bluuebunny/crossref_metadata_2025_split huggingface dataset:
α2-Adrenergic Receptor and Isoflurane Modulation of Presynaptic Ca2+ Influx and Exocytosis in Hippocampal Neurons
Authors: Hara Masato , Zhou Zhen-Yu , Hemmings Hugh C. 
Published: June 2016

Abstract

Background
Evidence indicates that the anesthetic-sparing effects of α2-adrenergic receptor (AR) agonists involve α2A-AR heteroreceptors on nonadrenergic neurons. Since volatile anesthetics inhibit neurotransmitter release by reducing synaptic vesicle (SV) exocytosis, the authors hypothesized that α2-AR agonists inhibit nonadrenergic SV exocytosis and thereby potentiate presynaptic inhibition of exocytosis by isoflurane.

Methods
Quantitative imaging of fluorescent biosensors of action potential–evoked SV exocytosis (synaptophysin-pHluorin) and Ca2+ influx (GCaMP6) were used to characterize presynaptic actions of the clinically used α2-AR agonists dexmedetomidine and clonidine, and their interaction with isoflurane, in cultured rat hippocampal neurons.

Results
Dexmedetomidine (0.1 μM, n = 10) or clonidine (0.5 μM, n = 8) inhibited action potential–evoked exocytosis (54 ± 5% and 59 ± 8% of control, respectively; P < 0.001). Effects on exocytosis were blocked by the subtype-nonselective α2-AR antagonist atipamezole or the α2A-AR–selective antagonist BRL 44408 but not by the α2C-AR–selective antagonist JP 1302. Dexmedetomidine inhibited exocytosis and presynaptic Ca2+ influx without affecting Ca2+ coupling to exocytosis, consistent with an effect upstream of Ca2+–exocytosis coupling. Exocytosis coupled to both N-type and P/Q-type Ca2+ channels was inhibited by dexmedetomidine or clonidine. Dexmedetomidine potentiated inhibition of exocytosis by 0.7 mM isoflurane (to 42 ± 5%, compared to 63 ± 8% for isoflurane alone; P < 0.05).

Conclusions
Hippocampal SV exocytosis is inhibited by α2A-AR activation in proportion to reduced Ca2+ entry. These effects are additive with those of isoflurane, consistent with a role for α2A-AR presynaptic heteroreceptor inhibition of nonadrenergic synaptic transmission in the anesthetic-sparing effects of α2A-AR agonists.
Forward to the Past—Oncology Between Underdiagnosis and Overtreatment
Authors: Weyers Wolfgang 
Published: June 2016

Abstract:
Efforts at early detection of cancer have resulted in a sharp increase of overdiagnoses, ie, benign lesions being misinterpreted as malignant ones. Clinical overdiagnoses usually prompt a biopsy to be performed. The number of biopsies has risen dramatically, and the average time and diligence devoted to them have decreased. Biopsy specimens are often extremely small and sometimes crushed, leading to great difficulties in the assessment of histopathologic findings. In their fear not to overlook a malignant lesion, histopathologists confronted with an equivocal lesion tend to err on the malignant side, the results being histopathologic overdiagnoses and overtreatment. Epidemiologists have tried to counter those problems by cautioning against cancer screening and by inaugurating a change in nomenclature: the term “cancer” has been reserved for lesions likely to result in death, whereas earlier stages of the same process are referred to by different names emphasizing their ostensible innocuousness, and any diagnosis of a malignant neoplasm that does not produce symptoms or kill the patient is qualified as “overdiagnosis.” In contrast to those suggestions that ignore biologic entities and sacrifice the foundations of morphologic diagnosis, measures are discussed that may help to overcome the problem of overdiagnosis and overtreatment in more substantial fashion.
Resveratrol Cardioprotection Against Myocardial Ischemia/Reperfusion Injury Involves Upregulation of Adiponectin Levels and Multimerization in Type 2 Diabetic Mice
Authors: Yang Qiang , Wang Hai-chang , Liu Yi , Gao Chao , Sun Lu , Tao Ling 
Published: June 2016

Abstract:
Downregulation of adiponectin (APN) multimerization is significantly correlated with the aggravation of myocardial ischemia/reperfusion (MI/R) injury in type 2 diabetes mellitus (T2DM). Resveratrol (RSV) upregulates APN multimerization in adipocytes, but whether RSV improves endogenous APN multimerization and thus attenuates MI/R injury in T2DM mice has never been investigated. T2DM mice were treated with 10 mg/kg RSV daily for 3 weeks, followed by 30 minutes of myocardial ischemia and 3 hours or 24 hours of reperfusion. RSV administration alleviated MI/R injury in diabetic mice, as evidenced by reduced infarct size, cardiomyocyte apoptosis, and caspase-3 activity, and improved cardiac function. Moreover, RSV reversed the downregulated APN levels and multimerization both in plasma and adipose tissue, accompanied by increased disulfide bond A oxidoreductase-like protein (DsbA-L) expression in T2DM mice. Conversely, serving as a key downstream molecule of APN in ameliorating MI/R injury, inhibition of AMP-activated protein kinase (AMPK) significantly attenuated the cardioprotective effects of RSV. In conclusion, long-term administration of RSV upregulates adiponectin levels and multimerization in T2DM mice, consequently attenuating MI/R injury partially through APN-AMPK signaling.
Prevention and management of urologic injury during gynecologic laparoscopy
Authors: Findley Austin D. , Solnik M. Jonathon 
Published: June 2016

Purpose of review
This article provides an update on the best practices for the prevention, recognition, and management of urinary tract injuries that may occur during gynecologic laparoscopic surgery.

Recent findings
Higher surgical volume is directly associated with improved surgical outcomes, denoted by consistently lower rates of complications for commonplace procedures such as hysterectomy. As a result, expert opinion on prevention of iatrogenic urologic injury suggests a real need for improved education and training of gynecologic surgeons. Discontinued manufacturing of indigo carmine has led to the utilization of alternative methods to assess ureteral patency during cystoscopy, such as phenazopyridine or sodium fluorescein. Intraoperative cystoscopy has been shown to detect approximately 50% of urinary tract injuries during hysterectomy, but has limited accuracy and does not necessarily decrease delayed postoperative complications. When identified, most urologic injuries can be managed in a minimally invasive fashion.

Summary
A thorough understanding of pelvic anatomy and early recognition of urinary tract injuries can significantly reduce surgical morbidity for women undergoing laparoscopic surgery.
Transconjunctival Approach for Zygomatic Fracture: A Single Surgeon’s Experience of More Than 20 Years
Authors: Uemura Tetsuji , Watanabe Hidetaka , Masumoto Kazuyuki , Chuman Takahiro , Satake Yoshiyasu , Yanai Tetsu , Harada Yoshimi , Ishihara Yasuhiro , Kikuchi Mamoru 
Published: June 2016

Background:
To let experts evaluate a single surgeon’s experience with a combined transconjunctival and intraoral upper vestibular approach in the repair of zygomatic fractures encountered in 46 East Asian patients whom he treated over the past 20 years.

Methods:
Patients were identified from a database, and a retrospective case note review was conducted. A total of 67 conjunctival and secondary incisions were made on 46 patients for repair of zygomatic fractures. All operative procedures were performed using a combination of transconjunctival and intraoral upper vestibular approaches to repair zygomatic fractures.

Results:
The infraorbital rim and/or lateral buttress and/or lateral orbit was stabilized with titanium miniplates in 28 patients and absorbable miniplates in 11 patients. Seven patients required only reduction technique with no need of plates. Four cases needed additional canthotomy besides a conjunctival approach. No ectropion or entropion developed in any of the patients. Complications included eyelid laceration during surgery (n = 1), herniation of the conjunctiva (n = 1), temporary pyogenic granuloma of the conjunctiva after surgery (n = 1), and temporary entropion in a secondary incision (n = 1).

Conclusions:
A combined transconjunctival and intraoral upper vestibular approach in repairing zygomatic fractures is simple, easy, and effective, leaving no conspicuous facial scars. It is vitally important, however, that the surgeon masters the technique of transconjunctival approach well before he has good results in East Asian patients.
The incidence of gastrointestinal pathology and subsequent anemia in young men presenting with iron deficiency without anemia
Authors: Carter Dan , Bardan Eytan , Derazne Estela , Tzur Dorit , Avidan Benjamin 
Published: June 2016

Background and aims
The etiology of iron deficiency (ID) without anemia in young men is unclear, and there are no evidence-based recommendations for the required gastrointestinal (GI) evaluation. The aims of this study were to examine the incidence of significant GI pathology and the development of anemia during the follow-up of young men presenting with ID, but without anemia.

Methods
All young men (18–30 years) who served in the Israel Defense Forces during the years 2005–2013 and had at least a single laboratory test indicative of ID without anemia were followed until the diagnosis of significant GI pathology or discharge from military service.

Results
The study population included 2061 young men (mean age 20.7±1.8). During follow-up of 3150 person years, significant GI pathologies were diagnosed in 39 patients: inflammatory bowel disease in 25 (1.2%), celiac disease in 8 (0.4%), and peptic disease in 4 (0.1%). No cases of GI-related cancer were diagnosed. ID anemia developed during follow-up in 203 (9.8%). Lower baseline hemoglobin levels, lower ferritin levels, and younger age at diagnosis were more common among those who developed anemia. The development of anemia was a predisposing factor for the diagnosis of GI pathology (risk ratio=3.60, 95% confidence interval 1.34–8.32, P=0.012).

Conclusion
Significant GI pathology is very uncommon in young men presenting with ID. Overt anemia developed in close to 10% of the study cohort. Therefore, we advise simple GI evaluation (celiac serology, C-reactive protein or fecal calprotectin, and urease breath test) as well as follow-up in this population.
Pediatric‐onset Chronic Nonspecific Multiple Ulcers of Small Intestine
Authors: Uchida Keiichi , Nakajima Atsushi , Ushijima Kosuke , Ida Shinobu , Seki Yoshitaka , Kakuta Fumihiko , Abukawa Daiki , Tsukahara Hisayuki , Maisawa Shun‐ichi , Inoue Mikihiro , Araki Toshimitsu , Umeno Junji , Matsumoto Takayuki , Taguchi Tomoaki 
Published: June 2016

ABSTRACTWe performed a Japanese nationwide survey of pediatric‐onset chronic nonspecific multiple ulcers of the small intestine between January 2000 and July 2013 in 176 institutions of pediatric surgery or pediatric gastroenterology and clarified the clinical features associated with genetic abnormalities in the Solute Carrier Organic Anion Transporter Family, Member 2A1 (SLCO2A1) gene. A total of 4 cases (3 girls and 1 boy) were diagnosed in this series, which had to be differentiated from Crohn disease, Behçet disease, tuberculosis, or drug‐induced enteropathy. Clinical symptoms appeared in infants and accurate diagnosis required several years. Medical therapies for inflammatory bowel disease were administered in all patients; however, 2 of the 4 patients had mutation in the SLCO2A1 gene which are responsible for primary hypertrophic osteoarthopathy, and underwent strictureplasty or ileal resection after long‐term follow‐up. Pediatric gastroenterologists should include this new entity in the differential diagnosis of small intestinal ulcers and inflammatory bowel disease.
Case Report
Authors: Austin Andrea L. , Magana Julia N. , Rudinsky Sherri L. , Portouw Steven J. 
Published: June 2016

Background
The most common cause of genital lesions is herpes simplex virus (HSV) (Pediatr Dermatol. 2012;29:147–153). However, in children and adolescents who are not sexually active, several other causes need to be considered.

Case
A 13-year-old adolescent girl presented to the emergency department with genital lesions. A gynecologist was consulted at time of presentation for concerns of a primary HSV infection and concurred. Final HSV and sexually transmitted infection testing were subsequently negative. At outpatient follow-up, a child abuse pediatrician made the diagnosis of aphthous genital ulcers (AGUs). Awareness of the diagnosis of AGUs is important because alternate diagnoses such as HSV could imply child abuse. It is critical to include AGUs in the differential diagnosis and to provide the appropriate referrals.
Men's Understanding of and Experiences During the Postcircumcision Abstinence Period: Results From a Field Study of ShangRing Circumcision During Routine Clinical Services in Kenya and Zambia
Authors: Barone Mark A. , Li Philip S. , Zulu Robert , Awori Quentin D. , Agot Kawango , Combes Stephanie , Simba Raymond O. , Lee Richard K. , Hart Catherine , Lai Jaim Jou , Zyambo Zude , Goldstein Marc , Feldblum Paul J. , Sokal David C. 
Published: June 2016

Background:
Men's understanding of counseling messages after voluntary medical male circumcision (VMMC) plays an important role in whether they follow them. Data on triggers for early resumption of sex may be useful as scale-up of VMMC for HIV prevention continues in sub-Saharan Africa.

Methods:
Data on understanding of post-VMMC abstinence recommendations, resumption of sex, condom use, and triggers for resuming sex were collected from participants during a follow-up interview 35–42 days after ShangRing circumcision in Kenya and Zambia.

Results:
Of 1149 men who had ShangRing circumcision, 1096 (95.4%) completed follow-up. Nearly all (99.2%) reported being counseled to abstain from sex post-VMMC; among those, most (92.2%) recalled the recommended abstinence period was 6 weeks. Most men (94.1%) reported that the counselor gave reasons for post-VMMC abstinence and recalled appropriate reasons. Few (13.4%) men reported resuming sex at 35–42 days' follow-up. Among those, 54.8% reported never using a condom post-VMMC. Younger participants (odds ratio 0.3, 95% confidence interval: 0.2 to 0.5, P < 0.0001) and those reporting at least some condom use at baseline (odds ratio 0.5, 95% confidence interval: 0.3 to 0.7, P = 0.0003) were less likely to report resuming sex. Among men who reported some condom use, most (71.5%) said condoms were much easier or easier to use after circumcision. Men reported various reasons for early resumption of sex, primarily strong sexual desire (76.4%).

Conclusions:
Most men reported awareness of and adherence to the counseling recommendations for post-VMMC abstinence. A minority reported early resumption of sex, and, among those, condom use was low. Results could be used to improve post-VMMC counseling.
Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi
Authors: Kohler Pamela K. , Tippett Barr Beth A. , Kang'ombe Anderson , Hofstee Carola , Kilembe Franklin , Galagan Sean , Chilongozi David , Namate Dorothy , Machaya Medson , Kabwere Khuliena , Mwale Mwawi , Msunguma Wezi , Reed Jason , Chimbwandira Frank 
Published: June 2016

Introduction:
Nonsurgical adult male circumcision devices present an alternative to surgery where health resources are limited. This study aimed to assess the safety, feasibility, and acceptability of the PrePex device for adult male circumcision in Malawi.

Methods:
A prospective single-arm cohort study was conducted at 3 sites (1 urban static, 1 rural static, 1 rural tent) in Malawi. Adverse event (AE) outcomes were stratified to include/exclude pain, and confidence intervals (CIs) were corrected for clinic-level clustering.

Results:
Among 935 men screened, 131 (14.0%) were not eligible, 13 (1.4%) withdrew before placement, and 791 (84.6%) received the device. Moderate and severe AEs totaled 7.1% including pain [95% CI: 3.4–14.7] and 4.0% excluding pain (95% CI: 2.6 to 6.4). Severe AEs included pain (n = 3), insufficient skin removal (n = 4), and early removal (n = 4). Among early removals, 1 had immediate surgical circumcision, 1 had surgery after 48 hours of observation, 1 declined surgery, and 1 did not return to our site although presented at a nearby clinic. More than half of men (51.9%) reported odor; however, few (2.2%) stated they would not recommend the device to others because of odor. Median levels of reported pain (scale, 1–10) were 2 (interquartile range, 2–4) during application and removal, and 0 (interquartile range, 0–2) at all other time points.

Conclusions:
Severe AEs were rare and similar to other programs. Immediate provision of surgical services after displacement or early removal proved a challenge. Cases of insufficient skin removal were linked to poor technique, suggesting provider training requires reinforcement and supervision.
Comparative Cost Analysis of Surgical and PrePex Device Male Circumcision in Zimbabwe and Mozambique
Authors: Schutte Carl , Tshimanga M , Mugurungi Owen , Come Iotamo , Necochea Edgar , Mahomed Mehebub , Xaba Sinokuthemba , Bossemeyer Debora , Ferreira Thais , Macaringue Lucinda , Chatikobo Pessanai , Gundididza Patricia , Hatzold Karin 
Published: June 2016

Background:
The PrePex device has proven to be safe for voluntary medical male circumcision (VMMC) in adults in several African countries. Costing studies were conducted as part of a PrePex/Surgery comparison study in Zimbabwe and a pilot implementation study in Mozambique.

Methods:
The studies calculated per male circumcision unit costs using a cost–analysis approach. Both direct costs (consumable and nonconsumable supplies, device, personnel, associated staff training) and selected indirect costs (capital and support personnel costs) were calculated.

Results:
The cost comparison in Zimbabwe showed a unit cost per VMMC of $45.50 for PrePex and $53.08 for surgery. The unit cost difference was based on higher personnel and consumable supplies costs for the surgical procedure, which used disposable instrument kits. In Mozambique, the costing analysis estimated a higher unit cost for PrePex circumcision ($40.66) than for surgery ($20.85) because of higher consumable costs, particularly the PrePex device and lower consumable supplies costs for the surgical procedure using reusable instruments. Supplies and direct staff costs contributed 87.2% for PrePex and 65.8% for surgical unit costs in Mozambique.

Discussion:
PrePex device male circumcision could potentially be cheaper than surgery in Zimbabwe, especially in settings that lack the infrastructure and personnel required for surgical VMMC, and this might result in programmatic cost savings. In Mozambique, the surgical procedure seems to be less costly compared with PrePex mainly because of higher consumable supplies costs. With reduced device unit costs, PrePex VMMC could become more cost-efficient and considered as complementary for Mozambique's VMMC scale-up program.
The Zürich Maxi Mental Status Inventory (ZüMAX): Test-Retest Reliability and Discriminant Validity in Stroke Survivors
Authors: Tobler-Ammann Bernadette C. , de Bruin Eling D. , Brugger Peter , de Bie Rob A. , Knols Ruud H. 
Published: June 2016

Objective:
To examine discriminant validity and test-retest reliability of the Zürich maxi mental status inventory (ZüMAX) in patients with stroke.

Background:
The ZüMAX is a novel domain-specific cognitive assessment tool to screen for disturbances in neuropsychological function. The test can be used in stroke rehabilitation to estimate severity of cognitive impairment. Because evidence for validity and reliability is lacking, the tool’s clinical use is limited.

Methods:
We administered the ZüMAX in a test-retest design to 33 community-dwelling stroke survivors, and once to 35 healthy controls matched for age and sex.

Results:
We found significant group differences in subscores for the cognitive domains of executive functions and language as well as total score (P=0.001 to 0.004); we did not find group differences for the domains of praxia (defined as the ability to perform purposeful actions), visual perception and construction, or learning and memory. Test-retest reliability of the total score was good (intraclass correlation coefficient=0.81), with the individual domain subscores ranging from poor to fair (0.59 to 0.79). The ZüMAX could detect changes in patients with low smallest detectable differences in executive functions, language, and praxia (0.05 to 1.49) and total score (0.09).

Conclusion:
The ZüMAX has moderate to good test-retest reliability. Furthermore, the tool might discriminate between healthy persons and chronic stroke survivors on three of five subscales. The ZüMAX shows promise in measuring neuropsychological disturbances in stroke survivors; however, further trials are required with larger samples.
Factors affecting genetic connectivity and diversity of the island night lizard
Authors: Rice Stephen E. , Clark Rulon W. 
Published: June 2016

AbstractHabitat loss and fragmentation is one of the most severe threats to global biodiversity. Because human development often fragments natural areas into habitat “islands”, studies which characterize the genetic structure of species isolated on oceanic islands may provide insight into the management of anthropogenic habitat islands. The San Clemente Island night lizard,Xantusia riversiana reticulata, is endemic to two California Channel Islands, each with a history of anthropogenic disturbance. We genotyped 917 individuals from San Clemente Island and Santa Barbara Island at 23 microsatellite loci to quantify population structure and identify natural and anthropogenic landscape features affecting intra-island connectivity. We found significant, but shallow, population structure on each island with sites < 400 m apart identified as distinct genepools. Landscape genetic analyses identified conductive habitat as California boxthorn and prickly pear cactus on both islands. Landscape features which decreased connectivity were unique to each island and included natural and human-mediated features. These results can inform management plans on each island by identifying habitat targets for mitigation and restoration efforts designed to improve connectivity. Our results highlight the need for considering fine-scale features correlated with contemporary and historical patterns of fragmentation, especially in small and isolated habitats on the mainland that may be analogous to oceanic islands.
Merkel cell carcinoma associated with stable chronic hemodialysis: A report of two cases
Authors: Nagase Kotaro , Kimura Hiromi , Ogawa Shizuka , Tara‐Hashimoto Akiko , Koba Shinichi , Inoue Takuya , Narisawa Yutaka 
Published: June 2016

AbstractMerkel cell carcinoma (MCC) is a rare but aggressive cutaneous malignancy associated with the Merkel cell polyomavirus (MCPyV). Multiple studies have shown that the incidence of MCC is higher among immunocompromised individuals than among the general population. In fact, immunosuppressed individuals account for approximately 10% of the MCC patient population. In this report, we describe two cases of MCPyV‐related MCC in Japanese patients on hemodialysis. In both the cases, MCC was present on the face. Both cellular and humoral immunities have been shown to be decreased in uremic patients, and dialysis patients have a high risk of viral‐mediated cancers, including human papillomavirus‐associated cancers. Immune dysfunction related to uremia and dialysis may be associated with a high risk of developing MCC.