bluuebunny/crossref_metadata_2025 huggingface dataset:
Endothelial reticulon-4B (Nogo-B) regulates ICAM-1–mediated leukocyte transmigration and acute inflammation
Authors: Di Lorenzo Annarita , Manes Thomas D. , Davalos Alberto , Wright Paulette L. , Sessa William C.
Published: December 2010

The reticulon (Rtn) family of proteins are localized primarily to the endoplasmic reticulum (ER) of most cells. The Rtn-4 family, (aka Nogo) consists of 3 splice variants of a common gene called Rtn-4A, Rtn-4B, and Rtn-4C. Recently, we identified the Rtn-4B (Nogo-B) protein in endothelial and smooth muscle cells of the vessel wall, and showed that Nogo-B is a regulator of cell migration in vitro and vascular remodeling and angiogenesis in vivo. However, the role of Nogo-B in inflammation is still largely unknown. In the present study, we use 2 models of inflammation to show that endothelial Nogo-B regulates leukocyte transmigration and intercellular adhesion molecule-1 (ICAM-1)–dependent signaling. Mice lacking Nogo-A/B have a marked reduction in neutrophil and monocyte recruitment to sites of inflammation, while Nogo-A/B−/− mice engrafted with wild-type (WT) bone marrow still exhibit impaired inflammation compared with WT mice engrafted with Nogo-A/B−/− bone marrow, arguing for a critical role of host Nogo in this response. Using human leukocytes and endothelial cells, we show mechanistically that the silencing of Nogo-B with small interfering RNA (siRNA) impairs the transmigration of neutrophils and reduces ICAM-1–stimulated phosphorylation of vascular endothelial-cell cadherin (VE-cadherin). Our results reveal a novel role of endothelial Nogo-B in basic immune functions and provide a key link in the molecular network governing endothelial-cell regulation of diapedesis.
An eikonal-based formulation for traveltime perturbation with respect to the source location
Authors: Alkhalifah Tariq , Fomel Sergey
Published: December 2010

Traveltime calculations amount to solving the nonlinear eikonal equation for a given source location. The relationship between the eikonal solution and its perturbations is analyzed with respect to the source location and a partial differential equation is developed that relates the traveltime field for one source location to that for a nearby source. This linear first-order equation in one form depends on lateral changes in velocity and in another form is independent of the velocity field and relies on second-order derivatives of the original traveltime field. For stable finite-difference calculations, this requires the velocity field to be smooth in a sense similar to ray-tracing requirements. Our formulation for traveltime perturbation has several potential applications, such that as traveltime calculation by source-location perturbation, velocity-independent interpolation including datuming, and velocity estimation. Additionally, higher-order expansions provide parameters necessary for Gaussian-beam computations.
Fluid pressure arrival-time tomography: Estimation and assessment in the presence of inequality constraints with an application to production at the Krechba field, Algeria
Authors: Rucci Alessio , Vasco D. W. , Novali Fabrizio
Published: December 2010

Deformation in the overburden proves useful in deducing spatial and temporal changes in the volume of a producing reservoir. Based on these changes, we have estimated diffusive traveltimes associated with the transient flow due to production, and then, as the solution of a linear inverse problem, the effective permeability of the reservoir. An advantage of the approach based on traveltimes, as opposed to one based on the amplitude of surface deformation, is that it is much less sensitive to the exact geomechanical properties of the reservoir and overburden. Inequalities constrain the inversion, under the assumption that the fluid production only results in pore volume decreases within the reservoir. The formulation has been applied to satellite-based estimates of deformation in the material overlying a thin gas production zone at the Krechba field in Algeria. The peak displacement after three years of gas production is found to be approximately [Formula: see text], overlying the eastern margin of the anticlinal structure defining the gas field. Using data from 15 irregularly spaced images of range change, we have calculated the diffusive traveltimes associated with the startup of a gas production well. The inequality constraints were incorporated into the estimates of model parameter resolution and covariance, improving the resolution by roughly 30% to 40%.
Transient receptor potential ion channel Trpm7 regulates exocrine pancreatic epithelial proliferation by Mg2+-sensitive Socs3a signaling in development and cancer
Authors: Yee Nelson S. , Zhou Weiqiang , Liang I-Chau
Published: December 2010

Genetic analysis of pancreatic development has provided new insights into the mechanisms underlying the formation of exocrine pancreatic neoplasia. Zebrafish sweetbread (swd) mutants develop hypoplastic acini and dysmorphic ducts in the exocrine pancreas, with impeded progression of cell division cycle and of epithelial growth. Positional cloning and allelic complementation have revealed that the swd mutations affect the transient receptor potential melastatin-subfamily member 7 (trpm7) gene, which encodes a divalent cation-permeable channel with kinase activity. Supplementary Mg2+ partially rescued the exocrine pancreatic defects of the trpm7 mutants by improving cell-cycle progression and growth and repressing the suppressor of cytokine signaling 3a (socs3a) gene. The role of Socs3a in Trpm7-mediated signaling is supported by the findings that socs3a mRNA level is elevated in the trpm7 mutants, and antisense inhibition of socs3a expression improved their exocrine pancreatic growth. TRPM7 is generally overexpressed in human pancreatic adenocarcinoma. TRPM7-deficient cells are impaired in proliferation and arrested in the G0-G1 phases of the cell division cycle. Supplementary Mg2+ rescued the proliferative defect of the TRPM7-deficient cells. Results of this study indicate that Trpm7 regulates exocrine pancreatic development via the Mg2+-sensitive Socs3a pathway, and suggest that aberrant TRPM7-mediated signaling contributes to pancreatic carcinogenesis.
Bocmodifies the holoprosencephaly spectrum ofCdomutant mice
Authors: Zhang Wei , Hong Mingi , Bae Gyu-un , Kang Jong-Sun , Krauss Robert S.
Published: December 2010

Holoprosencephaly (HPE) is caused by a failure to form the midline of the forebrain and/or midface. It is one of the most common human birth defects, but clinical expression is extremely variable. HPE is associated with mutations in the sonic hedgehog (SHH) pathway. Mice lacking the Shh pathway regulator Cdo (also called Cdon) display HPE with strain-dependent penetrance and expressivity, implicating silent modifier genes as one cause of the variability. However, the identities of potential HPE modifiers of this type are unknown. We report here that whereas mice lacking the Cdo paralog Boc do not have HPE, Cdo;Boc double mutants on a largely Cdo-resistant genetic background have lobar HPE with strong craniofacial anomalies and defects in Shh target gene expression in the developing forebrain. Boc is therefore a silent HPE modifier gene in mice. Furthermore, Cdo and Boc have specific, selective roles in Shh signaling in mammals, because Cdo;Boc double-mutant mice do not display the most severe HPE phenotype seen in Shh-null mice, nor do they have major defects in digit patterning or development of vertebrae, which are also Shh-dependent processes. This is in contrast to reported observations in Drosophila, where genetic removal of the Cdo and Boc orthologs Ihog and Boi results in a complete loss of response to the hedgehog ligand. Therefore, there is evolutionary divergence between mammals and insects in the requirement of the hedgehog pathway for Cdo/Ihog family members, with mammalian development involving additional factors and/or distinct mechanisms at this level of pathway regulation.
Synthesis of Cyclophane Dimer Using Cyclophane-tethered Fmoc-amino Acid Derivatives as a Multivalent Host
Authors: Hayashida Osamu , Nakashima Tomomi
Published: December 2010

Water-soluble cyclophane dimer was synthesized by Fmoc-chemistry of cyclophane-tethered Fmoc-lysine derivative, as a multivalent host. The host showed enhanced guest binding affinity relative to that by monocyclic cyclophane, as confirmed by fluorescence spectroscopy as well as surface plasmon resonance measurements.
Organocatalyst-mediated Aldol–Robinson Cascade Reactions: A Convenient Synthesis of Substituted Cyclohex-2-enones
Authors: Wang Li , Gong Qing-Ping , Liu Xiao-Jun , Li Yong-Hong , Huang Ping , Wang Bi-Qin , Zhao Ke-Qing
Published: December 2010

A convenient organocatalytic process for the chemoselective synthesis of substituted cyclohex-2-enones was developed. The cascade reaction involves a remarkable Michael addition of an acyclic ketone-based enamine onto unmodified enones. The enamine-mediated aldol–Robinson cascade reactions of aromatic and aliphatic aldehydes with acetone produced substituted cyclohex-2-enones in moderate to high yields under mild reaction conditions.
Preparation of (Sr0.5Ba0.5)Si2N2O2:Eu2+ Phosphor and Its Luminescence Properties
Authors: Lei Bingfu , Machida Ken-ichi , Horikawa Takashi , Hanzawa Hiromasa
Published: December 2010

Eu2+ ion-doped oxynitride phosphor, (Sr0.5Ba0.5)Si2O2N2:Eu2+, was prepared by solid-state reaction using metal alloy as precursor. Owing to the relatively high activity of the metal alloy precursor compared with the inert Si3N4, a single phase of solid solution phosphor (Sr0.5Ba0.5)Si2O2N2:Eu2+ was easily obtained at 1400 °C under atmospheric pressure. It showed a broad excitation band originating from the 4f7 → 4f65d transition of Eu2+ ion, extending to 520 nm, and centering at 460 nm and a strong emission band peaking at 565 nm. The high emission and small thermal quenching allow this material to be used for phosphor-converted white LEDs.
Does Network Theory Connect to the Rest of Us? A Review of Matthew O. Jackson's Social and Economic Networks
Authors: Rauch James E
Published: December 2010

The ubiquity of networks in our social lives has long been recognized, and their importance in our economic lives is increasingly recognized as well. Yet the literature synthesized in Matthew O. Jackson's Social and Economic Networks, which covers the theory of how networks form, decay, and shape behavior at a general level, has had little influence on either applied theory or empirical work in this area. This is partly because of limitations of network theory as it has evolved in this literature. After describing the network theory presented in the book, I discuss these limitations and make some tentative suggestions as to how they might be overcome. (JEL D85, L14, Z13)
What Evidence is There That a Physiotherapy Service in the Emergency Department Improves Health Outcomes? A Systematic Review
Authors: Kilner Emily
Published: December 2010

Objective

The nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care staff, though it is unclear how such a service affects health outcomes. The objective was to identify the effect an emergency department physiotherapy service has on health outcomes.

Method

Systematic searches were carried out on the following databases: CINAHL, Medline, Web of Knowledge, Scopus, PEDro, PubMed, Cochrane and Academic Search Premier. Selection criteria included full-text English primary studies published in peer-reviewed journals, investigating physiotherapy services based directly in the emergency department. Papers were appraised using a researcher-developed appraisal of bias tool.

Results

Eleven eligible primary studies were identified. For most, the likelihood of methodological bias was high or unknown due to inadequate detail provided. Three studies were judged to have introduced little bias. At system and provider levels, there is insufficient evidence to support benefits of an emergency department physiotherapy service. At patient level, there is high-level evidence of benefits in terms of improved pain control and reduced disability in the short term.

Conclusions

Research evidence does not support the use of physiotherapists in emergency departments.
Identifying Poorly Performing General Practices in England: A Longitudinal Study Using Data from the Quality and Outcomes Framework
Authors: Ashworth Mark , Schofield Peter , Seed Paul , Durbaba Stevo , Kordowicz Maria , Jones Roger
Published: December 2010

Objective

To determine the characteristics of general practices which perform poorly in terms of Quality and Outcome (QOF) performance indicators in England's NHS.

Method

Retrospective, four year longitudinal study, 2005 to 2008. Data were obtained from 8515 practices (99% of practices in England) in year 1, 8264 (98%) in year 2, 8192 (98%) in year 3 and 8256 (99%) in year 4. Outcome measures: QOF performance scores; social deprivation (IMD-2007) and ethnicity from the 2001 national census; general practice characteristics.

Results

We identified a cohort of 212 (2.7%) practices which remained in the lowest decile for total QOF scores in the four years following the introduction of the QOF. A total of 705,386 patients were registered at these practices in year 4. These practices were more likely to be singlehanded (odds ratio [OR], 13.8), non-training practices (OR, 3.9) and located in deprived areas (OR, 2.6; most vs least deprived quintiles). General practitioners (GPs) in these practices were more often aged ≥65 years or more (OR, 7.3; mean GP age ≥65 years vs <45 years), male (OR 2.0), UK qualified (OR 2.0) with small list sizes (OR 3.2; list size <1000 vs 1500-2000 patients). We identified individual QOF indicators which were poorly achieved. The reported prevalence of most chronic diseases was lower in the poorly performing cohort.

Conclusions

A small minority of practices have remained poor performers in terms of measurable performance indicators over a four-year period. The strongest predictors of poor QOF performance were singlehanded and small practices, and practices staffed by elderly GPs.
Open Access Research
Authors: Wright Kath , Light Kate , Stirk Lisa
Published: December 2010

Open access makes research results available via the Internet without the user needing to have a subscription or to make a one-off payment to a publisher. This model of publication has resulted in the creation of both digital repositories and open access electronic journals. Material published using either of these routes is often free of restrictions in terms of both copyright and licensing.

This edition of ‘What's on the web’ reviews three websites that look at different aspects of open access: developing open access repositories in universities, academic publishing and communication, and an example of an open access publisher. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:
Accidental renal injury by an external heating device during surgery in rats
Authors: Roehl A B , Teubner A , Funcke S , Goetzenich A , Rossaint R , Tolba R , Hein M
Published: December 2010

Hypothermia can be caused by anaesthesia and/or surgery and represents a daily challenge in the operating room. Experimental animal surgery settings typically use heating pads or warming blankets to maintain the rodent's body temperature during long-lasting experiments. Warming is crucial in small animal experiments because these animals quickly lose temperature due to their large body surface to body weight ratio. While establishing a left ventricular infarction model in rats, we inserted a rectal temperature probe. The heating pad's set point was 37°C. Although a dual set point control circuit should prevent overheating, we observed a maximum heating pad's surface temperature of 43°C between the animal's back and the surface of the heating pad. At the end of the experiments, which lasted up to 8 h, the animals showed severe haematuria and segmental kidney damage. We hypothesized that overheating of the heating pad and uneven distribution of temperature led to kidney damage. Therefore, the maximal temperature of commonly used heating pads must be tightly controlled to avoid overheating, which may cause kidney or tissue injury, may falsify the experimental data and could influence the study results.
Role of laparoscopic nephrectomy for refractory hypertension in poorly functioning kidneys
Authors: Elhage Oussama , Sahai Arun , Challacombe Ben , Murphy Declan , Scoble John , Dasgupta Prokar
Published: December 2010

INTRODUCTION

Hypertension is a common medical problem mainly treated by effective antihypertensive drugs. Persistent hypertension can be difficult to manage and have detrimental effect on vital organs. Nephrectomy of poorly functioning kidneys may be indicated in a minority of such cases.

PATIENTS AND METHODS

We performed laparoscopic nephrectomy on 12 patients with refractory hypertension.

RESULTS

Eight had complete response, three had partial response and one had no response.

CONCLUSIONS

Laparoscopic nephrectomy has a role in carefully selected adult patients with refractory hypertension due to non-functioning kidney. Patients need to understand the surgical risks as well as the small risk of failure to treat hypertension.
Bare below elbows: does this policy affect handwashing efficacy and reduce bacterial colonisation?
Authors: Burger A , Wijewardena C , Clayson S , Greatorex RA
Published: December 2010

INTRODUCTION

UK Department of Health guidelines recommend that clinical staff are ‘bare below the elbows’. There is a paucity of evidence to support this policy. One may hypothesise that absence of clothing around wrists facilitates more effective handwashing: this study aims to establish whether dress code affects bacterial colonisation before and after handwashing.

SUBJECTS AND METHODS

Sixty-six clinical staff volunteered to take part in the study, noting whether they were bare below the elbows (BBE) or not bare (NB). Using a standardised technique, imprints of left and right fingers, palms, wrists and forearms were taken onto mini agar plates. Imprints were repeated after handwashing. After incubation, colonies per plate were counted, and subcultures taken.

RESULTS

Thirty-eight staff were BBE and 28 were not. A total of 1112 plates were cultured. Before handwashing there was no significant difference in number of colonies between BBE and NB groups (Mann–Whitney, P < 0.05). Handwashing reduced the colony count, with greatest effect on fingers, palms and dominant wrists (t-test, P < 0.05). Comparing the two groups again after handwashing revealed no significant difference (Mann–Whitney, P < 0.05). Subcultures revealed predominantly skin flora.

CONCLUSIONS

There was a large variation in number of colonies cultured. Handwashing resulted in a statistically significant reduction in colony count on fingers, palms and dominant wrist regardless of clothing. We conclude that handwashing produces a significant reduction in number of bacterial colonies on staff hands, and that clothing that is not BBE does not impede this reduction.
Impact of organisational changes on fracture neck of femur management
Authors: Mallick Emad , Gulihar Abhinav , Taylor Grahame , Furlong Andrew , Pandey Radhakant
Published: December 2010

INTRODUCTION

In 2005, University Hospitals of Leicester formed a Fracture Neck of Femur (#NOF) project group to improve care of this group of patients.

SUBJECTS AND METHODS

The salient changes effected by the group were the appointment of designated orthogeriatricians, trauma co-ordinators, clinical aides, and discharge nurses.

RESULTS

As a result of these measures, the number of patients going to theatre within 48 h of admission rose from 38.5% in 2005/6 to 90% in 2007/8. In-hospital mortality decreased from 16.5% in 2005/6 to 10.9% in 2007/8. The 30-day mortality dropped from 13% in 2005/6 to 10.9% in 2007/8. Hospital stay reduced from 29 days in 2005/06 to 17 days in 2007/8.

CONCLUSIONS

Re-organisation of available resources has a positive impact on reducing mortality and in-hospital stay of fracture neck of femur patients.
Today or tomorrow? A retrospective analysis of the clinical indications used to request urgent magnetic resonance imaging of the spine
Authors: Thangarajah Tanujan , O’Donoghue Donal , Pillay Robin
Published: December 2010

INTRODUCTION

The finite resources available to National Health Service institutions require clinicians to order investigations that are not readily available appropriately. This is particularly true for the radiological assessment of patients presenting with features pertaining to acute spinal cord dysfunction. Such cases conventionally require urgent magnetic resonance imaging (MRI) which is sometimes performed ‘out-of-hours’. There is evidence to suggest, however, that a high proportion of patients do not have a structural abnormality on MRI to account for their clinical findings, and consequently the majority of scans that are requested urgently are normal. The primary aim of this study was to determine whether any clinical feature(s) could accurately predict the presence of a structural abnormality on MRI. As a secondary objective, the ability of such features to predict the need for spinal surgery was assessed.

PATIENTS AND METHODS

A retrospective analysis of consecutive patients who warranted urgent MRI was conducted. Eighty-one patients were eligible for study. The Fisher’s test was used for statistical analysis of all data. A P-value of less than 0.05 was considered to be significant.

RESULTS

MRI was performed within 24 h of admission in 16 patients, and of these, seven had surgery within 24–48 h. Only two patients were found to have significant neurological compromise. Despite both a history and examination suggesting otherwise, MRI was normal in 10 patients (12%).

CONCLUSIONS

We were unable to elucidate any clinical features that were able to predict the presence of an abnormal MRI. We did find, however, that patients with a combination of both subjective neurological findings and positive neurological signs (P = 0.02), saddle anaesthesia and/or decreased anal tone (P = 0.03) or sciatica (P = 0.02) had pathology on MRI that warranted surgical intervention. The authors recommend that the aforementioned features formulate the basis of guidelines used to request and/or perform MRI urgently since they are highly suggestive of surgical intervention. Conversely, patients who do not exhibit the above examination findings might not require either an urgent or ‘out-of-hours’ scan, but could potentially be investigated less expediently and/or wait until ‘normal working hours’.
Urinary Catalytic Iron in Obesity
Authors: Thethi Tina K , Parsha Kaushik , Rajapurkar Mohan , Mukhopadhyay Banibrata , Shah Sudhir , Yau C Lillian , Japa Shanker , Fonseca Vivian
Published: December 2010

INTRODUCTION

Obesity precedes the development of many cardiovascular disease risk factors, including type 2 diabetes mellitus (DM), hypertension, and chronic kidney disease. Catalytic iron, which has been associated with these chronic diseases, may be one of the links between obesity and these multifactorial diverse disorders.

OBJECTIVE

We investigated whether urinary catalytic iron is increased in obese individuals without DM and overt kidney disease.

STUDY DESIGN

We measured urinary catalytic iron using established methods in 200 randomly selected individuals without DM [100 who were obese (body mass index ≥30 kg/m2) and 100 who were nonobese (body mass index ≤27)]. Participants were selected from an outpatient clinic and community setting and were part of an ongoing cross-sectional study of obesity in individuals between the ages of 18 and 70 years.

RESULTS

There was a significant difference in mean (95% CI) urinary catalytic iron excretion between the obese participants and the nonobese participants, 463 (343–582) nmol/mg [52.3 (38.8–65.8) nmol/μmol] vs 197 (141–253) nmol/mg [22.3 (15.9–28.6) nmol/μmol]; P < 0.001. The significant predictors of increased urinary catalytic iron were obesity (P = 0.001) and waist-to-hip ratio (P = 0.03).

CONCLUSIONS

Our study results demonstrate that obesity and waist-to-hip ratio are associated with increased urinary catalytic iron, which may be a useful marker of oxidative stress. Additional studies are needed to determine the role of catalytic iron in increased cardiovascular disease and chronic kidney disease associated with obesity.
Polymorphisms at the regulatory regions of the CASR gene influence stone risk in primary hyperparathyroidism
Authors: Vezzoli Giuseppe , Scillitani Alfredo , Corbetta Sabrina , Terranegra Annalisa , Dogliotti Elena , Guarnieri Vito , Arcidiacono Teresa , Paloschi Vera , Rainone Francesco , Eller-Vainicher Cristina , Borghi Loris , Nouvenne Antonio , Guerra Angela , Meschi Tiziana , Allegri Franca , Cusi Daniele , Spada Anna , Cole David E C , Hendy Geoffrey N , Spotti Donatella , Soldati Laura
Published: December 2010

Background and objective

Single nucleotide polymorphisms (SNPs) of the calcium-sensing receptor (CASR) gene at the regulatory region were associated with idiopathic calcium nephrolithiasis. To confirm their association with nephrolithiasis, we tested patients with primary hyperparathyroidism (PHPT).

Design

A genotype–phenotype association study.

Methods

In all, 332 PHPT patients and 453 healthy controls were genotyped for the rs7652589 (G>A) and rs1501899 (G>A) SNPs sited in the noncoding regulatory region of the CASR gene. Allele, haplotype, and diplotype distribution were compared between PHPT patients and controls, and in stone forming and stone-free PHPT patients.

Results

The allele frequency at rs7652589 and rs1501899 SNPs was similar in PHPT patients and controls. The A minor alleles at these two SNPs were more frequent in stone forming (n=157) than in stone-free (n=175) PHPT patients (rs7652589: 36.9 vs 27.1%, P=0.007; rs1501899: 37.1 vs 26.4%, P=0.003). Accordingly, homozygous or heterozygous PHPT patients for the AA haplotype (n=174, AA/AA or AA/GG diplotype) had an increased stone risk (odds ratio 1.83, 95% confidence interval 1.2–2.9, P=0.008). Furthermore, these PHPT patients had higher serum concentrations of ionized calcium and parathyroid hormone (1.50±0.015 mmol/l and 183±12.2 pg/ml) than patients with the GG/GG diplotype (n=145, 1.47±0.011 mmol/l (P=0.04) and 150±11.4 pg/ml (P=0.049)). Using a logistic regression model, the increase in stone risk in PHPT patients was predicted by AA/AA or AA/GG diplotype, the highest tertile of serum ionized calcium values and the lowest tertile of age.

Conclusions

Polymorphisms located in the regulatory region of the CASR gene may increase susceptibility of the PHPT patients to kidney stone production.
Assessing adrenal status in patients before and immediately after coronary artery bypass graft surgery
Authors: Debono Miguel , Sheppard Lorcan , Irving Sarah , Jackson Philip , Butterworth Jo , Brookes Zoe L S , Newell-Price John , Ross Jonathan J , Ross Richard J
Published: December 2010

Objective

Patients with cortisol deficiency poorly tolerate any systemic inflammatory response syndrome (SIRS), and may die if not treated with sufficient exogenous glucocorticoids. Controversy surrounds what constitutes a ‘normal’ adrenal response in critical illness. This study uses conventional tests for adrenal insufficiency to investigate cortisol status in patients undergoing elective coronary artery bypass surgery, a condition frequently associated with SIRS.

Design

A prospective, observational study.

Methods

Thirty patients with impaired left ventricular function (ejection fraction >23% <50%) underwent basal ACTH measurement, and a short cosyntropin test (250 μg, i.v.) 1 week preoperatively, and at +4 h following induction of general anaesthesia. Preoperatively, a 30 min cortisol level post cosyntropin >550 nmol/l was taken as a normal response.

Results

Prior to surgery, all patients had a normal response to cosyntropin. Postoperatively, eight patients (26.7%) did not achieve stimulated cortisol levels >550 nmol/l and the mean peak cortisol postoperatively was lower (1048 vs 730 nmol/l; P<0.001). There was a significant rise in ACTH after surgery (21 vs 184 ng/l; P=0.007) and reduction in Δ-cortisol post cosyntropin (579 vs 229 nmol/l; P<0.001). There was no change in basal cortisol pre- and post-operatively (447 vs 501; P=0.4). All patients underwent routine, uneventful postoperative recovery.

Conclusion

Up to one quarter of patients with a normal cortisol status preoperatively demonstrated a raised ACTH and deficient cortisol response postoperatively. Despite these responses, all patients had uneventful outcomes. These data reinforce the need for caution when interpreting results of endocrine testing following major surgery or in the intensive care environment, and that prognostic value of these results may be of limited use.
Many routes to the same destination: lessons from skeletal muscle development
Authors: Mok Gi Fay , Sweetman Dylan
Published: December 2010

The development and differentiation of vertebrate skeletal muscle provide an important paradigm to understand the inductive signals and molecular events controlling differentiation of specific cell types. Recent findings show that a core transcriptional network, initiated by the myogenic regulatory factors (MRFs; MYF5, MYOD, myogenin and MRF4), is activated by separate populations of cells in embryos in response to various signalling pathways. This review will highlight how cells from multiple distinct starting points can converge on a common set of regulators to generate skeletal muscle.
Pcsk6 mutant mice exhibit progressive loss of ovarian function, altered gene expression, and formation of ovarian pathology
Authors: Mujoomdar Michelle L , Hogan Laura M , Parlow Albert F , Nachtigal Mark W
Published: December 2010

Bioactivation of precursor proteins by members of the proprotein convertase (PC) family is essential for normal reproduction. ThePcsk6gene is a member of the PC family that is expressed in numerous ovarian cell types including granulosa cells and oocytes. We hypothesized that loss of PCSK6 would produce adverse effects in the mouse ovary. Mice incapable of expressing PCSK6 (Pcsk6tm1Rob) were obtained, and reproductive parameters (serum hormones, whelping interval, estrus cyclicity, and fertility) were compared toPcsk6+/+mice. WhilePcsk6tm1Robfemale mice are fertile, they manifest reduced reproductive capacity at an accelerated rate relative toPcsk6+/+mice. Reproductive senescence is typically reached by 9 months of age and is correlated with loss of estrus cyclicity, elevated serum FSH levels, and gross alterations in ovarian morphology. A wide range of ovarian morphologies were identified encompassing mild, such as an apparent reduction in follicle number, to moderate – ovarian atrophy with a complete absence of follicles – to severe, manifesting as normal ovarian structures replaced by benign ovarian tumors, including tubulostromal adenomas. Targeted gene expression profiling highlighted changes in RNA expression of molecules involved in processes such as steroidogenesis, gonadotropin signaling, transcriptional regulation, autocrine/paracrine signaling, cholesterol handling, and proprotein bioactivation. These results show that PCSK6 activity plays a role in maintaining normal cellular and tissue homeostasis in the ovary.
Serum Dioxins and Polychlorinated Biphenyls Are Associated With Growth Among Russian Boys
Authors: Burns Jane S. , Williams Paige L. , Sergeyev Oleg , Korrick Susan , Lee Mary M. , Revich Boris , Altshul Larisa , Del Prato Julie T. , Humblet Olivier , Patterson Donald G. , Turner Wayman E. , Needham Larry L. , Starovoytov Mikhail , Hauser Russ
Published: December 2010

OBJECTIVE:

We evaluated the associations of serum dioxins and polychlorinated biphenyls (PCBs) with longitudinally assessed growth measurements among peripubertal Russian boys.

METHODS:

A total of 499 boys from Chapaevsk, Russia, aged 8 to 9 years were enrolled in the study from 2003 to 2005 and were followed prospectively for 3 years. Blood samples were collected and physical examinations were conducted at entry and repeated at annual study visits. Multivariate mixed-effects regression models for repeated measures were used to examine the associations of serum dioxins and PCBs with longitudinal measurements of BMI, height, and height velocity.

RESULTS:

Serum dioxin (total 2005 toxic equivalency [TEQ] median: 21.1 pg/g lipid) and PCBs (median sum of PCBs: 250 ng/g lipid) were measured in 468 boys. At study entry and during 3 years of follow-up, >50% of the boys had age-adjusted BMI and height z scores within 1 SD of World Health Organization–standardized mean values for age. Boys in the highest exposure quintile of the sum of dioxin and PCB concentrations and total TEQs had a significant decrease in mean BMI z scores of 0.67 for dioxins and TEQs and 1.04 for PCBs, compared with boys in the lowest exposure quintile. Comparison of the highest versus the lowest quintile revealed that higher serum PCB concentrations were associated with significantly lower height z scores (mean z-score decrease: 0.41) and height velocity (mean decrease: 0.19 cm/year) after 3 years of follow-up.

CONCLUSIONS:

Our findings suggest that exposures to dioxins and PCBs are associated with reduced growth during the peripubertal period and may compromise adult body mass, stature, and health.
Prevalence of Noise-Induced Hearing-Threshold Shifts and Hearing Loss Among US Youths
Authors: Henderson Elisabeth , Testa Marcia A. , Hartnick Christopher
Published: December 2010

OBJECTIVE:

We investigated trends in noise-induced threshold shifts (NITSs), high-frequency hearing loss (HFHL), and low-frequency hearing loss (LFHL).

METHODS:

A total of 4310 adolescents 12 to 19 years of age completed audiometric testing during National Health and Nutrition Examination Surveys in 1988–1994 and 2005–2006. NITS criteria were audiometric patterns of decreased 3- to 6-kHz thresholds but preserved 0.5- to 1-kHz and 8-kHz thresholds; HFHL and LFHL criteria were high and low pure-tone averages, respectively, of >15 dB HL.

RESULTS:

There were no significant increases in NITSs (odds ratio [OR]: 0.81 [95% confidence interval [CI]: 0.53–1.22]; P = .29), HFHL (OR: 1.21 [95% CI: 0.87–1.69]; P = .25), or LFHL (OR: 1.37 [95% CI: 0.77–2.45]; P = .28) between survey periods. However, a significant increase in the prevalence of NITSs occurred among female youths (11.6% [95% CI: 9.0%–14.1%] vs 16.7% [95% CI: 13.2%–20.3%]; P < .0001). The overall prevalence of exposure to loud noise or listening to music through headphones in the previous 24 hours increased from 19.8% (95% CI: 17.6%–22.1%) to 34.8% (95% CI: 31.0%–38.5%; P < .0001). In 2005–2006, female youths had a similar prevalence of exposure to recreational noise (23.6% [95% CI: 19.6%–27.6%] vs 27.7% [95% CI: 23.6%–31.8%]; P < .0001) and a lower prevalence of hearing-protection use (3.4% [95% CI: 1.6%–5.3%] vs 10.3% [95% CI: 7.3%–13.2%]; P < .0001) compared with male youths.

CONCLUSIONS:

Increased exposure to recreational noise and minimal use of hearing protection might have lead to an increase in NITS prevalence among female youths.
Integrative Pediatric Care: Parents' Attitudes Toward Communication of Physicians and CAM Practitioners
Authors: Ben-Arye Eran , Traube Zina , Schachter Leora , Haimi Motti , Levy Moti , Schiff Elad , Lev Efraim
Published: December 2010

OBJECTIVE:

In this study, we explored parents' perspectives toward complementary and alternative medicine (CAM) use by their children and its impact on parent-doctor and doctor–CAM-practitioner communication.

PATIENTS AND METHODS:

We designed a 2-arm study of parents who approached either conventional primary care or CAM clinics with their children to consult physicians or practitioners regarding their child's health.

RESULTS:

A total of 599 parents responded to our questionnaire (319 in 5 conventional clinics [83.9% response rate] and 280 in 21 CAM clinics [71.2% response rate]). Parents in conventional clinics reported less use of CAM by their children within the previous year (35.3% vs 73.7%; P < .0001) but used more traditional and homemade remedies (46.4% vs 12.7%; P < .0001). Both parent groups largely supported informing their child's physician regarding CAM use and expected the physician to initiate a CAM–related conversation and to refer their child to a CAM practitioner. The 2 groups' respondents largely supported communication between the child's physician and the CAM practitioner by the use of a referral/medical letter. Compared with respondents in CAM clinics, parents in conventional clinics were more supportive of CAM integration in a pediatric primary care setting and envisioned a more dominant role of physicians regarding CAM referral and a significant role of physicians in providing CAM.

CONCLUSIONS:

Parents who are referred to conventional and CAM clinics express distinctive attitudes toward CAM integration in pediatric care. Parents perceive physician–CAM practitioner communication as highly important and instrumental in promoting their children's health and safety.
After ASTRAL and STAR — whither renal artery stenting?
Authors: Sos T. A.
Published: December 2010

ASTRAL and STAR, two recent prospective randomized trials to compare renal artery stenting with optimal medical management versus optimal medical management alone for patients with renal insufficiency and renal artery stenosis, have concluded that there was no additional benefit to stenting. Patient selection and methodological issues in these studies cast doubt on the validity of their results and conclusions for patients with renal insufficiency and physiologically (hemodynamically) significant renal artery stenosis, i.e. true ischemic nephropathy.
Treatment of early hepatic artery complications after adult liver transplantation: A single center experience
Authors: Doros A. , Nemes B. , Máthé Z. , Németh A. , Hartmann E. , Deák Á. P. , Lénárd Zs. F. , Görög D. , Fehérvári I. , Gerlei Zs. , Fazakas J. , Tóth Sz. , Kóbori L.
Published: December 2010

Introduction

Hepatic artery complication represents recognized sequel of liver transplantation that carries significant morbidity and mortality. Besides retransplantation, hepatic artery recanalization is provided surgically, or by percutaneous angioplasty and stent placement. This study provides an analysis of a single center experience comparing surgical and interventional treatments in cases of early hepatic artery complications.

Methods

In this retrospective single center study, 25 of 365 liver transplant recipients were enrolled who developed early hepatic artery complication after transplantation. Percutaneous intervention was performed in 10 cases, while surgical therapy in 15 cases. Mean follow-up time was not different between the groups (505±377 vs. 706±940 days, respectively).

Results

6 patients in the Intervention Group and 10 patients in the Surgery Group are alive. The retransplantation rate (1 and 3) was lower after interventional procedures, while the development of biliary complications was higher. The mortality rate was higher after operative treatment (2 and 5).

Conclusion

Interventional therapy is a feasible and safe technique for treatment of early hepatic artery complication after transplantation. Being less invasive it is an invaluable alternative treatment having results comparable to surgical methods.
Rotational atherectomy of a severely calcified superficial femoral artery stenosis after failed balloon passage — Case report
Authors: Ruzsa Z. , HÜttl K. , Tóth K. , Merkely B.
Published: December 2010

Rotational atherectomy (RA) in peripheral circulation is an advanced revascularization procedure, often used in cases where traditional percutaneous transluminal angioplasty (PTA) is inadequate and bypass grafting is either unavailable or undesired. We report on a case, where RA was successfully performed after failed traditional PTA. The case highlights the importance of RA in peripheral cases where severe calcification occurs and the lesion is not suitable for PTA (cannot be passed with balloon or is undilatable).
Postconditioning attenuates remote organ injury after lower limb arterial occlusion
Authors: Gyurkovics E. , Arányi P. , Turóczi Zs. , Garbaisz D. , Varga M. , Hegedüs V. , Lotz G. , Kupcsulik P. , Szijártó A.
Published: December 2010

Introduction

External aortic compression due to acute gastric dilation is a rare etiology of the lower limb ischemia. This phenomenon leads the author to design experimental study for reperfusion syndrome. The lower limb ischemia-reperfusion (IR) injury consists of local and systemic components called the reperfusion syndrome. It can progrediate into a multi-organ failure which defines postoperative survival. A postconditioning is a surgical technique, which has a potential to reduce IR injury, therefore to prohibit the development of reperfusion syndrome.

Aim

XXXto examine on an experimental model, whether postonditioning is a practicable technique in infarenal aortic surgeries.

Materials and Methods

Male Wistar rats underwent 180 minutes of infrarenal aortic occlusion with 4, 24 and 72 hours of reperfusion. Postconditioning (10 sec. reocclusion / 10 sec. perfusion in 6 cycles) was applied in one group of each reperfusion time. Blood, urine, and histological (muscle, lung, kidney and liver) samples were collected at the postischemic 4th, 24th, and 72th hour.

Results

The early inflammatory response (TNFa, free radicals) and late local inflammation were reduced by posctonditioning significantly. Postconditioning was able to reduce the remote organ injury of lungs and kidneys, the morphological and laboratorial results showed significant difference between the postconditioning and the control group in these two organs. The method's positive effect on remote organ injury remained long-term.

Conclusion

Postconditioning seems to be an applicable process to reduce both local inflammatory and systemic complications of IR injury following vascular surgeries.
Successful surgical intervention in a case of spontaneous chylothorax in an infant unresponsive to conservative therapy
Authors: Szakszon K. , Veres Z. L. , Boros M. , Kiss S. Sz. , Nagy B. , Bálega E. , Papp á. , Németh E. , Pataki I. , Szabó T.
Published: December 2010

We report a case of an infant with spontaneous chylothorax due to the congenital malformation of a small lymph vessel of the chest wall. Conservative therapy with omitting long-chain fatty acids from the diet, fat-free nutrition, total parenteral nutrition and intravenous somatostatin did not result in the decrease of pleural effusion. Thoracic surgical intervention performing thoracic duct ligation and using fibrin sealants was applied after 10 days of unsuccessful conservative therapy, and resulted in the complete recovery of the patient. Our experience support the already existing observations, that in cases where the daily loss of chyle exceeds 100 ml per age years and/or lasts longer than 2 weeks, early surgical intervention is recommended.
Ablation of premature ventricular complexes originating from the left ventricular outflow tract using a novel automated pace-mapping software
Authors: Széplaki G. , Tahin T. , Szilágyi SZ. , Osztheimer I. , Bettenbuch T. , Srej M. , Merkely B. , Gellér L.
Published: December 2010

Pace-mapping is an important tool during the ablation of premature ventricular complexes (PVCs) or ventricular tachycardia. The automated pace mapping system software (PaSo module, CARTO XP v9, Biosense/Webster) allows direct comparisons between paced ECGs and the acquired PVC ECG during ablation in a reasonable time. We report our experience with the automated pace mapping system during the ablation of PVCs in the left ventricular outflow tract (LVOT). A 67-year-old male patient was referred to our Department because of recurrent resting atypical chest pain. A 12 lead ECG showed frequent PVCs with LVOT morphology and a 24-hour Holter ECG revealed, that 31% of the total beats were monomorphic PVCs. We decided to perform a radiofrequency catheter ablation. After recording an electroanatomic and an activation map during PVCs, pace-mapping was performed with the PaSo module of the CARTO system. The best percent match area (89.0%) was found in the LVOT, where we performed multiple ablations and PVCs disappeared. According to our initial experience, automated pace-mapping systems might be useful during ablation of PVCs or ventricular tachycardias. Appropriate use of the software allows more objective and faster comparisons compared with conventional manual techniques.
Atrial fibrillation following slow pathway modification?
Authors: Clemens M. , Csanádi Z.
Published: December 2010

We are exposing a differential diagnostic problem in the case report of a young female with the diagnosis of atrial fibrillation who was referred to our Institute for pulmonary vein isolation. Based on the 12-lead ECG we found an unusal mechanism resulting in irregular, narrow QRS tachycardia, which was also confirmed by an electrophysiological study.
First-Principles and Quantum Transport Studies of Metal-Graphene End Contacts
Authors: Cho Kyeongjae , Gong Cheng , Lee Geunsik , Wang Weichao , Shan Bin , Vogel Eric M. , Wallace Robert M.
Published: December 2010

Metal-graphene contact is of critical significance in graphene-based nanoelectronics. There are two possible metal-graphene contact geometries: side-contact and end-contact. In this paper, we apply first-principles calculations to study metal-graphene end-contact for these three commonly used electrode metals (Ni, Pd and Ti) and find that they have distinctive stable end-contact geometries with graphene. Transport properties of these metal-graphene-metal (M-G-M) end-contact structures are investigated by density functional theory non-equilibrium Green’s function (DFT-NEGF) algorithm. The Transmission as a function of chemical potential (E-EF) shows asymmetric curves relative to the Fermi level. Transmission curves of Ni-G-Ni and Ti-G-Ti contact structures indicate that bulk graphene sheet is n-doped by Ni and Ti electrodes, but that of Pd-G-Pd shows p-doping of graphene by Pd electrode. The contact behaviors of these electrodes are consistent with experimental observations.
Nano-Patterning of Graphene Structures Using Highly Focused Beams of Gallium Ions
Authors: Gierak Jacques , Lucot Damien , Ouerghi Abdelkarim , Patriarche Gilles , Bourhis Eric , Faini Giancarlo , Mailly Dominique
Published: December 2010

Graphene is generating a considerable interest in materials science and condensed-matter physics. One crucial technological problem, that will govern future applicability of this material, is related to the patterning of graphene while preserving the exceptionally high crystallinity and electronic properties of this material. This article is aiming at demonstrating that a highly focused beam of gallium ions can be applied for sculpting ultra-thin and high quality suspended graphene nano-ribbons (GNRs).