bluuebunny/crossref_metadata_2025 huggingface dataset:
Airborne contact dermatitis from methylchloroisothiazolinone in wall paint. Abolition of symptoms by chemical allergen inactivation
Authors: Bohn Susanna , Niederer Markus , Brehm Klaus , Bircher Andreas J.
Published: March 2003

Preservatives such as isothiazolinones in paints have been reported to cause airborne contact dermatitis. The patients whom we report experienced acute dermatitis on air‐exposed skin and respiratory symptoms after staying in recently painted rooms. Kathon® (methylchloroisothiazolinone/ methylisothiazolinone) added as preservative to the wall paint was identified as causative agent. In one individual symptoms rapidly disappeared after treatment of the painted walls with inorganic sulfur salt, which leads to inactivation of the allergenic properties of methylchloroisothiazolinone/ methylisothiazolinone. We describe the patients, the clinical course and review the literature pertinent to such cases. In addition we report on the chemical analyses of the decorating paints used, and on experiments on emission and air concentration of methylchloroisothiazolinone/methylisothiazolinone from a painted surface before and after inactivation by sodium bisulfite.
In‐situ evaluation of barrier‐cream performance on human skin using laser‐induced breakdown spectroscopy
Authors: Sun Qing , Tran Michael , Smith Benjamin , Winefordner James D.
Published: March 2003

Laser‐induced breakdown spectroscopy (LIBS) was used to evaluate the effect of barrier creams (skin protective creams) on human skin. A Nd: YAG laser at 1064 nm was used with a pulse energy of 100 mJ. A method was developed to measure the effectiveness of barrier creams against zinc ion absorption from aqueous zinc chloride solution and oil paste zinc oxide, which represent model hydrophilic and lipophilic metal compounds, respectively. Zinc was chosen since it posed no risk to human skin. 3 representative commercial barrier creams advertised as being effective against lipophilic and hydrophilic substances were evaluated by measuring zinc absorbed through the stratum corneum. 4 consecutive skin surface biopsies (SSB) were taken from biceps of the forearms of 6 volunteers at time periods of 0.5 h and 3 h after application of the protective cream. Results were compared with control skin where no barrier cream was used. The zinc atomic emission line at 213.9 nm was selected. Gate delay and gate width time was optimized to obtain the best signal‐to‐noise ratio (SNR) and precision. This method provided a facile and rapid screening of the effectiveness of skin barrier creams against zinc ion penetration. The barrier creams were shown to provide appreciable protection against the penetration of both ZnCl2 and ZnO into the skin.
Prevalence of nickel allergy among Finnish university students in 1995
Authors: Mattila Leena , Kilpeläinen Maritta , Terho Erkki O. , Koskenvuo Markku , Helenius Hans , Kalimo Kirsti
Published: March 2003

Nickel allergy was studied in a sample of 1st‐year university students starting their studies in 1995. A total of 296 subjects (72%) of 413 invited participated in the clinical examination, and 284, 96 male and 188 female, were patch tested (69%). A history of nickel sensitization was enquired for. Prick tests and serum specific IgE levels were determined. Occurrence of atopic dermatitis, hand eczema, and current exposure to metals were recorded. Nickel allergy was encountered in 39% of all female students, in 42% of females with pierced skin, and in 14% of females without pierced skin. The corresponding figures for males were 3%, 7% and 3%. In the multiple regression analysis, the risk factors for nickel allergy were female sex (OR 8.1, p<0.01), current metal exposure at examination (OR 4.1, p<0.01) and skin piercing (OR 3.6, p<0.05). Positive prick tests or elevated IgE levels to common allergens were not significantly associated with nickel allergy. In female students, the prevalence of nickel allergy has increased from 13% in 1986 to 39%. The prevalence among males has remained low at 3%. The results indicate that, in addition to skin piercing, current metal contacts are important risk factors for nickel allergy. This finding gives support to the EU Nickel Directive.
Reduction of use of latex gloves in food handlers: an intervention study
Authors: Lee Adriene , Nixon Rosemary , Frowen Kathryn
Published: March 2003

Frequent latex glove use is a risk factor for the development of latex allergy. With the increase in latex glove use, latex allergy has become more prevalent. There are a number of occupational groups in which the use of latex gloves is both inappropriate and even hazardous, including food handlers, where the hazard relates particularly to their latex‐sensitive customers. The aim of this study was to assess both the use of latex gloves by food handlers and the impact of an intervention study on reducing latex glove use. This was done at the Queen Victoria Market in Melbourne, Australia. We found that 10 out of 30 stalls (33%) used latex gloves, and that following a short education program, this was reduced to 1 stall (3%, p=0.006). The potential to reduce latex glove use by using this intervention study was 93% (95% confidence interval of 54% – 100%). We recommend that food handlers be educated during their training, not only about hygiene issues, but also about the appropriate type of glove to wear, in order to prevent both the development of a new occupational group at risk of becoming allergic to latex, but more importantly to protect their latex‐sensitive customers.
Results of a quality of life questionnaire in a patch test clinic population
Authors: Linn Holness D.
Published: March 2003

There has been increasing interest in quality of life outcomes, but there has been little reported on this topic for individuals with contact dermatitis. The objectives of this study were (i) to pilot a dermatology‐specific quality of life instrument to assess its acceptability in a patch test clinic population, (ii) to see the effects of contact dermatitis on the patients’ lives and (iii) to determine what factors may influence quality of life outcomes in this population. A dermatology‐specific quality of life instrument was modified and used for 339 patients undergoing patch testing in a contact dermatitis clinic. The most common effect was pain or itching in 61%. Approximately 1/3 noted embarrassment, interference with work, or sleep disturbance. Other concerns were reported by less than 25% of the population. On multivariate analysis, the key factor influencing most outcomes was hand involvement. The instrument was well accepted by the clinic population and is now being used in a prospective study of outcomes. In the population assessed, it demonstrated the effects of disease. Analysis suggests that a key factor influencing these quality of life outcomes is hand involvement.
Diaminodiphenylmethane (DDM): frequency of sensitization, clinical relevance and concomitant positive reactions
Authors: Fortina A. Belloni , Piaserico S. , Larese F. , Recchia G. P. , Corradin M. T. , Gennaro F. , Carrabba E. , Peserico A.
Published: March 2003

Diaminodiphenylmethane (DDM) is an aromatic diamine used in the manufacture of rubber, plastics, diisocyanates, dyes and adhesives. It may cross‐react with para‐(amino)compounds. Allergic patch test reactions to DDM are relatively frequent, but their relevance is often difficult to detect. We report our experience in 6809 patients (4589 female, 2220 male, mean age 39.9±17.8 years) with suspected contact dermatitis patch tested during the period 1997–1999 by the North‐East Italy Contact Dermatitis Group (NEICDG). A positive patch test to DDM was detected in 132 (1.9%) patients (88 female, 44 male, mean age 49.5±16.2 years). Eczema was mostly localized on the hands. The relevance was detected in 31 patients. A logistic regression analysis showed an association with patient’s age (odds ratio 5.4 for age 30–59 years), absence of atopic diseases (odds ratio 3.1) and presence of leg ulcer (odds ratio 5). We found a highly significant correlation (p<0.001) between sensitivity to DDM and to para‐phenylenediamine, Disperse Yellow 3, cobalt chloride, fragrance mix, benzocaine, paraben mix and primin. Positive patch test results to DDM were relatively frequent. The difficulty in detecting the relevance of these sensitizations may be related to the surprisingly high frequency of concomitant positive reactions to other allergens.
Prurigo pigmentosa from contact allergy to chrome in detergent
Authors: Kim Myung‐Hwa , Choi Yoo‐Won , Choi Hae‐Young , Myung Ki‐Bum
Published: March 2003

Prurigo pigmentosa is a recurrent inflammatory dermatosis characterized by pruritic erythematous papules and reticulate hyperpigmentation that occurs most frequently in spring and summer. The etiology of prurigo pigmentosa remains unknown. Numerous authors have suggested that various contact allergens may be pathogenic or triggering factors, but nearly all attempts to identify an allergen have been unsuccessful. We report a case of prurigo pigmentosa induced by contact allergy to chrome in detergent, supporting the conclusion that contact allergens such as chrome may play a rôle in inducing prurigo pigmentosa.
Positive patch‐test reactions to para‐phenylenediamine, their clinical relevance and the concept of clinical tolerance
Authors: Chan Yuin‐Chew , Ng See‐Ket , Goh Chee‐Leok
Published: March 2003

406 patients were patch tested over an 18‐month period (January 1998 to June 1999) at a dermatology referral centre. 33 patients (8.1%) had a positive reaction to para‐phenylenediamine (PPD). 20 patients were experiencing PPD hair dye dermatitis (present relevance, 61%), 2 were using PPD hair dyes without developing dermatitis (clinical tolerance, 6%), 4 had previously used PPD hair dyes with dermatitis in the past (past relevance, 12%), 3 had previously used PPD hair dyes without dermatitis (past exposure, 9%) and 4 had no known exposure to PPD (unknown relevance, 12%). Of the 20 patients whose test results were of present relevance, 17 avoided PPD hair dyes, resulting in total clearance of the dermatitis in all except 3, who had concurrent endogenous eczema. 3 continued using PPD hair dyes: 2 had recurrent contact dermatitis and 1 avoided dermatitis with meticulous technique. The 2 patients with clinical tolerance continued using PPD hair dyes with no dermatitis.
A case of contact urticaria syndrome due todi(2‐ethylhexyl) phthalate (DOP) in work clothes
Authors: Sugiura Keiji , Sugiura Mariko , Hayakawa Ritsuko , Shamoto Mikihiro , Sasaki Kazumi
Published: March 2003

We previously reported a case of contact urticaria syndrome (CUS) due to di(2‐ethylhexyl) phthalate (DOP) in a polyvinyl chloride (PVC) grip on cotton gloves. The patient reported in this previous paper was careful not to have any contact with PVC products in his daily life or in his working environment. He discontinued the use of protective gloves with a PVC grip that was the cause of CUS. When working, he used cotton gloves without a PVC grip. We prescribed antihistamines which slightly improved his condition. However, when he wore work clothes while on duty, CUS relapsed. This condition was severe and made him feel anxious. When we advised him to wear a cotton shirt under his work clothes, the contact urticaria did not develop. We suspected that some component of the work clothes was the cause of his symptoms. A prick test with the extract solution of his work clothes showed a wheal and flare at the 15 min reading. The common component of the grip and the work clothes was found by analysis to be DOP.
Sensitizing capacity of some trimers in p‐tert‐butylphenol‐formaldehyde resin
Authors: Zimerson Erik , Bruze Magnus
Published: March 2003

Contact allergy to p‐tert‐butylphenol formaldehyde resin (PTBP‐F‐R) is not rare. This resin consists of a large number of substances, most of which are still unknown. For diagnostic and preventive reasons the chemical identity of the sensitizers should be known, as well as their sensitizing capacities, cross‐reaction patterns and presence in the environment. The aims of this study were to investigate the sensitizing capacities and potential cross‐reacting patterns for 4‐tert‐butyl‐ 2,6‐bis‐(5‐tert‐butyl‐2‐hydroxy‐3‐hydroxymethyl‐benzyloxymethyl)‐phenol (XIII), 4‐tert‐butyl‐2‐ (5 ‐ tert ‐ butyl ‐ 2 ‐ hydroxy‐benzyloxymethyl) ‐ 6 ‐ (5 ‐ tert ‐ butyl ‐ 2 ‐ hydroxy ‐ 3 ‐ hydroxymethyl‐benzyloxy methyl)‐phenol (XIVa) and 7,15,23‐tri‐tert‐butyl‐25,26,27‐trihydroxy‐2,3,10,11,18,19‐hexahomo‐3,11,19‐trioxacalix(3)arene (XVIII) by the guinea pig maximization test. 4‐tert‐Butyl‐2,6‐bis‐hydroxymethyl‐phenol, 4‐tert‐butylbenzene‐1,2‐diol, 4‐tert‐butyl‐2‐hydroxymethyl‐phenol, 4‐tert‐butyl‐phenol, 4‐tert‐butyl‐2‐(5‐tert‐butyl‐2‐hydroxy‐3‐hydroxymethyl‐benzyloxymethyl)‐6‐hydroxymethyl‐phenol, 4‐tert‐butyl‐2‐[5‐tert‐butyl‐3‐(5‐tert‐butyl‐2‐hydroxy‐3‐hydroxymethyl‐benzyloxymethyl) ‐ 2 ‐hydroxy‐benzyloxymethyl] ‐ 6 ‐ (5 ‐ tert‐butyl‐ 2 ‐hydroxy‐ 3 ‐hydroxymethyl‐benzyloxymethyl)‐ phenol and were used as potential cross‐reacting substances. In this study it is strongly indicated that the linear trimer XIII has a sensitizing capacity in the guinea pig which was significant when compared to the controls (p = 0.024). No cross‐reactions were detected in animals induced with the linear trimer XIII. The linear trimer XIVa and the cyclic trimer XVIII failed to induce sensitization.
Investigation of the skin sensitizing activity of linalool
Authors: Basketter David A. , Wright Zoë M. , Colson Neil R. , Patlewicz Grace Y. , Pease Camilla K. Smith
Published: March 2003

An increasing range of chemicals appears to be capable of causing skin sensitization as a result of their capacity to undergo air oxidation (autoxidation) with the consequent formation of reactive species such as epoxides and hydroperoxides. In this small investigation, the ability of linalool, a common fragrance ingredient, to cause such effects was quantified using the local lymph node assay before and after careful purification by vacuum distillation. The commercially available grade of linalool (97% purity) was shown to be a weak skin sensitizer. Various impurities, including linalool oxide, dihydrolinalool, epoxylinalool, 3‐hexenyl butyrate and 3,7‐dimethyl‐1,7‐octadiene‐3,6‐diol were identified and were completely removed (except for the dihydrolinalool remaining at 1.4%) and the re‐purified linalool retested. Neither linalool or dihydrolinalool are protein‐reactive compounds. The sensitization potency of the re‐purified linalool sample was considerably reduced, but not entirely eliminated, suggesting either that an allergenic impurity could be very quickly reformed by mechanisms of activation or that certain potent undetectable allergens remained. Both possibilities are consistent with what is understood of the chemistry and composition of commercially available linalool.
Audit of Finn Chamber® patch test preparation
Authors: Moffitt D. L. , Sharp L. A. , Sansom J. E.
Published: March 2003

Reproducibility of patch test reactions is an important aspect of patch testing. Thin layer rapid use epicutaneous tests (TRUE TestTM) are preloaded with allergen, whereas Finn Chambers® are empty discs that have allergen applied from a syringe. The amount of allergen applied to each Finn Chamber® is therefore potentially variable depending on technique. This may increase the risk of non‐reproducibility of reactions. We have performed an audit of patch test preparation in our department looking at weight variation of both individual Finn Chambers® and 3 completed panels before and after allergen application. We found that the variance in weight was not significant for 2 of the 3 panels and single Finn Chambers® with allergen in petrolatum. The variance in weight was significant for single Finn Chambers® with allergen in solution and the third panel, which contains an allergen in solution. The clinical significance of these results is unclear.
The trabecular structure of developing human mandible
Authors: Wojtowicz A. , Chaberek S. , Pirino A. , Montella A. , Bandiera P. , Kinsner A. , Ostrowski K.
Published: March 2003

In this paper we tried to analyse in quantitative terms the differences in trabecular structure of human mandibles 8, 10 and 12 weeks old. The analysis was performed on decalcified Sirius‐red stained trabeculae, photographed in polarised light. The data obtained from Fourier transforms of scanned pictures were evaluated by discriminant analysis to show the differences between the analysed stages of development. Also, various parts of the mandible were compared because the clinical experience shows that the frequency of pathological changes is different in different parts of mandible bone. The complexity of trabecular structure of bone samples was measured by fractal dimension. It is concluded that this quantitative approach is reliable and, in the future, could be used for physiological and pathological analyses of bone biopsies.
The histologic spectrum of epidermodysplasia verruciformis in transplant and AIDS patients
Authors: Morrison Carl , Eliezri Yehuda , Magro Cynthia , Nuovo Gerard J.
Published: March 2003

Background: The purpose of this study was to correlate the histologic findings of skin lesions clinically suspicious for epidermodysplasia verruciformis with the viral findings in patients with organ transplants or AIDS.

Methods:  Thirty‐seven skin biopsies from 17 patients (six with AIDS and 11 with transplants) were studied as a non‐randomized, controlled, unblinded case series by in situ hybridization for HPV DNA.

Results:  Nineteen (51%) of these biopsies were HPV‐positive by in situ hybridization either for HPV type 5 (five cases), type 8 (10 cases), type 16 (four cases) or HPV 31 (one case, with one case of dual infection). Only eight of the 19 HPV‐positive tissues (42%) showed the classic histologic features of verruca planae. The more common histologic feature significantly associated with HPV detection was a focally thickened and disrupted granular layer (13/19 [68%] vs. 8/18 [44%], p < 0.04). Dysplasia was evident in 12/19 HPV‐positive tissues (63%), which was significantly greater than in patients with congenital epidermodysplasia verruciformis (20%).

Conclusions:  Oncogenic HPV types are detected in about one‐half of skin biopsies from immunocompromised patients with a clinical presentation suspicious for epidermodysplasia verruciformis. Many of these lesions lack the histologic features of verruca planae, a focally thickened granular layer is a marker for viral detection, and the risk for dysplasia in such lesions is much higher than in epidermodysplasia verruciformis not associated with acquired immunosuppression.
Clinical decision‐making in restorative dentistry. Content‐analysis of diagnostic thinking processes and concurrent concepts used in an educational environment
Authors: Maupomé Gerardo , Sheiham Aubrey
Published: March 2003

Context:

Dental practice is affected by variation in diagnosis and treatment planning between clinicians. The process underlying the decisions leading to management of dental caries is poorly understood.

Objective: To explore diagnostic thinking and identify information used in the diagnosis, management and treatment of caries.

Subjects/materials:

15 senior dental students (mean age, 23.1 years; 66% female) in Mexico City were interviewed using a Simulated Patient Model (SPM).

Methods:

The SPM consultation session and its review, aimed at eliciting an introspective recall description of the Diagnostic Thinking Processes (DTP) and the pieces of information (concepts) employed, were transcribed and content‐analyzed (CA). CA reproducibility coefficients were 0.53 to 0.64. The cognitive psychology Gale & Marsden (GM) model was used to structure DTP and concepts. Data were analyzed with chi‐squared tests.

Results: DTP utilization was similar to the original report in endocrinology and neurology cases. A wide variety of concepts were combined with DTP to describe the strategies and information preferentially resorted to while addressing four areas identified in the consultation.

Conclusions: Narrow arrays of concepts of restorative concern (mostly physical features present in/on teeth) were often investigated using DTP 1, 2 and 4 in combination with the use of dental explorers. The heuristics detected link features common to the GM model and to an indirect pattern‐recognition model, whereby reliance on visual/tactile concepts facilitates the acquisition of a clinically meaningful image. Non‐clinical factors believed to be at play in the application of strategies were not investigated but were controlled for in the SPM.
In vivo diagnostic assessment of dentinal caries by junior and senior students using red acid dye
Authors: Tassery H. , Déjou J. , Chafaie A. , Camps J.
Published: March 2003

The aim of this study was firstly to determine and compare the ability of inexperienced junior dental students (Fourth‐year) and senior students (Fifth‐year) versus a dental school instructor to identify demineralized dentine with the aid of a caries‐disclosing solution and secondly to evaluate an eventual improvement of the caries diagnosis accuracy of junior (Fourth‐year) and senior (Fifth‐year) dental students. Three successive stages were used to check the ability of the dental students to diagnose and excavate the de‐mineralized dentine. This study pointed out that 96% of junior dental students versus a teacher failed to remove all of the demineralized dentine without the use of a caries detector at the first stage and 79% at the second stage in the same condition. 100% of senior students versus a teacher, also failed to diagnose dental caries without a caries detector, but only at the first stage. However, at the second stage, unlike the junior students, all of the senior students were able to remove all of the demineralized dentine. Without the use of a caries detector dye, the risks of the dental students leaving demineralized dentine are high. This technique may be particularly helpful for the fourth‐year students who are performing their first restorative treatment.
A virtual classroom for undergraduate Periodontology: a pilot study
Authors: Mattheos Nikos , Nattestad Anders , Schittek Martin , Attström Rolf
Published: March 2003

The Integrated Distributed Learning Environments or virtual classrooms constitute a new promising structure in education of health care personnel. A virtual classroom was developed aiming to teach periodontology to an international group of 28 dental students using a problem‐based learning (PBL) approach. The course was web‐based and included synchronous and asynchronous communication, on‐line libraries and multimedia material. Students were organised in 4 independent groups and each group was appointed a tutor. The results of the study indicate that one of the most positive effects students experienced was competence in using the computer. They also rated highly the use of multimedia for learning of clinical procedures. It was found that web boards and email were too slow to allow group work in the virtual classroom. Real time communication programs were found to be superior for problem discussion and hypothesis formulation. However, email and the web board played a significant role during certain steps of the PBL method. The students expressed a positive attitude for the combined use of network‐based learning and problem‐based education. Our present experience suggests that distance learning should be organised with a mixture of different media, allowing communication of knowledge and skills between the resources and the students, as well as cooperation between the students. Computer literacy among teachers and students is limited and should be enhanced. Finally, personal contact between the resource persons and the students before the distant learning course commences helps the learning process.
Personality of dental students in two dental schools in the United Kingdom and in Ireland
Authors: Fenlon Michael R. , McCartan Bernard E. , Sheriff M. , Newton Tim J.
Published: March 2003

The personality characteristics of students from two dental schools, one in the United Kingdom which admitted students using interviews, and one in Ireland which accepted students solely on examination results, were assessed using the short form of the Eysenck Personality Questionnaire. Results were compared with norms for age and sex. Personality scores of students from the Irish dental school were not significantly different from normal scores. Female and male students from the United Kingdom school scored higher than would be expected on extraversion, and male students from the same school scored lower than would be expected on neuroticism. The differences in personality between the two schools may be explained by the different methods of admission.
Rating of statements in an internal course evaluation: comparison between different groups of assessors
Authors: Elen Jan , Naert Ignace , Lambrechts Paul , Garmyn Peter , Verdonck Anne , Van der Plaetsen Ibe , Goijens Kris , Quirynen Marc
Published: March 2003

The increased concern for accountability and quality improvement is inducing universities throughout Europe to evaluate and control performance. The establishment of criteria for educational quality, a requirement for a successful evaluation, was studied as part of an evaluation of the dental education programme at the Catholic University of Leuven. Criteria suggested by different groups (members of the internal evaluation commission including graduate and postgraduate students; members of the academic staff of the School of Dentistry, Oral Pathology and Maxillo‐facial Surgery, and other members of the academic staff, not directly belonging to the school), were analysed by means of ANOVA with Scheffé posthoc tests to identify intergroup differences. It was hypothesized that a closer connection to the dental curriculum or a higher responsibility in the evaluation process would result in stricter criteria. For 108 different questions (in the form of statements with a six point Likert‐type scale), members of the three groups had to indicate the score below which the quality would be considered suboptimal. Except for one question, no significant differences were found between ratings given by the members of the internal evaluation commission and other members of the School. Significant differences were found between non‐school members and school‐ and/or commission‐members. This study indicates that agreement on educational quality may be presupposed within an academic faculty and between members of the internal evaluation commission. However, the study also indicated that some caution should be exercised when ‘external’ teachers are included in the evaluation process.
4.1 Web‐based interactive learning programmes
Authors: Nattestad Anders , Attstrom Rolf , Mattheos Nikos , Ramseier Christoph , Canegallo Lorenza , Eaton Ken , Feeney Luke , Goffin Guy , Markovska Neda , Maixner William , Persson Rutger , Reynolds Patricia , Ruotoistenmaki Juha , Schittek Martin , Spohn Eric , Sudzina Mike
Published: March 2003

In the future, the training of competent dentists will need to take advantage of up‐to‐date digital technologies and learning practices. In order to accomplish this, the following goals should be considered: i) the design of ‘customizable’ web‐based curriculum matrices that accommodate the training philosophies and resources of individual dental schools; ii) the development of digital instructional modules that can be incorporated or downloaded into specific parts of a curriculum; iii) the establishment of an e‐consortium, which provides peer view and guidance in the design of teaching modules, and which is responsible for the storage, maintenance, and distribution of teaching modules within the consortium; iv) the development of central human and physical resources at each dental school to enable the seamless delivery of instructional modules in a variety of learning environments; and v) the assessment and provision of ICT training to students and faculty with respect to the use of computers and related digital technologies and educational software programmes. These goals should lead to the creation of a ‘virtual dental school’. Within this project summative and formative evaluations should be performed during both the production and development of teaching material (e‐learning material) and the learning process. During the learning process the following aspects should be measured and evaluated: i) students' behaviour; and ii) effectiveness, retention and the transfer of e‐learned material into the clinical situation. To obtain evidence of the efficacy of e‐learning material a certain amount of research has to be done in the near future. It is suggested that all parameters currently known have to be implemented during the development of a learning programme. Previous workers have evaluated the following elements with e‐learning: i) planning, ii) programming and technical development, iii) learning behaviours, iv) learning outcomes of both the programme and the student, v) the acquisition of knowledge, skills and attitude and vi) the transfer of e‐learned skills into clinical situations.
Species richness and rarity in European rodents
Authors: Kryštufek Boris , Griffiths Huw I.
Published: March 2003

The presence or absence of 77 rodent species was scored within 427 squares of 100×100 miles. The grid encompassed the entirety of Europe west of the Urals and north of the Caucasus, but excluded all offshore islands. Rodent distributional ranges varied between 26 000 and 22 670 000 km2. Very large ranges were uncommon and 53% of species had ranges covering <20% of the study area. Range size showed no correlation with body size, nor did it depend on taxonomic provenance. However, saltatorial rodents appeared to have the largest median ranges and fossorial species the smallest. Species densities varied between 4 and 26 species/grid square, with the highest densities coinciding broadly with the steppe–deciduous forest ecotone. The degree of endemism showed a different geographic pattern from that of species density, with the highest values at lower latitudes. Forty‐nine squares (11% of Europe's surface) identified as species richness and endemism “hot spots” contained >80% of genera and species, their largest contiguous coincidence being in the southern Balkans, the Carpathian Basin, southern Ukraine and cis‐Caucasia.
The effects of individual interactions and habitat preferences on spatial structure in a grassland bird community
Authors: Mikami Osamu K. , Kawata Masakado
Published: March 2003

Spatial structure and the distribution of individuals within a community might be influenced by several factors such as habitat heterogeneity and local interactions among individuals of the same and different species. We investigated the spatial distributions of eight bird species in a grassland community during the breeding season and examined whether the spatial distributions of individuals were influenced by interactions among neighboring individuals or different habitat preferences of different bird species.  In order to identify the effects of the interactions among neighboring individuals and habitat preference, we developed a randomization test in which species identifications were randomly allocated to the observed individual positions within areas with the same vegetation structure. The randomization test indicated that individuals tend to have territories near the territories of individuals of the same species or of a particular species more frequently (or less frequently) than those expected from random distributions of individuals.  Among these associations, only one case was explained by individual interactions, and 19 cases were explained by habitat preference.  The results suggest that both individual interactions and habitat preference affected the spatial distributions of individuals and possibly influence the species compositions and diversity in grassland bird communities.
Scale dependence of spatial patterns and cartography on the detection of landscape change: relationships with species’ perception
Authors: Suárez‐Seoane Susana , Baudry Jacques
Published: March 2003

This paper analyses how landscape pattern detection changes when different spatial and temporal scales and several levels of detail of the cartography are used to describe a landscape affected by land abandonment in northern Spain. In order to integrate landscape composition and structure at different temporal and spatial scales in the same framework, a multiple correspondence factorial analysis was ran for each typology of landscape units. Annual rates of change and scale dependencies were calculated for each typology from the Euclidean distances in the factorial space. Finally, the potential assessment of habitat utilisation by species with different landscape perception and movement capacity was modelled for the range of typologies.  The amount of variance explained by the factorial analysis decreased with the complexity of the typology. Annual rates of change appeared different according to the time span and the detail of the landscape unit typology used. For all typologies, changes were faster during 1983–95, a period characterised by massive land abandonment. However, when the whole period (1956–95) was considered, annual changes were much lower, showing differences between typologies. As a general trend, the variance of the mean annual change decreased with the size of the analysis units. In response to land abandonment, different scale dependencies were found for different levels of detail of the cartography. Coarser typologies are suitable when analysing highly mobile species. However, species with small movement capacity or with a preference for homogeneous habitats perceive more detail in landscape. In this case, a detailed typology is more appropriate.
Influence of the joint treatment with granulocyte colony‐stimulating factor and drugs elevating extracellular adenosineon erythropoietic recovery following 5‐fluorouracil‐induced haematotoxicityin mice
Authors: Weiterová L. , Hofer M. , Pospíšil M. , Znojil V. , Vácha J. , Vacek A. , Pipalová I.
Published: March 2003

Abstract: The presented data address the problem of pleiotropic effects of granulocyte colony‐stimulating factor (G‐CSF) and suggest the ability of drugs increasing the level of extracellular adenosine to activate erythropoiesis when given jointly with G‐CSF. To demonstrate these interactions, the effects of the drugs on the recovery from erythropoietic damage induced in mice by a single dose of 5‐fluorouracil (5‐FU) were investigated. Elevation of extracellular adenosine and thus activation of adenosine receptors was induced by joint administration of dipyridamole (DP), a drug inhibiting the cellular uptake of adenosine, and adenosine monophosphate (AMP), an adenosine prodrug. The drugs were injected in a 4‐d treatment regimen starting 2 h after 5‐FU injection. Both DP+AMP and G‐CSF alone induced only weak effects. However, the combination of the three drugs produced significant elevation of erythrocytes in the peripheral blood which pertained in the post‐treatment period. Stimulation of proliferation of erythroid progenitor cells (BFU‐E) in femoral bone marrow and increased levels of reticulocytes in the peripheral blood were observed in the course of the 4‐d treatment regimen. In addition, significantly decreased mean cell haemoglobin accompanying the elevated numbers of erythrocytes in the combination‐treated mice was found. This effect could be interpreted as the result of a sublethal 5‐FU‐induced damage to erythroid progenitor and precursor cells forced to proliferate intensively by the combination therapy. The observed additivity and synergism of G‐CSF with elevated extracellular adenosine in terms of erythropoiesis is an interesting finding with potential implications in clinical practice.
Influence of gemcitabine (2′,2′‐difluoro‐deoxycytidine) and 2‐chlorodeoxyadenosine on growth of normal and leukemic cellsin vitro
Authors: Lech‐Marańda Ewa , Korycka Anna , Robak Tadeusz
Published: March 2003

Abstract: The aim of the study was to investigate the influence of gemcitabine (2′,2′‐difluorodeoxycytidine, dFdC) used alone and in combination with 2‐chlorodeoxyadenosine (2‐CdA) on the colony growth of normal granulocyte‐macrophage progenitor cells (CFU‐GM) from 15 hematologically healthy donors as well as on CFU‐GM from 15 chronic myelogenous leukemia (CML) patients in semisolid cultures in vitro. dFdC and 2‐CdA were used either separately or in the following combinations of concentrations: (1) 0.25 nM of dFdC and 2.5 nM of 2‐CdA; (2) 0.5 nM of dFdC and 5 nM of 2‐CdA; (3) 1 nM of dFdC and 10 nM of 2‐CdA; (4) 2 nM of dFdC and 20 nM of 2‐CdA. We observed that both dFdC and 2‐CdA used separately inhibited the growth of colonies formed by normal and CML CFU‐GM cells in a dose‐dependent manner. Moreover, the combined therapy with dFdC and 2‐CdA caused statistically significant inhibition of the colony growth in both normal and CML CFU‐GM cultures. In addition, the inhibition of CML CFU‐GM colony formation was greater and statistically significant in the case of the combined therapy using higher concentrations of these drugs as compared with inhibition of the growth of normal CFU‐GM colonies. These observations were the basis for the evaluation of the interaction type between dFdC and 2‐CdA. We have shown that dFdC used in a combination with 2‐CdA acts in an additive way on normal and CML CFU‐GM cells.
Effect of pamidronate administration on markers of bone turnover and disease activity in multiple myeloma
Authors: Terpos Evangelos , Palermos John , Tsionos Konstantinos , Anargyrou Konstantinos , Viniou Nora , Papassavas Pantelis , Meletis John C. , Yataganas Xenophon
Published: March 2003

Abstract: Aim: Bisphosphonates are potent inhibitors of osteoclastic activity and are used in the treatment of multiple myeloma (MM) in combination with chemotherapy. The effect of pamidronate on markers of bone resorption [cross‐linked N‐telopeptides of type I collagen (NTx)], markers of bone formation [serum alkaline phosphatase (BAP) and osteocalcin (OSC)], interleukin‐6 (IL‐6), β2‐microglobulin, CRP, paraprotein and disease‐related pain and skeletal events has been evaluated in 62 newly diagnosed patients with MM. Patients and methods: The patients were randomly assigned to two groups: the first included 32 patients under chemotherapy and pamidronate (group I) and the second 30 patients on chemotherapy only (group II). Pamidronate was administered at a monthly dose of 90 mg iv, and the above parameters were evaluated at the beginning of this study and after 1, 3, 6, 9, 12 and 14 months of treatment. Results: The addition of pamidronate to chemotherapy resulted in a significant reduction of NTx, IL‐6 and paraprotein from the 3rd month and of β2‐microglobulin, CRP and pain from the 6th month of treatment. No changes of NTx, IL‐6, β2‐microglobulin, CRP or skeletal events were observed in patients of group II, while paraprotein was significantly reduced after 6 months of treatment. The differences in NTx, IL‐6, paraprotein and β2‐microglobulin were statistically significant between the two groups. Multivariate analysis revealed a significant correlation between changes of NTx, changes of IL‐6 in both groups and reduction of pain and paraprotein in group I. Conclusions: These results suggest that pamidronate may have a synergistic action with chemotherapy in decreasing osteoclastic activity, in reducing markers of myeloma activity and myeloma related pain and in improving the quality of life in patients with MM.
Epitope identification for human neutrophil flavocytochrome b monoclonals 48 and 449
Authors: Burritt James B. , Fritel Garth N. , Dahan Iris , Pick Edgar , Roos Dirk , Jesaitis Algirdas J.
Published: March 2003

Abstract: Flavocytochrome b558 (Cyt b) is important in generating superoxide and other toxic oxygen species involved in inflammation and host defense. Monoclonal antibodies (mAbs) 48 and 449 bind the gp91phox and p22phox subunits of Cyt b, respectively, and have been used to characterize this enzyme complex. Until now, data were unavailable to predict which regions of the protein were bound by each antibody. Random sequence phage‐display peptide library analysis of each antibody was used to select peptides that mimic the sequence of each protein epitope. Phage sequences selected by mAb 48 presented the consensus peptide sequence, DRDVXTGL, which closely resembles 498EKDVITGL505 of gp91phox. Phage selected by mAb 449 contributed the consensus WRWPGPQVL, resembling in part 182GPQV185 of p22phox. Confirmation for this second epitope was provided by peptide walking analysis. Identifying the protein residues bound by these antibodies makes each a more informative probe for Cyt b analysis.
Cell kinetic study of normal humanbone marrow hematopoiesis andacute leukemia using 7AAD/PY
Authors: Toba Ken , Koike Tadashi , Watanabe Kenichi , Fuse Ichiro , Takahashi Masuhiro , Hashimoto Shigeo , Takahashi Hidenobu , Abe Takashi , Yano Toshio , Shibazaki Yasuhiko , Itoh Hiromi , Aizawa Yoshifusa
Published: March 2003

We have used the 7AAD/PY method to analyze the cell cycle status of normal human bone marrow hematopoiesis, and found that the cell kinetics differed. There were cells with relatively low levels of RNA in the S‐phase (Type I) and a high level in the S phase (Type II). T‐cells, B‐cells, nucleated red cells and CD34+/CD19+ early B‐cells in bone marrow were Type I, whereas myelomonocytic subset and CD34+/CD33 dim+ common myeloid cells were Type II. AC133+/CD38 dim cells, which were thought to be lineage‐marker negative hematopoietic stem cells, had intermediate amounts of RNA in the S‐phase between Type I and II (Type 0). Seventy‐four cases of acute leukemia were also analyzed. Most of the T‐ and B‐ALL cases were found to be Type I, most of the ANLL cases were Type II, and there were 10 cases that were Type 0. These findings yielded fundamental information about normal hematopoiesis and acute leukemia.
Treatment of chronic myeloid leukemia in the blastic phase with fludarabine, cytosine arabinoside and G‐CSF (FLAG)
Authors: Tedeschi A. , Montillo M. , Ferrara F. , Nosari A. , Mele G. , Copia C. , Leoni P. , Morra E.
Published: March 2003

Abstract: The present study was undertaken to evaluate the efficacy of the association of fludarabine plus Ara‐C and G‐CSF (FLAG) in the treatment of 15 patients with chronic myeloid leukemia in the blastic phase (CML‐BP).Patients achieving a partial remission (PR) after the first course received a second FLAG. Complete remission (CR) was consolidated with another FLAG regimen. Patients were then submitted to an individualized program of treatment depending on age and suitable donors. Overall seven patients achieved CR (46.7%), three (20%) showed a primary resistant disease, while three (20%) died during remission induction therapy. Five of them received a consolidation therapy; in two cases further treatment was not performed because of severe toxicity. Median overall survival and disease‐free survival were of 7.5 and 4.5 months, respectively. FLAG proved to be effective in achieving a high CR rate in patients with CML‐BP. Median overall survival and disease‐free survival were not significantly improved compared to previous studies. Nevertheless, the treatment was well tolerated even in a group of heavily pretreated patients, allowing further transplantation opportunities in younger patients.
Ex vivo expansion and characterisation of CD34+ cells derived from chronic myeloid leukaemia bone marrow and peripheral blood, and from normal bone marrowand mobilised peripheral blood
Authors: Garin Marina I. , Apperley Jane F. , Melo Junia V.
Published: March 2003

Abstract: Ex vivo culture of CD34+ has the potential to provide large numbers of cells for clinical use in autologous and allogeneic transplantation and for experimental research involving genetic manipulation. We evaluated the ex vivo expansion of CD34+ cells obtained from bone marrow (BM) and peripheral blood (PB) of untreated patients with chronic myeloid leukaemia (CML) in chronic phase and compared these results with those obtained from BM from normal volunteers (NBM) and peripheral blood after mobilising chemotherapy from patients with non‐haematological disorders (MPB). Selected CD34+ cells were stimulated with interleukin 1(β), interleukin IL‐3, interleukin IL‐6 and stem cell factor. The proliferation observed in patients with CML was similar to that seen in normal donors. CD34+ cells derived from patients with CML are more differentiated than their normal counterparts, as shown by the coexpression of CD34 and CD33 antigens on day 0 (85.6% for CML‐BM and 76.8% for CML‐PB). The culture conditions allowed a significant expansion of granulocyte‐macrophage colony forming units (CFU‐GM) from NBM (33‐fold increase) and MPB (22‐fold increase), in contrast with CML‐derived BM and PB CD34+ cells (2.3‐fold increase). These results indicate that the optimal time to harvest ex vivo expanded cells is dependent on a critical compromise between cell numbers and successful retention of their repopulating potential.
Administration of a modified chemotherapeutic regimen containing vincristine, liposomal doxorubicin and dexamethasone to multiple myeloma patients: preliminary data
Authors: Tsiara S. N. , Kapsali E. , Christou L. , Panteli A. , Pritsivelis N. , Bourantas K. L.
Published: March 2003

Abstract: For elderly patients with multiple myeloma (MM), conventional melphalan and prednisone (MP) therapy has been the treatment of choice; the vincristine, doxorubicin and dexamethasone (VAD) regimen is preferred for younger patients who also receive high‐dose melphalan in combination with autologous or allogeneic bone marrow transplantation (BMT). Although survival time is similar in both the MP and VAD regimens, the continuous infusion of doxorubicin which the latter treatment entails constitutes a disadvantage along with the 4‐day hospitalization required. Doxorubicin also induces cardiotoxicity, particularly in the elderly. A modified form of VAD therapy includes liposomal doxorubicin (Caelyx®) (40 mg/kg for 1 d), oncovin (2 mg for 1 d) and dexamethasone 40 mg for 4 d per os. Doxorubicin encapsulated with liposomes has less cardiotoxicity, is more efficient and has fewer side effects than conventional doxorubicin, and it can be administered on an outpatient basis: dexamethasone can be given orally and vincristine in bolus infusion. In order to estimate its efficacy and tolerability, we administered this regimen to 12 patients (first‐line treatment in 6 patients, salvage therapy in 6 patients). All patients exhibited good tolerance to liposomal doxorubicin with no severe side effects. Eight patients achieved complete hematological remission and three partial response. One patient died before completing the treatment.

In conclusion, compared to other therapies, this modified VAD regimen containing liposomal doxorubicin can be more easily administered to MM patients, without severe side effects and with increased full remission rates, almost similar to those with the conventional VAD treatment.