bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy
Authors: Clark Gary , Sadur Craig , Puligandla Balaram 
Published: October 2008

AbstractBackgroundPatients with pancreatic tumors that induce hypoglycemia present with a myriad of symptoms. Laboratory testing can frequently result in data challenging to the clinician to confirm the biochemical diagnosis. Proinsulin, in addition to insulin levels, may be essential in evaluating and diagnosing an insulinoma.MethodsThe objective of this case report is to demonstrate the potential importance of proinsulin levels in the evaluation of tumor‐induced hypoglycemia. We report a 49‐year‐old woman with an unusual clinical presentation. Unlike many patients with tumor‐induced hypoglycemia, her fasting glucose levels were fairly unimpressive, her insulin levels were undetectable during a prolonged fast, and she had elevated proinsulin levels.ResultsThe inpatient fast was remarkable for levels of serum glucose 53 mg/dl or higher, a serum insulin <2 uIU/ml, C‐peptide 0.7–1.1 (nl 0.8–3.1 ng/ml), and proinsulin 29.2–36.8 pmol/l (nl ≤ 18.8 pmol/l). CT scanning of the abdomen revealed multiple pancreatic lesions. A laparoscopic distal pancreatectomy led to the removal of multiple neuroendocrine tumors, which stained only for proinsulin and not for other pancreatic tumor markers. Postoperatively, she normalized her biochemical serum studies and has remained symptom‐free 2 years later.ConclusionsThe measurement of proinsulin plays an important part in the diagnostic workup of neuroendocrine tumors causing hypoglycemia. These potentially malignant tumors can be treated adequately with minimally invasive surgery.
Hepatic Metastasectomy for Soft‐Tissue Sarcomas: Is It Justified?
Authors: Rehders A. , Peiper M. , Stoecklein N. H. , Alexander A. , Boelke E. , Knoefel W. T. , Rogiers X. 
Published: October 2008

AbstractBackgroundExcept for patients with gastrointestinal stromal tumors (GIST), systemic chemotherapy in patients with liver metastasis of soft‐tissue sarcoma (STS) is not effective. Therefore, all patients with resectable liver metastases underwent surgical therapy. We present our experience with this approach during the last 13 years.MethodsAll patients (n = 45) with liver metastasis of STS undergoing surgical therapy were prospectively analyzed. Clinical and histopathological parameters as well as the postoperative course were recorded. Survival data were analyzed by using the Kaplan‐Meier method and the log‐rank test.ResultsTwenty‐seven of 45 patients with liver metastasis underwent hepatic resection; 59% of these patients had a solitary metastasis, 22% had two metastases, and 18% had three or more metastatic nodules. The surgical perioperative mortality was 7%. The median survival was 44 (range, 1–123) months, and the 5‐year survival was 49%. Repeated resection for recurrent tumor was performed in eight patients, which yielded a median survival of 76 months.ConclusionsPatients who have hepatic metastases that are functionally and technically resectable should be considered for surgery because this treatment offers the chance for long‐term survival (>5 years).
Prevalence of Symptoms and Use of Medication for Gastroesophageal Reflux in an Australian Community
Authors: Watson David I. , Lally Carolyn J. 
Published: October 2008

AbstractIntroductionGastroesophageal reflux disease is common in Western societies, although the prevalence of reflux symptoms in the community is not well described. In this study we determined the prevalence of symptoms of gastroesophageal reflux and other “esophageal” symptoms, and the consumption of medication for reflux in an Australian community.Patients and methodsA population sample designed to accurately reflect the characteristics of the population aged 15 years or older in the State of South Australia was studied. Demographic data; symptoms specific to reflux, dysphagia, and abdominal bloating; and the consumption of antireflux medication were determined in a face‐to‐face interview. The frequency and severity of heartburn and dysphagia were assessed with analog scales.ResultsA total of 2,973 people (age range: 15–95 years) were interviewed between September and December 2006. Approximately half experienced the symptom of heartburn; 21.2% experienced heartburn at least once a month, and 12.4% described frequent symptoms of heartburn (at least a few times each week). Of those with heartburn, 25.0% graded it as moderate or severe, 10.9% reported some dysphagia for solid foods, and 6.9% reported dysphagia for liquids. 3.7% described dysphagia for solids at least once a month. Abdominal bloating was reported by 48.2%. 16.9% were taking medications for reflux symptoms (10.1% proton pump inhibitors, 1.2% H2‐receptor antagonists, 2.1% simple antacids, 3.4% alternative medications). Heartburn was more common in individuals who consumed medication. There were significant associations between heartburn and bloating, and between heartburn and dysphagia.ConclusionsSymptoms of gastroesophageal reflux and the use of medications to treat such symptoms are very common in the community of South Australia. Nearly 1 in 7 people over the age of 15 consume medication for the treatment of symptoms of reflux.
Clinicopathological Features of Tumors as Predictors of the Efficacy of Primary Neoadjuvant Chemotherapy for Operable Breast Cancer
Authors: Shien Tadahiko , Akashi‐Tanaka Sadako , Miyakawa Kunihisa , Hojo Takashi , Shimizu Chikako , Seki Kunihiko , Ando Masashi , Kohno Tsutomu , Taira Naruto , Doihara Hiroyoshi , Katsumata Noriyuki , Fujiwara Yasuhiro , Kinoshita Takayuki 
Published: October 2008

AbstractBackgroundNeoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early‐stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reduction to reduce the volume of subsequent breast resection. Clinicopathological markers that predict patient response to NC are needed to individualize treatment.MethodsFrom 1998 to 2006, 368 patients with primary breast cancer underwent curative surgical treatment after NC (anthracycline and/or taxane without trastuzumab). We retrospectively evaluated the clinicopathological features and classification of the tumors using computed tomography (CT) before NC and analyzed the correlation with the pathological complete response (pCR) and reduction of tumor size after treatment.ResultsThe overall response and pCR rates in these patients were 86% and 17%, respectively. In multivariate analysis, classification as a scirrhous‐type tumor was an independent predictor of reduced likelihood of pCR (p = 0.0115; odds ratio 0.21). For tumor reduction, histological grade 3 (p = 0.0002; odds ratio 3.3) and localized tumors identified by using CT imaging (p = 0.0126; odds ratio 2.4) were independent predictors in multivariate analysis.ConclusionsIn this study, NC often did not result in pCR for breast cancers classified as scirrhous. Furthermore, tumor type classification using CT imaging and histological grading was effective to predict tumor reduction in response to NC that included an anthracycline and/or a taxane.
Mechanism of cellular rejection in transplantation
Authors: Ingulli Elizabeth 
Published: October 2008

AbstractThe explosion of new discoveries in the field of immunology has provided new insights into mechanisms that promote an immune response directed against a transplanted organ. Central to the allograft response are T lymphocytes. This review summarizes the current literature on allorecognition, costimulation, memory T cells, T cell migration, and their role in both acute and chronic graft destruction. An in depth understanding of the cellular mechanisms that result in both acute and chronic allograft rejection will provide new strategies and targeted therapeutics capable of inducing long-lasting, allograft-specific tolerance.
How Do Organizations and Social Policies ‘Acculturate’ to Immigrants? Accommodating Skilled Immigrants in Canada
Authors: Sakamoto Izumi , Wei Yi , Truong Lele 
Published: October 2008

AbstractWhile the idea of acculturation (Berry 1997) was originally proposed as the mutual change of both parties (e.g., immigrants and the host society), the change processes of host societies are neglected in research. A grounded theory study explored the efforts of human service organizations to ‘acculturate’ to an increasingly diverse immigrant population, through interviews conducted with service providers serving Mainland Chinese immigrants. Acculturation efforts of human service organizations (mezzo‐level acculturation) were often needs‐driven and affected by the political will and resultant funding programs (macro‐level forces). Even with limitations, human service organizations commonly focused on hiring Mainland Chinese immigrants to reflect the changing demographics of their clientele and creating new programs to meet the language and cultural backgrounds of the clients. To contextualize these organizational efforts, an analysis of how policy changes (macro‐level acculturation) interact with organizational practice is presented. Finally, the meaning of acculturation for the host society is discussed.
The Case of a City Where 1 in 6 Residents is a Refugee: Ecological Factors and Host Community Adaptation in Successful Resettlement
Authors: Scott Smith R. 
Published: October 2008

AbstractThe notable success of an upstate New York community in resettling refugees raises the question of whether multiple waves of resettlement over a 15‐year period have resulted in greater accommodation to refugees. Structured interviews based on transactional models of acculturation were used along with archival data to explore ecological factors supporting a host community's behavioral flexibility and perseverance in response to the influx of refugees. Evidence suggests that socioeconomic climate, historical background/social norms, and the organizational structure of agencies involved in resettlement moderate successful inclusion of refugees into a host community in a bidirectional process.
Tetrahydrobiopterin deficiency in human rabies
Authors: Willoughby R. E. , Opladen T. , Maier T. , Rhead W. , Schmiedel S. , Hoyer J. , Drosten C. , Rupprecht C. E. , Hyland K. , Hoffmann G. F. 
Published: October 2008

SummaryRabies is a fatal viral encephalitis characterized by a clinically acute and progressive course. With rare exceptions, there is a discrepancy between clinical outcome and frank histological alterations in rabies. Investigators have postulated that rabies virus may modify neurotransmission through occupancy of cellular receptors or alteration of ion channels. We took advantage of these observations to improvise a successful therapy for rabies. The Milwaukee protocol (www.mcw.edu/rabies) was further modified to treat two German patients. We measured pterins and monoamine neurotransmitter metabolites in the CSF of patients with rabies by HPLC with electrochemical or fluorescent detection. We report loss of tetrahydrobiopterin (BH4) and associated pathological decrease of dopaminergic and serotoninergic neurotransmission in three successive patients with rabies. CSF levels of BH4 and neurotransmitter metabolites increased in two patients who were supplemented. Our findings support the long‐standing speculation of modified neurotransmission in the pathogenesis of rabies, but by another mechanism. Brain turnover of dopamine and serotonin is reduced following rabies‐acquired BH4 deficiency. Neuronal nitric oxide synthase is BH4‐dependent and may also be involved, possibly causing cerebrovascular insufficiency in one patient. This work must be carefully replicated in animal models and future patients. We are cautiously optimistic at the prospect of readily available, metabolically specific, enteral therapy for rabies.
Diversity of the Enzymatic Activity in the Lipoxygenase Gene Family of Arabidopsis thaliana
Authors: Bannenberg Gerard , Martínez Marta , Hamberg Mats , Castresana Carmen 
Published: October 2008

AbstractLipoxygenases (LOX) catalyze the oxygenation of polyunsaturated fatty acids, the first step in the biosynthesis of a large group of biologically active fatty acid metabolites collectively named oxylipins. In the present study we report the characterization of the enzymatic activity of the six lipoxygenases found in the genome of the model plant Arabidopsis thaliana. Recombinant expressed AtLOX‐1 and AtLOX‐5 had comparable oxygenase activity with either linoleic acid or linolenic acid. AtLOX‐2, AtLOX‐3, AtLOX‐4 and AtLOX‐6 displayed a selective oxygenation of linolenic acid. Analyses by high‐performance liquid chromatography and gas chromatography‐mass spectrometry demonstrated that AtLOX‐1 and AtLOX‐5 are 9S‐lipoxygenases, and AtLOX‐2, AtLOX‐3, AtLOX‐4 and AtLOX‐6 are 13S‐lipoxygenases. None of the enzymes had dual positional specificity. The determined activities correlated with that predicted by their phylogenetic relationship to other biochemically‐characterized plant lipoxygenases.
Determination of Triacylglycerols in Butterfat by Normal‐Phase HPLC and Electrospray–Tandem Mass Spectrometry
Authors: Kalo P. , Kemppinen A. , Ollilainen V. 
Published: October 2008

AbstractHere, we report the identification and quantification of the molecular species of long‐, medium‐, and short‐chain triacylglycerols (TAG) in butterfat (BF), including TAG with an odd number of acyl carbons (ACN) and TAG with unidentified molecular species. In the present study, in addition to auto‐MS2, a large number of methods, each recording MS2 for 1–4 ions, were used for identification of TAG species. For the quantification of long‐chain, odd ACN TAG, and TAG with unidentified molecular species, molar correction factors (MCF) were calculated from the uncorrected mol% (area mol%) of each ACN:DB (number of double bonds) class in randomized butterfat (RBF), and the respective mol% in the calculated random composition of RBF. The butyrate, caproate, and medium‐chain (C8, C10) TAG were quantified using regio‐ or acyl‐chain‐specific MCF calculated from their area mol% in RBF and mol% in the calculated random composition. These methods enabled us to identify ca. 450 TAG species in 184 quantified peaks of 88 ACN:DB classes. The proportions of saturated, monoene, diene, triene, tetraene, pentaene, and hexaene TAG were 40.0, 38.4, 16.2, 4.5, 0.6, 0.1, and 0.03 mol%, respectively. The proportions of TAG with not identified molecular species and odd ACN TAG were 11.8 and 5.7 mol%, respectively. The most abundant short‐chain TAG species were butyroyldipalmitoylglycerol + butyroylmyristoylstearoylglycerol (5.25 mol%) and butyroylpalmitoyloleoylglycerol (4.08 mol%).
Unwanted pregnancy as a risk factor for offspring schizophrenia-spectrum and affective disorders in adulthood: a prospective high-risk study
Authors: McNeil T. F. , Schubert E. W. , Cantor-Graae E. , Brossner M. , Schubert P. , Henriksson K. M. 
Published: October 2008

BackgroundThis study investigated whether ‘unwanted pregnancy’ (i.e. a negative or ambivalent attitude towards the pregnancy/reproduction) is associated with schizophrenia-spectrum and affective disorders in the offspring in adulthood, and if so, whether other pregnancy, perinatal, childhood or genetic-risk factors account for this association.MethodIn a prospective study beginning during pregnancy, unwanted pregnancy (in combination with other early life risk factors) was studied in relation to adult mental disorders in 75 genetic high-risk (HR) and 91 normal-risk (NR) offspring, defined through maternal psychosis history. Early life risk factors were studied through personal interviews, observations and medical records, and offspring mental disorders were independently diagnosed through follow-up examination at about 22 years of age.ResultsUnwanted pregnancy by itself was significantly related to adult offspring schizophrenia-spectrum disorders in both the total sample and the HR subgroup, but the effect was found to be limited to the HR group and occurred in interaction with genetic risk. Other co-temporaneous pregnancy stressors and later perinatal complications, malformations and early childhood environmental stressors could not explain this relationship. Unwanted pregnancy also interacted with genetic-risk status in relating to affective disorders in the offspring.ConclusionsUnwanted pregnancy, when occurring together with genetic risk for psychosis, was found to be related to both adult schizophrenia-spectrum and affective mental disorders in the offspring. Although the effect of unwanted pregnancy could be mediated by other yet-unidentified factors, unwanted pregnancy might be a functional, discrete environmental psychosocial factor with its own deleterious impact on offspring mental development, when co-occurring with genetic risk.
Working memory in schizophrenia: a meta-analysis
Authors: Forbes N. F. , Carrick L. A. , McIntosh A. M. , Lawrie S. M. 
Published: October 2008

BackgroundMemory impairment is being recognized increasingly as an important feature of the neuropsychology of schizophrenia. Dysfunction of working memory, a system for the short-term storage and manipulation of information, may relate to a number of core symptoms of schizophrenia. Many studies have examined working memory function in schizophrenia but a clear understanding of the nature and extent of any deficit has been elusive.MethodA systematic review and meta-analysis of studies comparing working memory function in subjects with schizophrenia and healthy controls was performed. Following a comprehensive literature search, meta-analyses were conducted on 36 measures of phonological, visuospatial and central executive working memory functioning, encompassing 441 separate results from 187 different studies.ResultsStatistically significant effect sizes were found for all working memory measures, indicating deficits in schizophrenia groups. Some of these were robust findings in the absence of evidence of significant heterogeneity or publication bias. Meta-regression analyses showed that the working memory deficit was not simply explained by discrepancies in current IQ between schizophrenia and control groups.ConclusionsLarge deficits in working memory were demonstrated in schizophrenia groups across all three working memory domains. There were, however, no clear differences across subdomains or between particular working memory tasks. There was substantial heterogeneity across results that could only be partly explained.
Symptoms of post-concussional syndrome are non-specifically related to mild traumatic brain injury in UK Armed Forces personnel on return from deployment in Iraq: an analysis of self-reported data
Authors: Fear N. T. , Jones E. , Groom M. , Greenberg N. , Hull L. , Hodgetts T. J. , Wessely S. 
Published: October 2008

BackgroundMild traumatic brain injury (mTBI) is being claimed as the ‘signature’ injury of the Iraq war, and is believed to be the cause of long-term symptomatic ill health (post-concussional syndrome; PCS) in an unknown proportion of military personnel.MethodWe analysed cross-sectional data from a large, randomly selected cohort of UK military personnel deployed to Iraq (n=5869). Two markers of PCS were generated: ‘PCS symptoms’ (indicating the presence of mTBI-related symptoms: none, 1–2, 3+) and ‘PCS symptom severity’ (indicating the presence of mTBI-related symptoms at either a moderate or severe level of severity: none, 1–2, 3+).ResultsPCS symptoms and PCS symptom severity were associated with self-reported exposure to blast whilst in a combat zone. However, the same symptoms were also associated with other in-theatre exposures such as potential exposure to depleted uranium and aiding the wounded. Strong associations were apparent between having PCS symptoms and other health outcomes, in particular being a post-traumatic stress disorder or General Health Questionnaire case.ConclusionsPCS symptoms are common and some are related to exposures such as blast injury. However, this association is not specific, and the same symptom complex is also related to numerous other risk factors and exposures. Post-deployment screening for PCS and/or mTBI in the absence of contemporaneous recording of exposure is likely to be fraught with hazards.
Ian Ramsey on Talk about God
Authors: Evans Donald 
Published: October 2008

For Ian Ramsey, talk about God raises many philosophical problems:‘If we are not to use anthropomorphic concepts like love, power, wisdom, we cannot talk about God; but if we do use them, how do we manage to talk of God and not man?’ (MJGC152)‘Believers wish on the one hand to claim that he (God) is indescribable and ineffable, and yet on the other hand to talk a great deal about him. Nay more, when they speak of God they say that he is transcendent and immanent, im passible yet loving, and so on. But if we speak like this, are we talking significantly at all? Here is the Falsification Problem: What kind of talk can this talk about God be, if it permits us to use such conflicting descriptions of God and to continue to use these descriptions in the face of any and all empirical phenomena?’ (RL 13–14).
Existence as a Perfection: A Reconsideration of the Ontological Argument
Authors: Howe Leroy T. 
Published: October 2008

Anselm's two ‘ontological’ arguments rest upon three fundamental assertions:(1) The idea of God is the idea of a being than which nothing more perfect is conceivable.(2) Whatever exists in the understanding and outside the understanding is more perfect than whatever exists in the understanding alone. (Prosologion 2)(3) Whatever cannot be conceived not to exist is more perfect than whatever can be conceived not to exist. (Proslogion 3)
Science and Religion: Their Logical Similarity
Authors: Miller John F. 
Published: October 2008

In his “Theology and Falsification” Professor Antony Flew challenges the sophisticated religious believer to state under what conceivable occurrences he would concede that there really is no God Who loves mankind:‘Just what would have to happen not merely (morally and wrongly) to tempt but also, logically and rightly, to entitle us to say “God does not love us” or even “God does not exist”? I therefore put…the simple central questions, “What would have to occur or to have occurred to constitute for you a disproof of the love of, or of the existence of, God”?’
On the Alleged Inseparability of Morality and Religion
Authors: Klemke E. D. 
Published: October 2008

In his Morality and Religion, W. W. Bartley III states that ‘the chief aim of this study is to get clearer about the extent to which morality and religion may be interdependent’ (p. i). After stating various possible alternatives, in terms of the logical relationships of derivability and compatibility, which are relevant to this issue, Prof. Bartley in fact devotes his book to a consid eration of four views:(1) Morality is reducible to religion.(2) Religion is reducible to morality.(3) Morality and religion are in conflict (partly, not wholly).(4) Morality and religion are inseparable.
The Role of the Anugītā in the Understanding of the Bhagavadgītā
Authors: Sharma Arvind 
Published: October 2008

Sometime after the famous fratricidal battle among the Bharatas known as the Mahābhārata war was over (on the eve of which the Bhagavadgītā had been revealed to Arjuna by Krŗşņa), Arjunarequested Krŗşņa… to repeat the instruction which had already been conveyed to him on ‘the holy field of Kurukşetra’ but which had gone out of his ‘degenerate mind’. Kŗşņa thereupon protests that he is not equal to a verbatim recapitulation of the Bhagavadgītā but agrees in lieu of that to impart to Arjuna the same instruction in other words, through the medium of a certain ancient story – or purātana itihāsa. And the instruction thus conveyed constitutes what is called the Anugītā, a name which is in itself an embodiment of this anecdote.