bluuebunny/crossref_metadata_2025 huggingface dataset:
A Nursing Model of Community Organization for Change
Authors: Anderson Diane , Guthrie Teresa , Schirle Rebecca
Published: March 2003

Community health nursing has the potential to reach beyond the individual and create interventions that affect the community as a whole. The Nursing Model of Community Organization for Change presented in this article describes the relationships among the concepts of empowerment, partnership, participation, cultural responsiveness, and community competence within a community organizing context. These concepts are implemented through the use of the Nursing Model of Community Organization for Change, which consists of four phases: assessment/reassessment, planning/design, implementation, and evaluation/dissemination. This nursing model provides a theoretical framework for community health professionals when creating community health interventions in partnership with community members.
Developing a School Asthma Policy
Authors: McGhan Shawna L. , Reutter Linda I. , Hessel Patrick A. , Melvin Darrel , Wilson Douglas R.
Published: March 2003

Schools are faced with the challenging mandate of addressing the learning needs of students while simultaneously managing a gamut of behavior and health problems. School health policies have been successfully used for many health‐related issues. Although asthma is the most common chronic disease among children, schools receive only a small amount of support to manage asthma issues. This article describes our experiences in developing an asthma policy in schools. The problem of asthma in schools was assessed as part of a comprehensive community‐based asthma intervention, and a plan was established to develop a school asthma policy. The goal of the policy was to facilitate a physical and social environment that enabled students with asthma to control optimally their condition, have a good quality of life, and learn effectively. Specific objectives included enhancing environmental control, educating staff, clarifying medication protocols, and responding appropriately to symptoms. Strategies in developing the policy included strengthening collaboration and networks among health, school, and community sectors; defining the role of the school and health sectors; designing the policy; refining the policy based on stakeholder feedback; and developing an evaluation plan.
Health Care Delivery System Influences Changes in Nursing Educational Materials
Authors: Baldwin Joan H. , Conger Cynthia O'Neill , Maycock Chloe , Abegglen JoAnn C.
Published: March 2003

The changing health care delivery system has affected nursing care delivery models. To meet the needs of these shifting sands, health‐related professions must examine curricula preparing new graduates. An exploratory, descriptive survey design was employed to discover motivators for and types of curricular changes occurring in nursing programs and determine what supportive educational materials are needed. One hundred sixty‐seven (26%) of the 651 surveys mailed to a sample of the whole of U.S. baccalaureate nursing programs were returned. Relationships between and among categories of nominal data culled from the participants' experiences were compared using nonparametric statistics. Findings demonstrated why and what changes were made and what educational materials are needed to support new curricula. Results also indicated that blurring of boundaries between community and general acute care nursing is necessary, and changes throughout curricula, including educational materials, must reflect the real‐life community aspects of the health care needs of all individuals.
Maternal Characteristics and Maternal Limit‐Setting Styles
Authors: LeCuyer‐Maus Elizabeth A. , Houck Gail M.
Published: March 2003

In a longitudinal study of 126 mothers and toddlers during toddlerhood, maternal limit‐setting styles were assessed at 12, 24, and 36 months in relation to selected maternal characteristics. Mothers using teaching‐based limit‐setting styles at 12 months reported more optimal relationship histories of care and overprotection/control in their own families of origin. The main contributor to a maternal teaching‐based limit‐setting style in this sample was years of formal education, followed by a more multicausal conceptualization of how children develop. Thus, while years of formal education appear to facilitate the use of a teaching‐based limit‐setting style, formal education is not the only way to develop these skills. Maternal conceptualization of development may be amenable to intervention through a number of alternative learning activities. Further research is needed to explore the effects of different types of educational and learning opportunities on current maternal behavior, with the goal of optimizing socialization skills related to the development of toddler self‐regulation.
A Public Health Nursing Practice Model: Melding Public Health Principles with the Nursing Process
Authors: Smith Kathleen , Bazini‐Barakat Noël
Published: March 2003

Abstract  There has been a shift in emphasis in public health from the provision of personal health services for individuals to efforts targeted at improving the health of the whole community. Many in public health nursing (PHN) have welcomed this shift, recognizing the important role PHN can play in promoting health and preventing disease for all. There continues to be a need to redefine PHN roles and practice so that public health nurses can participate more effectively. Los Angeles County Department of Health Services Public Health Nursing (LAC PHN) has developed a practice model grounded in nationally recognized components: the public health team, PHN standards of practice, the 10 Essential Public Health Services, Healthy People 2010's 10 Leading Health Indicators and additional local indicators, and the Minnesota Public Health Nursing Interventions Model. The LAC PHN Practice Model provides a conceptual framework that assists in clarifying the role of the public health nurse and presents a guide for public health practice applicable to all public health disciplines.
Pagetoid Self‐Healing Langerhans Cell Histiocytosis in an Infant
Authors: Hashimoto Ken , Schachner Lawrence A. , Huneiti Abdallah , Tanaka Kazuaki
Published: March 2003

We report Langerhans cell (LC) histiocytosis in a male infant who developed numerous papular lesions on the trunk and posterior scalp soon after birth and spontaneously recovered from the disease within 7 months. Histologically S‐100‐positive cells were detected in the epidermis and papillary dermis, in some lesions mostly in the epidermis. Tumor cells in the epidermis were either clustered, forming nests, or scattered singly in pagetoid fashion. Electron microscopy confirmed the presence of Birbeck granules in these cells. They exhibited many interesting features usually not found in normal LCs, including mitosis, frequent apoptosis, Birbeck granules invaginated in the nucleus, auto‐phagocytosis of Birbeck granules, and active ingestion of extracellular material through Birbeck granules attached to cell membranes. It is suggested that either a strong epidermotropism of tumor cells or a proliferation of the resident LCs of the epidermis is responsible for this intraepidermal growth pattern. Cellular necrosis through very active apoptosis and the superficial nature of the growth might have contributed to the self‐healing course in this patient.
The Spectrum of Epidermal Nevi: A Case of Verrucous Epidermal Nevus Contiguous with Nevus Sebaceus
Authors: Waltz Karen M. , Helm Klaus F. , Billingsley Elizabeth M.
Published: March 2003

During the normal development of skin, pluripotential cells give rise to keratinocytes, sebaceous glands, hair follicles, apocrine glands, and eccrine glands. In epidermal nevi, these components emerge in an abnormal mixture within a circumscribed site. Many authors have categorized epidermal nevi based on their predominant component; however, there is often notable overlap that occurs within a single area or within contiguous areas. We report a verrucous epidermal nevus contiguous to a nevus sebaceus of Jadassohn. The categories of epidermal nevi are somewhat artificial. Our case supports the view that epidermal nevi have a spectrum of manifestations, including verrucous epidermal nevi and nevus sebaceus of Jadassohn.
Acrodermatitis Enteropathica with Pseudomonas aeruginosa Sepsis
Authors: Özkan Şebnem , Özkan Hasan , Fetil Emel , Çorapçiog lu Funda , Yilmaz Şebnem , Özer Erdener
Published: March 2003

Abstract: Acrodermatitis enteropathica is characterized by eczematous and scaly plaques on the face, scalp, acral, and anogenital regions. In addition to typical lesions, unusual prominent vesiculobullous lesions are also described. We report a full‐term, 9‐month‐old boy who has acrodermatitis enteropathica and Pseudomonas sepsis. In this patient there were clinical findings of sepsis and eczematous vesiculobullous lesions on the periorificial and acral areas. Serum zinc level was extremely low. Pseudomonas aeruginosa was identified in cultures of blood and fluid which was aspirated from the bullous lesions. After oral zinc sulfate and intravenous antibiotic treatment his condition improved within 2 weeks.
Myxoid Liposarcoma in a 12‐Year‐Old Girl
Authors: Vocks Elisabeth , Worret Wolf‐Ingo , Burgdorf Walter H. C.
Published: March 2003

Abstract: A 12‐year‐old girl developed a myxoid liposarcoma on the inner side of her right thigh. Liposarcomas are extremely rare at this age compared to benign lipoblastomas, which are the most frequent tumors of fatty tissue in childhood. The prognosis of myxoid liposarcoma is good, especially when, as in this patient, the tumor is located in the subcutis where a large and deep excision is possible and often curative.
Crusted Scabies in an Immunocompetent Child: Treatment with Ivermectin
Authors: Gladstone Hayes B. , Darmstadt Gary L.
Published: March 2003

Abstract: An 11‐year‐old girl presented to our clinic with recalcitrant crusted scabies despite repeated applications of topical scabicides. She had no history of corticosteroid use prior to onset of the eruption and no evidence of immunodeficiency. A combination of oral ivermectin, topical lindane, and keratolytics cleared the infestation. Our patient is exceptional in that she had no risk factors commonly associated with a propensity to develop crusted scabies. While topical therapy remains the first‐line treatment for children with classic scabies, in the unusual instance of a child with recalcitrant, crusted scabies, ivermectin may offer an efficacious alternative, although it should be used with caution. We discuss the use of oral ivermectin for treatment of crusted scabies and the challenging comprehensive management needed for this socially stigmatizing condition.
Epidermolysis Bullosa, Pyloric Atresia, and Obstructive Uropathy: A Report of Two Case Reports with Molecular Correlation and Clinical Management
Authors: Wallerstein Robert , Klein Marcy Lentnek , Genieser Nancy , Pulkkinen Leena , Uitto Jouni
Published: March 2003

Abstract: The epidermolysis bullosa‐pyloric atresia‐obstructive uropathy (EB‐PA‐OU) association is a rare, but well‐described multisystem disease. While the prognosis at this time is still poor, an increasing number of patients are surviving to adolescence with aggressive care. It is important to understand this syndrome in order to anticipate medical complications and offer preventive strategies where possible. Prompt and expectant management of obstructive uropathy is crucial in these patients. Evidence of ureterovesicular obstruction may require bowel diversion, as excision of the obstructed ureterovesicular junction with reimplantation is often associated with a high risk of reobstruction. Many newborns succumb to sepsis or dehydration and electrolyte imbalance. Those infants who survive need close monitoring for the development of obstructive uropathy, failure to thrive, protein‐losing enteropathy, respiratory compromise, and increased susceptibility to invasive infections. Once a clinical diagnosis is made, mutational analysis can confirm it and facilitate genetic counseling, as recurrence risks are 25% for this autosomal recessive condition. Mutational analysis enables direct genetic testing and accurate prenatal diagnosis. As more patients are studied, genotype/phenotype correlations may be possible.
Vegetant Bromoderma in an Infant
Authors: Bel Susana , Bartralot Ramón , García Daniel , Aparicio Gloria , Castells Antonio
Published: March 2003

Bromoderma is a cutaneous reaction caused by the use of products containing bromide. In this report we describe a 2‐month‐old girl who was admitted to our institution with vegetative lesions on the face and scalp owing to the administration of a syrup containing sodium bromide.
Satoyoshi Syndrome
Authors: Wisuthsarewong Wanee , Likitmaskul Supawadee , Manonukul Jane
Published: March 2003

Satoyoshi syndrome is a very rare disorder of unknown etiology, characterized by progressive, intermittent, painful muscle spasms, alopecia universalis, diarrhea or unusual malabsorption, various endocrine disorders, and secondary skeletal abnormalities. This report describes a 9‐year‐old Thai girl who developed alopecia universalis when she was 6 years old. At age 7 years, she began to have recurrent, painful muscle spasms. The spasms progressed in time, producing recurrent patella dislocation. The laboratory investigations and radiologic study were compatible with Satoyoshi syndrome. She was treated with oral corticosteroid therapy, with marked improvement of her muscle spasms and alopecia. She underwent corrective surgery for deformities of both knees with a normal healing process.
Itraconazole is Effective in the Treatment of Tinea Capitis Caused by Microsporum Canis
Authors: Gupta Aditya K. , Ginter Gabriele
Published: March 2003

Tinea capitis is a relatively common superficial fungal infection in children which requires oral antifungal therapy. In a prospective, open study over 24 weeks, itraconazole 5 mg/kg/day, given as capsules or as an oral suspension for a period of 2–12 weeks, was used to treat children 1–12 years of age who had M. canis tinea capitis. Children with mycologic evidence of M. canis tinea capitis were entered into the study and asked to return at week 2 and then every 2 weeks thereafter until cured, with a maximum of 12 weeks of active treatment. At each visit the scalp was sampled and the material processed for light microscopy and culture examination. An extra 2 weeks of itraconazole was prescribed if the mycology from the sample obtained on the previous visit indicated that there was still presence of the organism. Patients were administered either 2, 4, 6, 8, 10, or 12 weeks of treatment. The final follow‐up visit was at 12 weeks from the cessation of drug therapy. Laboratory blood testing was performed only if indicated by history, examination, or the development of side effects. There were 107 patients (49 boys, 58 girls; mean ± standard error = 5.6 ± 0.2 years). Thirteen of the 107 children were given the oral suspension. At week 12 from the cessation of treatment there was complete (clinical and mycologic) cure in all 107 children. Increasing age of the patient correlated significantly with the length of itraconazole capsule therapy (p = 0.03). The duration of itraconazole treatment also correlated significantly with the severity of tinea capitis at baseline (p = 0.02). Adverse effects were observed in 5 children receiving itraconazole capsules (n = 94). These were regarded as being possibly or probably due to the drug in two children (mild transient stomach ache in one and moderate diarrhea in one). The child with diarrhea stopped therapy at week 4 with complete resolution of symptoms. One of 13 children receiving the oral suspension had mild, transient diarrhea. There were no drop‐outs in this group. Laboratory testing was not required in any patient. Compliance was very good in the patient group. Itraconazole 5 mg/kg/day given either as a capsule or an oral suspension for 4–8 weeks is effective and safe in the treatment of tinea capitis caused by M. canis.
Congenital Lymphedema and Distichiasis
Authors: Samlaska Curt P.
Published: March 2003

Distichiasis is defined as a double row of eyelashes. Inherited forms of distichiasis have been associated with early and late‐onset congenital lymphedema. We report on a child with distichiasis and congenital lymphedema in which it is unknown whether the cause of lymphedema was due to a spontaneous mutation or acquired secondary to an intrauterine infection. Acquired forms of distichiasis are reviewed.
Analytical Study of Pustular Eruptions in Neonates
Authors: Nanda Soni , Reddy B. S. N. , Ramji S. , Pandhi Deepika
Published: March 2003

Abstract: Pustular eruptions are commonly encountered in neonatal practice. Much confusion exists among clinicians because of the similarity in clinical lesions, paucity of relevant literature, and varied nomenclature used for these diseases. This often results in inappropriate diagnoses and therapies, besides subjecting the neonates to invasive and traumatic investigative procedures. We conducted a comprehensive study of pustular eruptions in 100 neonates, using the clinical examination and simple laboratory tests to arrive at a practical diagnostic and therapeutic approach to this problem. Of the 100 neonates with pustular eruptions, 36% were in the early neonatal period (first week of life). A slight male preponderance with a male:female ratio of 1:0.79 was observed. The majority of the families of these infants had poor socioeconomic status (96%) and were living in slums (71%). A study of their educational status revealed that 54% of the mothers were uneducated. Fifty‐seven percent of the neonates were born at home. The clinical pattern of diseases among these neonates was that 58% of them had infections [impetigo (23%), intertrigo (14%), scabies (6%), and viral diseases (6%)]. Noninfectious diseases (42%) included miliaria pustulosa, erythema toxicum neonatorum, epidermolysis bullosa, and contact dermatitis. Simple laboratory investigations helpful in establishing the diagnosis were smears processed with Gram (24%) and Giemsa (39%) stains and wet mounts with 10% potassium hydroxide (KOH) solution (27%) for direct microscopic examination. More than half (53%) of the patients required no specific treatment except for counseling and medications to alleviate symptoms, while others with an infectious etiology responded to topical and or systemic antibiotics/antifungals. Pustular eruptions in neonates include both infectious and noninfectious diseases. Simple laboratory tests such as Gram‐ and Giemsa‐stained smears, direct microscopy with 10% KOH wet mounts, bacterial and fungal cultures are helpful in establishing the diagnosis and occasionally skin biopsy is needed. A practical diagnostic and therapeutic approach to this problem is discussed.
Eruptive Pseudoangiomatosis
Authors: Angelo C. , Provini A. , Ferranti G. , Palermi G. , Paradisi M.
Published: March 2003

Abstract: Eruptive pseudoangiomatosis is a rare, benign, spontaneously regressive disease. The term was recently coined to describe a dermatosis characterized by the sudden onset of a few to several bright red angioma‐like papules with histopathologic findings distinct from that of true angiomas. We describe a 7‐year‐old patient with the typical lesions of eruptive pseudoangiomatosis.
D‐Penicillamine Treatment for Lipoid Proteinosis
Authors: Kaya Tamer Irfan , Kokturk Aysin , Tursen Umit , Ikizoglu Guliz , Polat Ayse
Published: March 2003

Abstract: Lipoid proteinosis, a rare disorder inherited in an autosomal recessive fashion, is characterized by the deposition of hyaline‐like material in the skin, mucous membranes, and other tissues. Perturbation of collagen metabolism has been suggested to play an important role in the pathogenesis. No effective therapy is available for the disease. The chelating agent D‐penicillamine has long been used to treat several diseases. In addition to its immunosuppressive and anti‐inflammatory effects, it also impairs fibroblast proliferation and inhibits the formation of the cross‐links in collagen and elastin fibers. A 13‐year‐old girl was clinically and histologically diagnosed with lipoid proteinosis. We treated her with 600 mg/day of D‐penicillamine for 2 years. The patient had improved clinically and histopathologically by the end of this treatment. We suggest D‐penicillamine as a promising agent, even in low doses, for the treatment of lipoid proteinosis.
Closed Continuous‐Flow Centrifuge
Authors: Judson George , Jones Alan , Kellogg Robert , Buckner Dean , Eisel Robert , Perry Seymour , Greenough William
Published: March 2003

Guest Editor's Introduction: The introduction of the NCI/IBM 2990 Blood Cell Separator made possible the processing of plasma and white cells by uninterrupted whole blood flow through a centrifugal apparatus. The story of the development of the separator relates the involvement of G.T. Judson whose son suffered from leukemia. Judson, a research engineer with IBM, and Freireich at the National Cancer Institute designed and fabricated a prototype device that would therapeutically remove WBCs. The initial emphasis on WBC removal later shifted to plasma removal. This paper reprinted here with permission was printed in Nature vol. 217, page 816–818 (1968), and describes the basic design and operational details of the device.
Membrane Processes for Plasma Separation and Plasma Fractionation: Guiding Principles for Clinical Use
Authors: Malchesky Paul S.
Published: March 2003

Abstract:The use of membranes in blood processing range from the use of large‐pore structures for filtration of blood for the removal of large particles (>20 μm transfusion filters) to membranes for the dialysis of blood for the removal of low molecular weight solutes in the treatment of renal failure. Within the past 20 years, membranes have been applied in the separation of plasma from whole blood. Compared to centrifugal plasma separation membrane, plasma separation is preferred when used with on‐line plasma fractionation since the plasma is free of cells. In addition, membranes have also been applied in the on‐line treatment of plasma for the selective removal of macromolecules in selected disease states obviating the need for plasma replacement products. The membranes used for plasma separation and fractionation may be distinguished from conventional dialysis membranes and high‐flux membranes used in hemofiltration by their very high or select passage of plasma proteins. Membrane techniques are simple and safe to apply and can be competitive to other plasma separation and treatment technologies.
Allogeneic Peripheral Blood Stem Cell Transplantation for Severe Aplastic Anemia
Authors: Gürman G. , Çelebi H. , Üstün C. , Arat M. , İlhan O. , Özcan M. , Arslan Ö. , Uysal A. , Akan H. , Beksaç M. , Konuk N. , Koç H.
Published: March 2003

Abstract: Allogeneic peripheral blood stem cell transplantation (PBSCT) is rarely applied for the treatment of severe aplastic anemia (SAA) because of questionable durability of engraftment and increased risk of graft versus host disease (GVHD). We performed allogeneic PBSCT in 3 SAA patients from their human leukocyte antigen (HLA)–identical siblings. One received bone marrow after conditioning with cyclophoshamide (Cy) plus antithymocyte globulin. He had a second transplant with peripheral blood stem cells from the original donor because of a graft failure (GF). Two other patients received PBSCT as a first option, with Cy as the only conditioning drug. The 3 patients received short‐term methotrexate and cyclosporine as a postgrafting immunosupression. In the latter 2 cases, no GF has been observed, and a successful and complete hematological recovery was achieved and maintained for 28 and 25 months, respectively. In conclusion, PBSCT provides a quick and complete hematological recovery in SAA patients.
A New Method for Removal of Albumin‐Binding Uremic Toxins: Efficacy of an Albumin‐Dialysate
Authors: Abe Takaya , Abe Tomiya , Ageta Shunrou , Kakuta Takatosi , Suzuki Nobuo , Hirata Haruhisa , Shouno Mineo , Saio Hidetoshi , Akizawa Tadao
Published: March 2003

Abstract: It is difficult for conventional hemodialysis to remove albumin‐binding uremic toxins (ABUTs) even though they are low molecular weight substances. We investigated the efficiency of albumin‐dialysate (AD) for removal of ABUT. Phenols and indoxyl sulfate were selected as ABUT. In vitro dialysis was performed for 2 h in the closed circuit with ABUT containing plasma as a test solution using conventional dialysate (CD) or AD. By the use of CD, the ABUT concentration in the test solution only was reduced by 20 to 30%. On the other hand, AD caused a marked reduction and an increase in test solution and dialysate concentration of ABUT, respectively. ABUT in AD could be adsorbed effectively by activated‐charcoal column; accordingly, the ABUT concentration in the test solution continued to decrease throughout the study period. These results suggest that AD could remove ABUT more efficiently than CD, and AD may be useful for reducing accumulated ABUT levels.
Influence of Storage Time on Activation of Platelets Collected with CS 3000 Plus and Cobe Spectra Using Platelet Storage Containers
Authors: Kutlay Sim , Ilhan Osman , Arslan Onder , Beksac Meral
Published: March 2003

Abstract: The aim of this study was to evaluate the in vitro activation in platelet suspensions collected with CS 3000 Plus and Cobe Spectra cell separators using platelet storage containers and the role of white blood cell (WBC) concentration of the suspension in this activation. Seventy‐seven donors were subjected to automated platelet donations with 1 type of equipment (37 with Cobe Spectra and 40 with CS 3000 Plus). Blood samples were obtained immediately after separation and on the third day of storage at 22°C in constant agitation. The WBC concentrations of these samples were studied before storage. Paraformaldehyde‐fixed platelets were incubated with 2 murine monoclonal antibodies: CD42b and CD62. Murine monoclonal antibody immunoglobulin G was used as a negative isotypic control. Bound antibody was then quantitated by flow cytometry. On the third day of storage, a significant increase in CD62 expression rate was observed in platelet suspensions collected with both kinds of equipment. Mean expression rates for Cobe Spectra on Day 0 and Day 3 were 25.6 ± 6.2% and 69.2 ± 9.7%, respectively. Mean expression rates for CS 3000 Plus on Day 0 and Day 3 were 23.4 ± 8.2% and 67.0 ± 8.2%, respectively. The mean results for both devices were 22.8 ± 4.56% for Day 0 and 68.7 ± 13.2% for Day 3. There was no difference between CD42b mean fluorescence intensity on Days 0 and 3 for the 2 devices (p > 0.5). Mean WBC concentrations in the platelet suspensions for Cobe Spectra and CS 3000 Plus were 0.37 × 103/μl and 0.42 × 103/μl, respectively, and there was no relation between WBC concentration and increase in CD62 expression. Both kinds of equipment were found to be similar according to in vitro activation markers.
Continuous Arterial Infusion of Prostaglandin E1 via the Superior Mesenteric Artery in the Treatment of Postoperative Liver Failure
Authors: Asanuma Yoshihiro , Sato Tsutomu , Kato Takeshi , Nanjo Hiroshi , Kurokawa Toshiaki , Yasui Ouki , Koyama Kenji
Published: March 2003

Abstract: Impaired hepatic blood flow is one of the causative factors in postoperative liver failure. To restore the hepatic blood flow in case of hepatic artery interruption (HAI), the effect of continuous arterial infusion of prostaglandin E1 (PGE1), which has a strong vasodilatory effect on vascular smooth muscles, was assessed experimentally and clinically. Twelve pigs underwent ligation and division of the hepatic artery and were divided into 2 groups. In the control group, saline was infused in the superior mesenteric artery (SMA), and in the PGE1 group, 0.02 μg/kg/min of PGE1 was infused continuously in the SMA. Hepatic oxygen delivery (HDo2) in the control group was 87.8 ± 8.9 ml/min before HAI and decreased to 43.1 ± 2.6 ml/min at 60 min after HAI, showing 50.9% decrease by HAI. On the contrary, HDo2 in the PGE1 group was 86.7 ± 9.1 ml/min before HAI and was 76.6 ± 12.2 ml/min at 60 min after HAI, showing only 11.6% decrease by HAI. Clinically, a 65‐year‐old female suffering from cholangiocellular carcinoma underwent extended left hepatic lobectomy. At operation, the branch of the hepatic artery to the anterior segment of the liver was ligated, and the right branch of the portal vein became stenotic unavoidably. Postoperatively, severe liver dysfunction developed so that continuous PGE1 infusion in the SMA was initiated at a rate of 0.01 μg/kg/min on the eighth postoperative day and continued for 9 days. Plasma exchange was performed twice concomitantly. Portal venous flow increased from 612 ml/min to 1,192 ml/min, and bile flow from external biliary drainage tube doubled by the PGE1 infusion. The liver function was ameliorated after PGE1 infusion.
Apheresis in Cryoglobulinemia Complicating Hepatitis C and in Other Renal Diseases
Authors: Dominguez Jesus H. , Sha Edward
Published: March 2003

Abstract: Removal of cryoglobulins by plasma exchange is now an accepted therapy. Cryoglobulins are circulating complexes that can deposit on small vessels and cause limited or extensive tissue injury. There are 3 major classes of cryoglobulins. Type I cryoglobulins are monoclonal and are detected in a variety of lymphoproliferative disorders. Type II cryoglobulins are mixed containing monoclonal and polyclonal IgG or IgM molecules. Type III cryoglobulins are also mixed and contain polyclonal IgG. Type II cryoglobulins are largely caused by hepatitis C virus infection; hence, they are the most common of the 3 types. In hepatitis C, cryoglobulins are linked to glomerular immune complex injury, oftentimes accompanied by vasculitis of the skin, nerves, and other vital organs. Immediate removal of cryoglobulins by plasma exchange is an effective short‐term treatment that can complement more‐specific therapies. Plasma exchange has also been used to remove other circulating nephrotoxic agents such as antiglomerular basement antibodies that cause Goodpasture's syndrome, protease inhibitor autoantibodies that cause thrombotic thrombocytopenic purpura, and antiglomerular factors that cause some types of focal glomerulosclerosis.
Establishment of Woody Riparian Species from Natural Seedfall at a Former Gravel Pit
Authors: Roelle James E. , Gladwin Douglas N.
Published: March 2003

Establishment of native riparian communities through natural seedfall may be a viable reclamation alternative at some alluvial sand and gravel mines where water level can be controlled in the abandoned pit. We experimented with this approach at a pit in Fort Collins, Colorado, where a drain culvert equipped with a screw gate allows water levels to be manipulated. From 1994 to 1996 we conducted a series of annual drawdowns during the period of natural seedfall of Populus deltoides subsp. monilifera (plains cottonwood), Salix amygdaloides (peachleaf willow), and S. exigua (sandbar willow), thus providing the bare, moist substrate conducive to establishment of these species. Establishment was highly variable from year to year; in the fall following establishment, frequency of occurrence on 0.5‐m2 sample plots ranged from 8.6% to 50.6% for cottonwood, 15.9% to 22.0% for peachleaf willow, and 21.7% to 50.0% for sandbar willow. Mean densities, however, were comparable to those reported for other locations. Concurrent establishment of the undesirable exotic Tamarix ramosissima (saltcedar) was a problem, but we were able to eradicate most saltcedar seedlings by reflooding the lower elevations of the annual drawdown zones each fall. At the end of the 3‐year period, at least one of the three native woody species survived on 41.1% of the plots, while saltcedar was present on only 6.1%. In addition to the potential for establishing valuable native habitats, adaptations of the techniques described may require less earth moving than other reclamation approaches.
Riparian Forest Restoration Along Large Rivers: Initial Results from the Sacramento River Project
Authors: Alpert Peter , Griggs F. Thomas , Peterson Daryl R.
Published: March 2003

Restoration of riparian vegetation along large rivers is complicated by the patchiness of the habitat and by conflicts with the societal need to control flooding. The Sacramento River Project, led by The Nature Conservancy in northern California, is testing whether it is possible to restore native forest along a large river without removing flood control. We conducted a post‐hoc analysis of monitoring data collected by the project on 1–4‐year old plantings of 10 native trees and shrubs at five sites. Two questions of general interest were: Can one identify types of species or sites that are especially suitable for restoration in such riparian habitats? To what degree must sites be treated as mosaics of patches, with different types of patches that are suited to different species? Plant performance as measured by height was better in species of Salicaceae or in species planted as cuttings than in species of other families or in species planted as seedings or seeds. Three within‐site factors, land form, soil depth to a buried layer of sand or gravel, and soil texture, affected the growth of several species, indicating that sites do need to be treated as patchy. However, there was little evidence that different species performed better on different types of patches. Instead, areas with deep or fine soils seemed to be favorable for a number of species. Results suggest that it is feasible to re‐establish native trees and shrubs along large, regulated rivers, at least at certain sites for an initial period of several years with the aid of weed control and irrigation. Shallowly buried layers or lenses of gravel or sand are a hidden, fine‐scale factor that can reduce plant growth on river terraces.
THROMBOMODULIN DEFICIENCY IN HUMAN DIABETIC NERVE MICROVASCULATURE
Authors: Hafer Macko CE , Ivey FM , Gyure KA , Sorkin JD , Macko RF
Published: March 2003

Human diabetic neuropathy is multifactorial in etiology, with ischemia as a final common pathology. Although impaired vascular endothelial cell function in diabetic microvascular injury is established, the role of thrombomodulin (TM)‐dependent protein C antithrombotic mechanism in the pathogenesis of neuropathy is unclear. This neuropathologic case‐control study investigated whether vascular endothelial TM expression is deficient in peripheral nerve microvessels in diabetic neuropathy. Sural nerve biopsies from 7 patients with diabetic neuropathy and 10 with axonal neuropathy without vasculopathy were immunostained with anti‐TM and anti‐von Willebrand factor (vWF; an endothelial cell marker) antibodies. The proportion of TM‐positive microvessels was expressed relative to total vWF‐staining vessels, according to vessel caliber and regional distribution within the nerve. In diabetic nerves compared with reference controls, the proportion of TM‐positive endoneurial microvessels was 15‐fold lower (0.02 vs. 0.30 in diabetic nerves vs. controls, P < 0.004), and the proportion of small‐caliber epineurial microvessels was 10‐fold lower (0.04 vs. 0.43, P < 0.001). No TM expression was detected at the perineurium in diabetic or control nerves. We demonstrate a substantial reduction of vascular endothelial TM expression throughout human diabetic neuropathy. These findings suggest that an impaired native TM‐dependent protein C antithrombotic mechanism may contribute to microvascular ischemia in the pathogenesis of diabetic neuropathy.
CHARACTERIZATION AND PHYLOGENETIC POSITION OF THE ENIGMATIC GOLDEN ALGA PHAEOTHAMNION CONFERVICOLA: ULTRASTRUCTURE, PIGMENT COMPOSITION AND PARTIAL SSU rDNA SEQUENCE
Authors: Andersen Robert A. , Potter Dan , Bidigare Robert R. , Latasa Mikel , Rowan Kingsley , O’Kelly Charles J.
Published: March 2003

The morphology, ultrastructure, photosynthetic pigments, and nuclear‐encoded small subunit ribosomal DNA (SSU rDNA) were examined for Phaeothamnion confervicola Lagerheim strain SAG119.79. The morphology of the vegetative filaments, as viewed under light microscopy, was indistinguishable from the isotype. Light microscopy, including epifluorescence microscopy, also revealed the presence of one to three chloroplasts in both vegetative cells and zoospores. Vegetative filaments occasionally transformed to a palmelloid stage in old cultures. An eyespot was not visible in zoospores when examined with light microscopy, but small droplets, similar to eyespot droplets, were apparent beneath the shorter flagellum when cells were viewed with electron microscopy. Zoospores had two flagella that were laterally inserted in the cell approximately one‐third of the cell length from the apex. The longer flagellum was directed anteriorly and the shorter flagellum was directed posteriorly. Electron microscopy revealed the presence of tubular tripartite flagellar hairs on the longer flagellum, but no lateral filaments were found on the tripartite hairs. The general organization of the flagellar root system was similar to that of zoospores belonging to the Xanthophyceae and Phaeophyceae. However, the transitional region of the flagella contained a transitional helix with four to six gyres. Microtubular root R1 consisted of six microtubules at its proximal end and one microtubule at its distal end. Roots R2 and R4 consisted of one microtubule each and root R3 consisted of two microtubules. No rhizoplast was found. Thin‐layer chromatography revealed the presence of fucoxanthin, diadinoxanthin, neoxanthin, and heteroxanthin as well as chlorophylls a, c1 and c2. High‐performance liquid chromatography revealed the presence of fucoxanthin, diadinoxanthin, diatoxanthin, heteroxanthin, and β,β‐carotene as well as chlorophylls a and c. The complete sequence of the SSU rDNA could not be obtained, but a partial sequence (1201 bases) was determined. Parsimony and neighbor‐joining distance analyses of SSU rDNA from Phaeothamnion and 36 other chromophyte algae (with two Öomycete fungi as the outgroup) indicated that Phaeothamnion was a weakly supported (bootstrap = <50%, 52%) sister taxon to the Xanthophyceae representatives and that this combined clade was in turn a weakly supported (bootstrap = <50%, 67%) sister to the Phaeophyceae. Based upon ultrastructural observations, pigment analysis, and SSU rDNA phylogenetic analysis, Phaeothamnion is not a member of the Chrysophyceae and should be classified as incertae sedis with affinities to the Xanthophyceae and Phaeophyceae.
FIRST REPORT OF GYMNODINIUM PULCHELLUM (DINOPHYCEAE) IN NORTH AMERICA AND ASSOCIATED FISH KILLS IN THE INDIAN RIVER, FLORIDA
Authors: Steidinger Karen A. , Landsberg Jan H. , Truby Earnest W. , Roberts Beverly S.
Published: March 2003

Fish and invertebrate kills were reported from September to October 1996 in the Indian River, Florida, coincident with blooms of the dinoflagellate Gymnodinium pulchellum Larsen 1994. This is the first report of a bloom of this species in the Americas. Fish and invertebrate species affected were common snook (Centropomus undecimalis), striped mullet (Mugil cephalus), hardhead catfish (Arius felis), red drum (Sciaenops ocellatus), sheepshead (Archosargus probatocephalus), black drum (Pogonias cromis), blue crab (Callinectes sapidus), and shrimp (Penaeus spp.). However, Gymnodinium pulchellum has previously caused fish kills in Japan and Australia. Examination of archived phytoplankton samples from a fish kill reported in the same area of the Indian River in August 1990 confirmed the presence of high concentrations of G. pulchellum. Fish kills associated with Alexandrium monilatum and potentially Pfiesteria‐like species in the Indian River also are discussed. Scanning electron microscopy provided additional morphological detail on this distinct but little‐known dinoflagellate.
THE TYPE SPECIES OF CERAMIUM (RHODOPHYTA), CERAMIUM VIRGATUM ROTH: TYPIFICATION AND PHYLOGENY
Authors: Maggs A. C. , McIvor L. M. , Evan C. M. , Stanhope J. M.
Published: March 2003

The type species of Ceramium is Ceramium virgatum Roth (1797, Cat. Bot I: 148, pl. VIII, fig. 1). This has been treated as a probable synonym of Ceramium nodulosum (Lightfoot) Ducluzeau, one of the species formerly confused under the illegitimate name Ceramium rubrum (Hudson) C. Agardh. However, in 1996 Silva showed that C. nodulosum (Lightfoot) Ducluzeau is a later homonym of C. nodulosum de Candolle 1805, and advocated conserving C. rubrum with a neotype. As an alternative to this, we investigated whether the name C. virgatum might be available for this species. The lectotype of C. virgatum is Roth's illustration of a much‐branched, fully corticate, Ceramium specimen from Eckwarden, North Sea, which could represent any member of the ‘C. rubrum’ group. We obtained material resembling Roth's, from the North Sea island of Helgoland, as a potential epitype. Its rbcL sequence was aligned with sequences of all C. rubrum‐like species in the British Isles, i.e. C. secundatum, C. botryocarpum, C. pallidum and ‘C. nodulosum’. The Helgoland material was clearly conspecific with ‘C. nodulosum’ from Ireland (0.08% divergence). We therefore suggest that the name C. virgatum Roth should be employed for this species. Phylogenetic analyses of these sequences aligned with various representatives of the tribe Ceramieae, placed the North Atlantic C. rubrum‐like species in two well‐supported clades. In one of these, C. virgatum is basal to C. secundatum and C. botryocarpum. The other clade consists of C. pallidum and a partly ecorticate species resembling C. diaphanum.
A MOLECULAR ANALYSIS OF THE EUGLENOPHYTES USING SSU RDNA
Authors: Linton Eric W. , Nudelman Maria Alejandra , Conforti Visitacion , Triemer Richard E.
Published: March 2003

Almost since the creation of the genus Euglena (Ehrenberg), the taxa assigned to it have been separated, split apart, and reorganized into new genera based on morphological relationships, resulting in the creation of the genera Phacus (Dujardin), Lepocinclis (Perty), Astasia (Pringsheim), and Khawkinea ( Jahn and McKibben) based on intuitive methods. In an effort to assess the validity of these genera, we have used small subunit (SSU) rDNA data to generate a phylogenetic framework for these genera, with particular attention to the genus Euglena. Using the conserved sequence areas, we performed a phylogenetic analysis using parsimony, maximum likelihood, and distance methods. These different criteria have resulted in trees of the same topology. The euglenoid clade was composed of phagotrophic euglenoids at the base, which gave rise to phototrophs that in turn gave rise to osmotrophs. Among the photosynthetic taxa, the biflagellate form diverged prior to the uniflagellate form. Additionally, the need for a revision in the taxonomy of some of these genera was demonstrated. Currently, taxa from the photosynthetic genera Euglena, Phacus, and Lepocinclis do not form monophyletic clades, but are intermixed with each other as well as with the osmotrophic taxa, Astasia and Khawkinea.
PHOTOACCLIMATION IN THE TROPICAL CORALLINE ALGA HYDROLITHON ONKODES (RHODOPHYTA, CORALLINACEAE) FROM A FRENCH POLYNESIAN REEF
Authors: Payri Claude E. , Maritorena Stéphane , Bizeau Christophe , Rodière Michel
Published: March 2003

Pigment concentration, in vivo absorption, and photosynthetic parameters of the coralline alga Hydrolithon onkodes (Heydrich) Penrose and Woelkerling were compared among samples from a lagoon and from a reef crest of Tahiti Island. Four groups of specimens were considered, differing in their natural exposure to PAR. For specimens collected from the lagoon, the tissues from low‐light samples had significantly higher pigment concentration, particularly chl a and phycobilins, compared with the high‐light exposed plants that contained more total carotenoids. The in vivo absorption spectra normalized to chl a (called a* values) also revealed differences. The low‐light samples had a reduced absorption capacity and a well‐marked phycobilin absorption signature, whereas sunlit samples showed a greater absorption at wavelengths absorbed mainly by chl a and carotenoids. The decrease of a* when pigment concentration increased is interpreted as a consequence of the pigment packaging. Significantly lower α (chlorophyll basis) and higher Ek values were found in the shaded plants. The values of Pmax for the four groups of specimens were not significantly different. The samples showed various degrees of photoinhibition depending on the light exposure during growth, and this effect was more pronounced in the shaded plants. The specimens from the reef crest deviate from the general model presented for the lagoon samples and show a mix of sun‐ and shade‐exposed characteristics. We have shown that the coralline alga H. onkodes responds to its light environment, probably by acclimation rather than ecotypic genetic variation, by adjusting its physiology, but some morphological differences are also involved. Photoacclimation can explain partly the wide distribution of this species over the reef ecosystem and its major contribution to the building of the reef.
ION FLUXES AND MODIFICATION OF THE EXTRACELLULAR MATRIX DURING GAMETE RELEASE IN FUCOID ALGAE
Authors: Speransky Vladislav V. , Brawley Susan H. , McCully Margaret E.
Published: March 2003

A rapid phase transition in the extracellular matrix (ECM) of the reproductive tissues (= receptacles) has been proposed to cause gamete release in fucoid algae. We tested this model with cryoanalytical energy dispersive x‐ray microanalysis (EDX) scanning electron microscopy (SEM) of rapidly frozen hydrated receptacles of Silvetia compressa Serrão, Cho, Boo et Brawley that were planed to smooth faces using a cryoultramicrotome. Every receptacle typically contained a region(s) of intracellular accumulation of K and Cl and a region(s) of efflux of K and Cl to the ECMs, regardless of treatment (e.g. calm vs. shaken conditions in the light, anthracene‐9‐carboxylic acid). Although longitudinal variations in [K] and [Cl] between ECM and cells were common, a tissue within any transverse plane of the receptacle was in the same state of efflux or accumulation of K and Cl. The strongest and most extensive effluxes occurred during the time of irreversible commitment to gamete release (i.e. 2–4 min darkness after light potentiation). A receptacle may oscillate rapidly between global states of accumulation and efflux at this time. The polysaccharide collar between the oogonium and stalk cell expanded during Cl and K efflux into the ECM of the conceptacle and condensed when [K] and [Cl] were low in the conceptacle ECM. During periods of strong efflux associated with gamete release, the collar and other components of the exochiton ruptured. Detached gametangia were guided to the pore by the paraphyses. The ECM of the conceptacle is sulfur rich (226 mM) compared with the ECM of the medulla (8 mM). This analysis supports the importance of osmotic modification of the ECM during gamete release and demonstrates that the receptacle is a dynamic signaling organ.