bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Intentionally Self-Inflicted, Accidental and Iatrogetic Foreign Objects in the Genitourinary Tract
Authors: Rieder Jocelyn , Brusky John , Tran Viet , Stern Karen , Aboseif Sherif
Published: May 2010

Purpose: Retrospective evaluation of a series of patients presenting with genitourinary foreign objects. Patients and Methods: From 1997 to 2007, 11 men and 2 women were treated for a variety of foreign objects in the genitourinary tract. Medical records were reviewed for presentation, diagnosis, mental status, drug dependency, treatment, and follow-up. Results: 13 patients were seen for removal of the foreign objects or for treatment of the sequela. These objects were intentionally self-inflicted, accidentally introduced or iatrogenic in nature. Intentional objects included: safety pins, screwdriver, marbles, pen cap, pencils, straw, cocaine, stiff metal wire and part of a pizza mixer. Accidental objects included: magnets, female catheter, urinary incontinence devices and part of a Foley catheter. The iatrogenic object was a reservoir from an inflatable penile implant. Smaller noninjurious objects were retrieved cystoscopically or at the bedside; larger objects or objects associated with trauma to the urethra needed open and reconstructive operations. Conclusions: Generally thought to be self-inflicted for personal gratification, the source of genitourinary objects can also be accidental or iatrogenic. The most traumatic injuries are purposely self-inflicted and found in patients who remove the objects themselves. These patients are at higher risk of permanent urethral damage needing complex surgical treatment and follow-up.
Outcome of Adjuvant Radiotherapy after Radical Prostatectomy for Prostate Cancer Patients
Authors: Suzuki Kazumi , Nakano Kazuhiko , Morita Tatsuo
Published: May 2010

Aim: To examine the outcome and risk factors of biochemical failure (BCF) in Japanese prostate cancer (PCa) patients treated with adjuvant radiotherapy (RT) after radical prostatectomy (RP). Patients and Method: In this study we enrolled 83 Japanese patients having clinically organ-confined PCa without neoadjuvant treatments who received conventional RT (60 Gy) after RP. All patients had extracapsular extension (ECE) and/or positive surgical margin (PSM) of the RP specimens, but no lymph node metastasis. The disease-specific, clinical failure-free, and BCF-free survivals were analyzed. Furthermore, the risk factors affecting the BCF-free survival were examined in detail. Results: The 5-year disease-specific, clinical failure-free, and BCF-free survival rates were 100, 99, and 87%, respectively. The clinicopathological factors associated with BCF were seminal vesicle invasion (SVI) (p = 0.024), perineural invasion (PNI) (p = 0.03), and pre-RT prostate-specific antigen (PSA) (p = 0.014). In the patients with PSM (n = 59), the entire surgical margin-positive patients had a significantly higher risk of BCF than the focal surgical margin-positive patients (p = 0.015). Multivariate analysis showed that SVI and pre-RT PSA were independent prognostic factors of BCF (p = 0.0142, p = 0.0225, respectively). 22% of our patients had only low-grade adverse effects. Conclusion: The outcome of adjuvant RT after RP in the Japanese patients with ECE and/or PSM was excellent, and the adverse effects were mild and tolerable. However, the patients with SVI, PNI, entire surgical margin-positive specimens, or high pre-RT PSA had poor biochemical control by only adjuvant RT after RP.
Is Treatment of Hemorrhagic Radiation Cystitis with Hyperbaric Oxygen Effective?
Authors: Mohamad Al-Ali Badereddin , Trummer Harald , Shamloul Rany , Zigeuner Richard , Pummer Karl
Published: May 2010

Objective: We report our own experience with the use of hyperbaric oxygen (HBO) for the management of postradiation hemorrhagic cystitis. Methods: We reviewed retrospectively 14 patients from 2001 to 2007 with different pelvic organ malignancies who developed radiation cystitis after irradiation. Patients received 100% oxygen in a hyperbaric chamber at a pressure of 2.5 atmospheres absolute, 60 min bottom time, once a day, 7 days a week for at least 1 month. In principle, 30 HBO treatments per course were performed. After every course of HBO treatments, therapeutic effect was evaluated. The mean duration of follow-up of all patients was 18 months (range: 1–6 years). Results: Patients were divided into 2 groups, group 1 (treatment group, n = 10) and group 2 (without treatment, n = 4). The mean duration between the onset of hematuria and the beginning of HBO therapy was 8.9 months (range: 3–34). Group 2 did not receive HBO because they were not healthy enough. Only 2 patients (20%) of group 1 recovered from their hemorrhagic cystitis. Group 1 had a significantly lower cure rate of postirradiation hemorrhagic cystitis in comparison to group 2. Conclusions: Our experience with the use of HBO did not yield favorable results. Randomized well-controlled studies are needed.
Is It Possible to Predict Sepsis, the Most Serious Complication in Prostate Biopsy?
Authors: Simsir Adnan , Kismali Erkan , Mammadov Rashad , Gunaydin Gurhan , Cal Cag
Published: May 2010

Objective: Prostate biopsy for the diagnosis of prostate cancer by transrectal ultrasonography (TRUS) is a common procedure used in daily urology practice with a low complication rate and easy applicability. In this study, the precipitating factors and prophylaxis for sepsis, the worst complication of the procedure, were assessed. Patients and Methods: 2,023 patients with suspected prostate cancer who underwent biopsy by TRUS in one center were assessed retrospectively. The relationship between sepsis and age, serum total prostate-specific antigen (PSA) level, PSA density, prostate volume, number of biopsies, number of repeated biopsies, accompanying diagnosis of prostatitis, presence of urethral catheter, and presence of diabetes mellitus was assessed. Data were analyzed using the t test and logistic regression analysis. Results: Of the 2,023 patients, 62 (3.06%) developed sepsis within 5 days after biopsy. There was no significant relationship between the biopsy and the above parameters using the logistic regression analysis. Using the t test, it was found that the number of biopsy cores (p < 0.001), presence of urethral catheter (p < 0.0001), and presence of diabetes mellitus (p < 0.0001) were predictive factors for sepsis. Conclusion: Sepsis is a rare but life-threatening complication after prostate biopsy by TRUS. Although preoperative prophylactic oral antibiotics and enema before biopsy have proven to be effective in decreasing urinary tract infection rates, patients with urethral catheter, diabetes mellitus or those to undergo biopsy from more sites than ten cores should be closely monitored after biopsy.
Management of Vesico-Urethral Anastomosis Disruption after Radical Prostatectomy
Authors: Shaw G. , Ioannou I. , Gelister J. , Briggs T.
Published: May 2010

Background/Aims: Disruption of vesico-urethral anastomosis is a complication which can have dramatic results on the post-operative quality of life of the patient who has had radical prostatectomy. We present our own experience of this complication and discuss the aetiology, treatment and outcome with reference to published data on the subject. We suggest means by which to prevent this complication. Methods: A retrospective notes review was performed on our own series of 4 patients with disruption of the vesico-urethral anastomosis after radical prostatectomy. A literature review was performed on the subject. Results: We explore ways of managing this complication based on our own series and the published data. We find that urethral disruption is most often significant if a blind attempt at catheter reinsertion by an inexperienced doctor is made. Replacement over a guide-wire using a flexible cystoscope is reasonable provided a significant distraction injury has not already occurred. Conclusions: Replacement of the urethral catheter which has fallen out/is blocked should be done using cystoscopic guidance, if it needs to be replaced at all. We find that outcome, in terms of urinary continence, is better if, having sustained a significant disruption of the anastomosis, immediate surgical revision of anastomosis is performed.
Is a Single Focus of Low-Grade Prostate Cancer Diagnosed on Saturation Biopsy Predictive of Clinically Insignificant Cancer?
Authors: Pepe P. , Fraggetta F. , Galia A. , Candiano G. , Grasso G. , Aragona F.
Published: May 2010

Objectives: To evaluate the incidence of indolent prostate cancer (PCa; <0.5 ml cancer and Gleason score, GS, ≤6) in men with microfocal PCa diagnosed on saturation biopsy (SPBx) submitted to radical retropubic prostatectomy. Methods: From January 2005 to December 2008, 413 patients (median age 61.5 years) underwent SPBx (median 30 cores). A single neoplastic microfocus (5% or less of cancer in a single core) was found in 55 men and all patients underwent retropubic prostatectomy. Median PSA was equal to 8.2 ng/ml, digital rectal examination was negative and GS was 6 in 40 cases and not evaluable in 15 cases. Results: Prostatectomy specimens showed a significant cancer in 48/55 (87.3%) patients with a median GS of 6.2 (range 5–8), presence of extraprostatic extension and positive surgical margins in 15 (27.3%) and 8 (14.5%) cases, respectively. Six patients had an indolent PCa, and in 1 case no tumor was found. Conclusions: Patients with a single microfocal PCa diagnosed on SPBx corresponded to an insignificant cancer in surgical specimens only in 12.7% of cases, but they should be informed that they may harbor more aggressive disease with a risk of non-organ-confined cancer that in our series was 27.3%.
The Proportion of Free PSA and Upgrading of Biopsy Gleason Score after Radical Prostatectomy
Authors: Visapää Harri , Hotakainen Kristina , Lundin Johan , Ala-Opas Martti , Stenman Ulf-Håkan
Published: May 2010

Introduction: Upgrading of biopsy Gleason score (GS) after radical prostatectomy (RP) to GS ≧7 is common in patients with low-grade prostate cancer in biopsy. We evaluated whether a low proportion of free PSA (%fPSA) and total PSA (tPSA) predict significant upgrading after RP. Patients and Methods: 122 patients with biopsy GS 5 or 6 prostate cancer and a tPSA <10 ng/ml who underwent RP in our academic center were included in the study. The utility of prebiopsy %fPSA and tPSA as predictors of significant upgrading was evaluated. Results: Among patients undergoing RP, upgrading to GS ≧7 was found in 61 of 122 (50%) patients. A low %fPSA was a predictor of significant upgrading of tumors with biopsy GS 5 or 6 prostate cancer in patients with tPSA <10 ng/ml. Conclusions: Our results suggest that the selection of prostate cancer patients for active surveillance or re-biopsy may be improved by using %fPSA as a predictor of significant upgrading.
Effects of Androgen Ablation Therapy in TRAIL Death Ligand and Its Receptors Expression in Advanced Prostate Cancer
Authors: Koksal Ismail Turker , Sanlioglu Ahter Dilsad , Kutlu Omer , Sanlioglu Salih
Published: May 2010

Background: It is not known whether androgen ablation therapy (AAT) influences TRAIL death ligand and its receptors expression of prostate cancer (PCa) cells. Aim: To investigate whether hormonal therapy alters the expression of TRAIL death ligand and TRAIL receptors in patients with advanced PCa. Patients and Methods: 26 untreated and 20 AAT-treated advanced PCa patients were included in the study. The patients who received AAT were divided into two groups based on hormone sensitivity status. TRAIL ligand and receptor expression were determined by a conventional immunohistochemistry method. Results: TRAIL death ligand and TRAIL-R2 death receptor were upregulated in PCa patients who received AAT. Hormone-refractory PCa patients exhibited lower levels of TRAIL death receptor (TRAIL-R1 and TRAIL-R2) expression compared to hormone-sensitive PCa patients. Conclusions: AAT alters TRAIL death ligand and its receptors expression in patients with PCa.
In vitro Vascular Effects Produced by Crude Aqueous Extract of Green Marine Algae, Cladophora patentiramea (Mont.) Kützing, in Aorta from Normotensive Rats
Authors: Lim Yee-Ling , Mok Shiueh-Lian
Published: May 2010

Objectives: To investigate the antihypertensive activity of aqueous extracts obtained from Malaysian coastal seaweeds and to determine the pharmacological mechanisms of the extracts on rat aorta in vitro. Materials and Methods: The antihypertensive activity of 11 species of seaweeds (5 brown, 1 red and 5 green algae) were tested by cumulative addition of the extracts to phenylephrine (PE)-precontracted Wistar-Kyoto (WKY) aortic rings in in vitro isometric contraction studies. Mechanisms for vasorelaxant effect were investigated in the presence of various antagonists. Results: Of the 11 species tested, 2 showed a vasorelaxant effect. Further investigation of the mechanisms of action of the aqueous extract of green alga, Cladophora patentiramea (AECP),showed that the vascular relaxant effect was endothelium- and concentration-dependent. A maximum relaxation of 45.8 ± 4.6% (n = 8, p < 0.001) was obtained at 0.1 mg/ml of extract, after which the response was found to reduce in a concentration-dependent manner to 15.7 ± 4.9% (n = 8, p < 0.001) at the highest extract concentration tested. Pretreatment of endothelium-intact aortic rings with Nω-nitro-L-arginine methyl ester (L-NAME, 30 µM), 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 10 µM) and methylene blue (100 µM) resulted in a complete blockade of AECP-induced vasorelaxation. However, the relaxant effects of the extract were not blocked by atropine (1 µM), indomethacin (10 µM) and glibenclamide (10 µM), although the maximum relaxant responses were enhanced in the presence of glibenclamide. Conclusion: Our data showed that the in vitro vascular relaxant effect of AECPwas mediated through endothelium-dependent nitric oxide-cGMP pathway, and was not associated with the release of vasodilator prostaglandins, activation of muscarinic receptors, or ATP-sensitive potassium channels opening.
Comparison of Obesity and Its Relationship to Some Metabolic Risk Factors of Atherosclerosis in Arabs and South Asians in Kuwait
Authors: Babusik Pavel , Duris Ivan
Published: May 2010

Objective: The aims of the study were to compare obesity and its association with risk factors of atherosclerosis in Arabs and South Asians in Kuwait and to define which of the anthropometric parameters is best suited for clinical purposes in general. Subjects and Methods: Two hundred eighty adults, patients of Al-Rashid Hospital, a private general hospital in Kuwait, were enrolled in the study. Of the 280 patients, 144 were Arab and 136 were South Asian. Basic anthropometric parameters for obesity, fasting blood glucose, total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides (TG) were determined. The relationship between anthropometric variables and relevant metabolic variables, as well as a comparison between the different groups, was estimated using standard statistical methods. Results: Arabs were not only more obese [in males, p < 0.001 for body mass index (BMI), waist circumference (WC) and hip circumference (HC) and p = 0.001 for waist-to-hip ratio (WHR); in females, p < 0.001 for BMI, p = 0.004 for WC and p = 0.041 for HC], but also developed obesity at a younger age than did South Asians, even though, in South Asians, all anthropometric parameters were positively correlated with age (p = 0.004 for BMI, p = 0.001 for HC and p < 0.001 for WC and WHR). South Asians, however, were more prone to develop adverse effects in both lipid and glucose metabolism than Arabs were. In South Asian males, ethnicity was an independent predictor of triglycerides, according to the multiple linear regression analysis. The WHR appeared to be the most suitable predictor of dyslipidemia and impaired glucose metabolism. Conclusion: The degree of adiposity was different between Arabs and South Asians in Kuwait. Abdominal obesity had a different impact on cardiovascular risk factors in these two ethnic groups in Kuwait.
Factors Responsible for Asthma and Rhinitis among Kuwaiti Schoolchildren
Authors: Abal A.T. , Ayed A. , Nair P.C.M.G. , Mosawi M. , Behbehani N.
Published: May 2010

Objective: The aim of this study was to assess the prevalence of asthma among schoolchildren and to determine the level house dust mites in Kuwaiti homes and its role in asthma and rhinitis. Subjects and Method: The International Study of Asthma and Allergy in Children questionnaire was distributed to schoolchildren in the age group of 5–7 years, after random sampling from all the five governorates of Kuwait. The questionnaires were completed and initiated by parents with the help of the investigator and parents. House dust was collected from the bedroom floor of 549 houses in the same geographical areas where the schoolchildren were sampled, extracted and assayed for mite Der p 1 by ELISA method. Results: The estimated prevalence of asthma was 22.4% and that of rhinitis was 23%. House dust collected from the bedroom floor was found to contain low levels of Der p 1. There was no significant difference (p = 0.969) in the level of Der p 1 between areas in Kuwait. The highest levels of Der p 1 ranged from 0.02 to 0.10 mg/g in 3.5% of the total samples examined. Conclusions: There is a high prevalence of asthma and rhinitis among the schoolchildren in Kuwait. However, the level of dust mitogens investigated in this study was below the level of concern, thus undermining their role in increasing asthma cases in Kuwait. Therefore, further studies are needed to understand the role of other mite allergens and other factors that contribute to the increased prevalence of allergic diseases in Kuwaiti children.
Clinical Evaluation of Posterior Resin Composite Restorations Placed by Dental Students of Kuwait University
Authors: Al-Samhan Asmaa , Al-Enezi Hanadi , Alomari Qasem
Published: May 2010

Objective: To investigate the survival rate over a 3-year period of posterior resin composite restorations placed by dental students of Kuwait University. Materials andMethods: Posterior resin composite restorations placed by 5th-, 6th- and 7th-year dental students between 2004 and 2005 were evaluated. All patients with posterior composite restorations placed during this period of time were recalled. Of the 204 eligible patients, 139 attended the recall. 432 posterior resin composite restorations were evaluated clinically and radiographically according to the United States Public Health Service criteria. For each restoration, the survival time and/or reasons for failure were recorded. Descriptive statistics and logistic regression analysis were used to analyze the data at a statistically significant level of p < 0.05. Results: At 3 years, the survival rate of the restorations was 95.1%, resulting in an annual failure rate of 1.7%. Recurrent caries was the most common cause of failure (71.4%). Oral hygiene and gender and age of the patient were the factors that affected the failure rate of the restoration (p < 0.05). Other factors such as tooth type and location, type of cavity, type of liner used and level of the student who performed the procedure did not affect the failure rate (p > 0.05). Conclusion: Dental students of Kuwait University were able to place resin composite restorations in posterior teeth with a low annual failure rate. Recurrent caries was the most common cause of failure of posterior resin composite restorations. Oral hygiene was the most important factor in determining the survival of resin composite restorations.
Absence of Neisseria meningitidis from Throat Swabs of Kuwaiti Pilgrims after Returning from the Hajj
Authors: Husain Entesar H. , Dashti Ali A. , Electricwala Qudsiya Y. , AbdulSamad AbdulSamad M. , Al-Sayegh Safeya
Published: May 2010

Objective: To investigate whether or not Neisseria meningitidis was present in the throat of Kuwaiti pilgrims after returning from the Hajj. Method: Throat swabs were taken from 177 participants 1 week after returning from the Hajj. The participants were asked about: associated medical conditions, meningococcal vaccination status and the intake of ciprofloxacin before leaving Mecca for Kuwait. Results: There was no throat colonization with N. meningitidis on any of the throat swabs. Of the 177 pilgrims, 163 (92%) were vaccinated with meningococcal quadrivalent vaccine before leaving to Saudi Arabia. Ninety-seven of the pilgrims (83%) had received one dose of ciprofloxacin before leaving Mecca. Conclusion: The result showed that vaccination before leaving Kuwait and ciprofloxacin prophylaxis were effective in preventing throat colonization with Neisseria meningitidis.
Systemic Inflammatory Response and Survival in Patients with Localised Prostate Cancer: 10-Year Follow-Up
Authors: McArdle Peter A. , Qayyum Tahir , McMillan Donald C.
Published: May 2010

Aim: To examine the prognostic value of circulating C-reactive protein concentrations at diagnosis in patients with organ-confined prostate cancer. Patients and Methods: Ninety-eight patients with histologically proven clinically localised prostate cancer were studied. Clinical stage, tumour grade, circulating PSA and C-reactive protein concentrations at diagnosis were recorded. Results: The majority of patients was under the age of 70 years and had low-grade tumours. Approximately half the patients received radical local treatment. During the follow-up period (median 10 years) 38 patients died, of whom 18 died of prostate cancer, 6 of other cancers and 14 of non-cancer causes. On univariate survival analysis, age (p < 0.001), Gleason score (p < 0.05), C-reactive protein (p < 0.05) and treatment (p < 0.05) were significant predictors of overall survival. On univariate survival analysis, age (p < 0.001), Gleason score (p < 0.05) and C-reactive protein (p < 0.05) were significant predictors of prostate cancer-specific survival. On multivariate analysis of these significant variables age (HR 4.88, 95% CI 1.79–13.29, p < 0.01), Gleason score (HR 2.16, 95% CI 1.23–3.78, p < 0.01) and C-reactive protein (HR 1.88, 95% CI 1.01–3.52, p < 0.05) remained significant independent predictors of prostate cancer-specific survival. Conclusion: The results of the present study show that the presence of a systemic inflammatory response, at diagnosis, independently predicts poor long-term cancer outcome in patients with localised prostate cancer.
Factor X Deficiency Presenting with Bilateral Chronic Subdural Hematoma
Authors: Senturk Senem , Guzel Ebru , Hasanefendioglu Bayrak Aylin , Bukte Yasar , Guzel Aslan
Published: May 2010

Factor X deficiency is a rare coagulation defect that can result in several hemorrhagic manifestations including central nervous system hematomas in infants and children. In this case report, we present computed tomography (CT) and magnetic resonance (MR) imaging findings of bilateral chronic subdural hematomas due to factor X deficiency. Cranial CT and MR imaging in a hypoactive 7-month-old male infant with right hemiparesis revealed bilateral chronic subdural hematomas at different stages. Laboratory findings showed a severe factor X deficiency, with a level of 0.7%. After fresh frozen plasma replacement, the patient was operated and the large hematoma on the left side evacuated. The patient recovered uneventfully and remained asymptomatic during the 1-year follow-up.
Disappearing Bone Disease and Chiari I Malformation
Authors: Hughes Betsy D. , Grant Gerald A. , Cummings Thomas J. , Fuchs Herbert E.
Published: May 2010

Gorham’s disease is a rare disorder in which massive osteolysis occurs within bone, and therefore earns its historical name: disappearing bone disease. We describe a case of Chiari I malformation in a patient with this rare disorder, with treatment consisting of a suboccipital craniectomy, C1 laminectomy, and duraplasty for Chiari decompression.
New Insights into the Regulation of Signalling by Toll-Like Receptors and Nod-Like Receptors
Authors: Coll Rebecca C. , O’Neill Luke A.J.
Published: May 2010

The activation of Toll-Like receptors (TLRs) and Nod-like receptors (NLRs) triggers intracellular signalling pathways that lead to effector mechanisms in innate immunity and inflammation. The negative regulation of TLR signalling has been extensively studied. Current areas of research include post-transcriptional regulation by miRNA, post-translational regulation by ubiquitination and regulation by splice variants such as MyD88s, TRAM adaptor with GOLD domain and IRAK2 isoforms. The negative regulation of NLR signalling is a relatively new area of research. Examples include a splice variant of NOD2, the ubiquitin editing enzyme A20, pyrin domain-only proteins and caspase recruitment domain-only proteins which all have a negative effect on NOD2 or NLRP3 signalling. A greater understanding of the mechanisms underlying the negative control of TLR and NLR signalling may provide new targets for therapeutic intervention.
Differences in Response to Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and Chronic Obstructive Pulmonary Disease
Authors: Kozu Ryo , Senjyu Hideaki , Jenkins Sue C. , Mukae Hiroshi , Sakamoto Noriho , Kohno Shigeru
Published: May 2010

Background: The benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) are well recognized. However, whether individuals with idiopathic pulmonary fibrosis (IPF) benefit is less clear. Objectives: To evaluate the effects of pulmonary rehabilitation in subjects with IPF and compare their responses with a group of COPD subjects who underwent an identical program. Methods: For- ty-five subjects with IPF and 45 age- and Medical Research Council grade-matched COPD subjects were recruited. Subjects completed an 8-week outpatient pulmonary rehabilitation program. Dyspnea, peripheral muscle force, exercise capacity (6-min walk distance, 6MWD), activities of daily living, and health status (36-item short-form survey, SF-36) were assessed at baseline, immediately following and at 6 months following completion of the program. Results: Adherence to the program was similar in both groups. Significant improvements in dyspnea, muscle force, exercise capacity and ADL were observed in both groups (all p < 0.05); however, the magnitude of improvement in all outcomes was less in the IPF group [mean (95% CI) improvement in 6MWD, IPF 16.2 (7.1–25.4); COPD 53.1 (44.9–61.2)]. All domains of SF-36, with the exception of social function, improved (all p < 0.05) in the COPD group; however, there were no changes in SF-36 scores in the IPF group. The benefits were well maintained in the COPD group at 6 months, but, with the exception of the ADL score, the benefits were no longer present in the IPF group. Conclusions: Pulmonary rehabilitation in IPF produces only modest short-term gains in dyspnea, exercise capacity and ADL, but does not improve health status.
Galaninergic Innervation of the Cholinergic Vertical Limb of the Diagonal Band (Ch2) and Bed Nucleus of the Stria terminalis in Aging, Alzheimer's Disease and Down's Syndrome (Part 2 of 2)
Authors: Mufson Elliott J. , Cochran Elizabeth , Benzing William , Kordower Jeffrey H.
Published: May 2010

The galanin (GAL) containing peptide fiber system circuit which innervates acetylcholine containing basal forebrain neurons has been shown to hypertrophy and hyperinnervate remaining cholinergic Ch4 perikarya in Alzheimer's disease (AD). The present study examined whether a similar hyperinnervation occurs within the cholinergic vertical limb of the diagonal band nucleus (Ch2), a portion of the basal forebrain which, unlike Ch4, exhibits only modest degeneration in AD. Furthermore, we evaluated whether GAL hyperinnervation occurs within the basal forebrain in Down's syndrome, a genetic disorder with extensive AD-like pathology including cholinergic basal forebrain neuron degeneration. The present study revealed that virtually all Ch2 neurons were GAL immunonegative. However, this region was innervated by GAL immunoreactive (ir) interneurons and fibers associated with a major galaninergic pathway which travels through the substantia innominata enroute to the hypothalamus, bed nucleus of the stria terminalis as well as vertical limb of diagonal band nucleus. GAL-ir fibers coursing within this fiber bundle hypertrophied in AD relative to age matched controls and the Down's cases. Within the putative Ch2 terminal zones in AD, many of the remaining cholinergic neurons were hyperinnervated by GAL despite the modest reduction in Ch2 neurons. In contrast, GAL-ir fibers were not hypertrophied in Down's syndrome despite extensive cholinergic cell loss within Ch4. Taken together these findings suggest that extensive cholinergic basal forebrain cell loss alone is not sufficient to trigger the basal forebrain GAL plasticity response found in AD.
Fatal End of a Safety Algorithm for Pulmonary Vein Isolation With Use of High-Intensity Focused Ultrasound
Authors: Neven Kars , Schmidt Boris , Metzner Andreas , Otomo Kiyoshi , Nuyens Dieter , De Potter Tom , Chun K.R. Julian , Ouyang Feifan , Kuck Karl-Heinz
Published: May 2010

Background—

High-intensity focused ultrasound (HIFU) can achieve pulmonary vein isolation (PVI), but there are safety concerns after severe complications. Therefore, we evaluated an esophageal temperature (ET)-guided safety algorithm to apply HIFU safely.

Methods and Results—

After standard left atrial access, HIFU was repeatedly applied until PVI was complete. A safety algorithm was used: ≤3 complete ablations per pulmonary vein (PV), early abortion when no effect after 50%of programmed time or when ET was ≥40.0°C, use of power modulation (PM) at ET 39.0°C: to reduce ablation temperature in surrounding tissue, acoustic power is switched on/off at 1 Hz; in all first ablations, use of PM after 50% of programmed time. Touch-up radiofrequency ablation was used when PVI failed. Periprocedural ET monitoring and endoscopy 2 days after ablation were performed. Twenty-eight patients (18 males; mean age at enrollment, 63 years), with paroxysmal atrial fibrillation (AF; n=19) and persistent AF (n=9) were included. In 84 of 109 PV (9 of 25 patients), PVI was achieved using HIFU only. In 9 of 109 PV, HIFU was aborted because of high ET. Mean ET at the end of the ablations with and without use of PM were 38.1±2.0°C and 37.4±1.0°C (
P
=0.0002). During endoscopy in 2 of 26 patients, a small thermal lesion was found. Other complications included 2 persistent phrenic nerve palsies, 1 ischemic stroke, 1 pericardial effusion 48 days after ablation, 1 unexplained death 49 days after ablation, and 1 lethal atrial-to-esophageal fistula 31 days after ablation.

Conclusions—

The safety algorithm failed to prevent lethal complications. Currently HIFU does not meet the safety standards required for treatment of atrial fibrillation.
Cilostazol Increases Skin Perfusion Pressure in Severely Ischemic Limbs
Authors: Miyashita Yusuke , Saito Shigeru , Miyamoto Akira , Iida Osamu , Nanto Shinsuke
Published: May 2010

Skin perfusion pressure (SPP) is a measure of peripheral circulation; low SPP (<40 mm Hg) indicates poor wound healing. Cilostazol is used to alleviate symptoms and improve walking distance in patients with peripheral artery disease (PAD), but its effect on SPP is unknown. We enrolled patients whose symptoms were Rutherford class 3 or 4 and whose SPP was <40 mm Hg. We analyzed patient symptoms, ankle-brachial index (ABI), and SPP before and 1 month after treatment with cilostazol. We analyzed 20 legs of 14 patients. Cilostazol improved symptoms in 12 legs. The average heart rate increased from 76 ± 16 to 84 ± 20 beats/min (P < .05). Cilostazol did not increase the ABI but caused a significant increase in the SPP from 24.5 ± 8.88 to 42.8 ± 21.0 mm Hg (P < .01). Cilostazol increases microvascular circulation in severely ischemic limbs and may be useful in critical limb ischemia.
Examining the Association Between Childhood Asthma and Parent and Grandparent Asthma Status: Implications for Practice
Authors: Valerio Melissa A. , Andreski Patricia M. , Schoeni Robert F. , McGonagle Katherine A.
Published: May 2010

Examination of intergenerational asthma beyond maternal asthma has been limited. The association between childhood asthma and intergenerational asthma status among a national cohort of children was examined. The genealogical sample (2552 children) participating in the Child Development Supplement of the Panel Study of Income Dynamics was studied. Multivariate regression was used to determine intergenerational asthma. Children with a parent with asthma were almost twice as likely (odds ratio [OR] = 1.96) to have asthma compared with those without a parent with asthma. Children with a parent and grandparent with asthma were more than 4 times more likely to have asthma compared with those without a parent and grandparent with asthma (OR = 4.27). Children with a grandparent with asthma were more likely to have asthma (OR = 1.52). A family history of asthma was a significant predictor of physician diagnosed asthma in children regardless of race/ethnicity and socioeconomic status. Findings support the collection of family history, including grandparent asthma status.
Sex Differences in Trajectories of Offending Among Puerto Rican Youth
Authors: Jennings Wesley G. , Maldonado-Molina Mildred M. , Piquero Alex R. , Odgers Candice L. , Bird Hector , Canino Glorisa
Published: May 2010

Although sex is one of the strongest correlates of crime, contentions remain regarding the necessity of sex-specific theories of crime. The current study examines delinquent trajectories across sex among Puerto Rican youth socialized in two different cultural contexts (Bronx, United States; and San Juan, Puerto Rico). Results indicate similar substantive offending trajectories across males and females within each cultural context, that males exhibit a higher frequency of offending and higher levels of risk factors for delinquency, and more similarities than differences in how risk/protective factors relate to patterns of offending across male versus female youth. Study limitations and implications for sex-specific criminological theories are also discussed.
Fabrication and Characterization of Aluminum-Carbon Nanotube Powder and Polycarbonate/Aluminum-Carbon Nanotube Composites
Authors: San Ha Hwang  , Bang Dae-Suk , Kwan Han Yoon  , Park Young-Bin , Lee Dae-Yeol , Jeong Sung-Sil
Published: May 2010

Carbon nanotube reinforced aluminum powders (Al-CNT) were fabricated by ball milling. The morphology observed by a scanning electron microscope showed impregnation of CNTs on the surface of aluminum flakes (Al-flakes). Polycarbonate (PC)/Al-CNT nanocomposites were prepared by a twin-screw extruder. The electrical resistivity of PC/Al-flake composites did not change with Al-flake content, while that of PC/CNT nanocomposites decreased with increasing CNT content, and the percolation threshold was obtained at 2 wt% CNT loading. The electrical resistivity of PC/Al-CNT nanocomposites showed a behavior similar to PC/CNT nanocomposites. The thermal conductivity of the composites increased with increasing filler contents. The PC/Al-CNT composites showed a viscosity trend that is similar to PC/CNT composites; however, it showed higher viscosities (G*, G") than PC/Al-flake composites in the low frequency range (up to ∼10 Hz) and lower viscosities in the higher frequency range (>10 Hz). The tensile modulus of PC/ Al-CNT composite increased while the strength decreased with increasing filler content. The modulus of PC/Al-CNT composite was higher than PC/CNT and PC/ Al-flake composites.
PAR-2 Regulates Dental Pulp Inflammation Associated with Caries
Authors: Lundy F.T. , About I. , Curtis T.M. , McGahon M.K. , Linden G.J. , Irwin C.R. , El Karim I.A.
Published: May 2010

Protease-activated receptors (PARs) are G-protein-coupled receptors that are activated enzymatically by proteolysis of an N-terminal domain. The cleavage and activation of PARs by serine proteases represent a novel mechanism by which such enzymes could influence the host inflammatory response. The aim of this study was to determine whether PAR-2 expression and activation were increased in dental caries. Using immunohistochemistry, we showed PAR-2 to be localized to pulp cells subjacent to caries lesions, but minimally expressed by healthy pulp tissue. Trypsin and the PAR-2 agonist (PAR2-AP) activated PAR-2 in an in vitro functional assay. Endogenous molecules present in pulp cell lysates from carious teeth specifically activated PAR-2, but those from healthy teeth failed to do so. The activation of PAR-2 in vitro was shown to increase the expression of the pro-inflammatory mediator cyclo-oxygenase-2 (COX-2), providing a mechanism whereby PAR-2 could modulate pulpal inflammation.
Stimulation of IL-6 Cytokines in Fibroblasts by Toll-like Receptors 2
Authors: Souza P.P.C. , Palmqvist P. , Lundgren I. , Lie A. , Costa-Neto C.M. , Lundberg P. , Lerner U.H.
Published: May 2010

The osteotropic interleukin-6 (IL-6) types of cytokines IL-6, IL-11, and leukemia inhibitory factor (LIF), but not oncostatin M, are expressed by human gingival fibroblasts, and their expressions are regulated by IL-1 and tumor necrosis factor-α (TNF-α). In the present study, we investigated whether signaling through Toll-like receptor 2 (TLR2) can affect the expression of these cytokines in human gingival fibroblasts. Lipopolysac-charide (LPS) from P. gingivalis was found to stimulate IL-6 and LIF mRNA and protein, but not IL-11 or OSM mRNA. Using two synthetic ligands acting specifically at TLR2 and siRNA knockdown of TLR2, we demonstrated the important role of TLR2 in the stimulation of IL-6 and LIF in gingival fibroblasts. Analysis of these data suggests that signaling through the innate immune system controls the expression of osteotropic cytokines in human gingival fibroblasts.
Resin Infiltration of Caries Lesions
Authors: Paris S. , Hopfenmuller W. , Meyer-Lueckel H.
Published: May 2010

Resin infiltration is an innovative approach to arrest progression of caries lesions. The aim of this randomized split-mouth placebo-controlled clinical trial was to assess whether resin infiltration of proximal lesions is more effective than non-operative measures alone with respect to the inhibition of caries progression. In 22 young adults, 29 pairs of interproximal lesions with radiological extension into the inner half of enamel or the outer third of dentin were randomly allocated to two treatment groups. In the test group, lesions were infiltrated (Icon, pre-product; DMG). A placebo treatment was performed in the control group. All participants received instructions for diet, flossing, and fluoridation. The primary outcome after 18 months was radiographic lesion progression (assessed by digital subtraction radiography). No unwanted effects could be observed. In the effect group, 2/27 lesions (7%) and in the control group 10/27 lesions (37%) showed progression (p = 0.021; McNemar). Infiltration of interproximal caries lesions is efficacious in reducing lesion progression.
Oral Bifidobacteria
Authors: Beighton D. , Al-Haboubi M. , Mantzourani M. , Gilbert S.C. , Clark D. , Zoitopoulos L. , Gallagher J.E.
Published: May 2010

Bifidobacteria are aciduric bacteria that might play a role in the caries process. To test the hypothesis that Bifidobacteria behave as caries-associated organisms, as predicted by the ecological plaque hypothesis, we determined salivary levels of Bifidobacteria and caries-associated organisms for 156 older adults. Salivary levels of Bifidobacteria, mutans streptococci, lactobacilli, and yeasts were correlated with each other (p < 0.001), negatively correlated with salivary flow rate (p < 0.001), and positively correlated with plaque index (p < 0.05). Salivary Bifidobacteria levels were positively associated with the number of filled (p < 0.001) and decayed (p = 0.036) tooth surfaces and negatively associated with number of teeth (p < 0.001) and salivary flow rate (p = 0.049). In regression analyses, caries experience was significantly associated with only salivary Bifidobacteria (p < 0.001) and yeast (p < 0.001) levels and the individual’s age (p = 0.021). Bifidobacteria should be regarded as caries-associated organisms whose role in the caries process and as markers of caries risk requires further investigation.
Disparity between Dental Needs and Dental Treatment Provided
Authors: Naegele E.R. , Cunha-Cruz J. , Nadanovsky P.
Published: May 2010

We hypothesized that more teeth would be treated by fee-for-service dentists than predicted by salaried dentists. In a cohort of 3818 participants, the number of teeth treated was related to the number of teeth with treatment needs by means of a zero-inflated negative binomial model. Among those obtaining dental care within 6 months (study population, n = 1239), the adjusted predicted number of teeth treated was 2 (95%CI = 1.7;2.3) for patients with no treatment needs. The sum of teeth treated by fee-for-service dentists (4374 when considering the whole cohort and 3550 when considering the study population) was much higher than that predicted by salaried dentists (4220 when considering the whole cohort and 1770 when considering the study population). Our findings demonstrate a disparity between dental needs assessment and the dental treatment actually provided.
Mothers’ Caries Increases Odds of Children’s Caries
Authors: Weintraub J.A. , Prakash P. , Shain S.G. , Laccabue M. , Gansky S.A.
Published: May 2010

There are many determinants of children’s dental caries. We hypothesized that a mother’s untreated caries was associated with increased likelihood of her children’s untreated caries, after controlling for other factors. This population-based study was conducted in a rural, primarily Hispanic, California community. Interview and dental examination data for mother-child (children < 18 yrs old) dyads were analyzed. In a Generalized Estimation Equation (GEE) logit model for mothers (n = 179) and children (n = 387), maternal untreated caries was a statistically significant correlate of child’s untreated caries, odds ratio (OR) = 1.76 (95%CI: 1.10, 2.70), adjusted for demographic factors. This relationship did not change when behavioral and dental utilization factors were added to the model, OR = 1.85 (95% CI: 1.12, 3.07). Maternal untreated caries almost doubled the odds of children’s untreated caries and significantly increased child’s caries severity by about 3 surfaces. Caries prevention and dental utilization programs for mothers and their children should be increased.
Statewide Testing of Reading and Possible Implications for Students With Disabilities
Authors: Johnstone Christopher J. , Thurlow Martha L.
Published: May 2010

This article reports on findings from a review of statewide large-scale test blueprints. The qualitative and descriptive numerical review of themes found in state blueprints provides information on trends in statewide reading assessments. These trends are then set against the backdrop of testing accommodations for students with disabilities. Results indicate that most constructs tested in statewide assessments are amenable to accommodations, but some present challenges (e.g., those that test foundational skills of reading such as phonemic awareness). Next steps are proposed, focusing on both paper-based and computerized statewide tests.
Case Study of the Out-of-Plane Shear Strength Measurement of Paper Machine Clothing
Authors: Hakala T. , Harlin A.
Published: May 2010

The press section is essential for paper machine efficiency, and its runnability is connected to the press felt properties. We studied the out-of-plane shear behavior of press felt specimens in both dry and wet conditions. Our strength tester laboratory set-up was modified to simulate pressure pulses in mechanical dewatering in the paper machine. The test arrangement used a moving upper jaw to generate dynamic stress, gluing and a watering system. Draw speeds, length of displacement, number of tensile cycles, and glue type were standardized during the preliminary work. After tests, 45 load-and-unload cycles were plotted in curves, and shear strength and modulus values were calculated. Results show that hysteresis and non-homogenous behavior, drop in maximum forces, and negative load values in the unload direction are connected to the design, density, wetness, fiber entanglement, and intersections of the specimen. The results benefit the work of wet press modeling.
Evaluation of Overall and Local Ventilation in Diapers
Authors: Satsumoto Yayoi , Havenith George
Published: May 2010

A device to evaluate the distribution of the ventilation in diapers by using a tracer gas method (steady state method) was developed to investigate the effect of the design- and material-factor of diapers on heat and water vapor transfer by ventilation. This device can also evaluate the quantitative local microclimate ventilation rate during rest or walking between the interior of the diaper and the ambient atmosphere. Using forced ventilation, it was shown that the devices’ measurement captured the actual ventilation in the diapers. For the overall ventilation values it was found that the air permeability of the diaper fabric affected the ventilation but did not dominate it. It means the ventilation was affected not only by the air permeability but also by the construction and design of clothing. Leg movement caused about 20% increase of ventilation compared to the static condition. The ventilation of the pants design diapers were less affected by the movement. For the local ventilation values, the ventilation of the front upper site contributed heavily to the overall ventilation. The repeatability of the microclimate ventilation values measured by the steady state method obtained in our present study was better than that of the transient method reported in our earlier paper. It was demonstrated that the device allowed the evaluation of diaper design for the purpose of improving the microclimate in the diaper.
Mathematical Basis for Classification of Twisted Multiplied Fancy Yarns
Authors: Grabowska Katarzyna Ewa
Published: May 2010

This paper introduces the shape coefficient of fancy yarn as a tool for classifying twisted multiplied fancy yarns. Mathematical functions have been used to describe yarn tensions in the twist zone as a basis for analysis of their variability pattern. On the basis of conducted analyses, characteristic values of the shape coefficient have been identified, according to which twisted multiplied fancy yarns can be classified in an objective way.
Preparation and Physical Properties of Regenerated Cellulose Fibres from Sugarcane Bagasse
Authors: Uddin Ahmed Jalal , Yamamoto Atsushi , Gotoh Yasuo , Nagura Masanobu , Iwata Mahito
Published: May 2010

To produce cellulose regenerated fibres with high mechanical properties at low cost, sugarcane bagasse was chosen as a cheap raw material. In this study, bagasse was dissolved in N-methylmorpholine- N-oxide (NMMO) 0.9 hydrate, and fibres were prepared by the dry jet-wet spinning method by using dilute water/NMMO mixture as a coagulant, as is done in the production of commercial lyocell fibre. The effects of other coagulants, including water, methanol, isopropanol and ethanol, on the physical properties of the fibres were also investigated. Among these coagulants, fibres produced in ethanol and water/NMMO mixture exhibited the superior tensile strength and initial modulus although had some NMMO trapped in fibre matrix. After removal of NMMO by a simple heat treatment, much improvement in the fibre structure and mechanical properties was observed. The cross-sectional morphology and surface of these two fibres reveal the occurrence of fibrillation due to their high degree of crystallinity and overall high molecular orientation. The bagasse regenerated fibres produced in this study had a tensile strength of approximately 530 MPa and Young’s modulus of approximately 33 GPa, which are comparable to those of commercial lyocell fibre.