bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of 530‐bp deletion in Actinobacillus actinomycetemcomitans leukotoxin promoter region
Authors: Contreras A. , Rusitanonta T. , Chen C. , Wagner W. G. , Michalowicz B. S. , Slots J.
Published: March 2003

Actinobacillus actinomycetemcomitans strains showing a 530‐bp deletion in the promoter region of the leukotoxin gene operon elaborate high amounts of leukotoxin that may play a role in the pathogenesis of periodontal disease. This study used polymerase chain reaction detection to determine the occurrence of the 530‐bp deletion in 94 A. actinomycetemcomitans strains from individuals of various ethnic backgrounds. Eleven blacks and one Hispanic subject but no Caucasian or Asian subjects showed the 530‐bp deletion in the leukotoxin promoter region, suggesting that the deletion is mainly a characteristic of individuals of African descent. A. actinomycetemcomitans strains exhibiting a deletion in the leukotoxin promotor region occurred both in individuals having severe periodontitis and in adolescents revealing no evidence of destructive periodontal disease.
Microorganisms isolated from root canals presenting necrotic pulp and their drug susceptibility in vitro
Authors: Lana M. A. , Ribeiro‐Sobrinho A. P. , Stehling R. , Garcia G. D. , Silva B. K. C. , Hamdan J. S. , Nicoli J. R. , Carvalho M. A. R. , Farias L. de M.
Published: March 2003

The knowledge about causative agents involved in endodontic infections is increasing, especially due to the improvement of culture techniques for anaerobic bacteria, showing that these microorganisms are predominant in this pathology. In this study, 31 canals with pulp necrosis were microbiologically analyzed before and after manipulation. Obligate and facultative anaerobes, microaerophilic bacteria and yeasts were recovered from 24, 14, 5 and 2 clinical specimens, respectively. The most frequent genera were Prevotella, Fusobacterium, Lactobacillus, Streptococcus, Clostridium and Peptostreptococcus for bacteria and Candida and Saccharomyces for yeasts. Strong positive associations, using an odds ratio system, were found between Clostridium and Prevotella and between Peptostreptococcus and Fusobacterium. Even after the instrumentation and the use of Ca(OH)2, facultative anaerobes were detected in two root canals and yeasts in three. Microorganisms were isolated from seven canals at the end of the endodontic treatment: facultative anaerobes from five and yeasts from one. The microbiological evaluation of root canals with pulp necrosis suggests the presence of polymicrobial infections, mainly involving obligate anaerobes, and shows that the infection may persist after treatment.
Association between betel quid chewing, periodontal status and periodontal pathogens
Authors: Ling L.‐J. , Hung S.‐L. , Tseng S.‐C. , Chen Y.‐T. , Chi L.‐Y. , Wu K.‐M. , Lai Y.‐L.
Published: March 2003

The present investigation examined whether an association exists between betel quid chewing and signs of periodontal disease and determined the prevalence of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis by polymerase chain reaction. The periodontal status of 34 betel quid chewers and 32 non‐betel quid chewers were compared. A significantly higher prevalence of bleeding on probing was found in betel quid chewers than non‐chewers among the subjects with higher plaque level, greater gingival inflammation, deeper probing depth or greater attachment loss. Also, the results suggested that betel quid chewers may harbor higher levels of infection with A. actinomycetemcomitans and P. gingivalis than non‐betel quid chewers. The association persists after adjusting for severity of the clinical parameters. In conclusion, betel quid chewing was associated with a higher prevalence of bleeding on probing where higher clinical levels of disease existed, and with a likelihood of subgingival infection with A. actinomycetemcomitans and P. gingivalis.
The isolation, identification and molecular analysis of Candida spp. isolated from the oral cavities of patients with diabetes mellitus
Authors: Manfredi M. , McCullough M. J. , Al‐Karaawi Z. M. , Hurel S. J. , Porter S. R.
Published: March 2003

Previous studies have shown a high incidence (77%) of isolation of Candida spp. from the oral cavities of patients with type 1 diabetes mellitus. The aim of the present study was to assess the prevalence of yeast in the oral cavities of patients suffering from type 1 and type 2 diabetes mellitus. The patients were classified according to the level of diabetic control (HbA1c), and further stratified on the presence or absence of dental prosthesis. Oral rinse samples were assessed for the growth of yeast and the degree of colonization. Oral isolates were defined to the species level by both phenotypic and novel molecular methods. The overall proportion (60%) of diabetic patients who had Candida spp. isolated from the oral cavity was similar to that previously reported. Local oral factors, such as the presence of dentures, seemed to have a greater influence than diabetic status on the amount and species of Candida isolated from the oral cavities of diabetic patients. Diabetic patients with dentures had more non‐albicans Candida isolated from their mouths than dentate diabetic patients. Candida dubliniensis was isolated from diabetic patients and may have a predilection for dentate patients.
Allergen‐induced cytokine secretion in relation to atopic symptoms and immunoglobulin E and immunoglobulin G subclass antibody responses
Authors: Jenmalm M. C. , Björkstén B. , Macaubas C. , Holt B. J. , Smallacombe T. B. , Holt P. G.
Published: March 2003

There are few studies on allergen‐induced cytokine production in allergic children, and little is known of antigen‐specific cytokine regulation of human immunoglobulin (Ig) G subclass antibody responses. An association with T‐helper 1 (Th1)‐like immunity and complement‐activating antibodies remains to be demonstrated in humans. We have previously observed that atopic symptoms are associated with high levels of IgG subclass, especially IgG4, antibodies to birch and β−lactoglobulin. The differences were seen early in life for the food allergen and increased with age for the inhaled allergen. The aim of this study was to investigate the association between atopic symptoms, birch allergen‐, and β‐lactoglobulin‐induced cytokine production in peripheral blood mononuclear cells (PBMC), and serum IgE and IgG subclass antibody responses to these allergens in children in order to further clarify the role of Th1‐ and Th2‐like immunity in responses to various antigens. PBMC from 55 eight‐year old children, who had been followed prospectively from birth, were stimulated with birch‐ and β‐lactoglobulin. Production of interleukin (IL)‐5, IL‐6, IL‐10, IL‐13 and interferon (IFN)‐γ was analysed by ELISA and expression of IL‐4 and IL‐9 mRNA by semiquantitative reverse transcriptase–polymerase chain reaction (RT‐PCR). IgG subclass antibody levels to birch‐ and β‐lactoglobulin in serum were determined by ELISA, and IgE antibodies by Magic‐Lite™ and CAP‐RAST™, respectively. Birch‐induced expression of IL‐4, but not of the other cytokines, was associated with IgE antibodies to birch. Furthermore, the IL‐4 expression and IL‐6 production correlated with serum IgG4 antibody levels to this allergen, and IFN‐γ secretion with IgG1 antibody responses. There were no correlations between β‐lactoglobulin‐stimulated cytokine production and IgG subclass antibody levels to that allergen, except for a negative association between β‐lactoglobulin‐stimulated IL‐4 expression and IgG1 antibodies. Atopic children tended to have high levels of birch and β‐lactoglobulin‐induced IL‐5, IL‐6 and IL‐10 secretion. Birch‐induced IL‐4 expression may be the major factor in determining IgE antibody formation to that allergen, while allergen‐induced IL‐5, IL‐6 and IL‐10 secretion in PBMC is associated with atopic symptoms. Th1‐like immunity to inhaled allergens could be associated with production of the opsonizing and complement‐activating IgG1 antibody subclass, and Th2‐like immunity with IgG4 antibody responses.
Different serum interleukin‐12 and sCD30 levels in food‐ and pollen‐sensitized children
Authors: Blanco Quirós A. , Arranz E. , Hoyos C. , Gómez Carrasco J. A. , Andión R.
Published: March 2003

It has been proposed that a down‐regulation of interleukin (IL)‐12 and interferon (IFN)‐γ might be related to susceptibility to allergy in early life. The aim of this study was to assess serum IL‐12 levels in food‐sensitized and pollen‐sensitized children and to compare these with another activation marker, sCD30. Twenty children with pollen allergy and 22 food‐sensitized children were included. The diagnosis of immunoglobulin (Ig)‐E‐mediated allergy, suggested by clinical symptoms, was based on skin‐prick tests, serum IgE antibodies and total IgE levels. Samples from 24 non‐allergic children were used as controls. IL‐12 and sCD30 levels were measured by ELISA. It was found that pollen‐sensitized patients had normal IL‐12 and higher sCD30 levels than controls (114 vs. 63 U/ml, p = 0.028), but, surprisingly, food‐sensitized infants showed normal sCD30 and increased serum IL‐12 levels (323 vs. 118 pg/ml, p = 0.0001). No differences were found in patients suffering from asthma or allergic dermatitis. Levels of sCD30 and IL‐12 determined in May showed a strong correlation with those obtained in November. Interleukin‐12 and IgE levels had an inverse correlation (r = –0.494, p = 0.0001) whereas no correlation was found between sCD30 and IgE. Age had a strong negative influence on IL‐12 levels in allergic (Z = 4.834, p < 0.0005) and in normal children (Z = 3.00, p < 0.002); by contrast, sCD30 levels were not significantly age‐dependent. When IL‐12 levels from the food‐allergy group were compared with those from normal controls younger than 4 years of age, the difference remained significant (p =  0.001), ruling out an age‐bias. The conclusions made in this study were that serum IL‐12 and sCD30 showed different behaviors in children with food or pollen allergy. We found IL‐12 and sCD30 levels in pollen‐allergic patients that agree with the classical T‐helper (Th) 1/Th2 paradigm of allergy. In contrast, serum IL‐12 levels were increased in food‐sensitized children, suggesting a different immunologic pathogenesis.
Food allergy: When and how to perform oral food challenges
Authors: Sicherer Scott H.
Published: March 2003

In many situations, the diagnosis of food allergy rests simply upon a history of an acute onset of typical symptoms, such as hives and wheezing, following the isolated ingestion of a suspected food, with confirmatory laboratory studies of positive prick skin tests or RASTs. However, the diagnosis is more complicated when multiple foods are implicated or when chronic diseases, such as asthma or atopic dermatitis, are evaluated. The diagnosis of food allergy and identification of the particular foods responsible is also more difficult when reactions are not mediated by IgE antibody, as is the case with a number of gastrointestinal food allergies. In these latter circumstances, well‐devised elimination diets followed by physician‐supervised oral food challenges are critical in the identification and proper treatment of these disorders. Since childhood food allergies to common allergenic foods such as milk, egg, wheat and soy are usually outgrown, oral food challenges are also an integral part of the long‐term management of these children.
Concerns and expectations of parents with atopic infants
Authors: Arvola Taina , Tahvanainen Annette , Isolauri Erika
Published: March 2003

The incidence of atopic diseases has rapidly increased in developed countries. The purpose of this study was to describe the problems that parents experience when atopic disease occurs in their children at an early age and what parents expect and get from health care professionals in the management of these problems. The parents of 81 high‐risk atopic infants completed a questionnaire during the infant's first attendance at the Tampere University Hospital, Finland. The patients were treated by an intervention team comprising a pediatric nurse and two pediatricians consulting with dietician and a dermatologist to detect the infant's specific food allergies and to introduce and advise on appropriate diets at weaning. After a 9‐month intervention period, the parents' perception of the intervention was evaluated by a second questionnaire. The skin prick test was positive to cow's milk in 30%, to egg in 26%, and to cereals in 19% of infants during breast‐feeding. Double‐blind placebo‐controlled cow's milk challenge was positive in 56% of infants. Upon introduction of a tolerated weaning diet, subjective symptoms and the extent and intensity of atopic eczema diminished as evidenced by lowered SCORAD scores, from 19.3 to 8.2 (F = 57.6, p < 0.0001; SCORAD – scoring index combining extent, severity and subjective symptoms of atopic eczema). Ninety per cent of parents found the care of an atopic infant more demanding than that of a healthy child. This was because of the persistence of symptoms, such as atopic eczema and pruritus, and restlessness during sleep. For the management of these problems the parents advocated diagnostic evaluation and elimination of specific foods from the diet of the lactating mother. They expected from the intervention accurate diagnosis of food allergies, practical advice on elimination diets, alleviation of symptoms, and follow‐up of growth and nutrition, and they considered the care provided by the intervention team to suffice in these aims. The present data support a comprehensive team approach to the care of atopic infants and their parents.
Montelukast in the treatment of children with moderate‐to‐severe atopic dermatitis: A pilot study
Authors: Pei Ann Yuk Sau , Chan Henry Hin Lee , Leung Ting Fan
Published: March 2003

The primary action of leukotrienes includes contraction of human airway muscle, chemotaxis, and increased vascular permeability, with secondary effects of inhibiting allergen‐induced early and late responses. Although there is limited available information and research regarding leukotrienes in atopic dermatitis (AD), there is evidence to support their role in the pathogenesis of the disease. We conducted a pilot study to test the efficacy of montelukast, a cysteinyl‐leukotriene‐1 receptor antagonist, in 15 patients (6–16 years of age) with moderate‐to‐severe AD, using a randomized double‐blind placebo‐controlled crossover study. These patients had chronic moderate‐to‐severe AD, despite being on conventional therapy. They were randomized either to placebo for 4 weeks and then the study drug for 4 weeks, or vice versa. There was a 2‐week run‐in period for all participants before commencement of the study, and a 2‐week washout before crossover. At enrollment and on each follow‐up visit, every patient was assessed by a single observer and objectively scored for disease extent and severity. A subjective score was given for the impact of eczema on daily living. There was statistical improvement in patents on active treatment compared with placebo in the severity of AD (p < 0.05). Our findings suggest that leukotriene receptor antagonist as an adjunct treatment has an anti‐inflammatory effect on moderate‐to‐severe AD. A larger trial is needed to ascertain its efficacy fully.
Complement analysis in children with idiopathic membranoproliferative glomerulonephritis: A long‐term follow‐up
Authors: Schwertz Rainer , Rother Ursula , Anders Dietrich , Gretz Norbert , Schärer Karl , Kirschfink Michael
Published: March 2003

Fifty children with idiopathic membranoproliferative glomerulonephritis (MPGN), aged 2–14 years at apparent onset, were monitored for the presence of C3 nephritic factor (C3 NeF) and signs of complement activation in serum. In addition, C3 allotyping was performed in 32 patients. Observation time ranged from 2 to 20 (median 11) years. C3 NeF activity was detected at least once in 60% of the patients (in 11 of 26 with type I, in 15 of 17 with type II, and in four of seven with type III). C3 NeF‐positive patients had significantly reduced levels of CH50 and C3 and elevated levels of C3dg/C3d. During follow‐up, C3 levels were persistently normal in 62% of the patients with MPGN type I and in 43% with type III but in only 18% with type II. C3 allotype frequencies differed from those found in healthy controls with a significant shift to the C3F/C3FS variants in C3 NeF‐positive patients. C3b(Bb)P as a marker for alternative pathway activation was not increased in C3 NeF‐positive patients. Despite the presence of C3 NeF activity, C3 levels remained normal in six patients throughout the observation period. C3 NeF became undetectable in six patients, whereas seven developed C3 NeF activity during follow‐up. There was no significant difference in renal survival probability in patients with or without C3 NeF activity. Neither C3 variants nor continous low C3 or low CH50 levels had any prognostic value for the clinical outcome. No factor H deficiency was detected.
Long‐term treatment with cetirizine of infants with atopic dermatitis: A multi‐country, double‐blind, randomized, placebo‐controlled trial (the ETAC™trial) over 18 months
Authors: Diepgen Thomas L.
Published: March 2003

H1‐receptor antagonists are considered central to the treatment of atopic dermatitis (AD)‐associated pruritus and are widely used in the treatment of AD despite a lack of double‐blind, randomized clinical trials. In this study we analyzed the effects of the long‐term use of cetirizine on the severity, natural history, and treatment of AD. In the prospective, multi‐country, double‐blind, randomized, placebo‐controlled Early Treatment of the Atopic Child (ETAC™) study, 817 infants (12–24 months of age) who suffered from AD at study entry and with a history of atopic disease in a parent or sibling were treated for 18 months with either cetirizine (0.25 mg/kg) or placebo twice daily. All concomitant medications for the treatment of AD were allowed but had to be recorded by the investigator in the case report form; the concomitant use of H1‐antihistamines was discouraged. The primary end‐point for efficacy was the onset of asthma. Secondary parameters of efficacy, however, were the consumption of concomitant medications for AD (topical and systemic treatment) and the severity of symptoms related to AD, which was rated with the AD scale, SCORAD. The severity of AD, as measured by SCORAD, decreased significantly (p < 0.001) over the study period (18 months) in both groups. Other oral H1‐antihistamines were significantly more often used in the placebo group than in the cetirizine group (24.9% vs. 18.6%, p = 0.03). The number of infants who developed urticaria during the study period was significantly lower with cetirizine treatment (placebo group: 16.2%; cetirizine group: 5.8%; p < 0.001). For the treatment of AD, mild topical corticosteroids (class I, e.g. hydrocortisone) were used in 41.6% of the patients (placebo group 41.6%, cetirizine group 41.7%) and moderate‐to‐potent topical corticosteroids (class II, III, IV) in 55.0% (respectively 56.4% and 53.5%). The duration of the use of topical moderate‐to‐potent corticosteroids differed between the cetirizine group and the placebo group (mean percentage of days: placebo 25.2, median 2.4; cetirizine mean 18.8, median 0.95 p = 0.067, Mann–Whitney test, not statistically significant). In sub‐groups of infants with a SCORAD of ≥ 25, this cortico‐sparing effect was statistically significant (placebo 35.1 vs. 25.8 in the cetirizine group; p = 0.014, Mann–Whitney test). In conclusion, in view of the proven safety of cetirizine, the use of this drug might help to reduce the duration and the amount of moderate‐to‐strong topical corticosteroids used in the treatment of infants and children with AD. However, further studies designed with the primary end‐point of AD are clearly indicated to confirm the benefits of the use of H1‐antihistamines in the management of AD.
Duration of immunity to diphtheria and tetanus in young kidney transplant patients
Authors: Pedrazzi C. , Ghio L. , Balloni A. , Panuccio A. , Foti M. , Edefonti A. , Assael B. M.
Published: March 2003

Abstract: A considerable proportion of patients with renal transplant, evaluated many years after transplant, lack protective diphtheria antibody levels, despite primary immunization, but maintain immunity to tetanus. These patients respond to a diphtheria and tetanus booster but the duration of the response is uncertain. This study was undertaken to assess if protective antibodies evoked by primary immunization are lost quickly after transplantation, and whether the extent of the immune response to a booster influences the persistence of protective antibodies. We studied 15 patients (group 1) immediately after renal transplant and 35 patients with renal transplant for 6 ± 4 yr who received a diphtheria and tetanus booster (group 2). Six patients (40%) of the first group lost protective diphtheria antibodies a median time of 6.5 months after transplant. Thirty‐three patients of the second group responded to the booster with normal diphtheria antibody titers (> 1 IU/mL) in 22 cases and with low titers in 11. Four of the latter lacked immunity to diphtheria at 12 months follow‐up. All patients with normal immunity maintained protective levels of diphtheria antibodies. The low responders had a creatinine clearance of 50 ± 20 mL/min/1.73 m2. Tetanus immunity was maintained in almost all patients of both groups. In conclusion, renal transplant patients had an accelerated loss of diphtheria antibodies in the early post‐transplant period. Response to a diphtheria booster identified a group at particular risk, namely the low responders, who may require frequent booster doses. This group had significantly poorer renal function than the normal responders.
Heart transplantation on the first day of life from an anencephalic donor
Authors: Parisi F. , Squitieri C. , Carotti A. , Di Carlo D. , Gagliardi M. G.
Published: March 2003

Abstract: Heart transplantation on the first day of life, and graft harvesting from anencephalic donors, have been very rare events in the history of transplantation. At Bambino Gesù Hospital (Rome), heart transplantation was performed on a newborn 9 h after birth, using a graft harvested from an anencephalic donor. This graft achieved a good cardiocirculatory function, but the recipient died of necrotizing enterocolitis (NEC) on post‐operative day (POD) 10. Despite failure, this case and other reports support the concept that hearts from anencephalic donors can work normally, and indicate that heart transplantation on the first day of life may have a favorable outcome if postoperative maintenance of multi‐organ balance and function is successful.
Unusual presentation of graft‐versus‐host disease in pediatric liver transplant recipients: Evidence of late and recurrent disease
Authors: Pinna Antonio D. , Weppler Deborah , Berho Mariana , Masetti Michele , DeFaria Werviston , Kato Tomoaki , Thompson John , Ricordi Camillo , Tzakis Andreas G.
Published: March 2003

Graft‐versus‐host disease (GvHD) is a multi‐organ disease caused by mature donor T cells that are activated by alloantigens expressed by the host antigen‐presenting cells. GvHD has been reported after solid organ transplantation with two principal presentations: humoral and cellular. In the cellular type of GvHD after liver transplantation the symptoms are identical to the GvHD after bone marrow transplant, except that the liver is spared because it lacks host antigens. We have described three cases of intestinal GvHD after pediatric liver transplant with an unusual recurrent late presentation in two patients. Two patients were female, and their age at the time of transplant was 8 and 9 months, respectively, and one was an 8‐month‐old male. They all received reduced liver allografts of identical blood type from three different donors. One patient received two doses of donor bone marrow cell infusion. Two patients received double immunosuppressive therapy constituted by tacrolimus at a dose of 0.05 mg/kg p.o. b.i.d. and steroids 10 mg p.o. daily. One patient received a triple drug immunosuppression with tacrolimus (0.05 mg/kg p.o. b.i.d.), steroids (10 mg p.o. daily) and mycophenolate mofetil (125 mg p.o. b.i.d.). Diagnosis of intestinal GvHD was confirmed histologically on intestinal biopsies performed at the time of presentation of the clinical symptoms or at autopsy.
Cognitive functioning in children on dialysis and post‐transplantation
Authors: Brouhard Ben H. , Donaldson Lynn A. , Lawry Kathleen W. , McGowan Kathryn R. B. , Drotar Dennis , Davis Ira , Rose Stephen , Tejani Amir
Published: March 2003

Abstract: We studied 124 children, 62 patient‐subjects who had end‐stage renal disease (ESRD) and 62 sibling‐controls who closely matched the patient‐subjects in terms of their ethnicity and their socioeconomic status, to discern whether children with ESRD would perform less well than their siblings on standardized achievement and intelligence quotient (IQ) tests, and to determine whether ethnicity would influence such results. The subjects were recruited from nine pediatric transplant and dialysis centers across the United States. Thirty‐one subjects were white (Euro‐American), 17 were African‐American, and 14 were categorized as ‘other’. The average age of the patient‐subjects was 13.7 ± 0.44 yr; and of the sibling‐controls 13.7 ± 0.38 yr. Most patients (61%) and siblings (84%) were in regular school classes, and most (87% and 92%, respectively) attended school full‐time. The average IQ percentile rank for the patients was significantly lower than their siblings (31 ± 4 vs. 44 ± 5, respectively, with normal = 50). Patients tended to score lower on achievement tests compared with their siblings (spelling: 88.7 ± 4 vs. 94.6 ± 2; arithmetic: 88.5 ± 2 vs. 94.0 ± 2; reading: 91.9 ± 2 vs. 100 ± 3, respectively). Patients scores on achievement tests were influenced by age at diagnosis and by the mother/caregiver's lower achievement. Also, increased time on dialysis predicted lower scores on achievement tests. Neither dialysis/transplant status nor ethnicity significantly affected outcome. Our data suggest that ESRD, but not ethnicity or dialysis/transplant status, is a risk factor for lower IQ and academic achievement, especially in younger children, in children who spend more time living with ESRD, and in children whose mother's/caregiver's have lower educational levels.
Effect of grapefruit juice on cyclosporin A pharmacokinetics in pediatric renal transplant patients
Authors: Brunner Lane J. , Pai Ki‐Soo , Munar Myrna Y. , Lande Marc B. , Olyaei Ali J. , Mowry Jeanne A.
Published: March 2003

Abstract: Cyclosporin A (CsA) is an important immunosuppressant that is prone to numerous drug interactions. Grapefruit juice has been investigated, as a possible adjunct to CsA dosing in adult renal transplant recipients, to decrease CsA metabolism and reduce dosages. This study investigated this combination in pediatric renal transplant patients. Six stable pediatric renal transplant patients were entered into an open‐label, four‐period cross‐over study in which patients were given their current CsA dose as either an oral solution (CsA‐Sol) or a microemulsion (CsA‐ME). In addition, drugs were administered concurrently with water or grapefruit juice. Steady‐state pharmacokinetic profiles were taken during each of the four periods. Following the concurrent administration of grapefruit juice, CsA whole‐blood 12‐h trough levels were significantly increased during CsA‐Sol dosing. Furthermore, the CsA elimination rate constant was significantly reduced during the same period. After CsA‐ME dosing, no differences in CsA pharmacokinetics were found between concurrent water or grapefruit ingestion. Grapefruit juice co‐administration reduced the production of CsA metabolites, AM1 and AM9, during CsA‐Sol dosing. No changes in CsA metabolite production were found when patients were given CsA‐ME with grapefruit juice as compared with water. Hence, alterations in CsA absorption and elimination occur with concurrent grapefruit juice ingestion when stable pediatric renal transplant patients are taking the oral CsA solution, but not the microemulsion formulation. These changes may be mediated by alterations in intestinal or hepatic metabolism, or drug absorption. The effect of grapefruit juice on CsA absorption is not readily predictable in these patients.
Arrhythmias after pediatric lung transplantation
Authors: Hoffman Timothy M. , Rhodes Larry A. , Wieand Tammy S. , Spray Thomas L. , Bridges Nancy D.
Published: March 2003

Abstract: Atrial arrhythmias have been reported after congenital heart surgery involving extensive atrial suture lines. Experimental studies involving bilateral lung transplantation (Tx) suggest that the left atrial suture lines predispose to atrial flutter. The overall incidence and type of arrhythmias after pediatric lung Tx have not previously been described and therefore the purpose of this study was to prospectively screen and describe arrhythmias in a subset of our lung transplant population. Over a 1‐yr study period, all recipients of bilateral lung Tx were admitted to a full‐disclosure telemetry unit. Single‐lead electrocardiograms were recorded continuously and reviewed daily via a beat‐by‐beat analysis. A total of 314 patient days (range 9–93, median 43 days) were recorded from seven patients. The incidence of arrhythmias observed per total patient days included junctional escape rhythm (4.8%), non‐sustained ventricular tachycardia (4.1%), accelerated junctional (2.5%), sinus bradycardia (2.2%), non‐sustained supraventricular tachycardia (1.3%), ectopic atrial tachycardia (1.0%), sustained ventricular tachycardia (0.3%), junctional ectopic tachycardia (0.3%), and second degree heart block (0.3%). No patient had sustained supraventricular tachycardia, atrial flutter, atrial fibrillation, or complete heart block. Arrhythmias were treated in two patients. During the follow‐up period, one patient received amiodarone for ventricular tachycardia (which was also noted and treated prior to transplant). We conclude that among pediatric lung transplant recipients admitted for their transplant surgery, arrhythmia is uncommon and rarely requires therapy.
Predictors for abnormal voiding cystourethrography in pediatric patients undergoing renal transplant evaluation
Authors: Ramirez Sylvia P. B. , Lebowitz Robert L. , Harmon William E. , Somers Michael J. G.
Published: March 2003

Abstract: The role of pretransplant voiding cystourethrography (VCUG) in adults has been questioned owing to the low prevalence of abnormal findings. As there are no studies evaluating the relevance of VCUG in children and because vesicoureteral reflux (VUR) occurs with higher prevalence in children, we performed a retrospective cohort study to identify any predictors for abnormal VCUG. We reviewed 271 consecutive renal transplants performed between 1980 and 1997. By logistic regression, the etiology of end‐stage renal disease (ESRD) and age at transplantation (Tx) were strong predictors of abnormal pretransplant VCUG findings in children. On multi‐variate analysis, children with urologic etiologies of renal disease had an odds ratio (OR) of 16.5 (p < 0.0001) for abnormal VCUG as compared to children with non‐urologic or acquired causes of ESRD. Similarly, children transplanted when younger than 8 yr of age had an OR of 3.0 (p = 0.0043) for having an abnormal VCUG when compared with older children. Finally, our analysis suggests that children with abnormal pretransplant VCUG findings, whether or not pretransplant surgical correction was performed, were over three‐fold more likely to require post‐transplant urologic surgery when compared to children with normal pretransplant VCUG. We conclude that urologic causes of ESRD and age under 8 yr are strong independent predictors of abnormal pretransplant VCUG findings, and that these findings are of clinical relevance both in deciding whether to pursue pretransplant VCUG and in the post‐transplant course of the patient.
Obstacles to organ donation in ethnic minorities
Authors: Callender C. O. , Miles P. V.
Published: March 2003

Abstract: The number one problem in transplantation today is the shortage of organ donors. While the numbers of ethnic minority donors have increased over the last 20 yr, there is still a need for community outreach and education in order to dispel the myths and misperceptions within minority communities so that a greater number of persons will ultimately become donors. While lack of awareness, religious myths and misperceptions, medical distrust, fear of premature death, and racism continue to cause reluctance within ethnic minority communities, the National Minority Organ Tissue Transplant Education Program (National MOTTEP) applies a methodology which has proven successful within various ethnic minority populations. The methodology utilizes ethnically similar and culturally sensitive transplant recipients, candidates and donors or donor families, along with health care providers, as effective messengers who are recognized within the community. In addition, community volunteers are solicited to become involved in hands‐on program planning and implementation of activities, which will impact the community regarding their knowledge, attitudes and behaviors. Data collected from 914 consenting adult participants indicated that there were significant increases (p < 0.000) in trust in doctors, future plans to become organ donors, and changes in the participants' spiritual/religious beliefs about organ/tissue donation. The conclusion is that culturally appropriate health education programs targeting ethnic minority populations can effect positive change in knowledge, attitudes, and behavior.
The outcome of pediatric cadaveric renal transplantation in the UK and Eire
Authors: Postlethwaite Robert J. , Johnson Rachel J. , Armstrong Samantha , Belger Mark A. , Fuggle Susan V. , Martin Susan , Middleton Derek , Ray Terry C. , Rigden Susan P. A. , Verrier‐Jones Kate , Morris Peter J. ,   the Paediatric Task Force of United Kingdom Transplant, Bristol, UK
Published: March 2003

Abstract: An analysis of all pediatric cadaveric renal transplant recipients in the UK and Eire was undertaken to review the outcomes of pediatric cadaveric renal transplantation and to consider the implications for organ allocation procedures for pediatric recipients. Factors influencing the outcome of 1,252 pediatric cadaveric renal transplants in the UK and Eire in the 10‐yr period from 1 January 1986 to 31 December 1995 were analyzed by Cox proportional hazards regression, including analysis of four distinct post‐transplant epochs (0–3 months, 3–12 months, 12–36 months, and beyond 36 months). At the time of analysis (December 2000), 113 (11%) recipients had died and 47% of grafts had failed. In the multi‐factorial modelling, the factors significantly affecting transplant outcome were cold ischaemia time, donor and recipient age and human leucocyte antigen (HLA) matching. Epoch analysis demonstrated that these factors operated at different times post‐transplant. Cold ischaemia time had a strong influence on outcome at 3 months. A highly significant increased risk of graft failure was associated with donors under 5 yr of age. Young recipients had an increased risk of failure in the short term, but beyond 1 yr post‐transplant there were few failures in young recipients while a steady rate of graft loss persisted in the older children. In terms of HLA matching, the worst outcome was observed for two HLA‐DR mismatched grafts, while 000 and favorably matched kidneys (100, 010, 110 HLA‐A, ‐B, ‐DR mismatches) survived longest. Hence, a policy of exchanging organs on the basis of HLA matching is justified for 000 mismatched and favorably matched kidneys. The poor outcome associated with very young donors should discourage pediatric units from transplanting kidneys from such young donors. The reasons for late losses in older recipients need investigation.
Regulatory role of auxin in adventitious root formation in two species of Rumex, differing in their sensitivity to waterlogging
Authors: Visser Eric J. W. , Heijink Clementine J. , Van Hout Karen J. G. M. , Voesenek Laurentius A. C. J. , Barendse Gerard W. M. , Blom Cornelis W. P .M.
Published: March 2003

Adventitious rooting in Rumex plants, in which the root systems were in hypoxic conditions, differed considerably between two species. R. palustris, a species from frequently flooded river forelands, developed a large number of adventitious roots during hypoxia, whereas adventitious root formation was poor in R. thyrsiflorus, a species from seldom flooded dykes and river dunes. Adventitious rooting could also be evoked in aerated plants of both species by application of auxin (1‐naphthaleneacetic acid or indoleacetic acid) to the leaves. The response to auxin was dose‐dependent, but even high auxin doses could not stimulate R. thyrsiflorus to produce as many adventitious roots as R. palustris. Consequently, the difference between the species in the amount of adventitious root formation was probably genetically determined, and not a result of a different response to auxin.

A prerequisite for hypoxia‐induced adventitious root formation is the basipetal transport of auxin within the shoot, as specific inhibition of this transport by N‐1‐naphthylphthalamic acid severely decreased the number of roots in hypoxia‐treated plants. It is suggested that hypoxia of the root system causes stagnation of auxin transport in the root system. This can lead to an accumulation of auxin at the base of the shoot rosette, resulting in adventitious root formation.
Effects of nitrogen deficiency on accumulation of fructan and fructan metabolizing enzyme activities in sink and source leaves of barley (Hordeum vulgare)
Authors: Wang Changwen , Tillberg Jan‐Eric
Published: March 2003

Seedlings of barley (Hordeum vulgare L. cv. Agneta) were grown hydroponically under continuous light, constant temperature and relative humidity. During the first two weeks, the relative growth rate (RGR) was kept at 25% by limiting only the supply of nitrogen. The cultures were then transferred to nitrogen‐free media and the amounts of fructan, starch, sucrose, glucose and fructose in sink and source leaves were measured at 0, 12, 24, 48, 72, 120 and 156 h. The activities of two key enzymes in fructan metabolism, sucrose:sucrose fructosyltransferase (SST), fructan exohydrolase (FEH), as well as acid invertase were also measured in the two types of leaves.

The fructan and starch levels in both sink and source leaves increased during nitrogen deficiency. The highest increase in starch was 200% of the control while for fmctans a 700% increase was recorded. The activity of SST increased parallel to fructan accumulation in sink leaves. However the FEH activity was constant and not affected by nitrogen deficiency. The invertase activity both in sink and source leaves was reduced by nitrogen deficiency. More fructans as well as sucrose and fructose accumulated in source leaves compared to sink leaves both before and after nitrogen starvation. The results show that fructan is the major carbohydrate reserve accumulating under nitrogen deficiency both in sink and source leaves in barley plants. The induction of fructan accumulation in sink leaves caused by nitrogen deficiency is intimately connected with the regulation of SST
Changes in leaf expansion and epidermal screening effectiveness in Liquidambar styraciflua and Pinus taeda in response to UV‐B radiation
Authors: Sullivan Joe H. , Howells Bradley W. , Ruhland Christopher T. , Day Thomas A.
Published: March 2003

Absorption or screening of ultraviolet‐B (UV‐B) radiation by the epidermis may be an important protective method by which plants avoid damage upon exposure to potentially harmful UV‐B radiation. In the present study we examined the relationships among epidermal screening effectiveness, concentration of UV‐absorbing compounds, epidermal anatomy and growth responses in seedlings of loblolly pine (Pinus taeda L.) and sweetgum (Liquidambar styraciflua L.). Seedlings of each species were grown in a greenhouse at the University of Maryland under either no UV‐B radiation or daily supplemental UV‐B radiation levels of 4, 8 or 11 kJ m−2 of biologically effective UV‐B (UV‐BBE) radiation. Loblolly pine seedlings were subsequently grown in the field under either ambient or supplemental levels of UV‐B radiation. At the conclusion of the growing season, measurements of epidermal UV‐B screening effectiveness were made with a fiber‐optic microprobe. In loblolly pine, less than 0.5% of incident UV‐B radiation was transmitted through the epidermis of fascicle needles and about 1% was transmitted in primary needles. In contrast, epidermal transmittance in sweetgum ranged from about 20% in leaves not preconditioned to UV‐B exposure, to about 10% in leaves grown under UV‐B radiation. The concentration of UV‐absorbing compounds was unaffected by UV‐B exposure, but generally increased with leaf age. Increases in epidermal thickness were observed in response to UV‐B treatment in loblolly pine, and this accounted for over half of the variability in UV‐B screening effectiveness. In spite of the low levels of UV‐B penetration into the mesophyll, delays in leaf development (both species) and final needle size (loblolly pine) were observed. Seedling biomass was reduced by supplemental UV‐B radiation in loblolly pine. We hypothesize that the UV‐induced growth reductions were manifested by changes in either epidermal anatomy or epidermal secondary chemistry that might negatively impact cell elongation.
Control of tuberisation in potato by gibberellins and phytochrome B
Authors: Jackson Stephen D. , Prat Salomé
Published: March 2003

Phytochrome B‐deficient plants exhibit increased gibberellin (GA) levels or responsiveness, which may contribute to their elongated growth and reduced chlorophyll levels. We have investigated the effects of applications of gibberellic acid and an inhibitor of gibberellin biosynthesis, ancymidol, on wild‐type and phytochrome B‐antisense potato (Solanum tuberosum ssp. andigena) plants. The results showed that some phenotypes of the phytochrome B‐antisense plants, i.e. increased stem length and reduced chlorophyll, can be mimicked by treating wild‐type plants with gibberellic acid. However, another phenotype, i.e. tuberisation response in long days, is mimicked by application of a GA biosynthesis inhibitor ancymidol, thus appearing to be the result of a reduction in the gibberellin levels. A simple increase in gibberellin levels or sensitivity is, therefore, not sufficient to explain the phenotype of the antisense plants.
Abscisic acid involvement in the induction of summer‐dormancy in Poa bulbosa, a grass geophyte
Authors: Ofir Micha , Kigel Jaime
Published: March 2003

Summer‐dormancy occurs in geophytes that inhabit regions with a Mediterranean climate (mild, rainy winters and hot, dry summers). The environmental control of summer‐dormancy and the involvement of phytohormones in its induction have been little studied. Poa bulbosa L. is a perennial grass geophyte in which summer‐dormancy is induced by long days and by high temperature. Prolonged treatment with ABA (0.1‐1.0 mM) under non‐inductive 8‐h short days (SD) resulted in cessation of leaf and tiller production and in the development of typical features of dormancy: bulbing at the base of the tillers and leaf senescence. Short‐term applications of ABA had similar effects but dormancy was transient, i.e. after a short while, leaf growth from the formed bulbs was resumed. ABA treatment of plants growing under an inductive 16‐h photoperiod (LD) enhanced the onset of dormancy. Endogenous levels of ABA in leaf blades and at the tiller base (where the bulb develops) increased markedly after the plants were transferred from SD to LD. This increase was greater in the tiller base, and concomitant with bulb maturation. High temperature (27/22 vs 22/17°C) accelerated both bulb development and ABA accumulation in leaf blades.

These results suggest that ABA plays a key role in the photoperiodic induction and development of summer‐dormancy in P. bulbosa.
Endo‐β‐1,4‐glucanases are involved in peach fruit growth and ripening, and regulated by ethylene
Authors: Bonghi Claudio , Ferrarese Luca , Ruperti Benedetto , Tonutti Pietro , Ramina Angelo
Published: March 2003

During peach (Prunus persica[L.] Batsch) fruit development and ripening the cell wall undergoes several structural and biochemical changes driven by several hydrolases. Among these, the endo‐β‐1,4‐D‐glucanase (EGase, EC 3.2.1.4), or cellulase, may play a crucial role. Involvement of EGase throughout development and ripening of the fruit of cv. Redhaven was assessed by monitoring enzyme activity, specific polypeptide accumulation and gene transcription. During the four stages of growth EGase activity was high during S1 and in the early S2, declined during S3, and increased with the onset of ripening (S4). Two isoforms with isolectric points of 6.5 and 9.5 were identified. The pI 6.5 EGase was the only form present during the early stages of growth. whereas the pI 9.5 EGase was most abundant during ripening. The same isoforms were present in leaf and fruit abscission zones. The antibody raised against the pI 9.5 EGase, purified from leaf abscission zones, cross‐reacted with a protein of 54 kDa. A cDNA clone of 753 bp encoding peach EGase was obtained by RT‐PCR. EGase transcripts, detectable only after amplification of total RNA by RT‐PCR, were observed during S1, and at the preclimacteric and climacteric stages. However, the strongest hybridisation occurred at ripening, in correspondence with the maximal enzyme activity and polypeptide accumulation, which took place before the ethylene climacteric and in the early stage of flesh softening. Propylene treatments reduced EGase activity during the early stage of fruit growth but dramatically enhanced enzyme activity and the related transcript accumulation at ripening, and accelerated the loss of firmness. In fruit treated with 2,5‐norbornadiene the softening process was strongly inhibited and the rise in EGase transcripts and activity did not take place. The results point to the EGases being involved in early fruit growth and the initial phases of softening. The presence of two isoforms and the dual effect of propylene on enzyme activity suggest that different EGase genes operate during the early and late developmental stages in peach fruit.