bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of array‐based whole genome scanning technologies as a cytogenetic tool in haematological malignancies
Authors: Maciejewski Jaroslaw P. , Tiu Ramon V. , O’Keefe Christine
Published: June 2009

Karyotypic analysis provides useful diagnostic information in many haematological malignancies. However, standard metaphase cytogenetics has technical limitations that result in the underestimation of the degree of chromosomal changes. Array‐based technologies can be used for karyotyping and can supplant some of the shortcomings of metaphase cytogenetics, and include single nucleotide polymorphism arrays (SNP‐A) and comparative genomic hybridization arrays (CGH‐A). Array‐based cytogenetic tools do not rely on cell division, have superb resolution for unbalanced lesions and allow for the detection of copy number‐neutral loss of heterozygosity, a type of lesion not seen with metaphase cytogenetics. Moreover, genomic array analysis is automated and results can be objectively and systematically analysed using biostatistical algorithms. As a potential advantage over genomic approaches, metaphase cytogenetics can detect balanced chromosomal defects and resolves clonal mosaicism. Initial studies performed in various haematological malignancies indicate the potential of SNP‐A‐based karyotyping as a useful clinical cytogenetic detection tool. The current effort is aimed at developing rational diagnostic algorithms for the detection of somatic defects and the establishment of clinical correlations for novel SNP‐A‐detected chromosomal defects, including acquired somatic uniparental disomy. SNP‐A can complement metaphase karyotyping and will probably play an important role in clinical cytogenetic diagnostics.
‘Cannibalism’ (cell phagocytosis) does not differentiate reactive renal tubular cells from urothelial carcinoma cells
Authors: Ohsaki H. , Haba R. , Matsunaga T. , Nakamura M. , Kiyomoto H. , Hirakawa E.
Published: June 2009

Objective:  Cannibalism of one cell by another in voided urine cytology has been considered a cytological feature for differentiating urothelial carcinoma (UC) from benign lesions. Recently, however, we observed cannibalism in voided urine obtained from patients with renal glomerular disease (RGD). The purpose of this study was to determine the cytomorphological and immunocytochemical characteristics of cannibalism in voided urine from RGD.

Methods:  Seventy cytology specimens of voided urine were examined and the findings were compared with the histological findings. In addition, we compared the cytomorphological and immunocytochemical differences in cannibalism found in RGD and cases of UC selected as showing cannabilism.

Results:  Cannibalism in voided urine was found in three (5.5%) of 55 RGD cases. The finding was measured as (1+) < 5 cells, (2+) 5–20 cells, and (3+) > 20 cells and was (1+) in all three RGD cases, compared with 6.7%, 60% and 33.3% respectively in 15 UC cases. Differences in low cellularity cases (1+) and moderate to high cellularity cases (2+ or 3+) were statistically significant between RGD (3 and 0) and UC (1 and 14) (P=0.005). The maximum diameter of cannibalized cells in RGD was 24.3–33.0 μm (mean 29.8 μm) versus 18.0–30.4 μm (mean 23.3 μm) in UC (P=0.004). Necrosis and isomorphic erythrocytes were absent in RGD, but were found in 46.7% and 86.7%, respectively, of UC cases (P=0.245 and P=0.012). Dysmorphic erythrocytes were identified in all three cases with RGD and 13.3% of UC (P=0.012). Vimentin reactivity was found in all cases with cannibalism in RGD, but never in UC (P=0.001).

Conclusions:  Our results demonstrated that cannibalism in voided urine is present not only in UC but also in RGD. Furthermore, we showed that cellularity of cannibalism, vimentin reactivity and background differed significantly and can be used for differential diagnosis between the two groups.
Fatty acids as metabolic mediators in innate immunity
Authors: Kopp A. , Gross P. , Falk W. , Bala M. , Weigert J. , Buechler C. , Neumeier M. , Schölmerich J. , Schäffler A.
Published: June 2009

Background  Increasing data support the hypothesis of a local and systemic crosstalk between adipocytes and monocytes mediated by fatty acids. The aim of this study was to characterize the immunomodulatory effects of a large panel of fatty acids on cytokines and chemokines in monocytic THP‐1 cells and primary human monocytes. We tested whether anti‐inflammatory fatty acids are able to inhibit the binding of lipopolysaccharide (LPS) to its receptor, toll‐like receptor/MD‐2 (TLR4/MD‐2).

Materials and methods  Resistin, monocyte chemoattractant protein‐1 (MCP‐1) and tumour necrosis factor (TNF) were measured by enzyme‐linked immunosorbent assay. Proteins were analysed by Western blot. A designed Flag‐tagged TLR4/MD‐2 fusion protein (LPS trap) was used to investigate the effect of fatty acids on binding of LPS to its receptor. In 30 patients with type 2 diabetes mellitus (T2D), the correlation of serum triglyceride levels with LPS‐induced monocyte activation was analysed.

Results  Eleven fatty acids investigated exerted differential effects on the monocytic release of cytokines and chemokines. Eicosapentaenoic acid had potent anti‐inflammatory effects on human primary monocytes and THP‐1 cells; 100 and 200 μM eicosapentaenoic acid dose‐dependently inhibited LPS binding to the LPS trap. LPS‐induced release of monocytic MCP‐1 and TNF was significantly and positively correlated with serum triglyceride levels in 30 patients with T2D.

Conclusions  Monocytic activation is differentially regulated by fatty acids and depends on triglyceride levels in T2D. The main finding of the present study shows that eicosapentaenoic acid inhibits the specific binding of LPS to TLR4/MD‐2. Eicosapentaenoic acid represents a new anti‐inflammatory LPS‐antagonist.
Prevalence of metabolic syndrome and its relationship with leisure time physical activity among Peruvian adults
Authors: Gelaye B. , Revilla L. , Lopez T. , Sanchez S. , Williams M. A.
Published: June 2009

Background  Metabolic syndrome (MetS) is an important risk factor of cardiovascular disease (CVD) and type 2 diabetes. Previous studies have suggested an inverse relationship between physical activity and MetS. However, these findings were inconsistent, and few investigators have examined these associations among South Americans. We estimated the prevalence of MetS and its association with leisure time physical activity (LTPA) among Peruvian adults.

Materials and methods  This cross‐sectional study of 1675 individuals (619 men and 1056 women) was conducted among residents in Lima and Callao, Peru. Information about LTPA, socio‐demographical and other lifestyle characteristics was collected by interview. The presence of MetS was defined using the Adult Treatment Panel III criteria.

Results  Overall, the prevalence of MetS was 26·9% and was more common among women (29·9%) than men (21·6%). Habitual participation in LTPA was associated with a 23% reduced risk of MetS (OR = 0·77; 95% CI: 0·60–1·03). There was an inverse trend of MetS risk with amount of LTPA (P = 0·016). Compared with non‐exercisers, those who exercised <150 min/week had a 21% reduced risk of MetS (AOR = 0·79; 95% CI 0·60–1·04). Individuals who exercised ≥150 min/week, compared with non‐exercisers, had a 42% reduced risk of MetS (AOR = 0·58; 95% CI: 0·36–0·93). Associations of similar magnitudes were observed when men and women were studied separately.

Conclusion  These data document a high prevalence of MetS and suggest an association with LTPA among urban dwelling Peruvians. Further prospective studies are needed to confirm these observations and to examine interventions that may promote increased physical activity in this population.
Feather micro‐organisms and uropygial antimicrobial defences in a colonial passerine bird
Authors: Møller Anders P. , Czirjak Gabor Á. , Heeb Philipp
Published: June 2009

1. The relationship between the composition of communities of micro‐organisms and their hosts remains poorly understood. We conducted extensive field studies of feather‐degrading bacteria, other cultivable bacteria, and fungi on the plumage of a migratory bird, the barn swallowHirundo rusticaLinnaeus, to understand the association between micro‐organisms, host sociality and host antimicrobial defences, as reflected by the size of the uropygial gland.

2. The abundance of feather‐degrading bacteria, but not other cultivable bacteria or fungi, decreased with increasing size of the uropygial gland.

3. Females had more feather‐degrading bacteria than males.

4. Barn swallows living in larger colonies had more feather‐degrading bacteria than less social conspecifics.

5. These findings suggest that the uropygial gland plays a specific role in regulating the abundance of feather‐degrading bacteria that furthermore depends on the social environment of the host.
Carotenoid and melanin‐based ornaments signal similar aspects of male quality in two populations of the common yellowthroat
Authors: Dunn Peter O. , Garvin Julia C. , Whittingham Linda A. , Freeman‐Gallant Corey R. , Hasselquist Dennis
Published: June 2009

1. Female preferences for particular male ornaments may shift between populations as a consequence of ecological differences that change the reliability and detectability of the ornament, but few studies have examined how ornaments function in different populations.

2. We examined the signalling function of male plumage ornaments in a warbler, the common yellowthroat (Geothlypis trichas), breeding in New York (NY) and Wisconsin (WI), USA. Males have two prominent ornaments: a black facial mask pigmented with melanin and a yellow bib pigmented by carotenoids. Previous studies in WI indicate that the size of the mask, and not the bib, is primarily related to female choice and male reproductive success. In NY, however, the pattern is reversed and attributes of the bib (size and colour), and not the mask, are the target of sexual selection.

3. We found that brightness of the yellow bib was the best signal of humoral immunity (immunoglobulin G) in NY and mask size was the best signal in WI, after controlling for breeding experience and capture date. Thus, similar aspects of male quality appeared to be signalled by different ornaments in different populations.

4. There was no difference between populations in the level of plasma carotenoids or the prevalence of malarial parasites, which may affect the costs and benefits of choosing males with particular ornaments in each location.

5. Even though females in different populations prefer different ornaments produced by different types of pigments, these ornaments appear to be signalling similar aspects of male quality. Our results caution against inferring the function of particular ornaments based simply on their type of pigment.
Undetected factor VIII in a patient with type 3 von Willebrands disease mistaken as severe haemophilia A
Authors: MULLAH‐ALI A. M. , CHAN A. K. , LILLICRAP D. , DECKER K. , SEROSKI W. , MOFFAT K. , WALKER I. , PAI M. K.
Published: June 2009

Summary.  von Willebrand disease (VWD) type 3 is a rare disorder characterized by absent or <0.1 UmL−1 of ristocetin cofactor (VWF:RCo), and a very low level of factor VIII (FVIII:C). A total absence of FVIII:C has never been reported in type 3 VWD. This case illustrates the effect of severe von Willebrand factor (VWF) deficiency on the factor VIII level.
Inhibition of cyclooxygenase‐2 impairs the expression of essential plasma cell transcription factors and human B‐lymphocyte differentiation
Authors: Bernard Matthew P. , Phipps Richard P.
Published: June 2009

Cyclooxygenase (Cox) inhibitors are among the most widely used and commonly prescribed medications. Relatively little is understood about their influence on human immune responses. Herein, we discovered a novel and important mechanism whereby non‐steroidal anti‐inflammatory drugs (NSAIDs) blunt human B‐cell antibody production. We demonstrate that the Cox‐2 selective small molecule inhibitors SC‐58125 and NS‐398 attenuate the production of human antibody isotypes including immunoglobulin M (IgM), IgG1, IgG2, IgG3 and IgG4. In addition, inhibition of Cox‐2 significantly reduced the generation of CD38+ IgM+ and CD38+ IgG+ antibody‐secreting cells. Interestingly, we discovered that inhibition of Cox‐2 activity in normal human B cells severely reduced the messenger RNA and protein levels of the essential plasma cell transcription factor, Blimp‐1. These observations were mirrored in Cox‐2‐deficient mice, which had reduced CD138+ plasma cells and a near loss of Blimp‐1 expression. These new findings demonstrate a critical role for Cox‐2 in the terminal differentiation of human B lymphocytes to antibody‐secreting plasma cells. The use of NSAIDs may adversely influence the efficacy of vaccines, especially in the immunocompromised, elderly and when vaccines are weakly immunogenic.
Setting priorities for health interventions in developing countries: a review of empirical studies
Authors: Youngkong Sitaporn , Kapiriri Lydia , Baltussen Rob
Published: June 2009

Objective  To assess and summarize empirical studies on priority‐setting in developing countries.

Methods  Literature review of empirical studies on priority‐setting of health interventions in developing countries in Medline and EMBASE (Ovid) databases.

Results  Eighteen studies were identified and classified according to their characteristics and methodological approaches. All studies were published after 1999, mostly between 2006 and 2008. Study objectives and methodologies varied considerably. Most studies identified sets of relevant criteria for priority‐setting (17/18) and involved different stakeholders as respondents (11/18). Studies used qualitative (8/15) or quantitative (3/15) techniques, or combinations of these (4/15) to elicit preferences from respondents. In a few studies, respondents deliberated on results (3/18). A minority of studies (7/18) resulted in a rank ordering of interventions.

Conclusions  This review has revealed an increase in the number of empirical studies on priority‐setting in developing countries in the past decade. Methods for explicit priority‐setting are developing, being reported and are verifiable and replicable and can potentially lead to solutions for ad hoc policy‐making in health care in many developing countries.
Therapeutic itineraries of patients with ulcerated forms of Mycobacterium ulcerans (Buruli ulcer) disease in a rural health zone in the Democratic Republic of Congo
Authors: Kibadi Kapay , Boelaert Marleen , Kayinua Makanzu , Minuku Jean‐Bedel , Muyembe‐Tamfum Jean‐Jacques , Portaels Françoise , Lefèvre Pierre
Published: June 2009

Objective  To describe lay perceptions of the ulcerated forms of Mycobacterium ulcerans, commonly called Buruli ulcer (BU), and therapeutic itineraries of BU patients in a rural area of the Democratic Republic of Congo.

Methods  Qualitative research consisting of semi‐structured interviews of 19 patients with clinical signs of BU and 12 in‐depth interviews of confirmed cases allowing for a detailed reconstruction of the itineraries followed.

Results  The first symptoms of BU are perceived as mild. The perceived seriousness of the disease increases as the ulceration persists, increases in size or results in complications. Knowledge about the biomedical aetiology of the disease is scarce; it is commonly believed to be due to witches’ attacks or bad fate. Four therapeutic paths are taken: self‐medication, traditional therapy, the church and the health centre. However lay perception, recourse to traditional treatments and self‐medication only partially explain the long delays in diagnosis (on average 6 months); the main problem lies with health providers, particularly the lack of proper diagnostic capability.

Conclusions  Diagnostic capabilities at health centre level need to be strengthened through training and supervision. Engaging with the population and the traditional healers would render health promotion messages on BU more relevant and culturally acceptable.
Assessment of cardiovascular risk in waiting‐listed renal transplant patients: a single center experience in 558 cases
Authors: Leonardi G. , Tamagnone M. , Ferro M. , Tognarelli G. , Messina M. , Giraudi R. , Fop F. , Picciotto G. , Biancone L. , Segoloni G. P.
Published: June 2009

Abstract:  Cardiac screening is recommended to prevent cardiovascular death after renal transplantation. This retrospective observational study illustrates the results of application of a cardiac assessment algorithm in a series of 558 renal transplant candidates at a single center in Turin, Italy. A dipyridamole‐stress sestamibi myocardial scintiscan (DMS) performed in 302/558 (54.1%) cases was positive in 52 (17.2%), negative in 200 (66.2%), borderline in 16 (5.3%), and with signs of previous necrosis in 34 (11.4%). Coronary lesions detected by angiography in 48.1% of the 52 positives were treated medically (13.5%) or by percutaneous/surgical procedure (34.6%). Coronary lesions were detected in 14.1% of asymptomatic population subgroup. The minor and major cardiovascular event rates and the cardiovascular death rate were 1.9%, 0%, and 0%, respectively, in positive DMS group (high‐cardiological risk) vs. 10%, 4.5%, and 3.5% in the negatives (p > 0.5; n.s.). It is suggested that not increased cardiovascular event or deaths rates in the high‐risk group reflect early coronary lesion detection and correction. Since 55.9% of cardiovascular events or deaths occurred in the negative group more than 24 months after the DMS, its mandatory repetition every two yr after a negative finding is recommended.
HLA‐DRB1*0908, a new allele was identified by sequence‐based typing in a Korean individual
Authors: Kim Y.‐H. , Kang Y.‐M. , Lee G.‐E. , Cho Y.‐S.
Published: June 2009

A new human leukocyte antigen DRB1*0908 differs from GTC to AGC in DRB1*090102 at codon 57 with a coding change, valine to serine.
CTLA4 gene polymorphisms and soluble CTLA4 protein in Behcet’s disease
Authors: Park K. S. , Baek J. A. , Do J. E. , Bang D. , Lee E.‐S.
Published: June 2009

Cytotoxic T lymphocyte antigen 4 (CTLA4; CD152) is a costimulatory molecule expressed on activated T cells that plays a key inhibitory role during T lymphocyte activation. The gene encoding for CTLA4 has been suggested as a candidate for conferring susceptibility to autoinflammatory diseases. We investigated the polymorphisms of the CTLA4 gene [promoter region (−1722 T/C, −1661 A/G and −318 C/T) and exon 1 (+49 G/A)] and the differences of serum soluble sCTLA4 levels in 285 patients with Behcet’s disease (BD) and 287 controls. The frequency of the CTLA4 −1661 GG genotype was significantly higher in BD patients than in controls [P = 0.019, odds ratio (OR) = 5.2, 95% confidence interval (CI) = 1.13–23.86]. Also, the genotype frequency for CTLA4 −1722 TC was significantly higher (P = 0.014, OR = 1.8, 95% CI = 1.13–2.99), while CTLA4 −1722 CC was significantly lower (P = 0.018, OR = 0.4, 95% CI = 0.20–0.87) in BD patients with ocular lesions compared with patients without this symptom. Serum sCTLA4 levels in BD patients were significantly lower, especially in BD patients with the CTLA4 +49 G allele, than those in healthy controls (P < 0.05). Although our understanding of the role of the CTLA4 gene and its protein product in BD is incomplete, these results suggest that single nucleotide polymorphisms of the promoter and exon regions in the CTLA4 gene are candidates that predispose to BD and that sCTLA4 may be related to the immunological abnormalities and disease expressions associated with BD.
Feasibility of a new method to collect exhaled breath condensate in pre‐school children
Authors: Rosias Philippe P. R. , Robroeks Charlotte M. , Van De Kant Kim D. , Rijkers Ger T. , Zimmermann Luc J. , Van Schayck Constant P. , Heynens Jan W. , Jöbsis Quirijn , Dompeling Edward
Published: June 2009

Rosias PPR, Robroeks CM, van de Kant KD, Rijkers GT, Zimmermann LJ, van Schayck CP, Heynens JW, Jöbsis Q, Dompeling E. Feasibility of a new method to collect exhaled breath condensate in pre‐school children.  Pediatr Allergy Immunol 2010: 21: e235–e244. © 2009 John Wiley & Sons A/S

Exhaled breath condensate (EBC) is a promising non‐invasive method to assess respiratory inflammation in adults and children with lung disease. Especially in pre‐school children, condensate collection is hampered by long sampling times because of open‐ended collection systems. We aimed to assess the feasibility of condensate collection in pre‐school children using a closed glass condenser with breath recirculation system, which also collects the residual non‐condensed exhaled breath, and subsequently recirculates it back into the condenser. Condensate was collected before and after breath recirculation in 70 non‐sedated pre‐school children with and without recurrent wheeze. Cytokines (IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐13, TNF‐α) were measured in 50 μl samples using ultrasensitive multiplexed liquid bead array. The success rate of condensate collection increased from 64% (without recirculation) to 83% (after breath recirculation), and mean condensate volume from 214 to 465 μl respectively. Detection of cytokines was successful in 95–100% of samples. Cytokine concentrations before and after breath recirculation were not different (p > 0.232). In asthmatic children, only TNF‐α concentrations were significantly decreased, compared to non‐asthmatics. In pre‐school children, the collection of EBC is feasible using a new closed glass condenser with breath recirculation system. This new method may help to assess – non‐invasively – cytokine profiles in asthmatic and non‐asthmatic pre‐school children.
T regulatory cells in xenotransplantation
Authors: Muller Yannick D. , Golshayan Déla , Ehirchiou Driss , Wekerle Thomas , Seebach Jörg D. , Bühler Leo H.
Published: June 2009

Abstract:  The role of T regulatory cells (Treg) in the induction and maintenance of allograft tolerance is being studied to a great extent. In contrast, little is known on their potential to prevent graft rejection in the field of xenotransplantation, where acute vascular rejection mediated by cellular and humoral mechanisms and thrombotic microangiopathy still prevents long‐term graft survival. In this regard, the induction of donor‐specific tolerance through isolation and expansion of xenoantigen‐specific recipient Treg is currently becoming a focus of interest. This review will summarize the present knowledge concerning Treg and their potential use in xenotransplantation describing in particular CD4+CD25+Foxp3+ T cells, CD8+CD28− Treg, double negative CD4−CD8− T cells, and natural killer Treg. Although only studied in vitro so far, human CD4+CD25+Foxp3+ Treg is currently the best characterized subpopulation of regulatory cells in xenotransplantation. CD8+CD28− Treg and double negative CD4−CD8− Treg also seem to be implicated in tolerance maintenance of xenografts. Finally, one study revealing a role for natural killer CD4+Vα14+ Treg in the prolongation of xenograft survival needs further confirmation. To our opinion, CD4+CD25+Foxp3+ Treg are a promising candidate to protect xenografts. In contrast to cadaveric allotransplantation, the donor is known prior to xenotransplantation. This advantage allows the expansion of recipient Treg in a xenoantigen specific manner before transplantation.
Biomechanical properties of adult‐excised porcine trachea for tracheal xenotransplantation
Authors: Shi Hong‐Can , Deng Wei‐Jun , Pei Chang , Lu Dan , Zhang Xiao‐Jun , Wang Xiao‐Hong , Zeng Yan‐Jun
Published: June 2009

Abstract:  Background:  To investigate and evaluate the biomechanical properties of adult‐excised porcine trachea, thereby providing experimental methods and evidence for biomedical engineering of artificial trachea.

Methods:  The TY8000 servo‐handle tension test machine was used to measure biomechanical indices, such as bending stiffness, radial pedestal, and stress‐straining. The residual stress and bursting strength of adult‐excised porcine trachea was evaluated.

Results:  Residual stress was retained in the adult‐excised porcine trachea. The force of radial pedestal was detected as 10 N, when the diameter of a 50‐mm trachea was compressed to 50%. The bursting strength decreased from 180 mmHg of pharyngeal portion to 110 mmHg in tracheal carina. When the trachea flexed forward or either right or left by 50°, tension reached 0.296 to 0.131 N and 0.254 to 0.150 N, respectively. The curve of stress‐straining measured, according to computer data and results, suggested that tension was maintained at a low level at 50% strain.

Conclusions:  Residual stress was retained in the excised porcine trachea, and the porcine trachea membrane disrupted when pressure in the inner wall increased. The porcine trachea exhibits good radial pedestal force, bending, and elongation properties.
Resistance to beet armyworm in a chickpea recombinant inbred line population
Authors: Clement S. L. , Sharma H. C. , Muehlbauer F. J. , Elberson L. R. , Mattinson D. S. , Fellman J. K.
Published: June 2009

Beet armyworm, Spodoptera exigua (Hübner), is an economic pest of chickpea, Cicer arietinum L., in Mexico and the Indian subcontinent. Larvae feed on the vegetative and reproductive stages of chickpea and the development of plant resistance is a priority in the management of this pest. Forty‐two recombinant inbred lines (RILs) from a chickpea recombinant inbred line population (CRIL‐7) developed from a cross between FLIP 84‐92C (susceptible C. arietinum) and PI 599072 (resistant C. reticulatum Lad. accession) were rated resistant (nine lines with post‐trial larval weights 0.42–0.59 mg), moderately resistant/susceptible (25 lines, larval weights 0.61–0.99 mg) and susceptible (eight lines, larval weights 1.01–2.17 mg) to beet armyworm larvae in a general glasshouse screening. Resistance and susceptibility of entries (RILs in the CRIL‐7 population, parents, checks) was based on the average weight gain and fate of early‐stage larvae on pre‐flowering plants. In a growth chamber trial, early‐instar larval weight gain differed significantly (P < 0.0001) among entries (12 RILs, parents, checks), with mean weights from 0.80 mg (resistant RIL) to 4.03 mg (susceptible kabuli cultivar). There were no significant differences (P = 0.0836) in larval mortality among the entries in the growth chamber trial, although mortality rates were 28.2–61.9%. Flavonoid and isoflavonoid extractions and analyses did not clarify the role played by these phytochemicals in chickpea resistance to S. exigua. The requisite high levels of resistance to S. exigua and other pests for breeding resistant culivars may reside in the CRIL‐7 population.
Usefulness of smears in intra‐operative diagnosis of newly described entities of CNS
Authors: Varikatt Winny , Dexter Mark , Mahajan Hema , Murali Rajmohan , Ng Thomas
Published: June 2009

The recent edition of World Health Organisation (WHO) Classification of Tumours of the Central Nervous System has incorporated a substantial number of important changes. It has recognised several new entities, many of which are rare. Intra‐operative diagnosis of these tumours can be difficult with the freezing artefact that often cripples brain frozen sections. In many instances intra‐operative smears are extremely useful adjuvants in neuropathological diagnosis. In this article, we describe intra‐operative smear findings of three of the newly described tumours. Their characteristic cytologic features are illustrated along with differentiating features from the common mimics, together with a general approach to brain smears. The entities we discuss here are papillary glioneuronal tumour, papillary tumour of the pineal region and angiocentric glioma. All three tumours share at least focal pseudo‐papillary/vasculocentric architecture. Smears from papillary glioneuronal tumour demonstrated dual population of cells in a neuropil background, whereas papillary tumour of the pineal region and angiocentric glioma comprise a single population of cells. These two tumours can further be differentiated based on their cell morphology and background.
NovelSCN1Amutations in Indonesian patients with severe myoclonic epilepsy in infancy
Authors: Herini Elisabeth Siti , Gunadi  , Van Kempen Marjan J.A. , Yusoff Surini , Sutaryo  , Sunartini  , Patria Suryono Yudha , Matsuo Masafumi , Lindhout Dick , Nishio Hisahide
Published: June 2009

Background: Severe myoclonic epilepsy in infancy (SMEI) and borderline SMEI (SMEB) are caused by a mutation inSCN1A, which encodes a voltage‐gated sodium channel α1‐subunit protein. Although many mutations inSCN1Ahave been associated with clinical features of SMEI or SMEB from different ethnic groups, there have been no such reports from the South‐East Asian populations so far.

Methods: Patients 1 and 2 were Indonesian children diagnosed as having SMEI and SMEB based on their clinical features.SCN1Awas screened for mutations using a combination of polymerase chain reaction and denaturing high‐performance liquid chromatography. Nucleotide substitutions were confirmed on direct sequencing.

Results: In patient 1, a G‐to‐A heterozygous transition was detected at nucleotide 4834 (c.4834G>A) in exon 25, leading to substitution of valine with isoleucine at amino acid position 1612 (p.V1612I) in the SCN1A protein. In patient 2 a T‐to‐G heterozygous transversion was identified at nucleotide 5266 (c.5266T>G) in exon 26, leading to substitution of cysteine with glycine at amino acid 1756 (p.C1756G) in the SCN1A protein. Both amino acid substitutions might disrupt these highly conserved regions in species from drosophila to human, leading to dysfunction of the protein. p.V1612I and p.C1756G were determined as disease‐causing mutations due to their absence in the control population.

Conclusion: The first cases of SMEI and SMEB are reported in South‐East Asian populations. Two novelSCN1Amutations are also identified in these patients, p.V1612I and p.C1756G, which may lead to neuronal excitability or convulsions.
Associated conditions and clinical significance of awake bruxism
Authors: Kwak Yong Tae , Han Il‐Woo , Lee Phil Hyu , Yoon Joon‐Kee , Suk Seung‐Han
Published: June 2009

Background: Awake bruxism is defined as an oral parafunctional activity that includes clenching and grinding of teeth during wakefulness. Confirming the possible related anatomy and the clinical significance of awake bruxism in geriatric hospitals is the aim of this study.

Methods: We analyzed the medical records of 503 patients who were admitted to hospital from April to June 2008. After the recognition of bruxism, the clinical, brain imaging studies and statistical parametric mapping (SPM) of brain single photon emission computed tomography were performed.

Results: In each disease group, five of 125 Alzheimer's disease (AD) patients (4.0%), three of 11 frontotemporal dementia (FTD) patients (27.3%), seven of 230 stroke patients (including two patients related to citalopram, 3.0%), one of 45 Parkinson's disease patients (2.2%) and four of 17 hydrocephalus patients (23.5%) had bruxism. Even though awake bruxism occurred early after stroke onset, it occurred late after AD and FTD onset. This occurred in a far advanced stage of AD, while it occurred in a moderately advanced stage of FTD. SPM analysis in AD and FTD patients with awake bruxism revealed significant hypoperfusion in frontotemporal and other subcortical structures. Surface electromyography recordings from the masseter muscle showed rhythmic regular motor activity at a rate of 1–2/s.

Conclusion: This study suggests that awake bruxism is encountered not infrequently in various diseases in geriatric hospitals. It is frequently observed in FTD and normal pressure hydrocephalus, which characteristically shows frontal lobe dysfunction. These facts and SPM analysis show that awake bruxism can be regarded as a frontal neurological sign of various neurological disorders.
A critique of elective pediatric supraglottic airway devices
Authors: WHITE MICHELLE C. , COOK TIM M. , STODDART PETER A.
Published: June 2009

In 1988, when the Laryngeal Mask Airway‐Classic™ (Intavent Orthofix, Maidenhead, UK), was introduced there were only two choices of airway management: tracheal tube or facemask. The supraglottic airway, as we now understand the term, did not exist. Yet, 20 years later, we are faced with an ever increasing choice of supraglottic airway devices (SAD). For many SADs, with the exception of the LMA‐ClassicTM and LMA‐ProsealTM (Intavent Orthofix, Maidenhead, UK), there is a lack of high quality data of efficacy. The best evidence requires a randomized controlled trial comparing a new device against an established alternative, properly powered to detect clinically relevant differences in clinically important outcomes. Such studies in children are very rare. Safety data is even harder to establish particularly for rare events such as aspiration. Therefore, most safety data comes from extended use rather than high quality evidence which inevitably biases against newer devices. For reason of these factors, claims of efficacy and particularly safety must be interpreted cautiously. This narrative review aims to present the evidence surrounding the use of currently available pediatric SADs in routine anesthetic practice.
Sedation and analgesia in the pediatric intensive care unit following laryngotracheal reconstruction
Authors: HAMMER GREGORY B.
Published: June 2009

Background:  Children undergoing laryngotracheal reconstruction (LTR) may remain electively intubated in the pediatric intensive care unit (PICU) for several days following surgery to facilitate wound healing. These patients require sedation and analgesia with or without neuromuscular blockade inorder to prevent excessive head and neck movement with resultant tension on the tracheal anastomosis. Achieving this level of immobility features in caring for these children.

Aim:  The aims of this article are to describe a variety of commonly used sedation and analgesic agents and to provide guidance as to their optimal use following LTR.
The design of pediatric tracheal tubes
Authors: LEONG LISA , BLACK ANN E.
Published: June 2009

Differences in the anatomy and physiology of the young child necessitate specialist equipment and anesthetic equipment is constantly evolving. We will review the factors influencing the design of pediatric tubes and highlight those areas of special interest. There have been pleas for more standardization of tube markings, as this would help with positioning of tubes, especially in small babies, and there are recent advances in this area. Anesthetists need to be aware that there are important differences between tubes so that they take this into account when choosing an appropriate tube. In addition, developments in the design of cuffed tubes are increasingly being used both for routine care and specialist surgery.
A disquisition on sleep‐disordered breathing in children
Authors: LERMAN JERROLD
Published: June 2009

Sleep‐disordered breathing (SDB) is a continuum of breathing abnormalities that affects children and adults. This disorder has been continuously evolving, particularly in children, with new insights in its pathogenesis, clinical manifestations, diagnosis, treatments, and outcomes. The purpose of this review is to provide a current framework for pediatric anesthesiologists to address the perioperative needs of these children to ensure their safe conduct through anesthesia.
Anatomy and assessment of the pediatric airway
Authors: ADEWALE LOLA
Published: June 2009

Airway and respiratory complications are the most common causes of morbidity during general anesthesia in children. The airway changes in size, shape and position throughout its development from the neonate to the adult (1). Knowledge of the functional anatomy of the airway in children forms the basis of understanding the pathological conditions that may occur. This in turn allows a comprehensive assessment of the pediatric airway to take place, including a detailed medical history, clinical examination and specific investigative procedures.
The Management of difficult intubation in children
Authors: WALKER ROBERT W.M. , ELLWOOD JAMES
Published: June 2009

This article looks at the current techniques and equipment recommended for the management of the difficult intubation scenario in pediatric practice. We discuss the general considerations including preoperative preparation, the preferred anesthetic technique and the use of both rigid laryngoscopic and fiberoptic techniques for intubation. The unanticipated scenario is also discussed.
Anesthesia for laser surgery of the airway in children
Authors: BEST CRISPIN
Published: June 2009

Anesthesia for laser surgery in children carries a number of particular challenges and pitfalls. The anesthetist must be aware not only of the problems of anesthetizing a patient with a potentially compromised airway but also of how to maintain homeostasis when surgery is taking place, as procedures may make a bad situation temporarily worse. Personnel must also be very aware of the benefits and dangers of medical lasers, and what safety precautions must be taken to ensure their proper use. This section will deal with the properties of lasers, how and why they are used, and a description of how these procedures are carried out in our own institution.
Imaging of the pediatric airway
Authors: ESLAMY HEDIEH K. , NEWMAN BEVERLY
Published: June 2009

Airway compromise can be fixed, dynamic (with varying degrees of collapse during the respiratory cycle), or exhibit both components. The location of the abnormality can be classified as extrinsic (located outside but exerting mass effect on the airway) or intrinsic (intramural and/or intraluminal). The etiologies of airway compromise are categorized as: congenital, infectious, inflammatory, traumatic, vascular, or neoplastic (1). The role of imaging of the airway is to determine the presence, nature and anatomic level of airway compromise, categorize it as intrinsic or extrinsic, provide a differential diagnosis, and guide further imaging or management (1). The differential diagnosis of a lesion takes into account the patient’s age and gender, location of the lesion, clinical presentation, and imaging appearance.
How did the Macintosh laryngoscope become so popular?
Authors: SCOTT JEANETTE , BAKER PAUL A.
Published: June 2009

The Macintosh laryngoscope has been described as ‘the most numerously and widely made durable item in the history of anesthesia’ (Sir Anthony Jephcott, February 6, 1983). This laryngoscope was originally designed to facilitate intubation in unparalyzed patients and became universally adopted by the anesthetic community. In spite of enormous subsequent changes in anesthetic practice, the Macintosh laryngoscope continues to dominate 50 years after its key indication has become obsolete. This study explores the development and success of this ubiquitous instrument.
Effects of adjustable gastric banding on gastroesophageal reflux and esophageal motility: a systematic review
Authors: De Jong J. R. , Besselink M. G. H. , Van Ramshorst B. , Gooszen H. G. , Smout A. J. P. M.
Published: June 2009

Controversial opinions exist concerning the effect of laparoscopic adjustable gastric banding on gastroesophageal reflux. MEDLINE and EMBASE databases were searched for relevant studies on patients undergoing adjustable gastric banding. Data are expressed in mean (range). Twenty studies were identified with a total of 3307 patients. The prevalence of reflux symptoms decreased postoperatively from 32.9% (16–57) to 7.7% (0–26.9) and medication use from 27.5% (16–38.5) to 9.5% (3.1–19.2). Newly developed reflux symptoms were found in 15% (6.1–20) of the patients. The percentage of esophagitis decreased postoperatively from 33.3% (19.4–61.6) to 27% (2.3–60.8). Newly developed esophagitis was observed in 22.9% (0–38.4). Pathological reflux was found in 55.8% (34.9–77.4) preoperatively and postoperatively in 29.4% (0–41.7) of the patients. Lower esophageal sphincter pressures increased from 12.9 to 16.9 mmHg (11.3–21.4). Lower esophageal sphincter relaxation decreased from 100% to 79.7% (58–86). The percentage of dysmotility increased from 3.5% (0–10) to 12.6% (0–25). Adjustable gastric banding has anti‐reflux properties resulting in resolution or improvement of reflux symptoms, normalized pH monitoring results and a decrease of esophagitis on short term. However, worsening or newly developed reflux symptoms and esophagitis are found in a subset of patients during longer follow‐up.
8. How to Impute Interactions, Squares, and other Transformed Variables
Authors: von Hippel Paul T.
Published: June 2009

Researchers often carry out regression analysis using data that have missing values. Missing values can be filled in using multiple imputation, but imputation is tricky if the regression includes interactions, squares, or other transformations of the regressors. In this paper, we examine different approaches to imputing transformed variables; and we find one simple method that works well across a variety of circumstances. Our recommendation is to transform, then impute—i.e., calculate the interactions or squares in the incomplete data and then impute these transformations like any other variable. The transform-then-impute method yields good regression estimates, even though the imputed values are often inconsistent with one another. It is tempting to try and “fix” the inconsistencies in the imputed values, but methods that do so lead to biased regression estimates. Such biased methods include the passive imputation strategy implemented by the popular ice command for Stata.
Accuracy of iPhone Locations: A Comparison of Assisted GPS, WiFi and Cellular Positioning
Authors: Zandbergen Paul A
Published: June 2009

The 3G iPhone was the first consumer device to provide a seamless integration of three positioning technologies: Assisted GPS (A‐GPS), WiFi positioning and cellular network positioning. This study presents an evaluation of the accuracy of locations obtained using these three positioning modes on the 3G iPhone. A‐GPS locations were validated using surveyed benchmarks and compared to a traditional low‐cost GPS receiver running simultaneously. WiFi and cellular positions for indoor locations were validated using high resolution orthophotography. Results indicate that A‐GPS locations obtained using the 3G iPhone are much less accurate than those from regular autonomous GPS units (average median error of 8 m for ten 20‐minute field tests) but appear sufficient for most Location Based Services (LBS). WiFi locations using the 3G iPhone are much less accurate (median error of 74 m for 58 observations) and fail to meet the published accuracy specifications. Positional errors in WiFi also reveal erratic spatial patterns resulting from the design of the calibration effort underlying the WiFi positioning system. Cellular positioning using the 3G iPhone is the least accurate positioning method (median error of 600 m for 64 observations), consistent with previous studies. Pros and cons of the three positioning technologies are presented in terms of coverage, accuracy and reliability, followed by a discussion of the implications for LBS using the 3G iPhone and similar mobile devices.
Spatial Annotation Technology for Public Deliberation
Authors: Cai Guoray , Yu Bo
Published: June 2009

Many public policies and decisions deal with geospatially expressed problems that are complex and controversial in nature. Broad participation of all interested parties in the form of deliberative dialogues is crucial to making trustworthy decisions. However, supporting deliberative dialogues on spatial problems places unique requirements for technology mediation that go beyond the current state of research on public participation geographical information systems (PPGIS) and related technologies. In this article, we analyze the challenges of facilitating effective deliberation processes and highlight the progress needed to support spatially‐enabled public deliberation technologies. Then, we present ourGeoDeliberative Annotation Technology(GeoDAT) as a framework for addressing the above challenges. GeoDAT uses spatial annotation objects as models for deliberative artifacts, and manages annotations by a spatial data model that reflects the ecological relationships among annotations, visual contexts, discussion threads, spatial referents, and the cognitive states of their holders. As a proof of the concept, we have implemented GeoDeliberator based on the GeoDAT framework. GeoDeliberator is based on Web 2.0 technology and implemented in AJAX technology, and it offers some unique spatial annotation capture, retrieval and visualization capabilities, such as context memory, reference to multiple geo‐objects in one annotation, inferring and visualizing new relations using spatial‐temporal and thread‐based reasoning, and user‐controlled annotation sharing. We demonstrate the utility of GeoDeliberator through a simulated scenario where a community in a university campus deliberates on the alternative courses of actions available for building a smoke‐free campus.
A Customization of the Arc Marine Data Model to Support Whale Tracking via Satellite Telemetry
Authors: Lord‐Castillo Brett K , Mate Bruce R , Wright Dawn J , Follett Tomas
Published: June 2009

The Arc Marine data model is a generalized template to guide the implementation of geographic information systems (GIS) projects in the marine environment. It developed out of a collaborative process involving research and industry shareholders in coastal and marine research. This template models and attempts to standardize common ocean and coastal data types to facilitate data sharing and analytical tool development. In this study, Arc Marine is extended from its core model to fit the research goals of the whale satellite‐telemetry‐tagging program of the Oregon State University Marine Mammal Institute (MMI). The study sought the best customization of the generic Arc Marine data model to enhance the key advantages of satellite telemetry for mapping the distribution and movement of endangered marine mammal species. It was found that three new groups of object classes were needed (Animal, Telemetry, and Operations). Further customization involved the development of a comprehensive framework for animal tracking with Argos satellite telemetry data. A new multidimensional data cube model was also devised, showing how this extension of Arc Marine serves as an appropriate target schema for the application of on‐line analytical processing (OLAP) tools and spatial data mining of satellite telemetry tracking datasets.
CONSTANT PROPORTION PORTFOLIO INSURANCE IN THE PRESENCE OF JUMPS IN ASSET PRICES
Authors: Cont Rama , Tankov Peter
Published: June 2009

Constant proportion portfolio insurance (CPPI) allows an investor to limit downside risk while retaining some upside potential by maintaining an exposure to risky assets equal to a constant multiple of the cushion, the difference between the current portfolio value and the guaranteed amount. Whereas in diffusion models with continuous trading, this strategy has no downside risk, in real markets this risk is nonnegligible and grows with the multiplier value. We study the behavior of CPPI strategies in models where the price of the underlying portfolio may experience downward jumps. Our framework leads to analytically tractable expressions for the probability of hitting the floor, the expected loss, and the distribution of losses. This allows to measure the gap risk but also leads to a criterion for adjusting the multiplier based on the investor's risk aversion. Finally, we study the problem of hedging the downside risk of a CPPI strategy using options. The results are applied to a jump‐diffusion model with parameters estimated from returns series of various assets and indices.