bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for diabetic retinopathy in a South Indian Type 2 diabetic population—the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4
Authors: Pradeepa R. , Anitha B. , Mohan V. , Ganesan A. , Rema M.
Published: March 2008

Aims  To determine risk factors for diabetic retinopathy (DR) in an urban South Indian Type 2 diabetic population.

Methods  The Chennai Urban Rural Epidemiology Study is a large cross‐sectional study conducted in Chennai, South India. A total of 1736 Type 2 diabetic subjects were recruited for this study, which included 1382 known diabetic subjects (90.4% response rate) and 354 randomly selected, newly detected diabetic subjects diagnosed by oral glucose tolerance test. All subjects underwent four‐field stereo retinal colour photography, graded by the Early Treatment Diabetic Retinopathy Study protocol.

Results  Of the 1736 Type 2 diabetic subjects photographed, photographs could be graded in 1715 subjects. Stepwise ordinal logistic regression analysis revealed that male gender (P = 0.041), duration of diabetes (P < 0.0001), glycated haemoglobin (HbA1c; P < 0.0001), macroalbuminuria (P = 0.0002) and insulin therapy (P = 0.0001) were significantly associated with severity of DR. The risk for developing DR was 7.7 times (95% confidence interval 4.71–12.48, P < 0.0001) for elevated postprandial plasma glucose levels compared with 4.2 times (95% confidence interval 2.78–6.34, P < 0.0001) for elevated fasting plasma glucose when the fourth quartile values were compared with the first quartile glucose values.

Conclusions  In South Indian Type 2 diabetic subjects, duration of diabetes, HbA1c, male gender, macroalbuminuria and insulin therapy were independent risk factors for severity of DR. Postprandial hyperglycaemia indicated a higher risk for DR compared with elevated fasting plasma glucose levels.
Prevalence of the diabetic foot syndrome at the primary care level in Germany: a cross‐sectional study
Authors: Sämann A. , Tajiyeva O. , Müller N. , Tschauner T. , Hoyer H. , Wolf G. , Müller U. A.
Published: March 2008

Aims  The diabetic foot syndrome (DFS) is an important complication of diabetes mellitus resulting in amputations, disability and reduced quality of life. DFS is preventable. The aim was to investigate the prevalence of the DFS at the primary care level in Germany.

Methods  This was a cross‐sectional study of the prevalence of DFS, associated factors and glycaemic control at the primary care level in Germany. We examined an unselected sample of participants with known diabetes who were insured by Deutsche BKK, a large healthcare insurer.

Results  Three hundred and forty‐one general practitioners examined 4778 participants with diabetes mellitus: 366 (7.7%) participants (mean age 49 ± 16 years) had Type 1 and 4412 participants (mean age 66 ± 10 years) had Type 2 diabetes. DFS was diagnosed in 138 patients, resulting in a prevalence of 3.6%[95% confidence interval (CI) 1.9, 6.0] in Type 1 and 2.8% (95% CI 2.3, 3.4) in Type 2 diabetes. DFS was independently associated with age, duration of diabetes, height, current smoking and insulin therapy. There was no significant effect of glycaemic control on the risk of DFS. The prevalence of other abnormal foot findings was: peripheral neuropathy 9.7%, peripheral arterial disease 14.8% (absent dorsalis pedis), 12.4% (absent tibialis posterior), acute diabetic foot ulcer 0.8%, amputations of lower extremities 1.5%, and amputations limited to toes 0.5%.

Conclusions  The prevalence of the DFS at the primary care level in Germany is 2.9%. Almost 50% of patients with DFS had major or minor amputations. Common risk factors such as hyperkeratosis and poor glycaemic control can be modified. Effective therapeutic approaches in addition to methods for primary and secondary prevention of DFS should be used more widely.
Urban geography as pretext: Sociocultural landscapes of Kuala Lumpur in independent Malaysian films
Authors: Khoo Gaik Cheng
Published: March 2008

Current independent filmmaking in Malaysia has the potential to be an alternative and viable space for creative and political expression, relative to mainstream national cinema (Malay cinema) and to the state. I focus on alternative imagery and sociocultural mappings of Kuala Lumpur in three ‘indie’ films. All three films contain documentary elements capturing social geographies of the city not represented in mainstream Malay cinema, or even if represented not subjected to a critical gaze by the filmmaker. The Big Durian centres on the perspectives of the city's urban middle class of all ethnicities; Bukak Api portrays the daily struggles of Malay transsexual sex workers in Chow Kit, a predominantly working‐class Chinese neighbourhood and red light district; and 18? highlights the opinions of the nongovernmental organization community, bohemians, artists, anarchists and media activists mostly in the cosmopolitan suburb of Bangsar. These representations of the Malaysian urban landscape are pretexts for and politicize the national landscape through a discussion of ethnicity and race politics, sexuality, and the lack of space for freedom of creative expression and critical thinking.
Outsider and insider views of Saigon/Ho Chi Minh City: The Lover/L'Amant, Cyclo/Xích lô, Collective Flat/Chung c and Bargirls/Gái nhy
Authors: Do Tess , Tarr Carrie
Published: March 2008

This article addresses representations of Saigon/Ho Chi Minh City in four films made since ?i mi, the opening up of Vietnam to western influences, initiated in 1986. The Lover/L'Amant (1992) is a Franco‐British heritage film which reconstructs the city from a Eurocentric neocolonial perspective, while Cyclo/Xích lô (1995), a French‐funded film made by a France‐based Vietnamese filmmaker, is a contemporary poetic thriller which treats the city expressively as the site of present‐day corruption and violence. The nostalgia evident in these two ‘outsider’ films is contrasted with the more complex views of the city in two state‐funded low‐budget ‘insider’ films by local Vietnamese filmmakers, Collective Flat/Chung c (1999) and Bargirls/Gái nhy (2003); the first, an intellectual fable set in the decade or so following reunification/Independence in 1975 which recalls an attempt at collective living, the second, a hugely popular treatment of contemporary urban realities, both corrupt and progressive. Examining how the mise‐en‐scène and narratives of the city differ from film to film, the essay takes the representation of the city through changing historical, political, social and economic times, from colonial‐orientalist Saigon to corrupt, capitalist Ho Chi Minh City via the slow degeneration of the postwar socialist/collectivist experiment. In so doing, it confirms the importance of the films' moments and contexts of production in the construction of Saigon/Ho Chi Minh City as a cinematic ‘city‐text’.
Saigon from the diaspora
Authors: Carruthers Ashley
Published: March 2008

In the wake of reform in Vietnam and the end of the cold war, overseas Vietnamese are returning to their former homeland in increasing numbers. For most of the first generation in the diaspora, memories of wartime Saigon are now being augmented by a touristic experience of contemporary Saigon/Ho Chi Minh City. This essay asks how the co‐presence of these differently spatialized and temporalized ways of knowing the city affects the production and consumption of images of Saigon in overseas Vietnamese communities in the West. Based on media ethnography carried out in Vietnamese households in Sydney, the paper argues that changes in the way Saigon is represented in overseas Vietnamese popular culture reflect a shift in the larger politics of diasporic identity. While narratives of exile and refugeehood remain potent forms of affective (if not instrumental) politics in overseas Vietnamese contexts, transnational forms of consciousness and identification are beginning to enter into diasporic public culture, albeit in a highly contested way.
Cardboard monuments: City, language and ‘nation’ in contemporary Telugu cinema
Authors: Srinivas S. V.
Published: March 2008

This paper looks at how the city of Hyderabad, the capital of the south Indian state of Andhra Pradesh and production centre of the Telugu film industry, has been represented in recent popular cinema. It outlines the history of a new mode of representing the city in Telugu cinema and argues that its significance lies in the tendency to delocalize the city. Criminalization of the city's older inhabitants, who are marked by either religion (Islam) or their ‘non‐standard’ dialect of Telugu, often accompanies this move. In the process, any claims that they might have on the city are delegitimized. Okkadu, a major commercial hit, restaged the country versus city dichotomy and the antagonisms complicated by cultural and political tensions between the three constituent regions of Andhra Pradesh. This film follows the late 1990s trend in the film industry to recreate entire cityscapes within the studio, ensuring that location shooting in busy city streets and neighbourhoods merely returns us to the grandeur of lavish and ‘realistic’ studio sets. It reconstructs Hyderabad's most recognizable monument, the 400‐year‐old Charminar, in addition to its obviously imaginary residential neighbourhood. This paper looks at how and why the city of Hyderabad, especially its older parts, for which Charminar is a metonym, is rendered into a fantasy space in the film.
Strong representation of the presmoothed quantile function estimator for censored data
Authors: Jácome M. A. , Cao R.
Published: March 2008

We consider lifetime data subject to right random censorship. In this context, this paper deals with the topic of estimating the distribution function of the lifetime and the corresponding quantile function. As it has been shown that the classical Kaplan–Meier estimator of the distribution function can be improved by means of presmoothing ideas, we introduce a quantile function estimator via the presmoothed distribution function estimator studied by Cao et al. [Journal of Nonparametric statistics, Vol. 17 (2005) pp. 31–56.] The main result of this paper is an almost sure representation of this presmoothed estimator. As a consequence, its strong consistency and asymptotic normality are established. The performance of this new quantile estimator is analyzed in a simulation study and applied to a real data example.
Queues with service speed adaptations
Authors: Bekker R. , Boxma O.J. , Resing J.A.C.
Published: March 2008

In this paper, we consider various queueing models in which the server can work at two different service speeds. The speed of the server depends on either the number of customers or the workload. Our main interest is in the model in which service speed adaptations can take place only at the arrival instants of an external Poisson observer. Using insightful probabilistic arguments, we give the structure of the steady‐state queue length and workload distributions in the various models.

In addition, in case the service speed can only be adapted right after departure instants based on the number of customers, we provide explicit and intuitively appealing expressions for the steady‐state distribution of the number of customers present.
Monitoring process mean level using auxiliary information
Authors: Riaz Muhammad
Published: March 2008

In this study, a Shewhart‐type control chart is proposed for the improved monitoring of process mean level (targeting both moderate and large shifts which is the major concern of Shewhart‐type control charts) of a quality characteristic of interest Y. The proposed control chart, namely the Mr chart, is based on the regression estimator of mean using a single auxiliary variable X. Assuming bivariate normality of (Y, X), the design structure of Mr chart is developed for phase I quality control. The comparison of the proposed chart is made with some existing control charts used for the same purpose. Using power curves as a performance measure, better performance of the proposedMr chart is observed for detecting the shifts in mean level of the characteristic of interest.
β1‐ and β2‐Adrenoceptor polymorphisms and cardiovascular diseases
Authors: Brodde Otto‐Erich
Published: March 2008

β1‐ and β2‐Adrenoceptors (AR) play a pivotal role in regulation of the cardiovascular system. Both β‐AR subtypes are polymorphic. There are two major single nucleotide polymorphisms (SNPs) in the β1‐AR gene: the Ser49Gly and Arg389Gly β1‐AR polymorphisms. In vitro, in recombinant cell systems Gly49 β1‐AR is much more susceptible to agonist‐promoted downregulation than Ser49 β1‐AR, while Arg389 β1‐AR is three to four times more responsive to agonist‐evoked stimulation than Gly389 β1‐AR. There are three major SNPs in the β2‐AR gene: the Arg16Gly, Gln27Glu and Thr164Ile β2‐AR polymorphisms (occur in humans only in the heterozygous form). In recombinant cell systems Gly16 β2‐AR is much more susceptible to agonist‐promoted downregulation while Glu27 β2‐AR is rather resistant to agonist‐induced downregulation but only in combination with Arg16, that occurs naturally extremely rare. Thr164 β2‐AR is three to four times more responsive to agonist‐evoked stimulation than Ile164 β2‐AR. This review summarizes results from various studies on the possible relationship of these polymorphisms to cardiovascular diseases. At present it appears to be clear that, for cardiovascular diseases such as hypertension, coronary artery disease and chronic heart failure, β1‐ and β2‐AR polymorphisms do not play a role as disease‐causing genes; however, they might affect drug responses. Thus, it might be possible, by assessing the β1‐AR genotype, to predict responsiveness to β1‐AR agonist and ‐blocker treatment: patients homozygous for the Arg389 β1‐AR polymorphism should be good responders while patients homozygous for the Gly389 β1‐AR polymorphism should be poor responders or non‐responders. Furthermore, subjects heterozygous for the Thr164Ile β2‐AR polymorphism exhibit blunted responses to β2‐AR stimulation. Finally, the Arg16Gln27 β2‐AR haplotype appears to be – at least in human vascular and bronchial smooth muscles – rather susceptible to agonist‐induced desensitization (in contrast to the recombinant cell system findings), and might have some predictive value for poor outcome of heart failure. However, future large prospective studies have to replicate these findings in order to substantiate their clinical relevance.
Assessment of drug‐induced liver injury in clinical practice
Authors: Isabel Lucena Ma , García‐Cortés Miren , Cueto Raquel , Lopez‐Duran JL , Andrade Raúl J
Published: March 2008

Currently, pharmaceutical preparations are serious contributors to liver disease, with hepatotoxicity ranking as the most frequent cause for acute liver failure and post‐marketing regulatory decisions. The diagnostic approach of drug‐induced liver injury (DILI) is still rudimentary and inaccurate because of the lack of reliable markers for use in general clinical practice. To incriminate any given drug in an episode of liver dysfunction is a step‐by‐step process that requires a high degree of suspicion, compatible chronology, awareness of the drug’s hepatotoxic potential, the exclusion of alternative causes of liver damage, and the ability to detect the presence of subtle data that favour a toxic aetiology. Clinical and laboratory data may also be assessed with algorithms or clinical scales, which may add consistency to the clinical judgment by translating the suspicion into a quantitative score. The CIOMS/RUCAM instrument is considered at present the best method for assessing causality in DILI, although it could be improved through the use of large database of bona fide DILI cases for validation criteria.
Stroke secondary prevention and blood pressure reduction: an observational study of the use of PROGRESS therapy
Authors: Bugnicourt Jean‐Marc , Chillon Jean‐Marc , Canaple Sandrine , Lamy Chantal , Godefroy Olivier
Published: March 2008

The Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS) showed the efficacy of blood pressure reduction in secondary stroke prevention. This anti‐hypertensive treatment (perindopril 4 mg daily plus indapamide 1.5 mg daily) is now routinely proposed to patients referred to our department for stroke or transient ischaemic attack (TIA). The aim of this study was to evaluate the prescription of PROGRESS therapy during hospitalization and to identify the predictors of therapy discontinuation after discharge. Eligible patients admitted to the Amiens University hospital for acute stroke or TIA from January to April 2003 were included (n = 101). At 1 year, the use of PROGRESS therapy was evaluated by structured phone interviews. In addition, each patient’s general practitioner (GP) was also contacted to provide information. PROGRESS therapy was mentioned on the hospital discharge summary significantly less frequently after cardioembolic stroke (OR: 0.15; 95% CI: 0.05–0.5; P = 0.001) and TIA (OR: 0.12; 95% CI: 0.02–0.7; P = 0.02). At 1 year, only 25.7% of patients were treated with optimal PROGRESS therapy (perindopril 4 mg daily plus indapamide 1.5 mg daily). Mention of PROGRESS therapy in the discharge summary was the main predictor of optimal PROGRESS therapy at 1 year (OR: 10.8; 95% CI: 1.3–88.3; P = 0.03). This study shows that mention of PROGRESS therapy in the discharge summary must be improved as it is associated with a higher use of these anti‐hypertensive agents 1 year after stroke/TIA.
Vasorelaxation induced by the essential oil of Croton nepetaefolius and its constituents in rat aorta are partially mediated by the endothelium
Authors: Magalhães Pedro Jorge Caldas , Lahlou Saad , Jucá Davi Matthews , Coelho‐de‐Souza Lívia Noronha , Da Frota Pedro Thiago Tibúrcio , Da Costa Adriana Maria Gurgel , Leal‐Cardoso José Henrique
Published: March 2008

Previously, we reported that essential oil of Croton nepetaefolius (EOCN) decreases blood pressure in normotensive rats, an effect that seems resulting from its vasodilatory action directly upon vascular smooth muscle. In the present study, we aimed to study the role of endothelium–nitric oxide pathway in the mediation of vasodilatory effects of EOCN and two of its constituents, methyleugenol and α‐terpineol, using rat isolated thoracic aorta and mesenteric vascular bed preparations. EOCN (1–300 μg/mL), in a concentration‐dependent manner, relaxed isolated endothelium‐intact aortic rings precontracted with KCl 60 mm, with an IC50 value of 26.7 (14.7–48.2) μg/mL. Either pretreatment of the tissue with l‐NAME, a nitric oxide synthase inhibitor, or mechanical endothelium removal increased significantly the IC50 value to 66.6 (52.7–84.1) or 105.6 (91.3–122.2) μg/mL, respectively. In endothelium‐intact aortic rings precontracted with norepinephrine, EOCN (10–200 μg/mL) produced a vasorelaxant action which was decreased by the pretreatment of the aortic rings with methylene blue, a guanylate cyclase inhibitor. In mesenteric bed preparations perfused under constant pressure, EOCN reverted the reduction of mesenteric flow caused by KCl (60 mm), an effect that was attenuated by l‐NAME. Vasodilator responses to EOCN in mesenteric bed preparations were mimicked by methyleugenol and α‐terpineol, and were also significantly reduced in the presence of l‐NAME. In conclusion, EOCN has vasorelaxant effects in both a resistance vascular bed and in a conduit artery. They seem attributed, at least in part, to the actions of its main constituents methyleugenol and α‐terpineol and appear partially dependent upon the integrity of a functional vascular endothelium. Inhibition of other transduction pathways may be involved in the mediation of these effects.
Plasma antioxidant status in septic critically ill patients: a decrease over time
Authors: Doise Jean‐Marc , Aho Ludwig Serge , Quenot Jean‐Pierre , Guilland Jean‐Claude , Zeller Marianne , Vergely Catherine , Aube Herve , Blettery Bernard , Rochette Luc
Published: March 2008

Severe septic states in humans are responsible for intense intravascular oxidative stress, which induces numerous adaptive mechanisms. We determined time sequence changes in total plasma antioxidant capacity (TAC) and major plasma antioxidant concentrations, which have not been fully explained in septic conditions. A cohort of 56 consecutive septic patients (septic shock n = 37, severe sepsis n = 19) and six healthy volunteers. We compared TAC and antioxidant levels in patients with one of two degrees of septic states, at the onset of illness, to those of healthy volunteers. Thereafter, over a 10‐day follow‐up, we observed daily the time sequence changes of the two septic populations in terms of TAC and antioxidants. At the onset, there was no difference between the three groups in terms of TAC values (healthy subjects 2.18 ± 0.04; severe sepsis 2.03 ± 0.07; septic shock 2.09 ± 0.09), then an equivalent time decline was observed in the two septic populations whatever the severity. TAC was statistically linked to uric acid, proteins in particular albumin and bilirubin (multivariate analysis), but no correlation was found with any vitamin (A, C and E). A sharp and persistent decrease in vitamin C concentrations was underlined. TAC, unaffected at first, deteriorated over time whatever the severity of the infection in these critically ill patients. TAC, unable to distinguish severe sepsis and septic shock, is unlikely to be a particularly useful outcome measure.
THE TAXONOMIC STATUS OF MEGALOSAURUS BUCKLANDII (DINOSAURIA, THEROPODA) FROM THE MIDDLE JURASSIC OF OXFORDSHIRE, UK
Authors: BENSON ROGER B. J. , BARRETT PAUL M. , POWELL H. PHILIP , NORMAN DAVID B.
Published: March 2008

Abstract:  The lectotype of the Middle Jurassic theropod dinosaur Megalosaurus bucklandii, a right dentary, can be diagnosed on the basis of two unique characters: a longitudinal groove on the ventral part of the lateral surface of the dentary and a slit‐like anterior Meckelian foramen. This taxon, the first dinosaur to be scientifically described, is therefore valid. Currently, however, no further material can be referred to this species with any certainty. Megalosaurus bucklandii occupies an uncertain systematic position but is not an abelisaurid or coelophysoid. Additionally, it does not possess the diagnostic dentary characters that are present in all known spinosauroids. Owing to this uncertainty, use of the family Megalosauridae should be discontinued until such time as its systematic position becomes clearer.
MUMMPIKIA GEN. NOV. AND THE ORIGIN OF CALCITIC‐SHELLED BRACHIOPODS
Authors: BALTHASAR UWE
Published: March 2008

Abstract:  Phosphatised limestone‐hosted and shale‐hosted specimens of the obolellid Mummpikia nuda gen. et comb. nov. and two further unidentified obolellids from the Early Cambrian Mural Formation (Jasper National Park, Canadian Rocky Mountains) provide novel insights into the shell microstructure of obolellids and the nature of their pedicle. The shell was penetrated by abundant canals of a sub‐μm diameter and the anterior tip of the delthyrium forms a projection into the body cavity that is penetrated by a thin canal. It is argued that both shell microstructure and posterior margin are linguliformean characters and that obolellids hold a position basal in the rhynchonelliform stem‐group.
A NEW PTEROSAUR FROM THE LIAONING PROVINCE OF CHINA, THE PHYLOGENY OF THE PTERODACTYLOIDEA, AND CONVERGENCE IN THEIR CERVICAL VERTEBRAE
Authors: ANDRES BRIAN , QIANG JI
Published: March 2008

Abstract:  The largest known flying organisms are the azhdarchid pterosaurs, a pterodactyloid clade previously diagnosed by the characters of their extremely elongate middle‐series cervical vertebrae. The named species of the Azhdarchidae are from the Late Cretaceous. However, isolated mid‐cervical vertebrae with similar dimensions and characters have been referred to this group that date back to the Late Jurassic, implying an almost 60 million year gap in the fossil record of this group and an unrecorded radiation in the Jurassic of all the major clades of the Pterodactyloidea. A new pterosaur from the Early Cretaceous of Liaoning Province of China, Elanodactylus prolatus gen. et sp. nov., is described with mid‐cervical vertebrae that bear these azhdarchid characters but has other postcranial material that are distinct from the members of this group. Phylogenetic analysis of the new species and the Pterodactyloidea places it with the Late Jurassic vertebrae in the Late Jurassic–Early Cretaceous Ctenochasmatidae and reveals that the characters of the elongate azhdarchid vertebrae appeared independently in both groups. These results are realized though the large taxon sampling in the analysis demonstrating that the homoplastic character states present in these two taxa were acquired in a different order in their respective lineages. Some of these homoplastic characters were previously thought to appear once in the history of pterosaurs and may be correlated to the extension of the neck regions in both groups. Because the homoplastic character states in the Azhdarchidae and Ctenochasmatidae are limited to the mid‐cervical vertebrae, these states are termed convergent based on a definition of the term in a phylogenetic context. A number of novel results from the analysis presented produce a reorganization in the different species and taxa of the Pterodactyloidea.
ON THE TUBE ULTRASTRUCTURE AND ORIGIN OF CALCIFICATION IN SABELLIDS (ANNELIDA, POLYCHAETA)
Authors: VINN OLEV , Ten HOVE HARRY A. , MUTVEI HARRY
Published: March 2008

Abstract:  Tube ultrastructure of Jurassic and Cretaceous Glomerula is very similar to that of Recent Calcisabella, supporting the synonymy of these genera and the early Mesozoic origin of calcification in sabellids. Tube structure of serpulids differs from that of Glomerula; calcareous tubes probably evolved convergently within Sabellida. The tube wall in Recent Glomerula piloseta is composed of subparallel lamellae of aragonitic, irregular spherulitic prisms in the inner layer, and spherulites in the outer layer. Calcified lamellae are separated by organic films of different thickness. The structure of the internal tube layer in Glomerula piloseta, and the structure of entire wall in fossil Glomerula, are similar to the tube structure of Dodecaceria (Polychaeta, Cirratulidae). The irregular spherulitic prisms of Glomerula are similar to those found in the external layer of Hydroides dianthus and the internal layer of Spiraserpula caribensis.
National Institute of Neurological Disorders and Stroke (NINDS): Advances in understanding and treating neuropathy, 24–25 October 2006; Bethesda, Maryland
Authors: Feldman Eva L. , Cornblath David R. , Porter John , Dworkin Robert , Scherer Steven
Published: March 2008

Abstract  National Institute of Neurological Disorders and Stroke sponsored a meeting to explore the current status of basic and clinical research in peripheral neurobiology and clinical neuropathy. The goal of the workshop was to identify areas where additional research could lead to the development of new therapeutics in the next 5 years. Participants discussed the current understanding of disease mechanisms of axonal and demyelinating neuropathies, existing techniques in research, disease biomarkers, and assessment of neuropathy. Painful neuropathies were discussed at the basic scientific and clinical levels in relation to new insights into etiology and treatment. The meeting concluded with a discussion on therapeutic development in neuropathy and the need for a unified approach to multicenter trials. Short‐term goals of the workshop were to form a working group for neuropathy, the Peripheral Neuropathy Study Group, and to translate new scientific findings into therapies and complete clinical trials.
Assessment of nerve excitability in toxic and metabolic neuropathies
Authors: Krishnan Arun V. , Lin Cindy S.‐Y. , Park Susanna B. , Kiernan Matthew C.
Published: March 2008

Abstract  Measurement of nerve excitability by threshold tracking provides complementary information to conventional nerve conduction studies and may be used to infer the activity of a variety of ion channels, energy‐dependent pumps, and ion exchange processes activated during the process of impulse conduction. This review highlights recent clinical excitability studies that have suggested mechanisms for nerve involvement in a range of metabolic and toxic neuropathies. While clinical nerve excitability studies are still in their infancy, and it is too early to know whether they have diagnostic value, there is growing evidence of their utility to provide novel insights into the pathophysiological mechanisms involved in a variety of neuropathic disturbances.
Lower touch sensibility in the extremities of healthy Indians: further deterioration with age
Authors: Jain Suman , Muzzafarullah Syed , Peri Sundaresh , Ellanti Ramesh , Moorthy Krishna , Nath Indira
Published: March 2008

Abstract  Touch sensibility testing is a cost‐effective, psychophysical measure of peripheral nerve function and impairment. However, there is limited information regarding the natural variability in touch sensibility across different populations and different age groups. We studied 568 healthy Indian volunteers without any clinical evidence of peripheral nerve disease. Touch sensibility was evaluated bilaterally in palms, feet, and heels, using Semmes‐Weinstein monofilaments, with target forces ranging from 0.008 to 300 g. No differences were observed between the right and the left limbs. The lowest target force detected ranged from 0.4 to 2 g in the palms and 1.4 to 15 g in the feet. These values showed further increase with age. Women compared with men had higher sensibility in the palms in most age groups. Touch sensibility thresholds recorded in a large group of Indians were higher than that reported in other populations. These findings have clinical implications for the diagnosis of early nerve impairment in the elderly and in disease states drawing attention to geographic variations in touch sensation.
Impairment of circulating CD4+CD25+ regulatory T cells in patients with chronic inflammatory demyelinating polyradiculoneuropathy
Authors: Chi Li‐Jun , Wang Hua‐Bing , Wang Wei‐Zhi
Published: March 2008

Abstract  Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune‐mediated peripheral nervous system disease. CD4+CD25+ T regulatory cells (Tregs) have been unequivocally shown to be critical in maintaining immune tolerance and preventing auto‐immune diseases by suppressing self‐reactive T cells. Thus, we hypothesized that the numbers and/or the function of Tregs would be deranged during the progressive or relapse phases of CIDP. The number of Tregs was determined by flow cytometry according to their characteristic CD4+CD25high membrane phenotype. Functional characterization of Tregs was analyzed by suppression of proliferation and secretion of cytokines by co‐cultured effector CD4+CD25− T cells. FOXP3 message expression level was assessed by quantitative real‐time polymerase chain reaction. The results showed significant reduction in both the number and the suppressive function of Tregs in the patients with CIDP compared with healthy controls. Also, Tregs isolated from CIDP patients expressed lower levels of FoxP3 mRNA. During the progressive or the relapsing phases of CIDP, the number of Tregs was reduced, and the suppressive function of them decreased. These findings may be helpful to our understanding of the possible role of Tregs in the pathogenesis of CIDP.
Diagnostic value of sural nerve biopsy in patients with suspected Borrelia neuropathy
Authors: Schäfers Maria , Neukirchen Sebastian , Toyka Klaus V. , Sommer Claudia
Published: March 2008

Abstract  Peripheral neuropathy is a recognized but incompletely understood manifestation of borreliosis. As the pathology of this neuropathy has been described only in small case series, the value of nerve biopsy findings for the pathologic diagnosis of Borrelia‐associated neuropathy is unclear. We collected and investigated 21 patients with peripheral neuropathy and with typical clinical and serologic signs of neuroborreliosis [Borrelia neuropathy (BN)]. Standard histology and immunohistochemistry were performed on sural nerve biopsies using antibodies to CD4, CD68 and membrane attack complex C5b‐9, intercellular adhesion molecule (ICAM)‐1, tumor necrosis factor (TNF)‐α, interleukin (IL)‐1, and IL‐6. Nine patients with idiopathic vasculitic neuropathy (VN) and 14 with idiopathic axonal neuropathy (AN) served as disease controls. In BN, the characteristic histology was that of an AN with transmural or perivascular lymphocytic infiltration of nerve vessels. In BN, but less in VN and AN, perineurial thickening and neovascularization were observed. For BN but not for VN, this thickening correlated with increased perineurial immunoreactivity (IR) to TNF‐α, C5b‐9, and ICAM‐1. In comparison to AN, both BN and VN displayed increased perineurial T‐cell infiltration and human leukocyte antigen (HLA)‐DR3‐IR. In the endoneurium, cytokine (IL‐1β, IL‐6, TNF‐α), HLA‐DR3, and ICAM‐1 expression was more pronounced in VN but not in BN. The neuropathy in patients with neuroborreliosis resembles idiopathic VN but shows some distinctive features. None of the findings of this study are disease specific but as a pattern may help support the diagnosis of inflammatory neuropathy in patients with serological evidence for Borrelia infection.
Measurement of forelimb function by digital video motion analysis in rat nerve transection models
Authors: Wang Huan , Spinner Robert J. , Sorenson Eric J. , Windebank Anthony J.
Published: March 2008

Abstract  The object of this study was to demonstrate that digital video motion analysis is a quantitative, valid, and reproducible method for evaluation of function in the rat model of forelimb nerve transection and repair. Median, ulnar, and radial nerves were transected and directly repaired in 220 g Sprague‐Dawley rats. Normal rats and sham‐operated rats served as controls (six rats in each group). Two‐dimensional (2D) digital video motion analysis was used to capture the gait cycle and quantify joint movement and changes in toe spread. Recordings were made preoperatively and at 1, 4, 8, 12, and 16 weeks postoperatively. Wrist and metacarpophalangeal (MP) joint extension decreased after radial nerve injury, and wrist and MP joint flexion decreased after combined median and ulnar nerve injury or injury to the median nerve only. Toe spread decreased after combined median and ulnar nerve injury and after radial nerve injury. Median or ulnar nerve injury alone did not lead to a significant change in toe spread. 2D digital video motion analysis can be used to quantify movement of the wrist and the MP joint in rats. It is a valid method to evaluate functional deficit and recovery after nerve injury and repair in the forelimb.
Retrograde Crossing through the Pedal Arch for Totally Occluded Tibial Artery
Authors: KAWARADA OSAMI , YOKOI YOSHIAKI , SEKII HIROYOSHI , HIGASHIUE SHINICHI
Published: March 2008

Critical limb ischemia is characterized by atherosclerotic disorder of the crural arteries. The occlusion of darsalis pedis and paramalleolar posterior tibial arteries is a rare atherosclerotic pattern in the crural arteries. We present a successful case of retrograde posterior tibial artery crossing through the pedal arch after antegrade recanalization of occluded anterior tibial and dorsalis pedis arteries, leading to the achievement of complete infrapopliteal recanalization and wound healing.
Fluoroscopy‐Guided Femoral Artery Puncture Reduces the Risk of PCI‐Related Vascular Complications
Authors: Fitts James , Ver Lee Peter , Hofmaster Patricia , Malenka David ,   for the Northern New England Cardiovascular Study Group
Published: March 2008

Background: In previous work by the Northern New England Cardiovascular Study Group, risk factors for vascular access site complications in percutaneous coronary intervention (PCI) were identified and a regional effort to reduce these complications was initiated. As part of this effort we considered making a regional recommendation that location of the femoral head as seen on fluoroscopy (fluoro) be used to help determine the site of femoral artery puncture. Therefore, we assessed the use of fluoro to determine whether it actually reduced the rate of vascular complications and shortened length of stay.

Methods: Data were collected prospectively on 2,651 consecutive PCIs at Eastern Maine Medical Center from 2000 to 2003 including use of fluoro, vascular access site complications (bleeding, pseudoaneurysm formation, hematoma, embolic event or thrombus, A‐V fistula), and length of stay.

Results: Use of fluoro among eight interventionists was variable: 3 < 20%, 3 35–50%, 2 > 70%. Among all interventions, 48% were performed with fluoro to guide vascular access. The use of fluoro was associated with a significantly lower incidence of pseudoaneurysms (0.3% vs. 1.1%, P = 0.017) and any arterial injury (0.7% vs. 1.9%, P < 0.01). There was no significant difference in bleeding (1.6% vs. 1.8%, P = 0.69). For each physician, there were fewer vascular injuries when fluoro was used. Average length of stay was significantly lower among patients in the fluoro group (2.1 days vs. 2.4, P < 0.01).

Conclusion: We conclude that using fluoro to guide vascular access leads to lower complication rates and a shorter length of stay. This approach may become our regional standard of care.
Early Results of Balloon Dilatation of the Stenotic Bovine Jugular Vein Graft in the Right Ventricular Outflow Tract in Children
Authors: STEINBERG J. , DAVE H. , KNIRSCH W. , PRÊTRE R. , WEISS M. , HARPES P. , KRETSCHMAR O.
Published: March 2008

The aim of this study was to evaluate the early results of interventional balloon dilatation of stenotic bovine jugular vein (BJV) grafts implanted for reconstruction of the right ventricular outflow tract (RVOT) in children.

Methods: From May 2001 to December 2005, 153 BJV grafts were implanted in children in our institution. An average of 16.9 (7.6–41.1) months after implantation, 17 balloon dilatations in a significant stenosis proximal (n = 1), distal anastomosis (n = 8), BJV valve (n = 3), or at multiple sites (n = 5) were performed in 15 children (male:female = 9:6) with a mean age of 3.9 (0.8–13.0) years. Balloon diameter was 75–133.3% (mean 100.3) of the original BJV size. Mean follow‐up was 8.8 (2 days to 22.8 months) months.

Results: In 10 interventions (58.8%) the instantaneous peak gradient was reduced below 50 mmHg. A balloon diameter ≥100% of the original BJV size correlated significantly with a successful intervention. No major complications, two minor (nonobstructive floating membranes at the dilatation site and one septicemia) occurred afterward. Freedom from reintervention after 6 months was 58.2% for all, 77.8% for dilatations of the proximal anastomosis and mixed stenotic lesions, and 33.3% for the distal anastomosis.

Conclusion: Balloon dilatation of stenotic BJV grafts is safe and can significantly reduce the pressure gradient in two‐thirds of interventions. Balloon diameters above the original graft size should be aimed for. The most frequent stenosis of the distal anastomosis tends to renarrow early after dilatation. Nevertheless, balloon dilatation should be considered in nearly every stenotic graft to gain time until a surgical or interventional graft exchange.
A double‐blind randomized clinical evaluation of enamel matrix derivative proteins for the treatment of proximal class‐II furcation involvements
Authors: Casarin Renato Corrêa Viana , Del Peloso Ribeiro Érica , Nociti Francisco Humberto , Sallum Antônio Wilson , Sallum Enilson Antônio , Ambrosano Gláucia Maria Bovi , Casati Márcio Zaffalon
Published: March 2008

Objective: The aim of the present randomized, double‐blind study was to evaluate the clinical response of proximal furcations treated with enamel matrix derivative proteins (EMD).

Material and Methods: Fifteen patients, each with a pair of contralateral class‐II proximal furcation involvements, presenting probing depths (PDs) 5 mm and bleeding on probing (BOP) were selected. The patients were randomly assigned to: control group (n=15) – open flap debridement (OFD)+24% ethylenediaminetetraacetic acid (EDTA) conditioning; test group (n=15) – OFD+24% EDTA conditioning+EMD application. Plaque index (PI), BOP, PD, gingival margin position (GMP), relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated immediately before and 2, 4 and 6 months after the surgeries.

Results: At 6 months, the RVCAL gains of the control and test group were 0.39 ± 1.00 and 0.54 ± 0.95 mm, while the RHCAL gains were 1.21 ± 2.28 and 1.36 ± 1.26 mm (p>0.05). The VBL and HBL gains of the control group were 1.04 ± 1.12 and 1.00 ± 1.79 mm, and 0.82 ± 1.82 and 1.17 ± 1.38 mm for the test group (p>0.05). In addition, a statistical difference was observed in the number of the remaining class‐II furcations between the test and control groups (p<0.05) in this period.

Conclusion: It may be concluded that the use of EMD in proximal furcations did not promote a superior reduction in PD or a gain in clinical and osseous attachment levels, but resulted in a higher rate of class‐II to class‐I furcation conversion.
Clinical outcomes after treatment of intra‐bony defects with an EMD/synthetic bone graft or EMD alone: a multicentre randomized‐controlled clinical trial
Authors: Jepsen S. , Topoll H. , Rengers H. , Heinz B. , Teich M. , Hoffmann T. , Al‐Machot E. , Meyle J. , Jervøe‐Storm P.‐M.
Published: March 2008

Objectives: Comparison of the outcomes of a combination of an enamel matrix derivative and a synthetic bone graft (EMD/SBC) with EMD alone in wide intra‐bony defects.

Material and Methods: Seventy‐three patients with chronic periodontitis were recruited in five centres in Germany. All patients had one wide intra‐bony defect of 4 mm. Surgical procedures involved microsurgical technique and the modified papilla preservation flap. After debridement, defects were randomly assigned to EMD/SBC (test) or EMD (control). Assessments at baseline and after 6 months included bone sounding, attachment levels, probing pocket depths, bleeding on probing and recessions. Early wound‐healing, adverse effects and patients' perceptions were also recorded.

Results: Both treatment modalities led to significant clinical improvements. Change in bone fill 6 months after surgery was 2.0 mm (± 2.1) in the test group and 2.1 mm (± 1.2) in the control group. A gain in clinical attachment of 1.3 mm (± 1.8) in the test group and 1.8 mm (± 1.6) in the control group was observed. One week after surgery, primary closure was maintained in 95% of the test sites and 100% of the control sites. No differences in patients' perceptions were found.

Conclusion: The results of the present study showed similar clinical outcomes following both treatment modalities.
Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes
Authors: Manau Carolina , Echeverria Ana , Agueda Anna , Guerrero Adrian , Echeverria Jose J.
Published: March 2008

Aim: The aim of this secondary analysis is to explore whether the application of different definition criteria of periodontitis, used in other similar studies, has an influence on the significance of the association between periodontitis and prematurity or low birth weight.

Material and Methods: Fourteen periodontitis definitions and more than 50 periodontal disease continuous measurements, found in 23 published studies, were applied to a cohort study that included 1296 pregnant women. The associations with adverse pregnancy outcomes were analysed using logistic regression analysis.

Results: Six of the 14 tested definitions of periodontitis resulted in statistically significant adjusted odds ratios (ORs) for some of the adverse pregnancy outcomes, while no significance was found for the other eight case definitions. Out of more than 50 periodontal continuous measurements tested, only 17 demonstrated statistically significant ORs.

Conclusions: Our results support the hypothesis that the significance of the association between periodontal disease and pregnancy outcomes may be determined by the periodontal disease definition or measurement used.
Effect of banana bunchy top virus infection on morphology and growth characteristics of banana
Authors: Hooks C.R.R. , Wright M.G. , Kabasawa D.S. , Manandhar R. , Almeida R.P.P.
Published: March 2008

Field experiments were conducted in Oahu, Hawaii, to investigate the effects of banana bunchy top virus (BBTV) infection on growth and morphology of banana (Musa acuminata). The time interval between aphid inoculation of BBTV and the initial appearance of disease symptoms (i.e. incubation period) was also determined. Plants infected with BBTV showed a significant reduction in petiole size (i.e. length and distance), plant canopy and height, leaf area, pseudostem diameter and chlorophyll content compared with control plants. Growth differences between virus‐infected and control plants were not observed until 40–50 days after the plants were inoculated with viruliferous aphids. Other growth parameters such as petiole width and leaf production were not statistically different between infected and control plants. The incubation period of banana bunchy top disease or appearance of symptoms ranged from 25 to 85 days after aphid inoculation. However, PCR assays provided earlier detection of BBTV in banana plants compared with visual symptoms.
EXERGETIC ASSESSMENT OF DRYING OF MINT LEAVES IN A HEAT PUMP DRYER
Authors: COLAK NESLIHAN , KUZGUNKAYA EBRU , HEPBASLI ARIF
Published: March 2008

This article deals with the exergy analysis of a single layer drying process of mint leaves in a ground source heat pump tray dryer, which was designed and constructed in the Solar Energy Institute, Ege University, Izmir, Turkey. The drying process was realized at three various drying air temperatures of 40, 45 and 50C, and mass flow rate from 0.01 to 0.05 kg/s at a constant relative humidity of 16%. The effects of temperatures and mass flow rates on the exergy losses, exergy efficiencies and improvement potentials of the drying process were investigated. Maximum exergy efficiency of the drying chamber was obtained at a temperature of 50C and a drying air mass flow rate of 0.05 kg/s. The exergy efficiency values were obtained to vary from 76.03 to 97.24% at drying air temperatures of 40–50C with drying air mass flow rates of 0.01–0.05 kg/s.

PRACTICAL APPLICATIONS

This study is useful for not only producers of dry mints, but also for all dry herbs. It may be successfully used in the design and performance evaluation of heat pump dryers.
SUBCRITICAL WATER EXTRACTION OF CAFFEINE FROM BLACK TEA LEAF OF IRAN
Authors: SHALMASHI ANVAR , GOLMOHAMMAD FERESHTEH , EIKANI MOHAMMAD H.
Published: March 2008

This study examines subcritical water extraction (SCWE) of caffeine from black tea leaf. The effects of various operating conditions such as water temperature (100, 125, 150 and 175C), water flow rate (1, 2 and 4 g/min), mean particle size (0.5, 1 and 2 mm) on extraction yield and rate were determined. SCWE at 175C, water flow rate of 2 g/min and mean particle size of 0.5 mm were found to be able to recover 3.82% (w/w) of caffeine present in the black tea leaf within 3 h of extraction. In comparison to the SCWE, conventional hot water extraction showed 3.30% (w/w) extraction yield. It was found also that pressure had no effect on extraction yield and rate.

PRACTICAL APPLICATIONS

Recently, subcritical water has become of great interest as an alternative solvent for extraction of natural active compounds. Subcritical water, as a green solvent, can be used in many different fields of applications. In recent years, extraction of flavors, fragrances and antioxidant components from plant materials, and hydrolysis of carbohydrates, vegetable oils and fatty acids have been widely investigated by many researchers. Using subcritical water for analytical purposes, for soil remediation and applying it as a reaction media are some other interesting fields for practical applications. Subcritical water is an excellent solvent for caffeine as well as many other organic compounds but is safer than the organic solvents that are used for caffeine extraction.