bluuebunny/crossref_metadata_2025 huggingface dataset:
Hookworm (Necator americanus) transmission in inland areas of sandy soils in KwaZulu‐Natal, South Africa
Authors: Mabaso M. L. H. , Appleton C. C. , Hughes J. C. , Gouws E.
Published: April 2004

This study extended the association between hookworm transmission in KwaZulu‐Natal and the sandy coastal plain by investigating the parasite's occurrence in isolated areas of sandy soils further inland. A school‐based prevalence survey was carried out in selected inland sandy areas and in surrounding areas dominated by clay soils within a narrow altitudinal range of between 500 and 700 m to reduce the effect of altitude on climate‐related factors (rainfall and temperature). Sandy areas situated on the coastal plain were included in the analysis for comparative purposes. Soil samples (0–50 mm depth) were collected from each locality to assess their nematode loadings and to analyse selected physical and chemical properties. Significant differences were found between the moderate prevalence of hookworm infection among children living in inland areas with sandy soils (17.3%) and the low prevalence in surrounding non‐sandy areas (5.3%, P < 0.001), and between infection among children living in all inland areas (9.3%) and the high prevalence on the coastal plain (62.5%, P < 0.001). Amounts of fine and medium sand were highest in both the coastal plain soils and in inland sandy areas and these fractions showed a significant positive correlation with hookworm prevalence and nematode loadings. Clay, coarse sand and organic matter contents were highest in surrounding non‐sandy soils and showed a significant negative correlation with the nematode variables. No statistically significant correlations were found with soil pH at study localities. We conclude that properties of inland sandy soils, particularly particle size distribution, correlate well with hookworm prevalence and nematode loadings and therefore provide a more suitable habitat for nematodes than surrounding non‐sandy areas. These results suggest that particle size distribution of sand fractions, organic matter and clay content in the soil influence the survival of hookworm larvae and hence the parasite's transmission.
Assessing obesity and overweight in a high mountain Pakistani population
Authors: Shah Syed M. , Nanan Debra , Rahbar Mohammad H. , Rahim Musa , Nowshad Gul
Published: April 2004

Objectives  To estimate the prevalence of obesity and overweight among adults in a high mountain rural population of Pakistan, and to determine the correlates of excess body weight.

Design  Cross‐sectional study.

Methods  A random sample of 4203 adults (aged 18 years and over) was selected by stratified random sampling from 16 villages in north Pakistan. Trained medical students measured height, weight and blood pressure. Trained interviewers obtained information from participants on sociodemographic variables, use of snuff, daily cigarette consumption, hypertension and family history of hypertension. Body mass index (BMI) calculated as kg/m2 was used to define overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2).

Results  Using weight and height data available for 1391 men and 2754 women, mean BMI was 22.4 (95% CI 21.9, 22.9) for men and 22.6 (95% CI 21.9, 23.2) for women. The age‐adjusted prevalence of BMI ≥ 25 (overweight/obesity) was 13.5% for men and 14.1% for women. Overweight/obesity increased with age and the increase per year was identical for both men and women [adjusted odds ratio (AOR) = 1.01, 95% CI 1.01, 1.03]. Overweight/obese men and women were more likely to be hypertensive (men, AOR = 3.32, 95% CI 2.16, 5.09; women, AOR = 1.70, 95% CI 1.21, 2.39). Overweight/obese women were more likely to work in business or as skilled workers (AOR = 6.24, 95% CI 1.18, 32.83) while overweight/obese men were more likely to work as government employees (AOR = 2.59, 95% CI 1.66, 4.03). Family history of hypertension was a significant correlate of overweight/obesity in men (P value 0.004) and women (P value 0.000). Overweight/obese men and women were less likely to use smokeless tobacco (men, AOR = 0.65, 95% CI 0.43, 0.97; women, AOR = 0.54, 95% CI 0.35, 0.85).

Conclusion  The prevalence of risk factors for non‐communicable diseases (NCDs) in Pakistan is expected to increase as further epidemiologic, nutritional and demographic changes occur. The assessment of excess body weight, and patterns and determinants of other risk factors for NCDs is important to provide useful guidelines in the planning of interventions to counter a growing problem.
Importance of nosocomial respiratory syncytial virus infections in an African setting
Authors: Madhi Shabir A. , Ismail Kuraysha , O'Reilly Cathryn , Cutland Clare
Published: April 2004

Objective  To define the importance of nosocomial‐acquired respiratory syncytial virus (RSV) infection in an area with a high prevalence of paediatric HIV‐1 infection.

Methods  A prospective study was performed that involved all children hospitalized to a general paediatric ward during the course of an RSV epidemic. These children were screened within 24 h of admission and subsequently at 3–4 day intervals for RSV infection using a direct immunofluorescence assay.

Results  RSV was detected in 36 (11.8%) of the 305 children upon initial investigation. Fourteen (38.9%) of the 36 children with community‐acquired RSV infection were HIV‐1 infected. Repeat sampling for RSV infection was performed in 130 children who tested negative for RSV infection on initial screening and who were hospitalized for ≥3 days. Nosocomial acquisition of RSV occurred among 11.5% of these children, of whom 33% were HIV‐1 infected. Fourteen (93.3%) of the children with nosocomial RSV acquisition were clinically symptomatic and treated for ‘nosocomial‐sepsis’. Furthermore, RSV was isolated from 54% of all children who were investigated for clinically diagnosed nosocomial sepsis. Two (13%) of 15 children with nosocomial RSV infection died; both had other underlying medical conditions.

Conclusion  RSV is an important under‐recognized cause of nosocomial infection and sepsis among children in this African country. Active interventions are warranted in addressing this problem, as has been successfully undertaken in developed countries.
Improving malaria home treatment by training drug retailers in rural Kenya
Authors: Marsh V. M. , Mutemi W. M. , Willetts A. , Bayah K. , Were S. , Ross A. , Marsh K.
Published: April 2004

Recent global malaria control initiatives highlight the potential role of drug retailers to improve access to early effective malaria treatment. We report on the findings and discuss the implications of an educational programme for rural drug retailers and communities in Kenya between 1998 and 2001 in a study population of 70 000. Impact was evaluated through annual household surveys of over‐the‐counter (OTC) drug use and simulated retail client surveys in an early (1999) and a late (2000) implementation area. The programme achieved major improvements in drug selling practices. The proportion of OTC anti‐malarial drug users receiving an adequate dose rose from 8% (n = 98) to 33% (n = 121) between 1998 and 1999 in the early implementation area. By 2001, and with the introduction of sulphadoxine pyrimethamine group drugs in accordance with national policy, this proportion rose to 64% (n = 441) across the early and late implementation areas. Overall, the proportion of shop‐treated childhood fevers receiving an adequate dose of a recommended anti‐malarial drug within 24 h rose from 1% (n = 681) to 28% (n = 919) by 2001. These findings strongly support the inclusion of private drug retailers in control strategies aiming to improve prompt effective treatment of malaria.
Effector Proteins Encoded by Salmonella Pathogenicity Island 2 Interfere with the Microtubule Cytoskeleton after Translocation into Host Cells
Authors: Kuhle Volker , Jäckel Daniela , Hensel Michael
Published: April 2004

The facultative intracellular pathogen Salmonella enterica has evolved strategies to modify its fate inside host cells. One key virulence factor for the intracellular pathogenesis is the type III secretion system encoded by Salmonella Pathogenicity Island 2 (SPI2). We have previously described SPI2‐encoded SseF and SseG as effector proteins that are translocated by intracellular Salmonella. Detailed analysis of the subcellular localization of SseF and SseG within the host cell indicated that these effector proteins are associated with endosomal membranes as well as with microtubules. Specific association with microtubules was observed after translocation by intracellular Salmonella as well as after expression by transfection vectors. In epithelial cells infected with Salmonella, both SseF and SseG are required for the aggregation of endosomal compartments along microtubules and to induce the formation of massive bundles of microtubules. These observations demonstrate that SPI2 effectors interfere with the microtubule cytoskeleton and suggest that microtubule‐dependent host cell functions such as vesicle transport or organelle positioning are altered by intracellular Salmonella.
Domains of the TGN: Coats, Tethers and G Proteins
Authors: Gleeson Paul A. , Lock John G. , Luke Michael R. , Stow Jennifer L.
Published: April 2004

The trans‐Golgi network is the major sorting compartment of the secretory pathway for protein, lipid and membrane traffic. There is a constant flow of membrane and cargo to and from this compartment. Evidence is emerging that the trans‐Golgi network has multiple biochemically and functionally distinct subdomains, each of which contributes to the combined sorting and transport requirements of this dynamic compartment. The recruitment of distinct arrays of protein complexes to trans‐Golgi network membranes is likely to produce the diversity of structure and biochemistry observed amongst subdomains that serve to generate different carriers or maintain resident trans‐Golgi network components. This review discusses how these subdomains may be formed and examines the molecular players involved, including G proteins, clathrin adaptors and golgin tethers. Diversity within these protein families is highlighted and shown to be critical for the functionality of the trans‐Golgi network, as a mediator of protein sorting and membrane transport, and for the maintenance of Golgi structure.
The Ubiquitin Ligase Rsp5p is Required for Modification and Sorting of Membrane Proteins into Multivesicular Bodies
Authors: Morvan Joelle , Froissard Marine , Haguenauer‐Tsapis Rosine , Urban‐Grimal Danièle
Published: April 2004

Precursor forms of vacuolar proteins with transmembrane domains, such as the carboxypeptidase S Cps1p and the polyphosphatase Phm5p, are selectively sorted in endosomal compartments to vesicles that invaginate, budding into the lumen of the late endosomes, resulting in the formation of multivesicular bodies (MVBs). These proteins are then delivered to the vacuolar lumen following fusion of the MVBs with the vacuole. The sorting of Cps1p and Phm5p to these structures is mediated by ubiquitylation, and in doa4 mutant cells, which have reduced level of free ubiquitin, these proteins are missorted to the vacuolar membrane. A RING‐finger ubiquitin ligase Tul1p has been shown to participate in the ubiquitylation of Cps1p and Phm5p. We show here that the HECT‐ubiquitin ligase Rsp5p is also required for the ubiquitylation of these proteins, and therefore for their sorting to MVBs. Rsp5p is an essential ubiquitin ligase containing an N‐terminal C2 domain followed by three WW domains, and a C‐terminal catalytic HECT domain. In cells with low levels of Rsp5p (npi1 mutant cells), vacuolar hydrolases do not reach the vacuolar lumen and are instead missorted to the vacuolar membrane. The C2 domain and both the second and third WW domains of Rsp5p are important determinants for sorting to MVBs. Ubiquitylation of Cps1p was strongly reduced in the npi1 mutant strain and ubiquitylation was completely abolished in the npi1 tul1Δ double mutant. These data demonstrate that Rsp5p plays a novel and key role in intracellular trafficking, and extend the currently very short list of substrates ubiquitylated in vivo by several different ubiquitin ligases acting cooperatively.
Successful transcatheter arterial embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac axis stenosis
Authors: KOBAYASHI TOSHIHIKO , UENOYAMA SHOICHI , ISOGAI SATOSHI
Published: April 2004

Abstract  A case of inferior pancreaticoduodenal artery (IPDA) aneurysm associated with celiac axis stenosis was successfully treated using only transcatheter arterial embolization (TAE). A 57‐year‐old woman was urgently referred to our hospital with sudden abdominal pain; computed tomography revealed retroperitoneal hematoma due to bleeding from an aneurysm around the superior mesenteric artery (SMA). Selective angiography into the SMA showed an aneurysm derived from the IPDA posterior branch; the IPDA anterior branch was intact and contrast medium flowed into the common hepatic artery territory through the pancreatic arcade because of celiac axis stenosis. We subsequently performed TAE on the lesion. Arteriography after TAE showed that the aneurysm had disappeared and that the IPDA anterior branch was intact. She had no aneurysm recurrence for about two years after the treatment. We believe that TAE is effective even for a PDA aneurysm with celiac axis stenosis or occlusion. However, it is important to perform embolization precisely and over a long period.
Structural and functional analysis of full‐length hepatitis B virus genomes in patients: Implications in pathogenesis
Authors: WEN YU‐MEI
Published: April 2004

The structural analysis, replicative efficiency and immunogenicity of hepatitis B virus (HBV) full‐length genomes isolated from different patients or asymptomatic carriers are presented in the present review. Data indicate the importance of viral genome‐based studies in elucidating the pathogenesis of HBV infections. Comparison of structural and functional characteristics of viral genomes isolated from various geographical regions might contribute to explaining the differences in HBV clinical manifestation and prognosis in different geographical regions.
Expression of cyclooxygenase‐2 in cholangiocarcinoma: Correlation with clinicopathological features and prognosis
Authors: KIM HONG JOO , LEE KYU TAEK , KIM EUN KYUNG , SOHN TAE SUNG , HEO JIN SEOK , CHOI SEONG HO , CHOI DONG IL , LEE JONG KYUN , PAIK SEUNG WOON , RHEE JONG CHUL
Published: April 2004

Background and Aims:  No information is available on the nature of the correlation between cyclooxygenase‐2 (COX‐2) expression and the clinicopathological features and prognosis of cholangiocarcinoma (CC). The goal of the present study was to determine the possible roles and clinical significance of COX‐2 expression in CC.

Methods:  We investigated the immunohistochemical expression of COX‐2 in 102 patients with CC with respect to clinicopathological characteristics, namely evidence of Clonorchis sinensis infection, proliferation index (PI, assessed by Ki‐67 expression), apoptotic index (AI, assessed by TUNEL stain), and microvessel density (MVD, assessed by CD34 expression). Evidence of C. sinensis infection was assessed by the microscopic examination of stools for C. sinensis ova, serological testing (ELISA), and the detection of peripheral bile duct dilations by imaging studies.

Results:  An immunohistochemical investigation demonstrated the immunolabeling of tumor cells, mainly in the cytoplasmic and perinuclear regions, in 53 (52%) of the 102 patients with CC. No significant differences were found in terms of age, sex, tumor differentiation, involvement of the resection margin, presence of lymph nodes or liver metastases, or in pTNM stage between COX‐2 positive and COX‐2 negative patients. However, evidence of C. sinensis infection was more common in COX‐2 positive patients (P < 0.05). No significant differences were found for PI, AI, MVD, or cumulative survival between COX‐2 positive and COX‐2 negative patients.

Conclusion:  Clonorchis sinensis infection is related to aberrant COX‐2 expression in patients with CC. However, COX‐2 expression is not related to clinical outcome in CC patients.
Contrast‐free unilateral endoscopic palliation in malignant hilar biliary obstruction: New method
Authors: SINGH V , SINGH G , VERMA GR , SINGH K , GULATI M
Published: April 2004

Background:  Bilateral endoscopic drainage is difficult in malignant hilar biliary obstruction. Recently, unilateral drainage in malignant hilar biliary obstruction has been shown to be equally effective. However, contrast injection leads to cholangitis. There have been no reported studies on contrast‐free metal stenting in malignant hilar biliary obstruction. The present study was undertaken to evaluate the results of contrast‐free unilateral metal stenting in type II malignant hilar biliary obstruction.

Methods:  We prospectively studied the results of unilateral metal stenting in type II malignant hilar biliary obstruction without contrast injection in 18 patients.

Results:  A successful endoscopic drainage was achieved in 100% (18/18) of patients with hilar strictures. Cholangitis and 30‐day mortality occurred in none.

Conclusions:  Unilateral endoscopic metal stenting without contrast in type II malignant hilar biliary obstruction is a safe and effective method of palliation.
Mucosal irritative and healing impairment action of risedronate in rat stomachs: Comparison with alendronate
Authors: KANATSU KENJI , AIHARA EITARO , OKAYAMA MITUAKI , KATO SHINICHI , TAKEUCHI KOJI
Published: April 2004

Background and Aim:  We used alendronate and risedronate as bisphosphonates and examined whether or not these agents have a mucosal irritative action in the stomach and impair the healing of pre‐existing gastric ulcers in rats.

Methods:  Male Sprague Dawley (SD) rats were used in the following two studies: (i) the effects of risedronate and alendronate on gastric potential difference (PD), gastric mucosal blood flow (GMBF) and acid back‐diffusion in the stomach mounted on ex vivo chamber under urethane anesthesia and; (ii) the influence of daily treatment with these drugs on the healing of acetic acid‐induced gastric ulcers was examined.

Results:  Mucosal application of risedronate produced PD reduction in the saline‐perfused stomachs in a dose‐dependent manner. Alendronate also produced a marked PD reduction, the effect being more potent than that of risedronate. In the stomach exposed to acid (100 mM HCl), both drugs produced a marked reduction in PD, followed by acid back‐diffusion and a small increase in GMBF, resulting in hemorrhagic lesions, and the effects again were more pronounced with alendronate. These irritative effects were dependent on the pH of drug solution and the action was more potent at pH 7 than pH 4. Conversely, the healing of acetic acid‐induced gastric ulcers was significantly delayed by daily administration of these drugs, yet this effect was less pronounced in the case of risedronate. The healing impairing effect of these bisphosphonates was potentiated by coadministration of indomethacin.

Conclusion:  Both alendronate and risedronate have mucosal irritative and healing impairing effects in the stomach, yet the effect of risedronate was much less pronounced compared to alendronate. It is assumed that risedronate is safer than alendronate as the antiresorptive agent in patients with diseases related to bone remodeling.
Helicobacter pylori and gastrointestinal symptoms in school children in Russia
Authors: NIJEVITCH ALEXANDER A , SHCHERBAKOV PETER L
Published: April 2004

Background and Aims:  Helicobacter pylori is considered to be the major cause of chronic gastritis and duodenal ulcer disease recurrence in childhood. However, the association between H. pylori and recurrent abdominal pain (RAP) syndrome is still controversial. Therefore, the spectrum of clinical variants of gastrointestinal symptoms associated with H. pylori‐positive status was studied in consecutive symptomatic children who were undergoing diagnostic endoscopy.

Methods:  A consecutive series of 225 school children from the Ural area of Russia (mean age 11.1 + 1.4 years, age range 7–15 years) who presented with RAP were investigated using esophagogastroduodenoscopy, including three antral biopsies for histology and polymerase chain reaction. Helicobacter pylori immunoglobulin G antibodies were found using a second‐generation enzyme immunoassay. Information about the clinical symptoms was collected using a special questionnaire.

Results:  The authors found a high incidence of H. pylori infection (80%) and peptic ulcers (16%) in 225 school children from the Ural area of Russia who were referred for upper gastrointestinal (UGI) endoscopy for chronic abdominal pain. Of the overall 225 symptomatic children who underwent endoscopy, 182 (80,8%) were found to be H. pylori‐positive. Duodenal ulcers were detected in 36 H. pylori‐positive children. A family history of peptic ulcers was significantly more frequent in the children infected with H. pylori (P < 0.001). Symptom score and duration of symptoms were similar, but night‐time pain (P < 0.0001) and fasting pain relieved by food (P < 0.001) were more frequent in the H. pylori‐positive children as compared with the H. pylori‐negative children.

Conclusions:  The present results provide further evidence for a significant association between H. pylori and some patterns of gastrointestinal symptoms in children who underwent UGI endoscopy in order to exclude an organic cause of severe chronic gastrointestinal disorders.
Double point mutation in the core promoter region of hepatitis B virus (HBV) genotype C may be related to liver deterioration in patients with chronic HBV infection
Authors: NAKASHIMA HISASHI , FURUSYO NORIHIRO , KUBO NORIHIKO , KASHIWAGI KENICHIRO , ETOH YOSHITAKA , KASHIWAGI SEIZABUROU , HAYASHI JUN
Published: April 2004

Background and Aim:  Hepatitis B virus (HBV) genotype C has a more severe pathogenesis than genotype B in Japan. We retrospectively investigated the relationship between HBV genotype and the core promoter (CP) (nt 1762 and 1764) and precore (PreC) (nt 1896) mutations of the HBV genome.

Methods:  A total of 129 Japanese patients (42 genotype B and 87 genotype C) with chronic HBV infection, living in two different geographical areas in Japan, were evaluated (mean follow‐up period 10.1 ± 3.8 years). In 2000, CP and PreC HBV mutations were analyzed by direct sequencing from sera. Hepatitis B e antigen (HBeAg), HBV DNA and serial alanine aminotransferase (ALT) changes were followed and determined using serological methods.

Results:  Genotype C patients had significantly higher rates of HBeAg (40.2%vs 2.4%), HBV DNA positivity (75.9%vs 7.1%) and ALT abnormality (71.3%vs 11.9%) than genotype B patients (all P < 0.05). Among genotype B patients, CP wild type (92.9%) was predominant and PreC mutation (88.1%) was predominant. However, among genotype C patients, CP mutation (75.9%) was predominant and PreC mutation (66.7%) was predominant. The CP mutation was found significantly more in genotype C than in genotype B (P < 0.05). Of the 67 patients with ALT abnormality, five (7.5%) genotype B and 62 (92.5%) genotype C patients (31 HBeAg positive and 31 negative) were found. Among the 31 genotype C patients who were HBeAg positive, the combination of CP mutation and PreC wild (54.8%) was predominant, while among the remaining 31 genotype C patients who were HBeAg negative, the combination of CP mutation and PreC mutant (71.0%) was predominant.

Conclusion:  Genotype C might be one of the worse prognostic markers in patients with chronic HBV infection, possibly because of mutation in the CP region.
Lafutidine inhibits Helicobacter pylori‐induced interleukin‐8 production in human gastric epithelial cells
Authors: NOZAWA YOSHIHISA , NISHIHARA KATSUSHI , AKIZAWA YUSHIRO , ORIMOTO NAOKI , NAKANO MOTOKO , UJI TATSUYA , AJIOKA HIROFUSA , KANDA ATSUHIRO , MATSUURA NAOSUKE , KINIWA MAMORU
Published: April 2004

Background and Aim:  Attachment of Helicobacter pylori to gastric epithelial cells leads to the production of chemokines, such as interleukin‐8 (IL‐8), which in turn activate and recruit neutrophils to the site of infection. Lafutidine [(+/–)‐2‐(furfurylsulfinyl)‐N‐(4‐(4‐(piperidinomethyl)‐2‐pyridyl)oxy‐(Z)‐2‐butenyl)acetamide] is a new type of antiulcer drug that possesses an antisecretory action as well as gastroprotective activity, independent of its antisecretory action. In the present study, we examined the effects of lafutidine on H. pylori‐induced IL‐8 release and H. pylori adhesion to MKN45 cells.

Methods:  MKN45 cells were stimulated with H. pylori, tumor necrosis factor (TNF)‐α, or IL‐1β, then IL‐6 and IL‐8 levels in the culture supernatants were determined with a specific enzyme‐linked immunosorbent assay kit.

Results:  Lafutidine significantly inhibited both the release of IL‐8 induced by H. pylori and the adhesion of H. pylori to cells in a dose‐dependent manner. These properties of lafutidine are unrelated to the blockade of histamine H2‐receptors, because the same effects have not been observed with other H2‐receptor antagonists, such as cimetidine and famotidine. Lafutidine also significantly inhibited H. pylori‐induced IL‐6 release. Both TNF‐α and IL‐1β‐induced IL‐8 releases, conversely, were little affected by lafutidine up to a concentration of 10−5 M.

Conclusions:  These results suggest that lafutidine inhibits IL‐8 release by inhibiting H. pylori adherence to gastric epithelial cells, indicating a novel mechanism by which lafutidine protects against the mucosal inflammation associated with H. pylori infection.
Mucosal concentration of basic fibroblast growth factor in the healing process in human giant gastric ulcers
Authors: MIZUKI AKIRA , TATEMICHI MASAYUKI , NISHIYA HIROMI , FUKUI KAZUTO , HAYASHI TATSUHIKO , TSUKADA NOBUHIRO , NAGATA HIROSHI , ISHII HIROMASA
Published: April 2004

Objectives:  Basic fibroblast growth factor (bFGF) is a key factor in the healing of human and experimental peptic ulcers, but the behavior of bFGF in human giant gastric ulcer remains to be determined. We determined the bFGF content in the rim of giant ulcers (bFGF rim) and in non‐ulcerated mucosa located opposite the ulcer (bFGF opposite) before and during treatment.

Methods:  Biopsy specimens were endoscopically obtained from 31 patients with giant gastric ulcers and 17 patients with small ulcers before and 2, 4 and 8 weeks after treatment. The bFGF concentrations in the specimens were measured using a sandwich enzyme immunoassay.

Results:  Before treatment, the bFGF rim and bFGF opposite concentrations were not associated with ulcer size. The bFGF rim concentration before treatment in the rapid healing group was higher than that in the slow healing group, but no significant difference in bFGF opposite concentrations were found between the two groups. The bFGF rim concentration in the rapid healing patients decreased during treatment, while the slow healing patients showed an inverse response. The bFGF opposite concentration did not change during treatment and bFGF rim concentrations in Helicobacter pylori‐positive stomachs were significantly lower than those in H. pylori‐negative stomachs.

Conclusions:  The bFGF rim concentration is not involved in the formation of giant gastric ulcers in humans. However, the bFGF rim concentration does appear to promote healing. The bFGF opposite concentration is not related to either the formation or healing of giant gastric ulcers.
The efficacy of couples‐based interventions for panic disorder with agoraphobia
Authors: Byrne Michael , Carr Alan , Clark Marie
Published: April 2004

From this systematic literature review it was concluded that panic disorder with agoraphobia (PDA) can sometimes occur in conjunction with marital problems. Couples‐based treatments for PDA – partner‐assisted exposure and marital therapy – can be an effective treatment for the condition. It is as effective as individually based cognitive behaviour therapy. Involving partners of people with PDA in therapy may be appropriate in some cases, particularly those in which there are marital difficulties. Couple‐focused interventions may enhance the maintenance of treatment gains by facilitating interactions that positively reinforce and perpetuate attempts by people with PDA to enter feared situations and cope with these effectively. People with PDA who have good marital relationships show a better response to both individual and couples‐based treatment programmes. In some instances effective couples‐based treatment leads to improvement in marital adjustment as well as in PDA symptomatology.
Significant and other: systemic family therapists on lesbians and gay men
Authors: Malley Maeve , Tasker Fiona
Published: April 2004

This paper discusses a questionnaire survey done with a sample of 130 systemic family therapists, which investigated their training in, and experience of, working with lesbian and gay male clients and attitudes towards lesbians and gay men using the Index of Attitudes to Homosexuals. The findings indicate that the majority of respondents had received relatively little training in working with this client group within their systemic training. It also indicated that their attitudes towards lesbians and gay men generally may have been influenced by the degree of social, professional or familial contact that they had with them.
Monitoring Elite Capture in Community‐Driven Development
Authors: Platteau Jean‐Philippe
Published: April 2004

Recently, a lot of attention has been paid to improving ways of assessing the effectiveness of development interventions. This is to be welcomed, especially with regard to community‐based or participatory aid projects, since considerable resources are currently being earmarked for these by almost all types of donor agencies, including large international organizations. Such projects are vulnerable to elite capture at local level, and this problem must be mitigated if most of the aid funds thus disbursed are to reach the intended beneficiaries. This article discusses several methods available to achieve that objective. In particular, it argues that the sequential and conditional release of aid funds may not be sufficient to keep elite capture well under control, making it necessary to resort to co‐ordination mechanisms among aid agencies, such as multilateral reputation mechanisms. Even these are not going to be effective enough, however. In the end, an active role will have to be played by the ultimate purveyors of aid money, whether the taxpayers or the contributors in fund‐raising campaigns.
War, Livelihoods and Vulnerability in Sri Lanka
Authors: Korf Benedikt
Published: April 2004

As the number of de‐stabilized regions of warfare or post‐war conditions worldwide continues to grow, this article investigates how civilians survive in the context of a civil war. It analyses livelihood strategies of farmers in the war‐torn areas of Sri Lanka, using an analytical framework based on a revised form of DFID's sustainable rural livelihoods approach, placing particular attention on the institutional reproduction of household capital assets in the war economy. The author delineates a three pillar model of household livelihood strategies focusing on how households (1) cope with the increased level of risk and uncertainty; (2) adjust their economic and social household assets for economic survival; and (3) use their social and political assets as livelihood strategies. Empirical evidence comes from four case study villages in the east of Sri Lanka. Although the four case studies were very close together geographically, their livelihood outcomes differed considerably depending on the very specific local political geography. The role of social and political assets is essential: while social assets (extended family networks) were important to absorb migrants, political assets (alliances with power holders) were instrumental in enabling individuals, households or economic actors to stabilize or even expand their livelihood options and opportunities. The author concludes that civilians in conflict situations are not all victims (some may also be culprits in the political economy of warfare), and that war can be both a threat and an opportunity, often at the same time.
Participatory Watershed Development in India: Can it Sustain Rural Livelihoods?
Authors: Ratna Reddy V. , Gopinath Reddy M. , Galab S. , Soussan John , Springate‐Baginski Oliver
Published: April 2004

The purpose of this article is to assess the impact of policy interventions through watershed development (WD) on the livelihoods of the rural communities. This is done by assessing the programme in the context of a sustainable rural livelihoods framework, that is, looking at its impact on the five types of capital assets and strategies required for the means of living. The article also examines the vulnerability and stability of these capital assets, as well as analysing which people participate in the programme and enhance their livelihoods through sharing its benefits. In the light of the analysis, it is argued that watershed development holds the potential for enhanced livelihood security even in geo‐climatic conditions where the watershed cannot bring direct irrigation benefits on a large scale. In such fragile environments, however, watershed development is a necessary but not a sufficient condition for sustaining rural livelihoods. While the focus of watershed development is primarily on strengthening the ecological base such as water bodies (including traditional tanks), grazing lands and wastelands, it should be complemented with other programmes which focus on landless poor households in order to make it pro‐poor. In the context of low rainfall regions where improvement in irrigation facilities is slow, agriculture alone cannot support the communities. Policies and programmes should aim at creating an environment for diverse livelihood activities, which are the choice of the household rather than distress activities.
Difficult but Not Impossible: The ANC's Decentralization Strategy in South Africa
Authors: Niksic George
Published: April 2004

As the neo‐liberal project has spread across the globe, decentralization has been a key component of it. In South Africa, the neo‐liberal macro‐economic strategy of the African National Congress (ANC) involves support for fiscal and administrative decentralization partly as a way to bring the private sector into basic service delivery and supposedly to make local government more efficient and effective. However, the ANC also sees decentralization as a way to empower the historically disadvantaged black population. Community‐based public–private partnerships have been one of the chief initiatives in this regard. In the metropolitan municipality of Port Elizabeth, small black contracting companies have been hired and trained to dispose of waste, construct roads and build houses. While not free of tensions and problems, this approach to decentralization has fostered a form of democratic development. This article uses examples from the Port Elizabeth experience to test and reflect upon a number of issues which are raised in the literature on decentralization.
Disciplining Subjectivity and Space: Representation, Film and its Material Effects
Authors: England Jennifer
Published: April 2004

Although the distinction between representation and reality is increasingly blurred, I argue that representational discourses have material effects in everyday life. By moving “outside the text” I trace the messy terrain between visual discourse and everyday life in Downtown Eastside, Vancouver by examining two questions: (1) how do discursive productions of visual culture articulate, inscribe, and discipline space and subjectivity and (2) how do aboriginal women negotiate the material consequences of those representations? Using discourse and feminist analysis, I analyse how a documentary film, produced by the Vancouver Police Department, constructs spaces and subjectivities of deviance through techniques of realism and the moral gaze of the police officers. I argue that aboriginal women negotiate these deviant representations through their experiences of racism and sexism by police officers. Consequently, aboriginal women are rendered either hyper‐visible or invisible by police officers, marked by their gender, race, and class. Combining an analysis of the documentary film and in‐depth interviews with aboriginal women, I argue that critical geographers must consider the analytical spaces “outside of the text” to explore the material effects of visual representations.
Evaluating ecosystem responses to rising atmospheric CO2 and global warming in a multi‐factor world
Authors: Norby Richard J. , Luo Yiqi
Published: April 2004

Analyses of ecosystem responses to global change must embrace the reality of multiple, interacting environmental factors. Ecosystem models demonstrate the importance of examining the combined effects of the gradually rising concentration of atmospheric CO2 and the climatic change that attends it. Models to forecast future changes need data support to be useful, and data–model fusion has become essential in global change research. There is a wealth of information on plant responses to CO2 and temperature, but there have been few ecosystem‐scale experiments investigating the combined or interactive effects of CO2 enrichment and warming. Factorial experiments to investigate interactions can be difficult to design, conduct, and interpret, and their results may not support predictions at the ecosystem scale – in the context of global change they will always be case studies. An alternative approach is to gain a thorough understanding of the modes of action of single factors, and rely on our understanding (as represented in models) to inform us of the probable interactions. Multifactor (CO2 × temperature) experiments remain important, however, for testing concepts, demonstrating the reality of multiple‐factor influences, and reminding us that surprises can be expected.
Familial Migraine With Aura: Association Study With 5‐HT1B/1D, 5‐HT2C, and hSERT Polymorphisms
Authors: Racchi Marco , Leone Massimo , Porrello Emanuela , Rigamonti Andrea , Govoni Stefano , Sironi Marita , Montomoli Cristina , Bussone Gennaro
Published: April 2004

Background.—The serotonergic system has a significant role in the pathophysiology and pharmacology of migraine.

Objective.—To study the association between the occurrence of migraine with aura and 5‐HT1B/1D and 5‐HT2C receptor gene and the human serotonin transporter (hSERT) gene polymorphisms in 18 unrelated families with multiple affected members.

Method.—Two polymorphisms in the 5‐HT1B/1D receptor gene and one polymorphism in the 5‐HT2C receptor gene were studied by restriction fragment length polymorphism analysis. Allelic variation of the hSERT, with 9, 10, and 12 copies of a “repetitive element,” was studied by polymerase chain reaction amplification of the variable number tandem repeat region.

Results.—Allelic distribution of 5‐HT1B/1D and 5‐HT2C receptor gene polymorphisms in affected patients did not differ in either of the control groups (unaffected relatives or unrelated healthy individuals). A trend toward a significant effect of the 12‐repeat hSERT allele as a risk factor for migraine with aura versus unrelated controls was observed.

Conclusion.—Our data do not support the involvement of 5‐HT1B/1D and 5‐HT2C receptor gene polymorphisms in migraine with aura, yet do suggest a possible role for a locus at or near the hSERT gene in the susceptibility to migraine with aura.
Electroacupuncture for Tension‐type Headache on Distal Acupoints Only: A Randomized, Controlled, Crossover Trial
Authors: Xue C. C. L. , MApplSc L. Dong , Polus B. , English R. A. , Zheng Z. , Costa C. Da , Li C. G. , Story D. F.
Published: April 2004

Objective.—To investigate the efficacy of electroacupuncture, applied to distal acupoints only, for tension‐type headache.

Background.—Electroacupuncture is commonly used for tension‐type headache, but when applied to distal acupoints only, evidence of its efficacy is lacking.

Design.—A randomized, single‐blinded, sham‐controlled, crossover clinical trial.

Methods.—The trial had 5 stages: baseline (2 weeks), phases I and II (each 4 weeks), washout period (2 weeks), and follow‐up (3 months after phase II). Forty patients were randomly assigned to either group A or group B. Group A received real electroacupuncture during phase I, then sham electroacupuncture in phase II. Group B received the treatments in reverse order. Outcome measures were headache frequency and duration, pain intensity using a visual analog scale, mechanical pain threshold, headache disability, and sickness impact. Data were analyzed by univariate 2‐way analysis of variance.

Results.—Thirty‐seven patients completed the trial. There were no significant differences between the 2 groups at baseline. At the end of phase I, group A, but not group B, demonstrated significant improvement in mean (standard error of the mean [SEM]) headache frequency (3.0 per month [0.3] versus 12.0 per month [1.7]), duration (13.3 hours [3.5] versus 32.0 hours [6.2]), pain intensity (32.8 mm [4.1] versus 47.5 mm [2.7]), pain threshold (right side, 2.9 kg/second [0.1] versus 0.9 kg/second [0.1]; left side, 2.4 kg/second [0.1] versus 1.1 kg/second [0.1]), headache disability score (6.0 [1.0] versus 16.3 [1.6]), and sickness impact score (288.7 [48.0] versus 687.1 [77.2]). For each parameter, significant differences also were demonstrated for both groups between baseline and phase II, and baseline and follow‐up. There were no significant differences between the groups at the end of follow‐up (P > .05).

Conclusion.—Electroacupuncture to distal points alone is effective for short‐term symptomatic relief of tension‐type headache.
Sympathetic Skin Response in Migraineurs and Patients With Medication Overuse Headache
Authors: Atasoy Huseyin T. , Atasoy Nuray , Unal Aysun E. , Sumer Murat
Published: April 2004

Background.—Autonomic dysfunction has been reported in patients with migraine, and it may play a role in promoting attacks.

Objective.—To investigate changes in the autonomic function of migraineurs and patients with medication overuse headache via sympathetic skin response, and to determine whether psychiatric comorbidity is related to any changes recorded.

Methods.—A consecutive series of patients with migraine (n = 45) and medication overuse headache (n = 53) were studied. Patients with other chronic diseases requiring medication were excluded. Sympathetic skin response latencies and amplitudes from the patients with headache (N = 98) and 40 healthy controls were compared statistically.

Results.—Sympathetic skin response latencies in patients with medication overuse headache and in migraineurs were significantly longer than in controls. To analyze the effect of psychiatric comorbidity, patients with medication overuse headache and migraineurs were each divided into 2 groups: those with psychiatric comorbidity and those without comorbidity. When the sympathetic skin response results of these 4 groups were compared with controls, the only statistically significant difference was between the sympathetic skin response latencies of controls and the latencies of patients with psychiatric comorbidity. We could not find any difference between the results from patients without psychiatric comorbidity and those of controls.

Conclusion.—Psychiatric disease may affect the results of autonomic function testing in migraineurs and patients with medication overuse headache. Consideration should be given to excluding patients with psychiatric comorbidity from studies investigating autonomic dysfunction in patients with headache.
Inpatient Treatment of Headache: An Evidence‐Based Assessment
Authors: Freitag Frederick G. , Lake Al , Lipton Richard , Cady Roger ,   US Headache Guidelines Consortium, Section on Inpatient Treatment Chairpersons, Diamond Seymour , Silberstein Stephen
Published: April 2004

Objective.—To evaluate inpatient treatment of headache in the United States.

Participants.—

Evidence.—

Conclusions.—
Prednisolone‐Responsive Headache in Patients With Solitary Cysticercus Granuloma and Seizures
Authors: Garg Ravindra Kumar , Kar Alok Mohan , Singh Maneesh Kumar
Published: April 2004

Background.—Solitary cysticercus granuloma is the commonest imaging abnormality in Indian patients with new‐onset seizures. Few patients, in addition, complain of disabling headache.

Objective.—To report our experience of 16 patients with new‐onset headache, seizures, and solitary cysticercus granuloma.

Methods.—Sixteen consecutive patients, who had moderate to severe new‐onset headache and fulfilled the diagnostic criteria of solitary cysticercus granuloma, were included in the study. The inclusion criteria were: occurrence of seizures, minimal or no neurologic deficit, absence of papilledema, no evidence of any systemic disorder, and computed tomography showing a single ring/disk‐enhancing lesion of <20 mm in diameter. Patients received antiepileptic monotherapy, oral analgesics, and prednisolone (1.5 mg/kg/day for 7 days). Prednisolone was then tapered over the next 7 days. Patients were followed for 6 months. Follow‐up computed tomography was performed after 2 months; in all 16 patients, the scans showed complete disappearance of the lesion.

Results.—After 14 days (at first follow‐up), all patients reported significant improvement in headache. Follow‐up after 2 months revealed that all patients were headache‐free. None of the patients reported any recurrence of headache.

Conclusion.—This open‐label study suggests the effectiveness of prednisolone for disabling headache in Indian patients with solitary cysticercus granuloma and seizures. There is a need, however, for more scientifically rigorous studies for further confirmation of our results.
Menstrual Cycle and ST Height
Authors: Endres Susanne , Mayuga Kenneth A. , Cristofaro Alessandro de , Taneja Taresh , Goldberger Jeffrey J. , Kadish Alan H.
Published: April 2004

Background: Sex hormones and menstrual cycle effects on ST height have not yet been clearly identified.

Methods: Twenty‐two young, healthy women (aged 22–32 years) were included in this study. Twelve‐lead ECGs were registered during menses, follicular and luteal phase of the menstrual cycle at baseline, and after double autonomic blockade (DAB). Chest leads V2–V4 and limb leads I and II were chosen for analysis. ST height was measured manually at J‐Point and 40 ms after the J‐Point, and values were corrected for QRS amplitude (J‐Point/QRS, 40 ms/QRS). Repeated measure ANOVA was used to analyze differences in ST height among the three phases of the menstrual cycle. A P‐value < 0.05 was considered as significant.

Results: At baseline, ST height, QTc, and T wave amplitude were not significantly different among the three phases of the menstrual cycle. After double autonomic blockade, ST height at 40 ms, J‐Point/QRS, and 40 ms/QRS was significantly higher during follicular versus luteal phase (0.152 ± 0.413 mm versus −0.007 ± 0.427 mm, P = 0.0059 at 40 ms; −0.001 ± 0.030 versus −0.015 ± 0.032, P = 0.0039 at J‐Point/QRS; 0.013 ± 0.031 versus −0.004 ± 0.032, P = 0.0005 at 40 ms/QRS) as was the QTc. ST height differences at J‐Point were not significantly different (−0.046 ± 0.395 mm follicular, −0.167 ± 0.448 mm luteal, and −0.083 ± 0.492 mm menses, P = 0.1014).

Conclusion: ST height and QTc varied among the three phases of the menstrual cycle, predominantly after double autonomic blockade. Female sex hormones that vary throughout the menstrual cycle may modulate measures of repolarization.