bluuebunny/crossref_metadata_2025 huggingface dataset:
The carbon kinetic isotope effects of ozone‐alkene reactions in the gas‐phase and the impact of ozone reactions on the stable carbon isotope ratios of alkenes in the atmosphere
Authors: Iannone R. , Anderson R. S. , Rudolph J. , Huang L. , Ernst D.
Published: July 2003

The kinetic isotope effects (KIEs) for several ozone‐alkene reactions in the gas phase were studied in a 30 L PTFE reaction chamber. The time dependence of the stable carbon isotope ratios and the concentrations were determined using a gas chromatography combustion isotope ratio mass spectrometry (GCC‐IRMS) system. The following average KIE values were obtained: 18.9 ± 2.8 (ethene), 9.5 ± 2.5 (propene), 8.7 ± 1 (1‐butene), 8.1 ± 0.4 (E‐2‐butene), 7.9 ± 0.4 (1,3‐butadiene), 6.7 ± 0.9 (1‐pentene), 7.3 ± 0.2 (Z‐2‐pentene), 6.7 ± 0.7 (cyclopentene), 6.1 ± 1 (isoprene), 5.0 ± 0.7 (1‐hexene), 5.6 ± 0.5 (cyclohexene), and 4.3 ± 0.7 (1‐heptene). These data are the first of their kind to be reported in the literature. The ozone‐alkene KIE values show a systematic inverse dependence from alkene carbon number. Based on the observed KIEs, the contribution of ozone‐alkene reactions to the isotopic fractionation of alkenes in the atmosphere can be estimated. On average this contribution is generally small compared to the impact of reaction with OH radicals. However, when OH‐concentrations are very low, e.g. during nighttime and at high latitudes in winter, the contribution of the ozone reaction dominates and under these conditions the ozone‐alkene reaction will have a clearly visible impact on the stable carbon isotope ratio of atmospheric alkenes.
A new approach for associating earthquakes with geological structures: Application to epicenters in southern Illinois and southeastern Missouri
Authors: Amorèse Daniel
Published: July 2003

A spatial statistical analysis method has been applied successfully on diffuse seismicity of southern Illinois and southeastern Missouri. The study area is a region of diffuse deformation and seismicity close to the New Madrid Seismic Zone. The New Madrid Earthquake Catalog is examined through the Blade Method applied on collapsed epicenters. This is a new approach since the Blade Method is applied on improved locations through the Best Estimate Method. The Blade Method performs tests on binomial distributions for the detection of significant seismic alignments within a sparse epicenter distribution. From the epicenters of the New Madrid Earthquake Catalog, using the Blade Method on collapsed epicenters, it is statistically valid to state that seismicity is associated with the New Madrid Seismic Zone and the Black, Ellington, Salem and Ste Genevieve faults.
High pressure magnetic transition in pyrrhotite and impact demagnetization on Mars
Authors: Rochette P. , Fillion G. , Ballou R. , Brunet F. , Ouladdiaf B. , Hood L.
Published: July 2003

Using neutron diffraction under pressure at room temperature, we observed that pyrrhotite undergoes a ferrimagnetic to paramagnetic transition at about 2.8 GPa. Complete demagnetization of remanence at the same pressure is confirmed in an independent experiment. Such a process provides a quantitative explanation of the magnetic structure of the Martian Southern Hemisphere assuming that pyrrhotite is the major magnetic mineral and that our static experiments can be extrapolated to dynamic pressure conditions. Indeed, the 3 GPa isobaric line during the two large impacts of Argyre and Hellas separates the magnetized and unmagnetized zones. We also infer a reinterpretation of Martian meteorites paleomagnetic signal.
Evidence of thermal and aerosol effects on the cloud‐to‐ground lightning density and polarity over large urban areas of Southeastern Brazil
Authors: Naccarato K. P. , Pinto O. , Pinto I. R. C. A.
Published: July 2003

The Brazilian lightning detection network detected about 310,000 cloud‐to‐ground flashes over three large metropolitan areas in Southeastern Brazil during three summer seasons (from 2000 to 2002). It was observed an enhancement of 60–100% in the flash density over the urban areas compared to their surroundings. Conversely, a decrease of 7–8% in the percentage of positive flashes was also observed. The spatial distribution of the flashes follows closely the shape of the São Paulo city heat island, thereby supporting the thermal hypothesis. The PM10 concentration showed a positive linear correlation with the number of cloud‐to‐ground flashes and a negative correlation with the percentage of positive flashes, supporting the aerosol hypothesis. These results indicate that both hypotheses should be considered to explain the CG lightning enhancements over the urban areas. However, only the aerosol hypothesis could better support the decrease of the percentage of positive flashes.
Identification of CO plumes from MOPITT data: Application to the August 2000 Idaho‐Montana forest fires
Authors: Lamarque J.‐F. , Edwards D. P. , Emmons L. K. , Gille J. C. , Wilhelmi O. , Gerbig C. , Prevedel D. , Deeter M. N. , Warner J. , Ziskin D. C. , Khattatov B. , Francis G. L. , Yudin V. , Ho S. , Mao D. , Chen J. , Drummond J. R.
Published: July 2003

This study focuses on the identification of carbon monoxide (CO) released during the forest fires that took place primarily in Montana and Idaho during the summer of 2000. We focus our analysis on the most intense period of the fires during the second half of August. During that period, the MOPITT instrument onboard the EOS‐Terra platform collected extensive measurements of CO. A simulation of the dispersal of the CO from the fires, constrained by the AVHRR observations of fire location and extent, clearly identifies the affected regions. The model results are compared with the CO observations from the COBRA experiment flight on August 19. Using these various data, we are able to identify the transport of the CO plume originating from the fires. In particular, it is shown that the CO travels eastward from the fires, reaching as far as the East coast and the Gulf of Mexico in a few days. Although the distribution of CO over the U.S. is clearly a combination of a variety of sources it is found that wildfires are a strong component of the summer tropospheric CO.
Variation of velocity and volume transport of the Tsugaru Warm Current in the winter of 1999–2000
Authors: Ito T. , Togawa O. , Ohnishi M. , Isoda Y. , Nakayama T. , Shima S. , Kuroda H. , Iwahashi M. , Sato C.
Published: July 2003

The variation of velocity and volume transport of the Tsugaru Warm Current (TWC) is investigated based on the data of continuous and cross‐sectional current monitoring in the Tsugaru Strait. During November 1999–March 2000, the structure of the velocity transection across the strait was almost stable in which the TWC occupied the central part of the strait, while the returning flows existed in the northern and southern part of the strait, and the velocity of these flows decreases with time. The volume transport of the TWC varies from 2.1 to 1.1 Sv, with the mean value of 1.5 Sv, following the variation of the TWC. The temporal variation of the volume transport shows a linear correlation with that of the sea level difference between the Japan Sea and the Pacific Ocean. The contribution of the sea level difference to the volume transport is estimated to be roughly 70%.
Estimating aquifer hydraulic properties from the inversion of surface Streaming Potential (SP) anomalies
Authors: Darnet Mathieu , Marquis Guy , Sailhac Pascal
Published: July 2003

Electrokinetic effects of water flow during pumping tests have been shown to generate surface Streaming Potential (SP) anomalies of several tens of mV that are well correlated with the geometry of the water table. It follows that SP measurements can be used to estimate aquifer hydraulic properties. We have developed an inversion scheme for surface SP data generated by flow pumping and found that we are able to estimate the hydraulic conductivity and the depth and the thickness of the aquifer. We applied our inversion scheme to the data from Bogoslovsky and Ogilvy [1973] and found a hydraulic conductivity of 10−5 m.s−1, an aquifer thickness of roughly 28 m and an electrokinetic coupling coefficient of −1 mV.m−1. These values are in the range of what is expected for this kind of environment.
Transverse halo orbits about Mars?
Authors: Howard J. E. , Krivov A. V. , Spahn F.
Published: July 2003

We predict a new family of charged dust rings about Mars, transverse to the ecliptic plane. These orbits are stable to the perturbations of planetary oblateness, Mars' orbital motion, and the solar wind. Lifetimes of individual orbits are limited primarily by the Lorentz force and Poynting‐Robertson drag, and may exceed 1000 years. They may be populated via collisions of micrometeoroids with one of the martian moons. Some of these small (≲1 μm) grains may be detected by the dust detector on board the Nozomi spacecraft now en route to Mars.
Proton aurora in the cusp during southward IMF
Authors: Frey H. U. , Mende S. B. , Fuselier S. A. , Immel T. J. , Østgaard N.
Published: July 2003

One of the most distinct aurorae in the high‐latitude dayside region occurs at the footprint of the cusp. The Spectrographic Imager SI‐12 channel on the IMAGE spacecraft allows for long‐duration observations of the proton aurora in this region and thus enables morphological and quantitative studies of the behavior of the proton aurora under different external solar wind conditions. Here we extend an earlier study of the proton aurora in the cusp during northward interplanetary magnetic field (IMF) conditions [Frey et al., 2002] to southward IMF conditions. We find a very similar dependence of the cusp aurora's location in magnetic local time (MLT) on the IMF By component, with locations at prenoon for negative By and postnoon for positive By. We also confirm the previously established dependence of the proton aurora brightness on the solar wind dynamic pressure. However, for similar solar wind pressures the proton aurora is brighter for the southward IMF case than for the northward IMF case. The other major difference between southward and northward IMF conditions is the very strong dependence of the latitude location on the magnitude of the IMF Bz for southward IMF. We discuss both differences in terms of the location of the reconnection site at the magnetopause that is connected to the ionosphere along cusp magnetic field lines.
Implementation of guidelines for seasonal allergic rhinitis: a randomized controlled trial
Authors: Bousquet J. , Lund V. J. , Van Cauwenberge P. , Bremard‐Oury C. , Mounedji N. , Stevens M. T. , El‐Akkad T.
Published: July 2003

Background: Allergic rhinitis is a common disease altering quality of life. Its treatment is well established and guidelines have been proposed. However, their efficacy has never been tested. The aim of the study was to validate the guidelines of the International Consensus on Rhinitis in the treatment of seasonal allergic rhinitis.

Methods: A multicenter, multinational, open label, parallel, randomized study compared two therapeutic strategies in seasonal allergic rhinitis during a 3‐week treatment. General practitioners were randomized into two groups. In the first group of 224 patients, doctors followed guidelines from the International Consensus on Rhinitis. Depending on the severity of nasal and ocular symptoms defined using visual analogue scales, patients received ebastine (an oral antihistamine), triamcinolone acetonide (a topical corticosteroid) and/or ophthalmic nedocromil sodium (a topical ocular cromone). In the second group of 241 patients, general practitioners had a free choice of treatment. The primary efficacy end points were quality of life measured using the standardized rhinoconjunctivitis quality of life questionnaire (RQLQ) and the symptom‐medication scores assessed daily with an electronic dairy system.

Results: Adjusted mean total symptom scores over 21 days were 4.93 in the guidelines strategy group compared with 7.48 in the free‐choice treatment group (P = 0.0001). Mean total scores in the RQLQ decreased by 2.19 in the guidelines group compared with a decrease of 1.79 in the free‐choice treatment group (P = 0.0001). At 21 days, the least square mean difference in improvement in overall scores for RQLQ in the guidelines group compared with the free‐choice treatment group was 0.53, which was greater than the minimal important difference.

Conclusions: Patients with seasonal allergic rhinitis often present severe symptoms which are not well recognized or controlled by physicians using their own criteria of severity and treatment. Using a simple method for the evaluation of the severity and a simple therapeutic scheme based on International Guidelines, patients with seasonal allergic rhinitis presented a significant improvement by comparison with those receiving a non‐standardized treatment.
Strategies for preventing wheezing and asthma in small children
Authors: Wickman M. , Melén E. , Berglind N. , Lennart Nordvall S. , Almqvist C. , Kull I. , Svartengren M. , Pershagen G.
Published: July 2003

Objective:  To assess the effects of living in agreement with allergy preventive guidelines on wheezing and asthma at 2 years of age.

Design:  Prospective birth cohort study (BAMSE). Questionnaires on heredity and environmental factors were answered when the child was 2 months, and detailed questionnaires on symptoms at 1 and 2 years of age.

Participants:  4089 children, born during 1994–1996.

Setting:  Child Health Centres in central and north‐western parts of Stockholm, Sweden.

Main outcome measures:  Wheezing and asthma up to the age of 2.

Results:  The effects of preventive guidelines regarding breastfeeding, maternal tobacco smoke and home dampness on wheezing and asthma were assessed in multiple logistic regression models. The cumulative incidence of recurrent wheezing at 2 years of age was 12.6% and of asthma 6.8% among those with a lifestyle in agreement with all guidelines and 24.1 and 17.9%, respectively, in families exposed to at least two of the three risk factors. Among children with no heredity, family lifestyle according to the guidelines gave a twofold reduction of asthma (5.3 vs. 10.5%), while the group with heredity had a threefold reduction (9.1 vs. 27.3%). The attributable fraction for asthma associated with the guidelines was 23% in total and 33% among those with heredity.

Conclusion:  In this observational study, family lifestyle according to preventive guidelines is associated with an important reduction of recurrent wheezing and asthma at 2 years of age, especially among children with allergic heredity. A follow‐up will determine whether there still a risk reduction of both symptoms and disease.
Human β‐defensins and toll‐like receptors in the upper airway
Authors: Claeys S. , De Belder T. , Holtappels G. , Gevaert P. , Verhasselt B. , Van Cauwenberge P. , Bachert C.
Published: July 2003

Background:  Measurement of innate markers in nasal mucosa, tonsils and adenoids might lead to new views about the role of innate immunity in the upper airway. In this study, the expression of human β‐defensins (HBD) 2 and 3 and toll‐like receptors (TLR) 2 and 4 in various upper airway diseases was investigated.

Methods:  Surgical samples from patients with tonsillar disease (n = 18), hypertrophic adenoids (n = 10) and sinonasal disease (n = 30) (chronic sinusitis, nasal polyps, turbinate mucosa as controls) were investigated by immunohistochemistry. Quantification of HBD‐2 and 3 mRNA, TLR‐2 and 4 mRNA expression was performed by real‐time polymerase chain reaction (PCR).

Results:  Immunohistochemistry revealed a strong expression of HBD‐2 in tonsillar tissue. Quantification of HBD‐2 and HBD‐3 mRNA showed a more than tenfold higher expression in tonsillar tissue than in adenoids, whereas in nasal biopsies, only negligible defensin expression could be measured. No significant differences were found for TLR‐4 between the various tissues, whereas TLR‐2 expression in adenoids was significantly lower compared with other tissues.

Conclusion:  These results demonstrate a strong defensin expression in tonsillar tissue compared with nasal and paranasal mucosa and adenoids. Toll‐like receptor expression in all these tissues illustrates a possibly important immunological sentinel function of upper airway mucosa.
Effectiveness of an intervention to reduce house dust mite allergen levels in children's beds
Authors: Mihrshahi S. , Marks G. B. , Criss S. , Tovey E. R. , Vanlaar C. H. , Peat J. K. ,   for the CAPS Team
Published: July 2003

Background:  In temperate climates, exposure to house dust mite (HDM) allergens is the strongest environmental risk factor for childhood asthma. Environmental modifications to limit exposure have the potential to reduce the prevalence of asthma. The aim of this study was to reduce allergen exposure for children at high risk of developing asthma.

Methods:  A total of 616 pregnant women were randomized to HDM intervention and control groups. The control group had no special recommendations whereas the intervention group was given allergen impermeable mattress covers and an acaricidal washing detergent for bedding. Children were visited regularly until 18 months of age to have dust collected from their bed.

Results:  Der p 1 concentrations in the control group increased from 5.20 μg/g at 1 month to 22.18 μg/g at 18 months but remained low in the intervention group, ranging from 3.27 μg/g at 1 month to 6.12 μg/g at 18 months.

Conclusions:  In a high HDM allergen environment, a combined approach using physical barriers and an acaricidal wash, is effective in reducing HDM allergen concentrations in bedding. However, even with these control measures in place, HDM allergen levels remained high by international standards.
IL3 effect on basophils histamine release upon stimulation with chronic urticaria sera
Authors: Ferrer M. , Luquin E. , Kaplan A. P.
Published: July 2003

Background:  Chronic urticaria is thought to be an autoimmune disorder in 35–40% of patients because of the presence of an immunoglobulin G (IgG) antibody reactive with the IgE receptor. Patients possessing this antibody are identified by the ability of serum to degranulate donor basophils to release histamine. We questioned whether priming of basophils with interleukin 3 (IL3) would facilitate identification of patients and/or alter the percentage of patients who have a positive assay.

Methods:  We incubated 37 chronic urticaria sera with basophils from donors with no urticaria with and without priming with IL3 and compared histamine release in each instance. We also preincubated basophils from a ‘non‐releaser’ with IL3, used these cells to assay chronic urticaria sera, and assessed the contribution of complement.

Results:  Interleukin 3 increases the amount of histamine release by the sera which is able to activate basophils, but it does not convert negative sera into positive releasers. Interleukin 3 is able to partially reverse ‘non‐releaser’ basophils into cells that respond to chronic urticaria sera, and complement cannot account for the augmentation seen.

Conclusions:  Preincubating basophils with IL3 facilitates the identification of sera with anti‐IgE receptor antibody but does not affect the percentage of sera designated as positive.
Comparison of ammoniated and nonammoniated extracts in children with latex allergy
Authors: La Grutta S. , Mistrello G. , Varin E. , Pajno G. B. , Passalacqua G.
Published: July 2003

Background:  The use of ammoniated or nonammoniated latex extracts for the diagnosis of latex allergy is still a matter of debate. The aim of our study was to compare the characteristics of the two types of extracts by immunoblotting and RAST techniques in children with ascertained latex allergy.

Methods:  Ammoniated (AL) and nonammoniated latex (NAL) extracts were prepared and blotted on SDS‐PAGE to resolve their components. Also a solid phase for RAST assays was prepared with the two extracts. The sera from 18 children (mean age 11.4 years, range 6–15 years), with ascertained latex allergy (clinical history, skin test, CAP‐RAST and provocation) were used for the experiments.

Results:  The NAL extract is resolved in many bands (5–100 kDa), whereas AL showed only few components, likely Hev b 4, 6 and 7. IgE reactivity against AL was observed only in 5/18 patients, whereas 12/18 were positive with NAL. The blotting profile against NAL was complex and the IgE recognition pattern involved different bands.

Conclusion:  The extract obtained from NAL is able to detect specific IgE against a greater number of allergenic determinants, and therefore a greater diagnostic accuracy can be expected.
Intranasal capsaicin reduces nasal hyperreactivity in idiopathic rhinitis: a double‐blind randomized application regimen study
Authors: Van Rijswijk J. B. , Boeke E. L. , Keizer J. M. , Mulder P. G. H. , Blom H. M. , Fokkens W. J.
Published: July 2003

Background:  In a recent study, we showed that intranasal capsaicin spray gives a significant and long‐term reduction of symptoms in nonallergic noninfectious perennial rhinitis patients. However, in daily practice, the studied application regimen proved to be impractical because of the large number of visits required in a short period of time. In the present study, we conducted a double‐blind double‐dummy parallel groups trial to determine whether a more practical capsaicin application schedule is equally effective.

Methods:  Thirty patients were randomized into two different treatment regimens: one group received capsaicin five times on the first day at 1‐h intervals. This was followed by a placebo dummy once every second or third day for a total of five treatments 2 weeks after the capsaicin application (group A). The other group (B) received the placebo dummy five times on the first day followed by capsaicin once every second or third day for a total of five treatments 2 weeks after the placebo application.

Results:  The visual analogue scale scores for overall nasal symptoms, rhinorrhea and nasal blockage showed significant decrease after the start of treatment in both groups, with a significantly steeper decrease in group A. A significant reduction in cold dry air dose responsiveness was also found up to 9 months after therapy in both groups, reflecting a decrease in nasal hyperreactivity. No significant changes in safety data (smell, blood pressure, heart rate) were found.

Conclusions:  We conclude that intranasal capsaicin seems safe to use and that five treatments of capsaicin on a single day is at least as effective as five treatments of capsaicin in 2 weeks.
Differences in mite fauna between the continental and Mediterranean climates of Croatia: microscopy and DustscreenTM test findings
Authors: Macan J , Kanceljak B , Plavec D , Milković‐Kraus S
Published: July 2003

Background:  The aim of this study was to evaluate the difference between the mite fauna in the inland and coastal Croatia.

Methods:  Ninety‐nine floor house dust samples were collected: 28 from the coastal area, 31 from the inland rural and 40 from the inland urban area. Data on basic household characteristics were collected for 81 of 99 households. The mites were separated from the dust using the floatation method and then microscopically identified. The levels of Dermatophagoides pteronyssinus (Der p) 1, Dermatophagoides farinae (Der f) 1 and Der 2 were measured using the DustscreenTM test. Ordinal descriptive statistics and nonparametric tests were used for data analysis, assuming statistical significance at P < 0.05.

Results:  More than 70% of mites identified in all areas were pyroglyphids. Nonpyroglyphid mites accounted for 20–25% of all identified mites in the coastal areas (Blomia, Lepidoglyphus and Glycyphagus) and with 15% in the inland areas (Lepidoglyphus and Acarus). The highest Der p 1 median levels were found in the coastal area, with significantly lower levels in the inland rural and inland urban areas (4.5; 2; 0.85 μg/g of dust; P = 0.0001). The highest Der f 1 median levels were found in the inland urban area, with significantly lower levels in the inland rural and coastal areas (0.88; 0.75; 0 μg/g of dust; P = 0.0013). The levels of Der f 1 were significantly higher in samples taken from households with central heating than from those with traditional heating (1; 0.25 μg/g of dust; P < 0.01).

Conclusions:  Separate diagnostic dust mite lists for the coastal and inland areas because of climatic and dwelling differences required to be implemented. Compared with traditional heating, central heating significantly increases the risk of exposure to Der f 1 levels >2 μg/g of dust (odds ratio, 7.35; 95% confidence interval, 1.43–37.87; P = 0.01).
Side‐effects of complementary and alternative medicine
Authors: Niggemann B. , Grüber C.
Published: July 2003

Complementary and alternative medicine are increasingly used to diagnose or treat allergic diseases, and numerous studies have reported benefits of this type of medicine. This article presents a review of the literature on risks of these methods. The potential sensitizing capacity of numerous herbal remedies may lead to allergic contact dermatitis and more rarely to IgE‐mediated clinical symptoms. Mechanical injuries may be observed following acupuncture leading to pneumothorax, cardiac tamponade or spinal injury. Infectious complications after acupuncture include hepatitis and bacterial endocariditis. Organ toxicity has been observed associated with various herbal preparations involving the liver, kidneys, and the heart. Some herbs may have cancerogenic properties. Severe nutritional deficiencies can occur in infants and small children given strict alternative diets, resembling ‘kwashiorkor’. Finally, among other miscellaneous adverse effects, adulteration with steroids, and herbal and drug interactions are discussed. The pattern of side‐effects is similar to that observed by the use of conventional medicine. Therefore, caution may be justified using both conventional and unconventional methods. Only if the benefit is proven and the side‐effects are established, should a given method be chosen.
Relationship between airway hyperresponsiveness to mannitol and adenosine monophosphate
Authors: Currie G. P. , Haggart K. , Brannan J. D. , Lee D. K. C. , Anderson S. D. , Lipworth B. J.
Published: July 2003

Background: Assessment of airway hyperresponsiveness (AHR) to indirect bronchoconstrictor stimuli is a useful noninvasive tool in the evaluation of asthma and its treatment. We investigated the putative relationship in AHR between inhaled adenosine monophosphate and mannitol.

Methods: Fifteen mild‐to‐moderate atopic asthmatics were evaluated. On two separate screening days, the threshold AMP concentration and threshold mannitol dose to provoke a given fall in FEV1 were measured.

Results: For AMP PC20vs. mannitol PD15, the Pearsons correlation coefficient was 0.80, P < 0.001. For AMP PC15vs. mannitol PD15 and AMP PC10vs. mannitol PD10 corresponding values were 0.83, P < 0.001 and 0.68, P = 0.005.

Conclusions: There was a highly significant association between the threshold concentration of AMP and dose of mannitol causing a given fall in FEV1. Further studies are required to evaluate the relationship between inhaled mannitol and other surrogate inflammatory markers.
Diagnosis of cypress pollen allergy: in vivo and in vitro standardization of a Juniperus ashei pollen extract
Authors: Hrabina M. , Dumur J.‐P. , Sicard H. , Viatte A. , Andre C.
Published: July 2003

Background: Cypress pollen allergy is a major cause of rhinoconjunctivitis and asthma in the Mediterranean area. The nonstandardized cypress allergen extracts currently available for the diagnosis of cypress allergy have a low level of activity. The search for an active material has led to the selection of Juniperus ashei (Ja) pollen because of its very high cross‐reactivity with cypress extracts and its superior allergenic activity. The aim of this study was to characterize in vitro and calibrate in vivo an in‐house reference extract (IHRS) of J. ashei pollen and determine the specificity and sensitivity of a standardized Ja extract for the prick test diagnosis of cypress allergy.

Methods: Juniperus ashei pollen extract was analysed by 2‐D electrophoresis. The IHRS Ja extract was calibrated by skin prick testing in 28 cypress‐allergic patients. The sensitivity and specificity of cypress allergy diagnosis using a standardized Ja extract was studied by skin prick test in 42 cypress‐allergic patients and 53 nonallergic patients. Jun a 1 content of the IHRS was determined by a monoclonal antibody‐based electrophoretic technique.

Results: The Jun a 1 content of the 100 IR/ml Ja IHRS extract was 180 μg/ml. For in vivo diagnosis of cypress allergy, Ja pollen extract demonstrated a sensitivity of 95%, a specificity of 100%, a negative predictive value of 96%, and a positive predictive value of 100%.

Conclusion: Standardized Ja pollen extract is therefore a very appropriate tool for the in vivo diagnosis of cypress pollen allergy and good candidate for specific immunotherapy.
Subjects with allergic rhinitis show signs of more severely impaired paranasal sinus functioning during viral colds than nonallergic subjects
Authors: Alho O.‐P. , Karttunen T. J. , Karttunen R. , Tuokko H. , Koskela M. , Suramo I. , Uhari M.
Published: July 2003

Background:  Viral cold is thought to be the major contributing factor in the pathogenesis of sinusitis, as it causes ostiomeatal obstruction. The aim was to evaluate whether paranasal sinus functioning during viral colds is similar in subjects with and without allergic rhinitis.

Methods:  Forty‐eight volunteers were examined during an early (2–4 days) natural cold and again 3 weeks later. The examinations included computed tomography (CT) scans, nasal mucosal biopsies, and viral and bacterial specimens. Subjects with positive skin prick tests and persistent or intermittent rhinitis were considered to have allergic immunoglobulin E (IgE)‐mediated rhinitis. In addition, specific IgE antibodies to staphylococcal enterotoxin B (SEB) were measured.

Results:  Nine subjects (19%) had allergic rhinitis. The allergic subjects were significantly more often IgE sensitized to SEB than the nonallergic subjects (33%vs 3%, P = 0.02). Viral etiology of the cold was identified in 32 (67%) subjects. The subjects with allergic rhinitis had significantly higher CT scores compared with nonallergic subjects during the colds (median (range) scores 16 (6–22) vs 6 (0–17), P = 0.004). In both groups, the median scores declined markedly during convalescence, but the difference remained significant (P = 0.009). Among the allergic subjects, those who were IgE sensitized to SEB tended to have the highest CT scores [median (range) 16 (16–22)]. Total serum IgE and the nasal subepithelial eosinophil counts correlated with the CT scores during the cold (rs = 0.38, P = 0.008 and rs = 0.46, P = 0.001, respectively).

Conclusions:  Subjects with allergic IgE‐mediated rhinitis had more severe paranasal sinus changes in CT scans than nonallergic subjects during viral colds. These changes indicate impaired sinus functioning and may increase the risk of bacterial sinusitis.
Unique origin and low penetrance of the 946delGAG mutation in Valencian DYT1 families
Authors: Carmona J , Burguera JA , Mollà B , Mulas F , Smeyers P , Carratalà F , De Yebenes JG , Hoenicka J , Palau F
Published: July 2003

Mutations in the DYT1 gene cause idiopathic torsion dystonia (ITD) transmitted in families as an autosomal dominant trait with incomplete penetrance. The most common mutation, 946delGAG, has been observed in populations with different ethnic and geographic origins. We have investigated 40 individuals from 22 unrelated families with ITD originating from the Land of Valencia, Spain, for the presence of this mutation and we found 5 patients and 6 unaffected subjects from 4 families who were carriers of the mutation. This finding indicates that 18% of families may be diagnosed as DYT1 and that penetrance is reduced. We detected two different geographic and linguistic origins of the Valencian families. However, by haplotype analysis using D9S1260, D9S1261, D9S63 and D9S1262 as flanking markers, we demonstrated that all affected and unaffected carriers shared a common chromosome confirming identical origin of the mutation in the four families. We postulate a unique origin for the 946delGAG mutation in the Land of Valencia and, based on linguistic criterion, we propose that the mutation might have occurred at the beginning of the second millennium. Genetic analysis of another family from Castilla‐La Mancha showed a different haplotype segregating with the disease, suggesting that at least two distinct mutational events for the 946delGAG mutation have occurred in Spain.
Two new PROP1 gene mutations responsible for compound pituitary hormone deficiency
Authors: Paracchini R , Giordano M , Corrias A , Mellone S , Matarazzo P , Bellone J , Momigliano‐Richiardi P , Bona G
Published: July 2003

Mutations in the Prophet of Pit‐1 (Prop‐1), a paired‐like homeodomain transcription factor involved in the early embryonic pituitary development, have been reported as a cause of combined hormone deficiency (CPHD) involving growth hormone (GH), prolactin (PRL), thyroid‐stimulating hormone (TSH), gonadotrophins and in some cases adrenocorticotrophic hormone (ACTH). We report two pre‐pubertal siblings with short stature and deficiency of GH and TSH at presentation. Molecular analysis of the PROP1 gene revealed compound heterozygotes for two novel missense mutations of the PROP1 gene affecting the same amino acid (Arg71Cys and Arg71His) in the first alpha helix of the Prop‐1 homeodomain.
Who gets the information about genetic testing for cancer risk? The role of race/ethnicity, immigration status, and primary care clinicians
Authors: Honda K
Published: July 2003

This study identified factors associated with awareness of genetic testing for cancer risk in the US general population. Multiple logistic regression analysis was used to analyze data from the 2000 National Health Interview Survey. The strong predictors were education, race/ethnicity, immigration status, health status, interaction with health professionals, controlling for socioeconomic status, cancer diagnosis, family history of cancer, and perceived personal cancer risk. The substantial lack of awareness of genetic testing among immigrant and ethnic populations warrants further research and tailored educational interventions. Ways to improve quality of patient interactions with non‐genetic clinicians in promoting public knowledge of genetic testing for cancer risk are also worthy of further exploration.
Nine novel mutations in the protoporphyrinogen oxidase gene in Swedish families with variegate porphyria
Authors: Wiman Å , Harper P , Floderus Y
Published: July 2003

Variegate porphyria (VP) is an autosomal‐dominant disorder that is caused by inheritance of a partial deficiency of the enzyme protoporphyrinogen oxidase (EC 1.3.3.4). It is characterized by cutaneous photosensitivity and/or various neurological manifestations. Protoporphyrinogen oxidase catalyses the penultimate step of haem biosynthesis, and mutations in the PPOX gene have been coupled to VP. In the present study, sequencing analysis revealed 10 different mutations in the PPOX gene in 14 out of 17 apparently unrelated Swedish VP families. Six of the identified mutations, 3G > A (exon 2), 454C > T (exon 5), 472G > C (exon 6), 614C > T (exon 6), 988G > C (exon 10) and IVS12 + 2T > G (intron 12), are single nucleotide substitutions, while 604delC (exon 6), 916‐17delCT (exon 9) and 1330‐31delCT (exon 13) are small deletions, and IVS12 + 2‐3insT (intron 12) is a small insertion. Only one of these 10 mutations has been reported previously. Three of the mutations were each identified in two or more families, while the remaining mutations were specific for an individual family. In addition to the 10 mutations, one previously unreported single nucleotide polymorphism was identified. Mutation analysis of family members revealed two adults and four children who were silent carriers of the VP trait. Genetic analysis can now be added to the conventional biochemical analyses and used in investigation of putative carriers of a VP trait in these families.
Syndromes of disordered chromatin remodeling
Authors: Ausió J , Levin DB , De Amorim GV , Bakker S , Macleod PM
Published: July 2003

Syndromes of disordered ‘chromatin remodeling’ are unique in medicine because they arise from a general deregulation of DNA transcription caused by mutations in genes encoding enzymes which mediate changes in chromatin structure. Chromatin is the packaged form of DNA in the eukaryotic cell. It consists almost entirely of repeating units, called nucleosomes, in which short segments of DNA are wrapped tightly around a disk‐like structure comprising two subunits of each of the histone proteins H2A, H2B, H3 and H4. Histone proteins are covalently modified by a number of different adducts (i.e. acetylation and phosphorylation) that regulate the tightness of the DNA–histone interactions. Mutations in genes encoding enzymes that mediate chromatin structure can result in a loss of proper regulation of chromatin structure, which in turn can result in deregulation of gene transcription and inappropriate protein expression. In this review we present examples of representative genetic diseases that arise as a consequence of disordered chromatin remodeling. These include: α‐thalassemia/mental retardation syndrome, X‐linked (ATR–X); Rett syndrome (RS); immunodeficiency‐centromeric instability–facial anomalies syndrome (ICF); Rubinstein–Taybi syndrome (RSTS); and Coffin–Lowry syndrome (CLS).
The genetics of pre‐eclampsia: a feto‐placental or maternal problem?
Authors: Cross JC
Published: July 2003

Pre‐eclampsia is a potentially life‐threatening disease of women during pregnancy leading to hypertension and proteinuria. It affects 1 in 15 pregnancies but, despite intense research efforts, the cause of the disease remains mysterious. Because pre‐eclampsia only occurs during pregnancy and its symptoms resolve after delivery, factors from the placenta are thought to be involved. The role of the placenta could be production of ‘abnormal’ factors that initiate widespread inflammation and vaso‐constriction. Alternatively, because the placenta normally contributes to maternal cardiovascular adaptations of pregnancy, it may be that normal placental functions fail in pre‐eclampsia or that susceptibilities in the mother to hypertensive, vascular and/or renal disease prevent the appropriate normal responses to them. The potential contributions of both maternal and fetal genes to the onset of the disease have complicated the genetic analysis of the disease in humans. Recent studies have identified strains of transgenic and mutant mice that develop the hallmark features of pre‐eclampsia‐like disease – gestational hypertension, proteinuria and kidney lesions (glomerulosclerosis). Comparison of three different mouse models suggests that pre‐eclampsia can be initiated by at least three independent mechanisms: pre‐existing borderline maternal hypertension that is exacerbated by pregnancy (BPH/5 strain of mice), elevated levels of the vasoconstrictor angiotensin II in the maternal circulation by placental over‐production of renin (renin/angiotensinogen transgenic mice), and placental pathology (p57Kip2 mutant mice). These findings imply that the pathogenesis of pre‐eclampsia cannot be explained by a single mechanism. Therefore, segregation of the human disease into different subtypes may be a key first step in identifying genetic risk factors.
Low utilisation of unactivated protein C in a patient with meningococcal septic shock and disseminated intravascular coagulation
Authors: Lignell A. , Siegbahn A. , Stridsberg M. , Pauksen K. , Gedeborg R. , Sjölin J.
Published: July 2003

Background:  Activated protein C has recently been shown in a multicentre trial to significantly reduce mortality in patients with septic shock. There are also some case reports and minor studies demonstrating promising results with the unactivated form of protein C. However, in children with severe meningococcal infection, skin biopsies have demonstrated low expression of endothelial thrombomodulin and protein C receptors, suggesting low protein C activation capacity in severe meningococcal sepsis.

Methods:  A patient with meningococcal septic shock was treated with two doses of the unactivated form of protein C, the first during intense activation of the coagulation system and the second during a phase of low grade or no activation. Repeated plasma samples were analysed for protein C concentration, which made it possible to compare pharmacokinetics and half‐lives of the two administrations. A shorter half‐life during intense coagulation was expected if there was an activation and consumption of the protein C administered.

Results:  The calculated half‐lives of protein C during intense and low grade activation were 32 h and 19 h, respectively, a magnitude similar to that reported in protein C‐deficient patients without infection.

Conclusion:  The result indicates that whole body utilisation of the unactivated protein C was low. Endothelial impairment of protein C activation does not seem to be restricted to the skin vessels only.
Pneumoperitoneum versus abdominal wall lift: effects on central haemodynamics and intrathoracic pressure during laparoscopic cholecystectomy
Authors: Andersson L. , Lindberg G. , Bringman S. , Ramel S. , Anderberg B. , Odeberg‐Wernerman S.
Published: July 2003

Background:  It has been shown repeatedly that laparoscopic cholecystectomy using pneumoperitoneum (CO2 insufflation) may be associated with increased cardiac filling pressures and an increase in blood pressure and systemic vascular resistance. In the present study, the effects on the central circulation during abdominal wall lift (a gasless method of laparoscopic cholecystectomy) were compared with those during pneumoperitoneum. The study was also aimed at elucidating the relationships between the central filling pressures and the intrathoracic pressure.

Methods:  Twenty patients (ASA I), scheduled for laparoscopic cholecystectomy, were randomised into two groups, pneumoperitoneum or abdominal wall lift. Measurements were made by arterial and pulmonary arterial catheterization before and during pneumoperitoneum or abdominal wall lift with the patient in the horizontal position. Measurements were repeated after head‐up tilting the patients as well as after 30 min head‐up tilt. The intrathoracic pressure was monitored in the horizontal position before and during intervention using an intraesophageal balloon.

Results:  After pneumoperitoneum or abdominal wall lifting there were significant differences between the two groups regarding MAP, SVR, CVP, CI, and SV. Analogous to previous studies, in the pneumoperitoneum group CVP, PCWP, MPAP, and MAP as well as SVR were increased after CO2 insufflation (P < 0.01), while CI and SV were not affected. In contrast, in the abdominal wall lift group, CI and SV were significantly increased (P < 0.01), as was MAP (P < 0.01), while CVP, PCWP, MPAP, and SVR were not significantly affected. There was a significant difference in intraesophageal pressure between the two groups. In the pneumoperitoneum group, the intraesophageal pressure was increased by insufflation (P < 0.01) while, in the abdominal wall lift group, it was unaffected. In the pneumoperitoneum group the mean increases in cardiac filling pressures were of the same magnitude as the mean increase in the intraesophageal pressure.

Conclusions:  In healthy patients, abdominal wall lift increased cardiac index while pneumoperitoneum did not. Cardiac filling pressures and systemic vascular resistance were increased by pneumoperitoneum but unaffected by abdominal wall lift. The recorded elevated cardiac filling pressures during pneumoperitoneum may be only a reflection of the increased intra‐abdominal pressure.
Influence of the cortical electrical activity level during general anaesthesia on the severity of immediate postoperative pain in the morbidly obese
Authors: Gurman G. M. , Popescu M. , Weksler N. , Steiner O. , Avinoah E. , Porath A.
Published: July 2003

Background:  The objective of anaesthesia is to provide hypnosis, analgesia and adequate conditions during surgery. It is difficult to establish the appropriate dose of general anaesthetic drugs in the morbidly obese patient. Moreover, there are conflicting data concerning adequate anaesthesia levels and the severity of postoperative pain.

The aim of this study was to investigate the relationship between the spectral edge frequency (SEF) during general anaesthesia and the severity of immediate postoperative pain following gastric banding surgery in morbidly obese patients.

Methods:  Seventy‐one ASA 2 morbidly obese patients (BMI > 35%) undergoing elective laparoscopic gastric banding procedure were recruited for this study.

Anaesthesia consisted of midazolam, fentanyl and thiopental for induction, vecuronium for muscle relaxation, N2O and isoflurane with additional fentanyl administrations, according to the clinical judgement of the anaesthesiologist, for maintenance.

Continuous SEF monitoring was added to the standard monitors (SpO2, ETCO2, ECG, NIBP, O2 and isoflurane concentration), but the EEG monitor screen was hidden from the anaesthesiologist's sight.

SEF postoperative analysis divided the patients into two groups: group 1, SEF‐recommended target range of 8–12 Hz, more than 80% of the surgical time; and group 2, SEF‐recommended target range of 8–12 Hz, less than 80% of the surgery duration. Pain intensity was assessed in the post anaesthesia care unit using a standard visual analogue scale (VAS) of 10 cm, when patients were awake enough to correct a deliberately given wrong own telephone or ID number. Intravenous morphine was administered for postoperative analgesia in 2‐mg increments, every 3–4 min, until the patient felt comfortable.

A recovery room nurse unaware of the SEF range recorded during surgery registered pain severity and morphine requirements.

Results:  The end‐tidal isoflurane concentration was significantly higher in group 1 than in group 2 (0.83 vs. 0.7 P = 0.016). The intensity of pain at admission into the recovery room and at discharge was significantly lower in group 1 than in group 2 (VAS 6.1 vs. 6.9–P = 0.0049, and 3.9 vs. 4.2–P = 0.00478, respectively).

Conclusions:  Keeping the SEF range between 8 and 12 Hz during anaesthesia for laparoscopic gastric banding for morbid obesity, both the immediate post operative pain intensity and morphine requirement, are significantly reduced.
What anaesthetists need to know about viral hepatitis
Authors: Lentschener C. , Ozier Y.
Published: July 2003

Background:  Viral hepatitis is a major world‐wide public health issue. An increasing number of virus hepatitis carriers with acute or chronic hepatitis at all stages of the disease will be referred to anaesthetists. An update of what anaesthetists should know about viral hepatitis was believed to be warranted.

Methods:  The present review focuses on (a) diagnosis criteria and main biological and clinical patterns of acute and chronic hepatitis, and (b) extrahepatic manifestations, and adverse effects resulting from specific drug therapy likely to influence anaesthetic care.

Results:  Elective surgery should be postponed and any medications that could be harmful to the liver should be disregarded in patients suspected of having acute viral hepatitis. A prothrombin time decrease to less than 50% (INR > 1.75) is the first sign of acute severe liver failure. Extrahepatic manifestations resulting mainly from small‐ and medium‐sized vessel alteration, and adverse effects caused by specific drug therapy are associated with chronic viral hepatitis and are likely to alter anaesthetic care. A titrated anaesthesia should be provided and agents not eliminated by the liver should be favoured. Vasopressor therapy should be administered early to control a systemic intraoperative blood pressure decrease associated with a high cardiac output. Prophylactic antibiotics should take into consideration the risk of translocation of gut bacteria to the systemic circulation. Prophylactic guidelines of hepatitis nosocomial transmission should be respected.

Conclusions:  Anaesthetists are likely to play a key role in immediate acute hepatitis and chronic hepatitis perioperative assessment and care.