bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of health and nutrition education intervention on women's postpartum beliefs and practices: a randomized controlled trial
Authors: Liu Nian , Mao Limei , Sun Xiufa , Liu Liegang , Yao Ping , Chen Banghua
Published: February 2009

Background

'Sitting month' is the Chinese tradition for postpartum customs. Available studies indicate that some of the traditional postpartum practices are potentially harmful for women's health. However, no intervention study aiming at postpartum practices has been performed. In this paper we evaluated the effect of a health and nutrition education intervention, which focused on improving postpartum dietary quality and optimal health behaviors.

Methods

The study design was a randomized controlled trial conducted in both urban and rural area of Hubei between August 2003 and June 2004. A total of 302 women who attended the antenatal clinic during the third trimester with an uncomplicated pregnancy were recruited. Women randomized to the education intervention group in both urban and rural area received two two-hour prenatal education sessions and four postpartum counseling visits. Control group women received usual health care during pregnancy and postpartum period. Women were followed up until 42 days postpartum. Outcome measures were nutrition and health knowledge, dietary behavior, health behavior and health problems during the postpartum period.

Results

Women in the intervention groups exhibited significantly greater improvement in overall dietary behaviors such as consumption of fruits, vegetables, soybean and soybean products as well as nutrition and health knowledge than those in the control groups. Significantly more women in the intervention groups give up the traditional behavior taboos. The incidence of constipation, leg cramp or joint pain and prolonged lochia rubra was significantly lower in the intervention groups as compared with the control groups.

Conclusion

The study shows that health and nutrition education intervention enable the women take away some of the unhealthy traditional postpartum practices and decrease the prevalence of postpartum health problems. The intervention has potential for adaptation and development to large-scale implementation.

Trial registration number

klACTRN12607000549426
Diagnosis and management of retroperitoneal ancient schwannomas
Authors: Choudry Haroon A , Nikfarjam Mehrdad , Liang John J , Kimchi Eric T , Conter Robert , Gusani Niraj J , Staveley-O'Carroll Kevin F
Published: February 2009

Background

Ancient schwannomas are degenerate peripheral nerve sheath tumors that very rarely occur in the retroperitoneum. They generally reach large proportions before producing symptoms due to mass effect. We describe three cases of retroperitoneal ancient schwannomas and discuss the diagnosis and management of these tumors.

Case presentations

Three female patients with retroperitoneal ancient schwannomas were reviewed. One patient presented with several weeks of upper abdominal pain and lower chest discomfort, whereas back pain and leg pain with associated weakness were predominant symptoms in the remaining two. Abdominal imaging findings demonstrated heterogeneous masses in the retroperitoneum with demarcated margins, concerning for malignancy. The patients successfully had radical excision of their tumors. Histological examination showed encapsulated tumors that displayed alternating areas of dense cellularity and areas of myxoid matrix consistent with a diagnosis of ancient schwannoma.

Conclusion

A diagnosis of ancient schwannoma should be entertained for any heterogeneous, well encapsulated mass in the retroperitoneum. In these cases less radical surgical resection should be considered as malignant transformation of these tumors is extremely rare and recurrence is uncommon following excision.
Evaluation of day one embryo quality and IVF outcome – a comparison of two scoring systems
Authors: Brezinova Jana , Oborna Ivana , Svobodova Magda , Fingerova Helena
Published: February 2009

Background

The aim of our retrospective study was to compare the clinical usefulness of two non-invasive embryo scoring systems based either on a simplified pronuclear morphology of the zygote or on early cleavage rate, as well as their combination, for the selection of embryos with the best implantation potential in embryo transfer (ET).

Methods

Over a period of five years, the quality of 2708 embryos from 364 IVF cycles in women under the age of 39 years was assessed using these scoring systems in a university assisted reproduction centre. ET was always performed on day 3 of cultivation. The outcome of ETs of 702 embryos scored in the respective systems or their combination was retrospectively analyzed in terms of biochemical (bPR) and clinical pregnancy rates (cPR) and implantation rate (IR). Mann-Whitney U test and t-test for differences between relative values were used, p < 0.05 was considered statistically significant.

Results

There was no difference in outcome parameters in 109 cycles where only Pattern "0" zygotes, according to our simplified pronuclear morphology classification, were transferred and 140 cycles where only "other" pattern zygotes were transferred, regardless of their cleavage rate. On the contrary, significantly greater cPR and IR (p = 0.003 and p = 0.006, respectively) were achieved in 120 cycles where only early cleavage (EC) embryos were transferred compared with 152 cycles where only non early cleavage (NEC) embryos were transferred regardless of their pronuclear morphology. The best outcome in terms of cPR (56%) and IR (43%) was found in 50 cycles when Pattern "0" and EC embryos only were used for transfer.

Conclusion

The results indicate that early cleavage is a better independent marker of implantation potential than zygote morphology. The best outcome can be achieved if both embryo scoring systems are used jointly and the embryo is classified as EC and Pattern "0".
Issues associated with assessing nuclear localization of N-terminally unphosphorylated β-catenin with monoclonal antibody 8E7
Authors: Maher Meghan T , Flozak Annette S , Hartsell Alyssa M , Russell Susan , Beri Rohinee , Peled Ofra N , Gottardi Cara J
Published: February 2009

Background

β-catenin is a dual function adhesion/transcriptional co-activator protein, and both functions are critical for normal tissue homeostasis. Since the transcriptional functions of β-catenin are more often implicated in various disease processes, there is much interest in the development and use of reagents to interrogate spatial and temporal evidence of β-catenin nuclear signaling in cells and tissues. An important study demonstrated that the signaling form of β-catenin is specifically unphosphorylated at residues S37 and T41, and suggested that this form exhibits a propensity for cytosolic/nuclear accumulation relative to the total pool of β-catenin.

Results

We show that monoclonal antibody, 8E7, which recognizes the signaling form of β-catenin specifically unphosphorylated at S37 and T41 (Active B-Catenin, ABC), also cross-reacts with a widely expressed, variably accessible nuclear antigen that is not β-catenin. In cell types commonly used to study Wnt activation, this non-specific nuclear staining can be robust, obscuring the ABC signal. Definitive detection of nuclear localized ABC can be confirmed through an ability of classical cadherins to sequester ABC to cell junctions. In tissues, milder antigen retrieval methods can reduce the accessibility of mAb 8E7 to this cross-reacting nuclear antigen.

Conclusion

These findings reveal that interpretation of nuclear, signaling active β-catenin using monoclonal antibody 8E7 should be considered judiciously, and in conjunction with independent methods.

Reviewers

This article was reviewed by Frank J. T. Staal (nominated by Rachel Gerstein), Jyoti M. Sen (nominated by Avinash Bhandoola) and Manabu Sugai.
Fgf receptor 3 activation promotes selective growth and expansion of occipitotemporal cortex
Authors: Thomson Rachel E , Kind Peter C , Graham Nicholas A , Etherson Michelle L , Kennedy John , Fernandes Ana C , Marques Catia S , Hevner Robert F , Iwata Tomoko
Published: February 2009

Background

Fibroblast growth factors (Fgfs) are important regulators of cerebral cortex development. Fgf2, Fgf8 and Fgf17 promote growth and specification of rostromedial (frontoparietal) cortical areas. Recently, the function of Fgf15 in antagonizing Fgf8 in the rostral signaling center was also reported. However, regulation of caudal area formation by Fgf signaling remains unknown.

Results

In mutant mice with constitutive activation of Fgf receptor 3 (Fgfr3) in the forebrain, surface area of the caudolateral cortex was markedly expanded at early postnatal stage, while rostromedial surface area remained normal. Cortical thickness was also increased in caudal regions. The expression domain and levels of Fgf8, as well as overall patterning, were unchanged. In contrast, the changes in caudolateral surface area were associated with accelerated cell cycle in early stages of neurogenesis without an alteration of cell cycle exit. Moreover, a marked overproduction of intermediate neuronal progenitors was observed in later stages, indicating prolongation of neurogenesis.

Conclusion

Activation of Fgfr3 selectively promotes growth of caudolateral (occipitotemporal) cortex. These observations support the 'radial unit' and 'radial amplification' hypotheses and may explain premature sulcation of the occipitotemporal cortex in thanatophoric dysplasia, a human FGFR3 disorder. Together with previous work, this study suggests that formation of rostral and caudal areas are differentially regulated by Fgf signaling in the cerebral cortex.
Currarino's syndrome misinterpreted as Hirschsprung's disease for 17 years: a case report
Authors: Saberi Hooshang , Habibi Zohreh , Adhami Amin
Published: February 2009

Background

Currarino's syndrome is an autosomal dominant hereditary disease known by the triad of anorectal stenosis, anterior sacral defect, and a presacral mass that is most often an anterior sacral meningocele. Actually this syndrome could remain asymptomatic in many instances, but symptomatic patients might present with constipation as the sole manifestation of the Currarino's syndrome among the other wide spectrum of manifestations.

Case presentation

An 18-year old woman was diagnosed with a late-recognized Currarino syndrome, presented by a longstanding constipation which had been wrongly diagnosed and treated as Hirschsprung's disease since early childhood.

Conclusion

Long-lasting constipation could imply to neural tube anomaly such as anterior sacral meningocele with or without association to Currarino's syndrome.
Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after unsuccessful ERCP: a case report
Authors: Alexiou Konstantinos , Sakellaridis Timothy , Sikalias Nikolaos , Karanikas Ioannis , Economou Nikolaos , Antsaklis Giorgios
Published: February 2009

Background

The presence of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum simultaneously is a rare complication of upper gastrointestinal endoscopy that usually indicates free perforation to the peritoneal cavity or the retroperitoneal space.

Case presentation

We report an unusual case of a self-limited subcutaneous emphysema, pneumomediastinum and pneumoperitoneum following an unsuccessful ERCP for removal of a common bile duct stone.

Conclusion

There was no radiological evidence of peritoneal or retroperitoneal perforation. This complication is distinct from pneumomediastinum and pneumoperitoneum due to perforation, and must be recognized, because it is benign and needs no surgical or radiological intervention.
Gene expression profiling of the tumor microenvironment during breast cancer progression
Authors: Ma Xiao-Jun , Dahiya Sonika , Richardson Elizabeth , Erlander Mark , Sgroi Dennis C
Published: February 2009

Introduction

The importance of the tumor microenvironment in breast cancer has been increasingly recognized. Critical molecular changes in the tumor stroma accompanying cancer progression, however, remain largely unknown. We conducted a comparative analysis of global gene expression changes in the stromal and epithelial compartments during breast cancer progression from normal to preinvasive to invasive ductal carcinoma.

Methods

We combined laser capture microdissection and gene expression microarrays to analyze 14 patient-matched normal epithelium, normal stroma, tumor epithelium and tumor-associated stroma specimens. Differential gene expression and gene ontology analyses were performed.

Results

Tumor-associated stroma undergoes extensive gene expression changes during cancer progression, to a similar extent as that seen in the malignant epithelium. Highly upregulated genes in the tumor-associated stroma include constituents of the extracellular matrix and matrix metalloproteases, and cell-cycle-related genes. Decreased expression of cytoplasmic ribosomal proteins and increased expression of mitochondrial ribosomal proteins were observed in both the tumor epithelium and the stroma. The transition from preinvasive to invasive growth was accompanied by increased expression of several matrix metalloproteases (MMP2, MMP11 and MMP14). Furthermore, as observed in malignant epithelium, a gene expression signature of histological tumor grade also exists in the stroma, with high-grade tumors associated with increased expression of genes involved in immune response.

Conclusions

Our results suggest that the tumor microenvironment participates in tumorigenesis even before tumor cells invade into stroma, and that it may play important roles in the transition from preinvasive to invasive growth. The immune cells in the tumor stroma may be exploited by the malignant epithelial cells in high-grade tumors for aggressive invasive growth.
Migration inhibitory factor (MIF) released by macrophages upon recognition of immune complexes is critical to inflammation in Arthus reaction
Authors: Paiva Claudia N , Arras Rosa H , Magalhães Elisabeth S , Alves Letícia S , Lessa Luiz Paulo , Silva Maria Helena , Ejzemberg Regina , Canetti Cláudio , Bozza Marcelo T
Published: February 2009

Deposition of immune complexes (IC) triggers FcγR-dependent inflammation, leading to tissue damage in rheumatoid arthritis, systemic lupus erythematous, immune glomerulonephritis, and several immune vasculitides. Evidences support a role for macrophage migration inhibitory factor (MIF) in a number of inflammatory diseases, but the triggering of its secretion and its physiopathological role upon IC deposition remain elusive. Herein, we show that human macrophages secreted MIF after IC recognition, which in turn controlled the secretion of TNF. Macrophages from Mif−/− mice produced smaller amounts of TNF when stimulated with IgG-opsonized erythrocytes than wild-type (WT) cells. Using passive reverse Arthus reaction in the peritoneum and lungs as a model for IC-induced inflammation, we demonstrated that Mif−/− mice had a milder response, observed by reduced neutrophil recruitment, vascular leakage, and secretion of TNF, MIP-2, and keratinocyte-derived chemokine compared with WT controls. Adoptive transfer of alveolar macrophages from WT to Mif−/− mice rescued pulmonary neutrophil recruitment and TNF production upon passive reverse Arthus reaction. Our study indicates that Arthus inflammatory reaction is largely dependent on MIF and poses macrophages as a source of the MIF released upon IC recognition. These results give experimental support to the proposition that blockade of MIF might constitute an adjunctive, therapeutic approach to IC disease.
Preliminary Design of Low-Rise Buildings Stiffened with Buckling-Restrained Braces by a Displacement-Based Approach
Authors: Teran-Gilmore Amador , Virto-Cambray Neftali
Published: February 2009

A displacement-based methodology for the preliminary design of a system of buckling-restrained braces is introduced. The methodology applies to the case of low-rise buildings, whose dynamic response is not significantly influenced by global flexural behavior or higher modes. The methodology is applied to the preliminary design of a five-story building located in the Lake Zone of Mexico City. From the evaluation of the global mechanical characteristics of the building and of its seismic performance when subjected to ground motions generated in that zone, it is concluded that the proposed methodology yields an adequate level of seismic design.
Three Immunomarker Support Vector Machines–Based Prognostic Classifiers for Stage IB Non–Small-Cell Lung Cancer
Authors: Zhu Zhi-Hua , Sun Bing-Yu , Ma Yun , Shao Jian-Yong , Long Hao , Zhang Xu , Fu Jian-Hua , Zhang Lan-Jun , Su Xiao-Dong , Wu Qiu-Liang , Ling Peng , Chen Ming , Xie Ze-Ming , Hu Yi , Rong Tie-Hua
Published: February 2009

Purpose

Approximately 30% of patients with stage IB non–small-cell lung cancer (NSCLC) die within 5 years after surgery. Current staging methods are inadequate for predicting the prognosis of this particular subgroup. This study identifies prognostic markers for NSCLC.

Patients and Methods

We used computer-generated random numbers to study 148 paraffin-embedded specimens for immunohistochemical analysis. We studied gene expression in paraffin-embedded specimens of lung cancer tissue from 73 randomly selected patients with stage IB NSCLC who had undergone radical surgical resection and evaluated the association between the level of expression and survival. We used support vector machines (SVM)–based methods to develop three immunomarker-SVM–based prognostic classifiers for stage IB NSCLC. For validation, we used randomly assigned specimens from 75 other patients.

Results

We devised three immunomarker-SVM–based prognostic classifiers, including SVM1, SVM2, and SVM3, to refine prognosis of stage IB NSCLC successfully. The SVM1 model integrates age, cancer cell type, and five markers, including CD34MVD, EMA, p21ras, p21WAF1, and tissue inhibitors of metalloproteinases (TIMP) –2. The SVM2 model integrates age, cancer cell type, and 19 markers, including BCL2, caspase-9, CD34MVD, low-molecular-weight cytokeratin, high-molecular-weight cytokeratin, cyclo-oxygenase-2, EMA, HER2, matrix metalloproteinases (MMP) –2, MMP-9, p16, p21ras, p21WAF1, p27kip1, p53, TIMP-1, TIMP-2, vascular endothelial growth factor (VEGF), and β-catenin. The SVM3 model consists of SVM1 and SVM2. The three models were independent predictors of overall survival. We validated the classifiers with data from an independent cohort of 75 patients with stage IB NSCLC.

Conclusion

The three immunomarker-SVM–based prognostic characteristics are closely associated with overall survival among patients with stage IB NSCLC.
Prediction ofBRCAMutations Using the BRCAPRO Model in Clinic-Based African American, Hispanic, and Other Minority Families in the United States
Authors: Huo Dezheng , Senie Ruby T. , Daly Mary , Buys Saundra S. , Cummings Shelly , Ogutha Jacqueline , Hope Kisha , Olopade Olufunmilayo I.
Published: February 2009

Purpose

BRCAPRO, a BRCA mutation carrier prediction model, was developed on the basis of studies in individuals of Ashkenazi Jewish and European ancestry. We evaluated the performance of the BRCAPRO model among clinic-based minority families. We also assessed the clinical utility of mutation status of probands (the first individual tested in a family) in the recommendation of BRCA mutation testing for other at-risk family members.

Patients and Methods

A total of 292 minority families with at least one member who was tested for BRCA mutations were identified through the Breast Cancer Family Registry and the University of Chicago. Using the BRCAPRO model, the predicted likelihood of carrying BRCA mutations was generated. Area under the receiver operating characteristic curves (AUCs) were calculated.

Results

There were 104 African American, 130 Hispanic, 37 Asian-American, and 21 other minority families. The AUC was 0.748 (95% CI, 0.672 to 0.823) for all minorities combined. There was a statistically nonsignificant trend for BRCAPRO to perform better in Hispanic families than in other minority families. After taking into account the mutation status of probands, BRCAPRO performance in additional tested family members was improved: the AUC increased from 0.760 to 0.902.

Conclusion

The findings support the use of BRCAPRO in pretest BRCA mutation prediction among minority families in clinical settings, but there is room for improvement in ethnic groups other than Hispanics. Knowledge of the mutation status of the proband provides additional predictive value, which may guide genetic counselors in recommending BRCA testing of additional relatives when a proband has tested negative.
Long-Term Survival of Patients With Glioblastoma Treated With Radiotherapy and Lomustine Plus Temozolomide
Authors: Glas Martin , Happold Caroline , Rieger Johannes , Wiewrodt Dorothee , Bähr Oliver , Steinbach Joachim P. , Wick Wolfgang , Kortmann Rolf-Dieter , Reifenberger Guido , Weller Michael , Herrlinger Ulrich
Published: February 2009

Purpose

To evaluate long-term survival in a prospective series of patients newly diagnosed with glioblastoma and treated with a combination of lomustine (CCNU), temozolomide (TMZ), and radiotherapy.

Patients and Methods

Thirty-nine patients received radiotherapy of the tumor site only (60 Gy) and CCNU/TMZ chemotherapy (n = 31 received standard-dose CCNU, 100 mg/m2 on day 1 and TMZ 100 mg/m2/d on days 2 to 6; n = 8 received intensified-dose CCNU 110 mg/m2 on day 1 and TMZ 150 mg/m2 on days 2 to 6) for up to six courses.

Results

In the whole cohort, the median overall survival (mOS) was 23.1 months; 47.4% survived for 2 years, and 18.5% survived for 4 years. After a median follow-up of 41.5 months, mOS had not been reached in the intensified group and was significantly higher than in the standard group (22.6 months; P = .024). In the intensified group, four of eight patients survived for at least 56 months, two of them without recurrence. O6-methylguanine–DNA methyltransferase (MGMT) gene promotor methylation in the tumor tissue was associated with significantly longer mOS (methylated, 34.3 months v nonmethylated, 12.5 months). A multivariate Cox proportional hazard model revealed MGMT status (methylated v nonmethylated; relative risk [RR] of death, 0.43; P = .003) and chemotherapy dose (intensified v standard; RR, 0.37; P = .012) as independent prognostic factors. WHO grade 4 hematoxicity was observed more frequently in the intensified group (57% v 16%).

Conclusion

The combination of radiotherapy, CCNU, and TMZ yielded promising long-term survival data in patients with newly diagnosed glioblastoma. Intensification of CCNU/TMZ chemotherapy may add an additional survival benefit, albeit with greater acute toxicity.
Recurrence Pattern After Temozolomide Concomitant With and Adjuvant to Radiotherapy in Newly Diagnosed Patients With Glioblastoma: Correlation With MGMT Promoter Methylation Status
Authors: Brandes Alba A. , Tosoni Alicia , Franceschi Enrico , Sotti Guido , Frezza Giampiero , Amistà Pietro , Morandi Luca , Spagnolli Federica , Ermani Mario
Published: February 2009

Purpose

The aim of the present study was to evaluate factors predicting the recurrence pattern after the administration of temozolomide (TMZ), initially concurrent with radiotherapy (RT) and subsequently as maintenance therapy, which has become standard treatment for patients with newly diagnosed glioblastoma (GBM).

Patients and Methods

Ninety-five patients with newly diagnosed GBM were treated with RT plus TMZ (75 mg/m2/d) followed by maintenance TMZ cycles (150 to 200 mg/m2 for 5 days every 28 days). Assessable MGMT methylation status and magnetic resonance imaging follow-up were mandatory in all cases.

Results

After a median follow-up of 18.9 months (range, 6.6 to 44.8 months), 79 patients (83%) had recurrence: inside the RT field in 57 patients (72.2%), outside in 17 patients (21.5%), and at RT margin in five patients (6.3%). MGMT status was correlated with the site of recurrence, which occurred inside, or at the margin of, the RT field in 51 patients (85%) with MGMT unmethylated status and in 11 patients (57.9%) with MGMT methylated status (P = .01). Recurrences outside the RT field occurred after a longer time interval than those inside the RT field (14.9 v 9.2 months, P = .02).

Conclusion

After the administration of TMZ concomitant with and adjuvant to RT in patients with GBM, the pattern of, and time to, recurrence are strictly correlated with MGMT methylation status.
Outcome of Deferred Initial Therapy in Mantle-Cell Lymphoma
Authors: Martin Peter , Chadburn Amy , Christos Paul , Weil Karen , Furman Richard R. , Ruan Jia , Elstrom Rebecca , Niesvizky Ruben , Ely Scott , DiLiberto Maurizio , Melnick Ari , Knowles Daniel M. , Chen-Kiang Selina , Coleman Morton , Leonard John P.
Published: February 2009

Purpose

Treatment of mantle-cell lymphoma (MCL) is nonstandardized, though patients are commonly treated immediately at diagnosis. Because data on observation, or “watch and wait,” have not been previously reported, we analyzed the outcome of deferred initial therapy.

Patients and Methods

Inclusion criteria in this retrospective analysis were a diagnosis of MCL between 1997 and 2007 and known date of first treatment. Hospital and research charts were reviewed for prognostic and treatment-related information. Date of death was derived from hospital records and confirmed using an online Social Security death index.

Results

Of 97 patients with MCL evaluated at Weill Cornell Medical Center, 31 patients (32%) were observed for more than 3 months before initial systemic therapy, with median time to treatment for the observation group of 12 months (range, 4 to 128 months). The observation group (median follow-up, 55 months) had a median age of 58 years (range, 40 to 81 years). Prognostic factors in assessable patients included advanced stage (III/IV) in 75%, elevated lactate dehydrogenase in 25%, and intermediate- or high-risk Mantle Cell International Prognostic Index in 54%. Better performance status and lower-risk standard International Prognostic Index scores were more commonly present in those undergoing observation. Although time to treatment did not predict overall survival in a multivariate analysis, the survival profile of the observation group was statistically superior to that of the early treatment group (not reached v 64 months, P = .004).

Conclusion

In selected asymptomatic patients with MCL, deferred initial treatment (“watch and wait”) is an acceptable management approach.
Tissue-specific conditionalCCM2knockout mice establish the essential role of endothelial CCM2 in angiogenesis: implications for human cerebral cavernous malformations
Authors: Boulday Gwénola , Blécon Anne , Petit Nathalie , Chareyre Fabrice , Garcia Luis A. , Niwa-Kawakita Michiko , Giovannini Marco , Tournier-Lasserve Elisabeth
Published: February 2009

Cerebral cavernous malformations (CCM) are vascular malformations of the brain that lead to cerebral hemorrhages. In 20% of CCM patients, this results from an autosomal dominant condition caused by loss-of-function mutations in one of the three CCM genes. High expression levels of the CCM genes in the neuroepithelium indicate that CCM lesions might be caused by a loss of function of these genes in neural cells rather than in vascular cells. However, their in vivo function, particularly during cerebral angiogenesis, is totally unknown. We developed mice with constitutive and tissue-specific CCM2 deletions to investigate CCM2 function in vivo. Constitutive deletion of CCM2 leads to early embryonic death. Deletion of CCM2 from neuroglial precursor cells does not lead to cerebrovascular defects, whereas CCM2 is required in endothelial cells for proper vascular development. Deletion of CCM2 from endothelial cells severely affects angiogenesis, leading to morphogenic defects in the major arterial and venous blood vessels and in the heart, and results in embryonic lethality at mid-gestation. These findings establish the essential role of endothelial CCM2 for proper vascular development and strongly suggest that the endothelial cell is the primary target in the cascade of events leading from CCM2 mutations to CCM cerebrovascular lesions.
Organic Field-effect Transistors Based on Solution-processible Dibenzotetrathiafulvalene Derivatives
Authors: Yoshino Takamasa , Shibata Koji , Wada Hiroshi , Bando Yoshimasa , Ishikawa Ken , Takezoe Hideo , Mori Takehiko
Published: February 2009

Organic field-effect transistors based on alkyl-substituted dibenzotetrathiafulvalenes (DBTTF) are fabricated by solution process. The molecules with butyl or longer alkyl groups are standing perpendicular to the substrates in the thin films, and the transistors exhibit comparable performance to the vacuum-deposited DBTTF devices.
Alkoxy-substituted Derivatives of π-Conjugated Acyclic Anion Receptors: Effects of Substituted Positions
Authors: Maeda Hiromitsu , Eifuku Nazuki
Published: February 2009

The synthesis, solid-state assemblies, and anion binding affinities of π-conjugated acyclic anion receptors with alkoxyphenyl substituents are discussed. The position of the alkoxy moiety is essential to determining not only the electronic state but also the anion binding affinity.
Crystal Structure of Complex of Gallocatechin Gallate and Caffeine
Authors: Ishizu Takashi , Tsutsumi Hiroyuki , Sato Takashi , Yamamoto Hideji , Shiro Motoo
Published: February 2009

A merohedrally twinned crystal of the complex of (−)-gallocatechin gallate and caffeine was prepared in aqueous solution, and X-ray crystallographic analysis was performed. The driving force for the formation of the complex was thought to be mainly the π–π interaction between the B′ ring of GCg and caffeine, the B ring of GCg and caffeine.
Single-molecule Imaging with an Inexpensive UV-LED Light Source
Authors: Hattori Akifumi , Habuchi Satoshi , Vacha Martin
Published: February 2009

The powerful tool of single-molecule detection and spectroscopy has so far been confined mainly to the visible spectral region. Here, we report the use of a low-cost high-power UV light emitting diode (LED) emitting at 365 nm as a light source for single-molecule detection in epi-fluorescence microscopy. The LED provides an affordable alternative to UV laser systems. The performance of the light source is demonstrated by recording fluorescence images and time-dependent fluorescence traces of single molecules of a laser dye p-bis(o-methylstyryl)benzene (bis-MSB) and of a conjugated polymer polyfluorene.
Correlation between Photocatalytic Activities and Structural and Physical Properties of Titanium(IV) Oxide Powders
Authors: Prieto-Mahaney Orlando-Omar , Murakami Naoya , Abe Ryu , Ohtani Bunsho
Published: February 2009

Correlation between structural and physical properties and photocatalytic activities for five kinds of reactions of 35 titania samples was obtained through multivariable analyses: photocatalytic activities were empirically reproduced by a linear combination of six properties with fair reliability. While a portion of results could be interpreted using a conventional mechanism, significant activity dependence on properties, not disclosed yet, was suggested.
Formation of Lyotropic Liquid Crystals from a Fatty Acid and a Nitrogenous Heterocyclic Compound in Water
Authors: Ma Fumin , Chen Xiao , Zhao Yurong , Wang Xudong , Jing Bo , Gao Fengqing , Qiu Huayu
Published: February 2009

Lyotropic liquid crystalline (LLC) phases of lauric acid in water have been successfully constructed with the aid of a N-heterocyclic compound in water. This novel ternary system can exhibit Lα phase with its lamellar spacing changing regularly in a wide concentration range.
Gertrude Stein (1874–1946) and the nucleus of Darkschewitsch: a discursive commentary
Authors: Golden Richard L
Published: February 2009

Gertrude Stein is an icon of American literature whose scientific and medical background has become shrouded in obscurity. As an undergraduate at Radcliffe she was strongly influenced by William James and published two papers on motor automatism in the Psychological Review. As a medical student at Johns Hopkins University, her research on the nucleus of Darkschewitsch was quoted in Lewellys F Barker's acclaimed textbook on neuroanatomy; Stein's first book appearance. The background of the Russian neurologist Liverji O Darkschewitsch, little known in the West, is explored particularly in regard to his relationship and collaboration with Sigmund Freud whose letters provide considerable insight. Gertrude Stein failed to graduate with her class of 1901 at Johns Hopkins and soon after departed for an expatriate life in Europe devoted to art and literature.
Professor Arthur Norman Exton-Smith CBE MA MD FRCP (1920–90): distinguished Geriatrician and Gerontologist
Authors: Denham M J
Published: February 2009

Professor Norman Exton-Smith was a highly respected, distinguished postwar consultant geriatrician with a worldwide reputation. He devoted his life to improving the medical care of elderly people and researching age-related decline in physical function, particularly thermoregulation and postural balance. He established thriving clinical and research departments at St Pancras Hospital, London. Many of his junior medical staff became well-known geriatricians. He published and lectured extensively, organized many meetings and conferences, and was advisor to the Department of Health and Social Security for many years. He was a valued authority on geriatric medicine within the Royal College of Physicians of London and a major influence in the British Geriatrics Society (BGS) of which he was Secretary and later the President.
John Hyacinth de Magellan (1722–90): 18th century physicist with views on medical matters
Authors: Fernandes-Thomaz Manuel
Published: February 2009

John Hyacinth de Magellan, whose Portuguese name was João Hyacintho de Magalhaens, though not a doctor nevertheless had many contacts with doctors and showed a genuine interest in disseminating medical news to his many friends and correspondents in Europe. The abundant and less formal correspondence with his friend Ribeiro Sanches forms the greater part of the work but in letters to other correspondents, including Trudaine de Montigny, Condorcet, Volta, J A Euler, Fabroni and Johann III Bernoulli, we find comments on medical subjects. The Sanches letters are particularly interesting because they are private, friend-to-friend letters that convey spontaneous and sincere thoughts and feelings.
Dr William Sargant (1907–88) and the emergence of physical treatments in British psychiatry
Authors: Beard John A S
Published: February 2009

Dr William Walters Sargant stands out as a firm champion of physical treatments in 20th century British psychiatry. Some saw his ultra-physical approach as evidence of the progress that the speciality of psychiatry had made in moving on from its unscientific beginnings in the 19th century. Other psychiatrists, however, maintained that Sargant's practices were too ‘surgical’, immoral even. Sargant was a flag-bearer for the new treatment methods of insulin coma, electroconvulsive therapy (ECT), psychosurgery and intensive drug therapy. He rebutted the claims of clinicians who argued for a more psychologically or socially driven approach. Moreover, he advocated the eradication of memories from the mind by physical means rather than teasing them out by Freudian analysis.
Nikolai Konstantinovich Kulchitsky (1856–1925)
Authors: Drozdov Ignat , Modlin Irvin M , Kidd Mark , Goloubinov Victor V
Published: February 2009

Nikolai Kulchitsky is best remembered for his identification of the Kulchitsky (enterochromaffin) cell. His life spanned a teaching and scientific career at Kharkov University, employment as the Imperial Minister of Education for all Russia, work in a soap factory and flight from the Russian Revolution to London, and a position at the University College with Elliot Smith. His subsequent contributions to the anatomic delineation of dual nerve-endings in the muscle were highly regarded, although his identification of the enterochromaffin cell (1897) remains his enduring scientific legacy. The observation of a cardinal neuroendocrine cell of the gut formed the basis for the subsequent delineation of the diffuse neuroendocrine system and provided the cellular framework on which the discipline of gut neuroendocrinology would be established. Kulchitsky's mysterious demise in a bizarre lift-shaft accident at UCL on his 69th birthday tragically terminated a life of service to science.
Variables determining outcome in total hip replacement surgery
Authors: Rolfson O. , Dahlberg L. E. , Nilsson J-å. , Malchau H. , Garellick G.
Published: February 2009

In this study we hypothesised that anxiety/depression, one of five dimensions in the health-related quality of life (HRQoL) measurement tool EQ-5D, could predict outcome after total hip replacement surgery.

Pre-operative and one-year post-operative data from the Swedish Hip Arthroplasty Register, including 6158 patients with primary osteoarthritis of the hip, were analysed. In order to examine the association between anxiety and outcome with respect to pain and satisfaction an analysis of covariance was used.

The pre-operative EQ-5D anxiety/depression dimension was a strong predictor for pain relief and patient satisfaction (p < 0.001).

Orthopaedic surgeons involved in the care of patients eligible for total hip replacement surgery should be aware that mental health may influence post-operative pain and HRQoL. An appropriate assessment of mental health may enable a modification in the way these patients are managed in order to optimise the outcome after joint replacement surgery.
Early palsy of the sciatic nerve due to heterotopic ossification after surgery for fracture of the posterior wall of the acetabulum
Authors: Manidakis N. , Kanakaris N. K. , Nikolaou V. S. , Giannoudis P. V.
Published: February 2009

We describe a patient in whom an initially intact sciatic nerve became rapidly encased in heterotopic bone formed in the abductor compartment after reconstruction of the posterior wall of the acetabulum following fracture. Prompt excision and neural release followed by irradiation and administration of indometacin resulted in a full neurological recovery and no recurrence 27 months later.
Conservative treatment of lumbar spondylolysis in childhood and adolescence
Authors: Sairyo K. , Sakai T. , Yasui N.
Published: February 2009

It has been noted that bony union of a pars defect can be achieved in children if they wear a trunk brace. Our aim was to evaluate how the stage of the defect on CT and the presence or absence of high signal change in the adjacent pedicle on T2-weighted MRI were related to bony healing. We treated 23 children conservatively for at least three months. There were 19 boys and four girls with a mean age of 13.5 years (7 to 17). They were asked to refrain from sporting activity and to wear a Damen soft thoracolumbosacral type brace. There were 41 pars defects in 23 patients. These were classified as an early, progressive or terminal stage on CT. The early-stage lesions had a hairline crack in the pars interarticularis, which became a gap in the progressive stage. A terminal-stage defect was equivalent to a pseudarthrosis. On the T2-weighted MR scan the presence or absence of high signal change in the adjacent pedicle was assessed and on this basis the defects were divided into high signal change-positive or -negative. Healing of the defect was assessed by CT.

In all, 13 (87%) of the 15 early defects healed. Of 19 progressive defects, only six (32%) healed. None of the seven terminal defects healed. Of the 26 high signal change-positive defects 20 (77%) healed after conservative treatment whereas none of the high signal change-negative defects did so. We concluded that an early-stage defect on CT and high signal change in the adjacent pedicle on a T2-weighted MR scan are useful predictors of bony healing of a pars defect in children after conservative treatment.
Fibular centralisation for the reconstruction of defects of the tibial diaphysis and distal metaphysis after excision of bone tumours
Authors: Puri A. , Subin B. S. , Agarwal M. G.
Published: February 2009

We evaluated the results of fibular centralisation as a stand alone technique to reconstruct defects that occurred after resection of tumours involving the tibial diaphysis and distal metaphysis.

Between January 2003 and December 2006, 15 patients underwent excision of tumours of the tibial diaphysis or distal metaphysis and reconstruction by fibular centralisation. Their mean age was 17 years (7 to 40). Two patients were excluded; one died from the complications of chemotherapy and a second needed a below-knee amputation for a recurrent giant-cell tumour. A total of 13 patients were reviewed after a mean follow-up of 29 months (16 to 48). Only 16 of 26 host graft junctions united primarily. Ten junctions in ten patients needed one or more further procedure before union was achieved. At final follow-up 12 of the 13 patients had fully united grafts; 11 walked without aids. The mean time to union at the junctions that united was 12 months (3 to 36). The mean Musculoskeletal Tumor Society Score was 24.7 (16 to 30).

Fibular centralisation is a durable reconstruction for defects of the tibial diaphysis and distal metaphysis with an acceptable functional outcome. Stable osteosynthesis is the key to successful union. Additional bone grafting is recommended for patients who need postoperative radiotherapy.
Large and massive tears of the rotator cuff
Authors: Hanusch B. C. , Goodchild L. , Finn P. , Rangan A.
Published: February 2009

The aim of this study was to determine the functional outcome and rate of re-tears following mini-open repair of symptomatic large and massive tears of the rotator cuff using a two-row technique.

The 24 patients included in the study were assessed prospectively before and at a mean of 27 months (18 to 53) after surgery using the Constant and the Oxford Shoulder scores. Ultrasound examination was carried out at follow-up to determine the integrity of the repair. Patient satisfaction was assessed using a simple questionnaire.

The mean Constant score improved significantly from 36 before to 68 after operation (p < 0.0001) and the mean Oxford Shoulder score from 39 to 20 (p < 0.0001). Four of the 24 patients (17%) had a re-tear diagnosed by ultrasound. A total of 21 patients (87.5%) were satisfied with the outcome of their surgery. The repair remained intact in 20 patients (83%). However, the small number of re-tears (four patients) in the study did not allow sufficient analysis to show a difference in outcome in relation to the integrity of the repair.
The effectiveness of a programme for neonatal hip screening over a period of 40 years
Authors: Myers J. , Hadlow S. , Lynskey T.
Published: February 2009

Since September 1964, neonates born in New Plymouth have undergone clinical examination for instability of the hip in a structured clinical screening programme. Of the 41 563 babies born during this period, 1639 were diagnosed as having unstable hips and 663 (1.6%) with persisting instability were splinted, five of which failed. Also, three unsplinted hips progressed to congenital dislocation, and there were four late-presenting (walking) cases, giving an overall failure rate of 0.29 per 1000 live births, with an incidence of late-walking congenital dislocation of the hip of 0.1 per 1000 live births.

This study confirms that clinical screening for neonatal instability of the hip by experienced orthopaedic examiners significantly reduces the incidence of late-presenting (walking) congenital dislocation of the hip.
Methicillin-resistant Staphylococcus aureus in orthopaedic trauma
Authors: Fascia D. T. M. , Singanayagam A. , Keating J. F.
Published: February 2009

We have conducted a case-control study over a period of ten years comparing both deep infection with methicillin-resistant staphylococcus aureus (MRSA) and colonised cases with a control group.

Risk factors associated with deep infection were vascular diseases, chronic obstructive pulmonary disease, admission to a high-dependency or an intensive-care unit and open wounds. Those for colonisation were institutional care, vascular diseases and dementia. Older age was a risk factor for any MRSA infection. The length of hospital stay was dramatically increased by deep infection.

These risk factors are useful in identifying higher-risk patients who may be more susceptible to MRSA infection. A strategy of early identification and isolation may help to control its spread in trauma units.
Repair of defects and containment in revision total knee replacement
Authors: Toms A. D. , Barker R. L. , McClelland D. , Chua L. , Spencer-Jones R. , Kuiper J.-H.
Published: February 2009

The treatment of bony defects of the tibia at the time of revision total knee replacement is controversial. The place of compacted morsellised bone graft is becoming established, particularly in contained defects. It has previously been shown that the initial stability of impaction-grafted trays in the contained defects is equivalent to that of an uncemented primary knee replacement. However, there is little biomechanical evidence on which to base a decision in the treatment of uncontained defects. We undertook a laboratory-based biomechanical study comparing three methods of graft containment in segmental medial tibial defects and compared them with the use of a modular metal augment to bypass the defect.

Using resin models of the proximal tibia with medial defects representing either 46% or 65% of the medial cortical rim, repair of the defect was accomplished using mesh, cement or a novel bag technique, after which impaction bone grafting was used to fill the contained defects and a tibial component was cemented in place. As a control, a cemented tibial component with modular metal augments was used in identical defects. All specimens were submitted to cyclical mechanical loading, during which cyclical and permanent tray displacement were determined.

The results showed satisfactory stability with all the techniques except the bone bag method. Using metal augments gave the highest initial stability, but obviously lacked any potential for bone restoration.
Review of Kinemax knee arthroplasty performed at the NHS Treatment Centre, Weston-Super-Mare
Authors: Kempshall P. J. , Metcalfe A. , Forster M. C.
Published: February 2009

As part of the government’s initiative to reduce waiting times for major joint surgery in Wales, the Cardiff and Vale NHS Trust sent 224 patients (258 knees) to the NHS Treatment Centre in Weston-Super-Mare for total knee replacement. The Kinemax total knee replacement system was used in all cases. The cumulative survival rate at three years was 79.2% (95% confidence interval (CI) 69.2 to 86.8) using re-operation for any cause as an endpoint and 85.3% (95% CI 75.9 to 91.8) using aseptic revision as an endpoint. This is significantly worse than that recorded in the published literature. These poor results have resulted in a significant impact on our service.
Six-year results of a prospective study of metal ion levels in young patients with metal-on-metal hip resurfacings
Authors: Daniel J. , Ziaee H. , Pradhan C. , McMinn D. J. W.
Published: February 2009

We describe the findings at six years in an ongoing prospective clinicoradiological and metal ion study in a cohort of 26 consecutive male patients with unilateral Birmingham Hip Resurfacing arthroplasties with one of two femoral head sizes (50 mm and 54 mm). Their mean age was 52.9 years (29 to 67). We have previously shown an early increase in the 24-hour urinary excretion of metal ions, reaching a peak at six months (cobalt) and one year (chromium) after operation. Subsequently there is a decreasing trend in excretion of both cobalt and chromium. The levels of cobalt and chromium in whole blood also show a significant increase at one year, followed by a decreasing trend until the sixth year.