bluuebunny/crossref_metadata_2025 huggingface dataset:
Isobutyl‐nitrite‐induced methemoglobinemia; treatment with an exchange blood transfusion during hyperbaric oxygenation
Authors: Jansen T. , Barnung S. , Mortensen C. R. , Jansen E. C.
Published: November 2003

A young man was accidentally intoxicated with isobutyl nitrite by a threefold lethal dose. Due to nitrites' ability to change hemoglobine into methemoglobine the patient showed signs of severe hypoxia, which could not be treated by conventional means. Therefore the patient was rapidly transferred to a hyperbaric chamber. The patient was treated with pure oxygen at 283 kPa under which a blood exchange transfusion was performed. The patient fully recovered.
Preparing teams for low‐frequency emergencies in Norwegian hospitals
Authors: Wisborg T. , Rønning T. H. , Beck V. B. , Brattebø G.
Published: November 2003

Background:  Medical emergencies and major trauma require optimal team function. Leadership, co‐operation and communication are the most essential issues. Due to low caseloads such emergencies occur rarely in most Norwegian hospitals. Team training of personnel between real emergencies is expected to improve performance in comparable settings. Most hospitals have cardiac arrest teams, but it is known that the training of such multiprofessional teams varies widely. We wanted to know if this also was the case for trauma teams and resuscitation teams for newborns.

Methods:  A telephone survey of training practices in all the Norwegian hospitals with acute cover was conducted in 2002. Information was obtained on whether trauma teams and neonatal resuscitation teams had participated in practical multiprofessional training during the previous 6 or 12 months.

Results:  Information was obtained from all 50 hospitals. Of the acute care hospitals, 30% had trained their trauma teams during the previous 6 months, and an additional 18% when considering the previous year, while 38% of neonatal wards had multiprofessional training during the previous 6 months, and additionally 13% had had training during the previous year. Additionally four neonatal wards had had regular training of nurses only. More than 80% of all respondents judged regular team training to be achievable, and none considered this training impossible.

Conclusion:  Only half the Norwegian acute care hospitals reported at least yearly training of trauma and neonatal resuscitation teams. Regular team training represents an underused potential to improve handling of low‐frequency emergencies.
Perioperative changes in cerebral ischemic markers in the cerebrospinal fluid after preoperative nimodipine treatment
Authors: Oehmke M. J. , Schirrmeister D. , Kuhn D. F. M. , Fritz T. , Engel J. , Hempelmann G.
Published: November 2003

Background:  Elderly patients with previous organ damage are at risk for minor neurologic deficits after major surgery. Spinal catheter analgesia is used whenever possible in this group and enables regular cerebrospinal fluid (CSF) sampling. Nimodipine, a calcium blocker, may have neuroprotective effects. We examined whether preoperative treatment with nimodipine affects ischemic markers in the CSF during extracranial surgery.

Methods:  We performed a prospective, randomized, placebo‐controlled, double‐blind study in patients (ASA III or IV, 65–85 years) that underwent elective implantation surgery of the hip joint with intrathecal catheter anesthesia. Starting 15 h before surgery, patients received either 30 µg kg−1 h−1 of nimodipine (n = 20) or 0.9% saline solution (placebo, n = 23) as a central venous infusion. The concentrations of neuron‐specific enolase, hypoxanthine, creatine‐kinase, lactate and pH in the CSF were determined before and immediately after surgery as well as 6 and 24 h after surgery.

Results:  Before surgery, the baseline CSF pH was normal in all patients. Immediately after surgery it fell significantly to 7.08 ± 0.29 in the placebo group and non‐significantly to 7.27 ± 0.38 in the treatment group; all values were normalized at 6 and 24 h after surgery in both groups. In the placebo group, lactate levels rose significantly from 1.48 ± 0.28 mmol l−1 before surgery to 1.77 ± 0.27 mmol l−1 immediately after surgery, and to 2.03 ± 0.32 mmol l−1 24 h after surgery. In the treatment group, lactate concentrations remained stable up to 6 h after surgery (1.55–1.62 mmol l−1), while an increase to 2.10 ± 0.48 mmol l−1 was observed 24 h after the operation. Neuron‐specific enolase, hypo‐xanthine and creatine‐kinase showed no change in either group.

Conclusion:  In conclusion, preoperative nimodipine treatment reduced intraoperative CSF acidosis and delayed surgery‐related increases in lactate concentration in the CSF by several hours in elderly, comorbid patients at risk for minor postoperative neurologic deficits.
Hemodynamic effects of a continuous infusion of levosimendan in critically ill patients with cardiogenic shock requiring catecholamines
Authors: Delle Karth G. , Buberl A. , Geppert A. , Neunteufl T. , Huelsmann M. , Kopp C. , Nikfardjam M. , Berger R. , Heinz G.
Published: November 2003

Background:  Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with decompensated heart failure with preserved arterial blood pressure. Data on its use in patients with cardiogenic shock are rare. The present series describes the 24‐h hemodynamic effects of levosimendan as add‐on therapy in desperately ill patients with cardiogenic shock requiring catecholamines.

Methods:  Ten patients with cardiogenic shock received levosimendan as continuous infusion of 0.1 µg kg−1 min−1 for 24 h. The patients were otherwise unselected. Hemodynamic measurements were routinely performed at baseline (time 0) and at 1, 8, 16 and 24 h after start of levosimendan (LS) using a Swan‐Ganz thermodilution catheter.

Results:  During the levosimendan infusion there was a significant increase in cardiac index from 1.8 ± 0.4 to 2.4 ± 0.6 L*min−1*m−2 (P = 0.023) and a significant decrease in systemic vascular resistance from 1559 ± 430 to 1109 ± 202 dyn*s*cm−5 (P = 0.001), respectively. Changes in catecholamine dose, and in systolic and diastolic blood pressure were not significant. Given the individual response to LS, 8/10 patients showed an increase in left ventricular stroke work index under reduced or roughly unchanged preload conditions after 8 h.

Conclusion:  This series shows that a LS infusion is feasible and able to improve hemodynamics in severely compromized, critically ill patients with cardiogenic shock requiring catecholamine therapy. Its potential advantages when compared with other inotropes are unclear. To clarify the potential role of LS in this clinical setting randomized controlled trials on hemodynamic and mortality endpoints are needed.
The first intensive care unit in the world: Copenhagen 1953
Authors: Berthelsen P. G. , Cronqvist M.
Published: November 2003

After an extensive survey of the medical literature we present compelling evidence that the first intensive care unit was established at Kommunehospitalet in Copenhagen in December 1953. The pioneer was the Danish anaesthetist Bjørn Ibsen. The many factors that interacted favourably in Copenhagen to promote the idea of intensive care therapy, half a century ago, are also described.
Associated factors of rehospitalization among schizophrenic patients
Authors: SUZUKI YURIKO , YASUMURA SEIJI , FUKAO AKIRA , OTANI KOICHI
Published: November 2003

Abstract  The purpose of the present study was to identify the associated factors of rehospitalization in schizophrenic patients. A case‐control study was conducted. The cases consisted of rehospitalized patients (n = 67) and controls selected from the outpatients who were matched by age, gender, and the period after the last discharge (n = 62). In the multiple logistic regression analysis, no clinic visits in the second month prior to entry, the number of clinic visits in the previous month, and junior high school graduation as education level were significantly (P < 0.01) associated with rehospitalization after controlling their present function as assessed by the Global Assessment of Functioning. Close monitoring of clinic visits and outreach service appear to be important in preventing rehospitalization of schizophrenic patients. These identified modifiable factors suggest further needs for development and implementation of integrated mental health services in the community.
Family features in primary social withdrawal among young adults
Authors: SUWA MAMI , SUZUKI KUNIFUMI , HARA KOICHI , WATANABE HISASHI , TAKAHASHI TOSHIHIKO
Published: November 2003

Abstract  The problem of ‘social withdrawal’ among young adults is the focus of considerable attention in Japan today. Among the various manifestations of social withdrawal, a ‘primary social withdrawal’ group has been identified that cannot be diagnosed by the established classification of mental disorders. In an earlier report it was suggested that the onset mechanism for primary social withdrawal is not merely a problem of the withdrawn person themselves, but also includes problems of family relationships. The aim of the present study was to identify the characteristics and problems in family relationships associated with primary social withdrawal. For that purpose a survey was conducted using David H. Olson's Family Adaptability and Cohesion Evaluation Scale as well as a questionnaire that the present authors devised on family interactions and the personal situation of the withdrawn person. The results pointed to the following four characteristics of primary social withdrawal families: (i) there are definite rules within the family; (ii) the families share values and an unfounded pride; (iii) there is a lack of emotional exchange in the family, and it is difficult for members to sympathize with each other's negative feelings; and (iv) although concerned about each other, there is little verbal exchange. From these family characteristics, the onset mechanism for withdrawal is triggered by insignificant matters such as minor setbacks in the developmental issues of youth. Then, given the person's personality traits and aforementioned characteristics in family relationships, the person becomes mired in social withdrawal.
A unification of small‐ and large‐crack growth laws
Authors: Hamm Richard W. , Johnson W. Steven
Published: November 2003

A generalized model enhancement is proposed to link small‐ and large‐crack growth laws. The enhancement is based on crack growth rate laws with crack tip plastic zone size formulations. Transition functions are used to transform small‐crack plastic zone sizes and crack growth law exponents to those predicted by linear‐elastic fracture mechanics. In doing so, influences on crack growth, e.g. constraint, crack aspect ratio and specimen geometry are accounted for. The applicability of the enhancement is directed toward instances where small cracks start from geometric features and grow through stress gradients to eventually become large cracks under nominal LEFM conditions. The enhancement is applied to the Wang model, and crack growth rate and fatigue lifetime predictions are made. The enhancement is shown to provide a good correlation to experimental results for Ti–6Al–4V under various maximum stresses at a stress ratio of R = 0.4.
Technical note High‐cycle fatigue crack initiation and propagation behaviour of high‐strength sprin steel wires
Authors: Wang Q. Y. , Berard J. Y. , Rathery S. , Bathias C.
Published: November 2003

An attempt has been made to characterize high‐cycle fatigue behaviour of high‐strength spring steel wire by means of an ultrasonic fatigue test and analytical techniques. Two kinds of induction‐tempered ultra‐high‐strength spring steel wire of 6.5 mm in diameter with a tensile strength of 1800 MPa were used in this investigation.

The fatigue strength of the steel wires between 106 and 109 cycles was determined at a load ratio R = −1. The experimental results show that fatigue rupture can occur beyond 107 cycles. For Cr–V spring wire, the stress–life (S–N ) curve becomes horizontal at a maximum stress of 800 MPa after 106 cycles, but the S–N curve of the Cr–Si steel continues to drop at a high number of cycles (>106 cycles) and does not exhibit a fatigue limit, which is more correctly described by a fatigue strength at a given number of cycles. By using scanning electron microscopy (SEM), the crack initiation and propagation behaviour have been examined. Experimental and analytical techniques were developed to better understand and predict high‐cycle fatigue life in terms of crack initiation and propagation. The results show that the portion of fatigue life attributed to crack initiation is more than 90% in the high‐cycle regime for the steels studied in this investigation.
Gigacycle fatigue of ferrous alloys
Authors: Wang Q. Y. , Berard J. Y. , Dubarre A. , Baudry G. , Rathery S. , Bathias C.
Published: November 2003

The objective of this paper is to determine the very long fatigue life of ferrous alloys up to 1 × 1010 cycles at an ultrasonic frequency of 20 kHz. A good agreement is found with the results from conventional tests at a frequency of 25 Hz by Renault between 105 and 107 cycles for a spheroidal graphite cast iron. The experimental results show that fatigue failure can occur over 107 cycles, and the fatigue endurance stress Smax continues to decrease with increasing number of cycles to failure between 106 and 109 cycles. The evolution of the temperature of the specimen caused by the absorption of ultrasonic energy is studied. The temperature increases rapidly with increasing stress amplitudes. There is a maximum temperature between 106 and 107 cycles which may be related to the crack nucleation phase. Observations of fracture surfaces were also made by scanning electron microscopy (SEM). Subsurface cracking has been established as the initiation mechanism in ultra‐high‐cycle fatigue (>107 cycles). A surface–subsurface transition in crack initiation location is described for the four low‐alloy high‐strength steels and a SG cast iron.
Closure‐free biaxial fatigue crack growth rate and life prediction under various biaxiality ratios in SAE 1045 steel
Authors: Varvani‐Farahani A. , Topper T. H.
Published: November 2003

Biaxial fatigue tests were performed on thin‐walled tubular 1045 steel specimens in a test fixture that applied internal and external pressure and axial load. There were two test series, one in which constant amplitude fully reversed strains (CAS) were applied and another in which large periodic compressive overstrain (PCO) cycles causing strains normal to the crack plane were inserted in a constant amplitude history of smaller strain cycles. Ratios of hoop strain to axial strain ofλ = −1, −0.625, −νand +1 were used in each test series. Fatigue crack growth behaviours under CAS and PCO histories were compared, and revealed that the morphology of the fracture surface near the crack tip and the crack growth rate changed dramatically with the application of the compressive overstrains. When the magnitude of the compressive overstrains was increased, the height of the fracture surface irregularities was reduced as the increasing overstrain progressively flattened the fracture surface asperities near the crack tip. The reduced asperity height was accompanied by drastic increases in crack growth rate and decreases in fatigue life.

Using a pressurizing device attached to the confocal scanning laser microscope (CSLM), crack opening measurements were obtained. Crack opening measurements showed that the biaxial cracks were fully open at zero internal pressure for block strain histories containing in‐phase PCO cycles of yield stress magnitude. Therefore, for the shear‐strained samples, there was no crack face interference and the strain intensity range was fully effective. For PCO tests (with biaxial strain ratios of −0.625 and +1), effective strain intensity data were obtained from tests with positive stress ratios for which cracks did not close. A number of strain intensity parameters derived from well‐known fatigue life parameters were used to correlate fatigue crack growth rates for the various strain ratios investigated. Predicted fatigue lifetimes based on a fatigue crack growth rate prediction program using critical shear plane parameters showed good agreement with the experimental fatigue life data.
Influence of microstructure of (α+β) Ti‐6.2.4.6 alloy on high‐cycle fatigue and tensile test behaviour
Authors: Jago G. , Bechet J.
Published: November 2003

Tensile and gigacyclic fatigue behaviour of Ti–6Al–2Sn–4Zr–6Mo alloy were investigated as a function of lamellar primary α‐ and β‐transformed microstructures. Three thermomechanical processes (TP1, TP2, TP3) were selected to produce different combinations of microstructural features on two slightly different compositions of the alloy (A and B). Ultrasonic fatigue tests were performed in air and liquid nitrogen at a frequency of 20 kHz (R = −1, T = 300 and 77 K), giving fatigue tests up to 109 cycles. Microstructural features and the fracture initiation dependence on the primary α lamellar phase were observed by SEM and/or characterized by quantitative image analysis. It has been found that the microstructure of alloy B produced by TP1 represents a better compromise between resistance to initiation and resistance to microcrack growth. Quicker initiation occurs in coarser α‐platelets (TP2, alloy B), and the continuous partially transformed β matrix appears to effectively decrease the tensile and HCF resistance. The bimodal structure (TP3, alloy B) has the best resistance at room temperature, but the presence of a coarse globular phase decreases this fatigue resistance at low temperature.
Determination of S–N curves with the application of artificial neural networks
Authors: Artymiak P. , Bukowski L. , Feliks J. , Narberhaus S. , Zenner H.
Published: November 2003

The present paper describes the application of artificial neural networks for estimating the finite‐life fatigue strength and fatigue limit. A comprehensive database with results of single‐stage tests on specimens which simulate structural components is evaluated and prepared for processing with the use of neural networks. The available data are subdivided into different classes. A total of six different data classes are specified. The results of the prediction by means of neural networks are superior to those obtained with conventional methods for calculating the fatigue strength. The experimental results are estimated with high accuracy.
A critical plane‐strain energy density criterion for multiaxial low‐cycle fatigue life under non‐proportional loading
Authors: Chen X. , Xu S. , Huang D.
Published: November 2003

A series of multiaxial low‐cycle fatigue experiments was performed on 45 steel under non‐proportional loading. The present evaluations of multiaxial low‐cycle fatigue life were systematically analysed. A combined energy density and critical plane concept is proposed that considers different failure mechanisms for a shear‐type failure and a tensile‐type failure, and from which different damage parameters for the critical plane‐strain energy density are proposed. For tensile‐type failures in material 45 steel and shear‐type failures in material 42CrMo steel, the new damage parameters permit a good prediction for multiaxial low‐cycle fatigue failure under non‐proportional loading. The currently used critical plane models are a special and simple form of the new model.
Recent developments in our understanding of melanocortin system in the regulation of food intake
Authors: Yang Y. K. , Harmon C. M.
Published: November 2003

Obesity has become one of the most significant public health problems facing the world today. However, the pathogenesis of obesity is multifactorial and involves the interaction of genetic and environmental factors. There is a pressing need to better understand the biochemical pathways that control energy intake and expenditure. In the last few years, a number of important signalling molecules have been identified that play important roles in obesity. One family of these molecules is the melanocortin system, which consists of several components: (1) melanocortin peptides; (2) the five seven‐transmembrane G‐protein coupled melanocortin receptors (MCRs); (3) the endogenous MCR antagonists, agouti and agouti‐related protein; (4) the endogenous melanocortin mediators, mahogany, and syndecan. This system plays a key role in the central nervous system control of feeding behaviour and energy expenditure. This article will provide an overview of the anatomy, physiology, and molecular biology of the melanocortin system, and recent developments in our understanding of this system in obesity.
Liquid calories and the failure of satiety: how good is the evidence?
Authors: Almiron‐Roig E. , Chen Y. , Drewnowski A.
Published: November 2003

Increasing rates of obesity and overweight have been attributed to the growing proportion of dietary energy that is consumed in liquid form. Liquids reportedly fail to trigger physiological satiety mechanisms so that compensation for energy consumed as beverages may be imprecise and incomplete. Sweetened beverages have come under particular scrutiny, as their consumption exceeds that of milk and fruit and vegetable juices. However, the evidence that liquids have less impact on satiety than do solid foods remains inconclusive. Some published studies have reported that liquids are less satiating than solids, whereas other studies have reported that solids are less satiating than liquids. In laboratory studies, the degree of energy compensation following pre‐load ingestion was influenced by subject characteristics, pre‐load volume, or the time lag between the pre‐load and the next meal. Such factors appear to interact with pre‐load texture in their impact on hunger and satiety and later food consumption.
Prevalence of overweight among children in Europe
Authors: Lobstein T. , Frelut M.‐L.
Published: November 2003

Estimates of the prevalence of childhood overweight and obesity have been made in several European countries during the last decade. The methods used and the assessment criteria differ from survey to survey. The present paper reports the prevalence data from 21 surveys in Europe using a single, internationally accepted definition of overweight in childhood, allowing direct comparisons to be made. A tendency for a higher prevalence of overweight among children in western and especially southern Europe is shown and some possible reasons for this are discussed.
Tracing the crimson thread: United Kingdom residents holding probated South Australian assets, 1905–1915
Authors: Shanahan Martin
Published: November 2003

At the beginning of the twentieth century, Australia and the United Kingdom enjoyed close economic, cultural and social links. One filament of the ‘crimson thread’ between the two countries was the personal asset holdings of individuals who possessed wealth in both countries. This article examines the asset holdings of estates probated in South Australia and the United Kingdom, and describes the relative wealth of a small set of trans‐national wealth holders. They are found to be an elite group whose wealth placed them in the upper reaches of the wealthy in both the UK and Australia.
Laparoscopical insertion of intraperitoneal catheters for intraperitoneal chemotherapy
Authors: Anaf Vincent , Gangji Diamon , Simon Philippe , Saylam Keziban
Published: November 2003

Background and methods.  Eight patients (seven clinically negative stage Ill ovarian cancer and one peritoneal mesothelioma) respectively underwent second‐look laparoscopy for staging, adhesiolysis and insertion of an intraperitoneal catheter and fixation of a portal. All patients had received six courses of cisplatin–paclitaxel‐based chemotherapy intravenously. At the end of the laparoscopic staging, a 5‐mm catheter was inserted under direct vision through a 5‐mm trocar in the abdomen. A preaponevrotic forceps was used to grasp the catheter and bring it to the portal, which is located on the intercostal aponevrosis 2 or 3 cm above the laparoscope entry.

Results.  Although previously operated, laparoscopy was possible in all patients and the catheters were easily inserted. All patients received intraperitoneal chemotherapy on the second postoperative day. We did not observe any complication after a mean follow‐up of 12 months.

Conclusions.   Laparoscopic insertion of intraperitoneal catheters is a feasible and safe procedure but requires experience in laparoscopic surgery. In many cases it might preclude from performing non‐useful laparotomies. It might help to reduce the hospital stay and the morbidity in relation to second‐look laparotomies. Compared with the blind surgical technique of insertion of intraperitoneal catheters, this technique also allows intraabdominal staging. Nevertheless, further studies are necessary to confirm our results.
Prospective randomized study comparing amoxicillin‐clavulanic acid with cefazolin as antimicrobial prophylaxis in laparotomic gynecologic surgery
Authors: Cormio Gennaro , Di Fazio Franco , Cacciapuoti Cinzia , Bettocchi Stefano , Borraccino Luisella , Selvaggi Luigi
Published: November 2003

Background.  To compare amoxicillin‐clavulanic acid with cefazolin as ultra‐short‐term prophylaxis in laparotomic gynecologic surgery.

Materials and methods.  A prospective randomized study was conducted to compare two antimicrobial regimens in surgical prophylaxis of laparotomic surgery. Patients were randomly allocated to receive amoxicillin‐clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 min before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract, and respiratory tract.

Results.  In the amoxicillin‐clavulanic acid (Group A) and cefazolin (Group B) groups, overall 346 and 352 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both arms. Febrile morbidity occurred in 21 (6.1%) and 26 (7.4%) patients, respectively, in the amoxicillin‐clavulanic acid and cefazolin groups. Wound infection and urinary tract infection were also higher, but not significantly in the cefazolin group (0.5% vs. 1.1% and 2.0% vs. 2.5%, respectively). There was one respiratory tract infection (0.2%) in Group B, and no septic death in either groups.

Conclusion.  Ultra‐short‐term prophylaxis with both amoxicillin‐clavulanic acid and cefazolin is safe in elective laparotomic gynecologic surgery.
The value of outpatient hysteroscopy in diagnosing endometrial pathology in postmenopausal women with and without hormone replacement therapy
Authors: Elliott Jackie , Connor Mary E. , Lashen Hany
Published: November 2003

Background.  This study examined the endometrial pathology in postmenopausal women who had experienced abnormal uterine bleeding, both with and without hormone replacement therapy (HRT), and who subsequently underwent outpatient hysteroscopy.

Methods.  This is a retrospective observational and comparative study. Patient data in the period from 1998 to 2001 inclusive were examined. The influence of various factors on the incidence of pathology was determined, for example HRT use, the type of HRT, age, etc. In addition, the reliability of hysteroscopy in identifying pathology was calculated.

Results.  A total of 503 patients presented with postmenopausal bleeding, 299 postmenopausal women and 204 women on HRT. The incidence of endometrial carcinoma was significantly higher in the postmenopausal women not on HRT (RR > 10), and occurred in women who were significantly older (p = 0.003). Other forms of pathology, such as complex hyperplasia, benign endometrial polyps and fibroids, did not significantly differ between the groups. Outpatient hysteroscopy correctly identified endometrial carcinoma in 98.2% of cases; however, it was less reliable in diagnosing other forms of pathology.

Conclusions.  The relative risk of a postmenopausal woman presenting to a hysteroscopy clinic with abnormal bleeding caused by endometrial cancer is more than 10 times the risk of an HRT counterpart. Furthermore, both hysteroscopy and pipelle sampling are required to accurately identify all cases of endometrial carcinoma.
Seven Antiphospholipid Antibodies in HIV‐Positive Patients: Correlation with Clinical Course and Laboratory Findings
Authors: Sedláček Dalibor , Ulčová‐Gallová Zdenka , Milichovská Lucie , Nováková Pavla , Rokyta Zdeněk
Published: November 2003

Objective:  To compare the clinical course of HIV‐1‐ infected patients, their CD4+, CD8+ T lymphocytes, and viral loads (VL) with the levels of seven antiphospholipid antibodies (aPLs) before, during, and after the highly active antiretroviral therapy (HAART).

Patients and methods:  aPLs were examined in patients (20 men, 10 women, aged 12–64 years, median 33 years) from the AIDS center of Western Bohemia before the initiation of HAART, and two (23 patients), and five (20 patients) years later. Flow‐cytometry was used for CD4+ and CD8+ T lymphocytes analysis, commercial kits were used for VL‐measurements, and commercial enzyme‐linked immunosorbent assay (ELISA) was used to determine serum levels of anti‐β2‐glycoprotein I (GPI) of immunoglobulin G (IgG) and IgA isotypes, and anticardiolipin levels (ACA) of IgG and IgM isotypes. APLs screening also included l‐α‐phosphatidic (ph) acid, l‐α‐phosphatidylethanolamine, l‐α‐phosphatidyl‐dl‐glycerol, l‐α‐phosphatidylinositol, and l‐α‐phosphatidylserine of IgG and IgM autoantibodies. Statistical analysis was performed using cut‐off levels for immunoglobulin‐isotypes of aPLs using 3 S.D. or 95th percentile calculated using Statgraphics‐software.

Results:  In 14 of 21 patients treated by HAART an increased number of CD4+ T lymphocytes was detected, and in 14 of 21 patients VL decreased below detection threshold during the 5 years of observation. We did not observe correlations of aPLs with age, the initial low CD4+ and high number of CD8+ T lymphocytes, and the viremic levels over the entire observation period. We did not find the elevation of aPLs in 2 of 5 patients in stage C (AIDS). Ten of 11 HIV‐positive homosexuals had positive aPLs, and the same result was seen in 7 of 10 patients infected through heterosexual intercourse.

aPLs levels were significantly increased in 18 of 30 patients at the beginning of HAART. ACA IgG was elevated in 14 of 30 cases, IgG antibodies against l‐α‐ph‐acid in 5 of 30, ph‐ethanolamine in 10 of 30, ph‐inositol in 9 of 30, and l‐serine in 14 of 30, combined positivity of six aPLs together was detected in 10 HIV positive patients. Significantly decreased levels of aPLs because of HAART were found in eight patients. APLs were still present in only four patients after 5 years of the treatment. Abnormalities in blood clotting were not present in any of our patients.

Conclusion:  Results of screening for seven aPLs in HIV‐positive patients suggest that HAART also positively influences the autoimmune response represented by aPLs levels, but individual differences in aPLs levels were observed.
PCBs, Hexachlorobenzene and DDE are not Associated with Recurrent Miscarriage
Authors: Sugiura‐Ogasawara Mayumi , Ozaki Yasuhiko , Sonta Shin‐ichi , Makino Tsunehisa , Suzumori Kaoru
Published: November 2003

Problem:  A case‐control study was designed to evaluate any associations between high exposure to polychlorinated biphenyls (PCB), hexachlorobenzene (HCB) and the 1,1,1,‐trichloro‐2,2‐bis (p‐chlorophenyl) ethane (DDT) metabolite 1,1‐dichloro‐2,2‐bis (p‐chlorophenyl) ethylene (DDE) and recurrent miscarriage and immunoendocrine abnormalities.

Methods of study:  A total of 18 kinds of co‐planer PCBs, HCB, DDE, natural killer cell (NK) activity, antiphospholipid antibodies, antinuclear antibody, prolactin, progesterone, thyroid‐stimulating hormone (TSH) and free T4 were examined in 45 patients with a history of three or more (3–11) consecutive first‐trimester miscarriages and 30 healthy women with no history of live birth and infertility.

Results:  There were no differences in mean ± S.D. values in serum samples for PCBs, HCB and DDE between patients and controls. Hypothyroidism, hyperprolactinemia, luteal phase defects, NK cell activity and the presence of autoantibodies were also not associated with levels of any of the compounds in the patients.

Conclusion:  PCBs, HCB and DDE are not associated with miscarriage and immunoendocrine abnormalities in patients with a history of recurrent miscarriage.
γ/δT‐cell Subsets, NKG2A Expression and Apoptosis of Vδ2+ T cells in Pregnant Women with or without Risk of Premature Pregnancy Termination
Authors: Szereday Laszlo , Barakonyi Aliz , Miko Eva , Varga Peter , Szekeres‐Bartho Julia
Published: November 2003

Problem:  Potentially cytotoxic Vδ2+ T lymphocytes recognize human leukocyte antigen‐E on the trophoblast via their CD94/NKG2A receptors. This study aims at determing the percentage of γ/δ T‐cell subsets, their NKG2A and Annexin V positivity in peripheral blood of healthy pregnant women and women at risk of premature pregnancy termination.

Method of Study:  Peripheral Vδ2+ cells from healthy pregnant women and from women at risk of premature pregnancy termination were tested for the KIR NKG2A and Annexin V positivity by flow cytometry.

Results:  The percentage of viable Vδ2+ T cells was higher, that of Vδ1+ T cells was lower in women at risk of premature pregnancy termination than in healthy pregnant women. The percentage of NKG2A+ Vδ2+ T cells was significantly lower in pregnant women at risk of premature pregnancy termination than in normal pregnancy.

Conclusions:  These data suggest the involvement of γ/δ T lymphocytes in the pathogenesis of premature pregnancy termination.
A Digital Method of Sperm Immobilization Test: Comparison to the Conventional Method
Authors: Komori Shinji , Hamada Yukari , Hasegawa Akiko , Tsubamoto Hiroshi , Horiuchi Isao , Tanaka Hiroyuki , Kasumi Hiroyuki , Shigeta Minoru , Koyama Koji
Published: November 2003

Antisperm antibodies have been found in infertile patients and those causing immobilization of sperm are considered to be closely related to unexplained infertility. These antibodies are usually identified by a sperm immobilization test which involves counting motile sperm under microscope. This test is subjective as it relies on the judgement of the examiner with respect to sperm motility. In this study, we analyzed motile sperm by a digital method using Sperm Quality Analyzer. The results were compared with those obtained by the conventional method. We found that the two methods yielded identical results, with 14 of 66 samples tested being positive and 52 negative for sperm immobilizing antibodies. These results show that the digital method is objective and of value in the measurement of motile sperm in determination of sperm immobilizing antibodies.
Inhibition of Human Polymorphonuclear Cell Oxidative Burst by 17‐β‐estradiol and 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin
Authors: Abrahams Vikki M. , Collins Jane E. , Wira Charles R. , Fanger Michael W. , Yeaman Grant R.
Published: November 2003

Problem: Polymorphonuclear cell (PMN) function may be directly influenced by 17‐β‐estradiol and the endocrine disruptor, 2,3,7,8‐tetrachloro‐dibenzo‐p‐dioxin (TCDD). This may have significant consequences on PMN function within the female reproductive tract. This study evaluated the effects of 17‐β‐estradiol and TCDD on PMN oxidative burst.

Method of study: Peripheral blood PMN were isolated from normal male donors. Following treatment with 17‐β‐estradiol, TCDD or both, PMN were stimulated with phorbol 12‐myristate 13‐acetate. Superoxide production was measured by lucigenin‐enhanced chemiluminescence.

Results: Following 24‐hr culture with either 17‐β‐estradiol or TCDD, PMN superoxide production was significantly reduced, however, no such inhibition was observed when PMN were cultured with both estradiol and TCDD. Using antagonists, the estradiol and TCDD effects on PMN superoxide production was shown to be estrogen and aryl hydrocarbon receptor mediated.

Conclusions: Estradiol and TCDD influence PMN oxidative burst through receptor mediated events. Such altered PMN function may have profound effects upon the normal endometrial cycle.
Transcriptional regulation of Pseudomonas aeruginosa rhlR, encoding a quorum-sensing regulatory protein
Authors: Medina Gerardo , Juárez Katy , Díaz Rafael , Soberón-Chávez Gloria
Published: November 2003

ThePseudomonas aeruginosa rhlRgene encodes the transcriptional regulator RhlR which has a central role in the quorum-sensing response. Different gene products involved in bacterial pathogenesis are regulated at the transcriptional level by two quorum-sensing response systems, Las and Rhl. The expression ofrhlRhas been reported to be under the control of the Las system, but its transcriptional regulation has not been studied in detail. Here, therhlRpromoter region has been characterized and shown to present four different transcription start sites, two of which are included in the upstream gene (rhlB) coding region. It was found thatrhlRexpression is not only dependent on LasR but also on different regulatory proteins such as Vfr and RhlR itself, and also on the alternative sigma factorσ54. It is reported thatrhlRexpression is partially LasR-independent under certain culture conditions and is strongly influenced by environmental factors.
Characterization of a soil-derived bacterial consortium degrading 4-chloroaniline
Authors: Radianingtyas Helia , Robinson Gary K. , Bull Alan T.
Published: November 2003

A bacterial consortium comprising four different species was isolated from an Indonesian agricultural soil using a mixture of aniline and 4-chloroaniline (4CA) as principal carbon sources. The four species were identified as Chryseobacterium indologenes SB1, Comamonas testosteroni SB2, Pseudomonas corrugata SB4 and Stenotrophomonas maltophilia SB5. Growth studies on aniline and 4CA as single and mixed substrates demonstrated that the bacteria preferred to grow on and utilize aniline rather than 4CA, although both compounds were eventually depleted from the culture supernatant. However, despite 100 % disappearance of the parent substrates, the degradation of 4CA was always characterized by incomplete dechlorination and 4-chlorocatechol accumulation. This result suggests that further degradation of 4-chlorocatechol may be the rate-limiting step in the metabolism of 4CA by the bacterial consortium. HPLC-UV analysis showed that 4-chlorocatechol was further degraded via an ortho-cleavage pathway by the bacterial consortium. This hypothesis was supported by the results from enzyme assays of the crude cell extract of the consortium revealing catechol 1,2-dioxygenase activity which converted catechol and 4-chlorocatechol to cis,cis-muconic acid and 3-chloro-cis,cis-muconic acid respectively. However, the enzyme had a much higher conversion rate for catechol [156 U (g protein)−1] than for 4-chlorocatechol [17·2 U (g protein)−1], indicating preference for non-chlorinated substrates. Members of the bacterial consortium were also characterized individually. All isolates were able to assimilate aniline. P. corrugata SB4 was able to grow on 4CA solely, while S. maltophilia SB5 was able to grow on 4-chlorocatechol. These results suggest that the degradation of 4CA in the presence of aniline by the bacterial consortium was a result of interspecies interactions.
In situ localization of manganese peroxidase production in mycelial pellets of Phanerochaete chrysosporium
Authors: Jiménez-Tobon G. , Kurzatkowski W. , Rozbicka B. , Solecka J. , Pocsi I. , Penninckx M. J.
Published: November 2003

The ultrastructure of Phanerochaete chrysosporium hyphae from pellets in submerged liquid cultures was investigated in order to learn more about the interrelation between fungal architecture and manganese peroxidase (MnP) production. At day 2 of cultivation, some subapical regions of hyphae in the outer and middle zones of the pellet initiated differentiation into intercalary thick-walled chlamydospore-like cells of about 10 μm diameter. At the periphery of the cytoplasm of these cells, a large number of mitochondria and Golgi-like vesicles were observed. The sites of MnP production were localized at different stages of cultivation by an immunolabelling procedure. The immunomarker of MnP was mainly concentrated in the chlamydospore-like cells and principally distributed in Golgi-like vesicles located at the periphery of the cytoplasm. The apices of hyphae in the outer layer of the pellets were apparently minor sites of MnP production. Maximal MnP release into the culture supernatant coincided with apparent autolysis of the chlamydospore-like cells. Production of extracellular autolytic chitinase and protease coincided with the disappearance of these structures from the pellets. The chlamydospore-like cells observed in the mycelial pellets of P. chrysosporium could be metabolically active entities operating as an enzyme reservoir, delivering their content into the surrounding medium possibly by an enzyme-mediated autolytic process.
An increase in the level of 2-oxoglutarate promotes heterocyst development in the cyanobacterium Anabaena sp. strain PCC 7120
Authors: Li Jian-Hong , Laurent Sophie , Konde Viren , Bédu Sylvie , Zhang Cheng-Cai
Published: November 2003

In the filamentous cyanobacteriumAnabaenasp. strain PCC 7120, a starvation of combined nitrogen induces differentiation of heterocysts, cells specialized in nitrogen fixation. How do filaments perceive the limitation of the source of combined nitrogen, and what determines the proportion of heterocysts? In cyanobacteria, 2-oxoglutarate provides a carbon skeleton for the incorporation of inorganic nitrogen. Recently, it has been proposed that the concentration of 2-oxoglutarate reflects the nitrogen status in cyanobacteria. To investigate the effect of 2-oxoglutarate on heterocyst development, a heterologous gene encoding a 2-oxoglutarate permease under the control of a regulated promoter was expressed inAnabaenasp. PCC 7120. The increase of 2-oxoglutarate within cells can trigger heterocyst differentiation in a subpopulation of filaments even in the presence of nitrate. In the absence of a source of combined nitrogen, it can increase heterocyst frequency, advance the timing of commitment to heterocyst development and further increase the proportion of heterocysts in apatSmutant. Here, it is proposed that the intracellular concentration of 2-oxoglutarate is involved in the determination of the proportion of the two cell types according to the carbon/nitrogen status of the filament.
Different susceptibility of two animal species infected with isogenic mutants of Mycobacterium bovis identifies phoT as having roles in tuberculosis virulence and phosphate transport
Authors: Collins Desmond M. , Kawakami R. Pamela , Buddle Bryce M. , Wards Barry J. , de Lisle Geoffrey W.
Published: November 2003

The Mycobacterium tuberculosis complex includes Mycobacterium bovis, which causes tuberculosis in most mammals, including humans. In previous work, it was shown that M. bovis ATCC 35721 has a mutation in its principal sigma factor gene, sigA, causing a single amino acid change affecting binding of SigA with the accessory transcription factor WhiB3. ATCC 35721 is avirulent when inoculated subcutaneously into guinea pigs but can be restored to virulence by integration of wild-type sigA to produce M. bovis WAg320. Subsequently, it was surprising to discover that WAg320 was not virulent when inoculated intratracheally into the Australian brushtail possum (Trichosurus vulpecula), a marsupial that is normally very susceptible to infection with M. bovis. In this study, an in vivo complementation approach was used with ATCC 35721 to produce M. bovis WAg322, which was virulent in possums, and to identify the virulence-restoring gene, phoT. There are two point deletions in the phoT gene of ATCC 35721 causing frameshift inactivation, one of which is also in the phoT of BCG. Knockout of phoT from ATCC 35723, a virulent strain of M. bovis, produced M. bovis WAg758, which was avirulent in both guinea pigs and possums, confirming that phoT is a virulence gene. The effect on virulence of mode of infection versus animal species susceptibility was investigated by inoculating all the above strains by aerosol into guinea pigs and mice and comparing these to the earlier results. Characterization of PhoT indicated that it plays a role in phosphate uptake at low phosphate concentrations. At least in vitro, this role requires the presence of a wild-type sigA gene and appears separate from the ability of phoT to restore virulence to ATCC 35721. This study shows the advantages of using different animal models as tools for the molecular biological investigation of tuberculosis virulence.
Genetic analysis of a plasmid encoding haemocin production in Haemophilus paragallinarum
Authors: Terry Tamsin D. , Zalucki Yaramah M. , Walsh Shannon L. , Blackall P. J. , Jennings Michael P.
Published: November 2003

The full sequence of plasmid p250, isolated from Haemophilus paragallinarum strain HP250, has been obtained. The plasmid contains seven ORFs: a putative integrase, a putative replication protein (repB) and five ORFs similar to those from the haemocin (bacteriocin) hmcDCBAI operon from Haemophilus influenzae. Of 19 other non-plasmid-containing H. paragallinarum strains screened (11 serovar reference strains and 8 field isolates), 17 strains produced haemocin and were resistant to killing by strain HP250. These strains, unlike strain HP250, have a chromosomally encoded haemocin operon. A number of other members of the family Pasteurellaceae were tested for haemocin sensitivity. Pasteurella avium, Pasteurella volantium and Pasteurella species A, all non-pathogenic bacteria found in the respiratory tract of chickens suffering from respiratory diseases, were sensitive to H. paragallinarum haemocin. However, amongst the pathogenic Pasteurellaceae, 50 % of P. multocida isolates and all five isolates of Pasteurella haemolytica tested were sensitive to the haemocin. Given the prevalence of haemocin production in H. paragallinarum strains, it may play a role in aiding colonization by inhibiting other Gram-negative bacteria that are associated with the respiratory tract in chickens. The origin of replication from plasmid p250 has been used to generate an Escherichia coli–H. paragallinarum shuttle vector which may be useful in genetically manipulating H. paragallinarum.
(De)regulation of key enzyme steps in the shikimate pathway and phenylalanine-specific pathway of the actinomycete Amycolatopsis methanolica
Authors: Kloosterman H. , Hessels G. I. , Vrijbloed J. W. , Euverink G. J. , Dijkhuizen L.
Published: November 2003

Prephenate dehydratase (PDT), chorismate mutase (CM) and 3-deoxy-d-arabino-7-heptulosonate 7-phosphate (DAHP) synthase are key regulatory enzymes in aromatic amino acid biosynthesis in the actinomyceteAmycolatopsis methanolica. Deregulated, feedback-control-resistant mutants were isolated by incubation ofA. methanolicaon glucose mineral agar containing the toxic analoguep-fluoro-dl-phenylalanine (pFPhe). Several of these mutants had completely lost PDT sensitivity to Phe inhibition and Tyr activation. Mutant characterization yielded new information about PDT amino acid residues involved in Phe and Tyr effector binding sites.A. methanolicawild-type cells grown on glucose mineral medium normally possess a bifunctional CM/DAHP synthase protein complex (with DS1, a plant-type DAHP synthase). The CM activity of this protein complex is feedback-inhibited by Tyr and Phe, while DS1 activity is mainly inhibited by Trp. Isolation of pFPhe-resistant mutants yielded two feedback-inhibition-resistant CM mutants. These were characterized as regulatory mutants, derepressed in (a) synthesis of CM, now occurring as an abundant, feedback-inhibition-resistant, separate protein, and (b) synthesis of an alternative DAHP synthase (DS2, anE. coli-type DAHP synthase), only inhibited by Tyr and Trp. DS1 and DS2 thus are well integrated inA. methanolicaprimary metabolism: DS1 and CM form a protein complex, which stimulates CM activity and renders it sensitive to feedback inhibition by Phe and Tyr. Synthesis of CM and DS2 proteins appears to be controlled co-ordinately, sensitive to Phe-mediated feedback repression.