bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Cognitive Dysfunction in Patients with Preoperative Cognitive Impairment
Authors: Silverstein Jeffrey H. , Steinmetz Jacob , Reichenberg Abraham , Harvey Philip D. , Rasmussen Lars S. 
Published: February 2007

Background
The authors explored the database of the first International Study of Postoperative Cognitive Dysfunction study to specify the domains of cognitive function that were most vulnerable and to determine the pattern of deterioration in patients with preoperative cognitive impairment.

Methods
One thousand two hundred eighteen patients were included in the first International Study of Postoperative Cognitive Dysfunction, where neuropsychological testing was performed at entry to the study, at 1 week, and at 3 months after surgery. The authors' analyses determined the extent to which seven neuropsychological measures changed after surgery with focus on the relation with preoperative cognitive impairment, defined as a preoperative score 1.5 SD below healthy controls in the memory test.

Results
Preoperative cognitive impairment was found in 74 patients at baseline. At 1 week, cognitive deterioration was seen in all tests, but in particular in the Letter Digit Coding and the time of the Stroop interference test, with 14% and 16% of the total sample (n = 1,016) exceeding 2 SD, respectively. At 3 months, deterioration was more uniform. Significantly fewer in the preoperative cognitive impairment group had deterioration in the memory test, both at 1 week and at 3 months, with no patient displaying a deterioration exceeding 2 SD.

Conclusions
Postoperative cognitive deterioration was seen in all tests, although most commonly in attention and cognitive speed at 1 week. Deterioration in memory was difficult to detect after surgery in patients with preoperative cognitive impairment.
High-dose Morphine Impairs Vascular Endothelial Function by Increased Production of Superoxide Anions
Authors: Lam Chen-Fuh , Liu Yen-Chin , Tseng Fan-Ling , Sung Yen-Hui , Huang Chien-Chi , Jiang Meei-Jyh , Tsai Yu-Chuan 
Published: February 2007

Background
The effects of high-dose morphine on vascular endothelial function have not been previously shown. The authors hypothesized that the pro-oxidant effect of high-dose morphine impairs vascular endothelial function.

Methods
Mice were subjected to placebo or morphine (20 mg/kg intraperitoneal) injection for consecutive 14 days. Aortas were harvested for assessment of vasomotor function by isometric force recordings. Protein expression p47phox was determined by Western blotting. Generations of superoxide anions were detected under a confocal microscope.

Results
Compared with controls, contraction response to phenylephrine was significantly enhanced in the aorta of mice treated with high-dose morphine (maximal contractions were 150 +/- 26 vs. 261 +/- 32 mg, respectively; n = 5 or 6, P = 0.04). Endothelium-dependent relaxations to acetylcholine (10 to 10 m) were significantly reduced in morphine-treated animals but were normalized by superoxide scavenging. Fluorescent densities of dihydroethidium were increased in the aorta of morphine-treated mice. Aorta of mice treated with morphine expressed higher levels of p47phox (a major subunit of nicotinamide adenine dinucleotide phosphate oxidase). In cultured endothelial cells, morphine enhanced production of reactive oxygen species.

Conclusions
Collectively, the authors' results showed that high-dose morphine impairs vascular endothelial function via attenuation of biologic activity of endothelium-derived nitric oxide. Chemical antagonism between superoxide anions generated by nicotinamide adenine dinucleotide phosphate oxidases may be the molecular mechanism responsible for the inactivation of endogenous nitric oxide after treatment with high-dose morphine.
Imaging Human Cerebral Pain Modulation by Dose-dependent Opioid Analgesia
Authors: Wagner Klaus J. , Sprenger Till , Kochs Eberhard F. , Tölle Thomas R. , Valet Michael , Willoch Frode 
Published: February 2007

Background
Previous imaging studies have demonstrated a number of cortical and subcortical brain structures to be activated during noxious stimulation and infusion of narcotic analgesics. This study used O-water and positron emission tomography to investigate dose-dependent effects of the short-acting mu-selective opioid agonist remifentanil on regional cerebral blood flow during experimentally induced painful heat stimulation in healthy male volunteers.

Methods
Positron emission tomography measurements were performed with injection of 7 mCi O-water during nonpainful heat and painful heat stimulation of the volar forearm. Three experimental conditions were used during both sensory stimuli: saline, 0.05 microg x kg x min remifentanil, and 0.15 microg x kg x min remifentanil. Cardiovascular and respiratory parameters were monitored noninvasively. Across the three conditions, dose-dependent effects of remifentanil on regional cerebral blood flow were analyzed on a pixel-wise basis using a statistical parametric mapping approach.

Results
During saline infusion, regional cerebral blood flow increased in response to noxious thermal stimulation in a number of brain regions as previously reported. There was a reduction in pain-related activations with increasing doses of remifentanil in the thalamus, insula, and anterior and posterior cingulate cortex. Increasing activation occurred in the cingulofrontal cortex (including the perigenual anterior cingulate cortex) and the periaqueductal gray.

Conclusions
Remifentanil induced regional cerebral blood flow increases in the cingulofrontal cortex and periaqueductal gray during pain stimulation, indicating that mu-opioidergic activation modulates activity in pain inhibitory circuitries. This provides direct evidence that opioidergic analgesia is mediated by activation of established descending antinociceptive pathways.
Randomized, Controlled Trial of Early Intravenous Nutrition for Prevention of Neonatal Jaundice in Term and Near‐term Neonates
Authors: Makay Balahan , Duman Nuray , Özer Esra , Kumral Abdullah , Yeşilirmak Didem , Özkan Hasan 
Published: February 2007

ABSTRACTBackground:This study was undertaken to investigate the effects of early parenteral nutrition on prevention of neonatal jaundice in term and near‐term neonates who could not be enterally fed.Patients and Methods:Seventy‐two infants were randomized into 2 groups: the early parenteral nutrition group (group 1) received 1.0 g/kg/d amino acids beginning within the first day and 1.0 g/kg/d lipid added the next day. The conventional nutrition group (group 2) started on a solution containing 10% glucose and electrolytes in the first 72 hours of life, followed by 0.5 g/kg/d amino acids and lipid. Amino acids and lipid were each increased by 0.5 g/kg/d to a maximum of 3.0 g/kg/d in both groups. Main outcome measures were energy intake; serum bilirubin levels at 24, 48, and 72 hours; need for phototherapy; and duration of phototherapy.Results:Higher energy intake was achieved after the first day in group 1. Daily serum bilirubin levels did not significantly differ between groups. Nine patients in each group required phototherapy. The initiation times of phototherapy were 92.9 hours ± 25.5 in group 1 and 83.1 hours ± 28.5 in group 2. Durations of phototherapy were 37.3 hours ± 11.1 in group 1 and 52.0 hours ± 20.7 in group 2. There were no significant differences in the requirement, initiation time, and duration of phototherapy.Conclusions:Early parenteral nutrition has no proven benefit in terms of therapy requirement or severity and duration of neonatal jaundice compared with conventional parenteral nutrition in term and near‐term infants who could not be enterally fed.
Topical Application of Mitomycin‐C in Oesophageal Strictures
Authors: Rosseneu S , Afzal N , Yerushalmi B , Ibarguen‐Secchia E , Lewindon P , Cameron D , Mahler T , Schwagten K , Köhler H , Lindley KJ , Thomson M 
Published: February 2007

ABSTRACTBackground:Benign oesophageal strictures may occur as a complication of caustic ingestion or severe gastro‐oesophageal reflux or as a sequela of oesophageal surgery and other fibrosing conditions. The traditional initial treatment of oesophageal strictures is intraluminal dilation; however, even if frequent, this occasionally may not provide adequate oesophageal lumen capacity or give significant symptom‐free intervals, and restricturing after dilation is difficult and challenging. Topical postdilation application of an antifibrotic agent, mitomycin‐C, in the treatment of an oesophageal stricture has been described.Patients and Methods:Eight centres participated, with a total of 16 patients (4 girls), median age 48 (range 0–276) months. The causes of stricture were as follows: caustic (10), post–trachea‐oesophageal fistula repair (2), peptic (2), Crohn disease (1), and dystrophic epidermolysis bullosa (1). The median (range) length and diameter of the strictures were as follows: 22 mm (8–50 mm) and 1.5 mm (1–6 mm). Of the 16 patients, 15 had undergone repeated dilations varying from 3 to more than 1000 (daily self‐bouginage) before mitomycin‐C, and the median interval between dilations was 4 weeks. Mitomycin‐C 0.1 mg/mL was applied after dilation for a median time of 3.5 minutes and a median of 3 (1–12) times.Results:Major success, both endoscopic and clinical improvement or cure, occurred in 10 of 16 patients. In 3 of 16 patients the interval period between dilations increased dramatically. Failure of therapy was considered in 3 of 16. All of the patients remained symptom free for a follow‐up time of as long as 5 years.Conclusions:Postdilation application of topical mitomycin‐C resulted in major success in 62.5% of patients and partial success in 19%, and it may be a useful strategy in oesophageal strictures of differing causes that are refractory to repeated perendoscopic dilation.
Cyclooxygenase‐2 Expression in Polyps From a Patient With Juvenile Polyposis Syndrome With Mutant BMPR1A
Authors: Kurland Jayde E , Beck Stayce E , Solomon Carol J , Brann Oscar S , Carethers John M , Huang Sherry C 
Published: February 2007

ABSTRACTObjectives:Cyclooxygenase‐2 (COX‐2) expression is increased in colorectal cancers and has been reported to be upregulated in Peutz‐Jeghers polyps. To determine whether germline and somatic loss of BMPR1A in polyps from a patient with juvenile polyposis syndrome have altered COX‐2 expression, we characterized a patient with juvenile polyposis syndrome for BMPR1A germline mutations and examined the polyps for BMPR1A expression and COX‐2 expression.Patients and Methods:DNA analysis for BMPR1A was performed on a patient with juvenile polyposis syndrome. Multiple polypectomies were performed, and several polyps showed adenomatous change. Genomic DNA was extracted from polyp material for loss of heterozygosity (LOH) analyses with microsatellite markers. Immunohistochemistry was performed on sections using antibodies for BMPR1A and COX‐2.Results:The kindred possessed a germline BMPR1A missense mutation. In polyp domains containing cystic and adenomatous epithelium, no LOH was observed using markers near the BMPR1A locus. Immunostaining indicated decreased expression of phospho‐SMAD1 (pSMAD1), functionally downstream of the mutant BMPR1A receptor in the cystic epithelium, with further reduction in adenomatous portions within the polyp. COX‐2 protein, normally not expressed in the colon, was present and increased in polyp epithelium.Conclusions:Decreased expression of pSMAD1 in the cystic epithelium with further reduction in the adenomatous area, and increase in COX‐2 expression within polyps from the BMPR1A heterozygote, suggest a potential mechanism for adenomatous pathogenesis in these hamartomatous polyps. This may imply that COX‐2 inhibitors could be a means for chemoprevention in this syndrome.
Epidermal Growth Factor Stimulates Chloride Transport in Primary Cultures of Weanling and Adult Rabbit Colonocytes
Authors: Carlos Maria A , Nwagwu Chimnoya , Ao Mei , Venkatasubramanian Jayashree , Boonkaewwan Chaiwat , Prasad Roli , Chowdhury Shamim AK , Vidyasagar Dharmapuri , Rao Mrinalini C 
Published: February 2007

ABSTRACTObjectives:We have shown that Ca2+‐dependent regulation of Cl− secretion in the mammalian colon exhibits age dependence. Because epidermal growth factor (EGF) has a well‐established role in growth and can increase intracellular calcium [Ca2+]i, it is conceivable that its developmental influence may extend to the regulation of intestinal ion transport. In this study, we examined the role of EGF in the regulation of Cl− transport in the developing rabbit distal colon.Materials and Methods:Because serum contains growth factors, which could have confounded our studies, we first established an optimal milieu for testing EGF in primary cultures of adult rabbit distal colonocytes by culturing them for 24 h in media containing 0%, 1%, 5%, and 20% serum. Chloride transport (millimoles per second) and [Ca2+]i were measured with use of the fluorescent indicator N‐(ethoxycarbonylmethyl)‐6‐methoxyquinolinium bromide (MQAE) and Fura‐2AM, respectively.Results:Serum depletion had no effect on cell number, DNA content, or basal Cl− transport, but it significantly affected cell viability. In media with 0%, 1%, or 20% serum, bethanechol, 8BrcAMP, taurodeoxycholate, and EGF stimulated Cl− transport to a similar extent. EGF maximally stimulated Cl− transport at 16.3 nmol/L and 20 minutes. Bethanechol, but not EGF, increased [Ca2+]i. EGF did not alter bethanechol‐stimulated Cl− transport or [Ca2+]i. EGF acts via an EGF‐receptor and mitogen activated protein kinase (MAPK) signaling pathway, since stimulation of Cl− transport was abolished by genistein, AG1478, and PD98059. Weanling and adult colonocytes, cultured in 1% serum, showed similar basal and EGF‐stimulated Cl− transport.Conclusions:EGF stimulates rabbit colonic Cl− transport via a Ca2+‐independent, tyrosine kinase‐ and MAPK‐dependent pathway, and its effects are not age dependent.
Regional population dynamics define the local genetic structure in Sorbus torminalis
Authors: ANGELONE S. , HILFIKER K. , HOLDEREGGER R. , BERGAMINI A. , HOEBEE S. E. 
Published: February 2007

AbstractRecent changes in sylvicultural practices in Central Europe have created forests with closed canopies, and tree species preferring open and sunny forests have declined in area and abundance. This led to increased isolation of populations of many rare insect‐pollinated, fleshy‐fruited species with a naturally scattered distribution. To gain insight into the regional population dynamics of such species, we investigated the consequences of spatial isolation, population size and density on the genetic structure of Sorbus torminalis and simultaneously considered the relationship between fecundity and habitat quality. Genotype data for biparentally (ISSRs) and maternally inherited (cpDNA PCR‐RFLPs) molecular markers were generated for 26 Swiss populations of S. torminalis. We applied analyses of molecular variance (amova) to both marker types and separated the relative contributions of pollen and seed dispersal to historical gene flow. amova detected significant differentiation among populations (ΦST ISSR = 0.107; ΦST cpDNA = 0.370) in both marker types. The relative rate of pollen to seed gene flow was low (r = 2.919) and significantly different from equality. Isolation by distance was weak within Eastern and Western Switzerland, although populations were substantially differentiated. Within‐population molecular variance was not explained by population size, whereas habitat quality (openness) positively influenced the percentage of fruiting trees and the degree of fruiting per tree, indicating that more open forests enhance sexual reproduction. Our findings of significant genetic differentiation in the absence of clear geographical structuring can be explained by the distinct ecology of S. torminalis and nondirectional colonization events in metapopulation‐like dynamics.
Immunological evaluation of personalized peptide vaccination with gemcitabine for pancreatic cancer
Authors: Yanagimoto Hiroaki , Mine Takashi , Yamamoto Koutaro , Satoi Sohei , Terakawa Naoyoshi , Takahashi Kanji , Nakahara Kimika , Honma Shigenori , Tanaka Masahiro , Mizoguchi Junko , Yamada Akira , Oka Masaaki , Kamiyama Yasuo , Itoh Kyogo , Takai Soichiro 
Published: February 2007

The aim of the present study was to investigate the safety and immune responses of personalized peptide vaccination when administered with gemcitabine (GEM) in advanced pancreatic cancer (APC) patients. Thirteen patients with APC were enrolled. Pre‐vaccination with peripheral blood mononuclear cells and plasma was carried out to examine cellular and humoral responses to 25 or 23 peptides in human leukocyte antigen A24++ or A2+++ patients, respectively. Only the reactive peptides (maximum of four) were then administered weekly at three different dose settings: 1, 2 and 3 mg of peptide. GEM was administered at 1000 mg/m2 per week for 3 weeks, followed by 1 week of rest. The combination therapy was well tolerated. Grade 3 toxicities were: anemia (three patients), neutropenia (two patients) and thrombocytopenia (two patients). Of these 13 patients, 11 (85%) showed clinical responses, such as reduction in tumor size and/or level of tumor markers. Augmentation of peptide‐specific cytotoxic T lymphocyte activity against pancreatic cancer cells was observed at each dose level, whereas the increment of peptide‐specific IgG antibodies was dependent on peptide dose. GEM did not inhibit the immune responses induced by personalized peptide vaccinations, and this new type of immunochemotherapy combination is recommended for further clinical study in APC patients. (Cancer Sci 2007; 98: 605–611)
Does matching matter? Examining matches and mismatches between patient attributes and therapy techniques in alcoholism treatment
Authors: Karno Mitchell P. , Longabaugh Richard 
Published: February 2007

ABSTRACTAims  This study assessed the predictive validity of the level of matching and mismatching between patients' personal attributes and aspects of outpatient psychotherapy they received.Design and participants  On the basis of patient‐by‐treatment interactions observed for this sample in previous research, patients with alcohol abuse or dependence (n = 137) were designated retrospectively as being matched, unmatched or mismatched on each of four patient and treatment variable pairings. These pairings included (1) patient depressive symptoms and therapy emotion focus, (2) patient trait anger and therapy confrontation, (3) patient interpersonal reactance and therapy confrontation and (4) patient interpersonal reactance and therapy structure.Measurements  Analyses of variance and logistic regression were used to assess the individual and additive effects of being matched and mismatched on the percentage of abstinent days (PDA) and recovery status in the year after treatment.Findings  Being mismatched on any of the four patient–treatment pairings was a significant predictor of more frequent alcohol use post‐treatment. Being matched on only two pairings predicted less frequent alcohol use, namely matches on therapy emotion focus with patient depressive symptoms and therapy structure with patient reactance. Matches appeared to optimize otherwise good outcomes, while mismatches had larger effect sizes and tended to predict relatively poor outcomes. The data supported the presence of an additive effect for mismatches on post‐treatment PDA. The group with the most mismatches fared considerably worse than a group with fewer mismatches. Several matches and mismatches also predicted recovery status, with some support found for additive effects.Conclusions  Mismatches between patient attributes and treatment appear to have serious consequences, and this effect is magnified with multiple mismatches. Matches, on the other hand, while beneficial, may not be necessary to achieve good outcomes.
Child welfare workers who are exhausted yet satisfied with their jobs: how do they do it?
Authors: Stalker Carol A. , Mandell Deena , Frensch Karen M. , Harvey Cheryl , Wright Margriet 
Published: February 2007

ABSTRACTIn response to a study of Canadian child welfare workers that unexpectedly found participants scoring high on a measure of emotional exhaustion (burnout) and, at the same time, high on overall job satisfaction, this paper reviews research that has investigated these constructs in the social work literature as well as in selected studies from sociology, social psychology, management and women’s studies. The review reveals that some previous studies also report the coexistence of high levels of emotional exhaustion and strong job satisfaction in child welfare and social worker samples. Several studies have suggested that individual characteristics, including finding reward in helping others, having a commitment to the mandate of child welfare and believing that one’s labour is ‘making a difference’, contribute to satisfaction with child welfare work in spite of work overload and emotional exhaustion. Attributions regarding causes of exhaustion, coping strategies and goal orientation may also attenuate the expected negative effects of emotional exhaustion. Considerable evidence supports the positive influence of variables organizational managers can control, including job autonomy, supportive supervisors, workload, promotional opportunities and perception of personal safety. The degree to which this phenomenon is associated with female socialization and the ‘ethic of care’ underlying social work is discussed. Implications for child welfare research, practice and policy are offered.
Congruence and co‐operation in social workers’ assessments of children in need
Authors: Platt Dendy 
Published: February 2007

ABSTRACTThis paper examines the concepts of congruence and co‐operation in social work practice with children and families. It describes findings from the author’s own research and attempts to deconstruct the interaction of the two phenomena. Using material from other published research, the paper proposes a model and suggests methods for analysing congruence and co‐operation in the practice context. The key implication is that the depth of a social worker’s understanding of a family situation may affect his or her assessment of parental co‐operation.