bluuebunny/crossref_metadata_2025 huggingface dataset:
INVOLVEMENT OF THE ENDOTHELIN ETBRECEPTOR IN GENDER DIFFERENCES IN DEOXYCORTICOSTERONE ACETATE‐SALT‐INDUCED HYPERTENSION
Authors: Kawanishi Hideaki , Hasegawa Youichi , Nakano Daisuke , Ohkita Mamoru , Takaoka Masanori , Ohno Yukihiro , Matsumura Yasuo
Published: August 2010

In the present study, we investigated the role of endothelin ETBreceptors in gender differences in the development of deoxycorticosterone acetate (DOCA)‐salt‐induced hypertension by using the spotting‐lethal (sl) rat, which carries a naturally occurring deletion in the ETBreceptor gene.

In wild‐type rats, the elevation of systolic blood pressure (SBP) by DOCA‐salt treatment for 4 weeks was extremely lower in females than in males, but this gender difference was partially attenuated in ovariectomized (OVX) animals. These alterations of SBP corresponded with vascular superoxide () production.

In homozygous (sl/sl) group, the SBP of male, intact female and OVX rats was markedly elevated by DOCA‐salt treatment to the same extent, indicating that the gender difference in DOCA‐salt‐induced hypertension was abolished by the genetic ETBreceptor deficiency. There were similar increases in the vascular endothelin (ET)‐1 content in the three DOCA‐salt‐treated animal groups, but vascularproduction in male and OVX rats was much higher than that in intact females.

Daily oral administration of ABT‐627, an ETAreceptor antagonist, tosl/slrats for 2 weeks suppressed the DOCA‐salt‐induced hypertension more efficiently in intact female rats than in male animals.

Thus, vascular oxidative stress is related, at least in part, to differences in the development of DOCA‐salt‐induced hypertension between male and female rats, but this gender difference is abolished by the genetic ETBreceptor deficiency, suggesting that ETBreceptor‐mediated vasoprotective actions contribute to the gender differences seen. In addition, in both sexes, vascular ET‐1 overproduction and the ETAreceptor‐mediated action seem to be responsible for the enhanced susceptibility to DOCA‐salt hypertension in genetic ETBreceptor deficiency.
IDENTIFICATION OF BLOOD PRESSURE CONTROL MECHANISMS BY POWER SPECTRAL ANALYSIS
Authors: Stauss Harald M
Published: August 2010

Blood pressure and organ perfusion are controlled by a variety of cardiovascular control systems, such as the baroreceptor reflex and the renin–angiotensin system (RAS), and by local vascular mechanisms, such as shear stress‐induced release of nitric oxide (NO) from the endothelium and the myogenic vascular response. Deviations in arterial blood pressure from its set point activate these mechanisms in an attempt to restore blood pressure and/or secure organ perfusion. However, the response times at which different cardiovascular mechanisms operate differ considerably (e.g. blood pressure control by the RAS is slower than blood pressure control via the baroreceptor reflex).

Owing to these different response times, some cardiovascular control systems affect blood pressure more rapidly and others more slowly. Thus, identifying the frequency components of blood pressure variability (BPV) by power spectral analysis can potentially provide important information on individual blood pressure control mechanisms.

Evidence is presented that the RAS, catecholamines, endothelial‐derived NO and myogenic vascular function affect BPV at very low frequencies (0.02–0.2 Hz) and that low‐frequency (LF) BPV (0.2–0.6 Hz) is affected by sympathetic modulation of vascular tone and endothelial‐derived NO in rats. In humans, LF BPV (0.075–0.15 Hz) is affected by sympathetic modulation of vascular tone and myogenic vascular function. The impact of the RAS and endothelial‐derived NO on BPV in humans requires further investigation.

In conclusion, power spectral analysis is a powerful diagnostic tool that allows identification of pathophysiological mechanisms contributing to cardiovascular diseases, such as hypertension, heart failure and stroke, because it can separate slow from fast cardiovascular control mechanisms. The limitation that some cardiovascular control mechanisms affect the same frequency components of BPV requires the combination of blood pressure spectral analysis with other techniques.
GENOTYPE AND ALLELE FREQUENCIES OF N‐ACETYLTRANSFERASE 2 AND GLUTATHIONE S‐TRANSFERASE IN THE IRANIAN POPULATION
Authors: Torkaman‐Boutorabi Anahita , Hoormand Mahmood , Naghdi Naser , Bakhshayesh Masoomeh , Milanian Iraj
Published: August 2010

1. Xenobiotic‐metabolizing enzymes constitute an important line of defence against a variety of carcinogens. Many are polymorphic, constituting the basis for the wide interindividual variation in metabolic capacity and possibly a source of variation in the susceptibility to chemical‐induced carcinogenesis. The aim of the present study was to determine the frequencies of important allelic variants in the N‐acetyltransferase 2 (NAT2) and glutathione S‐transferase (GST) genes in the Iranian population and compare them with frequencies in other ethnic populations.

Genotyping was performed in a total of 229 unrelated healthy subjects (119 men, 110 women) for NAT2 and 170 unrelated healthy subjects (89 men, 81 women) for GST from the general Tehran population. A combination of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was applied for typing of NAT2 polymorphisms. Detection of GSTM1 and GSTT1 null alleles was performed simultaneously using a multiplex PCR assay.

The frequencies of specific NAT2 alleles were 0.299, 0.314, 0.380, 0.007 and 0.000 for *4 (wild‐type), *5 (C481T, M1), *6 (G590A, M2), *7 (G857A, M3) and *14 (G191A, M4), respectively. The most prevalent genotypes were NAT2 *5/*6 (29.70%) and *4/*6 (21.40%). The GSTM1‐ and GSTT1‐null alleles were detected in 44.7 and 21.2% of subjects, respectively.

We found that Iranians resemble Indians with regard to allelic frequencies of the tested variants of NAT2. The predominance of slow (49.36%) and intermediate (41.47%) acetylation status compared with wild‐type rapid acetylation status (9.17%) in the study group suggests the significant prevalence of the slow acetylator (SA) phenotypes in the Iranian population. Our data confirmed that Iranians are similar to other Caucasian populations in the frequency of both GSTM1‐ and GSTT1‐null alleles.
Satellite cell activity in muscle regeneration after contusion in rats
Authors: Srikuea Ratchakrit , Pholpramool Chumpol , Kitiyanant Yindee , Yimlamai Tossaporn
Published: August 2010

1. The role of satellite cells in muscle growth during development is well documented, but the involvement of these cells in muscle repair after contusion is less well known. In the present study, we investigated the time‐course of satellite cell activity (from 3 h to 7 days) after contusion of rat gastrocnemius muscle using specific molecular markers for immunofluorescence and real‐time polymerase chain reaction (PCR).

2. Inflammation of the injured muscle occurred within 6 h, followed by disintegration of the damaged myofibres within 12 h. Newly formed myofibres appeared by Day 7.

3. The number of MyoD‐positive nuclei (activated satellite cells) in the injured muscle was significantly increased by 6 h, reaching a maximum by 12 h after contusion. However, the number of MyoD‐positive nuclei decreased towards control levels by Day 7. Changes in the number of bromodeoxyuridine‐labelled nuclei (proliferating satellite cells) paralleled the changes seen in the number of MyoD‐positive nuclei. Conversely, expression of myogenin protein was not apparent until Day 3 and increased further by Day 7. Colabelling of MyoD and myogenin was seen in only a few cells.

4. The time‐course of MyoD mRNA expression corresponded with MyoD protein expression. However, there were two peaks in myogenin mRNA expression: 6 h and Day 7 after contusion. The second peak coincided with upregulation of myostatin mRNA levels.

5. The results of the present study suggest that contusion activates a homogeneous population of satellite cells to proliferate within 3 days, followed by differentiation to form new myofibres. The latter may be regulated, in part, by myostatin.
High Susceptibility of Obese Hypertensive SHRSP.Z‐Leprfa/IzmDmcr Rats to Lipid Deposition in the Mesenteric Artery
Authors: Kunimasa Kazuhiro , Miura Chitose , Mori Hideki , Tsuchikura Satoru , Ikeda Katsumi , Gao Ming , Yamori Yukio , Mori Mari
Published: August 2010

1. Atherosclerosis is commonly observed in obesity. Obese atherosclerosis‐prone animals may be a promising tool for understanding the pathophysiology of obesity‐associated atherosclerosis. However, most rat strains are resistant to atherosclerosis. The aim of the present study was to assess the susceptibility of two obese hypertensive rat models, namely SHRSP.Z‐Leprfa/IzmDmcr rats (SHRSP‐fatty) and SHR.Cg‐Leprcp/NDmcr rats (SHR‐cp), to arterial lipid deposition, an initial stage of atherosclerosis, by comparing these strains with non‐obese stroke‐prone spontaneously hypertensive rats (SHRSP).

2. Eight‐week‐old male SHRSP, SHRSP‐fatty and SHR‐cp were fed a high‐fat and high‐cholesterol diet containing 20% palm oil, 5% cholesterol and 2% cholic acid for 5 weeks. Bodyweight, blood pressure and fasting serum levels of total cholesterol and triglycerides were measured in 12‐week‐old rats. Oil red O staining was used to visualize lipid deposition in the mesenteric artery.

3. The bodyweight of 12‐week‐old SHRSP‐fatty and SHR‐cp was higher than that of SHRSP (P < 0.005). Systolic blood pressure in SHRSP and SHRSP‐fatty was higher than in SHR‐cp (P < 0.005). Serum total cholesterol and triglyceride levels were elevated in SHRSP‐fatty (P < 0.005) and SHR‐cp (P < 0.05) compared with levels in SHRSP. Lipid deposition in the mesenteric artery was significantly greater in SHRSP‐fatty than in SHRSP (37.7 ± 4.9 vs 13.1 ± 2.8%, respectively; P < 0.005), but markedly reduced in SHR‐cp (1.8 ± 0.4%; P < 0.05).

4. The results of the present study indicate that SHRSP‐fatty are highly susceptible to arterial lipid deposition, whereas SHR‐cp are resistant. Thus, SHRSP‐fatty may be a useful obese rat model in which to investigate atherosclerotic processes.
Pharmacological evidence that stalk cell differentiation involves increases in the intracellular Ca2+ and H+ concentrations in Dictyostelium discoideum
Authors: Kubohara Yuzuru , Arai Akiko , Gokan Naomi , Hosaka Kohei
Published: August 2010

Differentiation‐inducing factors (DIFs) are required for stalk cell formation in Dictyostelium discoideum. In the present study, in order to support our hypothesis that DIFs may function via increases in [Ca2+]c and [H+]c, we investigated the combined effects of 5,5‐dimethyl‐2,4‐oxazolidinedione (DMO, a [H+]c‐increasing agent), thapsigargin (Tg) and BHQ ([Ca2+]c‐increasing agents) on in vitro stalk cell formation in several strains. DMO, in combination with Tg or BHQ, induced stalk cell formation in a DIF‐deficient mutant HM44. Although the rates of stalk cell induction by the drugs were low in the presence of cerulenin (an inhibitor of endogenous DIF production) in HM44 and V12M2 (a wild‐type strain), the drugs succeeded in inducing sufficient stalk cell formation when a small amount of DIF‐1 was supplied. Furthermore, co‐addition of DMO, BHQ and a small amount of DIF‐1 also induced sufficient stalk cell formation in AX‐4 (an axenic strain) and HM1030 (dmtA−) but not in CT15 (dimA−). The drugs suppressed spore formation and promoted stalk cell formation in both HM18 (a sporogenous mutant) and 8‐bromo‐cAMP‐stimulated V12M2. The present results suggest that DIFs function, at least in part, via increases in [Ca2+]c and [H+]c in D. discoideum.
Distribution of boulders at Miyara Bay of Ishigaki Island, Japan: A flow characteristic indicator of tsunami and storm waves
Authors: Goto Kazuhisa , Shinozaki Tetsuya , Minoura Koji , Okada Kiyohiro , Sugawara Daisuke , Imamura Fumihiko
Published: August 2010

This study investigates the distribution of boulders at Miyara Bay of Ishigaki Island, Japan. These boulders were deposited on a reef flat extending approximately 400–1300 m in width. Most boulders were rectangular to ellipsoidal, without sharp broken edges. They are reef and coral rock fragments estimated as <335 m3 (<633 t). Locally in the bay, the relationship between the boulder weight and position shows that boulders of a given weight have a clear limit on seaward distribution on the reef flat. For example, more than 1, 10, and 100 tons of boulders were deposited, respectively, more than 500, 300, and 100 m from the reef edge. The line is consistent with the possible landward transport limit by maximum storm waves at the Ryukyu Islands, suggesting that the line was formed by the reworking of some boulders by maximally strong storm waves, although we can not exclude the possibility that the line was formed by tsunamis. Furthermore, 68% of boulders at the bay are deposited beyond this line. Therefore, the presence of these boulders at their present positions is difficult to explain solely by storm waves, implying the possible tsunami origin of these boulders. The boulders are characteristically concentrated along the high‐tide line, suggesting the drastic reduction of the tsunami hydraulic force along the line. Previous studies using radiocarbon age dating, as well as our study, imply that at least 69 boulders at Miyara Bay were probably deposited at their present positions by the 1771 Meiwa tsunami, although some of these boulders might have been emplaced and displaced on the reef flat by prior tsunami or storm surges.
A simple, safe technique for the drainage of pancreatic pseudocysts
Authors: Thomasset Sarah C. , Berry David P. , Garcea Giuseppe , Ong Seok L. , Hall Thomas , Rees Yvonne , Sutton Christopher D. , Dennison Ashley R.
Published: August 2010

Background:  A number of methods are available for the drainage of pancreatic pseudocysts, including percutaneous, endoscopic and open approaches. In Leicester, we developed a combined radiological and endoscopic technique (predating the use of endoscopic/ultrasound) to allow drainage of pancreatic pseudocysts into the stomach. The aim of the study was to evaluate the long‐term results of this approach.

Methods:  This is a retrospective study of patients undergoing combined endoscopic/ultrasound‐guided percutaneous stenting between 1994 and 2007. Data were extracted from case records and our computerised radiology database.

Results:  Thirty‐seven combined endoscopic/ultrasound‐guided procedures were undertaken. Median patient age was 52 years (range 26–84 years). Nineteen pseudocysts were secondary to acute pancreatitis and 18 were in patients with chronic pancreatitis. The diameter of pseudocysts on pre‐procedure imaging ranged from 4 to 21 cm (median 11 cm). Median duration of hospital stay was 7 days (range 1–44 days) and 30‐day mortality was 0%. Stents were inserted in 70.3% of patients (n= 26). Of those patients stented during the combined procedure, three developed infection of the pseudocyst, necessitating open cystgastrostomy within the first month. During a mean follow‐up period of 41 months, two patients developed recurrent pseudocysts which were successfully drained with a further combined procedure (16 and 43 months). Repeat imaging in the remainder of patients failed to show any evidence of a persistent or recurrent pseudocyst beyond 2 months.

Conclusion:  Combined radiological and endoscopic drainage is safe, cost‐effective and highly efficient in preventing recurrent pseudocyst formation.
The impact of volume on outcomes after oesophageal cancer surgery
Authors: Rouvelas Ioannis , Lagergren Jesper
Published: August 2010

Oesophageal cancer is an aggressive disease with a poor prognosis. Oesophagectomy is an established, potentially curative treatment, for patients with resectable oesophageal cancer. The anatomical location of the oesophagus explains why this type of operation is one of the most demanding and traumatic surgical procedures undertaken in general surgery. Unfortunately, the risk for severe post‐operative complications is high and the chance for cure remains low. It is, however, encouraging that the post‐operative morbidity has been decreasing and the survival has been improving during recent years. Several factors might have contributed to this improvement, including the centralization of oesophageal cancer surgery to high volume centres. This review focuses on the impact of hospital and surgeon volume on various outcomes after oesophagectomy for oesophageal cancer. Most available research indicates that, as far as post‐operative complications, early post‐operative mortality and health economics after oesophagectomy are concerned, high surgery volume is to be recommended, while the few studies evaluating long‐term survival and health‐related quality of life adjusted for tumour stage found no evidence of a role for volume. In conclusion, the available literature supports the centralization of oesophagectomy for cancer to dedicated centres with a multidisciplinary approach and a good track record of valid clinical research.
The role of fibrin glue in decreasing chronic pain in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair: a Single surgeon's experience
Authors: Khaleal Fadil , Berney Christophe
Published: August 2010

Background:  Chronic pain is a disturbing severe complication of mesh inguinal hernia repair. Its risk, incidence, severity and its aetiologies vary widely in the literatures. It is well established that laparoscopic repair has decreased the incidence of chronic pain, but only to a certain degree. The main source of pain with this approach is staple fixation. Different ways of fixation were sought to avoid this problem.

Methods:  A review of the data collected prospectively, the cohort included 233 consecutive patients who underwent totally extraperitoneal (TEP) inguinal hernia repair by a single surgeon who used fibrin glue (Tisseel) to fix the mesh in all cases. Patients were reviewed by the original surgeon at 2 weeks and 6–12 weeks post‐operatively, but also at 6 months in the first year of the study, and selectively then after if pain was reported by the patient. Data was reviewed and analysed by the researcher as part of quality assurance.

Results:  During the period from February 2005 to September 2008, 233 consecutive patients underwent 309 TEP inguinal hernia repairs. The mean age was 44.9 years. There was no conversion to open surgery. There was no mortality and only one major morbidity. In total, eight patients were complaining of mild intermittent discomfort (2 in the groins and 6 in the testicles) on their second post‐operative review, but had no complaint at 6 months following their surgery. Chronic groin pain occurred in only one patient (0.43%).

Conclusions:  The use of fibrin glue is a safe and reliable way of mesh fixation in inguinal hernia repair, with very limited risk of developing chronic pain.
HYPERCALCAEMIA IN ASSOCIATION WITH RENAL FAILURE: THE ROLE OF IMMOBILISATION
Authors: PRINCE R. L. , EISMAN J. A. , SIMPSON R. W.
Published: August 2010

Hypercalcaemia occurring after ten weeks of immobilisation was observed in four adult patients all of whom had had prior renal failure sufficient to require renal dialysis. In all patients parathyroid hormone levels were normal or low and in three plasma 1,25(OH)2D3 levels were low. These findings are consistent with immobilisation induced increases in bone calcium resorption. Renal excretion of calcium may have been impaired by renal dysfunction resulting in hypercalcaemia and suppression of plasma PTH and 1,25(OH)2D3 levels. Resolution of the hypercalcaemia was associated with remobilisation. Parathyroidectomy is inappropriate treatment.
LONG TERM MINOXIDIL THERAPY and RENAL FUNCTION, CARDIAC FUNCTION, HYPERTRICHOSIS and BLOOD PRESSURE
Authors: JACKSON R. V. , WILLIAMSON M. M. , SENEVIRATNE B. , GORDON R. D.
Published: August 2010

Twenty‐eight patients with severe, refractory hypertension were treated with minoxidil, in combination with a beta‐blocker and a diuretic, for periods ranging from 1.5 to 39 months.

In 16 patients treated for more than a year (14 to 39 months, average 24) mean supine blood pressure fell from 209/115 mmHg to 163/87 mmHg at one year and 157/87 mmHg when last seen; mean standing blood pressure fell from 186/109 mmHg to 148/86 mmHg at one year and 147/88 mmHg when last seen. Minoxidil did not cause postural dizziness. Six patients with renal artery stenosis were treated for 1.5 to 11 months in preparation for renovascular surgery. Only one of 28 patients developed resistance to minoxidil (up to 80 mg daily) after an initial response.

Nine of the 16 patients treated for more than a year had plasma creatinine levels in excess of 0.20 mmol/l before commencing minoxidil. In three of them, levels increased further during treatment. In the remaining 13 patients, mean creatinine levels after one year and when last seen were not higher than pre‐treatment levels.

All patients experienced fluid retention and hypertrichosis after commencing minoxidil. These effects were always controllable but very large doses of frusemide and the use of depilatory creams were sometimes required. The average dose of frusemide was 240 mg daily. Treatment did not have to be ceased because of these side‐effects. Serial echocardiography revealed no evidence of pericardial effusion, and a significant reduction in estimated mean left ventricular mass in ten patients followed for at least one year.

It is concluded that minoxidil is an effective agent in the long‐term treatment of severe, resistant hypertension not responding to more conventional therapy. Provided that fluid retention and hypertrichosis were anticipated and treated vigorously when they arose, its use was not associated with any other serious problems.
MONOCLONAL ANTIBODIES IN CLINICAL MEDICINE – A REVIEW
Authors: THURLOW P. J. , MckENZIE I. F. C.
Published: August 2010

Monoclonal antibodies are produced by the cell fusion method, whereby immune murine spleen cells are fused with a murine myeloma to produce large quantities of specific homogenous antibodies. These have obvious advantages over conventional antisera particularly for in vitro diagnostic procedures. The use of monoclonal antibodies to human T cells, leukaemias and solid tumours are reviewed. In these areas, monoclonal antibodies are now being used for the diagnosis of disease activity, for the monitoring of graft rejection, and for the in vivo treatment of leukaemia and graft rejection in man. Murine monoclonal antibodies–examples of genetic engineering–represent a new and early phase of the use of molecular biological techniques for the production of reagents of use in clinical medicine.
Trends in the home management of non‐fatal acute myocardial infarction in Perth, Western Australia between 1984 and 1993
Authors: Bel H. C. , Parsons R. W. , Jamrozik K. D. , Fritjes C.
Published: August 2010

Background: Trends in the incidence of acute myocardial infarction (MI) that are based on admissions to hospital would be misleading if the proportion of non‐fatal infarctions treated at home changed over time.

Aim: To estimate trends in the management at home of cases of non‐fatal AM1 in Perth between 1984 and 1993 in order to determine if the number of such cases has remained consistently small and can be neglected in studies of the incidence of AMI.

Methods: In 1989, 251 general practitioners in Perth responded to a postal questionnaire asking about management of cases of AM1 at home in the preceding 12 months. In 1993, 288 general practitioners and 174 physicians responded to the same questionnaire.

Results: We estimate that 1.5% of all patients less than 65 years of age diagnosed with non‐fatal AM1 were managed at home in 1989. The corresponding figure for 1993 was 4.1%. A previous study in Perth in 1984 found that 3.9% of cases of non‐fatal AM1 in patients less than 65 years of age were managed at home.

Conclusion: The management at home of cases of non‐fatal AM1 in people of working age in Perth has remained at a negligible level from 1984 to 1993. Thus a register based on admissions to hospital for AM1 will accurately reflect trends in AM1 in people of working age.
Peripheral blood lymphocyte subset distribution and function in patients with Alzheimer's disease and other dementias
Authors: HU G.‐R , Walls R. S. , Creasey H. , McCusker E. , Broe G. A.
Published: August 2010

Background: Until recently, new data on immune aspects of Alzheimer's disease (AD) have suggested that some facets of AD pathogenesis may be immune related. However, the effects of dementia itself on immune function have not been considered.

Aim: To compare the distribution of peripheral blood lymphocyte subsets and their function in patients with AD and other dementias.

Methods: Peripheral blood lymphocyte numbers, T cell subset distribution, proliferative responses to mitogens and suppressor cell assay were studied in a well characterised group of patients with AD, and compared to patients with other forms of dementia. Age and sex matched elderly controls were screened to exclude dementia, and young controls were medical, paramedical and laboratory staff. Analysis of variance (ANOVA) and student's t test were used for statistical analysis.

Results: The CD8 + lymphocyte population was reduced in AD and in other forms of dementia, when compared with non‐demented elderly and young controls. Concanavalin A induced lymphocyte transformation was reduced in all dementia groups and in elderly compared with young controls. The changes in T cell numbers and function were not specific for Alzheimer's disease, but were found also in other forms of dementia.
Serum 25‐hydroxyvitamin D3 is related to physical activity and ethnicity but not obesity in a multicultural workforce
Authors: Scragg R. , Holdaway I. , Singh V. , Metcalf P. , Baker J. , Dryson E.
Published: August 2010

Methods: Serum 25‐hydroxyvitamin D3, a marker of recent sun exposure and vitamin D status, was measured in 390 New Zealand residents (95 Pacific Islanders, 74 Maori and 221 others mostly of European descent), who were part of a larger cross‐sectional survey of a workforce (n= 5677) aged 40–64 years.

Results: Serum 25‐hydroxyvitamin D3 levels were significantly lower in Pacific Islanders (mean (SE) = 56 (3) nmol/L; p= 0.0001) and Maoris (68 (3) nmol/L; p=0.036) compared with Europeans (75 (2) nmol/L) after adjusting for age, sex and time of year. Also adjusting for ethnic group, 25‐hydroxyvitamin D, was higher in people doing vigorous (aerobic) leisure physical activities (71 (2) nmol/L; p=0.0066) and moderate (non‐aerobic) activities (68 (3) nmol/L; p = 0.12) compared with those who were inactive (63 (2) nmol/L). However, 25‐hydroxyvitamin D3 was unrelated to body mass index, serum lipids, blood pressure or cigarette smoking.

Background: Recent research suggests that body vitamin D levels are decreased in coronary heart disease and diabetes, but it is unclear which cardiovascular risk factors are related to vitamin D status.

Aims: To examine the relation between vitamin D status and major cardiovascular risk factors.

Conclusions: People with increased skin pigmentation, such as Polynesians, and people who are inactive, have decreased body levels of vitamin D; this might partly explain their increased risk of cardiovascular disease.
Adjuvant chemotherapy for non‐metastatic osteosarcorna of the extremities in two New Zealand cancer centres
Authors: Jameson M. B. , Evans B. D. , Gray D. H. , Forgeson G. V. , Allan S. G. , Humm G. , Thomson J. , Harvey V. J. , Thompson P. I.
Published: August 2010

Background: Adjuvant chemotherapy significantly improves survival of patients with non‐metastatic osteosarcoma but most of the data come from trials conducted in major international cancer centres.

Aim: To review the efficacy and toxicity of an adjuvant chemotherapy regimen used in two regional cancer centres in New Zealand.

Methods: Retrospective review of patients treated for non‐metastatic high‐grade osteosarcoma of the extremities. The regimen (POMA) consists of high‐dose methotrexate 8 g/m2 and vincristine 1.5 mg/m2 (maximum 2 mg) on days 1 and 8 followed by folinic acid then doxorubicin 50 mg/m2 and cisplatin 100 mg/m2 on day 15. This cycle was repeated every 35 days. Following amputation patients received six cycles while in selected patients two cycles were planned prior to limb salvage surgery followed by a further four cycles. Actuarial survival was calculated using the Kaplan‐Meier method.

Results: Twenty patients were treated with POMA between 1986 and 1993. Amputation was performed in 16 patients and limb‐salvage surgery in four. Sixteen patients (80%) remain alive with no evidence of disease at a median follow‐up of 40 months. Thirteen patients (65%) have been continuously disease‐free. Actuarial survival at five years is 70%. Seven patients relapsed, six in lungs, of whom four underwent pulmonary metastasectomy; three of these remain free of disease 31, 35 and 40 months later. There was no local relapse. The toxicity of POMA is significant but tolerable.

Conclusion: The results obtained at two regional cancer centres in New Zealand using POMA compare favourably to those achieved in clinical trials performed at major international cancer centres.
Association between ulcerative colitis and multiple sclerosis
Authors: Pokorny C. S. , Beran R. G. , Pokorny M. J.
Published: August 2010

An association between inflammatory bowel disease (IBD) and multiple sclerosis (MS) has been described. The current study was undertaken to explore this association further. Personal records of patients with IBD and MS were reviewed. In addition, a search of medical records at a large tertiary teaching hospital in Sydney was carried out for the years 1996–2006. Four patients (three women and one man) with both ulcerative colitis and MS were identified. MS did not occur in any of our patients with Crohn’s disease. The association between ulcerative colitis and MS appears to be real and may help identify common factors involved in the cause of these two diseases. No association was found in this study between MS and Crohn’s disease, sparking consideration why such difference should occur. With the increasing use of biological therapies in IBD and their reported propensity to cause demyelination, recognition of an association is all the more important.
Are Australasian academic physicians an endangered species?
Authors: Wilson A.
Published: August 2010

It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient‐based services as well as a corporate health‐care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician‐scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital‐based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician‐scientists in academic practice and to develop workable solutions.
First Fracture Project: addressing the osteoporosis care gap
Authors: Vaile J. , Sullivan L. , Bennett C. , Bleasel J.
Published: August 2010

Patients sustaining a low‐trauma fracture are at greater risk of subsequent fracture, but as a group are poorly managed. We report the development of our ‘First Fracture Project’, in which we attempt to assess all patients over 50 years of age with a low‐trauma fracture attending orthopaedic fracture clinics and treat osteopenia and osteoporosis. We found that the First Fracture Project has greatly increased our success in improving delivery of osteoporosis care to appropriate at‐risk patients.
One drug or two? Step‐down therapy after i.v. antibiotics for community‐acquired pneumonia
Authors: Harrington Z. , Barnes D. J.
Published: August 2010

Background:  The aim of the study was to describe the oral antibiotics prescribed as step‐down therapy for patients hospitalized for community‐acquired pneumonia (CAP).

Methods:  A comparative audit of patient records in a Sydney teaching hospital, a district referral hospital and a regional hospital was carried out. Patients older than 15 years admitted between 1 July 2004 and 31 December 2004 with a diagnosis of CAP were identified by diagnostic code. The medical records were reviewed for patient demographics, the specialty of the attending physician, comorbidities, adverse drug events, relevant microbiological results and the antibiotic therapy prescribed for the treatment of pneumonia. Cases were randomly selected from all pneumonia admissions, with approximately equal numbers from urban and regional hospitals. One hundred and ninety‐six admissions for CAP (in 193 patients) were included in this review. Patients were predominantly cared for by respiratory physicians (62%) and geriatricians (14%). Eighty‐nine per cent of patients received dual antibiotic therapy on admission.

Results:  For patients commenced on two antibiotics, 62% were prescribed two oral antibiotics after completing i.v. therapy, 27% were prescribed one oral agent and 11% were prescribed no step‐down therapy. Geographic location and the presence of a documented antibiotic allergy affected prescribing practice. Neither the specialty of the attending medical officer nor the identification of a likely pathogen affected prescribing practice.

Conclusion:  Although most of the patients with CAP were initially prescribed two antibiotics, there was considerable variability in whether one, two or no oral agents were prescribed as step‐down therapy.
Ethics of organ donation and transplantation involving prisoners: the debate extends beyond our borders
Authors: Westall G. P. , Komesaroff P. , Gorton M. W. , Snell G. I.
Published: August 2010

The transplantation of solid organs raises many ethical considerations, many of which focus on the need to expand the donor pool, the limiting step in achieving ongoing growth in solid organ transplantation. A contentious source of organs, albeit not one practised in Australia or New Zealand, is the retrieval of donor organs from executed prisoners on death row. Although potentially increasing the organ donor pool, the acceptance of such organ donors raises significant ethical and legal concerns. These issues, although not appearing to affect directly and influence Australians, cannot be ignored given our position, both geographical and medical, in the wider Asia–Pacific region.
Wegener’s granulomatosis: epidemiological and clinical features in a South Australian study
Authors: Hissaria P. , Cai F. Z. J. , Ahern M. , Smith M. , Gillis D. , Roberts‐Thomson P.
Published: August 2010

Background:  The epidemiology of Wegener’s granulomatosis (WG) has shown a latitude‐dependent predisposition in Northern Hemisphere and in New Zealand. There are no studies describing epidemiology or long‐term follow up of WG reported from Australia. The aims of this study were to describe the epidemiological and clinical features of WG in South Australia (SA).

Methods:  The 5‐year incidence of WG in SA over the period 2001–2005 was determined using the International Classification of Diseases classification (M313) of the discharge diagnosis using the Integrated South Australian Activity Collection. A retrospective case record analysis of 30 patients fulfilling the American College of Rheumatology criteria for WG and managed at two regional hospitals over a 20‐year period (1985–2004) was carried out.

Results:  The 5‐year incidence of WG in SA was 56 per 106 (95% confidence interval 44.1–68.4 per 106). There were no regional or seasonal variations in disease occurrence. The demographic, clinical and serological features in the clinical study were similar to previously published studies. Significant treatment‐related morbidity was noted with 50% of patients having atherosclerotic vascular complications. The median survival was 12 years. There were two important periods with greater risk of dying – in the first 5 years and after 10 years.

Conclusion:  The 5‐year incidence of WG in SA is higher than that in the same latitudinal region in New Zealand (∼34°S). Atherosclerotic vascular disease was a major long‐term morbidity. There is increased incidence of early mortality, warranting the need for earlier diagnosis and better therapies. Further studies from Southern Hemisphere are required for better epidemiological description of this disease.
Use of tunnelled active fixation leads allows reliable temporary pacing over prolonged periods
Authors: Orsbourn G. , Lever N. , Harding S. A.
Published: August 2010

Temporary tunnelled pacing (TTP) is an alternative method of providing temporary pacing in which an active fixation permanent pacing lead is placed fluoroscopically through percutaneous venous access, tunnelled subcutaneously and connected to a resterilized external pulse generator. Our study shows that temporary tunnelled pacing is a safe and reliable method of achieving prolonged temporary pacing. We believe that temporary tunnelled pacing should be considered as an option in all patients who have an indication for prolonged temporary pacing.
Search engine as a diagnostic tool in difficult immunological and allergologic cases: is Google useful?
Authors: Lombardi C. , Griffiths E. , McLeod B. , Caviglia A. , Penagos M.
Published: August 2010

Background: Web search engines are an important tool in communication and diffusion of knowledge. Among these, Google appears to be the most popular one: in August 2008, it accounted for 87% of all web searches in the UK, compared with Yahoo‘s 3.3%. Google’s value as a diagnostic guide in general medicine was recently reported. The aim of this comparative cross‐sectional study was to evaluate whether searching Google with disease‐related terms was effective in the identification and diagnosis of complex immunological and allergic cases.

Methods: Forty‐five case reports were randomly selected by an independent observer from peer‐reviewed medical journals. Clinical data were presented separately to three investigators, blinded to the final diagnoses. Investigator A was a Consultant with an expert knowledge in Internal Medicine and Allergy (IM&A) and basic computing skills. Investigator B was a Registrar in IM&A. Investigator C was a Research Nurse. Both Investigators B and C were familiar with computers and search engines. For every clinical case presented, each investigator independently carried out an Internet search using Google to provide a final diagnosis. Their results were then compared with the published diagnoses.

Results: Correct diagnoses were provided in 30/45 (66%) cases, 39/45 (86%) cases, and in 29/45 (64%) cases by investigator A, B, and C, respectively. All of the three investigators achieved the correct diagnosis in 19 cases (42%), and all of them failed in two cases.

Conclusion: This Google‐based search was useful to identify an appropriate diagnosis in complex immunological and allergic cases. Computing skills may help to get better results.
FATIGUE CRACK INITIATION IN ALUMINIUM ALLOYS UNDER PROGRAMMED BLOCK LOADING
Authors: Gabra M. , Bathias C.
Published: August 2010

Abstract— Tests for fatigue crack initiation were carried out on two different aluminium alloys. Results and analysis of initiation under constant amplitude loading are presented; elastic and elastoplastic analyses are applied. Initiation under programmed block loading is investigated and damage accumulation is discussed. Tests were performed on two notch root radii:5 and 0.5mm. The electric potential method was used to detect fatigue crack initiation. Three point bending tests on smooth specimens were carried out to follow the evolution of damage during the crack initiation phase.
FATIGUE CRACK TIP MECHANICS OF A POWDER METALLURGY ALUMINUM ALLOY IN VACUUM AND HUMID AIR
Authors: Davidson D. L. , Lankford J.
Published: August 2010

Abstract— Fatigue crack tip opening displacements and strains in the material very close to the crack tip have been determined from measured displacements for cracks grown in both vacuum and humid air environments. The environment alters both the relations between crack tip opening displacement and crack tip strain, and the effect of cyclic stress intensity on these factors. Results of dynamic observation of intermittent crack growth are correlated with fractographic evidence. The relationships between crack tip parameters are used in a previously developed mathematical model. The effect of wet air on fatigue crack growth is found to be a reduction in crack tip plasticity.
FATIGUE‐CRACK ARREST IN MILD STEEL SPECIMENS UNDER CONSTANT AMPLITUDE LOADING
Authors: Pook L. P. , Greenan A. F.
Published: August 2010

Abstract— Unexpected arrest of long fatigue cracks was observed in mild steel single edge notch three‐point bend specimens tested under constant amplitude loading. Arrest was associated with a low, but still positive, slope of the crack length against stress intensity factor curve, and can be explained using the R ‐curve concept for fatigue‐crack growth. At a stress ratio of 0.1, the fatigue threshold was 6.6, 7.3 or 8.0 MN/m3/2 depending on the definition of threshold used. This has obvious implications for both the development of a standard test method for the fatigue threshold and the application of data to practical problems.
THE INFLUENCE OF PRECRACKING TECHNIQUES ON FATIGUE CRACK GROWTH THRESHOLDS UNDER MIXED MODE I/II LOADING CONDITIONS
Authors: Tong J. , Yates J. R. , Brown M. W.
Published: August 2010

Abstract—The influence of precracking history on the subsequent fatigue crack growth thresholds for branch cracks has been studied for AISI 316 stainless steel and BS4360 50D under mixed mode I/II loading. The work has examined: (1) the influence of precrack length; (2) the influence of stress intensity factor range at the final stage of precracking; (3) the influence of precracking loadR‐ratio; and (4) the influence of precracking unloading schemes. A computer controlled precracking test system has been set up in the current investigation and comparisons have been made between the results of computer controlled work and those published previously using a manually controlled technique. The results show that a computer controlled precracking method generally gives more conservative and more repeatable growth threshold values for branch cracks than a manually controlled precracking procedure.
SURFACE AND IN‐DEPTH CRACK PROPAGATION IN HIGH TEMPERATURE LOW‐CYCLE FATIGUE OF SUS 316 STAINLESS STEEL
Authors: Nishino S. , Yamada K.
Published: August 2010

Abstract— The low‐cycle fatigue crack propagation behaviour of surface cracks in SUS316 stainless steel at 700°C, in both the surface direction and the in‐depth direction, has been studied with special emphasis on the role of oxidation. The coalescence behaviour of surface cracks is essential for the process of crack propagation in high temperature low cycle fatigue, irrespective of the existence of oxidation effects. For sub‐surface cracks the process of crack propagation is divided into two stages characterized by differences in fracture mode. In both stages, the in‐depth crack propagation rate in air is higher than that in vacuum. This difference in crack propagation rate is the main reason for the decrease of fatigue life in air compared with that in vacuum. The crack propagation behaviour in the in‐depth direction can be estimated from the conversion of the surface crack length into the subsurface depth by the use of an aspect ratio.
AN EXPERIMENTAL STUDY ON THE OPENING AND CLOSURE BEHAVIOUR OF FATIGUE SURFACE, CORNER AND THROUGH‐THICKNESS CRACKS AT NOTCHES
Authors: Savaidis G. , Seeger T.
Published: August 2010

Abstract— The opening and closure behaviour of surface, corner and through‐thickness cracks in thin notched plates of FeE460 (Kt= 2.5) and A15086 (Kt= 3.4) was experimentally studied. The cracks were initiated and examined under uniaxial fully reversed constant amplitude and two‐step loading. Crack opening load values were measured during crack growth in notch sections with a nonuniform stress distribution using small strain gauges glued to the specimen surface, very close to the crack tip. The results represent a comprehensive set of experimental data for crack opening load values in dependence on crack lengths a, c and load level including the influence of overloads and covering all types of cracks. The results indicate uniform relationships between crack opening load levels and all crack types. Crack opening and closure occur at nearly the same strain level, which depends on the applied load level. The crack opening load values measured at large notched specimens differ from those measured at similar smaller specimens because of the different local stress gradients.
ON THE FRACTURE OF COLD‐WORKED Zr–2.5Nb PRESSURE TUBES FABRICATED FROM 100% RECYCLED MATERIAL
Authors: Davies P. H. , Aitchison I. , Himbeault D. D. , Järvine A. K. , Watters J. F.
Published: August 2010

Abstract A study was completed on irradiated and unirradiated (offcut) material from Pickering Nuclear Generating Station (NGS) A Unit 3 pressure tubes which were fabricated from ingots of 100% recycled material (quadruple‐vacuum‐arc‐melted). The toughness of the material is shown to be generally higher than that of previous material fabricated from < 100% recycled material (double‐vacuum‐arc‐melted). Fractographic and microstructural studies demonstrate that variations in toughness of the low chlorine (< 1 ppm) material are predominantly due to preferential void nucleation at particles, in particular aligned zirconium phosphides. In the absence of such particles, very high toughness levels can be maintained after irradiation.
CORRELATION OF FATIGUE CRACK GROWTH BEHAVIOUR WITH CRACK CLOSURE IN PEENED SPECIMENS
Authors: Zhu X. Y. , Shaw W. J. D.
Published: August 2010

Abstract Various residual stress conditions were introduced into the surface of a 7075‐T6 aluminium alloy by shot peening. This resulted in a considerable alteration in subsequent fatigue crack growth behaviour. A systematic investigation into the effects of a variety of conditions on fatigue crack propagation behavior was conducted. The degree of shot peening was established using the Almen scale and calibration strips. Changes occurred in crack re‐initiation lives, crack growth rate and hardness across the thickness profile. Residual stresses were introduced by various peening operations (such as different peening positions and loading specimens prior to and during peening). By measuring the crack opening level of peened specimens, changes in fatigue crack closure effect with respect to the crack extension in CT specimens are reported. The relations of re‐initiation life versus crack opening level and Almen levels, and of the crack closure effect versus Almen scales, were addressed experimentally. It was found that the improvement in re‐initiation life and the retarding effect of crack growth, both influenced by the Almen scales, are associated directly with the elevation of crack opening level, particularly at the stage of crack re‐initiation.