bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal and paternal alleles exhibit differential histone methylation and acetylation at maize imprinted genes
Authors: Haun William J. , Springer Nathan M.
Published: August 2008

Imprinting is an epigenetically controlled form of gene regulation in which the expression of a gene is based on its parent of origin. This epigenetic regulation is likely to involve allele‐specific DNA or histone modifications. The relative abundance of eight different histone modifications was tested at various regions in several imprinted maize (Zea mays) genes using a chromatin immunoprecipitation protocol coupled with quantitative allele‐specific single nucleotide polymorphism assays. Histone H3 lysine‐27 di‐ and tri‐methylation are paternally enriched at the imprinted loci Mez1, ZmFie1 and Nrp1. In contrast, acetylation of histones H3 and H4 and H3K4 dimethylation are enriched at the maternal alleles of these genes. Di‐ and tri‐methylation of H3 lysine‐9, which is generally associated with constitutively silenced chromatin, was not enriched at either allele of imprinted loci. These patterns of enrichment were specific to tissues that exhibit imprinting. In addition, the enrichment of these modifications was dependent upon the parental origin of an allele and not sequence differences between the alleles, as demonstrated by reciprocal crosses. This study presents a detailed view of the chromatin modifications that are associated with the maternal and paternal alleles at imprinted loci and provides evidence for common histone modifications at multiple imprinted loci.
Long‐term treatment with aspirin desensitization: a prospective clinical trial comparing 100 and 300 mg aspirin daily
Authors: Rozsasi A. , Polzehl D. , Deutschle T. , Smith E. , Wiesmiller K. , Riechelmann H. , Keck T.
Published: August 2008

Background:  The daily dose of aspirin in desensitization in aspirin‐sensitive asthmatics with nasal polyps is still a matter of debate.

Aims of the study:  To compare two doses of aspirin during the first year of desensitization and to evaluate long‐term effects on nasal/pulmonary symptoms.

Methods:  Patients with positive aspirin provocation test were treated with either 100 or 300 mg aspirin daily.

Results:  In all patients taking 100 mg aspirin (n = 7) recurrent nasal polyps were observed. No patient experienced reduction of asthma medication or improvement of pulmonary function. In the 300 mg group no recurrent nasal polyps were seen. Asthma medication could be reduced in three patients, pulmonary function was improved in five patients. Thirty‐nine consecutively desensitized patients, taking 300 mg aspirin, showed significant improvement of olfaction and polyp‐free nasal passages during the first year of therapy. After a median follow‐up of 27 months no sinus revision surgery was necessary.

Conclusions:  Aspirin desensitization followed by 300 mg aspirin daily is efficacious and results in polyp‐free nasal airways, improvement of sense of smell, and reduction of the need for sinus revision surgery for recurrent nasal polyps. Aspirin in a dose of 100 mg daily is not sufficient to effectively reduce nasal and bronchial or pulmonary symptoms and to prevent recurrent nasal polyps by at least the first 12 months of treatment.
A breath for health: an exploratory study in severe asthma patients in Turkey
Authors: Bavbek S. , Mısırlıgil Z. ,   Study Group
Published: August 2008

Background:  Severe asthma puts enormous burden on patients. To evaluate asthma‐related restrictions on patients’ daily lives along with their expectations about future asthma care.

Methods:  A structured questionnaire was administered to severe asthma patients at 25 centers across Turkey. The patients were divided into; uncontrolled (n: 274) and controlled asthma (n: 177) according to the existence of symptoms despite the GINA step 4 or 5 treatment.

Results:  A total of 451 patients (F/M: 337/114, mean age: 47.6 ± 13.2 years) were included; 93% were nonsmokers and 51.2% were atopic. Chronic rhino‐sinusitis, ASA/NSAID sensitivity, and osteoporosis were significantly higher in uncontrolled patients. Nearly 70% of the uncontrolled asthmatics defined asthma as disturbing with significant restrictions in daily life. The most important role for medication was symptom relief. One inhaler or one tablet a month was the most preferred form of drug usage. In addition, 30.6% of the patients had tried alternative treatment with herbal remedies. Although patients were willing to become members of an asthma association, they expected the Turkish government to provide special asthma clinics and fund research into new treatments. Controlled patients achieved or were close to achieving asthma control goals. Uncontrolled patients seemed to be more pessimistic in this respect, but they reserved significant levels of hope for the future. Two‐thirds of all the patients thought that they would receive better treatment in the next 5 years.

Conclusions:  In this study group, severe asthma patients face significant limitations in their daily lives, but they are optimistic about better asthma control and treatment options in the future.
Allergen inhalation decreases adenosine receptor expression in sputum and blood of asthma patients
Authors: Versluis M. , Van Den Berge M. , Timens W. , Luijk B. , Rutgers B. , Lammers J.‐W. J. , Postma D. S. , Hylkema M. N.
Published: August 2008

Background:  Adenosine is a signalling nucleoside that has been proposed to contribute to the pathogenesis of asthma. Adenosine is produced in inflammatory environments and acts via adenosine receptors (A1R, A2AR, A2BR, and A3R) expressed by a wide variety of cells, resulting in pro‐ and anti‐inflammatory effects.

Objective:  To compare AR expression in asthma patients and healthy subjects, and to assess the effect of allergen challenge on AR expression of inflammatory cells and on cytokines in peripheral blood and sputum in asthma.

Methods:  Asthma patients underwent an allergen challenge, and blood and induced sputum samples were taken before and 24 h after allergen challenge to study inflammatory cells numbers, AR expression and cytokine production. Blood and sputum were investigated at one time point in healthy subjects. AR expression was measured by flow cytometry (blood) or on cytospins using immunocytochemistry (sputum). Cytokines (luminex, ELISA) and adenosine (HPLC) were measured in sputum supernatant.

Results:  The percentage of A2BR expressing neutrophils in sputum was lower in asthma patients than in healthy subjects (P = 0.016). Allergen challenge decreased A1R and A2AR expression on neutrophils and A1R expression on T cells in peripheral blood (all P < 0.05). Allergen challenge increased IL‐8 levels and eosinophil numbers (P < 0.05), whereas it decreased thymic stromal lymphopoietin levels and the percentage of A1R expressing macrophages in induced sputum (P < 0.05).

Conclusions:  Allergen challenge has a down‐regulatory effect on AR expression in asthma, suggesting a contribution of adenosine‐related effector mechanisms in the pathophysiology.
Treatment with anti‐CC chemokine receptor 3 monoclonal antibody or dexamethasone inhibits the migration and differentiation of bone marrow CD34+ progenitor cells in an allergic mouse model
Authors: Ben S. , Li X. , Xu F. , Xu W. , Li W. , Wu Z. , Huang H. , Shi H. , Shen H.
Published: August 2008

Background:  The migration and in situ differentiation of CD34+ progenitors contribute to inflammatory eosinophilia in asthma and corticosteroids have been widely used in asthma. However, little is know about whether and how corticosteroids modulate the migration and differentiation of CD34+ progenitors. This study was aimed to investigate the impact of anti‐CC chemokine receptor 3 (CCR3) or dexamethasone on inflammatory eosinophilia in asthma and possible mechanism(s) underlying the action of dexamethasone or anti‐CCR3 on migration and differentiation of CD34+ progenitors in asthmatic context.

Methods:  Using an asthmatic mouse model, airway inflammation of anti‐CCR3‐ or dexamethasone‐treated mice and that of controls were characterized. And the migration and differentiation of CD34+ progenitor cells were analyzed in vivo, ex vivo or in vitro.

Results:  Treatment with anti‐CCR3 or dexamethasone significantly inhibited allergen‐induced eosinophilia and CD34+ progenitor cell infiltration in the lung, which was accompanied by lower levels of airway hyper‐responsiveness and mucus production. Moreover, anti‐CCR3 inhibited the eotaxin‐mediated migration and IL‐5/eotaxin‐induced differentiation of CD34+ progenitors in vitro. Dexamethasone was also shown to mitigate eotaxin‐mediated migration and IL‐5 or eotaxin‐promoted differentiation of CD34+ progenitor cells ex vivo, which were associated with the down‐regulation of CCR3 expression on bone marrow progenitor cells.

Conclusions:  Treatment with anti‐CCR3 or dexamethasone can inhibit the migration and differentiation of CD34+ progenitor cells by regulating the eotaxin/CCR3 axis in asthmatic mice. Our findings provide new insights into understanding the mechanism(s) underlying the action of dexamethasone and CCR3‐mediated signaling in allergic inflammation and aid in the design of new immunotherapy for intervention of human asthma.
Rationale for randomized controlled trials and for intention‐to‐treat analysis in transfusion medicine: are they one and the same?
Authors: Vamvakas E. C.
Published: August 2008

Articles on the appropriateness of intention‐to‐treat (ITT) vs. as‐treated (AT) analyses of randomized controlled trials (RCTs) have highlighted issues relevant to drug trials, such as approaches suitable for ‘explanatory’ vs. ‘pragmatic’ RCTs. These considerations are less relevant to transfusion medicine RCTs, especially those of red blood cell transfusion therapies where the main issue is whether to include in the analysis randomized patients who did not receive transfusion. This article discusses issues pertinent specifically to transfusion medicine RCTs, and the thesis presented here is that the primary analysis of any transfusion medicine RCT must be based on the ITT principle. This is because the rationale for randomization is to avoid selection bias and to generate experimental arms that are comparable with respect to all, known and unknown, confounding factors. Only the entire arms produced by random allocation of subjects are so comparable, and only an ITT analysis of these entire arms fulfills the purpose of randomization. Withdrawals of randomized patients compromise the comparability of the groups and the rationale for randomization. Deviations from the ITT principle may be valid only when other conditions are met to ensure that non‐adherence to ITT will not bias the results. For RCTs of red blood cell transfusion therapies, such conditions include that the RCTs be double‐blind and that transfusion criteria should be applied consistently. Nonetheless, the rationale for ITT can be reversed in equivalence and non‐inferiority trials where the finding of no difference is the objective of the research; thus, both ITT and AT analyses should be presented in these settings.
Transduction and Transplantation of Spermatogonia into the Testis of Ram Lambs through the Extra‐testicular Rete
Authors: Rodriguez‐Sosa JR , Silvertown JD , Foster RA , Medin JA , Hahnel A
Published: August 2008

Contents

Spermatogonial transplantation will provide a new way to study spermatogenesis in domestic animals, disseminate male genetics and produce transgenic animals, if efficiency can be improved. We evaluated a ‘surgical’ method for transplanting donor cells into testes of ram lambs, where the head of the epididymis is reflected, and a catheter introduced into the extra‐testicular rete testis. We also tested transduction of ram spermatogonia with a lentiviral (LV) vector as a means to identify permanent colonization, and introduce genes into donor cells. Eight ram lambs, 11‐ to 13‐week olds, were the recipients: in five, spermatogonia were injected into one testis, and the contralateral testis was an un‐manipulated control: in two, spermatogonia were injected into one testis and the contralateral was sham‐injected: in one, both testes were injected. Six lambs received spermatogonia labelled with a cell‐tracking dye and these were collected 1 or 2 weeks after transplantation; three lambs received spermatogonia transduced with a LV vector driving the expression of enhanced Green Fluorescence Protein and these were collected after 2 months. Donor cells were detected by immunohistochemistry in tubules of seven of nine recipient testes. Approximately 22% of tubule cross‐sections contained donor cells immediately after transplantation, and 0.2% contained virally transduced cells 2 months after transplantation. The onset of spermatogenesis was delayed, and there were lesions in both injected and sham‐injected testes. Despite the effects of the surgery, elongated spermatids were present in one recipient testis 2 months after surgery. The results suggest that, after modifying the surgical and transduction techniques, this approach will be a means to produce good colonization by donor spermatogonia in sheep testes.
Immunolocalization of Androgen Receptor in the Boar Epididymis: the Effect of GnRH Agonist Deslorelin
Authors: Kopera I , Tuz R , Hejmej A , Schwarz T , Koczanowski J , Bilińska B
Published: August 2008

Contents

Epididymides from nine crossbred male pigs [Polish Landrace × (Duroc × Pietrain)] (n = 3 per each group) were used in this study to show whether there are any differences between androgen receptor (AR) distribution along epididymal duct of a GnRH agonist deslorelin‐treated boars when compared to the control tissues. The active agent was administered by way of a subcutaneous controlled‐release implant containing 4.7 mg deslorelin at 91 or 147 days of age respectively. Boars from two experimental groups and the control group were slaughtered at 175 day of age. Immunolocalization was performed using a polyclonal rabbit antiserum against the AR. In control boars, strong staining for AR was detected in nuclei of the epithelial (principal and basal) and stromal cells, whereas in boars treated with deslorelin the staining was confined to the principal cell nuclei. In those treated for 84 days, AR‐immunostaining was weak or the principal cells were negative for the AR. Irrespective of the time from deslorelin insertion all stromal cells were immunonegative. The results demonstrate for the first time the effect of deslorelin on the distribution of the AR in the three regions of the boar epididymis. It is likely that stromal cells are more sensitive than epithelial cells to the regulation of AR expression by androgen. The morphological and functional alterations along the epididymal duct and lack of spermatozoa within the lumen after deslorelin treatment indicate that a potent GnRH agonist is likely responsible for an impairment of the microenvironment created by epididymal cells for sperm maturation and their storage.
Increasing patient comfort by optimized postoperative administration of intravesical mitomycin C
Authors: Stoehr Brigitte , Mueller Tilko , Granig Thomas , Zangerl Florian , Steiner Hannes
Published: August 2008

OBJECTIVE

To report a prospective controlled study to compare the acceptance of two different ways of administering intravesical mitomycin C, as the immediate intravesical administration of chemotherapy after surgery decreases the risk of recurrence in patients with superficial bladder cancer, but response rates are variable, partly because of inadequate drug delivery and thus an adequate administration time is important for optimum oncological efficacy.

PATIENTS AND METHODS

Between October 2004 and June 2005, 60 patients were divided after transurethral resection of superficial bladder cancer into two groups. Both groups received an intravesical instillation of 40 mg mitomycin C diluted in 40 mL distilled water at ≤6 h after surgery. In group A the catheter was clamped; in group B the catheter was not clamped but the urine bag was elevated to 1 m above the level of the supine patient to enable bladder contractions with no rigid resistance, and mitomycin C was retained within the bladder by hydrostatic pressure. Discomfort and pain were documented by the patient every 15 min. The instillation was terminated after 2 h, or earlier if the pain was not tolerable. The relapse rate during the follow‐up was also recorded.

RESULTS

Histology and the number of tumours resected was not significantly different between the groups. In group A the mean (sd, range) instillation time was 83.4 (3.1, 15–120) min and 11 (37%) patients tolerated all 120 min of treatment. The instillation time in group B was 110.4 (20.9, 60–120) min and 25 (83%) patients completed 120 min. The mean (sd) overall pain levels measured were significantly lower (P ≤ 0.05) in group B, at 2.7 (2.4) in group A and 1.8 (1.3) in group B. There was no remarkable difference between the groups in recurrence rates.

CONCLUSION

Elevation of the urine bag instead of clamping the catheter was associated with a significantly longer instillation, more patients completing the full 2 h of treatment and significantly lower pain sensations. There was no remarkable difference in the groups in recurrence rate during the follow‐up, but this might be because there were few patients in this pilot study.

[Corrections made after online publication 6 August 2008]
Resurgent Metropolis: Economy, Society and Urbanization in an Interconnected World
Authors: SCOTT ALLEN J.
Published: August 2008

An urban problematic is identified by reference to the essential characteristics of cities as spatially polarized ensembles of human activity marked by high levels of internal symbiosis. The roots of the crisis of the classical industrial metropolis of the twentieth century are pinpointed, and the emergence of a new kind of urban economic dynamic over the 1980s and 1990s is discussed. I argue that this new dynamic is based in high degree upon the growth and spread of cognitive‐cultural production systems. Along with these developments have come radical transformations of urban space and social life, as well as major efforts on the part of many cities to assert a role for themselves as national and international cultural centers. This argument is the basis of what we might call the resurgent metropolis hypothesis. The effects of globalization are shown to play a critical role in the genesis and geography of urban resurgence. Three major policy dilemmas of resurgent cities are highlighted, namely, their internal institutional fragmentation, their increasing character as economic agents on the world stage and the concomitant importance of collective approaches to the construction of localized competitive advantage, and their deepening social disintegration and segmentation.

Une problématique urbaine est dégagée à propos des caractéristiques essentielles des villes définies comme des ensembles d'activité humaine polarisés dans l'espace et marqués par une symbiose interne poussée. Les racines de la crise qu'a subie la métropole industrielle classique auxxesiècle sont mises en évidence. Est aussi étudié un nouveau type de dynamique économique urbaine apparu au cours des années 1980‐1990, cette dynamique étant largement fondée sur la croissance et la diffusion des systèmes de production cognitifs culturels. Parallèlement à ces évolutions, l'espace urbain et la vie sociale ont connu des transformations radicales, et nombre de villes ont entrepris de revendiquer un rôle de centre culturel national et international. Cet argument est à la base de ce qu'on pourrait appeler l'hypothèse d'une résurgence des métropoles. Il est montré que les effets de la mondialisation ont compté de façon cruciale dans la genèse et la géographie de la résurgence urbaine. Trois grands dilemmes politiques des ‘villes résurgentes’ sont soulignés: leur fragmentation institutionnelle interne; l'accentuation de leur place d'agents économiques sur la scène mondiale et l'importance concomitante des approches collectives pour construire des avantages concurrentiels localisés; ainsi que l'intensification de leur désintégration et de leur segmentation sociales.
The Role of the Individual – A Key to Learning in Preparedness Organizations
Authors: Nilsson Jerry , Eriksson Kerstin
Published: August 2008

A well functioning societal response to crises is benefited by individuals having adequate skills and knowledge. From a municipal perspective this requires the creation of a learning organization. The objective of this study is to determine whether individual municipal employees, who have the responsibility for preparedness planning, reason and act in ways that promote learning about crises and preparedness issues throughout the municipal organization. Analysis of interviews with preparedness planners in six Swedish municipalities on their strategies for preparedness planning, reveal that preparedness planning too often becomes a demarcated activity, restricted to not more than a handful of individuals. This study indicates that one reason for why the preparedness work becomes demarcated is that individuals central to the preparedness planning are not taking on roles for acting in ways that are required in order for a learning organization to be established.
The pattern of expression of Notch protein members in normal and pathological endometrium
Authors: Cobellis Luigi , Caprio Francesca , Trabucco Elisabetta , Mastrogiacomo Annunziata , Coppola Gabriele , Manente Lucrezia , Colacurci Nicola , De Falco Maria , De Luca Antonio
Published: August 2008

The objective of this study was to investigate the pattern of expression and the localization of Notch‐1, Notch‐4 and Jagged‐1 in physiological and pathological human endometrium and to evaluate the expression levels of two major regulators of the G1 checkpoint, namely cyclin D1 and p21. Sixty samples of physiological endometrium and 60 samples of pathological endometrium were used for the study. Evaluation of the expression level and the distribution of Notch pathway members and cell‐cycle proteins was performed by immunohistochemistry. In the physiological endometrium we observed an increase of Notch‐1 and Jagged‐1 from proliferative to secretory phase and an opposite trend for Notch‐4. In menopause, the level of expression of all three members of the Notch pathway decreased. We also observed a cyclin D1 increase from proliferative to secretory phase. By contrast, p21 showed a slight increase from proliferative to secretory phase. In the pathological endometrium, we observed an increase of Notch‐1 expression from polyps to carcinoma and decrease for Notch‐4 and Jagged‐1. Moreover, we observed a higher expression of cyclin D1 in all the endometrial pathologies. By contrast, the expression level of p21 slightly increased from polyps to carcinoma. We concluded that in human endometrium Notch‐4 seems to be more involved in controlling proliferation, whereas Notch‐1 seems to be more involved in differentiation programming. Deregulation of these functions may induce the onset of several endometrial pathologies from polyps to cancer.
Advances in plasma skin regeneration
Authors: Foster K Wade , Moy Ronald L , Fincher Edgar F
Published: August 2008

Plasma skin regeneration (PSR) is a novel method of resurfacing that uses plasma energy to create a thermal effect on the skin. PSR is different from lasers, light sources, and ablative lasers in that it is not chromophore dependent and does not vaporize tissue, but leaves a layer of intact, desiccated epidermis that acts as a natural biologic dressing and promotes wound healing and rapid recovery. Histological studies performed on plasma resurfacing patients have confirmed continued collagen production, reduction of elastosis, and progressive skin rejuvenation beyond 1 year after treatment. PSR has received US Food and Drug Administration 510 (k) clearance for treatment of rhytides of the body, superficial skin lesions, actinic keratoses, viral papillomata, and seborrheic keratoses. PSR also has beneficial effects in the treatment of other conditions including dyschromias, photoaging, skin laxity, and acne scars. The safety profile of PSR is excellent, and there have been no reports of demarcation lines in perioral, periorbital, or jawline areas, as can sometimes be observed following CO2 resurfacing. PSR is effective in improving facial and periorbital rhytides and can be used on nonfacial sites, including the hands, neck, and chest. Numerous treatment protocols with variable energy settings allow for individualized treatments and provide the operator with fine control over the degree of injury and length of subsequent recovery time.
An assessment of the efficacy of blue light phototherapy in the treatment of acne vulgaris
Authors: Ammad Sadia , Gonzales Maria , Edwards Chris , Finlay Andrew Y , Mills Caroline
Published: August 2008

Background  Acne vulgaris is a common skin condition that affects 8 out of 10 people. It varies from mild to severe, and different treatments target various aspects of the disease. Propionibacterium acnes, one of the culprits involved in the pathogenesis of acne vulgaris, is the main target of all major medical treatments used. Studies conducted in recent years have shown favorable effects within the visible light spectrum for the treatment of acne vulgaris.

Objective  In this study, we have evaluated the use of intense blue light within the spectral range of 415–425 nm (peak 420 nm) in the treatment of acne vulgaris.

Methods  Twenty‐one patients with mild to moderate facial acne were treated with blue light phototherapy. All patients were given 14‐min treatment sessions twice a week for 4 weeks. Acne severity was assessed using the Leeds Technique for grading and lesion counts. Disability was assessed using the Dermatology Life Quality Index (DLQI). In addition, standard digital and cross‐polarized light photographs were taken and graded by a blinded evaluator. Visual analog scale (VAS) scores and cultures for P. acnes were carried out before starting the treatment and upon completion of the treatment.

Results  Significant improvement was achieved in the Leeds Acne Grade (P = 0.001). The inflammatory (P = 0.001) and noninflammatory (P = 0.06) lesion counts also improved significantly. A similar change was noted in the DLQI (P = 0.001); a degree of significance was also achieved in the patients’ and the investigators’ VAS scores (P = 0.01 and P = 0.001, respectively). P. acnes colony counts failed to show a significant decrease at the end of the treatment and remained almost constant (P = 0.660).

Conclusions  We believe that blue light does appear to have some role in the management of acne and may be beneficial for the treatment of a select group of mild to moderate acne patients.
A novel ultraviolet photography technique for assessing photodamage
Authors: Draelos Zoe Diana , Klein Gregory , Biancone Gregory
Published: August 2008

Photography is critical to accurately capturing clinical results in cosmetic dermatology.  However, this shift from film to digital photography has made the capture of true ultraviolet (UV) images more difficult. Film cameras were developed that used special lighting and film to create true UV images, but this technology has not translated into the digital realm. At present, commercial digital photography systems use computer processing to generate UV‐like images from visible light photography. This research developed a technique to obtain UV images with a UV pass glass filter placed in front of the camera lens. The UV filter was opaque to visible light (400–750 nm) with a peak transmission at 360 nm. In addition, a glass infrared (IR) block filter was also placed in front of the UV filter during photography. This research resulted in the development of an affordable digital camera system that was able to capture true UV light photographs.  This technique can be used by research and clinical dermatologists to obtain photographs demonstrating changes in photodamage as a result of therapeutic intervention.
Medical rhinoplasty with hyaluronic acid and botulinum toxin A: a very simple and quite effective technique
Authors: Redaelli Alessio
Published: August 2008

Objective The management of nasal deformities, and in particular those with “plunging” tip, has always been a typical area of interest in surgery. In the author's experience many of these problems can be successfully approached with a new medical technique, which consists of using only hyaluronic acid for the correction of nasal angles and botulinum toxin for patients with hyperactivity of the depressor septi nasi muscle. The present study aims to illustrate this new technique and evaluates safety and results.

Materials and methods Ninety‐five patients were treated between January 2006 and July 2007. The average age of the patients was 42.7 years. In 45% of the cases, botulinum toxin was employed. In all of the cases, the treatment was conducted with hyaluronic acid (24 mg/mL), the same substance used for face rejuvenation. The amount varied from 0.6 to 1.4 mL.

Results Results were evaluated using a definitive graduated score calculated by patient's and doctor's satisfaction score (range, 1–10) and by photographs’ score at time 0, after 30 days, and after 180 days. It ranged from 8 to 10 (average of 9.1). No significant side effects were reported.

Conclusion The medical rhinoplasty for a “plunging” nose is a simple and very effective technique with immediate results. It can be used in those cases where patients are reluctant to undergo surgery, or as primary indication in the correction of minor nose defects. Results are satisfactory and no side effects have been reported so far. Results will last for a long time.
Dermal and epidermal remodeling using botulinum toxin type A for facial, nonreducible, hyperkinetic lines: two case studies
Authors: Bowler Patrick J
Published: August 2008

Background  Many studies confirm the safety and efficacy of botulinum toxin type A in a variety of clinical indications. Its use for treatment of hyperfunctional facial lines has become the most popular cosmetic procedure. These case studies comprise an evaluation of the long‐term treatment of two subjects treated with botulinum toxin type A (BOTOX®, Allergan, Irvine, CA, USA) for hyperfunctional, nonreducible, facial lines.

Aims  This paper aims to assess the long‐term effectiveness of BOTOX treatment for hyperfunctional facial lines in two subjects over 7 years.

Patients/methods  Two subjects (case 1: female aged 53 years; case 2: male age 50 years) presenting with glabelar, forehead, and periorbital facial lines were treated with BOTOX over a 7‐year period. Case 1 received a total of 24 treatments at 4‐monthly intervals, and case 2 received 21 treatments at 3‐ to 6‐monthly intervals.

Results  Skin quality continued to improve over time, revealing a smoother, enhanced, yet “natural” look. In particular, nonreducible forehead lines were effaced suggesting dermal and epidermal remodeling over long‐term treatment. There was no evidence of development of any new wrinkles secondary to BOTOX use, and both subjects continue to report high levels of treatment satisfaction. No safety issues were raised.

Conclusions  These case studies demonstrate that nonreducible horizontal forehead lines can show long‐term reduction with BOTOX treatment and high levels of subject satisfaction.
Pathogenesis of Helicobacter pylori Infection
Authors: Torres Javier , Backert Steffen
Published: August 2008

The clinical outcome of Helicobacter pylori infection is determined by a complex scenario of interactions between the bacterium and the host. The main bacterial factors associated with colonization and pathogenicity comprise outer membrane proteins including BabA, SabA, OipA, AlpA/B, as well as the virulence factors CagA in the cag pathogenicity island (cagPAI) and the vacuolating cytotoxin VacA. The multitude of these proteins and allelic variation makes it extremely difficult to test the contribution of each individual factor. Much effort has been put into identifying the mechanism associated with H. pylori‐associated carcinogenesis. Interaction between bacterial factors such as CagA and host signal transduction pathways seems to be critical for mediating the induction of membrane dynamics, actin‐cytoskeletal rearrangements and the disruption of cell‐to‐cell junctions as well as proliferative, pro‐inflammatory and antiapoptotic nuclear responses. An animal model using the Mongolian gerbil is a useful system to study the gastric pathology of H. pylori infection.
Helicobacter pylori Infection in Children
Authors: Daugule Ilva , Rowland Marion
Published: August 2008

The review summarizes the articles published on Helicobacter pylori in children between April 2007 and March 2008. Evidence is emerging in different populations including developing countries that the prevalence of H. pylori is declining in all age groups. The reasons for this are unclear but it is unlikely that treatment of infection or improvement in socioeconomic conditions fully explains the decline. For the first time, differences in the inflammatory response between adults and children have been well characterized in a group of adults and children from Chile with similar levels of H. pylori infection. This study suggests that the reduced inflammatory response to H. pylori at a cellular level in children could be the consequence of an enhanced Treg cell response, which in turn down‐regulates H. pylori‐induced inflammation. The publication of the Paediatric European Register for Treatment of Helicobacter pylori study (PERTH) is important as it demonstrates the advantages of different centers working in collaboration for the benefit of children. It also highlights the fact that while bismuth‐based treatment is more effective than proton pump inhibitor‐based treatment in children, bismuth preparations are not widely available for use in children.
Modification of the Risk of Mortality from Pneumonia with Oral Hygiene Care
Authors: Bassim Carol W. , Gibson Gretchen , Ward Timothy , Paphides Brian M. , DeNucci Donald J.
Published: August 2008

OBJECTIVES: To investigate the associations between the assignment of an oral hygiene aide staff member and risk factors for mortality from pneumonia in a nursing home and to test the hypothesis that this care would affect the incidence of mortality from pneumonia.

DESIGN: Electronic medical records.

SETTING: Nursing home.

PARTICIPANTS: One hundred forty‐three residents of a Veterans Affairs Medical Center (VAMC) nursing home.

METHODS: The electronic medical records of 143 residents of a VAMC nursing home were analyzed for risk factors for pneumonia. A certified nursing assistant had been assigned to provide oral hygiene care for residents on two of four nursing home wards. Researchers performed a longitudinal analysis of resident's medical records to investigate the association between the assignment of an oral hygiene aide with the risk of mortality from pneumonia.

RESULTS: Initially, the group that received oral care, an older and less functionally able group, showed approximately the same incidence of mortality from pneumonia as the group that did not receive oral care, but when the data were adjusted for the risk factors found to be significant for mortality from pneumonia, the odds of dying from pneumonia in the group that did not receive oral care was more than three times that of the group that did receive oral care (odds ratio=3.57, P=.03). Modified risk factors included age, functionality, cognitive function, and clinical concern about aspiration pneumonia.

CONCLUSION: Oral hygiene nursing aide intervention may be an efficient risk factor modifier of mortality from nursing home–associated pneumonia.
Urinary Complaints in Nondisabled Elderly People with Age‐Related White Matter Changes: The Leukoaraiosis And DISability (LADIS) Study
Authors: Poggesi Anna , Pracucci Giovanni , Chabriat Hugues , Erkinjuntti Timo , Fazekas Franz , Verdelho Ana , Hennerici Michael , Langhorne Peter , O'Brien John , Scheltens Philip , Visser Marieke C. , Crisby Milita , Waldemar Gunhild , Wallin Anders , Inzitari Domenico , Pantoni Leonardo ,   on behalf of the LADIS Study Group
Published: August 2008

OBJECTIVES: To investigate, in a cohort of nondisabled elderly people, the association between urinary complaints and severity of age‐related white matter changes (ARWMC).

DESIGN: Cross‐sectional data analysis from a longitudinal multinational study.

SETTING: The Leukoaraiosis And DISability Study, assessing ARWMC as an independent predictor of the transition from functional autonomy to disability in elderly subjects.

PARTICIPANTS: Six hundred thirty‐nine subjects (288 men, 351 women, mean age 74.1±5.0) with magnetic resonance imaging (MRI)‐detected ARWMC of different severity.

MEASUREMENTS: ARWMC severity was graded on MRI as mild, moderate, and severe (Fazekas scale). MRI assessment also included ARWMC volumetric analysis and the count of infarcts. Urinary complaints (nocturia, urinary frequency, urgency, incontinence) were recorded based on subjects' answers to four questions.

RESULTS: In comparing the three ARWMC severity groups, there was a significant difference only in prevalence of urgency, with 16% of subjects in the mild severity group, 17% in the moderate severity group, and 25% in the severe group (P=.03). Adjusting for age, sex, lacunar and nonlacunar infarcts, diabetes mellitus, and use of diuretics, severe ARWMC retained an independent effect in the association with urinary urgency (odds ratio=1.74, 95% confidence interval=1.04–2.90, severe vs mild group). Subjects with urinary urgency also had higher ARWMC volumes (25.2, vs 20.4 mm3 in those without urinary urgency; P<.001). Urgency was confirmed to be associated with the severe degree of ARWMC, irrespective of complaints of memory, gait disturbances, or history of depression.

CONCLUSION: In a cohort of nondisabled elderly people, severe ARWMC were associated with urinary urgency, independent of other potential confounders and vascular lesions of the brain.
Short‐Stay Nursing Home Rehabilitation Patients: Transitional Care Problems Pose Research Challenges
Authors: Quinn Charlene C. , Port Cynthia L. , Zimmerman Sheryl , Gruber‐Baldini Ann L. , Kasper Judith D. , Fleshner Irene , Yody Barbara , Loome John , Magaziner Jay
Published: August 2008

A clinical intervention pilot study to improve depression care for short‐stay nursing home Medicare‐reimbursed rehabilitation patients funded by the National Institute on Aging was conducted. Despite solid theoretical and clinical grounding and the support of a large nursing home company, several roadblocks to implementation were encountered, including involving patients and families, communication between providers, involving community primary care physicians, staff time constraints, and conducting research with short‐stay patients. Although frustrating from a research standpoint, these roadblocks closely reflect problems identified by the American Geriatrics Society as impeding the delivery of high‐quality transitional care in geriatrics. These research roadblocks are described as they were encountered in the clinical setting, and each is placed within the larger context of challenges associated with care transitions, especially for older persons with complex health needs receiving nursing home rehabilitation. Finally, recommendations are offered for researchers conducting much‐needed research within geriatric transitional care settings, including starting early in the care transition chain and assisting patients and families with providing continuity across care settings.
Value of anaerobic culture in bacterial surveillance program for platelet concentrates
Authors: Lee C.K. , Ho P.L. , Lee K.Y. , Tsui G.T.F. , Chua E. , Tsoi W.C. , Lin C.K.
Published: August 2008

BACKGROUND: Short‐term aerobic bacterial culture (STABC) has been used routinely in Hong Kong since 1998 to reduce bacterial contamination in platelet concentrates (PCs) with good results. With more countries implementing routine aerobic and anaerobic cultures of PCs, a prospective study was conducted to determine the value of anaerobic culture to STABC.

STUDY DESIGN AND METHODS: PC tested by STABC was used as control. Twenty milliliters of the PC selected for this study was aliquoted and pooled for 7 days aerobic and anaerobic culture. If the initial culture was positive, samples retrieved from the original PC and their associated components were cultured for confirmation and microbiologic identification.

RESULTS: A total of 10,035 PC units (2007 pools) were tested. The confirmed positive rates by aerobic and anaerobic cultures per pool were 3 (0.15%) and 13 (0.65%), respectively, which was equivalent to an increased yield from 0.03 to 0.13 percent of PC if anaerobic culture was added. Of the 10 bacteria detected by anaerobic culture only, 9 were found to be Propionibacterium acnes and the remaining one Peptostreptococcus sp. Their mean detection time from inoculation was 92.16 hours (range, 50.4‐124.8 hr).

CONCLUSION: Addition of anaerobic culture to our routine STABC would significantly increase the detection rate of bacterial contaminated PC. However, since only slow‐growing bacteria were detected, and because their clinical significance was uncertain, it is concluded that there was no clear justification to introduce anaerobic culture locally if 5‐day shelf life for PCs was to be maintained.
Ablation of Ventricular Tachycardia in Patients with Nonischemic Cardiomyopathy
Authors: BOGUN FRANK , MORADY FRED
Published: August 2008

Mapping and ablation of ventricular tachycardia (VT) in patients with nonischemic cardiomyopathy can be challenging. In this article, we describe the approach to VT in patients with nonischemic cardiomyopathy that we use at the University of Michigan. Imaging, especially with delayed enhanced cardiac magnetic resonance imaging, plays a central role in planning a mapping and ablation procedure. During the mapping procedure, pace‐mapping in conjunction with voltage maps focusing on areas with isolated potentials helps to identify scar areas that are critical for VT in these patients.
A Prospective Pediatric Clinical Trial of Digital Music Players: Do They Interfere with Pacemakers?
Authors: CHIU CHRISTINE C. , HUH JUNE , DE SOUZA LAURA , ALFARO‐RAMIREZ ARMANDO , CLEGG ROBIN , FENWICK LAURA , HAMILTON ROBERT M. , KIRSH JOEL A. , GROSS GIL J. , GAO DONGSHENG , STEPHENSON ELIZABETH A.
Published: August 2008

Background:
There has been recent concern in the media about iPod™ interference with pacemakers. We systematically tested two types of digital music players (DMP) on pacemaker or ICD function in children.

Methods/Results:
Patients were monitored by a 6‐lead ECG and programmer telemetry. The pacemaker was tested in bipolar and unipolar sensing at normal and maximal sensitivities. The order of DMP tested was randomized. Each DMP was placed on top of the pacemaker pocket, put into “play” mode three times (5 seconds each), with and without programmer wand placed one cm adjacent to DMP. Pacemaker interference was defined as: pacing inhibition, inappropriate pacing, oversensing, or detection of high‐rate episodes associated with the use of DMP. Of the 67 patients (mean age 12 ± 5 years), 62 had pacemakers and five had ICDs; 39 endocardial and 28 epicardial systems. Patients were tested with Sansa™ (67), iPod™ 30 GB (51), and other DMPs (43). There was no evidence of interference with pacemaker function by any DMP under any of the study conditions (each performed in triplicate). Reproducible programmer telemetry interference was shown in 11 cases (Medtronic 6/47, St. Jude Medical 5/18, Guidant 0/2) related to use of iPod™ (6), Sansa™ (1), or others (4). None of these were associated with any evidence of pacemaker malfunction.

Conclusion:
Interference with pacemaker function could not be shown with iPod™ or MP3 players. No additional precaution beyond standard is necessary for patients with pacemakers when they are using these players.
Esophageal Hematoma Complicating Catheter Ablation for Atrial Fibrillation
Authors: McCALL REBECCA , THOMAS STUART P.
Published: August 2008

Significant injury to the esophagus during ablation for atrial fibrillation is rare but may be devastating. Esophageal fistulas and injury to branches of the vagus nerve resulting in gastric stasis have previously been described. In this case report, we describe another type of esophageal injury associated with catheter ablation for atrial fibrillation. The patient experienced chest pain and vomiting on recovery from anesthesia. Echocardiography and computerized tomography were used to identify a large esophageal hematoma. The hematoma was treated conservatively and the patient recovered fully after several weeks.
Influence of methylene tetrahydrofolate reductase polymorphisms and coadministration of antimetabolites on toxicity after high dose methotrexate
Authors: Van Kooten Niekerk Peter Buur , Schmiegelow Kjeld , Schroeder Henrik
Published: August 2008

Background and objective:  Through interruption of maintenance treatment with 6‐mercaptopurine (6MP), toxicity after high‐dose methotrexate (HDMTX) may compromise the efficiency of the treatment of children with acute lymphocytic leukaemia (ALL). We investigated the influence of polymorphisms in the methylene tetrahydrofolate reductase (MTHFR) gene and coadministration of antimetabolites on post‐HDMTX toxicity.

Methods:  Toxicity was retrospectively analysed after 656 HDMTX courses administered to 88 paediatric ALL patients at a single treatment centre.

Results:  High‐dose methotrexate with high‐intensity co‐treatment (6MP 75 mg/m2/d + MTX 20 mg/m2/wk) was found associated with increased odds of haematological toxicity (OR’s: 3.47–7.88; P’s: <0.001), hepatic toxicity (OR = 6.91; P < 0.001), hospitalization with fever (OR = 2.2; P = 0.004) and interruption maintenance treatment (OR = 15.9; P < 0.001) compared to HDMTX with low‐intensity co‐treatment (6MP 25 mg/m2/d). Addition of cytarabine to the low‐intensity co‐treatment increased the odds of neutropenia (OR = 3.51; P = 0.002), thrombocytopenia (OR = 6.56; P < 0.001), hepatic toxicity (OR = 3.84; P = 0.012) and interruption of maintenance treatment (OR = 4.25; P = 0.002). Alterations in 6MP dose were associated with significant changes in toxicity. Dose reduction reduced the odds of haematological toxicity (OR’s: 0.22–0.34; P’s: <0.001–0.020), while dose increase increased the odds of haematological toxicity (OR’s: 2.72–7.42; P’s: 0.006–0.027), fever (OR = 2.65; P = 0.037) and interruption of maintenance treatment (OR = 3.04; P = 0.032). No convincing associations were found between the MTHFR C677T or A1298C polymorphisms and toxicity.

Conclusion:  Our findings demonstrate that toxicity after HDMTX is influenced by coadministrated antimetabolites, and modifiable by alterations in 6MP dose. Prevention of toxicity related withdrawals through 6MP dose reduction could be a way of increasing total dose intensity.
Spawning site selection by Eurasian perch (Perca fluviatilis L.) in relation to temperature and wave exposure
Authors: Probst W. N. , Stoll S. , Hofmann H. , Fischer P. , Eckmann R.
Published: August 2008

Abstract –  The selection of spawning depth by Eurasian perch Perca fluviatilis was investigated in an experiment using artificial substrata in Lake Constance during the spawning season of 2007. The experiment compared spawning behaviour at substrata between 0.5 and 15 m depth at two sites exposed to different regimes of ship‐generated wave action. The total abundance of egg ribbons did not differ significantly between the two sites, but the preferred spawning depth was deeper at the wave exposed site (5 m) compared to the sheltered site (2 m). While water temperatures could not account for the observations, differences in wave exposure may explain the different spawning depth preferences. At both sites, large egg ribbons were generally found in deeper water, and large egg ribbons occurred more frequently at the sheltered site. Because the egg ribbons of perch are likely to have a size‐dependent susceptibility to hydrodynamic stress, large females may be expected to select deeper spawning locations where the effects of surface waves are considerably attenuated.