bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels of knowledge of Down syndrome and Down syndrome testing in Australian women
Authors: Mulvey Sheila , Wallace Euan M
Published: February 2008

Summary: At their first hospital antenatal visit, 209 women were interviewed to explore their level of knowledge of Down syndrome and the available prenatal tests. Overall, the women had limited knowledge. Non‐Caucasian women had less knowledge of Down syndrome, available prenatal tests and the association of Down syndrome with advanced maternal age than Caucasian women. Women with a history of a previous pregnancy and women over 35 years of age were not more aware of Down syndrome or the available tests than other women. These findings have significant implications for antenatal education and the implementation of screening programs for Down syndrome.
Accuracy and modifying factors of the sonographic estimation of fetal weight in a high‐risk population
Authors: Edwards Andrew , GofF Jo , Baker Lesleigh
Published: February 2008

Summary: There have been a number of reviews assessing the accuracy of different methods of sonographic estimation of fetal weight, without identifying any clearly superior equation. In order to optimise accuracy in a high‐risk population, we decided to compare some of the most popular early equations with the newer volume‐based equations, and to try and identify factors that affect the ability of these equations to estimate fetal weight accurately.

We collected the scan and delivery details of 192 fetuses born within one week of a sonographic estimation of fetal weight. We then applied three of the most popular equations and two newer volume‐based equations to the recorded fetal biometric parameters to assess the performance of each equation overall, and under varying maternal, fetal, and scan conditions.

The equations of Shepard, Hadlock A, Hadlock B and Combs produced similar results with systematic (mean) errors in the range 1.2‐1.9% and random error characterised by one standard deviation in the range of 8.6–9.5%. Dudley's volume‐based equation produced a significant systematic error in the form of a mean error of 7.4%, which corresponds to a mean birthweight (BW) which is 7.4% above the mean estimated fetal weight (EFW).

When we stratified the study group by birthweight, Combs' equation produced significant differences in the mean error, (p < 0.00001), that ranged from a mean overestimation in fetal weight of 8.5% for babies with BW < 1000 g to a mean underestimation in fetal weight of 6.2% for babies with BW > 3000 g. Oligohydramnios resulted in a trend towards an increased mean error for all equations which was only statistically significant for Hadlock B.

The equations Shepard and Hadlock A performed best in our high‐risk population. They produced the smallest systematic errors across the entire study group and were not adversely affected by variations in birthweight, liquor volume, or fetal presentation. The newer, volume‐based equations were disappointing, producing large systematic errors. Large random errors in all equations continue to be the Achilles' heel that limit the value of sonographic EFW.
An improved system of bladder drainage
Authors: Hewson AD
Published: February 2008

Summary: We report the successful use of a modified No. 8 infant feeding tube for postoperative bladder drainage in 100 gynaecological patients after surgery.

In previous years, problems arising from the use of transurethral postoperative catheter drainage led to the use of various types of suprapubic catheter drainage after gynaecological surgery. However, this method of catheter drainage still carries the risk of complications, and many surgeons have preferred to persist with transurethral bladder drainage. Several authors have described the post‐operative use of a small diameter transurethral feeding tube so as to enable the patient to void around the tube, thus avoiding the risks of repeated reinsertion of a catheter if there is delay in re‐establishment of normal voiding. The simplicity of this method and its low cost encouraged us to carry out a trial of the method and we have introduced some modifications to improve the technique.

Our experience of the method and the positive comments from nursing staff and patients have led us to adopt it for most of our postoperative gynaecological patients and we believe it deserves wider use.
What is the probability of conception for couples entering an IVF program?
Authors: Kovacs GT , MacLachlan V , Brehny S
Published: February 2008

Summary: The outcome of 4225 couples undergoing 8207 in vitro fertilisation (IVF) cycles over a six year period has been analysed using life table analysis. Pregnancy was expressed as a ‘clinical pregnancy ‐fetus visible on ultrasound’ per stimulated cycle oocyte collection, with pregnancies obtained from frozen embryos being referred to the cycle where they were collected. We found that only 1 in 200 patients proceeded beyond six cycles and the cumulative per cent pregnant was 20.7% after the first cycle, with nearly half pregnant within three and over two‐thirds being pregnant within six cycles. We find this is a useful way to present the chance of pregnancy to prospective couples.
Body composition and energy metabolism in pregnancy
Authors: Martin Allison , Brown Mark A , O'Sullivan Anthony J
Published: February 2008

Summary: The objective of the study was to measure energy metabolism and body composition during pregnancy and postpartum, compared to non‐pregnant women, using non‐invasive techniques.

A longitudinal study of eight normotensive pregnant women was carried out at 19 ± 1 and 36 ± 1 weeks gestation, and postpartum. A cross‐sectional study was also performed comparing postpartum to 12 nonpregnant women. Indirect calorimetry was performed while fasting to measure basal metabolic rate (BMR) and postprandially to measure diet‐induced thermogenesis (DIT). Body composition consists of fat mass, lean body mass (LBM), and total body water (TBW) and was measured by bio‐electrical impedance. Insulin resistance was indirectly assessed by glucose and insulin concentration and DIT.

Weight gain in pregnancy was predominantly fat mass (p < 0.01), but LBM and TBW also increased (p < 0.01). Weight loss postpartum was comprised of fat mass, LBM and TBW (p < 0.01). BMR, glucose and insulin increased in pregnancy and decreased postpartum (p < 0.05), but DIT was unchanged. The BMR was not correlated with weight gain. Apart from fat mass, postpartum and non‐pregnant women were similar. The insulin resistance increased insulin and glucose levels but not DIT.

Fat mass was the major component of weight gain during pregnancy and there was an increase in BMR, glucose and insulin but no change in DIT. BMR decreased to normal but fat mass remained elevated 16 weeks post‐partum.
Trial of labour after four Caesarean sections: a case report and literature review
Authors: Wood Jane R , Quinlivan Julie A , Keirse Marc JNC
Published: February 2008

Summary: We present the case of a woman who requested trial of labour following four Caesarean sections and achieved a vaginal birth. We discuss the recent legal rulings pertaining to patient consent in respect to Caesarean section and published data on outcomes following trial of labour after more than 1 Caesarean section.
Personal preferences of obstetricians towards childbirth
Authors: Land Russell , Parry Emma , Rane Ajay , Wilson Don
Published: February 2008

Summary: Our objective was to determine obstetricians' personal choices in relation to modes of delivery and long‐term outcomes.

A structured confidential survey was mailed out to all Australian and New Zealand Fellows, Members, and Australian Trainees with The Australian and New Zealand Journal of Obstetrics and Gynaecology November 1999 edition. The response rate overall was 26% (478). Eleven per cent (54) chose to have an elective Caesarean section (ECS) in the absence of any clinical indication. The most common reason for this was fear of faecal and urinary incontinence (82%). Two‐thirds (318) were agreeable to patients requesting an ECS in this same setting. Twenty‐six per cent said they would choose ECS if the estimated tetal weignt (EFW) was > 4000g which more than doubled to 55% (261) if EFW was > 4500 g. Ventouse delivery was the most popular method of assisted rotational delivery at 45% (214) followed closely by Keilland's forceps at 40% (189). Caesarean section (CS) was chosen by only 14% (65) in this scenario. ECS was the preferred method for breech delivery at 38% (181) followed by trial of breech delivery at 23% (109). Thirty‐two per cent (154) of respondents would attempt external cephalic version prior to deciding mode of delivery. Respondents felt the most important factors for postnatal incontinence included: antenatal incontinence (64%), length of second stage > one hour (50%), forceps delivery (46%), and EFW > 4000 gat term (44%).
Total laparoscopic hysterectomy with laparosonic coagulating shears: a retrospective report of 200 consecutive cases
Authors: Carlo Gregory M , Carlton Mark A
Published: February 2008

Summary: Despite 10 years of intensive education and training in Australia only around 14% of hysterectomies are performed with laparoscopic assistance. In particular total laparoscopic hysterectomy (TLH) has a poor penetration rate because of perceived technical difficulties that include instrumentation, prolonged operating times and an increase in complications. We present a series of 200 consecutive cases of TLH with very good results and propose that because of the many advantages that this technique offers that it should become the standard procedure for benign uterine disease.
Laparoscopic assisted Doderlein hysterectomy: initial experience in a provincial Australian centre
Authors: Craig Simon , Giltrap Scott
Published: February 2008

Summary: Despite the theoretical advantages that laparoscopic hysterectomy techniques offer, this is not a commonly performed operation in Australia.

The laparoscopically assisted Doderlein hysterectomy is a technique that offers significant advantages in speed, ease of performance, and low cost.

We describe our technique and results of the first 36 cases performed for a range of clinical indications and uterine weights, using widely available and non‐disposable equipment. Operating time (including adjunctive operations) varied from 48 to 165 minutes and no significant complications were encountered.
The advantages of mierolaparoscopic left upper quadrant entry in selected patients
Authors: Parker Jim , Rahimpanah Farhad
Published: February 2008

Summary: We describe a series of cases where mierolaparoscopic left upper quadrant (LUQ) entry was used as the primary peritoneal entry site in patients considered unsuitable for initial port placement through the umbilicus. Mierolaparoscopic LUQ entry is becoming a standard technique in gynaecological laparoscopic surgery and appears to provide a safe alternative entry site in selected patients.
Methadone and the pregnant user: a matter for careful clinical consideration
Authors: Hulse Gary K , O'Neill George
Published: February 2008

Summary: The practice of placing all pregnant heroin users on methadone as the treatment of choice needs to be questioned. While it may be suitable for those who stabilise their illicit heroin use at or shortly after conception, its suitability for those who show little movement away from regular heroin use and its associated lifestyle is more circumspect. Neonates of women who continue heroin use throughout pregnancy are likely to be below birthweight and/or premature. As a consequence, they are in a less than optimal condition to cope with the additional assault caused by prescribed methadone such as neonatal withdrawal. This may help explain why the relative risk of neonatal mortality in women who continue illicit heroin use during pregnancy and are prescribed methadone, is greater than for those who continue to use heroin but are not prescribed methadone. Clinicians must take the time of maternal presentation and the likelihood of continued maternal heroin use into consideration when determining who is suitable for methadone and whether a reduced level of methadone will suffice. A number of different clinical scenarios are identified and possible management strategies discussed. The need to develop innovative services appropriate for pregnant women who continue regular heroin use, and for well‐designed studies that define best practice for the management of these women is evident.
Malignant mixed Müllerian tumour of the cervix treated with concurrent chemoradiation
Authors: Gastrell FH , Brasch HD , Johnson CA , Bethwaite PB , McConnell DT
Published: February 2008

Summary: Malignant mixed Mullerian tumours of the cervix are very uncommon. Of the 26 cases reported in the literature only 8 consist of homologous sarcoma with squamous cell carcinoma. Historically treatment has been with radiation or surgery or a combination of both. We describe a locally advanced case treated with concurrent chemoradiation.
Notification of Papanicolaou smear results: a survey of women's experiences and preferred means of notification
Authors: Peres Matthew , Wellman Michelle
Published: February 2008

In a population of Australian women attending a colposcopy clinic, we aimed to establish the method by which they were notified of their Pap smear result, who notified them of their result, and if given the choice, how they would prefer to be notified.

Of women attending a colposcopy clinic between October 1998 and June 1999, 59.7% participated in the survey. There was a final sample of 210 women after exclusion of questionnaires with missing data.

The doctor most often notified women of their Pap smear result (81.7%). The usual methods of notification were by a follow‐up appointment (43.1%), by a telephone call (35.8%) or with a letter (13.8%); 42% of women preferred to be notified with a mailed copy of the report and explanation of follow‐up; 29.6% preferred to be telephoned with the result, and 11.3% would prefer a follow‐up appointment. Women preferred methods of notification which were initiated by the doctor. Women have varying preferences, which commonly differ from the current services provided by both GPs and colposcopy clinic. To overcome this, women could be asked to nominate their preferred method of notification when completing the cervical smear request form.
A portable, disposable device for patient‐controlled epidural analgesia following Caesarean section: evaluation by patients and nurses
Authors: Banks Samantha , Pavy Timothy
Published: February 2008

Twenty patients undergoing elective Caesarean section were provided with a pethidine‐primed disposable Go Medical epidural infuser for postoperative pain control. Patients and nurses evaluated the device by completing a questionnaire.

The infuser delivered adequate analgesia, was easy to understand and use, provided the patients with control over their pain relief and allowed good mobility. The nursing staff found the device easy to prime and understand, the only drawback being the occasional incidence of equipment failure. The patients expressed a high level of satisfaction with the device and all would use it again if offered the chance.

We conclude that the Go Medical epidural infuser is a safe and effective device as used in the postnatal ward setting.
Carrying their own medical records: the perspective of pregnant women
Authors: Phipps Hala
Published: February 2008

Freedom of information, access to and ownership of medical records are current and controversial issues in Australia. Relating to pregnancy and birth the debate provokes emotional responses and raises important questions about access to information, decision‐making, responsibility, power and control.

The aim of this qualitative study was to explore the impact on pregnant women of carrying their medical records throughout pregnancy. Twenty‐one women participated in face‐to‐face individual interviews, which were coded for thematic analysis. The study found the reaction of women toward carrying their own records to be overwhelmingly positive. Maternal record holding had the potential to improve the level of communication between the health care worker and the pregnant woman and provided a greater sense of sharing and communication within the family.

The study also established that maternal record holding was of benefit to the woman's partner who was better informed and more involved in the pregnancy. All but one of the women who participated favoured carrying their records in subsequent pregnancies. A concern about the potential for losing or misplacing records was not seen in this study, as no women lost their records. A sense of ownership would argue against this possible drawback.
A randomised trial of oral versus vaginal administration of misoprostol for the purpose of mid‐trimester termination of pregnancy
Authors: Gilbert A , Reid R
Published: February 2008

A prospective randomised controlled trial was undertaken to compare the efficacy of two routes of administration, oral versus vaginal, of the prostaglandin El analogue misoprostol (Cytotec) to effect termination of pregnancy in the mid‐trimester.

Fifty‐five women were recruited into the trial; 26 to receive all doses orally and 29 via the vaginal route. The dosing regimen was 400 μg as the initial dose followed by a second dose of 200 μg two hours later and then four‐hourly 200 μg doses until delivery or 32 hours from commencement of treatment. If delivery had not been effected by the last dose of misoprostol, a Syntocinon infusion was started synchronously Misoprostol administered vaginally was significantly more effective than when administered orally as judged by induction‐to‐delivery interval and also the need or otherwise to augment therapy with a Syntocinon infusion. The average induction‐to‐delivery interval was 17.5 hours in the vaginal group compared to 33 hours in the oral group (p = 0.0003). The percentages of women who delivered at 24 and 48 hours were 93% and 100% in the vaginal administration group and 19% and 70% in the oral administration group (p < 0.05). No significant differences in complication rates or side effects were noted between the two groups
Identification of unique gene expression patterns within different lesional sites of keloids
Authors: Seifert Oliver , Bayat Ardeshir , Geffers Robert , Dienus Kirstin , Buer Jan , Löfgren Sture , Matussek Andreas
Published: February 2008

Keloid disease is a significant clinical problem, especially in black populations, with an estimated incidence of 4–16%. Keloids are fibroproliferative dermal tumors developing as a result of deregulated wound healing. The dynamic nature of keloids is illustrated by clinical regression in the center, while the margin remains active growing into the surrounding healthy skin. Therefore, the gene expression profiles of fibroblasts from different sites of the keloids were characterized using Affymetrix microarrays covering the whole human genome. This study revealed 105 genes that were differentially regulated (79 genes were up‐regulated and 26 down‐regulated) in a unique gene expression profile in different sites of keloids where progression or regression of the process was in progress. The apoptosis inhibitor AVEN was found to be up‐regulated at the active margin of keloids, while apoptosis‐inducing genes such as ADAM12 and genes inducing extracellular matrix (ECM) degradation such as matrix metalloproteinase‐19 were up‐regulated in the regressing keloid center. We identified genes previously not described in the development of keloids. Activating proapoptotic genes or inhibiting ECM‐inducing genes as INHBA or monocyte chemoattractant protein‐1 might be possible target genes for new treatment strategies for keloid disease.
Purification of R‐phycoerythrin from Porphyra haitanensis (Bangiales, Rhodophyta) using expanded‐bed absorption1
Authors: Niu Jian‐Feng , Wang Guang‐Ce , Zhou Bai‐Cheng , Lin Xiang‐Zhi , Chen Chang‐Sheng
Published: February 2008

R‐phycoerythrin (R‐PE) was purified from leafy gametophyte of Porphyra haitanensis T. J. Chang et B. F. Zheng (Bangiales, Rhodophyta) by a simple, scaleable procedure. Initially, phycobiliproteins were extracted by repeated freeze‐thaw cycles, resulting in release from the algal cells by osmotic shock. Next, R‐PE was recovered by applying the crude extract with a high concentration of (NH4)2SO4 salt directly to the expanded‐bed columns loaded with phenyl‐sepharose. An expanded‐bed volume twice the settled‐bed volume was maintained; then low (NH4)2SO4 concentration was used to develop the column. After two rounds of hydrophobic interaction chromatography (HIC), R‐PE was purified by anion‐exchange column. The method was also successful with free‐living conchocelis of P. haitanensis. The purified R‐PE was identified with electrophoresis, and absorption and fluorescence emission spectroscopy. The results were in agreement with those previously reported. The yield with a spectroscopic purity (OD565/OD280) higher than 3.2 (the ratio of A565/A620 ≤ 0.02) was 1.4 mg · g−1 of leafy gametophyte of P. haitanensis. For the free‐living conchocelis of P. haitanensis extract, R‐PE could be purified successfully with only one round of HIC. The yield with a spectroscopic purity (OD565/OD280) higher than 3.2 (the ratio of A565/A620 ≤ 0.02) was 5.0 mg · g−1 of free‐living conchocelis of P. haitanensis. The method described here is a scaleable technology that allows a large quantity of R‐PE to be recovered from the unclarified P. haitanensis crude extract. It is also a high protein recovery technology, reducing both processing costs and times, which enhances the value of this endemic Porphyra of China.
Ablation of Posteroseptal and Left Posterior Accessory Pathways Guided by Left Atrium–Coronary Sinus Musculature Activation Sequence
Authors: PAP RÓBERT , TRAYKOV VASSIL B. , MAKAI ATTILA , BENCSIK GÁBOR , FORSTER TAMÁS , SÁGHY LÁSZLÓ
Published: February 2008

Introduction: While some posteroseptal and left posterior accessory pathways (APs) can be ablated on the tricuspid annulus or within the coronary venous system, others require a left‐sided approach. “Fragmented” or double potentials are frequently recorded in the coronary sinus (CS), with a smaller, blunt component from left atrial (LA) myocardium, and a larger, sharp signal from the CS musculature.

Methods and Results: Forty patients with posteroseptal or left posterior AP were included. The LA–CS activation sequence was determined at the earliest site during retrograde AP conduction. Eleven APs (27.5%) were ablated on the tricuspid annulus (right endocardial), 9 (22.5%) inside the coronary venous system (epicardial), and 20 (50%) on the mitral annulus (left endocardial). A “fragmented” or double “atrial” potential was recorded in all patients inside the CS at the earliest site during retrograde AP conduction. Sharp potential from the CS preceded the LA blunt component (sharp/blunt sequence) in all patients with an epicardial AP, and in 10 of 11 (91%) patients with a right endocardial AP. Therefore, 18 of 19 (95%) APs ablated by a right‐sided approach produced this pattern. The reverse sequence (blunt/sharp) was recorded in 19 of 20 (95%) patients with a left endocardial AP.

Conclusion: During retrograde AP conduction, the sequence of LA–CS musculature activation—as deduced from analysis of electrograms recorded at the earliest site inside the CS—can differentiate posteroseptal and left posterior APs that require left heart catheterization from those that can be eliminated by a totally venous approach.
Randomized Study Comparing Mechanical with Electronic 2‐Dimensional Intracardiac Ultrasound Monitoring (MEDIUM) during Percutaneous Closure of Patent Foramen Ovale in Adult Patients with Cryptogenic Stroke
Authors: Zanchetta Mario , Pedon Luigi , Olivieri Armando , Benacchio Luca
Published: February 2008

Background: Previous studies have shown that mechanical and electronic intracardiac echocardiography (ICE) improves ultrasound monitoring during transcatheter patent foramen ovale (PFO) interventional closure. Objectives: This study sought to compare the procedural data, clinical imaging quality, and effectiveness PFO closure by using two different ICE monitoring modalities. Methods: Patients referred for PFO closure (n = 82) were randomly assigned to mechanical (group 1) or electronic (group 2) ICE monitoring of Amplatzer device implantation. The digital ICE images were evaluated offline by means of absolute visual grading analysis score (VGASabs), and the residual shunting at follow‐up were assessed by means of contrast echocardiographic studies, all blinded regarding the ICE closure monitoring modality. Results: The two groups were comparable with respect to clinical baseline characteristics, intracardiac fossa ovalis measurements, and procedural data (fluoroscopy time, procedure time and measurement of the amount of radiation that the patients absorbed). The total VGASabs ranked the mechanical clinical images in a higher order than the electronic ones (3.78 ± 0.09 vs 3.58 ± 0.12, P = 0.005); additionally, three patients (7.3%) of group 2 needed to cross over to mechanical ICE monitoring because a right‐convex atrial septal aneurysm configured itself incompletely. No differences in rates of residual shunting were observed at 12 months follow‐up between the two groups (97.5% vs 94.7%, P = 0.951). Conclusions: Electronic monitoring of PFO closure performed a less diagnostic impact than the mechanical one while maintaining comparable procedural data and clinical outcome. These results represent an important step in validating these new intracardiac ultrasound imaging modalities.
Clinical Utility of New Real Time Three‐Dimensional Transthoracic Echocardiography in Assessment of Mitral Valve Prolapse
Authors: Hirata Kumiko , Pulerwitz Todd , Sciacca Robert , Otsuka Ryo , Oe Yukiko , Fujikura Kana , Oe Hiroki , Hozumi Takeshi , Yoshiyama Minoru , Yoshikawa Junichi , Di Tullio Marco , Homma Shunichi
Published: February 2008

Background: Noninvasive and accurate assessment of mitral valve anatomy has become integral in the presurgical evaluation of patients with mitral valve prolapse (MVP). Recently developed real time three‐dimensional (RT3D) ultrasound allows online acquisition, rendering, and can provide accurate information on cardiac structures. We sought to evaluate the feasibility of RT3D for the assessment of MVP segments when compared with transesophageal echocardiography (TEE) and intraoperative findings. Methods: We examined 42 patients with MVP using RT3D, two‐dimensional (2D) transthoracic echocardiography (TTE) and TEE. For RT3D analysis, cropping planes were used to slice the 3D volume on line to visualize the prolapsed segments of the mitral valve leaflets. The mitral valve was divided into six segments based on the American Society of Echocardiography's recommendations. Two experienced cardiologists evaluated echocardiographic images. Results: Adequate RT3D images of the mitral valve were acquired in 40 out of 42 patients. The sensitivity and specificity of RT3D for defining prolapsed segments when compared with TEE were 95% and 99%, respectively (anterior leaflet: 96% and 99%, posterior leaflets: 93% and 100%, respectively). The sensitivity and specificity of TTE were 93% and 97%, respectively (anterior leaflet: 96% and 98%, posterior leaflets: 90% and 97%, respectively). Interobserver agreement for RT3D (Kappa 0.95, 95% confidence interval [CI] 0.91–1.00) was significantly greater than for TTE (Kappa 0.85, 95% CI 0.78–0.93) (P < 0.05). The elapsed time for completion of RT3D (14.4 ± 2.8 min) was shorter than for TEE (26.4 ± 4.7 min, P < 0.0001) and TTE (19.0 ± 3.1 min, P< 0.0001). Conclusions: RT3D is fast, accurate, and highly reproducible for assessing MVP.
CD44 and hyaluronan engagement promotes dexamethasone resistance in human myeloma cells
Authors: Ohwada Chikako , Nakaseko Chiaki , Koizumi Masayuki , Takeuchi Masahiro , Ozawa Shinichi , Naito Megumi , Tanaka Hiroaki , Oda Kayo , Cho Ryuko , Nishimura Miki , Saito Yasushi
Published: February 2008

Dexamethasone (Dex) is an effective therapeutic agent against multiple myeloma (MM); however, resistance to it often becomes a clinical issue. CD44 is an adhesion molecule that serves as a cell surface receptor for extracellular matrix components, including hyaluronan (HA). HA is an extracellular matrix component that is involved in survival and progression in MM. In the present report, we describe isolation of a CD44‐expressing population from a Dex‐sensitive MM cell line, RPMI8226, in which the CD44‐high population had a significantly higher potential to resist Dex than did the CD44‐low population. Furthermore, we demonstrate that CD44 engagement by an anti‐CD44 monoclonal antibody (mAb) or HA protects MM cells from Dex‐induced growth inhibition. The activity of HA was partially inhibited by blocking its binding to CD44, indicating that CD44 mediates HA activity promoting MM cell survival. CD44 engagement by an anti‐CD44 mAb led to phosphorylation and degradation of IκB‐α, thus preventing its Dex‐induced up‐regulation. Our data suggest that CD44 is not only an important mediator for the survival activity of HA, but it may also contribute to MM cell resistance to Dex.
Identification and characterization of the first large deletion of the MYH9 gene associated with MYH9 disorders
Authors: Kunishima Shinji , Matsushita Tadashi , Hamaguchi Motohiro , Saito Hidehiko
Published: February 2008

MYH9 disorders are autosomal dominant macrothrombocytopenias with leukocyte inclusion bodies. Single point mutations in the protein‐coding sequence of the MYH9 gene are the most common cause. So far no large gene deletion/insertion and splicing defects have been reported. Conventional DNA sequencing of each MYH9‐coding exon showed no abnormalities in a patient. Reverse transcription‐ polymerase chain reaction (PCR) amplification and sequencing of neutrophil mRNA identified an inframe deletion of exon 25. Further long‐range PCR amplification of genomic DNA revealed a deletion of 1220 nucleotides including entire exon 25. Immunoblot analysis showed a small, abnormal protein in neutrophils but not in platelets. This is the first report of a large deletion of the MYH9 gene leading to the development of MYH9 disorders.
Age‐matched lymphocyte subpopulation reference values in childhood and adolescence: application of exponential regression analysis
Authors: Huenecke Sabine , Behl Michael , Fadler Carla , Zimmermann Stefanie Y. , Bochennek Konrad , Tramsen Lars , Esser Ruth , Klarmann Dieter , Kamper Martina , Sattler Alexandra , von Laer Dorothee , Klingebiel Thomas , Lehrnbecher Thomas , Koehl Ulrike
Published: February 2008

Background:  Normal values of lymphocyte subpopulations for healthy children and adults have been published in defined age groups exclusively, which results in difficult data interpretation for patients close to the limit of contiguous age group ranges. In addition, normal values for a number of lymphocyte subpopulations have not been established to date.

Objective:  The aim of this study was to develop a model which provides continuous age‐dependent reference values. This model was applied for lymphocyte subpopulations such as naïve and memory T cells as well as their activation profile with diagnostic relevance in children and adults.

Study design:  A total of 100 blood samples, obtained from 80 healthy children and 20 adults were analysed by means of four colour‐flow cytometry. Continuous age‐dependent reference values were computed based on the residual values in an exponential regression model.

Results:  We calculated a continuous age‐related regression model for both, absolute cell counts and percentages of CD3+CD4+ T helper (TH) cells, CD3+CD8+ cytotoxic T cells, CD56+CD3− natural killer (NK) cells, CD56+CD3+ T cells, CD3+CD4+CD45RA+ naïve TH cells, CD3+CD4+CD45RO+ memory TH cells, CD3+CD8+CD45RA+CD28+ naïve cytotoxic T cells, CD3+CD8+CD45RO+ memory cytotoxic T cells, CD3+CD8+CD69+ early activated cytotoxic T cells and CD3+CD8+HLA‐DR+ late activated cytotoxic T cells, respectively, to obtain reference values.

Conclusion:  Based on an exponential regression model, the obtained reference values reflect the continuous maturation of lymphocyte subsets during childhood.
The oxidation products of melatonin derivatives exhibit acetylcholinesterase and butyrylcholinesterase inhibitory activity
Authors: Siwicka Aleksandra , Molęda Zuzanna , Wojtasiewicz Krystyna , Zawadzka Anna , Maurin Jan K. , Panasiewicz Mirosława , Pacuszka Tadeusz , Czarnocki Zbigniew
Published: February 2008

Abstract:  It is already well documented that melatonin exhibits strong antioxidant properties. It traps several reactive oxygen species including singlet oxygen, peroxyl and hydroxyl radicals. Also, peroxynitrite‐induced reactions are inhibited by melatonin. The oxidation of melatonin by singlet molecular oxygen [O2 (1Δg)] may produce cyclic 3‐hydroxymelatonin whose structure we have already studied. In this investigation we report on the synthesis of several melatonin analogues having a carbamate substituent instead of the methoxy group at 5 position of the indole ring. These compounds behave analogously to melatonin with respect to singlet oxygen and produce the corresponding cyclic 3‐hydroxymelatonin analogues. The structures of the products were investigated with spectral methods and X‐ray crystallography. The compounds obtained possess the 2,3,8,8a‐tetrahydropyrrolo[2,3‐b]indole heterocyclic system which is a structural motif characteristic of alkaloids, physostigmine and phenserine, that are potent acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibitors used in the Alzheimer’s disease treatment. We measured the inhibitory activity of the obtained compounds against AChE and BChE from human erythrocytes and serum. In the case of the compounds having a phenylcarbamate and methoxyphenylcarbamate substituents, the inhibitory activity (IC50) ranged from 0.252 ± 0.033 to 3.804 ± 0.581 μm. Other compounds were less active and showed rather complex interactions with the structure–activity relationship in need of further investigation.
Long‐term postinfarction melatonin administration alters the expression of DHPR, RyR2, SERCA2, and MT2 and elevates the ANP level in the rat left ventricle
Authors: Sallinen Pirkko , Mänttäri Satu , Leskinen Hanna , Vakkuri Olli , Ruskoaho Heikki , Saarela Seppo
Published: February 2008

Abstract:  We investigated the effect of 2 wk continuous postinfarction subcutaneous melatonin supply on the expression of the rat left ventricular (LV) dihydropyridine receptor (DHPR), ryanodine receptor (RyR2), and sarco‐endoplasmic reticulum Ca2+‐ATPase2 (SERCA2), as they are fundamental proteins in cardiac contractility. The levels of plasma and LV atrial (ANP) and brain natriuretic peptide and melatonin were also measured, as was the expression of LV MT1 and MT2 receptors and pineal arylalkylamine N‐acetyltransferase. Myocardial infarction (MI) was induced by ligation of the left anterior descending coronary artery and vehicle or melatonin (4.5 mg/kg per day) was administered by subcutaneous osmotic pumps. Echocardiography, real‐time quantitative reverse transcription‐polymerase chain reaction, and western blotting were used to analyze the samples. Echocardiography revealed that MI induced serious systolic LV dysfunction. The expression of DHPR, RyR2, and SERCA2 mRNAs was significantly lower in the LVs of melatonin‐treated MI rats compared with vehicle‐treated rats (P < 0.01 for DHPR and P < 0.05 for RyR2 and SERCA2). Melatonin also elevated the amount of LV MT2 receptors to 1.9‐fold (P < 0.05) and the concentration of LV ANP to over fivefold (P < 0.05) compared with vehicle rats after MI. Therefore, the results suggest that melatonin may influence the cardiac contractility after MI by regulating the expression of DHPR, RyR2, and SERCA2, and melatonin receptors, particularly MT2s, might contribute to the postinfarction cardioprotective actions of melatonin. Furthermore, the finding of the relationship between melatonin and ANP suggests a novel mechanism for melatonin in protecting the heart after MI.
A CD63 Mutant Inhibits T‐cell Tropic Human Immunodeficiency Virus Type 1 Entry by Disrupting CXCR4 Trafficking to the Plasma Membrane
Authors: Yoshida Takeshi , Kawano Yuji , Sato Kei , Ando Yoshinori , Aoki Jun , Miura Yoshiharu , Komano Jun , Tanaka Yuetsu , Koyanagi Yoshio
Published: February 2008

We have discovered that an N‐terminal deletion mutant of a membrane protein, CD63, (CD63ΔN) blocks entry of CXCR4‐using, T‐cell tropic human immunodeficiency virus type 1 (X4 HIV‐1) by suppressing CXCR4 surface expression. This suppression was observed for CXCR4 but not for CD4, CCR5, CD25, CD71 or other tetraspanin proteins. The suppression of CXCR4 expression on the plasma membrane appeared to be caused by mislocalization of CXCR4 and exclusive transportation of CXCR4 toward intracellular organelles, mainly late endosomes/lysosomes. Our data suggest that CXCR4 trafficking can be modified in terms of its recruitment to the plasma membrane without enhancing the degradation or arresting vesicular transport of CXCR4.
Guanxi Dynamics: Shifts in the Closeness of Ties Between Chinese Coworkers
Authors: Chen Xiao-Ping , Peng Siqing
Published: February 2008

Adopting a dynamic view of guanxi, we investigated how the closeness in Chinese coworker relationship changes as a function of interpersonal incidents, exploring factors such as the prior closeness level as well as the valence and job relevance of the incident. Two studies of PRC managers probed the content and dynamics of their coworker relationships. Results indicate that such relationships mix affective and instrumental ties. A key finding about changes is that the increase in closeness created by positive incidents was greater when the prior relationship was distant, and the decrease created by negative incidents was greater when the prior relationship was close. The implications of these findings for theory development and future guanxi research are discussed.
Framing China: Transformation and Institutional Change through Co-evolution
Authors: Krug Barbara , Hendrischke Hans
Published: February 2008

This paper proposes a new institutional perspective to explain not only the diversity of local business systems in China but also how this diversity results from the integration of major institutional forces. We model the emergence of China's business systems as a co-evolutionary process unfolding along a business–government and a micro–macro-level dimension structured by intergovernmental institutional competition, business to business and business to government networking and public-private corporate governance. We find that: (i) China's emerging business system is the result of local institutional competition at the micro level that reduces the need for national (macro) institutions and impacts on the local implementation of national (including supranational) policies; (ii) the interaction between government and business is structured through networks which operate according to an economic rationale while drawing on cultural norms and traditions; and (iii) local businesses interact with local governments to recombine productive factors and reorganise firms and industries in line with local institutions. We conclude that the astonishing adaptability of Chinese businesses as well as the risk of corruption and lack of formal control at local government level are elements of locally differentiated business systems which are held together by an overarching institutional architecture.
Speed and selection in the evolution of killer‐cell immunoglobulin‐like receptors
Authors: Martinez‐Borra J. , Khakoo S. I.
Published: February 2008

The killer‐cell immunoglobulin‐like receptors (KIR) form a diverse family of receptors that control the functions of natural killer cells. Sequencing of KIR from primates has revealed the unexpected extent to which this gene family has diversified mostly likely in response to pathogens and to pathogen‐mediated selection of their MHC class I ligands. Human KIR diversity is now a burgeoning area for disease association studies. This review examines the evolution of KIR from a primate‐centric view in order to rationalize our current knowledge of the diversity of human KIR.
Synthesis of Methods, Rules, and Issues of Standardizing Nursing Intervention Language Mapping
Authors: Delaney Connie , Moorhead Sue
Published: February 2008

TOPIC. Nursing language mapping.

PURPOSE. To synthesize the methods, rules and issues described in two studies that mapped nonstandardized nursing orderslinterventions into the Nursing Interventions Classification (NIC).

SOURCES. The methods and results of studies conducted by Moorhead & Delaney and Coenen et al.

CONCLUSIONS. Results indicate that the NIC is an effective classification of mapping nursing orders/interventions to support across‐site comparisons of nursing treatments. A set of decision rules to support mapping of interventions to the NIC is outlined.
Enlisting close connections: a matter of course for vicarious liability?
Authors: Yap Po Jen
Published: February 2008

In determining whether an employer is vicariously liable for the torts committed by his employee, the House of Lords in the landmark decision of Lister v Hesley Hall proposed that courts should now focus on the relative closeness between the nature of the employment and the tort. Unfortunately, this touchstone test simply begs the question of how close must the nature of employment and the tortious action be before liability can be found. To say that the tort in question was inextricably interwoven or so closely connected with the nature of the employment is conclusory not prescriptive. The close connection test in itself merely provides the court with a formula to confirm its result, not reach one. This author seeks to argue instead that the following legal tests should be employed to determine whether an employee's wrong was committed in the course of his employment. (1) Where the employee has been negligent in the performance of his duties or where the employee has deliberately engaged in self-serving conduct (not amounting to a tort) and in doing so negligently causes injury to another, the employer would only be vicariously responsible if the injury suffered by the victim arises from the inherent risks of the employment. (2) Where the tort committed by the employee is trespassory/intentional in nature, the employer would only be vicariously liable if he has materially increased the likelihood of occurrence of an injury that arises from an inherent risk of the employment. Essentially, my suggested formula would only find liability when the injury suffered by the victim arises from the risks inherent in the tortfeasor's employment, ie the employer would not be liable for all risks he creates when the wayward worker is in his employ.
Osteopontin expression in normal and hypobaric hypoxia‐exposed rats
Authors: Uenoyama M. , Ogata S. , Nakanishi K. , Kanazawa F. , Hiroi S. , Tominaga S. , Kanatani Y. , Seo A. , Matsui T. , Suzuki S.
Published: February 2008

Aim:  Experimental pulmonary hypertension induced in a hypobaric hypoxic environment (HHE) is characterized by structural remodelling of the heart and pulmonary arteries. Osteopontin (OPN) has emerged as a key factor in cardiovascular remodelling in response to pressure or volume overload. We studied the possible effects of HHE on the OPN synthesis system.

Methods:  One hundred and forty‐eight male Wistar rats were housed in a chamber with conditions equivalent of an altitude of 5500 m for up to 21 days.

Results:  Plasma OPN protein level was found to be significantly decreased on day 0.5 of exposure to HHE, as was the level in the adrenal gland (which secreted highest levels of OPN protein). In the right ventricle of the heart (mRNA) and the lung (protein), OPN expression was found to be significantly increased only on day 1 and day 5, respectively, of exposure to HHE. By immunohistochemistry, the distribution and intensity of OPN protein in several organs were found to alter during exposure to HHE. However, these changes in OPN synthesis did not coincide with the moderate increase in pulmonary arterial pressure (PAP) (maximal mean PAP, 24.5 mmHg) during HHE.

Conclusion:  Pulmonary hypertension in HHE with conditions equivalent of an altitude of 5500 m may induce little or no OPN in heart and lung. Sustained induction may require a more severe PAP overload.
Heart and brain circulation and CO2 in healthy men
Authors: Yokoyama I. , Inoue Y. , Kinoshita T. , Itoh H. , Kanno I. , Iida H.
Published: February 2008

Aim:  To compare blood flow response to arterial carbon dioxide tension change in the heart and brain of normal elderly men.

Methods:  Thirteen healthy elderly male volunteers were studied. Hypercapnea was induced by carbon dioxide inhalation and hypocapnea was induced by hyperventilation. Myocardial blood flow [mL min−1 × (100 g of perfusable tissue)−1] and cerebral blood flow [mL min−1 × (100 g of perfusable tissue)−1] were measured simultaneously at rest, under carbon dioxide gas inhalation and hyperventilation using the combination of two positron emission tomography scanners.

Results:  Arterial carbon dioxide tension increased significantly during carbon dioxide inhalation (43.1 ± 2.7 mmHg, P < 0.05) and decreased significantly during hyperventilation (29.2 ± 3.4 mmHg, P < 0.01) from baseline (40.2 ± 2.4 mmHg). Myocardial blood flow increased significantly during hypercapnea (88.7 ± 22.4, P < 0.01) from baseline (78.2 ± 12.6), as did the cerebral blood flow (baseline: 39.8 ± 5.3 vs. hypercapnea: 48.4 ± 10.4, P < 0.05). During hypocapnea cerebral blood flow decreased significantly (27.0 ± 6.3, P < 0.01) from baseline as did the myocardial blood flow (55.1 ± 14.6, P < 0.01). However, normalized myocardial blood flow by cardiac workload [100 mL mmHg−1 × (heart beat)−1 × (gram of perfusable tissue)−1] was not changed from baseline (93.4 ± 16.6) during hypercapnea (90.5 ± 14.3) but decreased significantly from baseline during hypocapnea (64.5 ± 18.3, P < 0.01).

Conclusion:  In normal elderly men, hypocapnea produces similar vasoconstriction both in the heart and brain. Mild hypercapnea increased cerebral blood flow but did not have an additional effect to dilate coronary arteries beyond the expected range in response to an increase in cardiac workload.
External Dependent Economy and Structural Real Estate Bubbles in China
Authors: Sun Lijian , Zhang Shengxing
Published: February 2008

This study explores the relationship between external dependent economic structure, surplus monetary liquidity and real estate bubbles in China. Employing monthly data from 28 Chinese provinces over the period 2004‐2005, we test whether real estate bubbles are caused by structural surplus monetary liquidity, controlling other possible factors. Our empirical findings show that the growth of private savings in the banking sector, as an index of surplus monetary liquidity, ferments real estate bubbles regardless of the different development level across the 28 provinces.
Indian Buddhist Preachers Inside and Outside the Sūtras
Authors: Nance Richard
Published: February 2008

The subject of the preacher in Indian Buddhist history and literature is one that has gone almost completely unexplored by modern scholars. Indian Buddhist preachers have historically served as voices for Buddhist teaching, but they have also been voiced by that teaching, articulated in the very sūtra texts that they are charged to preserve and protect. This article explores a few portraits of preachers painted in the Buddhist sūtra corpus, and attempts to draw provisional conclusions regarding the impact of such portraits on Buddhist preachers’ own conceptions of doctrinal authority. As Gregory Schopen's work reminds us, we cannot straightforwardly recover an accurate picture of ‘what Buddhism was’ from texts that concern ‘what Buddhism should be’. But, it is no less a mistake to assume either that normative texts do not influence history, or that the traces of such influence are nowhere evident in normative texts. This article explores some of the ways in which these reciprocal impacts may be glimpsed.