bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of science in resolution of environmental crises at Kesterson Reservoir and Mono Lake, California
Authors: Quinn Nigel W. T. , Vorster Peter T.
Published: March 2003

Two events in California’s recent history have had a profound impact in shaping present and future water resources policy: the selenium contamination at Kesterson Reservoir and the battle to save Mono Lake. The irrigation‐induced selenium toxicity discovered at Kesterson changed public perception of agriculture as a benign consumer of water, eroded the political power of the agricultural lobby, and has contributed to a revision in the allocation of water between the cities, agriculture and the environment. The Mono Lake Decisions of 1983 and 1994 set an equally important precedent in affirming the State’s public trust obligation to preserve public resources and to reconsider previous water right allocations in the light of evolving knowledge and changing priorities. Both of these issues were important precursors for the current multibillion dollar State and Federal (CALFED) initiative to ‘fix’ the myriad of biologic, hydrologic and water quality problems of the San Francisco Bay estuary. In this paper, we compare the Kesterson and Mono Lake controversies and discuss the role of science and research in attempting to resolve these issues. We conclude by drawing linkages to the current CALFED initiative and suggesting implications for future water quality management in California’s lakes and reservoirs.
Prediction of Lake Baikal ecosystem behaviour using an ecosystem disturbance model†
Authors: Silow Eugene A. , Baturin Vladimir A. , Stom Devard J.
Published: March 2003

This paper combines predictions of the effects of anthropogenic impacts on the plankton of Lake Baikal with models of ecosystem disturbance. Increases in mineralization, non‐toxic organic matter, nutrients, phenolic compounds, oil products and heavy metals were simulated. Significantly higher sensitivity of the community below the ice to external influences was demonstrated compared to the summer–autumn community, when there was no ice layer. Models of the distribution of aquatic pollutants demonstrate the occurrence of deviations from ecosystem state parameters in the bottom layer under the influence of pollutant input with precipitation and the distribution of perturbations over greater (up to 500 km) distances. Simulation of pollutant input at present levels shows that Lake Baikal is already perturbed. This is indicated by increases in bacterial and summer phytoplankton biomass and nutrient concentration, and by fluctuations in the zooplankton biomass.
Analytical techniques for monitoring harmful cyanobacteria in lakes
Authors: Hummert C. , Dahlmann J. , Reichelt M. , Luckas B.
Published: March 2003

The toxins of cyanobacteria include potent neurotoxins and hepatotoxins. Deaths after exposure by ingestion of cyanobacterial cells and toxins from freshwater sources have been reported. The hepatotoxins are cyclic peptides, which comprise microcystins (MC) and nodularin (NOD), and they cause poisonings with an established syndrome of human and animal illnesses. The identification and determination of these hepatotoxic peptides are challenges for analytical chemists. Methods based on solid phase extraction and size exclusion chromatography are available for the clean up of raw extracts. Both principles are also used for the enrichment of MC from low contaminated sample material. The separation of MC is achieved by high‐pressure liquid chromatography methods with ultraviolet (UV) detection or mass spectrometric detection. The unambiguous identification of MC not available as standards is possible by mass spectrometry (MS) or, under optimal conditions, by UV spectrometry using diode array detection. To date, 60 different MC and four NOD have been described, but new compounds are frequently identified. Therefore, powerful tools for the elucidation of the structure of unknown MC are an important need. In addition to classical methods for structure elucidation (e.g. nuclear magnetic resonance spectrometry), microwave‐assisted hydrolysis of cyclic peptides followed by enantio‐selective determination of the amino acid profiles can be used. More recently, MS with collision‐activated dissociation has become an important tool for obtaining structure information. The present paper discusses the advantages and disadvantages of the various analytical techniques used for monitoring of cyanobacteria in lakes, optimized or developed at the Institute of Nutrition, Jena, Germany. A pathway for handling MC‐containing samples with regard to different analytical tasks (i.e. the identification and elucidation of structure followed by qualitative and quantitative determination) is proposed.
Long‐term changes in the aquatic biota of Lake Abashiri, a meromictic lake in northeastern Hokkaido, Japan
Authors: Kuwabara Ren
Published: March 2003

Lake Abashiri is an example of a meromictic lake under the stability of upper oligohaline water and lower polyhaline water, but a brackish lake on the whole. Nevertheless, boundary depth of the hypolimnetic layer has gradually decreased with time. At the same time, this has led to an increase in salinity and eutrophication in the epilimnion and to an acceleration of deoxygenation of the hypolimnion, attributed to the upwelling of bluish water. In order to investigate succession of the aquatic biota linked to these hydrological changes, results of occasional long‐term studies on the distribution of plankton and benthos were summarized, mostly from Japanese publications of lake surveys. In each result, the boundary of the polyhaline hypolimnetic layer has gradually risen from 13 to 7 m depth between 1932 and 1955, and has been determined, in recent years, to be 5.5 m. Salinity of the epilimnion was lower than 0.1‰ in 1930s, and 0.5–0.6‰ in the 1940s before 1949. Thereafter, salinity increased to 1.8–2.3‰ until recently, with levels now often over 3‰. Following these hydrological changes, the succession of planktonic fauna and flora, particularly of the dominant species, has exhibited a gradual change from freshwater to brackish or salinity tolerant species during the 72 year period from 1926 to 1997, including a period of variable species composition in 1975–1980 and a period of degradation after that. In contrast, according to available data, the benthic community has remained unchanged in terms of the composition of dominant species in all habitats during the same 72 year period. The dominance of some plankton and benthos species has been maintained over several decades, although the community structures have displayed a few phases of abundance and regression during these 72 years.
Environmental surveys of toxic chemicals in aquatic environments in Japan
Authors: Kadokami Kiwao , Hiraki Toshikazu , Jyotatsu Taiji
Published: March 2003

A law concerning the examination and regulation of manufacture of chemical substances (the Chemical Substances Control Law) was enacted in 1973 to prevent environmental pollution by chemical substances, such as polychlorinated biphenyl‐like chemicals. In response to the enactment of the law, Environment Agency Japan (the former Ministry of the Environment) began successive environmental safety inspections a year later, including environmental surveys for existing chemicals. Since then, approximately 800 kinds of chemical substances have been investigated and 40% of them have been detected. Many substances suspected of posing risks to humans have been regulated on the basis of results of these environmental surveys. At present, five environmental surveys of water, bottom sediment and aquatic organisms are being carried out by cooperation between the Environment Ministry and all Local Governments in Japan. These surveys have been designed to collect information about chemical contamination across the whole country, and will measure change and variation in chemical contamination over time and space, and also examine measures for reducing the risks posed by chemical substances. Furthermore, the data obtained may contribute to an understanding of environmental contamination by chemical substances in Japan and in other industrial countries.
A morphometric study of subcortical changes in Alzheimer's disease
Authors: Ohara Kazuyuki , Miyoshi Koho , Takauchi Shigeru , Kokai Masahiro , Nakajima Takaya , Morita Yoshio
Published: March 2003

The populations and loss of neurons, the density of neurofibrillary tangles (NFT) and senile plaque (SP), and the macroscopic shrinkage of the subcortical areas in patients with Alzheimer's disease (AD) were quantitatively evaluated using computer‐based image analysis techniques. Twelve subcortical areas were examined at distinct levels of the brain in eight AD cases and five age‐matched controls. The areas examined were as follows: the nucleus basalis of Meynert (nbM); globus pallidus (GP); putamen (PT); claustrum (CL); the anterior thalamic nucleus (THA: anterior ventral thalamic nucleus); medial thalamic nucleus (THM: medio‐dorsal thalamic nucleus); lateral thalamic nucleus (THL: ventro‐lateral and ventro‐anterior thalamic nuclei); subthalamic nucleus (ST); substantia nigra, zona compacta (SNC); red nucleus (RD); locus ceruleus (LC); and raphe nucleus (RP). Distinct neuronal loss and a high density of NFT were shown in the nbM, LC, RP, CL, SNC, and THA in the AD brain. Because of the high density of the NFT relative to the neuronal loss, neuronal loss in those nuclei may have been mainly caused by NFT formation. In the THM and THL, no distinct neuronal loss but some degree of NFT formations was detected. In the GP, ST, and RD, neuronal shrinkage or loss was shown in patients with AD. With respect to the SP, the density of SP in the CL, PT and THM was high (1.7–2.2%), whereas that in the SNC, GP, ST and RD was low. This finding suggests that SP may not have major effects on the neuronal degeneration observed in subcortical nuclei of patients with AD. Although macroscopic shrinkage of all subcortical nuclei was seen in AD patients, selective vulnerability to atrophic change was not evident at macroscopic levels. This comprehensive morphometric study offers more precise information for evaluating the subcortical dysfunction in AD patients than do conven‐tional neuropathological examinations.
Morphometric investigation of the hippocampal formation in Ihara's genetically epileptic rats using magnetic resonance images and histopathology
Authors: Takamori Michie , Amano Shigeru , Nakasu Yoko , Ito Ryuta , Ihara Nobuo , Kataoka Hideo , Hazama Fumitada , Morita Rikushi
Published: March 2003

The newly developed Ihara's genetically epileptic rat (IGER) is thought to be a useful tool for studying epilepsy of the limbic type. Morphological changes in the hip‐pocampus, which is one of the characteristic findings in the brains of patients with temporal lobe epilepsy, were presumed to occur also in IGER during the course of epileptic activities. We investigated chronological changes in volume of the IGER hippocampal formation using mag‐netic resonance (MR) imaging. The experiment consisted of two protocols. First, MR imaging was performed for volumetric measurement of the cerebrum and the hippocampus in four male IGER, each at 2, 4, 6, 8, 10 and 12 months of age. After MR examination, the brains were subjected to histological and morphometric examinations. Second, changes in the hippocampal volume were traced chronologically in three IGER at the ages of 2, 4, 6, 8 and 10 months. Age‐matched Wistar rats were used as controls. In IGER, the volume of the cerebrum, especially of the hippocampus, and the ratio of the hippocampal to the cerebral volume increased, in concert with the increase in seizure activities. Histological and morphometric invest‐igations revealed that there was mild astrogliosis and marked microgliosis with hypertrophic change in the hippocampal formation with aging, but no loss of neurons was observed. Neither an increase in volume nor gliosis was found in the brains of control rats. The enlargement of the hippocampal formation in IGER brains was assumed to be partially due to gliosis of astrocyte and microglia with hypertrophy.
Cortical dysplasia in surgical pathology of intractable epilepsy
Authors: Arai Nobutaka
Published: March 2003

Recent knowledge on cortical malformative lesions, which have been targets for surgical treatment in the control of intractable epilepsy, is covered in this paper. Focal cortical dysplasia of Taylor (1971) has been established as a clinico‐pathological entity in which a variety of dysplastic cells are seen, such as cytomegalic neurons, bizarre glial or neuronal cells and ballooned cells of both origins. In a strict sense, ‘cortical dysplasia’ should imply ‘focal cortical dysplasia’ of Taylor, although the term ‘cortical dysplasia’ is occasionally used to cover a wider spectrum of cerebral malformation. Other indications in malformative lesions for surgery are hemimegalencephaly and tuberous sclerosis. Recently, special attention has been given to the coexistence of focal cortical dysplasia and tumors, which include mixed neuroglial tumors such as ganglioglioma or dysembry‐oplastic neuroepithelial tumors.
Pathology of the arteries in the central nervous system with special reference to their dilatation: Blood flow
Authors: Masuda Hirotake , Sugita Akihiro , Zhuang Yong‐Jie
Published: March 2003

Arteries that belong to the central nervous system (CNS) have thick and monotonous internal elastic lamina (IEL), Willis ring, and no collateral branch to the systemic circulation. These characteristics suggest that the circulation of the CNS is constant. In order to know how flow controls the arterial configuration of the CNS, flow of the vertebral and basilar arteries was increased experimentally using eight adult male Japanese white rabbits. Flow increase was induced by the simple ligation of the bilateral common carotid arteries (ligation group, n = 4) or by the ligation of the bilateral common carotid arteries at 1 week after arteriovenous fistula (AVF) between the left common carotid artery and the left external jugular vein (ligation plus AVF group, n = 4). Cineangiography revealed distinct flow increase in the ligation group at 5 weeks after ligation and in the ligation plus AVF group at 5 weeks after AVF (4 weeks after ligation). Vertebral and basilar arteries were remarkably dilated and elongated. Histopathologically, severe disruption of the IEL and focal thinning of the media were distinct. Endothelial cells were preserved and there was no inflammatory cell infiltration. These morphological features are consistent with increased flow‐induced adaptive remodeling. It is suggested that the constancy of the flow may give the arterial tree of the CNS these morphological characterizations.
Nicastrin, a key regulator of presenilin function, is expressed constitutively in human neural cell lines
Authors: Satoh Jun‐ichi , Kuroda Yasuo
Published: March 2003

Nicastrin acts as a key regulator for presenilin (PS)‐mediated γ‐secretase cleavage of β‐amyloid precursor protein by forming a functional complex with PS1 and PS2. Both TNF‐α and IL‐1, aberrantly produced by activated microglia and astrocytes, play a role in amyloidogenesis and neurodegeneration in the brains of Alzheimer's disease (AD) patients, while BDNF synthesized chiefly by neurons has been found to be substantially reduced in AD brains. To investigate the constitutive and cytokine/neurotrophic factor‐regulated expression of nicastrin in human neural cells, its mRNA levels were studied by RT‐PCR and northern blot analysis in SK‐N‐SH neuroblastoma cells, IMR‐32 neuroblastoma cells, U‐373MG astrocytoma cells, and NTera2 teratocarcinoma‐derived differentiated neurons (NTera2‐N) following exposure to TNF‐α, IL‐1β, BDNF, dibutyryl cyclic AMP, or phorbol 12‐myristate 13‐acetate. Nicastrin mRNA expression was identified in all human neural and non‐neural cell lines and tissues examined. The levels of nicastrin mRNA, however, were unaltered in SK‐N‐SH, IMR‐32, U‐373MG, and NTera2‐N cells by exposure to the factors tested, and unchanged in NTera2 cells during retinoic acid‐induced neuronal differentiation. These results indicate that nicastrin mRNA is expressed constitutively in human neural cell lines, where its expression is not regulated at the transcriptional level by a battery of cytokines and growth/differentiation factors which are supposed to be involved in amyloidogenesis, neurodegeneration or neuroprotection in AD brains.
Hemorrhage in the oculomotor nerve as a complication of leukemia
Authors: Jinnai Kenji , Hayashi Yoshitake
Published: March 2003

Oculomotor paralysis of a patient with leukemia was revealed at autopsy to be caused by a hemorrhage in the oculomotor nerve. In a 63‐year‐old woman with pre‐B‐cell acute lymphatic leukemia, leukemic invasions occurred in her spinal cord and right oculomotor nerve during a hematological remission state. The oculomotor palsy was aggravated to complete paralysis during a leukemic relapse, which lasted until her death. An autopsy revealed a hemorrhage along with leukemic cells in the right oculomotor nerve at the segment in the upper orbital fissure. Although hemorrhagic oculomotor paralysis is a very rare complication, reports of its occurrence will likely increase with improved survival times of leukemia patients due to advances in chemotherapy.
Effects of stereotactic radiosurgery on metastatic brain tumors of various histopathologies
Authors: Kamada Kensaku , Mastuo Takayuki , Tani Masaharu , Izumo Tsuyoshi , Suzuki Yaeko , Okimoto Tomoaki , Hayashi Nobuyuki , Hyashi Kuniaki , Shibata Shobu
Published: March 2003

Although reports have been published describing clinical results in a large series of patients with metastatic brain tumors treated by stereotactic radiosurgery (SRS), clinical neuropathological correlation has rarely been available. The present paper describes three autopsy cases and one surgical case treated with linear accelerator based radiosurgery. The cases comprised a lung cancer, a rectal cancer, an osteosarcoma, and a malignant melanoma. Histological sections of each tumor were analyzed by light microscopy based on the Ohosi and Shimosato's histopathological classification of the effects of radiation therapy. In three cases (pulmonary squamous cell carcinoma, rectal adenocarcinoma and osteosarcoma), a large area of the tumors consisted of coagulation necrosis and non‐viable tumor cells, while coagulation necrosis and non‐viable tumor cells comprised a very small part of the malignant melanoma. Histopathological type of the metastatic brain tumor may be one of the factors influencing outcome after SRS.
Alterations of NMDAR1 and NMDAR2A/B immunoreactivity in the hippocampus after perforant pathway lesion
Authors: Iwakiri Masahiko , Mizukami Katsuyoshi , Ishikawa Masanori , Hidaka Shin , Asada Takashi
Published: March 2003

Immunohistochemical techniques were employed to examine the changes in immunolabeling of the N‐methyl‐d‐aspartate (NMDA) receptor subunits NMDAR1 and NMDAR2A/B within the hippocampus 1, 3, 7, 14 and 30 days after a unilateral perforant pathway lesion was made in a rat brain. At 1 day post‐lesion, we observed a decrease in NMDAR1 immunolabeling in the granule cells in the dentate gyrus as well as in the mossy cells in the polymorphic region ipsilateral to the lesion, while an increase in diffuse neuropil labeling was observed. At 3 days post‐lesion, we observed a marked increase in NMDAR1 immunolabeling in the outer molecular layer of the dentate gyrus as well as in the stratum moleculare in the CA fields ipsilateral to the lesion. Although this increase was less marked at 7 and 14 days post‐lesion, an increase in NMDAR1 immunolabeling was evident at 30 days post‐lesion. In contrast, although a transient increase in NMDAR2A/B immunolabeling was observed in the outer molecular layer at 3 days post‐lesion, no other changes were detectable at any of the time points examined. Our study suggests that each subunit of the NMDA receptor displays a different response to deafferentation of the perforant pathway. We have previously observed that changes in the immunoreactivity of the receptor subunits of another class of glutamate receptor, α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoaxolepropionate (AMPA), occur at 30 days post‐lesion but not after a relatively short survival time. NMDA receptor subunits demonstrate an earlier response to the loss of the perforant pathway fibers than do the AMPA receptor subunits.
FKBP12 immunoreactivity in the human spinal cord of motor neuron disease patients
Authors: Kihira Tameko , Hironishi Masaya , Utunomiya Hidehiro , Kondo Tomoyoshi
Published: March 2003

We investigated the FKBP12 immunoreactivity in the spinal cord of neurological controls and motor neuron disease (MND) patients. In the neurological controls, the spinal neurons were markedly stained with antihuman FKBP12 (N‐19 and C‐19) antibodies. FKBP12 immunoreactivity was associated with lipofuscin in formalin‐fixed paraffin‐embedded samples. In an electron microscopic view, the 10‐nm colloidal gold particles labeled by the anti‐FKBP12 (N‐19) antibody were present on the lipofuscin of the spinal anterior horn neurons. In the MND cases, atrophic neurons with an abundance of lipofuscin granules in the anterior horns of the spinal cord were mildly stained with the anti‐FKBP12 (N‐19 and C‐19) antibodies. Normal‐appearing neurons, inclusion‐laden neurons and chromatolytic neurons of MND cases were weak or negatively stained with anti‐FKBP12 (N‐19) antibodies. These findings suggest that FKBP12 (N‐19) may decrease in the early stages of degeneration in MND. Complexes of FKBP12 and ligands were reported to have neuroprotective and/or neuroregenerative properties. It is speculated that the decrease in FKBP12 (N‐19) plays some causative role in the development of neurodegeneration in MND. Further investigation of FKBP12 and ligands may help elucidate the pathogenesis of MND.
Genotype‐phenotype correlation in CAG‐repeat diseases
Authors: Yamada Mitsunori , Tsuji Shoji , Takahashi Hitoshi
Published: March 2003

The expansion of a CAG repeat is a common causative gene mutation in several hereditary neurodegenerative disorders, including dentatorubral‐pallidoluysian atrophy (DRPLA). Although, in DRPLA, it is revealed that the variety of clinical manifestations is related to the variable expansion of the CAG repeat, there are still many problems in the correlation between the symptoms and neuropathologic findings. Recent immunohistochemical studies have revealed that diffuse intranuclear accumulation of mutant proteins with expanded polyglutamine stretches is a significant pathology in DRPLA, and involves a wide range of the CNS regions far beyond the lesion distribution previously established by neuronal loss. This novel pathology may become a clue for elucidating molecular mechanisms of neuronal dysfunction and establishing clinicopathological correlations in CAG‐repeat diseases.
Gliofibrous nodule in the cerebello‐medullary fissure
Authors: Yoshida Kazunari , Hiraga Kenji , Ishimori Hisatsugu , Katayama Makoto , Kawase Takeshi , Ikeda Eiji , Mukai Makio
Published: March 2003

An extra‐axial nodule in the cerebello‐medullary fissure is described, occurring in a 27‐year‐old‐woman. MRI and CT scans revealed the lesion was a non‐enhanced round mass, which was associated with mild atrophy of the surrounding cerebellum, but with no perifocal edema. In the surgical observation, the mass was white, elastic and hard, well demarcated and localized in the cerebello‐medullary fissure. Histologically, the lesion was composed of astrocytes and collagen‐producing fibroblasts with no anaplasia. These findings suggested that the lesion was hamartomatous, but not neoplastic. This type of gliofibrous nodule has not been previously reported.
Oxidant stress is increased within the glomerulus in experimental diabetic nephropathy
Authors: Kitching A Richard , RÜGER1 Beate M , DAVIS1 Paul F
Published: March 2003

SUMMARY: The mechanisms by which the metabolic consequences of hyperglycaemia induce diabetic renal injury remain ill‐defined. We hypothesized that oxidant stress, a consequence of hyperglycaemia, is increased in glomeruli from Lewis rats with streptozotocin (STZ)‐induced diabetes prior to major structural and functional glomerular damage. After 12 weeks of diabetes, Lewis rats had not developed proteinuria and their glomeruli appeared normal by light microscopy. However, kidneys of diabetic animals had higher levels of lipid peroxides and malondialdehyde (MDA) than control rats. Immunohistochemistry demonstrated MDA–lysine adducts in glomeruli of diabetic rats, and that lipid peroxides and MDA were increased in glomerular lysates of diabetic rats. A possible mechanism for this finding was suggested by the observation that freshly isolated whole glomeruli from STZ rats showed a greater capacity than glomeruli from control rats to produce H2O2. Activity of the inducible form of superoxide dismutase (SOD) Mn‐SOD was increased in glomerular lysates from STZ rats, consistent with its induction by oxidant stress. Immunostaining for Cu,Zn SOD showed increased protein in glomeruli, although compared with the increase in Mn‐SOD activity, Cu,Zn‐SOD activity was not substantially increased, potentially as a result of partial inactivation of this enzyme by glycation. The increased oxidant stress in untreated diabetic rats was a consequence of hyperglycaemia and not due to a direct nephrotoxic effect of STZ, as at least some of these changes were attenuated by insulin treatment of diabetic animals. Collectively, these results demonstrate that experimental diabetes mellitus is accompanied by increased oxidant stress within glomeruli.
Urinary transforming growth factor‐β1 is an indicator of histological chronicity in IgA nephropathy
Authors: Takazoe Kazunori , Utsunomiya Yasunori , Kawamura Tetsuya , Sakai Osamu , Hosoya Tatsuo
Published: March 2003

SUMMARY: This study examined urinary excretion of transforming growth factor‐β1 (TGF‐β1) in adult IgA nephropathy and compared this with clinical and histological parameters. TGF‐β1 was measured by enzyme‐linked immunosorbent assay in 24‐h urine specimens from 25 patients with IgA nephropathy (17 men, eight women). Urine from eight age‐matched control subjects served as the control. Serum TGF‐β1 was also measured in 16 out of the 25 patients and six age‐matched control subjects. TGF‐β1 was detected in the urine in 72% of IgA nephropathy patients(18/25), but was not detected in any of the control subjects. Patients with decreased renal function (creatinine clearance (Ccr) < 80 mL/min) had higher urine levels of TGF‐β1 than those with normal renal function (Ccr ≥ 80 mL/min) (141.8 ± 60.0 ng/day vs 39.7 ± 33.2 ng/day, P < 0.01). The level of TGF‐β1 gave a negative correlation with Ccr (r = −0.62, P = 0.001), but not with proteinuria (r = 0.11, P = 0.58). Twenty‐two of the patients were evaluated histologically. The urinary TGF‐β1 levels correlated with both global sclerosis and interstitial volume (r = 0.52, P < 0.05, and r = 0.51, P < 0.05, respectively). However, there was no correlation between TGF‐β1 levels and glomerular intracapillary inflammatory cell score, mesangial proliferation score or the matrix score. No correlation was found between TGF‐β1 levels and the number of glomerular or interstitial CD68+ cells. No significant differences in serum TGF‐β1 levels were observed between patients with normal Ccr and those with decreased Ccr. Also, its levels were found to be independent of the urine levels. In conclusion, 24‐h urinary TGF‐β1 excretion was found to correlate with Ccr, global sclerosis and interstitial volume, demonstrating that urinary TGF‐β1 is an indicator of chronicity in adult IgA nephropathy.
Laminin in the interstitium indicates prognosis in patients with IgA nephropathy
Authors: Jinde Kiichiro , Yagame Mitsunori , Sun Wei , Kurokawa Kiyoshi , Sakai Hideto
Published: March 2003

SUMMARY:

Laminin is implicated in cell migration, remodelling of the extracellular matrix and basement membrane. Therefore, laminin deposition could be of concern in the progression of some renal diseases. In the present study, immunohistochemical and in situ hybridization studies were performed for laminin in IgA nephropathy (IgAN) specimens in order to reveal the importance of laminin deposition for their prognosis. Fifteen patients were used as the stable group who maintained stable renal function for more than 10 years after biopsy. Thirteen patients formed the progressive group who reached end‐stage renal failure within 10 years after biopsy. Immunohistochemically, laminin was specifically deposited in damaged glomeruli and strong immunoreactivity was particularly shown in the expanded interstitial area containing infiltrating mononuclear cells. Although the staining score in glomeruli was not significantly different between these two groups (P = 0.181), deposition in the expanded interstitium was extensive and significantly greater in the progressive group (P < 0.01). In situ hybridization revealed that most of the interstitial cells and some of the tubular cells expressed laminin messenger ribonucleic acid. In conclusion, the extent of interstitial laminin deposition was an important prediction of adverse renal outcome. This laminin could be produced by interstitial cells and/or tubular cells.
Outcome of aneurysmal subarachnoid haemorrhage in patients on maintenance haemodialysis
Authors: Nishihara Gakusen , Nakamoto Masahiko , Okamoto Yuji , Kajihara Kazunori , Sakemi Takanobu
Published: March 2003

SUMMARY:

To investigate the outcome of aneurysmal subarachnoid haemorrhage (SAH) in patients on maintenance haemodialysis (HD), eight patients on maintenance HD and 245 patients not on HD who suffered from SAH, all of whom were surgically treated at our institution between 1993 and 1997, were reviewed. The clinical features and 3‐month outcome of SAH were analysed in the eight HD patients (three males, five females) and compared with those in the 245 non‐HD patients (77 males, 168 females). Although there were no significant differences in the patient’s age, gender and pre‐operative grading of SAH with the Hunt and Hess grading scale, the mortality rate in HD patients was significantly higher than that in non‐HD patients (50% [4/8] vs 13% [32/245]; P < 0.01). It was concluded that the outcome of aneurysmal SAH in HD patients was extremely poor. The explanation for the worse prognosis in HD patients seems not to lie in systemic heparization but in a vulnerability to SAH, because SAH in all HD patients occurred after anticoagulant activity from the previous dialysis had already disappeared.
Lipid hydroperoxides: Elevated levels in patients on haemodialysis and patients with chronic renal failure
Authors: Mondorf UF , Schmidt R , Siegers J , Gross W , Geiger H , Scheuermann EH
Published: March 2003

SUMMARY:

Patients with renal disease often develop accelerated atherosclerosis resulting in more frequent cardiovascular complications compared to the general population. It has been suggested that peroxidation of low density lipoprotein (LDL) contributes to the pathogenesis of atherosclerosis and glomerulosclerosis. The present study aimed to investigate the phosphatidylcholine hydroperoxide (PC‐OOH) content of LDL in patients with chronic renal failure (CRF) and patients on haemodialysis (HD). Plasma was obtained from healthy volunteers (n = 20; age 45.8 ± 16.9 years), CRF patients (n = 23; age 49.4 ± 18.1 years) and patients on HD (n = 19; age 59.1 ± 10.3 years). The lipid profile was studied in all patients. The LDL was isolated by sequential ultracentrifugation. The oxidized PC‐OOH content of LDL was measured by high performance liquid chromatography with chemiluminescence detection (HPLC‐CL). Compared to the controls, patients with proteinuria had significantly higher plasma concentrations for total cholesterol, LDL‐cholesterol and apoB, whereas patients on HD had significantly higher levels of triglycerides and reduced HDL and apoA1 plasma concentrations. Significantly elevated levels of PC‐OOH were found in HD patients (22.56 ± 13.40 pmol/mg LDL‐cholesterol) and CRF patients (13.12 ± 15.15 pmol/mg LDL‐cholesterol) compared to the controls (0.56 ± 0.38 pmol/mg LDL‐cholesterol; P < 0.001). In HD patients the PC‐OOH concentration was higher compared to CRF patients (P < 0.05). It was concluded that lipid hydroperoxides increase in renal disease and in patients on HD. These elevated lipid hydroperoxides may contribute to the increased risk for atherosclerosis in these patients.
Does an endoluminal catheter brush improve flows or unblock haemodialysis catheters?
Authors: Archis CA , Blacka J , Brown MA
Published: March 2003

SUMMARY:

Endoluminal brushing, used to declot various types of central venous access lines, was undertaken in 19 haemodialysis catheters (vascaths) that were either totally occluded or produced flows inadequate for successful dialysis. Six (32%) were able to be used successfully immediately after the procedure, two after intracatheter urokinase following brushing and in a further three catheter patency was restored by rebrushing. Endoluminal brushing, with or without additional urokinase, restored patency in 42% of these catheters and dialysis was still successful in this group after 2 weeks. Endoluminal brushing did not change oxygen saturation, pulse rate, blood pressure or temperature in these patients and there were no episodes of clinical pulmonary embolism or sepsis. These findings suggest a role for endoluminal brushing in the early management of occluded haemodialysis catheters.
Comparison of dialysis adequacy at two dialysate potassium concentrations
Authors: Sangthawan Pornpen , Atkins Robert C , Kerr Peter G
Published: March 2003

SUMMARY: It has been suggested that haemodialysis adequacy is greater dialysing against a 3 mmol/L potassium dialysate concentration than against a 1 mmol/L potassium concentration. As most dialysis patients dialyse against 1 or 2 mmol/L potassium, the dialysis adequacy at these two potassium concentrations was compared. Ten stable haemodialysis patients were randomly assigned to dialyse against 1 mmol/L potassium dialysate (K1) followed by 2 mmol/L potassium dialysate (K2) or vice versa. All other dialysis parameters were held stable. The mean urea reduction ratio was 68.3 ± 6.2 using K1 and 69.5 ± 6.4 using K2 (P < 0.05 using Wilcoxon for paired data). The Kt/V, however, did not differ (1.39 ± 0.23 for K1 and 1.41 ± 0.23 for K2). The urea rebound was also not different between K1 and K2, with a trend to higher rebound using K2. The percentage rebound in urea was 6.0 ± 2.5 for K1 and 7.1 ± 2.8% for K2. In this setting, K2 dialysate offered no advantage in terms of urea rebound or Kt/V. Based on previously published data, a dialysate potassium concentration of 3 mmol/L may be required to achieve significant benefit in terms of dialysis adequacy.
Hypertensive kidney disease in African Americans
Authors: Agodoa Lawrence
Published: March 2003

End‐stage renal disease is a significant public health problem in both developed and developing countries. The magnitude and pattern of renal disease varies between countries. This variability could probably be explained by the racial and ethnic composition. The United States is a typical example, showing significant racial and ethnic differences in the magnitude and pattern of renal disease. African Americans, Native Americans and Pacific Islanders are disproportionately afflicted with end‐stage kidney failure (ESRD), compared with Caucasians and Asians. Whereas diabetes mellitus, primarily type 2, is the predominant cause of renal disease (and ESRD) in the US, and prominently in Native Americans, hypertensive kidney disease is the most prevalent cause of ESRD in African Americans. Some of the suggested reasons for the increased incidence and prevalence of hypertensive kidney disease in African Americans include the higher prevalence and severity of hypertension, especially in the early years of life, lower socio‐economic status leading to inadequate health care, a greater propensity towards developing intrinsic renal vascular disease, a greater tendency towards developing target organ damage at ‘normal’ blood pressure levels, and the use of drugs that are less renoprotective to treat their blood pressure.
Cardiac evaluation of haemodialysis‐related hypotension using dobutamine stress echocardiography
Authors: Poldermans Don , Meiracker2 Anton H Van Den , Bax1 Jeroen J , Zietse2 Robert
Published: March 2003

SUMMARY: Haemodialysis‐related hypotension occurs in approximately 30% of patients. Myocardial ischaemia and/or insufficient contractile reserve in response to sympathetic stress may be involved in the pathogenesis of hypotension during dialysis. Using dobutamine stress echocardiography, left ventricular function at rest, myocardial contractile reserve and the presence and extent of ischaemia can be assessed in a non‐invasive way. This short review will focus on the potential value of dobutamine stress echocardiography for the evaluation of hypotension‐prone haemodialysis patients.
RACTK1: a putative inward rectifier potassium channel of the distal nephron. Investigation in Xenopus laevis oocytes
Authors: Bhandari Sunil , Hunter Malcolm
Published: March 2003

To date, cloning and examination of the functional properties of RACTK1, a K+ channel present in the distal nephron, have been performed in Chinese hamster ovary cells, but not using the oocyte expression system. We examined the expression and cytological localization of RACTK1 protein in Xenopus oocytes. In vitro transcribed cRNA of ROMK1, RACTK1, streptavidin‐tagged constructs of RACTK1 and ROMK1, alone or in concert, were injected into oocytes. Protein expression was evaluated by two‐electrode voltage clamp, followed by immunocytochemistry. ROMK1 and co‐injected oocytes (tagged and untagged) exhibited barium‐sensitive K+ conductances significantly greater than both RACTK1 (tagged and untagged) and water‐injected oocytes. Water‐injected oocytes failed to demonstrate protein expression. Expression of membrane protein was evident in ROMK1‐injected and RACTK1/ROMK1 co‐injected oocytes, but not in RACTK1‐injected oocytes. RACTK1 does not produce an extracellular membrane protein in oocytes. Therefore, this system is not suitable for further study or verification of the properties of RACTK1.
Hepatitis infection in haemodialysis patients
Authors: HUANG Chiu‐Ching
Published: March 2003

SUMMARY: Known hepatitis infections among haemodialysis patients include hepatitis B, hepatitis C, hepatitis G and TT virus. Haemodialysis patients with hepatitis B and/or hepatitis C infection may progress to develop significant morbidity, such as cirrhosis, hepatitic failure or hepatocellular carcinoma. Hepatitis B infection may be treated with α‐interferon or lamivudine. Hepatitis C infection may be treated with α‐interferon, but frequent severe adverse effects were observed, while ribavirin is contraindicated for patients with renal failure. Treatment for hepatitis B and/or hepatitis C are costly, and the risk of post‐transplant reactivation of hepatitis has been reported. Prevention of nosocomial transmission of hepatitis infection with strict infection control and universal precautions is more important. Accumulating evidence suggests that both hepatitis G virus and TT virus (TTV) are not significant causes of liver disease. Routine screening for hepatitis G or TTV viraemia in haemodialysis patients is not indicated at present.
Hypertensive crisis after discontinuation of an angiotensin‐converting enzyme inhibitor in a patient with renal dysfunction
Authors: YAMAMOTO Kouji , KITAZAWA Kozo , HONDA Hirokazu , FURUTA Emiko , NISHIMOTO Yukihiro , SHIBATA Takanori , SUGISAKI Tetsuzo
Published: March 2003

SUMMARY: A 54‐year‐old woman with hypertension treated for 2 years with enalapril, 10 mg daily, was admitted to hospital because of progressively worsening renal function. There was no evidence of scleroderma, except for the presence of anticentromere antibodies. to prevent hyperkalaemia and further deterioration of renal function, enalapril was abruptly withdrawn and replaced with a calcium antagonist on the second hospital day, but hypertensive crisis developed. Renal failure requiring haemodialysis developed 2 weeks after admission. Findings of a renal biopsy were consistent with scleroderma kidney. Scleroderma is difficult to diagnose in the absence of cutaneous symptoms. Therefore, angiotensin‐converting enzyme inhibitors should only be discontinued with care in patients with renal dysfunction if there is the possibility of scleroderma without skin changes.
AusDiab renal study: indicators of renal disease
Authors: Chadban SJ
Published: March 2003

SUMMARY: The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) was designed to determine the prevalence of diabetes and abnormal glucose metabolism, lifestyle and health behaviours and early indicators of renal disease in Australian adults. The study screened 11 247 adults aged ≥ 25 years residing in randomly selected districts in all States and Territories of Australia between April 1999 and December 2000. Diabetes and hypertension were detected in 7.5% and 28.8%, respectively. Proteinuria was detected in 2.5% of subjects tested and serum creatinine was elevated in 1.06%. Dipstick screening followed by analysis of a mid‐stream urine sample revealed haematuria in 6.8% of subjects tested. Body mass index scores indicated that 48.2% of all men screened were overweight, and a further 19.1% were obese. Of the women, 30.2% were overweight and 21.8% obese. The results of the AusDiab study suggests one‐third of the Australian adult population have at least one indicator of renal disease.
Using anthropology to analyse healthcare situations
Authors: Collière Marie‐Françoise
Published: March 2003

An anthropological approach to caring has much to offer practising health workers, especially nurses. While its attitude towards knowledge differs from that used in much traditional medical and clinical education, its capacity to draw on the observations and life experiences of both carers and those cared and those cared for in the design of care plans can provide insights and information crucial to recovery and to an extended healthy life. This article models Claude Lévi‐Strauss' structural anthropological method within nursing care situations.
Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, Canada
Authors: O’Brien‐Pallas Linda , Baumann Andrea
Published: March 2003

Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, Canada

This paper reflects how health services research ‘evidence’ was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision‐makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of Health’s Nursing Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing’s contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research‐based evidence and now the challenge becomes to monitor the implementation of these resolutions over time.
Gender, ‘race’, poverty, health and discourses of health reform in the context of globalization: a postcolonial feminist perspective in policy research
Authors: Anderson Joan M.
Published: March 2003

Gender, ‘race’, poverty, health and discourses of health reform in the context of globalization: a postcolonial feminist perspective in policy research

In this paper, I draw on extant literature and my empirical work to discuss the impact of globalization and healthcare reform on the lives of women — those from countries of the South as well as of the North. First, I review briefly the economic hardships identified in different sectors of the population that have been attributed to how globalization is now working. Second, I examine what these global processes mean for health, with particular focus on poverty, gender, racialization and health. Third, I reflect on how nurse scientists might develop research agendas in the 21st century that would foster social transformation and social justice for all people. The position taken here is not an indictment of globalization. Rather, I argue that globalization is a fact in all of our lives. There are positive aspects of globalization. There are also negative aspects which we must collectively address, given that the issues identified can have deleterious consequences for the world’s poor, women in particular. I suggest that, to construct knowledge for practice and praxis, research agendas of the future should be inclusive of subaltern voices. I argue that drawing on a postcolonial feminist epistemology might help us to define such agendas, and express the multilayered sociopolitical contexts of health and illness in advocacy with policy‐makers.
The implications of healthcare reforms for the profession of nursing
Authors: Dingwall Robert , Allen Davina
Published: March 2003

The implications of healthcare reforms for the profession of nursing

This paper offers a wide‐ranging analysis of concerns that the value of emotion work within nursing is being eroded. We examine the occupation’s historical development to argue that, in so far as emotion work has any essence within nursing, it is as an occupational myth which has been deployed to legitimate nurses’ jurisdictional claims. We argue that recent developments in health‐care raise questions about the benefits of claims of this kind and suggest that a little more realism about the nature of nursing work might make for a more sustainable professional future.
Towards a more place‐sensitive nursing research: an invitation to medical and health geography
Authors: Andrews Gavin J.
Published: March 2003

During recent years, nursing research has adopted and integrated perspectives and theoretical frameworks from a range of social science disciplines. I argue however, that a lack of attention has been paid in past research to the subdiscipline of medical geography. Although this may, in part, be attributed to a divergence between research priorities and foci, traditional ‘scientific’ geographical approaches may still be relevant to a wide range of nursing research. Furthermore, a recasting, redirecting and broadening of medical geography in the 1990s, towards what is termed health geography, has enhanced the discipline and provided a more cultural and expansive recognition of health, and a more comprehensive understanding of the dynamic relationship between people, health and place. Given the increasing range of places where health‐care is provided and received, and some recent linkages made between nursing and place by nurse‐theorists, these newer perspectives and concepts may be particularly useful for interpreting nurses’ and patients’ relationships both within and with a variety of healthcare settings and living spaces. Indeed, although a more place‐sensitive nursing research is potentially a trans‐disciplinary academic endeavor, a range of geographical approaches would be central to such a project.