bluuebunny/crossref_metadata_2025 huggingface dataset:
Parasites, fossils and geologic history: Historical biogeography of the South American freshwater croakers, Plagioscion spp. (Teleostei, Sciaenidae)
Authors: Boeger Walter A. , Kritsky Delane C.
Published: March 2003

A hypothesis on the historical biogeography of the freshwater croakers, Plagioscion spp. (Teleostei: Sciaenidae), is developed based on data from the phylogeny of their monogenoidean parasites (Platyhelminthes), the geology of South America and the fossil record. Analyses suggest that the common ancestor of Plagioscion spp. colonized freshwater concomitantly with the common ancestor of their parasites, Euryhaliotrema spp. Colonization probably occurred via a marine transgression through western Venezuela that developed about 20 million years ago (Mya). This transgression with its postulated highly variable temporal and spatial salinity conditions most likely represented the facilitating event associated with freshwater colonization. A less likely alternative, that colonization occurred via the Mar del Plata in southern South America, is not supported by the geographical distributions and putative phylogeny of extant species of Plagioscion.
Transient expression of a vacuolar peroxidase increases susceptibility of epidermal barley cells to powdery mildew
Authors: Kristensen Brian Kåre , Ammitzbøll Henriette , Rasmussen Søren Kjærsgård , Nielsen Kirsten Annette
Published: March 2003

summary

The expression of genes encoding the peroxidases, Prx7 and Prx8, is induced in barley leaf tissue after inoculation with the barley powdery mildew fungus, Blumeria graminis f.sp. hordei (DC) Speer (Bgh). The role of these peroxidases in general barley defence responses against fungal attack was investigated using a transient expression system. Colonization frequencies of Bgh on cells transfected with Prx7 or Prx8 expression‐, mutant‐ or fusion‐DNA constructs were compared to the frequencies on cells expressing a β‐glucuronidase (GUS) control construct. Twice the number of powdery mildew colonies were observed on cells expressing Prx7 as compared to control cells. Introduction of either mutant or truncated versions of Prx7 showed that decreased resistance against Bgh was dependent on the presence of the C‐terminal signal peptide required for correct subcellular targeting, but not affected significantly by mutations in the catalytic centre. No impact on Bgh performance was observed after the introduction of Prx8 or mutant constructs. An enhanced accumulation of the apoplastic Prx8 was verified by immunocytology. These results indicate a more complex role of peroxidases in defence responses than was previously suspected.
The role of nurses in the human immunodeficiency virus/acquired immune deficiency syndrome policy process in Botswana
Authors: Phaladze N. A.
Published: March 2003

In Botswana, there is dearth of literature on the role of nursing in health‐care policy and resource allocation and yet nurses constitute the majority (85%) of health manpower. The health‐care delivery system depends mostly on nurses for service provision. There were two main purposes of this study: first, to gather descriptive data from major key players (with particular emphasis on nurses) concerning knowledge of the policy process and resource allocation for management and care of clients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in Botswana; and, second, to identify nurse characteristics (e.g. position, education, experience, job category) associated with motivation to influence health‐care policy in HIV/AIDS management and care in Botswana. A policy process conceptual framework was used to guide data collection and analysis. A case‐study research method was used to conduct in‐depth interviews from a purposive sample of 19 policy makers, and a survey questionnaire was used to collect data from a purposive sample of 95 registered nurses from six study sites in Botswana. The study findings indicate minimal participation of nurses in health‐care policy process and resource allocation. The demographic variable of position was a predictor of the involvement of nurses in policy and in budgetary decisions. Both survey and interview data indicated that this minimal participation of nurses in the policy process resulted in implementation problems, thus compromising service provision. Implications of the findings for the nursing profession, nursing practice and policy, which address the importance of nurses’ involvement, are discussed.
Sharing in Practice: New Partnerships for Health
Authors: Ann Bisch Sally
Published: March 2003

A vital part of health care, sharing in practice is not a vision for the future but the reality of today. Below, the meaning and implications of sharing in practice not just for nursing but for health care.
Nursing and Home Care in Europe
Authors: Ehrenfeld Mally
Published: March 2003

The demographic trend of a rapidly ageing society becomes increasingly persuasive. More chronically ill patients will be discharged to home care. More people with psychotic problems and debilitating diseases will be living in communities. All require nursing care. This situation is recognized everywhere and no boundaries can change this future.
Nursing as a practical science: some insights from classical Aristotelian science *
Authors: Whelton Beverly J. B.
Published: March 2003

Abstract This paper discusses a classic Aristotelian understanding of science, nature, and methods of inquiry and proof. It then discusses nursing as a practical science and provides some demonstrations through the application of classical methods. In the Aristotelian tradition an individual substance is a unity of form and matter: form being the intelligible universal that becomes the concept, while matter is the principle of individuation. Science is mediate intellectual causal knowledge. Inquiry uses hypothetical argument, and proof that is from valid syllogistic reasoning with true premises provides necessity and certitude. This proof requires knowledge of the natural kind that gives origin to the attributes under investigation. The variability of nature is overcome by reasoning on the supposition of the end.

Within the classical understanding of speculative and practical science, nursing is a practical science. As a science, nursing investigates the principles and causes of its subject, be that human beings, health or nursing behaviours as knowable nursing operations. The goal is knowledge of practice for the sake of practice, but nursing as a science is not operable. Nursing practice, that is nursing art or technologies, must complete the science. Reasoning on the supposition of the end, for example of cardiac compensation, allows one to identify necessary activities and physical states. Three causal demonstrations about decubiti show that demonstrations are possible. Classical science would teach us that the practical science of nursing studies human nature in order to identify principles and causes of health and principles and causes of nursing operations themselves. It also requires that the science ends in practical operation. Thus, proper decisions and individual actions in particular patient situations must complete nursing science.
Against meaning
Authors: Paley John
Published: March 2003

Abstract The idea of meaning plays, together with the notion of caring, a pivotal role in recent nursing theory, informing its approach to philosophy, research and practice. Unlike caring, however, it has received relatively little analytical attention – a fact that is surprising in view of the scepticism about meaning that is characteristic of much contemporary philosophy and social theory. This paper reviews the philosophical literature on meaning, highlighting sceptical currents in the Wittgensteinian corpus, neo‐behaviourism and poststructuralism. It also considers a similar line of thought that has emerged in social theory, questioning the explanatory value of concepts such as ‘practice’, ‘culture’, ‘norms’, ‘tacit knowledge’, and ‘tradition’. All these perspectives suggest that there is something wrong with the common‐sense picture of a set of shared, implicit rules that account for our ability to understand and communicate; and they all point to an alternative picture which is naturalistic, materialist and causal, and which depicts ‘shared meaning’ as a rather mysterious quality, unable to explain the familiar regularities of verbal and nonverbal behaviour. In this picture, while the idea of meaning can be retained, it ceases to be something shared, and becomes something individual and idiosyncratic, a unique cluster of associations, concomitants, and other habits of thought. The paper closes with a brief interpretation of what the alternative implies for a research methodology in nursing. In particular, it proposes that certain well established approaches will have to be abandoned, and that qualitative strategies will have to be grounded in a rigorous scientific framework, rather than in techniques (such as phenomenology), which presuppose a misleading and inaccurate conception of what meaning is.
The early relationship of mother and pre‐infant: Merleau‐Ponty and pregnancy
Authors: Wynn Francine
Published: March 2003

Abstract This paper critically evaluates current conceptions of pregnancy as a possession of either mother or infant. In opposition to the more common stance that marks birth as the beginning of intercorporeality and perception, pregnancy is instead phenomenologically delineated as a chiasmic relationship between mother and her pre‐infant from a Merleau‐Pontian perspective. This paper maintains that during pregnancy a mother‐to‐be and her pre‐infant are deepened and modified through their intertwining.
The Influence of Processing Variables on Performance of O/W Emulsion Gels Based on Polymeric Emulsifier (Pemulen ®TR‐2NF)
Authors: Simovic S. , Milic‐Askrabic J. , Vuleta G. , Ibric S. , Stupar M.
Published: March 2003

Pemulens® (BF Goodrich) are hydrophobically‐modified copolymers of acrylic acid (Acrylates/C10–C30 alkyl acrylates) that could act both as primary emulsifiers for o/w emulsions and viscosity enhancing agents. The aim of this study was to assess the influence of different processing conditions (mixing equipment, speed and time of agitation) on the aesthetic characteristics, viscosity and physical stability of o/w emulsion gels based on the polymeric emulsifier (Pemulen TR‐2 NF). This objective was achieved by applying a two‐factor three‐level experimental design at two sets: using a laboratory mixer and a disperser. Independent variables were mixing speed and time and dependant variables i.e. responses, were millimetres of oil phase separated after centrifugation at 3500 rpm in a laboratory centrifuge, and viscosity at shear rate 180 l/s. The responses were fitted into a second order model by means of a multiple regression analysis. For the samples prepared on the laboratory mixer it was shown that mixing time and speed produce a statistically important influence on viscosity, but not on physical stability: with increasing mixing speed and time the viscosity linearly increases. If we assume that greater energy input obtained by increasing the mixing speed and time produces a decrease in drop size and polydispersity and better developed gel network, then the optimal processing conditions will be at the point where maximal viscosity is attained. This result was in accordance with the centrifugation test – the best stability appeared when maximal mixing speed and time were applied, although this effect appeared not to be statistically significant. For samples prepared using dispersers no statistically important influence of processing variables on viscosity and physical stability was found. Additionally, emulsion samples prepared using the laboratory mixer appeared homogenous, while in samples prepared using the disperser, undispersed polymer lumps appeared. Based on physical characteristics of the emulsions, it could be concluded that the disperser is an inappropriate tool for processing the emulsions based on Pemulen polymers.
The Effects of Areca Catechu L Extract on Anti‐Inflammation and Anti‐Melanogenesis
Authors: Lee Kun‐Kook , Choi Jung‐Do
Published: March 2003

Ethanolic extract (CC‐516) from Areca catechu L was prepared and its various biological activities were evaluated, CC‐516 showed potent anti‐oxidative, free radical scavenging, and anti‐hyaluronidase activity. Anti‐oxidative effect of CC‐516 (IC : 45.4 μg/ml) was lower than butylated hydroxytoluene (IC
: 5μg ml), but similar to tocopherol and higher than ascorbic acid. Especially, CC‐516 exhibited relatively high free radical scavenging activity (IC
: 10.2 μg/ml) compared to control. CC‐516 inhibited effectively hyaluronidase activity (IC
: 416 μg/ml), showed inhibition in vivo on delayed hypersensitivity as well as croton‐oil induced ear edema in mice when it was topically applied. These results strongly suggest that CC‐516 may reduce immunoregulatory/inflammatory skin trouble. Also, from the results, we have elucidated that CC‐516 showed anti‐allergic and anti‐cytotoxicity activity. The whitening effect of CC‐516 shown by the inhibition of mushroom tyrosinase activity with IC
of 0.48 mg/ml and of melanin synthesis in B16 melanoma cells. This study indicates that CC‐516 is effective on anti‐inflammatory/anti‐melanogenesis, and can be used as a new agent for cosmetics.
Leg Wash Protocol to Assess the Skin Moisturization Potential of Personal Cleansing Products
Authors: Ertel Keith D. , Neumann Paula B. , Hartwig Paula M. , Rains Gayle Y. , Keswick Bruce H.
Published: March 2003

Many personal cleansers claim to provide a skin moisturization benefit, but there has been relatively little discussion in the scientific literature of the clinical methods that provide the basis for such claims. We have developed a leg wash method to assess the dry skin improvement potential of personal cleansing products. The protocol is performed on ’natural’ dry leg skin to avoid potential confounds that may result from applying cleansers to soap‐damaged skin. Washes are conducted over a period of days or weeks, with visual and instrumental assessments performed at various times throughout the period to characterize products’ short‐term and cumulative skin effects. Studies conducted with a variety of personal cleansing technologies demonstrate the method’s ability to discriminate products on the basis of their dry skin improvement potential. Further, results from a series of eleven leg wash studies conducted with the same treatment pair under different test conditions (time of year, test facility, expert grader) demonstrate the protocol’s robustness. The data generated under this protocol show that personal cleansing products differ widely in their ability to improve dry skin. Our results indicate that there is a wide range of efficacy among moisturizing personal cleansing products, with some products delivering a significant dry skin improvement benefit even for periods as long as 24 hours.
The non‐linear viscoelastic behaviour of human hair at moderate extensions
Authors: Barnes  , Roberts
Published: March 2003

Synopsis

We report the results of experiments carried out on the stress relaxation of slightly stretched human hair. The results show that human hair is viscoelastic, and that when quickly extended to a moderate degree (0.5–6.5%) and held, the force generated will fall to half its original value in about 15 h. However, the relaxation process is also dependent on extension, so that iso‐chronous (constant time) data is non‐Hookean. We show that the iso‐chronous stress/strain behaviour departs from linearity at about 1% extension and the modulus progressively decreases thereafter according to a power‐law relationship with strain.

Résumé

Nous présentons ici les résultats d’expériences réalisées afin d’étudier la relaxation de la contrainte appliquée sur un cheveu humain légèrement étiré. Les résultats obtenus montrent que le cheveu humain est viscoélastique, et que lorsque’il est étiré rapidement, et de façon modérée (0,5–6,5%), la force nécessaire pour le maintenir étiré diminue de moitié en 15 heures. La relaxation dépend également du degré d’extension, de sorte que les données isochrones (à temps constant) ne suivent pas la loi de Hooke. Nous avons démontré que le comportement isochrone contrainte/cisaillement dévie du comportement linéaire lorsque le cheveu est étiré de 1% environ et que le module décroît ensuite progressivement en suivant une loi de puissance avec le cisaillement.
Foods and factors that protect against dental caries
Authors: Moynihan Paula
Published: March 2003

Summary Some foods contain factors that protect against dental caries including milk, cheese, unrefined plant foods and tea. Milk and cheese contain calcium, phosphate and casein all of which are anti‐cariogenic. Additionally, cheese is a strong gustatory stimulant to salivary flow – which helps neutralise dental plaque acids, thus preventing dental caries development. Unrefined plant foods contain phosphates and phytate both of which have cariostatic properties and consumption of these foods also causes mechanical stimulation of salivary flow. Some foods, such as chocolate, honey, molasses and liquorice, contain protective factors but nonetheless remain cariogenic because of their high content of sugars. Initial research into the anti‐carries effect of green and black tea extracts have provided encouraging results and further research in this area is awaited.
The modifiable factors affecting bone mineral accumulation in girls: the paradoxical effect of exercise on bone
Authors: Keay Nicola
Published: March 2003

Amongst women in exercise training, the female athlete triad is on the increase. This is the combination of disordered eating, amenorrhoea and osteoporosis. However, the effects of exercise training on bone mineral accumulation in youngsters is not fully known. Bone mass increases rapidly during childhood and adolescence until peak bone mass (PBM) is attained. PBM is an important determinant of adult bone mineral density (BMD) and therefore optimisation of PBM is valuable in the prevention of osteoporosis. This paper reviews the effects of exercise training on the accumulation of bone mineral in girls.
PLATELET GLYCOPROTEIN GENE POLYMORPHISMSAND RISKOF THROMBOSIS: FACTSAND FANCIES
Authors: Reiner Alexander P. , Siscovick David S. , Rosendaal Frits R.
Published: March 2003

Over the past several years, platelet glycoprotein gene polymorphisms have received increasing attention as possible inherited determinants of prothrombotic tendency. However, their role in genetic susceptibility to thrombotic disease remains controversial. The glycoprotein IIIa Leu33Pro amino acid substitution appears to be associated with a subtle effect on platelet thrombogenicity in vitro, but is not a major risk factor for arterial thrombotic disease among the general population. Evidence suggests that the glycoprotein IIIa Pro33 allele may be associated with increased risk of thrombotic events following coronary re‐vascularization and possibly among younger subjects with atherosclerosis. The nucleotide 807T variant of glycoprotein Ia is associated with increased platelet glycoprotein Ia/IIa receptor density, collagen‐induced platelet adhesion and an increased risk of early onset myocardial infarction and stroke. Evaluation of the roles of the glycoprotein Ibα Thr145Met and variable number of tandem repeat polymorphisms has been complicated by their lack of well‐defined effects on platelet adhesive function and the strong linkage disequilibrium between the two sites. Future epidemiologic studies of platelet glycoprotein gene polymorphisms will require larger sample sizes and family based approaches to further elucidate clinically important associations with thrombotic disease, including gene‐environment and gene–gene interactions. Other polymorphisms of potential functional significance within genes encoding platelet membrane proteins will undoubtedly be discovered. The challenge will be to integrate advances in platelet biology with molecular and genetic epidemiology to enhance our understanding of the genetic determinants of common, but etiologically complex thrombotic diseases.
ADVANCESINTHE UNDERSTANDINGAND MANAGEMENTOF ACUTE PROMYELOCYTIC LEUKEMIA
Authors: Mandelli Franco , Avvisati Giuseppe , Coco Francesco Lo
Published: March 2003

Considerable progress has been made over the past decade in the understanding and management of acute promyelocytic leukemia (APL). At the laboratory level, molecular mechanisms underlying the arrest of differentiation that typically features in this malignancy, have been clarified and currently provide important models for addressing future investigation aimed at releasing the maturation block in other malignancies. In the clinic, advances in the management of APL have converted this rapidly fatal disease into the most frequently curable leukemia in adults. Use of retinoids in combinatorial protocols with anthracycline‐based chemotherapy for front line treatment currently results in long‐term survival and potential cure in at least 60% of newly diagnosed patients. Even after relapse, the disease is still curable in a high percentage of cases by various approaches including combinations of chemotherapy, retinoids, arsenic trioxide, stem cell transplantation and antibody‐targeted chemotherapy. Genetic testing for identification of the disease‐specific gene rearrangement and monitoring of residual disease have proved critical in establishing correct diagnosis and better evaluate the response to therapy at the molecular level. Current ‘hot’ issues for clinical investigation include: (i) better understanding and management of the severe coagulopathy present at diagnosis in most patients; (ii) the definition of risk categories to improve identification of patients at highest risk of relapse and (iii) the translation of successful differentiation therapy to other leukemia subsets.
Cytogenetics and molecular genetics of acute lymphoblastic leukemia
Authors: Harrison Christine J. , Foroni Letizia
Published: March 2003

An important factor in the diagnosis of acute lymphoblastic leukemia (ALL) is that karyotype is an independent prognostic indicator, with an impact on the choice of treatment. Outcome is related to the number of chromosomes. For example, high hyperdiploidy (51–65 chromosomes) is associated with a good prognosis, whereas patients with near haploidy (23–29 chromosomes) have a poor outcome. The discovery of recurring chromosomal abnormalities in the leukemic blasts of patients with ALL has identified a large number of genes involved in leukemogenesis. Certain specific genetic changes are related to prognosis. The ETV6/AML1 fusion arising from the translocation (t12;21) (p13;q22) has been associated with a good outcome; the BCR/ABL fusion of (t9;22)(q34;q11), rearrangements of the MLL gene, and abnormalities of the short arm of chromosomes 9 involving the tumor suppressor genes p16INK4A have a poor prognosis. Unfortunately, the classification of patients into prognostic groups based on cytogenetics is not always as predicted. Even when other clinically based risk factors are taken into account, some patients with good‐risk cytogenetic features will relapse. In the search for new measures of prognosis, it has recently emerged that the level of minimal residual disease following induction therapy can be a reliable predictor of outcome in ALL.
Changing treatment patterns among patients with HIV: Royal Free Hospital 1987–97
Authors: Mocroft A. , Sabin CA. , Youle M. , Swaden L. , Tyrer M. , Wilson D. , Madge S. , Johnson MA. , Phillips AN.
Published: March 2003

Objective Following the publication of results of large‐scale clinical trials, antiretroviral treatment for HIV has changed dramatically. The aim of this study was to describe changes in antiretroviral treatment and the way treatments were combined among 1806 patients with HIV seen at a single centre at the Royal Free Hospital, London, UK.

Design and method Each calendar year was divided into quarters, and the number of patients receiving treatment and participating in clinical trials was determined.

Results The proportion of patients on no therapy decreased from over 90% at the beginning of 1988 to under 15% at the end of 1997. Monotherapy was the only form of treatment available before 1992 but its use dropped to 2% by the end of 1997. The standard of care at the end of 1997 was triple combination therapy, used in over 40% of patients. There were dramatic changes in the use of individual agents; use of zidovudine decreased from 50% during 1989 to 25% during 1997, while use of lamivudine and stavudine saw an exponential rise in 1997. The protease inhibitors were used in equal proportions in this clinic population; the use of dual protease therapy began in 1997 and was rising rapidly by the end of the year.

Conclusions There have been major changes in the use of antiretroviral therapy at this centre, particularly during 1996 and 1997. The long‐term cost implications and side‐effects of intensive treatment regimens remain to be addressed.
The effect of ritonavir on saquinavir plasma concentration is independent of ritonavir dosage: combined analysis of pharmacokinetic data from 97 subjects
Authors: Kilby JM , Hill A , Buss N
Published: March 2003

Objective

To determine the correlation between ritonavir (RTV) dose and the degree of enhancement of saquinavir (SQV) exposure.

Methods

Combined analysis of pharmacokinetic data at steady state obtained from two open‐label, randomized, parallel‐group, multiple‐dose, single‐centre studies involving healthy volunteers. Plasma samples for SQV assay were obtained from 97 healthy subjects following multiple dosing of a range of SQV (400–1800 mg) plus RTV (100–400 mg) dosages for 13–14 days. The pharmacokinetics of SQV were derived by model‐independent, noncompartmental methods. Data were analysed by multivariate regression of log transformed Cmin and Cmax (geometric means) of SQV dosage as the dependent variable and independent variables of SQV and RTV dosage. Ritonavir was fitted as both a continuous and a categorical variable.

Results

There is a strong effect of any dose of RTV on Cmax and Cmin of SQV (P < 0.0001 for both parameters), but no greater effect of higher vs. lower RTV dosages on either parameter (Cmax: P=0.4373; Cmin: P=0.3393). Higher SQV dosage correlates linearly with higher Cmax (P=0.0093) and Cmin (P=0.0010), but the effects of increasing SQV dosages are less than with the addition of any RTV dose.

Conclusions

RTV enhances SQV concentrations to increase Cmax and Cmin. This effect is similar for RTV dosages of 100–400 mg twice daily. Based on this concept of ‘mini‐dose’ RTV, once‐daily dosing of 1600 mg SQV/100 mg RTV and twice‐daily 1000 mg SQV/100 mg RTV are currently being evaluated in clinical trials.
Impact of adherence on duration of virological suppression among patients receiving combination antiretroviral therapy
Authors: Raboud JM , Harris M , Rae S , Montaner JSG
Published: March 2003

Objective

To assess the effect of adherence to antiretroviral therapy on the duration of virological suppression after controlling for whether or not the patient ever attained a plasma viral load below the limit of detection of sensitive HIV‐1 RNA assays.

Methods

Data were combined from three randomized, blinded clinical trials (INCAS, AVANTI‐2, and AVANTI‐3) that compared the antiviral effects of two‐ and three‐drug antiretroviral regimens. Virological suppression was defined as maintaining a plasma viral load below 1000 copies/mL. Adherence was defined prospectively and measured by patient self‐report.

Results

Adherence did not have a major impact on the probability of achieving virological suppression for patients receiving dual therapy. However, for patients receiving triple therapy, adherence increased the probability of virological suppression, whether the plasma viral load nadir was above or below the lower limit of quantification. Compared to adherent patients with a plasma viral load nadir below the lower limit of quantification, the relative risk of virological failure was 3.0 for non‐adherent patients with a nadir below the limit, 18.1 for adherent patients with a nadir above the limit, and 32.1 for non‐adherent patients with a nadir above the limit.

Conclusion

For patients receiving current three‐drug antiretroviral regimens, adherence to therapy and plasma viral load nadir are important factors determining the duration of virological suppression.
Bath psoralen‐ultraviolet A therapy in atopic eczema
Authors: De Kort Wja , Van Weelden H
Published: March 2003

Aims To evaluate the efficacy of bath psoralen‐ultraviolet A (PUVA) therapy in severe cases of atopic dermatitis (AD) in adults using the extended Six Area, Six Sign Atopic Dermatitis (SASSAD) score.

Methods Thirty‐five adult subjects with severe AD underwent bath PUVA therapy for a maximum of 30 sessions ranging from one to three times a week. The only other treatment allowed during the study was topical application of hydrocortisone.

Results There were a total of six drop‐outs, three due to aggravation of symptoms. After the maximum 30 sessions the remaining 29 subjects showed 82.1% improvement in the severity of lesions, 75.2% reduction in extension of lesions, 74% improvement in itching and 79% improvement in night‐time rest. Patient evaluations gave an overall score of 8.8 on a scale of 0–10.
Acitretin and treatment of the oral leucoplakias. A model to have an active molecules release
Authors: Gaeta Gm , Gombos F , Femiano F , Battista C , Minghetti P , Montanari L , Satriano Ra , Argenziano G
Published: March 2003

Aims

The aim of this study was to investigate the effectiveness of acitretin in a new topical formulation (mucoadhesive two‐layer tablets) for the treatment of oral leucoplakias.

Methods

Twenty‐one volunteers, 16 men, five women, with oral leucoplakia (histologically diagnosed), were included in this double‐blind placebo‐controlled study. Patients were randomized in three groups (A, B, C) of seven patients each. Groups A and B received tablets with different in vitro release profiles, and group C subjects (controls) received tablets without acitretin. The acitretin dose was 20 mg/day (two 10 mg tablets daily). Serum aspartate aminotransferase, alanine aminotransferase, cholesterol and triglycerides were evaluated before and after treatment. At the end of therapy the concentrations of acitretin in plasma, saliva and tissue were measured by high‐performance liquid chromatography.

Results

At the end of the study 71% (groups A and B) of patients showed clinical remission or marked improvement. No improvement was noted in the control subjects (group C). These results were further confirmed by histological findings. There were no significant changes in laboratory values in the three groups. The acitretin concentration in plasma and tissue ranged from 0 to 50 mg with no difference between groups A and B, and it was very high in saliva (ranging from 4.9 to 43 mg) with higher concentrations in group A than in group B (due to a longer adhesion time in group A). Patients’ compliance was excellent. The results show that mucoadhesive tablets of topical acitretin are efficacious in the treatment of oral leucoplakia without systemic side‐effects.
Results of atopy patch tests with house dust mites in adults with ‘intrinsic’ and ‘extrinsic’ atopic dermatitis
Authors: Ingordo V , D’Andria G , D’Andria C , Tortora A
Published: March 2003

Background The most frequently employed diagnostic criteria of atopic dermatitis (AD) can be fulfilled in the absence of elevated total circulating IgE or specific IgE to food allergens or environmental aeroallergens and/or in the absence of personal or familial history of atopy as well. Therefore a distinction between ‘extrinsic’ or ‘allergic’ and ‘intrinsic’ or ‘non‐allergic’ AD has been suggested. Recently, a patch test with environmental aeroallergens, named atopy patch test (APT), has been proposed for use in the study of AD.

Objective The aim of this study was to investigate the reactivity to APT in patients with ‘extrinsic’ and ‘intrinsic’ AD.

Patients, materials and methods Two groups of adult male subjects with AD were examined consecutively in our department (Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy) and patch tested with whole bodies of house dust mites (HDM) at a concentration of 20% in petrolatum (Dermatophagoides pteronyssinus 50%, D. farinae 50%). The groups included: (i) 95 patients affected by the adult clinical form of ‘extrinsic’ AD; (ii) 12 patients affected by the adult clinical form of ‘intrinsic’ AD; and (iii) a control group of 49 adult healthy male subjects with a negative anamnesis for eczema and atopy and negative skin prick test to aeroallergens/food allergens and/or normal level of total circulating IgE, also patch tested with the same allergen. The statistical differences were calculated by χ2 test and 95% confidence intervals (CI) were provided.

Results The APT was positive in 47.4% (CI: 37–57%) of ‘extrinsic’ AD, in 66.6% (CI: 41–93%) of ‘intrinsic’ AD and in 12.2% (CI: 3–21%) of healthy subjects. The differences between the two AD subgroups and the control group were statistically significant (P < 0.001).

Conclusions APT positivity is more frequent in both ‘extrinsic’ and ‘intrinsic’ AD than in unaffected subjects. Other studies are needed to confirm our data and to explain why the APT is positive in the ‘intrinsic’ form.
Elastosis perforans serpiginosa in an adult with Down's syndrome: report of a case with symmetrical localized involvement
Authors: De Pasquale R , Nasca MR , Musumeci ML , Micali G
Published: March 2003

Elastosis perforans serpiginosa (EPS) is a rare perforating dermatosis in which elastic fibers extrude from the papillary dermis producing umbilicated papules, characteristically arranged to form arciform or serpiginous patterns on the skin. It can be observed in patients with Down's syndrome, in whom in some cases the disease has been reported to be more widespread and to run a longer course. We present the case of a 20‐year‐old girl with Down's syndrome, hypothyroidism, acne and hypertrichosis, who had a 2‐year history of multiple atrophic lesions with an arciform pattern on the distal extensor portions of both thighs, histologically showing the typical features of EPS.
Linear childhood cutaneous lupus erythematosus following blaschko lines
Authors: Requena C , Torrelo A , De Prada I , Zambrano A
Published: March 2003

We report a case of a 3‐year‐old Spanish boy with linear cutaneous lupus erythematosus following the lines of Blaschko on his face and neck. Histological examination established the diagnosis. Only eight cases of discoid lupus erythematosus following the lines of Blaschko have been reported previously.
A case of sarcomatoid carcinoma of the skin
Authors: Inaloz HS , Ayyalaraju RS , Holt PJA , Laidler P
Published: March 2003

We describe the histological and immunocytochemical findings of an exophytic cutaneous tumour with mixed features of atypical fibroxanthoma (AFX) and basal cell carcinoma (BCC). A 73‐year‐old woman presented with a rapidly growing tumour measuring 35 mm in diameter and 10 mm in height on the left forearm. The tumour was excised and histology revealed a biphasic tumour with a pleomorphic spindle cell component and an associated tumour composed of discrete islands of atypical basaloid cells with peripheral palisading consistent with BCC. The two tumours merged into each other at one point. The spindle cell tumour showed a positive immunocytochemical reaction to fibrohistiocytic marker of KP‐1 (CD68) and a negative immunocytochemical reaction to AE1/AE3, CAM5.2, S‐100 and HMB‐45, features consistent with AFX. Immunocytochemistry of the basaloid tumour showed a positive reaction to epithelial markers AE1/AE3 and CAM5.2, and a negative reaction to S‐100, HMB‐45 and KP‐1 (CD68). To date, 15 cases of primary cutaneous carcinosarcoma have been reported in the literature. It has been postulated that these tumours may originate from undifferentiated progenitor cells capable of producing multiple cell lines.
Atrophodermia vermiculata: case report and review of the literature
Authors: Jansen T , Sander CA , Altmeyer P
Published: March 2003

A 21‐year‐old woman with an 11‐year history of symmetric reticular atrophy on both cheeks, pre‐auricular areas, and forehead is presented. The depressions gave a worm‐eaten appearance to the skin. Histopathological findings from a biopsy specimen of lesional skin revealed an atrophic follicle. The connective tissue showed mild inflammation in perifollicular and perivascular distribution. The hair follicle was widely dilated and was filled with a keratotic plug. This case points out many of the outstanding clinical and histopathological features of atrophodermia vermiculata as described previously. Atrophodermia vermiculata appears to be one of a group of closely related conditions characterized by keratosis pilaris and atrophy of the skin.
New established melanoma cell lines: genetic and biochemical characterization of cell division cycle
Authors: Vozza A , Borriello A , Criniti V , Vozza G , Della Ragione F
Published: March 2003

Background Cancer might be envisaged as the result of a genetic process causing the unregulated proliferation of a given cell as well as its inability to undergo differentiation and/or apoptosis. Alterations of genes regulating cell division cycle appear to play a key role in the development of human cancer.

Objective On the bases of the above considerations, we decided to establish new cell lines from human melanoma specimens, in order to analyse the molecular alterations in primary preparations of malignant cells.

Results The present paper describes two new established cell lines and their genetic and biochemical features. Both the melanoma cell lines show inactivation of the cyclin‐dependent kinase inhibitor gene, CDKN2A/p16INK4A, thus demostrating that this alteration occurs in primary human melanomas. No other alterations were observable when we investigated several different cell cycle genes including those encoding cyclins, cyclin‐dependent kinases and cyclin‐dependent kinase inhibitors. Analyses at protein level by means of immunoblotting confirmed the results obtained at the genetic level. Moreover, the inducibility of a pivotal cyclin‐dependent kinase inhibitor gene, namely p21CIP1 gene, was obtained by treating the cells with histone deacetylase inhibitors, namely butyrate and phenylbutyrate.

Conclusions Our results suggest a primary role of cyclin‐dependent kinase inhibitor genes inactivation in the origin of human melanoma and allow the proposal of new therapeutic strategies based on the transcriptional activation of p21CIP1 gene.
Maternal Employment and Family Responsibilities: the Perspectives of Mothers of Children with Intellectual Disabilities
Authors: Shearn Julia , Todd Stuart
Published: March 2003

Over recent decades, there has been a substantial increase in the proportion of women in the workforce with dependent children. However, this trend is not evident for mothers of children with disabilities. Their employment levels are greatly reduced. The present paper examines the nature of the restrictions which affect the employment participation of these mothers and explores the meaning work has for them. The data presented in this paper were derived from qualitative interviews with 18 mothers of children with disabilities aged between 5 and 15 years. These mothers found employment difficult. They encountered unusual time demands, and a lack of adequate and affordable child care. Furthermore, they felt that their employment opportunities were restricted by attitudes prevalent in society concerning appropriate roles for women, especially mothers of children with disabilities. The lack of opportunities to engage in employment led, in varying degrees, to feelings of isolation, a lack of fulfilment and low self‐esteem. The mothers felt that they were on the periphery of society with little release from the pressures of caring. Mothers who had part‐time jobs often did poorly paid work of low status, thereby encountering few opportunities to use their skills and abilities to the full. Those who attempted a full‐time job experienced stress from the dual demands of home and work, and from a fear that they were failing as mothers. The present paper highlights areas which require attention to improve the employment experience of these mothers.
The Meanings of Close Friendship: the Views of Four People with Intellectual Disabilities
Authors: Knox Marie , Hickson Fay
Published: March 2003

The present study examined the views of four people with intellectual disabilities (IDs) on the relationships in their lives which they described as close friendships. A participatory approach was adopted in this study, whereby the participants were seen as experts on their own close friendship experiences and the researchers as marshallers of this expertise. To this end, two in‐depth interviews were conducted with each participant. They shared their individual expertise on the close friendships in their lives. The participants delineated two distinctive types of close friendships: the ‘good mate’ and the girlfriend/boyfriend. The factors mediating each of these friendship types are discussed. Avenues for further research and consideration are given. These include the significance of friendships with people with IDs, intimate relationships, the impact of environmental factors on friendship enactment and friendships with older people who have IDs. Finally, the present paper argues for the value of adopting participatory approaches to research with people who have IDs.
‘Quality of Life’ Assessment in Critical Context
Authors: Ager Alastair
Published: March 2003

This paper argues that shifts in the focus of human services – and, in particular, what counts as a successful outcome of such provision – reflect wider societal trends in values and concerns. The current ascendance of ‘quality of life’ (QoL) as a metric of service outcome is noted. The core functions of QoL assessments are identified and related to underlying qualities reflected in the majority of QoL assessments: comprehensiveness, context independence and the capability to reflect personal subjectivity. The attractiveness of these qualities is linked to current trends in philosophical thought, underpinning contemporary culture and social policy. It is proposed that the pre‐eminence of QoL assessment as an approach to service planning and evaluation reflects the capacity of the QoL concept to accommodate tensions between modernist and postmodernist expectations, and serve as a basis for transparent resource allocation between competing priorities for restricted public spending. QoL may thus be seen as a successful ‘meme’ which has reproduced in a social and intellectual climate to which it is well adapted. The consequences of this for the use and abuse of QoL assessments within services for persons with intellectual disabilities are discussed and practical implications noted.
Human fetal foramen ovale flow velocity waveforms relative to fetal breathing movements in normal term pregnancies
Authors: van Eyck J. , Stewart P. A. , Wladimiroff J. W.
Published: March 2003

The relationship between foramen ovale flow velocity waveforms and high‐amplitude fetal breathing movements was studied in ten normal term pregnancies using Doppler ultrasonography. Peak systolic and averaged flow velocities demonstrated a statistically significant increase during fetal breathing activity, suggesting a raised pressure gradient between the right and left atria. This could be explained by a temporal reduction in pulmonary venous return to the left atrium during the inspiratory phase of the fetal breathing cycle. The breathing‐related increase in foramen ovale flow velocity suggests that fetal breathing activity facilitates the distribution of well‐oxygenated blood to the aorta and cerebral circulation. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Is the quality of transvaginal images superior to transabdominal ones under matched conditions?
Authors: Kossoff G. , Griffiths K. A. , Dixon C. E.
Published: March 2003

Transvaginal images, under matched conditions, are in general superior in quality to transabdominal sonograms. The difference is, however, not dramatic and instances frequently occur when the same quality and even inferior images are obtained on transvaginal examinations.

The dominant factor is the amount of overlying tissues. For the same thickness, subcutaneous tissues have greater degrading characteristics. Subcutaneous tissues also mar the quality of images by giving rise to strong multiple reflection artifacts.

The major factors for image degradation are associated with a moderate increase in the width of the ultrasonic beam and a large increase in the side lobes.

The dramatic superiority of transvaginal imaging described in previous comparison studies is due principally to the use of higher frequencies, more strongly focused beams and closer positioning of tissues to the transducer. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
The influence of angiotensin II‐induced vasoconstriction on common carotid artery blood flow and velocity—time profiles in normal women
Authors: Loquet Ph. , Pipkin F. Broughton , Symonds E. M. , Rubin P. C.
Published: March 2003

Non‐invasive methods of measuring blood velocity, especially Doppler velocimetry, are being increasingly used in obstetrics to provide observational information. We report a preliminary study of their usefulness in experimental studies.

Doppler velocimetry was used to assess blood flow and velocity–time profiles in the common carotid artery of seven women of reproductive age before and during the incremental administration of angiotensin II.

Angiotensin II infusion evoked the expected increments in systolic and diastolic arterial pressure and fall in heart rate. Angiotensin II was associated with a dose‐dependent fall in maximum blood velocity, which, at an average rise in systolic blood pressure of 23 mmHg, had fallen from 91 ± 16 to 52 ± 4 (mean ± SD, p < 0.01). Absolute maximum blood velocity was strongly correlated with systolic and diastolic blood pressures (p < 0.001 for both). The minimum velocity was unaltered throughout, and the calculated flow did not change significantly (490 ± 100 cf. 380 ± 50 ml/min). Overall, these findings are in agreement with those previously reported using invasive methods of monitoring flow during angiotensin II infusion, and further support the usefulness of Doppler velocimetry as an investigative tool in human physiology and pharmacology.

However, the pulsatility index, resistance index and systolic/diastolic velocity ratio all fell significantly during angiotensin II infusion (p < 0.01 for all). The conventional interpretation of a fall in these indices, i.e. reduced downstream resistance, is clearly erroneous under these circumstances, since angiotensin II induces arteriolar vasoconstriction. This illustrates the importance of interpretation of Doppler velocity envelopes in the light of pharmacological mechanisms likely to be evoked by the experimental procedure. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology