bluuebunny/crossref_metadata_2025 huggingface dataset:
Allogeneic cell therapy from immunized donors with tumor antigen peptide enhances the antitumor effect after cyclophosphamide‐using non‐myeloablative allogeneic hematopoietic cell transplantation
Authors: Hamaguchi Masumitsu , Eto Masatoshi , Kamiryo Yoriyuki , Takeuchi Ario , Harano Masahiko , Tatsugami Katsunori , Teshima Takanori , Harada Mamoru , Yoshikai Yasunobu , Naito Seiji
Published: November 2008

Non‐myeloablative allogeneic stem cell transplantation is an option for the treatment of hematological malignancies as well as solid tumors. We recently proposed a cyclophosphamide‐using non‐myeloablative cell therapy in which donor lymphocytes infusion (DLI) was carried out after tolerance induction to donor cells. In this study, we tested the possibility that the cyclophosphamide‐using cell therapy could be augmented by pre‐immunization of donors before DLI. We initially assessed whether or not the cyclophosphamide‐using cell therapy could also show antitumor effect against subcutaneously established colon 26 carcinoma. As a tumor antigen‐derived peptide for colon 26, we used AH1, an immunodominant H‐2Ld‐binding peptide derived from the envelope protein (gp70) of an endogenous murine leukemia virus. The cyclophosphamide‐using cell therapy with the DLI from donors which were pre‐immunized with the AH1 peptide was compared with that from non‐immunized mice. The cyclophosphamide‐using cell therapy significantly suppressed subcutaneously established colon 26 carcinoma, and the tumor‐rejected mice acquired the tumor‐specific protective immunity. When combined with the DLI from donors that were immunized with AH1, antitumor effect of the cyclophosphamide‐using cell therapy was significantly augmented. The DLI from tumor peptide‐immunized donors showed no influence on donor chimerism and bodyweight of the treated mice, indicating no increased risk of graft‐versus‐host disease. Tumor‐specific cytotoxic T lymphocytes could be generated from tumor‐rejected mice. Our results indicate that the cyclophosphamide‐using non‐myeloablative cell therapy with the DLI from tumor peptide‐immunized donors is a useful protocol to augment graft‐versus‐tumor effect without exacerbation of graft‐versus‐host disease. (Cancer Sci 2009; 100: 138–143)
Vasohibin‐1 in human breast carcinoma: A potential negative feedback regulator of angiogenesis
Authors: Tamaki Kentaro , Moriya Takuya , Sato Yasufumi , Ishida Takanori , Maruo Yohei , Yoshinaga Kousuke , Ohuchi Noriaki , Sasano Hironobu
Published: November 2008

Vasohibin‐1 is a recently identified negative feedback inhibitor or suppressor of angiogenesis induced by vascular endothelial growth factor (VEGF)‐A. The status of vasohibin‐1 in human breast carcinoma has not been examined. We examined 151 breast specimens including 98 cases of invasive ductal carcinoma (IDC), 12 of ductal carcinoma in situ (DCIS), 16 of fibroadenoma (FA), six of inflammatory lesion, nine of fibrocystic change and seven of non‐pathological breast tissue. We immunolocalized vasohibin‐1 and compared its immunoreactivity to that of VEGF‐A, basic fibroblastic growth factor (bFGF), VEGF receptor 2 (Flk‐1), CD31, CD34 and Ki‐67/MIB‐1. The correlation of vasohibin‐1 immunoreactivity with overall survival (OS), and disease‐free survival (DFS) of the patients with breast carcinoma was also evaluated. In addition, we evaluated Ki‐67 and CD31, and Ki‐67 and vasohibin‐1 double‐immunostaining for further characterization of neovascularization. Vasohibin‐1 was detected in endothelial cells of human breast and its immunodensity was significantly higher in IDC and inflammatory lesions than the other types (P < 0.001). In addition, a significant positive correlation was detected between vasohibin‐1 and VEGF‐A, bFGF or Flk‐1 (P < 0.001). There was also positive associations between vasohibin‐1 and OS (P = 0.004) and between vasohibin‐1 and DFS (P ≤ 0.001) in carcinoma cases. Results of double‐immunostaining demonstrated the ratio of Ki‐67‐positive cells among vasohibin‐1‐positive endothelial cells (46.5%) was significantly higher than those among CD31‐positive cells (23.5%). This is the first study demonstrating the status of vasohibin‐1 in human breast lesions, which indicates that vasohibin‐1 is associated with neovascularization and may especially play important roles in the regulation of intratumoral angiogenesis in human breast cancer. (Cancer Sci 2009; 100: 88–94)
Visualization of novel virulence activities of the Xanthomonas type III effectors AvrBs1, AvrBs3 and AvrBs4
Authors: GÜRLEBECK DOREEN , JAHN SIMONE , GÜRLEBECK NORMAN , SZCZESNY ROBERT , SZUREK BORIS , HAHN SIMONE , HAUSE GERD , BONAS ULLA
Published: November 2008

Xanthomonas campestris pv. vesicatoria secretes at least 20 effector proteins through the type III secretion system directly into plant cells. In this study, we uncovered virulence activities of the effector proteins AvrBs1, AvrBs3 and AvrBs4 using Agrobacterium‐mediated transient expression of the corresponding genes in Nicotiana benthamiana, followed by microscopic analyses. We showed that, in addition to the nuclear‐localized AvrBs3, the effector AvrBs1, which localizes to the plant cell cytoplasm, also induces a morphological change in mesophyll cells. Comparative analyses revealed that avrBs3‐expressing plant cells contain highly active nuclei. Furthermore, plant cells expressing avrBs3 or avrBs1 show a decrease in the starch content in chloroplasts and an increased number of vesicles, indicating an enlargement of the central vacuole and the cell wall. Both AvrBs1 and AvrBs3 cause an increased ion efflux when expressed in N. benthamiana. By contrast, expression of the avrBs3 homologue avrBs4 leads to large catalase crystals in peroxisomes, suggesting a possible virulence function of AvrBs4 in the suppression of the plant defence responses. Taken together, our data show that microscopic inspection can uncover subtle and novel virulence activities of type III effector proteins.
Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation – a 12‐week, randomized, double‐blind, placebo‐controlled study
Authors: QUIGLEY E. M. M. , VANDEPLASSCHE L. , KERSTENS R. , AUSMA J.
Published: November 2008

Background Chronic constipation may result in disabling symptoms, is often unsatisfactorily treated by laxatives and negatively impacts quality of life (QoL).

Aim A randomized, double‐blind, placebo‐controlled, phase III trial to evaluate the efficacy and safety of a selective, high‐affinity 5‐HT4receptor agonist, prucalopride, in patients with chronic constipation [≤2 spontaneous complete bowel movements (SCBMs)/week].

Methods Placebo, 2 or 4 mg prucalopride was administered orally once daily, for 12 weeks. The primary efficacy endpoint was the proportion of patients with ≥3 SCBMs/week, averaged over 12 weeks. Other assessments included BM frequency, constipation‐related QoL and symptoms and tolerability.

Results Among 641 patients, significantly more patients taking prucalopride 2 or 4 mg (24%) than placebo (12%), achieved the primary efficacy endpoint (≥3 SCBMs/week) or an increase of ≥1 SCBMs/week; 43% and 47% vs. 28% respectively. Prucalopride‐treated patients also achieved significantly greater satisfaction with treatment and bowel function, and improved perception of constipation severity and constipation‐related QoL, compared with placebo. Most frequent treatment‐related adverse events were headache, abdominal pain, nausea and diarrhoea (mainly during day 1). There were no differences in comparison to placebo in the incidence of serious adverse effects or cardiovascular events.

Conclusion Over 12 weeks, prucalopride was effective and well tolerated in chronic constipation.
Systematic review: pancreatic enzyme treatment of malabsorption associated with chronic pancreatitis
Authors: WALJEE A. K. , DIMAGNO M. J. , WU B. U. , SCHOENFELD P. S. , CONWELL D. L.
Published: November 2008

Background  Pancreatic enzyme supplementation is standard treatment for malabsorption caused by chronic pancreatitis. The FDA recently required all manufacturers to submit New Drug Applications to continue to market these agents because published data demonstrated variation in formulation, bioavailability and shelf‐life while providing limited data about efficacy and safety.

Aim  To review systematically the design and results of randomized, parallel‐design trials of pancreatic enzyme supplements in chronic pancreatitis patients with steatorrhea.

Methods  A computer‐assisted search of MEDLINE and EMBASE was performed to identify relevant studies. Two authors performed duplicate data extraction on study design, improvement in coefficient of fat absorption (CFA), diarrhoea and adverse events using pre‐specified forms. Agreement between investigators for data extraction was greater than 95%.

Results  Of 619 articles found through literature searching, 20 potentially relevant articles were identified and four manuscripts met inclusion criteria. No studies performed head‐to‐head comparisons of different supplements. Enzyme supplementation is more likely to improve CFA compared with placebo, but fat malabsorption remained abnormal. Important differences in patient population, study endpoint, study design, pancreatic enzyme dosage and measurement of CFA were present across trials, which precluded comparison of different agents.

Conclusions  Enzyme supplementation improves CFA compared to placebo, but may not abolish steatorrhoea.
Plasma lipids and inflammation in active inflammatory bowel diseases
Authors: ROMANATO G. , SCARPA M. , ANGRIMAN I. , FAGGIAN D. , RUFFOLO C. , MARIN R. , ZAMBON S. , BASATO S. , ZANONI S. , FILOSA T. , PILON F. , MANZATO E.
Published: November 2008

Background  Ulcerative colitis (UC) and Crohn’s disease (CD) can cause metabolic and inflammatory alterations.

Aim  To evaluate the relationships between inflammatory parameters, plasma lipids and phospholipid fatty acid (FA) composition in patients with active UC and CD.

Methods  Diet, the Harvey–Bradshaw Activity Index (HBAI), inflammatory parameters, lipoproteins and FA composition were assessed in 60 CD and 34 UC.

Results  No differences in clinical parameters were observed in the two groups. Total cholesterol correlated inversely with the number of bowel movements in both groups and directly with BMI in UC. Arachidonic acid correlated inversely with HBAI in UC and total and HDL cholesterol were inversely related to C‐reactive protein (CRP) in CD while HDL correlated with CRP in UC. Docosapentaenoic acid was the only polyunsaturated n‐3 FA that was correlated to CRP in both groups. Total cholesterol was independently associated in the multiple regression analysis with the number of bowel movements and systemic inflammation.

Conclusions  Total and LDL cholesterol were lower in the active UC and CD than in the healthy subjects and were correlated with the systemic inflammatory status. Phospholipid FA composition was correlated to the systemic inflammatory status, but was unrelated to dietary intake and intestinal disease activity.
Systematic review: open, small‐incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis
Authors: KEUS F. , GOOSZEN H. G. , VAN LAARHOVEN C. J. H. M.
Published: November 2008

Background  Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small‐incision cholecystectomy is lacking.

Aim  To compare the effects of open, small‐incision and laparoscopic cholecystectomy techniques for patients with symptomatic cholecystolithiasis.

Methods  We conducted updated searches until January 2007 in multiple databases. We assessed bias risk.

Results  Fifty‐nine trials randomized 5556 patients. No significant differences in primary outcomes (mortality and complications) were found among all three techniques. Both minimal invasive techniques show advantages over open cholecystectomy in terms of convalescence. Small‐incision cholecystectomy showed shorter operative time compared with laparoscopic cholecystectomy (random effects, weighted mean difference, 16.4 min; 95% confidence interval, 8.9–23.8), but the two techniques did not differ regarding hospital stay and conversions.

Conclusions  No significant differences in mortality and complications were found among all three techniques. Laparoscopic cholecystectomy and small‐incision cholecystectomy are preferred over open cholecystectomy for quicker convalescence. Laparoscopic cholecystectomy and small‐incision cholecystectomy show no clear differences on patient outcomes.
Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid‐associated osteoporosis in patients with ulcerative colitis
Authors: KITAZAKI S. , MITSUYAMA K. , MASUDA J. , HARADA K. , YAMASAKI H. , KUWAKI K. , TAKEDATSU H. , SUGIYAMA G. , TSURUTA O. , SATA M.
Published: November 2008

Background  Bone loss is often observed in patients with ulcerative colitis, particularly if they require glucocorticoids.

Aim  To determine whether the bisphosphonate, alendronate, is safe and effective in preserving bone mass compared to the active vitamin D3, alfacalcidol, in ulcerative colitis patients receiving glucocorticoids.

Methods  Thirty‐nine patients with ulcerative colitis and treated with glucocorticoids were randomized to receive alendronate (5 mg/day) or alfacalcidol (1 μg/day) daily for 12 months. Loss of bone mass was evaluated by bone mineral density, bone resorption by urinary N‐telopeptide for type I collagen, and bone formation by serum bone alkaline phosphatase.

Results  Alendronate, but not alfacalcidol, significantly increased bone mineral density in the lumbar spine. Alendronate decreased serum bone alkaline phosphatase levels, but alfacalcidol did not. Urinary N‐telopeptide for type I collagen levels decreased in both groups, but were significantly lower in the alendronate group. There were no significant differences in the adverse events in the two groups.

Conclusion  Our study indicates that alendronate is a safe, well‐tolerated and more effective therapy than alfacalcidol for preventing glucocorticoid‐associated bone loss in patients with ulcerative colitis.
Socio‐demographic factors influence chronic proton pump inhibitor use by a large population in the Netherlands
Authors: Van BOXEL O. S. , HAGENAARS M. P. , SMOUT A. J. P. M. , SIERSEMA P. D.
Published: November 2008

Background  Chronic proton pump inhibitor (PPI) use is common in the Western world. Socio‐economic status and socio‐demographic factors have been shown to influence decisions related to prescribing of various drugs, but the influence of these factors on chronic PPI use is uncertain.

Aim  To study the influence of SES and socio‐demographic factors on chronic PPI use.

Methods  Data were collected from a database of a Dutch health insurance company. Subjects having had at least one prescription for a PPI were identified and followed up for 6 months. Patients were then subdivided into chronic PPI users. Socio‐demographic status was based on neighbourhood level of residence. Logistic regression was performed to determine socio‐demographic factors associated with PPI use.

Results  A total of 2 001 787 insured individuals were included, 85 253 subjects were chronic users. Both low income (OR 1.55; CI 1.52–1.58) and low educational level (OR 1.33; CI 1.31–1.36) were associated with chronic PPI use. Other independent predictive variables included use of 10 or more concomitant medications (OR 5.33; CI 4.96–5.72) and the use of prokinetic drugs (OR 10.01; CI 9.22–10.88).

Conclusions  Patients of a lower socio‐demographic status are more likely to use PPIs on a chronic basis. The observed gradient in PPIs use may reflect differences in health, healthcare use or healthcare supply.
Adalimumab for Crohn’s disease with intolerance or lost response to infliximab: a 3‐year single‐centre experience
Authors: OUSSALAH A. , BABOURI A. , CHEVAUX J.‐B. , STANCU L. , TROUILLOUD I. , BENSENANE M. , BOUCEKKINE T. , BIGARD M.‐A. , PEYRIN‐BIROULET L.
Published: November 2008

Background  Adalimumab is effective in inducing clinical remission in patients with Crohn’s disease who lost response or became intolerant to infliximab.

Aim  To evaluate long‐term efficacy and safety of adalimumab as a second line therapy in luminal and fistulizing Crohn’s disease.

Methods  We report our single‐centre experience in 53 patients. We evaluated maintenance of clinical response defined as the absence of adverse events leading to drug withdrawal, no major abdominal surgery and no loss of clinical response in initial responders. Major abdominal surgery, steroid sparing, complete fistula closure and safety were also assessed.

Results  The probability of maintaining clinical response was 77.2%, 67.8% and 50.8% at 26, 52 and 130 weeks respectively. The probability of remaining major abdominal surgery‐free was 82.3% at 26, 52 and 130 weeks. Complete fistula closure occurred in six of 10 patients, and eight of 10 patients were able to taper steroid therapy. Adverse events occurred in 31 patients (58.5%) leading to adalimumab withdrawal in nine patients (17%).

Conclusion  Adalimumab therapy may be effective in the long term in both luminal and fistulizing Crohn’s disease in infliximab‐failure patients, half of patients maintaining clinical response and potentially avoiding major abdominal surgery in 80% of cases.
Effects of hospital policies and practices on initiation and duration of breastfeeding
Authors: Manganaro R. , Marseglia L. , Mamì C. , Paolata A. , Gargano R. , Mondello M. , Puliafito A. , Gemelli M.
Published: November 2008

Background  The aim of this study was to verify if hospital policies and practices, independently of main maternal sociodemographic determinants, influence initiation and duration of breastfeeding.

Methods  The study was carried out at the Immunization Centre of Messina where all infants born in the four maternity wards of Messina are vaccinated, using a structured questionnaire, constructed in conformity with the methodology suggested by the WHO.

Results  Data analysis, performed by non‐parametric and multivariate analysis of variance and by Kaplan–Meier curves, showed that the highest probability rate (P < 0.001) of initiation and duration of breastfeeding, independently of maternal age, parity, education levels, smoke and work was found in infants born in a University Hospital, characterized by earlier times of first suckling, longer hospital stay and higher rate of exclusive breastfeeding at discharge.

Conclusion  Our data emphasize the role and responsibility of hospital policies and practices in the promotion, and in the duration of breastfeeding.
Impact of native, heat‐processed and encapsulated hazelnuts on the allergic response in hazelnut‐allergic patients
Authors: Worm M. , Hompes S. , Fiedler E.‐M. , Illner A.‐K. , Zuberbier T. , Vieths S.
Published: November 2008

Background
Pollen‐associated food allergy is common. However, systemic reactions or even life‐threatening anaphylaxis are rare.

Objective
The aim of this study was to investigate the clinical impact of native, heat‐processed and encapsulated hazelnuts (HN) in patients with proven HN allergy.

Methods
One hundred and thirty‐two patients with a positive history of HN allergy were recruited. Sensitization was confirmed by a skin prick test (SPT) and sIgE against HN. After an HN‐free diet, double‐blind placebo‐controlled challenges were performed with increasing amounts of native and roasted HN. A subset of patients were given HN capsules to circumvent the oral mucosa. Basophil activation was measured by flow cytometry before and after provocation but also ex vivo using native and roasted HN extracts.

Results
Three groups of HN‐allergic patients were identified depending on their clinical reaction pattern. The dosages by which allergic reactions were elicitated varied for native HN from 0.01 to 2.0 g, with a median of 0.1 g, for roasted HN from 0.01 to 10.0 g, with a median of 0.23 g, and for encapsulated HN from 0.1 to 3.0 g, with a median of 0.3 g. Accordingly, the SPT was more frequently positive and resulted in greater weal reactions if native HN was used. This finding was confirmed by ex vivo basophil activation showing that significantly higher allergen extract concentrations (roasted>native) were necessary to induce 50% basophil activation.

Conclusion
Our data show that heat processing of HN reduces its allergenicity. SPT but also the basophil activation test can be used to determine the reactivity of an allergen extract.
Role of T cells in the pathogenesis of atopic dermatitis
Authors: Ogg G.
Published: November 2008

Our understanding of the pathogenesis of atopic dermatitis has been dramatically enhanced following the identification of the association with loss of function mutations in filaggrin, an epidermal protein thought to be important for cutaneous barrier integrity. However, it has also emerged that Th2 cytokines can influence barrier function, including through modulation of the expression of filaggrin, other structural proteins and peptides important for microbial barrier function. A picture is developing of a complex interplay between epidermal and non‐epidermal susceptibilities that contribute to disease. Understanding the key components involved will be important for the identification of new approaches to treatment.
Characterization of cis‐regulatory elements conferring mercury‐induced interleukin‐4 gene expression in rat mast cells: a role for signal transducer and activator of transcription 6 and TATA box binding sites
Authors: Wu Zonglin , Pearson Alex , Oliveira David
Published: November 2008

We have previously shown that oxidative stress is involved in the pathogenesis of a mercuric chloride (HgCl2)‐induced, T helper type 2 (Th2)‐driven autoimmune syndrome in Brown Norway (BN) rats. In the context of the syndrome, the oxidative stress‐induced mast cell response seems to determine the development of the early phase of vasculitis, while oxidative stress‐mediated interleukin (IL)‐4 production may contribute to the subsequent Th2‐driven autoimmune response. However, the molecular basis of IL‐4 gene transcription induced by HgCl2 in mast cells remains unknown. In the present study, we dissect the critical regulatory mechanisms in the IL‐4 gene promoter in the rat mast cell line RBL‐2H3. Immunoprecipitation provided evidence that treatment with HgCl2 increased phosphorylation of signal transducer and activator of transcription 6 (STAT6). Transient transfection reporter analyses with a series of 5′ end deletions of the IL‐4 promoter produced evidence that STAT6 and TATA box binding sites are important in HgCl2‐induced IL‐4 gene expression. Subsequent elimination of one or both sites by site‐directed mutagenesis significantly inhibited IL‐4 promoter activity. Our results provide evidence that STAT6 and TATA box regulatory elements play an important role in HgCl2‐induced IL‐4 transcription in rat mast cells.
Penile hygiene: puberty, paraphimosis and personal care for men and boys with an intellectual disability
Authors: Wilson N. J. , Cumella S. , Parmenter T. R. , Stancliffe R. J. , Shuttleworth R. P.
Published: November 2008

Background  Supporting men and boys with an intellectual disability (ID) to meet their penile hygiene needs is perhaps one of the least acknowledged but most confronting issues facing care staff. The delivery of intimate hygiene can be a challenging topic particularly as it has been drawn into the emerging sexuality discourse and the ongoing abuse narrative. Compounding this challenge is the lack of guidance in intimate care for support staff. In addition, whereas the male with an ID outnumber the female, female care staff greatly outnumber male staff. Whether this situation affects outcomes for men and boys with an ID is unknown but it is an issue which should be examined.

Method  This paper reports data from two separate studies, one quantitative the other qualitative, which sought to explore penile hygiene as a male health issue.

Results  Results show the practice of care staff to be inconsistent, the views and values of care staff to be divergent. Some patterns and contextual differences were identified depending upon the gender of care staff. An emerging dialogue described some of the positive contributions that male staff make to men and boys with an ID.

Conclusions  The penile health needs of men and boys with an ID are being compromised by a lack of guidance, training, knowledge and limited gender‐sensitive care.
Emerging patterns in the comparative analysis of phylogenetic community structure
Authors: VAMOSI S. M. , HEARD S. B. , VAMOSI J. C. , WEBB C. O.
Published: November 2008

The analysis of the phylogenetic structure of communities can help reveal contemporary ecological interactions, as well as link community ecology with biogeography and the study of character evolution. The number of studies employing this broad approach has increased to the point where comparison of their results can now be used to highlight successes and deficiencies in the approach, and to detect emerging patterns in community organization. We review studies of the phylogenetic structure of communities of different major taxa and trophic levels, across different spatial and phylogenetic scales, and using different metrics and null models. Twenty‐three of 39 studies (59%) find evidence for phylogenetic clustering in contemporary communities, but terrestrial and/or plant systems are heavily over‐represented among published studies. Experimental investigations, although uncommon at present, hold promise for unravelling mechanisms underlying the phylogenetic community structure patterns observed in community surveys. We discuss the relationship between metrics of phylogenetic clustering and tree balance and explore the various emerging biases in taxonomy and pitfalls of scale. Finally, we look beyond one‐dimensional metrics of phylogenetic structure towards multivariate descriptors that better capture the variety of ecological behaviours likely to be exhibited in communities of species with hundreds of millions of years of independent evolution.
Hair growth stimulatory effect by a combination of 5‐aminolevulinic acid and iron ion
Authors: Morokuma Yuki , Yamazaki Masashi , Maeda Tatsuo , Yoshino Ikuyo , Ishizuka Masahiro , Tanaka Tohru , Ito Yoshiyasu , Tsuboi Ryoji
Published: November 2008

Background  5‐Aminolevulinic acid (5‐ALA) is a precursor of a tetrapyrrole compound. 5‐ALA has been used for photodynamic therapy as well as for plant growth. 5‐ALA and iron ion are precursors of heme, which is incorporated into hemoglobin and cytochrome.

Aim  To explore the possible application of a 5‐ALA and iron ion admixture on hair growth in mice.

Methods  The effect of a 5‐ALA and iron ion admixture on hair growth and cell proliferation in mice was examined. The dorsal hair of 8‐week‐old male CeH/HeN mice was clipped, and a 5‐ALA and iron ion admixture was applied to the dorsal skin once daily for 21 days in a room supplied with common room lights. Hair growth was later examined by calculating the ratio of the area showing hair growth to the total clipped area. For the cell proliferation assay, a 5‐ALA and iron ion admixture at several different concentrations was added to a culture medium containing keratinocytes or fibroblasts, and the cell numbers were counted.

Results  Mice treated with an admixture of 5‐ALA and iron ion showed significant hair growth (P < 0.05) at day 15 relative to those treated with iron ion alone, as revealed by the Tukey–Kramer test. The stimulatory effect of the mixture was almost identical to that of 5% minoxidil. No proliferation of keratinocytes or fibroblasts was observed, however, when an admixture of 5‐ALA and iron ion was added to the medium.

Conclusions  The results suggest that an admixture of 5‐ALA and iron ion stimulates murine hair growth in vivo independent of epithelial and mesenchymal cells, although the precise mechanism is still uncertain. This mixture has the potential to become a beneficial new treatment for alopecia.
An unusual and serious complication of topical wart treatment with monochloroacetic acid
Authors: Tan Baser Nesrin , Yalaz Burcin , Yilmaz Ali Cemal , Tuncali Dogan , Aslan Gurcan
Published: November 2008

Numerous chemical agents are used in the topical treatment of warts. Monochloroacetic acid (MCAA) is one of these agents, which is used in low or high concentrations in most European countries. MCAA is a strong organic acid which is irritating and corrosive to the skin and has a high systemic toxicity. In addition to wart treatment, it is used for industrial purposes, such as the synthesis of certain organic chemicals. We present a case of joint deformity manifesting after the use of a preparation containing MCAA for topical wart treatment. This underlines the need to reassess the safety of MCAA use for topical wart treatment.
Chanarin–Dorfman syndrome with eccrine gland vacuolation: a case report
Authors: Pahwa Manish , Kar Rakhee , Singh Avninder , Goel Alka , Ramesh V. , Jain Rakesh
Published: November 2008

Chanarin–Dorfman syndrome is a rare congenital disorder of lipid metabolism characterized by ichthyosis, leukocytic vacuolation (Jordan's anomaly), and variable involvement of the liver and neuromuscular system, with about 40 cases described worldwide to date. We report one more case of this rare syndrome, with certain peculiarities, namely vacuolation in eccrine glands, in a young male adult.
Density of dendritic cells around basal cell carcinomas is related to tumor size, anatomical site and stromal characteristics, and might be responsible for the response to topical therapy
Authors: Rybka Maria O. , Cintra Maria L. , De Souza Elemir M. , Metze Konradin
Published: November 2008

Background  The dermal dendritic cell (DC) is considered to be an important component of the host defense against basal cell carcinomas (BCCs). Imiquimod, an immunologic response modifier, has recently been introduced in the topical therapy of BCCs. There is some evidence that the DC pretreatment density may affect the efficacy of imiquimod. The aim of our study was to find out which clinical or histological variables are related to the DC density at the margins of BCCs.

Methods  Thirty cases of BCCs of aggressive and 30 cases of nonaggressive subtypes were selected from our files. In histological sections, the density of FXIIIa‐positive DCs and 1A4‐positive myofibroblasts in the tumor surrounding stroma was quantified, as well as the stroma type, the tumor size and the DC density in the normal dermis.

Results  In nonaggressive BBCs, a multiple linear regression showed that a higher DC density was associated with an increased number of myofibroblasts, smaller tumors and those located on the face. For the aggressive subtypes, a higher DC density was related not only to an increased myofibroblast density, smaller BCCs or location on the face, but also to the presence of less mucinous and more granulation type stroma and an increased DC density in the normal dermis. The stability of the models was confirmed by bootstrap resampling.

Conclusion  Our study demonstrates that the density of DCs around BCCs is related to tumor size, localization and characteristics of the surrounding tumor stroma.
Lack of evidence for hepatitis C virus infection in association with lichen planus
Authors: Stojanovič Larisa , Lunder Tomaž , Poljak Mario , Marš Tomaž , Mlakar Boštjan , Matičič Mojca
Published: November 2008

Background  The association between hepatitis C virus (HCV) infection and lichen planus (LP) is a subject of controversy. Prevalence studies of HCV infection in LP patients in various countries reveal diverse results. The Slovenian population is rather homogenous with specific geographic and epidemiological characteristics. Lack of data or contradictory results from neighboring countries urged the need for a case‐controlled study in our LP patients.

Methods  The retrospective study was performed on 173 LP patients. Control group included 218 patients with dermatological diseases other than LP.

Results  Anti‐HCV antibodies were found in 2/173 patients (1.2%) with LP and in 0/218 controls. No statistically significant difference was found between the study and control group regarding anti‐HCV antibody prevalence (P = 0.195; estimated OR 6.4, 95% CI 0.3–134.0) and risk factors for HCV infection.

Conclusions  Based on our results, anti‐HCV antibody testing is not necessarily required in LP patients with no risk factors for HCV infection in this geographic region.
Parental experiences of the newborn hearing screening programme in Wales: a postal questionnaire survey
Authors: Fox Rosemary , Minchom Sally
Published: November 2008

Objectives  To evaluate parental experiences and satisfaction with Newborn Hearing Screening Wales, which was set up over 18 months in 2003–04 to provide an all‐Wales neonatal hearing screening programme.

Methods  A postal questionnaire was developed and piloted, then distributed to mothers of babies who had recently been screened.

Results  General satisfaction levels were high. Women were less satisfied with the information provided than with staff or the test itself. Women whose babies had had no clear responses on initial screening were significantly more likely to feel that the test upset their baby (P < 0.05) and that there were things they were unhappy with about the screening programme (P < 0.01). These women also reported significantly more anxiety after screening than women whose babies had clear initial responses (P < 0.01).

Conclusions  The survey results provide a baseline against which future user satisfaction surveys of neonatal hearing screening programmes can be evaluated. They highlight significant differences in user satisfaction between those whose babies had clear responses on initial screening and those who did not, and point to areas where improvement may be possible.
Views of treatment decision making from adolescents with chronic illnesses and their parents: a pilot study
Authors: Knopf Jennifer M. , Hornung Richard W. , Slap Gail B. , DeVellis Robert F. , Britto Maria T.
Published: November 2008

Objective  Shared decision making may increase satisfaction with health care and improve outcomes, but little is known about adolescents’ decision‐making preferences. The primary purpose of this study is to describe the decision‐making preferences of adolescents with chronic illnesses and their parents, and the extent to which they agree.

Design  Survey.

Setting and participants  Participants were 82 adolescents seen at one of four paediatric chronic illness subspecialty clinics and 62 of their parents.

Main variables  Predictor variables include sociodemographics, health parameters, risk behaviour, and physical and cognitive development. The main outcome variable is preferences for decision‐making style.

Results and conclusions  When collapsed into three response categories, nearly equal percentages of adolescents (37%) and parents (36%) preferred shared decision making. Overall, the largest proportion of adolescents (46%) and parents (53%) preferred passive decision making compared to active or shared decision making. Across five response choices, 33% of pairs agreed. Agreement was slight and not significant. Improved general health perceptions (OR = 0.76, 95% CI = 0.59–0.99) and improved behaviour (OR = 0.75, 95% CI = 0.56–0.99) were significantly associated with parents’ preferences for less active decision making. Older age was significantly associated with agreement (OR 1.58, 95% CI = 1.09–2.30) between parents and adolescents. The paucity of significant predictor variables may indicate physicians need to inquire directly about patient and parent preferences.
Wise owls and professors: the role of older researchers in the review of the National Service Framework for Older People
Authors: Cornes Michelle , Peardon John , Manthorpe Jill ,   The 3YO Project Team
Published: November 2008

Aim  This article explores the involvement of older people in research and inspection, reflecting on the learning from the recent ‘joint review’ of the National Service Framework for Older People in England.

Methodological context  Working in 10 different localities, the ‘joint review’ comprised a formal inspection of health and local council services (carried out by the Healthcare Commission, Commission for Social Care Inspection and the Audit Commission) and an externally commissioned university‐led research project designed to ascertain the views and experiences of older people living in the 10 inspection sites. In total, 1839 older people were interviewed individually and through focus groups and an additional 4200 older people completed questionnaires. A distinctive feature of the research was the inclusion of a team of older researchers who had undertaken training in research methods in later life. Reflections of the older researchers and other members of the research team on undertaking this large‐scale user involvement project were ascertained via a day‐long seminar which was tape recorded and transcribed.

Learning  While many espouse the principle of ‘service user involvement’ in research, there is a need to move beyond the rhetoric of participation and any blanket assumptions about what it means to be an ‘older researcher’, a ‘service user researcher’ or indeed, a ‘professional researcher’. This means ensuring that within any given team (user‐controlled or collaborative) there are clear lines of accountability and equal opportunities for individual appraisal, support, and personal or professional development. Such considerations are key to working with ‘older researchers’ and encouraging diversity in the research workforce more generally.
Corticosteroids usage in pediatric liver transplantation: To be or not to be!
Authors: Al‐Sinani Siham , Dhawan Anil
Published: November 2008

Abstract:  The theoretical risks of early SW, <3 months post‐LT, and complete elimination (steroid‐free LT) lie in mainly three areas, namely the risks of AGR, CGR, and the development of d‐AIH that has been described in SW post‐LT in children. These should be balanced against the benefits of early SW mainly manifested as effects on growth post‐LT. In this paper, we focused on the clinical trials that included CS therapy risks and benefits in pediatric LT. Focusing mainly on CGR and d‐AIH as risks, and the beneficial effects on growth post‐LT with either low‐dose CS, SW, or steroid‐free regimens. Main conclusions from comparing a large number of studies are: early SW or elimination from immunosuppression protocols was neither harmful to the patient nor to the graft survival rate in the short term, the overall impression is that steroids negatively affect growth in LT recipients when used in high doses and prolonged course, and that development of d‐AIH is not associated with CS therapy with evidence that chronic low dose steroids post‐LT have no preventative role against d‐AIH.
Investigation of impaired carbohydrate metabolism in pediatric liver transplant recipients
Authors: Gökçe Selim , Durmaz Özlem , Çeltik Coşkun , Aydoğan Ayşen , Baş Firdevs , Türkoğlu Ümit , Özden İlgin , Sökücü Semra
Published: November 2008

Abstract:  OGTT was performed in 28 liver transplants maintained with tacrolimus to investigate carbohydrate metabolism and assess risk factors for development of PTDM. None had PTDM that was detected by OGTT. Early PTDM in four cases (14.3%) resolved in follow‐up. Five new cases (17.9%) demonstrated DCM (DCM  = IGT ± hyperinsulinemia). Fasting measurements were normal in two hyperinsulinemic cases. With one (20%, p > 0.05) exception none of the children with DCM were overweight or had a family history of diabetes. All five (100%) children with DCM had been given high cumulative dosage of steroids 18 (78.3%) – without DCM (p > 0.05). The median age of children with DCM was greater [4.3 (12.7–18.0) vs. 7.0 (2.3–18.0) yr, p < 0.01] and duration of follow‐up longer [5.3 (2.3–7.0) vs. 2.5 (0.7–7.3) yr, p < 0.05]. Four children (80%) with DCM were pubertal (p < 0.05). However, neither age nor duration of follow‐up or pubertal stage had significant effect on DCM development. Early PTDM is a transient phenomenon and is not predictive for future development of diabetes. DCM is frequently observed in liver transplanted children. Albeit the children with DCM were given high cumulative dose of steroids, were older, mostly were pubertal, and had longer duration of follow‐up, we cannot draw firm conclusions on effects of the risk factors on carbohydrate metabolism because of the small sample size and relatively short duration of follow‐up. Unlike fasting measurements, OGTT can detect all children with DCM.
Screening of weed extracts for antifungal properties against Colletotrichum lagenarium, the causal agent of anthracnose in cucumber
Authors: INAGAKI HIDEHIRO , YAMAGUCHI AKIRA , KATO KIMIHIKO , KAGEYAMA CHIZUKO , IYOZUMI HIROYUKI , OKI YOKO
Published: November 2008

The antifungal activity of the leaf extracts from 203 weed species was investigated by performing a bioassay using cucumber plants and Colletotrichum orbiculare. The leaf extracts from four families, namely, Urticaceae, Onagraceae, Commelinaceae, and Solanaceae, showed a relatively stronger inhibition of the anthracnose lesions in cucumber plants when compared with the other families investigated in the study. A remarkable inhibition of anthracnose infection in cucumber leaves was observed with the extracts from the following 19 weed species: Boehmeria nipononivea and Boehmeria longispica, Persicaria scabra, Ranunculus japonicus and Ranunculus sceleratus, Cardamine flexuosa, Oenothera biennis, Aeschynomene indica, Indigofera pseudo‐tinctoria, Torilis scabra, Calystegia japonica, Solanum americanum, Bidens pilosa, Gnaphalium japonicum, Kalimeris yomena, Bromus catharticus, Cynodon dactylon, Alopecurus aequalis, and Scirpus tabernaemontani. In particular, it is noteworthy that the extracts from C. dactylon, K. yomena, and S. americanum completely inhibited anthracnose infection in cucumber.
An alternative management for high‐risk patients with rectal prolapse
Authors: Parés D. , Vial M. , Grande L.
Published: November 2008

Indication  The management of rectal prolapse in presence of high‐risk comorbidities can be challenging. We report the use of an anal plug as a noninvasive alternative in patients with contraindication of surgery.

Method  This small device opens up in about 30 s to fit the contour of the lower rectum avoiding faecal leakage or in our case, the rectal prolapse. Although the plug is poorly tolerated in some cases, this device may be used up to 12 h per day and no adverse effects have been reported.

Comparison with other methods  Nonsurgical alternatives described in the literature, such as sclerotherpy in children, are not routinely used in the adult population. The main advantage of the anal plug is its simplicity and safety as in the series published for the treatment of faecal incontinence no adverse events were described.

Conclusion  An anal plug for rectal prolapse is an alternative in high‐risk patients or during the time before surgical treatment.
The effect of aspirin in the recurrence of colorectal adenomas: a meta‐analysis of randomized controlled trials
Authors: Gao F. , Liao C. , Liu L. , Tan A. , Cao Y. , Mo Z.
Published: November 2008

Purpose  Colorectal adenomas are precursors of most colorectal cancers and are important targets for chemoprevention. Aspirin is thought to play an important role in chemoprevention. However, the role of aspirin in preventing recurrence of adenomas is controversial. We performed a systematic review and meta‐analysis to evaluate the effect of aspirin in preventing the recurrence of colorectal adenoma.

Method  Trials were located through Medline, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). From 14 articles screened, three were identified as randomized controlled trials and were included for data extraction. Main outcome measures were the recurrence of any new adenoma and advanced adenoma. The meta‐analysis was performed with the fixed‐effects model.

Results  A total of 2338 participants were enrolled in the three studies and 2175 of them completed the follow‐up colonoscopy. We found that the relative risks of any adenoma (when compared with the placebo group) were 0.859 in the high dose of aspirin groups (95% confidence interval (CI), 0.756–0.976, P = 0.019), 0.826 in the low dose of aspirin groups (95% CI 0.706–0.965, P = 0.016) and 0.836 in the both aspirin combined groups (95% CI 0.746–0.937, P = 0.002). For the recurrence of advanced adenoma, the relative risk (when compared with the placebo group) was 0.655 (95% CI 0.513–0.837, P = 0.001) in the aspirin groups without considering the dose.

Conclusion  This meta‐analysis suggests that aspirin prevents recurrent colorectal adenomas among patients with a history of colorectal adenomas.
Pilot study evaluating ureteric physiological changes with a novel ‘ribbon stent’ design using electromyographic and giant magnetoresistive sensors
Authors: Natalin Ricardo A. , Hruby Gregory W. , Okhunov Zhamshid , Singh Harmanmeet , Phillips Courtney K. , Humphrey Peter A. , Gupta Mantu , Landman Jaime
Published: November 2008

OBJECTIVE

To test a novel ‘ribbon stent’ (RS) design using an extraluminal bipolar electromyographic (EMG) and giant magnetoresistive (GMR) sensor system to characterize ureteric responses.

MATERIALS AND METHODS

In all, 11 female domestic pigs were divided into three groups to evaluate ureteric physiology: group 1 (two pigs) with an unstented ureter, group 2 (three) with a standard 6 F ureteric stent, and group 3 (six) with the RS. For all groups EMG/GMR evaluation was performed at baseline, immediately after stenting, and at 3 and 7 days after stenting. All pigs underwent standardized retrograde ureteropyelogram evaluation at these time points, and after the final evaluation the pigs were killed and the urinary tract was harvested for histopathological evaluation.

RESULTS

One stent in group 3 could not be deployed due to a problem with ureteric access. For groups 1, 2 and 3 the ureteric peristaltic activity was 109, 63, 72 events/h at baseline (P = 0.49); 61, 70, and 66 events/h immediately after stenting (P = 0.97); 66, 0, 8 events/h at 3 days after stenting (P = 0.002); and 61, 12, 0 events/h at 7 days after stenting, respectively (P = 0.049).

CONCLUSION

The RS was deployed easily and safely in the porcine model using a standard technique. As with a standard stent, there was significant ureteric dilation and decrease in peristalsis with the RS.