bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative induction with sorafenib pathologically downstaged advanced renal cell carcinoma: A case report
Authors: Kinoshita Tatsuya , Inoue Hitoshi , Kinouchi Toshiro , Kobayashi Masao , Takada Tsuyoshi , Hara Tsuneo , Hatano Koji , Nonomura Norio
Published: March 2010

We present the case of a patient with renal cell carcinoma treated preoperatively with sorafenib. Complete resection of the left renal mass measuring 7.2 × 6.6 cm seemed to be difficult at diagnosis because of large renal hilar lymph nodes. With a short period of sorafenib administration, marked shrinkage of the renal mass and lymphadenopathy was observed after the patient experienced fulminant hepatic failure and a severe hand–foot skin reaction. Two‐dimensional computed tomography revealed 60%, 78% and 84% reduction in the primary renal tumor, lung metastatic nodules and lymph nodes, respectively. Tumor shrinkage allowed for complete resection of the left kidney and the lymphadenopathy. Pathological findings revealed that over 90% of the renal tumor was substituted by necrotic fibrotic tissue and that the residual neoplastic component was diagnosed as clear cell carcinoma. The lymph nodes that were resected were negative for malignancy. At 6 months after radical nephrectomy, a new computed tomography scan revealed no evidence of disease with the disappearance of lung nodules.
Morphological sperm defects analyzed by light microscopy and transmission electron microscopy and their correlation with sperm motility
Authors: Visco Vincenzo , Raffa Salvatore , Elia Jlenia , Delfino Michele , Imbrogno Norina , Torrisi Maria Rosaria , Mazzilli Fernando
Published: March 2010

Objectives:  To compare sperm defects as assessed by light microscopy (LM) and transmission electron microscopy (TEM), and to correlate them with sperm motility.

Methods:  A cohort of 40 male partners of infertile couples was selected. Group 1 (n = 31) included subjects with motility >5 and <50%, group 2 (n = 9) included those with motility <5% and the control group consisted of 10 normospermic subjects. Semen analysis of morphological parameters was carried out by LM and TEM.

Results:  A linear correlation between LM and TEM regarding head defects and excess residual cytoplasm (r = 0.87 and 0.90) was found, whereas there was a poor correlation between tail and midpiece anomalies (r = 0.46 and 0.21). No significant variations were detected by LM and TEM regarding sperm head defects and excess residual cytoplasm, whereas TEM showed a significantly greater percentage of tail and midpiece alterations compared with LM in groups 1 and 2, as well as controls (P < 0.05). The microtubular pattern ‘<9 + 2’ represented the most frequent axonemal morphological alteration.

Conclusions:  TEM might represent an additional diagnostic tool in the presence of severe sperm hypomotility or absence of motility.
Transnasal transsphenoid approach: a minimally invasive approach for removal of cavernous haemangiomas located at inferomedial part of orbital apex
Authors: Chen Lukui , White William L , Xu Bainan , Tian Xinhua
Published: March 2010

Abstract

Ten patients complaining of visual impairment, proptosis or ocular pain, were selected for transnasal transsphenoid microsurgical approach to address cavernous haemangiomas located at inferomedial part of orbital apex. Via this approach, the contents of orbital apex were clearly illuminated and exposed as large as the surgical removal required. All tumours were identified under frameless image‐guided neuronavigation and removed completely without any complications and recurrence in a mean of 12.2 months follow‐up. It is concluded that a transnasal transsphenoid microsurgical approach is a minimally invasive surgery for cavernous haemangiomas located at inferomedial part of orbital apex.
High glucose‐induced apoptosis in bovine retinal pericytes is associated with transforming growth factor β and βIG‐H3: βIG‐H3 induces apoptosis in retinal pericytes by releasing Arg‐Gly‐Asp peptides
Authors: Han Jeung H , Ha Sung W , Lee In K , Kim Bo W , Kim Jung G
Published: March 2010

Abstract

Background:  Transforming growth factor β (TGF‐β) plays an important role in diabetic retinopathy. βIG‐H3 is a downstream target molecule of TGF‐β that may participate in the pathogenesis of diabetic retinopathy and in particular in the loss of pericytes during early pathological changes.

Methods:  We observed bovine retinal pericytes apoptosis and the increased expression of TGF‐β and βIG‐H3 induced by high concentrations of glucose in the cell culture media. An anti‐TGF‐β antibody was used to block glucose‐induced retinal pericytes apoptosis. Retinal pericytes were also transfected with cDNA encodings either wild‐type or mutant βIG‐H3 lacking Arg‐Gly‐Asp (RGD) sequences in order to validate the effects of βIG‐H3 and RGD signalling on retinal pericytes apoptosis.

Results:  A cell death‐detecting enzyme‐linked immunosorbent assay revealed that 25 mM glucose significantly increased cell death compared with 5.5 mM glucose after 5 or 7 days of exposure (P < 0.01). High glucose significantly increased the TGF‐β levels as compared with 5.5 mM glucose after 5 days, and βIG‐H3 levels after 3, 5 and 7 days of exposure (P < 0.01). TGF‐β increased cell death and βIG‐H3 levels in a dose‐dependent manner, with a maximal effect observed at 1 ng/mL. An anti‐TGF‐β antibody nearly completely blocked high glucose‐induced cell death. Wild‐type βIG‐H3‐transfected cells showed a significant increase in cell death as compared with mutant βIG‐H3‐transfected (Mycb‐c) cells, untransfected or mock‐transfected cells.

Conclusion:  These results suggest that hyperglycaemia‐induced expression of TGF‐β and βIG‐H3 contributes to accelerated retinal pericytes apoptosis. βIG‐H3 induces pericytes apoptosis through its RGD motif, which may constitute an important pathogenic mechanism leading to pericytes loss in diabetic retinopathy.
Diabetic retinopathy and the major causes of vision loss in Aboriginals from remote Western Australia
Authors: Clark Antony , Morgan William H , Kain Sam , Farah Hussein , Armstrong Kiele , Preen David , Semmens James B , Yu Dao‐Yi
Published: March 2010

Abstract

Purpose:  To report on diabetic retinopathy (DR) and the major causes of vision loss and blindness in Aboriginals in the Eastern Goldfields region of Western Australia between 1995 and 2007.

Methods:  Aboriginals (>16 years old) diagnosed with diabetes or eye problems from 11 communities in the Eastern Goldfields region of Western Australia were examined annually from 1995 to 2007. Data collected from prospective clinical examination included; visual acuity (VA), causes of vision loss, and whether DR was present. Severity of DR was graded according to the Early Treatment of Diabetic Retinopathy Study modified Airlie House grading system.

Results:  A total of 920 Aboriginals underwent 1331 examinations over the study period. There were 246 eyes with vision loss (best‐corrected VA < 6/12) in 159 Aboriginals, of whom five were bilaterally blind. The four major known causes of vision loss were cataract (n = 53, 30.1%), DR (n = 44, 25.0%), uncorrected refractive error (n = 31, 17.6%) and trauma (n = 19, 10.8%). Aboriginals who had diabetes were far more likely to have vision loss (odds ratio = 8.5, 95% confidence interval 5.7–12.6, P < 0.0001). Of the 329 Aboriginals with diabetes, 82 (24.9%) had DR, and 32 (9.7%) had vision‐threatening retinopathy. Of those with diabetes, 94 (42.5%) returned for follow‐up examination on an average of 3.2 visits with a median time between visits of 2 years.

Conclusion:  The four major causes of vision loss in Aboriginals from the Eastern Goldfields are largely preventable and/or readily treated. DR and other diabetes‐related eye conditions are a major cause of vision loss in Aboriginals, representing a significant health challenge for health services and clinicians into the future.
Clinical characteristics and outcome of current standard management of central retinal artery occlusion
Authors: Rudkin Adam K , Lee Andrew W , Aldrich Eric , Miller Neil R , Chen Celia S
Published: March 2010

Abstract

Background:  To investigate the visual outcomes in acute central retinal artery occlusion (CRAO) with current standard therapy at two university teaching hospitals.

Methods:  Retrospective analysis of two cohorts of CRAO patients from John Hopkins Hospital (JHH; USA), and Flinders Medical Centre (FMC; Australia), treated with current standard therapy. The outcome measures were visual acuity, and subsequent ocular and systemic ischaemic events.

Results:  The mean follow‐up period was 11.2 ± 13.1 months in the JHH cohort and 35.4 ± 34.9 months in the FMC cohort. The frequency distribution of vascular risk factors and the incidence of subsequent ischaemic events were similar for the patients from both institutions. All patients from JHH were treated as inpatients, whereas 79% of patients from FMC were treated as outpatients. More patients in the JHH cohort underwent paracentesis, ocular massage or were treated with intraocular hypotensive agents (76%) than in the FMC cohort (26%); however, there was no significant difference in visual outcome between the two cohorts (P = 0.114).

Conclusion:  Despite differences in management of CRAO between two institutions in different countries, visual outcomes were similar. This suggests a lack of efficacy of current standard treatment in acute CRAO.
Calciphylaxis of the temporal artery masquerading as temporal arteritis
Authors: Awwad Shady T , Ghosn Samer , Hogan R Nick
Published: March 2010

Abstract

We describe a case of a 75‐year‐old man with diabetes type II and end‐stage renal disease, presenting with a one‐month history of blurring of vision in the left eye. Fundus exam showed pale and swollen optic nerve in the left eye, and temporal artery biopsy showed diffuse and extensive calcification at the internal elastic lamina and media. Biopsy of dusky erythematous lesions over the calves revealed the diagnosis of calciphylaxis. The temporal artery calcific lesions should hence be differentiated from the less extensive atherosclerotic changes, which mainly affect the media of the artery, as it is crucial to suspect this life‐threatening diagnosis in patients at risk.
Autohydrolysis of plant xylans by apoplastic expression of thermophilic bacterial endo‐xylanases
Authors: Borkhardt Bernhard , Harholt Jesper , Ulvskov Peter , Ahring Birgitte K. , Jørgensen Bodil , Brinch‐Pedersen Henrik
Published: March 2010

The genes encoding the two endo‐xylanases XynA and XynB from the thermophilic bacterium Dictyoglomus thermophilum were codon optimized for expression in plants. Both xylanases were designed to be constitutively expressed under the control of the CaMV 35S promoter and targeted to the apoplast. Transient expression in tobacco and stable expression in transgenic Arabidopsis showed that both enzymes were expressed in an active form with temperature optima at 85 °C. Transgenic Arabidopsis accumulating heterologous endo‐xylanases appeared phenotypically normal and were fully fertile. The highest xylanase activity in Arabidopsis was found in dry stems indicating that the enzymes were not degraded during stem senescence. High levels of enzyme activity were maintained in cell‐free extracts from dry transgenic stems during incubation at 85 °C for 24 h. Analysis of cell wall polysaccharides after heat treatment of wildtype and transgenic extracts from dry stems showed a decrease in the molecular weight of xylans from transgenic stems.
Agency Conflicts, Controlling Owner Proximity, and Firm Value: An Analysis of Dual‐Class Firms in the United States
Authors: Hoi Chun‐Keung , Robin Ashok
Published: March 2010

Manuscript Type: Empirical

Research Question/Issue: The study seeks to understand whether the proximity of the largest shareholder (controller) to the locus of management – whether the controller is a top executive, a board member, or an outsider – determines the value of US dual‐class firms.

Research Findings/Insights: Using a sample of 209 US dual class firms from the year 2000 and a corresponding control sample of single‐class firms, we run cross‐sectional regressions to determine the effect of the controller on firm value. We present robust evidence that dual‐class firm value is negatively related to controller proximity. Dual‐class structure overall is unrelated to firm value, because despite its negative effects with high proximity controllers there appear to be benefits when controller proximity is low (when the largest shareholder is an outsider).

Theoretical/Academic Implications: Ownership structure is a widely studied subject but most studies focus on insider ownership. More nuanced aspects of ownership such as controller proximity are needed in empirical studies and theoretical models. These nuances could help us better understand the interplay between the incentive of various parties (e.g., managers, large shareholders) and the opportunity available for extraction of private benefits.

Practitioner/Policy Implications: A practitioner implication is that shareholder of high‐proximity dual‐class firms must seek additional control mechanisms to curb agency costs. A policy implication is that investor protection (laws and institutional structure protecting shareholders) works only to a limited extent – it curbs overt acts of expropriation, but cannot eliminate acts engineered by insiders.
THE INTEGRATED APPROACH IN NEIGHBOURHOOD RENEWAL: MORE THAN JUST A PHILOSOPHY?
Authors: AALBERS MANUEL B. , VAN BECKHOVEN ELLEN
Published: March 2010

Across Europe, area‐based policies have been developed as a mode of urban governance to deal with the unfavourable situation in many urban neighbourhoods, particularly large post‐Second World War developments. The philosophy behind these area‐based policies is that integrated initiatives to deal with the physical, economic and social aspects of these urban neighbourhoods, will lead to the most effective solution. This paper focuses on the ‘integrated’ aspect of area‐based policies in the Netherlands. We find that there is an unbalanced relationship between policies that focus on physical interventions and those that focus on social interventions. Also, findings show that some area‐based initiatives claiming to be using an integrated approach are not. ‘Integration’ is often a term used by policy‐makers but not implemented. This lack of integration is partly due to the limited flexibility in decision‐making at the local level in dividing funds between and within the different policy fields.
Bickerstaff’s encephalitis and Miller Fisher syndrome associated with voltage‐gated potassium channel and novel anti‐neuronal antibodies
Authors: Tüzün E. , Kürtüncü M. , Lang B. , İçöz S. , Akman‐Demir G. , Eraksoy M. , Vincent A.
Published: March 2010

Background:  GQ1b antibody (GQ1b‐Ab) is detected in approximately two‐thirds of sera of patients with Bickerstaff’s encephalitis (BE). Whilst some of the remaining patients have antibodies to other gangliosides, many patients with BE are reported to be seronegative.

Methods and Results:  Voltage‐gated potassium channel antibody (VGKC‐Ab) at high titer was detected during the diagnostic work‐up of one patient with BE. Sera of an additional patient with BE and nine patients with Miller Fisher syndrome (MF) (all GQ1b‐Ab positive) were investigated for VGKC‐Ab and other anti‐neuronal antibodies by radioimmunoprecipitation using 125I‐dendrotoxin‐VGKC and immunohistochemistry, respectively. Two patients with MF exhibited moderate titer VGKC‐Abs. Regardless of positivity for VGKC or GQ1b antibodies, serum IgG of all patients with BE and MF reacted with the molecular layer and Purkinje cells of the cerebellum in a distinctive pattern.

Conclusion:  Voltage‐gated potassium channel antibodies might be involved in some cases of BE or MF. The common staining pattern despite different antibody results suggests that there might be other, as yet unidentified, antibodies associated with BE and MF.
What is Theological Interpretation? The Example of Robert W. Jenson
Authors: SARISKY DARREN
Published: March 2010

Theological interpretation is an approach to reading generated by a theological understanding of the biblical text, of the community that reads it theologically, and of the practice of reading. This essay argues this point on the basis of the work of one representative theological interpreter, Robert W. Jenson. In addition, it entertains John Barton's objection that theological interpretation amounts to eisegesis. The article concludes that theological exegesis does not necessarily involve reading one's views into the text, but rather that it results in putting the text to a different end.
Predicting potential distributions of invasive species: where to go from here?
Authors: Gallien Laure , Münkemüller Tamara , Albert Cécile H. , Boulangeat Isabelle , Thuiller Wilfried
Published: March 2010

Aim  There has been considerable recent interest in modelling the potential distributions of invasive species. However, research has developed in two opposite directions: the first, focusing on screening, utilizes phenomenological models; the second, focusing on predictions of invasion dynamics, utilizes mechanistic models. Here, we present hybrid modelling as an approach to bridge the gap and to integrate the advantages of both research directions.

Location  Global.

Methods  First, we briefly summarize the characteristics and limitations of both approaches (screening vs. understanding). Then, we review the recent developments of hybrid models, discuss their current problems and offer suggestions to improve them.

Results  Generally, hybrid models are able to combine the advantages of currently used phenomenological and mechanistic approaches. Main challenges in building hybrid models are the choices of the appropriate degree of detail and efficiency and the decision on how to connect the different sub‐models. Given these challenges, we discuss the links between the phenomenological and the mechanistic model parameters, the underlying concepts of fundamental and realized niches and the problem of feedback loops between population dynamics and environmental factors.

Main conclusions  Once the above challenges have been addressed and the necessary framework has been developed, hybrid models will provide outstanding tools for overcoming past limitations and will provide the means to make reliable and robust predictions of the potential distribution of invasive species, their population dynamics and the potential outcomes of the overall invasion process.
Purinoreceptor‐mediated current in myocytes from renal resistance arteries
Authors: Harhun Maksym I , Povstyan Oleksandr V , Gordienko Dmitri V
Published: March 2010

Background and purpose: Ionotropic purinoreceptors (P2X) in renal vascular smooth muscle cells (RVSMCs) are involved in mediating the sympathetic control and paracrine regulation of renal blood flow (RBF). Activation of P2X receptors elevates [Ca2+]iin RVSMCs triggering their contraction, leading to renal vasoconstriction and decrease of RBF. The goal of the present work was to characterize the P2X receptor‐mediated ionic current (IP2X) and to identify the types of P2X receptors expressed in myocytes isolated from interlobar and arcuate arteries of rat kidney.

Experimental approach: The expression of P2X receptors in isolated RVSMCs was analysed by reverse transcription (RT)–PCR. IP2Xand membrane potential were recorded using the amphotericin B‐perforated patch method.

Key results: RT–PCR analysis on single RVSMCs showed the presence of genes encoding P2X1 and P2X4 receptors. Under voltage clamp conditions, the selective P2X receptor agonist αβ‐methylene ATP (αβ‐meATP) evoked IP2Xsimilar to that induced by ATP. Under current clamp conditions, both ATP and αβ‐meATP evoked a spike‐like membrane depolarization followed by a sustained depolarization, linking P2X receptors in RVSMCs to sympathetic control of renal vascular tone. A selective antagonist of P2X1 receptors, NF279, reduced IP2Xamplitude by ∼65% concentration‐dependently manner within the nanomolar to sub‐micromolar range. The residual current was resistant to micromolar concentrations of NF279, but was inhibited by sub‐millimolar to millimolar concentrations of NF279.

Conclusions and implications: Two types of functional P2X receptors, monomeric P2X1 and heteromeric P2X1/4 receptors, are expressed in RVSMCs. Our study has identified important targets for possible pharmacological intervention in the sympathetic control of renal circulation.

British Journal of Pharmacology(2010)160,987–997; 10.1111/j.1476‐5381.2010.00714.x
Prostaglandin signalling in cerebral ischaemia
Authors: Andreasson Katrin
Published: March 2010

The inducible cyclooxygenase COX‐2 exerts neurotoxic effects in a wide spectrum of neurological disease models, including models of cerebral ischaemia and chronic neurodegeneration. As COX‐1 and COX‐2 catalyse the first committed step in prostaglandin synthesis, recent efforts have focused on identifying the downstream prostaglandin signalling pathways responsible for mediating the toxic effect of COX‐2. Recent studies in models of in vitro excitotoxicity or hypoxia demonstrate that certain prostaglandin receptors mediate toxic effects, but a large number appear to mediate paradoxically protective effects. In vivo studies have begun to confirm initial in vitro findings, with selected prostaglandin receptors eliciting either neurotoxic or protective effects in models of cerebral ischaemia. In the present issue, Ikeda‐Matsuo et al. examine the function of the PGE2 EP3 receptor in a model of transient focal ischaemia and explore its potential signalling through Rho kinase activation.

This article is a commentary on Ikeda‐Matsuo et al., pp. 847–859 of this issue. To view this paper visit http://dx.doi.org/10.1111/j.1476‐5381.2010.00711.x
European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society – First Revision
Authors:   Joint Task Force of the EFNS and the PNS
Published: March 2010

Background: Consensus guidelines on the definition, investigation, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have been published (J Peripher Nerv Syst 2005; 10: 220–228, Eur J Neurol 2006; 13: 326–332). Objectives: To revise these guidelines. Methods: Disease experts, including a representative of patients, considered references retrieved from MEDLINE and Cochrane Systematic Reviews published between August 2004 and July 2009 and prepared statements that were agreed in an iterative fashion.

Recommendations: The Task Force agreed on Good Practice Points to define clinical and electrophysiological diagnostic criteria for CIDP with or without concomitant diseases and investigations to be considered. The principal treatment recommendations were: (i) intravenous immunoglobulin (IVIg) (Recommendation Level A) or corticosteroids (Recommendation Level C) should be considered in sensory and motor CIDP; (ii) IVIg should be considered as the initial treatment in pure motor CIDP (Good Practice Point); (iii) if IVIg and corticosteroids are ineffective, plasma exchange (PE) should be considered (Recommendation Level A); (iv) if the response is inadequate or the maintenance doses of the initial treatment are high, combination treatments or adding an immunosuppressant or immunomodulatory drug should be considered (Good Practice Point); (v) symptomatic treatment and multidisciplinary management should be considered (Good Practice Point).
Neurological monitoring reduces the incidence of bortezomib‐induced peripheral neuropathy in multiple myeloma patients
Authors: Velasco Roser , Petit Josep , Clapés Victoria , Verdú Enric , Navarro Xavier , Bruna Jordi
Published: March 2010

Bortezomib (BTZ) is a proteasome inhibitor approved in the treatment of multiple myeloma (MM). Bortezomib‐induced peripheral neuropathy (BIPN) is an unpredictable dose‐limiting adverse event in one‐third of patients. In the present study, 58 relapsed/refractory MM patients treated with BTZ were analyzed. The study's aim was to compare BIPN incidence and severity between both groups and to identify risk factors of BIPN. Twenty‐four MM patients were evaluated by a neurologist periodically during BTZ treatment in order to prevent high‐grade BIPN. Thirty‐five MM patients previously treated with BTZ were reviewed. Seven (29%) patients in the monitored group and 19 (56%) in the historical cohort developed BIPN (p = 0.044). In the univariate analysis, factors related to BIPN in the whole series were age, number of vincristine and BTZ cycles, lactate dehydrogenase and neurological monitoring. Multivariate analysis revealed that absence of neurological monitoring (Hazard Ratio [HR]: 4.94 IC 95% [1.31–18.68], p = 0.019) and prior treatment with vincristine (HR: 1.34 IC 95% [1.04–1.74], p = 0.026) were associated with greater risk of BIPN. Baseline total neuropathy score‐clinical version (TNSc) was a good predictor of BIPN, with higher risk for patients with TNSc >2 (p = 0.038). Neurological monitoring is useful for diminishing BIPN. Neurological monitoring of patients with baseline TNSc >2 should be considered.
Localization of brain‐derived neurotrophic factor, neurotrophin‐4, tropomyosin‐related kinase b receptor, and p75NTR receptor by high‐resolution immunohistochemistry on the adult mouse neuromuscular junction
Authors: Garcia Neus , Tomàs Marta , Santafe Manel M. , Lanuza M. Angel , Besalduch Nuria , Tomàs Josep
Published: March 2010

Neurotrophins and their receptors, the trk receptor tyrosine kinases (trks) and p75NTR, are differentially expressed among the cell types that make up synapses. It is important to determine the precise location of these molecules involved in neurotransmission. Here we use immunostaining and Western blotting to study the localization and expression of neurotrophin brain‐derived neurotrophic factor (BDNF) and neurotrophin‐4 (NT‐4) and the receptors tropomyosin‐related kinase b (trkB) and p75NTR at the adult neuromuscular junction. Our confocal immunofluorescence results on the whole mounts of the mouse Levator auris longus muscle and on semithin cross‐sections showed that BDNF, NT‐4, trkB, and p75NTR were localized on the three cells in the neuromuscular synapse (motor axons, post‐synaptic muscle and Schwann cells).
A current view of the diagnosis, clinical variants, response to treatment and prognosis of chronic inflammatory demyelinating polyradiculoneuropathy
Authors: Viala Karine , Maisonobe Thierry , Stojkovic Tanya , Koutlidis Régine , Ayrignac Xavier , Musset Lucile , Fournier Emmanuel , Léger Jean‐Marc , Bouche Pierre
Published: March 2010

We retrospectively analyzed 146 patients fulfilling the European Federation of Neurological Societies and the Peripheral Nerve Society (EFNS/PNS) criteria for definite chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) to (1) evaluate the relevance of these criteria, (2) assess the frequency of CIDP variants, and (3) determine the response to treatment and the prognosis. We found that 75% of these patients fulfilled the main EFNS/PNS clinical and electrophysiological criteria (type I). The remaining patients were diagnosed using laboratory tools as supportive criteria. The common form of CIDP represented 51% of patients. We observed a high frequency of the sensory variant (35% of patients) and the rapid onset form (18%). A positive response to treatment was observed in 87% of patients, with a similar efficacy of prednisone and IVIg. However, in the long term, 40% of treated patients remained dependent on treatment. The IVIg dependency rate was higher than the prednisone or plasma exchange dependency rate (55%, 18%, and 23%, respectively; p = 0.0054). Severe handicap was observed in 24% of patients.
The Kv7 potassium channel activator flupirtine affects clinical excitability parameters of myelinated axons in isolated rat sural nerve
Authors: Sittl Ruth , Carr Richard W. , Schwarz Jürgen R. , Grafe Peter
Published: March 2010

Flupirtine is an activator of Kv7 (KCNQ/M) potassium channels that has found clinical use as an analgesic with muscle relaxant properties. Kv7 potassium channels are expressed in axonal membranes and pharmacological activation of these channels may restore abnormal nerve excitability. We have examined the effect of flupirtine on the electrical excitability of myelinated axons in isolated segments of rat sural nerve. Axonal excitability was studiedin vitrowith the same parameters used by clinical neurophysiologists to assess peripheral nerve excitabilityin situ. Application of flupirtine in low micromolar concentrations resulted in an increase in threshold current, a reduction of refractoriness and an increase in post‐spike superexcitability. These effects are consistent with an increase in Kv7 conductance and membrane hyperpolarization. Flupirtine also enhanced and prolonged the late, long‐lasting period of axonal subexcitability that follows a short burst of action potentials. This effect was blocked by XE 991 (10 µM), an antagonist of Kv7 channels. In summary, flupirtine affects measures of excitability that are altered in the myelinated axons of patients with peripheral nerve disorders. This indicates that neuropathies with abnormal nerve excitability parameters corresponding to those affected by flupirtine may benefit from activation of axonal Kv7 potassium channels.
Eutrophication in the Baltic Sea
Authors: Saikku Laura , Asmala Eero
Published: March 2010

Fish consumption is increasing globally. Overfishing puts pressure on fisheries, but aquaculture provides an alternative to satisfy the growing need for seafood. However, nutrient emissions from aquaculture contribute to eutrophication, and raising fish from the top of the food chain is inefficient. Here we use the approach of industrial ecology and report ImPACT decomposition analysis of the drivers of nutrient emissions to the Baltic Sea from rainbow trout aquaculture in Finland during 1980−2007. During this period, the nitrogen load studied increased markedly and was 522 tonnes in 2007. The phosphorus load quadrupled and then returned to its original level of about 65 tonnes. The Finnish population increased slightly, while the average affluence level increased significantly. Total salmonid consumption increased substantially during the period. The increasing percentage of imported salmonids and improvements in domestic aquaculture technology ended the period of strong growth of emissions in the 1980s. Decreasing the nutrient load through reductions in salmonid consumption in the future is unlikely, due to health benefits and consumer preferences. Replacing domestic production with import of salmonids raises questions regarding outsourcing of the environmental impact, and regarding rural development in Finland. Major improvements in production technology are not in sight. New perspectives on rainbow trout aquaculture may be needed, including using feed from the Baltic Sea, thus closing the nutrient cycle or changing consumption and production to herbivorous fish species.
Long‐Term Pain Relief in Patients with Cervicogenic Headaches after Pulsed Radiofrequency Application into the Lateral Atlantoaxial (C1‐2) Joint Using an Anterolateral Approach
Authors: Halim Willy , Chua Nicholas H L , Vissers Kris C
Published: March 2010

The lateral atlantoaxial joint has long been reported as a source of cervicogenic headache. We present a retrospective study, including 86 patients who had undergone lateral C1‐2 joint pulsed radiofrequency application, for cervicogenic headache in a single pain center from March 2007 to December 2008. The percentage of patients who had ≥50% pain relief at 2 months, 6 months, and 1 year were 50% (43/86), 50% (43/86), and 44.2% (38/86), respectively. Long‐term pain relief at 6 months and 1 year were predicted reliably by ≥50% pain relief at 2 months (P < 0.001). Apart from 1 patient that complained of increased severity of occipital headache lasting several hours, we had no other reported complications.
Oral Burning Sensation: Prevalence and Gender Differences in a Japanese Population
Authors: Suzuki Nagaaki , Mashu Shigenari , Toyoda Masamoto , Nishibori Masakazu
Published: March 2010

Background:  Burning mouth syndrome (BMS) is characterized by an oral burning sensation (OBS) in the tongue or other oral mucous membrane in the absence of any clinical abnormal findings. It frequently affects middle‐aged and aged women. Although there are many oral disorders with OBS besides BMS, the prevalence of OBS is unclear.

Aim:  To investigate the prevalence of OBS and analyze the gender differences in a Japanese population.

Methods:  The study subjects were 2599 dental patients in two dental offices in Tokyo, Japan. The prevalence of OBS was investigated using a questionnaire.

Results:  The mean ages of the subjects were 42.7 ± 13.8 (mean ± SD) years of age in male and 40.1 ± 15.4 (mean ± SD) years of age in female. The prevalence of OBS “at present” was 2.8% of 1310 male subjects and 3.2% of 1289 female subjects. There was no statistically significant difference between them for each decade. The prevalence including “at present” and “in the past” were 9.3% in male subjects and 10.8% in female subjects; this difference was not statistically significant.

Conclusion:  These findings fail to demonstrate a female predilection for OBS.
How Important is alzheimer's Disease as a Risk Factor for Unprovoked Seizures and Epilepsy in the Elderly?
Authors: Abou-Khalil Bassel W.
Published: March 2010

Seizures in Alzheimer Disease: Who, When, and How Common? Scarmeas N, Honig LS, Choi H, Cantero J, Brandt J, Blacker D, Albert M, Amatniek JC, Marder K, Bell K, Hauser WA, Stern Y. Arch Neurol 2009;66:992–997. BACKGROUND: Transient symptoms in Alzheimer disease (AD) are frequent and include seizures, syncope, and episodes of inattention or confusion. The incidence of seizures in AD and predictors of which patients with AD might be more predisposed to them is based primarily on retrospective studies and is not well established. OBJECTIVE: To determine the incidence and predictors of new-onset unprovoked seizures. DESIGN: Prospective cohort study. SETTING: Three academic centers. PATIENTS: Four hundred fifty-three patients with probable AD observed prospectively from mild disease stages since 1992. MAIN OUTCOME MEASURE: Informant interviews every 6 months included questions about whether the patient had a seizure (convulsion, fainting, or “funny” spell) and whether diagnosis or treatment for epilepsy or seizure was made. Two epileptologists independently retrospectively reviewed all available medical records for 52 patients with positive responses to either of these questions, and using a specific checklist form, events were diagnosed as to whether they were unprovoked seizures (intrarater concordance, κ = 0.67). Diagnosis of unprovoked seizures constituted the event in survival analyses. Potential predictors included sex, age, race/ethnicity, educational achievement, duration of illness, baseline cognition and function, depression, medical comorbidities, and time-dependent use of cholinesterase inhibitors and neuroleptic agents, apolipoprotein E genotype, and previous electroencephalographic findings. RESULTS: Over the course of 3,518 visit-assessments (per patient: mean, 7.8; maximum, 27), 7 patients (1.5%) developed seizures. Younger age was associated with higher risk (hazard ratio, 1.23; 95% confidence interval, 1.08–1.41; P = .003 for each additional year of age) of seizure incidence. No other predictor was significant. The overall incidence of seizures was low (418 per 100 000 person-years of observation) although significantly higher than expected for idiopathic unprovoked seizures in similar age ranges of the general population (hazard ratio, 8.06; 95% confidence interval, 3.23–16.61). CONCLUSIONS: Unprovoked seizures are uncommon in AD, but they do occur more frequently than in the general population. Younger age is a risk factor for seizures in AD.
Teaching the Teachers: Data to Benefit School Systems and Doctors about Children with Newly Diagnosed Epilepsy
Authors: Loring David W.
Published: March 2010

Neuropsychological Status at Seizure Onset in Children: Risk Factors for Early Cognitive Deficits. Fastenau PS, Johnson CS, Perkins SM, Byars AW, deGrauw TJ, Austin JK, Dunn DW. Neurology 2009;73(7):526–534. OBJECTIVE: This large, prospective, community-based study characterized neuropsychological functioning and academic achievement at the time of the first recognized seizure and identified risk factors for cognitive deficits. METHODS: We compared 282 children (ages 6–14 years, IQ ≥ 70) with a first recognized seizure to 147 healthy siblings on a battery of well-standardized and widely used neuropsychological and academic achievement tests and examined relationships with demographic and clinical variables. RESULTS: In this intellectually normal cohort, 27% with just one seizure and up to 40% of those with risk factors exhibited neuropsychological deficits at or near onset. Risk factors associated with neuropsychological deficits included multiple seizures (i.e., second unprovoked seizure; odds ratio [OR] = 1.96), use of antiepileptic drugs (OR = 2.27), symptomatic/cryptogenic etiology (OR = 2.15), and epileptiform activity on the initial EEG (OR = 1.90); a child with all 4 risks is 3.00 times more likely than healthy siblings to experience neuropsychological deficits by the first clinic visit. Absence epilepsy carried increased odds for neuropsychological impairment (OR = 2.00). CONCLUSIONS: A subgroup of intellectually normal children with seizures showed neuropsychological deficits at onset. Academic achievement was unaffected, suggesting that there is a window early in the disorder for intervention to ameliorate the impact on school performance. Therefore, the risk factors identified here (especially if multiple risks are present) warrant swift referral for neuropsychological evaluation early in the course of the condition.
Affect of Seizures during Gestation on Pregnancy Outcomes in Women with Epilepsy
Authors: Harden Cynthia
Published: March 2010

Affect of Seizures During Gestation on Pregnancy Outcomes in Women with Epilepsy. Chen YH, Chiou HY, Lin HC, Lin HL. Arch Neurol 2009;66(8):979–984. OBJECTIVE: To assess whether seizures in women with epilepsy during pregnancy contribute to adverse pregnancy outcomes. DESIGN: A retrospective cross-sectional study. SETTING: Taiwan. PATIENTS: This study linked 2 nationwide population-based data sets: Taiwan's birth certificate registry and the Taiwan National Health Insurance Research Data set. A total of 1,016 women with epilepsy were selected who had single births from 2001 to 2003 and who had been diagnosed with epilepsy within 2 years prior to their index delivery, together with 8,128 matched women without chronic disease as a comparison cohort. Women with epilepsy were further stratified into 2 groups for analysis: women who did and did not have seizures during pregnancy. MAIN OUTCOME MEASURES: Low-birth-weight infants, preterm delivery, and infants who are small for gestational age (SGA). RESULTS: Compared with women without epilepsy, epileptic seizures during pregnancy were independently associated with a 1.36-fold (95% confidence interval [CI], 1.01–1.88), 1.63-fold (95% CI, 1.21–2.19), and 1.37-fold (95% CI, 1.09–1.70) increased risk of low-birth-weight infants, preterm delivery, and SGA, respectively, after adjusting for family income and parental and infant characteristics. Further, the risk of SGA increased significantly (odds ratio, 1.34; 95% CI, 1.01–1.84) for women with seizures during pregnancy compared with women with epilepsy who did not have seizures during pregnancy. CONCLUSION: We suggest preventing seizures during pregnancy as an essential step to reduce risk of adverse pregnancy outcomes.
Prenatal Effects of Antiepileptic Drugs
Authors: Ikonomidou Chrysanthy
Published: March 2010

Antiepileptic drugs (AEDs) target ion channels and neurotransmitter systems in the brain; these same targets are responsible for regulation of processes essential for brain development. In this review, experimental findings on adverse effects of AEDs in the developing mammalian brain will be presented, including interference with physiological apoptotic cell death, cell proliferation and migration, neurogenesis, axonal arborization, synaptogenesis, and synaptic plasticity.
Real World, Long‐Term Outcomes Comparison Between Paclitaxel‐Eluting and Sirolimus‐Eluting Stent Platforms
Authors: SIDHU MANDEEP S. , BROWN JEREMIAH R. , YANG RAYSON C. , DeVRIES JAMES T. , JAYNE JOHN E. , HETTLEMAN BRUCE D. , FRIEDMAN BRUCE J. , NILES NATHANIEL W. , KAPLAN AARON V. , ROBB JOHN F. , MALENKA DAVID J. , THOMPSON CRAIG A. ,   for the Dartmouth Dynamic Registry Investigators
Published: March 2010

We compare real‐world, extended target vessel revascularization (TVR)‐free survival following percutaneous coronary intervention (PCI) for patients receiving either sirolimus‐eluting stents (SES) or paclitaxel‐eluting stents (PES) following an index drug‐eluting stent (DES) supported procedure. We analyzed 2,363 consecutive patients having first DES‐supported PCI at receiving PES (n = 1,012) or SES (n = 1,332) from April 2004 to July 2006. Baseline clinical and procedural characteristics and in‐hospital outcomes were recorded during the time of the index procedure and extended clinical outcomes data were obtained thereafter. TVR and all cause mortality were identified during the study period. Adjusted Kaplan‐Meier and Cox's proportional hazard survival methods were performed. TVR‐free survival at 2.3 years was 91.3% for SES compared with 88.9% for PES (P = 0.06). Kaplan‐Meier survival curves did not significantly differ (adjusted hazard ratio −1.39 [95% CI 0.99–1.97]) between the SES and PES patient cohorts. TVR was similar between the stent platforms at one (96.6% for SES [95% CI 95.3–97.6] vs. 95.7% for PES [95% CI 94.1–96.9]) and two (95.0%[95% CI 93.0–96.4] for SES vs. 93.7% for PES [95% CI 91.6–95.3]) years. Overall survival at 2 years was 96.2% for SES (95% CI 94.7–97.3) and 95.3% for PES (95% CI 93.7–96.5). SES and PES drug‐eluting stent platforms have good and similar extended outcomes in this real world registry of unselected patients having PCI. (J Interven Cardiol 2010;23:167‐175)
Bias‐Corrected Diagonal Discriminant Rules for High‐Dimensional Classification
Authors: Huang Song , Tong Tiejun , Zhao Hongyu
Published: March 2010

SummaryDiagonal discriminant rules have been successfully used for high‐dimensional classification problems, but suffer from the serious drawback of biased discriminant scores. In this article, we propose improved diagonal discriminant rules with bias‐corrected discriminant scores for high‐dimensional classification. We show that the proposed discriminant scores dominate the standard ones under the quadratic loss function. Analytical results on why the bias‐corrected rules can potentially improve the predication accuracy are also provided. Finally, we demonstrate the improvement of the proposed rules over the original ones through extensive simulation studies and real case studies.
Multivariate Association and Dimension Reduction: A Generalization of Canonical Correlation Analysis
Authors: Iaci Ross , Sriram T.N. , Yin Xiangrong
Published: March 2010

SummaryIn this article, we propose a new generalized index to recover relationships between two sets of random vectors by finding the vector projections that minimize anL2distance between each projected vector and an unknown function of the other. The unknown functions are estimated using the Nadaraya–Watson smoother. Extensions to multiple sets and groups of multiple sets are also discussed, and a bootstrap procedure is developed to detect the number of significant relationships. All the proposed methods are assessed through extensive simulations and real data analyses. In particular, for environmental data from Los Angeles County, we apply our multiple‐set methodology to study relationships between mortality, weather, and pollutants vectors. Here, we detect existence of both linear and nonlinear relationships between the dimension‐reduced vectors, which are then used to build nonlinear time‐series regression models for the dimension‐reduced mortality vector. These findings also illustrate potential use of our method in many other applications. A comprehensive assessment of our methodologies along with their theoretical properties are given in a Web Appendix.
Intentions of Older Homebound Women to Reduce the Risk of Falling Again
Authors: Porter Eileen J. , Matsuda Sandy , Lindbloom Erik J.
Published: March 2010

Purpose: Researchers have tested interventions to prevent recurrent falls for older people without exploring their intentions to prevent another fall. Lack of knowledge about such intentions is an impediment to intervention effectiveness. The purpose was to describe intentions to prevent another fall as discerned during a study with older homebound women.

Methods: Data were obtained during a series of four in‐home interviews over 18 months with monthly telephone contacts between interviews; fall history was updated at each contact. A descriptive phenomenological method was used to analyze data.

Findings: Of the 40 women, 36 (aged 85 to 98 years) had fallen at home at least once before enrolling in the study, or had a subsequent or initial fall during the study. The overall intention was reducing my risk of falling again at home, with its components figuring out the reason that I fell and changing my ways to reduce my risk of falling again at home. Most women explained reasons for a fall and voiced intentions to prevent a similar fall. Women who viewed falls as unexpected events were uncertain that they could prevent a fall or felt unable to do so and voiced few preventive intentions. A few women voiced generalized preventive intentions to change health‐related behaviors or habits.

Conclusions: Most intentions were tied directly to the situation in which a fall had occurred. Such specificity could limit effectiveness of personal efforts to prevent falls in other situations.

Clinical Relevance: Practitioners should converse with older women who have fallen about their intentions to prevent another fall and weigh the need to help them generalize both the risk of falling again and their risk reduction intentions.
On the efficiency of composting organic wastes
Authors: Kan Iddo , Ayalon Ofira , Federman Roy
Published: March 2010

We develop a mathematical programming model for the analysis of a nationwide waste‐management system based on composting of organic wastes. The model integrates a wide range of engineering, environmental, and economic factors, including estimated production functions based on agronomic experimental data, as well as demand functions for vegetative agricultural products. The model is applied to the case of Israel, comprising 14 groups of municipalities as the source of organic municipal solid waste and wastewater‐treatment sludge, 8 composting plants, and 13 agricultural regions; the latter constitute the source of livestock manure and are the consumers of compost to be potentially applied to 42 crops. From a social point of view, 90% of the compost's potential production was found to be warranted. This efficient solution, however, does not emerge under the base‐year‐observed situation, largely because of the absence of source separation of organic municipal solid waste and the farmers' lack of awareness of compost's advantages as a substitute for conventional fertilizers and as a soil‐amending product. Consequently, most of the organic wastes are disposed of by landfilling, resulting in a loss of $102 million per year in terms of net social benefits. While the consumers of agricultural products are expected to benefit from a shift from the base‐year situation to the efficient solution, most of their gain is expected to come at the expense of the farming sector. Nevertheless, the appearance of the efficient solution does not depend on administrative compensation payments, but on the removal of bottlenecks. Potential government intervention strategies to promote the change are analyzed.