bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytogenetic and molecular characterization of the derivative Y chromosome: a case study of an azoospermic patient
Authors: Roovere T , Peters M , Horelli‐Kuitunen N , Mölter‐Väär T , Punab M , Rootsi S , Poolamets O , Salumets A
Published: September 2007

The success of infertility treatment depends on the underlying cause and severity of the infertility problem. The current report addresses the complex genotype–phenotype interactions in an azoospermic man. Cytogenetic, molecular cytogenetic and molecular genetic studies indicated the derivative monocentric Y chromosome with duplication of Yp11 (including SRY gene) and partial deletion of Yq11 (including azoospermia factor – AZFb‐c regions) as the most probable cause of the severe testicular failure. Our study emphasizes the importance of detailed genetic analysis in male infertility evaluation and helps to estimate the outcome of infertility treatment.
Cotard's syndrome in adolescents and young adults is associated with an increased risk of bipolar disorder
Authors: Consoli Angèle , Soultanian Charlotte , Tanguy Marie‐Laure , Laurent Claudine , Perisse Didier , Luque Rogelio , Berrios German E , Cohen David
Published: September 2007

Objectives:  To assess the effect of age at onset on the phenomenology of Cotard's syndrome (CS) as a recent study reported a high rate of occurrence of bipolar disorder (BD) in adolescents and young adults with CS followed up for ≥2 years.

Methods:  We reviewed all cases of CS reported since it was first described. A statistical analysis was carried out to determine the effect of age at onset on CS phenomenology.

Results:  We found 138 cases including 21 cases aged 25 years or younger. In these younger CS patients, BD was more frequent, and the risk of associated BD was increased nine times (p < 0.0001). Within the BD sub‐group (n = 27), admixture analysis identified two sub‐groups with mean ages at onset of 18.7 years [standard deviation (SD) = 3.2] and 50.5 years (SD = 11.7).

Conclusions:  Young people with CS should be monitored carefully for the onset of BD, and families should be educated about this risk. Treatment with mood stabilizers can be helpful for those who develop BD. Within BD associated with CS, early versus late onset should be distinguished.
The impact of environmental temperature on lithium serum levels
Authors: Wilting Ingeborg , Fase Sandra , Martens Edwin P , Heerdink Eibert R , Nolen Willem A , Egberts Antoine CG
Published: September 2007

Objectives:  Three studies have reported a seasonal variation in lithium serum levels, with higher levels during summer. Our objective was to investigate the impact of actual environmental temperature on lithium serum levels.

Methods:  A retrospective study was conducted using available records of lithium serum levels for the period between January 1995 and July 2004, obtained from three large teaching hospitals in The Netherlands. Lithium serum levels were linked to season and average daily temperature data obtained from the Royal Netherlands Meteorological Institute. An analysis was performed on all lithium serum levels not accounting for the intra‐individual dependency of lithium serum levels. The association between season, temperature and both absolute lithium serum level and the frequency of potentially toxic serum levels was investigated. A mixed model analysis, accounting for intra‐individual dependency of lithium serum levels, was performed.

Results:  A total of 41,102 lithium serum levels (3,054 patients) were included. A significant difference in mean lithium serum levels across seasons (p < 0.001) and temperature categories (p = 0.001) was found, peaking in summer [0.761 mmol/L, ± standard error of the mean (SEM) 0.002] and at temperatures of 15–20°C [0.762 mmol/L (± SEM 0.005)], and at a minimum in winter [0.748 mmol/L (± SEM 0.002)] and at <0°C [0.741 mmol/L (± SEM 0.005)]. The relative frequency of potentially toxic serum levels significantly differed between seasons (p = 0.023, highest in winter), but not between temperature categories (p = 0.481). A significant positive association for intra‐individual lithium serum level and season (p < 0.001) and temperature (p < 0.001) was established.

Conclusions:  Season and environmental temperature have a statistically significant but therapeutically irrelevant effect on lithium serum levels.
Immune variations in bipolar disorder: phasic differences
Authors: Ortiz‐Domínguez Abigail , Hernández María Eugenia , Berlanga Carlos , Gutiérrez‐Mora Doris , Moreno Julia , Heinze Gerhard , Pavón Lenin
Published: September 2007

Objectives:  To characterize the immunological variations of patients with a bipolar disorder (BD) diagnosis in manic (BDm) and depressive (BDd) phases, by the quantification of the serum levels of interleukin (IL)‐1β, ‐2, ‐4, ‐6 and tumor necrosis factor alpha (TNF‐α).

Methods:  Twenty physically healthy patients with a BD type I diagnosis and 33 matched controls were studied, after giving informed consent. The inclusion criteria included at least three weeks without any kind of psychopharmacological treatment, Young Mania Rating Scale score ≥20 for BDm (n = 10) and Hamilton Depression Rating Scale score ≥21 for BDd patients (n = 10). Exclusion criteria included any infectious diseases, allergies or any other kind of medical illness that required treatment with immunosuppressors, as well as any other diagnosis in Axis I. Physical and laboratory examinations were performed to rule out any clinical illness. Enzyme‐linked immunosorbent assay (ELISA) was used to analyze the serum cytokines concentration.

Results:  BD patients, when compared to controls, showed significant differences (p ≤ 0.05) in the serum levels of the measured cytokines. The sub‐group of BDd patients showed an increase in IL‐6 and TNF‐α, as well as a decrease in IL‐2 concentration. The BDm sub‐group, on the other hand, showed an increase in TNF‐α and IL‐4 values, with a low concentration of IL‐1 and IL‐2. The comparison between both sub‐groups suggests that there is a distinctive cytokine pattern for the specific phases of the disorder: for mania, we found a high IL‐4 and low IL‐1β and IL‐6 concentration, while in the depressive phase, the inverse pattern was found.

Conclusions:  Our results show the existence of phasic differences in the serum levels of cytokines in BD.
Efficacy of a protein kinase C inhibitor (tamoxifen) in the treatment of acute mania: a pilot study
Authors: Zarate Carlos A , Singh Jaskaran B , Carlson Paul J , Quiroz Jorge , Jolkovsky Libby , Luckenbaugh David A , Manji Husseini K
Published: September 2007

Objectives: Considerable preclinical biochemical and behavioral data suggest that protein kinase C inhibition would bring about antimanic effects. Notably, the structurally highly dissimilar antimanic agents lithium and valproate, when administered in therapeutically relevant paradigms, attenuate protein kinase C inhibition function. There is currently only one relatively selective protein kinase C inhibitor that crosses the blood–brain barrier available for human use – tamoxifen. Our group recently conducted a single‐blind study with tamoxifen in acute mania and found that it significantly decreased manic symptoms within ashort periodof time (3–7 days). In this study, we investigated whether antimanic effects can be achieved with a protein kinase C inhibitor in subjects with mania.

Methods: In a double‐blind, placebo‐controlled study, 16 subjects with bipolar disorder, manic or mixed, with or without psychotic features, were randomly assigned to receive tamoxifen (20–140 mg/day; n = 8) or placebo (n = 8) for three weeks. Primary efficacy was assessed by the Young Mania Rating Scale.

Results: Subjects on tamoxifen showed significant improvement in mania compared to placebo as early as five days, an effect that remained significant throughout the three‐week trial. The effect size for the drug difference was very large (d = 1.08, 95% confidence interval 0.45–1.71) after three weeks (p = 0.001). At study endpoint, response rates were 63% for tamoxifen and 13% for placebo (p = 0.12).

Conclusions: Antimanic effects resulted from a protein kinase C inhibitor; onset occurred within five days. Large, controlled studies with selective protein kinase C inhibitors in acute mania are warranted.
Patterns of mating call preferences in túngara frogs, Physalaemus pustulosus
Authors: RYAN M. J. , BERNAL X. E. , RAND A. S.
Published: September 2007

We examine acoustic mating preferences of a focal population at four different scales of divergence: within the population, between populations in the same genetic group, between populations in different genetic groups and between different species. At all scales there is substantial genetic divergence, variation in mating signals and preferences are influenced by signal variation. There is, however, no support for the hypothesis that mating preferences accumulate predictably with genetic distance. Females preferred the local conspecific call to the foreign conspecific call in about one‐third of the experiments, and preferred the local call to all of the heterospecific calls tested. But there was no significant relationship between the variation in the strength of preference and genetic distance either among conspecific populations, or among heterospecific species. Thus, in this study macroevolutionary patterns are not apparent at the microevolutionary scale.
Microscopic Characterization of Teeth of Pacas Bred in Captivity (Agouti paca, Linnaeus, 1766)
Authors: Oliveira F. S. , Canola J. C. , Oliveira P. T. , Pécora J. D. , Capelli A.
Published: September 2007

The microscopic description of the teeth of pacas (Agouti paca) bred in captivity was developed for providing biological data on one of the largest American wild rodents, as not many references exist in the literature about this species. Two newborn males, two adult males (9 and 72 months old), one newborn female and two adult females (30 and 54 months old) were used after death due to fights, neonatal cannibalism or unknown causes. Animals were radiographed, and their teeth were extracted and put on an acrylic resin block, cut on a diamond‐like disc microtome and diaphanized. It was noted that enamel surrounds the coronary dentine and projects to the root region, besides being present as internal laminae, arranged in a parallel way and in the vestibulolingual direction. The dentine is located between the enamel laminae and surrounds the pulp horns. The cementum is located internal to the enamel laminae. From scanning electronic microscopy, we find that the enamel is the outer element on the vestibular surface, and it is in direct contact with the dentine. On the lingual surface, the cementum and dentine are the outer elements.
Occurrence and hygienic relevance of fungi in drinking water
Authors: Kanzler D. , Buzina W. , Paulitsch A. , Haas D. , Platzer S. , Marth E. , Mascher F.
Published: September 2007

Fungi, above all filamentous fungi, can occur almost everywhere, even in water. They can grow in such a quantity in water that they can affect the health of the population or have negative effects on food production. There are several reports of fungal growth in water from different countries, but to our knowledge none from Austria so far. The aim of this study was to gain an overview of the spectrum of filamentous fungi and yeasts in drinking water systems. Thirty‐eight water samples from drinking water and groundwater were analysed. Fungi were isolated by using membrane filtration and plating method with subsequent cultivation on agar plates. The different taxa of fungi were identified using routine techniques as well as molecular methods. Fungi were isolated in all water samples examined. The mean value for drinking water was 9.1 CFU per 100 ml and for groundwater 5400 CFU per 100 ml. Altogether 32 different taxa of fungi were found. The taxa which occurred most frequently were Cladosporium spp., Basidiomycetes and Penicillium spp. (74.6%, 56.4% and 48.7%, respectively). This study shows that drinking water can be a reservoir for fungi, among them opportunists, which can cause infections in immunosuppressed patients.
RESISTANCE TO FAS‐MEDIATED APOPTOSIS IN MALIGNANT TUMOURS IS RESCUED BY KN‐93 AND CISPLATIN VIA DOWNREGULATION OF c‐FLIP EXPRESSION AND PHOSPHORYLATION
Authors: Yang Bao‐Feng , Xiao Chang , Li Hong , Yang Shi‐Jie
Published: September 2007

The purpose of the present study was to investigate the molecular mechanisms that control tumour cell resistance and to search for molecules that could overcome Fas ligand (FasL) or CH‐11 resistance in certain tumours, including glioma and melanoma.

Twelve tumour cell lines were examined for their sensitivity to CH‐11‐induced apoptosis and then two of each of the CH‐11‐sensitive and ‐resistant tumour cell lines were analysed for Fas‐mediated death‐inducing signalling complex (DISC). The calmodulin kinase II (CaMKII) inhibitor KN‐93 and the chemotherapeutic drug cisplatin were used to treat resistant cells; the effects of these two drugs on CH‐11‐resistant tumour cells were investigated.

In CH‐11‐sensitive tumour cells, apoptosis‐initiating caspase 8 and caspase 10 were recruited to the DISC, where they became activated through autocatalytic cleavage, leading to apoptosis through cleavage of downstream substrates, such as caspase 3 and DNA fragmentation factor 45.

In CH‐11‐resistant cells, cellular Fas‐associated death domain‐like interleukin‐1b‐converting enzyme inhibitory protein (c‐FLIP) proteins were recruited to the DISC, resulting in inhibition of caspase 8 and caspase 10 cleavage. The c‐protein expression and phosphorylation of FLIP and CaMKII protein and enzyme activity were upregulated in resistant cells. Treatment of resistant cells with 100 mmol/L KN‐93 and 10 mg/mL cisplatin downregulated c‐FLIP expression, inhibited c‐FLIP phosphorylation and rescued CH‐11 sensitivity.

In conclusion, KN‐93 and cisplatin inhibit c‐FLIP protein expression and phosphorylation restores CH‐11‐induced apoptosis in tumour cells. tHe present study provides evidence for the use of a new combination therapeutic strategy in the treatment of malignant tumours.
PRESSOR AND NON‐PRESSOR EFFECTS OF SODIUM LOADING ON STROKE IN STROKE‐PRONE SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Zhang Wei , Liu Ai‐Jun , Yi‐Ming Wuliya , Liu Jian‐Guo , Shen Fu‐Ming , Su Ding‐Feng
Published: September 2007

Aetiological studies have shown that sodium loading increases both blood pressure and death from stroke. The present study was designed to investigate the pressor and non‐pressor effects of sodium loading on stroke in stroke‐prone spontaneously hypertensive rats (SHRSP).

Eighty‐five female SHRSP were used. Forty‐nine SHRSP, aged 5 months, were randomly divided into two groups with or without sodium loading and their survival times were recorded. Thirty‐six SHRSP, aged 3 months, were randomly divided into two groups and were instrumented to determine blood pressure, heart period and baroreflex sensitivity (BRS) after 4 months of sodium loading or normal rat chow. After determination of BRS, blood samples were collected for the measurement of tumour necrosis factor (TNF), interleukin (IL)‐1β, IL‐6 and angiotensin (Ang) II and brains were dissected for light microscopic examination.

Over the 15 month period, the mortality of control SHRSP was 37.5%, which reached 80.0% in the sodium loading group. Compared with the control group, blood pressure was increased but BRS was significantly decreased (P < 0.001) in sodium‐loaded rats. Levels of IL‐1β, IL‐6 and AngII were all significantly increased (P < 0.05) in the sodium‐loaded rats. Sodium loading also markedly increased the number of cerebral aneurysms. Multivariate regression analysis showed that IL‐6 was the most significant factor related to aneurysm formation.

Sodium loading increases death from stroke in SHRSP. The increased blood pressure, impaired BRS, inflammatory reaction and the formation of cerebral aneurysms may contribute to the development of stroke.
PEROXISOME PROLIFERATOR‐ACTIVATED RECEPTOR‐γ AGONISTS ATTENUATE ANGIOTENSIN II‐INDUCED COLLAGEN TYPE I EXPRESSION IN ADVENTITIAL FIBROBLASTS
Authors: Zhang Jia , Fang Ning‐Yuan , Gao Ping‐Jin , Wu Ling‐Yun , Han Wei‐Qing , Guo Shu‐Jie , Shen Wei‐Li , Zhu Ding‐Liang
Published: September 2007

Angiotensin (Ang) II‐mediated oxidative stress may be important in enhanced adventitial fibroblast collagen formation. The aim of the present study was to test whether PPAR‐γ agonists 15‐deoxy‐Δ12,14‐prostaglandin J2 (15d‐PGJ2) and pioglitazone could alter AngII‐induced collagen type I formation in vascular adventitial fibroblasts via reactive oxygen species (ROS).

Vascular adventitial fibroblasts were isolated from rat thoracic aortas of male Sprague‐Dawley rats and treated with different concentrations of AngII for different periods of time. The expression of collagen type I induced by AngII was examined by western blot. Expression of PPAR‐γ mRNA was examined by reverse transcription–polymerase chain reaction (RT‐PCR). Intracellular ROS generation was measured by flow cytometry. Activation of transcription factors nuclear factor (NF)‐κB and activator protein (AP)‐1 was assessed by an electrophoretic mobility shift assay.

Angiotensin II increased expression of collagen type I in a time‐ and dose‐dependent manner in adventitial fibroblasts. In addition, AngII stimulated intracellular generation of ROS in adventitial fibroblasts. Pretreatment of cells with 15d‐PGJ2 and pioglitazone attenuated collagen type I expression and generation of ROS induced by AngII, respectively. Moreover, we observed that N‐acetylcysteine inhibited collagen type I expression induced by AngII as did the PPAR‐γ agonists. Angiotensin II treatment activated the redox‐sensitive transcription factors NF‐κB and AP‐1, whereas pretreatment with 15d‐PGJ2 and pioglitazone reduced the AngII‐induced DNA‐binding activity of NF‐κB but not AP‐1.

Our data demonstrate that the PPAR‐γ agonists 15d‐PGJ2 and pioglitazone attenuate AngII‐mediated collagen type I expression in adventitial fibroblasts, which may be mediated by the modulation of ROS release and the redox‐sensitive transcription factor NF‐κB.
CORRELATION OF BODY COMPOSITION WITH CARDIAC FUNCTION AND ARTERIAL COMPLIANCE
Authors: Zeng Qiang , Sun Xiao‐Nan , Fan Li , Ye Ping
Published: September 2007

The aim of the present study was to examine the correlation of precisely measured body composition with cardiac function and arterial compliance.

Body composition was determined in a total of 325 healthy volunteers (217 men, 108 women) with an average age of 48 years using bioelectrical impedance analysis (BIA). Multiple body components, such as water, fat, mineral, protein and intracellular and extracellular liquid, were included in our measurements. Aortic pulse wave velocity (PWV) was evaluated to assess arterial stiffness, whereas cardiac function was examined by echocardiography. Levels of serum glucose, high‐density lipoprotein–cholesterol, triglycerides, creatinine and uric acid were measured to evaluate the cardiovascular risk of the participants.

All parameters of body composition, especially body fat rate (BFR; body fat mass/weight, were closely correlated with arterial function as evaluated by PWV. However, plasma homocysteine, one of the independent risk factors for cardiovascular diseases, failed to exhibit any correlation with arterial compliance. Notably, the BFR was found to be associated with both systolic and diastolic cardiac function with high correlation coefficients. Individuals with normal systolic and diastolic function were characterized with lower PWV values for the aorta, as well as arm and inferior arteries, indicating better arterial compliance. Body fat mass and BFR were significantly lower in subjects with normal systolic function than those with defective arterial compliance.

In conclusion, our data provide new insights into the intrinsic correlation between body composition and cardiac function, as well as arterial compliance, implicating a potential application of BIA in the clinical prediction and diagnosis of cardiovascular disease.
ROLE OF CARDIAC HYPERTROPHY IN REDUCING THE SENSITIVITY OF CARDIOPULMONARY REFLEX CONTROL OF RENAL SYMPATHETIC NERVE ACTVITY IN SPONTANEOUSLY HYPERTENSIVE RATS
Authors: De Andrade Tadeu Uggere , Abreu Gláucia R , Moysés Margareth R , De Melo Cabral Antônio , Bissoli Nazaré S
Published: September 2007

The gain of the volume‐sensitive cardiopulmonary reflex (VSCR) is impaired in spontaneously hypertensive rats (SHR). Sensitivity of VSCR control of efferent renal sympathetic nerve activity (RSNA) in SHR is restored when cardiac hypertrophy and hypertension are reduced by enalapril treatment.

The present study investigated which of these two parameters, cardiac hypertrophy or hypertension, has more influence on the impairment of VSCR control of RSNA in SHR.

Rats (SHR or Wistar‐Kyoto (WKY) rats) were treated with enalapril (10 mg/kg per day; SHRE and WKYE groups, respectively) or hydralazine (5 mg/kg per day; SHRH and WKYH groups, respectively) mixed in their food for 1 month. Control SHR and WKY rats were fed a normal diet. After the treatment regimen, the VSCR was evaluated by determining the decrease in RSNA elicited by acute isotonic saline volume expansion. Mean arterial pressure (MAP) was assessed via an intrafemural catheter and cardiac hypertrophy was determined by the left ventricular (LV) weight/bodyweight (BW) ratio.

Afferent baroceptor nerve activity (BNA) was also evaluated during volume expansion to verify participation of the baroreflex.

Volume expansion produced an attenuated renal sympathoinhibitory response in SHR compared with WKY rats. Enalapril treatment restored the volume expansion‐induced decrease in RSNA in SHRE (–41 ± 8%) compared with WKY rats (–44 ± 3%). Although both enalapril and hydralazine treatment reduced MAP in SHR (P < 0.01; 126 ± 5, 133 ± 6 and 160 ± 6 mmHg in SHRE, SHRH and SHR, respectively), hydralazine did not restore the sensitivity of VSCR control of RSNA in SHRH. Spontaneously hypertensive rats with established hypertension had a higher LV/BW ratio compared with WKY rats (3.22 ± 0.14 vs 1.98 ± 0.06 mg/g, respectively; P < 0.01). Enalapril reduced the LV/BW ratio in SHRE (2.30 ± 0.07 mg/g; P < 0.01). Although hydralazine reduced LV hypertrophy, there was a weaker reduction in SHRH (2.68 ± 0.04 mg/g; P < 0.05) compared with SHRE. There was no statistically significant difference among the WKY rat, WKYE and WKYH groups (P > 0.05). There was no change in afferent BNA during volume expansion in normal or hypertensive animals.

Taken together, these results indicate that the impairment of VSCR control of RSNA in the SHR model of hypertension correlates better with the magnitude of cardiac hypertrophy than the level of arterial pressure.
Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection
Authors: Buzás György M , Józan Jolán
Published: September 2007

Several aspects of Helicobacter pylori eradication have been meta‐analyzed; however, nitrofuran‐based therapies constitute an exception. The aim of this study was the systematic review and meta‐analysis of the effect of furazolidone‐ and nitrofurantoin‐based regimens in the eradication of infection. Studies evaluating the effects of nitrofurans on H. pylori were identified from Medline, EMBASE, the Cochrane Controlled Trials Register and congress abstracts. The studies were classified into groups based on first‐, second‐ and third‐line regimens. The pooled eradication rates and combined odd ratios of the individual studies were calculated and compared with the published meta‐analysis. The factors influencing the efficiency of the regimens were also analyzed. Side‐effects of nitrofuran‐based regimens were also analyzed. The pooled eradication rate of primary proton pump inhibitor‐based regimens containing furazolidone was 76.3% (CI 67.8–84.2). The odds ratio for furazolidone‐based regimens versus standard triple therapies was 2.34 (CI 0.76–3.92). Ranitidine bismuth citrate + furazolidone‐based triple regimens were equally efficient (83.5%, CI 74.0–93.0, P = 0.06 versus triple therapies). Schedules including a H2 antagonist + furazolidone + one other antibiotic achieved pooled eradication rates of 79.9% (CI 67.8–89.9, P = 0.04). Bismuth‐based triple therapies achieved 84.5% (CI 72.6–93.0, P = 0.002). Primary quadruple regimens containing furazolidone were superior to triple therapies (83.4%, CI 69.7–92.3, P = 0.01). Second‐line schedules containing furazolidone obtained eradication rates of 76.1% (CI 66.4–85.0, P = 0.28 versus primary regimens). Third‐line ‘rescue’ therapies were efficient in 65.5% of the cases (CI 56.3–75.5, P = 0.0001). Side‐effects of the regimens containing furazolidone were more frequent than in standard therapies (P = 0.02). The combined odds ratio of side‐effects for furazolidone‐based versus standard therapies was 0.74 (CI 0.32–1.98). The duration of treatment, but not the furazolidone dose, influenced the treatment outcome. Primary triple regimens containing furazolidone are slightly less efficient than the standard primary combinations; primary quadruple regimens were more efficient than triple therapies. Furazolidone is also efficient as a component of second‐line or rescue therapies.
Recent trends in the treatment of testosterone deficiency syndrome
Authors: Hong Bum Sik , Ahn Tai Young
Published: September 2007

Abstract: Testosterone deficiency syndrome (TDS) is defined as a clinical and biochemical syndrome associated with advancing age and is characterized by typical symptoms and deficiency in serum testosterone levels. TDS is a result of the interaction of hypothalamo‐pituitary and testicular factors. Now, treatment of TDS with testosterone is still controversial due to a lack of large, controlled clinical trials on efficacy. The risks of treatment with testosterone appear to be minimal, although long‐term studies on the safety of testosterone therapy are lacking. The aim of the therapy is to establish a physiological concentration of serum testosterone in order to correct the androgen deficiency, relieve its symptoms and prevent long‐term sequelae. All of the available products, despite their varying pharmacodynamic and pharmacokinetic profiles, are able to reach this goal. Newer testosterone patches seem not to cause severe skin irritation. Testosterone gels minimize the skin irritation while providing flexibility in dosing and a low discontinuation rate. Oral testosterone undecanoate (TU) is free of liver toxicity. Recent formulation of oral TU markedly increased shelf‐live, a major drawback in the older preparation. Producing swings in testosterone levels rising rapidly to the supraphysiological range is not the case with the new injectable long‐acting preparation of TU. To be able to rapidly react and stop treatment in cases where side‐effects and contraindications are detected, the short‐acting transdermal and oral delivery modes have certain advantages. However, there is no evidence that the use of an injectable long‐acting TU in men with TDS has limitations in clinical application for this reason. The use of dehydroepiandrosterone is still controversial because of a lack of well designed long‐term trials, although some recent studies suggest positive effects on various body systems. Only a few studies have been carried out to investigate the effect of hCG (human chorionic gonadotropin) in TDS with some positive results on various body systems.
Who cares for older people with mental illness? A survey of residential aged care facilities in the Australian Capital Territory: Implications for mental health nursing
Authors: Jones Tony S. , Matias May , Powell Jo , Jones Eriita G. , Fishburn Joe , Looi Jeffrey C.L.
Published: September 2007

ABSTRACT:  Residential aged care facilities are increasingly becoming locations wherein the most frail and older people with mental illness live out the remainder of their lives, yet it has become apparent in recent years that these institutions are fraught with a variety of social and clinical problems. One issue of concern has been the exodus of registered nurses (both general and psychiatric), who have been increasingly replaced by carers with little or no expertise in psychiatric illness or disorders of cognitive decline. This ‘de‐professionalizing’ of aged care has important implications for the well‐being of clients, particularity those with complex mental health problems. In this survey we sought to discover demographic information concerning those who provide front‐line care to this population of aged Australians, and we sought also to ascertain how much education in caring for residents who suffer specifically from neurodegenerative disorders (the dementias) and mental illness was provided by the facilities to those who care for such older people. The lack of training in the areas of mental health and cognitive impairment raises a variety of issues that mental health nurses need to address. These issues cover clinical, professional, and social justice dimensions. We believe that mental health nurses are strategically and professionally placed to take a leadership role in raising the profile of aged care in this country and they need to act proactively to secure the well‐being of this particularly vulnerable client group.
Ogres and Angels in the madhouse. Mental health nursing identities in film
Authors: De Carlo Keri
Published: September 2007

ABSTRACT:  This project applied ethnographic content analysis to examine 19 American films made during the period 1942–2005. The purpose of this examination is to consider how the medium of American film portrays psychiatric mental health nursing and its world within the hospital. It critiques the way film frames mental health nursing and the profession's interactions with other disciplines, such as psychiatry, that might reveal a disposition that is peculiar to this group. It concludes that Hollywood film genre continues to perpetuate the notion that mental health nursing occupies an aberrant, secret, and dangerous world and that its role remains one of custodial companionship. If Chiari, Pinel, and Tuke, the founders of moral therapy during the Age of Reason observed these films, they could be forgiven if they wondered whether psychiatric mental nursing remained trapped in the Middle Ages While some of the films reviewed may be considered vacuous nonsense, its discourses reflect how society views people with serious mental illness and those who nurse them. This critique is a challenge for the profession to educate society regarding the profession's true work, reclaiming its commitment to affirming the dignity and human rights of those with mental illness by instigating political strategies that will destabilize the subversive and dividing practices that film merely manipulates.
Aging and metabolic syndrome effect on carotid atherosclerosis assessed by ultrasonography
Authors: Kawamoto Ryuichi , Ohtsuka Nobuyuki , Ninomiya Daisuke , Nakamura Shumpei , Inoue Ai
Published: September 2007

Objective:  To investigate the relationships between carotid atherosclerosis, age and metabolic syndrome (MetS), by ultrasonographically examining the carotid arteries of subjects who ranged from young adults to centenarians.

Methods:  Carotid intima‐media thickness (IMT) was evaluated by B‐mode ultrasonography in 1540 patients (685 men, aged 70 ± 15 years, and 855 women, aged 74 ± 13 years) in the Medical Department of Seiyo Municipal Nomura Hospital. We investigated the association between carotid IMT as well as plaque, and confounding risk factors including MetS by using the 2005 Japanese criteria.

Results:  MetS increased with age until the fifth to seventh decade of life but began to decrease in the more elderly subjects. Carotid IMT increased in a linear manner with age (r = 0.442, P < 0.001) and occurrence of plaques also increased up to the ninth decade of life (P for trend <0.001). Multiple logistic regression analysis for carotid IMT ≥1.10 mm and plaque occurrence was performed using age, sex, smoking status, low‐density lipoprotein cholesterol and MetS as variables. In subjects less than 80 years old, male sex and MetS were significant factors for carotid IMT ≥1.10 mm. However, in subjects 80 years or older, MetS was not related to carotid IMT ≥1.10 mm. The appearance of plaque was associated with age and smoking status, but not with MetS.

Conclusion:  MetS confers an increased risk of cardiovascular morbidity in subjects aged less than 80 years, and its identification may thus be important in risk assessment and treatment of patients.
Family relationships for self‐care‐dependent older people at home
Authors: Kodama Hiroko , Suda Yuko , Takahashi Ryutaro , Nishimura Masanori , Izumo Yuji , Watanabe Makoto , Kudo Hisashi , Kudo Hideaki , Sasaki Hidetada
Published: September 2007

Background:  Although the government recommends self‐care‐dependent older people be cared for at home, family relationships between caregivers and self‐care‐dependent older people surely would be one of the key factors for care at home. Good memories of family caregivers for self‐care‐dependent older people before self‐care‐dependence would overcome negative psychological symptoms to care at home.

Methods:  We investigated family relationships before and after having self‐care‐dependent older people at home in a rural town of Oodate, Akita Prefecture, and an urban district of Katsushika, Tokyo. Among 12 261 dependent elderly (2668 in Oodate and 9593 in Katsushika), 9606 stayed at home (2009 in Oodate and 7597 in Katsushika) and 1036 family caregivers (381 in Oodate and 655 in Katsushika) completed the questionnaires and entered the present study.

Results:  Good and medium relationships were dominant and bad family relationships were limited in number after self‐care‐dependence. Family relationships after self‐care significantly correlated with family relationships before self‐care for all main caregivers. There was no significant difference in family relationships between Oodate and Katsushika.

Conclusion:  Keeping a good relationship with main caregivers before self‐care would be one of the important factors in caring for self‐care‐dependent older people at home.
Antepartum detection of cord presentation by transvaginal ultrasonography for term breech presentation: Potential prediction and prevention of cord prolapse
Authors: Kinugasa Masato , Sato Tetsuya , Tamura Maki , Suzuki Hiromi , Miyazaki Yoshihiko , Imanaka Motoharu
Published: September 2007

Aim:  We evaluated the efficacy of antepartum screening for cord presentation by trans‐vaginal ultrasonography (TVS) on predicting and preventing umbilical cord prolapse (UCP) in term breech delivery.

Methods:  We investigated every woman with a breech‐presenting fetus for cord presentation by weekly TVS after 36 weeks of gestation since 1995. If the cord was found in advance of fetal presenting parts, we recommended her to undergo elective cesarean section to avoid UCP. We studied the incidence of cord presentation by TVS and the clinical courses of the cases with it for 198 women who delivered breech after 36 weeks from 1995 to 2005 (group A). Further, the incidence of UCP was compared between group A and another 230 women who delivered breech at term from 1983 to 1994 (group B).

Results:  Cord presentation was detected by TVS at least once in eight (4%) group A patients. Seven of them underwent elective cesarean section and, in six of these (86%), cord presentation was still found at the time of operation. The eighth patient became free of cord presentation at the later examinations and delivered vaginally without UCP. A hundred and twenty‐one (61%) women in group A and 159 (69%) women in group B delivered vaginally. No UCP occurred in group A, while it occurred in 10 (4%) cases of group B (P < 0.01), and one baby died of it.

Conclusions:  Detection of cord presentation by TVS has a potential to predict and reduce UCP in breech delivery at term.
Association of Chlamydia trachomatis serology with tubal infertility in Nigerian women
Authors: Omo‐Aghoja Lawrence O. , Okonofua Friday E. , Onemu Samson O. , Larsen Ulla , Bergstrom Staffan
Published: September 2007

Aim:  To determine the association between tubal infertility and Chlamydia trachomatis in Nigerian women.

Methods:  This case‐control study is from the Departments of Obstetrics and Gynecology of two tertiary hospitals in Nigeria. One hundred and sixty‐two infertile patients with tubal occlusion had 162 pregnant women matched for age as controls. Information on sociodemographic variables, sexual and reproductive risk factors, and history of previous pelvic infections were elicited using a study protocol. The prevalence of Chlamydia Trachomatis antibody was determined for cases and controls.

Results:  The prevalence of serum Chlamydia antibody was significantly higher in cases (65.8%) compared with controls (17.3%; P < 001). The effects of Chlamydia antibodies on infertility were strengthened in the multivariate model controlling for Chlamydia antibodies and gynecologic symptoms, compared to the univariate model. However, the association was attenuated and non‐significant when the effects of gynecologic symptoms, sociodemographic characteristics, contraceptive and sexual history were controlled in the conditional logistic regression model. The strongest independent predictors of infertility in the model were vaginal discharge, education less than tertiary and more than three lifetime sexual partners (proxies of sexually transmitted infections).

Conclusions:  There was no strong independent association between Chlamydia antibodies and the risk of being infertile in Nigerian women. By contrast, the proxies of sexually transmitted infections were significant predictors of infertility in the women. Efforts to address these factors, which are proxies of sexually transmissible infections, Chlamydia infection, and health‐seeking behavior for these infections, will likely contribute to reducing the burden of infertility in Nigerian women.
Aromatase inhibitor‐induced bone mineral loss and its prevention by bisphosphonate administration in postmenopausal breast cancer patients
Authors: Yonehara Yukie , Iwamoto Ichiro , Kosha Shoichiro , Rai Yoshiaki , Sagara Yoshiatsu , Douchi Tsutomu
Published: September 2007

Aim:  To investigate aromatase inhibitor‐induced bone mineral loss and its prevention by bisphosphonate administration in postmenopausal breast cancer patients.

Methods:  Subjects were 17 postmenopausal breast cancer patients (mean age, 63.3 ± 9.9 years) receiving non‐steroidal aromatase inhibitor (AI; anastrozole, 1 mg daily) only and 10 such patients (mean age, 65.0 ± 5.1 years) receiving AI + bisphosphonate (risedronate sodium, 2.5 mg daily) for 6 months. All of the subjects had undergone surgical resection and had positive estrogen receptor tumor status. Age, age at menopause, years since menopause, height, weight, and body mass index (Wt/Ht2) were recorded. Lumbar spine (L2–4) bone mineral density (BMD), T‐, and Z‐scores were assessed on dual‐energy X‐ray absorptiometry before and after therapy.

Results:  In the AI‐only group BMD, T‐, and Z‐scores significantly decreased from the baseline during the 6‐month therapy period (P < 0.05). Mean decreases in L2–4 BMD and Z‐score were 2.5% and 3.0%, respectively. In the AI + bisphosphonate group, however, BMD, T‐, and Z‐scores significantly increased from the baseline values (P < 0.01). Mean increases in L2–4 BMD and Z‐score were 4.5% and 3.3%, respectively.

Conclusion:  AI carries a potential risk of bone mineral loss despite the short therapy duration. Bisphosphonate has a preventive effect on this loss.
Late onset of pulmonary embolism caused by lymphocyst following pelvic lymphadenectomy
Authors: Tsuji Yoriko , Kawaguchi Ryuji , Haruta Shoji , Shigetomi Hiroshi , Ueda Sachiyo , Kanayama Seiji , Yoshida Shozo , Sakata Mariko , Sado Toshiyuki , Yamada Yoshihiko , Kitanaka Koji , Kobayashi Hiroshi
Published: September 2007

Herein is reported a case of late‐onset pulmonary embolism following pelvic surgery, despite prophylactic measures in the perioperative period. Twenty‐six days after hysterectomy and pelvic lymphadenectomy for endometrial carcinoma, an 83‐year‐old woman developed a pulmonary embolism. This was caused by pelvic lymphocyst, which, in turn, led to chronic compression of the right external iliac vein. This case strongly suggests that prolonged postoperative thromboembolic prophylaxis should be considered in elderly patients undergoing lymphocyst following pelvic surgery.
Simple sling resection and a second, intermediate polypropylene mesh for treatment of vaginal tape protrusion concurrent with recurrent urinary stress incontinence after TVT procedure
Authors: Lo Tsia‐Shu , Lee Shu‐Jane
Published: September 2007

The tension‐free vaginal tape (TVT) procedure is a simple, effective and minimally invasive method for the surgical treatment of urodynamic stress incontinence (USI). Yet, complications such as mesh protrusion and recurrent urinary leakages after TVT have been reported. A case of recurrent USI complicated with vaginal mesh protrusion following a TVT procedure was referred. Video‐urodynamics and introital ultrasonography confirmed that the recurrence of USI was secondary to mal‐position of the protruded TVT. A simple salvaging procedure was carried out. The mal‐positioned distal protruded TVT was resected and a second intermediate piece of polypropylene (Prolene) mesh was replaced at mid‐urethra. The operation time was short and blood loss was minimal. The patient was objectively continent at 6 months follow‐up with no defect of healing. Considering the cost‐effectiveness and invasiveness of the surgeries, the method of inserting an intermediate mesh is clinically useful.
Presynaptic regulation of dendrodendritic dopamine transmission
Authors: Beckstead Michael J. , Ford Christopher P. , Phillips Paul E. M. , Williams John T.
Published: September 2007

The amount of dopamine release from terminals in the forebrain following an electrical stimulus is variable. This dynamic regulation, both between and within trains of electrical stimuli, has fostered the notion that burst firing of dopamine neuronsin vivomay be a determinant of dopamine release in projection areas. In the present study dendritic dopamine release was examined in the substantia nigra and ventral tegmental area in mouse brain slices using whole‐cell recording of a dopamine‐mediated inhibitory postsynaptic current (IPSC). Paired stimuli produced a depression of the IPSC that was not observed with paired pulses of exogenously applied dopamine. Increasing the number of electrical stimuli from one to five produced an increase in the amplitude the dopamine IPSC but the increase was less than additive, indicating a depression of transmission with each successive stimulus. Analysis with fast‐scan cyclic voltammetry demonstrated that presynaptic D2‐autoreceptors did not contribute to the depression. Facilitation of the IPSC was observed only after the probability of release was reduced. Thus the regulation of dopamine release in the cell body region was dependent on dopamine neuron impulse activity. Under circumstance where there was initially little activity the probability of dopamine release was high and repetitive activation resulted in depression of further release. With increased activity, the release probability decreased and a burst of activity caused a relative facilitation of dopamine release. This form of regulation would be expected to limit activity within the cell body region.
Bax‐dependent and ‐independent death of motoneurons after facial nerve injury in adult mice
Authors: Park Ok‐hee , Lee Kea Joo , Rhyu Im Joo , Geum Dongho , Kim Hyun , Buss Robert , Oppenheim Ronald W. , Sun Woong
Published: September 2007

Nerve injury‐induced neuronal death may occur after accidental trauma or nerve inflammation. Although the response to facial root avulsion has been examined in rodent models, there are conflicting results as to whether motoneuron (MN) death is mediated by apoptosis or necrosis. We examined the response of MNs and proximal nerves after facial nerve avulsion in adult mice. Following facial nerve avulsion in 4–5‐week‐old mice, we observed a progressive reduction of MNs such that by 4 weeks less than 10% of avulsed MNs remained compared with the control side. The profile of MN degeneration was distinct from axotomy‐induced responses. For example, the onset of MN death was more rapid, and the extent of MN loss was greater compared with axotomy. Furthermore, the degeneration of oligodendrocytes and the activation of microglia were increased in the proximal nerve after avulsion. Ultrastructural observations suggested that root avulsion mainly induces non‐apoptotic neuronal death, although a small subset of neurons appeared to die via apoptosis. To evaluate the contribution of apoptotic death, we evaluated MN responses in Bax‐knockout (KO) mice in which neurons are rescued from apoptotic death. Surprisingly, although the majority of Bax‐KO mice exhibited only a moderate MN loss after avulsion, a subset of Bax‐KO mice (25%) exhibited extensive MN death and injury‐induced changes in the nerve that were indistinguishable from events in wild‐type littermates. These results suggest that both Bax‐dependent and ‐independent forms of cell death are evoked by root avulsion, and that programmed cell death may be involved in triggering a robust necrotic response.
Insular cortex lesions fail to block flavor and taste preference learning in rats
Authors: Touzani Khalid , Sclafani Anthony
Published: September 2007

The role of the insular cortex (IC) in learning to associate orosensory cues with the oral and post‐oral properties of carbohydrate was examined. Rats with either small (gustatory region) or large (gustatory and visceral regions) ibotenic acid lesions of the IC learned to prefer flavors (Experiments 1 and 3) and taste mixtures (Experiments 2 and 4) paired with intragastric infusions of maltodextrin. The rats with large IC lesions also learned a preference for a flavor cue paired with the sweet taste of fructose (Experiment 5). In fact, they showed enhanced conditioning and retarded extinction compared with controls. Collectively, these data provided no evidence that IC is essential for flavor preference learning based on associations between the orosensory cues and the oral and post‐oral reinforcing properties of nutrients.
Endothelial progenitor cells for the treatment of diabetic vasculopathy: panacea or Pandora’s box?
Authors: Liew A. , McDermott J. H. , Barry F. , O’Brien T.
Published: September 2007

The discovery of endothelial progenitor cell (EPC) a decade ago has refuted the previous belief that vasculogenesis only occurs during embryogenesis. The reduced circulating concentration of EPCs is a surrogate marker of endothelial function and has been implicated in the pathogenesis of many vascular diseases. To date, the therapeutic benefit of neovascularization in ischaemic conditions in a non‐diabetic setting has been demonstrated. This article aims to review the biology of EPCs in the diabetic setting with special emphasis on the effects of cardiovascular risk factor modification on EPC phenotype and methods to reverse or augment EPC dysfunction. The potential of the use of EPCs in the treatment of the diabetic vascular dysfunction will also be discussed.
Notes on a transformation: RBC's journey
Authors: Bigsby Elisabetta , Ready Douglas
Published: September 2007

In 2003, analysts disparaged Canada's RBC Financial Group for its acceptable but unremarkable performance. Lately, it has delivered nine quarters of stellar financial results. What changed?Elisabetta Bigsby and Douglas Ready tell how transformation champions can make change the coin of the realm.
Optimal optimism
Authors: Trevelyan Rose
Published: September 2007

A positive outlook can be a powerful force in business. But what if someone's optimism is unrealistic, unfounded or excessive?Rose Trevelyan says the results can be lethal. So, how can you be optimistic without being overconfident?
King's counsel
Authors: Smith Charles E.
Published: September 2007

Should executive coaches think of themselves as filling the same role Merlin did with King Arthur?Charles E. Smith would insist on it.