bluuebunny/crossref_metadata_2025 huggingface dataset:
The relative impacts of wilting, chopping, compaction and air infiltration on the conservation characteristics of ensiled grass
Authors: McEniry J. , O’Kiely P. , Clipson N. J. W. , Forristal P. D. , Doyle E. M.
Published: November 2007

The chemical composition of baled silage frequently differs from that of comparable conventional silage. The extents of wilting, chopping, compaction and air infiltration potentially contribute to these differences in conservation characteristics. An experiment was organized in a 3 (0, 24 or 48‐h wilting to influence herbage dry‐matter content) × 2 (unchopped or chopped) × 2 (with or without compaction) × 2 (with or without air infiltration) factorial arrangement of treatments, to elucidate the relative effects of these factors on the conservation characteristics of ensiled grass. Dry‐matter content of herbage and infiltration of air had a greater effect on silage conservation characteristics than chopping and compaction. The main interactions were between wilting and air infiltration, wilting and compaction, and compaction and air infiltration. Air infiltration stimulated a secondary fermentation in the unwilted herbage, reflected in a large increase (P < 0·001) in clostridial activity. As wilting progressed, air infiltration facilitated yeast respiration of water‐soluble carbohydrates (WSC) and resulted in an increase (P < 0·001) in in‐silo fresh‐weight losses. Compaction reduced (P < 0·05) silage pore space and, as a result, the extent to which air could penetrate the silage mass. Compaction of the wilted herbage restricted respiration and was reflected in increased (P < 0·05) concentrations of WSC and in a reduction (P < 0·001) in fresh‐weight loss. The rapid achievement and maintenance of adequately anaerobic conditions is the primary requirement for baled silage. This study showed that failure to achieve this will lead to progressively greater losses, especially with drier herbage.
Important characteristics of software development team members: an empirical investigation using Repertory Grid
Authors: Siau Keng , Tan Xin , Sheng Hong
Published: November 2007

An information system is typically developed by a team of information systems (IS) professionals. Research shows that teams staffed with the right people are more likely to be effective and efficient. There is a paucity of study that examines the important traits of IS professionals in team contexts. The objective of this research is to identify and understand the important characteristics of good team members in software development projects. We applied an established psychological technique (Repertory Grid) to guide our interviews with 21 experienced IS professionals, who have had extensive experience in software development teams. The comprehensive list of important characteristics was analysed qualitatively using open coding method of grounded theory. Fifty‐nine unique characteristics were identified and classified into eight categories. Among them, attitude/motivation, knowledge, interpersonal/communication skills, and working/cognitive ability were perceived by research participants to be the most important categories. Our study provides a context‐specific (i.e. software development team) evaluation of important characteristics of IS professionals. The results have significant implications for IS recruiting, IS training, IS staffing, and IS human resource management. Our study also supplements the research on management of IS development teams.
Oestrogen supplementation following castration promotes stromal remodelling and histopathological alterations in the Mongolian gerbil ventral prostate
Authors: Scarano Wellerson Rodrigo , De Sousa Daniel Emídio , Campos Silvana Gisele Pegorin , Corradi Lara Silvia , Vilamaior Patricia Simone Leite , Taboga Sebastião Roberto
Published: November 2007

The effect of oestradiol on the intact and castrated adult gerbil prostate was evaluated by focussing on stromal and epithelial disorders, and hormonal receptor immunoreactivity. The experimental animals were studied by histological, histochemical and immunohistochemical techniques, morphometric–stereological analysis and transmission electron microscopy. Epithelial alterations in the oestradiol‐treated animals were frequent, with an increase in epithelial cell height, areas of intense dysplasia and hyperplasia and formation of prostatic intraepithelial neoplasia (PIN). Another aspect that did not depend on the presence of testosterone was the arrangement of the fibrillar and non‐fibrillar elements of the extracellular matrix among smooth muscle cells (SMC), suggesting a possible role of these cells in rearrangement and synthesis of these components, after oestrogenic treatment. In the castrated animals, an accumulation of extracellular matrix elements under the epithelium was evident, while in the intact animals the same compounds were dispersed and scarce. In the groups of intact and castrated animals, SMC and fibroblasts exhibited a secretory phenotype, which was accentuated after oestradiol administration. There was an increase of the immunoreactivity to α‐oestrogen and androgen receptors in hyperplastic areas compared to normal epithelium, revealing the involvement of these steroid receptors in the hyperplasia and PIN development.
Nutritional content of school meals in Hull and the East Riding of Yorkshire: a comparison of two schools
Authors: Gatenby L. A.
Published: November 2007

Background  In April 2004 Hull City Council introduced free healthy school meals for primary and special schools pupils (approximately 20,500 children) in an attempt to reduce health inequalities. The meals aimed to meet the Caroline Walker Trust (CWT) nutritional guidelines for primary schools. The study assesses the nutritional content of the meals, including children's actual intake. The Hull school is compared with a neighbouring school with no such initiative.

Methods  64 childern aged 9–10 years participated from 2 primary schools. Fieldwork was undertaken over 5 days in each school. 320 meals were weighted and photographed before and after consumption to assess actual intake.

Results  Hull childern consumed (p < 0.001) less total fat, sugar and sodium than neighbouring children. Both schools exceeded the CWT recommendations for these nutrients. Statistically significant (p < 0.001) differences were observed between nutrient intakes of energy, iron, zinc, folate and magnesium (p < 0.001) with Hull children consuming less than neighbouring children. Childern's intake at both schools did not meet recommended guidelines for 11 of the 17 nutrients assessed.

Conclusion  Although Hull's school meals aimed to provide childern with adequate nutritional intake, findings demonstrate that, on average, childeren are served and consume inadequate levels of many nutrients.
Daily Profile in Melanopsin Transcripts Depends on Seasonal Lighting Conditions in the Rat Retina
Authors: Mathes A. , Engel L. , Holthues H. , Wolloscheck T. , Spessert R.
Published: November 2007

The retinal photopigment melanopsin (Opn4) mediates photoentrainment of the circadian system. In the present study, seasonal regulation of the melanopsin gene was investigated in comparison with the arylalkylamine N‐acetyltransferase (AA‐NAT) gene as an indicator of retinal pacemaker output. For this purpose, the daily profiles in the amount of melanopsin mRNA and AA‐NAT mRNA were monitored under 8 : 16 h light/dark, 12 : 12 h light/dark and 16 : 8 h light/dark photoperiods using real‐time polymerase chain reaction analysis. We found that, under all of the lighting regimes, melanopsin and AA‐NAT expression oscillated with a peak around dark onset and the middle of the dark phase, respectively. The lighting regime influenced both genes, but in an opposing manner. Under long photoperiods, the duration of peak expression was prolonged for melanopsin, whereas it was shortened for AA‐NAT. Under constant darkness, the rhythm of mRNA was abolished for melanopsin, but persisted for AA‐NAT whereas, under constant light, the rhythm of mRNA was abolished for both genes. Our findings suggest that, in contrast to the AA‐NAT gene, the daily and photoperiod‐dependent regulation of the melanopsin gene does not rely on a circadian oscillator but is directly illumination‐dependent.
Melanocortin‐4 Receptor Activation Stimulates Hypothalamic Brain‐Derived Neurotrophic Factor Release to Regulate Food Intake, Body Temperature and Cardiovascular Function
Authors: Nicholson J. R. , Peter J.‐C. , Lecourt A.‐C. , Barde Y.‐A. , Hofbauer K. G.
Published: November 2007

In the present study, we aimed to investigate the neuromodulatory role played by hypothalamic brain‐derived neurotrophic factor (BDNF) in the regulation of acute cardiovascular and feeding responses to melanocortin‐4 receptor (MC4R) activation. In vitro, a selective MC4R agonist, MK1, stimulated BDNF release from isolated rat hypothalami and this effect was blocked by preincubation with the MC3/4R antagonist SHU‐9119. In vivo, peripheral administration of MK1 decreased food intake in rats and this effect was blocked by pretreatment with an anti‐BDNF antibody administered into the third ventricle. When anorexia was induced with the cannabinoid‐1 receptor (CB1R) antagonist AM251, the anti‐BDNF antibody did not prevent the reduction in food intake. Peripheral administration of MK1 also increased mean arterial pressure, heart rate and body temperature. These effects were prevented by pretreatment with the anti‐BDNF antibody whereas the intracerebroventricular administration of BDNF caused changes similar to those of MK1. These findings demonstrate for the first time that activation of MC4R leads to an acute release of BDNF in the hypothalamus. This release is a prerequisite for MC4R‐induced effects on appetite, body temperature and cardiovascular function. By contrast, CB1R antagonist‐mediated anorexia is independent of the MC4R/BDNF pathway. Overall, these results show that BDNF is an important downstream mediator of the MC4R pathway.
The Mga virulence regulon: infection where the grass is greener
Authors: Hondorp Elise R. , McIver Kevin S.
Published: November 2007

Co‐ordinate regulation of virulence gene expression in response to different host environments is central to the success of the group A streptococcus (GAS, Streptococcus pyogenes) as an important human pathogen. Mga represents a ubiquitous stand‐alone virulence regulator that controls genes (Mga regulon) whose products are necessary for adherence, internalization and host immune evasion. Mga highly activates a core set of virulence genes, including its own gene, by directly binding to their promoters. Yet, Mga also influences expression of over 10% of the GAS genome, primarily genes and operons involved in metabolism and sugar utilization. Expression of the Mga regulon is influenced by conditions that signify favourable growth conditions, presumably allowing GAS to take advantage of promising new niches in the host. The ability of Mga to respond to growth signals clearly involves regulation of mga expression via global regulatory networks such as RALPs, Rgg/RopB and the catabolite control protein CcpA. However, the presence of predicted PTS regulatory domains (PRDs) within Mga suggests an intriguing model whereby phosphorylation of Mga by the PTS phosphorelay might link growth and sugar utilization with virulence in GAS. As Mga homologues have been found in several important Gram‐positive pathogens, the Mga regulon could provide a valuable paradigm for increasing our understanding of global virulence networks in bacteria.
Differential Flo8p‐dependent regulation of FLO1 and FLO11 for cell–cell and cell–substrate adherence of S. cerevisiae S288c
Authors: Fichtner Lars , Schulze Florian , Braus Gerhard H.
Published: November 2007

Cell–cell and cell–surface adherence represents initial steps in forming multicellular aggregates or in establishing cell–surface interactions. The commonly used Saccharomyces cerevisiae laboratory strain S288c carries a flo8 mutation, and is only able to express the flocculin‐encoding genes FLO1 and FLO11, when FLO8 is restored. We show here that the two flocculin genes exhibit differences in regulation to execute distinct functions under various environmental conditions. In contrast to the laboratory strain Σ1278b, haploids of the S288c genetic background require FLO1 for cell–cell and cell–substrate adhesion, whereas FLO11 is required for pseudohyphae formation of diploids. In contrast to FLO11, FLO1 repression requires the Sin4p mediator tail component, but is independent of the repressor Sfl1p. FLO1 regulation also differs from FLO11, because it requires neither the KSS1 MAP kinase cascade nor the pathways which lead to the transcription factors Gcn4p or Msn1p. The protein kinase A pathway and the transcription factors Flo8p and Mss11p are the major regulators for FLO1 expression. Therefore, S. cerevisiae is prepared to simultaneously express two genes of its otherwise silenced FLO reservoir resulting in an appropriate cellular surface for different environments.
Gastrointestinal transit abnormalities are frequently detected in patients with unexplained GI symptoms at a tertiary centre
Authors: Sadik R. , Stotzer P.‐o. , Simrén M. , Abrahamsson H.
Published: November 2007

Abstract  The aim of this prospective study was to analyse the yield and utility of a gastrointestinal (GI) transit measurement procedure in clinical practice. Patients referred by gastroenterologists to a tertiary centre for detailed transit measurements were prospectively included. All together 243 patients were enrolled. Body mass index was recorded. The patients were categorized according to the predominant symptom into five groups: diarrhoea, constipation, nausea, vomiting and abdominal pain. The patients recorded their bowel movements and GI symptoms daily during the week before the transit measurement. Percentiles 5 and 95 of the transit values in 83 healthy subjects served as reference values. Widespread abnormalities were found in the five patient groups and 63% of the patients had at least one transit abnormality. The abnormalities were more frequent in men compared with women. Patients with underweight had more motility disturbances compared with other patients. In male and female patients with vomiting a significant delay of transit in the ascending colon was observed compared with healthy subjects. Large‐scale transit measurements frequently detect transit abnormalities in clinical practice and may elucidate the relationship between some GI symptoms and abnormal motility.
RNA interference‐mediated repression of sucrose‐phosphatase in transgenic potato tubers (Solanum tuberosum) strongly affects the hexose‐to‐sucrose ratio upon cold storage with only minor effects on total soluble carbohydrate accumulation
Authors: CHEN SHUAI , HAJIREZAEI MOHAMMAD R. , ZANOR MARÍA‐INÉS , HORNYIK CSABA , DEBAST STEFAN , LACOMME CHRISTOPHE , FERNIE ALISDAIR R. , SONNEWALD UWE , BÖRNKE FREDERIK
Published: November 2007

Storage of potato tubers at low temperatures leads to the accumulation of glucose and fructose in a process called ‘cold sweetening’. The aim of this work was to investigate the role of sucrose‐phosphatase (SPP) in potato tuber carbohydrate metabolism at low temperature (4 °C). To this end, RNA interference (RNAi) was used to reduce SPP expression in transgenic potato tubers. Analysis of SPP specific small interfering RNAs (siRNAs), SPP protein accumulation and enzyme activity indicated that SPP silencing in transgenic tubers was stable during the cold treatment. Analysis of soluble carbohydrates showed that in transgenic tubers, cold‐induced hexogenesis was inhibited while, despite strongly reduced SPP activity, sucrose levels exceeded wild‐type (WT) values four‐ to fivefold after 34 d of cold treatment. This led to a drastic change in the hexose‐to‐sucrose ratio from 1.9 in WT tubers to 0.15 to 0.11 in transgenic tubers, while the total amount of soluble sugars was largely unchanged in both genotypes. Sucrose‐6F‐phosphate (Suc6P), the substrate of SPP, accumulated in transgenic tubers in the cold which most likely enables the residual enzyme to operate with maximal catalytic activity in vivo and thus, in the long term, counterbalances reduced SPP activity in the transformants. Northern analysis revealed that cold‐induced expression of vacuolar invertase (VI) was blocked in SPP‐silenced tubers explaining a reduced sucrose‐to‐hexose conversion. Suc6P levels were found to negatively correlate with VI expression. A possible role of Suc6P in regulating VI expression is discussed.
Risk of anal furunculosis in German Shepherd dogs is associated with the major histocompatibility complex
Authors: Kennedy L. J. , O’Neill T. , House A. , Barnes A. , Kyöstilä K. , Innes J. , Fretwell N. , Day M. J. , Catchpole B. , Lohi H. , Ollier W. E. R.
Published: November 2007

Anal furunculosis (AF) is a chronic, progressive inflammatory disease of the perianal tissues most frequently affecting middle‐aged or older German Shepherd dogs (GSD). Because this breed accounts for over 80% of all reported cases, there is likely to be a genetic association with disease susceptibility. Although there are some similarities with perianal fistulation that occurs in human Crohn’s disease, the aetiology and pathogenesis of AF are still poorly understood. Recent research has suggested an immune‐mediated aetiology, and evidence for this has been further provided by clinical responses to the immunosuppressive drug cyclosporin. The aim of the current study was to investigate canine major histocompatibility complex immune response genes. Dog leucocyte antigen class II alleles and haplotypes were characterised by sequence‐based typing of 107 GSD affected with AF and 196 breed‐matched controls collected in the UK. A highly significant association of DLA‐DRB1*00101 with the presence of AF was observed (OR = 5.01, CI = 2.7–9.3,P < 0.00000001). This association was confirmed in a second cohort of GSD collected in Finland. Homozygosity for this allele is associated with an earlier disease onset.
IgG and IgE avidity characteristics of peanut allergic individuals
Authors: El‐Khouly Fatima , Lewis Stella Anne , Pons Laurent , Burks A. Wesley , Hourihane Jonathan O'Brien
Published: November 2007

The role of antibody avidity in allergy is poorly understood and there is no existing literature describing antibody avidity in food allergy. The main aim of this study was to investigate IgE and IgG avidity to a total peanut protein extract (TPPE) and purified Ara h 2 in a group of well‐characterized peanut allergic individuals. Forty peanut allergic patients underwent a double‐blind placebo‐controlled low‐dose peanut challenge, during which the severity of the patients’ peanut allergy was scored. Serum peanut‐specific IgE (psIgE) and IgG (psIgG) concentrations were measured for 37 individuals and the avidities of the same antibodies to a TPPE and purified Ara h 2 were determined using a thiocyanate ELISA method. Both IgE and IgG avidity to Ara h 2 showed weak positive correlations with challenge score [r = 0.459 (p = 0.012) and r = 0.486 (p = 0.003), respectively]. IgE avidity to TPPE showed a weak positive correlation with skin prick test results (SPT), r = 0.467 (p = 0.004) and there was an inverse relationship between the ratio of total IgE:psIgE and challenge score r = −0.561 (p < 0.001). No significant relationship was found between the ratios of IgE avidity:IgG avidity and challenge score or SPT. This is the first description of IgE and IgG avidity in peanut allergy, and it appears that the avidities of IgE and IgG antibodies to purified Ara h 2 are weakly related to the severity of peanut allergy (as measured by a challenge score).
The changing prevalence of asthma, allergic rhinitis and atopic eczema in African adolescents from 1995 to 2002
Authors: Zar Heather J , Ehrlich Rodney I , Workman Lesley , Weinberg Eugene G
Published: November 2007

The prevalence of asthma and allergic disease in children has been increasing in developed countries, but there is little information on these trends in Africa. The aim of this study was to assess time trends in the symptoms of asthma, allergic rhinitis, and atopic eczema among South African adolescents. The study was carried out by comparing cross‐sectional data from two International Study of Asthma and Allergies in Childhood (ISAAC phase I and phase III) questionnaire based surveys conducted 7 yr apart of self‐reported symptoms in 13‐ to 14‐yr‐old adolescents. In both surveys, schools in the same geographical area in Cape Town, South Africa, were randomly selected. A school‐based sample of 5178 (in 1995) and 5037 (in 2002) pupils participated. The 12‐month prevalence of wheezing (16% vs. 20.3%), exercise‐induced wheeze (21.5% vs. 32.5%), nocturnal cough (23.6% vs. 36.6%), sleep disturbance due to wheeze (9.6% vs. 16%), or severe wheeze (5.1% vs. 7.8%) increased significantly, as measured by the written questionnaire. A rise in asthma symptoms was confirmed by the video questionnaire responses, in which the 12‐month prevalence of wheezing (6.5% vs.11.2%), exercise‐induced wheeze (11.5% vs. 13.9%), nocturnal wheeze (3.9% vs. 5.3%), nocturnal cough (11.6% vs. 19.2%), or severe wheeze (5% vs. 7%) also increased significantly. There was a small increase in the percentage of children diagnosed with asthma from 1995 to 2002 (13.1% vs. 14.4%), this was not significant. The 12‐month prevalence of symptoms of allergic rhinitis (30.4% vs. 38.5%), rhinoconjunctivitis (17.6% vs. 24.3%) and eczema (11.8% vs. 19.4%) also increased significantly. An increase in the prevalence of allergic symptoms occurred in girls and boys. Limitation of daily activity from nasal symptoms (22.3% vs. 37.8%) and sleep disturbance because of eczema (8.4% vs. 15.7%) increasingly affected quality of life on the quality of life. Symptoms of asthma, allergic rhinitis and atopic eczema in adolescents have increased over the past 7 yr in this geographical area. Allergic diseases are common in this group of adolescents and increasingly impair their quality of life.
Changing patterns of hepatitis A and E sero‐prevalences in children after the 1999 earthquakes in Duzce, Turkey
Authors: Kaya Ayse Demet , Ozturk C Elif , Yavuz Taner , Ozaydin Cigdem , Bahcebasi Talat
Published: November 2007

Aim:  Hepatitis A and E are enteric viral diseases that are characteristically found in developing countries. Sero‐epidemiological data about both infections showed higher prevalence rates soon after the 1999 earthquakes in Duzce, Turkey. The aim of the present study was to evaluate the data 4 years after the earthquakes.

Methods:  The study group included 589 children (72.3% boys) who were between the ages of 6 months and 17 years (mean age 11.5 years). The children were separated into three groups: Group 1 (ages 6 months to 5.9 years), Group 2 (ages 6.0–12.9 years) and Group 3 (ages 13.0–17.0 years). Serum anti‐hepatitis A virus IgG and anti‐hepatitis E virus IgG were determined using commercial enzyme‐linked immunosorbent assay kits. The data were tested for statistical significance with the χ2‐test.

Results:  The sero‐prevalence rates of hepatitis A and E were 63.8% and 0.3%, respectively. The sero‐prevalence rates of both hepatitis A and E increased with age, and there was no significant difference between the genders. Hepatitis A infection was associated with socio‐economic condition, crowded living environment, and education level of the family (P < 0.01).

Conclusions:  Hepatitis A infection is still common, whereas hepatitis E infection appears to be relatively rare in paediatric age groups in Duzce, Turkey.
Relationship of transforming growth factor‐beta1 with tumour necrosis factor‐alpha and endothelial activation in patients with stable renal transplantation
Authors: PALERMO ALESSANDRO , MULÈ GIUSEPPE , VADALÀ ANNA , VACCARO FRANCESCO , GUARNERI MARCO , ARSENA ROSALIA , BRIOLOTTA CHIARA , CERASOLA GIOVANNI , COTTONE SANTINA
Published: November 2007

Aim:  To evaluate whether or not transforming growth factor‐beta1 is related to inflammation markers and to intercellular and vascular cell adhesion molecules in patients with stable renal transplantation.

Methods:  Serum concentrations of transforming growth factor‐beta1, tumour necrosis factor‐alpha, C‐reactive protein and adhesion molecules were analysed in 33 renal transplanted patients, 33 patients with chronic renal insufficiency (matched to the transplanted group for level of renal function), and 33 hypertensives with normal renal function. anova, Student's t‐test and simple regression analysis were used to analyse the data.

Results:  Transplanted patients showed higher values than hypertensives of transforming growth factor‐beta1, tumour necrosis factor‐alpha, C‐reactive protein and adhesion molecules (P < 0.0001 for all). Renal insufficiency group exhibited higher concentrations of transforming growth factor‐beta1, tumour necrosis factor‐alpha, C‐reactive protein and adhesion molecules than hypertensives (P < 0.0001 for all). Transplanted and renal insufficiency patients had similar blood pressure and renal function levels, and transforming growth factor‐beta1, tumour necrosis factor‐alpha, C‐reactive protein and adhesion molecules were not significantly different. In transplanted and in renal insufficiency groups transforming growth factor‐beta1, adhesion molecules and tumour necrosis factor‐alpha correlated significantly each other and with glomerular filtration rate (P < 0.001 for all).

Conclusion:  In long‐term renal transplantation inflammation and endothelial activation biomarkers, the pro‐fibrotic cytokine transforming growth factor‐beta1 and kidney function are interrelated. Because of the relevant role that inflammation, organ fibrosis and graft dysfunction may play against renal and cardiovascular survival of graft recipients, a better comprehension of the interactions between these variables is needed.
Oxidative stress in rat kidneys due to 3,4‐methylenedioxymetamphetamine (ecstasy) toxicity
Authors: NINKOVIĆ MILICA , SELAKOVIĆ VESNA , ÐUKIĆ MIRJANA , MILOSAVLJEVIĆ PETAR , VASILJEVIĆ IVANA , JOVANOVIĆ MARINA , MALIČEVIĆ ŽIVORAD
Published: November 2007

Aim: The mechanism of MDMA (3,4‐methylenedioxymethamphetamine)‐induced toxicity is believed to be, in part, due to enhanced oxidative stress. As MDMA is eliminated via the kidney, the aim of this study was to investigate whether MDMA created conditions of oxidative stress within rat kidney.

Methods: Adult male Wistar rats were divided into three groups, control treatment (water), acute MDMA administration (single oral dose: 5, 10, 20 or 40 mg/kg body weight) and subacute MDMA administration (5, 10, or 20 mg/kg body weight per day during 14 days). Animals were sacrificed 8 h after the single oral MDMA administration in the acute MDMA administration group and after the last MDMA administration in the subacute MDMA administration group. Rectal temperature measurements, oxidative stress status parameters and histological examinations were performed.

Results: In all MDMA‐administered rats, rectal temperature markedly increased peaking approximately 1 h after MDMA ingestion. Superoxide dismutase activity and thiobarbituric acid reactive substances increased after MDMA administration. Histological examinations of the kidney revealed dose‐dependent disruption of tissue structure in subacute MDMA‐administered rats. The latter was not observed in acute MDMA‐administered rats.
How to attract a nephrology trainee: Quantitative questionnaire results
Authors: LANE CATHIE ANNE , HEALY CAROL , HO MARIA‐THERESA , PEARSON SALLIE‐ANNE , BROWN MARK ASHLEY
Published: November 2007

Aim:  Global health workforce shortages are being experienced across many specialties. Australia faces a nephrology workforce shortage coupled with increased demand for nephrology services. This study examines issues impacting on the choice of nephrology as a career and identifies factors that can be modified to improve trainee recruitment. This study provides evidence to inform those seeking to address nephrology, and by extrapolation, other specialty workforce shortages,

Methods:  In Australia in 2005, a mailed self‐administered questionnaire was sent to all basic physician trainees eligible for the clinical component of the Royal Australasian College of Physicians' examination. Trainees were asked about the main influences on career choice; including perceived motivators and detractors surrounding a career in nephrology.

Results:  Of the 531 doctors surveyed, 222 (42%) responded. Younger respondents and those with previous nephrology experience were more likely to consider nephrology. Perceptions deterring respondents from considering nephrology included inflexible work hours, an absence of positive role models, the perceived restriction of the subspecialty to a hospital‐based practice and poor remuneration relative to other specialties.

Conclusion:  Exposure to a nephrology term in early postgraduate years is an important factor in a decision to undertake nephrology training. During these rotations; trainees need to experience positive role modelling. Effective trainee recruitment strategies should utilize the positive influence of role models, and must consider restructuring workforce and training activities to improve work hour flexibility and remuneration. Negative perceptions, acting as barriers to the pursuit of a career in nephrology, must be addressed and any misinformation corrected.
Recent advances in non‐invasive prenatal DNA diagnosis through analysis of maternal blood
Authors: Sekizawa Akihiko , Purwosunu Yuditiya , Matsuoka Ryu , Koide Keiko , Okazaki Shiho , Farina Antonio , Saito Hiroshi , Okai Takashi
Published: November 2007

Prenatal diagnosis of aneuploidy and single‐gene disorders is usually performed by collecting fetal samples through amniocentesis or chorionic villus sampling. However, these invasive procedures are associated with some degree of risk to the fetus and/or mother. Therefore, in recent years, considerable effort has been made to develop non‐invasive prenatal diagnostic procedures. One potential non‐invasive approach involves analysis of cell‐free fetal DNA in maternal plasma or serum. Another approach utilizes fetal cells within the maternal circulation as a source of fetal DNA. At the present time, fetal gender and fetal RhD blood type within RhD‐negative pregnant women can be reliably determined through analysis of maternal plasma. Furthermore, genetic alterations can be diagnosed in the maternal plasma when the mother does not have the alterations. However, the diagnosis of maternally inherited genetic disease and aneuploidy is limited using this approach. Non‐invasive prenatal diagnosis through examination of intact fetal cells circulating within maternal blood can be used to diagnose a full range of genetic disorders. Since only a limited number of fetal cells circulate within maternal blood, procedures to enrich the cells and enable single cell analysis with high sensitivity are required. Recently, separation methods, including a lectin‐based method and autoimage analyzing, have been developed, which have improved the sensitivity of genetic analysis. This progress has supported the possibility of non‐invasive prenatal diagnosis of genetic disorders. In the present article, we discuss recent advances in the field of non‐invasive prenatal diagnosis.
Influence of progesterone on myometrial contractility in pregnant mice treated with lipopolysaccharide
Authors: Anbe Hiroshi , Okawa Toshiaki , Sugawara Noboru , Takahashi Hidenori , Sato Akira , Vedernikov Yuri P. , Saade George R. , Garfield Robert E.
Published: November 2007

Aim:  To evaluate the effect of progesterone on interleukin (IL)‐6, prostaglandin (PG) E2 and nitric oxide (NO) metabolite (NOx) production and contractile activity by NO in pregnant mice treated with lipopolysaccharide (LPS).

Methods:  Pregnant C57BL mice on day 14 of gestation were killed 6 h after i.p. injection of LPS (400 μg/kg) or vehicle. Progesterone (2 mg) was subcutaneously injected 2 h before LPS treatment. Uterine rings were equilibrated in Krebs‐Henseleit solution (37°C) bubbled with 20% O2 and 5% CO2 (pH 7.4) for sampling and isometric tension recording. IL‐6, PGE2 and NOx productions were measured from the bathing solution. Changes in spontaneous contractile activity in response to cumulative concentrations of l‐arginine, diethylamine/nitric oxide (DEA/NO, the NO donor), and 8‐bromo‐cGMP (8‐br‐cGMP) were compared. Integral contractile activity over 10 min after each concentration was calculated and expressed as percentage change from basal activity. Statistical analyses were performed using one‐way anova followed by Dunnett's test (significance was defined as P < 0.05).

Results:  Interleukin‐6 (34.7 ± 6.0 pg/g tissue), PGE2 (66.8 ± 6.7 pg/g tissue) and NOx (51.0 ± 5.4 pmol/2 mL/g wet tissue) production were significantly stimulated by LPS treatment (138.2 ± 23.2, 147.0 ± 29.0, 98.6 ± 16.2, respectively; P < 0.05). l‐arginine, DEA/NO and 8‐br‐cGMP concentration‐dependently inhibited spontaneous contractions in uterine rings both in LPS‐treated and ‐untreated animals. Treatment with LPS significantly attenuated the maximal inhibition induced by l‐arginine, DEA/NO and 8‐br‐cGMP in uterine rings from pregnant mice. Progesterone significantly decreased the levels of IL‐6 production (74.9 ± 12.1, P < 0.05), but not PGE2 and NOx production, and contractile responses by l‐arginine, DEA/NO and 8‐br‐cGMP.

Conclusions:  The administration of LPS is associated with increases in IL‐6, PGE2 and NO, and these increases may or may not have a role to play in LPS‐induced preterm labor. Progesterone reduced the LPS‐induced increase in IL‐6 production and this may be one of the ways that progesterone reduces the risk of preterm labor.
Ultrastructural evaluation of type II pneumocytes in the hypoplastic lung of rabbit fetuses induced by oligohydramnios
Authors: Asabe Koushi , Oka Yoichiro , Kai Hiroki , Shirakusa Takayuki
Published: November 2007

Aim:  The present study was carried out using electron microscopy to evaluate the expression of lamellar bodies in type II pneumocytes of fetal rabbit lungs with hypoplasia induced by oligohydramnios.

Methods:  Using an amniotic shunting rabbit model, the lungs obtained from 32 fetuses, including 16 experimental fetuses (shunting group) and 16 control fetuses (control group), were used for electron microscopic studies. At least 250 type II pneumocytes per fetus were photographed. The number of lamellar bodies per type II pneumocyte was counted.

Results:  The number of lamellar bodies per type II pneumocyte of the shunting group was consistently and significantly less than that of the control group (5.49 ± 2.07 vs 7.58 ± 2.08; P < 0.01).

Conclusions:  These results suggest that the occurrence of hypoplastic lungs induced by oligohydramnios is associated with an immaturity of the surfactant system, especially the expression of the lamellar bodies of type II pneumocytes.
Pregnancy complicated by diffuse chorioamniotic hemosiderosis: Obstetric features and influence on respiratory diseases of the infant
Authors: Yoshida Shiro , Kikuchi Akihiko , Sunagawa Sorahiro , Takagi Kimiyo , Ogiso Yoshifumi , Yoda Tatsuya , Nakamura Tomohiko
Published: November 2007

Aim:  To clarify the clinical features of pregnancy and neonatal respiratory problems associated with diffuse chorioamniotic hemosiderosis (DCH).

Methods:  Sixteen singleton cases of DCH without chorioamnionitis (CAM) were retrospectively analyzed and compared with gestation‐ and birthweight‐matched controls (32 cases of CAM and 32 cases of non‐DCH‐non‐CAM). Maternal symptoms and respiratory problems of the infants were investigated.

Results:  All 16 cases with DCH resulted in preterm delivery from 23 to 35 weeks' gestation. The presence of subchorionic hematoma in the first trimester (P < 0.001), recurrent vaginal bleeding (P < 0.001), brownish amniotic fluid (P < 0.001) and amniotic necrosis or degeneration (P < 0.001) were significantly more frequent in the DCH group compared to the CAM and non‐DCH‐non‐CAM groups. The incidence of dry lung syndrome and persistent pulmonary hypertension of the newborn (PPHN) was significantly higher in the DCH group than in the CAM (P < 0.001) and non‐DCH‐non‐CAM (P < 0.001) groups.

Conclusion:  Long‐term exposure to degenerating red blood cells is supposed to damage amnion, fetal alveolar epithelial cells and fetal pulmonary arteries, and may lead to dry lung syndrome and PPHN in the infant complicated by DCH.
Prospective randomized study of oxytocin discontinuation after the active stage of labor is established
Authors: Ustunyurt Emin , Ugur Mustafa , Ustunyurt Basak Ozlem , Iskender Tekin Can , Ozkan Ovgu , Mollamahmutoglu Leyla
Published: November 2007

Aim:  To investigate the effects of discontinuing oxytocin infusion on labor outcomes once the active stage of labor is established.

Methods:  This is a prospective study involving 342 pregnant women who underwent labor induction at our institution. Patients were randomly divided into two groups. In the first group oxytocin was discontinued at the beginning of the active phase of labor, and in the other group, oxytocin was administered until delivery.

Results:  Duration of the active phase and the second stage of labor were longer in the oxytocin‐discontinued group; however, this was not statistically significant. The rate of uterine hyperstimulation was significantly higher in oxytocin‐continued group (P < 0.05). The total cesarean delivery rate for the oxytocin‐continued group was 6.9%, compared with 4.8% in the oxytocin‐discontinued group (P > 0.05).

Conclusion:  Discontinuing oxytocin infusion once the active stage of labor is established may be an alternative protocol in developing countries where the conditions for fetal monitoring and emergency cesarean section are less available.
Clinical outcome of metastatic uterine leiomyosarcoma and carcinosarcoma in a single institute
Authors: Yoshinaga Mitsuhiro , Togami Shinichi , Tsuji Takahiro , Fukamachi Nobuyuki , Kamio Masaki , Yanagi Masakazu , Douchi Tsutomu
Published: November 2007

Aim:  To investigate the clinical outcome of uterine sarcomas, particularly in patients with pulmonary and abdominal metastasis, treated at a single institute.

Methods:  We identified five patients with uterine leiomyosarcoma (LMS), one patient with endometrial stromal sarcoma (ESS), and three patients with carcinosarcoma (CS) between 2003 and 2006.

Results:  All patients underwent at least hysterectomy and bilateral adnectomy. All five LMS cases (two patients in International Federation of Obstetrics and Gynecology stage I and three in stage III) recurred: one patient showed metastasis to the lung and four patients showed metastasis to the abdomen 16.6 months (mean) after hysterectomy. Two of three (66.7%) CS recurred: one patient showed metastasis to the lung and the other to the abdomen 5 months (mean) after hysterectomy. The ESS (stage I) patient showed metastasis to the lung 11 months after hysterectomy. Five patients with metastases received surgical interventions (two pulmonary resections and three abdominal resections), and all of these patients are currently alive 1.1–5.1 years postoperatively. Two patients with CS (stage I) and one patient with LMS (stage III) died of sarcoma dissemination, but neither of these three patients had undergone surgical intervention after hysterectomy (one for pulmonary and two for abdominal metastases).

Conclusions:  Resection of lung and abdominal metastases in uterine LMS and CS is beneficial to improve patient survival.
Detection of human papillomavirus DNA and genotyping in patients with epithelial ovarian carcinoma
Authors: Atalay Funda , Taskiran Cagatay , Taner M. Zeki , Pak Isın , Or Melis , Tuncer Serdar
Published: November 2007

Aim:  The purpose of this study was to investigate the possible role of human papillomavirus (HPV) in Turkish patients with epithelial ovarian cancer by using the highly sensitive technique of polymerase chain reaction (PCR) to identify all the subtypes of this unique oncogenic virus.

Methods:  All patients were subjected to initial surgery, and subsequently recruited for postoperative chemotherapy depending on the extent of the disease and their condition. HPV PCR screening was done from paraffin embedded samples. PCR amplifications were done using the MY09/11 primer set after digestion and phenol–chloroform extraction of the DNA. HPV PCR‐positive samples were analyzed and genotyped using an OpenGene automated DNA sequencing system.

Results:  Overall, 94 patients were included in this study. The mean age was 52.7 years (range, 21–76 years). As a histopathologic diagnosis, the majority of the patients had serous papillary tumors (81%). HPV was found to be positive in eight patients (8.5%). All of the positive patients had serous papillary tumors (8/76, 10.5%) and advanced stage disease. Six patients had HPV type 16, and the remaining two patients had HPV type 33. None of the patients had more than one type of HPV.

Conclusion:  HPV may have a role in the carcinogenesis of ovarian cancer. It is worth investigating this possible relation both in large case–control studies and in vitro models by using more sensitive techniques.
Correlation of angiogenesis and recurrence‐free survival of early stage cervical cancer patients undergoing radical hysterectomy with pelvic lymph node dissection
Authors: Phoophitphong Thitikul , Hanprasertpong Jitti , Dechsukhum Chavaboon , Geater Alan
Published: November 2007

Aim:  To assess the correlation between the intensity of tumor angiogenesis, expressed as microvessel density, and recurrence‐free survival in patients with early stage cervical cancer.

Methods:  In a historical cohort study of patients with early stage cervical cancer undergoing radical hysterectomy with pelvic lymph node dissection at Songklanagarind Hospital during January 1998–December 2004, histological slides were immunostained for factor VIII‐related antigen. Microvessel density was scanned at low magnification to identify the area with the highest number of vessels. Stained microvessels were counted at high magnification (×200) in an examination area of 0.25 mm2. Microvessel density and other potential prognostic factors were considered as covariates in multivariate Cox‐proportional hazards regression models to evaluate their association with recurrence‐free survival.

Results:  One hundred and sixty‐four patients were included in the study, and 16 patients developed recurrent disease during follow‐up. The overall 5‐year recurrence‐free survival was 86.9% (95% confidence interval [CI] 78.9–92.0). In the multivariate analysis, microvessel density (hazard ratio [HR], for ≥9 vs <6 vessels per high power field: 5.8, 95% CI 1.5–22.7; P = 0.013), tumor size (HR for maximum diameter ≥2 vs <2: 3.6, 95% CI 1.2–10.7; P = 0.017) and parity (HR for ≥3 vs <3: 3.6, 95% CI 1.2–10.7; P = 0.018) were identified as significant independent prognostic factors for recurrence‐free survival.

Conclusion:  Microvessel density is an independent prognostic parameter for recurrence‐free survival in patients with early stage cervical cancer. Microvessel density at or above the cut‐off point of nine vessels per high power field had significantly poorer recurrence‐free survival.
Role of a bipolar resectoscope in subfertile women with submucous myomas and menstrual disorders
Authors: Makris Nikolaos , Vomvolaki Eleftheria , Mantzaris George , Kalmantis Kostas , Hatzipappas John , Antsaklis Aris
Published: November 2007

Aim:  To evaluate the role of the Gynecare (Ethicon, Somerville, NJ, USA) bipolar resectoscope in resecting fibroids, and the effect of hysteroscopic myomectomy on infertility and pregnancy outcomes.

Methods:  From January 2000 to December 2005, we studied 59 women of reproductive age with menorrhagia, submucous myomas and one or more infertility factors. All women who participated had been subfertile for over 2 years. Fifteen of the 59 women displayed submucous myoma type O (intracavitary), 34 displayed submucous myoma type I (less than 50% within the myometrium) and the remaining 10 women displayed myoma type II (over 50% being within the myometrium).The mean age and standard deviation of these patients was 34.6 ± 4.4 years and the average size of myomas was 15 ± 10 mm. Treatment of these myomas was by hysteroscopic resection using a bipolar resectoscope.

Results:  Menorrhagic incidents improved in 20 of 32 women (62.5%). Twenty‐five women (42.4%) succeeded in becoming pregnant. The pregnancy rate was notably higher when the sole reason of subfertility was the presence of myoma (54.16%), and when the size of the myoma was equal to 2.5 cm (75%) or more.

Conclusion:  The use of the bipolar resectoscope in hysteroscopic removal of small submucous myomas is shown to be both feasible and effective in controlling menorrhagia and increasing the pregnancy rate in subfertile women, when submucous myomas are the only reason of infertility.
Laparoscopic salpingectomy in tubal pregnancy: Prospective randomized trial using endoloop versus electrocautery
Authors: Lim Yun‐Hsuen , Ng Soon P. , Ng Paul H. O. , Tan Ay E. , Jamil Muhammad A.
Published: November 2007

Aim:  Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre‐tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy.

Methods:  A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy.

Results:  The use of an endoloop was associated with a shorter operating time (48.85 min ± 21.019 vs 61.14 min ± 22.603, 95% CI −20.864 to −3.724), lower visual analog scores for postoperative pain at day 1 (2.02 ± 0.960 vs 2.74 ± 0.828, 95% CI −1.074 to −0.368) and day 7 (0.85 ± 0.802 vs 1.44 ± 0.837, 95% CI −0.916 to −0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 ± 6.119 vs 15.32 ± 8.326, 95% CI −10.529 to −4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days ± 0.817 vs 2.34 days ± 0.519, 95% CI −0.245 to −0.296) and interval from operation to discharge were similar.

Conclusion:  The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.