bluuebunny/crossref_metadata_2025 huggingface dataset:
Somnambulism, Migraine and Propranolol
Authors: Pradalier A. , Giroud M. , Dry J.
Published: September 2006

SYNOPSIS

150 migraine patients and 150 healthy subjects without headache were questioned about previous or current somnambulism. Previous or current somnambulism was found in 21.9% of the migraine group and in 6.6% of the control group; this difference is significant (p<0.001). Of the 25 migraine patients who had childhood or adult somnambulism, 16 had common migraine and 9 had classical migraine; classical migraine is over‐represented in patients with somnambulism. Three patients treated with propranolol described aggravation of current somnambulism or re‐appearance of previous somnambulism with the beginning of this drug treatment.
Early Morning Headache of Parkinson's Disease: A Hitherto Unrecognized Symptom?
Authors: Indo Toshikatsu , Takahashi Akira
Published: September 2006

SYNOPSIS

Reported in this paper are three cases of Parkinson's disease in which early morning headache occurred in coincidence with early morning akinesia. The common points found in the three cases were: (1) headache is relieved as Parkinsonian symptoms are improved by L‐dopa; (2) short duration improvement is remarkable; (3) early morning akinesia is marked; and (4) the pain relieving effect of L‐dopa given at midnight is invariably found. It appeared that in further studies on early morning headache in Parkinson's disease the relation of the headache to the pathophysiology of brain neuropeptides including b‐endorphin should be investigated.
Magnetic Resonance Imaging in Cerebral Venous Thrombosis, A Case Report
Authors: Donohoe Charles D. , Waldman Steven D. , Resor Louise D.
Published: September 2006

SYNOPSIS

In a patient presenting with headache, who later developed bilateral sixth nerve palsies and papilledema, an initial CT scan (unenhanced and enhanced) was normal, and a later CT scan was suggestive of superior sagittal sinus thrombosis. An MRI scan gave much less equivocal evidence of thrombosis of both the sagittal and the right transverse sinus. The diagnosis was confirmed by digital venous angiography.

MRI is a noninvasive investigation useful in the diagnosis of dural venous sinus thrombosis.
POSITIVE FEEDBACK AND THE DEVELOPMENT AND PERSISTENCE OF ECOSYSTEM DISRUPTIVE ALGAL BLOOMS1
Authors: Sunda William G. , Graneli Edna , Gobler Christopher J.
Published: September 2006

Harmful algal blooms (HABs) have occurred with increasing frequency in recent years with eutrophication and other anthropogenic alterations of coastal ecosystems. Many of these blooms severely alter or degrade ecosystem function, and are referred to here as ecosystem disruptive algal blooms (EDABs). These blooms are often caused by toxic or unpalatable species that decrease grazing rates by planktonic and benthic herbivores, and thereby disrupt the transfer of nutrients and energy to higher trophic levels, and decrease nutrient recycling. Many factors, such as nutrient availability and herbivore grazing have been proposed to separately influence EDAB dynamics, but interactions among these factors have rarely been considered. Here we discuss positive feedback interactions among nutrient availability, herbivore grazing, and nutrient regeneration, which have the potential to substantially influence the dynamics of EDAB events. The positive feedbacks result from a reduction of grazing rates on EDAB species caused by toxicity or unpalatability of these algae, which promotes the proliferation of the EDAB species. The decreased rates also lower grazer‐mediated recycling of nutrients and thereby decrease nutrient availability. Since many EDAB species are well‐adapted to nutrient‐stressed environments and many exhibit increased toxin production and toxicity under nutrient limitation, positive feedbacks are established which can greatly increase the rate of bloom development and the adverse effects on the ecosystem. An understanding of how these feedbacks interact with other regulating factors, such as benthic/pelagic nutrient coupling, physical forcing, and life cycles of EDAB species provides a substantial future challenge.
The production of red blood cell alloantibodies in mice transfused with blood from transgenic Fyb‐expressing mice
Authors: Campbell‐Lee Sally A. , Liu Jinhuan , Velliquette Randall W. , Halverson Gregory R. , Shirey R. Sue , Chaudhuri Asok , Reid Marion E. , Ness Paul M. , Baldwin William M.
Published: September 2006

BACKGROUND: A murine model would be useful to identify which immune mechanisms could be manipulated to treat or prevent red blood cell (RBC) alloimmunization in patients who become sensitized to multiple or widely expressed antigens.

STUDY DESIGN AND METHODS: Transgenic mice (B6CBAF1/J‐Tg‐Fyb) expressing the human Fyb antigen of the Duffy (Fy) blood group were donors. Recipient B6CBA‐F1 mice received four weekly intravenous (IV) transfusions: either 0.3 mL of washed buffy coat–depleted RBCs or 0.3 mL of RBCs with spleen cells. Titers of immunoglobulin M (IgM) and immunoglobulin G (IgG) were measured in recipient serum samples by flow cytometry with RBCs from donor mice as target cells. Recipient serum samples were also tested against human RBCs of various Fy phenotypes. Additionally, RBC survival studies were performed in alloimmunized mice utilizing biotin‐labeled Fyb transgenic mouse RBCs.

RESULTS: B6CBA‐F1 mice receiving washed buffy coat–depleted RBCs first made IgM, followed by IgG alloantibodies to transgenic mouse Fyb‐positive RBCs. Recipients of Fyb‐positive RBCs mixed with spleen cells also produced IgM and IgG alloantibodies, but at a slower rate than recipients of washed buffy coat–depleted RBCs. Serum samples showed specificity for Fy3, Fyb, and Fy6. Decreased survival of transfused RBCs was evident at 24 hours after transfusion.

CONCLUSIONS: It is possible to elicit the formation of anti‐Fy alloantibodies by IV transfusion in mice that lack Fy antigens. The transfusion of RBCs alone was adequate to stimulate alloantibody production in B6CBA‐F1 recipient mice. The survival of transfused Fyb‐positive RBCs is diminished in sensitized mice. This model will be useful in further studies of RBC alloimmunization.
Safety and donor acceptance of an abbreviated donor history questionnaire
Authors: Kamel Hany T. , Bassett Mary Beth , Custer Brian , Paden Christine J. , Strollo Angela M. , McEvoy Patrick , Busch Michael P. , Tomasulo Peter A.
Published: September 2006

BACKGROUND: Surveys have shown donor dissatisfaction with the duration of the donation process and repetitive questioning. An abbreviated donor history questionnaire (AQ) may improve satisfaction, but must be safe.

STUDY DESIGN AND METHODS: An FDA‐approved 34‐question AQ was implemented in 2003. Travel, medication, and health history questions were decreased by 18. Donors were eligible for AQ if they had successfully completed three donor suitability assessments on the full‐length questionnaire (FQ), including one in the prior 6 months. Data were analyzed from more than 50,000 donations during each of three 20‐day periods over the first year of progressive implementation of the AQ. We evaluated the performance of the AQ by comparing donor deferrals for medical history (MHD), physical examination findings (PED), and reactive screening and/or confirmatory tests (RSCT) for viral markers among AQ‐ineligible and AQ‐eligible donors and separately among AQ‐eligible donors who received AQ or FQ.

RESULTS: Approximately one‐third of presenting donors were AQ‐eligible. Use of AQ progressed from 48 percent in October 2003 to 76 percent in November 2004. AQ‐eligible donors had lower rates of MHD, PED, and RSCT than donors ineligible for AQ (p  < 0.05). Among donors eligible for the AQ, those who received the FQ had slightly more MHD and PED than those who received the AQ (p  < 0.05), but there was no difference in RSCT. A postdonation survey indicated significantly increased satisfaction and intent to donate among donors who received the AQ.

CONCLUSIONS: In frequent repeat donors, use of an AQ led to increased donor satisfaction and no significant medical concerns about donor or recipient safety.
Recombinant human granulocyte–colony‐stimulating factor–mobilized and apheresis‐collected endothelial progenitor cells: a novel blood cell component for therapeutic vasculogenesis
Authors: Körbling Martin , Reuben James M. , Gao Hui , Lee Bang‐Ning , Harris David M. , Cogdell David , Giralt Sergio A. , Khouri Issa F. , Saliba Rima M. , Champlin Richard E. , Zhang Wei , Estrov Zeev
Published: September 2006

BACKGROUND: Endothelial progenitor cells (EPCs) have been identified among hematopoietic tissue‐derived progenitor cells that are mobilized into the peripheral blood (PB) as a result of tissue injury. It therefore seems likely that circulating EPCs have therapeutic potential by aiding in the neovascularization of ischemic tissue. This study provides clinical data on the availability of circulating EPCs at steady state and after recombinant human granulocyte–colony‐stimulating factor (rHuG‐CSF) mobilization and their collection by leukapheresis.

STUDY DESIGN AND METHODS: Eight healthy donors underwent rHuG‐CSF treatment over 4 days, followed by leukapheresis. Blood samples taken before rHuG‐CSF treatment and before apheresis as well as apheresis‐collected samples were analyzed by flow cytometry and by real time reverse transcription–polymerase chain reaction for cells expressing EPC‐specific surface markers and tissue markers, respectively, and for EPC colony‐forming cells.

RESULTS: The median PB concentration of CD34+133+ vascular endothelial growth factor receptor‐2 (VEGFR‐2)‐+ EPCs increased 8‐fold from steady state to mobilized, and the concentration of CD34+133‐VEGFR‐2+ EPCs increased by 10‐fold. This mobilization pattern was similar to that of hematopoietic CD34+, CD133+, and CD34+117+ progenitor cells. The increase in the median circulating colony‐forming unit EPC concentration was 10‐fold over baseline. The median absolute number of CD34+133+VEGFR‐2+ cells collected by large‐volume leukapheresis was 0.8 × 106 per kg of body weight. In addition, a small subset of immature CD133+34– cells coexpressing VEGFR‐2 was identified in mobilized PB and in the apheresis collection. EPC‐specific cells contained in the apheresis product were also identified as expressing mRNA for the CD31 antigen, Tie‐2, and VEGFR‐2.

CONCLUSION: Circulating EPCs represent a novel blood cell component that can be collected by apheresis in large quantities and can be used clinically, either unmanipulated or EPC‐selected, for therapeutic vasculogenesis.
Neopterin levels during the early phase of human immunodeficiency virus, hepatitis C virus, or hepatitis B virus infection
Authors: Nübling C. Micha , Chudy Michael , Volkers Peter , Löwer Johannes
Published: September 2006

BACKGROUND: A study was conducted to assess the diagnostic sensitivity of neopterin screening of blood donors with regard to the detection of window‐phase specimens of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infection.

STUDY DESIGN AND METHODS: In total, 1002 diagnostic window‐phase specimens from 98 seroconversion panels (29 HIV‐1, 52 HCV, and 17 HBV) were analyzed with viral antigen detection, viral nucleic acid amplification testing (NAT), and neopterin quantitation assays. The study was completed by the analysis of 92 anti‐hepatitis B core antigen (HBc)‐reactive and 103 alanine aminotransferase (ALT)‐elevated blood donor specimens.

RESULTS: A significant association between elevated neopterin concentrations and the very early phase of HIV‐1 infection was found. No significant correlation could be observed between neopterin levels and the early phase of HCV or HBV infection. Neopterin concentration was not increased in specimens from blood donors with anti‐HBc reactivity or ALT elevation.

CONCLUSIONS: Neopterin screening of blood donors may identify window‐phase cases of HIV, but not of HCV or HBV infection. The diagnostic sensitivity of neopterin screening during the HIV window phase is similar to that of the p24 antigen test. With the introduction of viral NATs in blood screening, there is no additional benefit of neopterin screening with regard to the three blood‐borne viruses HIV, HCV, and HBV. Acute phases of other infectious agents, however, have been reported to be detected by neopterin enzyme‐linked immunosorbent assays.
Estimating blood needs for very‐low‐birth‐weight infants
Authors: Fabres Jorge , Wehrli Gay , Marques Marisa B. , Phillips Vivien , Dimmitt Reed A. , Westfall Andrew O. , Schelonka Robert L.
Published: September 2006

BACKGROUND: Red blood cell (RBC) transfusions are crucial for the care of very‐low‐birth‐weight (VLBW) infants. These infants frequently require multiple, small‐volume RBC transfusions, with potential exposure to multiple donors. Optimal protocols provide dedicated RBC units to reduce exposures and avoid RBC wastage.

STUDY DESIGN AND METHODS: This study was a retrospective, single‐institution review of RBC transfusions in VLBW infants. The RBC volume transfused during the entire hospitalization (VTH) and that transfused at 35 days were determined for all infants, 401 to 1250 g at birth, admitted to a Level III neonatal intensive care unit from January 1, 2000, through December 31, 2002. Multivariable models identified perinatal factors associated with volume transfused.

RESULTS: The 640‐infant cohort had a median birth weight (BW) of 818 g and gestational age (GA) of 26 weeks. Most infants (546 or 85%) required at least one RBC transfusion. Median number of RBC transfusions was 3 (range, 0‐30) and median volume transfused was 82 mL (range, 9‐737 mL). Of 328 infants who received all transfusions within a 35‐day period, only 5 (1.5%) required at least 200 mL. VTH was inversely related to BW and GA. Multivariable models identified BW, GA, age at first transfusion, and use of inotropes as variables associated with higher volume transfused.

CONCLUSION: Few VLBW infants use an entire RBC unit. One dedicated unit shared by two or more infants should meet their transfusion needs. GA, BW, and markers of illness severity predict increased RBC volume requirements.
Population‐based audit of fresh‐frozen plasma transfusion practices
Authors: Palo Riikka , Capraro Leena , Hovilehto Seppo , Koivuranta Merja , Krusius Tom , Loponen Elina , Mäntykoski Ritva , Pentti Jussi , Pitkänen Otto , Raitakari Maria , Rimpiläinen Jussi , Salmenperä Markku , Salo Hanna , Mäki Tiina
Published: September 2006

BACKGROUND: In contrast to decreasing red blood cell (RBC) consumption in Finland, the use of fresh‐frozen plasma (FFP) has been increasing since the 1990s, suggesting that FFP use may not always be optimal. To improve transfusion practices, knowledge of current FFP use and regional, national, and international comparison is necessary.

STUDY DESIGN AND METHODS: Nine (of 21) Finnish hospital districts participated. Data concerning FFP‐transfused patients in the years 2002 and 2003 were collected from existing computerized medical records into a yearly updated database as part of a Finnish benchmarking project on blood component use.

RESULTS: Data included 11,590 FFP‐transfused patients and 60,240 FFP units (71.2% of Finnish FFP use) delivered to Finnish hospitals during the study period. FFP was transfused most often to surgery patients (62.8% of FFP transfusion hospital visits) with blood circulatory system problems (32.3% of surgically treated and FFP‐transfused patients). In only 65.9 percent of FFP‐transfused patients were coagulation variables measured at any point in the hospital episode, and FFP was usually transfused in paired doses. Mean FFP use in Finland is comparable to other countries.

CONCLUSION: Although overall FFP use in Finland is similar to that of international figures, it does not ensure best practice. Perioperative staff, being the largest FFP user, should be encouraged to dose FFP based on coagulation variables and body weight. Improvement efforts should be directed to patient groups transfused with large amounts of FFP.
Incorporating Ethnographic Methods in Multidisciplinary Approaches to Risk Assessment and Communication: Cultural and Religious Uses of Mercury in Latino and Caribbean Communities
Authors: Riley Donna M. , Newby C. Alison , Leal‐Almeraz Tomás O.
Published: September 2006

The potential risk from cultural and religious practices involving mercury in Latino and Caribbean communities raises central methodological and ethical questions for risk assessment and risk communication. Here, specific cultural practices unfamiliar to most risk professionals carry significant inherent risks in the eyes of those professionals but not necessarily in the eyes of practitioners. Practitioners' past experience and history as targets of religious suppression and anti‐immigrant sentiment create a reluctance to engage with researchers or public health officials in risk assessment or preventive risk communication efforts. The potential for the risk—in this case mercury contamination in dwellings—to extend beyond the practicing community to future occupants adds to public health concern. Understanding the risks of these practices requires both an understanding of the cultural and political context, beliefs, and behaviors of mercury users and an understanding of the fate and transport of mercury in typical use scenarios. In this study, we employed ethnographic methods (interviews and participant observation) to understand beliefs and behavior about mercury use as well as quantitative modeling and measurement to estimate and assess potential exposures. This represents a new methodology tailored to situations in which traditional activities or observances that are integral components of cultural identity pose risks in and of themselves. Our findings indicate that there are different types of mercury use stemming from different cultural and religious traditions that result in different levels of exposure. Many of the mercury uses that can result in the highest exposures to mercury vapors have previously been attributed to the religious tradition of Santeria, but appear instead to have their roots outside of the religion.
Toward Improving Food Safety in the Domestic Environment: A Multi‐Item Rasch Scale for the Measurement of the Safety Efficacy of Domestic Food‐Handling Practices
Authors: Fischer Arnout R. H. , Frewer Lynn J. , Nauta Maarten J.
Published: September 2006

To reduce consumer health risks from foodborne diseases that result from improper domestic food handling, consumers need to know how to safely handle food. To realize improvements in public health, it is necessary to develop interventions that match the needs of individual consumers. Successful intervention strategies are therefore contingent on identifying not only the practices that are important for consumer protection, but also barriers that prevent consumers from responding to these interventions. A measure of food safety behavior is needed to assess the effectiveness of different intervention strategies across different groups of consumers. A nationally representative survey was conducted in the Netherlands to determine which practices are likely conducted by which consumers. Participants reported their behaviors with respect to 55 different food‐handling practices. The Rasch modeling technique was used to determine a general measure for the likelihood of an average consumer performing each food‐handling behavior. Simultaneously, an average performance measure was estimated for each consumer. These two measures can be combined to predict the likelihood that an individual consumer engages in a specific food‐handling behavior. A single “food safety” dimension was shown to underlie all items. Some potentially safe practices (e.g., use of meat thermometers) were reported as very difficult, while other safe practices were conducted by respondents more frequently (e.g., washing of fresh fruit and vegetables). A cluster analysis was applied to the resulting data set, and five segments of consumers were identified. Different behaviors may have different effects on microbial growth in food, and thus have different consequences for human health. Once the microbial relevance of the different consumer behaviors has been confirmed by experiments and modeling, the scale developed in the research reported here can be used to develop risk communication targeted to the needs of different consumer groups, as well as to measure the efficacy of different interventions.
Electrocardiographic Characteristics of Patients with Ebstein's Anomaly Before and After Ablation of an Accessory Atrioventricular Pathway
Authors: ITURRALDE PEDRO , NAVA SANTIAGO , SÁLICA GABRIEL , MEDEIROS ARGELIA , MÁRQUEZ MANLIO F. , COLIN LUIS , VICTORIA DIANA , DE MICHELI ALFREDO , GONZALEZ MARIO D.
Published: September 2006

The abnormal development of the tricuspid valve in patients with Ebstein's anomaly results in several activation abnormalities including delayed intraatrial conduction, right bundle branch block (RBBB), and ventricular preexcitation. The aim of the present study was to define the ECG characteristics before and after ablation of an accessory A‐V pathway (AP) in patients with Ebstein's anomaly.

Methods: A series of 226 consecutive patients with Ebstein's anomaly was studied. Sixty‐four patients (28%) had documented tachycardia. Thirty‐three patients with recurrent tachycardia were found to have a single right‐sided AP that was successfully ablated (study group). Thirty patients without tachycardia served as the control group.

Results: Only 21 of 33 patients (62%) had a typical ECG pattern of preexcitation. In addition, none of the patients had an ECG pattern of RBBB during sinus rhythm. In contrast, 28 of 30 (93%) patients in the control group had RBBB (P < 0.001). Radiofrequency catheter ablation resulted in appearance of RBBB in 31 of 33 (94%) patients. The absence of RBBB in patients with Ebstein's anomaly and recurrent tachycardia had a 98% sensitivity and 92% specificity for the diagnosis of an AP. The positive predictive value was 91% (0.77, 0.97 CI 95%) and the negative predictive value was 98% (0.85, 0.99 CI 95%).

Conclusion: One‐third of patients with Ebstein's anomaly and symptomatic tachyarrhythmias have minimal or absent ECG features of ventricular preexcitation. In these patients, the absence of RBBB pattern is a strong predictor of an AP.
Deterioration of Organization in the First Minutes of Atrial Fibrillation: A Beat‐to‐Beat Analysis of Cycle Length and Wave Similarity
Authors: RAVELLI FLAVIA , MASÈ MICHELA , GRECO MAURIZIO DEL , FAES LUCA , DISERTORI MARCELLO
Published: September 2006

Introduction: It has been recently suggested that many episodes of atrial fibrillation (AF) may be partially organized at the onset and thus more suitable for antitachycardia pacing therapy. Nevertheless, the time course of organization in the first minutes of AF has not been quantified yet.

Methods and Results: Twenty episodes of paroxysmal AF were studied. Electrograms were recorded from the right atrium (RA), distal (CSd), and proximal coronary sinus (CSp). The time course of AF cycle length (AFCL) and the regularity of wave morphology (similarity index S) were beat‐to‐beat measured at each recording site during the first 7 minutes of AF. AFCL and S showed a decreasing trend after the onset of AF. AFCL decreased from 208 ± 31 to 171 ± 21 msec (P < 0.001), from 206 ± 40 to 169 ± 23 msec (P < 0.001) and from 190 ± 42 to 152 ± 18 msec (P < 0.05), respectively, in RA, CSd, and CSp. Similarly, the similarity index decreased in CSd from 0.37 ± 0.27 to 0.12 ± 0.09 (P < 0.01) and in RA from 0.40 ± 0.18 to 0.17 ± 0.16 (P < 0.001). The 80% of the decrease occurred during the first 3 minutes of the arrhythmia, while after this time both cycle length and similarity index did not change significantly anymore. Conversely, the electrical activity in CSp was highly disorganized (S = 0.05 ± 0.03) even in the first minute of AF, and no decreasing temporal trend was observed.

Conclusion: Higher levels of organization and longer fibrillation intervals exist at the onset of AF. The degree of organization of the electrical activity decays within less than 3 minutes. Since antitachycardia pacing success rate increases with high levels of organization, these results suggest an early delivery of pacing treatment.
Tunicothrix rostrata n. g., n. sp., a New Urostylid Ciliate (Ciliophora, Stichotrichia) from the Yellow Sea
Authors: XU KUIDONG , LEI YANLI , CHOI JOONG KI
Published: September 2006

ABSTRACT. The morphology and infraciliature of a new ciliate, Tunicothrix rostrata n. g., n. sp., isolated from the Yellow Sea, are investigated using live observation and protargol impregnation. Tunicothrix rostrata measures about 160 × 40 μm in vivo, and has a frontal beak‐like protrusion, a conspicuous cortical alveolar layer, two right marginal rows, and usually three distinct midventral pairs. The discovery of T. rostrata enables us to reconsider the classification of Erniella wilberti, a curious ciliate with obscure midventral pairs. Both species are highly similar in overall appearance and nuclear and ciliary pattern. Thus, they are united in a new genus of the family Urostylidae, Tunicothrix, and E. wilberti is transferred to Tunicothrix: Tunicothrix wilbertiLin and Song, 2004 n. comb. By contrast, Erniella filiformis, type species of Erniella, has several ventral rows and does not belong to the urostylids. Tunicothrix rostrata is easily distinguished from T. wilberti by its beak‐like anterior protrusion and by the distinctly elongated right marginal row 2, which curves anteriorly on the dorsal side of the cells. Tunicothrix is closely related to Parabirojimia, differing by the invariably two (vs. five–eight) right marginal rows and the conspicuous (vs. ordinary) alveolar layer, a unique feature in urostylid ciliates.
The validity and utility of patients’ daily ratings of mood and impairment in clinical trials of bipolar disorder
Authors: Parker G. , Tully L. , Olley A. , Barnes C.
Published: September 2006

Objective:  Traditional cross‐sectional clinician‐rated measures have limited use in clinical trials of bipolar disorder. We examine the validity and usefulness of patients’ daily ratings of mood and functional impairment during a treatment trial.

Method:  Ten subjects with bipolar II disorder completed daily ratings of depression severity, depression, hypomania and functional impairment over a 9‐month trial. Ratings were correlated with clinician‐rated measures at nine time points to determine validity. Mood ratings were contrasted with cross‐sectional data for one subject to determine usefulness of such fine‐grained data.

Results:  Moderate to large correlations were found between patients’ and clinicians' ratings of mood and impairment for most of the nine time points. The utility of the patients’ ratings relative to clinician‐rated cross‐sectional measures was also illustrated.

Conclusion:  Results support the validity and usefulness of patients’ daily mood ratings.
Who is really in control of skin immunity under physiological circumstances – lymphocytes, dendritic cells or keratinocytes?
Authors: Paus Ralf , Schröder J. M. , Reich K. , Kabashima K. , Liu F. T. , Romani N. , Metz M. , Kerstan A. , Lee P. H. A. , Loser K. , Schön M. P. , Maurer M. , Stoitzner P. , Beissert S. , Tokura Y. , Gallo R. L. , Reich Kristian
Published: September 2006

Abstract:  Our views of the skin immunity theatre are undergoing constant change. These not only reflect paradigm shifts in general immunology and skin biology, but also have profound clinical implications, which call for strategic changes in dermatological therapy. Nowhere can this be witnessed at a greater level of instructiveness and fascination than when addressing the question posed by this new Controversies feature. Thus, after a very long period of dominance by T cells and Langerhans cells as ‘lead actors’ on the skin immunity stage, the lowly keratinocyte has recently made an astounding theatrical appearance as a key protagonist of the innate skin immunity system, which may control even acquired skin immune responses. Further enhancing dramatic complexity and tension, the mast cell has entered as an additional actor claiming centre stage, and the epidermal Langerhans cell has slipped in a surprise appearance as the chief agent of immunotolerance. May you, esteemed reader, enjoy the spectacle offered here by selected immunodermatology authorities who double as ‘stage managers’ pushing their respective favourite actors into the limelight. You get everything you may expect from a good performance – complete with the impresario's overture that lures you into the theatre and sets the stage, competing divas, recently discovered new talents and even the critic's digest while the performance is still ongoing. By the time the curtain drops, you will have reached your own, independent conclusions on how to answer the title question of this play – at least for the time being…
Periodontal infection control: current clinical concepts
Authors: WENNSTRÖM JAN L. , TOMASI CRISTIANO
Published: September 2006

The main objective of the treatment of patients with periodontitis is to establish adequate infection control in the dentogingival area. Pocket/root instrumentation (scaling and root planing), combined with effective self‐performed supragingival plaque control measures, constitute the basic treatment modalities, but also locally applied antiseptics and antibiotics may be utilized. The purpose of this article is to give an overview of current clinical concepts on periodontal infection control.
Advances in the treatment of root dentine sensitivity: mechanisms and treatment principles
Authors: GILLAM D.G. , ORCHARDSON R.
Published: September 2006

There are limited studies specifically on the prevalence of root dentine hypersensitivity or root sensitivity per se; most of the published information relates to the prevalence of dentine hypersensitivity (DH). Several investigators have suggested that there may be some justification on the basis of differing pathologies of distinguishing between those individuals complaining of DH who have relatively healthy mouths with those who complain of DH as a result of periodontal disease and/or its treatment. It is generally recognized that those individuals diagnosed with periodontal disease and having periodontal therapy including scaling procedures may have a higher prevalence than those who present with healthy mouths and evidence of gingival recession. The availability of a vast array of treatments, however, would indicate either that there is no one effective desensitizing agent for completely resolving the discomfort or that the condition, due to its highly subjective nature, is difficult to treat irrespective of the available treatment options. The importance of implementing preventative strategies in identifying and eliminating predisposing factors in particularly erosive factors (e.g. dietary acids) cannot be ignored if the practitioner is going to treat this troublesome clinical condition successfully. This paper will review the published literature and provide information as to the prevalence of the condition, its etiology and causal factors, as well as recommendations for the clinical management of the problem.
The endo‐perio lesion: a critical appraisal of the disease condition
Authors: ROTSTEIN ILAN , SIMON JAMES H.
Published: September 2006

Endodontic–periodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic–periodontal diseases vary and depend on the cause and the correct diagnosis of each specific condition. This article will appraise the interrelationship between endodontic and periodontal diseases and provide biological and clinical evidence of significance for diagnosis, prognosis, and decision‐making in the treatment of these conditions.
Diagnosis and treatment of accidental root perforations
Authors: TSESIS IGOR , FUSS ZVI
Published: September 2006

A review of endodontic and periodontal aspects on the prognosis, diagnosis, prevention, and treatment of accidental root perforations is presented. Successful treatment depends mainly on proper diagnosis and immediate sealing of the perforation to eliminate risk of infection. A classification of root perforations is presented in the review to assist the clinician in making a proper choice of treatment protocol.
Comparing running therapy with physiotraining therapy in the treatment of mood disorders
Authors: Judith Haffmans P. M. , Kleinsman Arlette C. M. , van Weelden Corry , Huijbrechts Irma P. A. M. , Hoencamp Erik
Published: September 2006

Background:

Despite various studies, supportive evidence for the efficacy of exercise in treatment of mental illness is still weak.

Objective:

The aim of this study was to compare two forms of exercise, namely running therapy (RT) and physiotraining therapy (PT), on stationary devices.

Methods:

Patients in a day treatment programme for treatment of affective disorders were randomly allocated to one of the exercise groups or to a control group. Depression scores, self-efficacy, physical conditions and appreciations of the training programme were measured.

Results:

After 6 weeks, no significant differences were found between both the training groups and the control group; however, after 12 weeks, the physiotraining group showed significant improvement on scores for blind-rated Hamilton Rating Scale for Depression and on scores for self-rated Beck Depression Inventory 21-item version.

Conclusions:

Our results suggest that PT has advantages over RT. We speculate that an improved feeling of self-efficacy may be a mediating factor.
No borna disease virus-specific RNA detected in blood of race horses and jockeys
Authors: Kim Yong-Ku , Noh Kyung-Bo , Han Chang-Su , Moon Ju-Young , Yoon Do-Kyung , Song Ki-Joon , Kim Dai-Jin , Kubera Marta , Maes Michael , Song Jin-Won
Published: September 2006

Background:

Borna disease virus (BDV) predominantly infects horses and sheep, causing a broad range of behavioural disorders. It is controversial whether BDV infects humans and causes psychiatric disorders.

Objectives:

We searched for BDV-derived nucleic acids in blood of race horses and jockeys riding the horses.

Methods:

We assayed for the BDV genome in RNA extracted from peripheral blood mononuclear cells (PBMC) of 39 race horses and 48 jockeys. Two polymerase chain reaction protocols [one-tube reverse transcription–polymerase chain reaction (RT-PCR) and two-step RT-PCR] were used to assay BDV p24 and p40 transcripts.

Results:

The p24 and p40 viral nucleic acid sequences were not detected in the PBMC RNAs from any of the race horses or jockeys.

Conclusions:

These data do not support an epidemiological association between BDV infection, race horses and humans.
Anesthesia for patients with pantothenate-kinase-associated neurodegeneration (Hallervorden-Spatz disease) – a literature review
Authors: Hinkelbein Jochen , Kalenka Armin , Alb Markus
Published: September 2006

Background:

Hallervorden-Spatz disease (HSD) is a rare, progressive neurodegenerative disorder; the new and preferred name for HSD is ‘pantothenate-kinase-associated neurodegeneration’ (PKAN). Other suggested names are ‘neurodegeneration with brain iron accumulation type 1’ or ‘infantile neuroaxonal dystrophy’. Patients with PKAN have many complications, which lead to numerous anesthetic management challenges. Reports concerning the anesthetic management of patients with PKAN are very limited.

Objective:

To determine the anesthetic management and techniques as well as relevant complications for patients with PKAN.

Methods:

In this study, we review previously published literature regarding the anesthesia-relevant clinical symptoms, the anesthetic management and techniques, and possible complications for this disorder.

Results:

Only four studies describing the anesthetic management and anesthetic techniques in patients with PKAN were found. Anesthesia-relevant symptoms influence the preanesthetic management (eg difficulties in articulation, dementia), the induction of anesthesia (eg oromandibular rigidity, seizures, dysphagia, aspiration) and the postoperative care (eg respiratory disability).

Conclusion:

Reports concerning the anesthetic management of patients with PKAN are very limited, possibly as a result of the rareness of the disorder. Like many other patients with neurodegenerative diseases, patients with PKAN have many anesthesia-relevant symptoms, leading to numerous anesthetic management challenges. In general, the anesthetic complications associated with PKAN are usually no different from those associated with other neurodegenerative diseases, and the management of these are usually concordant.
The education of health practitioners supporting breastfeeding women: time for critical reflection
Authors: Dykes Fiona
Published: September 2006

The protection, promotion and support of breastfeeding has now become a major international priority as emphasized in the Global Strategy for Infant and Young Child Feeding. Health practitioners, such as midwives, nurses and doctors, have a key role to play in providing support to breastfeeding women. This paper provides a critical discussion of educational requirements of health practitioners to equip them for their supportive role. The effective integration of embodied, vicarious, practice‐based and theoretical knowledge requires opportunities for deep critical reflection. This approach should facilitate personal reflection and critical engagement with broader socio‐political issues, thus allowing for collective understandings and change. Practitioners also need to understand breastfeeding as a biopsychosocial process that is dynamic, relational and changes over time. Recommendations are outlined with regards to multidisciplinary undergraduate education; mentorship schemes with knowledgeable role models supporting student practitioners; involvement of voluntary and peer supporters; post‐registration education; setting of national standards for breastfeeding education; tailored education for specific groups; designated funding; and involvement of breastfeeding specialists.
Assessing learning needs for breastfeeding: setting the scene
Authors: McFadden Alison , Renfrew Mary J. , Dykes Fiona , Burt Sue
Published: September 2006

Breastfeeding has a major contribution to make to public health, yet the UK, like many other developed countries, has low rates of breastfeeding. A contributing factor is that practitioners are ill‐prepared to support breastfeeding women. There is a mismatch between the care professionals provide and the support women desire. A national breastfeeding learning needs assessment (LNA) was carried out in England to provide a comprehensive picture of professional and practitioner learning needs and existing training opportunities and resources. The LNA comprised five elements, and sought the views of service users through consumer organizations and voluntary breastfeeding supporters. Two elements of the LNA are reported here. A search of RDLearning, a web‐based national resource, provided details of existing accredited courses in the UK for practitioners. Ten short courses provided by higher education institutions were identified, along with a range of courses offered by voluntary and other organizations, such as the National Childbirth Trust and UNICEF Baby Friendly Initiative. Second, an e‐mail survey of 28 key stakeholder organizations was undertaken, with a response rate of 68% (n = 18). All but one acknowledged that their members could benefit from further breastfeeding knowledge and expertise and were supportive of a national breastfeeding education initiative. The most popular forms of education provision were workshops and seminars, online and written information. The topic considered most important for all practitioners was the health outcomes of breastfeeding. Other contributions which stakeholder organizations felt they could make were the provision of information resources and setting up specialist interest groups.
Cell surface nucleolin on developing muscle is a potential ligand for the axonal receptor protein tyrosine phosphatase‐σ
Authors: Alete Daniel E. , Weeks Mark E. , Hovanession Ara G. , Hawadle Muhamed , Stoker Andrew W.
Published: September 2006

Reversible tyrosine phosphorylation, catalyzed by receptor tyrosine kinases and receptor tyrosine phosphatases, plays an essential part in cell signaling during axonal development. Receptor protein tyrosine phosphatase‐σ has been implicated in the growth, guidance and repair of retinal axons. This phosphatase has also been implicated in motor axon growth and innervation. Insect orthologs of receptor protein tyrosine phosphatase‐σ are also implicated in the recognition of muscle target cells. A potential extracellular ligand for vertebrate receptor protein tyrosine phosphatase‐σ has been previously localized in developing skeletal muscle. The identity of this muscle ligand is currently unknown, but it appears to be unrelated to the heparan sulfate ligands of receptor protein tyrosine phosphatase‐σ. In this study, we have used affinity chromatography and tandem MS to identify nucleolin as a binding partner for receptor protein tyrosine phosphatase‐σ in skeletal muscle tissue. Nucleolin, both from tissue lysates and in purified form, binds to receptor protein tyrosine phosphatase‐σ ectodomains. Its expression pattern also overlaps with that of the receptor protein tyrosine phosphatase‐σ‐binding partner previously localized in muscle, and nucleolin can also be found in retinal basement membranes. We demonstrate that a significant amount of muscle‐associated nucleolin is present on the cell surface of developing myotubes, and that two nucleolin‐binding components, lactoferrin and the HB‐19 peptide, can block the interaction of receptor protein tyrosine phosphatase‐σ ectodomains with muscle and retinal basement membranes in tissue sections. These data suggest that muscle cell surface‐associated nucleolin represents at least part of the muscle binding site for axonal receptor protein tyrosine phosphatase‐σ and that nucleolin may also be a necessary component of basement membrane binding sites of receptor protein tyrosine phosphatase‐σ.
A Model for Assessing the Shape of Solder Joints in the Presence of PCB and Package Warpage
Authors: Rayasam Mahidhar , Thompson Terrace B. , Subbarayan Ganesh , Gurumurthy C. , Wilcox J. R.
Published: September 2006

Our goals in this paper are to develop and demonstrate a computationally efficient methodology for assessing the effect of circuit board warpage, component warpage, and solder volume variation on the shape of the solder joints in area array packages. The effect of warpage is analyzed using a two-step procedure in the present paper. In the first step, the restoring forces and moments (in the molten state of solder droplet) that result from a given solder joint height, solder material volume, pad diameter, and pad inclination are predicted using the surface tension theory. In the second step of the analysis, the forces and moments at individual solder joints caused by varying solder heights and pad tilts are combined to predict the equilibrium configuration of the package. A program written in the MATHEMATICA® environment was developed to implement the above-described methodology. The developed procedure was validated on an experimental test vehicle with nine solder joints. The heights of solder joints computed by the program matched the experimentally measured heights to within ±5% error. Further, the general capabilities of the modeling procedure are demonstrated by assuming complex combinations of package and PCB warpage.
Experimental Study of Void Formation in Eutectic and Lead-Free Solder Bumps of Flip-Chip Assemblies
Authors: Wang Daijiao , Panton Ronald L.
Published: September 2006

This paper reports the experimental findings of void formation in eutectic and lead-free solder joints of flip-chip assemblies. A previous theory indicated that the formation of voids is determined by the direction of heating. The experiments were designed to examine the size and location of voids in the solder samples subject to different heat flux directions. A lead-free solder (Sn-3.5Ag-0.75Cu) and a eutectic solder (63Sn37Pb) were employed in the experiments. Previous experiments [Wang, D., and Panton, R. L., 2005, “Experimental Study of Void Formation in High-Lead Solder Joints of Flip-Chip Assemblies,” ASME J. Electron. Packag., 127(2), pp. 120–126; 2005, “Effect of Reversing Heat Flux Direction During Reflow on Void Formation in High-Lead Solder Bumps,” ASME J. Electron. Packag., 127(4), pp. 440–445] employed a high lead solder. 288 solder bumps were processed for each solder. Both eutectic and lead-free solder have shown fewer voids and much smaller void volume than those for high-lead solder. Compared with lead-free solder, eutectic solder has a slightly lower void volume and a lower percentage of defective bumps. For both eutectic and lead-free solders, irrespective of the cooling direction, heating solder samples from the top shows fewer defective bumps and smaller void volume. No significant effect on void formation for either eutectic or lead-free solder was found via reversing the heat flux direction during cooling. Unlike high-lead solder, small voids in eutectic or lead-free solder comprised 35-88% of the total void volume. The final distribution of voids shows a moderate agreement with thermocapillary theory, indicating the significance of the temperature gradient on the formation of voids.
Electronics Packaging Cooling: Technologies From Gas Turbine Engine Cooling
Authors: Arik M. , Bunker R. S.
Published: September 2006

Heat transfer in turbomachinery has been well established due to the long history of research in the field. A vast amount of research has been devoted to obtain flow fields and regimes, heat transfer modes, surface effects, and heat transfer enhancement techniques. Since most of the flows are in the turbulent regime of air cooling, various heat transfer enhancements such as turbulators, pin fins, concavities, and lattice cooling have been investigated. The electronics industry has shown a rapid increase in the functionality, speed, and the density of transistors, leading to a large increase in the required heat transfer. Most of the flows are in the transitional regime. Heat sinks are the primary choice for thermal management in electronics systems. Enhancements in heat sinks have been limited to taller and tighter fin spacing, while decreasing the weight and the cost. Current state-of-the-art for heat sinks in electronics components is lacking in heat transfer enhancement technologies, which is common in turbine heat transfer practice. Therefore, the primary goal of this paper is to examine the turbomachinery cooling technologies and to inform the packaging engineers about the thermal technologies on the other side of the thermal world.