bluuebunny/crossref_metadata_2025 huggingface dataset:
A parent‐completed developmental questionnaire: Follow up of ex‐premature infants
Authors: Skellern CY , Rogers Y , O'Callaghan MJ
Published: March 2003

Objective: Premature infants are at increased risk of developmental disability. Early identification of problems allows intervention to ameliorate or attenuate problems. A reliable screening tool allows triage of children in this high‐risk population by identifying those unlikely to need full developmental assessment. To explore the test characteristics of an established parent‐completed developmental assessment questionnaire ‘Ages and Stages Questionnaire’ (ASQ) in follow up of an Australian population of premature infants.

Methodology: One hundred and sixty‐seven children born prematurely with corrected ages 12‐ to 48‐months attending the Growth and Development Clinic at the Mater Children’s Hospital in Brisbane, Queensland, Australia; 136 questionnaires ‘ASQ’ were returned completed (81%) and were compared to formal psychometric assessment (Griffith Mental Development Scales for 12‐ and 24‐months, Bayley Mental Development Intelligence Scale for 18‐months, McCarthy General Cognitive Intelligence Scale for 48‐months). Developmental delay was considered to be present if any of the above psychometric assessments fell below 1.0 standard deviations (SD). The ASQ cut‐off used was 2.0 SD (US data derived means and SD).

Results: Aggregate results for all age groups comparing ASQ to psychometric assessments as ‘gold standards’ found the ASQ to have the following test characteristics: sensitivity (90%); specificity (77%); positive predictive value (40%); negative predictive value (98%); % over‐referred (20%); % under‐referred (1%); % agreement (79%). Likelihood ratio for children failing the ASQ was 3.8 and for passing the ASQ was 0.13. Twenty‐one children with known disabilities were included in the study and in 14 of these, the ASQ overall score agreed with the psychometric assessment (67%).

Conclusion: The high negative predictive value of the ASQ supports its use as a screening tool for cognitive and motor delays in the follow up of ex‐premature infants. This would need to be combined with other strategies as part of a comprehensive follow up program for ex‐premature infants.
Impact and aetiology of respiratory infections, asthma and airway disease in Australian Aborigines
Authors: Peat JK , Veale A
Published: March 2003

Abstract: In this review, we describe the burden of respiratory illness in Australian indigenous communities and examine evidence of aetiology. We have reviewed the results from studies of respiratory infections and asthma‐like symptoms conducted in remote and non‐remote indigenous communities and contrasted them with data from comparable studies in non‐indigenous communities. Although bias cannot be controlled and generalizability is an issue, the data are the only information available and, as such, provide a basis for a hypothesis generating approach to better health care. The evidence suggests that many indigenous people, especially those who live in non‐remote regions, have asthma‐like symptoms that are largely of an infectious rather than an allergic origin. Moreover, indigenous communities continue to be exposed to low immunisation rates, to have low rates of breastfeeding and to have high rates of cigarette smoking, all of which have the potential to increase the prevalence of respiratory illnesses. It is important to identify the most effective treatments and preventive strategies for respiratory symptoms that are prevalent in indigenous children. Respiratory symptoms that are largely of a bacterial–infectious origin may not benefit from commonly prescribed asthma therapies and, without appropriate treatment, may lead to ongoing health problems.
Childhood poisoning in Queensland: An analysis of presentation and admission rates
Authors: Reith DM , Pitt WR , Hockey R
Published: March 2003

Objective: To determine the presentation rates for paediatric poisoning by ingestion and the determinants of hospital admission.

Methodology: Cross‐sectional survey using an injury surveillance database from emergency departments in South Brisbane, Mackay and Mt Isa, Queensland, from January 1998 to December 1999. There were 1516 children aged 0–14 years who presented following ingestional poisoning.

Results: The presentation rates for poisoning were 690, 40 and 67 per 100 000 population aged 0–4, 5–9 and 10–14 years, respectively. The admission rates to hospital for poisoning were 144, 14 and 22 per 100 000 population aged 0–4, 5–9 and 10–14 years, respectively. Although presentation rates for poisoning were higher in the rural centres the admission rates were disproportionately high for the 0–4 years age group. The agents most frequently ingested were paracetamol, Dimetapp®, rodenticides and essential oils.

Conclusion: There is a need to design and implement interventions aimed at reducing poison exposures and unnecessary hospital admissions in the 0–4 years age group.
Paediatric palliative care: Distinctive needs and emerging issues
Authors: Hynson JL , Sawyer SM
Published: March 2003

Abstract: Palliative medicine has developed as a specialized field of practice in recent decades but the focus has been very much on older adults with incurable malignancies. The needs of dying children have not been addressed adequately and the question of who is best placed to provide care to this group remains the subject of some contention. Although the principles of palliative care apply equally to children, a number of fundamental differences influence their application in the paediatric setting. These include a heterogeneous patient population, physiological factors, developmental issues, parental involvement in care giving and decision making and the desire of most paediatricians to maintain close involvement with their patients. Families generally prefer home care and even quite severe symptoms can be managed in this environment with appropriate planning, expertise and support. The delivery of effective palliative care in the paediatric setting is contingent upon overcoming barriers between hospital and community and sharing expertise between paediatricians and palliative care physicians. Research is also required to increase the evidence base for practice.
The Sleep and Settle Questionnaire for parents of infants: Psychometric properties
Authors: Matthey S
Published: March 2003

Objective: To determine the psychometric properties of a parent‐report questionnaire (Sleep and Settle Questionnaire (SSQ)) assessing: (i) the infant’s sleep and settling behaviour, and (ii) the parent’s level of concern with such behaviours.

Methodology: Test‐retest reliability was determined by administering the SSQ to 20 mothers on two occasions, 7–14 days apart. Validity was determined by comparing SSQ responses between mothers with 6‐week‐old infants who, on a semistructured questionnaire, reported no sleep or settling difficulties (n = 56–60) with those who reported they were experiencing difficulties (n = 133). Further comparison was made with a sample of mothers (n = 34–36) attending a community class on sleep and settling difficulties with infants. Sensitivity to change was determined by comparing mothers’ SSQ responses at 6‐weeks and 6‐months postpartum.

Results: The SSQ was found to have low test–retest reliability on items referring to the infants’ sleep and settling behaviour, but moderate reliability for the extent that such behaviour bothered the parent. Comparison across the different samples showed good discriminant and concurrent validity.

Conclusions: Parental reports on the SSQ indicates that over a short period (1–2 weeks) the infants’ sleep and settling behaviour can change considerably, but that the extent to which such behaviour bothers the parent is more stable. Good validity demonstrates the SSQ is sensitive to differing infant behaviour. It is recommended as both a clinical and research instrument, and could be used to complement assessments focusing on the parent’s psychosocial adjustment in the early postpartum period.
Couple distress after sudden infant or perinatal death: A 30‐month follow up
Authors: Vance JC , Boyle FM , Najman JM , Thearle MJ
Published: March 2003

Objective:  To examine, using a 30‐month prospective study, patterns of anxiety, depression and alcohol use in couples following stillbirth, neonatal death or sudden infant death syndrome.

Methodology:  One hundred and thirty‐eight bereaved and 156 non‐bereaved couples completed standardized interviews at 2, 8, 15 and 30 months post‐loss.

Results:  At all interviews, bereaved couples were significantly more likely than non‐bereaved couples to have at least one distressed partner. Rarely were both partners distressed in either group. For bereaved couples, ‘mother only’ distress declined from 21% to 10% during the study. ‘Father only’ distress ranged from 7% to 15%, peaking at 30 months. Bereaved mothers who were distressed at 2 months reported significantly lower marital satisfaction at 30 months.

Conclusions:  At the couple level, the experience of a baby's death is multifaceted. Gender differences are common and partners’ needs may change over time. Early recognition of these differences may facilitate longer‐term adjustment for both partners.
Partial liquid ventilation and nitric oxide in experimental acute lung injury
Authors: Davies MW , Stewart MJ , Chavasse R , Bayley G , Butt W
Published: March 2003

Objective: To investigate the effects of inhaled nitric oxide (iNO) and partial liquid ventilation (PLV) on oxygenation and pulmonary haemodynamics in acute lung injury (ALI), and to assess their effects on lung function, systemic haemodynamics and lung injury.

Methods: Using saline lung lavage, ALI was induced in 18 piglets. A control group was ventilated with conventional mechanical ventilation (CMV) for 2 h. An iNO‐first group received iNO for the first hour and then iNO with PLV. A PLV‐first group received PLV for the first hour and then PLV with iNO. Variables were measured at baseline, 5 min postlavage, and at 1 h and 2 h postlavage.

Results: During the first hour, both treatment groups showed improvement in oxygenation index (OI). At 2 h, the dif­ferences in OI were statistically significant (P = 0.037), with a mean ± SD of 23.8 ± 20.7 in the control group, 4.4 ± 0.9 in the PLV‐first group and 6.5 ± 3.1 in the iNO‐first group. The OI was similar in both treatment groups (P = 0.178). At 2 h, the pulmonary artery pressure (PAP) was significantly different (P = 0.04) between groups, with a mean ± SD PAP of 36.3 ± 7.2 mmHg in the control group, 27.4 ± 4.0 mmHg in the PLV‐first group and 30.0 ± 4.1 mmHg in the iNO‐first group. The PAP was similar in both treatment groups (P = 0.319).

Conclusion: In ALI, oxygenation and pulmonary hypertension are improved with PLV and iNO given together, regardless of the order in which they are commenced.
Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemia
Authors: Boo N‐Y , Lee H‐T
Published: March 2003

Objective: To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy.

Methods: A randomized controlled study was carried out in the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia over a 12‐month period. Fifty‐four healthy term infants with severe hyperbilirubinemia were randomized to receive either solely enteral feeds (n = 27) or both enteral and intravenous (n = 27) fluid during phototherapy.

Results: There were no significant differences in the mean birthweight, mean gestational age, ethnic distribution, gender distribution, modes of delivery and types of feeding between the two groups. Similarly, there was no significant difference in the mean indirect serum bilirubin (iSB) level at the time of admission to the NICU between the enteral (359 ± 69 μmol/L [mean ± SD]) and intravenous group (372 ± 59 μmol/L; P = 0.4). The mean rates of decrease in iSB during the first 4 h of phototherapy were also not significantly different between the enteral group (10.4 ± 4.9 μmol/L per h) and intravenous group (11.2 ± 7.4 μmol/L per h; P = 0.6). There was no significant difference in the proportion of infants requiring exchange transfusion (P = 0.3) nor in the median duration of hospitalization (P = 0.7) between the two groups. No infant developed vomiting or abdominal distension during the study period.

Conclusion: Severely jaundiced healthy term infants had similar rates of decrease in iSB levels during the first 4 h of intensive phototherapy, irrespective of whether they received oral or intravenous fluid supplementation. However, using the oral route avoided the need for intravenous cannulae and their attendant complications.
Outcome evaluation of early discharge of asthmatic children from hospital: A randomized control trial
Authors: Stormon MO , Asperen PP VAN , Kilham HA
Published: March 2003

Abstract The objective of our study was to compare the safety and efficacy of discharging asthmatic children from hospital on three versus four hourly nebulized salbutamol. The setting was a tertiary referral paediatric hospital in Sydney, NSW, Australia. The design was a randomized controlled parallel group study. All children admitted to hospital with acute asthma and who were over 18 months of age were eligible to enter the study. Patients were excluded if they had non‐English speaking parents, no telephone, or chronic cardiac or neurological disease. Children were treated according to standard asthma management but were randomly allocated to be discharged on three or four hourly nebulized salbutamol. Patients were surveyed using a telephone questionnaire 1 to 2 weeks after discharge. The primary outcome measure was re‐presentation to the Emergency Department (ED) within 7 days. Other outcomes included readmission to hospital, re‐presentation to the local doctor, parental satisfaction and length of hospital stay. A total of 63 children were enrolled in the study (32 in the three hourly group and 31 in the four hourly group). There were no re‐presentations to the ED or hospital readmissions within 1 to 2 weeks in either group. However, re‐presentations to the local doctor were common, 71.8% in the three hourly and 74.1% in the four hourly groups, respectively. These were predominantly for routine review. The mean (± SD) hospital length of stay was not significantly different between the three and four hourly groups, 48.94 (± 20.61) and 54.88 (± 32.59) hours, respectively (P = 0.672). Parents felt the timing of discharge was ‘too early’ in five (15.6%) of three hourly and five (16.1%) of four hourly patients. Three (9.7%) of the four hourly but none of the three hourly patients felt they were sent home ‘later than necessary’. Five (15.1%) of the three hourly and three (9.7%) of the four hourly group parents did not feel comfortable looking after their child at home immediately after discharge. None of these differences were statistically significant. Discharge of asthmatic children from hospital on three hourly nebulized salbutamol is as safe and effective as on four hourly. Parents are generally very satisfied with timing of discharge, irrespective of frequency of nebulization. Earlier discharge benefits both the child and their family, and improves hospital bed utilization.
The application of the continuum of care model in the re‐configuration of nutrition and dietetics services
Authors: PATCH C , MILOSAVLJEVIC M
Published: March 2003

Abstract The continuum of health care model can be used to improve service delivery. Within a hospital setting, finite resources are available. Service gaps must be identified, priorities established and resources re‐distributed to meet these gaps. Using Continuous Quality Improvement (CQI) tools, barriers to change were identified and a plan for improvement was formulated. Areas receiving disproportionate resources were identified and a more even resource allocation adopted. In an illustration of the success of strategic change, core services were not only maintained but also showed improved efficiency. The Department of Nutrition and Dietetics at Wollongong and Port Kembla Hospitals achieved an increase in dietetic services through a reorientation of current resources.
Are unplanned readmissions to hospital really preventable?
Authors: Miles Thaïs Anitra , Lowe Julia
Published: March 2003

Abstract All John Hunter Hospital readmission data for October 1998 were examined. Twenty‐four readmissions out of 3081 total admissions (0.8%) were defined as adverse events (unplanned readmissions) being nominally due to inappropriate medical management. The 24 adverse events comprised 5.5% of the 437 readmissions. A further five readmissions occurred because scheduled theatre was cancelled. Remaining readmissions were due to the condition of the patient in each case. Of the 16 highly preventable adverse events, 10 were allocated to the minor temporary category of severity. It is difficult to evaluate these readmission rates because there are no comparable findings in other Australian studies. The adverse events showed no particular association with patient age, sex, hospital of original admission or hospital specialty. While they were technically preventable, after medical record review a senior clinician identified these as extremely difficult cases, indicating that better outcomes may not have been possible.
Home rehabilitation for older adults with fractured hips: How many will take part?
Authors: Crotty Maria , Kittel Alison , Hayball Nicki
Published: March 2003

Abstract Rehabilitation at home is a new ‘technology’ which has been promoted as an efficient alternative to hospital rehabilitation for older patients with conditions such as fractured hip. In Australia, no formal description of elderly patients with fractured hips likely to be eligible for home rehabilitation has been made and the acceptability of such services is unclear. Using information obtained prospectively from a consecutive sample of 188 patients with a fractured hip we describe the characteristics of older adults who were eligible for a trial examining home versus hospital rehabilitation. While staff assessed 36% of patients as eligible, only 20% were both eligible and agreeable. Reasons for refusal to participate included a preference for inpatient rehabilitation (26%), family reluctance (26%) and anxiety regarding the ability to manage at home (16%). Our results suggest that home rehabilitation is suitable for the least disabled group but is still unacceptable to many elderly patients and their families. As the population ages and hip fractures increase, home rehabilitation in its current form will have little impact on future bed needs.
A quality assurance activity to improve discharge communication with general practice
Authors: Bolton Patrick
Published: March 2003

Abstract The aim of this study was to describe and evaluate a method of improving the completion of discharge summary information. As a quality assurance activity, a self‐carbonating form for both the patient record and discharge letter was introduced to a general practice casualty (GPC) in Sydney, Australia, involving approximately 40 community GPs. Evaluation involved assessment of the change associated with this intervention on a cohort of GPs using logistic regression analysis, clustering at the level of the treating GP. The main outcome measure was completion of a discharge letter to the patient’s usual GP. Provision of discharge letters increased from 30% prior to the intervention to 90% following it (P < 0.0005; OR 11.9; 95% CI 8.6–16.4). It was concluded that solutions to problems of quality are best developed at the system level. The use of a self‐carbonating form to simultaneously generate a discharge letter and the medical record might be used by other similar services with good effect.
General practitioner–hospital communications: A review of discharge summaries
Authors: Wilson Stephen , Ruscoe Warwick , Chapman Margaret , Miller Rhona
Published: March 2003

Abstract The objective of this study was to examine the reliability, effectiveness, accuracy and timeliness of hospital to general practitioner (GP) information transfer by discharge summaries produced in a general public hospital in New South Wales, Australia. A retrospective audit of 569 patient discharge summaries and related medical records with a targeted GP interview was performed to determine receipt and clinical value of the recorded information. The main outcome measure was the number and quality of discharge summaries received by patient‐nominated GPs. Summaries written for patients discharged from hospital were estimated to be received by the patient‐nominated GP in 27.1% of cases. Discharge summaries audited were rated as being 63.6% accurate, with errors occurring in all facets of production. The current method of discharge summary production and distribution is unacceptable. The high number of errors (36.4%) and the low rate of receipt (27.1%), indicates that resources invested in the production of the discharge summary could be better utilized to improve information transfer.
Alteration of the water balance of lakes
Authors: Basso Eduardo
Published: March 2003

Two cases of alteration of the water balance of lakes are discussed, these are: (i) alteration of the hydrological cycle due to changes in the lake basin; and (ii) alteration of the hydrological cycle due to changes in the amount of evaporation from the lake surface. In both cases, the technical aspects that result from these changes are briefly discussed, as well as the use of methods for the chemical reduction of lake evaporation.
Dominance of Cylindrospermopsis raciborskii (Nostocales, Cyanoprokaryota) in Queensland tropical and subtropical reservoirs: Implications for monitoring and management
Authors: McGregor Glenn B. , Fabbro Larelle D.
Published: March 2003

Since October 1997, 47 reservoirs and weir pools across tropical and subtropical Queensland have been regularly monitored for the occurrence of planktic cyanoprokaryotes. Cylindrospermopsis raciborskii (Woloszynska) Seenaya & Subba Raju (Nostocales, Cyanoprokaryota) was found in 70% of the storages, with one storage displaying year‐round dominance, 50% of the reservoirs seasonally dominated and a seasonal presence in 46% of the weir pools. Maxima for the majority of storages occurred from late summer through to early autumn. The precise timing of onset of seasonal maxima varied considerably between storages and regions. Temperature and stratification patterns influenced seasonal recruitment with C. raciborskii reaching seasonal maxima in southern storages generally later than the northern storages. Overall peak seasonal abundance occurred in deep strongly stratified storages. The majority of storages experiencing concentrations > 15 000 cells mL–1 tested positive to the presence of the alkaloid cytotoxin, cylindrospermopsin. Median cylindrospermopsin concentration across the 14 reservoirs in which toxin was recorded was 3.4 μg L–1. The highest toxin concentrations were generally associated with storages in which C. raciborskii had been established for a considerable period of time, or occurred after the peak summer population maxima. Toxin concentrations of 1 μg L–1 were generally associated with cell concentrations of approximately 20 000 cells mL–1, hence this cell concentration threshold was adopted as a health trigger level at which to begin monitoring for toxicity. The morphology of this species was highly variable and included straight, coiled and sigmoid‐shaped trichomes. Populations were routinely recorded as mixtures of all three morphotypes or proceeded as transitions from one morphotype to another throughout the year. The dominance of C. raciborskii appears to be favoured by a set of environmental and hydrological factors that include long water residence time, high pH, high temperature, high incident irradiation and a thermally stratified water column. The lack of visual monitoring cues, such as scum formation, variation in colour of the water body, rapid germination of large numbers of cells, highly variable morphology, relative toxicity and persistence of this species year round in many areas, continues to make this species a primary focus of water managers.
Turbid flow through a tropical reservoir (Lake Dalrymple, Queensland, Australia): Responses to a summer storm event
Authors: Faithful John W. , Griffiths Dilwyn J.
Published: March 2003

The first flood event following a prolonged dry period is described for an impoundment, Lake Dalrymple, in tropical north‐eastern Australia. The event, in January 1996, generated substantial flow in the two main inflow sources: the Burdekin River from the north and the Suttor River from the south. Flow through the Burdekin River peaked early and then subsided to a lower level, but flow through the Suttor River persisted at a moderate level for over 15 days after the initial inflow. An extensive water quality survey was conducted on 16 January 1996 (seven days after the initial dam overflow) to determine the nature of the inflows originating from the two major subcatchments feeding the reservoir as they entered and passed through the impoundment. The inflow comprising waters of high turbidity and low conductivity occupied the mid‐column region along the two major inflow channels through the impoundment to the dam wall. The suspended particulate material in the form of silt and clay sized particles remained in suspension as the flow passed through the reservoir, due in part to the low ionic strength of the inflow and the relative densities of the inflowing and receiving waters. For both river sources, more than 50% of the total nitrogen and almost all of the total phosphorus were bound to the suspended particulate matter. Much of this was exported in the flow over the spillway. The highly turbid nature of the inflow resulted in strong attenuation of down‐welling photosynthetically active radiation (up to maximum attenuation values of 12.24 m–1 in the reservoir where the euphotic depth was only 0.38 m). The irradiance reflectance and the scattering coefficient were considerably higher than any reported for other Australian inland waters. Concentrations of viable chlorophyll a in the surface waters were very low (maximum value 3.4 μg L–1) because of the highly turbid conditions and extensive dilution by the inflow. The results of this study provide an example of the significant impact a large inflow of turbid, low conductance water can have on a large reservoir in the arid tropics following a prolonged dry period. During inflow events such as the one described in this paper, the reservoir becomes riverine in nature, and large amounts of suspended particulate matter and associated nutrients are transported through the reservoir.
Optical and biological properties of Lake Ülemiste, a water reservoir of the city of Tallinn I: Water transparency and optically active substances in the water
Authors: Erm A. , Arst H. , Trei T. , Reinart A. , Hussainov M.
Published: March 2003

Optical and biological measurements were performed in Lake Ülemiste in the summer of 1997 (four measurement days), and from May to October in 1998 (12 measurement days). This kind of data, describing the type and amount of optically active substances in the water, phytoplankton characteristics, the underwater light field, and temperature–oxygen situation in the lake are necessary when estimating the ecological state of the lake. Lake Ülemiste is the main drinking water reservoir of Tallinn, the capital of Estonia. Phytoplankton abundance and biomass, chlorophyllaand suspended matter were determined from collected Lake Ülemiste water samples in the laboratory. Spectrophotometrical processing of the filtered and unfiltered water was carried out to describe the beam attenuation coefficient spectra and optical influence of yellow substance in the water. Vertical profiles of downwelling irradiance of the PAR (400–700 m) region of the spectrum (and from these data the averaged over depth diffuse attenuation coefficient) were determined. The relative transparency of the water was estimated by using a Secchi disk. Passive optical remote measurements were episodically made from aboard a boat. Results obtained confirmed that Lake Ülemiste is turbid (almost hypertrophic), comparable with most turbid lakes in Estonia (e.g. Lake Võrtsjärv) and Finland (Lake Tuusulanjärvi). Its chlorophyllacontent varied within the range 13–121 mg m–3, phytoplankton biomass 3–107 mg L–1, phytoplankton abundance 65 000–999 000 mL–1, suspended matter 8–34 mg L–1, effective concentration of the yellow substance 6–30 mg L–1, diffuse attenuation coefficient of light in the PAR region 1.0–3.3 m–1and a Secchi disk depth of 0.5–1.75 m. The temporal variation of the spatial averages of these parameters during 1998 was analysed. Almost all characteristics showed an increase from May to midsummer with a maximum in late July or in August (correspondingly the Secchi depth values were minimal in late summer). The amount of yellow substance was an exception, which was nearly constant during the observation period. The maximum level of chlorophyllacontent in July and August 1998 markedly exceeded that in 1997, despite the fact that the summer of 1997 was sunny, but the summer of 1998 was cold and rainy. The correlative relationships between the different parameters were investigated together with the respective data for other lakes. They show that the data of Lake Ülemiste supplemented the correlation graph in the region of turbid lakes, whereby in all cases the correlation coefficient increased following the addition of Lake Ülemiste data. The highest correlation coefficient was obtained when light attenuation coefficient values were correlated with a sum of weighted concentrations of chlorophylla, yellow substance and suspended matter (multiple regression analysis).
Effect of hypolimnetic discharge on the faster deprivation of phosphorus from lake sediment (Lake Jabel, north‐east Germany)
Authors: Kleeberg Andreas , Hämmerling Ronny , Nixdorf Brigitte
Published: March 2003

After the reduction in external phosphorus‐load (P‐load), in‐lake measures became practicable for eutrophic Lake Jabel. The benthic release of phosphorus (P) was efficiently suppressed by a significant nitrate supply via its main tributary. The in‐situ stimulation of P‐release as a result of the temporary decrease in this nitrate load, and the simultaneous P‐removal by deep‐water siphoning and external P‐elimination was primarily designed for the faster deprivation of P from lake sediment. This new strategy was aimed at exhausting the ‘P‐surplus’, that is, the mobile redox‐sensitive iron‐bound P‐portions of the uppermost sediment layers, where a re‐supply from deeper layers is needed within the stratification period of 2 consecutive years of operation of the P‐elimination system. By studying early benthic P‐diagenesis it remains to be demonstrated whether this procedure can contribute to a re‐availability of P‐binding sites to guarantee the long‐term effect of the measure.
Lake Baikal: Model for sustainable development of the territory
Authors: Garmaeva Tatiana
Published: March 2003

Created 20–30 million years ago, Lake Baikal is one of approximately 13 ancient lakes in the world. Lake Baikal is also the deepest lake in the world with 365 rivers flowing into it and holding a full 20% of the liquid fresh water on the surface of the Earth. The lake stretches from the south‐eastern section of Siberia to portions of northern Mongolia. Administratively, it is divided between three members of the Russian Federation: the Republic of Buryatia, Irkutsk Oblast and Chita Oblast. Lake Baikal and its catchment area are characterized by considerable biodiversity and by a vast richness of natural resources. Well over half of the 2615 plant and animal species found in the Baikal region are endemic. Lake Baikal’s unusual biota includes the Baikal seal (Phoca sibirica) which lives nowhere else on Earth and is separated by 3220 km from its nearest relative. These freshwater seals give birth to their young in snow dens on the lake’s ice. The Baikal region is a spectacular example of coexistence among different cultures and faiths over centuries. Over 1000 archaeological remains of past cultures have been found near Lake Baikal shores. Preserving the unique lake culture, values and ecological, ethnic and cultural traditions of the local people is one of the key elements in developing a model for sustainable development in the Baikal region. Lake Baikal is currently still considered clear and healthy overall, however the number and type of pollution sources are growing, and local pollution can be severe. The main sources of pollution in Lake Baikal are industrial wastes and atmospheric emissions from the Baikalsk pulp and paper mill, atmospheric emissions from nearby industrial facilities, excessive nutrient loads from farming and sediment and wastes that flow into Lake Baikal through the Selenga River. In May 1999, protection of Lake Baikal was codified in federal law for the first time. Progress is being made on a number of fronts despite the turbulent political transformations in Russia in the last 10 years. For instance, in the Irkutsk region, stakeholders have worked together to reduce the flow of unpurified drainage into the lake by 10 million m3 year–1.
Causes of animal extinction in small irrigation reservoirs in Japan and requirements for future re‐establishment
Authors: Nakasone Hideo , Kuroda Hisao , Kato Tasuku
Published: March 2003

In the past, small irrigation reservoirs were constructed only for rice paddy irrigation in Japan. Many of the watersheds for these irrigation reservoirs were forests. These watersheds have been gradually developed into farmland or housing areas. After World War II, the use of chemical fertilizers, such as ammonium sulphate, became popular in upland fields in Japan. As a result, there are high concentrations of nitrates in groundwater and spring water under upland fields. Hence, irrigation reservoirs that collect water from these watersheds have been polluted by nitrates. High nitrates concentrations in irrigation reservoirs have been found where the watershed is located close to tea yards. However, there has been minimal research into these reservoirs in the fields of limnology and agricultural engineering. We have therefore tried to verify the water‐quality characteristics in irrigation reservoirs from the point of view of water‐quality conservation. In the process of the investigation, we encountered a quite significant reservoir called the Tanno Reservoir that has not seen any forms of life. We examined the causes of this lack of life, as well as measures that could be taken for the remediation of such a reservoir. This paper discusses and clarifies the results of these studies.
Assessing environmental change through chemical‐sediment chronologies from inland lakes
Authors: Yohn Sharon S. , Long David T. , Fett Joel D. , Patino Lina , Giesy John P. , Kannan Kurunthachalam
Published: March 2003

This paper examines the hypothesis that the spatial pattern of metal accumulation rates in inland lake sediments provides insight into the causes of the historical and continued loadings of contaminants to the environment. To address this, copper and lead accumulation rates in the Great Lakes' watershed were studied. A multi‐element approach was used, in which many non‐toxic chemicals were measured along with the toxic chemicals of interest, rather than a target‐specific approach. The multi‐element approach also allowed for assessing the environmental state of the lake with respect to its surrounding watershed. Sediment cores were collected from the deepest portion of five Michigan inland lakes, sectioned, metals extracted by nitric acid, microwave digestion and leachates analysed for 26 metals using an inductively coupled, plasma, mass spectrometer with hexapole technology. Sedimentation rates, ages and focusing factors were calculated via 210Pb. Dasymetric mapping was used to estimate population distributions in lake watersheds. Watershed area was estimated from digital elevation data using Arc/INFO (ESRI, Redlands, California). The data show that as loadings from dominant (regional) sources decrease (e.g. atmospheric deposition in the case of lead), new patterns provide insight into causes for continued contaminant loadings (e.g. population density). The data also show the universal response of the watersheds to the onset of the anthropogenic loadings of lead but not that of copper. Individual watersheds had different onset times for anthropogenic copper loadings. Recent lead loadings to the environment can be related to population density, and those of copper reflect, in part, a spatial pattern that is similar to the regional pattern for lead during the mid‐1970s. As this pattern for lead could be related to a regional gradient of lead concentrations in atmospheric deposition, the same relation cannot be made for copper. The cause for this spatial pattern for copper is not clear.
Primary progressive apraxia
Authors: Kawamura Mitsuru , Mochizuki Satoshi
Published: March 2003

We have investigated the clinical symptoms and pathological findings of primary progressive apraxia (PPA) in 31 cases in the literature and four of our own cases. The mean age of onset of the initial symptoms was 60.5 years, with a slight predilection for males. The time between the onset of symptoms and the medical examination was 3.1 years. The mean duration of illness was 4.2 years for the surviving cases and 6.8 years for the four deceased cases. The most frequently encountered apraxia symptom is a limb‐kinetic apraxia. It has become known that other forms of apraxia such as apraxia of speech, buccofacial apraxia and dressing apraxia, which are not established as a symptomatic condition, can manifest themselves in an isolated manner. Neurological examination often reveals extrapyramidal symptoms such as rigidity and myoclonus from the beginning of the illness. As for the higher functional problems, apraxia is often accompanied by a distrubance of calculation. With regard to the radiological findings, computed tomography and magnetic resonance imaging show characteristic atrophy with left–right inequality and diffuse disturbance in single photon emission computed tomography‐positron emission tomography study is seen on the more severely atrophic side. In autopsy and biopsy examinations, one patient was diagnosed with corticobasal degeneration, three cases were diagnosed with Alzheimer's disease and one with Pick's disease. PPA is a heterogeneous symptomatic condition. This paper confirm the existence of apraxias which were not previously recognized as concrete symptomatic conditions; furthermore, it is suggested that the cerebral system of behavioral association might be more subdivided than was formerly considered.
Mutational analysis of human p53 gene in human gliomas by Cleavase® fragment length polymorphism
Authors: Uehara Hisao , Kawano Hirokazu , Kataoka Hiroaki , Sameshima Tetsuro , Moriyama Takuzou , Nakano Shinichi , Wakisaka Shinichiro
Published: March 2003

Cleavase® fragment length polymorphism (CFLP) is a newly developed method used for the detection of gene mutation. This study evaluates the usefulness of this method. Thirty‐three human glioma specimens obtained at surgery were analyzed for human p53 gene mutation using radiolabeled polymerase chain reaction (PCR)‐based CFLP analysis and the results were compared with results of direct sequencing. Three (one of five anaplastic astrocytomas and two of 24 glioblastomas) and five (one of four low‐grade gliomas, one of five anaplastic astrocytomas and three of 24 glioblastomas) samples were suspected as being mutations in exon 5–6 and 7–8 of the p53 gene, respectively. Further, two of three (one anaplastic astrocytoma and one glioblastoma) and two of five (both glioblastoma) samples were confirmed as having mutations in direct sequence (their positive rates were 66.7 and 40%, respectively). However, the false‐negative rate of CFLP analysis was very low (0%, 0/60). Therefore, it was concluded that although PCR‐CFLP using a radioisotope might be too sensitive given its superior false‐negative rate, it offers an alternative protocol for the screening of the mutation of human p53 gene.
Frontotemporal dementia with tauopathy: A review and preliminary immunohistochemical study of tau kinases and phosphatases
Authors: Iijima Masaaki , Tabira Takeshi
Published: March 2003

Recent work has shown that frontotemporal dementia and Parkinsonism linked to chromosome 17 (FTDP‐17) is caused by tau gene mutations. Several different exonic and intronic mutations in the tau gene heve been found in many families with FTDP‐17. Patients with tau gene mutations show a wide variety of clinicopathological conditions, such as frontotemporal dementia, corticobasal degeneration, multiple system tauopathy with presenile dementia, pallido‐ponto‐nigral degeneration, disinhibition‐dementia‐parkinsonism‐amyotrophy complex, and progressive sub‐cortical gliosis. A Japanese family of frontotemporal dementia with a missense mutation S305N in exon 10 of the tau gene is reported. Post‐mortem examination of the brain revealed ring‐shaped neurofibrillary tangles (NFT) partially surrounding the nucleus, which were most prominent in the frontal, temporal, insular, and postcentral cortices, as well as in the dentate gyrus. Cortical NFT were restricted primarily to layer II. The missense mutation S305N did not reduce the ability of tau to promote microtubule assembly. Instead, it increased splicing of exon 10. Weak immunoreactivities of kinases for tau phosphorylation were found in late‐stage NFT in the dentate gyrus, whereas strong immunoreactivities were seen in early stage NFT in the temporal cortex. PP2B was present in temporal NFT. Although anti‐PP2A antibody labeled neurons, NFT were not stained, which suggests that the activity of this phosphatase might be decreased in NFT.
Frontotemporal dementia: Pick type
Authors: Ishizu Hideki , Tanabe Yasuyuki , Tareda Seishi , Takehisa Yasushi , Haraguchi Takashi , Nishinaka Tetsuya , Kuroda Shigetoshi
Published: March 2003

The status of Pick's disease within the concept of frontotemporal dementia (FTD) is unclear. Some researchers have defined Pick's disease as FTD with Pick bodies. Alternatively, the confusion may be clarified by using the term Pick body dementia (PBD) rather than by using the term Pick's disease in a narrow sense. Pick body dementia is characterized by a prominent frontotemporal lobar atrophy, gliosis, severe neuronal loss, ballooned neurons, and the presence of neuronal inclusions called Pick bodies. In recent years, studies of Pick body dementia have advanced from the standpoint of the tau pathology. Tau‐positive glial inclusions as well as neuronal inclusions have been observed in PBD and its related disorders. Various forms of FTD have been proposed based on the presence of neuronal or glial inclusions. We propose a new variant of FTD termed ‘glial tangle‐predominant type’. More research is required to understand the tau abnormalities in the various forms of FTD.
An autopsied case of Down syndrome with Alzheimer pathology and α‐synuclein immunoreactivity
Authors: Marui Wami , Iseki Eizo , Kosaka Kenji , Kato Masanori , Adachi Yoshiki , Uéda Kenji
Published: March 2003

An autopsied case of a 49‐year‐old man with Down syndrome is described. The patient developed mental deterioration and parkinsonism at the age of 44 years. The brain revealed Alzheimer's disease (AD) pathology in addition to anomalies and lesions of premature senility. In the substantia nigra, many neurofibrillary tangles (NFT) and some Lewy bodies (LB) were found, suggesting that a limited degree of Parkinson's disease (PD) pathology may combine with AD pathology to develop parkinsonism. However, spongiform change and ubiquitin‐positive spheroids in the central nucleus of the amygdala, which are peculiar to dementia with Lewy bodies (DLB), were observed, suggesting that the substantia nigra lesion is similar to that of DLB rather than that of PD. In addition, α‐synuclein‐positive neurons in the limbic areas, predominantly in the amygdala, were found. Their incidence and distribution did not fulfill the criteria of DLB. These neurons did not show the typical features of cortical type LB, and were mostly accompanied by tau‐positive NFT. These findings suggest that the presence of α‐synuclein‐positive neurons does not always indicate the presence of LB, and that the present case should not be regarded as the complication of DLB in Down syndrome.
A novel monoclonal antibody that recognizes human perivascular cells of the central nervous system under a specific immune reaction
Authors: Yokoo Hideaki , Isoda Koji , Sakura Mizuaki , Sasaki Atsushi , Hirato Junko , Nakazato Yoichi
Published: March 2003

Perivascular cells or fluorescent granular perithelial cells of the central nervous system are newly recognized members of monocyte/macrophage populations. In this study a monoclonal antibody, GP‐3, that labels proteinous lysosomal antigen of human perivascular cells, has been established. It selectively label the cells in foamy‐macrophage infiltrating diseased areas, such as Wallerian degeneration and contusion, without significant reaction to the cells in normal areas, infiltrating macrophages or microglia. These findings suggest that the perivascular cell is an independent cell type and the antigen molecule is fairly specific to perivascular cells and plays an unknown role in immune–nervous system interaction.
Locally reduced levels of acidic FGF lead to decreased expression of 28‐kDa calbindin and contribute to the selective vulnerability of the neurons in the entorhinal cortex in Alzheimer's disease
Authors: Thorns Veronika , Licastro Federico , Masliah Eliezer
Published: March 2003

Recent studies demonstrate that a disturbed calcium‐homeostasis leading to increased susceptibility to excitotoxic triggers plays a major role in the neurodegenerative process initiating in layer 2 of the entorhinal cortex (EC2) during Alzheimer's disease (AD). Thus, proteins binding free Ca11 (i.e. calbindin) and factors regulating these proteins are of great importance for the neuroprotective–neurotoxic balance in the affected brain regions. In the present combined human and in vitro study evidence is provided that altered levels of the acidic fibroblast growth factor (aFGF) and calbindin expression are concomitantly present in EC2 neurons and have interactive effects. A dramatic loss of aFGF‐ and calbindin‐labeled EC2 neurons was found. Further analysis of the surviving EC2 neurons revealed a strong immunoreactivity to calbindin and aFGF. In vitro experiments show that aFGF regulates calbindin expression, because treatment of differentiating neurons with recombinant aFGF increases calbindin expression in a time‐dependent fashion. The data imply that a reduced expression of aFGF in EC2 neurons of AD brains leads to lower levels of calbindin resulting in decreased neuroprotective capacity.
Pathology of radiation myelopathy
Authors: Okada Shinobu , Okeda Riki
Published: March 2003

Radiation myelopathy is principally a white matter injury of the spinal cord induced by ionizing radiation after a certain latent period. It involves myelinated fibers and blood vessels, and the lateral funiculi is most preferentially affected. Several factors, such as radiation dose, fractionation or linear energy transfer, modify its occurrence and severity. Although glial cells and vascular endothelium are proposed to be the main targets, and to play a role in the pathogenesis of radiation myelopathy, experimental researches support that radiation‐induced vascular damage resulting in vascular hyperpermeability and venous exudation is a basic process. Effect of ionizing radiation on each cellular component of the central nervous system, their contribution to radiation myelopathy, mechanisms of selective permeability and remaining problems are discussed.