bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral blood progenitor cell mobilization in patients with primary refractory lymphoma or at first relapse: comparison with patients at diagnosis and impact on clinical outcome
Authors: Tarella C. , Castellino C. , Cherasco C. , Bondesan P. , Giaretta F. , Corradini P. , Caracciolo D. , Gavarotti P , Pileri A.
Published: November 2003

Peripheral blood progenitor cell (PBPC) mobilization was evaluated in 53 patients receiving the high‐dose sequential (HDS) regimen: 27 had non‐Hodgkin's lymphoma or Hodgkin's disease, primary refractory or at first relapse, 26 had non‐Hodgkin's lymphoma at diagnosis. Mobilization was assessed following either 7 g/m2 cyclophosphamide (48 patients) or 2 g/m2 etoposide, both followed by G‐CSF (filgrastim) at 5 μg/kg/d. PBPC mobilization was significantly higher in patients at diagnosis compared to refractory/relapsed patients (median peak values of circulating CFU‐GM: 25 209/ml v 4270/ml , P < 0.0001 and CD34+ cells: 286/μl v 47/μl, P < 0.0001). All patients receiving HDS as up‐front treatment mobilized enough PBPC for an autograft, often requiring a single leukapheresis; whereas only 15 patients under salvage treatment with HDS were able to complete PBPC autograft. Bone marrow (BM) cells, alone or with PBPC, were needed in six patients, and autograft could not be performed in six patients. Among refractory/relapsed patients, those having a high PBPC mobilization experienced a significantly longer EFS compared to those who had not; autograft completion also significantly enhanced EFS. Thus, the use of an effective mobilizing protocol does not ensure adequate PBPC mobilization in moderately pretreated patients; low mobilization must be considered as an early sign of poor outcome in patients receiving a high‐dose salvage programme.
Spontaneous resolution of p58/EB6 antigen restricted NK‐type lymphoproliferative disease of granular lymphocytes: role of Epstein Barr virus infection
Authors: Zambello Renato , Loughran Jr Thomas P. , Trentin Livio , Rassu Mario , Facco Monica , Bortolin Michela , Nash Richard , Agostini Carlo , Semenzato Gianpietro
Published: November 2003

We describe a patient with a CD3− lymphoproliferative disease of granular lymphocytes (LDGL) characterized by proliferation of CD3−CD16+ GL, restricted to the expression of p58/EB6 antigen and lacking the p58/GL183 antigen. Using PCR analysis we demonstrated the presence of EBV DNA in the peripheral blood mononuclear cells and purified CD16+ GL from the patient; a monoclonal episomic configuration of the virus could not be demonstrated with Southern blot analysis. The presence of EBV DNA was also detected by PCR in the serum; this finding was associated with a serological pattern consistent with a previous, already seroconverted, EBV infection. During a 4‐year follow‐up the lymphocytosis spontaneously disappeared; interestingly, in terms of the p58 antigen expression, we provided evidence of the reconstitution of a normal pattern of circulating NK subsets (i.e. p58/EB6+ p58/GL183−, p58/EB6+ p58/GL183+, p58/EB6− p58/GL183−, p58/EB6− p58/GL183+). At the time of resolution of lymphocytosis, EBV‐PCR analysis still demonstrated the persistence of EBV DNA in peripheral blood mononuclear cells, but not in the patient's serum.  By indicating that inciting agents (in this case EBV) are involved in inducing the GL proliferation, our data contribute insights into the pathogenetic mechanisms accounting for in vivo GL accumulation in LDGL. It appears that a second, still unknown, event is required to determine the neoplastic transformation.
The presence of 19‐kDa Bcl‐2 in dividing cells
Authors: Hoetelmans R. W. M. , Van de Velde C. J. H. , Van Dierendonck J. H.
Published: November 2003

Abstract.  The 26‐kDa bcl‐2 gene product inhibits apoptosis and cell proliferation. Cleavage of Bcl‐2 into a 22‐kDa fragment inactivates its anti‐apoptotic activity and is a key event in apoptosis. Here, and in recent work, we describe massive 19‐kDa Bcl‐2 immunoreactivity in non‐apoptotic cells, suggesting a link with viability rather than cell death. Loss of 19 kDa Bcl‐2 in adriamycin‐induced apoptotic cells underlines this. G2/M‐phase accumulation of cells by nocodazole‐treatment also results in loss of 19 kDa Bcl‐2. Next to its well‐documented cytoplasmic localization, a substantial pool of Bcl‐2 resides in nuclei. Hampered nuclear localization of Bcl‐2 leads to a loss of cell cycle repression. This has led us to point at a pivotal role for nuclear Bcl‐2 in cellular proliferation. In this report, cellular fractionation of bcl‐2 transfected cells in various phases of the cell cycle reveals a constitutive cytoplasmic pool of 19 kDa Bcl‐2. Nuclear 19‐kDa Bcl‐2 immunoreactivity is far more pronounced in rapidly dividing nuclei compared with more quiescent nuclear fractions. This implicates that ongoing cell proliferation involves cleavage of nuclear Bcl‐2 with a 19‐kDa fragment.
Identification of differentially expressed genes in isogenic highly metastatic and poorly metastatic cell lines of R3230AC rat mammary adenocarcinoma
Authors: Günes H. , Carlsen S. A.
Published: November 2003

Abstract.  Tumour metastasis occurs as a result of a cascade of events including alterations in the expression of various genes. The identification of such genes is essential to understanding formation of metastasis. In a previous study, highly metastatic (LN4.D6) and poorly metastatic (CAb.D5) cell lines were obtained from the rat mammary adenocarcinoma cell line R3230AC. Subtractive hybridization was used to identify differentially expressed genes between these two cell lines. We identified eight cDNA clones in CAb.D5 and six cDNA clones in LN4.D6 that were differentially expressed. One of the cDNA clones in each cell line had no homology with known sequences. Expression patterns of these differentially expressed genes were examined in a pair of rat mammary and prostate adenocarcinoma cell lines. Compared with cell lines examined, cDNA FF‐10 was only expressed in CAb.D5; however, cDNA RB‐8, RE‐1, RF‐5 were only expressed in the highly metastatic LN4.D6. No correlation was observed between expression patterns of the differentially expressed genes and metastatic potential of these cells. However, differential expression of genes, especially cytokeratins (CK8 and CK5) and collagens (III and IV) between highly metastatic and low metastatic rat mammary adenocarcinoma cell lines might initiate further investigation of these genes in metastatic process.
Over‐expression of cyclin D1 regulates Cdk4 protein synthesis
Authors: Parker M. A. , Deane N. G. , Thompson E. A. , Whitehead R. H. , Mithani S. K. , Washington M. K. , Datta P. K. , Dixon D. A. , Beauchamp R. D.
Published: November 2003

Abstract.  Increased Cdk4 expression occurs coincident with over‐expression of cyclin D1 in many human tumours and tumourigenic mouse models. Here, we investigate both in vivo and in vitro the mechanism by which Cdk4 expression is regulated in the context of cyclin D1 over‐expression. Cdk4 mRNA levels in cyclin D1‐over‐expressing tissue and cultured cells were unchanged compared with controls. In contrast, Cdk4 protein levels were increased in cyclin D1‐over‐expressing tissue and cells versus their respective controls. This increase was not due to altered protein stability, but appeared to be due to an increase in Cdk4 protein synthesis. We also performed immunoprecipitation and in vitro kinase assays to demonstrate an increase in cyclin D1‐Cdk4 complex formation and associated kinase activity. Blocking cyclin D1 expression resulted in diminished Cdk4 protein but not mRNA levels. These findings suggest a mechanism by which Cdk4 expression is increased in the context of cyclin D1 over‐expression during tumourigenesis.
Dietary pectin and calcium inhibit colonic proliferation in vivo by differing mechanisms
Authors: Umar S. , Morris A. P. , Kourouma F. , Sellin J. H.
Published: November 2003

Abstract.  Diet plays an important role in promoting and/or preventing colon cancer; however, the effects of specific nutrients remain uncertain because of the difficulties in correlating epidemiological and basic observations. Transmissible murine colonic hyperplasia (TMCH) induced by Citrobacter rodentium, causes significant hyperproliferation and hyperplasia in the mouse distal colon and increases the risk of subsequent neoplasia. We have recently shown that TMCH is associated with an increased abundance of cellular β‐catenin and its nuclear translocation coupled with up‐regulation of its downstream targets, c‐myc and cyclin D1. In this study, we examined the effects of two putatively protective nutrients, calcium and soluble fibre pectin, on molecular events linked to proliferation in the colonic epithelium during TMCH. Dietary intervention incorporating changes in calcium [high (1.0%) and low (0.1%)] and alterations in fibre content (6% pectin and fibre‐free) were compared with the standard AIN‐93 diet (0.5% calcium, 5% cellulose), followed by histomorphometry and immunochemical assessment of potential oncogenes. Dietary interventions did not alter the time course of Citrobacter infection. Both 1.0% calcium and 6% pectin diet inhibited increases in proliferation and crypt length typically seen in TMCH. Neither the low calcium nor fibre‐free diets had significant effect. Pectin diet blocked increases in cellular β‐catenin, cyclin D1 and c‐myc levels associated with TMCH by 70%, whereas neither high nor low calcium diet had significant effect on these molecules. Diets supplemented with either calcium or pectin therefore, exert anti‐proliferative effects in mouse distal colon involving different molecular pathways. TMCH is thus a diet‐sensitive model for examining the effect of specific nutrients on molecular characteristics of the pre‐neoplastic colonic epithelium.
Ordinary chat and therapeutic conversation: phatic communication and mental health nursing
Authors: Burnard P
Published: November 2003

This paper offers a definition of ‘phatic communication’ and identifies examples of it. The paper also illustrates how a knowledge of such communication is useful for mental health nurses in conversation with their clients and colleagues. The importance of turn taking in conversations is also discussed in a cultural context. Various examples of phatic communication are offered.
Finding solutions through empowerment: a preliminary study of a solution‐orientated approach to nursing in acute psychiatric settings
Authors: STEVENSON C. , JACKSON S. , BARKER P.
Published: November 2003

Acute inpatient care is not a therapeutic milieu, perhaps owing to the lack of nursing skills. Solution‐focused therapy (SFT) has been successful in US inpatient facilities in relation to both objective and subjective ‘measures’. This paper reports a study of SFT in a UK context, with the aim of developing a user‐friendly SFT training course and assessing its impact on both nurses and clients, via a multifaceted, triangulated data collection design. Nurses’ knowledge and clinical performance were assessed, as was the client's perspective. There was a significant difference in nurses’ SFT knowledge after training and strong evidence of the model being used in practice during the course of training, although nursing documentation was not fully completed. Eighty‐three per cent of nurses said that they would continue using the model, and clients found the SFT approach helpful. The findings match the US experience of using SFT.
Asylum blues: staff attitudes towards psychiatric nursing in Sarawak, East Malaysia
Authors: ASHENCAEN CRABTREE S.
Published: November 2003

This paper draws upon findings from an ethnographic study of psychiatric service users in a psychiatric institution in Sarawak, East Malaysia. Findings focus primarily on the accounts of nursing staff in relation to attitudes towards psychiatric work and patients. These indicate that despite a rhetoric of decentralized services, a custodial ‘asylum’ model continues to influence the care of patients at many levels. Negative professional attitudes towards patients lead to issues of both moral and physical containment. However, an associated attitude of stigma and prejudice towards mental illness impacts upon how attractive a career in psychiatric nursing is perceived to be by respondents, subject to gender differentials.
Personal reflections of mental health nurses training to use Hobson's Conversational Model (psychodynamic‐interpersonal) of psychotherapy
Authors: PALEY G. , SHAPIRO D. A. , MYERS J. , PATRICK S. , REID E.
Published: November 2003

Current mental health policy documents highlight the need for mental health nurses to become increasingly involved in the delivery of evidence‐based psychological interventions. However, substantial evidence exists indicating that there is a paucity of training to adequately equip nurses to deliver these interventions and, even when training is available, there are barriers to their implementation into routine clinical practice. This paper reports on the personal reflections and experiences of a group of four mental health nurses undertaking training in the Conversational Model of psychotherapy (also known as psychodynamic‐interpersonal ‘PI’ psychotherapy). These reflections highlight the rewards and challenges arising from the effort to undertake training in an evidence‐based model of psychological intervention and from attempting to implement and sustain this training into routine practice.
The hierarchical spatial distribution of chloroplast DNA polymorphism across the introduced range of Silene vulgaris
Authors: McCauley D. E. , Smith R. A. , Lisenby J. D. , Hsieh C.
Published: November 2003

Silene vulgaris was introduced into North America sometime prior to 1800. In order to document the population structure that has developed since that time, collections were made from 56 local populations distributed among 9 geographical regions in eastern North America. Individual plants were characterized for chloroplast DNA (cpDNA) haplotype by restriction fragment size analysis of four noncoding regions of cpDNA amplified by polymerase chain reaction. A total of 19 cpDNA haplotypes were detected using this method. The overall gene diversity of 0.85 is quite similar to the diversity detected in these same regions of cpDNA in a previously published sample of S. vulgaris taken from across much of Europe. The spatial distribution of the North American cpDNA diversity was quantified by hierarchical F‐statistics that partitioned the genetic variance into variation among local populations within regions, and variation among regions. The average FST among populations within regions was 0.66 and the FST among regions was 0.09. The among‐region variation was due to both differences among regions in the frequency of two most common haplotypes, and to the presence of a number of region‐specific haplotypes. In order to test for isolation by distance at the regional level, FST values were calculated for all possible pairs of regions, and regressed against the geographical distance between those regions. There was no evidence for isolation by distance. It is suggested that the local population structure is generated by recent extinction/colonization dynamics, and that the among‐region structure reflects demographic events associated with range expansion following introduction to North America.
Genetic structure in a montane ranid frog: restricted gene flow and nuclear–mitochondrial discordance
Authors: Monsen Kirsten J. , Blouin Michael S.
Published: November 2003

There is substantial debate over the criteria that should be used to group populations of a species into distinct units for conservation (e.g. evolutionarily significant units, management units, distinct population segments). However, in practice molecular genetic differentiation is often the only or main criterion used to identify such units. Most genetic studies attempting to define conservation units in animals use a single molecular marker, most often mitochondrial, and use samples from a limited number of populations throughout the species’ range. Although there are many benefits to using mtDNA, certain features can cause it to show patterns of differentiation among populations that do not reflect the history of differentiation at the nuclear genome where loci controlling traits of adaptive significance presumably occur. Here we illustrate an example of such mitochondrial–nuclear discordance in a ranid frog, and show how using mtDNA or nuclear loci alone could have led to very different conservation recommendations. We also found very high genetic differentiation among populations on a local scale, and discuss the conservation implications of our results.
Comparative phylogeography of short‐tailed bats (Carollia: Phyllostomidae)
Authors: Hoffmann F. G. , Baker R. J.
Published: November 2003

This is the first study of comparative phylogeography involving closely related species of Neotropical bats of the family Phyllostomidae. We compared patterns of geographical variation within the five species of fruit‐eating bats currently recognized in the genus Carollia using the complete mitochondrial cytochrome‐b gene. Our results suggest that the combined effect of the uplift of the Andes and the Panamanian land bridge has been as important for bats as for terrestrial mammals in shaping present‐day biodiversity in the New World tropics. Species in this genus can be arranged in two highly supported clades, with a deep subdivision within each that corresponds well to differences across the Andes. We found three congruent phylogeographical patterns across species in this genus. First, the closer relationship between samples from western Ecuador and those from Central America, compared with populations east of the Andes in C. brevicauda, C. castanea and C. perspicillata. Second, the likelihood of a similar timing in South America for the arrival and diversification of C. brevicauda and C. perspicillata from their Central America ancestors. Third, the expansion of C. perspicillata and C. sowelli into northwestern Central America in the relatively recent past. Using a molecular clock, with rates ranging from 2.3 to 5% per 106 years, diversification within Carollia would have occurred over the last 1–4.5 Myr. These estimates agree well with the last rise of the Northern Andes and the Panama isthmus.
Fine‐scale genetic pattern and evidence for sex‐biased dispersal in the túngara frog, Physalaemus pustulosus
Authors: Lampert Kathrin P. , Rand A. Stanley , Mueller Ulrich G. , Ryan Michael J.
Published: November 2003

Túngara frogs (Physalaemus pustulosus) are a model system for sexual selection and communication. Population dynamics and gene flow are of major interest in this species because they influence speciation processes and microevolution, and could consequently provide a deeper understanding of the evolutionary processes involved in mate recognition. Although earlier studies have documented genetic variation across the species’ range, attempts to investigate dispersal on a local level have been limited to mark–recapture studies. These behavioural studies indicated high mobility at a scale of several hundred metres. In this study we used seven highly polymorphic microsatellite loci to investigate fine‐scaled genetic variation in the túngara frog. We analysed the influence of geographical distance on observed genetic patterns, examined the influence of a river on gene flow, and tested for sex‐biased dispersal. Data for 668 individuals from 17 populations ranging in distance from 0.26 to 11.8 km revealed significant levels of genetic differentiation among populations. Genetic differentiation was significantly correlated with geographic distance. A river acted as an efficient barrier to gene flow. Several tests of sex‐biased dispersal were conducted. Most of them showed no difference between the sexes, but variance of Assignment Indices exhibited a statistically significant male bias in dispersal.
Weed communities of winter wheat as influenced by input level and rotation
Authors: BARBERI P. , SILVESTRI N. , BONARI E.
Published: November 2003

The influence of cropping systems constituted by the combination of three input levels (low, intermediate and high) and four 2‐year rotations between a spring summer crop and winter wheat (Triticum aestivum L.) on the density and composition of the winter wheat weed flora was evaluated from 1989 to 1992. Spring summer crops were maize (Zea mays L.). soyabean (Glycine max (L.) Merr.). sugar beet (Beta vulgaris L.) and sunflower (Helianthus and L.) Total weed density at the end of the wheat tillering stage ranged from 2.5 to 128.7 plants m‐2 and generally decreased with cropping intensity, although to a differing extent, depending upon rotation. Differences among weed communities of the 12 cropping systems were mostly dependent upon input level. The effect of the preceding crop on the weed flora composition of winter wheat was evident only with reduced herbicide use (low‐input systems). Weed species could be ascribed to four categories: (a) species sporadically associated with cropping systems (most of the weeds); (b) species associated with a specific input level (e.g. Papaver rhoeas L. to low and intermediate input levels and Veronica persica Poiret to the high input ievel): (c) species associated with a specific rotation (e.g. Anm majus L. to sugar beet winter wheat): and (d) species associated with specitie plots that become important every other year (e.g. Convolvulus arvensis L. and Stellaria media (L.) Vill.).
Influence of weather on the efficacy of dichlorprop‐P/MCPA and trihenuron‐methyl
Authors: LUNDKVIST A.
Published: November 2003

The influence of weather on the efficacy of dichlorprop‐P/MCPA and tribenuron‐methyl on annual weeds in spritig barley was studied in the field during 4 years at six locations in southern Sweden. The herbicides were applied at one‐eighth to three‐quarters of the full dose at three application times with approximately 6‐day intervals. Weather stations, placed in the experiments, recorded climatic data, Maximum herbicide efficacy was obtained when spraying 1 week after the cotyledon stage with half or three‐quarters of the recommended dose. Dose‐response curves were estimated and the ED80 doses were calculated. On average, the herbicide dose required to obtain an effect of 80% was about 40% of the recommended dose. The influence of weather was analysed for seven different periods: 7 and 2 days before and after herbicide application, 1 day before and after application, and the day of herbicide treatment. The most pronounced eftects of weather were found for the day of and the day before herbicide application, revealing the strong influence of weather on herbicide uptake and plant metabolism. High air tetnperature and low global radiation during the day of treattnent reduced the ED80 dose of dichlorprop‐P/MCPA, whereas the ED80 dose of tribenuron‐methyl increased. For both herbicides, precipitation and high soil temperature increased the ED80 dose, which reflects the importance of rain on herbicide uptake and the effect of soil temperature on plant growth. The R2 values were higher in the analyses of dichlorprop‐P/MCPA than of tribenuron‐methyl, indicating that the effect of dichlorprop‐P/MCA was more weather‐dependent than that of tribenuron‐methyl. Separate analyses of the ED80 doses for Brassica napus L., Chenopodium, album L. and Stellaria media (L.) Vill. generally resulted in increased R2 values. but otherwise gave results similar to those for the total weed population. Although the analyses revealed significant effects of indivtdual weather factors on herbicide efficacy, it was not possible to discern a consistent and causal relationship between weather and herbicide performance.
The Ubiquitin‐Vacuolar Protein Sorting System is Selectively Required During Entry of Influenza Virus into Host Cells
Authors: Khor Rebecca , McElroy Lisa J. , Whittaker Gary R.
Published: November 2003

Influenza virus enters cells by endocytosis, and requires the low pH of the late endosome for successful infection. Here, we investigated the requirements for sorting into the multivesicular body pathway of endocytosis. We show that treatment of host cells with the proteasome inhibitors MG132 and lactacystin directly affects the early stages of virus replication. Unlike other viruses, such as retroviruses, influenza virus budding was not affected. The requirement for proteasome function was not shared by two other pH‐dependent viruses: Semliki Forest virus and vesicular stomatitis virus. With MG132 treatment, incoming influenza viruses were retained in endosomes that partially colocalized with mannose 6‐phosphate receptor, but not with classical markers of early or late endosomes. Colocalization was also observed with Rme‐1, which is part of the recycling pathway of endocytosis. In addition, influenza virus entry was dependent on the vacuolar protein sorting pathway, as over‐expression of dominant‐negative hVPS4 caused arrest of viruses in endosome‐like populations that partially colocalized with the hVPS4 protein. Overall, we conclude that influenza virus selectively requires the ubiquitin/vacuolar protein sorting pathway for entry into host cells, and that it must communicate with a specific cellular machinery for intracellular sorting during the initial phase of virus infection.
AAK1‐Mediated μ2 Phosphorylation is Stimulated by Assembled Clathrin
Authors: Conner Sean D. , Schröter Thomas , Schmid Sandra L.
Published: November 2003

AAK1, the adaptor‐associated kinase 1, phosphorylates the μ2 subunit of AP2 and regulates the recruitment of AP2 to tyrosine‐based internalization motifs found on membrane‐bound receptors. AAK1 overexpression specifically inhibits the AP2‐dependent internalization of transferrin receptor and LDL‐receptor related protein by functionally sequestering AP2 (Conner and Schmid. J Cell Biol 2003; 162: 773). However, while AAK1 stably associates with AP2 and specifically targets the μ2 subunit in vitro, μ2 phosphorylation in vivo was not altered by overexpression of either wild‐type or kinase‐inactive AAK1. These results suggested that AAK1 might be tightly regulated in the cell. Here, we report that AAK1 is an atypical kinase that is rate limited by its stable association with AP2 and that clathrin stimulates μ2 phosphorylation by AAK1. Efficient stimulation of AAK1 by clathrin involves multiple interactions between several domains on AAK1 and both heavy and light chains on clathrin. Importantly, incubation of AAK1 with clathrin cages resulted in even greater stimulation when compared to that of unassembled clathrin triskelia. Collectively, our observations indicate that clathrin function is not limited to structural and/or mechanical roles in endocytic vesicle formation: the stimulatory effects of clathrin on AAK1 activity argue that it also plays a regulatory role by modulating the activity of AP2 complexes through activation of AAK1. We suggest a model in which AAK1 is specifically activated in coated pits to enhance cargo recruitment and efficient internalization.
Massive tongue swelling following the use of synthetic saliva
Authors: Kandala Vijay , Playfor Stephen
Published: November 2003

A 5‐year‐old boy with cerebral palsy and severe learning difficulties developed massive tongue swelling of sudden onset following the use of synthetic saliva. Acute airway obstruction and severe stridor ensued which required tracheal intubation and transfer to paediatric intensive care. The child was treated with intravenous steroids, antihistamines and epinephrine. With cessation of synthetic saliva, the swelling gradually resolved and the child was extubated on day 5.
Influence of EEG monitoring on intraoperative stapedius reflex threshold values in cochlear implantation in children
Authors: Schultz B. , Beger F.A. , Weber B.P. , Niclaus O. , Lüllwitz E. , Grouven U. , Schultz A.
Published: November 2003

Background Cochlear implantation is a widely used means of treating deafness and severe hearing disorders. The surgical procedure includes inserting the cochlear implant electrode array into the cochlea and embedding the corresponding signal receiver in the mastoid bone behind the ear. Postoperative fitting of the externally worn speech processor is very important for successful use of the cochlear implant. For this purpose, electrically elicited stapedius reflex threshold values can be used. However, stapedius reflex threshold values measured intraoperatively are influenced by anaesthetics. The goal of this retrospective study was to find out whether electroencephalogram (EEG) control of anaesthesia produces more reliable reflex threshold values as a basis for the fitting of the speech processor.

Methods Three groups of children, after surgery for cochlear implantation, were analysed with regard to the magnitude of intraoperative electrically elicited stapedius reflex threshold values and their deviations from postoperatively determined maximum comfortable levels (group 1: methohexital/remifentanil with EEG monitoring, n = 10; group 2: isoflurane/fentanyl with EEG monitoring, n = 9; group 3: isoflurane/fentanyl without EEG monitoring, n = 11).

Results Children with EEG monitoring had significantly lower electrically elicited stapedius reflex threshold values and also significantly lower differences between intraoperative stapedius reflex threshold values and postoperatively determined maximum comfortable levels.

Conclusions Electroencephalogram monitoring in cochlear implantation is of considerable value in controlling anaesthesia and improving speech processor fitting based on more reliable intraoperative neurophysiological data.
Comparison of perioperative blood salvage and postoperative reinfusion of drained blood during surgical correction of craniosynostosis in infants
Authors: Orliaguet Gilles A. , Bruyere Marie , Meyer Philippe G. , Blanot Stéphane , Renier Dominique , Carli Pierre A.
Published: November 2003

Background The surgical correction of craniosynostosis may be associated with extensive blood loss and transfusion. The aim of this study was to compare the efficacy of the perioperative use of the continuous autotransfusion system (CATS group) and of the postoperative use of the CBCII ConstaVac® system (CV group) to reduce homologous transfusion in infants during repair of craniosynostosis.

Methods Two groups of consecutive infants, weighing <10 kg, and scheduled for the surgical correction of craniosynostosis, were compared retrospectively according to the blood salvaging system used: CATS group and CV group. The primary endpoint was the comparison of the total volume of homologous blood transfused.

Results There was no significant difference between the CV (n = 69) and the CATS (n = 135) groups with regard to physical, preoperative and postoperative data, except for the type of craniosysnostosis with more scaphocephaly in the CV group (P = 0.03). No significant difference in blood loss and homologous transfusion was observed between the two groups during the perioperative period. Two subgroups of patients were also compared: a subgroup including patients operated on with a linear craniectomy for scaphocephaly, and a subgroup including all other patients. There was also no significant difference in blood loss and homologous transfusion between the CV and the CATS groups for these two subgroups of patients.

Conclusion Our results suggest that the postoperative use of the CBCII ConstaVac® system is as efficient as the perioperative use of the CATS® system for reducing homologous blood transfusion during repair of craniosynostosis in infants weighing <10 kg.
Anaesthesia in a child with Sotos syndrome
Authors: Adhami Eftim J. , Cancio‐Babu Consolacion V.
Published: November 2003

Sotos syndrome is a rare condition characterized by typical facies, early accelerated growth, large body size, developmental delay and congenital heart defects. Reports of anaesthetic management of these children are very rare. We report a case of general anaesthesia in a 2½‐year‐old boy with this condition, undergoing inguinal hernia repair. The child had a marked developmental delay, hypotonia and mitral regurgitation. The key points in the management of anaesthesia in Sotos syndrome are discussed.
Anaesthesia for magnetoencephalography in children with intractable seizures
Authors: Szmuk Peter , Kee Spencer , Pivalizza Evan G. , Warters Robert D. , Abramson David C. , Ezri Tiberiu
Published: November 2003

Background Magnetoencephalography (MEG), a noninvasive technique for evaluation of epileptic patients, records magnetic fields during neuronal electrical activity within the brain. Anaesthesia experience for MEG has not yet been reported.

Methods We retrospectively reviewed records of 48 paediatric patients undergoing MEG under anaesthesia. Thirty‐one patients (nonprotocol group) were managed according to the anaesthesiologist's discretion. Premedication included oral midazolam, chloral hydrate or fentanyl oralet, intravenous midazolam or inhalational anaesthesia with sevoflurane. Anaesthesia was maintained with propofol, midazolam, fentanyl, alone or in combination. A subsequent protocol group (17 patients) received chloral hydrate as premedication and propofol for maintenance of anaesthesia.

Results There was an overall 25% failure of interictal activity and localization on the MEG scan. In the nonprotocol group, 11 scans failed (35.5%). Of these, eight (72.7%) received midazolam orally. Only one failure (5.8%) was recorded in the protocol group in a patient who received chloral hydrate as sedation supplemented by sevoflurane.

Conclusions In our experience, midazolam premedication resulted in a high MEG failure rate (73%). Chloral hydrate premedication and propofol maintenance resulted in a lower incidence of MEG failure (5.8%). General anaesthesia with a continuous infusion of propofol or sevoflurane appears acceptable, although, lighter levels of anaesthesia might be required to avoid interference with interictal activity of the brain.
Prolonged cannulation of the left internal mammary artery (LIMA) for blood pressure monitoring in a child after cardiopulmonary bypass
Authors: Verghese Susan T. , Sell Jeff E. , Midgley Frank M. , Margolis Mark , Martin Gerard R.
Published: November 2003

Cannulation of the radial artery percutaneously or by cut down is frequently used to monitor blood pressure in infants and children undergoing cardiopulmonary bypass. When radial artery cannulation is difficult because of previous cannulation attempts, and/or surgical cut downs, posterior tibial artery cannulation is sometimes undertaken. We describe a child in whom the left internal mammary artery (LIMA) was chosen for monitoring arterial blood pressure because of malfunction of the existing posterior tibial arterial pressure line after cardiopulmonary bypass. This line was used for more than 3 weeks postoperatively in the intensive care unit for monitoring and for sampling. There were no complications with the placement and/or the removal of this arterial line on the 25th postoperative day. When standard arterial monitoring sites are not accessible, internal mammary artery cannulation can provide reliable access for prolonged arterial blood pressure monitoring in the postoperative period in children.
Epidural analgesia in children. A survey of current opinions and practices amongst UK paediatric anaesthetists
Authors: Williams D.G. , Howard R.F.
Published: November 2003

Background Despite the widespread use of epidural analgesia in children its place in paediatric pain management has not been clearly established. In order to investigate the current practice of paediatric epidural analgesia in the UK paediatric anaesthetists and paediatric pain management teams were surveyed.

Methods Questionnaires were sent to the members of the Association of Paediatric Anaesthetists (APA) working within the UK and to lead clinicians and clinical nurse specialists for acute pain in the 26 designated major paediatric centres.

Results The response rate was 72%. There was little consensus regarding drugs and drug combinations used for epidural analgesia. A total of 36% of paediatric centres did not audit their epidural practice, and of those that did the reported incidences of side‐effects showed wide variation. Important differences in practice were also identified in the areas of patient selection, informed consent, the use of epidural test doses, drug delivery systems, monitoring and the management of side‐effects. Twelve per cent of specialist paediatric hospitals did not have an acute pain team and elsewhere the provision was often limited to staff with few or no specialist skills.

Conclusion There is wide variation in the practice of paediatric epidural analgesia in the UK. Inconsistencies are likely to be related to the poor evidence base available to guide clinical decision making and the lack of a specialized paediatric acute pain service in some centres. More research is required to determine the optimal management of epidural analgesia, and suitable clinical support for paediatric pain control should be more widely available.
Parental Dysphoria and Children's Internalizing Symptoms: Marital Conflict Styles as Mediators of Risk
Authors: Du rocher schudlich Tina D. , Cummings E. Mark
Published: November 2003

Parents' marital conflict styles were investigated as mediators in the associations between parental dysphoria and children's internalizing symptoms. A community sample of 267 children, ages 8 to 16, participated with their parents. Behavioral observations were made of parents' interactions during marital conflict resolution tasks. Questionnaires assessed parents' dysphoria and children's internalizing problems. Structural equation modeling indicated that marital discord, in particular, depressive conflict styles, mediated the relationship between parental dysphoria and children's internalizing problems. Furthermore, whereas for dysphoric mothers, depressive conflict styles partially mediated the links with children's internalizing, for fathers, depressive conflict styles fully mediated the links. Destructive and constructive marital conflict were associated with parental dysphoria (positively and negatively, respectively) but did not mediate the relations with children's internalizing.
Children and Adolescents' Internal Models of Food‐Sharing Behavior Include Complex Evaluations of Contextual Factors
Authors: Markovits Henry , Benenson Joyce F. , Kramer Donald L.
Published: November 2003

This study examined internal representations of food sharing in 589 children and adolescents (8–19 years of age). Questionnaires, depicting a variety of contexts in which one person was asked to share a resource with another, were used to examine participants' expectations of food‐sharing behavior. Factors that were varied included the value of the resource, the relation between the two depicted actors, the quality of this relation, and gender. Results indicate that internal models of food‐sharing behavior showed systematic patterns of variation, demonstrating that individuals have complex contextually based internal models at all ages, including the youngest. Examination of developmental changes in use of individual patterns is consistent with the idea that internal models reflect age‐specific patterns of interactions while undergoing a process of progressive consolidation.
The Development of Visual Short‐Term Memory Capacity in Infants
Authors: Ross‐sheehy Shannon , Oakes Lisa M. , Luck Steven J.
Published: November 2003

Four experiments assessed visual short‐term memory capacity in 4‐ to 13‐month‐old infants by comparing their looking to changing and nonchanging stimulus streams presented side by side. In each stream, 1 to 6 colored squares repeatedly appeared and disappeared. In changing streams, the color of a different randomly chosen square changed each time the display reappeared; the colors remained the same in nonchanging streams. Infants should look longer at changing streams, but only if they can remember the colors of the squares. The youngest infants preferred changing streams only when the displays contained one object, whereas older infants preferred changing streams when the displays contained up to 4 objects. Thus, visual short‐term memory capacity increases significantly across the first year of life.
Children's Responses to Everyday Marital Conflict Tactics in the Home
Authors: Cummings E. Mark , Goeke‐morey Marcie C. , Papp Lauren M.
Published: November 2003

Mothers' and fathers' reports of marital conflicts in the home were obtained (n=1,638 and 1,281 conflicts, respectively), including conflicts in front of the children (n=580 and 377, respectively). Participants were 116 families with children 8 to 16 years old (M=10.82 years, SD=2.17; 58 boys, 58 girls). Children's emotional responses indicated distinctions between distressing conflict tactics (i.e., threat, personal insult, verbal hostility, defensiveness, nonverbal hostility, marital withdrawal, physical distress) and those that increased their emotional security (i.e., calm discussion, support, affection). Analyses based on cross‐reporter informants of parental conflict and child responses strengthened confidence in the findings. Conflict tactics were related to marital functioning, and children's emotional reactions during marital conflicts were associated with their adjustment.
Tariff Policy and the Foreign Entry Decision in the Presence of a Cost‐Based Informational Asymmetry
Authors: Herander Mark G. , Kamp Brad
Published: November 2003

The paper demonstrates that the standard prediction on the relation between tariff rates and the mode of foreign entry—exports or direct investment—may not hold in the presence of incomplete information. A foreign firm lacks full information on the cost structure of an informed incumbent firm located in the domestic (potential) host country. Within a two‐period model, the local incumbent may behave in a manner which keeps the potential foreign entrant uninformed of its cost structure. In such a pooling equilibrium, the uninformed foreign firm either refrains from entering altogether or serves the host country via exports at tariff rates which would, otherwise under complete information, induce entry via direct investment. When entry mode is altered, other standard full‐information effects of trade policy may also no longer hold.
Mitochondrial dynamics
Authors: Logan David C.
Published: November 2003

Mitochondria cannot be createdde novobut instead must arise from the fission (division) of a parental organelle. In addition to fission, mitochondria also fuse with one another and it is thought that a co‐ordinated balance of these two processes controls mitochondrial shape, size and number. In the past 5–7 yr, molecular genetics coupled to state‐of‐the‐art cell biology, in particular the use of mitochondrial‐targeted green fluorescent protein (GFP), has enabled identification of proteins controlling mitochondrial shape, size and number in yeast and mammalian cells. Little is known about higher plant mitochondrial dynamics. Recently, however, several genes involved in the control of plant mitochondrial dynamics have been identified. The aim of this article is to bring together what is known about mitochondrial dynamics in any organisms and to relate this to our recent knowledge of the underlying processes in higher plants.

ContentsSummary463I.Introduction464II.Mitochondrial evolution464III.Mitochondria and the cytoskeleton465IV.Mitochondrial morphology, biogenesis, proliferation and inheritance466V.Mitochondrial fission and fusion468VI.Mitochondrial distribution470VII.Plant specific proteins playing a role in mitochondrial dynamics470VIII.Conclusions471Acknowledgements475References475
Becoming professional: exploring the complexities of professional socialization in health and social care
Authors: Clouder Lynn
Published: November 2003

A search of the literature, focusing on professional socialization of health and social care professionals, indicates little contemporary research and therefore a paucity of current debate around what the process involves. Most of the research, including perspectives dating back to the 1950s and 1960s, portrays professional socialization as a deterministic process of moulding essentially passive recipients. A social constructionist perspective, however, encourages a more sceptical view of the ways in which student professionals identify with professional norms and discourses within the context of health and social care. While acknowledging the power of the professions to regulate professional practice and entry into practice, the scope for individuals to exercise personal agency within the professional socialization process is made explicit.
Developing ‘the good healthcare practitioner’: clues from a study in medical education
Authors: Duncan Peter , Cribb Alan , Stephenson Anne
Published: November 2003

This article explores perspectives on the idea of ‘the good healthcare practitioner’, through active consideration of virtue theory and how virtue could be embedded and developed in the lives of healthcare practitioners. It draws particularly on exploratory work with a small number of medical students and general practitioners, in which these participants were asked to reflect on what, for them, constituted ‘the good doctor’. Three key themes emerged from this empirical work: the idea of medicine as a ‘lived experience’ and the potential of this to contribute to developing the lives of ‘good doctors’; the importance of relationships with patients in understanding who is a ‘good doctor’; and the essential need to attempt the marrying of technical medical knowledge with humanistic skills and intuitive sympathy in ‘good medical lives’. The article reflects on the implications of these themes for medical education and training in particular, and more generally for the wider healthcare field. Some methodological difficulties in the relationship between theoretical conceptions and these empirical investigations are discussed, as are those connected to using the experience of medicine as an exemplar for how the ‘good lives’ of healthcare practitioners, in general, might be developed.
Oxidative stress in Caenorhabditis elegans: protective effects of superoxide dismutase/catalase mimetics
Authors: Sampayo James N. , Olsen Anders , Lithgow Gordon J.
Published: November 2003

The lifespan of Caenorhabditis elegans can be extended by the administration of synthetic superoxide dismutase/catalase mimetics (SCMs) without any effects on development or fertility. Here we demonstrate that the mimetics, Euk‐134 and Euk‐8, confer resistance to the oxidative stress‐inducing agent, paraquat and to thermal stress. The protective effects of the compounds are apparent with treatments either during development or during adulthood and are independent of an insulin/IGF‐I‐like signalling pathway also known to affect thermal and oxidative stress resistance. Worms exposed to the compounds do not induce a cellular stress response and no detrimental effects are observed.