bluuebunny/crossref_metadata_2025 huggingface dataset:
The final step in the phage infection cycle: the Rz and Rz1 lysis proteins link the inner and outer membranes
Authors: Berry Joel , Summer Elizabeth J. , Struck Douglas K. , Young Ryland
Published: August 2008

Bacteriophage λ has four adjacent genes –S, R, Rz and Rz1– dedicated to host cell lysis. While S, encoding the holin and antiholin, and R, encoding the endolysin, have been intensively studied, the products of Rz and Rz1 have not been characterized at either the structural or functional levels. Rz1 is an outer membrane lipoprotein and our results indicate that Rz is a type II signal anchor protein. Here we present evidence that an Rz–Rz1 complex that spans the periplasm carries out the final step in the process of host lysis. These results are discussed in terms of a model where endolysin‐mediated degradation of the cell wall is a prerequisite for conformational changes in the Rz–Rz1 complex leading to the juxtaposition and fusion of the IM and OM. Fusion of the two membranes removes the last physical barrier to efficient release of progeny virions.
The RNA binding protein CsrA controls cyclic di‐GMP metabolism by directly regulating the expression of GGDEF proteins
Authors: Jonas Kristina , Edwards Adrianne N. , Simm Roger , Romeo Tony , Römling Ute , Melefors Öjar
Published: August 2008

The carbon storage regulator CsrA is an RNA binding protein that controls carbon metabolism, biofilm formation and motility in various eubacteria. Nevertheless, in Escherichia coli only five target mRNAs have been shown to be directly regulated by CsrA at the post‐transcriptional level. Here we identified two new direct targets for CsrA, ycdT and ydeH, both of which encode proteins with GGDEF domains. A csrA mutation caused mRNA levels of ycdT and ydeH to increase more than 10‐fold. RNA mobility shift assays confirmed the direct and specific binding of CsrA to the mRNA leaders of ydeH and ycdT. Overexpression of ycdT and ydeH resulted in a more than 20‐fold increase in the cellular concentration of the second messenger cyclic di‐GMP (c‐di‐GMP), implying that both proteins possess diguanylate cyclase activity. Phenotypic characterization revealed that both proteins are involved in the regulation of motility in a c‐di‐GMP‐dependent manner. CsrA was also found to regulate the expression of five additional GGDEF/EAL proteins and a csrA mutation led to modestly increased cellular levels of c‐di‐GMP. All together, these data demonstrate a global role for CsrA in the regulation of c‐di‐GMP metabolism by regulating the expression of GGDEF proteins at the post‐transcriptional level.
Gastric hypersensitivity induced by oesophageal acid infusion in healthy volunteers
Authors: Van Den Elzen B. D. J. , Tytgat G. N. J. , Boeckxstaens G. E. E.
Published: August 2008

Abstract  Distal oesophageal acid exposure has been shown to increase visceral sensitivity of the proximal oesophagus via central sensitization. Here we evaluated whether acidification of the distal oesophagus also affects the sensorimotor function of the proximal stomach. A gastric barostat study combined with a 30‐min acid (HCl 0.15 mol L−1) or saline infusion in the distal oesophagus was performed in 18 healthy volunteers. Gastric and cutaneous sensitivity was assessed before and up to 2 h after the start of infusion. Directly after acid infusion, but not after saline, the threshold for discomfort decreased (–6.4 ± 1.7 vs 0.4 ± 0.4 mmHg; P = 0.028) and distension‐induced symptoms increased significantly compared with the baseline (122 ± 49% vs −3 ± 9%). Cutaneous sensitivity remained unaffected by acid infusion. In contrast, when the infused liquid was aspirated 3 cm more distally, at the level of the lower oesophageal sphincter, the effect of acid infusion on gastric sensitivity was abolished and the increase in distension‐induced symptoms was reduced (61 ± 24%). Distal oesophageal acid infusion induces visceral hypersensitivity without affecting somatic sensitivity arguing against a similar mechanism of central sensitization as observed in non‐cardiac chest pain. As reduction of the acid load to the stomach prevented this effect, our findings indicate that either gastric and/or duodenal acidification is involved. It should be emphasized though that aspiration from distal oesophagus may have attenuated the effect by reducing the acid‐exposed area or by reducing the contact time.
The impact of anaesthetic technique on survival and fertility in Drosophila
Authors: CHAMPION DE CRESPIGNY FLEUR E. , WEDELL NINA
Published: August 2008

Abstract The consequences of ice and carbon dioxide anaesthetics on the survival and reproductive success of Drosophila simulans and Drosophila melanogaster were investigated after observations of high levels of mortality in D. simulans, possibly associated with brief chill coma. The association between brief chill coma and death is confirmed in female D. simulans but there is no mortality in male D. simulans or D. melanogaster of either sex. Mortality is unlikely to be associated with a strain specific cold intolerance because two geographically distinct populations of D. simulans were examined. In addition to the effect of ice anaesthesia, anaesthetizing newly‐eclosed male D. simulans with CO2 causes a reduction in fertility, which is evident 9–13 days after anaesthesia. This finding is important given that CO2 anaesthesia is a standard technique used in Drosophila and other insect cultures, and may have important consequences for studies of male fertility and sperm competition.
Responses of Brassica oleracea cultivars to infestation by the aphid Brevicoryne brassicae: an ecological and molecular approach
Authors: BROEKGAARDEN COLETTE , POELMAN ERIK H. , STEENHUIS GREET , VOORRIPS ROELAND E. , DICKE MARCEL , VOSMAN BEN
Published: August 2008

Intraspecific variation in resistance or susceptibility to herbivorous insects has been widely studied through bioassays. However, few studies have combined this with a full transcriptomic analysis. Here, we take such an approach to study the interaction between the aphid Brevicoryne brassicae and four white cabbage (Brassica oleracea var. capitata) cultivars. Both under glasshouse and field conditions, two of the cultivars clearly supported a faster aphid population development than the other two, indicating that aphid population development was largely independent of the environmental conditions. Genome‐wide transcriptomic analysis using 70‐mer oligonucleotide microarrays based on the Arabidopsis thaliana genome showed that only a small number of genes were differentially regulated, and that this regulation was highly cultivar specific. The temporal pattern in the expression behaviour of two B. brassicae‐responsive genes in all four cultivars together with targeted studies employing A. thaliana knockout mutants revealed a possible role for a trypsin‐and‐protease inhibitor in defence against B. brassicae. Conversely, a xyloglucan endotransglucosylase seemed to have no effect on aphid performance. Overall, this study shows clear intraspecific variation in B. brassicae susceptibility among B. oleracea cultivars under glasshouse and field conditions that can be partly explained by certain differences in induced transcriptional changes.
Arabidopsis transcript and metabolite profiles: ecotype‐specific responses to open‐air elevated [CO2]
Authors: LI PINGHUA , AINSWORTH ELIZABETH A. , LEAKEY ANDREW D. B. , ULANOV ALEXANDER , LOZOVAYA VERA , ORT DONALD R. , BOHNERT HANS J.
Published: August 2008

A Free‐Air CO2 Enrichment (FACE) experiment compared the physiological parameters, transcript and metabolite profiles of Arabidopsis thaliana Columbia‐0 (Col‐0) and Cape Verde Island (Cvi‐0) at ambient (∼0.375 mg g−1) and elevated (∼0.550 mg g−1) CO2 ([CO2]). Photoassimilate pool sizes were enhanced in high [CO2] in an ecotype‐specific manner. Short‐term growth at elevated [CO2] stimulated carbon gain irrespective of down‐regulation of plastid functions and altered expression of genes involved in nitrogen metabolism resembling patterns observed under N‐deficiency. The study confirmed well‐known characteristics, but the use of a time course, ecotypic genetic differences, metabolite analysis and the focus on clusters of functional categories provided new aspects about responses to elevated [CO2]. Longer‐term Cvi‐0 responded by down‐regulating functions favouring carbon accumulation, and both ecotypes showed altered expression of genes for defence, redox control, transport, signalling, transcription and chromatin remodelling. Overall, carbon fixation with a smaller commitment of resources in elevated [CO2] appeared beneficial, with the extra C only partially utilized possibly due to disturbance of the C : N ratio. To different degrees, both ecotypes perceived elevated [CO2] as a metabolic perturbation that necessitated increased functions consuming or storing photoassimilate, with Cvi‐0 emerging as more capable of acclimating. Elevated [CO2] in Arabidopsis favoured adjustments in reactive oxygen species (ROS) homeostasis and signalling that defined genotypic markers.
Cell cycle phase‐specific death response of tobacco BY‐2 cell line to cadmium treatment
Authors: KUTHANOVA ANDREA , FISCHER LUKAS , NICK PETER , OPATRNY ZDENEK
Published: August 2008

The character of programmed cell death (PCD) in plants differs in connection with the context, triggering factors and differentiation state of the target cells. To study the interconnections between cell cycle progression and cell death induction, we treated synchronized tobacco BY‐2 cells with cadmium ions that represent a general abiotic stressor influencing both dividing and differentiated cellsin planta. Cadmium induced massive cell death after application in all stages of the cell cycle; however, both the progression and the forms of the cell death differed pronouncedly. Apoptosis‐like PCD induced by cadmium application in the S and G2 was characterized by pronounced internucleosomal DNA fragmentation. In contrast, application of cadmium in M and G1 phases was not accompanied by DNA cleavage, indicating suppression of autolysis and non‐programmed character of the death. We interpret these results in the context of the situationin planta, where the induction of apoptosis‐like PCD in the S and G2 phase might be connected with a need to preserve genetic integrity of dividing meristematic cells, whereas suppression of PCD response in differentiated cells (situated in G1/G0 phase) might help to avoid death of the whole plant, and thus enable initiation of the recovery and adaptation processes.
Two divergent genes encoding L‐myo‐inositol 1‐phosphate synthase1 (CaMIPS1) and 2 (CaMIPS2) are differentially expressed in chickpea
Authors: KAUR HARMEET , SHUKLA RAKESH KUMAR , YADAV GITANJALI , CHATTOPADHYAY DEBASIS , MAJEE MANOJ
Published: August 2008

L‐myo‐inositol 1‐phosphate synthase (MIPS; EC5.5.1.4) catalyses the rate‐limiting step in inositol biosynthetic pathway, and is extremely widespread in living organisms including plants. Several plants possess multiple copies of MIPS gene(s) indicating a possibility of differential expression of each gene to perform distinct physiological functions. To explore this, two MIPS genes (CaMIPS1 and CaMIPS2) were isolated from a drought‐tolerant plant chickpea. Both genes are extremely divergent in respect to their introns, at the same time retaining 85% identity to their exons and functionally complementing inositol auxotroph Schizosaccharomyces pombe. Expression analysis showed both genes were expressed in all organs except seed, where only CaMIPS2 transcript was detected. Under environmental stresses, only CaMIPS2 was induced whereas CaMIPS1 expression remained same, which could be explained by the divergence of their 5′ upstream regulatory sequences. Remarkably, both gene products exhibited similar biochemical characteristics; however, CaMIPS2 retained higher activity than CaMIPS1 at a high temperature and salt concentration. Furthermore, functional expression of CaMIPS2 in S. pombe results better growth response than CaMIPS1 under stress environment. Taken together, our results suggest that CaMIPS1 and CaMIPS2 are differentially expressed in chickpea to play discrete though overlapping roles in plant; however CaMIPS2 is likely to be evolved through gene duplication to function under environmental stresses.
Transfusion trigger – how precise are we? Intraoperative blood transfusion practices in a tertiary centre in Nigeria
Authors: Desalu I. , Dada O. I. O. , Ahmed R. A. , Akin‐Williams O. O. , Ogun H. A. , Kushimo O. T.
Published: August 2008

summary To determine how well anaesthetists in Nigeria determine the need for transfusion based solely on physiological variables and estimated blood loss. To determine the incidence of inappropriate blood transfusion. Anaesthetists in our hospital determine when to transfuse patients based solely on clinical acumen. This may result in inappropriate transfusion especially in this subregion where blood donors are scarce and risk of transmission of infection high. All surgical patients requiring blood transfusion were prospectively studied over 3 months. Transfusion was based solely on the discretion of the attending anaesthetist. Haemoglobin (Hb) concentration was measured prior to transfusion and 24 h postoperatively. Appropriate transfusion was defined as blood transfusion at Hb < 8 g dL−1 or 10 g dL−1 in the elderly and those with medical comorbidities. The trigger for transfusion was documented as well as estimated blood loss. Thirty‐four patients were studied. The mean pretransfusion Hb was 8·09 ± 2·45 g dL−1 (range 4·6–14·2). Twenty‐one patients (61·8%) had appropriate blood transfusion. The commonest transfusion triggers were clinical pallor (82·4%), excessive blood loss (76·4%), delayed capillary refill (55·9%) and severe hypotension (50%). The use of near patient monitoring devices might further improve blood transfusion practice in this setting where donor blood is scarce.
Efforts of the United States’ National Marrow Donor Program and Registry to improve utilization and representation of minority donors
Authors: Johansen K. A. , Schneider J. F. , McCaffree M. A. , Woods G. L. ,   the Council on Science and Public Health, American Medical Association
Published: August 2008

summary Haematopoietic stem cell transplantation is often used as a therapy for patients with certain blood, metabolic or immune system disorders. The United States’ National Marrow Donor Program (NMDP) works to facilitate such life‐saving transplants by coordinating the donor search and match process. However, concern exists that the NMDP Registry is underutilized and under‐representative of racial and ethnic minorities. African‐Americans and Hispanics are somewhat under‐represented within the total number of donors, and it is estimated that the Registry is used by only approximately one‐third of patients needing transplants. The NMDP has instituted programmes that address such concerns, resulting in an increase in both the total number of donors and the minority representation on the Registry. It has also increased efforts to recruit donors of umbilical cord blood, often a viable alternative source of haematopoietic stem cells. Over the past 8 years, the Registry has grown by more than 30% to contain over seven million donors, and the proportional distribution of racial and ethnic groups on the Registry has steadily approached their proportional distribution in the US population. Continued efforts on the part of the NMDP to maintain a Registry that is large in number and ethnically diverse should help ensure access to haematopoietic stem cell transplants for all patients who need them. The procedures and experience of the NMDP and its Registry may have implications for registries elsewhere in the world as they confront similar issues of number and diversity.
Improvement in the performance of HIV screening kits
Authors: Perry K. R. , Ramskill S. , Eglin R. P. , Barbara J. A. J. , Parry J. V.
Published: August 2008

summary The aim of this study was to assess the performance of HIV screening kits introduced over a 12‐year period. HIV kits used by the National Blood Service (NBS) were assessed in the context of other HIV kits employed by diagnostic and reference laboratories. Thirty‐three HIV screening kits were assessed and 13 had the potential to be used by the NBS. Specimens applied to NBS evaluations included 2000 HIV‐negative specimens collected from blood donors, 200 HIV‐positive specimens and 21 seroconversion panels, with larger numbers applied to the latter two categories prior to implementation of Communauté Européennes (CE) marking. The 33 HIV kits gave repeat reactive rates, based on HIV‐negative specimens, of between 0% and 0·8% (and between 0% and 0·2% for kits relevant to the NBS). When examined for diagnostic sensitivity, the 33 kits gave sensitivities between 99·78% and 100%. Kits relevant to NBS gave sensitivities of 100% except one kit, which failed to detect one anti‐HIV‐2‐positive specimen. Twenty‐six kits were compared for detection of primary HIV infection. Of these, the 10 combined HIV antigen/antibody kits examined were more sensitive than other formats and have been exclusively adopted by NBS where operational considerations allow. Their added seroconversion sensitivity makes them the screening method of choice for populations at increased risk, e.g. in sexually transmitted infection (STI) clinics. The regular review of evaluation results has demonstrated a continuing improvement over time in the performance of HIV screening kits and contributed to advances in blood safety.
Antistreptococcal treatment of guttate psoriasis: a controlled study
Authors: Dogan Bilal , Karabudak Ozlem , Harmanyeri Yavuz
Published: August 2008

Background  The role of streptococcal infection in the initiation of guttate psoriasis is well‐recognized. But the treatment results with oral erythromycin and phenoxymethylpenicillin are conflicting.

Objective  Our purpose was to evaluate the effectiveness of these antibiotics in the treatment of streptococcus associated guttate psoriasis comparing with a control group.

Methods  A total of 43 male patients with serologic evidence of a recent streptococcal infection were studied. Their mean age was 21 years (ranged between 19 and 23 years). These 43 patients were randomly allocated into three groups (no treatment group n = 15, erythromycin group n = 14, phenoxymethylpenicillin group n = 14). Both the treatment groups were treated for 14 d. All the groups were followed up for additional 4 weeks.

Results  There were no statistically significant improvement in any group and among the groups.

Conclusion  There was no statistically significant improvement in streptococcus associated guttate psoriasis with or without a course of oral penicillin or erythromycin.
Alexithymia and dermatology: the state of the art
Authors: Willemsen Ria , Roseeuw Diane , Vanderlinden Johan
Published: August 2008

Background  Alexithymia is a personality trait characterized by difficulties in differentiating and describing feelings. Research indicates that alexithymia acts as a triggering factor for many medical and psychiatric disorders. The interest in alexithymia has increased considerably over the past decade. A state of the art review of recent research on alexithymia in medical and dermatological research is presented.

Methods  We reviewed most relevant publications on alexithymia from the field of clinical research, psychology, psychosomatics, and psycho‐neuro‐endocrinology. Systematic searches on alexithymia in dermatology were undertaken using the Cochrane Library and PUBMed.

Results  Interdisciplinary research, investigating alexithymia, is advancing rapidly into different fields of medicine. Alexithymia has been found to be associated with changes in sympathetic activity, immunity and brain activity. Some researchers link alexithymia with insecure parental attachment and adverse childhood experiences. Although research of alexithymia in dermatology is still scarce and reveals conflicting results, preliminary data show that alexithymia seems to be associated with alopecia areata, psoriasis, atopic dermatitis, vitiligo or chronic urticaria.

Conclusion  Present research findings on alexithymia in the field of dermatology suggest important implications for the treatment of some specific dermatological disorders. Besides treating comorbid psychological problems such as anxiety and depression, dermatologists should also be aware of alexithymia and its possible association with an underlying dermatologic disease.
Cutaneous cytomegalovirus infection in a patient with acquired immunodeficiency syndrome
Authors: AbdullGaffar Badr , Raman Lakshmiah G. , Al Muala Alia
Published: August 2008

Cytomegalovirus (CMV) infection in immunocompromised patients is a common opportunistic systemic infection which can lead to death, and usually presents with visceral manifestations, especially of the lung, brain, eye, and gastrointestinal tract. Cutaneous CMV infection is, however, relatively rare in immunocompromised patients. Cutaneous CMV infection can have variable clinical and histologic manifestations, and thus can be easily missed. We report a case of cutaneous CMV infection in a patient with acquired immunodeficiency syndrome, presenting as a generalized, pruritic, erythematous, maculopapular eruption.
Hospital inpatients’ experiences of access to food: a qualitative interview and observational study
Authors: Naithani Smriti , Whelan Kevin , Thomas Jane , Gulliford Martin C , Morgan Myfanwy
Published: August 2008

Background  Hospital surveys indicate that overall patients are satisfied with hospital food. However undernutrition is common and associated with a number of negative clinical outcomes. There is little information regarding food access from the patients’ perspective.

Purpose  To examine in‐patients’ experiences of access to food in hospitals.

Methods  Qualitative semi‐structured interviews with 48 patients from eight acute wards in two London teaching hospitals. Responses were coded and analysed thematically using NVivo.

Results  Most patients were satisfied with the quality of the meals, which met their expectations. Almost half of the patients reported feeling hungry during their stay and identified a variety of difficulties in accessing food. These were categorized as: organizational barriers (e.g. unsuitable serving times, menus not enabling informed decision about what food met their needs, inflexible ordering systems); physical barriers (not in a comfortable position to eat, food out of reach, utensils or packaging presenting difficulties for eating); and environmental factors (e.g. staff interrupting during mealtimes, disruptive and noisy behaviour of other patients, repetitive sounds or unpleasant smells). Surgical and elderly patients and those with physical disabilities experienced greatest difficulty accessing food, whereas younger patients were more concerned about choice, timing and the delivery of food.

Conclusions  Hospital in‐patients often experienced feeling hungry and having difficulty accessing food. These problems generally remain hidden because staff fail to notice and because patients are reluctant to request assistance.
A systematic review of decision support needs of parents making child health decisions
Authors: Jackson Cath , Cheater Francine M. , Reid Innes
Published: August 2008

Objective  To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child.

Context  The first step towards implementing patient decision support is to assess patients’ information and decision‐making needs.

Search strategy  A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched.

Inclusion criteria  Non‐intervention studies containing data on decision support needs of parents making child health decisions.

Data extraction and synthesis  Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre‐defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co‐ordinating Centre approach.

Main results  One‐hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making.
History of respiratory infections in the first 12 yr among children from a birth cohort
Authors: Grüber Christoph , Keil Thomas , Kulig Michael , Roll Stephanie , Wahn Ulrich , Wahn Volker ,   the MAS‐90 Study Group
Published: August 2008

Respiratory infections are the most frequent health problem in childhood. There is little precise information on how many respiratory illness episodes can be expected in a normal child. This study was designed to create reference values for the frequency of respiratory infections as recordable by history. Respiratory illnesses were recorded in a prospective birth cohort of 1314 German children born in 1990 and tracked until age 12 yr (760 children). Parents recorded the child’s illnesses in a diary and answered structured questions yearly up to age 12. Age of study subjects was categorized into infancy (0–2 yr), pre‐school age (3–5 yr), and school age (6–12 yr). The mean cumulative number of respiratory infection episodes up to age 12 yr was 21.9 (s.d. 9.0) episodes. In infancy, the mean annual number was 3.4 (3.7) episodes; at pre‐school age, 2.3 (2.6) episodes; and at school, age 1.1 (1.2) episodes. The mean cumulative time of episodes up to age 7 yr was 20.1 (15.2) wk. Forty‐five percent of the infants in the upper episode incidence tertile continued to be in the upper tertile at school age. Based on a twofold standard deviation of the mean number, up to 11 respiratory infection episodes per year in infancy, 8 episodes per year at pre‐school age, and 4 episodes per year at school age could be regarded as normal. Episodes within these reference values per se should not cause unwarranted concern or intervention because of suspected immunodeficiency.
High birth weight, asthma and atopy at the age of 16 yr
Authors: Remes S. T. , Patel S. P. , Hartikainen A‐L. , Jarvelin M‐R. , Pekkanen J.
Published: August 2008

The association between high birth weight and asthma has been suggested. The Northern Finland Birth Cohort 1986, a longitudinal cohort originally including 9479 participants, has been followed up since birth until the age of 16 yr. Using the data of this study, we analyzed the association of high birth weight with asthma and atopic sensitization at the age of 16 yr. The analysis included the 5995 subjects with complete skin prick test data and the 5500 subjects with data on doctor‐diagnosed asthma (written questionnaire) at the age of 16 yr. Atopy was defined as at least one positive skin prick test reaction, which definition was also used to separate atopic and non‐atopic asthma. There was a significant association between high birth weight (>4510 g) and asthma among the atopic subjects (OR 2.40, 95% CI 1.33–4.32). When looking at atopy, the highest risk was observed among the subjects with highest birth weight category (>4510 g) (OR 1.44, 95% CI 1.05–1.97) and the adjacent (4200–4500 g) birth weight category (OR 1.24, 95% CI 1.01–1.53), when compared with the reference category (2500–3340 g). Our results support the notion that high birth weight is associated with an increased risk of asthma and suggest that the association is mostly explained by an increased risk of atopy. The biological mechanisms behind the associations are unknown, but they could be related to obesity.
Cerebellar ataxia in youths at risk for bipolar disorder
Authors: Giles Lisa L , DelBello Melissa P , Gilbert Donald L , Stanford Kevin E , Shear Paula K , Strakowski Stephen M
Published: August 2008

Objective:  Structural, biochemical, and functional cerebellar abnormalities occur in individuals with or at‐risk for developing bipolar disorder (BD), but the clinical implications of these abnormalities are unknown. The present study examined cerebellar function in youths who were at familial risk for BD by comparing ataxia battery scores of youths with a bipolar parent to those of healthy youths.

Methods:  Trained raters administered an ataxia battery, consisting of three tasks, to children (aged 8–12 years) with at least one parent with BD type I (BDI) who themselves did not have BDI (at‐risk or AR group, n = 21) and healthy comparison children (aged 8–12 years) with parents free of DSM‐IV Axis I psychopathology (HC group, n = 23).

Results:  AR youths performed worse than HC youths on the Sharpened Romberg test (subjects standing heel‐to‐toe) and standing on one foot with eyes open (p < 0.02).

Conclusions:  The results indicate that youths at familial risk for BD have more difficulty performing a Sharpened Romberg test than a HC group, suggesting that midline cerebellar dysfunction may be a biomarker for the future development of BD. Further studies examining the relationships among youths at risk for BD, coordination abnormalities, and cerebellar dysfunction are needed.
Severity of mood symptoms and work productivity in people treated for bipolar disorder
Authors: Simon Gregory E , Ludman Evette J , Unützer Jürgen , Operskalski Belinda H , Bauer Mark S
Published: August 2008

Objective:  To evaluate the relationship between mood symptoms and work productivity in people with bipolar disorder.

Methods:  A total of 441 outpatients treated for bipolar disorder were enrolled from mental health clinics of a health plan in Washington State. A baseline assessment included confirmation of diagnosis (using the Structured Clinical Interview for DSM‐IV) as well as assessment of employment status, functional impairment, and days missed from work. Eight follow‐up interviews over 24 months included self‐reported employment status, self‐reported days missed from work due to illness, and assessment of current and interval mood symptoms using the Longitudinal Interval Follow‐up Examination.

Results:  Averaged over four assessments, patients with current major depression were 15% less likely to be employed than those without significant depressive symptoms [odds ratio (OR) = 0.84, 95% confidence interval (CI): 0.76–0.92]. Manic or hypomanic symptoms were not significantly associated with probability of employment (OR = 0.93, CI: 0.83–1.04). Among those employed, major depression was associated with 4.06 additional days of work missed per month (CI: 1.05–7.06) compared to those without significant depressive symptoms. Meeting criteria for manic or hypomanic episode was associated with a similar number of missed work days, but this difference was not statistically significant (adjusted difference = 4.11 days, CI: ‐0.18–8.40).

Conclusions:  Among patients with bipolar disorder, depression is strongly and consistently associated with decreased probability of employment and more days missed from work due to illness. Symptoms of mania or hypomania have more variable effects on work productivity.
Small effective population sizes in two planktonic freshwater copepod species (Eudiaptomus) with apparently large census sizes
Authors: ZELLER M. , REUSCH T. B. H. , LAMPERT W.
Published: August 2008

In small planktonic organisms, large census sizes (Nc) suggest large effective population sizes (Ne), but reliable estimates are rare. Here, we present Ne/Nc ratios for two freshwater copepod species (Eudiaptomus sp.) using temporal samples of multilocus microsatellite genotypes and a pseudo‐likelihood approach. Ne/Nc ratios were very small in both Eudiaptomus species (10−7–10−8). Although we hypothesized that the species producing resting eggs (E. graciloides) had a larger Ne than the other (E. gracilis), estimates were not statistically different (E. graciloides: Ne = 672.7, CI: 276–1949; E. gracilis: Ne = 1027.4, CI: 449–2495), suggesting that the propagule bank of E. graciloides had no detectable influence on Ne.
The oxidation handicap hypothesis and the carotenoid allocation trade‐off
Authors: ALONSO‐ALVAREZ C. , PÉREZ‐RODRÍGUEZ L. , MATEO R. , CHASTEL O. , VIÑUELA J.
Published: August 2008

The oxidation handicap hypothesis proposes that testosterone mediates the trade‐off between the expression of secondary sexual traits and the fight against free radicals. Coloured traits controlled by testosterone can be produced by carotenoid pigments (yellow–orange–red traits), but carotenoids also help to quench free radicals. Recently, it has been shown that testosterone increases the amount of circulating carotenoids in birds. Here, a testosterone‐mediated trade‐off in the carotenoid allocation between colour expression and the fight against oxidative stress is proposed. Male red‐legged partridges were treated with testosterone, anti‐androgens or manipulated as controls. Testosterone‐treated males maintained the highest circulating carotenoid levels, but showed the palest red traits and no evidence of oxidative damage. Increased levels of a key intracellular antioxidant (i.e. glutathione) indicated that an oxidative challenge was in fact induced but controlled. The trade‐off was apparently solved by reducing redness, allowing increased carotenoid availability, which could have contributed to buffer oxidative stress.
No resistance to male‐killing Wolbachia after thousands of years of infection
Authors: JAENIKE J. , DYER K. A.
Published: August 2008

Maternally transmitted male‐killing endosymbionts can exert strong and relentless selection pressure on their hosts to evolve resistance to these infections. Surveys of current infection prevalence and mtDNA diversity indicate that Drosophila innubila is and has been infected with male‐killing Wolbachia at moderate frequencies for extended evolutionary periods. Here, we use coalescent simulations to infer the minimum age of the Wolbachia infection in this species, and estimate that the infection is at least 15 000 and perhaps over 700 000 years old. We also surveyed this species for genetic variation for resistance to the male‐killing effects of infection. Our surveys revealed no evidence for any resistance polymorphism, such that all flies are completely susceptible to male killing. Given the general assumption that Drosophila can be selected for anything, the lack of resistance, despite thousands of years of strong selection, is an apparent evolutionary conundrum. We hypothesize that resistance requires a mutation of major effect that acts early in development, and that the adverse pleiotropic consequences of such mutations in both infected and uninfected individuals may exceed the possible benefit to infected flies.
Undetermined focal liver lesions on gray‐scale ultrasound in patients with fatty liver: Characterization with contrast‐enhanced ultrasound
Authors: Wang Zhi‐Li , Tang Jie , Weskott Hance Peter , Li Jun‐Lai , Wang Wei , Luo Yu‐Kun , An Li‐Chun , Xu Jian‐Hong
Published: August 2008

Background and Aim:  The purpose of this study was to assess the clinical value and potential impact of contrast‐enhanced ultrasound (CEUS) in the characterization of undetermined focal liver lesions (FLLs) in patients with fatty liver.

Methods:  Fifty‐two patients (34 men, 18 women) with fatty liver with 67 FLLs (size range, 1–8.6 cm; mean, 4.1 ± 3.1 cm) undetermined at baseline ultrasound (US) underwent contrast‐enhanced US. CEUS examinations were analyzed by two experienced sonologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity, the dynamic enhancement pattern in comparison with peripheral liver parenchyma. The final diagnosis was based on consensus interpreting of all examinations by another two expert observers with access to histological data. The characterization accuracy, sensitivity, and specificity of CEUS in characterizing the lesion as benign or malignant, and as the correct pathologic type, were analyzed.

Results:  After CEUS, two hemangiomas, three inflammatory pseudotumors, and one hepatocellular carcinoma were misdiagnosed. The overall characterization accuracy, sensitivity and specificity of CEUS were 91% (61/67), 91.7% (11/12), and 90.9% (50/55), respectively. Forty‐three benign lesions were diagnosed as the correct pathologic type. The portal venous phase and late phase were important in the characterization of the lesions. The characterization accuracy had no relationship with the size of FLLs.

Conclusion:  CEUS can improve the characterization of undetermined FLLs arising from fatty liver.
Cholangiocyte bile salt transporters in cholesterol gallstone–susceptible and resistant inbred mouse strains
Authors: Liu Julia J , Glickman Jonathan N , Masyuk Anatoliy I , LaRusso Nicholas F
Published: August 2008

Background and Aim:  We investigated the dietary and gender influences on the expression and functionality of cholangiocyte bile salt transporters and development of biliary hyperplasia in cholesterol gallstone‐susceptible C57L/J and resistant AKR/J mice.

Methods:  C57L and AKR mice were fed chow, a lithogenic diet, or a cholic acid‐containing diet for 14 days. Expression of cholangiocyte bile salt transporter proteins ASBT (SLC10A2), ILBP (FABP6), and MRP3 (ABCC3) were studied by Western blot analysis. Taurocholate uptake studies were performed using microperfusion of isolated bile duct units. The pre‐ and post‐perfusion taurocholate concentrations were analyzed by high performance liquid chromatography. Biliary proliferation in liver sections was scored.

Results:  The lithogenic diet induced ductular proliferation in C57L mice. On chow, SLC10A2 and ABCC3 were overexpressed in male and female C57L compared to AKR mice. A lithogenic diet reduced the expressions of FABP6 in both male and female C57L mice, SLC10A2 in female C57L mice, and ABCC3 in male C57L mice. These alterations in transporter expressions were not associated with changes in taurocholate uptake. The lithogenic diet induced biliary hyperplasia and reduced bile salt transporter expressions in C57L mice.

Conclusions:  Although bile salt uptake was not increased in the bile duct unit, we speculate that the biliary hyperplasia on the lithogenic diet may lead to an increase in intrahepatic bile salt recycling during cholesterol cholelithogenesis.
Polymorphism of human leptin receptor gene is associated with type 2 diabetic patients complicated with non‐alcoholic fatty liver disease in China
Authors: Lu Hongyun , Sun Jiazhong , Sun Liao , Shu Xiaochun , Xu Yancheng , Xie Danhong
Published: August 2008

Background and Aim:  To investigate the relationship between human leptin receptor (LEPR) gene G3057A polymorphism and type 2 diabetes mellitus (T2DM) patients complicated with or without non‐alcoholic fatty liver disease (NAFLD).

Methods:  Two hundred and sixteen cases of newly diagnosed T2DM patients (104 cases complicated with NAFLD) and 108 cases of normal glucose tolerances (NGT) were recruited. Hemi‐nested polymerase chain reaction restriction fragment length polymorphism (PCR‐RFLP) and PCR‐direct sequence analysis were conducted to detect the polymorphism of LEPR G3057A variation. Plasma leptin levels were measured by enzyme‐linked immunosorbent assay kit. Plasma lipid and glucose metabolic parameters were measured routinely. Liver ultrasound was carried out for all subjects.

Results:  T2DM patients complicated with NAFLD had higher plasma insulin, leptin, triglycerides (TG) and low‐density lipoprotein cholesterol (LDL‐C) levels than those without NAFLD and NGT subjects. The variant frequency at nucleotide 3057 G→A transversion was 76.0% in type 2 diabetic patients complicated with NAFLD, which was also significantly higher than those without NAFLD (62.1%) and NGT cases (53.2%). There was also significant difference in genotype distribution between the three groups (χ2 = 14.63, P < 0.01).

Conclusion:  The polymorphism of LEPR gene 3057 probably contributes to the onset of NAFLD by regulating lipid metabolism and affecting insulin sensitivity.
Outcome of self‐expandable metallic stents in low‐grade versus advanced hilar obstruction
Authors: Rerknimitr Rungsun , Kongkam Pradermchai , Kullavanijaya Pinit
Published: August 2008

Background:  Self‐expandable metallic stents (SEMS) are known to provide a longer patency time than plastic stents for malignant biliary obstructions including hilar obstruction. However, studies that focus on the efficacy of SEMS in low‐grade and advanced hilar obstructions are still scanty.

Methods:  Ninety four patients with malignant hilar obstructions were enrolled (six were later excluded). Patients were divided into two groups according to their Bismuth levels. Group A were patients with Bismuth I (n = 53). Group B were patients with Bismuth II, III and IV (n = 35). Technical success, complications, jaundice resolution, stent patency time, and patients’ survival were analyzed.

Results:  Our intention‐to‐treat analysis showed that group A had a significant lower rate of post‐endoscopic retrograde cholangiopancreatography (ERCP) cholangitis than group B; 16.1% versus 44.7%, (P < 0.01). Four patients from group B still had persistent jaundice. Our per protocol analysis demonstrated that median stent patency time in groups A and B were not statistically different (74 vs 60 days). Median survival time in groups A and B were also not statistically different (90 vs 75 days). In both groups, those without liver metastasis had significantly better patency and survival time than those with liver metastasis (P = 0.010 and 0.027, respectively).

Conclusions:  In patients with hilar obstruction, liver metastasis is one of the main factors that determine survival of the patient. Patency times of SEMS in both low‐grade and advanced obstructions are comparable. However, in the advanced group, there is a significant risk of post‐ERCP cholangitis.
Apgar scores reported in personal child health records: Validity for epidemiological studies?
Authors: Troude Pénélope , L'Hélias Laurence Foix , Raison‐Boulley Anne‐Marie , Castel Christine , Bouyer Jean , De La Rochebrochard Elise
Published: August 2008

Aim:  In epidemiological studies on children, information in the neonatal period that might affect children's long‐term health could be extracted from the personal child health record (PCHR), because the booklet exists in most countries. We aimed to assess, in individual children, the validity of Apgar scores reported in the PCHR using maternity medical records as the gold standard.

Methods:  In two French hospitals, 435 women who had a child in January 2006 were recruited and 90% filled in a postal questionnaire 6 weeks after delivery, copying neonatal information (including Apgar scores) from the PCHR. This information was compared with data independently recorded at birth by physicians in maternity medical records.

Results:  We found that the proportion of missing Apgar scores in the PCHR was higher when scores in the medical records were lower. Moreover, Apgar scores reported in the PCHR were overestimated when scores in the medical records were low. Using medical records as the gold standard, specificity for PCHR‐reported 1‐min Apgar score was 100% and sensitivity 33%. Similar trends were found for the 5‐min score. This supports the hypothesis that information considered as ‘socially sensitive’ by physicians may be intentionally altered in PCHRs.

Conclusions:  Apgar scores reported in PCHRs may not yield reliable information for epidemiological studies. When the PCHR is the only source of information for the neonatal period in an epidemiological study, it would be preferable to use a composite neonatal indicator rather than the Apgar score.
The terminal prostaglandin synthases mPGES‐1, mPGES‐2, and cPGES are all overexpressed in human gliomas
Authors: Mattila Simo , Tuominen Hannu , Koivukangas John , Stenbäck Frej
Published: August 2008

Prostaglandin E2 has been connected to processes promoting tumor growth in several human malignancies including gliomas. The terminal prostaglandin synthases mPGES‐1, mPGES‐2, and cPGES convert PGH2 into prostaglandin E2. The inhibition of their function could significantly reduce PGE2 levels in tumors while avoiding some side effects related to the inhibition of the upstream enzymes COX‐1 and COX‐2. In this study, the immunohistochemical staining of mPGES‐1 and, for the first time, the staining of mPGES‐2 and cPGES are characterized and compared with COX‐1 and COX‐2 staining in the same tumor samples of 94 human gliomas. The main results demonstrate over‐expression of all three proteins, including cPGES and mPGES‐2 that are commonly considered non‐inducible, in both low‐ and high‐grade tumors. For all three proteins, average expression in tumor cells was higher in grade III tumors than grade II tumors. The analysis showed no correlation between tumor grade and staining of tumor cells or vascular endothelium with any of the antibodies except in oligodendrogliomas where moderate correlation (linear correlation coefficient 0.6; P < 0.01) could be found between tumor grade and tumor cell staining with mPGES‐1 and cPGES. In grade II tumors which recurred and were reoperated upon during the data gathering period, average expression of COX‐2, mPGES‐1, and cPGES was higher than in tumors that were operated on only once. Our results demonstrate the significance of all three terminal prostaglandin synthases, mPGES‐1, mPGES‐2, and cPGES, as a possible future target of inhibition in glioma therapy.
The 60‐year battle against tuberculosis in Hong Kong—a review of the past and a projection into the 21st century
Authors: LEE Shiu‐Hung
Published: August 2008

Abstract:  Over the past 60 years, tuberculosis (TB) control in Hong Kong has gone through three phases of development. The first phase (from 1948 to the 1960s) was a phase of a wide spread of infectious diseases due to poor environmental hygiene and sanitation, overcrowding, malnutrition and the influx of residents returning to Hong Kong after the end of Pacific War. The second phase (from the 1970s to the 1980s) was a phase of rising chronic noncommunicable diseases due to the aging of the population. The third phase (1990s to the present) was a phase of double burden of diseases including both chronic noncommunicable diseases and the emergence of new infectious diseases.

The factors responsible for the successful control of TB in Hong Kong over the past 60 years are largely due to policy and commitment in resources by the government, contributions from non‐governmental organizations, academic institutions, public‐spirited individuals, the community and the devotion and dedication of the staff.

While Hong Kong has been successful in the control of TB and other infectious diseases, lessons have been learnt from the past. New challenges arise as a result of emergence of new infectious diseases such as HIV/AIDS, avian influenza (H5N1), and SARS. Changes in lifestyle and behaviour have added many socially related health problems. The SARS epidemic has also highlighted the problems of communication, collaboration and coordination between Hong Kong and Mainland China and among government departments in Hong Kong.

In order to be better prepared for the future, there must be continuous commitment from the government to develop an effective health care system, to give greater emphasis to health promotion and disease prevention, and to strengthen partnerships at regional and international levels, particularly in the Pearl River Delta Region, in a global effort to stop TB and other infectious diseases.