bluuebunny/crossref_metadata_2025 huggingface dataset:
MANAGEMENT TO PREVENT BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION USING THE FLUSH KNIFE FOR GASTRIC TUMORS
Authors: Toyonaga Takashi , Nishino Eisei , Dozaiku Toshio , Ueda Chie , Hirooka Tomoomi
Published: July 2007

The gastric vasculature responsible for intraoperative bleeding in endosocpic submucosal dissection (ESD) is the ramified vascular network occupying the middle of the submucosal layer and large vessels penetrating the muscle layer. Appropriate management for these vessels must be addressed. The trimming of the ramified vascular network can be safely performed with coagulation mode following shallow mucosal cutting. A large penetrating vessel usually requires precoagulation prior to dissection. These procedures are effectively performed with the water jet short needle knife (Flush knife).
Processing of melodic contours in urethane‐anaesthetized rats
Authors: Ruusuvirta Timo , Koivisto Kalle , Wikgren Jan , Astikainen Piia
Published: July 2007

The human brain can automatically detect changes even in repeated melodic contours of spectrally varying sounds. However, it is unclear whether this ability is specific to humans. We recorded event‐related potentials (ERPs) in urethane‐anaesthetized Wistar rats presented with rare pairs of tones (‘deviants’) interspersed with frequently repeated ones (‘standards’). The frequency of the tones varied nonsystematically across their pairs so that deviants stood out from standards only in the melodic ordering (ascending or descending) of the tones of a pair. We found that the absolute amplitude of the ERP was significantly higher to deviants than standards between 106 and 136 ms from the onset of the deviance, suggesting that the ability to automatically detect changes in higher‐order invariant attributes that emerge from consecutive sounds is not specific to humans.
Ketamine is effective in decreasing the incidence of emergence agitation in children undergoing dental repair under sevoflurane general anesthesia
Authors: ABU‐SHAHWAN IBRAHIM , CHOWDARY KHALID
Published: July 2007

Background:  Emergence agitation or delirium is a known phenomenon that may occur in children undergoing general anesthesia with inhaled agents. Our aim was to test the hypothesis that the addition of a small dose of ketamine at the end of sevoflurane anesthesia will result in a decrease in the incidence and severity of such phenomenon.

Methods:  We performed a randomized double blind study involving 85 premedicated children 4–7 years old undergoing dental repair. Children were premedicated with acetaminophen and midazolam. Anesthesia was induced and maintained with sevoflurane in N2O/O2. Group K received ketamine 0.25 mg·kg −1 and Group S received saline. We evaluated recovery characteristics upon awakening and during the first 30 min using the Pediatric Anesthesia Emergence Delirium scale.

Results:  Eighty of the 85 enrolled children completed the study. There were 42 children in Group I. Emergence agitation was diagnosed in seven children in the ketamine group (16.6%) and in 13 children in the placebo group (34.2%). There was no difference in time to meet recovery room discharge criteria between the two groups.

Conclusions:  We conclude that the addition of ketamine 0.25 mg·kg−1 can decrease the incidence of emergence agitation in children after sevoflurane general anesthesia.
The Chilean Socialist Party (PSCh): Constructing Consent and Disarticulating Dissent to Neo-Liberal Hegemony in Chile
Authors: Motta Sara C.
Published: July 2007

Adopting a neo-Gramscian framework, I argue that the Chilean Socialist Party (PSCh), as part of the governing Concertación coalition, has played a key role in constructing consent and disarticulating dissent to neo-liberal hegemony in Chile. This is the result of its co-optation into the neo-liberal historic bloc formed during the Pinochet dictatorship, of which the Concertación is the democratic political face. This process occurs in relation to the popular classes within, and outside, the PSCh, actualised by a series of intra-party, extra-party, policy-making and policy-discourse mediations. The analysis of the PSCh's role in (re)producing neo-liberal hegemony in Chile helps to unlock the black box of empirical and theoretical investigation as regards the construction of consent to neo-liberalism in the subordinated. In doing so it highlights the conflictual, contradictory and therefore contingent nature of this process.
Urban Housing as an Issue of Redistribution through Planning? The Case of Dhaka City
Authors: Begum Anwara
Published: July 2007

The rapid growth of population, the mushrooming of poor settlements and unplanned urbanization have crucial implications for the efficiency and equity of urban services. The resultant infringements of critical human rights throw into focus the importance of housing as a social policy issue. Urban services are strained in Dhaka city. Urban management has been disrupted as a result of spatial encroachment and environmental degradation. In addition to land scarcity, land speculation and endemic corruption, the high price of land is also a product of the system of land registration. The dearth of valuable urban land, together with delays in urban planning and its implementation, have made the acquisition of land for housing prohibitively expensive for middle and low‐income households. Consequently, the quality of the housing environment is deteriorating. The problem of housing finance is intrinsically linked to its affordability, being currently the prerogative only of the affluent. This article delineates the inherent lack of integrated urban planning, the lacunae within institutions responsible for urban management – and, contextually, the nature of housing as a social policy issue, where reinforced, coordinated planning and administration could ensure distributive benefits even to the poor.
BRINGING IN THE DEAD: BURIALS AND THE LOCAL PERSPECTIVE ON KYTHERA IN THE SECOND PALACE PERIOD
Authors: PRESTON LAURA
Published: July 2007

Summary.  This article analyses the mortuary data of the ‘Second Palace’ period (c. 1700–1450 BC) on the Aegean island of Kythera. It proposes that the chamber tombs which were first introduced to the island in this period can offer potential insights into aspects of local‐level social relations, especially at the central site of Kastri. This approach complements the broader cultural perspective that has usually been taken regarding these tombs, which have been viewed as indicators of Cretan cultural influence and, indeed, colonization. It is proposed that a strong horizontal in‐group solidarity was being expressed by the tomb‐using group at Kastri through spatial and diachronic uniformity in burial practices, and that this uniformity should be viewed at least partially as a response to local‐level social agendas. The hypothesis is then explored that status identities were also being asserted in the burial sphere by at least some members of this group, through tomb location, the resources devoted to mortuary rituals and, perhaps, emphasis on lineage.
THE TIMING OF SIGNALING: TO STUDY IN HIGH SCHOOL OR IN COLLEGE?*
Authors: Lee Sanghoon
Published: July 2007

American students study harder in college than in high school, whereas East Asian students study harder in high school than in college. This article proposes a signaling explanation. Signaling may occur over time both in high school and in college, and societies may differ in the timing of signaling. Students work harder in the signaling stage determined by the society as a whole. A testable implication is that high ability workers in East Asia are more concentrated among a few colleges than their U.S. counterparts. This implication is confirmed by top CEO education profile data in the United States and Korea.
USING LOTTERIES TO FINANCE PUBLIC GOODS: THEORY AND EXPERIMENTAL EVIDENCE*
Authors: Lange Andreas , List John A. , Price Michael K.
Published: July 2007

This study explores the economics of charitable fund‐raising. We begin by developing theory that examines the optimal lottery design while explicitly relaxing both risk‐neutrality and preference homogeneity assumptions. We test our theory using a battery of experimental treatments and find that our theoretical predictions are largely confirmed. Specifically, we find that single‐ and multiple‐prize lotteries dominate the voluntary contribution mechanism both in total dollars raised and the number of contributors attracted. Moreover, we find that the optimal fund‐raising mechanism depends critically on the risk postures of potential contributors and preference heterogeneity.
EFFICIENT MECHANISMS FOR MERGERS AND ACQUISITIONS*
Authors: Brusco Sandro , Lopomo Giuseppe , Robinson David T. , Viswanathan S.
Published: July 2007

We characterize incentive‐efficient merger outcomes when payments can be made both in cash and stock. Each firm has private information about both its stand‐alone value and a component of the (possibly negative) potential synergies. We study two cases: when transfers can, and cannot, be made contingent on the value of any new firm. When they can, we show that redistributing shares of any nonmerging firm generates information rents and provides necessary and sufficient conditions for the implementability of efficient merger rules. When they cannot, private information undermines efficiency more when it concerns stand‐alone values than synergies. Here, acquisitions emerge as optimal mechanisms.
ECONOMIES WITH PUBLIC PROJECTS: EFFICIENCY AND DECENTRALIZATION*
Authors: Graziano Maria Gabriella
Published: July 2007

The article deals with the two fundamental theorems of welfare economics for production economies with a finite set of agents, infinitely many private goods, and a set of public projects. The problem of efficiency and decentralization is addressed under the following very general assumptions: (a) the commodity–price duality is endowed with a consistent locally convex topology; (b) the set of public projects is without any mathematical structure. Moreover, any agent is characterized by a nonordered preference relation depending on consumption goods and public projects. Approximate and exact welfare theorems are discussed throughout the article.
Reward prediction error signals associated with a modified time estimation task
Authors: Holroyd Clay B. , Krigolson Olave E.
Published: July 2007

The feedback error‐related negativity (fERN) is a component of the human event‐related brain potential (ERP) elicited by feedback stimuli. A recent theory holds that the fERN indexes a reward prediction error signal associated with the adaptive modification of behavior. Here we present behavioral and ERP data recorded from participants engaged in a modified time estimation task. As predicted by the theory, our results indicate that fERN amplitude reflects a reward prediction error signal and that the size of this error signal is correlated across participants with changes in task performance.
Studies on UV reflection in feathers of some 1000 bird species: are UV peaks in feathers correlated with violet‐sensitive and ultraviolet‐sensitive cones?
Authors: MULLEN PETER , POHLAND GEORG
Published: July 2007

Nine hundred and sixty‐eight bird species, covering all orders, were studied in search of distinctive ultraviolet reflections. All species in the following orders were completely surveyed: Struthioniformes, Tinamiformes, Craciformes, Turniciformes, Galbuliformes, Upupiformes, Coliiformes, Apodiformes and Musophagiformes. The coloured plumage regions in particular exhibited high proportions of UV‐reflecting feathers. Bird orders with species which are believed to possess VS (violet‐sensitive) cone types mostly had their UV maxima between 380 and 399 nm while orders with species which are assumed to have UVS (ultraviolet‐sensitive) cone types contained significantly species which had their UV maxima between 300 and 379 nm. With an emphasis on non‐passerine birds the present study provides evidence that birds of many more groups may see UV light than have been studied to date. Ecological aspects related to UV reflection and perception, as well as sexual dimorphism visible only in the UV, are discussed.
Anthropogenic and environmental determinants of Greater Flamingo Phoenicopterus roseus breeding numbers and productivity in the Camargue (Rhone delta, southern France)
Authors: BECHET ARNAUD , JOHNSON ALAN R.
Published: July 2007

Predicting how bird populations may respond to climate change is a major challenge which could be addressed by understanding how past environmental processes have driven the variations of breeding population size and productivity. In inhabited regions, this issue may be complicated by the interference associated with heterogeneous levels of habitat management. Here, we have explored how several hydrological variables influenced the breeding of the Greater Flamingo Phoenicopterus roseus in the Camargue (Rhone delta, southern France) over a 28‐year period (1974–2001). In this region, Flamingos breed in a commercial salt pan. They forage in both salt pans and adjacent brackish lagoons. We hypothesized that breeding numbers, productivity and body condition of chicks at fledging were influenced positively by water levels of the Vaccares, the main lagoon of the delta, in spring (water and food availability) and the Rhone discharge in winter (nutrient availability in the salt pans). We controlled for variations of the flooding date of the breeding salt pan by the salt company and the size of the breeding island. We first found the Vaccares water levels and Rhone discharge to be negatively correlated with the North Atlantic Oscillation (NAO). Secondly, the number of Flamingo breeding pairs (range 3560–22 200) increased by 1767 ± 1418 (95% CI) with a 10‐day advance of the flooding date of the breeding salt pan and by 1146 ± 1081 per 10‐cm water level rise in the Vaccares. Productivity was 0.46 ± 0.41 chicks per pair and could not be explained by any of the variables considered. Finally, chick body condition decreased with the number of breeding pairs and Rhone discharge. Our results show that (1) this intensely managed system remains sensitive to large‐scale climate variations, (2) the breeding of the Greater Flamingo is affected by both climate variations and management of the salt pan, and (3) the expected enhancement of delta productivity by high river discharge was absent, probably prevented by dykes and embankments along the river. The response of bird populations to climate variations can thus be complex in intensely managed biological systems as found in the Mediterranean. We encourage pursuing such analyses incorporating anthropogenic variables explicitly in order to expand our capacity to make inference on the future of these systems.
Rare Adverse Medical Events in VA Inpatient Care: Reliability Limits to Using Patient Safety Indicators as Performance Measures
Authors: West Alan N. , Weeks William B. , Bagian James P.
Published: July 2007

Objective. To assess Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs) as performance measures using Veterans Administration hospitalization data.

Data Sources Study Setting. Nine years (1997–2005) of all Veterans Health Administration (VA) administrative hospital discharge data.

Study Design. Retrospective analysis using diagnoses and procedures to derive annual rates and standard errors for 13 PSIs.

Data Collection/Extraction Methods. For either hospitals or hospital networks (Veterans Integrated Service Networks [VISNs]), we calculated the percentages whose PSI rates were consistently high or low across years, as well as 1‐year lagged correlations, for each PSI. We related our findings to the average annual number of adverse events that each PSI represents. We also assessed time trends for the entire VA, by VISN, and by hospital.

Principal Findings. PSI rates are more stable for VISNs than for individual hospitals, but only for those PSIs that reflect the most frequent adverse events. Only the most frequent PSIs yield significant time trends, and only for larger systems.

Conclusions. Because they are so rare, PSIs are not reliable performance measures to compare individual hospitals. The most frequent PSIs are more stable when applied to hospital networks, but needing large patient samples nullifies their potential value to managers seeking to improve quality locally or to patients seeking optimal care.
Regression Tree Boosting to Adjust Health Care Cost Predictions for Diagnostic Mix
Authors: Robinson John W.
Published: July 2007

Objective. To assess the ability of regression tree boosting to risk‐adjust health care cost predictions, using diagnostic groups and demographic variables as inputs. Systems for risk‐adjusting health care cost, described in the literature, have consistently employed deterministic models to account for interactions among diagnostic groups, simplifying their statistical representation, but sacrificing potentially useful information. An alternative is to use a statistical learning algorithm such as regression tree boosting that systematically searches the data for consequential interactions, which it automatically incorporates into a risk‐adjustment model that is customized to the population under study.

Data Source. Administrative data for over 2 million enrollees in indemnity, preferred provider organization (PPO), and point‐of‐service (POS) plans from Thomson Medstat's Commercial Claims and Encounters database.

Study Design. The Agency for Healthcare Research and Quality's Clinical Classification Software (CCS) was used to sort 2001 diagnoses into 260 diagnosis categories (DCs). For each plan type (indemnity, PPO, and POS), boosted regression trees and main effects linear models were fitted to predict concurrent (2001) and prospective (2002) total health care cost per patient, given DCs and demographic variables.

Principal Findings. Regression tree boosting explained 49.7–52.1 percent of concurrent cost variance and 15.2–17.7 percent of prospective cost variance in independent test samples. Corresponding results for main effects linear models were 42.5–47.6 percent and 14.2–16.6 percent.

Conclusions. The combination of regression tree boosting and a diagnostic grouping scheme, such as CCS, represents a competitive alternative to risk‐adjustment systems that use complex deterministic models to account for interactions among diagnostic groups.
The Allocational Effects of the Precision of Accounting Estimates
Authors: DYE RONALD A. , SRIDHAR SRI S.
Published: July 2007

This paper studies the allocational effects associated with the precision of accounting estimates when the precision of estimates is a choice variable for firms. One part of the paper considers the effects of the observability of precision choices. We show that, generally, making precision choices private increases firms' equilibrium precision choices and also, as a by‐product, their equilibrium investment choices. We further show that, when firms' precision choices are private, there may be a “disclosure trap,” in which, unless investors conjecture the owner has chosen an estimate with the highest possible precision, the owner will respond to investors' conjecture by choosing an estimate whose precision is higher than investors' conjecture.

In a multifirm version of the model with endogenous investment, we show that the equilibrium investment by the firm increases in the precision of the firm's own estimate and decreases in the precisions of other firms' estimates.

Finally, we show that, in a setting where the firm's initial owner sells his stake in the firm over the course of two periods, with disclosures of estimates of the firm's value occurring prior to each sale of shares, if the precisions of the estimates are public, the equilibrium precisions of the estimates increase over time when the owner sells a sufficiently large fraction of the firm in the first period, and otherwise the equilibrium precisions of estimates remain constant over time.
Mutational Analysis of EFHC1 Gene in Italian Families with Juvenile Myoclonic Epilepsy
Authors: Annesi Ferdinanda , Gambardella Antonio , Michelucci Roberto , Bianchi Amedeo , Marini Carla , Canevini Maria Paola , Capovilla Giuseppe , Elia Maurizio , Buti Daniela , Chifari Rosanna , Striano Pasquale , Rocca Francesca E. , Castellotti Barbara , Cali Francesco , Labate Angelo , LePiane Emilio , Besana Dante , Sofia Vito , Tabiadon Giulietta , Tortorella Gaetano , Vigliano Piernanda , Vignoli Aglaia , Beccaria Francesca , Annesi Grazia , Striano Salvatore , Aguglia Umberto , Guerrini Renzo , Quattrone Aldo
Published: July 2007

Summary:  Objectives: Mutations in the EFHC1 gene have been reported in six juvenile myoclonic epilepsy (JME) families from Mexico and Belize. In this study, we screened 27 unrelated JME Italian families for mutations in the EFHC1 gene.

Materials and Methods: Twenty‐seven families (86 affected individuals, 52 women) with at least two affected members with JME were selected. DNA was isolated from peripheral blood lymphocytes by standard methods and each exon of the EFHC1 gene was amplified and sequenced using intronic primers.

Results: Two heterozygous mutations were identified in three unrelated families. One (R353 W) was a novel missense mutation, while the F229 L mutation was previously described (say which on of the two occurred in two families). Both mutations cosegregated with the disease. In a fourth family, the variant 545G→A (resulting in the amino acid substitution R182 H) cosegregated with JME.

Conclusions: The results of our study extend the distribution of EFHC1 mutations to the white population and confirm the high level of genetic heterogeneity associated with JME.
Infrastructure Vulnerability Assessment Model (I‐VAM)
Authors: Ezell Barry Charles
Published: July 2007

Quantifying vulnerability to critical infrastructure has not been adequately addressed in the literature. Thus, the purpose of this article is to present a model that quantifies vulnerability. Vulnerability is defined as a measure of system susceptibility to threat scenarios. This article asserts that vulnerability is a condition of the system and it can be quantified using the Infrastructure Vulnerability Assessment Model (I‐VAM). The model is presented and then applied to a medium‐sized clean water system. The model requires subject matter experts (SMEs) to establish value functions and weights, and to assess protection measures of the system. Simulation is used to account for uncertainty in measurement, aggregate expert assessment, and to yield a vulnerability (Ω) density function. Results demonstrate that I‐VAM is useful to decisionmakers who prefer quantification to qualitative treatment of vulnerability. I‐VAM can be used to quantify vulnerability to other infrastructures, supervisory control and data acquisition systems (SCADA), and distributed control systems (DCS).
Critical Asset and Portfolio Risk Analysis: An All‐Hazards Framework
Authors: Ayyub Bilal M. , McGill William L. , Kaminskiy Mark
Published: July 2007

This article develops a quantitative all‐hazards framework for critical asset and portfolio risk analysis (CAPRA) that considers both natural and human‐caused hazards. Following a discussion on the nature of security threats, the need for actionable risk assessments, and the distinction between asset and portfolio‐level analysis, a general formula for all‐hazards risk analysis is obtained that resembles the traditional model based on the notional product of consequence, vulnerability, and threat, though with clear meanings assigned to each parameter. Furthermore, a simple portfolio consequence model is presented that yields first‐order estimates of interdependency effects following a successful attack on an asset. Moreover, depending on the needs of the decisions being made and available analytical resources, values for the parameters in this model can be obtained at a high level or through detailed systems analysis. Several illustrative examples of the CAPRA methodology are provided.
Phase Evolution During Formation of SrAl2O4 from SrCO3 and α‐Al2O3/AlOOH
Authors: Chang Yu‐Lun , Hsiang Hsing‐I , Liang Ming‐Tsai
Published: July 2007

Through the execution of experimental investigation, thermogravimetry, X‐ray diffractometry, Fourier transform‐infrared spectrometry, transmission electron microscopy, and energy‐dispersive spectrometry, a variant reaction mechanism model was proposed for the solid‐state reaction between SrCO3 and Al2O3/AlOOH for formation of SrAl2O4 material. The solid‐state reaction is observed to be dependent on the calcination temperature. At temperatures lower than the transformation temperature of SrCO3 from orthorhombic to hexagonal (920°C), the reaction is attributed to the interfacial reaction between SrCO3 and alumina. Conversely, at temperatures higher than that, the solid‐state reaction is dominated by the diffusion of Al3+ ions into the SrCO3 lattice. In this mechanism, two metastable species, hexagonal SrCO3 and hexagonal SrAl2O4, were observed. The activation energies of SrCO3 decomposition in the solid‐state reaction also support these results. The interfacial reaction at low temperatures is characterized by a high activation energy of ∼130 kJ/mol; whereas, in the reaction at higher temperatures, the activation energy of SrCO3 decomposition decreases to 34 kJ/mol.
Mediation in War: Winning Hearts and Minds Using Mediated Condolence Payments
Authors: Joseph Jeremy
Published: July 2007

When an Iraqi noncombatant civilian is killed in the crossfire between the U.S. military and insurgents, the victim's family can apply for a “condolence payment” of up to $2,500 as a token of condolence and sympathy. As the process currently stands, the family member is handed a sum of money by U.S. personnel and ushered out the door. In this model, money equals apology. In this article, the author argues that the efficacy and efficiency of the current condolence payment program could be greatly increased by adding Arab‐Muslim mediation techniques tailored to Iraqi culture. Mediation would fill a gap in the current program to help foster a constructive, stabilizing dialogue between the U.S. military and aggrieved Iraqi civilians. The author believes that with each positive, mediated interaction — each reconciliative engagement between an aggrieved Iraqi civilian, a mediator, and a U.S. military representative — the U.S. military can prevent today's aggrieved Iraqi parent, sibling, or child from becoming tomorrow's insurgent.

This article was written with two goals. The implementation of a mediated condolence payment program, even on a limited or pilot basis, would likely increase the chances of American success in Iraq and improve the daily lives of Iraqi civilians. If it is not possible to implement such a program in Iraq before American involvement there ends, then it may still have value as an important component of the post‐conflict nation‐building playbook of the U.S. and other foreign forces.
Mortalin is a novel mediator of erythropoietin signaling
Authors: Ohtsuka Rie , Abe Yasunobu , Fujii Tomomi , Yamamoto Masahiro , Nishimura Junji , Takayanagi Ryoichi , Muta Koichiro
Published: July 2007

Erythropoietin (EPO) stimulates erythroid growth by enhancing the proliferation, maturation and survival of late‐stage erythroid progenitor cells. However, the entire process of EPO stimulation remains undetermined. To further clarify the intracellular mechanisms by which EPO affects the growth of erythroid progenitor cells, we analyzed proteins obtained from purified human erythroid colony‐forming cells (ECFCs) cultured with or without EPO, and one of the proteins apparently related with EPO stimuli was identified as mortalin (mthsp70/PBP74/Grp75/mot‐2), which is a member of the heat shock protein 70 family of chaperones. The amount of mortalin mRNA in ECFCs increased in an EPO dose‐dependent manner, and ECFC growth was dependent on the amount of mortalin. Furthermore, expression of mortalin in ECFCs was suppressed by a phosphatidylinositol 3‐kinase inhibitor. Finally, we analyzed gene expression patterns in ECFCs cultured with or without EPO after treatment with mortalin small interfering RNA (siRNA) using a DNA microarray. When ECFCs treated with mortalin siRNA were cultured with EPO, the expression of several genes overlapped with the profile seen in control ECFCs cultured without EPO. Our data suggest that mortalin is involved in the mediation of EPO signaling and plays an important role in stimulating the growth of erythroid progenitor cells.
Tissue microarray is inappropriate for analysis of BCL6 expression in diffuse large B‐cell lymphoma
Authors: Linderoth Johan , Ehinger Mats , Åkerman Måns , Cavallin‐Ståhl Eva , Enblad Gunilla , Erlanson Martin , Jerkeman Mats
Published: July 2007

Objective:  In this study, our aim was to investigate how different immunohistochemical techniques may influence the result of BCL6 positivity and categorization in germinal center (GC) and non‐GC derived diffuse large B‐cell lymphoma (DLBCL), as it has been proposed that classification of DLBCL according to cell‐of‐origin by immunohistochemistry may be performed as a routine procedure in the diagnostic work‐up. However, a number of technical issues need to be solved before introducing this as a standard technique.

Methods:  Tumor specimens from 122 patients with de novo stage II–IV disease, adequately treated with anthracycline‐containing chemotherapy regimens were collected. Immunohistochemical expression of BCL6, CD10, and MUM‐1/IRF4 was examined using a tissue microarray (TMA) technique. BCL6 and CD10 were also evaluated on whole tissue sections.

Results:  Due to profound tissue heterogeneity, BCL6 showed a wide range of positivity, with a high number of false negative results by TMA (25% positive), compared to 53% on whole tissue sections (WTS). CD10 was more homogeneously expressed, and TMA results corresponded better to WTS. Consequently, the results from categorization into GC and non‐GC DLBCL differed considerably by use of the two methods, and resulted in very different outcome in terms of overall survival.

Conclusion:  Immunohistochemical GC‐status determined on TMA is not reliable enough to be used for individual treatment decisions in DLBCL, mostly due to difficulties in interpreting BCL6 status.
≪ L'analogie ambulante ≫ ou Tournier et la force de l'exemple
Authors: Møller Martin Bruun
Published: July 2007

L'article explore la relation quelque peu conflictuelle qu'entretient Michel Tournier avec ≪ la littérature  pour enfants ≫ en analysant les deux romans (Vendredi ou les limbes du Pacifique et Gaspard, Melchior & Balthazar) pour lesquels il existe une réécriture (Vendredi ou la vie sauvage et Les Rois mages). Dans ces textes, en effet, Tournier se montre artisan de l’analogie (souvent distribuée sous forme d'une phrase comparative introduite par ≪ comme ≫) par lequel l'auteur croit atteindre l'intelligence de ses (plus jeunes) lecteurs. Le fait qu'un passage dans la version originale [la VO] et dans la version réécrite [la VR] témoignent d'un remplacement du groupe comparatif (par exemple la substitution de ≪ blanc comme la neige ≫ par ≪ blanc comme un cierge ≫) mérite une analyse, étant donné que ces réécritures semblent suggérer une réévaluation du domaine référentiel des phénomènes désignés. Bien que Tournier estime écrire tout simplement ≪ de son mieux ≫, ces réévaluations font manifester à tout le moins quelques idées partagées avec une littérature pour enfants.
The Symbolic Function of Food as Iconic Representation of Culture and Spirituality in Wolfram von Eschenbach's Parzival (ca 1205)
Authors: Classen Albrecht
Published: July 2007

As recent cultural‐historical studies have demonstrated, a careful analysis of food preparation and consumption can reveal much about a specific culture or society. Moreover, as this paper argues, a focus on a protagonist's attitude toward and reflection of foodstuff and meals can shed important light on his/her intellectual, cultural, and spiritual development. To test this thesis, this paper investigates how Parzival in Wolfram von Eschenbach's eponymous romance operates with food, how he performs in courtly society during banquets, and how his growing education and maturation is demonstrated through his changing behavior with regard to food at large. We can draw the significant conclusion that the growth of this hero is powerfully reflected through his relationship with food.
Transcriptional responses to reinforcing effects of cocaine in the rat hippocampus and cortex
Authors: Krasnova I. N. , Li S. M. , Wood W. H. , McCoy M. T. , Prabhu V. V. , Becker K. G. , Katz J. L. , Cadet J. L.
Published: July 2007

The psychostimulant effects of cocaine are thought to result from its ability to block dopamine (DA) uptake and increase DA levels in ventral striatum. In addition, cocaine causes biochemical changes in the brain areas involved in learning and memory, including hippocampus and cortex, whose role in drug reinforcement is now being actively investigated. Thus, we studied molecular events in the hippocampus and frontal cortex of rats treated with cocaine conditioned place preference (CPP) paradigm. After exposure to cocaine conditioning (cocaine paired), cocaine alone (cocaine non‐paired) or saline rats were tested for place conditioning. Cocaine (10 mg/kg) caused increases in time spent in the drug‐paired compartment. By using microarray analyses, we examined gene expression in the hippocampi and frontal cortices of cocaine‐paired rats, cocaine non‐paired and saline‐treated controls. Our study revealed that 214 transcripts were differentially regulated in the hippocampi of cocaine‐paired rats. These include genes that play roles in protein phosphorylation, RNA processing and protein synthesis, ubiquitin‐dependent protein degradation and cytoskeleton organization. In contrast, 39 genes were differently expressed in the frontal cortex. Our data support the possibility that molecular changes in the hippocampus might participate in the formation and maintenance of memory patterns induced by cocaine in the brain. Differences in the transcriptional responses in the hippocampus and cortex suggest the primary importance of the hippocampus for recent memory processing associated with cocaine‐induced CPP.
Interaction of Peroxides with Amalgam: A Case Report
Authors: DELIPERI SIMONE
Published: July 2007

Nightguard vital bleaching with 10% carbamide peroxide was shown to have some minor effects on certain brands of amalgam mainly related to mercury release. However, in this case report, amalgam staining of the bleaching tray was detected in correspondence of the left and right first upper molars following tooth whitening for a week. These teeth presented mesio occlusal distal amalgam fillings with superficial chipping at the cavosurface margins. The same phenomena did not occur in the mouth with other amalgam intracoronal restorations not showing marginal defects. No decay or discoloration was noted around the amalgam fillings both in the upper and lower teeth.

At the 1‐week recall visit, patient was recommended to avoid the bleaching gel application in the maxillary first molar teeth. The existing fillings were replaced with composite resin restorations after a 2‐week elapse time.

CLINICAL SIGNIFICANCE

The unusual amalgam staining of the bleaching tray suggests that amalgam restorations with defective cavosurface margins should be monitored during the tooth whitening therapy. Alternatively, their replacement should be considered prior to bleaching.
The Female Prostate Revisited: Perineal Ultrasound and Biochemical Studies of Female Ejaculate
Authors: Wimpissinger Florian , Stifter Karl , Grin Wolfgang , Stackl Walter
Published: July 2007

Introduction

Many speculations have been made on the possible existence of a “female prostate gland” and “female ejaculation.” Despite several reports on the subject, controversy still exists around the “female prostate” and whether such a gland might be the source of fluid emitted during orgasm (ejaculation).

Aim

To investigate the ultrasonographic, biochemical, and endoscopic features in two women who reported actual ejaculations during orgasm.

Main Outcome Measures

Perineal ultrasound studies, as well as biochemical characteristics of ejaculate and urethroscopy, have been performed in two women.

Methods

Two premenopausal women—44 and 45 years of age—who actually reported fluid expulsion (ejaculation) during orgasm have been investigated. Ultrasound imaging, biochemical studies of the ejaculated fluid, and endoscopy of the urethra have been used to identify a prostate in the female. Ejaculated fluid parameters have been compared to voided urine samples.

Results

On high-definition perineal ultrasound images, a structure was identified consistent with the gland tissue surrounding the entire length of the female urethra. On urethroscopy, one midline opening (duct) was seen just inside the external meatus in the six-o’clock position. Biochemically, the fluid emitted during orgasm showed all the parameters found in prostate plasma in contrast to the values measured in voided urine.

Conclusions

Data of the two women presented further underline the concept of the female prostate both as an organ itself and as the source of female ejaculation.
Determinants of Sexual Satisfaction in Men with Prostate Cancer
Authors: Nelson Christian J. , Choi Judy M. , Mulhall John P. , Roth Andrew J.
Published: July 2007

Objective

There is a growing debate about the important determinants of sexual satisfaction in men. Some authors argue that men's sexual satisfaction correlates with physical functioning variables such as erection quality and ejaculatory time. Other authors have suggested that the limited literature indicates that men's sexual satisfaction is related to psychosocial variables such as relationship satisfaction, depression, or anxiety. This study is the first to our knowledge to explore this question in men with prostate cancer.

Materials and Methods

This archival, cross-sectional research analyzed quality-of-life, depression, and anxiety data on 352 men with early- and late-stage prostate cancer. Questions from the Functional Assessment of Cancer Therapy Scale-Prostate Cancer Version were used to assess sexual satisfaction, erectile function, and relationship closeness. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression.

Results

In general, the subjects reported low sexual satisfaction with a mean score of 2.3 on a 5-point Likert scale (1–5). In the correlational analyses, arthritis, brachytherapy, and depression/anxiety were all negatively associated with sexual satisfaction, while erectile function and relationship closeness were positively associated with sexual satisfaction (P  < 0.05). In the subsequent multivariate analysis, erectile function (P  < 0.01), relationship closeness (P  < 0.05), and depression/anxiety (P  < 0.05) remained significant predictors of sexual satisfaction. In this model, erectile functioning produced the largest effect (beta = 0.57) as compared to relationship closeness and depression/anxiety (beta values approximately 0.11).

Conclusions

In this sample of men with prostate cancer, both physical and psychosocial variables were found to be important determinants of sexual satisfaction. Erectile function appears to have the strongest association with sexual satisfaction; however, variables such as relationship quality, depression, and anxiety are also clearly related to a satisfying sex life in this sample.
Enhanced External Counterpulsation in Patients with Coronary Artery Disease-Associated Erectile Dysfunction. Part II: Impact of Disease Duration and Treatment Courses
Authors: El-Sakka Ahmed I. , Morsy Ayman M. , Fagih Bassam I.
Published: July 2007

Introduction

Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED).

Aim

To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate of EECP on patients with IHD-associated ED.

Main Outcome Measures

We compared pre- and post-EECP responses to erectile function (EF) domain, Q3 and Q4 of the International Index of Erectile Function score in patients who received one or two courses of EECP and those who had <5- or ≥5-years duration of IHD.

Methods

As mentioned in part I a total of 44 male patients with intractable angina caused by coronary insufficiency were enrolled in this study. Treatment course of EECP consists of 35 1-hour sessions over 7 weeks. Another 35 1-hour sessions over another 7 weeks were offered to patients who received one course and required a second course because of no or minimal improvement from class IV to class III angina after the first course.

Results

Patients who received only one course (N = 34) had significantly higher EF domain, Q3 and Q4, in pre- and post-EECP results than patients who received two courses (N = 10) after they completed the first course. Patients who had <5-years duration of IHD had significantly higher pre- and post EECP than patients who had ≥5 years regarding EF domain, Q3 and Q4. Considering the global efficacy question, overall satisfaction, and angina, there were significant improvements of post EECP in patients with <5 years than in patients with ≥5-years duration of IHD.

Conclusion

The efficacy and satisfaction rate of EECP in patients with IHD-associated ED were negatively influenced by longer duration of IHD and requirement of a second course of EECP.
Prevalence and Risk Factors for Erectile Dysfunction in Korean Men: Results of an Epidemiological Study
Authors: Ahn Tai Young , Park Jong Kwan , Lee Sung Won , Hong Jun Hyuk , Park Nam Cheol , Kim Je Jong , Park Kwangsung , Park Hyesook , Hyun Jae Seog
Published: July 2007

Introduction

The prevalence of erectile dysfunction (ED) and associated risk factors has been described in many countries, but there are still only a few studies from Asia.

Aim

We investigated the prevalences of ED and premature ejaculation (PE) in Korean men and the impact of general health, lifestyle, and psychosocial factors on these conditions.

Methods

To assess ED and PE, 1,570 Korean men aged 40–79 years were interviewed with a self-administered questionnaire on sexual function and the International Index of Erectile Function (IIEF)-5. In addition, blood chemistry was analyzed for each subject.

Main Outcome Measures

The prevalences of ED and PE were obtained from self-reported ED, IIEF-5 scoring, EF (erectile function) domain scoring, and self-reported intravaginal ejaculatory latency time (IELT). The data were analyzed for the presence of risk factors and the relationship of general health, lifestyle, and psychosocial factors with ED.

Results

The prevalences of ED among Korean men were 13.4% (self-reported ED) and 32.4% (IIEF-5 score ≤ 17), and PE prevalences were 11% (IELT ≤ 2-min) and 33.1% (IELT ≤ 5-min). ED was more prevalent in the subject groups with older age, lower income, or lower education, and in subjects without a spouse. ED prevalence was positively associated with risk factors such as diabetes, hypertension, heart disease, psychological stress, and obesity. Levels of serum hemoglobin (Hb) A1c, triglycerides, testosterone, or dehydroepiandrosterone sulfate (DHEA-S) were significantly different between the ED and non-ED groups.

Conclusions

The prevalences of ED and PE in Korean men were 13.4% (self-reported ED) and 11% (IELT ≤ 2-min), respectively. Risk factors and other socioeconomic and mental health factors were associated with ED prevalence. Biochemical factors such as HbA1c, triglycerides, testosterone, and DHEA-S were significantly related to ED prevalence.
Palm Community Structure and Land Cover Changes in the San Juan Biological Corridor, Costa Rica
Authors: Wang Yung‐Ho (Ophelia)
Published: July 2007

Biological corridors connect forest fragments, minimize the isolation of remaining habitats, and reduce the negative impact of fragmentation. Important studies in a corridor include documentation of land cover and the relationships between the plant community and land cover changes. In this study, density, species richness, and species diversity of palms of different life stages and growth forms were documented in forty 10 × 10 m census plots in the San Juan Biological Corridor (SJBC), Costa Rica. Changes in the percent cover of agricultural, partially forested, and forested lands from 1979 to 2001 were quantified based on existing land classifications. Associations between these palm community characteristics and the reduction in forest cover in 200‐m and 1000‐m annuli surrounding the census plots were investigated. These palm community characteristics were spatially interpolated to examine their distributions in SJBC. The community characteristics of palms of all growth forms varied among census plots. Forested lands in SJBC decreased from 88 percent to 26 percent during 1979–2001, while the percentage cover of agricultural and partially forested lands increased. The annual deforestation rate was 0.8 percent from 1979 to 1992, 4.3 percent from 1992 to 1997, and 7.5 percent from 1997 to 2001. Overall, palm community characteristics of small‐canopy palms, dwarf palms, and cotyledonous seedlings had lower values with a lower percentage forest cover. The spatially interpolated palm community characteristics were consistently greatest within or adjacent to protected areas. This study demonstrates the complexity of the landscape and the effect of loss of adjacent forests on the palm community.
Coronary Risk Stratification in Patients with Ischemic Stroke or Transient Ischemic Stroke Attack
Authors: Touzé Emmanuel , Varenne Olivier , Calvet David , Mas Jean-Louis
Published: July 2007

Background

The risk of coronary artery disease (CAD) is traditionally considered high in patients who had an ischemic stroke or a transient ischemic attack (TIA). However, few studies have specifically assessed the absolute risk of coronary events in those patients and predictors of such events are not well known.

Summary of review

The overall risks of myocardial infarction and nonstroke vascular death are each around 2% per year. However, those risks are only about 1% per year in patients without CAD (i.e. the only ones who are likely to benefit from specific additional strategies). The prevalence of asymptomatic CAD ranges from 15% to 60%. Although potentially higher, the risk of CAD in patients with stroke/TIA related to atherosclerosis also seems to vary widely depending on the extent of the disease. Given the relatively low CAD risk, a simple systematic reinforcement of medical treatment in all patients may be not relevant. Up to now, there have been only limited ways to stratify the CAD risk in stroke/TIA patients. High-risk patients may be identified using the traditional cardiac scoring systems, but their validity has never been specifically assessed in stroke populations. The relative influence of traditional risk factors may be altered after a first vascular event. Stroke patients could also be screened for asymptomatic CAD. However, there is no simple and valid screening test for asymptomatic CAD that could be applied to all patients. Finally, there is still uncertainty about the potential benefits of treating asymptomatic CAD. Therefore, should the identification of patients with asymptomatic CAD requiring revascularization become feasible, the relevance of this strategy would remain to be evaluated by a randomized clinical trial.

Conclusion

The absolute risk of CAD in stroke/TIA patients is moderately high. More research is needed to identify high risk patients who could benefit from specific strategies.