bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational changes in nursing: the situation of enrolled nurses
Authors: Iley Karen
Published: December 2004

Background.  The move to one level of qualified nurse in the United Kingdom (UK) is, in part, a consequence of professionalizing strategies. Registered nurses now undertake technical work previously performed by doctors. The role of enrolled nurses, and their career intentions, have not been considered in light of these changes, despite the fact that many still work in the National Health Service.

Aim.  This paper considers the pursuit of professionalization by nurses, illustrating the argument with findings from an empirical study of conversion to registered nurse by enrolled nurses.

Methods.  The paper is based on a secondary analysis of a large data set, originally used to explore ethnic inequalities in nursing. Data from 2968 respondents were analysed to answer a number of research questions relating to the characteristics of different groups of enrolled nurses and predictors of conversion to registered nurse. These included demographic characteristics, markers of career orientation, career progression and job satisfaction.

Study limitations.  This study used secondary analysis of data and, therefore, exploration of issues was limited, not least because the data were 10 years old. Also, the design was cross‐sectional and respondents’ experiences related to different stages of the phenomenon under study and the same group was not studied over time.

Findings.  Enrolled nurses who had converted to registered nurse were more likely than those who had no intention of converting to: be male, be younger, have been nursing longer, not be working on elderly care wards, have a high career orientation, not have taken a career break, and work full‐time. Most of these factors predicted likelihood to convert. Although nurses who converted to registered nurse were more likely to anticipate career progression, they were less likely to be satisfied with their work.

Conclusion.  In attempts to define rewarding nursing work, the importance of ensuring that qualified nurses continue to retain basic nursing care skills should be acknowledged. This may offer an uncomfortable view to those seeking to further the professional status of nursing.
Fatigue during pregnancy predicts caesarean deliveries
Authors: Chien Li‐Yin , Ko Yi‐Li
Published: December 2004

Background. Previous studies on fatigue and pregnancy outcomes were confined to women with occupational fatigue and did not include women who did not work outside the home. Fatigue during mid‐ and late pregnancy has rarely been studied.

Aims. This paper reports a study examining the associations between work factors, household factors, and fatigue among low‐risk pregnant women in Taiwan and links the effects of fatigue to preterm births and caesarean deliveries.

Methods. The participants were 633 women who were 20–36 weeks pregnant without evidence of obstetrical complications at the time of interview. Pregnancy outcomes were abstracted from the hospital records after delivery. Fatigue was measured using the Fatigue Symptom Checklist. Women were categorized into three groups according to their work status: non‐working, sedentary work, and active work. Other work factors included hours worked and exposure to adverse work environments. Household factors included household work and childcare responsibilities. Multiple linear regression and logistic regression were used for the analysis.

Results. The factors significantly associated with fatigue in the regression model were age, infection during pregnancy, bleeding after 12 weeks of pregnancy, and work status. Women who did not work outside of the home had significantly higher fatigue scores than those who did sedentary work outside the home. Younger women had higher fatigue scores than older women. Fatigue scores during pregnancy predicted caesarean deliveries, given that age and obstetrical risks were controlled in the model.

Conclusions. Fatigue is a significant problem for pregnant women. Fatigue assessments should include morbidities during pregnancy as well as household and work‐related factors. Special attention should be paid to women who do not work outside the home. Staff should elicit information about fatigue and intervene early, as this may help decrease the number of caesarean deliveries.
Narrative inquiry: locating Aboriginal epistemology in a relational methodology
Authors: Barton Sylvia S.
Published: December 2004

Background. This methodology utilizes narrative analysis and the elicitation of life stories as understood through dimensions of interaction, continuity, and situation. It is congruent with Aboriginal epistemology formulated by oral narratives through representation, connection, storytelling and art. Needed for culturally competent scholarship is an experience of research whereby inquiry into epiphanies, ritual, routines, metaphors and everyday experience creates a process of reflexive thinking for multiple ways of knowing. Based on the sharing of perspectives, narrative inquiry allows for experimentation into creating new forms of knowledge by contextualizing diabetes from the experience of a researcher overlapped with experiences of participants – a reflective practice in itself.

Aim. The aim of this paper is to present narrative inquiry as a relational methodology and to analyse critically its appropriateness as an innovative research approach for exploring Aboriginal people's experience living with diabetes.

Nursing application. Narrative inquiry represents an alternative culture of research for nursing science to generate understanding and explanation of Aboriginal people's ‘diabetic self’ stories, and to coax open a window for co‐constructing a narrative about diabetes as a chronic illness. The ability to adapt a methodology for use in a cultural context, preserve the perspectives of Aboriginal peoples, maintain the holistic nature of social problems, and value co‐participation in respectful ways are strengths of an inquiry partial to a responsive and embodied scholarship.
Integration of overseas Registered Nurses: evaluation of an adaptation programme
Authors: Gerrish Kate , Griffith Vanessa
Published: December 2004

Background.  The growth in overseas nurse recruitment to address staff shortages in the United Kingdom (UK) has led to the proliferation of adaptation programmes for overseas nurses to gain appropriate experience and enable them register with the Nursing and Midwifery Council. This paper reports on selected findings from an independent evaluation of an adaptation programme for overseas Registered Nurses offered by a large acute National Health Service trust.

Aim.  This paper reports on a study to evaluate the programme with reference to its objectives, outcomes and overall success from the perspective of various stakeholders.

Methods.  A pluralistic evaluation research model was adopted to identify the criteria that stakeholders used to judge the success of an adaptation programme, and then to use these criteria to judge the programme in question. Data were collected by means of focus group and individual in‐depth interviews with overseas nurses, ward managers, mentors, senior nurse managers and educators over a 12 month period and analysed by drawing on the principles of dimensional analysis. The criteria for success identified by the various stakeholders provided a framework through which the overall success of the initiative could be judged.

Findings.  Five meanings of success were identified: gaining professional registration; fitness for practice; reducing the nurse vacancy factor; equality of opportunity and promoting an organizational culture that values diversity. Key findings relating to each of these are presented. The ease with which nurses gained UK registration and integrated into the nursing workforce was influenced by the characteristics of the work environment, level of support, and organizational context.

Conclusion.  Industrialized nations recruiting from the global nursing market need to invest in providing appropriate support to enable overseas nurses to adapt to working in a different health care system and social and cultural context.
Psychosocial interventions for people with a milder dementing illness: a systematic review
Authors: Bates Jane , Boote Jonathan , Beverley Catherine
Published: December 2004

Introduction.  Over the last three decades, interest has grown in the use of psychosocial interventions for people with dementia. Empirical studies and systematic reviews have been undertaken on a range of such interventions to examine their effectiveness. However, little account has been taken of the appropriateness of psychosocial interventions for people in different stages of the illness. This raises important questions about the degree to which the research evidence can be generalized for people in the milder and the more severe stages of dementia. This systematic review was undertaken therefore to investigate the effectiveness of psychosocial interventions for people with a milder dementing illness.

Methods.  A comprehensive search was undertaken using all the major health care databases, as well as various grey literature sources. For studies to be included in the review, they must have investigated the effect of one or more psychosocial intervention on people with a milder dementing illness, employing a controlled trial design, and measuring outcomes such as cognitive ability, communication, functional performance and well‐being. Identified studies were critically appraised, and where suitable for inclusion, data were extracted.

Results.  Four studies met the final inclusion criteria for the review, and covered three psychosocial interventions: reality orientation, procedural memory stimulation and counselling. No evidence was found for the effectiveness of counselling and procedural memory stimulation on the outcome measures used. However, some evidence was found that reality orientation is effective in improving cognitive ability, with a demonstrable long‐term gain using follow‐up data.

Conclusions.  The review provides some evidence for the use of reality orientation for people in the milder stages of dementia. However, due to the small sample sizes in all the included studies, more research is needed into the effectiveness of psychosocial interventions for this client group. Implications for nursing practice are discussed, and recommendations for future research are set out.
Thyroid status affects the rat cardiac β‐adrenoceptor system transiently and time‐dependently
Authors: Zwaveling J. , Batink H.D. , Taguchi K. , de Jong J. , Michel M.C. , Pfaffendorf M. , van Zwieten A.
Published: December 2004

The aim of this study was to investigate the time‐dependency of the influence of dysthryoid states on the β‐adrenoceptor system in rat heart left ventricle. Therefore, the influence of acute and chronic hyper‐ and hypothyrodism on β‐adrenoceptor‐induced left ventricular responses, β‐adrenoceptor density, cardiac noradrenaline tissue concentrations, Gsα‐proteins, and basal and stimulated adenylate cyclase activities was determined.

Hyperthyroid rats were obtained by feeding with thyroxine (T4)‐containing rat‐chow for 1,4 and 8 weeks. Hypothyroidism was induced by adding 0.05% propylthiouracil (PTU) to the drinking water. Rats of varying ages were used in order to compensate for the differences in the duration of the treatments. Rats were aged 3 and 5 months at the end of the experiments.

Thyroxine treatment for 4 and 8 weeks increased the cardiac sensitivity to isoprenaline, but maximal induced inotropic responses were decreased. Cardiac ventricular β‐adrenoceptor density was increased only in rats treated with T4 for 1 week. This transient effect of hyperthyroidism on cardiac β‐adrenoceptor density was not observed in older rats. The PTU treatment resulted in a stable decrease of cardiac β‐adrenoceptor density.

Left ventricular tissue noradrenaline concentrations were unaffected by hyperthyroidism, where a decrease was observed in hypothyroid rats. Density of Gsα proteins was increased in hearts from chronic hyperthyroid rats.

These results indicate that the increased sensitivity to β‐adrenoceptor‐mediated stimulation in chronic hyperthyroidism cannot be attributed to changes in cardiac β‐adrenoceptor density, but is probably caused by an enhanced content of Gsα. Accordingly, in hyperthyroidism, the β‐adrenoceptor system is influenced time‐dependently, whereas hypothyroidism affects the β‐adrenoceptor system independent of time.
Cardiac anticholinergic effects of procainamide and its N‐acelylated metabolite: experimental pharmacological and radioligand binding studies
Authors: Boucher M. , Chassaing C. , Laborde P. , Breysse C. , Herbet A.
Published: December 2004

The cardiac anticholinergic effects of procainamide (1 mg kg−1min−1) and its N‐acetylated metabolite (NAPA) at equimolar dose (1.16 mg kg−1min−1) were studied using in vivo experimental pharmacological and in vitro radioligand binding studies.

Procainamide and NAPA progressively reduced vagal stimulation‐induced bradycardia in chloralose‐anaesthetized dogs. As indicated by the ED50, the vagolytic activity of NAPA is 1.5–2.0 times weaker than that of procainamide. Both drugs increased heart rate, with lowering of mean blood pressure during the second part of procainamide infusion, but not during NAPA infusion.

Binding studies on rat heart membranes yielded Ki values that were 1.5 times higher for NAPA than for procainamide.

These results show that NAPA exerts a weaker cardiac vagolytic action than procainamide, which is probably linked to a lower ability to bind to cardiac muscarinic receptors.
Family dynamics of postnatally depressed mothers – discrepancy between expectations and reality
Authors: Tammentie Tarja , Paavilainen Eija , Åstedt‐Kurki Päivi , Tarkka Marja‐Terttu
Published: December 2004

Background.  The birth of a new family member always brings changes to family dynamics. The family has to adjust to a new situation and, although the time after childbirth is happy for most families, postnatal depression affects 10–15% of mothers annually.

Aims and objectives.  The purpose of this study was to ascertain families’ experiences of family dynamics when the mother suffers from postnatal depression.

Design.  Nine families (nine mothers, five fathers) where the mother had displayed symptoms of postnatal depression took part for the study.

Methods.  Data were collected through interviews with nine families where the mother had scored 13 or more on the Edinburgh Postnatal Depression Scale, completed 6–8 weeks after childbirth. Families were offered the opportunity to volunteer for the interview while taking part in a follow‐up study of postnatal depression in Finland. Interviews were analysed using the principles of grounded theory.

Results.  The findings showed that there was great discrepancy between expectations and reality in the depressed mothers’ families. Parents, especially mothers, strove for perfection, perceived the infant to tie them down and had high expectations of family life.

Conclusions.  Everyday family life and human relationships change, the depression and the parents’ attitudes towards the infant manifest themselves in different ways, and support is of great importance.

Relevance to clinical practice.  Women, especially those expecting their first child need a great deal of information about mood changes after childbirth and the opportunity to discuss the changes brought about by the birth of a child.
Communication with dying patients – perception of intensive care units nurses in Brazil
Authors: Trovo de Araujo Monica Martins , Paes da Silva Maria Julia
Published: December 2004

Aims and objectives.  This study aimed to assess whether nurses working in intensive care units view the establishment of communication with patients beyond therapeutic possibilities as an effective palliative therapeutic resource, and which aspects of this communication they valued most.

Method.  Data were collected in November 2002, by semi‐structured interviews with 10 nurses of both clinical and surgical intensive care unit at a school hospital in Sao Paulo city, Brazil. Interviews were recorded and transcribed to be further analysed according to the qualitative methodology of content analysis.

Results.  Four categories of thematic order raised from the collected statements, which clarify (i) the value of communication with terminal patients; (ii) the obstacles found during this process; (iii) the need to identify the individual demands of each patient, (iv) be able to use communication as a tool in the palliative care of the dying patient.

Conclusion.  In conclusion, we found that the nurses working at the intensive care unit do consider communication with dying patients an effective therapeutic resource, in spite of their own difficulties in communicating with dying patients, viewing themselves as ill prepared to the task, and often, distancing themselves from the dying patients because of their inability to deal with their own feelings, which were brought forth by the confrontation with the imminence of death.

Relevance to clinical practice.  Although the number of interviewed nurses in our study was small, the results corroborated the findings of other studies and revealed an educational aspect in nursing training that deserves serious consideration.
Universal precautions: a survey of community nurses’ experience and practice
Authors: Bennett Glynis , Mansell Ian
Published: December 2004

Background.  Universal precautions are a set of guidelines which aim to protect health care workers from blood‐borne infections. Community nurses often have to deliver care to people in less than ideal home conditions, their ability to comply with all universal precautions may therefore be compromised.

Aims and objectives.  This paper presents the findings of a questionnaire survey which aimed to explore community nurses’ experience and practices of using universal precautions.

Design and methods.  A questionnaire survey was used for this study. All community learning disability nurses, community mental health nurses and generic community nurses from one Welsh Health Authority were surveyed (n = 543) with a response rate of 70%.

Results.  The majority of community nurses reported compliance with universal precautions, although a small number of nurses stated that they re‐sheathed needles, inappropriately stored sharps containers, inadequately wore gloves and experienced difficulties in handwashing.

Conclusions and relevance to clinical practice.  Community nurses work in a unique and unpredictable environment, which may result in nurses being unable to comply with existing universal precautions guidelines. The production of new infection control guidelines for the community by the National Institute of Clinical Excellence in June 2003, has addressed some of the difficulties faced by community nurses.
Diseases of tunas,Thunnusspp.
Authors: Munday B L , Sawada Y , Cribb T , Hayward C J
Published: December 2004

Much is known about those aspects of tuna health which can be studied in wild populations, e.g. helminth parasites. However, because aquaculture of these species is in its infancy, knowledge of microbial, nutritional and environmental diseases is limited. This review is an attempt to bring together the available information on those diseases ofThunnusspp. which cause significant morbidity, mortality or economic loss. In doing so it has become clear that much more research needs to be undertaken on the physiology of the species (southern, northern and Pacific bluefin tuna) currently used in aquaculture in order for the pathogenesis of some conditions to be properly understood. Attempts at hatchery culture of Pacific bluefin tuna has indicated thatThunnusspp. will be problematic to hatch and propagate.
Islet antibodies and remaining β‐cell function 8 years after diagnosis of diabetes in young adults: a prospective follow‐up of the nationwide Diabetes Incidence Study in Sweden
Authors: Schölin A. , Björklund L. , Borg H. , Arnqvist H. , Björk E. , Blohmé G. , Bolinder J. , Eriksson J. W. , Gudbjörnsdottir S. , Nyström L. , Östman J. , Karlsson A. F. , Sundkvist G.
Published: December 2004

Objectives.  To establish the prevalence of remaining β‐cell function 8 years after diagnosis of diabetes in young adults and relate the findings to islet antibodies at diagnosis and 8 years later.

Design.  Population‐based cohort study.

Setting.  Nationwide from all Departments of Medicine and Endocrinology in Sweden.

Subjects.  A total of 312 young (15–34 years old) adults diagnosed with diabetes during 1987–88.

Main outcome measure.  Plasma connecting peptide (C‐peptide) 8 years after diagnosis. Preserved β‐cell function was defined as measurable C‐peptide levels. Three islet antibodies – cytoplasmic islet cell antibodies (ICA), glutamic acid decarboxylase antibodies and tyrosine phosphatase antibodies – were measured.

Results.  Amongst 269 islet antibody positives (ab+) at diagnosis, preserved β‐cell function was found in 16% (42/269) 8 years later and these patients had a higher body mass index (median 22.7 and 20.5 kg m−2, respectively; P = 0.0003), an increased frequency of one islet antibody (50 and 24%, respectively; P = 0.001), and a lower prevalence of ICA (55 and 6%, respectively; P = 0.007) at diagnosis compared with ab+ without remaining β‐cell function. Amongst the 241 patients without detectable β‐cell function at follow‐up, 14 lacked islet antibodies, both at diagnosis and at follow‐up.

Conclusions.  Sixteen per cent of patients with autoimmune type 1 diabetes had remaining β‐cell function 8 years after diagnosis whereas 5.8% with β‐cell failure lacked islet autoimmunity, both at diagnosis and at follow‐up.
Co‐occurrence in nature of different clones of the social amoeba,Dictyostelium discoideum
Authors: Fortunato A. , Strassmann J. E. , Santorelli L. , Queller D. C.
Published: December 2004

The social amoeba,Dictyostelium discoideum, produces a multicellular fruiting body and has become a model system for cell–cell interactions such as signalling, adhesion and development. However, unlike most multicellular organisms, it forms by aggregation of cells and, in the laboratory, forms genetic chimeras where there may be competition among clones. Here we show that chimera formation is also likely in nature, because different clones commonly co‐occur on a very small scale. This suggests thatD. discoideumwill likely have evolved strategies for competing in chimeras, and that the function of some developmental genes will be competitive. Natural chimerism also makesD. discoideuma good model organism for the investigation of issues relating to coexistence and conflict between cells.
New insights from fine‐scale spatial genetic structure analyses in plant populations
Authors: Vekemans X. , Hardy O. J.
Published: December 2004

Many empirical studies have assessed fine‐scale spatial genetic structure (SGS), i.e. the nonrandom spatial distribution of genotypes, within plant populations using genetic markers and spatial autocorrelation techniques. These studies mostly provided qualitative descriptions of SGS, rendering quantitative comparisons among studies difficult. The theory of isolation by distance can predict the pattern of SGS under limited gene dispersal, suggesting new approaches, based on the relationship between pairwise relatedness coefficients and the spatial distance between individuals, to quantify SGS and infer gene dispersal parameters. Here we review the theory underlying such methods and discuss issues about their application to plant populations, such as the choice of the relatedness statistics, the sampling scheme to adopt, the procedure to test SGS, and the interpretation of spatial autocorrelograms. We propose to quantify SGS by an ‘Sp’ statistic primarily dependent upon the rate of decrease of pairwise kinship coefficients between individuals with the logarithm of the distance in two dimensions. Under certain conditions, this statistic estimates the reciprocal of the neighbourhood size. Reanalysing data from, mostly, published studies, the Sp statistic was assessed for 47 plant species. It was found to be significantly related to the mating system (higher in selfing species) and to the life form (higher in herbs than trees), as well as to the population density (higher under low density). We discuss the necessity for comparing SGS with direct estimates of gene dispersal distances, and show how the approach presented can be extended to assess (i) the level of biparental inbreeding, and (ii) the kurtosis of the gene dispersal distribution.
Peptidoglycan hydrolytic activities associated with bacteriophage virions
Authors: Moak Michael , Molineux Ian J.
Published: December 2004

Murein hydrolases appear to be widespread in the virions of bacteriophages infecting Gram‐positive or Gram‐negative bacteria. Muralytic activity has been found in virions of the majority of a diverse collection of phages. Where known, the enzyme is either part of a large protein or found associated with other structural components of the virion that limit enzyme activity. In most cases, the lack of genetic and structural characterization of the phage precludes making a definitive identification of the enzymatic protein species. However, three proteins with muralytic activity have been unequivocally identified. T7gp16 is a 144 kDa internal head protein that is ejected into the cell at the initiation of infection; its enzyme activity is required only when the cell wall is more highly cross‐linked. P22gp4 is part of the neck of the particle and is essential for infectivity. The activity associated with virions of Bacillus subtilis phage ø29 and its relatives lies in the terminal protein gp3. These studies lead to a general mechanism describing how phage genomes are transported across the bacterial cell wall.
The galactokinase of Hypocrea jecorina is essential for cellulase induction by lactose but dispensable for growth on d‐galactose
Authors: Seiboth Bernhard , Hartl Lukas , Pail Manuela , Fekete Erzsébet , Karaffa Levente , Kubicek Christian P.
Published: December 2004

Lactose is the only soluble carbon source which can be used economically for the production of cellulases or heterologous proteins under cellulase expression signals by Hypocrea jecorina (=Trichoderma reesei). Towards an understanding of lactose metabolism and its role in cellulase formation, we have cloned and characterized the gal1 (galactokinase) gene of H. jecorina, which catalyses the first step in d‐galactose catabolism. It exhibits a calculated Mr of 57 kDa, and shows moderate identity (about 40%) to its putative homologues of Saccharomyces cerevisiae and Kluyveromyces lactis. Gal1 is a member of the GHMP family, shows conservation of a Gly/Ser rich region involved in ATP binding and of amino acids (Arg 51, Glu 57, Asp 60, Asp 214, Tyr 270) responsible for galactose binding. A single transcript was formed constitutively during the rapid growth phase on all carbon sources investigated and accumulated to about twice this level during growth on d‐galactose, l‐arabinose and their corresponding polyols. Deletion of gal1 reduces growth on d‐galactose but does only slightly affect growth on lactose. This is the result of the operation of a second pathway for d‐galactose catabolism, which involves galactitol as an intermediate, and whose transient concentration is strongly enhanced in the delta‐gal1 strain. In this pathway, galactitol is catabolised by the lad1‐encoded l‐arabinitol‐4‐dehydrogenase, because a gal1/lad1 double delta‐mutant failed to grow on d‐galactose. In the delta‐gal1 strain, induction of the Leloir pathway gene gal7 (encoding galactose‐1‐phosphate uridylyltransferase) by d‐galactose, but not by l‐arabinose, is impaired. Induction of cellulase gene expression by lactose is also impaired in a gal1 deleted strain, whereas their induction by sophorose (the putative cellulose‐derived inducer) was shown to be normal, thus demonstrating that galactokinase is a key enzyme for cellulase induction during growth on lactose, and that induction by lactose and sophorose involves different mechanisms.
Proteolytic degradation of Escherichia coli transcription activators SoxS and MarA as the mechanism for reversing the induction of the superoxide (SoxRS) and multiple antibiotic resistance (Mar) regulons
Authors: Griffith Kevin L. , Shah Ishita M. , E. Wolf Richard
Published: December 2004

In Escherichia coli, the SoxRS regulon confers resistance to redox‐cycling compounds, and the Mar regulon provides a defence against multiple antibiotics. The response regulators, SoxS and MarA, are synthesized de novo in response to their inducing signals and directly activate transcription of a common set of target genes. Although the mechanisms of transcription activation by SoxS and MarA have been well studied, little is known about how the systems are shut‐off once the inducing stress has subsided, except that de novo synthesis of the regulators is known to cease almost immediately. Here, we induced the SoxRS regulon and determined that, upon removal of the inducer, expression of the regulon's genes quickly returns to the preinduced level. This rapid shut‐off indicates that the system is reset by an active process. We found that SoxS is unstable and infer that SoxS degradation is responsible for the rapid return of the system to the ground state upon removal of the inducing signal. We also found that MarA is unstable and that the instability of both proteins is intrinsic and unregulated. We used null mutations of protease genes to identify the proteases involved in the degradation of SoxS and MarA. Among single protease mutations, only lon mutations increased the half‐life of SoxS and MarA. In addition, SoxS appeared to be nearly completely stable in a lon ftsH double mutant. Using hexahistidine tags placed at the respective ends of the activators, we found that access to the amino‐terminus is essential for the proteolytic degradation.
Coupling among interstitial cells of Cajal in the human ileum
Authors: Belzer V. , Nissan A. , Freund H. R. , Hanani M.
Published: December 2004

Abstract  Current knowledge on the morphology and physiology of interstitial cells of Cajal (ICC) is mostly based on animal studies, and information about the function of these cells in humans is scarce. There is ultrastructural evidence that ICC in the myenteric region (ICC‐MP) of the small intestine of several species are connected by gap junctions, but these were not observed in the human small intestine. The aim of the present study was to determine whether functional coupling also exists among ICC‐MP in the human ileum. We visualized ICC‐MP in live tissues using Nomarski optics, and verified their identity by staining for c‐Kit. ICC were injected intracellularly with the fluorescent dye Lucifer yellow, which crosses gap junctions. In most cases the labelled cells had oval somata with two primary processes. At normal pH (7.3–7.4) only 20.2% (21/104) of the injected ICC were coupled to other ICC. However, at pH 7.8–7.9 coupling incidence increased to 74.5% (35/47, P < 0.0001). The injected cells were coupled to one to 35 other ICC. Octanol blocked coupling in all cases. Apparently, gap junctions interconnect ICC in the human small intestine. Coupling was enhanced by a small increase in pH, suggesting that it may be under physiological control.
Barraquer–Simons syndrome with benign infundibulocystic proliferation
Authors: Tüzün Binnur , Kirçuval Deniz , Demirkesen Cuyan , Göksügür Nadir , Ünal Gaye , Tüzün Yalçin
Published: December 2004

A white man attended our outpatient clinic because of soft papules on the second finger of the left hand. They were livid red‐colored, warty surfaced cysts, 1–2 cm in diameter, arranged in an annular configuration (Fig. 1). The patient showed prominent zygomatic bones and symmetric loss of buccal fat pads (Bichat's fats), leading to sunken cheeks (Fig. 2). The history of the patient could not be taken because of his debility.

Soft papules on the second finger of the left hand

image

Symmetric loss of Bichat's fats

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Laboratory findings included: hemoglobin, 14.5 g/dL; Htc, 41.6%; red blood cells (RBC), 4.67/µL; white blood cells (WBC), 10.3 × 103/µL; Plt, 274 × 103/µL; mean corpuscular volume (MCV), 89.1 fL; mean corpuscular hemoglobin (MCH), 31.0 pg; mean corpuscular hemoglobin concentration (MCHC), 34.8 g/dL; blood urea nitrogen, 33 mg/dL; creatinine, 0.7 mg/dL; cholesterol, 152 mg/dL; total protein, 8.1 g/dL; albumin, 4.6 g/dL; total bilirubin, 0.5 mg/dL; direct bilirubin, 0.1 mg/dL; calcium, 8.8 mg/dL; erythrocyte sedimentation rate, 6 mm/h; urinalysis, normal – there was no anomaly in the urine in 24 h. The patient was negative for antinuclear antibody (ANA), anti‐DNA, anticentromer antibody, Scl 70 antibody, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV).

Chest X‐ray was normal. Hand X‐ray showed bone cysts on the distal phalanx of the second finger of the left hand.

Histologic examination of the papules on the second finger of the left hand revealed multilobulated or, in other words, proliferating cystic structures lined by epithelium similar to the infundibular epithelium of the hair follicle. The cysts were connected with the surface of the skin and were filled with cornified cells in a basket‐weave array (Fig. 3).

Nodules composed of benign infundibulocystic proliferation (hematoxylin and eosin, × 40)

image

The IQ was measured as 50 indicating mental retardation. Audiogram could not be performed, but sensory neural hearing loss was suspected. After 1.5 months of pimozide therapy (Nörofren, 2.5 mg/day), hearing loss was measured as 50% and a diagnosis of otosclerosis was made. The cystic lesions resolved completely and Bichat's fats regenerated partially.
Acral lentiginous melanoma: an immunohistochemical study of 20 cases
Authors: Kim You Chan , Lee Min Geol , Choe Sung Whan , Lee Mn Cheol , Chung Han Gil , Cho Sang‐Ho
Published: December 2004

Background Though acral lentiginous melanoma (ALM) is a major type of malignant melanoma, no immunohistochemical study on this type of melanoma has been reported.

Objective The purpose of this study is to analysis the immunohistochemical findings of ALM using routinely used immune markers.

Methods An immunohistochemical study was performed on paraffin sections of 20 ALMs using S‐100 protein, HMB‐45, MART‐1, vimentin, epithelial membrane antigen (EMA) and CAM 5.2.

Results S‐100 protein (95%) was found to be a more sensitive marker than either HMB‐45 (80%) or MART‐1 (70%) for recognizing ALM. Melanin bleaching was useful for recognizing heavily pigmented ALM using both S‐100 protein and HMB‐45. The intensity of HMB‐45 correlated well with the melanin content. However, there was no significant correlation between the intensity of S‐100 protein and the melanin content. One and two out of 20 cases stained focally with EMA and CAM5.2, respectively, but these cases stained also with HMB‐45 and/or S‐100 protein.

Conclusions S‐100 protein and HMB‐45 were relatively sensitive markers for recognizing ALM. Despite the occasional positivity for the epithelial markers in ALM, all epithelial marker‐positive cases stained also with HMB‐45 and/or S‐100 protein. Therefore, we recommend that the panel of antibodies used for recognizing ALM should contain at least S‐100 protein and HMB‐45.
Factors related to patient compliance in the treatment of acne vulgaris
Authors: McEvoy Bernard , Nydegger Rudy , Williams George
Published: December 2004

Background Missed appointments are a major problem in healthcare delivery, and are one element of patient compliance with treatment.

Aim To determine whether there was a relationship between the beliefs, attitudes, expectations of treatment, and previous treatment experiences of acne patients and the keeping of follow‐up appointments for treatment.

Methods One hundred and forty‐four consecutive patients presenting to a private dermatologist's office for the treatment of acne completed questionnaires concerning their beliefs and previous treatment, and a record was maintained of missed appointments over a series of five scheduled appointments. A control group of middle and high school students completed the same pretreatment questionnaire. Six months after starting treatment, a second questionnaire was completed regarding compliance with treatment, problems with medication, and frequency of appointments and appointment keeping.

Results There were very few differences between patients and controls in beliefs about the cause and treatment of acne. Patient appointment keeping was as follows: 28% of acne patients attended all four follow‐up appointments, 10% three follow‐up appointments, 15% two follow‐up appointments, 13% one follow‐up appointment, and 19% no follow‐up appointments. Fifteen per cent of patients dropped out of treatment for one or two appointments and then returned.

Conclusions Demographic factors, such as gender, race, method of payment for medical services, and type of therapy prescribed, were more important in determining appointment keeping behavior than were patient attitudes and beliefs, previous therapy, or severity of acne. Although there was no correlation between appointment keeping and knowledge of the condition, knowledge of the medication, severity of acne, age, or previous medical treatment, relationships were observed between demographic factors and appointment keeping.
Oral erosive/ulcerative lichen planus: preliminary findings in an open trial of sulodexide compared with cyclosporine (ciclosporin) therapy
Authors: Femiano Felice , Gombos Fernando , Scully Crispian
Published: December 2004

Objective To study the effect of the heparinoid sulodexide systemically, compared with topical cyclosporine (ciclosporin), on chronic oral erosive/ulcerative lichen planus.

Study design An open nonrandomized trial was conducted in two groups of 10 Italian patients with lichen planus, with subjective assessment of pain and assessment of ulceration amelioration by nonblinded clinicians.

Results Comparable pain relief and amelioration of erosions/ulcers were seen in patients on sulodexide and in those on ciclosporin, but with faster healing in those on sulodexide.

Conclusions Sulodexide appears to be as effective, and perhaps more effective, than topical ciclosporin in the therapy of oral lichen planus, and is less expensive, but full double‐blind placebo‐controlled studies are required.
Cosmetic dermatitis – current perspectives
Authors: Mehta Surjit Singh , Reddy Belum Siva Nagi
Published: December 2004

Background Increasing use of cosmetics by modern society has contributed alarming to an rise in the incidence of cosmetic dermatitis (CD). The causative agents are skin, hair, nail and eye cosmetics. Reported cases of cosmetic dermatitis represent only the tip of the iceberg, as most patients who experience an adverse reaction to cosmetics do not consult a physician but discontinue using the suspected items.

Methods A comprehensive history followed by adequate clinical examination and patch test is important to diagnose reaction to cosmetics. In addition other tests like Repeated Open Application Test (ROAT), usage test, elimination test and safety test are important, as many cosmetics and their ingredients are either weak allergens or irritants.

Results A wide variety of adverse reactions to cosmetics are seen which are of both irritant and allergic type. Pattern of CD varies in different parts of the world depending upon the type and frequency of different cosmetics used. Reactions are more commonly seen in females of younger age and the face is the most common site.

Conclusions Though prevention is better than cure, but cosmetics have definitely infiltrated into our life style. We cannot prevent use of cosmetics but can only limit their use by educating their users and helping them in judicious selection of the required cosmetics.
Gene flow and immigration rate in an island population of great tits
Authors: Verhulst S. , Van Eck H. M.
Published: December 2004

It is generally recognized that immigration and gene flow cannot be equated, but few detailed quantitative comparisons of these processes have been made over the entire lifetime of individual animals. We analyzed data collected in a longterm study of an island population of great tits Parus major, and tested two assumptions frequently made in population genetic studies. (1) The assumption that there is no difference in reproductive output between immigrant and resident breeding birds was refuted for females but not for males. Lifetime production of local recruits (LRS) was reduced by 37% in immigrant females, because female immigrants tended to leave the island after breeding, and thus reproduced for fewer years. Female LRS was density dependent, but the effect of density was independent of status (resident/immigrant). (2) The assumption that mating was random with respect to status was also refuted: assortative mating was found, even when temporal and spatial aggregation of immigrants was controlled for. Thus both assumptions were refuted, and gene flow was lower than immigration rate.
Socio‐economics of brood destruction during supersedure in the carpenter bee Xylocopa pubescens
Authors: Hogendoorn K.
Published: December 2004

In nests of the facultatively social carpenter bee Xylocopa pubescens, both intruders and nestmates destroyed brood during supersedure. However, nestmates and intruders differed with respect to the frequency and the pattern of brood destruction. Intruders destroyed more brood than did nestmates. In addition, intruders appeared to destroy all stages of brood at equal frequencies, whereas nestmates had a preference for opening and thereby destroying newly made cells. Several hypotheses concerning the ultimate reasons for these differences were tested. These differences are not due to either a lack of breeding space, or to an attempt to prevent an imminent loss of dominance. The number of brood cells destroyed by nestmates was not influenced by the degree of relatedness. This indicates that the difference between nestmates and intruders was not based on active kin recognition. The most likely reason why nestmates prefer to open young brood cells is that they can then reallocate the pollen contents of these cells to their own brood. A difference in knowledge about the location of newly made cells may explain the differences in the pattern and the frequency of brood destruction by nestmates and intruders. Furthermore, a superseding nestmate may slightly enhance her average indirect fitness by destroying the brood contents of newly made cells while leaving older brood cells intact.
Source‐sink populations in Mediterranean Blue tits: evidence using single‐locus minisatellite probes
Authors: Dias P. C. , Verheyen G. R. , Raymond M.
Published: December 2004

Long term studies on population biology of Blue tits (Parus caeruleus L.) in Mediterranean habitats have shown that in patchy landscapes life‐history traits seem to be adapted to the predominant type of habitat, where reproductive success is higher. The “source‐sink hypothesis” suggests that differences in the local production of fledglings result in an asymmetrical gene flow from rich deciduous habitats (“source”) to evergreen poor habitats (“sink”), preventing local adaptation in evergreen habitats.

In this study we used single‐locus minisatellite DNA probes to test the following predictions of the source‐sink hypothesis: 1) source and sink populations are not genetically differentiated; 2) amount of gene flow is ranked in the following decreasing order: between source and sink habitats, among source habitats and among sink habitats; and 3) linkage disequilibrium is higher in sink than in source populations. Results were consistent with these three predictions, and with previous results obtained using other approaches. Results clearly support a source‐sink functioning of Blue tit populations in southern France mosaic landscapes, and emphasise the need of combining genetic and ecological studies to understand the functioning of natural populations.
Covariation among floral traits in Spergularia marina (Caryophyllaceae): geographic and temporal variation in phenotypic and among‐family correlations
Authors: Mazer S. J. , Delesalle V. A.
Published: December 2004

Strong covariation among traits suggests the presence of constraints on their independent evolution due to pleiotropy, to linkage, or to selective forces that maintain particular trait combinations. We examined floral trait covariation among individuals, among maternal families within and across populations, and over time, in greenhouse‐raised plants of the autogamous Spergularia marina. We had three aims. First, since the phenotype of traits expressed by modular organs often changes as individuals age, estimates of the degree of genetic covariation between such traits may also change over time. To seek evidence for this, we measured weekly (for five weeks) an array of floral traits among plants representing ∼ 10 maternal families from each of four populations. The statistical significance of the phenotypic and among‐family correlations among traits changed over time. Second, we compared populations with respect to trait covariation to determine whether populations or traits appear to be evolving independently of one another. Differences observed among populations suggest that they have diverged genetically. Third, we sought correlations that might reflect constraints on the independent evolution of floral traits. Investment in another and ovule production per flower vary independently among maternal families; there was no evidence for a “trade‐off” between male and female investment. We propose that in autogamous taxa one should not find a negative correlation between pollen and ovule production per flower, as such taxa cannot evolve sexual specialization and should be under strong selection to maintain an efficient pollen:ovule ratio, preventing the evolution of male‐biased or female‐biased genotypes. We found that other pairs of floral traits, however, expressed highly signficant correlation coefficients, suggesting the presence of some evolutionary constraints, at least within some populations, although their strength depended on exactly when flowers were sampled.
Environment-dependent reversal of a life history trade-off in the seed beetle Callosobruchus maculatus
Authors: Messina F. J. , Fry J. D.
Published: December 2004

Environmental manipulations have consistently demonstrated a cost of reproduction in the capital-breeding seed beetle, Callosobruchus maculatus, as females deprived of seeds or mates lay fewer eggs and thereby increase their longevity. Yet fecundity and longevity tend to be positively correlated within populations, perhaps as a consequence of individual differences in resource acquisition. We conducted a split-brood experiment that combined a manipulation of seed availability (seeds present or absent) with a quantitative-genetic analysis of fecundity and lifespan in each environment. Each trait was significantly heritable in each environment. Seed availability not only altered mean fecundity and longevity between environments, but also modified how the traits were correlated within environments. The signs of both the phenotypic and genetic correlations switched from positive when seeds were present to negative when seeds were absent. This reversal persisted even after the effect of body mass (a potential indicator of resource acquisition) was statistically controlled. Cross-environment genetic correlations were positive but significantly less than one for each trait. We suggest that the reversal of the fecundity–longevity relationship depends on a shift in the relative importance of resource-acquisition and resource-allocation loci between environments. In particular, a cost of reproduction may be apparent at the individual level only when seeds are scarce or absent because differences in reproductive effort become large enough to overwhelm differences in resource acquisition. Despite their common dependence on resources acquired during larval stages, fecundity and lifespan in C. maculatus do not appear to be tightly coupled in a physiological or genetic sense.