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Selected AbstractsMuscle type-specific response of PGC-1, and oxidative enzymes during voluntary wheel running in mouse skeletal muscleACTA PHYSIOLOGICA, Issue 3-4 2006S. Ikeda Abstract Aim:, It is generally accepted that endurance exercise increases the expression of peroxisome proliferator-activated receptor , coactivator-1, (PGC-1,), which governs the expression of oxidative metabolic enzymes. A previous report demonstrated that the regulation of mitochondrial protein expression in skeletal muscles in response to cold exposure depends on muscle fibre type. Cold exposure and endurance exercise are both metabolic challenges that require adjustments in mitochondrial energy metabolism, we hypothesized that the exercise-induced increase in oxidative enzymes and PGC-1, expression is higher in fast-type than in slow-type muscle. Methods:, Female ICR mice were individually housed in cages equipped with running wheel for 1, 2, 4, 6 or 8 weeks. The soleus, plantaris (PLA) and tibialis anterior (TA) muscles were then prepared from each mouse. The expression levels of PGC-1,, mitochondrial proteins and GLUT4 were evaluated by Western blotting. Results:, The expression level of PGC-1, was increased only in the PLA muscle. Furthermore, the expression levels of all mitochondrial proteins and GLUT4 in the PLA muscle were increased. In the TA muscle, although there was no increase in PGC-1, expression, the expression levels of mitochondrial proteins and GLUT4 were increased. Conclusions:, These results suggest that muscle type-specific responses occur during endurance exercise, and that the increase in PGC-1, expression is not the only factor that promotes oxidative capacity as a result of endurance exercise. [source] Comparison of the effects of HGF, BDNF, CT-1, CNTF, and the branchial arches on the growth of embryonic cranial motor neuronsDEVELOPMENTAL NEUROBIOLOGY, Issue 2 2002Arifa Naeem Abstract In the developing embryo, axon growth and guidance depend on cues that include diffusible molecules. We have shown previously that the branchial arches and hepatocyte growth factor (HGF) are growth-promoting and chemoattractant for young embryonic cranial motor axons. HGF is produced in the branchial arches of the embryo, but a number of lines of evidence suggest that HGF is unlikely to be the only factor involved in the growth and guidance of these axons. Here we investigate whether other neurotrophic factors could be involved in the growth of young cranial motor neurons in explant cultures. We find that brain-derived neurotrophic factor (BDNF), ciliary neurotrophic factor (CNTF) and cardiotrophin-1 (CT-1) all promote the outgrowth of embryonic cranial motor neurons, while glial cell line-derived neurotrophic factor (GDNF) and neurotrophin-3 (NT-3) fail to affect outgrowth. We next examined whether HGF and the branchial arches had similar effects on motor neuron subpopulations at different axial levels. Our results show that HGF acts as a generalized rather than a specific neurotrophic factor and guidance cue for cranial motor neurons. Although the branchial arches also had general growth-promoting effects on all motor neuron subpopulations, they chemoattracted different axial levels differentially, with motor neurons from the caudal hindbrain showing the most striking response. © 2002 Wiley Periodicals, Inc. J Neurobiol 51: 101,114, 2002 [source] Assessment of the predictive value of clinical and histopathological factors as well as the immunoexpression of p53 and bcl-2 proteins in response to preoperative chemotherapy for esophageal squamous cell carcinomaDISEASES OF THE ESOPHAGUS, Issue 3 2000J. Szumilo The aim of the study was to determine the predictive value of selected clinical and histopathological factors as well as the immunohistochemical expression of p53 and bcl-2 proteins in the prediction of the pathological response to preoperative chemotherapy in esophageal squamous cell carcinoma. Thirty-four patients with advanced squamous cell carcinoma of the thoracic esophagus (T2,4 N0,1 M0), who underwent one cycle of cisplatin and 5-fluorouracil therapy followed by subtotal esophagectomy, were studied. All clinical factors (tumor longitudinal diameter in a computed tomographic scan, invasion depth, the presence of lymph node metastasis and clinical tumor staging) were evaluated before the onset of the therapy. The histopathological features (grade of differentiation, degree of keratinization, nuclear polymorphism, mitotic index, pattern of cancer invasion and inflammatory response), and the expression of p53 and bcl-2 proteins were also estimated in prechemotherapy endoscopic biopsy specimens. Pathological response to chemotherapy was assessed in surgically resected specimens. Of 34 patients, two (5.9%) showed complete response (CR), six patients (17.6%) exhibited major histological changes (partial response 1; PR1), 24 (70.6%) showed minor histological changes (partial response 2; PR2), and two patients (5.9%) exhibited no response to chemotherapy (stable disease; SD). There were no significant relationships between the response to preoperative chemotherapy (CR + PR1 vs. PR2 + SD) and the majority of the clinical and all the histopathological features. Deeper cancer invasion before chemotherapy was the only factor that tended to worsen the therapy effect (p < 0.01). The pathological response to treatment had no significant associations with the expression of p53 and bcl-2 proteins in esophageal squamous cell carcinoma. It should be noted, however, that both patients in CR were p53 and bcl-2 protein-negative. [source] Post-gall induction performance of Adelges Abietis (L.) (Homoptera: Adelgidae) is influenced by clone, shoot length, and density of colonising gallicolaeECOLOGICAL ENTOMOLOGY, Issue 1 2010LEAH FLAHERTY 1. We evaluated the effect of clone (one susceptible and one resistant clone), shoot length, crown level, and gallicola density on post-gall induction performance of Adelges abietis. Galls that had been successfully induced by one fundatrix on a range of shoot sizes were selected, and the number of gallicolae that could colonise the gall was manipulated. 2. Post-induction gall development success was inversely related to shoot length and was higher on the susceptible clone than on the resistant clone. As gallicola density did not influence the proportion of galls that successfully completed development, reduced post-induction gall development on large shoots was not likely to be result of an insufficient stimulus from gallicolae. 3. Clone was the only factor that significantly influenced gall volume and galls were larger on the susceptible clone than on the resistant clone. As gall volume did not increase when more gallicolae attempted to colonise a gall, competition within a gall increased. Gallicola survival was inversely related to the number of colonising gallicolae. Our results suggest that gall size may be limiting at natural densities. 4. Previous studies report positive relationships between gall induction success and fundatrix density, and between gall size and fundatrix density. As each fundatrix produces one egg mass of gallicolae, this study suggests that there may be a trade-off between the successful induction of a large gall and subsequent survival of gallicolae. 5. In the present study, clone influenced all measures of post-gall induction performance. Performance was always higher on the susceptible than on the resistant clone. [source] Age-dependent clutch size in a koinobiont parasitoidECOLOGICAL ENTOMOLOGY, Issue 1 2005Jelmer A. Elzinga Abstract., 1. The Lack clutch size theory predicts how many eggs a female should lay to maximise her fitness gain per clutch. However, for parasitoids that lay multiple clutches it can overestimate optimal clutch size because it does not take into account the future reproductive success of the parasitoid. 2. From egg-limitation and time-limitation models, it is theoretically expected that (i) clutch size decreases with age if host encounter rate is constant, and (ii) clutch size should increase with host deprivation and hence with age in host-deprived individuals. 3. Clutch sizes produced by ageing females of the koinobiont gregarious parasitoid Microplitis tristis Nees (Hymenoptera: Braconidae) that were provided daily with hosts, and of females ageing with different periods of host deprivation were measured. 4. Contrary to expectations, during the first 2 weeks, clutch size did not change with the age of the female parasitoid, neither with nor without increasing host-deprivation time. 5. After the age of 2 weeks, clutch size decreased for parasitoids that parasitised hosts daily. The decrease was accompanied by a strong decrease in available eggs. However, a similar decrease occurred in host-deprived parasitoids that did not experience egg depletion, suggesting that egg limitation was not the only factor causing the decrease in clutch size. 6. For koinobiont parasitoids like M. tristis that have low natural host encounter rates and short oviposition times, the costs of reproduction due to egg limitation, time limitation, or other factors are relatively small, if the natural lifespan is relatively short. 7. Koinobiont parasitoid species that in natural situations experience little variation in host density and host quality might not have strongly evolved the ability to adjust clutch size. [source] Premature termination of treatment in an inpatient eating disorder programmeEUROPEAN EATING DISORDERS REVIEW, Issue 4 2007Philip C. Masson Abstract This retrospective study was conducted to explore rates, timing and predictors of two forms of premature termination of treatment (PTT) in an inpatient eating disorders programme: patient dropout (DO) and administrative discharge (AD). A chart review was conducted to obtain demographic, Eating Disorder Inventory-2 (EDI-2), and Resident Assessment Instrument-Mental Health (RAI-MH) data for 186 patients being treated for bulimia nervosa (BN), anorexia nervosa (AN), or eating disorder not otherwise specified (EDNOS). Overall, of the 37.6% of patients who terminated treatment prematurely, 22.1% of patients dropped out, and 15.5% of patients were administratively discharged. Time at which discharge occurred was found to be associated with the type of premature termination. The presence of DSM-IV Axis-I comorbidity was found to be the only factor associated with an increased risk of being administratively discharged. No factors were predictive of patients dropping out of treatment. The findings support the notion that AD and patient DO are different events that may have different factors influencing their rates and timing. Implications for future research and programme planning are discussed. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Risk factors for severe infection in patients with hairy cell leukemia: a long-term study of 73 patientsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2009Ghandi Damaj Abstract Although the survival of patients with hairy cell leukemia (HCL) has been improved by the therapeutic introduction of interferon , and purine analogs, it is still worsened by complications such as severe infections. In this long-term study, we identified factors influencing patient outcomes in 73 patients with HCL. Median age at diagnosis was 53 yr and the gender ratio (M/F) was 2.3. At the time of HCL diagnosis, 60 patients (82%) were symptomatic and 22 of these had an infection. After a median follow-up of 13 yr, eight patients had died of secondary cancer (n = 2), HCL progression (n = 1) and age-related complications (n = 5). The 10-yr overall survival (OS), progression-free survival and relapse rates were 91 ± 3%, 14 ± 5% and 87 ± 5%, respectively. In multivariate analyses, age >53 yr was the only factor adversely influencing OS and secondary cancer incidence, with adjusted hazard ratio (HR) of 9.30 (95%CI, 1.15,76.6; P = 0.037) and 2.80 (95%CI, 1.05,7.71; P = 0.04), respectively. Eleven patients developed severe infections. Absolute lymphocyte count (<1 × 109/L) at diagnosis was the only factor influencing the occurrence of severe infections, with an adjusted HR of 4.01 (P = 0.007). Strikingly, we did not observe any significant correlation between neutrophil or monocyte counts and the incidence of infection. We confirmed long-term survival in HCL but found a high incidence of infection , even late in the course of the disease. The absolute lymphocyte count at diagnosis is a risk factor for the occurrence of severe infections. In addition to careful monitoring of infections, prompt initiation of anti-HCL treatment should be considered in patients with low lymphocyte counts. [source] Disseminated intravascular coagulation in acute leukemia: clinical and laboratory features at presentationEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2006Masamitsu Yanada Abstract:,Background:,Although there are two major scoring systems for the clinical diagnosis of disseminated intravascular coagulation (DIC), the validity of these systems for leukemia-associated DIC remains to be confirmed. Methods:,By analyzing 125 newly diagnosed acute leukemia patients, we investigated clinical and laboratory features of leukemia-associated DIC, and determined the validity of the two established criteria. Results:,A total of 36 patients (29%) were diagnosed with DIC according to expert opinion, a method regarded as the de facto gold standard. Leukemia-associated DIC is characterized by rare manifestation of organ failure because of thrombosis and no relevance of the platelet count for the diagnosis. The results of receiver operating characteristics analysis favored fibrin degradation product (FDP) rather than D-dimer as the fibrin-related marker test. Although prothrombin time, plasma fibrinogen, and serum FDP levels were significantly different for patients with and without DIC, multivariate analysis identified FDP levels to be the only factor associated with DIC diagnosis. The cut-off level of 15 ,g/mL for FDP was found to be the most effective to differentiate DIC from non-DIC, resulting in diagnostic sensitivity and specificity of 92% and 96%, respectively. The diagnostic results for our patients produced with this FDP-based system were at least comparable with or superior to those obtained with the two currently available scoring systems. Conclusions:,Our findings suggest that an FDP-based criterion may be applicable for the diagnosis of leukemia-associated DIC. Although it appears to be simple and practicable enough for clinical use, prospective validation of this criterion is needed. [source] Potential role for Interleukin-28B genotype in treatment decision-making in recent hepatitis C virus infection,HEPATOLOGY, Issue 4 2010Jason Grebely Polymorphisms in the IL28B (interleukin-28B) gene region are important in predicting outcome following therapy for chronic hepatitis C virus (HCV) infection. We evaluated the role of IL28B in spontaneous and treatment-induced clearance following recent HCV infection. The Australian Trial in Acute Hepatitis C (ATAHC) was a study of the natural history and treatment of recent HCV, as defined by positive anti-HCV antibody, preceded by either acute clinical HCV infection within the prior 12 months or seroconversion within the prior 24 months. Factors associated with spontaneous and treatment-induced HCV clearance, including variations in IL28B, were assessed. Among 163 participants, 132 were untreated (n = 52) or had persistent infection (infection duration ,26 weeks) at treatment initiation (n = 80). Spontaneous clearance was observed in 23% (30 of 132 participants). In Cox proportional hazards analysis (without IL28B), HCV seroconversion illness with jaundice was the only factor predicting spontaneous clearance (adjusted hazards ratio = 2.86; 95% confidence interval = 1.24, 6.59; P = 0.014). Among participants with IL28B genotyping (n = 102 of 163 overall and 79 of 132 for the spontaneous clearance population), rs8099917 TT homozygosity (versus GT/GG) was the only factor independently predicting time to spontaneous clearance (adjusted hazard ratio = 3.78; 95% confidence interval = 1.04, 13.76; P = 0.044). Participants with seroconversion illness with jaundice were more frequently rs8099917 TT homozygotes than other (GG/GT) genotypes (32% versus 5%, P = 0.047). Among participants adherent to treatment and who had IL28B genotyping (n = 54), sustained virologic response was similar among TT homozygotes (18 of 29 participants, 62%) and those with GG/GT genotype (16 of 25, 64%, P = 0.884). Conclusion: During recent HCV infection, genetic variations in IL28B region were associated with spontaneous but not treatment-induced clearance. Early therapeutic intervention could be recommended for individuals with unfavorable IL28B genotypes. (HEPATOLOGY 2010;) [source] Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: Comparative analysis from two centers,HEPATOLOGY, Issue 4 2009Anna Cavazza The limited information and divergent results on the prevalence, incidence, and risk factors for hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) may be due to the low prevalence of the disease and geographical and environmental differences. Therefore, we analyzed the incidence, prevalence, survival, and risk factors for HCC in patients with PBC from two European centers (389 from Barcelona, Spain, and 327 from Padova, Italy) followed up for 9.3 ± 6.5 years. Gender, age, smoking habit, alcohol consumption, presence of hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (anti-HCV), and advanced histological stage (III-IV) were evaluated as risk factors for tumor development. Twenty-four patients (13 from Barcelona and 11 from Padova) developed HCC. The prevalence of HCC was similar in Barcelona (3.34%) and Padova (3.36%). The incidence was 0.35 and 0.37 per 100 patient-years, respectively. Male gender, age >52 years, smoking habit, alcohol >40 g/day, HBsAg, and anti-HCV were not associated with HCC. Advanced histological stage was the only factor associated with the development of HCC (odds ratio [OR]: 5.80, 95% confidence interval [CI]: 2.34-14.38, P < 0.001). When analyzing the two series separately, male gender was associated with higher likelihood of HCC in Padova (OR: 8.09, 95% CI: 1.93-33.8, P < 0.01). The median survival after the diagnosis of HCC was 36 months. Conclusion: The prevalence and incidence of HCC is similar in Spain and Italy and the advanced histological stage is the only risk factor associated with the development of HCC in PBC. The slight disparities observed between the two series might be explained by patient features on diagnosis of liver disease. (HEPATOLOGY 2009.) [source] Accuracy and Efficiency of Computer-Aided Nursing DiagnosisINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2008Sachiko Kurashima MSN PURPOSE.,This study aims to determine whether a computer-aided nursing (CAN) diagnosis system improves diagnostic accuracy and efficiency. METHODS.,A randomized crossover trial was performed using two kinds of case studies with 42 nurses as subjects. The subjects were divided into a group using the CAN diagnosis system and a group using a handbook of nursing diagnosis. Degree of accuracy was judged by using Lunney's seven-point interval scale, while efficiency was evaluated by time required for diagnosis. FINDINGS.,There was no significant difference between the two groups in terms of diagnostic accuracy; however, time required for diagnosis was significantly shorter for subjects who used the CAN diagnosis system than for those who did not. Multiple regression analysis showed that the use of the CAN diagnosis system was the only factor associated with the time required for making the nursing diagnosis. CONCLUSIONS.,The use of the CAN diagnosis system improved the efficiency of the diagnostic process without reducing the level of accuracy of nursing diagnoses. PRACTICE IMPLICATIONS.,The use of a computerized system should be a useful tool for implementation of standardized nursing terminologies. [source] The Role of Executive Stock Options in On-Market Share Buybacks,INTERNATIONAL REVIEW OF FINANCE, Issue 3 2010ASJEET S. LAMBA ABSTRACT The increasing use of on-market buyback programs in Australia may not be fully explained by the typical motivations of information signaling and free cash flows offered by previous researchers. For some firms at least, management may believe the shares are overvalued. It is in this context that we examine whether managers of firms with high levels of executive stock options have an incentive to initiate buyback programs. It has been argued that managers may be motivated to undertake on-market buyback programs in order to neutralize the dilution of earnings per share caused by their stock options, rather than for signaling purposes. Our findings are consistent with this argument because we find that the higher the proportion of executive stock options outstanding the more likely it is for firms to undertake larger on-market buyback programs. Overall our results indicate that the existence of executive stock options influences managers' decision to implement on-market buyback programs but that it is not the only factor that managers take into consideration. [source] Feeding and anhydrobiosis in bdelloid rotifers: a preparatory study for an experiment aboard the International Space StationINVERTEBRATE BIOLOGY, Issue 4 2004Claudia Ricci Abstract. Here we report the effect of food concentration on the recovery from anhydrobiosis of a bdelloid rotifer, Macrotrachela quadricornifera. Cohorts were either starved, or fed high or low concentrations of food, before being dried and their subsequent recovery rates determined. The rotifers starved for 3 d before anhydrobiosis recovered in significantly higher proportion, and those fed lower food concentration recovered better than those fed higher food concentration. In addition, starvation did not decrease the recovery of other bdelloid species (Philodina roseola and Adineta sp. 1) which were either fed or starved before anhydrobiosis. These results suggest that a successful recovery from anhydrobiosis is not dependent on prior resource level supplied to the bdelloids. However, the lack of resources might not be the only factor in a successful recovery from anhydrobiosis. Observations using scanning electron microscopy of fed individuals of M. quadricornifera entering anhydrobiosis showed that some food remained in the digestive tract. Thus, we propose that the negative effect of rich food may be due to a purely mechanical effect and may be interfering with a proper folding of the rotifer body at the onset of anhydrobiosis. This contribution results from studies carried out in preparation for biological experiments scheduled on the International Space Station (ISS). [source] An investigation of incident frequency, duration and lanes blockage for determining traffic delayJOURNAL OF ADVANCED TRANSPORTATION, Issue 3 2009Yi (Grace) Qi Traffic delay caused by incidents is closely related to three variables: incident frequency, incident duration, and the number of lanes blocked by an incident that is directly related to the bottleneck capacity. Relatively, incident duration has been more extensively studied than incident frequency and the number of lanes blocked in an incident. In this study, we provide an investigation of the influencing factors for all of these three variables based on an incident data set that was collected in New York City (NYC). The information about the incidents derived from the identification can be used by incident management agencies in NYC for strategic policy decision making and daily incident management and traffic operation. In identifying the influencing factors for incident frequency, a set of models, including Poisson and Negative Binomial regression models and their zero-inflated models, were considered. An appropriate model was determined based on a model decision-making tree. The influencing factors for incident duration were identified based on hazard-based models where Exponential, Weibull, Log-logistic, and Log-normal distributions were considered for incident duration. For the number of lanes blocked in an incident, the identification of the influencing factors was based on an Ordered Probit model which can better capture the order inherent in the number of lanes blocked in an incident. As identified in this study, rain is the only factor that significantly influenced incident frequency. For incident duration and the number of lanes blocked in an incident, various factors had significant impact. As concluded in this study, there is a strong need to identify the influencing factors in terms of different types of incidents and the roadways where the incidents occured. [source] Therapeutic plasma exchange as a nephrological procedure: A single-center experience ,,JOURNAL OF CLINICAL APHERESIS, Issue 4 2005Fred E. Yeo Abstract In the United States, therapeutic plasma exchange (TPE) is both performed and requested by a wide range of services, often on an empiric basis (before a diagnosis is established). Whether empiric therapy is beneficial has not been established. Patients were identified from an electronic procedure log that included those patients who received plasmapheresis at Walter Reed Army Medical Center from 1996 to 2003. The clinical indications, referring service, and outcomes (including deaths) that occurred were tabulated. Between March 1997 and August 2003, 568 TPE treatments were performed in 54 patients. The majority of the diagnoses were either neurologic (48%) or hematologic (37%). Thirty-three patients (61%) received TPE for a Category I indication. Twelve cases were performed empirically (without an established diagnosis) at the request of the referring service, most (7) performed for presumed thrombotic thrombocytopenic purpura (TTP). Almost 80% of patients required central venous catheters for treatment. Twelve patients (22%) experienced a major complication including death, and six patients (11%) died. Of the patients who died, 5 (83%) were treated empirically versus one death (17%) among patients not treated empirically, P < 0.001 by Chi Square. Only one of the seven patients treated empirically for TTP died, however. In logistic regression analysis, empiric treatment was the only factor independently associated with death, adjusted odds ratio, 34.2, 95% CI, 3.4, 334.8, P = 0.003. The most common indication for TPE was neurological disease, which also accounted for the highest proportion of complications. With the exception of presumed TTP, performing TPE in the absence of a confirmed diagnosis was not beneficial. J. Clin. Apheresis Published 2005 Wiley-Liss, Inc. [source] Young age a predictor of weak reactivity in a rapid antibody test in infants infected with HIVJOURNAL OF MEDICAL VIROLOGY, Issue 8 2010Leana Maree Abstract In a resource-constrained African setting, children suspected of being infected with HIV are often screened with rapid antibody tests prior to definitive diagnosis with viral genome detection. It has previously been shown that a rapid antibody assay such as the CapillusÔ HIV-1/HIV-2 test may have a high false-negative rate in infants. In this study CD count and percentage, HIV-1 viral load, antigen-specific reactivity, and age was explored as predictors of negative or low antibody reactivity by this assay. Young age was found to be the only factor associated significantly with low antibody reactivity. This phenomenon appeared to be specific to HIV since no such age association was found for antibody reactivity to tetanus toxoid. Rapid assays only validated in adults should therefore be used with utmost caution in young infants since this may lead to high rates of false-negative results. J. Med. Virol. 82:1314,1317, 2010. © 2010 Wiley-Liss, Inc. [source] Surgery after neoadjuvant chemotherapy for colorectal liver metastases is safe and feasible in elderly patientsJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2009Dietmar Tamandl MD Abstract Background Surgery for colorectal liver metastases is part of the endeavor to cure metastatic colorectal cancer (mCRC). Neoadjuvant chemotherapy increases progression free survival in resectable patients. The safety and feasibility of this concept has not been investigated in elderly patients. Methods We performed a comparative analysis of data from 244 patients who were resected for colorectal liver metastases between 1999 and 2004 at our institution. Seventy patients were aged 70 or older; they form the basis of this analysis. Results Twenty-nine patients received neoadjuvant chemotherapy (oxaliplatin-based chemotherapy (XELOX), 19; 5-fluorouracil (5-FU), 10) prior to surgery. XELOX was associated with higher response rates to chemotherapy (CR,+,PR: XELOX 68% vs. 5-FU 0%, P,=,0.001), and responding patients had a better overall (OS, P,<,0.001) and recurrence free survival (RFS, P,<,0.001) compared to others. Response to neoadjuvant chemotherapy was the only factor on multivariate analysis predicting longer OS and RFS (P,=,0.01 and P,=,0.001). Conclusion Neoadjuvant chemotherapy can be administered safely in patients older than 70 years and appears to be effective in prolonging long-term outcome. Patients responding to neoadjuvant treatment have a significantly better prognosis after liver resection. J. Surg. Oncol. 2009;100:364,371. © 2009 Wiley-Liss, Inc. [source] Assessing sediment inputs to small reservoirs in Upper East Region, GhanaLAKES & RESERVOIRS: RESEARCH AND MANAGEMENT, Issue 4 2009Afua Adwubi Abstract Many small dams and dugouts have been constructed in the Upper East Region of Ghana to address the problem of regional water scarcity. The reservoirs were constructed primarily as water supplies for agricultural irrigation and livestock watering, aquaculture and domestic use. However, many of the reservoirs dry up during the dry season, affecting the livelihoods of their basin inhabitants. A major cause for the dried reservoirs is siltation, which reduces the reservoir's storage capacities. The goal of this study is to quantify the annual siltation rate of four study reservoirs, using a bathymetric survey and reservoir soil sampling. The sediment yield and its relation to catchment area also were assessed. The results of this study indicate that the annual siltation rates are 1272, 3518, 2764 and 6135 t year,1 for Doba, Dua, Zebilla and Kumpalgogo reservoirs, respectively. Analyses of the sediment yield and catchment areas illustrated that the sediment yields decreased with increasing catchment area. All the study reservoirs have lost their dead storage capacity, which was meant to store sediment until the end of their anticipated design lives. The decreasing storage capacity because of siltation will affect the livelihoods of the local basin inhabitants, as the reservoirs will not be able to achieve all their intended purposes. The results of this study indicate that, because siltation is not the only factor threatening the benefits gained from the reservoirs, the integrated assessment of all relevant factors is required. [source] Preservation of mouse liver tissue during cold storage in experimental solutions assessed by x-ray microanalysisLIVER TRANSPLANTATION, Issue 3 2003Inna Kozlova The increasing use of organs for transplantation necessitates the development of optimal preservation techniques. The goal of this study was to investigate changes in elemental content in mouse liver cells during cold storage by x-ray microanalysis in parallel with morphologic studies. Tissue was stored at 4°C for 4 to 12 hours in normal Krebs-Ringer solution (high sodium/potassium ratio), modified Krebs-Ringer solution (low Na+/K+ ratio), Euro-Collins solution, University of Wisconsin (UW) solution, or seven modified versions of the UW solution. Incubation of liver in normal Krebs-Ringer solution caused a significant increase in sodium and decrease in potassium concentrations in contrast to incubation in other solutions. The concentration of sodium, potassium, and chlorine in the cells closely followed the concentration in the storage solution, indicating that the intracellular concentration of these ions during storage is entirely dependent on diffusion processes. The calcium concentration was independent of the storage solution used. Studies by light and transmission electron microscopy showed good preservation of hepatocytes after storage for 8 and 12 hours in UW solution and its variants, modified Krebs-Ringer solution and Euro-Collins solution, but showed moderate damage to mitochondria and swelling of the endoplasmic reticulum in normal Krebs-Ringer solution. In addition, damage to the sinusoidal endothelial cells was observed after 4 hours in normal Krebs-Ringer solution and after 8 to 12 hours in the other solutions. In conclusion, the only factor determining the intracellular concentration of diffusible ions after cold tissue storage is the ionic composition of the extracellular medium. X-ray microanalysis provides an objective method for assessing whether the intracellular ionic composition of tissue is maintained during storage. [source] Does tacrolimus offer virtual freedom from chronic rejection after primary liver transplantation?LIVER TRANSPLANTATION, Issue 7 2001048 liver transplantations with a mean follow-up of 6 years, prognostic factors in Tacrolimus has proven to be a potent immunosuppressive agent in liver transplantation (LT). Its introduction has led to significantly less frequent and severe acute rejection. Little is known about the rate of chronic rejection (CR) in primary LT using tacrolimus therapy. The aim of the present study is to examine the long-term incidence of CR, risk factors, prognostic factors, and outcome after CR. The present study evaluated the development of CR in 1,048 consecutive adult primary liver allograft recipients initiated and mostly maintained on tacrolimus-based immunosuppressive therapy. They were evaluated with a mean follow-up of 77.3 ± 14.7 months (range, 50.7 to 100.1 months). To assess the impact of primary diagnosis on the rate and outcome of CR, the population was divided into 3 groups. Group I included patients with hepatitis C virus (HCV)- or hepatitis B virus (HBV)-induced cirrhosis (n = 312); group II included patients diagnosed with primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), or autoimmune hepatitis (AIH; n = 217); and group III included patients with all other diagnoses (n = 519). Overall, 32 of 1,048 patients (3.1%) developed CR. This represented 13 (4.1%), 12 (5.5%), and 7 patients (1.3%) in groups I, II, and III, respectively. The relative risk for developing CR was 3.2 times greater for group I and 4.3 times greater for group II compared with group III. This difference was statistically significant (P = .004). The incidence of acute rejection and total number of acute rejection episodes were significantly greater in patients who developed CR compared with those who did not (P < .0001). Similarly, the mean donor age for CR was significantly older than for patients without CR (43.0 v 36.2 years; P = .02). Thirteen of the 32 patients (40.6%) who developed CR retained their original grafts for a mean period of 54 ± 25 months after diagnosis. Seven patients (21.9%) underwent re-LT, and 12 patients (38.3%) died. Serum bilirubin levels and the presence of arteriopathy, arterial loss, and duct loss on liver biopsy at the time of diagnosis of CR were significantly greater among the 3 groups of patients. In addition, patient and graft survival for group I were significantly worse compared with groups II and III. We conclude that CR occurred rarely among patients maintained long term on tacrolimus-based immunosuppressive therapy. When steroid use is controlled, the incidence of acute rejection, mean donor age, HBV- and/or HCV-induced cirrhosis, or a diagnosis of PBC, PSC, or AIH were found to be predictors of CR. Greater values for serum bilirubin level, duct loss, arteriopathy, arteriolar loss, and presence of HCV or HBV were found to be poor prognostic factors for the 3 groups; greater total serum bilirubin value (P = .05) was the only factor found to be significant between patients who had graft loss versus those who recovered. [source] Increased Ventricular Ectopic Activity in Relation to C-Reactive Protein, and NT-Pro-Brain Natriuretic Peptide in Subjects With No Apparent Heart DiseasePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2006AHMAD SAJADIEH M.D. Background: Subjects with frequent ventricular premature complexes (VPC) and no apparent heart disease make a heterogenic group with regard to prognosis. Some biomarkers have recently proved useful in risk stratification in different heart diseases. We examined prognostic impact of NT-Pro-brain natriuretic peptide (NT-Pro BNP), and C-reactive protein (CRP) in relation to frequent VPC in subjects with no apparent heart disease. Methods: Six hundred seventy-eight healthy subjects between 55 and 75 years of age with no history of cardiovascular disease were included in the study. All were tested with fasting laboratory testing and 48-hour ambulatory ECG monitoring. Frequent VPC was defined as VPC ,30/hour. Results: In 56 subjects (8%) with frequent VPC the prognosis was much poorer compared to those without frequent VPC (Hazard ratio and 95% CI: 2.3;1.2,4.4, P = 0.01), after adjustment for conventional risk factors. In subjects with frequent VPC increased levels of CRP (above 2.5 ,g/mL) was the only factor among the tested biomarkers, which was associated with a poor prognosis. Taking subjects without frequent VPC as reference, the hazard ratio and 95% CI for subjects with frequent VPC and increased CRP was 3.6;1.8,7.1, P = 0.0004, and for those with frequent VPC and normal CRP 0.8;0.2,3.5, P = 0.83, after correction for conventional risk factors. Conclusions: Among middle-aged and elderly subjects with no apparent heart disease and frequent VPCs, a CRP value ,2.5 ,g/mL is associated with a significantly higher risk of death and acute myocardial infarction. These subjects deserve primary prevention measures and further work up for structural heart disease. [source] Effects of changing risk factors on increasing asthma prevalence in southern TaiwanPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2003Hui-chun A. Tsuang Summary The study sought to identify factors with consistent relationships with the prevalence of asthma and postulate causes for the increasing prevalence. Reduplication of prevalence surveys was conducted among children of similar ages (6,12 years) from the same area (Tainan City, Taiwan). A total of 7523 primary school children from 1993 and 7224 from 1997 participated in the study. The reported prevalence of diagnosed asthma increased from 6.46% in 1993 to 8.45% in 1997 (relative risk 1.31, 95% CI 1.16, 1.47). Among all environment- and heredity-related factors examined, only four showed consistent relationships with childhood asthma, and all appeared to be a related hereditary condition. Dander allergy is the only factor that increased correspondingly with the prevalence of childhood asthma; therefore, it seems to be the most likely key factor responsible for the increasing trend. The investigation of the interactive effects imposed by the environment- (dander exposure) and heredity-related (atopic sensitisation) factors are recommended for further studies. [source] Early bacteremia in pediatric hematopoietic stem cell transplant patients on oral antibiotic prophylaxisPEDIATRIC BLOOD & CANCER, Issue 2 2005Leslie S. Kersun MD, MSCE Abstract Background Bacteremia occurs during hematopoietic stem cell transplant (HSCT) in 20%,25% of patients and the use of gut decontamination (GD) to decrease this risk is controversial. Our purpose was to determine the incidence of bacteremia and antimicrobial resistance post-HSCT in pediatric patients receiving GD, and to identify risk factors associated with infection. Procedures This was a retrospective cohort study of 182 pediatric patients undergoing first HSCT for malignant disease at The Children's Hospital of Philadelphia from January, 1999 to December, 2002. We examined the impact of age, sex, race, diagnosis, disease status, conditioning regimen, recent bacteremia, stem cell source, donor, graft versus host disease prophylaxis agents, and mucositis severity using Cox proportional hazard models. GD consisted of amoxicillin (azithromycin, if penicillin allergic) and oral gentamicin. Outcome was first episode of bacteremia prior to absolute neutrophil count (ANC) 500/mm3. Antibiotic susceptibilities were performed on all isolates. Results Seventy-four patients (41%) developed bacteremia. The majority were Gram-positive cocci, with Staphylococcal (50%) and Streptococcal species (28%) the most common. Gram-negative organisms were identified in 22% with Pseudomonas (5.7%) and Klebsiella species (3.4%) the most common. Of the Streptococcal infections, 72% were resistant to ampicillin; only 25% of the Gram-negative bacteria were resistant to gentamicin. Race was the only factor associated with early bacteremia (hazard ratio 2.3 for non-Caucasian, non-African-American patients, CI 1.3,4.3, P,=,0.007) Conclusions Early bacteremia is common after HSCT, despite the use of GD. Resistant Gram-positive organisms predominate, consistent with recent trends in immunocompromised patients. Although used in practice, there is no clear evidence for the efficacy of GD and this study provides the basis upon which to develop a randomized clinical trial evaluating the current GD regimen with placebo. © 2004 Wiley-Liss, Inc. [source] Intracranial hemorrhage following allogeneic hematopoietic stem cell transplantation,AMERICAN JOURNAL OF HEMATOLOGY, Issue 5 2009Yuho Najima Charts and radiographs of 622 allogeneic hematopoietic stem cell transplant (HSCT) recipients, over a 20-year period, were retrospectively reviewed for intracranial hemorrhage (ICH) following transplant. A total of 21 cases of ICH were identified (3.4%) including 15 cases of intraparenchymal hemorrhage (IPH), two cases of subarachnoid hemorrhage (SAH), and four cases of subdural hematoma (SDH). The median time from transplantation to the onset of ICH was 63 days (range, 6,3,488 days). The clinical features of post-transplant ICH patients were similar and included hypertension, diabetes mellitus, chronic graft-versus-host disease (GVHD), systemic infection, and veno occlusive disease (VOD), recently referred to as sinusoidal obstruction syndrome, in addition to severe thrombocytopenia. Mortality rate was especially high (89%) after IPH with a median survival of 2 days (range, 0,148 days). In contrast, all patients with SAH or SDH following HSCT survived. The cause of post-transplant ICH appears to be multifactorial, including thrombocytopenia, hypertension, acute GVHD, VOD, and radiation therapy. Most patients in our series displayed severe thrombocytopenia at the onset of ICH, even though adequate prophylactic platelet transfusions were given. By univariate analysis, cord blood transplantation, acute GVHD, systemic infection, and VOD were related to the incidence of ICH, whereas prior CNS episodes and radiation therapy did not reach statistical significance. A multivariate analysis with logistic regression identified acute GVHD as the only factor that significantly influenced ICH occurrence. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source] Improved outcome of pediatric kidney transplantations in the Netherlands , Effect of the introduction of mycophenolate mofetil?PEDIATRIC TRANSPLANTATION, Issue 1 2005Karlien Cransberg Abstract:, Collaboration of the Dutch centers for kidney transplantation in children started in 1997 with a shared immunosuppressive protocol, aimed at improving graft survival by diminishing the incidence of acute rejections. This study compares the results of transplantations in these patients to those in a historical reference group. Ninety-six consecutive patients receiving a first kidney transplant were treated with an immunosuppressive regimen consisting of mycophenolate mofetil, cyclosporine and corticosteroids. The results were compared with those of historic controls (first transplants between 1985 and 1995, n = 207), treated with different combinations of corticosteroids, cyclosporine A and/or azathioprine. Cytomegalovirus (CMV) prophylaxis was prescribed to high-risk patients in the study group, and only a small proportion of the reference group. The graft survival at 1 yr improved significantly: 92% in the study group, vs. 73% in the reference group (p < 0.001). In the study group 63% of patients remained rejection-free during the first year; in the reference group 28% (p < 0.001). After statistical adjustment of differences in baseline data, as cold ischemia time, the proportion of LRD, preemptive transplantation, and young donors, the difference between study and reference group in graft survival (RR 0.33, p = 0.003) and incidence of acute rejection (RR 0.37, p < 0.001), as the only factor, remained statistically significant, indicating the effect of the immunosuppressive therapy. In the first year one case of malignancy occurred in each group. CMV disease occurred less frequently in the study group (11%) than in the reference group (26%, p = 0.02). As a new complication in 4 patients bronchiectasis was diagnosed. A new consensus protocol, including the introduction of mycophenolate mofetil, considerably improved the outcome of pediatric kidney transplantation in the Netherlands, measured as reduction of the incidence of acute rejection and improved graft survival. [source] The South, Medium-Sized Cities, and a New Look at the Determinants of African-American RepresentationPOLITICS & POLICY, Issue 4 2003Peter F. Burns This paper examines the determinants of African-American representation on city councils in medium-sized urban areas to provide greater insight into the strategies African-Americans use to achieve political incorporation and the extent to which traditionally excluded groups have access to elected positions in the United States. I argue that previous studies generate varied conclusions about the determinants of African-American representation on city councils because scholars fail to recognize that minority political strategies may vary based on the relative and absolute size of the minority population. I examine the determinants of African-American representation in medium-sized cities to consider whether African-Americans employ an electoral mobilization strategy when they make up a large percentage of the electorate but lack the large absolute numbers necessary to sustain demand-protest activities. A regression analysis indicates that the percentage of African-Americans in the electorate is the only factor that significantly affects African-American descriptive representation. This finding supports the hypothesis that African-Americans use an electoral strategy when they lack large absolute numbers. This research also confirms Guinier's (1994) claims that African-Americans fail to achieve proportional representation in the current electoral system and suggests that the plurality system comes with high start-up costs for a traditionally excluded group. [source] EFFECT OF RESECTION AND OUTCOME IN PATIENTS WITH RETROPERITONEAL SARCOMAANZ JOURNAL OF SURGERY, Issue 6 2006Antonio Chiappa Background: A consecutive series of 47 patients with retroperitoneal sarcoma (RPS) were resected and prospectively followed. Method: Between July 1994 and March 2005, 47 patients (24 men, 23 women; mean age, 56 years; range, 17,82 years) were evaluated. Results: A total of 23 patients had primary RPS and 24 patients had recurrent RPS. A total of 30 out of 47 patients (64%) underwent removal of contiguous intra-abdominal organs. The peroperative mortality was nil and significant preoperative complications occurred in eight cases only (17%). High tumour grade and incomplete resection were significant variables for a worse survival in all 47 patients, both in the univariate and multivariate analyses (P = 0.008 and P = 0.016, respectively). Among 28 radically resected patients, only histological grade affected overall survival (90% 5-year survival for low-grade tumour vs 26% 5-year survival for high-grade tumour; P = 0.006) with a similar effect noted for disease-free survival. Conclusions: Histological grade was the only factor that affected overall and disease-free survival for RPS tumours. An aggressive surgical approach in both primary and recurrent RPS is associated with long-term survival. [source] Sublethal costs associated with the consumption of toxic prey by snakesAUSTRAL ECOLOGY, Issue 2 2009JOHN S. LLEWELYN Abstract Costs of plant defences to herbivores have been extensively studied, but costs of chemical defences to carnivores are less well understood. We examine the costs to Australian keelback snakes (Tropidonophis mairii, Gray 1841) of consuming cane toads (Bufo[Rhinella]marinus Linnaeus 1758). Cane toads (an invasive species in Australia) are highly toxic. Although keelbacks can consume toads without dying (unlike most Australian snakes), we show that cane toads are poor quality prey for keelbacks. Toads are of low net nutritional value, take longer to consume than do native frogs and reduce the snake's locomotor performance for up to 6 h after ingestion of a meal. These latter effects may increase a snake's vulnerability to predation. Nutritional content of vertebrate prey is not the only factor driving the evolution of foraging behaviour; other more subtle costs, such as risk of predation, may be widespread. [source] The Effect of Hurricane Iris on the Food Supply of Black Howlers (Alouatta pigra) in Southern Belize1BIOTROPICA, Issue 1 2005Mary S. M. Pavelka ABSTRACT Hurricanes frequently affect the forests of South and Central America; however, few studies have quantified their effects to forest structure, especially when concentrating on the food supply of an animal population. Hurricane Iris made landfall in Southern Belize on 8 October 2001, severely damaging a 52 hectare site where the behavioral ecology of a population of Central American Black Howlers (Alouatta pigra) had been under study for 2.5 yr. The hurricane resulted in a mortality rate of 35 percent for major food trees, which was primarily attributed to uprooting, snapping, and major delimbing. This damage accounted for 97 percent of the food tree loss between the two sample periods. Tree species differences were found in both the percentage loss and category of damage to food trees. Trees of different heights also experienced different percentage loss and levels of damage; subcanopy and emergent trees experienced higher loss than canopy trees, and subcanopy trees were frequently uprooted. This was partially attributed to a lack of buttressing on these subcanopy trees. Buttressing was found to decrease the frequency of uprooting. Tree size was the only factor that did not influence either damage or death. Trees from which fruit were eaten by black howlers died more than twice as often as did trees eaten for leaves. [source] Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infantsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2004Arsenio Spinillo Objective To assess the risk of persistent (>7 days) increases in brain parenchymal echogenicity in preterm infants and their association with known obstetric risk factors. Design Case,control study of prospectively collected data. Setting A University hospital in Northern Italy. Population Eighty-five singleton infants between 24 and 34 weeks of gestation with a cranial ultrasonographic diagnosis of persistently increased parenchymal echogenicity without development of cystic degeneration, and 170 control infants with negative cranial ultrasonographic findings. Methods A comparison of the prevalence of selected obstetric risk factors between infants with persistent echo-dense lesions and negative controls. Main outcome measures Odds ratios of persistent echo-dense lesions including first-degree interactions between variables. Results After adjusting for birthweight, logistic regression analysis showed that the only factor associated with an increased risk of persistent brain echo-dense lesions in infants was multiple courses of antenatal steroids (OR = 2.14, 95% CI = 1.11,4.15, P= 0.024). In this group, the risk of persistent echo-dense lesions was particularly high in: (i) mothers receiving dexamethasone rather than betamethasone (P value for interaction = 0.015) and (ii) after expectant management of pre-eclampsia or intrauterine growth retardation (P value for interaction = 0.03). Conclusions Multiple doses of antenatal steroids, especially dexamethasone, could influence the prevalence of persistent increases in brain parenchymal echogenicity in preterm infants. [source] | ||||||||||||||||||||||||||||||||||||||||