bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased Adherence of cagG‐DeletedHelicobacter pylori to Gastric Epithelial Cells in Japanese Clinical Isolates
Authors: Mizushima Takuji , Sugiyama Toshiro , Kobayashi Takahiko , Komatsu Yoshito , Ishizuka Jun , Kato Mototsugu , Asaka Masahiro
Published: March 2003

Background. The cag pathogenicity island (cag PAI) is a major virulence factor. The ability of Helicobacter pylori to adhere to gastric epithelial cells is an important initial step for virulence. The aim of this study was to evaluate the relationship between genetic variations of cag PAI in Japanese clinical isolates and the ability of H. pylori to adhere to gastric epithelial cells.

Materials and Methods. The polymerase chain reaction and Southern blot analysis were used to verify the presence or absence of cagA, cagE, cagG, cagI and cagM in the cag PAI in 236 Japanese clinical isolates. The ability of H. pylori to adhere to KATOIII cells was examined by flow cytometry.

Results. Seven (3.0%) cag PAI partial‐deleted strains were found in 236 clinical isolates, and these strains showed three patterns in the deleted region within the cag PAI. All of the cagG‐deleted strains showed decreased adherence to KATOIII cells, in comparison with cagG‐positive strains. These strains had abolished IL‐8 induction despite the presence of cagE, which is essential for IL‐8 induction.

Conclusions. Our results suggest that cagG or surrounding genes in the cag PAI has a function related to adhesion to epithelial cells.
Antral Nodularity and Positive CagA Serology are Distinct and Relevant Markers of Severe Gastric Inflammation in Children with Helicobacter pylori Infection
Authors: Luzza Francesco , Pensabene Licia , Imeneo Maria , Mancuso Maria , Giancotti Laura , La Vecchia Anna M. , Costa Maria C. , Strisciuglio Pietro , Pallone Francesco
Published: March 2003

Background. The aim of this study was to assess whether the endoscopic finding of antral nodularity and serum IgG antibodies to CagA are associated with higher grades of gastric inflammation.

Materials and methods. The comprehensive data of two previously published trials were reanalysed. One hundred and fifty‐three children (median age 9.5 years) who underwent gastroscopy were included. Biopsy specimens from the antrum and corpus were taken to assess Helicobacter pylori status, gastritis score and lymphoid follicles. During endoscopy, antral nodularity was noted. Serum samples were assayed for IgG antibodies to CagA.

Results. The presence of antral nodularity (nod+) and positive CagA serology (CagA+) were each found in 32 of the 77 (41.5%) children who had evidence of H. pylori infection. Crosstabulation showed that 20 children (26%) were nod+/CagA+, 12 (15.5%) nod+/CagA−, 12 (15.5%) nod‐/CagA+ and 33 (43%) nod−/CagA−. Gastritis score was significantly lower in nod−/CagA−children than in nod+/CagA− (p = .004), nod−/CagA+ (p = .002) and nod+/CagA+ (p < .001), both in the antrum and corpus. Completely normal gastric histology was only found in the nod−/CagA−subgroup of H. pylori‐infected children (eight of 33, 24%). Regression analysis showed that antral nodularity and positive CagA serology were related to severe gastric inflammation independently of each other and age. Separate analysis showed that inflammation (p < .001), activity (p < .001) and H. pylori density (p = .002) scores were significantly lower in nod−/CagA−children compared with nod+/CagA+ children. The number of lymphoid follicles in the gastric mucosa was related to antral nodularity (p = .003) and positive CagA serology (p = .043), independently of each other.

Conclusions. Antral nodularity and positive CagA serology are distinct and relevant markers of severe gastric inflammation in children with H. pylori infection. The lack of both findings in the same child reflects low‐grade or no gastritis.
Helicobacter pylori inflammation and immunity
Authors: Nedrud John G. , Blanchard Samra S. , Czinn Steven J.
Published: March 2003

Gastric inflammation is a significant contributor to the disease process associated with Helicobacter pylori infection. It appears that both bacterial genes and differential host responses make interrelated contributions to gastritis and disease outcome after H. pylori infection. While the cag pathogenicity island (PAI) continues to be a focus for much of this investigation on the bacterial side, other bacterial genes/proteins are certainly important as well. On the host cell side, significant progress is being made defining the eucaryotic signaling cascades induced after host cells interact with H. pylori. The role of host cell cytokines, gastric acid, and mast cells is also being actively studied. Prospects for control of H. pylori associated disease continue to include vaccination. The mechanism(s) for vaccine‐mediated control of H. pylori infection and disease remain ill‐defined but recent evidence from animal models suggests that the inflammatory response may be involved. Manipulating the host response to H. pylori infection in humans to take advantage of the possible beneficial effects of inflammation, while minimizing its detrimental effects is a significant challenge for the future.
Age, Self‐Efficacy, and Change in Patients' Adjustment to Cancer
Authors: Lev Elise L. , Paul Diane , Owen Steven V.
Published: March 2003

objectives:The purpose of this secondary analysis was to investigate cancer patients' self‐care self‐efficacy and measures of adjustment over time, as well as the role of self‐care self‐efficacy with measures of adjustment. The primary study was a longitudinal study of cancer patients and family members' adjustments.

materials and methods:Three hundred seven cancer patients at all stages of cancer completed study instruments on one occasion; 181 completed the instruments 4 months later; and 124, 8 months later. Instruments included the Strategies Used by Patients to Promote Health (SUPPH) to measure self‐care self‐efficacy, the Functional Assessment of Cancer Treatment (FACT) to measure quality of life, the Profile of Mood States (POMS) to measure patients' mood disturbances, and the Symptom Distress Scale (SDS) to measure patients' concerns.

results:Using analysis of variance, a series of one‐way repeated measures used to investigate changes in cancer patients' self‐care self‐efficacy and measures of adjustment revealed significant decreases in patients' self‐care self‐efficacy (P= .01) and quality of life (P= .001) over time. Patients' symptoms and mood disturbances did not significantly change over time. The role of self‐care self‐efficacy with measures of adjustment was investigated using canonical correlations. For the predictor variables, subscores for coping and enjoying life on the SUPPH showed the strongest loadings, 0.83 and 0.94, respectively. On the dependent variables, the FACT was by far the most important variable, with a loading of 0.92.

conclusions:Results demonstrate that without intervention, cancer patients' measures of self‐efficacy and adjustment decrease over time, and patients' self‐efficacy influences their adjustment. Psychosocial interventions have been designed to increase self‐efficacy and to enhance adjustment. Longitudinal study of efficacy‐enhancing interventions is needed.
Processes of Change Related to Smoking Behavior Among Cancer Patients
Authors: Schnoll Robert A. , Malstrom Michael , James Calvin , Rothman Randi L. , Miller Suzanne M. , Ridge John A. , Movsas Benjamin , Langer Corey , Unger Michael , Goldberg Melvyn
Published: March 2003

purpose: The purpose of this study was to examine the degree to which transtheoretical model processes of change (methods and strategies for cessation) were associated with smoking status and quitting behavior (ie, intentions and attempts to quit) among pa‐ tients with head and neck or lung cancer. The relationship between medical variables and processes of change was also explored.

description of study: Twenty‐nine smokers and 45 abstainers who were recruited from treatment clinics within a comprehensive cancer center completed a brief survey. Multivariate analysis of variance and Pearson correlation procedures were used to evaluate hypothesized relationships.

results: As hypothesized, quitters used behavioral processes such as counter‐conditioning and reinforcement management significantly more than smokers and used self‐reevaluation, an experiential process, significantly less than smokers. Contrary to the hypothesis, however, quit attempts and intentions were associated with both experiential (ie, consciousness raising and self‐reevaluation) and behavioral (ie, reinforcement management and self‐liberation) processes of change. Use of the processes of change was not influenced by medical variables, including cancer type, illness phase, disease stage, type of current medical treatment, and duration of illness.

clinical implications: These findings suggest that behavioral counseling to promote smoking cessation for patients with cancer should involve assisting the patient to do the following: develop an awareness of the health risks related to continued smoking; devise and use alternative behaviors; implement the use of reinforcement strategies for cessation successes; and develop a sense of confidence and commitment about quitting as well as healthy lifestyle values. These strategies are discussed within the context of models and guidelines for smoking cessation in clinical practice.
Factors in Making the Decision to Forgo Conventional Cancer Treatment
Authors: Verhoef Marja J. , White Margaret A.
Published: March 2003

purpose: The purpose of this study was to explore why and how patients with cancer decide to forgo conventional cancer treatments in favor of alternative treatments and which factors influence such decisions.

description of study: Due to the exploratory nature of the study, this was a qualitative study using focus groups and in‐depth interviews in a convenience sample of patients. All patients had received diagnoses of cancer and had refused one or more conventional treatments offered to them by their cancer healthcare professionals.

results: Thirty‐one persons with cancer, widely varying in age and tumor sites, volunteered to take part in the study. Of these, 12 refused all conventional treatment, 13 refused most or some of the treatments recommended, and 6 discontinued conventional treatment. The decision‐making model, which emerged from the data, identifies several groups of variables. These include factors that predispose participants to the decision to forgo conventional treatment(s), such as having a close relative or friend who has died from cancer when receiving conventional treatment; experiences around the diagnosis; and factors relevant after the diagnosis, such as beliefs, need for control, side effects of conventional cancer treatment, and communication with physicians. Last, perceived outcomes of the decision proved to be an important theme in the focus groups and interviews.

clinical implications: Patients with cancer may benefit from counseling to help them explore the difference between their diagnosis and treatment plan and those of family members or friends who died of cancer while receiving conventional treatment. Counseling also may be helpful in resolving emotional issues underlying the decision to forgo treatment. Last, patients should have access to healthcare professionals, including physicians and counselors, who would assist them with their decision making without judging or intimidating them.
Colorectal Cancer Screening Barriers in Persons with Low Income
Authors: Holmes‐Rovner Margaret , Williams Gilbert A. , Hoppough Susan , Quillan Lisa , Butler Rishan , Given C. William
Published: March 2003

purpose: The purpose of this study was to provide insight into the modest success of a physician and patient education and reminder program that improved screening rates from 37% to 49% among rural Medicaid‐eligible patients in western Michigan.

description of study: The following four focus groups were conducted: African American men, African American women, White men, and White women, matched with moderators by gender and ethnicity. The sample was selected by contacting prior eligible screening refusers, completing groups with a convenience sample who had accepted screening. Twenty‐one patients participated who were ages >50 years. The screening refusal rates were 19% for men and 9% for women. Open‐ended questions guided the discussion of colorectal cancer (CRC) attitudes, beliefs, and practices.

results: All participants believed in the efficacy of cancer screening. White women were better informed about screening purposes and procedures. The major barriers to screening were quality of care (ie, the perceived lack of offering screening and the follow‐up of test results) and the potential for pain from screening or treatment of CRC, should it be discovered.

clinical implications: Successful efforts to improve awareness of the importance and efficacy of screening must further address deeply held skepticism and fears about CRC screening in this population. A fruitful direction for this difficult problem appears to be improved communication (both negative and positive test results). Without feedback, patients with negative results may assume lack of provider follow‐through.
Viatical Settlements
Authors: Badreshia Sonia , Bansal Vivek , Houts Peter S. , Ballentine Noel
Published: March 2003

purpose: This study was performed to assess the knowledge, attitudes, and experiences with viatical settlements among hospice staff who provide financial counseling to terminally ill patients and their families.

description of study: A random sample of 300 hospices in the 50 states was selected from the National Hospice Directory. Staff members who provide financial counseling to patients and families were interviewed by phone using a 31‐item structured questionnaire.

results: The response rate was 80%. The results showed that only 4% of hospices provide information about viatical settlements to all patients, while 32% provide information only if asked. Only 9% of respondents rated themselves as very informed about viatical settlements, and 53% rated themselves as moderately informed. Of the 47 hospices where at least one patient had used a viatical settlement, 92% felt the patient had a positive experience using the resource. In response to a hypothetical case of a terminally ill patient considering a viatical settlement, 40% responded positively, while 51% were neutral.

clinical implications: Among hospice financial counselors who have had experience with viatical settlements, most report positive experiences. When asked to respond to a hypothetical case, most respondents were either neutral or positive. However, lack of knowledge about viatical settlements may limit the availability of this resource for terminally ill patients and their families.
Adherence to Moderate‐Intensity Exercise During Breast Cancer Therapy
Authors: Pickett Mary , Mock Victoria , Ropka Mary E. , Cameron Lane , Coleman Meghan , Podewils Laura
Published: March 2003

purpose: The aims of this pilot study were the following: 1) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospective, randomized, controlled experimental design; 2) to examine the influence of disease symptoms and treatment side effects on exercise levels; and 3) to suggest methods that may improve future clinical trials of moderate‐intensity exercise in similar populations.

description of study: Fifty‐two patients with newly diagnosed breast cancer were randomly assigned to one of two treatment arms: usual care or usual care plus exercise. Those assigned to the exercise group received a standardized, self‐administered, home‐based brisk walking intervention in addition to usual care. Each day subjects completed self‐report diary forms that elicited information about activity levels, and the occurrence of symptoms and side effects during cancer treatment.

results: Analyses of self‐reported daily activity levels revealed a diffusion of treatment effect. Fifty percent of the usual‐care group reported maintaining or increasing their physical activity to a moderate‐intensity level, while 33% of the exercise group did not exercise at the prescribed levels. Analyses of self‐reported disease symptoms and treatment side effects did not reveal clinically meaningful differences between the two groups.

clinical implications: The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs. Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies.
Bladder Cancer
Authors: Pashos Chris Leo , Botteman Marc F. , Laskin Benjamin Lewis , Redaelli Alberto
Published: March 2003

purpose: The purpose of this article is to present an overview of the epidemiology diagnosis, and management of bladder cancer, with a focus on the early stage of this disease.

overview: English‐language articles published between 1990 and 2000, as well as selected abstracts published in non‐English languages before 1990, were reviewed. Epidemiologic data clearly indicate that bladder cancer is much more common in men, White persons, and the elderly. Cigarette smoking appears to be the most significant environmental risk factor. Screening for the disease is currently not standard in the United States or Canada. Potential tests include urine cytology, hematuria dipstick, and the urinary biomarkers. Diagnosis is made most often on the basis of the findings of cystoscopy, tumor biopsy, and urine cytology. Transurethral resection (TUR) of the tumor is generally the first‐line treatment for superficial disease. Cystectomy is the “gold standard” treatment for invasive disease in many countries, although trimodality therapy (TUR, radiation, systemic chemotherapy) has shown promise as a bladder‐preserving strategy. Intravesical therapy is effective for preventing disease recurrence, although its role in slowing disease progression is uncertain. Chemotherapy and radiation also can be used with cystectomy to treat or prevent pelvic recurrence of invasive disease or to prolong life in patients with metastatic disease.

clinical implications: Bladder cancer is a commonly occurring disease. Prevention efforts must focus on the avoidance or cessation of cigarette smoking and on public education relating to known environmental risk factors. Patient and disease factors must be considered in making treatment decisions and determining prognosis. Careful follow‐up after treatment is essential. It is hoped that ongoing research on potential tumor markers and tumor‐specific therapies ultimately will result in improved clinical outcomes for patients with this malignancy.
Ancestors and variants: tales from the cryptic
Authors: Browne William E. , Davis Gregory K. , McClintock James M.
Published: March 2003

SUMMARY Those who work at the interface of development and evolution are united by the conviction that developmental comparisons can shed light on both the evolution of specific morphologies and the macroevolutionary process itself. In practice, however, the field comprises a diversity of approaches. As the field grows and practitioners attempt to digest a growing mountain of comparative data, the various approaches of “Evo Devo” have themselves evolved. A meeting organized by the authors and held at the University of Chicago in the Spring of 1999 illustrated some of these changes. This review will draw on its content to discuss recent developments in two areas: the reconstruction of common ancestors and the developmental basis of evolutionary change.
Expression of a Scr/Hox5 gene in the larval central nervous system of the gastropod Haliotis, a non‐segmented spiralian lophotrochozoan
Authors: Giusti Andrew F. , Hinman Veronica F. , Degnan Sandie M. , Degnan Bernard M. , Morse Daniel E.
Published: March 2003

SUMMARY Hox genes encode a set of evolutionarily conserved transcription factors that regulate anteroposterior patterning mechanisms in insects and vertebrates and are expressed along this axis in a range of bilaterians. Here we present the developmental expression of a Scr/Hox5 gene in the gastropod mollusc Haliotis. In Haliotis, embryogenesis yields a non‐feeding trochophore larva that subsequently develops into the veliger larva, which possesses many of the characteristics of the adult body plan. Quantitative RT‐PCR analysis reveals that this gene, which is called Hru‐Hox5, is first expressed in the trochophore larva. Hru‐Hox5 transcript prevalence increases continually through larval development until metamorphic competence develops in the veliger and then again over the first four days of metamorphosis. In situ hybridization reveals that larval expression of Hru‐Hox5 is restricted primarily to the primordial and newly formed branchial ganglia, located between the anterior cerebral‐pleuropedal ganglionic complex and the posterior visceral ganglia. The expression of Hru‐Hox5 in the central region of the abalone CNS is similar to that observed for its orthologue (Lox20 ) in the leech, suggesting that Hox5 genes were used, along with other Hox genes, to pattern the CNS of the ancestral spiralian lophotrochozoan.
Characterization of the Hox gene cluster in the malaria vector mosquito, Anopheles gambiae
Authors: Devenport Martin P. , Blass Claudia , Eggleston Paul
Published: March 2003

SUMMARY The Hox genes play a central role in regulating development and are involved in the specification of cell fates along the anteroposterior axis. In insects and vertebrates, these genes are clustered and organized in an arrangement that is largely conserved across evolutionary lineages. By exploiting the sequence conservation of the homeobox, orthologues of the Hox genes Sex combs reduced (Scr  ), fushi tarazu (ftz ), Antennapedia (Antp), Ultrabithorax (Ubx ), and abdominal‐A (abd‐A) have been isolated from the malaria vector mosquito, Anopheles gambiae. These genes were first identified in Drosophila, where they achieve a high level of functional complexity, in part, by the use of alternative promoters, polyadenylation sites, and splicing to generate different protein isoforms. Preliminary analyses of the Anopheles Hox genes suggest that they do not achieve their functional complexity in the same manner. Using a combination of in situ hybridization to polytene chromosomes and chromosome walking, the Anopheles Hox genes have been localized to a single cluster in the region 19D–E on chromosome 2R, a situation distinct from that of Drosophila where the Hox complex is split into two clusters. This study, therefore, provides a framework for future comparative analyses of the structure, organization, and expression of developmental regulatory genes between the lower and higher Diptera. Moreover, the genes that have been isolated enhance the genetic and physical maps of chromosome 2R in this medically important mosquito species.
Phenotypic and dynamical transitions in model genetic networks II. Application to the evolution of segmentation mechanisms
Authors: Salazar‐Ciudad I. , Solé R. V. , Newman S. A.
Published: March 2003

SUMMARYKnowledge of the genetic control of segmentation inDrosophilahas made insect segmentation a paradigmatic case in the study of the evolution of developmental mechanisms. InDrosophila, the patterns of expression of segmentation genes are established simultaneously in all segments by a complex set of interactions between transcriptional factors that diffuse in a syncytium occupying the whole embryo. Such mechanisms cannot act in short germ‐band insects where segments appear sequentially from a cellularized posterior proliferative zone. Here, we compare mechanisms of segmentation in different organisms and discuss how the transition between the different types of segmentation can be explained by small and progressive changes in the underlying gene networks. The recent discovery of a temporal oscillation in expression during somitogenesis of vertebrate homologs of the pair‐rule genehairyenhances the plausibility of an earlier proposal that the evolutionary origin of both the short‐ and long germ‐band modes of segmentation was an oscillatory genetic network (Newman 1993). An implication of this scenario is that the self‐organizing, pattern‐forming system embodied in an oscillatory network operating in the context of a syncytium (i.e., a reaction‐diffusion system)—which is hypothesized to have originated the simultaneous mode of segmentation—must have been replaced by the genetic hierarchy seen in modern‐dayDrosophilaover the course of evolution. As demonstrated by the simulations in the accompanying article, the tendency for “emergent” genetic networks, associated with self‐organizing processes, to be replaced through natural selection with hierarchical networks is discussed in relation to the evolution of segmentation.
How many processes are responsible for phenotypic evolution?
Authors: Fusco Giuseppe
Published: March 2003

SUMMARYIn addressing phenotypic evolution, this article reconsiders natural selection, random drift, developmental constraints, and internal selection in the new extended context of evolutionary developmental biology. The change of perspective from the “evolution of phenotypes” toward an “evolution of ontogenies” (evo‐devo perspective) affects the reciprocal relationships among these different processes. Random drift and natural selection are sibling processes: two forms of post‐productional sorting among alternative developmental trajectories, the former random, the latter nonrandom. Developmental constraint is a compound concept; it contains even some forms of natural (“external” and “internal”) selection. A narrower definition (“reproductive constraints”) is proposed. Internal selection is not a selection caused by an internal agent. It is a form of environment‐independent selection depending on the level of the organism's internal developmental or functional coordination. Selection and constraints are the main deterministic processes in phenotypic evolution but they are not opposing forces. Indeed, they are continuously interacting processes of evolutionary change, but with different roles that should not be confused.
Conservation of the expression of Dll, en, and wg in the eye‐antennal imaginal disc of stalk‐eyed flies
Authors: Hurley Imogen , Fowler Kevin , Pomiankowski Andrew , Smith Hazel
Published: March 2003

SUMMARY We studied the developmental basis of exaggerated eye span in two species of stalk‐eyed flies (Cyrtodiopsis dalmanni and Sphyracephala beccarri). These flies have eyes laterally displaced at the end of eyestalks, and males have greatly exaggerated eye span, which they use as a sexual display. To investigate eye span development we have compared eye‐antennal disc morphology and the expression of three key regulator genes of Drosophila head development, Distal‐less (Dll), engrailed (en), and wingless (wg), in the stalk‐eyed flies and Drosophila. We found great similarity in the basic division of the disc into anterior‐antennal and posterior‐eye portions and in the general patterning of Dll, en, and wg. Unexpectedly, our results showed that although the eye and antenna are adjacent in adult stalk‐eyed flies, their primordia are physically separated by the presence of an intervening region between the anterior and posterior portions of the disc. This region is absent from Drosophila eye‐antennal discs. We chose two stalk‐eyed fly species that differed in the degree of eyestalk exaggeration but surprisingly we found no corresponding difference in the size of the en‐wg expression domains that mark the boundaries of the dorsal head capsule primordia. In summary, our expression data establish the regional identity of the eye‐antennal disc and provide a framework from which to address the developmental genetics of hypercephaly.
Étienne Geoffroy St.‐Hilaire: father of “evo‐devo”?
Authors: Panchen Alec L.
Published: March 2003

SUMMARY In the early decades of the nineteenth century, the most important disagreement among comparative anatomists was not evolution versus “special creation” but between advocates of “transcendental morphology” and those of teleological anatomy—form versus function. In France this dichotomy was represented by the 1830–1832 public debate between Geoffroy St.‐Hilaire (form) and Cuvier (function). Geoffroy's aim was to establish links of homology (known to him as “analogies”) between the four “embranchements” into which Cuvier had divided the animal kingdom. Despite the fanciful nature of some of his homologies, Geoffroy, who was guided by his “principe de connections,” set in motion a school of morphology, some of whose conclusions, notably the homology of the dorsal surface of segmented invertebrates with the ventral surface of vertebrates, has been corroborated by recent studies in developmental genetics.
The development and evolution of insect mouthparts as revealed by the expression patterns of gnathocephalic genes
Authors: Rogers Bryan T. , Peterson Michael D. , Kaufman Thomas C.
Published: March 2003

SUMMARY To understand better both the development and evolution of insect mouthparts, we have compared the expression pattern of several developmentally important genes in insects with either mandibulate or stylate‐haustellate mouthparts. Specifically, we examined the expression of the proboscipedia (pb) and Distal‐less (Dll  ) gene products as well as three regulators of pb, Sex combs reduced (Scr ), Deformed (Dfd ), and cap ‘n’ collar (cnc). These genes are known to control the identity of cells in the gnathal segments of Drosophila melanogaster and would appear to have similar conserved functions in other insects. Together we have made an atlas of gene expression in the heads of three insects: Thermobia domestica and Acheta domestica, which likely exemplify the mandibulate mouthparts present in the common insect ancestor, and Oncopeltus fasciatus, which has piercing–sucking mouth parts that are typical of the Hemiptera. At the earliest stages of embryogenesis, only the expression of pb was found to differ dramatically between Oncopeltus and the other insects examined, although significant differences were observed later in development. This difference in pb expression reflects an apparent divergence in the specification of gnathal identity between mandibulate and stylate‐haustellate mouthparts, which may result from a “phylogenetic homeosis” that occurred during the evolution of the Hemiptera.
Determining the role that ecological and developmental constraints play in controlling disparity: examples from the crinoid and blastozoan fossil record
Authors: Ciampaglio Charles N.
Published: March 2003

SUMMARYIt is widely believed that morphological constraints are responsible for the observed pattern of decreasing major morphological innovation in both the Metazoa and Metaphytes over geological time. This is readily seen as the decreasing trend of origination of higher taxa: phyla, classes, and orders. Currently, there are two competing evolutionary hypotheses that have been proposed to explain this phenomenon: (1) the empty ecospace hypothesis and (2) the developmental constraint hypothesis. To distinguish between hypotheses 1 and 2, the change of morphological innovation before and after several mass extinction events was measured in the Crinoidea and Blastozoa. Mass extinction intervals provided a means in which to remove ecospace limiting constraints and allow the developmental constraint hypothesis to be thoroughly tested. Within the Crinoidea, disparity was measured before and after three mass extinctions. Within the Blastozoa, disparity was measured before and after two mass extinctions. For each taxon, three suites of characters were analyzed: ecological, nonecological, or “developmental” and a combination of the two previous suites plus 50 additional characters. Four different measures of disparity were used to analyze each character suite. In the majority of the cases investigated, disparity rebounds to comparable levels or in some cases higher levels in both the Crinoidea and Blastozoa. The results indicate that developmental constraints are not responsible for the decrease in disparity throughout the geologic range of the taxa. The more likely scenario is that increasingly structured ecological guilds have made it much more difficult to allow large increases in disparity.
Developmental mechanisms of threshold evolution in a polyphenic beetle
Authors: Moczek Armin P. , Nijhout H. Frederik
Published: March 2003

SUMMARYPolyphenic development is thought to play a pivotal role in the origin of morphological novelties. However, little is known about how polyphenisms evolve in natural populations, the developmental mechanisms that may mediate such evolution, and the consequences of such modification for patterns of morphological variation. Here we examine the developmental mechanisms of polyphenism evolution in highly divergent natural populations of the dung beetle,Onthophagus taurus.Males of this species express two alternative morphologies in response to larval feeding conditions. Favorable conditions cause males to grow larger than a threshold body size and to develop a pair of horns on their heads. Males that encounter relatively poor conditions during larval life do not reach this threshold size and remain hornless. Exotic populations ofO. taurushave diverged dramatically in body size thresholds in less than 40 years since introduction to new habitats, resulting in the expression of highly divergent and novel horn length–body size scaling relationships in these populations. Here we show that larvae of populations that have evolved a larger threshold body size (1) have to accumulate greater mass to become competent to express the horned morph, (2) require more time to complete the final instar, (3) are less sensitive to the juvenile hormone (JH) analogue methoprene, and (4) exhibit a delay in the sensitive period for methoprene relative to other developmental events. JH has been shown previously to control horn expression in this species. Our results show that threshold evolution may be mediated via changes in the degree and timing of sensitivity to JH and may result in correlated changes in the dynamics and duration of larval development. Strain‐specific differences in JH sensitivity have previously been demonstrated in other insects. However, to the best of our knowledge this is the first demonstration that changes in the timing of the sensitive period for JH may play an equally important role in the evolution of novel thresholds. We discuss our findings in the context of the developmental regulatory mechanisms that underlie polyphenic development and use our results to explore the consequences of, and constraints on, polyphenism evolution in nature.
Changes in Pericardial Calcification Due to Antiplatelet Agents: In Vitro Studies
Authors: Chandy Thomas , Vasudev Sindhu C. , Rao Gundu H.R.
Published: March 2003

To develop tissue valves for prolonged use in the cardiovascular system, the complicated process of surface induced calcification must be better understood. Calcification was examined for 60 days on glutaraldehyde treated bovine pericardium (GABP) and enzyme extracted tissues fixed in glutaraldehyde (GATBP) incubated in metastable solutions of calcium phosphate, and the roles of aspirin and persantine in conjunction with vitamins C, B, or E, gentamycin (antibiotic), or pentothal sodium (anesthetic) in the medium were examined. Further, the diffusion of calcium across the GATBP was evaluated using a diffusion cell with 2 compartments. Pericardial calcification as also observed using scanning electron microscopy (SEM) techniques. It seems that the examined antiplatelet agents can modify the pericardial surfaces and subsequently their mineralization processes (GATBP, 31.7 μg/mg tissue; in the presence of 5 mg% vitamin C, 13.1 μg/mg tissue; in 1.5 mg% aspirin, 17.2 μg/ mg tissue; and 1 mg% gentamycin, 14.8 μg/mg tissue) on exposure with the metastable calcium phosphate solution for 60 days. In addition, these agents may modify calcium transport and interfere with the adsorption at the surface, hence reducing calcium nodulation on GATBP. Scanning electron micrographs also revealed a reduction in calcium deposition on the pericardium due to these antiplatelet agents. It may be hypothesized that the influx of calcium on GATBP may be due to the cellular components or the involvement of plasma proteins like the fibrinogen molecule. The exact mechanism of these changes in the calcification of the pericardium are still unknown. From these in vitro findings, it appears that a combined vitamin therapy with low doses of aspirin may be beneficial for platelet suppression and thereby for prevention of thrombosis and calcification. However, more in vivo studies are needed to develop applications.
Therapeutic Apheresis for Septic Patients with Organ Dysfunction: Hemoperfusion using a Polymyxin B Immobilized Column
Authors: Tani Tohru , Hanasawa Kazuyoshi , Endo Yoshihiro , Yoshioka Toyokazu , Kodama Masashi , Kaneko Masamitsu , Uchiyama Yoshimitsu , Akizawa Tadao , Takahasi Kodo , Sugai Katsuo
Published: March 2003

A prospective clinical study was performed to evaluate a new method of treatment of endotoxin shock, a column containing polystyrene fibers with covalently bound immobile polymyxin B. Direct hemoperfusion using the column removes circulating endotoxin by adsorption. All of the patients studied, 37 in the treatment group and 33 in the control group, had endotoxemia and failure of 1 or more organs. The perfusion was performed 1–7 times per patient, 2 h/session. The survival rate was significantly higher in the treatment group (54%) than in the controls (36.4%). The mean plasma endotoxin concentration was significantly lowered by the treatment from 83.7 pg/ml before perfusion to 56.4 pg/ml immediately after and 28.5 pg/ml the day after the treatment, and the posttreatment level was much lower in those who survived (mean, 18.8 pg/ml) compared to those who died (mean, 88 pg/ml). Various parameters of cardiac function also improved after the treatment.
An Extracorporeal Warm Perfusion Device for Basic Research: Possibility of Avoiding Some Animal Experiments
Authors: Mayer Berndt A.
Published: March 2003

Abstract: An advantage of development of an extracorporeal warm perfusion device is that some animal experiments can be saved because investigations can be carried out on isolated blocks of body tissue which would otherwise entail an animal experiment. It is possible that several teams work with different flaps of one animal. The liquid medium for perfusion is an aqueous solution which combines a culture medium for keratinocytes, neonatal calf serum, l‐glutamine, antibiotics, and an antimycotic. Pedicled flaps from animals killed in a slaughterhouse can also be used. The oxygenation of the nutritive medium is achieved through an aqueous phase gas exchange. This method is stable and easily reproducible. Perfused porcine flaps have been reimplanted for vital assessment.
Doppler Aortic Flow Pattern in the Recovering Heart Treated by Cardiac Extracorporeal Membrane Oxygenation International Society for Artificial Organs
Authors: Konishi Hiroaki , Misawa Yoshio , Nakagawa Yukinori , Fuse Katsuo
Published: March 2003

A 39‐year‐old man was admitted to our hospital because of chest pain and was diagnosed with severe heart failure due to viral myocarditis. Intraaortic balloon pumping (IABP) and cardiac extracorporeal membrane oxygenation (ECMO) were employed. Using Doppler echocardiography, we evaluated the descending aortic blood flow pattern. When cardiac ECMO was initiated from the right femoral artery, a strong backflow of blood generated by the pump was observed in the abdominal aorta because the forward flow from the native heart was weak. Two days later, the blood flow was reversed from the thoracic to abdominal aorta; the natural flow was strengthened because the native heart had improved. The observation of this phenomenon is helpful for determining the recovery of cardiac function under cardiac ECMO support.
Cytokines and Endotoxin Removal by Sorbents and Its Application in Push–Pull Sorbent‐Based Pheresis: The Biologic‐DTPF System
Authors: Steczko Janusz , Ash Stephen R. , Blake Donald E. , Carr David J. , Bosley Rebecca H.
Published: March 2003

The BioLogic‐DTPF System (DTPF) combines the Biologic‐DT hemodiabsorption system (DT) in series with the Biologic PF push–pull pheresis system (PF) in which PF membranes separate plasma for direct contact between plasma proteins and the sorbents. Preliminary studies conducted in bovine serum albumin (BSA) solution and in bovine plasma allowed charcoal and silica to be evaluated as adsorbents for the PF module. Equilibrium binding experiments in BSA showed a high capacity of cytokine (IL‐1β, TNFα) binding by powdered charcoal, 70–90 ng/g. Kinetic binding studies in bovine plasma revealed relatively quick adsorption of IL‐1β and IL‐6 by charcoal with the capacity range of 1.2–2.0 ng/g for tested cytokines (IL‐1β and TNFα). Further laboratory studies with plasma have shown that powdered silica has an even greater binding capacity, up to 13 ng/g for TNFα depending upon particle size, and more rapid binding for all tested cytokines than powdered charcoal. Cholestyramine is a more efficient sorbent for removal of endotoxin than either charcoal or silica. In vitro tests using whole blood have demonstrated that the DTPF, with powdered charcoal as the sorbent, clears cytokines (TNFα, IL‐1β, and IL‐6) at 12.6–23.4 ml/min, bilirubin at 17.8–34.7 ml/min, and creatinine at 53.6–82.6 ml/min. The removal of some cytokines during the first clinical trial is also discussed.
Numerical Simulation of the Pulsating Catheter Pump: A Left Ventricular Assist Device
Authors: Verkerke Gijsbertus jacob , Mihaylov Dimitri , Geertsema Albert anne , Lubbers Jaap , Rakhorst Gerhard
Published: March 2003

Abstract: The pulsating catheter (PUCA) pump, a left ventricular assist device, consists of a hydraulically or pneumatically driven membrane pump, extracorporeally placed and mounted to a valved catheter. The catheter is introduced into an easily accessible artery and positioned with its distal tip in the left ventricle. Blood is aspirated from the left ventricle during systole and ejected into the ascending aorta during diastole. A numerical model of the PUCA pump has been developed to determine the internal diameter of the PUCA pump catheter that allows a certain blood flow. The model considers a limitation of mechanical blood damage and determines the accompanying pressure and flow profile for driving the pump. For a flow of 5 L/min, a catheter with an internal diameter of at least 6.95 mm is required. For 3 L/min, the minimal diameter is 5.50 mm. The latter catheter can be introduced in the axillary artery, the former via the aorta during an open thorax surgical procedure. To validate the numerical model, 2 different PUCA pump configurations were tested in vitro. Results showed a good resemblance between model and in vitro behavior of the PUCA pump.
A Newly Designed Adapter for Testing an Ex Vivo Mitral Valve Apparatus
Authors: Katoh Tomoe , Ikeda Nobutaka , Nishi Kentaro , Gohra Hidenori , Hamano Kimikazu , Noda Hiroshi , Fujimura Yoshihiko , Esato Kensuke
Published: March 2003

Abstract: Few instruments are currently available to test mitral valve function in an ex vivo state due to the technical difficulties involved. To investigate the native ex vivo mitral valve or prosthetic mitral valve with chordae, we developed a mitral valve adapter with an annulus suturing portion and 2 papillary muscle suturing sites that can be changed in angle, direction, and length of chordae. We used this adapter to test an ex vivo mitral apparatus in beagle dogs and evaluated the morphology and function of the mitral apparatus by endoscopy. Our newly designed mitral valve adapter proved extremely useful for examining the ex vivo mitral valve anatomy and function and for testing stentless mitral prostheses with annular‐papillary muscle continuity.
Clinical Experience of Left Ventricular Assist Systems at The Heart Institute of Japan
Authors: Kitamura Masaya , Kawai Akihiko , Hachida Mitsuhiro , Nishida Hiroshi , Endo Masahiro , Koyanagi Hitoshi
Published: March 2003

The main indications for left ventricular assist system (LVAS) support are postcardiotomy ventricular failure as temporary circulatory support and end‐stage cardiomyopathy as chronic circulatory support. To clarify the efficacy of LVAS support, we assessed the clinical outcome of a pneumatic LVAS and an electromagnetic LVAS for patients with severe ventricular failure. As of March 1998, 5 patients with postcardiotomy ventricular failure had received the pneumatic LVAS support, and 2 other patients with end‐stage idiopathic cardiomyopathy had undergone implantation of the electromagnetic LVAS. The drive control of the LVAS was mainly counterpulsation in the diastole of the native heart. In the 5 postcardiotomy patients, the duration of pneumatic LVAS support ranged from 30 to 312 h (mean, 109.2). All 3 patients with more than 72 h support were successfully weaned, and 2 of them survived. The other 2 patients with cardiogenic shock and less than 36 h support could not be weaned from the LVAS. In the 2 cardiomyopathy patients, 1 patient was well maintained by the electromagnetic LVAS support and underwent successful heart transplantation 7 months later. The other patient has been chronically supported by the LVAS for 2 months and is doing well so far. These results suggest that selective application of the pneumatic LVAS as a temporary support and the electromagnetic LVAS as a chronic support might be appropriate for maximizing the effectiveness of LVAS treatment for profound cardiac failure.
Strength Improvement of Knee Extensor Muscles in Patients with Chronic Heart Failure by Neuromuscular Electrical Stimulation
Authors: Quittan Michael , Sochor Andrea , Wiesinger Günther F. , Kollmitzer Josef , Sturm Barbara , Pacher Richard , Mayr Winfried
Published: March 2003

Patients with severe chronic heart failure (CHF) suffer from marked weakness of skeletal muscles. Neuromuscular electrical stimulation (NMES) proved to be an alternative to active strength training. The objective of this study was to test the feasibility and effectiveness of NMES in patients with chronic heart failure. Seven patients (56.0 ± 5.0 years, CHF for 20 ± 4 months, left ventricular ejection fraction 20.1 ± 10.0%) finished an 8 week course of NMES of the knee extensor muscles. The stimulator delivered biphasic, symmetric, constant voltage impulses of 0.7 ms pulse width with a frequency of 50 Hz, 2 s on and 6 s off. No adverse effects occurred. After the stimulation period, the isokinetic peak torque of the knee extensor muscles increased by 13% from 101.0 ± 8.7 Nm to 113.5 ± 7.2 Nm (p = 0.004). The maximal isometric strength increased by 20% from 294.3 ± 19.6 N to 354.14 ± 15.7 N (p = 0.04). This increased muscle strength could be maintained in a 20 min fatigue test indicating decreased muscle fatigue. These results demonstrate that NMES of skeletal muscles in patients with severe chronic heart failure is a promising method for strength training in this group of patients.