bluuebunny/crossref_metadata_2025 huggingface dataset:
Synergy between 5‐HT4 receptor activation and acetylcholinesterase inhibition in human colon and rat forestomach
Authors: Cellek S. , Thangiah R. , Jarvie E. M. , Vivekanandan S. , Lalude O. , Sanger G. J.
Published: April 2008

Abstract  5‐Hydroxytryptamine (5‐HT4) receptor agonists increase gastrointestinal (GI) motility by enhancing enteric acetylcholine release which is then metabolized by acetylcholinesterase (AChE) to inactive metabolites. As both AChE inhibitors and, more usually, 5‐HT4 receptor agonists are used to increase GI motility, an understanding of how these two different types of drugs might interact becomes of great importance. Our aim was to investigate the hypothesis that the effect of AChE inhibition will synergise with the ability of 5‐HT4 receptor agonism to increase cholinergic activity, leading to an effect greater than that evoked by each action alone. We tested the activity of the 5‐HT4 receptor agonist, prucalopride (10 nmol L−1–30 μmol L−1) and an AChE inhibitor, neostigmine (1 nmol L−1–10 μmol L−1) on cholinergically mediated contractions elicited by electrical field stimulation of human isolated colon circular muscle and rat isolated forestomach longitudinal strips. The experiments with human colon were performed in the presence of an inhibitor of nitric oxide synthase (Nω‐nitro‐l‐arginine methyl ester, 300 μmol L−1). Prucalopride and neostigmine both enhanced cholinergic contractions in both tissues. The effect of prucalopride was inhibited in both tissues by SB‐204070, a 5‐HT4 receptor antagonist. In the presence of a minimum effective concentration of neostigmine (30 nmol L−1) and a submaximum concentration of prucalopride (3 μmol L−1) the enhancement of contractions was greater than either compound alone in both tissues. These data demonstrate that the combination of prucalopride and neostigmine potentiate cholinergic contractions more than their arithmetic sum of their individual values. The results suggest that a synergy between 5‐HT4 receptor agonism and AChE inhibition could be established pharmacologically which could be utilized as a novel prokinetic approach to functional GI disorders.
Postprandial gastric antral contractions in patients with gastro‐oesophageal reflux disease: a scintigraphic study
Authors: Barbieri C. L. A. , Troncon L. E. A. , Herculano J. R. L. , Aprile L. R. O. , Moraes E. R. , Secaf M. , Dantas R. O.
Published: April 2008

Abstract  Disturbed gastric contractility has been found in manometric studies in patients with gastro‐oesophageal reflux disease (GORD), but the pathophysiological role of this abnormality is unclear. We aimed at assessing postprandial gastric antral contractions and its relationships with gastric emptying and gastro‐oesophageal reflux in GORD patients. Fasted GORD patients (n = 13) and healthy volunteers (n = 13) ingested a liquid meal labelled with 72 MBq of 99mTechnetium‐phytate. Gastric images were acquired every 10 min for 2 h, for measuring gastric emptying half time. Dynamic antral scintigraphy (one frame per second), performed for 4 min at 30‐min intervals, allowed estimation of both mean dominant frequency and amplitude of antral contractions. In GORD patients (n = 10), acidic reflux episodes occurring 2 h after the ingestion of the same test meal were determined by ambulatory 24‐h oesophageal pH monitoring. Gastric emptying was similar in GORD patients and controls (median; range: 82 min; 58–126 vs 80 min; 44–122 min; P = 0.38). Frequency of antral contractions was also similar in both groups (3.1 cpm; 2.8–3.6 vs 3.2 cpm; 2.4–3.8 cpm; P = 0.15). In GORD patients, amplitude of antral contractions was significantly higher than in controls (32.7%; 17–44%vs 23.3%; 16–43%; P = 0.01), and correlated positively with gastric emptying time (Rs = 0.58; P = 0.03) and inversely with the number of reflux episodes (Rs = −0.68; P = 0.02). Increased amplitude of postprandial gastric antral contractions in GORD may comprise a compensatory mechanism against delayed gastric emptying and a defensive factor against acidic gastro‐oesophageal reflux.
Serotonergic signalling in the stomach and duodenum of patients with gastroparesis
Authors: Van Lelyveld N. , Ter Linde J. , Schipper M. , Samsom M.
Published: April 2008

Abstract  Serotonin (5‐HT) is involved in the regulation of motoric and sensory functions of the upper gastrointestinal tract. The aim of the current study was to determine whether serotonergic signalling is altered in patients with idiopathic gastroparesis. Mucosal biopsy specimens were collected from the duodenum, antrum and fundus of 11 patients with idiopathic gastroparesis and 11 healthy controls. Neuroendocrine cells, specifically 5‐HT producing cells, were counted after immunohistochemistry, and non‐neuronal mRNA expression levels of tryptophan hydroxylase (TPH)‐1, 5‐HT transport protein (SERT), 5‐HT3 and 5‐HT4 receptor were quantified by real time RT‐PCR. The number of 5‐HT producing cells was comparable between patients and controls. No difference in expression of TPH‐1 (rate limiting enzyme in 5‐HT biosynthetic pathway) and SERT (responsible for 5‐HT uptake) was found between patients and controls (P > 0.05). In the duodenum, the expression of the 5‐HT3 receptor subunits and the 5‐HT4 receptor was comparable between both groups. However, the 5‐HT4(c) splice variant was expressed more abundantly in healthy controls compared to patients (P = 0.015). This study suggests that the delayed gastric emptying and upper abdominal symptoms in idiopathic gastroparesis do not result from altered mucosal 5‐HT biosynthetic and uptake capacity.
Oesophageal afferent pathway sensitivity in non‐erosive reflux disease
Authors: Hobson A. R. , Furlong P. L. , Aziz Q.
Published: April 2008

Abstract  Patients with non‐erosive reflux disease (NERD) report symptoms which commonly fail to improve on conventional antireflux therapies. Oesophageal visceral hyperalgaesia may contribute to symptom generation in NERD and we explore this hypothesis using oesophageal evoked potentials. Fifteen endoscopically confirmed NERD patients (four female, 29–56 years) plus 15 matched healthy volunteers (four female, 23–56 years) were studied. All patients had oesophageal manometry/24‐h pH monitoring and all subjects underwent evoked potential and sensory testing, using electrical stimulation of the distal oesophagus. Cumulatively, NERD patients had higher sensory thresholds and increased evoked potential latencies when compared to controls (P = 0.01). In NERD patients, there was a correlation between pain threshold and acid exposure as determined by DeMeester score (r = 0.63, P = 0.02), with increased oesophageal sensitivity being associated with lower DeMeester score. Reflux negative patients had lower pain thresholds when compared to both reflux positive patients and controls. Evoked potentials were normal in reflux negative patients but significantly delayed in the reflux positive group (P = 0.01). We demonstrate that NERD patients form a continuum of oesophageal afferent sensitivity with a correlation between the degree of acid exposure and oesophageal pain thresholds. We provide objective evidence that increased oesophageal pain sensitivity in reflux negative NERD is associated with heightened afferent sensitivity as normal latency evoked potential responses could be elicited with reduced afferent input. Increased oesophageal afferent pain sensitivity may play an important role in a subset of NERD and could offer an alternate therapeutic target.
Impedance‐pH monitoring: new standard for measuring gastro‐oesophageal reflux
Authors: Bredenoord A. J.
Published: April 2008

Abstract  Impedance monitoring is a new technique that can be used to detect the flow of fluids and gas through hollow viscera. With impedance monitoring gastro‐oesophageal reflux can be detected independent of its acidity by differences in electrical impedance between the mucosal surface, fluids and gas that surround the catheter. Clinically, it is used in combination with oesophageal pH monitoring, and the combination of impedance‐pH monitoring allows recognition of both acidic and weakly acidic reflux episodes. Studies have shown that impedance‐pH monitoring is useful in the evaluation of patients with proton pump inhibitor‐resistant typical reflux symptoms, as it provides a higher yield in detecting reflux as the cause of a patient’s symptoms compared to pH monitoring alone. It is therefore likely that impedance‐pH monitoring will largely replace pH monitoring in the next 5 years and it will become the standard for reflux detection.
Placental characteristics and birthweight
Authors: Salafia Carolyn M. , Zhang Jun , Charles Adrian K. , Bresnahan Michaeline , Shrout Patrick , Sun Wenyu , Maas Elizabeth M.
Published: April 2008

Standard gross placental measures capture dimensions relevant to specific placental functions. Our objective was to determine their accountability independent of placental weight for variance in birthweight, an important proxy for intrauterine ‘adequacy’ in fetal origins studies. The sample consisted of 24 152 singleton liveborn children of the Collaborative Perinatal Project delivered from 34 to 42 completed weeks gestation, with complete data for six placental measures (placental disc shape, umbilical cord length, distance from cord insertion to nearest margin, large diameter, small diameter, placental thickness) and placental weight. Associations between birthweight and placental measures were examined using multiple linear regression. Placental weight alone accounted for 36.6% of birthweight variation; the six other placental measures accounted for 28.1%. Combined, all placental measures accounted for 39.1% of birthweight variation. Seven maternal characteristics (age, height, weight, parity, socio‐economic status, cigarette use, and race) were investigated to determine whether their known associations with birthweight were mediated by placental markers. Analysis suggested that the impact of all maternal characteristics except smoking was consistent with mediation by placental characteristics.
NaCl‐induced changes in cytosolic free Ca2+ in Arabidopsis thaliana are heterogeneous and modified by external ionic composition
Authors: TRACY FRANCES E. , GILLIHAM MATTHEW , DODD ANTONY N. , WEBB ALEX A. R. , TESTER MARK
Published: April 2008

Increases in cytosolic free Ca2+ ([Ca2+]cyt) are common to many stress‐activated signalling pathways, including the response to saline environments. We have investigated the nature of NaCl‐induced [Ca2+]cyt signals in whole Arabidopsis thaliana seedlings using aequorin. We found that NaCl‐induced increases in [Ca2+]cyt are heterogeneous and mainly restricted to the root. Both the concentration of NaCl and the composition of the solution bathing the root have profound effects on the magnitude and dynamics of NaCl‐induced increases in [Ca2+]cyt. Alteration of external K+ concentration caused changes in the temporal and spatial pattern of [Ca2+]cyt increase, providing evidence for Na+‐induced Ca2+ influx across the plasma membrane. The effects of various pharmacological agents on NaCl‐induced increases in [Ca2+]cyt indicate that NaCl may induce influx of Ca2+ through both plasma membrane and intracellular Ca2+‐permeable channels. Analysis of spatiotemporal [Ca2+]cyt dynamics using photon‐counting imaging revealed additional levels of complexity in the [Ca2+]cyt signal that may reflect the oscillatory nature of NaCl‐induced changes in single cells.
Type B pigmentary demarcation lines in a Chinese amenorrheic woman
Authors: Ma Hui‐Jun , Zhao Guang , Dang Yu‐Ping
Published: April 2008

A 51‐year‐old Chinese woman (phototype III) presented to our dermatology clinic with a 3‐month history of asymptomatic pigmented maculae on the lower limbs that developed in the 11th month of amenorrhea. She had noticed no other areas of pigmentary change and denied any inflammatory episode or topical medication before their development. No personal or family history of hormonal imbalance or pigmentary demarcation lines (PDLs) was found. Physical examination revealed broad, band‐like pigmentation symmetrically distributed all over the flexor aspects of the lower limbs (Fig. 1). The medial borders of the pigmented areas were sharply demarcated, but the lateral borders merged imperceptibly into the normal skin. The patient was otherwise healthy. Laboratory examination, including full blood count, liver tests, triiodothyronine (T3), thyroxine (T4), and thyrotropic‐stimulating hormone (TSH), were normal. Hormonal investigations (Table 1) were within normal limits, except that estradiol (E2) was sharply decreased and follicle‐stimulating hormone (FSH) was highly elevated. Ultrasonic B‐mode examination showed a normal uterus and ovaries. No treatment was applied to the lesions. At a follow‐up visit, 16 months after onset, the pigmentary lines had resolved spontaneously. Moreover, the titers of hormones in serum had moved closer to normal values (Table 1).

Pigmentary demarcation lines on the buttocks and flexor aspect of the legs. The outer part is darker

image

Hormone investigations on the serum of our patient with pigmentary demarcation lines (PDLs)

3 months after onset
16 months after onset

Normal results
Abnormal results
Normal results
Abnormal results

1. Prolactin
1. Estradiol, 12.9 pmol/L Normal, 40.0–100 pmol/L
1. Prolactin
1. Estradiol, 36.46 pmol/L Normal, 40.0–100 pmol/L

2. Luteotropic hormone
2. Follicle‐stimulating hormone, 94.3 U/L Normal, 1.5–33.4 U/L
2. Luteotropic hormone
2. Follicle‐stimulating hormone, 53.2 U/L Normal, 1.5–33.4 U/L

3. Progestone

3. Progestone

4. Total testosterone

4. Total testosterone

5. Free triiodothyronine

5. Free triiodothyronine

6. Free thyroxine

6. Free thyroxine

7. Thyroid‐stimulating hormone

7. Thyroid‐stimulating hormone
Combining systemic retinoids with biologic agents for moderate to severe psoriasis
Authors: Smith Elizabeth C. A. , Riddle Christy , Menter M. Alan , Lebwohl Mark
Published: April 2008

Background  Moderate to severe psoriasis, which is defined as psoriasis affecting more than 20% of the body surface area, often requires a combination of therapies to achieve remission. Although numerous data exist regarding the use of acitretin and biologic agent therapy alone for psoriasis, little is known about the efficacy, safety, and tolerability of acitretin combined with biologic agents.

Methods  Fifteen patients with psoriasis treated with concomitant acitretin and a biologic agent were identified, and their charts were reviewed for response to therapy, additional therapy necessary for disease management, side‐effects, and laboratory abnormalities whilst on combination therapy. The Institutional Review Board did not require approval for this chart review.

Results  Twenty‐nine per cent of patients showed clearance of psoriasis, 43% of patients showed an improvement of 90%, 14% showed an improvement of 75%, and 7.1% showed no change. During treatment with acitretin and biologic agent, five patients required no adjunctive treatment. Three patients were able to stop narrow‐band ultraviolet‐B (UV‐B) therapy after an average of 2.33 months of combination therapy. Only one patient continued to require phototherapy (UV‐B) in addition to the biologic agent. Three patients developed squamous cell carcinoma (SCC) whilst on combination therapy, but all patients had a previous history of SCC. One patient developed non‐Hodgkin's lymphoma after 3 years of etanercept and acitretin, and the etanercept was discontinued.

Conclusions  Acitretin combined with biologic agents offers a promising method of managing refractory psoriasis. More research is needed to determine the long‐term safety and efficacy of this combination.
Dermatitis cruris pustulosa et atrophicans – a frequent but poorly understood tropical skin condition – a case report from Burkina Faso
Authors: Bens Guido , Franck Frédéric , Diatto Georges , Preney Laure , Darie Hervé , Géniaux Marc
Published: April 2008

Dermatitis cruris pustulosa et atrophicans (DCPA) is a benign inflammatory skin disease of the younger population in the tropics. Although this pustular skin condition of particular topography is frequently seen by dermatologists in tropical countries, its origin remains unknown. We report the case of a young woman with DCPA associated with prurigo nodularis. A bacterial origin has not been demonstrated in this case. Histology showed an intraepidermal neutrophilic pustule with dermal and subcutaneous infiltration by neutrophils and eosinophils forming flame figures. Different pathogenic hypotheses are discussed with special regard to a potential relationship between DCPA and eosinophilic cellulitis.
Connexin 26 mutation in keratitis–ichthyosis–deafness (KID) syndrome in mother and daughter with combined conductive and sensorineural hearing loss
Authors: Kelly Brent , Lozano Annabelle , Altenberg Guillermo , Makishima Tomoko
Published: April 2008

Background  Keratitis–ichthyosis–deafness (KID) syndrome most commonly results from a mutation in the gap‐junctional protein connexin 26 (Cx26) gene, GJB2. Most cases are sporadic and are associated with sensorineural hearing loss.

Methods  We encountered a mother and daughter with KID syndrome, and pursued genetic analysis and an extensive hearing loss evaluation.

Results  The analysis of genomic DNA of both affected patients revealed the mutation 148G → A in GJB2 (D50N). No mutation was found in an unaffected son. Auditory phenotype analysis showed a combined conductive and sensorineural hearing loss in both affected patients.

Conclusions  This is the second vertical transmission of the D50N mutation. These are the first two cases with combined sensorineural and conductive hearing loss without any significant history of middle ear disease. This points to the possibility that the Cx26 D50N mutation can cause conductive hearing loss.
Metabolic syndrome associated with toenail onychomycosis in Taiwanese with diabetes mellitus
Authors: Chang Shun‐Jen , Hsu Shih‐Chieh , Tien Kai‐Jen , Hsiao Jeng‐Yueh , Lin Shiu‐Ru , Chen Hung‐Chun , Hsieh Ming‐Chia
Published: April 2008

Background  Onychomycosis is a complication of diabetes mellitus (DM), which has a deleterious impact on the quality of life.

Aim  To explore the prevalence of onychomycosis amongst Taiwanese diabetics, and to analyze the factors associated with onychomycosis after adjusting for age and sex.

Methods  A total of 1245 Taiwanese diabetics were enrolled, and a nested case–control study was performed by onychomycosis outcome and the exposures were compared.

Results  The overall prevalence of onychomycosis among DM patients was 30.76% (383/1245), with a significantly higher prevalence in men than in women (P = 0.024). The factors associated with onychomycosis in matched pairs by gender and age were analyzed in 375 pairs. It was found that metabolic syndrome, obesity, triglyceride (TG) levels, and glycosylated hemoglobin (HbA1c) were associated with onychomycosis (P < 0.05).

Conclusion  Higher prevalence rates of onychomycosis were found in men and older DM patients. Metabolic syndrome, obesity, high TG levels, and poor glycemic control were associated with onychomycosis.
Immunohistochemical characterization of the cellular infiltrate in localized scleroderma
Authors: Xie Yong , Zhang Xiaoyong , Wakasugi Shoji , Makino Takamitsu , Inoue Yuji , Ihn Hironobu
Published: April 2008

Background  Localized scleroderma is a connective tissue disorder with hardening of the skin and fibrosis of the affected tissue as the most prominent features. The etiology of localized scleroderma is still unknown, but immunologic factors may play an important role in the pathogenesis. This study was performed to determine the immunohistochemical features of the cellular infiltrate in localized scleroderma.

Methods  Skin samples were obtained from six patients by 6‐mm punch biopsy. The samples were stained with monoclonal antibodies against CD1a, CD3, CD4, CD8, CD20, CD25, CD30, and CD57. The number of cells stained with each monoclonal antibody was calculated.

Results  There were more CD1a+, CD3+, CD4+, CD8+, CD20+, CD25+, and CD57+ cells in the dermal infiltrate in localized scleroderma relative to those in normal controls. The numbers of CD1a+, CD3+, CD4+, CD8+, and CD57+ cells in localized scleroderma were significantly greater than those in normal skin (P < 0.05). The number of CD30+ cells in localized scleroderma was almost the same as that in normal skin.

Conclusions  This study reveals that T lymphocytes, Langerhans cells, and natural killer cells may play important roles in the pathogenesis of localized scleroderma.
Matrine inhibits invasiveness and metastasis of human malignant melanoma cell line A375 in vitro
Authors: Liu Xiao‐yan , Fang Hong , Yang Zheng‐gang , Wang Xiao‐yong , Ruan Li‐ming , Fang De‐ren , Ding Ying‐guo , Wang Yi‐na , Zhang Yu , Jiang Xiao‐ling , Chen Hong‐chao
Published: April 2008

Background  Matrine is a traditional Chinese medicine with significant inhibitory activity against malignant tumors. Its effects on the invasiveness and metastasis of malignant tumors have rarely been reported.

Aim  To investigate whether matrine can inhibit the metastasis‐related activities of the human malignant melanoma cell line A375 in vitro.

Methods  3‐(4,5‐Dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide (MTT) assay and Annexin‐V–fluorescein isothiocyanate/propidium iodide (Annexin‐V‐FITC/PI) affinity assay were used to examine the effects of matrine on the proliferation and apoptosis induction of A375 cells. The morphologic changes of A375 cells were observed by light and electron microscopy. Semiquantitative reverse transcription‐polymerase chain reaction (RT‐PCR) and Western blotting were performed to evaluate the expression of heparanase mRNA and protein. The effect of matrine on the adhesion ability and invasiveness of treated A375 cells was tested by cell–Matrigel adhesion assay and Matrigel invasion assay, respectively.

Results  Matrine showed significant inhibition of the proliferation of A375 cells in a dose‐ and time‐dependent manner. It also induced apoptosis in a dose‐dependent manner. Compared with the control group, the levels of heparanase mRNA and protein expression of A375 cells treated with different concentrations of matrine were decreased significantly, as were their adhesion ability and invasiveness.

Conclusions  These findings indicate that matrine inhibits the invasiveness and metastasis of A375 cells in vitro. The mechanisms may be linked to the inhibition of cellular proliferation, induction of apoptosis, and downregulation of heparanase mRNA and protein expression.
Orthogonal polarization technique in the assessment of human skin microcirculation
Authors: Lupi Omar , Semenovitch Ivan , Treu Curt , Bouskela Eliete
Published: April 2008

Background  The “gold standard” for the study of the in vivo microcirculation is intravital microscopy. The recently developed method of orthogonal polarization of light [orthogonal polarization spectral (OPS) imaging] allows for the in vivo transcutaneous evaluation of the microcirculation without the need for invasive surgical procedures.

Methods  The application of polarized light originating from a 100 W halogen tungsten lamp is able to penetrate tissues at a depth of up to 3 mm, and generates reissued light from this depth. The evaluation of this depolarized light, from a deeper origin, may be carried out separately from the light reflected by the more superficial layers of the tissue under study because this light retains photon polarization, whereas the former light undergoes real depolarization.

Results  The process of validation of the OPS technique, when compared with intravital microscopy, the “gold standard” for the in vivo observation of the microcirculation, has shown that it is as effective and reliable as the gold standard, reaching the same resolution level in the visualization of blood vessels, but without the need for invasive surgical procedures.

Conclusions  The OPS technique is a very promising tool for dermatologists and researchers, especially in the study of vasculitis, chronic venous insufficiency, and skin tumors.
Donor's understanding of the definition of sex as applied to predonation screening questions
Authors: O’Brien S. F. , Ram S. S. , Yi Q.‐L. , Goldman M.
Published: April 2008

Background and Objectives  Predonation screening questions about sexual risk factors should provide an extra layer of safety from recently acquired infections that may be too early to be detected by testing. Donors are required to read a definition of sex as it applies to predonation screening questions each time they come to donate, but how well donors apply such definitions has not been evaluated. We aimed to determine how donors define sex when answering screening questions.

Materials and Methods  In total, 1297 whole blood donors were asked in a private interview to select from a list of sexual activities which ones they believed were being asked about in sexual background questions. Donors’ definitions were coded as under‐inclusive, correct or over‐inclusive in relation to the blood services’ definition. Qualitative interviews were carried out with 21 donors to understand reasoning behind definitions.

Results  Most donors had an over‐inclusive definition (58·7%) or the correct definition (31·9%). Of the 9·4% of donors who had an under‐inclusive definition, 95% included both vaginal and anal sex, but not oral sex. About 9% in each group were first‐time donors (P > 0·05) who had never read the definition. The qualitative interviews indicated that donors reason their definition based on their own concept of transmissible disease risk.

Conclusion  Donors apply a range of definitions of sex when answering questions about their sexual background. This may be due to different concepts of risk activities, and required reading of the definition has little impact.
Pallor of the optic disc in children
Authors: Ouvrier R.A.
Published: April 2008

This report discusses the subject of pallor of the optic disc from the viewpoint of a paediatric neurologist. The paper is divided into two sections, one on optic atrophy in childhood and the second on optic nerve hypoplasia. Optic atrophy in children is a topic which is very poorly covered in standard textbooks either of neurology or ophthalmology. This review attempts to develop a working approach to the management of children who present with optic nerve atrophy as their primary neurological finding.
Effectiveness and predictability of tendon lengthening procedures
Authors: Peart D. A. , Molteno A.C.B.
Published: April 2008

A retrospective study was performed on the results of surgery in infantile esotropia with the aim of comparing recessions with a loop (a procedure in which the effect of a recession is increased by attaching the muscle to the globe with an intervening loop of suture to lengthen the tendon) to standard recession operations. The results of surgery were examined in 188 cases, of which 41 had been treated using a loop alone and 38 using a loop combined with a recession. The loop or sling procedure was found to be as predictable as conventional surgery and effective in increasing the amount of correction obtained.
Blind registrations in Western Australia: a five‐year study
Authors: Cooper Richard L.
Published: April 2008

This paper reports the annual blind certification by the Association for the Blind, Western Australia, for five consecutive years, to December 1988. The data are analysed with a view to obtaining minimum figures for incidence of the major causes of blindness in this state.
Modified Bahasa Malaysia version of VF‐14 questionnaire: assessing the impact of glaucoma in rural area of Malaysia
Authors: Maharajah Kodisvary R , Tet Cheong Min , Yaacob Azhany , Tajudin Liza‐Sharmini Ahmad , Foster Paul J
Published: April 2008

Abstract

Purpose:  To evaluate the functional impairment of glaucoma patients, using a modified Bahasa Malaysia version of VF‐14 questionnaire, and to correlate the score with the severity of the disease.

Methods:  One‐to‐one interview by trained interviewers was conducted on glaucoma patients seen in the eye clinic of Hospital Universiti Sains Malaysia, using a modified validated Bahasa Malaysia version of VF‐14 questionnaire. The severity of glaucoma was determined based on the better‐eye Advanced Glaucoma Intervention Study Scale (AGIS) score of visual field analysis on the latest most reliable visual field. The literacy rate, living situation, better‐eye visual acuity and lens status were also documented.

Results:  A total of 110 glaucoma patients were recruited (54.5% primary open‐angle glaucoma, 21.8% primary angle‐closure glaucoma, 19.2% normotensive glaucoma and 4.5% pseudoexfoliative glaucoma) and majority with bilateral involvement. Based on the better‐eye AGIS score, 41.5% were in advanced stage, 29.1% moderate and 29.1% mild. There was a significant association between VF‐14 scoring with the better‐eye AGIS score (r =−0. 579, P < 0.001), age (r = −0.313, P = 0.000) and better‐eye visual acuity (r = −0.752, P = 0.000). Based on the multivariate analysis, there was a significant association of the questionnaire score and better‐eye AGIS score (P < 0.001).

Conclusion:  The Bahasa Malaysia version of modified VF‐14 questionnaire is a useful tool in quantifying quality of life among glaucoma patients in rural area with high illiteracy rate and provides moderate correlation with severity of the disease. Customization of quality of life questionnaire according to custom and culture of the community will provide better insight to the functional impairment of glaucoma patients.
Meta‐analysis of randomized controlled trials comparing timolol with brimonidine in the treatment of glaucoma
Authors: Loon Seng Chee , Liew Gerald , Fung Adrian , Reid Sharon E , Craig Jonathan C
Published: April 2008

Abstract

This paper aims to compare the efficacy and tolerability of timolol versus brimonidine in the treatment of glaucoma. Comprehensive searches were performed using Medline, Embase and the Cochrane Controlled Trials Register for randomized controlled trials comparing timolol and brimonidine. Two reviewers independently assessed trials for eligibility and quality and extracted data. A random effects model was used to combine studies. Outcome was defined as the absolute mean intraocular pressure (IOP) reduction from baseline to end‐point for efficacy, and relative risk (RR) for adverse events. Subgroup analysis and meta‐regression were used to explore heterogeneity according to trial design and quality. Ten publications reporting on eight trials with 2387 participants were included in the meta‐analysis. Two further trials were commented on qualitatively. IOP reduction was not significantly different between timolol and brimonidine. Weighted mean difference (WMD) of IOP reduction was 0.24 mmHg (favouring brimonidine) with a 95% confidence interval of −0.57 to 1.04 mmHg. There was significant heterogeneity between studies (χ213 = 73.75, P < 0.00001, I2 = 91%). Subgroup analysis showed no significant WMD for studies where data were analysed from end‐points ≥6 months or <6 months. Meta‐regression analysis showed increased WMD IOP reduction in favour of brimonidine with increased trial quality (t3 = −4.58, P = 0.01), but no significant association with trial duration (t3 = 0.73, P = 0.51) or size (t3 = −0.59, P = 0.57). The RR of ocular allergy was much lower with timolol than brimonidine (RR = 0.08, 95% confidence interval 0.01 to 0.47). Publication bias was not evident on a funnel plot, although the number of studies was small. The conclusion is that both drugs are equally effective in lowering IOP. Brimonidine is associated with a higher rate of allergy.
Densiron intraocular tamponade: a case series
Authors: Lim Beng Liam , Vote Brendan
Published: April 2008

Abstract

Purpose:  To report on the use of Densiron (heavy silicone oil), a new endotamponade agent with proposed benefits in complex retinal detachments involving inferior proliferative vitreoretinopathy.

Method:  Retrospective case note review.

Results:  Ten cases (10 eyes) in which Densiron was used in eyes which had failed initial retinal detachment surgery. The overall success rate of long‐term total reattachment was 70%. Mean preoperative visual acuity was logMAR 2.03 (SD 0.406), which improved to a mean postoperative visual acuity of logMAR 1.00 (SD 0.571) (P = 0.001).

Conclusion:  Densiron was well tolerated with few side‐effects and appears to be a useful agent in patients with inferior proliferative vitreoretinopathy.
Verteporfin photodynamic therapy for anterior segment neovascularization secondary to ischaemic central retinal vein occlusion
Authors: Parodi Maurizio Battaglia , Iacono Pierluigi , Ravalico Giuseppe
Published: April 2008

Abstract

Purpose:  To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for anterior segment neovascularizations (ASNVs) in patients affected by ischaemic form of central retinal vein occlusion (CRVO).

Methods:  Prospective non‐comparative case series including 10 consecutive patients (10 eyes) affected by ischaemic CRVO. Main outcome measure was the obliteration of ASNV.

Results:  One month after PDT, biomicroscopic examination showed partial obliteration of iris new vessels and complete closure of angle neovascularization. Iris fluorescein angiography performed 1 week after treatment showed partial closure of the iris new vessels with no evidence of leakage in the late phases. During the subsequent examinations, a partial reopening of the iris and angle new vessels in association with dye leakage on fluorescein angiography was evident. In any case, the fluorescein leakage turned out to be still reduced with respect to the baseline aspects.

Conclusions:  Our results show that PDT with verteporfin can partially obliterate ASNVs in eyes affected by ischaemic CRVO preventing from the evolution towards advanced stages of neovascular glaucoma, but is not effective in cases with complete angle synechial closure.
Awareness of diabetic eye disease among general practitioners and diabetic patients in Yangon, Myanmar
Authors: Muecke James S , Newland Henry S , Ryan Philip , Ramsay Emmae , Aung Mya , Myint San , Esmail‐Zadeh Ramin , Zborowska Bogna , Selva Dinesh
Published: April 2008

Abstract

Background:  Diabetes is an increasing problem in Myanmar with more than three million people affected. There are no data on awareness of diabetic retinopathy among the general practitioners (GPs) or diabetic population of Myanmar. This study aims to evaluate the awareness of diabetes‐related eye disease among GPs and diabetic patients in Yangon, Myanmar.

Design:  A cross‐sectional survey.

Methods:  From the Myanmar Medical Association Registry of 978 practicing GPs in Yangon, 200 were randomly selected and a structured questionnaire was sent to each. Each GP was asked to give a separate questionnaire to the first five diabetic patients who attended their practice.

Results:  One hundred GPs and 480 patients returned the questionnaires. Although 99% of GPs were aware that diabetes could result in loss of vision, 49% never examined the fundi of their diabetic patients. Of the diabetic patients, 86% were aware that diabetes could damage their eyesight. Although 92% realized they should visit an ophthalmologist regularly, only 57% had seen an ophthalmologist. Patients who never attended school were less likely to visit an ophthalmologist than those with tertiary education (odds ratio 0.24; 95% confidence interval 0.09, 0.66). Patients with diabetes for less than 2 years were less likely to visit an ophthalmologist than those with diabetes for more than 10 years (odds ratio 0.21; 95% confidence interval 0.9, 0.44). There was no association between age, gender or work status and the likelihood of having seen an ophthalmologist.

Conclusion:  Although both GPs and diabetic patients are aware of the need for regular fundal screening, just over half the patients had been screened. There exists a need for programmes in Myanmar to induce a behavioural change in diabetic patients with regards to screening examinations.
The analysis of predicted capsular bag diameter using modified model of capsule measuring ring in Asians
Authors: Kim Jin‐Hyoung , Lee Doh , Cha Young‐Dong , Oh Sae‐Hoon , Mah Ki‐Choong , Lee Moo‐Suk
Published: April 2008

Abstract

Background:  This study measured the capsular bag diameter (CBD) of Asian eyes using a modified capsular measuring ring (CMR) after cataract surgery, and identified preoperative predictive factors for postoperative CBD and the change of capsular bag diameter after surgery.

Methods:  This prospective study followed 25 eyes undergoing cataract surgery inserted with a CMR before intraocular lens (IOL) implantation at the Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Republic of Korea. Axial length (AL), anterior chamber depth (ACD), lens thickness, corneal power and corneal size were measured preoperatively. CBD was calculated using the CMR in a dilated state at postoperative 1 day, 1 week, 1 month, 2 months, and 1 year.

Results:  AL (R = 0.713) and ACD (R = 0.402) were found to positively correlate with CBD at postoperative 1 week. AL (P < 0.001) and ACD (P = 0.046) were found to be predictors of CBD. The mean CBD gradually decreased to 11.30 ± 1.76 mm at 1 day, 10.86 ± 1.06 mm at 1 week, 10.23 ± 1.43 mm at 1 month, 9.88 ± 1.31 mm at 2 months, and 9.85 ± 1.43 mm at 1 year.

Conclusion:  CBD size could be determined using a CMR implanted during surgery. AL and ACD were predictors of postoperative CBD. Predicting CBD in this way may assist in selecting appropriately sized IOL, which will lead to improved visual quality after cataract surgery.
Diagnosis of solid pancreatic masses by endoscopic ultrasound‐guided fine‐needle aspiration
Authors: Wilson J. L. , Kalade A. , Prasad S. , Cade R. , Thomson B. , Banting S. , Mackay S. , Desmond P. V. , Chen R. Y. M.
Published: April 2008

Background:  Endoscopic ultrasound (EUS) with fine‐needle aspiration (FNA) is increasingly being used in the staging algorithm for pancreatic carcinoma. This allows for a tissue diagnosis, which was previously difficult to obtain. The aim of this study is to assess the utility of EUS–FNA in establishing the diagnosis of solid pancreatic mass lesions in an Australian population.

Methods:  A retrospective review of the EUS databases of St Vincent’s Hospital Melbourne and Western Hospital, Melbourne from November 2002 to May 2006 was undertaken. The focus was on patients with a solid pancreatic mass who underwent EUS–FNA. Surgical pathology or long‐term follow up was used to identify false‐positive or false‐negative results.

Results:  EUS was undertaken to investigate a solid pancreatic or distal common bile duct mass lesion in 155 patients. Seventy‐two of these underwent EUS‐guided FNA. Mean age was 68 years. A positive tissue diagnosis of malignancy could be made in 55 (76%). Nine (13%) had benign histology, with 8 (11%) having inadequate tissue obtained from FNA. A later tissue diagnosis of carcinoma was made in eight of those with either benign or inadequate histology, although in all cases there were EUS features diagnostic of malignancy, with FNA limited by technical difficulties. The overall utility of EUS–FNA showed a sensitivity of 87%, specificity 100%, positive predictive value 100%, negative predictive value 52% and overall accuracy 89%.

Conclusion:  EUS–FNA gives a high return for histological diagnosis of solid pancreatic mass lesions and should be part of the standard management algorithm for pancreatic carcinoma.
Disturbance‐driven changes in the variability of ecological patterns and processes
Authors: Fraterrigo Jennifer M. , Rusak James A.
Published: April 2008

Understanding how disturbance shapes the dynamics of ecological systems is of fundamental importance in ecology. One emerging approach to revealing and appreciating disturbance effects involves examining disturbance‐driven changes in the variability of ecological responses. Variability is rarely employed as a response variable to assess the influence of disturbance, but recent studies indicate that it can be an extremely sensitive metric, capturing differences obscured by averaging and conveying important ecological information about underlying causal processes. In this paper, we present a conceptual model to understand and predict the effects of disturbance on variability. The model estimates qualitative changes in variability by considering disturbance extent, frequency and intensity, as well as ecosystem recovery, and thereby captures not only the immediate effects of disturbance but also those that arise over time due to the biotic response to an event. We evaluate how well the model performs by comparing predictions with empirical results from studies examining a wide variety of disturbances and ecosystems, and discuss factors that may modify or even confound predictions. We include a concise guide to characterizing and detecting changes in variability, highlighting the most common and easily applied methods and conclude by describing several future directions for research. By considering variability as a response to disturbance, we gain another metric of fundamental system behaviour, an improved ability to identify organizing features of ecosystems and a better understanding of the predictability of disturbance‐driven change – all critical aspects of assessing ecosystem response to disturbance.
Public Choice and the Extent of the Market
Authors: Buchanan James M. , Yoon Yong J.
Published: April 2008

In analyzing political processes, public choice scholars invoke a two‐level choice, choices within rules and constitutional choices among sets of rules. This paper considers rules that set the limits for market choice through the political‐collective action. Three familiar categories of institutional constraints are examined: prohibition, regulation, and taxation‐public spending, that are significant in limiting the trading process. The motivation for institutional‐constitutional construction may originate from sources other than economic objectives. We note that institutional parameters include political and legal constraints, as supplemented by traditions and conventions which may affect choice behavior. We relate the analysis to Adam Smith's vision of the achievement of natural liberty and economic progress through his theorem that economic productivity depends on market size.
The Making of a Global European Economist
Authors: Colander David
Published: April 2008

This paper provides results of a survey of European graduate programs that are designing their programs to be similar to top US programs and compares those results to an earlier study done by the author of US schools. The study (1) provides a profile of European graduate economics students; (2) considers the degree to which European training at these schools differs from U.S. training, (3) offers some insights into the differences that exist among some top European programs in economics, and (4) provides a glimpse of the views that the students have of economics and of the training they are receiving. It finds that these global European programs are similar in many ways to US programs and that the students are satisfied with the programs. However, because of the different job markets in the US and Europe, it is not clear that the training is appropriate for the majority of European students. The paper concludes with a discussion of some of the concerns that should be kept in mind by other programs as they consider adapting their programs to become a ‘global’ program. These concerns include the argument that the traditional European system did a number of things right; the European academic economics institutional structure is quite different from the U.S. institutional structure; and the U.S. system has its own set of problems.
Mirror, Mirror on the Wall, Who Is the Happiest of Them All?
Authors: Torgler Benno , Antić Nemanja , Dulleck Uwe
Published: April 2008

This paper turns Snow‐White's magic mirror onto recent economics Nobel Prize winners, top economists and happiness researchers, and through the eyes of the ‘man in the street’ seeks to determine who the happiest academic is. The study not only provides a clear answer to this question but also unveils who is the ladies' man and who is the sweetheart of the aged. It also explores the extent to which information matters and whether individuals' self‐reported happiness affects their perceptions about the happiness of these superstars in economics.
The Social Costs of Civil Conflict: Evidence from Surveys of Happiness
Authors: Welsch Heinz
Published: April 2008

This paper uses data on stated subjective well‐being to capture the intangible costs of civil conflict. By running cross‐national regressions with happiness as the dependent variable, and the number of conflict victims and income as explanatory variables, it investigates if and in which way civil conflict affects happiness, and derives the implied monetary equivalent of the unhappiness caused. The paper finds that the number of conflict victims and their change over time significantly affect subjective well‐being directly through health and psychic effects as well as indirectly through reduced income. The non‐pecuniary effects are found to be larger than the income‐related effect. A change over time in the number of victims has a stronger impact on well‐being than the current number. There are sizeable monetary equivalents to these effects.
Buyer–Supplier and Supplier–Supplier Alliances: Do They Reinforce or Undermine One Another?
Authors: Lazzarini Sergio G. , Claro Danny P. , Mesquita Luiz F.
Published: April 2008

abstract  Previous research has portrayed buyer–supplier and supplier–supplier alliances as important mechanisms to foster learning and exchange efficiencies. Controversy remains, however, as to how these alliances interact. While some propose they reinforce one another (e.g. learning in horizontal ties generates positive spillovers to vertical ties), others propose a negative interplay (e.g. when increasing vertical‐tie intensity, suppliers may weaken horizontal ties to avoid retaliation from buyers who wish to preserve bargaining power). We empirically test these competing views using survey data from the Brazilian auto‐parts industry. In an attempt at reconciliation, we propose that the positive or negative interaction between vertical and horizontal alliances depends on the level of technological uncertainty of goods exchanged. Vertical ties seem to inhibit horizontal ties when technological uncertainty is low; when technological uncertainty is higher, vertical and horizontal ties do not seem to have any meaningful form of interaction. We discuss implications for theory and practice.
Reflecting on Reflexivity: Reflexive Textual Practices in Organization and Management Theory
Authors: Alvesson Mats , Hardy Cynthia , Harley Bill
Published: April 2008

abstract  This paper identifies four sets of textual practices that researchers in the field of organization and management theory (OMT) have used in their attempts to be reflexive. We characterize them as multi‐perspective, multi‐voicing, positioning and destabilizing. We show how each set of practices can help to produce reflexive research, but also how each embodies limitations and paradoxes. Finally, we consider the interplay among these sets of practices to develop ideas for new avenues for reflexive practice by OMT researchers.