bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of insulin and thiazolidinedione therapy in massively obese patients with Type 2 diabetes
Authors: Buch H. N. , Baskar V. , Barton D. M. , Kamalakannan D. , Akarca C. , Singh B. M.
Published: March 2003

Aims To evaluate the influence of addition of rosiglitazone to insulin therapy over a 24‐week period in massively obese patients with poorly controlled Type 2 diabetes taking large doses of insulin.

Methods Eight massively obese patients (median body mass index (BMI) 42 kg/m2) with Type 2 diabetes who were on large doses of insulin (median daily dose of 204 U) and/or had poor glycaemic control (median HbA1c of 8.1% (upper limit for normal 5.5%)) were treated over a 24‐week period with the combination of insulin and maximum doses of rosiglitazone. Outcomes monitored were changes in weight, BMI, HbA1c, dose of insulin and development of side‐effects.

Results At the end of 24 weeks there was a median weight gain of 3 kg (P < 0.01), a fall in median HbA1c from 8.1% to 6.7% (16% reduction from baseline) (P < 0.01) and a reduction in median insulin dose from 204 U/day to 159 U/day (P < 0.01) (23% reduction from baseline). Peripheral oedema was the only significant side‐effect and was seen in five patients.

Conclusions Combination of insulin and rosiglitazone is effective in massively obese patients with Type 2 diabetes, though there is a high incidence of peripheral oedema.
Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes
Authors: Anderson B. J. , Vangsness L. , Connell A. , Butler D. , Goebel‐Fabbri A. , Laffel L. M. B.
Published: March 2003

Aims Behavioural support around diabetes management tasks is linked to glycaemic outcomes. In this study we investigated the relationship between diabetes‐related parental behaviours (conflict around and involvement in treatment tasks), adherence to blood glucose monitoring (BGM), and glycaemic control in youth with short duration Type 1 diabetes mellitus (DM).

Methods In a cross‐sectional study, 104 youth (aged 8–17 years, duration of Type 1 DM 0.5–6 years) along with a parent, completed the Diabetes Conflict Scale. Parental involvement in management tasks was assessed with structured interviews and the Diabetes Family Responsibility Questionnaire. Adherence to BGM was evaluated by family report and by independent clinician rating. Glycaemic control was assessed with glycosylated haemoglobin (HbA1c) (ref. range, 4–6%).

Results Children (8–12 years; n = 69) and adolescents (13–17 years; n = 35), respectively, had similar durations of diabetes (x ± sd; 2.7 ± 1.69, 2.4 ± 1.32 years) and similar glycaemic control (8.3 ± 1.1%, 8.4 ± 1.1%). In both age groups, parental involvement was a significant predictor of adherence to BGM (P = 0.01). Multivariate analyses, controlling for age, sex, disease duration, and BGM adherence, revealed that higher diabetes conflict significantly related to poorer glycaemic control (HbA1c) (R2 = 0.17; P < 0.01).

Conclusions These findings indicate that in this cohort, early in the course of diabetes, diabetes‐specific conflict and adherence to BGM became strongly linked to the child's glycaemic control. This suggests that to insure optimal control, it may be beneficial to introduce targeted interventions to build positive family involvement and interaction around diabetes tasks early in the disease course, before negative behaviours become established.

Diabet. Med. 19, 635–642 (2002)
European comparison of costs and quality in the prevention of secondary complications in Type 2 diabetes mellitus (2000–2001)
Authors: Gandjour A. , Kleinschmit F. , Lauterbach K. W. ,   the INTERCARE International Investigators
Published: March 2003

Aims To compare the out‐patient costs and process quality of preventing secondary complications in patients with Type 2 diabetes mellitus in France, Germany, Italy, The Netherlands, Sweden, Switzerland, and the UK.

Methods A total of 188 European physician practices assessed annual services for one hypothetical average patient (cost evaluation) and 178 practices reported retrospective data on one or two real patients (quality evaluation) in 2000/2001. In countries with a detailed fee‐for‐service schedule (Germany, Italy, and Switzerland) reimbursement fees were used to approximate costs. These fee‐for‐service schedules were also used to develop index (average) fees for all countries, in order to measure resource utilization. The following process quality indicators were evaluated: control of HbA1c; control of lipids; urine test for (micro)albuminuria; control of blood pressure; foot examination; neurological examination; eye examination; and patient education. For each country an average quality rating was calculated by weighting the response to each quality indicator with the level of scientific evidence.

Results Average quality ratings ranged from 0.40 in The Netherlands to 0.62 in the UK (0 = lowest rating; 1 = highest rating). Total annual costs for secondary prevention were higher in Switzerland than in Germany and Italy (EUR475, EUR381, and EUR283, respectively). Resource utilization was highest in Germany and lowest in the UK.

Conclusions The overall quality of preventive services documented was found to be poor in the seven European countries studied. The UK rated as both the most effective and the most efficient country in providing secondary prevention in Type 2 diabetes.
Nitric oxide and vascular endothelial growth factor concentrations are increased but not related in vitreous fluid of patients with proliferative diabetic retinopathy
Authors: Hernández C. , Lecube A. , Segura R. M. , Sararols L. , Simó R.
Published: March 2003

Aims Several reports have implicated nitric oxide (NO) in the angiogenic process. The assessment of NO stable end products, nitrite and nitrate (NOx), is commonly used as a measure of NO production in biological fluids. The aims of the study were to investigate NOx concentrations in the vitreous fluid of patients with proliferative diabetic retinopathy (PDR) and to evaluate the relationship between NOx and vascular endothelial growth factor (VEGF).

Patients and methods Serum and vitreous fluid samples were obtained simultaneously at the time of vitreoretinal surgery from 23 patients with PDR, and 17 control non‐diabetic patients with non‐proliferative ocular disease. NOx was determined by using the Griess reaction and VEGF levels were assessed by ELISA.

Results The intravitreous concentration of NOx was significantly elevated in patients with PDR in comparison with the control group (31.6 ± 2.96 µmol/l vs. 18 ± 2.46 µmol/l; P = 0.01). However, we did not detect any differences between NOx serum concentrations. We observed a correlation between serum and vitreous levels of NOx in diabetic patients (r = 0.79; P < 0.001), but not in the control group. Intravitreous levels of VEGF in patients with PDR were higher than those obtained in serum (1.42 ng/ml (0.12–7.62) vs. 0.12 ng/ml (0.03–0.42); P < 0.01). Vitreal levels of VEGF were strikingly higher in patients with PDR than in the control subjects (1.42 ng/ml (0.12–7.62) vs. 0.009 ng/ml (0.009–0.04); P < 0.001). No correlation between vitreal concentrations of NOx and VEGF was observed, either in diabetic patients or in the control group.

Conclusions NOx and VEGF are increased but not related in the vitreous fluid of diabetic patients with PDR. Our results suggest that serum diffusion could play a significant role in explaining the increase of NOx. By contrast, intraocular production seems to be the main factor responsible for the intravitreous enhancement of VEGF.

Diabet. Med. 19, 655–660 (2002)
Multifaceted support to improve clinical decision making in diabetes care: a randomized controlled trial in general practice
Authors: Frijling B. D. , Lobo C. M. , Hulscher M. E. J. L. , Akkermans R. P. , Braspenning J. C. C. , Prins A. , Van Der Wouden J. C. , Grol R. P. T. M.
Published: March 2003

Aims To evaluate the effectiveness of a multifaceted intervention to improve the clinical decision making of general practitioners (GPs) for patients with diabetes. To identify practice characteristics which predict success.

Methods Cluster randomized controlled trial with 124 practices and 185 GPs in The Netherlands. The intervention group received feedback reports and support from a facilitator; the control group received no special attention. Outcome measures were the compliance rates with evidence‐based recommendations pertaining to discussion of body weight control, discussion of problems with medication, blood pressure measurement, foot examination, eye examination, initiating anti‐diabetic medication or increasing the dosage in cases of uncontrolled blood glucose, and scheduling a follow‐up appointment.

Results The GPs reported on their clinical decision making in 1410 consultations with Type 2 diabetic patients at baseline and 1449 consultations after the intervention period. The intervention resulted in statistically significant improvement for two of the seven outcome measures: foot examination (odds ratio 1.68; 95% confidence interval 1.19–2.39) and eye examination (1.52; 1.07–2.16). Discussion of problems with medication showed a near significant trend towards increased benefit for the intervention group (1.52; 0.99–2.32). Practice characteristics were not found to be related to the success of the intervention.

Conclusions Feedback reports with support from facilitators appear to increase rates of foot examination and eye examination in general practice. Alternative interventions should be explored to improve the pursuit of metabolic control by GPs.
A time‐limited, problem‐orientated psychotherapeutic intervention in Type 1 diabetic patients with complications: a randomized controlled trial
Authors: Didjurgeit U. , Kruse J. , Schmitz N. , Stückenschneider P. , Sawicki P. T.
Published: March 2003

Aims To examine the effects of a time‐limited, problem‐orientated psychotherapeutic intervention on self‐defined psychological problems and metabolic control in Type 1 diabetic patients with microvascular complications.

Design Randomized wait‐list controlled trial with a follow‐up of 6 months.

Setting Out‐patient clinic of a university diabetes centre.

Participants Forty‐six Type 1 diabetic patients with intensified insulin therapy and presence of microvascular diabetic complications. Twenty‐four patients were randomly allocated to the intervention group and 22 patients to the control group.

Intervention Participation in a structured, problem‐orientated, time‐limited psychotherapeutic intervention (IG). The control group (CG) patients received routine diabetes care in a specialized diabetes university clinic.

Outcome measures Degree of change of three self‐defined main psychological and psychosocial problems (no. 1, no. 2 and no. 3) on a 1–10 graded scale and glycosylated haemoglobin HbA1c values.

Results Two patients (one in each group) died during the study period. All remaining patients were followed for 6 months. Problem scores were high at baseline in both groups: IG/CG (mean values, standard deviation in parentheses): problem no. 1, 7.8 (2.0)/8.3 (1.7); problem no. 2, 7.7 (2.3)/7.6 (1.8); and problem no. 3, 7.7 (2.3)/7.4 (2.6). At follow‐up, all problems were significantly lower in the intervention group (IG) when compared with the CG: IG/CG: problem no. 1, 4.3 (2.9)/6.8 (3.0), P
 
=
 0.03; problem no. 2, 3.9 (2.4)/5.8 (2.8), P
 
=
 0.03; problem no. 3, 4.7 (2.4)/6.8 (2.4), P
 
=
 0.02. Mean HbA1c decreased in the intervention group by 0.6 (1.2)% and increased in the control group by 0.1 (0.7)%, P
 
=
 0.016. In patients with suboptimal metabolic control, i.e. HbA1c
 > 8%, mean HbA1c decreased by 1.0 (1.2)% in the IG and increased by 0.1 (0.7)% in the CG, P   =  0.011.

Conclusion A time‐limited, structured, problem‐orientated psychotherapeutic intervention decreases the severity of psychological problems and improves metabolic control in Type 1 diabetic patients with microvascular complications and self‐management of intensified insulin therapy.
Interleukin‐6 polymorphism (–634C/G) in the promotor region and the progression of diabetic nephropathy in Type 2 diabetes
Authors: Kitamura A. , Hasegawa G. , Obayashi H. , Kamiuchi K. , Ishii M. , Yano M. , Tanaka T. , Yamaguchi M. , Shigeta H. , Ogata M. , Nakamura N. , Yoshikawa T.
Published: March 2003

Aims Interleukin‐6 (IL‐6) is a multifunctional cytokine produced by many different cell types, including glomerular mesangial cells. Recently, a novel C/G polymorphism at position −634 in the promotor region of the IL‐6 gene has been reported. The aim of this study was to investigate whether the −634C/G polymorphism is associated with an increased risk for progression to diabetic nephropathy as well as elevated levels of IL‐6 secretion by peripheral blood mononuclear cells.

Methods The frequency of the −634C/G polymorphism was determined in Japanese patients with Type 2 diabetes and either normoalbuminuria (n = 162), microalbuminuria (n = 138), or macroalbuminuria (n = 154) by polymerase chain reaction‐restriction fragment length polymorphism analysis. The level of IL‐6 secretion in relation to genotype was assessed in lipopolysaccharide or advanced glycation end products‐stimulated IL‐6 secretion by peripheral mononuclear cells.

Results The frequency of the −634G/G genotype and −634*G allele was significantly increased in the patients with macroalbuminuria compared with patients with normoalbuminuria (genotype: χ2 = 6.787, Pc = 0.0368; allele: χ2 = 9.080, Pc = 0.0104). Stepwise multiple regression analysis in these patients showed that hypertension (F = 40.48) and IL‐6‐634 gene polymorphism (F = 5.48) were the relevant variables for the progression of Type 2 diabetic nephropathy. Analysis of the IL‐6 secretion data revealed that individuals carrying the −634*G allele had a higher IL‐6 secretion capacity than those without the *G allele (P < 0.05).

Conclusions These results suggest that the IL‐6‐634C/G polymorphism may be a possible genetic susceptibility factor for the progression of diabetic nephropathy.

Diabet. Med. 19, 1000–1005 (2002)
High incidence of Type 2 diabetes mellitus in South African Indians: a 10‐year follow‐up study
Authors: Motala A. A. , Pirie F. J. , Gouws E. , Amod A. , Omar M. A. K.
Published: March 2003

Aims Previous cross‐sectional studies have established that South African Indians have a high prevalence of Type 2 diabetes mellitus. A prospective community study was undertaken to determine the incidence of Type 2 diabetes and the risk factors associated with its development in a cohort of South African Indians who had been studied 10 years previously.

Methods This is a report on 563 subjects who participated both at baseline and at the 10‐year follow‐up study. In the baseline study, 2479 subjects (> 15 years) were studied; using 1985 World Health Organization criteria for glucose tolerance based on 75 g oral glucose tolerance tests (OGTT), the crude prevalence of diabetes mellitus (Diabetes) was 9.8% and of impaired glucose tolerance (IGT) 5.8% (age and sex‐adjusted prevalence 13% and 6.9%, respectively).

Results At the 10‐year follow‐up study, 563 of the subjects who could be traced consented to a repeat OGTT; of these, 91 (16.2%) were classified as Diabetes and 41 (7.3%) as IGT. Of the subjects who did not have diabetes at baseline (n = 517), 49 (9.5%) progressed to diabetes (PTD) and 40 (7.7%) had IGT. The crude cumulative incidence of diabetes was 9.5% (rate of progression 0.95% per annum; incidence density 9.5/1000 person years) with an age and sex‐adjusted cumulative incidence of 8.3% (rate of progression 0.95% per annum; incidence density 8.3/1000 person years). Examination of risk factors predictive of subsequent diabetes development was undertaken by analysis of baseline (year 0) variables in the 517 subjects who did not have diabetes at baseline. In multivariate analysis using a logistic regression model, the significant predictive risk factors for future diabetes included 2‐h post load plasma glucose (2 PG) (P < 0.0001, odds ratio (OR) 1.7, 95% confidence interval (CI) 1.4–2.1), body mass index (BMI) (P < 0.006, OR 1.1, 95% CI 1.0–1.3) and obesity (P < 0.01, OR 4.6, 95% CI 1.4–14.7).

Conclusions This long‐term study has shown that in South African Indians there is a high incidence of Type 2 diabetes, and in this population significant predictors include higher baseline blood glucose, BMI and obesity.
Constraints on modelling the deforestation and degradation of tropical open woodlands
Authors: Grainger Alan
Published: March 2003

Ecosystem heterogeneity and lack of data on areas and deforestation rates have constrained the modelling of deforestation in tropical open woodlands. Smaller and more continuous changes in ecosystem quality attributes (e.g. canopy cover, tree density and biomass density) are best described as degradation, not deforestation. Suggestions are made for constructing degradation models by relaxing some assumptions of deforestation models to cope with the multiple uses of multiple vegetation layers by multiple users. Employing biomass as a dependent variable would account for biomass reductions caused by changes in woodland area, tree density and the biomass of retained trees and shrubs, and overcome the problem of how to aggregate changes in woodland area and tree density. Disaggregating models by woodland type is also recommended.
Ploidy race distributions since the Last Glacial Maximum in the North American desert shrub, Larrea tridentata
Authors: Hunter Kimberly L. , Betancourt Julio L. , Riddle Brett R. , Van Devender Thomas R. , Cole Kenneth L. , Spaulding W. Geoffrey
Published: March 2003

A classic biogeographic pattern is the alignment of diploid, tetraploid and hexaploid races of creosote bush (Larrea tridentata) across the Chihuahuan, Sonoran and Mohave Deserts of western North America. We used statistically robust differences in guard cell size of modern plants and fossil leaves from packrat middens to map current and past distributions of these ploidy races since the Last Glacial Maximum (LGM).

Glacial/early Holocene (26–10 14C kyr bp or thousands of radiocarbon years before present) populations included diploids along the lower Rio Grande of west Texas, 650 km removed from sympatric diploids and tetraploids in the lower Colorado River Basin of south‐eastern California/south‐western Arizona. Diploids migrated slowly from lower Rio Grande refugia with expansion into the northern Chihuahuan Desert sites forestalled until after ~4.0 14C kyr bp. Tetraploids expanded from the lower Colorado River Basin into the northern limits of the Sonoran Desert in central Arizona by 6.4 14C kyr bp. Hexaploids appeared by 8.5 14C kyr bp in the lower Colorado River Basin, reaching their northernmost limits (~37°N) in the Mohave Desert between 5.6 and 3.9 14C kyr bp.

Modern diploid isolates may have resulted from both vicariant and dispersal events. In central Baja California and the lower Colorado River Basin, modern diploids probably originated from relict populations near glacial refugia. Founder events in the middle and late Holocene established diploid outposts on isolated limestone outcrops in areas of central and southern Arizona dominated by tetraploid populations.

Geographic alignment of the three ploidy races along the modern gradient of increasingly drier and hotter summers is clearly a postglacial phenomenon, but evolution of both higher ploidy races must have happened before the Holocene. The exact timing and mechanism of polyploidy evolution in creosote bush remains a matter of conjecture.
Effects of body mass, climate, geography, and census area on population density of terrestrial mammals
Authors: Silva Marina , Brimacombe Michael , Downing John A.
Published: March 2003

Aim

The aim of this study was to investigate the effects of climate, geography, census area and the distribution of body mass on the mass : density relationship in terrestrial mammal populations.

Location

The areas covered include most major terrestrial biomes including the tropics, savannas, and temperate forests.

Method

Data on population density and body mass from 827 populations belonging to 330 different terrestrial mammal species were derived from a review of the literature.

Results

LOWESS and polynomial regression analysis indicated that the overall mass : density relationship on log‐log scales was not linear and that the slope of this relationship behaves differently across the range of body mass. Body mass explained between 37 and 67% of the variability in population density depending upon the dietary category or the biome group. We also developed two multivariate models that can explain up to 65% of the variability in population density in terrestrial mammals. We also tested for a confounding effect of census area on the mass : density relationship on log‐log scales in terrestrial mammals.

Conclusions

Our findings support previous studies suggesting that body mass is a major predictor of the variance in population density in terrestrial mammals. We suggest that the non‐linearity of the mass : density relationship may result from the fact that the overall distribution of body mass is a mixture of distributions across dietary groups and biomes. In contrast to body mass, our results indicate that climatic and geographical factors have a minor effect on population density. Although census area was closely correlated with body mass, body mass was generally a better predictor of population density than was census area.
Range size and its ecological correlates among the pteridophytes of Carrasco National Park, Bolivia
Authors: Kessler Michael
Published: March 2003

AimTo identify the factors determining the range size of pteridophytes (ferns and allied plants) in an Andean region.

LocationHumid eastern Andean slope in Carrasco National Park, Bolivia.

MethodsI used a macroecological approach to search for correlations of range size to elevation, habitat type, life form, reproductive strategy, the species’ elevational range, and its frequency, among the 473 pteridophyte species recorded in the park.

ResultsRange sizes were smallest at 1800–3500 m elevation and in localized habitats with little disturbance (ravines, ridges), while regularly disturbed habitats (pastures, roadsides) supported widespread species. Families and genera differed with respect to the range sizes of their species, but this pattern was not correlated to any other studied factor and could not be explained. Species with restricted ranges tended to be more frequent in the study area than widespread species. Widespread species tended to have large elevational ranges, implying that they are ecologically more adaptable than localized species. There was no relationship of range size to life form or to the studied reproductive aspects (sexual vs. asexual reproduction, chlorophyllous vs. achlorophyllous spores).

ConclusionsThe above trends were mostly uncorrelated and explained a rather small portion of the observed range size variance. Thus, it is not yet possible to draw a cohesive picture of the factors determining pteridophyte range size. Intriguing questions for future research include the relationship of range size to dispersal, competitive ability, and taxonomic affinity.
Scale in macroecology
Authors: Blackburn Tim M. , Gaston Kevin J.
Published: March 2003

The past 15 years have seen the development of macroecology as a respectable discipline within the biological sciences. Initial concerns about the utility of a large‐scale approach to ecology have been quietened, if not eliminated, but other arguments about spatial scale in ecology have arisen to take their place. The situation has moved from the absolute advocacy of small‐scale over large‐scale studies to an advocacy of some large scales in preference to others. Here, we argue that there is no general sense in which one scale of study (either in terms of spatial extent or sampling resolution) is better than any other. As long as there are sensible reasons for using the scale chosen, studies at all scales have the potential to inform about the structure and function of the ecological systems that clothe this planet.
Phytogeographical relationships among high mountain areas in the Baetic Ranges (South Spain)
Authors: Mota J. F. , Pérez‐García F. J. , Jiménez M. L. , Amate J. J. , Peñas J.
Published: March 2003

The Mediterranean area is regarded nowadays as one of the hot‐spots of world biodiversity. The Baetic ranges in Spain have such a large number of endemic plant taxa that the territory has been recognized as a well‐defined biogeographical unit. These endemic taxa tend to concentrate on disjunct highland areas that have been described consequently as ‘highland islands’. Despite the importance and complexity of these sites, the research carried out so far has produced only descriptive classifications. These approaches overlook the relationships between the sites and do not serve to identify the main centres of endemism. Herein, multivariate analysis techniques (cluster analysis and reciprocal averaging) and the parsimony analysis of endemicity (PAE), applied to the 222 orophilous endemic taxa of the Baetic ranges, have been used to reveal the floristic similarities between the areas involved, to identify the centres of endemism and to re‐assess the previous classifications. Four centres of endemism are defined, one siliceous and three calcareous. The most outstanding feature in the Baetic ranges is precisely the floristic difference between siliceous and calcareous mountains. Calcareous territories extend along a SW–NE axis in line with the oceanic–continental gradient. The nature of the soil in the vast siliceous and calcareous–dolomitic territories of the Sierra Nevada is probably the cause of the remarkable floristic diversity. Not surprisingly, in our analysis these areas stand out as centres of endemism. We conclude that previous biogeographical classifications of the ranges are too rigid and do not properly reflect the floristic similarities of the area under study.
Foliicolous lichens from Valdivian temperate rain forest of Chile and Argentina: evidence of an austral element, with the description of seven new taxa
Authors: Lücking R. , Wirth V. , Ferraro L.I. , Cáceres M.E.S.
Published: March 2003

Aim To describe the composition, diversity and biogeographical affinities of the foliicolous lichen mycobiota in Valdivian temperate rain forest in southern South America.

Location Seven localities in Chile (IX to XI region) and Argentina (Neuquén province).

Methods Opportunistic sampling of leaf substrates, identification of taxa, and assignment to distribution types.

Results Thirty‐seven species, including three lichenicolous fungi, were found in the studied collections, increasing the number of foliicolous taxa known from Valdivian temperate rain forest to 55. New records for the area include Arthonia cyanea, Byssoloma marginatum, B. subdiscordans, Fellhanera bouteillei, F. dispersa, F. subfuscatula, Gyalectidium caucasicum, G. ciliatum, Logilvia gilva, Porina thaxteri, Strigula nitidula and the lichenicolous A. microsticta, Helicobolomyces lichenicola and Opegrapha sipmanii. Seven taxa are described as new: Enterographa falcata, Gyalectidium chilense, G. plicatum, Gyalideopsis choshuencensis, Porina fulvelloides, Strigula wandae and Trichothelium meridionale ssp. austroamericanum.

Conclusions There are unexpected floristic affinities in the foliicolous lichen mycobiota of Valdivian temperate rain forest with those of New Zealand and Tasmania. Three typically foliicolous species clearly belong to an austral element: Caprettia setifera and Badimiella pteridophila, both known previously from New Zealand and Tasmania; and Kantvilasia hians, known already from Tasmania and Valdivian temperate rain forest. Other Southern Hemisphere lichens, such as Parmeliella nigrocincta, P. thysanota and Psoroma caliginosum, are also found commonly on leaves. On the other hand, specific affinities of the foliicolous lichen mycobiota of Valdivian temperate rain forest with the Neotropics are absent: most of the species shared between the two regions belong to a cosmopolitan‐tropical or a circumpacific element. Thus far, nine taxa are endemic to Valdivia. The Valdivian temperate rain forest foliicolous lichen mycobiota is therefore regarded as one of six distinctive regions in the world.
Island ecology and contingent theory: the role of spatial scale and taxonomic bias
Authors: Báldi András , McCollin Duncan
Published: March 2003

Scale, the scale dependency of patterns and processes, and the ways that organisms scale their responses to these patterns and processes are central to island and landscape ecology. Here, we take a database of studies in island ecology and investigate how studies have changed over a 40‐year period with respect to spatial scale and organisms studied. We demonstrate that there have been changes in the spatial scale of islands studied and that there is taxonomic bias in favour of vertebrates in island ecological studies when compared to scientific publications as a whole. We discuss how such taxonomic bias may have arisen and discuss the implications for ecology and biogeography.
Active habitat selection by pre‐settlement reef fishes
Authors: Montgomery John Charles , Tolimieri Nicholas , Haine Olivia Sophie
Published: March 2003

Our understanding of habitat selection by reef fish larvae has changed dramatically in the last 10 years. Fish larvae have long been considered passive particles at the mercy of ocean currents, tides and weather events. For reef fishes, ecological evidence has shown that passive dispersal alone often cannot explain larval distributions, suggesting active behaviour by reef fish larvae. While behaviourally modified passive transport may be important, recent work demonstrates that some reef fish larvae have the capability to actively swim to settlement habitat. They can orientate to reefs from distances of at least 1 km and can swim at speeds of 13.5 cm s−1for several days. The question then becomes, what are the cues that fish larvae use to orientate to reefs? Ambient reef sound has been shown to be attractive to reef fish larvae, and current research aims to understand better the nature and use of these acoustic cues. Other potential cues include chemoreception/olfaction, wave cues and visual location of reefs. A better understanding of active habitat selection and the underlying sensory and behavioural mechanisms will improve our knowledge of recruitment processes in reef fish ecology, and may have implications for active management of reef fish populations.
Parallel speciation, despeciation and respeciation: implications for species definition
Authors: Turner George F
Published: March 2003

Can the same species arise more than once in different places or at different times? Can a species go extinct by hybridization? If so, can it reappear afterwards? Biologists are used to thinking about species as historical events. They arise once (speciation), exist for a certain time (undergoing stasis or anagenetic change) and then disappear (extinction). Some people even like to think of them as ‘individuals’, although, whether the use of the technical philosophical definition of this word is helpful to many biologists, is perhaps debatable. By and large, our observations of real animal species are not at all incompatible with these ideas. But, recent studies on fishes are suggesting that we may need to rethink our views of the life of a species to include the concepts of parallel speciation, despeciation and respeciation.The ideas I discuss in this paper are not necessarily new, but many fish biologists, like myself, may not have found any particular reason to consider them until recently. There is a very large literature on species concepts, and in a short opinion piece, I could scarcely attempt to do justice to the breadth of the debate or the complexity of the arguments raised. I will focus on issues relating to practical implications of species concepts that have to come to my attention as a fish biologist working on evolutionary questions.
Bulbar palsy in senile onset familial amyloid polyneuropathy (30Val→Met): transthyretin‐amyloid deposits in the hypoglossal nerve root
Authors: Ikeda K. , Kinoshita M. , Takamiya K. , Iwasaki Y. , Tomita Y. , Nakano I. , Nakazato M.
Published: March 2003

Japanese familial amyloid polyneuropathy (FAP type I) is characterized clinically by autonomic and sensorimotor polyneuropathy. Bulbar palsy or lower cranial amyloid neuropathy has not been reported in this disease. We report a 72‐year‐old man with senile onset FAP type I, who developed bulbar palsy and sensorimotor polyneuropathy without autonomic failures. He noticed dysesthesia and muscle weakness in the feet at the age of 67 years. Neurological examination showed bulbar signs and sensorimotor polyneuropathy, but not autonomic neuropathy. Electromyography showed denervation in the tongue and extremities. Sural nerve biopsy revealed a profound reduction of myelinated fibers. Neuropathological studies indicated axonal degeneration and transthyretin‐amyloid deposits in the peripheral nerves and hypoglossal nerves or roots. DNA analysis demonstrated transthyretinMet30' mutation. We provide the novel possibility that bulbar palsy, due to amyloid neuropathy, can occur in FAP type I.
In vivo PET study of cerebral [11C] methyltetrahydroaminoacridine distribution and kinetics in healthy human subjects
Authors: Traykov Latchezar , Tavitian Bertrand , Jobert Antoinette , Boller François , Forette Françoise , Crouzel Christian , Giamberardino Luigi Di , Pappata Sabina
Published: March 2003

It is unclear whether the palliative effects of tetrahydroaminoacridine (THA) (tacrine, Cognex) on the clinical symptoms of patients affected by Alzheimer's disease (AD) are the result of its inhibitory activity on acetylcholinesterase or on other complex sites of action. In order to investigate the cerebral distribution and kinetics of THA in the human brain in vivo, we performed positron emission tomography (PET) imaging with [11C[N‐methyl‐tetrahydro‐aminoacridine (MTHA) in healthy human volunteers. After intravenous injection, [11C[MTHA crossed the blood‐brain barrier and reached its maximum uptake between 10 and 40 minutes, depending on the brain regions. Uptake was higher in the grey matter structures, and lower in the white matter. After this peak, the radioactivity remained quasi‐constant until 60 minutes in all regions with a half‐life varying from 2.44 hours in the thalamus to 3.42 hours in the cerebral cortex. The ratios of regional to whole cerebral cortex brain radioactivity calculated between 50 and 70 minutes after the tracer injection were 1.14 ± 0.04, 1.07 ± 0.03 and 1.06 ± 0.04 in the putamen, cerebellum and thalamus, respectively. Overall, these results show that: (1) [11C]MTHA crosses the blood‐brain barrier easily and is highly concentrated in the brain; (2) the regional brain distribution of [11C]MTHA does not parallel that of in vivo acetylcholinesterase (AChE) concentrations; and (3) the cerebral kinetics of [11C]MTHA are consistent with known plasmatic pharmacokinetics of THA in AD patients. We conclude that PET imaging with [11C]MTHA is a useful method for assessing the cerebral distribution and kinetics of THA in vivo.
A 24‐month, double‐blind, placebo‐controlled multicentre pilot study of the efficacy and safety of nicergoline 60 mg per day in elderly hypertensive patients with leukoaraiosis
Authors: Bès André , Orgogozo Jean‐Marc , Poncet Michel , Rancurel Gérald , Weber Michel , Bertholom Nadine , Calvez Roger , Stehlé Brigitte ,   French Study Group of Leukoaraiosis,   French Study Group
Published: March 2003

In this pilot study, 72 non‐demented and non‐depressive elderly hypertensive patients with evidence of leukoaraiosis on cerebral computed tomography scan (Rezek score: ≥ 16) were randomly assigned to receive either nicergoline 30 mg b.i.d. (n= 36) or a placebo (n= 36) for 24 months. All patients received antihypertensives and their hypertension was controlled under treatment. They were evaluated by nine neuropsychological tests exploring memory, concentration, verbal and motor performances, administered at baseline and at every six‐month interval during the study period. At baseline, the two groups were comparable for all demographic and clinical characteristics, including cognitive functions, except for the delayed recall of the Auditory Verbal Learning Test (AVLT), which was better in the placebo group (P= 0.04). Changes in scores over time were compared between the two groups. At the last visit, patients on nicergoline (n= 31) were found to have deteriorated less or to have improved more on test scores than the patients on placebo (n= 30). Significant differences were observed for memory function (AVLT short term recall, P= 0.026; AVLT delayed recall, P= 0.013; and, Benton Visual Retention Test, P= 0.002) and attention and concentration (Letter Cancellation Test, P= 0.043; and, WAIS‐R Digit Symbol subtest, P= 0.006). The Rezek score remained unchanged in the two groups. Tolerance of nicergoline was similar to that of placebo. In conclusion, this study shows that nicergoline 30 mg b.i.d. administered over a 24‐month period attenuates the deterioration in cognitive functions in elderly hypertensive patients with leukoaraiosis. Whether these effects were specific for this type of white matter changes could not be determined in the context of this pilot study.
Positive association between an estrogen receptor gene polymorphism and Parkinson's disease with dementia
Authors: Isoe‐Wada Kenji , Maeda Masanobu , Yong Ji , Adachi Yoshiki , Harada Hideaki , Urakami Katsuya , Nakashima Kenji
Published: March 2003

Parkinson's disease (PD) is a common cause of dementia in the elderly. Dementia in Alzheimer's disease (AD) and PD share common biologic and clinical features. The estrogen receptor (ER) gene is one of the susceptibility genes for AD. In order to test the hypothesis that the overlap between AD and PD may have a genetic basis, we determined ER gene polymorphisms in 13 PD patients with dementia (PDD) (age ± SD; 71.9 ± 5.5 years), 71 PD patients without dementia (PDND) (68.4 ± 7.5 years), 86 AD patients (76.8 ± 8.0 years) and 51 control subjects (CTL) (74.9 ± 6.9 years). ER genotypes were classified as a P or p allele on the basis of a Pvu II‐RFLP, and X and x on the basis of a Xba I‐RFLP. The frequency of the P allele in the PDD group as well as the AD group was higher than that in CTL. There was no significant difference in the distribution of the P allele between CTL and PDND. There were no significant differences in the distribution of the X allele among the PDD, PDND and CTL groups, whereas a higher incidence was found in AD. We conclude that the ER gene may be a common susceptibility gene for dementia in PD as well as AD.
Psychogenic pseudoepileptic seizures: clinical and electroencephalogram (EEG) video‐tape recordings
Authors: Jędrzegczak Joanna , Owczarek Krzysztof , Majkowski Jerzy
Published: March 2003

This paper presents a clinical and electrophysiological analysis of type and duration of seizures recorded by means of long‐term video electroencephalogram (EEG) monitoring, a method which enables accurate diagnosis of psychogenic pseudoepileptic seizures occurring with or without epileptic seizures. Analysis is based on 1083 patients, hospitalized at our department between 1990 and 1997, with a preliminary diagnosis of epilepsy. Psychogenic pseudoepileptic seizures were diagnosed in 85 patients (7.8%). In 48 patients, pseudoepileptic seizures alone were diagnosed (group 1). whereas 37 patients had a mixed condition in which pseudoepileptic seizures were accompanied by epileptic seizures (group 2). For comparison of duration of pseudo‐ and epileptic seizures a control group (group 3), consisting of 55 patients randomly selected from the population of patients suffering from epileptic seizures alone, was parceled out. Long‐term video EEG monitoring was performed in 70 patients. In 55 (79%) of these patients 230 seizures (221 pseudoepileptic and nine epileptic) were recorded. In 30 patients (32%), the diagnosis was based on clinical observation of the seizures and on the number of EEG recordings, including activating procedures such as sleep deprivation, photostimulation, hyperventilation and anti‐epileptic drug withdrawal. We found that the duration of epileptic seizures was significantly shorter than the duration of psychogenic pseudoepileptic seizures. Our study has exposed the difficulties involved in the diagnosis of psychogenic pseudoepileptic seizures and the negligible value of neuroimaging techniques and interictal EEG recordings in the differential diagnosis of epileptic versus nonepileptic seizures. In this study, psychogenic seizures were significantly more frequent in women than in men; patient history analysis did not confirm the hypothesis that sexual abuse may cause psychogenic seizures.
Palmar and axillary hyperhidrosis treated with botulinum toxin: one‐year clinical follow‐up
Authors: Naver H. , Swartling C. , Aquilonius S.‐M.
Published: March 2003

Focal hyperhidrosis is a common and sometimes handicapping condition for which the presently most effective treatment, sympathectomy, often leads to irreversible side‐effects. We aimed to study effectiveness and tolerability of an alternative treatment with botulinum toxin injections over a period of one year for this condition.

Twenty‐eight patients with palmar (n = 19) and/or axillary (n = 13) hyperhidrosis were treated with intracutaneous injections of botulinum toxin (Botox®)
2 U/4 cm2. Sweat function was studied clinically and by objective measurements after treatment of one side. Treated and untreated sides, and pre‐ and post‐treatment skin areas were compared. Subjective evaluation was performed after treatment of one side and 2–5 months after treatment of both sides. Duration of effect was controlled by a one‐year follow‐up.

Sweating disappeared in eight out of 13 patients with axillary and in five out of 19 with palmar hyperhidrosis, and was reduced markedly in another five out of 13 and 10 out of 19 patients. Two‐thirds of those treated for hand sweat noticed a slight and transient reduction of power of finger grip. No side‐effects were noticed after treatment of axillary hyperhidrosis. We find intracutaneous injections of botulinum toxin with this technique safe and effective, and due to the relatively long duration of effect the treatment should be recommended before sympathectomy for focal hyperhidrosis.
Increasing loss of brain tissue with increasing dementia: a stereological study of post‐mortem brains from elderly females
Authors: Regeur L.
Published: March 2003

Neocortical volumes, cortical thickness and volumes of archicortex, the ventricular system, the central grey matter and white matter were estimated using stereological methods on the brains from 28 elderly females (mean age 81.8 years) with increasing degree of senile dementia and brains from 13 (mean age 82.7 years) female controls who did not suffer from dementia. The estimator of pial surface area, as opposed to the other stereological techniques used in this study, was not strictly unbiased. Brains from patients with dementia (14 Alzheimer cases and 14 non‐Alzheimer cases) had decreased cortex volume, and neocortical thickness was significantly reduced in the patients with dementia, with the highest degree of reduction in those whose dementia was most severe, as were the volumes of archicortex. No statistically significant difference was found in the volumes of cortex, white matter, central grey structures, ventricular volume or archicortex between the cases with Alzheimer’s dementia (N = 14) compared with those with non‐Alzheimer dementia (N = 14). The ventricular volume increased with increasing degree of dementia, but did not reach statistical significance in the dementia group compared with the control group. Surface area did not change in those patients with dementia, and no significant reductions were found in the volumes of white matter or central grey structures in the patients with dementia compared with controls.
Isolated, unilateral, reversible palsy of the hypoglossal nerve
Authors: Giuffrida S. , Lo Bartolo M. L. , Nicoletti A. , Reggio E. , Lo Fermo S. , Restivo D. A. , Domina E. , Reggio A.
Published: March 2003

We report three patients with isolated unilateral hypoglossal nerve palsy who experienced an excellent outcome. In two patients no cause was found.

Our study seems to confirm that the occurrence of benign and idiopathic isolated unilateral palsy of the hypoglossal nerve is more frequent than previously reported. We would like to stress that neuroimaging studies remain mandatory in order to exclude other common causes, such as tumour and spontaneous or traumatic vascular lesions, in which a specific treatment is necessary.
Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients
Authors: Khedr E. M. , El Shinawy O. , Khedr T. , Aziz Ali Y. A. , Awad E. M.
Published: March 2003

This study investigates the effect of stroke on the corticodiaphragmatic pathway and attempts to clarify the relationship between neurophysiological data and degree of motor disability, site of infarction in computerized tomography (CT) scan, diaphragmatic excursion, blood gases and pulmonary function in stroke patients. Using magnetic stimulation of the scalp sites and cervical roots, an assessment of corticodiaphragmatic pathway was made. The study included 34 sequentially selected patients from a total of 250 patients with acute ischemic stroke. Twenty‐five (age‐ and sex‐matched) volunteers served as controls. Sixteen patients had cortical infarction, 13 had subcortical infarction and five had both cortical and subcortical infarction. The mean according to the Scandinavian Stroke Scale was 32.2. Decreased diaphragmatic excursion was observed in 41% of the patients. Twenty‐four patients (70.5%) had abnormal magnetic evoked potentials (MEPs) in the affected hemisphere. In five patients MEPs could not be elicited from the affected hemisphere; the remaining 19 patients had abnormal values of both cortical latency and central conduction time (CCT). Cortical latency, CCT, amplitude of compound muscle action potentials (CMAPs) and excitability threshold of the affected hemisphere were significantly altered compared with both the unaffected hemisphere and the control group. Those patients with hemiplegia had a greater degree of hypoxia, hypocapnia and decreased serum bicarbonate level compared with the control group. Also, hemiplegic patients had different degree of respiratory dysfunction. A statistically significant association was found between neurophysiological data and disability score, diaphragmatic excursion, site of infarction in CT scan and degree of respiratory dysfunction. Central diaphragmatic impairment may occur in acute stroke and could contribute to the occurence of hypoxia in those patients.
Botulinum toxin type A management of spasticity in the context of orthopaedic surgery for children with spastic cerebral palsy
Authors: Graham H. K.
Published: March 2003

Cerebral palsy is the most common cause of physical disability affecting children in developed countries. Although cerebral palsy is, by definition, a ‘static encephalopathy’ the associated musculoskeletal pathology is progressive and current definitions are therefore somewhat inadequate. Understanding the stages of the musculoskeletal pathology is fundamental to understanding current management strategies, including spasticity management, strengthening programmes and deformity correction by orthopaedic surgery. In this review, a number of new management strategies are described, in which spasticity management by intramuscular injections of botulinum toxin type A and deformity correction, by orthopaedic surgery, are combined.