bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital Malformations of the Middle Ear with an Intact External Ear: A Review of 38 Cases
Authors: Baba Shunkichi , Ikezono Tetsuo , Pawankar Ruby , Yagi Toshiaki
Published: May 2004

In patients with middle ear malformations, one can expect an improvement in hearing following ear surgery. Thus, it is crucial for the ear surgeon to have an increased awareness of this disease. For a better understanding of this condition, 38 patients who underwent ear surgery were studied. All patients had congenital ossicular malformations but with an intact external ear. On the basis of our intra-operative observations, 15 cases were assigned to group A (single malformation) and 23 cases to group B (multiple malformations). The pre-operative air-conduction threshold in group B patients was higher than that in group A. Pre-operatively in group A 2 out of 20 ears had mild, 17 had moderate and 1 had severe hearing loss (HL). In group B, out of 25 ears, 3 had mild, 13 had moderate and 9 had severe HL. Post-operatively in group A, 2 had normal hearing, 16 had mild, 2 had moderate and none had severe HL. In group B, postoperatively 1 had normal hearing, 18 had mild, 4 moderate and 2 severe HL. Therefore, in patients with multiple middle ear malformations, the surgeon should know that the prospect of an improvement in the hearing threshold is rather low even after surgical reconstruction.
Ossifying Haemangioma of the Frontal Sinus
Authors: Naim Ramin , Steinhoff Inga , Hörmann Karl , Maurer Joachim T.
Published: May 2004

First described by Natali, the ossifying haemangioma is a rare entity. Although cases of ossifying haemangioma have been described in the literature, no involvement of the frontal sinus has been presented yet. We present a 46-year-old female patient who complained of recurrent cephalalgia and pressure in her forehead for 3 months. A computerized tomography scan demonstrated a compact radiopaque density arising from the floor of the middle cavity of her frontal sinus. Surgery was performed using the coronal approach. A rhomboid-shaped ossified tumour in the middle cavity of the frontal sinus was found with no signs of bleeding, partially obstructing the right sinus ostium. The small tumour was removed at the very base showing slight bleeding. Two weeks later, during the clinical follow-up, the patient did not complain of any of her previous symptoms. Previous studies have presented ossifying haemangioma of the temporal bone as an extremely aggressive entity affecting the 7th cranial nerve. In our case, the frontal sinus showed no signs of destruction of the adjacent tissue, and the only associated symptom was frontal cephalalgia. Because no critical surgical complications have been observed, no further changes to the surgical procedure appear necessary. We recommend performing a computerized tomography 6–12 months after surgery for follow-up to detect possible tumour regrowth.
Recurrent Pregnancy Loss and Its Relation to FV Leiden, FII G20210A and Polymorphisms of Plasminogen Activator and Plasminogen Activator Inhibitor
Authors: Wolf Cornelia E. , Haubelt Hannelore , Pauer Hans Ulrich , Hinney Bernd , Krome-Cesar Claudette , Legler Tobias J. , Hellstern Peter , Emons Günter , Zoll Barbara , Köhler Michael
Published: May 2004

Thrombophilic disorders and hypofibrinolysis were demonstrated to be risk factors in a majority of women with recurrent pregnancy loss (RPL) and infertility. We investigated the association of FV G1691A mutation, F II G20210A gene polymorphism (PM), 4G/5G PAI-1 and Alu I/D tPA PM in 32 women with infertility and 49 women with at least 2 unexplained early abortions. FV Leiden mutation was significantly more common in women with RPL (10%, p = 0.02) and infertility (19%, p = 0.0005) compared with controls (2%). PAI-1 4G PM and t-PA Alu I PM, alone or in combination, were not associated with RPL or infertility. 9/49 women with RPL showed coagulation disorders with heterozygous FV Leiden mutation (5), FXII (1), protein C (1) or protein S (2) deficiency. However, due to the small number of patients studied, no definite conclusion can be drawn.
The Effect of Dietary Bacillus Natto Productive Protein on in vivo Endogenous Thrombolysis
Authors: Yamashita T. , Oda E. , Giddings J.C. , Yamamoto J.
Published: May 2004

The influence of dietary bacillus natto productive protein (BNPP) on endogenous thrombolysis was investigated in the rat. Animals were given a standard feed for 14 weeks, to which 0.2 or 1% BNPP was added. Thrombolysis was evaluated using an He-Ne laser-induced thrombosis model in mesenteric microvessels. Changes in thrombus volume, reflecting thrombolysis, decreased to 82% of the initial value in the control group. In contrast, the thrombus volume decreased to 67% in the animals fed 0.2% BNPP, and decreased to 51% in the group given 1% BNPP. The extent of thrombolysis in the 1% BNPP group was equivalent to that seen in animals treated with a bolus intravenous infusion of 0.2 mg/kg tissue plasminogen activator. The results demonstrated that the dietary administration of BNPP enhanced endogenous thrombolysis in a dose-dependent manner. Argatroban (2 mg/kg/h) enhanced endogenous fibrinolysis only in control animals, but not in the BNPP groups. The results support the suggestion that dietary supplementation with BNPP may provide a simple means to promote fibrinolysis not only in the treatment of thromboembolism but also in the prevention of venous occlusion.
Effects of Surgical Trauma and Cardiopulmonary Bypass on Active Thrombin Concentrations and the Rate of Thrombin Inhibition in vivo
Authors: Velan Tomas , Chandler Wayne L.
Published: May 2004

The in vivo concentration of active thrombin and the second-order rate constant for the inhibition of thrombin by antithrombin (kinh) were estimated in patients undergoing cardiopulmonary bypass (CPB) based on measured levels of hemostatic markers in combination with a computer model of the patient’s hemostatic and vascular systems. At baseline kinh = 0.6 ± 0.1 µM–1 s–1 leaving 270 ± 101 fM of active thrombin in the circulation. These factors were unchanged after sternotomy. Soon after heparin administration and the start of CPB, kinh increased 25-fold resulting in decreased active thrombin. After CPB and heparin neutralization, kinh decreased to 8-fold above baseline allowing active thrombin levels to rise. Both factors had returned to normal 2 h after surgery. We conclude that CPB with heparinization results in a rapid increase in thrombin inhibition leading to decreased active thrombin levels in vivo.
Factor V Gene (1691A and 4070G) and Prothrombin Gene 20210A Mutations in Patients with Behçet’s Disease
Authors: Ateş Aşkın , Düzgün Nurşen , Ulu Arzu , Aydintuğ Tiryaki A. Olcay , Akar Nejat
Published: May 2004

Objectives: Behçet’s disease (BD) is a chronic inflammatory disorder of still unknown etiology, characterized by endothelial cell injury/dysfunction and thrombosis and/or aneurysm of large blood vessels. Thrombophilia may play a role in the pathogenesis of thrombosis in BD. The common inherited gene defects, factor V (FV) 1691A (Leiden) and prothrombin (PT) 20210A, are known risk factors for thrombosis. The FV 4070G polymorphism was shown to influence circulating FV levels and to contribute to the activated protein C resistance phenotype. The aim of the study was to evaluate the role of FV 1691A, FV 4070G and PT 20210A gene mutations in Turkish BD patients with and without venous thrombosis. Methods: Seventy-one patients with BD (27 with venous thrombosis) and 91 healthy subjects were included in the study. FV 1691A, FV 4070G, and PT 20210A mutations were determined by a method based on PCR-RFLP. Results: The frequency of FV 1691A heterozygous mutation in BD patients with venous thrombosis (25.9%) was significantly higher than that in healthy subjects (8.8%; OR = 3.63; 95% CI 1.18–11.2). Although the frequency of this mutation in patients with venous thrombosis was higher than that in the patients without venous thrombosis (11.4%), the difference did not reach a statistically significant level (OR = 2.73; 95% CI 0.77–9.70). In BD patients with thrombosis, the frequencies of FV 4070G and PT 20210A were not significantly different compared to the BD patients without venous thrombosis and healthy subjects. Conclusions: Our results suggest that the FV 1691A, FV 4070G, and PT 20210A mutations are unlikely to play an important role in the pathogenesis of thrombosis in patients with BD.
Fibrinogen Polymorphisms Taq I, Hae III and Bcl I Are Not Associated with a Higher Risk of Deep Vein Thrombosis
Authors: Božič Mojca , Teran Nataša , Peterlin Borut , Stegnar Mojca
Published: May 2004

High fibrinogen is recognised as a risk factor for atherosclerosis. It seems that high fibrinogen is also a risk factor for deep vein thrombosis (DVT). It has been shown that certain polymorphisms in fibrinogen genes can influence the fibrinogen level. In this study, fibrinogen levels and the frequency of the polymorphisms Taq I, Hae III and Bcl I were studied in 114 patients with DVT and 244 healthy subjects. In non-smokers, fibrinogen levels above 5 g/l were associated with an increased risk of DVT (odds ratio 3.3, 95% confidence interval 1.6–7.0). The frequencies of common alleles were similar in patients and healthy subjects for all polymorphisms. An association between fibrinogen levels and the polymorphisms Taq I, Hae III and Bcl I was found in healthy subjects, but not in the patients. It was concluded from these data that the polymorphisms Taq I, Hae III and Bcl I are not major risk factors for DVT.
Recent Advances in the Structure and Assembly of the Archaeal Flagellum
Authors: Bardy Sonia L. , Ng Sandy Y.M. , Jarrell Ken F.
Published: May 2004

Archaeal motility occurs through the rotation of flagella that are distinct from the flagella found on bacteria. The differences between the two structures include the multi-flagellin nature of the archaeal filament, the widespread posttranslational modification of the flagellins and the presence of a short signal peptide on each flagellin that is cleaved by a specific signal peptidase prior to the incorporation of the mature flagellin into the flagellar filament. Research has revealed similarities between the archaeal flagellum and the type IV pilus, including the presence of similar unusual signal peptides on the flagellins and pilins, similarities in the amino acid sequences of the major structural proteins themselves, as well as similarities between potential assembly and processing components. The recent suggestion that type IV pili are part of a family of cell surface complexes, coupled with the similarities between type IV pili and archaeal flagella, raise questions about the evolution of these systems and possible inclusion of archaeal flagella into this surface complex family.
Pulling Together with Type IV Pili
Authors: Nudleman Eric , Kaiser Dale
Published: May 2004

Type IV pili are an efficient and versatile device for bacterial surface motility. They are widespread among the β-, γ-, and δ-proteobacteria and the cyanobacteria. Within that diversity, there is a core of conserved proteins that includes the pilin (PilA), the motors PilB and PilT, and various components of pilus biogenesis and assembly, PilC, PilD, PilM, PilN, PilO, PilP, and PilQ. Progress has been made in understanding the motor and the secretory functions. PilT is a motor protein that catalyzes pilus retraction; PilB may play a similar role in pilus extension. Type IV pili are multifunctional complexes that can act as bacterial virulence factors because pilus-based motility is used to spread pathogens over the surface of a tissue, or to build multicellular structures such as biofilms and fruiting bodies.
Cytophaga-Flavobacterium Gliding Motility
Authors: McBride Mark J.
Published: May 2004

Flavobacterium johnsoniae, like many other members of the Cytophaga-Flavobacterium-Bacteroides group, displays rapid gliding motility. Cells of F. johnsoniae glide over surfaces at rates of up to 10 µm/s. Latex spheres added to F. johnsoniae bind to and are rapidly propelled along cells, suggesting that adhesive molecules move laterally along the cell surface during gliding. Genetic analyses have identified a number of gld genes that are required for gliding. Three Gld proteins are thought to be components of an ATP-binding-cassette transporter. Five other Gld proteins are lipoproteins that localize to the cytoplasmic membrane or outer membrane. Disruption of gld genes results not only in loss of motility, but also in resistance to bacteriophages that infect wild-type cells, and loss of the ability to digest the insoluble polysaccharide chitin. Two models that attempt to incorporate the available data to explain the mechanism of F. johnsoniae gliding are presented.
Shaping and Moving a Spiroplasma
Authors: Trachtenberg Shlomo
Published: May 2004

The Mollicutes (Spiroplasma, Mycoplasma and Acholeplasma) are the most minimal cells known to exist, being the smallest and simplest free-living and self-replicating forms of life. Phylogenetically, the Mollicutes are related to gram-positive bacteria and have evolved, by regressive evolution and genome reduction, from Clostridia. The smallest genome in this group (Mycoplasma genitalium – 5.77 × 105 bp) is only twice that of a large virus (e.g., Entomopox viruses). The largest Mollicute genome (Spiroplasma LB12 – 2.2 × 106 bp) is only about half that of, e.g., Escherichia coli. Structurally, the Mollicutes lack cell walls and flagella, but have internal cytoskeletons and are motile and chemotactic. Only a cholesterol-containing unit membrane envelops the cells. No analogs to the bacterial chemotactic and motility (che, mot, fla) genes, genes for a two-component signal transduction system, genes associated with gliding, or genomic homologs for the eukaryotic cytoskeleton and motor proteins were found in the Mollicutes. The Spiroplasmas are unique amongst the Mollicutes in having a well-defined basic helical cell geometry. In this respect, the Spiroplasma cell can, essentially, be viewed as a helical dynamic membranal tube (diameter ∼0.2 µm; equivalent to that of one eukaryotic flagellar axoneme or to a bacterial flagellar bundle). A flat cytoskeletal ribbon of parallel fibrils is attached to the inside of the cellular tube. Both tube and cytoskeleton are mutually coiled into a dynamic helix driven by differential length changes of the fibrils, which function as linear motors. The cytoskeletal ribbon follows the shortest (inner) helical line on the inner surface of the cellular tube. Being helical allows for further analytical reduction and consequent structural quantification of Spiroplasma. Of particular importance is the ability to correlate light and electron microscopy data and to calculate the fibril lengths (and corresponding molecular dimensions) in the helical and nonhelical dynamic states. The structural unit of the contractile cytoskeleton is a ∼50-Ångstrom-wide filament comprised of pairs of the 59-kD fib gene product. The monomers are arranged in pairs with opposite polarities allowing for a ∼100-Ångstrom-long axial repeat. The functional unit of the contractile cytoskeletal ribbon is a fibril comprised of an aligned pair of filaments. Neighboring repeats form a tetrameric ring with a lateral repeat of ∼100 Å. The axial length of the rings may shorten by ∼40%, driving the changes in the fibril lengths and, consequently, helical dynamics. Local length changes result in helical symmetry breaking and nonreciprocating cell movements allowing for net directional displacement. Flexing allows for changes in swimming direction.
Examination of Fetal Cells and Cell-Free Fetal DNA in Maternal Blood for Fetal Gender Determination
Authors: Zhao Xiao Xi , Suzumori Nobuhiro , Ozaki Yasuhiko , Sato Takeshi , Suzumori Kaoru
Published: May 2004

Background: To assess applicability of noninvasive methods for prenatal sex determination, both intact fetal cells and cell-free DNA from maternal blood were studied. Methods: Maternal peripheral blood samples were obtained from 41 women carrying chromosomally normal fetuses and from 3 women with aneuploid fetuses (47,XX,+18; 47,XY,+18 and 47,XY,+21) at 9–22 weeks of gestation. DNA was extracted from the plasma fraction and analyzed by the nested polymerase chain reaction (PCR) using Y chromosome specific primers. After fetal cells were enriched by MACS, fluorescence in situ hybridization (FISH) with chromosome X and Y specific probes was performed to detect XY cells. Results: Although Y-chromosome-specific DNA was detected by PCR analysis in all maternal plasma samples with male fetuses, 26% women bearing female fetuses also gave positive results. By FISH analysis, XY cells were detected in not only 58% of women bearing male fetuses, but also 13% of their counterpoints with female fetuses. Conclusions: Our findings suggested that consistent results for fetal gender using PCR or FISH cannot be obtained with intact fetal cells and cell-free DNA present in maternal blood and plasma at 9–22 weeks of gestation, despite their apparent abundant presence.
Midbrain Ischemia Presenting as Vertical Gaze Palsy: Value of Diffusion-Weighted Magnetic Resonance Imaging
Authors: Seifert T. , Enzinger C. , Ropele S. , Storch M.K. , Fazekas F.
Published: May 2004

Background: Conventional magnetic resonance imaging may fail to identify very small but clinically relevant acute subcortical brain infarcts. Diffusion-weighted magnetic resonance imaging (DWI) is very sensitive and specific for acute cerebral ischemia and should contribute to the early detection of such lesions. Methods: We analyzed 6 patients who presented with acute vertical gaze palsy and in whom DWI was performed within 1–6 days from symptom onset. Results: DWI accurately identified ischemia in an area supplied by the posterior thalamosubthalamic paramedian artery in all patients. T2-weighted and FLAIR imaging failed to identify the clinically relevant lesion in 2 and 3 patients, respectively. Conclusion: DWI improves the clinicoanatomical correlation in patients presenting with supranuclear oculomotor disturbances.
Long-Term Change in Size of Cerebral Infarction: Predictive Value of Brain Perfusion SPECT Using Statistical Parametric Mapping
Authors: Watanabe Hiroshige , Murata Yuji , Ohashi Isamu , Oda Kenji , Matsushima Eisuke , Okubo Yoshiro , Shibuya Hitoshi
Published: May 2004

A focus of infarction is surrounded by hypoperfused areas. The present study was undertaken to examine the long-term changes in the size of infarcts, the relationship between the size of an infarct and the extent of the surrounding hypoperfused areas, and the background of such changes. The subjects of this study were 11 patients with ischemic lesions of the brain who had undergone brain SPECT (99mTc-ethyl cysteinate dimer) within 1 week after initial MRI, and who underwent MRI again more than half a year later. Statistical parametric mapping (SPM) was conducted to detect significantly hypoperfused areas on the SPECT images. Relative size of significantly hypoperfused areas on SPM and infarcts on T2-weighted MR images were measured. The patients were divided into two groups based on the percentage of the infarct’s size relative to the size of the surrounding hypoperfused areas (75–125 and 0–39%). Infarcts in the ‘75–125%’ group showed little change in size, while in the ‘0–39%’ group infarcts increased slowly until it reached the same rate as the former group. All patients with infarct in the ‘0–39%’ group were noted to have severe stenosis of the internal carotid arteries bilaterally. Patients having severe stenosis of the internal carotid artery often had a slowly enlarging infarct. SPM seems to be useful in predicting the ultimate size of the infarct.
Pulse Pressure in Acute Stroke Is an Independent Predictor of Long-Term Mortality
Authors: Vemmos Konstantinos N. , Tsivgoulis Georgios , Spengos Konstantinos , Manios Efstathios , Daffertshofer Michael , Kotsis Vassilios , Lekakis John P. , Zakopoulos Nikolaos
Published: May 2004

The management of blood pressure (BP) during the acute phase of stroke remains a matter of debate. The aim of the present study was to evaluate a possible association between long-term mortality and BP values in acute stroke by means of BP monitoring. We studied a consecutive series of 198 first-ever acute stroke patients. BP monitoring was initiated in all subjects within 24 h of ictus. One year after stroke onset, 34 (17.7%) patients had died. Multivariate Cox regression analysis revealed only age, level of consciousness on admission, lacunar stroke and 24-hour pulse pressure (24-hour PP) as significant outcome predictors. The hazards ratio for 1-year mortality associated with every 10 mm Hg increase in 24 h PP was 1.39 (95% CI: 1.04–1.86, p = 0.028). The present results demonstrate that increasing 24-hour PP levels in patients with acute stroke are independently associated with higher long-term mortality. This may have implications in acute stroke BP management and warrants further investigation.
German Cockroach Extract Induces Activation of Human Eosinophils to Release Cytotoxic Inflammatory Mediators
Authors: Sohn Myung-Hyun , Lee Young-Ah , Jeong Kyeong-Yong , Sim Seobo , Kim Kyu-Eun , Yong Tai-Soon , Shin Myeong Heon
Published: May 2004

Background: Eosinophils play an important role in the pathogenesis of allergic diseases. Sensitization and exposure to cockroach allergen have been demonstrated to be one of the major risk factors for the development of bronchial asthma. However, little is known regarding the functional capacity of cockroach extract antigen to activate human eosinophils. Objective: We investigated whether German cockroach extract can activate human eosinophils to release cytotoxic inflammatory mediators. Methods: Purified eosinophils from the peripheral blood were incubated with various concentrations (0–200 µg/ml) of German cockroach extract antigen. Effector functions of eosinophils were checked by degranulation and superoxide anion production. In addition, we examined surface expression of CD11b and CD69, and intracellular activation of p38 mitogen-activated protein kinase (p38 MAP kinase) in cockroach-stimulated eosinophils. Results: German cockroach extract induced degranulation and superoxide production from human eosinophils. In addition, incubation of eosinophils for 3 h with the cockroach extract resulted in an increased level of the surface expression of CD11b and CD69. Furthermore, cockroach-induced superoxide production from eosinophils was significantly inhibited by the pretreatment of cells with a p38 MAP kinase inhibitor SB202190. Indeed, a large amount of phosphorylated forms of p38 MAP kinase was detected in cockroach-stimulated eosinophils. Conclusions: Our results suggest that German cockroach extract induces activation of human eosinophils to release cytotoxic inflammatory mediators such as superoxide and granular proteins.
ADRB2 Polymorphisms and Asthma Susceptibility: Transmission Disequilibrium Test and Meta-Analysis
Authors: Migita Ohsuke , Noguchi Emiko , Jian Zhang , Shibasaki Masanao , Migita Takuo , Ichikawa Kunio , Matsui Akira , Arinami Tadao
Published: May 2004

Background: The β2-adrenergic receptor (ADRB2) is the most common adrenergic receptor in the lung, and associations between ADRB2 polymorphisms and intermediate phenotypes of asthma have been reported. Four missense polymorphisms (Arg16Gly, Gln27Glu, Val34Met, and Thr164Ile) and one polymorphism in the 5′ leader cistron of the ADRB2 messenger RNA has been identified. In vitro studies have shown that these missense polymorphisms can affect ADRB2 function. Methods: To examine possible associations of ADRB2 polymorphisms with asthma susceptibility, we performed transmission disequilibrium tests (TDT) of 137 Japanese families identified through children with atopic asthma. Results: We did not find associations between any alleles of the ADRB2 polymorphisms and asthma by TDT (p > 0.1). We also performed a meta-analysis of data from all available studies. The random-effects model showed no significant odds ratio for the Arg16Gln (odds ratio = 1.05, p = 0.53) or Gln27Glu (odds ratio = 1.12, p = 0.22) polymorphism. Conclusion: Our data indicate that ADRB2 does not contribute substantially to susceptibility to asthma, but it is possible that these polymorphisms influence disease activity and drug responses in individuals with asthma.
Role and Modulation of CD16 Expression on Eosinophils by Cytokines and Immune Complexes
Authors: Davoine Francis , Labonté Isabelle , Ferland Claudine , Mazer Bruce , Chakir Jamila , Laviolette Michel
Published: May 2004

Background: Blood eosinophils express CD16 on their surface when stimulated in vitro with platelet-activating factor or IFNγ. Transient expression of CD16 is also observed in vivo following aeroallergen challenge of asthmatic subjects. The present work is aimed at evaluating the possible mechanisms modulating eosinophil expression of CD16 and the biological functions of this receptor. Methods: First, purified blood eosinophils were incubated with IL-1β, IL-2, IL-4, IL-5, IL-9 or IL-16, GM-CSF, IFNγ, eotaxin or 5-oxo-ETE and CD16 expression was measured. Second, the capacity of CD16 to mediate degranulation induced by IgG immune complexes (IC) was evaluated in eosinophils with low and high CD16 expression. Finally, serum allergen-specific IgE and IgG, and total IgE levels were measured at baseline in allergic asthmatics and correlated with changes observed in blood eosinophil CD16 expression (ΔCD16) following allergen challenge. Results: Only IFNγ and IL-2 significantly increased the number of CD16+ eosinophils, respectively, 37 ± 10% (p = 0.0038) and 38 ± 8% (p = 0.0006), compared to control, 7 ± 2%. IgG IC induced degranulation in eosinophils with low and high CD16 expression and monoclonal anti-CD16 and anti-CD32 antibodies inhibited this. IgG IC increased eosinophil CD16 expression (14 ± 6%, p = 0.0008) and this effect was blocked by pretreatment with anti-CD32 antibodies. ΔCD16 following allergen challenge correlated with the specific IgG/total IgE ratio (r2 = 0.41, p = 0.036). Conclusion: These data suggest that formation of IgG IC is associated with surface eosinophil CD16 expression in asthma and that CD16 in cooperation with CD32 mediates IC-induced degranulation.
Qualitative and Quantitative Evaluation of Bird-Specific IgG Antibodies
Authors: Lopata Andreas L. , Schinkel Magda , Potter Paul C. , Jeebhay Mohamed F. , Hashemi Carolin , Johansson S.G.O. , van Hage-Hamsten Marianne
Published: May 2004

Background: Exposure to organic dust produced by birds often gives rise to an immune response, e.g. IgG antibodies, but intense exposure can lead to high concentrations of IgG antibodies and the development of allergic alveolitis, often known as ‘bird fancier’s lung’. The aim of this study was to establish the distribution of bird-specific IgG antibodies in exposed and nonexposed individuals and compare a nonquantitative and quantitative method in evaluating raised levels of IgG antibodies. Methods: Sera were collected in Sweden and South Africa and levels of IgG antibodies specific to pigeon, budgerigar and parrot antigens were quantified using the UniCAP system. Results were compared to the precipitation in gel assay. The IgG antibody values of symptomatic patients without precipitating antibodies (non-PP group; n = 51) and patients with precipitating antibodies (PP group; n = 34) were analyzed and compared to nonexposed asymptomatic blood donors (BD group; n = 73) and environmentally exposed pigeon breeders (n = 11). Results: The IgG antibody response of the analyzed groups in Sweden and South Africa did not vary significantly from each other. IgG antibody responses were the strongest to pigeon antigens with clear increased IgG antibody levels in the PP group [geometric mean (GM) 603 mg/l] compared to the non-PP (GM 6.9 mg/l) and BD group (GM 5.0 mg/l). Threshold values, calculated as the GM value from the BD group plus 3 standard deviations (99% confidence interval), were 9.8, 10.8 and 10.0 mg/l for pigeons, budgerigars and parrots, respectively. Comparison of the two methods resulted in a good concordance with a level of agreement of 94.1% (kappa statistic = 0.83). Conclusions: The UniCAP system for the detection of bird-specific IgG antibodies is a highly reproducible, generally available, quantitative method for routine diagnostic testing and monitoring of exposed subjects with a very high level of agreement to the precipitating gel assay.
Anodal Current Intensities above 40 μA Interfere with Current-Induced Axon-Reflex Vasodilatation in Human Skin
Authors: Tartas M. , Durand S. , Koïtka A. , Bouyé P. , Saumet J.L. , Abraham P.
Published: May 2004

When using iontophoresis, the ‘non-specific’ vasodilatation (NSV) that is observed as a result of C-fibre excitation is generally attributed to the local accumulation of protons under the anode. NSV following prolonged 100-µA anodal current application only appears after the current is stopped. Break excitation alone does not explain the delayed onset of this vasodilatation. We hypothesised that this delay could result from an anodal block and thus, that a minimal intensity would be required to achieve hyperpolarisation of primary afferent fibres (mainly C-fibres). Using laser Doppler flowmetry, cutaneous blood flow was recorded in the forearms of 8 healthy volunteers 2 min before current application, during the application and 20 min after stopping the monopolar anodal current. In protocol 1, after 2.5 min of current application at an intensity of 100 µA, the intensity was abruptly decreased to 0–80 µA for a second 2.5-min period. The onset of vasodilatation was only delayed at intensities >30 µA during this second period. In protocol 2, re-application of the current after a 50-second interruption (expected to allow for the occurrence of an axon reflex) did not interfere with the onset of vasodilatation. Thus: (1) the minimal intensity interfering with the axon reflex is far lower than that reported for C-fibre blockade in isolated nerves; (2) the results suggest that current application does not directly interfere with the vasodilator mechanisms induced by the axon reflex at the level of smooth muscle cells.
Neonatal Outcome in Pregnancies after Preterm Delivery for HELLP Syndrome
Authors: Aslan Halil , Gul Ahmet , Cebeci Altan
Published: May 2004

Objective: To compare neonatal outcome after preterm delivery of infants where pregnancy had been complicated by the HELLP syndrome. Study Design: The maternal and neonatal charts of 475 consecutive pregnancies complicated by hypertensive disorders at our perinatal unit were reviewed. The HELLP syndrome was defined by previously published laboratory criteria. 93 women fulfilled the criteria and constituted our HELLP syndrome study group. 188 normotensive patients who were delivered because of preterm labor comprised the control group. Results were compared by means of χ2 analysis and Student’s t test where appropriate. Results: There were 518 pregnancies complicated by hypertensive disorders and 93 by HELLP syndrome. The incidence of HELLP syndrome among women with severe preeclampsia was 19.5%. We found a significant difference in the incidence of intrauterine growth restriction (61.2 vs. 5.8%, p < 0.0001), intrauterine fetal death (13.9 vs. 6.9%, p = 0.035), abruptio placenta (13.9 vs. 2.6%, p = 0.001), and fetal distress (35.4 vs. 12.2%, p < 0.0001) between the two groups. There were no significant differences in complications (respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and sepsis) between the HELLP syndrome group and controls. However, the neonatal death rate and the need for mechanical ventilation and neonatal intensive care were greater in the HELLP syndrome group. Conclusions: Our study suggests an increased mortality and morbidity in newborns of mothers complicated with HELLP syndrome that can be partly attributed to increased rates of intrauterine growth restriction and fetal distress, particularly beyond 32 weeks of gestation.
The Interaction between Heart Failure, Renal Failure and Anemia – The Cardio-Renal Anemia Syndrome
Authors: Silverberg Donald S. , Wexler Dov , Blum Miriam , Wollman Yoram , Schwartz Doron , Sheps David , Keren Gad , Iaina Adrian
Published: May 2004

Background: Many patients with congestive heart failure (CHF) have chronic kidney insufficiency (CKI) and anemia. Aims: The purpose of this review is to clarify the relationship between these three factors and to study the effect of correction of anemia in CHF and CKI. Findings: Anemia, CHF and CKI are each capable of causing or worsening each other. Thus they form a vicious circle which can result in progressive CHF, CKI and anemia. Aggressive therapy of CHF, CKI and control of the associated anemia with erythropoietin and i.v. iron can prevent the progression of CHF and CKI, reduce hospitalization, and improve quality of life. Conclusion: CHF patients are a major source of end-stage renal failure patients and deserve special attention. If treated well and early, progressive heart failure and renal failure can be prevented. Cooperation between nephrologists, cardiologists, and other internists will improve the care of all three conditions and prevent their progression.
Impact of Residual Renal Function on Volume Status in Chronic Renal Failure
Authors: Pecoits-Filho Roberto , Gonçalves Simone , Barberato Silvio H. , Bignelli Alexandre , Lindholm Bengt , Riella Miguel C. , Stenvinkel Peter
Published: May 2004

During the past few years, it has become increasingly evident that residual renal function (RRF) is an important and independent predictor of poor outcome in patients with chronic kidney disease (CKD). Although the causes of this observation are not fully understood, it appears that the loss of RRF impairs both fluid removal and clearance of solutes, which in turn leads to uremic toxicity and increased morbidity and mortality. There is increasing evidence that patients with CKD develop signs of fluid overload already in the early phases of the disease, and this may be a stimulus for inflammatory activation. Recently, an inflammatory component was identified in uremic atherosclerotic and non-atherosclerotic cardiovascular disease (CVD), which have been consistently associated with poor clinical outcome in patients with CKD. Signs of systemic inflammation occur in parallel to the impairment in renal function, and the pathophysiology is most likely multifactorial, including a decrease in cytokine clearance, advanced glycation end-product accumulation, oxidative stress, and principal fluid overload. Additionally, inflammation seems to be a predictor of accelerated loss of renal function. In this article, we discuss the evidence showing that patients with CKD generally have fluid overload, the mechanisms by which impaired renal function may lead to a chronic inflammatory state, and the available information linking fluid overload to accelerated loss of renal function and CVD through inflammation. Inflammation may lead to the development of complications of CKD, in particular CVD, but on the other hand may also lead to a faster progression of renal disease. Strategies aiming to reduce fluid overload may be useful to reduce cardiovascular morbidity and mortality, but also preserve RRF.
GH and Cortisol Response to Glucagon Administration in Short Children
Authors: Johnstone H.C. , Cheetham T.D.
Published: May 2004

Objective: To establish whether there is a link between GH status and glucose response to glucagon and to identify determinants of maximum GH and cortisol concentrations. Methods: 95 children referred for assessment of short stature, slow growth or suspected hypothalamo-pituitary dysfunction were assigned to normal, organic GH-deficient or non-organic GH-deficient groups on the basis of history, GH response and MRI findings. Results: Baseline glucose and glucose nadir were related to age in normal children, but the glucose response to glucagon was not linked to GH status. Peak GH response was positively related to age in prepubertal children and peak cortisol was inversely related to age. Conclusions: GH status is not a major determinant of the glucose response to glucagon. There is a relationship between age and the GH/cortisol response in short normal children.
Migratory Necrolytic Dermatitis Presenting after Cephalosporin Administration in a Patient with a Pancreatic Head Mass
Authors: Gumbs Andrew A. , Parisi Valeria , Sargenti Manuela , Bassi Claudio
Published: May 2004

Migratory necrotizing dermatitis is one of the most distressing presenting symptoms of glucagonomas. This rare functioning pancreatic endocrine tumor is third in incidence after insulinomas and gastrinomas and is often malignant at the time of diagnosis. Elevated serum glucagon levels cause decreased amino acid levels which is believed to be the principal cause of the dermatitis. Other symptoms include anemia, visual scotomata and mild diabetes mellitus. Medical treatment alone including octreotide and amino acid supplementation has been reported to eliminate the dermatitis. Nonetheless, surgical resection or debulking remains the definitive treatment when possible. Because of its rarity, diagnosis may be delayed by years accounting for the high rate of metastasis at presentation. Reported here is the case of a 77-year-old man who presented with a migratory necrotizing dermatitis after antibiotic treatment and whose diagnosis of a glucagonoma was then delayed for over 1 year.
Granulocyte Extravasation and Recruitment to Sites of Interstitial Inflammation in Patients with Renal Failure
Authors: Dadfar Elham , Lundahl Joachim , Jacobson Stefan H.
Published: May 2004

Background: We have shown that leukocytes collected from sites of interstitial inflammation in patients on hemodialysis have a disturbed expression of CD11b compared to cells from healthy subjects. The aim of the present study was to study adhesion molecule expression on granulocytes in the peripheral circulation and at sites of interstitial inflammation in patients with renal failure. Methods: Two skin blisters were raised in 10 patients and 19 healthy subjects and interstitial exudates collected (0 h). Skin chambers were applied and exposed to buffer or serum for 10 h in order to induce an intermediate and an intense interstitial inflammation. Cells and blister fluid were collected for determination of leukocyte count, CD11b/CD62L expression, interleukin-8 (IL-8) concentration in the interstitium and blister activity in terms of CD11b up-regulation. Results: At the sites of intermediate and intense inflammation, granulocytes from patients with renal failure showed significantly higher expression of CD62L (p < 0.01 and p < 0.001, respectively) and significantly lower expression of CD11b (p < 0.0001 and p < 0.0001, respectively) compared to corresponding cells from healthy subjects. The interstitial concentration of IL-8 was significantly lower at the sites of intermediate (p < 0.005) and intense inflammation (p < 0.05) in patients with renal failure compared to in healthy subjects. In order to explore whether the decreased CD11b expression observed in patients is due to the interstitial milieu, blister exudates from patients and healthy subjects were incubated with leukocytes from healthy blood donors. Blister exudates from patients had a similar capacity to mobilize CD11b on granulocytes in vitro compared with blister exudates from healthy subjects. There was no consistent correlation between the expression of adhesion molecules on granulocytes in the interstitium and the concentration of IL-8 or the total interstitial concentration of chemotactic mediators. Conclusion: Constitutive cellular determinants are probably involved in the disturbed expression of adhesion molecules on granulocytes at sites of interstitial inflammation in patients with renal failure.
IGFs, IGFBPs, IGF-Binding Sites and Biochemical Markers of Bone Metabolism during Differentiation in Human Pulp Fibroblasts
Authors: Reichenmiller Katharina M. , Mattern Christel , Ranke Michael B. , Elmlinger Martin W.
Published: May 2004

Objective: To investigate the role of the insulin-like growth factors (IGF) system during the differentiation of human pulp-derived fibroblasts (HPF). Methods: Primary HPF were cultured for 24 days in DMEM medium with IGF-I or IGF-II (50 ng/ml each). Cell growth and morphology, alkaline phosphatase (ALP) activity, the concentration of free deoxypyridinoline (DPD), IGF-I, -II, IGFBP-2 and -3 were studied. The number of 125I-IGF-I binding sites was estimated by Scatchard analysis. Results: Light-microscopically visible nodules emerged during differentiation. Simultaneously, the ALP activity increased steadily between days 8 and 24, while the DPD concentration decreased by about 50%. The HPF produced high concentrations of IGF-II (2.00–1.30 µg/106 cells) but low IGF-I, IGFBP-2. IGFBP-2 was not changed, IGFBP-3 increased by 65% during differentiation. The number of IGF binding sites increased from 8,500 ± 55 per cell (day 8) up to 22,000 ± 570 (day 24). Conclusion: The increasing number of IGF-binding sites accompanied by alterations in the biochemical bone markers during the differentiation of HPF suggests an autocrine/paracrine role for the IGFs in the formation of dentinal hard tissue.
Computer Simulation of Flood Operation in Multireservoir Systems
Authors: Niewiadomska-Szynkiewicz Ewa
Published: May 2004

In this article, a summary of experience with the development of methods for controlling multiplereservoir systems during flood periods, gained through computer simulation, is presented. Several decision mechanisms based on online forecasting and optimization are taken into consideration. Particular attention is focused on a two-level control structure with periodic coordination. The advantages of applying parallel global algorithms to determine the optimal decisions regarding outflows from the reservoirs are presented. Advantages of developing sophisticated control structures, as well as decision mechanisms with respect to the available quality of inflow forecasting and delays involved by data transmission and computation time, are considered. Finally, the results of simulations of online management in the case study of two reservoir systems located in the southern part of Poland are described and discussed.
An Investigation on the Effect of Fiber Weight Fraction on Buckling of Laminated Composite Plates
Authors: Ray Chaitali
Published: June 2004

The effect of fiber weight fraction on buckling of laminated composite plates has been investigated in the present study. The elastic properties of individual laminae are calculated from the elastic properties of fiber and matrix materials. The laminated plate has been modeled using eight noded isoparametric quadratic plate bending element using first order shear deformation theory. The buckling parameter of laminated composite plate has been calculated and compared with those available in literature. A detailed parametric study has been performed to investigate the effect of fiber weight fraction on buckling of laminated composite plates.
Open Psychiatric Services in Interwar France
Authors: Thomas Gregory M.
Published: May 2004

The open psychiatric service established in Paris by Édouard Toulouse was meant to provide early, active psychiatric treatment to mildly afflicted individuals without subjecting them to legal commitment. Psychiatric reformers also hoped that the service would help to raise the status of psychiatry by tying their specialty's fate to laboratory science and hospital medicine. This article traces the genesis of open psychiatric services in interwar France and surveys the debates they engendered within the French psychiatric community. It highlights the role of World War I in the implementation of open services and in the creation of a pool of patients who required assistance.
Analysis and Synthesis of Reconfigurable Robotic Systems
Authors: Bi Z. M. , Gruver William A. , Lang S. Y. T.
Published: May 2004

Reconfigurable Manufacturing Systems (RMSs) offer a key technology for the realization of mass customization. Compared with integral systems, RMS may provide system configurations to satisfy a wide range of Functional Requirements (FRs). An important issue for RMS is configuration design, the determination of a configuration from all of feasible configurations to meet FRs. Configuration design of strongly coupled RMS, such as reconfigurable robotic system, has particular challenges due to special characteristics compared with dedicated systems. In this research, a methodology for the design of Reconfigurable Robotic Systems (RRSs) is described. The proposed methodology can be generalized to other reconfigurable manufacturing systems having similar features.
Virtual-Build-to-Order as a Mass Customization Order Fulfilment Model
Authors: Brabazon Philip G. , MacCarthy Bart
Published: May 2004

Virtual-build-to-order (VBTO) is a form of order fulfilment system in which the producer has the ability to search across the entire pipeline of finished stock, products in production, and those in the production plan, in order to find the best product for a customer. It is a system design that is attractive to Mass Customizers, such as those in the automotive sector, whose manufacturing lead time exceeds their customers’ tolerable waiting times, and for whom the holding of partly finished stocks at a fixed decoupling point is unattractive or unworkable. This paper describes and develops the operational concepts that underpin VBTO, in particular the concepts of reconfiguration flexibility and customer aversion to waiting. Reconfiguration is the process of changing a product’s specification at any point along the order fulfilment pipeline. The extent to which an order fulfilment system is flexible or inflexible reveals itself in the reconfiguration cost curve, of which there are four basic types. The operational features of the generic VBTO system are described and simulation is used to study its behaviour and performance. The concepts of reconfiguration flexibility and floating decoupling point are introduced and discussed.
Assessing Variable Levels of Platform Commonality Within a Product Family Using a Multiobjective Genetic Algorithm
Authors: Simpson Timothy W. , D’Souza Brayan S.
Published: May 2004

Many companies are using product families and platform-based product development to reduce development costs and lead-time while increasing product variety and customization. Multiobjective optimization is experiencing new found use in the field of product family design to facilitate product platform design and help resolve the inherent tradeoff between commonality and distinctiveness that exists within a product family. After discussing the uses of multiobjective optimization in product family design and the limitations of current approaches, we introduce a genetic algorithm-based approach for product family design that has been developed to overcome these challenges. The proposed genetic algorithm (GA) modifications enable it to simultaneously design the product platform and its corresponding family of products while considering varying levels of platform commonality within the product family. The effectiveness of the proposed approach is demonstrated through the design of a family of General Aviation Aircraft and comparison against previous results. The impact of seeding the proposed GA with two product families, one with all products common and one with all products unique, is studied and shown to yield a richer Pareto set in fewer generations.