulated increases in mucociliary clearance in response to inhaled dust exposure.
Changes in elastic fibres in the small airways and alveoli in COPD
Authors: Black P. N. , Ching P. S. T. , Beaumont B. , Ranasinghe S. , Taylor G. , Merrilees M. J.
Published: January 2008

Small airways are the major site of airflow obstruction in chronic obstructive pulmonary disease (COPD). This is attributed to loss of elastin in alveoli and fibrosis in small airways. In the present study, it was hypothesised that changes to elastic fibres in alveoli might be paralleled by a similar reduction in elastic fibres in small airways.

Tissue blocks from patients who had lobectomy for bronchial carcinoma were studied. Patients were classified as COPD (forced expiratory volume in one second (FEV1) <80% predicted, FEV1/forced vital capacity (FVC) <0.7) or controls (FEV1≥80% pred, FEV1/FVC ≥0.7). Elastic fibres were visualised using Elastic van Gieson staining and the volume fraction (v/f) of elastic fibres was determined as a percentage of tissue volume using point counting. Elastic fibre networks were also visualised by confocal microscopy.

The v/f for elastic fibres in alveoli was 18.6% for COPD and 32.8% in controls. In the airways the v/f was 14.6% for COPD and 25.5% in controls. FEV1% predicted was correlated with v/f in both alveoli and small airways.

The volume fraction of elastic fibres was reduced to a similar extent in small airways and alveoli in chronic obstructive pulmonary disease and both were correlated with the extent of airflow obstruction. Loss of elastic fibres in small airways may contribute to the development of airflow obstruction in chronic obstructive pulmonary disease.
Standardversuspatient-centred asthma education in the emergency department: a randomised study
Authors: Smith S. , Mitchell C. , Bowler S.
Published: January 2008

High re-attendance rates are common after asthma emergency department (ED) care. Inadequate patient education has been cited as a potential cause of re-attendance and the optimal format of education is uncertain. The present study aimed to compare the effectiveness of patient-centred education (PCE) and standard asthma patient education on ED re-attendance.

A randomised controlled trial was conducted at two inner-city Australian teaching hospitals’ EDs, where patients received either standard patient education (SPE) or PCE. Both groups received a six-topic curriculum. However, PCE patients reordered the topics according to their own priority and thus controlled the order of education.

In total, 146 adult patients presenting to EDs with acute asthma were enrolled. After 4 months, ED re-attendance decreased from 22 to 12% in the PCE group and remained unchanged in the SPE group (between group odds ratio 0.4, 95% confidence interval (0.2–1.1)). In 78 patients discharged after ED care, the PCE group had fewer re-attendances after 4 and 12 months (0.3 (0.1–0.9) and 0.3 (0.1–0.8), respectively ). PCE patients with no general practitioner care in the preceding 7 days had fewer re-attendances after 4 and 12 months (0.1 (0.0–0.7) and 0.2 (0.0–0.6), respectively). A trend of better asthma control was evident, with a reduction in activity limitation.

In conclusion, patient-centred education offers promise as a brief education process in the emergency department. However, a large multicentre trial of patient-centred education is required.
Cathepsin H and napsin A are active in the alveoli and increased in alveolar proteinosis
Authors: Woischnik M. , Bauer A. , Aboutaam R. , Pamir A. , Stanzel F. , de Blic J. , Griese M.
Published: January 2008

Pulmonary alveolar proteinosis (PAP) is a group of rare diseases with disturbed homeostasis of alveolar surfactant. While 90% of the primary adult forms are caused by granulocyte-macrophage colony-stimulating factor autoantibodies, the underlying cause of the juvenile form remains unknown. In order to distinguish primary from secondary effects in the pathogenesis of these two forms, the present authors studied the surfactant protein processing proteases napsin A and cathepsin H.

In total, 16 controls, 20 patients with juvenile PAP and 13 adults with idiopathic PAP were enrolled. Amounts and activities of the proteases in the bronchoalveolar lavage fluid (BALF) were determined by immunoblotting and specific substrate cleavage.

Both proteases were present and active in BALF from controls and increased in juvenile and adult PAP patients. The amount of active cathepsin H in relation to total cathepsin H was increased in PAP patients compared with controls. Cystatin C, the physiological inhibitor of cathepsin H in the alveolar space, was not increased to the same degree as cathepsin H, resulting in an imbalance of inhibitor to protease in the alveolar space.

A general defect in napsin A or cathepsin H expression or activity was not the specific cause for abnormal surfactant accumulation in juvenile pulmonary alveolar proteinosis.
Impact of chronic airflow obstruction in a working population
Authors: Roche N. , Dalmay F. , Perez T. , Kuntz C. , Vergnenègre A. , Neukirch F. , Giordanella J-P. , Huchon G.
Published: January 2008

Data on the individual and collective impact of chronic airflow obstruction at a population level are scarce. In a nationwide survey, dyspnoea, quality of life and missed working days were compared between subjects with and without spirometrically diagnosed chronic airflow obstruction.

Subjects aged ≥45 yrs were recruited in French health prevention centres (n = 5,008). Results of pre-bronchodilator spirometry and questionnaires (European Community Respiratory Health Survey-derived questionnaire and European quality of life five-dimension questionnaire) were collected. Adequate datasets were available for 4,764 subjects aged 60±10 yrs (only 2% were aged ≥80 yrs).

The prevalence of airflow obstruction (forced expiratory volume in one second/forced vital capacity of <0.70) was 7.5%. The vast majority (93.9%) of cases had not been diagnosed previously. Health status was significantly influenced by dyspnoea. Both were associated with the number of missed working days. Despite mild-to-moderate severity, subjects with chronic airflow obstruction exhibited more dyspnoea, poorer quality of life and higher numbers of missed working days (mean 6.71versus1.45 days·patient−1·yr−1in patients without airflow obstruction, for the population with no known heart or lung disease).

In conclusion, even mild-to-moderate airflow obstruction is associated with an impaired health status, which represents an additional argument in favour of early detection in chronic obstructive pulmonary disease.
Right ventricular contractility in systemic sclerosis-associated and idiopathic pulmonary arterial hypertension
Authors: Overbeek M. J. , Lankhaar J-W. , Westerhof N. , Voskuyl A. E. , Boonstra A. , Bronzwaer J. G. F. , Marques K. M. J. , Smit E. F. , Dijkmans B. A. C. , Vonk-Noordegraaf A.
Published: January 2008

Since systemic sclerosis (SSc) also involves the heart, the aim of the present study was to evaluate possible differences in right ventricular (RV) pump function between SSc-associated pulmonary arterial hypertension (PAH; SScPAH) and idiopathic PAH (IPAH).

In 13 limited cutaneous SScPAH and 17 IPAH patients, RV pump function was described using the pump function graph, which relates mean RV pressure (P̄RV) and stroke volume index (SVI). Differences in pump function result in shift or rotation of the pump function graph.P̄RVand SVI were measured using standard catheterisation. The hypothetical isovolumicP̄RV(P̄RV,iso) was estimated using a single-beat method. The pump function graph was approximated by a parabola:P̄RV = P̄RV,iso[1–(SVI/SVImax)2], where SVImaxis the hypothetical maximal SVI at zeroP̄RV, enabling calculation of SVImax.

There were no differences in SVI and SVImax. BothP̄RVandP̄RV,isowere significantly lower in SScPAH than in IPAH (P̄RV30.7±8.5versus41.2±9.4 mmHg;P̄RV,iso43.1±12.4versus53.5±10.0 mmHg). Since higher pressures were found at similar SVI, the difference in the pump function graph results from lower contractility in SScPAH than in IPAH.

Right ventricular contractility is lower in systemic sclerosis-associated pulmonary arterial hypertension than in idiopathic pulmonary arterial hypertension.
Distinguishing phenotypes of childhood wheeze and cough using latent class analysis
Authors: Spycher B. D. , Silverman M. , Brooke A. M. , Minder C. E. , Kuehni C. E.
Published: January 2008

Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. The present study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions.

From a population-based, longitudinal cohort study of 1,650 preschool children, 319 with parent-reported wheeze or chronic cough were included. Phenotypes were identified by latent class analysis using data on symptoms, skin-prick tests, lung function and airway responsiveness from two preschool surveys. These phenotypes were then compared with respect to outcome at school age.

The model distinguished three phenotypes of wheeze and two phenotypes of chronic cough. Subsequent wheeze, chronic cough and inhaler use at school age differed clearly between the five phenotypes. The wheeze phenotypes shared features with previously described entities and partly reconciled discrepancies between existing sets of phenotype labels.

This novel, multidimensional approach has the potential to identify clinically relevant phenotypes, not only in paediatric disorders but also in adult obstructive airway diseases, where phenotype definition is an equally important issue.
Initiation of human myoblast differentiation via dephosphorylation of Kir2.1 K+ channels at tyrosine 242
Authors: Hinard Valérie , Belin Dominique , Konig Stéphane , Bader Charles Roland , Bernheim Laurent
Published: January 2008

Myoblast differentiation is essential to skeletal muscle formation and repair. The earliest detectable event leading to human myoblast differentiation is an upregulation of Kir2.1 channel activity, which causes a negative shift (hyperpolarization) of the resting potential of myoblasts. After exploring various mechanisms, we found that this upregulation of Kir2.1 was due to dephosphorylation of the channel itself. Application of genistein,a tyrosine kinase inhibitor, increased Kir2.1 activity and triggered the differentiation process, whereas application of bpV(Phen), a tyrosine phosphatase inhibitor, had the opposite effects. We could show that increased Kir2.1 activity requires dephosphorylation of tyrosine 242; replacing this tyrosine in Kir2.1 by a phenylalanine abolished inhibition by bpV(Phen). Finally, we found that the level of tyrosine phosphorylation in endogenous Kir2.1 channels is considerably reduced during differentiation when compared with proliferation. We propose that Kir2.1 channels are already present at the membrane of proliferating, undifferentiated human myoblasts but in a silent state, and that Kir2.1 tyrosine 242 dephosphorylation triggers differentiation.
Multiple RTK pathways downregulate Groucho-mediated repression inDrosophilaembryogenesis
Authors: Cinnamon Einat , Helman Aharon , Ben-Haroush Schyr Rachel , Orian Amir , Jiménez Gerardo , Paroush Ze'ev
Published: January 2008

RTK pathways establish cell fates in a wide range of developmental processes. However, how the pathway effector MAPK coordinately regulates the expression of multiple target genes is not fully understood. We have previously shown that the EGFR RTK pathway causes phosphorylation and downregulation of Groucho, a global co-repressor that is widely used by many developmentally important repressors for silencing their various targets. Here, we use specific antibodies that reveal the dynamics of Groucho phosphorylation by MAPK, and show that Groucho is phosphorylated in response to several RTK pathways during Drosophila embryogenesis. Focusing on the regulation of terminal patterning by the Torso RTK pathway, we demonstrate that attenuation of Groucho's repressor function via phosphorylation is essential for the transcriptional output of the pathway and for terminal cell specification. Importantly, Groucho is phosphorylated by an efficient mechanism that does not alter its subcellular localisation or decrease its stability; rather, modified Groucho endures long after MAPK activation has terminated. We propose that phosphorylation of Groucho provides a widespread,long-term mechanism by which RTK signals control target gene expression.
Mind bomb 2, a founder myoblast-specific protein, regulates myoblast fusion and muscle stability
Authors: Carrasco-Rando Marta , Ruiz-Gómez Mar
Published: January 2008

A fundamental step during Drosophila myogenesis is the specification of founder myoblasts (FMs). Founders possess the information required for the acquisition of muscle identity and for the execution of the myogenic programme, whereas fusion-competent myoblasts (FCMs) acquire this information after fusing to founders. Very little is known about genes that implement the execution of the myogenic programme. Here we characterise Mind bomb 2 (Mib2), a protein with putative E3 ubiquitin ligase activity that is exclusive of FMs and necessary for at least two distinct steps of the founder/myotube differentiation programme. Thus, in mib2 mutants, the early process of myoblast fusion is compromised, as FMs undergo a reduced number of rounds of fusion with FCMs. At later stages, with the onset of muscle contraction, many muscles degenerate, display aberrant sarcomeric structure and detach from tendons. The fusion process requires intact E3-RING-finger domains of Mib2 (the putative catalytic sites), probably to eliminate the FCM-specific activator Lmd from nascent myotubes. However, these sites appear dispensable for muscle integrity. This, and the subcellular accumulation of Mib2 in Z and M bands of sarcomeres, plus its physical interaction with nonmuscle myosin (a Z-band-localised protein necessary for the formation of myofibrils), suggest a structural role for Mib2 in maintaining sarcomeric stability. We suggest that Mib2 acts sequentially in myoblast fusion and sarcomeric stability by two separable processes involving distinct functions of Mib2.
DrosophilaPxt: a cyclooxygenase-like facilitator of follicle maturation
Authors: Tootle Tina L. , Spradling Allan C.
Published: January 2008

Prostaglandins are local transient hormones that mediate a wide variety of biological events, including reproduction. The study of prostaglandin biology in a genetically tractable invertebrate model organism has been limited by the lack of clearly identified prostaglandin-mediated biological processes and prostaglandin metabolic genes, particularly analogs of cyclooxygenase (COX),the rate-limiting step in vertebrate prostaglandin synthesis. Here, we present pharmacological data that Drosophila ovarian follicle maturation requires COX-like activity and genetic evidence that this activity is supplied in vivo by the Drosophila peroxidase Pxt. pxt mutant females are sterile, and maturing follicles show defects in actin filament formation,nurse cell membrane stability and border cell migration. Maturation of pxt follicles in vitro is stimulated by prostaglandin treatment and fertility is restored in vivo to pxt mutants by expressing mammalian Cox1 protein. Our experiments suggest that prostaglandins promote Drosophila follicle maturation, in part by modulating the actin cytoskeleton, and establish Drosophila oogenesis as a model for understanding these critical biological regulators.
Delimiting the conserved features ofhunchbackfunction for the trunk organization of insects
Authors: Marques-Souza Henrique , Aranda Manuel , Tautz Diethard
Published: January 2008

The gap gene hunchback in Drosophila acts during syncytial blastoderm stage via a short-range gradient and concentration-dependent activation or repression of target genes. Orthologues of hunchback can be easily found in other insects, but it has been unclear how well its functions are conserved. The segmentation process in most insect embryos occurs under cellular conditions, which should not allow the formation of diffusion-controlled transcription factor gradients. We have studied here in detail the function of hunchback in the short germ embryo of Tribolium using parental RNAi and interaction with possible target genes. We find that hunchback is a major regulator of the trunk gap genes and Hox genes in Tribolium, but may only indirectly be required to regulate other segmentation genes. The core function of hunchback appears to be the setting of the Ultrabithoraxexpression border via a repression effect, and the activation of the Krüppel expression domain. These regulatory effects are likely to be direct and are conserved between Drosophila and Tribolium. We find no evidence for a classical gap phenotype in the form of loss of segments in the region of expression of hunchback. However, the phenotypic effects in Tribolium are highly comparable with those found for other short germ embryos, i.e. the core functions of hunchback in Tribolium appear to be the same in these other insects, although they are evolutionarily more distant to Tribolium,than Tribolium is to Drosophila. These results allow the disentanglement of the conserved role of hunchback in insects from the derived features that have been acquired in the lineage towards Drosophila. Given that the gap phenotype appears to occur only in long germ embryos and that the main role of hunchback appears to be the regionalization of the embryo, it may be appropriate to revive an alternative name for the class of gap genes, namely `cardinal genes'.
Outcomes in Squamous Cell Carcinoma with Advanced Neck Disease
Authors: Keir James A , Whiteside Olivia JH , Winter Stuart C , Maitra Sushir , Corbridge Rogan C , Cox Graham J
Published: January 2008

INTRODUCTION

Treatment of advanced neck disease (N2c/N3) in head and neck squamous cell carcinoma is contentious. The aim of this study was to review the survival outcome following surgical excision of neck disease and the complications of this surgery.

PATIENTS AND METHODS

A retrospective review of the case notes of 39 patients treated at the Oxford Radcliffe Infirmary Head and Neck Unit with squamous cell carcinoma and advanced neck metastases confirmed as either pN2c or pN3 on histological examination was performed. Patients were treated with surgery and, in some cases, with adjunctive postoperative radiotherapy at the centre between August 1996 and November 2004. The study sought to establish the demographics, UICC staging/pathology, method of treatment, complications, recurrence and survival. Kaplan-Meier curves were used for statistical analysis of survival. Comparisons were then made between the cohort and historical control groups.

RESULTS

All patients were UICC stage IV disease. The 2- and 5-year overall survival in patients with resectable disease was 63% and 52%, respectively.

DISCUSSION

Patients with advanced neck disease have traditionally been thought to have terrible prognosis and, therefore, treatment is controversial. In treating advanced head and neck cancer, there has been a recent trend away from surgery towards chemotherapy and/or radiotherapy.

CONCLUSIONS

Comparing this study group to historical controls that include chemotherapy and/or radiotherapy, the outcomes appear favourable. The use of a combination of radiotherapy and surgery is advocated; it is suggested that advanced neck disease can have an acceptable prognosis and morbidity and that local disease control may be achieved.
What do Patients Think about being Copied into their GP Letters?
Authors: Pothier David D , Nakivell Paul , Hall Charles EJ
Published: January 2008

INTRODUCTION

Sending patients a copy of the letters that are produced for their referring general practitioners (GPs) from an out-patient consultation is a policy of the UK Department of Health. Little research has been done to establish how patients attending out-patient departments feel about this practice and the effect this may have on the department itself.

PATIENTS AND METHOD

We asked 500 patients attending our out-patient department to complete a questionnaire. Patients were only included if they had previously been offered a copy letter by our department.

RESULTS

Of patients, 95% were in favour of the practice and 93.4% understood all or most of the contents of the letter. Dictation in front of the patients made them less likely to request a copy of the letter (P < 0.001). Impact of queries related to the letters was minimal with only three patients making contact with the department during the 3 months that the study was being conducted.

CONCLUSIONS

Our experience has shown that copying patients into their GP letters is a useful and popular practice for patients and has little impact on the running of the department. Patients also are in favour of having their letter dictated in their presence and this reduces their need to have a copy sent to them.
Scientific Basis for the Treatment of Low Back Pain
Authors: Mulholland RC
Published: January 2008

Disc degeneration causes back pain because the function of the disc as a load transferring structure is abnormal, producing abnormal patterns of load which cause pain. Fusion has been unpredictable because it only fortuitously addresses loading. A fusion may be in such a position that it takes load from the disc, and this may be reflected in the way the fusion models, demonstrating a weight bearing pattern, but this is unpredictable. Recognition that we are dealing with a problem of load transfer allows us to design any surgical implant to solve this problem, without stopping movement.
Bacterial Contamination of Hospital Bed-Control Handsets in a Surgical Setting: A Potential Marker of Contamination of the Healthcare Environment
Authors: Brady RRW , Kalima P , Damani NN , Wilson RG , Dunlop MG
Published: January 2008

INTRODUCTION

Patients undergoing colorectal surgical resections have a high incidence of surgical site infection (SSI). Many patient-specific risk factors have been recognised in association with SSI in such patients, but environmental contamination is increasingly recognised as a contributor to hospital-acquired infection (HAI). This study set out to describe the bacterial contamination of the patient environment, using hospital bed-control handsets, as they are frequently handled by both staff and patients and represent a marker of environmental contamination.

PATIENTS AND METHODS

On two unannounced sampling events, 1 week apart, 140 bacteriological assessments were made of 70 hospital bed control handsets within a specialist colorectal surgical unit.

RESULTS

Of the handsets examined, 67 (95.7%) demonstrated at least one bacterial species (52.9% grew 1, 30% grew 2 and 12.9% grew 3 or more bacterial species). Of these, 29 (41.4%) bed-control handsets grew bacteria known to cause nosocomial infection, including 22 (31.4%) handsets which grew Enterococcus spp., 9 (12.9%) which grew MRSA, 2 (2.9%) which grew MSSA, 2 (2.9%) which grew coliforms, and 1 (1.4%) handset which grew anaerobes. At 1-week follow-up, 31 bed-control handsets showed evidence of contamination by the same bacterial species.

CONCLUSIONS

This study revealed high levels of bacteria known to cause HAI, contaminating hospital bed-control handsets in a surgical setting. Further study is now required to confirm whether hospital environmental contamination is causally involved in SSI.
Three Fatal Cases of Squamous Cell Carcinoma Arising in Chronic Perineal Hidradenitis Suppurativa
Authors: Maclean Gael M , Coleman David J
Published: January 2008

INTRODUCTION

Hidradenitis suppurativa (HS) is a chronic, inflammatory and suppurative disorder of skin bearing apocrine glands. The most severe complication is squamous cell carcinoma (SCC) and we here present three cases, all of which proved fatal, and review the past 40 years of published cases.

PATIENTS AND METHODS

Three advanced cases of SCC arising in chronic HS have been referred for reconstructive surgery over the past 8 years. Another 28 cases published over the past 40 years were identified using a Medline search (search items in combination: hidradenitis, squamous, carcinoma).

RESULTS

The male:female ratio was 4:1, most (61%) were perineal or buttock. We found no reports of SCC arising in axillary disease. The symptomatic history of HS prior to SCC diagnosis ranged from 3–50 years with a mean of 25 years. Age at diagnosis of SCC ranged from 27–71 years, and 15 patients (48%) died within 2 years of SCC diagnosis.

CONCLUSIONS

We advocate that hidradenitis suppurativa arising in extra-axillary sites is a pre-malignant condition, and should not be treated conservatively; curative resection is the mainstay of management.
Nephroureterectomy for Transitional Cell Carcinoma – The Value of Pre-Operative Histology
Authors: Chitale Sudhanshu , Mbakada Rashidi , Irving Stuart , Burgess Neil
Published: January 2008

INTRODUCTION

Nephroureterectomy with excision of a cuff of bladder remains the standard for managing upper tract transitional cell carcinoma (TCC). Increasing use of diagnostic upper tract endoscopy has underlined the importance of obtaining a pre-operative histological diagnosis in order to avoid under-treating high-grade or multifocal disease and over-treating low-grade disease, which could, in selected cases, be managed conservatively. We review nephroureterectomy at our institution over a 10-year period with particular reference to a pre-operative histological diagnosis.

PATIENTS AND METHODS

Nephroureterectomy was performed in 113 patients from February 1994 to February 2004. Of these cases, 58 were for upper tract TCC and 50 of these 58 had intravenous urography (IVU): 9 had only IVU, 28 had an additional CT scan, 5 had an additional ultrasonography and 8 had additional CT + ultrasonography for pre-operative work-up. Thirty-four of the 58 cases had retrograde pyelography. Nineteen (32.7%) of the 58 cases had a pre-operative ureteroscopy (URS) and biopsy; 14 of these had rigid URS for tumours in the lower (11) and middle (3) thirds of the ureter and 5 had flexible URS for pelvicalyceal tumours by an experienced endourologist. Thirty-one (53%) of the 58 tumours were within the pelvicalyceal system and 27 within the ureter (upper, 5; middle, 3; lower, 19). Forty-eight patients underwent a total nephroureterectomy: 40 had a two incision approach and 8 had an endoscopic resection of the lower ureter. Five of the 58 cases had a sub-total nephroureterectomy and 5 a laparoscopic nephroureterectomy with open excision of lower ureter.

RESULTS

Nineteen (32.7%) of the 58 patients had a pre-operative histological diagnosis – 17 G2pTa, 1 G1pTa, and 1 G2pT1. Fourteen (74%) biopsies matched the final postoperative histology, but 1 was down-staged, 3 up-staged and 1 up-graded compared to the original histology. Five (12.8%) of 39 patients without pre-operative histology had no TCC in the final surgical specimen: 4 (10.25%) had benign pathology such as capillary haemangioma, urothelial cysts and reactive urothelial changes while one had renal cell carcinoma (RCC).

CONCLUSIONS

This study underlines the importance of obtaining a pre-operative histological diagnosis in cases with presumed upper tract TCC. Failure to do so can result in unnecessary ablative surgery for benign disease. Such an approach can also help identify multifocality and grade of disease so that treatment of upper tract TCC can be tailored more appropriately with ablative surgery for high-grade or multifocal disease and conservative (endoscopic) therapy for low-grade disease in selected cases. Patients with suspected TCC of the upper tract should be managed at centres where facilities for the comprehensive evaluation of such tumours exist.
A Survey of Users of a Dental Access Centre Situated in an Area of Mixed Socioeconomic Affluence and Deprivation
Authors: Harris Rebecca , Burnside Girvan
Published: January 2008

Objective

To describe the users of a Dental Access Centre (DAC) situated in an area of England with a mixed socioeconomic profile, their pattern of use, and their perception of the role of the service.

Method

A sample of users was drawn from a DAC in Cheshire's clinical database. A postal questionnaire was sent to these users via a three-stage mailing, using a prize draw incentive to promote response. After the third mailing stage, non-responders were also contacted by telephone.

Results

A high proportion of users lived relatively near the DAC. Over 80% of respondents were unregistered with a dentist in Cheshire. The centre appeared to be used for symptomatic care only, with no respondents reporting using the centre for routine care (including check-ups).

Conclusion

The role of DACs was originally envisaged as providing a service for unregistered patients wanting convenient, accessible, emergency care, and as providing routine National Health Service (NHS) care, including check-ups in geographical areas where there is limited availability of NHS care in general dental practice. In a geographical area with low dental need, one might expect the DAC to fulfil the second of these roles. However, this study suggests that even in this type of area, users of the DAC who responded to the questionnaire viewed it as a source of emergency care and not as a provider of routine care.