bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baroreflex Sensitivity Is Impaired in Patients with Obstructive Jaundice
Authors: Song Jian-gang , Cao Yun-fei , Sun Yu-ming , Ge Yan-hu , Xu Xue-wu , Yang Li-qun , Liu Zhi-qiang , Song Shao-li , Yu Wei-feng 
Published: August 2009

Background
Obstructive jaundice is associated with enhanced susceptibility to hypotensive shock, renal failure, and toxic effects of endotoxin, which results in high perioperative morbidity and mortality. Since the normal arterial baroreflex function is necessary for hemodynamic homeostasis and improving survival in sepsis, this study aimed to determine whether baroreflex sensitivity was impaired in jaundiced patients.

Methods
Thirty-five patients with obstructive jaundice scheduled for surgery were included, and 30 nonjaundiced patients served as controls. A modified Oxford pharmacologic technique was used for evaluating baroreflex sensitivity immediately before the surgery. Potential factors that may affect baroreflex sensitivity in jaundice, such as liver biochemistry, plasma concentrations of methionine-enkephalin, atrial natriuretic peptide and nitrate, were also measured.

Results
Patients with obstructive jaundice had decreased sensitivity in both the sympathetic and vagal components of the baroreflex, as compared with the controls (P < 0.01). There was a significant inverse correlation between plasma atrial natriuretic peptide concentration and decreased sympathetic baroreflex sensitivity in the jaundiced group (r = -0.44, P = 0.008).

Conclusions
Baroreflex sensitivity is impaired in patients with obstructive jaundice, which may contribute to their enhanced susceptibility to the well-known perioperative complications. The underlying mechanisms for such a change may be associated with an increased level of plasma atrial natriuretic peptide.
Delayed Treatment with Isoflurane Attenuates Lipopolysaccharide and Interferon γ–induced Activation and Injury of Mouse Microglial Cells
Authors: Kim Jie-Ae , Li Liaoliao , Zuo Zhiyi 
Published: August 2009

Background
Isoflurane pretreatment can induce protection against lipopolysaccharide and interferon gamma (IFNgamma)-induced injury and activation of mouse microglial cells. This study's goal was to determine whether delayed isoflurane treatment is protective.

Methods
Mouse microglial cells were exposed to various concentrations of isoflurane for 1 h immediately after the initiation of lipopolysaccharide (10 or 1000 ng/ml) and IFNgamma (10 U/ml) stimulation or to 2% isoflurane for 1 h at various times after initiation of the stimulation. Nitrite production, lactate dehydrogenase release, and cell viability measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay were assessed after stimulation with lipopolysaccharide and IFNgamma for 24 h. Inducible nitric oxide synthase (iNOS) protein expression was quantified by Western blotting. The iNOS expression in mouse brain was also studied.

Results
Isoflurane applied 0 and 2 h after the initiation of lipopolysaccharide and IFNgamma stimulation improved cell viability. Isoflurane at 2%, but not at 1 or 3%, reduced the lipopolysaccharide and IFNgamma-induced nitrite production and decreased cell viability. Aminoguanidine, an iNOS inhibitor, also attenuated this decreased cell viability. Chelerythrine and bisindolylmalemide IX, protein kinase C inhibitors, abolished isoflurane effects on cell viability and iNOS expression after lipopolysaccharide and IFNgamma application. Isoflurane also decreased lipopolysaccharide-induced iNOS expression in mouse brain. Late isoflurane application to microglial cells reduced lipopolysaccharide and IFNgamma-induced lactate dehydrogenase release that was not inhibited by aminoguanidine.

Conclusions
These results suggest that delayed isoflurane treatment can reduce lipopolysaccharide and IFNgamma-induced activation and injury of microglial cells. These effects may be mediated by protein kinase C.
Perioperative Peripheral Nerve Injuries
Authors: Welch Marnie B. , Brummett Chad M. , Welch Terrence D. , Tremper Kevin K. , Shanks Amy M. , Guglani Pankaj , Mashour George A. 
Published: August 2009

Background
Peripheral nerve injuries represent a notable source of anesthetic complications and can be debilitating. The objective of this study was to identify associations with peripheral nerve injury in a broad surgical population cared for in the last decade.

Methods
At a tertiary care university hospital, the quality assurance, closed claims, and institution-wide billing code databases were searched for peripheral nerve injuries over a 10-yr period. Each reported case was individually reviewed to determine whether a perioperative injury occurred, defined as a new sensory and/or motor deficit. The location and type of the injury were also identified. Nerve complications as a result of the surgical procedure itself were excluded, and an expert review panel assisted in the adjudication of unclear cases. Patient preoperative characteristics, anesthetic modality, and surgical specialty were evaluated for associations.

Results
Of all patients undergoing 380,680 anesthetics during a 10-yr period, 185 patients were initially identified as having nerve injuries, and after review, 112 met our definition of a perioperative nerve injury (frequency = 0.03%). Hypertension, tobacco use, and diabetes mellitus were significantly associated with perioperative peripheral nerve injuries. General and epidural anesthesia were associated with nerve injuries. Significant associations were also found with the following surgical specialties: Neurosurgery, cardiac surgery, general surgery, and orthopedic surgery.

Conclusions
To our knowledge, this is the largest number of consecutive patients ever reviewed for all types of perioperative peripheral nerve injuries. More importantly, this is the first study to identify associations of nerve injuries with hypertension, anesthetic modality, and surgical specialty.
Preserved Memory Function during Bispectral Index–guided Anesthesia with Sevoflurane for Major Orthopedic Surgery
Authors: Kerssens Chantal , Gaither Julie R. , Sebel Peter S. 
Published: August 2009

Background
Memory function under anesthesia is undesired but may arise from light hypnosis as well as stress-enhanced learning during surgery. The bispectral index (BIS, Aspect Medical Systems, Norwood, MA) is a monitor of hypnotic state that can help to avoid light hypnosis (i.e., BIS above 60). This study tested the hypothesis that BIS-guided anesthesia maintaining BIS 50-60 reduces the likelihood of memory function under anesthesia.

Methods
After obtaining informed consent, 128 patients scheduled for joint replacement surgery under general anesthesia with sevoflurane were randomly assigned to BIS-guided anesthesia, titrating drugs to BIS 50-60 (BIS group), or a standard practice group in which BIS was recorded but did not guide drug administration. After induction, all patients were repeatedly played a list of 15 words. After recovery from anesthesia, all were interviewed about recall and completed a recognition memory test containing the presented words (targets, 33.3%) and new words (distractors). Preoperatively, patients filled out a stress questionnaire (Spielberger State-Trait Anxiety Inventory).

Results
BIS values above 60 were recorded in both groups, but no patient recalled the presented words postoperatively. Only patients in the BIS group selected targets more often than distractors (37.1% vs. 31.5% hit rate, P = 0.001). Target hit rates correlated poorly to stress scores (P > 0.9), but were associated with the amount of fentanyl received preoperatively (P = 0.01) and pain management technique (P < 0.01).

Conclusions
BIS titration to BIS 50-60 does not necessarily curb memory function under anesthesia when BIS values higher than 60 occur. Preoperative analgesia attenuated the likelihood of memory function under anesthesia.
Contact-free Infrared Thermography for Assessing Effects during Acupuncture: A Randomized, Single-blinded, Placebo-controlled Crossover Clinical Trial
Authors: Agarwal-Kozlowski Kamayni , Lange Ann-Christin , Beck Helge 
Published: August 2009

Background
Although evidence of its effects is tentative, acupuncture has long been used in the treatment of multiple maladies. So far, it has not been possible to discriminate the effects of the venue from specific results of needling itself, thus physicians merely depend on patients' statements. The authors investigated the efficacy of infrared thermography in distinguishing response to true acupuncture as compared to nonacupoint cutaneous and muscular needling (sham or minimal acupuncture), as well as without manipulation.

Methods
Thermographic imaging was performed in 50 healthy volunteers randomly assigned to four groups: Acupuncture of Hegu (LI 4), needling of a cutaneous and a muscular point where no acupuncture point has been described yet, and without manipulation. In a crossover protocol, each proband completed all four arms of the protocol in a random order. Infrared thermograms were gathered at defined points in each group.

Results
A significant increase in surface temperature occurred within 2 min after needling the acupuncture point Hegu (from 30.1 +/- 2.7 degrees C [SD] to 31.2 +/- 3.0 degrees C and to 31.9 +/- 2.5 degrees C after 10 min, P < 0.001), whereas needling of the cutaneous and muscular point, as well as without any manipulation resulted in a decrease of temperature in the monitored area.

Conclusion
Contact-free infrared thermographic imaging is a reliable and easy-to-handle tool to distinguish between needling at Hegu and needling of a nonacupoint ("sham" acupuncture).
Book Reviews
Authors: Rosenau Milton D. 
Published: August 2009

In light of the changes occurring in the European Common Market in 1992, it is particularly timely to review two books that contrast new product development practices in the United States with those in Europe and other countries. Both books are based on academics' research but are intended to provide practical insights for practitioners.The first review is of a book that summarizes an extensive study of the world auto industry. This book, which does offer many practical lessons, compares industry practices in the United States, Europe and Japan.The second review, by Chris Panton, examines a book that contrasts product development practices in American and British firms. Our reviewer finds that this book primarily offers an effective summary of conventional wisdom but fewer practical insights.
Mantle cell lymphoma with central nervous system involvement: frequency and clinical features
Authors: Gill Saar , Herbert Kirsten E. , Prince H. Miles , Wolf Max M. , Wirth Andrew , Ryan Gail , Carney Dennis A. , Ritchie David S. , Davies John M. , Seymour John F. 
Published: August 2009

SummaryReported rates of central nervous system (CNS) involvement in mantle cell lymphoma (MCL) are highly variable but substantial (4–26%). Data is lacking regarding risk factors for CNS relapse, and for those patients in whom CNS prophylaxis could be beneficial. We present single institution retrospective analysis of data of baseline features, clinical course, rate of CNS disease and putative risk factors in 62 patients with MCL (18 female, 44 male). CNS disease (all cases were symptomatic) occurred in four patients at a median of 12 months (range 1–58) from diagnosis, with a crude incidence of 6·5% and 5‐year actuarial incidence of 5 ± 3%. Two cases had blastic MCL at diagnosis. Survival after CNS relapse ranged from 2–9 months. Patients who developed CNS disease had a significantly shorter survival from diagnosis than those who did not (P = 0·0024). Symptomatic CNS disease in patients with MCL either at presentation or relapse is an uncommon but devastating complication. In younger patients, more aggressive immuno‐chemotherapy regimens containing CNS‐penetrating agents may reduce the incidence of CNS disease. While not routinely justified for all patients, CNS prophylaxis may particularly benefit patients with blastic histology at diagnosis, or those with systemic relapse after first‐line treatment.
Extended triple intrathecal therapy in children with T‐cell acute lymphoblastic leukaemia: a report from the Israeli National ALL‐Studies
Authors: Stark Batia , Avrahami Galia , Nirel Ronit , Abramov Aya , Attias Dina , Ballin Ami , Bielorai Bella , Burstein Yoav , Gavriel Hertzel , Elhasid Ronit , Kapelushnik Joseph , Sthoeger Dalia , Toren Amos , Wientraub Michael , Yaniv Isaac , Izraeli Shai 
Published: August 2009

SummaryOwing to the increased central nervous system (CNS) relapse risk in T‐cell acute lymphoblastic leukaemia (ALL), it is unclear whether preventive cranial radiation (pCRT) can be safely omitted. In this study, pCRT was replaced by extended triple intrathecal therapy (TIT) in prednisone good early responders – medium‐risk (MR) group, accounting for 76% of T‐ALL patients. From 1989 to 2003, 143 T‐ALL patients aged 1–18 years were enrolled in the Israel National Studies (INS) 89 (n = 84) and INS 98 (n = 59) trials, based on ALL‐Berlin–Frankfurt–Munster (BFM) 86/90 and ALL‐BFM 95 protocols, respectively. Five‐year event‐free survival (EFS) of the MR group in the INS 89 (n = 60) was 70 ± 5·9% and the INS 98 (n = 43), 83·7 ± 5·6% (P = 0·12); the cumulative incidence (CI) of any CNS relapse was 5·0 ± 2·8% and 2·3 ± 2·3% (P = 0·50), respectively. There was no difference in outcome between MR patients with a white blood cell count (WBC) ≥100 × 109/l treated with extended TIT (n = 17) or pCRT (n = 10). For all T‐ALL patients, 5‐year EFS was 61·9 ± 5·3% in INS 89 and 72·9 ± 5·8% in INS 98, (P = 0·21); the CI of any CNS relapse was 7·1 ± 2·8% and 1·7 ± 1·7% (P = 0·142), respectively. Outcome of T‐ALL MR patients given extended TIT in the context of BFM‐based protocols with long‐term follow‐up appeared to be comparable to studies in which a larger proportion of patients was irradiated, and was associated with low risk of CNS relapse, regardless of the WBC.
Immune function in children under chemotherapy for standard risk acute lymphoblastic leukaemia – a prospective study of 20 paediatric patients
Authors: Eyrich Matthias , Wiegering Verena , Lim Annick , Schrauder Andre , Winkler Beate , Schlegel Paul G. 
Published: August 2009

SummaryMultidrug chemotherapy is a highly effective treatment for paediatric acute lymphoblastic leukaemia (ALL), but at the same time compromises immunity of patients. Immune function in a homogenous cohort of 20 children with standard‐ and intermediate‐risk ALL was analysed by immunophenotyping, intracellular cytokine staining, assessment of serum cytokine concentrations, T‐cell receptor (TCR) repertoire diversity and thymic function. B‐cells were most severely affected by chemotherapy, rapidly declined under induction and did not recover until the cessation of maintenance therapy. This recovery was paralleled by a relative increase in naive IgM+IgD+CD27− B‐cells, indicating de novo B‐cell generation as the major pathway for B‐cell reconstitution. T‐ and Natural Killer‐cells were less severely affected. Although numerically diminished by chemotherapy, they had partially recovered at the end of induction. Interestingly, CD4:CD8 ratio, distribution of naive versus memory T‐cells, cytokine production, TCR‐repertoire complexity and thymic function were all only marginally affected by chemotherapy. Patients receiving dexamethasone had significantly less IFNγ+ T‐cells than those receiving prednisone. Our data show that during chemotherapy in standard‐ and intermediate‐risk paediatric ALL patients the T‐cell system remains relatively well preserved. Future studies will show if this effect can be exploited for inclusion of immunotherapy in standard ALL treatment protocols.
Bottom‐up effects of glucosinolate variation on aphid colony dynamics in wild cabbage populations
Authors: NEWTON ERIKA , BULLOCK JAMES M. , HODGSON DAVE 
Published: August 2009

Abstract.1. There is an ongoing debate about the relative importance of top‐down and bottom‐up regulation of herbivore dynamics in the wild. Secondary metabolites, produced by plants, have negative effects on survival and growth of some herbivore species, causing bottom‐up regulation of population dynamics. Herbivore natural enemies may use plant secondary metabolites as cues to find their prey, but their survival and reproduction can also be influenced by the upward cascade of secondary metabolites through the food web. Thus plant chemistry might also affect herbivore populations by mediating top‐down regulation.2. We investigated the influence of heritable variation in aliphatic glucosinolates, a class of secondary metabolites produced by Brassica plants, on the relative importance of top‐down and bottom‐up regulation of Brevicoryne brassicae (mealy cabbage aphid) colonies in natural Brassica oleracea (wild cabbage) populations. We manipulated natural enemy pressure on plants differing in their glucosinolate profiles, and monitored aphid colony growth and disperser production.3. Aphid colony sizes were significantly smaller on plants producing sinigrin, compared with plants producing alternative aliphatic glucosinolates. Aphid natural enemy numbers correlated with aphid colony size, but there was no additional effect of the plants' chemical phenotype on natural enemy abundance. Furthermore, experimental reduction of natural enemy pressure had no effect on aphid colony size or production of winged dispersers.4. Our results provide evidence for glucosinolate‐mediated, bottom‐up regulation of mealy cabbage aphid colonies in natural populations, but we found no indication of top‐down regulation. We emphasise that more studies of these processes should focus on tritrophic interactions in the wild.
Resolving the conflict between driven‐grouse shooting and conservation of hen harriers
Authors: Thompson Patrick S. , Amar Arjun , Hoccom David G. , Knott Jeff , Wilson Jeremy D. 
Published: August 2009

Summary 1.  Birds of prey and driven‐grouse shooting are at the centre of a long‐standing human–wildlife conflict. Hen harrier predation can reduce grouse shooting bags, limit grouse populations and cause economic losses. Despite legal protection, hen harrier numbers are severely depleted on driven‐grouse moors. 2.  In limited trials, provision of supplementary food to hen harriers greatly reduced their predatory impact on young grouse, but did not result in higher grouse densities for shooting. Consequently, grouse moor managers have failed to adopt the technique. 3.  A recent Forum paper has called for a trial ‘population ceiling scheme’ for hen harriers, arguing that this represents the best way to increase hen harrier numbers on driven‐grouse moors. Once densities exceed the agreed ceiling, the excess would be translocated to other suitable habitat. 4.  Whilst a ‘ceiling’ scheme might work, it would be difficult to implement and we believe that other approaches to population recovery should be tested first. 5.  While driven‐grouse shooting makes an important economic contribution to some rural communities, some grouse moor owners receive considerable sums of public money. Despite this, many moors are in poor condition, the ecosystem services they supply may be at risk from both climate change and current management practices, and grouse numbers are in decline. The socio‐economic and environmental implications of alternative models of grouse management need urgent examination. 6.
Synthesis and applications. If driven‐grouse shooting is only viable when birds of prey are routinely disturbed and killed, then we question the legitimacy of driven‐grouse shooting as a sustainable land use. Moorland owners need to consider more broadly sustainable shooting practices for the 21st century.
Hen harriers and red grouse: economic aspects of red grouse shooting and the implications for moorland conservation
Authors: Sotherton Nick , Tapper Stephen , Smith Adam 
Published: August 2009

Summary 1.  Thirgood & Redpath (2008) propose ways in which red grouse : hen harrier conflicts could be resolved. It has also been suggested that grouse management could accept lower bag sizes (number of birds shot) thus reducing the need for intensive management of predators and habitats. This would allow hen harriers to co‐exist more easily on grouse moors. 2.  We compare the bags, costs and incomes from these less intensive forms of grouse shooting with the more intensive driven shooting. 3.  Allowing high density grouse moors to decline to low density ones will result in greater loss of income than the corresponding saving of costs. This can result in moor owners abandoning grouse management and thus gamekeepers losing their employment. 4.  Losing gamekeepers from the uplands would jeopardize the protection of heather moorland and Special Protection Areas for birds, large areas of which are keepered and which currently support high numbers of breeding waders. 5.
Synthesis and applications. We agree with the study by Thirgood & Redpath that consideration of social and economic factors will be needed to resolve conflict but a reduction in management effort from driven to walked‐up shooting is not the answer. A more satisfactory approach to the harrier : grouse conflict could be to try to reduce harrier predation by means of diversionary feeding and to address the problem of the rapid build‐up in harrier numbers by exploring the use of a ceiling on harrier densities.
Hen harriers and red grouse: moving towards consensus?
Authors: Redpath Steve , Thirgood Simon 
Published: August 2009

Summary 1.  The presence of predators may lead to conflict between different stakeholders. Finding ways to resolve such conflicts is a challenge to all involved. 2.
Within the UK a long and, at times, acrimonious conflict has developed around the conservation of hen harriers Circus cyaneus on moorland managed for red grouse Lagopus lagopus scoticus. This paper follows our original forum article and the replies from colleagues in the Royal Society for the Protection of Birds (RSPB) and the Game and Wildlife Conservation Trust (GWCT). 3.  Whilst differences of opinion remain, there are encouraging signs that both sides are striving for consensus. There is broad agreement that evidence is required on three fronts to address: (1) the ecological, economic and social consequences of alternative forms of land management in the uplands; (2) the efficacy of diversionary feeding of hen harriers; and (3) the utility of a brood management scheme to improve harrier conservation status and reduce the extent of the conflict. 4.
Synthesis and applications: The conflict between hen harrier conservation and red grouse management has existed for decades with little sign of progress. For the first time, stakeholders, researchers and policy advisors are engaged in effective dialogue and are striving for solutions. There are encouraging signs that all sides are now willing to listen to alternative viewpoints and appear prepared to seriously consider compromises. It is to be hoped that a solution to the harrier–grouse conflict can be found as this will have considerable positive ramifications for management of heather moorlands in the UK and wider implications for the conservation of predators around the world.