bluuebunny/crossref_metadata_2025 huggingface dataset:
Colonization by annual plants of an experimentally altered desert landscape: source—sink relationships
Authors: Boeken Bertrand , Shachak Moshe
Published: May 2003

We studied how annual plant species colonize a set of patches (natural and humanmade) in a shrubland landscape in the Negev desert. We asked what patch properties and species' attributes affect colonization during 4 years after experimental formation of eight sets of pits and mounds.

The ‘sink function’ of patches was measured as the numbers of colonizing species, the proportion of patches colonized during each year, and the abundance of the colonizers. The effects of species' dispersal mode and propagule size were examined.

In the first growing season, pits and mounds were colonized by large numbers of species. The total number of colonizing species was similar for the two patch types, but incidence was higher in pits than in mounds.

The early colonizers were mainly wind‐dispersed and showed both high abundance and incidence. Dispersal mode did not affect colonization in the second year and later, nor did propagule size througout the experiment.

Most early colonizers became resident in the patches, but pits and mounds showed some further colonization during the second year. In the third and fourth year both the numbers of colonizing species and their incidence decreased.

Pits were mainly colonized from outside the experimental units to which they belonged, whereas mounds received species mostly from the adjacent pits within the same units.

From the second year on, patches of undisturbed crusted soil were also colonized, mainly from the adjacent pits and mounds. The number of colonizing species in undisturbed patches increased during the last, high‐rainfall, year both per patch and for the whole set of patches.

We conclude that the sink function of patches for colonization increases with removal of vegetation, soil crust and seed bank, with patch capacity to capture resource and plant propagules, and with amount of rainfall. Sink function decreased with time due to decreasing availability of new species, but increased with the presence of stronger sink patches in the vicinity.

We suggest that the concept of sink function, in terms of the numbers, incidence and abundance of species of colonizing sets of patches, can be a powerful tool for linking community and landscape processes.
Phenotypic selection and population differentiation in relation to habitat heterogeneity in Arrhenatherum elatius (Poaceae)
Authors: Petit Christophe , Thompson John D.
Published: May 2003

Population differentiation in variable environments is often related to the different local selection pressures that plants may experience. We examine the relation between reproductive success and morphological and phenological traits in woodland and open habitat populations of the tetraploid grass Arrhenatherum elatius.

The reproductive correlates of morphological and phenological variation were estimated in woodland and open habitats, and on plants from each of three populations from woodland and three from open habitats grown in a garden environment at two light intensity levels. Genetic variation in these populations was estimated in uniform conditions.

Temporal and spatial differences in phenotypic selection on morphology and phenology were observed within and between the two sites. Plants from the two sites showed significant phenotypic and genetic differences, and there is a dramatic reduction in reproductive success in the woodland habitat and in plants from this habitat grown in the two garden environments.

In controlled conditions, selection patterns were similar to those observed in natural habitats, suggesting that light availability may be an important ecological factor involved in population differentiation in A. elatius. The presence of significant genetic variability for the studied traits indicates the presence of a genetic potential to respond to the detected selection pressures.

We argue that a clear understanding of patterns of local adaptation and phenotypic selection in this species requires that they are examined in the light of regional processes related to seed dispersal and relative abundance in open and woodland habitats.
Selection of micro‐organisms in a spatially explicit environment and implications for plant access to nitrogen
Authors: Kinzig Ann P. , Harte John
Published: May 2003

Evolution of a microbial nitrogen‐uptake strategy that removes nitrogen at less than the maximum potential rate creates soil environments favourable for increased plant access to nitrogen. Plant productivity is thus increased, and achievement of maximum microbial biomass is facilitated through increased microbial access to plant‐derived carbon.

Simulations show that micro‐organisms exhibiting such a ‘strategic’ nitrogen uptake will be competitively excluded by more voracious micro‐organisms in a homogeneous system, but can persist in a spatially explicit system. This persistence of less voracious micro‐organisms contrasts with the frequently held view that micro‐organisms in soil systems take up nitrogen at the maximum possible rate.

The selection of strategic or voracious microbial types in a spatially explicit environment is sensitive to the frequency of plant and microbial disturbance, and to the rate of diffusion of inorganic nitrogen in the soil system. In particular, the strategic (less voracious) microbial types are favoured under conditions of low plant disturbance, low to moderate diffusion of inorganic nitrogen, and moderate microbial disturbance.

When selection favours strategic microbial types, plant access to nitrogen is increased. Plants may also evolve strategies in a spatially explicit environment that will increase population densities of favourable, strategic microbial types.
Shrikes, lizards and Lycium intricatum (Solanaceae) fruits: a case of indirect seed dispersal on an oceanic island (Alegranza, Canary Islands)
Authors: Nogales M. , Delgado J. D. , Medina F. M.
Published: May 2003

Indirect seed dispersal in the system Lycium intricatum (Solanaceae)–lizards (Gallotia atlantica)–shrikes (Lanius excubitor) was studied in Alegranza, a xerophytic small island of the Canarian archipelago.

A total of 835 seeds (224 obtained from lizard droppings and 611 from shrike pellets) was found by analysing 123 droppings and 146 pellets. Lycium fruit remains (including seeds) were observed in 31.7% of the lizard droppings and 50% of the shrike pellets.

As would be expected for legitimate seed dispersers, external seed damage produced by each species was negligible. Lycium seeds were significantly matched with the presence of lizard remains in shrike pellets. Seeds in shrike pellets have come from fruit consumed by lizards that have been predated by the shrikes, and not directly from bird frugivory.

Seeds from shrike pellets showed significantly higher germination rates than those from uneaten fruits and lizard droppings.

It seems probable that different treatments in the guts of each species and retention time are two main factors influencing the germination process. While gut pass time in G. atlantica has been estimated to be 2.42 days on average, the retention time of a seed inside a shrike gizzard is much shorter (45–55 min).

This is a new case of the scarcely known phenomenon of indirect seed dispersal, which seems to acquire a relatively important role in small islands where the animal–plant interaction is very intense and all the elements of the system are native.
Evaluation of an intervention system for parents of children with intellectual disability and challenging behaviour
Authors: Hudson A. M. , Matthews J. M. , Gavidia‐Payne S. T. , Cameron C. A. , Mildon R. L. , Radler G. A. , Nankervis K. L.
Published: May 2003

Background  Signposts is a flexible intervention system for families of children who have intellectual disability and challenging behaviour. The Signposts materials include eight information booklets, a workbook and videotape for parents, and a series of instructional manuals for therapists. The system was designed so that it can be delivered in several different ways, i.e. group support, telephone support and self‐directed modes.

Methods  The present study was an evaluation of these three modes of delivery and involved 115 families.

Results  Following the use of the Signposts materials in parent training programmes, the subjects reported that they were less stressed, felt more efficacious about managing their children's behaviour, were less hassled about meeting their own needs and that their children's behaviour had improved. Additionally, families generally reported high levels of satisfaction with the content and delivery of the materials.

Conclusions  Finally, there were minimal differences among the three modes of delivery on the measures used, although families who used the self‐directed mode were less likely to complete the materials. Implications of these results for service delivery are discussed.
Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: a Double ABCX Model
Authors: Saloviita T. , Itälinna M. , Leinonen E.
Published: May 2003

Background  Twenty variables based on the Double ABCX Model of adaptation and selected on the basis of previous research were chosen to explain the parental stress of the mothers (n = 116) and fathers (n = 120) of children with an intellectual disability (age range = 1– 10 years).

Methods  Principal component analysis, rotated into varimax‐criterion, was done separately for mothers and fathers. The solution containing eight factors was considered best for both groups. They accounted for more than 70% of the total variance of the original variables. These eight orthogonal components were then entered into a stepwise regression analysis that was done separately for mothers and fathers.

Results  The multiple regression equations obtained explained 72% of the variance in maternal stress and 78% of the variance in paternal stress. The equations for mothers and fathers contained six and seven components, respectively.

Conclusions  The variables used in the present study were highly successful in accounting for parental stress. The results confirm the importance of intervening factors in explaining the stress. The single most important predictor of parental stress was the negative definition of the situation. In mothers, the negative definition was associated with the behavioural problems of the child while, in fathers it was connected with the experienced social acceptance of the child.
Influence of macrostructure of society on the life situation of families with a child with intellectual disability: Sweden as an example
Authors: Olsson M. B. , Hwang P. C.
Published: May 2003

Background Most studies on families with children with intellectual disability (ID) have been carried out in the UK or the USA, and are influenced by the societal organization, and political and economic climate of those countries. In the USA and the UK, the care and well‐being of children, with or without ID, are seen almost exclusively as the individual family's responsibility. In Sweden, the care and well‐being of children are seen more as a joint responsibility. Swedish society has developed many privileges for all parents in order to help them care for their children, and the support for parents of children with disabilities is provided exclusively by the Government and the community. The overall question explored in this descriptive, quantitative and qualitative study was: Are families in Sweden experiencing the stressors and life situations described in the studies of parents in more individualistic societies?

Methods Two hundred and twenty‐six families with children with ID and 234 control families with children ranging from 0 to 16 years of age answered mail surveys.

Results Taken together, parents in Sweden describe most of the stressors proposed in the international literature with the exception of financial strain. Restricted social life and time restrictions seem to be the two most evident and bothersome stressors for Swedish families with children who have ID.

Conclusions As in previous research, the parents of children with ID and autism experienced more stressors and restrictions in their lives than the parents of children with DS and control families.
Management of respite and personal assistance services in a consumer‐directed family support programme
Authors: Caldwell J. , Heller T.
Published: May 2003

Background  The present study explores the management of respite and personal assistance services by families with relatives with developmental disability (DD). It focuses on the control of families over recruiting, hiring, training, scheduling, directing and negotiating wages of the staff they hire to provide services.

Methods  Surveys from 97 families using paid respite or personal assistance services were used to test associations between: 1) level of control of services and outcome variables; 2) hiring relatives to provide services and outcome variables.

Results  More control by families in the management of their respite/personal assistance services was associated with increased service satisfaction, increased community involvement of individuals with DD and increased employment of mothers. Families tended to hire friends, neighbours, and to a great extent, other family members. Hiring of other relatives to provide services was associated with the increased community involvement of individuals with DD.

Conclusions  The present study supports the idea that there are benefits for both caregivers and individuals with DD with increased control of respite and personal assistance services. The study also supports benefits associated with hiring relatives and recommends additional research in this area to guide policies.
Are the native giant tortoises from the Seychelles really extinct? A genetic perspective based on mtDNA and microsatellite data
Authors: Palkovacs Eric P. , Marschner Monique , Ciofi Claudio , Gerlach Justin , Caccone Adalgisa
Published: May 2003

The extinction of the giant tortoises of the Seychelles Archipelago has long been suspected but is not beyond doubt. A recent morphological study of the giant tortoises of the western Indian Ocean concluded that specimens of two native Seychelles species survive in captivity today alongside giant tortoises of Aldabra, which are numerous in zoos as well as in the wild. This claim has been controversial because some of the morphological characters used to identify these species, several measures of carapace morphology, are reputed to be quite sensitive to captive conditions. Nonetheless, the potential survival of giant tortoise species previously thought extinct presents an exciting scenario for conservation. We used mitochondrial DNA sequences and nuclear microsatellites to examine the validity of the rediscovered species of Seychelles giant tortoises. Our results indicate that the morphotypes suspected to represent Seychelles species do not show levels of variation and genetic structuring consistent with long periods of reproductive isolation. We found no variation in the mitochondrial control region among 55 individuals examined and no genetic structuring in eight microsatellite loci, pointing to the survival of just a single lineage of Indian Ocean tortoises.
The novel protein phosphatase PphA fromSynechocystisPCC 6803 controls dephosphorylation of the signalling protein PII
Authors: Ruppert Ulrike , Irmler Angelika , Kloft Nicole , Forchhammer Karl
Published: May 2003

The family of PIIsignal transduction proteins consists of one of the most highly conserved signalling proteins in nature. The cyanobacterial PIIhomologue transmits signals on the nitrogen and carbon status of the cells through phosphorylation of a seryl residue. Recently, we identified a protein phospha‐tase 2C (PP2C) homologue from the cyanobacteriumSynechocystisPCC 6803, termed PphA, to be the cellular phospho‐PII(PII‐P) phosphatase. In this investigation, we characterized the enzymatic properties of PphA and investigated the regulation of its catalytic activity towards PII‐P. PphA dephosphorylates phosphocasein and PII‐P with similar efficiency in a strictly Mg2+‐ or Mn2+‐dependent reaction. Low‐molecular‐weight phosphorylated molecules are poor substrates for PphA. Its reactivity towards PII‐P, but not towards phosphocasein, is inhibited by various nucleotides, suggesting that this effect is based on specific properties of the PIIprotein. The inhibitory effect of ATP can be strongly enhanced by the addition of 2‐oxoglutarate or oxaloacetate. At low concentrations of 2‐oxoglutarate, changes in the ATP levels within the physiological range affect the degree of PII‐Pase inhibition, whereas at 2‐oxoglutarate levels beyond 0.1 mM, inhibition is almost complete at very low ATP levels. This suggests that PIIdephosphorylation is not only sensitive to 2‐oxoglutarate and oxaloacetate levels, it also integrates signals from the energy charge of the cells under specific cellular conditions.
Sperm cells of Zea mays have a complex complement of mRNAs
Authors: Engel Michele L. , Chaboud Annie , Dumas Christian , McCormick Sheila
Published: May 2003

Although double fertilization in angiosperm was discovered in 1898, we still know nothing about the proteins that mediate gamete recognition and fusion in plants. Because sperm are small and embedded within the large vegetative cell of the pollen grain, mRNAs from sperm are poorly represented in EST databases. We optimized fluorescence‐activated cell sorting (FACS) in order to isolate Zea mays sperm free of contaminating vegetative cell cytoplasm, and constructed a cDNA library. Sequencing of over 1100 cDNAs from the unamplified library revealed that sperm have a diverse complement of mRNAs. Most transcripts were singletons; the most abundant was sequenced only 17 times. About 8% of the sequences are predicted to encode secreted or plasma membrane‐localized proteins and are therefore candidates that might mediate gamete interactions. About 8% of the sequences correspond to retroposons. Plant sperm have condensed chromatin and are thought to be transcriptionally inactive. We used RT‐PCR and in situ hybridization to determine when selected sperm mRNAs were transcribed. Sperm transcripts encoding proteins involved in general cell functions were present throughout pollen development and were more abundant in tricellular pollen than in sperm cells, suggesting that these transcripts were also present in the larger vegetative cell. However, several transcripts, which encode proteins that are most similar to hypothetical Arabidopsis proteins, appeared to be present exclusively in the sperm cells inside mature pollen, but were already present in unicellular microspores. This suggests that certain transcripts might be transcribed early during pollen development and later partitioned into the sperm cells.
Remuneration for blood donation and attitudes towards blood donation and receipt in Leeds
Authors: Jones R. P. O. , Prasad V. , Kuruvatti J. , Tahir N. , Whitaker P. , Dawson A. S. J. , Williams R.
Published: May 2003

Summary. In a survey of attitudes towards remuneration for blood donation in Leeds, the following questions were completed by 489 adults (N), of whom 89 were regular donors, 105 were lapsed donors and 295 had never donated:

‘If you needed blood, would you be content if the donor had been paid: yes/no’.

‘If I were paid enough I would be less/equally/more likely to donate blood ’.

The majority (67·7%) of potential recipients would be content if the donor had been paid. The prospect of remuneration made 16·4% of respondents more likely and 14·5% less likely to donate. As the difference is less than 2% of N, offering remuneration may not lead to a significant increase in the number of donations. A statistical comparison (χ2 = 45, d.f. = 2, P << 0·001) showed associations between the responses ‘more likely to donate if paid’ and ‘content to receive blood from a paid donor’, and between the responses ‘less likely to donate if paid’ and ‘not content to receive blood from a paid donor’. Age distributions are presented for the donor status categories and the responses to the main questions. Of 129 people who stated a minimum, nonzero payment that would persuade them to donate, 103 (80%) suggested £10 or less.
Possible mechanisms underlying development of transfusion‐related acute lung injury: roles of anti‐major histocompatibility complex class II DR antibody
Authors: Nishimura M. , Mitsunaga S. , Ishikawa Y. , Satake M.
Published: May 2003

Summary.  Anti‐major histocompatibility complex (anti‐MHC) antibodies (Abs) and antipolymorphonuclear neutrophil (anti‐PMN) Abs are generally considered as the main causes of the development of transfusion‐related acute lung injury (TRALI), which is one of the most severe and sometimes lethal side effects of transfusion. These Abs are postulated to activate recipient's leucocytes, resulting in the release of soluble factors such as reactive oxygen species and detrimental cytokines and chemokines. The harmful effects on the lung tissues and resident leucocytes of these malignant factors are suspected to be profoundly involved in TRALI reactions. Several reports have indicated the principle effect of biologically active lipids on the pathogenesis of TRALI. However, the precise mechanisms of TRALI development remain unclear. To resolve this issue, we have been investigating cytokines that induce continuous inflammation of the lungs, specifically focusing on the cytokines derived from activated PMNs. We observed that the granulocyte–macrophage colony‐stimulating factor (GM‐CSF) markedly enhances the expression of MHC class II DR in PMNs. Moreover, MHC class II DR‐expressing PMNs were also proved to express a high‐affinity receptor for immunoglobulin E (IgE) (FcεRI) and to produce tumour necrosis factor‐α, interferon‐γ and interleukin‐18 following a challenge with an anti‐MHC class II DR monoclonal Ab (MoAb) or anti‐DR antiserum. It is strongly suggested that amongst various inflammatory mediators, at least these three cytokines may contribute to the duration of inflammatory reactions in the lungs. Furthermore, FcεRI expression, in GM‐CSF‐treated PMNs, suggests the involvement of PMNs in IgE‐mediated immune reactions.
Erythema induratum of bazin: role of polymerase chain reaction in diagnosis
Authors: Jacinto Sylvia S. , Nograles Kristine B.
Published: May 2003

A 55‐year‐old man presented with recurrent multiple ulcerative nodules and plaques of 1‐year duration over the lower extremities. They were recalcitrant to topical (hydrocortisone cream) and systemic (pentoxyfylline, cefotiam) drugs. Skin surface examination of the affected areas showed the skin to be studded with violaceous nodules and/or plaques. A few of these had draining ulcers. The nature of the fluid was serosanguous. The lesions were located on the shins of the legs (Fig. 1). They were bilateral and asymmetrical. In addition, nontender, erythematous nodules of annular configuration were located on the right knee and elbow, and a few toes. The arterial pulsation was within normal limits. Serial hematoxylin‐eosin stained sections prepared from a representative lesion were marked by the presence of palisading granulomatous dermatitis (Fig. 2). A granulomatous folluculitis in the deep dermis and a thrombotic arteriole in the subcutis were also found. Sections counter‐stained for the presence of acid‐fast bacilli were negative. Paraffin‐embedded biopsy specimens were subjected to DNA analysis using the IS6110 gene as a polymerase chain reaction (PCR) primer, and were found to be positive. Serial chest X‐rays taken at an interval of 4 months showed findings indicative of active pulmonary tuberculosis. Anti‐tubercular therapy (ATT) comprising 450 mg of rifampicin, 300 mg of isoniazid, 800 mg of pyrazinamide and 1500 mg of ethambutol was administered for a period of 2 months followed by 450 mg of rifampicin and 300 mg of isoniazid for another 2 months. There was perceptible healing of the lesions, leaving atrophic and hyperpigmented scars.

Multiple, violaceous, ulcerated plaques and nodules on the shins of both legs

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Palisading granuloma (H&E, × 50)

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The use of the freer dissector for the removal of trichilemmal cysts
Authors: Ikizoglu Guliz , Kaya Tamer Irfan , Tursen Umit , Baz Kiymet
Published: May 2003

Background Trichilemmal cysts are keratin‐containing cysts, usually situated on the scalp. They often show an autosomal dominant inheritance pattern. Excision is the treatment of choice. We describe a practical surgical technique that eases the removal of these cysts.

Methods A 24‐year‐old woman presented with a 5‐year history of cystic lesions on her scalp, clinically diagnosed as trichilemmal cysts. She was treated with the new technique. After making a small incision under local anesthesia, a freer dissector (Aesculap® OL 165 R) was used as a blunt dissector. The freer dissector was inserted through the incision. A blunt dissection was made to dissect the cyst free from the surrounding dermis and, by using the dissector as a lever, gentle pressure was applied to the opposite side to ease the cyst from the dermis. Four cysts were removed with this technique.

Results The treatment was well tolerated by the patient. No complications developed during or after the procedure.

Conclusions This modified technique is simple and practical. The slight curve at each end of the freer dissector makes it easy to grasp the cyst and, functioning like forceps, the cyst can be eased from the dermis. We believe that the use of the freer dissector in the surgical excision of trichilemmal cysts aids and speeds up the procedure.
Treatment of chromomycosis by cryosurgery with liquid nitrogen: 15 years’ experience
Authors: Castro Luiz G. M. , Pimentel Eugênio R. A. , Lacaz Carlos S.
Published: May 2003

Background Chromomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by various dematiaceous fungi, the most common of which is Fonsecaea pedrosoi. The disease is difficult to treat.

Methods Twenty‐two chromomycosis patients treated by cryosurgery with liquid nitrogen as the sole or associated therapy were studied. Diagnosis was confirmed by direct examination of KOH cleared specimens, culture, and histology, according to a method previously described by Pimentel et al. (Pimentel ERA, Castro LGM, Cucé LC, Sampaio SAP. Treatment of chromomycosis by cryosurgery with liquid nitrogen. J Dermatol Surg Oncol 1989; 15: 72–77). Small lesions were frozen in a single session, whilst larger lesions were frozen in small parts. All patients received double freeze–thaw cycles. An author‐created severity index, based on the extent of the diseased area, number of lesions, presence of complications (lymphedema, ulceration, and secondary infection) and unresponsiveness to previous treatments, was used to determine disease severity.

Results Fonsecaea pedrosoi was isolated from all but one patient. Caucasian (50.0%) males (4.5 : 1.0) were most commonly affected. The average number of cryosurgery sessions per patient was 6.7, varying from one to 22 sessions. The duration of treatment lasted for up to 126 months. Nine patients (40.9%) were considered to be cured (clinically disease‐free period of at least 3 years), eight (36.4%) were under observation (clinically disease‐free but less than 3 years of follow‐up), two (9.1%) were under treatment (still with active lesions), and three (13.6%) were classified as unsuccessful. The average cure period was 7.5 years, varying from 3 to 16 years. Five (55.6%) of the nine cured patients had been cured for periods exceeding 9 years. Six (66.7%) of the nine cured patients were classified as having mild, two (22.2%) severe, and one (11.1%) moderate disease.

Conclusions Cryosurgery with liquid nitrogen is an option in the treatment of chromomycosis.
Increased hydrogen peroxide generation by neutrophils from patients with acne inflammation
Authors: Akamatsu Hirohiko , Horio Takeshi , Hattori Kazuhiro
Published: May 2003

Background Reactive oxygen species generated by neutrophils are closely correlated with the pathogenesis of a variety of inflammatory skin diseases. The aim of this study was to investigate the possible role of reactive oxygen species generated by neutrophils in the mediation of acne inflammation.

Methods Bacterial phagocytotic stimuli, mediated by opsonin activity, were applied to whole blood, and neutrophil hydrogen peroxide production was measured.

Results Patients with acne inflammation showed a significantly increased level of hydrogen peroxide produced by neutrophils compared to patients with acne comedones and healthy controls. There were no marked differences in the level of hydrogen peroxide produced by neutrophils between patients with acne comedones and healthy controls. In addition, patients with acne inflammation treated by oral administration of minocycline hydrochloride, a drug that inhibits hydrogen peroxide generation by neutrophils, showed a significant decrease in the ability of neutrophils to produce hydrogen peroxide in accordance with a decrease in the inflammatory activity of acne lesions.

Conclusions The present study seems to suggest that acne inflammation is mediated in part by hydrogen peroxide generation by neutrophils.
Achievements of dermatological research in Denmark and Israel: a comparative 10‐year study
Authors: Enk Claes D. , Levy Louis
Published: May 2003

Wide differences of achievement in dermatological research between Denmark and Israel have been reported, although the two countries are comparable in terms of academic dermatological structure. The aims of the present study were to document these differences by means of bibliometric analysis, and to attempt to elucidate the causes of these differences. Employing MEDLINE searches for the 10‐year period 1988–97, quantitative and qualitative comparisons of the dermatological publications from these two countries were conducted. We found the achievements of Danish dermatological research to be superior to those of Israel, and suggest that the large proportion of case reports and reviews is one cause of the relatively low ranking of Israeli dermatological research efforts.
Churg–Strauss syndrome manifested by urticarial plaques
Authors: Tlacuilo‐Parra Alberto , Soto‐Ortíz José Alfredo , Guevara‐Gutiérrez Elizabeth
Published: May 2003

A 49‐year‐old mestizo Mexican woman, who had suffered with asthma for 30 years, presented with a 6‐week history of fever, hyaline rhinorrea, myalgias, and arthralgias, with thoracic pain in the right apical and retrosternal region and dyspnea with little effort, without response to antimicrobials or bronchodilators. Four weeks previously, she had developed three painful urticarial plaques on the right thigh and genital region, accompanied by paresthesia in the same extremity. These correlated with the remission of asthma.

Physical examination demonstrated three erythematous and edematous plaques, measuring from 1.5 cm to 20 cm, with ill‐defined borders (Fig. 1), on the inner side of the right thigh, inguinal and crural regions. Laboratory tests showed a hemoglobin level of 14 g/dL, a hematocrit of 44%, leukocytes of 8003/mm3, eosinophils of 2020/mm3 (25.2%), platelets of 244,000/mm3, an erythrocyte sedimentation rate of 80 mm/h, and immunoglobulin E (IgE) elevated to 224 U/mL. Urinalysis, complement, and antinuclear antibody tests were normal or negative. Chest roentgenogram showed a micronodular infiltrate in the right apex and inferior lobe; X‐rays of the paranasal sinuses were normal. A biopsy of the skin demonstrated an infiltration in the dermis with a predominance of eosinophils infiltrating the vascular walls (Fig. 2). There were no granulomas.

Erythematous and edematous urticaria‐like plaques on the thigh

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Perivascular infiltrate with predominantly eosinophils and lymphocytes with degenerated collagen fibers

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She showed a good response to oral corticosteroids, with total remission of symptoms and normalization of the eosinophil count and IgE levels.
Sunscreen use and skin protection behavior on the Belgian beach
Authors: Devos Steven A. , Baeyens Katrien , Van Hecke Lien
Published: May 2003

Background Public health campaigns encourage the public to protect themselves against skin cancer by using sunscreens and taking other protective measures. However, it is difficult to estimate the level of awareness among the general public.

Methods This study explores the prevalence and predictors of solar protection behavior in a community sample of beachgoers. During the months of May, June, July and August 2001 a total of 360 participants (145 men and 215 women) were randomly selected from several Belgian beaches in and around the city of Ostend, Belgium. The solar protection behavior of each participant was assessed by direct observation and interview.

Results The risk awareness percentages were 70.6% for skin cancer, 60.8% for sunburn and 25.0% for skin aging. These percentages were considerably higher in the female participant group than in the male group. Sunscreen cream was the most popular preventive behavior, especially in the female population, whereas the alternative protective measures (limited exposure during peak sun hours, the use of shade and the use of protective clothing and hats) were more popular in the male group.

Conclusions While solar protection has become part of routine beach behavior, there is room for improvement by more frequent application of sunscreen cream, the use of a higher sun protection factor (SPF) (15+), timed sunbathing, more use of clothing and hats and more seeking of shade. The results of this study can assist in evaluating the effectiveness of current sun‐protection campaigns and health education programs.
Ultraviolet radiation properties as applied to photoclimatherapy at the Dead Sea
Authors: Kudish A. I. , Abels D. , Harari M.
Published: May 2003

Background The Dead Sea basin, the lowest terrestrial point on earth, is recognized as a natural treatment center for patients with various cutaneous and rheumatic diseases. Psoriasis is the major skin disease treated at the Dead Sea with excellent improvement to complete clearance exceeding 85% after 4 weeks of treatment. These results were postulated to be associated with a unique spectrum of ultraviolet radiation present in the Dead Sea area.

Methods The UVB and UVA radiation at two sites is measured continuously by identical sets of broad‐band Solar Light Co. Inc. meters (Philadelphia, PA). The spectral selectivity within the UVB and UVA spectrum was determined using a narrow‐band spectroradiometer, UV‐Optronics 742 (Orlando, FL). The optimum exposure time intervals for photoclimatherapy, defined as the minimum ratio of erythema to therapeutic radiation intensities, were also determined using a Solar Light Co. Inc. Microtops II, Ozone Monitor‐Sunphotometer.

Results The ultraviolet radiation at the Dead Sea is attenuated relative to Beer Sheva as a result of the increased optical path length and consequent enhanced scattering. The UVB radiation is attenuated to a greater extent than UVA and the shorter erythema UVB spectral range decreased significantly compared with the longer therapeutic UVB wavelengths.

Conclusions It was demonstrated that the relative attenuation within the UVB spectral range is greatest for the shorter erythema rays and less for the longer therapeutic UVB wavelengths, thus producing a greater proportion of the longer therapeutic UVB wavelengths in the ultraviolet spectrum. These measurements can be utilized to minimize the exposure to solar radiation by correlating the cumulative UVB radiation dose to treatment efficacy and by formulating a patient sun exposure treatment protocol for Dead Sea photoclimatherapy.
Lichen planopilaris: report of 30 cases and review of the literature
Authors: Chieregato C. , Zini A. , Barba A. , Magnanini M. , Rosina P.
Published: May 2003

Background Lichen planopilaris (LPP) affects primarily the scalp, resulting in scaling, atrophy, and alopecia with scarring. The purpose of our study was to obtain original data on LPP and to evaluate the efficacy of topical therapy in comparison with systemic therapies.

Methods We examined 30 patients affected by LPP between 1996 and 2001, performing clinical, laboratory, histopathologic and direct immunofluorescence examinations. Twenty‐one of the patients (70%) were women and nine (30%) were men. The average age at presentation was 51.5 years. The average duration of the disease was 13 months at the time of the diagnosis. All patients received topical steroids for a total of 12 weeks.

Results Resolution of the inflammatory process and blocking of the cicatricial progression were observed in 66% of cases, a mild reduction of fibrosis and cicatrization in 20% of patients, and no response in 13%.

Conclusions We concluded that topical therapy may be a valid alternative to systemic therapies, especially in patients with lesions in the early phase.
Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate
Authors: Contreras Michael E. , Gottfried Lisa C. , Bang Ran H. , Palmer Charles H.
Published: May 2003

A 70‐year‐old white man presented to our clinic with a 6–8‐month history of a pruritic, occasionally burning eruption in both axillae. He had been using the same deodorant for more than 1 year and denied any changes in laundry detergent, soaps, or shampoos. He also denied application of other topical products. On physical examination, there were slightly erythematous, lichenified plaques in both axillae, with more extensive involvement of the left side (Fig. 1). Histologic examination of a punch biopsy specimen from a left axillary plaque revealed hyperkeratosis with retention of nuclei and keratohyaline granules in the stratum corneum (Fig. 2). The stratum granulosum was slightly thickened, and the epidermis was mildly acanthotic. Patch tests of the patient's deodorant and shampoo were negative. The patient was advised to discontinue use of his deodorant. His right axilla was treated with topical calcipotriene, applied twice daily, and his left axilla was treated with topical 12% ammonium lactate, applied twice daily. One month later, the lesions in the right axilla had completely resolved. The left axilla was slightly improved, but still exhibited dusky erythematous plaques. After one additional month of treatment with ammonium lactate, the left axillary lesions completely resolved. A follow‐up examination 9 months later revealed no recurrence of the lesions in either axilla.

Erythematous, lichenified plaques in the axilla

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Photomicrograph of biopsy specimen showing keratohyaline granules in the stratum corneum (hematoxylin and eosin, × 200)

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Bromoderma
Authors: Anzai Saburo , Fujiwara Sakuhei , Inuzuka Miki
Published: May 2003

A 3‐year‐old Japanese girl with severe epilepsy had been treated with potassium bromide since August 1999. The dose of potassium bromide was increased from 0.5 g/day to 0.8 g/day in May 2000 because of poor control of epilepsy. She also presented high fever, caused by bacterial pneumonia, in the same period. On June 11, a reddish eruption suddenly appeared on her back. Physical examination revealed grain‐size, dark‐red, erythematous papules and pustules on the back and face (Fig. 1). Some of the lesions on the back were ovoid to circular with small pustules and necrotic centers. Although some papules seemed to have dell in their centers, showing the appearance of herpes virus infection, Tzanck test was negative. A biopsy specimen obtained from one of the papules revealed a massive infiltration of eosinophils and neutrophils, forming an abscess in the epidermis and dermis (Fig. 2). The serum bromide level, which was 43.7 mEq/L (normal, 0–5 mEq/L) on May 25, increased to 114 mEq/L on June 14. The eruption disappeared within 10 days after the withdrawal of potassium bromide and treatment with topical sulfadiazine silver cream. The serum bromide decreased to 56.8 mEq/L on July 6.

Multiple papules and pustules on the back

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Intraepidermal and intradermal abscess (hematoxylin and eosin stain, × 100)

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Evaluation of clinical findings according to sex in 2313 Turkish patients with Behçet's disease
Authors: Tursen Umit , Gurler Aysel , Boyvat Ayse
Published: May 2003

Background Behçet's disease is a multisystem disease featuring mucocutaneous, ocular, articular, vascular, intestinal, urogenital, and neurologic involvement and occurs with a high prevalence in the Mediterranean including Turkey. Higher incidence of severe clinical course and systemic involvement is observed in male patients.

Objective To determine the influence of sex on the clinical course of Behçet’ s disease.

Methods We retrospectively evaluated the clinical findings of 2313 Behçet patients followed up at the multidisciplinary Behçet's Disease Center at Ankara University.

Results The male/female patient ratio was 1.03. Oral aphthae was seen in all patients. In male Behçet patients, the prevalence of mucocutaneous lesions and systemic manifestations was as follows: 85.6% genital aphthae, 45.5% erythema nodosum, 59.5% papulopustular lesions, 17.5% thrombophlebitis, 38.1% ocular involvement, 11.3% articular involvement, 11.7% vascular involvement, 3.3% neurologic involvement, 1.4% gastrointestinal involvement, and 1.8% pulmonary involvement. In female Behçet patients, the prevalence of manifestations were as follows: 91% genital aphthae, 49.8% erythema nodosum, 48.3% papulopustular lesions, 3.5% thrombophlebitis, 19.8% ocular involvement, 11.8% articular involvement, 2.1% vascular involvement, 1.3% neurologic involvement, 1.4% gastrointestinal involvement, and 0.03% pulmonary involvement.

Conclusions Only genital aphthae and erythema nodosum were more frequent in females. On the other hand papulopustular eruptions, thrombophlebitis, ocular, neurologic, pulmonary and vascular involvement were more frequent in males. While female patients had the best prognosis, male patients had a worse overall prognosis than females.
Ulcers caused by bullous morphea treated with tissue‐engineered skin
Authors: Martin Lucy K. , Kirsner Robert S.
Published: May 2003

Bullous morphea is an uncommon form of localized scleroderma. The exact pathogenesis is unknown and treatment of the accompanying ulcers is problematic. We report a patient with bullous morphea with long‐standing ulcers whom we successfully treated with the tissue‐engineered skin Apligraf (Organogenesis Inc., Canton, MA). The patient experienced rapid improvement in granulation tissue and the ulcers healed 4 months after a single application. The rationale for the use of Apligraf is based on experience with patients with venous ulcers who have surrounding peri‐ulcer fibrosis. This condition, termed lipodermatosclerosis, has been reported as a poor prognostic factor for healing, yet many ulcers associated with lipodermatosclerosis may respond to treatment with tissue‐engineered skin. Taken in concert, these results suggest a role for tissue‐ engineered skin in the treatment of chronic wounds with surrounding fibrosis.
Recurrent aphthous stomatitis unresponsive to topical corticosteroids: a study of the comparative therapeutic effects of systemic prednisone and systemic sulodexide
Authors: Femiano Felice , Gombos Fernando , Scully Crispian
Published: May 2003

Background Recurrent aphthous stomatitis (RAS) is a common oral condition, the etiology of which remains largely unclear. Numerous therapeutic protocols have been tried. Apart from immunomodulators, no therapy is unequivocally effective, and many systemic therapies have potential adverse effects.

Objective To compare, in patients with frequent RAS unresponsive to conventional therapies, the therapeutic effectiveness of systemic prednisone with that of systemic sulodexide, a low‐molecular‐weight heparin with immunosuppressive activity but few adverse effects.

Methods The study involved a group of 30 patients suffering from frequent minor RAS over ≥ 4 months unresponsive to topical corticosteroids. Patients were randomly assigned to one of three study groups: blind therapy with systemic sulodexide or systemic prednisone and control (no treatment). The outcomes were assessed blind on the basis of the days to recovery from pain and days to recovery from ulceration (epithelialization) during the first month of therapy; the number of aphthae appearing during the second month of therapy; and the number of aphthae appearing in the 2 months after the end of the 2‐month treatment cycle.

Results and conclusions The effectiveness of systemic sulodexide was almost comparable with that of systemic prednisone in patients with frequent RAS, without significant adverse effects.
Linear ectodermal cutaneous hamartoma
Authors: Campen Rebecca , Zembowicz Artur , Liu Vincent , Wrone David
Published: May 2003

We report the case of a 23‐year‐old Japanese woman with a linear lesion following Blaschko's lines down the anterior and lateral aspects of her right leg. Biopsy showed a mosaic of hamartomatous changes characteristic of verrucous epidermal nevus, nevus sebaceus, and eccrine angiomatous hamartoma. The lesion has been present since birth. There is no family history of similar lesions.
Quality assessment of seven types of fresh‐frozen plasma leucoreduced by specific plasma filtration
Authors: Chabanel A. , Sensebé I. , Masse M. , Maurel J. P. , Plante J. , Hivet D. , Kannengiesser C. , Naegelen C. , Joussemet M. , Marchesseau B. , Rasongles P. , Proust F. , David C. , Montembault A. M. , Bergeat P.
Published: May 2003

Background and Objectives A study was undertaken to determine plasma quality after specific filtration.

Materials and Methods Seven types of plasma were tested, after filtration of plasma from filtered or non‐filtered whole blood. Leucocyte counting was carried out after a 30‐fold concentration of the sample. Twenty‐nine parameters (including coagulation testing, proteins, coagulation factors and activation markers) were measured before and after filtration, and after 6 months of storage.

Results After specific plasma filtration, the average residual leucocyte counts were less than 2250/l. In spite of small statistically significant changes in proteins, coagulation factors and complement activation, this study showed that plasma filtration did not alter plasma quality. After 6 months of storage at −30 °C, factor VIII recovery varied between 91 and 109%. Haemostasis parameters and activation markers remained within the normal range.

Conclusions Specific plasma filtration reduced the leucocyte number to < 104 leucocytes/l. The quality of plasma was not altered by the additional step of specific plasma filtration.
Superiority of minipool nucleic acid amplification technology for hepatitis B virus over chemiluminescence immunoassay for hepatitis B surface antigen screening
Authors: Minegishi K. , Yoshikawa A. , Kishimoto S. , Yugi H. , Yokoya N. , Sakurada M. , Kiyokawa H. , Nishioka K. ,   the Japanese Red Cross NAT Screening Research Group
Published: May 2003

Background and Objectives The Japanese Red Cross (JRC) have developed a fully automated multiplex (MPX) nucleic acid amplification technology (NAT) system for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus 1 (HIV‐1). This is used to test serologically negative blood units from volunteer, non‐remunerated donors. The system utilizes a 50‐sample pool for NAT screening with an input volume of each pool. This results in a significantly higher sensitivity for hepatitis B than that seen with highly sensitive hepatitis B surface antigen (HBsAg) testing.

Materials and Methods From 1 February 2000 to 15 October 2001, over 11 million donations, which were serologically negative, were tested using the MPX NAT system. Donations found to be HBV DNA positive were further tested by using the chemiluminescence immunoassay (CLIA).

Results Out of 181 HBV DNA‐positive donations, 96 (53%) and 76 (42%) were negative by individual enzyme immunoassay (EIA) and CLIA testing, respectively.

Conclusions The sensitivity of the 50‐sample pool MPX NAT system was higher than that of individual HBsAg screening by CLIA. By adopting this NAT‐screening system, the JRC has improved the safety of the blood supply and maintained supply across Japan.