bluuebunny/crossref_metadata_2025 huggingface dataset:
Infantile Acropustulosis Revisited: History of Scabies and Response to Topical Corticosteroids
Authors: Mancini Anthony J. , Frieden Ilona J. , Paller Amy S.
Published: March 2003

Abstract: Infantile acropustulosis (IA) is a condition of young children characterized by recurrent episodes of pruritic vesicles and pustules in an acral distribution. Several reports describe patients with scabies infestation prior to the diagnosis of IA, although the relationship between the two remains unclear. Furthermore, optimal therapy is controversial. We reviewed the history of scabies and response to therapy in 21 patients diagnosed with IA at two institutions between 1983 and 1997. A history of prior treatment for scabies was noted in 14 patients, although only two had mites, feces, or ova detected on microscopic examination for diagnostic verification. All patients were treated with topical corticosteroids (4 with class I, 12 with class II, 3 with class III, 1 with class IV, and 1 with class VI). All 18 patients who returned for follow‐up experienced significant improvement or cleared completely with treatment. There were no observed cutaneous or systemic side effects from corticosteroid therapy. We conclude that a history of preceding scabies is common in patients with IA, but often this diagnosis is made without microscopic confirmation. We also demonstrate that mid‐ to high‐potency topical corticosteroids are a safe and effective first‐line therapy for patients with IA.
Wrinkly Skin Syndrome: Ultrastructural Alterations of the Elastic Fibers
Authors: Boente María del C. , Winik Beatriz C. , Asial Raúl A.
Published: March 2003

We report the clinical and pathologic features of a patient with wrinkly skin syndrome. The essential clinical features were wrinkly skin with poor elasticity over the abdomen and on the dorsum of the hands and feet, increased palmar and plantar creases, and a prominent venous pattern over the chest. On light microscopy, histopathologic findings included appreciable heterogeneity in the structure, amount, and distribution pattern of elastic fibers. Agglutination and fragmentation of the microfibrillar component and a remarkable decrease in elastin were the major ultrastructural features. The differential diagnosis with other connective tissue disorders is discussed.
Primary Disseminated Varicella Presenting as an Acute Abdomen
Authors: Kim Susan H. , Haycox Claire
Published: March 2003

We report a patient admitted with acute abdominal pain initially thought to be due to pancreatitis of unclear etiology. Later during his hospitalization he was diagnosed with primary varicella infection. The association between varicella and systemic multiorgan disease needs to be recognized in both immunocompetent and immunocompromised patients. A prompt diagnosis prevents delay in the treatment of varicella, as well as in monitoring for and preventing complications of disseminated infection.
Effect of Penicillin G on Corium Thickness in Linear Morphea of Childhood: An Analysis Using Ultrasound Technique
Authors: Möhrenschlager Matthias , Jung Claus , Ring Johannes , Abeck Dietrich
Published: March 2003

Abstract: Linear morphea is the most common form of localized scleroderma in children. The pathogenesis of this disorder is unknown. We report a child with a 6‐year history of linear morphea in whom intravenous administration of 5 MU aqueous penicillin G three times a day for 10 consecutive days caused reduction in the thickness of the corium as demonstrated by ultrasound measurements.
Profile and Outcome of Childhood Mycosis Fungoides in Singapore
Authors: Tan Eileen , Tay Yong‐Kwang , Giam Yoke‐Chin
Published: March 2003

Abstract: Mycosis fungoides (MF) is the most common form of cutaneous T‐cell lymphoma. It usually occurs in middle‐aged and elderly persons, although several reports have described its occurrence in young children. The aim of this study was to review the profile and outcome of childhood MF in Singapore from 1989 to 1998. A total of nine patients (six males and three females) were diagnosed with MF before the age of 21 years. There were four Chinese, four Malay, and one Indian. The age at the time of histologic diagnosis ranged from 6 to 20 years (mean 14.3 years). Eight of the nine patients presented with hypopigmented patches and plaques. According to TNM staging, three were in stage 1A and six in stage 1B. The treatment modalities included psoralen plus ultraviolet A (PUVA) (n = 5), UVB (n = 2), and potent topical steroids (n = 2). We found that PUVA induced a faster clinical remission, but maintenance PUVA was required to prolong the relapse‐free interval. This study also highlighted the need to consider MF in the differential diagnosis of hypopigmented dermatoses in dark‐skinned individuals, especially if they occur on the buttocks.
Cutaneous Sinus Histiocytosis and Chronic Uveitis
Authors: Silvestre J. F. , Aliaga A.
Published: March 2003

Abstract: Sinus histiocytosis with massive lymphadenitis or Rosai–Dorfman disease (RDD) is a rare, benign, proliferative histiocytic disease of unknown origin. It predominately affects the lymph nodes The skin is the extranodal organ most frequently involved, although a few patients present with only lesions of the skin and soft tissues, without involvement of the lymph nodes (purely cutaneous RDD). Ocular involvement is rare, and generally localized to the eyelid. We report an unusual case of cutaneous sinus histiocytosis without nodal involvement and with bilateral uveitis in a girl. As far as we know, this is the first case reported in which cutaneous and ocular RDD occurred without nodal involvement.
Vulvar Disease in Children: A Clinical Audit of 130 Cases
Authors: Fischer Gayle , Rogers Maureen
Published: March 2003

Abstract: We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch–Schönlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.
Bart Syndrome: The Congenital Localized Absence of Skin May Follow the Lines of Blaschko. Report of Six Cases
Authors: Duran‐McKinster Carola , Rivera‐Franco Ana , Tamayo Lourdes , De La Luz Orozco‐Covarrubias Ma , Ruiz‐Maldonado Ramón
Published: March 2003

Abstract: Three cutaneous manifestations are characteristic of Bart syndrome: congenital localized absence of skin (CLAS), mucocutaneous blistering, and nail abnormalities. Six cases of Bart syndrome are herein reported. Localized absence of skin is present at birth, particularly on the anterior aspects of the lower extremities and dorsa of the feet. Physical trauma in utero has been proposed as a mechanism to explain the denuded areas on the limbs. The recurrent, highly similar pattern of the congenital defect in regard to location and clinical appearance in our patients and in most of the reported cases strongly suggests that trauma is too simplistic an explanation. Because of the observed bilateral and symmetric distribution of denuded areas in an S‐shaped broad band, their sharply demarcated borders, the involvement of the toe webs, and the frequent similar involvement of the soles, we suggest that congenital localized absence of skin in Bart syndrome may follow the lines of Blaschko.
Prevalence and Nature of Nail Alterations in Pediatric Patients
Authors: Iglesias Alejandra , Tamayo Lourdes , Sosa‐de‐Martínez Cristina , Durán‐McKinster Carola , Orozco‐Covarrubias Luz , Ruiz‐Maldonado Ramón
Published: March 2003

Abstract: The purpose of this investigation was to explore the frequency and nature of ungual alterations in patients of a pediatric dermatology department at a third‐level pediatric hospital. The first 20 patients with nail alterations seen each year during a 5‐year period from 1992 through 1996 were included, totaling 100 patients. The rate of nail alterations was 11% (1/9) in pediatric dermatology patients. There were 5 infants, 19 preschoolers (2‐ to 5‐year‐olds), 38 school children (6‐ to 11‐year‐olds), and 38 adolescents (12‐ to 17‐year‐olds). The most frequent diagnoses were onychomycosis (23), nail alterations in a genodermatosis (23), nail alterations associated with dermatoses (16), onychocryptosis (11), and paronychia (10). Toenails were involved in 54 patients, fingernails in 25, and both in 21 patients. Twenty nails were involved in 21 patients. A high prevalence of nail alterations was found in pediatric dermatology patients, some of which were nonspecific, while others provided important diagnostic clues.
Agenesis of the Scrotum
Authors: Montero Margarita , Méndez Roberto , Tellado Manuel , Vela Diego , Pais Ernesto , Gallego Manuel
Published: March 2003

Abstract: Congenital agenesis of the scrotum skin is an extremely rare disorder with only two cases previously reported. We report a newborn with scrotal agenesis and congenital hypothyroidism.
Pseudo‐Kaposi Sarcoma with Arteriovenous Malformation
Authors: Larralde Margarita , Gonzalez Virginia , Marietti Rosana , Nussembaum Daniel , Peirano Miguel , Schroh Roberto
Published: March 2003

Pseudo‐Kaposi sarcoma with vascular malformation (Stewart–Bluefarb syndrome) is an uncommon and important entity characterized by congenital arteriovenous malformation and skin lesions that may resemble Kaposi sarcoma. This is usually seen in the lower limb of young people. We report a case of this syndrome in a 17‐year‐old boy who had skin lesions on the right leg and foot.
The Use of Digital Dermoscopy for the Follow‐Up of Congenital Nevi: A Pilot Study
Authors: Braun R P , Calza A M , Krischer J , Saurat J H
Published: March 2003

One of the main problems in the management of congenital nevi is the potential risk for malignant transformation and the resulting need for follow‐up examination. Dermoscopy is a noninvasive technique that has been shown to be useful for the follow‐up of benign melanocytic skin lesions as well as the early diagnosis of malignant melanoma. Therefore we thought to use the digital dermoscopy (DD) technique for the follow‐up of congenital nevi. For documentation purposes we registered an overview, and the following standardized dermoscopic images of every lesion: representative architectural pattern, border of the lesion, and regions of “special interest.” In all instances the examination with digital dermoscopy was well tolerated by the patients and the integration of the parents to the “live” examination on the computer screen was appreciated. The follow‐up was easy to perform with these standardized documents. We showed the feasibility of follow‐up of congenital nevi using digital dermoscopy. Furthermore, we identified three different patterns as well as some typical structures seen in congenital nevi by DD.
Linear Cutaneous Lupus Erythematosus in the Lines of Blaschko
Authors: Lee Mi‐Woo , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung
Published: March 2003

The lines of Blaschko describe distribution patterns which may represent embryologic developmental pathways. This distribution may occasionally be followed by some congenital and acquired skin disorders. We describe a child with linear cutaneous lupus erythematosus (LCLE) following Blaschko lines on the face.
Stevens–Johnson Syndrome Developing in a Girl with Systemic Lupus Erythematosus on High‐Dose Corticosteroid Therapy
Authors: Samimi Sarah S. , Siegfried Elaine
Published: March 2003

Stevens–Johnson syndrome (SJS) is a vesiculobullous disease of the skin and mucosa. This generalized hypersensitivity reaction is well known to occur in association with certain drugs, particularly sulfonamides, nonsteroidal anti‐inflammatory agents (NSAIDs), and anticonvulsants. The disease is usually seen in children and young adults and is often treated with corticosteroids. We present a 9‐year‐old girl with lupus nephritis who developed cutaneous bullae and mucositis while being treated with intravenous methylprednisolone. The initial differential diagnosis included bullous lupus, but skin biopsy specimen findings supported a diagnosis of SJS. She was treated with intravenous immunoglobulin (IVIg).
The North American Experience with Photopheresis
Authors: Zic John A. , Miller Jami L. , Stricklin George P. , King Jr Lloyd E.
Published: March 2003

Photopheresis or extracorporeal photochemotherapy (ECP) is a novel immunomodulatory therapy based upon pheresis of light‐sensitive cells. Whole blood is removed from patients who have previously ingested the photosensitizing agent 8‐methoxypsoralen (8‐MOP) followed by leukapheresis and exposure of the 8‐MOP containing white blood cells (WBCs) extracorporeally to an ultraviolet A (UVA) light source prior to their return to the patient. In 1988, the Food and Drug Administration (FDA) approved photopheresis for the treatment of cutaneous T‐cell lymphoma (CTCL). Treatment of CTCL with photopheresis has been reported in over 300 patients worldwide. Photopheresis has also demonstrated encouraging results in the treatment of solid organ transplant rejection, graft versus host disease, scleroderma, and other autoimmune diseases although fewer patients have been studied. This review will focus on the North American experience with photopheresis.
A New Concept of Bioartificial Liver Based on a Fluidized Bed Bioreactor
Authors: Doré Emmanuel , Legallais Cécile
Published: March 2003

Many bioartificial livers have been developed, but most of them suffer from difficulty when being scaled up and from poor efficiency of mass transfer between the plasma and the immobilized hepatocytes. We present a new concept of bioartificial liver based on the fluidized bed motion of hepatocytes entrapped in alginate beads. The bioreactor is designed to offer stable behavior. The maximum fluid perfusion velocity is determined to avoid any bead release from the bioreactor. The fluidized bed height depends on the amount of beads and the velocity employed. Under the optimized operating conditions, the mass transfer between perfusion fluid and beads is very efficient; only 10 min are necessary to reach concentration equilibrium. Hence, this fluidized bed bioartificial liver appears to be a promising tool for a liver support system in the treatment of acute liver failure.
An Experimental Artificial Liver Utilizing Extracorporeal Metabolism with Sliced or Granulated Canine Liver
Authors: Nose Y. , Mikami J. , Kasai Y. , Sasaki E. , Agishi T. , Danjo Y.
Published: March 2003

Guest Editor's Introduction: This paper was originally presented at the 9th congress of ASAIO in April 1963. The original paper was printed in Volume IX of Trans. Soc. Artif. Int. Organs 1963, pages 358–362. It was reprinted with permission in Therapeutic Apheresis, Volume 4, Issue 1, 2000 as a millennium project of the International Society for Apheresis. This paper describes for the first time a hybrid artificial live and extracorporeal circulatory system composed of a specially developed high permeable gel type cellophane membrane. This membrane separated the patient's blood and the metabolic fluid in which freeze‐dried canine liver granules were contained. Carbohydrate metabolism and ammonia detoxification were maintained in this metabolic chamber, eventually helping the patient's metabolic functions. In addition to experimental studies, four clinical studies were briefly reported.
The Development and First Clinical Use of Semipermeable Microcapsules (Artificial Cells) as a Compact Artificial Kidney
Authors: Chang Thomas M.S. , Malave N.
Published: March 2003

Guest Editor's Introduction: Activated charcoal has a microporous structure and a large surface area that nonspecifically adsorbs the substances in the molecular weight range of 100–5,000, including hepatoxins, uremic toxins and drugs. The success of the first clinical trial for the treatment of chronic renal failure with an activated charcoal column was carried out by Yatidis in 1964, but the clinical application for the charcoal column has not been possible. This is because the charcoal presented major problems such as the release of microparticles and platelet activation. Chang solved these problems by developing the activated charcoal which was microcapsulated by biocompatible materials. Since then, many kinds of activated charcoal columns have been commercialized for blood purification use and are still widely utilized. This paper which describes the first clinical use of microcapsulated charcoal was printed in Trans Am Soc Artif Intern Organs, vol 16, page 141–148 (1970) and is reprinted here with permission.
Development of a Specific Immunoadsorbent Containing Immobilized Synthetic Peptide of Acetylcholine Receptor for Treatment of Myasthenia Gravis
Authors: Nakaji S. , Oka K. , Tanihara M. , Takakura K. , Takamori M.
Published: March 2003

INTRODUCTION Guest Editor's Introduction: The most specific adsorption of antibody can be achieved by the application of antigen‐antibody binding. The antibody is specific for a particular part of antigen called epitope rather than for the whole antigen molecules. Therefore, the immobilized epitope for target antibody could be used as the ligand of the adsorbent. Kuraray Co. developed a specific adsorbent for the anti‐acetylcholine receptor antibody. The adsorbent consists of microporous cellulose beads for the base material which immobilized a synthetic peptide as the epitope ligand. This paper describes the basic design and in vitro characteristics of the adsorbent. This paper was printed in Therapeutic Plasmapheresis, vol 12, page 573–576 (1993), and reprinted here with permission.
State of Percutaneous Transluminal Coronary Artery Angioplasty and Effectiveness of Low‐Density Lipoprotein Apheresis
Authors: Miyamoto Takamichi , Niwa Akihiro , Sinoda Toshio
Published: March 2003

Abstract: We have recognized percutaneous transluminal coronary artery angioplasty (PTCA) as an important procedure for achieving myocardial revascularization. PTCA has been performed for stable and unstable angina, acute myocardial infarction, and silent myocardial ischemia. Among many new devices, the coronary stent is the most important advancement in PTCA. Frequent stent use is due to the introduction of antiplatelet therapy to prevent stent thrombosis. One serious problem is that PTCA, even with stent use, often causes chronic restenosis. This problem has not been solved, however, despite various strategies. Aggressive lipid‐lowering therapy is one of the most important therapies for coronary heart disease. The findings in aggressive lipid‐lowering therapy show us its importance. We report that low‐density lipoprotein (LDL) apheresis, when performed immediately before and after PTCA, can prevent restenosis of coronary artery lesions. Lipid‐lowering therapy should be applied more aggressively with medicine and/or with LDL apheresis for patients who have undergone PTCA.
Comparison of Lymphocyte Depletion and Clinical Effectiveness on Filtration Leukocytapheresis in Patients with Rheumatoid Arthritis
Authors: Ueki Yukitaka , Nakamura Hideki , Kanamoto Yasuhide , Miyazaki Masaya , Yano Mayumi , Matsumoto Kazunari , Miyake Seibei , Tominaga Tan , Tominaga Masaya , Yamasaki Satoshi , Eguchi Katsumi
Published: March 2003

Abstract: We evaluated the relationship between the clinical benefit of filtration leukocytapheresis (LCP) and the number of removed leukocytes in patients with rheumatoid arthritis (RA). LCP was performed in 31 drug‐resistant RA patients. LCP was carried out 3 times with 1 week separating each session. Assessment of RA before and after LCP showed a substantial and rapid improvement in tender joint counts, swollen joint counts, and patients' and physicians' assessments. Careful analysis indicated that 19 of 31 patients with RA showed ≥20% improvement following LCP therapy. The number of leukocytes in the peripheral blood significantly decreased during each session of LCP. However, there was no significant decrease in the number of circulating blood cells during the study period. No adverse reactions or complications were noted. There was no significant difference in any indices of clinical activity and the removal rates of leukocytes between responders and nonresponders. The total numbers of removed lymphocytes in responders were significantly higher than those in nonresponders (responders 64.1 × 108 versus nonresponders 50.7 ×108, p < 0.05). The relationship between clinical effectiveness and the number of removed granulocytes and monocytes was not statistically significant. Our results suggest that filtration LCP to remove leukocytes from the peripheral blood, especially lymphocytes, exerts an immunomodulatory effect in patients with RA.
Effectiveness of Combining Plasma Exchange and Continuous Hemodiafiltration (Combined Modality Therapy in a Parallel Circuit) in the Treatment of Patients with Acute Hepatic Failure
Authors: Nakae Hajime , Yonekawa Chikara , Wada Hiroshi , Asanuma Yoshihiro , Sato Tsutomu , Tanaka Hiroyuki
Published: March 2003

Abstract: Plasma exchange has gained widespread acceptance as an effective mode of blood purification in patients suffering from acute hepatic failure. However, it is still undetermined whether a single use of plasma exchange is capable of removing inflammatory cytokines completely or of preventing the development of citrate toxicity inherent with fresh frozen plasma. To clarify these issues we developed combined plasma exchange and continuous hemodiafiltration (CHDF) modality in which CHDF is performed in an opposite direction to plasma exchange. This study was designed to assess the effectiveness of combined modality therapy. Fifteen patients with acute hepatic failure were treated with plasma exchange (plasma exchange group) or plasma exchange and CHDF (plasma exchange + CHDF group), and various biochemical parameters were determined before and after treatment. Although citrate levels increased significantly after treatment compared with pretreatment levels in both the plasma exchange group and the plasma exchange + CHDF group, the percentage of the increase in citrate levels was significantly higher in the plasma exchange group than in the plasma exchange + CHDF group. Bilirubin levels were significantly lower after treatment in both the plasma exchange and plasma exchange + CHDF groups. There were no significant differences in tumor necrosis factor‐α levels before and after treatment in the plasma exchange group, but they were significantly lower after treatment in the plasma exchange + CHDF group. Interleukin‐6 (IL‐6) levels increased significantly after treatment in the plasma exchange group, but there were no significant differences in the IL‐6 levels before and after treatment in the plasma exchange + CHDF group. Interleukin‐8 levels increased significantly after treatment in the plasma exchange group while decreasing significantly after treatment in the plasma exchange + CHDF group. These results indicate that combining plasma exchange and CHDF in a parallel circuit is an effective modality for suppressing the elevation of blood citrate levels and for removing inflammatory cytokines. This finding may have important implications for the development of an effective treatment for patients with acute hepatic failure.
Off‐Line Leukapheresis Using Leukofiltration for Active Ulcerative Colitis: A Case Report
Authors: Endo Yoshihiro , Tsuzuki Hideyuki , Fujino Mitsuhiro , Tabata Takahisa , Oka Hiroshi , Shimizu Tomoharu , Hanasawa Kazuyoshi , Tani Tohru
Published: March 2003

Abstract: The method of leukocytapheresis for ulcerative colitis (UC) by using extracorporeal circulation (on‐line system) has been reported. To perform leukocytapheresis, we have applied leukocyte elimination filters for blood transfusion to leukocytapheresis without using extracorporeal circulation (off‐line leukocytapheresis system). Four hundred milliliters of peripheral blood was collected and reinfused through a leukocyte elimination filter. This procedure was repeated 5 times, and up to 2,000 ml of peripheral blood was treated. This method has been applied once a week for 5 weeks. We applied the off‐line leukapheresis system to a 31‐year‐old male ulcerative colitis patient. As a result, the frequency of defecation and the dose of medicine were effectively decreased, and endoscopic finding was also improved. Because of the absence of complications observed with the on‐line system, the off‐line leukocytapheresis system that we have applied to the clinical patient is simple, safe, and useful.
Experimental Study Using Heparin‐Immobilized Adsorbent of EDA(+)fibronectin
Authors: Yonekawa Motoki , Tanaka Michiko , Kawamura Akio , Kukita Kazutaka , Tamaki Tohru , Meguro Jun‐ichi , Sakashita Eiji , Sawamoto Masaaki
Published: March 2003

Abstract: EDA(+)fibronectin, which might participate in the pathogenesis and/or progress of immune diseases, is efficiently removed from plasma by cryofiltration; however, cryofiltration removes not only EDA(+)fibronectin, but also other proteins. We thus developed a new adsorbent by using its high affinity with heparin. The purpose of this study was to evaluate the efficacy of the adsorbent of EDA(+)fibronectin (OHC‐20) in experimental arthritis. The experimental arthritis was induced by injection of 0.5 mg of Mycobacterium butyricum in Lewis rats. Rats were divided into 4 groups; 1 nontreatment group, and 3 treatment groups. Adsorption therapy in treatment groups was performed three times: on Days 1, 3, and 5 in Group A; Days 7, 9, and 11 in Group B; and Days 13, 15, and 17 in Group C. The walking postures of rats improved from dragging to walking on tiptoe, and the increase of hind‐foot volume was suppressed in Groups B and C. We conclude that heparin‐immobilized adsorbent might be promising for immune diseases.
Status of Platelet Collection and Platelet Transfusion
Authors: Omokawa Susumu , Notoya Takeshi , Kumagai Mikako , Takada Goro , Watanabe Emiko , Echigoya Yasuko , Saito Miyo , Abe Makoto , Osato Noriko , Kawakami Keizou
Published: March 2003

Abstract: Platelet product derived from single donor plateletpheresis is required to reduce the risks of adverse reactions by blood transfusion. The objectives of this study are to evaluate the status of platelet collection and its efficacy by various kinds of plateletpheresis equipment and to assess the achievement of platelet transfusion by platelet product derived from a single donor. Since the blood centers have introduced some kinds of efficient plateletpheresis equipment, large units of platelet products have been supplied mainly for the patients. Amicus and CCS might be preferable plateletpheresis machines because of their collection efficiencies and wider indication for donors. The average number of donors of platelet product per patient has recently reached nearly 1.0, and around 90% of patients have received platelet product derived from a single donor in the recent several years. However, platelet transfusion derived from a single donor has not yet been completely achieved. Each regional blood center should seriously consider the efficacy of each plateletpheresis equipment and arrange the equipment to collect platelets more effectively to achieve platelet transfusion from a single donor.
Tandem Plasmapheresis and Hemodialysis
Authors: Bhowmik Dipankar , Jain Pawan Kumar , Masih Justin Aslam , Saha Debashish , Gupta Sanjay , Agarwal Sanjay Kumar , Tiwari Suresh Chandar , Dash Suresh Chandra
Published: March 2003

Abstract: Many patients requiring plasmapheresis (PE) have renal failure and also need hemodialysis. If done separately almost 6–7 h is required. Hence, we decided to perform the procedures simultaneously in those patients requiring both PE and hemodialysis. The plasmafilter was inserted into the extracorporeal circuit after the hemodialyzer. A total of 8 such sessions of tandem PE and hemodialysis were performed in 2 patients. This is called tandem PE/hemodialysis. The total procedure was completed in the same time as is required for routine hemodialysis. The total amount of priming fluid is also less when PE and hemodialysis are performed separately. Thus, it is economically beneficial to the hospital and also convenient to the patient. Apart from transient episodes of hypotension, which were corrected by saline infusion, no other complications were noted.
The Erythrocyte Adhesiveness/Aggregation Test to Reveal Real‐Time Information of Rheological Relevance in Patients with Familial and Primary Hypercholesterolemia Before and Following Plasma Exchange
Authors: Hershcovici Tiberiu , Elishkevitz Keren , Rotstein Rivka , Fusman Renato , Zeltser David , Shapira Itzhak , Arber Nadir , Avitzour Daniel , Berliner Shlomo , Beigel Yitzhak
Published: March 2003

Abstract: We applied an erythrocyte adhesiveness/aggregation test (EAAT) to a model of plasma exchange in individuals with familial and primary hypercholesterolemia. The significant (p < 0.0001) reduction in the concentration of fibrinogen by 56%, globulins by 48%, and cholesterol by 53% corresponded to the expected significant (p < 0.0001) reduction in the degree of erythrocyte adhesiveness/aggregation in the peripheral venous blood. By virtue of its being a real‐time, simple, very‐low‐cost, and essentially bedside technique, the EAAT might have the potential of disclosing information of rheological relevance immediately before, during, as well as following apheretical procedures administered to patients with an impaired rheological profile.
Plasma Exchange Versus Double Filtration Plasmapheresis in the Treatment of Guillain‐Barré Syndrome
Authors: Lyu Rong‐Kuo , Chen Wei‐Hung , Hsieh Sung‐Tsang
Published: March 2003

Abstract: Previous studies have shown that both plasma exchange (PE) and double filtration plasmapheresis (DFPP) are effective treatments in Guillain‐Barré syndrome (GBS). Whether PE and DFPP have similar effects in GBS is not clear. This report compares the therapeutic effectiveness of PE and DFPP in GBS patients treated in 3 major hospitals in northern Taiwan. A total of 102 patients were included in this survey, including 39 with PE (hereafter PE group) and 63 with DFPP (hereafter DFPP group). Both groups showed significant improvement of disability scores after treatment. However, time to onset of effect was shorter (5.6 ± 3.5 versus 7 ± 3.4 days, p < 0.05), and changes of disability scores were more prominent (1.3 ± 0.8 versus 0.8 ± 0.8, p < 0.05) in the PE group than the DFPP group. Mortality and outcome after 6 months were not different between the 2 groups. In conclusion, both PE and DFPP are effective treatments in GBS. PE was superior to DFPP in short‐term effectiveness. The long‐term effectiveness was not different.
Neonatal Alloimmune Thrombocytopenia
Authors: Rothenberger Sandra
Published: March 2003

Abstract: Neonatal alloimmune thrombocytopenia (NAIT) can occur when a mother is immunized against fetal platelet antigens inherited from the father. Early diagnosis and appropriate platelet transfusion therapy are essential to prevent life‐threatening intracranial hemorrhage in the thrombocytopenic fetus or neonate. Five major human platelet antigen (HPA) systems are capable of causing this disorder with HPA‐1a indicated most frequently. This article reviews the pathophysiology, clinical aspects, and management of NAIT. We also present our experience with treatment of neonates affected with this disorder.
A Case of Acute Hepatic Insufficiency Treated with Novel Plasmapheresis Plasma Diafiltration for Bridge Use Until Liver Transplantation
Authors: Mori Tsuyoshi , Eguchi Yutaka , Shimizu Tomoharu , Endo Yoshihiro , Yoshioka Toyokazu , Hanasawa Kazuyoshi , Tani Tohru
Published: March 2003

Abstract: A patient with acute hepatic insufficiency induced by a drug presented to our institution, and we performed a novel plasmapheresis that we call plasma dia‐filtration (PDF). The patient was a 36 year old woman. She underwent 11 sessions of PDF for a duration of about 9 h for each procedure using the Evacure EC‐2A filter together with 20 units of fresh frozen plasma and dialysate simultaneously. Serum levels of total bilirubin and prothrombin time were significantly improved after she underwent each procedure. However, after the third procedure the levels returned to the same level as on the previous day. Encephalopathy improved after the first procedure, and this improvement was maintained until the ninth procedure. The patient prepared to undergo liver transplantation after the tenth procedure because of the development of hepatic coma, but she died of respiratory insufficiency before undergoing the procedure. Accordingly in this case, PDF worked to maintain liver function in acute liver failure and may act as bridge therapy until the patient can undergo liver transplantation.
Prediction of Vegetation Succession in Human‐Disturbed Habitats Using an Expert System
Authors: Prach Karel , Pyšek Petr , Šmilauer Petr
Published: March 2003

Detailed information, both quantitative and observational, on the course of vegetation succession in various human‐disturbed habitats in Central Europe was used to construct an expert system named SUCCESS. Using the system, it is possible to predict tentatively the sequence of seral stages and dominant species exchange in successional seres initiated on bare ground and lasting up to 50 years. Simple information on geographical position, type of substratum, relief, moisture, nutrient content, character of surrounding vegetation, and size of the disturbed area is taken into consideration to predict site‐specific succession in the particular habitats. The expert system is supposed to help landscape managers, nature conservationists, and environmental impact assessment experts in decision‐making procedures to take into account the development of vegetation in man‐made sites. Moreover, it also summarizes scientific information on the pattern of vegetation change in human‐disturbed habitats in the geographical area considered.
Success of Instream Habitat Structures After a 50‐Year Flood in Gold Creek, Montana
Authors: Schmetterling David A. , Pierce Ronald W.
Published: March 2003

Gold Creek, in western Montana, lost complexity and diversity of fish habitat following riparian logging activities, removal of instream wood, and subsequent scouring. In the 4.8‐km study area, the stream was almost totally void of large woody debris (4.2 pieces/km) and associated pools (1.3 pools/km). We constructed 66 structures made of natural materials (rock and wood) that resulted in 61 new pools in the study area in an attempt to restore salmonid habitat in the fall of 1996. An estimated 50‐year recurrence interval flood occurred in the following spring. Of the original 66 structures, 55 (85%) remained intact and stable. Laterally confined reaches retained significantly more pools than laterally extended reaches. Owing to a history of anthropogenic impacts in forested streams in the intermountain west, restoration efforts are needed. If instream structures are tailored to specific morphologic channel types, fish habitat restoration can be successful and withstand major floods.
Moderating Night Radiative Cooling Reduces Frost Damage to Metrosideros polymorpha Seedlings Used for Forest Restoration in Hawaii
Authors: Scowcroft Paul G. , Meinzer Frederick C. , Goldstein Guillermo , Melcher Peter J. , Jeffrey Jack
Published: March 2003

Winter frosts caused by radiative cooling were hypothesized to limit successful reintroduction of Hawaiian plants other than Acacia koa to alien‐dominated grasslands above 1700 m elevation. We determined, in the laboratory, the temperature at which irreversible tissue damage occurred to Metrosideros polymorpha leaves. We also conducted a field study of this species to determine if (1) leaf damage was correlated with sub‐zero leaf temperatures, (2) radiative cooling could be moderated by canopies of A. koa, and (3) low soil temperatures contributed to seedling damage. The last was evaluated by thermally buffering seedlings with water‐filled bladders placed at their base to keep roots warm, or by installing a radiation shield to reduce early morning transpiration when water uptake from cold soils would be least. Leaf temperatures were monitored between midnight and 7:00 a.m. using fine‐wire thermocouples, and leaf damage was recorded monthly. In the laboratory, supercooling protected leaves from mild sub‐zero temperatures; irreversible tissue damage occurred at about −8°C. In the field, leaf damage was strongly correlated with degree‐hours below freezing. Unprotected seedlings suffered the greatest leaf damage. Those sheltered under A. koa trees rarely experienced temperatures below −3°C, and damage was minimal. Shaded and thermally buffered seedlings suffered less damage than unprotected plants, probably due to elevated leaf temperatures rather than improved water relations. Using A. koa or artificial devices to reduce radiative cooling during winter nights should enhance establishment of M. polymorpha in high‐elevation rangeland.
Modeling Nutritional Carrying Capacity for Translocated Desert Bighorn Sheep in Western Texas
Authors: DeYoung Randall W. , Hellgren Eric C. , Fulbright Tim E. , Robbins W. Frank , Humphreys Ira D.
Published: March 2003

Restoration of desert bighorn sheep (Ovis canadensis) is proceeding in several western states. Measurement of nutritional resources (quality and quantity) is not normally conducted to assess future and present translocation sites, although it has been recommended generally for evaluation of ungulate habitat. We estimated nutritional carrying capacity (based on nitrogen in forage species) of three mountain ranges in Trans‐Pecos Texas where desert bighorn sheep have been translocated. We used an explicit nutritional constraint model to estimate carrying capacity on a seasonal basis. Although drought conditions prevailed during the study period, bighorns were not limited by quantity of vegetation. However, forage biomass of high nutritional quality (>1.5% N) was very low (<9 kg/ha in spring; <1 kg/ha in all other seasons). Consequently, there appeared to be inadequate forage of high N content for bighorns to meet reproductive requirements in some seasons. Estimates generated using the explicit nutritional constraint carrying capacity model appeared to be realistic relative to observed densities. Nutritional sampling and modeling can predict potential carrying capacity on areas scheduled for restoration or on ranges already stocked, predict effects of management on carrying capacity, and allow managers to compare among restoration sites. We recommend that desert bighorn managers focus on monitoring the abundance of high‐quality (%N) forage species, especially during periods of drought or higher nutritional requirements (e.g., lactation, post‐weanling growth).
Estimating the Effect of Beach Nourishment on Caretta caretta (Loggerhead Sea Turtle) Nesting
Authors: Rumbold D. G. , Davis P. W. , Perretta C.
Published: March 2003

Caretta caretta (loggerhead sea turtle) nesting activity was recorded daily during three seasons prior to and two seasons immediately following a beach nourishment (replenishment) project in Palm Beach County, Florida. Surveys were done at the nourished beach (Jupiter/Carlin) and at two natural beaches (Juno and Tequesta). The size of the nourishment effect on nesting activity was estimated using Before‐After‐Control‐Impact Paired Series (BACIPS) models. Nesting declined by 4.4 to 5.4 nests km−1 day−1 on the nourished beach compared to the two natural beaches in the first season after nourishment. At the same time, false crawls (FC, non‐nesting crawls) increased by 5.0 to 5.6 FC km−1 day−1 on the nourished beach. In the second season following nourishment, nesting was reduced by 0.5 to 1.6 nests km−1 day−1 on the nourished beach compared to the two natural beaches. The increase in false crawl frequency in the second season following nourishment was 0.7 to 0.9 FC km−1 day−1.These results suggest that beach nourishment significantly decreased loggerhead sea turtle nesting during the first season following the project. However, the size of the effect, in terms of nesting frequency and false crawl frequency, was much reduced by the second season following nourishment.
Wyoming Big Sagebrush Density: Effects of Seeding Rates and Grass Competition
Authors: Williams Mary I. , Schuman Gerald E. , Hild Ann L. , Vicklund Laurel E.
Published: March 2003

The mining industry commonly seeds shrubs and grasses concurrently on coal‐mined lands of northeastern Wyoming, but ecological interactions between seeded shrubs and grasses are not well documented. Artemisia tridentata Nutt. ssp. wyomingensis (Beetle and Young) (Wyoming big sagebrush) is the dominant pre‐mining shrub on many Wyoming mine sites. Despite past failures to establish Wyoming big sagebrush, the Wyoming Department of Environmental Quality, Land Quality Division's rules and regulations require establishment of 1 shrub per m2 on 20% of post‐mined land in Wyoming. A study was established at the Belle Ayr Coal Mine south of Gillette, Wyoming to evaluate the effects of sagebrush seeding rates and grass competition on Wyoming big sagebrush seedling density. Three sagebrush seeding rates (1, 2, and 4 kg pure live seed [pls]/ha; 350, 700, and 1,400 pls/m2, respectively) and seven cool‐season perennial grass mixture seeding rates (0, 2, 4, 6, 8, 10, and 14 kg pls/ha; 0, 187, 374, 561, 750, 935, and 1,309 pls/m2, respectively) were applied during winter 1998–1999. Pascopyrum smithii (Rydb.) A. Love (western wheatgrass), Elymus lanceolatus (Scribner & J.G. Smith) Gould (thickspike wheatgrass), and Elymus trachycaulus (Link) Gould ex Shinners (slender wheatgrass) comprised the grass seed mix (equal seed numbers of each species). Sagebrush seedling density differed among sagebrush seeding rates but not among grass seeding rates. On all sampling dates in 1999 and 2000, sagebrush seedling density differed among sagebrush rates and was greatest at the 4 kg pls/ha sagebrush seeding rate. All sagebrush seeding rates provided densities of at least 1 shrub per m2 after two growing seasons. Grass density and production in 2000 suggest that adequate grass production (75 g/m2) was achieved by seeding at 6 to 8 kg pls/ha. Within these grass seeding rates, four or more sagebrush seedlings per m2 were attained when sagebrush was seeded at 2 to 4 kg pls/ha. Use of these seeding rate combinations in mine reclamation can achieve Wyoming big sagebrush standards and reduce reseeding costs.
Rehabilitation of Degraded Areas of Central Amazonia Using Direct Sowing of Forest Tree Seeds
Authors: Camargo José Luís Campana , Ferraz Isolde Dorothea Kossman , Imakawa Angela Maria
Published: March 2003

Deforestation in the Amazon Basin is still increasing, and the rehabilitation of these lands continues to be a challenge. Autoecological studies of most Amazonian species are rare, and efficient techniques for restoration of forested habitats have yet to be developed. The aim of this study was to test direct sowing as a rehabilitation technique for sites with different degrees of disturbance: bare soil, pasture, and secondary and mature forests in Central Amazonia, Brazil. At each site, we sowed seeds of 11 native tree species. Throughout the following year we evaluated germination and seedling survival. The germination differed according to the study site and species. Seedling survival in degraded sites was higher than in other areas. After 1 year in the bare soil site, 33% of the sown seeds of eight species developed seedlings; in the pasture the establishment was 23%, in secondary forest 15%, and in mature forest 12% of only four species. The only widespread survivor with more than 45% emergence in all perturbed sites was Caryocar villosum. No pioneer seedlings remained after 1 year. There was a positive correlation between seed size and survival. Large‐seeded non‐pioneer species seem to be more suitable for direct sowing than small‐seeded species. We recommend a combination of direct sowing and planting of seedlings as an appropriate means to accelerate the rehabilitation of degraded areas in Central Amazonia.
A Monitoring Protocol to Assess Tidal Restoration of Salt Marshes on Local and Regional Scales
Authors: Neckles Hilary A. , Dionne Michele , Burdick David M. , Roman Charles T. , Buchsbaum Robert , Hutchins Eric
Published: March 2003

Assessing the response of salt marshes to tidal restoration relies on comparisons of ecosystem attributes between restored and reference marshes. Although this approach provides an objective basis for judging project success, inferences can be constrained if the high variability of natural marshes masks differences in sampled attributes between restored and reference sites. Furthermore, such assessments are usually focused on a small number of restoration projects in a local area, limiting the ability to address questions regarding the effectiveness of restoration within a broad region. We developed a hierarchical approach to evaluate the performance of tidal restorations at local and regional scales throughout the Gulf of Maine. The cornerstone of the approach is a standard protocol for monitoring restored and reference salt marshes throughout the region. The monitoring protocol was developed by consensus among nearly 50 restoration scientists and practitioners. The protocol is based on a suite of core structural measures that can be applied to any tidal restoration project. The protocol also includes additional functional measures for application to specific projects. Consistent use of the standard protocol to monitor local projects will enable pooling information for regional assessments. Ultimately, it will be possible to establish a range of reference conditions characterizing natural tidal wetlands in the region and to compare performance curves between populations of restored and reference marshes for assessing regional restoration effectiveness.
Constraints of Seed Bank Species Composition and Water Depth for Restoring Vegetation in the Florida Everglades, U.S.A.
Authors: Smith Stephen M. , McCormick Paul V. , Leeds Jennifer A. , Garrett Patrick B.
Published: March 2003

The Rotenberger Wildlife Management Area (RWMA) is a northern Everglades marsh, in Florida, U.S.A., that will undergo hydrologic restoration to remedy an artificially shortened hydroperiod. In an effort to predict vegetation responses to the impending changes in hydrology, plant community development from the resident seed bank was observed in response to three different moisture regimes in March and September 1998. Percent cover, species densities, total seedling densities, and percentages of facultative, facultative‐upland, and upland indicator species were significantly higher in moist than in saturated soils. Flooding inhibited the germination of all species except Typha domingensis (cattail), which emerged in the highest numbers from saturated soils in both assays. Lythrum alatum (purple loosestrife) was abundant in both saturated and moist conditions. The season of assay affected species densities and the communities. Percent facultative‐wetland species increased in saturated soils in the March assay but not in September. In contrast, percent obligate hydrophytes were higher in saturated conditions only in the September assay. In general the assay communities bore little resemblance to vegetation in currently undisturbed or historic wetlands of the northern Everglades. Consequently the RWMA seed bank will contribute little to the development of a restored community. Moreover, rehydration may encourage the spread of undesirable hydrophytes such as T. domingensis. This study supports the contention that hydrologic restoration must be accompanied by some level of active vegetation management and that the reference condition cannot be attained passively.