bluuebunny/crossref_metadata_2025 huggingface dataset:
Trapping hydrogen atoms from a neon-gas matrix: A theoretical simulation
Authors: Bovino S. , Zhang P. , Kharchenko V. , Dalgarno A.
Published: August 2009

Hydrogen is of critical importance in atomic and molecular physics and the development of a simple and efficient technique for trapping cold and ultracold hydrogen atoms would be a significant advance. In this study we simulate a recently proposed trap-loading mechanism for trapping hydrogen atoms released from a neon matrix. Accurate ab initio quantum calculations are reported of the neon-hydrogen interaction potential and the energy- and angular-dependent elastic scattering cross sections that control the energy transfer of initially cold atoms are obtained. They are then used to construct the Boltzmann kinetic equation, describing the energy relaxation process. Numerical solutions of the Boltzmann equation predict the time evolution of the hydrogen energy distribution function. Based on the simulations we discuss the prospects of the technique.
Energy loss rate of hot electrons due to confined acoustic phonon modes in a freestanding quantum well structure
Authors: Bhat J. S. , Nesargi R. A. , Mulimani B. G.
Published: August 2009

The energy loss rate of hot electrons in a semiconducting freestanding quantum well structure, in the presence of zero and finite quantizing magnetic field, is studied using electron temperature model. Electron interaction with confined acoustic phonons via deformation potential coupling described by elastic continuum model is considered. Numerical results are given for GaN, InAs, and InSb with zinc-blende structure and GaAs freestanding quantum well structures for the dependence of energy loss rate on electron temperature and the magnetic field. The results are compared to those obtained for bulk description of acoustic phonon modes.
Magnetogravitational potential revealed near a liquid-vapor critical point
Authors: Lorin Clément , Mailfert Alain , Chatain Denis , Félice Hélène , Beysens D.
Published: August 2009

Magnetic forces are increasingly used to compensate weight in multiphase matter (solids, liquids, or vapor), but compensation cannot be strictly uniform. In order to determine quantitatively the remaining forces, a magnetogravitational potential was constructed. The potential can be revealed by the shape of the liquid-vapor interfaces near the critical point, where the interfacial tension vanishes. Experiments near the critical point of H2 (33K) are reported which support this finding.
Invited Review Article: Imaging techniques for harmonic and multiphoton absorption fluorescence microscopy
Authors: Carriles Ramón , Schafer Dawn N. , Sheetz Kraig E. , Field Jeffrey J. , Cisek Richard , Barzda Virginijus , Sylvester Anne W. , Squier Jeffrey A.
Published: August 2009

We review the current state of multiphoton microscopy. In particular, the requirements and limitations associated with high-speed multiphoton imaging are considered. A description of the different scanning technologies such as line scan, multifoci approaches, multidepth microscopy, and novel detection techniques is given. The main nonlinear optical contrast mechanisms employed in microscopy are reviewed, namely, multiphoton excitation fluorescence, second harmonic generation, and third harmonic generation. Techniques for optimizing these nonlinear mechanisms through a careful measurement of the spatial and temporal characteristics of the focal volume are discussed, and a brief summary of photobleaching effects is provided. Finally, we consider three new applications of multiphoton microscopy: nonlinear imaging in microfluidics as applied to chemical analysis and the use of two-photon absorption and self-phase modulation as contrast mechanisms applied to imaging problems in the medical sciences.
On the growth and electrical characterization of CuO nanowires by thermal oxidation
Authors: Gonçalves A. M. B. , Campos L. C. , Ferlauto A. S. , Lacerda R. G.
Published: August 2009

We present a detailed study on the growth process of cupric oxide (CuO) nanowires by thermal oxidation. The morphology of nanowires, obtained at different oxidation temperatures and times, was determined. The diameter of nanowires was found to depend linear on temperature whereas the time dependence of their length is modeled by a parabolic law. The results suggest that CuO nanowires are formed as a result of the competition between grain boundary and lattice diffusion of Cu atoms across a Cu2O layer. Electrical characterization of the nanowires was also performed. A field effect transistor was produced with an isolated nanowire showing p-type characteristics. The resistivity, mobility, and density of carriers were calculated. Nanowire growth by thermal oxidation is very simple and has great potential to be used for large scale production; this opens possibilities for various kinds of application.
On the solutions of three-dimensional non-null magnetic reconnection
Authors: Al-Salti Nasser , Hornig Gunnar
Published: August 2009

Here we present solutions of a stationary magnetohydrodynamic (MHD) model for three-dimensional (3D) magnetic reconnection in the absence of a null point. The solutions are found in the form of an expansion scheme with a localized nonideal region. A wide variety of both analytical and numerical solutions of the resistive MHD equations can be obtained via an integration scheme, which includes free functions to match boundary conditions. General analytical solutions are obtained for the first few orders, whereas higher order solutions require numerical integration. Thus, numerical techniques have been used to examine the contribution of some higher order terms. The obtained solutions show important differences between 3D solutions and the commonly used two-dimensional models. In particular, they show the existence of more complicated current and flow structures in the reconnection region.
Theory of fine-scale zonal flow generation from trapped electron mode turbulence
Authors: Wang Lu , Hahm T. S.
Published: August 2009

Most existing zonal flow generation theory has been developed with a usual assumption of qrρθi⪡1 (qr is the radial wave number of zonal flow and ρθi is the ion poloidal gyroradius). However, recent nonlinear gyrokinetic simulations of trapped electron mode turbulence exhibit a relatively short radial scale of the zonal flows with qrρθi∼1 [Z. Lin et al., Proceedings of the 21st International Conference on Plasma Physics and Controlled Nuclear Fusion Research, Chengdu, China, 2006 (International Atomic Energy Agency, Vienna, 2006); D. Ernst et al., Phys. Plasmas 16, 055906 (2009)]. This work reports an extension of zonal flow growth calculation to this short wavelength regime via the wave kinetics approach. A generalized expression for the polarization shielding for arbitrary radial wavelength [L. Wang and T. S. Hahm, Phys. Plasmas 16, 062309 (2009)] which extends the Rosenbluth–Hinton formula in the long wavelength limit is applied.
Modulation of alternating electric field inside photoexcited carbon nanotubes
Authors: Zhang Hong , Miyamoto Yoshiyuki
Published: August 2009

Modulation of an alternating electric field (E-field) inside semiconducting carbon nanotubes (CNTs) has been studied with polarization perpendicular to the tube axis. The real-time dynamics of the electron wave functions and atoms in the CNTs was investigated by applying first-principles time-dependent density functional theory. The E-field inside the CNTs was not screened completely and was actually enhanced depending on the frequency. The enhancement was due to the increasing amplitude of the oscillating electron cloud with the resonant frequency. This finding provides a clear insight into the optical response of CNTs and also of molecules encapsulated in CNTs.
Thermal transport through superlattice solid-solid interfaces
Authors: Murad Sohail , Puri Ishwar K.
Published: August 2009

Using molecular dynamics, we consider the thermal resistances of superlattices consisting of varying numbers of distinct nanolayers of two different materials. These are placed between two water reservoirs at uniform hot and cold temperatures. The interfacial resistances produced between different solid layers can lead to significantly lower heat transfer for a specified temperature difference. Such a large reduction in thermal transport cannot be explained by the interfacial resistance alone. In addition to the interfacial resistance between two adjacent superlattice layers, the relatively wide thermal boundary layers that are produced adjacent to the interfaces introduces a supplementary resistance.
Influence of miscible viscous fingering of finite slices on an adsorbed solute dynamics
Authors: Mishra M. , Martin M. , De Wit A.
Published: August 2009

Viscous fingering (VF) between miscible fluids of different viscosities can affect the dispersion of finite width samples in porous media. We investigate here the influence of such VF due to a difference between the viscosity of the displacing fluid and that of the sample solvent on the spatiotemporal dynamics of the concentration of a passive solute initially dissolved in the injected sample and undergoing adsorption on the porous matrix. Such a three component system is modeled using Darcy’s law for the fluid velocity coupled to mass-balance equations for the sample solvent and solute concentrations. Depending on the conditions of adsorption, the spatial distribution of the solute concentration can either be deformed by VF of the sample solvent concentration profiles or disentangle from the fingering zone. In the case of deformation by fingering, a parametric study is performed to analyze the influence of parameters such as the log-mobility ratio, the ratio of dispersion coefficients, the sample length, and the adsorption retention parameter k′ on the widening of the solute concentration peak. The results highlight experimental evidences obtained recently in reversed-phase liquid chromatography.
On anomalies in elastic electron scattering cross sections from protons
Authors: Moreh R. , Nemirovsky D.
Published: August 2009

A critical examination of recent elastic electron scattering reports on H-containing samples is carried out. We show that all results are consistent with the conclusion that no anomaly exists in the measured e-H scattering intensities as compared to e-scattering from other light atoms such as D or C. The scattering results are, in fact, in agreement with the classical Rutherford formula and there is no need to invoke short-lived quantum entanglement of the protons to explain the existing data. The neutron-proton scattering intensities on H-containing samples were also examined and found to agree with standard cross sections. Also no theoretical evidence was found supporting the existence of the reported anomalies.
Phenotypic variability in Holcus lanatus L. in southern Chile: a strategy that enhances plant survival and pasture stability
Authors: López Ignacio F. , Balocchi Oscar A. , Kemp Peter D. , Valdés Claudio
Published: August 2009

Holcus lanatus L. can colonise a wide range of sites within the naturalised grassland of the Humid Dominion of Chile. The objectives were to determine plant growth mechanisms and strategies that have allowed H. lanatus to colonise contrasting pastures and to determine the existence of ecotypes of H. lanatus in southern Chile. Plants of H. lanatus were collected from four geographic zones of southern Chile and established in a randomised complete block design with four replicates. Five newly emerging tillers were marked per plant and evaluated at the vegetative, pre-ear emergence, complete emerged inflorescence, end of flowering period, and mature seed stages. At each evaluation, one marked tiller was harvested per plant. The variables measured included lamina length and width, tiller height, length of the inflorescence, total number of leaves, and leaf, stem, and inflorescence mass. At each phenological stage, groups of accessions were statistically formed using cluster analysis. The grouping of accessions (cluster analysis) into statistically different groups (ANOVA and canonical variate analysis) indicated the existence of different ecotypes. The phenotypic variation within each group of the accessions suggested that each group has its own phenotypic plasticity. It is concluded that the successful colonisation by H. lanatus has resulted from diversity within the species.
The preproghrelin gene is required for the normal integration of thermoregulation and sleep in mice
Authors: Szentirmai Éva , Kapás Levente , Sun Yuxiang , Smith Roy G. , Krueger James M.
Published: August 2009

Peptidergic mechanisms controlling feeding, metabolism, thermoregulation, and sleep overlap in the hypothalamus. Low ambient temperatures and food restriction induce hypothermic (torpor) bouts and characteristic metabolic and sleep changes in mice. We report that mice lacking the preproghrelin gene, but not those lacking the ghrelin receptor, have impaired abilities to manifest and integrate normal sleep and thermoregulatory responses to metabolic challenges. In response to fasting at 17 °C (a subthermoneutral ambient temperature), preproghrelin knockout mice enter hypothermic bouts associated with reduced sleep, culminating in a marked drop in body temperature to near-ambient levels. Prior treatment with obestatin, another preproghrelin gene product, attenuates the hypothermic response of preproghrelin knockout mice. Results suggest that obestatin is a component in the coordinated regulation of metabolism and sleep during torpor.
A medaka model of cancer allowing direct observation of transplanted tumor cells in vivo at a cellular-level resolution
Authors: Hasegawa Sumitaka , Maruyama Kouichi , Takenaka Hikaru , Furukawa Takako , Saga Tsuneo
Published: August 2009

The recent success with small fish as an animal model of cancer with the aid of fluorescence technique has attracted cancer modelers' attention because it would be possible to directly visualize tumor cells in vivo in real time. Here, we report a medaka model capable of allowing the observation of various cell behaviors of transplanted tumor cells, such as cell proliferation and metastasis, which were visualized easily in vivo. We established medaka melanoma (MM) cells stably expressing GFP and transplanted them into nonirradiated and irradiated medaka. The tumor cells were grown at the injection sites in medaka, and the spatiotemporal changes were visualized under a fluorescence stereoscopic microscope at a cellular-level resolution, and even at a single-cell level. Tumor dormancy and metastasis were also observed. Interestingly, in irradiated medaka, accelerated tumor growth and metastasis of the transplanted tumor cells were directly visualized. Our medaka model provides an opportunity to visualize in vivo tumor cells “as seen in a culture dish” and would be useful for in vivo tumor cell biology.
Helminth products bypass the need for TSLP in Th2 immune responses by directly modulating dendritic cell function
Authors: Massacand Joanna C. , Stettler Rebecca C. , Meier Reto , Humphreys Neil E. , Grencis Richard K. , Marsland Benjamin J. , Harris Nicola L.
Published: August 2009

Thymic stromal lymphopoietin (TSLP) is an interleukin (IL)-7-like cytokine, mainly expressed by epithelial cells, and key to the development of allergic responses. The well-documented involvement of TSLP in allergy has led to the conviction that TSLP promotes the development of inflammatory Th2 cell responses. However, we now report that the interaction of TSLP with its receptor (TSLPR) has no functional impact on the development of protective Th2 immune responses after infection with 2 helminth pathogens,Heligmosomoides polygyrusandNippostrongylus brasiliensis. Mice deficient in the TSLP binding chain of the TSLPR (TSLPR−/−) exhibited normal Th2 cell differentiation, protective immunity and memory responses against these two distinct rodent helminths. In contrast TSLP was found to be necessary for the development of protective Th2 responses upon infection with the helminthTrichuris muris(T. muris). TSLP inhibited IL-12p40 production in response toT. murisinfection, and treatment of TSLPR−/−animals with neutralizing anti-IL-12p40 monoclonal antibody (mAb) was able to reverse susceptibility and attenuate IFN-γ production. We additionally demonstrated that excretory-secretory (ES) products fromH. polygyrusandN. brasiliensis, but notT. muris, were capable of directly suppressing dendritic cell (DC) production of IL-12p40, thus bypassing the need for TSLP. Taken together, our data show that the primary function of TSLP is to directly suppress IL-12 secretion, thus supporting Th2 immune responses.
Multi-scale models of cell and tissue dynamics
Authors: Stolarska Magdalena A. , Kim Yangjin , Othmer Hans G.
Published: August 2009

Cell and tissue movement are essential processes at various stages in the life cycle of most organisms. The early development of multi-cellular organisms involves individual and collective cell movement; leukocytes must migrate towards sites of infection as part of the immune response; and in cancer, directed movement is involved in invasion and metastasis. The forces needed to drive movement arise from actin polymerization, molecular motors and other processes, but understanding the cell- or tissue-level organization of these processes that is needed to produce the forces necessary for directed movement at the appropriate point in the cell or tissue is a major challenge. In this paper, we present three models that deal with the mechanics of cells and tissues: a model of an arbitrarily deformable single cell, a discrete model of the onset of tumour growth in which each cell is treated individually, and a hybrid continuum–discrete model of the later stages of tumour growth. While the models are different in scope, their underlying mechanical and mathematical principles are similar and can be applied to a variety of biological systems.
Axial-symmetry breaking in constrained membranes
Authors: Biscari Paolo , Napoli Gaetano
Published: August 2009

We study the equilibrium shapes of a lipid membrane, attached to a fixed circular substrate. We show how the weakening of the boundary conditions is able to break the axial symmetry of the optimal equilibrium configuration. We derive the critical threshold of the symmetry-breaking transition, and obtain the analytical expression of the free-energy minimizers in the quasi-planar approximation. Metastable states turn out to contain contributions only from the axisymmetric mode, and at most one single non-trivial Fourier mode.
Low density lipoprotein receptor‐related protein 5 (LRP5) mutations and osteoporosis, impaired glucose metabolism and hypercholesterolaemia
Authors: Saarinen Anne , Saukkonen Tero , Kivelä Tero , Lahtinen Ulla , Laine Christine , Somer Mirja , Toiviainen‐Salo Sanna , Cole William G. , Lehesjoki Anna‐Elina , Mäkitie Outi
Published: August 2009

Objective  Mutations in the low‐density lipoprotein receptor‐related protein 5 gene (LRP5) underlie osteoporosis–pseudoglioma syndrome. Animal models implicate a role for LRP5 in lipid and glucose homeostasis. The objective was to evaluate metabolic consequences of LRP5 mutations in humans.

Design and patients  Thirteen Finnish individuals with homozygous or heterozygous LRP5 mutations were assessed for bone health, glucose and lipid metabolism, and for serum serotonin concentration. Results were compared with findings in family members without mutations.

Measurements  Bone mineral density (BMD), vertebral morphology, oral and intravenous glucose tolerance tests, lipid profile and serum serotonin concentrations.

Results  Two individuals were homozygous for R570W, one compound heterozygous for R570W and R1036Q, and 10 were heterozygous (six for R570W, three for R1036Q and one for R925C). Subjects with two LRP5 mutations had multiple spinal fractures and low BMD. Subjects with one mutation had significantly lower median lumbar spine (P = 0·004) and femoral neck (P = 0·005) BMD Z‐scores, and more often vertebral fractures than the 18 individuals without mutations. Of the 12 subjects with LRP5 mutation six had diabetes and one had impaired glucose tolerance. Intravenous glucose tolerance tests suggested impaired beta‐cell function; no insulin resistance was observed. Prevalence of hypercholesterolaemia was similar in mutation positive and negative subjects. Serum serotonin concentrations showed a trend towards higher concentrations in subjects with LRP5 mutation.

Conclusions  We found high prevalence of osteoporosis and abnormal glucose metabolism in subjects with LRP5 mutation(s). Further studies are needed to establish the role of LRP5 in glucose and lipid metabolism.
Bone marrow transplantation in Europe: major geographical differences
Authors: GRATWOHL A. , HERMANS J. , GOLDMAN J. M. , GAHRTON G. ,   (for the European Group for Bone Marrow Transplantation [EBMT])
Published: August 2009

Abstract. In 1991 171 teams in 21 European countries performed 4976 bone marrow transplants. There were 1829 transplants from an HLA‐identical sibling donor. 101 from a non‐identical family member. 30 from a twin. 217 from an unrelated volunteer donor and 2799 autologous transplants. Indications for transplants were leukaemias in 2569 (52%), lymphoproliferative disorders in 1472 (30%), solid tumours in 549 (11%), aplastic anaemia and thalassaemia in 261 (5%), inborn errors in 97 and miscellaneous disorders in 28 patients. There are marked differences between the participating European countries. They relate to absolute numbers, indications and techniques. Less than 10 transplants per 10‐million inhabitants are performed in Eastern European countries. Ten to fifty transplants per 10‐million inhabitants are done in two, 50–100 transplants per 10‐million inhabitants in five, 100–200 transplants per 10‐million inhabitants in eight countries and more than 200 per 10‐million inhabitants in one country (P < 0.01). The number of transplant teams ranges from less than one to twelve per 10‐million inhabitants (P < 0.01). For the continent it becomes 3.3 per 10‐million inhabitants.

The reasons for these differences are not explained by this survey. The most likely explanation for the differences in transplant activity is availability of transplant beds, trained staff and resources. Bone marrow transplants are expensive. However, the demand is increasing and will increase further with the routine availability of unrelated volunteer donors. Clearly, criteria are required in Europe to define the indications and solutions to meet the legitimate requirements for transplantation in the various regions of Europe.
Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis
Authors: FARIÑAS M. C. , ECHEVARRÍA S. , SAMPEDRO I. , GONZALEZ A. , DEL MOLINO A. PÉREZ , GONZÁLEZ‐MACÍAS J.
Published: August 2009

Abstract. Cerebral toxoplasmosis is optimally treated with the combination of high doses of sulphadiazine and pyrimethamine. We described two patients with AIDS treated for cerebral toxoplasmosis who developed renal failure due to sulphadiazine‐induced crystalluria. Symptoms and renal failure were rapidly reversed with urine alkalinization and hydration. A careful monitoring and adequate hydration of patients with AIDS treated with high doses of sulphadiazine appears mandatory to avoid this complication.
Supraventricular tachycardia, right atrial pressure, atrial natriuretic peptide and polyuria—a necessary sequence ?
Authors: TAN S. Y. , NOLAN J. , CRAIG K. , SWAINSON C. P.
Published: August 2009

Abstract. The release of atrial natriuretic peptide (ANP) may be stimulated by tachycardia and the evidence from human studies suggests that this is mediated by a rise in atrial pressure. However, animal experiments suggest that tachycardia can by itself increase ANP levels without increasing right atrial pressure (RAP). We report here the case of a healthy volunteer who had supraventricular tachycardia (SVT) whilst participating in a study evaluating the relationship between changes in RAP and changes in ANP. The ANP levels rose following the SVT but there was no rise in RAP, suggesting that heart rate can modulate ANP levels without changes in RAP as has been shown in animal experiments.
Sleep habits and sleep disturbances among the elderly—an epidemiological survey
Authors: GISLASON T. , REYNISDÓTTIR H. , KRISTBJARNARSON H. , BENEDIKTSDÓTTIR B.
Published: August 2009

Abstract. Objectives. To analyse simultaneously sleep habits and sleep disturbances in an elderly population and numerous factors possibly affecting sleep at the same time.

Design. A cross‐sectional epidemiological survey by means of questionnaires.

Setting. The capital city of Iceland, Reykjavik and surrounding suburbs.

Participants. A randomly selected, but stratified sample with 100 men and 100 women in each 5‐year age group of the ages 65–84 years—800 individuals altogether.

Main outcome measure. Sleep habits and sleep disturbances.

Results. The mean duration of sleep was 7.25 h (sd 74 min). Mean sleep onset time was 00.13 hours and was not related to age and gender but was delayed at weekends. Daytime napping was reported by 50% of the men and 31% of the women (P < 0.001). Difficulty maintaining sleep (DMS) was the most commonly reported insomnia complaint (men 37% and women 30%). Sleep charts revealed that men woke up an average of 1.2 times per night but women 0.8 times per night (P < 0.01). Difficulty initiating sleep was reported by 9.6% and early morning awakening (EMA) by 16.7%. Pain was a strong factor contributing to EMA. There was also an increase in EMA complaints among the elderly with obstructive pulmonary diseases and systemic hypertension. The prevelance of insomnia was only partly related to age and gender. Multiple regression analyses, however, showed different interrelationships between insomnia and other symptoms and findings for men versus women.

Conclusion. DMS is the most commonly reported insomnia complaint among the elderly (men 37% and women 30,%). The prevalence of insomnia did not increase with age in our study group.
Lymphocytic gastritis: an unusual cause of hypoproteinaemia
Authors: FARAHAT K. , HAINAUT P. , JAMAR F. , HAOT J. , LAMBERT M.
Published: August 2009

Abstract. Lymphocytic gastritis (LG) is a disorder characterized by diffuse infiltration of the gastric epithelium by small lymphocytes. Its cause remains largely unknown, although several arguments favour an immune origin. Hypoproteinaemia induced by leakage of plasma proteins into the gastric lumen is a rare complication of LG. We report here on three cases of LG whose presenting symptom was lower limb oedema secondary to hypoproteinaemia. The diagnosis was based on radiological, endoscopic and histopathological findings. Radionuclide studies allowed confirmation of the loss of proteins in the stomach. Therapy with omeprazole or H2‐receptors antagonists proved to be successful. The relationship between LG and varioliform gastritis is reviewed.
Anaphylatoxins in dilated cardiomyopathy
Authors: SAMSONOV M. , NASSONOV E. , MASENKO V. , NAUMOV V. , MAREEV V. , BELENKOV Yu.
Published: August 2009

Abstract. Objects. The aim of the study was to investigate the possible relationship between activation of complement system and thromboembolic complications in dilated cardiomyopathy (DCMP).

Methods. The plasma C3a and C5a concentrations were determined by radioimmunoassay measurement (Amersham International, UK) in 23 patients with DCMP, 9 with hypertrophic cardiomyopathy (HCMP) and 11 healthy volunteers.

Results. The mean C3a concentration was significantly higher in DCMP patients (572 ± 55 ng ml−1) compared with hypertrophic cardiomyopathy (344 ± 30 ng ml−1) and with healthy controls (294 ± 43 ng ml−1) (P < 0.001). There were no significant correlations for C5a concentrations in this group. Mean C3a concentration in DCMP patients with thromboembolic complications (736 ± 95 ng ml−1) was also significantly higher compared with DCMP patients without these complications (344 ± 14 ng ml−1) (P < 0.001).

Conclusions. We conclude that anaphylatoxins may play a role in the pathogenesis of thromboembolic complications.
No evidence of mitochondrial abnormality in skeletal muscle of patients with iron‐deficient anaemia
Authors: THOMPSON C. H. , KEMP G. J. , TAYLOR D. J. , RADDA G. K. , RAJAGOPALAN B.
Published: August 2009

Abstract. Objectives. Patients with iron deficiency anaemia complain of decreased exercise capacity. We asked whether this is due to defective oxidative ATP synthesis in skeletal muscle as a consequence of reduced blood oxygen content and/or intrinsic mitochondrial abnormalities.

Design. We used 31P magnetic resonance spectroscopy to examine skeletal muscle bioenergetics in iron‐deficient patients and in age‐ and sex‐matched controls.

Setting. The patients were recruited from the primary care population.

Subjects. We studied seven symptomatic female iron‐deficient patients (aged 32–70 years) with haemoglobin (Hb) concentration, [Hb], 8.0 g dl−1. Six had menorrhagia, the cause in the seventh patient remained undiagnosed. Results were compared with those of 8 healthy female controls (aged 25–48 years) with mean [Hb] 13.7 g dl−1.

Results. The right calf muscle was by studied 31P magnetic resonance spectroscopy in a 1.9 T superconducting magnet. We measured the intracellular concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), adenosine triphosphate (ATP) and the intracellular pH at rest, during plantar flexion exercise and during recovery from exercise.

Exercise duration was reduced in the patients, yet end‐exercise PCr/(PCr + Pi) was higher and adenosine diphosphate (ADP) lower than in controls. After exercise, initial PCr recovery was slowed but this was probably because of the lower cytosolic ADP concentration.

Conclusions. Mitochondrial ATP synthesis was not limited by oxygen supply or an intrinsic mitochondrial defect. Therefore, the reduced exercise capacity seen in iron deficiency could be due to central causes and not to skeletal muscle metabolic abnormalities.
Accuracy of clinical diagnoses in a teaching hospital: a review of 997 autopsies
Authors: KAJIWARA J. K. , ZUCOLOTO S. , MANÇO A. R. X. , MUCCILLO G. , BARBIERI M. A.
Published: August 2009

Abstract. Objectives. To analyse the concordance between clinical and autopsy diagnoses.

Design. Nine‐hundred‐and‐ninety‐seven autopsies were studied comparing the diagnoses of the autopsy requests with those of the death certificates and autopsy reports. The cases were grouped according to the 17 categories of diseases of the International Classification of Diseases (ICD) and the concordance was analysed with the k (kappa) coefficient of concordance.

Setting. The Hospital da Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil.

Subjects. The patients autopsied at HCFMRPUSP during the period between 1978 and 1980.

Main outcome measures. k statistics offer an alternative approach to measuring the concordance between clinical and autopsy diagnoses.

Results. The k‐value obtained was equal to 0.601 with a variance of 1.545 times 10−4 when comparing the clinical diagnoses and the autopsy diagnoses, and equal to 0.661 with a variance of 1.531 times 10−4 comparing the clinical diagnoses with those obtained after the gross examination. These values are significant at the level of 5%, i.e. there is an overall statistical concordance between clinical and autopsy diagnoses although the value is not absolute (k= 1.00).

Conclusions. If autopsies are heeded without bias, they will continue to give important feedback concerning medical diagnosis.
Hand abnormalities are strongly associated with the duration of diabetes mellitus
Authors: GAMSTEDT A. , HOLM‐GLAD J. , OHLSON C.‐G. , SUNDSTRÖM M.
Published: August 2009

Abstract. Objectives. To study the prevalence of hand abnormalities in diabetic patients and to evaluate associations between the hand abnormalities and diabetic variables, ergonomic factors and smoking habits.

Design. Cross‐sectional study of 100 patients selected at random.

Setting. Out‐patient clinic, Department of Internal Medicine, Örebro Medical Centre Hospital in Sweden.

Main outcome measures. Presence and extent of carpal tunnel syndrome (CTS), Dupuytren's contracture (DC), flexor tenosynovitis (FTS), and limited joint mobility (LJM). Duration of diabetes, metabolic control, chronic diabetic complications, blood pressure, ergonomic factors and smoking habits.

Results. Carpal tunnel syndrome, DC, FTS and LJM were each present in about 20% of the patients. Hand abnormalities were observed in 50 patients and more than one abnormality was found in 26 of the patients. The hand abnormalities were associated with the duration of diabetes but not with the metabolic control or with other diabetic complications. However, the diabetic complications were associated with bad metabolic control and with the duration of diabetes. Hand abnormalities correlated with heavy manual work but not with smoking habits. Twenty‐five of the 50 patients with hand syndromes were disabled to such an extent that surgery was recommended.

Conclusion. The prevalence of hand abnormalities in diabetic patients is high and increases with the duration of diabetes. In many cases patients with hand abnormalities can be helped by surgery.
Correspondence between screening and intra‐arterial blood pressures in young men with borderline hypertension
Authors: BERGBRANT A. , HANSSON L. , JERN S.
Published: August 2009

Abstract. Objectives. To evaluate the screening blood pressure (BP) for identification of individuals with a mild but persistent elevation of BP refered to as borderline hypertension (BH).

Design. Based on screening data from approximately 10500 men at a military enlistment centre in 1987; an unbiased population sample of young men were recruited. Blood pressure follow‐up and investigation of anthropometric and metabolic data were made at Östra Hospital.

Subjects. Men aged 19.8 years (range 17–28) were screened. Three hundred and six were found to have elevated BP (systolic BP (SBP) > 145 mmHg and/or diastolic BP (DBP) ≥ 85 mmHg). Of these, 179 were re‐examined after 1–3 years, by which time three individuals exceeded the limits for established hypertension and 80 fulfilled the BP criteria for BH (in two out of two blood pressure measurements). Fifty‐four of these BH individuals were investigated with intra‐arterial (i.a.) BP measurements. A normotensive control (NC) group (SBP 110–130 and DBP 60–80 mmHg; n = 20) from the same population was examined concomitantly.

Results. At screening, at the 2‐year clinic follow‐up and again during the intra‐arterial recording, SBP was significantly different in BH vs. NC. With DBP an increasing difference between the groups was observed with time. There were highly significant correlations between screening and 2‐year clinic BP (r = 0.72, P < 0.001; n = 74) and screening and i.a. BP (r = 0.57, P < 0.001; n = 74).

Conclusions. These data show that there is a correspondence between BP at the screening procedure and i.a. BP measured 2 years later, indicating that the screening procedure is a useful way of identifying young men with mild but persistent BP elevation. This interpretation is supported by metabolic and biochemical differences between the groups.
Disseminated Mycobacterium malmoense infection in a patient with chronic granulocytic leukaemia
Authors: ENGERVALL P. , BJÖRKHOLM M. , PETRINI B. , HEURLIN N. , HENRIQUES B. , KÄLLENIUS G.
Published: August 2009

Abstract. Mycobacterium malmoense is an atypical mycobacterium previously isolated from lymph nodes in children and from adults with pulmonary disease. Disseminated infection is extremely rare and bone marrow involvement has never previously been described. We report a patient with chronic granulocytic leukaemia and persistent fever with granuloma in the bone marrow due to disseminated M. malmoense infection. The patient initially received treatment with isoniazid, ethambutol and rifampicin with clearance of mycobacteria in the bone marrow and clinical improvement. Sensitivity in vitro was established for streptomycin, amikacin, ethambutol and rifabutin. The patient eventually expired as a result of progressive respiratory failure from other opportunistic infections. At autopsy staining of samples from lung parenchyma revealed fungal hyphi but staining for Pneumocystis carinii and myobacteria were negative.
Survival analysis of 118 patients with systemic sclerosis
Authors: CZIRJÁK L. , NAGY Z. , SZEGEDI G.
Published: August 2009

Abstract. Life‐table analysis based on the survival statistics of 118 Hungarian patients with systemic sclerosis suggests that the presence of skin hypo‐ and/or hyperpigmentation indicates a poor prognosis. Furthermore, truncal skin involvement, lung, cardiac, and renal manifestations, older age at the onset of disease, anaemia, hand deformity, and elevated erythrocyte sedimentation rate values, predict an unfavourable prognosis, whilst patients with exposure to chemicals shows a relatively favourable disease outcome.
Cardiovascular risk factors in treated hypertensives—a nation‐wide, cross‐sectional study in Sweden
Authors: NILSSON P. , ANDERSSON D. K. G. , ANDERSSON P.‐E. , SCHWAN Å , ÖSTLIND B. , MALMBORG R. , LITHELL H. , ANDERSSON O. K.
Published: August 2009

Abstract. Hypertensive patients still face a considerable risk of cardiovascular disease in spite of drug treatment in many studies. This may partly be explained by metabolic disturbances, both primarily linked to hypertension but also secondarily influenced by anti‐hypertensive drugs themselves.

In order to evaluate residual cardiovascular risk factors we investigated 1915 treated hypertensives (912 males, 1003 females) attending 128 health centres from all parts of Sweden.

Mean blood pressure was 148/91 mmHg for males and 151/90 for females, but a substantial proportion of all patients were not well controlled, having a diastolic blood pressures ≥ 100 mmHg (17% males, 12% females). Total cholesterol and HDL‐cholesterol were 6.03 and 1.25 mmol l−1 for males, and 6.40 and 1.50 for females. The corresponding figures for serum triglycerides were 2.03 and 1.72 mmol l−1 respectively. In all, 38% of the hypertensives had hypercholesterolaemia (≥ 6.5 mmol l−1) and 27% hypertriglyceridaemia (≥ 2.3 mmol l−1). The lipid/lipoprotein findings may also be influenced by the various anti‐hypertensive drugs used in Sweden. The prevalence of smoking and diabetes mellitus were 25% and 11% for men, and for women 24% and 9%.

In conclusion, Swedish hypertensives show evidence of significant residual cardiovascular risk factors in spite of treatment. This may be of importance for future relative and absolute cardiovascular risk. It is time to re‐evaluate the effectiveness of our management and care of hypertensive patients.
Anaphylactoid shock following Hymenoptera sting as a presenting symptom of systemic mastocytosis
Authors: KORS J. W. , VAN DOORMAAL J. J. , DE MONCHY J. G. R.
Published: August 2009

Abstract. Systemic mastocytosis is a rare and chronic disorder characterized by a pathologically increased number of mast cells in various tissues and overproduction of mast cell mediators. From a group of 15 patients (10 females. 5 males) with systemic mastocytosis five female patients presented with a history of an anaphylactoid shock reaction to wasp sting. Three of them had no demonstrable specific IgE against wasp or bee venom in serum, and a skin test that was only weakly positive for wasp venom. One patient had specific IgE against wasp venom and a clearly positive skin test to wasp venom. The other patient had specific IgE against both wasp and bee venom and a skin test that was only weakly positive to wasp venom. Two patients had to stop a hyposensitization procedure because of systemic side effects. The five patients did not differ from the other patients with systemic mastocytosis with regard to either clinical symptoms and signs or urinary excretion of histamine metabolites. From the latter group two female and three male patients said they had been stung by a wasp in the past. Thus, anaphylactoid shock after Hymenoptera sting can be a presenting symptom of systemic mastocytosis and may be caused by an IgE‐as well as a non‐IgE‐mediated mechanism. In cases of anaphylactoid reaction to Hymenoptera sting, especially when there is no IgE demonstrable in serum or in cases of intolerance of hyposensitization, the diagnosis of systemic mastocytosis should be considered, also in the absence of the clinical hallmarks of urticaria pigmentosa.
Severe skin necrosis following warfarin therapy in a patient with protein C deficiency
Authors: LOCHT H. , LINDSTRÖM F. D.
Published: August 2009

Abstract. A female patient with a history of both arterial and venous thrombosis developed extensive skin necrosis following warfarin treatment. When protein C deficiency was diagnosed, successful anticoagulation with warfarin was achieved by prolonging the course of intravenous heparin and introducing warfarin therapy with a low initial dose which was gradually increased. Aspects of the pathogenic mechanism are discussed.
Transgenic mouse models for tumour‐suppressor genes
Authors: KUMAR T. R. , DONEHOWER L. A. , BRADLEY A. , MATZUK M. M.
Published: August 2009

Abstract. Tumour‐suppressor genes are negative regulators of cell division and growth. Over the past decade, multiple, distinct tumour‐suppressor genes have been identified and cloned. In recent years, the ability to specifically manipulate the mouse genome via over‐expression, underexpression or deletion of genes using transgenic expression systems and embryonic stem cell (ES) technology has led to the identification and definition of the precise function of several tumour suppressor genes in vivo. Included in this group are mice with mutations in the p53 and retinoblastoma (Rb) genes. p53 Mutant mice are highly susceptible to tumour development and will serve as excellent models to understand the aetiology and pathology of several human cancers. In contrast to the role of the Rb gene in human retinoblastomas, mice heterozygous for a mutant Rb allele do not develop retinoblastoma, but develop pituitary tumours instead. Similar ES cell technology has been used to generate α‐inhibin deficient mice. Inhibin‐deficient mice develop gonadal and adrenal tumours with nearly 100% penetrance. These studies have identified inhibin as a novel secreted tumour suppressor. In the future, many of the unidentified functions of tumour‐suppressor genes can be tested using this powerful in vivo assay system.
Molecular tools for presymptomatic testing in multiple endocrine neoplasia type 1
Authors: LARSSON C. , CALENDER A. , GRIMMOND S. , GIRAUD S. , HAYWARD N.K. , TEH B. , FARNEBO F.
Published: August 2009

Abstract. The aim of this workshop session was to define a set of molecular tools for pre‐clinical diagnosis in affected families, and to assess presence or absence of linkage to 11q13 in families with classical MEN1 as well as with MEN 1‐related clinical features. A consensus linkage map of first‐ and second‐choice markers based on PCR as well as Southern blotting was established at the workshop. Based on the results from linkage analysis in 87 families with classical MEN1, presymptomatic testing using the suggested panel of markers, can now be performed with great accuracy.
Acquired total immunoglobulin G deficiency in a patient with primary biliary cirrhosis
Authors: TAKE HITOSHI , KUBOTA KAZUO , TAMURA KOUSEI , KURABAYASHI HITOSHI , TAMURA JUN'ICHI , SHIRAKURA TAKUO
Published: August 2009

Abstract. A 38‐year‐old Japanese woman was hospitalized for susceptibility to respiratory tract infections. Clinical examinations revealed asymptomatic primary cholestasis, abnormally elevated immunoglobulin M (IgM) and antimitochondrial antibody, being consistent with asymptomatic primary biliary cirrhosis. Three years later her serum immunoglobulin G (IgG) decreased remarkably, whereas other immunoglobulins were unchanged. Immunological examinations on the peripheral blood lymphocytes demonstrated spontaneous over‐synthesis of serum IgM and decreased synthesis of IgG due to abnormal function of both T and B cells. Our case suggests a new possible association between primary biliary cirrhosis and IgG deficiency.
Benefits and liabilities of hypermobility in the back pain disorders of industrial workers
Authors: LARSSON L.‐G. , Mudholkar Govind S. , BAUM J. , SRIVASTAVA D. K.
Published: August 2009

Abstract. Objectives. Back pain disorders, sometimes called ‘the nemesis of medicine and the albatross of industry’, are ubiquitous, but have stubbornly defied diagnosis and treatment. Hypermobility syndrome, which is also very common, has been called ‘an enigma of human physiology’. Both conditions have attracted wide attention and interest only recently. In an earlier study, we considered the benefits and liabilities of joint hypermobility by studying 660 musicians in the USA. In a parallel manner, the present study analysed the back pain disorders of 606 workers in a Swedish high‐technology industrial plant in the context of spinal hypermobility.

Subjects and methods. The 606 industrial workers were examined for spinal hypermobility using a standard protocol, and interviewed for work‐related body‐posture requirements and the low back, shoulder and neck pain disorders experienced by them. The data were analysed for associations between hypermobility and physical complaints as a whole, and by taking into account gender and body‐postures at work.

Results. Twenty‐six per cent (37) of 144 workers with hypermobility but only 14% (64) of 453 without hypermobility experienced back pain (P < 0.002). Among the 326 workers with sitting or standing jobs, 40% (29) of 71 with hypermobility had back pain, whereas only 12% (30) of the 255 without hypermobility experienced back pain (P < 0.001). The corresponding numbers with back pain for 235 in jobs with changing body‐postures were 4.5% (3) of 66 with hypermobility and 14% (14) of 169 without hypermobility (P = 0.04).

Conclusions. Hypermobility of the spine is an asset if the work requires change of body‐posture, but a liability for those in a standing or sitting assignment. It reinforces a similar hypothesis proposed by Larsson et al.
Medical ethics – new horizons
Authors: Böttiger Lars Erik
Published: August 2009

Abstract. The medical ethics of Hippocrates are no longer sufficient in a society with changing social attitudes and, especially, rapidly developing medical technologies.

This Minisymposium is the third in a series of three, dealing with Medical Journals (J Intern Med 1992; 231: 99–102) and their central role in the distribution of new medical knowledge, bringing them into close contact with Scientific misconduct in medical research (J Intern Med 1994; 235: 103–35) and Medical ethics (this Minisymposium). The contents of the three Minisymposia are of importance not only to those dealing with medical journals but to all physicians – regardless of whether they are involved in research or in patient care – and to all others involved in health care.

The Minisymposium gives a brief history of the development of research ethics, widens the scope of medical ethics and discusses its transcultural aspects. From a more practical standpoint the two last articles deal with the problem of who makes the decisions for whom, and when to stop treatment – both with relevance to one of the most important problems of medicine today: prioritization.

The reader should note the difference between ‘medical ethics’, which is the wider concept, and ‘research ethics’, which deal specifically with the relation between the researcher and her/his patient or volunteer.