bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of functional categories in bilingual children's language mixing and differentiation
Authors: RUBIN EDWARD J. , TORIBIO ALMEIDA JACQUELINE
Published: February 2007

ABSTRACT: The present paper examines the simultaneous development of the two linguistic competences of the bilingual child. It has been observed that language mixing, defined as the indiscriminate combinations of elements from each of the component languages, is most frequent during a very early phase of language acquisition. However, as the child acquires greater competence in the two languages, the language contact which is in evidence (if any at all) increasingly takes the form of code‐switching, defined as language alternations which are constrained by syntactic principles. In the present study, special attention is devoted to the role of functional categories in the development patterns attested, and we defend a position intermediate between the strong continuity and weak continuity hypotheses. Thus, our overview of childhood bilingualism may be viewed as reflecting the convergence of developments in linguistic theory, language acquisition, and language contact.
Afterword
Authors: MYERS‐SCOTTON CAROL
Published: February 2007

ABSTRACT:This afterword provides a discussion of each of the four papers, as they were presented at the 1995 Symposium at the annual meeting of the American Association of Applied Linguistics. It does so in terms of the premises of the Matrix Language Frame Model, especially the matrix language vs. embedded language distinction and the content vs. system morpheme distinction.
Immune Evasion by Helicobacter pylori: Gastric Spiral Bacteria Lack Surface Immunoglobulin Deposition and Reactivity with Homologous Antibodies
Authors: Darwin Peter E. , Sztein Marcelo B. , Zheng Qiao‐Xi , James Stephen P. , Fantry George T.
Published: February 2007

Background.
Helicobacter pylori infection persists in the presence of potent serum and gastric mucosal anti‐body responses against bacterial antigens. The aim of this article is to report on a study determine whether there is antibody deposition on H. pylori in vivo in the stomach of infected patients and whether gastric and cultured forms of H. pylori differ in their antibody reactivity.

Materials and Methods.Serum, gastric biopsies, and antral brushings were obtained from 10 patients having endoscopy. H. pylori was cultured from gastric biopsies. Bacterial samples were stained directly for immunoglobulin deposition and indirectly using rabbit antiurease serum or patient serum. Samples were examined by immunofluorescence microscopy and flow cytometry.

Results.Although spiral bacteria could be identified easily by acridine orange staining and antiurease staining of gastric brushings from H. pylori infected patients, gastric bacteria did not have detectable IgG or IgA present, and only one of five samples could be stained for IgG and IgA indirectly using patient serum. In contrast, cultured bacteria could be stained readily with homologous serum for IgG and IgA in the majority of cases. Low pH inhibited immunoglobulin reactivity with cultured H. pylori.

Conclusions.Gastric H. pylori may evade humoral defense owing to poor deposition of immunoglobulin in the gastric environment or failure to express surface antigens that are present on cultured forms of H. pylori.
Epidemiology of Gastric Non‐Hodgkin's Lymphoma Patients: Parallels with Helicobacter pylori
Authors: Thorburn Christine , Rodriguez Larissa , Parsonnet Julie
Published: February 2007

Background.

The incidence of gastric non‐Hodgkin's lymphoma (NHL) is increasing in the United States. However, little is known about the etiology of the disease. Some studies have shown an association between gastric NHL and Helicobacter pylori. No study has specifically delineated demographic features that distinguish gastric NHL patients from nongastric NHL patients.

Materials and Methods.To obtain information about the differences between gastric and nongastric NHL patients, we conducted a hospital chart review study. We examined charts of all 25 cases of primary gastric NHL, as well as charts of 75 randomly selected nongastric NHL patients as controls. All patients were seen in the Division of Oncology at Stanford University Medical Center from 1972 to 1991. Demographic information was tabulated, and differences between the cases and controls were noted. The identified risk factors were determined by both univariate and logistic regression analyses.

Results.There was no difference between gastric NHL cases and nongastric controls with respect to age, gender, race, and family history of any cancer. However, in logistical regression, persons with gastric NHL were more likely than those with other forms of NHL to be born outside the United States (odds ratio = 12.8; 95% confidence interval = 2.9–56.0) and also to have a family history of stomach cancer (odds ratio = 18.4; 95% confidence interval 2.1–160.1).

Conclusions.Gastric NHL is more likely than NHL at other sites to occur in persons with a family history of gastric cancer or in those born in developing countries. This epidemiological pattern supports the identified role of H. pylori in the development of gastric lymphoma.
Effectiveness of Quadruple Therapy Using Lansoprazole, Instead of Omeprazole, in Curing Helicobacter pylori Infection
Authors: de Boer Wink A. , van Etten Ruud J. X. M. , Lai J. Y. L. , Schneeberger Peter M. , van De Wouw Branka A. M. , Driessen Willem M. M.
Published: February 2007

Background.Omeprazole enhances the efficacy of bismuth‐based triple therapy. It is unknown whether the same is true for other proton pump inhibitors. Lansoprazole has superior anti‐Helicobacter activity in vitro and possibly also in vivo; therefore we investigated quadruple therapy with lansoprazole.

Materials and Methods.In two studies performed in separate hospitals, a total of 67 Helicobacter pylori–positive patients were treated with 7‐day quadruple therapy (lansoprazole, colloidal bismuth subcitrate, tetracycline, and metronidazole) after 3 days of lansoprazole pretreatment. Testing for cure was done by endoscopy in study 1 and by breath test in study 2.

Results.Cure rates per protocol were 31 of 31 (100%) in study 1 and 30 of 32 (94%) in study 2. Intention‐to‐treat cure rates were 31 of 35 (89%) in study 1 and 30 of 32 (94%) in study 2. Cured overall were 32 of 34 with a metronidazole sensitive strain and 3 of 3 with a metronidazole‐resistant strain. Data on side effects were collected from 51 patients. Twelve (21%) had no side effects, 27 (53%) had mild side effects, 10 (20%) had moderate side effects, but only 2 (4%) had severe side effects. Side effects, never were the reason that a patient stopped taking the medication.

Conclusions.The results with lansoprazole‐quadruple therapy are comparable to the historic control group treated with omeprazole‐quadruple therapy. The cure rate is very high, and although mild to moderate side effects occured in many patients, everybody finished the treatment regime.
Twenty‐Minute Fasting Version of the US 13C‐Urea Breath Test for the Diagnosis of H. pylori Infection
Authors: Malaty Hoda M. , El‐Zimaity Hala M. T. , Genta Robert M. , Klein Peter D. , Graham David Y.
Published: February 2007

Background.In large‐scale multi‐center clinical trials, the US 13C‐urea breath test (UBT) has proven to have a sensitivity and specificity of approximately 95%. Ingestion of a meal to delay gastric emptying has advantages of increasing the level of signal as well as prolonging the duration of significantly increased 13C excretion, at the expense of requiring 40 to 60 minutes to complete the test. Our aim was to explore the utility of the 13C‐UBT with a total duration of 30 minutes or less.

Methods. After a baseline breath sample was obtained, 125 mg of 13C‐urea was given in 100 ml of water, and additional breath samples were taken after 20 and 30 minutes. The results of the UBT were compared to histological assessment, culture, and the rapid urease test. 13C‐UBTs were carried out on normal volunteers who underwent gastroscopy during which six mucosal biopsies were taken. Three biopsies were for histological evaluation (Genta stain), two for culture, and one was for agar gel rapid urease testing. The UBT was conducted 2 to 3 days either before or after the endoscopic procedure.

Results.The cutoff value for a positive UBT was enrichment of 2.4Δ%0 (delta over baseline). Of the 66 tests, 51%0 were Helicobacter pylori‐positive. There were no false positive UBTs and only two false negative UBTs at 20 minutes (sensitivity, 96%; specificity, 100%). At 30 minutes, one other UBT was false negative (gray zone of 2.36%0.) (sensitivity, 94%; specificity, 100%).

Conclusion. These results suggest that omission of the meal and shortening the duration of the US 13C‐UBT to 20 minutes still may maintain excellent specificity and sensitivity of the test.
The Role of Ranitidine Bismuth Citrate in Significantly Reducing the Emergence of Helicobacter pylori Strains Resistant to Antibiotics
Authors: McLaren Alistair , Donnelly Christine , McDowell Sylvia , Williamson Russell
Published: February 2007

Background.

This study was carried out to investigate the clinical observation that the emergence of antibiotic resistance can be reduced in Helicobacter pylori if agents are administered in combination with bismuth salts.

Materials and Methods.

Two H. pylori clinical isolates were grown on chocolate Columbia agar containing either ranitidine bismuth citrate (RBC) at one‐half lethal concentration (8 μg/ml) or no drug control for 22 subcultures. After 1, 5, 8, 14, 17, and 22 subcultures, the emergence of antibiotic resistance to metronidazole, clarithromycin, and streptomycin was calculated and statistically analyzed.

Results.

Acquisition of resistance to metronidazole was reduced significantly for both strains (p = .007 and 0.014) and for one strain against clarithromycin (p = .037). However, spontaneous emergence of resistance to streptomycin was not altered significantly. In an analysis of the effect of long‐term exposure of the isolates to RBC, susceptibility to bismuth was unaltered in one strain and had risen by only twofold in the other at experiment termination.

Conclusion.

RBC significantly decreased resistance acquisition in an inherently sensitive strain and also decreased resistance emergence in a strain that readily became metronidazole‐resistant.
Effects of Smoking on Cure ofHelicobacter pyloriInfection and Duodenal Uulcer Recurrence in Patients Treated with Clarithromycin and Omeprazole
Authors: Bardhan Karna D. , Graham David Y. , Hunt Richard H. , O’morain Colm A.
Published: February 2007

Background.

Smoking may affect adversely the cure rate forHelicobacter pyloriinfection in patients treated with amoxicillin and omeprazole. Therapy with clarithromycin and omeprazole was tested for its effectiveness in the treatment ofH. pyloriinfection in smokers and nonsmokers.

Materials and Methods.

Patients with verified duodenal ulcer andH. pyloriinfection received clarithromycin 500 mg tid, in combination with omeprazole 40 mg/day, for 2 weeks, followed by omeprazole (20 or 40 mg daily) for 2 additional weeks according to a randomized, double‐blind, multicenter design. Patients were analyzed by their smoking status for the cure ofH. pyloriinfection, ulcer healing, and prevention of duodenal ulcer recurrence.

Results.

After treatment with clarithromycin and omeprazole,H. pyloriinfection was cured in 71% of the smokers and in 77% of the nonsmokers (evaluated 4–6 weeks after treatment). Overall ulcer healing was 95%, and overall ulcer recurrence was 19%. ForH. pylori–negative patients, ulcer recurrence was 12% in both smokers and nonsmokers. None of these values was significantly different when smokers were compared to nonsmokers.

Conclusions.

Therapy with clarithromycin and omeprazole is effective for cure ofH. pyloriinfection in smokers and nonsmokers. Smoking has no effect on duodenal ulcer healing or duodenal ulcer recurrence for patients treated with this regimen.
Hematoxylin and Eosin Staining of Gastric Tissue for the Detection of Helicobacter pylori
Authors: Fallone Carlo A. , Loo Vivian G. , Lough John , Barkun Alan N.
Published: February 2007

Background.

Gold standard methods of detection of Helicobacter pylori are expensive, difficult to perform, or not widely available. The purpose of this study was to assess hematoxylin and eosin staining of antral tissue, a relatively inexpensive and widely available method of H. pylori detection.

Materials and Methods.

The hematoxylin and eosin stain was assessed as a method of H. pylori detection, with 2 × 2 table analysis using culture as the gold standard in 133 gastric biopsy specimens obtained from patients both before and following attempted eradication.

Results.

Performance of the stain was good among untreated patients as well as among patients having previously undergone an eradication treatment, with an overall accuracy of 92% (95% confidence intervals: 86–96), sensitivity of 93% (87–97), and specificity of 87% (69–96).

Conclusion.

The hematoxylin and eosin stain is an inexpensive method of H. pylori detection but with test performance characteristics inferior to Giemsa, Genta, or silver stains.
Promotion of Ulcerative Duodenitis in Young Ferrets by Oral Immunization with Helicobacter mustelae and Muramyl Dipeptide
Authors: Whary Mark T. , Palley Lori S. , Batchelder Margaret , Murphy James C. , Yan Lili , Taylor Nancy S. , Fox James G.
Published: February 2007

Background.

The purpose of this study was to determine whether oral immunization of ferret kits with a whole‐cell sonicate of Helicobacter mustelae lysate (Hml) and the adjuvant muramyl dipeptide (MDP) would reduce the incidence of natural colonization with H. mustelae and the extent of Helicobacter‐associated gastritis by enhancing the host mucosal immune response.

Materials and Methods.

Between the ages of 4 and 11 weeks, 44 ferret kits were gavaged with Hml and various doses of MDP. The extent of gastritis and duodenitis and the immune response to H. mustelae were evaluated.

Results.

All kits became colonized naturally with H. mustelae and the majority developed mild to severe gastritis and duodenitis. Kits that received Hml with MDP developed significantly greater inflammation of the gastric antrum and duodenum, as compared to kits vaccinated with Hml alone. Vaccination with Hml and 50 μg of MDP was associated with severe lesions in the proximal duodenum characterized by accumulation of mononuclear inflammatory cells, mucosal erosion, and ulceration. Although serum antibody specific for H. mustelae in 4‐week‐old kits was approximately 50% of adult levels, a finding attributable to passively acquired maternal antibody, both systemic and mucosal antibody levels became depressed over time despite oral vaccination. The humoral immune response was sufficiently low to prevent detection of any significant dose effect of MDP on antibody levels among experimental groups.

Conclusions.

Oral vaccination of young ferrets with Hml and 50 μg MDP increased the risk of Helicobacter‐associated mucosal ulceration in the proximal duodenum, which was associated with low humoral (but significant cell‐mediated) immune responses to H. mustelae. In retrospect, the frequency of vaccination may have suppressed the systemic humoral immune response, thereby promoting mucosal damage by H. mustelae. The 50‐μg dose of MDP enhanced the cell‐mediated immune response, which indirectly contributed to development of severe lesions. The increased frequency of mucosal damage associated with this vaccination regimen enhances the value of the ferret model for studying duodenal ulceration secondary to Helicobacter infection.
Effect of Fasting Subjects’ Posture on 13C‐Urea Breath Test for Detection of Helicobacter pylori Infection
Authors: Miwa Hiroto , Murai Toshio , Ohkura Ryuichi , Kawabe Masato , Tanaka Hiroshi , Ogihara Tatsuo , Watanabe Sumio , Sato Nobuhiro
Published: February 2007

Background.

Although many factors that may affect the 13C‐urea value have been verified, no literature is available regarding the effect of the posture of the patient on the shape of the Δ13C excretion curve. In an effort to contribute to the development of a simple and standard procedure for the 13C‐urea breath test, we investigated whether either the posture of the patient during the procedure or the mouthwash after dosing affects the shape of the Δ13C excretion curve.

Materials and Methods.

Seventy‐two Helicobacter pylori–infected subjects were divided into four groups according to the position during procedure and the mouthwash after dosing: group A, in the supine position with mouthwash; group B, in the sitting position with mouthwash; group C, changed position by rolling with mouthwash; and group D, changed position (as did group C) without mouthwash. Absolute values of Δ13C at each sampling point were compared in the four groups.

Results.

Δ13C values in group A gradually increased until the 15‐minute point; those in group B were almost stable from 5 to 30 minutes, and those in group C peaked at the 5‐minute point, then decreased until 30 minutes, the values becoming similar at the 20‐minute point. Significant differences were seen between groups A, B, C, and D at the 5‐ and 10‐minute points.

Conclusion.

These results suggest that posture and mouthwash affect Δ13C value at the 5‐ and 10‐minute points. Sampling at 20 (maybe 15 or 30) minutes for fasting patients in a sitting position is considered to be appropriate for detection of H. pylori infection in a standard two‐sampling‐point 13C‐urea breath test.
The Efficacy and Safety of One‐Week Triple Therapy with Lansoprazole, Clarithromycin, and Metronidazole for the Treatment ofHelicobacter pyloriInfection in Japanese Patients
Authors: Takimoto Takuya , Satoh Kiichi , Taniguchi Yushi , Saifuku Koji , Kihira Ken , Seki Masaru , Yoshida Yukio , Ido Kenichi , Kimura Ken
Published: February 2007

Background.

The aim of this study was to evaluate the efficacy and tolerability of 1‐week, low‐dose triple therapy with lansoprazole, clarithromycin, and metronidazole (LCM) for the cure ofH. pyloriinfection and to establish the adequate dosage of a new triple therapy for Japanese patients.

Materials and Methods.

One hundred fourH. pylori–positive Japanese patients were assigned alternatively to one of two groups: one to receive either 30 mg lansoprazole once in the morning, 200 mg clarithromycin twice daily, and 250 mg metronidazole twice daily for 1 week (LCM1; n = 52); the other to receive 30 mg lansoprazole once in the morning, 200 mg clarithromycin twice daily, and 500 mg metronidazole twice daily for 1 week (LCM2; n = 52).H. pyloriinfection was assessed by smear, culture, and histological assessment (Giemsa stain) performed before and 4 weeks after cessation of the therapy.

Results.

The overall cure rates ofH. pyloriinfection were 92.3% (48 of 52; 95% confidence interval (CI), 85% to 100%) in LCM1 and 92.3% (48 of 52; 95% CI, 85% to 100%) in LCM2. The cure rates in the patients without prior treatment were 95.7% (44 of 46; 95% CI, 89%–100%) in LCM1 and 95.7% (45 of 47; 95% CI, 89%–100%) in LCM2. Minor side effects were observed in 7.7% of LCM1 and 9.6% of LCM2, respectively.

Conclusion.

The LCM1 regimen consisting of 30 mg lansoprazole once daily, 200 mg clarithromycin twice daily, and 250 mg metronidazole twice daily (the regular doses in ordinary use in Japan) is a highly effective and safe regimen for Japanese patients. LCM1 as a new triple therapy is a promising regimen for the first‐line treatment ofH. pyloriinfection in Japanese patients.
Omeprazole‐Based Dual and Triple Therapy for the Treatment ofHelicobacter pyloriInfection in Peptic Ulcer Disease: A Randomized Trial
Authors: Pieramico Oreste , Zanetti Mario V. , Innerhofer Matthias , Malfertheiner Peter
Published: February 2007

Objectives.

It was our goal to evaluate the efficacy and safety and patient compliance with omeprazole‐based dual and triple therapy for eradication ofHelicobacter pyloriin peptic ulcer disease.

Materials and Methods.

One hundred seventy‐five consecutive patients withH. pyloriinfection and associated active peptic ulcer were included.H. pyloriinfection was assessed by rapid urease test and histological analysis. Patients were randomized among three treatments: group 1 (56 patients): omeprazole, 20 mg bid, and amoxicillin, 1 gm bid, for 2 weeks; group 2 (61 patients): omeprazole, 20 mg bid, plus amoxicillin, 1 gm bid, and metronidazole, 500 mg bid, for 1 week; and group 3 (58 patients): omeprazole, 20 mg bid, plus amoxicillin, 1 gm bid, and clarithromycin, 500 mg bid, for 1 week. Ulcer healing and cure of infection were evaluated at 4 to 6 weeks after cessation of therapy. Eradication rate was calculated per‐protocol and by an intention‐to‐treat analysis.

Results.

At posttreatment endoscopy, duodenal ulcer was healed in 98.3% of patients. Eleven patients (6%) were lost to follow‐up.H. pyloriinfection was treated successfully in 55% (95% confidence interval [CI] = 41%–69%) of patients of group 1; 86% (95% CI = 77%–95%) of group 2 (p< .001 vs. group 1); and 93% (95% CI = 85%–100%) of group 3 (p< .001 vs. group 1). On intention‐to‐treat analysis, eradication was 52%, 80%, and 86% in groups 1, 2, and 3, respectively. A good compliance was observed in more than 90% of patients of all groups. Side effects were reported by 7% of patients in group 1, 9% in group 2, and 11% in group 3. None of the patients stopped therapy because of side effects.

Conclusions.

Dual‐therapy omeprazole‐amoxicillin for 2 weeks is associated with significantly lower eradication rate than is 1‐week omeprazole‐based triple therapies. Triple therapy is well‐tolerated and produces side effects similar to those of dual therapy. The highest cure rate ofH. pyloriinfection was achieved with triple therapy of omeprazole, amoxicillin, and clarithromycin for 1 week.
Shelf Life of Unbuffered Rapid Urease Test
Authors: Ng Fook‐Hong , Wong Siu‐Yin , Chang Chee‐My
Published: February 2007

Background.

Unbuffered rapid urease test (RUT) is an accurate and inexpensive method to detect Helicobacter pylori. However, the test is not always readily available because the reagents must be mixed freshly or stored at −20°C after mixing. From our experience, storage at 4°C for less than 6 days seemed to have no effect on the test’s accuracy. This prospective study was undertaken to evaluate the shelf life of our unbuffered RUT.

Material and Methods.

Forty‐five patients were studied. From all patients, two sets of antral biopsy (X2) and body biopsy (X1) were taken. One set was subjected to histological examination; the other set was placed into a single capped Eppendorff tube for RUT. The tube was examined for any color change at 1 and 5 minutes.

Results.

Twenty‐six patients (58%) were infected as defined by histological examination. The reagent was classified according to the storage time (group 1, ≤ 5 days; group 2, > 5 days). The mean storage times of group 1 (n = 24) and group 2 (n = 21) were 3.1 (1.7 SD) days and 7.7 (1.2 SD) days, respectively. At 1 and 5 minutes, the sensitivity of group 1 was consistently higher than that of group 2 (1 minute, 61% versus 38%; 5 minutes, 92% versus 62%), and no false‐positive result was observed in either group.

Conclusion.

RUT remains highly sensitive and specific when it was stored at 4°C for up to 5 days but should be discarded after that period.
Catalase and Superoxide Dismutase Secreted from Helicobacter pylori
Authors: Mori Mikiji , Suzuki Hidekazu , Suzuki Masayuki , Kai Akemi , Miura Soichiro , Ishii Hiromasa
Published: February 2007

Background.

Previously, we have reported that toxic oxidants produced by activated neutrophils play a pivotal role in the development of Helicobacter pylori–induced gastric mucosal damage. Microorganisms, however, are characterized by their ability to produce a variety of antioxidant enzymes. This study is designed to measure the oxygen radical scavenging enzymes, such as catalase and superoxide dismutase (SOD), and urease in the supernatant of H. pylori (NCTC11637) suspension.

Materials and Methods.

H. pylori was inoculated on a sheep blood agar plate and harvested. Bacterial suspensions (109 cfu/ml phosphate buffer) were washed twice and incubated at 37°C for 1, 2, 12, and 24 hours or were sonicated in ice. Their supernatants were obtained by centrifugation and filtration. SOD activity was measured spectrophotometrically by the cytochrome c method. Catalase activity was assayed by the fall in absorbance at 240 nm as H2O2 is degraded. Urease activity was determined by measuring the release of ammonia using Berthelot reaction.

Results.

Activities of both SOD and catalase were detected in the supernatants of 1‐hour microaerophilic incubation. Their activities were almost constant in 4‐, 12‐, and 24‐hour microaerobic incubation or sonication. Urease activity was increased dramatically in proportion to the period of microaerobic incubation.

Conclusion.

Although H. pylori possesses antioxidant as a constitutive compartment, the magnitude of its secretion was below the detectable level. It is not likely that SOD and catalase play a significant role for scavenging the oxidants from injured gastric mucosa, such as infiltrated leukocytes.
Ultrastructural Study of Antral G Cells in Patients with Duodenal Ulcer: Effect of Helicobacter pylori Eradication
Authors: Sugamata Masao , Ihara Tomomi , Todate Asahi , Sugamata Miho , Hirakawa Ryuichi , Yoshida Yukio , Yamanaka Takeo , Miyata Michio , Miura Myota
Published: February 2007

Background.

It is established now that Helicobacter pylori infection is associated with exaggerated gastrin release to meals and other stimuli and that the abnormal secretion of gastrin is reversed after successful treatment of the infection. By comparing morphology of G cells from the same patients before and after treatment, we were able to investigate the ultrastructural effect of cure of H. pylori on G cells.

Methods.

Gastric mucosal biopsy specimens were obtained from 10 patients with duodenal ulcer before and 3, 6, and 9 months after cure of H. pylori infection. Negative controls consisted of four healthy volunteers without H. pylori infection. G cells were evaluated by immunohistochemical and electron microscopy. Treatment with H2‐antagonists was continued for 6 months after cure of the H. pylori infection.

Results.

Ultrastructural studies of secretory granules of antral G cells in controls displayed a broad range of electron density ranging from dark with a full appearance to totally electron‐lucent with a “vacuolating” appearance. In duodenal ulcer patients before treatment, electron‐lucent vacuolating granules predominated. After elimination of H. pylori, G‐cell granules showed a marked increase in electron density close to that of controls.

Conclusions.

Our study showed that the density of granules of G cells is decreased in H. pylori–infected duodenal ulcer patients compared to that in H. pylori–negative controls and is consistent with enhanced gastrin release. Cure of H. pylori infection was associated with return to normal density of G‐cell granules.
Rapid Polymerase Chain Reaction Screening of Helicobacter pylori Chromosomal Point Mutations
Authors: Ge Zhongming , Taylor Diane E.
Published: February 2007

Background.

Microdiversity (within individual genes) in the genomes of different Helicobacter pylori strains has been demonstrated to be more frequent than that seen in other prokaryotes. Point mutations in some genes, such as the vacA and 23S ribosomal RNA genes could result in the alteration of pathogenicity or antibiotic susceptibility of individual H. pylori strains. Development of a simple, rapid, and reliable screening method would be useful in the molecular characterization of genetic variation among different H. pylori strains.

Materials and Methods.

The copP gene from H. pylori UA802 was used as a model for developing a mutation screening method. Four point mutations were introduced into the copP gene by in vitro site‐directed mutagenesis and were verified by DNA sequencing. The mutated copP gene replaced the wild‐type locus by natural transformation and homologous recombination. The site‐specific mutants were screened by polymerase chain reaction (PCR) using 3′‐end mismatched primers. The origins of the PCR fragments were demonstrated by Southern hybridization with the copP‐derived DNA probe.

Results.

Three of these four mutations were characterized by PCR with the specific primers that contained the 3′‐terminal nucleotide complementary only to the mutated nucleotide on both plasmid and chromosomal DNA templates. One mutation was able to be identified with the foregoing primer containing an additional wild‐type nucleotide at its 3′‐end. Point mutant screening with these specific primers offers 100% sensitivity in the aforementioned conditions. To achieve optimal screening, the concentration of magnesium and the annealing temperature have to be adjusted.

Conclusion.

The procedure reported in this study is a simple, economical, rapid, and efficient approach in the identification of site‐specific mutations on both plasmids and chromosomal DNA. Although the method was developed by using a specified H. pylori gene, it can be extended easily to other genes of interest in H. pylori or other organisms.
Sucralfate as an Alternative to Bismuth in Quadruple Therapy for Helicobacter pylori Eradication
Authors: Korman Melvyn G. , Bolin Terry D. , Engelman Jeffrey L. , Pianko Stephen
Published: February 2007

Background.

There are persuasive arguments for treating all patients with Helicobacter pylori– associated peptic ulcer disease. However, the choice of therapeutic regimen remains problematical. Bismuth triple therapy produces greater than 80% cure of H. pylori infection, whereas omeprazole and bismuth quadruple therapy has produced cure rates in excess of 90%. Colloidal bismuth is not available in many countries, hence limiting the use of bismuth‐based therapeutic regimens. We substituted widely available sucralfate for bismuth in a quadruple‐therapy regimen.

Method.

We studied 223 consecutive patients with gastritis or peptic ulcer disease in whom H. pyori infection was confirmed by CLOtest (Delta West Ltd., Bentley, WA, Australia) or histological assessment. Successful therapy was validated by the 14C urea breath test 4 to 6 weeks after therapy. Omeprazole, 20 mg was given twice daily for 10 days. After 3 days of omeprazole sucralfate (1 gm qid), tetracycline (500 mg qid) and metronidazole (400 mg tid) were added for 7 days.

Results.

Therapy was successful in 194 of 223 patients(87%). Compliance was excellent, with only two patients being unable to tolerate therapy. Side effects were minimal and included nausea, vomiting, headache, and vaginal moniliasis. At 6 months’ follow‐up, 10 of 210 patients (5%) who were previously documented as “cured” had a positive breath test.

Conclusions.

The wide availability of sucralfate in many countries makes it a possible alternative to bismuth for use in proton pump quadruple‐therapy regimens, achieving a reasonable cure rate for H. pylori infection.
Seroprevalence of Helicobacter pylori in German Infants and Children
Authors: Hornemann Frauke , Nilius Manfred , Malfertheiner Peter , Bartmann Peter
Published: February 2007

Background.

The purpose of the study was to evaluate the serological prevalence of Helicobacter pylori (H. pylori) infection during infancy and childhood in Germany.

Patients and Methods.

We quantified specific IgG antibody titers against H. pylori by enzyme‐linked immunosorbent assay (ELISA) technique (BIO‐RAD G.A.P. IgG‐test) from healthy children under 18 years (n = 216) admitted to hospital for minor surgical procedures. All patients were age 0–18 years and lived in the southern part of Germany (Bavaria and Baden‐Wuerttemberg). For each age group, 12 different sera were obtained and were determined in duplicate. We analyzed the 216 sera within 6 age groups of equal size. Mean titers> 19 U/ml were considered positive for H. pylori infection.

Results.

None of the sera of 48 children less than 4 years old were positive for anti‐H. pylori specific IgG antibodies. Titers above 19 U/ml were found in 8.3% (3/36 sera each, CI 95% 1–21.7%) in the children age three to five and nine to 11 years. Six‐ to eight‐year‐old children showed a 19.4% seroprevalence (7/36 sera, CI 95% 8.2‐48%) and children 12–14 years old showed a seropositivity of 16.7% (6/36 sera, CI 95% 6.6–  46.1%). In contrast, 47.2% (17/36 sera, CI 26.5–70.3%) of the adolescents older than 14 years had positive H. pylori antibody titers (p < .01, compared to the age‐group 12–14 years). The test for linear trend (seropositivity and age) was significant with p < .001. The overall incidence increase with age in prevalence of H. pylori infection was found to be 0.9% per year within this population.

Conclusions.

In contrast to published data from other European and non‐European countries, we could not detect H. pylori infection in German infants less than four years old by measurement of IgG antibodies. In the older subjects, seropositivity increased significantly and linearly with age.
Psychological Risk Factors in Headache
Authors: Nicholson Robert A. , Houle Timothy T. , Rhudy Jamie L. , Norton Peter J.
Published: February 2007

Headache is a chronic disease that occurs with varying frequency and results in varying levels of disability. To date, the majority of research and clinical focus has been on the role of biological factors in headache and headache‐related disability. However, reliance on a purely biomedical model of headache does not account for all aspects of headache and associated disability. Using a biopsychosocial framework, the current manuscript expands the view of what factors influence headache by considering the role psychological (i.e., cognitive and affective) factors have in the development, course, and consequences of headache. The manuscript initially reviews evidence showing that neural circuits responsible for cognitive–affective phenomena are highly interconnected with the circuitry responsible for headache pain. The manuscript then reviews the influence cognitions (locus of control and self‐efficacy) and negative affect (depression, anxiety, and anger) have on the development of headache attacks, perception of headache pain, adherence to prescribed treatment, headache treatment outcome, and headache‐related disability. The manuscript concludes with a discussion of the clinical implications of considering psychological factors when treating headache.
Periodic Lateralized Frontal Epileptiform Discharges with Ipsilateral Epilepsia Partialis Continua
Authors: Young G. Bryan , Blume Warren T.
Published: February 2007

Summary:  Purpose: Lateralized clonic jerks of the extremities during epileptic seizures usually arise from the contralateral rolandic cortex. In our exceptional case one‐sided extremity twitches related to epileptiform activity in the ipsilateral frontal lobe.

Methods: Case study with clinical‐electroencephalographic correlation.

Results: A 47‐year‐old man suffered destruction of most of his right cerebral hemisphere, including the perirolandic region. Epilepsia partialis continua (EPC) ensued, with clonic jerks of the proximal right upper and lower limbs temporally related to periodic lateralized epileptiform discharges (PLEDs) from the parasagittal region of the right frontal lobe with a variable time interval over 100 ms. Sectioning of the subcortical callosal and projection connections of the frontal lobe abolished the clonic jerks.

Conclusions: We propose the ipsilateral EPC arose from projections from the supplementary motor region to the medullary reticular formation to account for the long and variable latency between PLEDs and jerks.
Age‐dependent Effects of Topiramate on the Acquisition and the Retention of Rapid Kindling
Authors: Mazarati Andréy , Shin Don , Auvin Stéphane , Sankar Raman
Published: February 2007

Summary:  Purpose: To examine antiepileptogenic, disease modifying, and anticonvulsant effects of topiramate under conditions of rapid kindling at different stages of development.

Methods: Afterdischarge threshold (ADT) and duration (ADD) were examined in 2‐, 3‐, and 5‐week‐old Wistar rats before and after administration of topiramate (200 mg/kg). Animals underwent a rapid kindling protocol (sixty 10‐s trains, bipolar 20 Hz square wave pulses delivered every 5 min). The progression of behavioral and electrographic seizures, and responses to test stimulations 24 h after the protocol were compared between topiramate and vehicle‐treated control rats. In addition, rats that were previously given vehicle only prior to kindling, were then given topiramate to examine the effect on established kindled seizures.

Results: In 2‐week‐old animals, topiramate affected neither the baseline afterdischarge, nor the progression of kindled seizures. In 3‐week‐old rats, topiramate did not modify the baseline afterdischarge, but significantly delayed the occurrence of full motor seizures in response to repeated stimulations. Topiramate treatment of 5‐week‐old rats increased baseline ADT, shortened ADD, and delayed the progression of kindled seizures. Twenty‐four h after the last kindling stimulation, animals of all ages exhibited a decreased ADT, an increase ADD, and developed behavioral seizures in response to threshold stimulation. Vehicle‐treated kindled rats that were then given topiramate displayed significantly attenuated behavioral seizures induced by the threshold stimulation.

Conclusions: Topiramate exhibited age‐dependent disease‐modifying effects under conditions of rapid kindling, but failed to block epileptogenesis. Topiramate also inhibited kindled seizures with equal efficacy across the three ages.
Prenatal Assessment for Childhood Discipline Experiences
Authors: Gaffney Kathleen Flynn , Holley‐Wilcox Pamela , Jones Graciella
Published: February 2007

purpose.:
To explore relationships between pregnant womens' childhood experiences with discipline and 1) prenatal plans for disciplining own child and 2) later maternal‐infant interactions

design. Prospective correlational study

setting. Prenatal clinics and home visits

participants. Low‐income pregnant women (N = 205) with a mean educational level of 12 years

main outcome measures. Adapted Ways of Handling Irritating Behaviors (Mother and you) Scales, NCAST Teaching Scale, Home Observation for Measurement of the Environment Scale

results. Correlations between childhood experiences with discipline and 1) plans for later discipline strategies with own child and 2) infant components of maternal‐infant interactions, including clarity of cues and responsiveness to the mother

conclusions. Prenatal assessment for childhood experiences with discipline may uncover factors associated with a break in the trajectory for optimal maternal‐child interactions described by Barnard's theoretical framework.
School‐Based Care: Clinical Challenges and Research Opportunities
Authors: Walker Patricia Hinton , Bowllan Nancy , Chevalier Nancy , Gullo Sharon , Lawrence Lorraine
Published: February 2007

purpose. To explore clinical challenges and research opportunities in one school‐based clinic in a faculty practice model of health care delivery

client population. Ninth‐through twelfth‐graders at an Eastern urban high school, 80% of the students are from ethnic minorities

conclusions. Clinical, administrative, and research challenges need to be addressed on a larger scale through practice‐based research networks across the country in order to have an impact on policy

practice implications. School‐based care required integration of primary care and management of psychosocial and developmental needs. Practice in this setting includes primary, secondary, and tertiary prevention as intervention.
Relationships Among Prenatal Maternal Attachment, Presence of Postnatal Depressive Symptoms, and Maternal Role Attainment
Authors: Fowles Eileen R.
Published: February 2007

purpose. To examine the relationships among a woman's attachment to her fetus, the presence of postpartum depressive symptoms, and subsequent perceptions of maternal role attainment three months after birth

design. A longitudinal, panel design

setting. Hospital‐sponsored childbirth education classes

participants. Primiparous women (N = 136) at 24–40 weeks of pregnancy and 9–14 weeks after the birth

main outcome measures. Perceived Competence Scale, Myself as Mother Scale, and My Baby Scale

results. Prenatal maternal attachment was positively related to maternal role attainment but not to postpartum depressive symptoms. Postpartum depression was negatively related to maternal role attainment.

conclusions. These findings enhance maternal identity theory and provide a means to evaluate the transition to motherhood.
The Father‐Infant Relationship: Becoming Connected
Authors: Anderson Arnette Marie
Published: February 2007

purpose. To explore fathers' experiences of developing a relationship with their infants during the infant's first 2 months of life

design. Grounded theory approach

setting. Fathers' homes or other mutually agreed‐upon site

participants. First‐time fathers (N = 14), ages 28–44, Caucasian, middle class

main outcome measures. Tape‐recorded semistructured interviews to elicit fathers' perceptions of their fathering selves, their infants, and the father‐infant relationship.

results. Using constant comparative method for analysis, three major categories were identified as operative in the initial development of the father‐infant relationship: (a) making a commitment, (b) becoming connected, and (c) making room for the baby.

conclusions. With an increased understanding of the father‐infant relationship, nurses can provide humanistic, thoughtful care to assist fathers in developing this significant relationship.
Parents' Resources and Home Management of the Care of Chronically Ill Infants
Authors: Sterling Yvonne M. , Jones Linda Corson , Johnson Deborah H. , Bowen Melissa R.
Published: February 2007

purpose. To identify resources of parents or primary caretakers who managed chronically ill infants at home and to determine psychometric properties of Home Care Resources Inventory (HCRI)

design. Cross‐sectional, descriptive

setting. Outpatient clinics

participants. Parents or primary caretakers (N = 100) of chronically ill infants who were discharged from hospital at least one week; 93% of sample were mothers; infants' ages ranged from 1–22 months

main outcome measures. HCRI, the Spielberger State Anxiety Inventory, and a demographic questionnaire

results. Parents reported strong resources in the area of support and inconsistent resources in areas of coping, time, and respite. The HCRI has acceptable psychometric properties.

conclusions. Identifying resources, especially personal time and respite, is essential for successful home management of chronically ill infants. The HCRI can be used to pinpoint areas that are strong or weak in the two resource areas measured.
Smoking Status Among Women in Households With Young Children
Authors: Sarna Linda , Brecht Mary Lynn
Published: February 2007

purpose. To identify sociodemographic and health‐related correlates of smoking status among women in households with young children.

design. A secondary analysis of the 1992 California Behavioral Risk Factor Surveillance System public‐use data tape

participants. Women (N = 520) in households with very young children (≤ 5 years of age)

main outcome measures. Current smoking status

results. Approximately 18% were current smokers; more than 40% smoked more than 10 cigarettes each day. A majority of smokers indicated a high level of nicotine addiction, but had plans to quit. Smoking prevalence varied by sociodemographic variables with higher rates for unmarried, less than college educated, and unemployed participants. Health status also was related to smoking, with higher rates among those with poor health and those limited in activities.

conclusions. Smoking is one way of coping with the stressors of daily life, including those associated with caring for young children. Special cessation efforts may be needed for the unemployed, the unmarried woman, and for those in poor health.
Parent Line: Nurse Telephone Intervention for Parents and Caregivers of Children from Birth Through Age 5
Authors: Moore Mary Lou , Krowchuk Heidi
Published: February 2007

purpose. To describe the development and implementation of Parent Line, a program to improve the health and development status of children through periodic telephone contact by nurses.

population. Low‐income parents of children from birth through age 5.

conclusion. Telephone contact with a nurse, combined with peer counselor contact when no telephone is available, is welcomed by parents and can address needs in a timely way that might be unmet otherwise. Telephone intervention can provide social and emotional support, education, and advocacy for families.

practice implications. The telephone can be of value to pediatric nurses in providing anticipatory guidance and health teaching, and be a support to parents throughout the preschool years.
Teaching Teens to Cope: Coping Skills Training for Adolescents With Insulin‐Dependent Diabetes Mellitus
Authors: Davidson Maryanne , Boland Elizabeth A. , Grey Margaret
Published: February 2007

purpose. To review the potential use and application of coping‐skills training in teaching adolescents effective ways of managing the stressors related to living with diabetes mellitus.

population. Adolescents ages 13 to 20 with insulin‐dependent diabetes mellitus who are participating in the research project, “Nursing Intervention to Implement DCCT Therapy in Youth” at Yale University School of Nursing.

conclusions. Teaching adolescents with diabetes mellitus to use appropriate coping skills may help them cope with the day‐to‐day management of the illness and aid in long‐term adaptation.

practice implications. Research has suggested that the use of effective coping skills may aid in healthy long‐term adaptation to diabetes mellitus. Thus, nurses caring for adolescents with this illness should teach and be role models for these effective coping strategies.
Mothering Children Who Survive Brain Injuries: Playing the Hand You're Dealt
Authors: Guerriere Denise , McKeever Patricia
Published: February 2007

Purpose. To explore how mothers come to terms with the multiple changes that occur in children who sustain sudden brain injuries

design. A descriptive study based on symbolic interactionist principles

setting. Mothers' homes or a private interview room in a hospital

participants. Seven mothers recruited through a pediatric rehabilitation center

main outcome measures. Each mother described her experiences with her child in one open‐ended interview.

results. Mothers' lives changed abruptly and profoundly when a previously healthy child suffered a catastrophic brain injury. Their accounts revealed how they had come to regard themselves and the children as “different people” after the injury. Their reconstructions were the result of continuous self‐reflection and interactions with others. Mothers had recast life in general from being predictable and controllable to being precarious and dominated by fate. Believing they had no other choice, they played the hand they had been dealt.

conclusions. Nurses can play an important role in helping mothers of children who have brain injuries by reassuring them that feelings of guilt and helplessness are not uncommon, praising them for learning new caregiving skills, and treating children with brain injuries with respect and dignity.