bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of the Infarct Pattern Caused by Vulnerable Aortic Arch Atheroma: DWI and Multidetector Row CT Study
Authors: Kim Suk Jae , Ryoo Sookyung , Hwang Jaechun , Noh Hyun Jin , Park Jae Hyun , Choe Yeon Hyeon , Bang Oh Young
Published: June 2012

Background: Aortic arch atheroma (AAA) has been accepted as a possible embolic source in patients with ischemic stroke, especially cryptogenic stroke. However, despite its well-known role as a risk factor for stroke, research focused on the mechanism or characteristics of stroke caused by AAA is insufficient. In this study, we aimed to evaluate clinical and radiological characteristics including lesion pattern on DWI in acute stroke patients associated with vulnerable AAA detected by multidetector row computed tomography (MDCT). Methods: From September 2008 through May 2011, patients who presented with acute ischemic stroke and underwent MDCT were found in a prospective stroke registry. Patients without evident stroke etiology were included and classified by presence of vulnerable AAA. Vulnerable AAA was defined as (i) at least 6 mm thick adjacent to the aortic wall; (ii) ulcerated plaque, or (iii) soft plaque. Soft plaque was defined as the presence of clearly visualized area of hypoattenuation (<80 Hounsfield units) suggestive of thrombus. The patients without vulnerable AAA were classified as no/simple AAA group. The characteristics of diffusion-weighted MRI (DWI) lesions were analyzed in terms of the number and size of the lesions, and the involved vascular territories. Results: A total of 63 cryptogenic stroke patients were included in this study. Vulnerable AAA was observed in 15 (23.8%) patients. The patients with vulnerable AAA were older than those with no/simple AAA (p = 0.026). DWI analysis revealed that the vulnerable AAA group had a greater chance of having multiple and small lesions in multiple vascular territories that were mainly located in cortical and border-zone regions than the no/simple AAA group. Multiple logistic regression analysis showed that age (odds ratio 1.17; 95% confidence interval 1.02–1.34) and multiple small lesions in multiple vascular territories (odds ratio 33.18; 95% confidence interval 4.26–258.45) were independently associated with vulnerable AAA. Conclusion: Vulnerable AAA is independently associated with a DWI pattern characterized by multiple small scattered lesions in multiple vascular territories in conjunction with age. It may help determine stroke mechanism quickly and easily, and provide more information about the pathomechanism of vulnerable AAA-related stroke.
Incidence of Hospital-Admitted Severe Traumatic Brain Injury and In-Hospital Fatality in Norway: A National Cohort Study
Authors: Andelic N. , Anke A. , Skandsen T. , Sigurdardottir S. , Sandhaug M. , Ader T. , Roe C.
Published: June 2012

Aims: The aims of this study were to assess the incidence of hospital-admitted severe traumatic brain injury (TBI) in the adult population in Norway, and to determine whether there were differences in the epidemiological characteristics of severe TBI between rural and urban regions. Methods: A prospective population-based study on adults with severe TBI admitted to the Norwegian Trauma Referral Centres during the 2-year period (2009–2010). The electronic patient register was searched weekly for ICD-10 diagnoses of intracranial injuries (S06.0–S06.9) to identify patients. Severe TBI was defined as lowest unsedated Glasgow Coma Scale Score ≤8 during the first 24 h after injury. Results: The annual age-adjusted incidence was estimated at 5.2/100,000 in 2009 and 4.1/100,000 in 2010. The highest frequency of hospitalized patients was found among the youngest and the oldest age groups. The most common causes of injury were falls and transport accidents. The highest in-hospital case-fatality rate was found among the oldest patients. There were consistent epidemiological characteristics of severe TBI from both rural and urban regions. Conclusions: The incidence of hospital-admitted patients with severe TBI in this national study supports the declining incidence of TBI reported internationally. No major differences were found in epidemiological characteristics between the urban and rural parts of Norway.
Gamma Knife Radiosurgery for Recurrent Glossopharyngeal Neuralgia after Microvascular Decompression
Authors: Stanic Sinisa , Franklin Stephen D. , Pappas Conrad T. , Stern Robin L.
Published: June 2012

Background: We report the first application of Gamma Knife radiosurgery (GKR) for recurrent glossopharyngeal neuralgia (GN) after microvascular decompression (MVD). The patient is a 51-year-old male with left-sided GN. He underwent MVD and did well for almost 4 years. Later on, the patient started to experience recurrent intolerable throat pain, frequently 10/10 in intensity. Based on the application of radiosurgery for trigeminal neuralgia, GKR was offered to the patient. Methods: After careful identification of the nerve with the assistance of a neuroradiologist, we targeted the nerve root complex, which is the cisternal portion of the nerve, using the Coherent Oscillatory State Acquisition for the Manipulation of Image Contrast (COSMIC) pulse sequence with contiguous 1-mm slices obtained by an 1.5 Tesla MRI. The radiosurgery was planned utilizing the Leksell Gamma Plan version 8.1. A single shot with a 4-mm collimator was used to deliver 80 Gy to the 100% isodose line. Results: Four weeks after the treatment, the patient began to notice significant pain relief. At the 12-month follow-up, the patient’s pain, which was intolerable prior to radiosurgery, was mild and occasional. Conclusion: GKR, which is now widely used for refractory trigeminal neuralgia, can be considered for refractory or recurrent GN. With a multidisciplinary approach and advanced neuroimaging, GKR is feasible for GN after MVD, despite the shortness of the intracranial cisternal nerve portion. Further studies are necessary to establish the role of GKR for refractory GN after MVD; however, given its rarity and the lack of experience with GKR for this condition, retrospective studies with dozens of patients are almost impossible at this time.
Incidence of the Pneumoconioses in the United Kingdom General Population between 1997 and 2008
Authors: Amar Rajeev K. , Jick Susan S. , Rosenberg Daniel , Maher Toby M. , Meier Christoph R.
Published: June 2012

Background: The incidence of the pneumoconioses in the UK is primarily estimated using occupational-based registries and disability pension schemes. These sources indicate a downward trend in the incidence of the pneumoconioses from 1995 onwards. There are no previously published general population-based observational studies quantifying the incidence of the pneumoconioses in the UK. Objectives: The aim of this study was to investigate the incidence of the pneumoconioses in the UK general population between 1997 and 2008 using data from the General Practice Research Database (GPRD). Methods: Data from the UK-based GPRD were used to estimate the incidence of pneumoconioses over a 12-year period (1997–2008). Crude incidence rates for asbestosis and non-asbestos-related pneumoconioses were stratified by gender, age group and calendar period, and rate ratios were adjusted using Poisson regression. Results: The majority of cases was diagnosed with asbestosis, and the overall, crude incidence density for this pneumoconiosis during the 12-year study period was 2.7 (95% confidence interval 2.5–2.9) per 100,000 person-years. The incidence increased progressively during the period 1997–2005 and then decreased slightly during the period 2006–2008, even after controlling for the strong effect of an ageing UK population. The non-asbestos-related pneumoconioses, in contrast to asbestosis, showed a progressive reduction in incidence from 2003 onwards. Conclusions: This study demonstrates that the pneumoconioses remain an important public health issue and, furthermore, documents an overall increase in asbestosis incidence in the UK between 1997 and 2008.
Modest Changes in Cerebral Glucose Metabolism in Patients with Sleep Apnea Syndrome after Continuous Positive Airway Pressure Treatment
Authors: Ju Gawon , Yoon In-Young , Lee Sang Don , Kim Yu Kyeong , Yoon Eunjin , Kim Jeong-Whun
Published: June 2012

Background: Decreased cerebral glucose metabolism has been reported in patients with sleep apnea syndrome (SAS), but it has yet to be decided whether cerebral glucose metabolism in SAS can be altered by continuous positive airway pressure (CPAP) treatment. Objective: The aim of this study was to evaluate cerebral glucose metabolism changes in patients with SAS after CPAP treatment. Methods: Thirteen middle-aged male patients with severe SAS [mean age 49.3 ± 7.2 years, mean apnea-hypopnea index (AHI) 60.4 ± 21.2] and 13 male controls (mean age 46.0 ± 9.4 years, mean AHI 4.1 ± 3.7) participated in the study. All 26 study subjects underwent fluorodeoxyglucose-positron emission tomography (FDG-PET), but SAS patients underwent FDG-PET twice, namely before and 3 months after acceptable CPAP usage. Results: Significant hypometabolism was observed in the bilateral prefrontal areas, left cuneus and left cingulate cortex of SAS patients before CPAP, and after CPAP, significant increases in cortical glucose metabolism were observed in the bilateral precentral gyri and left anterior cingulate cortex. However, these improvements in hypometabolism in both areas were insufficient to reach control levels, and hypometabolism in other regions persisted after CPAP treatment. Conclusions: Reduced cerebral glucose metabolism in the precentral gyrus and the cingulate cortex in patients with SAS was modestly improved by acceptable CPAP treatment. The findings of this study suggest that acceptable CPAP usage cannot completely reverse reduced cerebral glucose metabolism in SAS patients. Further studies are required to evaluate the long-term effects of CPAP treatment with total compliance.
Critical Imbalance of TNF-α and Soluble TNF Receptor 1 in a Patient with Macrophage Activation Syndrome: Potential Implications for Diagnostics and Treatment
Authors: Flammiger Anna , Fiedler Walter , Bacher Ulrike , Bokemeyer Carsten , Schneider Marion , Binder Mascha
Published: June 2012

Macrophage activation syndrome (MAS) is a life-threatening disease with sustained activation of inflammatory cells and release of proinflammatory TNF-α. Under physiological conditions, TNF-α initiates a negative feedback mechanism, mediated by shedded, soluble TNF receptor ectodomains, eventually limiting the inflammatory reaction. Here, we report on a 27-year-old critically ill patient with refractory MAS and an insufficient negative feedback regulation, resulting in an overwhelming inflammatory response. A personalized treatment with soluble TNF receptor etanercept resulted in a durable remission. Further studies are warranted to establish whether the TNF cytokine profile may help to successfully guide patient selection for biological therapies.
Preclinical Assessment of Infant Formula
Authors: Lönnerdal Bo
Published: June 2012

Infant formulas are the sole or predominant source of nutrition for many infants and are fed during a sensitive period of development and may therefore have short- and long-term consequences for infant health. Preclinical safety assessment therefore needs to include both short-term and long-term studies in animals. It is recommended that procedures are instituted by which experts may serve as independent scientists for companies developing novel products, without having their integrity compromised, and later serve the legislative institutions. A two-level assessment approach to determine the potential toxicity of a novel ingredient, its metabolites, and their effects in the matrix on developing organ systems has been suggested by IOM. This appears reasonable, as novel ingredients can be of different levels of concern. The use of modern methods in genomics and proteomics should be considered in these evaluation processes as well as novel methods to evaluate outcomes, including metabolomics and molecular techniques to assess the microbiome.
Current Safety Standards in Infant Nutrition – A European Perspective
Authors: Hernell Olle
Published: June 2012

Foods intended specifically for infants and young children are considered under European community law and are defined in specific commission directives. In principal, these directives conclude that such foods must be safe, have a special composition, be distinguishable from normal foods, be suitable for fulfilling particular nutritional requirements, and should, when marketed, indicate such suitability. Since infant formulas are intended as the sole source of nutrition during the first months of life, their nutritional adequacy and safety are particularly strictly regulated. The Scientific Committee on Food report from 2003, on which the current commission directive is based, makes clear recommendations on how benefits, suitability, and safety of modifications beyond established standards should be documented and evaluated. These principles resulted in part from a workshop on characterization of infant food modifications in the EU and two position papers by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). These papers are reviewed below.
Thiamine-Deficient Infant Formula: What Happened and What Have We Learned?
Authors: Shamir Raanan
Published: June 2012

Introduction: In 2003, a thiamine-deficient soy infant formula was produced in Germany and marketed exclusively in Israel. Between October and November 2003, infants with encephalopathy were admitted to several intensive care units in Israel and were later diagnosed as suffering from thiamine deficiency. The soy formula consumed by these children was found to be the cause of these admissions. Methods: A Medline search using the terms ‘thiamine deficiency’ and ‘formula’ or ‘feeding’ without year limit identified relevant published data on that event. Newspapers from Israel were screened from November 2003 until April 2011. Results: On November 2003, 2–6% of infants in Israel consumed this formula. The consumption of this thiamine-deficient formula was associated with the death of 3 infants and with more than 20 infants manifesting neurologic damage. In this report, we summarize the chain of events, the neurologic outcome, and discuss the lessons needed to be learned from this sad event. Conclusions: Based on difficulties in diagnosis of subtle deficiencies, we suggest that apparent history of safe use is not a reliable source for establishing adequate intake. Infant formulae can be produced or imported only under stringent criteria with the manufacturer/importer having total responsibility for the product.
Safety Aspects in Preparation and Handling of Infant Food
Authors: Turck Dominique
Published: June 2012

Powdered infant formula (PIF) can become contaminated during production with harmful bacteria such as Cronobacter spp. (formerly Enterobactersakazakii). Inadequate conditions of preparation and handling of PIF can therefore exacerbate the risk of severe infection, especially in preterm infants. The WHO emphasized three main interventions for preparation and handling of PIF: (1) to dilute the powdered milk in water at a temperature of at least 70°C to inactivate Cronobacter spp.; (2) to consume milk right after each preparation, and (3) to store reconstituted milk at <5°C. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the French Food Safety Agency (Afssa) disagree with the heating process because of possible adverse effects on nutrients and the risk of severe burns. In home settings, PIF should be prepared fresh for each meal and be kept warm in bottle warmers or thermos bottles. In institutional settings, written guidelines for preparation and handling of PIF should be established. The use of sterile liquid formula is encouraged for healthy newborn infants in maternity wards; PIF should be prepared on a daily basis. Safe infant feeding involves the production of microbiologically cleaner infant formula by industry, and both education and support for the caregivers in preparing and handling the formula.
Higher Expression of the Novel Gene Upregulated Gene 4 in Two Acute Lymphoblastic Leukemia Patients with Poor Prednisolone Response
Authors: Oymak Yesim , Dodurga Yavuz , Turedi Aysen , Yaman Yontem , Ozek Gulcihan , Carti Ozgur , Gunes Burcak Tatlı , Erbudak Esin , Berber Ergul , Avci Cıgır Biray , Vergin Canan
Published: June 2012

Elucidation of the molecular mechanisms of leukemogenesis is important for a better understanding of the prognosis of acute lymphoblastic leukemia (ALL). Studies have shown that the expression of upregulated gene 4 (URG4), which promotes cell growth and survival, is increased in different types of carcinomas including hepatocellular carcinoma, gastric cancer and osteosarcoma. Similarly, higher expression of URG4 and cyclin D1 gene might promote proliferation of the blast cells by causing escape from the G1 checkpoint and entry into the S phase. This study reports the high expression level of URG4 in 2 high-risk ALL patients for the first time in the literature. In conclusion, the higher expression of URG4 in our 2 patients suggests that URG4 might be involved in leukemogenesis. Future studies with a large number of high-risk ALL patients and cell culture studies are needed to demonstrate the exact role of URG4 in leukemogenesis.
An Evaluation of Hardware and Surgical Complications with Deep Brain Stimulation Based on Diagnosis and Lead Location
Authors: Falowski Steven , Ooi Yinn Cher , Smith Adam , Verhargen Metman Leonard , Bakay Roy A.E.
Published: June 2012

Introduction: Deep brain stimulation is the most frequently performed neurosurgical procedure for movement disorders. This procedure is well tolerated, but not free of complications. Analysis of hardware complications based on patient diagnosis and lead location could prove valuable in recognizing potential pitfalls and patients at higher risk. Methods: This review analyzes the most common surgery-related complications that may occur based on diagnosis and lead location. Patients were categorized based on diagnosis – Parkinson’s disease (PD), dystonia, and essential tremor (ET) – as well as by lead location – subthalamic nucleus (STN), globus pallidus interna (GPi), and ventral intermediate nucleus of the thalamus (Vim). It is a retrospective review of 326 patients undergoing 949 procedures over a 10-year period by one surgeon. Fisher’s exact test and χ2 test were employed and multivariate logistic regression analysis was performed to identify the significant variables of correlation. Results: Overall lead revision was observed at 5.7%, but was observed at 11.9% of GPi lead placements, and 10.7% of dystonia patients with only 4.6% of STN lead placements. Total extension revision was at 2.5%, but observed at 5.3% for dystonia patients and at only 1.4% for ET patients. Overall infection rate was at 1.9% with the highest rate observed in dystonia and ET patients. Postoperative complications with hardware, erosion, infection, and delayed stimulation failure were observed more often with ET and dystonia than with PD. This difference was statistically significant between dystonia and PD (p < 0.03) but not between the other disease entities (p > 0.05). On multivariate analysis, age and gender had no correlation with these complications. PD had significantly fewer complications on forward selection regression analysis (p = 0.004). Asymptomatic intracerebral hemorrhage was at 2.5% with the majority in Vim and none observed in GPi placements. There was only one symptomatic hemorrhage with a permanent deficit. Infarcts were observed at 0.8%. There were no mortalities. Conclusion: This large series of patients and long-term follow-up demonstrate that risks of complications are not universal among movement disorder patients. Diagnosis and lead location are important risk stratification factors in determining complications.
Patient Preferences in Screening for Recurrent Disease after Potentially Curative Esophagectomy
Authors: Blom R.L.G.M. , Nieuwkerk P.T. , van Heijl M. , Bindels P. , Klinkenbijl J.H.G. , Sprangers M.A.G. , van Berge Henegouwen M.I.
Published: June 2012

Background: Routine imaging (RI) as part of follow-up after potentially curative esophagectomy is currently not widely accepted. If detected recurrent disease could be adequately treated, it remains unclear whether patients would want to take part in a screening program. The aim of this study was to determine the extent to which patients who underwent esophagectomy prefer follow-up with or without RI. Methods: Patients who underwent esophagectomy for carcinoma without evidence of recurrent disease were included. An interview-administered questionnaire was used to assess fear of recurrence and elicit patient preferences for the frequency and duration of follow-up and hypothetical changes of survival chances (1–10%). Results: 45/54 eligible patients (83%) participated in this study. The majority of patients preferred follow-up with RI (67%) even if screening would not provide a survival benefit; this proportion increased up to 93% if the proposed chances of survival improved. Younger patients and patients with a lower histopathological tumor stage were more likely to desire follow-up with RI. Conclusion: Most patients who underwent esophagectomy preferred RI as part of follow-up over outpatient clinic visits only, even if such screening would not provide a survival benefit. Further research is needed to determine the most accurate screening modality and most efficient follow-up interval.
Epidemiologic and Clinical Features of Bell’s Palsy among Children in Northern California
Authors: Rowhani-Rahbar Ali , Baxter Roger , Rasgon Barry , Ray Paula , Black Steven , Klein Jerome O. , Klein Nicola P.
Published: June 2012

Background: Bell’s palsy (BP) is an acute, idiopathic, and usually unilateral paralysis of the facial nerve. Large population-based studies of BP among children are lacking. We determined epidemiologic and clinical features of BP among children enrolled in a large integrated health care delivery system. Methods: From 2001 through 2006, all children ≤18 years of age diagnosed with BP within the population of Kaiser Permanente Northern California were identified using the International Classification of Diseases, 9th Revision, code 351.0. All cases were adjudicated by an otolaryngologist and categorized as definite, probable, or rejected. Using chart abstraction forms, epidemiologic and clinical features of BP were determined. Results: Of a total of 977 cases initially identified, 822 (84.1%) were adjudicated as a definite or probable case. The overall incidence rate of BP during the study period was 18.8 (95% CI 17.6–20.2) per 100,000 person-years. The incidence rate increased by age and was higher in females than males across all age strata. There was no evidence for a seasonal pattern in the occurrence of BP (p for trend = 0.81). Conclusions: BP among children may be more common than previously recognized.
Viral Hepatitis Infections in Chronic Kidney Disease Patients and Renal Transplant Recipients
Authors: Urbánek Petr
Published: June 2012

Within the last few decades, the incidence and prevalence of both hepatitis B and C infections have decreased among kidney disease patients. Significant advances have been made in the prevention of hepatitis B and C virus transmission in these high-risk populations; however, the transmission risk is still not negligible. Viral hepatitis infections represent a significant problem among kidney disease patients; patients on regular dialysis, as well as renal transplant recipients (RTRs) due to their epidemiological, virological, and clinical features. Chronic hepatitis B and C have a strong impact on the clinical course of kidney disease as well as on the clinical course after kidney transplantation. The purpose of this review is to focus on the epidemiology, transmission modes, natural courses, and treatment options of hepatitis B and C infections in both chronic kidney disease patients and RTRs.
Localized Gastric Cancer Treated with Chemoradation without Surgery: UTMD Anderson Cancer Center Experience
Authors: Suzuki Akihiro , Xiao Lianchun , Taketa Takashi , Blum Mariela A. , Matamoros, Jr. Aurelio , Chien Pamela L. , Mansfield Paul F. , Fournier Keith F. , Weston Brian , Lee Jeffrey H. , Bhutani Manoop S. , Estrella Jeannelyn S. , Delclos Marc E. , Krishnan Sunil , Das Prajnan , Ajani Jaffer A.
Published: June 2012

Background: In patients with localized gastric cancer (LGC) who are unfit for surgery, decline surgery, or have unresectable cancer, chemoradiotherapy may provide palliation; however, data in the literature are sparse. Methods: We identified 66 LGC patients who had definitive chemoradiation but no surgery. All patients had baseline and postchemoradiation staging including an endoscopic biopsy. Multiple statistical methods were used to analyze outcomes. Results: Most patients were men and most had stage III or IV cancer. Five patients were surgery eligible but declined to have surgery. The median follow-up time was 33.9 months (95% CI 18.3–49.6). The median survival time (MST) for 66 patients was only 14.5 months (95% CI 10.8–19.7) and the median relapse-free survival (RFS) was 5.03 months (95% CI 4.67–6.40). The estimated overall survival (OS) and RFS rates at 3 years were 22.6% (95% CI 13.7–37.3) and 7.7% (95% CI 3.2–18.6), respectively. Twenty-three (35%) patients who achieved a clinical complete response (cCR; negative postchemoradiation biopsy and no progression by imaging) fared better than those who achieved less than cCR (<cCR) [cCR: MST 30.7 months (95% CI 20.4–NA); <cCR: MST 10.6 months (95% CI 8.43–14.9); p < 001]. In multivariate analysis, cCR was the only independent prognosticator for OS [hazard ratio (HR) = 0.32, p < 0.0012] and RFS (HR = 0.12, p < 0.0001). Conclusion: Our data demonstrate that in the absence of surgery, outcomes with definitive chemoradiation are only modest. A third of the patients achieved cCR and had a longer OS and RFS than those who achieved <cCR.
The Role of Systematic Data Reviews in Safety Assessment of Infant Nutrition
Authors: Szajewska Hania
Published: June 2012

To make informed, evidence-based decisions regarding whether a given intervention is necessary, information about its benefits as well as harms is needed. Systematic reviews are always at the top of the evidence hierarchy. In general, the methodology for conducting systematic reviews of benefits and safety/harms overlaps. While systematic reviews of randomized controlled trials (RCTs) are sufficient for providing information regarding the efficacy and short-term safety aspects of these trials, they may be insufficient for providing adequate information about long-term safety and consequences. To adequately address harms, systematic reviews should include evidence from both RCTs and non-RCTs. The inclusion of the latter is to be considered particularly for addressing rare adverse effects, long-term adverse effects, or outcomes that were unknown at the time the RCTs were performed.
The Different Induction Mechanisms of Growth Arrest DNA Damage Inducible Gene 45 β in Human Hepatoma Cell Lines
Authors: Seewoo Varun , Yang Weiping , Du Hailei , Wang Jiayu , Lin Andy , Shen Baiyong , Peng Chenghong , Li Hongwei , Qiu Weihua
Published: June 2012

Aims: Downregulation of the growth arrest and DNA damage-inducible gene 45 β (GADD45β) has been verified to be specific to HCC and consistent with the degree of malignancy. The differences in induction mechanisms of GADD45β were investigated based on transcriptional regulation. Methods: Following our published data from S-adenosylmethionine (SAMe), oxaliplatin and sorafenib were further used to stimulate GADD45β expression in cultured HepG2 (p53 wild type) and Hep3B (p53 null) hepatoma cells in vitro. The different effects on cell viability, DNA synthesis and caspase activities were also measured. Results: Oxaliplatin and sorafenib could induce GADD45β in both HepG2 and Hep3B in a dose-dependent manner with rapid and direct cytotoxic effect. Transcriptional activity of NF-ĸB and E2F-1 were both enhanced by oxaliplatin and sorafenib. However, SAMe could only induce GADD45β in HepG2 through the NF-ĸB pathway, resulting in a slow and indirect cytotoxic effect. Although all three inducers could lead to a pronounced rise in caspase activities, only high concentration of SAMe could inhibit DNA synthesis as significantly as the chemo drugs. No apparent changes in GADD45β induction, promoter activity or cytotoxic effects were observed in Hep3B+p53 when treated with oxaliplatin and sorafenib, while relatively significant changes occurred with SAMe. Conclusion: GADD45β induction is a novel mechanism of SAMe-mediated hepatoprotection with p53 involvement.
Religiosity, Spirituality, Social Support, Health Behaviour and Dental Caries among 35- to 44-Year-Old Jerusalem Adults: A Proposed Conceptual Model
Authors: Zini A. , Sgan-Cohen H.D. , Marcenes W.
Published: June 2012

The aim of this study was to assess the relationship between religiosity and dental caries, and whether oral health-related behaviours, spirituality and social support are included in the potential pathways which explain the association between religiosity and dental caries. The present cross-sectional study employed a stratified sample, according to religiosity level (33.1% secular, 33.1% religious and 33.9% orthodox), of 254 Jewish adults in Jerusalem. The objective was to examine the pathway between religiosity, spirituality and social support and its effect on oral health outcomes by DMFT, controlling for socio-economic position and health behaviour determinants. Religiosity was determined and validated by self-definition. Social support was assessed by the Multidimensional Scale of Perceived Social Support. Spirituality was estimated by the Hebrew version of the SpREUK Questionnaire for Religiosity, Spirituality and Health. The mean caries experience (DMFT) was 10.75. Secular people revealed significantly higher DMFT than their religious and orthodox counterparts (78.0 vs. 43.9 and 39.3%, respectively, p < 0.01). A conceptual logistic regression model revealed a possible pathway, wherein a higher level of religiosity was distally associated with superior dental health outcomes, mediated by high spirituality, strong social support and positive oral health behaviours. The present study identified a strong statistical association between caries experience and religiosity. The direction of the association suggested that being religious had a protective effect on caries experience. Our conceptual hierarchical approach suggests a pathway to explain the association between the level of religiosity and dental caries experience. In this study this association was mediated by extrinsic (i.e. social support) and intrinsic (i.e. spirituality) pathways.
SMARCE1 Promotes Chicken Embryonic Gonad Development by Regulating ERα and AR Expression
Authors: Gong P. , Yang Y. , Lei W. , Feng Y. , Li S. , Peng X. , Gong Y.
Published: June 2012

SMARCE1 is one of some differentially expressed genes screened from a subtracted cDNA library between females and males during the period of sex differentiation. To understand the potential role of SMARCE1 in avian sex determination and differentiation, over-expression of SMARCE1 was performed in chicken embryos using the RCASBP.B retrovirus. Results showed that SMARCE1 expression was up-regulated in the infected embryonic gonads at the investigated stages (E6.5–E12.5) assessed by quantitative real-time RT-PCR, whole mount in situ hybridization and immunohistochemistry. With the over-expression of SMARCE1, CYP19A1, FOXL2, ERα, and SOX9 expression was significantly up-regulated while AR expression was significantly decreased in the male and/or female chicken gonad. Nevertheless, DMRT1 and AMH expression was not changed after the over-expression of SMARCE1. It is proposed that it might be via the SMARCE1-FOXL2 pathway that CYP19A1 expression was activated, and DMRT1 expression may be independent of the SMARCE1-SOX9 pathway. Meanwhile, the SMARCE1-AR pathway might be antagonized by up-regulated expression of ERα via estrogen-ER/androgen-AR signaling. The results of HE staining showed that the ovarian cortex was thickened and both testis seminiferous cord and interstitial cells were increased with the over-expression of SMARCE1. In conclusion, SMARCE1 can promote chicken embryonic gonad development by regulating the ERα and AR expression.
Distal Venous Arterialization and Reperfusion Injury: Focus on Oxidative Status
Authors: Djoric P. , Zeleskov-Djoric J. , Stanisavljevic D.M. , Markovic Z.D. , Zivkovic V. , Vuletic M. , Djuric D. , Jakovljevic V.
Published: June 2012

In patients with unreconstructable arterial occlusive disease distal venous arterialization (DVA) seems to be a promising option in the treatment. The goals of this prospective study were to assess clinical efficiency and possible impact of DVA on tissue damage by estimating oxidative status of patients with critical limb ischemia treated with this procedure. The subjects were 60 randomized patients: 30 were undergoing DVA and 30 were treated with antiaggregation therapy. During the mean follow-up period (6.13 ± 4.32 months for DVA vs. 6.74 ± 0.5 months for antiaggregation therapy) survival (p < 0.01), limb salvage (p < 0.001), pain relief (p < 0.001) and wound healing (p < 0.001) rates were significantly different between the two groups of patients in favor of the DVA group. Ten minutes after declamping we observed a decreasing trend in the lactate level in the blood of the deep venous system (p < 0.001). Also, on postoperative day 7 digital systolic pressure and digital-brachial index were higher than before the operation (p < 0.001). In blood samples collected immediately before and successively at 1, 3, 5 and 10 min postoperatively, prooxidative status (thiobarbituric acid reactive substances, O2–, H2O2 and nitric oxide) and antioxidative enzymes (superoxide dismutase, catalase and glutathione reductase) were determined spectrophotometrically. Using the nonparametric Friedman test, we noted statistically nonsignificant differences (p > 0.05) in values of both prooxidative parameters and enzymes of the antioxidative defense system, before and successively at 1, 3, 5 and 10 min after operation. These results indicate that there was no statistically significant reperfusion injury after revascularization, which could have been expected after this surgical procedure, thus confirming its validity in these patients.
Complications from the Placement of a Tension-Free Suburethral Sling Using the Transobturator and Retropubic Methods for Treatment of Female Urinary Incontinence
Authors: Arrabal-Polo Miguel Ángel , Palao-Yago Francisco , Zuluaga-Gómez Armando , López-León Víctor M. , Merino-Salas Sergio , Lahoz-García Clara , Arrabal-Martín Miguel
Published: June 2012

Objective: The aim of our study was to retrospectively analyze surgical complications arising from the collocation of suburethral mesh in the lower urinary tract, using both the transobturator and retropubic methods. Patients and Methods: During the period between November 2002 and June 2011, we retrospectively studied 190 patients that were treated for stress urinary incontinence using a tension-free suburethral sling. 50 patients were treated using the retropubic route (SPARC®), and 140 patients were treated using a transobturator (MONARC®). Results: In total, 16.57% of the patients presented with intraoperative, immediate postoperative or later postoperative complications. We observed a higher rate of complications with patients who were operated on retropubically (26%) than with patients who were operated on using the transobturator method (12%). Conclusions: The rate of complications for our study was low, and was even lower in the case of transobturator tape. Thus, we usually used transobturator tape in the treatment of stress incontinence.
Intravesical Recurrence after Surgical Management of Urothelial Carcinoma of the Upper Urinary Tract
Authors: Hirano Daisaku , Okada Yasuhiro , Nagane Yusuke , Satoh Katsuhiko , Mochida Junichi , Yamanaka Yataroh , Hirakata Hitoshi , Yamaguchi Kenya , Kawata Nozomu , Takahashi Satoru , Henmi Akihiro
Published: June 2012

Objectives: To elucidate clinicopathological risk factors for intravesical recurrence (IVR) in patients undergoing nephroureterectomy for upper urinary tract urothelial carcinoma (UUT-UC). Methods: We identified a study population of 151 consecutive patients without previous or concurrent bladder cancer who underwent nephroureterectomy for UUT-UC. IVR was assessed in relation to tumor location, size, and multifocality, operation modality and time, stage, grade, lymphovascular invasion, regional lymph node metastasis, preoperative urinary cytology, and perioperative chemotherapy. The median follow-up time was 24 months. Results: Of 151 patients, 51 (34%) developed IVR after nephroureterectomy, and 50 (98%) of the patients presented with IVR within 2 years. Tumor multifocality and site (located in ureter) were determined as risk factors for IVR by univariate analysis. In a multivariate analysis, only tumor multifocality (relative risk: 4.024, p = 0.001) was an independent predictor of IVR. Ten-year cancer-specific survival rates for the patients with and without IVR were 68 and 52%, respectively (p = 0.06). Conclusions: Tumor multifocality is a significant risk factor in developing IVR after surgery for UUT-UC. These results indicate that despite most IVR occurring within 2 years of treatment, it is necessary to follow such patients more closely using cystoscopy. However, IVR is unlikely to indicate a poorer prognosis.
Glutathione Peroxidase 1 Pro198Leu Polymorphism in Brazilian Alzheimer’s Disease Patients: Relations to the Enzyme Activity and to Selenium Status
Authors: Cardoso Bárbara Rita , Ong Thomas Prates , Jacob-Filho Wilson , Jaluul Omar , Freitas Maria Isabel d’Ávila , Cominetti Cristiane , Cozzolino Silvia Maria Franciscato
Published: June 2012

Background/Aims: Oxidative stress plays a central role in Alzheimer’s disease (AD). Pro198Leu cytosolic glutathione peroxidase (GPx1) polymorphism seems to be associated with a lower activity of this enzyme, but there are no studies with AD patients. Thus, the aim was to determine the frequency of the GPx1 Pro198Leu polymorphism in AD patients and to verify its relation to glutathione peroxidase (GPx) activity and selenium (Se) status. Methods: The study was carried out in a group of AD elderly (n = 28) compared to a control group (n = 29). Blood Se concentrations were measured through hydride generation atomic absorption spectroscopy. GPx activity was determined using a commercial kit, and the polymorphism using amplified DNA sequencing. Results: The distribution of genotypes was not different between groups. The variant allele frequency was 0.179 (AD group) and 0.207 (control group). Although no differences regarding GPx activity were found between individuals with different genotypes, lower blood Se levels were found in Pro/Pro AD patients compared to Pro/Pro control subjects, which was not found in the Pro/Leu groups. Moreover, the association between the erythrocyte Se concentration and GPx activity was affected by the Pro198Leu genotype. Conclusions: Results indicate that this polymorphism had apparently affected Se status in AD patients and that more studies in this field are necessary.
Renal Function after Preeclampsia: A Longitudinal Pilot Study
Authors: Spaan Julia J. , Ekhart Timo , Spaanderman Marc E.A. , Peeters Louis L.H.
Published: June 2012

Background: Women with a history of preeclampsia are at increased risk to develop end-stage renal disease. In this longitudinal study, we evaluated renal function in women with a history of severe preeclampsia and parous controls over a period of 14 years. Methods: Renal function was measured 1 and then 14 years postpartum by para-aminohippurate and inulin clearances in 20 women with a history of severe preeclampsia and 8 parous controls. Results: The difference in glomerular filtration rate 1 year postpartum between women with a history of preeclampsia and parous controls (112 ± 10 and 125 ± 8 ml/min/1.73 m2, p < 0.01) had disappeared 14 years postpartum (104 ± 10 and 109 ± 13 ml/min/1.73 m2, p = 0.37). There was a consistent trend for a lower effective renal plasma flow both 1 and 14 years postpartum (477 ± 90 and 543 ± 92, p = 0.09 and 473 ± 85 and 543 ± 98 ml/min/1.73 m2, p = 0.07). Conclusions: This explorative study suggests no accelerated renal function loss in the first decade after preeclampsia.
Lesioning and Stimulation in Tremor-Predominant Movement Disorder Patients: An Institutional Case Series and Patient-Reported Outcome
Authors: Bahgat Diaa , Raslan Ahmed M. , McCartney Shirley , Burchiel Kim J.
Published: June 2012

Background: In certain movement disorder cases, a combined stimulation and lesioning approach in the same patient could be the ideal beneficial option. Objectives: The object of this study was to retrospectively examine the indications, outcome and complications in patients who had undergone both a lesioning (thalamotomy) and deep brain stimulation (DBS) procedure (bilateral or unilateral) for a tremor-predominant movement disorder performed by a single surgeon at one institution over a 15-year period. Methods: A retrospective review of patient records was undertaken. Patient outcome was based on follow-up visit chart notes and on a non-validated patient telephone questionnaire. Results: Thirty patients required a combined stimulation and lesioning approach to control tremor. Twelve patients had either unilateral or bilateral DBS as the first procedure followed by thalamotomy; two patients required a third procedure. Eighteen patients had thalamotomy as the first procedure followed by contralateral DBS either as the second or the third procedure. Eight patients required three procedures, which included either a repeat thalamotomy or a repeat DBS. We were able to contact 22 of 30 (15 male and 15 female, average age 70.7 ± 15.4 years) tremor-predominant movement disorder patients, retrospectively. Patient-reported outcome as assessed by a non-validated telephone questionnaire was: improvement in both symptoms and function in 59%, symptom but not function improvement in 32% and no improvement in either symptom or function or worsening in 9%. In comparison, based on retrospective chart review, 77% of patients had improved symptoms and functions, 20% of patients had improved symptoms with no effect on function and 3% of patients had no improvements of symptoms or functions. Conclusions: Lesioning, which has to a great extent fallen out of favor, still has a valuable role to play in the treatment of tremor-predominant movement disorders; it can still be applied in combination with stimulation with outcome results similar to that of bilateral stimulation.
Effects of Cannabinoid Receptor Agonist WIN 55,212-2 on Blood-Brain Barrier Disruption in Focal Cerebral Ischemia in Rats
Authors: Chi Oak Z. , Barsoum Sylviana , Grayson Jeremy , Hunter Christine , Liu Xia , Weiss Harvey R.
Published: June 2012

This study was performed to investigate whether WIN 55,212-2 (WIN), a cannabinoid receptor agonist, could attenuate blood-brain barrier (BBB) disruption in focal cerebral ischemia in rats and whether the CB1 receptor antagonist rimonabant could prevent this attenuation. A total of 0.3 or 1 mg/kg of WIN was injected intravenously before and after permanent middle cerebral artery (MCA) occlusion. Some animals were pretreated with rimonabant 2 mg/kg i.p. before receiving 0.3 mg/kg of WIN. At 1 h after MCA occlusion, BBB permeability was determined by measuring the transfer coefficient (Ki) of 14C-α-aminoisobutyric acid and the volume of dextran distribution. With MCA occlusion, Ki increased in the ischemic cortex (IC) in all of the experimental groups. However, the Ki of the IC of the WIN 0.3 and 1 mg/kg groups was lower (–46 and –42%, respectively, p < 0.05) than that of the control group. With rimonabant pretreatment, the Ki of the IC became higher (+88%, p < 0.05) than with WIN 0.3 mg/kg alone and similar to that of the control rats. The difference in the volume of dextran distribution between the IC and the contralateral cortex was significant in the control but not in the WIN-treated rats. With rimonabant pretreatment, however, the difference became significant. Our data demonstrated that WIN could attenuate BBB disruption in focal cerebral ischemia and this attenuation could be prevented with rimonabant. Our data suggest an involvement of CB1 receptors in the regulation of BBB disruption in the early stage of stroke.
Regulation of Transforming Growth Factor-β1 Activation and Expression in the Tissue Remodeling Involved in Chronic Rhinosinusitis
Authors: Kou Wei , Hu Guo-Hua , Yao Hong-Bing , Wang Xiao-qiang , Shen Yang , Kang Hong-Yong , Hong Su-Ling
Published: June 2012

Transforming growth factor-β1 (TGF-β1) plays a key role in the tissue remodeling processes involved in chronic rhinosinusitis (CRS), with the biological functions of secreted TGF-β1 regulated by multiple proteins. Among these regulators, latency-associated peptide and latent TGF-β-binding protein inhibit TGF-β1 function, whereas different proteases and integrins activate it. Progress in understanding the factors responsible for the bioactivity and expression of TGF-β1 has revealed that the dysregulation of TGF-β1 activation and expression is closely associated with the chronic respiratory inflammatory diseases involved in CRS. This review of the regulation of TGF-β1 activation and expression provides insight into the mechanism responsible for the different CRS subtypes, which will help further the investigation of novel therapy targets for the treatment of CRS.
Quality and Safety Aspects of Infant Nutrition
Authors: Koletzko Berthold , Shamir Raanan , Ashwell Margaret ,   on behalf of the Early Nutrition Academy (ENA) and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)
Published: June 2012

Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health.