bluuebunny/crossref_metadata_2025 huggingface dataset:
A Randomized Trial of a Screening, Case Finding, and Referral System for Older Veterans in Primary Care
Authors: Rubenstein Laurence Z. , Alessi Cathy A. , Josephson Karen R. , Trinidad Hoyl M. , Harker Judith O. , Pietruszka Fern M.
Published: January 2007

OBJECTIVES: To test whether a system of screening, assessment, referral, and follow‐up provided within primary care for high‐risk older outpatients improves recognition of geriatric conditions and healthcare outcomes.

DESIGN: Controlled clinical trial with 3‐year follow‐up; intervention versus control group allocation based on practice group assignment.

SETTING: Department of Veterans Affairs (VA) ambulatory care center.

PARTICIPANTS: Seven hundred ninety‐two community‐dwelling patients aged 65 and older identified by postal screening survey.

INTERVENTION: The intervention combined a structured telephone geriatric assessment by a physician assistant, individualized referrals and recommendations, selected referral to outpatient geriatric assessment, and ongoing telephone case management.

MEASUREMENTS: Main outcomes were VA medical record evidence of recognition and evaluation of target geriatric conditions (depression, cognitive impairment, urinary incontinence, falls, functional impairment), functional status (Functional Status Questionnaire, FSQ), and hospitalization (VA databases and self‐reported non‐VA usage).

RESULTS: Intervention participants were more likely to have target conditions recognized, evaluated, and referred to specialized services within 12 months of enrollment, although there were no significant differences in FSQ scores or acute hospitalization between intervention and control groups at 1, 2, or 3 years follow‐up. Subgroup analyses suggested improvements in depression symptoms and functional impairment at 1‐year follow‐up in intervention participants with these problems at baseline, but these findings were not evident at later follow‐up.

CONCLUSION: The intervention increased recognition and evaluation of target geriatric conditions but did not improve functional status or decrease hospitalization. Innovative screening methods can identify older people in need of geriatric services, but achieving measurable improvement in functional status or hospitalization rates will likely require a more‐intensive intervention than a program involving primarily unsolicited referrals and short‐term consultations.
Association Between Advance Directives and Quality of End‐of‐Life Care: A National Study
Authors: Teno Joan M. , Gruneir Andrea , Schwartz Zachary , Nanda Aman , Wetle Terrie
Published: January 2007

OBJECTIVES: To examine the role of advance directives (ADs) 10 years after the Patient Self‐Determination Act.

DESIGN: Mortality follow‐back survey.

SETTING: People who died in a nursing home, hospital, or at home.

PARTICIPANTS: Bereaved family member or other knowledgeable informant.

MEASUREMENTS: Telephone interviewers that asked about the use of written ADs, use of life‐sustaining treatment, and quality of care by asking whether staff provided desired symptom relief, treated the dying with respect, supported shared decision‐making, coordinated care, and provided family with the needed information and emotional support.

RESULTS: Of the 1,587 people who died, 70.8% had an AD. Persons who died at home with hospice or in a nursing home were more likely to have an AD. In addition, those with an AD were less likely to have a feeding tube (17% vs 27%) or use a respirator in the last month of life (11.8% vs 22.0%). Bereaved family members who reported that the decedent did not have an AD were more likely to report concerns with physician communication (adjusted odds ratio (AOR)=1.4, 95% confidence interval (CI)=1.1–1.6) and with being informed about what to expect (AOR=1.2, 95% CI=1.0–1.3). No statistically significant differences were observed in other outcomes. Even in those with an AD, important quality concerns remained; one in four reported an unmet need in pain, one in two reported inadequate emotional support for the patient, and one in three stated inadequate family emotional support.

CONCLUSION: Bereaved family member report of completion of an AD was associated with greater use of hospice and fewer reported concerns with communication, yet important opportunities remain to improve the quality of end‐of‐life care.
Shear Bond Strength Evaluation of Different Veneering Systems on Ni‐Cr Alloys
Authors: Çiftçi Yalçın , Canay Şenay , Hersek Nur
Published: January 2007

Purpose: The aim of this study was to evaluate the shear bond strength of four esthetic veneering materials on nickel‐chromium (Ni‐Cr) alloy.

Materials and Methods: Forty square patterns (10 × 10 × 1.5 mm) were cast with Ni‐Cr, divided equally into four groups, and received four treatments for veneering: conventional porcelain‐fused‐to‐metal (PFM), Artglass, Targis/Vectris, and Biodent light‐cured prosthodontic composite resins. After sandblasting of the cast metal surfaces with 50 μm alumina, the composites were applied to the surfaces according to manufacturers' recommendations. Shear bond strength was determined at a crosshead speed of 0.5 mm/min. Results were analyzed statistically with Kruskal‐Wallis analysis of variance and multiple comparison tests.

Results: Mean shear bond strength values were 34.96 MPa for PFM, 14.17 MPa for Targis/Vectris, 13.64 MPa for Artglass, and 10.56 MPa for Biodent. The PFM group exhibited significantly higher bond strength values compared with the other three groups (p < 0.001).

Conclusion: PFM showed considerably higher shear bond strength values than the three metal‐resin bonding techniques.
Transfusion‐related acute lung injury surveillance (2003‐2005) and the potential impact of the selective use of plasma from male donors in the American Red Cross
Authors: Eder Anne F. , Herron Ross , Strupp Annie , Dy Beth , Notari Edward P. , Chambers Linda A. , Dodd Roger Y. , Benjamin Richard J.
Published: January 2007

BACKGROUND:American Red Cross surveillance data on transfusion‐related acute lung injury (TRALI) fatalities were analyzed to evaluate the association with components from donors with white blood cell (WBC) antibodies and to examine the potential impact of the selective transfusion of plasma from male donors.

STUDY DESIGN AND METHODS:Suspected TRALI reports in 2003 through 2005 were identified and all fatalities were reviewed and classified by three physicians as “probable TRALI” or of “unrelated etiology,” with independent review of the associated serologic investigation. Hospital investigational and reporting biases could not be fully controlled in this retrospective study.

RESULTS:A total of 550 reports of suspected TRALI, including 72 fatalities, were investigated. The number of reports increased each year and the rate varied by geographic region. Retrospective review of fatalities revealed 38 cases of probable TRALI, the majority (24 of 38 [63%]) after plasma transfusion. A female, WBC antibody–positive donor was involved in 71 percent (27 of 38) of cases and in 75 percent (18 of 24) of cases involving plasma transfusion. Female antibody‐positive donors were more likely to be associated with probable TRALI than with unrelated cases (p = 0.0001; odds ratio [OR], 9.5; 95% confidence interval [CI], 2.9‐31.1]. The rate of probable TRALI among recipient fatalities was higher for plasma components (1:202,673; OR, 12.5; 95% CI, 5.4‐28.9) and apheresis platelets (PLTs; 1:320,572; OR, 7.9; 95% CI, 2.5‐24.8) compared to red cells (1:2,527,437). Male donors contributed 64.5 and 52.0 percent of distributed apheresis PLTs and plasma components, respectively, in 2005.

CONCLUSION:Plasma components linked to female donors with WBC antibodies were responsible for the majority of probable TRALI fatalities. Prudent measures to limit transfusion of WBC antibody–containing plasma components may prevent as many as six fatalities per year in the Red Cross system.
Optimal Security Design and Dynamic Capital Structure in a Continuous‐Time Agency Model
Authors: DeMARZO PETER M. , SANNIKOV YULIY
Published: January 2007

We derive the optimal dynamic contract in a continuous‐time principal‐agent setting, and implement it with a capital structure (credit line, long‐term debt, and equity) over which the agent controls the payout policy. While the project's volatility and liquidation cost have little impact on the firm's total debt capacity, they increase the use of credit versus debt. Leverage is nonstationary, and declines with past profitability. The firm may hold a compensating cash balance while borrowing (at a higher rate) through the credit line. Surprisingly, the usual conflicts between debt and equity (asset substitution, strategic default) need not arise.
Does the Contribution of Corporate Cash Holdings and Dividends to Firm Value Depend on Governance? A Cross‐country Analysis
Authors: PINKOWITZ LEE , STULZ RENÉ , WILLIAMSON ROHAN
Published: January 2007

Agency theories predict that the value of corporate cash holdings is less in countries with poor investor protection because of the greater ability of controlling shareholders to extract private benefits from cash holdings in such countries. Using various specifications of the valuation regressions of Fama and French (1998), we find that the relation between cash holdings and firm value is much weaker in countries with poor investor protection than in other countries. In further support of the importance of agency theories, the relation between dividends and firm value is weaker in countries with stronger investor protection.
Information, Trading, and Volatility: Evidence from Weather‐Sensitive Markets
Authors: FLEMING JEFF , KIRBY CHRIS , OSTDIEK BARBARA
Published: January 2007

We find that trading‐ versus nontrading‐period variance ratios in weather‐sensitive markets are lower than those in the equity market and higher than those in the currency market. The variance ratios are also substantially lower during periods of the year when prices are most sensitive to the weather. Moreover, the comovement of returns and volatilities for related commodities is stronger during the weather‐sensitive season, largely due to stronger comovement during nontrading periods. These results are consistent with a strong link between prices and public information flow and cannot be explained by pricing errors or changes in trading activity.
Information Cascades: Evidence from a Field Experiment with Financial Market Professionals
Authors: ALEVY JONATHAN E. , HAIGH MICHAEL S. , LIST JOHN A.
Published: January 2007

Previous empirical studies of information cascades use either naturally occurring data or laboratory experiments. We combine attractive elements from each of these lines of research by observing market professionals from the Chicago Board of Trade (CBOT) in a controlled environment. Analysis of over 1,500 individual decisions suggests that CBOT professionals behave differently from our student control group. For instance, professionals are better able to discern the quality of public signals and their decisions are not affected by the domain of earnings. These results have implications for market efficiency and are important in both a positive and normative sense.
Whom You Know Matters: Venture Capital Networks and Investment Performance
Authors: HOCHBERG YAEL V. , LJUNGQVIST ALEXANDER , LU YANG
Published: January 2007

Many financial markets are characterized by strong relationships and networks, rather than arm's‐length, spot market transactions. We examine the performance consequences of this organizational structure in the context of relationships established when VCs syndicate portfolio company investments. We find that better‐networked VC firms experience significantly better fund performance, as measured by the proportion of investments that are successfully exited through an IPO or a sale to another company. Similarly, the portfolio companies of better‐networked VCs are significantly more likely to survive to subsequent financing and eventual exit. We also provide initial evidence on the evolution of VC networks.
Accuracy of Intracardiac Echocardiography for Assessing the Esophageal Course Along the Posterior Left Atrium: A Comparison to Magnetic Resonance Imaging
Authors: KENIGSBERG DAVID N. , LEE BENJAMIN P. , GRIZZARD JOHN D. , ELLENBOGEN KENNETH A. , WOOD MARK A.
Published: January 2007

Background: Atrioesophageal fistula is a potentially fatal complication of ablation in the left atrium (LA) to treat atrial fibrillation.

Objective: The objective of our study was to systematically evaluate the diagnostic potential of intracardiac echocardiography (ICE) for accurately assessing the esophageal course along the posterior LA.

Methods: Thirty‐five patients underwent magnetic resonance imaging (MRI) before and ICE during pulmonary vein (PV) isolation to visualize the esophagus. The location of the esophagus was determined in relation to the PVs and anatomic regions of the LA by both ICE and MRI. Using the MRI images as a reference, the accuracy of ICE localization was assessed.

Results: The most common location for the esophagus to appear was the mid‐posterior wall (80% of patients by ICE, 71% of patients by MRI), followed by the left posterior wall (71% of patients by ICE, 63% of patients by MRI) and the right posterior wall (60% of patients by ICE, 51% of patients by MRI). The esophagus was seen to course near the left PV antrums (left superior PV antrum 34% of patients by ICE and MRI; left inferior PV antrum 34% of patients by ICE, 37% of patients by MRI), left superior PV (17% of patients by ICE, 20% of patients by MRI), left inferior PV (17% of patients by ICE and MRI), right inferior PV antrum (29% of patients by ICE, 37% of patients by MRI) and the right inferior PV (3% of patients by ICE, 17% of patients by MRI). The sensitivity for esophageal location by ICE compared to that by MRI ranged between 33% (right inferior PV) and 92% (left superior PV antrum, left inferior PV antrum, and mid‐posterior wall). The specificity for esophageal location by ICE compared to that by MRI ranged between 60% (mid‐posterior wall) and 100% (right inferior PV). The positive predictive value ranged between 80% (left inferior PV) and 100% (right inferior PV). The negative predictive value ranged between 84% (right inferior PV antrum) and 96% (left superior PV antrum).

Conclusion: Phased array ICE provides rapid, real‐time localization of the esophagus during LA ablation that is comparable to MRI.
The Diagnosis of Cardiac Arrhythmias: A Prospective Multi‐Center Randomized Study Comparing Mobile Cardiac Outpatient Telemetry Versus Standard Loop Event Monitoring
Authors: ROTHMAN STEVEN A. , LAUGHLIN JAMES C. , SELTZER JONATHAN , WALIA JASJIT S. , BAMAN RAKESH I. , SIOUFFI SAMER Y. , SANGRIGOLI ROBERT M. , KOWEY PETER R.
Published: January 2007

Introduction: Ambulatory electrocardiographic monitoring systems are frequently used in the outpatient evaluation of symptoms suggestive of a cardiac arrhythmia; however, they have a low yield in the identification of clinically significant but infrequent, brief, and/or intermittently symptomatic arrhythmias. The purpose of this study was to compare the relative value of a mobile cardiac outpatient telemetry system (MCOT) with a patient‐activated external looping event monitor (LOOP) for symptoms thought to be due to an arrhythmia.

Methods and Results: The study was a 17‐center prospective clinical trial with patients randomized to either LOOP or MCOT for up to 30 days. Subjects with symptoms of syncope, presyncope, or severe palpitations who had a nondiagnostic 24‐hour Holter monitor were randomized. The primary endpoint was the confirmation or exclusion of a probable arrhythmic cause of their symptoms. A total of 266 patients who completed the monitoring period were analyzed. A diagnosis was made in 88% of MCOT subjects compared with 75% of LOOP subjects (P = 0.008). In a subgroup of patients presenting with syncope or presyncope, a diagnosis was made in 89% of MCOT subjects versus 69% of LOOP subjects (P = 0.008). MCOT was superior in confirming the diagnosis of clinical significant arrhythmias, detecting such events in 55 of 134 patients (41%) compared with 19 of 132 patients (15%) in the LOOP group (P < 0.001).

Conclusions: MCOT provided a significantly higher yield than standard cardiac loop recorders in patients with symptoms suggestive of a significant cardiac arrhythmia.
Relationship between Slow Coronary Flow and Left Atrial Appendage Blood Flow Velocities
Authors: Demirbag Recep , Gur Mustafa , Yilmaz Remzi , Arslan Sukru , Guler Niyazi
Published: January 2007

Aims: This study was undertaken to assess whether slow coronary flow (SCF)
is related to low left atrial appendage (LAA) blood flow velocities. Methods: Study subjects consist of 44 patients with SCF and 11 volunteer subjects with normal coronary angiogram. The diagnosis of SCF was made using the TIMI frame count method. The blood flow velocities were obtained by placing a pulsed‐wave Doppler sample volume inside the proximal third of the LAA. Results: The mean LAA emptying velocities (MEV)
were significantly lower in patients than control subjects (34.5 ± 9.9 cm/sec vs 84.0 ± 12.1 cm/sec; P < 0.001). In bivariate analysis, significant correlation was found between MEV, and systolic pulmonary venous flow, mean TIMI frame count, deceleration time, and isovolumetric relaxation time (P < 0.05). By multiple linear regression analysis, mean TIMI frame count (ß=–0.865, P < 0.001) was identified as independent predictors of MEV. Conclusion: This study indicates that SCF phenomenon may be related to low LAA blood flows.
Peripheral neuroblastic tumours in eastern Denmark 1972–2002
Authors: ZIMLING ZARAH GLAD , RECHNITZER CATHERINE , RASMUSSEN MARIANNE , PETERSEN BODIL LAUB
Published: January 2007

The peripheral neuroblastic tumour group includes neuroblastoma, ganglioneuroblastoma and ganglioneuroma. Neuroblastoma is the most common extracranial solid tumour of childhood. We have evaluated the histological presentation, MYCN gene status, and clinical course of peripheral neuroblastic tumours diagnosed and treated in eastern Denmark from 1972–2002. 125 patients were diagnosed with peripheral neuroblastic tumour during this 30‐year period. The histological material was reviewed and classified into three categories in accordance with the Shimada system: unfavourable histology, favourable histology, and benign tumours. MYCN status was determined by fluorescent in situ hybridization (FISH) on paraffin sections from the primary tumour. Clinical information was obtained from hospital records. Diagnostic likelihood ratios in the two groups were calculated to compare the ability of MYCN status and histological classification to predict 5‐year outcome. 41 tumours showed unfavourable histology, 30 tumours showed favourable histology, 11 were benign, and 43 were unclassifiable due to limited amounts of primary tumour, bad preservation or inaccessibility of the primary tumour necessitating metastatic tumour biopsy for diagnosis. Unfavourable histology was associated with widespread disease (p<0.001). The overall 5‐year survival rate was 45%, which correlates well with the European survival rate reported for this time period. The 5‐year survival rate in the unfavourable group was 30% as compared to 100% in the favourable histology group (p<0.001). The survival rate in the unclassifiable group was 13%. 26% of the neuroblastomas were MYCN amplified. MYCN amplification was associated with undifferentiated histology, a histological subtype of the unfavourable histology group (p<0.001). For unfavourable histology the positive diagnostic likelihood ratio was 2.9 as compared to 4.7 for MYCN amplification. The study has confirmed the prognostic significance of the Shimada system in the peripheral neuroblastic tumour group in a retrospective material, and has also demonstrated the prognostic superiority of MYCN compared to histological classification, thus reducing the necessary amounts of tumour tissue.
Different ways to antiangiogenesis by angiostatin and suramin, and quantitation of angiostatin‐induced antiangiogenesis
Authors: BAHRAMSOLTANI MAHTAB , PLENDL JOHANNA
Published: January 2007

Angiogenesis, i.e. sprouting of new vessels, their remodelling and regression, is a prerequisite for growth and differentiation of organs and tissues. It is involved in many pathological processes, particularly growth and metastasis of tumours. Angiostatic therapy is a promising new strategy in the treatment of cancer. Angiogenesis inhibitors could intervene in the different phases of the angiogenic cascade, i.e. migration, proliferation, differentiation and three‐dimensional organisation of endothelial cells, to inhibit the generation of tumour vessels. The aim of this study was to explore whether in a previously validated in vitro model for quantitation of angiogenesis the effects of the angiostatic factors angiostatin and suramin can be investigated and quantified. Examination of angiostatin and suramin showed that angiostatin‐induced antiangiogenesis resulted in inverse angiogenesis. The addition of suramin initially resulted in increased angiogenesis. However, long‐term incubation ultimately led to disintegration of endothelial structures, thus establishing the angiostatic effects of suramin. Antiangiogenesis was not only quantified using the previously validated method. It also lent itself to assessment of the extent of antiangiogenesis within the various phases of the angiogenic cascade. This method may therefore be employed in trial studies of potential angiostatic substances and related cellular mechanisms.
Optic nerve invasion of uveal melanoma.
Authors: LINDEGAARD JENS , ISAGER PETER , PRAUSE JAN ULRIK , HEEGAARD STEFFEN
Published: January 2007

The aim of the study was to identify the histopathological characteristics associated with the invasion of the optic nerve of uveal melanoma and to evaluate the association between invasion of the optic nerve and survival. In order to achieve this, all uveal melanomas with optic nerve invasion in Denmark between 1942 and 2001 were reviewed (n=157). Histopathological characteristics and depth of optic nerve invasion were recorded. The material was compared with a control material from the same period consisting of 85 cases randomly drawn from all choroidal/ciliary body melanomas without optic nerve invasion. Prelaminar/laminar optic nerve invasion was in multivariate analysis associated with focal retinal invasion, neovascularization of the chamber angle, and scleral invasion. Postlaminar invasion was further associated with non‐spindle cell type and rupture of the inner limiting membrane of the retina. The optic nerve was invaded in four different ways: 1) by tumor extension from the neuroretina through the lamina cribrosa; 2) by direct extension into the optic nerve head between Bruch's membrane and the border tissue of Elschnig; 3) by direct invasion through the border tissue of Elschnig; and 4) in one case a tumor spread along the inner limiting membrane to the optic nerve through the lamina cribrosa. Invasion of the optic nerve had no impact on all‐cause mortality or melanoma‐related mortality in multivariate analyses. The majority of melanomas invading the optic nerve are large juxtapapillary tumors invading the optic nerve because of simple proximity to the nerve. A neurotropic subtype invades the optic nerve and retina in a diffuse fashion unrelated to tumor size or location.
Mutational analysis of PTPRT phosphatase domains in common human cancers
Authors: LEE JONG WOO , JEONG EUN GOO , LEE SUNG HAK , NAM SUK WOO , KIM SANG HO , LEE JUNG YOUNG , YOO NAM JIN , LEE SUG HYUNG
Published: January 2007

A recent report revealed that the protein‐tyrosine phosphatase, receptor‐type, T (PTPRT) gene is somatically mutated in several types of human cancer, suggesting that the mutated PTPRT gene is a tumor suppressor gene in human cancers. However, because previously the mutational search has focused primarily on colon cancers, data on PTPRT mutations in other types of human cancer have largely been lacking. Here, we performed a mutational analysis of the PTPRT phosphatase domain by polymerase chain reaction‐based single‐strand conformation polymorphism (PCR‐SSCP) assay in 345 cases of common human cancers, including colon carcinomas, hepatocellular carcinomas, acute leukemias, gastric carcinomas, breast carcinomas and non‐small cell lung cancers. We detected PTPRT phosphatase domain mutations in 1 of 105 colon carcinomas (1%) and 1 of 48 gastric carcinomas (2%), but none in acute leukemias, hepatocellular carcinomas, breast carcinomas and non‐small cell lung cancers. The PTPRT mutation detected in the colon carcinoma was a missense mutation and the mutation in the gastric carcinomas was a splice‐site mutation. Contrary to the previous report on the frequent PTPTR phosphatase domain mutations in colon cancers, this study demonstrated that the somatic mutation of the PTPRT phosphatase domain rarely occurred in common human cancers. The data suggested that alterations of the PTPRT‐mediated signaling pathway by PTPRT phosphatase domain mutation may not play a critical role in the development of common human cancers.
Downregulation of cell cycle modulators p21, p27, p53, Rb and proapoptotic Bcl‐2‐related proteins Bax and Bak in cutaneous melanoma is associated with worse patient prognosis: preliminary findings
Authors: Tchernev Georgi , Orfanos C.E.
Published: January 2007

Background:  Cutaneous melanoma is a tumor with high metastatic potential, but the mechanisms leading to progression are still not fully understood. To provide further molecular basis for understanding the progression of melanoma, the aim of this study was to examine the expression pattern of cell cycle modulators (p21, p27, p53 and Rb) and proapoptotic multidomain Bcl‐2 related proteins (Bax and Bak) and to analyze its differences in patients with and without progression stages.

Methods:  We have studied 31 patients with cutaneous melanoma at stage IIa (Breslow thickness 1.5–4.0 mm), and follow them for 10‐year period. Eighteen of these patients developed metastasis. The determination of selected molecular markers participating in cell cycle regulation and apoptosis was performed by immunohistochemistry.

Results:  We have observed a significant increase in the loss of expression of the Bax, Bak, p21, p27, p53 and Rb. The analysis of the relationship between these downregulated markers and Breslow thickness showed significant positive correlation (r = 0.556, p = 0.029) and predictive value if thickness below 2.3 mm (OR = 3.0, 95% CI = 0.312–28.84).

Conclusions:  Our study showed that the downregulation of the markers associated with cell cycle control and apoptosis is of great value in predicting malignant transformation and in assessing the risk of metastases development for 10‐year follow‐up period.
Endometriosis: clinical monitoring and treatment procedures in Rhesus Monkeys
Authors: Mattison Julie A. , Ottinger Mary Ann , Powell Douglas , Longo Dan L. , Ingram Donald K.
Published: January 2007

The National Institute on Aging (NIA) sponsored a workshop on September 8, 2004, to discuss the incidence, diagnosis, and clinical treatment of endometriosis in rhesus monkey colonies. Because of the growing number of aging studies using rhesus monkeys, this disease has become more prevalent as monkeys are living into advanced ages in captivity. The objective of the workshop was to gather information from various NIA‐supported aging rhesus colonies on the incidence, clinical manifestations, indicators for early detection, and possible treatment options for endometriosis. Participants outlined a course of action for the effective management of this disease that would best maintain the integrity of long‐term aging studies.
Granulated and Non‐Granulated Decidual Prolactin‐Related Protein‐Positive Decidual Cells in the Pregnant Mouse Endometrium
Authors: Candeloro Luciane , Zorn Telma M.T.
Published: January 2007

Problem

Identification of the cell types responsible for the synthesis of decidual prolactin‐related protein (dPRP) in the pregnant mouse endometrium.

Method of study

Histochemistry and immunocytochemistry were used to determine peri‐implantation dPRP and perlecan distribution in the mouse uterus.

Results

We identified dPRP in pre‐decidual and mature decidual cells from days 5 to 12 of pregnancy. On day 8, dPRP immunoreactivity was detected within cytoplasmic granules of a specific population of granulated decidual cells (GDCs). In mesometrial decidual cells, weak immunoreactivity was seen from days 7 to 14. Between days 11 and 14, dPRP was found in cytoplasm and in the extracellular matrix surrounding islands of spongiotrophoblast. Perlecan, a heparan sulfate proteoglycan, was co‐localized with dPRP.

Conclusion

GDCs are a putative source of dPRP in pregnant mice. Co‐localization of perlecan with dPRP suggests that the former acts as a dPRP reservoir and facilitates its paracrine effect in developing placental tissues.
Combined Thrombophilic Mutations in Women with Unexplained Recurrent Miscarriage
Authors: Sotiriadis Alexandros , Vartholomatos George , Pavlou Matthaios , Kolaitis Nicolaos , Dova Leucothea , Stefos Theodor , Paraskevaidis Evangelos , Kalantaridou Sophia N.
Published: January 2007

Problem

To compare the prevalence of five common thrombophilic polymorphisms and their combination in women with recurrent miscarriage and a control group.

Method of study

Genomic analysis using polymerase chain reaction (PCR) was carried out in patients with two or more miscarriages and controls for Factor V Leiden, Factor V A1299H (HR2), Factor II G20210A, MTHFR C677T and MTHFR A1298C. Secondary analyses were made for number of miscarriages and gestational age at miscarriage.

Results

None the mutations was associated with significantly increased risk for recurrent miscarriage. The prevalence of combined thrombophilias (4/88 versus 2/88) did not increase the risk for miscarriage (OR 2.04, 95% CI 0.36–11.47). Although virtually all patients with thrombophilia had miscarriages ≤10 weeks, statistical significance was not reached due to the small size of the >10 weeks’ subgroup. There was no difference in the distribution of Factor V Leiden (P = 1.000), FII G20210A (P = 0.652), and MTHFR C677T (P = 0.869) between patients with two and three or more miscarriages, whereas MTHFR A1298C was more common among patients with two miscarriages (P = 0.017).

Conclusions

Combinations of the five thrombophilic mutations studied are an uncommon event with heterogeneous pattern and they do not significantly increase the risk for miscarriage.
Local Markers for Prediction of Women at Higher Risk of Developing Sequelae to Chlamydia trachomatis Infection
Authors: Agrawal Tanvi , Vats Vikas , Salhan Sudha , Mittal Aruna
Published: January 2007

Problem

Chlamydial infections are often associated with various fertility‐related disorders. Serological prediction of these has limitations, as they do not differentiate between past and current infections. Thus, we looked for local markers that could predict more precisely women at higher risk of developing severe complications.

Method of study

A total of 320 Chlamydia trachomatis positive women with or without fertility disorders were tested for the prevalence of immunoglobulin A antibodies to synthetic peptides of chlamydial heat‐shock protein 60 (cHSP60) and cHSP10 along with cervical interferon‐gamma (IFN‐γ) and serum C‐reactive protein (CRP) levels.

Results

Positive IFN‐γ level was the single best predictor for fertility disorder [odds ratio (OR) 15.4]. The predictive value of IFN‐γ could be significantly improved only by the addition of CRP test (OR 37.9).

Conclusion

Positive IFN‐γ levels in cervical washes along with elevated CRP levels could be used to predict women who are at higher risk of developing fertility disorders.
Recurrent Pregnancy Loss and Inappropriate Local Immune Response to Sex Hormones
Authors: Itsekson Alek M. , Seidman Daniel S. , Zolti Matityahu , Lazarov Anneta , Carp Howard J.A.
Published: January 2007

Problem

The cause of recurrent miscarriage is often unknown. Recurrent miscarriage may be associated with inappropriate responses to progesterone and estrogen. We examined whether the condition may be diagnosed by skin testing.

Method of study

In a longitudinal prospective study, the weal and flare reaction after intradermal injection of estradiol and progesterone was compared in 29 women with recurrent miscarriage to the response in 10 healthy women. Reactions were evaluated after 20 min, 24, and 48 hr and 5 days later.

Results

Estrogen hypersensitivity was found in 23 patients, and progesterone hypersensitivity in 20 patients. No patient in the control group demonstrated sex hormone hypersensitivity.

Conclusion

Recurrent pregnancy loss may be associated with inappropriate local immune responses to sex hormones. Further research is necessary into the mechanisms of hypersensitivity to estrogen and progesterone and their interactions with other systems.
The spread of prions through the body in naturally acquired transmissible spongiform encephalopathies
Authors: Beekes Michael , McBride Patricia A.
Published: January 2007

Transmissible spongiform encephalopathies are fatal neurodegenerative diseases that are caused by unconventional pathogens and affect the central nervous system of animals and humans. Several different forms of these diseases result from natural infection (i.e. exposure to transmissible spongiform encephalopathy agents or prions, present in the natural environment of the respective host). This holds true also for scrapie in sheep, bovine spongiform encephalopathy in cattle, chronic wasting disease in elk and deer, or variant Creutzfeldt–Jakob disease in humans, all of which are assumed to originate predominantly from peroral prion infection. This article intends to provide an overview of the current state of knowledge on the spread of scrapie, chronic wasting disease, bovine spongiform encephalopathy and variant Creutzfeldt–Jakob disease agents through the body in naturally affected hosts, and in model animals experimentally challenged via the alimentary tract. Special attention is given to the tissue components and spreading pathways involved in the key stages of prion routing through the body, such as intestinal uptake, neuroinvasion of nerves and the central nervous system, and centrifugal spread from the brain and spinal cord to peripheral sites (e.g. sensory ganglia or muscles). The elucidation of the pathways and mechanisms by which prions invade a host and spread through the organism can contribute to efficient infection control strategies and the improvement of transmissible spongiform encephalopathy diagnostics. It may also help to identify prophylactic or therapeutic approaches that would impede naturally acquired transmissible spongiform encephalopathy infections.
Regulation of tristetraprolin during differentiation of 3T3‐L1 preadipocytes
Authors: Lin Nien‐Yi , Lin Chung‐Tien , Chen Yu‐Ling , Chang Ching‐Jin
Published: January 2007

Tristetraprolin is a zinc‐finger‐containing RNA‐binding protein. Tristetraprolin binds to AU‐rich elements of target mRNAs such as proto‐oncogenes, cytokines and growth factors, and then induces mRNA rapid degradation. It was observed as an immediate‐early gene that was induced in response to several kinds of stimulus, such as insulin and other growth factors and stimulators of innate immunity such as lipopolysaccharides. We observed that tristetraprolin was briefly expressed during a 1–8 h period after induction of differentiation in 3T3‐L1 preadipocytes. Detailed analysis showed that tristetraprolin mRNA expression was stimulated by fetal bovine serum and differentiation inducers, and was followed by rapid degradation. The 3′UTR of tristetraprolin mRNAs contain adenine‐ and uridine‐rich elements. Biochemical analyses using RNA pull‐down, RNA immunoprecipitation and gel shift experiments demonstrated that adenine‐ and uridine‐rich element‐binding proteins, HuR and tristetraprolin itself, were associated with tristetraprolin adenine‐ and uridine‐rich elements. Functional characterization confirmed that tristetraprolin negatively regulated its own expression. Thus, our results indicated that the tight autoregulation of tristetraprolin expression correlated with its critical functional role in 3T3‐L1 differentiation.
Molecular basis of cerebral neurodegeneration in prion diseases
Authors: Tatzelt Jörg , Schätzl Hermann M.
Published: January 2007

The biochemical nature and the replication of infectious prions have been intensively studied in recent years. Much less is known about the cellular events underlying neuronal dysfunction and cell death. As the cellular function of the normal cellular isoform of prion protein is not exactly known, the impact of gain of toxic function or loss of function, or a combination of both, in prion pathology is still controversial. There is increasing evidence that the normal cellular isoform of the prion protein is a key mediator in prion pathology. Transgenic models were instrumental in dissecting propagation of prions, disease‐associated isoforms of prion protein and amyloid production, and induction of neurodegeneration. Four experimental avenues will be discussed here which address scenarios of inappropriate trafficking, folding, or targeting of the prion protein.
Tissue expression and biochemical characterization of human 2‐amino 3‐carboxymuconate 6‐semialdehyde decarboxylase, a key enzyme in tryptophan catabolism
Authors: Pucci Lisa , Perozzi Silvia , Cimadamore Flavio , Orsomando Giuseppe , Raffaelli Nadia
Published: January 2007

2‐Amino 3‐carboxymuconate 6‐semialdehyde decarboxylase (ACMSD, EC 4.1.1.45) plays a key role in tryptophan catabolism. By diverting 2‐amino 3‐carboxymuconate semialdehyde from quinolinate production, the enzyme regulates NAD biosynthesis from the amino acid, directly affecting quinolinate and picolinate formation. ACMSD is therefore an attractive therapeutic target for treating disorders associated with increased levels of tryptophan metabolites. Through an isoform‐specific real‐time PCR assay, the constitutive expression of two alternatively spliced ACMSD transcripts (ACMSD I and II) has been examined in human brain, liver and kidney. Both transcripts are present in kidney and liver, with highest expression occurring in kidney. In brain, no ACMSD II expression is detected, and ACMSD I is present at very low levels. Cloning of the two cDNAs in yeast expression vectors and production of the recombinant proteins, revealed that only ACMSD I is endowed with enzymatic activity. After purification to homogeneity, this enzyme was found to be a monomer, with a broad pH optimum ranging from 6.5 to 8.0, a Km of 6.5 µm, and a kcat of 1.0 s−1. ACMSD I is inhibited by quinolinic acid, picolinic acid and kynurenic acid, and it is activated slightly by Fe2+ and Co2+. Site‐directed mutagenesis experiments confirmed the catalytic role of residues, conserved in all ACMSDs so far characterized, which in the bacterial enzyme participate directly in the metallocofactor binding. Even so, the properties of the human enzyme differ significantly from those reported for the bacterial counterpart, suggesting that the metallocofactor is buried deep within the protein and not as accessible as it is in bacterial ACMSD.
Audit on extracorporeal shockwave lithotripsy of renal and ureteric stones in Tuen Mun Hospital using Dornier Lithotripter S
Authors: Au Wing‐Hang , Yu Cheong , Yung Yee‐Ping , Chan Wai‐Hee , Mah Ida Soo‐Fan , Man Chi‐Wai
Published: January 2007

Objectives:  We report our results of an audit on extracorporeal shockwave lithotripsy (ESWL) of renal and ureteric stones using the Dornier Lithotripter S (Dornier MedTech, Wessling, Germany).

Materials and Methods:  We retrospectively reviewed the outcome of ESWL for patients treated between March and December 2003 (pilot). Prospective collection of data was performed for patients treated between October 2004 and March 2005 (re‐audit) after an upgrade to the power unit of our shockwave emitter by the manufacturer in September 2004. Patient demographic data, target stone characteristics and treatment outcome were recorded. Analysis of the results between the two periods was made.

Results:  ESWL was performed on 232 and 220 target stones in the pilot and re‐audit periods, respectively. Patient demographic data and stone characteristics were similar between the two periods. Clinical success (stone fragments less than 4 mm in size after one session of ESWL) was achieved in 31% and 61% (stone‐free 19% and 38%) of patients in the pilot and re‐audit periods, respectively (P < 0.0001, χ2 test). Patients requiring re‐treatment with ESWL to achieve success and auxiliary procedure reduced to 8% and 5%, respectively, in the re‐audit period (pilot: 14% and 14%, respectively). The overall complication rate was reduced from 6.2% (pilot) to 3.3% (re‐audit). Obstructive complications significantly reduced from 4.8% to 0.5% (pilot vs re‐audit, Fisher’s exact test, P = 0.012).

Conclusion:  Effectiveness of our lithotripter was significantly improved and obstructive complications were significantly reduced after an upgrade to the power unit of the electromagnetic shockwave emitter of our lithotripter.
Rhinolith of endogenous origin: A rare entity
Authors: Shaw Leslie Chi‐Kee
Published: January 2007

An unusual case of chronic unilateral nasal obstruction and rhinorrhoea is reported in which an elderly female patient with previous cleft palate repair developed rhinoliths around a tooth within the nasal cavity. The diagnosis of rhinolith should be suspected if a calcified nasal mass is evident radiologically in a patient with unilateral nasal symptoms. Complete resolution of nasal symptoms is easily achieved with surgical removal of rhinoliths. This case highlights the importance of examining the nasal cavities in any adult patient with a unilateral nasal symptom. Computerized tomography of sinuses is a useful adjunct to determine the diagnosis. If the diagnosis is in doubt, referral for an otolaryngologist’s assessment should be made.
Rare case of spontaneous rupture of a urinary bladder carcinoma causing intestinal obstruction and peritonitis
Authors: Rangarajan Muthukumaran , Jayakar Salem M.
Published: January 2007

Spontaneous rupture of the urinary bladder is a rare condition, especially due to squamous cell carcinoma. Less than 10 cases have been reported so far. The patient was a 30‐year‐old male presenting with difficulty passing urine, dribbling, dysuria and right loin pain of 4 days duration and constipation for 2 days. He then developed features of intestinal obstruction with peritonitis. Laparotomy revealed advanced urinary bladder carcinoma adherent to the ileum and urine in the peritoneal cavity. There was a perforation of the urinary bladder separate from the area of adherence. Palliative surgery was performed. Histopathology report was squamous cell carcinoma. The present case is being reported, as it is a diagnostic dilemma and is a rare condition, this being only the seventh case reported in the literature. The mortality rate is high and even though the patient had postoperative problems, he survived.
Optimal surgical treatment for bilateral multinodular goitre
Authors: Karanikolic Aleksandar , Pesic Milica , Djordjevic Nebojsa , Kocic Radivoj , Radenkovic Sasa , Pesic Miomir , Stankovic‐Djordjevic Dobrila
Published: January 2007

Objective:  In the present study, we compared subtotal thyroidectomy (STT) with total thyroidectomy (TT) in the management of bilateral multinodular goitre.

Methods:  A total of 204 consecutive patients with bilateral multinodular goitre were assigned to have either TT (n = 73) or STT (n = 131). Demographic details, hospital stay, biochemical findings, indications for operation and complications were noted.

Results:  There was no significant difference in the age and sex ratio between the two groups (P = 0.695 and P = 0.733). According to thyroid functional status, the majority of patients were euthyroid in both groups (73.28%vs 84.90%). Goitre grades II and III presented the most common indication for STT and TT. Hospital stay for patients who underwent TT was significantly longer compared to STT (P < 0.001). There was no significant difference in the rate of permanent complications.

Conclusions:  In the present study, we have shown that the risk of permanent complications with TT is no greater than with STT.
Thermal sensitivity of Phytophthora cinnamomi and long‐term effectiveness of soil solarisation to control avocado root rot
Authors: Gallo L. , Siverio F. , Rodríguez‐Pérez A.‐M.
Published: January 2007

Root rot caused by the fungus Phytophthora cinnamomi is a major disease of avocados worldwide. Heat sensitivity of a collection of P. cinnamomi isolates was determined by exposing agar discs containing mycelium or mycelium plus chlamydospores at various temperatures for different periods. Long‐term effectiveness of soil solarisation to control Phytophthora root rot was evaluated in two field trials. In the first, soil disinfestation by solarisation was applied in 1990 to a naturally infested plot before planting avocado (Persea americana) and viñatigo (Persea indica) seedlings. In the second trial, established avocado trees were solarised for four consecutive summers (1996–1999). Results for heat sensitivity showed that fungal mycelium was inactivated after 1–2 h at 38°C. However, 1–2 h at 40°C was needed to kill all propagules when chlamydospores were present. Fungal growth inhibition after thermal treatments was related to levels of time and temperature, and detrimental effects occurred as consequence of sublethal thermal doses. Soil solarisation presented long‐term positive effects when applied as a preplanting treatment. Five years after solarisation, disease severity (0–5 scale where 0 = healthy and 5 = dead plant) of avocado and viñatigo planted in solarised soil was 2.03 and 0.71, respectively, compared with 4.65 and 4.84 in controls. Eleven years after solarisation, the percentage of dead plants in solarised soil was 73% for avocado and 43% for viñatigo but 100% in controls. In contrast, an insufficient level of control was observed in established orchards, probably because of the lower temperature reached during solarisation under the shade of tree canopy. In this situation, maximum temperatures at 5‐cm depth were 10–13.7°C lower than under solar‐heated mulch, only exceeding 40°C in 1997.
Syntactic Priming
Authors: Branigan Holly
Published: January 2007

Syntactic priming effects, or the tendency to repeat syntactic structure across otherwise unrelated utterances, have been extensively investigated over the last two decades. Because such effects rely upon the language processor recognising a syntactic relationship between two utterances, they offer a versatile behavioural tool for investigating how syntactic structure is represented by the human cognitive system. In this paper, we review existing evidence to show that such effects can be truly syntactic in nature, and that they suggest syntactic representations that in many ways resemble strikingly those proposed by theoretical linguists on the basis of nonbehavioural measures. We suggest that there is a surprising dichotomy between the pervasiveness of such effects in contexts involving language production and their apparent elusiveness in language comprehension. We consider how syntactic priming research can cast light on issues of theoretical linguistic interest, including language use in special populations, and evaluate alternative explanations for the effects.