bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring T cell immunity to influenza vaccination in children after haemopoietic stem cell transplantation
Authors: Haining W. Nicholas , Evans John W. , Seth Nilufer P. , Callaway G. Derek , Wucherpfennig Kai W. , Nadler Lee M. , Guinan Eva C.
Published: October 2004

Quantitative assessment of immunogen‐specific T cell responses may provide a meaningful surrogate marker of functional immunity in patients following haemopoietic stem cell transplantation (HSCT). We developed a flow‐cytometric assay to quantify antigen‐specific T cell immunity to influenza‐A and studied the T cell response to influenza vaccination in five children, 3–21 months post‐HSCT. All patients showed an increase in influenza‐A‐specific CD4+ immunity following vaccination while none had a detectable IgG response to the vaccine. This assay proved sufficiently sensitive to evaluate changes in T cell memory in immunocompromised individuals and could be used to better characterize post‐HSCT immune reconstitution.
A population study to define the incidence and survival of multiple myeloma in a National Health Service Region in UK
Authors: Phekoo K. J. , Schey S. A. , Richards M. A. , Bevan D. H. , Bell S. , Gillett D. , Møller H. ,   on behalf of Consultant Haematologists, South Thames Haematology Specialist Committee
Published: October 2004

Epidemiology data on multiple myeloma (MM) occurrence and outcome is inconsistent whilst a major limitation of randomized controlled trials is selection bias. We present a population‐based analysis of patients diagnosed with MM in the South Thames area, which comprises 5·4 million adult inhabitants. A total of 855 cases of MM were ascertained between 1999 and 2000 in a collaborative project involving haematologists and the Thames Cancer Registry. The age‐standardized rate was 3·29 per 100 000 and 4·82 cases per 100 000 (World Standard and European Population respectively). The median age was 73 years. The median survival for the whole group was 24 months whist it was 42 and 18 months in those aged less than 65 years and greater than 65 years respectively (P < 0·001). This population study has shown a higher incidence than previously reported in the UK and Europe and provides a benchmark for future studies. If survival is to be improved, future clinical trials and health care planning should consider patients over 65 years of age.
Synergistic epistasis and alternative hypotheses
Authors: Trouve S. , Ding A. , Goudet J.
Published: October 2004

Inbreeding generally results in deleterious shifts in mean fitness. If the fitness response to increasing inbreeding coefficient is non-linear, this suggests a contribution of epistasis to inbreeding depression. In a cross-breeding experiment, Salathé & Ebert (2003. J. Evol. Biol. 16: 976–985) tested and found the presence of this non-linearity in Daphnia magna. They argue that epistatic interactions cause this non-linearity. We argue here that their experimental protocol does not allow disentangling the effect of synergistic epistasis from two alternative hypotheses, namely hybrid vigour and statistical non-independence of data.
An experimental evaluation of self-interference in Narcissus assoanus: functional and evolutionary implications
Authors: Cesaro A. C. , Barrett S. C. H. , Maurice S. , Vaissiere B. E. , Thompson J. D.
Published: October 2004

Floral traits that reduce self-pollination in hermaphroditic plants have usually been interpreted as mechanisms that limit the genetic consequences of self-fertilization. However, the avoidance of sexual conflict between female and male function (self-interference) may also represent an important selection pressure for the evolution of floral traits, particularly in self-incompatible species. Here, we use experimental manipulations to investigate self-interference in Narcissus assoanus, a self-incompatible species with a stigma-height dimorphism in which the degree of spatial separation between sex organs (herkogamy) differs strikingly between the long- and short-styled morphs (hereafter L- and S-morphs). We predicted that weak herkogamy in the L-morph would cause greater self-pollination and hence self-interference. Experimental self-pollination reduced seed set when it occurred prior to, or simultaneously with, cross-pollination in the L-morph, but only if it occurred prior to cross-pollination in the S-morph. In the field, autonomous self-pollination was greater in the L-morph than the S-morph, but we found no evidence that self-interference reduced maternal or paternal fitness in either morph. One-day-old flowers of the L-morph have reduced stigma receptivity and hence exhibit protandry, whereas stigma receptivity and anther dehiscence are concurrent in the S-morph. This suggests that the two style morphs have alternative strategies for reducing self-interference: dichogamy in the L-morph and herkogamy in the S-morph. These results provide insight into the mechanisms that reduce sexual conflict in hermaphrodite plants and are of significance for understanding the evolution and maintenance of sexual polymorphisms.
Genetic and morphological data supporting the hypothesis of adaptive radiation in the endemic fish of Lake Matano
Authors: Roy D. , Docker M. F. , Hehanussa P. , Heath D. D. , Haffner G. D.
Published: October 2004

Adaptive radiation resulting from differential selection acting on functional features is believed to be an important source of biodiversity. In this study, morphometric measures and mitochondrial DNA are used to test for adaptive radiation within four fish genera (Glossogobius, Oryzias, Dermogenys and Telmatherina) endemic to an ancient island lake (Lake Matano, Sulawesi, Indonesia), using the framework proposed by Schluter (The Ecology of Adaptive Radiation, Oxford University Press, 2000). We demonstrate common ancestry and rapid divergence in one genus (Telmatherina) based on 560 bp of 16S sequence data. We found higher levels of variation in feeding-related traits (N = 8) for Telmatherina relative to the other genera, while no differences were found for sexual display traits (N = 8) or neutral morphological traits (N = 8). Telmatherina also had the highest number of distinct colouration patterns among the four genera. These data, combined with the very low productivity of the lake, are indicative of selection driving adaptive radiation. The morphometric divergence in the Telmatherina likely results from selection acting on feeding traits in this low productivity lake, leading to trophic specialization among closely related morphotypes. These results provide indirect but compelling data supporting the adaptive radiation of Telmatherina in this system.
Evidence for epistasis: reply to Trouve et al.
Authors: Ebert D. , Salathé P. , Kawecki T. J.
Published: October 2004

Salathé and Ebert (2003, J. Evol. Biol. 16: 976–985) have shown that the mean logarithmic fitness of Daphnia magna clones declined faster than linearly with increasing inbreeding coefficient F. They interpreted this result as evidence for synergistic epistasis. Trouve et al. (2004, J. Evol. Biol., doi: 10.1111/j.1420-9101.2004.00755.x) suggested that hybrid vigour could be an alternative explanation for this finding. We use a population genetic model to support the original claim that the marked deviation from linearity cannot be explained without epistasis. We further argue that the relevant reference population is the metapopulation and not the subpopulation. Taken together, we believe that synergistic epistasis between recessive deleterious alleles segregating in the D. magna metapopulation is the most likely explanation for the finding of Salathé and Ebert.
Careful physical examination is essential in the preoperative assessment of children for dental extractions under general anesthesia
Authors: Rutherford John , Stevenson Ruth
Published: October 2004

Background : Physical examination is routinely carried out for the preoperative assessment of children, but is it of value in day stay community dental surgery?

Methods : A prospective survey of new diagnoses made on children presenting for community dental extractions and compared with children having nondental surgery.

Results : Five of 216 children for dental extractions were seen with new diagnoses made, with a variety of conditions including patent ductus arteriosus, aortic stenosis, ventricular septal defect and obstructive sleep apnea. No new diagnoses were made in 294 nondental children in the same period.

Conclusions : Physical examination provides a useful adjunct to the history in children undergoing community dental extraction. There is potentially significant morbidity undiagnosed in apparently fit children presenting for dental surgery.
Vertical infraclavicular brachial plexus block in children: a preliminary study
Authors: de Jose Maria Belen , Tielens Luc K.P.
Published: October 2004

Background : Brachial plexus blockade is a well‐established technique in upper limb surgery. Among the infraclavicular approaches, the vertical infraclavicular brachial plexus (VIP) block is easy to perform and has a large spectrum of nerve blockade. The aim of this preliminary study was to determine the ease, effectiveness, safety, and duration of the VIP block in pediatric trauma surgery.

Methods : Fifty‐five patients (ASA physical status I and II, age range 5–17 years old) scheduled for upper limb trauma surgery received a VIP block under light general anesthesia, using 0.5 ml·kg−1 of ropivacaine 0.5%. The number of attempts and time to perform the block, the occurrence of a surgical response, the visual analogue score (VAS) scores, the incidence of complications and the duration of the block were evaluated.

Results : The brachial plexus was found easily at the first or second attempt in 85% (47 of 55) of the cases, in 15% (eight of 55) of the cases it was localized after three to four attempts. The mean time to perform the block was 3.35 ± 3.37 min. Ninety‐eight percentage (54 of 55) of the blockades were effective for surgery and in just one case was ineffective. The VAS scores at the end of the procedure in 100% (55 of 55) of the cases were <3. There were no cases with clinical signs of pneumothorax nor inadvertent puncture of major vessels. Two patients developed a Horner's syndrome and in one a mild superficial hematoma at the puncture site occurred. The mean sensory block duration was 8.45 ± 1.71 h and the mean motor block duration was 6.52 ± 2.50 h.

Conclusions : In this preliminary study, the VIP block was easy to perform, effective and free of major complications for pediatric trauma surgery. With the doses of ropivacaine we used it was useful for intra‐ and postoperative analgesia.
Herbal medicine use by children presenting for ambulatory anesthesia and surgery
Authors: Crowe Suzanne , Lyons Barry
Published: October 2004

Background : Herbal medicine use has become increasingly popular throughout the world. Some of these agents may have serious interactions with anesthetic drugs. Children may potentially be more vulnerable to such interactions because of altered drug handling. While the prevalence of herbal medicine use by children with some chronic illnesses has been estimated, the incidence of this in a population of otherwise healthy children admitted for minor ambulatory anesthesia and surgery is currently unknown.

Methods : Parents of 601 children presenting consecutively for ambulatory surgery were asked to complete a questionnaire detailing administration of herbal medicines to their child.

Results : This study identified that 6.4% of children were currently taking an herbal preparation; while a further 10.1% had taken an herbal medicine in the past. Echinacea and arnica were the commonest used herbal remedies. A significant number of children had taken agents which may interact with anesthesia and surgery: St John's Wort, valerian, garlic and gingko. Information on herbal medicines was mostly obtained by parents from nonmedical sources.

Conclusions : A total of 16.6% of children had a current or past history of ingestion of herbal medicines. This finding may have implications for the perioperative management of children presenting for day‐case surgery.
Use of a remifentanil–propofol mixture for pediatric flexible fiberoptic bronchoscopy sedation
Authors: Berkenbosch John W. , Graff Gavin R. , Stark James M. , Ner Zarah , Tobias Joseph D.
Published: October 2004

Background : Flexible fiberoptic bronchoscopy is an important diagnostic tool for pediatric pulmonologists. Because of its favorable respiratory profile, ketamine has become a popular sedative for this procedure, but may be associated with unpleasant emergence reactions in the older child. Remifentanil is a newer, ultra‐short acting opioid that has been shown to provide effective sedation and cough suppression for fiberoptic bronchoscopy when combined with intermittent propofol boluses. However, delivery of these agents as a combined, single infusion has not been described.

Methods : Children ≥2 years of age undergoing fiberoptic bronchoscopy were enrolled. Remifentanil was mixed in a single syringe with undiluted propofol giving final drug concentrations of 10 mg·ml−1 of propofol and 15–20 μg·ml−1 of remifentanil. Sedation was induced with a bolus of approximately 0.1 ml·kg−1 of this mixture and maintained by titrating the drip throughout the procedure. Vital signs, sedative effectiveness, recovery patterns, and complications were prospectively recorded.

Results : Fifteen patients aged 9.0 ± 5.3 years were sedated. Sedation was induced with 1.2 ± 0.4 mg·kg−1 propofol (2.4 ± 0.8 μg·kg−1 remifentanil) and maintained with 4.1 ± 1.8 mg·kg−1·h−1 propofol (0.13 ± 0.06 μg·kg−1·min−1 remifentanil). Five patients received low‐dose ketamine to augment sedation. The maximal decrease in respiratory rate was 6.1 ± 5.3 b·min−1 (27.6 ± 21%) and no patient became hypoxemic. All procedures were completed easily without significant complication. Patients recovered to baseline 13.3 ± 8.5 min following infusion discontinuation.

Conclusions : A remifentanil/propofol mixture provided effective sedation and rapid recovery in pediatric patients undergoing fiberoptic bronchoscopy.
MESOLITHIC AND NEOLITHIC (DIS)CONTINUITIES IN THE DANUBE GORGES: NEW AMS DATES FROM PADINA AND HAJDUČKA VODENICA (SERBIA)
Authors: BORIĆ DUŠAN , MIRACLE PRESTON
Published: October 2004

Summary.  In this paper we present 17 new AMS dates from the Mesolithic–Early Neolithic sites of Padina and Hajdućka Vodenica and discuss the continuity and nature of occupation at them in the context of the Mesolithic–Neolithic transformations in the Danube Gorges region (north‐central Balkans), c.10000–5500 Cal BC. The dates indicate long occupation sequences and help refine the stratigraphies of the two sites. They, also enable us to date architectural features, burial positions and bone/antler tools, and to further our understanding of the impact of the noted aquatic reservoir effect on radiocarbon dating of human and dog remains from this region. Finally, these dates suggest continuity of occupation at sites other than Lepenski Vir in the Danube Gorges at the time of the Mesolithic–Neolithic transition, c.6300–5950 Cal BC.
CASTING THE RIACE BRONZES (2): A SCULPTOR's DISCOVERY
Authors: KONSTAM NIGEL , HOFFMANN HERBERT
Published: October 2004

Summary.  The discovery presented in this paper may reshape the stylistic history of Greek art. It is that the torso and limbs of the Riace Bronzes were cast from life, rather than having been previously modelled in clay.
GRANARIES AND GARRISONS IN ROMAN FORTS
Authors: RICHARDSON A.
Published: October 2004

Summary.  A statistical investigation into the relationship between granary floor area and garrison in Roman forts suggested that for a year's corn an auxiliary infantry cohort was typically allotted 2,500 sq. feet of granary area, or 5 sq. feet each for 500 men. Cavalry fort granaries were insufficient for a year's corn but each cavalryman probably had 7.5 sq. feet of granary area which gave 3,600 sq. feet for 480 men. Information from Polybius suggested that legionary and auxiliary infantrymen had 16 cu. feet of corn per year, an auxiliary cavalryman 152 cu. feet and the legionary cavalryman 216 cu. feet. This paradigm facilitated the issue of corn by the modius and the granary model allowed ten modii per sq. foot of floor area so that the input for an infantryman was 50 modii per year. This allowed for a 4 per cent loss during storage so 48 modii per man could be withdrawn. But granary areas varied and some forts appear to have been depots for others. A simple algorithm is given to list the possible options for known granaries in terms of the numbers of men and duration of supply. With two floors, the Chester granaries would hold a year's corn for a legionary establishment, while the wooden granaries at Inchtuthil would have held a year's corn for some 6,800 infantry on one floor. The Severan base at South Shields could have held a year's corn for about 11,000 infantry.
Hair colouring, permanent styling and hair structure
Authors: Harrison S , Sinclair R
Published: October 2004

Hair is an important component of body image and has immense psychological importance for both men and women. Women, in particular, over the ages have modified their appearance through changing their hair colour or style. Hair can be straight, wavy or curly, blonde, black, brown or red. These natural variations are an important part of our identity that can be manipulated according to the dictates of fashion, culture or society.

Different types of hair have varying affinity for the different colouring and waving methods. Damaged hair also has a different affinity for hair products than normal healthy hair. The hair shaft is remarkably strong and resistant to the extremes of nature. Hair cosmetics are widely available and manipulate the structural properties of hair. Whilst most procedures are safe, there is considerable potential for damage to the hair and hair problems of acute onset, including hair breakage, hair loss and loss of condition, are frequently blamed on the last product used on the hair. Hair problems are particularly prevalent among people who repeatedly alter the natural style of their hair.
Laser therapy of spider leg veins
Authors: Wollina U , Schmidt W‐D , Hercogova J , Fassler D
Published: October 2004

Background  Spider leg veins are a common aesthetic problem in females. The standard treatment is sclerotherapy but lasers have been used for decades to solve this problem as well.

Aim  To review recent advances in laser physics and its tissue interactions with skin vessels. The different laser types used to treat spider leg veins are discussed, including their advantages, limitations and possible adverse effects.

Method  The international literature on laser therapy for spider leg veins has been reviewed with particular emphasis on the last decade.

Results  Recent developments in laser technology allow a more selective and well‐tolerated therapy. Efficacy has also improved. Most studies report a greater than 75% improvement in spider leg veins as a realistic goal for laser therapy. Clinic response depends upon wavelength, fluence, pulse width and pulse duration, cooling and the diameter and colour of spider leg veins.

Conclusions  Sclerotherapy remains the gold standard treatment for spider leg veins. Nevertheless, laser therapy has become increasingly efficacious and convenient. Laser selectivity has been improved by technological progress. The ideal laser, however, has yet to be invented.
Nail abrasion
Authors: Di Chiacchio N , Kadunc B V , De Almeida A R T , Madeira C L
Published: October 2004

Certain diseases of the nail complex cause hyperkeratosis or alterations of the shape of the nail plate. These conditions may be painful, may decrease the penetration of topical medicaments and may be ugly.

 The nail plate abrasion, performed with dermabrader device or sandpaper, has application in patients suffering from onychomycosis, psoriasis, subnail infections and haematomas. The technique facilitates the collection of scales for mycological examination, decreases treatment time (of topical monotherapy) for onychomycosis and provides greater comfort for the patient by reducing nail plate thickness. It can also be useful for the partial removal of the nail plate in cases of haematomas and subnail infections.

 Nail abrasion is an effective and inexpensive method, easily applied in either nail pathologies with hyperkeratosis of the nail plate or in those requiring partial removal of the plate.
Bargaining Over Housework
Authors: Parkman Allen M.
Published: October 2004

Abstract.  This paper investigates the limited increase in housework provided by husbands in response to higher earnings and labor force participation by their wives. An explanation is provided that integrates the time availability, relative resources, and gender ideology perspectives that traditionally have been used to explain housework decisions. The outcome is the result of a bargaining process in which two concerns are identified as limiting the response of primary wage earning spouses to the employment of secondary wage earning spouses. First, the secondary wage earners’ employment may in part be motivated by a concern about the durability of their marriage rather than their family's welfare. Second, a balancing of the inconveniences and the net earnings of the additional employment may be viewed as making only a limited contribution to the family's welfare. Empirical results of an analysis of the individual household tasks imply that both gender ideology and the spouses’ earnings are important in determining the hours that each spouse devotes to household tasks. When making decisions about the amount of housework to perform, both spouses respond to changes in relative earnings, but the response of husbands, who are usually the primary wage earners, is smaller than that of wives, who tend to be the secondary wage earners.
Spousal Complementarity in Home Production
Authors: Leeds Michael A. , Allmen Peter von
Published: October 2004

Abstract.  Economists have increasingly recognized the growing role of married women in the labor market by treating the labor supply decisions of married couples as joint decisions. However, they have yet to apply the same reasoning to home production. We build a more complete model of household time allocation that consists of a system of simultaneous equations estimating hours of labor supply and home production. Using data on white couples from Wave XXV of the Panel Study of Income Dynamics, we find that working wives act as if their husbands are substitutes for home production while other wives do not. Husbands’ responses to their wives’ behavior depends upon whether children are present.
Noneconomic Objectives in the History of Economic Thought
Authors: Maneschi Andrea
Published: October 2004

Abstract.  Noneconomic objectives were a significant part of the international economics subspecialty in economics.
When Did Equality Become a Noneconomic Objective?
Authors: Persky Joseph
Published: October 2004

Abstract.  This brief survey begins with a suggested procedure for determining whether a given economist viewed a particular goal as an economic or noneconomic objective. Roughly speaking, the approach rests on whether that economist attempted a serious analysis of the tradeoffs between the goal in question and some measure of value. In this view, noneconomic objectives, for any school, include all those objectives that, while recognized as potentially legitimate, are not analyzed in terms of commensurable value measures. Three points to notice about the definition: (1) For any economist, economic objectives should be distinguished from a class of intermediate goods valued largely for their predicted positive impact on production; (2) Some objectives may be altogether dismissed by a school, either as beyond the expertise of economic analysis or as downright harmful; (3) Simply acknowledging the existence of a “cost” to achieving a goal leaves that goal as noneconomic since no attempt at valuation has been made.

The paper goes on to sketch three viewpoints toward income equality—that of the classical school as summarized in the work of J. S. Mill, that of the early neoclassicists as represented by Marshall and Pigou, and that of the “new welfare economics” as developed by Kaldor and Hicks. The classical economists valued the relief of poverty, but explicitly attacked anything but the most basic redistributional efforts because of expected dire effects on production. The early neoclassicists built equality implicitly into a utilitarian social welfare function. The “new welfare economics” doubted economists’ ability to assess the value of equality, although perhaps not their ability to measure its opportunity cost. Thus the basic argument: both the classicists and the early neoclassicists saw equality as an economic objective, while the new welfare economics was largely built on denying this status to equality.
A Novel Use of Atrial Septostomy and Stent Implantation in a Patient with Complex Cyanotic Congenital Heart Disease and Severe Pulmonary Hypertension
Authors: CHAKRABARTI SANTABHANU , BROWN ELSPETH M. , SALMON ANTHONY P. , KEETON BARRY R. , VETTUKATTIL JOSEPH J.
Published: October 2004

Patients with unpalliated complex cyanotic congenital heart may have significant morbidity resulting from severe pulmonary hypertension. In late stages, medical management is often difficult, and worsening right heart failure is resistant to medication. The risk of complications and early death can be averted by detailed evaluation and prompt intervention to identify the reversible elements that compound their physiology. It is vital to address any treatable issue to improve a patient's quality of life while awaiting heart–lung transplantation. Our case is a good example of such an approach, where the identification and treatment of reversible pulmonary venous hypertension in the background of irreversible pulmonary arterial hypertension, by offloading the left atrium by atrial septostomy and stent implantation, resulted in significant improvement in the quality of life for the patient.
The Current and Future Role of Percutaneous Coronary Intervention in Patients with Coronary Artery Disease
Authors: LIPINSKI MICHAEL J. , FEARON WILLIAM F. , FROELICHER VICTOR F. , VETROVEC GEORGE W.
Published: October 2004

With increasing research on vulnerable plaques and uncertainty regarding which lesions require revascularization, the goal of this review is to clarify the indications for percutaneous coronary intevention and discuss which lesions do not warrant treatment by intervention. This paper also briefly reviews the potential advantages and limitations of technology that may enable detection of atherosclerotic plaques that are prone to rupture and discusses the future utility of these technologies in prevention of acute coronary syndromes. Providing an evidence‐based understanding of lesion morphology and clinical variables that influence outcome enables the interventional cardiologist to determine which atherosclerotic plaques require PCI.
The Influence of Obstructive Sleep Apnea on FFR Measurements for Coronary Lesion Assessment
Authors: CIARAMITA JEFFREY P. , PARHAM WALTER A. , HERRMANN STEVEN , KHOUKAZ SOUHEIL , KERN MORTON J.
Published: October 2004

Fractional flow reserve (FFR) determinations have been demonstrated to be largely independent of changes in systemic hemodynamic changes. Herein, we describe a case of obstructive sleep apnea cyclically altering FFR measurements from normal to abnormal in a patient with an intermediately severe coronary narrowing following treatment for an acute coronary syndrome. To eliminate uncertainty, FFR measurements should be made if possible during suspended respiration.
Monitoring of Enoxaparin Level Using Citrated Clotting Time during Percutaneous Coronary Intervention
Authors: DÍEZ JOSE G. , CHEONG BENJAMIN Y.C. , O'MEALLIE LAWRENCE P. , ALT ECKHARD U.
Published: October 2004

Objectives: To evaluate the use of citrated clotting time (CCT) during percutaneous coronary intervention (PCI) in both emergent and elective scenarios and using intravenous (IV) or subcutaneous (SC) dosing.

Background: Monitoring of enoxaparin during PCI had limitations in the past due to lack of point‐of‐care testing. Introduction of the CCT enables the determination of the degree of anticoagulation by enoxaparin.

Methods and Results: An analysis on 51 consecutive patients revealed that after three SC doses (1 mg/kg twice a day) or a single IV bolus (1 mg/kg) of enoxaparin, the CCT was consistently in the therapeutic range of ≥260 seconds (475 ± 105 and 565 ± 151 sec, respectively). Patients who received <3 SC doses of enoxaparin were subtherapeutic for PCI. A supplemental IV bolus of 0.3 mg/kg was found always to raise the CCT to therapeutic level (499 ± 178 sec).

Conclusions: Enoxaparin was found to be effective and safe during PCI with low vascular complication rate (9.3%). Patients who received <3 SC doses of enoxaparin benefit most from using CCT monitoring. IV dosing consistently achieved adequate anticoagulation.
Polymer‐Based Paclitaxel‐Eluting Stents in Percutaneous Coronary Intervention:
Authors: HALKIN AMIR , STONE GREGG W.
Published: October 2004

Drug‐eluting stents have altered the practice of interventional cardiology by dramatically reducing the risk of angiographic and clinical restenosis following percutaneous coronary intervention. Based on extensive preclinical study and clinical trial data, the polymer‐based, slow rate‐release paclitaxel‐eluting TAXUS stent has recently received Food and Drug Administration approval for sale in the United States. In the current article, we review the available data from the TAXUS trials that have demonstrated that implantation of the slow rate‐release TAXUS stent is safe and, in terms of restenosis, markedly superior to bare metal stenting for the treatment of de novo lesions <28 mm in length in arteries 2.5–3.75 mm in diameter. Additional trials in the TAXUS program are currently examining the role of slow and moderate rate‐release polymer‐based, paclitaxel‐eluting stents in a broader range of clinical settings and lesion subsets.
Anti‐thyroid Antibodies and Antiphospholipid Syndrome: Evidence of Reduced Fecundity and of Poor Pregnancy Outcome in Recurrent Spontaneous Aborters
Authors: De Carolis Caterina , Greco Elisabetta , Guarino Maria D. , Perricone Carlo , Lago Alessandro Dal , Giacomelli Roberto , Fontana Luigi , Perricone Roberto
Published: October 2004

Problem:  To determine the presence of anti‐thyroid antibodies in patients with primary antiphospholipid syndrome (APS) [antiphospholipid antibodies (aPL) + recurrent spontaneous abortion (RSA)], compare APS alone with APS and thyroid autoimmunity for fecundity and for pregnancy outcome.

Method of Study:  A total of 203 non‐pregnant women affected with primary APS were evaluated for anti‐thyroid antibodies; 162 non‐pregnant women affected with RSA and thyroid autoimmunity alone served as controls.

Results:  Anti‐thyroid antibodies were found in 27% of APS patients studied. Patients with aPL alone had higher percentages of spontaneous pregnancies (P < 0.0001) and live births (P = 0.0003), when compared with patients positive for anti‐thyroid antibodies alone or with aPL.

Conclusions:  Thyroid autoimmunity is frequently present in APS recurrent aborters and is often associated with either reduced fecundity or with poor pregnancy outcome. Thyroid antibodies should always be evaluated in women with RSA including those with aPL.
The Effect of Testosterone on Cytokine Production in the Specific and Non‐specific Immune Response
Authors: Posma Elske , Moes Henk , Heineman Maas Jan , Faas Marijke M.
Published: October 2004

Problem:  Cytokine production of monocytes and lymphocytes differs between males and females. This difference is characterized by a decreased percentage of interleukin (IL)‐2‐producing lymphocytes and an increased percentage of IL‐12, IL‐1β and tumour necrosis factor (TNF)‐α‐producing monocytes in males compared with females. In the present study, we investigated whether testosterone may explain these differences.

Method of study:  Stimulated whole blood of healthy woman was incubated with different concentrations of testosterone. Intracellular lymphocyte production of IL‐2 and interferon (IFN)‐γ, as well as intracellular monocyte production of IL‐12, IL‐1β and TNF‐α were measured using flow cytometry.

Results:  A significant increased percentage of IL‐12‐ and IL‐1β‐producing monocytes was found after incubation with physiological concentrations of testosterone. No effect of testosterone was found on IL‐2‐ and IFN‐γ‐producing lymphocytes and TNF‐α‐producing monocytes.

Conclusions:  The increased percentage of IL‐12‐ and IL‐1β‐producing monocytes in males compared with females in vivo may be induced by testosterone, as the in vitro percentage of IL‐12‐ and IL‐1β‐producing monocytes is increased after incubation with physiological concentrations of testosterone.
Effect of Estradiol on Mouse Uterine Epithelial Cell Transepithelial Resistance (TER)
Authors: Grant‐Tschudy Katherine S. , Wira Charles R.
Published: October 2004

Problem: 
The effects of estradiol on epithelial cell function in the uterus may either be direct or indirect through the paracrine effects of underlying stromal cells. The aim of this study was to test whether estradiol‐17β (E2) acts directly to regulate uterine epithelial cell monolayer integrity.

Methods of Study:  Mouse uterine epithelial cells were isolated and grown on cell culture inserts to form confluent, polarized monolayers, as indicated by the development of high transepithelial resistance (TER).

Results:  When polarized epithelial cells were treated with E2, TER was significantly decreased within 24 hr of exposure. Epithelial cells remained hormonally responsive in culture for at least 10 days. In contrast to estradiol, incubation with progesterone, cortisol, aldosterone, and DHT had no effect on uterine epithelial cell TER. The ability of E2 to decrease TER was inhibited following co‐incubation with ICI 182,780, a pure estrogen receptor antagonist. To further investigate the mechanism involved in estradiol‐induced decreases in TER, we tested the effect of TAPI‐0, an inhibitor of matrix metalloproteinases. Our findings indicate that TAPI‐0 reversed the inhibitory effect of E2 on TER.

Conclusions:  These studies demonstrate that epithelial monolayer integrity is directly influenced by E2 and ER mediated. Further, it suggests that the mechanism through which estradiol decreases TER is mediated by matrix metalloproteinases.
Determining the Heat Capacity Ratio of Air from “Almost Adiabatic” Compressions
Authors: Krause Dennis E. , Keeley Walter J.
Published: October 2004

In this paper we demonstrate that the observed discrepancy between the measured and expected values of the heat capacity ratio γ = CP/CV for air obtained using the PASCO Adiabatic Gas Law Apparatus1 is due primarily to the finite compression time in the experiment. We devised an empirical method for obtaining a more accurate value of γ using this apparatus, which should be adaptable to other methods of measuring γ that use approximately adiabatic processes.
ISOTOPIC ANOMALIES IN A URANIUM CLUSTER FORMED BY LAIS
Authors: VAN DE WALLE J. , TARENTO R. J. , JOYES P.
Published: October 2004

A study of a Au–U liquid alloy ion source (LAIS) where uranium is enriched in its lighter element (20% 235U, 80% 238U) has been performed by high resolution mass spectrometry. Monoatomic species Au+, Au2+, U2+, U3+ and polyatomic species [Formula: see text], [Formula: see text], Au n U + are observed. The monoatomic results are well explained by the Kingham postionization process. [Formula: see text] and Au n U + species present an interesting odd–even effect characteristic of monovalent elements. The main result of this preliminary letter is a heteroisotope anomaly which appears in [Formula: see text], [Formula: see text] and [Formula: see text] emission where only homoisotopes are detected. A similar phenomenon was reported for [Formula: see text] and [Formula: see text] in a previous work and was attributed to a higher state of excitation of emitted heteroisotope aggregates which explode as they fly to the collector.1,2
Effect of active muscle mass during ischemic exercise on peak lower leg vascular conductance
Authors: Polichnowski Aaron J. , Heyer Ellen K. , Ng Alexander V.
Published: October 2004

Uncertainty exists as to whether a period of passive arterial occlusion (PAO) or ischemic exercise (IE) results in peak lower leg vascular conductance (LVC). This uncertainty is due to the different body positions, active muscle mass, and occlusion times used for PAO or IE. The purpose of this study was to examine whether 10 min of PAO elicits a similar LVC compared with ischemic dorsiflexion (IDF), ischemic plantar flexion (IPF), and ischemic plantar-dorsiflexion (IPDF). Ten subjects (5 women, 27 ± 9 yr, 68 ± 3 kg) were studied on 3 days over 1 wk in a semireclined position with the right foot attached to an isokinetic dynamometer. Mean arterial pressure (Finapres) and lower leg blood flow (LBF, venous occlusion plethysmography) were measured at rest and after PAO and IE. PAO was administered randomly on 1 of the 3 days and before IE. IE protocols consisted of maximal isokinetic dorsiflexion and/or plantar flexion at 120 and 60°/s, respectively. In a second experiment, an additional eight subjects (4 women, 29 ± 12 yr, 77 ± 12 kg) were studied to examine the effect of isokinetic speed during IDF on peak LBF and LVC. Peak LVC (ml·min−1·100 ml−1·mmHg−1) was similar among IPF (0.590 ± 0.16), IPDF (0.532 ± 0.17), and PAO (0.511 ± 0.18), and significantly lower after IDF (0.334 ± 0.15). No differences in peak LBF and LVC were observed after IDF using different isokinetic speeds. We conclude that 10 min of PAO, IPF, and IPDF performed in a similar posture are adequate stimuli to elicit peak LVC.
Periodic acceleration: effects on vasoactive, fibrinolytic, and coagulation factors
Authors: Adams Jose A. , Bassuk Jorge , Wu Dongmei , Grana Maria , Kurlansky Paul , Sackner Marvin A.
Published: October 2004

Cellular and isolated vessel experiments have shown that pulsatile and laminar shear stress to the endothelium produces significant release of mediators into the circulation. Periodic acceleration (pGz) applied to the whole body in the direction of the spinal axis adds pulses to the circulation, thereby increasing pulsatile and shear stress to the endothelium that should also cause release of mediators into the circulation. The purpose of this study was to determine whether addition of pulses to the circulation through pGzwould be sufficient to increase shear stress in whole animals and to acutely release mediators and how such a physical maneuver might affect coagulation factors. Randomized control experiments were performed on anesthetized, supine piglets. The treatment group (pGz) ( n = 12) received pGzwith a motion platform that moved them repetitively head to foot at ±0.4 g at 180 cpm for 60 min. The control group ( n = 6) was secured to the platform but remained on conventional ventilation throughout the 4-h protocol. Compared with control animals and baseline, pulsatile stress produced significant increases of serum nitrite, prostacyclin, PGE2, and tissue plasminogen activator antigen and activity, as well as D-dimer. There were no significant changes in epinephrine, norepinephrine, cortisol, and coagulation factors between groups or from baseline values. Pulsatile and laminar shear stress to the endothelium induced by pGzsafely produces increases of vasoactive and fibrinolytic activity. pGzhas potential to achieve mediator-related benefits from the actions of nitric oxide and prostaglandins.
Pressure-induced smooth muscle cell depolarization in pulmonary arteries from control and chronically hypoxic rats does not cause myogenic vasoconstriction
Authors: Naik Jay S. , Earley Scott , Resta Thomas C. , Walker Benjimen R.
Published: October 2004

Chronic obstructive pulmonary diseases, as well as prolonged residence at high altitude, can result in generalized airway hypoxia, eliciting an increase in pulmonary vascular resistance. We hypothesized that a portion of the elevated pulmonary vascular resistance following chronic hypoxia (CH) is due to the development of myogenic tone. Isolated, pressurized small pulmonary arteries from control (barometric pressure ≅ 630 Torr) and CH (4 wk, barometric pressure = 380 Torr) rats were loaded with fura 2-AM and perfused with warm (37°C), aerated (21% O2-6% CO2-balance N2) physiological saline solution. Vascular smooth muscle (VSM) intracellular Ca2+concentration ([Ca2+]i) and diameter responses to increasing intraluminal pressure were determined. Diameter and VSM cell [Ca2+]iresponses to KCl were also determined. In a separate set of experiments, VSM cell membrane potential responses to increasing luminal pressure were determined in arteries from control and CH rats. VSM cell membrane potential in arteries from CH animals was depolarized relative to control at each pressure step. VSM cells from both groups exhibited a further depolarization in response to step increases in intraluminal pressure. However, arteries from both control and CH rats distended passively to increasing intraluminal pressure, and VSM cell [Ca2+]iwas not affected. KCl elicited a dose-dependent vasoconstriction that was nearly identical between control and CH groups. Whereas KCl administration resulted in a dose-dependent increase in VSM cell [Ca2+]iin arteries taken from control animals, this stimulus elicited only a slight increase in VSM cell [Ca2+]iin arteries from CH animals. We conclude that the pulmonary circulation of the rat does not demonstrate pressure-induced vasoconstriction.
A Concept of Value during Experimental Exchange in Brown Capuchin Monkeys, Cebus apella
Authors: Brosnan Sarah F. , de Waal Frans B.M.
Published: October 2004

We evaluated the response of brown capuchin monkeys to two differentially valued tokens in an experimental exchange situation akin to a simple barter. Monkeys were given a series of three tests to evaluate their ability to associate tokens with food, then their responses were examined in a barter situation in which tokens were either limited or unlimited. Capuchins did not perform barter in the typical sense, returning the tokens which were associated with the reward. However, females, but not males, showed a different response, preferring the higher-value token. This may indicate that they learned to prefer one token over the other rather than to associate the tokens with their specific rewards. This sex difference parallels previous findings of greater reciprocity in female brown capuchins than in males.
Dietary Folate and the Risk of Depression in Finnish Middle-Aged Men
Authors: Tolmunen Tommi , Hintikka Jukka , Ruusunen Anu , Voutilainen Sari , Tanskanen Antti , Valkonen Veli-Pekka , Viinamäki Heimo , Kaplan George A. , Salonen Jukka T.
Published: October 2004

Background: Several cross-sectional studies have focused on the low blood folate levels of depressive patients. Nevertheless, no prospective studies have been published on the association between dietary folate and depression. Methods: We studied the association between dietary folate and cobalamin and receiving a discharge diagnosis of depression in a prospective follow-up setting. Our cohort was recruited between 1984 and 1989 and followed until the end of 2000, and it consisted of 2,313 men aged between 42and 60 years from eastern Finland. Results: The mean intake of folate in the whole cohort was 256 µg/day (SD = 76). Those below the median of energy-adjusted folate intake had higher risk of getting discharge diagnosis of depression (RR 3.04, 95% CI: 1.58, 5.86) during the follow-up period than those who had a folate intake above the median. This excess risk remained significant after adjustment for current socioeconomic status, the baseline HPL depression score, the energy-adjusted daily intake of fibre and vitamin C, and the total fat intake. Conclusions: A low dietary intake of folate may be a risk factor for severe depression. This also indicates that nutrition may have a role in the prevention of depression.
Prospective Examination of Anxiety Persistence and Its Relationship to Cardiac Symptoms and Recurrent Cardiac Events
Authors: Grace Sherry L. , Abbey Susan E. , Irvine Jane , Shnek Zachary M. , Stewart Donna E.
Published: October 2004

Background: The current study builds on previous research demonstrating a link between anxiety and inhospital recurrent ischemic and arrhythmic events, by examining the effects of persistent anxiety on recurrent events 1 year later. Methods: 913 patients with unstable angina (UA) and myocardial infarction (MI) from 12 coronary care units were recruited, and follow-up data were collected at 6 and 12 months after the event. Measures included cardiac symptomatology, healthcare utilization, the anxiety subscale of the Primary Care Evaluation of Mental Disorders , the phobic anxiety subscale of the Middlesex Hospital Questionnaire, and the Beck Depression Inventory. Results: Over one third of participants with UA and MI experienced elevated anxiety at the time of the ischemic event, and these symptoms persisted for 1 year in 50% of anxious participants. Although participants with anxiety reported more atypical cardiac symptomatology, the prevalence of typical cardiac symptoms such as chest pain did not differ based on anxiety. After controlling for the severity of the coronary event, family income, sex, diabetes, and smoking, the following variables were significantly predictive of self-reported recurrent cardiac events at 6 months or 1 year: older age, family history of cardiovascular disease, greater depressive symptomatology at baseline, and anxiety at 6 months. Only 38% of anxious patients were asked about such symptoms, indicating underutilization of effective psychotherapeutic treatment. Conclusions: Over and above the effects of depressive symptomatology (among other confounding variables), nonphobic anxiety appears to have a negative effect on self-reported outcome following an ischemic coronary event. Anxiety symptomatology is underrecognized and undertreated, and examination of effects of treatment on secondary prevention must be pursued.
Mentalizing Language Development in a Longitudinal Attachment Sample: Implications for Alexithymia
Authors: Lemche Erwin , Klann-Delius Gisela , Koch Rainer , Joraschky Peter
Published: October 2004

Background: The construct of alexithymia implies a deficit in symbolization for emotional, somatic, and mental states. However, the etiologic factors for alexithymia have not yet been fully elucidated. The present study investigated the use of mentalizing language, i.e. the utterance of internal states, from a developmental perspective according to attachment organization and disorganization. Methods: A longitudinal design across 4 time points was applied to a volunteer sample of 42 children. At 12 months, children were tested with the strange situation procedure, the standard measure of attachment at the optimal age, and attachment classifications were taken of videotapes. At ages 17, 23, 30 and 36 months, mother and child were observed in simplified separation episodes of 30 min duration. Transcripts of the sessions were subject to coding of internal state words. Results: During the investigated span, securely attached children rapidly acquired emotion, physiology, cognition and emotion-regulatory language, whereas insecurely attached and disorganized children either completely lacked internal state language or displayed a considerable time lag in the use of emotion and cognition vocabulary. Conclusion: The results raise the possibility that alexithymia might be a consequence of deficits in the development of internal state language in the context of insecure or disorganized childhood attachment relationships.