bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of food allergen‐specific cytokine production by T lymphocytes of children with multiple allergies
Authors: Scott‐Taylor T. H. , Hourihane J. B. , Harper J. , Strobel S.
Published: November 2005

Background
The contribution of different T cell subsets to the overall measured cytokine response to food allergens is largely unexplored.

Method
The patterns of cytokine production of peripheral blood‐derived T cells after allergen stimulation were studied in 22 children with multiple food allergies and in 20 non‐allergic children as controls, using flow cytometry.

Results
Proportions of T cells of food‐sensitized children spontaneously secreting IFN‐γ and IL‐10 (without antigen stimulation) were lower than non‐atopic children and adult controls (P0.001). The proportions of IL‐4‐producing cells in vitro were significantly increased (P0.04) and IFN‐γ‐producing cells were significantly reduced (P0.05) in sensitized children after incubation with and without dendritic cell presentation of peanut extract, β‐lactoglobulin and ovalbumin. The reverse pattern was found in non‐sensitized children and adult controls. IL‐4 secretion in allergic children to sensitizing allergens was mainly restricted to the CD4+ CD45 RO+ population while in non‐atopic controls both CD4+ and CD8+ CD45 RO+ cells produced mostly IFN‐γ. Food‐specific IgE values did not correspond with cytokine responses but IL‐4 production and IFN‐γ reduction relative to normal children were closely associated with total IgE levels.

Conclusion
Food‐allergic children's IL‐4 cytokine response to their relevant allergens is predominantly from a memory population of CD4+ CD45 RO+ cells, whereas IL‐4 and IFN‐γ secretion of non‐allergic controls was predominantly from mixed CD4+ and CD8+ CD45 RO+ populations.
Markers of platelet activation in plasma of patients suffering from persistent allergic rhinitis with or without asthma symptoms
Authors: Kasperska‐Zając A. , Rogala B.
Published: November 2005

Background
Increased circulating levels of platelet release products are detected in various types of inflammation. It has been demonstrated that allergen challenge promotes platelet activation and leads to the release of chemokines such as platelet factor 4 (PF‐4) and β‐thromboglobulin (β‐TG).

Objective
The aim of this study was to determine whether or not circulating platelets get into an activated state during allergic inflammatory reactions induced by long‐term natural exposure to allergens.

Methods
Plasma levels of PF‐4 and β‐TG (established markers of in vivo platelet activation) were determined by ELISA method in symptomatic patients with allergy to house dust mites, suffering from persistent allergic rhinitis (PAR) in the absence of asthma symptoms (12 men and 8 women; mean age 22 years) and from PAR with mild asthma (10 men and 6 women; mean age 23 years), as well as in healthy controls (10 men and 10 women; mean age 23 years).

Results
No significant differences were found between PAR patients with or without symptoms of asthma and healthy non‐atopic subjects with respect to plasma levels of PF‐4 and β‐TG as well as platelet count.

Conclusions
It seems that patients undergoing continuous natural exposure to sensitizing allergens, with subsequent PAR alone or with concomitant mild asthma, have no altered platelet activity in vivo, as reflected by plasma levels of the chemokines. These findings, in conjunction with earlier data, indicate that differences may exist in platelet activity, including releasability of platelet products between patients with distinct clinical manifestation of atopy.
Wheezing in Chinese schoolchildren: disease severity distribution and management practices, a community‐based study in Hong Kong and Guangzhou
Authors: Ko F. W. S. , Wang H. Y. , Wong G. W. K. , Leung T. F. , Hui D. S. C. , Chan D. P. S. , Zhong N. S. , Lai C. K.W.
Published: November 2005

Background
Asthma is a common chronic disease and information on its management practices at the community level is helpful in identifying problems and improving asthma care.

Objective
To assess the severity status and management of the asthma symptom of wheeze of children at the community level in Hong Kong (HK) and Guangzhou (GZ).

Methods
Cross‐sectional study of children aged 10 years using the International Study of Asthma and Allergic disease in Childhood (ISAAC Phase II protocol). Asthma management and lung function were assessed in 178 (98 from HK and 80 from GZ) randomly selected children with wheeze over the past 12 months.

Results
Eighty‐three percent, 11%, 6% and 0% of children suffered from intermittent, mild persistent, moderate persistent and severe persistent asthma, respectively, according to the frequency of their symptoms. Addition of spirometric parameter only changed the asthma severity classification in 2.8% of children. Medications were used by 30.6% and 71.3% of children for wheeze in HK and GZ, respectively. In HK, inhaled β2‐agonist (73.3% among the drug users) was the commonest medication used followed by inhaled corticosteroid (ICS) (23.3%). In GZ, inhaled β2‐agonist was used by 75.4% of children, but use of ICS (26.3%), oral β2‐agonist (26.3%), oral theophylline (45.6%), oral ketotifen (36.8%) and oral steroid (35.1%) were also common. ICS was only used by 11.4% of children with persistent asthma. Ten percent and 18.7% of children in HK and GZ, respectively, had emergency department visits, while 16.3% and 11.6% of children in HK and GZ, respectively, had missed school secondary to asthma over the past 1 year.

Conclusions
Most children in the community had intermittent asthma and addition of lung function to symptoms did not significantly affect classification of asthma severity. Significant morbidity was seen even in this group of children with mostly intermittent and mild persistent asthma.
Identification of strong interleukin‐10 inducing lactic acid bacteria which down‐regulate T helper type 2 cytokines
Authors: Niers L. E. M. , Timmerman H. M. , Rijkers G. T. , van Bleek G. M. , van Uden N. O. P. , Knol E. F. , Kapsenberg M. L. , Kimpen J. L. L. , Hoekstra M. O.
Published: November 2005

Background
Decreased exposure to microbial stimuli has been proposed to be involved in the increased prevalence of atopic disease. Such a relationship was indicated by enhanced presence of typical probiotic bacteria in the intestinal flora correlating with reduced prevalence of atopic disease. Recent clinical trials suggested that probiotic bacteria may decrease and prevent allergic symptoms, but which (different) species or strains may contribute is poorly understood.

Objective
We sought to select probiotic bacteria by their ability to modulate in vitro production of cytokines by peripheral blood mononuclear cells (PBMCs), to make a rational choice from available strains.

Methods
PBMCs, purified monocytes, and lymphocytes from healthy donors were co‐cultured with 13 different strains of probiotic bacteria. The effect of lactic acid bacteria (LAB) on different cell populations and effects on cytokine production induced by the polyclonal T cell stimulator phytohaemagglutinin (PHA) was evaluated by measuring T helper type 1, T helper type 2 (Th2), and regulatory cell cytokines in culture supernatants by multiplex assay.

Results
PBMCs cultured with different strains produced large amounts of IL‐10 and low levels of IL‐12p70, IL‐5, and IL‐13. In PHA‐stimulated PBMC cultures, the tested strains decreased the production of Th2 cytokines. Neutralizing IL‐10 production resulted in partial to full restoration of Th2 cytokine production and concurred with an increase in pro‐inflammatory cytokines such as IL‐12p70 and TNF‐α. Within the PBMCs, the CD14+ cell fraction was the main source of IL‐10 production upon interaction with LAB.

Conclusion
Our results indicate that certain strains of lactobacilli and bifidobacteria modulate the production of cytokines by monocytes and lymphocytes, and may divert the immune system in a regulatory or tolerant mode. These specific strains may be favorable to use in prevention or treatment of atopic disease.
Intensive sampling and transplantation experiments reveal continued effects of episodic acidification on sensitive stream invertebrates
Authors: KOWALIK RENATA A. , ORMEROD S. J.
Published: November 2005

1. Although mean pH is increasing in acidified streams throughout Europe, benthic invertebrates are recovering only slowly. One developing hypothesis is that acid episodes continue to restrict recolonisation and recovery. Here, we used intra‐annual sampling in replicate circumneutral, acid and episodic streams at the Llyn Brianne experimental catchments to assess possible mayfly exposure to episodic effects quantified from a risk index based on long‐term discharge. Episodic effects were then tested using short‐term transplantations of animals in enclosures.

2. No mayflies occurred in acid streams while Baetis rhodani occurred in episodic streams but declined to zero density following low pH in autumn. Ephemerella ignita, Baetis vernus, B. muticus, Rhithrogena semicolorata, Ecdyonurus spp. and Heptagenia lateralis occurred only in the circumneutral streams. The first two species were present as nymphs only during July and August so that episodic exposure risk was minimal, but the remaining species occurred as nymphs in all months.

3. Baetis rhodani transplanted during base‐flow (September 2003) and high‐flow (April 2004) were exposed to either; (i) continual (chronic) exposure in the acid streams over 16 days or (ii) repeated short‐term (episodic) exposure to acid conditions for 2 × 4 day periods interspersed with 4‐day recovery periods in the circumneutral streams. Baetis survival in the circumneutral streams (always pH > 5.7) remained high during both low‐ and high‐flow. By comparison, mortality increased (P < 0.01) during chronic and episodic exposure, but only during high‐flow (mean pH 3.8–3.9, cf. 5.5–5.8 at low flow) when mortality varied significantly in the order chronic (>80%) > episodic (>40%) >circumneutral (<10%).

4. We conclude that, despite Europe‐wide trends towards chemical recovery from acidification, even short exposures to high‐flow events at Llyn Brianne are still sufficiently acid to reduce the survival of B. rhodani. Most mayfly species absent from acid and episodic streams have life cycles that would increase acid exposure risks during autumn and winter, and this may be sufficient to explain their current distribution.
Molecular characterization and evolution of the repeating units of histone genes in Drosophila americana: coexistence of quartet and quintet units in a genome
Authors: Nagoda N. , Fukuda A. , Nakashima Y. , Matsuo Y.
Published: November 2005

Quintet and quartet repeating units of the histone genes in Drosophila americana were cloned and characterized. Nucleotide sequence analysis of the units showed that a 3175 bp unit contained the core histone genes but lacked the H1 gene (‘quartet unit’) while a 5025 bp unit contained all five histone genes (‘quintet unit’). Comparative analysis suggested that these repeating units diverged before the separation of D. americana and D. virilis. Multiple forms of H1 genes, differing by 5.8% of amino acids, were found in D. americana. The genomic organization of the histone gene family in D. americana was found to be very similar to that of D. virilis.
Natural transformation of Neisseria gonorrhoeae: from DNA donation to homologous recombination
Authors: Hamilton Holly L. , Dillard Joseph P.
Published: November 2005

Gonococci undergo frequent and efficient natural transformation. Transformation occurs so often that the population structure is panmictic, with only one long‐lived clone having been identified. This high degree of genetic exchange is likely necessary to generate antigenic diversity and allow the persistence of gonococcal infection within the human population. In addition to spreading different alleles of genes for surface markers and allowing avoidance of the immune response, transformation facilitates the spread of antibiotic resistance markers, a continuing problem for treatment of gonococcal infections. Transforming DNA is donated by neighbouring gonococci by two different mechanisms: autolysis or type IV secretion. All types of DNA are bound non‐specifically to the cell surface. However, for DNA uptake, Neisseria gonorrhoeae recognizes only DNA containing a 10‐base sequence (GCCGTCTGAA) present frequently in the chromosome of neisserial species. Type IV pilus components and several pilus‐associated proteins are necessary for gonococcal DNA uptake. Incoming DNA is subject to restriction, making establishment of replicating plasmids difficult but not greatly affecting chromosomal transformation. Processing and integration of transforming DNA into the chromosome involves enzymes required for homologous recombination. Recent research on DNA donation mechanisms and extensive work on type IV pilus biogenesis and recombination proteins have greatly improved our understanding of natural transformation in N. gonorrhoeae. The completion of the gonococcal genome sequence has facilitated the identification of additional transformation genes and provides insight into previous investigations of gonococcal transformation. Here we review these recent developments and address the implications of natural transformation in the evolution and pathogenesis N. gonorrhoeae.
A phosphorelay system controls stalk biogenesis during cell cycle progression in Caulobacter crescentus
Authors: Biondi Emanuele G. , Skerker Jeffrey M. , Arif Muhammad , Prasol Melanie S. , Perchuk Barrett S. , Laub Michael T.
Published: November 2005

A fundamental question in developmental biology is how morphogenesis is coordinated with cell cycle progression. In Caulobacter crescentus, each cell cycle produces morphologically distinct daughter cells, a stalked cell and a flagellated swarmer cell. Construction of both the flagellum and stalk requires the alternative sigma factor RpoN (σ54). Here we report that a σ54‐dependent activator, TacA, is required for cell cycle regulated stalk biogenesis by collaborating with RpoN to activate gene expression. We have also identified the first histidine phosphotransferase in C. crescentus, ShpA, and show that it too is required for stalk biogenesis. Using a systematic biochemical technique called phosphotransfer profiling we have identified a multicomponent phosphorelay which leads from the hybrid histidine kinase ShkA to ShpA and finally to TacA. This pathway functions in vivo to phosphorylate and hence, activate TacA. Finally, whole genome microarrays were used to identify candidate members of the TacA regulon, and we show that at least one target gene, staR, regulates stalk length. This is the first example of a general method for identifying the connectivity of a phosphorelay and can be applied to any organism with two‐component signal transduction systems.
Requirement of aminoacyl‐tRNA synthetases for gametogenesis and embryo development in Arabidopsis
Authors: Berg Michael , Rogers Rebecca , Muralla Rosanna , Meinke David
Published: November 2005

Aminoacyl‐tRNA synthetases (AARSs) are required for translation in three different compartments of the plant cell: chloroplasts, mitochondria and the cytosol. Elimination of this basal function should result in lethality early in development. Phenotypes of individual mutants may vary considerably, depending on patterns of gene expression, functional redundancy, allele strength and protein localization. We describe here a reverse genetic screen of 50 insertion mutants disrupted in 21 of the 45 predicted AARSs in Arabidopsis. Our initial goal was to find additional EMB genes with a loss‐of‐function phenotype in the seed. Several different classes of knockouts were discovered, with defects in both gametogenesis and seed development. Three major trends were observed. Disruption of translation in chloroplasts often results in seed abortion at the transition stage of embryogenesis with minimal effects on gametophytes. Disruption of translation in mitochondria often results in ovule abortion before and immediately after fertilization. This early phenotype was frequently missed in prior screens for embryo‐defective mutants. Knockout alleles of non‐redundant cytosolic AARSs were in general not identified, consistent with the absolute requirement of cytosolic translation for development of male and female gametophytes. These results provide a framework for evaluating redundant functions of AARSs in Arabidopsis, a valuable data set of phenotypes resulting from multiple disruptions of a single basal process, and insights into which genes are required for both gametogenesis and embryo development and might therefore escape detection in screens for embryo‐defective mutants.
Genetic diversity of the annual weedMonochoria vaginalisin southern China detected by random amplified polymorphic DNA and inter‐simple sequence repeat analyses
Authors: LI W G , SHEN J J , WANG J B
Published: November 2005

Two molecular genetic screening techniques, RAPD (random amplified polymorphic DNAs) and ISSR (inter‐simple sequence repeats), were applied to detect the level and pattern of genetic diversity ofMonochoria vaginalis, a common weed of rice fields, in seven populations from southern China. Among these populations, 116 bands were amplified by 18 RAPD primers, of which 34 bands (29.31%) were polymorphic, and 14 ISSR primers produced 111 bands with 87 polymorphic bands (78.38%). Within each population, a relatively low level of genetic diversity was detected by both RAPD and ISSR analyses, with a mean genetic diversity (H) of 0.0348 and 0.0551 respectively. Analysis of molecular variance of the data from the RAPD and ISSR markers detected that the majority of total genetic variation existed among populations (73.50% and 76.70% respectively) and only minor genetic variation within populations (26.50% and 23.30% respectively). Cluster analysis divided the seven populations into two groups, indicating that the genetic relationships among populations have relatively low correlation with their geographical distribution (Mantel test;r = 0.45 and 0.48 respectively). Our results indicated that both RAPD and ISSR markers were effective and reliable for accurately assessing the degree of genetic variation ofM. vaginalis. Comparing the two techniques, ISSR markers were more efficient than the RAPD assay. The Mantel test gaver = 0.16, suggesting no correlation between these two molecular markers.
Competitive interactions in mixtures of broccoli and Chenopodium album grown at two UV‐B radiation levels under glasshouse conditions
Authors: FURNESS N H , JOLLIFFE P A , UPADHYAYA M K
Published: November 2005

Ultraviolet‐B radiation effects on intra‐ and interspecific competition in broccoli (Brassica oleracea) and Chenopodium album were studied using bivariate factorial experiments. A randomized block design was used in which three monoculture densities for each species [144 (low), 256 (medium), and 400 (high) plants m−2] and all binary combinations were grown in a glasshouse at two (4 and 7 kJ m−2 day−1) UV‐BBE radiation levels for 4 weeks in 1999 and 5 weeks in 2000. Inverse yield–density relationships were more discernible at 4, compared with 7 kJ m−2 day−1 UV‐BBE radiation. Substitution rates, indicating the balance of intra‐ to interspecific competitive effects, declined for broccoli at 7, compared with 4 kJ m−2 day−1 UV‐BBE radiation, largely because of reduced interspecific competitive influences. Conversely, substitution rates increased for C. album grown at 7 kJ m−2 day−1 UV‐BBE radiation, as a result of both decreased intraspecific and increased interspecific competition. Interspecific competitive effects were influenced more than intraspecific competitive effects by UV‐B radiation. Based on relative magnitude of substitution rates, C. album was a stronger competitor than broccoli at 4 kJ m−2 day−1 UV‐BBE radiation in both years, and at 7 kJ m−2 day−1 UV‐BBE radiation in 1999. In 2000, broccoli was the stronger competitor at 7 kJ m−2 day−1 UV‐BBE radiation. Overall, the relative competitiveness of broccoli was enhanced, while that of C. album diminished at 7, compared with 4 kJ m−2 day−1 UV‐BBE radiation. These findings indicate that above‐ambient UV‐B radiation has the potential to alter crop–weed competitive interactions, which could change acceptable weed threshold levels.
Host specificity of Fusarium oxysporum Schlect (isolate PSM 197), a potential mycoherbicide for controlling Striga spp. in West Africa
Authors: MARLEY P S , KROSCHEL J , ELZIEN A
Published: November 2005

The ability of Fusarium oxysporum (PSM 197), a potential mycoherbicide for control of Striga hermonthica, to control different Striga species (S. hermonthica, S. asiatica and S. gesneroides) and another parasitic weed, Alectra vogelli, was investigated under glasshouse conditions. Significant reductions in the total number of emerged plants of S. asiatica (91.3%), S. gesneroides (81.8%) and S. hermonthica (94.3%) were achieved in the presence of F. oxysporum (PSM 197). The pathogen only caused a reduction of 8.5% in A. vogelli. This high susceptibility of the three Striga species provides a possible opportunity to control these parasites simultaneously with this mycoherbicide.
Non‐melanoma skin cancer in Catalonia. A community‐based prevalence study
Authors: Estrada Jordi Graells
Published: November 2005

Introduction  Accurate epidemiologic studies of non‐melanoma skin cancer in South Europe are nearly absent. Incidence studies based on treated cases are difficult and may overlook asymptomatic tumors. Studying cohorts of populations in order to establish prevalence data are necessary to give realistic impressions of the problem.

Materials and methods  A population‐based cohort of 1000 women was examined for skin cancer. The sample was obtained from women attending a massive campaign of mammography addressing all women aged 50–65 years in the area of Sant Boi de Llobregat, Catalonia, Spain. Examination included full body areas, except those covered by underwear or hair, and feet.

Results  Nine cases of basal cell carcinoma were histologically confirmed, resulting in a prevalence of 900 cases in 105 (95% CI 601; 1198). Five of them were located on the trunk, in non‐exposed sites.

Conclusion  The prevalence of basal cell carcinoma found in our population is one of the highest reported in Europe. A significant proportion of tumors are on the trunk, suggesting the existence of a high proportion of undetected cases. Similar studies in 5–10‐year intervals could aid detection of changing trends in the prevalence of skin cancer in our population.
The psoriasis disability index in Chinese patients: contribution of clinical and psychological variables
Authors: Yang Yong , Koh David , Khoo Lawrence , Nyunt Shwe Zin , Ng Vivian , Goh Chee Leok
Published: November 2005

Objectives  To provide a description of medical and psychological aspects of Chinese psoriasis patients, and to examine the specific contribution of demographic, medical and psychological variables to the Psoriasis Disability Index.

Methods  Ninety‐three Chinese psoriasis patients underwent a clinical assessment using the Psoriasis Area and Severity Index (PASI) and completed a questionnaire that included questions on demographic and medical data, the Hospital Anxiety and Depression Scale (HADS) and the Psoriasis Disability Index (PDI).

Results  Psoriasis patients with cosmetic involvement had higher levels of anxiety and depression and higher disability scores than those without cosmetic involvement. Thirty‐four per cent of the patients reported a significant level of anxiety (HADS‐anx. > 11). The clinical severity of psoriasis was not associated with psychological and PDI scores. Multiple regression analysis indicated that psychological variables were associated with PDI scores, and explained 30% of the variance. However, demographic and psoriasis severity variables explained only 6% of the variance.

Conclusion  Psoriasis patients suffer from anxiety and depression. Psychological factors are much stronger determinants of the PDI than demographic, disease related variables. Clinical management of the disease should consider both clinical and psychological factors.
Skin diseases in Turkish renal transplant recipients
Authors: Alper Sibel , Kilinc Isil , Duman Soner , Toz Huseyin , Ceylan Can , Unal Idil , Aytimur Derya
Published: November 2005

Background  Organ transplant recipients are predisposed to a variety of cutaneous complications due to immunosuppressive therapy. We aimed to determine the prevalence and the clinical spectrum of skin diseases in renal transplant recipients (RTRs).

Methods  One hundred and eleven RTRs were examined at the Renal Transplantation Center in Ege University Hospital between October 1999 and October 2001. The effects of age, gender and duration time after transplantation on cutaneous manifestations were evaluated and the dermatologic manifestations in RTRs were compared with findings in a control group consisting of 100 patients. The t‐test, χ2 test and Fisher's exact test were used for statistical analysis.

Results  Seventy‐five patients (66.4%) had an infection of the skin, 66 patients (58.4%) had drug‐related manifestations, and 11 patients (9.7%) had premalignant or malignant skin lesions. Human papilloma virus (HPV) infections were the most common skin lesions. There was no significant relation between age and gender and the incidence of skin diseases in RTRs. The incidence of HPV infections, tinea versicolor and premalignant and malignant lesions increased with the duration of immunosuppression. The incidence of infectious skin diseases, especially HPV infections and tinea versicolor, was higher in the study group than in the control group.

Conclusions  In this study, we observed that cutaneous lesions, especially those caused by infectious diseases, had a higher frequency in RTRs. The findings emphasize the importance of regular dermatological screening in these patients, which can provide early diagnosis and a better quality of life for RTRs.
Case of pemphigus vulgaris in oral mucosa showing an extension to the body surface with recurrent varicella
Authors: Horiguchi Yuji , Fujii Shinobu , Takase Sawako , Mori Ryoko
Published: November 2005

A 60‐year‐old female with pemphigus vulgaris limited to the oral mucosa being treated with prednisolone showed a widespread extension of lesions to the body and extremities over a short period. The eruptions on the body began as small vesicles that looked unlike the blisters of pemphigus vulgaris, and increased to large blisters and erosions compatible with pemphigus. A smear test of the vesicles in the early stage demonstrated multinucleated acantholytic keratinocytes, which were positively stained with an antivaricella zoster virus (VZV) antibody by the immunoperoxidase method. The widespread eruptions improved immediately after 5 days’ administration of valaciclovir hydrochloride tablets and increased dosage of prednisolone, leaving tiny shallow scars and pigmentation. The anti‐VZV antibody in the serum was not elevated, and there were no zosteriform eruptions noted during the course. We thought that widespread extension of the pemphigus vulgaris in this case was provoked by recurrent varicella, in a similar fashion to Koebner phenomenon.
Disseminated coccidioidomycosis with cutaneous lesions clinically mimicking mycosis fungoides
Authors: Crum Nancy F.
Published: November 2005

This report describes the second known case of disseminated coccidioidomycosis mimicking mycosis fungoides since the original description more than 100 years ago. Coccidioidomycosis should be considered in persons from an endemic area presenting with nonhealing or suspicious skin lesions. Diagnosis is established by skin biopsy and silver staining showing granulomas and classic Coccidioides immitis spherules. Disseminated coccidioidomycosis most commonly involves the skin and can have a variety of cutaneous manifestations. The first description of a Coccidioides immitis infection in 1892 was initially diagnosed as mycosis fungoides. We present the second case of coccidioidomycosis masquerading as mycosis fungoides.
A case of erythema elevatum diutinum associated with breast carcinoma
Authors: Yilmaz Fikriye , Araç Mehmet , Çiftçioglu M. Akif , Yilmaz Ertan
Published: November 2005

A 53‐year‐old woman diagnosed with invasive ductal‐type breast carcinoma was referred to our clinic with red–purple lesions on the hands and legs. She had neither pruritus nor pain. The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy.

Dermatologic examination revealed reddish‐violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints (Fig. 1). Multiple red–purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2). The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal.

Violaceous papules and plaques on the dorsal hands

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Red–purple, circumscribed, papules and plaques over the shins

image

A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3).

Predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (hematoxylin and eosin stain, ×100)

image

Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection.

In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy. Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed.

Healed lesion 3 weeks after high‐potency topical glucocorticoids

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Bullous pemphigoid with nail loss
Authors: Gualco Francesco , Cozzani Emanuele , Parodi Aurora
Published: November 2005

The nail can be affected in autoimmune bullous diseases. Because of the different antigens involved, nails are often affected in epidermolysis bullosa acquisita (EBA), but not in bullous pemphigoid (BP). We describe an unusual case of BP with permanent loss of toenails.
Optimal management of a flammable forest providing timber and carbon sequestration benefits: an Australian case study*
Authors: Spring Daniel , Kennedy John , Nally Ralph Mac
Published: November 2005

In deciding to keep or fell a forest stand given its age, the risk of loss of timber through wildfire is an important consideration. If trees also have value from sequestration of carbon, another effect of fire is the unplanned loss of stored carbon. Factors affecting the decision to keep or fell trees, and how much to spend on fire protection, are investigated using stochastic dynamic programming, using carbon sequestration in stands of mountain ash in Victoria as a case study. The effect of treating sawlogs as a permanent carbon sink after harvesting is explored.
GM crop technology and trade restraints: economic implications for Australia and New Zealand*
Authors: Anderson Kym , Jackson Lee Ann
Published: November 2005

How much might the potential economic benefit from enhanced farm productivity associated with crop biotechnology adoption by Australia and New Zealand (ANZ) be offset by a loss of market access abroad for crops that may contain genetically modified (GM) organisms? This paper uses the Global Trade Analysis Project (GTAP) model to estimate effects of other countries' GM policies without and with ANZ farmers adopting GM varieties of various grains and oilseeds. The gross economic benefits to ANZ from adopting GM crops under a variety of scenarios could be positive even if the strict controls on imports from GM‐adopting countries by the European Union are maintained, but not if North‐East Asia also applied such trade restaints. From those gross economic effects would need to be subtracted society's evaluation of any new food safety concerns and negative environmental externalities (net of any new environmental and occupational health benefits), as well as any extra costs of segregation, identity preservation and consumer search.
Intergenerational Earnings Mobility in Norway: Levels and Trends*
Authors: Bratberg Espen , Anti Nilsen Øivind , Vaage Kjell
Published: November 2005

Using longitudinal data for Norwegian children born in 1950, 1955, 1960 and 1965, we find a relatively high degree of earnings mobility. There is no tendency toward decreasing mobility over the cohorts. Conditioning on the position in the earnings distribution, the analysis indicates quite high mobility in the middle of the distribution and somewhat more persistence at the top and bottom. This approach also reveals increased mobility over time for sons, but a less clear picture for daughters.
Optimal Workfare with Voluntary and Involuntary Unemployment*
Authors: Kreiner Claus Thustrup , Tranæs Torben
Published: November 2005

This paper addresses the welfare implications of introducing workfare into unemployment benefit policy. We consider a population composed of employed and unemployed workers and of individuals who do not seek employment. Job search behavior is unobservable, which means that voluntarily unemployed individuals can claim unemployment insurance (UI) benefits intended for unemployed workers. As a consequence, pecuniary benefit schemes underinsure workers against unemployment. We show that requiring unproductive activities (workfare) in exchange for UI benefits may generate a Pareto improvement by facilitating better unemployment insurance for workers, and we characterize the situations where this is the case.
Social behavior and cortisol reactivity in children with fragile X syndrome
Authors: Hessl David , Glaser Bronwyn , Dyer‐Friedman Jennifer , Reiss Allan L.
Published: November 2005

Objective:  To examine the association between limbic‐hypothalamic‐pituitary‐adrenal (L‐HPA) axis reactivity and social behavior in children with fragile X syndrome (FXS).

Method:  Salivary cortisol changes and concurrent anxiety‐related behaviors consistent with the behavioral phenotype of FXS were measured in 90 children with the fragile X full mutation and their 90 unaffected siblings during a social challenge task in the home.

Results:  Boys and girls with FXS demonstrated more gaze aversion, task avoidance, behavioral signs of distress, and poorer vocal quality than the unaffected siblings. Multiple regression analyses showed that after accounting for effects of IQ, gender, age, quality of the home environment, and basal cortisol level, cortisol reactivity to the task was significantly associated with social gaze in children with FXS. The most gaze‐aversive children with FXS had cortisol reductions, whereas those with more eye contact demonstrated the most cortisol reactivity. Unaffected siblings demonstrated an opposite pattern in which less eye contact was associated with increased cortisol reactivity.

Conclusions:  Results of the study suggest a unique relation between abnormal gaze behavior and L‐HPA mediated stress reactivity in FXS.
Fine‐motor skill deficits in childhood predict adulthood tic severity and global psychosocial functioning in Tourette's syndrome
Authors: Bloch Michael H. , Sukhodolsky Denis G. , Leckman James F. , Schultz Robert T.
Published: November 2005

Background: Most children with Tourette's syndrome (TS) experience a significant decline in tic symptoms during adolescence. Currently no clinical measures have been identified that can predict whose tic symptoms will persist into adulthood. Patients with TS have deficits on neuropsychological tests involving fine‐motor coordination and visual‐motor integration. We seek to determine if these neuropsychological tests are useful in predicting future symptom severity.

Methods: Thirty‐two children, aged 8–14, with TS underwent clinical evaluation and a focused neuropsychological testing battery consisting of the Purdue Pegboard, Beery Visual‐Motor Integration (VMI) Test and the Rey‐Osterreith Complex Figure Task (RCFT). A follow‐up clinical assessment was performed on these children an average of 7.5 years later. Ordinal logistic regression analysis was used to correlate neuropsychological testing at Time 1 with tic severity, OCD severity and global psychosocial functioning at Time 2.

Results: Poor performance with the dominant hand on the Purdue Pegboard test predicted worse adulthood tic severity and correlated with tic severity at the time of childhood assessment. Poor performance on the VMI and Purdue Pegboard tests (both dominant and non‐dominant hand) also predicted worse adulthood global psychosocial functioning. None of the neuropsychological tests were useful in predicting the future course of OCD symptoms in TS patients.

Conclusion: Fine motor skill deficits may be a predictor of future tic severity and global psychosocial function in children with TS. We hypothesize that performance on the Purdue Pegboard test may serve as a useful endophenotype in the study of TS and provide a rough measure of the degree of basal ganglia dysfunction present in TS patients.
Studying health information from a distance: refining an e‐learning case study in the crucible of student evaluation
Authors: Booth Andrew , Levy Philippa , Bath Peter A. , Lacey Terence , Sanderson Mark , Diercks‐O’Brien Gabi
Published: November 2005

Purpose: To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning.

Setting/Participants/Resources: First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield.

Methodology: Individual qualitative user surveys and interviews.

Results/Outcomes: Formative evaluation has played a significant role in refining the case study through its text‐based, intermediate and CD‐ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current.

Discussion/Conclusion: The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration.
A strategic approach to developing e‐learning capability for healthcare
Authors: Clarke Angie , Lewis Dina , Cole Ian , Ringrose Liz
Published: November 2005

Objectives:  This article examines a strategic approach to developing e‐learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e‐learning developments are considered.

Methods:  The 2‐year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e‐learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented.

Results:  The MLE has been piloted and on‐line learning packages have been acquired. There has been a phased take‐up of e‐learning opportunities and e‐tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning.

Conclusions:  The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e‐learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints—the MLE's benefits are widely recognized.
Effective e‐learning for health professionals and students—barriers and their solutions. A systematic review of the literature—findings from the HeXL project
Authors: Childs Sue , Blenkinsopp Elizabeth , Hall Amanda , Walton Graham
Published: November 2005

Introduction: In 2003/4 the Information Management Research Institute, Northumbria University, conducted a research project to identify the barriers to e‐learning for health professionals and students. The project also established possible ways to overcome these barriers. The North of England Workforce Development Confederation funded the project.

Methodology: The project comprised a systematic review of the literature on barriers to and solutions/critical success factors for e‐learning in the health field. Fifty‐seven references were suitable for analysis. This review was supplemented by a questionnaire survey of learners and an interview study of learning providers to ensure that data identified from the literature were grounded in reality.

Results: The main barriers are: requirement for change; costs; poorly designed packages; inadequate technology; lack of skills; need for a component of face‐to‐face teaching; time intensive nature of e‐learning; computer anxiety.

A range of solutions can solve these barriers. The main solutions are: standardization; strategies; funding; integration of e‐learning into the curriculum; blended teaching; user friendly packages; access to technology; skills training; support; employers paying e‐learning costs; dedicated work time for e‐learning.

Conclusions: The authors argue that librarians can play an important role in e‐learning: providing support and support materials; teaching information skills; managing and providing access to online information resources; producing their own e‐learning packages; assisting in the development of other packages.
A simple in vitro model for investigating epithelial/mesenchymal interactions: keratinocyte inhibition of fibroblast proliferation and fibronectin synthesis
Authors: HARRISON CAROLINE A. , DALLEY ANDREW J. , MAC NEIL SHEILA
Published: November 2005

Hypertrophic scarring and graft contracture are major causes of morbidity after burn injuries. It is well established that application of a split‐thickness skin graft reduces scarring and contraction, and cultured epithelial autografts have a similar effect. To investigate the influence of keratinocytes on fibroblast proliferation and fibronectin synthesis, we used an in vitro separated co‐culture model in which epithelial sheets were cultured above fibroblast monolayers without physical contact. We also investigated the response of fibroblasts to keratinocyte‐conditioned medium (KCM) obtained from confluent and subconfluent keratinocyte monolayers. Both cultured epithelial sheets, composed of adherent fully confluent keratinocytes, and their conditioned medium, reduced fibroblast proliferation. However, KCM from subconfluent keratinocytes stimulated fibroblast proliferation at low concentrations while inhibiting it at higher concentrations, indicating that keratinocytes can produce both mitogenic and growth‐inhibiting factors for fibroblasts. KCM, but not epithelial sheet co‐culture, also inhibited fibroblast fibronectin synthesis. This indicates regulation of fibroblast phenotype by soluble factors released by the keratinocyte and also suggests that there is a dialogue between keratinocytes and fibroblasts with respect to fibronectin production. We conclude that this separated co‐culture model is a simple way to study epithelial/mesenchymal communication particularly with respect to the role of the fibroblast in wound healing.
Hyperoxia and angiogenesis
Authors: HOPF HARRIET W. , GIBSON JEFFREY J. , ANGELES ADAM P. , CONSTANT JAMES S. , FENG JOHN J. , ROLLINS MARK D. , ZAMIRUL HUSSAIN M. , HUNT THOMAS K.
Published: November 2005

We hypothesized that tissue hyperoxia would enhance and hypoxia inhibit neovascularization in a wound model. Therefore, we used female Swiss‐Webster mice to examine the influence of differential oxygen treatment on angiogenesis. One milliliter plugs of Matrigel®, a mixture of matrix proteins that supports but does not itself elicit angiogenesis, were injected subcutaneously into the mice. Matrigel® was used without additive or with added vascular endothelial growth factor (VEGF) or anti‐VEGF antibody. Animals were maintained in hypoxic, normoxic, or one of four hyperoxic environments: hypoxia—13 percent oxygen at 1 atmosphere absolute (ATA); normoxia—21 percent oxygen at 1 ATA; hyperoxia—(groups a–d) 100 percent oxygen for 90 minutes twice daily at the following pressures: Group a, 1 ATA; Group b, 2 ATA; Group c, 2.5 ATA; Group d, 3.0 ATA. Subcutaneous oxygen tension was measured in all groups. The Matrigel® was removed 7 days after implantation. Sections were graded microscopically for the extent of neovascularization. Angiogenesis was significantly greater in all hyperoxic groups and significantly less in the hypoxic group compared with room air‐exposed controls. Anti‐VEGF antibody abrogated the angiogenic effect of both VEGF and increased oxygen tension. We conclude that angiogenesis is proportional to ambient pO2 over a wide range. This confirms the clinical impression that angiogenesis requires oxygen. Intermittent oxygen exposure can satisfy the need for oxygen in ischemic tissue.
Age‐dependent response of primary human dermal fibroblasts to oxidative stress: cell survival, pro‐survival kinases, and entrance into cellular senescence
Authors: GURJALA ANANDEV N. , LIU W. ROBERT , MOGFORD JON E. , PROCACCINI PIERO S. A. , MUSTOE THOMAS A.
Published: November 2005

A central question in cell biology is how cells become senescent. After a finite number of cell divisions, normal cultured human cells enter a state of irreversible growth arrest, termed “replicative senescence.” Alternatively, oxidative stress in the form of hydrogen peroxide (H2O2) can render human dermal fibroblasts (HDFs) nonproliferative and quiescent, a phenomenon known as stress‐induced premature senescence (SIPS). Although critical to the understanding of the pathophysiological basis of many diseases, there is no research to date that has simultaneously examined the interactions between age, oxidative stress, and SIPS. Therefore, the goals of this study were to examine in concert the interactions between these three factors in primary HDFs, and to test our central hypothesis that aging lowers the ability of primary HDFs to respond to oxidative stress. Our data provide, for the first time, evidence that aging dramatically reduces the capacity of primary HDFs to respond to the challenge of hydrogen peroxide. Specifically, aged HDFs showed decreased cell viability, decreased phosphorylation (activation) of pro‐survival kinases (Akt and ERK 1/2), and increased entrance into a senescent state when compared with their younger counterparts. Another important conclusion of this study is that blockade of transforming growth factor‐β1 had a pronounced “rescue effect” in the aged, preventing entrance of HDFs into cellular senescence.