bluuebunny/crossref_metadata_2025 huggingface dataset:
Extent of lymphadenectomy in radical cystectomy for bladder cancer
Authors: Ather M Hammad , Fatima Sadaf , Sinanoglu Orhun
Published: July 2005

Background

The benefit of pelvic lymphadenectomy in patients with cancer of the urinary bladder remains controversial. Though the inclusion of lymph node dissection in conjunction with radical cystectomy for patients with clinically negative nodes is well accepted, however, the extent of the nodal dissection remains contentious, particularly in patients with gross disease and T1G3 cancer. The extent of the primary bladder tumor, number of lymph nodes removed and the lymph node tumor burden are important prognostic variables in patients undergoing cystectomy. We analyzed the impact of the extent of lymphadenectomy during radical cystectomy on survival in the contemporary literature.

Methods

A Pubmed search was carried out for the literature published over the last 15 years using bladder cancer, radical cystectomy, survival, lymphadenectomy and complications as the key words. We have discussed the extent of lymphadenectomy on survival and its anatomical basis to determine the optimal number of lymph nodes to be removed and the concept of node density.

Results

Evidence from contemporary literature indicate significantly increased survival rates after cystectomy in patients with bladder cancer diagnosed with stages III or IV disease who have had relatively more lymph nodes examined, suggesting that even some patients with higher stage disease may benefit from extended pelvic lymphadenectomy at the time of cystectomy. Studies also indicate that more extensive lymphadenectomy significantly improved the prognosis of patients with bladder cancer, not only by providing prognostic information but perhaps it is also due to its inherent therapeutic value.

Conclusion

Extended lymph node dissection improves local control and survival. However, in the absence of controlled randomized trial this remains a dubitable issue.
Occult solitary submucosal jejunal metastasis from esophageal carcinoma
Authors: Lindenmann Joerg , Gollowitsch Franz , Matzi Veronika , Porubsky Christian , Maier Alfred , Smolle-Juettner Freyja Maria
Published: July 2005

Background

Metastatic tumors of the intestinal tract from extra-abdominal sites are rare. In esophageal cancer, the liver, lung and the bones are the most common sites of metastases. Metastasis to intestines are very rare.

Case presentation

A 54-year old male was admitted with esophageal squamous cell carcinoma (SCC) associated with dysphagia II-III and weight loss of 20 kg. Preoperative routine staging failed to detect any metastases. A transthoracic esophagectomy and orthotopic gastric pull-up with collar esophago-gastrostomy, associated with 2-field lymphadenectomy was perfromed. During the digital placement of the naso-jejunal feeding catheter a submucosal jejunal nodule with a diameter of 1 cm, about 40 cm distal to the duodeno-jejunal fold was detected which was completely resected by jejunotomy. Histopathology of jejunal nodule showed metastasis from esophageal squamous cell carcinoma.

Conclusion

Because of the extensic esophageal lymphatic system, an occult widespread dissemination of the tumor cells into the abdominal cavity is possible. Additional intraoperative evaluation of the small intestine and the complete abdominal cavity should be performed in every operation of esophageal carcinoma to detect possible occult intraabdominal metastases.
Comparison of incidence/risk of venous thromboembolism (VTE) among selected clinical and hereditary risk markers: A community-based cohort study
Authors: Spannagl Michael , Heinemann Lothar AJ , DoMinh Thai , Assmann Anita , Schramm Wolfgang , Schürmann Rolf
Published: July 2005

Background

Little information is available from community-based long-term VTE cohort studies to compare the absolute thrombosis risk of established clinical and genetic risk factors.

Materials and methods

The occurrence of venous thromboembolism (VTE) was observed during a 10-year observation period in the BAvarian ThromboEmbolic Risk (BATER) study, a cohort study of 4337 women (age 18–55 years). We collected data on demographics, reproductive life, lifestyle, conditions/diseases, and particularly potential risk factors for VTE with a self-administered questionnaire. The objective was to present incidence rates of VTE and to show relative risk estimated associated with different clinical and genetic risk factors.

Results

34 new, by diagnostic means confirmed VTE events occurred during the observation time of 32,656 women-years (WY). The overall incidence of VTE was 10.4 per 104 WY. The incidence rates varied markedly among different risk cohorts. The highest incidence was observed in women with previous history of VTE, followed by family history of VTE. None of the measured "genetically-related risk markers" (antithrombin, protein C, FVL, prothrombin mutation, or MTHFR) showed a significant VTE risk.

Conclusion

Most of the discussed VTE risk factors showed no significant association with the occurrence of new VTEs due to smallness of numbers. Only first-degree family history of VTE and own history of a previous VTE event depicted a significant association with future VTE. Clinical information seems to be more important to determine future VTE risk than genetically related laboratory tests.
Increasing weight-bearing physical activity and calcium-rich foods to promote bone mass gains among 9–11 year old girls: outcomes of the Cal-Girls study
Authors: French Simone A , Story Mary , Fulkerson Jayne A , Himes John H , Hannan Peter , Neumark-Sztainer Dianne , Ensrud Kristine
Published: July 2005

Background

A two-year, community-based, group-randomized trial to promote bone mass gains among 9–11 year-old girls through increased intake of calcium-rich foods and weight-bearing physical activity was evaluated.

Methods

Following baseline data collection, 30 5th-grade Girl Scout troops were randomized to a two-year behavioral intervention program or to a no-treatment control group. Evaluations were conducted at baseline, one year, and two years. Measures included bone mineral content, density, and area (measured by DXA), dietary calcium intake (24-hour recall), and weight-bearing physical activity (physical activity checklist interview). Mixed-model regression was used to evaluate treatment-related changes in bone mineral content (g) for the total body, lumbar spine (L1-L4), proximal femur, one-third distal radius, and femoral neck. Changes in eating and physical activity behavioral outcomes were examined.

Results

Although the intervention was implemented with high fidelity, no significant intervention effects were observed for total bone mineral content or any specific bone sites. Significant intervention effects were observed for increases in dietary calcium. No significant intervention effects were observed for increases in weight-bearing physical activity.

Conclusion

Future research needs to identify the optimal dosage of weight-bearing physical activity and calcium-rich dietary behavior change required to maximize bone mass gains in pre-adolescent and adolescent girls.
The complexity of anatomical systems
Authors: Grizzi Fabio , Chiriva-Internati Maurizio
Published: July 2005

Background

The conception ofanatomical entitiesas a hierarchy of infinitely graduated forms and the increase in the number of observed anatomical sub-entities and structural variables has generated a growingcomplexity, thus highlighting new properties of organised biological matter.

Results

(1) Complexity is so pervasive in the anatomical world that it has come to be considered as a primary characteristic of anatomical systems. (2) Anatomical entities, when viewed at microscopic as well as macroscopic level of observation, show a different degree of complexity. (3) Complexity can reside in thestructureof the anatomical system (having many diverse parts with varying interactions or an intricate architecture) or in itsbehaviour. Often complexity in structure and behaviour go together. (4) Complex systems admit many descriptions (ways of looking at the system) each of which is only partially true. Each way of looking at a complex system requires its own description, its own mode of analysis and its own breaking down of the system in different parts; (5) Almost all the anatomical entities display hierarchical forms: their component structures at different spatial scales or their process at different time scales are related to each other.

Conclusion

The need to find a new way of observing and measuring anatomical entities, and objectively quantifying their different structural changes, prompted us to investigate the non-Euclidean geometries and the theories of complexity, and to apply their concepts to human anatomy. This attempt has led us to reflect upon the complex significance of the shape of an observed anatomical entity. Its changes have been defined in relation to variations in itsstatus: from a normal (i.e.natural) to a pathological or altered state introducing the concepts ofkinematicsanddynamicsof anatomical forms,speedof their changes, and that ofscaleof their observation.
Statistical distribution of blood serotonin as a predictor of early autistic brain abnormalities
Authors: Janušonis Skirmantas
Published: July 2005

Background

A wide range of abnormalities has been reported in autistic brains, but these abnormalities may be the result of an earlier underlying developmental alteration that may no longer be evident by the time autism is diagnosed. The most consistent biological finding in autistic individuals has been their statistically elevated levels of 5-hydroxytryptamine (5-HT, serotonin) in blood platelets (platelet hyperserotonemia). The early developmental alteration of the autistic brain and the autistic platelet hyperserotonemia may be caused by the same biological factor expressed in the brain and outside the brain, respectively. Unlike the brain, blood platelets are short-lived and continue to be produced throughout the life span, suggesting that this factor may continue to operate outside the brain years after the brain is formed. The statistical distributions of the platelet 5-HT levels in normal and autistic groups have characteristic features and may contain information about the nature of this yet unidentified factor.

Results

The identity of this factor was studied by using a novel, quantitative approach that was applied to published distributions of the platelet 5-HT levels in normal and autistic groups. It was shown that the published data are consistent with the hypothesis that a factor that interferes with brain development in autism may also regulate the release of 5-HT from gut enterochromaffin cells. Numerical analysis revealed that this factor may be non-functional in autistic individuals.

Conclusion

At least some biological factors, the abnormal function of which leads to the development of the autistic brain, may regulate the release of 5-HT from the gut years after birth. If the present model is correct, it will allow future efforts to be focused on a limited number of gene candidates, some of which have not been suspected to be involved in autism (such as the 5-HT4 receptor gene) based on currently available clinical and experimental studies.
Heparan sulfate proteoglycan induces the production of NO and TNF-α by murine microglia
Authors: Bussini Simona , Meda Lucia , Scarpini Elio , Clementi Emilio , Conti Giancarlo , Tiriticco Marco , Bresolin Nereo , Baron Pierluigi
Published: July 2005

Background

A common feature of Alzheimer's disease (AD) pathology is the abundance of activated microglia in neuritic plaques containing amyloid-beta protein (Aβ) and associated molecules including heparan sulfate proteoglycan (HSPG). Besides the role as pathological chaperone favouring amyloidogenesis, little is known about whether or not HSPG can induce microglial activation. Cultures of primary murine microglia were used to assess the effect of HSPG on production of proinflammatory molecules that are known to be present in neuritic plaques of AD.

Results

HSPG stimulated up-regulation of tumor necrosis factor-alpha (TNF-α), production of inducible nitric oxide synthase (iNOS) mRNA and accumulation of TNF-α protein and nitrite (NO2-) in a time- and concentration-dependent manner. The effects of HSPG were primarily due to the property of the protein core as indicated by the lack of microglial accumulation of TNF-α and NO2-in response to denaturated HSPG or heparan sulfate GAG chains (HS).

Conclusion

These data demonstrate that HSPG may contribute to chronic microglial activation and neurodegeneration seen in neuritic plaques of AD.
Reporting incidence from a surveillance system with an operational case definition of unknown predictive value positive
Authors: Kegler Scott R
Published: July 2005

When reporting incidence rate estimates for relatively rare health conditions, associated case counts are often assumed to follow a Poisson distribution. Case counts obtained from large-scale electronic surveillance systems are often inflated by the presence of false positives, however, and adjusted case counts based on the results of a validation sample will have variances which are hyper-Poisson. This paper presents a simple method for constructing interval estimates for incidence rates based on case counts that are adjusted downward using an estimate of the predictive value positive of the surveillance case definition.
Human cytomegalovirus uracil DNA glycosylase associates with ppUL44 and accelerates the accumulation of viral DNA
Authors: Prichard Mark N , Lawlor Heather , Duke Gregory M , Mo Chengjun , Wang Zhaoti , Dixon Melissa , Kemble George , Kern Earl R
Published: July 2005

Background

Human cytomegalovirus UL114 encodes a uracil-DNA glycosylase homolog that is highly conserved in all characterized herpesviruses that infect mammals. Previous studies demonstrated that the deletion of this nonessential gene delays significantly the onset of viral DNA synthesis and results in a prolonged replication cycle. The gene product, pUL114, also appears to be important in late phase DNA synthesis presumably by introducing single stranded breaks.

Results

A series of experiments was performed to formally assign the observed phenotype to pUL114 and to characterize the function of the protein in viral replication. A cell line expressing pUL114 complemented the observed phenotype of a UL114 deletion virus in trans, confirming that the observed defects were the result of a deficiency in this gene product. Stocks of recombinant viruses without elevated levels of uracil were produced in the complementing cells; however they retained the phenotype of poor growth in normal fibroblasts suggesting that poor replication was unrelated to uracil content of input genomes. Recombinant viruses expressing epitope tagged versions of this gene demonstrated that pUL114 was expressed at early times and that it localized to viral replication compartments. This protein also coprecipitated with the DNA polymerase processivity factor, ppUL44 suggesting that these proteins associate in infected cells. This apparent interaction did not appear to require other viral proteins since ppUL44 could recruit pUL114 to the nucleus in uninfected cells. An analysis of DNA replication kinetics revealed that the initial rate of DNA synthesis and the accumulation of progeny viral genomes were significantly reduced compared to the parent virus.

Conclusion

These data suggest that pUL114 associates with ppUL44 and that it functions as part of the viral DNA replication complex to increase the efficiency of both early and late phase viral DNA synthesis.
Animal models of attention-deficit hyperactivity disorder
Authors: Russell Vivienne A , Sagvolden Terje , Johansen Espen Borgå
Published: July 2005

Although animals cannot be used to study complex human behaviour such as language, they do have similar basic functions. In fact, human disorders that have animal models are better understood than disorders that do not. ADHD is a heterogeneous disorder. The relatively simple nervous systems of rodent models have enabled identification of neurobiological changes that underlie certain aspects of ADHD behaviour. Several animal models of ADHD suggest that the dopaminergic system is functionally impaired. Some animal models have decreased extracellular dopamine concentrations and upregulated postsynaptic dopamine D1 receptors (DRD1) while others have increased extracellular dopamine concentrations. In the latter case, dopamine pathways are suggested to be hyperactive. However, stimulus-evoked release of dopamine is often decreased in these models, which is consistent with impaired dopamine transmission. It is possible that the behavioural characteristics of ADHD result from impaired dopamine modulation of neurotransmission in cortico-striato-thalamo-cortical circuits. There is considerable evidence to suggest that the noradrenergic system is poorly controlled by hypofunctional α2-autoreceptors in some models, giving rise to inappropriately increased release of norepinephrine. Aspects of ADHD behaviour may result from an imbalance between increased noradrenergic and decreased dopaminergic regulation of neural circuits that involve the prefrontal cortex. Animal models of ADHD also suggest that neural circuits may be altered in the brains of children with ADHD. It is therefore of particular importance to study animal models of the disorder and not normal animals. Evidence obtained from animal models suggests that psychostimulants may not be acting on the dopamine transporter to produce the expected increase in extracellular dopamine concentration in ADHD. There is evidence to suggest that psychostimulants may decrease motor activity by increasing serotonin levels. In addition to providing unique insights into the neurobiology of ADHD, animal models are also being used to test new drugs that can be used to alleviate the symptoms of ADHD.
Local hyperhemia to heating is impaired in secondary Raynaud's phenomenon
Authors: Boignard Aude , Salvat-Melis Muriel , Carpentier Patrick H , Minson Christopher T , Grange Laurent , Duc Catherine , Sarrot-Reynauld Françoise , Cracowski Jean-Luc
Published: July 2005

Accurate and sensitive measurement techniques are a key issue in the quantification of the microvascular and endothelial dysfunction in systemic sclerosis (SSc). Thermal hyperhemia comprises two separate mechanisms: an initial peak that is axon reflex mediated; and a sustained plateau phase that is nitric oxide dependent. The main objective of our study was to test whether thermal hyperhemia in patients with SSc differed from that in patients with primary Raynaud's phenomenon (RP) and healthy controls. In a first study, we enrolled 20 patients suffering from SSc, 20 patients with primary RP and 20 healthy volunteers. All subjects were in a fasting state. Post-occlusive hyperhemia, 0.4 mg sublingual nitroglycerin challenge and thermal hyperhemia were performed using laser Doppler flowmetry on the distal pad of the third left finger. In a second study, thermal hyperhemia was performed in 10 patients with rheumatoid arthritis and 10 patients with primary RP. The thermal hyperhemia was dramatically altered in terms of amplitude and kinetics in patients with SSc. Whereas 19 healthy volunteers and 18 patients with primary RP exhibited the classic response, including an initial peak within the first 10 minutes followed by a nadir and a second peak, this occurred only in four of the SSc patients (p < 0.0001). The 10 minutes thermal peak was 43.4 (23.2 to 63), 42.6 (31 to 80.7) and 27 (14.7 to 51.4) mV/mm Hg in the healthy volunteers, primary RP and SSc groups, respectively (p = 0.01), while the 44°C thermal peak was 43.1 (21.3 to 62.1), 42.6 (31.6 to 74.3) and 25.4 (15 to 52.4) mV/mm Hg, respectively (p = 0.01). Thermal hyperhemia was more sensitive and specific than post-occlusive hyperhemia for differentiating SSc from primary RP. In patients with rheumatoid arthritis, thermal hyperhemia was also altered in terms of amplitude. Thermal hyperhemia is dramatically altered in patients with secondary RP in comparison with subjects with primary RP. Further studies are required to determine the mechanisms of this altered response, and whether it may provide additional information in a clinical setting.
Households matter: the quiet demography of urban transformation
Authors: Buzar Stefan , Ogden Philip E. , Hall Ray
Published: July 2005

During the last three decades, the household has become the focus of a wide range of sociodemographic processes, including the destabilization of traditional patterns of marriage, cohabitation and divorce; the growing fluidity of ties of kin and friendship; and increasingly complex transitions through the life course. However, these dynamics - which are often summarized under the common heading of the `second demographic transition' - have been marginalized in the mainstream geographical literature. In this paper, we draw attention to the extensive, albeit fragmented, body of sociological, economic, feminist and geographical insights into the changing social geometry of the household. Recent developments in these domains have affirmed the pivotal role of the household in shaping the geographies of gender, home and everyday life. We underline the importance of households as agents of urban transformation, arguing in favour of the further incorporation of household demography into the interpretation of contemporary urban problems and trends.
Globalizing retail: conceptualizing the distribution-based transnational corporation (TNC)
Authors: Wrigley Neil , Coe Neil M. , Currah Andrew
Published: July 2005

In this article we argue that the retail transnational corporation (TNC) is an entity that merits urgent theoretical and empirical investigation from economic geographers. Using recent theoretical developments that conceptualize TNCs as the complex nexus of intrafirm, interfirm and extrafirm relational networks, we explore the special characteristics of retail TNCs that distinguish them from their manufacturing counterparts, still the predominant focus of interest in the literature on economic globalization. In particular, using Hess's (2004) notion of three different kinds of embeddedness (societal, network, territorial), we explain how it is the necessarily high territorial embeddedness in markets and cultures of consumption, planning and property systems, and logistical and supply chain operations that defines the distinctive theoretical and organization challenge of the retail TNC. In turn, we argue that this high level of embeddedness frequently implies a very different experience of host-market regulation than is found in other sectors. Additionally, we use Dicken's (2000) distinction between `placing firms' and `firming places' to explore how territorial embeddedness of the retail TNC is influenced by its societal embeddedness (home country institutional origins), and how network embeddedness is critical to an understanding of how places/host economies are inserted, reciprocally, into the organizational spaces of the retail TNCs. In particular, we argue that intrafirm management of innovation and knowledge dynamics across highly dispersed store and sourcing operations poses particular problems and possibilities for retail TNCs.
Beyond rescaling: reintegrating the `national' as a dimension of scalar relations
Authors: Mansfield Becky
Published: July 2005

Among scholars of globalization and neoliberalism, there has been a marked turn away from the national as a relevant scale in today's world, with researchers arguing that the national is being `rescaled' to local, regional and global scales. This paper argues that we need to move beyond this rescaling argument to recognize that the national still is relevant in contemporary political economy. Seeing the national not as a discrete scale but as a dimension of political economic practice is an alternative analytical approach that treats the national as constitutively implicated in other scaled activities. Distinctions between one scale and another are not so clear. This approach enhances our understanding of contemporary patterns and processes because, instead of focusing on one set of scales or another, analysis can reveal relations among multiple scales. This approach also moves us beyond the historical periodization posited in the rescaling literature. Instead of providing descriptions of contemporary change in which the dominant national is giving way to a messier configuration of global and local scales, the idea of scales-as-dimensions offers a way of analysing scalar relations more generally. This can then be used in both contemporary and historical analysis. The rescaling argument treats the national largely as residual, which serves to draw our attention away from complex scalar practices without offering a truly different way of thinking about scalar relations.
MALToma and lupus
Authors: Oliveri C , Hughes G RV , D’Cruz D P
Published: July 2005

We present two patients with low-grade non-Hodgkin MALT lymphoma (mucosa-associated lymphoid tissue) occurring years before clinical evidence of autoimmune disorders. While the strong association between autoimmune disorders, in particular Sjögren’s syndrome and MALToma, is well described, the developement of MALToma years before the onset of an autoimmune disease is very unusual.
Relapse with transformation of lupus nephritis in a transplant kidney
Authors: Thomas M , Blennerhassett J , Walker R
Published: July 2005

Lupus nephritis is a constellation of different renal histologies, characterized by an immune complex mediated glomerular disease. Histological transformation in lupus nephritis usually occurs from a mild mesangial proliferative glomerulonephritis to a more aggressive diffuse proliferative lesion. We present a case of relapsed systemic lupus erythematosus (SLE) in a renal transplant recipient in which there was a histological transformation from the original diffuse proliferative lupus nephritis in the native kidneys to a membranous lupus nephritis in the renal transplant.
Acute pulmonary edema, capillaritis and alveolar hemorrhage: pulmonary manifestations coexistent in antiphospholipid syndrome and systemic lupus erythematosus?
Authors: Nguyen V A , Gotwald T , Prior C , Obermoser G , Sepp N
Published: July 2005

Pulmonary capillaritis and alveolar hemorrhage are rare yet serious and life threatening complications of systemic lupus erythematosus (SLE). Pulmonary manifestations of antiphospholipid syndrome (APS) are similar and include, apart from pulmonary embolism and pulmonary hypertension, pulmonary capillaritis, diffuse alveolar hemorrhage and respiratory insufficiency in patients with catastrophic APS. Herein, we described the radiological features of three patients with pulmonary and SLE-associated APS, manifested with pulmonary edema, capillaritis and alveolar hemorrhage. We observed that the radiological features of pulmonary APS shared close resemblance to those of pulmonary SLE. Based on these findings, we conclude that both entities are not only histologically, but also radiologically indistinguishable from each other, suggesting a mutual pathogenetic mechanism. This raises the question of whether some of the reported lupus pneumonitis cases in the past might be manifestations of APS rather than of SLE.
Clinical disease activity and titers of anti-dsDNA antibodies measured by an automated immunofluorescence assay in patients with systemic lupus erythematosus
Authors: López-Hoyos M , Cabeza R , Martínez-Taboada V M , Crespo J , SanSegundo D , Blanco R , López-Escribano H , Peña M , Rodríguez-Valverde V
Published: July 2005

Autoantibodies specific for double stranded DNA (anti-dsDNA Abs) are a serological biomarker of systemic lupus erythematosus (SLE) and constitute useful tools for monitoring many SLE patients. A new automated immunofluorescence and quantitative assay (EliA dsDNA) has recently become available. Its performance has been demonstrated to be equivalent to the Farr and Crithidia luciliae fluorescence (CLIFT) tests. The aim of the present work was to assess the utility of this new assay to monitor clinical activity in a large cohort of SLE patients. To this end, 1020 sera from 181 SLE patients were evaluated by the two methods. Results showed a higher frequency of positive results of anti-dsDNA Abs during lupus flares measured by EliA dsDNA than by CLIFT. Likewise, titers of those Abs were significantly increased in active SLE in comparison with inactive SLE when measured by EliA dsDNA but not by CLIFT. Serum titers of anti-dsDNA Abs by both assays showed a significant negative association with concentrations of C3 and C4. In summary, this retrospective study on a large cohort of patients demonstrated that EliA dsDNA was at least as useful as CLIFT as monitoring tool in the follow-up of SLE patients, but with the advantages of being automated, quick and quantitative.
The effects of vitamin A derivative etretinate on the skin of MRL mice
Authors: Ikeda T , Nishide T , Ohtani T , Furukawa F
Published: July 2005

MRL/Mp-lpr/lpr (MRL/lpr) mice are characterized by the disorder of apoptosis due to defects in Fas antigens and autoimmune symptoms including spontaneous lupus erythematosus (LE)-like skin lesions. MRL/Mp- +/+ (MRL/n) mice do not carry the defect of lpr mutation nor do they exhibit skin disorders during the first six months of life. Retinoids are known to inhibit the proliferation of skin fibroblasts, collagen synthesis, modulate immune responses, and apoptosis by Fas ligand upregulation in skin fibroblasts. We examined changes in dermal thickness and appearance of skin disorders in five months old MRL/lpr mice by oral treatment with etretinate, a retinoic acid derivative. Etretinate treated MRL/lpr mice did not have skin lesions or dermatopathological characteristics including an increase in cells infiltrating the dermis. The mean dermal thickness of MRL/lpr and MRL/n mice treated with etretinate decreased significantly and apoptotic cells density in the dermis of MRL/lpr mice with etretinate was significantly higher compared with the control group (P, 0.05) although MRL/lpr mice have a defect within the Fas antigen. We assumed that etretinate reduced dermal thickness, and suppressed the appearance of skin lesions by inducting apoptosis and perhaps regulation of cytokine expression.
Antiphospholipid antibody associated thrombocytopenia and the paradoxical risk of thrombosis
Authors: Atsumi T , Furukawa S , Amengual O , Koike T
Published: July 2005

The pathogenesis of thrombocytopenia in patients with antiphospholipid syndrome (APS) is heterogeneous. Patients with antiphospholipid antibodies (aPL) and thrombocytopenia in the absence of clinical manifestations of APS will be diagnosed and treated as idiopathic thrombocytopenic purpura. However, the presence of aPL places those individuals at particular risk for developing both bleeding and thrombotic complications. Therefore, we propose the inclusion of such patients in the subgroup ‘aPL-associated thrombocytopenia’. More attention should be devoted to this subgroup of patients to elucidate the role of aPL in the development of thrombocytopenia and to facilitate the adequate monitoring of its potential thrombotic risk.
Oral pamidronate prevents high-dose glucocorticoid-induced lumbar spine bone loss in premenopausal connective tissue disease (mainly lupus) patients
Authors: Toukap A Nzeusseu , Depresseux G , Devogelaer J-P , Houssiau F A
Published: July 2005

Glucocorticoid (GC)-induced osteoporosis contributes to chronic damage in patients suffering from connective tissue diseases (CTD) such as systemic lupus erythematosus (SLE). In this study, performed in an highly selected cohort of premenopausal female CTD (mostly lupus) patients, given high-dose GC therapy for severe disease, we show that lumbar spine bone loss can be averted by treatment with oral disodium pamidronate combined with calcium salts and vitamin D3 supplements and not by calcium salts and vitamin D3 supplements alone. We stress the need for optimal GC-induced bone loss prevention therapy in premenopausal patients, a too often neglected issue in patients whose survival has dramatically improved over the last decades.
Nailfold capillaroscopy changes in systemic lupus erythematosus: correlations with disease activity and autoantibody profile
Authors: Riccieri V , Spadaro A , Ceccarelli F , Scrivo R , Germano V , Valesini G
Published: July 2005

In systemic lupus erythematosus (SLE) nailfold capillaroscopy (NC) studies have described many different nonspecific patterns. We decided to evaluate NC changes in 44 SLE patients, comparing them with the main clinical, demographic and laboratory parameters, thus to define the real role for NC and its abnormalities in the management of this disease. Fifteen patients (34%) complained of Raynaud’s phenomenon; nine of them (20%) showed relevant capillaroscopic changes (capillaroscopic score >1). In details: three patients (6.8%) had loss of capillaries, while 18 (41%) had a capillary length variability, 16 (36.5%) showing shorter and two (4.5%) longer capillaries; tortuous, meandering, bizarre, ramified and/or bushy capillaries were found in 26 (59%), seven (16%), two (4.5%), three (7%) cases, respectively. An irregular distribution of the capillary array was present in six cases (14%) while microhaemorrhages were found in four cases (9%). 4 patients (9%) showed enlarged capillaries and changes of blood flow. A capillaroscopic score >1 was more frequently associated with higher ECLAM ( P < 0.005) and SLEDAI ( P < 0.01) activity scores, with the presence of anti-cardiolipin ( P < 0.04) and anti-Sm ( P < 0.04) antibodies, and also with the presence ( P < 0.04) and higher titer ( P < 0.001) of anti-dsDNA antibodies. No statistically significant correlation was found among the different capillaroscopy findings, age, disease duration, or treatment, nor with any clinical manifestation of the disease, such as cutaneous, renal or neurological. Our findings confirm the importance of the microvascular involvement in SLE. The NC abnormalities seem to be related to the disease activity and to the presence of many different antibodies, highly involved in the expression of SLE. NC proved to be an easy-to-perform noninvasive technique, able to achieve useful data to better evaluate such a pleomorphic disease as SLE.
Birth weight and systemic lupus erythematosus
Authors: Coleman L A , Naleway A L , Davis M E , Greenlee R T , Wilson D , McCarty D J
Published: July 2005

The fetal environment may be a contributing factor in the etiology of some adult diseases. This study examined whether birth weight, birth length and gestational age are associated with the subsequent development of systemic lupus erythematosus (SLE). The Marshfield Clinic Lupus Registry was searched to identify patients who were born at Saint Joseph’s Hospital in Marshfield, Wisconsin, USA. Birth data on each case and five age-, sex-, and race-matched controls were recorded from medical and delivery room register records. Perinatal data were obtained for 23 cases and 115 controls. The unadjusted mean birth weight was similar for cases (3407 + 581 g) and controls (3422 + 514 g). Birth length was not different between groups. Birth weight adjusted for gestational age, analysed by conditional logistic regression, was not statistically significantly different between groups. We concluded that birth weight and length were similar among SLE cases and controls, suggesting that these perinatal characteristics are not associated with subsequent SLE.
High prevalence of vertebral deformity in premenopausal systemic lupus erythematosus patients
Authors: Borba V ZC , Matos P G , da Silva Viana P R , Fernandes A , Sato E I , Lazaretti-Castro M
Published: July 2005

In this paper we searched for vertebral deformities in a group of 70 premenopausal systemic lupus erythematosus (SLE) patients (31.8 ± 8.1 years old) and compared them to a matched control group of 22 healthy women (32.0 ± 8.9 years old). Patients and controls performed spine X-ray (XR) morphometry and lumbar spine and femoral neck bone mineral density (BMD). Clinical data was obtained by a questionnaire and charts review. Thoracic or lumbar spine fracture was observed in 15 (21.4%) SLE patients, while no deformities were found in the control group ( P = 0.018). BMD was not different amongst SLE patients and controls and between SLE patients with or without deformities. Although BMD could not predict what patient have deformity, seven patients (46.6%) with deformity had a lumbar spine or femoral neck Z-score less than -1 SD [median = -0.59 (-3.72 to +0.88) and -0.20 (-4.05 to +1.87)] respectively. In addition, we found a negative correlation between number of fracture per patient and lumbar spine and femoral neck BMD ( R = 0.58, P = 0.04 and R = 0.84, P = <0.0001 respectively). No significant correlation was found between number of deformities and clinical data. This is the first study to search for vertebral deformities in SLE patients and to demonstrate a high prevalence of deformities in a relative young SLE population. These findings bring up the necessity to look for spine deformities in this group of women regardless the BMD.
Polymyositis/dermatomyositis-associated lung disease: analysis of a series of 81 patients
Authors: Selva-O’Callaghan A , Labrador-Horrillo M , Muñoz-Gall X , Martínez-Gomez X , Majó-Masferrer J , Solans-Laque R , Simeon-Aznar C P , Morell-Brotard F , Vilardell-Tarrés M
Published: July 2005

The objective of this study was to assess the prevalence, clinical, histological and immunological characteristics, and the long-term outcome of polymyositis-(PM) and dermatomyositis-(DM) associated lung disease, and to define subgroups of lung-associated inflammatory myopathies. This retrospective study included 81 consecutive patients diagnosed with PM/DM. Pulmonary involvement was systematically investigated in relation to clinical symptoms by chest radiography, high resolution computed tomography and pulmonary function testing. Anti-synthetase autoantibodies (ASA) were analysed by ELISAandconfirmedbyproteinandRNA immunoprecipitation methods. Statistical analyses were done with the Student t-test and Fisher exact test. Cumulative survival probabilities were estimated by the Kaplan-Meier method and Cox regression analysis. Fifty patients (61%) presented pulmonary involvement. Thirty-two (39%) had interstitial lung disease and five of them had devastating acute interstitial pneumonia with pneumomediastinum and an unfavorable prognosis. Histology showed diffuse alveolar damage in this subgroup and ASA were negative. Eighteen patients (22%) presented restrictive myopathic lung disease; in three of them respiratory muscles could not maintain ventilation. ASA were positive in 17 of the 50 patients (34%) and were significantly associated with interstitial lung disease (OR: 4.5 [95% CI: 1.3-15.3]), arthritis (OR: 6.0 [95% CI: 1.3-29.2]) and ‘mechanic hands’ (OR: 8.5 [95% CI: 1.7-41.4]); the presence of these autoantibodies did not imply worse survival prognosis. We concluded that clinical and immunological characteristics allowed the grouping of patients into different types of PM/DM lung-associated disease. Presence of ASA did not affect survival. ASA-negative patients with acute interstitial pneumonitis and pneumomediastinum had an unfavorable prognosis.
Breaking of tolerance to native DNA in nonautoimmune mice by immunization with natural protein/DNA complexes
Authors: Voynova E N , Tchorbanov A I , Todorov T A , Vassilev T L
Published: July 2005

A major event in the pathogenesis of systemic lupus erythematosus (SLE) is the breaking of tolerance to native DNA and the appearance of IgG anti-double-stranded (ds) DNA antibodies. The mechanisms of the losing of tolerance are not well understood. Continuous efforts have been made in the past to induce anti-native DNA IgG autoantibodies in non-autoimmune animals but the relevance of the approaches used to what happens in spontaneous disease is unclear. We succeeded in breaking tolerance to native DNA in nonautoimmune-prone BALB/c mice by immunization with natural DNA/protein complexes. These complexes included nucleosomes, crude commercial histone and nucleohistone preparations. The anti-dsDNA IgG response lasted for more than anyear. IgG deposition in the kidneys of the animals was repeatedly shown. As DNA-specific B cells behave in many ways as non-autoreactive B cells, we suggest that the activity of the self-reactive B lymphocytes could be selectively inhibited in a way that mimics a physiological mechanism controlling the magnitude and duration of the IgG antibody response to foreign antigens.
Beliefs, Points of View, and Multiple Environments*
Authors: Wilks Yorick , Bien Janusz
Published: July 2005

The paper describes a system for dealing with nestings of belief in terms of the mechanism of computational environment. A method is offered for computing the beliefs of A about B (and so on) in terms of the systems existing knowledge structures about A and B separately. A proposal for belief percolation is put forward: percolation being a side effect of the process of the computation of nested beliefs, but one which could explain the acquisition of unsupported beliefs. It is argued that the mechanism proposed is compatible with a general least effort hypothesis concerning human mental functioning.
Nameheads*
Authors: Carroll John M.
Published: July 2005

Proper names often have shorter variants, e.g., the Boston Common < == > the Common, New York City < == > New York. A description of this phenomenon is proposed that decomposes it into four sub‐processes: Category Ellipsis, Location Ellipsis, Appellation Formation, and Explicit Metonomy. Discussion focusses principally on the former two processes, which produce “nameheods”—briefer alternations of proper names that preserve the naming function. It is argued that the name shortening processes (a) operate in a lexical domain; but (b) are non‐grammatical. An extra‐grammatical analysis of the processes is outlined.
Structure‐Mapping: A Theoretical Framework for Analogy*
Authors: Gentner Dedre
Published: July 2005

A theory of analogy must describe how the meaning of an analogy is derived from the meanings of its parts. In the structure‐mapping theory, the interpretation rules are characterized as implicit rules for mapping knowledge about a base domain into a target domain. Two important features of the theory are (a) the rules depend only on syntactic properties of the knowledge representation, and not on the specific content of the domains; and (b) the theoretical framework allows analogies to be distinguished cleanly from literal similarity statements, applications of abstractions, and other kinds of comparisons.

Two mapping principles are described: (a) Relations between objects, rather than attributes of objects, are mapped from base to target; and (b) The particular relations mapped are determined by systematicity, as defined by the existence of higher‐order relations.
Passing Markers: A Theory of Contextual Influence in Language Comprehension*
Authors: Charniak Eugene
Published: July 2005

Most Artificial Intelligence theories of language either assume a syntactic component which serves as “front end” for the rest of the system, or else reject all attempts at distinguishing modules within the comprehension system. In this paper we will present an alternative which, while keeping modularity, will account for several puzzles for typical “syntax first” theories. The major addition to this theory is a “marker passing” (or “spreading activation”) component, which operates in parallel to the normal syntactic component.
Shareability: The Social Psychology of Epistemology*
Authors: Freyd Jennifer J.
Published: July 2005

Psychologists and cognitive scientists interested in the nature of internal representations of human knowledge often use observable regularities or structures to infer what the innate constraints on those representations must be like. It is possible, however, that certain structures might come about only when a group of people share a knowledge domain. Furthermore, it is possible that there are analyzable constraints on knowledge structures that emerge when knowledge is being shared. Such constraints are referred to in this paper as “shareability” constraints. A number of examples of observable structures in human knowledge are discussed in terms of shareability constraints. An attempt is made to determine which sorts of structures are most shareable, and how those structures may differ from the sorts of structures that are easily represented by the individual mind but not easily shared between minds.
The Role of Affect in Narratives*
Authors: Dyer Michael G.
Published: July 2005

Affect states and reactions commonly occur in narratives. This paper discusses the importance of affect knowledge and processing in the context of BORIS, a computer program which reads and answers questions about narratives involving multiple sources of knowledge. There are several reasons why affects are important in a process model of narrative comprehension: For one thing, affects describe goal situations and signal the occurrence of expectation failures. Affective reactions also serve as an indication of the status of interpersonal relationships. Finally, affects influence the kinds of thematic structures which become instantiated in episodic memory.
Maintaining Organization in a Dynamic Long‐Term Memory*
Authors: Kolodner Janet L.
Published: July 2005

As new unanticipated items are added to a memory, it must be able to reorganize itself, integrating the new items into its structure. The reorganization process must maintain the memory's structure and also build up the knowledge retrieval strategies need to search that structure. This study will present an algorithm for knowledge‐based memory reorganization. Included in that algorithm are processes for directed generalization and generalization refinement. A fact retrieval system called CYRUS which uses the algorithm is also presented. Conclusions are drawn about maintaining accessibility in a conceptual memory, organizing generalized knowledge with respect to specific knowledge, and expected retrieval failures due to change over time in the memory's organization.
Reconstructive Memory: A Computer Model*
Authors: Kolodner Janet L.
Published: July 2005

This study presents a process model of very long‐term episodic memory. The process presented is a reconstructive process. The process involves application of three kinds of reconstructive strategies—component‐to‐context instantiation strategies, component‐instantiation strategies, and context‐to‐context instantiation strategies. The first is used to direct search to appropriate conceptual categories in memory. The other two are used to direct search within the chosen conceptual category. A fourth type of strategy, called executive search strategies, guide search for concepts related to the one targeted for retrieval.

A conceptual memory organization implied by human reconstructive memory is presented along with examples which motivate it. A basic retrieval algorithm is presented for traversing that stucture. Retrieval strategies arise from failures in that algorithm. The memory organization and retrieval processes are implemented in a computer program called CYRUS which stores events in the lives of former Secretaries of State Cyrus Vance and Edmund Muskie and answers questions posed in English concerning that information. Examples which motivate the process model are drawn from protocols of human memory search. Examples of CYRUS's behavior demonstrate the implemented process model. Conclusions are drawn concerning retrieval failures and the relationship of episodic and semantic memory.