bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of myogenic progenitor cells and myonuclei is altered in women with vs. those without chronically painful trapezius muscle
Authors: Mackey Abigail L. , Andersen Lars L. , Frandsen Ulrik , Suetta Charlotte , Sjøgaard Gisela
Published: October 2010

It is hypothesized that repeated recruitment of low-threshold motor units is an underlying cause of chronic pain in trapezius myalgia. This study investigated the distribution of satellite cells (SCs), myonuclei, and macrophages in muscle biopsies from the trapezius muscle of 42 women performing repetitive manual work, diagnosed with trapezius myalgia (MYA; 44 ± 8 yr; mean ± SD) and 20 matched healthy controls (CON; 45 ± 9 yr). Our hypothesis was that muscle of MYA, in particular type I fibers, would demonstrate higher numbers of SCs, myonuclei, and macrophages compared with CON. SCs were identified on muscle cross sections by combined immunohistochemical staining for Pax7, type I myosin, and laminin, allowing the number of SCs associated with type I and II fibers to be determined. We observed a pattern of SC distribution in MYA previously only reported for individuals above 70 yr of age. Compared with CON, MYA demonstrated 19% more SCs per fiber associated with type I fibers (MYA 0.098 ± 0.039 vs. CON 0.079 ± 0.031; P < 0.05) and 40% fewer SCs associated with type II fibers (MYA 0.047 ± 0.017 vs. CON 0.066 ± 0.035; P < 0.05). The finding of similar numbers of macrophages between the two groups was not in line with our hypothesis and suggests that the elevated SC content of MYA was not due to heightened inflammatory cell contents, but rather to provide new myonuclei. The findings of greater numbers of SCs in type I fibers of muscle subjected to repeated low-intensity work support our hypothesis and provide new insight into stimuli capable of regulating SC content.
Exercise mitigates the stunting effect of cold temperature on limb elongation in mice by increasing solute delivery to the growth plate
Authors: Serrat Maria A. , Williams Rebecca M. , Farnum Cornelia E.
Published: October 2010

Ambient temperature and physical activity modulate bone elongation in mammals, but mechanisms underlying this plasticity are a century-old enigma. Longitudinal bone growth occurs in cartilaginous plates, which receive nutritional support via delivery of solutes from the vasculature. We tested the hypothesis that chronic exercise and warm temperature promote bone lengthening by increasing solute delivery to the growth plate, measured in real time using in vivo multiphoton microscopy. We housed 68 weanling female mice at cold (16°C) or warm (25°C) temperatures and allowed some groups voluntary access to a running wheel. We show that exercise mitigates the stunting effect of cold temperature on limb elongation after 11 days of wheel running. All runners had significantly lengthened limbs, regardless of temperature, while nonrunning mice had shorter limbs that correlated with housing temperature. Tail length was impacted only by temperature, indicating that the exercise effect was localized to limb bones and was not a systemic endocrine reaction. In vivo multiphoton imaging of fluoresceinated tracers revealed enhanced solute delivery to tibial growth plates in wheel-running mice, measured under anesthesia at rest. There was a minimal effect of rearing temperature on solute delivery when measured at an intermediate room temperature (20°C), suggesting that a lasting increase in solute delivery is an important factor in exercise-mediated limb lengthening but may not play a role in temperature-mediated limb lengthening. These results are relevant to the study of skeletal evolution in mammals from varying environments and have the potential to fundamentally advance our understanding of bone elongation processes.
The Effect of Smoking on the Dysphonia Severity Index in Females
Authors: Awan Shaheen N.
Published: October 2010

Objective: This study investigated the capability of the Dysphonia Severity Index (DSI) and its component measures to reveal differences in vocal capability between groups of young adult female smokers and nonsmokers. Patients and Methods: The subjects were 30 female nonsmokers and 30 female smokers between the ages of 18 and 24 years. Data on the DSI components (maximum phonation time, MPT; highest phonational frequency, F0 high; lowest intensity, Ilow, and jitter) were collected, followed by calculation of the DSI. Results: Significant differences between groups were observed on the DSI, with reduced DSI scores in smokers primarily due to reductions in F0 high and increases in Ilow. A strong partial correlation between MPT and the DSI in smokers may be indicative of reductions in respiratory support and/or phonatory control. Conclusions: Significant group differences in the DSI and component measures may be indicative of early changes in vocal function secondary to smoking. Reductions in frequency and dynamic range are consistent with the possibility of increased vocal fold mass in smokers. The results indicate that significant differences in the DSI between groups may be observed in subjects with perceptually normal vocal quality and with normal levels of vocal perturbation.
Air Pulse Deformation Measurement: A Preliminary Method for Noninvasive Vocal Fold Pliability Analysis
Authors: Larsson H. , Lindestad P.Å. , Hertegård S.
Published: October 2010

Objective: A new method, air pulse pliability measurement, is presented, with which the pliability and elasticity of the vocal folds was measured in vitro and in vivo using air pulses. The size of the mucosal movements induced by air pulse stimulation was measured with a laser-based technique. Subjects and Methods: The air pulses fed via a 2-mm tubing, introduced through the working channel of a flexible endoscope. Both in vitro and in vivo tests were performed. Nine normal, vocally healthy subjects were examined by air pulse stimulations of the vocal folds, of the skin (cheek and dorsum of the hand) and of the inside of the lips. Results: The in vitro tests showed a coefficient of variation of 5% within a range of 1–5 mm from the probe to the surface. The elasticity data showed no differences between vocal folds, lips or cheek. The hand data showed a significantly higher stiffness as compared to the other 3 measuring points (p < 0.001). The coefficient of variation was about 35% for all measuring points, but in ideal conditions on skin it was 9%. Conclusion: The results show that the technique allows automatic, quantitative, noninvasive vocal fold pliability measurements on awake subjects.
Objective Vocal Parameters in Farsi-Speaking Adults with Down Syndrome
Authors: Seifpanahi Sadegh , Bakhtiar Mehdi , Salmalian Tahmineh
Published: October 2010

Previous studies have indicated significant differences in vocal parameters between children with Down syndrome and normal children. This study was performed to see whether there is a significant dissociation between normal adults and adults with Down syndrome in terms of some vocal parameters. The participants were 22 adults with Down syndrome and 22 normal adults matched for age and gender. We measured jitter, shimmer, fundamental frequency (F0), and maximum phonation time (MPT). The results showed a significantly higher F0 and a significantly lower jitter in the Down syndrome group compared to the control group, while the average amounts of MPT and shimmer were not different. Moreover, the shimmer and jitter of females in both groups were lower than those of males. These findings might be the result of a physiological retardation of the larynx rather than mental retardation in the Down syndrome population.
Respiratory Retraining Therapy in Long-Term Treatment of Paradoxical Vocal Fold Dysfunction
Authors: Nacci Andrea , Fattori Bruno , Segnini Giovanni , Dallan Iacopo , Panicucci Erica , Rocchi Valeria , Ursino Francesco
Published: October 2010

Objectives: Paradoxical vocal fold dysfunction (PVFD) is a disorder in the larynx featuring involuntary adduction of the vocal folds during the inspiratory phase of breathing. The symptoms include acute episodes of dyspnea and bouts of coughing. To date, there is no universally acknowledged treatment for PVFD, though respiratory retraining therapy is the treatment of choice. Aims: The purpose of this work was to evaluate the results of long-term respiratory retraining therapy in cases of PVFD. Patients and Methods: We treated 20 patients with PVFD for 2 years: 10 subjects were submitted to a cycle of respiratory retraining therapy every 12 months (receiving a total of 3 cycles) while 10 were given a cycle every 3 months (for a total of 9 cycles) no matter what their clinical conditions were. Results: The results show that long-term respiratory retraining is particularly efficacious if the cycles of treatment are repeated, no matter what clinical conditions are present. In fact, when only one cycle of retraining treatment is given a year, there is initial improvement followed by progressive worsening. Conclusions: Long-term respiratory rehabilitation is effective, especially if the treatment is given at least once every 3 months.
Voice Handicap and Health-Related Quality of Life after Treatment for Small Laryngeal Carcinoma
Authors: Killguβ Helen , Gottwald Frank , Haderlein Tino , Maier Andreas , Rosanowski Frank , Iro Heinrich , Psychogios Georgios , Schuster Maria
Published: October 2010

Treatment of small carcinoma of the larynx may lead to voice handicap and restricted quality of life. The relationship between the two is revealed. Sixty-five patients aged 62.1 ± 10.0 years rated their voice handicap and quality of life after treatment of T1 (n = 35) or T2 (n = 30) laryngeal carcinoma during regular out-patient examinations. For the self-assessment of the voice, the Voice Handicap Index (VHI) and the disease-independent Short Form-36 Health Survery (SF-36) questionnaires were used. Voice handicap (total score 38.9 ± 26.0) did not differ in the two tested groups, T1 and T2, and the data of SF-36 (physical score 43.0 ± 10.7; mental score 50.2 ± 9.1) showed significant differences for the mental score. Patients rated their voice handicap worse than healthy persons did after treatment of laryngeal carcinoma. VHI and SF-36 data were strongly correlated. Voice handicap is significantly related to the quality of life, especially affecting the mental domain. Thus, the rehabilitation of voice disorders should have a beneficial impact on quality of life.
Induced Chromosome Deletion in a Williams-Beuren Syndrome Mouse Model Causes Cardiovascular Abnormalities
Authors: Goergen Craig J. , Li Hong-Hua , Francke Uta , Taylor Charles A.
Published: October 2010

Aims: The Williams-Beuren syndrome (WBS) is a genetic disorder caused by a heterozygous ∼1.5-Mb deletion. The aim of this study was to determine how the genetic changes in a Wbs mouse model alter Eln expression, blood pressure, vessel structure, and abdominal aortic wall dynamics in vivo. Methods: Elastin (ELN) transcript levels were quantified by qRT-PCR and blood pressure was measured with a tail cuff system. M-mode ultrasound was used to track pulsatile abdominal aortic wall motion. Aortas were sectioned and stained to determine medial lamellar structure. Results: ELN transcript levels were reduced by 38–41% in Wbs mice lacking one copy of the ELN gene. These mice also had a 10–20% increase in mean blood pressure and significantly reduced circumferential cyclic strain (p < 0.001). Finally, histological sections showed disorganized and fragmented elastin sheets in Wbs mice, but not the characteristic increase in lamellar units seen in Eln+/– mice. Conclusions: The deletion of Eln in this Wbs mouse model results in lower gene expression, hypertension, reduced cyclic strain, and fragmented elastin sheets. The observation that the number of medial lamellar units is normal in Wbs deletion mice, which is in contrast to Eln+/– mice, suggests other genes may be involved in vascular development.
Connexin Channel-Dependent Signaling Pathways in Inflammation
Authors: Scheckenbach K.E. Ludwig , Crespin Sophie , Kwak Brenda R. , Chanson Marc
Published: October 2010

Inflammation is a highly regulated process with common but also specific characteristics in each tissue affected. Recruitment of leukocytes from the blood to the injured tissue is an important early step in the inflammatory cascade. This review highlights the role of connexins (Cxs) in the regulation of both acute and chronic inflammatory processes. Cxs form gap junction channels that provide a cytoplasmic continuity between adjacent cells allowing the intercellular exchange of ions and metabolites. Their structural halves form connexons or hemichannels. Each of them consists of 6 Cx proteins and hemichannels not taking part in gap junction formation but facilitating the release of small molecules such as ATP. Based on the differential distribution of various Cxs in different tissues such as the brain, lung capillaries and large blood vessels, our aim was to analyze the specific roles of Cxs in the inflammatory process in these tissues. Three typical sites of inflammation were chosen to shed light on similarities and differences in several types of responses: (1) atherosclerosis as a model for chronic inflammation, (2) the lung as an example of acute inflammation and (3) the ‘immune-privileged’ environment of the brain to highlight specific reactions of the vasculature to ischemic damage and inflammation at this site.
Patient Perspectives on Group Benefits and Harms in Genetic Research
Authors: Goldenberg A.J. , Hull S.C. , Wilfond B.S. , Sharp R.R.
Published: October 2010

Background: It is unclear how the possible effects of genetic research on socially identifiable groups may impact patient willingness to donate biological samples for future genetic studies. Methods: Telephone interviews with patients at 5 academic medical centers in the U.S. examined how patients’ beliefs about benefits and harms to ones racial or ethnic group shape decisions to participate in genetic research. Results: Of the 1,113 patients who responded to questions about group harms and benefits, 61% of respondents indicated that potential benefits to their own racial or ethnic group would be a big or moderate part of their decision to donate a sample for genetic research. 63% of black respondents and 57% of white respondents indicated that they were ‘very’ or ‘moderately concerned’ about genetic research findings being used to discriminate against people by race or ethnicity. 64% of black and 34% of white respondents reported that their willingness to donate a blood sample would be substantially reduced due to these concerns. Conclusion: Our findings suggest that a key factor in many patients’ decisions to donate samples for genetic research is how those studies may impact identifiable racial and ethnic groups. Given the importance of these considerations to many patients, our study highlights a need to address patients’ concerns about potential group benefits and harms in the design of future research studies and DNA biobanks.
Marfan Syndrome Decreases Ca2+ Wave Frequency and Vasoconstriction in Murine Mesenteric Resistance Arteries without Changing Underlying Mechanisms
Authors: Syyong H.T. , Chung A.W.Y. , van Breemen C.
Published: October 2010

Background/Aims: Vascular smooth muscle in Marfan syndrome, a connective tissue disorder caused by mutations in FBN1 encoding fibrillin-1, is associated with decreased tonic contraction. As Ca2+ waves are tightly associated with vasoconstriction, we hypothesized decreased tonic contraction in Marfan syndrome is due to aberrant Ca2+ wave signaling. Methods: Isometric force and intracellular Ca2+ were measured from second-order mesenteric arteries from mice heterozygous for the Fbn1 allele encoding a cysteine substitution (Fbn1C1039G/+). Results: Phenylephrine concentration-dependently induced tonic contraction associated with sustained repetitive oscillations in intracellular [Ca2+] in both control and Marfan vessels, although Marfan vessels displayed significantly decreased Ca2+ wave frequency and decreased number of cells exhibiting waves. Inhibition of sarcoplasmic reticulum Ca2+ re-uptake by cyclopiazonic acid abolished Ca2+ waves, dramatically decreasing tonic contraction. Nifedipine significantly reduced Ca2+ wave frequency and tonic contraction, while the nifedipine-insensitive component was abolished by SKF-96365. Ca2+ waves and tonic contraction were abolished by 2-aminoethoxydiphenylborate, but were unaffected by ryanodine or tetracaine. Conclusion: Phenylephrine-induced Ca2+ waves underlie tonic contraction in resistance-sized mesenteric arteries and appear to be produced by repetitive cycles of regenerative Ca2+ release from the sarcoplasmic reticulum. Decreased frequency of Ca2+ waves in Marfan syndrome appears to be responsible for reduced tonic contraction.
Factors Associated with Participation in Providing Buccal Cell DNA for a Genetic Epidemiologic Study
Authors: Kang D.R. , Kim C. , Hur N.W. , Shim J.S. , Shin S.C. , Suh I.
Published: October 2010

Aims: Our aim was to investigate factors associated with participation in buccal cell DNA collection using a large-scale prospective cohort study. Methods: Of the 183,634 Korea Medical Insurance Corporation (KMIC) prospective cohort study enrollees, 44,773 (36,794 men) were randomly selected. Buccal cell collection kits were mailed and collected from March to September 2004. Epidemiologic characteristics measured at baseline (1990 or 1992) and during follow-up (1998) were compared between respondents and nonrespondents. Results: Among the 13,084 (29.2%) respondents, 78.7% submitted usable samples (DNA concentration ≧3 µg). After adjustments for either or both age and family history of chronic disease, participation in men was positively associated with old age, a family history of chronic disease, low subjective health status, and regular exercise, and negatively associated with current smoking status. In women, only old age was associated with participation. Low body mass index (BMI) (<18.5 kg/m2), blood pressure, total cholesterol, and fasting blood glucose level were negatively associated with participation in men after adjustments for age and family history of chronic disease, but not in women, except for low BMI. Conclusions: In this study, collecting buccal cell DNA by mailed survey has a low success rate (29%), and there appear to be a nonresponse bias and gender differences in the collection process.
A Comparison of Vowel Productions in Prelingually Deaf Children Using Cochlear Implants, Severe Hearing-Impaired Children Using Conventional Hearing Aids and Normal-Hearing Children
Authors: Baudonck N. , Van Lierde K. , Dhooge I. , Corthals P.
Published: October 2010

Objective: The purpose of this study was to compare vowel productions by deaf cochlear implant (CI) children, hearing-impaired hearing aid (HA) children and normal-hearing (NH) children. Patients and Methods: 73 children [mean age: 9;14 years (years;months)] participated: 40 deaf CI children, 34 moderately to profoundly hearing-impaired HA children and 42 NH children. For the 3 corner vowels [a], [i] and [u], F1, F2 and the intrasubject SD were measured using the Praat software. Spectral separation between these vowel formants and vowel space were calculated. Results: The significant effects in the CI group all pertain to a higher intrasubject variability in formant values, whereas the significant effects in the HA group all pertain to lower formant values. Both hearing-impaired subgroups showed a tendency toward greater intervowel distances and vowel space. Conclusion: Several subtle deviations in the vowel production of deaf CI children and hearing-impaired HA children could be established, using a well-defined acoustic analysis. CI children as well as HA children in this study tended to overarticulate, which hypothetically can be explained by a lack of auditory feedback and an attempt to compensate it by proprioceptive feedback during articulatory maneuvers.
A Review of Ranibizumab Clinical Trial Data in Exudative Age-Related Macular Degeneration and How to Translate It into Daily Practice
Authors: Monés Jordi
Published: October 2010

The results of randomized controlled clinical trials of ranibizumab for the treatment of age-related macular degeneration established a new standard of care with the prospect of improved vision in many patients. Subsequent trials have explored different strategies to increase response rates and reduce treatment frequency. This review analyzes the key clinical trial data for ranibizumab on the basis of which the author proposes a new treatment regimen with the aim of rationalizing treatment frequency without compromising improvements in vision – the FUSION regimen. This consists of an initiation phase followed by pro re nata (PRN) retreatment combined with fixed injections after a period of disease inactivity of 2–4 months (depending on the time elapsed since the last injection). A randomized clinical trial is recommended for comparing monthly, PRN and the FUSION regimens.
The Impact of the 2007 ATS/IDSA Diagnostic Criteria for Nontuberculous Mycobacterial Disease on the Diagnosis of Nontuberculous Mycobacterial Lung Disease
Authors: Chae Dong-Ryeol , Kim Yu-Il , Kee Seung-Jung , Kim Yoon-Hee , Chi Su-Young , Ban Hee-Jung , Kwon Yong-Soo , Oh In-Jae , Kim Kyu-Sik , Kim Soo-Ock , Kim Young-Chul , Lim Sung-Chul
Published: October 2010

Background: In 2007, the American Thoracic Society (ATS) and Infectious Disease Society of America (IDSA) published new diagnostic guidelines for nontuberculous mycobacterial (NTM) disease. Bacteriological criteria have become simpler compared to the 1997 ATS diagnostic criteria. Objective: For assessing the impact of the 2007 ATS/IDSA diagnostic criteria, we compared the diagnosis rate and time to diagnosis of NTM lung disease using the 1997 and 2007 ATS guidelines. Methods: Sixty-four patients who had excreted Mycobacterium intracellulare, M. avium, M. abscessus or M. kansasii at least one time in their respiratory specimens at Chonnam National University Hospital were reviewed. The 1997 ATS and 2007 ATS/IDSA guidelines were applied to these patients. Results: Thirty-seven of 64 patients (57.8%) were diagnosed with NTM lung disease by the 1997 ATS criteria. When the 2007 ATS/IDSA criteria were applied, 6 patients were newly diagnosed with NTM lung disease. The diagnosis rate significantly increased from 57.8 to 67.2% (p < 0.001). The time to diagnosis in the 1997 ATS and 2007 ATS/IDSA guidelines was 46.4 ± 53.0 and 36.2 ± 38.5 days, respectively (p = 0.002). Conclusion: These data suggest that we can shorten the time to diagnose NTM lung disease and diagnose more simply by using the 2007 ATS/IDSA guidelines. Further study will be needed to assess that these changes affect the management of NTM disease.
Biweekly Vinorelbine and Gemcitabine as Second-Line Treatment and Beyond in Non-Small Cell Lung Cancer
Authors: Chelis L. , Xenidis N. , Amarantidis K. , Prassopoulos P. , Chamalidou E. , Neanidis K. , Mikroulis D. , Chatzaki E. , Karakitsos P. , Kakolyris S.
Published: October 2010

Background: To evaluate the activity and tolerance of gemcitabine (GEM) in combination with vinorelbine (VRL) in pretreated patients with advanced non-small cell lung cancer (NSCLC). Patients and Methods: Fifteen patients with advanced NSCLC who had disease progression after a cisplatin- or taxane-based front-line regimen were enrolled into a 2-stage design trial and were treated with VRL 30 mg/m2 i.v. for 10 min followed by GEM 1,200 mg/m2 i.v. for 30 min on days 1 and 15 of each 28-day cycle. Chemotherapy was given for 6 cycles unless disease progression or unacceptable toxicity was seen. The patients’ median age was 64 years and the performance status (WHO) was 0 (n = 7), 1 (n = 5), and 2 (n = 3). The treatment was second line for 10 (67%) and third line or more for 5 (33%) patients. Results: No complete or partial responses were observed. Stable disease was seen in 4 (27%) patients and progressive disease in 11 (73%). The median time to tumor progression was 3 months (range 1–12) and the median survival was 4 months (range 2–31). Severe myelotoxicity was infrequent. Grade 2 neutropenia was observed in 2 (13%) patients, grade 2 thrombocytopenia in 1 (7%), and grade 2 anemia in 3 (20%). Nonhematologic toxicities were very mild and easily manageable. Conclusion: The GEM plus VRL combination at the present doses and schedule is a safe but ineffective regimen; therefore, it is not recommended as second-line treatment in patients with advanced NSCLC.
Low Endotoxin Release from Escherichia coli and Bacteroides fragilis during Exposure to Moxifloxacin
Authors: Trautmann Matthias , Scheibe Cordula , Wellinghausen Nele , Holst Otto , Lepper Philipp M.
Published: October 2010

Background: Bacterial endotoxin is known to act as a potent trigger of disseminated coagulation and septic shock. During clinical antibiotic treatment, endotoxin may be released from Gram-negative bacteria. It is known that antibiotic classes differ in their ability to induce endotoxin release. Aim: It was the aim of this study to test the endotoxin-liberating potential of different antibiotics with activity against Escherichia coli and Bacteroides fragilis.Methods: In vitro test models were used to evaluate the endotoxin-liberating potential of moxifloxacin, a 4th-generation quinolone with antianaerobic activity. Bacteria were exposed to moxifloxacin at 2×, 10× and 50× the minimal inhibitory concentration. Endotoxin release was measured by enzyme-linked immunosorbent and Limulus amoebocyte lysate assays. Comparator drugs were ceftazidime and imipenem, i.e. antibiotics with known high and low endotoxin-liberating potential, respectively. As a parameter for biological responses to endotoxin, the release of proinflammatory cytokines (tumor necrosis factor-α, interleukin-1β) from monocytes/macrophages was quantified with bioassays. Results: In all test systems, release of endotoxin during exposure of bacteria to moxifloxacin was minimal or low and comparable with that of imipenem. Conclusions: Moxifloxacin has a low potential to cause endotoxin-mediated detrimental clinical effects. Concerning its endotoxin-releasing properties, moxifloxacin appears to be a choice equivalent to the carbapenems.
The Neuropeptide Catestatin Acts As a Novel Angiogenic Cytokine via a Basic Fibroblast Growth Factor–Dependent Mechanism
Authors: Theurl Markus , Schgoer Wilfried , Albrecht Karin , Jeschke Johannes , Egger Margot , Beer Arno G.E. , Vasiljevic Danijela , Rong Song , Wolf Anna Maria , Bahlmann Ferdinand H. , Patsch Josef R. , Wolf Dominik , Schratzberger Peter , Mahata Sushil K. , Kirchmair Rudolf
Published: October 2010

Rationale:

The neuropeptide catestatin is an endogenous nicotinic cholinergic antagonist that acts as a pleiotropic hormone.

Objective:

Catestatin shares several functions with angiogenic factors. We therefore reasoned that catestatin induces growth of new blood vessels.

Methods and Results:

Catestatin induced migration, proliferation, and antiapoptosis in endothelial cells and exerted capillary tube formation in vitro in a Matrigel assay, and such effects were mediated via G protein, mitogen-activated protein kinase, and Akt. Catestatin-induced endothelial cell functions are further mediated by basic fibroblast growth factor, as shown by blockade of effects by a neutralizing fibroblast growth factor antibody. Furthermore, catestatin released basic fibroblast growth factor from endothelial cells and stimulated fibroblast growth factor signaling. In addition to its function on endothelial cells, catestatin also exerted effects on endothelial progenitor cells and vascular smooth muscle cells. In vivo, catestatin induced angiogenesis in the mouse cornea neovascularization assay and increased blood perfusion and number of capillaries in the hindlimb ischemia model. In addition to angiogenesis, catestatin increased density of arterioles/arteries and incorporation of endothelial progenitor cells in the hindlimb ischemia model, indicating induction of arteriogenesis and postnatal vasculogenesis.

Conclusion:

We conclude that catestatin acts as a novel angiogenic cytokine via a basic fibroblast growth factor–dependent mechanism.
Impact of Microalbuminuria on Incident Stroke
Authors: Lee Meng , Saver Jeffrey L. , Chang Kuo-Hsuan , Liao Hung-Wei , Chang Shen-Chih , Ovbiagele Bruce
Published: October 2010

Background and Purpose—

Microalbuminuria, a marker of both kidney disease and endothelial dysfunction, may be associated with global vascular risk, but the nature and magnitude of the link between microalbuminuria and incident stroke has not been clearly defined. The purpose of this study was to assess the consistency and strength of the association of microalbuminuria with risk of stroke in prospective studies using meta-analysis.

Methods—

We conducted a systematic search of electronic databases and bibliographies for studies reporting a multivariate-adjusted estimate, represented as relative risk with 95% CI, of the association between microalbuminuria and stroke risk. Studies were excluded if a majority of study participants had established kidney disease or pre-eclampsia. Estimates were combined using a random-effect model.

Results—

We identified 12 studies, with a total of 48 596 participants and 1263 stroke events. Overall, presence of microalbuminuria was associated with greater stroke risk (relative risk, 1.92; 95% CI, 1.61 to 2.28;
P
<0.001) after adjustment for established cardiovascular risk factors. There was evidence of significant heterogeneity in the magnitude of the association across studies (
P
for heterogeneity <0.001,
I
2
=68%), which was partially explained by differences in study population, microalbuminuria definition, and different microalbuminuria-related risk among stroke subtypes. However, in stratified analyses, microalbuminuria was associated with increased risk of subsequent stroke in all subgroups (general population, diabetics, those with known stroke).

Conclusions—

Microalbuminuria is strongly and independently associated with incident stroke risk. Future studies should explore whether microalbuminuria is just a risk marker or a modifiable risk factor for stroke.
Intravenous Alteplase for Stroke in Those Older Than 80 Years Old
Authors: Ford Gary A. , Ahmed Niaz , Azevedo Elsa , Grond Martin , Larrue Vincent , Lindsberg Perttu J. , Toni Danilo , Wahlgren Nils
Published: October 2010

Background and Purpose—

Risks and benefits of intravenous thrombolysis for patients with stroke >80 years of age are unclear. We examined outcomes and symptomatic intracerebral hemorrhage rates in ≤80- and >80-year-old patients in the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis Register.

Methods—

We compared mortality and independence (modified Rankin Scale 0 to 2) at 3 months and symptomatic intracerebral hemorrhage (per Safe Implementation of Treatment in Stroke ≥4-point deterioration in National Institutes of Health Stroke Scale within 36 hours and Type 2 parenchymal hemorrhage and per National Institute of Neurological Disorders and Stroke [any increase in National Institutes of Health Stroke Scale and any hemorrhage]) of 1831 patients >80 years of age with 19 411 patients ≤80 years of age compliant with other European licensing criteria.

Results—

The >80-year-old group (median, 83 years) had more severe strokes (median National Institutes of Health Stroke Scale 14 versus 12), lower levels of prestroke independence (modified Rankin Scale 0 to 1, 82% versus 93%), and a larger proportion of females (59% versus 39%) compared with the younger group (68 years). Symptomatic intracerebral hemorrhage was not significantly increased after adjustment for other risk factors in those >80 years of age compared with those ≤80 years of age (per Safe Implementation of Treatment in Stroke 1.8% versus 1.7%,
P
=0.70, adjusted OR, 0.90, 95% CI, 0.73 to 1.09;
P
=0.28; per National Institute of Neurological Disorders and Stroke 9.5% versus 7.8%,
P
<0.005, adjusted OR, 0.96, 95% CI, 0.87 to 1.06,
P
=0.42). The patients >80 years of age had a higher mortality rate (30% versus 12%;
P
<0.005; adjusted OR, 1.53; 95% CI, 1.43 to 1.65;
P
<0.005) and reduced independence (35% versus 57%;
P
<0.005; adjusted OR, 0.73; 95% CI, 0.68 to 0.78;
P
<0.005).

Conclusions—

Selected patients with acute ischemic stroke >80 years of age otherwise fulfilling the intravenous alteplase license criteria have a similar rate of symptomatic intracerebral hemorrhage compared with younger patients and are appropriate candidates for thrombolysis. The higher mortality and the poorer functional outcome are consistent with the overall worse prognosis seen in the natural history of this age group.
Unfractionated or Low–Molecular Weight Heparin for the Treatment of Cerebral Venous Thrombosis
Authors: Coutinho Jonathan M. , Ferro José M. , Canhão Patrícia , Barinagarrementeria Fernando , Bousser Marie-Germaine , Stam Jan
Published: October 2010

Background and Purpose—

There is no consensus whether to use unfractionated heparin or low–molecular weight heparin for the treatment of cerebral venous thrombosis. We examined the effect on clinical outcome of each type of heparin.

Methods—

A nonrandomized comparison of a prospective cohort study (the International Study on Cerebral Vein and Dural Sinus Thrombosis) of 624 patients with cerebral venous thrombosis. Patients not treated with heparin (n=107) and those who sequentially received both types of heparin (n=99) were excluded from the primary analysis. The latter were included in a secondary analysis, allocated according to the type of heparin given first. The primary end point was functional independency at 6 months (modified Rankin scale score ≤2). Secondary end points were complete recovery (modified Rankin scale score 0 to 1), mortality, and new intracranial hemorrhages.

Results—

A total of 119 patients received low–molecular weight heparin (28%) and 302 received unfractionated heparin (72%). Significantly more patients treated with low–molecular weight heparin were functionally independent after 6 months, both in univariate analysis (odds ratio, 2.1; CI, 1.0 to 4.2) and after adjustment for prognostic factors and imbalances (odds ratio, 2.4; CI, 1.0 to 5.7). In the secondary analysis, there was a similar, nonsignificant trend (odds ratio, 1.7; CI, 0.80 to 3.6). Low–molecular weight heparin was associated with less new intracerebral hemorrhages (adjusted odds ratio, 0.29; CI, 0.07 to 1.3), especially in patients with intracerebral lesions at baseline (adjusted odds ratio, 0.19; CI, 0.04 to 0.99). There was no difference in complete recovery and mortality.

Conclusions—

This nonrandomized study in patients with cerebral venous thrombosis suggests a better efficacy and safety of low–molecular weight heparin over unfractionated heparin. Low–molecular weight heparin seems preferable above unfractionated heparin for the initial treatment of cerebral venous thrombosis.
Stroke Risk and Antithrombotic Strategies in Atrial Fibrillation
Authors: Medi Caroline , Hankey Graeme J. , Freedman Saul B.
Published: October 2010

Background and Purpose—

Although the stroke rate associated with atrial fibrillation has declined over the last 10 years, the emerging atrial fibrillation epidemic threatens to increase the incidence of cardioembolic stroke.

Summary of Review—

Oral anticoagulants are superior antithrombotic agents but are underused due to fear of bleeding and uncertainty about which patients will benefit. Individualized decisions on antithrombotic therapy require balancing the competing risks of thromboembolism and bleeding. The CHADS
2
(Congestive heart failure, Hypertension, Age >75 years, and Diabetes mellitus, and 2 points for prior Stroke/transient ischemic attack) score and other schemes provide an estimate of thromboembolic risk; however, the external validity of these estimates in the context of well-controlled risk factors, or a hypercoagulable state, is uncertain. Moreover, it is very difficult to estimate bleeding risk. Recent studies highlight the need for meticulous international normalized ratio control to achieve optimal outcomes hampered by the high bleeding risk during oral anticoagulant inception and other limitations of warfarin. Dabigatran is at least as efficacious as warfarin in preventing stroke and systemic embolism for patients in whom the risk of thromboembolism outweighs bleeding risk. In addition, the results of ongoing trials evaluating alternative anticoagulants such as oral anti-Xa agents are awaited. In this review, we discuss emerging therapies including available and completed trials of direct antithrombins and anti-Xa agents, including ximelagatran, idraparinaux, and dabigatran; and new device therapies including left atrial appendage occlusion devices.

Conclusions—

In light of these promising new therapies, it is likely that atrial fibrillation thromboembolism guidelines will need to be rewritten and frequently updated.
An Epidemiological Study of Stroke Hospitalizations in Maputo, Mozambique
Authors: Damasceno Albertino , Gomes Joana , Azevedo Ana , Carrilho Carla , Lobo Vitória , Lopes Hélder , Madede Tavares , Pravinrai Pius , Silva-Matos Carla , Jalla Sulemane , Stewart Simon , Lunet Nuno
Published: October 2010

Background and Purpose—

Already a major cause of death and disability in high-income countries, the burden of stroke in sub-Saharan Africa is also expected to be high. However, specific stroke data are scarce from resource-poor countries. We studied the incidence, characteristics, and short-term consequences of hospitalizations for stroke in Maputo, Mozambique.

Methods—

Over 12 months, comprehensive data from all local patients admitted to any hospital in Maputo with a new stroke event were prospectively captured according to the World Health Organization’s STEPwise approach to stroke surveillance program. Disability levels (pre- and posthospital discharge) and short-term case-fatality (in-hospital and 28 days) were also studied.

Results—

Overall, 651 new stroke events (mean age 59.1±13.2 years and 53% men) were captured by the registry with 601 confirmed by CT scan (83.4%) or necropsy (8.9%). Crude and adjusted (world reference population) annual incidence rates of stroke were 148.7 per 100 000 and 260.1 per 100 000 aged ≥25 years, respectively. Of these, 531 (81.6%) represented a first-ever stroke event comprising 254 ischemic (42.0%) and 217 (36.1%) an intracerebral hemorrhage. Before admission, 561 patients (86.2%) had hypertension and 271 (41.6%) had symptoms for >24 hours. In-hospital and 28-day case-fatality were 33.3% and 49.6% (72.3% for hemorrhagic stroke), respectively. From almost no preadmission disability, 64.4% of 370 survivors at 28 days had moderate-to-severe disability.

Conclusions—

The burden of disease associated with stroke is high in Maputo, emphasizing the importance of primary prevention and improvement of the standards of care in a developing country under epidemiological transition.
Detection of Intracranial In-Stent Restenosis Using Quantitative Magnetic Resonance Angiography
Authors: Amin-Hanjani Sepideh , Alaraj Ali , Calderon-Arnulphi Mateo , Aletich Victor A. , Thulborn Keith R. , Charbel Fady T.
Published: October 2010

Background and Purpose—

In-stent restenosis (ISR) after angioplasty/stenting for intracranial stenosis has been reported in up to 25% to 30% of patients. Detection and monitoring of ISR relies primarily on serial catheter angiography, because noninvasive imaging methods are typically hampered by stent-related artifact. We examined the value of serial vessel flow measurements using quantitative magnetic resonance angiography (QMRA) in detection of ISR.

Material and Methods—

Records of patients undergoing stenting for intracranial symptomatic stenosis >50% between 2005 and 2009 were retrospectively reviewed. Angiographic images were graded by a blinded neurointerventionalist for stenosis pretreatment, immediately after treatment, and during follow-up. Flow in the affected vessel measured by QMRA was recorded; >25% reduction in flow was considered indicative of an adverse change. Clinical data regarding neurological outcome were also collected.

Results—

Twenty-eight patients underwent stenting during the time interval studied. Of these, 12 patients (mean age, 55.5 years; 8 female) had contemporaneous angiography and QMRA and were analyzed. Median follow-up was 9 months. Six patients (50%) demonstrated angiographic restenosis 2 to12 months after treatment; all had an analogous decrease in flow in the vessel of interest. Of 3 patients with more severe flow decrement (>50%), 2 experienced stroke. None of the patients without angiographic ISR demonstrated a flow decrease on QMRA.

Conclusions—

In this preliminary series, flow decrease on QMRA is highly predictive of angiographic ISR. Additionally, the degree of flow decrement correlates with symptomatic ISR. QMRA may provide a useful noninvasive tool for serial monitoring after intracranial stenting.
Decadal Climate Predictability and Prediction: Where Are We?
Authors: Mehta Vikram , Meehl Gerald , Goddard Lisa , Knight Jeff , Kumar Arun , Latif Mojib , Lee Tong , Rosati Anthony , Stammer Detlef
Published: October 2010

No Abstract available.
Observational Evidence for Oceanic Controls on Hurricane Intensity
Authors: Lloyd Ian D. , Vecchi Gabriel A.
Published: October 2010

The influence of oceanic changes on tropical cyclone activity is investigated using observational estimates of sea surface temperature (SST), air–sea fluxes, and ocean subsurface thermal structure during the period 1998–2007. SST conditions are examined before, during, and after the passage of tropical cyclones, through Lagrangian composites along cyclone tracks across all ocean basins, with particular focus on the North Atlantic. The influence of translation speed is explored by separating tropical cyclones according to the translation speed divided by the Coriolis parameter. On average for tropical cyclones up to category 2, SST cooling becomes larger as cyclone intensity increases, peaking at 1.8 K in the North Atlantic. Beyond category 2 hurricanes, however, the cooling no longer follows an increasing monotonic relationship with intensity. In the North Atlantic, the cooling for stronger hurricanes decreases, while in other ocean basins the cyclone-induced cooling does not significantly differ from category 2 to category 5 tropical cyclones, with the exception of the South Pacific. Since the SST response is nonmonotonic, with stronger cyclones producing more cooling up to category 2, but producing less or approximately equal cooling for categories 3–5, the observations indicate that oceanic feedbacks can inhibit intensification of cyclones. This result implies that large-scale oceanic conditions are a control on tropical cyclone intensity, since they control oceanic sensitivity to atmospheric forcing. Ocean subsurface thermal data provide additional support for this dependence, showing weaker upper-ocean stratification for stronger tropical cyclones. Intensification is suppressed by strong ocean stratification since it favors large SST cooling, but the ability of tropical cyclones to intensify is less inhibited when stratification is weak and cyclone-induced SST cooling is small. Thus, after accounting for tropical cyclone translation speeds and latitudes, it is argued that reduced cooling under extreme tropical cyclones is the manifestation of the impact of oceanic conditions on the ability of tropical cyclones to intensify.
Quality Control and Calibration of the Dual-Polarization Radar at Kwajalein, RMI
Authors: Marks David A. , Wolff David B. , Carey Lawrence D. , Tokay Ali
Published: October 2010

The dual-polarization weather radar on the Kwajalein Atoll in the Republic of the Marshall Islands (KPOL) is one of the only full-time (24/7) operational S-band dual-polarimetric (DP) radars in the tropics. Through the use of KPOL DP and disdrometer measurements from Kwajalein, quality control (QC) and reflectivity calibration techniques were developed and adapted for use. Data studies in light rain show that KPOL DP measurements are of sufficient quality for these applications. While the methodology for the development of such applications is well documented, the tuning of specific algorithms to the particular regime and observed raindrop size distributions requires a comprehensive testing and adjustment period. Presented are algorithm descriptions and results from five case studies in which QC and absolute reflectivity calibration were performed and assessed. Also described is a unique approach for calibrating the differential reflectivity field when vertically pointing observations are not available. Results show the following: 1) DP-based QC provides superior results compared to the legacy Tropical Rainfall Measuring Mission (TRMM) QC algorithm (based on height and reflectivity thresholds), and 2) absolute reflectivity calibration can be performed using observations of light rain via a published differential phase–based integration technique; results are within ±1 dB compared to independent measurements. Future extension of these algorithms to upgraded Weather Surveillance Radar-1988 Doppler (WSR-88D) polarization diverse radars will benefit National Aeronautics and Space Administration’s (NASA’s) Precipitation Measurement Missions (PMM) validation programs.
Can Fully Accounting for Clouds in Data Assimilation Improve Short-Term Forecasts by Global Models?
Authors: Pincus Robert , Patrick Hofmann Robert J. , Anderson Jeffrey L. , Raeder Kevin , Collins Nancy , Whitaker Jeffrey S.
Published: October 2010

This paper explores the degree to which short-term forecasts with global models might be improved if clouds were fully included in a data assimilation system, so that observations of clouds affected all parts of the model state and cloud variables were adjusted during assimilation. The question is examined using a single ensemble data assimilation system coupled to two present-generation climate models with different treatments of clouds. “Perfect-model” experiments using synthetic observations, taken from a free run of the model used in subsequent assimilations, are used to circumvent complications associated with systematic model errors and observational challenges; these provide a rough upper bound on the utility of cloud observations with these models. A series of experiments is performed in which direct observations of the model’s cloud variables are added to the suite of observations being assimilated. In both models, observations of clouds reduce the 6-h forecast error, with much greater reductions in one model than in the other. Improvements are largest in regions where other observations are sparse. The two cloud schemes differ in their complexity and number of degrees of freedom; the model using the simpler scheme makes better use of the cloud observations because of the stronger correlations between cloud-related and dynamical variables (particularly temperature). This implies that the impact of real cloud observations will depend on both the strength of the instantaneous, linear relationships between clouds and other fields in the natural world, and how well each assimilating model’s cloud scheme represents those relationships.