bluuebunny/crossref_metadata_2025 huggingface dataset:
Antigenic Relationships between Candida albicans and Various Yeasts as Reflected by Immunoglobulin-Class Specificity
Authors: Segal E. , Vardinon N. , Schwartz J. , Eylan E.
Published: October 2008

A group of guinea pigs was inoculated into the foot pads with a single dose of Candida albicans in complete Freund’s adjuvant, while another group was similarly inoculated once in the foot pads but also several times intramuscularly, with Candida alone. All guinea pigs were bled at different intervals after immunization and sera were separated chromatographically into IgG and IgM fractions. In order to study the antigenic relationships as reflected by immunoglobulin-class specificity, IgG and IgM fractions and whole sera obtained from guinea pigs differently immunized, were tested for the presence of agglutinins against C. albicans, six other species of Candida, and species of the ascosporogenous genera Saccharomyces, Kluyveromyces and Schizosaccharomyces. The results show that (1) only IgG fractions of the different sera prepared contained the specific anti-C. albicans antibodies; (2) IgG and IgM fractions of the sera obtained from a single inoculation did not reveal a specific pattern expressing antigenic relationships of the yeasts studied, and (3) the IgM fractions of the sera obtained from several inoculations had a more homogenous pattern of reactivity, since mainly these contained the agglutinins against the ascosporogenous yeast species.
The Source of Ascitic Fluid in Experimental Cirrhosis in the Rat
Authors: Mazzacca G. , Bianco A.R. , Budillon G. , Perillo N.
Published: October 2008

In order to disclose the source of ascitic fluid in liver cirrhosis, normal and cirrhotic rats were injected with fluorescein into the paracecal vein. The green fluorescence was then evaluated on the surface of the liver, the intestine and the peritoneum. Among healthy rats and in those with anascitic cirrhosis a very slight fluorescence was detected on the liver capsule whereas among rats with ascitic cirrhosis a distinct fluorescence was shown on the liver surface, the small intestine and the peritoneum. Therefore, the peritoneum is a source of ascitic fluid in cirrhosis of the rat.
F Antigen. III. Immunological and Biological Properties
Authors: Utzinger R.
Published: October 2008

Relationship of the isoforms of F antigens from A2G and CBA inbred mouse strains have been worked out in detail in respect to their immunogenicity. Mice from several inbred strains have been shown to possess the ability of forming anti-F upon stimulation with xenogeneic F antigens from certain species. An immuno-electrophoretic method for sensitive quantitation of the antigen is described. During human ontogenesis the antigen appears very early. It could never be detected in serum except in cases of acute liver disease. A small fragment set free under denaturing conditions showed the ability of inhibiting precipitation of the complete antigen by antibody. The F protein seems to be a vehicle for this small fragment possessing haptenic properties and probably being responsible for the universal cross-reactivity.
Peripheral Nervous System Involvement in Experimental Tuberculosis
Authors: Mauss H.
Published: October 2008

Following intravenous injection of mycobacteria in the mouse the bacilli are regularly found in the peripheral nervous system after the 5th day. The peripheral nerves and autonomic ganglia are involved at the level of the perineural cells and the sheath of Schwann. When the organisms are of low virulence (BCG, Mycobacterium intracellulare) the development of the nodules is limited. In the case of a virulent strain (Ravenel) extensive granulomas are found but epithelioid cells, always found in other organs, are constantly absent. In animals previously immunized, the bacilli seem to implant themselves as in the controls, but multiply more slowly; the nodules are more infrequent and the lymphoid infiltration appears earlier with the multiplication of interstitial cells.
Adhérence de E. coli pathogènes aux cellules épithéliales de la muqueuse intestinale du lapin
Authors: Demierre G. , Rivier D. , Hilpert H. , Gerber H. , Zinkernagel R.
Published: October 2008

Inhibiting effect of hyperimmune bovine colostrum and of various carbohydrates. In order to study the mode of action of a bovine anti-Escherichia coli lactoserum (BLS), we have used a new test measuring the adherence of pathogenic E. coli on epithelial cells isolated from the small intestine of rabbit. A mixed suspension of E. coli and of epithelial cells is incubated for 15 min and the number of bacteria adhering to the cells counted under the microscope. The BLS at a concentration of 3.5 mg/ml IgG is able to reduce this number by a factor of 3–5. After absorption of the BLS with formaldehyde-treated bacteria, this factor is smaller than 2. At a concentration of 5 mg/ml, D-mannose and α-methylmannoside are as efficient inhibitors of adherence as BLS; at the same concentration, L-mannose is ineffective. The cultures of E. coli strongly agglutinating guinea pig erythrocytes, adhere to a larger extent to the epithelial cells. The last two observations confirm the important role played by fimbriae for the adhesive properties of E. coli. The presence of fimbrial antibodies would partially explain the inhibiting effect of BLS on adherence.
Histochemical Studies of Human Breast Tumors: Activity of Alkaline Phosphatase, Acid Phosphataseand Glucose-6-Phosphate Dehydrogenase
Authors: Livni N. , Laufer A.
Published: October 2008

Histochemical studies of human breast tumors were performed with particular emphasis on the activity of alkaline phosphatase (A1P), acid phosphatase (AcP) and glucose-6-phosphate dehydrogenase (G6PDH). Enzyme activities in benign and malignant lesions were compared. A1P was prominent in normal mammary epithelium, limited to the myoepithelial layer in benign tumors and was absent in cords of malignant cells. AcP activity was faintly detected in normal mammary epithelium, increased in canalicular epithelium of fibroadenomas and was marked in malignant cells. G6PDH exhibited marked activity in neoplastic epithelium and the stroma of nearly all carcinomas studied, whereas in benign tumors, G6PDH activity was strictly limited to the connective tissue. The study suggests a strong correlation between G6PDH activity and malignancy. The different results obtained by various workers in this field are critically reviewed, and discussed in the light of the results of the present study.
Failure to Induce Autoimmune Phenomena in Mice by Administration of Highly Purified C-Type Particles from NZB Mice
Authors: Schaap O.L. , de Groot Els R. , van Loghem J.J.
Published: October 2008

Highly purified C-type particles from milk of NZB mice were ineffective in the transfer of Coombs positive hemolytic anemia and cryoglobulinemia to neonatal BALB/cHeA and NZC/Bl mice. Injection of neonatal NZB mice with these particles did not change the frequency or time of onset of these phenomena. Antinuclear antibodies were found in all injected animals in the same frequencies as in the control groups.
Fine Structural Changes in Embryonic Chick Heart Ventricle Induced by Lead Poisoning
Authors: Gilani S.H.
Published: October 2008

The embryonic chick heart ventricle of day 11 was studied electron microscopically to learn the structural changes that develop in lead poisoning. The chick embryos were administered with 0.015 mg/egg of lead acetate at day 2. The most pronounced changes observed in the ventricle were: malformed mitochondria, disorganized, short and scanty myofibrils and abundance of swollen vacuoles. The ultrastructure of the ventricle from the control chick embryos was normal. The most frequent change noted in the ventricular tissue was an alteration in the myofibrils.This study indicates that electron microscopic changes can be induced in the embryonic chick heart ventricle by lead poisoning.
Neuere Methoden zum Nachweis von Antigenen und Antikörpern
Authors: Krech U.
Published: October 2008

With the improvement of diagnostic procedures for the demonstration of antigens and antibodies it has been possible to increase the sensitivity and the specificity of antigen/antibody reactions, to introduce microtechniques and to apply a certain degree of automation and standardization, to allow a better interpretation of the results, and to cope with the ever increasing load of serological reactions.
Implications physio-pathologiques des complexes antigène-anticorps
Authors: Zubler R. , Nydegger U.E. , Izui S. , Lambert P.H. , Miescher P.A.
Published: October 2008

Seventy years after the description of the Arthus phenomenon, the concept of immune complex mediated pathology is widely recognized in clinical pathophysiology. The availability of methods for the detection of soluble immune complexes opens new paths for clinical investigation in this field. This is demonstrated for systemic lupus erythematosus, viral hepatitis B and herpes zoster disease. New experimental approaches deal with the question of tissue localization of immune complex mediated diseases, e.g. through affinity of antigens for certain tissue structures.
Characterization of Two H2S Producing, Multiple Drug-Resistant Isolates of Escherichia colifrom Clinical Urine Specimens
Authors: Traub Walter H. , Kleber Ingrid
Published: October 2008

Two H2S producing, multiple drug-resistant variants of Escherichia coli were isolated from clinical urine specimens. Both isolates transferred, eleven resistance determinants to recipient strains of E. coli K 12 and nine r-determinants to Klebsiella pneumoniae recipients; in no instance was transfer of the ‘curing’-refractory H2S marker demonstrable.
Das serologische Verhalten der pyogenen Anaerobier Peptococcus asaccharolyticus und P. prevotii
Authors: Böhm G. , Werner H.
Published: October 2008

Using rabbit antisera against whole-cell adjuvant-free antigens, the serological behaviour of ten butyrate-producing Peptococcus strains, five belonging to P. asaccharolyticus and five to P. prevotii, was studied in cross-agglutination and gel-diffusion experiments. Agglutination occurred in all the homologous and nearly one third of the heterologous antigen-antibody systems. Cross-reactions, however, were clearly restricted to members of the same Peptococcus species. In gel-diffusion studies, autoclaved extracts of the Peptococcus cultures reacted exclusively with their homologous antisera, whereas reciprocal and unilateral intra-specific cross-reactions were due to non-heated extracts. The antisera against the five P. asaccharolyticus strains remained negative when tested with antigens of the five P. prevotii cultures; so did the antisera against the P. prevotii strains when tested with P. asaccharolyticus antigens, excepting one antiserum which reacted with non-heated extracts of a P. asaccharolyticus culture. This sole interspecific unilateral cross-reaction was not confirmed with two other rabbit antisera prepared with the same P. prevotii strain. From the results obtained it becomes evident that the two butyrate-positive Peptococcus species, P. asaccharolyticus and P. prevotii, are serologically unrelated. This supports the biochemical species differentiation which is merely based on the end pH value in peptone-yeast extract-glucose medium, indole formation and several other ‘classical’ features remaining unconsidered. Moreover, the close serological relationship existing between members of the same Peptococcus species is apt to facilitate immunological studies in the infected host.
Influence of Age and Sex on Carcinoma and Cirrhosis of the Liver in AXC Strain Rats Ingesting 0.025% N-2-Fluorenyldiacetamide
Authors: Reuber Melvin D.
Published: October 2008

Inbred A×C male and female rats, 4, 12, 24, and 52 weeks of age, ingested 0.025% N-2-fluorenyldiacetamide in a semisynthetic diet. Both age and sex were important in the development of hepatic lesions. The 4- and 12-week-old males developed a higher incidence of carcinomas and cirrhosis of the liver than did the females of the same ages or the males and females 24 and 52 weeks of age. Four-week-old male rats had more carcinomas per liver, larger carcinomas, more poorly differentiated (as compared with well differentiated), and some carcinomas were cholangiocellular as well as hepatocellular. There were a few hepatic lesions in the younger female rats; however, female rats of all ages were relatively resistant to hepatic carcinogenesis.
Skeletal Effects of Cholesterol Feeding
Authors: Silberberg Ruth
Published: October 2008

The effect of a 4% supplement of cholesterol to a standard diet on knee joints and vertebral columns was investigated in male mice of strain C57B1. The experimental diet was fed from the time of weaning through the 18-month period of observation or from the age of 1 year to the end of the experiment at 18 months of age. The incidence of osteoarthrosis was increased in mice fed cholesterol from the age of 12 months on. The incidence of spondylosis was increased after lifelong feeding as well as after feeding of cholesterol during the second year of life. This increase involved both, spondylosis associated with or uncomplicated by prolapse of intervertebral discs. The incidence of simple disc prolapse was not affected by the experimental diet.
Submicroscopic Response of Articular Chondrocytes to a Cholesterol-Containing Diet
Authors: Silberberg Ruth , Hasler Mary
Published: October 2008

10 days’ to 3 months’ consumption of a diet containing 4% cholesterol causes a minor and transitory stimulation of articular chondrocytes of mice. The transitory disturbance is accompanied by a more permanent increase in glycogen, by abnormal deposition of cytoplasmic lipid and by an increase in the fibrillarity of the pericellular matrix. The changes are consistent with the failure of the cholesterol diet to influence the course of osteoarthrosis if fed to mice from an early age through life.
Reappearance of α-Fetoprotein in Spontaneous Hepatitis in the Rat
Authors: Boss J.H.
Published: October 2008

Reappearance of AFP was demonstrated in a single rat out of a large control population. At autopsy, this DOCA-hypertensive rat was found to have a form of hepatitis associated with proliferative activity, i.e., cellular unrest, mitotic figures and oval cell hyperplasia. It is submitted that increased AFP synthesis in this animal with spontaneous hepatitis is causally related to hepatocellular regeneration.
Hypercholesterolemia Enhances 15-Lipoxygenase–Mediated Vasorelaxation and Acetylcholine-Induced Hypotension
Authors: Aggarwal Nitin T. , Pfister Sandra L. , Campbell William B.
Published: October 2008

Objective—

Arachidonic acid (AA) metabolites from 15-lipoxygenase-1 (15-LO-1), trihydroxyeicosatrienoic acid (THETA), and hydroxyepoxyeicosatrienoic acid (HEETA) relax arteries. We studied 15-LO-1 expression, THETA and HEETA synthesis, and their effect on arterial relaxations and blood pressure in hypercholesterolemic nonatherosclerotic rabbits.

Methods and Results—

Immunoblots, RTPCR analysis, and
14
C-AA metabolism revealed that hypercholesterolemia increased 15-LO-1 expression in the endothelium and THETA and HEETA synthesis in the arteries. Isometric tension recording, in presence of nitric oxide synthase (NOS) and cyclooxygenase (COX) inhibitors, showed greater relaxations to acetylcholine (ACH) and AA (max 76.0±4.6% and 79.5±2.4%, respectively) in aortas from hypercholesterolemic rabbits compared with normal rabbits (max 39.1±2.8% and 39.9±2.2%, respectively). AA induced greater hyperpolarization in the smooth muscle cells of hypercholesterolemic aortas (−45.85±3.0 mV) compared with normal aortas (−31.45±1.9 mV). The ACH- and AA-relaxations were inhibited by 15-LO-1 inhibitors. ACH induced hypotensive responses were greater in hypercholesterolemic rabbits in absence (−54.9±3.3%) or presence (−48.5±3.2%) of NOS and COX-inhibitors compared with control rabbits (−31.6±3.3% and −24.3±1.6%, respectively). BW755C reduced these responses in hypercholesterolemic rabbits to −29.3±2.3%.

Conclusion—

Hypercholesterolemia increases endothelial 15-LO-1 expression, THETA and HEETA synthesis and enhances vasorelaxation.
Dyslipidemia and Atherosclerosis Induced by Chronic Intermittent Hypoxia Are Attenuated by Deficiency of Stearoyl Coenzyme A Desaturase
Authors: Savransky Vladimir , Jun Jonathan , Li Jianguo , Nanayakkara Ashika , Fonti Shannon , Moser Ann B. , Steele Kimberly E. , Schweitzer Michael A. , Patil Susheel P. , Bhanot Sanjay , Schwartz Alan R. , Polotsky Vsevolod Y.
Published: October 2008

Obstructive sleep apnea leads to chronic intermittent hypoxia (CIH) and is associated with atherosclerosis. We have previously shown that C57BL/6J mice exposed to CIH and a high-cholesterol diet develop dyslipidemia, atherosclerosis of the aorta, and upregulation of a hepatic enzyme of lipoprotein secretion, stearoyl coenzyme A desaturase 1 (SCD-1). We hypothesized that (1) SCD-1 deficiency will prevent dyslipidemia and atherosclerosis during CIH; and (2) human OSA is associated with dyslipidemia and upregulation of hepatic SCD. C57BL/6J mice were exposed to CIH or normoxia for 10 weeks while being treated with either SCD-1 or control antisense oligonucleotides. Obese human subjects underwent sleep study and bariatric surgery with intraoperative liver biopsy. In mice, hypoxia increased hepatic SCD-1 and plasma very-low-density lipoprotein cholesterol levels and induced atherosclerosis lesions in the ascending aorta (the cross-section area of 156514±57408 μm
2
), and descending aorta (7.0±1.2% of the total aortic surface). In mice exposed to CIH and treated with SCD-1 antisense oligonucleotides, dyslipidemia and atherosclerosis in the ascending aorta were abolished, whereas lesions in the descending aorta showed 56% reduction. None of the mice exposed to normoxia developed atherosclerosis. In human subjects, hepatic SCD mRNA levels correlated with the degree of nocturnal hypoxemia (
r
=0.68,
P
=0.001). Patients exhibiting oxyhemoglobin desaturations at night showed higher plasma triglyceride and low-density lipoprotein cholesterol levels, compared to subjects without hypoxemia. In conclusion, CIH is associated with dyslipidemia and overexpression of hepatic SCD in both humans and mice alike; SCD-1 deficiency attenuates CIH-induced dyslipidemia and atherosclerosis in mice.
Infusion of Reconstituted High-Density Lipoprotein Leads to Acute Changes in Human Atherosclerotic Plaque
Authors: Shaw James A. , Bobik Alex , Murphy Andrew , Kanellakis Peter , Blombery Peter , Mukhamedova Nigora , Woollard Kevin , Lyon Stuart , Sviridov Dmitri , Dart Anthony M.
Published: October 2008

Studies have shown a reduction in plaque volume and change in plaque ultrasound characteristics after 4 infusions of reconstituted high-density lipoprotein (rHDL). Whether rHDL infusion leads to acute changes in plaque characteristics in humans is not known. Patients with claudication scheduled for percutaneous superficial femoral artery revascularization were randomized to receive 1 intravenous infusion of either placebo or rHDL (80 mg/kg given over 4 hours). Five to 7 days following the infusion, patients returned and revascularization was performed including atherectomy to excise plaque from the superficial femoral artery. Twenty patients (17 males) average age, 68±10 years (mean±SD) were recruited. Eleven patients had a history of documented coronary artery disease, all patients were on aspirin, and 18 were on statins. Ten of the patients received rHDL and 10 placebo. There was significantly less vascular cell adhesion molecule-1 expression (28±3% versus 50±3%;
P
<0.05) and a reduction in lipid content in the plaque of HDL-treated subjects compared to placebo. The level of HDL cholesterol increased by 20% after infusion of rHDL and the capacity of apolipoprotein B–depleted plasma to support cholesterol efflux increased. Intravenous infusion of a single dose of reconstituted HDL led to acute changes in plaque characteristics with a reduction in lipid content, macrophage size, and measures of inflammation. These changes may contribute to the cardioprotective effects of HDL.
Vascular Endothelial Growth Factor-A and Platelet-Derived Growth Factor-B Combination Gene Therapy Prolongs Angiogenic Effects via Recruitment of Interstitial Mononuclear Cells and Paracrine Effects Rather Than Improved Pericyte Coverage of Angiogenic Vessels
Authors: Korpisalo Petra , Karvinen Henna , Rissanen Tuomas T. , Kilpijoki Johanna , Marjomäki Varpu , Baluk Peter , McDonald Donald M. , Cao Yihai , Eriksson Ulf , Alitalo Kari , Ylä-Herttuala Seppo
Published: October 2008

Vessel stabilization and the inhibition of side effects such as tissue edema are essential in angiogenic gene therapy. Thus, combination gene transfers stimulating both endothelial cell and pericyte proliferation have become of interest. However, there is currently little data to support combination gene transfer in large animal models. In this study, we evaluated the potential advantages of such a strategy by combining the transfer of adenoviral (Ad) vascular endothelial growth factor (VEGF)-A and platelet-derived growth factor (PDGF)-B into rabbit hindlimb skeletal muscle. AdLacZ alone or in combination with AdVEGF-A were used as controls. Contrast-enhanced ultrasound, modified Miles assay, and immunohistology were used to quantify perfusion, vascular permeability, and capillary size, respectively. Confocal microscopy was used in the assessment of pericyte-coverage. The transfer of AdPDGF-B alone and in combination with AdVEGF-A induced prominent proliferation of α-smooth muscle actin–, CD31-, RAM11-, HAM56-, and VEGF- positive cells. Although, pericyte recruitment to angiogenic vessels was not improved, combination gene transfer induced a longer-lasting increase in perfusion in both intact and ischemic muscles than AdVEGF-A gene transfer alone. In conclusion, intramuscular delivery of AdVEGF-A and AdPDGF-B, combined, resulted in a prolonged angiogenic response. However, the effects were most likely mediated via paracrine mechanisms rather than an increase in vascular pericyte coverage.
Ca
2+
Influx Through T- and L-Type Ca
2+
Channels Have Different Effects on Myocyte Contractility and Induce Unique Cardiac Phenotypes
Authors: Jaleel Naser , Nakayama Hiroyuki , Chen Xiongwen , Kubo Hajime , MacDonnell Scott , Zhang Hongyu , Berretta Remus , Robbins Jeffrey , Cribbs Leanne , Molkentin Jeffery D. , Houser Steven R.
Published: October 2008

T-type Ca
2+
channels (TTCCs) are expressed in the developing heart, are not present in the adult ventricle, and are reexpressed in cardiac diseases involving cardiac dysfunction and premature, arrhythmogenic death. The goal of this study was to determine the functional role of increased Ca
2+
influx through reexpressed TTCCs in the adult heart. A mouse line with cardiac-specific, conditional expression of the α1G-TTCC was used to increase Ca
2+
influx through TTCCs. α1G hearts had mild increases in contractility but no cardiac histopathology or premature death. This contrasts with the pathological phenotype of a previously studied mouse with increased Ca
2+
influx through the L-type Ca
2+
channel (LTCC) secondary to overexpression of its β2a subunit. Although α1G and β2a myocytes had similar increases in Ca
2+
influx, α1G myocytes had smaller increases in contraction magnitude, and, unlike β2a myocytes, there were no increases in sarcoplasmic reticulum Ca
2+
loading. Ca
2+
influx through TTCCs also did not induce normal sarcoplasmic reticulum Ca
2+
release. α1G myocytes had changes in LTCC, SERCA2a, and phospholamban abundance, which appear to be adaptations that help maintain Ca
2+
homeostasis. Immunostaining suggested that the majority of α1G-TTCCs were on the surface membrane. Osmotic shock, which selectively eliminates T-tubules, induced a greater reduction in L- versus TTCC currents. These studies suggest that T- and LTCCs are in different portions of the sarcolemma (surface membrane versus T-tubules) and that Ca
2+
influx through these channels induce different effects on myocyte contractility and lead to distinct cardiac phenotypes.
Increased Stroke Risk Is Related to a Binge Drinking Habit
Authors: Sundell Laura , Salomaa Veikko , Vartiainen Erkki , Poikolainen Kari , Laatikainen Tiina
Published: October 2008

Background and Purpose—

Heavy alcohol consumption increases the risk for all strokes, whereas moderate regular alcohol consumption is associated with a lower risk for ischemic stroke. The purpose of this study was to evaluate the effect of different drinking patterns on stroke risk, independent of average alcohol intake.

Methods—

A prospective cohort study of 15 965 Finnish men and women age 25 to 64 years who participated in a national risk factor survey and had no history of stroke at baseline were followed up for a 10-year period. The first stroke event during follow-up served as the outcome of interest (N=249 strokes). A binge drinking pattern was defined as consuming 6 or more drinks of the same alcoholic beverage in men or 4 or more drinks in women in 1 session. Cox proportional-hazards models were adjusted for average alcohol consumption, age, sex, hypertension, smoking, diabetes, body mass index, educational status, study area, study year, and history of myocardial infarction.

Results—

Binge drinking was an independent risk factor for total and ischemic strokes. Compared with non–binge drinkers, the hazard ratio for total strokes among binge drinkers was 1.85 (95% CI, 1.35 to 2.54) after adjusting for average alcohol consumption, age, and sex; the association was diluted after adjustment for other risk factors. Compared with non–binge drinkers, the risk for ischemic stroke was 1.99 (95% CI, 1.39 to 2.87) among binge drinkers; the association remained statistically significant after adjustment for potential confounders.

Conclusions—

This study found that a pattern of binge drinking is an independent risk factor for all strokes and ischemic stroke.
Racial Differences in Vascular Risk Factors and Outcomes of Patients With Intracranial Atherosclerotic Arterial Stenosis
Authors: Waddy Salina P. , Cotsonis George , Lynn Michael J. , Frankel Michael R. , Chaturvedi Seemant , Williams Janice E. , Chimowitz Marc
Published: October 2008

Background and Purpose—

Atherosclerotic intracranial stenosis is an important cause of stroke in blacks, yet there are limited data on vascular risk factors and outcome. We analyzed the vascular risk factors and outcomes of blacks and whites in the Warfarin versus Aspirin for Symptomatic Intracranial Disease (WASID) trial.

Methods—

Baseline characteristics and outcomes (ischemic stroke, brain hemorrhage, or vascular death combined and ischemic stroke alone) were compared between blacks (n=174) and whites (n=331) using univariate and multivariate analyses.

Results—

Blacks were significantly (
P
<0.05) more likely than whites to be/have: female, hypertension history, diabetes history, higher LDL, higher total cholesterol, lower triglycerides, unmarried, unemployed, nonprivate insurance, no insurance, stroke as qualifying event, <70% stenosis, symptomatic anterior circulation vessel, no antithrombotic medication before qualifying event, and no family history of myocardial infarction. Blacks more frequently reached an end point of ischemic stroke, brain hemorrhage or vascular death (28% versus 20%; hazard ratio of 1.49, 95% CI 1.03 to 2.17,
P
=0.03), had a higher 2-year event rate (0.28 versus 0.19), and reached the end point of ischemic stroke alone (25% versus 16% at 2 years; hazard ratio of 1.62,
P
=0.017). In multivariate analysis, race was associated with ischemic stroke (
P
=0.0488) but not with the end point ischemic stroke, brain hemorrhage or vascular death (
P
=0.188).

Conclusions—

Blacks with intracranial stenosis are at higher risk of stroke recurrence than whites. This risk warrants additional study of factors contributing to stroke in blacks and highlights the need for aggressive risk factor management in blacks to prevent recurrence.
Reflections on Equity, Adequacy, and Weighted Student Funding
Authors: Ladd Helen F.
Published: October 2008

Within the context of the school finance literature, the concepts of equity and adequacy raise a number of complex definitional and pragmatic issues. The purpose of this article is to clarify those issues and to use those concepts to evaluate the recent policy proposal called weighted student funding (WSF). Though WSF contains some equity-enhancing elements, it could fall short of its equity goals because of imperfect weights. This approach also fails to take full account of the concentrations of challenging-to-educate students and their effects on the distribution of teachers. In addition, the WSF proposal can be faulted for paying no attention to adequacy, potentially stigmatizing individual students, and placing so much focus on individual schools. A more complete evaluation of WSF would require a broader institutional perspective that extends beyond the equity and adequacy considerations of this article.
Equality, Adequacy, and Educational Policy
Authors: Satz Debra
Published: October 2008

In this article I argue that the distinction between an adequate education and an equal education has been overdrawn. In my view, a certain type of equality—civic equality—is internal to the idea of educational adequacy. An education system that completely separates the children of the poor and minorities from those of the wealthy and middle class cannot be adequate for a democratic society. Educational adequacy should be tied to the requirements of equal citizenship. I also argue that my conception of adequacy in education has advantages over competing frameworks. I contrast its implications for a recent policy proposal that argues for weighted student funding (WSF) with the assessment of this proposal from an equality framework. While weighting in favor of the least advantaged students is important, the critical issue is whether or not such weighting is sufficient for bringing all students up to adequacy's high bar. This means that to be adequate, WSF must be placed in a larger policy context.
Outcome of Functional Constipation in Childhood: A 10-Year Follow-Up Study
Authors: Michaud Laurent , Lamblin Marie-Dominique , Mairesse Sophie , Turck Dominique , Gottrand Frédéric
Published: October 2008

Objectives To assess the outcome of patients presenting with functional constipation in childhood during a 10-year period and to determine any risk factors for developing persistent constipation throughout adolescence and adulthood.

Patients and Methods 72 children (mean age 4 years; 40 boys) referred for constipation were included in a longitudinal set of observations. Initial workup included segmental colonic transit time and anorectal manometry; 45 of the 72 patients could be reevaluated 10 to 12 years later.

Results 21 of 45 patients (46%; 95% confidence interval 29% to 67%) remained constipated at follow-up. Encopresis and recurrent abdominal pain were present in 25% and 56% of patients, respectively. Patients with anorectal dyssynergia remained more frequently constipated at follow-up than the others: 61% versus 29% ( P < .05).

Conclusion Almost 50% of patients presenting with constipation during childhood remained constipated on long-term follow-up. Anorectal dyssynergia is associated with a worse prognosis.
Age- and Ethnic-Specific Elevation of ALT Among Obese Children at Risk for Nonalcoholic Steatohepatitis (NASH): Implications for Screening
Authors: Leung Daniel H. , Williams Kent , Fraley J. Kennard , Klish William J.
Published: October 2008

The objectives are to: (1) characterize ethnic-specific differences in alanine aminotransferase (ALT) elevation among obese children, (2) investigate the earliest ages at which significant ALT elevation occurs, and (3) determine associations between ALT and biochemical parameters. A cohort of 134 multiethnic obese children and adolescents was analyzed retrospectively. ALT levels ≥45 U/L or <45 U/L, denoting high or normal risk, were used to categorize obese children's risk for developing nonalcoholic steatohepatitis. In all, 60% of Hispanics had high-risk ALT levels compared with 12% of whites and 8% of blacks. A significantly higher proportion of boys had ALT ≥ 45 U/L (49.4%, vs 37.9% for girls, P = .002); 17.5% were Hispanic boys less than 7 years old. Obese Hispanic children, particularly boys, not only have higher ALT levels but present alarmingly young with high-risk levels. This study highlights a discrete subgroup of children who may present with fatty liver at a younger age and should be screened earlier.
Clinical Response to 2 Commonly Used Switch Formulas Occurs within 1 Day
Authors: Berseth Carol Lynn , Johnston William H. , Stolz Suzanne I. , Harris Cheryl L. , Mitmesser Susan Hazels
Published: October 2008

Very fussy or extremely fussy infants were randomized to receive: soy-based formula (Soy: n = 82) or a partially hydrolyzed cow's milk protein (CMP), low-lactose formula (PHF: n = 77) in a multicenter, double-blind, randomized, parallel, prospective 28-day feeding trial. Body weight and infant formula tolerance were reported. Adverse events were recorded throughout the study. A significant reduction in mean scores of fussiness, gas, spit-up, and crying compared with baseline measures was observed in infants who received either Soy or PHF within 1 day of formula intake; improvement in symptoms was sustained by study end. Stool consistency remained constant through day 28 in the PHF group, whereas stools in the Soy group became more firm by day 2 and did not return to prestudy consistency. PHF, with a protein profile patterned more closely on human breast milk, improved symptoms of formula intolerance as well as soy-based formula.
Epidemiologic Findings of Cancer Detected in a Pediatric Emergency Department
Authors: Kundra Manu , Stankovic Curt , Gupta Nimisha , Thomas Ronald , Hamre Merlin , Mahajan Prashant
Published: October 2008

This study describes epidemiologic findings of pediatric cancer diagnosed in the emergency department (ED) setting. Medical records are retrospectively reviewed on all patients in the hospital's cancer database between 2000 and 2004 who were diagnosed as having cancer or whose oncologic diagnosis was missed during their ED presentation. Of 427 patients identified in the cancer database, 18% (77 of 427) are analyzed. Oncologic diagnosis was missed in 5% (4 of 77) of the eligible patients initially presenting to the ED. The incidence of cancer in the ED is 22.8 cases per 100 000 ED visits. The most prevalent cancer is related to the hematologic system (37.7%), followed by the central nervous system (31.2%) and the abdomen (22.1%). Hematologic, central nervous system, and abdominal cancers constitute approximately 90% of all childhood cancers. Cancer is diagnosed frequently in our ED patient population. Based on the prevalence of certain tumors, the diagnostic approach to children with hematologic, neurologic, or abdominal complaints should include evaluation for any underlying cancer.
Handedness Effects on Procedural Training in Pediatrics
Authors: Damore Dorothy , Rutledge John , Pan Sharon , Knotek Nicole , Ramundo Maria
Published: October 2008

Objective To determine handedness effects on procedural training.

Patients and Methods Pediatric trainees and attendings from 3 institutions participated in a Web-based survey examining whether handedness affected learning procedures, the hand used to perform procedures, and if handedness training was received.

Results and Conclusions Of 778 physicians, 39% completed surveys, and 11% wrote with their left hand. Learning procedures were affected in left-handed physicians (60% vs 7.7%; odds ratio [OR] = 17.9; 95% confidence interval [CI] = 7.9-40.1), and they used their non-dominant or both hands to perform procedures (48.6% vs 21%; OR = 3.6; 95% CI = 1.7-7.4). Few physicians received handedness training (20% vs 10.7%; P= .16). Left-handed physicians were affected learning lumbar puncture (29% vs 4%; OR= 10.0; 95% CI = 3.8-26.4), intubation (36% vs 5%; OR=11.0; 95% CI=4.4-27.4), and suturing (32% vs 4%; OR = 11.7; 95% CI = 4.5-30.5).
Evaluation of Microcytic Anemia
Authors: Jain Shilpa , Kamat Deepak
Published: October 2008

Anemia is defined as a reduction in red blood cell mass or hemoglobin concentration in blood. It is statistically differentiated from normal states as a hemoglobin concentration or hematocrit 2 SD below the mean for the healthy population adjusted for age and sex. Anemias may be classified based on the morphologic function of red blood cells and their size on a peripheral blood smear. Subcategories are microcytic, normocytic, and macrocytic anemias, but these are not mutually exclusive. In infants and children, the most common form of anemia is microcytic. A detailed history and physical examination with appropriate laboratory test results can help detect the correct cause of anemia in most patients. The objective of this article is to aid physicians taking care of children in conducting a proper evaluation to identify the correct cause of microcytic anemia.
Management of Infantile Colic: A Review
Authors: Cohen-Silver Justine , Ratnapalan Savithiri
Published: October 2008

Infantile colic is an easily identified childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community's inability to prescribe a cure for colic. This article reviews the current concepts for management options of infantile colic.
Puberty, Contraception, and Hormonal Management for Young People With Disabilities
Authors: Zacharin Margaret R.
Published: October 2008

Assessment and management of a young person with a severe disability is multifaceted and complex. Variations of puberty can cause major concerns for parents and carers, with fears of imminent menstruation, peer and personal differences, concern for height outcome, as well as grief for a loss of childhood. Addressing physical, emotional, and social issues assists in optimizing outcomes. This article outlines specific evaluation and detailed management strategies for female and male pubertal problems in the context of disability, including treatments for extreme pubertal delay or acceleration, menstrual management at different ages, contraceptive issues, and sexual function and choices for both sexes.
Short-Term Outcomes of Late Preterms: An Institutional Experience
Authors: Vachharajani Akshaya J. , Dawson Jeffrey G.
Published: October 2008

This article describes the short-term outcomes of late preterm neonates born between 34 and 36 (6/7) weeks gestational age (GA) in a 4-year period. A total of 1381/ 20554 (6.7%) births were between 34 and 36 weeks of GA and were predominantly Caucasian (87%). In all, 697/1381 (51%) were admitted to nursery whereas 684/1381 (49%) remained with their mothers. Of the babies born at 34, 35, and 36 weeks GA, 97%, 53%, and 32%, respectively, required admission and of these 30%, 33%, and 23%, respectively, required respiratory support. Air leaks developed in <4% infants. Median length of stay and age at full enteral feeds were 11, 6, and 4 days and 10, 6, and 3 days for 34, 35, and 36 weeks GA, respectively. It is concluded that late preterms have significant morbidity in the neonatal period.
The Effect of Universal Maternal Screening on the Incidence of Neonatal Early-Onset Group B Streptococcal Disease
Authors: Eberly Matthew D. , Rajnik Michael
Published: October 2008

Objective To determine the effect of the revised guidelines on incidence of neonatal early-onset group B streptococcal disease (EoGBS) via retrospective analysis of births in a military population.

Methods Information from records of all live births within military hospitals from 1993 to 2007 was obtained. The data were divided into three time frames, representing the evolution of identifying and managing at-risk deliveries for GBS transmission.

Results Incidence of EoGBS decreased from 1.95 to 0.72 per 1000 live births following institution of the 1996 Centers for Disease Control and Prevention recommendations and continued to fall to 0.47 per 1000 since the adoption of universal screening in 2002.

Conclusions Universal culture-based screening is more effective than risk-based screening in preventing EoGBS in term infants. Cases of EoGBS continue to occur, however, at a baseline rate of nearly 0.5 per 1000 births, thus emphasizing the need for rapid diagnostics and ultimately a vaccine.
Effect of Dapoxetine on the Pharmacokinetics and Hemodynamic Effects of Tamsulosin in Men on a Stable Dose of Tamsulosin
Authors: Modi N. B. , Kell S. , Aquilina J. , Rivas D.
Published: October 2008

The tolerability of dapoxetine, a short‐acting selective serotonin reuptake inhibitor being developed for premature ejaculation, was evaluated when coadministered with tamsulosin. Adult men on a stable dose of tamsulosin were randomized to also receive dapoxetine 30 or 60 mg, or placebo, in a crossover design. Supine and standing vital signs were measured on days 1 and 7. Plasma samples were collected for measurement of tamsulosin, dapoxetine, and dapoxetine metabolites. Coadministration of dapoxetine with tamsulosin did not alter orthostatic profiles or affect the incidence of orthostatic hypotension. Tamsulosin and dapoxetine pharmacokinetics were not altered. Adverse events were reported by 5.4%, 10.9%, and 23.2% of participants receiving tamsulosin with placebo, dapoxetine 30 mg, and dapoxetine 60 mg, respectively. The most common adverse events were diarrhea, dizziness, headache, and nausea. Therefore, dapoxetine had no clinically important effects on the pharmacokinetics or orthostatic profile of tamsulosin in men on a stable tamsulosin regimen.
Team Negotiation: Social, Epistemic, Economic, and Psychological Consequences of Subgroup Conflict
Authors: Halevy Nir
Published: October 2008

Large collectives (e.g., organizations, political parties, nations) are seldom unitary players. Rather, they consist of different subgroups that often have conflicting interests. Nonetheless, negotiation research consistently regards negotiating teams, who represent these collectives, as monolithic parties with uniform interests. This article integrates concepts from social psychology, management, political science, and behavioral game theory to explore the effects of subgroup conflict on team negotiation. Specifically, the present research introduced a conflict of interests within negotiating teams and investigated how this internal conflict affects the outcome of the negotiation between teams. An experiment with 80 four-person teams found that conflict between subgroups had a detrimental effect on the performance of negotiating teams. This research also employed a recent model of motivated information processing in groups to investigate possible processes underlying the effect of subgroup conflict on team negotiation.
Intensive Insulin Therapy in Practice: Can We Do It?
Authors: Dossett Lesly A. , Collier Bryan , Donahue Rafe , Mowery Nathan T. , Dortch Marcus J. , Guillamondegui Oscar , Diaz Jose J. , May Addison K.
Published: October 2008

Background: Intensive insulin therapy (IIT) is the standard of care in the ICU, but precise implementation of insulin protocols has been difficult in clinical practice. The authors' objective was to quantify adherence to an IIT protocol in a practice setting, and to describe how adherence impacts overall blood glucose (BG) control. Methods: A retrospective analysis of a cohort of critically ill patients treated with IIT was performed. Protocol adherence was evaluated by assessing the timing of BG measurements. Each measurement was categorized according to the time from the previous reading: early (<1 hour), on time (1‐3 hours), and late (>3 hours). Outcome measures included mean and median BG for each time category as well as the proportion of values within the target range. Results: In 1106 trauma and surgical ICU patients, 54,139 measurements were available for analysis. The overall mean BG (116 mg/dL) was near the target (80‐110 mg/dL), but only 46% of values were within this range. There were 45,806 (86%) measurements on time, 2749 (5%) early, and 4478 (9%) were late. BG values of late measurements were less likely to be within range (34% vs 46% for on time measurements, P < .001). Of late measurements, 19% were >200 mg/dL, 13% were 150‐200 mg/dL, and 16% were <60 mg/dL. Conclusions: IIT is difficult to implement precisely in a complex ICU environment. Measurement timing impacts overall BG control, with late measurements more often associated with severe hyperglycemic (BG > 150 mg/dL) and hypoglycemic (BG < 60 mg/dL) episodes.
Review: A psychopharmacological treatment algorithm for generalised anxiety disorder (GAD)
Authors: Davidson JR , Zhang W. , Connor KM , Ji J. , Jobson K. , Lecrubier Y. , McFarlane AC , Newport DJ , Nutt DJ , Osser DN , Stein DJ , Stowe ZN , Tajima O. , Versiani M.
Published: October 2008

Generalised anxiety disorder (GAD) is defined as excessive and uncontrollable worry and anxiety about everyday life situations. It is a chronic disorder, and is associated with substantial somatisation, high rates of comorbid depression and other anxiety disorders, and significant disability. The evidence base for pharmacotherapy and psychotherapy has continued to grow, and a wide range of drug choices for GAD now exists. Current guidelines for GAD generally restrict themselves to presentation of the evidence for various treatments, which, as a result, generally do not offer detailed discussion or recommendation of strategies beyond the first level of treatment, or take into account the individual circumstances of the patient. Thus, there is a lack of algorithm-based treatment guidelines for GAD. Our aim is, therefore, to present an algorithm for the psychopharmacologic management of GAD, intended for all clinicians who treat patients with GAD, where issues of pharmacotherapy are under consideration. We also hope that these GAD algorithms and other guidelines can help to identify high-priority areas that need further study. In this algorithm, we provide a sequenced approach to the pharmacotherapy of GAD, taking into account salient symptomatology and comorbidity, levels of evidence and extent of response. Special issues, including comorbidity, insomnia, suicidality, substance abuse, treatment adherence, pregnancy and lactation, cross-cultural issues, use of medication in the elderly, psychosocial treatment and dosing issues are also addressed.
Ecstasy (MDMA) and high prevalence psychiatric symptomatology: somatic anxiety symptoms are associated with polydrug, not ecstasy, use
Authors: Bedi G. , Van Dam NT , Redman J.
Published: October 2008

Although previous studies have examined anxiety and depression in ecstasy (±3,4-methylenedioxymethamphetamine; MDMA) users, it remains unclear whether symptoms are associated specifically with ecstasy or with polydrug use in general. We compared mean symptomatology and clinically significant symptoms in 45 ecstasy polydrug, 48 cannabis polydrug and 40 legal drug users, who completed standardised self-report anxiety and depression symptom measures. We further examined whether group differences were secondary to increased somatic symptom reporting, which may reflect acute/subacute drug effects. Anxiety and depression scores were higher in polydrug than legal drug users, with no difference between ecstasy and cannabis groups. There was no difference in numbers meeting criteria for clinically significant depression or ‘moderate’ or ‘severe’ anxiety, but the polydrug group contained more individuals reporting at least ‘mild’ anxiety symptoms than the legal drug control. Multivariate analyses indicated that anxiety alone was sufficient to discriminate groups. Polydrug users reported more somatic anxiety symptoms than legal drug users, but endorsed equivalent numbers of non-somatic symptoms. High prevalence psychiatric symptomatology in ecstasy polydrug users may be associated with polydrug rather than ecstasy use. Higher ratings in polydrug users appear to be secondary to increased somatic symptom reporting, suggesting possible impacts of drug effects on symptom endorsement.