bluuebunny/crossref_metadata_2025 huggingface dataset:
The Silent Sinus Syndrome: A Case Series and Literature Review
Authors: Vander Meer Joseph B. , Harris Gerald , Toohill Robert J. , Smith Timothy L.
Published: September 2004

Purpose The purpose of this study is to describe the clinical and pathologic features of a form of chronic maxillary atelectasis referred to as the silent sinus syndrome, which is characterized by progressive enophthalmos secondary to maxillary collapse resulting from maxillary sinus hypoventilation.

Methods A retrospective medical record analysis was carried out to identify patients with enophthalmos secondary to maxillary collapse. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A complete literature review for relevant studies was performed to examine possible pathophysiology and similar cases.

Results Four patients with enophthalmos and asymptomatic maxillary sinus disease were identified. On computed tomography, all four of the patients had opacified, partially collapsed maxillary sinuses with osteopenia of the sinus walls and orbital floor displacement resulting in enophthalmos. All four underwent successful functional endoscopic sinus surgery and transconjunctival orbital floor repair.

Conclusion In some instances, chronic maxillary atelectasis can present with enophthalmos secondary to collapse of the maxillary sinus. For reasons that are unclear, the sinus component of the disease remains asymptomatic and is discovered only after thorough evaluation of the enophthalmos.
Laryngopharyngeal Reflux Symptoms Improve Before Changes in Physical Findings
Authors: Belafsky Peter C. , Postma Gregory N. , Koufman James A.
Published: September 2004

Background Patients with laryngopharyngeal reflux (LPR) undergoing treatment appear to have improvement in symptoms before the complete resolution of the laryngeal findings.

Objective To determine whether patients with LPR experience an improvement in symptoms before the complete resolution of the laryngeal findings.

Methodology Forty consecutive patients with LPR documented by double‐probe pH monitoring were evaluated prospectively. Symptom response to therapy with proton pump inhibitors was assessed at 2, 4, and 6 months of treatment with a self‐administered reflux symptom index (RSI). In addition, transnasal fiberoptic laryngoscopy (TFL) was performed and a reflux finding score (RFS) was determined for each patient at each visit.

Results The mean RSI at entry was 19.3 (± 8.9 standard deviation) and it improved to 13.9 (± 8.8) at 2 months of treatment (P <.05). No further significant improvement was noted at 4 months (13.1 ± 9.8) or 6 months (12.2 ± 8.1) of treatment. The RFS at entry was 11.5 (± 5.2), and it improved to 9.4 (± 4.7) at 2 months, 7.3 (± 5.5) at 4 months, and 6.1 (± 5.2) after 6 months of treatment (P <.05 with trend).

Conclusions Symptoms of LPR improve over 2 months of therapy. No significant improvement in symptoms occurs after 2 months. This preliminary report demonstrates that the physical findings of LPR resolve more slowly than the symptoms and this continues throughout at least 6 months of treatment. These data imply that the physical findings of LPR are not always associated with patient symptoms, and that treatment should continue for a minimum of 6 months or until complete resolution of the physical findings.
Benign Positional Vertigo Without Detectable Nystagmus
Authors: Tirelli Giancarlo , D'Orlando Elena , Giacomarra Vittorio , Russolo Mario
Published: September 2004

Objectives To demonstrate that for treatment of benign positional vertigo it is not necessary to identify a positional nystagmus.

Study Design Prospective trial of 43 patients with positional vertigo without clinical evidence of positional nystagmus who were treated with a modified canal‐repositioning maneuver.

Methods Results were compared with the results obtained in the treatment of posterior semicircular cupolo‐canalithiasis with typical positional nystagmus with the same repositioning maneuver.

Results Treatment of 43 patients with positional vertigo without positional nystagmus resulted in a 60.46% (26/43) complete recovery rate and a 6% (3/43) persistence of disorder rate compared with a 90% complete recovery rate obtained in 90 patients with typical benign positional paroxysmal vertigo (with positional nystagmus).

Conclusions What is attempted by this work is to confirm that through clinical evaluation based on history and positioning tests alone, one can obtain acceptable results in treatment of supposed canalithiasis without having detected the pathognomonic nystagmus.
Selective Vestibular Ablation by KTP Laser in Endolymphatic Hydrops
Authors: Adamczyk Melanie , Antonelli Patrick J.
Published: September 2004

Objectives and Hypothesis Vertigo, the cause of disability in many patients with Ménière's disease, may be the result of the effects of endolymphatic hydrops on the semicircular canals. We hypothesize that intractable vertigo may be controlled by destruction of the semicircular canal neuroepithelium using visible light lasers without the need for extensive fenestration of the bony labyrinth. This study was designed to assess the cochlear effects of potassium titanyl phosphate (KTP) laser‐assisted triple semicircular canal ablation (TSCA) in endolymphatic hydrops.

Study Design Randomized, prospective, and controlled.

Methods Forty‐one adult guinea pigs underwent either a unilateral endolymphatic duct occlusion to induce hydrops or a sham procedure. Ten weeks after induction of the hydrops, a KTP laser‐assisted TSCA or a sham surgery was performed.

Results Electrocochleographic thresholds to clicks and tone‐bursts (2–20 kHz) did not change significantly up to 4 weeks after TSCA in hydropic ears. Cross‐sectional histology confirmed the presence of hydrops and the ablation of the semicircular canals. Cochlear whole‐mounts for hair cell counts showed no significant loss of outer or inner hair cells in hydropic ears treated with TSCA.

Conclusion KTP laser‐assisted TSCA can be performed in the guinea pig model of endolymphatic hydrops without significant loss of hearing. Evaluation of this technique may be warranted in patients with intractable Ménière's disease.
DiHA (Dextranomers in Hyaluronan) Injections for Treatment of Insufficient Closure of the Vocal Folds: Early Clinical Experiences
Authors: Hallén Lars , Testad Per , Sederholm Elisabeth , Dahlqvist Åke , Laurent Claude
Published: September 2004

Objective To determine the clinical effects of injecting DiHA (a mixture of dextranomer molecules and 1% hyaluronan solution in equal proportions) as a “space filler” into the vocal folds of patients experiencing insufficient closure of the vocal folds resulting from either unilateral vocal fold paralysis or bowed vocal folds.

Study Design A consecutive series of patients with insufficient closure of the vocal folds treated with DiHA injections and prospectively followed up with videostroboscopy and voice recordings that were evaluated by expert panels.

Methods During a 21/2‐year period, 14 patients with insufficient closure of the vocal folds were included. Six had a unilateral vocal fold palsy and 8 patients had “bowed” vocal folds. DiHA was injected into one vocal fold. Laryngoscopic examination and voice recordings were performed pre‐ and postoperatively. Expert panels did the evaluation of the stroboscopy examination and the perceptual voice analysis.

Results Three patients were operated on with local and 11 under general anesthesia. All patients with unilateral palsy improved their stroboscopic status regarding both the wave and the closure after injection. Also, their voice parameters were significantly improved. Among the patients with bowed vocal folds, all except 2 showed an improvement in the glottic wave, 5 of 8 improved in glottic closure, and 3 improved their voice parameters significantly.

Conclusion This early clinical experience indicates that DiHA fulfills most of the requirements of an ideal “space‐filling” substance for voice restoration in patients experiencing insufficient vocal fold closure.
Soleus Neurotomy for Treatment of the Spastic Equinus Foot
Authors: Decq Philippe , Filipetti Paul , Cubillos Alexandro , Slavov Velislav , Lefaucheur Jean-Pascal , Nguyen Jean-Paul ,   Groupe d'Evaluation et de Traitement de la Spasticité et de la Dystonie
Published: September 2004

OBJECTIVE

This prospective, nonrandomized, noncontrolled study was performed to evaluate the results of a new type of neurotomy, namely the soleus neurotomy, for treatment of the spastic equinus foot.

METHODS

Between May 1996 and March 1998, 46 patients were treated for a spastic equinus foot. Clinical status, spasticity (Ashworth Scale score), and kinematic parameters of the gait were determined before and after surgery. The neurotomy was performed on the upper nerve of the soleus in all cases and was associated with other neurotomies (lower nerve of the soleus, 21 patients; gastrocnemius, 9 patients, tibialis posterior, 18 patients; flexor hallucis longus, 16 patients; and flexor digitorum longus, 17 patients).

RESULTS

The mean follow-up period was 15 months (range, 8–28 mo). The equinus deformity disappeared clinically in all patients. Before the operation, all patients had an Ashworth Scale score of 2, with an inexhaustible clonus present on knee extension and persisting with knee flexion (Tardieu Scale score, 4), which was abolished in 95% of the patients after surgery. Two patients still had some clonus on knee extension; this did not interfere with their clinical improvement. Knee recurvatum disappeared in eight patients. Analysis of kinematic parameters demonstrated a statistically significant increase in joint motion of the second rocker (P = 0.0026) of the ankle during stance. The duration of the stance or swing phase, length of the walking cycle, and velocity or rate of spontaneous walking were not significantly modified.

CONCLUSION

The study demonstrated that soleus neurotomy is effective for the treatment of spastic equinus foot, leading to abolition of spasticity and improvement in the range of ankle motion during the stance phase of gait.
Population-Based Assessment of Burn Injury in Southern Iowa: Identification of Children and Young-Adult At-Risk Groups and Behaviors
Authors: Wibbenmeyer Lucy Ann , Amelon Margery Josephine , Torner James Corydon , Kealey Gerald Patrick , de Mola Rebecca Marie Loret , Lundell John , Lynch Charles F. , Aspelund Thor , Zwerling Craig
Published: September 2004

Although nonfatal burn injuries vastly outnumber fatal injuries, their epidemiology is not well defined. We sought to determine the epidemiology of nonfatal burn injuries in a largely rural region of a midwestern state to target intervention efforts at populations and injury mechanisms at risk. Data were retrospectively collected on a population-based sample of medically treated burn injuries in 10 counties in southern Iowa from 1997 to 1999 using International Classification of Diseases, 9th Revision, Clinical Modification codes (ICD-9-CM, Ncode 940–949) to identify burn-related emergency room visits from computerized lists. A total of 1430 emergency room visits were identified, with 1382 records available for review. Injuries were grouped into etiology subcategories to better delineate common mechanisms and determine methods of prevention. Scald and hot-object contact and flame-related injuries were the leading causes of burn injury. Scald and contact injuries were subdivided into three major sets of scenarios, scald and contact injuries related to household food preparation and consumption, work-related scald and contact injuries. and injuries resulting from contact with nonfood and nonbeverage-related household objects. Children ages 0 to 4 had the highest population-based scald and hot-object contact injury rate of all age groups, with an average annual incidence rate of 35.9 per 10,000. Injuries in this age group were most commonly related to household objects (34.7%) followed by food preparation (25.3%). Children and young adults ages 5 to 24 were also the most likely to be injured by flame and fire-related causes secondary to open fires. Nonfatal burn injuries typically afflict children and young adults in definable patterns, suggesting intervention strategies. Future studies need to better delineate the contributing factors associated with these injuries to refine the intervention strategies.
Frequency of Anxiety in Myasthenia Gravis
Authors: Lundeen Jessica , Fisher Justin , Kothari Milind J
Published: September 2004

Symptoms of anxiety are common in many chronic medical conditions. Myasthenia gravis (MG) is a chronic neuromuscular condition characterized by fatigable weakness; few studies to date have examined the occurrence of anxiety in patients with MG and related it to anxiety in other chronic conditions. Sixty-nine patients were given a set of self-administered questionnaires, which included the Beck Anxiety Inventory (BAI). The BAI was scored and showed that 55% of the patients had scores suggestive of anxiety. Forty percent was mildly anxious, 12% were moderately anxious, and 3% were severely anxious. This study suggests that anxiety is at least as common in patients with MG as in patients with other chronic medical conditions. It also suggests that the BAI is a clinically useful tool for assessing anxiety in such a population.
Phosphoproteomics of the Arabidopsis Plasma Membrane and a New Phosphorylation Site Database[W]
Authors: Nühse Thomas S. , Stensballe Allan , Jensen Ole N. , Peck Scott C.
Published: September 2004

Functional genomic technologies are generating vast amounts of data describing the presence of transcripts or proteins in plant cells. Together with classical genetics, these approaches broaden our understanding of the gene products required for specific responses. Looking to the future, the focus of research must shift to the dynamic aspects of biology: molecular mechanisms of function and regulation. Phosphorylation is a key regulatory factor in all aspects of plant biology; but it is difficult, if not impossible, for most researchers to identify in vivo phosphorylation sites within their proteins of interest. We have developed a large-scale strategy for the isolation of phosphopeptides and identification by mass spectrometry (Nühse et al., 2003b). Here, we describe the identification of more than 300 phosphorylation sites from Arabidopsis thaliana plasma membrane proteins. These data will be a valuable resource for many fields of plant biology and overcome a major impediment to the elucidation of signal transduction pathways. We present an analysis of the characteristics of phosphorylation sites, their conservation among orthologs and paralogs, and the existence of putative motifs surrounding the sites. These analyses yield general principles for predicting other phosphorylation sites in plants and provide indications of specificity determinants for responsible kinases. In addition, more than 50 sites were mapped on receptor-like kinases and revealed an unexpected complexity of regulation. Finally, the data also provide empirical evidence on the topology of transmembrane proteins. This information indicates that prediction programs incorrectly identified the cytosolic portion of the protein in 25% of the transmembrane proteins found in this study. All data are deposited in a new searchable database for plant phosphorylation sites maintained by PlantsP (http://plantsp.sdsc.edu) that will be updated as the project expands to encompass additional tissues and organelles.
Transcript Profiling in thechl1-5Mutant of Arabidopsis Reveals a Role of the Nitrate Transporter NRT1.1 in the Regulation of Another Nitrate Transporter, NRT2.1[W]
Authors: Muños Steéphane , Cazettes Ceéline , Fizames Ceécile , Gaymard Freédeéric , Tillard Pascal , Lepetit Marc , Lejay Laurence , Gojon Alain
Published: September 2004

Arabidopsis thaliana mutants deficient for the NRT1.1 NO3  − transporter display complex phenotypes, including lowered NO3  − uptake, altered development of nascent organs, and reduced stomatal opening. To obtain further insight at the molecular level on the multiple physiological functions of NRT1.1, we performed large-scale transcript profiling by serial analysis of gene expression in the roots of the chl1-5 deletion mutant of NRT1.1 and of the Columbia wild type. Several hundred genes were differentially expressed between the two genotypes, when plants were grown on NH4NO3 as N source. Among these genes, the N satiety-repressed NRT2.1 gene, encoding a major component of the root high-affinity NO3  − transport system (HATS), was found to be strongly derepressed in the chl1-5 mutant (as well as in other NRT1.1 mutants). This was associated with a marked stimulation of the NO3  − HATS activity in the mutant, suggesting adaptive response to a possible N limitation resulting from NRT1.1 mutation. However, derepression of NRT2.1 in NH4NO3-fed chl1-5 plants could not be attributed to lowered production of N metabolites. Rather, the results show that normal regulation of NRT2.1 expression is strongly altered in the chl1-5 mutant, where this gene is no more repressible by high N provision to the plant. This indicates that NRT1.1 plays an unexpected but important role in the regulation of both NRT2.1 expression and NO3  − HATS activity. Overexpression of NRT2.1 was also found in wild-type plants supplied with 1 mM NH4  + plus 0.1 mM NO3  −, a situation where NRT1.1 is likely to mediate very low NO3  − transport. Thus, we suggest that it is the lack of NRT1.1 activity, rather than the absence of this transporter, that derepresses NRT2.1 expression in the presence of NH4  +. Two hypotheses are discussed to explain these results: (1) NRT2.1 is upregulated by a NO3  − demand signaling, indirectly triggered by lack of NRT1.1-mediated uptake, which overrides feedback repression by N metabolites, and (2) NRT1.1 plays a more direct signaling role, and its transport activity generates an unknown signal required for NRT2.1 repression by N metabolites. Both mechanisms would warrant that either NRT1.1 or NRT2.1 ensure significant NO3  − uptake in the presence of NH4  + in the external medium, which is crucial to prevent the detrimental effects of pure NH4  + nutrition.
Detection of Campylobacter and Escherichia coli O157:H7 from filth flies by polymerase chain reaction
Authors: Szalanski A. L. , Owens C. B. , Mckay T. , Steelman C. D.
Published: September 2004

Abstract.  Flies (Diptera: Muscidae) that breed in faeces and other organic refuse (filth flies) have been implicated as vectors of pathogenic bacteria including Escherichia coli O157:H7, which cause haemorrhagic colitis in humans, and Campylobacter, which is the principal causative agent of human enteritis. The potential role of filth flies in the epidemiology of these pathogens in the United States was investigated by examining the prevalence of Campylobacter spp. and E. coli O157:H7 from two Arkansas turkey facilities. Polymerase chain reaction was conducted on DNA extractions of individual Musca domestica Linnaeus, Stomoxys calcitrans (Linnaeus), Hydrotaea aenescens (Wiedemann), Adia cinerella Fallen and turkey faecal samples using primers specific for E. coli H7, O157 and Campylobacter spp. Culturing verified that the flies were carrying viable Campylobacter spp. and E. coli O157:H7. Results from this study indicated that M. domestica, S. calcitrans, H. aenescens and Anthomyids are capable of carrying Campylobacter in North American poultry facilities and that the E. coli O157:H7 is carried by house flies and black dump flies associated with poultry. This PCR method provided a rapid and effective method to identify Campylobacter spp. and E. coli O157:H7 directly from individual filth flies.
Variation in the load of the horn fly, Haematobia irritans, in cattle herds is determined by the presence or absence of individual heifers
Authors: Jensen K.‐M. V. , Jespersen J. B. , Birkett M. A. , Pickett J. A. , Thomas G. , Wadhams L. J. , Woodcock C. M.
Published: September 2004

Abstract.  The distribution of horn flies, Haematobia irritans (L.) (Diptera: Muscidae), in herds of Danish Holstein‐Friesian cattle was investigated in two studies conducted during two field seasons. In the first study, highly significant differences in fly distribution between the most and the least fly‐susceptible heifers were observed. In one herd, the mean difference between the most fly‐susceptible and the most fly‐resistant heifers was 268 Ha. irritans specimens. The highest ratio between upper and lower mean fly number was 64.1:1, whereas the lowest was 3.1:1. In the second year, it was demonstrated that the heifers kept their rank in fly attraction over time. The trial clearly demonstrated that some heifers were attracting flies, whereas others, even in the same herd, only carried a few. In the second study, heifers were moved in and out of herds in an attempt to manipulate fly loads in the herds. In year 1, one herd (herd A) received four fly‐resistant heifers from another herd (herd B), resulting in a drop in the mean number of flies, whereas herd B received four fly‐susceptible heifers from herd A, resulting in an elevation of the mean number of flies. In year 2, a similar pattern emerged using herds C and D, and when the cattle were later returned to their original herds, the fly loads returned to their original distribution. The data presented here show unequivocally that, for horn flies, there can be considerable differences in fly loads for individual heifers within the Holstein‐Friesian breed. Furthermore, the overall fly load within herds can be manipulated, and can be reversed. Thus, the distribution in the number of flies within a herd appears to depend on the number of fly‐resistant or fly‐susceptible heifers. The possible role of chemical factors emitted by heifers, i.e. volatile semiochemicals, in determining differences in fly loads is discussed, whereby attractants are emitted by fly‐susceptible heifers and enable flies to locate their host, and repellents are emitted by fly‐resistant heifers such that the flies are actively repelled from the herd.
A Determination of the Prevalence of Gender‐based Violence among Conflict‐affected Populations in East Timor
Authors: Hynes Michelle , Ward Jeanne , Robertson Kathryn , Crouse Chadd
Published: September 2004

The Reproductive Health Response in Conflict (RHRC) Consortium designed a standardised questionnaire to measure gender‐based violence (GBV) prevalence in conflict‐affected settings. A preliminary field test was undertaken July—August 2002 in one urban and one rural district in East Timor to assess the prevalence of GBV among women 18–49 years of age during and after conflict. The field test used a cross‐sectional survey design with a two‐stage random selection process. During the year preceding East Timor's 1999 crisis, 23.8 per cent of respondents reported physical assault by an intimate partner; this rate was not significantly different in the year preceding the survey (24.8 per cent). Assault by perpetrators outside the family declined significantly from 24.2 per cent during the crisis to 5.8 per cent post‐crisis for physical assault (p<.001) and 22.7 per cent during the crisis to 9.7 per cent post‐crisis for sexual assault (p=0.046). The field test stimulated and informed additional research in East Timor, and the complementary findings of these research initiatives continue to be used to develop local policies and programming to prevent and address GBV.
Thinking Ahead about Reproductive Health: Contingency Planning and Emergency Preparedness in Crisis Situations (Iraq and West Africa)
Authors: DeLargy Pamela , Alakbarov Ramiz
Published: September 2004

The United Nations Population Fund (UNFPA) coordinated efforts to integrate RH into contingency planning for the 2003 Iraq crisis and the 2003 regional response for displaced populations in West Africa. Using UNFPA's network of country offices in the Middle East, staff developed logistics plans, conducted workshops and pre‐positioned RH supplies. Though refugee movements did not occur, the contingency planning enhanced the response capacity of UNFPA offices and made it possible to rapidly provide assistance inside Iraq. In West Africa, multi‐country workshops and follow‐up resulted in country‐level and regional action plans useful during the renewed crises of 2003; scarce funding, however, limited their full implementation.

UNFPA's experiences show that contingency planning requires committing resources for crises, some of which will not occur; new staff skills; and follow‐up. Moreover, RH is considered by some to be additional to the core elements of contingency planning. RH's political sensitivity, particularly with certain donors, further complicated integrated planning.
Community nursing: health professional and public perceptions
Authors: McKenna Hugh , Keeney Sinead
Published: September 2004

Background.  Almost 10 years ago senior United Kingdom nurses met at Heathrow Airport to discuss the challenges and opportunities facing nursing. One aspect of this ‘Heathrow Debate’ was to encourage nurses to work closer with members of the public. The resulting report stated that nurses have not been effective in working outside their professional area and, in particular, they have not been adept at working in partnership with the public.

Aim.  The aim of this paper is to report a study to obtain the views of general practitioners (GPs), community nurses and members of the public on how the public perceive community nursing. A further aim was to explore the perceptions of senior health care managers and policymakers about public involvement in primary care.

Methods.  A two‐stage Delphi investigation was undertaken with community nurses (n = 38), GPs (n = 14) and members of the public (n = 8). In addition, one‐to‐one interviews were carried out with 34 senior health service managers and policymakers.

Findings.  There was agreement on the following issues: community nurses must work more closely with members of the public; there is a lack of public understanding on the roles of community nurses and specialist nurses; there is public support for nurse prescribing; there is a preference for seeing the community nurse as opposed to the GP; and people prefer one nurse to care for them rather than a variety of nurses. Comments from managers and senior policymakers showed agreement on the public being involved in primary care, but an acknowledgement that this was problematic. A number of recommendations are outlined.
Changing nurses’ dis‐empowering relationship patterns
Authors: Daiski Isolde
Published: September 2004

Background. Nurses’ inter‐ and intra‐disciplinary relationships are frequently interpreted as oppressed group behaviours, contributing to their relatively dis‐empowered status. In the context of restructuring in health care, this study examined the views of hospital staff nurses about their relationships with nursing colleagues and other health care professionals and their ideas for change.

Aim. The aim of this paper is to report a study to add the views of staff nurses to the discourse on restructuring and to make visible the processes that contribute to their marginalization.

Design. The study was descriptive and exploratory. Staff nurses from various hospitals in a large Canadian city were selected by theoretical sampling.

Method. Twenty volunteer staff nurses were interviewed between 1998 and 1999, using broad, open‐ended questions and prompts to explore nurses’ various relationships in the health care system. This approach allowed for multiple responses and expansions of ideas, without losing focus. The interviews were audio‐taped and later transcribed. Thematic analysis was carried out.

Findings. Many participants were aware of inter‐disciplinary hierarchies, particularly between nurses and physicians. Many also showed insights into their own intra‐disciplinary hierarchies and mutual non‐supportiveness. Both types of relationships were found to be inextricably linked, sustaining nurses’ oppression through dis‐empowering discourses. Nurses expressed many ideas about how to promote mutually supportive relationships.

Conclusion. Change for the better needs to come from within the nursing profession. To develop effective strategies, bedside nurses have to be included in decision‐making processes affecting them and their practice, about which they are the experts. Mutual respect, awareness‐raising through education, development of caring nursing communities, mentorship and non‐hierarchical leadership are key to stopping dis‐empowering discourses and practices amongst nurses.
Diabetes care: practice nurse roles, attitudes and concerns
Authors: Kenealy Tim , Arroll Bruce , Kenealy Helen , Docherty Barbara , Scott David , Scragg Robert , Simmons David
Published: September 2004

Background.  Practice nurses (PNs) are the largest group of nurses providing primary care for patients with diabetes in New Zealand, and changes in the health system are likely to have a substantial effect on their roles. To inform the development of a new primary health care nursing structure and evaluate the new role associated with this, it will be important to have data on current practice nurse roles.

Aims.  The aim of this paper is to report a study to compare the diabetes‐related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care.

Methods.  Questionnaires were mailed to all 146 PNs in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organization, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life.

Results.  More nurses surveyed in 1999 had postregistration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999.

Conclusions.  Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
The gprA and gprB genes encode putative G protein‐coupled receptors required for self‐fertilization in Aspergillus nidulans
Authors: Seo Jeong‐Ah , Han Kap‐Hoon , Yu Jae‐Hyuk
Published: September 2004

The filamentous fungus Aspergillus nidulans possesses both asexual and sexual reproductive cycles. Sexual fruiting bodies (cleistothecia) can be formed in both homothallic (self) and heterothallic (outcross) conditions. In this study, we characterized two genes, gprA and gprB, that are predicted to encode putative G protein‐coupled receptors (GPCRs) similar to fungal pheromone receptors. Deletion (Δ) of gprA or gprB resulted in the production of a few small cleistothecia carrying a reduced number of ascospores, whereas ΔgprAΔgprB eliminated fruiting body formation in homothallic conditions. However, nullifying gprA and/or gprB did not affect vegetative growth, asexual sporulation, Hülle cell formation or even cleistothecia formation in outcross, indicating that GprA and GprB are specifically required for self‐fertilization. The gprA and gprB genes encode two transcripts and, for both genes, larger transcripts are detectable during vegetative growth and asexual development whereas smaller transcripts accumulate during sexual development. Upregulation of nsdD encoding a key sexual developmental activator resulted in the production of barren cleistothecia in the ΔgprAΔgprB mutant, suggesting that NsdD can partially rescue the developmental defects caused by deletion of GPCRs and that GprA/B‐mediated signalling may activate other genes necessary for maturation of cleistothecia and ascosporogenesis. Deletion of gprA and/or gprB suppressed growth defects caused by ΔgprD, implying that GprA/B function downstream of GprD‐mediated negative control of sexual development.
Quorum sensing and signal interference: diverse implications
Authors: Zhang Lian‐Hui , Dong Yi‐Hu
Published: September 2004

Quorum sensing (QS) is a community genetic regulation mechanism that controls microbiological functions of medical, agricultural and industrial importance. Discovery of microbial QS signals and the signalling mechanisms led to identification of numerous enzymatic and non‐enzymatic signal interference mechanisms that quench microbial QS signalling. Evidence is accumulating that such signal interference mechanisms can be developed as promising approaches to control microbial infection and biofilm formation. In addition, these mechanisms exist not only in microorganisms but also in the host organisms of bacterial pathogens, highlighting their potential implications in microbial ecology and in host–pathogen interactions. Investigation of QS and signal interference mechanisms might significantly broaden the scope of research in microbiology.
Identification of QTLs affecting adaptive traits in Castanea sativa Mill
Authors: CASASOLI M , POT D. , PLOMION C. , MONTEVERDI M. C. , BARRENECHE T. , LAUTERI M. , VILLANI F.
Published: September 2004

A QTL analysis for three different adaptive traits was performed in an F1 progeny of Castanea sativa Mill. The female and male parents originated from two Turkish chestnut populations adapted to a drought and humid environment, respectively. QTLs for bud flush, growth and carbon isotope discrimination were detected over a 3‐year period. Bud set was also recorded in the last year of measurement. Thirty‐five individual QTLs were detected for phenology, 28 for growth and 17 for carbon isotope discrimination, most of them explaining a low to moderate proportion of the total phenotypic variance. QTLs were distributed throughout the whole genome. Temporally stable QTLs were identified for all the traits analysed, with phenology showing the higher proportion of stable QTLs. Interesting phenotypic correlations and co‐localizations among QTLs for different adaptive traits were observed, allowing the formulation of an hypothesis about the genetic adaptation of the female parent to drought.
Reactive oxygen species‐mediated enzymatic systems involved in the oxidative action of 2,4‐dichlorophenoxyacetic acid*
Authors: ROMERO‐PUERTAS M. C. , MCCARTHY I. , GÓMEZ M. , SANDALIO L. M. , CORPAS F. J. , DEL RÍO L. A. , PALMA J. M.
Published: September 2004

2,4‐dichlorophenoxyacetic acid (2,4‐D) is an analogue compound to the plant hormone indole‐3‐acetic acid (IAA), which is used either as a growth‐promoting substance or as a herbicide, depending on its concentration. In this work, the effect of 2,4‐D on the growth and ROS metabolism of pea (Pisum sativum L.) leaves is reported. The herbicide considerably reduced the plant growth and negatively influenced several physiological parameters in a dose‐dependent manner. At structural level, damage of the mesophyll cells and the enlargement and dilation of thylakoids were observed in 2,4‐D‐treated plants. 2,4‐D notably affected xanthine oxidase and superoxide dismutase activities, as well as the activity and transcript levels of the ascorbate–glutathione cycle enzymes, ascorbate peroxidase, monodehydroascorbate reductase, and glutathione reductase. Furthermore, in herbicide‐treated plants, an increase in the H2O2 production, levels of lipid peroxidation, endopeptidase activity and oxidatively modified proteins took place. Results obtained showed that an overproduction of superoxide radicals (O2−) and hydrogen peroxide (H2O2) could take place in plants treated with 2,4‐D, thus contributing to the generation of oxidative stress, with the concomitant degradation of proteins. A model of the role of ROS‐mediated enzymatic systems in the oxidative mode of action of 2,4‐D and other auxinic herbicides is proposed.
A Base‐Off Analogue of Coenzyme‐B12 with a Modified Nucleotide Loop
Authors: Poppe László , Stupperich Erhard , Hull William E. , Buckel Thomas , Rétey János
Published: September 2004

(Coβ‐5′‐Deoxyadenosin‐5′‐yl)‐(p‐cresolyl)cobamide (Ado‐PCC), an analogue of the base‐off form of coenzyme‐B12 (CoB12), was prepared by alkylation of (Coα/β‐cyano/aqua)‐(p‐cresolyl)cobamide (PCC) with 5′‐chloro‐5′‐deoxyadenosine. The 500 MHz 1H‐NMR spectrum of Ado‐PCC in D2O at pH 7.4 was completely analyzed using COSY and NOESY two‐dimensional experiments. The coenzyme and inhibitory activities of Ado‐PCC were tested with three coenzyme‐B12‐dependent enzymes: (R)‐methylmalonyl‐CoA mutase, glycerol dehydratase, and diol dehydratase. Ado‐PCC showed strong coenzyme activity with methylmalonyl‐CoA mutase, which is known to bind the base‐off form of CoB12. In contrast, Ado‐PCC had no coenzyme activity but acted instead as a competitive inhibitor with glycerol dehydratase and diol dehydratase, which are likely to prefer the base‐on form of CoB12. These results indicate that Ado‐PCC, whose structure is analogous to the base‐off form of CoB12, can be used for probing the mode of coenzyme binding by coenzyme‐B12‐dependent enzymes.
Vinblastine‐Induced Formation of Tubulin Polymers is Electrostatically Regulated and Nucleated
Authors: Rai Sadananda S. , Wolff J.
Published: September 2004

Vinblastine promotes tubulin polymerization as measured by turbidity at 400 nm. Unlike microtubule assembly, this mode of polymerization does not require GTP and, in fact, GTP inhibits polymerization, as do other G nucleotides in the potency order: GtetraP≥ GTP > GDP > GMP > no nucleotide. Inhibition is not nucleoside‐specific as ATP, ADP, and CTP also inhibit, and inorganic oligophosphates are as inhibitory as nucleotides in the order tetraphosphate ≈ triphosphate > pyrophosphate ≥ phosphate. Inhibition of polymerization is a rough function of the number of anionic charges and can be mimicked by suramin or tartrate. It is not due to sequestration of magnesium or to debinding of vinblastine. The anion‐induced decrease in turbidity generation is reflected in the amount of tubulin that is pelletable, but even in the absence of turbidity significant pelletable tubulin persists which can be assessed by 90° light scattering. Formation of this polymer is less sensitive to anions.

Shearing of GTP‐inhibited and vinblastine‐induced samples promotes turbidity and addition of seeds made from vinblastine polymers leads to rapid increases in turbidity in a concentration‐dependent manner. Adjustment of the vinblastine concentration permits the demonstration of a latent period for polymerization that can be shortened by polymer seeds. Vinblastine‐induced polymerization shows a critical concentration, and, in the presence of GTP, two distinct critical concentrations can be identified. We conclude that charge–charge interactions play a significant role in the formation of vinblastine‐induced polymers, and that their formation is a two‐step process resembling a nucleation/elongation mechanism.
In vitroActivities of Granule‐Bound Poly[(R)‐3‐Hydroxyalkanoate] Polymerase C1 ofPseudomonas oleovorans
Authors: Kraak Marjan Nienke , Kessler Birgit , Witholt Bernard
Published: September 2004

A newly developedin vitroactivity assay for medium‐chain‐length(mcl)‐poly(3‐hydroxyalkanoate) polymerases is described. Polymerase C1 ofPseudomonas oleovoransGPo1 attached to isolated granules was used as model enzyme. A direct correlation was found between (R)‐3‐hydroxyoctanoylCoA depletion and poly(3‐hydroxyalkanoate) synthesis due to polymerase C1 activity. Highest activities of 1.13 U/mg granule bound protein and highest specific activities of 2.3 U/mg polymerase C1 were determined towards (RS)‐3‐hydroxyoctanoylCoA. A first determination of aKmvalue for mcl poly(3‐hydroxyalkanoate) polymerases was performed leading to an estimatedKmof 0.16 (± 0.1) mM for granule bound polymerase C1 with (RS)‐3‐hydroxyoctanoylCoA as substrate. Polymerase C1 showed no activity towards (RS)‐3‐hydroxybutyrylCoA and a specific activity of 0.28 U/mg polymerase C1 for (R)‐3‐hydroxyvalerylCoA. (R)‐3‐HydroxyoctanoylCoA and a mixture of (RS)‐3‐hydroxyoctanoylCoA were both depleted for more than 75% by granule‐bound polymerase C1, suggesting a non‐rate‐limiting epimerase activity attached to poly(3‐hydroxyalkanoate) granules isolated fromPseudomonas putidaGPp104[pGEc405]. Whereas no relationship was found between the activity of granule‐bound polymerase C1 and poly(3‐hydroxyalkanoate) content of the granules, higher activities were measured when a higher substrate concentration or more enzyme was present in thein vitroactivity assay.
Differential Androgen Regulation of the Murine Genes for Cysteine‐Rich Secretory Proteins (CRISP)
Authors: Haendler Bernard , Habenicht Ursula‐Friederike , Schwidetzky Uta , Schüttke Iris , Schleuning Wolf‐Dieter
Published: September 2004

The androgen dependency of the genes coding for the cysteine‐rich secretory proteins (CRISP) was analysed in their main sites of expression. Male mice were treated with the gonadotropin‐releasing hormone antagonist Ac‐DNapAla‐DClPhAla‐DPyrAla‐Ser‐Tyr‐DCtl‐Leu‐Lys(Mor)‐Pro‐DAla‐NH2[DNapAla, D‐2‐naphthyl‐Ala; DClPhAla, D‐4‐chlorphenyl‐Ala; DPyrAla, D‐pyridyn‐3‐yl‐Ala; DCtl, D‐citrulline; Lys(Mor), L‐2‐amino‐6‐(morpholin‐4‐yl)‐hexanoic acid], andCRISPRNA levels were assessed by northern blot and competitive reverse transcriptase‐mediated (RT)‐PCR. In the salivary gland,CRISP‐1and to a lesser extentCRISPS‐3expression was markedly reduced, in spite of an up‐regulation of androgen receptor transcript levels. A down‐regulation ofCRISP‐1expression was also observed in the epididymis. Conversely, the levels of the testicularCRISP‐2transcripts were hardly affected at all. Female mice were ovariectomised and treated with testosterone propionate, and their salivary gland RNAs analysed.CRISP‐1andCRISP‐3RNA levels were significantly increased, and these effects were prevented by a concomitant treatment with the antiandrogen flutamide. Androgen receptor transcript levels were not affected by androgen administration but increased following antiandrogen treatment.CRISPexpression during postnatal development was monitored by northern blot analysis.CRISP‐1andCRISP‐2transcripts were detected as early as 22 days after birth in the epididymis and testis, respectively, whereasCRISPS‐3mRNA was visible only from day 30 in the salivary gland. A sharp increase of allCRISPlevels was noted on day 40, coincident with the onset of sexual maturity. Altogether these results indicate that despite their high similarity, theCRISPgenes are differentially regulated by androgens.
Apoptotic Cell Death Induced by Inhibitors of Energy Conservation
Authors: Marton Attila , Mihalik Rudolf , Bratincsák András , Adleff Vilmos , Peták István , Végh Miklós , Bauer Pál I. , Krajcsi Péter
Published: September 2004

Energy charge controls intermediary metabolism and cellular regulation. Here we show that inhibition of energy conservation at the level of glucose uptake, glycolysis, citric acid cycle, and oxidative phosphorylation induces cell death, leading to fragmentation of DNA into an oligonucleosomal ladder and morphological changes typical for apoptosis. Bc1‐2, the prototype of oncogenes that suppress cell death, efficiently inhibits apoptosis induced by metabolic inhibitors. Bcl‐2 does not antagonize the inhibitory potential of mitochondrial inhibitors, and cannot prevent or delay the decrease of the cellular ATP level subsequent to metabolic inhibition. Thus, we propose that Bcl‐2 blocks apoptosis at a point downstream of the collapse of the cellular‐energy homeostasis.
Mitochondrial Transcription Initiation in the Crustacean Artemia franciscana
Authors: Carrodeguas José A. , Vallejo Carmen G.
Published: September 2004

Mitochondrial transcription has been studied in several vertebrate organisms, but so far no report on mitochondrial transcription initiation in invertebrates has been published. Here we present an analysis of transcription initiation sites using in vivo‐synthesized transcripts in the crustacean Artemia franciscana. The mitochondrial genome of Artemia has the same coding capacity as most animal mitochondrial genomes, and its overall organization is almost identical to that of Drosophila. Using in vitro capping, RNA mapping techniques and northern hybridization, we have identified a main initiation site for heavy‐strand transcription that matches the 5· end of 12S rRNA, on one end of the control region. This nascent RNA has an unusually small size and a highly heterogeneous 5· end. A second potential transcription‐initiation site has been located 250 bp upstream of the former, giving rise to a larger, less abundant RNA which also has an heterogeneous 5· end. The two sites have sequence similarity from which a consensus could be derived. Using the same methods we failed to identify any clear initiation site for transcription of the light strand, nevertheless a candidate has been located on the opposite side of the control region, with respect to the heavy‐strand initiation sites.
Design of Synthetic Antimicrobial Peptides Based on Sequence Analogy and Amphipathicity
Authors: Tossi Alessandro , Tarantino Chiara , Romeo Domenico
Published: September 2004

Novel α‐helical antimicrobial peptides have been devised by comparing the N‐terminal sequences of many of these peptides from insect, frog and mammalian families, extracting common features, and creating sequence templates with which to design active peptides. Determination of the most frequent amino acids in the first 20 positions for over 80 different natural sequences allowed the design of one peptide, while a further three were based on the comparison of the sequences of α‐helical antimicrobial peptides derived from the mammalian cathelicidin family of precursors. These peptides were predicted to assume a highly amphipathic α‐helical conformation, as indicated by high mean hydrophobic moments. In fact, circular dichroism experiments showed clear transitions from random coil in aqueous solution to an α‐helical conformation on addition of trifluoroethanol. All four peptides displayed a potent antibacterial activity against selected gram‐positive and gram‐negative bacteria (minimum inhibitory concentrations in the range 1–8 μM), including some antibiotic resistant strains. Permeabilization of both the outer and cytoplasmic membranes of the gram‐negative bacterium, Escherichia coli, by selected peptides was quite rapid and a dramatic drop in colony forming units was observed within 5 min in time‐killing experiments. Permeabilization of the cytoplasmic membrane of the gram‐positive bacterium, Staphylococcus aureus, was instead initially quite slow, gathering speed after 45 min, which corresponds to the time required for significant inactivation in time‐killing studies. The cytotoxic activity of the peptides, determined on several normal and transformed cell lines, was generally low at values within the minimum inhibitory concentration range.