bluuebunny/crossref_metadata_2025 huggingface dataset:
Recovery of the Decorin‐Enriched Fraction, Extract (D), From Human Skin: An Accelerated Protocol
Authors: Wheatley Denys N. , Graham Emma , McMaster R. Shannon , Muir Ian F. K. , Holmes John D. , Davies Michaela
Published: September 2004

The original extraction procedure of Engel and Catchpole [1] has often been used to recover decorin‐enriched material from the skin. This material has a strong inhibitory effect on fibroblast proliferation, and clearly suppresses it in skin except after the first 5–6 days of wounding when new scaffold material is required. The aim of our present study has been to find and evaluate the product of a faster recovery method, and to check its consistency as a more reliable means of regularly obtaining sufficient material for topical application in wounds that might become hypertrophic. Modifications of the original Toole and Lowther [2] extraction procedure have been carefully evaluated in an attempt to cut preparation time without compromising biological activity of the inhibitory extract. We have devised a faster recovery procedure without compromising biological activity, even if initial recovery has been somewhat reduced. The latter problem could be offset by repeated cycles of the final extraction step. The main inhibitory activity is shown to be within the decorin‐enriched “extract D,” as the core protein and DSPG II. Adjustment of the extract towards neutrality after dialysis against water keeps most of the extracted protein in solution and yielded a decorin‐enriched preparation that had a specific activity equivalent to that of the old method. It also yielded a fraction that was readily lyophilised to give a small amount of material that could be stored indefinitely without loss of activity and readily redissolved in aqueous solution. A reliable and relatively quick method is presented for the production, from human skin, of a decorin‐enriched preparation that has strong fibroblast inhibitory action. The value of the procedure is that it is inexpensive and can produce the quantities that might be used topically in reducing hypertrophic scarring of wounds.
Effect of Synthetic Truncated Apolipoprotein C‐I Peptide on Plasma Lipoprotein Cholesterol in Nonhuman Primates
Authors: Kushwaha Rampratap S. , McGill Henry C. , Hausheer Frederick H.
Published: September 2004

The present studies were conducted to determine whether a synthetic truncated apoC‐I peptide that inhibits CETP activity in baboons would raise plasma HDL cholesterol levels in nonhuman primates with low HDL levels. We used 2 cynomolgus monkeys and 3 baboons fed a cholesterol‐ and fat‐enriched diet. In cynomolgus monkeys, we injected synthetic truncated apoC‐I inhibitor peptide at a dose of 20 mg/kg and, in baboons, at doses of 10, 15, and 20 mg/kg at weekly intervals. Blood samples were collected 3 times a week and VLDL + LDL and HDL cholesterol concentrations were measured. In cynomolgus monkeys, administration of the inhibitor peptide caused a rapid decrease in VLDL + LDL cholesterol concentrations (30%–60%) and an increase in HDL cholesterol concentrations (10%–20%). VLDL + LDL cholesterol concentrations returned to baseline levels in approximately 15 days. In baboons, administration of the synthetic inhibitor peptide caused a decrease in VLDL + LDL cholesterol (20%–60%) and an increase in HDL cholesterol (10%–20%). VLDL + LDL cholesterol returned to baseline levels by day 21, whereas HDL cholesterol concentrations remained elevated for up to 26 days. ApoA‐I concentrations increased, whereas apoE and triglyceride concentrations decreased. Subcutaneous and intravenous administrations of the inhibitor peptide had similar effects on LDL and HDL cholesterol concentrations. There was no change in body weight, food consumption, or plasma IgG levels of any baboon during the study. These studies suggest that the truncated apoC‐I peptide can be used to raise HDL in humans.
Expression of Mn‐Superoxide Dismutase Gene in Nontumorigenic and Tumorigenic Human Mammary Epithelial Cells
Authors: Mukhopadhyay Sutapa , Das Salil K. , Mukherjee Shyamali
Published: September 2004

Manganese superoxide dismutase (Mn‐SOD), localized at the mitochondrial matrix, has the ability to protect cells against oxidative damage. It has been reported that low levels of Mn‐SOD gene expression cause the development of certain kind of tumors. On the other hand, overexpression of Mn‐SOD gene may play an important role in the development of cancer. In our study, we find that Mn‐SOD activity was higher in nonaggressive (MCF‐7) and aggressive (BT‐549 and 11‐9‐14) breast cancer cell lines compared to that of nontumorigenic (MCF‐12A and MCF‐12F) mammary epithelial cell lines. We also observed an increased expression of Mn‐SOD gene in cancerous cell lines. The elevated level of SOD activity in nonaggressive and aggressive breast epithelial cell lines was associated with some changes in nucleotide sequence.
Nitric Oxide as a Unique Bioactive Signaling Messenger in Physiology and Pathophysiology
Authors: Tuteja Narendra , Chandra Mahesh , Tuteja Renu , Misra Mithilesh K.
Published: September 2004

Nitric oxide (NO) is an intra‐ and extracellular messenger that mediates diverse signaling pathways in target cells and is known to play an important role in many physiological processes including neuronal signaling, immune response, inflammatory response, modulation of ion channels, phagocytic defense mechanism, penile erection, and cardiovascular homeostasis and its decompensation in atherogenesis. Recent studies have also revealed a role for NO as signaling molecule in plant, as it activates various defense genes and acts as developmental regulator. In plants, NO can also be produced by nitrate reductase. NO can operate through posttranslational modification of proteins (nitrosylation). NO is also a causative agent in various pathophysiological abnormalities. One of the very important systems, the cardiovascular system, is affected by NO production, as this bioactive molecule is involved in the regulation of cardiovascular motor tone, modulation of myocardial contractivity, control of cell proliferation, and inhibition of platelet activation, aggregation, and adhesion. The prime source of NO in the cardiovascular system is endothelial NO synthase, which is tightly regulated with respect to activity and localization. The inhibition of chronic NO synthesis leads to neurogenic and arterial hypertensions, which later contribute to development of myocardial fibrosis. Overall, the modulation of NO synthesis is associated with hypertension. This review briefly describes the physiology of NO, its synthesis, catabolism, and targeting, the mechanism of NO action, and the pharmacological role of NO with special reference to its essential role in hypertension.
The College Departure Process among the Academic Elite
Authors: Hermanowicz Joseph C.
Published: October 2004

High attrition from a selective school is an especially unexpected institutional outcome: Students and schools invest significant resources to ensure a match. This study examines the departure process underlying students’ decisions to leave college, based on a case study of attrition at a major selective urban American university. The analysis is based on in-depth interviews designed to identify the qualitative aspects of attrition as a process that leads to students’ ultimate decisions to disenroll. The results suggest that intervention may most profitably lie in the communication and interaction networks established between students and university personnel. When working successfully, such networks can enable discussion that informs students’ decisions about whether to leave or to stay. The departure process discovered at this university may possess characteristics that can inform retention policy at other institutions of higher education in both urban and nonurban settings.
Gender Context of Schooling and Levels of Stress among Early Adolescent Pupils
Authors: Brutsaert Herman , Van Houtte Mieke
Published: October 2004

In present analysis, an attempt is made to identify perceived social support mechanisms through which the gender composition of the school may influence pupils’ stress responses. Use was made of data from 68 academically oriented secondary schools in Flanders, Belgium. Of these schools, 25 were mixed-sex schools and 43 were single-sex schools (21 girls’ and 22 boys’ schools). Respondents (3,370 girls and 3,057 boys) were 3rd-year students, ages 14 and 15. A multilevel analysis (Hierarchical Linear Modeling) was performed adjusting for parental socioeconomic status (SES), parental support, academic performance, curriculum enrollment, school mean SES, sense of belonging in school, and quality of teacher-pupil relationships. Results show that early adolescent girls in single-sex schools experience lower levels of stress than coeducational schoolgirls do and that this effect is largely accounted for by sense of belonging.
Reduced Female Marriage Opportunity and History of Single Parenthood
Authors: Barber Nigel
Published: October 2004

This study investigated whether historical changes in nonmarital birth ratios would respond to the availability of marriageable men. Nonmarital birth ratios for Scotland (1861 to 1980), England (1851 to 1980), and the United States (1800 to 1988) were studied at 4-year or 5-year intervals. Nonmarital births were negatively correlated with the supply of single men in each country. Regression analyses controlling for time trend and economic prosperity had the same result. Single parenthood increased when women faced a weak marriage market.
Assessment of Tourism/Hospitality Journals’ Role in Knowledge Transfer: An Exploratory Study
Authors: Frechtling Douglas C.
Published: October 2004

This study is a preliminary assessment of the transfer of knowledge from 13 popular tourism, hospitality, and related academic journals to managers, researchers, and other practitioners in the U.S. tourism and hospitality industries. It is based on a sample survey of members of two organizations that cover these populations: the Travel and Tourism Research Association and the Travel Industry Association of America. This study finds, among other results, that the two populations differ in their proportions that read any journals and specific journals, that there are preferences for journals that vary by occupation and tourism industry sector, and that relatively little transmission of knowledge is taking place from leading journals to industry practitioners. Recommendations are presented for further research and action.
All Our Troubles Seem So Far Away: Temporal Pattern to Accessible Alternatives and Retrospective Team Appraisals
Authors: Sanna Lawrence J. , Chang Edward C. , Carter Seth E.
Published: October 2004

Three studies tested the hypothesis that thoughts about alternatives become increasingly accessible over time, leading poor outcomes to feel subjectively farther away and less inevitable. This subjective temporal distance bias was obtained even though actual time since poor and good outcomes was identical. In Study 1, participants who recalled distant poor team outcomes thought of alternatives easily and outcomes felt farther away and less inevitable. Thoughts about outcomes were most easily accessible after good outcomes, which felt closer and more inevitable. In Study 2, with measures obtained immediately or at a later time on a negotiation task, changes over time occurred primarily for poor team outcomes. In Study 3, team performance on an investment task indicated it is whether alternatives are thought of easily, not thought content, that produces this effect. Discussion centers on temporal appraisals, other temporal biases, and teams.
Implicit and Explicit Ethnocentrism: Revisiting the Ideologies of Prejudice
Authors: Cunningham William A. , Nezlek John B. , Banaji Mahzarin R.
Published: October 2004

Two studies investigated relationships among individual differences in implicit and explicit prejudice, right-wing ideology, and rigidity in thinking. The first study examined these relationships focusing on White Americans’ prejudice toward Black Americans. The second study provided the first test of implicit ethnocentrism and its relationship to explicit ethnocentrism by studying the relationship between attitudes toward five social groups. Factor analyses found support for both implicit and explicit ethnocentrism. In both studies, mean explicit attitudes toward out groups were positive, whereas implicit attitudes were negative, suggesting that implicit and explicit prejudices are distinct; however, in both studies, implicit and explicit attitudes were related (r = .37, .47). Latent variable modeling indicates a simple structure within this ethnocentric system, with variables organized in order of specificity. These results lead to the conclusion that (a) implicit ethnocentrism exists and (b) it is related to and distinct from explicit ethnocentrism.
Increasing the Precision of Subscale Scores by Using Out-of-Scale Information
Authors: Kahraman Nilufer , Kamata Akihito
Published: October 2004

In this study, the precision of subscale score estimates was evaluated when out-of-scale information was incorporated. Procedures that incorporated out-of-scale information and only information within a subscale were compared through a series of simulations. It was revealed that more information (i.e., more precision) was always provided for subscale score estimates when out-of-scale information was used. The degree of the information gain depended on the number of out-of-scale items, the magnitude of item discrimination power, and the magnitude of subscale-trait correlation. Also, the accuracy of subscale score estimates was evaluated. Contrary to precision, subscale score estimates were somewhat more biased with out-of-scale information when there were more out-of-scale items and/or when out-of-scale items had high item discrimination power. This tendency was more apparent when the correlation between subscale traits was low. It was concluded that subscale-trait correlation is an important factor to be considered when out-of-scale information is used.
A Tale of Two Cities
Authors: Silk Michael L.
Published: October 2004

Through infusing a spatial imagination with social and historical perspectives, the current article excavates and theorizes the contingent relations, structure, and effects that link the sporting spaces of Memphis, their prevailing determinate forces, and social consequences. Memphis is an archetypal exemplar of a city that has recentered itself around a spectacular space of sporting consumption by exploiting the kind of urban culture that helps position the city within the global fray. Yet this veil of appearance conceals the marked gendered, class, racial, and ethnic polarizations that mark the city. To this end, this article critically investigates the physical and imagined transformations in the city that take place according to distinctly capitalist criteria—in particular, the spaces of corporatized sport production and consumption—that can be seen to be destroying the older urban fabric thereby exacerbating structural divisions and creating new lines of inequality.
Bodies, Narratives, Selves, and Autobiography
Authors: Sparkes Andrew C.
Published: October 2004

This article focuses on Lance Armstrong’s autobiography titled It’s Not About the Bike: My Journey Back to Life. From a perspective informed by autobiographical studies and the sociology of the body and illness, insights are provided into a variety of bodies, selves, and narratives that circulate within the text. The case is made that early in his sporting career, Armstrong develops a disciplined and dominating body that has an elective affinity for the cyborg narrative. On being diagnosed with cancer, these ideal body types lead him toward a restitution narrative. The illness experience, however, provides an opportunity for a communicative body to emerge that links him to a quest narrative. On returning to elite sport, former body-self relationships are restored and foregrounded. Issues are raised regarding the cultural shaping of Armstrong’s autobiography, and its form and content are problematized.
Exercise Self-Efficacy, Enjoyment, and Feeling States Among Adolescents
Authors: Robbins Lorraine B. , Pis Monika B. , Pender Nola J. , Kazanis Anamaria S.
Published: October 2004

Knowledge of cognitions and feelings related to physical activity (PA) can assist in counseling adolescents to prevent the decrease in PA that occurs during this developmental period. This study, which involves a 2 (gender) 2 (race) 3 (developmental stage) design, examines relationships among PA self-efficacy (SE), enjoyment, and feeling states (FS) during PA and compares responses among 168 African American and European American boys and girls during early, middle, and late adolescence. More positive FS during a standardized PA episode on a treadmill predicts higher postactivity SE and greater enjoyment of the task. FS worsens as the session progresses, particularly for adolescents who in early puberty, report feeling significantly worse than those in both middle and late puberty at 16 minutes and 20 minutes. Findings suggest that nurses should assist adolescents to reduce negative feelings during activity to augment PA enjoyment, as well as SE following PA.
A Turkish Language Equivalence of the Exercise of Self-Care Agency Scale
Authors: Nahcivan Nursen O.
Published: October 2004

This article is about the pilot test of a Turkish version of the Exercise of Self-Care Agency Scale (ESCA) using a randomized convenience sample of 119 bilingual Turkish adolescents. The instrument was translated into Turkish, back translated, and pilot tested to linguistic equivalence. Bilingual participants were randomly assigned to four groups. Each participant was administered both the English and the Turkish versions of the scale but in different order at 5-week intervals. The results show that the Turkish version of the ESCA was linguistically equal to the English form. Test-retest correlations were acceptably high (r = .80 to .90). Internal consistency of the total scale of the ESCA was adequate, with an alpha coefficient of .89 for the Turkish version and .88 for the English version. Further research in the development of this translated form would need to demonstrate its applicability and generalizability to monolingual Turkish adolescents.
Assessment of Patient Pain in the Postoperative Context
Authors: Manias Elizabeth , Bucknall Tracey , Botti Mari
Published: October 2004

Because of its subjective nature, the assessment of pain requires the use of comprehensive practices that accurately reflect a patient’s experiences of pain. The purpose of this study was to determine how nurses make decisions in their assessment of patients’ pain in the postoperative clinical setting. An observational design was chosen as the means of examining pain activities in two surgical units of a metropolitan teaching hospital in Melbourne, Australia. Six fixed observation times were selected. Each 2-hour observation period was examined 12 times thus resulting in 74 observations. In total, 316 pain activities were determined. Five themes relating to assessment were identified from the data analysis: simple questioning, use of a pain scale, complex assessment, the lack of pain assessment, and physical examination for pain. The study identified how nurses’ prioritization of work demands created barriers in conducting timely and comprehensive pain assessment decisions.
Pain Assessment Practices With Nursing Home Residents
Authors: Clark Lauren , Jones Katherine , Pennington Karen
Published: October 2004

The purpose of this research was to describe the kinds of pain assessments nursing home staff use with nursing home residents and the characteristics and behaviors of residents that staff consider as they assess pain. Twenty-one focus groups were held in 12 nursing homes. Nurses and other nursing home staff attended the focus groups. Coding techniques consistent with ethnographic methodology were used for data analysis. Four themes identified an underlying uncertainty in assessing residents’ pain, the staff relationship-centered approach to pain assessment, the resident cues that alert staff to pain, and residents’ characteristics important to the nursing assessment. Composition of focus groups made a difference in participation of certified nursing assistants in focus group discussion. Urban and rural differences were noted across the focus groups. Research is needed to further refine pain assessment techniques specifically for nursing home settings.
Building Human Capital Through Public-Private Cooperation: The Case of Metropolitan College
Authors: Strother Stuart C. , Koven Steven G. , Howarth David , Pan Zhenfeng
Published: October 2004

Metropolitan College was created to induce United Parcel Service (UPS) not to close its hub operation in Louisville, Kentucky. Participants in the program work the third shift at UPS and attend one of three local colleges tuition-free. Stakeholders agree that Metropolitan College has accomplished the goals laid out at its inception. This article evaluates the effects of the program from the perspective of one of the participating colleges. A cohort of Metropolitan College students enrolled at the University of Louisville is compared with traditional students at the institution. Inferences are made regarding the effect of Metropolitan College on key university “quality” indicators, including retention and academic performance. This article also assesses Metropolitan College from the perspective of human capital development. It tests the assertion that the program contributes to human capital development by accessing a cohort of students with different sociodemographic characteristics from those typically found at the University of Louisville.
“We’d Have to Sink the Ships”: Impact Studies and the 2002 West Coast Port Lockout
Authors: Hall Peter V.
Published: October 2004

During the West Coast port lockout in fall 2002, a widely quoted estimate claimed that a 10-day shutdown of port facilities would cost the U.S. economy $1.94 billion a day. This article argues that the estimated economic losses were vastly over inflated, and the episode provides an opportunity to reflect on the use of economic impact studies to study short-term disruptions of infrastructure services. Port impact studies are deficient in this task because they do not adequately address the possibilities for substitution, even in the short run. In part, this is because port impact studies are poorly designed to deal with the changing nature of the relationship between seaport operations and regional economic development. Impact studies assume a continuous monotonic relationship between cargo throughput and economic measures. This ignores the fact that port-using firms have differential abilities to adjust to disruptions and that their adjustment behavior creates both losers and winners.
Manual Lymphatic Drainage Therapy
Authors: Korosec Barbara J.
Published: October 2004

Health care providers are constantly confronted with the challenge of providing quality health care while at the same time containing escalating costs. Incorporating complementary therapies into standard health care practices can assist in escalating the healing process, enhancing general wellness, focusing on prevention, and promoting a better quality of life. This article discusses manual lymphatic drainage therapy and identifies the value of as well the indications for the therapy. A brief overview of the lymphatic system is included.
Reiki: The Re-Emergence of an Ancient Healing Art in Modern Times
Authors: Gilberti Theresa C.
Published: October 2004

Reiki has experienced a tremendous rebirth and expansion since its rediscovery by Dr. Mikao Usui in the early 1900s. The number of Reiki practitioners has grown to several hundred thousand worldwide. After Reiki instruction and attunements by a Reiki master/teacher, the practitioners, through intention alone, pull concentrated life force into their bodies and pass it through the hands to the client. The Reiki session places the client into a deep state of relaxation and peace, allowing the body to rebalance and heal. Reiki is not a religion, dogma, or creed, nor can it create or cause anyone harm. In fact, Reiki is beneficial to the practitioner and the client. Anyone can learn Reiki. There are no special skills or education necessary to learn this ancient healing art—only an open mind and heart.
State Economic Incentives: Stimulus or Reallocation?
Authors: Calcagno Peter T. , Thompson Henry
Published: October 2004

This article estimates the effects of state economic incentives during the 1980s and interprets results in the context of a general-equilibrium specific-factors model of production. The issue is whether investment incentives had a net positive impact on manufacturing value added because subsidized firms would pull resources from the rest of the state economy. The public finance literature provides the foundation of the econometric model. Empirical results are consistent with theoretical predictions of the specific-factors model that resources would come from other sectors. Incentives are associated with a reduction in manufacturing value added.
McTV
Authors: Waisbord Silvio
Published: October 2004

Globalization has intensified interconnectivity among television industries worldwide. Interconnectivity happens through structural and institutional linkages among television systems and industries worldwide, resulting in an increasingly integrated global business governed by similar practices and goals. The dynamics are reflected in the popularity of television formats. On the surface, global dissemination of formats may suggest not only the global integration of the economy of the industry but also the standardization of content. A dozen media companies are able to do business worldwide by selling the same idea, and audiences seem to be watching national variations of the same show. At a deeper level, however, formats attest to the fact that television still remains tied to local and national cultures. Bringing up examples of Latin American cases, this article argues that television is simultaneously global and national, shaped by the globalization of media economics and the pull of local and national cultures.
Setting of noninvasive pressure support in young patients with cystic fibrosis
Authors: Fauroux B. , Nicot F. , Essouri S. , Hart N. , Clément A. , Polkey M.I. , Lofaso F.
Published: September 2004

The aim of the current study was to compare a clinical noninvasive method of setting up noninvasive pressure support ventilation (PS-NI) in young patients with cystic fibrosis (CF), based on parameters such as breathing frequency, arterial oxygen saturation and comfort rating, with a more invasive method (PS-I) targeted at optimising unloading of the inspiratory muscles and enhancing patient-ventilator synchronisation.

PS-NI and PS-I were compared in random order in 10 children with CF.

PS-NI differed from PS-I with regard to the level of inspiratory pressure (n=5), rate of inspiratory pressurisation (n=1), inspiratory trigger sensitivity (n=2) and expiratory trigger sensitivity (n=5). Although both methods modified breathing pattern, improved oxygen saturation and reduced diaphragmatic pressure time product (450±91 cmH2O·s−1·min−1during spontaneous breathing, and 129±125 and 104±75 cmH2O·s−1·min−1during PS-NI and PS-I, respectively), patient-ventilator synchrony and patient comfort were enhanced more during PS-I.

In young patients with cystic fibrosis, setting up pressure support using a clinical noninvasive approach based on easily measurable parameters, such as respiratory rate and comfort rating, is as effective as a more invasive technique based on unloading of the inspiratory muscles and optimising patient-ventilator synchronisation. However, whilst the standard clinical method is satisfactory in the majority of patients, more invasive measurements should be considered in patients who have difficulty synchronising with the ventilator to enhance patient tolerance and compliance.
Expansion of CCR5+ CD4+ T-lymphocytes in the course of active pulmonary tuberculosis
Authors: Santucci M.B. , Bocchino M. , Garg S.K. , Marruchella A. , Colizzi V. , Saltini C. , Fraziano M.
Published: September 2004

Nonsyncytium inducing, macrophage tropic HIV strains predominate in the course of active tuberculosis (TB). The present study assesses the expression of CCR5 in CD4+ T-lymphocytes from blood and bronchoalveolar lavage (BAL) of TB patients, non-TB lung disease controls and healthy controls.

Memory (CD45RO+), recently activated (CD69+), proliferating (Ki67+) CCR5+ or CCR3+ CD4+ T-lymphocytes were determined by multiparametric flow cytometry analysis.

Results show that BAL CD4+ T-lymphocytes expressing CCR5 or CCR3 were significantly increased when compared to peripheral blood both in patients and in healthy controls. However, the data show that the proportions of peripheral blood CCR5+ CD4+ and CCR3+ CD4+ T-lymphocytes and BAL CCR5+ CD4+ T-lymphocytes, but not BAL CCR3+ CD4+ T-lymphocytes, were significantly increased in TB patients. Furthermore, the observation that BAL CCR5+ CD4+ T-lymphocytes from TB patients expressed early activation markers, were not proliferating and showed down-regulation of CCR5 expression suggests recruitment and trapping at the site of disease.

Altogether, these results suggest that the lower respiratory tract mucosa may provide cellular targets accessible for efficient transmission of macrophage tropic HIV-1 variants and that tuberculosis may enhance this phenomenon.
Brief adrenomedullin inhalation leads to sustained reduction of pulmonary artery pressure
Authors: von der Hardt K. , Kandler M.A. , Chada M. , Cubra A. , Schoof E. , Amann K. , Rascher W. , Dötsch J.
Published: September 2004

The effect of aerosolised adrenomedullin (ADM), a potent vasodilator peptide, on pulmonary artery pressure was studied for 24 h in a surfactant-depleted piglet model.

Animals received either aerosolised ADM (50 ng·kg−1·min−1, ADM, n=6), or aerosolised normal saline solution (control, n=6). Aerosol therapy was performed for a 2 h treatment period followed by a 22 h observation period. Ventilator settings were adapted to keep arterial oxygen tension and carbon dioxide arterial tension between 13.3–14.6 kPa and 4.9–5.7 kPa, respectively.

Aerosolised ADM reduced mean pulmonary artery pressure (MPAP) compared with the control group (end-point median 24 h after therapy start: ΔMPAP −14.0versus−8.0 mmHg; 23.5 h after therapy start). After therapy start, mean systemic arterial pressure (MAP) was not significantly different between the groups (end-point median: MAP ADM 70 (61/74)versuscontrol 72 (54/81) mmHg). Endothelin-1, a potent pulmonary vasoconstrictor, is regulated by ADMviacAMP. Twenty two hours after inhalation of aerosolised ADM, endothelin-1 mRNA in lung tissue and endothelin-1 protein expression in pulmonary arteries was reduced compared with controls (median semi-quantitative immunhistochemical score: ADM 0.21, control 0.76).

Aerosolised adrenomedullin significantly reduced mean pulmonary artery pressure independently of arterial oxygen tension.
The effect of fluticasone on the airway inflammatory response to organic dust
Authors: Ek A. , Palmberg L. , Larsson K.
Published: September 2004

Exposure to organic dust in a swine house causes acute airway inflammation and increased bronchial responsiveness to methacholine in healthy subjects. The aim of this study was to investigate whether an inhaled glucocorticoid, fluticasone propionate, alters the acute airway responses induced by exposure in a swine barn.

In 15 healthy subjects, analysis of nasal lavage fluids, serum samples and bronchial methacholine responsiveness were performed before and after exposure to organic dust in a swine house for 3 h. Seven subjects received fluticasone propionate (500 µgb.i.d.by inhalation and 100 µg intranasally once daily) and eight subjects received placebo during the 2 weeks prior to exposure.

Post-exposure plasma interleukin (IL)-6 levels and body temperature were significantly lower in the fluticasone group than in the placebo group. Intranasally administered fluticasone propionate significantly attenuated the plasma protein (assessed as albumin concentrations) leakage and IL-8 and tumour necrosis factor-α response induced by exposure. Fluticasone propionate inhalation exerted no influence on the increased bronchial responsiveness to methacholine induced by exposure.

In conclusion, glucocorticoid treatment attenuated the inflammatory response to inhaled organic dust without influencing the increased bronchial responsiveness to methacholine.
Sputumversusbronchoscopy for diagnosis ofPseudomonas aeruginosabiofilms in cystic fibrosis
Authors: Aaron S.D. , Kottachchi D. , Ferris W.J. , Vandemheen K.L. , St. Denis M.L. , Plouffe A. , Doucette S.P. , Saginur R. , Chan F.T. , Ramotar K.
Published: September 2004

The present authors hypothesised that bronchoscopy with protected specimen brush may sample biofilm-forming bacteria adherent to the airway wall, whereas traditional sputum collection may not.

Pseudomonas aeruginosaobtained from sputum, bronchoalveolar lavage and protected brush, taken from the right upper lung bronchus of 12 adult patients with cystic fibrosis, were compared. Retrieved bacteria were genotyped, and grown in planktonic cultures and as biofilms, and susceptibilities to individual antibiotics and to antibiotic combinations were determined.

Bacterial cultures obtained using bronchoscopy did not yield any new strains of bacteria that were not also found in sputum. A total of 10 patients (83%) had a single strain ofP. aeruginosafound using sputum, bronchoalveolar lavage and protected brush techniques, and two patients (17%) had two strains recovered in sputum, but only one strain was recovered using bronchoscopic techniques. Susceptibility to single antibiotics and to antibiotic combinations were not different between planktonically or biofilm-grown bacteria derived from sputum, as compared to those obtained by bronchoalveolar lavage and protected brush.

In conclusion, sputum collection provides as much information as bronchoscopy for characterising the genotype and antibiotic susceptibility of chronicPseudomonas aeruginosainfection in patients with stable cystic fibrosis.
Radiofrequency ablation of airway smooth muscle for sustained treatment of asthma: preliminary investigations
Authors: Cox P.G. , Miller J. , Mitzner W. , Leff A.R.
Published: September 2004

Bronchial thermoplasty is a procedure now being tested in humans for the treatment of asthma. Current studies focusing on safety are encouraging. The procedure, which causes extensive ablation of airway smooth muscle (ASM), is well tolerated, and there is a sustained reduction in airway responsiveness to methacholine. Two assumptions underlie the development of this procedure: 1) ASM is a vestigial tissue; and 2) that treatment directed at ASM alone will provide sustained symptomatic and physiological improvement in asthmatic humans. Even if this procedure is efficacious, it must be safe in the long-term. Current studies in animals and humans suggest that this is very likely to be the case.

While bronchial thermoplasty may have a broad application, especially for patients who wish for a permanent amelioration of their symptoms or have difficulty adhering to medical regimens, the compelling use of this procedure is for patients who are inadequately controlled on current drug therapy or who cannot adhere to therapeutic regimens. The application of this procedure for the treatment of asthma is currently being considered by regulatory agencies, and study centres are currently disseminated throughout North America and Europe. Within the next 1–2 yrs, a profile of the potential role of this therapy in human asthma should be developed fully.
Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness
Authors: Studer S.M. , Levy R.D. , McNeil K. , Orens J.B.
Published: September 2004

The success of lung transplantation has improved over time as evidenced by better long-term survival and functional outcomes. Despite the success of this procedure, there are numerous problems and complications that may develop over the life of a lung transplant recipient. With proper monitoring and treatment, the frequency and severity of these problems can be decreased. However, significant improvement for the overall outcomes of lung transplantation will only occur when better methods exist to prevent or effectively treat chronic rejection.
Sarcoidosis: social predictors of severity at presentation
Authors: Rabin D.L. , Thompson B. , Brown K.M. , Judson M.A. , Huang X. , Lackland D.T. , Knatterud G.L. , Yeager H. , Rose C. , Steimel J.
Published: September 2004

To determine relationships among social predictors and sarcoidosis severity at presentation, demographic characteristics, socioeconomic status, and barriers to care, A Case-Control Etiologic Study of Sarcoidosis (ACCESS) was set up.

Patients self-reported themselves to be Black or White and were tissue-confirmed incident cases aged ≥l8-yrs-old (n=696) who had received uniform assessment procedures within one of 10 medical centres and were studied using standardised questionnaires and physical, radiographical, and pulmonary function tests. Severity was measured by objective disease indicators, subjective measures of dyspnoea and short form-36 subindices.

The results of the study showed that lower income, the absence of private or Medicare health insurance, and other barriers to care were associated with sarcoidosis severity at presentation, as were race, sex, and age. Blacks were more likely to have severe disease by objective measures, while women were more likely than males to report subjective measures of severity. Older individuals were more likely to have severe disease by both measures.

In conclusion, it was found that low income and other financial barriers to care are significantly associated with sarcoidosis severity at presentation even after adjusting for demographic characteristics of race, sex, and age.
Task force on chronic interstitial lung disease in immunocompetent children
Authors: Clement A. , committee members
Published: September 2004

Chronic interstitial lung diseases in children represent a heterogeneous group of disorders of both known and unknown causes that share common histological features. Despite many efforts these diseases continue to present clinical management dilemmas, principally because of their rare frequency that limits considerably the possibilities of collecting enough cases for clinical and research studies.

Through a Task Force conducted by the European Respiratory Society, which comprised respiratory physicians and basic scientists from across Europe, 185 cases of interstitial lung diseases in immunocompetent children were collected and reviewed. The present report provides important clinically-relevant information on the current approach to diagnosis and management of chronic interstitial lung diseases in children. In addition, recommendations for the management of paediatric interstitial lung diseases, as well as new insights into interstitial lung diseases pathophysiology during childhood are discussed.
The use of alveolar epithelial type I cell-selective markers to investigate lung injury and repair
Authors: McElroy M.C. , Kasper M.
Published: September 2004

Alveolar epithelial type I cells cover most of the internal surface area of the lungs.

Ultrastructural studies demonstrate that alveolar epithelial type I cell damage is frequently observed in acute and chronic lung diseases.

This article discusses the use of cell-selective proteins as markers for the investigation of injury and repair of the alveolar epithelium. The utility of proteins specific to alveolar epithelial type I cells as diagnostic markers of alveolar epithelial injury in acute lung injury is considered, and expression of proteins selective for alveolar epithelial type I cells in lungs following injury and in fibrosis are discussed.
Country-specific cost-effectiveness of early intervention with budesonide in mild asthma
Authors: Buxton M.J. , Sullivan S.D. , Andersson L.F. , Lamm C.J. , Liljas B. , Busse W.W , Pedersen S. , Weiss K.B.
Published: September 2004

Early intervention with budesonide is an effective strategy for mild persistent asthma, which has been shown to provide additional clinical benefits at a low incremental cost using USA cost data. The present authors analysed whether this strategy would be cost-effective using cost data for other countries.

Based on the 3-yr prospective, randomised, double-blind inhaled Steroid Treatment As Regular Therapy (START) in early asthma study (comparing budesonide and placebo combined with usual asthma therapy), the cost-effectiveness was estimated separately for eight different countries, from both healthcare payer and societal perspectives, of adding budesonide to usual asthma therapy. Local unit costs were applied to data for the total trial population. Incremental cost-effectiveness ratios (ICER) were estimated as cost per symptom-free day (SFD) gained.

Budesonide increased SFDs by an average of 14.1 days annually. From a healthcare payer perspective, budesonide would reduce the total cost of asthma care in Australia. In Sweden, Canada, France, Spain, UK, China and the USA, the ICER ranged from US$2.4–11.3 per SFD. From a societal perspective, budesonide would be cost-saving in Australia, Canada and Sweden.

In conclusion, for countries where costs with budesonide are higher, the policy implication has to be determined by that health system's willingness to pay for an additional symptom-free day. However, where budesonide therapy increases symptom-free days and reduces total costs, the policy conclusion clearly favours early intervention.
An increase in exhaled nitric oxide is not associated with activity in pulmonary sarcoidosis
Authors: Ziora D. , Kałuska K. , Kozielski J.
Published: September 2004

Exhaled nitric oxide (eNO) concentration measurement may permit the noninvasive estimation of the severity of airways inflammation in respiratory tract diseases. The aim of this study was to evaluate the correlation between eNO concentration and the activity of sarcoidosis, its radiographic staging and lung function abnormalities.

eNO concentration was measured using a chemiluminescent analyser in 27 patients with sarcoidosis and 11 control subjects.

The mean eNO concentration in patients with sarcoidosis was significantly higher (6.7±0.50 parts per billion (ppb)) than that in the control group (5.17±0.73 ppb). eNO concentration was similar in radiographic stage I, II and III patients (6.53, 7.32 and 6.24 ppb, respectively). No significant difference was found in eNO concentration between the patients with active and inactive disease. Nor did eNO concentration differ between the patients with and without indication for therapy. There was no significant correlation between eNO concentration and forced vital capacity or bronchoalveolar lavage fluid lymphocyte and macrophage counts. There was a weak correlation between eNO concentration and single-breath carbon monoxide diffusing capacity of the lung.

Exhaled nitric oxide concentration is elevated in patients with sarcoidosis. This concentration does not depend on the radiographic staging, activity or progression of the disease.
Occupational asthma in newly employed workers in intensive swine confinement facilities
Authors: Dosman J.A. , Lawson J.A. , Kirychuk S.P. , Cormier Y. , Biem J. , Koehncke N.
Published: September 2004

Respiratory symptoms, reductions in pulmonary function and increased bronchial responsiveness have been described in exposed workers and in naïve volunteers exposed to intensive swine production facilities. Typically, this occurs in persons who have been employed for a long duration or in previously unexposed, naïve volunteers.

The current authors describe four cases, all female, who developed acute onset of wheezing and cough suggestive of asthma within weeks of commencing full-time employment in intensive swine production facilities.

None of the workers were aware of any previous asthma, allergies or hay fever. All four employees reported improvement of symptoms on cessation of work in the facilities and consequent withdrawal from exposure. However, when seen at the respiratory clinic, cases 1 and 3 continued to be either mildly symptomatic or were taking medications with continued borderline airways responsiveness, as measured by methacholine challenge test up to 4 and 5 months, respectively, following work cessation. Case 2 continued to have symptoms for ≥3 months after work cessation. Only case 1, however, was seen at repeated visits in the respiratory clinic. One worker participated in a work re-entry trial and experienced profound coughing and chest tightness within an hour of entry, after which, the trial had to be terminated. Provocative concentration causing a 20% fall in forced expiratory volume in one second (PC20) measured 5 h later was lower than pre-trial PC20. No acute exposure event was recorded in the workers prior to the onset of symptoms.

To the current authors' knowledge, this is the first report of occupational asthma occurring in newly employed full-time intensive swine production workers after a short-term exposure and should raise awareness that previously unexposed workers may be at risk of developing what would appear to be long-term asthma after relatively short-term exposure.
Extracellular matrix regulates human airway smooth muscle cell migration
Authors: Parameswaran K. , Radford K. , Zuo J. , Janssen L.J. , O'Byrne P.M. , Cox P.G.
Published: September 2004

Extracellular matrix proteins regulate the survival and proliferation of smooth muscle cells. Their effect on airway smooth muscle cell migration is not known.

Their role in leukotriene-primed (0.1 µM leukotriene E4) chemotaxis of cultured human airway smooth muscle cells towards platelet-derived growth factor BB (1 ng·mL−1) was investigated.

Migration of cells was greater on membranes coated with collagens III and V and fibronectin compared to collagen I, elastin and laminin (all 10 µg·mL−1). Concentration-dependent promotion of migration was observed on collagen I (1,000>10 µg·mL−1), which was associated with increased phosphorylation of Src kinase. This was not observed on laminin or elastin. The role of Src kinase was further confirmed by demonstrating that its inhibitor, PP1 analogue (1 µM), inhibited chemotaxis. Collagen I itself was not a chemoattractant; however, haptokinesis was observed when cells were primed with leukotriene E4, and haptotaxis when cells were primed with platelet-derived growth factor. The priming effect of leukotrienes on chemotaxis was not elicited by promoting adhesion, increasing surface expression of β1, αvand α5integrin, or Src kinase phosphorylation.

These experiments demonstrate that the extracellular matrix, along with growth factors and cysteinyl leukotrienes, can regulate human airway smooth muscle cell migration. This may be relevant in the remodelling process in chronic airway diseases, such as asthma.