bluuebunny/crossref_metadata_2025 huggingface dataset:
Delayed Defibrillation Testing in Patients Implanted with Biventricular ICD (CRT‐D): A Reliable and Safe Approach
Authors: GASPARINI MAURIZIO , GALIMBERTI PAOLA , REGOLI FRANÇOIS , CERIOTTI CARLO , BONADIES MARIKA
Published: August 2010

Background: Defibrillation testing (DT) at the end of the implantation of cardiac resynchronization pacemaker with a defibrillator (CRT‐D) exposes heart failure (HF) patients to increased procedural risks. However, until now, delayed DT has not been assessed as a possible option in HF patients implanted with CRT‐D.

Objective: Aim of the present study is to assess safety and feasibility of delayed DT in HF patients treated with CRT‐D.

Material and Methods: Two hundred and eleven consecutive patients (mean age: 65 years, mean NYHA class 3.0, mean EF: 29.3%) underwent CRT‐D implantation from October 1999 to December 2004. In the first 17 patients, DT was performed at the end of CRT‐D implantation. In the other 194 consecutive patients, DT was performed at 2 months after CRT‐D implantation. Outcome of DT, as well as “acute” LV lead dislodgment rate were evaluated in the latter group of 194 patients undergoing a delayed DT. Also, ICD function was assessed through device telemetry analysis at 2 months.

Results: At delayed DT, first shock was effective in 187 of 194 patients (96%), ineffective VF interruption at maximum energy occurred only in one patient (0.5%), and acute LV lead dislodgment was 1%. No ICD therapy failure occurred in the 2‐month untested period.

Conclusion: DT performed 2 months after CRT‐D implantation is safe and feasible; this is possibly related to the improvement of clinical conditions and hemodynamic status as well as greater lead stability 2 months after CRT‐D.
Curative Therapy for Swallowing‐Induced Tachycardia by Pulmonary Vein Antrum Isolation
Authors: YAMAUCHI YASUTERU , AONUMA KAZUTAKA , SEKIGUCHI YUKIO , HIGUCHI KOJI , OBAYASHI TOHRU , ISOBE MITSUAKI
Published: August 2010

We present a case of a 49‐year‐old man who experienced invariably reproducible paroxysmal supraventricular tachycardia during swallowing. Because beta‐blockers and multiple antiarrhythmic drugs failed to prevent the episodes of this tachycardia, we performed catheter mapping and ablation. After placing multiple decapolar catheters, when the patient swallowed a few sections of an orange, intracardiac mapping revealed atrial premature beats and atrial tachycardia that lasted for a few seconds and arose from an ostial site of the right superior pulmonary vein. After the right superior pulmonary vein antrum was completely isolated, the patient became free from the swallowing‐induced tachycardia.
Systematic Review of Educational Interventions for Improving Advance Directive Completion
Authors: Durbin Christine R. , Fish Anne F. , Bachman Jean A. , Smith Katharine V.
Published: August 2010

Purpose: To systematically analyze evidence about the outcome and percent of newly completed ADs, focusing on the effectiveness of (a) types of educational interventions versus controls and (b) one educational intervention over another.

Design: Systematic review of literature based on Cochrane review criteria.

Methods: Twelve randomized and four nonrandomized studies were selected from the nursing, medical, and social work literature that met the following criteria: described educational interventions, provided information to calculate the percent of newly completed ADs as an outcome, and published between 1991 and 2009. The review focused primarily on randomized studies. Reviewers calculated the percent of newly completed ADs by determining the number of subjects per group without an AD at baseline and the percentage of those who then completed one by the end of the studies.

Findings: Findings were inconsistent regarding all types of educational interventions studied versus controls. Sufficient evidence exists to conclude that combined written and verbal educational interventions were more effective than single written interventions in increasing the percent of newly completed ADs in adult clinic outpatients and hospitalized elderly.

Conclusions: Calculating the percent of newly completed ADs was successful in allowing for study result comparisons. Overall, the evidence base regarding the effectiveness of single or combined educational interventions in increasing AD completion is weak. Randomized studies with diverse samples should be conducted against controls before more studies comparing interventions are undertaken.

Clinical Relevance: This article provides nurses with a summary of research related to educational interventions and AD completion and identifies where future study is needed.
Compensatory releases reduce genetic differentiation among Atlantic salmon populations in the Baltic Sea: evidence from the River Ume‐Vindelälven
Authors: Vasemägi A.
Published: August 2010

About 90% of salmon smolts in the Baltic Sea derive from hatchery enhancement programmes designed to compensate for loss of catches and genetic resources due to the damming of salmon rivers. The potential threat of genetic homogenization from extensive hatchery releases, however, has not been thoroughly investigated. We provide evidence that straying from deliberate releases poses a threat to indigenous populations by identifying the origin of 127 fin‐clipped (hatchery) salmon caught in the River Ume‐Vindelälven during 1997 to 2000, using mtDNA and six microsatellite loci. The analysis of eight potential donor stocks revealed that compensatory releases from the R. Ångerman and R. Luleälven hatcheries have resulted in a significant amount of straying to the river Ume‐Vindelälven (at least 10 and 12 migrants per year). As predicted to due to increased migration, the analysis of temporal samples from the wild population of R. Vindelälven showed a decreasing trend in genetic differentiation estimates (measured as Fst) relative to hatchery the hatchery strains of R. Ångermanälven and R. Luleälven. Our results suggest that gene flow from compensatory releases poses a serious threat to the genetic makeup of the existing wild populations in the Baltic.
Turkish Community Mediation
Authors: Wall, Jr. James A. , Beriker Nimet , Wu Sharon
Published: August 2010

This study investigates the mediations of 67 mediators from western Turkey and 38 Kurd mediators from eastern Turkey. Utilizing a cultural effects model, we predicted and subsequently found that Kurd mediators—who are highly collectivistic and have a tribal‐based social structure—more frequently emphasize harmony, and they stress the cost of the conflict to society. In addition, the Kurds more often rally third parties for the mediations, having them present at the mediation, as well as relying on their advice and assistance. In addition to the ethnic differences, we predicted and found that imams (i.e., mosque leaders) more frequently utilized religious‐based tactics (e.g., walking under the Koran) than did their secular counterparts.
Nectar vs. honeydew feeding by aphid parasitoids: does it pay to have a discriminating palate?
Authors: Vollhardt Ines M.G. , Bianchi Felix J.J.A. , Wäckers Felix L. , Thies Carsten , Tscharntke Teja
Published: August 2010

As food items can vary in nutrient composition, diet selectivity can be an important trait to optimize nutrition. Most parasitoids depend as adults on various sugar‐rich food sources such as nectar and honeydew. Nectar is often superior as a food source to honeydew, yielding higher parasitoid longevity. Little is known, however, of a preference parasitoids may have for one of these sugar sources and how this affects variation in their life‐history traits. In this study, a combined empirical and modelling approach was adopted. First, it was investigated whether parasitoids show a feeding preference for nectar or honeydew in the laboratory and whether feeding history affects the preference of parasitoids. Second, using a process‐based spatially explicit simulation model, it was evaluated how preference for nectar affects parasitoid life‐history variables in fields with varying flower densities. The laboratory study revealed that naïve parasitoids showed no preference for either nectar or honeydew. However, when parasitoids had fed previously on honeydew and were then given the choice between nectar and honeydew, they preferred feeding on nectar to honeydew (with marginal statistical significance). Model simulations indicated that when nectar sources were present in the field, parasitoids that showed preference for nectar had a 1.3–1.8 times longer life span and parasitised up to 1.4 times more hosts than parasitoids that did not distinguish between honeydew and nectar. These combined empirical and modelling data suggest that aphid parasitoids may be able to discriminate between nectar and honeydew, and that a preference for nectar may enhance their longevity and reproduction in fields where nectar sources are available.
Evolving paradigms for repair of tissues by adult stem/progenitor cells (MSCs)
Authors: Prockop Darwin J. , Kota Daniel J. , Bazhanov Nikolay , Reger Roxanne L.
Published: August 2010

Paradigm I: the haematopoietic niche

Paradigm II: engraftment/differentiation

Paradigm III: transient ‘quasi‐niches’

Conclusions/perspectives

In this review, we focus on the adult stem/progenitor cells that were initially isolated from bone marrow and first referred to as colony forming units‐fibroblastic, then as marrow stromal cells and subsequently as either mesenchymal stem cells or multipotent mesenchymal stromal cells (MSCs). The current interest in MSCs and similar cells from other tissues is reflected in over 10,000 citations in PubMed at the time of this writing with 5 to 10 new publications per day. It is also reflected in over 100 registered clinical trials with MSCs or related cells (http//www.clinicaltrials.gov). As a guide to the vast literature, this review will attempt to summarize many of the publications in terms of three paradigms that have directed much of the work: an initial paradigm that the primary role of the cells was to form niches for haematopoietic stem cells (paradigm I); a second paradigm that the cells repaired tissues by engraftment and differentiation to replace injured cells (paradigm II); and the more recent paradigm that MSCs engage in cross‐talk with injured tissues and thereby generate microenvironments or ‘quasi‐niches’ that enhance the repair tissues (paradigm III).
Manic episodes are associated with grey matter volume reduction — a voxel‐based morphometry brain analysis
Authors: Ekman C. J. , Lind J. , Rydén E. , Ingvar M. , Landén M.
Published: August 2010

Ekman CJ, Lind J, Rydén E, Ingvar M, Landén M. Manic episodes are associated with grey matter volume reduction — a voxel‐based morphometry brain analysis.

Objective:  To investigate whether the lifetime number of affective episodes or illness duration is associated with changes in local grey matter volume, in patients with bipolar I disorder without comorbid conditions.

Method:  Magnetic resonance imaging scans of 55 patients with bipolar I disorder were analysed using VBM.

Results:  Smaller grey matter volume in the inferior frontal gyri of the dorsolateral prefrontal cortices (DLPFC) correlated significantly to the lifetime number of manic episodes. No association between local grey matter volume and the lifetime number of depression episodes or illness duration was found.

Conclusion:  We found strong evidence for a linear correlation between a decrease in DLPFC volume and the lifetime number of manic episodes in patients with bipolar I disorder. Interestingly, DLPFC is known to be important for executive functions and the findings in this study might hence be linked to the executive cognitive deficits associated with bipolar disorder.
A manually controlled new device for punctuate mechanical stimulation of teeth during functional magnetic resonance imaging studies
Authors: Habre‐Hallage Pascale , Hermoye Laurent , Gradkowski Wojciech , Jacobs Reinhilde , Reychler Hervé , Grandin Cécile B.
Published: August 2010

Habre‐Hallage P, Hermoye L, Gradkowski W, Jacobs R, Reychler H, Grandin CB. A manually controlled new device for punctuate mechanical stimulation of teeth during functional magnetic resonance imaging studies. J Clin Periodontol 2010; 37: 863–872. doi: 10.1111/j.1600‐051X.2010.01596.x.

Aim: To design a simple and affordable device that could apply standardized mechanical punctuate stimuli to trigger the periodontal mechanoreceptors during functional magnetic resonance imaging (fMRI).

Material and Methods: A new manually controlled device using von Frey monofilaments was tested on a phantom and on eight volunteers. Four block design paradigms with different timing were compared. Teeth 11, 12, 13, 21, 22, 23 and the thumb were stimulated.

Results: The device did not induce any artefacts in MR images. The most efficient protocol included an epoch duration of 24 s and stimuli delivered at 1 Hz. When stimulating the teeth, activations of the primary (S1) and secondary (S2) somatosensory areas were consistently obtained, either on the ipsilateral, contra‐lateral or both sides. Stimulation of the thumb led to activations of the contra‐lateral S1 area and either ipsilateral or contra‐lateral S2 area.

Conclusion: The use of this innovative tool should allow to perform fMRI studies aimed to unveil the neural correlates of periodontal neural receptors, and to understand their plasticity induced by tooth loss and their eventual replacement by endosseous oral implants.
Attitudes towards oral health among parents of 6‐year‐old children at risk of developing caries
Authors: Vermaire J.H. , Hoogstraten J. , Van Loveren C. , Poorterman J.H.G. , Van Exel N.J.A.
Published: August 2010

Vermaire JH, Hoogstraten J, van Loveren C, Poorterman JHG, van Exel NJA. Attitudes towards oral health among parents of 6‐year‐old children at risk of developing caries. Community Dent Oral Epidemiol 2010; 38: 507–520. © 2010 John & Wiley & Sons A/S

Abstract – Objectives:  Parental attitudes are likely to play a role in achieving and maintaining a desired level of oral health in children. To be useful in individually delivered caries prevention programmes, parental attitudes should be identified at individual level. Q‐methodology has been proved successful in identifying attitudes in a wide range of disciplines but in dentistry Q‐studies are scarce. In this study Q‐methodology was used to identify parents’ prevailing attitudes towards the oral health of their children.

Methods:  Thirty‐nine parents ranked 37 statements regarding the dental health behaviour they apply to their 6‐year‐old child. They later explained their rankings during a short interview. In Q‐methodology, rather than reporting one average composite attitude and opinion, various combinations of opinions and attitudes concerning these statements are identified using by‐person factor analysis.

Results:  Based on their beliefs, attitudes and cognitions, five categories of parents were found: (i) conscious and responsible, (ii) trivializing and fatalistic, (iii) appearance‐driven and open‐minded, (iv) knowledgeable but defensive and (v) conscious and concerned.

Conclusions:  Q‐methodology appears to be a fruitful way to structure the complexity of parents’ opinions and attitudes towards their children’s dental health. It appears that Q‐methodology provides comprehensive clusters of individual attitudes, based on various levels of responses to a wide range of questions. The five identified profiles may be useful in developing tailor‐made prevention strategies in caries prevention.
Short‐term zoledronic acid reduces trabecular bone remodeling in dogs
Authors: Helm Nathan B. , Padala Soumya , Beck F. Michael , D’Atri Andrew M. , Huja Sarandeep S.
Published: August 2010

Helm NB, Padala S, Beck FM, D’Atri AM, Huja SS. Short‐term zoledronic acid reduces trabecular bone remodeling in dogs. Eur J Oral Sci 2010; 118: 460–465. © 2010 Eur J Oral Sci

The effects of zoledronic acid, a bisphosphonate, on the trabecular bone remodeling (TBR) of the mandibular condyle are unknown. The objectives of this study were to quantify and compare TBR in the mandibular condyle and vertebrae of 2‐ to 3‐yr‐old dogs and to evaluate the effects of short‐term zoledronic acid on TBR. Bone samples from two, age‐matched groups of dogs [seven dogs were given no treatment (NT group) and seven dogs were treated with four total infusions of zoledronic acid administered monthly (ZOL group)] were analyzed using histomorphometry. Trabecular bone remodeling and microarchitecture were quantified and analyzed statistically. Physiologic TBR, quantified in the NT group, was significantly higher (more than sixfold) in the vertebrae than in the mandibular condyle. Trabecular bone remodeling in the vertebrae of dogs of the ZOL group was 96% lower than in dogs of the NT group. By contrast, TBR in the mandibular condyle of dogs in the ZOL group was statistically equivalent to that of dogs in the NT group. Our results demonstrate that the physiological TBR in aged dogs is vastly different in the mandibular condyle compared to that in the vertebra. A higher level of physiologic TBR in the vertebra than in the mandibular condyle results in greater reduction of TBR in response to short‐term treatment with zoledronic acid.
Appearance benefits of skin moisturization
Authors: Jiang Z.‐X. , DeLaCruz J.
Published: August 2010

Background/purpose: Skin hydration is essential for skin health. Moisturized skin is generally regarded as healthy and healthy looking. It is thus speculated that there may be appearance benefits of skin moisturization. This means that there are corresponding changes in the optical properties when skin is moisturized.

Methods: The appearance of the skin is the result of light reflection, scattering and absorption at various skin layers of the stratum corneum, epidermis, dermis and beyond. The appearance benefits of skin moisturization are likely primarily due to the changes in the optical properties of the stratum corneum. We hypothesize that the major optical effect of skin moisturization is the decrease of light scattering at the skin surface, i.e., the stratum corneum. This decrease of surface scattering corresponds to an increase of light penetration into the deeper layers of the skin. An experiment was conducted to measure the corresponding change in skin spectral reflectance, the skin scattering coefficient and skin translucency with a change in skin hydration. In the experiment, skin hydration was decreased with the topical application of acetone and alcohol and increased with the topical application of known moisturizers and occlusives such as PJ.

Result and conclusion: It was found that both the skin spectral reflectance and the skin scattering coefficient increased when the skin was dehydrated and decreased when the skin was hydrated. Skin translucency increased as the skin became moisturized. The results agree with the hypothesis that there is less light scattering at the skin surface and more light penetration into the deeper skin layers when the skin is moisturized. As a result, the skin appears darker, more pinkish and more translucent.
The Interface of the Immune and Reproductive Systems in the Ovary: Lessons Learned from the Corpus Luteum of Domestic Animal Models
Authors: Pate Joy L. , Toyokawa Koji , Walusimbi Sadhat , Brzezicka Edyta
Published: August 2010

Citation Pate JL, Toyokawa K, Walusimbi S, Brzezicka E. The interface of the immune and reproductive systems in the ovary: lessons learned from the corpus luteum of domestic animal models. Am J Reprod Immunol 2010

The dynamic changes that characterize the female reproductive system are regulated by hormones. However, local cell‐to‐cell interactions may mediate responsiveness of tissues to hormonal signals. The corpus luteum (CL) is an excellent model for understanding how immune cells are recruited into tissues and the role played by those cells in regulating tissue homeostasis or demise. Leukocytes are recruited into the CL throughout its lifespan, and leukocyte‐derived cytokines have been found in corpora lutea of all species examined. The proinflammatory cytokines inhibit gonadotropin‐stimulated steroidogenesis, profoundly stimulate prostaglandin synthesis by luteal cells, and promote apoptosis. However, there is mounting evidence that leukocytes and luteal cells communicate in different ways to maintain homeostasis within the functional CL. Domestic animals have provided important information regarding the presence and role of immune cells in the CL.
Change in prevalence of overweight and obesity in Finnish children – comparison between 1974 and 2001
Authors: Vuorela Nina , Saha Marja‐Terttu , Salo Matti K
Published: August 2010

Objective:  To analyse the possible changes in the prevalence of overweight and obesity comparing birth cohorts from four different decades in Finland.

Design:  A retrospective longitudinal growth study.

Methods:  The subjects representing five birth cohorts: 1974 (n = 1109), 1981 (n = 987), 1991 (n = 586), 1995 (n = 856) and 2001 (n = 766) in the city of Tampere and three rural municipalities in Finland. Data included five consecutive height and weight measurements from 2 to 15 years of age. Normal weight, overweight and obesity at the time points were classified by body mass index (BMI, kg/m2) according to international age‐ and gender‐specific BMI cut‐off points. The chi‐square test was used to analyse the differences in the between birth cohorts.

Results:  The combined prevalence of overweight and obesity decreased significantly in 2‐year‐old boys (p = 0.009) and girls (p = 0.002) from 1974 to 2001. Insignificant fluctuation was seen in 5‐ and 7‐year‐old children. Both the prevalence of obesity and the combined prevalence of overweight and obesity showed a significant increase in 12‐ (p = 0.031 and p < 0.001) and 15‐year‐old boys (p < 0.001 in both) from the 1970s to 2000s. In girls, the prevalence of obesity as well as the combined prevalence of overweight and obesity increased significantly in the age group of 12 years (p = 0.023), but not in that of 15 years.

Conclusions:  During the last three decades, overweight and obesity have become clearly more prevalent in Finnish young adolescents. This trend has been more obvious in boys than in girls. At the same time, 2‐year‐old children have shown an opposite trend.
High‐frequency ventilation with the Dräger Babylog 8000plus: measuring the delivered frequency
Authors: Wheeler KI , Schmölzer GM , Morley CJ , Davis PG
Published: August 2010

Background:  Ventilator frequency is one of the determinants of tidal volume delivery during high‐frequency ventilation. Clinicians increasingly use data on ventilator displays to inform their decisions.

Aim:  To measure the frequencies delivered by the Dräger Babylog 8000plus ventilator when used in high‐frequency mode.

Methods:  Ventilator waveforms using a test lung were recorded at the full range of settings 5–20 Hz using Spectra software at 1000 Hz. The changes in frequency produced by a 1‐ Hz change in set frequency were calculated. Actual and displayed frequencies were compared.

Results:  For settings up to 12 Hz, median (range) difference between set and delivered frequencies was 0 (−0.4 to +0.1) Hz. Above 12 Hz, delivered frequency varied by −0.3 (−1.9 to +0.3) Hz. For 1‐ Hz changes in frequency settings, in the range 5–12 Hz, 1‐ Hz changes produced a change in delivered frequency of 1.0 (0.6–1.4) Hz. Above 12 Hz, the corresponding changes were 0.7 (0–2.9) Hz. The ventilator displays the set frequency during operation rather than the delivered frequency.

Conclusion:  At 12 Hz and below, the differences between set and delivered frequencies were relatively small compared with those at 13 Hz and higher. Above 13 Hz, the difference between set and delivered frequencies was up to 2.9 Hz. Some frequency setting changes did not result in a change in delivered frequency.
HUMAN ACUTE PANCREATITIS
Authors: AHO HEIKKI J. , NEVALAINEN TIMO J. , HAVIA V. TAPANI , HEINONEN REIJO J. , AHO ALLAN J.
Published: August 2010

The histology and ultrastructure of resected pancreas from seven patients suffering from acute haemorrhagic pancreatitis were studied. Special attention was paid to necrotic acini and zymogen granules. Acinar cells in the border of necrotic and non‐necrotic parenchyma contained lipid droplets, autophagic vacuoles, bundles of intermediate filaments and degenerated cell organelles, including zymogen granules. PAS‐positive material derived from secretory proteins was situated in dilated acinar lumina and in the interstitium, and proved to be fibrillar in fine structure. There were thrombosed vessels and extravasated erythrocytes at the border of the parenchymal necrosis. Bundles of intermediate filaments were often the only identifiable structures in the severely necrotic acinar cells. The amount of lipid was decreased in damaged fat cells. Older fat necroses were surrounded by myofibroblasts. It was concluded that acinar and fat cells undergo concomitant necrosis in the inflamed pancreas, zymogen granules degenerate in the acinar cells at the border of necrotic and non‐necrotic areas, and secretory proteins may be displaced in the interstitium outside acinar lumina. Myofibroblasts participate in the healing of autodigestive injuries.
IMMUNE AND NON‐IMMUNE PRECIPITATION OF HUMAN SERA WITH GONOCOCCI AND MENINGOCOCCI
Authors: RØD Terje O. , Mæland Johan A.
Published: August 2010

Sera from 218 healthy humans were examined by double‐diffusion and counter‐electrophoresis against the ultrasonically‐disrupted N. gonorrhoeae strain 8551 and the group B N. meningitidis strain Ne 15. All the sera examined contained precipitins against one or more antigens common to the bacteria. On immunodiffusion analysis, the sera formed a precipitation line, called the curved line, close to the gonococcal antigen basin but not the meningococcal antigen basin. It was not formed after digestion of serum with pepsin. IgG prepared from human serum by DEAE cellulose chromatography or the F(ab')2 fragment of IgG did not produce the line. The serum component involved was separated from IgA, IgG, and IgM by gel filtration, and was eluted in fractions suggestive of a molecular weight close to that of albumin. Presumably, the curved line resulted from non‐immune interaction of a constituent of the gonococcus with a human serum component of unknown identity.
ANTIBODY RESPONSE AND OPSONIZATION AFTER PNEUMOCOCCAL VACCINATION IN SPLENECTOMIZED CHILDREN AND HEALTHY PERSONS
Authors: Johansen Kirsten Stæhr , Pedersen Freddy Karup
Published: August 2010

A significant rise in antibody against pneumococcal types 3, 6A and 25 after pneumococcal vaccination could be demonstrated in 26 of 30 individuals (87%) using an enzyme‐linked immunosorbent assay. Similar geometric mean antibody fold increases were found in splenectomized children, non‐splenectomized children and healthy adults for types 6A and 25. Splenectomized children exhibited a somewhat lower, but not statistically significant, geometric mean antibody fold increase against type 3 (p = 0.10), as compared to non‐splenectomized children. For the whole group a negative correlation could be demonstrated between prevaccination antibody concentration and antibody fold increase after vaccination. After vaccination an enhanced serum opsonic activity against type 3 was found by granulocyte glucose‐1‐14C oxidation for the whole group of 30 patients (p<0.05) but nine individual patients (30%) failed to exhibit an increase. No differences between the three patient groups were demonstrable. Changes in serum opsonic activity could not be detected by a pneumococcal bactericidal assay.
THE INFLUENCE OF VARIOUS FIXATIVES ON THE IMMUNOHISTOCHEMICAL DEMONSTRATION OF A NUMBER OF PLASMA PROTEINS AND ONCOFETAL PROTEINS IN PARAFFIN EMBEDDED MATERIAL
Authors: JACOBSEN MARIANNE , JACOBSEN GRETE KRAG
Published: August 2010

The influence of different fixatives on the antigenicity of alpha‐fetoprotein (AFP), albumin, prealbumin, transferrin, ferritin, human chorionic gonadotropin (HCG), specific pregnancy beta1‐glycoprotein (SP1) and human placental lactogen (HPL) was studied. No single fixative was superior for all the antigens investigated. For intracellular antigens the best all‐round fixatives were, however, 10% buffered formalin, 4% buffered paraformaldehyde, 10% formol‐calcium and ethanol acetic acid (EA), cold processed. The preferable fixatives were for AFP: Bouińs fixative, B‐5 and EA; for albumin: 10% formol‐calcium; for prealbumin: Zambonis fixative and B‐5; for transferrin: EA; for ferritin: 10% buffered formalin, 4% buffered paraformaldehyde, Lillies fixative, Zambonis fixative and EA; for HCG: Bouińs fixative and B‐5; for SP1: Lilliés fixative and EA; and for HPL: 4% buffered paraformaldehyde and Lilliés fixative. The preservation of extracellular antigens was different from the above mentioned intracellular ones. Thus fixation in 10% buffered formalin gave poor results while the coagulant fixatives such as Bouins fixative, B‐5 and Clelands fixative in general showed good preservation of the antigenicity of the extracellular antigens.
NEUTROPHIL RECRUITMENT IN SKIN WINDOW CHAMBERS – ACTIVATION BY COMPLEMENT
Authors: Elmgreen Jens
Published: August 2010

Complement was studied in skin window chambers, a human model of neutrophil recruitment in acute aseptic inflammation. Autologous plasma activated by the alternative pathway served as attractant; control chambers were filled with a balanced salt solution or with non‐activated plasma samples. Neutrophil accumulation during a 24‐hour period was consistently enhanced by activated complement in all of 15 healthy volunteers. Control chambers showed negligible cell counts. Reference assays revealed 1) consumption of the centrally placed complement component, C3, 2) generation of chemotactic activity as assessed in Boyden chambers by the standard complement activation procedure. Simultaneously obtained responses to activated complement in skin window chambers and in the Boyden assay of chemotaxis showed a highly significant, positive correlation. Our results demonstrate that the biological capacity of complement includes stimulation of neutrophil migration during simulated in vivo conditions and thus extends previous observations in animals.
RENAL STRUCTURE AND FUNCTION IN CHRONIC EXPERIMENTAL AORTIC COARCTATION IN DOGS TREATED WITH ANTIHYPERTENSIVE DRUGS
Authors: HUTTUNEN NIILO‐PEKKA , AUTIO‐HARMAINEN HELENA , UHARI MATTI , TARKKA MATTI , PAKARINEN ARTO
Published: August 2010

The possible damaging effect on the kidneys of antihypertensive therapy in aortic coarctation was evaluated experimentally in eighteen canine puppies. Aortic coarctation was carried out in 13 puppies at the age of two months while sham‐surgery was carried out on five control puppies. Six coarctated dogs were treated with hydrochlorothiazide, propranolol and prazosin. Antihypertensive therapy was started two months after the operation. Seven coarcted puppies did not receive any treatment. The dogs were followed up for 7 months after which fixation of the kidneys was performed. Antihypertensive therapy decreased blood pressure significantly although the level seen in the control dogs was not attained. There were no signs of deterioration of renal function. Neither light microscopic analysis nor electron microscopy revealed morphological abnormalities in the kidneys of any of the dogs. The present results show that active antihypertensive therapy in experimental coarctation, although not resulting in a normalization but in a significant lowering of blood pressure, is safe and does not cause any morphologic damage in the kidney before corrective surgery. The absence of juxtaglomerular hypertrophy supports the hypothesis that the renin‐angiotensin system is not activated in chronic coarctation of aorta.
AN ENZYME‐LINKED‐IMMUNOSORBENT ASSAY METHOD FOR DETECTION OF IMMUNOGLOBULINS TO PERTUSSIS TOXIN
Authors: Zackrisson G. , LagergÅRd T. , LÖNnroth I.
Published: August 2010

A microplate enzyme‐linked‐immunosorbent assay (ELISA) for detection of antibodies against pertussis toxin, using fetuin as a spacer‐layer between the solid phase and pertussis toxin, was compared to a method using pertussis toxin alone as antigen. Antibodies of IgG, IgM and IgA classes were studied in paired human sera. Raised antibody levels were demonstrated for ten children suffering from whooping cough. Antibody levels in sera from 20 healthy 4‐year‐old children showed high correlation to earlier experienced pertussis. No significant antibody titer changes against pertussis toxin were seen in children with adenovirus infection. The investigation shows that precoating with fetuin improves the sensitivity of the method as much as 5–30 times and makes the method useful in serological diagnosis of whooping cough.
INTRAEPITHELIAL NEOPLASIA IN THE ANAL CANAL
Authors: Fenger C. , Nielsen V. THUE
Published: August 2010

Anal canal intraepithelial neoplasia (ACIN) in the form of squamous dysplasia and carcinoma in situ is a rare condition. In this paper we present all 19 cases diagnosed in Denmark in a two‐year period. The incidence was 0.2/105/year compared to 0.7/105/year for variants of squamous carcinoma in the anal canal. Most cases of ACIN were incidental findings at minor anal surgery. Histologically, one half of the lesions were located in the anal transitional zone above the dentate line. Two of the 19 patients died from colo‐rectal carcinoma and 17 were alive 5 years later. Nine of the patients were controlled by biopting, and 4 recurrences of the intraepithelial changes were found among these, all with an initial lesion of ACIN III. None of the patients developed invasive carcinoma of the anal canal during the 5 years, but one half of the females had previous or accompanying neoplasia of the vulva and perineum.
STANDARDIZATION OF A CHEMILUMINESCENCE METHOD FOR THE MEASUREMENT OF MENINGOCOCCAL OPSONINS USING ETHANOL FIXED MENINGOCOCCI
Authors: Halstensen Alfred , Haneberg BjøRn
Published: August 2010

A chemiluminescence (CL) method using polymorphonuclear leukocytes (PMNLs) and an automatic photoluminometer was used to measure serum opsonins to viable and inactivated group B meningococci. Continuous mixing at 37°C both during opsonization and phagocytosis was essential for optimal CL responses. The CL response increased rapidly during an opsonization time up to 7.5 min, and with PMNL and bacteria concentrations up to 37.5 times 105 and 3.8 times 107 cells/ml, respectively. Opsonized ethanol fixed meningococci gave CL responses similar to those of viable meningococci, but had a better reproducibility. Using the ethanol fixed bacteria, the variation of PMNLs from different donors, the day‐to‐day variation, and the coefficient of variation of the CL responses, were all less than 10%. The opsonic activity of convalescent sera from 10 patients with meningococcal disease was markedly higher than that of sera obtained during the acute phase of the disease. Thus, this standardized CL assay using ethanol fixed bacteria is a highly reproducible and sensitive method for measuring serum opsonins to meningococci.
CEREBELLAR FOLIATION IN RATS4. Mid‐line Distortion of the Primary Fissure in Normal Postnatal Rats
Authors: CONRADI NILS G.
Published: August 2010

Two types of mid‐line distortion affecting the primary fissure of the cerebellum in foetal rats were recently described (Conradi1987a). During the postnatal period, cells of the external granular layer (EGL) in distorted regions differentiated to granule cells, forming a heterotopic granule cell layer replacing the deeper portion of the fissure. Differentiated heterotopic granule cells were seen close to normal EGL. Formation and growth of lobules V and VI, apart from the partial fusion at the mid‐line, was not affected by the distortions. The findings support the previous suggestion that foliation is relatively independent of formation of a fissure. A network of capillaries was formed in the heterotopic granule cell layer and was continuous with capillaries in the molecular layer of lobules V and VI. The frequency of capillaries in the heterotopias increased in parallel with an increased activity of oxidative enzymes, simulated that in the internal granule cell layer and was higher than that in the molecular layer. These findings support the suggestion of a correlation between nerve‐cell differentiation and capillary growth.
Using video narratives of women's lived experience of breastfeeding in midwifery education: exploring its impact on midwives' attitudes to breastfeeding
Authors: Taylor Alison M. , Hutchings Maggie
Published: August 2010

Strong evidence supports the health benefits of breastfeeding contributing to the public health campaign to improve initiation and duration of breastfeeding globally, yet breastfeeding continuation rates are persistently low in the UK. Inadequate support from health professionals appears to be an underlying feature, aggravated by a dearth of professional education that uses a biopsychosocial approach. This paper describes how using women's video narratives of their lived experience of breastfeeding within higher education impacted positively on the attitudes of a group of midwives in relation to supporting breastfeeding women. It reports on the qualitative element of a two‐phase sequential mixed methods study where focus group methods generated rich data about how and why the educational intervention altered attitudes. Analysis was thematic. Six major themes emerged, ‘listening and learning from real women's experiences’; ‘generation of emotions’; ‘acquisition of new knowledge and learning’; ‘reflection on practice’; ‘promotion of independent learning’ and ‘sharing learning and ideas with peers’. ‘Listening and learning from real women's experiences’ was central to learning, and was pivotal to attitudinal change, motivating an intense need to improve practice. Findings support the value of using women's video narratives within midwifery education, through their power to integrate affective and cognitive learning, and to promote a transformative learning process. This novel approach brings value‐added learning benefits by enhancing the potential to improve attitudes towards supporting breastfeeding women and improving clinical practice.
Conformation‐dependent hydride transfer in neuronal nitric oxide synthase reductase domain
Authors: Welland Andrew , Daff Simon
Published: August 2010

Calmodulin (CaM) activates the constitutive isoforms of mammalian nitric oxide synthase by triggering electron transfer from the reductase domain FMN to the heme. This enables the enzymes to be regulated by Ca2+ concentration. CaM exerts most of its effects on the reductase domain; these include activation of electron transfer to electron acceptors, and an increase in the apparent rate of flavin reduction by the substrate NADPH. It has been shown that the former is caused by a transition from a conformationally locked form of the enzyme to an open form as a result of CaM binding, improving FMN accessibility, but the latter effect has not been explained satisfactorily. Here, we report the effect of ionic strength and isotopic substitution on flavin reduction. We found a remarkable correlation between the rate of steady‐state turnover of the reductase domain and the rate of flavin reduction over a range of different ionic strengths. The reduction of the enzyme by NADPH was biphasic, and the amplitudes of the phases determined through global analysis of stopped‐flow data correlated with the proportions of enzyme known to exist in the open and closed conformations. The different conformations of the enzyme molecule appeared to have different rates of reaction with NADPH. Thus, proximity of FMN inhibits hydride transfer to the FAD. In the CaM‐free enzyme, slow conformational motion (opening and closing) limits turnover. It is now clear that this motion also controls hydride transfer during steady‐state turnover, by limiting the rate at which NADPH can access the FAD.
Nurses' use of water‐filled gloves in preventing heel pressure ulcer in the University College Hospital, Ibadan, Nigeria
Authors: Adejumo Prisca Olabisi , Ingwu Justin Agorye
Published: August 2010

This cross‐sectional descriptive survey examined use (knowledge, perception and practices) of water‐filled gloves (WFGs) by nurses in the prevention of heel pressure ulcer (PU) in the University College Hospital (UCH), Ibadan, Nigeria. Participants were 250 purposively selected nurses working in the Neurosciences and Surgical units. Quantitative data were generated through the administration of a semi‐structured questionnaire, whereas the qualitative data were collected through in‐depth interview. Hypotheses were tested using chi‐square analysis at a significance level of 0.05, whereas the manual content analysis was used to analyse the qualitative data. Results showed that a significant number of nurses at UCH, Ibadan, were knowledgeable about WFGs and actually used them in their clinical practice. Years of experience in clinical practice was found to be significantly related to knowledge and use of WFGs in heel PU (X2 = 41·677; DF = 5; P = 0·001). Nurses with adequate knowledge of risk factors in the development of PU used WFGs more than those who were not aware (X2 = 44·907; DF = 3; P = 0·009). Nurses' perception about WFGs was also significantly related to its use (X2 = 4·527; DF = 1; P = 0·033). Although knowledge level and perception of WFGs and its use by nurses was fairly adequate, continuous education for practicing nurses should be encouraged in resource‐limited settings.
Post‐surgical wound infections involving Enterobacteriaceae with reduced susceptibility to β‐lactams in two Portuguese hospitals
Authors: Fernandes Rúben , Prudêncio Cristina
Published: August 2010

The post‐surgical period is often critical for infection acquisition. The combination of patient injury and environmental exposure through breached skin add risk to pre‐existing conditions such as drug or depressed immunity. Several factors such as the period of hospital staying after surgery, base disease, age, immune system condition, hygiene policies, careless prophylactic drug administration and physical conditions of the healthcare centre may contribute to the acquisition of a nosocomial infection. A purulent wound can become complicated whenever antimicrobial therapy becomes compromised. In this pilot study, we analysed Enterobacteriaceae strains, the most significant gram‐negative rods that may occur in post‐surgical skin and soft tissue infections (SSTI) presenting reduced β‐lactam susceptibility and those presenting extended‐spectrum β‐lactamases (ESBL). There is little information in our country regarding the relationship between β‐lactam susceptibility, ESBL and development of resistant strains of microorganisms in SSTI. Our main results indicate Escherichia coli and Klebsiella spp. are among the most frequent enterobacteria (46% and 30% respectively) with ESBL production in 72% of Enterobacteriaceae isolates from SSTI. Moreover, coinfection occurred extensively, mainly with Pseudomonas aeruginosa and Methicillin‐resistant Staphylococcus aureus (18% and 13%, respectively). These results suggest future research to explore if and how these associations are involved in the development of antibiotic resistance.
Price competition under universal service obligations
Authors: Gautier Axel , Wauthy Xavier
Published: August 2010

In industries like telecom, postal services or energy provision, universal service obligations (uniform price and universal coverage) are often imposed on one market participant. Universal service obligations are likely to alter firms' strategic behavior in such competitive markets. In the present paper, we show that, depending on the entrant's market coverage and the degree of product differentiation, the Nash equilibrium in prices involves either pure or mixed strategies. We show that the pure strategy market sharing equilibrium, as identified by Valletti, Hoernig, and Barros (2002), defines a lower bound on the level of equilibrium prices.
Safety of Physiological Testosterone Therapy in Women: Lessons from Female-to-Male Transsexuals (FMT) Treated with Pharmacological Testosterone Therapy
Authors: Traish Abdulmaged M. , Gooren Louis J.
Published: August 2010

Introduction

The safety of long-term physiological doses of testosterone (T) therapy in women with sexual dysfunction is a contentious issue, in part, because of fear of adverse effects, such as breast cancer, vascular disease, and excessive virilization. This unsubstantiated fear has hampered progress in treating women with sexual dysfunction using T therapy in physiological doses to achieve circulating levels in the normal range.

Aim

To examine evidence derived from studies in female-to-male transsexuals (FMT) treated with supraphysiological (pharmacological) doses of T for long periods of time with no apparent major adverse effects.

Methods

A comprehensive literature search of relevant articles published between 1980 and 2010 pertaining to the topic of T in FMTs was performed using PubMed. The following key words were used: female-to-male transsexuals; testosterone; virilization; gender re-assignment; and androgen therapy in women. Relevant articles were retrieved, reviewed, and the information was analyzed and evaluated for study methodology and major findings.

Main Outcome Measures

Data from peer-reviewed publications were critically analyzed and the information was summarized.

Results

The data from the studies reported in the literature to date strongly suggest that treatment of FMTs with supra-physiological doses of T had minimal adverse effects. No increase in mortality, breast cancer, vascular disease, or other major health problems were reported.

Conclusions

No significant serious adverse effects were reported in FMTs treated with pharmacological doses of T. In light of the findings with supraphysiological doses of T, we suggest that treatment with T at doses producing physiological levels in women with sexual dysfunction are expected to produce limited and minimal adverse effects.
Adult T‐cell leukemia/lymphoma in Taiwan: An analysis of 17 patients and review of the literature
Authors: LEE Chun‐Wei , CHANG Ming‐Chih , CHANG Yi‐Fang , HSIEH Ruey‐Kuen , LIN Johnson , CHEN Kung‐Shen
Published: August 2010

Aim:  We reviewed our experience with adult T‐cell leukemia (ATL), describing the clinical manifestations and outcome in order to facilitate case recognition in the future.

Methods:  We retrospectively reviewed the charts of 17 patients with ATL diagnosed from January 1996 to September 2009 at Mackay Memorial Hospital, Taipei, Taiwan.

Results:  The overall survival of the whole study group was 138 days. The medial survival of the 10 patients who received chemotherapy is 204 days. The other six patients who did not receive any chemotherapy had a median survival of 28 days. The co‐infection rate with HTLV‐1 and HBV or HCV is 47% and 35% respectively.

Conclusion:  ATL in Taiwan is a rare malignant T‐cell lymphoma with a very poor prognosis. Our series raised the interesting possibility of an association with chronic hepatitis B or C.