bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of Abnormal Q Waves in Hypertrophic Cardiomyopathy Assessed by Intracoronary Electrocardiography
Authors: KOGA YOSHINORI , YAMAGA AKIHIKO , HIYAMUTA KOHJI , IKEDA HISAO , TOSHIMA HIRONORI
Published: December 2004

Introduction: To clarify the mechanisms of abnormal Q waves in hypertrophic cardiomyopathy (HCM), local epicardial electrical activities were assessed by intracoronary electrocardiography (ECG).

Methods and Results: Unipolar intracoronary ECG was recorded by introducing a guide wire for angioplasty into the left anterior descending artery (LAD) in 20 patients with HCM and 10 control subjects. Intracoronary ECG showed no Q waves in any control subjects. Intracoronary ECG showed no Q waves in 8 HCM patients without abnormal Q waves on surface ECG. In 12 HCM patients with abnormal Q waves on surface ECG, 4 showed Q waves on intracoronary ECG associated with regional wall‐motion abnormalities, suggesting Q waves are formed by loss of electrical forces due to transmural myocardial fibrosis. The remaining 8 patients, who did not have Q waves on intracoronary ECG, showed greater thickening of the basal free wall than the apical free wall, with no wall‐motion abnormalities. Intracoronary ECG was characterized by increased R or R′ waves and prolonged R peak times at the proximal LAD, suggesting Q waves are formed by increased electrical forces of hypertrophied basal septal and/or ventricular free wall, unopposed by apical forces.

Conclusion: The study findings provide evidence for two mechanisms of abnormal Q waves in HCM: (1) loss of electrical forces due to transmural myocardial fibrosis, and (2) altered direction of resultant initial QRS vector due to increased electrical forces of disproportionate hypertrophy of the basal septal and/or ventricular free wall, unopposed by apical forces.
Coexistence of Two Types of Ventricular Fibrillation During Acute Regional Ischemia in Rabbit Ventricle
Authors: LIU YEN‐BIN , PAK HUI‐NAM , LAMP SCOTT T. , OKUYAMA YUJI , HAYASHI HIDEKI , WU TSU‐JUEY , WEISS JAMES N. , CHEN PENG‐SHENG , LIN SHIEN‐FONG
Published: December 2004

Introduction: We previously reported that a normal ventricle can demonstrate two types of ventricular fibrillation (VF), depending on the underlying electrophysiologic characteristics at the time of VF induction. We hypothesize that the two types of VF can coexist in acutely ischemic ventricles.

Methods and Results: Optical mapping studies were performed with di‐4ANEPPS in 15 Langendorff‐perfused rabbit hearts. Coronary artery branches were ligated to create regional ischemia in 10 hearts. Action potential duration measured to 50% repolarization (APD50) during ischemia showed an area with uniformly shortened APD50 (zone 1), an area with normal or lengthened APD50 (zone 3), and an area in between with an APD50 gradient (zone 2). Ischemia flattened APD restitution (APDR) slope and reduced conduction velocity in zone 1, creating a condition for type II VF. APDR steepened and the conduction velocity changed little in the nonischemic zone (zone 3), creating a condition for type I VF. During induced VF, the dominant frequency in zones 2 and 3 progressively increased after ischemia onset. The dominant frequency in zone 1 (ischemic zone) first decreased and then slightly increased but typically remained less than the dominant frequency in zone 3. The number of wavebreaks increased with time in all three zones (baseline: 4.3 ± 1.5; 30 min: 11.7 ± 5.6; 60 min: 15.6 ± 11 per frame; P < 0.01).

Conclusion: Two types of VF can coexist during acute regional ischemia. Both ischemic and nonischemic regions develop proarrhythmic changes during regional ischemia, thus contributing to increased ventricular vulnerability to VF and sudden death during acute coronary occlusion.
Mechanism of Adenosine‐Induced Termination of Focal Atrial Tachycardia
Authors: HIGA SATOSHI , TAI CHING‐TAI , LIN YENN‐JIANG , LIU TU‐YING , LEE PI‐CHANG , HUANG JIN‐LONG , YUNIADI YOGA , HUANG BIEN‐HSIEN , HSIEH MING‐HSIUNG , LEE SHIH‐HUANG , KUO JEN‐YUAN , LEE KUN‐TAI , CHEN SHIH‐ANN
Published: December 2004

Introduction: Adenosine can terminate most focal atrial tachycardias (ATs). However, information about the termination mechanism is limited. This study investigated the effects and mechanism of adenosine on terminating focal AT using a three‐dimensional noncontact mapping system.

Methods and Results: The study consisted of 7 patients (4 men and 3 women; age 44 ± 29 years) with focal AT. Cycle length variation and atrial activation pattern at baseline and just before AT termination by adenosine (3–12mg) were analyzed. Noncontact mapping demonstrated focal AT propagated from the origin (O) with preferential conduction and spread away from the breakout sites to the whole atrium. Compared to baseline AT, termination episodes revealed higher mean beat‐to‐beat variation of AT cycle length (11.7 ± 11.7 msec vs 4.7 ± 4.5 msec, P < 0.001) and standard deviation of normalized AT cycle length (0.033 ± 0.014 vs 0.011 ± 0.005, P < 0.001). In termination episodes, adenosine significantly decreased the peak negative voltage of AT‐O (–27.2 ± 15.3%, P < 0.01), preferential conduction (proximal: –32.1 ± 18.7, mid: –28.4 ± 22.8, distal portion: –29.6 ± 21.4%, P < 0.01), and breakout (–31.4 ± 12.5%, P < 0.01). However, adenosine did not affect voltage in nontermination episodes. Adenosine shifted the locations of AT‐O in 5 of 10 AT episodes with termination. Mean number of shifting AT‐O was 2.4 ± 1.5 (range 1–4), with maximum shifting distance of 15.0 ± 3.1 (range 10–19) mm. Focal activation at AT‐O simply disappeared in all termination episodes and therefore was not due to conduction block within preferential conduction or breakout site. Catheter ablation lesions covered 50% of total shifting origins, without late recurrence.

Conclusion: Adenosine‐induced AT termination was associated with significantly decreased electrogram voltage, shifting AT‐O locations, and disappearance of focal activation.
Relationship Between Anatomic Location of the Crista Terminalis and Double Potentials Recorded During Atrial Flutter:
Authors: OKUMURA YASUO , WATANABE ICHIRO , YAMADA TAKESHI , OHKUBO KIMIE , SUGIMURA HIDEZOU , HASHIMOTO KENICHI , KOFUNE TATSUYA , TAKAGI YASUHIRO , WAKITA RIE , OSHIKAWA NAOHIRO , KAWAUCHI KAZUNORI , SAITO SATOSHI , OZAWA YUKIO , KANMATSUSE KATSUO , YOSHIKAWA YASUYUKI , ASAKAWA YUKO
Published: December 2004

Introduction: The activation sequence in typical atrial flutter (AFL) around the tricuspid annulus is well described. However, activation of the remainder of the right atrium (RA) is not well defined. Previous studies have shown a linear block at the crista terminalis (CT) during AFL. The aim of this study was to evaluate the relationship between the location of the CT and the line of block by intracardiac echocardiography (ICE).

Methods and Results: Twenty‐one patients with typical AFL were included in the study. The ICE imaging catheter (9‐French with 9‐MHz ultrasound transducer) was advanced to the RA. Under ICE guidance, a 20‐pole roving catheter was used to map double potentials (DPs) during AFL, and three‐dimensional images of the RA were reconstructed. During counterclockwise (CCW), clockwise (CW) AFL, or both, a line of conduction block manifested by DPs was identified at a septal site adjacent to the CT in 12 patients and in the posteroseptal RA in 9 patients.

Conclusion: The functional line of block in CCW and CW AFL is localized not at the CT but at the septal edge of the CT or in the posteroseptal RA.
Coronary Sinus Recordings of Double Potentials Associated with Retrograde Conduction Through Left Atrioventricular Accessory Pathways
Authors: AKIYAMA MASAHIRO , KANEKO YOSHIAKI , TANIGUCHI YASUHIRO , NAKAJIMA TADASHI , MANITA MAMORU , ITO TOSHIO , SAITO AKIHIRO , KURABAYASHI MASAHIKO
Published: December 2004

Introduction: In some patients with left AV accessory pathway (AP), double potentials are recorded along the coronary sinus (CS) during retrograde AP conduction only. This electrophysiologic study was performed to clarify the origin and clinical significance of double potentials in 11 patients.

Methods and Results: The direction of activation of the first, relatively blunt component (DP1) was lateral to septal in 5 patients with anterior or anterolateral AP, centrifugal in 2 patients with posterior or posterolateral AP, and septal to lateral in 4 patients with posteroseptal AP, suggesting the earliest activation of DP1 was near the AP. The direction of activation of the second, sharper potentials (DP2) were septal to lateral in all patients. The double potentials were fused in the paraseptal CS region. Pacing from the lateral CS musculature or lateral left atrium reproduced the double potentials. The effective refractory period of the double potentials was reached by ventricular extrastimulation, and the left atrial deflection preceded the double potentials, excluding a ventricular or AP origin.

Conclusion: In patients with connections between the paraseptal CS musculature and left atrium but no connections more laterally, retrograde left AP conduction is associated with double potentials in the CS recordings. The double potentials represent activation of the left atrial insertion of the AP (DP1) and later activation of the CS musculature (DP2) via connections between the paraseptal CS musculature and left atrium, respectively. The activation pattern of DP1 depends on AP location, thus providing important information for AP localization during CS mapping.
Population recovery of common brushtail possums after local depopulation
Authors: Ji Weihong , Sarre Stephen D. , White Piran C. L. , Clout Mick N.
Published: December 2004

Brushtail possums (Trichosurus vulpecula) were live-trapped for two years prior to and following depopulation in two ~6-ha areas of native forest in New Zealand. The populations had recovered to 55% of the original density at one site and 40% of the original density at the other site, two years after the depopulation. The post-removal populations responded to reduced density with a higher proportion of females breeding, higher survival rate of young, and less seasonal fluctuation in body condition. The initial recolonisation was probably mainly due to surrounding animals shifting their ranges into the depopulated area, rather than long-range dispersal, which resulted in an even sex ratio in the recovering populations. The greater proportion of adult males in the post-removal populations is likely to increase sexual contact rates for females. This would enhance the dissemination of a viral-vectored biological control agent through the population, when used as part of an integrated control program.
Leg problems and banding-associated leg injuries in a closely monitored population of North Island robin (Petroica longipes)
Authors: Berggren Åsa , Low Matthew
Published: December 2004

Although plastic and metallic leg bands are widely used for identifying individual birds to assist population monitoring, the health risks associated with banding are quantified relatively rarely. We recorded the general occurrence of foot and leg injuries during a four-year study of the North Island robin (Petroica longipes) and assessed the probability of banding–injury relationships. While most leg problems were not obviously related to banding (transient lameness, congenital deformity, infection, fracture), on 10 occasions individuals experienced lameness or injury directly because of the presence of bands (~2.5% of individuals per year). In eight of these instances, individual robins caught their back toe (hallux) in between a band and their tarsus. This resulted in an inability to place the affected foot on the ground, and in some cases a pedal injury. We believe that this previously undescribed toe entrapment is made possible because of the robin’s sideways perching behaviour on upright vegetation. This highlights that relationships between leg banding and injury may be species-specific and that the impacts of banding should be identified and quantified in all species in which it is used. This will allow more accurate assessments of the risks and benefits associated with this common marking technique.
Observer error in exit counts of flying-foxes (Pteropus spp.)
Authors: Westcott David , McKeown Adam
Published: December 2004

Population estimation and monitoring is a fundamental component in the conservation management of any species. For species such as flying-foxes (Pteropus spp.) population estimation is complicated by the large number of animals involved, their mobility and the conditions under which counts are conducted. Because count results are used in the determination of management requirements, they are the focus of much critical attention. Despite this, while measures of the precision of fly-out counts of Pteropus spp. have been published, measures of their accuracy have not. In this paper we present an assessment of the accuracy and precision of observer counts of dusk fly-outs by comparing recordings of observers’ counts with a video of the same fly-out. Observer’s counts were significantly related to the video-count (rs = 0.69, P < 0.0001), with the average observer’s count underestimating the video-count by 14.7% (± 25, s.d.) of the video-count. Observers’ errors increased with the rate at which flying-foxes left the camp and with the width of the fly-out stream. These results suggest that while observers’ errors are inherent in dusk fly-out counts, these errors are manageable and relatively predictable. Other sources of error are likely to have a greater impact on the final population estimate at both camp and regional scales.
Presidential Address
Authors: Silbereisen Rainer K.
Published: December 2004

It is well known that human development is influenced by social change. In particular, as evidenced by research on German unification, the rapid change of social institutions can impact on various aspects of behaviour and development. Based on my own research experience in this field, I want to show the necessity for a better interdisciplinary collaboration, for more comparative research across divergent manifestations of social change, and for a strong orientation towards application. The address begins with a record of unwarranted assertions about the consequences of German unification. Following that, I discuss the role played by the change of social institutions in the timing of important psychosocial transitions during adolescence and young adulthood. Next, I present a conceptual model that informed our research on self-efficacy as a resource in mastering the new challenges. I conclude with suggestions concerning the development of interventions aimed at increasing people’s capabilities to capitalise on opportunities provided by profound change in social institutions. At each step, such research needs to be supported by comprehensive models of the interplay between context and the individual. I also underscore the role of ISSBD as a potential broker for new efforts in research and application in this regard.
Do Fundamentals Explain the Behaviour of the Swedish Real Effective Exchange Rate?
Authors: Nilsson Kristian
Published: December 2004

This study examines the long‐run relationship between the real effective exchange rate and its fundamental determinants, and derives a real effective equilibrium exchange rate for the Swedish krona. Our results indicate that the krona was severely overvalued in late 1992, when the fixed exchange rate regime was abandoned. By the end of 2000 the krona was undervalued by approximately 5 percent, given the prevailing economic conditions. Arithmetic examples of suitable SEK/EUR conversion rates are calculated under various assumptions to provide a guideline if Sweden were to adopt the euro in the future.
Swedish Postwar Business Cycles: Generated Abroad or at Home?
Authors: Lindé Jesper
Published: December 2004

The relative importance of foreign and domestic shocks for the Swedish postwar business cycle is examined in a neoclassical stochastic growth model of a small open economy. Since recent research has shown that fiscal policy shocks may be important for business cycles, I extend previous work in the literature by allowing for stochastic fiscal policy. It is found that the introduction of fiscal policy improves the empirical fit of the model, although not significantly so when hours worked are detrended with the HP filter. The results suggest that domestic shocks are more important than foreign shocks for output fluctuations. Among the domestic shocks, innovations in fiscal policy seem to have been more important than technology shocks during this period. Foreign shocks are very important for fluctuations in the real exchange rate and the current account.
Prices vs. Quantities: The Irrelevance of Irreversibility*
Authors: Baldursson Fridrik M. , Von Der Fehr Nils‐Henrik M.
Published: December 2004

We explore the efficacy of price and quantity controls in a dynamic setup in which the decisions of some agents are irreversible. The assumption of irreversibility is shown to improve the performance of a tax relative to that of a system of tradable quotas and significantly alter the equilibrium behavior of agents. We nevertheless conclude that taking into account the fact that agents’ decisions may be irreversible does not lead to policy implications significantly different from those reached in a simpler model in which irreversibility is ignored.
‘She is but a Woman’: Kitty Byron and the English Edwardian Criminal Justice System
Authors: Frost Ginger
Published: December 2004

In 1902, Kitty Byron stabbed her cohabitee, Reginald Baker, on a public street. Though her murder was premeditated, and she was of a lower class than her married lover, Byron gained the sympathy of the press and public, primarily due to the gender failings of her partner. Based on the legal records of the Home Office and newspaper reports, this case study illustrates the limitations of the criminal justice system in dealing with women's violence, especially in an age of increasingly sensational press coverage. The courts showed surprising sympathy to a ‘fallen’ woman, but at the cost of simplifying her story, confirming misogynist stereotypes and underestimating the danger she posed.
Prostitution, Sex Work and Violence: Discursive and Political Contexts for Five Texts on Paid Sex, 1987–2001
Authors: Shah Svati P.
Published: December 2004

This article deals with the trope of the victimised, female body in feminist debates on the selling of sexual services. The notion of ‘violence’ is central to the construction of a key axis of the debates. The article explores these issues by discussing five recent and historical feminist works on prostitution/sex work, and touches on works which address methodological issues of gathering information on an activity which is, by definition, illicit, stigmatised and socio‐politically marginalised. The essay brings out several tensions in the framing of the present debates, especially regarding the varied contexts of ‘the West’ and the ‘non‐West’, as well as issues of macropolitical change, including economic globalisation. It concludes with the ways in which the texts serve to disaggregate the concepts of ‘sex work’ and ‘violence’.
Licensing Laws and Implications for Private Investment: The Case of Tanzania*
Authors: Marandu Edward E.
Published: December 2004

Abstract:  This paper investigates the licensing provisions in the Electricity Ordinance of Tanganyika that are believed to influence private sector investment. There were three main strands to the analytical methodology — textual analysis, actual practice and perceptions of key stakeholders. The findings suggest that there is sufficient evidence to support the belief that the existing licensing laws in Tanzania do not provide the necessary features for attracting private investment, namely clarity, efficiency and transparency. More specifically the Electricity Ordinance of 1931 is so much outdated that it is not fit for amendment; instead it should be considered for revocation and a new law be enacted. The new law should: (a) provide for a clear licensing procedure in the sense that it should specify what activities need licence; who can apply for licence; where one can apply for licence; what documents to fill; (b) provide for efficiency‐enforcing provisions such as stipulating the time frame for the regulator to finish processing an application; (c) provide for a transparent licensing procedure in the sense that it should prescribe a large amount of openness — publishing of applications and that minutes be on open display as required in Uganda and Zimbabwe. The proposed multi‐sector regulator for utilities is a step in the right direction for it reduces the chances for regulatory capture, thus reinforcing transparency in the dealings of the regulator.
African Social Sciences and Development in the New Century: Challenges and Prospects
Authors: Anugwom Edlyne E.
Published: December 2004

Abstract:  This paper examines the travails of the social sciences in Africa since the post‐colonial era. It pinpoints the fact that the ability of the social sciences to be really meaningful to the delusive development quest by Africa has been undermined by a combination of structural and epistemological problems. These problems range from the dismal economic environment in the continent, the structural limitations imposed on research, poor conditions of service to laziness and epistemological inferiority among African social scientists. However, the paper posits that the current wind of change blowing across Africa, a re‐examination of the epistemology of the field and a conscientious self‐reappraisal will ultimately reposition the social sciences to play significant roles in the development of Africa.
Management of a parturient with respiratory failure secondary to cystic fibrosis
Authors: Cameron A. J. D. , Skinner T. A. J.
Published: December 2004

A 21‐year‐old with end‐stage respiratory failure and cor pulmonale due to cystic fibrosis became pregnant. Her forced expiratory volume in 1 s (FEV1) was 17% of that predicted antenatally, and termination was strongly advised on the grounds that continuing pregnancy was likely to be fatal. She elected to continue with the pregnancy and gave birth by lower segment caesarean section at 29 weeks and 5 days' gestation. Despite a problematic postnatal course, she was successfully discharged home and, 7 months postnatally, continues to live at home with her partner and their baby. There are no previous reports of cystic fibrosis patients with this level of respiratory impairment surviving pregnancy.
Predictors of long‐term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non‐cardiac surgery
Authors: Filipovic M. , Jeger R. V. , Girard T. , Probst C. , Pfisterer M. , Gürke L. , Studer W. , Seeberger M. D.
Published: December 2004

The aim of this prospective study was to assess predictors of long‐term outcome in patients with documented or suspected coronary artery disease who survive major non‐cardiac surgery. The impact of patients' comorbidities, pre‐operative heart rate variability and postoperative increase in cardiac troponin I on all‐cause mortality and major cardiac events within 2 years was explored using multivariable logistic regression. Six of 173 patients died within the first month after surgery and were excluded from the study. Thirty‐four of 167 patients (20%) died 1–24 months after surgery. Independent predictors of all‐cause mortality were history of congestive heart failure (odds ratio 6.4 [95%, confidence interval 1.7–24]), pre‐operatively depressed heart rate variability (odds ratio 6.4 [95%, confidence interval 1.9–21]), and age > 70 years (odds ratio 4.5 [95%, confidence interval 1.2–16]). In contrast, postoperative elevation of cardiac troponin I did not independently predict all‐cause mortality or major cardiac events.
The Glidescope® system: a clinical assessment of performance
Authors: Rai M. R. , Dering A. , Verghese C.
Published: December 2004

The Glidescope® is a new videolaryngoscope. It has a digital camera incorporated in the blade which displays a view of the vocal cords on a monitor. This allows the placement of a tracheal tube to be visualised. We describe its performance in 50 patients who required orotracheal intubation for elective surgery. Two investigators performed 25 intubations each. Intubation with the Glidescope® was successful in 47 of the 50 cases. The three failures occurred early in the series and were attributed to the initial learning curve. The success rate after the first eight patients in each series was 100%. The median (IQR [range]) time to intubation was 40 (30–55 [15–105]) s. The Glidescope® provided a grade I view of the glottis in 44 cases and a grade II view in six cases. The view of the larynx was improved in almost half (23) of the cases. The Glidescope® improved the view by one grade in 22 and by two grades in one patient. We conclude that the Glidescope® is an effective device for tracheal intubation and provides an improved view of the larynx. Further clinical studies are necessary to evaluate its role in airways that are difficult to manage.
Randomised controlled cross‐over comparison of continuous positive airway pressure through the Hamilton Galileo ventilator with a Dräger CF 800 device*
Authors: Sutton P. J. , Perkins C. L. , Giles S. P. , McAuley D. F. , Gao F.
Published: December 2004

In this controlled, randomised cross‐over trial on 26 intensive care patients, we compared the effects on haemodynamic and respiratory profiles of continuous positive airway pressure delivered through the Hamilton Galileo ventilator or a Dräger CF 800 device. We also compared the nursing time saved using the two approaches when weaning patients from mechanical ventilation. We did not find significant differences in haemodynamics, respiratory rate, physiological dead space, oxygen saturation and carbon dioxide production between the continuous positive airway pressure generated by the Galileo and Dräger machines. However, there was a 10‐fold reduction in nursing time using the Galileo ventilator compared with the Dräger generator. We conclude that continuous positive airway pressure delivered through the Galileo ventilator is as efficient as a Dräger device but consumes less nursing time.
Serum surfactant protein D is elevated in allergic patients
Authors: Koopmans J. G. , Van Der Zee J. S. , Krop E. J. M. , Lopuhaä C. E. , Jansen H. M. , Batenburg J. J.
Published: December 2004

Background
There is evidence that surfactant protein (SP)‐D is important in the innate, as well as in the adaptive pulmonary immune response. Serum concentrations of SP‐D have been proposed as parameter of the integrity of the blood–airspace barrier in interstitial lung diseases. We hypothesized that serum SP‐D concentrations are affected in allergic patients and correlate with changes in allergic airway inflammation.

Objective
To determine levels of serum SP‐D in allergic patients compared with non‐allergic controls. Furthermore, to investigate associations between serum SP‐D concentrations on the one hand and changes in commonly used markers of bronchial inflammation in allergic airways disease on the other hand.

Materials and methods
Fifty allergic patients were studied and bronchial allergen challenge was used as a model to increase bronchial allergic inflammation in these patients. Serum SP‐D concentrations, inflammatory parameters in induced sputum and bronchial hyper‐responsiveness (BHR) were determined before and after allergen challenge. Twenty‐five non‐allergic volunteers served as controls.

Results
Baseline serum SP‐D was significantly higher in allergic patients as compared with controls (mean serum SP‐D concentration (95% confidence interval): 62.7 (55.5, 70.0) in allergic patients vs. 49.5 (36.7, 62.3) ng/mL in non‐allergic controls, P=0.006). In addition, baseline serum SP‐D appeared to be an independent predictor for the magnitude of the late asthmatic response after allergen challenge. Furthermore, serum SP‐D was predictive for the sputum eosinophil cationic protein concentration after allergen challenge.

Conclusion
We propose that serum SP‐D concentrations are associated with allergic bronchial inflammation and may give additional information, beside BHR and sputum eosinophils, about the degree of bronchial inflammation in allergic patients.
Mothers of very low birth weight infants have less atopy than mothers of full‐term infants
Authors: Savilahti E. , Siltanen M. , Pekkanen J. , Kajosaari M.
Published: December 2004

Background
Studies on the pregnancy outcome of asthmatic mothers have suggested an increased rate of preterm deliveries. In contrast, our earlier study suggests that mothers of very low birth weight (VLBW) (<1500 g) infants less frequently had atopy than did mothers of full‐term infants.

Methods
We inquired about symptoms of atopy and doctor‐diagnosed atopy in parents of 370 infants of VLBW (<1500 g) and 544 parents of full‐term infants. Odds ratios for atopic symptoms and diagnosed atopy were calculated, and groups were compared with a trend test.

Results
Mothers of preterm infants of birth weight (BW) <1000 g significantly less often had physician‐diagnosed allergic rhinitis (AR) (P=0.02). Among all the mothers, a trend test showed that maternal AR was significantly (P=0.03) higher in parallel with a higher infant BW. Fathers of infants with different BWs showed no differences in prevalence of atopic symptoms.

Conclusion
We thus infer that maternal balance between T‐helper type 1 (Th1) and Th2 cells, shifted towards Th2 in those with AR, may have a favourable effect on maintenance of pregnancy before gestational week 30.
Suppressive activity of fexofenadine hydrochloride on metalloproteinase production from nasal fibroblasts in vitro
Authors: Asano K. , Kanai K.‐I. , Suzaki H.
Published: December 2004

Background
Allergic rhinitis (AR) is an inflammatory disease characterized by nasal wall remodelling with intense infiltration of eosinophils and mast cells/basophils. Matrix metalloproteinases (MMPs), MMP‐2 and MMP‐9, are the major proteolytic enzymes that induce airway remodelling. These enzymes are also important in the migration of inflammatory cells through basement membrane components.

Objective
We evaluated whether fexofenadine hydrochloride (FEX), the carboxylic acid metabolite of terfenadine with selective H1‐receptor antagonist activity, could inhibit MMP production from nasal fibroblasts (NFs) in response to TNF‐α stimulation in vitro.

Methods
NFs were established from nasal polyp‐derived fibroblasts (PFs) taken from patients with AR. Nasal mucosal fibroblasts (MFs) were also induced from nasal mucosal tissues from septal deformity patients without allergy. PF and MF (2 × 105 cells/mL, each) were stimulated with TNF‐α in the presence of various concentrations of FEX. After 24 h, culture supernatants were obtained and assayed for MMP‐2, MMP‐9, tissue inhibitor of metalloproteinase (TIMP)‐1 and TIMP‐2 levels by ELISA. The influence of FEX on mRNA expression of MMPs and TIMPs in 4 h‐cultured cells was also evaluated by real‐time RT‐PCR. Furthermore, nuclear factor‐κB (NF‐κB) activation in fibroblasts treated with FEX for 4 h was examined by ELISA.

Results
FEX at more than 350 ng/mL inhibited the production of MMP‐2 and MMP‐9 from both PF and MF in response to TNF‐α stimulation, whereas TIMP‐1 and TIMP‐2 production was scarcely affected by FEX. FEX also inhibited MMP mRNA expression and NF‐κB activation in PF and MF after TNF‐α stimulation.

Conclusion
The present data suggest that the attenuating effect of FEX on MMP‐2 and ‐9 production from NFs induced by inflammatory stimulation may underlie the therapeutic mode of action of the agent on allergic diseases, including AR.
The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndrome
Authors: Taramarcaz P. , Gibson P. G.
Published: December 2004

Background
Allergic rhinitis (AR) and asthma often coexist and may represent two manifestations of the same disease recently named combined AR and asthma syndrome (CARAS).

Aim
To review the common pathophysiology of combined AR and asthma and to investigate the efficacy of intranasal corticosteroids (INCS).

Methods
Medline was used to identify articles relevant to mechanisms. A Cochrane systematic review was performed to assess the efficacy of INCS in CARAS.

Results
There is cross‐talk, evidence of a common inflammatory response in both sites, linked by a systemic component. The efficacy of anti‐inflammatory INCS on asthma outcomes was assessed in a systematic review of 12 randomized controlled trials involving 425 subjects. After INCS there were non‐significant trends for improvement in asthma symptom score (standardized mean difference (SMD) of 0.61; P=0.07), forced expiratory volume in 1 s (SMD of 0.31; P=0.08), and morning peak expiratory flow (weighted mean difference of 36.51; P=0.06). There was no impact on methacholine airways responsiveness (SMD of −0.20; P=0.4). The review identified two promising new treatment options in united airway disease such as INCS as monotherapy in rhinitis and mild asthma, and a combined intranasal and intrabronchial corticosteroid (IBCS) deposition technique.

Conclusion
Common mucosal inflammatory responses occur in CARAS. This systematic review shows trends for a benefit of INCS in CARAS, but recognizes that more research is needed. At this stage, the current best practice is to treat asthma conventionally with IBCS with or without β2‐agonist and to add INCS to improve specific rhinitis symptoms.
Effectiveness of different techniques for removing gutta‐percha during retreatment
Authors: Masiero A. V. , Barletta F. B.
Published: December 2004

Aim  To evaluate the effectiveness of various techniques for removing filling material from root canals in vitro.

Methodology  Eighty extracted mandibular premolar teeth were selected for the study. The teeth were root filled using thermomechanical compaction of gutta‐percha. After 8 months, the filling material was removed and canals were reinstrumented using the following techniques: group I – hand instrumentation with K‐type files (SybronEndo, Orange, CA, USA); group II – K3 Endo System (SybronEndo); group III – M4 system (SybronEndo) with K‐type files (SybronEndo); and group IV – Endo‐gripper system (Moyco Union Broach, York, PA, USA) with K‐type files (SybronEndo). The amount of filling debris remaining on root canal walls was assessed radiographically; the images were digitized and analysed using AutoCAD 2000 software. Total canal area, area of the cervical, middle and apical thirds, and area of remaining filling material were outlined by one operator. The ratios between these areas were calculated as percentages of remaining debris. Thereafter, data were analysed by means of one‐way anova and the post‐hoc Duncan test to identify differences between the four techniques.

Results  Multiple comparisons of the percentages of remaining filling material in the entire canal did not reveal any significant differences between the methods of removal. However, when each third was analysed separately, significant differences for remaining debris were present between groups. The apical third had the most remaining material, whilst the cervical and middle thirds were significantly cleaner (P = 0.002). Comparison of the techniques revealed that teeth instrumented with K3 rotary instruments had a lower ratio of remaining filling material in the apical third (P = 0.012).

Conclusion  In the apical third, K3 rotary instruments were more efficient in removing gutta‐percha filling material than the other techniques, which were equally effective for the other thirds.
An in vitro evaluation of the ability of ozone to kill a strain of Enterococcus faecalis
Authors: Hems R. S. , Gulabivala K. , Ng Y.‐L. , Ready D. , Spratt D. A.
Published: December 2004

Aim  To evaluate the potential of ozone as an antibacterial agent using Enterococcus faecalis as the test species.

Methodology  Ozone was produced by a custom‐made bench top generator and its solubility in water determined by ultraviolet (258 nm) spectrophotometric analysis of solutions through which ozone was sparged for various time‐periods. The antibacterial efficacy of ozone was tested against both broth and biofilm cultures. Ozone was sparged for 30, 60, 120 and 240 s, through overnight broth cultures of a strain of E. faecalis (E78.2) and compared with those that were centrifuged, washed and resuspended in water. Enterococcus faecalis (E78.2) biofilms were grown on cellulose nitrate membrane filters for 48 h and suspended in water through which ozone gas was sparged with stirring for 60, 120 and 240 s in a standard fashion. In a separate test, biofilms were also exposed to gaseous ozone. Sodium hypochlorite (NaOCl) was used as a positive control. All experiments were repeated four times.

Results  There were significant (P < 0.05) reductions of bacteria in the unwashed (2 log10 reductions) and washed (5 log10 reductions) broth cultures following 240 s applications. Biofilms incubated for 240 s with ozonated water showed no significant reduction in cell viability attributable to ozone alone, whereas with NaOCl no viable cells were detected over the same time. Gaseous ozone applied for 300 s had no effect on these biofilms.

Conclusions  Ozone had an antibacterial effect on planktonic E. faecalis cells and those suspended in fluid, but little effect when embedded in biofilms. Its antibacterial efficacy was not comparable with that of NaOCl under the test conditions used.
Reference values for clinical chemistry and clinical hematology parameters in cynomolgus monkeys
Authors: Schuurman Henk‐Jan , Smith Harold T
Published: December 2004

Abstract:  Background:  In vivo xenotransplantation modeling in large animal species is often performed in nonhuman primates, including baboons. For proper data interpretation, reference values for clinical chemistry and hematology are required.

Methods:  These values are available from baseline levels in animals subjected to tolerability/pharmacokinetic studies. For each individual study two tests for clinical chemistry and hematology were performed before the start of treatment.

Results and conclusion:  Baseline levels were determined in 27 males and 15 females, in total 106 determinations (53 in males, and 53 in females). For a number of parameters levels in cynomolgus monkeys show clear differences from those in baboons. These data are reported here to provide baseline values for veterinarians and investigators using nonhuman primates in experimental studies.
Pre‐transplant blood transfusion and cyclosporin A induce long‐term hamster cardiac xenograft survival in immunocompetent rats
Authors: Vriens Patrick W. , Stoot Jan H. , van der Steenhoven Tim J. , Hoyt Grant , Bouwman Eelco , Robbins Robert C.
Published: December 2004

Abstract:  Background:  In previous studies we have shown that pre‐transplant hamster blood transfusion (HBT) can induce non‐responsiveness in the T cell independent immunecompartment and result in tolerance towards hamster cardiac xenografts (Xgs) in T cell deficient athymic nude rats. In this study we test the combination of pre‐transplant HBT with cyclosporin A (CSA) in immunocompetent Lewis rats.

Methods:  Before transplantation of a hamster cardiac Xg, 1 ml hamster blood was administered to nude rats or Lewis rats. CSA dissolved in olive oil was given orally at varying doses. Anti‐hamster antibodies were measured by flowcytometry.

Results:  In nude rats HBT 3 days before transplantation resulted in 100% long‐term survival >100 days (n = 9). In Lewis rats, HBT resulted in hyperacute rejection (HAR) (n = 6). Treatment of nude rats with CSA at doses varying from five to 20 mg/kg/day and treatment of Lewis rats with CSA five or 10 mg/kg/day did not effect Xg survival. However, treatment of Lewis rats with CSA 20 mg/kg/day led to long‐term survival of five of nine Xgs (p < 0.01). Combination of HBT with CSA 10 mg/kg/day in Lewis rats resulted in long‐term survival of four of seven Xgs. HBT and CSA 20 mg/kg/day resulted in 100% long‐term survival (n = 9). Immunoglobulin M (IgM) increased after HBT and CSA in these Lewis rats, but decreased after transplantation and remained low over time. When CSA was discontinued, IgM increased and Xgs were rejected (n = 3).

Conclusions:  This study confirms that pre‐transplant HBT results in long‐term survival of hamster cardiac Xgs in nude rats. HBT and CSA have strong synergistic effects in immunocompetent Lewis rats. Combination of HBT with CSA treatment leads to long‐term Xg survival in Lewis rats, whereas HBT alone results in HAR. The presence of T cells has a dominant influence on Xg survival after pre‐transplant blood transfusion.
Magnetic resonance imaging anatomy of the anal canal
Authors: Kashyap P , Bates N
Published: December 2004

The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams.
Scintigraphic findings in synovial sarcoma with structural correlation
Authors: Mackie GC , Schlicht SM
Published: December 2004

Synovial sarcoma is a relatively rare malignant soft tissue tumour. It is highly aggressive, tends to occur in young adults and has a poor prognosis. The scintigraphic findings in 10 patients with histopathologically proven synovial sarcoma were reviewed. Most of the lesions occurred in the extremities and intense uptake of thallium was observed on 30‐min and 4‐h imaging in almost all cases. Thallium has an important role in the detection of possible metastatic disease and in monitoring response to therapy. The scintigraphic features of synovial sarcoma are presented and correlated with the radiographic findings.
Quality improvement through teleradiology: Opportunities and challenges
Authors: Tie M , Koczwara B
Published: December 2004

Teleradiology is rapidly establishing its presence as an effective solution to the problem of provision of radiological services in remote locations. Although significant effort has been put into the development and establishment of quality assurance (QA) processes required for the implementation and conduct of this new technology, little attention has been given to the possible use of teleradiology in enhancing quality and safety of radiological practice, and as an alternative to conventional quality improvement (QI) initiatives. This paper critically evaluates teleradiology from the point of view of its potential use in QA/QI and considers its possible advantages as well as limitations. Considering the unique features of teleradiology such as remote access that can be simultaneous at multiple sites, rapid transfer of information and computerized data storage as well as good reproducibility and reliability of data, the authors argue that teleradiology represents an ideal tool which can not only be equivalent to other methods of QA in radiology but in some instances may be superior to them.
Clinical verification of the superiority of the current International Union Against Cancer staging criteria in an Australian population of patients with nasopharyngeal carcinoma
Authors: Corry J , Fisher R , Rischin D , Porceddu S , Peters LJ
Published: December 2004

The purpose of this study is to assess the prognostic abilities of the fourth and fifth edition International Union Against Cancer (UICC) staging systems for nasopharyngeal carcinoma (NPC) in Australian patients. All patients planned for curative treatment at the Peter MacCallum Cancer Centre from April 1985 to December 1999 were included in this study. There were 181 patients eligible for this study. The median follow up was 7.6 years. Histological subgroups were World Health Organization (WHO) 1 (23), WHO 2 (12), and WHO 3 (146). Presentation with stage IV disease was 83% by UICC fourth edition staging and 34% by UICC fifth edition staging. The 5 years failure‐free survival (FFS) rates for stage 1, 2, 3 and 4 disease by the fourth edition was 77, 100, 93, and 49% respectively,and by the fifth edition was 85, 76, 57 and 36%, respectively. The 5 years overall survival (OS) for stage 1, 2, 3, and 4 disease by the fourth edition was 77, 100, 100 and 61%; respectively, and by the fifth edition was 85, 82, 67 and 53%, respectively. Stage 4 patients by the fourth edition were reclassified as stages 2, 3 and 4 by the fifth edition with hazard ratios of 0.77, 1.01 and 1.79, respectively. In multifactor analysis, the fifth edition staging system was significantly related to FFS and OS after allowing for the fourth edition (FFS: P = 0.002; OS: P = 0.005), but the fourth edition was not significantly related to FFS or OS after allowing for the fifth edition (FFS: P = 0.96; OS: P = 0.96). This study confirms the prognostic superiority of the fifth edition UICC staging system over the fourth edition staging system in an Australian NPC population.
Acute presentations of renal artery stenosis in three patients with a solitary functioning kidney
Authors: Pun E , Dowling RJ , Mitchell PJ
Published: December 2004

Renal artery stenosis can present uncommonly in the acute state as flash pulmonary oedema and hypertensive encephalopathy. We present three such cases in patients with a solitary functioning kidney, with successful management via renal artery angioplasty and stent insertion.
Ultrasonic fetal size measurements in Brisbane, Australia
Authors: Schluter PJ , Pritchard G , Gill MA
Published: December 2004

The purpose of this paper was to construct population‐specific charts of fetal biometry for 11−41 weeks gestation in relation to known gestational age from a large population of normal Australian pregnancies when examination is performed to a standard protocol by experienced operators. All consenting eligible women attending a large Brisbane clinic between January 1993 and April 2003 were recruited. Menstrual history was taken prior to examination. Measurements were performed to a standard protocol. Prospective assessment was made about the association between gestational age from the last menstrual period and biometry. Exclusion principles were applied. Statistical analyses were performed using polynomial regression models and thorough diagnostic checks were undertaken. Included within the study were separate scans for 20 555 pregnancies from 17 660 women. Equations, means and 95th reference intervals were derived and reported for the following sonographic measurements: biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). Population‐specific regression equations for BPD, HC, AC and FL have been proposed for Australian pregnancies. Once validated by others, we believe they will warrant consideration for adoption by the Australasian Society for Ultrasound in Medicine.
‘Social Exclusion’ Discourse and Chronic Poverty: A South African Case Study
Authors: Du Toit Andries
Published: December 2004

This article questions the export of ‘social exclusion’ discourse to the field of development and poverty studies. It considers the findings of ongoing research into chronic poverty in the Western Cape district of Ceres, one of the centres of the South African deciduous fruit export industry. It explores the links between the livelihood options of poor people and processes of global integration, agro‐food restructuring and the modernization of paternalist farming styles. In this context the concept of ‘social exclusion’ is of only limited utility, and has significant disadvantages. Although it has the potential to focus attention on the disabling effects of poverty, its most common usage often fails to capture how poverty can flow not only from exclusion but also from processes of integration into broader economic and social networks. The author argues that these are better captured by the notion of ‘adverse incorporation’, and calls for a more cautious approach to the modernizing myths and moralizing narratives that shape policy debates.