bluuebunny/crossref_metadata_2025 huggingface dataset:
Disposition kinetics of albendazole and metabolites in laying hens
Authors: BISTOLETTI M. , ALVAREZ L. , LANUSSE C. , MORENO L.
Published: April 2012

Bistoletti, M., Alvarez, L., Lanusse, C., Moreno, L. Disposition kinetics of albendazole and metabolites in laying hens. J. vet. Pharmacol. Therap. 36, 161–168.

An increasing prevalence of roundworm parasites in poultry, particularly in litter‐based housing systems, has been reported. However, few anthelmintic drugs are commercially available for use in avian production systems. The anthelmintic efficacy of albendazole (ABZ) in poultry has been demonstrated well. The goal of this work was to characterize the ABZ and metabolites plasma disposition kinetics after treatment with different administration routes in laying hens. Twenty‐four laying hens Plymouth Rock Barrada were distributed into three groups and treated with ABZ as follows: intravenously at 10 mg/kg (ABZ i.v.); orally at the same dose (ABZ oral); and in medicated feed at 10 mg/kg·day for 7 days (ABZ feed). Blood samples were taken up to 48 h posttreatment (ABZ i.v. and ABZ oral) and up to 10 days poststart feed medication (ABZ feed). The collected plasma samples were analyzed using high‐performance liquid chromatography. ABZ and its albendazole sulphoxide (ABZSO) and ABZSO2 metabolites were recovered in plasma after ABZ i.v. administration. ABZ parent compound showed an initial concentration of 16.4 ± 2.0 μg/mL, being rapidly metabolized into the ABZSO and ABZSO2 metabolites. The ABZSO maximum concentration (Cmax) (3.10 ± 0.78 μg/mL) was higher than that of ABZSO2Cmax (0.34 ± 0.05 μg/mL). The area under the concentration vs time curve (AUC) for ABZSO (21.9 ± 3.6 μg·h/mL) was higher than that observed for ABZSO2 and ABZ (7.80 ± 1.02 and 12.0 ± 1.6 μg·h/mL, respectively). The ABZ body clearance (Cl) was 0.88 ± 0.11 L·h/kg with an elimination half‐life (T1/2el) of 3.47 ± 0.73 h. The T1/2el for ABZSO and ABZSO2 were 6.36 ± 1.50 and 5.40 ± 1.90 h, respectively. After ABZ oral administration, low ABZ plasma concentrations were measured between 0.5 and 3 h posttreatment. ABZ was rapidly metabolized to ABZSO (Cmax, 1.71 ± 0.62 μg/mL) and ABZSO2 (Cmax, 0.43 ± 0.04 μg/mL). The metabolite systemic exposure (AUC) values were 18.6 ± 2.0 and 10.6 ± 0.9 μg·h/mL for ABZSO and ABZSO2, respectively. The half‐life values after ABZ oral were similar (5.91 ± 0.60 and 5.57 ± 1.19 h for ABZSO and ABZSO2, respectively) to those obtained after ABZ i.v. administration. ABZ was not recovered from the bloodstream after ABZ feed administration. AUC values of ABZSO and ABZSO2 were 61.9 and 92.4 μg·h/mL, respectively. The work reported here provides useful information on the pharmacokinetic behavior of ABZ after both i.v. and oral administrations in hens, which is a useful first step to evaluate its potential as an anthelmintic tool for use in poultry.
An Outer Membrane Vesicle Vaccine for Prevention of Serogroup A and W‐135 Meningococcal Disease in the African Meningitis Belt
Authors: Norheim G. , Tunheim G. , Næss L. M. , Kristiansen P. A. , Caugant D. A. , Rosenqvist E.
Published: April 2012

The bacterium Neisseria meningitidis of serogroups A and W‐135 has in the recent decade caused most of the cases of meningococcal meningitis in the African meningitis belt, and there is currently no efficient and affordable vaccine available demonstrated to protect against both these serogroups. Previously, deoxycholate‐extracted outer membrane vesicle (OMV) vaccines against serogroup B meningococci have been shown to be safe and induce protection in humans in clonal outbreaks. The serogroup A and W‐135 strains isolated from meningitis belt epidemics demonstrate strikingly limited variation in major surface‐exposed protein structures. We have here investigated whether the OMV vaccine strategy also can be applied to prevent both serogroups A and W‐135 meningococcal disease. A novel vaccine combining OMV extracted from recent African serogroup A and W‐135 strains and adsorbed to aluminium hydroxide was developed and its antigenic characteristics and immunogenicity were studied in mice. The specificity of the antibody responses was analysed by immunoblotting and serum bactericidal activity (SBA) assays. Moreover, the bivalent A+W‐135 vaccine was compared with monovalent A and W‐135 OMV vaccines. The bivalent OMV vaccine was able to induce similar SBA titres as the monovalent A or W‐135 OMV towards both serogroups. High SBA titres were also observed against a meningococcal serogroup C strain. These results show that subcapsular antigens may be of importance when developing broadly protective and affordable vaccines for the meningitis belt.
Chimerism but not Neonatal Antigen Exposure Induces Transplant Tolerance
Authors: Peiguo Z. , Shijie Z. , Liang M.
Published: April 2012

Acquired transplant tolerance could be readily induced during foetal or neonatal period through donor cell infusion, but it is not the case in adults. This phenomenon has been attributed to the variation of immune system development in neonatal and adult periods. To investigate the role of immature immune system and chimerism in neonatal transplant tolerance, irradiated spleen cells or cell fraction from F1 (BALB/c × C57BL/6) or GFP‐F1 mice were injected intravenously into neonatal C57BL/6 mice to induce tolerance. Irradiated cells or cell fraction could not induce chimerism and transplant tolerance in neonatal mice, even increasing the dose of donor cells to 5 × 107. Living donor cells induced tolerance in neonatal mice, and the quantity of living cells was correlated with the degree of chimerism and tolerance. At the amount of 3 × 107 F1 spleen cells, skin grafts were survived permanently in more than 80% of treated mice. However, the amount of 0.7 × 107 F1 spleen cells could only slightly prolong allografts’ survival. The more donor cells were infused, the higher level of chimerism was achieved, and the higher frequency of alloreactive T cells was deleted. Chimerism is prerequisite for the induction and maintenance of tolerance. Chimerism in long‐term tolerant mice was significantly higher than that in chronic graft rejected mice, with 6.48 ± 4.02% versus 1.41 ± 0.77%. It implies that transplant tolerance depends on the establishment of chimerism, but not on antigen exposure to immature immune system in foetus or neonates.
Antioxidation status and histidine dipeptides content in broiler blood and muscles depending on protein sources in feed
Authors: Kopeć W. , Jamroz D. , Wiliczkiewicz A. , Biazik E. , Hikawczuk T. , Skiba T. , Pudło A. , Orda J.
Published: April 2012

One‐day‐old chickens were fed mixtures containing different raw materials (fish by‐products meal, porcine blood cells meal, blood meal, wheat gluten, fodder yeast), as a source of histidine and β‐alanine – components of carnosine. Control birds were administered a feed mixture, in which soy bean meal was the main protein source. The bodyweight, feed consumption and conversion, antioxidant characteristics and histidine dipeptides content in blood and muscles, and also amino acid composition of chicken meat on day 34 post‐hatch were recorded. The best (p < 0.05) performance and feed conversion were observed in chickens fed mixture containing porcine blood cells meal. In blood plasma of control chickens, a significantly (p < 0.01) higher ability to scavenge DPPH radicals was found. However, the highest catalase activity in erythrocytes was determined in chickens fed mixtures with blood by‐products. Insignificant differences in both carnosine and anserine levels in plasma between treatments were noted. Breast muscles from control birds were characterized by lower activity of glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) (p < 0.05; p < 0.01), than those from chickens fed blood by‐products. Improved ability to reduce ferric ions (FRAP) (p < 0.01) and carnosine content in meat from chickens fed blood cell meal were recorded. No direct relations between amino acids content in feed mixtures and in meat were observed.
ENDOSCOPIC TREATMENT FOR BILIARY STRICTURE SECONDARY TO CHRONIC PANCREATITIS
Authors: ITO KEI , FUJITA NAOTAKA , NODA YUTAKA , KOBAYASHI GO , HORAGUCHI JUN
Published: April 2012

The causes of benign biliary stricture include chronic pancreatitis, primary/immunoglobulin G4‐related sclerosing cholangitis and complications of surgical procedures. Biliary stricture due to fibrosis as a result of inflammation is sometimes encountered in patients with chronic pancreatitis. Frey's procedure, which can provide pancreatic duct drainage with decompression of biliary stricture, can be an initial treatment for chronic pancreatitis with pancreatic and bile duct strictures with upstream dilation. When patients are high‐risk surgical candidates or hesitate to undergo surgery, endoscopic treatment appears to be a potential second‐line therapy. Placement of multiple plastic stents is currently considered to be the best choice as endoscopic treatment for biliary stricture due to chronic pancreatitis. Temporary placement with a fully covered metal stent has become an attractive option due to the lesser number of endoscopic retrograde cholangiopancreatography (ERCP) sessions and its large diameter. Further clinical trials comparing multiple placement of plastic stents with placement of a covered metal stent for biliary stricture secondary to chronic pancreatitis are awaited.
SAFETY AND EFFICACY OF COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION BY THE TRAINEE ENDOSCOPISTS
Authors: NIIMI KEIKO , FUJISHIRO MITSUHIRO , GOTO OSAMU , KODASHIMA SHINYA , KOIKE KAZUHIKO
Published: April 2012

The colorectum is known to be the most difficult organ to perform endoscopic submucosal dissection (ESD), however, the training has not been sufficiently established. In our hospital, the essential condition to start colorectal ESD was to experience at least 30 gastric ESD and to have sufficient knowledge and techniques beforehand. Rectal ESD were initially performed under supervision of ESD experts. According to their technical acquisition, the ESD experts allocated lesions to the trainees from smaller lesions in the distal colon to larger lesions in the proximal colon. We retrospectively investigated the outcomes of 92 and 23 colorectal ESD performed by two trainee endoscopists (A/B) who gained experience on our training scheme. The rates of en bloc/complete resection for A and B were 92.4%/73.9% and 95.7%/65.2%, respectively. The rates of bleeding/perforation, which occurred only with A, were 1.1%/3.3%, respectively. Intraoperative perforation occurred in one case (4.3%) in the later period. In the later period, en bloc resection rate remained high in spite of the difficult lesions. Our training scheme enabled trainees to perform colorectal ESD effectively and safely from the initial period. Step‐by‐step accumulation of cases such as from the rectum to the colon may be desirable for the introduction of colorectal ESD.
TRANSPAPILLARY BILIARY FORCEPS BIOPSY TO DISTINGUISH BENIGN BILIARY STRICTURE FROM MALIGNANCY: HOW MANY TISSUE SAMPLES SHOULD BE OBTAINED?
Authors: KAWASHIMA HIROKI , ITOH AKIHIRO , OHNO EIZABURO , GOTO HIDEMI , HIROOKA YOSHIKI
Published: April 2012

Background:  The sensitivity of transpapillary biliary forceps biopsy for malignancy has been reported as varying from 43–81%. Therefore, there are false negatives in more than 20% of patients, which makes it difficult to diagnose benign biliary stricture as benignancy in a clinical setting.

Methods:  To clarify the number of tissue samples that should be obtained during transpapillary forceps biopsy to distinguish benign biliary stricture from malignancy, patients undergoing transpapillary biliary forceps biopsy at our institute were examined retrospectively in this study.

Results:  Seventy‐two biliary forceps biopsy procedures were performed on 61 patients. The final diagnoses were malignant biliary stricture in 34 patients and benign stricture in 27 patients. The overall sensitivity and specificity for malignancy in this study were 76.5% and 100%, respectively. There were zero out of 10 (0%) false‐negative patients when three or more tissue samples were obtained. In contrast, when four or more tissue samples were obtained, eight out of eight (100%) patients had negative diagnoses for malignancy and were finally diagnosed with benignancy.

Conclusion:  We suggest that three or more tissue samples are recommended for the diagnosis of biliary malignant stricture.
DESIRABLE TRAINING AND ROLES OF JAPANESE ENDOSCOPISTS TOWARDS THE FURTHER PENETRATION OF ENDOSCOPIC SUBMUCOSAL DISSECTION IN ASIA
Authors: FUJISHIRO MITSUHIRO , JUNG HWOON‐YONG , GODA KENICHI , HIRASAWA KINGO , KAKUSHIMA NAOMI , LEE I‐LIN , MORITA YOSHINORI , ODA ICHIRO , TAKEUCHI MANABU , YAMAMOTO YORIMASA , ZHOU PING‐HONG , UEDO NORIYA
Published: April 2012

Endoscopic submucosal dissection (ESD) was invented in Japan and is now permeating into the rest of the world. Therefore, it is necessary to elucidate the desirable ESD training by knowing the current status of ESD training in Japan. After this, we mainly discussed the following three topics: (i) requirements for preceptees to start ESD training; (ii) requirements for competent endoscopists in ESD; and (iii) requirements for preceptors in the first half of the upper gastrointestinal tract session at the Endoscopic Forum Japan 2011. Additionally, we discussed what Japanese endoscopists can do for further permeation of ESD outside Japan, especially in Asia in the second half. The session was wrapped up by the conclusions that it was absolutely necessary to establish official training courses authorized by the Japan Gastroenterological Endoscopy Society with certification for trainees and trainers and our Japanese endoscopists had a responsibility to spread ESD safely and reliably by collaborating with enthusiastic endoscopists in each country which have different backgrounds in terms of incidences and screening systems of target diseases, accessibility to endoscopy, medical economics, national characters, and so on.
DETERMINING EARLY GASTRIC CANCER LESIONS APPROPRIATE FOR ENDOSCOPIC SUBMUCOSAL DISSECTION TRAINEES: A PROPOSAL RELATED TO CURABILITY
Authors: HIRASAWA KINGO , KOKAWA ATSUSHI , KOU RYONHO , OKA HIROYUKI , MAEDA SHIN , TANAKA KATSUAKI
Published: April 2012

Endoscopic submucosal dissection (ESD) was introduced worldwide as a new treatment option for early gastric cancer. Our objective was to discuss the limited ESD reports available and to determine the lesions suitable for use in training endoscopists on which lesions are appropriate for ESD. We reviewed a series of ESD reports that have been written on various risk factors related to the resectability or curability of a variety of lesions. These published studies show that certain risk factors such as tumor size and location and the presence of ulceration are closely related to both resectability and curability. Because the combination of these risk factors resulted in a much higher risk than did any single factor, we recently established a ‘risk assessment chart’ to determine an individual's total risk of treatment failure for early gastric cancer that has been treated using ESD. This risk chart provides a clear indication that small, non‐ulcerated lesions located in the lower third of the stomach have a high rate of curative resection and are technically less challenging if ESD is used. We suggest that trainees should gain ESD experience with such lesions before they start to perform ESD on more difficult lesion types that have a lower probability of curative resection. In addition, we suggest that this risk assessment chart is suitable for the pretreatment assessment of curability and the likelihood of successful en bloc resection.
MANAGEMENT OF BENIGN STRICTURES OF THE EXTRAHEPATIC BILE DUCT DUE TO CHRONIC PANCREATITIS AND SURGICAL INTERVENTION
Authors: ITOI TAKAO , KHOR CHRISTOPHER JL
Published: April 2012

In the Endoscopic Forum Japan 2011 (EFJ 2011), we focused on the management of biliary strictures derived from chronic pancreatitis and surgical intervention. We concluded that regardless of causes of strictures, a large bore single plastic stent is better as a first choice of stenting. As a next step, multiple plastic stents may be preferable compared to a covered self‐expandable metallic stent in case of unexpected adverse events and cost of stent. In the near future, we believe that not only progress of treatment technique and accessories but also good understanding of the pathology of biliary strictures will lead to the best management.
CURRENT OPINIONS FOR ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL TUMORS FROM OUR EXPERIENCES: INDICATIONS, TECHNICAL ASPECTS AND COMPLICATIONS
Authors: HOTTA KINICHI , YAMAGUCHI YUICHIRO , SAITO YUTAKA , TAKAO TOSHITATSU , ONO HIROYUKI
Published: April 2012

Endoscopic submucosal dissection (ESD) was first applied in the resection of large colorectal tumors 10 years ago. Frequent complications and technical difficulties were serious problems at first, but were gradually improved with experience. Here, we describe the indications, technical aspects and management of complications of ESD for colorectal tumors. In 2009, we introduce the use of small tip insulation‐tipped diathermic (IT) knife. Features separating it from the IT knife and IT Knife2 are a smaller ceramic tip and small round disk at the root of the tip. During submucosal dissection, the small tip IT knife could dissect large pieces of tissue intact. This allows us to shorten the procedure time, particularly the submucosal dissection component. A total of 146 ESD for 140 patients were performed between January 2009 and July 2011. En bloc, and en bloc and R0 resection rates were 92.5% and 83.6%, respectively. Median procedural time was 48.5 min for 40.5 mm specimens. Perforation and delayed bleeding occurred in 2.1% and 1.4%, respectively. We successfully performed ESD for colorectal tumors with a shortened procedure time while preserving quality and safety.
HOW TO TEACH AND LEARN ENDOSCOPIC SUBMUCOSAL DISSECTION FOR UPPER GASTROINTESTINAL NEOPLASM IN JAPAN
Authors: GODA KENICHI , FUJISHIRO MITSUHIRO , HIRASAWA KINGO , KAKUSHIMA NAOMI , MORITA YOSHINORI , ODA ICHIRO , TAKEUCHI MANABU , YAMAMOTO YORIMASA , UEDO NORIYA
Published: April 2012

Background:  Endoscopic submucosal dissection (ESD) is an innovative and promising procedure. However, ESD experience is mostly limited to Japan and a few countries in Asia. An appropriate training system should be proposed from Japan to promote a permeation of ESD technique. We conducted questionnaire survey to representative Japanese experts to reveal their training method of ESD for upper gastrointestinal neoplasm

Materials and Methods:  We sent the questionnaire on gastric and esophageal ESD to 9 Japanese experts in ESD. The questionnaire results were discussed in a session of Endoscopic Forum Japan 2011 held in Tokyo.

Results:  The inception criteria consisted of two main elements, diagnostic ability and primary endoscopy technique of preceptees. Preceptees should observe and attend as many ESD cases as possible. Most of the experts recommend training with isolated or live animal stomach or esophagus. Lesion in the distal stomach is the most suitable for the first real ESD by a preceptee. Being proficient in a gastric ESD is needed before starting esophageal ESD. Preceptor should have significantly high level of diagnostic ability and proficient ESD techniques in the colorectum as well as the stomach and esophagus.

Conclusion:  The present questionnaire survey seems to reveal basic elements required for ESD training program. We believe that this is also helpful in other countries where ESD would be initiated and penetrated safely and properly.
ENDOSCOPIC RESECTION FOR EARLY GASTRIC CANCER: CURRENT STATUS IN KOREA
Authors: JUNG HWOON‐YONG
Published: April 2012

Endoscopic mucosal resection (EMR) was introduced in the 1990s, and endoscopic submucosal dissection (ESD) in 2003. Currently, ESD is becoming the main procedure for the resection of early gastric cancer (EGC), and provides safer and curative outcomes. Endoscopic resection (ER) showed excellent long‐term survival in Korea. The number of ESD has doubled over 5 years. ESD might be better than EMR in terms of en bloc resection, complete resection and long‐term outcome. Novel techniques including endoscopic full‐thickness resection with lymph node dissection will be positioned for some EGC.
COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION IN JAPAN AND WESTERN COUNTRIES
Authors: URAOKA TOSHIO , PARRA‐BLANCO ADOLFO , YAHAGI NAOHISA
Published: April 2012

Various studies by Japanese endoscopists have demonstrated that colorectal endoscopic submucosal dissection (ESD) can overcome technical limitations of the endoscopic mucosal resection (EMR) technique such as piecemeal resection for flat lesions larger than 20 mm, resection of lesions involving the dentate line or the ileocecal valve and lesions with the non‐lifting sign, and achieve higher en bloc resection rate. However, it is infrequently performed in Western countries in comparison with Japan, despite the advantages explained above. There are some differences between Japan and Western countries in environments and clinical settings for performing ESD in the colorectum. Endoscopists who perform colorectal ESD around the world are considering that refinements in ESD techniques, devices and training will be necessary to further reduce a higher risk of complications and longer procedure times before adoption of ESD can be recommended on a widespread international scale.
THE 2011 GREAT EAST JAPAN EARTHQUAKE: A REPORT OF A REGIONAL HOSPITAL IN FUKUSHIMA PREFECTURE COPING WITH THE FUKUSHIMA NUCLEAR DISASTER
Authors: IRISAWA ATSUSHI
Published: April 2012

A catastrophic undersea megathrust earthquake of magnitude 9.0 off the coast of Japan occurred at 14:46 JST on Friday, 11 March 2011. The earthquake triggered powerful tsunami waves, and the tsunami precipitated Fukushima nuclear accidents. After the terrible earthquake, many people fled from the nuclear accident and arrived at places far from the nuclear power plant. In this article, I present a story of one measure devised to deal with the problem of the Fukushima nuclear accident at a regional hospital of Fukushima prefecture, Aizu General Hospital, which is located far from the Fukushima nuclear plant. In addition, I briefly report the current situation of Fukushima prefecture after the 2011 Great East Japan earthquake. In our hospital, the countermeasure headquarters was established to supply medical care for those who had been injured by tsunami waves and the Fukushima nuclear accident. Especially, the screening for radioactive exposure using a dosimeter to take decontamination measures for cases of external exposure was extremely important task. Nevertheless, because the accurate knowledge related to radioactive contamination didn't provide, most medical staff fell into confusion. Fukushima prefecture has been ‘shrinking’ since the nuclear accident. However, today, although some hot spots remain in residential areas, the radioactive contamination is decreasing little by little. Many people in Fukushima Prefecture advance as one, facing forward. Recently, decontamination projects started. Efforts must be continued over a long period.
CURRENT SITUATION OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR SUPERFICIAL NEOPLASMS IN THE UPPER DIGESTIVE TRACT IN EAST ASIAN COUNTRIES: A QUESTIONNAIRE SURVEY
Authors: UEDO NORIYA , JUNG HWOON‐YONG , FUJISHIRO MITSUHIRO , LEE I‐LIN , ZHOU PING‐HONG , CHIU PHILIP WAI YAN , CHANG DONGKYUNG , GODA KENICHI
Published: April 2012

Aim:  This study was carried out to understand the current practice and learning of endoscopic submucosal dissection (ESD) for superficial esophageal and gastric cancers in East Asian countries.

Methods:  A questionnaire survey was used to investigate differences in upper gastrointestinal (GI) ESD among East Asian countries.

Results:  ESD is used by many endoscopists in not only tertiary centers but also secondary care hospitals in China, Korea and Japan. By contrast, it is less used by doctors in tertiary centers in Hong Kong and Taiwan. However, the general trend appears to be the same; ESD, which is a highly advanced endoscopic technique, is being transmitted from preceptors to preceptees in tertiary centers, then from doctors in tertiary centers to experienced doctors in secondary hospitals. The speed of learning and uptake in the practice of this procedure will depend on the volume of cases. Upper GI ESD can be expected to spread at a similar rate across different districts or hospitals in East Asia because of similarities in disease prevalence. Also, endoscopists in this region can easily learn from each other by attending international conferences or visiting endoscopy units to learn the procedure.

Conclusion:  Efforts to establish a standardized protocol for ESD practice and training are important, and may help endoscopists around the world develop this technique further.
CURRENT STATUS OF COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION IN JAPAN AND OTHER ASIAN COUNTRIES: PROGRESSING TOWARDS TECHNICAL STANDARDIZATION
Authors: SAITO YUTAKA , KAWANO HIROSHI , TAKEUCHI YOJI , OHATA KEN , OKA SHIRO , HOTTA KINICHI , OKAMOTO KOICHI , HOMMA KIYOAKI , URAOKA TOSHIO , HISABE TAKASHI , CHANG DONG KYUNG , ZHOU PING‐HONG
Published: April 2012

Aim:  The primary purpose of this questionnaire survey study was to determine the current status of colorectal endoscopic submucosal dissection (ESD) in specialized Japanese referral centers before and after introduction of a government‐approved advanced medical treatment system; and, secondly, to determine the current status of colorectal ESD in other Asian specialized referral centers.

Methods:  A total of 1321 colorectal ESDs were performed in 11 institutions including two Asian centers outside Japan.

Results:  Overall en‐bloc resection, curative resection, R0 resection, perforation, delayed bleeding and emergency surgery rates were 95.4%, 89.1%, 87.2%, 2.9%, 2.5% and 0.2%, respectively. Similar clinical results were reported in the two Asian centers.

Conclusion:  There were no significant differences with regards to clinical results between the two periods although the perforation rate decreased from 3.3% to 2.4%. In addition, colorectal ESD has become increasingly standardized technically at specialized referral centers not only in Japan, but several other Asian referral institutions as well.
ROLE OF ENDOSCOPIC STENTING FOR BILIARY STRICTURES IN CHRONIC PANCREATITIS
Authors: CRAIG PHILIP I
Published: April 2012

Aim:  To review the published work concerning the role of biliary stenting for chronic pancreatitis‐related strictures.

Methods:  A case study in which multiple plastic stents are used to manage a chronic pancreatitis biliary stricture is presented, and the published work reviewed.

Results:  There has been a gradual evolution in the endoscopic management of distal biliary strictures secondary to chronic pancreatitis. Most early series used single (usually 10 F) plastic stents for varying time periods. Long‐term stricture resolution occurred in only approximately 25% of patients and stent‐related complications were high if stent exchanges were not performed routinely every 3–4 months. Recent studies using multiple (≥3) 10 F stents placed sequentially every few months for approximately 12 months have resulted in resolution of biliary strictures in up to 90% of patients. In general, the use of both uncovered and partially covered self‐expandable metal stents for biliary strictures due to chronic pancreatitis have been disappointing due to problems with epithelial hyperplasia involving the uncovered portions of the self‐expandable metal stents resulting in late stent occlusion and other problems. Similarly, early published data does not at this stage support the routine use of fully covered self‐expandable metal stents because of unacceptable stent‐related complications.

Conclusion:  Chronic pancreatitis‐related biliary strictures should be managed initially with sequentially‐placed multiple 10 F plastic stents for approximately 12 months.
Colorectal cancer surgery 2000–2008: evaluation of a prospective database
Authors: Due Steven L. , Wattchow David A. , Sweeney James L. , Milliken Lesley , Luke Colin G.
Published: April 2012

Background:  Colorectal cancer is a common cause of cancer death in Australia and is primarily managed operatively. Surgical databases are valuable in monitoring performance in cancer treatment and detecting problems and trends.

Methods:  Diagnostic and treatment variables and short‐term outcomes were gathered prospectively for patients undergoing resection for colorectal cancer over a 9‐year period. Survival data were obtained by linkage to state and interstate death indices.

Results:  Eight hundred and five patients underwent resection for colorectal cancer during the study period. Overall 5‐year survival was 61%. Five‐year cancer‐specific survival was 73%. Five‐year cancer‐specific survival for Australian Clinico‐Pathological Staging (ACPS) stages A, B, C and D was 96, 80, 61 and 19%, respectively (P < 0.0001). Emergency presentations showed diminished survival (59% versus 75%, P < 0.0001) after controlling for age and stage (hazard ratio (HR) 1.78, P= 0.005), as did transfusion recipients (63% versus 74%, P= 0.0014; HR 1.78, P= 0.004). Anastomotic leak did not affect survival in multivariable analysis. Non‐cancer causes accounted for 26% deaths, primarily comprising cardiovascular deaths in the elderly.

Discussion:  High case ascertainment, data completeness and accuracy can be obtained with prospective, independently gathered data linked electronically to national death records. Survival for colorectal cancer in South Australia continues to improve. Close follow‐up for disease recurrence is warranted for transfusion recipients, emergencies and advanced disease. Locally managed databases with linkage to state registries and other institutions are powerful methods to improve data quality and surgical care at a national level.
Evaluation of service users' experiences of participating in an exercise programme at the Western Australian State Forensic Mental Health Services
Authors: Wynaden Dianne , Barr Lesley , Omari Omar , Fulton Anthony
Published: April 2012

Approximately 210 patients are admitted each year to the Western Australian State Forensic Mental Health Service, and most present with psychotic illness, along with other physical and mental comorbidities. In 2010, a healthy lifestyle programme, which included a formal exercise programme coordinated by an exercise physiologist, was introduced at the service. A self‐report questionnaire was developed to obtain feedback on the programme, and 56 patients completed the questionnaire during the 6‐month evaluation period. As well as providing patients with access to regular physical activity, the programme also supports the recovery philosophy, where patients work in partnership with forensic mental health staff. Overall, patients reported that the programme assisted them to manage their psychiatric symptoms, as well as improving their level of fitness, confidence, and self‐esteem. In addition, patients received education about the importance of regular exercise to their mental health, and the role exercise plays in preventing chronic illness and obesity. While the benefits of exercise on mental health outcomes for people with depression and anxiety are well established, this evaluation adds to the evidence that such programmes provide similar benefits to people who have a psychotic illness and are hospitalized in an acute secure setting.
Should we or shouldn't we? Mental health nurses' views on physical health care of mental health consumers
Authors: Happell Brenda , Scott David , Platania‐Phung Chris , Nankivell Janette
Published: April 2012

People diagnosed with a mental illness experience poorer physical health than the general population. Nurses have been identified for their potential role in addressing physical health needs of consumers of mental health services. This paper reports on preliminary findings of a qualitative study on health‐care services for physical and mental health in a regional area in Australia. A key purpose of the study was to explore the perceptions of nurses working in mental health settings of their physical care with consumers. A qualitative, exploratory approach was undertaken. Semi‐structured focus groups were conducted with 38 nurses from one mental health service. Nurse participants described a common co‐occurrence of physical problems and mental illness and expressed the importance of health‐care services to treatment and prevention. Participants expressed divergent views on nurses' capacity to contribute to better health‐care processes.
Minding our own bodies: Reviewing the literature regarding the perceptions of service users diagnosed with serious mental illness on barriers to accessing physical health care
Authors: Chadwick Angelina , Street Clare , McAndrew Sue , Deacon Maureen
Published: April 2012

International studies consistently demonstrate that individuals diagnosed with severe mental illness (SMI) have an increased risk of co‐morbid physical health problems and premature death. During the past decade, government policy in the UK has focused on improving the physical health of those with SMI. Despite this, international research has continued to report barriers to accessing appropriate services. These have been identified as emanating from service users and professionals alike, and also from institutional bureaucracy. Most of this research has reported difficulties from the perspective of various professional groups, with little attention being paid to the service user voice. Studies from the service user perspective undertaken in the past 10 years equate to six qualitative and three quantitative studies, and it appears that poor physical health care remains a problem in the developed world. The quality of this care is compromised by practical problems and interpersonal difficulties between service users and health‐care providers and between providers of mental health services and those providing physical health care. This paper presents a review of the nine international studies and discusses the implications for developing policy and practices that could lead to improved physical health‐care services for people experiencing SMI.
Dietary habits of patients with schizophrenia: A self‐reported questionnaire survey
Authors: Simonelli‐Muñoz Agustin J. , Fortea Maria I. , Salorio Pilar , Gallego‐Gomez Juana I. , Sánchez‐Bautista Sonia , Balanza Serafin
Published: April 2012

The present study was carried out to determine the dietary habits of patients with schizophrenia and the influence of these habits on the degree of obesity. The study was developed in a sample of 159 patients, who were given a self‐reported questionnaire, to ascertain the influence of socio‐familiar aspects, pharmacological treatment, and dietary habits. Anthropometric measurements (body mass index (BMI) and waist circumference (WC)) were also taken. Patients with schizophrenia presented unhealthy dietary habits, as indicated by the finding that 51% of the patients took no longer than 15 min to eat, 40.8% did not eat fruit daily, and 63.1% did not eat fish. Women were three times more likely to be obese than men (odds ratio (OR) = 2.91, P = 0.021). Patients classified as having unhealthy dietary habits have a 2.33‐fold higher risk of obesity than patients with good dietary habits (OR = 2.33, P = 0.034). In summary, this paper highlights the fact that patients with schizophrenia have a detrimental dietary pattern that is associated with an increase in BMI and WC, with the consequent development of obesity and related metabolic alterations, regardless of the pharmacological treatment being followed. Future research directions will include exploring the need for nutritional education programmes to improve the dietary habits of such patients.
Betaproteobacterial symbionts of the ciliate Euplotes: origin and tangled evolutionary path of an obligate microbial association
Authors: Vannini Claudia , Ferrantini Filippo , Ristori Alessandro , Verni Franco , Petroni Giulio
Published: April 2012

The Polynucleobacter–Euplotes association is an obligatory symbiotic system between a monophyletic group of ciliate species belonging to the genus Euplotes and bacteria of the species Polynucleobacter necessarius (Betaproteobacteria). Both organisms are unable to survive independently. Several studies revealed the existence of free‐living populations of Polynucleobacter bacteria which are phylogenetically closely related to the endosymbiotic ones, but never share associations with Euplotes in the natural environment. Hence, following the most parsimonious explanation on the origin of the association, this symbiosis should represent a synapomorphic character for the hosts' clade. Nevertheless, phylogenetic analyses performed on an increased number of strains here presented suggest that Euplotes species, during their evolution, recruited Polynucleobacter bacteria as symbionts more than once. Moreover, in three cases, we observed different bacteria as obligate symbionts. These symbionts are the first characterized representatives of a phylogenetic lineage branching in a basal position with respect to the genus Polynucleobacter. The hypothesis that the original obligate symbionts belonged to this newly discovered clade and that, only subsequently, in most cases they have been replaced by Polynucleobacter bacteria recruited from the environment is proposed and discussed. The evolutionary path of this association seems anyway to have been more complex than so far supposed.
Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs
Authors: Hex N. , Bartlett C. , Wright D. , Taylor M. , Varley D.
Published: April 2012

Diabet. Med. 29, 855–862 (2012)

Aims  To estimate the current and future economic burdens of Type 1 and Type 2 diabetes in the UK.

Methods  A top‐down approach was used to estimate costs for 2010/2011 from aggregated data sets and literature. Prevalence and population data were used to project costs for 2035/2036. Direct health costs were estimated from data on diagnosis, lifestyle interventions, ongoing treatment and management, and complications. Indirect costs were estimated from data on mortality, sickness, presenteeism (potential loss of productivity among people who remain in work) and informal care.

Results  Diabetes cost approximately £23.7bn in the UK in 2010/2011: £9.8bn in direct costs (£1bn for Type 1 diabetes and £8.8bn for Type 2 diabetes) and £13.9bn in indirect costs (£0.9bn and £13bn). In real terms, the 2035/2036 cost is estimated at £39.8bn: £16.9bn in direct costs (£1.8bn for Type 1 diabetes and £15.1bn for Type 2 diabetes) and £22.9bn in indirect costs (£2.4bn and £20.5bn). Sensitivity analysis applied to the direct costs produced a range of costs: between £7.9bn and £11.7bn in 2010/2011 and between £13.8bn and £20bn in 2035/2036. Diabetes currently accounts for approximately 10% of the total health resource expenditure and is projected to account for around 17% in 2035/2036.

Conclusions  Type 1 and Type 2 diabetes are prominent diseases in the UK and are a significant economic burden. Data differentiating between the costs of Type 1 and Type 2 diabetes are sparse. Complications related to the diseases account for a substantial proportion of the direct health costs. As prevalence increases, the cost of treating complications will grow if current care regimes are maintained.
The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service
Authors: STEWART JESSICA M. , SANSON‐FISHER ROB W. , EADES SANDRA , FITZGERALD MICHAEL
Published: April 2012

Introduction and Aims. Primary health‐care services need to maximise prevention activities to improve the health of Aboriginal and Torres Strait Islander people. This study determined Aboriginal and Torres Strait Islander people's risk status and screening history for cardiovascular, diabetes and cancer, and identified opportunities for prevention based on patient's health concerns.

Design and Methods. Consenting adult patients attending an Aboriginal Community Controlled Health Service completed interview surveys. Outcome measures were: patient's self‐reported rates of smoking, at‐risk alcohol consumption, body mass index and screening rates for cholesterol, diabetes, blood pressure, cervical and breast cancer, the proportion of patients with multiple risk factors and health information patients prioritise to receive from their doctor.

Results. We surveyed 587 patients giving a consent rate of 77%. Patient's self‐reported being at risk due to smoking (51%), harmful alcohol consumption in both short term (10%) and long term (10%), and overweight (28%) and obese (49%) body mass index. The proportion of patients who had not been screened within the recommended guidelines was 27% for cholesterol, 24% for diabetes, 40% for blood pressure, 47% for cervical cancer and 54% for breast cancer. The majority (73%) of patients had multiple risk factors. Patients prioritised receiving health information on diabetes (45%), weight (43%) and heart disease (43%).

Discussion and conclusions. Many patients were at high risk, and were concerned about the health risks they experience. Strategies are needed to help clinic staff identify risks, and maximise prevention activities according to best‐practice guidelines, particularly to patients who experience multiple risk factors. [Stewart JM, Sanson‐Fisher RW, Eades S, Fitzgerald M. The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service. Drug Alcohol Rev 2012;31:617–624]
Natural Mentors, Racial Identity, and Educational Attainment Among African American Adolescents: Exploring Pathways to Success
Authors: Hurd Noelle M. , Sánchez Bernadette , Zimmerman Marc A. , Caldwell Cleopatra H.
Published: April 2012

The present study explored how relationships with natural mentors may contribute to African American adolescents’ long‐term educational attainment by influencing adolescents’ racial identity and academic beliefs. This study included 541 academically at‐risk African American adolescents transitioning into adulthood. The mean age of participants at Time 1 was 17.8 (SD = .64) and slightly over half (54%) of study participants were female. Results of the current study indicated that relationships with natural mentors promoted more positive long‐term educational attainment among participants through increased private regard (a dimension of racial identity) and stronger beliefs in the importance of doing well in school for future success. Implications of these findings and directions for future research are discussed.
Thin‐Slice Decisions Do Not Need Faces to be Predictive of Election Outcomes
Authors: Spezio Michael L. , Loesch Laura , Gosselin Frédéric , Mattes Kyle , Alvarez R. Michael
Published: April 2012

Rapid decisions about political candidates, made solely on the basis of candidate appearance, associate with real electoral outcomes. A prevailing interpretation is that these associations result from heuristic cognitive processing of cues from the face to yield a judgment about the candidate, processing that is shared by both voters and experimental participants. Here, we report findings suggesting that nonfacial aspects of a candidate's appearance are important cues for voter decision making. We asked participants to look at pairs of candidate images and decide (a) whom to vote for (SimVote), (b) who looks more physically threatening (Threat), and (c) who looks more competent to hold congressional office (Competence). When participants saw only the candidates' faces, there was no association between their decisions and electoral outcomes, except for Threat. Yet when participants saw the candidate images with the faces removed, there was a strong association between their decisions and voters' decisions, for all decision types. This suggests that the appearance‐related heuristics that some voters use to guide their decisions may include mental schemas for processing appearance cues other than those associated with facial features. Such schema‐based processing has implications for understanding the neurobiological system underlying thin‐slice decisions from appearance alone.
How Should I Be? A Defense of Platonic Rational Egoism
Authors: Gentzler Jyl
Published: April 2012

There has been a long tradition of interpreting Plato as a rational egoist. Over the past few decades, however, some scholars have challenged this reading. While Rational Egoism appeals to many ordinary folk, in sophisticated philosophical circles it has fallen out of favor as a general and complete account of the nature of reasons for action. I argue that while the theory of practical rationality that is often equated with rational egoism—a view that I call ‘Simple‐Minded Rational Egoism'—is neither plausible nor endorsed by Plato in his Republic, there is a more complex version of Rational Egoism to which Plato is indeed committed. Moreover, such a conception of practical rationality is not vulnerable to the standard set of objections that contemporary philosophers have made against Rational Egoism.
Glasshouse vs field experiments: do they yield ecologically similar results for assessing N impacts on peat mosses?
Authors: Limpens J. , Granath G. , Aerts R. , Heijmans M. M. P. D. , Sheppard L. J. , Bragazza L. , Williams B. L. , Rydin H. , Bubier J. , Moore T. , Rochefort L. , Mitchell E. A. D. , Buttler A. , van den Berg L. J. L. , Gunnarsson U. , Francez A. ‐J. , Gerdol R. , Thormann M. , Grosvernier P. , Wiedermann M. M. , Nilsson M. B. , Hoosbeek M. R. , Bayley S. , Nordbakken J. ‐F. , Paulissen M. P. C. P. , Hotes S. , Breeuwer A. , Ilomets M. , Tomassen H. B. M. , Leith I. , Xu B.
Published: April 2012

See also the Commentary by Curtis and Queenborough
Bacterial lipopolysaccharide protects the retina from light‐induced damage
Authors: Bordone Melina P. , Lanzani María Florencia , López‐Costa Juan José , Chianelli Mónica S. , Franco Pablo , Sáenz Daniel A. , Rosenstein Ruth E.
Published: April 2012

J. Neurochem. (2012) 122, 392–403.

Light‐induced damage is a widely used model to study retinal degeneration. We examined whether bacterial lipopolysaccharide (LPS) protects the retina against light‐induced injury. One day before intense light exposure for 24 h, rats were intravitreally injected with LPS in one eye and vehicle in the contralateral eye. At several time points after light exposure, rats were subjected to electroretinography and histological analysis. Bax, Bcl‐xL, p‐Akt, and p‐Stat3 levels were assessed by Western blotting, and retinal thiobarbituric acid reactive substances levels were measured as an index of lipid peroxidation. One group of animals received injections of dexamethasone, aminoguanidine (an inducible NOS inhibitor), 5‐hydroxydecanoic acid (a mitochondrial K+/ATP channel blocker), or wortmannin [a phosphoinositide‐3‐kinase (PI3K) inhibitor] in order to analyze their effect on the protection induced by LPS. LPS afforded significant morphologic and functional protection in eyes exposed to intense light. Light damage induced an increase in mitochondrial Bax/cytoplasmic Bax ratio, and lipid peroxidation which were prevented by LPS. Dexamethasone and wortmannin (but not aminoguanidine or 5‐hydroxydecanoic acid) prevented the effect of LPS. Moreover, wortmannin prevented the effect of LPS on p‐Akt levels. These results indicate that LPS provides retinal protection against light‐induced stress, probably through a PI3K/Akt‐dependent mechanism.