bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical management of giant Brunner's gland hamartoma: case report and literature review
Authors: Stewart Zoe A , Hruban Ralph H , Fishman Elliot F , Wolfgang Christopher L 
Published: September 2009

Abstract
Brunner's gland hamartomas (BGH) are uncommon benign tumors of the duodenum forming mature Brunner's glands. We report here an unusual case of a giant BGH that was not amenable to endoscopic or surgical local resection thus requiring a pancreaticoduodenectomy for extirpation. The relevant literature is discussed.
Phylogeographic analysis reveals association of tick-borne pathogen, Anaplasma marginale, MSP1a sequences with ecological traits affecting tick vector performance
Authors: Estrada-Peña Agustín , Naranjo Victoria , Acevedo-Whitehouse Karina , Mangold Atilio J , Kocan Katherine M , de la Fuente José 
Published: September 2009

Abstract

Background

The tick-borne pathogen Anaplasma marginale, which is endemic worldwide, is the type species of the genus Anaplasma (Rickettsiales: Anaplasmataceae). Rhipicephalus (Boophilus) microplus is the most important tick vector of A. marginale in tropical and subtropical regions of the world. Despite extensive characterization of the genetic diversity in A. marginale geographic strains using major surface protein sequences, little is known about the biogeography and evolution of A. marginale and other Anaplasma species. For A. marginale, MSP1a was shown to be involved in vector-pathogen and host-pathogen interactions and to have evolved under positive selection pressure. The MSP1a of A. marginale strains differs in molecular weight because of a variable number of tandem 23-31 amino acid repeats and has proven to be a stable marker of strain identity. While phylogenetic studies of MSP1a repeat sequences have shown evidence of A. marginale-tick co-evolution, these studies have not provided phylogeographic information on a global scale because of the high level of MSP1a genetic diversity among geographic strains.

Results

In this study we showed that the phylogeography of A. marginale MSP1a sequences is associated with world ecological regions (ecoregions) resulting in different evolutionary pressures and thence MSP1a sequences. The results demonstrated that the MSP1a first (R1) and last (RL) repeats and microsatellite sequences were associated with world ecoregion clusters with specific and different environmental envelopes. The evolution of R1 repeat sequences was found to be under positive selection. It is hypothesized that the driving environmental factors regulating tick populations could act on the selection of different A. marginale MSP1a sequence lineages, associated to each ecoregion.

Conclusion

The results reported herein provided the first evidence that the evolution of A. marginale was linked to ecological traits affecting tick vector performance. These results suggested that some A. marginale strains have evolved under conditions that support pathogen biological transmission by R. microplus, under different ecological traits which affect performance of R. microplus populations. The evolution of other A. marginale strains may be linked to transmission by other tick species or to mechanical transmission in regions where R. microplus is currently eradicated. The information derived from this study is fundamental toward understanding the evolution of other vector-borne pathogens.
Influence of Duration of Diabetes, Glycemic Control, and Traditional Cardiovascular Risk Factors on Early Atherosclerotic Vascular Changes in Adolescents and Young Adults with Type 2 Diabetes Mellitus
Authors: Shah Amy S. , Dolan Lawrence M. , Kimball Thomas R. , Gao Zhiqian , Khoury Philip R. , Daniels Stephen R. , Urbina Elaine M. 
Published: September 2009

Background: Carotid intima-media thickness (IMT) provides a mechanism for detecting early atherosclerosis. Little information is available concerning carotid IMT and the progression of atherosclerosis in adolescents and young adults with type 2 diabetes mellitus.
Objective: We sought to determine the factors that contribute to early changes in carotid IMT in youth with type 2 diabetes mellitus and to identify any predictors of increased carotid IMT.
Methods: Demographic, anthropometric, laboratory data and carotid imaging were obtained in 129 youth of mixed ethnicity, ages 10–23 yr. Associations of carotid IMT outcomes and risk variables were analyzed by regression analysis. Logistic regression was performed to elucidate independent determinants that predict a worse carotid IMT.
Results: Carotid IMT increased with higher glycosylated hemoglobin (HbA1c) levels and longer duration of diabetes. Regression modeling showed that HbA1c and duration of diabetes in the presence of traditional cardiovascular risk factors (male sex, LDL cholesterol, and blood pressure) were independent determinants of carotid IMT. Logistic regression analysis demonstrated that each 1% increase in HbA1c or each year increase in duration of type 2 diabetes mellitus is associated with approximately 30% increased odds of a thicker carotid IMT.
Conclusions: Poorer glycemic control and longer disease duration have independent adverse effects on carotid IMT in youth with type 2 diabetes mellitus. These adverse effects appear to be more prominent in males. Developing effective strategies to improve blood glucose control in youth with type 2 diabetes mellitus is essential to prevent or limit the development and progression of atherosclerotic cardiovascular disease.
Poor glucose control, longer duration of diabetes, and traditional cardiovascular risk factors are associated with increased carotid intimal wall thickness in adolescents with type 2 diabetes mellitus.
Dual Inhibition of Mitogen-Activated Protein Kinase Kinase and Mammalian Target of Rapamycin in Differentiated and Anaplastic Thyroid Cancer
Authors: Jin Ning , Jiang Tianyun , Rosen D. Marc , Nelkin Barry D. , Ball Douglas W. 
Published: September 2009

Context: Differentiated thyroid cancer and anaplastic thyroid cancer tumors frequently have activation of the ras/raf /MAPK kinase (MEK)/ERK and phosphatidylinositol 3-kinase (PI-3K)/AKT/mammalian target of rapamycin (mTOR) signaling pathways.
Objective: The objective of the study was to investigate the efficacy of MEK and mTOR inhibitors in preclinical thyroid cancer treatment models with defined mutation status.
Experimental Design: The MEK inhibitor AZD6244 (ARRY-142886) and mTOR inhibitor rapamycin were tested separately and in combination in 10 differentiated thyroid cancer and anaplastic thyroid cancer cell lines and in a xenograft model for evidence of pathway inhibition, growth inhibition, apoptosis, and long-range adaptation and resistance.
Results: Seven of 10 tested lines had evidence of significant basal activity of the PI-3K/AKT/mTOR pathway, with elevated phosphorylated AKT and phosphorylated p70 S6 kinase. Activation of ras/RAF/MEK/ERK was equally common in this panel. All 10 lines exhibited better than 60% growth inhibition with combined MEK and mTOR inhibition, including lines with BRAF, Ret-PTC, ras, and PTEN mutations. Rapamycin or AZD6244 alone achieved this threshold in six and two lines, respectively. Dual-pathway inhibition in the Ret-PTC mutant cell line TPC1 caused an intense G1 arrest in cell culture and reversible cytostatic inhibition in a xenograft model. We did not observe significant feedback up-regulation of AKT activation in either acute or prolonged exposures.
Conclusion: These preclinical results support the inclusion of thyroid cancer patients in early-phase clinical trials combining ras/RAF/MEK/ERK and PI-3K/AKT/mTOR pathway inhibition.
Combined treatment with a MEK inhibitor (AZD6244/ARRY-142886) plus an mTOR inhibitor (Rapamycin) inhibited growth of thyroid cancer cells in vitro, and in a xenograft model, more potently than either agent alone.
A Missense GATA3 Mutation, Thr272Ile, Causes the Hypoparathyroidism, Deafness, and Renal Dysplasia Syndrome
Authors: Gaynor Katherine U. , Grigorieva Irina V. , Nesbit M. Andrew , Cranston Treena , Gomes Thushari , Gortner Ludwig , Thakker Rajesh V. 
Published: September 2009

Context: The hypoparathyroidism, deafness, renal dysplasia (HDR) syndrome is caused by mutations in the gene encoding GATA3, which belongs to a family of dual zinc-finger transcription factors that have a role in vertebrate embryonic development.Objective: The aim of the study was to identify the GATA3 mutation in a HDR patient and determine its functional consequences.Patient and Design: A patient with HDR was studied after approval from the local ethical committee. Leukocyte DNA was used with GATA3-specific primers for PCR amplification, and the DNA sequences of the PCR products were determined. Wild-type and mutant GATA3 constructs were transfected into COS-7 cell, and their functions were assessed by Western blot analysis, immunocytochemistry, EMSAs, luciferase reporter assays, and three-dimensional modeling.Results: A novel missense mutation, Thr272Ile, in zinc finger 1 (ZnF1) of GATA3 was identified. Western blot analysis and immunofluorescence revealed that the mutation did not affect nuclear localization of GATA3. However, EMSAs showed it to reduce DNA binding affinity, but not stability, and yeast two-hybrid assays demonstrated that the mutant GATA3 resulted in a loss of interaction with ZnF1 and ZnF6 of the cofactor FOG2. The mutant GATA3 significantly reduced luciferase reporter activity by more than 65% (P &lt; 0.001), and three-dimensional modeling indicated that the functional abnormalities may be due to a loss of Thr272 polar side chain interaction with Leu268.Conclusions: A novel missense HDR-associated GATA3 mutation, Thr272Ile, has been identified and shown to result in reduced DNA binding, a partial loss of FOG2 interaction, and a decrease in gene transcription.Hypoparathyroidism, Deafness, and Renal Dysplasia syndrome can result from the missense mutation Thr272Il3 in the transcription factor GATA3, which results in reduced DNA binding, partial loss of interaction with the protein cofactor FOG2, and a decrease in transcriptional activity.
An approach to standardize, quantify and record progress of routine upper limb therapy for stroke subjects: The Action Medical Research Upper Limb Therapy protocol
Authors: Rosewilliam Sheeba B , BüCher Catherine , Roffe Christine , Pandyan Anand D 
Published: September 2009

Introduction. Explicitly describing therapy for research purposes, in terms of content and quantity, improves the validity of research and facilitates evidence-based clinical practice. However, such descriptions are not common in therapy research. The aim was to develop an upper limb therapy protocol which reflected local clinical practice in the stroke unit, and a recording form to document the content, quantity and progression of therapy. Methods. This was a multi-method study. A list of interventions commonly used for the rehabilitation of the stroke upper limb was compiled following a systematic literature search. This was then refined into the Action Medical Research Upper Limb Therapy (AMRULT) protocol in a two-stage process involving a survey and a group discussion. Six physical therapists and three occupational therapists supported its development. The AMRULT protocol was then piloted in a two-arm randomized controlled trial with 90 stroke patients for therapy and recording purposes. Results. The protocol classified therapies based on therapy input as passive, active assisted, active/strengthening and functional. Using this form it was possible to not only summarize the content of therapy but also objectively document progression (e.g. 14% of the participants progressed to functional exercises between the 5th and 8th weeks after stroke onset). Discussion. The AMRULT protocol and associated recording form were useful in both standardizing the delivery and quantification (content and progression) of therapy. While the AMRULT protocol was devised for a specific purpose, the method used can be adapted to develop protocols to support other research studies.
Echinocandins: The Newest Class of Antifungals
Authors: Sucher Allana J , Chahine Elias B , Balcer Holly E 
Published: September 2009

Objective: To review the mechanism of action, antifungal spectrum of activity, pharmacodynamics, pharmacokinetics, clinical efficacy, and safety of the echinocandins. Data Sources: A MEDLINE search (1982–May 2009) was conducted for articles published in the English language using the key words caspofungin, micafungin, anidulafungin, and echinocandins. Study Selection and Data Extraction: Medicinal chemistry, in vitro, and animal studies, as well as human trials were reviewed for information on the pharmacodynamics, pharmacokinetics, efficacy, and safety of each echinocandin. Clinical trials were reviewed and included to compare and contrast the available echinocandins. Data Synthesis: Three echinocandin antifungal agents are currently approved for use in the US: caspofungin, micafungin, and anidulafungin. The echinocandins have a unique mechanism of action, inhibiting β-(1,3)-d-glucan synthase, an enzyme that is necessary for the synthesis of an essential component of the cell wall of several fungi. The echinocandins display fungistatic activity against Aspergillus spp. and fungicidal activity against most Candida spp., including strains that are fluconazole-resistant. The echinocandins have been shown to be efficacious for the treatment of esophageal candidiasis, candidemia, and invasive candidiasis. In addition, caspofungin has demonstrated efficacy as empiric treatment of febrile neutropenia and salvage therapy for the treatment of invasive aspergillosis, and it is the only echinocandin approved for use in pediatric patients. Micafungin is the only echinocandin approved for use as prophylaxis against Candida infections in patients undergoing hematopoietic stem cell transplantation. Overall, resistance to echinocandins is still rare, and all agents are well tolerated, with similar adverse effect profiles and few drug–drug interactions. Conclusions: Echinocandins, the newest addition to the arsenal of antifungals, offer potential advantages over other classes of agents. Clinicians should assess their distinguishing characteristics, including route of metabolism, drug interaction profile, and approved indications for use, when determining which agent to include on a formulary.
Challenges in thermodynamics: Irreversible processes, nonextensive entropies, and systems without equilibrium states
Authors: Hołyst Robert 
Published: September 2009

Abstract
Recent works on evaporation and condensation demonstrate that even these simplest irreversible processes, studied for over 100 years, are not well understood. In the case of a liquid evaporating into its vapor, the liquid temperature is constant during evaporation and the evaporation flux is governed by the heat transfer from the hotter vapor into the colder liquid. Whether liquid evaporates into its own vapor or into the vacuum, the irreversible pathway in the process goes through a number of steps which quickly lead to the steady-state conditions with mechanical equilibrium in most parts of the system—the fact overlooked in all previous studies. Even less is known about general rules which govern systems far from equilibrium. Recently, it has been demonstrated that a work done in an irreversible process can be related to the free energy difference between equilibrium states joined by the process. Finally, a real challenge in thermodynamics is a description of living systems since they do not have equilibrium states, are nonextensive, (i.e., they cannot be divided into subsystems), and cannot be isolated. Thus, their proper description requires new paradigms in thermodynamics.
Experimental techniques for the determination of thermophysical properties to enhance chemical processes
Authors: Richon Dominique 
Published: September 2009

Abstract
It is of utmost importance to have accurate experimental data available in order to develop accurate modeling for scientific and engineering purposes as it is emphasized through several herein-reported discussions with reknown scientists and engineers. Many methods are used to determine phase equilibria. Classification of the methods is not straightforward as several basic principles can be mixed in several different ways. In this paper, we have selected some techniques, developed in our laboratory, to illustrate one type of classification. Several apparatuses are described. The techniques where all phases are analyzed are very often preferred to those relying on partial determinations requiring data treatment through models. The internal analyses by means of spectroscopic or other in situ analysis techniques are not applicable every time. Then, sampling devices are necessary. Sampling devices must be reliable and lead to extract sample amounts small enough not to disturb the equilibrium under study. The ROLSI™ sampler developed at MINES ParisTech is a very powerful device allowing one to work up to 100 MPa, 850 K, with corrosive components and with samples from 1 μg to some mg. Applications of this sampler are described for fundamental research (phase equilibrium measurements) and industrial purposes (process control and monitoring).
The Declaimer's One-man Show. Playing with Roles and Rules in the Pseudo-Quintilian Declamationes maiores
Authors: Hömke Nicola 
Published: September 2009

Zusammenfassung
Der rhetorische Fundus eines römischen Schaudeklamators ist, verglichen mit dem eines Gerichtsredners oder Schuldeklamators, um ein effektvolles Instrument reicher: In bewusster Abkehr von der 〟lehrbuchgemäßen” Affektenlehre kann er das Publikum gerade dadurch gewinnen, dass er die Figuren, die er (narrativ und ethopoietisch) in seiner Rede vorstellt, rollenuntypisch 〟agieren” lässt. Das zeigt sich beispielhaft in den pseudo-quintilianischen Declamationes maiores 10, 12, 14 und 15. Das kreative Potential dieses Genres wird insbesondere an Declamatio maior 15 deutlich, in der der Deklamator sogar seine eigene Rolle spielerisch in Frage stellt: Die Rede wird so zum Ein-Mann-Theaterstück, in dem auch die Deklamatorenrolle nur eine unter mehreren personae ist.
The Parental Craniofacial Morphological Features in Chinese Patients with Sporadic Nonsyndromic Cleft Lip with or without Palate
Authors: Lu Da-wei , Shi Bing , Chen Huai-qing , Li Yu , Meng Tian , He Xing , Zheng Qian 
Published: September 2009

Objective: To evaluate the parental craniofacial morphology in Chinese patients with sporadic nonsyndromic cleft lip with or without palate. Methods: A total of 98 parental pairs of nonsyndromic unilateral incomplete cleft lip children, 207 parental pairs of nonsyndromic complete cleft lip and palate children, and 206 normal persons from Sichuan University were involved in this study. A conventional cephalometric analysis was used to measure angles, linear distances, and their ratios. Two-sample Student's t tests and a multivariate discriminant analysis were applied to the data. Results: Data indicate that the unaffected parents of nonsyndromic cleft lip children had on average significantly more acute cranial base angle (Angle N-S-Ba) and larger nasal width (NC-NC′) (p < .01). The healthy parents of nonsyndromic cleft lip and palate children consistently displayed a more acute cranial base angle (Angle N-S-Ba), shorter palatal length (A- PNS) and maxillary length (PNS-ANS), a more obtuse gonial angle (Angle Me-Go-Ar), and a larger y-axis length (S-Gn) and nasal width (NC-NC′) (p < .01). Conclusions: All these results indicate that the healthy parents of patients with nonsyndromic cleft lip with or without palate show distinct characteristics in craniofacial morphology. These parental craniofacial features are more obvious in patients with cleft lip with palate than those with cleft lip only. In general, the characteristics seem to be more distinct in the fathers than in the mothers of cleft patients.
Prevalence of Upper Cervical Vertebrae Anomalies in Patients with Cleft Lip and/or Palate and Noncleft Patients
Authors: Lima Marta Cunha , Franco Eduardo Jacomino , Janson Guilherme , Carvalho Izabel Maria Marchi , Santos Carlos Ferreira , Capelozza Ana Lúcia Alvares 
Published: September 2009

Objectives: To investigate the prevalence of upper cervical vertebrae anomalies in patients with isolated cleft lip, isolated cleft palate, and complete cleft lip and palate, as well as to compare the prevalence of these anomalies between groups, between genders, and with noncleft patients. Design: Retrospective cross-sectional study of randomly selected patients. Setting: Radiology Section, Hospital for Rehabilitation of Craniofacial Anomalies and Department of Orthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. Participants: The sample comprised 300 lateral cephalograms of cleft patients, aged 12 to 13 years, of both genders, from the files of the Hospital for Rehabilitation of Craniofacial Anomalies–University of São Paulo and 300 lateral cephalograms from noncleft patients of the Department of Orthodontics, Bauru School of Dentistry. Cephalograms of patients with syndromes were not included. Method: Radiographs were interpreted on a film viewer by a single examiner; the profiles of vertebrae were traced on acetate paper, and cervical vertebrae anomalies were registered and categorized into posterior arch deficiencies, fusion, and association of both. Main Outcome Measures: Statistical comparison of groups using the chi-square test. Results: In the cleft group, 38.67% of the patients had cervical vertebrae anomalies. Of those in the noncleft sample, 31% showed anomalies of the cervical spine. This difference was statistically significant. There was no statistically significant difference when the types of clefts were compared with each other or when both genders were compared in both samples. Conclusions: This study confirms the association between clefts and cervical anomalies. Additional research on this topic is necessary.
Treatment of Velopharyngeal Inadequacy in a Patient with Submucous Cleft Palate and Myasthenia Gravis
Authors: Rikihisa Naoaki , Udagawa Akikazu , Yoshimoto Shinya , Ichinose Masaharu , Kimura Tomoe , Shimizu Sara 
Published: September 2009

Objective: To describe the clinical course and management of a patient with submucous cleft palate who developed myasthenia gravis (MG) as an adult and suffered recurrent hypernasality. Few reports have described MG patients undergoing pharyngeal flap surgery for velopharyngeal incompetence, and these have described only slight speech improvement in such patients. Design: Case report. Patient: The patient underwent primary pushback palatoplasty and superiorly based pharyngeal flap surgery for submucous cleft and short palate at age 7. Hypernasality showed major improvement after initial surgery. At age 19, the patient developed MG that triggered the recurrence of velopharyngeal incompetence. Intervention: After MG was treated, revision pushback palatoplasty was performed for velopharyngeal incompetence when the patient was 24 years old. Preoperatively and postoperatively, the patient was evaluated by the same speech-language-hearing therapists, each with at least 5 years of clinical experience in cleft palate speech. Results: After the second pushback palatoplasty, hypernasality and audible nasal air emission during speech decreased to mild. Conclusion: Primary pushback palatoplasty and pharyngeal flap surgery were performed for the submucous cleft palate. Revision pushback palatoplasty improved velopharyngeal inadequacy induced by MG. Decreased perceived nasality positively influenced the patient's quality of life. Combined pushback palatoplasty and pharyngeal flap surgery is thus an option in surgical treatment for velopharyngeal inadequacy to close the cleft and the velopharyngeal orifice in cases of cleft palate and MG.