bluuebunny/crossref_metadata_2025 huggingface dataset:
Lead ion adsorption on montmorillonite–Al hydroxide polymer systems
Authors: Janssen R. P. T. , Bruggenwert M. G. M. , Van Dijk G. , Van Riemsdijk W. H.
Published: March 2007

Clay–Al hydroxide polymer systems (CAlHO) can bind heavy metals effectively. Their adsorption behaviour depends on the type of metal. We studied the dependence of Al‐loading and pH on the adsorption of Pb to Na‐saturated montmorillonite–Al hydroxide polymer systems. The available binding sites on the Al hydroxide polymers (AlHO) had a strong affinity for Pb ions, whereas a minor amount of Pb was bound to the clay surface. The pH had a pronounced effect on the Pb binding to the AlHO. At pH 6.0, AlHO effectively adsorbed Pb. The amount of Pb adsorbed to the AlHO, expressed per mole Al, increased with increasing amount of AlHO fixed. Lead bound to the AlHO could easily be removed by exchange and is therefore reversibly bound to the AlHO. Probably, Pb is outer‐sphere bound to the AlHO and an electrostatic bonding mechanism is involved. At pH 5.0 there was almost no adsorption of Pb to the AlHO, and the adsorption of Pb to the clay surface was limited because Al3+ ions competed with Pb2+ for exchangeable sites. At pH 6.6 and relatively large Pb concentrations, separate precipitates of Pb(OH)2 and Al(OH)3 were formed. Results from experiments in pure clay systems suggest that the Pb(OH)2 precipitate was present as positively charged Pb polymers.
Stream ecosystem responses to spatially variable land cover: an empirically based model for developing riparian restoration strategies
Authors: JOHNSON THOMAS E. , MCNAIR JAMES N. , SRIVASTAVA PUNEET , HART DAVID D.
Published: March 2007

1. The restoration of native, forested riparian habitats is a widely accepted method for improving degraded streams. Little is known, however, about how the width, extent and continuity of forested vegetation along stream networks affect stream ecosystems.

2. To increase the likelihood of achieving restoration goals, restoration practitioners require quantitative tools to guide the development of restoration strategies in different catchment settings. We present an empirically based model that establishes a relationship between a ‘stress’ imposed at different locations along a stream by the spatial pattern of land cover within catchments, and the response of biologically determined ecosystem characteristics to this stress. The model provides a spatially explicit, quantitative framework for predicting the effects of changes in catchment land cover composition and spatial configuration on specific characteristics of stream ecosystems.

3. We used geospatial datasets and biological data for attached algae and benthic macroinvertebrates in streams to estimate model parameters for 40 sites in 33 distinct catchments within the mid‐Atlantic Piedmont region of the eastern U.S. Model parameters were estimated using a genetic optimisation algorithm. R2 values for the resulting relationships between catchment land cover and biological characteristics of streams were substantially improved over R2 values for spatially aggregated regression models based on whole‐catchment land cover.

4. Using model parameters estimated for the mid‐Atlantic Piedmont, we show how the model can be used to guide restoration planning in a case study of a small catchment. The model predicts the quantitative change in biological characteristics of the stream, such as indices of species diversity and species composition, that would occur with the implementation of a hypothetical restoration project.
Information and self‐management needs of people living with bleeding disorders: a survey
Authors: BARLOW J. H. , STAPLEY J. , ELLARD D. R. , GILCHRIST M.
Published: March 2007

Summary.  The aim of the study was to conduct a survey of information and self‐management needs among members of the UK Haemophilia Society (HS). Of 1082 members mailed, 307 took part in the survey, the mean age was 52.4 years (SD 14.8), 85% were male, 96% white and 66% were living with haemophilia A. 90% felt that there is a lack of understanding amongst the public regarding bleeding disorders, 76% felt that health professionals understood their health and information needs and 32% had experienced problems managing anxiety and or depression. Results suggest that there was a ‘stigma’ attached to having a bleeding disorder and almost half are very careful about informing others that they have a bleeding disorder. Self‐efficacy was relatively high within the sample. Many respondents wanted to be kept informed about current research and the opportunity to participate in research. Women experienced a greater need for more information than men, particularly in the area of the ‘medical management’ and ‘emotional’ topics. Men appeared to need more information and or training on ‘physical’ aspects such as physiotherapy and joint replacement. The study provides an insight into the educational and self‐management needs of those affected by bleeding disorders and highlights the importance of providing accessible information.
Nursing and medical documentation on patients’ cultural background
Authors: Gebru Kerstin , Åhsberg Elizabeth , Willman Ania
Published: March 2007

Aims and objectives.  To investigate if, and to what extent, nursing and medical documentation in patient records include entries on cultural background.

Background.  Health care professionals in Sweden may have difficulties in providing satisfactory care, due to lack of knowledge about immigrants’ background. According to Swedish law the information needed to guarantee safe care must be specified in the patients’ records. It is, therefore, important to investigate what information nurses and physicians document on patients’ cultural background.

Design and methods.  In this descriptive study, archival data concerning older and terminally ill patients were analysed retrospectively. The sample consisted of records from 121 patients ≥65 years at the time of death, who were born abroad and died during the year 1999. Content analysis was used to interrogate data collected from patient records, which related to the patient's cultural background. Entries (sentences or portion of sentences) were identified, coded and categorized using Leininger's Sunrise Model.

Results.  From the patient records, entries could be related to all the factors in the upper part of the Sunrise Model. Some factors were found in all records, and all factors, except technological factors, could be traced across the patients’ records. Information concerning folk/lay care could not be found.

Conclusions.  The results from this study indicate that nurses’ and physicians’ documentation in patient records included all factors in the Sunrise Model except technological. The overall impression is that the documentation is partly atomistic and insufficient as cultural assessment.

Relevance to clinical practice.  Even if the health care personnel want to reduce the amount of documentation produced, this study highlighted the importance of documentation on cultural factors. To save time the nursing documentation could be based on the Sunrise Model and structured according to the VIPS model.
Never‐ending making sense: towards a substantive theory of the information‐seeking behaviour of newly diagnosed cancer patients
Authors: McCaughan Eilis , McKenna Hugh
Published: March 2007

Aim.  The aim of this paper was to report a study which explored the information‐seeking behaviour of patients newly diagnosed with cancer in the immediate postdiagnosis period.

Background.  Information is an important tool for cancer patients. There is evidence that patients’ information needs are not being adequately met and, in many cases, patients often do not recall much information at the time of diagnosis.

Method.  Using a grounded theory approach, a theoretical sample of 27 newly diagnosed patients was interviewed in their own homes. Data were analysed using grounded theory analysis procedures.

Results.  A substantive theory describing the transitions from ‘being traumatized’ by the diagnosis, through a phase of trying to ‘take it on’, through to ‘taking control’ is tentatively offered. It provides a theoretical framework to understand newly diagnosed cancer patients’ changing, varied and continuing needs and their efforts to regain some control over their lives. Their information‐seeking behaviour seemed a journey of ‘never‐ending making sense’ with ongoing discovery and new information needs as they struggled with the effects of the disease and treatments.

Conclusions.  The processes and stages identified in this study provide nurses with a framework to assess the readiness of patients to receive information and to assist them in their efforts to regain some control over their disease and their lives.

Relevance to clinical practice.  Health professionals need to be aware of these stages, to be equipped to assess the need of individuals for information and support.
Factors predicting perceived improved health after emergency room visits
Authors: Wong Frances KY , Liu Jiexin , Chang Katherine , Chow Susan K Yee
Published: March 2007

Aim.  This study examines the key factors contributing to perceived improved health after emergency room (ER) visits.

Background.  Perceived health is a subjective measure of health status. It is an important and useful concept in nursing and assessment of health services because it reflects the clients’ own assessment of his/her health, which may have led to their subsequent health‐seeking behaviour.

Methods.  Secondary analysis of a main study which aimed at examining the effects of nurse follow‐up on ER revisits using randomized‐controlled trial. In this study, binary logistic regressions were conducted to identify factors associated with the dependent variable, perceived improved health 30 days after the index ER visit. Data were collected from 795 subjects and the sources of data were from medical records and telephone interviews.

Results.  Gender, income, usual practice in managing minor illness, what to do other than attending the ER, nurse follow‐up, general self‐rated health, triage, considered other doctors on the day of index ER visit, times of attending general outpatient clinic and times of attending general practitioner were found to be significantly associated with perceived improved health 30 days after the index ER visit.

Conclusion.  Many of the variables identified in this study that predicted perceived improved health concurred with previous findings. What is of interest is that nurse follow‐up but not multiple medical consultations helped enhance perceived improved health. We speculate that there was no continuity of care in the multiple medical consultations. Where as in the nurse follow‐up, the nurse was able to follow through the care of individuals, monitor their progress and make appropriate referrals. This study shows that the nurse is an appropriate person to mediate the health needs of individuals and the healthcare system and to enhance health maintenance for individuals in the community without excessively using medical services.

Relevance to clinical practice.  The nurses providing care during the transitional phase should not only include the traditional clinical or hospital system variables, but should also take into account the general health perception of patients, because these are the predictors of health services utilization and morbidity.
Differentiation of Human Tumour‐associated Dendritic Cells into Endothelial‐like Cells: An Alternative Pathway of Tumour Angiogenesis
Authors: Gottfried E. , Kreutz M. , Haffner S. , Holler E. , Iacobelli M. , Andreesen R. , Eissner G.
Published: March 2007

Until recently, the only accepted mechanism of tumour vascularization was the sprouting of endothelial cells (EC) from pre‐existing vessels, while recent studies suggest the contribution of stem cell‐derived endothelial progenitors as well as cells from the myeloid lineage. Here, we show a new way of endothelial differentiation that involves the specific modulation of monocytes by the tumour environment. The tumour milieu is characterized by the presence of cytokines and lactate which induce the differentiation of tumour‐invading monocytes into tumour‐associated dendritic cells (DC). Additional incubation of tumour‐associated DC with pro‐angiogenic factors, such as vascular endothelial growth factor and oncostatin M, led to transdifferentiation into endothelial‐like cells. The cells showed strong expression of von Willebrand factor and VE‐Cadherin, both classical EC markers, while leukocytic markers were reduced. In addition, they were able to form network‐like structures on matrigel, which could be blocked by the DNA‐based drug Defibrotide. This finding may be of great therapeutic relevance for tumour therapy.
Arabic version of Skindex‐16: Translation and cultural adaptation, with assessment of reliability and validity
Authors: AlGhamdi Khalid M. , AlShammari Sulaiman A.
Published: March 2007

Background  Quality‐of‐life is increasingly recognized as an important measure in dermatology; however, most currently available dermatologic quality‐of‐life measures were originally created for the English language. Skindex‐16 being one, is a self‐administered questionnaire covering the symptoms, emotions and functioning aspects.

Objectives  Our aim was to translate into Arabic and culturally adapt Skindex‐16 following the international guidelines for cross‐cultural adaptation of health‐related quality‐of‐life measures. Moreover, its validity and reliability would be assessed.

Methods  Translation and transcultural adaptation of Skindex‐16 were performed. Subsequently, a cross‐sectional study was conducted where 678 persons (338 patients and 340 healthy people) responded to the Arabic version of Skindex‐16. Evaluations of the semantic equivalence of back‐translated items, reliability, construct validity, and content validity of the Arabic version were the main outcome measures.

Results  Two problematic items as well as the introductory (header) statement required a second translation and back‐translation to achieve satisfactory agreement with the original instrument. The final Arabic version of Skindex‐16 was internally reliable (Cronbach's α‐range for the scales 0.81–0.92). The instrument demonstrated both construct and content validity. As hypothesized, the scores for dermatologic patients were higher than those for healthy persons (mean 31.5 vs. 21.1, P < 0.001, respectively). Similarly, scores for patients with inflammatory dermatosis were higher than those for patients with isolated skin lesions (mean 32.99 vs. 25.3, P < 0.05), indicating a poorer quality‐of‐life. However, greater than 63% of the patients’ responses to an open‐ended question about their skin disease were addressed by items in the instrument.

Conclusion  We have developed a semantically equivalent translation with cultural adaptation of Skindex‐16 into Arabic. The assessment of its measurement properties shows that it is quite reliable and a valid measure of the effects of skin diseases on the quality‐of‐life in Saudi patients.
A comparative study of cyclization strategies applied to the synthesis of head‐to‐tail cyclic analogs of a viral epitope
Authors: Valero M.‐L. , Giralt E. , Andreu D.
Published: March 2007

A family of head‐to‐tail cyclic peptide models of the antigenic site A (G‐H loop of viral protein 1) of foot‐and‐mouth disease virus has been designed on the basis of the three‐dimensional structure adopted by the linear peptide YTASARGDLAHLTTT upon binding to neutralizing monoclonal antibodies. Three different methods of cyclization have been examined to access the peptides. Solution cyclization of a minimally protected linear precursor provided the expected products but required several purification steps that lowered the yields to 10%. The two other approaches relied on side‐chain anchoring of the peptide through the Asp residue and cyclization on the solid phase. A synthetic scheme combining Fmoc, tBu and OAI protections was practicable but inefficient when scaled‐up. The combination of Boc, Bzl and OFm protections was more promising, but suffered from high epimerization during the initial esterification of Boc‐Asp‐OFm to benzyl alcohol‐type resins. This problem was solved by performing the esterification via the cesium salt of Boc‐Asp‐OFm. With this improvement, the Boc/Bzl/OFm has become the method of choice for the preparation of cyclic head‐to‐tail peptides in satisfactory yields and with minimal purification.
Second‐generation nanofiltered plasma‐derived mannan‐binding lectin product: process and characteristics
Authors: Laursen I. , Houen G. , Højrup P. , Brouwer N. , Krogsøe L. B. , Blou L. , Hansen P. R.
Published: March 2007

Background and Objectives  Mannan‐binding lectin (MBL) is an important component of the innate immune defence; it binds to carbohydrate structures on pathogenic micro‐organisms resulting in complement activation and opsonization. Individuals with low MBL levels are at risk of recurrent and severe infections. Substitution therapy with plasma‐derived MBL is a promising treatment of diseases associated with MBL deficiency. A first‐generation MBL product has been shown to be safe and well tolerated, and patients have benefited from MBL treatment. Following is a description of the development of a nanofiltered second‐generation MBL product from Cohn fraction III, with the use of a new affinity matrix for MBL purification and the characteristics of this improved product.

Materials and Methods  Carbohydrate‐based gels were comparatively screened as affinity matrices. MBL was extracted from fraction III, and affinity purified on a Superdex 200 pg column. The eluted material underwent two virus reduction steps: filtration through Planova 20N and solvent/detergent treatment. It was further purified by anion‐exchange and gel‐filtration chromatography. The affinity eluate and the final MBL fraction were characterized by protein chemical, immunological, and functional assays.

Results  In production scale, Superdex 200 pg was found to be superior to other carbohydrate‐based matrices, and MBL was affinity purified from fraction III with a yield of 70%. The viral safety was increased by performing a nanofiltration of the affinity eluate through Planova 20N with a minimal loss of MBL. The purity of the final MBL fraction was 53% excluding the MBL‐associated serine proteases (MASP). The product consisted of high‐oligomeric MBL, with two dominating forms, and with MASP‐1, ‐2, ‐3 and 19 kDa MBL‐associated protein (MAp19). Only a few protein impurities were present, the major being α2‐macroglobulin. MBL formed complexes with α2‐macroglobulin bridged by MASP‐1 covalently attached to the latter. The functional activity, assessed by mannan‐binding activity and opsonic function, was intact, whereas half of the C4 activating capacity was lost during the production process.

Conclusion  A second‐generation MBL process was developed with an average yield of 50%. It was possible to nanofilter the MBL‐MASP complexes through Planova 20N with only a minor loss resulting in an increased safety profile of this MBL product.
Effects of UVB radiation on marine and freshwater organisms: a synthesis through meta‐analysis
Authors: Bancroft Betsy A. , Baker Nick J. , Blaustein Andrew R.
Published: March 2007

Ultraviolet‐B (UVB) radiation is a global stressor with potentially far‐reaching ecological impacts. In the first quantitative analysis of the effects of UVB on aquatic organisms, we used meta‐analytic techniques to explore the effects of UVB on survival and growth in freshwater and marine systems. Based on the large body of literature on the effects of UVB in aquatic systems, we predicted that UVB would have different effects in different habitats, experimental venues, trophic groups and life history stages. Contrary to our predictions, we found an overall negative effect of UVB on both survival and growth that crossed life histories, trophic groups, habitats and experimental venues. UVB had larger negative effects on growth in embryos compared with later life history stages. Despite the overall negative effect of UVB, effect sizes varied widely. In the survival analyses, no relationship between mean effect size and taxonomic groups or levels of exposure to UVB was detected. In the growth analyses, a larger negative effect on protozoans was observed. Our analyses suggest that the effects of UVB in aquatic systems are large and negative but highly variable between organisms. Variation in susceptibility may have important implications for population and community structure.
Treatment of anovaginal or rectovaginal fistulas with modified Martius graft
Authors: Songne K. , Scotté M. , Lubrano J. , Huet E. , Lefébure B. , Surlemont Y. , Leroy S. , Michot F. , Ténière P.
Published: March 2007

Objective  The treatment of ano‐ or rectovaginal fistula is still difficult. The use of the Martius flap is well described as an adjunctive technique in their repair. We report our experience of a modified Martius flap in the management of ano‐ or rectovaginal fistula.

Method  This is a retrospective study of 14 women presenting with an anovaginal (n = 9) or rectovaginal fistula (n = 5). All were treated by a modified Martius graft. The aetiology included Crohn's disease (n = 7), ulcerative colitis (n = 4), radio‐induced (n = 1), obstetric (n = 1) and villous tumour (n = 1).

Results  All 14 fistulas healed within the 3 months after surgery. Subsequently, two patients with Crohn's disease required an abdominoperineal resection owing to progressive anal lesions. Two other patients experienced faecal incontinence which improved with functional rehabilitation treatment.

Conclusion  A modified Martius flap is a valuable option in the treatment of ano‐ or rectovaginal fistula. In the case of Crohn's disease, however, the prognosis depends primarily on subsequent clinical evolution of the condition.
Global factors shaping the future of food aid: the implications for WFP
Authors: Maxwell Daniel
Published: March 2007

Food aid is a key component of a humanitarian response but its use in other programming contexts is subject to numerous criticisms. Even in humanitarian emergencies food aid is often late, unreliable and out of proportion to other elements of the response. Three major factors will shape the future of food aid. First, mechanisms of food aid governance are being reviewed and may undergo major changes—particularly the Food Aid Convention now that hopes have diminished for an Agreement on Agriculture at the World Trade Organisation. The second significant factor is donor agency trends. Overall levels of food aid have dropped fairly steadily in recent decades and there are several discernible trends in resource allocation, procurement and the use of food aid. The third factor is an emerging body of best practice that will define acceptable standards of food aid programming in the future.
Fields as a framework for integrating GIS and environmental process models. Part 1: Representing spatial continuity
Authors: KEMP KAREN K
Published: March 2007

Linking a GIS to a spatially distributed, physically‐based environmental model offers many advantages. However, the implementation of such linkages is generally problematic. Many problems arise because the relationship between the reality being represented by the mathematical model and the data model used to organize the spatial data in the GIS has not been rigorously defined. In particular, while many environmental models are based on theories that assume continuity and incorporate physical fields as independent variables, current GISs can only represent continuous phenomena in a variety of discrete data models. This paper outlines a strategy in which field variables are used to enable modellers to work directly with the spatial data as spatially continuous phenomena. This allows the manner in which the spatial data has been discretized and the ways in which it can be manipulated to be treated independently from the conceptual modelling of physical processes. Modellers can express their spatial data needs as representations of reality, rather than as elements of a GIS database, and a GIS‐independent language for model development may result. By providing a formal linkage between the various models of spatial phenomena, a mechanism is created for the explicit expression of transformation rules between the different spatial data models stored and manipulated by a GIS.
The truth about Ground Truth
Authors: OPENSHAW S
Published: March 2007

This paper presents a critical appreciation of the book edited by Pickles called Ground Truth. It offers a response in defence of GIS, written from the perspective of a quantitative geographer's unavoidably academic view of the strengths and weaknesses of GIS and Ground Truth. In essence, there is a growing need for a multi‐partisan approach to improving rather than rubbishing a geoinformation technology that is an expanding global industry of considerable relevance both to the present and to the future.
Incorporating Cellular Automata simulators as analytical engines in GIS
Authors: PARK SOOHONG , WAGNER DANIEL F
Published: March 2007

Contemporvy GIS suffer from a variety of problems. These include poor ability to handle dynamic spatial models, poor performance for many operations, and poor handling of the temporal dimension. Cellular Automata (CA) are dynamic mathematical systems based on discrete time and space. While CA have many similarities to GIS, and indeed excel in many areas in which GIS are deficient, they cannot themselves be considered as GIS since they lack the necessary sophisticated Capabilities in data input, data storage and retrieval, and data output. However, the advantages of CA in data analysis and modelling are significant. In order to exploit fully the advantages of each system ‐ GIS and CA ‐ we have developed a methodology and prototype system for coupling GIS and CA, in which the CA serves as an alternative analytical engine for the GIS. In the prototype system, spatial, temporal (i.e. time series), and spatio‐temporal filters as well as spatial diffusion operators are developed. In addition, the integrated system provides a flexible framework for the programming and running of dynamic spatial models. We conclude that CA represent a viable alternate analytical engine for GIS and provide increased ability for dynamic spatial modelling within GIS.
Inequality and Politics in the Creative City‐Region: Questions of Livability and State Strategy
Authors: McCANN EUGENE J.
Published: March 2007

City‐regionalism and livability are concepts that feature prominently in recent writings on urban politics and policy. Policy discussions have seen the two concepts fused together in such a way that regional competitiveness is generally understood to entail high levels of ‘livability’ while urban livability is increasingly discussed, measured and advocated at a city‐regional scale. It is, then, important to understand how these concepts work in tandem and to delineate the often‐elided politics of reproduction through which they operate. This paper begins by elaborating on the politically powerful fusion of city‐regionalist and urban livability discourses, using the example of Richard Florida’s creative city argument. It then discusses the politics of city‐regionalism and livability through the case of Austin, Texas, a city that has framed its policy in terms of regionalism and livability but which is also characterized by marked income inequality and a neighborhood‐based political struggle over the city’s future. The paper concludes by drawing lessons from the discussion and suggesting that the city‐regional livability agenda can best be understood as a geographically selective, strategic, and highly political project.
Is major liver surgery associated with an increased systemic inflammatory response? A prospective comparison of hemihepatectomy and other major abdominal surgery
Authors: Wiezer Marinus J. , Meijer Catharina , Vuylsteke Ronald , Pullens Renee H. , Prins Hubert A. , Cuesta Miguel A. , Meijer Sybren , Hack C. Erik , van Leeuwen Paul A. M.
Published: March 2007

Abstract: Aims/Background: Extensive liver resection is associated with a higher morbidity and mortality than other major abdominal surgery. Because the liver is responsible for the clearance of pathogenic particles as well as the clearance and degradation of several inflammatory mediators, the high rate of complications after liver surgery may be due to an enhanced or prolonged inflammatory response. The objective of this prospective study was to investigate whether major liver resection is associated with an enhanced systemic inflammatory response. Methods: The course of various inflammatory parameters was studied in 12 patients undergoing a hemihepatectomy and the results were compared with those of 12 patients undergoing other major abdominal surgery. Results: After hemihepatectomy, the plasma levels of IL‐6, IL‐8, sPLA2 and elastase were similar to the levels after other major abdominal surgery, though the hepatectomized patients showed higher levels of lactoferrin, possibly due to impaired hepatic clearance. In addition, the hemihepatectomized patients showed signs of impaired liver function, as was indicated by increased plasma bilirubin and ASAT levels, whereas the other patients did not. Conclusions: The inflammatory response associated with major liver resection is not significantly different from that after other major abdominal surgery, and therefore does not explain the increased complication rate that is seen after major liver resection. We infer that the most important factor in the development of complications after liver resection may be the hepatic failure itself.
Relationship of hepatitis C viremia to HIV state and to infection by specific hepatitis C genotypes
Authors: Pérez‐Gracia T. , Galán F. , Fernández‐Gutiérrez C. , Girón J. A. , Rodríguez‐lglesias M.
Published: March 2007

Abstract: Aims/Background: This study was undertaken to examine the relationship of hepatitis C (HCV) viremia to human immunodeficiency virus (HIV) infection and to investigate the evidence of infection by specific hepatitis C genotypes. Patients and methods: The analysis of HCV viremia was performed by reverse transcription‐polymerase chain reaction in serum samples from 186 patients' selected by their positivity for anti‐HCV antibodies. All samples were tested for HIV infection. In those patients with sera positivity for HCV RNA, isolates were genotyped by line probe assay. In those patients whose sera were negative for HCV RNA, antibodies specific for genotypes implicated in past HCV infection were detected by ELISA. Results: HCV RNA was detected in 117 patients with anti‐HCV antibodies (62.9%). There was no statistically significant association between HCV RNA and HIV positivity (Odds ratio, O.R.: 1.75. Confidence interval 95%, C.I.: 0.92–3.33, p=0.095). A positive association was demonstrated between infection by HCV genotype 3 and HCV viremia (O.R.: 10.67, C.I.: 1.51–458.05, p=0.015) in HIV‐infected patients, as well as between infection by HCV genotype 1 and HCV viremia (O.R.: 4.71, C.I.: 1.65–13.75, p=0.002) in HIV‐non infected individuals. In both groups, a negative association was observed between past HCV infection by multiple genotypes and HCV viremia (HIV‐infected patients, O.R.: 0.10, C.I.: 0.00–1.11, p=0.033. HIV‐non infected patients, O.R.: 0.05, C.I.: 0.00–0.41, p=0.001). Conclusions: Infection by specific HCV genotypes (type 3 in HIV‐infected patients and by type 1 in HIV‐non infected ones) implies a higher risk of HCV viremia, whereas multiple HCV types infection is negatively associated with this probability. HIV coinfection does not influence the probability of HCV viremia.
Loss of heterozygosity and microsatellite instability in human non‐neoplastic hepatic lesions
Authors: Tsopanomichalou Maria , Kouroumalls Elias , Ergazaki Maria , Spandldos Demetrios A.
Published: March 2007

Abstract: Aims/background: Carcinogenesis is thought to be a multistage process that occurs as a result of mutations in oncogenes and tumor suppressor genes. One way to monitor a vast range of these changes is by microsatellite PCR amplification that detects loss of heterozygosity and microsatellite instability between normal and tumor specimens of the same subject. Viral cirrhosis is considered a strong predisposing factor for the development of liver cancer. The aim of the study therefore was to examine precancerous hepatic lesions and compare them with others not considered as high risk for hepatocellular carcinoma. Methods: We examined 43 subjects for 19 microsatellite markers spanning chromosomes 1, 9 and 17. Normal specimens were blood samples that were compared to liver needle biopsies. Samples were classified according to histo‐logical features as non‐cancerous (10 cases) and pre‐cancerous (33 cases, chronic hepatitis and cirrhosis). Results: Our results indicate that there is a tendency of increased chromosomal alteration as lesions become chronic. Samples from patients with antibodies to antibodies for hepatitis C virus show more alterations than hepatitis B positive samples. Stea‐tohepatitis, a disease of unknown etiology, appears to have a high number of microsatellite abnormalities. Conclusions: Microsatellite APOA2 located on chromosome 1, shows a statistically significant increase in the rate of loss of heterozygosity as liver lesions become more severe, indicating the presence of tumor suppressor genes which may be involved in the development of these lesions.
Effects of dietary iron overload on progression in chemical hepatocarcinogenesis
Authors: Stål Per , Wang Gen‐Sheng , Olsson Jerker M. , Eriksson Lennart C.
Published: March 2007

Abstract: Aim: The present study was undertaken to investigate possible effects of dietary iron during the progression step in hepatocarcinogenesis. Methods: Two experiments were performed, in which preneoplastic foci were produced in rat liver using the Solt & Farber protocol, with diethylnitrosamine as initiator and partial hepatectomy + 2‐acetyl‐aminofluorene as promoter. Two weeks after promotion, animals were fed 1.25–2.5% dietary carbonyl iron or a control diet until sacrifice. In the first experiment, animals were killed at different time points when they developed an abdominal mass in combination with weight loss. In the second experiment, animals were sacrificed 45 weeks post‐promotion. Liver tumours were counted and histologically graded. Tumour levels of ubiquinone‐9 and α‐tocopherol were determined with HPLC, and labelling and apoptotic indices calculated using immunohistochemistry. The number and area of glutathione S‐transferase 7,7 (GST‐7,7)‐positive foci were determined. Results: In experiment number 1, survival and tumour differentiation were similar in iron‐treated animals and controls. In the second experiment, iron‐treated rats had an increased number of GST‐7,7‐positive foci compared to controls. Number and size of carcinomas were similar between the groups, whereas tumour differentiation was higher in rats exposed to iron. Cell proliferation, apoptosis and concentrations of α‐tocopherol in tumours were not altered by iron. The ratio of reduced/oxidized ubiquinone‐9 was decreased in tumours from iron‐treated animals. Conclusion: In this model, dietary iron overload resulted in an increased number of preneoplastic foci but did not enhance the progression of these into hepatocellular carcinomas. Iron decreased the ratio of reduced/oxidized ubiquinone‐9 in tumours, indicating that neoplastic liver cells utilize intracellular ubiquinones as a defense mechanism against iron‐induced oxidative stress.
T1762/A1764 variants of the basal core promoter of hepatitis B virus; serological and clinical correlations in Chinese patients
Authors: Hou Jinlin , Lau George K. K. , Cheng Jinjun , Cheng Chi Chung , Luo Kangxian , Carman William F.
Published: March 2007

Abstract: Background: A double variant in the basal core promoter, converting nucleotide 1762 from A to T (T1762) and nucleotide 1764 from G to A (A1764), has been described in patients with chronic hepatitis B infection. Its prevalence and significance in Chinese chronic HBV carriers are unknown. Methods: We studied 177 Chinese patients with chronic HBV infection (chronic hepatitis/asymptomatic: 89/88; hepatitis B e antigen positive/negative: 84/93). The double variant was detected by mismatched polymerase chain reaction and restriction fragment length polymorphism analysis. The reliability of this method was verified by sequencing in 41 serum samples with 100% matching. Results: The double variant T1762/A1764 was found in 52 of 89 patients with chronic hepatitis, but in only 6 of 59 asymptomatic carriers (p<0.001). The prevalence was significantly lower in hepatitis B e antigen positive patients (23/84) than in hepatitis B e antigen negative patients (35/64) (p<0.005). Precore variant, A1896 was detected in 40 individuals; 31 of them suffered from chronic hepatitis and 9 were asymptomatic (p<0.001). A combination of both variants T1762/A1764 and A1896 was seen in 3 of 59 asymptomatic and 22 of 89 patients with chronic hepatitis (p<0.005). Conclusions: Mismatched polymerase chain reaction with restriction fragment length polymorphism provides a reliable, easy and fast method for detection of the presence of the T1762/A1764 variant. In Chinese chronic hepatitis B carriers, T1762/A1764 variant was associated with both active liver disease and hepatitis B e antigen negativity.
Hepatitis C infection in an Italian population not selected for risk factors
Authors: Maggi G. , Armitano S. , Brambilla L. , Brenna M. , Cairo M. , Galvani G. , Gola D. , Komla‐Ebri K. , Marmondi E. , Perricone G. , Posca M. , Vegezzi P. G. , Vergani C. , De Leo Giuseppe
Published: March 2007

Abstract: Aims/Background: This study estimated the prevalence of HCV infection and relationship with viremia in a general population. The inhabitants of Albavilla town were personally invited to participate. Methods: Out of 3997 inhabitants falling within the age range 18–85 years, 2403 (participation rate 60.1%) were examined for transaminases, HCVAb, HCVRNA, genotype and immunoblot assay. The following information was collected: sex, age, blood transfusions, surgery, use of glass syringes, drug addiction, alcohol consumption, tattoos and body mass index. Results: 115 (4.8%) were HCVAb+, the prevalence being 1.2% under 40 years. Transfusion in the past was the only risk factor for HCV infection. Among the HCVAb+ subjects, 71 (61.7%) were HCVRNA+. 40.8% of the HCVAb+/HCVRNA+ group had normal ALT, compared with 68% of those with HCVAb+/HCVRNA‐. The HCV genotypes in the 71 HCVRNA+ subjects were: 2a/2c in 58 (81.7%), 40% of them with normal ALT;1b in 11 (15.5%), none with normal ALT; genotype 3 in two (2.8%). Conclusion: The prevalence of HCVAb in this general population was 4.8%. About 3% were HCVRNA positive and of these genotype 2a/ 2c was present in 81.6%.
Imbalance between cell proliferation and cellular DNA fragmentation in hepatocellular carcinoma
Authors: Wu Pui‐Chee , Lau Victor Kar‐Tai , Fang Jane Wing‐Sang , Lai Vicky Ching‐Ha , Lai Ching‐Lung , Lau Johnson Yiu‐Nam
Published: March 2007

Abstract: Aim/Background: Hepatocellular carcinoma (HCC) is known for its rapid growth. This study was undertaken to determine the expression of proliferative markers, apoptosis (DNA fragmentation) and oncogene products known to regulate apoptosis (p53, bcl‐2) in HCC. Methods: 150 Chinese patients with HCC were studied (M:F 128:22, age 14–88 years), Immunohistochemistry was employed to detect cell proliferative markers (PCNA, Ki67), and oncogene products known to regulate apoptosis (p53, bcl‐2). DNA fragmentation was determined by terminal dUTP nick end labeling (TUNEL). Results: 98% and 95% of HCC had PCNA (median 2+) and Ki67 (median 2+) detected respectively. TUNEL labeling was detected in only a small number of tumor cells (no labeling in 11%, median 1/1000 cell labeled, range: 0–70/1000 cells). There was no correlation between TUNEL labeling and the clinical parameters (sex, age, cirrhosis, and survival) and the expression of cell proliferative markers. p53 was detected in 53% of the patients (median 1+, range: 0–4+) and bcl‐2 was detected in a small proportion of tumor cells in only 13% of the HCCs (range: 0–1+). The expression of p53 and Bcl‐2 did not correlate with TUNEL labeling or the natural survival. Conclusions: Cell proliferation in HCC is unmatched by apoptosis, accounting for the rapid growth of this tumor. This lack of apoptosis in HCC is unrelated to the expression of p53 or bcl‐2 over‐expression.
Expression of nerve growth factor in hepatolithiasis
Authors: Ohta Tetsuo , Elnemr Ayman , Yasui Toshiaki , Kitagawa Hirohisa , Kayahara Masato , Fushida Sachio , Nishimura Gen‐ichi , Nagakawa Takukazu , Miwa Koichi , Yamamoto Miyuki , Terada Tadashi , Nakanuma Yasuni
Published: March 2007

Abstract: Aims/Background: Nerve growth factor (NGF) has recently been shown to influence the survival and function of non‐neuronal inflammatory cells, possibly through its activity as a colony‐stimulating factor. It may also play an important role in acute inflammation and tissue repair. However, no prior report has focused on NGF in chronic inflammatory diseases of the gastrointestinal and biliary tracts. The aim of this study was to examine the expression of NGF in hepatolithiasis. Methods: Twenty‐six liver specimens resected from 22 patients with intrahepatic calcium bilirubinate stones and from 4 patients with intrahepatic cholesterol stones were examined immunohistochemically. Results: The 22 patients with calcium bilirubinate stones demonstrated NGF immunoreactivity associated with surrounding inflammatory cells that was localized to the epithelia of proliferative peribiliary glands in the ductal wall. However, neither the surface lining of the bile duct nor hepatocytes expressed detectable NGF immunoreactivity. In the cholesterol stones cases in contrast, peribiliary glandular elements and inflammatory cell infiltration were less extensive than those observed in cases of calcium bilirubinate stones, and NGF immunoreactivity was not noted. Conclusions: These observations suggest that proliferative peribiliary glands express NGF protein in chronic proliferative cholangitis. This is characteristic of intrahepatic calcium bilirubinate stones.
Leukoreduced buffy coat–derived platelet concentrates photochemically treated with amotosalen HCl and ultraviolet A light stored up to 7 days: assessment of hemostatic function under flow conditions
Authors: Lozano Miguel , Galan Ana , Mazzara Roberto , Corash Laurence , Escolar Ginés
Published: March 2007

BACKGROUND: Amotosalen plus ultraviolet A light photochemical treatment (PCT) inactivates high titers of bacteria, and other pathogens, in platelet concentrates (PCs) potentially allowing the storage of platelets (PLTs) for up to 7 days. Adhesion and aggregation of PLTs to injured vascular surfaces are critical aspects of PLT hemostatic function.

STUDY DESIGN AND METHODS: Two ABO‐identical leukoreduced buffy coat–derived PCs in additive solution were mixed and divided: one‐half underwent PCT (PCT‐PCs) and the other was kept as a control (C‐PCs); both were stored under standard conditions. The total number of paired PCs studied was nine. Samples were taken on Day 1 (before PCT) and after 5 and 7 days of storage. The adhesion and aggregation capacities were evaluated under flow conditions in a ex vivo perfusion model.

RESULTS: Compared to control, PCT resulted in a decrease in PLT count of 6.5 percent (p = 0.004) and 10.2 percent (p = 0.008) after 5 and 7 days' storage, respectively (n = 9). PLT interaction with subendothelium was mainly in form of adhesion. The surface covered by PCT PLTs on Day 1 was 26.0 ± 4.2 percent (mean ± SEM). On Day 5, PCT‐PCs showed a covered surface of 20.9 ± 2.2 percent, and the C‐PCs, 20.6 ± 1.6 percent. After 7 days, PCT‐PCs produced a nonsignificant higher PLT deposition compared to control (27.1 ± 2.9% vs. 21.2 ± 2.8%, p = 0.06).

CONCLUSION: PCT of PCs and storage up to 7 days was associated with a 10.2 percent decrease in PLT count due to processing losses compared to C‐PC. PLT adhesive and aggregating capacities under flow conditions of PCT‐PCs were similar to C‐PCs and remained well preserved for up to 7 days of storage.
Wound‐healing properties of trehalose‐stabilized freeze‐dried outdated platelets
Authors: Sum Ruth , Hager Sarah , Pietramaggiori Giorgio , Orgill Dennis P. , Dee Josh , Rudolph Alan , Orser Cindy , Fitzpatrick G. Michael , Ho David
Published: March 2007

BACKGROUND: The wound‐healing applications of platelet (PLT)‐derived cytokines, proteins, and membranes is accepted but continues to be investigated. In this study, it is demonstrated that stabilized freeze‐dried PLTs prepared from outdated PLTs (FDPOs) accelerate wound healing and form tube structures as well as stabilized indated freeze‐dried PLTs (FDPIs) and room‐temperature fresh PLTs (RT‐PLTs).

STUDY DESIGN AND METHODS: Experiments were designed to compare in vitro and in vivo wound‐healing properties of FDPI, FDPO, and RT‐PLT preparations. The concentration of PLT‐derived growth factor (PDGF)‐ββ and transforming growth factor (TGF)‐β1 was determined, and the abilities of FDPIs, FDPOs and RT‐PLTs to induce endothelial cell proliferation and promote endothelial cell tube formation (cells formed solid spouts connecting neighboring cells to form tube structures) were observed. Wound‐healing characteristics were measured by surgically inducing 1‐cm2, full‐thickness wounds on db/db mice (n = 10 per group). The wounds were treated with single or multiple doses of FDPIs and FDPOs. Wound closure rate was determined, and histology samples were evaluated for cellular makeup.

RESULTS: FDPOs retained the same levels of PDGF‐ββ and TGF‐β1 and were able to promote endothelial cell proliferation and tube formation in vitro as well as FDPIs or RT‐PLTs. Multiple applications of FDPO accelerated wound closure and enhanced reepithelialization when compared to untreated wounds in db/db mice.

CONCLUSION: FDPOs enhanced wound healing in db/db mice as well as FDPIs and RT‐PLTs. Wound closure was obtained 6 days earlier than untreated wounds and histologic examination revealed reduced granulation and increased cellular angiogenesis.
Quantitation of RHD by real‐time polymerase chain reaction for determination of RHD zygosity and RHD mosaicism/chimerism: an evaluation of four quantitative methods
Authors: Krog Grethe Risum , Clausen Frederik Banch , Dziegiel Morten Hanefeld
Published: March 2007

BACKGROUND: Determination of RHD zygosity of the spouse is crucial in preconception counseling of families with history of hemolytic disease of the fetus and newborn caused by anti‐D. RHD zygosity can be determined by quantitative real‐time polymerase chain reaction (PCR) basically by determining RHD dosage, and this feature is relevant in investigating RHD mosaicism and chimerism.

STUDY DESIGN AND METHODS: Monoplex and duplex real‐time PCRs, uncalibrated and calibrated, were tested. RHD zygosity was determined for 72 samples and compared with serology‐based prediction of RHD zygosity. Additionally, a range of constructed RHD dosages were compared with determined RHD dosages. Finally three samples, Days 1, 90, and 120, from a patient with loss of D were included.

RESULTS: All setups enabled differentiation between hemi‐ and homozygous samples. Results from calibrated methods had the smallest variation and enabled differentiation at the mean ± 3SD. Incongruity between determined and predicted RHD zygosity was found in three samples. PCR–sequence‐specific priming specific for the hybrid downstream Rhesus box was performed on those samples confirming the real‐time PCR results. Determined RHD dosage equaled constructed RHD dosage in both calibrated real‐time PCRs. Patient samples showed RHD with a mean of 1, 5, and 8 percent relative to GAPDH in all samples.

CONCLUSION: Duplex calibrated real‐time PCR was a robust and exact method for determination of RHD zygosity and applicable in evaluation of RHD mosaicism and chimerism. This was illustrated with patient samples, where this assay revealed for the first time signs of mosaicism in both expression of D antigens and in RHD dosage.