bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet degranulation and monocyte–platelet complex formation are increased in the acute and convalescent phases after ischaemic stroke or transient ischaemic attack
Authors: McCabe Dominick J. H. , Harrison Paul , Mackie Ian J. , Sidhu Paul S. , Purdy Gordon , Lawrie Andrew S. , Watt Hilary , Brown Martin M. , Machin Samuel J.
Published: June 2004

Flow cytometric studies suggest that platelets are activated in ischaemic stroke or transient ischaemic attack (TIA). However, few studies have measured circulating leucocyte–platelet complexes in this patient population. Whole blood flow cytometry was used to quantify the expression of CD62P‐, CD63‐, and PAC1‐binding, and the percentages of leucocyte–platelet complexes in acute (1–27 d, n = 79) and convalescent (79–725 d, n = 70) ischaemic cerebrovascular disease (CVD) patients compared with controls without CVD (n = 27). We performed a full blood count, and measured plasma levels of soluble P‐selectin, soluble E‐selectin, and von Willebrand factor antigen (VWF:Ag) as additional markers of platelet and/or endothelial cell activation. The median percentage CD62P expression and the median percentage monocyte–platelet complexes were higher in both acute and convalescent CVD patients than controls (P ≤ 0·02). The mean white cell count and mean VWF:Ag levels were significantly elevated in the acute and convalescent phases after ischaemic stroke or TIA (P ≤ 0·02). Otherwise, there was no significant increase in any other marker of platelet or endothelial activation in CVD patients. There was a positive correlation between the percentage expression of CD62P and the percentages of both neutrophil–platelet and monocyte–platelet complexes in the acute phase, and the percentages of all leucocyte–platelet complexes in the convalescent phase after ischaemic CVD. This study provides evidence for ongoing excessive platelet and/or endothelial activation in ischaemic CVD patients despite treatment with antithrombotic therapy.
Nursing care at night: an evaluation using the Night Nursing Care Instrument
Authors: Oléni Magnus , Johansson Peter , Fridlund Bengt
Published: May 2004

Introduction.  Night nurses carry overall nursing responsibility for approximately half the time that patients spend in hospital. However, there is a paucity of literature that focuses on nursing care provided at night.

Aim.  The aim of this study was to evaluate nursing care provided at night from the perspective of both nurses and patients.

Methods.  The study, which had an evaluative and a comparative design, was carried out using the Night Nursing Care Instrument at a hospital in southern Sweden. Nurses (n = 178) on night duty were consecutively selected, while the patients (n = 356) were selected by convenience sampling.

Results.  The results showed a statistically significant difference between nurses’ assessments and patients’ perceptions of the nursing care provided at night in nursing interventions (P < 0·0001). In the areas of medical interventions and evaluation, no statistically significant differences were found between nurses and patients. For eight of 11 items, patients reported that they were satisfied (≥80%) with the nursing care provided at night.

Conclusions.  These findings suggest that night nurses need to improve their ability to assess patients’ needs for nursing care at night. A first step in this direction is for them to become aware of how patients perceive night nursing. As a second step, nurses need to increase their knowledge of which nursing actions promote patients’ rest at night.
Midlife experiences of Thai women
Authors: Arpanantikul Manee
Published: May 2004

Background.  Midlife is not a universal notion because the conception of midlife arises from specific historical and social conditions. This can be a challenging time for women; however, the study of Thai women in the middle years has received relatively little attention.

Aim.  This paper reports a study exploring the meaning of midlife to Thai women currently residing in Bangkok.

Method.  The integration of Heideggerian phenomenology and feminist theory guided data collection. Experiential understanding of midlife phenomena was obtained through interviewing 32 Thai women with diverse educational and socioeconomic backgrounds. Each description was analysed to identify themes pertinent to the individual midlife experience. Emergent themes were extracted from the similarities and differences across descriptions to depict the broad points of view of women's midlife experiences.

Findings.  Five collective themes were identified: being stereotyped, transforming, being vulnerable to poor health, adapting, and thinking ahead.

Conclusion.  The findings reflected the fact that these women's midlife experiences were the product of the interrelationship of biological, psychological, and sociocultural factors. Awareness of these interrelationships in mind could enrich understanding of midlife experience in women, guide family members and friends in supporting midlife women, including helping to uphold their dignity, and raise the consciousness of health planners and health care professionals for developing effective programmes and interventions to promote wellness for Thai midlife women. The findings could help nurses to build their practice on a significant philosophical foundation and increase their sensitivity with regard to holistic care for midlife women.
Groningen Orthopaedic Social Support Scale: validity and reliability
Authors: Van Den Akker‐Scheek Inge , Stevens Martin , Spriensma Alette , Van Horn Jim R.
Published: May 2004

Background.  Social support is an important factor in the rehabilitation process, as it has a positive influence on patients’ health, functioning and recovery. In particular, perceived social support and instrumental support are important after total hip or knee arthroplasty. However, nursing staff often appear to estimate the amount of support available to patients by number of visitors. Until now, no suitable Dutch‐language scale was available to measure social support in orthopaedic patients.

Aim.  The aim of this paper is to describe the development and initial validity and reliability testing of the Groningen Orthopaedic Social Support Scale, a self‐report questionnaire to measure social support in patients after total hip or knee arthroplasty.

Methods.  A total of 119 people who had had arthroplasty completed the Groningen Orthopaedic Social Support Scale and a control scale. The reliability and validity of the questionnaire were analysed.

Results.  Reliability of the Groningen Orthopaedic Social Support Scale can be considered satisfactory, with a Cronbach's alpha of 0·89. Analysis of construct validity by means of factor analysis yielded two factors: perceived social support and instrumental support. A Pearson's correlation between these subscales was moderate (r = 0·61 and statistically significant). Concurrent validity can be considered satisfactory, with a Pearson correlation of 0·72 (P < 0·001) between the Groningen Orthopaedic Social Support Scale and the control list.

Conclusions.  The Groningen Orthopaedic Social Support Scale can be considered suitable for measuring social support. It can be used to help nursing staff determine if a patient's need for social support is fulfilled, and to advise family and friends on the basis of the results. The questionnaire can also be used to establish the role of social support as a factor in supportive interventions during and after hospital stay.
What counts as evidence in evidence‐based practice?
Authors: Rycroft‐Malone Jo , Seers Kate , Titchen Angie , Harvey Gill , Kitson Alison , McCormack Brendan
Published: May 2004

Background.  Considerable financial and philosophical effort has been expended on the evidence‐based practice agenda. Whilst few would disagree with the notion of delivering care based on information about what works, there remain significant challenges about what evidence is, and thus how practitioners use it in decision‐making in the reality of clinical practice.

Aim.  This paper continues the debate about the nature of evidence and argues for the use of a broader evidence base in the implementation of patient‐centred care.

Discussion.  Against a background of financial constraints, risk reduction, increased managerialism research evidence, and more specifically research about effectiveness, have assumed pre‐eminence. However, the practice of effective nursing, which is mediated through the contact and relationship between individual practitioner and patient, can only be achieved by using several sources of evidence. This paper outlines the potential contribution of four types of evidence in the delivery of care, namely research, clinical experience, patient experience and information from the local context. Fundamentally, drawing on these four sources of evidence will require the bringing together of two approaches to care: the external, scientific and the internal, intuitive.

Conclusion.  Having described the characteristics of a broader evidence base for practice, the challenge remains to ensure that each is as robust as possible, and that they are melded coherently and sensibly in the real time of practice. Some of the ideas presented in this paper challenge more traditional approaches to evidence‐based practice. The delivery of effective, evidence‐based patient‐centred care will only be realized when a broader definition of what counts as evidence is embraced.
Competition for attachment of aquaculture candidate probiotic and pathogenic bacteria on fish intestinal mucus
Authors: Vine N G , Leukes W D , Kaiser H , Daya S , Baxter J , Hecht T
Published: May 2004

Probiotics for aquaculture are generally only selected by their ability to produce antimicrobial metabolites; however, attachment to intestinal mucus is important in order to remain within the gut of its host. Five candidate probiotics (AP1–AP5), isolated from the clownfish, Amphiprion percula (Lacepéde), were examined for their ability to attach to fish intestinal mucus and compete with two pathogens, Aeromonas hydrophila and Vibrio alginolyticus. Two different radioactive isotopes were used to quantify competition between pathogens and probionts. Attachment of the pathogens was enhanced by the presence of the candidate probiotics. However, the addition of the candidate probiotics after the pathogens resulted in reduced pathogen attachment. Only AP5 caused lower attachment success of V. alginolyticus when added before the pathogen. When AP5 was added first, the average attachment change was 41% compared with 72% when added after V. alginolyticus, suggesting that the probiotic is displaced but that enhanced attachment of the pathogen does not occur. Conversely, when V. alginolyticus was added first, followed by AP5, attachment change was 37% while AP5 had 92% attachment change when added second. This implies that the pathogen was displaced by the candidate probiotic and therefore it appeared that, based on the ability of probiont AP5 to attach to mucus, the growth of the pathogen in the digestive tract might be suppressed by the candidate probiont's presence.
The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review
Authors: Wulffelé M. G. , Kooy A. , de Zeeuw D. , Stehouwer C. D. A. , Gansevoort R. T.
Published: June 2004

Background.  The UKPDS 34 showed that intensive treatment with metformin significantly reduces macrovascular end‐points and mortality in individuals with newly diagnosed type 2 diabetes compared with intensive treatment with insulin or sulphonylurea derivatives, despite similar glycaemic control. How this should be explained is as yet unclear. We hypothesized that metformin may have a glucose‐lowering independent effect on blood pressure and lipid profile. In order to test this hypothesis we systematically reviewed the literature and pooled the data obtained in a meta‐analysis.

Methods.  Included were randomized‐controlled trials in patients with type 2 diabetes mellitus and metformin treatment lasting at least 6 weeks. To identify all eligible trials we conducted electronic searches using the bibliographic databases Medline and Embase, contacted the manufacturer and checked obtained publications for cross‐references.

Results.  Forty‐one studies (3074 patients) provided data on blood pressure and/or lipid profile. When compared with control treatment, metformin associated effects on systolic and diastolic blood pressure and HDL cholesterol were small and statistically not significant [−1.09 mmHg 95% confidence interval (−3.01–0.82), P = 0.30; −0.97 (−2.15–0.21) mmHg, P = 0.11 and +0.01 (−0.02–0.03) mmol L−1, P = 0.50, respectively]. Compared with control treatment, however, metformin decreased plasma triglycerides, total cholesterol and LDL cholesterol significantly [−0.13 (−0.21–−0.04) mmol L−1, P = 0.003; −0.26 (−0.34–−0.18) mmol L−1, P < 0.0001 and −0.22 (−0.31–−0.13) mmol L−1, P < 0.00001, respectively]. We found no indications for publication bias. Of note, glycaemic control as assessed by HbA1c was better with metformin than with control treatment [−0.74 (−0.84–−0.65) percentage point; P < 0.00001]. When studies were subdivided into tertiles according to increasing difference in glycaemic control between metformin and control treatment, it appeared that in case of near similar glycaemic control metformin had no effect versus control treatment on triglycerides, whereas still there was a significant effect on total and LDL cholesterol.

Conclusions.  This meta‐analysis of randomized‐controlled clinical trials suggests that metformin has no intrinsic effect on blood pressure, HDL cholesterol and triglycerides in patients with type 2 diabetes. This drug, however, independent of its effect on glycaemia, reduces total and LDL cholesterol significantly, but the reductions in these variables are relatively small.
Lipoprotein lipase gene variants and progression of nephropathy in hypercholesterolaemic patients with type 2 diabetes
Authors: Solini A. , Passaro A. , Fioretto P. , Nannipieri M. , Ferrannini E.
Published: June 2004

Objective.  Recent prospective studies have identified hyperlipidaemia as an independent determinant of diabetic nephropathy. Lipoprotein lipase (LPL) is a key enzyme in the postprandial processing of triglycerides and VLDL. Among a number of common sequence variants of the LPL, HindIII has been associated with coronary heart disease and, more recently, with microalbuminuria in type 2 diabetes. We evaluated the progression of renal disease in hypercholesterolaemic type 2 diabetic patients in relation to this polymorphism.

Design and subjects.  We followed up for 4 years 65 consecutively enrolled microalbuminuric patients with type 2 diabetes; of whom 28 had hypercholesterolaemia (6.62 ± 0.9 mmol L−1, group A) and 37 were normocholesterolaemic (4.68 ± 0.5 mmol L−1, group B).

Main outcome measures.  After performing the genetic analyses, albumin excretion rate (AER) and estimated glomerular filtration rate (GFR), calculated by the simplified equation of the MDRD Study Group, were repeated every year.

Results.  In group A, AER increased more (∂AER: 11 [38] vs. 4 [18] μg min−1 per year in group B, P < 0.0001) while GFR declined faster (−3.5 ± 2.1 vs. −2.0 ± 1.4 mL min−1 per year, P < 0.02). Patients homozygous for the allele + of HindIII showed a significantly faster decline of GFR and a higher increase of AER (both P = 0.0001) even after adjustment for cholesterol levels and anthropometric variables.

Conclusions.  In hypercholesterolaemic type 2 diabetic patients with microalbuminuria, the renal disease has an accelerated course, particularly in those carrying the H+/H+ genotype of the HindIII polymorphism at the LPL locus.
The incidence and survival of acute de novo leukaemias in Estonia and in a well‐defined region of western Sweden during 1982–1996: a survey of patients aged ≥65 years
Authors: Luik E. , Palk K. , Everaus H. , Varik M. , Aareleid T. , Wennström L. , Juntikka E.‐L. , Safai‐Kutti S. , Stockelberg D. , Holmberg E. , Kutti J.
Published: June 2004

Objectives.  To compare the incidence and survival of acute de novo leukaemias with particular reference to political/socio‐economic and environmental factors in two neighbouring countries over the three 5‐year periods (1982–1996).

Patients.  The present report covers only patients diagnosed when aged ≥65 years.

Setting.  A well‐defined area of Sweden, the so‐called Western Swedish Health Care Region and Estonia. Population‐wise, the western Swedish Region and Estonia are very similar; area‐wise they are also well comparable.

Results.  The number of acute de novo leukaemias was quite dissimilar in the two countries (Estonia, n = 137, Sweden, n = 354). The age standardized incidence rates regarding the total number of acute de novo leukaemias was 5.31 per 100 000 inhabitants/year for Estonia and 7.99 for Sweden, this difference being statistically significant. However, the difference was merely attributable to incidence rates as regards acute myeloblastic leukaemias (AML); on the contrary, differences as regards acute lymphoblastic leukaemias (ALL) and non‐classifiable, undifferentiated or biphenotypic acute leukaemias (uAL) were negligible. The relative survival for the total material of patients was significantly higher for Swedish when compared with Estonian patients (P < 0.001). Thus, the relative survival for the total material of patients aged ≥65 years in Estonia at 1 year was 8.5% and at 3 years 3.5% respectively. The corresponding figures for the Swedish patients were considerably higher, 22.7 and 7.7% respectively. This difference, however, applied only for patients with AML (P < 0.001), whereas the results for patients with ALL and uAL were equally dismal.

Conclusion.  The results clearly reflect how political and socio‐economic factors may influence the survival of acute leukemia patients in two neighbouring countries.
Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease
Authors: Førli L. , Halse J. , Haug E. , Bjørtuft Ø. , Vatn M. , Kofstad J. , Boe J.
Published: June 2004

Objective.  To study the influence of underweight, body composition and vitamin D deficiency on bone mineral density in patients with advanced pulmonary disease.

Design.  Cross‐sectional study with time span for inclusion set at 5 years.

Setting.  The clinical work and biochemical analyses were carried out at Rikshospitalet University Hospital, Norway. Analyses for vitamin D metabolites and bone markers were carried out at Aker University Hospital, and bone measurements at Clinic of Osteoporosis.

Subjects.  Seventy‐one candidates for lung transplantation (63% chronic obstructive pulmonary disease, 42 underweight and 29 normal weight) were included.

Main outcome measures.  Body composition, bone mineral density at lumbar spine and femur neck, serum concentration of calcidiol and vitamin D intake.

Results.  Subnormal calcidiol levels were present in 52% of the underweight patients and 69% of the normal‐weight patients. The resulting models of linear regression showed that for the lumbar spine T scores model, the total variation of 16.7% was explained by group (underweight/normal weight), sex and age. For the femur neck T scores model, the total variation of 20.4% was explained by the interaction of underweight and vitamin D deficiency (with borderline significance) and by arm muscle circumference percentage of standard. In patients with normal calcidiol levels, the median intake of vitamin D was 17 μg in the underweight patients and 11 μg in the normal‐weight patients.

Conclusions.  Vitamin D deficiency was common in both underweight and normal‐weight patients, but only in the underweight patients, an association between vitamin D deficiency and reduced femur neck T scores was indicated.
Estimation of glomerular filtration rate in the elderly: a comparison of creatinine‐based formulae with serum cystatin C
Authors: Wasén E. , Isoaho R. , Mattila K. , Vahlberg T. , Kivelä S.‐L. , Irjala K.
Published: June 2004

Objectives.  To estimate the prevalence of decreased kidney function in an elderly population and to evaluate the impact of using alternative markers of glomerular filtration rate (GFR), focusing on serum cystatin C (Cys C) and the Modification of Diet in Renal Disease (MDRD) Study prediction equation.

Design and methods. In a cross‐sectional community‐based survey renal function was assessed by serum creatinine (SCreat), Cys C and GFR predicted by the Cockcroft‐Gault (CG) and the MDRD Study formulae. Associations with age, gender and proteinuria were analysed by linear models.

Subjects.  A total of 1246 elderly residents in Lieto, Finland, 64–100 years of age.

Results.  The prevalence of moderately or severely decreased renal function, estimated by the MDRD Study equation, was 35.7%; the CG formula yielded 58.6%. The profile of Cys C performance, including variation across age groups and level of health status, showed greater similarity to GFR estimated using the MDRD Study equation than to SCreat alone, or GFR estimated using the CG formula. Discordance between high Cys C levels and only mildly decreased GFR estimates was observed in subjects with functional limitations. Microalbuminuria was associated with Cys C levels only (P =0.047).

Conclusion.  Prevalence estimates of decreased renal function amongst the elderly vary considerably depending on prediction formula used. Variation in creatinine metabolism amongst elderly comorbid patients and the critical dependence on the SCreat assay and exact calibration, make the use of creatinine‐based formulae to predict GFR questionable in geriatric clinical practice. In this setting, Cys C is a promising alternative.
Ageing and the Diurnal Expression of the mRNAs for Vasopressin and for the V1a and V1b Vasopressin Receptors in the Suprachiasmatic Nucleus of Male Rats
Authors: Kalamatianos T. , Kalló I. , Coen C. W.
Published: May 2004

Changes in the function of neuropeptide synthesizing cells within the suprachiasmatic nucleus (SCN), the site of the predominant circadian pacemaker, may underlie the disturbance of rhythms observed during ageing. Arginine vasopressin (AVP) is synthesized by nearly one‐third of SCN neurones in the rat. This peptide has predominantly excitatory actions within the SCN mediated by V1‐type receptors; the extent to which the V1a and/or V1b receptor subtypes are involved in SCN functions remains to be determined. The present study used isotopic in situ hybridization histochemistry to examine the effects of ageing on expression of mRNAs for AVP and V1a in the SCN and for V1b in the SCN and supraoptic nucleus (SON) of male rats kept under a 12 : 12 h light/dark cycle. Analysis of film autoradiographs from young adult (2–3‐month‐old; n = 40) or aged (19–20‐month‐old; n = 40) animals, at eight time points across the light/dark cycle, revealed an equivalent pattern and amplitude for the diurnal rhythm of AVP mRNA in the SCN of the young adult and aged groups. Both groups also displayed a significant diurnal rhythm in the expression of V1a receptor mRNA; however, the amplitude of this rhythm was reduced in the aged group, due to increased levels during the light phase and early part of night. Although the expression of V1b mRNA did not display a significant diurnal rhythm within the SCN or SON, persistently elevated levels for V1b mRNA were observed in the aged group at both sites.
Depletion of Oestrogen Receptor‐β Expression in Magnocellular Arginine Vasopressin Neurones by Hypovolaemia and Dehydration
Authors: Somponpun S. J. , Sladek C. D.
Published: May 2004

Oestrogen receptor (ER)‐β expression correlates inversely with osmotic control of arginine vasopressin (AVP) release such that cellular dehydration induced by 72 h of 2% saline consumption depletes ER‐β in the magnocellular AVP neurones in the supraoptic (SON) and paraventricular nuclei (PVN). The current studies were performed to determine whether other pathways that stimulate AVP release, such as hypovolaemia, also regulate ER‐β expression in these nuclei, and to evaluate the time course of the change in ER‐β expression during water deprivation and subsequent rehydration. ER‐β expression was evaluated immunocytochemically. In rats made hypovolaemic with a subcutaneous injection of 40% polyethylene glycol (PEG), a significant depletion of ER‐β in both SON and magnocellular PVN (P ≤ 0.001) was evident 8 h post PEG injection. ER‐β was also significantly depleted following 20 h and 26 h of water deprivation in SON (P = 0.003) and magnocellular PVN (P < 0.001). Six hours of rehydration in rats that had been water deprived for 26 h induced recovery of expression that was statistically significant, although not complete (P ≤ 0.015 in PVN). Thus, for the first time, the present studies demonstrate that haemodynamic in addition to osmotic influences are capable of regulating ER‐β expression in the magnocellular system, and that the combination of these factors induced by a physiological manipulation (e.g. 20 h of water deprivation) can eliminate ER‐β expression. Because ER‐β has been shown to mediate inhibition of AVP secretion in explants of the hypothalamic‐neurohypophyseal system, these data suggest that down‐regulation of ER‐β may contribute to stimulated AVP release during hypovolaemic states such as fluid deprivation and haemorrhage.
Primary hereditary ichthyoses in the Eastern Province of Saudi Arabia
Authors: Al‐Zayir Ahmad A. , Al‐Amro Alakloby Omar M.
Published: May 2004

Background  Of 10,455 new dermatology patients seen at the Dermatology Clinic of King Fahad Hospital of the University, Al‐Khobar, Saudi Arabia, between January 1990 and December 1995, the epidemiologic and demographic features of 71 patients, each with a histopathologically confirmed diagnosis of one specific type of primary hereditary ichthyosis (PHI), have been reviewed.

Objective  To study and document the epidemiologic and demographic profiles of patients with PHI in the Eastern Province of Saudi Arabia.

Methods  From the outpatient department dermatology logbooks, 71 patients with PHI, from 10,455 new cases with different dermatologic problems seen during the 5‐year period, were included in this study. Using specially designed protocol forms, epidemiologic and demographic data were extracted from the medical records of the patients, entered into a computer, and analyzed using the SPSS program.

Results  Seventy‐one patients with PHI, 44 males and 27 females (ratio, 1.63 : 1), were seen at our Dermatology Clinic between January 1990 and December 1995. The occurrence rate of PHI in our clinic is 0.67%, i.e. approximately 7 per 1000 new cases. The clinical pattern of PHI was as follows: 31 patients (44.7%) with ichthyosis vulgaris (IV), 12 (16.9%) with X‐linked recessive ichthyosis (XLRI), four (5.6%) with lamellar ichthyosis (LI), three (4.2%) with bullous ichthyosiform erythroderma (BIE), and 21 (29.6%) with nonbullous ichthyosiform erythroderma (NBIE). IV was most common, followed by NBIE. Parental consanguinity was high (approximately 85%), and the family history was positive in 53 of the 71 cases (75%).

Conclusions  This preliminary study has attempted to document the epidemiologic patterns of PHI patients in Saudi Arabia and, to our knowledge, this is the first report of its kind in this country. We found a high rate of parental consanguinity, a high percentage of patients with a positive family history, and many siblings affected by the severest forms of PHI, namely NBIE, BIE, and LI, which accounted for 39.4% of all cases of PHI.
Linear IgA dermatosis with IgA and IgG autoantibodies to the 180 kDa bullous pemphigoid antigen (BP180): evidence for a distinct subtype
Authors: Metz Brandie J. , Ruggeri Sun Young , Hsu Sylvia , Reed Jon A. , Ghohestani Ali S. , Uitto Jouni , Ghohestani Reza F.
Published: May 2004

Background  Autoantibodies in linear immunoglobulin A (IgA) disease (LAD) are reported to be of IgA class and directed against a 97–120 kDa epidermal antigen.

Methods  We report a 39‐year‐old woman with clinical features of LAD and with circulating IgA and IgG autoantibodies to the 180 kDa bullous pemphigoid antigen (BP180).

Results  Histopathology of lesional skin revealed a subepidermal blister with mixed inflammatory cell infiltrate. Direct immunofluorescence of perilesional skin showed linear deposits of IgA along the dermal–epidermal junction. The antigen specificity of the patient's circulating antibodies was determined by Western blotting and enzyme‐linked immunoabsorbent assay (ELISA) using various antigen sources, including cultured human keratinocytes, dermal protein lysates, and purified laminin‐5, as well as proteins corresponding to BP180, the 230 kDa bullous pemphigoid antigen (BP230), laminin‐5 subunits, and collagen IV α1–α6 chains. IgA and IgG antibodies in the patient's serum were directed against BP180, and no IgA or IgG reactivity was found against the other skin antigens.

Conclusions  These data provide evidence for the presence of a subtype of LAD with dual IgA and IgG autoimmune response to BP180.
Cardio‐facio‐cutaneous syndrome: report of a case with a review of the literature
Authors: Nanda Soni , Rajpal Monika , Reddy Belum S. N.
Published: May 2004

A sporadic case of cardio‐facio‐cutaneous syndrome occurring in an 18‐year‐old girl is reported, with a brief review of pertinent literature, for its rarity and clinical interest. She had a characteristic cranio‐facial appearance, a wide range of ectodermal defects, dystrophic nails and teeth, palmo‐plantar keratoderma, typical short, coarse, unruly hair, pulmonic stenosis and mild mental retardation. She had no history of consanguinity and genetic studies did not reveal any abnormality.
Residual skin cancer after preoperative biopsy: evaluation by Mohs micrographic surgery
Authors: Alcalay Joseph , Alkalay Ronen , Hazaz Bilha
Published: May 2004

Background  Some patients are referred for Mohs surgery with no or minimal clinical evidence of skin cancer at the biopsy site.

Objective  To determine the incidence of residual skin cancer at biopsy sites during Mohs micrographic surgery.

Methods  We evaluated all patients that underwent Mohs surgery for basal cell and squamous cell carcinomata in one year. The study was carried out prospectively. Debulking was done using a no. 15 blade at the clinical borders of the tumor or biopsy site. All specimens were sectioned at the middle and cut to the periphery at 20‐µm intervals.

Results  Seven hundred and forty‐one patients underwent operations. In 390 patients, a biopsy was performed prior to surgery. A total of 351 patients were biopsied as prestaged (chemocheck) during surgery. Ninety‐nine (25%) of the preoperatively biopsied patients showed no residual tumor in the debulking specimen or the first layer. Of these 99 patients, 84 had basal cell carcinoma and 15 had superficial or in situ squamous carcinoma.

Conclusions  In this study, preoperative biopsy for diagnosis of skin cancer of the face was curative in 25% of patients, despite pathologic diagnosis of incompletely excised tumor. However, as the majority of preoperatively biopsied patients showed residual tumor, Mohs micrographic surgery is indicated in all patients with incomplete removal of skin cancer of the head and neck.
Methicillin‐resistant Staphylococcus aureus in community‐acquired pyoderma
Authors: Umashankar Nagaraju , Bhat Gopalkrishna , Kuruvila Maria , Ganesh S. Pai , Jayalakshmi  , Ravindra P. Babu
Published: May 2004

Background  Methicillin‐resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. It can also cause community‐acquired infections. Indian reports about MRSA in community‐acquired infections are rare.

Aim  To evaluate the rate of MRSA in community‐acquired pyoderma and the nasal colonisation with S. aureus in such patients.

Methods  Two hundred and fifty patients with community‐acquired pyoderma, who attended outreach camps around Mangalore, south India between January 2000 and July 2001, were studied. Swabs collected from the skin lesions and anterior nares were inoculated onto blood agar and MacConkey's agar. Antimicrobial sensitivity testing was performed using Kirby–Bauer disk diffusion, agar dilution, and agar screen.

Results  Of 250 pyoderma cases, S. aureus was isolated from 202 (80.8%) patients. Twenty‐two (10.9%) S. aureus isolates were methicillin resistant, 179 (88.6%) were resistant to penicillin, and 114 (56.4%) were resistant to erythromycin. S. aureus colonization in the anterior nares was observed in 136 (54.4%) cases, 11.8% of which were MRSA. Antibiograms of clinical isolates of S. aureus matched with nasal isolates in 99 (49%) cases.

Conclusion  The emergence of MRSA in the community is a warning. A high nasal carriage rate may contribute to recurrent pyoderma. A correct antimicrobial policy and the avoidance of inappropriate antimicrobial usage are mandatory to reduce the spread of MRSA in the community.
Extensive inflammatory nevus comedonicus involving half of the body
Authors: Kirtak Necmettin , Inaloz H. Serhat , Karakok Metin , Erguven H. Gulcin , Ozgoztasi Orhan
Published: May 2004

Nevus comedonicus is an uncommon variant of adnexal hamartoma without known cause. It usually occurs on the face, neck and chest and appears as groups of closely arranged dilated follicular openings with keratin plugs. We report extensive inflammatory nevus comedonicus in a 14‐year‐old boy involving half of his body, limited by the midline, with suppuration and residual scarring. The lesions first appeared at 3 years of age and worsened at the start of puberty. The clinical features, etiopathology, histopathology and treatment options of nevus comedonicus are briefly reviewed in the light of the literature.
Immunohistochemical study of serotonin in lesions of psoriasis
Authors: Huang Jianguo , Li Guiming , Xiang Jihu , Yin Daochun , Chi Ridong
Published: May 2004

Objective  To study the role of serotonin in the pathogenesis of psoriasis.

Methods  Immunohistochemical techniques were used to study the expression of serotonin in the lesions of patients with psoriasis.

Results  Expression of serotonin was significantly stronger in the prickle cells, sweat gland cells, sebaceous gland cells, and hair roots of the lesions in the progressive stage of psoriasis than in the static stage. There was no difference in serotonin expression between the vulgaris type and the pustular type. No expression of serotonin occurred in the specimens of normal skin.

Conclusion  Serotonin probably plays an important role in the pathogenesis and activity of psoriasis.
A θ‐defensin composed exclusively of d‐amino acids is active against HIV‐1
Authors: Owen S.M. , Rudolph D. , Wang W. , Cole A.M. , Sherman M.A. , Waring A.J. , Lehrer R.I. , Lal R.B.
Published: May 2004

Abstract:  The ability of certain θ‐defensins, including retrocyclin‐1, to protect human cells from infection by HIV‐1 marks them as potentially useful molecules. θ‐Defensins composed of l‐amino acids are likely to be unstable in environments that contain host and microbial proteases. This study compared the properties of two enantiomeric θ‐defensins, retrocyclin‐1, and RC‐112. Although these peptides have identical sequences, RC‐112 is composed exclusively of d‐amino acids, whereas retrocyclin‐1 contains only l‐amino acids. We compared the ability of these peptides to protect JC53‐BL human cells from infection by 30 primary HIV‐1 isolates. JC53‐BL cells are modified HeLa cells that express surface CD4, CXCR4, and CCR5. They also contain reporter cassettes that are driven by the HIV‐1 LTR, and express β‐galactosidase and luciferase. The HIV‐1 isolates varied in co‐receptor specificity and included subtypes A, B, C, D, CRF01‐AE, and G. RC‐112 was several fold more potent than retrocyclin‐1 across the entire HIV‐1 panel. Although RC‐112 bound immobilized gp120 and CD4 with lower affinity than did retrocyclin‐1, surface plasmon resonance experiments performed with 1 μg/mL of RC‐112 and retrocyclin‐1 revealed that both glycoproteins were bound to a similar extent. The superior antiviral performance of RC‐112 most likely reflected its resistance to degradation by surface‐associated or secreted proteases of the JC53‐BL target cells. θ‐Defensins composed exclusively of d‐amino acids merit consideration as starting points for designing microbicides for topical application to the vagina or rectum.
Synthesis, radiolabeling and in vitro and in vivo characterization of a technetium‐99m‐labeled alpha‐M2 peptide as a tumor imaging agent
Authors: Okarvi S.M.
Published: May 2004

Abstract:  In an effort to develop a peptide‐based radiopharmaceutical for the detection of breast cancer, we have prepared an analog of αM2 peptide, modified to incorporate an N3S chelate system. Mercaptoacetyltriglycine (MAG)3‐derivatized αM2 peptide was prepared by solid‐phase synthesis and radiolabeled with 99mTc by an exchange method. In vitro cell‐binding on human breast cancer cell lines, MDA‐MB‐231 and MCF‐7, indicated the affinity and specificity of 99mTc‐MAG3‐αM2 toward breast cancer cells. Additionally, the radiolabeled peptide showed rapid internalization into human breast cancer cells. In vivo biodistribution in mice showed that the radiolabeled peptide cleared rapidly from the blood and most non‐target tissues and was excreted significantly via the kidneys. Uptake of 99mTc‐MAG3‐αM2 in the tumor was moderate. The radiochemical and in vitro and in vivo characterization indicates that the radiolabeled peptide has certain favorable properties and it might be a useful radiopharmaceutical for the detection of breast cancer in vivo.
Potential for protein deposition and threonine requirement of modern genotype barrows fed graded levels of protein with threonine as the limiting amino acid
Authors: Thong H. T. , Liebert F.
Published: May 2004

The study was conducted to estimate the actual genetic potential for daily protein deposition of growing barrows [genotype: Piétrain × (Duroc × Landrace)]. Twenty‐four pigs with an average initial body weight (BW) of 43.7 ± 0.7 kg were used in a N‐balance study. Semi‐purified diets with graded levels of crude protein (45.8, 94.2, 148.0, 198.9, 255.5 and 300.2 g/kg DM) were used, based on a constant mixture of wheat, soya bean protein concentrate and potato protein concentrate as protein sources. The amino acid pattern of the diets was according to the ideal amino acid ratio for growing pigs (Wang and Fuller, 1989), with the exception of threonine (adjusted as limiting amino acid).

N‐balance data were used to estimate daily N‐maintenance requirement (NMR = 446 mg N/BW/day) by regression method and the theoretical maximum of daily N‐retention (PDmaxT = 3115 mg N/BW/day) based on N‐utilization model of Gebhardt (1966) using program Mathematica 3.0. The results indicate that PDmaxT of pigs under study is much higher than results from earlier studies with older genotypes. In summary, pigs of modern genotype have a very high genetic potential for daily protein deposition and these actual data are important basic informations for estimation of amino acid requirement within the model used. Threonine requirement data depending on threonine efficieny and protein deposition (8.96, 10.45 and 12.22 g/day for 130, 145 and 160 g daily protein deposition; 50 kg body weight) are discussed.
Requirement of true ileal digestible threonine of growing and finishing pigs
Authors: Ettle T. , Roth‐Maier D. A. , Bartelt J. , Roth F. X.
Published: May 2004

Ninety‐six crossbred barrows and gilts were used to investigate the optimum supply of true ileal digestible threonine for growing (approximately 35–65 kg body weight) and finishing (approximately 65–110 kg body weight) pigs. For this purpose, according to a bifactorial arrangement in the grower as well as in the finisher phase four dietary threonine levels were combined with two dietary levels of lysine. Measurement criteria were body weight gain, feed intake, feed conversion rate and carcass characteristics. In the grower stage at the lower lysine level daily gain increased numerically (p < 0.1) and the feed to gain ratio decreased significantly with an increasing dietary true ileal digestible threonine concentration. Increasing the true ileal digestible lysine concentration of the diet from 7.8 to 9.2 g/kg increased average daily gain in the grower stage significantly from 815 to 855 g and decreased the feed to gain ratio significantly. In finishing pigs, daily gain and feed to gain ratio were significantly improved by an increasing dietary true ileal digestible threonine concentration from 821 to 902 g and from 3.14 to 2.94 kg/kg, respectively, but not by the differing lysine supply. As in the grower stage, barrows consumed more feed than gilts at similar growth rates and this resulted in a significantly reduced feed to gain ratio in gilts compared with barrows.

The requirements of true ileal digestible threonine for optimize both, daily gain and feed to gain ratio, as derived by the broken‐line model were 10.3 g/animal and day for growing and 10.7 g/animal and day for finishing pigs respectively.
Changes in plasma non‐esterified fatty acids, glucose and α‐amino nitrogen and their relationship with body weight and plasma growth hormone in growing buffaloes (Bubalus bubalis)
Authors: Mondal M. , Prakash B. S.
Published: May 2004

A study was undertaken to investigate the changes of plasma non‐esterified fatty acids (NEFA), glucose and α‐amino nitrogen and their relationship with age, body weight (BW) and plasma growth hormone (GH) in growing buffaloes. For the purpose, six growing female Murrah buffalo calves of 6–8 months of age were selected on the basis of their BW and fed according to Kearl standard (Nutrient Requirements of Ruminants in Developing Countries, International Feedstuffs Institute, Utah State University, Utah, USA, 1982, p. 89) for growing buffaloes (target growth rate 500 g/day) to meet energy and protein requirement of the animals. Blood samples collected at fortnight intervals for 1 year were analysed for plasma NEFA, glucose, α‐amino nitrogen and GH. The animals were also weighed at fortnight intervals. Plasma NEFA and glucose levels were found to decrease (p < 0.01) with age. Unlike plasma NEFA and glucose, plasma α‐amino nitrogen level increased (p < 0.01) as the buffaloes become older. Plasma NEFA and glucose concentrations in growing buffaloes were found to be positively correlated with plasma GH (r = 0.379 and 0.420 respectively), but these were non‐significant (p > 0.01). However, plasma NEFA and glucose showed a good correlation (p < 0.01; r = 0.780 and 0.652 respectively) with plasma GH per 100 kg live weight. Plasma α‐amino nitrogen exhibited non‐significant (p > 0.01) negative correlation (r = −0.295) with plasma GH but a negative correlation (p < 0.01; r = −0.641) with GH per 100 kg BW. So, plasma metabolites showed a definite pattern of change during growth and these have a significant (p < 0.01) correlation with plasma GH per 100 kg BW than GH.
Effect of exercise on the mobilization of retinol and retinyl esters in plasma of sled dogs
Authors: Raila J. , Stohrer M. , Forterre S. , Stangassinger M. , Schweigert F. J.
Published: May 2004

Fasting dogs do transport vitamin A (VA) in plasma not only as retinol but predominantly as retinyl esters. Contrary to retinol, nothing is known concerning the effects of athletic performance on plasma retinyl ester concentrations. The aim of this study was therefore to examine whether physical stress because of exercise and modification of the oxidative stress by supplementation ofα‐tocopherol influences the concentrations of retinol and retinyl esters in plasma of sled dogs. The study was carried out on 41 trained adult sled dogs, which were randomly assigned into two groups. One group (19 dogs) was daily substituted with 50 mgdl‐α‐tocopheryl acetate per kilogram body weight and the control group (22 dogs) was maintained on a basal diet during 3 months prior to exercise. The plasma concentrations of retinol, retinyl esters,α‐tocopherol and triglycerides were measured immediately before, directly after and 24 h after exercise. The supplementation ofα‐tocopheryl acetate had no effect on plasma retinol and retinyl ester concentrations at any measurement time point. However, retinyl ester levels doubled in the non‐supplemented group immediately after the race (p < 0.001), whereas in the supplemented group similar high levels were observed not until 24 h post‐racing (p < 0.001). The high levels of retinyl esters were paralleled to some extent by an increase in plasma triglyceride concentrations, which were significantly higher 24 h post‐racing than immediately before (p < 0.001) and after exercise (p < 0.001) in both groups. The increase in retinyl ester concentrations might be indicative of their mobilization from liver and adipose tissue. Whether plasma retinyl esters can be used as an indicator for the extent of nutrient mobilization during and post‐exercise in sled dogs remains to be elucidated.
Dynamics of yolk sac resorption and post‐hatching development of the gastrointestinal tract in chickens, ducks and geese
Authors: Jamroz D. , Wertelecki T. , Wiliczkiewicz A. , Orda J , Skorupińska J.
Published: May 2004

Under similar environmental conditions, 100 male Shaver–Starbro hybrid chickens, 100 male Mulard cross‐line ducklings and 100 male Landaise goslings kept in 30 metabolic cages from the first day of life (10 birds of each species separately per cage) were chosen for the study. The animals were fed semi ad libitum diets with crude protein content and energy density similar to that used for poultry species, avoiding feed residues. During the first 21 days of life they received starter diets and from day 22 to 42 grower diets. Maize accounted for 23‐‐40% and barley constituted 10–18%. Wheat accounted for 20.0% in starter diets and 10–18% in grower diets. Resorption of yolk sac residues, performance, development of the intestinal tract in young chickens, ducklings and goslings were assessed. During the first 5 days of life intensive absorption of yolk sac ingredients was observed. On day 7, residues of the yolk sac were found in more than 30% of chickens compared with approximately 10% in geese. In ducklings residues of the yolk sac were not found. On day 16 unabsorbed yolk sacs were found in approximately 10% of chickens. Liver and pancreas weighed the highest in geese and in ducks; in chickens the weight of these organs was significantly lower (p < 0.01). The relative values calculated to 100 g of metabolic body weight show that the average small intestine in chickens was significantly longer (p < 0.01) than in ducks or geese. The intestinal tract developed earlier in the chicken than in the water fowl.
PROTECTION AGAINST KAINATE NEUROTOXICITY BY PYRROLIDINE DITHIOCARBAMATE
Authors: Shin Eun‐Joo , Jhoo Jin Hyeong , Kim Won‐Ki , Jhoo Wang Kee , Lee Chaeyoung , Jung Bae Dong , Kim Hyoung‐Chun
Published: May 2004

1. The effect of pyrrolidine dithiocarbamate (PDTC) on kainate (KA)‐induced neurotoxicity was examined in Sprague‐Dawley rats.

2. At 10 mg/kg, i.p., KA produced seizures accompanied by neuronal loss in the hippocampus and increased levels of malondialdehyde (MDA) and protein carbonyl.

3. Pretreatment with PDTC (100 or 200 mg/kg, p.o., every 12 h ×5) blocked KA‐induced neurotoxicities (seizures, increases in MDA and protein carbonyl and neuronal losses) in a dose‐dependent manner. These effects were counteracted by the adenosine A1 receptor antagonist 8‐cyclopentyl‐1,3‐dimethylxanthine (25 or 50 µg/kg, i.p.), but not by the A2A receptor antagonist 1,3,7‐trimethyl‐8‐(3‐chlorostyryl)xanthine (0.5 or 1 mg/kg, i.p.) or the A2B receptor antagonist alloxazine (1.5 or 3.0 mg/kg, i.p.).

4. Our results suggest that the anticonvulsant and neuroprotective effects of PDTC are mediated, at least in part, via adenosine A1 receptor stimulation.