bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling assimilation rates of 14 temperate arable weed species as a function of the environment and leaf traits
Authors: STORKEY J
Published: September 2005

Information on the response of assimilation rate to environmental factors is lacking for many less competitive weed species that need to be considered in the context of increasing farm biodiversity. A pot experiment was sown to parameterize gross assimilation rate at light saturation and initial light use efficiency for 14 common UK annual weeds and winter wheat at four leaf temperatures. Field experiments were also sown to measure inter‐specific differences in specific leaf area (SLA), leaf nitrogen content and assimilation rates in the field at near‐optimum temperatures. A generic relationship describing the response of assimilation rate to temperature and light using SLA and leaf nitrogen content as conversion factors successfully predicted inter‐specific differences in assimilation rates in the field. This relationship could be incorporated into weed–crop competition models to predict the productivity and competitive impact of weed mixtures, including species outside the current data set. Assimilation rates at light saturation in the field were determined largely by SLA. This trait was variable between species and within a species across the growing season and needs to be well described in mechanistic competition models to accurately calculate instantaneous assimilation rates.
‘Universal’ primers for PCR‐sequencing of grass chloroplastic acetyl‐CoA carboxylase domains involved in resistance to herbicides
Authors: DÉLYE C , MICHEL S
Published: September 2005

Primers were designed to amplify two regions involved in sensitivity to herbicides inhibiting the plastidic acetyl‐CoA carboxylase (ACCase) from grasses (Poaceae). The first primer pair amplified a 551‐bp amplicon containing a variable Ile/Leu codon at position 1781 in Alopecurus myosuroides sequence. The second primer pair amplified a 406‐bp amplicon containing four variable codons (Trp/Cys, Ile/Asn, Asp/Gly, Gly/Ala) at positions 2027, 2041, 2078 and 2096, respectively, in A. myosuroides sequence. Both primer pairs amplified the targeted fragments from genes encoding plastidic ACCases, but not from the very similar genes encoding cytosolic ACCases. Clear DNA sequences were obtained from fresh or dried plant material from the field, and from 29 various grass species. Sequences revealed that the gene encoding plastidic ACCase in Poa annua and Festuca rubra contained a Leu1781 codon, in agreement with both species being inherently tolerant to herbicides inhibiting ACCase. Sequencing confirmed the hybrid origin of P. annua. Compared with ACCase enzyme assay, polymerase chain reaction is faster, can be performed from a single plant and suppresses the need for radioactive experiments. It can be completed with basic molecular biology laboratory equipment. It is the tool of choice for diagnosing resistance caused by alteration(s) of the plastidic ACCase.
Using a competition model to quantify the optimal trade‐off between machine vision capability and weed removal effectiveness
Authors: GRUNDY A C , ONYANGO C M , PHELPS K , READER R J , MARCHANT J A , BENJAMIN L R , MEAD A
Published: September 2005

The algorithm of an optical detection system was first investigated for its ability to correctly classify transplanted crops and weeds during the critical early stages of crop establishment and its robustness over a range of different crop species. The trade‐off was then examined between increasing the sensitivity of the detection system vs. the possibility of, in doing so, misclassifying some crop plants as weeds and inadvertently removing them. This was achieved by running a competition model using parameters derived from the image analysis and assessing the outcome of scenarios in terms of yield. The optimum parameter values to maximize the detection of the crop and the optimum parameter values to maximize the detection of the weed appeared relatively insensitive to time of image capture or weed density. They also appeared insensitive for different crop species where the crop had similar growth habit. However, competition scenarios indicated that the detection system parameter settings to achieve optimum yields were sensitive to the competitive ability of the weed species. For Veronica persica, crop yield was more sensitive to accidental crop removal than from competition. In contrast, in the presence of Tripleurospermum inodorum, yield loss was more attributable to weed competition. Importantly, linking the detection system with the competition model illustrated the principle that optimum yield may not necessarily be obtained by maximizing weed removal or minimizing crop removal. This first example of combining a detection system with a competition model presents a new opportunity to quantify the sensitivity of image classification in terms of yield.
Development of arable weed seedbanks during the 6 years after the change from conventional to organic farming
Authors: ALBRECHT H
Published: September 2005

All of the arable land of a farm in southern Germany was investigated during an 8‐year period, starting 2 years before and ending 6 years after the change to organic farming. The first 3 years after the conversion, the total seed number in the soil increased from 4050 to 17 320 m−2. From the fourth to the sixth year, it dropped back to 10 220 m−2. The number of seeds increased particularly at sites with a low crop cover and a high density of weed plants at the soil surface. The increase predominantly occurring on the more fertile soils may have been caused by the rotation commencing with less competitive crops. Crops which increased the seedbank by 30–40% were winter cereals, sunflowers and lupins. Potatoes and sown fallow caused no significant change and grass–clover mixtures even reduced the number of seeds by 39%. Among 44 species occurring frequently enough for statistical analysis, 31 increased and only 3 decreased. The change of management particularly increased summer annual, perennial and dicotyledonous weeds. This can be attributed to both operations which are characteristic of organic farming (e.g. replacing herbicide applications by mechanical weed control) and to general modifications of the management practice which may also occur in non‐organic farming systems (increasing the percentage of broad leaved and spring sown crops in crop rotation). The present study confirms investigations into the aboveground vegetation that indicate that arable organic farming favours plant species diversity and provides evidence that the conversion need not encourage the dominance of a few noxious weeds.
Preferences of cardiologists and clinical geneticists for the future organization of genetic care in hypertrophic cardiomyopathy: a survey
Authors: Van Langen IM , Birnie E , Schuurman E , Tan HL , Hofman N , Bonsel GJ , Wilde AAM
Published: September 2005

In view of the increasing demands for genetic counselling and DNA diagnostics in cardiogenetics, the roles of cardiologists and clinical geneticists in the delivery of care need to be redefined. We investigated the preferences of both groups of professionals with regard to the future allocation of six cardiogenetic responsibilities in counselling and testing, using hypertrophic cardiomyopathy (HCM) as a prevalent model disease. In this cross‐sectional survey, the participants were Dutch cardiologists (n = 643) and clinical geneticists (n = 60), all members of professional societies. Response rates were 33 and 82%, respectively. In both groups, the majority preferred to perform most of the tasks described above in collaboration. Informing HCM patients about the genetics of HCM and requesting DNA testing in symptomatic patients was viewed by 43 and 35% of cardiologists, respectively, as their sole responsibility, however, and 39 and 59% of clinical geneticists did not object to these views. Both groups felt that the task of discussing the consequences of HCM for offspring and that of discussing the results of DNA diagnostics should be shared or performed by clinical geneticists. Both groups considered co‐ordination of family screening the sole responsibility of clinical geneticists. Opinions on who should request DNA diagnostics in asymptomatic relatives were divided: 86% of clinical geneticists considered it their exclusive responsibility, 10% of cardiologists believed that this task could be performed individually by either group and 30% preferred to collaborate. Most professionals said that they would appreciate education programmes and clinical guidelines. Both cardiologists and clinical geneticists prefer to share rather than divide most cardiogenetic responsibilities in caring for HCM patients. Consequently, capacity problems in both groups are to be expected. To safeguard current professional standards in genetic counselling and testing, deployment of non‐medical personnel might be essential.
Human syndromes with congenital patellar anomalies and the underlying gene defects
Authors: Bongers EMHF , Van Kampen A , Van Bokhoven H , Knoers NVAM
Published: September 2005

Genetic disorders characterized by congenital patellar aplasia or hypoplasia belong to a clinically diverse and genetically heterogeneous group of lower limb malformations. Patella development involves different molecular and cellular mechanisms regulating dorso‐ventral patterning, cartilage and bone formation along endochondral ossification pathways, and growth. Several human genes that are important for patella development have been uncovered by the study of human limb malformation syndromes, yet causative genes for many more such disorders await to be identified and their complex interactions in the developmental pathways deciphered. Mutant animal models of congenital patellar aplasia or hypoplasia are certainly instrumental to create more insight into this aspect of limb development. Moreover, investigation of the complete phenotype of human syndromes and animal models may reveal novel insights into the pleiotropic roles of the responsible genes in the normal developmental of other organ systems. In this review, the phenotype and gene defects of syndromes with congenital patellar aplasia or hypoplasia will be discussed, including the nail patella syndrome, small patella syndrome, isolated patella aplasia hypoplasia, Meier–Gorlin syndrome, RAPADILINO syndrome, and genitopatellar syndrome.
Living donation: focus on public concerns
Authors: Zink Sheldon , Weinreib Robert , Sparling Thalia , Caplan Arthur L
Published: September 2005

Abstract:  In December 2002, a conference was held in Philadelphia to discuss public concerns about living organ transplantation with the goal of reaching a consensus about new strategies for such transplants. The conference was hosted by the Hospital of the University of Pennsylvania and the Center for Bioethics. A multidisciplinary group of leading experts and stakeholders was called to assess the current status of living donation and suggest productive changes to ensure safer and more ethically sound procedures for both donors and recipients. Prior to the meeting, the research team from the University of Pennsylvania, Center for Bioethics, conducted literature reviews and extensive background research on living organ transplantation. Summary briefs were prepared for all conference participants. Issues were divided into four subcategories; two or three experts led the discussion on each topic. At the conclusion of the conference, the points raised were summarized and discussed, and additional comments were offered before general agreement was reached on each subject. Transcribed minutes and summary statements were reviewed and circulated among participants to allow for additional comments and clarification. All feedback was incorporated into the statement, and a draft of the article was recirculated. Participants who have endorsed the following statements have agreed that these points represent the intent and spirit of the discussion, yet each participant reserves the right to disclaim the document in its entirety. The views represented in the consensus points are held by members of the consensus group and do not necessarily represent the views of the sponsor.

A consensus was reached to propose new strategies and make improvements on existing practices and protocols. Specific attention was paid to the widely accepted needs of consistent and responsible communication with the public and press, standardization in donor assessment, a national living donor registry and new research focusing on larger sample numbers and long‐term donor follow‐up. These consensus points support the work carried out by other advisory transplant organizations and should assist in advocating for living organ donors, the live donor transplant process and the concerns of the public.
Repetitive DNA polymorphisms in following chimerism after allogeneic bone marrow transplantation
Authors: Grubic Zorana , Stingl Katarina , Jelicic Esma Cecuk , Zunec Renata , Kastelan Andrija , Seiwerth Ranka Serventi , Bogdanic Vinko , Labar Boris , Brkljacic Vesna Kerhin
Published: September 2005

Abstract:  Information about the chimeric status of patients is of great importance in comparison of different conditioning and prophylactic regimens as well as for the post‐bone marrow transplantation (BMT) therapies. In some cases, mixed chimerism (MC) can also be predictive of relapse. Analysis of the short tandem repeats (STR) loci by polymerase chain reaction (PCR) is a choice method for this purpose. In this study, we monitored 15 patients after BMT. Twelve of them underwent classical‐conditioning regimen while the remaining three patients were subjected to non‐myeloablative conditioning (minitransplantation). Evaluation of chimerism was performed using five STR and one variable number of tandem repeats (VNTR) locus. Four additional loci were PCR‐amplified in cases of minitransplantation. Samples were analyzed by electrophoresis in an ALFexpress sequencer. MC was detected in seven cases of which it was predictive of relapse for two patients, who suffered from acute lymphocytic leukemia (ALL). The PCR‐STR method proved to be a fast and relatively simple method, while the tested STR loci showed a high level of informativeness.
Older living donors provide excellent quality kidneys: a single center experience (older living donors)
Authors: Johnson Scott R , Khwaja Khalid , Pavlakis Martha , Monaco Anthony P , Hanto Douglas W
Published: September 2005

Abstract: Background: The role of advanced age live donors remains controversial because of decline in glomerular filtration rate and perceived increased risks of perioperative complications.

Methods: A retrospective review of all live donor transplants performed from January 2000 to December 2003.

Results: Seventy‐eight live donor transplants were performed during the period of review, 47 (60.3%) female and 31 (39.7%) male. Twenty‐two (28.2%) of the donors were >50 yr old, 15 (68%) female and seven (32%) male. Living related donation was performed in 56 (74.4%) and unrelated in 20 (35.6%). Laparoscopic nephrectomy was performed in 29 (37.2%) and open nephrectomy in 49 (62.8%). More donors >50 underwent laparoscopic nephrectomy, 13 of 22 (59.1%) vs. 16 of 56 (28.6%). Overall patient and graft survival at 1 yr are 97 and 97%. One‐year patient and graft survival is 100% vs. 96% and 100% vs. 96% in the older vs. young donors. Rejection occurred in nine of 78 (11.5%), but was not different between groups. Older donors had a reduced creatinine clearance 107.5 ± 3.4 vs. 124.2 ± 3.1 mL/min (p = 0.002) and a reduced clearance normalized for body surface area 60.6 ± 3.6 mL/(min m2) vs. 70.2 ± 2.6 mL/(min m2) (p = 0.045). Recipient serum creatinine was higher on postoperative day 1 in the older donor group 5.4 mg/dL vs. 4.4 mg/dL (p = 0.009). There was no difference in recipient serum creatinine at postoperative day 7, 30, 90, 180, 365 and 730. Donor serum creatinine was not different between groups on postoperative days 1, 7 and 30 but was higher in group 1 vs. group 2 on postoperative day 365, 1.26 ± 0.26 mg/dL vs. 1.01 ± 0.18 mg/dL (p = 0.020).

Conclusions: Despite a reduced initial creatinine clearance, renal function is comparable in recipients of both young and old donor kidneys. Older donors had a slightly reduced serum creatinine 1 yr post‐donation that warrants additional follow‐up to determine if the observations continue. The introduction of laparoscopic nephrectomy may provide additional incentive for older donors to present for live donor nephrectomy.
Is alanine aminotransferase a good marker of histologic hepatic damage in renal transplant patients with hepatitis C virus infection?
Authors: Perez Renata M , Ferreira Adalgisa SP , Medina‐Pestana José O , Lanzoni Valeria P , Silva Antonio Eduardo B , Ferraz Maria Lucia G
Published: September 2005

Abstract:  Introduction:  Renal transplant (RTx) patients with hepatitis C frequently show normal levels of alanine aminotransferase (ALT) and the significance of ALT in this group has not been established.

Aim:  To determine the value of ALT as a marker of histologic hepatic damage in RTx patients with hepatitis C virus (HCV) infection.

Materials and methods:  HCV‐RNA‐positive RTx patients with a liver biopsy were analyzed regarding staging and the grading of periportal and lobular necroinflammatory activity. Spearman's correlation coefficient was used to determine the correlation between ALT and histologic variables. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) of ALT in the detection of septal fibrosis and interface hepatitis, and/or confluent necrosis were calculated.

Results:  Fifty‐three patients (32 men, 60%), with a mean age of 42 ± 10 yr and time since transplant of 5 ± 4 yr were included. Only 27 (51%) patients showed elevated ALT levels, which were associated with septal fibrosis (p = 0.001), interface hepatitis (p < 0.001) and confluent necrosis (p = 0.05). A correlation was observed between ALT and staging (r = 0.50, p < 0.001), periportal necroinflammatory activity (r = 0.59, p < 0.001) and lobular necroinflammatory activity (r = 0.50, p < 0.001). The sensitivity, specificity, PPV and NPV of ALT were 92, 61, 41 and 96%, respectively, for the detection of septal fibrosis, and 87, 77, 74 and 88% for the detection of interface hepatitis and/or confluent necrosis.

Conclusion:  ALT is a good marker of histologic hepatic lesion in HCV‐infected RTx patients and, therefore, liver biopsy can be avoided in patients with persistently normal ALT.
Equal overall rejection rate in pre‐transplant flow‐cytometric cross‐match negative and positive adult recipients in liver transplantation
Authors: Matinlauri Irma H , Höckerstedt Krister A , Isoniemi Helena M
Published: September 2005

Abstract: T cell IgG flow‐cytometric cross‐matches (FCXM) using 48 stored pre‐transplant patient serum samples and 40 stored serum samples collected 3 wk after liver transplantation and frozen spleen cells of cadaveric donors in 48 consecutive liver transplantations were performed retrospectively. T cell IgG FCXM using pre‐transplant serum samples was compared with 46 complement‐dependent lymphocytotoxic cross‐matches (CDCXM) performed at the time of transplantation. Clinical relevance of these tests was evaluated in relation to acute rejection, 1‐, 3‐ and 5‐yr graft and patient survival. The incidence of positive FCXM was 33% (16 of 48) and 13% (six of 46) by CDCXM. The median time of acute rejection was 29 d after transplantation in FCXM positive group (range 13–101 d) and 22 d in FCXM negative group (range 7–157 d, NS). Rejection rate was similar in 16 pre‐transplant FCXM positive patients (eight of 16, 50%) compared with six pre‐transplant CDCXM positive patients (three of six, 50%; NS). Recipients having graft rejection tended to be more often pre‐transplant FCXM positive (eight of 21, 38%) than CDCXM positive (three of 21, 14%), but the difference was not significant (p > 0.1). No difference was found in the positive predictive value in relation to acute rejection between positive FCXM and CDCXM (69% vs. 50%; NS). Furthermore there was no correlation between post‐transplant positive FCXM and acute rejection. No difference was found between pre‐transplant T cell IgG FCXM positive and negative recipients in relation to graft or patient survival.

Our findings are supportive for little risk associated with preformed donor‐specific antibodies in liver transplantation.
Influence of CYP3A5 and MDR1 polymorphisms on tacrolimus concentration in the early stage after renal transplantation
Authors: Zhang Xin , Liu Zhi‐hong , Zheng Jing‐min , Chen Zhao‐hong , Tang Zheng , Chen Jin‐song , Li Lei‐shi
Published: September 2005

Abstract:  Objective:  Tacrolimus is an immunosuppressive drug with a narrow therapeutic range and wide interindividual variation in its pharmacokinetics. Cytochrome P450 (CYP) 3A and P‐glycoprotein (P‐gp, encoded by MDR1) play an important role in the absorption and metabolism of tacrolimus. The objective of this study was to evaluate whether or not CYP3A5*1/*3 or MDR1 C3435T polymorphisms are associated with the tacrolimus concentration per dose.

Methods:  CYP3A5 and MDR1 genotypes were determined by polymerase chain reaction followed by restriction fragment length polymorphism analysis in 118 Chinese renal transplant patients receiving tacrolimus. Whole blood trough tacrolimus concentration was measured by enzyme‐linked immunosorbent assay and dose‐adjusted concentration (ng/mL per mg/kg/d) was calculated at 1 wk, 1 month, and 3 months after transplantation.

Results:  The dose‐adjusted concentration of CYP3A5*1/*1 and *1/*3 patients was significantly lower than *3/*3 patients (32.8 ± 17.7 and 41.6 ± 15.8 vs. 102.3 ± 51.2 at 1 wk; 33.1 ± 7.5 and 46.4 ± 12.9 vs. 103 ± 47.5 at 1 month; 35.3 ± 20.9 and 59.0 ± 20.6 vs. 150 ± 85.3 at 3 months after transplantation respectively). At 1 wk, 46% of the CYP3A5*1 allele carriers had a tacrolimus concentration lower than 5 ng/mL and 77% lower than 8 ng/mL, whereas 20% of the *3/*3 patients had a concentration higher than 20 ng/mL. There was a mild difference between *1/*1 homozygotes and *1/*3 heterozygotes at 1 and 3 months after transplantation. No difference was found among the MDR1 genotypes.

Conclusion:  CYP3A5*1/*3 polymorphisms are associated with tacrolimus pharmacokinetics and dose requirements in renal transplant recipients. Pharmacogenetic methods could be employed prospectively to help initial dose selection and to individualize immunosuppressive therapy.
Serum protein electrophoresis abnormalities in adult solid organ transplant patients with post‐transplant lymphoproliferative disorder*
Authors: Tsai Donald E , Aqui Nicole A , Tomaszewski John E , Olthoff Kim M , Ahya Vivek N , Kotloff Robert M , Bloom Roy D , Brozena Susan C , Hodinka Richard L , Stadtmauer Edward A , Schuster Stephen J , Nasta Sunita D , Porter David L , Luger Selina M , Klumpp Thomas R
Published: September 2005

Abstract:  Post‐transplant lymphoproliferative disorder (PTLD) is an Epstein–Barr virus (EBV) associated malignancy that occurs in the setting of pharmacologic immunosuppression used after organ transplantation. The presence of monoclonal gammopathy (MG) after organ transplantation is a risk factor for the development of PTLD. We retrospectively explored the characteristics of serum protein electrophoresis (SPEP) in 38 adult solid organ transplant patients with biopsy proven PTLD and SPEP. Twenty‐three (61%) had MG with nine (24%) showing multiple MG. Background gammaglobulin levels were abnormal in 13 (34%) patients with five (13%) and eight (21%) having polyclonal hypergammaglobulinemia or hypogammaglobulinemia, respectively. Hypogammaglobulinemia was correlated with the presence of MG (p = 0.01) and polymorphic B‐cell hyperplasia histology (p = 0.01). No correlation between SPEP findings and overall survival were noted. With median follow‐up of 116 wk (range 2–261 wk), 21 (55%) patients are alive with 20 (53%) in complete remission. Response to reduction in immunosuppression was correlated with improved overall survival (262 wk vs. 68 wk, p = 0.003). Persistence of MG after complete response of the PTLD did not predict relapse. There is a high incidence of MG and gammaglobulin abnormalities in patients with PTLD.
Tacrolimus as secondary intervention vs. cyclosporine continuation in patients at risk for chronic renal allograft failure
Authors: Waid Thomas ,   for the CRAF Study Group
Published: September 2005

Abstract:  Background:  Chronic renal allograft failure (CRAF) is the leading cause of graft loss post‐renal transplantation. This study evaluated the efficacy and safety of tacrolimus as secondary intervention in cyclosporine‐treated kidney transplantation patients with impaired allograft function as indicated by elevated serum creatinine (SCr) levels.

Methods:  Patients receiving cyclosporine‐based immunosuppression who had an elevated SCr at least 3 months post‐renal transplantation were enrolled. Treatment allocation was 2:1 to switch to tacrolimus or continue cyclosporine. This analysis was performed after 2 yr; patients will be followed for an additional 3 yr.

Results:  There were 186 enrolled and evaluable patients. On baseline biopsy, 90% of patients had chronic allograft nephropathy. Baseline median SCr was 2.5 mg/dL in both treatment groups. For patients with graft function at month 24, SCr had decreased to 2.3 mg/dL in the tacrolimus‐treated patients and increased to 2.6 mg/dL in the cyclosporine‐treated patients (p = 0.01). Acute rejection occurred in 4.8% of tacrolimus‐treated patients and 5.0% of cyclosporine‐treated patients during follow‐up. Two‐year allograft survival was comparable between groups (tacrolimus 69%, cyclosporine 67%; p = 0.70). Tacrolimus‐treated patients had significantly lower cholesterol and low‐density lipoprotein levels and also had fewer new‐onset infections. Cardiac conditions developed in significantly fewer tacrolimus‐treated patients (5.6%) than cyclosporine‐treated patients (24.3%; p = 0.004). Glucose levels and the incidences of new‐onset diabetes and new‐onset hyperglycemia did not differ between treatment groups.

Conclusions:  Conversion from cyclosporine to tacrolimus results in improved renal function and lipid profiles, and significantly fewer cardiovascular events with no differences in the incidence of acute rejection or new‐onset hyperglycemia.
Planning helps, behavioral disengagement does not: coping and depression in the spouses of heart transplant candidates
Authors: Burker Eileen J , Evon Donna , Loiselle Marci Marroquin , Finkel Jerry , Mill Michael
Published: September 2005

Abstract:  Objective:  To describe the coping strategies used by the spouses of cardiac patients who are pursuing heart transplant and to determine whether coping strategies predict depression in these spouses.

Method:  This is a cross‐sectional design with 28 spouses (86% female) of cardiac patients who were being evaluated for heart transplant at a large medical center. Coping styles were measured using the COPE Inventory (Carver CS, Scheier MF, Weintraub JK, J Pers Soc Psychol 1989: 56: 267). Depression was assessed with the Center for Epidemiological Studies Depression Scale (Radloff LS, Appl Psychol Meas 1977: 1: 385).

Results:  Spouses reported using adaptive coping strategies more than the less adaptive strategies. Increased levels of depression were positively correlated with ‘behavioral disengagement’ and negatively correlated with ‘planning’ coping strategies.

Conclusions:  Most studies find that maladaptive coping styles are associated with psychological distress. Consistent with these findings, we found that behavioral disengagement was associated with increased levels of depression. However, in the present study the more adaptive coping strategy of planning was associated with lower levels of psychological distress. These findings suggest that in the spouses of heart transplant candidates, both maladaptive and adaptive coping strategies may serve as markers of the presence or absence of emotional distress and thus may help in identifying spouses who may benefit from psychological, social work, or nursing interventions.
Family discussions about organ donation: how the media influences opinions about donation decisions
Authors: Morgan Susan E , Harrison Tyler R , Long Shawn D , Afifi Walid A , Stephenson Michael S , Reichert Tom
Published: September 2005

Abstract:  In this study, 78 family pair dyads (spouses, parent–child pairs, or siblings) were brought into an interaction laboratory set up like a living room. After being briefed on the study, family members discussed a series of eight questions about their thoughts and opinions about organ donation. Thematic analysis of the thousands of pages of transcripts revealed that family members believe that they receive important information about organ donation through the media. Unfortunately, the most influential information came from sensationalistic, negative media portrayals. The myths that seem to be the most actively referenced by the media include premature declaration of death, the transference of personality traits from donor to recipient, a US black market for organs, corruption in the medical community, and corruption in the organ allocation system (which allows celebrities to get transplants first). Although these are not the only myths that the generally public holds to be true, the media is a powerful source of support for these particular myths. Therefore, such myths must be countered effectively if greater consent for organ donation is to be attained.
The natural history of renal function following orthotopic heart transplant
Authors: Al Aly Ziyad , Abbas Samer , Moore Eric , Diallo Ousmane , Hauptman Paul J , Bastani Bahar
Published: September 2005

Abstract: Background: The outcome of solid organ transplantation has dramatically improved after the introduction of the calcineurin inhibitor cyclosporine. With the increasing longevity of heart transplant recipients, the long‐term effects of cyclosporine on renal function have become more evident. The natural history of kidney function following orthotopic heart transplant is not well defined and long‐term follow up studies are scant.

Methods: We conducted an observational study on patients who received a heart transplant at Saint Louis University Hospital between January 1, 1983 and December 31, 1988. Patients were followed up for 15 yr or until death whichever occurred first. In order to assess the effect of heart transplantation and cyclosporine exposure on long‐term renal function we restricted the statistical analysis to patients who survived the first year post‐transplantation.

Results: A total of 68 patients received orthotopic heart transplants at Saint Louis University Hospital between 1983 and 1988. Forty‐eight (71%) patients survived for more than 1 yr. All patients were treated with cyclosporine based triple immunosuppressive regimen, with gradual cyclosporine dose reduction over time. The mean duration of follow‐up was 8 yr. The estimated GFR at 5 and 10 yr post‐transplant were significantly lower than estimated GFR at baseline and 1 yr post‐transplant. There was no significant difference between estimated GFR at 15 yr and estimated GFR at baseline or 1 yr post‐transplant. The cumulative incidence of chronic renal failure (GFR ≤ 29 mL/min/1.73 m2) at 5, 10 and 15 yr was 4.2, 10.4 and 12.5%, respectively (p < 0.05). The cumulative incidence of severe chronic renal failure (GFR ≤ 15 mL/min/1.73 m2) at 5, 10 and 15 yr was 2.1, 8.3 and 8.3%, respectively. The mortality rate was 8, 37, and 52% at 5, 10, and 15 yr, respectively. The 10 and 15 yr survivors had an estimated GFR at 1 yr post‐transplant that was significantly higher than the non‐survivors. Age, pre‐transplantation estimated GFR, pre‐transplantation diabetes and pre‐transplantation hypertension are risk factors associated with ≥10 mL/min/1.73 m2decrement in estimated GFR.

Conclusion: Heart transplant survivors beyond the first year post‐transplant have a significant decrease in renal function and significant mortality observed over time. Age, pre‐transplant GFR, pre‐transplant diabetes and pre‐transplant hypertension are important risk factors for decrement in renal function.
Structure and property of self‐assemble valinyl bolaform amides having different chirality
Authors: Doi M. , Asano A. , Yoshida H. , Inouguchi M. , Iwanaga K. , Sasaki M. , Katsuya Y. , Taniguchi T. , Yamamoto D.
Published: September 2005

Abstract:  Bolaform amides were designed from N,N'‐bis(carboethoxy‐l‐valinyl)‐diaminoethane (1) by linking t‐butyloxycarbonyl‐valine through ethylenediamine (EDA) to enable spectroscopic and X‐ray diffraction analyses. N,N'‐Bis(Boc‐l‐valinyl)‐diaminoethane (2) and N,N'‐bis(Boc‐d‐valinyl)‐diaminoethane (3) were composed of l‐Val and d‐Val, respectively. N‐(Boc‐l‐valinyl)‐N'‐(Boc‐d‐valinyl)‐diaminoethane (4) was composed of both l‐Val and d‐Val, and was achiral (meso‐peptide). Peptide 5 was a 1 : 1 mixture of 2 and 3, and was also achiral (racemate). These peptides mediated gelation of corn oil at a concentration of approximately 1%. Within crystals, the peptides formed β‐sheet ribbons, but differences were observed in hydrogen‐bonding patterns and side‐chain arrangements. These differences were also deduced from temperature dependence of amide protons. Force‐field calculations based on the crystal structures indicated that association of β‐sheet ribbons had energy benefits, and it was assumed that molecular aggregation progressed spontaneously. These structural studies indicated the chirality of amino acids affected for the properties of bolaform amides.
Plasmepsin inhibitors: design, synthesis, inhibitory studies and crystal structure analysis
Authors: Kesavulu M. M. , Prakasha Gowda A. S. , Ramya T. N. C. , Surolia N. , Suguna K.
Published: September 2005

Abstract:  Plasmepsin group of enzymes are key enzymes in the life cycle of malarial parasites. As inhibition of plasmepsins leads to the parasite's death, these enzymes can be utilized as potential drug targets. Although many drugs are available, it has been observed that Plasmodium falciparum, the species that causes most of the malarial infections and subsequent death, has developed resistance against most of the drugs. Based on the cleavage sites of hemglobin, the substrate for plasmepsins, we have designed two compounds (p‐nitrobenzoyl‐leucine‐β‐alanine and p‐nitrobenzoyl‐leucine‐isonipecotic acid), synthesized them, solved their crystal structures and studied their inhibitory effect using experimental and theoretical (docking) methods. In this paper, we discuss the synthesis, crystal structures and inhibitory nature of these two compounds which have a potential to inhibit plasmepsins.
Anaesthetic management of Osler–Weber–Rendu syndrome with coexisting congenital methaemoglobinaemia
Authors: Sharma D. , Pandia M. P. , Bithal P. K.
Published: September 2005

A 9‐year‐old cyanosed child suffering from Osler–Weber–Rendu syndrome with bilateral pulmonary arteriovenous malformations (PAVMs) was posted for cerebral angiography under general anaesthesia. Careful preanaesthetic evaluation led to the diagnosis of coexisting congenital methaemoglobinaemia. There is no previous report of Osler–Weber–Rendu syndrome coexisting with congenital methaemoglobinaemia. This report emphasizes that a second contributory cause of cyanosis must be suspected and meticulously looked for if the symptomatology in a patient cannot be explained by a single established diagnosis. Positive‐pressure ventilation was associated with reduction in arterial oxygenation despite an increasing inspired oxygen concentration, which returned to preanaesthetic levels only after extubation and resumption of spontaneous respiration.
Cardiac tamponade and septic shock caused by viral infection in a previously healthy woman
Authors: Laurila J. J. , Ala‐Kokko T. I. , Tuokko H. , Syrjälä H.
Published: September 2005

A previously healthy woman was admitted to hospital after ‘flu‐like’ symptoms for 5 days followed by acute intense abdominal and lower back pain. On admission she was found to be in severe shock and was transferred to the ICU. Echocardiography revealed cardiac tamponade, and pericardiocentesis was performed immediately. Thereafter her cardiovascular state improved, but she developed hypotension with low systemic vascular resistance and required vasoactive treatment for 4 days. Nine days after admission the patient was transferred to the ward, after which she recovered rapidly and completely. The cause of her illness was extensively screened. No underlying disease was found, and all bacterial cultures remained negative. Acute virus infection was confirmed by diagnostic elevations of antibody titers to Influenza A and adenovirus. Adenovirus was also isolated from her bronchoalveolar lavage fluid.
Hyperbaric oxygen attenuation of lipopolysaccharide‐induced acute lung injury involves heme oxygenase‐1
Authors: Huang T.‐Y. , Tsai P.‐S. , Wang T.‐Y. , Huang C.‐L. , Huang C.‐J.
Published: September 2005

Background:  Hyperbaric oxygen (HBO) attenuates lipopolysaccharide (LPS)‐induced acute lung injury. This beneficial effect of HBO involves inhibition of inducible nitric oxide synthase (iNOS) expression and subsequent nitric oxide (NO) biosynthesis. We sought to investigate the role of heme oxygenase‐1 (HO‐1) on this HBO inhibition of iNOS induction and acute lung injury in septic rat lungs.

Methods:  Before the experiment, 72 rats were randomly allocated to receive HBO or air treatment. With or without HBO pre‐treatment, the rats were further divided into the following subgroups (n = 6): (i) LPS injection, (ii) normal saline (N/S) injection, (iii) hemin (a HO‐1 inducer) plus LPS, (iv) hemin alone, (v) tin protoporphyrin (SnPP; a HO‐1 inhibitor) plus LPS, and (vi) SnPP alone. All rats were maintained for 6 h and then sacrificed with a high‐dose pentobarbital injection. Lung injuries and relevant enzymes expression were thus assayed.

Results:  Histological analysis, PMNs/alveoli ratio, and wet/dry weight ratio measurements demonstrated that LPS caused significant lung injury and HBO and/or hemin significantly attenuated this LPS‐induced lung injury. Increased pulmonary iNOS expression and NO production were associated with lung injury. Induction of HO‐1, by HBO and/or hemin, significantly attenuated this LPS‐induced iNOS expression and acute lung injury. SnPP, on the contrary, offset the effects of HBO and worsened the LPS‐induced lung injury.

Conclusions:  HBO may act through inhibiting pulmonary iNOS expression to attenuate LPS‐induced acute lung injury in septic rats. Furthermore, this HBO attenuation of iNOS expression involves HO‐1 induction.
Blood‐borne factors possibly associated with post‐operative nausea and vomiting: an explorative study in women after breast cancer surgery
Authors: Oddby‐Muhrbeck E. , Eksborg S. , Helander A. , Bjellerup P. , Lindahl S. , Lönnqvist P.
Published: September 2005

Background:  The pathophysiology behind post‐operative nausea and vomiting (PONV) is still not fully understood, especially with respect to gender. According to PONV risk scores, female gender is the strongest predictor for PONV. The risk for PONV after general anaesthesia for breast cancer surgery is 50–80%. The aim of the present explorative study was to identify blood‐borne factors that might be associated with the development of PONV in women undergoing breast cancer surgery as a basis for further studies.

Methods:  Fifty patients were enrolled prospectively in the study. A standardized sevoflurane‐based anaesthetic was used. Blood samples for the analysis of vasopressin, gastrin, cholecystokinin, epinephrine, norepinephrine, dopamine, serotonin, platelet count and blood glucose were taken at six pre‐determined time points peri‐operatively, and PONV was assessed during 24 h.

Results:  PONV was found in 27 of 47 patients completing the study. Patients with PONV had a larger variability of the platelet count (P = 0.001), a reduced platelet count on the first post‐operative day (P = 0.02) and a less pronounced relationship between the platelet count and whole blood serotonin (P = 0.004) compared with non‐PONV patients. A lack of a decrease in epinephrine levels in response to the induction of anaesthesia (P = 0.03) and increased levels of vasopressin (P < 0.001), epinephrine (P = 0.005) and blood glucose (P = 0.004) were observed in the early post‐operative period in PONV patients.

Conclusion:  Three different platelet‐associated factors and an altered epinephrine pattern were found to be associated with the occurrence of PONV after breast cancer surgery.
The proportion of intensive care unit admissions related to alcohol use: a prospective cohort study
Authors: Uusaro A. , Parviainen I. , Tenhunen J. J. , Ruokonen E.
Published: September 2005

Background:  Alcohol abuse is a risk factor for serious illnesses, and a history of chronic alcohol abuse adversely affects the outcome of critically ill patients. It is not known what proportion of intensive care unit (ICU) admissions is related to alcohol use. Therefore, we investigated the proportion of emergency admissions related to alcohol.

Methods:  A prospective cohort study was conducted in a university hospital ICU. All adult patients (n = 893) who underwent emergency admission to our ICU during a period of 1 year were studied.

Results:  The admitting physician determined whether there was a relationship between alcohol use and admission. ICU and hospital mortality and ICU length of stay (LOS) were recorded. The Therapeutic Intervention Scoring System (TISS) was used for ICU resource use estimation. There was a relationship between alcohol use and admission in 24% (215/893) of admissions and, in 156/893 admissions (17.5%), this seemed to be definite. ICU LOS was 1.2 days (0.7; 2.3) (median; interquartile range) for alcohol‐related and 1.8 days (0.9; 3.6) for other admissions (P < 0.001). Patients with alcohol‐related admissions consumed 17.8% of ICU patient‐days and 18.7% of all accumulated TISS scores. ICU (8.8 vs. 10.5%, P = 0.603) and hospital (19.1 vs. 20.2%, P = 0.769) mortalities were no different between alcohol‐related and other admissions.

Conclusion:  ICU admission is very often related to long‐term chronic and/or occasional alcohol use.
Effects of PentaLyte® and Voluven® hemodilution on plasma coagulation kinetics in the rabbit: role of thrombin‐fibrinogen and factor XIII‐fibrin polymer interactions
Authors: Nielsen V. G.
Published: September 2005

Background:  Hydroxyethyl starch (HES) administration has resulted in decreased hemostasis and fibrinogen (FI)‐thrombin‐(FIIa)‐Factor XIII (FXIII) interactions. I proposed to determine the hemostatic effect of hemodilution with PentaLyte® (6% HES, mean molecular weight 220 kDa) and Voluven® (6% HES, 130 kDa).

Methods:  Rabbits were intravenously administered 20 ml/kg PentaLyte® or Voluven® (n = 8 per fluid) over 10 min. Plasma was obtained prior to, 1 min and 1 h after hemodilution. Thrombelastography was performed, with clot initiation (R, sec), clot propagation (α, degrees), and clot strength (shear elastic modulus, G, dynes/cm2) determined over 20 min. Celite‐activated samples had either no additions or addition of FI, FIIa or activated FXIII (FXIIIa) to restore protein content to pre‐diluted values.

Results and conclusions:  While there were no significant differences between the groups, R significantly decreased 1 h after hemodilution compared with values observed before and 1 min after hemodilution, whereas α and G significantly decreased 1 min after hemodilution and then significantly, but only partially, increased 1 h after hemodilution compared with pre‐dilution values. Addition of FI, FIIa and FXIIIa significantly decreased R in both groups. α and G 1 min after hemodilution were significantly enhanced by FI, FIIa, FXIIIa in both groups; however, 1 h after hemodilution, rabbits administered PentaLyte® had α and G enhanced only by FI and FXIIIa addition, whereas animals administered Voluven® had α and G significantly enhanced by FI addition. PentaLyte® and Voluven® hemodilution initially diminishes FIIa‐FI and FXIIIa‐fibrin, but within an hour primarily inhibit FXIIIa‐fibrin interactions in the rabbit.
Post‐operative myocardial dysfunction does not affect the physiological response to early mobilization after coronary artery bypass grafting
Authors: Kirkeby‐Garstad I. , Stenseth R. , Sellevold O. F. M.
Published: September 2005

Background:  An acute increase in oxygen demand can be compensated for either by increased cardiac index (CI) or increased oxygen extraction, resulting in reduced mixed venous oxygen saturation (SvO2). We tested the hypothesis that post‐operative cardiac dysfunction may explain why oxygen extraction alone is increased during early mobilization after cardiac surgery.

Methods:  Twenty patients with a pre‐operative ejection fraction > 50% were included in an open prospective observational study comparing the changes in SvO2 and hemodynamics during mobilizations immediately prior to surgery and on the first post‐operative morning.

Results:  Mobilization induced an absolute reduction in SvO2 of 17.7 ± 7.4% pre‐ and 19.0 ± 5.5% post‐operatively (NS). ANOVA for a series of measurements throughout the mobilization sequence identified no different effect on SvO2 between pre‐ and post‐operative mobilizations (P = 0.567). The SvO2 level was reduced post‐operatively resulting in a SvO2 during standing exercise of 55% before and 49% after the surgery (P < 0.01). Mobilization increased the heart rate (HR) and decreased the stroke volume index (SVI), leaving CI unchanged. This response was similar pre‐ and post‐operatively (NS). Compared with pre‐operative measurements, CI and HR increased post‐operatively while SVI remained unchanged despite elevated cardiac filling pressures and reduced systemic vascular resistance. The left ventricular stroke work index was reduced, indicating reduced myocardial performance.

Conclusion:  Myocardial function was reduced on the first morning after coronary artery bypass grafting (CABG), but during post‐operative mobilization this reduction did not significantly influence the changes in CI or SvO2.