bluuebunny/crossref_metadata_2025 huggingface dataset:
Contractile actin expression in torn human menisci
Authors: Lin B. Y. , Richmond J. C. , Spector Myron
Published: March 2003

The human meniscus is subject to injury that necessitates repair or removal. Many aspects of the cellular response to injury have not been well characterized. The purpose of this study was to describe the cellular distributions within the torn human meniscus. In addition to evaluating the cell density in selected regions, we investigated the cellular expression of a contractile actin isoform that has recently been found in the intact human meniscus. Included as a contemporaneous comparative group were torn human meniscal allografts. We hypothesized that a hypercellular surface zone would be found in the torn menisci, with a higher percentage of cells in this peripheral region expressing α‐smooth muscle actin compared with other locations in the interior of the remnant. The rationale for this hypothesis was based on prior immunohistochemical investigations of the distribution of α‐smooth muscle actin–containing cells in the torn human anterior cruciate ligament. Eighteen torn meniscal specimens were obtained from 17 patients, 0.5 to 84 months after injury, and four torn allograft meniscal samples were retrieved from three patients, 11 to 49 months after implantation. Microtomed sections of paraffin‐embedded tissue were stained with hematoxylin and eosin and a monoclonal antibody to α‐smooth muscle actin. The cell density and percentage of cells containing α‐smooth muscle actin were determined in the following zones: synovial, vascular, hypercellular with loose collagen, hypocellular with dense collagen, and organized collagen. A cellular layer that resembled synovium was present on the surface of all but two of the specimens. Vascular regions were often continuous with the synovium abutting the more interior loose collagen zones. The total cell density was greatest in each of the zones closest to the periphery (synovium, vascular, and loose collagen; p < 0.001), when compared to the interior of the tissue. The synovium‐like layer was found to have the highest percentage of α‐smooth muscle actin–expressing cells and the highest α‐smooth muscle actin–containing cell density (p < 0.05). Similar results were found for the torn allograft menisci. These findings confirm the working hypothesis and suggest that the torn human meniscus is capable of mounting a reparative response, including the proliferation of cells capable of contributing to wound closure. This underscores the importance of providing a bridging scaffold into which such cells can migrate. (WOUND REP REG 2002;10:259–266)
Differential expression of urokinase‐type plasminogen activator and plasminogen activator inhibitor‐1 in early and late gestational mouse skin and skin wounds
Authors: Huang Eunice Y. , Wu Huayang , Island Eddie R. , Chong Sheree S. , Warburton David , Anderson Kathryn D. , Tuan Tai‐Lan
Published: March 2003

Early gestation fetal mouse skin heals without scars. Plasminogen activator inhibitor‐1 (PAI‐1) has been associated with postnatal organ fibrosis. We hypothesized that the relative balance between urokinase‐type plasminogen activator (uPA) and PAI‐1 expression in favor of uPA prevents scarring in early fetal skin wounds, whereas a change in favor of PAI‐1 in late gestation results in wound scarring. To evaluate uPA and PAI‐1 expression, 1‐mm skin wounds were made in E14.5 and E18 mice and harvested 24, 48, or 96 hours postwounding. Aprotinin (2 mg/ml)‐coated beads were injected into selected E14.5 wounds. Normal skin and skin wounds were evaluated for uPA, PAI‐1, and collagen expression. We showed that in normal skin uPA level is higher in E14.5 than in E18 mice, while PAI‐1 is lower in E14.5 than in E18 mice. After wounding, E14.5 wounds show a moderate increase in uPA and a minimal increase in PAI‐1. E18 wounds show a transient increase in uPA but a significant, sustained increase in PAI‐1. Addition of aprotinin to E14.5 wounds causes an increase in collagen deposition. We conclude that the differential expression of uPA and PAI‐1 in the skin of early vs. late gestation mice may contribute to the degree of scar formation seen after cutaneous injury. (WOUND REP REG 2002;10:387–396)
Fluid evolution during metamorphism of the Otago Schist, New Zealand: (I) Evidence from fluid inclusions
Authors: SMITH*  , YARDLEY
Published: March 2003

Fluid inclusion salinities from quartz veins in the Otago Schist, New Zealand, range from 1.0 to 7.3 wt% NaCl eq. in the Torlesse terrane, and from 0.4 to 3.1 wt% NaCl eq. in the Caples terrane. Homogenization temperatures from these inclusions range from 124 to 350 °C, with modal values for individual samples ranging from 163 to 229 °C, but coexisting, low‐salinity inclusions exhibiting metastable ice melting show a narrower range of T h from 86 to 170 °C with modes from 116 to 141 °C. These data have been used in conjunction with chlorite chemistry to suggest trapping conditions of ≈350–400 °C and 4.1–6.0 kbar for inclusions showing metastable melting from lower greenschist facies rocks, with the densities of many other inclusions reset at lower pressures during exhumation of the schist. The fluid inclusion salinities and Br/Cl ratios from veins from the Torlesse terrane are comparable to those of modern sea‐water, and this suggests direct derivation of the vein fluid from the original sedimentary pore fluid. Some modification of the fluid may have taken place as a result of interaction with halogen‐bearing minerals and dehydration and hydration reactions. The salinity of fluids in the Caples terrane is uniformly lower than that of modern sea‐water, and this is interpreted as a result of the dilution of the pore fluid by dehydration of clays and zeolites. The contrast between the two terranes may be a result of the original sedimentary provenance, as the Torlesse terrane consists mainly of quartzofeldspathic sediments, whilst the Caples terrane consists of andesitic volcanogenic sediments and metabasites which are more prone to hydration during diagenesis, and hence may provide more fluid via dehydration at higher grades.
Application of K‐feldspar–jadeite–quartz barometry to eclogite facies metagranites and metapelites in the Sesia Lanzo Zone (Western Alps, Italy)*
Authors: TROPPER  , ESSENE  , SHARP  , HUNZIKER
Published: March 2003

The eclogite facies assemblage K‐feldspar–jadeite–quartz in metagranites and metapelites from the Sesia‐Lanzo Zone (Western Alps, Italy) records the equilibration pressure by dilution of the reaction jadeite+quartz=albite. The metapelites show partial transformation from a pre‐Alpine assemblage of garnet (Alm63Prp26Grs10)–K‐feldspar–plagioclase–biotite±sillimanite to the Eo‐Alpine high‐pressure assemblage garnet (Alm50Prp14Grs35)–jadeite (Jd80–97Di0–4Hd0–8Acm0–7)–zoisite–phengite. Plagioclase is replaced by jadeite–zoisite–kyanite–K‐feldspar–quartz, and biotite is replaced by garnet–phengite or omphacite–kyanite–phengite. Equilibrium was attained only in local domains in the metapelites and therefore the K‐feldspar–jadeite–quartz (KJQ) barometer was applied only to the plagioclase pseudomorphs and K‐feldspar domains. The albite content of K‐feldspar ranges from 4 to 11 mol% in less equilibrated assemblages from Val Savenca and from 4 to 7 mol% in the partially equilibrated samples from Monte Mucrone and the equilibrated samples from Montestrutto and Tavagnasco. Thermodynamic calculations on the stability of the assemblage K‐feldspar–jadeite–quartz using available mixing data for K‐feldspar and pyroxene indicate pressures of 15–21 kbar (±1.6–1.9 kbar) at 550±50 °C. This barometer yields direct pressure estimates in high‐pressure rocks where pressures are seldom otherwise fixed, although it is sensitive to analytical precision and the choice of thermodynamic mixing model for K‐feldspar. Moreover, the KJQ barometer is independent of the ratio PH2O/PT. The inferred limiting a(H2O) for the assemblage jadeite–kyanite in the metapelites from Val Savenca is low and varies from 0.2 to 0.6.
Petrology of gedrite‐bearing rocks in mid‐crustal ductile shear zones from the Eastern Ghats Belt, India
Authors: Dasgupta  , Sengupta  , Sengupta PR. , Ehl  , Raith
Published: March 2003

A suite of metapelitic, basic and quartzofeldspathic rocks intruded by enderbitic gneiss from the southernmost tip of the Eastern Ghats Belt, India, and metamorphosed atc.750–800 °C, 6 kbar, were subjected to repeated ductile shear deformation, hydration, cooling and accompanying alkali metasomatism along narrow shear zones. Gedrite‐bearing assemblages developed in the shear zones traversing metapelitic rocks. Interpretation of the reaction textures in an appropriateP–T grid in the system FMASH, an isothermal–isobaricμH2O–μNa2Ogrid in the system NFMASH, and geothermobarometric data suggest a complex evolutionary history for the gedrite‐bearing parageneses. Initially, gedrite‐bearing assemblages were produced due to increase inμNa2Oat nearly constant but highμH2Oaccompanying cooling. Gedrite was partially destabilized to orthopyroxene+albite due to progressively increasingμNa2O. During further cooling and at increasedμH2Oa second generation of gedrite appeared in the rocks.
Multi‐stage pseudomorphic replacement of garnet during polymetamorphism: 1. Microstructures and their interpretation
Authors: Cesare
Published: March 2003

Metapelites from the southern aureole of the Vedrette di Ries tonalite (eastern Alps) were variably overprinted by contact and earlier regional metamorphic events during pre‐Alpine and Alpine metamorphic cycles. In these rocks, starting from a primary garnet mica‐schist (garnet stage), a complex sequence of transformations, affecting the site of the garnet, has been recognized. In the outermost part of the aureole, the primary garnet sites are occupied by nodules of kyanite (kyanite stage). Closer to the tonalite, kyanite is replaced by staurolite (staurolite stage), which in turn is pseudomorphed by muscovite (muscovite stage). The aggregates of kyanite do not overgrow garnet directly; they post‐date a stage (fibrolite stage) represented by the pseudomorphic alteration of garnet into fibrolitic sillimanite plus biotite. A further sericite stage is likely to have occurred between the fibrolite and kyanite stages. Preservation of the sub‐spherical garnet shape during all these transformations and persistence of mineralogical and textural relicts from earlier stages were favoured by the very low strain experienced by the rocks since the garnet stage. The textural sequence is in agreement with the metamorphic history of this part of the Austroalpine basement of the Eastern Alps: the garnet and fibrolite stages, and the coeval main foliation of the samples, are referred to the high‐grade Hercynian metamorphism; the kyanite stage to the Eo‐Alpine metamorphism; the staurolite and muscovite stages to the Oligocene contact metamorphism. It is suggested that kyanite growth as microgranular aggregates took place in polymetamorphic rocks where static, high‐P/low‐T  metamorphism overprinted high‐T  assemblages that contained sillimanite or andalusite.
δ18O and yttrium zoning in garnet: time markers for fluid flow?
Authors: Skelton A. , Annersten H. , Valley J.
Published: March 2003

The relative timing of two discrete pulses of metamorphic fluid flow is constrained based on chemical zoning in several garnet crystals from Kvaløya, Troms, northern Norway. The garnet crystals measured 1–2 cm in diameter and were contained within c. 1.6 Ga, staurolite grade metasediments. Major element zoning indicates that garnet grew under normal prograde conditions in the garnet and/or staurolite zones.

Timing constraints are based on comparisons between major and trace element chemical zoning, oxygen isotope (δ18O) zoning and deformational (inclusion trail) zoning in one of the garnet. We interpret at least two pulses of metamorphic fluid flow. The first pulse occurred during the syn‐tectonic growth interval. The δ18O zoning was reversed relative to ‘normal’ prograde zoning and the δ18O maximum was located within the syn‐tectonic growth zone, displaced 3–4 mm from the garnet core. The fluid might have been sourced in neighbouring calcareous pelites and may also have caused formation of an Y ring. The second (and subsequent) pulse(s) occurred during/after the post‐tectonic growth interval. δ18O was locally increased at the garnet rim, particularly where the rim was sheared. The incomplete rim was also enriched in calcium. Transport of oxygen and calcium by metamorphic fluids is well documented. Transport of Y is both problematic and poorly understood, but might have been facilitated by complexing with F and/or CO2.
Thermal modelling in shallow subduction: an application to low P/T metamorphism of the Cretaceous Shimanto Accretionary Complex, Japan
Authors: Miyazaki K. , Okumura K.
Published: March 2003

This paper presents the results of numerical modelling to investigate the regional occurrence of prehnite‐bearing metamorphic rocks at shallow levels in subduction zones. The modelling assumes a simple geometrical configuration in which the thermal structure in a prism is controlled by boundary conditions at the top and base of the prism. It is expected that the predominant metamorphic facies in a prism will change with decreasing age of the descending slab. The results of thermal modelling show that the facies boundary between pumpellyite–actinolite and prehnite–actinolite facies (including prehnite–pumpellyite facies) overlaps with an array of P–T conditions in the prism when the age of a descending slab is younger than 10 Myr. This implies that the change of the predominant metamorphic facies from pumpellyite–actinolite to prehnite–actinolite facies will switch drastically. The critical age of the switch depends on subduction parameters. In particular, the critical age of the descending slab is <5 Myr in the case of no shear heating, with a subduction rate of v=75–200 mm y−1 and subduction angle of θ=5–15°. For shear heating (constant shear stress=30 MPa) with a subduction rate of v=75 mm y−1 and subduction angle of θ=10° the critical age is 7 Myr. To test this switching behaviour in the development of prehnite–actinolite facies in the prism, petrologic data from the Cretaceous Shimanto Accretionary Complex (CSAC) in Kyushu, Japan were compiled. The regional occurrence and mineral assemblages of prehnite‐bearing metamorphic rocks suggest that the most of CSAC was metamorphosed under prehnite–actinolite facies. This conclusion is consistent with subduction of a young, hot slab, as has been proposed based on other geological observations. This suggests that the regional extent of the prehnite–actinolite facies metamorphic rocks may be a unique evidence for the subduction of a young, hot slab.
An experimental study of grain scale melt segregation mechanisms in two common crustal rock types
Authors: Holyoke C. W. , Rushmer T.
Published: March 2003

Creation of pathways for melt to migrate from its source is the necessary first step for transport of magma to the upper crust. To test the role of different dehydration‐melting reactions in the development of permeability during partial melting and deformation in the crust, we experimentally deformed two common crustal rock types. A muscovite‐biotite metapelite and a biotite gneiss were deformed at conditions below, at and above their fluid‐absent solidus. For the metapelite, temperatures ranged between 650 and 800 °C at Pc=700 MPa to investigate the muscovite‐dehydration melting reaction. For the biotite gneiss, temperatures ranged between 850 and 950 °C at Pc=1000 MPa to explore biotite dehydration‐melting under lower crustal conditions. Deformation for both sets of experiments was performed at the same strain rate (ε.) 1.37×10−5 s−1. In the presence of deformation, the positive ΔV and associated high dilational strain of the muscovite dehydration‐melting reaction produces an increase in melt pore pressure with partial melting of the metapelite. In contrast, the biotite dehydration‐melting reaction is not associated with a large dilational strain and during deformation and partial melting of the biotite gneiss melt pore pressure builds more gradually. Due to the different rates in pore pressure increase, melt‐enhanced deformation microstructures reflect the different dehydration melting reactions themselves. Permeability development in the two rocks differs because grain boundaries control melt distribution to a greater extent in the gneiss. Muscovite‐dehydration melting may develop melt pathways at low melt fractions due to a larger volume of melt, in comparison with biotite‐dehydration melting, generated at the solidus. This may be a viable physical mechanism in which rapid melt segregation from a metapelitic source rock can occur. Alternatively, the results from the gneiss experiments suggest continual draining of biotite‐derived magma from the lower crust with melt migration paths controlled by structural anisotropies in the protolith.
High‐pressure granulites: formation, recovery of peak conditions and implications for tectonics
Authors: O'Brien P. J. , Rötzler J.
Published: March 2003

High‐pressure granulites are characterised by the key associations garnet‐clinopyroxene‐plagioclase‐quartz (in basic rocks) and kyanite‐K‐feldspar (metapelites and felsic rocks) and are typically orthopyroxene‐free in both basic and felsic bulk compositions. In regional metamorphic areas, two essential varieties exist: a high‐ to ultrahigh‐temperature group and a group representing overprinted eclogites. The high‐ to ultrahigh‐temperature type formerly contained high‐temperature ternary feldspar (now mesoperthite) coexisting with kyanite, is associated with garnet peridotites, and formed at conditions above 900 °C and 1.5 GPa. Clinopyroxene in subordinate basic rocks is Al‐rich and textural evidence points to a high‐pressure–high‐temperature melting history. The second variety contains symplectite‐like or poikilitic clinopyroxene‐plagioclase intergrowths indicating former plagioclase‐free, i.e. eclogite facies assemblages. This type of rock formed at conditions straddling the high‐pressure amphibolite/high‐pressure granulite field at around 700–850 °C, 1.0–1.4 GPa. Importantly, in the majority of high‐pressure granulites, orthopyroxene is secondary and is a product of reactions at pressures lower than the peak recorded pressure. In contrast to low‐ and medium‐pressure granulites, which form at conditions attainable in the mid to lower levels of normal continental crust, high‐pressure granulites (of nonxenolith origin) mostly represent rocks formed as a result of short‐lived tectonic events that led to crustal thickening or subduction of the crust into the mantle. Short times at high‐temperature conditions are reflected in the preservation of prograde zoning in garnet and pyroxene. High‐pressure granulites of both regional types, although rare, are known from both old and young metamorphic terranes (e.g. c. 45 Ma, Namche Barwa, E Himalaya; 400–340 Ma, European Variscides; 1.8 Ga Hengshan, China; 1.9 Ga, Snowbird, Saskatchewan and 2.5 Ga Jianping, China). This spread of ages supports proposals suggesting that thermal and tectonic processes in the lithosphere have not changed significantly since at least the end of the Archean.
Nontransplant Therapy for Dialysis‐Related Amyloidosis
Authors: Copley John B. , Lindberg Jill S.
Published: March 2003

There is no specific treatment for dialysis‐related amyloidosis (DRA). Available therapy is directed at removal of large quantities of β2‐microglobulin (β2M) and palliation of symptoms. Plasma concentrations of β2M in end‐stage renal disease (ESRD) depend on the degree of residual renal function, the type of blood purification therapy, and properties of the dialysis filtration membrane. Retention of β2M appears to be a necessary, although not sufficient, condition for DRA. While preserving residual renal function is important, dialysis modality largely determines β2M removal. Convective dialysis treatments (hemofiltration and hemodiafiltration) remove β2M more efficiently than diffusive treatments (conventional dialysis). In addition, column adsorption of β2M can extensively remove the molecule, as can nocturnal hemodialysis. Hemodialysis membrane properties that are particularly important with regard to β2M removal include permeability, adsorptive capacity, and biocompatibility. As such, β2M removal with highly permeable biocompatible membranes such as polysulfone and polyacrylonitrile is relatively large. Several studies have suggested that use of such membranes can significantly delay DRA development and may be useful in ameliorating DRA‐associated symptoms. Non‐dialysis‐related therapy for DRA is palliative and includes both medical and surgical therapies. Medical therapy includes low‐dose corticosteroids and nonsteroidal anti‐inflammatory drugs (NSAIDs). Surgical therapy consists of relief of carpal tunnel syndrome, or palliation of shoulder pain, destroyed weight‐bearing joints, or spinal cord compression. DRA is a serious complication of long‐term dialysis. It is important for nephrologists to recognize the condition and attempt to slow its progression.
Catheter Access for Hemodialysis: An Overview
Authors: Butterly David W. , Schwab Steve J.
Published: March 2003

The provision of hemodialysis requires repeated, reliable access to the central circulatory system. Long‐term hemodialysis has best been provided by arteriovenous fistulae and arteriovenous grafts. In recent years, more and more patients have been chronically dialyzed with tunneled dialysis catheters. These catheters, which were originally developed as a short‐term bridge to permanent vascular access, have made up an increasing percentage of maintenance vascular access. While these catheters have the advantage of ease of placement and are immediately ready for use, they substantially increase the risk of bacteremia, stenosis of central veins, and even mortality.
Review Articles: Inflammation in End‐stage Renal Disease: Sources, Consequences, and Therapy
Authors: Stenvinkel Peter , Alvestrand Anders
Published: March 2003

Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in patients with end‐stage renal disease (ESRD). Although traditional risk factors are common in ESRD patients, they alone may not be sufficient to account for the high prevalence of CVD in this condition. Recent evidence demonstrates that chronic inflammation, a nontraditional risk factor which is commonly observed in ESRD patients, may cause malnutrition and progressive atherosclerotic CVD by several pathogenetic mechanisms. The causes of inflammation in ESRD are multifactorial and, while it may reflect underlying CVD, an acute‐phase reaction may also be a direct cause of vascular injury by several pathogenetic mechanisms. Available data suggest that proinflammatory cytokines play a central role in the genesis of both malnutrition and CVD in ESRD. Thus it could be speculated that suppression of the vicious cycle of malnutrition, inflammation, and atherosclerosis (MIA syndrome) would improve survival in dialysis patients. Recent evidence has demonstrated strong associations between inflammation and both increased oxidative stress and endothelial dysfunction in ESRD patients. As there is not yet any recognized, or even proposed, treatment for ESRD patients with chronic inflammation, it would be of obvious interest to study the long‐term effect of various anti‐inflammatory treatment strategies on the nutritional and cardiovascular status as well as outcome in these patients.
Comparative Review of the Pharmacokinetics of Vitamin D Analogues
Authors: Bailie George R. , Johnson Curtis A.
Published: March 2003

This article reviews the pharmacokinetic characteristics of calcitriol, paricalcitol, and doxercalciferol, and provides an overview of the metabolism of vitamin D. Calcitriol and paricalcitol have similar pharmacokinetic profiles, with terminal half‐lives ranging from 5 to 10 hours in healthy subjects to 15–30 hours in patients undergoing dialysis. Both are active on intravenous administration and little of the active agent remains in the circulation after 24 hours, although they are normally given every 48–72 hours. Doxercalciferol is a prohormone, requiring hepatic metabolism to the active metabolite 1α,25‐(OH)2D2. The half‐life of 1α,25‐(OH)2D2 is about 34 hours in healthy subjects and about 45 hours in dialysis patients, resembling physiologic blood concentrations of endogenous vitamin D. More studies are warranted to determine the disposition of the vitamin D analogues, especially in selected populations such as pediatric and geriatric dialysis patients.
Amplified in Breast Cancer‐1 Glutamine Repeat and Prostate Cancer Risk
Authors: Platz Elizabeth A. , Giovannucci Edward , Brown Myles , Cieluch Carsta , Shepard Timothy F. , Stampfer Meir J. , Kantoff Philip W.
Published: March 2003

Objectives: Amplified in breast cancer‐1 (AIB1) is a steroid receptor coactivator that enhances estrogen‐dependent transcriptional activation by the estrogen receptor. It is unknown whether AIB1 also interacts with the androgen receptor. Because the development and progression of prostate cancer is likely to be partially mediated by steroid hormones, we investigated whether a polymorphic CAG/CAA repeat encoding glutamine in the AIB1 gene is related to prostate cancer risk in a nested study of 581 patients and 786 age‐matched control subjects in the Physicians' Health Study.

Materials and Methods: DNA was extracted from peripheral whole blood, and the region encompassing the repeat was amplified using fluorescent‐labeled primers. The fragments were run on polyacrylamide gels and sized by computer software. We estimated the relative risk (RR) of prostate cancer for AIB1 glutamine repeat length from logistic regression models controlling for the matching variables.

Results: Three glutamine repeat lengths were prevalent: 29 (47.8% among control subjects), 28 (38.5% among control subjects), and 26 (12.6% among control subjects). Compared to 29 repeats, the RR of prostate cancer was 0.92 (95% confidence interval [CI] 0.72–1.17) for 26 repeats and 1.01 (95% CI 0.86–1.19) for 28 repeats. Compared to 28/29, the RR of prostate cancer was not significantly altered for any of the other common genotypes. No clear associations were present for AIB1 glutamine repeat length genotype by stage at the diagnosis/histologic grade of the tumor.

Conclusion: This study does not support an important role in prostate cancer incidence or aggressiveness of AIB1 glutamine repeat length in the range observed in this predominately white cohort.
PSP94: Evaluation of Prognostic Utility in Patients Treated with Radiotherapy for Nonmetastatic Prostate Cancer
Authors: Bauman G. S. , Xuan J. , Chin J. , Sakai H. , Guo Y. , Garde S. , Fraser J. , Venkatesan V. M.
Published: March 2003

Objectives: Conflicting reports exist as to the utility of PSP94 in the diagnosis and management of prostate cancer. We have identified serum‐bound forms of PSP94 in prostate cancer patients. To further evaluate the usefulness of this finding, we measured bound and free serum PSP94 levels in patients with nonmetastatic prostate cancer before radiotherapy.

Materials and Methods: Pretreatment levels of free PSP94 in 42 patients were measured in serum via a competitive enzyme‐linked immunosorbent assay. Levels of bound PSP94 were measured by a semiquantitative assay after fractionation of total serum proteins by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis and Western blot analysis. Pretreatment levels of prostate specific antigen (PSA) were measured by a commercially available assay. Archival sera from 42 patients and a subgroup of 27 patients with “favorable” pretreatment PSA values (i.e., < 10 ng/ml) were statistically analyzed. Pretreatment levels of PSP94 (free and bound) and PSA, as well as tumor stage and grade, were correlated with treatment outcome (biochemical relapse‐free survival) postradiotherapy.

Results: Pretreatment PSA and the ratio of bound to free PSP94 were significant predictors of relapse postradiotherapy on univariate analysis. An elevated ratio of bound to free PSP94 was a stronger predictor (p = 0.0074) of relapse postradiotherapy compared with PSA level (p = 0.070) in a subgroup of prostate cancer patients with “favorable” pretreatment PSA levels.

Conclusions: The results presented here indicate that serum PSP94‐bound complexes must be considered in evaluating the clinical utility of PSP94 as a prostate cancer marker. A higher ratio of bound to free PSP94 may indicate worse outcome postradiotherapy. Differential testing of serum PSP94 has shown that it, in addition to PSA, may be of prognostic value for patients receiving radiotherapy for nonmetastatic prostate cancer.
Implementing Nurse Home Visitation Programs
Authors: Hanks Carole A , Smith Judy
Published: March 2003

Nurse home visitation has been an important component of public health for over 100 years. Recent reports of large clinical trials have provided a convincing body of evidence of the cost‐effectiveness of home visitation. The findings from these studies have helped to renew policy interest in nurse home visitation as a means of improving health and quality of life for low‐income families. Reimplementing home visitation on a large scale, however, will require using nurses with little or no home‐visiting experience. Sponsoring organizations must delegate, and nurses from hospitals or clinics must accept, responsibility for both increased autonomy and discretion of home visitors. Case study analysis of observational and interview data from the implementation of a large demonstration home visitation program carried out in a health department in a mid‐South city from 1989 to 1994 provides evidence that the bottom‐up perspective of Hanf and Toonen (1983) best describes how such programs can be put in place. Nurses with little community experience were able to create appropriate strategies to help families achieve the broad program goals in the context of resource constraints associated with a poverty‐level lifestyle and the existing health and human service system. Furthermore, nurses were able to establish an organizational culture and job structure in a city/county health department to support their work.
An Explanatory Model of Variables Influencing Health Promotion Behaviors in Smoking and Nonsmoking College Students
Authors: Martinelli Angela Maria
Published: March 2003

College students can establish healthy lifestyle practices that can have lifelong implications. Many students, however, continue to engage in risky behaviors such as active and passive smoking. The purpose of this study was to test an explanatory model of variables which can influence health promotion behaviors in smoking and nonsmoking college students. Pender's Health Promotion Model provided the framework for the study. Health promotion behaviors were found to be most effective when students: had an increased self‐efficacy, avoided environmental tobacco smoke (ETS), perceived themselves as healthy, were female, and had a powerful external and internal health locus of control. College students may benefit from health promotion interventions designed to influence the avoidance of ETS and alter perceptions of self‐efficacy, control of health, and health status. Such interventions may result in a decrease in both active and passive smoking.
The Relationship Between Self‐Esteem, Health Habits, and Knowledge of BSE Practice in Female Inmates
Authors: Brewer M. Kathleen , Baldwin Dee
Published: March 2003

This article reports on data derived from an investigation of the self‐esteem, health habits, and knowledge of breast self‐examination (BSE) practice in female inmates. A descriptive correlational study was conducted with a prison sample of 197 adult females incarcerated in a women's state prison. Major findings of the study suggest that female inmates in general had medium to high self‐esteem, poor health habits before incarceration, and minimal knowledge about BSE practice. Only 26% reported correct knowledge related to frequency in BSE practice, and few reported that they knew correct BSE technique. In addition, findings suggest that a correlation does not exist between self‐esteem and knowledge of BSE practice, and participants' last grade completed served as a good predictor of women's knowledge of BSE practice.
Performing a Program Evaluation in a Family Case Management Program: Determining Outcomes for Low Birthweight Deliveries
Authors: Prozialeck Linda L , Pesole Lorene
Published: March 2003

Program evaluations have become an integral part of public health practice. To illustrate the program evaluation process, an evaluation of clinical outcomes for clients of the Family Case Management (FCM) program administered by the nursing division of the DuPage County Health Department, Wheaton, Illinois, is presented. Birth outcomes for 1996 clients of the program who had a previous low‐birthweight (LBW) infant and a subsequent birth using the prenatal services of the FCM program were analyzed. A purposive sample of clients was selected from the FCM prenatal program. Birth outcomes including infant gestational age and birthweight, maternal weight gain, and other key variables were compared to provision of health department services. Descriptive statistical methods were used to explore the relationship between birth outcomes and prenatal care between the first pregnancy and the second pregnancy. Analysis of the data showed improvements in maternal weight gain, infant birthweight and gestational age, prenatal care access, public health nurse (PHN) contacts, and physician visits. A positive association was shown between the early entry and increased use of prenatal services to improved birth outcomes in the subsequent pregnancy.
In Harm's Way: Recognizing and Addressing Alcohol Risk for Rural Disadvantaged Pregnant Mothers
Authors: Ettlinger Trudee
Published: March 2003

The following article describes the efforts of a group of rural Vermont maternal child health (MCH) nurses who addressed alcohol risk for the pregnant mothers they served through the Women, Infants, and Children (WIC) Supplemental Nutrition program. As front‐line providers, MCH nurses are in a position to both improve the detection of problem drinking during pregnancy and to strengthen maternal alcohol prevention and intervention initiatives. Results showed that a more refined screening for alcohol provided an opportunity to promote harm reduction.
The Clinical Specialist in Community Health Nursing: A Solution for the 21st Century
Authors: Hemstrom Marion , Ambrose MaryAnn , Donahue Gayle , Glick Laurie , Lai Hui Ling , Preechawong Sunida
Published: March 2003

The clinical specialist (CS) in community health nursing (CHN) addresses health problems in populations and communities in ways that are different from and complimentary to strategies used by practitioners of individualized patient care. Four programs based on comprehensive assessments, systematic program planning, deliberate implementation, and both formative and summative evaluation are presented. The programs were developed by graduate students in the CHN clinical specialization major at the Frances Payne Bolton School of Nursing. With expert faculty guidance and a competency‐driven program of study, strategies were implemented to promote the health of community‐dwelling well elderly people, home health care nurses who provide service to patients with respiratory problems, and high school students in a private religious school. Experienced parish nurses also benefited from a program designed to enhance their skills in theological reflection. This article also describes the curricular design developed to educate this clinician for the 21st century. Lastly, continued attention to the dynamic criteria of the American Nurses Association Standards of Community Health Nursing Practice is recommended as crucial to the further development of this clinical specialization.
The Role of the Nurse on a Transdisciplinary Early Intervention Assessment Team
Authors: Stepans Mary Beth , Thompson Christy L. , Buchanan Michelle L.
Published: March 2003

Assessing young children with disabilities is a complex process requiring the expertise of a team of professionals from several disciplines. Team members often include the child's family members, early childhood special educators, clinical psychologists, speech‐language pathologists, social workers, physical and occupational therapists, pediatricians, and nurses. A team approach meets standards of best practice in early childhood intervention and encourages full family participation in the assessment process. This article explores the process of team building, role release through a transdisciplinary approach, and a nurse's role on a transdisciplinary assessment team.
Health Promotion Practices of Older Adults: Model Testing
Authors: Resnick Barbara
Published: March 2003

Abstract  The purpose of this study was to describe the primary and secondary health promotion activities of a group of older adults living independently in a continuing care retirement community. Primary and secondary health promotion activities were described and compared among the young old (ages 65–80), the old (ages 81–85), and the old‐old (ages 86–101). Model testing of the factors that influence participation in health‐promoting activities was also completed. This descriptive study included 206 of 210 residents who participated in a single face‐to‐face interview. The majority of the participants were female (79%), white (99%), and cognitively intact. Those in the old‐old age group were less likely than the old and young‐old groups to have: (1) their stools checked for occult blood; (2) their skin checked for lesions; or (3) a recent mammogram, Pap test, or prostate exam. Model testing found that age, chronic illnesses, degree of physical and mental health, and cognitive status directly or indirectly influenced older adults' participation in primary and secondary health behaviors.
Adolescent Health Promotion Scale: Development and Psychometric Testing
Authors: Chen Mei‐Yen , Wang Edward K. , Yang Rea‐Jane , Liou Yiing‐Mei
Published: March 2003

Abstract  The purpose of this study was to assess the psychometric properties of a newly devised instrument, the Adolescent Health Promotion scale (AHP), a 40‐item Likert‐type self‐report instrument used to detect unhealthy lifestyles in adolescents. Content validity was considered to be supported based on the findings of previous studies and the observations of a panel of 14 content experts. This study examined the construct validity and reliability of the instrument. The psychometric properties of the AHP, including item analysis, factor analysis, and reliability measures, were assessed based on the responses of 1,128 Taiwanese adolescents. Kaiser‐Meyer‐Olkin (KMO) measures and Bartlett's sphericity test showed that the samples met the criteria for factor analysis. Factor analysis yielded a six‐factor instrument that explained 51.14% of the variance in the 40 items. The six factors were social support, life appreciation, health responsibility, nutritional behaviors, exercise behaviors, and stress management. The Cronbach alpha reliability coefficient for the total scale was 0.932, and alpha coefficients for the subscales ranged from 0.75 to 0.88. The results of this study indicate that the AHP has good construct validity and reliability in Taiwanese and that its use by school health nurses to assess adolescent health promotion programs is warranted.
Mucocutaneous Manifestations of HIV Infection in 91 Children Born to HIV‐Seropositive Women
Authors: Wananukul Siriwan , Thisyakorn Usa
Published: March 2003

Abstract: We examined 91 children under the age of 13 years with definite HIV infection born to HIV‐seropositive women. The clinical spectrum of HIV infection in children younger than 13 years who are born to HIV‐infected mothers was revised in 1994 into four clinical categories: category N (not symptomatic), category A (mildly symptomatic), category B (moderately symptomatic), and category C (severely symptomatic). Mucocutaneous manifestations were found in 47 (51.6%) of these children. The prevalence of mucocutaneous manifestations in categories A, B, and C were 4%, 62%, and 75%, respectively. The mucocutaneous manifestations in patients in categories B and C were significantly more common than in those category A (p < 0.001). The most common finding was oral candidiasis (36.3%). Drug rash, pruritic papular eruption, herpes zoster, cutaneous candidiasis, Penicillium marneffei infection, and herpes simplex virus stomatitis were found in 6.6%, 5.5%, 4. 4%, 3.4%, and 2. 2% of patients, respectively. All three patients who had disseminated P. marneffei infection were in category C.
Labial Fusion in Children: A Presenting Feature of Genital Lichen Sclerosus?
Authors: Gibbon Karen L. , Bewley Anthony P. , Salisbury Jennifer A.
Published: March 2003

Abstract: Labial fusion is a common condition seen most frequently in infants and young children. While most cases are “physiological,” we believe it can occasionally be the presenting feature of genital lichen sclerosus.
Trichophyton tonsurans Tinea Capitis and Tinea Corporis: Treatment and Follow‐Up of Four Affected Family Members
Authors: Ravenscroft J. , Goodfield M. J. D. , Evans E. G. V.
Published: March 2003

Abstract: We report a Caucasian family of two veterinary practitioners and their two children, ages 2 years and 6 months, simultaneously infected with the dermatophyte Trichophyton tonsurans, causing tinea capitis and tinea corporis in the children and tinea corporis in the parents. The parents and older child were successfully treated with oral terbinafine. The infant clinically responded to treatment with topical terbinafine and ketoconazole shampoo but presented with recurrent tinea capitis 12 months later, from which T. tonsurans was cultured. At this time, scalpbrush samples from the other family members failed to culture any fungi, and neither were fungi isolated from the family hairbrushes. The infant then received oral terbinafine, resulting in clinical and mycologic cure. After a further 12 months follow‐up, there has been no mycologic evidence of recurrence in any family member.
Childhood Pernio and Cryoproteins
Authors: Weston William L. , Morelli Joseph G.
Published: March 2003

Abstract: Childhood pernio is an uncommon condition described mainly through isolated case reports. We examined the cutaneous spectrum, clinical associations, presence of cryoproteins, and evolution of the condition in children, and performed a retrospective case series evaluation of children with pernio seen at a single ambulatory care university center over a 10‐year period. Cases were drawn from a population of 3.2 million. Follow‐up was at least 3 years. We found four boys and four girls with pernio. Distribution of skin lesions was on the fingers, toes, and ears. Four children had cryoglobulins or cold agglutinins, two had a positive rheumatoid factor, and none had a positive ANA or ANA profile. All eight cleared within 3 months and did not recur over at least a 3‐year period. We concluded that childhood pernio is uncommon and may be associated with the presence of cryoproteins.
Henoch–Schönlein Purpura: Simultaneous Occurrence in Two Siblings
Authors: Levy‐Khademi Floris , Korman Stanley H. , Amitai Yona
Published: March 2003

Abstract: Simultaneous occurrence of Henoch–Schönlein purpura (HSP) in family members is not well documented. We describe simultaneous onset of HSP in two sisters 1 day after the wearing of new synthetic slippers. Such an occurrence of the disease implies a common cause, however, in most patients the search for a causative agent is usually futile. There was no clear evidence of infection in our patients. The association of the appearance of the disease with the use of the slippers in our patients could indicate a possible, although unlikely, cause for their HSP.
Nodular Tuberculid: A Report of Four Patients
Authors: Jordaan H. Francois , Schneider Johann W. , Abdulla Ebrahim A. K.
Published: March 2003

Abstract: The tuberculids are hypersensitivity reactions to Mycobacterium tuberculosis (MTB) and include papulonecrotic tuberculid (PNT), lichen scrofulosorum, erythema induratum of Bazin (EIB), and phlebitic tuberculid. Papulonecrotic tuberculid displays papulonecrotic lesions mostly on the extensor surfaces of the limbs. Histopathology shows necrosis, granulomatous inflammation (GI), and occasionally vasculitis, usually in the superficial dermis. Erythema induratum of Bazin shows nodulo‐ulcerative lesions on the posterior aspect of the legs. Histopathology reveals a septolobular panniculitis, necrosis, GI, and vasculitis. The Mantoux test is strongly positive and associated tuberculosis (TB) may be present in both conditions. MTB cannot be demonstrated with a Ziehl–Neelsen (ZN) stain or cultured. The polymerase chain reaction has demonstrated MTB DNA in PNT (50%) and EIB (25%). The tuberculids respond to full anti‐TB treatment. We document four patients with nodules on the legs in whom the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. Nodular tuberculid (NT) is regarded as a suitable term for these lesions. All patients were female. Their ages were 19 months, 12 years, 17 years, and 5 years. All patients presented with nodules on the limbs. These nodules were approximately 1 cm in diameter, dull red or bluish‐red, and nontender. Ulceration was not present. The number of nodules varied from a few to many. The Mantoux test was strongly positive in all the patients. Associated pulmonary TB was present in two patients. Histopathology showed GI (n = 4), vasculitis (n = 2), and coagulative necrosis (n = 2). A ZN stain was negative in each case. All patients received anti‐TB treatment for 6 months [rifampicin (n = 4), isoniazid (n = 4), pyrazinamide (n = 4), and ethambutol (n = 2)]. At 12 months follow‐up, skin and pulmonary lesions had resolved in all. Nodular tuberculid should be distinguished from arthropod bites and papular urticaria, dermal erythema multiforme, evolving vasculitis, evolving folliculitis, and erythema nodosum. Histopathologically NT should be distinguished from other causes of granulomatous vasculitis and GI with or without necrosis. In children with nodules on the limbs unresponsive to routine treatment, skin biopsy should be done to exclude NT. Nodular tuberculid represents a hybrid between PNT and EIB with characteristic clinicopathologic features and should be included in the classification of cutaneous TB.
Oral Griseofulvin Remains the Treatment of Choice for Tinea Capitis in Children
Authors: Bennett Michelle L. , Fleischer Alan B. , Loveless James W. , Feldman Steven R.
Published: March 2003

Abstract: Tinea capitis is one of the most common infections of children. The standard treatment is griseofulvin. Itraconazole and terbinafine have in large part replaced griseofulvin in the treatment of onychomycosis and, in addition to fluconazole and ketoconazole, are evolving treatments for tinea capitis. The purpose of this review is to compare the efficacy, safety, and cost of oral antifungal agents for tinea capitis. Small, open‐label studies of itraconazole, terbinafine, and fluconazole have reported encouraging results, suggesting that these drugs may be effective alternatives to griseofulvin; however, in large controlled studies griseofulvin continues to exhibit greater or equal efficacy. Ketoconazole appears to be the least efficacious. All five drugs appear relatively safe, however, only griseofulvin has a long track record of safety, is Food and Drug Administration (FDA) approved for the treatment of tinea capitis in children, and has the least known drug interactions. Fluconazole is FDA approved for use in children more than 6 months of age, yet not for the treatment of tinea capitis. Oral griseofulvin and terbinafine tablets are the least expensive of the antifungal agents; griseofulvin suspension is, however, more expensive than fluconazole suspension. For the combined reasons of efficacy, safety, and cost, and a long track record of use, we feel oral griseofulvin is still the present treatment of choice for tinea capitis. Newer antifungals are currently under investigation, and their role in treating tinea capitis in children is still being defined.