bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender Differences in Teen Parents' Perceptions of Parental Responsibilities
Authors: Dallas Constance , Wilson Tony , Salgado Vanessa
Published: March 2003

Accurate information concerning teen parents' knowledge of their children's development and their expectations for paternal involvement becomes increasingly important as efforts increase to promote involvement of unmarried fathers with their children. The purpose of this descriptive study was to assess differences in the knowledge and perceptions of normal child development, and expectations for paternal responsibilities between unmarried, low‐income African American and Mexican American adolescent mothers and their males partners. Seven unmarried adolescent mothers participated in a focus group interview held at a family service agency in the Midwest. Afterward, their male partners and reported fathers of their babies, participated in a separate focus group interview The mean age of the adolescent mother participants was 16.7 years, the mean age of their partners was 19.3 years. Data were analyzed using a tape‐based analysis method. A number of differences were identified between the perceptions of the adolescent mothers and young fathers including their level of child development knowledge, context for selecting physical methods of discipline, expectations for paternal role behaviors, and feelings about child support payments and establishing legal paternity. The study findings may help health care providers develop more effective prenatal and parenting educational experiences for adolescent parents.
Health Care Access: A Consumer Perspective
Authors: Higgs Zana Rae , Bayne Tina , Murphy Denice
Published: March 2003

This article describes the use of action research as an information base for policy formulation by a collaborative partnership in Spokane, Washington. Health and social service providers recognized access to care by uninsured persons as a major community issue. Little was known from the consumers' perspective about factors limiting access. No benchmarks existed against which to measure progress. Investigators collected mailed surveys from 475 residents of six Spokane neighborhoods and 97 persons participated in 12 focus group sessions. Income, education, and ethnicity were primary factors affecting perceptions of degree to which medical, dental, and mental health needs were being met. Many residents were unable to obtain needed health care; low‐cost dental and mental health services were named as their highest priorities. Quality of care, relationships with providers, immediacy of access, and cost were important concerns. Major barriers were cost, length of time before one could get an appointment, lack of comfort with providers, and having to miss work for appointments. Consumer input is critical in understanding local issues in health care. Action research that combines qualitative and quantitative data enhanced practice/policy decisions through assuring ownership of the research and immediate use of findings by involved agencies.
The Impact of a Stroke Screening Program
Authors: Willoughby Deborah F. , Sanders Leigh , Privette Arlene
Published: March 2003

Stroke is a leading cause of serious disability and is the third leading cause of death in the United States. Prevention and early intervention are key to reducing death and disability from stroke. This study investigated the impact of a community‐based stroke‐screening program on the knowledge of participants regarding signs and symptoms of stroke, related emergency action, and personal risk factors for stroke. Self‐reported behavioral changes were also recorded. Initial data were collected at the screening site as part of the program, and follow‐up data were collected by telephone interview at 1, 3, and 6‐month intervals after the screening. Of the 107 people who participated in the screening, 85 (79%) participated in all three follow‐up interviews. Findings indicate that participants in this community‐based stroke‐screening program showed increases in their knowledge about stroke, including what a stroke is, signs and symptoms, related emergency action, personal risk factors, and ways to reduce risk. Furthermore, the findings demonstrate that the knowledge was retained throughout the study period. Approximately half of the participants also reported having made at least one behavioral change to reduce their stroke risk.
A Participatory Assessment of Environmental Health Concerns in an Ojibwa Community
Authors: Severtson Dolores J. , Baumann Linda C. , Will James A.
Published: March 2003

This research employed a participatory approach to explore environmental health (EH) concerns among Lac Courte Oreilles (LCO) Ojibwa Indians in Sawyer County, Wisconsin. The project was grounded in a broad ecological conceptualization of EH and in principles of health promotion and community participation. Community participation was accomplished through a steering committee that consisted of the primary author and LCO College faculty and community members. The selected assessment methodology was a self‐administered survey mailed to LCO members in Sawyer County. Concern for environmental issues was high in this tribal community, especially for future generations. Concern was higher among older members and tribal members living on rather than off the reservation. Local environmental issues of concern were motorized water vehicles, effects from global warming, aging septic systems on waterways, unsafe driving, and contaminated lakes/streams. The LCO community can use survey results to inform further data needs and program development.
Interventions to Promote Physical Activity Among African American Women
Authors: Banks‐Wallace JoAnne , Conn Vicki
Published: March 2003

The lack of routine physical activity among African American women places them at risk for negative health outcomes associated with inactivity. The number of studies focused on African American women has increased dramatically in the past decade. This review examined the intervention research literature testing strategies to increase activity among African American women. Eighteen studies with 1,623 subjects were retrieved. Diverse interventions, settings, and measures were reported. Common methodologic weaknesses included lack of randomization of subjects, single‐group design, instruments without documented validity and reliability, significant attrition, and questionable timing of outcome variable measurement. Strategies to design and deliver culturally appropriate interventions are reviewed. Suggestions for future research, such as examining intragroup differences and communal resources, are provided.
A Mosaic Pattern of Alopecia in the Oral‐Facial‐Digital Syndrome Type I (Papillon‐Léage and Psaume Syndrome)
Authors: Del C. boente María , Primc Norma , Veliche Hugo , Rosales S. , Carrero‐Valenzuela Roque , Saleme Cesar , Asial Raúl
Published: March 2003

Abstract: We present an infant girl with oral‐facial‐digital syndrome type I, who had alopecia following the scalp lines of Blaschko, and we discuss the characteristics of alopecia in this syndrome.
Acral Erythema in Children Receiving High‐Dose Methotrexate
Authors: Millot Frédéric , Auriol Francois , Brecheteau Pierre , Guilhot Francois
Published: March 2003

Abstract: Scant information is available concerning the occurrence and evolution of chemotherapy‐induced acral erythema in children receiving intravenous high‐dose methotrexate (MTX). Among 50 children with acute lymphoblastic leukemia or lymphoblastic lymphoma receiving a total of 203 courses of high‐dose MTX (3–8 g/m2), 3 cases of acral erythema were observed. Painful erythema of finger and toe pads was noted in three children 3 days to 2 weeks after MTX infusion. The lesions resolved completely after blister formation and desquamation. These patients subsequently received high‐dose MTX therapy without cutaneous problems. The present work points out that the chemotherapeutic schedule need not be modified in selected patients who develop acral erythema following high‐dose MTX infusion.
Pain Management of Junctional Epidermolysis Bullosa in an 11‐Year‐Old Boy
Authors: Chiu Yao‐Kun , Prendiville Julie S. , Bennett Susan M. , Montgomery Carolyne J. , Oberlander Tim F.
Published: March 2003

Abstract: Epidermolysis bullosa is a group of hereditary blistering disorders for which there is no definitive therapy. Wound care is an important component of management. Regular dressing changes are required to protect blistered and eroded skin, and to prevent secondary infection and sepsis. These dressing changes can be very painful for patients with extensive erosions. We report our experience of pain management in an 11‐year‐old boy with severe junctional epidermolysis bullosa. Amitryptiline and cognitive behavioral techniques were effective in relieving chronic pain and discomfort. Oral midazolam 0.33 mg/kg administered 20 minutes prior to baths and dressing changes substantially improved his tolerance of wound care.
Phakomatosis Pigmentovascularis: A New Case with Renal Angiomas and Some Considerations About the Classification
Authors: Landro Anna Di , Tadini G. Luca , Marchesi Lorenzo , Cainelli Tullio
Published: March 2003

We report phakomatosis pigmentovascularis detected in a Caucasian child characterized by the presence of a nevus flammeus and nevus anemicus on the face, a telangiectatic linear nevus of the right leg, and a very extensive blue spot covering 60% of the body surface, with ocular melanosis. Multiple angiomatous lesions of the kidney are associated without alterations of the central nervous system (CNS). This association has not been reported before; it could be a further expression of the complex of developmental defects. Our case corresponds exactly to type IIb in the classification of phakomatosis pigmentovascularis proposed by Hasegawa. As this classification seems very extensive, the higher incidence of cases corresponding to the second subtype suggests that we should identify it by the term phakomatosis pigmentovascularis, while the others could be considered as only very uncommon variants.
Sacral Nevus Flammeus Simplex: The Role of Imaging
Authors: Ben‐Amitai Dan , Davidson Shmuel , Schwartz Michael , Prais Dario , Shamir Raanan , Metzker Aryeh , Merlob Paul
Published: March 2003

Abstract: Neonates with midline lumbar, thoracic, or occipital cutaneous lesions should be suspected of having spinal dysraphism and should undergo an imaging study. The aim of the present study was to evaluate whether sacral nevus flammeus simplex (SNFS) in neonates is associated with spinal dysraphism. During a period of 6 months, we prospectively examined all neonates in our center for the presence of SNFS. Those affected were evaluated for associated anomalies by physical and neurologic examination and ultrasound imaging of the lumbosacral area. Twenty‐eight of 3623 neonates (0.77%) were diagnosed as having SNFS. In 64% of the SNFS patients, nevus flammeus simplex (NFS) was noted as well. Physical and neurologic examinations were unremarkable. Ultrasound imaging of the lumbosacral area was performed in 25 patients (89%) and revealed diastematomyelia in one. The results show that SNFS may constitute the only cutaneous sign of spinal dysraphism. In conclusion, we recommend that neonates with SNFS be investigated for occult spinal dysraphism.
Spinal Dysraphism Presenting as Acro‐Osteolysis: Report of Four Cases
Authors: Sethuraman Gomathy , Handa Sanjeev , Singh Paramjeet , Ghosh Debabrata , Kumar Bhushan
Published: March 2003

Abstract: The acro‐osteolyses are a heterogeneous group of disorders characterized by bone resorption. The disorder may occur as familial, idiopathic, or secondary to vascular, inflammatory, or neurologic conditions. Acro‐osteolysis is rare in association with spinal dysraphism. It is even rarer for it to be the presenting symptom in spinal dysraphism. We report here four patients in whom the diagnosis of spinal dysraphism was established while investigating for the various causes of acro‐osteolysis. All four patients presented with trophic changes and acro‐osteolysis. Hyperhidrosis in the affected limb was seen in three patients. One patient had leg pain, the others had no sensory or motor deficits. Magnetic resonance imaging showed spinal dysraphism in all four patients.
Histopathologic Maturation of Juvenile Xanthogranuloma in a Short Period
Authors: Kubota Yumiko , Kiryu Hiromaro , Nakayama Juichiro , Koga Tetsuya
Published: March 2003

Abstract: We present a case of solitary juvenile xanthogranuloma (JXG) on the scalp of an 8‐month‐old girl. The initial biopsy specimen showed a dense collection of small histiocytes as evidenced by CD68 staining without either lipidization or giant cell formation, admixed with a small number of lymphocytes. On the other hand, sections from the excised specimen obtained 2 weeks after the initial biopsy from the same site showed a mixed proliferation of abundant foam cells together with Touton giant cells, some small histiocytes, and small numbers of lymphocytes and eosinophils. Mitotic figures were fewer in the excised nodule than in the initial biopsy specimen. Fascicles of spindle‐shaped cells arranged in a vague storiform pattern were additionally found in the deep portion of the nodule. Our case findings suggest that xanthomatization of the JXG could have been accelerated by the inflammation associated with the biopsy, based on the histopathologic fact that the change from an early phase to a mature form occurred within the very short period of 2 weeks.
Subepidermal Calcified Nodule
Authors: Juzych Lydia A. , Nordby Catherine A.
Published: March 2003

Abstract: Subepidermal calcified nodule is an uncommon, but specific subtype of idiopathic calcinosis. It presents as an asymptomatic, solitary, yellow‐white or erythematous filiform tumor. The most common location is on the head and neck region of male children. Serum calcium and phosphorus levels are normal. Histopathologic examination reveals a focal papillary dermal collection of dark blue‐staining, large, amorphous deposits, and/or small calcified globules surrounded by a lymphohistiocytic infiltrate. The causes and histiogenesis of these deposits have not been fully established, but the most favored theory is that calcium is deposited on a preexisting lesion. The treatment of choice is surgical removal with histopathologic examination. We describe a healthy 11‐year‐old Caucasian boy with an asymptomatic, warty growth below his left eye. Excision with histopathologic examination confirmed the diagnosis of subepidermal calcified nodule. There has been no sign of recurrence to date.
Minocycline Hypersensitivity Syndrome with Hypotension Mimicking Septic Shock
Authors: Colvin Jill H. , Sheth Anita P.
Published: March 2003

Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. A serious but rare adverse effect caused by minocycline therapy is a hypersensitivity syndrome (HS), consisting of fever, skin eruption, and internal organ involvement that begins within 8 weeks of therapy initiation. We report a case of minocycline HS with unique features, namely, associated hypotension, and a rebound of the cutaneous eruption upon discontinuation of systemic steroids.
Atypical Pityriasis Rubra Pilaris Associated with Arthropathy and Osteoporosis: A Case Report with 15‐Year Follow‐Up
Authors: Behr Fiona D. , Bangert Jerry L. , Hansen Ronald C.
Published: March 2003

Pityriasis rubra pilaris (PRP) is an idiopathic papulosquamous disease that clinically presents with palmoplantar keratoderma and follicular hyperkeratotic papules that coalesce into scaly erythematous plaques. We report a unique case of atypical PRP beginning at 1 year of age with associated severe arthropathy and osteoporosis. We further discuss the clinical and histopathologic aspects of PRP, its possible etiology, and other associated conditions.
Epidemiology of Dermatophytoses in Children Living in Northeast France: A 5‐Year Study
Authors: Reichert‐Pénétrat S. , Contet‐Audonneau N. , Barbaud A. , Schurra J. P. , Fortier B. , Schmutz J.L.
Published: March 2003

Dermatologic fungal infections are thought to occur less frequently in children than in adults. This study, performed over a 5‐year period, emphasizes the interregional variability of dermatophytes that cause skin and cutaneous apprendageal diseases in children. In northeast France, two‐thirds of dermatophytoses are due to zoophilic fungi, while they are most commonly caused by anthropophilic agents in the Paris region and in other countries. The clinical features of pediatric dermatophytoses vary with the age of the child: tinea capitis and tinea corporis are far more frequent before the age of 12 years. After the age of 12, even if these are still quite frequent, tinea pedis and onychomycosis become more common.
Bullous Pemphigoid in Two Young Infants
Authors: Petronius Danny , Bergman Reuven
Published: March 2003

Bullous pemphigoid (BP) usually affects the elderly. The disease is uncommon in children and only a few cases have been described in infants ≤4 months of age. We describe two infants, ages 3 and 4 months, with BP. One infant had a recalcitrant course, and responded only to a combination of high‐dose oral corticosteroids and dapsone.
Cutis Laxa in Seven Members of a North‐Indian Family
Authors: Sarkar Rashmi , Kaur Charandeep , Kanwar Amrinder J. , Basu Srikanta
Published: March 2003

Abstract: Congenital cutis laxa, characterized by cutaneous laxity and loose skin, may be autosomal dominant or autosomal recessive. The autosomal dominant variety is usually not associated with any systemic defects and has a good prognosis. We report an unusual family in which seven members were affected by the autosomal dominant variant of this disorder. We suggest that close monitoring of the cardiorespiratory systems may be worthwhile to detect any systemic complications, although these complications are rare in the autosomal dominant variant of cutis laxa.
Fatal Septicemia in an Infant with Keratitis, Ichthyosis, and Deafness (KID) Syndrome
Authors: Gilliam Amy , Williams Mary L.
Published: March 2003

Abstract: Keratitis, ichthyosis, and deafness (KID) syndrome is a rare congenital disorder of unknown etiology in which increased susceptibility to viral, bacterial, and mycotic infections has been observed. We report an infant with KID syndrome who died from overwhelming systemic infection. To date, investigations into the immune function of patients with this syndrome have not revealed a common underlying systemic immune deficit. However, the severity of infections and multiplicity of organisms observed in this syndrome suggest that a primary immunodeficiency is present in addition to an impaired cutaneous barrier to microorganisms.
Cutis Marmorata Telangiectatica Congenita: Report of Two Persistent Cases
Authors: Mazereeuw‐Hautier Juliette , Carel‐Caneppele Stephanie , Bonafé Jean‐Louis
Published: March 2003

Abstract: Cutis marmorata telangiectatica congenita (CMTC) is defined as a localized or generalized reticulated, blue‐violet vascular network in skin that is present at birth. The evolution is characterized by rapid improvement within 2 years. Rarely the lesions do not improve very much with age. Few reports include long‐term follow‐up of CMTC. We report two patients with persistent CMTC, including one with nervous breakdown and failure of laser treatment. The cause and incidence of persistent CMTC is unknown. Parents can be counseled that over time the lesions of CMTC may or not improve. There seems to be no predictive clinical sign. CMTC is usually a benign condition and therapy is rarely discussed. Treatment of persistent CMTC seems difficult and the effectiveness of laser therapy needs to be evaluated.
The Role of Therapeutic Apheresis in the Treatment of Cancer: A Review
Authors: Lentz M. Rigdon
Published: March 2003

Immunosuppression is a hallmark of advanced malignancies in man. Over the past 40 years, many investigators have identified soluble immunosuppressive factors in blood, serum, ascitic fluid, and pleural fluid from cancers in man and other species. Suppressive factors have also been identified that are produced by tumors. The description of immunosuppressive factors in the blood of vertebrates who either have cancer or who are pregnant is significant, for only in pregnancy and cancer does a seemingly normal immune system tolerate immunogenic neoantigen. Tumor necrosis factors (TNFs) are known to be pleiotropic cytotoxic cytokines that are produced by macrophages and lymphocytes. These cells are thought to be suppressed in patients who have cancer or who are pregnant. Recently, elevated blood levels of soluble tumor necrosis factor receptors (sTNFRs) have been reported in the blood in a variety of cancers and pregnancy. In 1990, after our initial publication of the discovery of sTNFRs in the serum and low molecular weight ultrafiltrates of serum from a variety of cancer patients, others confirmed significant elevations of sTNFRs in cancer patients. This elevation was found to correlate with a poor prognosis. The biologic activity of proinflammatory cytokines as well as the suppressive role of their shed receptors is herein reviewed. Work with cancer patients using ultrapheresis to reduce these suppressive molecules by the authors and others is reviewed. Several recommendations are made for future directions.
Double Filtration Plasmapheresis
Authors: Agishi T. , Kaneko I. , Hasuo Y. , Hayasaka Y. , Sanaka T. , Ota K. , Amemiya H. , Sugino N. , Abe M. , Ono T. , Kawai S. , Yamane T.
Published: March 2003

Guest Editor's Introduction: This paper was presented at the 26th ASAIO Congress held in April 1980. It was printed in Trans. Am. Soc. Artif. Intern Organs, Volume 26, page 406–411, 1980, and reprinted here with permission. This is the first clinical paper dealing with double filtration plasmapheresis. The plasma separator was made using Kuraray's polyvinyl alcohol hollow fiber, and Kuraray's plasma fractionator was made of ethylene vinyl alcohol hollow fibers. Seven patients afflicted with various diseases were treated by this method for 2 to 10 sessions. This procedure required supplemental infusion of albumin solution.
Membrane Plasmapheresis in the United States: A Review Over the Last 20 Years
Authors: Siami Ghodrat A. , Siami Flora S.
Published: March 2003

Abstract: Plasmapheresis is a general term involving extracorporeal plasma separation by centrifugation or primary membrane plasma separator (MPS). Further plasma processing can be accomplished by the use of secondary membrane plasma fractionation (PF), as in double filtration plasmapheresis, also called cascade filtration, low‐density lipoprotein pheresis, thermofiltration, and cryofiltration apheresis. Otherwise, the separated plasma is replaced by colloid solution as in plasma exchange (PE). PE is used, unselectively, to treat patients with immunological, neurological, hematological, renal, and metabolic disorders. Secondary PF may be a more selective alternative. In general, the primary MPS and secondary PF are safe, effective, and biocompatible. The advantages of the primary MPS include its simplicity to use with blood pumps and no observed white blood cell or platelet loss, compared with centrifugation. The disadvantages are lack of versatility, the need to monitor transmembrane pressure to prevent hemolysis, and possible biocompatibility issues such as use of polyvinyl alcohol membranes. The advantages of secondary PF, compared with PE, include selective removal of macromolecules according to molecular weight and filter pore size. No deficiency syndromes or sepsis are observed, nor is replacement solution required. More than 1 plasma volume may be processed, and it is less expensive than PE. Cryofiltration apheresis, using the cryoglobulin filter, selectively removes cryoproteins and is a specific treatment for cryoprecipitate‐induced diseases. The disadvantages of PF include biocompatibility, especially with concomitant ACE inhibitor use, and membrane plugging. An important disadvantage is that most PFs are investigational in the United States. This article reviews the availability, safety, efficacy, and biocompatibility of primary MPSs and secondary PF in the United States.
Fibrinogen Adsorption in the Diabetic Foot Syndrome and Peripheral Arterial Occlusive Disease: First Clinical Experience
Authors: Richter Werner O. , Jahn Peter , Jung Norbert , Nielebock Erika , Tachezy Hauke
Published: March 2003

Abstract:The elimination of fibrinogen from plasma improves plasma viscosity and whole‐blood viscosity. For extracorporeal adsorption of fibrinogen, the pentapeptide gly‐pro‐arg‐pro‐lys was coupled to sepharose CL‐4B. Adsorbers containing 135 ml of coupled sepharose CL‐4B were used to eliminate fibrinogen from the plasma of 7 men and 3 women (48–75 years old). Nine patients suffered from diabetes mellitus, 1 patient from peripheral arterial occlusive disease, and 5 patients were on regular hemodialysis. Treatments were scheduled on Days 1, 2, 4, 6, 8, 10, 13, 16, 19, 22, 25, and 28. One hundred forty‐four treatments with fibrinogen adsorption were performed. No clinical side effects due to the fibrinogen adsorption procedure were observed. In these 10 patients, fibrinogen concentration before the first treatment was 473.7 ± 183.7 mg/dl. In the first treatment session, fibrinogen concentration was lowered to 241.4 ± 125.8 mg/dl by treating 4,270 ± 1,180 ml of plasma. In the following 134 treatments, the pretreatment concentration of fibrinogen was 262.6 ± 83.4 mg/dl, and the posttreatment concentration was 120.6 ± 37.2 mg/dl. The mean amount of plasma treated was 3,737 ± 1,643 ml, and the mean duration of a treatment session (except first treatment) was 143.7 ± 63.1 min. In 7 patients, a mean posttreatment fibrinogen concentration of ≤123 mg/dl was obtained; in the other patients, concentrations of 133, 177, and 184 mg/dl were obtained. Yet, the decrease of fibrinogen concentration was also pronounced in these 3 patients: −82%, −67%, and −73%, respectively. During the treatment period of 28 days, wound healing was observed in 9 of the 10 patients. In conclusion, affinity chromatography using the pentapeptide gly‐pro‐arg‐pro‐lys is an effective, selective, and safe procedure to lower fibrinogen concentration in plasma. It could be a therapeutic option in severe blood vessel disease in which drug therapy is not sufficient and invasive procedures such as bypass or angioplasty cannot be applied. Yet, more information is needed, for example, about the fibrinogen concentration that has to be reached to get the maximal improvement of micro‐ and/or macrocirculation.
Apheresis in Treatment of the Inflammatory Demyelinating Peripheral Neuropathies
Authors: Kincaid John C.
Published: March 2003

Abstract: The inflammatory demyelinating peripheral neuropathies are recognizable treatable entities within the broad field of diseases of the peripheral nervous system. Most peripheral nerve diseases are still of undetermined causation and have no direct disease‐modifying treatment. This paper reviews the diagnostic features of the inflammatory neuropathies, presumed mechanisms of pathogenesis, and the role of apheresis, along with other immunomodulating therapies, in the management of these diseases.
First Steps Toward the Establishment of a German Low‐Density Lipoprotein‐Apheresis Registry: Recommendations for the Indication and for Quality Management
Authors: Schettler V. , Wieland E. , Armstrong V.W. , Kleinoeder T. , Grunewald R.W. , Müller G.A. ,   the Participants of the Göttingen Consensus Conferences
Published: March 2003

Abstract: New recommendations for the indication of treatment with selective extracorporeal plasma therapy low‐density lipoprotein apheresis (LDL‐apheresis) in the prevention of coronary heart disease are urgently needed. The following points are the first results of the ongoing discussion process for indications for LDL‐apheresis in Germany: all patients with homozygous familial hypercholesterolemia with functional or genetically determined lack or dysfunction of LDL receptors and plasma LDL cholesterol levels >13.0 mmol/L (>500 mg/dL); patients with coronary heart disease (CHD) documented by clinical symptoms and imaging procedures in which over a period of at least 3 months the plasma LDL cholesterol levels cannot be lowered below 3.3 mmol/L (130 mg/dL) by a generally accepted, maximal drug‐induced and documented therapy in combination with a cholesterol‐lowering diet; and patients with progression of their CHD documented by clinical symptoms and imaging procedures and repeated plasma Lp(a) levels >60 mg/dL, even if the plasma LDL cholesterol levels are lower than 3.3 mmol/L (130 mg/dL). Respective goals for LDL cholesterol concentrations for high‐risk patients have been recently defined by various international societies. To safely put into practice the recommendations for LDL‐apheresis previously mentioned, standardized treatment guidelines for LDL‐apheresis need to be established in Germany that should be supervised by an appropriate registry.
Leukocyte Apheresis Using a Centrifugal Cell Separator in Refractory Ulcerative Colitis: A Multicenter Open Label Trial
Authors: Kohgo Y. , Hibi H. , Chiba T. , Shimoyama T. , Muto T. , Yamamura K. , Popovsky M.A. ,   the Study Group for Alternative Therapies in Ulcerative Colitis Patients
Published: March 2003

Abstract: Recently, successful results of ulcerative colitis (UC) treatments with leukocyte apheresis have been reported by several institutes. To certify the efficacy of leukocyte apheresis in refractory UC patients, a multicenter open label trial was conducted, and results were analyzed. Fifty patients diagnosed with active steroid‐resistant UC were enrolled in this study from 14 medical centers. Using a centrifugal cell separator (Component Collection System, Haemonetics), leukocyte apheresis was performed once a week for 5 weeks. General conditions and abdominal symptoms were recorded daily, and laboratory tests were followed weekly. Changes of colonoscopic and histological manifestations of luminal activity through the study period were evaluated. At the end of the study period, stool frequency was decreased to less than 4 times a day in 68.4% (26 of 38) and serum C‐reactive protein (CRP) concentration was normalized in 56.7% (17 of 30) of the patients. Colonoscopic remission was achieved in 57.7% (26 of 45), and histological improvement was noted in 54.1% (20 of 37) of the patients tested. Improved disease activity was demonstrated in 74% (37 of 50) of the patients by general assessment criteria. Analysis of the trial data confirmed the valid clinical efficacy of leukocyte apheresis by centrifugal cell separator in refractory UC patients.
Quantifying the Effects of Green Crab Damage to Eelgrass Transplants
Authors: Davis Ryan C. , Short Frederick T. , Burdick David M.
Published: March 2003

Mesocosm experiments were conducted in the summer of 1996 to quantify the effect of bioturbation byCarcinus maenas(the introduced European green crab) on survival of transplantedZostera marina(eelgrass). The research grew out of a successful 2.52 ha eelgrass transplant project in the Great Bay Estuary of New Hampshire. At several subtidal sites, green crabs were found to damage transplanted eelgrass by cutting the shoots to the extent that some sites demonstrated poor survival. In three separate experiments, eight replicate mesocosm tanks were transplanted with 36 shoots of eelgrass, and different crab densities were introduced into the tanks. The number of shoots damaged by crabs was significantly higher in tanks with moderate (4.0 crabs/m2), high (7.0 crabs/m2), or very high (15.0 crabs/m2) crab densities than in tanks with low (1.0 crabs/m2) crab densities. Up to 39% of viable shoots were lost within one week of exposure to green crab activities. The mesocosm results demonstrated that green crabs were not directly attracted to eelgrass but that they significantly decreased transplant survival through their activity. Field densities of green crabs were found to exceed the density at which most damage occurred in the experiments, suggesting that this introduced species can be a major determinant of eelgrass transplant survival. The results underscore the major influence that biological components of transplant sites can have on transplant survival, and the need for their consideration in the site selection process.
Eradication of Norway Rats for Recovery of Seabird Habitat on Langara Island, British Columbia
Authors: Taylor Rowland H. , Kaiser Gary W. , Drever Mark C.
Published: March 2003

IntroducedRattus norvegicus(Norway rats) caused the decline ofSynthliboramphus antiquus(ancient murrelets) and other seabirds breeding on Langara Island (approximately 3,100 ha), British Columbia. Using funds from the litigation settlement following theNestuccaoil spill, Environment Canada eradicated Norway rats using a technique developed in New Zealand which involved dispensing wax baits containing the anticoagulant brodifacoum at 50 ppm from fixed bait stations. Bait stations were placed every 75 to 100 m on a grid over the entire island (1 station/ha). Rats removed bait for 26 days, after which crews placed baits in protective plastic bags in each bait station. Stations loaded with baits were left on the island and rechecked four times over 2 years, after which bait stations and remaining bait were removed. The eradication succeeded. No signs of rats have been detected on Langara Island and its associated islands since January 1996. No rats were trapped during 1,700 trap‐nights following the poison campaign. Incisor marks of rats were not found on apples or oil‐dipped chew‐sticks.Corvus corax(common ravens) likely suffered greater than 50% mortality from the eradication after apparently gaining access to the poison directly from bait stations and from scavenging rat carcasses. A monitoring and response system is being developed in conjunction with current users of the islands. The success on Langara Island demonstrates how the technique proven on small New Zealand islands of less than 300 ha can be effectively extrapolated to much larger islands.
Genetic Bottlenecks Resulting from Restoration Efforts: The Case of Bighorn Sheep in Badlands National Park
Authors: Ramey Rob Roy , Luikart Gordon , Singer Francis J.
Published: March 2003

Using the example of a reintroduced bighorn sheep population in Badlands National Park, South Dakota we demonstrate the usefulness of neutrality tests and demographic data for detecting a severe genetic bottleneck (Ne < 10). From demographic data the effective population size of the founding population at Badlands was estimated to be six, and a heterozygosity excess test revealed evidence of a severe population bottleneck. We discuss the criteria for intervention when there is evidence of a severe bottleneck, and propose methods of mitigating the potentially deleterious long‐term consequences of such bottlenecks. These issues are presented in the context of bighorn sheep reintroductions, but the issues are also of general importance to restoration efforts involving other large vertebrates.
Genetic Polymorphism and Transplantation Success in the Mediterranean SeagrassPosidonia oceanica
Authors: Procaccini Gabriele , Piazzi Luigi
Published: March 2003

We studied the role of genetic variability of donor beds in establishing transplantation criteria for the Mediterranean seagrassPosidonia oceanica.Horizontal rhizomes, collected from three geographically distinct populations, were transplanted into a common bed at a highly human‐impacted locality. The transplantation site was located near one of the donor populations. After three years, the shoots collected in the population adjacent to the transplanting site showed the lowest growth performance. Genetic variability, assessed through the analysis of hypervariable microsatellite regions, and growth performance followed a similar trend. The shoots growing and branching at the highest rate were those collected from populations with the highest heterozygosity values, despite greater geographic distance. No genetic differences were found between the transplanted shoots and shoots from donor meadows, as expected due to the low rate of sexual reproduction inP. oceanicaand the short time that had passed since the transplants. The problem of affecting the local gene pool by the introduction of foreign genotypes could arise, but introduction of new alleles could balance the degradation of genetic variability caused by human impact. In general our study suggests that the genetic variability of source material is an important aspect to consider in the development of seagrass restoration strategies.
Riparian Forest Restoration: Increasing Success by Reducing Plant Competition and Herbivory
Authors: Sweeney Bernard W. , Czapka Stephen J. , Yerkes Tina
Published: March 2003

The reestablishment of riparian forest is often viewed as “best management practice” for restoring stream ecosystems to a quasi‐natural state and preventing non‐point source contaminants from entering them. We experimentally assessed seedling survivorship and growth of Quercus palustris (pin oak), Q. rubra (red oak), Q. alba (white oak), Betula nigra (river birch), and Acer rubrum (red maple) in response to root‐stock type (bare root vs. containerized), herbivore protection (tree shelters), and weed control (herbicide, mowing, tree mats) over a 4‐year period at two riparian sites near the Chester River in Maryland, U.S.A. We started with tree‐stocking densities of 988/ha (400/ac) in the experimental plots and considered 50% survivorship (i.e., a density of 494/ha [200/ac] at crown closure) to be an “acceptable or minimum” target for riparian restoration. Results after four growing seasons show no significant difference in survivorship and growth between bare‐root and containerized seedlings when averaged across all species and treatments. Overall survivorship and growth was significantly higher for sheltered versus unsheltered seedlings (49% and 77.6 cm vs. 12.1% and 3.6 cm, respectively) when averaged across all species and weed control treatments. Each of the five test species exhibited significantly higher 4‐year growth with shelter protection when averaged across all other treatments, and all species but river birch had significantly higher survivorship in shelters during the period. Seedlings protected from weeds by herbicide exhibited significantly higher survivorship and growth than seedlings in all other weed‐control treatments when averaged across all species and shelter treatments. The highest 4‐year levels of survivorship/growth, when averaged across all species, was associated with seedlings protected by shelters and herbicide (88.8%/125.7cm) and by shelters and weed mats (57.5%/73.5 cm). Thus, only plots where seedlings were assisted by a combination of tree shelters and either herbicide or tree mats exhibited an “acceptable or minimum” rate of survivorship (i.e.,>50%) for riparian forest restoration in the region. Moreover, the combined growth and survivorship data suggest that crown closure over most small streams in need of restoration in the region can be achieved most rapidly (i.e., 15 years or less) by protecting seedlings with tree shelters and controlling competing vegetation with herbicides.
Burning and Grazing Management in a California Grassland: Effect on Bunchgrass Seed Viability
Authors: Dyer Andrew R.
Published: March 2003

Prescribed fire is an important management tool for reducing the dominance of non‐native species in annual grasslands; both annual and perennial native species show strong vegetative responses in the subsequent growing season. However, although the post‐fire contribution of native species to the seed bank is assumed to be larger than in pretreatment years, the effects on seed quality, particularly viability and longevity, are not well understood. In this study, I germinated Nassella pulchra (purple needlegrass) seed that had been stored for 10 years after collection from target plants receiving treatment combinations of summer burning and grazing by sheep. Seeds from burned plants were larger and had higher germinability than seed from unburned plants. Seeds from plants that were both burned and grazed had the highest germination. The strong relationship between long‐term viability and seed size suggests greater maternal provisioning and increased seed quality subsequent to burning and grazing. I conclude that managing for seed quality may be a useful approach for conservation of native species in California's critically endangered grassland habitats.
Using Dominance‐Diversity Curves to Assess Completion Criteria After Bauxite Mining Rehabilitation in Western Australia
Authors: Grant C. D. , Loneragan W. A.
Published: March 2003

Abstract Dominance‐diversity curves have been previously constructed for a range of ecosystems around the world to illustrate the dominance of particular species and show how their relative abundances compare between communities separated in time or space. We investigate the usefulness of dominance‐diversity curves in rehabilitated areas to compare the floristic composition and abundance of “undisturbed” areas with disturbed areas, using bauxite mining rehabilitation in Western Australia as an example. Rehabilitated pits (11–13 years old) subjected to prescribed fire in autumn and spring were compared with unburned rehabilitated areas and the native jarrah (Eucalyptus marginata) forest. Dominance diversity curves were constructed by ranking the log of the species density values from highest to lowest. Species were categorized according to a variety of functional responses: life form (trees, shrubs, subshrubs, and annuals), fire response syndrome (seeder or resprouter), nitrogen fixing capability, and origin (native or adventive). Exponential functions showed extremely good fits for all sites (r2 = 0.939–0.995). Dominance diversity graphs showed that after burning of rehabilitated areas, sites exhibited a more similar dominance‐diversity curve than before burning. This was emphasized in a classification (UPGMA) of the regression equations from the dominance‐diversity curves that showed that sites burned in spring were more similar to the native forest than sites burned in autumn. There was no significant segregation of the nitrogen‐fixing and species origin categories, although the life form and fire response groupings showed significant segregation along the dominance‐diversity curve. Resprouters tended to be over‐represented in the lower quartiles and under‐represented in the upper quartiles of post‐burn sites. It is suggested that using dominance‐diversity curves in the monitoring of rehabilitated areas may be a useful approach because it provides an easily interpretable visual representation of both species richness and abundance relationships and may be further utilized to emphasize categories of plants that are over‐ or under‐represented in rehabilitated areas. This will assist in the post‐rehabilitation management of these sites.
Fire in the Suburbs: Ecological Impacts of Prescribed Fire in Small Remnants of Longleaf Pine (Pinus palustris) Sandhill
Authors: Heuberger Kimberly A. , Putz Francis E.
Published: March 2003

Abstract Logging, fire suppression, and urbanization have all contributed to the serious decline and fragmentation of Pinus palustris (longleaf pine) ecosystems in the southeastern United States. Effective management of the remaining patches of these pyrogenic communities must incorporate periodic low‐intensity fires, even where they are located on private lands in populated urban and suburban areas. To explore the effects of fire and its potential use for restoration and management of small fragments surrounded by suburban development, we conducted growing season prescribed fires in remnant longleaf pine sandhill patches in the suburbs of Gainesville, Florida. Density and composition of hardwoods were surveyed pre‐burn and 1 and 9 months post‐burn. Woody stem density decreased in the burn plots, predominantly in the smaller size classes. Flowering responses of forbs and small shrubs were surveyed six times post‐burn for 1 year. Overall, the burns did not yield greater densities of flowering stems, but burn patches had higher species richness and diversity than control patches. In addition, there were consistently greater numbers of “showy flowered” sandhill species in flower in burn patches relative to controls. The results of this research demonstrate that prescribed fire can be used for restoration and management of small remnants of longleaf pine sandhill in suburban neighborhoods. It is also clear that although a single prescribed burn can be effective, it will take more than one burn to attain desired restoration goals in degraded longleaf remnants.
Chronic inflammatory demyelinating polyneuropathy caused by HIV infection in a patient with asymptomatic CMT 1A
Authors: Rajabally Yusuf , Vital Anne , Ferrer Xavier , Vital Claude , Julien Jean , Latour Philippe , Vandenberghe Antoon , Lagueny Alain
Published: March 2003

Abstract  It is well known that patients with Charcot‐Marie‐Tooth (CMT) disease are liable to present with episodes of cortisone‐responsive demyelination, and a superimposed inflammatory component has been suggested. We report a patient who presented with a chronic inflammatory demyelinating polyneuropathy due to a recent HIV infection, which revealed a previously asymptomatic CMT 1A disease documented by identification of the characteristic duplication on the p11.2 region of chromosome 17. The inflammatory process was characterized by pathologic findings on a superficial peroneal nerve biopsy, and the patient improved significantly after corticotherapy. This report gives support to the hypothesis of a genetic susceptibility to inflammatory demyelinating processes in certain CMT kindreds.
Expression and localization of insulin receptor in rat dorsal root ganglion and spinal cord
Authors: Sugimoto Kazuhiro , Murakawa Yuichi , Sima Anders A. F.
Published: March 2003

Abstract  The expression and localization of the insulin receptor (IR) was examined in rat dorsal root ganglia (DRG) and spinal cord using Western blotting, in situ hybridization and immunocytochemistry. Western blotting showed that the molecular weight of the IR β subunit was higher in PNS than that found in CNS. Both IR mRNA and protein expressions were highest in small‐sized sensory DRG neurons and myelinated sensory root fibers expressed higher levels of IR protein than myelinated anterior root fibers. In the spinal cord, IR immunoreactive neurons were present in lateral lamina V and in lamina X, suggesting the presence of IR in nociceptive pathways. Electronmicroscopy of DRGs revealed a polarized localization of the IR in abaxonal Schwann cell membranes, outer mesaxons in close vicinity to tight junctions of both myelinating and non‐myelinating Schwann cells and to plasma membranes of sensory neurons. From these findings, we speculate that insulin may play a role in sensory fibers involved in nociceptive function often perturbed in diabetic neuropathy. The high expression of IR localizing to tight junctions of dorsal root mesaxons of DRGs may suggest a regulatory role on barrier functions compensating for the lack of a blood–nerve barrier in dorsal root ganglia. This is consistent with the colocalization of IR with tight junctions of the paranodal barrier and endoneurial endothelial cells in peripheral nerve.