bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring kidney function in diabetic nephropathy
Authors: GROTH S. , PETERSEN C. , DIRKSEN A. , PARVING H.‐H.
Published: October 2011

Abstract Groth S, Petersen C, Dirksen A, Parving H.‐H (Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital and Rigshospitalet, Hvidøre Hospital, Copenhagen. Denmark). Monitoring kidney function in diabetic nephropathy.

We investigated the validity of a one plasma sample method (I) compared with a multiple plasma sample method (II) for routine clinical determination of glomerular filtration rate (GFR) in 35 insulin‐dependent diabetic patients suffering from nephropathy. GFR was measured after an intravenous bolus injection of 100 μCi 51Cr‐EDTA by determination of plasma radioactivity in venous blood samples taken from the other arm 180, 200, 220 and 240 min after the injection (II). The plasma radioactivity in the sample drawn 240 min after injection was used in method I. During the mean investigation period of 32 months (12–62 months) a total of 184 GFR determinations were performed. The average interval between the GFR measurements was 6 months (1–21 months). In 127/184 of the study intervals method I indicated a decrease in GFR. The corresponding figure for method II was almost identical, 130/184. The mean decline in GFR was 8.1 ± 7.2 and 7.8 ± 6.9 ml year−1 1.73 m−2 using methods I and II, respectively (NS). The methods essentially provided the same GFR values in absolute terms (r = 0.98, P < 0.001). We conclude that the one plasma sample method can be used as a valid routine technique in non‐uraemic patients with nephropathy.
Iron deficiency: does it matter?
Authors: DALLMAN P. R.
Published: October 2011

AbstractDallman PR (Department of Pediatrics, School of Medicine, University of California‐San Francisco, CA 94143, USA). Iron deficiency: does it matter?

Iron deficiency causes different abnormalities in the three major population groups that are at risk. In pregnant women, epidemiological studies suggest that anaemia, presumably due mainly to iron deficiency, is associated with an increased risk of low birth weight, prematurity, and perinatal mortality. In iron‐deficient infants and children, there is convincing evidence of impaired psychomotor development and cognitive performance. Finally, iron‐deficient women during the childbearing years (and iron‐deficient men) have a decreased work capacity and less efficient response to exercise. These symptoms provide ample justification for preventing and treating a common and easily correctable nutritional disorder.
Rectal potential differences in irritable bowel syndrome and in inflammatory bowel diseases in man
Authors: PIENKOWSKI P. , FIORAMONTI J. , FREXINOS J.
Published: October 2011

Abstract Pienkowski P, Fioramonti J, Frexinos J (Service de Nutrition et de Gastroentérologie, CHU Rangueil et INRA Département de Pharmacologie. Toulouse, France). Rectal potential difference in irritable bowel syndrome and in inflammatory bowel diseases in man.

We have studied rectal potential difference (pd) in 200 subjects: 30 healthy volunteers or control patients, 46 patients with irritable bowel syndrome (IBS) and painless diarrhoea (group I), 60 IBS patients without diarrhoea (group II) and 64 patients with inflammatory bowel disease (IBD) with (group III, n = 41) or without (group IV, n = 23) rectal involvement. Pd measurement used a rectal perfused probe and a subcutaneous needle both connected, via agar‐KCl bridges, to calomel electrodes and a millivoltmeter. Statistical analysis used Student's t‐test for paired and unpaired data and Mann‐Whitney U‐test as appropriate. Mean rectal pd values were, respectively, −43.5 ± 8.7 mV in control group, −32.9 ± 10.2 mV in IBS‐group I patients (P < 0.001), −41.3 ± 12 mV in IBS‐group II patients (NS), −21.4 ± 14.1 mV in IBD patients with rectal involvement (P < 0.001), and −45.1 ± 14.3 mV in IBD‐group IV patients (NS). A histological examination was performed in 36 IBS patients; mean rectal pd was significantly decreased in patients showing abnormal patterns (n = 27, pd = −31.8 ± 9 mV) compared to patients with normal mucosa (n = 9, pd = −41.1 ± 6.5 mV; P < 0.01). These results show that:

(1) potential difference is significantly decreased in patients with ulcerative and rectal involvement; (2) in patients with Crohn's disease, normal rectal pd values do not assess the appearance of colonic mucosa above; (3) patients with IBS and diarrhoea also present a significant diminution in mean rectal pd.

Although the mechanisms involved remain unclear, rectal pd measurement appears to be an objective test for intestinal mucosae weakness in functional or inflammatory diseases of the large intestine and rectum.
Waldenström's macroglobulinaemia: results of a combined oral treatment in 34 newly diagnosed patients
Authors: PETRUCCI M. T. , AVVISATI G. , TRIBALTO M. , GIOVANGROSSI P. , MANDELLI F.
Published: October 2011

Abstract Petrucci MT, Awisati G, Tribalto M, Giovangrossi P, Mandelli F. (Section of Hematology, Department of Human Biopathology, University ‘La Sapienza’ and Division of Hematology, S. Eugenio Hospital, University ‘Tor Vergata’, Rome, Italy). Waldenström's macroglobulinaemia: results of a combined oral treatment in 34 newly diagnosed patients.

From February 1978 to September 1987, 34 patients with Waldenström's macroglobulinaemia (WM) were treated using an oral combination consisting of melphalan (6 mg m, days−2 1–7) cyclophosphamide (125 mg m−2, days 1–7) and prednisone (40 mg m−2, days 1–7). Courses were repeated every 4–6 weeks for a total of 12 courses. After the completion of 12 courses, responding patients received continuous treatment with chlorambucil (3 mg m−2 d−1) and prednisone (6 mg m−2 d−1) until relapse.

Following the induction, 23 of 31 evaluated patients (74%) have responded to induction therapy of whom eight (26% of the 31 evaluated patients) achieved complete remission defined as disappearance of all clinical and laboratory features characteristic of WM. The overall median response duration, as of December 1988, has not yet been reached, while the overall median event‐free survival duration for the entire population and for responding patients is 66 months in both groups. However, in responding patients the event‐free survival duration after 66 months reaches a plateau. Toxicity was limited to transient nausea and vomiting (grade 2 according to WHO).

In conclusion, this study demonstrates the efficacy and safety of an oral polychemotherapeutic treatment in the management of Waldenström's disease.
A double‐blind placebo‐controlled study of the efficacy and tolerability of ebastine against hayfever in general practice patients
Authors: ANKIER S. I. , WARRINGTON S. J.
Published: October 2011

Abstract Ankier SI, Warrington SJ (Charterhouse Clinical Research Unit Ltd., ‘Boundary House’, 91–93 Charterhouse Street, London EC1M 6HR, UK). A double‐blind placebo‐controlled study of the efficacy and tolerability of ebastine against hayfever in general practice patients. Journal of Internal Medicine 1989; 226: 453–58

Ebastine is an H1 antihistamine. Using a double‐blind, parallel group randomized study design, the efficacy and the tolerability of oral ebastine (10 mg daily escalating to 40 mg daily according to clinical need) was compared over 4 weeks during 1986 with matching placebo in 40 general practice patients suffering from hayfever. Ebastine (19 patients) was more effective (P < 0.05) than placebo (21 patients) against symptoms of running nose, itching nose, sneezing and blocked nose. Ebastine was superior to placebo in respect of the total symptom score as well as when judged by the investigators’ and the patients’ opinion of overall efficacy. Ebastine caused few adverse events, none of which resulted in a patient being withdrawn from treatment. Significantly more patients were withdrawn because of inefficacy from the placebo (n = 12) than from the ebastine (n = 3) treatment group (P < 0.02). It is concluded that ebastine (10–40 mg daily) is an effective and well tolerated treatment for hayfever.
Recombinant Adenovirus Delivery of Calreticulin–ESAT‐6 Produces an Antigen‐Specific Immune Response but no Protection Against a Mycobacterium Tuberculosis Challenge
Authors: Esparza‐González S. C. , Troy A. , Troudt J. , Loera‐Arias M. J. , Villatoro‐Hernández J. , Torres‐López E. , Ancer‐Rodríguez J. , Gutiérrez‐Puente Y. , Muñoz‐Maldonado G. , Saucedo‐Cárdenas O. , Montes‐de‐Oca‐Luna R. , Izzo A.
Published: October 2011

Bacillus Calmette–Guerin (BCG) has failed to efficaciously control the worldwide spread of the disease. New vaccine development targets virulence antigens of Mycobacterium tuberculosis that are deleted in Mycobacterium bovis BCG. Immunization with ESAT‐6 and CFP10 provides protection against M. tuberculosis in a murine infection model. Further, previous studies have shown that calreticulin increases the cell‐mediated immune responses to antigens. Therefore, to test whether calreticulin enhances the immune response against M. tuberculosis antigens, we fused ESAT‐6 to calreticulin and constructed a recombinant replication‐deficient adenovirus to express the resulting fusion protein (AdCRT–ESAT‐6). The adjuvant effect of calreticulin was assayed by measuring cytokine responses specific to ESAT‐6. Recombinant adenovirus expressing the fusion protein produced higher levels of interferon‐γ and tumour necrosis factor‐α in response to ESAT‐6. This immune response was not improved by the addition of CFP‐10 to the CRT‐ESAT‐6 fusion protein (AdCRT–ESAT‐6–CFP10). Mice immunized with these recombinant adenoviruses did not decrease the mycobacterial burden after low‐dose aerosol infection with M. tuberculosis. We conclude that calreticulin can be used as an adjuvant to enhance the immune response against mycobacterial antigens, but it is not enough to protect against tuberculosis.
Long‐term outcome after acute renal replacement therapy: a narrative review
Authors: RIMES‐STIGARE C. , AWAD A. , MÅRTENSSON J. , MARTLING C.‐R. , BELL M.
Published: October 2011

Background

Acute kidney injury (AKI) necessitating renal replacement therapy (RRT) is associated with high short‐term mortality, relatively little however is known of the long‐term outcome in these patients. This narrative review describes renal recovery, long‐term mortality, and quality of life in RRT patients with acute kidney injury.

Methods

A literature search using the PubMed search engine from the year 2000 to present with the MeSH terms 1) acute kidney injury, renal replacement therapy, prognosis, and 2) acute kidney injury, quality of life, prognosis, was performed, including studies addressing long‐term outcome (over 60 days) in adults with AKI on RRT.

Results

According to inclusion criteria, twenty two studies were eligible. Outcome varied depending on AKI aetiology, setting, co‐morbidity and pre‐morbid renal function. Five‐year‐survival was between 15% and 35%, with dialysis dependence in less than 10% of survivors. Renal recovery, even if incomplete occurred during the first year. Quality of life assessment amongst survivors indicated moderate physical impairment and reduced mental health scores. A majority of patients returned to employment and self‐sustainability and reported acceptable to good quality of life. Over 90% of patients indicated that they would undergo the same treatment again.

Discussion and Conclusions

Early initiation of treatment and fine‐tuning of the RRT technique may improve outcome. Consensus regarding AKI definitions, renal function measurement and standardised follow‐up regimens are required. Further long‐term studies are needed.
The severity of sevoflurane‐induced malignant hyperthermia
Authors: MIGITA T. , MUKAIDA K. , KOBAYASHI M. , HAMADA H. , KAWAMOTO M.
Published: October 2011

Background

Malignant hyperthermia (MH) is a potentially fatal complication of general anesthesia triggered by volatile anesthetics. In animal studies, sevoflurane has been reported to be a weak triggering agent. The aim of this study was to evaluate the clinical severity of sevoflurane‐induced MH compared to isoflurane.

Methods

From the Japanese MH database containing information for 520 MH cases since 1961, we analyzed 147 cases classified by the MH Clinical Grading Scale (CGS) as ‘very likely’ or ‘almost certain’, accumulated from 1990 to 2009. Sevoflurane without succinylcholine (S‐SCh (‐) group) was given to 48 cases, and isoflurane without succinylcholine (I‐SCh (‐) group) was given to 30. Variables studied were outcome, CGS score, CGS rank, the first MH sign, and time from induction to onset of MH (occurrence time). Clinical signs and maximum laboratory data from six processes of the CGS were also analyzed. Each of the Mann–Whitney U‐test or the unpaired t‐test was used for group comparisons.

Results

Mortality was 8.3% in the S‐SCh (‐) group and 10.0% in the I‐SCh (‐) group (P = 0.803). The CGS scores were 53.4 (SD, 12.2) and 52.3 (11.7) (P = 0.691), respectively. The five processes of the CGS did not differ between groups. Median occurrence times were 72.5 minutes (range, 36.3–127.5) and 65.0 minutes (30.0–131.3), respectively (P = 0.890).

Conclusion

There were no clinically apparent differences between MH triggered by sevoflurane and isoflurane, and thus no evidence to support the postulate that sevoflurane is a weak or weaker MH triggering agent.
Alkaline phosphatase as an early marker of hemolysis in newborns
Authors: Nalbantoğlu Ayşin , Ovalı Fahri , Nalbantoğlu Burçin
Published: October 2011

Background:  Early diagnosis and appropriate management of neonatal hyperbilirubinemia are very important in order to prevent bilirubin encephalopathy and kernicterus. Several diagnostic tests may be used for this purpose, including bilirubin level itself. The aim of the present study was to investigate whether serum alkaline phosphatase (ALP), which is an intracellular enzyme found abundantly in red blood cells, could be used for the early diagnosis and prediction of hyperbilirubinemia in newborns.

Methods:  A total of 100 babies were evaluated, starting from the sixth hour after birth, and serum ALP and bilirubin levels were analyzed.

Results:  ALP levels were significantly higher in babies requiring therapy such as phototherapy or exchange transfusion (247.01 ± 67.44 IU/L vs 154.25 ± 56.07 IU/L). ALP levels rose significantly with rising total bilirubin level.

Conclusion:  ALP levels at the sixth hour of life may be a significant predictor of developing hemolysis and hyperbilirubinemia requiring treatment.
Experiencing Range in an Electric Vehicle: Understanding Psychological Barriers
Authors: Franke Thomas , Neumann Isabel , Bühler Franziska , Cocron Peter , Krems Josef F.
Published: October 2011

Range of electric vehicles (EVs) has long been considered a major barrier in acceptance of electric mobility. We examined the nature of how range is experienced in an EV and whether variables from other adaptation contexts, notably stress, have explanatory power for inter‐individual differences in what we term comfortable range. Forty EVs were leased to a sample of users for a 6‐month field study. Qualitative and quantitative analyses of range experiences were performed, including regression analyses to examine the role of stress‐buffering personality traits and coping skills in comfortable range. Users appraised range as a resource to which they could successfully adapt and that satisfied most of their daily mobility needs. However, indicators were found that suggested suboptimal range utilisation. Stress‐buffering personality traits (control beliefs, ambiguity tolerance) and coping skills (subjective range competence, daily range practice) were found to play a substantial role in comfortable range. Hence, it may be possible to overcome perceived range barriers with the assistance of psychological interventions such as information, training, and interface design. Providing drivers with a reliable usable range may be more important than enhancing maximal range in an electric mobility system.
What is the evidence for the management of urethral amyloidosis? A systematic review of the literature
Authors: Mangera Altaf , Linton Kate D. , Fernando Malee , Channer Judy , Chapple Christopher R.
Published: October 2011

What's known on the subject? and What does the study add?

Urethral amyloidosis is rare and urethrotomy has been proposed as a suitable treatment option.

By reviewing the literature and comparing our own experiences, we have shown urethroplasty to have good medium term outcomes in patients with urethral amyloidosis, whereas urethrotomy may lead to recurrence.

OBJECTIVE

Urethral amyloidosis (UA) is a rare condition which may be encountered by an urological surgeon. We reviewed the literature regarding the presentation, investigation and management of UA.

PATIENTS AND METHODS

A systematic review of the English literature on PubMed was conducted and we indentified 39 articles which reported 45 patients. We included our experience with four patients from our tertiary centre.

RESULTS

The majority of patients reported symptoms consistent with a urethral structure. Most patients were treated with urethrotomy, only two patients have been reported to have had a urethroplasty in the literature. Medium and long term outcome data is lacking for urethrotomy and urethroplasty. We found recurrence in our patients after urethromoty and incomplete resection of UA. We describe short (6 month) and medium term (18 month) outcomes in two patients who underwent augmentation urethroplasty.

CONCLUSION

Although urethrotomy and dilatation have been proposed in the past, we found these may still lead to disease progression and therefore urethroplasty may be the most appropriate long term management option.
The Sacrifice of Silence: Fear and Trembling and the Secret of Faith
Authors: PODMORE SIMON D.
Published: October 2011

This article examines the important hermeneutical and theological relation between silence and sacrifice in Søren Kierkegaard's (1813–55) divisively enigmatic Fear and Trembling. I contend that this relation becomes clearest when the silence of Abraham is explicated in relation to his esoteric proclamation that ‘God himself will provide a lamb for the burnt offering’. In Abraham's reply to Isaac, the secret of Abraham's faith is concomitantly revealed (as a trust in the notion that ‘with God all things are possible’) and concealed (as a paradoxically ‘impossible’ possibility which cannot be adequately conveyed to ‘the other’). This thereby proposes a qualitative distinction between Abraham's reverent silence before God and his aporetic silence before the other.
Love from Afar: Distance, Intimacy and the Theology of Love
Authors: SAARINEN RISTO
Published: October 2011

Proceeding from Jean‐Luc Marion's The Erotic Phenomenon, this article discusses how the Christian concept of love can manifest intimacy. While most theological concepts of love spell out the requirement of distance, they do not pay sufficient attention to the intimate variants of love. The article argues that a full‐fledged theological account should make room for love's different economic and donative variants, as well as for love's advance from ‘distance’ to ‘visibility’ and, finally, ‘intimacy’. Concrete examples of intimate love include mystical union, transforming hospitality, fidelity and love that is as strong as death.
Skin improvement with two different oestroprogestins in patients affected by acne and polycystic ovary syndrome: clinical and instrumental evaluation
Authors: Colonna L. , Pacifico V. , Lello S. , Sorge R. , Raskovic D. , Primavera G.
Published: October 2011

Background  Despite it is accepted that acne is mostly caused by an hyper‐responsiveness of the pilo‐sebaceous unit to normal circulating androgen hormones, in a few patients, especially women, acneic lesions can be associated with increased serum androgen levels (hyperandrogenism), of which polycystic ovary syndrome (PCOS) is the most common cause. In women with acne and proven PCOS therapy with estroprogestins (EPs) can be an excellent option.

Objective  The aim of the study was to assess the effects of two estroprogestins (EPs), ethinyl‐estradiol (EE) 30 mcg/drospirenone (DRSP) 3 mg, and ethinyl‐estradiol (EE) 30 mcg/chlormadinone acetate (CMA) 2 mg, both on increased serum androgen levels and on several skin parameters in women affected by mild to severe acne and polycystic ovary syndrome (PCOS).

Methods  Fifty‐nine women were randomized to receive EE/DRSP (n = 32) or EE/CMA (n = 27) for six months. Evaluation of serum androgen levels, grading of acne and hirsutism (respectively with Pillsbury and Ferriman‐Gallwey score) and non‐invasive assessment of skin hydration, transepidermal water loss (TEWL) and skin homogeneity were performed at baseline, at 3 and 6 months (end of treatment).

Results  Both treatments were well tolerated and showed a significant improvement of skin and hormonal parameters, although EE/DRSP showed a more potent effect on acne and seborrhea.

Conclusions  Estroprogestins represent an effective and safe treatment in women with acne and polycystic ovary syndrome (PCOS). Nevertheless, the combination EE 30 mcg/DRSP 3 mg appears to be a more potent therapeutic option.
Capital Gains Taxation and Equity Returns: The Case of Mutual Savings Banks
Authors: Kelly Michael A. , Wu Xin , Chambers Donald R.
Published: October 2011

Abstract:  IPOs of demutualized savings banks create tax sensitive shareholders with identical acquisition dates and tax bases. We investigate security volume and returns surrounding the one‐year anniversary of the IPOs when unrealized capital gains and losses for original shareholders become long‐term capital gains for taxation purposes. Trading volume levels confirmed our hypothesis that investors defer the recognition of capital gains, but we could not confirm that tax motivated trading affected security prices. The results have implications beyond taxation and US markets. For non‐institutional investors, presumed to exhibit non‐rationality, tax motivated trading exists and does not have a significant effect on prices.
How Effective is the European Union's Savings Tax Directive? Evidence from Four EU Member States*
Authors: RIXEN THOMAS , SCHWARZ PETER
Published: October 2011

This article examines the strategies employed by individual investors to evade cross‐border capital income taxation, and evaluates the effectiveness of the European Union Savings Tax Directive (STD). Using data for four European countries, the results are, first, individual investors adapted to the institutional changes implemented by the STD before it became effective in 2005; second, the strategy of reallocating assets from debt to equity products in the same country is more important than shifting portfolio capital out of co‐operating countries into third countries; third, countries opting for a retention tax did not experience an outflow of portfolio capital, whereas countries engaged in information exchange lost capital relative to third countries outside the scope of the STD; and finally, there is considerable heterogeneity across countries. While there are strong behavioural responses by French investors, no evidence was found of cross‐border tax evasion by Italian investors, which may be explained by the absence of a national automatic reporting system on capital income in Italy. Overall, the findings show that the STD does not effectively prevent tax evasion and thus lend support to calls for tightening the directive.
Measurement of Aβ1–42 in cerebrospinal fluid is influenced by matrix effects
Authors: Slemmon J. Randall , Meredith Jere , Guss Valerie , Andreasson Ulf , Andreasen Niels , Zetterberg Henrik , Blennow Kaj
Published: October 2011

J. Neurochem. (2012) 120, 325–333.

Aβ1–42 measurement in CSF is an important biochemical marker for Alzheimer disease (AD). However, our understanding of why this biomarker is predictive and why it is often difficult to measure in a reproducible fashion is still lacking. To study these questions, the concentration of Aβ1–42 in CSF was compared before and after denaturation with 6M guanidine and reverse‐phase HPLC. Measurement of the Aβ1–42 after denaturation and reverse‐phase HPLC demonstrated that considerably more Aβ1–42 was present in CSF than revealed when assaying non‐denatured CSF. A comparison of Aβ1–42 concentrations before and after HPLC in AD CSF with that in normal controls suggested that matrix interference may affect the differentiation between the diagnostic groups. A similar effect was observed with dilutions of crude CSF. Together, these results suggested that at least part of the mechanism by which low Aβ1–42 concentrations in CSF function as a biomarker of AD is related to matrix components which preferentially hide a portion of the Aβ1–42 from detection in AD CSF. In contrast, we show that the association of the APOEε4 allele with lower Aβ1–42 concentrations in CSF is preserved even after denaturation and HPLC. A similar relationship between the presence of the APOEε4 allele and lower concentrations of Aβ1–40 was also apparent, thereby generating similar ratios of Aβ1–42/ Aβ1–40 across the APOE genotypes. The results from the present study suggested that Aβ1–42 in CSF functions as a biomarker of AD in tandem with other CSF matrix components that are increased in AD CSF. Further studies are needed to identify which matrix factors (e.g. binding of Aβ to proteins) underlie the increased detection of Aβ1–42 concentrations after denaturation and HPLC. The data also suggested that denaturation and HPLC of CSF may be a useful approach for studies using Aβ1–42 as a pharmacodynamic marker or in other paradigms where measurement of total non‐covalently bound Aβ1–42 is required.
Measurements of wound edge microvascular blood flow during negative pressure wound therapy using thermodiffusion and transcutaneous and invasive laser Doppler velocimetry
Authors: Borgquist Ola , Anesäter Erik , Hedström Erik , Lee Charles K. , Ingemansson Richard , Malmsjö Malin
Published: October 2011

The effects of negative pressure wound therapy (NPWT) on wound edge microvascular blood flow are not clear. The aim of the present study was therefore to further elucidate the effects of NPWT on periwound blood flow in a porcine peripheral wound model using different blood flow measurement techniques. NPWT at –20, –40, –80, and –125 mmHg was applied to a peripheral porcine wound (n = 8). Thermodiffusion, transcutaneous, and invasive laser Doppler velocimetry were used to measure the blood perfusion 0.5, 1.0, and 2.5 cm from the wound edge. Thermodiffusion (an invasive measurement technique) generally showed a decrease in perfusion close to the wound edge (0.5 cm), and an increase further from the edge (2.5 cm). Invasive laser Doppler velocimetry showed a similar response pattern, with a decrease in blood flow 0.5 cm from the wound edge and an increase further away. However, 1.0 cm from the wound edge blood flow decreased with high pressure levels and increased with low pressure levels. A different response pattern was seen with transcutaneous laser Doppler velocimetry, showing an increase in blood flow regardless of the distance from the wound edge (0.5, 1.0, and 2.5 cm). During NPWT, both increases and decreases in blood flow can be seen in the periwound tissue depending on the distance from the wound edge and the pressure level. The pattern of response depends partly on the measurement technique used. The combination of hypoperfusion and hyperperfusion caused by NPWT may accelerate wound healing.
Comparison of Different Fabrication Techniques for Human Adipose Tissue Engineering in Severe Combined Immunodeficient Mice
Authors: Frerich Bernhard , Winter Karsten , Scheller Konstanze , Braumann Ulf‐Dietrich
Published: October 2011

Adipose tissue engineering has been advocated for soft‐tissue augmentation and for the treatment of soft tissue defects. The efficacy in terms of persistence of the engineered fat is, however, not yet understood and could depend on the nature of fabrication and application. The high metabolic demand of adipose tissue also points to the problem of vascularization. Endothelial cell (EC) cotransplantation could be a solution. Human adipose tissue‐derived stromal cells were seeded on collagen microcarriers and submitted to adipogenic differentiation (“microparticles”). In a first run of experiments, these microparticles were implanted under the skin of severe combined immunodeficient (SCID) mice (n = 45) with and without the addition of human umbilical vein ECs (HUVECs). A group of carriers without any cells served as control. In a second run, adipose tissue constructs were fabricated by embedding microparticles in fibrin matrix with and without the addition of HUVEC, and were also implanted in SCID mice (n = 30). The mice were sacrificed after 12 days, 4 weeks, and 4 months. Mature adipose tissue, fibrous tissue, and acellular regions were quantified on whole‐specimen histological sections. The implantation of microparticles showed a better sustainment of tissue volume and a higher degree of mature adipose tissue compared with adipose tissue constructs. Immunohistology proved obviously perfused human tissue‐engineered vessels. There was a limited but not significant advantage in EC cotransplantation after 4 weeks in terms of tissue volume. In groups with EC cotransplantation, there were significantly fewer acellular/necrotic areas after 4 weeks and 4 months. In conclusion, the size of the implanted tissue equivalents is a crucial parameter, affecting volume maintenance and the gain of mature adipose tissue. EC cotransplantation leads to functional stable vascular networks connecting in part to the host vasculature and contributing to tissue perfusion; however, the long‐term benefit depends on additional basic conditions that need further research.
Intradiscal Pulsed Radiofrequency Application Following Provocative Discography for the Management of Degenerative Disc Disease and Concordant Pain: A Pilot Study
Authors: Rohof Olav
Published: October 2011

Abstract:  The development of diagnostic criteria and the use of provocative discography allow identifying the degenerative disc as causative structure for chronic low‐back pain. Unfortunately, none of the available interventional treatment options have been demonstrated to be effective over a prolonged period of time for a considerable number of patients.

Pathophysiological studies indicate sprouting of sensory nerves and inflammatory processes as underlying pain mechanisms.

Pulsed radiofrequency (PRF) treatment in small and larger joints was described to reduce pain and improve healing by stimulating the immunology. Earlier findings of PRF applied in the disc annulus were promising. It is assumed that PRF applied in the nucleus would change the conductivity of nerve endings and provide a clinically relevant pain reduction. The application of the electric field of PRF in the disc may also activate the immune system, thus reducing the inflammation process of chronic pain.

Pulsed radiofrequency in the nucleus was studied in 76 patients with discogenic pain confirmed by magnetic resonance imaging and provocative discography. At 3‐month follow‐up, 38% of the patients had > 50% pain reduction, at 12 month the effect is maintained in 29%. In patients with unsatisfactory pain relief 3 months after the intervention, secondary pain sources may have been revealed. The latter were treated accordingly. Of all patients, 56% had > 50% pain reduction 1 year after first treatment.

Our findings suggest that PRF in the nucleus may be considered for patients with proven discogenic pain. A randomized controlled trial to confirm our findings is justified.▪
Pain Relief in Laparoscopic Cholecystectomy—A Review of the Current Options
Authors: Mitra Sukanya , Khandelwal Purva , Roberts Kurt , Kumar Salil , Vadivelu Nalini
Published: October 2011

Abstract:  Pain relief after laparoscopic cholecystectomy (LC) is an issue of great practical importance. Pain after LC has several origins: incisional, local visceral, peritoneal, and referred. Several modalities have been employed for achieving effective and safe analgesia: nonsteroidal anti‐inflammatory drugs (NSAIDs) and cyclooxygenase‐2 (COX‐2) inhibitors, gabapentinoids, local anesthetics, and transversus abdominis plane (TAP) block. They have their advantages and disadvantages, and multimodal approaches are often followed because of the multiple sources of pain. Among COX‐2 inhibitors, parecoxib and valdecoxib are useful, and fears regarding their cardiovascular adverse effects in noncardiac surgery (such as LC) have not been substantiated when used in short term. Gabapentin is useful but more data are needed regarding pregabalin because of inconsistent results. Local anesthetics (LA) can be particularly useful, both port‐site infiltration and intraperitoneal instillation in the intra‐operative period. Factors enhancing the effectiveness of these agents include early instillation before creating the pneumoperitoneum, larger volume of medium used for instillation, and favorable pharmacological characteristics of the agent. Combination of LA with either NSAID/COX‐2 inhibitors or fibrin sealant appears to be effective, although more research is required for determining the exact combinations and efficacy using direct comparisons with single‐modality interventions. Finally, newer procedures such as TAP block appear promising if replicated.▪
Emerging indications for the levonorgestrel‐releasing intrauterine system (LNG‐IUS)
Authors: HEIKINHEIMO OSKARI , GEMZELL‐DANIELSSON KRISTINA
Published: October 2011

The levonorgestrel intrauterine system (LNG‐IUS), originally designed for long‐term contraceptive use, has been on the Scandinavian market for approximately 20 years. Novel clinical indications for the LNG‐IUS, derived mainly from investigator‐initiated studies, are emerging. These include heavy menstrual bleeding associated with uterine fibroids, endometriosis, adenomyosis, as well as endometrial hyperplasia. In both cohort and randomized studies, the LNG‐IUS is effective in decreasing heavy menstrual bleeding, also in women diagnosed with uterine fibroids. In randomized studies the LNG‐IUS has shown comparable clinical efficacy to GnRH analogues or progestins for the symptomatic treatment of endometriosis. Experience with LNG‐IUS in adenomyosis is based on prospective cohort studies. Dysmenorrhea has been reported to decrease in all women, and uterine volume was seen to diminish in some of these studies. In the treatment of endometrial hyperplasias, including atypical hyperplasia, the LNG‐IUS is equal or superior to treatment with systemic progestins. Further studies are needed to examine the full potential of the LNG‐IUS in such common clinical situations.
Periodontal disease: a new factor associated with the presence of multiple complex coronary lesions
Authors: Romagna Christine , Dufour Laurie , Troisgros Odile , Lorgis Luc , Richard Carole , Buffet Philippe , Soulat Gilles , Casillas Jean Marie , Rioufol Gilles , Touzery Claude , Zeller Marianne , Laurent Yves , Cottin Yves
Published: October 2011

Background and Aim

Periodontal disease, including bone loss, is thought to be involved in coronary artery disease. Multiple complex coronary lesions relate to multifocal destabilization of coronary plaques. We investigated whether bone loss could be associated with the presence of multiple complex coronary lesions.

Methods

This cross‐sectional study included 150 patients with recent myocardial infarction (<1 month). Multiple complex coronary lesions were determined at coronary angiography. A panoramic dental X‐ray including bone loss >50% was performed. Patients with no or simple complex lesions were compared to patients with multiple complex lesions.

Results

Over 20% of patients had multiple complex coronary lesions. Patients with multiple complex lesion were less likely to be women and more likely to have multivessel disease or elevated C‐reactive protein (CRP) than patients with no or single complex lesion. Bone loss >50% tended to be more frequent in patients with multiple complex lesions (p = 0.063). In multivariate analysis, multivessel disease, gender and CRP were associated with multiple complex lesion. Bone loss >50% increased the risk of multiple complex lesion.

Conclusion

Bone loss was associated with complex multiple coronary lesions, beyond systemic inflammation. These findings may bear important clinical implications for the prevention and treatment of coronary artery disease.
Ankylosis of temporomandibular joint after the traumatic brain injury: a report of two cases
Authors: Meng Qinggong , Li Bo , Long Xing , Li Jian , Yan Quanmei
Published: October 2011

Abstract –  Mouth opening limitation after the neurosurgical procedures is a common complication and usually resolves within 3 months. If limited mouth opening remains unresolved on the long term, an intra‐articular ankylosis of temporomandibular joint may develop eventually. The possible mechanisms base on the myositis and atrophy of the masticatory muscles for these craniotomies are often involved in the temporalis. This article reports two unusual cases with the intra‐articular ankylosis of temporomandibular joint after the traumatic brain injury, who received a modified surgical treatment for joint ankylosis. Therefore, the early diagnosis and intervention are important to minimize these complications.
A simple assay to study social behavior inDrosophila: measurement of social space within a group1
Authors: Simon A. F. , Chou M.‐T. , Salazar E. D. , Nicholson T. , Saini N. , Metchev S. , Krantz D. E.
Published: October 2011

We have established a new simple behavioral paradigm inDrosophila melanogasterto determine how genes and the environment influence the behavior of flies within a social group. Specifically, we measure social space as the distance between two flies. The majority of Canton‐s flies, regardless of their gender, are within two body lengths from each other. Their social experience affects this behavior, with social isolation reducing and mating enhancing social space respectively, in both males and females. Unlike several other social behaviors in the fly, including the formation of social groups themselves (a well‐described behavior), social space does not require the perception of the previously identified aggregation pheromonecis‐vaccenyl acetate. Conversely, performance of the assay in darkness or mutations in the eye pigmentation genewhiteincreased social space. Our results establish a new assay for the genetic dissection of a fundamental mode of social interaction.
Neurodegeneration of Drosophila drop‐dead mutants is associated with hypoxia in the brain
Authors: Kim J. Y. , Jang W. , Lee H. W. , Park E. , Kim C.
Published: October 2011

The Drosophila drop‐dead (drd) mutant undergoes massive brain degeneration, resulting in sudden death. drd encodes a multi‐pass membrane protein possessing nose resistant to fluoxetine (NRF) and putative acyltransferase domains. However, the etiology of brain degeneration that occurs in drd mutant flies is still poorly understood. Herein, we show that drd neurodegeneration may be because of an oxygen deficit in the brain. We found that DRD protein is selectively expressed in cells secreting cuticular and eggshell layers. These layers exhibit blue fluorescence upon UV excitation, which is reduced in drd flies. The drd tracheal air sacs lacking blue fluorescence collapse, which likely contributes to hypoxia. Consistently, genes induced in hypoxia are up‐regulated in drd flies. Feeding of anti‐reactive oxygen species agents partially rescue the drd from sudden death. We propose that drd flies can provide a non‐invasive animal model for hypoxia‐induced cell death.
Ultrasensitive Measurements of Microbial Rhodopsin Photocycles Using Photochromic FRET
Authors: Bayraktar Halil , Fields Alexander P. , Kralj Joel M. , Spudich John L. , Rothschild Kenneth J. , Cohen Adam E.
Published: October 2011

Microbial rhodopsins are an important class of light‐activated transmembrane proteins whose function is typically studied on bulk samples. Herein, we apply photochromic fluorescence resonance energy transfer to investigate the dynamics of these proteins with sensitivity approaching the single‐molecule limit. The brightness of a covalently linked organic fluorophore is modulated by changes in the absorption spectrum of the endogenous retinal chromophore that occur as the molecule undergoes a light‐activated photocycle. We studied the photocycles of blue‐absorbing proteorhodopsin and sensory rhodopsin II (SRII). Clusters of 2–3 molecules of SRII clearly showed a light‐induced photocycle. Single molecules of SRII showed a photocycle upon signal averaging over several illumination cycles.
Phlorotannin and Antioxidant Responses Upon Short‐term Exposure to UV Radiation and Elevated Temperature in Three South Pacific Kelps
Authors: Cruces Edgardo , Huovinen Pirjo , Gómez Iván
Published: October 2011

Rapid adjustments of the photosynthetic machinery and efficient antioxidant mechanisms to scavenge harmful ROS are physiologic adaptions exhibited by intertidal seaweeds to persist in temperate regions. This study examines short‐term (3 h) responses of three large kelps from the cold‐temperate coast of Chile, normally adapted to water temperatures <16°C, but exposed abruptly to simultaneous high temperatures and UV radiation during low tide in summer. The kelps were exposed in the laboratory to three temperatures (10, 20 and 28°C) with and without UV radiation, and photochemical reactions, concentration of phlorotannins and antioxidant activity were examined. The exposure to elevated temperature (slightly exacerbated by the presence of UV radiation) decreased photochemical processes (measured as fluorescence kinetics) in the three studied species and increased lipid peroxidation in two of them. The concentration of total soluble phlorotannins was variable and correlated with the antioxidant activity in the presence of UV radiation. Insoluble phlorotannins did not change during the exposure. In all, the downregulation of the photochemical machinery, which was expressed as dynamic photoinhibition, and the rapid induction of soluble phlorotannins triggered by UV radiation minimized the effects of oxidative stress and maintained the operation of photochemical processes during short‐term thermal stress.
Predictors of 1‐year visual outcome in neovascular age‐related macular degeneration following intravitreal ranibizumab treatment
Authors: Bloch Sara B. , la Cour Morten , Sander Birgit , Hansen Louise K. H. , Fuchs Josefine , Lund‐Andersen Henrik , Larsen Michael
Published: October 2011

Purpose:  To describe predictors of visual outcome in patients treated with intravitreal ranibizumab for choroidal neovascularisation (CNV) in age‐related macular degeneration (AMD).

Methods:  Retrospective review of 279 patients with CNV in AMD who fulfilled MARINA/ANCHOR study eligibility criteria and were treated with repeated intravitreal injections of ranibizumab 0.5 mg in routine clinical practice, beginning with three initial injections at 4‐week intervals followed by individualized retreatment for the subsequent 9 months. Study parameters included best‐corrected visual acuity (BCVA) and morphological characteristics.

Results:  Mean BCVA relative to baseline was +4.7 (p < 0.0001), +4.2 (p < 0.0001)and −0.4 (p > 0.667) Early Treatment Diabetic Retinopathy Study letters after 3, 6 and 12 months, respectively, after a mean of 5.1 injections when the proportion of patients with BCVA ≥70 letters had doubled compared with baseline. Predictive factors for BCVA ≤35 letters after 12 months were BCVA ≤35 letters at baseline and month 3 (p < 0.0001) while BCVA ≥70 letters at month 12 was associated with BCVA ≥70 letters at baseline and month 3 (p < 0.001) and with total lesion size <4 DA (p = 0.0147).

Conclusion:  Under a ranibizumab regimen with substantially fewer injections than with fixed four‐weekly injection regimens, BCVA was improved compared with the natural history of neovascular AMD, but did not achieve the visual gain observed in randomized clinical trials using fixed 4‐week retreatment. Visual acuity at month 3, after the initial fixed‐interval injections, was the strongest predictor of BCVA at month 12.
Glaucoma management in Sweden – results from a nationwide survey
Authors: Lindén Christina , Bengtsson Boel , Alm Albert , Calissendorff Berit , Eckerlund Ingemar , Heijl Anders
Published: October 2011

Purpose:  To report the results from a nationwide survey on glaucoma management in Sweden, performed as a part of an Open Angle Glaucoma project conducted by the Swedish Council on Health Technology Assessment 2004–2008.

Methods:  In 2005, a survey was distributed to all providers of glaucoma care in Sweden: public eye departments, public outpatient departments and private practices. The questionnaire included questions on number of examined patients, types of examinations during one defined week, internal organization and access to diagnostic equipment. The questionnaire was endorsed by the Swedish Ophthalmological Society. Reminders were sent out to nonresponders.

Results:  Response rate was high; 97% (33/34) of eye departments, 85% (39/46) of outpatient departments and 55% (69/125) of private practices. Out of 29 282 visits in ophthalmic care during the study week, 7737 (26%) were related to glaucoma. Diagnostic equipment was generally available; all public eye facilities and 92% of private practices had at least one computerized perimeter, while equipment for fundus photography/imaging was available at 100% of eye departments, 82% of outpatient departments and 62% of private practices. The number of visual field tests and fundus images was rather low. Survey results indicate that patients on the average underwent bilateral field testing every 2nd year and fundus imaging every 8th year.

Conclusion:  Glaucoma care generated about a quarter of all patient visits in Swedish ophthalmic care. Access to diagnostic facilities was good. To meet modern standards of glaucoma care, glaucoma damage must be measured and followed more closely than at the time of the survey.
Complete remission and fatal interstitial pneumonitis related to nab‐paclitaxel in refractory small cell lung cancer: A case report and review of the literature
Authors: Wang Binchao , Yang Jinji , Luo Donglan , Qiao Huixian , Xie Zhi , Zhang Xuchao , Wu Yilong
Published: October 2011

For refractory or resistant small cell lung cancer (SCLC), there is no standard treatment. We report a case of refractory SCLC achieving complete remission and then developing fatal interstitial pneumonitis after treatment with single‐agent nab‐paclitaxel. The relevant literature has also been reviewed. In terms of effectiveness, evidences exists that some refractory or resistant SCLC patients respond to paclitaxel, including nab‐paclitaxel and solvent‐based paclitaxel. Paclitaxel‐related fatal interstitial pneumonitis is an uncommon event, with five fatal cases reported in the literature. It appears to occur in weekly paclitaxel‐treated patients and develop during the middle‐to‐late phase of treatment. Therefore, further randomized clinical trials should be encouraged. In our case, positive immunohistochemical analysis for caveolin‐1 in the tumor vascular endothelia suggests that the complete response may have been facilitated by enhanced transportation of paclitaxel through the tumor vascular barrier via caveolin‐1, despite being negative for secreted protein acidic and rich in cysteine (SPARC) in tumor cells. Further molecular investigations of gp60, caveolin‐1 and SPARC will shed light on tailored treatment in this setting.