bluuebunny/crossref_metadata_2025 huggingface dataset:
The Older They Are, the Less Successful They Become? Findings from the Georgia Centenarian Study
Authors: Cho Jinmyoung , Martin Peter , Poon Leonard W.
Published: July 2012

This study examined whether oldest-old adults are successful agers. Three hundred and six octogenarians and centenarians of Phase III of the Georgia Centenarian Study participated in this study. A first model examined Rowe and Kahn’s successful aging model (Rowe and Khan (1997 and 1998)) including the probability of disease, physical or cognitive capacity, and engagement with life. All three components were applied to assess how many oldest-old adults satisfied all three criteria. The result showed about 15% of octogenarians (15.1%), and none of centenarians satisfied all three components of successful aging. Consequently, a second alternative model focused on psychosocial aspects including three different components: subjective health, perceived economic status, and happiness. Different from Rowe and Kahn’s successful aging model, a total of 62.3% of octogenarians and 47.5% of centenarians satisfied all three components of the alternative model of successful aging. The results suggest that additional criteria of successful aging should be considered thereby expanding the concepts and multidimensional aspects of successful aging among oldest-old adults.
Anesthesia for Suboccipital Craniotomy in a Patient with Lymphangioleiomyomatosis: A Case Report
Authors: Peterfreund Robert A. , Luman Emily , Martuza Robert L.
Published: July 2012

Lymphangioleiomyomatosis (LAM) is a rare pulmonary condition often presenting with spontaneous pneumothorax. Imaging or biopsy confirm the diagnosis. Published case reports describe the anesthetic management of patients with LAM undergoing brief procedures. No reports describe the anesthetic management for lengthy neurosurgical procedures. We describe anesthetic management for craniotomy in a patient with LAM.Clinical Features. A woman presented with 2 spontaneous left pneumothoraces. She received a diagnosis of LAM by imaging. She did well after pleurodesis. Hearing loss and tinnitus led to brain imaging demonstrating a large left cerebello-pontine angle mass. She presented for elective craniotomy to remove the mass while preserving cranial nerve function. Our technique for general endotracheal anesthesia aimed to reduce the likelihood of another pneumothorax while providing good surgical conditions and permitting neuromonitoring.Conclusion. We demonstrate the successful anesthetic management of a patient with LAM undergoing a lengthy suboccipital craniotomy for a posterior fossa mass.
Host-Bacteria Crosstalk at the Dentogingival Junction
Authors: Pöllänen M. T. , Laine M. A. , Ihalin R. , Uitto V.-J.
Published: July 2012

The dentogingival junction is of crucial importance in periodontal host defense both structurally and functionally. Oral bacteria exert a constant challenge to the host cells and tissues at the dentogingival junction. The host response is set up to eliminate the pathogens by the innate and adaptive defense mechanisms. In health, the commensal bacteria and the host defense mechanisms are in a dynamic steady state. During periodontal disease progression, the dental bacterial plaque, junctional epithelium (JE), inflammatory cells, connective tissue, and bone all go through a series of changes. The tissue homeostasis is turned into tissue destruction and progression of periodontitis. The classical study of Slots showed that in the bacterial plaque, the most remarkable change is the shift from gram-positive aerobic and facultatively anaerobic flora to a predominantly gram-negative and anaerobic flora. This has been later confirmed by several other studies. Furthermore, not only the shift of the bacterial flora to a more pathogenic one, but also bacterial growth as a biofilm on the tooth surface, allows the bacteria to communicate with each other and exert their virulence aimed at favoring their growth. This paper focuses on host-bacteria crosstalk at the dentogingival junction and the models studying itin vitro.
Bone Demineralization in Postmenopausal Women: Role of Anamnestic Risk Factors
Authors: La Vignera Sandro , Condorelli Rosita A. , Vicari Enzo , Nicoletti Chiara , Calogero Aldo E.
Published: July 2012

This study evaluated the effects of LT4 administration on the bone mineral density (BMD) in physiological postmenopausal women after two years of continuative treatment. 110 postmenopausal women with nodular goiter aged between 50 and 55 years were examined before and after 2 years of therapy with a fixed dose of LT4 (1.6 mcg/kg/die) for the treatment of nodular thyroid disease. The results showed that the patients on treatment with LT4 have a slight, but significant reduction of the BMD after 2 years of treatment, associated with increased serum levels of alkaline phosphatase and urinary excretion of hydroxyproline, confirming our data conducted on the same group after one year of therapy. Comparison between patients receiving LT4 (group A) or not (group B) showed that group A patients had significantly lower BMD. We demonstrated the statistically significant influence of the following risk factors on BMD: (1) body mass index<19 kg/m2; (2) the onset of menarche after the age of 15 years; (3) positive history for period of amenorrhoea; (4) nulliparity.
Clustering-Based Method for Developing a Genomic Copy Number Alteration Signature for Predicting the Metastatic Potential of Prostate Cancer
Authors: Pearlman Alexander , Campbell Christopher , Brooks Eric , Genshaft Alex , Shajahan Shahin , Ittman Michael , Bova G. Steven , Melamed Jonathan , Holcomb Ilona , Schneider Robert J. , Ostrer Harry
Published: July 2012

The transition of cancer from a localized tumor to a distant metastasis is not well understood for prostate and many other cancers, partly, because of the scarcity of tumor samples, especially metastases, from cancer patients with long-term clinical follow-up. To overcome this limitation, we developed a semi-supervised clustering method using the tumor genomic DNA copy number alterations to classify each patient into inferred clinical outcome groups of metastatic potential. Our data set was comprised of 294 primary tumors and 49 metastases from 5 independent cohorts of prostate cancer patients. The alterations were modeled based on Darwin’s evolutionary selection theory and the genes overlapping these altered genomic regions were used to develop a metastatic potential score for a prostate cancer primary tumor. The function of the proteins encoded by some of the predictor genes promote escape from anoikis, a pathway of apoptosis, deregulated in metastases. We evaluated the metastatic potential score with other clinical predictors available at diagnosis using a Cox proportional hazards model and show our proposed score was the only significant predictor of metastasis free survival. The metastasis gene signature and associated score could be applied directly to copy number alteration profiles from patient biopsies positive for prostate cancer.
Molecular Dynamics Analysis of PVA‐AgnP Composites by Dielectric Spectroscopy
Authors: González-Campos J. Betzabe , Prokhorov Evgen , Sanchez Isaac C. , Luna-Bárcenas J. Gabriel , Manzano-Ramírez Alejandro , González-Hernández Jesús , López-Castro Yliana , del Río Rosa E.
Published: July 2012

The molecular dynamics of PVA/AgnP composites were studied by dielectric spectroscopy (DS) in the 20–300°C temperature range. Improper water elimination leads to misinterpretation of thermal relaxations in PVA composites in agreement with the previous report for pristine PVA. The evaporation of water and its plasticizing effect are more evident in pure PVA confirming the existence of strong interaction between OH groups of PVA chains and AgnP. Dry films show a single nonlinear VFT dependence (from 45°C until melting) associated to the α‐relaxation and, therefore, to the glass transition phenomenon and from dielectric measurements, the Tg of composites vary from 88°C for pristine PVA to 125°C for PVA/AgnP (5 wt%). Below 45°C, dry films exhibit a single Arrhenius behavior showing a 3D hopping conductivity as explained based on the variable range hopping model. PVA/AgnP composites have higher conductivity compared to pristine PVA, and it increases as AgnP weight percent increases. Finally, DMA measurements support the statement that a secondary relaxation was erroneously assigned as the glass transition of PVA and composites in previous reports.
Recurrent Mutations of MYD88 and TBL1XR1 in Primary Central Nervous System Lymphomas
Authors: Gonzalez-Aguilar Alberto , Idbaih Ahmed , Boisselier Blandine , Habbita Naïma , Rossetto Marta , Laurenge Alice , Bruno Aurélie , Jouvet Anne , Polivka Marc , Adam Clovis , Figarella-Branger Dominique , Miquel Catherine , Vital Anne , Ghesquières Hervé , Gressin Rémy , Delwail Vincent , Taillandier Luc , Chinot Olivier , Soubeyran Pierre , Gyan Emmanuel , Choquet Sylvain , Houillier Caroline , Soussain Carole , Tanguy Marie-Laure , Marie Yannick , Mokhtari Karima , Hoang-Xuan Khê
Published: July 2012

Purpose: Our objective was to identify the genetic changes involved in primary central nervous system lymphoma (PCNSL) oncogenesis and evaluate their clinical relevance.

Experimental Design: We investigated a series of 29 newly diagnosed, HIV-negative, PCNSL patients using high-resolution single-nucleotide polymorphism (SNP) arrays (n = 29) and whole-exome sequencing (n = 4) approaches. Recurrent homozygous deletions and somatic gene mutations found were validated by quantitative real-time PCR and Sanger sequencing, respectively. Molecular results were correlated with prognosis.

Results: All PCNSLs were diffuse large B-cell lymphomas, and the patients received chemotherapy without radiotherapy as initial treatment. The SNP analysis revealed recurrent large and focal chromosome imbalances that target candidate genes in PCNSL oncogenesis. The most frequent genomic abnormalities were (i) 6p21.32 loss (HLA locus), (ii) 6q loss, (iii) CDKN2A homozygous deletions, (iv) 12q12-q22, and (v) chromosome 7q21 and 7q31 gains. Homozygous deletions of PRMD1, TOX, and DOCK5 and the amplification of HDAC9 were also detected. Sequencing of matched tumor and blood DNA samples identified novel somatic mutations in MYD88 and TBL1XR1 in 38% and 14% of the cases, respectively. The correlation of genetic abnormalities with clinical outcomes using multivariate analysis showed that 6q22 loss (P = 0.006 and P = 0.01) and CDKN2A homozygous deletion (P = 0.02 and P = 0.01) were significantly associated with shorter progression-free survival and overall survival.

Conclusions: Our study provides new insights into the molecular tumorigenesis of PCNSL and identifies novel genetic alterations in this disease, especially MYD88 and TBL1XR1 mutations activating the NF-κB signaling pathway, which may be promising targets for future therapeutic strategies. Clin Cancer Res; 18(19); 5203–11. ©2012 AACR.
Molecular Investigation of Virulence Determinants between a Virulent Clinical Strain and an Attenuated Strain of Burkholderia pseudomallei
Authors: Puthucheary S.D. , Puah Suat Moi , Chai Hwa Chia , Thong Kwai Lin , Chua Kek Heng
Published: July 2012

Burkholderia pseudomallei is the causative agent of melioidosis. We initiated this investigation with a virulent and an attenuated strain of B. pseudomallei. Pulsed-field gel electrophoresis was carried out initially for macrogenomic comparison of both strains of B. pseudomallei. However, the pulsotypes obtained were identical and therefore we applied a subtractive hybridization technique to distinguish and determine the possible differences between the two strains. Six virulence strain-specific DNA fragments were obtained and the encoding homolog proteins were identified as a xenobiotic-responsive element family of transcriptional regulator, a hypothetical protein, an unknown protein, a plasmid recombination enzyme, a regulatory protein and a putative hemolysin activator protein. A combination of at least three of these determinants was identified in 45 clinical isolates when screening was carried out with self-designed multiplex PCR targeting the six putative virulent determinants. Our data demonstrated that different combinations of the six putative virulence genes were present in the clinical isolates indicating their probable role in the pathogenesis of B. pseudomallei infections.
Arterial Bleeding during Transurethral Resection of Bladder Cancer Managed by Endovascular Intervention
Authors: Ortegren Joakim , Sundqvist Pernilla , Strandberg Charlotta , Weber Per , Liedberg Fredrik
Published: July 2012

In this case report, we describe a severe arterial bleeding during transurethral resection of bladder cancer where routine endoscopic methods failed to stop the hemorrhage. In a vascular operating theater selective angiography with coiling managed the bleeding without any surgery-related complications.
Serum Levels of Soluble Adhesion Molecules as Prognostic Factors for Acute Liver Failure
Authors: Ohnishi Atsuyuki , Miyake Yasuhiro , Matsushita Hiroshi , Matsumoto Kazuyuki , Takaki Akinobu , Yasunaka Tetsuya , Koike Kazuko , Ikeda Fusao , Shiraha Hidenori , Nouso Kazuhiro , Yamamoto Kazuhide
Published: July 2012

Background/Aims: In patients with septic shock, the degree of liver dysfunction is correlated with serum levels of soluble intercellular adhesion molecule (sICAM)-1. We aimed to assess the usefulness of serum levels of soluble adhesion molecules as prognostic factors for acute liver failure (ALF). Methods: Serum levels of soluble platelet endothelial cell adhesion molecule (sPECAM)-1, sICAM-3, soluble endothelial (sE) selectin, sICAM-1, soluble platelet selectin, and soluble vascular cell adhesion molecule-1 on admission were measured in 37 ALF patients and 34 healthy controls. Results: Twenty-two ALF patients (59%) reached to fatal outcomes. Serum levels of sPECAM-1, sICAM-3, sE-selectin and sICAM-1 were higher in ALF patients than healthy controls. In 37 ALF patients, by the multivariate logistic regression analysis, ratio of direct to total bilirubin (per 0.1 increase; OR 0.11, 95% CI 0.01–0.99), serum sPECAM-1 level (per 100 ng/ml increase; OR 4.37, 95% CI 1.23–15.5) and serum sICAM-1 level (per 100 ng/ml increase; OR 0.49, 95% CI 0.27–0.89) were associated with fatal outcomes. Using receiver operating characteristics curve, each area under the curve of serum sPECAM-1 and sICMA-1 levels as prognostic factors was 0.71 and 0.74, respectively. Conclusion: Serum sPECAM-1 and sICAM-1 levels may be useful for predicting the prognosis of ALF.
Comparison of Event-Based Methods Using Optical Coherence Tomography and Automated Perimetry to Detect the Progression of Glaucoma in Patients with Open-Angle Glaucoma
Authors: Lee Marvin , Yang Hongseok , Kim Jongwan , Ahn Jaehong
Published: July 2012

Background/Aims: To compare event-based methods for estimating the incidence of glaucoma progression using optical coherence tomography (OCT) and automated perimetry and to assess agreement between structural and functional tests for detecting glaucoma progression. Methods: Functional progression of glaucoma was estimated by guided progression analysis (GPA) using a Humphrey field analyzer (HFA), and structural progression was assessed by OCT and defined as the decrease in retinal nerve fiber layer thickness based on test-retest variability data of previous reports on clock-hour and quadrant maps. The level of agreement between structural and functional progression was evaluated using kappa statistics. Results: Fifty eyes of 50 patients with open-angle glaucoma were enrolled in this retrospective study. The incidence of visual field progression estimated by GPA was 18%. The occurrence of structural progression assessed by OCT ranged from 18 to 68%. The more stringent OCT progression criterion using a quadrant map showed the best agreement with HFA GPA (ĸ = 0.423) and detected perimetric progression with high specificity, while the less stringent OCT criterion considering any clock hour showed the lowest agreement with functional progression (ĸ = 0.098). Conclusion: OCT progression criteria based on test-retest variability showed moderate agreement with perimetric progression, and more stringent criteria showed better agreement with functional progression than less stringent ones.
Terminal Restriction Fragment Length Polymorphism Analysis of the Gut Microbiota Profiles of Pediatric Patients with Inflammatory Bowel Disease
Authors: Aomatsu Tomoki , Imaeda Hirotsugu , Fujimoto Takehide , Takahashi Kenichiro , Yoden Atsushi , Tamai Hiroshi , Fujiyama Yoshihide , Andoh Akira
Published: July 2012

Background/Aim: We analyzed the fecal microbiota profiles of pediatric patients with inflammatory bowel disease. Method: Terminal restriction fragment length polymorphism analysis was performed in 10 fecal samples from Crohn’s disease (CD), 14 samples from ulcerative colitis (UC) and 27 samples from healthy individuals. The bacterial diversity was evaluated by the Shannon diversity index. Result: In CD patients, a setting of similarity generated three major clusters. The majority of CD patients were classified into CD clusters I and II (9 out of 10), but the majority of healthy individuals (21 of 27) were classified into CD cluster III. In UC patients, a setting of similarity also generated three major UC clusters, but each cluster was not characteristic for UC patients or healthy individuals. The changes in simulated bacterial composition indicated that the class Clostridia, including the genus Faecalibacterium, was significantly decreased in CD patients as compared to UC patients and/or healthy individuals. The genus Bacteroides was also decreased as compared to healthy individuals. The bacterial diversity measured by the Shannon diversity index was significantly reduced in CD patients as compared to healthy individuals. Conclusion: The gut microbiota profile of pediatric CD patients was different from that of healthy children.
Emergent Early Markers of Renal Progression in Autosomal-Dominant Polycystic Kidney Disease Patients: Implications for Prevention and Treatment
Authors: Helal Imed , Reed Berenice , Schrier Robert W.
Published: July 2012

Autosomal-dominant polycystic kidney disease (ADPKD) is the most common single cause of end-stage renal disease after diabetes, hypertension and glomerulonephritis. The clinical course of ADPKD is highly variable. Even with optimal care and therapy monitoring, currently the progression of ADPKD is slowed but not stopped. Newer treatments will no doubt become available in the future, but their side effect profiles will always need to be considered. Therefore, markers to distinguish ADPKD patients with a poor versus a good prognosis will be helpful. Several risk factors influencing kidney disease progression in ADPKD have been identified in the current era. The present review will discuss the spectrum of early markers of ADPKD renal disease progression. Specifically, the volume of total kidney, hypertension, glomerular hyperfiltration, renal blood flow, microalbuminuria, uric acid, and urinary molecular markers will be discussed. On this background, implications for the prevention and treatment of kidney disease progression in ADPKD are also discussed.
Thyroid Function Tests in Obese Prepubertal Children: Correlations with Insulin Sensitivity and Body Fat Distribution
Authors: Brufani Claudia , Manco Melania , Nobili Valerio , Fintini Danilo , Barbetti Fabrizio , Cappa Marco
Published: July 2012

Background/Aims: Elevated thyroid-stimulating hormone (TSH) concentrations in association with normal/slightly elevated free triiodothyronine (fT3) and/or free thyroxine (fT4) have been consistently found in obese children. To examine relationships between adiposity, insulin sensitivity, and TSH, fT3 and fT4. Methods: 240 overweight/obese prepubertal children were studied. Fasting TSH, fT3, fT4, glucose, insulin, C-peptide, lipids, leptin and adiponectin were evaluated. Insulin sensitivity and resistance were estimated [quantitative insulin check index (QUICKI), insulin sensitivity index (ISI), and hepatic insulin resistance index]. Body fat was measured by dual-energy X-ray absorptiometry. The central obesity index was calculated as the ratio of fat tissue in the trunk region to fat tissue in the leg region. Results: The multiple regression analysis with age, gender and measures of fatness as covariates showed that QUICKI was the only significant negative predictor of TSH and central obesity index the strongest positive predictor of fT3, in association with either age or hepatic insulin resistance index, and that the only positive determinant of fT4 was hepatic insulin resistance index. Conclusions: Reduced insulin sensitivity is associated with augmented TSH and fT4, while progressive central fat accumulation is strictly related to a parallel increase in fT3 levels, independently from total body fat. Further studies are needed to understand mechanisms linking thyroid function to insulin sensitivity and body composition in obese children.
High Intellectual Function in Individuals with Mutation-Positive Microform Holoprosencephaly
Authors: Solomon B.D. , Pineda-Alvarez D.E. , Gropman A.L. , Willis M.J. , Hadley D.W. , Muenke M.
Published: July 2012

Holoprosencephaly is the most common malformation of the forebrain and typically results in severe neurocognitive impairment with accompanying midline facial anomalies. Holoprosencephaly is heterogeneous and may be caused by chromosome aberrations or environmental factors, occur in the context of a syndrome or be due to heterozygous mutations in over 10 identified genes. The presence of these mutations may result in an extremely wide spectrum of severity, ranging from brain malformations incompatible with life to individuals with normal brain findings and subtle midline facial differences. Typically, clinicians regard intellectual disability as a sign that a parent or relative of a severely affected patient may be a mildly affected mutation ‘carrier’ with what is termed microform holoprosencephaly. Here we present 5 patients with clear phenotypic signs of microform holoprosencephaly, all of whom have evidence of above-average intellectual function. In 4 of these 5 individuals, the molecular cause of holoprosencephaly has been identified and includes mutations affecting SHH, SIX3, GLI2, and FGF8. This report expands the phenotypic spectrum of holoprosencephaly and is important in the counseling of patient and affected families.
Cognitive Factors Affecting Free Recall, Cued Recall, and Recognition Tasks in Alzheimer’s Disease
Authors: Yamagishi Takashi , Sato Takuya , Sato Atsushi , Imamura Toru
Published: July 2012

Background/Aims: Our aim was to identify cognitive factors affecting free recall, cued recall, and recognition tasks in patients with Alzheimer’s disease (AD). Subjects: We recruited 349 consecutive AD patients who attended a memory clinic. Methods: Each patient was assessed using the Alzheimer’s Disease Assessment Scale (ADAS) and the extended 3-word recall test. In this task, each patient was asked to freely recall 3 previously presented words. If patients could not recall 1 or more of the target words, the examiner cued their recall by providing the category of the target word and then provided a forced-choice recognition of the target word with 2 distracters. The patients were divided into groups according to the results of the free recall, cued recall, and recognition tasks. Multivariate logistic regression analysis for repeated measures was carried out to evaluate the net effects of cognitive factors on the free recall, cued recall, and recognition tasks after controlling for the effects of age and recent memory deficit. Results: Performance on the ADAS Orientation task was found to be related to performance on the free and cued recall tasks, performance on the ADAS Following Commands task was found to be related to performance on the cued recall task, and performance on the ADAS Ideational Praxis task was found to be related to performance on the free recall, cued recall, and recognition tasks. Conclusion: The extended 3-word recall test reflects deficits in a wider range of memory and other cognitive processes, including memory retention after interference, divided attention, and executive functions, compared with word-list recall tasks. The characteristics of the extended 3-word recall test may be advantageous for evaluating patients’ memory impairments in daily living.
Consumption of Sugar-Sweetened Beverages in Relation to the Metabolic Syndrome among Iranian Adults
Authors: Khosravi-Boroujeni Hossein , Sarrafzadegan Nizal , Mohammadifard Noushin , Alikhasi Hasan , Sajjadi Firouzeh , Asgari Sedigheh , Esmaillzadeh Ahmad
Published: July 2012

Background: Few data are available linking intake of sugar-sweetened beverages (SSBs) with the metabolic syndrome. Furthermore, findings from these studies are inconsistent and most are from Western societies; no information is available in this regard from Middle Eastern populations. Objective: This study was conducted to assess the relationship between SSB consumption and metabolic syndrome in an Iranian adult population. Methods: In this cross-sectional study, data from 1,752 people (782 men and 970 women) that were selected with the multistage cluster random sampling method from three counties of Isfahan, Najafabad and Arak were used. A validated food frequency questionnaire was used to assess participants’ usual dietary intakes. Consumption of SSBs was calculated by summing up the consumption of ‘soft drinks’ and ‘artificially sweetened fruit juices’. To categorize participants, we used three levels of SSB consumption: <1 time/week, 1–3 times/week, and >3 times/week. Biochemical assessments were done after an overnight fasting. Metabolic syndrome was defined according to the guidelines of Adult Treatment Panel III. Results: Subjects with high consumption of SSBs (>3 times/week) were younger than those with low consumption (<1 time/week). Mean BMI was not significantly different across SSB categories. High consumption of SSBs was associated with greater intakes of energy and almost all food groups. We found a significant difference in serum triglyceride levels between men consuming SSBs 1–3 times/week and those consuming <1 time/week. However, after controlling for potential confounders, this association disappeared. In crude models, no significant associations were found between SSB intake and prevalence of the metabolic syndrome in either gender. After adjustment for potential confounders including BMI, we found that men in the top category of SSB intake were 17% more likely to have the metabolic syndrome (odds ratio (OR) 1.17; 95% confidence interval (95% CI) 0.56–2.46), while women in the highest category were 20% less likely to have the syndrome (OR 0.80; 95% CI 0.46–1.42) as compared with those in the bottom category. However, these associations were not significant in either men or women. Conclusion: Our results do not support the previous findings on the association between SSB consumption and metabolic syndrome. Prospective studies are needed to further explore for this association.
Gastrobronchial Fistula as a Complication of Bariatric Surgery: A Series of 6 Cases
Authors: Sakran Nasser , Assalia Ahmad , Keidar Andrei , Goitein David
Published: July 2012

Objective: To present a multicenter series of 6 patients who developed gastrobronchial fistula (GBF). GBF is a rare subtype of gastric leaks following bariatric surgery, which is the mainstay of treatment for the obesity pandemic. Methods: We retrospectively identified 6 patients with GBF (out of 2,308 cases performed: 0.2%). One patient had undergone Roux-en-Y gastric bypass, and 5 had a sleeve gastrectomy. Demographics, previous surgeries, clinical presentation, timing of fistula diagnosis, diagnostic and treatment measures employed, and outcome were collected. Results: Four patients were female, the average age and BMI were 42 years and 42.5 kg/m2, respectively. Three patients had previous surgeries (Nissen fundoplication, adjustable gastric banding, and vertical banded gastroplasty). Median time to fistula diagnosis was 40 days (range 15–90 days). Clinical presentation included chronic cough, hemoptysis, dyspnea and fever as well as persistent left pleural effusion or pneumonia. Diagnosis was confirmed by computed tomography in all cases. Two patients were treated nonoperatively, while 4 eventually required surgery for resolution. Left lower lobectomy was necessary in 3 of 4 cases. Concomitant procedures were total gastrectomy in 2 cases and conversion of a sleeve to a gastric bypass in 1 case. Resolution occurred 30 days to 2 years after initial surgery. No mortalities were encountered. Conclusions: GBF is a rare but devastating complication following bariatric surgery. It may develop as a late complication of a chronic upper gastric leak. Surgery is curative although nonoperative management may be warranted in selected cases.
Evolution of the Arterial Structure and Function From Infancy to Adolescence Is related to Anthropometric and Blood Pressure Changes
Authors: Sarkola Taisto , Manlhiot Cedric , Slorach Cameron , Bradley Timothy J. , Hui Wei , Mertens Luc , Redington Andrew , Jaeggi Edgar
Published: July 2012

Objective—

To develop a normative data set and to study the relationship among arterial structure, different anthropometric measures, blood pressure, and arterial function during healthy childhood using very-high-resolution ultrasound (25–55 MHz).

Methods and Results—

In 135 healthy children between 0 and 18 years of age, we assessed the structure of the carotid arteries, larger peripheral arteries, aorta, and left ventricle with ultrasound. Arterial stiffness was assessed by pulse wave velocity and endothelial function by brachial flow-mediated dilation. Reference curves adjusted for age and body surface area of arterial lumen diameters, intima-media thickness, and adventitia thickness were developed. Arterial walls thicken during childhood predominantly as a result of a progressive increase in intima-media thickness. There were significant associations among lumen diameter (
R
2
range, 0.20–0.88 for different arteries;
P
<0.001), intima-media thickness (
R
2
range, 0.47–0.85;
P
<0.001), left ventricular mass (
R
2
=0.90;
P
<0.001), and adventitia thickness (
R
2
range, 0.15–0.22;
P
<0.001) with sex, age, body surface, and systolic blood pressure. Arterial wall stress was associated with lumen diameter (
R
2
range, 0.52–0.83;
P
<0.001) and intima-media thickness (
R
2
range, 0.53–0.88;
P
<0.001). Limited relationships were found among arterial wall layer thickness, stiffness, and endothelial function.

Conclusion—

In healthy children, the evolution of the arterial structure is mainly related to anthropometrics and blood pressure.
An Observational Study of Vertical Eddy Diffusivity in the Hurricane Boundary Layer
Authors: Zhang Jun A. , Drennan William M.
Published: July 2012

Although vertical eddy diffusivity or viscosity has been extensively used in theoretical and numerical models simulating tropical cyclones, little observational study has documented the magnitude of the eddy diffusivity in high-wind conditions (>20 m s−1) until now. Through analyzing in situ aircraft data that were collected in the atmospheric boundary layer of four intense hurricanes, this study provides the first estimates of vertical distributions of the vertical eddy diffusivities for momentum, sensible heat, and latent heat fluxes in the surface wind speed range between 18 and 30 m s−1. In this work, eddy diffusivity is determined from directly measured turbulent fluxes and vertical gradients of the mean variable, such as wind speed, temperature, and humidity. The analyses show that the magnitudes of vertical eddy diffusivities for momentum and latent heat fluxes are comparable to each other, but the eddy diffusivity for sensible heat flux is much smaller than that for the latent heat flux. The vertical distributions of the eddy diffusivities are generally alike, increasing from the surface to a maximum value within the thermodynamic mixed layer and then deceasing with height. The results indicate also that momentum and latent heat are mainly transferred downgradient of the mean flow and that countergradient transport of the sensible heat may exist. The observational estimates are compared with the eddy diffusivities derived from different methods as used in planetary boundary layer (PBL) parameterization schemes in numerical models as well as ones used in previous observational studies.
Synoptic Weather Types for the Ross Sea Region, Antarctica
Authors: Cohen Lana , Dean Sam , Renwick James
Published: July 2012

Synoptic classifications over the Southern Ocean in the Ross Sea region of Antarctica (50°S–Antarctic coast, 150°E–90°W) have been derived from NCEP reanalysis data (1979–2011), producing a set of six synoptic types for the region. These types describe realistic synoptic conditions for the region and represent the moisture-bearing low pressure systems that circulate around Antarctica. The types are described as follows: low Bellingshausen/Amundsen (L-BA), low (L), zonal (Z), low Ross (L-R), ridge (R), and low Amundsen (L-A).

Seasonal frequencies of the synoptic types reflect the seasonal zonal shift of the Amundsen Sea low (ASL) and also correlate well with the Southern Oscillation index (SOI) and the southern annular mode (SAM). Variability in the occurrences of the synoptic types L-R and L-BA indicate a shifting of the position of the ASL farther east (west) toward (away from) the Antarctic Peninsula during La Niña (El Niño) and positive (negative) SAM conditions. A joint linear regression of the SOI and SAM indices show the strongest correlations with the types L-BA and L-R in the spring and quantifies the joint forcing effect of these climate cycles on synoptic variability in the region.

As a demonstration of how synoptic classification provides links between large-scale atmospheric circulation and local climate parameters, the synoptic types are related to precipitation and temperature at Roosevelt Island, an ice core site on the Ross Ice Shelf (80°S, 160°W). The synoptic types provide quantification of distinct precipitation and temperature regimes at this site, which allows for more fundamental understanding of the precipitation source regions and transport pathways that drive the variability in snow and ice proxies.
Climate Change on the Northern Tibetan Plateau during 1957–2009: Spatial Patterns and Possible Mechanisms
Authors: Cuo Lan , Zhang Yongxin , Wang Qingchun , Zhang Leilei , Zhou Bingrong , Hao Zhenchun , Su Fengge
Published: July 2012

Gridded daily precipitation, temperature minima and maxima, and wind speed are generated for the northern Tibetan Plateau (NTP) for 1957–2009 using observations from 81 surface stations. Evaluation reveals reasonable quality and suitability of the gridded data for climate and hydrology analysis. The Mann–Kendall trends of various climate elements of the gridded data show that NTP has in general experienced annually increasing temperature and decreasing wind speed but spatially varied precipitation changes. The northwest (northeast) NTP became dryer (wetter), while there were insignificant changes in precipitation in the south. Snowfall has decreased along high mountain ranges during the wet and warm season. Averaged over the entire NTP, snowfall, temperature minima and maxima, and wind speed experienced statistically significant linear trends at rates of −0.52 mm yr−1 (water equivalent), +0.04°C yr−1, +0.03°C yr−1, and −0.01 m s−1 yr−1, respectively. Correlation between precipitation/wind speed and climate indices characterizing large-scale weather systems for four subregions in NTP reveals that changes in precipitation and wind speed in winter can be attributed to changes in the North Atlantic Oscillation (NAO), the Arctic Oscillation (AO), the East Asian westerly jet (WJ), and the El Niño–Southern Oscillation (ENSO) (wind speed only). In summer, the changes in precipitation and wind are only weakly related to these indices. It is speculated that in addition to the NAO, AO, ENSO, WJ, and the East and South Asian summer monsoons, local weather systems also play important roles.
Effects of greige cotton lint properties on hydroentangled nonwoven fabrics
Authors: Sawhney APS , Reynolds M , Allen H , Slopek R , Condon B
Published: July 2012

This study determined the effects of fiber length, the length uniformity index, micronaire (fineness), and strength of greige cotton lint on properties of nonwoven fabrics. Seven bales of pre-cleaned greige ( non-bleached) cotton were procured from a US cotton producer and ginner. Each bale primarily had only one particular fiber quality parameter (e.g., length, length uniformity, micronaire, or strength) as a significant variable of interest, while other metrics remained subdued to the most practically possible extent. The fiber stock from each separate bale was processed into a lightly needlepunched substrate/fabric and then uniformly converted into a hydroentangled nonwoven fabric structure of the same nominal weight. All of the fibers and fabrics involved in the study were analyzed for their quality attributes. Although this study did not reveal any clear-cut, significant effects (obvious relations or correlations) of the fiber quality variables/metrics investigated, for the first time ever new information has been given that may be useful in the selection of optimally economical cotton for the production of cotton-based nonwoven fabrics for certain applications. At the minimum, this study has demonstrated that, unlike in traditional yarn-based textile processing, the greige cotton lint(s) of (typically) varied fiber metrics could be satisfactorily processed into viable nonwoven fabrics of acceptable physical and mechanical properties, as determined by standard test methods and procedures.
How general practitioners treat migraine patients—evaluation of a headache guideline
Authors: Zielman R , Veenstra PJL , Zwet EW van , Berg JSP van den
Published: July 2012

Aim: The aim of the study was to evaluate the pharmacological treatment of migraine patients by general practitioners before referral to a neurologist. First, was the pharmacological treatment in accordance with the Dutch College of General Practitioners headache guideline? Second, which migraine characteristics were associated with receiving migraine-specific medication?

Methods: Migraine patients (age ≥18 years) who visited the neurology outpatient clinic for the first time were included. Migraine characteristics and pharmacological status were collected retrospectively for each patient from the general practitioner’s referral letter, hospital record and a headache characteristics questionnaire.

Results: A total of 420 migraine patients were included. Only 18.3% of the patients with two or more migraine attacks per month were using prophylactic medication. Furthermore, only 11.7% of patients with symptoms of nausea and/or vomiting were using anti-emetic medication. More than half of patients (51.7%) were using triptans and were likely to have typical migraine symptoms and a long history of migraine.

Conclusions: Migraine prophylactic medication and anti-emetics are underutilized in the primary care setting for migraine patients in the Netherlands, when compared to the general practitioners guideline. It is important to enhance the knowledge of general practitioners regarding the diagnosis of migraine, and to increase awareness of the headache guideline.
Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women
Authors: Littleton Heather L. , Grills-Taquechel Amie E. , Buck Katherine S. , Rosman Lindsey , Dodd Julia C.
Published: July 2012

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women’s attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.
Arthroscopic Treatment of Rotator Cuff Tears With Shoulder Stiffness
Authors: Chuang Tai-Yuan , Ho Wei-Pin , Chen Chih-Hwa , Lee Chian-Her , Liau Jiann-Jong , Huang Chang-Hung
Published: July 2012

Background:

In a single arthroscopic surgery for rotator cuff tears with a stiff shoulder, closed manipulation with or without arthroscopic capsular release has been combined with the repair. Few studies have reported functional results after this surgery, and a clinical comparison has not been reported.

Purpose:

To compare functional outcomes with and without capsular release in arthroscopic treatment of rotator cuff tears with a stiff shoulder.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Among patients who underwent arthroscopic rotator cuff repairs with a concomitant stiff shoulder, 34 patients were treated with either manipulation and arthroscopic capsular release (group A; n = 18) or manipulation without capsular release (group B; n = 16). Preoperative mean passive forward flexion was 118° in group A and 117° in group B, whereas external rotation at the side was 28° and 29°, respectively. All patients were evaluated at a minimum 2-year follow-up in terms of visual analog scale for pain, muscle power, range of motion, Constant score, modified American Shoulder and Elbow Surgeons (ASES) shoulder evaluation form, and modified University of California at Los Angeles (UCLA) scores.

Results:

The mean modified ASES score was 90.3 for group A and 87.7 for group B ( P = .086). The mean UCLA scores were 34.3 and 33.0, respectively ( P = .247). The 2 groups showed a significant difference in forward flexion and external rotation post operatively, as group B recovered more slowly. There was no difference in the mean visual analog scale for pain at the last follow-up, but a 13° difference in forward flexion ( P < .001) and a 10° difference in external rotation ( P =.001) were seen.

Conclusion:

Overall satisfactory results could be achieved by either method, whereas rapid recovery and improvement of range of motion could be achieved by using a single arthroscopic repair and concomitant release for patients with rotator cuff tears with stiff shoulder.
Histological Assessment of Mechanoreceptors in Achilles Allografts After Anterior Cruciate Ligament Reconstruction
Authors: Kim Sung Hun , Chun Churl Hong , Chun Keun Churl , Jo Hyang Jeong , Kim Kwang Mee
Published: July 2012

Background:

There is a lack of histological studies investigating the presence of mechanoreceptors in anterior cruciate ligament (ACL) allografts.

Hypothesis:

Mechanoreceptors would not grow in Achilles allografts after ACL reconstruction.

Study Design:

Case series study; Level of evidence, 4.

Methods:

Tissue samples were obtained from 11 patients who underwent ACL reconstruction using Achilles tendon allografts. They underwent biopsies during second-look arthroscopies. The mean period from ACL reconstruction to harvesting tissue was 26.63 months (range, 12-120 months). The control group consisted of 2 normal ACLs procured from 42- and 45-year-old men who underwent amputation above the knee due to trauma.

Results:

Ruffini corpuscles and free nerve endings were shown to be present in the specimens of the control group by processing hematoxylin-eosin stains and immunohistochemical stains with monoclonal antibodies against S-100. In the Achilles allografts, mechanoreceptors were not observed. However, fibroblasts, collagen fibers, and vessels that were not present in fresh-frozen Achilles allografts before surgery were observed.

Conclusion:

The results demonstrate that Achilles tendon allografts appeared similar to normal ligaments except for the lack of histological evidence of mechanoreceptors. In other words, there are no newly ingrown mechanoreceptors in ACL allografts.
Effect of Fatigue on Tibial Rotation After Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Hantes Michael E. , Tsarouhas Alexandros , Giakas Giannis , Spiropoulos Giannis , Sideris Vasilios , Christel Pascal , Malizos Konstantinos N.
Published: July 2012

Background:

Fatigue is an extrinsic factor adversely affecting joint proprioception and neuromuscular response, thereby increasing anterior cruciate ligament (ACL) strain and injury risk. The effectiveness of the single- and double-bundle techniques for ACL reconstruction to control residual rotational knee laxity under fatigue has not been examined.

Hypothesis:

Fatigue results in a significant increase in tibial rotation angles and moments in both ACL-intact and single- and double-bundle ACL-reconstructed knees. The 2 groups with ACL-reconstructed knees will show no significant differences in tibial rotation angles and moments either pre- or postfatigue.

Study Design:

Controlled laboratory study.

Methods:

Twenty-four male patients who underwent successful single-bundle (n = 12) or double-bundle (n = 12) ACL reconstructions and 10 matched healthy controls were subjected to a standard lower limb muscle fatigue protocol using an isokinetic dynamometer. Three-dimensional motion analysis was used to measure tibial rotation and rotational knee moments in the pre- and postfatigue states, during a swinging maneuver on the weightbearing leg from a standing position with the knee in extension.

Results:

Tibial rotation of the single-bundle group significantly increased postfatigue (prefatigue 22° ± 10° vs 29° ± 15° postfatigue, P = .015). In contrast, the double-bundle group showed similar tibial rotation values pre- and postfatigue (16° ± 6° vs 18° ± 4°, P = .22). The double-bundle group showed a trend toward decreased tibial rotation values pre- and post-fatigue compared with controls (22 ± 4 and 23 ± 4) ( P = .065 and .08, respectively). In the prefatigue state, rotational moments (N·mm/Kg) of the single-bundle (339 ± 148) and double-bundle (317 ± 97) groups were significantly lower than that of controls (465 ± 134) ( P = .05 and .03, respectively). In the postfatigue state, an increase was observed in rotational moments of the single-bundle (388 ± 131) and double-bundle (408 ± 187) groups compared with prefatigue values, whereas a decrease was noted in the control group (411 ± 117).

Conclusion:

Single-bundle ACL-reconstructed knees demonstrate a reduced ability to resist rotational loads under fatigue. Double-bundle reconstructed knees had significantly better control of tibial rotation when fatigued. However, they demonstrate an excessive, yet not significant, reduction in tibial rotation compared with the intact knee, suggesting a possible overcorrection in rotational laxity.