bluuebunny/crossref_metadata_2025 huggingface dataset:
Seizure worsening with Topiramate amongst Indians with refractory epilepsy
Authors: Krishnan P. R. , Tripathi M. , Jain S.
Published: August 2003

In a prospective open label add‐on study on 95 patients (age 1–63 years, mean 17.76 ± 13.83 years) with seizures refractory to conventional antiepileptic drugs (AEDs) and other new AEDs, the addition of Topiramate (TPM) resulted in seizure worsening in 18 patients (19%) necessitating drug withdrawal over an average follow‐up period of 4.94 ± 1.69 months. Patients who had seizure worsening were older (P = 0.02), were more likely to have had a history of status epilepticus in the past (P = 0.03), were on three conventional AEDs (P = 0.027) or had tried one of the other new AEDs in the past with poor response (P = 0.04). Seven of 18 patients who had seizure worsening with TPM (7.4%) experienced initial seizure worsening, probably representing the subgroup with ‘true’ seizure worsening whilst 11 (11.6%) had initial improvement followed by ‘apparent’ seizure worsening. Initial seizure worsening was noted to be significantly more in females when compared with males who worsened after initial improvement (P = 0.05).
Acute disseminated encephalomyelitis in children: clinical features and HLA‐DR linkage
Authors: Idrissova Zh. R. , Boldyreva M. N. , Dekonenko E. P. , Malishev N. A. , Leontyeva I. Y. , Martinenko I. N. , Petrukhin A. S.
Published: August 2003

This study includes 90 children (41 female and 49 male) in the age range of 2–16 years with acute disseminated encephalomyelitis (ADEM). Thirty‐three patients developed ADEM following rubella infection, 26 children following varicella infection, 20 suspected viral aetiology ADEM and 11 multiphasic disseminated encephalomyelitis (MDEM). All patients had neurological, routine laboratory and viral serology study with an enzyme‐linked immunosorbent assay. Brain and/or spinal cord magnetic resonance imaging (MRI) were performed in 14 children. A follow‐up study was in 1–5 years. Typing of DRB1 gene HLA class II was performed in 38 patients. We established that the varicella and rubella groups had preferential patterns. Rubella ADEM is characterized by acute explosive onset, seizures, coma and moderate pyramidal signs, whereas varicella infection is characterized by cerebella ataxia and mild pyramidal dysfunction. The suspected viral aetiology ADEM was characterized by polisymptomatic presentation. MDEM was characterized by older age of patients (11.6 ± 2.8 years), more severe and prolonged local neurological symptoms, including myelitis symptoms and marked extrapyramidal signs, with distinct demyelination in MRIs. As a whole, ADEM is associated with DRB1*01 and DRB1*017(03) in the Russian population. Thus, ADEM is a separate autoimmune condition with a specific mechanism due to the type of genetic immunoregulatory base and specificity of viral trigger.
Focally folded myelin in Charcot–Marie–Tooth type 1B disease is associated with Asn131Lys mutation in myelin protein zero gene: short report
Authors: Kochański A. , Drac H. , Jędrzejowska H. , Hausmanowa‐Petrusewicz I.
Published: August 2003

Charcot–Marie–Tooth disease type 1B (CMT1B) is a demyelinating neuropathy inherited as an autosomal dominant trait. The majority of CMT1B cases are caused by mutations in the myelin protein zero (P0) gene (MPZ). Only a few mutations in MPZ gene have been reported to be associated with focally folded myelin sheaths. We have studied five patients from one family with five generations, affected by CMT1B disease. The morphological studies of sural nerve biopsy performed in the proband revealed fibers with focally folded myelin. DNA sequencing analysis showed the Asn131Lys mutation in the MPZ gene in three members of the affected family.
A case of micrographia after subcortical infarction: possible involvement of frontal lobe function
Authors: Nakamura M. , Hamamoto M. , Uchida S. , Nagayama H. , Amemiya S. , Okubo S. , Tanaka K.
Published: August 2003

Most reports of micrographia associated with focal brain lesions have related this finding to damage in the left basal ganglia. Here we describe the case of a 68‐year‐old man presenting with reversible micrographia accompanied by hypophonia in the absence of extrapyramidal signs after cerebral infarction in the left subcortical region. At the time of the patient's admission, diffusion‐weighted magnetic resonance imaging sequence showed the lesion to principally involve the corona radiata, with some involvement of the putamen. Neurologically, mild right‐sided brachiofacial hemiparesis and grasp reflexes – a frontal lobe sign – were observed. As his micrographia and hypophonia improved, the patient's grasp reflexes improved in parallel. In addition, recovery of regional cerebral blood flow in the left frontal lobe was confirmed by single photon emission computed tomography (technetium‐99 m HMPAO). The present case suggests the possibility that the function of frontal‐subcortical circuit might also be involved in the production and improvement of micrographia and that micrographia and hypophonia may share a common pathophysiology.
Therapeutic effect of repetitive transcranial magnetic stimulation on motor function in Parkinson's disease patients
Authors: Khedr E. M. , Farweez H. M. , Islam H.
Published: August 2003

Cortical excitability of the primary motor cortex is altered in patients with Parkinson's disease (PD). Therefore, modulation of cortical excitability by high frequency repetitive transcranial magnetic stimulation (rTMS) of the motor cortex might result in beneficial effects on motor functions in PD. The present study aims to evaluate the effect of rTMS of the motor cortex on motor functions in patients with PD.

Thirty‐six unmedicated PD patients were included consecutively in this study. The patients were assigned in a randomized pattern to one of two groups, one group receiving real‐rTMS (suprathreshold 5‐Hz, 2000 pulses once a day for 10 consecutive days) and the second group receiving sham‐rTMS using closed envelopes. Total motor section of Unified Parkinson's Disease Rating Scale (UPDRS), walking speed, and self‐assessment scale were performed for each patient before rTMS and after the first, fifth, 10th sessions, and then after 1 month. Evaluation of these measures was performed blindly without knowing the type of rTMS.

anova for repeated measurements revealed a significant time effect for the total motor UPDRS, walking speed and self‐assessment scale during the course of the study in the group of patients receiving real‐rTMS (P = 0.0001, 0.001, and 0.002), while no significant changes were observed in the group receiving sham‐rTMS except in self‐assessment scale (P = 0.019). A 10‐day course of real‐rTMS resulted in statistically significant long‐term improvement of the motor functions in comparison with the sham‐rTMS. The rTMS could have a therapeutic role of for PD patients.
Multiple modifiable risk factors for first ischemic stroke: a population‐based epidemiological study
Authors: Hadjiev D. I. , Mineva P. P. , Vukov M. I.
Published: August 2003

The aims of this epidemiological population‐based cohort study were to examine the prevalence of the multiple modifiable vascular risk factors, their distribution patterns and outcomes among a Bulgarian urban population. A total of 500 volunteers, 200 men and 300 women, without clinical signs and symptoms of cerebrovascular disease, aged 50–79 years, were enrolled in the study. A structured questionnaire, physical examination, electrocardiogram records, a battery of laboratory tests and carotid duplex scanning were employed. Three or more modifiable vascular risk factors were detected in 52% (260/500) of the subjects. Dyslipidemias, hypertension, obesity, cigarette smoking and cardiac diseases were found to be the most prevalent single risk factors. Asymptomatic carotid stenosis (ACS) of 50% or greater was detected in 8.8% (23/260) of the volunteers examined. After a 2‐year follow‐up, 2.7% (7/260) of the persons with modifiable vascular risk factors reached the end point transient ischemic attacks (TIAs), ischemic stroke and myocardial infarction. The following combinations of risk factors among the subjects enrolled in the study were significantly associated with these outcomes: hypertension and cardiac diseases (OR = 6.82; 95% CI, 1.21‐38.41), cardiac diseases and obesity (OR = 6.13; 95% CI, 1.27–29.72), ACS and high low‐density lipoprotein (LDL) cholesterol levels (OR = 11.11; 95% CI, 1.58–78.29). The identification of subjects with multiple vascular risk factors may be important for primary medical or surgical stroke prevention.
Alpha B‐crystallin is not a dominant peripheral T‐cell autoantigen in multiple sclerosis amongst Sardinians
Authors: Sotgiu S. , Pugliatti M. , Contu S. , Sanna A. , Sgaramella E. , VanNoort J. M. , Rosati G.
Published: August 2003

The heat shock protein alpha B‐crystallin appears to be the dominantly recognized autoantigen in the early demyelinative process of multiple sclerosis (MS) in brain of patients. In Sardinia, MS is linked to human leucocyte antigen (HLA)‐DR alleles that might influence the production of cytokines from peripheral lymphocytes. We tested the nature of peripheral anti‐alpha B‐crystallin‐specific T‐cell response in the context of predisposing HLA haplotypes both in MS patients and healthy controls. The alpha B‐crystallin specific T‐cell lines were generated by using the ‘split‐well’ technique. The results indicate that the presence of short‐term T‐cell lines towards alpha B‐crystallin is numerically comparable between the two groups and not restricted to MS‐predisposing HLA‐DR alleles. As for the T‐cell characterization, CD4+ anti‐alpha B‐crystallin T cells secreting high levels of interferon‐γ are similarly identified in MS and healthy donors. In conclusion, the peripheral response towards the myelin antigen alpha B‐crystallin is neither quantitatively nor qualitatively peculiar to MS, in contrast to the theoretical paradigm suggesting peripheral activation of myelin‐reactive T cells to be the prerequisite for MS induction.
MR imaging of the brain in patients with hepatic form of Wilson's disease
Authors: Kozić D. , Svetel M. , Petrović B. , Dragašević N. , Semnic R. , Kostić V. S.
Published: August 2003

The aim of this study was to detect the sites and frequency of possible lesions by brain magnetic resonance imaging (MRI; 1,5T) in a group of 16 neurologically asymptomatic patients with hepatic form of Wilson's disease (WD; seven untreated and nine under treatment). Abnormal MR findings of the brain were found in 75% of patients. Lesions in brain parenchyma were detected in all untreated, drug‐naive patients and in 44% of treated patients. Abnormal signal in globus pallidus, putamen, and caudate nucleus was revealed in 86, 71 and 71% of treated and in 33, 33 and 22% of untreated patients, respectively. In five of eight patients with putaminal pathology (62.5%) and in four of seven patients with caudate nuclei involvement (57%), only proton density 2‐weighted sequence (PDW) exhibited sensitivity for lesion detection, with both T1W and long echo T2W sequences being insensitive. This superiority of PDW sequence was even more pronounced in the group of untreated patients in whom 80% of putaminal pathology was visible exclusively on this sequence. The lower frequency of lesions in the group of treated in comparison with untreated patients indicated that they might be reversible in the course of chronic chelating therapy.
SCA2 and SCA3 mutations in young‐onset dopa‐responsive parkinsonism
Authors: Svetel M. , Djarmati A. , Dragašević N. , Savić D. , Čuljković B. , Romac S. , Kostić V. S.
Published: August 2003

In this study no one of our 85 patients of Serbian origin with young‐onset (≤ 45 years) dopa‐responsive parkinsonism (YOP), previously proved negative for PARK1 and PARK2 mutations, had either spinocerebellar ataxia type 2 (SCA2) or SCA3 mutation. These data do not prove the significance of these two mutations in either sporadic or familial YOP suggestive of Parkinson's disease.
Recalcitrant psoriasis vulgaris associated with Laurence–Moon–Biedl syndrome
Authors: Margolin L , Haliulin Y
Published: August 2003

We report a 30‐year‐old European (Ashkenazi Jewish) male with Laurence–Moon–Biedl syndrome (Bardet–Biedl type) who was hospitalized because of severe recalcitrant plaque‐type psoriasis. Laurence–Moon–Biedl syndrome has been shown to be linked to the chromosome 11q region in the majority of the patients of European descent. The same 11q region had increased frequency of aberrations in the study that included cytogenetic analysis of 477 psoriatic patients. The animal model of the syndrome (mice) showed abnormalities in hair growth and epidermal differentiation. This genetic association between Laurence–Moon–Biedl syndrome and psoriasis can contribute to the understanding of the factors involved in the initiation of psoriasis and factors that modulate its severity and resistance to therapy.
Histological and immunofluorescence findings of non‐follicular papulopustular lesions in patients with Behçet's disease
Authors: Alpsoy E , Uzun S , Akman A , Alpaslan Acar M , Memişoǧlu HR , Başaran E
Published: August 2003

Background Papulopustular lesions (PPL), the most common type of cutaneous lesions in Behçet's disease (BD), clinically may not be differentiated from ordinary acne. Disagreement exists as to the exact nature of these acneiform and folliculitis‐like lesions and whether to include them as a major criterion.

Objective We investigated whether PPL can be a useful tool for the diagnosis of BD when non‐follicular lesions over the trunk or extremities were selected, and were correlated with histological and/or immunofluorescence study.

Methods Seventeen patients with BD (five women, 12 men; mean ± SEM age, 32 ± 7.9 years), were enrolled in the study with blind histopathological and immunofluorescence studies. Biopsies of the PPL and adjacent (approximately 2 cm distant) normal‐appearing skin were performed from the extremities and trunk. Follicle‐based acneiform lesions and those lesions over face were excluded. Histological evaluation primarily included epidermal and dermal alterations, cellular infiltration and vascular changes. We also performed direct immunofluorescence studies, using polyclonal antibodies for IgA, IgG, IgM, C3 and fibrin.

Results Lesional specimens of the patients with BD revealed a significant leucocytoclastic vasculitis as compared with non‐lesional skin (P < 0.05). The vessels of the lesional skin showed a higher IgM deposition than non‐lesional skin (52.9% and 17.6%) (P < 0.05). IgG, C3 and fibrin deposits on the vessels of the lesional skin were also higher than non‐lesional skin (35.3, 11.8%; 41.2, 17.6%; and 47.1, 17.6%, respectively), but the differences were not statistically significant.

Conclusions Our findings indicate that non‐follicular PPL over the trunk or extremities are more specific, and immune complex‐mediated vasculitis is likely to be the main feature of these lesions, as they are in other cutaneous lesions of BD.
An unusual presentation of primary cutaneous squamous cell carcinoma
Authors: Baloǧlu H , Doǧan B
Published: August 2003

The cutaneous squamous cell carcinoma is a malignant epithelial tumour that usually arises from an underlying precursor skin lesion. We report the case of a 65‐year‐old woman with multiple de novo squamous cell carcinomas in an unusual presentation.
Pimecrolimus: A review
Authors: Gupta AK , Chow M
Published: August 2003

Pimecrolimus (SDZ ASM 981), an ascomycin derivative, is one of the new classes of immunomodulating macrolactams and was specifically developed for the treatment of inflammatory skin diseases. The interest in pimecrolimus has been substantial because of its significant anti‐inflammatory activity and immunomodulatory capabilities and its low systemic immunosuppressive potential. The mechanism of action of pimecrolimus is the blockage of T cell activation. Pimecrolimus (like all ascomycins) is an immunophilin ligand, which binds specifically to the cytosolic receptor, immunophilin macrophilin‐12. This pimecrolimus‐macrophilin complex effectively inhibits the protein phosphatase calcineurin, by preventing calcineurin from dephosphorylating the nuclear factor of activated T cells (NF‐AT), a transcription factor. This results in the blockage of signal transduction pathways in T cells and the inhibition of the synthesis of inflammatory cytokines, specifically Th1‐ and Th2‐type cytokines. Pimecrolimus has also been shown to prevent the release of cytokines and pro‐inflammatory mediators from mast cells. Several studies have evaluated the effectiveness of pimecrolimus as a treatment for skin diseases. In animal models of allergic contact dermatitis, topical pimecrolimus was found to be effective. In human studies of allergic contact dermatitis pimecrolimus demonstrated significantly more efficacy than the control treatment. As well, the effectiveness of pimecrolimus 0.6% cream was comparable to 0.1% betamethasone‐17‐valerate; however, pimecrolimus was not associated with any of the side effects characteristic of a topical steroid. Topical application of pimecrolimus is not associated with skin atrophy. Pimecrolimus is effective and safe in both children and adults with atopic dermatitis. When pimecrolimus 1% cream has been applied to adult atopics, improvement has been observed as early as the first week, with a 72% reduction in severity after 3 weeks. Pharmacokinetic studies have shown very low blood levels of pimecrolimus following topical application, with no accumulation after repeated applications. Following application of pimecrolimus cream occasional transient irritation may be experienced at the application site. Similar results have also been found in children aged 3 months and older following application of pimecrolimus 1% cream. Topical pimecrolimus in psoriasis appears to exhibit a dose‐dependent therapeutic effect under semi‐occlusive conditions. Pimecrolimus has an enormous potential as a new treatment of inflammatory skin diseases. It has been shown to be effective in atopic and allergic contact dermatitis, with a favorable adverse‐effects profile, which includes little effect on the systemic immune response.
Cholesterol crystal embolization: an atherosclerotic disease with frequent and varied cutaneous manifestations
Authors: Donohue KG , Saap L , Falanga V
Published: August 2003

In this paper the basic pathogenesis of cholesterol crystal embolization (CCE) is described, its clinical characteristics are presented and diagnosis and therapy are discussed. The main focus will be on the cutaneous manifestations; however, considering that CCE is a systemic illness, findings in other organs will also be highlighted, particularly the commonly involved renal and gastrointestinal systems.
Itching attacks with generalized hyperhydrosis as initial symptoms of Hodgkin's disease
Authors: Stadie V , Marsch WCH
Published: August 2003

Background Clinical signs of Hodgkin's disease are unexplained weight loss, nocturnal sweating, fever and more or less permanent itching or pain around the affected lymphnodes, especially after alcohol consumption. Paraneoplastic symptoms are major challenges to the dermatologist, particularly if these seem harmless, though somewhat strange, as in the following case.

Observation A 35‐year‐old patient had suffered for about 6 months from paroxysmal severe itching. A transient, generalized hyperhydrosis followed these attacks closely. The itching attacks usually began between the fingers and on the palms of the hands, and then spread to become generalized over the entire integument. The itching attacks commonly occurred three times daily for only a few minutes, while the subsequent severe hyperhydrosis, with cold sweat, lasted up to an hour.

Conclusions This case illustrates the necessity of considering a malignant underlying disease like Hodgkin's disease, not only in the presence of the well‐known B‐symptoms, but also when peculiar symptom combinations, like itching attacks and immediately subsequent transient generalized hyperhydrosis are present.
Mycosis fungoides responding to systemic itraconazole
Authors: Cooper SM , Sheridan A , Burge S
Published: August 2003

Mycosis fungoides is a form of cutaneous lymphoma with a typically indolent course. We describe an unexpected, repeated response to a systemic antifungal agent, itraconazole. The mechanism of action is speculative but itraconazole has marked immunosuppressive activity on T‐lymphocyte proliferation in vitro.
Penile paraffinoma
Authors: Santos P , Chaveiro A , Nunes G , Fonseca J , Cardoso J
Published: August 2003

A 40‐year‐old Caucasian man, originating from Ukraine, but living for the last year and a half in Portugal, presented to our department with a one year history of an irregular penile mass and phimosis. He reluctantly admitted that 8 years previously he had multiple mineral oil injections in the penis , for the purpose of penile enlargement. A diagnosis of penile paraffinoma was made and surgical excision was performed at the urology department. Paraffinoma results from mineral‐oil injections : such practice is very rare in the western world nowadays, however, it still is performed in many Eastern European Countries.
Lupus vulgaris over a tattoo mark – inoculation tuberculosis
Authors: Ghorpade A
Published: August 2003

Lupus vulgaris developing after tattooing and remaining exclusively confined to it, in a 40‐year‐old‐lady is reported. The tattooing was done one year earlier by a roadside tattoo artist. Diagnosis was suggested by the clinical features and confirmed by histopathology.
Cutaneous infection caused by Salmonella typhi
Authors: Marzano AV , Mercogliano M , Borghi A , Facchetti M , Caputo R
Published: August 2003

Salmonella typhi is a flagellated, gram‐negative bacillus belonging to the family Enterobacteriaceae responsible for typhoid fever, which is a prolonged bacteraemic, systemic illness with minimal, at least initially, diarrhoea. Localized infection is a not uncommon complication of salmonella septicaemia, particularly occurring in immunocompromised patients. However, salmonella localization to the skin presenting as cutaneous ulceration is regarded as a rare event. We report a unique case of such a presentation as the sole clinical manifestation of infection with S. typhi and highlight the possible salmonella aetiology for unusual cutaneous lesions in individuals coming from endemic areas.
Analytic quantification of solar lentigines lightening by a 2% hydroquinone–cyclodextrin formulation
Authors: Petit L , Piérard GE
Published: August 2003

Background The innate melanin pigmentation of skin is modulated during lifetime by a series of factors, including ageing and chronic ultraviolet light exposure. Actinic lentigines may be of particular concern from a cosmetic point of view. Conventional hypopigmenting agents are usually deceptive. Using cyclodextrins to form inclusion compounds with these agents might represent a more active drug delivery system.

Objective To assess sensitive and objective methods predicting the effects of a 2% hydroquinone–cyclodextrin formulation on solar lentigines.

Study design Thirty Asian adults applied a 2% hydroquinone–cyclodextrin formulation once daily on solar lentigines of a forearm for 2 months. The other untreated forearm served as a control. Monthly assessments were performed using skin colorimetry and fluorescence video recording combined with image analysis. Corneomelametry following photodensitometry of cyanoacrylate skin surface strippings was performed after melanin staining of the samples.

Results The control untreated solar lentigines showed no significant variations in the biometrological parameters. By contrast, the test formulation induced lightening of the solar lentigines. Corneomelametry disclosed improvement after 1 months’ treatment, whereas the other assessments only reached significance after 2 months.

Conclusions A 2% hydroquinone–cyclodextrin formulation proved to be effective in lightening actinic lentigines. Corneomelametry predicted the effects discernible at a later stage by in vivo colour assessments of the melanin content.
Cutaneous angiosarcoma of the face
Authors: Cannavò SP , Lentini M , Magliolo E , Guarneri C
Published: August 2003

Cutaneous angiosarcoma is a rare tumour of vascular origin, which has a poor prognosis because of its high potential for metastasis. We report the case of a 57‐year‐old man with an 8‐month history of a progressively enlarging, asymptomatic red patch over the left periorbital region of the face, previously diagnosed as angiolupoid leishmaniasis, insect‐bites, ‘cellulitis’ and treated with several topical antibiotic and steroid therapy, without any improvement. A skin biopsy of the lesion was performed and histological and immunohistochemical examination revealed a pattern of poorly differentiated angiosarcoma. The peculiarity of the localization at the periorbital area and the particular clinical presentation are emphasized.
Squamous cell carcinoma in vitiligo lesion after long‐term PUVA therapy
Authors: Park HS , Lee YS , Chun DK
Published: August 2003

Photochemotherapy using psoralen and ultraviolet (UV)A irradiation (PUVA) is a useful treatment method for vitiligo. However, long‐term PUVA therapy may cause several adverse effects including skin cancer, especially squamous cell carcinoma (SCC). We describe a case of SCC in vitiligo lesion after long‐term PUVA therapy.
Monochromatic excimer light 308 nm in the treatment of vitiligo: a pilot study
Authors: Leone G , Iacovelli P , Paro Vidolin A , Picardo M
Published: August 2003

Objective To study the efficacy and safety of monochromatic excimer light (MEL) on 37 vitiligo patients referred to our clinic.

Methods In a pilot study, 37 patients (17 males, 20 females) with acrofacial (n = 21), focal (n = 11), segmental (n = 1), and generalized (n = 4) vitiligo were treated twice weekly with MEL for a maximum period of 6 months.

Results Thirty‐five patients (95%) showed signs of repigmentation within the first eight treatments. The treatment resulted in good repigmentation in 16 patients, and excellent repigmentation in 18 patients. Adverse events were limited to transient erythema. In addition, some patients (n = 3) not responding to prior narrow‐band UVB (NB UVB) phototherapy showed good results with MEL in our series.

Conclusions Treatment with 308 nm MEL for vitiligo may be more effective in obtaining rapid repigmentation than phototherapy with NB UVB. The results in this study are similar to those recently reported with a 308 nm excimer laser, but 308 MEL could present some advantages: the possibility of treating larger areas compared to the 308 nm excimer laser, with shorter treatment times and better patient compliance. The overall good results and the early appearance of repigmentation contribute to reducing the cumulative exposure to UV radiation.
Necrotizing fascitis induced by mosquito bite
Authors: Verma SB
Published: August 2003

Necrotizing fascitis usually occurs after a perforating trauma or sometimes surgery. It is an acute necrotizing process which involves the fascia of the skin. Within one or two days of the causative event the patient experiences pain, oedema and a dusky bluish–red discolouration of the skin with or without bullae formation. These areas become gangrenous usually by the fifth day. Often any specific organisms are not grown on culture, but the common ones that are include beta‐haemolytic streptococci, coliforms, enterococci, pseudomonas. Treatment comprises early detection, surgical debridement, intravenous antibiotics and supportive care. We report a case of grossly neglected necrotizing fascitis caused by mosquito bites. Our treatment consisted of intravenous antibiotics, thorough debridement, regular dressings and a split‐thickness skin graft. These measures collectively preserved an otherwise hopelessly mutilated upper limb.
Lymphangioma circumscriptum of the penis mimicking venereal lesions
Authors: Gupta S , Radotra B D , Javaheri S M , Kumar B
Published: August 2003

Lymphangioma circumscriptum (LC) involving the penis is rare. We report two patients with penile LC. The lesions developed in early infancy in one patient, and during puberty in the other. The lesions resembled molluscum contagiosum in one and genital warts in the other. The first patient was previously treated with a diagnosis of venereal disease. A literature search found only 4 LC patients with penile lesions reported in the English literature. These cases are presented for their rarity, and to increase diagnostic vigilance and desirability of non‐intervention.
Mitochondrial DNA Variability in Bosnians and Slovenians
Authors: Malyarchuk B. A. , Grzybowski T. , Derenko M. V. , Czarny J. , Drobnič K. , Miścicka‐Śliwka D.
Published: August 2003

Mitochondrial DNA variability in two Slavonic‐speaking populations of the northwestern Balkan peninsula, Bosnians (N = 144) and Slovenians (N = 104), was studied by hypervariable segments I and II (HVS I and II) sequencing and restriction fragment‐length polymorphism (RFLP) analysis of the mtDNA coding region. The majority of the mtDNA detected in Southern Slavonic populations falls into the common West Eurasian mitochondrial haplogroups (e.g., H, pre‐V, J, T, U, K, I, W, and X). About 2% of the Bosnian mtDNAs encompass East Eurasian and African lineages (e.g., M and L1b, respectively). The distribution of mtDNA subclusters in Bosnians, Slovenians and the neighbouring European populations reveals that the common genetic substratum characteristic for Central and Eastern European populations (such as Germans, Poles, Russians and Finns) penetrates also South European territories as far as the Western Balkans. However, the observed differentiation between Bosnian and Slovenian mtDNAs suggests that at least two different migration waves of the Slavs may have reached the Balkans in the early Middle Ages.
Selective Pressure has not Acted Against Hypercoagulability Alleles in High‐Altitude Amerindians
Authors: Rupert J. L. , Monsalve M. V. , Kidd K. K. , Tan C. , Hochachka P. W. , Devine D. V.
Published: August 2003

Elevated hematocrit increases blood oxygen carrying capacity in high‐altitude populations, but blood viscosity and coaguability may increase concomitantly. Alleles of the β‐fibrinogen gene (FGB) associated with lower fibrinogen levels are more common in highland Amerindians (Quechua) than lowland Amerindians (Na‐Dene). Although genetic drift could account for this, selection may have acted against transmission of hypercoagulability alleles at high altitude. To test this hypothesis, we compared allele frequencies between Quechua and more closely related lowlanders (Maya) at loci in the genes encoding β‐fibrinogen (FGB), factors V (F5), VII (F7) and XIII (F13), α2‐integrin (ITGA2) and plasminogen activator inhibitor type 1 (PAI‐1; SERPINE1). No significant differences in allele frequencies were found except 485arg in the gene encoding factor V, which was more common in the Quechua. These data do not support the hypothesis that selection has acted to eliminate alleles associated with hypercoagulability in Andean highlanders.
Designing a Coherent Ecological Network for Large Mammals in Northwestern Europe
Authors: Bruinderink Geert Groot , Van Der Sluis Theo , Lammertsma Dennis , Opdam Paul , Pouwels Rogier
Published: August 2003

Abstract: In densely populated northwestern Europe, native large mammals are confronted with a very fragmented landscape, and most of the areas they inhabit are island‐like reserves threatened with total isolation from other reserves. The only way to counteract the threat of further decline in the numbers of large‐mammal species is to restore their habitats. The appropriate size of future reserves could be estimated from the habitat requirements of wild ungulates that are considered key species for ecosystem functioning. The species selected to guide the design of large nature reserves in northwestern Europe is the red deer ( Cervus elaphus) because of its widespread distribution, key role in ecosystem functioning, and home‐range size. We describe a network analysis of the Netherlands, Belgium, and adjacent parts of France and Germany, performed with the LARCH landscape ecology model, that was conducted in order to identify the structure of the ecological network for red deer and the spatial connectivity of the landscape. The resulting maps show areas that could support viable populations and indicate habitat areas that will support persistent populations only if they are in a network of linked habitats. The gaps and barriers that prevent connectivity in such networks guide the design of effective corridors to increase spatial connectivity. The results of our analysis can be used for policy decisions on nature conservation and spatial planning, and the method is applicable to other regions and species.
Effects of Forest Roads on Understory Plants in a Managed Hardwood Landscape
Authors: Watkins Radley Z. , Chen Jiquan , Pickens Jim , Brosofske Kimberley D.
Published: August 2003

Abstract: The effect of forest roads on species distribution and dispersal is an important conservation and management issue. We examined distributions of understory plants and their relationships to unpaved forest roads in a northern hardwood landscape in the Chequamegon National Forest, Wisconsin ( U.S.A. ). At six different sites, we recorded species cover, canopy cover, litter depth and cover, and bare ground at 11 distances ( 0, 5, 10, 15, 20, 30, 45, 60, 90, 120, and 150 m ) from the road edge. At each of the 11 distances, we established a 60‐m transect parallel to the road edge, within which we sampled 10 randomly placed 1 × 1 m plots ( 660 plots ). We examined changes in species abundance ( percent species cover per plot ), richness, and Shannon‐Wiener diversity (  H′ ) with distance from the roads in an effort to determine the degree and magnitude of road effects on plant distribution. The species richness and H′ of native plants and the abundance of exotic species were clearly related to distance from the roads. Exotic species were most prevalent within 15 m of roads, occurring infrequently in the interior forest. The richness and H′ of native species were lower on the roadsides but reached interior‐forest levels within a short distance ( 5 m ) from the roads. The roads appeared to be associated with a disturbance corridor that affected site variables up to 15 m into the hardwood stands. At our six sites we detected 117 species, 25% of which occurred more frequently near the road, with only 12% having a 90% or greater preference for the forest interior. Our results suggest that roads have associated effects that alter interior‐forest conditions and thus plant species composition and abundance; however, these effects are limited in depth of penetration into managed forests.
Restoring Arthropod Communities in Coastal Sage Scrub
Authors: Burger J. C. , Redak R. A. , Allen E. B. , Rotenberry J. T. , Allen M. F.
Published: August 2003

Abstract: Coastal sage scrub in California and northern Baja California has been severely affected by urban expansion and is, in places, badly in need of restoration. We measured arthropod abundance and diversity on one of its primary components, the native shrub Artemisia californica ( Asteraceae; California sage ), to evaluate whether arthropod communities had become reestablished after a restoration attempt. Arthropods were collected from shrubs on planted and undisturbed sites 6 years after a restoration attempt. Fifty‐seven families and 146 adult morphospecies were found. Family and species richness were greater on planted shrubs, but arthropod diversity, once differences in species' abundances were corrected for, was greater on naturally established plants. Common arthropods occurred at similar densities regardless of planting history. The proportion of single occurrences of a species, in contrast, was significantly greater on naturally established shrubs. Planted shrubs supported more predators relative to herbivores than did naturally established shrubs. Planted shrubs were still distinguishable from naturally established ones in that they were both more isolated from neighboring shrubs and surrounded by more invasive weeds. We suggest that small‐scale restoration attempts can be successful at restoring basic elements of surrounding biodiversity. They do create a different community, however, both taxonomically and functionally, and are at least initially less able to support rare species.
Potential Impact of Global Climate Change on Species Richness of Long‐Distance Migrants
Authors: Lemoine Nicole , Böhning‐Gaese Katrin
Published: August 2003

Abstract: Little evidence exists demonstrating that global climate change leads to systematic changes in the structure of ecological communities. For avian communities, one would expect warmer winters to lead to declines in numbers of long‐distance migrants if resident birds benefit from warmer winters and impose increasing competitive pressure on migrants. To study the potential influence of global climate change on long‐distance migrants, we correlated the number of all species of land birds and the number and proportion of long‐distance migrants, short‐distance migrants, and residents in 595 grid cells across Europe. We used mean temperature of the coldest month, mean spring temperature, and spring precipitation as measures of climatic conditions in winter and during the breeding period. The number and proportion of long‐distance migrants decreased with increasing winter temperature, decreasing spring temperature, and increasing spring precipitation. We used this spatial relationship between bird community structure and climate in Europe to make predictions about changes in bird communities of the Lake Constance region, Central Europe, between two census periods ( 1980–1981 and 1990–1992 ). Winter temperature in this region increased significantly between the two censuses, whereas spring temperature and precipitation did not change. As predicted from the models, the proportion of long‐distance migrants decreased and the number and proportion of short‐distance migrants and residents increased between the two censuses. The significant declines of the long‐distance migrants in the Lake Constance region are of a magnitude that can be explained by the observed climate change. Our results suggest that increasingly warmer winters may pose a more severe threat to long‐distance migrants than to the other bird groups.
Roads as Conduits for Exotic Plant Invasions in a Semiarid Landscape
Authors: Gelbard Jonathan L. , Belnap Jayne
Published: August 2003

Abstract: Roads are believed to be a major contributing factor to the ongoing spread of exotic plants. We examined the effect of road improvement and environmental variables on exotic and native plant diversity in roadside verges and adjacent semiarid grassland, shrubland, and woodland communities of southern Utah ( U.S.A. ). We measured the cover of exotic and native species in roadside verges and both the richness and cover of exotic and native species in adjacent interior communities ( 50 m beyond the edge of the road cut ) along 42 roads stratified by level of road improvement (  paved, improved surface, graded, and four‐wheel‐drive track ). In roadside verges along paved roads, the cover of Bromus tectorum was three times as great ( 27% ) as in verges along four‐wheel‐drive tracks (  9% ). The cover of five common exotic forb species tended to be lower in verges along four‐wheel‐drive tracks than in verges along more improved roads. The richness and cover of exotic species were both more than 50% greater, and the richness of native species was 30% lower, at interior sites adjacent to paved roads than at those adjacent to four‐wheel‐drive tracks. In addition, environmental variables relating to dominant vegetation, disturbance, and topography were significantly correlated with exotic and native species richness and cover. Improved roads can act as conduits for the invasion of adjacent ecosystems by converting natural habitats to those highly vulnerable to invasion. However, variation in dominant vegetation, soil moisture, nutrient levels, soil depth, disturbance, and topography may render interior communities differentially susceptible to invasions originating from roadside verges. Plant communities that are both physically invasible ( e.g., characterized by deep or fertile soils ) and disturbed appear most vulnerable. Decision‐makers considering whether to build, improve, and maintain roads should take into account the potential spread of exotic plants.
Extent of Nontimber Resource Extraction in Tropical Forests: Accessibility to Game Vertebrates by Hunters in the Amazon Basin
Authors: Peres Carlos A. , Lake Iain R.
Published: August 2003

Abstract:Extractive activities targeting a wide range of nontimber forest products ( NTFPs ) are ubiquitous in tropical forests, yet the extent of structurally intact forests in a given region affected by this form of cryptic disturbance is poorly documented. We conducted a basin‐wide geographic information system analysis of the nonmotorized accessibility of Amazonian NTFP extraction and estimated the proportion of the Amazon drainage basin within Brazil ( 3.74 million km 2 ) that can be accessed on foot from the nearest navigable river or functional road. We use a long‐term series of standardized line‐transect vertebrate censuses conducted throughout the region to illustrate the effects of physical accessibility on wildlife densities in terms of hunting pressure as a function of distance from the nearest point of access. Population abundance in large‐bodied, prime‐target species preferred by game hunters tended to increase at greater distances from the access matrix, whereas small‐bodied species ignored by hunters usually showed the reverse trend. In addition, we estimated the proportion of presumably inviolate core areas within nature, extractive, and indigenous reserves of Brazilian Amazonia that are prohibitively remote and unlikely to be overhunted; for instance, only 1.16% of the basin‐wide area is strictly protected on paper and is reasonably safe from extractive activities targeted to game vertebrates and other valuable NTFPs. Finally, we discuss the concept of truly undisturbed wildlands in the last major tropical forest regions by distinguishing potentially overharvested areas from those that remain largely or entirely pristine and that maintain viable populations of a full complement of harvest‐sensitive species.
Effects of Prairie Fragmentation on the Nest Success of Breeding Birds in the Midcontinental United States
Authors: Herkert James R. , Reinking Dan L. , Wiedenfeld David A. , Winter Maiken , Zimmerman John L. , Jensen William E. , Finck Elmer J. , Koford Rolf R. , Wolfe Donald H. , Sherrod Steve K. , Jenkins M. Alan , Faaborg John , Robinson Scott K.
Published: August 2003

Abstract:Grassland fragmentation and habitat loss are hypothesized to be contributing to widespread grassland bird declines in North America due to the adverse effects of fragmentation on breeding bird abundance and reproductive success. To assess the effects of fragmentation on the reproductive success of grassland birds, we measured rates of nest predation and brood parasitism for four species of birds ( Grasshopper Sparrow [Ammodramus savannaru], Henslow's Sparrow[Ammodramus henslowii], Eastern Meadowlark [ Sturnella magna], and Dickcissel [ Spiza Americana] ) in 39 prairie fragments ranging from 24 to>40,000 ha in size in five states in the mid‐continental United States. Throughout the region, nest‐predation rates were significantly influenced by habitat fragmentation. Nest predation was highest in small (<100 ha ) and lowest in large ( >1000 ha ) prairie fragments. Rates of brood parasitism by Brown‐headed Cowbirds (   Molothrus ater ), however, were not consistently related to fragment size and instead were more strongly related to regional cowbird abundance, being significantly higher in regions with high cowbird abundance. Differences in nest‐predation rates between large fragments ( 54–68% of all nests lost to predators ) and small fragments ( 78–84% lost to predators ) suggest that fragmentation of prairie habitats may be contributing to regional declines of grassland birds. Maintaining grassland bird populations, therefore, may require protection and restoration of large prairie areas.
Effects of Urbanization and Habitat Fragmentation on Bobcats and Coyotes in Southern California
Authors: Riley Seth P. D. , Sauvajot Raymond M. , Fuller Todd K. , York Eric C. , Kamradt Denise A. , Bromley Cassity , Wayne Robert K.
Published: August 2003

Abstract:Urbanization and habitat fragmentation are major threats to wildlife populations, especially mammalian carnivores. We studied the ecology and behavior of bobcats (   Lynx rufus ) and coyotes ( Canis latrans ) relative to development in a fragmented landscape in southern California from 1996 to 2000. We captured and radiocollared 50 bobcats and 86 coyotes, determined home ranges for 35 bobcats and 40 coyotes, and measured their exposure to development (  “urban association”  ) as the percentage of each home range composed of developed or modified areas. Both species occupied predominantly natural home ranges. Adult female bobcats had low levels of urban association, significantly lower than coyotes, adult male bobcats, and young female bobcats. Home‐range size was positively correlated with urban association for coyotes and adult male and young female bobcats, suggesting that human‐dominated areas were less suitable than natural areas in some important way. Animals more associated with non‐natural areas had higher levels of night activity, and both bobcats and coyotes were more likely to be in developed areas at night than during the day. Survival rates were relatively high and were not related to urban association, at least for animals>6–9 months of age. Mortality rates from human‐related causes such as vehicle collisions and incidental poisoning were also independent of urban association. In this region, even the few animals that had almost no human development within their home range were vulnerable to human‐related mortality. Carnivore conservation in urban landscapes must account for these mortality sources that influence the entire landscape, including reserves. For bobcats, preserving open space of sufficient quantity and quality for adult females is necessary for population viability. Educating local residents about carnivores is also critical for conserving populations in urban areas.