bluuebunny/crossref_metadata_2025 huggingface dataset:
Larval parasitism by native insects on the introduced stem‐galling moth Epiblema strenuana Walker (Lepidoptera: Tortricidae) and its implications for biological control of Parthenium hysterophorus (Asteraceae)
Authors: Dhileepan K , Lockett Catherine J , McFadyen Rachel E
Published: January 2005

Abstract  The significance of natural enemies in the failure or reduced effectiveness of weed biological control agents remains largely unknown. Larval and pupal parasitism by native insects in the stem‐galling moth Epiblema strenuana was studied in north Queensland, 4 (1986–87) and 16 (1998–99) years after its introduction as a biological‐control agent for Parthenium hysterophorus. Specific questions answered in this study are: (i) Has parasitism increased over the years?; (ii) Are the levels of parasitism influenced by the host plant phenology?; and (iii) What are the potential implications of current parasitism levels for the effectiveness of E. strenuana? There was no increase in the parasitoid species assemblage over the years. In 1986–87, Antrocephalus sp. and Bracon sp. were the most predominant species. The combined larval and pupal parasitism was low (2.6%) and there was no seasonal difference in the parasitism levels. In 1998–99 Bracon sp. was the most prevalent species. Parasitism by Bracon sp. in 1998–99 was several times higher (22.9%) than the combined larval and pupal parasitism in 1986–87. However, parasitism by Bracon sp. remained low (6.5–8.2%) at the beginning of the parthenium‐growing season, and reached peak levels (49–53%) only at the end of the season. Parasitism by Bracon sp. was also significantly lower in rosettes (7.2%) than in flowering plants (22.8%). Galling can have a negative impact on the weed only when initiated at the rosette stage. In 1998–99 lower levels of parasitism early in the season when most plants are in the rosette stage suggest that the impact of parasitism on the effectiveness of the gall insect may not be significant.
Six‐year review of Acanthamoeba keratitis in New South Wales, Australia: 1997–2002
Authors: Butler Tom KH , Males John J , Robinson Lyon P , Wechsler Alfred W , Sutton Gerard L , Cheng Joanna , Taylor Peter , McClellan Kathleen
Published: January 2005

Aim: To assess the incidence and risk factors for Acanthamoeba keratitis (AK), the diagnostic interval, and the efficacy and outcome of current treatment among the population of New South Wales, Australia.

Methods: A retrospective review was carried out of all cases of AK treated at the Sydney Eye Hospital between January 1997 and December 2002.

Results: Twenty patients were identified with a mean follow up of 24.8 ± 21.5 months. Acanthamoeba keratitis constitutes 4.7% of severe infective keratitis treated at Sydney Eye Hospital. The mean interval from first presentation to diagnosis was 26.6 ± 35.1 days overall; 17.2 ± 33.1 days for those presenting directly to our unit (69% being diagnosed within 72 h of presentation), and 44.1 ± 34.0 days for those first presenting elsewhere. Of those with a diagnostic delay >1 month, 57% had been mistakenly diagnosed with Herpes simplex keratitis. Sixteen (80%) wore contact lenses, and eight (40%) had additional risk factors including poor lens hygiene. Complications occurred in 16 (80%), with seven (35%) requiring surgical intervention. Visual acuity improved in 18 (90%), worsened in two patients (10%), and 75% achieved 6/12 or better at last follow up.

Conclusions: Acanthamoeba keratitis is a rare infection, and contact lens wear remains the commonest association, with poor hygiene constituting significant additional risk. The visual outcome has improved with the availability of effective amoebicidal agents, but patients with a diagnostic delay and non‐contact lens wearers are at increased risk of recurrent disease. A high index of clinical suspicion remains the most effective strategy in implementing early treatment, and enabling a favourable outcome.
Enucleation versus evisceration
Authors: O'Donnell Brett A , Kersten Robert , McNab Alan , Rose Geoffrey , Rosser Paul
Published: January 2005

The choice of enucleation and evisceration for removal of an eye remains controversial in certain circumstances. An international panel was asked to give their surgical management of two clinical cases that require either enucleation or evisceration. Case one follows multiple vitreoretinal procedures, and the risk of sympathetic ophthalmia is considered in the surgical management. Case two has had postoperative endophthalmitis, and the possibility of implant infection following insertion of an orbital implant with evisceration and enucleation is discussed.
Conjunctival benign reactive lymphoid hyperplasia associated with myopic scleral thinning
Authors: Rofail Marc , Lee Lawrence R , Whitehead Kevin
Published: January 2005

Known causes of conjunctival salmon patches include lymphoma, amyloidosis, sarcoidosis, leukaemia and benign reactive lymphoid hyperplasia. The aetiology of benign reactive lymphoid hyperplasia is thought to be a localized reactive change induced by an irritative or antigenic stimulus. The case of benign reactive lymphoid hyperplasia reported herein occurred in a myopic patient with extremely thin sclera. The authors’ hypothesis is that choroidal antigens are able to perfuse through thin sclera and act as chronic irritants to the overlying conjunctiva resulting in a lymphoid response and subsequent salmon patch formation.
Traumatic lenticele
Authors: Sony Parul , Khokhar Sudarshan , Panda Anita
Published: January 2005

A 55‐year‐old woman presented with sudden diminution of vision in her left eye following trauma with her own finger. Examination revealed a firm subconjunctival swelling superiorly with aphakia and hypotony. Lens spike was absent on B‐scan. Ultrasonic biomicroscopy showed thickened conjunctiva, a subconjunctival mass lesion with an underlying uveoscleral discontinuity. A surgical repair was performed with successful restoration of globe integrity. This case demonstrates that ultrasonic biomicroscopy may reveal the site and the extent of occult scleral rupture and help in precise surgical planning.
Clinical outcome of chronic immunosuppression in patients with non‐infectious uveitis
Authors: Menezo Victor , Lau Chun , Comer Marie , Lightman Susan
Published: January 2005

Aim: To determine the visual outcome and corticosteroid dose requirement in patients with non‐infectious uveitis affecting the posterior segment treated with corticosteroids and additional second‐line immunosuppression.

Method: A retrospective, non‐comparative case series was carried out. Seventy‐two patients (141 eyes) with uncontrolled non‐infectious uveitis on systemic prednisolone were treated with at least one second‐line immunosuppressive agent in addition to systemic prednisolone and followed for at least 3 months. Visual acuity (VA), clinical disease activity, corticosteroid‐sparing effect, disease relapses requiring corticosteroid dose increase, and side‐effects from second‐line agents were evaluated.

Results: At the end of the follow‐up period (mean: 55.5 months), 70 eyes (49.6%) had VA of 6/9 or better. There was a reduction in the mean maintenance dose of prednisolone required before the introduction of the second‐line agent (19 mg/day ± 2 SE) when compared to the mean maintenance dose of prednisolone at the end of the data collection (9 mg/day ± 1 SE; P < 0.001). There was also a significant reduction in the number of disease relapses requiring an increase in prednisolone dose after starting the second‐line agents as compared to the year before (P < 0.02).

Conclusion: In patients with uveitis affecting the posterior segment, the addition of all second‐line immunosuppressive therapy was effective in allowing reduction of the dose of systemic prednisolone to 10 mg/day or less, in controlling intraocular inflammation, reducing the number of relapses and in maintaining vision. Because of their side‐effects, immunosuppressive treatment should be individualized and monitored closely but its addition is beneficial in the short and longer term.
Clinical features and visual outcome of intermediate uveitis in children
Authors: Jain Rajni , Ferrante Paulo , Reddy Gopi T , Lightman Susan
Published: January 2005

Purpose: To determine the presentation, course, treatment and outcome of idiopathic intermediate uveitis in children.

Methods: The records of all patients under the age of 16 presenting with idiopathic intermediate uveitis under the care of one consultant (SL) between 1990 and 2001 were reviewed. The case notes were analysed with respect to presenting symptoms, associated conditions, ocular signs, change in visual acuity, treatment and complications. All patients with systemic disease were specifically excluded from the study.

Results: Twenty‐six patients (45 eyes) were identified with intermediate uveitis from 114 cases of childhood uveitis seen. The mean age at presentation was 10 years (range 7–13 years) and the average follow‐up time was 3 years (range 0–7 years). All patients had varying degrees of vitritis, 28 eyes had snowbanks and 5 had cystoid macular oedema at presentation. Six patients required no treatment, five received topical treatment only, five were managed with orbital floor steroids alone and a further two were managed with orbital floor steroids and oral prednisolone. Systemic steroids were required in eight patients, four of whom also required cyclosporin. Six of these children had successful disease control and maintained a visual acuity of 6/9 in at least one affected eye.

Conclusion: Idiopathic intermediate uveitis is a relatively uncommon condition in children but can have severe effects on vision. With careful management, vision can be preserved in at least one eye. This study describes the course of the disease in a relatively large series. The variation in disease severity prompts the use of individually tailored immunosuppressive regimens.
Incidence and progression of diabetic retinopathy in an Aboriginal Australian population: results from the Katherine Region Diabetic Retinopathy Study (KRDRS). Report no. 2
Authors: Jaross Nandor , Ryan Philip , Newland Henry
Published: January 2005

Background: The Katherine Region Diabetic retinopathy Study (KRDRS) was carried out in the Lower Top End of the Northern Territory of Australia between 1993 and 1996 as part of the Northern Territory Eye Health Program. It investigated diabetic eye conditions and their determinants in the Australian Aboriginal population of the region.

Methods: The KRDRS was comprised of two cross‐sectional surveys, in 1993 and in 1996, and involved a total of 477 subjects with diabetes. Ninety‐six subjects were seen in both surveys and met the criteria for inclusion in the longitudinal study. Each subject underwent a general eye examination and retinal photography.

Results: The annual incidence rates of retinopathy were 5.6% (95% CI 3.0–10.0%) and 4.2% (95% CI 2.5–7.0%) in subjects and eyes, respectively. This compares with 8% (in subjects) of the overall Australian diabetic population found in the Newcastle Study of Diabetic Retinopathy. However, each year 1.2% of subjects (95% CI 0.2–3.8%) and 1.3% of eyes (95% CI 0.2–4.5%) with no pre‐existing retinopathy developed vision‐threatening retinopathy. The respective findings for maculopathy were 2.2% (95% CI 0.7–4.6%) and 1.7% (95% CI 0.7–3.2%), and for clinically significant macula oedema (CSME) 1.1% (95% CI 0.2–3.1%) and 0.9% (95% CI 0.3–2.2%). The annual incidence of CSME in those with no maculopathy when first seen was 1.1% (95% CI 0.2–3.3%) and 0.9% (95% CI 0.3–2.2%) in subjects and eyes, respectively. The annual progression to CSME in those with maculopathy was 4.8% (95% CI 0.1–26.5%) and 6.1% (0.7–21.9%) in subjects and eyes, respectively.

Conclusion: Results of the KRDRS show that despite a lower overall incidence of diabetic retinopathy among Aboriginal diabetics compared to the general Australian diabetic population, there are important reasons to consider Aboriginal diabetics at special risk. These reasons include the highest reported incidence of vision‐threatening retinopathy in Australia, one of the highest ever reported incidences of CSME in the world and the likelihood that the severity of the problem may be underestimated because of the relatively short observation time and the low average time since diagnosis. It is also acknowledged that the small numbers in the study limit our ability to reliably detect progression between subsets of the population and much larger studies are required to make statistically significant comparisons.
Choice of intraocular lens may not affect refractive stability following cataract surgery
Authors: Landers John , Liu Henry
Published: January 2005

Purpose: To assess whether the choice of an intraocular lens (IOL) with rigid haptics (Sensar) or an IOL with pliable haptics (Acrysof) has an effect on refractive stability following cataract surgery.

Methods: Seventy‐three patients were recruited consecutively as they returned for their 6‐month visit following cataract surgery. There were 37 patients who had received an Acrysof IOL and 36 who had received a Sensar IOL. Each patient had their refractive error measured at the 1‐month postoperative visit. At the 6‐month follow‐up visit, refraction was repeated. The change in refractive error was then compared between IOL groups and other factors that may affect postoperative refractive stability including preoperative refraction, axial length, keratometry, wound type and wound meridian.

Results: An Acrysof IOL showed minimal myopic movement, whereas a Sensar IOL was more likely to move hypermetropically. However, this difference was not statistically significant (t = 1.92; P = 0.06). The magnitude of the shift in spherical equivalent in either direction for the Acrysof group was 0.37 ± 0.35 D and for the Sensar group was 0.28 ± 0.31 D. Again, this difference was not statistically significant (t = 1.17; P = 0.25). However, preoperative anterior chamber depth was associated with postoperative refractive shift (t = 2.66; P = 0.009). Furthermore, patients with a scleral wound showed a small against‐the‐rule shift in cylindrical refractive error. No other factors were associated with postoperative refractive shift amongst the sample.

Conclusions: There were no clinically significant differences in postoperative refractive stability between the Acrysof and Sensar groups. However, preoperative anterior chamber depth was associated with the magnitude of shift in spherical equivalent.
Computerized corneal topography in a paediatric population with Down syndrome
Authors: Vincent Andrea L , Weiser Brent A , Cupryn Monique , Stein Raymond M , Abdolell Mohamed , Levin Alex V
Published: January 2005

Purpose: To characterize abnormal corneal topographic changes using corneal computerized videokeratography (CVK) in a paediatric population with Down syndrome, and in their parents.

Methods: Prospective, non‐randomized clinical trial. Twenty‐one children with Down syndrome (mean age 6.9 years) recruited from The Hospital for Sick Children, 18 of their parents, and a paediatric control group of 60 otherwise well children (mean age 9 years), underwent complete ocular examination and CVK using the EyeSys system. Corneal topographic maps were assessed subjectively, and three objective parameters analysed: central corneal power (CP), difference in central corneal power between the two eyes (DCP), and inferior–superior steepening asymmetry (I‐S).

Results: Corneal curvature in children with Down syndrome was significantly steeper than in the paediatric control population (CP 46.66 vs 42.60 D, P < 0.0001), but changes with age paralleled that of the control population. DCP and I‐S values were also significantly different from the control population (P < 0.0001). 39% of the parents of children with Down syndrome had at least one abnormal parameter.

Conclusions: This study demonstrates that CVK is a useful tool in the ocular assessment of patients with Down syndrome. The findings suggest that this patient population have abnormalities of corneal shape even in the absence of clinical evidence of keratoconus. A greater than expected incidence of abnormal topographic changes was observed in the parents of these patients.
Systemic toxicity of tacrolimus given by various routes and the response to dose reduction
Authors: Akar Yusuf , Yucel Gultekin , Durukan Ali H , Yucel Iclal , Arici Gulbin
Published: January 2005

Purpose: To evaluate the long‐term systemic toxicity of tacrolimus (FK‐506) administered by various routes, and to assess the effect of dose reduction on toxicity.

Methods: The study animals were 120 experimentally naïve adult female Wistar rats weighing 200–250 g each. The rats were randomly divided into 10 equal groups (n = 12 in each) and treated with tacrolimus administered topically (in drops, 0.3%, q.i.d.), intravitreally (0.5 mg/kg bodyweight/week), intramuscularly (1 mg/kg bodyweight/week), low‐dose intravenously (1 mg/kg bodyweight/week) and in high‐dose intravenously (2 mg/kg bodyweight/week) for 3 months. The rats in the control groups (one for each different route of administration) were treated with 0.9% NaCl. The blood concentration of tacrolimus, complete blood count and biochemistry parameters were measured each month for the 3‐month study period.

Results: The rats in the control groups and experimental groups administered topical and intravitreal tacrolimus did not demonstrate any systemic toxic effects. The rats that developed certain toxic effects (hyperglycaemia, hyperkalaemia and nephrotoxicity) in the groups given low‐dose or high‐dose i.v. tacrolimus responded well to dose reduction. Following dose reduction, blood glucose concentrations decreased from 247.4 ± 42.3 mg/dL to 189.6 ± 37.9 mg/dL (P < 0.05), and from 237.4 ± 41.1 mg/dL to 182.3 ± 22.7 mg/dL (P < 0.05) in the low‐ and high‐dose i.v. tacrolimus‐treated rats, respectively. The rats that developed impaired hepatic function after high‐dose tacrolimus did not respond to dose reduction. Baseline cholesterol concentrations for the intramuscular and low‐ and high‐dose i.v. tacrolimus‐treated groups, demonstrated decreases, respectively, from 87.4 ± 14.0 mg/dL, 86.4 ± 14.0 mg/dL and 90.4 ± 14.3 mg/dL to 53.6 ± 9.8 mg/dL, 52.1 ± 12.5 mg/dL and 63.5 ± 11.7 mg/dL by the end of the second month. The differences were found to be statistically significant (P < 0.05 for each result).

Conclusion: Topical or intravitreal administration of tacrolimus seems to be systemically safe whereas parenteral administration can cause some systemic haematological changes such as dose‐dependent decreased serum cholesterol concentrations. Dose reduction may prevent such adverse effects.
Bilateral choroidal metastasis from carcinoma ex pleomorphic adenoma of the parotid gland
Authors: Ilhan H Deniz , Öner F Hakan , Sarıoglu Sülen , Lebe Banu , Saatci A Osman
Published: January 2005

The histological, clinical and angiographic findings are reported of a 34‐year‐old man with bilateral visual loss who had left parotidectomy with subsequent radiotherapy due to carcinoma ex pleomorphic adenoma of the parotid gland 1 year before. Funduscopy disclosed choroidal masses with surrounding serous retinal detachment in both posterior poles. At the time of ocular diagnosis, lung, pleura and pharynx metastases had recently been revealed. Because of the extent of disease and its poor prognosis, no treatment was offered. Although parotid gland carcinoma usually spreads via lymphatics, choroidal involvement may rarely occur due to haematogenous dissemination.
Bilateral macular cysts following electric burn
Authors: Sony Parul , Venkatesh Pradeep , Tewari Hem Kumar , Garg Sat Pal
Published: January 2005

A 28‐year‐old man presented with bilateral acute loss of vision following a high‐voltage injury. The visual acuity was 6/36 in the right eye and 6/24 in the left eye. Fundus examination revealed a well‐defined round lesion simulating a full thickness macular hole in the right eye and yellow deposits in the macular area in the left eye. Optical coherence tomography (OCT) showed bilateral macular cysts, with intact outer and inner retinal layers. At 1 month follow up, OCT showed a persistent macular cyst in the right eye with spontaneous resolution of the macular cyst along with visual improvement in the left eye.
Refractive surgery and strabismus
Authors: Kowal Lionel , Battu Ravindra , Kushner Burton
Published: January 2005

This review discusses the potential for strabismic complications after refractive surgery for hyperopia, myopia, anisomyopia, astigmatism and monovision, and how to avoid these complications. Guidelines are given for assessing patients with strabismus seeking refractive surgery. Screening tests are suggested that lead to stratification of refractive surgery patients into different risk groups each warranting a different intensity of evaluation.
Successful treatment of surgically induced necrotizing scleritis with tacrolimus
Authors: Young Alvin L , Wong SM , Leung Alfred TS , Leung Gloria YS , Cheng Lulu L , Lam Dennis SC
Published: January 2005

A 46‐year‐old man developed surgically induced necrotizing scleritis (SINS) 7 months following uneventful primary bare sclera pterygium excision. The patient underwent two scleral patch grafts for SINS but despite the use of cyclophos­phamide and azathioprine, the scleral patch grafts failed within 1 month of surgery on both occasions. Tacrolimus was used for his third scleral patch graft. No recurrence of necrotizing scleritis was observed for 2 years. Tacrolimus may be considered as a valuable adjunctive immuno­suppressant in the management of resistant necrotizing scleritis.
Metastatic lung and pleural malignancy presenting as bilateral acute anterior uveitis
Authors: Idris Iskandar , Lim Chea S , Johnston Ian D , Mansell Peter
Published: January 2005

Anterior uveitis is associated with a variety of underlying systemic diseases but the association between bilateral acute anterior uveitis (BAAU) and lung and pleural malignancy is not widely recognized. The case is described here of a 61‐year‐old woman presenting to an eye clinic with BAAU. A routine chest radiograph performed principally to exclude pulmonary sarcoidosis revealed an intrapulmonary mass and she was subsequently found to have widespread lung and pleural malignancies. Evidence is discussed that suggests a link and potential aetiology between BAAU and lung and pleural malignancies. The present case shows the virtue of requesting a chest radiograph in patients presenting with BAAU, even in the absence of other symptoms or clinical findings.
Management of rhegmatogenous retinal detachment in a full‐term pregnancy
Authors: Kent‐Smith Brian T , Wilson Graham A
Published: January 2005

Although exudative retinal detachments have been well documented to occur during pregnancy, reports of rhegmatogenous retinal detachments occurring during pregnancy are rare. A case is presented herein of rhegmatogenous retinal detachment occurring during pregnancy. Some of the challenges arising from this uncommon clinical scenario are discussed.
In vivo confocal microscopy of megalocornea with central mosaic dystrophy
Authors: Uçakhan Ömür Ö , Kanpolat Ayfer , Yilmaz Nurgül
Published: January 2005

In vivo confocal microscopy was performed on the central cornea of both eyes of a patient with megalocornea and central mosaic dystrophy. In the stroma, starting just below Bowman's membrane, polygonal, moderately reflective areas of opacification separated by diagonal hyporeflective striations were observed. The opaque areas appeared smaller in the anterior stromal layers and seemed to get larger towards the posterior stroma. The epithelium, Bowman's membrane and endothelium appeared normal. In vivo confocal microscopy is helpful in evaluating the morphological characteristics of corneal dystrophies, degenerations or developmental abnormalities of the cornea, and may prove to be helpful in understanding their pathophysiology.
Tachycardia and myocardial ischaemia following subconjunctival injection of mydricaine (number 02) for vitrectomy procedure
Authors: Keembiyage Ranasiri Dayawansa , Newland Henry Simpson , Lai Choong
Published: January 2005

Mydricaine is a mydriatic agent used routinely at the Royal Adelaide Hospital in subconjunctival injections that are given prior to all vitreoretinal surgery. The drug is manufactured by the hospital pharmacy and each vial of 0.4 mL mydricaine number 02 consists of a mixture of 1.3 mg atropine sulphate, 0.12 mg adrenaline and 8.4 mg procaine hydrochloride. Mydricaine is routinely used by many vitreoretinal units, even though the drug is not listed in the British National Formulary (BNF) or Monthly Index of Medical Specialities (MIMS). Therefore, published case reports provide the main forum for reporting side‐effects. The case presented is of a patient with no previous ischaemic heart disease who developed transient myocardial ischaemia with tachycardia following the administration of subconjunctival mydricaine number 02. To the authors’ knowledge this is the first case report documenting myocardial ischaemia in a patient with no previous ischaemic heart disease following mydricaine administration.
Low expression of XIAP‐associated factor 1 in human colorectal cancers
Authors: MA Tian Le , NI Pei Hua , ZHONG Jie , TAN Ji Hong , QIAO Min Min , JIANG Shi Hu
Published: January 2005

OBJECTIVE:  Eight cellular homologs of the inhibitors‐of‐apoptosis proteins (IAP) have been identified in humans and of them, the X‐linked IAP (XIAP) is the most potent. XIAP‐associated factor 1 (XAF1) is a newly discovered XIAP‐binding protein that negatively regulates the caspase‐inhibiting activity of XIAP. It is either not expressed or present at extremely low levels in many cancer cell lines. The aims of the present study were: (i) to investigate the expression of XAF1 in human colorectal cancers (CRC) both in vitro and in vivo, and (ii) to evaluate the possibility of XAF1 as a new tumor marker.

METHODS:  The expression of XAF1 in four human colon cancer cell lines (Colo205, Colo320, SW1116, LoVo) and in samples from 70 patients with CRC was analyzed by reverse transcriptase‐polymerase chain reaction. XAF1 concentrations were also detected in the peripheral circulation of the 70 patients, as well as three traditional circulating cancer‐associated antigens.

RESULTS:  A low concentration of XAF1 mRNA was detectable in the three colon cancer cell lines other than Colo205, which showed the strongest expression of XAF1. The expression of XAF1 in tissue was relatively lower in primary CRC compared with a relatively higher level in benign colorectal tumors (P < 0.01). Although the XAF1 expression in circulation of those with CRC was also lower than in those with benign tumors, there was no statistical significance (P > 0.05).

CONCLUSIONS:  The present results suggest that the low expression of XAF1 in tumor tissue coincides with a similar level in the peripheral circulation, which contributes at least part to the malignant behavior of CRC. Integrating the XAF1 relative expression value with the other three traditional tumor biomarkers created a four‐parameter assay that significantly improved the rate of diagnosis of CRC.
Antinociceptive property of tegaserod in a rat model of chronic visceral hypersensitivity
Authors: LIANG Lie Xin , ZHANG Qing , QIAN Wei , HOU Xiao Hua
Published: January 2005

OBJECTIVE:  To establish a model of chronic visceral hypersensitivity in rats and to investigate the effect of tegaserod, a partial 5‐hydroxytryptamine‐4 receptor agonist, on visceral hypersensitivity.

METHODS:  Neonate Sprague‐Dawley rats at 8–21 days after birth underwent colorectal distension once daily. Adult rats aged 8–10 postnatal weeks underwent colorectal distension and the abdominal withdrawal reflex (AWR) during the distension was determined. The AWR score was recorded before and after intraperitoneal administration of either tegaserod (treatment group: 0.3 mg/kg) or vehicle (control group).

RESULTS:  Changes in the AWR score were dependent on the pressure intensity of the colorectal distension (P < 0.01). At pressures of 40, 60 and 80 mmHg, the AWR scores in the model rats with visceral hypersensitivity were significantly higher than those recorded in the control group (1.95 ± 0.16 vs 1.35 ± 0.15, 2.82 ± 0.12 vs 2.17 ± 0.13, 3.20 ± 0.14 vs 2.59 ± 0.14, P < 0.01). Compared with the controls, tegaserod significantly decreased the AWR scores at the distension pressures of 40, 60 and 80 mmHg (1.95 ± 0.50 vs 1.32 ± 0.55, 3.05 ± 0.48 vs 2.32 ± 0.54, 3.25 ± 0.63 vs 2.77 ± 0.51, P < 0.05).

CONCLUSIONS:  Adult rats can develop chronic visceral hypersensitivity after transient colorectal mechanical irritation during their postnatal period. Tegaserod increases the pain threshold to noxious stimuli, suggesting an antinociceptive property in its effect on visceral hypersensitivity.
Comparative analysis of patients with clinically diagnosed colorectal cancer and those detected by mass screening
Authors:   COLORECTAL CANCER COOPERATING GROUP, BEIJING SOCIETY OF GASTROENTEROLOGY
Published: January 2005

OBJECTIVE:  To analyze the differences and similarities between patients with colorectal cancer (CRC) who had been clinically diagnosed (CD) and those detected by mass screening (MS), and thus clarify the practical significance of CRC screening in China.

METHODS:  All the data for the CRC patients in the CD group were collected by registration through a cohort study, and the patients in the MS group were selected from mass screening of a natural population of 19 852 in Beijing Metropolitan area. CRC was confirmed pathologically in both groups.

RESULTS:  Patients over the age of 50 years with CRC comprised 81.9% of the CD group and 83.3% of the MS group; the percentage of Dukes A + B was 41.1% and 91.7%, respectively; 0.28% of individuals with risk factors in the MS group were found to have CRC, whereas 0.05% did not (P < 0.05). Endoscopically, 44.7% of the protruding type CRC were Dukes A or B compared with only 10% of the ulcerated type (χ2 = 22.304, P < 0.001). The positivity rate of the fecal occult blood (FOB) test was 79.9% in Dukes A + B and 82.0% in Dukes C + D, showing no difference between the FOB test and Dukes staging in diagnosing CRC (χ2 = 0.087, P = 0.768). The percentage of patients with increased serum concentration of carcinoembryonic antigen in Dukes C + D was significantly higher than that in Dukes A + B (χ2 = 5.547, P = 0.019). Among the moderately and well‐differentiated CRC, 51.8% (159/307) were Dukes A + B, resulting in a significant difference (χ2 = 14.504, P < 0.001). There was a familial history of malignancies in 17.9% of CRC cases and 14.6% of their first‐degree relatives suffered from malignant tumors.

CONCLUSIONS:  The incidence of CRC in Beijing Metropolitan area has been rising significantly. The staging and prognosis of CRC involves symptomatology, laboratory tests, endoscopic findings and pathologic characteristics. Mass screening is effective for detecting early CRC in China.
Metal‐induced oxidative damage in cultured hepatocytes and hepatic lysosomal fraction: beneficial effect of a curcumin/absinthium compound
Authors: BARRETO R , KAWAKITA S , TSUCHIYA J , MINELLI E , PAVASUTHIPAISIT K , HELMY A , MAROTTA F
Published: January 2005

OBJECTIVE:  Metals undergo redox cycling and there is increasing evidence of free radical generation and oxidative injury in the pathogenesis of liver injury and fibrosis in metal storage diseases. The aim of the present study was to test a natural hepatoprotective compound in metal‐induced liver injury.

METHODS:  Hepatocytes were isolated from Wistar rats by collagenase perfusion method and cultured as such and also with α‐linolenic acid (LNA)‐bovine serum albumin (BSA). Hepatocytes were then cultured with a graded dilution of PN‐M001 (100 µg/mL and 200 µg/mL), which is a curcuma/absinthium‐containing compound, or sylibin (100 µg/mL) dissolved in dimethyl sulfoxide for 10 min before the addition of metallic salts (iron, copper and vanadium). Lysosomal fractions were prepared for lysosome fragility tests in which β‐galactosidase activity and lactate dehydrogenase (LDH) leakage were measured, as well as oxidative damage tests in the presence of hydrophilic and lipophilic free radical generators. Quenching activity by 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) was also assessed.

RESULTS:  Malonildialdehyde accumulation in the medium showed a direct time‐course increase with incubation time. Both PN‐M001 and sylibin showed a significant protective effect against all challenge metal ions, as expressed by the half inhibition concentration (IC50) against lipid peroxidation. However, on a molar ratio, sylibin seemed to be more effective than PN‐M001 in Fe‐induced peroxidative damage (P < 0.05). Both test compounds, irrespective of the concentration, significantly reduced the LDH and β‐galactosidase concentration in the lysosomal fractions. As compared with untreated lysosomal fractions challenged with the two peroxide radicals generators, either PN‐M001 or sylibin exerted significant protection However, PN‐M001 was significantly better than sylibin in suppressing acid phosphatase enzyme activity. Both compounds showed comparable and significant DPPH radical‐scavenging activity.

CONCLUSION:  These data support the potential clinical application of curcumin‐containing compounds.
Modulation of the molecular conformation of a hepatocyte‐targeting gene drug in order to improve its expression efficiency in vitro
Authors: LIU Xiao Wei , LU Fang Gen , WU Xiao Ping , OUYANG Chun Hui , YANG Dong Ye , YOU Yu , LIAN Guang Hui
Published: January 2005

AIM:  To construct different conformations of a plasmid DNA/vector complex (pcDNA3.1/IFN‐γ‐ASOR‐PLL) and transfect cells of the hepatoma cell line BEL7402 to investigate the optimal conformation of the complex for improved expression efficiency in the target cell.

METHODS:  Double‐distilled water and adjuvant were added to the naked pcDNA3.1/IFN‐γ, target vector ASOR‐PLL and the ASOR‐PLL–pcDNA3.1/IFN‐γ complex to create different conformations; molecules that were transfected into BEL7402 cells and the expression efficiency was determined by measuring the IFN‐g concentration in the culture supernatant by ELISA.

RESULTS:  Naked pcDNA3.1/IFN‐γ DNA distributed linearly in double‐distilled water and condensed into a mica configuration in adjuvant; ASOR‐PLL had a net‐like distribution without adjuvant and a spider‐like form in the adjuvant‐treated group; the ASOR‐PLL–pcDNA3.1/IFN‐g complex had a divaricate form without adjuvant, but a bead‐like or granular conformation in 0.1 and 0.2 mol/L of adjuvant, a homogeneous bacilliform or chromatoid‐shaped conformation in 0.3 mol/L adjuvant, and varied shapes in 0.4 and 0.5 mol/L adjuvant. The supernatant IFN‐γ expression in the bacilliform/chromatoid conformation complex group was the highest among the different conformation groups and controls. When chloroquine was added the supernatant IFN‐γ concentration increased in the liposome group and decreased in the bacilliform/chromatoid conformation group .

CONCLUSIONS:  The two structural molecules and their complex, ASOR‐PLL–pcDNA3.1/IFN‐γ, were adjustable in the liquid mode. The specific bacilliform/chromatoid conformation of complex was lysosome enzyme‐resistant and could play an active role in improving the efficiency of gene expression. The hypothesis that a chromosome‐like conformation of the target gene molecule is involved in enhancing exogenous gene expression is proposed.
Clinical characteristics of acute pancreatitis patients with elevated serum triglyceride concentration
Authors: JIANG Chong Yi , HAN Tian Quan , FENG Fei Ling , KONG Lei , CAI Xing Xing , ZHANG Sheng Dao
Published: January 2005

OBJECTIVE:  To evaluate the clinical characteristics of acute pancreatitis (AP) patients with elevated serum triglyceride (TG) concentration.

METHODS:  Ninety‐nine cases of AP admitted from January 2000 to January 2002 were analyzed: 28 cases comprised the TG‐elevated group (serum TG >1.7 mmol/L) and 71 cases were the TG‐normal group (serum TG ≤1.7 mmol/L).

RESULTS:  The AP patients with elevated serum TG accounted for 11.3% (9/80) of all AP cases during the study period. Pulmonary, cardiovascular and renal dysfunction within 72 h of onset of AP were all higher in the TG‐elevated group than in the group with normal TG (25.0% vs 1.4%; 17.9% vs 1.4%; 14.3% vs 1.4%, respectively; P < 0.05). The incidence of pancreatic pseudocyst was 53.6% and 4.2%, respectively, in the group with elevated TG and in the group with normal TG (P < 0.05).

CONCLUSIONS:  Patients with AP and elevated serum TG concentration have organ dysfunction at an earlier stage and increased local complications. Non‐surgical therapy was common for the majority of these patients.
Should we eradicate Helicobacter pylori infection in patients receiving nonsteroidal anti‐inflammatory drugs or low‐dose aspirin?
Authors: CHAN Francis KL
Published: January 2005

Whether Helicobacter pylori infection alters the risk of ulcer disease in patients receiving nonsteroidal anti‐inflammatory drugs (NSAIDs) or low‐dose aspirin is one of the most controversial topics in peptic ulcer research. This is an important management issue, particularly in countries where peptic ulcer disease is common and the prevalence of H. pylori infection is high. Current evidence shows that H. pylori infection increases the ulcer risk associated with NSAIDs or low‐dose aspirin. Eradication of H. pylori reduces the subsequent risk of endoscopic and complicated ulcers in patients who are about to start long‐term NSAIDs. Among patients with H. pylori infection and a history of ulcer bleeding who continue to use low‐dose aspirin, 1 week of eradication therapy prevents recurrent ulcer bleeding. Failure of eradication and concomitant use of NSAIDs, however, account for most cases of recurrent bleeding with low‐dose aspirin. The apparent protective effect of H. pylori in long‐term NSAIDs users reported in some studies was actually the weeding out of susceptible patients who were intolerant to NSAIDs. There is no convincing evidence that eradication of H. pylori has any clinically important adverse effect on the healing and prevention of ulcers in NSAIDs users.
A new statistical approach for assessing similarity of species composition with incidence and abundance data
Authors: Chao Anne , Chazdon Robin L. , Colwell Robert K. , Shen Tsung‐Jen
Published: January 2005

The classic Jaccard and Sørensen indices of compositional similarity (and other indices that depend upon the same variables) are notoriously sensitive to sample size, especially for assemblages with numerous rare species. Further, because these indices are based solely on presence–absence data, accurate estimators for them are unattainable. We provide a probabilistic derivation for the classic, incidence‐based forms of these indices and extend this approach to formulate new Jaccard‐type or Sørensen‐type indices based on species abundance data. We then propose estimators for these indices that include the effect of unseen shared species, based on either (replicated) incidence‐ or abundance‐based sample data. In sampling simulations, these new estimators prove to be considerably less biased than classic indices when a substantial proportion of species are missing from samples. Based on species‐rich empirical datasets, we show how incorporating the effect of unseen shared species not only increases accuracy but also can change the interpretation of results.
Predator effects on herbivore and plant stability
Authors: Halpern Benjamin S. , Borer Elizabeth T. , Seabloom Eric W. , Shurin Jonathan B.
Published: January 2005

Humans are rapidly altering the diversity and composition of ecological communities by accelerating rates of species extinctions and introductions. These changes in diversity are not random and disproportionately involve the addition or extinction of predators. Theoretical and microcosm studies suggest predator removal may either increase or decrease ecosystem stability. Here we test whether the addition or removal of predators affects aggregate biomass stability in 40 experiments carried out in six different ecosystems. Predators did not alter the temporal variability of autotroph biomass, but significantly destabilized herbivore biomass. The effects of predators on herbivore biomass stability varied significantly among ecosystems, with benthic and pelagic lake systems showing the greatest shifts. Consequently, the addition of predators to communities, as occurs in many conservation efforts, biological control programmes and species introductions, may lead to more variable system dynamics.
Effects of a belowground mutualism on an aboveground mutualism
Authors: Wolfe Benjamin E. , Husband Brian C. , Klironomos John N.
Published: January 2005

Studies of multitrophic interactions between below‐ and aboveground communities have generally focused on soil organisms and antagonists of plant shoots and leaves (herbivores). Despite the widespread occurrence of plant mutualists below‐ and aboveground which can occur on the same host plant, the potential for interactions between them has not been considered. Here we demonstrate that aboveground plant mutualists, insect pollinators, are strongly influenced by belowground plant mutualists, arbuscular mycorrhizal fungi. The presence of arbuscular mycorrhizal fungi in the roots ofChamerion angustifoliumincreased pollinator visitation and per cent seed set of this plant in the field by up to two times compared with non‐mycorrhizal plants. We propose that interactions between belowground and aboveground mutualisms are widespread and may play important functional roles in populations and communities.
Cost‐Effectiveness of Individual versus Group Psychotherapy for Sexually Abused Girls
Authors: McCrone Paul , Weeramanthri Tara , Knapp Martin , Rushton Alan , Trowell Judith , Miles Gillian , Kolvin Israel
Published: January 2005

Background:  Children who have been sexually abused may suffer from emotional and behavioural difficulties. Recent research found that individual and group psychotherapy have similar outcomes. In this study we compare the costs and cost‐effectiveness of the two therapies and support for carers.

Methods:  Subjects were recruited to two clinics in London and randomly allocated to the two treatments. The different components of each intervention were identified and costed.

Results:  Total mean costs of individual therapy were found to be £1246 greater than for group therapy. Costs as they would apply in routine practice were relatively unchanged. Group therapy was thus more cost‐effective than individual therapy.

Discussion:  Carefully considering the impact of different therapies could allow more treatment to be offered from available staff resources and budgets. However, this is a single small study and further work is required to strengthen the evidence‐base before change in practice is readily undertaken.
Initial Home Health Outcomes under Prospective Payment
Authors: Schlenker Robert E. , Powell Martha C. , Goodrich Glenn K.
Published: January 2005

Objective. To assess initial changes in home health patient outcomes under Medicare's home health Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services (CMS) in October 2000.

Data Sources/Study Setting. Pre‐PPS and early PPS data were obtained from CMS Outcome and Assessment Information Set (OASIS) and Medicare claims files.

Study Design. Regression analysis was applied to national random samples (n=164,810) to estimate pre‐PPS/PPS outcome and visit‐per‐episode changes.

Data Collection/Extraction Methods. Outcome episodes were constructed from OASIS data and linked with Medicare claims data on visits.

Principal Findings. Outcome changes (risk adjusted) were mixed and generally modest. Favorable changes included higher improvement rates under PPS for functioning and dyspnea, higher community discharge rates, and lower hospitalization and emergent care rates. Most stabilization (nonworsening) outcome rates also increased. However, improvement rates were lower under PPS for wounds, incontinence, and cognitive and emotional/behavioral outcomes. Total visits per episode (case‐mix adjusted) declined 16.6 percent although therapy visits increased by 8.4 percent.

Conclusions. The outcome and visit results suggest improved system efficiency under PPS (fewer visits, similar outcomes). However, declines in several improvement rates merit ongoing monitoring, as do subsequent (posthome health) hospitalization and emergent care use. Since only the early PPS period was examined, longer‐term analyses are needed.
The Determinants of Private Medical Insurance Prevalence in England, 1997–2000
Authors: King Derek , Mossialos Elias
Published: January 2005

Objective. The aim of this paper is to identify the factors that determine the prevalence of private medical insurance (PMI) in England.

Data Sources/Study Setting. Secondary data sources are the British Household Panel Survey (BHPS) 1997–2000, Laing's Healthcare Market Review 1999–2000, the United Kingdom (U.K.) Department of Health's National Health Service Waiting Times Team, and the Work Force Statistics Branch of the Department of Health.

Study Design. Logistic regression models for panel data were used to compare non‐PMI subscribers with individual subscribers and those with employer‐provided PMI.

Data Collection/Extraction Methods. The BHPS data are collected by the Institute for Social and Economic Research at the University of Essex. Other data used were collected by Laing and Buisson and the U.K. Department of Health.

Principal Findings. Individual PMI is more prevalent among the well‐educated and healthy. Income, age, sex, and political preference are key determinants of PMI prevalence for both individual and employer paid PMI. Individuals are also likely to reflect on information with regard to waiting times in deciding whether or not to purchase PMI cover. The withdrawal of the tax subsidy in 1997 to PMI subscribers over 60 years of age did not impact on their rate of withdrawal from PMI coverage relative to the rate among all PMI subscribers, but may have discouraged potential new subscribers.

Conclusions. Current trends in the PMI market suggest that, over time, individually purchased PMI is likely to be partially displaced by PMI purchased as part of a company‐based plan. However, having PMI is linked to economic factors in both groups, suggesting a similar segment of the population valuing the responsiveness that PMI provides. Geographic factors relating to waiting times and supply‐side factors are associated with both individual and company‐based PMI. The withdrawal of the tax subsidy to individual subscribers older than age of 60 resulted in a significant decline in the demand for PMI. In particular, the number of new subscribers in this group declined substantially.
Editorials: L‐Carnitine Supplementation in Dialysis Patients: Does the Evidence Justify Its Use?
Authors: Steinman Theodore I.
Published: January 2005

Beginning January 1, 2003, the Centers for Medicare and Medicaid Services (CMS) initiated a national coverage determination for the use of levo‐carnitine (L‐carnitine) in end‐stage renal disease (ESRD) patients as a supplement for individuals defined as having a carnitine deficiency, accompanied by either erythropoietin (EPO)‐resistant anemia and/or symptomatic intradialytic hypotension. The CMS criteria established for use of this supplement is minimal because EPO‐resistant anemia and symptomatic intradialytic hypotension are never defined with any degree of scientific rigor. Even with the minimal criteria, CMS rejected 97% of the claims submitted over the first 6 months of the national coverage. Most importantly, scientific studies to justify use of the supplement do not exist. Based on limited scientific investigations, there appears to be no justification for the government paying for this supplement. A randomized, prospective, controlled study is needed to determine if there is any benefit from L‐carnitine supplementation. Pending appropriate scientific proof, I do not believe that we should continue to waste our limited ESRD resources on a treatment of unproven benefit.