bluuebunny/crossref_metadata_2025 huggingface dataset:
Burden of allergic disease in the UK: secondary analyses of national databases
Authors: Gupta R. , Sheikh A. , Strachan D. P. , Anderson H. R.
Published: April 2004

Background
Although allergy represents an important source of patient morbidity and healthcare utilization, there is little reliable information on the overall disease burden posed by allergic conditions in the UK.

Objectives
Focusing on the following conditions: allergic rhinitis, anaphylaxis, asthma, conjunctivitis, eczema/dermatitis, food allergy and urticaria/angioedema, we sought to (i) describe the prevalence, incidence and outcomes of allergic disorders; (ii) describe the NHS healthcare burden posed by allergic disorders; (iii) estimate the costs of allergic disorders from a healthcare perspective.

Methods
Secondary analyses of data from the Health Survey for England, Scottish Health Survey, International Study of Allergies and Asthma in Childhood, European Community Respiratory Health Survey, Morbidity Statistics from General Practice 1991/1992, Royal College of General Practitioners Weekly Returns Service, Prescribing Analysis and Cost data, Hospital Episodes Statistics and national mortality data.

Results
Thirty‐nine percent of children and 30% of adults have been diagnosed with one or more atopic conditions. Six percent of general practice consultations and 0.8% of hospital admissions are for allergic diseases. Treatments for asthma and other allergic disorders currently account for 10% of primary care prescribing costs. Direct NHS costs for managing allergic problems are estimated at over one billion UK pounds per annum.

Conclusions
Allergic disorders are common throughout the UK, affecting males and females of all ages and peoples from all social classes and ethnic groups. They currently represent a substantial burden of morbidity and health service cost.
Relationship of airway symptoms from chemicals to capsaicin cough sensitivity in atopic subjects
Authors: Millqvist E. , Johansson Å. , Bende M.
Published: April 2004

Background
It is well known that some patients with allergy complain of airway symptoms from chemicals (ASCs) and strong odours. However, the importance of such information for the treatment of allergic disease is not known. Such symptoms in non‐allergic patients have previously been shown to be related to increased sensory nerve reactivity, which is expressed as increased cough sensitivity to inhaled capsaicin.

Objective
The aim of this study was to examine ASC in atopic patients and relate it to cough reaction to capsaicin inhalation.

Materials and methods
Fifty‐seven consecutively chosen, skin prick‐positive patients with symptoms of the upper and/or lower airways completed a questionnaire concerning ASC. The patients were then divided into two groups, those with and those without such symptoms. Both groups were provoked with inhaled capsaicin in three increments and compared with 73 healthy control subjects.

Results
Out of 57 atopic patients, 34 reported ASC agents and 23 did not. The patients with ASC were older (P<0.01) and coughed significantly more on capsaicin provocation (P<0.001), but did not differ from them with respect to the allergic disease or its treatment or to smoking habits. Patients with atopy but without ASC did not differ from healthy controls with regard to sensitivity to capsaicin inhalation. The scored degree of ASC was directly related to the number of coughs during the capsaicin provocation.

Conclusion
ASC in atopic patients are related to increased airway sensory nerve reactivity. There is still no explanation for this in certain patients with atopy, but age may be a confounding factor.
Potato tuber proteins efficiently inhibit human faecal proteolytic activity: implications for treatment of peri‐anal dermatitis
Authors: Ruseler‐van Embden J. G. H. , Van Lieshout L. M. C. , Smits S. A. , Van Kessel I. , Laman J. D.
Published: April 2004

Background  Frequent diarrhoea after intestinal resections and faecal incontinence in healthy infants may lead to perianal injury. A causative agent may be a high concentration of pancreatic proteases in faeces. The aim of the present study was to assess whether protease inhibitors are applicable for treating and preventing peri‐anal dermatitis by inhibiting the initial cause of the inflammation, the faecal proteases.

Design  Proteolytic activity was estimated in faeces of subjects frequently suffering from peri‐anal dermatitis: patients with intestinal resections and healthy infants. The development of perianal dermatitis was studied after the construction of a reservoir with ileoanal anastomosis. The inhibitory effect of crude and partly purified potato juice on proteolytic activity of faecal output from patients with intestinal resections and healthy infants was investigated in vitro and in vivo (skin tests).

Results  Faecal protease activity in faeces from patients with intestinal resections and healthy infants was found to be significantly higher than in healthy adults. After the construction of an ileum reservoir, 46 of 48 patients developed a protease‐related peri‐anal dermatitis. The partly purified protein fraction from potatoes inhibited the larger part of faecal proteases in vitro and completely prevented skin irritation by pancreatic proteases dissolved in sterilized faecal fluid, in a 24‐h skin test, on the back of healthy human volunteers.

Conclusions  Potato proteins contain protease inhibitors, which suppress almost the complete proteolytic activity in faeces. Topical application of potato protease inhibitors might be a novel approach in preventing protease‐induced peri‐anal dermatitis, and therapeutic studies are needed to confirm our results.
Rat duodenal IRP1 activity and iron absorption in iron deficiency and after H2O2 perfusion
Authors: Schümann K. , Brennan K. , Weiss M. , Pantopoulos K. , Hentze M. W.
Published: April 2004

Background  Iron regulatory protein 1 (IRP1), a post‐transcriptional regulator of iron metabolism, is activated in the duodenum of iron‐deficient animals, which is associated with increased iron absorption. In cell cultures IRP1 was also activated by iron‐independent signals, such as H2O2. Here we investigate whether luminal perfusion of rat duodenum with H2O2 activates duodenal IRP1 and modulates duodenal iron absorption.

Methods  Duodena from iron‐adequate Sprague‐Dawley rats were luminally perfused with H2O2. Iron regulatory protein‐1 activity was determined in duodenal mucosa or in villus and crypt preparations by an electrophoretic mobility shift assay. Duodenal 59Fe absorption was measured in isolated, perfused duodenal segments ex vivo and in ligated loops in vivo. 59Fe uptake from the blood side was assessed after i.v. injection of 59Fe‐nitrilotriacetic acid.

Results  Similar to iron deficiency, the perfusion with 0–50 mM of H2O2 increases duodenal IRP1 activity along the entire crypt villus‐axis in a dose‐dependent manner. After H2O2 treatment, IRP1 remains activated for 12–24 h in the tips and for 72 h in the crypts. In iron‐deficiency, IRP activation correlates with increased 59Fe absorption. However, the H2O2 treatment fails to stimulate any increase in 59Fe uptake, without promoting damage of mucosal architecture or impairing glucose and water transport.

Conclusion  Duodenal 59Fe uptake is not affected by the H2O2‐mediated activation of IRP1.
Identification of Enterococcci isolated from canals of root filled teeth with periapical lesions and their antimicrobial susceptibility to different antibiotics
Authors: Pinheiro E. T. , Gomes B. P. F. A. , Drucker D. B.
Published: April 2004

Aim  The objective of the present study was to investigate the occurrence of Enterococcus spp. in root filled teeth with periapical lesions and the in vitro antimicrobial susceptibility of the isolates.

Methodology  Sixty teeth with failed root canal treatment were included in the study. During nonsurgical endodontic retreatment, the root filling material was removed and the canals were sampled and microbiologically examined. Enterococcus ssp. isolates were tested for their antibiotic susceptibilities using the E‐test system (AB BIODISK, Solna, Sweden). The following antibiotics were used: benzylpenicillin, amoxicillin, amoxicillin‐clavulanic acid, erythromycin, azithromycin, vancomycin, chloramphenicol, tetracycline, doxycycline, ciprofloxacin and moxifloxacin. The strains were also tested for β‐lactamase production with nitrocefin (Oxoid, Hampshire, England).

Results  Microorganisms were recovered from 51 of 60 teeth. Enterococcus faecalis was recovered from 27 of the 51 canals with bacteria, 18 times in pure culture. All strains were susceptible to penicillins; however, the MICs of amoxicillin and amoxicillin‐clavulanic acid (MIC90 = 0.75 µg mL−1) were lower than that for benzylpenicillin (MIC90 = 3.0 µg mL−1). All strains studied were also susceptible to vancomycin and moxifloxacin, while 95.2% were susceptible to chloramphenicol. Among the isolates, 85.7% were susceptible to tetracycline and doxycycline, and 80.9% to ciprofloxacin. The MIC of erythromycin ranged from 0.38 to >256 µg mL−1; only 28.5% of the strains were susceptible (MIC ≤ 0.5 µg mL−1). Limited susceptibility was also observed with azithromycin, which was active against only 14.2% of isolates. No strains produced β‐lactamase.

Conclusions  Enterococcus faecalis was present in a large number of canals in teeth with failed root fillings and were completely susceptible, in vitro, to amoxicillin, amoxicillin‐clavulanic acid, vancomycin and moxifloxacin. Most isolates were susceptible to chloramphenicol, tetracycline, doxycycline or ciprofloxacin. Erythromycin and azithromycin were least effective. (Supported by the Brazilian agencies FAPESP 00/13686‐8, 00/13689‐7; CNPq 520277/99‐6 and CAPES BEX2449/02‐1).
Group‐specific polymerase chain reaction for DNA‐based analysis of species diversity and identity in dietary samples
Authors: Jarman S. N. , Deagle B. E. , Gales N. J.
Published: April 2004

Unique DNA sequences are present in all species and can be used as biomarkers for the detection of cells from that species. These DNA sequences can most easily be detected using the polymerase chain reaction (PCR), which allows very small quantities of target DNA sequence to be amplified even when the target is mixed with large amounts of nontarget DNA. PCR amplification of DNA markers that are present in a wide range of species has proven very useful for studies of species diversity in environmental samples. The taxonomic range of species to be identified from environmental samples may often need to be restricted to simplify downstream analyses and to ensure that less abundant sequences are amplified. Group‐specific PCR primer sets are one means of specifying the range of taxa that produce an amplicon in a PCR. We have developed a range of group‐specific PCR primers for studying the prey diversity found in predator stomach contents and scats. These primers, their design and their application to studying prey diversity and identity in predator diet are described.
Differentiation in a geographical mosaic of plants coevolving with ants: phylogeny of theLeonardoxa africanacomplex (Fabaceae: Caesalpinioideae) using amplified fragment length polymorphism markers
Authors: Brouat C. , Mckey D. , Douzery E. J. P.
Published: April 2004

Comprising four allopatric subspecies that exhibit various grades of ant–plant interactions, from diffuse to obligate and symbiotic associations, theLeonardoxa africanacomplex (Fabaceae, Caesalpinioideae) provides a good opportunity to investigate the evolutionary history of ant–plant mutualisms. A previous study of theL. africanacomplex based on chloroplast DNA noncoding sequences revealed a lack of congruence between clades suggested by morphological and plastid characters. In this study, we analysed phylogenetic relationships within theL. africanacomplex using a Bayesian probability approach on amplified fragment length polymorphism markers. The results reported permit partial validation of the four subspecies ofL. africanapreviously defined by morphological and ecological markers. Incongruences between phylogenies based on chloroplast DNA and amplified fragment length polymorphism markers are discussed in the light of morphological and ecological data, and confronted with hypotheses of convergence, lineage sorting and introgression.
Long‐distance seed dispersal in a metapopulation ofBanksia hookerianainferred from a population allocation analysis of amplified fragment length polymorphism data
Authors: He Tianhua , Krauss Siegfried L. , Lamont Byron B. , Miller Ben P. , Enright Neal J.
Published: April 2004

There is currently a poor understanding of the nature and extent of long‐distance seed dispersal, largely due to the inherent difficulty of detection. New statistical approaches and molecular markers offer the potential to accurately address this issue. A log‐likelihood population allocation test (aflpop) was applied to a plant metapopulation to characterize interpopulation seed dispersal.Banksia hookerianais a fire‐killed shrub, restricted to sandy dune crests in fire‐prone shrublands of the Eneabba sandplain, southwest Australia. Population genetic variation was assessed for 221 individuals sampled from 21 adjacent dune‐crest populations ofB. hookerianausing amplified fragment length polymorphism. Genetic diversity was high, with 175 of 183 (96%) amplified fragment length polymorphism markers polymorphic. Of the total genetic diversity, 8% was partitioned among populations byamovaandFST. There was no relationship between genetic diversity within populations and population demographic parameters such as population size and sample size. A population allocation test on these data unambiguously assigned 177 of 221 (80.1%) individuals to a single population. Of these, 171 (77.4% of total) were assigned to the population from which they were sampled and 6 (2.7% of total) were assigned to a known population other than the one from which they were sampled. A further 9 (4.1% of total) were assigned to outside the sampled metapopulation area, and 35 individuals (15.8%) could not be assigned unambiguously to any particular population. These results suggest that both the extent [15 of 221 (6.8%) individuals originating from a population other than the one in which they occur] and distance (1.6 to > 2.5 km), of seed dispersal between dune‐crest populations is greater than expected from previous studies. The extent of long‐distance interpopulation seed dispersal observed provides a basis for explaining the survival of populations of the fire‐killedB. hookerianain a landscape experiencing frequent fire, where local extinctions and recolonizations may be a regular occurrence.
Comparison of different nuclear DNA markers for estimating intraspecific genetic diversity in plants
Authors: Nybom Hilde
Published: April 2004

A compilation was made of 307 studies using nuclear DNA markers for evaluating among‐ and within‐population diversity in wild angiosperms and gymnosperms. Estimates derived by the dominantly inherited markers (RAPD, AFLP, ISSR) are very similar and may be directly comparable. STMS analysis yields almost three times higher values for within‐population diversity whereas among‐population diversity estimates are similar to those derived by the dominantly inherited markers. Number of sampled plants per population and number of scored microsatellite DNA alleles are correlated with some of the population genetics parameters. In addition, maximum geographical distance between sampled populations has a strong positive effect on among‐population diversity. As previously verified with allozyme data, RAPD‐ and STMS‐based analyses show that long‐lived, outcrossing, late successional taxa retain most of their genetic variability within populations. By contrast, annual, selfing and/or early successional taxa allocate most of the genetic variability among populations. Estimates for among‐ and within‐population diversity, respectively, were negatively correlated. The only major discrepancy between allozymes and STMS on the one hand, and RAPD on the other hand, concerns geographical range; within‐population diversity was strongly affected when the former methods were used but not so in the RAPD‐based studies. Direct comparisons between the different methods, when applied to the same plant material, indicate large similarities between the dominant markers and somewhat lower similarity with the STMS‐based data, presumably due to insufficient number of analysed microsatellite DNA loci in many studies.
Temporal and spatial genetic structure in Vitellaria paradoxa (shea tree) in an agroforestry system in southern Mali
Authors: Allaye Kelly Bokary , Hardy Olivier , Bouvet Jean‐Marc
Published: April 2004

Ten microsatellite loci were used to investigate the impact of human activity on the spatial and temporal genetic structure of Vitellaria paradoxa (Sapotaceae), a parkland tree species in agroforestry systems in southern Mali. Two stands (forest and fallow) and three cohorts (adults, juveniles and natural regeneration) in each stand were studied to: (i) compare their levels of genetic diversity (gene diversity, HE; allelic richness, Rs; and inbreeding, FIS); (ii) assess their genetic differentiation (FST); and (iii) compare their levels of spatial genetic structuring. Gene diversity parameters did not vary substantially among stands or cohorts, and tests for bottleneck events were nonsignificant. The inbreeding coefficients were not significantly different from zero in most cases (FIS = −0.025 in forest and 0.045 in fallow), suggesting that the species is probably outbreeding. There was a weak decrease in FIS with age, suggesting inbreeding depression. Differentiation of stands within each cohort was weak (FST = 0.026, 0.0005, 0.010 for adults, juveniles and regeneration, respectively), suggesting extensive gene flow. Cohorts within each stand were little differentiated (FST = −0.001 and 0.001 in forest and fallow, respectively). The spatial genetic structure was more pronounced in fallow than in forest where adults showed no spatial structuring. In conclusion, despite the huge influence of human activity on the life cycle of Vitellaria paradoxa growing in parkland systems, the impact on the pattern of genetic variation at microsatellite loci appears rather limited, possibly due to the buffering effect of extensive gene flow between unmanaged and managed populations.
No apparent reduction of gene flow in a hybrid zone between the West and North European karyotypic groups of the common shrew, Sorex araneus
Authors: Andersson A.‐C. , Narain Y. , Tegelström H. , Fredga K.
Published: April 2004

The common shrew, Sorex araneus, exhibits an unusually high level of karyotypic variation. Populations with identical or similar karyotypes are defined as chromosome races, which are, in turn, grouped into larger evolutionary units, karyotypic groups. Using six microsatellite markers, we investigated the genetic structure of a hybrid zone between the Sidensjö and Abisko chromosome races, representatives of two distinct karyotypic groups believed to have been separated during the last glacial maximum, the West European karyotypic group (western group) and the North European karyotypic group (northern group), respectively. Significant FST values among populations suggest some weak genetic structure. All hierarchical levels show similar levels of genetic differentiation, equivalent to levels of genetic structure in several intraracial studies of common shrew populations from central Europe. Notably, genetic differentiation was of the same order of magnitude between and within karyotypic groups. Although the genetic differentiation was weak, the correlation between genetic and geographical distance was positive and significant, suggesting that the genetic variation observed between populations is a function of geographical distance rather than racial origin. Hence, considerable chromosomal differences do not seem to prevent extensive gene flow.
Genetic diversity andWolbachiainfection of theDrosophilaparasitoidLeptopilina clavipesin western Europe
Authors: Pannebakker Bart A. , Zwaan Bas J. , Beukeboom Leo W. , Van Alphen Jacques J. M.
Published: April 2004

Wolbachiaare maternally transmitted bacteria that alter their arthropod hosts’ reproduction in various ways, including parthenogenesis induction (PI).Wolbachia‐induced parthenogenesis can have drastic effects on the genetic structure of its host because it potentially reduces populations to clones without genetic exchange. However,Wolbachia‐induced parthenogenesis does not inevitably result in a reduction of genetic variation of infected populations vs. uninfected populations, because the parthenogenetic populations are initially derived from uninfected populations and can thus show similar genetic variation. Here we investigate these issues in infected and uninfected populations of theDrosophilaparasitoidLeptopilina clavipesin western Europe. Wasps from 19 sites in the Netherlands, France and northern Spain were screened forWolbachiaand analysed using amplified fragment length polymorphism (AFLP) markers. All the populations from the Netherlands and mid‐France were infected with the same two strains ofWolbachia, whereas populations from the Pyrenees were not infected. The infected and uninfected populations show identical levels of genetic variation, but have clearly diverged genetically, indicating the presence of a barrier that prevents gene flow. Within the infected wasps two distinct genotypes were found at multiple localities, indicating the coexistence of multiple clones. The conditions promoting clonal coexistence inL. clavipesare discussed.
Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV‐infected mothers
Authors: Poggensee Gabriele , Schulze Katja , Moneta Ilaria , Mbezi Paulina , Baryomunsi Chris , Harms Gundel
Published: April 2004

Current infant feeding guidelines of UNICEF/UNAIDS/WHO for HIV‐infected women recommend the avoidance of breastfeeding or to breastfeed exclusively. In the context of a prevention of HIV mother‐to‐child transmission programme we assessed the feeding practices in peripheral areas of Tanzania and Uganda. A total of 237 mothers in south‐western Tanzania and 424 mothers in western Uganda attending urban and rural antenatal care services as well as village women were interviewed with regard to duration of breastfeeding, time of introduction of additional nutrients and type of solid and liquid nutrients. The average reported duration of breastfeeding was 24 months in Tanzania but 18 months in Uganda (P < 0.001). Solid nutrients were added on average at month 6 in both areas while liquids were given significantly earlier in Tanzania (month 4) than in Uganda (month 5; P < 0.001). A total of 19% and 48% of the study participants, respectively, stated to breastfeed their infants exclusively at the age of 4 months in Tanzania and Uganda. Age between 26 and 35 years, urban residence and ethnic group were the risk factors for earlier introduction of nutrients in Uganda. In Tanzania, solid maize porridge was the most frequent (94%) and often single nutrient given during breastfeeding, while in Uganda combinations of nutrients such as bananas, millet and beans were used. Milk was the most frequently added fluid in Uganda whereas in Tanzania various liquids such as liquid maize porridge, milk, juice or water were used. Feeding practices differed considerably in the two countries. According to the interviewees, exclusive breastfeeding was rarely practiced in Tanzania. Our findings underline the necessity to promote exclusive breastfeeding if infant feeding recommendations are to be realized and emphasize the need to assess the local situation in order to ensure that locally appropriate information and recommendations are given to the target groups.
Spatial and temporal analysis of the distribution of hantavirus pulmonary syndrome in Buenos Aires Province, and its relation to rodent distribution, agricultural and demographic variables
Authors: Busch M. , Cavia R. , Carbajo A. E. , Bellomo C. , Gonzalez Capria S. , Padula P.
Published: April 2004

We studied the spatial and temporal distribution of Hantavirus Pulmonary Syndrome (HPS) cases from 1998 to 2001 in the Buenos Aires Province, Argentina. HPS is a severe viral disease whose natural reservoir are rodents of the subfamily Sigmodontinae (Muridae) and which occurs in many countries of South and North America. We considered two spatial arrangements: cells of 18.5 × 18.5 km2; and departments, the political subdivisions of the province, as spatial units. We tested the departure from a Poisson distribution of the number of cases per cell and per month with the Variance/Mean index, while the interaction between spatial and temporal clustering was tested by means of the Knox and Mantel tests. We constructed probability maps in which the HPS rates per department were considered Poisson variates according to population, area and the product of population and area. We analysed the relation between rodent distribution, environmental and demographic variables and HPS cases conducting preliminary univariate analysis from which we selected variables to enter in general linearized models. We found that both the spatial and temporal distribution of cases is strongly aggregated. The spatiotemporal interaction appears to be related to a strong seasonality and the existence of particular ecological conditions rather than epidemic transmission of the disease. The main explanatory variables for the distribution of HPS cases among the departments of the Buenos Aires Province were human population, the distribution of the rodent Oxymycterus rufus and evapotranspiration. The last two variables are probably indicators of favourable ecological conditions for the reservoirs, which encompass other variables not taken into account in this study.
Maternal anaemia and its impact on perinatal outcome
Authors: Lone Farah Wali , Qureshi Rahat Najam , Emanuel Faran
Published: April 2004

Objective  To find out the relationship between maternal anaemia and perinatal morbidity and mortality.

Method  A cohort of 629 pregnant women was studied from October 2001 to October 2002. Of these, 313 were anaemic (haemoglobin <11 g/dl in labour and on two previous occasions in current pregnancy). A total of 316 women had haemoglobin >11 g/dl at all times in pregnancy and were labelled as non‐anaemic. Perinatal outcomes included preterm delivery, low birth weight (LBW) at delivery, intrauterine growth restriction, perinatal mortality, APGAR score at 1 and 5 min, intrauterine foetal demise (IUD).

Results  The risk of preterm delivery and LBW among exposed group was 4 and 1.9 times higher among anaemic women, respectively. Newborns of anaemic mothers had 1.8 times increased risk of having an APGAR score of <5 at 1 min and the risk of IUD was 3.7 times higher for anaemic women.

Conclusion  Low maternal haemoglobin levels are associated with increased risk of preterm delivery, LBW babies, APGAR score <5 at 1 min and IUD.
A Mutant Impaired in SNARE Complex Dissociation Identifies the Plasma Membrane as First Target of Synaptobrevin 2
Authors: Martinez‐Arca Sonia , Arold Stefan , Rudge Rachel , Laroche Fabrice , Galli Thierry
Published: April 2004

Membrane fusion depends on the formation of a complex of four SNARE motifs, three that bear a central glutamine and are localized in the target membrane (t‐SNARE) and one that bears an arginine and is localized in the donor vesicle (v‐SNARE). We have characterized the arginine 56 to proline mutant (R56P) of synaptobrevin‐2 (Sb). SbR56P was blocked at the plasma membrane in association with the endogenous plasma membrane t‐SNARE due to an inhibition of SNARE complex dissociation, suggesting that the plasma membrane is its first target. Cell surface blockade of SbR56P could be rescued by coexpression of synaptophysin, a partner of Sb. Sb was blocked at the plasma membrane but SNARE complexes were unaffected in cells expressing defective dynamin, indicating that the phenotype of SbR56P was not due to an internalization defect. When expressed in neurons, SbR56P localized both to axonal and dendritic plasma membranes, showing that both domains are initial targets of Sb. The R56P mutation affects a highly conserved position in v‐SNAREs, and might thus provide a general tool for identifying their first target membranes.
Predicting Function from Structure: 3D Structure Studies of the Mammalian Golgi Complex
Authors: Mogelsvang Soren , Marsh Brad J. , Ladinsky Mark S. , Howell Kathryn E.
Published: April 2004

3D electron tomography studies of the structure of the mammalian Golgi complex have led to four functional predictions (1). The sorting and exit site from the Golgi comprises two or three distinct trans‐cisternae (2). The docking of vesicular–tubular clusters at the cis‐face and the fragmentation of trans‐cisternae are coordinated (3). The mechanisms of transport through, and exit from, the Golgi vary with physiological state, and in different cells and tissues (4). Specialized trans‐ER functions in the delivery of ceramide to sphingomyelin synthase in the trans‐Golgi membrane, for the regulated sorting via sphingolipid‐cholesterol‐rich domains. These structure‐based predictions can now be tested using a variety of powerful cell and molecular tools.
Propranolol alone may not be acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients: Randomized controlled trial
Authors: TOMIKAWA MORIMASA , SHIMABUKURO RINSHUN , OKITA KEISHI , TSUTSUMI NORIFUMI , AKAHOSHI TOMOHIKO , HASHIZUME MAKOTO , SUGIMACHI KEIZO
Published: April 2004

Background and Aim:  In Japan, endoscopic injection sclerotherapy (EIS) is widely used to prevent first esophageal variceal bleeding, in contrast to pharmacological therapy which is the main treatment used in the rest of the world. The present study investigated if propranolol alone is acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients. This was compared with EIS.

Methods:  Twenty‐five Japanese cirrhotic patients with endoscopically proven, likely to bleed esophageal varices were randomly assigned for propranolol administration (12 patients; group A) and EIS (13 patients; group B) to prevent first esophageal variceal bleeding. Complications, non‐recurrence rate, bleeding rate and probability of survival were compared between the two groups.

Results:  One patient in group A had severe bradycardia with loss of consciousness that seriously worsened his quality of life. The cumulative non‐recurrence rate of group A was significantly lower compared with that of group B (P < 0.05). In group A, 2 of the 12 patients requested to discontinue taking propranolol and were excluded from the trial. The EIS treatment (group B) showed excellent results. No patient in group A or group B bled from esophageal varices throughout this study. The two groups showed no statistically significant differences in probability of survival.

Conclusions:  Propranolol alone may not be acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients.
Increased expression of transforming growth factor‐alpha and epidermal growth factor receptors in rat chronic reflux esophagitis
Authors: FUJIWARA YASUHIRO , HIGUCHI KAZUHIDE , HAMAGUCHI MASAKI , TAKASHIMA TAKASHI , WATANABE TOSHIO , TOMINAGA KAZUNARI , OSHITANI NOBUHIDE , MATSUMOTO TAKAYUKI , ARAKAWA TETSUO
Published: April 2004

Background and Aim:  Transforming growth factor‐alpha (TGF‐α), which binds to epidermal growth factor receptors (EGF‐R), stimulates esophageal epithelial cell proliferation, enabling rapid repair after mucosal injury. The aim of the present study was to examine epithelial proliferation and dynamics of TGF‐α and EGF‐R gene and protein expression in rat chronic acid reflux esophagitis.

Methods:  Gastric acid reflux esophagitis was induced in Wistar rats by ligating the transitional region between the forestomach and the glandular portion, and by covering the duodenum near the pyloric ring with a small piece of an 18Fr Nélaton catheter. Epithelial cell proliferation was assessed by bromodeoxyuridine (BrdU) uptake. Expression of TGF‐α and EGF‐R mRNA and protein was assessed by reverse transcription‐polymerase chain reaction (RT‐PCR) and immunohistochemistry.

Results:  Esophageal lesions were observed in the lower and middle esophagus. Histologically, a significant increase in mucosal thickening with elongation of lamina propria papillae and basal cell hyperplasia was observed. The BrdU labeling index was significantly increased from 2.7 ± 1.0 in normal mucosa and 2.8 ± 1.2 in background mucosa adjacent to the esophageal lesion, to 60.3 ± 32.7 in the lesions of chronic esophagitis. Expression of TGF‐α and EGF‐R mRNA in the esophageal lesion significantly increased compared to those in the control and background tissue, whereas treatment with rabeprazole significantly inhibited increases in TGF‐α and EGF‐R mRNA expression. According to immunohistochemical study, TGF‐α and EGF‐R revealed strong expression in esophageal lesions compared with control and background mucosa. The superficial layer of the esophagus was strongly positive for TGF‐α and most cells in regions of basal hyperplasia had a positive reaction for EGF‐R in the esophagitis lesion.

Conclusion:  Epithelial proliferation and expression of TGF‐α and EGF‐R were significantly increased in rat chronic reflux esophagitis. Activation of TGF‐α and EGF‐R genes in response to acid reflux may facilitate rapid mucosal healing by stimulating epithelial proliferation. These results suggest that TGF‐α and EGF‐R play crucial roles in rat chronic reflux esophagitis.
Evaluation of esophageal varices using contrast‐enhanced coded harmonic ultrasonography
Authors: TAMANO MASAYA , YONEDA MASASHI , KOJIMA KAZUO , HASHIMOTO TAKASHI , MUROHISA TOSHIMITSU , MAJIMA YUICHI , KUSANO KOJI , NAKAMURA TETSUYA , SUGAYA HITOSHI , TERANO AKIRA
Published: April 2004

Aim:  To investigate if esophageal varices can be evaluated using external contrast‐enhanced ultrasonography with Levovist and coded harmonic angio (CHA).

Methods:  Subjects were six healthy adult volunteers and 23 patients with liver cirrhosis. After identification of the lower esophagus under B‐mode scanning, 300 mg/mL of Levovist was intravenously injected into the cubital vein at a rate of 1 mL/s under observation by CHA‐mode scanning. Approximately 30 s after intravenous administration, interval‐delay scanning was performed every second to visualize the area around the lower esophageal lumen. The degree of ultrasonographic enhancement was assessed as either no enhancement (negative); linear enhancement along the esophageal wall (weak) or full enhancement of the esophageal lumen (strong). Endoscopic evaluation of esophageal varices was also performed.

Results:  The CHA enhancement around the lower esophageal lumen was identified in 21 of the 23 patients. Of these 21 patients, endoscopic assessments of varices were as follows: F0 in four patients, F1 in seven patients, F2 in three patients, and F3 in seven patients. Nine patients were red color sign (RCS)‐positive. Regarding the relationship between ultrasonographic enhancement and endoscopic assessment, enhancement was identified as negative in all four F0 patients, negative in three and weak in three and strong in one of the seven F1 patients, weak in one and strong in two of the three F2 patients, and weak in two and strong in five of the seven F3 patients, respectively. Furthermore, of the nine RCS‐positive patients, enhancement was recognized as strong in seven and weak in two patients. Ultrasonographic enhancement was identified as negative in all six healthy volunteers.

Conclusions:  By performing contrast‐enhanced CHA ultrasonography using Levovist, ultrasonographic enhancement was detectable in all patients with varices categorized as F2 or above. Because the present method is easy to perform and causes less pain to patients compared to endoscopy, it is useful for following and assessing esophageal varices in patients with liver cirrhosis.
Correlation between plasma levels of matrix metalloproteinase (MMP)‐9 /MMP‐2 ratio and α‐fetoproteins in chronic hepatitis carrying hepatitis B virus
Authors: CHUNG TAE‐WOOK , KIM JEONG‐RAN , SUH JEONG‐IL , LEE YOUNG‐CHOON , CHANG YOUNG‐CHAE , CHUNG TAI HO , KIM CHEORL‐HO
Published: April 2004

Background:  Matrix metalloproteases (MMP) and α‐fetoproteins (AFP) are involved in hepatitis B virus (HBV)‐induced chronic hepatitis. In the present study, we have determined the correlation between the MMP‐9/MMP‐9 ratio and AFP levels in the serum of patients during chronic viral B hepatitis.

Methods:  Twenty‐eight healthy individuals (18 men and 10 women) with a mean age of 36.3 years (range 23–58 years) and 50 patients (42 men, 8 women) with a mean age of 39.7 years (range 22–61 years) participated in the study. Forty‐eight participants had HBV and the remaining two were either hepatitis G virus (HGV) or hepatitis C virus (HCV) carriers. Values of patients were compared with those obtained from 12 blood donor controls (5 men, 7 women), mean age 36 years (range 21–46 years). Patient's sera were subjected to examination of hepatitis B surface (HBs) and hepatitis B early (Hbe) antigen, SGOT, SGPT, AFP, MMP‐2 and MMP‐9. Serum levels of MMP‐2 and MMP‐9 activities were measured by a zymogram protease assay and densitometric measurement. The ratios of MMP‐9 to MMP‐2 were calculated by dividing the densitometric results.

Results:  Compared with the healthy controls, the mean serum concentrations of MMP‐2 were slightly increased in the chronic HBV patients. In contrast, compared with the healthy controls, the mean serum concentrations of MMP‐9 were significantly increased in the chronic HBV patients. When the ratios of the MMP‐9/MMP‐2 and amounts of the serum AFP were compared, a specific correlation between these two parameters was observed. Higher amounts of AFP were detected in the patients with a low ratio of MMP‐9/MMP‐2. Patients with hepatocellular carcinoma (HCC) and cirrhosis showed relatively low MMP‐9/MMP‐2 ratios in chronic hepatitis B. In addition, AFP levels of HCC and cirrhosis were higher than in chronic HBV patients.

Conclusions:  These results indicate that the AFP level and ratio of MMP‐9 and MMP‐2 is highly correlated in chronic HBV‐induced hepatitis. Because the serum MMP activities were significantly varied between each stage of AFP production in liver disease, an individual profile of these parameters might serve as an easy accessing serum marker to monitor the progression of liver disease.
Dancing on a razor's edge: systemic group work with batterers
Authors: Rivett Mark , Rees Alyson
Published: April 2004

This paper describes a systemic approach to working with domestic violence which does not focus upon couple therapy but rather adapts the Duluth ‘co‐ordinated community response’ model. It proposes that this model may be understood from a systemic perspective by drawing upon the ‘levels of context’ ideas prevalent within systemic therapy. The paper then demonstrates the practice of group work with men who are violent to their partners from this systemic perspective. The group work undertaken with these men may be understood as ‘systemic’ from a number of viewpoints. These include constructing the work within a systemic context, retaining a systemic perspective in the work, and adapting various systemic methods in the group work itself. In describing this approach to work with men who have abused their women partners, the authors hope to contribute to the domestic violence literature, to the understanding of group work methods within systemic work, and to the knowledge of practitioners who need to engage and work with abusive men.
Hidden Child Workers: Young Carers in Zimbabwe
Authors: Robson Elsbeth
Published: April 2004

Drawing on an interview‐based case study of young people caring for dependent adult members of their households in Harare, this paper connects the experiences of young carers in Zimbabwe to global forces—namely the HIV/AIDS pandemic and economic liberalisation. It is argued, firstly, that care‐giving by young people is a largely hidden and unappreciated aspect of national economies which is growing as an outcome of conservative macroeconomic policies and the HIV/AIDS explosion. Secondly, that young people have a right to recognition of their work as work. Thirdly, while acknowledging that conceptualising childhood is problematic, there needs to be less emphasis on northern myths of childhood as a time of play and innocence and more attention on defending children's rights to work as well as to be supported in their work under appropriate circumstances. The articulation between global processes and the localised experiences of individual children as providers of care within the home contributes to efforts to re‐introduce social reproduction as an important (but often missing) aspect of debates around globalisation. In addition, this article adds to the growing literature on the geographies of childhood while tackling the imbalance within that literature, whereby working young people and those of the global South are relatively neglected. Suggestions are offered in the conclusions for policy recommendations to recognise and support young carers in Africa, while calling for further research.
Below‐ground process responses to elevated CO2 and temperature: a discussion of observations, measurement methods, and models
Authors: Pendall Elise , Bridgham Scott , Hanson Paul J. , Hungate Bruce , Kicklighter David W. , Johnson Dale W. , Law Beverly E. , Luo Yiqi , Megonigal J. Patrick , Olsrud Maria , Ryan Michael G. , Wan Shiqiang
Published: April 2004

Rising atmospheric CO2 and temperatures are probably altering ecosystem carbon cycling, causing both positive and negative feedbacks to climate. Below‐ground processes play a key role in the global carbon (C) cycle because they regulate storage of large quantities of C, and are potentially very sensitive to direct and indirect effects of elevated CO2 and temperature. Soil organic matter pools, roots and associated rhizosphere organisms all have distinct responses to environmental change drivers, although availability of C substrates will regulate all the responses. Elevated CO2 increases C supply below‐ground, whereas warming is likely to increase respiration and decomposition rates, leading to speculation that these effects will moderate one another. However, indirect effects on soil moisture availability and nutrient supply may alter processes in unexpected directions. Detailed, mechanistic understanding and modelling of below‐ground flux components, pool sizes and turnover rates is needed to adequately predict long‐term, net C storage in ecosystems. In this synthesis, we discuss the current status of below‐ground responses to elevated CO2 and temperature and potential feedback effects, methodological challenges, and approaches to integrating models and measurements.
Responses of spring phenology to climate change
Authors: Badeck Franz‐W. , Bondeau Alberte , Böttcher Kristin , Doktor Daniel , Lucht Wolfgang , Schaber Jörg , Sitch Stephen
Published: April 2004

Climate change effects on seasonal activity in terrestrial ecosystems are significant and well documented, especially in the middle and higher latitudes. Temperature is a main driver of many plant developmental processes, and in many cases higher temperatures have been shown to speed up plant development and lead to earlier switching to the next ontogenetic stage. Qualitatively consistent advancement of vegetation activity in spring has been documented using three independent methods, based on ground observations, remote sensing, and analysis of the atmospheric CO2 signal. However, estimates of the trends for advancement obtained using the same method differ substantially. We propose that a high fraction of this uncertainty is related to the time frame analysed and changes in trends at decadal time scales. Furthermore, the correlation between estimates of the initiation of spring activity derived from ground observations and remote sensing at interannual time scales is often weak. We propose that this is caused by qualitative differences in the traits observed using the two methods, as well as the mixture of different ecosystems and species within the satellite scenes.
Almotriptan Improves Response Rates When Treatment Is Within 1 Hour of Migraine Onset
Authors: Dowson A. J. , Massiou H. , Lainez J. M. , Cabarrocas X.
Published: April 2004

Background.—Results from open‐label trials with almotriptan and sumatriptan have shown higher response rates when treatment was initiated early after acute migraine onset.

Objective.—To investigate the temporal component of early intervention by measuring 2‐hour pain‐free and sustained pain‐free responses to almotriptan and sumatriptan when the study drug was taken within 1 hour of onset of moderate to severe pain.

Methods.—This was a post hoc analysis from a double‐blind, randomized, placebo‐controlled trial of almotriptan and sumatriptan. Men and women, 18 to 65 years of age, who met International Headache Society criteria for migraine with or without aura were eligible. Patients were randomized to receive a single oral dose of almotriptan 12.5 or 25 mg, sumatriptan 100 mg, or placebo at the onset of a severe or moderate migraine attack. For this post hoc analysis, the almotriptan 25‐mg dose was excluded because 12.5 mg is the recommended dose. The primary efficacy assessment was sustained pain‐free, defined as pain‐free at 2 hours postdose with no recurrence from 2 to 24 hours and no use of rescue medication. Only patients who took study medication within 1 hour of migraine onset were included in the analysis.

Results.—Of the 475 patients involved in the original study, 253 (53.3%) initiated treatment within the 0‐ to 1‐hour interval. For these patients, 2‐hour pain‐free rates were 37.9% for almotriptan 12.5 mg (P= .016 versus placebo), 35.7% for sumatriptan 100 mg (P= .028 versus placebo), and 18.9% for placebo. Only almotriptan was significantly higher than placebo on the sustained pain‐free rate—34.7% (P= .022 versus placebo); the sustained pain‐free rate for sumatriptan was 29.6% and for placebo, 17.0%.

Conclusion.—Initiation of treatment with almotriptan 12.5 mg within the first hour after acute migraine onset resulted in a significantly higher sustained pain‐free response compared with placebo. There was no significant difference in sustained pain‐free rates between sumatriptan and placebo. These results are consistent with those from a previous open‐label trial, and suggest that early intervention with almotriptan can improve clinical outcome.