bluuebunny/crossref_metadata_2025 huggingface dataset:
Vasculature of the orbital rete in the Japanese deer (Cervus nippon)
Authors: Ninomiya  , Masui
Published: March 2003

The vasculature of the orbital rete (rete mirabile ophthalmicum) in Japanese deer (Cervus nippon) was studied using corrosion casting, scanning electron microscopy, and histology. The orbital rete is a flat, triangular‐ or leaf‐shaped arterial network, which consists of a complex of small arterioles, that intermixes with a similar complex of the supraorbital vein at the base of the orbital cavity. Blood to the retina passes through the orbital rete. The orbital retial arterioles leave the parent external ophthalmic artery at right angles forming T‐shaped bifurcations, and follow a tortuous, undulating course. Each retial arteriole is connected by side branches and forms a rope‐ladder‐like network. Some of the side branches are surrounded by a groove representing the intra‐arterial cushion that regulates blood flow at branching sites. The central retinal artery supplying the retina originates from the orbital rete. The ciliary arteries supplying the choroid arise from the external ophthalmic artery proximal to the orbital rete. The anatomical specializations of the orbital rete may involve buffering the blood pressure and flow to the retina and regulating ocular tissue temperature as in the carotid rete. In addition, the orbital rete may help dampen the tension that the vessel exerts on the retina, by stretching in response to eyeball movement.
Intraocular melanoma in an alpaca
Authors: Hamor  , Severin  , Roberts
Published: March 2003

A case of primary intraocular melanoma in an alpaca is reported. This patient also presented with a mild normocytic, normochromic anemia and hypoproteinemia. These can be markers of an immunodeficiency syndrome associated with llamas. Although this patient did not appear to have clinical signs of this syndrome, its presence needed to be ruled out as animals affected with this syndrome are subject to recurrent severe debilitating diseases and death. To our knowledge, intraocular melanoma has not been previously reported in an alpaca.
Immunohistochemical characterization of intraocular metastasis of a canine transmissible venereal tumor
Authors: Pereira J.S. , Silva A.B.F. , Martins A.L.B. , Ferreira A.M.R. , Brooks D.E.
Published: March 2003

Little has been published on intraocular metastasis of transmissible venereal tumors (TVT) in dogs. This report presents a 4‐year‐old male Labrador Retriever with a previous history of subcutaneous TVT which underwent total remission after treatment with vincristine. The dog presented with clinical signs of uveitis and increased intraocular pressure (IOP) in both eyes. After enucleation of the left eye, a diagnosis of TVT was made based on morphology, histology and immunohistochemistry (IHC). IHC staining for vimentin, S‐100 protein, cytokeratin and HMB45 was performed to differentiate this lesion from TVT, lymphoma, melanoma, carcinomas, neurogenic tumors and fibrosarcoma. The IHC findings supported the diagnosis of TVT for this round cell tumor.
The effects of topical tropicamide and systemic medetomidine, followed by atipamezole reversal, on pupil size and intraocular pressure in normal dogs
Authors: Wallin‐Håkanson Nils , Wallin‐Håkanson Berit
Published: March 2003

Twenty normal Golden Retrievers being screeened for eye, hip and elbow diseases were given tropicamide topically and medetomidine systemically. Medetomidine effects were later reversed with systemic atipamezole. Pupil size and intraocular pressure changes were determined. Pupil size increased significantly following tropicamide administration and continued to increase slightly but significantly after medetomidine injection. It was unclear whether the slight increase in pupil size following medetomidine administration was due to continued effect of tropicamide or due to the medetomidine itself. Atipamezole did not influence pupil size. Intraocular pressure (IOP) was not affected by these drugs. Ophthalmic screening examination for inherited disease following tropicamide administration is equally feasible prior to sedation with medetomidine and after reversal with atipamezole, but not during the period of sedation.
Ocular complications of persistent hyperplastic primary vitreous in three dogs
Authors: Bayón A. , Tovar M. C. , Fernández del Palacio M. J. , Agut A.
Published: March 2003

Persistent hyperplastic primary vitreous (PHPV) syndrome associated with either severe ocular complications or multiple ocular lesions was diagnosed in three young dogs, a Samoyed, a Spanish Pachon, and a mixed breed dog. Due to opacification of the anterior ocular structures, B‐mode and color‐flow Doppler ultrasonography were performed to aid diagnosis. The Samoyed presented with unilateral hyphema; the Spanish Pachon presented with unilateral secondary glaucoma associated with uveitis and hyphema OD and leucocoria OU; and the mixed breed presented with bilateral leucocoria. B‐mode ultrasonography of the Samoyed revealed a subcapsular cataract and a hyperechoic tubular structure attached from the optic disk to the posterior lens capsule. In the Spanish Pachon B‐mode ultrasonography of the right eye indicated microphakia, cataract formation, and a retrolental mass with a thin hyperechoic strand stretching from the optic disk to the posterior lens; and for the right eye cataract formation, PHPV, retinal detachment, and vitreous hemorrhage. In the mixed breed dog, B‐mode ultrasonography of both eyes indicated microphthalmia, retrolental mass, and hyperechoic lenses. By color‐flow Doppler imaging, blood flow was present in the retrolental mass of the right eye suggesting a persistent hyaloid artery.
Systemic hypertensive disease and the feline fundus
Authors: Crispin Sheila M. , Mould John R. B.
Published: March 2003

The fundoscopic appearance and some of the histopathological findings of arterial hypertension in the cat are reviewed in relation to the anatomical and physiological features that place retinal function at particular risk when the eye is subjected to sustained increased arterial blood pressure. The fundus changes fall into three categories: hypertensive retinopathy, hypertensive choroidopathy and hypertensive optic neuropathy, and information from cases with confirmed arterial hypertensive disease is used to provide a basis for discussion and future investigation.
Spontaneous cataracts in laboratory rabbits
Authors: Munger Robert J. , Langevin Nicholas , Podval J.
Published: March 2003

Objective To document the occurrence and incidence of spontaneously occurring cataracts in older New Zealand White (NZW) and New Zealand White × New Zealand Red (NZW × NZR – F1) rabbits during prescreening examinations at Alcon Laboratories.

Procedures A retrospective study was conducted on prescreening examination records of NZW and NZW × NZR (F1) rabbits at Alcon Laboratories between April 1999 and May 2001.

Results A total of 946 rabbits (670 NZW and 276 NZW × NZR) ranging in age from 77 to 288 days were examined. Of the NZW rabbits, 333 were males and 337 were females. Of the NZW × NZR (F1) rabbits, 139 were males and 137 were females. Thirty‐eight NZW rabbits (23 males and 15 females) exhibited immature cataracts in one or both eyes, and three NZW × NZR (F1) rabbits (one male and two females) exhibited cataracts in one or both eyes. The overall incidence of cataracts was 4.3% of all rabbits. Males and females were equally affected, but a significant difference in the incidence of cataracts existed between the NZW and NZW × NZR (F1) rabbits with 5.7% of the NZW rabbits affected and 1.1% of the NZW × NZR (F1) rabbits affected.

Conclusion Spontaneous juvenile cataracts occur in rabbits and may develop as incidental lesions during toxicologic studies. The incidence of cataracts noted in our studies is consistent with an autosomal recessive mode of inheritance, but further studies are needed to confirm the mode or modes of inheritance. Hybrid pigmented rabbits (F1 or NZW × NZR) exhibited a significantly lower incidence of cataracts.
Hemangiosarcoma of the third eyelid in a cat
Authors: Multari Domenico , Vascellari Marta , Mutinelli Franco
Published: March 2003

A case of hemangiosarcoma of the third eyelid in a 15‐year‐old Domestic Short‐haired cat is reported. A small red mass protruding from the anterior surface of the third eyelid in the left eye was present. Only mild bilateral conjunctivitis and nuclear sclerosis were revealed on initial ophthalmic examination. After anti‐inflammatory treatment, surgery and cryotherapy were performed. On histopathologic examination the mass was located just beneath the conjunctival epithelium, suggesting that the conjunctiva was the tissue of origin. The tumor showed high cellularity and was composed of pleomorphic spindle and polygonal cells arranged in interlacing bundles and solid sheets. The presence of slit‐like spaces between tumor cells containing erythrocytes demonstrated the vascular differentiation. Mitotic activity was moderate, but atypical mitoses were detected. The surgical area healed uneventfully and after 7 months there was no recurrence. To the authors’ knowledge, this is the first report of conjunctival hemangiosarcoma of the third eyelid in a cat.
Phylogenetic analysis of the Rhabdocoela (Platyhelminthes) with emphasis on the Neodermata and relatives
Authors: Zamparo David , Brooks Daniel R. , Hoberg Eric P. , McLennan Deborah A.
Published: March 2003

Phylogenetic systematic analysis of 24 taxa representing the rhabdocoel platyhelminths, based on a suite of 89 morphological characters, produced two equally parsimonious trees, 181 steps long, with a consistency index (CI) of 0.69 and a rescaled consistency index (RCI) of 0.56, differing only with respect to that portion of the tree containing Umagillidae, Acholadidae, Graffillinae, Pseudograffillinae, Pterastericolidae and Hypoblepharinidae. Our results accommodate all previously proposed sister taxa to the Neodermata in a single clade in which ((Dalyelliidae + Temnocephalida) Typhloplanidae) is the sister group of ((Fecampiidae + Urastoma) (Udonella((Aspidogastrea + Digenea) (Monogenea (Gyrocotylidea (Amphilinidea + Eucestoda)))))). Bootstrap and jackknife analyses indicate that the groupings of ((Dalyelliidae + Temnocephalida) Typhloplanidae) and of ((Fecampiidae + Urastoma) (Udonella((Aspidogastrea + Digenea) (Monogenea (Gyrocotylidea (Amphilinidea + Eucestoda)))))) are highly robust, with the latter clade having a CI of 90% and RCI of 82%. Disagreements among previous analyses of these taxa have been due to the influence of missing data for critical characters in key taxa and differences in the taxa analysed, rather than any inherent weakness in the morphological data. Non‐phylogenetic systematic approaches to homology assessment and misconceptions regarding phylogenetic systematic methodology are discussed. Recent analyses combining sequence data with a subset of approximately 60% of the morphological characters should be re‐assessed using the entire morphological database. Even ifUdonellais a monogenean, it is most parsimonious to suggest that the common ancestor of the Neodermata had a vertebrate–arthropod two‐host life cycle.
The barley powdery mildew protein kinase C gene, pkc1 and pkc‐like gene, are differentially expressed during morphogenesis
Authors: Zhang Ziguo , Priddey Gemma , Gurr Sarah Jane
Published: March 2003

summary

Protein kinase C agonist assays revealed the phorbol ester, phorbol 12‐myristate 13‐acetate, invoked germling morphogenesis and enhanced PKC activity in Blumeria graminis. No antagonist of mildew PKC activity was found but the data fuelled a hunt for powdery mildew pkc genes. Oligonucleotides, designed on the basis of conserved ATP‐binding and kinase domains within the catalytic core of eukaryotic protein kinase proteins, were used as primers to amplify chromosomal and cDNA fragments from the barley powdery mildew fungus graminis. Three kinase gene fragments were isolated (pkc1, pkc‐like and cpka) and the full length genomic sequences of the mildew pkc and pkc‐like genes were determined by ‘step down’ PCR. RT‐PCR transcript profiles showed the three genes to be differentially regulated during germling morphogenesis.
Acculturation and breast self‐examination among immigrant Latina women in the USA
Authors: Peragallo N. P. , Fox P. G. , Alba M. L.
Published: March 2003

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self‐examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low‐income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.
Regional Examination for Nurse Registration, Commonwealth Caribbean
Authors: Reid U. V.
Published: March 2003

In 1990, a Regional Examination for Nurse Registration was approved by the Conference of Ministers Responsible for Health in the Commonwealth Caribbean.

The examination allows for standardization and improvement of nursing education, as well as reciprocity and ease‐of‐movement for Registered Nurses among the countries of the region.

A Planning Committee and a Blueprint Committee were established to develop the examination process. Committee membership included the Principal/Chief Nursing Officers, Nurse Tutors, and General Nursing Council representatives of each country, as well as educators from the two universities of the region.

The accepted model, based on mutually agreed competencies for the Registered Nurse to practice in the region, forms the basis for the elaboration of the blueprint and the administrative manuals.

The treatment of test items, assembling and conducting the examinations, which consist of four papers, as well as scoring the examination results, and notifying students of the results, are the responsibility of each General Nursing Council.

The 13 General Nursing Councils with responsibility for Schools of Nursing meet annually as a regional committee to prepare the examinations, using a different country for each meeting; countries are rotated alphabetically. There is no permanent site for the administration of the examination.

Membership to the regional committee, known as the Regional General Nursing Councils (RGNCs), is for 3 years. This staggering of membership allows for continuity.
The older adult: a comparison of long‐term care in Glasgow and San Francisco
Authors: Joy J. P. , Fong C. M.
Published: March 2003

Population trends show an increasing proportion of people older than 65 years of age. This report aims to describe the facilities/services accessible to the older adult living in Glasgow, Scotland and in San Francisco, United States of America. This comparative study serves to develop a broader understanding of what is involved in the process of ageing, and describes how these two cities are responding to the needs of older people. Long‐term caring provision is complex and involves multiple agencies, often leaving both lay and professional individuals ill‐informed as to which services exist and how best to use them. The nurse can be instrumental in providing information, viable alternatives and services. In this article, options available for caring of the older adult and financing of care are discussed along with a number of recommendations based on observations described, data collected and literature researched. With the advent of care being provided in the community, there is now a continuum of services ranging from independent living at home to dependent care in hospital. Whether an individual remains at home depends on the availability and affordability of, and access to, other resources/facilities. Creative alternatives are needed for care of the older adult in this millennium. This report describes the need for an integrated system of care, which can adjust to variations in clients' needs. Progressive care facilities, intergenerational sharing, community volunteer service programmes for the older person and Edenizing are a few recommendations discussed by the authors.
Reorganized structure and other proposals for the ICNP® development
Authors: Kisilowska M.
Published: March 2003

All of those who are engaged in the International Classification for Nursing Practice (ICNP®) project are aware of the mistakes still being found in its classification. However, these are not recognized as faults, but rather as a challenge for better work and continuous efforts on its improvement. This article discusses proposed changes to the structure of the ICNP®, according to the rules of building such ‘tools’, as well as new axes that can be added to make the classification beneficial across a broader spectrum of applications, not solely in electronic patient record‐keeping and statistics.
WHO Priorities for a Common Nursing Research Agenda
Authors: Hirschfeld Miriam J.
Published: March 2003

In September 1997 a high‐powered research team was brought to Geneva by ICN to set priorities and recommend strategies for ICN leadership roles (see INR, November‐December 1997, page 161). An analysis of their findings is now being made. Meanwhile, extracts from country and regional reviews of nursing research presented at the expert group meeting are provided on the following pages, beginning with the WHO Nursing Unit analysis of research at nursing/midwifery collaborating centres and suggested future focus for nursing research.
Dying in the USA and Japan: selected legal and ethical issues
Authors: Davis Anne , Mitoh Takkako
Published: March 2003

While Japan and the USA are culturally different, they face many of the same ethical and legal issues in the area of death and dying. Facing these issues at different times and in different ways, both countries have sought solutions that fit their own social values and traditions.
Mad, sad or bad. Moral luck and Michael Stone
Authors: Noguera Anita R.
Published: March 2003

Abstract This paper discusses the philosophical doctrine of moral luck, as described by Bernard Williams in his book of the same name. It first describes Williams' account and then uses the case of Michael Stone, a convicted murderer with a long history of mental disorder, and mental health practitioners’ interventions in his case, to test and debate Williams’ views. It examines four major areas of these, including the classical notion of moral luck, retroactive judgement, agent regret and justifiable and unjustifiable decision‐making. It concludes that, in view of what has been said, whilst Williams’ views are applicable and appropriate to many areas of the Stone case, ‘traditional’ moral views on rights, obligations and principles cannot be entirely laid aside in evaluating this.
Needs, closeness and responsibilities. An inquiry into some rival moral considerations in nursing care
Authors: Nortvedt Per
Published: March 2003

AbstractThe first part of this paper seeks to clarify how interpersonal relationships are generally rooted in considerations about trust, vulnerability and interpersonal dependence. However, for nurse–patient relationships, and from the point of view of justice and fair rationing, it is essential to investigate their distinct moral nature. Hence, the second part of the paper argues that nurse–patient relationships, as a special kind of interpersonal relationship, raise particular normative issues. I will discuss dilemmas facing nurses and professional care‐givers in general who are torn between their obligations to existing patients and more general and impartial considerations regarding the distribution of nursing care. This discussion concerning the normative claims of immediacy and mercy vs. fairness in health care is a pressing issue for nursing care. The claims that arise from particular relationships in nursing care are typically associated with closeness to a person's vulnerabilities. The pressing issue is how considerations of mercy and protection of individual patients can be safeguarded within today's nursing and health‐care practices in which distributivist considerations are crucial.
Inhibitory Effects of 150 Plant Extracts on Elastase Activity, and Their Anti‐inflammatory Effects
Authors: Lee K.‐K. , Kim J.‐H. , Cho J.‐J. , Choi J.‐D.
Published: March 2003

The inhibitory effects of 150 medicinal plants on elastase activity were investigated. Among the 150 plants, six plant extracts (final concentration 1 mg/ml in methanol) exhibited more than 65% of inhibition of elastase activity. The inhibitory effects of six active plants, including Areca catechu (IC50, 42.4 μg/ml), Cinnamonum cassia (IC50, 208.7 μg/ml), Myristica fragrans (IC50, 284.1 μg/ml), Curcuma longa (IC50, 398.4 μg/ml), Alpinia katsumadai (IC50, 465.7 μg/ml) and Dryopteris cassirrhizoma (IC50, 714.4 μg/ml) on the activity of human leukocyte elastase, hyaluronidase and lipid peroxidation were examined. In the lipid peroxidation assay, using the TBA method, three of the six plants, including Curcuma longa (IC50, 45.5 μg/ml), Areca catechu (IC50, 51.0 μg/ml) and Alpinia katsumadai (IC50, 116.3 μg/ml) exhibited more than 70% inhibition at the concentration of 1 μg/ml, but only one plant, Areca catechu (IC50, 563 μg/ml) showed high inhibitory effect on hyaluronidase activity. The results suggest that medicinal plants showing several biological activities may be potent inhibitors of the anti‐ageing process in skin. This property might be useful for application in cosmetics.
Skin Moisturisation and Elasticity Originate From at Least Two Different Mechanisms
Authors: Wiechers J.M. , Barlow T.
Published: March 2003

Skin moisturisation and elasticity are clearly linked in people’s mind. For a large series of neat personal care ingredients we measured both their skin moisturising and plasticising performance on human skin in‐vivo, and were able to rank the products according to their effectiveness. Efficacy was expressed relative to benchmark products: glycerine for moisturisation and water for elasticity. A good spread in skin moisturisation efficacy was found: 15 of our products had a relative performance of less than 30%, 23 products scored between 30 and 70% and 7 ingredients marked above 70%. For skin elasticity, the number of products in the corresponding groups was 36, 4 and 2. This discrepancy could be due to the choice of benchmark products, but when the values for relative elasticity performance of the various ingredients were plotted against those of relative moisturisation effectiveness, it became obvious that skin moisturisation and elasticity are not linearly correlated. This is at least remarkable as water was used as the benchmark product for skin elasticity. The common belief that increased skin moisturisation will automatically lead to enhanced skin elasticity is therefore unlikely to be true.

The only logical conclusion seems to be that different molecular and/or biochemical mechanisms are contributing to these two skin functionalities. By means of Principal Component Analysis, the correlation between molecular descriptors such as skin penetration and humectancy on the one hand and substantivity and occlusivity on the other was evaluated to explain the observed skin moisturisation. It became obvious that none of these purely molecule‐based molecular descriptors could explain the measured skin effects. Skin itself plays an important role in a yet unidentified manner. If both activities are desired in one cosmetic formulation, at least two active ingredients will need to be incorporated, each contributing to one of the two effects.

Examples of multifunctional mixtures and an assessment of the feasibility of obtaining multifunctional molecules are presented.
Evaluation of the irritant capacity of decyl polyglucoside
Authors: Vozmediano  , Carbajo  , Franco  , Milán  , Padilla  , Sarmiento
Published: March 2003

Synopsis

The irritant capacity of several anionic, amphoteric and non‐ionic surfactants has been studied by non‐invasive techniques, specifically by evaporimetry, laser Doppler flowmetry and one‐dimensional cutaneous ecography. Some of the surfactants most frequently used in shampoos and shower/foam gels were selected for testing. A series of aqueous solutions containing 5% of the active material in these products was patched onto normal skin; controls for comparison were set up with water and with sodium lauryl sulphate (SLS), a recognized irritant standard substance.

It was deduced from the results obtained that, of the surfactants tested, the one showing the lowest irritant capacity is decyl polyglucoside, followed in increasing order of irritant capacity, by cocoamidopropyl betaine, magnesium laurylether sulphate and sodium laurylether sulphate.

Résumé

La capacitée irritante des beaucoups des tensioactives anioniques, anfoteric et no‐ioniques on étéétudiées avec métodes no invasives, particulierment avec évaporimetrie, laser DOPPLER et écografie cutanée unidimensionel. On á selectionné pour son texture quelques tensioactives utilisée plus frequement en shampooing et gel de bains ou douche.

On á formulé une series des solutions ocuoses en contenent un 5% des matieres actives quón á emplâtre en peaux normaux, on áétablie des contrôles des comparations avec de l’eau et sodium lauryl sulphate (SLH) une substancie de reconnue irritabilitée.

Des resultats obtenue on á deduit que tous les tensioactives quón á textés, celui qui á montré le meneur capacité irritant il fut decyl polyglucoside, suivi en ordre montante de capacité irritant por cocamidopropyl betaine, magnesium laureth sulphate et sodium laureth sulphate.
The 2000 Dietary Guidelines for Americans: foundation of US nutrition policy
Authors: Johnson Rachel K.
Published: March 2003

The Dietary Guidelines for Americans form the foundation of US federal nutrition policy. The Food Guide Pyramid, the most widely distributed and best‐recognised nutrition education tool ever produced in the US, is based partially on the Dietary Guidelines. In addition, every federal nutrition programme in the United States uses the Dietary Guidelines as part of their nutrition standards. Federal law requires that the guidelines be reviewed every five years. The Dietary Guidelines Advisory Committee was charged with answering the question, ‘what should Americans eat to be healthy?’ After rigorously reviewing the scientific, peer‐reviewed literature the committee recommended a new set of guidelines for the year 2000. The guidelines are intended for healthy children (ages 2 years and older) and generally healthy adults of any age. The guidelines were expanded from seven in 1995 to ten in 2000. The 2000 Dietary Guidelines for Americans are; (1) aim for a healthy weight; (2) be physically active each day; (3) let the pyramid guide your food choices; (4) eat a variety of grains daily, especially whole grains; (5) eat a variety of fruits and vegetables daily; (6) keep foods safe to eat; (7) choose a diet that is low in saturated fat and cholesterol and moderate in total fat; (8) choose beverages and foods that moderate your intake of sugars; (9) choose and prepare foods with less salt; and (10) if you drink alcoholic beverages, do so in moderation.
The biology of white adipocyte proliferation
Authors: Hausman D. B. , DiGirolamo M. , Bartness T. J. , Hausman G. J. , Martin R. J.
Published: March 2003

Expanded adipose tissue mass increases the risk for many clinical conditions including diabetes, hypertension, coronary atherosclerotic heart disease, and some forms of cancer. Therefore, it is imperative that we understand the mechanisms by which fat pads expand. The enlargement of fat cells during the development of obesity has been previously hypothesized to be a triggering factor for the proliferation of new fat cells. There is now a preponderance of evidence that adipose tissue is a source of growth factors such as IGF‐I, IGF binding proteins, TNFα, angiotensin II, and MCSF that are capable of stimulating proliferation. The relative importance of these autocrine/paracrine factors in the normal control of preadipocyte proliferation is unknown. In addition, the proliferative response of preadipocytes to the paracrine milieu is undoubtedly modulated by neural inputs to fat tissue and/or serum factors. Together, these multiple regulatory controls orchestrate overall and region‐specific adipose tissue cellularity responses associated with the development of hyperplastic obesity. Both in vivo and in vitro studies are needed to understand the complex, interacting physiological mechanisms by which growth of this important organ is regulated.
Should obese patients be counselled to follow a low‐glycaemic index diet? No
Authors: Raben A.
Published: March 2003

In diabetes research the glycaemic index (GI) of carbohydrates has long been recognized and a low GI is recommended. The same is now often the case in lipid research. Recently, a new debate has arisen around whether a low‐GI diet should also be advocated for appetite‐ and long‐term body weight control. A systematic review was performed of published human intervention studies comparing the effects of high‐ and low‐GI foods or diets on appetite, food intake, energy expenditure and body weight. In a total of 31 short‐term studies (<1 d), low‐GI foods were associated with greater satiety or reduced hunger in 15 studies, whereas reduced satiety or no differences were seen in 16 other studies. Low‐GI foods reducedad libitumfood intake in seven studies, but not in eight other studies. In 20 longer‐term studies (<6 months), a weight loss on a low‐GI diet was seen in four and on a high‐GI diet in two, with no difference recorded in 14. The average weight loss was 1.5 kg on a low‐GI diet and 1.6 kg on a high‐GI diet. To conclude, there is no evidence at present that low‐GI foods are superior to high‐GI foods in regard to long‐term body weight control. However, the ideal long‐term study wheread libitumintake and fluctuations in body weight are permitted, and the diets are similar in all aspects except GI, has not yet been performed.
Possible involvement of the adipose tissue renin‐angiotensin system in the pathophysiology of obesity and obesity‐related disorders
Authors: Goossens G. H. , Blaak E. E. , Van Baak M. A.
Published: March 2003

Angiotensin II (Ang II), acting on the AT1 and AT2 receptors in mammalian cells, is the vasoactive component of the renin‐angiotensin system (RAS). Several components of the RAS have been demonstrated in different tissues, including adipose tissue. Although the effects of Ang II on metabolism have not been studied widely, it is intriguing to assume that components of the RAS produced by adipocytes may play an autocrine, a paracrine and/or an endocrine role in the pathophysiology of obesity and provide a potential pathway through which obesity leads to hypertension and type 2 diabetes mellitus. In the first part of this review, we will describe the production of Ang II, the different receptors through which Ang II exerts its effects and summarize the concomitant intracellular signalling cascades. Thereafter, potential Ang II‐induced mechanisms, which may be associated with obesity and obesity‐related disorders, will be considered. Finally, we will focus on the different pharmaceutical agents that interfere with the RAS and highlight the possible implications of these drugs in the treatment of obesity‐related disorders.
NOVEL BIOLOGICALLY BASED THERAPEUTIC STRATEGIES IN MYELOMA
Authors: Gupta Deepak , Hideshima Teru , Anderson Kenneth C.
Published: March 2003

Multiple myeloma remains incurable despite advances in conventional chemotherapy and wider applicability of high dose chemotherapy with single and/or tandem autologous peripheral blood stem cell transplantation. Although a complete remission rate of 41% and an event‐free survival of 43 months have been reported after tandem transplantation, it is highly unlikely that further improvements in the outcome of multiple myeloma will be achieved by escalating cytotoxic chemotherapy alone. Novel biologically based therapies are therefore urgently required. Targeted therapeutic approaches based on: identification of genetic abnormalities in malignant plasma cells; interrupting growth of myeloma cells; triggering apoptotic signaling cascades in tumor cells; modulating growth and survival of multiple myeloma cells in the bone marrow microenvironment, i.e. angiogenesis and cytokine networks; enhancing allogeneic and autologous antimyeloma immunity; and characterizing newer myeloma antigens for serotherapy are under development. These therapies offer great promise, used alone/or in combination with conventional treatment approaches, to improve the outcome in this disease in newly diagnosed/refractory or relapsed patients with multiple myeloma.
How generalizable are the results of large randomized controlled trials of antiretroviral therapy?
Authors: Moore Daj , Goodall Rl , Ives Nj , Hooker M , Gazzard Bg , Easterbrook Pj
Published: March 2003

Objectives To examine the generalizability of two large randomized controlled clinical trials of antiretroviral therapy in HIV‐infected individuals.

Methods The demographic, clinical and laboratory characteristics of HIV‐infected participants in two antiretroviral trials (Concorde and Delta) at three study sites were compared with those of two other groups of patients to whom the trial results would be applicable: eligible patients who were screened for the trials but who did not enrol, and eligible patients who were not approached or screened for the trials.

Results Among enrolled participants in the Concorde and Delta trials there was an under‐representation of patients who had acquired HIV infection heterosexually (P = 0.014) or through injecting drug use (P = 0.03), and a greater representation of homosexual men (P < 0.001) compared to non‐enrolled participants. Trial participants in Concorde had significantly less advanced immunosuppression compared to non‐trial participants (P = 0.0001), while in Delta the converse was true. Concorde participants were also much less likely to be lost to follow‐up for more than a year (9%) compared to eligible but unscreened patients (40%) (P < 0.001), and screened but unenrolled patients (22%) (P = 0.035).

Conclusions In applying the findings of large randomized clinical trials, it is important to establish whether there are systematic differences between the characteristics of trial participants and eligible non‐participants, which might affect the generalizability of the study results. A log of the characteristics of enrolled as well as eligible but non‐enrolled patients should be maintained so that the representativeness of the trial population can be evaluated.
Immune reconstitution pneumonitis following Pneumocystis carinii pneumonia in HIV‐infected subjects
Authors: Barry SM , Lipman MCI , Deery AR , Johnson MA , Janossy G
Published: March 2003

An HIV‐infected man presented with a pneumonic illness following an episode of treated Pneumocystis carinii pneumonia (PCP). He had a rise in his CD4 count from 4 to 125 cells/µL on antiretroviral therapy prior to the onset of the second respiratory event. Bronchoalveolar lavage (BAL) revealed no pathogen, although a CD4 lymphocytosis in addition to a highly unusual population of rapidly proliferating CD8 cells was demonstrated. Following 2 weeks of steroid and anti‐pneumocystis therapy, a repeat bronchoscopy demonstrated that the expression of these markers had returned to low values. This second respiratory illness, which may have arisen as a consequence of the regenerating immune response reacting to residual P. carinii antigen in the lung, is apparently not rare. When we reviewed our case notes, five further individuals were identified that had started antiretroviral therapy following an episode of PCP and subsequently developed a self‐limiting pneumonitis for which no pathogen was identified on bronchoscopy.
Predictors of recent HIV testing in homosexual men in Australia
Authors: Jin FY , Prestage G , Law MG , Kippax S , Van de Ven P , Rawsthorne P , Kaldor JM , Grulich AE
Published: March 2003

Objectives

To describe time trends and other predictors of recent HIV testing among homosexual men enrolled in behavioural surveillance studies in Australia.

Methods

Repeated cross‐sectional studies during the period 1996–2001 in Australian capital cities. Men were recruited from a variety of community‐based settings, including gay community outdoor events, sex on premises venues, and social venues. They underwent a brief self‐administered questionnaire in which they reported their HIV status, HIV‐testing history, sexual behaviour and demographic information.

Results

Questionnaires were returned for 22 161 HIV‐negative or status‐unknown participants. While 85.3% had ever tested for HIV, 57.6% had tested in the last 12 months. Recent testing was greater in those living in Sydney, in younger men, in gay‐identified men, in gay community‐attached men, in those who reported unprotected anal intercourse and a higher number of sexual partners, and in partners of HIV‐positive men. Although recent testing declined from 1996 to 2001, this trend was no longer significant when adjusted for other testing predictors.

Conclusions

In Australia, HIV testing among gay men decreased slightly from 1996 to 2001, but the trend was not significant when adjusted for other predictors. Testing levels were highest among those at highest risk of HIV infection, and lowest among non gay‐identified and non gay‐community attached homosexual men.
Lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis: coincidence or association?
Authors: Apaydin Rebiay , Bilen Nilgün , Bayramgürler Dilek , Harova Gökhan , Çetinarslan Berrin
Published: March 2003

Primary localized cutaneous amyloidosis (PLCA) is characterized by the deposition of amyloid in a previously apparently normal skin with the absence of other systemic or cutaneous disorder. Although ankylosing spondylitis may be associated with secondary systemic amyloidosis, no reports have been found showing the association of this disease with PLCA. In addition, the association of PLCA with autoimmune thyroiditis has not been previously reported. We report a concomitant occurrence of lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis in a caucasian woman.
Chronic urticaria: diagnostic recommendations
Authors: Bindslev‐Jensen Carsten , Finzi Aldo , Greaves Malcolm , Camarasa Jose , Ortonne Jean‐Paul , Schöpf Erwin , Tennstedt Dominique
Published: March 2003

A group of European recognized dermatologists – the European Working Group on the Diagnosis of Chronic Urticaria – met on 12 March 1999 to discuss best practice for assessing and diagnosing patients with chronic urticaria. These are their recommendations. The recommendations will be valuable for the majority of cases, but are not exhaustive and may not include every possible precipitating factor.
Recurrent R156H mutation of KRT10 in a Japanese family with bullous congenital ichthyosiform erythroderma
Authors: Mayuzumi Nobuyasu , Shigihara Takako , Ikeda Shigaku , Ogawa Hideoki
Published: March 2003

Recently, mutations of keratin 1 gene (KRT1) and keratin 10 gene (KRT10) have been reported in various patients with bullous congenital ichthyosiform erythroderma (BCIE). The substitution of arginine (R) to histidine (H) at amino acid residue 156 (R156H) of coiled 1A region is one of the most frequent mutations of KRT10. In this study, we searched for a mutation in KRT1 and KRT10 in a Japanese family with BCIE and detected mutation R156H in KRT10. Our search led to the detection of R156H. This mutation was not detected in 50 normal individuals. These results confirmed that codon 156 is a frequently mutated site, and that R156H in KRT10 is likely also to be a mutation hotspot in Japanese patients with BCIE.
Lupus erythematosus‐like lesions in a carrier of X‐linked chronic granulomatous disease
Authors: Córdoba‐Guijarro S , Feal C , Daudén E , Fraga J , García‐Díez A
Published: March 2003

Chronic granulomatous disease (CGD) is an inherited immunodeficiency disease. Carrier status of CGD has been reported in association with lupus erythematosus‐type lesions. A 35‐year‐old woman, mother of a child with X‐linked CGD presented an 8‐year history of erythematous plaques with an arciform pattern on the upper trunk, back and arms. The nitroblue tetrazolium test revealed the carrier status of the patient. Haematological, biochemical and immunological tests (including ANA, DNA, SSA‐Ro, SSB‐La, RNP, SM and Jo1 antibodies) were normal or negative except for a polyclonal hypergammaglobulinaemia with high serum IgA. Histological examination showed a papillary and perifollicular lymphohistiocytic infiltrate. Direct immunofluorescence was negative. We report a female carrier of X‐linked CGD who developed clinical subacute lupus erythematosus‐like lesions. We review the literature and discuss the pathogenetic mechanisms involved in the condition.
Pemphigus vulgaris and disseminated nocardiosis
Authors: Martín Fj , Pérez‐Bernal Am , Camacho F
Published: March 2003

Infectious diseases, in particular septicaemia from Staphylococcus aureus, Proteus vulgaris and Pseudomonas aeruginosa, are the most severe and frequent complications for the immunosuppressive therapy of pemphigus. Infection by Nocardia asteroides in subjects with pemphigus vulgaris is rare. We report the sixth case found of such an association; the subject died of disseminated nocardiosis while receiving steroids and immunosuppressive drugs, 4 years after being diagnosed with chronic pemphigus vulgaris.
Sporotrichosis masquerading as pyoderma gangrenosum: case report and review of 19 cases of sporotrichosis
Authors: Byrd DR , El‐Azhary RA , Gibson LE , Roberts GD
Published: March 2003

We present the case of a 59‐year‐old woman who had large ulcerations on her right leg that were diagnosed initially as pyoderma gangrenosum and treated with three immunosuppressive agents (cyclosporin, prednisone and azathioprine) for 6 months. Results of a biopsy at 6 months showed numerous cigar‐shaped bodies consistent with Sporothrix schenckii; identification was confirmed by tissue culture. A retrospective review was performed for all cases diagnosed as sporotrichosis from tissue culture or biopsy specimens at the Mayo Clinic. Nineteen cases were identified. The present case was the only one in which fungal organisms were visible on histological examination. The present case emphasizes the importance of making a definitive histological diagnosis in unusual ulcer cases or in suspected cases of pyoderma gangrenosum before the initiation of immunosuppressive therapy. The large number of cigar‐shaped bodies in the tissue is a rare finding in sporothrix infection and has been reported in only two cases previously.
Increased incidence of pemphigus vulgaris in southern Europeans living in Germany compared with native Germans
Authors: Hahn‐Ristic K , Rzany B , Amagai M , Bröcker E‐B , Zillikens D
Published: March 2003

Background The two major subtypes of pemphigus include: pemphigus vulgaris (PV) and pemphigus foliaceus. Only limited data are available on the epidemiology of these diseases.

Objective The aim of the present study was to estimate the gender‐ and age‐specific incidences of PV in two well‐defined regions of Germany and to compare the incidences among native Germans with those in citizens from other countries living in Germany.

Methods We performed a retrospective review of records from all patients that were diagnosed with PV at the Departments of Dermatology in Würzburg and Mannheim between 1989 and 1997.

Results During the observation period, 14 patients were diagnosed with PV coming from an area with 1.46 million residents. With regard to the patients’ age, the highest incidence for women was found in the 51–65‐year‐old‐age group with 2.34 [95% confidence interval (CI): 0.36; 7.76] new cases per 1 million inhabitants per year. The highest incidence for men was observed in the over 65‐year‐old age group with 3.72 (95% CI: 0.95; 9.8) cases/million per year. In the 51–65‐year‐old age group, we found a 25‐fold higher incidence of PV in foreigners living in Germany compared with native Germans. The age‐adjusted incidence of PV was ninefold higher in foreigners compared with native Germans. Interestingly, all non‐German patients came from two southern European countries (Turkey and Italy).

Conclusions The age‐adjusted incidence of PV differs between native Germans and foreigners living in Germany. Further studies are necessary to address the risk factors (genetic and/or environmental) that contribute to this difference.
Primary cutaneous plasmacytosis in a child. Is this a new entity?
Authors: Aricò M , Bongiorno MR
Published: March 2003

Plasma cell proliferations represent a heterogeneous spectrum of disorders. A 7‐year‐old Caucasian female had suffered an asymptomatic eruption on the trunk for 4 years. Physical examination revealed a plaque with scattered red–brown papules and nodules. Chemical analysis revealed normal proteinaemia. Histological examination of biopsy specimens showed dense perivascular and periadnexal infiltrate, consisting largely of plasma cells, in the superficial and deep dermis. Immunohistochemical study showed that many cells of the infiltrate were CD20 positive. The plasma cells expressed κ and λ light chains. The girl’s status (age; absence of hypergammaglobulinaemia, lymphadenopathy and hepatosplenomegaly; presence of an infiltrate of mature polyclonal plasma cells restricted only to the skin) differed from those generally seen in diseases with plasma cell proliferation reported in the literature. This case seems unlike any other described up to the present time.
The effects of 17 August Marmara earthquake on patient admittances to our dermatology department
Authors: Bayramgürler D , Bilen N , Namlı S , Altinaş L , Apaydın R
Published: March 2003

On 17 August 1999 a devastating earthquake with a magnitude of 7.4 on the Richter scale occurred in Marmara region of Turkey and the epicentre of the earthquake was our city. In this study we aimed to determine the influence of a major earthquake on patient admittance's to the outpatient clinic of our dematology department. All the registrations of the outpatient clinic of our dermatology department in a period of 6 months after the earthquake and the same period last year were revised retrospectively and categorized into 15 subgroups. The first 3 months registrations (earthquake group 1) and the second 3 months registrations (earthquake group 2) after the earthquake were compared with those of the same periods in last year, respectively (control group 1 and control group 2). Also the earthquake group 1 was compared with the earthquake group 2. When the results were evaluated, it was seen that the incidence of infections‐infestations was significantly higher in the earthquake group 1 when compared with the control group 1. When the earthquake group 2 and the control group 2 were compared with each other regarding the incidences of the skin diseases, no statistically significant difference was found. The incidences of erythematous‐squamous skin diseases, pruritus and neurocutaneous dermatoses and eczemas were significantly higher in the earthquake group 2 when compared with the earthquake group 1. On the other hand, the incidences of infections‐infestations and dermatoses due to physical factors were significantly lower in the earthquake group 2 when compared with the earthquake group 1. We think that the alteration in the admittance's to outpatient clinic of our dermatology department in the first 3 months after the earthquake is due to the damaged infrastructures and unhygienic life conditions and in the second 3 months is due to psycho‐emotional factors related to earthquake.