bluuebunny/crossref_metadata_2025 huggingface dataset:
ALTERATION OF FEXOFENADINE DISPOSITION IN THE RAT ISOLATED PERFUSED LIVER FOLLOWING INJECTION OF BACTERIAL LIPOPOLYSACCHARIDE
Authors: Tong Yen , Zhang Ruhong , Ngo Suong NT , Davey Andrew K
Published: September 2010

The aim of the present study was to examine the effect of bacterial lipopolysaccharide (LPS) on the disposition of an organic anion transporting polypeptide and P‐glycoprotein substrate in the rat isolated perfused liver.

Male Sprague‐Dawley rats were divided into four groups. Three of the groups received 1, 2.5 or 5 mg/kg, i.p., Escherichia coli LPS in sterile saline. The fourth group received an equivalent volume of sterile saline i.p. Twenty‐four hours after treatment, rats were anaesthetized and the liver isolated and perfused with fexofenadine at an initial concentration of 2000 ng/mL in a recirculating system. Perfusate and bile samples were collected for 60 min and the liver was collected at the end of the perfusion. Fexofenadine concentrations were determined by HPLC. Fexofenadine pharmacokinetic parameters, the final liver : perfusate (L : P) and bile : liver (B : L) concentration ratios were determined.

Injection of LPS changed the hepatic disposition of fexofenadine. The changes were most marked in the 5 mg/kg LPS group. Notably, clearance from the perfusate (CL) and into the bile (CLB; 5.9 ± 0.6 and 1.24 ± 0.20 mL/min, respectively), L : P (44 ± 11) and B : L (17 ± 2) were all reduced (P < 0.05) in this group compared with control (CL 10.0 ± 1.1 mL/min; CLB 2.7 ± 0.5 mL/min; L : P 87 ± 14; and B : L 30 ± 4).

In conclusion CL and CLB were reduced following treatment with LPS in a manner consistent with downregulation of both canalicular and sinusoidal transport.
UPREGULATION OF ANGIOTENSIN AT1 RECEPTOR AND INTRACELLULAR KINASE GENE EXPRESSION IN HYPERTENSIVE RATS
Authors: Reja Valin , Goodchild Ann K , Phillips Jacqueline K , Pilowsky Paul M
Published: September 2010

Activation of angiotensin II AT1 receptors (AT1R) stimulates catecholamine systems within both central and peripheral tissues that are associated with blood pressure control. In the present study, we sought to determine whether the hypertensive phenotype of the spontaneously hypertensive rat (SHR) is associated with changes in AT1R gene expression and whether gene expression of downstream signalling molecules was coupled to catecholamine gene expression, both in key brainstem nuclei and in peripheral sites implicated in cardiovascular control.

Gene expression levels of AT1R, extracellular signal‐regulated kinase (ERK) 1 and 2 and phosphatidylinositol 3‐kinase (PI3‐K) were quantified in Wistar‐Kyoto (WKY) rats and SHR. Messenger RNA expression levels were quantified using real time reverse transcription–polymerase chain reaction. In addition, we investigated whether there was a relationship between gene expression and systolic blood pressure.

The gene expression levels of AT1R, ERK2 and PI3‐K were significantly higher in the paraventricular nucleus of the hypothalamus (4.12‐, 1.40‐ and 1.38‐fold, respectively), rostral ventrolateral medulla (2.71‐, 1.33‐ and 2.73‐fold, respectively), spinal cord (30.5‐, 2.72‐ and 1.53‐fold, respectively), adrenal medulla (1.68‐, 1.55‐ and 1.76‐fold, respectively) and coeliac ganglion (1.39‐, 1.35‐ and 1.12‐fold, respectively) in SHR compared with WKY rats. There was no significant difference in the level of ERK1 gene expression between the two strains. The gene expression levels of AT1R and ERK2 were positively correlated with blood pressure in all central nervous tissues investigated in the SHR, but not in WKY rats. Gene expression levels of the AT1R in the coeliac ganglion and adrenal medulla were also positively correlated with increased systolic blood pressure.

The present data suggest that a defect in AT1R expression (that may further alter downstream signalling pathways) in the SHR may be responsible, at least in part, for the hypertensive phenotype.
HIGH‐FAT FEEDING REDUCES ENDOTHELIUM‐DEPENDENT VASODILATION IN RATS: DIFFERENTIAL MECHANISMS FOR SATURATED AND UNSATURATED FATTY ACIDS?
Authors: Song Guang‐Yao , Gao Yu , Di Yu‐Wei , Pan Li‐Li , Zhou Yu , Ye Ji‐Ming
Published: September 2010

Chronic feeding with a high‐fat diet can cause metabolic syndrome in rodents similar to humans, but the role of saturated versus unsaturated fats in vascular tension remains unclear.

The present study shows that rats on a diet rich in either saturated or unsaturated fat had higher blood pressure compared with chow‐fed rats (approximately 130 vs 100 mmHg, respectively), along with hyperlipidaemia and insulin resistance. Compared with responses of phenylephrine‐preconstricted artery segments from chow‐fed rats, vasorelaxation of isolated renal arteries from high‐fat fed rats was reduced substantially (> 50%) in response to acetylcholine (0.01–10 µmol/L) and moderately to nitroprusside ( 1 µmol/L) at low concentrations. Acetylcholine‐induced vasorelaxation of arteries from high‐fat fed rats was also more sensitive to inhibition by the nitric oxide (NO) synthase inhibitors NG‐nitro‐l‐arginine and methylene blue.

In human umbilical vein endothelial cells, the production of NO and endothelin‐1 was significantly inhibited by unsaturated fatty acids. In comparison, saturated fatty acids stimulated endothelin‐1 production without altering NO production.

The data indicate that both saturated and unsaturated high‐fat feeding may result in an increase in blood pressure owing to reduced endothelium‐dependent vasorelaxation in the arterial system. The impaired endothelium‐dependent vasorelaxation induced by saturated and unsaturated fatty acids may involve different mechanisms.
MECHANISMS UNDERLYING NEBIVOLOL‐INDUCED ENDOTHELIAL NITRIC OXIDE SYNTHASE ACTIVATION IN HUMAN UMBILICAL VEIN ENDOTHELIAL CELLS
Authors: Ladage Dennis , Brixius Klara , Hoyer Heike , Steingen Caroline , Wesseling Andreas , Malan Daniela , Bloch Wilhelm , Schwinger Robert HG
Published: September 2010

Nebivolol (NEB) has been shown to be a selective blocker of β1‐adrenoceptors with additional vasodilating properties that are mediated, at least in part, by an endothelial‐dependent liberation of nitric oxide (NO). In the present study, we investigated the underlying mechanisms of NEB‐induced vasodilation.

Immunohistochemical staining of endothelial nitric oxide synthase (eNOS) was performed in the absence and presence of NEB in human umbilical vein endothelial cells (HUVEC). In addition, we measured the release of nitric oxide (NO) using diaminofluorescein. Metoprolol (MET) was used for comparison.

Nebivolol, but not MET (each at 10 µmol/L), caused a time‐dependent increase in NO release from HUVEC, as demonstrated by an increase in DAF fluorescence at 0 versus 10 min (+234 ± 7 and 55 ± 22% basal, respectively). Blockade of β3‐adrenoceptors by SR 59230A (1 µmol/L) partially reduced the NEB‐induced increase in DAF fluorescence. Complete inhibition of NEB‐induced NO liberation was achieved by the simultaneous blockade of β3‐adrenoceptors and oestrogen receptors (with 1 µmol/L ICI 182,780).

Application of NEB significantly increased eNOS translocation and serine 1177 phosphorylation of eNOS. However, NEB did not alter eNOS‐phosphorylation at threonine 495 and at serine 114.

In conclusion, the endothelium‐dependent NO liberation induced by NEB is due to stimulation of β3‐adrenoceptors and oestrogen receptors and coincides with eNOS translocation and a phosphorylation at eNOS‐serine 1177. These characteristics of NEB may be beneficial not only when treating patients suffering from cardiovascular disease, but may also prevent further deterioration of endothelial dysfunction.
GROWTH INHIBITION OF MESENCHYMAL STEM CELLS BY ASPIRIN: INVOLVEMENT OF THE WNT/β‐CATENIN SIGNAL PATHWAY
Authors: Wang Yiner , Chen Xi , Zhu Weiquan , Zhang Hao , Hu Shengshou , Cong Xiangfeng
Published: September 2010

Mesenchymal stem cell (MSC) therapy is drawing increasing attention in cardiology. However, the effect of aspirin, an assistant medication used extensively in the treatment of cardiovascular diseases, on MSC is not clear.

In the present study, we investigated the effect of aspirin on the growth of MSC in vitro and the underlying mechanism of its action.

The 3‐(4,5‐dimethyl‐2 thiazoyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide (MTT) assay revealed that 1, 5 and 10 mmol/L aspirin inhibited the growth of MSC by 18, 37 and 62%, respectively. DNA synthesis of MSC was inhibited by 25, 57 and 90% followoing treatment with 1, 5 and 10 mmol/L aspirin, respectively, as determined by the tritiated thymidine incorporation assay. No cytotoxicity was observed based on Trypan blue dye exclusion and cell morphological observations. Western blot analysis demonstrated that the protein level of phosphorylated β‐catenin increased, whereas that of cyclin D1 decreased, after treatment of MSC with aspirin. Cell cycle analysis showed that aspirin failed to significantly alter the proportion of cells in different stages of the cell cycle.

These observations indicate that aspirin inhibits MSC proliferation and that the downregulation of the wnt/β‐catenin signal pathway may be involved in the growth inhibition of MSC by aspirin.
DO WE TREAT OUR HEAD INJURY PATIENT BETTER THAN THE PAST? A CLINICAL RETROSPECTIVE SURVEY OF HEAD INJURY PATIENT IN 1999 TO 2000
Authors: Man Hung Wai , Fong Dawson
Published: September 2010

The article will collect about 1600 head injury patients of all severity in Tuen Mun Hospital for the period from January 1999 to June 2000. The mechanism, severity, diagnosis and treatment, as well as outcome, of each patient will be studied and entered in our database. Thorough analysis will be carried out to obtain our local statistical results. Furthermore, we would like to compare our result with the past, especially before the era of CT scan. It will enable us to evaluate whether technology advancement does improve the outcome of head injury patients.
Inverse expression of estrogen receptor‐β and nuclear factor‐κB in urinary bladder carcinogenesis
Authors: Kontos Stylianos , Kominea Athina , Melachrinou Maria , Balampani Eleni , Sotiropoulou‐Bonikou Georgia
Published: September 2010

Objectives:  To investigate the expression of nuclear factor‐κB (NF‐κB) and estrogen receptor‐β (ER‐β) signalling pathways in bladder urothelial carcinoma according to clinicopathological features, in order to elucidate their role during carcinogenesis.

Methods:  Immunohistochemical methodology was carried out on formalin‐fixed, paraffin‐embedded sections from urinary bladder carcinomas of 140 patients (94 males and 46 females) who underwent transurethral resection of bladder neoplasms. Correlations between ER‐β and NF‐κB, and tumor grade and T‐stage were evaluated, along with demographic data, sex and age.

Results:  A significant decrease in ER‐β expression in the nucleus of bladder cells during loss of cell differentiation (rs = −0.61, P‐value < 0.001, test of trend P‐value = 0.003) and in muscle invasive carcinomas (T2–T4; test of trend P‐value < 0.001) was found. p65 Subunit of NF‐κB was expressed in the nucleus and in the cytoplasm of bladder epithelial cells. A strong positive association between tumor grade and nuclear expression of NF‐κB was shown. No correlation between NF‐κB, nuclear or cytoplasmic staining, with T‐stage was observed. An inverse correlation between ER‐β and nuclear p65 immunoreactivity was observed (rs = −0.45, P‐value < 0.001). There was no correlation with demographic data.

Conclusions:  Our immunohistochemical study suggests the possible inverse regulation of NF‐κB and ER‐β transcription factor during bladder carcinogenesis. Selective ER‐β agonists and agents, inhibitors of NF‐κB, might represent a possible new treatment strategy for bladder urothelial tumors.
Bilateral exudative retinal detachment as the first sign of relapsing acute myelogenous leukaemia
Authors: Wu Lihteh , Calderón Marcos , Hernández Gerardo , Marbis José , Ramírez Víctor
Published: September 2010

Abstract

Bilateral exudative retinal detachment is rarely seen as an ocular manifestation of acute myelogenous leukaemia. Herein, a case is described where a trans‐scleral choroidal biopsy was used to diagnose relapsing acute myelogenous leukaemia when the rest of her systemic work‐up was negative.
Sensitivity and specificity of Heidelberg Retinal Tomography II parameters in detecting early and moderate glaucomatous damage: effect of disc size
Authors: Uysal Yusuf , Bayer Atilla , Erdurman Cüneyt , Kiliç Selim
Published: September 2010

Abstract

Purpose:  To determine the efficacy of Heidelberg Retinal Tomography II (HRTII) parameters in differentiating normal eyes from eyes with early or moderate glaucomatous damage.

Methods:  HRTII tests were performed on 70 eyes of 70 patients with early or moderate glaucomatous damage, and 70 eyes of 70 healthy subjects. HRTII stereometric parameters, global and sectorial rim area parameters were recorded. Sensitivity and specificity of each parameter were calculated. Cases were divided into three groups according to disc size as large, medium and small, and mean values of parameters in glaucoma and control groups were compared.

Results:  Mean disc area was larger in the glaucoma group (P < 0.05). There was a significant difference between the two groups for all stereometric parameters, except height variation contour, mean retinal nerve fibre layer thickness and retinal nerve fibre layer cross‐sectional area stereometric parameters. There was also a significant difference between the groups for global, temporal, superior temporal and inferior temporal rim area parameters. In small discs, however, this difference disappeared in all parameters except temporal rim area and superior temporal rim area sectorial parameters. When all the cases were included, the quartet parameters having the highest specificity (80%) and sensitivity (74.3%) were cup volume, rim volume, cup shape measure and height variation contour parameters.

Conclusion:  Some HRTII parameters have better sensitivity and specificity than the others. It is necessary to pay special attention in evaluating small discs.
Photodynamic treatment of a secondary vasoproliferative tumour associated with sector retinitis pigmentosa and Usher syndrome type I
Authors: Osman Saatci A , Aylin Yaman , Gul Arıkan , Celikel Harika
Published: September 2010

Abstract

Vasoproliferative tumours may be primary or secondary and present with severe exudation leading to marked visual loss. We describe a 47‐year‐old man with unilateral secondary vasoproliferative tumour associated with sector retinitis pigmentosa and Usher I syndrome who was successfully treated with a single session of photodynamic treatment. Standard treatment protocol was used except that the treatment duration was doubled. A year after the treatment, the angioma‐like tumour vanished and exudation was dramatically reduced. Photodynamic therapy seems to be a minimally invasive and safe technique in eyes with secondary vasoproliferative tumours.
Phaco‐microtrabeculectomy: technique and intraocular pressure control in comparison with microtrabeculectomy
Authors: Rotchford Alan P , Vernon Stephen A
Published: September 2010

Abstract

Purpose:  To describe a modified technique for combined cataract and glaucoma drainage surgery involving a small flap (micro) trabeculectomy combined with phaco‐emulsification (PMT). To assess the level of intraocular pressure (IOP) control achieved by this procedure in comparison with microtrabeculectomy (MT) alone.

Methods:  In this retrospective controlled case series records were reviewed for 37 consecutive low‐risk patients undergoing PMT augmented with 5‐fluorouracil (5‐FU) and 37 low‐risk subjects undergoing MT with 5‐FU. IOP control was compared by survival analysis using IOP targets ≤21 mmHg and ≤16 mmHg at final follow up and with at least a 25% reduction from the preoperative pressure.

Results:  Mean follow up was 41.7 months (range 19.0–72.0) in the PMT group and 43.5 months (range 18.0–66.0) in the MT group. A final IOP ≤ 21 mmHg and with at least a 25% reduction from the preoperative pressure was achieved in 91.9% patients undergoing PMT (70.3% on no glaucoma drops). IOP <= 16 mmHg and with at least a 25% reduction from the preoperative pressure was achieved in 67.6% (56.8% without drops). There were no significant differences in survival rates between PMT and MT for either IOP target. The mean final IOPs were 13.4 and 13.5 mmHg on a mean of 0.6 and 0.8 glaucoma drops in the PMT and MT groups, respectively. In the PMT final visual acuity improved by at least one Snellen line in 81.1% and was worse in a single eye.

Conclusions:  IOP control following combined surgery by PMT is as good as following MT alone.
Detection of staphylococcus species by polymerase chain reaction in late‐onset endophthalmitis after cataract surgery and posterior capsulotomy
Authors: Mochizuki Kiyofumi , Murase Hiroki , Sawada Akira , Suzuki Takashi
Published: September 2010

Abstract

We report a case of late‐onset endophthalmitis that developed 5 years after an uneventful phacoemulsification with implantation of a posterior chamber intraocular lens. Posterior capsulotomy was performed with by Nd:YAG laser 1 month after the cataract surgery. Polymerase chain reaction with agarose gel electrophoresis identified a Staphylococcus species in a sample from the aqueous humour. The endophthalmitis was responsive to medical therapy including antibiotic agents, and it resolved without any surgical intervention.
Early electroretinographic features of streptozotocin‐induced diabetic retinopathy
Authors: Shinoda Kei , Rejdak Robert , Schuettauf Frank , Blatsios Georgios , Völker Michael , Tanimoto Naoyuki , Olcay Tatar , Gekeler Florian , Lehaci Cristina , Naskar Rita , Zagorski Zbigniew , Zrenner Eberhart
Published: September 2010

Abstract

Background:  This study set out to document the early electrophysiological and immunohistochemical changes that occur in the retina of experimentally induced diabetic rats.

Methods:  Diabetes was induced in rats by intraperitoneal injection of 60 mg/kg of streptozotocin (STZ). Electroretinogram readings were taken monthly under either short‐duration or long‐duration stimuli for up to 3 months after STZ. Oscillatory potentials (OP) and the amplitudes and implicit times of a‐ and b‐waves were analysed, and b‐wave amplitudes were analysed using a Naka–Rushton fit. Scotopic a‐waves were analysed with photoreceptor models, and Rmp3 (the maximum a‐wave amplitude) and S (sensitivity) were calculated. Three months after STZ injection, immunohistochemistry for glial fibrillary acidic protein was performed on the retinas of the STZ‐treated rats and age‐matched controls.

Results:  The implicit OP times were significantly longer in the diabetic rats as compared with the controls, and this difference was noted as early as 1 month following STZ treatment. Other electrophysiological parameters, such as OP amplitudes, a‐ and b‐wave amplitude as well as the implicit times, did not differ from controls at this stage. The sacrificed STZ‐treated rats also demonstrated marked enhancement of glial fibrillary acidic protein immunoreactivity, suggesting that at least in experimentally induced diabetic retinopathy there is increased Müller cell reactivity.

Conclusion:  The results of this study indicated that functional alterations in the retina develop rapidly after the onset of diabetes. Analysis of each electroretinogram component may be useful in further investigating the development mechanisms of diabetic retinopathy.
Favourable response to infliximab in a case of bilateral refractory Mooren's ulcer
Authors: Fontana Luigi , Parente Gabriella , Neri Piergiorgio , Reta Massimo , Tassinari Giorgio
Published: September 2010

Abstract

A woman with progressive bilateral Mooren's ulcer developed recurrent corneal perforations and melting requiring tectonic grafts, despite conventional immunosuppressant therapy. Following treatment with infliximab, an anti‐tumour necrosis factor agent, the patient showed marked reduction in conjunctival inflammation and no further recurrence of corneal thinning and perforation during 2‐year follow up on maintaining treatment.
How significant is a family history of glaucoma? Experience from the Glaucoma Inheritance Study in Tasmania
Authors: Green Catherine M , Kearns Lisa S , Wu Johnny , Barbour Julie M , Wilkinson Robyn M , Ring Maree A , Craig Jamie E , Wong Tiffany L , Hewitt Alex W , Mackey David A
Published: September 2010

Abstract

Purpose:  To determine what proportion of primary open angle glaucoma (POAG) in Tasmania, Australia is familial.

Methods:  Between 1994 and 1996 an audit of Tasmanian patients diagnosed with glaucoma was performed. Identified probands along with their family members were invited to participate. Family history of POAG was noted and pedigrees constructed. Each participant underwent a detailed examination, including visual acuity, intraocular pressure measurement, gonioscopy, optic disc assessment and visual field testing. Participants were classified as normal, suspect or POAG. Data from 467 participants in the Twins Eye Study in Tasmania (TEST) were used as a reference for the general population.

Results:  Of 2062 participants examined, 1700 were classified as POAG. A total of 1014 participants (59.6%) belonged to families in which other members were affected (familial glaucoma). Six hundred and fifty‐six of these 1014 familial cases (64.8%) had a first‐degree relative affected. The number of affected members in the family groups varied from two to 29. Six hundred and eighty‐eight participants had no known family history of POAG (sporadic glaucoma). There were significantly more POAG patients with a family history of POAG compared to the TEST population (χ2 = 161.81, P < 0.0001), and for a person with POAG the odds ratio of having a positive family history was 4.1 (95% confidence interval: 3.2–5.2).

Conclusion:  Approximately 60% of POAG in Tasmania is familial. This percentage is higher than most previous reports of familial glaucoma and emphasizes the importance of genetics in POAG, with major implications for screening and future research.
Clinical Case Notes
Authors: Sugisaka Eiko , Ohde Hisao , Shinoda Kei , Mashima Yukihiko
Published: September 2010

Abstract

We describe a patient with Leber's hereditary optic neuropathy (LHON) who had a unilateral involvement and a gradual recovery of vision. A 50‐year‐old woman was referred to our clinic in December 2004 for the treatment of left optic neuritis. The visual acuity was 0.01 in her left eye and 1.5 in her right eye. The left eye had a central scotoma and a relative afferent pupillary defect. Ophthalmoscopy revealed a hyperaemic optic disc with indistinct margins in the left eye. Fluorescein angiography showed circumpapillary microangiopathy in both eyes and staining of the left optic disc. An nt 11778 mutation was identified and she was diagnosed with LHON. The central scotoma gradually improved, and the visual acuity had recovered to 0.3 in August 2007. LHON should still be considered even in older female patients presenting with unilateral acute visual loss when microangiopathy is seen. In such cases, molecular testing is effective in confirming a diagnosis of LHON.
Photographic Essays
Authors: Roydhouse Trent C , Roydhouse J Doug
Published: September 2010

Abstract

Retinal pigment epithelial tears are most commonly found in the context of aged related macular degeneration with associated choroidal neovascular membrane or retinal pigment epithelial atrophy. We report a case of spontaneous giant pigment epithelial tear in a patient with only relevant history of head trauma many years prior to presentation.
Differentiation of rat mesenchymal stem cells transplanted into the subretinal space of sodium iodate‐injected rats
Authors: Gong Lihua , Wu Qiang , Song Beiwen , Lu Bin , Zhang Yi
Published: September 2010

Abstract

Purpose:  The differentiation of rat bone marrow mesenchymal stem cells (MSCs) was investigated in a retinal pigment epithelium (RPE) damage model induced by the administration of sodium iodate.

Methods:  Cultured rat MSCs were transfected with enhanced green fluorescent protein and transplanted into the subretinal space of rats injected 4 days earlier with sodium iodate. Immunofluorescence analysis was performed 5 weeks later.

Results:  The transduction efficiency was 99.9%. Viable MSCs were detected 5 weeks after transplantation, mainly in the subretinal space. The cells expressed pan‐cytokeratin, glial fibrillary acidic protein and rhodopsin.

Conclusions:  Bone marrow MSCs transplanted into the subretinal space of sodium iodate‐injected rats have the ability to differentiate into RPE, photoreceptor and glial lineage cells.
Immunohistochemistry in diagnostic ophthalmic pathology: a review
Authors: Eagle Jr Ralph C
Published: September 2010

Abstract

Immunohistochemistry (IHC) is a powerful laboratory technique that employs antibodies to identify cellular components. IHC has revolutionized histopathological diagnosis in the past several decades. This review of IHC in diagnostic ophthalmic pathology will concentrate on common lesions and diagnostic scenarios that frequently are evaluated by IHC in a busy ophthalmic pathology laboratory. Antibodies and markers that are used in the evaluation of ophthalmic lesions will be emphasized.
Intracorneal ring segments in ectatic corneal disease – a review
Authors: Piñero David P , Alio Jorge L
Published: September 2010

Abstract

The purpose of this review is to collect and summarize all the scientific literature regarding the use of intracorneal ring segments (ICRS) in corneal ectatic disease. These implants, initially designed to correct myopia in normal eyes, are implanted in the deep corneal stroma with the aim of achieving modifications to the corneal curvature and subsequently refractive adjustments. Colin et al. in 2000 were the first to report the efficacy of these implants in reducing the refractive error and corneal steepening in keratoconus eyes. Two main types of ICRS have been developed and used for the treatment of ectatic corneal disease, different in profile and diameter of implantation: Intacs and Ferrara rings. Successful outcomes have been reported by several authors with these implants in keratoconic eyes using different nomograms. Besides keratoconus, ICRS have been also used successfully for the management of pellucid marginal degeneration and post‐laser in situ keratomileusis corneal ectasia. The implantation procedure may be performed today by two surgical techniques to create the corneal channels where implants are inserted: mechanical dissection using a manual semicircular dissector (mechanical‐assisted) and photodisruption of lamellar tissue using the femtosecond laser technology (femtosecond‐assisted). With both techniques, visual, refractive and topographic improvements have been observed, although higher incidence of intraoperative and postoperative complications have been reported with the mechanical procedure according to the evidence found in the peer‐reviewed literature. ICRS technology is a promising therapeutic option in corneal ectatic disease, avoiding corneal graft and allowing a visual and refractive rehabilitation.
Laser epithelial keratomileusis in 2010 – a review
Authors: O'Keefe Michael , Kirwan Caitriona
Published: September 2010

Abstract

Photorefractive keratectomy, laser epithelial keratomileusis (LASEK) and Epi‐LASIK are all variants of a similar type refractive surgery involving laser on the surface of the cornea and differ mainly in management of the epithelium. Although laser in situ keratomileusis (LASIK) is currently the most popular form of refractive surgery, LASEK is the procedure of choice in some patients. We highlight potential complications of LASEK and how these may be managed. Following laser refractive surgery, corneal thickness is reduced, which has implications for intraocular pressure measurement and glaucoma screening and management. This is particularly important following surface laser procedures where no evidence of previous surgery may be visible. In the event that cataract surgery is required at a later date, correct calculation of the appropriate intraocular lens power can be difficult and it thus important that patients are given their preoperative keratometry readings and refraction. Compared with LASIK patients, those who undergo LASEK are considered to be at lower risk of corneal ectasia. Improved understanding of wound healing post LASEK and better postoperative pain management are ongoing challenges.
Laser in situ keratomileusis in 2010 – a review
Authors: Sutton Gerard L , Kim Peter
Published: September 2010

Abstract

Laser in situ keratomileusis has become a widely accepted and commonly performed surgical refractive procedure. With the rapid advances in laser technology and surgical techniques, the visual outcomes and safety of this procedure has significantly improved. This review outlines the historical background, recent technological advances, indications, patient assessment and selection, the surgical technique, as well as complications of the procedure and their management.
Keratoprostheses in clinical practice – a review
Authors: Gomaa Ahmed , Comyn Oliver , Liu Christopher
Published: September 2010

Abstract

The search for a substitute for the natural cornea dates back more than 200 years. Although several devices have been developed and trialled, very few have had successful long‐term results and continue in regular clinical use. Keratoprosthesis (KPro) surgery is complex and should be performed in centres with an experienced multidisciplinary team. Currently available KPro devices range from the totally synthetic, such as the Boston KPro, to the totally biological tissue‐engineered artificial cornea. The osteo‐odonto keratoprothesis combines a synthetic optic with a biological haptic. All keratoprostheses have significant limitations, although visual improvement is possible with each of the devices in clinical use today. This review discusses these devices with emphasis on their indications, surgical techniques and results, before briefly exploring emerging devices and innovative approaches for the future.
Laparoendoscopic single‐site surgery: complications and how to avoid them
Authors: Berkowitz Jared R. , Allaf Mohamad E.
Published: September 2010

INTRODUCTION

Laparoendoscopic single‐site surgery (LESS) has emerged as a natural progression from standard laparoscopy aiming to further minimize the morbidity of urological procedures. Recent advances in technology and instrumentation coupled with a mastery of laparoscopic surgery by some has led to the incorporation of LESS techniques in a variety of complex urological operations. Given the paucity of published data regarding complications, we review the collective experience as well as share our own results and observations.

METHODS

A literature search of published series on LESS was performed focusing on complications and other difficulties associated with this new technique. The experience with LESS at our institution was also evaluated for complications and means of avoiding them.

RESULTS

A few complications relating to LESS specifically are reported in the literature. These are generally related to the access site and the ability to manage situations that require added dexterity. Conversion to standard laparoscopy (or open surgery) is rare while insertion of an additional port appears to be more common.

CONCLUSIONS

LESS is an evolving platform and may have a steeper learning curve than standard laparoscopy. In experienced hands, the rates of LESS complications appear to be similar to other surgical techniques.
Experimental foundation for natural orifice transluminal endoscopic surgery and hybrid natural orifice transluminal endoscopic surgery
Authors: Lima Estevao , Rolanda Carla , Autorino Riccardo , Correia‐Pinto Jorge
Published: September 2010

Natural orifice transluminal endoscopic surgery (NOTES) is one of the most exciting concepts that has emerged recently in the surgical field. All accesses to the abdominal cavity in the porcine model using natural orifices, e.g. transgastric, transvesical, transcolonic and transvaginal, have been described and explored. The experimental feasibility of all procedures by NOTES was successfully demonstrated in the porcine model using different types of natural orifices. However, few translations to the human have been made. NOTES is in a developmental stage and much work is still needed to refine techniques, verify safety and document efficacy. This paper is an update on the experimental foundation for NOTES and hybrid NOTES and examines the opportunities presented by this new surgical vision.
Pure and hybrid natural orifice transluminal endoscopic surgery (NOTES): current clinical experience in urology
Authors: Autorino Riccardo , Haber Georges‐Pascal , White Michael A. , Khanna Rakesh , Altunrende Fatih , Yang Bo , Forest Sylvain , Stein Robert J. , Kaouk Jihad H.
Published: September 2010

An exciting era of discovery in the field of scarless urological surgery has just begun. Hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy has been reported by a few groups in the last two years. Recently, our group at the Cleveland Clinic was able to demonstrate the feasibility of a transvaginal pure NOTES nephrectomy. During this pioneering period, a critical appraisal of results and a scrupulous determination of benefits are of utmost importance. Further studies are awaited to define the actual role of NOTES in the management of urological diseases.
Robotic laparoendoscopic single‐site surgery
Authors: White Michael A. , Haber Georges‐Pascal , Autorino Riccardo , Khanna Rakesh , Altunrende Fatih , Yang Bo , Stein Robert J. , Kaouk Jihad H.
Published: September 2010

Laparoscopic surgery is frequently used in urology and the introduction of the da Vinci surgical system has served to further increase the demand for these procedures. Yet, laparoscopy is not without its drawbacks including port site complications, such as bleeding, hernia, internal organ damage and scarring. To further decrease morbidity of standard laparoscopy, newer techniques such as laparoendoscopic single‐site surgery (LESS) are currently being investigated. LESS is technically challenging and reduces instrument triangulation and robust retraction, and is associated with a steep learning curve. To help overcome current limitations we have introduced the da Vinci surgical system to LESS and report our experience with robotic laparoendoscopic single‐site surgery.
Training for laparoendoscopic single‐site surgery and natural orifice transluminal endoscopic surgery
Authors: Stroup Sean P. , Bazzi Wassim , Derweesh Ithaar H.
Published: September 2010

A combination of refinements in laparoscopic instrumentation and increasing surgical experience has driven innovation in the area of laparoendoscopic single‐site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). By combining working ports and the extraction incision into one site, LESS allows access to the peritoneum with fewer incisions and less scarring than the traditional multiport laparoscopic technique. Reduced incisional morbidity and improved cosmesis have sparked a growing interest in the utilization of these techniques to perform urological surgery. Mastering of the technique requires training and repetition to develop the muscle memory required to perform these challenging procedures. Although there has been an explosion of literature published about initial experiences with LESS and NOTES, little has been written about training and implementation of this approach. Here, we describe our institutional experience and the essential elements of a LESS and NOTES training curriculum and offer some insight into establishing a successful programme.
Revenue Mobilization in African Countries: Does Natural Resource Endowment Matter?*
Authors: Ndikumana Léonce , Abderrahim Kaouther
Published: September 2010

Abstract:  Natural resource endowment offers great opportunities for achieving high levels of growth and development, notably via fiscal revenue mobilization throughout the entire chain of operations from exploration to production to exports. In the case of African countries, however, resource‐rich countries have not yet been able to take full advantage of their resource wealth to mobilize government revenue. In fact it appears that they have often been outperformed by their resource‐scarce counterparts in this regard. Is the low revenue performance a result of distorted incentives induced by the natural resource bonanza or the lack of capacity to harness the revenue potential from the natural resource industry? This paper explores these questions and provides some empirical evidence based on data from a sample including African countries as well as countries from Latin America, Asia, and the Middle East for the period 1980–2007. The paper undertakes an econometric analysis to examine the factors that determine revenue performance in African countries from a comparative perspective, with a focus on the role of natural resource endowment. The results are consistent with the evidence from the literature, especially with regard to the role of economic structure (notably the share of agriculture in GDP), the tax base (per capita income), and trade. We compute an index of revenue performance that relates the actual revenue to the level predicted by the econometric model and we find that African resource‐rich countries have performed poorly relative to their resource‐scarce counterparts and compared to the oil‐rich Middle Eastern countries. The paper concludes with some policy implications for African countries.
The External Debt‐Servicing Constraint and Public‐Expenditure Composition in Sub‐Saharan Africa
Authors: Fosu Augustin Kwasi
Published: September 2010

Abstract:  In the light of the current global financial and economic crises, how would governments in sub‐Saharan Africa (SSA) allocate their budgets across sectors in response to a binding debt‐servicing constraint? Within a framework of public‐expenditure choice, the present paper estimates constraint‐consistent debt‐service ratios and employs them in a Seemingly Unrelated Regression involving a five‐year panel for up to 35 African countries over 1975–94, a period preceding the Highly Indebted Poor Countries (HIPC) initiatives. While observed debt service is found to be a poor predictor of expenditure allocation, constraining debt servicing shifts spending away from the social sector, with similar impacts on education and health. The implied partial elasticity of the sector's expenditure share with respect to debt is estimated at 1.5, the highest responsiveness by far among all the explanatory variables considered, including external aid. Thus, if the social sector is to be protected, sufficient debt relief for SSA countries should be pursued.
Understanding the Growth of African Financial Markets*
Authors: Andrianaivo Mihasonirina , Yartey Charles Amo
Published: September 2010

Abstract:  This paper examines empirically the determinants of financial market development in Africa with an emphasis on banking systems and stock markets. The results show that income level, creditor rights protection, financial repression, and political risk are the main determinants of banking sector development in Africa, and that stock market liquidity, domestic savings, banking sector development, and political risk are the main determinants of stock market development. We also find that liberalizing the capital account promotes financial market development only in countries with high incomes, well‐developed institutions, or both. The powerful impacts of political risk on both banking sector and stock market development suggest that resolution of political risk may be important to the development of African financial markets.
Unlocking Productive Entrepreneurship in Africa's Least Developed Countries*
Authors: Brixiova Zuzana
Published: September 2010

Abstract:  In Africa's least developed countries (LDCs), escape from poverty and convergence to living standards of more advanced economies depends critically on structural transformation and the emergence of productive entrepreneurship that would accelerate growth and job creation. So far, however, subsistence agriculture has been the main source of employment in these countries, while a dynamic private sector in industry or high value‐added services has remained elusive. Utilizing the flow approach to labor markets, this paper complements the empirical literature and numerous surveys on small and medium enterprise (SME) constraints and develops a theoretical framework that examines the main obstacles to entrepreneurship in Africa's LDCs. The paper posits that given the persistent frictions in product and labor markets as well as skill shortages that characterize these economies, development of productive entrepreneurship cannot be left to markets alone. The policy analysis suggests that the state has an important role to play. Well‐targeted government interventions including training of potential entrepreneurs and workers can help to establish more modern and highly productive SME clusters that Africa's LDCs need.
Team conflict in ICT‐rich environments: Roles of technologies in conflict management
Authors: Correia Ana‐Paula
Published: September 2010

This study looks at how an information and communication technologies (ICT)‐rich environment impacts team conflict and conflict management strategies. A case study research method was used. Three teams, part of a graduate class in instructional design, participated in the study. Data were collected through observations of team meetings, interviews with individual members, plus analysis of electronic documents exchanged among team members.

Findings indicate that all teams experienced conflict at some level and that conflict management strategies evolved over time. ICT played a dual role in the conflict management of teams. These technologies seemed to facilitate conflict management by offering a formal means of communication, by making communication more effective with minimal waste or unnecessary effort, and by creating opportunities for more thoughtful reactions, with chances for reflection on the content. However, ICT also aggravated conflict, specifically when strategies for use were imposed, when team members became blunt and forthright, and when misinterpretations occurred because of differing senses of urgency in replying to emails.
Agency Working in Britain: Character, Consequences and Regulation
Authors: Forde Chris , Slater Gary
Published: September 2010

Debate over the nature of temporary agency work has intensified in recent times, spurred on by a proposed European directive and by speculation about links with the much heralded ‘knowledge’ economy. This paper examines the debate, focusing on the current character of agency work in Britain. Using data from the Labour Force Survey (LFS), we assess some of the claims commonly made about agency work, relating to the personal and employment characteristics of those engaged in such work, the motives of agency workers and the prospects for those who take up agency jobs. In considering the arguments surrounding regulatory change, we find there is a strong case for regulation, but that this rests on the continued disadvantage associated with agency work, with little evidence of an impact from the purported ‘knowledge’ economy.
Labour and the Struggle over the Future European Model of Capitalism: British and Swedish Trade Unions and their Positions on EMU and European Co-operation
Authors: Bieler Andreas
Published: September 2010

Based on a critical International Political Economy (IPE) perspective including a strategic-relational approach to the state, this article analyses Swedish and British trade unions' position on Economic and Monetary Union (EMU) and European co-operation. Importantly, unions in both countries support EMU membership, but transnational British labour is much more in favour of co-operation at the regional level than Swedish transnational labour. While the latter still enjoys good access to policy-making within the Swedish form of state, the former is rather marginalised in Britain and looks to the European Union as an alternative arena for influence. It is further shown that on the one hand British unions continue to reject neo-liberalism. On the other, some transnational sector unions in Sweden have, however, started to accept core neo-liberal concepts.
Foetal alcohol spectrum disorders (FASD): raising awareness in early years settings
Authors: Blackburn Carolyn , Whitehurst Teresa
Published: September 2010

In this article Carolyn Blackburn who is currently project officer for the Training and Development Agency for Schools and Teresa Whitehurst who is a research and development officer at Sunfield School in Worcestershire discuss how educationalists are being required to support an increasing number of children with new and emerging disabilities including Foetal Alcohol Spectrum Disorders (FASD) for which they may be ill equipped if knowledge and resources are not available. FASD is an umbrella term used to describe a range of intellectual and physical disabilities that may occur when alcohol is consumed by the mother during pregnancy. This may lead to learning difficulties in the areas of gross and fine motor control, social and emotional development, hyperactivity and attention disorders, understanding rules and cause and effect, receptive and expressive language, and problem solving and numeracy. Educating and caring for these children needs a unique approach that relies on reflective practice and adaptive teaching techniques. This article focuses on a collaborative project with Worcestershire Early Years entitled Building Bridges with Understanding. The project focused on raising awareness and increasing knowledge of FASD in early years practitioners to support children with a range of difficulties and provides access to a free downloadable resource pack.
Is disclosure the right way to comply with stakeholders? The Shell case
Authors: Ortiz Martinez Esther , Crowther David
Published: September 2010

This paper is part of an ongoing research project and builds upon a previous one in which we explain the failure of the Agency Theory through the Shell case. In that, we analysed the behaviour of Shell managers, who reclassified oil reserves, playing with the share price because they owned share options. This previous paper established an important literature framework that is continued and organized to go deeper into our analysis in this paper. The goal here is to show that the way that is supposed to be the right tool to inform stakeholders – disclosure – is not enough, and even in the Shell case, no one would have noticed the problems with the oil reserves through the mere analysis of the company disclosure during the ‘strange period’ (1998–2003). The methodology used in this paper is lexical analysis, which seems to be an innovative and effective approach to the analysis of Corporate Social Disclosure, given the un‐codified nature of the latter. The conclusions obtained highlight the problem of lack of transparency in the contents of corporate social disclosure: some firms avoid communicating crucial contents, some others twist the results in order to camouflage advantages to shareholders or managers. If it is like this for disclosing firms, what is happening in the case of non‐disclosing firms?
Trust, coordination and knowledge flows in R&D projects: the case of fuel cell technologies
Authors: Nygaard Stian , Russo Angeloantonio
Published: September 2010

This paper explores influential factors for research and development project success as a result of knowledge flows rising from a trust‐based mechanism within and outside the project. Project success is herein defined in terms of results obtained and partner commitment. A sample of 85 organizations involved in 17 European research and development projects under the fifth Framework Programme focused on fuel cell technology projects is used to test the hypotheses. Results provide several insights. First, organizations should take care of trust as the mechanism supporting internal knowledge flows arising from projects in which they are directly involved; second, external R&D ties arise from a kind of interlocking partner mechanism, but the latter does not contribute to the focal project success.