bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of direct immunofluorescence in predicting remission in pemphigus vulgaris
Authors: Balighi Kamran , Taheri Arash , Mansoori Parisa , Chams Cheida
Published: March 2006

Background  Pemphigus vulgaris is characterized by the presence of autoantibodies to desmogleins. Multiple relapses and remission may occur during the course of the disease. The goal of this study was to determine whether direct immunofluorescence study has any value in detecting immunological remission of pemphigus vulgaris.

Methods  Fifty‐seven patients with pemphigus vulgaris who were in clinical remission for at least 3 months, while taking prednisolone 5–7.5 mg/day, were recruited retrospectively for the study. Direct immunofluorescence study had been performed in all patients after a period of at least 3 months in clinical remission. Treatment had been discontinued in all patients with negative results of direct immunofluorescence.

Results  Of 57 patients who were in clinical remission, 24 patients (42%) had negative and 33 patients (58%) had positive results of direct immunofluorescence. Eleven patients (46%) with negative results of direct immunofluorescence relapsed within the first year of the follow‐up period. Nine patients with negative direct immunofluorescence had a history of more than 6 months of clinical remission before direct immunofluorescence study. Among them, two patients (22%) relapsed. None of four patients with history of more than 12 months of clinical remission before a negative direct immunofluorescence study relapsed.

Conclusions  Negative direct immunofluorescence is an indicator of immunological remission in patients with pemphigus vulgaris after 6–12 months in clinical remission.
Structural and Ultrastructural Study of the Intracranial Portion of the Oculomotor, Trochlear and Abducent Nerves in Dog
Authors: Vivo J. , Morales J. L. , Díz A. , Galisteo A. M. , Monterde J. G. , Agüera E. , Miró F.
Published: March 2006

The right intracranial portion of the oculomotor, trochlear and abducent nerves were removed from six adult German shepherd dogs and analysed by light and electron microscopy. In all cases the nerve sectional area was calculated. Unmyelinated and myelinated fibres were analysed and number, diameter and cross‐sectional area were calculated. In myelinated fibres, also calculated were the corresponding axon area and diameter, and myelin sheath thickness. The mean number of myelinated fibres was 8543.50 ± 1231.85 being the unmyelinated 1402 ± 241.58 in the oculomotor nerve; 1509 ± 223.17 and 287.67 ± 72.28 in the trochlear nerve and 2473.00 ± 211.41 and 231.25 ± 92.67 respectively in the abducent. The mean diameter was 10.23 ± 0.68 μm in myelinated and 0.43 ± 0.21 for unmyelinated in oculomotor nerve, 10.53 ± 0.55 μm and 0.33 ± 0.04 for the trochlear, and 10.45 ± 1.27 μm and 0.47 ± 0.09 in the abducent nerve respectively. This study reveals that oculomotor, trochlear and abducent nerves of the dog show structural and ultra‐structural features similar to the same nerves in other species.
Absence of Hyaline Cartilage in the Tongue of ‘Caspian Miniature Horse’
Authors: Rezaian M.
Published: March 2006

Histology of the tongue, including apex, root and body, in four adult Caspian miniature horses was examined. Serial sections with 6 μm thickness were stained with haematoxylin–eosin and Masson trichrome and studied under light microscope. The tongue was covered by stratified squamous epithelium. It was thick and keratinized bearing numerous lingual papillae on the dorsum, mostly filiform with a very fine keratinized thread projecting above the surface and bending backward. The fungiform papillae were sparsely scattered among the filiform papillae and covered with keratinized squamous epithelium. Few taste buds were detected on it. The two very large vallate papillae were detected on the dorsum, just rostral to the root, which were covered with stratified squamous epithelium with relatively high amounts of taste buds in the epithelium of the surrounding grooves. The foliate papillae were present near the palatoglossal arch and had a few taste buds. The epithelium covering the ventral surface of the tongue was thin and keratinized. The lingual muscle core consisted of transverse, longitudinal and perpendicular bundles of skeletal muscle fibres. Clusters of minor salivary glands were present between the muscle fibres and lamia propria. Most of the lingual glands were mucous and most of the gustatory ones were serous type. The mid‐dorsal special structure of the tongue (dorsal lingual cartilage) contained sparse skeletal muscle fibres and was rich in white adipose tissue. Hyaline cartilage, routinely observed in this structure in the horses, was not detected in Caspian miniature horse.
Computerized Three‐Dimensional Reconstruction of Cartilage Canals in Chick Tibial Chondroepiphysis
Authors: Eslaminejad M. R. B. , Valojerdi M. R. , Yazdi P. E.
Published: March 2006

Cartilage canals have been extensively investigated, in particular as to their mode of formation, morphologic distribution, function and fate. We studied the morphological pattern of the cartilage canals of the right upper chondroepiphysis of the tibia of chick embryos, Hamburger–Hamilton stages 35–42, in serial sagittal wax sections and in reconstructions made with AutoCAD software. The spatial arrangement of the canals is presented in a series of drawings made according to computerized images. The canals were penetrated from three distinct surfaces: the anterior and superior surfaces of the tubercle and the posterior surfaces of the medial and lateral condyles. Immediately after entering, nearly all the canals were extended toward the medial or lateral aspects of the chondroepiphysis, from which no canals took their origin. All of the cartilage canals connected with the perichondrium, and their branching did not follow a specific pattern. The condylar canals did not unite with the tubercular ones.
Endemic dwarf birchBetula apoiensis(Betulaceae) is a hybrid that originated fromBetula ermaniiandBetula ovalifolia
Authors: NAGAMITSU TERUYOSHI , KAWAHARA TAKAYUKI , KANAZASHI AYAKO
Published: March 2006

Betula apoiensis(Betulaceae), a tetraploid endemic to Mount Apoi in Hokkaido, is endangered in Japan. To reveal the origin of this species, the internal transcribed spacers and 5.8S gene of nuclear ribosomal DNA (ITS + 5.8S) and a microsatellite with its flanking region of nuclear DNA (Bp09) were sequenced and their haplotypes were determined for 12Betulaspecies in the Sakhalin, Hokkaido and Honshu Islands. The most parsimonious trees of ITS + 5.8S and Bp09 haplotypes had different topologies and no clades were consistent between the two trees. In both ITS + 5.8S and Bp09,B. apoiensisshared identical haplotypes withBetula ermaniiandBetula ovalifolia, and had haplotypes that appeared to have been derived from each of the two species. This result suggests thatB. apoiensisoriginated from hybridization betweenB. ermaniiandB. ovalifolia.
Effect of a multi‐stemmed growth form on matter production of an understory shrub, Stephanandra incisa
Authors: AIKAWA SHIN‐ICHI , HORI YOSHIMICHI
Published: March 2006

Developmental processes and biomass allocation of a multi‐stemmed shrub, Stephanandra incisa, were measured to reveal the advantages of a multi‐stemmed growth form on matter production. Stephanandra incisa is a low shrub species that mainly grows in the forest understory. The current‐year shoots become shorter by yearly branching that effectively increases the allocation ratio to photosynthetic organs. The frequency distribution of relative current‐year shoot length (the ratio of current‐year shoot length to stem length) in each ramet (a stem and its crown) of a clump (genet) were skewed to larger length classes in younger ramets and gradually skewed to shorter length classes in older ramets. The biomass allocation ratio of non‐photosynthetic organs to photosynthetic organs in ramets changed from a declining trend to a rising trend as the age of the ramets increased. The biomass allocation ratios of ramets and clumps increased with their size, but the ratio of clumps showed lower values than that of ramets of the same size. The age and size structures of ramets in clumps contributed to the narrow variability of the biomass allocation ratio. Stephanandra incisa showed a high biomass allocation ratio to leaves and maintained the ratio with a multi‐stemmed growth form.
Equity accounting adoption in regulated and unregulated settings: an empirical study
Authors: Morris Richard D. , Gordon Isabel
Published: March 2006

This article examines equity accounting adoption by Australian companies before and after standard AAS 14 (1984), the first standard on equity accounting in Australia. To bypass a legal constraint, AAS 14 and its successor ASRB 1016 (1989) required that equity accounting of associates appear in supplementary disclosures (third‐column or footnote) and not in consolidated accounts. Before AAS 14, extensive voluntary adoption of equity accounting occurred in consolidated accounts. Equity accounting adopters from 1971 to 1989 were matched in their adoption years with companies that could have used equity accounting but did not. Throughout, equity accounting adopters’ EPS tended to be declining and equity accounting adoption tended to increase reported earnings. After AAS 14, adopters showed equity accounting via a third column if it increased reported earnings but in footnote disclosures if it reduced reported earnings. Leverage is associated with adoption before but not after AAS 14, perhaps because the standards required equity accounting in supplementary disclosures which had no impact on borrowing constraints, while no such restriction on equity accounting existed before regulation. Pre‐AAS14 adopters tended not to be audited by large audit firms. Adopters after AAS 14 had higher ratios of investments in associates to total tangible assets; before AAS 14 they did not. The results are consistent with equity accounting being adopted opportunistically; there is limited evidence to support contractual efficiency motives.
Bury pacioli in africa: a bookkeeper's reification of accountancy
Authors: Sy Aida , Tinker Tony
Published: March 2006

The origins of accountancy are all too frequently equated with the antecedents of double‐entry bookkeeping, notwithstanding warnings from both Pacioli and Littleton to the contrary. It is ironic that Pacioli—the formalizer of double‐entry bookkeeping—is lionized today in the appellation, ‘Father of Accounting’. Here, we argue that this promotion of Pacioli the Technocrat fails to acknowledge incipient social aspects of his work (and that found in more ancient texts). Further, we contend that such reconstructions of Paciolian and ancient works are not entirely innocent. Rather, they fit nicely with a Eurocentric and post‐colonial ideology, which anoints with enthusiasm an Italian monk as accounting's premier contributor to modern civilization (sic). This view simultaneously construes other civilizations as underdeveloped, pre‐modern, and even barbaric (with the corollary of providing a moral pretext for invading, occupying and ‘saving’ a subjugated people). It should come as no surprise that Western accounting scholars haven't searched too hard for alternative ‘Fathers of Accounting’ among colonized civilizations. This article, in contrast to the orthodox wisdom, seeks to redeem Littleton's notion of ‘Accountancy’ in a way that encompasses the diversity of counting, measuring, recording, reporting and accountability that functioned in different ancient and contemporary social formations. Such a view introduces an older and richer lineage for accountancy—as a field that is, and always has been, integral to social, political and cultural life. In short, we propose burying Pacioli the Bookkeeper, and redeeming Pacioli the Social Actor, by explicating the social, cultural and political content inchoate in his work, and that found in even more explicit pre‐Paciolian ancient texts (particularly those from Africa, that reach back to the Dawn of Civilization).
Accounting for deferred tax in Japanese Banks and the consequences for their international operations
Authors: Gee Maria A. , Mano Tomoko
Published: March 2006

In recent years, financial reporting has changed in Japan towards the requirements of internationally recognized accounting standards. At the same time, banks suffered significant bad debts on their loans and it became difficult to maintain capital adequacy ratios at the level required for international operations. In this context, using as case studies the five major banking groups in Japan from 2002 to 2004, we address four related research questions concerned with the importance of deferred tax for the maintenance of regulatory capital. The responses of the government, regulatory agencies and auditors to problems with deferred tax accounting are also considered. We find that, without deferred tax assets, the five major banking groups would not have been allowed to operate internationally. We also suggest implications, and conclude that the solutions to these problems lie not just with the accounting profession but also with the government and regulatory agencies, as part of wider financial, rather than accounting, reform.
The Italian economia aziendale and chambers’ CoCoA
Authors: Capalbo Francesco , Clarke Frank
Published: March 2006

At first glance the Italian accounting tradition of Economia Aziendale and Chambers’ system of Continuously Contemporary Accounting (CoCoA) appear extreme opposites. The ex ante financial calculation of distributable income drawing on the net present values of the aggregative net assets in the former, and in the latter a system of accounting for an all‐inclusive income with the separable assets measured in terms of their current cash equivalents, appear irreconcilable, unlikely bedfellows. But the International Financial Reporting Standards present a system using separable and aggregative assets’ fair values and calculations of their net present values in assessing asset impairment. Whether Economia Aziendale and CoCoA are indeed so opposed deserves renewed examination.

Anglo‐American accounting, of which expositions of CoCoA are part, is said to lack a business economics tradition of the kind said to justify Economia Aziendale. This stands in stark contrast with European traditions manifested in the Dutch Bedrijfseconomie, the German Betriebswirtschaft, and the Italian Economia Aziendale.

This article seeks to understand that absence by contrasting—the Economia Aziendale framework and accounting theory developed in the Anglo‐American tradition. The primary elements of space and time coordination—the lynchpins of the pure theory of the azienda (the core of Economia Aziendale)—are generally regarded as missing in the Anglo‐American tradition. But the original construction of Economia Aziendale leads to the generalization that any attempt to determine a firm's value or to measure and analyse its performance during its lifetime would result in an unacceptable interruption of the space and time coordination, and yield unreliable results.

Curiously, the analysis here exposes an unexpected complementarity of Chambers’ CoCoA and some postulates of the pure theory of Economia Aziendale. The theory that has been only partially acceptable to the Anglo‐American profession (namely its use of market [fair] values) emerges as highly compatible with the most theoretically extreme in the Italian tradition.
Attenuation of contractility in rat epididymal vas deferens by Rho kinase inhibitors
Authors: Amobi N. I. B. , Chung I.‐P. , Smith I. C. H.
Published: March 2006

1 The involvement of Ca2+ sensitization mediated through Rho kinase in the contractility of rat epididymal vas deferens was investigated using Rho kinase inhibitors, trans‐4‐[(1R)‐1‐aminoethyl]‐N‐4‐pyridinilcyclohexanecarboxamide dihydrochloride (Y‐27632) and 1‐(5‐isoquinolinesulphonyl)homopiperazine (HA 1077), in comparison with myosin light chain kinase (MLCK) inhibitors, wortmannin and 1‐(5‐chloronaphthalenesulphonyl)homopiperazine (ML‐9) and agents that affect protein kinase C (PKC) and non‐receptor tyrosine kinase intracellular signalling.

2 In Ca2+‐free/ethyleneglycol‐bis‐(β‐aminoethylether)N,N,N′,N′‐tetraacetic acid (EGTA) (1 mm) medium, noradrenaline evoked sustained contractions. Y‐27632 and HA 1077 caused a concentration‐dependent inhibition and complete relaxation (IC50, 1.08 and 1.75 μm respectively). The Ca2+‐free contraction was reduced by wortmannin (10 μm) or ML‐9 (10 μm) but not by inhibitors of diacylglycerol metabolism, 3‐[2‐[4[bis(4‐Fluoropheny)methylene]‐1‐piperidinyl]‐2,3‐dihydro‐2‐thioxi‐4(H)‐quinazolinone (R59949) (10 μm) or 1,6‐bis(cyclohexyloximinocarbonylamino)hexane (RHC‐80267) (10 μm) or by the phospholipase A2 (PLA2) inhibitor, quinacrine (up to 100 μm) or tyrosine kinase inhibitor, genistein (30 μm).

3 In the presence of Ca2+ (2.5 mm), noradrenaline (100 μm) evoked rhythmic activity and biphasic tonic contractions. Y‐27632 (1–10 μm) or HA 1077 (1–10 μm) reduced the amplitude of rhythmic activity and tonic contractions. ML‐9 (10 μm) attenuated the occurrence of rhythmic activity and modestly reduced the tonic contractions. ML‐9 (10 μm) combined with Y‐27632 (10 μm) significantly reduced the tonic contractions. ML‐9 (30 μm) alone (or combined with Y‐27632 10 μm) suppressed the rhythmic activity and substantially reduced (or abolished) the tonic contractions.

4 Contractions evoked by high [K+]o (120 mm) or α,β‐methylene ATP (10 μm) were reduced significantly by Y‐27632 (1–3 μm) indicating that the Rho kinase signalling pathway is activated by direct tissue depolarization or by stimulation of ligand‐gated P2X purinoceptors.

5 Collectively, these results indicate that Ca2+‐sensitization mediated by Rho kinase is involved in agonist‐ or depolarization‐induced contraction of rat epididymal vas deferens. It is the major contractile mechanism underlying noradrenaline‐induced Ca2+‐free responses. It contributes to Ca2+‐dependent rhythmic contractility and optimizes the development of full contractile tension triggered through calmodulin/MLCK activation by stimulated influx of Ca2+.
Dopamine plasma membrane transporter (DAT) in rat thymus and spleen: an immunochemical and immunohistochemical study
Authors: Mignini F. , Traini E. , Tomassoni D. , Amenta F.
Published: March 2006

1 The expression of the dopamine plasma membrane transporter (DAT) was investigated in rat thymus and spleen by immunochemical and immunohistochemical techniques.

2 Antibodies raised against a peptide mapping near the amino terminus of DAT were bound to a single band of approximately 76 kDa in thymus and spleen membranes as well as in striatal and kidney membranes which were used as dopaminergic reference tissues.

3  Reverse transcription‐polymerase chain reaction analysis revealed that both thymus and spleen expressed DAT mRNA.

4 Immunohistochemistry revealed in rat thymus a DAT immune reaction in the wall of arteries located in septa of connective tissue as well as in the medulla, with a reticular localization and an apparent negative reaction of thymocytes.

5 In the spleen, DAT immunoreactivity was located primarily in the red‐white pulp marginal zone, within small cells, likely corresponding to lymphocytes and in the wall of white pulp arteries.

6 The presence of a dopamine transporter suggests that dopamine released in the lymphoid microenvironment may contribute to neuroimmune modulation. It cannot be excluded a different activity of dopamine in primary and secondary immune organs, such as maturation and selection of lymphocytes and activation of immune responses in the spleen.
Radioligand binding and functional responses of ligands for human recombinant adenosine A3receptors
Authors: Yates L. , Clark J. H. , Martin T. J. , James S. , Broadley K. J. , Kidd E. J.
Published: March 2006

1 The binding and functional properties of adenosine receptor ligands were compared in Chinese hamster ovary cells transfected with human adenosine A3receptors. Inhibition of [125I]‐aminobenzyl‐5′‐N‐methylcarboamidoadenosine ([125I]‐AB‐MECA) binding by adenosine receptor ligands was examined in membrane preparations. Inhibition of forskolin‐induced cAMP accumulation by agonists was measured using a cAMP enzyme immunoassay.

2 The rank order of agonist potency for both assays wasN6‐(3‐iodobenzyl)‐adenosine‐5′‐N‐methyluronamide (IB‐MECA) > 5′‐N‐ethylcarboxamidoadenosine (NECA) > (−)‐N6‐[(R)‐phenylisopropyl] adenosine (R‐PIA) > 4‐aminobenzyl‐5′‐N‐methylcarboxamidoadenosine (AB‐MECA) > N6‐cyclopentyl adenosine (CPA) > adenosine. The radioligand binding rank order of antagonist potency wasN‐[9‐chloro‐2‐(2‐furanyl)[1,2,4]‐triazolo[1,5‐c]quinazolin‐5‐benzeneacetamide (MRS1220) > 1,3‐dipropyl‐8‐cyclopentylxanthine (DPCPX) > 8‐phenyltheophylline (8‐PT) > 8‐(p‐sulfophenyl)‐theophylline (8‐SPT). MRS1220 competitively inhibited the effect of IB‐MECA on cAMP production, with aKBvalue of 0.35 nm. These data are characteristic of adenosine A3receptors.

3 The absence of Mg2+and presence of guanosine 5′‐(γ‐thio)triphosphate (GTPγS) significantly reduced agonist binding inhibition potency, indicating binding to high‐ and low‐affinity states. The IB‐MECA, NECA and R‐PIA IC50values were greater for the cAMP assay than for radioligand binding, suggesting an efficient stimulus–response transduction pathway.
Gender and United States Citizenship in Nation and Empire
Authors: McKenzie Beatrice
Published: March 2006

In the past twenty years, women’s history, ethnic studies, colonial studies, and labor history have so impacted the field of gender and citizenship that most new scholarship successfully incorporates issues of race, gender and, to a lesser extent, class. The study of sexuality and the impact of globalization on citizenship are important new directions for the field. A deep theoretical divide exists between those who believe that American citizenship has become progressively more inclusive over time and those who believe citizenship is based upon the exclusion of some to the detriment of all.
Women, Gender, and Rulership in Medieval Italy
Authors: Hurlburt Holly S.
Published: March 2006

This article addresses the multifaceted relationship between women and political power on the Italian peninsula during the emergence, flourishing and struggles of local powers, both communes and principalities. Natal and marital ties, widowhood, regency, intercession, patronage, and ritual were some of the devices by which women in this era of political changeability helped to forge political alliances, and ruled, represented, and influenced ruling bodies.
Exploration of the Evidence
Authors: Taylor Rod S. , Niv David , Raj Prithvi P.
Published: March 2006

Abstract:  Faced with rapidly escalating costs, healthcare policy makers are increasingly turning to research evidence to serve as a basis for their population‐based decisions on access and funding of new and existing therapies—health technology assessment. A two‐stage approach is often used to arrive at a policy recommendation for a given treatment. First, following a systematic review of literature, the “level of evidence” for the treatment is assessed according to epidemiological principles. Then a grade of policy recommendation is provided based on both the level of evidence and the applicability of the evidence to current clinical practice. To assess the current evidence basis for refractory neuropathic pain, a comprehensive search was undertaken for systematic reviews of pharmacological interventions and interventional procedures (ie, spinal cord stimulation, therapeutic blocks, radiofrequency procedures, and surgery). Of the 33 systematic reviews identified, the majority provided evidence for the use of drugs and spinal cord stimulation in the management of various neuropathic pain indications. Little evidence was found for either radiofrequency procedures or therapeutic blocks. By including randomized controlled trials, a number of these systematic reviews indicate a high grade of evidence. Nevertheless, more pragmatic clinical trials are needed to address the evidence needs of healthcare policy makers. These trials should address a direct comparison of the relative effectiveness of neuropathic pain therapies, particularly in combination with other therapies and at different points in the disease course.
Neural Modulation by Blocks and Infusions
Authors: Varrassi Giustino , Paladini Antonella , Marinangeli Franco , Racz Gabor
Published: March 2006

Abstract:  Neural blockade is widely used in clinical practice to alleviate acute or chronic pain, including neuropathic pain. However, to date there is little controlled evidence to confirm the efficacy of nerve blocks in neuropathic pain. The most common indication for nerve blocks, especially sympathetic blockade, is complex regional pain syndrome, in which success rates of up to 38% have been achieved, depending on the type of the block used. Greater efficacy has been achieved by combining a nerve block with patient‐controlled analgesia. Sympathectomy is recommended for the treatment of neuropathic pain only after careful consideration of its usefulness, effectiveness, and risk of adverse effects. Current evidence and clinical experience suggest that neural blockade could be a useful adjunct in the management of refractory neuropathic pain, but further well‐controlled studies would be of great benefit to support this type of therapy.
Drug Delivery Systems
Authors: Erdine Serdar , De Andrés José
Published: March 2006

Abstract:  Intrathecal drug delivery (IDD) is a proven and effective treatment alternative in carefully selected patients with chronic pain that cannot be controlled by a well‐tailored drug regime and/or spinal cord stimulation (SCS), and may be specifically trialed in patients who fail to respond to SCS. While the lack of randomized controlled trials is often perceived as a limitation of IDD, many studies attest to the efficacy of this therapy, and a number are large‐scale and with follow‐up periods of up to five years. Good to excellent pain relief is achieved in many patients who have failed more conservative therapies, and there is often a reduced need for analgesia. The advent of patient‐controlled analgesia allows flexibility of dosing according to the patient's needs. Consequently, quality of life improves in many patients and the majority express satisfaction with treatment. Some patients are able to return to work. The benefits of IDD (including a potent analgesic response with a more stable therapeutic drug level, decreased latency, increased duration of action, and decreased pharmacological complications) mean that side effects such as nausea, vomiting, sedation, and constipation are reduced. In addition, IDD demonstrates long‐term cost‐effectiveness when compared to conventional pain therapies, addressing a concern that affects many physicians in clinical practice today.
Grain‐Boundary Grooving of Plasma‐Sprayed Yttria‐Stabilized Zirconia Thermal Barrier Coatings
Authors: Erk Kendra A. , Deschaseaux Christophe , Trice Rodney W.
Published: March 2006

The focus of this study was to determine the mechanisms responsible for the microstructural changes of plasma‐sprayed 7 wt% Y2O3–ZrO2 thermal barrier coatings with annealing from 800° to 1400°C. Mullins's thermal grooving theories have been applied to plasma‐sprayed TBCs to determine the dominant mass transport mechanism at various temperatures. Grain‐boundary groove widths were measured as a function of annealing time and temperature using atomic force microscopy (AFM). The same collection of grains was analyzed after progressive heat treatments. Surface diffusion was found to be the dominant diffusion mechanism at 1000°C, corresponding to the disappearance of intralamellar cracks at that temperature. At 1100°C, both surface and volume diffusion were active. Volume diffusion, found to be the dominant diffusion mechanism at 1200°C and above, was responsible for the sintering of interlamellar pores observed from AFM analysis of a single, progressively heat‐treated interlamellar boundary. Surface roughening was observed to coarsen with increased annealing time and disappear with increased annealing temperature.
Surveillance of Infection Control Procedures in Dialysis Units in Japan: A Preliminary Study
Authors: Yanai Mitsuru , Uehara Yuki , Takahashi Susumu
Published: March 2006

Abstract:  As there is a high risk of indirect and direct transmission of infectious agents in chronic hemodialysis, infection control procedures should be established in dialysis units. This paper presents the findings of a questionnaire designed to survey the current status of infection control procedures in hemodialysis settings. Two hundred and forty‐three hemodialysis units in Japan were surveyed. Nearly 90% of hemodialysis units reported compliance with each procedure recommended by the Center for Disease Control and Prevention in the United States, including use of disposable gloves, handling of non‐disposable or non‐single‐use items, and routine serological testing of blood‐borne viruses. However, more than 50% of units reported that they did not comply with recommendations concerning some procedures, such as places for preparing medications and their delivery, clean areas in the units, vaccination for hepatitis B, and additional measures for hepatitis B surface antigen (HBs‐Ag) positive patients. Especially, the concept of universal precautions seemed to be misunderstood in units with a high prevalence of anti‐hepatitis C antibody‐positive (anti‐HCV Ab‐positive) patients. In conclusion, further intensive education and training will be necessary to establish infection control procedures.
Prognostic Factors for a Composite End‐Point of Renal Outcomes in Patients With Chronic Kidney Disease
Authors: Morita Satoshi , Fukuhara Shunichi , Akizawa Tadao , Asano Yasushi , Koshikawa Shozo , Koide Keizo , Kurokawa Kiyoshi
Published: March 2006

Abstract:  We aimed to investigate prognostic factors for a composite end‐point of end‐stage renal disease (ESRD) and the progression of renal disease in Japanese patients with chronic renal disease. Using a composite end‐point comprising a doubling of serum creatinine (sCr), an increase in sCr level to 6.0 mg/dL, or initiation of dialysis and renal transplantation caused by ESRD, we examined data obtained in a prospective cohort study. The present study consisted of 641 patients who were 20 years of age or older with chronic renal disease caused by diabetic nephropathy, glomerulonephritis, or nephrosclerosis, and who had baseline sCr levels of 5.0 mg/dL or less. The following criteria were examined as prognostic factors: sex; age; elapsed time from initial diagnosis; disease underlying the nephropathy (diabetic or non‐diabetic); complications with hypertension, hyperlipidemia, or anemia; baseline sCr level; therapeutic regimen, including use of ACE inhibitors or Ca2+‐channel blockers; and diet. A log‐rank test was used for univariate analysis, and Cox regression analysis was used for multivariate analysis. Underlying disease (diabetic or non‐diabetic), baseline sCr level, and Ca2+‐channel blocker therapy were significantly related to event incidence. In the present study, we identified underlying disease and baseline sCr level as important prognostic factors for a composite end‐point in a predialysis patient population in both the early and middle stages of renal disease. These factors should be considered as balancing variables for randomization in future clinical studies.
Leukocytapheresis for Ulcerative Colitis: A Comparative Study of Anticoagulant (Nafamostat Mesilate vs. Dalteparin Sodium) for Reducing Clinical Complications
Authors: Ashizuka Shinya , Nishiura Ryosuke , Ishikawa Naoto , Yamaga Junichi , Inatsu Haruhiko , Fujimoto Shouichi , Eto Tanenao
Published: March 2006

Abstract:  Leukocytapheresis (LCAP) is a therapeutic strategy for extra corporeal immunomodulation that has been used to treat several immunological disorders, including ulcerative colitis (UC), with encouraging results, inducing remission in steroid‐resistant patients. However, we have experienced some complications during or after LCAP therapy. Common adverse effects include fever, chills, nausea, vomiting, and hypotension. One of the reasons for these adverse effects might be the use of nafamostat mesilate (NM) as an anticoagulant. In the present study, 75 patients with UC were divided into two groups, an NM group and a dalteparin sodium (DS) group. The clinical efficacy of these treatments, improvement after treatment, changes in leukocyte differential count, and adverse effects after LCAP therapy were then compared. The clinical efficacy, improvement after treatment, and changes in leukocyte classification were not significantly different between the two groups, while some adverse effects were observed in the NM group but not in the DS group. In conclusion, LCAP therapy is a useful therapy for patients with moderate to severe UC who fail to respond to glucocorticoid therapy, however, a safe anticoagulant should be used to avoid its related adverse effects.
Low‐density Lipoprotein Apheresis Therapy With a Direct Hemoperfusion Column: A Japanese Multicenter Clinical Trial
Authors: Tasaki Hiromi , Yamashita Kazuhito , Saito Yasushi , Bujo Hideaki , Daida Hiroyuki , Mabuchi Hiroshi , Tominaga Yoshihiro , Matsuzaki Masunori , Fukunari Kenichi , Nakazawa Ryoichi , Tsuji Masahiro , Kawade Yasumasa , Yamamoto Shigeo , Ueda Yukio , Takayama Kimihiro
Published: March 2006

Abstract:  Low‐density lipoprotein (LDL) apheresis has been applied to patients with familial hypercholesterolemia (FH) with coronary artery disease (CAD). To examine the efficacy and safety of a new type of LDL adsorption column (KLD01, Kaneka, Osaka, Japan), which deals with whole blood without separating plasma, the new system was evaluated in a multicenter trial. The present study included 33 FH patients with CAD (24 males, 9 females, 57 ± 13 years) who were treated five times with a mean interval of 2.12 ± 0.60 weeks between treatments. We studied the removal efficacies for serum LDL cholesterol, Lipoprotein(a) (Lp(a)) and triglyceride, the times for the preparation of the system and for treatment, symptoms, and the biochemical data. The scheduled treatments were completed by 31 patients. Serum levels of LDL cholesterol, Lp(a) and triglycerides were all significantly reduced with KLD01; 61.5 ± 6.2%, 72.4 ± 5.9% and 69.5 ± 9.7%, respectively. The times for both setting up the column system (26 ± 7 min) and treatment (138 ± 20 min) were shorter with KLD01 than conventional methods. Adverse reactions occurred in eight cases (17 episodes), but the patients fully recovered immediately after each apheresis therapy session. We conclude that the new type of LDL adsorption column, one that deals with whole blood, is a promising apheresis therapy for FH patients in view of its efficacy, reduced time for treatment, and safety.
The Effect of Continuous Veno‐Venous Hemofiltration or Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber on Neutrophil Respiratory Oxidative Burst in Patients With Sepsis and Septic Shock
Authors: Naka Toshio , Shinozaki Masahiro , Akizawa Tadao , Shima Yukihiro , Takaesu Hideki , Nasu Hideki
Published: March 2006

Abstract:  Neutrophil activates and injures tissues and organs during sepsis or septic shock. Blood purification therapies such as continuous veno‐venous hemofiltration (CVVH) and direct hemoperfusion with polymyxin‐immobilized fiber (PMX‐DHP) have been used for the treatment of sepsis and septic shock, however, the effects of such therapies on neutrophil activation have previously been poorly understood. We sought to evaluate neutrophil reactive oxygen species (ROS), especially H2O2 production, in the pathophysiology of sepsis or septic shock and the effect of CVVH or PMX‐DHP on neutrophil ROS. Seven critically ill septic patients requiring CVVH (and 12 matched septic patients who did not require CVVH as control) and seven septic shock patients treated with PMX‐DHP were studied. We found that patients with sepsis or septic shock had significantly higher levels of neutrophil ROS compared with normal volunteers (183 ± 42, 292 ± 90, and 103 ± 30) (P < 0.05, and <0.005). Neutrophil ROS did not change over time in patients treated either with CVVH or without CVVH. In contrast, neutrophil ROS significantly inhibited PMX‐DHP treatment in patients with septic shock (pretreatment; 292 ± 88 vs. post‐treatment; 205 ± 93, P < 0.05). In conclusion, neutrophil ROS was significantly enhanced in the sepsis or septic shock affected patients. CVVH did not affect neutrophil ROS while PMX‐DHP significant inhibited neutrophil ROS.
Blood Purification for Critical Illness: Cytokines Adsorption Therapy
Authors: Tsuchida Kenji , Yoshimura Rikio , Nakatani Tatsuya , Takemoto Yoshiaki
Published: March 2006

Abstract:  Blood purification therapies have been clinically applied to treat cytokine‐induced pathological effects. The effects of broad‐spectrum adsorption using Lixelle (β2‐microglobulin adsorption column; Kaneka Corporation, Osaka, Japan) for the condition of hypercytokinemia in vitro, in an animal model and in humans with sepsis were investigated. We found that Lixelle could selectively adsorb not only β2‐microglobulin but also cytokines composed of glycoproteins in vitro. In addition, Lixelle beads could adsorb not only endotoxin (ET) but also microbial fragments such as peptidoglycan (PG) which is a component of Gram‐positive bacteria. Hypercytokinemic rats were connected to a direct hemoperfusion (DHP) system using a mini Lixelle column and time‐course changes in plasma levels of inflammatory cytokines were examined. In addition, a Lixelle column was used in direct hemoperfusion in patients with systemic inflammatory response syndrome (SIRS), and the relationship between a decrease in cytokines and clinical course was examined. The increases in plasma levels of IL‐6 and tumor necrosis factor‐alpha (TNF‐α) were significantly inhibited in the group treated with the Lixelle column in an animal model. In humans with sepsis, for IL‐1β, IL‐1Ra, IL‐6, IL‐8, and TNF‐α, the adsorbing rates in vivo before and after the use of the Lixelle column tended to decrease with time. However, the reduction rates at 5 min after the start were 31.4, 39.3, 36.4, 76.2 and 71.6%, respectively, and at 3 h after the start, the rates were 18.0, 17.7, 12.9, 31.8, and 32.9%, respectively. Clinically, their blood pressure increased and they recovered from shock status. These results suggest that SIRS and sepsis with hypercytokinemia can be treated with the DHP using the Lixelle column.
Effects of Immunoadsorption on the nt‐BNP and nt‐ANP Plasma Levels of Patients Suffering From Dilated Cardiomyopathy†
Authors: Staudt Alexander , Staudt Yvonne , Hummel Astrid , Empen Klaus , Dörr Marcus , Trimpert Christiane , Birkenmeier Katrin , Kühl Uwe , Noutsias Michel , Russ Dirk , Felix Stephan B
Published: March 2006

Abstract:  Immunoadsorption (IA) represents an additional therapeutic approach in patients with severe heart failure due to dilated cardiomyopathy (DCM). nt‐BNP and nt‐ANP plasma levels are prognostic markers in patients with heart failure. The effect of IA on nt‐BNP and nt‐ANP plasma levels is unknown. In this case control study, 30 patients suffering from severe heart failure (LVEF < 35%) due to DCM were included. In 15 patients, IA was carried out in four courses of monthly intervals until month 3. For analysis of the acute and prolonged effects, the plasma levels of nt‐BNP and nt‐ANP were determined before and after each IA course. In 15 comparable DCM patients (controls), plasma levels of nt‐BNP and nt‐ANP were determined at baseline and after 3 months. LVEF remained stable during this study in the control group. In contrast, in the IA group after 3 months, LVEF increased from 29.7 ± 1 to 38.6 ± 2%, P < 0.001. In the control group, the nt‐BNP and nt‐ANP plasma levels remained stable during the 3 months of the study. In the IA group after the first IA course, the level of nt‐BNP was acutely reduced from 1501 ± 328 to 925 ± 151 fmol/mL, P < 0.01. In addition, the nt‐ANP level was reduced from 4439 ± 1271 to 2897 ± 825 fmol/mL, P < 0.01. In the IA group, the reduction of these two parameters remained detectable after 3 months before the last course: nt‐BNP: 714 ± 119 fmol/mL, nt‐ANP: 2227 ± 427 fmol/mL, P < 0.05. The improvement of left ventricular function during IA is accompanied by a reduction of nt‐BNP and nt‐ANP plasma levels in patients with DCM.
Effects of Extracorporeal Treatment With Lixelle on the Mortality and Inflammatory Responses to Endotoxin‐Induced Shock in Rats
Authors: Tsuda Kazunobu , Taniguchi Takumi
Published: March 2006

Abstract:  Endotoxemia and endotoxic shock are common problems in intensive care units and are associated with a very high mortality. Several previous studies have shown that Lixelle, which absorbs beta2‐microglobulin for the treatment of dialysis‐related amyloidosis, is also useful for the adsorption of inflammatory cytokines and endotoxins. The current study examined the use of Lixelle and its effects on the mortality and inflammatory responses to endotoxin‐induced shock in rats. Male Sprague‐Dawley rats were anesthetized and assigned to one of four groups (N = 13 per group): Escherichia coli endotoxin (15 mg/kg, i.v.) alone (endotoxemic); direct hemoperfusion apheresis without Lixelle for 120 min (direct hemoperfusion (DHP) alone); Lixelle treatment with Lixelle for 120 min immediately after endotoxin injection (Lixelle treatment); or Lixelle treatment with Lixelle for 120 min 2 h after endotoxin injection (Lixelle post‐treatment). Hemodynamics and plasma lactate and cytokine concentrations were measured during observation. Mortality was assessed up to 8 h after the endotoxin injection. The mortality rates at 8 h after endotoxin injection were 92%, 85%, 23% and 46% for the endotoxemic, DHP‐alone, Lixelle treatment, and Lixelle post‐treatment groups, respectively. Elevated plasma cytokine concentrations were less conspicuous in the Lixelle treatment group than in the other three groups. Thus, Lixelle treatment drastically reduced the high mortality and the inflammatory responses in endotoxin‐exposed rats. Moreover, Lixelle post‐treatment also suppressed hypotension and a high mortality, although the inflammatory responses were the same as for endotoxin alone. These findings indicate that Lixelle treatment might be an effective therapy for endotoxemia and endotoxic shock.
The Bookmark Standard‐Setting Method: A Literature Review
Authors: Karantonis Ana , Sireci Stephen G.
Published: March 2006

The Bookmark method for setting standards on educational tests is currently one of the most popular standard‐setting methods. However, research to support the method is scarce. In this report, we review the published and unpublished literature on this method as well as some seminal work in the area of evaluating standard‐setting studies. Our review highlights both strengths and limitations of the method. Strengths include its wide acceptance and panelist confidence in the method. Limitations include a potential bias to produce lower‐than‐intended standards and problems in selecting the most appropriate response probability value for ordering the items presented to panelists. It is clear that more research on this method is needed to support its wide use. Several areas for future research to better understand the validity of the Bookmark method for setting standards on educational tests are presented.
The Use of Generalizability (G) Theory in the Testing of Linguistic Minorities
Authors: Solano–Flores Guillermo , Li Min
Published: March 2006

We contend that generalizability (G) theory allows the design of psychometric approaches to testing English‐language learners (ELLs) that are consistent with current thinking in linguistics. We used G theory to estimate the amount of measurement error due to code (language or dialect). Fourth‐ and fifth‐grade ELLs, native speakers of Haitian‐Creole from two speech communities, were given the same set of mathematics items in the standard English and standard Haitian‐Creole dialects (Sample 1) or in the standard and local dialects of Haitian‐Creole (Samples 2 and 3). The largest measurement error observed was produced by the interaction of student, item, and code. Our results indicate that the reliability and dependability of ELL achievement measures is affected by two facts that operate in combination: Each test item poses a unique set of linguistic challenges and each student has a unique set of linguistic strengths and weaknesses. This sensitivity to language appears to take place at the level of dialect. Also, students from different speech communities within the same broad linguistic group may differ considerably in the number of items needed to obtain dependable measures of their academic achievement. Whether students are tested in English or in their first language, dialect variation needs to be considered if language as a source of measurement error is to be effectively addressed.
Blood flow to the promontory in cochlear otosclerosis
Authors: Nakashima T. , Sone M. , Fujii H. , Teranishi M. , Yamamoto H. , Otake H. , Sugiura M. , Naganawa S.
Published: March 2006

Objective:  To investigate Schwartze sign with measurements of blood flow to the promontory in patients with cochlear otosclerosis.

Design:  Prospective clinical study.

Setting:  Tertiary referral centre.

Participants:  Five patients with cochlear otosclerosis and five control subjects. Significant decalcification around the cochlea was observed by computed tomography (CT) in patients with cochlear otosclerosis. However, no recognizable lesion was observed at the oval window in two patients. One patient had mixed hearing loss and four patients had sensorineural hearing loss without an air–bone gap.

Main outcome measures:  The relationship between CT findings and the presence or absence of Schwartze sign was investigated. Blood flow to the promontory was measured through the tympanic membrane using laser speckle flowgraphy and laser Doppler flowmetry.

Results:  The Schwartze sign correlated significantly with otosclerotic lesions invading the promontory. Patients with otosclerosis exhibited elevated and pulsating blood flow to the promontory with the Schwartze sign.

Conclusions:  Computed tomography demonstrated that cochlear otosclerosis can exist without the oval window lesion. Schwartze sign can be used as a sign of the otosclerotic invasion to the promontory. The reddening of the Schwartze sign is likely due to increased blood flow.
How we do it: Technical note: endoscopic removal of cerumen
Authors: Pothier D.D.
Published: March 2006

Keypoints

• Syringing of ears to remove cerumen is losing favour in primary care owing to the fact that it is carried out ‘blind’ and that the potential exists for serious complications.

• Dewaxing under direct vision is difficult without a microscope.

• A technique is described where wax is removed under direct vision using a rigid endoscope in conjunction with a Jobson–Horne probe and St Bartholomew's wax hook.

• This is a relatively inexpensive technique that could be introduced to primary care practitioners or to ENT surgeons who do not have easy access to an operating microscope in the outpatient department.