bluuebunny/crossref_metadata_2025 huggingface dataset:
Transnational Corporations and Repression of Political Rights and Civil Liberties: An Empirical Analysis
Authors: Busse Matthias
Published: February 2004

Transnational Corporations are often accused by non‐governmental organisations of ignoring fundamental democratic rights, such as civil liberties and political rights, in the countries of their investments. This paper attempts to explore empirically the complex relationship between foreign investment and democracy in a systematic way, using different econometric techniques. In contrast to the public discussion over recent years and the view held by non‐governmental organisations, the results show that enhanced democratic rights are associated with higher foreign investment in the 1990s. Interestingly, this positive link does not hold for the 1970s and 1980s, when a substantial portion of foreign investment went to countries with repressive governments.
The Effectiveness of Written Recasts in the Second Language Acquisition of Aspectual Distinctions in French: A Follow‐Up Study
Authors: Ayoun Dalila
Published: February 2004

This follow‐up study on the acquisition of the aspectual distinction between the passé composé (PC) and the imparfait (IMP) investigates the differential outcomes of the results presented in an earlier study, Ayoun (2001), by pursuing two lines of research: the effectiveness of written recasts versus models and traditional grammar instruction, and the development of temporality in the interlanguage of French college students as second language learners (i.e., the Aspect Hypothesis). The earlier study found that all learners improved in their use of the PC but not the IMP. The R(recast)‐group out‐performed the M(model)‐group and the G(grammar)‐group, with a significant difference over the latter but not the former, which supported the hypothesis that recasts are the most effective form of treatment. The qualitative results of the present study weaken this finding because it was more difficult to distinguish among the three different treatments: (a) The G‐group outperformed the R‐ and M‐groups in accuracy and frequency in the PC; (b) all three groups decreased in their accuracy and frequency in the IMP but the G‐group outperformed the other two groups; (c) the three groups were practically identical in the production of various predicate types in the PC and IMP on the pre‐ and posttests; and (d) overall, it was the G‐group's performance that showed a greater aspectual use of predicate frequency and type in the IMP. These new results partially support a prediction of the Aspect Hypothesis, according to which the use of past tense morphology is influenced by lexical class, but they offer only tentative support for the Imparfait Spreading hypothesis. A few preliminary suggestions regarding pedagogical applications are offered.
Student Spanish Use and Investment in a Dual Immersion Classroom: Implications for Second Language Acquisition and Heritage Language Maintenance
Authors: Potowski Kim
Published: February 2004

In dual immersion classrooms, students from different language backgrounds are immersed in the minority language for large portions of the school day with the expectation that they will become equally proficient in their first language (L1) and in their second language (L2). Research on dual immersion indicates that students reach above‐average levels of academic achievement and linguistic proficiency, but, to date, very few quantifications have been made of how much of the minority language is used in these environments. Given that actually speaking a language is crucial for L2 acquisition as well as for heritage language maintenance, this study explored how much Spanish was used and for what purposes by 4 students (2 Spanish L1 and 2 two Spanish L2) in a Spanish/English dual immersion classroom.

Over 2,000 turns of natural classroom speech were recorded during a 5‐month period. Overall, the students used Spanish 56% of the time, with 4 major trends: (a) The girls used more Spanish than the boys, regardless of L1; (b) the students averaged 82% Spanish when talking with the teacher, but only 32% when talking to peers; (c) Spanish was used primarily for on‐task topics; (d) the students' English when speaking with peers covered a wider range of functions than did their Spanish. These findings lend support to proposals that a kind of diglossia exists in immersion classrooms (Tarone & Swain, 1995).

Additional ethnographic data gathered through extensive participant‐observations and interviews were interpreted using the concept of investment (Norton, 2000). Explanations of the students' language use are offered according to their sometimes competing identity investments.
Interlinguistic Variation and Similarity in Second Language Speech Act Behavior
Authors: Yu Ming–Chung
Published: February 2004

This study investigates the compliment response behavior of 2 groups of Chinese learners of English, one living in the United States and the other in Taiwan. The present study compared the behavior of these learner groups with that of native Chinese and English speakers in order to determine how they respond to compliments in different situations when two contextual variables, addressees' status and gender, vary.

Compliment responses by the Chinese using Chinese and the learners in Taiwan were more likely to be rejections than acceptances, whereas responses to compliments by the Americans and the learners in the United States were more likely to be acceptances than rejections. Furthermore, although there were substantial differences between the 2 learner groups, the performance of both reflected native language (L1) communicative styles and transfer of L1 sociocultural strategies in their second language behavior.
In vitro antimicrobial effect of chlorhexidine‐impregnated gutta percha points on Enterococcus faecalis
Authors: Lui J. N. , Sae‐Lim V. , Song K. P. , Chen N. N.
Published: February 2004

Aim  To evaluate the in vitro antimicrobial effect of chlorhexidine‐impregnated gutta percha points, Roeko activ point (Roeko, Langenau, Germany) on Enterococcus faecalis.

Methodology  Human maxillary premolar roots were prepared with .04 rotary ProFile instruments to a master apical file size 40, autoclave‐sterilized and then infected with E. faecalis (ATCC 29212) for 3 weeks. Baseline controls were carried out verifying negligible effects of plain gutta percha cones on E. faecalis. Subsequent to intracanal placement of calcium hydroxide, ‘activ points’ or saline (positive control) and the 2‐week incubation in 54 root specimens, dentine sampling at depths of 100 and 250 µm was carried out using .04 rotary ProFile instruments at sizes 60 and 90 to assess the quantity of bacteria present. Inactivating agents were used prior to sampling and the colony‐forming units (CFU) of E. faecalis were then plate‐counted after culturing. Statistical analysis was completed using the paired t‐test.

Results  In comparison to the positive control, treatment with calcium hydroxide (P = 0.000 and 0.000) or activ points (P = 0.000 and 0.002) produced significantly lower colony counts of E. faecalis at dentine depths of 100 and 250 µm, respectively. Calcium hydroxide (2.10 × 102 CFU mL−1) was significantly more effective than activ points (1.58 × 103 CFU mL−1) at 100 µm (P = 0.013), but not at 250 µm (P = 0.353). Neither of these two medications was able to eliminate E. faecalis completely.

Conclusions  Chlorhexidine‐impregnated activ points did not possess an in vitro inhibitory activity strong enough to eliminate E. faecalis completely from infected dentinal tubules.
Transforming Growth Factor‐beta 1 (TGF‐beta 1) expression in normal healthy pulps and in those with irreversible pulpitis
Authors: Piattelli A. , Rubini C. , Fioroni M. , Tripodi D. , Strocchi R.
Published: February 2004

Aim  To evaluate the Transforming Growth Factor‐beta 1 (TGF‐beta 1) expression in normal healthy pulps and in those with irreversible pulpitis.

Methodology  Twenty‐three normal, healthy pulps were removed from mandibular third molars, and 20 pulps were retrieved from teeth with irreversible pulpitis. TGF‐beta 1 was evaluated in the odontoblastic and subodontoblastic layers, in the stromal cells (fibroblasts), and in the blood vessels. TGF‐beta 1 expression was determined by evaluating 500 cells in the odontoblastic and subodontoblastic layers and 500 fibroblasts in the stroma for each specimen, and counting the number of positive cells. The number of the positive vessels was evaluated in 10 high power fields (HPF). In almost all cases, the cellular positivity was cytoplasmatic. Statistical analysis was performed using Mann–Whitney U‐ and Student's t‐tests.

Results  A higher expression of TGF‐beta 1 was found in the odontoblastic–subodontoblastic layer of the irreversible pulpitis specimens; this difference was statistically significant (P = 0.0002). No statistically significant difference was observed between the two groups in TGF‐beta 1 expression in the stromal cells (P = 0.54) or in the vascular component (P = 0.94).

Conclusions  The higher and statistically significant expression of TGF‐beta 1 found in the odontoblastic–subodontoblastic layer of irreversible pulpitis specimens may indicate a role for TGF‐beta 1 in the dentinal repair processes after pulp inflammation.
Endodontic treatment of primary teeth using a combination of antibacterial drugs
Authors: Takushige T. , Cruz E. V. , Asgor Moral A. , Hoshino E.
Published: February 2004

Aim  To evaluate the clinical outcome of ‘Lesion Sterilization and Tissue Repair’ (LSTR) therapy for endodontic treatment of primary teeth.

Methodology  A mixture of metronidazole, ciprofloxacin, and minocycline (3Mix) in ointment (macrogol mixed with propylene glycol: MP) or in a root canal sealer was used to disinfect infected root canals of 56 patients aged 4–18 years. Out of a total of 87 primary teeth, 81 cases had physiologic root resorption. A total of 54 radiolucent periradicular lesions were present. The root canals were not prepared before or after disinfection. 3Mix medicament (3Mix‐MP/3Mix‐sealer) was placed at orifices of root canals or on the bottom of pulp chambers, and then sealed with glass‐ionomer cement and further reinforced by a composite resin inlay prepared using a direct method and cemented with resin.

Results  In all cases, clinical symptoms such as gingival swelling (52 cases), sinus tracts (22 cases), induced dull pain (3 cases), spontaneous dull pain (26 cases), and pain on biting (46 cases) disappeared after treatment, although in four cases clinical signs and symptoms were finally resolved only after retreatment using the same procedures. Thus, gingival abscesses and fistulae, if present, disappeared after a few days. Successor permanent teeth erupted without any disorders, or were found radiographically to be normal and in the process of eruption. All the cases were evaluated as successful. The mean function time of the primary teeth was 680 days (range: 68–2390 days), except for one case in which the successor permanent tooth was congenitally missing.

Conclusion  Primary teeth with periradicular lesions with or without physiologic root resorption were treated successfully by the LSTR endodontic therapy.
C‐shaped root canals of mandibular second molars in a Korean population: clinical observation and in vitro analysis
Authors: Seo M. S. , Park D. S.
Published: February 2004

Aim  To investigate the incidence and morphology of C‐shaped root canals of the mandibular second molar in a Korean population.

Methodology  Through clinical observation, randomly selected 272 mandibular second molars of Korean patients were accessed and evaluated after taking radiographs for determination of working length. In an in vitro analysis, 96 extracted mandibular second molars of Korean patients were collected and embedded in resin using an Endodontic cube technique, and were sectioned at intervals of 1 mm. The specimens were then observed with a surgical microscope and were photographed. Canal configurations were assigned to one of three categories: Category I defined a C‐shaped outline without any separation; Category II referred to those with canal configurations, where dentine separated one distinct canal from a buccal or lingual C‐shaped canal; Category III had two or more discrete and separate canals.

Results  In clinical observation, 89 of 272 teeth (32.7%) had C‐shaped canals. Of the 96 teeth examined in vitro, 30 (31.3%) had C‐shaped canals. Upon in vitro analysis, only 1 tooth at the subpulpal level and 10 teeth at the apical 1 mm level were categorized under Category III.

Conclusion  There was high prevalence of C‐shaped root canals in the mandibular second molars of Koreans. C‐shaped canals having semicolon and continuous shapes at the canal orifice have a high possibility of being divided into two or three canals in the apical region.
Proliferation of dental pulp fibroblasts in response to thrombin involves mitogen‐activated protein kinase signalling
Authors: Gruber R. , Jindra C. , Kandler B. , Watzak G. , Fischer M. B. , Watzek G.
Published: February 2004

Aim  To examine the involvement of mitogen‐activated protein kinases (MAPK) signalling on thrombin‐stimulated human dental pulp fibroblasts (DPF).

Methodology  Dental pulp fibroblasts were isolated from dental pulp connective tissue of third molars and expanded in vitro. Expression of thrombin receptors was analysed by RT‐PCR, and cell proliferation was measured by 3[H]‐thymidine incorporation assay. Phosphorylation levels of MAPK were determined by Western blot analysis, and alkaline phosphatase activity was measured to serve as a marker for odontogenic differentiation. Statistical analysis was performed by Student's t‐test.

Results  Dental pulp fibroblasts express the thrombin receptors protease‐activated receptor‐1 (PAR‐1), PAR‐3 and PAR‐4. Measurement of 3[H]‐thymidine incorporation revealed a dose‐dependent increase of DNA synthesis in response to thrombin treatment. The thrombin‐induced mitogenic activity was decreased by the extracellular signal‐regulated protein kinase (ERK) signalling inhibitor PD98059 (P < 0.05), and by SB203580 (P < 0.05), a p38 MAPK inhibitor. Western blot analysis demonstrated increased phosphorylation of ERK in DPF following stimulation with thrombin, while p38 MAPK and c‐Jun NH2‐terminal kinase (JNK) were not activated. Alkaline phosphatase activity of DPF remained unchanged upon incubation with thrombin.

Conclusions  These results suggest that signalling via MAPK mediates the mitogenic activity of thrombin on DPF and may thus play a role during the early stages of pulp repair.
Population synchrony within and among Lepidoptera species in relation to weather, phylogeny, and larval phenology
Authors: Raimondo Sandy , Liebhold Andrew M. , Strazanac John S. , Butler Linda
Published: February 2004

Abstract.  1. The population dynamics of native herbivore species in central Appalachian deciduous forests were studied by analysing patterns of synchrony among intra‐ and interspecific populations and weather.

2. Spatial synchrony of 10 Lepidoptera species and three weather variables (minimum temperature, maximum temperature, precipitation) from 12 sites was measured using cross‐correlation functions relating levels of synchrony to the distance separating each set of populations. Based on both the pattern of synchrony and the region‐wide cross‐correlation coefficients, Lepidoptera species appear to be synchronised, at least in part, by local weather conditions.

3. Interspecific cross‐correlations were calculated for all sympatric species pairs and trends in interspecific synchrony were related to phylogenetic relatedness, life‐history timing, and weather. Interspecific synchrony was highest among species whose larvae were present during the same time of the season, but there was no relationship between interspecific synchrony and phylogenetic affinity.

4. Spatial synchrony of weather variables was significantly related to both species of some interspecific pairs, indicating weather as a potential mechanism involved in synchronising populations of different species.
Young people as teachers and learners in the workplace: challenging the novice–expert dichotomy
Authors: Fuller Alison , Unwin Lorna
Published: February 2004

Conventionally, apprenticeship is understood as a linear journey from novice to expert in which ‘old‐timers’ mould their successors. This paper challenges the assumptions that expertise is equated solely with status and experience in the workplace, and that all novices and experts, regardless of context, are seen as the same.
Pharmacokinetics of desflurane uptake into the brain and body
Authors: Lu C. C. , Tsai C. S. , Ho S. T. , Chueng C. M. , Wang J. J. , Wong C. S. , Chang S. Y. , Lin C. Y.
Published: February 2004

The aim of this study was to investigate the pharmacokinetics of desflurane uptake into the brain and body by comparing desflurane concentrations in internal jugular‐bulb blood (Jdes), arterial blood (Ades) and pulmonary arterial blood (PAdes) at a fixed inspired desflurane concentration. Thirteen patients (aged 42–72 years) undergoing coronary artery bypass grafting surgery were enrolled in this study. They were anaesthetised using a constant 5% inspired desflurane concentration (CIdes) during the first hour of anaesthesia. Under constant volume‐controlled ventilation, CIdes and end‐tidal desflurane (CEdes) were measured with an infrared analyser. The desflurane concentration in the blood was analysed using gas chromatography, and cardiac output was measured using an Opti‐Q pulmonary artery catheter. It took 24 min for the Jdes to equilibrate with Ades. Both CIdes–CEdes and Ades–PAdes gradients persisted during the study period. There was no further uptake of desflurane into the brain after 24 min but there was near‐constant uptake into the body.
The moisture‐conserving performance of breathing system filters during the first three minutes of simulated use
Authors: Wilkes A. R.
Published: February 2004

Breathing system filters are recommended for use during anaesthesia to protect the patient from inhaling gas‐borne particles. Filters placed at the patient connection port of the breathing system can also humidify the inspired gases. The end‐inspired moisture content was measured when using five different filters with two different ventilatory test conditions on a patient model during a typical pre‐oxygenation period of 3 min. The moisture content of the end‐inspired air at the end of the 3‐min period varied from 6.4 to 27.8 and from 4.4 to 25.9 g.m−3 for tidal volumes of 0.5 and 1.0 l, respectively (p < 0.0001 for all pairwise comparisons of the five filters and for the two tidal volumes). Those breathing system filters that have at least an adequate level of performance (at least 20 g.m−3) will generally achieve this level within the 3‐min pre‐oxygenation period.
Pressures within air‐filled tracheal cuffs at altitude – an in vivo study
Authors: Henning J. , Sharley P. , Young R.
Published: February 2004

Aeromedical transport of mechanically ventilated critically ill patients is now a frequent occurrence. However, the performance of the air filled tracheal tube cuff at altitude has not been studied in vivo. We measured the tracheal cuff pressures at ground level and at 3000 ft, in 10 intubated patients. With air providing the seal in the cuff the mean rise in cuff pressure was 23 cmH2O, which took the pressures above the critical perfusion pressure of the tracheal mucosa. This could lead to tracheal injury.
Measuring tracheal airway pressures during transtracheal jet ventilation: an observational study*
Authors: Patel C. , Diba A.
Published: February 2004

Tracheal airway pressures were measured via a transduced fibrescope during transtracheal jet ventilation in 10 patients. Ravussin transtracheal jet ventilation catheters were inserted under local anaesthesia. Following induction of general anaesthesia, tracheal airway pressures were measured at three anatomical levels during fibreoptic intubation. Overall pressure changes during transtracheal jet ventilation were small with the maximal pressure increase (13 mmHg) measured at the carina.
The moisture‐conserving performance of breathing system filters in use with simulated circle anaesthesia breathing systems*
Authors: Wilkes A. R.
Published: February 2004

Breathing system filters can be used to humidify gases delivered to patients. Performance can be determined by measuring the net moisture loss (the difference between expired and inspired levels of humidity) from a patient model. The net moisture loss should be decreased by increasing the level of humidity in the breathing system by, for example, using a circle breathing system. The effect of four different filters, three different levels of humidity in the breathing system (7, 13 and 19 g.m−3) and two tidal volumes (0.5 l and 1.0 l) on the net moisture loss from a patient model was measured. The net moisture loss decreased as the humidity in the breathing system increased and was less for the lower tidal volume. Adequate levels of humidity (≥ 20 g.m−3) will be delivered to patients by most filters provided they are used in conjunction with circle breathing systems and low fresh gas flows.
Activity‐Dependent Dynamics of Coexisting Brain‐Derived Neurotrophic Factor, Pro‐Opiomelanocortin and α‐Melanophore‐Stimulating Hormone in Melanotrope Cells ofXenopus laevis
Authors: Wang L. C. , Meijer H. K. , Humbel B. M. , Jenks B. G. , Roubos E. W.
Published: February 2004

Brain‐derived neurotrophic factor (BDNF) is involved as an autocrine factor in the regulation of the secretory activity of the neuroendocrine pituitary melanotrope cells ofXenopus laevis. We studied the subcellular distribution of BDNF inXenopusmelanotropes using a combination of high‐pressure freezing, cryosubstitution and immunoelectron microscopy. Presence of BDNF, pro‐opiomelanocortin (POMC) and α‐melanophore‐stimulating hormone (αMSH) within melanotrope secretory granules was studied by triple‐labelling immunoelectron microscopy. In addition, intracellular processing of BDNF was investigated by quantifying the number of immunogold particles in different stages of secretory granule maturation, in animals adapted to black or white background light conditions. The high‐pressure freezing technique provides excellent preservation of both cellular ultrastructure and antigenicity. BDNF coexists with POMC and αMSH within secretory granules. BDNF‐immunoreactivity increases along the secretory granule maturation axis (i.e. from electron‐dense, via moderately electron‐dense, to electron‐lucent secretory granules). Immature, low immunoreactive, electron‐dense secretory granules are assumed to contain mainly or even exclusively proBDNF. Strongly immunoreactive electron‐lucent secretory granules represent the mature granule stage in which proBDNF has been processed to mature BDNF. Furthermore, in moderately electron‐dense secretory granules, immunoreactivity is markedly (+79%) higher in black‐adapted than in white‐adapted animals, indicating that stimulation of melanotrope cell activity by the black background condition speeds up processing of BDNF from its precursor in this granule stage. It is concluded that, in theXenopusmelanotrope, BDNF biosynthesis and processing occur along the secretory granule maturation axis, together with that of POMC‐derived αMSH, and that the environmental light condition not only controls the biosynthesis and secretion of BDNF and of POMC end‐products, but also regulates the rate of their intragranular processing.
A pheochromocytoma presenting as generalized pigmentation
Authors: Zawar Vijay P. , Walvekar Rajesh
Published: February 2004

A 25‐year‐old man presented with pigmentation over the face and hands of 6 months’ duration, which darkened on sun exposure. Four weeks after the onset of pigmentation, he experienced intermittent episodes of excessive sweating, tremors, fatiguability, and headache, which had gradually increased in frequency over the last 5 months. There was a history of anorexia and weight loss of 7 kg over the last 6 months.

There was no history of previous drug ingestion, chemical exposure, or any major illness. The family history, including diabetes, tuberculosis, hypertension, endocrine tumors, and pigmentation, was negative.

On dermatologic examination, slate‐gray macular pigmentation was noticed on the forehead, cheeks, nose, lips (Fig. 1), helices of the ears, and dorsum of the hands, with prominence over the knuckles and the skin over the interphalangeal joints, elbows, and knees (Fig. 2).

Slate‐gray pigmentation on the forehead, cheeks, nose, and lips

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Slate‐gray pigmentation on the dorsum of the hands, knuckles, and skin over the interphalangeal joints

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The scars of acne and previous injuries over the legs were also hyperpigmented. The mucosa of the hard palate showed streaky linear pigmentation in the midline.

On general examination, tachycardia was a constant feature at all visits, and more marked on the last three visits (104, 100, and 120/min, respectively). Hypertension was noted in the right upper arm in the supine position at two of the last three consultations (140/100, 120/84, and 180/118 mmHg, respectively). A significant orthostatic hypotension was noted on standing during the last visit, i.e. 150/110 mmHg.

The following laboratory investigations were performed: hemoglobin (Hb), 11.7 g%; erythrocyte sedimentation rate (ESR), 30 mm in the first hour; serum cortisol, 26.8 mg/dL (N < 14 mg/dL, PM sample); serum adrenocorticotrophic hormone (ACTH), 101 pg/mL (N < 60 pg/mL); urinary vanillylmandelic acid (VMA), 16.3 mg in 24 h (N < 9 mg/24 h). The following were all within normal limits: complete blood count (CBC), blood sugar, urinalysis, serum electrolytes, calcium, B‐12 levels, thyroid and liver function tests, and stool (routine and occult blood) test. Chest X‐ray, thyroid scan, and ultrasonography were normal. Human immunodeficiency virus (HIV) was nonreactive.

Abdominal sonography revealed a hypoechoic and well‐circumscribed mass in the left suprarenal area. Computed tomography of the abdomen confirmed a tumor location in the left adrenal gland with mild enhancement after contrast (Fig. 3).

Ultrasonography depicting tumor location in the left adrenal gland

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The patient was operated on to remove a mass measuring 5 cm × 3.5 cm × 3.2 cm. Histopathology of the tissue confirmed a diagnosis of pheochromocytoma.

To our surprise, the pigmentation faded rapidly in the immediate postoperative period and the scar at the operation site did not pigment significantly (Fig. 4).

Post‐operative fading of pigmentation 6 weeks after surgery

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Propionibacterium acnes biotypes and susceptibility to minocycline and Keigai‐rengyo‐to
Authors: Higaki Shuichi , Nakamura Motokazu , Morohashi Masaaki , Yamagishi Takayoshi
Published: February 2004

Background  Propionibacterium acnes is the predominant organism in acne lesions, but the sensitivity of different biotypes of P. acnes to therapeutic agents has seldom been reported.

Methods  To characterize biotypes of P. acnes and to measure the effects of Keigai‐rengyo‐to (KRT) and minocycline (MINO) on clinical P. acnes isolates.

Results  Propionibacterium acnes biotype III (BIII) is the most common form of identified acne lesion, followed by P. acnes biotype I. BIII was isolated from mild, moderate and severe severity and the average lipase activity of BIII was higher than that of Biotypes I, II, IV and V. No significant differences in the decrease of free fatty acid production elicited by KRT or by MINO were found between BIII and the other biotypes. The degree of decreased butyric acid production was greater than that of propionic acid production in the medium supplemented with MINO. The percent decrease of butyric acid production elicited by 1 mg/mL of KRT was the same as that elicited by 0.1 µg/mL of MINO. Among biotypes of P. acnes, the minimal inhibitory concentrations of agents tested were generally higher in erythritol‐positive biotypes than in erythritol‐negative biotypes.

Conclusion  The high frequency of BIII might be responsible for the severity of acne in patients. It seems that if the same concentrations of MINO and KRT are used, the antilipase activity of MINO is stronger than that of KRT. Minocycline also has a direct anti‐lipase activity against P. acnes. The mechanism underlying the influence of erythritol on the susceptibility of P. acnes to these agents remains unknown.
Clinicopathologic features of ulcerative‐atrophic sarcoidosis
Authors: Yoo Simon S. , Mimouni Daniel , Nikolskaia Olga V. , Kouba David J. , Sauder Daniel N. , Nousari Carlos H.
Published: February 2004

Background  Sarcoidosis is a chronic granulomatous disease of unknown etiology. Cutaneous disease is common and includes two clinicopathologic categories: granulomatous infiltration or a reactive phenomenon. In the granulomatous infiltrative group, clinical manifestations can be variable. Ulcers in sarcoidosis are uncommonly recognized and have been categorized previously under the rubric of atrophic, necrobiosis‐like, or ulcerative sarcoidosis.

Patients and methods  We evaluated retrospectively sarcoidosis patients presenting to the Johns Hopkins Department of Dermatology between June 1989 and May 2002. Multiple skin biopsies were performed for histopathologic evaluation. Investigation for extracutaneous manifestations, including routine serologic assays, chest radiography, pulmonary function tests, electrocardiogram, and angiotensin‐converting enzyme level, and referral for ophthalmologic examination were performed in all patients.

Results  Of 147 consecutive patients presenting with cutaneous sarcoidosis, seven demonstrated ulcerative‐atrophic sarcoidosis lesions. All patients were African‐American (five females and two males). All patients had ulcers surrounded by atrophic necrobiosis lipoidica‐like plaques on the pretibial areas. All patients had other mucocutaneous manifestations of sarcoidosis, with the majority having evidence of internal disease. Combined immunosuppressive and immunomodulatory therapy was effective in controlling the cutaneous manifestations of all patients with ulcerative sarcoidosis.

Conclusions  The ulcerative variant is a poorly defined subset of cutaneous sarcoidosis. Trauma, superimposed on atrophic plaques, appears to be the principal mechanism of this rare variant of cutaneous sarcoidosis.
Therapeutic potential of azithromycin in rosacea
Authors: Bakar Özgür , Demirçay Zeynep , Gürbüz Oya
Published: February 2004

Background  Systemic antibiotics currently used in the treatment of rosacea are sometimes associated with uncomfortable side‐effects. Therefore, a need for an effective agent with few side‐effects and good patient compliance exists. Azithromycin, a macrolide antibiotic with prolonged mode of action, has recently been found to be an effective alternative in the treatment of inflammatory acne. We planned a study to evaluate the efficacy and safety of azithromycin in rosacea.

Methods  An open‐labeled study was performed in a population of 18 patients, with Plewig‐Kligman stage 2 rosacea. Patients were given oral azithromycin for 12 weeks in decreasing doses.

Results  Fourteen subjects completed the trial. The treatment produced therapeutic benefits with regard to total scores as well as inflammatory lesion scores. At the end of 12 weeks, there was a 75% decrease in total scores (P < 0.001) and an 89% decrease in inflammatory lesion scores compared with basal values. Improvement continued during the 4 weeks after treatment. Adverse effects were minimal and well tolerated in most patients.

Conclusion  Azithromycin is a promising agent in the treatment of rosacea with its few side‐effects and good patient compliance.
Dr Karel Fleischmann: The story of an artist and physician in Ghetto Terezin
Authors: Hoenig Leonard J. , Spenser Tomas , Tarsi Anita
Published: February 2004

Dr Karel Fleischmann (1897–1944) was a Jewish dermatologist and noted Czech artist. During World War II, Fleischmann was confined by the Nazis in Ghetto Terezin (Theresienstadt), which was located in the Protectorate of Bohemia and Moravia. While at Terezin, Fleischmann became a leader of the ghetto's health care system and administered programs that helped to dramatically reduce the high mortality rate of the Jewish population from disease. In his spare time, Fleischmann drew works of art that portrayed the daily life and suffering of the Jews in Ghetto Terezin. Although Fleischmann perished in the Auschwitz‐Birkenau concentration camp, his artwork survived the war. This article pays tribute to Dr Karel Fleischmann by telling the story of his life and by citing selections from his art, poetry and prose.
Effect of synthetic peptides corresponding to residues 313–332 of the αIIb subunit on platelet activation and fibrinogen binding to αIIbβ3
Authors: Mitsios John V. , Tambaki Afroditi P. , Abatzis Morfis , Biris Nikolaos , Sakarellos‐Daitsiotis Maria , Sakarellos Constantinos , Soteriadou Ketty , Goudevenos John , Elisaf Moses , Tsoukatos Demokritos , Tsikaris Vassilios , Tselepis Alexandros D.
Published: February 2004

The platelet integrin receptor αIIbβ3 plays a critical role in thrombosis and haemostasis by mediating interactions between platelets and several ligands but primarily fibrinogen. It has been shown previously that the YMESRADR KLAEVGRVYLFL (313–332) sequence of the αIIb subunit plays an important role in platelet activation, fibrinogen binding and αIIbβ3‐mediated outside‐in signalling. Furthermore, we recently showed that the 20‐residue peptide (20‐mer) αIIb 313–332, is a potent inhibitor of platelet aggregation and fibrinogen binding to αIIbβ3, interacting with fibrinogen rather than the receptor. In an effort to determine the sequence and the minimum length required for the biological activity of the above 20‐mer, we synthesized seven octapeptides, each overlapping by six residues, covering the entire sequence and studied their effect on platelet activation as well as fibrinogen binding to activated platelets. We show for the first time that octapeptides containing the RAD sequence are capable of inhibiting platelet aggregation and secretion as well as fibrinogen binding to the activated αIIbβ3, possibly interacting with the ligand rather than the receptor. This suggests that the RAD sequence, common to all the inhibitory peptides, is critical for their biological activity. However, the presence of the YMES sequence, adjacent to RAD, significantly increases the peptide's biological potency. The development of such inhibitors derived from the 313–332 region of the αIIb subunit may be advantageous against the RGD‐like antagonists as they could inhibit platelet activation without interacting with αIIbβ3, thus failing to further induce αIIbβ3‐mediated outside‐in signalling.
“Del grasso di Lorenzo un’ampolletta”: Relics and Representations in the Quest for Forgiveness in Renaissance Rome
Authors: Newbigin Nerida
Published: February 2004

Giuliano Dati's poem Gli stazoni & perdonanze che sono la Quaresima e l’Octava della Pasqua di Resurrexo in Roma che sono a cinquantaquattro chiese (1492–1493) is a guide to the stations and indulgences of Rome. The first part of the paper examines relics and guides and their role in lay piety. The second part looks at the way in which the Confraternity of the Gonfalone used some of the key Holy Week stations, and subsequently abandoned them in 1490 for the Colosseum where it performed its Easter plays, composed by the same Giuliano Dati and others.
Catechism and Confraternitas on the Piazza San Giovanni: How the Misericordia Used Image and Text to Instruct its Members in Christian Theology
Authors: Earenfight Phillip
Published: February 2004

This study concerns the Allegory of Divine Misericordia, a fresco painted in 1342 for the entrance hall of the Compagnia di Santa Maria della Misericordia in Florence. It examines how the fresco functioned in part as at catechetical tool for members of the confraternity and their visitors. Through an analysis of the numerous inscriptions and the corresponding imagery that make up the fresco, this study demonstrates how the painting provided essential theological material for the confraternity members to read, memorize, and recite regularly.
Hedonic Price Indexes and the Matched Models Approach
Authors: Silver Mick , Heravi Saeed
Published: February 2004

We consider three approaches to estimating quality‐adjusted price changes: (i) the dummy variable approach from a hedonic regression, (ii) a superlative or exact hedonic index and (iii) a matching technique—a technique akin to that used by statistical offices. The dummy variable approach is prevalent in the literature and has been used for independent estimates of quality changes when commenting on sources of error in consumer price indexes. However, the availability of scanner data provides an opportunity to utilize data on the prices (unit values), volumes and quality characteristics of a much wider range of transactions and to consider methods less restrictive than the dummy variable approach. The practical use of superlative or exact hedonic index and matching techniques using scanner data is explored, and the results from all three methods are compared. A feature of the paper is the breadth of the empirical work. It not only encompasses three different approaches, but extends across four different types of consumer durables. The manner in which the three approaches relate to each other is explored and the implications for quality‐adjusted price changes is discussed.
Trade Liberalization and the Balance of Payments in Selected Developing Countries
Authors: Santos‐Paulino Amelia U.
Published: February 2004

An analysis is made of the impact of the reduction of tariff and non‐tariff barriers on the trade balance and the current account of the balance of payments of 22 developing countries from Africa, Latin America, East Asia and South Asia that have undertaken important trade reforms since the mid‐1970s. The study applies dynamic panel data and time series/cross‐section analysis. The main findings are that liberalization has worsened the balance of trade and the balance of payments, because imports have increased more rapidly than exports. The adverse effect on the trade balance has been nearly 2 per cent of GDP. The impact of liberalization and other variables varies according to the region and type of trade policy regime existing.
Fiat Money in a Search‐Theoretical Model with Generalist Consumers
Authors: Cuadras‐Morató Xavier
Published: February 2004

There are two general ways in which the role of fiat money has been introduced in the standard monetary search‐theoretical model. The first is to bring in the model a fiat object with different intrinsic properties. The second is to introduce a centralized institution that favors the use of fiat money through specific transaction policies. We carry out a similar exercise for a modified version of the model in which agents have a different structure of preferences. We characterize the conditions for which there exist equilibria with circulating fiat money and evaluate the main differences with the results derived from the standard model.
The attitudes of a group of operating room nurses and nurse anaesthetists towards perioperative conversation
Authors: Hansson Elsa , Söderhamn Olle
Published: February 2004

Perioperative nursing roles continue to change rapidly as we enter the 21st century. The need for good leadership skills, expert clinical skills, creative management and ongoing education and research, continues to grow in many surgical departments. Perioperative nursing roles are evolving in response to healthcare reforms, technological developments, patient demands and changing opportunities for advanced nursing practice. The aim of this study was to investigate the attitudes of a group of operating room nurses and nurse anaesthetists towards perioperative conversation. A questionnaire, which included a specific attitude scale, was constructed and used in the collection of data. The informants were 86 operating room nurses and nurse anaesthetists. The results showed that the nurses had a positive attitude towards perioperative conversation. There were significant differences in attitudes related to age, gender, educational level, category of profession and working hours. Reliability, measured using the Cronbach's alpha coefficient for the attitude scale, was 0.96. The validity of the scale was high.
T Wave Spectral Variance for Noninvasive Identification of Patients with Idiopathic Dilated Cardiomyopathy Prone to Ventricular Fibrillation Even in the Presence of Bundle Branch Block or Atrial Fibrillation
Authors: STEINBIGLER PETER , HABERL RALPH , STEINBECK GERHARD
Published: February 2004

Conventional methods using Holter ECG recordings for noninvasive risk stratification are limited in patients with idiopathic dilated cardiomyopathy (IDC) prone to ventricular fibrillation (VF) having atrial fibrillation (AF) or bundle branch block (BBB). We therefore investigated, whether spectral assessment of beat‐to‐beat alternations of repolarization is associated with VF in these patients. Twenty‐four‐hour Holter ECG recordings in 462 patients with IDC were used. The VF group comprised of 64 consecutive patients who survived cardiac arrest, the no VF group consisted of 398 consecutive patients without a history of malignant ventricular arrhythmia. One hundred patients with ischemic cardiomyopathy (ICM) served as a control group. In each patient, 1,024 consecutive T waves were aligned using cross correlation methods. Two‐dimensional Fourier transform (2D FFT) used the data matrix of 1,024 consecutive 200‐ms segments centered to the T wave peak. Power spectra of the 2D FFT revealed the frequency content of the T wave in the first dimension and the periodicity of this frequency content in the second dimension. The ratio between periodic frequency contents and the sum of nonperiodic and periodic frequency contents between 0.5 and 50 Hz is equal to the T wave spectral variance (TWSV) index. Thus, TWSV index = 0 would mean that all 1,024 T waves are identical and TWSV index = 1 would mean that the 1,024 T waves are totally variable. The TWSV index was significantly higher in the VF group (0.93 ± 0.14) than in the no VF group (0.53 ± 0.13, P < 0.01). The best cutoff between the VF and the no VF group was achieved by using a TWSV index of 0.75 (sensitivity = 89%, specificity = 78%). No significant differences were observed between patients with and without AF or with and without BBB, and between patients with IDC and ICM. Even in the presence of BBB or AF spectral assessment of T wave alternations by TWSV index using 2D FFT in Holter ECG recordings, allows the identification of patients with IDC at risk for VF. (PACE 2004; 27:156–165)
Does Sinus Rhythm Beget Sinus Rhythm?
Authors: SPURRELL PHILIP , MITCHELL ANDREW , KAMALVAND KAYVAN , HIGSON MIKE , SULKE NEIL
Published: February 2004

The aim of this study was to determine the effect of early patient activated cardioversion of atrial fibrillation (AF) using the atrial defibrillator on recurrence of AF. Fifteen patients, mean age 63 ± 14 years, 80% men, with drug‐resistant persistent AF were implanted with the Jewel AF atrial defibrillator. All patients performed self‐administered cardioversion for AF recurrences. Over a 2 year follow‐up, 238 patient‐activated cardioversions were performed in 14 patients. Sinus rhythm was restored on every occasion with 96% of episodes terminating with a single shock. The median time from AF onset to patient awareness of symptoms was 2.5 hours. The median time from onset of symptoms to cardioversion was 3.5 hours. Comparison of the first and second six month period following implant showed a nonsignificant increase in mean total AF duration (75.7 ± 107.8 hours vs 146.6 ± 194.1 hours, P = 0.28). Two patients (13%) had a decreasing frequency of AF recurrences. The majority continued to have regular recurrences of AF. The atrial defibrillator is an extremely effective method of restoring sinus rhythm in patients with persistent AF. Regular early use of the atrial defibrillator, increased the duration of sinus rhythm in a minority of patients during long‐term follow‐up. Most patients had regular recurrences of AF requiring patient‐activated cardioversion. (PACE 2004; 27:175–181)
Sleep Apnea:
Authors: GARRIGUE STEPHANE , BORDIER PHILIPPE , BAROLD S. SERGE , CLEMENTY JACQUES
Published: February 2004

In the general adult population, prevalence of sleep apnea syndrome reaches 4% in men and 2% in women. Continuous positive airway pressure is the most efficient treatment. At the present time, although severe atrial bradycardias could occur during sleep apnea episodes, cardiac pacing has not been demonstrated as an efficient treatment for those bradycardias. Treating sleep apnea generally reduces the number of bradyarrhythmias. However, recent studies reported a beneficial effect of atrial pacing on the sleep apnea burden. The mechanisms rely on two phenomena: first to counteract nocturnal hypervagotonia, and second to treat heart failure. By increasing the heart rate, cardiac output improves, which mitigates pulmonary subedema. Consequently, stimulation of the pulmonary afferent vagal fibers is diminished, which reduces central sleep apnea incidence. During nocturnal hypervagotonia, snoring and obstructive apnea episodes are increased, mainly due to an excessive muscular relaxation of the upper airway area inducing cyclical substantial decreases in the airway caliper. In patients with a low heart rate, atrial pacing can counteract hypervagotonia by enhancing the sympathetic tone and modifying the degree of vigilance. Accordingly, in the near future, sleep apnea treatment might potentially rely on atrial pacing in bradycardic patients with hypervagotonia (with or without heart failure). The role of the physician would then be not only to diagnose sleep apnea, but also to identify potential responders to cardiac pacing. (PACE 2004; 27:204–211)
Lower Observed Versus Expected (Based on U.S. Age and Gender Specific Rates) Survival in Patients Treated for Near‐Fatal Ventricular Arrhythmias
Authors: KULASINGAM SHALINI L. , AKIYAMA TOSHIO , MOUNSEY J. PAUL , LEDINGHAM ROBERT , HALLSTROM ALFRED P. ,   AVID Investigators
Published: February 2004

Implantable cardioverter defibrillators (ICDs) have improved survival for patients with ventricular fibrillation (VF) or sustained vertricular tachycardia (VT). However, the survival of these patients compared to the general population has not been assessed. Observed survival rates for patients randomized to either antiarrhythmic drug therapy (mainly amiodarone) arm or ICD arm were compared to expected rates, calculated using age and sex‐specific survival rates derived from the 1989–1991 US population life tables and applied to the age and sex distribution of patients in each arm. Consistent with the results of the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial, patients randomized to receive ICDs experienced significantly higher survival than those in the drug arm; however, both groups experienced significantly lower survival than expected using age and gender matched U.S. survival rates. Within arms, the difference between the observed and expected rates increased over 3 years of follow‐up from 7.7% to 15.3% for the ICD arm, and from 14.6% to 26.4% for the drug arm. These results quantify the improvements in survival that can be expected for VF or VT patients using drug or ICD therapies and underscore the need for continued research into methods for further improving the overall level of health of these patients. (PACE 2004; 27: 230–234)