bluuebunny/crossref_metadata_2025 huggingface dataset:
DIRECT FABRICATION OF ORIENTED MnS THIN FILMS BY CHEMICAL BATH DEPOSITION
Authors: FAN DONG BO , WANG HAO , ZHANG YONG CAI , CHENG JIE , YAN HUI , YOSHIMURA MASAHIRO
Published: March 2004

Oriented thin films of manganese sulfide ( MnS ) have been deposited by a simple chemical bath deposition (CBD) method, which was a soft solution-processing route for preparation of semiconductor thin films. By varying deposition conditions (e.g. bath temperature, concentration ratio of Mn 2+ ions to CH 3– CS – NH 2 and concentration ratio of Mn 2+ ions to C 6 H 5 Na 3 O 7), the effects of synthetic conditions on the properties of films were investigated. On the basis of experimental results, the synthetic conditions were optimized. The crystallinity and orientation of films were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Using the optical absorption data, the optical band gap for the MnS films was determined to be 3.23 eV.
WETTING OF ROUGH SURFACES
Authors: ZHANG XINPING , YU SIRONG , HE ZHENMING , MIAO YAOXIN
Published: March 2004

This paper focuses on effects of roughness on wettability. According to Wenzel's equation, the transition of theoretical wetting contact angles is 90°, whereas many experimental results have indicated that such a transition takes place at contact angles smaller than 90°. A new model of wetting on roughness surface is established in this paper. The model indicates that the influencing factors of wetting on roughness surface include not only equilibrium contact angle θ0 and surface roughness, but also the system of liquids and solid substrates. There is a corresponding transition angle for every surface roughness, and the transition angle is lower than 90°. Surface roughness is propitious to improve the contact angle only when θ0 is lower than the transition angle. The effect of surface roughness on the contact angle increases with the increase of rE. To engineer the surface with different roughnesses, a Ti test sample is polished with sandpaper with abrasive number 350, 500, 1000 and 2000; the contact angles of water on Ti are measured by the sessile drop method. The results of the theoretical analysis agree with experimental ones.
AN EXTENSIBLE ARCHITECTURE-BASED FRAMEWORK FOR COORDINATION LANGUAGES
Authors: FINK TORSTEN , OTTO KARSTEN
Published: March 2004

The dynamic and heterogeneous nature of distributed systems makes the development of distributed applications a difficult task. Various tools, such as middleware systems, component systems, and coordination languages, offer support the application developer at different levels.

There are several coordination systems that integrate such tools into a complete environment to build applications from heterogeneous components. To achieve extensibility they usually have a layered architecture: an application is first mapped to a middle layer and then to a target system. But this approach hides the specific features of a target system from the developer, as they are not represented in the middle layer, and often induces additional run-time overhead.

In this paper, we introduce the extensible coordination framework ECF that allows developers to build efficient distributed applications which exploit the specific features of the target systems. Support for target systems and application domains are encapsulated by extension modules. Modules can be built on top of other modules to support refined functionality.
FULLY AUTOMATED PEELING TECHNIQUE FOR T1-WEIGHTED, HIGH-QUALITY MR HEAD SCANS
Authors: MEEGAMA RAVINDA G. N. , RAJAPAKSE JAGATH C.
Published: March 2004

In order to conduct many non-intrusive clinical studies of the human brain, an accurate model that is capable of extracting the brain matter from magnetic resonance images (MRI) is required. We present a fully automated two-stage procedure to extract the brain matter accurately from a database of T1-weighted, high-quality MRI of healthy subjects. The procedure is initiated using a three dimensional (3D) segmentation process to separate the brain from other anatomical structures. The extracted brain is then subjected to an adaptive filter to remove cerebro-spinal fluid that fills sulcal cavities. The experiments clearly demonstrate the capability of the present technique in accurately peeling the brain. The accuracy of the results is tested using relative gray and white matter concentrations of both simulated and real MR images.
A GENETIC ALGORITHM-BASED APPROACH FOR DETECTION OF SIGNIFICANT VERTICES FOR POLYGONAL APPROXIMATION OF DIGITAL CURVES
Authors: SARKAR BISWAJIT , SINGH LOKENDRA KUMAR , SARKAR DEBRANJAN
Published: March 2004

A polygonal approximation captures the essential features of a digital planar curve and yields a compact representation. Those points of the digital curve that carry vital information about the shape of the curve form the vertices of the approximating polygon and are called significant vertices. In this paper, we present a genetic algorithm-based approach to locate a specified number of significant points, such that the approximation error between the original curve and its polygonal version obtained by joining the adjacent significant points is minimized. By using a priori knowledge about the shape of the curve we confine our search to only those points of the curve that have the potential of qualifying as significant points. We also incorporate chromosome differentiation to improve upon the effectiveness of the search in arriving at a near-optimal polygonal approximation. Finally, we show that the proposed method performs remarkably well when evaluated in terms of the metrics available for assessing the goodness of a polygonal approximation algorithm.
AUTOMATIC IMAGE REGISTRATION USING VIRTUAL CIRCLES
Authors: ALHICHRI HAIKEL S. , KAMEL MOHAMED
Published: March 2004

The main contribution of this work is a novel set of image features called the virtual circles and their use in the registration of images under similarity transformations. A virtual circle is a circle with maximal radius encompassing a background area that does not contain edge points. It has many useful properties such as its radius, and its dominant edge direction for example, which can be utilized for efficient registration. Furthermore, virtual circles are frequent and can be extracted efficiently with the help of the distance transform from many types of images. We have tested the new virtual circles method in the registration of 66 pairs of images, half of which are printed labels and the other half are indoor scenes. Experimental results have shown that this method has a linear complexity in terms of the number of pixels. It is also highly automatic, because it has a small number of parameters, which almost never need to be changed throughout the experiments.
VECTORIZATION AND PRECISE REFRACTIONS IN BEAM TRACING
Authors: KOYAMA KAZUHIRO , TOMIZAWA YOSHIAKI , OKADA MINORU
Published: March 2004

In this paper we propose two improvements to the beam tracing method, one is to reduce the final redundant-drawing of pixel fragments into the frame buffer, and the other is to use Snell's law instead of the tangent law. It is well known that the ray tracing scheme is one of the most effective methods for high quality CG image synthesis. The beam tracing method was introduced because traditional ray tracing algorithms have a significant calculation cost. In the improved method, the projection screen is recursively divided into non-overlapping coherent region segments based on the coherence of the ray-trace-tree structure of a given scene, and an image can be synthesized after the segmentation process by tracing one or several rays in each region segment. We introduced Snell's law for the refractions of the rays. Therefore, we can reduce the computational cost of ray tracing, eliminate the extra calculations caused by overlapping polygons on a screen, and increase the quality of CG images generated by our proposed method.
COMPUTER PROOFS OF MATRIX PRODUCT IDENTITIES
Authors: LARCOMBE PETER J. , RIESE AXEL , ZIMMERMANN BURKHARD
Published: March 2004

We introduce in this paper a straightforward but useful method for computing indefinite rational matrix products. The method is used to prove a certain identity involving definite sums and a definite integral.
SOME SPECIAL FAMILIES OF HYPERELLIPTIC CURVES
Authors: SHASKA TANUSH
Published: March 2004

Let [Formula: see text] denote the locus of hyperelliptic curves of genus g whose automorphism group contains a subgroup isomorphic to G. We study spaces [Formula: see text] for G≅ℤn, ℤ2⊕ℤn, ℤ2⊕A4, or SL2(3). We show that for G≅ℤn, ℤ2⊕ℤn, the space [Formula: see text] is a rational variety and find generators of its function field. For G≅ℤ2⊕A4, SL2(3) we find a necessary condition in terms of the coefficients, whether or not the curve belongs to [Formula: see text]. Further, we describe algebraically the loci of such curves for g≤12 and show that for all curves in these loci, the field of moduli is a field of definition.
ON-SHELL SYMMETRIES
Authors: FATIBENE L. , FERRARIS M. , FRANCAVIGLIA M.
Published: March 2004

We define on-shell symmetries and characterize them for Lagrangian systems. The terms appearing in the variation of the Poincaré–Cartan form, which vanish because of field equations, are found to be strongly constrained if the space of solutions has to be preserved. The behavior with respect to solution dragging is also investigated in order to discuss relations with the theory of internal symmetries of a PDE.
Control of T Cell Viability
Authors: Marrack Philippa , Kappler John
Published: March 2004

▪ Abstract  The factors affecting T cell viability vary depending on the type and status of the T cell involved. Naïve T cells die via a Bcl-2/Bim dependent route. Their deaths are prevented in animals by IL-7 and contact with MHC. Activated T cells die in many different ways. Among these is a pathway involving signals that come from outside the T cell and affect it via surface receptors such as Fas. Activated T cells also die through a pathway driven by signals generated within the T cell itself, a cell autonomous route. This pathway involves members of the Bcl-2 family, in particular Bcl-2, Bcl-xl, Bim, and probably Bak. The viability of CD8+ and CD4+ memory T cells is controlled in different ways. CD8+ memory T cells are maintained by IL-15 and IL-7. The control of CD4+ memory T cells is more mysterious, with roles reported for IL-7 and/or contact via the TCR.
Multiple Roles of Antimicrobial Defensins, Cathelicidins, and Eosinophil-Derived Neurotoxin in Host Defense
Authors: Yang De , Biragyn Arya , Hoover David M. , Lubkowski Jacek , Oppenheim Joost J.
Published: March 2004

Mammals generate a diverse array of antimicrobial proteins, largely represented by defensins or cathelicidins. The direct in vitro microbicidal activity of antimicrobial proteins has long been considered an important innate immune defense, although the in vivo relevance has only very recently been established for certain defensins and cathelicidins. Mammalian defensins and cathelicidins have also been shown to have multiple receptor-mediated effects on immune cells. Beta-defensins interact with CCR6; murine β-defensin-2 in addition activates TLR4. Cathelicidins act on FPRL1-expressing cells. Furthermore, several defensins have considerable immunoenhancing activity. Thus, it appears that mammalian antimicrobial proteins contribute to both innate and adaptive antimicrobial immunity.
MolecularDefects inHumanSevereCombinedImmunodeficiency andApproaches toImmuneReconstitution
Authors: Buckley Rebecca H.
Published: March 2004

▪ Abstract  Mutations in nine different genes have been found to cause the human severe combined immunodeficiency syndrome. The products of three of the genes—IL-2RG, Jak3, and IL-7Rα—are components of cytokine receptors, and the products of three more—RAG1, RAG2, and Artemis—are essential for effecting antigen receptor gene rearrangement. Additionally, a deficiency of CD3δ, a component of the T-cell antigen receptor, results in a near absence of circulating mature CD3+ T cells and a complete lack of γ/δ T cells. Adenosine deaminase deficiency results in toxic accumulations of metabolites that cause T cell apoptosis. Finally, a deficiency of CD45, a critical regulator of signaling thresholds in immune cells, also causes SCID. Approaches to immune reconstitution have included bone marrow transplantation and gene therapy. Bone marrow transplantation, both HLA identical unfractionated and T cell–depleted HLA haploidentical, has been very successful in effecting immune reconstitution if done in the first 3.5 months of life and without pretransplant chemotherapy. Gene therapy was highly successful in nine infants with X-linked SCID, but the trials have been placed on hold due to the development of a leukemic process in two of the children because of insertional oncogenesis.
T Lymphocyte–EndothelialCellInteractions
Authors: Choi Jaehyuk , Enis David R. , Koh Kian Peng , Shiao Stephen L. , Pober Jordan S.
Published: March 2004

▪ Abstract  Human vascular endothelial cells (EC) basally display class I and II MHC-peptide complexes on their surface and come in regular contact with circulating T cells. We propose that EC present microbial antigens to memory T cells as a mechanism of immune surveillance. Activated T cells, in turn, provide both soluble and contact-dependant signals to modulate normal EC functions, including formation and remodeling of blood vessels, regulation of blood flow, regulation of blood fluidity, maintenance of permselectivity, recruitment of inflammatory leukocytes, and antigen presentation leading to activation of T cells. T cell interactions with vascular EC are thus bidirectional and link the immune and circulatory systems.
The Dynamic Life of Natural Killer Cells
Authors: Yokoyama Wayne M. , Kim Sungjin , French Anthony R.
Published: March 2004

▪ Abstract  Natural killer (NK) cells play important roles in immunological processes, including early defense against viral infections. This review provides an overview of the dynamic in vivo life of NK cells from their development in the bone marrow to their mature peripheral responses and their ultimate demise, with particular emphasis on mouse NK cells and viral infections.
Ubiquitin Ligases and the Immune Response
Authors: Liu Yun-Cai
Published: March 2004

Ubiquitin (Ub)-protein conjugation represents a novel means of posttranscriptional modification in a proteolysis-dependent or -independent manner. E3 Ub ligases play a key role in governing the cascade of Ub transfer reactions by recognizing and catalyzing Ub conjugation to specific protein substrates. The E3s, which can be generally classified into HECT-type and RING-type families, are involved in the regulation of many aspects of the immune system, including the development, activation, and differentiation of lymphocytes, T cell–tolerance induction, antigen presentation, immune evasion, and virus budding. E3-promoted ubiquitination affects a wide array of biological processes, such as receptor downmodulation, signal transduction, protein processing or translocation, protein-protein interaction, and gene transcription, in addition to proteasome-mediated degradation. Deficiency or mutation of some of the E3s like Cbl, Cbl-b, or Itch, causes abnormal immune responses such as autoimmunity, malignancy, and inflammation. This review discusses our current understanding of E3 Ub ligases in both innate and adaptive immunity. Such knowledge may facilitate the development of novel therapeutic approaches for immunological diseases.
TheRole ofSuppressors ofCytokineSignaling(SOCS) Proteins inRegulation of theImmuneResponse
Authors: Alexander Warren S. , Hilton Douglas J.
Published: March 2004

▪ Abstract  Cytokines are an integral component of the adaptive and innate immune responses. The signaling pathways triggered by the engagement of cytokines with their specific cell surface receptors have been extensively studied and have provided a profound understanding of the intracellular machinery that translates exposure of cells to cytokine to a coordinated biological response. It has also become clear that cells have evolved sophisticated mechanisms to prevent excessive responses to cytokines. In this review we focus on the suppressors of cytokine signaling (SOCS) family of cytoplasmic proteins that completes a negative feedback loop to attenuate signal transduction from cytokines that act through the janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. SOCS proteins inhibit components of the cytokine signaling cascade via direct binding or by preventing access to the signaling complex. The SOCS proteins also appear to target signal transducers for proteasomal destruction. Analyses of genetically modified mice in which SOCS proteins are overexpressed or deleted have established that this family of negative regulators has indispensable roles in regulating cytokine responses in cells of the immune system as well as other tissues. Emerging evidence also suggests that disruption of SOCS expression or activity is associated with several immune and inflammatory diseases, raising the prospect that manipulation of SOCS activity may provide a novel future therapeutic strategy in the management of immunological disorders.
Role of rib cage elastance in the coupling between the abdominal muscles and the lung
Authors: Cappello Matteo , De Troyer André
Published: March 2004

The abdominal muscles expand the rib cage when they contract alone. This expansion opposes the deflation of the lung and may be viewed as pressure dissipation. The hypothesis was raised, therefore, that alterations in rib cage elastance should affect the lung deflating action of these muscles. To test this hypothesis and evaluate the quantitative importance of this effect, we measured the changes in airway opening pressure (Pao), abdominal pressure (Pab), and rib cage transverse diameter during isolated stimulation of the transversus abdominis muscle in anesthetized dogs, first with the rib cage intact and then after rib cage elastance was increased by clamping the ribs and the sternum. Stimulation produced increases in Pao, Pab, and rib cage diameter in both conditions. With the ribs and sternum clamped, however, the change in Pab was unchanged but the change in Pao was increased by 77% ( P < 0.001). In a second experiment, the transversus abdominis was stimulated before and after rib cage elastance was reduced by removing the bony ribs 3–8. Although the change in Pab after removal of the the ribs was still unchanged, the change in Pao was reduced by 62% ( P < 0.001). These observations, supported by a model analysis, indicate that rib cage elastance is a major determinant of the mechanical coupling between the abdominal muscles and the lung. In fact, in the dog, the effects of rib cage elastance and Pab on the lung-deflating action of the abdominal muscles are of the same order of magnitude.
Contribution of nNOS- and eNOS-derived NO to microvascular smooth muscle NO exposure
Authors: Kavdia Mahendra , Popel Aleksander S.
Published: March 2004

Nitric oxide (NO) plays an important role in autocrine and paracrine manner in numerous physiological processes, including regulation of blood pressure and blood flow, platelet aggregation, and leukocyte adhesion. In vascular wall, most of the bioavailable NO is believed to derive from endothelial cell NO synthase (eNOS). Recently, neuronal NOS (nNOS) has been identified as a source of NO in the vicinity of microvessels and has been shown to participate in vascular function. Thus NO can be produced and transported to the vascular smooth muscle cells from 1) endothelial cells and 2) perivascular nerve fibers, mast cells, and other nNOS-containing sources. In this study, a mathematical model of NO diffusion-reaction in a cylindrical arteriolar segment was formulated. The model quantifies the relative contribution of these NO sources and the smooth muscle availability of NO in a tissue containing an arteriolar blood vessel. The results indicate that a source of NO derived through nNOS in the perivascular region can be a significant contributor to smooth muscle NO. Predicted smooth muscle NO concentrations are as high as 430 nM, which is consistent with reported experimental measurements (∼400 nM). In addition, we used the model to analyze the smooth muscle NO availability in 1) eNOS and nNOS knockout experiments, 2) the presence of myoglobin, and 3) the presence of cell-free Hb, e.g., Hb-based oxygen carriers. The results show that NO release by nNOS would significantly affect available smooth muscle NO. Further experimental and theoretical studies are required to account for distribution of NOS isoforms and determine NO availability in vasculatures of different tissues.
Activity-Driven Synaptic and Axonal Degeneration in Canine Motor Neuron Disease
Authors: Carrasco Dario I. , Rich Mark M. , Wang Qingbo , Cope Timothy C. , Pinter Martin J.
Published: March 2004

The role of neuronal activity in the pathogenesis of neurodegenerative disease is largely unknown. In this study, we examined the effects of increasing motor neuron activity on the pathogenesis of a canine version of inherited motor neuron disease (hereditary canine spinal muscular atrophy). Activity of motor neurons innervating the ankle extensor muscle medial gastrocnemius (MG) was increased by denervating close synergist muscles. In affected animals, 4 wk of synergist denervation accelerated loss of motor-unit function relative to control muscles and decreased motor axon conduction velocities. Slowing of axon conduction was greatest in the most distal portions of motor axons. Morphological analysis of neuromuscular junctions (NMJs) showed that these functional changes were associated with increased loss of intact innervation and with the appearance of significant motor axon and motor terminal sprouting. These effects were not observed in the MG muscles of age-matched, normal animals with synergist denervation for 5 wk. The results indicate that motor neuron action potential activity is a major contributing factor to the loss of motor-unit function and degeneration in inherited canine motor neuron disease.
The Role of New Agents in the Treatment of Colorectal Cancer
Authors: Folprecht Gunnar , Köhne Claus-Henning
Published: March 2004

New drugs improved efficacy or convenience of treatment in metastatic colorectal cancer. The oral fluoropyrimidines capecitabine and UFT are less toxic but equally efficacious relative to intravenous bolus 5-fluorouracil (5-FU)/folinic acid (FA). These agents might be beneficial for patients who unlikely benefit from the more intensive combination therapy with infusional 5-FU/FA and irinotecan or oxaliplatin. First-line therapy with irinotecan or oxaliplatin and 5-FU/FA induces an objective response in up to 50% of the patients and may allow neoadjuvant concepts in unresectable liver metastasis. The combination therapy increased progression-free survival and in the case of irinotecan/5-FU/FA also overall survival when compared to 5-FU/FA. Sequential treatment with infusional 5-FU/FA plus oxaliplatin followed by 5-FU/FA plus irinotecan or vice versa results in a median survival exceeding 20 months. Thus, patients in a good performance status and with favorable prognostic parameters should be offered first-line combination treatment of irinotecan or oxaliplatin with 5-FU/FA, whereby 5-FU is preferably administered as an infusion for combination therapy. New targets in the treatment of colorectal cancer are the EGF and VEGF receptor. The monoclonal EGF receptor antibody cetuximab alone and in combination with irinotecan is active in second-line treatment. The VEGF antibody bevacizumab prolongs survival when given in combination with 5-FU/FA and irinotecan.
Response to Chemotherapy (Irinotecan plus 5-Fluorouracil) in Colorectal Carcinoma Can Be Predicted by Tumour DNA Content
Authors: Bendardaf R. , Lamlum H. , Ristamäki R. , Ålgars A. , Collan Y. , Pyrhönen S.
Published: March 2004

Objective: The aim of this study was to identify markers that might predict response to chemotherapy. Postoperative chemotherapy improves the outcome in stage III colon cancer and is widely accepted as a standard therapy, but there are currently no reliable predictors to identify and select patients that will benefit. Methods: Using DNA image cytometry, the DNA content was determined from the isolated nuclei of 56 primary colorectal carcinomas of patients who received chemotherapy (either irinotecan or irinotecan plus 5-fluorouracil and folinic acid) for advanced disease. Response to chemotherapy could be reliably evaluated in 53 patients. Results: The modal DNA content (ploidy status) of the tumour correlated with the observed response to chemotherapy (p = 0.01). An objective response was observed in 56% of patients whose tumour histograms displayed tetraploid, peri-tetraploid or multiploid patterns of peaks, compared with 19% in patients with diploid, peri-diploid or aneuploid peaks. Notably, 86% (6/7) of patients whose tumours displayed a multiploid peak pattern showed an objective response and 1 patient had stable disease. Conclusion: This study suggests that modal DNA content can be used to predict a patient’s response to chemotherapy in advanced colorectal carcinoma. This may help in identifying patients who will benefit most from therapy for advanced colorectal cancer.
Social Support and the Persistence of Complaints in Chronic Fatigue Syndrome
Authors: Prins J.B. , Bos E. , Huibers M.J.H. , Servaes P. , van der Werf S.P. , van der Meer J.W.M. , Bleijenberg G.
Published: March 2004

Background: Several studies suggested that the surroundings of chronic fatigue syndrome (CFS) patients are of importance in the persistence of complaints. Contrary to what was expected, participation in support groups has not led to clinical improvement. The purpose of the present study was to describe social support in CFS patients as compared with other fatigued and non-fatigued groups. Further, changes in social support and the influence of social support on the course of CFS over a period of more than 1 year were studied in patients with and without treatment. Methods: Baseline data were assessed in 270 CFS patients, 150 disease-free breast cancer patients, 151 fatigued employees on sick-leave and 108 healthy subjects using the Social Support List and Significant Others Scale. CFS patients were followed in cognitive behaviour therapy (CBT), guided support groups and natural course at 8 and 14 months. Results: CFS patients and fatigued employees reported more negative interactions and insufficiency of supporting interactions than cancer patients and healthy controls. No differences in frequency of supporting interactions were found. Negative interactions decreased significantly after treatment with CBT, but did not change in support groups or natural course. In the natural course, higher fatigue severity at 8 months was predicted by more negative interactions at baseline. Conclusions: In CFS patients and fatigued employees, social support is worse than in disease-free cancer patients and healthy controls. Lack of social support was identified as a new factor in the model of perpetuating factors of fatigue severity and functional impairment in CFS.
Does Meeting Needs Improve Quality of Life?
Authors: Slade Mike , Leese Morven , Ruggeri Mirella , Kuipers Elizabeth , Tansella Michele , Thornicroft Graham
Published: March 2004

Background: This study investigated the relationship between patient-rated unmet needs and subjective quality of life using routine outcome data. Methods: 265 mental health service patients from South Verona were assessed using the Camberwell Assessment of Need, the Lancashire Quality of Life Profile, and other standardised assessments of symptoms, disability, function and service satisfaction. At 1-year follow-up, 166 patients were still in contact, of whom 121 patients (73%) were re-assessed. Results: Higher baseline quality of life was associated with being male, a diagnosis of psychosis, higher disability, higher satisfaction with care, fewer staff-rated or patient-rated unmet needs, and fewer patient-rated met needs (accounting for 40% of the variance). Specifically, fewer baseline patient-rated unmet needs were cross-sectionally associated with a higher quality of life (B = –0.08, 95% CI –0.12 to –0.04). Apart from its baseline value, the only baseline predictor of follow-up QoL was patient-rated unmet need (B = –0.08, 95% CI –0.21 to –0.09), accounting for 58% of the variance in follow-up quality of life. Graphical chain modelling confirmed this association. Conclusions: The association between high numbers of unmet needs and low subjective quality of life appears increasingly robust across several studies. Future research will need to investigate whether changes in needs precede changes in quality of life. This study provides further evidence that a policy of actively assessing and addressing patient-rated unmet needs may lead to improved quality of life.
Convergent and Discriminant Validity of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist
Authors: Mataix-Cols David , Fullana Miquel Ángel , Alonso Pino , Menchón Josep Manuel , Vallejo Julio
Published: March 2004

Background: The factor structure of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (Y-BOCS-SC) has been well established, but its convergent and divergent reliability have yet to be studied. Methods: Fifty-six obsessive-compulsive disorder (OCD) patients were administered the clinician-administered Y-BOCS-SC and Hamilton Rating Scale for Depression (HRSD), together with the self-administered Maudsley Obsessive Compulsive Inventory (MOCI), Padua Inventory (PI), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). Results: Overall, the correspondence between the Y-BOCS-SC and self-administered measures of OCD symptoms was poor to moderate. Its convergent validity was adequate for its washing dimension but poor for its other dimensions. The discriminant validity of the Y-BOCS-SC was adequate, showing little overlap with overall illness severity (total Y-BOCS) and state measures (BDI, STAI, HRSD). In contrast, self-administered OCD measures were significantly correlated with overall illness severity and state measures. Conclusions: The convergent validity of the Y-BOCS-SC was generally poor and this could only be partially explained by the incomplete coverage of some OCD symptoms in the self-administered scales. Its discriminant validity was good. Both self- and clinician-administered measures should be used in OCD research, as they seem to measure relatively non-overlapping constructs. Further research on the psychometric properties of the Y-BOCS-SC is needed.
Soluble Transferrin Receptor and Its Ratio to Erythroblasts in Bone Marrow May Be a New Diagnostic Tool to Distinguish between Aplastic and Refractory Anemia
Authors: Matsuda Akira , Misumi Motohiro , Shimada Tsuneyuki , Yoshida Katsuhiko , Yagasaki Fumiharu , Ito Yoshihiro , Kawai Nobutaka , Murohashi Ikuo , Hirashima Kunitake , Bessho Masami
Published: March 2004

Myelodysplastic syndromes (MDS), especially refractory anemia (RA) are very heterogeneous diseases regarding their morphological, biological and clinical features. One important clinical problem is the difficulty of diagnosis. Soluble transferrin receptors (sTfRs) reflect the erythropoietic activity in the bone marrow (BM). To establish whether determination of serum sTfR could be useful for the differential diagnosis between RA and aplastic anemia (AA), we measured the serum sTfR concentrations, BM cellularity and BM erythroblast percentages in 14 untreated AA and 7 untreated RA patients. The serum sTfR levels of the RA patients (820.1 ± 402.8 ng/ml) were significantly higher than those of the AA patients (491.1 ± 195.2 ng/ml; p = 0.0207). However, the serum sTfR values of RA and AA patients also overlapped. A new index, the ‘sTfR-E index’ [the ratio of serum sTfR level (ng/ml) to BM cellularity (%) × BM erythroblasts (%)] is proposed, which is expected to reflect the number of transferrin receptors (TfR) on the cell membrane per BM erythroblast. The sTfR-E index values of the 7 RA patients (0.395 ± 0.234) were significantly lower than those of the 14 AA patients (2.669 ± 1.633; p = 0.0003). The sTfR-E index values of AA and RA patients overlapped only marginally. In conclusion, the sTfR-E index may be a useful new diagnostic tool to distinguish between AA and RA patients.
Prefibrotic Chronic Idiopathic Myelofibrosis – A Diagnostic Enigma?
Authors: Thiele J. , Kvasnicka H.M.
Published: March 2004

To analyze precursor lesions of chronic idiopathic myelofibrosis (CIMF) 21 patients were recruited who developed manifest myelofibrosis after about 70 months, preceded by a prefibrotic stage but without interference by cytoreductive therapy. Prodromal bone marrow lesions included a prominent granulocytic and megakaryocytic proliferation with megakaryocytes showing conspicuous abnormalities associated with a borderline to slight anemia, thrombocytosis, and minimal splenomegaly. Comparison of this cohort with 211 additional patients at this precursor stage revealed no differences concerning clinical findings and bone marrow histopathology. Relative incidence of prefibrotic CIMF was 24% and median survival 143 months, thus contrasting overt CIMF (82 months). In CIMF progressive myelofibrosis occurred in more than 50% of patients according to the last biopsy specimen; however, this figure increased according to relevant clinical data in the follow-up period.
Acute Myeloid Leukemia Secondary to a Myelodysplastic Syndrome with t(3;3) (q21;q26) in an HIV Patient Treated with Chemotherapy and Highly Active Antiretroviral Therapy
Authors: Breccia Massimo , Gentile Giuseppe , Martino Pietro , Petti Maria Concetta , Russo Eleonora , Mancini Marco , Alimena Giuliana
Published: March 2004

We describe the first case of secondary acute myeloid leukemia (AML) with t(3;3) (q21;q26) occurring in a human immunodeficiency virus (HIV)-infected patient sequentially treated with chemotherapy and highly active antiretroviral therapy (HAART). The t(3;3) is a nonrandom abnormality found in a small percentage of patients with myelodysplastic syndrome, secondary AML or chronic myeloid leukemia and is strongly associated with abnormal thrombopoiesis and a particularly poor prognosis. So far, it has never been observed in HIV-positive patients. Sporadic cases of AML have been reported in HIV patients and the feasibility of chemotherapy in association with HAART and disease outcome are still not clearly defined. Despite the poor response to chemotherapy in our case, which might also be related to the unfavorable karyotype, the secondary nature of the disease and the HIV positivity, the patient had a relatively long period of survival that could be due to the use of HAART. The association of chemotherapy with HAART appeared to be feasible and tolerable and could be suggested as a choice treatment in this peculiar subset of HIV/AML patients.
Comparable Efficacy and Tolerability of Formoterol (Foradil®) Administered via a Novel Multi-Dose Dry Powder Inhaler (Certihaler™) or the Aerolizer® Dry Powder Inhaler in Patients with Persistent Asthma
Authors: Dahl R. , Creemers J.P. , van Noord J. , Sips A. , Della Cioppa G. , Thomson M. , Andriano K. , Kottakis J. , Fashola T.
Published: March 2004

Background: For maximum treatment compliance there is a need to provide asthma patients with devices that suit their particular preferences. The Foradil® Certihaler™ is a novel multi-dose dry powder inhaler developed to increase the choice of devices available. Objectives: To evaluate the safety and efficacy of formoterol administered via the Foradil Certihaler, or via the single-dose inhaler Foradil® Aerolizer®. Methods: This was a randomized, placebo-controlled, double-dummy, incomplete block crossover, dose-ranging and pharmacokinetic study in patients with persistent asthma. Sixty-seven patients (mean 48.0 years) were randomized to formoterol 5, 10, 15 and 30 µg twice daily via the Certihaler, 12 µg formoterol b.i.d. via the Aerolizer, or placebo in four 1-week double-blind treatment periods separated by 1-week single-blind washouts. Results: All formoterol doses delivered via the Certihaler or the Aerolizer significantly increased FEV1 compared with placebo (p < 0.0001). Formoterol demonstrated an onset of action of <3 min. All active treatments were well tolerated. Tremor was the most common adverse event and was more pronounced at high doses. At lower doses the incidence of tremor with the Certihaler was similar to that observed with placebo or the Aerolizer. The pharmacokinetic evaluation comprised 41 patients (mean 45.9 years). Urinary excretion of unchanged formoterol and total formoterol increased with dose delivered via the Certihaler. The optimum dose of formoterol via the Certihaler was 10 µg. Conclusion: Delivery of formoterol via the Certihaler or Aerolizer combines rapid relief with enduring control and provides convenient bronchodilation in patients with persistent asthma.
Non-Invasive Pressure Support Ventilation in Patients with Respiratory Failure due to Severe Acute Cardiogenic Pulmonary Edema
Authors: Valipour Arschang , Cozzarini Wolfgang , Burghuber Otto C.
Published: March 2004

Background: Recent studies suggest the use of non-invasive pressure support ventilation (NIPSV) in patients with acute cardiogenic pulmonary edema (ACPE). However, it remains unclear whether all patients with ACPE benefit from NIPSV. Objectives: To investigate short-term effects of NIPSV on respiratory, hemodynamic and oxygenation parameters in patients with respiratory failure due to severe ACPE and to identify factors predicting the need for intubation and in-hospital mortality. Methods: In a prospective, uncontrolled, open study, 28 patients admitted with signs and symptoms of severe respiratory distress due to ACPE were given NIPSV in addition to standardized pharmacological treatment. Physiological parameters were obtained before and after NIPSV, and intubation rate and in-hospital mortality were recorded. Results: NIPSV increased arterial oxygenation from paO2 54.2 ± 12.4 to 76.9 ± 12.6 mm Hg (p = 0.0001) and decreased respiratory frequency from 40.1 ± 8.2 to 22.4 ± 4.9 breaths/min (p = 0.0001). Significant improvements were also noted for heart rate, blood pressure and the paO2/FiO2 ratio. Four patients (14%) required intubation despite NIPSV. Patients who required intubation had lower paCO2 levels (p = 0.0002), lower serum bicarbonate concentrations (p = 0.04) and lower systolic blood pressure (p = 0.045) than patients who were successfully treated with NIPSV. Eight patients (28.5%) died during hospitalization. In patients with a paCO2 ≤35 mm Hg on admission, the in-hospital mortality was 87%, but in patients with a paCO2 >35 mm Hg the in-hospital mortality was 6%. Conclusions: NIPSV improves oxygenation and alleviates respiratory distress in patients with respiratory failure due to severe ACPE. However, a subgroup of patients with hypocapnia on admission might have a poor prognosis, with a higher risk of intubation and in-hospital mortality.
Comparative Effects of a Two-Week Treatment with Nebivolol and Nifedipine in Hypertensive Patients Suffering from COPD
Authors: Cazzola Mario , Matera Maria Gabriella , Ruggeri Paolo , Sanduzzi Alessandro , Spicuzza Lucia , Vatrella Alessandro , Girbino Giuseppe
Published: March 2004

Background: It has been suggested that the antihypertensive agent nebivolol, a β1-adrenoceptor-blocking agent that modulates the endogenous production of nitric oxide, is preferable to ‘conventional’ β1-blockers in hypertensive patients with airway dysfunction. Objectives: Since β1-blockade by nebivolol is larger after repeated dosing than after a single oral intake, we have explored its effect on pulmonary function after a 2-week treatment in hypertensive patients with mild to moderate COPD. Methods: A single-blind crossover design was used. Twenty patients with COPD as selected above and with a diastolic blood pressure of 95–110 mm Hg after 1 week of placebo run-in were entered into the two 2-week active treatment periods with either 5 mg nebivolol (n = 10) or 30 mg nifedipine gastrointestinal-transport-system (GITS) (n = 10) taken for a period of 2 weeks. After a further 1-week washout, subjects were crossed-over to receive the other drug for 2 additional weeks. At each visit, changes in spirometric indexes and the interaction with the bronchodilator effect of salbutamol were investigated. Moreover, systolic and diastolic blood pressure (BP) together with heart rate were manually measured in order to evaluate the cardiovascular effects of the different treatments. Throughout the study, patients recorded symptoms. Results: Similar and significant reductions in systolic and diastolic BP were observed with both treatments. The impact of nifedipine on FEV1 was not significant (p > 0.05), while that of nebivolol was slight. The maximum response to salbutamol was slightly decreased with either nebivolol or nifedipine GITS. Day-to-day airway obstruction control, interpreted from patient recordings of symptom scores and inhaler use, was similar with both treatments. Conclusions: Our pilot study suggests that the use of nebivolol in hypertensive patients with stable mild to moderate COPD was safe during a 2-week trial. Evaluation of longer time periods, larger patient numbers with more severe COPD or during exacerbations is warranted.
Differences in the Distribution of CD4+ and CD8+ T Cells in Emphysematous Lungs
Authors: Aoshiba Kazutetsu , Koinuma Miyuki , Yokohori Naoko , Nagai Atsushi
Published: March 2004

Background: Recent studies have shown that T cells are the predominant cells infiltrating the alveolar wall of patients with emphysema. Since CD4+ and CD8+ cells have dissimilar function, they may have different distributions in emphysematous lungs. Objectives: The aim of this study was to investigate whether CD4+ and CD8+ are differently distributed in the lungs of patients with emphysema. Methods: We evaluated CD4+ and CD8+ cell infiltration in lung tissue sections obtained from smokers with pulmonary emphysema who had undergone lung volume reduction surgery (n = 10). Paraffin-embedded lung tissue sections were immunostained using antibodies against CD4+ or CD8+, and distributions of CD4+ and CD8+ cells were evaluated using a morphometric analysis. We determined the degree of emphysema using the area fraction of the alveolar wall (AA,aw) and examined its relation to the number of cells per unit area of the alveolar wall (NA). Results: The majority of CD4+ cells were located in the lung parenchyma of severe emphysematous lesions characterized by the lowest alveolar wall fraction (AA,aw). In contrast, more CD8+ cells were located in mild emphysematous lesions than in severe lesions. Conclusions: These results suggest that CD4+ and CD8+ cells are differently distributed according to the severity of emphysema. CD4+ T cells are located preferentially in severe emphysematous lesions whereas CD8+ T cells occur preferentially in mild emphysematous lesions.
Shewanella putrefaciens Isolated in a Case of Ventilator-Associated Pneumonia
Authors: Jorens Philippe G. , Goovaerts K. , Ieven M.
Published: March 2004

We report the isolation of the aquatic gram-negative bacterium Shewanella putrefaciens from the bronchoalveolar lavage in a case of ventilator-associated pneumonia. To our knowledge, this species has never been isolated from the lower respiratory tract before as a potential pathogen.
Monocyte Chemoattractant Protein-1 Promoter –2518 Polymorphism May Have an Influence on Clinical Heterogeneity of Bipolar I Disorder in the Korean Population
Authors: Pae Chi-Un , Kim Jung-Jin , Yu Hye-Sook , Lee Chang-Uk , Lee Soo-Jung , Jun Tae-Youn , Lee Chul , Paik In-Ho
Published: March 2004

The aim of this study was to investigate the association between monocyte chemoattractant protein-1 (MCP1) promoter –2518 polymorphism and DSM-IV-based bipolar I disorder (BID) in Korea. Ninety-two patients with BID and 114 healthy controls participated in this study. A polymerase chain reaction-based method was used for genotyping. Genotype and allele distributions in patients with BID were not different from those of the controls, nor were they different according to clinical factors in the patient group. However, the frequency of the A allele (p = 0.028) was significantly different when subdividing the patient group into patients with manic episode versus depressed and mixed episode. The present study suggests that the MCP1 promoter –2518 polymorphism may not confer susceptibility to BID itself, but could have an influence on the clinical heterogeneity of BID, at least in the Korean population.
Cross-Linking of Human Amniotic Membrane by Glutaraldehyde
Authors: Spoerl Eberhard , Wollensak Gregor , Reber Friedemann , Pillunat Lutz
Published: March 2004

Purpose: The transplantation of cryopreserved human amniotic membrane has been introduced recently for the reconstruction of the ocular surface. However, in some diseases the transplant usually dissolves rather quickly and early detachment may occur. Therefore, we tried to stabilize the amniotic transplant by applying glutaraldehyde for collagen cross-linking of the membrane. Methods: 18 human amnions were prepared. 4 × 4 cm pieces of amnion were treated with 0.1% glutaraldehyde solution for 30 min. Biomechanical force-elongation measurements were performed and resistance to enzymatic digestion by 0.1% collagenase solution was tested and compared to cryopreserved and untreated fresh amnion. 8 patients with various ocular surface defects were treated with cross-linked amnion and compared to 5 patients with cryopreserved amnion. Results: The force of the amnion cross-linked with glutaraldehyde at 2.5 mm elongation was increased statistically significant by 175% versus fresh amnion and 76.8% versus the cryopreserved amnion. Glutaraldehyde-treated membranes were virtually completely resistant to enzymatic digestion, while fresh and cryopreserved amnions were dissolved completely by day 7. In patients, the cross-linked membrane was preserved for up to 90 days without any signs of dissolution of the membrane and good transparency. Conclusions: Collagen cross-linking using glutaraldehyde leads to a significant increase in the biomechanical strength and enzymatic resistance of amnion, better transparency and less wrinkling. The cross-linked membrane does not dissolve for months and is well suited for the surface reconstruction of the cornea.
Retinal Antigens Are Recognized by Antibodies Present in Sera of Patients with Multiple Sclerosis
Authors: Gorczyca Wojciech A. , Ejma Maria , Witkowska Danuta , Misiuk-Hojło Marta , Kuropatwa Marianna , Mulak Małgorzata , Szymaniec Stanisław
Published: March 2004

Multiple sclerosis (MS) is frequently accompanied by visual symptoms including those related to retinal disorders. Since they may be a consequence of an autoimmune reaction, we examined whether sera of patients with diagnosed MS and changes in visual-evoked potentials contain antibodies against retinal antigens (retAgs). Immunoblot analysis revealed that MS sera recognized mainly a 46-kD antigen, a 41-kD antigen, retinal arrestin, to a smaller extent also 70-, 56-, 43-, and 36-kD proteins. Patients whose sera showed the highest reactivity with 41- and 46-kD antigens had deficiencies in visual acuity, visual fields, ophthalmoscopy, and electroretinograms. Our observation suggests that antibodies to these retAgs may play a role in the origin of ophthalmologic impairment in MS.