bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta‐analysis of case series studies
Authors: El Dib Regina , Touma Naji J. , Kapoor Anil
Published: February 2012

Study Type – Therapy (systematic review)

Level of Evidence 2b

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

The oncological success of partial nephrectomy in the treatment of small renal masses is well established. However, partial nephrectomy has largely supplanted the radical approach. In the last decade, laparoscopy has been adopted as the new surgical approach for the treatment of renal cell carcinoma. Laparoscopy offers the advantage of lower analgesic use, shorter hospital stay, and quicker recovery time. More recently, ablative technologies have been investigated as an alternative to laparoscopic partial nephrectomy. These techniques can often be performed percutaneously in the radiology suite, or laparoscopically without the need for hilar clamping. However, only the cryoablation and radiofrequency ablation modalities have had widespread use with several series reporting short to intermediate results.

This review shows that both cryoablation and radiofrequency ablation are promising therapies in patients with small renal tumours (<4 cm), who are considered poor candidates for more involved surgery.

OBJECTIVE

To determine the current status of the literature regarding the clinical efficacy and complication rates of cryoablation vs radiofrequency ablation in the treatment of small renal tumours.

METHODS

A review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: MEDLINE, EMBASE and LILACS.

Inclusion criteria were (i) case series design with more than one case reported, (ii) use of cryoablation or radiofrequency ablation, (iii) patients with renal cell carcinoma and, (iv) outcome reported as clinical efficacy.

When available, we also quantified the complication rates from each included study.

Proportional meta‐analysis was performed on both outcomes with a random‐effects model. The 95% confidential intervals were also calculated.

RESULTS

Thirty‐one case series (20 cryoablation, 11 radiofrequency ablation) met all inclusion criteria.

The pooled proportion of clinical efficacy was 89% in cryoablation therapy from a total of 457 cases. There was a statistically significant heterogeneity between these studies showing the inconsistency of clinical and methodological aspects.

The pooled proportion of clinical efficacy was 90% in radiofrequency ablation therapy from a total of 426 cases. There was no statistically significant heterogeneity between these studies.

There was no statistically significant difference regarding complications rate between cryoablation and radiofrequency ablation.

CONCLUSIONS

This review shows that both ablation therapies have similar efficacy and complication rates.

There is urgency for performing clinical trials with long‐term data to establish which intervention is most suitable for the treatment of small renal masses.
THE SUBSTANCE VIEW: A CRITIQUE
Authors: LOVERING ROB
Published: February 2012

According to the theory of intrinsic value and moral standing called the ‘substance view,’ what makes it prima facie seriously wrong to kill adult human beings, human infants, and even human fetuses is the possession of the essential property of the basic capacity for rational moral agency – a capacity for rational moral agency in root form and thereby not remotely exercisable. In this critique, I cover three distinct reductio charges directed at the substance view's conclusion that human fetuses have the same intrinsic value and moral standing as adult human beings. After giving consideration to defenders of the substance view's replies to these charges, I then critique each of them, ultimately concluding that none is successful. Of course, in order to understand all of these things – the reductio charges, defenders of the substance view's replies to them, and my criticisms of their replies – one must have a better understanding of the substance view (in particular, its understanding of rational moral agency) as well as its defense. Accordingly, I address the substance view's understanding of rational moral agency as well as present its defense.
Democratic Political Leadership in the New Media Age: A Farewell to Excellence?
Authors: Helms Ludger
Published: February 2012

This article looks into the ambiguous effects that ‘mediatisation’ in its various forms has had, or may have, on the conditions for good democratic political leadership by prime ministers and presidents in established western democracies. For the purposes of this article, good democratic political leadership is defined in terms of three fundamental criteria: authenticity, effectiveness and responsibility. Whereas the ‘new media age’ offers political chief executives some distinct opportunities with regard to all three criteria, these tend to be outweighed by a wealth of media-related constraints which in sum make good democratic political leadership considerably more difficult and demanding than ever. Understood as a publicly responsible profession, contemporary political science, and comparative executive leadership research more specifically, faces two inter-related tasks: to penetrate empirically the notorious smokescreens of executive politics, and to provide the public with reasonable standards for evaluating the performance of executive leaders.
“It Was Never Good World Sence Minister Must Have Wyves”: Clerical Celibacy, Clerical Marriage, and Anticlericalism in Reformation England
Authors: PARISH HELEN
Published: February 2012

The impact of the Reformation was felt strongly in the nature and character of the priesthood, and in the function and reputation of the priest. A shift in the understanding of the priesthood was one of the most tangible manifestations of doctrinal change, evident in the physical arrangement of the church, in the language of the liturgy, and in the relaxation of the discipline of celibacy, which had for centuries bound priests in the Latin tradition to a life of perpetual continence. Clerical celibacy, and accusations of clerical incontinence, featured prominently in evangelical criticisms of the Catholic church and priesthood, which made a good deal of polemical capital out of the perceived relationship of the priest and the efficacy of his sacred function. Citing St Paul, Protestant polemicists presented clerical marriage as the only, and appropriate remedy, for priestly immorality. But did the advent of a married priesthood create more problems than it solved? The polemical certainties that informed evangelical writing on sacerdotal celibacy did not guarantee the immediate acceptance of a married priesthood, and the vocabulary that had been used to denounce clergy who failed in their obligation to celibacy was all too readily turned against the married clergy. The anti‐clerical lexicon, and its usage, remained remarkably static despite the substantial doctrinal and practical challenges posed to the traditional model of priesthood by the Protestant Reformation.
Moyes, Menzies, and the Vietnam War: New Insights Into the Public Correspondence Between the Prime Minister and the Bishops
Authors: TERRACINI PAUL
Published: February 2012

In March 1965 a group of Anglican bishops signed an open letter to the prime minister of Australia, Sir Robert Menzies, expressing its concerns about the rapid deterioration of the situation in Vietnam. The letter had been composed by the retired Bishop of Armidale, John Stoward Moyes. The bishops urged Menzies to use his influence with the United States Government to ensure that the possibility of a negotiated settlement of the conflict could be explored to the full. The letter, and the prime minister's public response, thrust John Moyes and his episcopal co‐signatories into the centre of a national debate on Vietnam. Following Menzies's brusque reply, Moyes composed a second and more critical open letter. The prime minister then issued a more detailed response one week before he committed Australian combat troops to the Vietnam War. The initiative taken by Bishop Moyes constituted the first major instance of public debate in Australia concerning the wisdom and morality of the government's policy on Vietnam.
Hilda Mary Woods MBE, DSc, LRAM, FSS (1892–1971): Reflections on a Fellow of the Royal Statistical Society
Authors: Farewell Vern , Johnson Tony , Gear Rosemary
Published: February 2012

We have previously described the content of a text by Woods and Russell, An Introduction to Medical Statistics, compared it with Principles of Medical Statistics by Hill and set both volumes against the background of vital statistics up until 1937. The two books mark a watershed in the history of medical statistics. Very little has been recorded about the life and career of the first author of the earlier textbook, who was a Fellow of the Royal Statistical Society for at least 25 years, an omission which we can now rectify with this paper. We describe her education, entry into medical statistics, relationship with Major Greenwood and her subsequent career and life in Ceylon, Kenya, Australia, England and South Africa.
The Liquidity Dynamics of Bank Defaults
Authors: Morkoetter Stefan , Schaller Matthias , Westerfeld Simone
Published: February 2012

We compare liquidity patterns of 10,979 failed and non‐failed US banks from 2001 to mid‐2010 and detect diverging capital structures: failing banks distinctively change their liquidity position about three to five years prior to default by increasing liquid assets and decreasing liquid liabilities. The build‐up of liquid assets is primarily driven by short term loans, whereas long term loan positions are significantly reduced. By abandoning (positive) term transformation throughout the intermediate period prior to a default, failing banks drift away from the traditional banking business model. We show that this liquidity shift is induced by window dressing activities towards bondholders and money market investors as well as a bad client base.
Low free testosterone in HIV‐infected men is not associated with subclinical cardiovascular disease
Authors: Monroe AK , Dobs AS , Xu X , Palella FJ , Kingsley LA , Post WS , Witt MD , Brown TT
Published: February 2012

Objectives

Low testosterone (T) is associated with cardiovascular disease (CVD) and increased mortality in the general population; however, the impact of T on subclinical CVD in HIV disease is unknown. This study examined the relationships among free testosterone (FT), subclinical CVD, and HIV disease.

Methods

This was a cross‐sectional analysis in 322 HIV‐uninfected and 534 HIV‐infected men in the Multicenter AIDS Cohort Study. Main outcomes were coronary artery calcification presence, defined as a coronary artery calcium (CAC) score > 10 (CAC score was the geometric mean of the Agatston scores of two computed tomography replicates), and far wall common carotid intima‐media thickness (IMT)/carotid lesion presence by B‐mode ultrasound.

Results

Compared with the HIV‐uninfected men in our sample, HIV‐infected men were younger, with lower body mass index (BMI) and more often Black. HIV‐infected men had lower FT (age‐adjusted FT 88.7 ng/dL vs. 101.7 ng/dL in HIV‐uninfected men; P = 0.0004); however, FT was not associated with CAC, log carotid IMT, or the presence of carotid lesions. HIV status was not associated with CAC presence or log carotid IMT, but was associated with carotid lesion presence (adjusted odds ratio 1.69; 95% confidence interval 1.06, 2.71) in HIV‐infected men compared with HIV‐uninfected men.

Conclusions

Compared with HIV‐uninfected men, HIV‐infected men had lower FT, as well as more prevalent carotid lesions. In both groups, FT was not associated with CAC presence, log carotid IMT, or carotid lesion presence, suggesting that FT does not influence subclinical CVD in this population of men with and at risk for HIV infection.
Still Punching below Its Weight? Coherence and Effectiveness in European Union Foreign Policy*
Authors: THOMAS DANIEL C.
Published: February 2012

Although scholars and practitioners have long argued that greater political coherence will make the European Union a more effective international actor, the relationship between coherence and effectiveness has not been well defined or tested. This article defines the two concepts, proposes three hypotheses regarding the relationship between them, and examines the extent and consequences of EU coherence on an issue that the EU has highlighted as essential to its foreign policy mission: the good functioning of the International Criminal Court (ICC). It finds that the EU exhibited considerable coherence in its response to the United States' campaign for ICC ‘non‐surrender agreements’, yet failed in its effort to shape the behaviour of other states. Coherence may be necessary for the EU to exert its influence abroad, but it is not sufficient in a multi‐centric world order where many others do not share the EU's collective policy preferences and are ready to deploy vast resources in pursuit of their goals. The article also considers the implications of this study for future research on EU foreign policy actorness, coherence and effectiveness.
Three‐dimensional and molecular analysis of the arterial pole of the developing human heart
Authors: Sizarov Aleksander , Lamers Wouter H. , Mohun Timothy J. , Brown Nigel A. , Anderson Robert H. , Moorman Antoon F. M.
Published: February 2012

Labeling experiments in chicken and mouse embryos have revealed important roles for different cell lineages in the development of the cardiac arterial pole. These data can only fully be exploited when integrated into the continuously changing morphological context and compared with the patterns of gene expression. As yet, studies on the formation of separate ventricular outlets and arterial trunks in the human heart are exclusively based on histologically stained sections. So as to expand these studies, we performed immunohistochemical analyses of serially sectioned human embryos, along with three‐dimensional reconstructions. The development of the cardiac arterial pole involves several parallel and independent processes of formation and fusion of outflow tract cushions, remodeling of the aortic sac and closure of an initial aortopulmonary foramen through formation of a transient aortopulmonary septum. Expression patterns of the transcription factors ISL1, SOX9 and AP2α show that, in addition to fusion of the SOX9‐positive endocardial cushions, intrapericardial protrusion of pharyngeal mesenchyme derived from the neural crest contributes to the separation of the developing ascending aorta from the pulmonary trunk. The non‐adjacent walls of the intrapericardial arterial trunks are formed through addition of ISL1‐positive cells to the distal outflow tract, while the facing parts of the walls form from the protruding mesenchyme. The morphogenetic steps, along with the gene expression patterns reported in this study, are comparable to those observed in the mouse. They confirm the involvement of mesenchymal tissues derived from endocardium, mesoderm and migrating neural crest cells in the process of initial septation of the distal part of the outflow tract, and its subsequent separation into discrete intrapericardial arterial trunks.
Morphological preservation of carbonaceous plant fossils in blueschist metamorphic rocks from New Zealand
Authors: GALVEZ M. E. , BEYSSAC O. , BENZERARA K. , BERNARD S. , MENGUY N. , COX S. C. , MARTINEZ I. , JOHNSTON M. R. , BROWN G. E.
Published: February 2012

Morphological and chemical evidence of ancient life is widespread in sedimentary rocks retrieved from shallow depths in the Earth’s crust. Metamorphism is highly detrimental to the preservation of biological information in rocks, thus limiting the geological record in which traces of life might be found. Deformation and increasing pressure/temperature during deep burial may alter the morphology as well as the composition and structure of both the organic and mineral constituents of fossils. However, microspore fossils have been previously observed in intensely metamorphosed rocks. It has been suggested that their small size, and/or the nature of the polymer composing their wall, and/or the mineralogy of their surrounding matrix were key parameters explaining their exceptional preservation. Here, we describe the remarkable morphological preservation of plant macrofossils in blueschist metamorphic rocks from New Zealand containing lawsonite. Leaves and stems can be easily identified at the macroscale. At the microscale, polygonal structures with walls mineralized by micas within the leaf midribs and blades may derive from the original cellular ultrastructure or, alternatively, from the shrinkage during burial of the gelified remnants of the leaves in an abiotic process. Processes and important parameters involved in the remarkable preservation of these fossils during metamorphism are discussed. Despite the excellent morphological preservation, the initial biological polymers have been completely transformed to graphitic carbonaceous matter down to the nanometer scale. This occurrence demonstrates that plant macrofossils may experience major geodynamic processes such as metamorphism and exhumation involving deep changes and homogenization of their carbon chemistry and structure but still retain their morphology with remarkable integrity even if they are not shielded by any hard‐mineralized concretion.
RECQL4 localizes to mitochondria and preserves mitochondrial DNA integrity
Authors: Croteau Deborah L. , Rossi Marie L. , Canugovi Chandrika , Tian Jane , Sykora Peter , Ramamoorthy Mahesh , Wang ZhengMing , Singh Dharmendra Kumar , Akbari Mansour , Kasiviswanathan Rajesh , Copeland William C. , Bohr Vilhelm A.
Published: February 2012

RECQL4 is associated with Rothmund–Thomson Syndrome (RTS), a rare autosomal recessive disorder characterized by premature aging, genomic instability, and cancer predisposition. RECQL4 is a member of the RecQ helicase family, and has many similarities to WRN protein, which is also implicated in premature aging. There is no information about whether any of the RecQ helicases play roles in mitochondrial biogenesis, which is strongly implicated in the aging process. Here, we used microscopy to visualize RECQL4 in mitochondria. Fractionation of human and mouse cells also showed that RECQL4 was present in mitochondria. Q‐PCR amplification of mitochondrial DNA demonstrated that mtDNA damage accumulated in RECQL4‐deficient cells. Microarray analysis suggested that mitochondrial bioenergetic pathways might be affected in RTS. Measurements of mitochondrial bioenergetics showed a reduction in the mitochondrial reserve capacity after lentiviral knockdown of RECQL4 in two different primary cell lines. Additionally, biochemical assays with RECQL4, mitochondrial transcription factor A, and mitochondrial DNA polymerase γ showed that the polymerase inhibited RECQL4’s helicase activity. RECQL4 is the first 3′–5′ RecQ helicase to be found in both human and mouse mitochondria, and the loss of RECQL4 alters mitochondrial integrity.
A revision of the anatomy of the Early Devonian jawed vertebratePtomacanthus anglicusMiles
Authors: BRAZEAU MARTIN D.
Published: February 2012

Abstract: The spine‐bearing jawed vertebrates (gnathostomes) assigned to the assemblage ‘Acanthodii’ play a key role in understanding the early evolution of osteichthyans and chondrichthyans. Amongst ‘acanthodians’, the genusPtomacanthushas played a prominent role owing to its shark‐like tooth files. Recently described braincase material from this taxon contrasts strongly with the osteichthyan‐like braincase ofAcanthodes, the only other ‘acanthodian’ for which this anatomy is well known. This seriously challenges acanthodian monophyly or at least the prevailing interpretation ofAcanthodes. This study presents a redescription and updated comparison of the anatomy ofPtomacanthusbased on unfigured material from the type and referred specimens, as well as adding new data on spine and scale histology.Ptomacanthusis remarkably heterosquamous compared to some other ‘acanthodians’. Further to its resemblances toClimatius,Ptomacanthusshares some features of the external morphology of its scales with the enigmatic genusObtusacanthus. The scale crowns ofPtomacanthusexhibit both superpositional and areal growth. The bases, however, grow separately from the crown. As inAcanthodes, scales are here inferred to be added to the body from posterior to anterior. In spite of its chondrichthyan‐like form and characters,Ptomacanthusremains difficult to place on either the chondrichthyan, osteichthyan or gnathostome stem. Different placements each require invoking considerable character incongruence. Nevertheless, these new data fromPtomacanthusprovide broader anatomical context for hard tissue characters commonly described on the basis of isolated remains.
The cholecystokinin CCK2 receptor antagonist, JNJ‐26070109, inhibits gastric acid secretion and prevents omeprazole‐induced acid rebound in the rat
Authors: Barrett TD , Lagaud G , Wagaman P , Freedman JM , Yan W , Andries L , Rizzolio MC , Morton MF , Shankley NP
Published: February 2012

BACKGROUND AND PURPOSE

JNJ‐26070109 [(R)4‐bromo‐N‐[1‐(2,4‐difluoro‐phenyl)‐ethyl]‐2‐(quinoxaline‐5‐sulfonylamino)‐benzamide] is a novel antagonist at cholecystokinin CCK2 receptors with good pharmacokinetic properties and represents a novel mechanism for the treatment of gastro‐oesophageal reflux disease (GORD). The purpose of the present study was to determine whether chronic treatment with JNJ‐26070109 could prevent, as well as treat, acid rebound in rats.

EXPERIMENTAL APPROACH

A chronic fistula was surgically inserted into the stomach of rats to enable the measurement of acid secretion under basal, pentagastrin and histamine‐stimulated conditions. JNJ‐26070109 and omeprazole were administered separately and in combination.

KEY RESULTS

Sustained administration of omeprazole alone and in combination with JNJ‐26070109 inhibited gastric acid secretion by >90%. However, 3 days after withdrawing treatment, there was a rebound hypersecretion by ∼1.5‐fold in omeprazole‐treated animals. No such acid rebound was observed with JNJ‐26070109 alone or with co‐administration of JNJ‐26070109 and omeprazole. The anti‐trophic effects of JNJ‐26070109 in the gastric mucosal paralleled the effects on acid rebound. Administration of JNJ‐26070109 for 3 days after cessation of omeprazole prevented the occurrence of acid rebound. Interestingly, chronic, but not acute, treatment with JNJ‐26070109 also inhibited histamine‐stimulated acid secretion.

CONCLUSIONS AND IMPLICATIONS

Chronic administration of JNJ‐26070109 effectively inhibited gastric acid secretion and suppressed proton pump inhibitor (PPI)‐induced acid rebound in the rat. This work advances the field by demonstrating that modest doses of a competitive CCK2 receptor antagonist have significant and functionally important anti‐trophic actions in the gastric mucosa. These properties make JNJ‐26070109 a suitable candidate for clinical investigation for the treatment of GORD.
Luminal cholinergic signalling in airway lining fluid: a novel mechanism for activating chloride secretion via Ca2+‐dependent Cl‐ and K+ channels
Authors: Hollenhorst Monika I , Lips Katrin S , Wolff Miriam , Wess Jürgen , Gerbig Stefanie , Takats Zoltan , Kummer Wolfgang , Fronius Martin
Published: February 2012

BACKGROUND AND PURPOSE Recent studies detected the expression of proteins involved in cholinergic metabolism in airway epithelial cells, although the function of this non‐neuronal cholinergic system is not known in detail. Thus, this study focused on the effect of luminal ACh as a regulator of transepithelial ion transport in epithelial cells.

EXPERIMENTAL APPROACH RT‐PCR experiments were performed using mouse tracheal epithelial cells for ChAT and organic cation transporter (OCT) transcripts. Components of tracheal airway lining fluid were analysed with desorption electrospray ionization (DESI) MS. Effects of nicotine on mouse tracheal epithelial ion transport were examined with Ussing‐chamber experiments.

KEY RESULTS Transcripts encoding ChAT and OCT1–3 were detected in mouse tracheal epithelial cells. The DESI experiments identified ACh in the airway lining fluid. Luminal ACh induced an immediate, dose‐dependent increase in the transepithelial ion current (EC50: 23.3 µM), characterized by a transient peak and sustained plateau current. This response was not affected by the Na+‐channel inhibitor amiloride. The Cl‐‐channel inhibitor niflumic acid or the K+‐channel blocker Ba2+ attenuated the ACh effect. The calcium ionophore A23187 mimicked the ACh effect. Luminal nicotine or muscarine increased the ion current. Experiments with receptor gene‐deficient animals revealed the participation of muscarinic receptor subtypes M1 and M3.

CONCLUSIONS AND IMPLICATIONS The presence of luminal ACh and activation of transepithelial ion currents by luminal ACh receptors identifies a novel non‐neuronal cholinergic pathway in the airway lining fluid. This pathway could represent a novel drug target in the airways.
Clinical, histopathological and immunohistochemical characterization of canine indolent lymphoma
Authors: Flood‐Knapik K. E. , Durham A. C. , Gregor T. P. , Sánchez M. D. , Durney M. E. , Sorenmo K. U.
Published: February 2012

Indolent lymphoma comprises up to 29% of all canine lymphoma; however, limited information exists regarding the subtypes and biological behaviour. This retrospective study describes the clinical characteristics, histopathological and immunohistochemical features, treatment, outcome and prognostic factors for 75 dogs with indolent lymphoma. WHO histopathological classification and immunohistochemistry (IHC) for CD79a, CD3, Ki67 and P‐glycoprotein (P‐gp) was performed. The most common histopathological subtype was T‐zone, 61.7%, (MST 33.5 months), followed by marginal zone, 25%, (MST 21.2 months), P = 0.542. The addition of IHC to preliminary histopathological classification resulted in a revised diagnosis in 20.4% of cases. The use of systemic treatment did not influence survival, P = 0.065. Dogs treated with chlorambucil and prednisone did not reach a MST, compared with a MST of 21.6 months with CHOP‐based chemotherapy, P = 0.057. The overall MST of 4.4 years confirms that this is indeed an indolent disease. However, the effect of systemic treatment must be determined through prospective trials.
The Framingham risk score and heart disease in nonalcoholic fatty liver disease
Authors: Treeprasertsuk Sombat , Leverage Scott , Adams Leon A. , Lindor Keith D. , St Sauver Jennifer , Angulo Paul
Published: February 2012

The accuracy of the Framingham risk score (FRS) in identifying patients with nonalcoholic fatty liver disease (NAFLD) at higher 10‐year coronary heart disease (CHD) risk remains unknown. We aimed at evaluating both the baseline probability of CHD as predicted by the FRS and the actual long‐term occurrence of CHD in NAFLD patients. This was a longitudinal study of a community‐based cohort. A total of 309 NAFLD patients were followed up for 11.5 ± 4.1 years (total 3554 person‐years). The overall calculated 10‐year CHD risk was significantly higher in the NAFLD cohort than the absolute CHD risk predicted by the FRS for persons of the same age and gender (10.9 ± 9.3% vs. 9.9 ± 5.9%, respectively, P < 0.0001), and higher in men than women (12.6 ± 10.3% vs. 9.6 ± 8.1%, respectively, P = 0.006). New onset CHD occurred in 34 patients (11% vs. 10.9% predicted at baseline, P = NS), whereas 279 (89%) patients did not develop CHD. Using multivariable analysis, the FRS was the only variable significantly associated with new onset CHD (OR = 1.13, 95% CI = 1.05–1.21; P = 0.001). A FRS cut‐point of 11 in women, and 6 in men had a sensitivity of 80% and 74%, respectively, and a negative predictive value of 97% and 93% respectively. NAFLD patients have a higher 10‐year CHD risk than the general population of the same age and gender. The FRS accurately predicts the higher 10‐year CHD risk in NAFLD patients, and helps identify those patients expected to derive the most benefit from early intervention to prevent CHD events.
Trichophyton Tonsurans Induced Recurrent Onychomadesis in a Very Young Infant
Authors: Khanna Deepshikha , Goel Alka , Kedar Ashwini , Manchanda Vikas , Agarwal Swastika
Published: February 2012

Abstract:  Onychomadesis, or nail shedding, is rarely seen in children and can be due to stress, systemic illnesses, trauma, and drug therapy or may be idiopathic. Fungal infection of the nail is only rarely reported as a cause of onychomadesis. We present here a case of Trichophyton tonsurans–induced onychomycosis and resultant onychomadesis in a 9‐month‐old boy with onset of lesions at 2 weeks of life.
Spitz Nevus Arising upon a Congenital Glomuvenous Malformation
Authors: Arica Deniz A. , Arica Ibrahim E. , Yayli Savas , Cobanoglu Umit , Akay Bengu N. , Anadolu Rana , Bahadir Sevgi
Published: February 2012

Abstract:  There are several reports of the collision of vascular and pigmentary anomalies (e.g., phakomatosis pigmentovascularis) and the association between congenital melanocytic nevi and infantile hemangiomas. We report a case of Spitz nevus arising in skin overlying a congenital plaque‐like glomuvenous malformation (GVM). This is the first report of a Spitz nevus arising in direct contiguity to a GVM.
Multiple Eruptive Pilomatricomas in a 9‐year‐Old Boy with Glioblastoma
Authors: Hollmig S. Tyler , Tollefson Megha M. , Kim Jinah , Khuu Phuong
Published: February 2012

Abstract:  A 9‐year‐old male presented to our dermatology clinic with a recent history of developing numerous cutaneous pilomatricomas, and was subsequently discovered to have sustained a recurrence of his glioblastoma multiforme. Immunohistochemical staining of a representative pilomatricoma and his original brain tumor revealed upregulation and nuclear localization of beta‐catenin, a sign associated with poor prognosis in glioblastoma. We hypothesize that the development of multiple pilomatricomas may have been a hallmark of this patient's tumor recurrence and provide support for a recent report of an association between multiple pilomatricomas and gliomatosis cerebri.
Perception of Earthquake Risk in Taiwan: Effects of Gender and Past Earthquake Experience
Authors: Kung Yi‐Wen , Chen Sue‐Huei
Published: February 2012

This study explored how individuals in Taiwan perceive the risk of earthquake and the relationship of past earthquake experience and gender to risk perception. Participants (n= 1,405), including earthquake survivors and those in the general population without prior direct earthquake exposure, were selected and interviewed through a computer‐assisted telephone interviewing procedure using a random sampling and stratification method covering all 24 regions of Taiwan. A factor analysis of the interview data yielded a two‐factor structure of risk perception in regard to earthquake. The first factor, “personal impact,” encompassed perception of threat and fear related to earthquakes. The second factor, “controllability,” encompassed a sense of efficacy of self‐protection in regard to earthquakes. The findings indicated prior earthquake survivors and females reported higher scores on the personal impact factor than males and those with no prior direct earthquake experience, although there were no group differences on the controllability factor. The findings support that risk perception has multiple components, and suggest that past experience (survivor status) and gender (female) affect the perception of risk. Exploration of potential contributions of other demographic factors such as age, education, and marital status to personal impact, especially for females and survivors, is discussed. Future research on and intervention program with regard to risk perception are suggested accordingly.
Significance of Missing Telemetered Markers in Implanted Cardioverter‐Defibrillators
Authors: BAROLD S. SERGE , STROOBANDT ROLAND X , HEUVERSWYN FREDERIC VAN , HERWEG BENGT
Published: February 2012

Background:
 We report three patients with St Jude ICDs (St. Jude Medical, Sylmar, CA, USA) where some aspect of the marker channel was missing.

Methods and Results:
 Two cases were caused by the simultaneous occurrence of two distinct cardiac or device events that affected the proper delivery of markers by the telemetry system. Inability of the devices to sequentially process these events resulted in incomplete transmission of telemetry data to the programmers and caused missing markers in the telemetry recordings. In the third case, sensed atrial interference resulted in a short period of atrial asynchronous pacing, which prevented the delivery of a sensed atrial marker coincident with an atrial electrogram. This atrial electrogram by virtue of its timing would have otherwise been sensed outside the atrial refractory period.

Conclusion:
 The perplexing recordings of the three patients should not be interpreted as representing true pacemaker malfunction. PACE 2012; 35:409–415)
Cardiac Resynchronization Therapy with or Without Anatomical Reverse Remodeling Does Not Affect Defibrillation Threshold
Authors: KARTAL YILDIRIM , YAVUZGIL OGUZ , BOZOGLU MUHITTIN , ALP ALPAY , CAN LEVENT H. , HASDEMIR CAN
Published: February 2012

Background:

Recent clinical trials have documented beneficial reverse‐remodeling effects with cardiac resynchronization therapy (CRT). The aim of this study was to investigate the effect of CRT with or without reverse anatomical remodeling of the left ventricle on defibrillation threshold (DFT) levels in a prospective and consecutive group of patients with class II‐IV systolic heart failure.

Methods:

Study population consisted of 29 patients (14 women and 15 men; mean age 61 ± 11 years old). All patients underwent baseline (within 24‐hours of cardiac resynchronization therapy‐defibrillator [CRT‐D] implantation) and 6‐month follow‐up DFT testing. Reverse anatomical remodeling of the left ventricle was defined as ≥15% reduction in left ventricular end‐systolic volume at the end of 6 months of follow‐up compared to baseline.

Results:

Baseline, average DFT was 8.8 ± 5.9 J. Left ventricular end‐diastolic volume was the only predictor of baseline DFT level (P = 0.02) among the baseline demographics. Safety margin of at least 10 J was achieved in all patients. Average DFT at the end of 6 months of biventricular pacing was 9.2 ± 6.9 J. One patient (3.4%) failed to have a safety margin of 10 J. Reverse anatomical remodeling was observed in 14 (48%) patients and did not have any effect on DFT level. There were no complications related to DFT testings.

Conclusions:

Baseline average DFT in patients undergoing CRT‐D was ≤10 J in our study. CRT‐D with or without anatomical reverse remodeling does not affect DFT at the end of 6 months of follow‐up. High DFT level at the end of 6 months of follow‐up is rare (3.4%) among patients with current CRT‐D devices. PACE 2012; 35:416–421)
Assessing Treatment‐Selection Markers using a Potential Outcomes Framework
Authors: Huang Ying , Gilbert Peter B. , Janes Holly
Published: February 2012

Summary Treatment‐selection markers are biological molecules or patient characteristics associated with one’s response to treatment. They can be used to predict treatment effects for individual subjects and subsequently help deliver treatment to those most likely to benefit from it. Statistical tools are needed to evaluate a marker’s capacity to help with treatment selection. The commonly adopted criterion for a good treatment‐selection marker has been the interaction between marker and treatment. While a strong interaction is important, it is, however, not sufficient for good marker performance. In this article, we develop novel measures for assessing a continuous treatment‐selection marker, based on a potential outcomes framework. Under a set of assumptions, we derive the optimal decision rule based on the marker to classify individuals according to treatment benefit, and characterize the marker’s performance using the corresponding classification accuracy as well as the overall distribution of the classifier. We develop a constrained maximum‐likelihood method for estimation and testing in a randomized trial setting. Simulation studies are conducted to demonstrate the performance of our methods. Finally, we illustrate the methods using an HIV vaccine trial where we explore the value of the level of preexisting immunity to adenovirus serotype 5 for predicting a vaccine‐induced increase in the risk of HIV acquisition.
A Prelinguistic Gestural Universal of Human Communication
Authors: Liszkowski Ulf , Brown Penny , Callaghan Tara , Takada Akira , de Vos Conny
Published: February 2012

Several cognitive accounts of human communication argue for a language‐independent, prelinguistic basis of human communication and language. The current study provides evidence for the universality of a prelinguistic gestural basis for human communication. We used a standardized, semi‐natural elicitation procedure in seven very different cultures around the world to test for the existence of preverbal pointing in infants and their caregivers. Results were that by 10–14 months of age, infants and their caregivers pointed in all cultures in the same basic situation with similar frequencies and the same proto‐typical morphology of the extended index finger. Infants’ pointing was best predicted by age and caregiver pointing, but not by cultural group. Further analyses revealed a strong relation between the temporal unfolding of caregivers’ and infants’ pointing events, uncovering a structure of early prelinguistic gestural conversation. Findings support the existence of a gestural, language‐independent universal of human communication that forms a culturally shared, prelinguistic basis for diversified linguistic communication.
Potential biomarkers in psychiatry: focus on the cholesterol system
Authors: Woods Alisa G. , Sokolowska Izabela , Taurines Regina , Gerlach Manfred , Dudley Edward , Thome Johannes , Darie Costel C.
Published: February 2012

● Introduction

● Methods for proteomic analysis

  – Sample fractionation/biochemical fractionation

  – MS

● The cholesterol system

  – Cholesterol and apolipoproteins

  – Cholesterol

  – Apos

  – ApoE

  – ApoB

  – ApoA1 and ApoA4

● The cholesterol system and specific disorders

  – Alzheimer's disease

  – Schizophrenia

  – Depression

  – Developmental disorders: ASDs

● Discussion

  – Proteomic considerations for analysis of Apos

  – Considering diet and lifestyle effects on the cholesterol system

  – Consequences of disturbed cholesterol and Apos in the CNS

● Conclusion

Measuring biomarkers to identify and assess illness is a strategy growing in popularity and relevance. Although already in clinical use for treating and predicting cancer, no biological measurement is used clinically for any psychiatric disorder. Biomarkers could predict the course of a medical problem, and aid in determining how and when to treat. Several studies have indicated that of candidate psychiatric biomarkers detected using proteomic techniques, cholesterol and associated proteins, specifically apolipoproteins (Apos), may be of interest. Cholesterol is necessary for brain development and its synthesis continues at a lower rate in the adult brain. Apos are the protein component of lipoproteins responsible for lipid transport. There is extensive evidence that the levels of cholesterol and Apos may be disturbed in psychiatric disorders, including autistic spectrum disorders (ASD). Here, we describe putative serum biomarkers for psychiatric disorders, and the role of cholesterol and Apos in central nervous system (CNS) disorders.
The potential benefits of participating in early‐phase clinical trials in multiple myeloma: long‐term remission in a patient with relapsed multiple myeloma treated with 90 cycles of lenalidomide and bortezomib
Authors: Richardson Paul G. , Laubach Jacob P. , Schlossman Robert L. , Ghobrial Irene M. , Redman Katherine C. , Mckenney Mary , Warren Diane , Noonan Kimberly , Lunde Laura , Doss Deborah , Colson Kathleen , Hideshima Teru , Mitsiades Constantine , Munshi Nikhil C. , Anderson Kenneth C.
Published: February 2012

We present the case of a woman with relapsed multiple myeloma (MM) who received combination lenalidomide and bortezomib therapy for 90 cycles followed by continuous lenalidomide monotherapy and has completed over 100 cycles of treatment to date. The patient was diagnosed with advanced‐stage, symptomatic MM in 2001. Following a partial response (PR) to dexamethasone in combination with pamidronate and thalidomide, the patient underwent protocol‐directed non‐myeloablative allogeneic bone marrow transplantation from her matched sibling donor the following year. In 2004, the patient relapsed and was enrolled in a phase I, dose‐escalation trial of lenalidomide plus bortezomib for relapsed and refractory MM. After eight cycles of study treatment, the patient achieved a minimal response. The patient received a total of 90 cycles of treatment with lenalidomide 5 mg given for 14 d every 21 d, and 1 mg/m2 of bortezomib initially given on days 1, 4, 8, and 11 for the first 20 cycles, and then weekly thereafter on days 1 and 8. Bortezomib was discontinued after 90 cycles, and the patient continued to receive lenalidomide monotherapy. As of cycle 100, the patient achieved a PR. Currently, she is clinically stable with response sustained for over 7 yrs. Therapy has been well tolerated with no significant long‐term toxicity; no dose reductions of lenalidomide and bortezomib were required. The excellent tolerability of this steroid‐free approach and the durable response seen underscore the potential benefits of participating in early‐phase clinical trials evaluating novel therapies and new drug combinations. This case further supports that combination treatment with lenalidomide and bortezomib is an effective therapy in the management of patients with relapsed and refractory MM.
Dental injury and its prevention in Swiss rugby
Authors: Schildknecht Stefan , Krastl Gabriel , Kühl Sebastian , Filippi Andreas
Published: February 2012

Abstract –  Objectives:  Rugby players are at a high risk of sustaining dental injury because of the high number of tackles implicit to the game. This study aimed to determine the frequency of injuries sustained by players in the Swiss rugby league.

Methods:  During the 2010/11 season, 517 rugby players from 19 clubs were questioned about dental trauma as well as the use of mouthguards and other forms of body protection. The level of awareness about tooth avulsion and replantation was also assessed. Participants included athletes from four different leagues; National (155), Premier (122), Women’s (90) and Juniors (150).

Results:  Of the 517 players taking part in the survey, 54.4% had sustained at least one serious injury and 39.5% had sustained a facial injury. One hundred and thirty‐nine athletes (37.3%) had observed another player sustain a dental injury during a game, whilst 35 (6.8%) had personally sustained one or more dental injuries. Dental injury rate was considerably higher amongst forwards than backs. Four hundred and fifty‐six players (88.2%) wore a mouthguard of which three‐quarters were tailor‐made. Three hundred and thirteen players (60.5%) were aware that an avulsed tooth can be replanted; however, only 27 (5.2%) had heard of the tooth rescue boxes. These results demonstrate that, whilst general injuries occur with regularity in rugby, dental injuries are not amongst the most common forms. This is almost certainly attributable to the high level of mouthguard usage. Particularly for players in the junior league, in which the use of mouthguards was lowest, the risk of dental injury may be reduced by an increased level of education about tooth protection.

Conclusions:  To this end, an increased awareness about and usage of tooth rescue boxes would be desirable. It would seem sensible to make the wearing of mouthguards compulsory in contact sports such as rugby.
A toothbrush impalement injury of the floor of mouth in autism child
Authors: Sasaki Ryo , Uchiyama Hiroto , Okamoto Toshihiro , Fukada Kenji , Ogiuchi Hideki , Ando Tomohiro
Published: February 2012

Abstract –  Penetrating injuries in the oral cavity are common in children. However, penetrating injuries with retained foreign bodies are rare. We report a case of a toothbrush impalement injury of the floor of the mouth in a child with autism. A 5‐year‐old boy with autism presented with an accidentally impaled toothbrush in the oral cavity. He was taken to the operation room and examined under general anesthesia. The handle of the toothbrush was cut off using rib scissors for mask ventilation, and intra‐oral intubation was performed. The toothbrush was located approximately 2.5 cm into the floor of the mouth. The toothbrush was removed uneventfully. Intravenous antibiotic therapy was instituted during hospitalization, and discharge from the hospital occurred 4 days after the operation.
Effect of vitamin C deficiency during postnatal development on adult behavior: functional phenotype of Gulo(−/−) knockout mice
Authors: Chen Y. , Curran C. P. , Nebert D. W. , Patel K. V. , Williams M. T. , Vorhees C. V.
Published: February 2012

Organisms using oxygen for aerobic respiration require antioxidants to balance the production of reactive oxygen species during metabolic processes. Various species – including humans and other primates – suffer mutations in the GULO gene encoding L‐gulono‐γ‐lactone oxidase; GULO is the rate‐limiting enzyme in the biosynthesis of ascorbate, an important cellular antioxidant. Animals lacking the ability to synthesize vitamin C develop scurvy without dietary supplementation. The Gulo(−/−) knockout (KO) mouse requires oral supplemental vitamin C; without this supplementation the animal dies with a scorbutic condition within several weeks. Vitamin C is known to be most abundant in the brain, where it is believed to play important roles in neuroprotection, neurotransmission and neuromodulation. We therefore hypothesized that ascorbate deficiency in Gulo(−/−) KO mice might lead to an abnormal behavioral phenotype. We established the amount of ascorbate in the drinking water (220 ppm) necessary for generating a chronic low‐ascorbate status in the brain, yet clinically the mice appeared healthy throughout 100 days postpartum at which time all behavioral‐phenotyping tests were completed. Compared with Gulo(+/+) wild‐type littermates, ascorbate‐deficient Gulo(−/−) mice were found to be less active in moving in their environment; when in water, these mice swam more slowly in some tests, consistent with a mild motor deficit. We found no evidence of cognitive, anxiety or sensorimotor‐gating problems. Despite being less active, Gulo(−/−) mice exhibited exaggerated hyperactivity to the dopaminergic agonist methamphetamine. The subnormal movement, combined with hypersensitivity to a dopamine agonist, point to developmental ascorbate deficiency causing long‐term striatal dysfunction.