bluuebunny/crossref_metadata_2025 huggingface dataset:
Cyclooxygenase‐2 and the renal renin–angiotensin system
Authors: Harris R. C. , Zhang M.‐Z. , Cheng H.‐F.
Published: July 2004

In the kidney, cyclooxygenase‐2 (COX‐2) is expressed in the macula densa/cTALH and medullary interstitial cells. The macula densa is involved in regulating afferent arteriolar tone and renin release by sensing alterations in luminal chloride via changes in the rate of Na+/K+/2Cl− cotransport, and administration of non‐specific cyclooxygenase inhibitors will blunt increases in renin release mediated by macula densa sensing of decreases in luminal NaCl. High renin states [salt deficiency, angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers, diuretic administration or experimental renovascular hypertension] are associated with increased macula densa/cTALH COX‐2 expression. Furthermore, there is evidence that angiotensin II and/or aldosterone may inhibit COX‐2 expression. In AT1 receptor knockout mice, COX‐2 expression is increased similar to increases with ACE inhibitors or AT1 receptor blockers. Direct administration of angiotensin II inhibits macula densa COX‐2 expression. Previous studies demonstrated that alterations in intraluminal chloride concentration are the signal for macula densa regulation of tubuloglomerular feedback and renin secretion, with high chloride stimulating tubuloglomerular feedback and low chloride stimulating renin release. When cultured cTALH or macula densa cells were incubated in media with selective substitution of chloride ions, COX‐2 expression and prostaglandin production were significantly increased. A variety of studies have indicated a role for COX‐2 in the macula densa mediation of renin release. In isolated perfused glomerular preparations, renin release induced by macula densa perfusion with a low chloride solution was inhibited by a COX‐2 inhibitor but not a COX‐1 inhibitor. In vivo studies in rats indicated that increased renin release in response to low‐salt diet, ACE inhibitor, loop diuretics or aortic coarctation could be inhibited by administration of COX‐2‐selective inhibitors. In mice with genetic deletion of COX‐2, ACE inhibitors or low‐salt diet failed to increase renal renin expression, although renin significantly increased in wild type mice. In contrast, in COX‐1 null mice there were no significant differences in either the basal or ACE inhibitor‐stimulated level of renal renin activity from plasma or renal tissue compared with wild type mice. In summary, there is increasing evidence that COX‐2 expression in the macula densa and surrounding cortical thick ascending limb cells is regulated by angiotensin II and is a modulator of renal renin production. These interactions of COX‐2 derived prostaglandins and the renin–angiotensin system may underlie physiological and pathophysiological regulation of renal function.
The renin–angiotensin system in kidney development: role of COX‐2 and adrenal steroids
Authors: Jensen B. L. , Stubbe J. , Madsen K. , Nielsen F. T. , Skøtt O.
Published: July 2004

Recent data from studies in rodents with targeted gene disruption and pharmacological antagonists have shown that the renin–angiotensin–aldosterone system (RAAS) and cyclooxygenase type‐2 (COX‐2) are necessary for late stages of kidney development. The present review summarizes data on the developmental changes of RAAS and COX‐2 and the pathways by which they are activated; their possible interplay and the mechanisms by which they affect kidney development. Intrarenal and circulating renin and angiotensin II (ANG II) are stimulated at birth in most mammals. In rats, renin and ANG II stay significantly elevated in the suckling period while aldosterone stabilizes at an adult level. COX‐2 is stimulated in thick ascending limb of Henle's loop in the suckling period at a time when urine concentrating ability is not developed. Data suggest that this induction is mediated by combined low plasma glucocorticoid concentration and by a low NaCl intake. Studies with selective inhibitors of COX‐2 and COX‐2 null mice show that COX‐2 activity stimulates renin secretion from JG‐cells during postnatal kidney development and that lack of COX‐2 activity leads to pathological change in cortical architecture and eventually to renal failure. In the postnatal period, ANG II initiates and maintains pelvic and ureteric contractions necessary for urine flow. Lack of ANG II in the neonatal period is thought to cause injury by a chronic increase of renal pelvic pressure. Aldosterone is crucial for survival and growth in the neonatal period through its effects on sodium reabsorption and the intrarenal sensitivity to aldosterone is increased in the postnatal period. Final maturation of the kidney occurs through an intimate interplay between a low dietary sodium intake and a non‐responsive HPA‐axis which stimulates cortical COX‐2 activity. COX‐2 supports increased activity of the RAAS and may contribute to a low concentrating ability.
Are there clinical phenotypes of homozygous sickle cell disease?
Authors: Alexander Neal , Higgs Douglas , Dover George , Serjeant Graham R.
Published: July 2004

The distribution of clinical features was examined in subjects with homozygous sickle cell (SS) disease in the Jamaican Cohort Study to determine whether there is evidence of distinct clustering of symptoms or clinical phenotypes. A twofold model yielded groups that could be interpreted as painful crisis or leg ulcer phenotypes and 78% of patients were classified with 95% confidence into one of these. The painful crisis phenotype also manifested higher frequencies of dactylitis, meningitis/septicaemia, acute chest syndrome and stroke. Attempts to define a three‐group model were less convincing although 43% of patients could be allocated with 95% confidence. The three‐group model essentially divided subjects with the leg ulcer phenotype into subgroups with higher and lower frequencies of painful crisis, dactylitis, meningitis/septicaemia and acute chest syndrome. In the three‐group model, the painful crisis phenotype had lower total haemoglobin, fetal haemoglobin, mean cell volume and higher reticulocytes but there was no apparent influence of alpha thalassaemia or beta globin haplotype. Both environmental and genetic factors are likely to contribute to most manifestations of SS disease and the evidence for different clinical phenotypes suggests that a search for associated genetic polymorphisms may provide insights into the mechanisms of clinical variability in SS disease.
Activated protein C levels in Behçet's disease and risk of venous thrombosis
Authors: Navarro Silvia , Ricart José María , Medina Pilar , Vayá Amparo , Villa Piedad , Todolí José , Estellés Amparo , Micó María Luisa , Aznar Justo , España Francisco
Published: July 2004

Behçet's disease is a multi‐systemic inflammatory disorder of unknown cause. Most abnormalities have been associated with endothelial injury caused by vasculitis. Thrombosis occurs in about 25% of patients, although the mechanism is unknown. The objective of this study was to evaluate the protein C activation system in Behçet's disease and its correlation with venous thromboembolism (VTE). Thirty‐nine patients (12 with VTE) and 78 age‐ and sex‐matched controls were included in the study, and levels of protein C, protein S, activated protein C (APC), protein C inhibitor (PCI), soluble thrombomodulin (TM), antithrombin (AT), α1‐antitrypsin, fibrinogen, factor VIII, von Willebrand factor (VWF) and C‐reactive protein (CRP) were measured. APC and TM levels were significantly lower in patients than in controls, whereas protein S, AT, α1‐antitrypsin, fibrinogen, factor VIII, VWF and CRP levels were significantly higher in patients than in controls. APC, PCI and TM levels were lower in patients with VTE (0·65 ± 0·19 ng/ml, 86% ± 22% and 15·5 ± 7·1 ng/ml respectively) than in those without VTE (0·78 ± 0·17 ng/ml, 100% ± 15% and 22·1 ± 15·3 ng/ml) (P < 0·05). In patients, APC levels below 0·75 ng/ml (10th percentile of the control group) increased the risk of VTE about fivefold (odds ratio = 5·1; 95% confidence interval = 1·1–23·4). These results show that reduced APC levels are associated with the high incidence of VTE in Behçet's disease.
Novel 2′‐substituted, 3′‐deoxy‐phosphatidyl‐myo‐inositol analogues reduce drug resistance in human leukaemia cell lines with an activated phosphoinositide 3‐kinase/Akt pathway
Authors: Tabellini Giovanna , Tazzari Pier Luigi , Bortul Roberta , Billi Anna Maria , Conte Roberto , Manzoli Lucia , Cocco Lucio , Martelli Alberto M.
Published: July 2004

Activation of the phosphoinositide 3‐kinase (PI3‐K)/Akt signalling pathway has been linked with resistance to chemotherapeutic drugs, and its down‐regulation, by means of pharmacological inhibitors of PI3‐K, considerably lowers resistance to various types of therapy in cell lines derived from solid tumours. Recently, a new class of Akt inhibitors, referred to as phosphatidylinositol ether lipids (PIAs), have been synthesized. We tested whether two new PIAs could lower the sensitivity threshold to chemotherapeutic drugs of human leukaemia cell lines with an activated PI3‐K/Akt network. We used HL60AR (for apoptosis resistant), K562 and U937 cells. The two pharmacological inhibitors, used at 5 μmol/l, down‐regulated Akt kinase activity and phosphorylation. Neither of the two chemicals affected the activity of other signalling proteins in the Akt pathway, such as phosphoinositide‐dependent protein kinase‐1 or PTEN. When employed at 5 μmol/l, the Akt inhibitors markedly reduced the resistance of the leukaemic cell lines to etoposide or cytarabine. Remarkably, a 5 μmol/l concentration of the inhibitors did not negatively affect the survival rate of human cord blood CD34+ cells. Overall, our results indicate that new selective Akt pharmacological inhibitors might be used in the future for overcoming Akt‐mediated resistance to therapeutic treatments of acute leukaemia cells.
A single, multiplex analysis for all relevant activating NRAS gene mutations using heteroduplex generators
Authors: Belli Carolina , Bowen Derrick J. , Brasi Carlos De , Larripa Irene
Published: July 2004

We describe a multiplex polymerase chain reaction (PCR)‐based test that detected all relevant NRAS activating mutations using a single PCR followed directly by electrophoresis. The test uses a Universal Heteroduplex Generator (UHG) to detect exon‐2 (codon 61) NRAS mutations in multiplex with an UHG for exon‐1 (codons 12 and 13). The method differentiated all 19 relevant mutations in these exons and showed a mutation independent sensitivity of approximately 6%. The sensitive, specific detection of all NRAS activating mutations using this single rapid test represents a minimum workload and could be applied readily for large‐scale screening and for routine analysis.
Rapamycin‐mediated induction of γ‐globin mRNA accumulation in human erythroid cells
Authors: Mischiati Carlo , Sereni Alessia , Lampronti Ilaria , Bianchi Nicoletta , Borgatti Monica , Prus Eugenia , Fibach Eitan , Gambari Roberto
Published: July 2004

The present study aimed to determine whether rapamycin could increase the expression of γ‐globin genes in human erythroid cells. Rapamycin is a macrocyclic lactone that possesses immunosuppressive, antifungal and anti‐tumour properties. This molecule is approved as an immunosuppressive agent for preventing rejection in patients receiving organ transplantation. To verify the activity of rapamycin, we employed two experimental cell systems, the human leukaemia K562 cell line and the two‐phase liquid culture of human erythroid progenitors isolated from normal donors and patients with β‐thalassaemia. The results suggested that rapamycin, when compared with cytosine arabinoside, mithramycin and cisplatin, is a powerful inducer of erythroid differentiation and γ‐globin mRNA accumulation in human leukaemia K562 cells. In addition, when normal human erythroid precursors were cultured in the presence of rapamycin, γ‐globin mRNA accumulation and fetal haemoglobin (HbF) production increased to levels that were higher than those obtained using hydroxyurea. These effects were not associated with inhibition of cell growth. Furthermore, rapamycin was found to increase HbF content in erythroid precursor cells from four β‐thalassaemia patients. These results could have practical relevance, because pharmacologically mediated regulation of the expression of human γ‐globin genes, leading to increased HbF, is considered a potential therapeutic approach in haematological disorders, including β‐thalassaemia and sickle cell anaemia.
In patients with myelodysplastic syndromes response to rHuEPO and G‐CSF treatment is related to an increase of cytogenetically normal CD34+ cells
Authors: Rigolin Gian Matteo , Porta Matteo Della , Ciccone Maria , Bugli Anna Maria , Bragotti Letizia Zenone , Mauro Endri , Fraulini Chiara , Rossi Antonella Russo , Bardi Antonella , Cuneo Antonio , Castoldi Gianluigi
Published: July 2004

The in vivo effect of recombinant human erythropoietin (rHuEpo) and granulocyte colony‐stimulating factor (G‐CSF) combined treatment on CD34+ cells was evaluated by fluorescence in situ hybridization (FISH) in 13 myelodysplastic syndrome (MDS) patients with known cytogenetic abnormalities. After treatment, responsive patients presented a significantly lower proportion of FISH abnormal CD34+ cells than before treatment (P = 0·003), and in comparison with unresponsive cases (P = 0·007). Response to treatment was associated with a reduced degree of apoptosis in CD34+ cells (P = 0·021): however, no difference in telomere length was observed in responsive patients after growth factor administration. Although the number of patients analysed was relatively small, the present data suggest that, in MDS patients, response to rHuEpo and G‐CSF may be related to the proliferation of karyotypically normal but potentially defective CD34+ progenitor cells.
Dendritic cells fused with core binding factor‐beta positive acute myeloid leukaemia blast cells induce activation of cytotoxic lymphocytes
Authors: Banat G.‐Andre , Usluoglu Nurguel , Hoeck Marianne , Ihlow Kerstin , Hoppmann Sabine , Pralle Hans
Published: July 2004

Several reports have described various strategies of dendritic cell (DC) vaccination to induce specific T‐cell responses in patients with acute myeloid leukaemia (AML). About 50–60% of AML cases blasts have chromosomal abnormalities, such as inv(16) or t(8,21), which could encode for leukaemia‐specific antigenic peptide sequences, possibly presented in the context of self‐major histocompatibility complex (MHC) molecules. As the co‐culture of AML blasts with T lymphocytes seldom resulted in T‐cell stimulation, we fused AML blasts with autologous DC to enhance this effect. The fusion cells expressed MHC class I and II, CD40, B7‐1, B7‐2, CD209 and several adhesion molecules. In a mixed lymphocyte hybrid reaction, the fusion cells induced the proliferation of autologous T cells. Moreover, in the special case of fusion cells established from AML blasts with the chromosomal abnormality inv(16), the autologous T lymphocytes could be primed to induce cytotoxicity against up to 70% autologous AML blasts in a effector:target ratio of 20:1. Blocking assays demonstrated that the lysis was chiefly mediated by CD8+, CCR7− T lymphocytes, which could be further expanded in the form of effector memory CD8+ T cells by repeated co‐cultures with the autologous fusion cells.
Effects of genetic fusion of factor IX to albumin on in vivo clearance in mice and rabbits
Authors: Sheffield William P. , Mamdani Asif , Hortelano Gonzalo , Gataiance Sharon , Eltringham‐Smith Louise , Begbie Megan E. , Leyva Rina A. , Liaw Peter S. , Ofosu Frederick A.
Published: July 2004

Individuals with haemophilia B require replacement therapy with recombinant or plasma‐derived coagulation factor IX (fIX). More benefit per injected dose might be obtained if fIX clearance could be slowed. The contribution of overall size to fIX clearance was explored, using genetic fusion to albumin. Recombinant murine fIX (MIX), and three proteins with C‐terminal epitope tags were expressed in HEK 293 cells: tagged MIX (MIXT), tagged mouse serum albumin (MSAT) and MFUST, in which MIX and MSAT were fused in a single polypeptide chain. Proteins MFUST and MIXT were two‐ to threefold less active in clotting assays than MIX. In mice, the area under the clearance curve (AUC) was reduced for MFUST compared with MSAT or plasma‐derived MSA (pd‐MSA); the terminal catabolic half‐life (t0·5) did not differ amongst the three proteins. Two minutes after injection, >40% of the injected MFUST was found in the liver, compared with <10% of either MSAT or pd‐MSA. In rabbits, the AUC for MFUST was reduced compared to MIXT, MSAT, or pd‐MSA, while the t0·5 of the fusion protein fell between that of MIXT and MSAT or pd‐MSA. Similar results were obtained with non‐radioactive fused or non‐fused recombinant human fIX in fIX knockout mice. The clearance behaviour of the fusion protein thus more closely resembled that of fIX than that of albumin despite a modest increase in terminal half‐life, suggesting that fIX‐specific interactions that are important in determining clearance were maintained in spite of the increased size of the fusion protein.
Recessive genes controlling resistance to Helminthosporium leaf blight in synthetic hexaploid wheat
Authors: Ragiba M. , Prabhu K. V. , Singh R. B.
Published: July 2004

A study was conducted under controlled environment conditions in a phytotron to determine the nature of the inheritance of resistance Helminthosporium leaf blight (HLB) in a synthetic hexaploid wheat line, ‘Chirya‐3’, against the isolate KL‐8 of Bipolaris sorokiniana from the major wheat growing region of India. Crosses were made between two susceptible lines ‘WH 147’ and ‘Chinese Spring’. Analyses of F1 and F2 populations of these two crosses (‘WH 147’×‘Chirya‐3’ and ‘Chinese Spring’×‘Chirya‐3’) showed that resistance against the isolate in ‘Chirya‐3’ was governed by two recessive genes functioning in a complementary interaction giving an F2 segregation pattern of 1 : 15 (resistant : susceptible). The segregation pattern of the resistant F2 progenies in F3 families from both crosses confirmed that two homozygous recessive genes were responsible for resistance to the isolate of Bipolaris sorokiniana in the synthetic line ‘Chirya‐3’. It is proposed that the genes be designated as hlbr1 and hlbr2.
Evidence of pathotypes among Australian isolates of crown rust infecting perennial ryegrass
Authors: Aldaoud R. , Anderson M. W. , Reed K. F. M. , Smith K. F.
Published: July 2004

Fifty‐three genotypes of perennial ryegrass selected from a range of cultivars and ecotypes were evaluated for their reaction to crown rust isolates collected from Western Australia, Victoria, Queensland, South Australia or New South Wales in Australia. The reactions of the clones to inoculation provided evidence for the development of a differential set of perennial ryegrass genotypes, but also demonstrated that a large number of genotypes displayed universal reactions to infection with any of the crown rust isolates.
Isolation of two microsatellite markers from BAC clones of the Vf scab resistance region and molecular characterization of scab‐resistant accessions in Malus germplasm*
Authors: Vinatzer B. A. , Patocchi A. , Tartarini S. , Gianfranceschi L. , Sansavini S. , Gessler C.
Published: July 2004

A polymerase chain reaction (PCR)‐based method was developed to isolate microsatellite markers from large‐insert genomic DNA clones of bacterial artificial chromosome (BAC) libraries. The method is fast and economic since it does not require subcloning. It was applied to isolate a microsatellite marker from a BAC clone of the chromosomal region containing the apple scab resistance gene Vf. The Vf gene of Malus floribunda 821 is the most widely used source of scab resistance in apple breeding. A second microsatellite was found on the extremity of a BAC clone flanking the Vf locus. The two microsatellites allowed the identification of the presence of the Vf gene in the scab‐resistant accessions M. micromalus SA573‐3, ‘Golden Gem’, M. prunifolia 19651 and MA 16 not previously known to carry this gene. They were also used to verify the correctness of the published genealogical tree of the Vf cultivar ‘Florina’, in which a probable mistake was identified. This analysis shows the importance of genotyping the Vf locus when choosing scab‐resistant germplasm as parents in breeding programmes.
Screening for lodging resistance in spring wheat breeding programmes
Authors: Kelbert A. J. , Spaner D. , Briggs K. G. , King J. R.
Published: July 2004

Selection for lodging resistance in Canadian hard red spring wheat under natural conditions is difficult due to the sporadic and often random nature of lodging events. We conducted field trials in Edmonton AB Canada (2000–2002) to determine if either a high seeding rate, or artificially inducing lodging (by dragging a weighted apparatus across plots at the early milk stage), would be an effective screen for determining genetic lodging resistance in wheat breeding programmes. For the 25 genotypes tested, applying artificial lodging at the experimental mean early milk stage was a suitable method to screen and identify lodging tolerant and susceptible genotypes. Tolerance to artificially induced lodging was mainly found within semi‐dwarf genotypes, and susceptibility was mainly found within Canadian bread wheat genotypes. Severe lodging resulted in yield losses as high as 40%. Lodging tolerant genotypes identified in this study are now being crossed into elite western Canadian bread wheat in an effort to increase genetic lodging resistance within Canadian breeding lines.
Development of molecular markers to assess the level of introgression of Populus tremula into P. alba natural populations
Authors: Fossati T. , Patrignani G. , Zapelli I. , Sabatti M. , Sala F. , Castiglione S.
Published: July 2004

Morphological traits traditionally adopted to discriminate between Populus alba L. and P. tremula L. have frequently led to misclassifi‐cation of their spontaneous hybrid P. × canescens Sm. Moreover, they may not be of any help in cases of spontaneous backcross phenomena. These limitations can be overcome by molecular markers, which are not environmentally influenced nor subjectively assessed. In this study, the effectiveness of amplified fragment length polymorphism (AFLP) and simple sequence repeat (SSR) markers in species and hybrid discrimination was evaluated by analysing a set of reference samples of P. alba, P. tremula and P. × canescens. Species‐specific and species‐indicative AFLPs, as well as diagnostic SSR alleles, were recorded in both P. alba and P. tremula reference samples. The results allowed a clear distinction between the two poplar species and their hybrid. Using these diagnostic markers, a natural population of P. alba trees sampled along the Ticino river basin in northern Italy was analysed, and P. × canescens individuals, intermingled with P. alba trees, were detected.
Natural outcrossing rate in Vernonia galamensis
Authors: Baye T. , Becker H. C.
Published: July 2004

Vernonia galamensis is a potential new industrial crop growing wild in Ethiopia. The seed oil is rich in vernolic acid, an epoxy fatty acid, which is of interest for oleochemical uses. Basic information on the reproductive system of Vernonia is still very limited. The amount of natural outcrossing was estimated at two locations in Ethiopia (Alemaya and Babile) using flower colour as a marker. Single plants with white flowers, which is a monogenic recessive trait, were planted in plots with normal pink flowers and the outcrossing rate was estimated from the frequency of pink‐flowered plants in the progeny of the white‐flowered plants. Estimates of the natural outcrossing rate ranged between individual plants from 3.5 to 16% at Alemaya and 2.5 to 12% at Babile. Vernonia galamensis can be classified as a mainly self‐pollinated species.
Intracranial aspergillosis in a non‐immunocompromised patient treated for muscle‐invasive bladder cancer
Authors: MERSEBURGER AXEL STUART , OELKE MATHIAS , HARTMANN JOERG , STENZL ARNULF , KUCZYK MARKUS ANTONIUS
Published: July 2004

Abstract  We report a case of intracerebral Aspergillosis in a patient undergoing radical cystectomy for the treatment of muscle‐invasive bladder cancer who did not reveal any deterioration of the immune system. Aspergillus fumigatus is an ubiquitously present, airborne fungus that tends to infect the upper respiratory tract. However, the latter was not observed in the patient presented. Complications in the form of an involvement of the central nervous system are very rarely recognized as a result of an Aspergillus infection and primarily occur in patients who are not immunologically competent. To our knowledge, we present the first case of intracerebral invasive Aspergillosis in an otherwise healthy patient diagnosed with an urological malignancy.
Small cell carcinoma arising from the proximal urethra
Authors: RUDLOFF UDO , AMUKELE SAMUEL A. , MOLDWIN ROBERT , QIAO XIAOYING , MORGENSTERN NORA
Published: July 2004

Abstract  Primary neuroendocrine carcinomas of the lower urinary tract are distinctly rare, locally aggressive neoplasms with a high rate of metastasis. We present a case of primary small cell carcinoma of the urethra occurring in a 64‐year‐old man. The clinical, histological and immunohistochemical features of urethral small cell carcinoma are highlighted with respect to the differential diagnosis of neuroendocrine and other urethral tumors. The possible histogenesis of urethral small cell carcinoma, reported at this location in only a small number of cases, is briefly discussed. We favor an origin from pluripotent epithelial stem cells as one of the possible histogenic pathways.
An unusual complication of Burch colposuspension
Authors: MANIKANDAN RAMASWAMY , PRITCHARD SUSAN , BROWN STEPHEN C W
Published: July 2004

Abstract  Burch colposuspension remains one of the successful operations for genuine stress incontinence. We report a patient who developed an intravesical foreign body granuloma post‐Burch colposuspension. Any patient developing unexplained lower urinary tract symptoms following bladder or pelvic surgery for incontinence must be evaluated endoscopically in order to exclude this complication.
Clinical characteristics of normotensive renal transplant recipients with microalbuminuria and effects of angiotensin II type I receptor antagonist on urinary albumin excretion
Authors: SATOH SHIGERU , HORIKAWA YOHEI , KAKINUMA HIDEAKI , TSUCHIYA NORIHIKO , WANG LIZHONG , KATO TETSURO , HABUCHI TOMONORI
Published: July 2004

Abstract Aim: Microalbuminuria is typically observed in renal transplant recipients with systemic hypertension. The effects of angiotensin II type 1 receptor antagonist (losartan) on the hypertensive recipients have been evaluated. However, the clinical background of normotensive recipients with microalbuminuria and the effect of losartan administration in those subjects have not been clarified. One of the two purposes for the present study was to investigate the clinical characteristics of normotensive recipients with microalbuminuria. The other was to evaluate the effect of losartan on urinary excretion of albumin in these patients.

Methods: The clinical data and the change of the single kidney glomerular filtration rate (GFR) for the graft by radionuclide study were assessed in 13 normotensive recipients with microalbuminuria. These were compared with the data of 13 normotensive patients without microalbuminuria. The 13 recipients with microalbuminuria were treated with losartan for one year and urine excretion of albumin, N‐acetyl‐β‐D‐glucosaminidase (NAG) and serum creatinine (S‐Cr) levels were measured.

Results: The GFR of the grafts from donors to recipients significantly increased (30.9 to 55.2 mL/min) in microalbuminuric recipients, but did not significantly increase in the non‐microalbuminuric recipients. Decreases of the urinary excretion rate of albumin (351 ± 261 at baseline to 158 ± 14 mg/gCr at 12 months), NAG (13 ± 5 to 10 ± 3 IU/gCr) and S‐Cr (1.7 ± 0.6 to 1.5 ± 0.4 mg/dL) were observed in the microalbuminuric recipients with losartan administration.

Conclusions: The present study suggests that an increased single kidney GFR of the graft from the donorin situto the recipient might be a cause of microalbuminuria in normotensive recipients. The one‐year effects of losartan were observed in terms of the decrease in urinary excretion of albumin, NAG and S‐Cr levels.
Effects of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion: Preliminary results
Authors: HONJO HISASHI , KAMOI KAZUMI , NAYA YOSHIO , UKIMURA OSAMU , KOJIMA MUNEKADO , KITAKOJI HIROSHI , MIKI TSUNEHARU
Published: July 2004

Abstract  Background:  The present study was designed to reveal the usefulness of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion as evaluated by symptom scores, transrectal ultrasonography (TRUS) and magnetic resonance (MR) venography.

Methods:  Ten male patients suffering from non‐inflammatory chronic pelvic pain syndrome (NIH category IIIB) with intrapelvic venous congestion were treated using acupuncture. Eight patients had previously received pharmacotherapy, which was unsuccessful. Acupuncture was performed using disposable stainless steel needles, which were inserted into the bilateral BL‐33 points and rotated manually for 10 min. The treatment was repeated every week for 5 weeks without other therapeutic maneuvers. Results from TRUS and MR venography, as well as clinical symptoms based on the NIH chronic prostatitis symptom index (NIH‐CPSI) and the international prostate symptom score (IPSS), were compared before and after the treatment.

Results:  No side‐effects were recognized throughout the treatment period. The average pain and QOL scores of the NIH‐CPSI 1 week after the 5th acupuncture treatment decreased significantly (P < 0.05 and P < 0.01, respectively) compared with the baseline. The maximum width of the sonolucent zone 1 week after the 5th treatment also decreased significantly (P < 0.01, compared with the baseline). Intrapelvic venous congestion demonstrated by MR venography was significantly improved in four patients.

Conclusion:  This study provided novel information concerning the therapeutic effects of acupuncture on non‐inflammatory chronic pelvic pain syndrome.
Urodynamic effects and safety of modified intravesical oxybutynin chloride in patients with neurogenic detrusor overactivity: 3 years experience
Authors: SAITO MOTOAKI , WATANABE TAKESHI , TABUCHI FUMIE , OTSUBO KENJI , SATOH KEISUKE , MIYAGAWA IKUO
Published: July 2004

Abstract  Background:  Intravesical oxybutynin chloride with hydroxypropylcellulose (HPC) (modified intravesical oxybutynin) has been reported to be effective for treatment of overactive bladder. We reported the short‐term effects of modified intravesical oxybutynin previously. In the present article, we detail the results of a 3‐year follow‐up study of patients from our previous analysis and report the efficacy and side‐effects of modified intravesical oxybutynin.

Methods:  Modified intravesical oxybutynin (5 mg/10 mL, twice a day) was applied for more than 3 years to six neurogenic overactive detrusor patients (three men and three women, average age 53.3 years) who were not satisfied with oral anticholinergic agents or the other therapy. A cystometogram (CMG) was performed before, 1 week after and 3 years after the start of modified intravesical oxybutynin treatment. We evaluated the patient's satisfaction of this treatment after 4 weeks and again after 3 years. We compared the patients’ answers before and after the therapy (excellent, good, fair, unchanged and worse). We also monitored systemic and topical side‐effects in these patients during this period.

Results:  CMG studies showed that two of six patients no longer exhibited uninhibited contraction 1 week after the treatment and that the cystocapacity of patients before, 1 week after and 3 years after the initial modified intravesical oxybutynin was 129.7 ± 19.4, 283.5 ± 40.4 and 286.8 ± 38.1 mL, respectively. For the evaluation of patients’ satisfaction with this treatment, four patients considered the therapy excellent and one patient described it as good after both 4 weeks and after 3 years. Two patients dropped out of the study; one developed left ureteral cancer (2.25 years) and the other developed ileus (1.5 years). Dry mouth and acute cystitis were observed in both patients.

Conclusion:  Modified intravesical oxybutynin is an effective and relatively safe option of therapy for overactive bladder patients. However, this therapy requires careful observation for emergent side‐effects.
Buprenorphine blocks withdrawal in morphine‐dependent rat pups
Authors: Stoller Dawn C. , Smith Forrest L.
Published: July 2004

Background : Infants placed on extracorporeal membrane oxygenation (ECMO) or mechanical ventilation often need continuous morphine infusions for pain relief and sedation. The resulting physical dependence requires an additional 2–3‐week hospital stay to taper the morphine to avoid withdrawal. Buprenorphine effectively blocks abstinence in dependent adults, and in infants it could accelerate or eliminate the tapering schedule, thereby enabling earlier hospital dismissals.

Methods : Morphine‐dependent infant rats were used in this study to determine the effectiveness of buprenorphine in blocking abstinence. Postnatal day‐14 (P14) rats were implanted with osmotic minipumps that delivered saline (1 μl·h−1) or morphine (2 mg·kg−1 h−1) for 72 h. The minipumps were then removed to allow the rats to undergo spontaneous morphine withdrawal.

Results : The withdrawal period lasted approximately 72 h out of a 96‐h observation period. The following signs were significant during these hours: wet‐dog shakes, 1–72 h; abdominal stretches, 1–72 h; forepaw tremors, 1–24 h; splayed hind‐limbs, 1–72 h; ptosis, 4–72 h; and evoked vocalization, 4 and 8 h. A single 1 mg·kg−1 buprenorphine dose significantly decreased wet‐dog shakes from 1 to 72 h, abdominal stretches from 1 to 48 h, forepaw tremors and splayed hind‐limbs 1–8 h, and ptosis and evoked vocalization at 4 and 8 h. Repeated administration of 1 mg·kg−1 buprenorphine before pump removal and at 24, 48 and 72 h resulted in a greater magnitude of blockade of abstinence throughout the 96‐h observation period.

Conclusions : Buprenorphine may prove to be a suitable drug for treating opioid withdrawal in human infants.
Low doses of rocuronium during remifentanil–propofol‐based anesthesia in children: comparison of intubating conditions*
Authors: Özteki̇n Sermi̇n , Hepaǧuşlar Hasan , Ki̇lerci̇k Hakan , Kar Aysun Afi̇fe , Boyaci Fi̇gen , Elar Zahi̇de
Published: July 2004

Background : In this prospective double‐blind study, intubation conditions were compared at 90 s following two different low doses of rocuronium during remifentanil and propofol anesthesia in children undergoing ambulatory procedures.

Methods : Forty‐four children (ASA I‐II, aged 3–12 years) undergoing day case ENT surgery were premedicated with midazolam 0.5 mg· kg−1. Following atropine 10 μg·kg−1, remifentanil infusion 0.5 μg·kg−1·min−1 was started. After 60 s, anesthesia was induced with propofol 2.5 mg·kg−1. Immediately after a bolus dose of propofol, the children received rocuronium doses of 0.15 mg·kg−1 (group I, n = 22) or 0.3 mg·kg−1 (group II, n = 22) in a randomized manner, after which an infusion of propofol 6 mg·kg−1 h−1 was added to the infusion of remifentanil 0.5 μg·kg−1 min−1 for maintenance of anesthesia. Intubating conditions were evaluated 90 s after rocuronium administration applying the Copenhagen Scoring System which included components of laryngoscopy, vocal cord movement and reaction to intubation. Hemodynamic values were recorded at predetermined time intervals.

Results : Excellent, good and poor intubation conditions were 18.2, 40.9 and 40.9% in group I and 40.9, 54.5 and 4.5% in group II. Clinically acceptable intubating conditions (excellent and good) were significantly higher in group II (95.5%) than in group I (59.1%) (P = 0.004). Mean values of heart rate and blood pressure did not differ significantly between groups. No children required any intervention for hemodynamic instability and/or muscle rigidity.

Conclusions : The results suggest that 0.3 mg·kg−1 of rocuronium may be a better low dose than 0.15 mg·kg−1 of rocuronium for clinically acceptable intubating conditions in pediatric ambulatory surgery during remifentanil–propofol‐based anesthesia at the doses used in the study.
Propofol or propofol–alfentanil anesthesia for painful procedures in the pediatric oncology ward
Authors: von Heijne Margareta , Bredlöv Britt , Söderhäll Stefan , Olsson Gunnar L.
Published: July 2004

Background : For children with cancer receiving curative treatment, the pain of diagnostic and therapeutic procedures is often worse than that of the disease itself.

In order to evaluate if light propofol anesthesia in the pediatric oncology ward (POW) could improve the management of procedure pain and anxiety, a questionnaire was developed.

Methods : After prolonged EMLA application, 65 propofol anesthetics were performed successfully in 28 children during lumbar puncture and/or bone marrow aspiration in the POW, with short recovery time and without major adverse events. The questionnaire was mailed to the parents of the 28 children who were included in the survey.

Results : The return of questionnaire compliance was 89% (25 of 28), 12 females and 13 males, mean age was 7 years (range 2–16). Among those who replied, the diagnoses were acute lymphatic leukemia in 21, lymphoma in two and tumor in the other two. In the questionnaire, all parents/patients reported advantages with anesthesia in the POW compared with the operating room. In the list of stated advantages, 88% marked ‘familiar nurses and doctors’, 84%‘familiar environment’, 80%‘closer to own room’, 68%‘the child more calm’, 72%‘shorter waiting‐time’, 60%‘faster recovery’, 44%‘shorter fasting‐time’ and 44%‘parents more calm’, as benefits. For future procedures requiring anesthesia to reduce pain, discomfort and/or anxiety, 92% of the parents/patients preferred anesthesia in the POW.

Conclusions : If anesthesia is chosen for invasive procedures, this study suggest that propofol anesthesia in the POW is preferred by parents and children.
Axillary brachial plexus block for treatment of severe forearm ischemia after arterial cannulation in an extremely low birth‐weight infant
Authors: Breschan Christian , Kraschl Raimund , Jost Robert , Marhofer Peter , Likar Rudolf
Published: July 2004

Severe limb ischemia after arterial catheterization in neonates and premature infants is a well‐recognized problem. The usual treatment of ischemic injuries includes removal of the catheter and elevation of the effected limb. If unsuccessful, tissue necrosis and loss may follow. We report the case of a 700 g infant with severe distal forearm ischemia after right radial and ulnar artery catheterization. Immediate removal of the arterial line did not improve ischemia. Thirty‐six hours later a brachial plexus block via the axillary approach with 0.5 ml bupivacaine 0.125% was performed resulting in rapid improvement, restricting ischemia eventually to fingers II–V as well as the distal part of the thumb. Brachial plexus blockade and active vasodilatation in tiny neonates after severe local ischemia are discussed.
A review of the literature on how important water is to the world's elderly population
Authors: Davidhizar R. , Dunn C. L. , Hart A. N.
Published: July 2004

Aim:  This article reviews the literature on how important water is to the world's elderly population.

Background:  Water is a finite resource, so we must preserve the water that we have. Physiological aspects and what water requirements our bodies maintain sum up this essential nutrient for life. Dehydration is a concern in the elderly.

Conclusions:  Five strategies related to water intake can promote health: (1) assess for symptoms which may indicate dehydration, (2) encourage ingestion of fluids and foods to maintain an optimal fluid level, (3) be alert to physical and clinical conditions affecting hydration in the elderly, (4) consider environmental factors which may affect body fluids, electrolytes and acid‐base balance, and (5) encourage methods to increase fluid consumption.
Nursing the dying: essential elements in the care of terminally ill patients
Authors: De Araújo M. M. T. , Da Silva M. J. P. , Francisco M. C. P. B.
Published: July 2004

Aim:  To verify those aspects of care that nurses view as important when assisting patients beyond therapeutic possibilities and who are not under intensive care.

Objectives:  (1) To find out how nurses cope with daily confrontation with the death and suffering of dying patients, (2) To identify whether nurses feel it is important to have communication skills in order to assist the terminally ill patient, (3) To estimate nurses’ degree of work satisfaction, and (4) To explore the humane aspects of nursing assistance to the dying.

Method:  Data were collected in January and February of 2002 by means of individual semistructured interviews with 14 nurses from the unit of haematology at a general hospital in the city of Sao Paulo, Brazil. Interviews were recorded, transcribed, and further analysed according to the qualitative method proposed by Bardin (1977).

Results:  We found that Brazilian nurses caring for dying patients should be receiving psychological and emotional support. Results also highlighted different individual approaches in the endeavour to communicate with terminally ill patients, as well as the avoidance patterns developed by some nurses. The latter appeared to be as a result of personal difficulties in coping with the reality of human suffering and death. Finally, there is a need for better preparation in communication skills for nurses caring for terminally ill patients.

Conclusion:  Although the number of interviewed nurses in our study was small, the results corroborated the findings of other studies on the subject.
Evaluation of training of trainers courses for Oromia (Ethiopia) health professional schools’ tutors*
Authors: Beier‐Holgersen R. , Van Diest R. , Resti C. V.
Published: July 2004

Background:  In Ethiopia training tutors in the health system are part of a major health programme. A previous study disclosed that tutors felt they lacked sufficient teaching skills.

Aim:  The Teaching Methodology Course (TMC) described here was designed to correct these deficiencies. The aim of the study was firstly to evaluate the usefulness of questionnaires in terms of TMC quality control and secondly to evaluate whether the subcourses differed in terms of self‐progress evaluation and course evaluation.

Content:  The TMC consists of eight subcourses and is evaluated according to a quality circle described previously.

Methods:  Two questionnaires were used as part of the TMC quality control, one to assess tutors’ self‐progress and the other to examine tutors’ opinion about the course instructors’ pre‐defined teaching skills.

Results:  In the questionnaires a distinction was made between ‘good’ and ‘bad’ subcourses. Moreover, the quantitative evaluation of subcourses was in accord with the tutors’ written qualitative comments.

Conclusion:  The questionnaires can be used for TMC quality control in order to improve at least some subcourses.
Regionalism and Multilateral Trade Liberalization with Asymmetric Countries
Authors: Hadjiyiannis Costas
Published: July 2004

The paper examines the impact of regionalism on the process of multilateral trade liberalization when countries are asymmetric. The author uses a three‐country, three‐good, competing exporters model, with countries being symmetric in everything but their discount factors. The equilibrium regional agreement is found to be a customs union between a patient and an impatient country and that the impact of regionalism depends on the discount factors. The impact of regionalism on multilateral trade liberalization depends critically on which countries engage in regionalism.
Interannual Climate Variation, Climate Prediction, and Agricultural Trade: the Costs of Surprise versus Variability
Authors: Hallstrom Daniel G.
Published: July 2004

Agriculture remains sensitive to variation in rainfall and temperature. Fortunately, our ability to predict the lower frequency variation in the earth's atmosphere is increasing rapidly. While information cannot affect the underlying source of variability, it allows unexpected shocks to be anticipated and acted upon. This paper develops and analyzes an intertemporal Ricardian trade model with Bayesian beliefs. Results in this paper show that improved climate prediction reduces expected prices, but increases price variability. In addition, trade is crucial to realizing the potential benefits of climate prediction. The value of climate prediction is highest with both storage and trade, and falls by over 300% when a country is in autarky.
Why Do More Open Chinese Provinces Have Bigger Governments?
Authors: Jeanneney Sylviane Guillaumont , Hua Ping
Published: July 2004

The transition of China towards a market economy was accompanied by a vast fiscal decentralization movement. Econometric analysis of the determinants of public expenditure of the Chinese provinces does not permit rejection of the hypotheses that (i) the behavior of provinces is similar to that of governments in developing economies significantly affected by external shocks, and (ii) in order to alleviate external risk, they take control of a more significant share of the revenues of the economy.
Chernoff Faces in Microsoft Excel
Authors: Hunt Neville
Published: July 2004

This article describes how Chernoff faces can be drawn in Microsoft Excel.
Line‐Fitting with Outliers
Authors: Glaister Elizabeth M. , Glaister Paul
Published: July 2004

This article illustrates a method for fitting straight lines to data that is resistant to outliers and might therefore sometimes be preferred to the customary least squares procedure.
Investigating Probabilistic Intuitions
Authors: Quinn Robert J.
Published: July 2004

This article explores the intuitions of secondary education majors regarding probability. This is accomplished by administering a two‐question instrument to 113 participants. Their responses to these questions, and more importantly the explanations they provide for these answers, are analysed. The conclusions drawn may be informative to teachers of probability and statistics as they attempt to remediate common probabilistic misconceptions and devise more effective teaching strategies.
Docosahexaenoic acid promotes neurite growth in hippocampal neurons
Authors: Calderon Frances , Kim Hee‐Yong
Published: July 2004

Docosahexanoic acid (22:6n‐3; DHA) deficiency during development is associated with impairment in learning and memory, suggesting an important role of DHA in neuronal development. Here we provide evidence that DHA promotes neuronal differentiation in rat embryonic hippocampal primary cultures. DHA deficiency in vitro was spontaneously induced by culturing hippocampal cells in chemically defined medium. DHA supplementation improved DHA levels to values observed in freshly isolated hippocampus. We found that DHA supplementation in culture increased the population of neurons with longer neurite length per neuron and with higher number of branches. However, supplementation with arachidonic, oleic or docosapentaenoic acid did not have any effect, indicating specificity of the DHA action on neurite growth. Furthermore, hippocampal cultures obtained from n‐3 fatty acid deficient animals contained a lower DHA level and a neuronal population with shorter neurite length per neuron in comparison to those obtained from animals with adequate n‐3 fatty acids. DHA supplementation to the deficient group recovered the neurite length to the level similar to n‐3 fatty acid adequate cultures. Our data demonstrates that DHA uniquely promotes neurite growth in hippocampal neurons. Inadequate neurite development due to DHA deficiency may contribute to the cognitive impairment associated with n‐3 fatty acid deficiency.