bluuebunny/crossref_metadata_2025 huggingface dataset:
From childhood trauma to adult well‐being through psychosocial assistance of Chilean families
Authors: Punamäki Raija‐Leena
Published: October 2004

This study examined whether psychosocial assistance in childhood predicted coping strategies, family atmosphere, learning experiences and mental health in adulthood. Participants were 153 Chileans (14–30 years old) who, as children, had lost a family member through political imprisonment, execution, disappearance, or expulsion from the country. SEM‐modeling revealed that early timing and substantial duration of psychosocial assistance in childhood predicted good mental health and positive learning experiences in adulthood via effective coping strategies. In addition, a family atmosphere characterized by high cohesion and a low level of conflict associated with good mental health and positive learning experiences. Both the nature of childhood trauma and the timing and duration of assistance turned out to be crucial for later resourcefulness and well‐being. Children who had lost a parent as executed or disappeared were the most task‐oriented and conscientious students and enjoyed a harmonious family life. Early initiation and substantial duration of assistance predicted lower levels of poor mental health symptoms (posttraumatic, depressive, anxiety, somatic, and aggressive) in adulthood. © 2001 John Wiley & Sons, Inc.
Sarason's context of productive learning: Towards the development of a measure to assess teacher goals
Authors: Forbes‐Jones Emma L. , Cowen Emory L.
Published: October 2004

The authors developed a 40‐item teacher‐completed measure designed to assess educational goals, including Sarason's concept of a context of productive learning (COPL). Elementary‐level teachers from schools across a range of sociodemographic contexts rated the importance of each of several goals. Factor analysis identified four factors: Traditional Learning, Context of Productive Learning (COPL), Teacher Control, and Meeting Requirements. Teachers who reported high levels of enjoyment of teaching and those teaching in the lower grades had higher scores on the COPL factor than their opposites. Also, teachers who reported that their teaching objectives had been shaped more by personal values and experiences than by training and supervision had higher COPL factor scores. Needed future steps include refinement of its item composition, replication with a larger sample, and exploration of its relationship to (a) actual teacher behaviors in the classroom and (b) pertinent child educational and behavioral outcomes. © 2001 John Wiley & Sons, Inc.
Who joins a preventive intervention? How risk status predicts enrollment
Authors: Ireys Henry T. , DeVet Katherine A. , Chernoff Robin
Published: October 2004

The objective of this study was to identify social, psychological, and health‐related variables that predict mothers' refusals to join a prevention program for families of children with chronic illnesses. A two‐step recruitment process was used with 193 families of children with chronic illnesses. First, families were recruited for a longitudinal research survey. Then, mothers were given the opportunity to randomly receive one of two programs. Mothers who refused the opportunity to participate in either program continued in the research project. Data were collected through structured interviews at baseline and 12 months later. Compared to mothers who agreed to participate in one of the programs, those who refused reported more confidence, more support, and less depression and higher functional status and better adjustment in their child. Mothers who agree to participate in a longitudinal research effort but refuse to participate in an intervention program are likely to be functioning well, and may perceive no need for a program designed to prevent mental health problems. © 2001 John Wiley & Sons, Inc.
The communication of empathy in couples during the transition to parenthood
Authors: Pistrang Nancy , Picciotto Anna , Barker Chris
Published: October 2004

This study examined how empathy is communicated and experienced in the helping interactions of couples expecting their first baby. Eighteen couples took part in a semistructured communication task, and then, in a tape‐assisted recall session, identified helper responses that were high and low in empathy. Qualitative data analysis yielded five themes characterizing high empathy responses—checking out or exploring meaning, acknowledging the concern, articulating meaning or summarizing, offering solutions, and a mutual experience—and five themes characterizing low empathy responses—missing the point, dismissing the concern, offering solutions, redirecting the conversation, and persuading. The findings suggest both similarities and differences between the communication of empathy in this population and existing theoretical conceptions of empathy in psychological therapy. Implications for preventive interventions for couples are discussed. © 2001 John Wiley & Sons, Inc.
Color doppler sonography for ventral hernias in patients with acute abdomen: Preliminary findings
Authors: Liang Ren‐Jow , Wang Hsiu‐Po , Huang Shih‐Pei , Wu Ming‐Shiang , Lin Jaw‐Town
Published: October 2004

Purpose

We assessed the usefulness of color Doppler sonography (CDUS) in evaluating the vascular status of ventral hernias and distinguishing incarcerated from nonincarcerated ventral hernias.

Methods

In this prospective study, 10 patients who presented with acute abdomen and had ventral hernias underwent CDUS from August 1999 to May 2000. Patient age and sex and the clinical severity, mode of therapy, and outcome in these 10 patients were evaluated in relationship to the CDUS findings.

Results

Five patients had readily visible flow in the bowel within the hernial sac on CDUS. Two of these 5 had spontaneous reduction under conservative treatment, and 3 had asymptomatic ventral hernias with acute abdomen caused by spontaneous bacterial peritonitis. Barely visible flow was visualized in the bowel by CDUS in 4 other patients. Three of these underwent emergency surgery because of peritoneal signs; 2 of them were found to have ischemic changes in the bowel. The fourth patient underwent a successful manual reduction. The remaining patient had absent flow in the bowel on CDUS and underwent emergency surgery, which revealed gangrenous changes in the bowel.

Conclusions

The intensity of the Doppler signals on CDUS appears to be a promising predictor of bowel viability in cases of ventral hernia. Thus, CDUS should impact the determination of the treatment plan, including whether to provide conservative treatment or surgery. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:435–440, 2001.
Sonographic appearance of aggressive angiomyxoma of the scrotum
Authors: De La Ossa Margarita , Castellano‐Sanchez Amilcar , Alvarez Elena , Smoak William , Robinson Morton J.
Published: October 2004

Aggressive angiomyxoma (AAM) is a rare, locally infiltrative tumor that occurs almost exclusively in the pelvic and perineal regions of women of childbearing age. We report the unusual case of a 26‐year‐old man with an AAM presenting as a slowly enlarging scrotal mass. Gray‐scale scrotal sonography demonstrated a well‐demarcated, hypoechoic, extratesticular, extraepididymal mass with multiple thin, echogenic internal septa. The mass arose inferior to the left testicle and displaced the testicle cephalad. Color Doppler sonography revealed surrounding vascularity but no Doppler signals within the mass. The testicles and epididymides demonstrated normal echogenicity and vascularity. Histologic examination of the excised mass revealed a well‐demarcated, nonencapsulated lesion composed of spindle‐shaped cells in a myxoid background with a prominent vascular component. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:476–478, 2001.
Sonographic findings in type I glycogen storage disease
Authors: Pozzato Carlo , Botta Anna , Melgara Chiara , Fiori Laura , Giannì Maria Lorella , Riva Enrica
Published: October 2004

Purpose

The aim of this study was to document the sonographic appearance and dimensions of the liver and spleen in patients affected by type I glycogen storage disease and to correlate those findings with laboratory data to evaluate the potential role of sonography in diagnosing that disease.

Methods

Fourteen patients (age range, 3–26 years; 10 patients younger than 18 years) with type I glycogen storage disease proved by liver biopsy were studied prospectively with gray‐scale sonography, color Doppler sonography, and spectral analysis. The liver, kidneys, spleen, portal system, hepatic veins, and hepatic arteries were evaluated. Laboratory data were correlated with sonographic findings.

Results

In 13 (93%), of 14 patients, the liver was enlarged, and in 11 patients (79%), hepatic echogenicity was increased. In 9 patients (64%), both kidneys were enlarged, and in 6 cases (43%), the spleen was enlarged. In all patients, flow in the portal, splenic, and superior mesenteric veins was hepatopetal, and flow in the hepatic veins was triphasic. In 5 patients (36%), both triglyceride and total cholesterol levels were higher than normal. No focal hepatic lesions were identified. Analysis found no significant association between sonographic findings and laboratory data.

Conclusions

The most frequent sonographic findings in patients with type I glycogen storage disease were hepatomegaly, increased hepatic echogenicity, and enlarged kidneys. Sonography may help in the diagnosis of type I glycogen storage disease, but a liver biopsy is required for a definitive diagnosis. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:456–461, 2001.
Inexpensive holder for hand‐trimming resin‐embedded tissues
Authors: Wise Robert R.
Published: October 2004

A simple and inexpensive mount for securely holding resin‐embedded tissues for trimming prior to sectioning for light or electron microscopy is described. The unit is composed of a base plate from which a 12.7‐mm drill chuck protrudes. A tissue block is clamped into a microtome chuck and that is mounted in the drill chuck. A standard dissecting microscope is placed over the unit and used to magnify the block for trimming. Total cost of materials is estimated to be $20–40 USD. Microsc. Res. Tech. 56:306–307, 2002. © 2002 Wiley‐Liss, Inc.
Localization of metals in cells of saprophagous soil arthropods (Isopoda, Diplopoda, Collembola)
Authors: Köhler Heinz‐R.
Published: October 2004

This review summarizes results on the intracellular distribution of metals in cells of woodlice (Isopoda), millipedes (Diplopoda), and springtails (Collembola), which are three major groups of saprophagous arthropods contributing to the turnover of soil organic matter. Although the impact of metals and also metal pollution has inevitably been shown at levels of higher biological organization than subcellular mechanisms in these animal groups, the aim of this review is to focus exclusively on storage sites and aspects of intracellular metal metabolism. Thus, methodologically, results obtained by microscopical techniques such as histochemistry, X‐ray microanalysis, energy filter transmission electron microscopy, or laser microprobe mass spectrometry were given preference. Results from atomic absorption spectrophotometry of cellular fractions were kept to a minimum. In all three taxa, the main intracellular metal storage sites are various types of “granules” which are widely distributed throughout cell types associated with the digestive system. Microsc. Res. Tech. 56:393–401, 2002. © 2002 Wiley‐Liss, Inc.
Cellular and subcellular distribution of metals in molluscs
Authors: Marigómez Ionan , Soto Manu , Cajaraville Miren P. , Angulo Eduardo , Giamberini Laure
Published: October 2004

The cellular processes involved in metal metabolism in molluscs are reviewed, with emphasis on the contribution of microscopy (AMG, ARG, EPMA, and SIMS) to both basic research of metal cell biology and applied environmental research. In molluscs, metal uptake may occur by facilitated diffusion, active transport, or endocytosis, and can be enhanced by MT synthesis or formation of mineralized granules. In aquatic molluscs, gills constitute a key interface for dissolved metal uptake, where metals are bound to MT, incorporated into lysosomes, and released basally towards the blood plasma and circulating hemocytes. However, particulate metal uptake is mainly achieved via the digestive tract by endocytosis; further metals are transferred first to lysosomes and then to residual bodies, especially in the digestive cells of the digestive gland. Additionally, metals can be accumulated selectively in specific cell types. As ligands pools differ from cell to cell, different metals may be retained in different cell types. Class “a” metals are localized in cells with granules composed of carbonate, oxalate, phosphate, and sulfate (oxygen donors), whereas “b” metals are associated with those cell types rich in sulfur and nitrogen ligands (sulfur donors). In molluscs, oxygen donors occur in connective tissue calcium cells and basophilic cells, whereas sulfur donors are present in digestive cells, podocytes, nephrocytes, and rhogocytes. Hemocytes, which constitute the most relevant system for metal transport between tissues, move around the body and may penetrate tissues and remove metals from the inner medium to be accumulated in lysosomes as nondigested products. Rhogocytes also participate in metal mobilization, accumulation, and release. The assessment of metal levels in target cells of sentinel molluscs by microscopic techniques provides an early‐warning measure, with promising applications as an exposure biomarker for environmental monitoring programs. Microsc. Res. Tech. 56:358–392, 2002. © 2002 Wiley‐Liss, Inc.
In vivo structural imaging of the rat brain with a 3‐T clinical human scanner
Authors: Pfefferbaum Adolf , Adalsteinsson Elfar , Sullivan Edith V.
Published: October 2004

Purpose

To examine the feasibility of using product acquisition software on a 3‐T human MRI system to acquire high‐resolution structural brain images in the rat.

Materials and Methods

Three sets of dual spin‐echo, high‐resolution (0.234 × 0.234 mm in‐plane, 0.5 mm thick) images covering the entire rat brain were collected and averaged in 66 min. The images had sufficient signal‐to‐noise ratio (SNR) and resolution for visual identification and manual outlining of exemplary structures, including the lateral ventricles and dorsal and ventral portions of the hippocampus. Further, the data were adequate for unsupervised, automated segmentation, permitting quantification of the dorsolateral ventricles. The images compared favorably with those collected on a 7‐T system.

Results

Interrater reliabilities (intraclass correlations) of manual ventricular scoring were greater than 0.97, and manual vs. automated correlations were 0.97. The variability of lateral ventricular size across animals was substantially higher than that of the hippocampus.

Conclusion

The large variability of some brain structures that can exist across even a highly selected strain of rats can readily be detected with the use of human 3‐T systems for the study of small animals. J. Magn. Reson. Imaging 2004;20:779–785. © 2004 Wiley‐Liss, Inc.
Serological and molecular screening for viruses in blood donors from Ntcheu, Malawi: High prevalence of HIV‐1 subtype C and of markers of hepatitis B and C viruses
Authors: Candotti D. , Mundy C. , Kadewele G. , Nkhoma W. , Bates I. , Allain J.‐P.
Published: October 2004

The prevalence of antibodies to human immunodeficiency virus type 1 (HIV‐1), hepatitis C virus (HCV), human T lymphotropic virus I (HTLV‐I), and hepatitis B (HBV) surface antigen (HBsAg) was determined in blood donors from Ntcheu, Malawi. Each donation was also screened for HIV‐1 RNA and HCV RNA. Among 159 blood donations, the prevalence of HIV‐1 infection was 10.7%, 8.1% for HBV carriage, 6.8% for anti‐HCV, and 2.5% for anti‐HTLV‐I. HIV‐1/HTLV‐I and HIV‐1/HCV dual infections were observed in 1.2% of the donations. Consequently, 13% of blood donors from Ntcheu should be deferred for retroviral infections and 15% for hepatitis viral infections. Sequence analyses of the HIV‐1 strains revealed a relatively homogeneous circulation of subtype C viruses in Malawi. These findings confirm the high endemicity of blood‐borne viruses in Malawi and the need for a sensitive viral screening of blood donations to improve blood safety. J. Med. Virol. 65:1–5, 2001. © 2001 Wiley‐Liss, Inc.
Persistent hyperendemicity of hepatitis C virus infection in Taiwan: The important role of iatrogenic risk factors
Authors: Sun Chien‐An , Chen Hui‐Chi , Lu Sheng‐Nan , Chen Chien‐Jen , Lu Chih‐Feng , You San‐Lin , Lin Szu‐Heng
Published: October 2004

The purpose of this study was to investigate determinants of endemic hepatitis C virus (HCV) infection within communities in Taiwan. A two‐phase study, including a seroprevalence survey and a prevalent case‐control study at the first phase, which has been published previously, and a follow‐up seroconversion determination and an incident case‐control study during the second phase, was carried out to evaluate correlates of persistent endemic HCV infection. At the first phase, a total of 12,021 men and 1,819 women who were 30–64 years old and living in seven townships in Taiwan were tested for the seroprevalence of antibodies to HCV (anti‐HCV). In addition, a prevalent case‐control study involving 272 HCV‐positive cases and 282 seronegative controls identified from the anti‐HCV testing was conducted to investigate risk factors associated with HCV prevalence. During the second phase, a total of 2,728 men and 834 women who were seronegative at recruitment participated in the 1‐year prospective study on anti‐HCV seroconversion. Subsequently, an incident case‐control study based on 39 seroconverters and 81 persistently seronegative controls were carried out to elucidate determinants of HCV seroconvertion. Antibodies to HCV were tested by the second‐generation enzyme immunoassay. Information on risk factors of HCV infection was collected from subject interviews. The prevalence of anti‐HCV consistently increased with age (range 2.9–5.4%), whereas no apparent age trend was observed for anti‐HCV seroconversion rate (range 0.9–1.7%). A striking geographical variation in seroprevalence and seroconversion rates of anti‐HCV was observed in the study townships. Furthermore, a significant geographical correlation between HCV seroprevalence and seroconversion rates was noted (r = 0.962, P = 0.001). From the results of both prevalent and incident case‐control comparisons, medical injections were found to be the main mode to sustain the persistent endemic state of HCV infection within a community (odds ratios for prevalent and incident case‐control studies were 2.5 (95% CI = 1.7–3.6) and 3.1 (95% CI = 1.4–7.1), respectively. The data indicate that the basis for HCV transmission has already been existed in study areas and the iatrogenic risk factor tended to be the major determinant for sustaining persistent endemicity within a community. J. Med. Virol. 65:30–34, 2001. © 2001 Wiley‐Liss, Inc.
Fatal adenovirus type 7b infection in a child with Smith‐Lemli‐Opitz syndrome
Authors: Beby‐Defaux A. , Maille L. , Chabot S. , Nassimi A. , Oriot D. , Agius G.
Published: October 2004

Adenovirus type 7 causes worldwide respiratory tract infections, mainly in children. Severe systemic infections can occur, especially in immunocompromised patients and in patients with underlying chronic diseases. This report describes the first case of a fatal disseminated adenovirus type 7 infection in a child with Smith‐Lemli‐Opitz syndrome, a rare autosomal recessive disorder due to a primary enzymatic defect in cholesterol metabolism. Nasopharyngeal secretions and autopsy specimens including liver, lung, pleural fluid, and rectum were collected for viral culture. Adenovirus serotype 7 strains were obtained from all anatomic sites, except the liver. All these clinical isolates were analyzed using restriction endonuclease digestion of the genome, identifying them as genome type 7b, a virulent type. In this case, the fatal evolution could have been accelerated by the presence of an immunodeficiency although immunodeficiency is not included in the definition of Smith‐Lemli‐Opitz syndrome. The frequent recurrent banal infections in Smith‐Lemli‐Opitz syndrome could be prevented by a cholesterol supplementation regimen. Finally, this report emphasizes the need for efficient therapy for disseminated adenovirus infections, especially for virulent genome types. J. Med. Virol. 65:66–69, 2001. © 2001 Wiley‐Liss, Inc.
Area under the viraemia curve versus absolute viral load: Utility for predicting symptomatic cytomegalovirus infections in kidney transplant patients
Authors: Schäfer Peter , Tenschert Werner , Cremaschi Liana , Schröter Matthias , Zöllner Bernhard , Laufs Rainer
Published: October 2004

A novel approach to predicting symptomatic cytomegalovirus (CMV) infections combines the level and the duration of viraemia in a single parameter. Sixty‐four kidney transplant recipients were monitored by quantitative shell vial culture, pp65 antigenaemia, and polymerase chain reaction (PCR) of leucocytes. The area under the curve (AUC) of each parameter was determined from the onset of viraemia to the beginning of antiviral treatment. The AUC values were significantly higher in symptomatic than in asymptomatic patients. For antigenaemia and PCR, optimal AUC thresholds for predicting symptomatic CMV infections were determined. They were superior to standard cutoff levels of absolute viral load in sensitivity, specificity, and positive and negative predictive value. In 8 of the 23 patients who became symptomatic, impending clinical features were indicated earlier by the AUC thresholds than by standard viral load. In conclusion, the concept of the AUC should facilitate identification of patients at risk of symptomatic CMV infection. J. Med. Virol. 65:85–89, 2001. © 2001 Wiley‐Liss, Inc.
Kaposi's sarcoma‐associated herpesvirus serology in Europe and Uuganda: Multicentre study with multiple and novel assays
Authors: Schatz Octavian , Monini Paolo , Bugarini Roberto , Neipel Frank , Schulz Thomas F. , Andreoni Massimo , Erb Peter , Eggers Maren , Haas Jürgen , Buttò Stefano , Lukwiya Matthew , Bogner Johannes R. , Yaguboglu Svenja , Sheldon Julie , Sarmati Loredana , Goebel Frank Detlef , Hintermaier Renate , Enders Gisela , Regamey Nicolas , Wernli Marion , Stürzl Michael , Rezza Giovanni , Ensoli Barbara
Published: October 2004

A multicentre study was undertaken to define novel assays with increased inter‐assay concordance, sensitivity, specificity and predictive value for serological diagnosis of human herpesvirus type 8 (HHV‐8) infection. A total of 562 sera from European and Ugandan human immunodeficiency virus (HIV)‐infected or uninfected individuals with or without Kaposi's sarcoma (KS) and blood donors were examined under code by 18 different assays in seven European laboratories. Sera from KS patients and all non‐KS sera found positive by at least 70%, 80%, or 90% of the assays were considered “true positive.” The validity of the assays was then evaluated by univariate logistic regression analysis. Two immunofluorescence assays (IFA) for detection of antibodies against HHV‐8 lytic (Rlyt) or latent (LLANA) antigens and two enzyme‐linked‐immunosorbent assays (ELISA) (M2, EK8.1) for detection of antibodies against HHV‐8 structural proteins were found to be highly concordant, specific, and sensitive, with odds ratios that indicated a high predictive value. When used together, the two IFA (Rlyt‐LLANA) showed the best combination of sensitivity (89.1%) and specificity (94.9%). The performance of these assays indicate that they may be used for the clinical management of individuals at risk of developing HHV‐8 associated tumours such as allograft recipients. J. Med. Virol. 65:123–132, 2001. © 2001 Wiley‐Liss, Inc.
Detection of influenza a subtypes in community‐based surveillance
Authors: Boon A.C.M. , French A.M.F. , Fleming D.M. , Zambon M.C.
Published: October 2004

A rapid microtitre cell enzyme immuno assay (cell‐EIA) was developed for the detection of influenza A subtypes in nasopharyngeal(NPS) swabs taken for surveillance. During the 1997/1998 influenza season in the United Kingdom, cell‐EIA was compared to cell culture for the detection and typing of influenza A viruses in NPS obtained by sentinel general practitioners in community surveillance. The cell EIA can also be used to detect different influenza A subtypes (H3N2, H1N1, H5N3, H5N1, H7N7, and H9N2) and was used as a rapid detection assay for the screening of individuals returning from Hong Kong with influenza‐like illness suspected to be due to H5N1 in 1997/98, providing a rapid, efficient, inexpensive method for the screening of influenza A cases during an outbreak or pandemic situation. The cell‐EIA results reflected the results obtained by traditional virus culture within the age distribution of samples, clinical symptoms, and time between date of illness onset and sampling of cases, indicating its usefulness in surveillance of human and non‐human influenza viruses. During two outbreaks of influenza in schools, Directigen© Flu‐A, a near patient test, the cell‐EIA, and tissue culture were compared. The cell‐EIA gave higher sensitivity and specificity (74% and 90%) than Directigen© Flu‐A (65% and 84.6%) in comparison with cell culture. J. Med. Virol. 65:163–170, 2001. © 2001 Wiley‐Liss, Inc.
Presumed common source outbreaks of hepatitis A in an endemic area confirmed by limited sequencing within the VP1 region
Authors: Arauz‐Ruiz Patricia , Sundqvist Lena , García Zaida , Taylor Lizeth , Visoná Kirsten , Norder Helene , Magnius Lars O.
Published: October 2004

Hepatitis A virus isolates from anti‐HAV IgM positive sera of 70 hepatitis cases in two outbreaks and 216 other cases in Central America, 136 sporadic cases and 53 cases from an hyper‐endemic region in Costa Rica, were compared by phylogenetic analyses within the VP1 region. The outbreaks in all 531 cases, in 1992 and 1999, respectively, were presumed water borne. In the first outbreak, HAV RNA could be detected in 70% of the cases sampled during 6 weeks after onset of jaundice. In the hyper‐endemic region of San Ramón in Costa Rica, 1,932 cases were registered between 1972 and 1985. All isolates belonged to subtype 1A. Background isolates from Costa Rica and El Salvador tended to form separate subclusters in the phylogenetic tree construction and were mostly unrelated to subtype 1A strains from other parts of the world. Based on their amino acid sequences, four HAV strains, all related to CR326 sampled in Costa Rica in 1960, were found to have circulated in the area during the last three decades. However, on the basis of nucleotide variability the isolates from the outbreaks could be distinguished from the strains from sporadic cases and sequence analysis could confirm the epidemiological homogeneity of both outbreaks. In the hyper‐endemic region, 16 different sequences were encountered forming one single subcluster. Thus, limited sequencing within the VP1 region proved useful to identify outbreaks of hepatitis A in a highly endemic area, where most strains were local and only one subtype was prevalent. J. Med. Virol. 65:449–456, 2001. © 2001 Wiley‐Liss, Inc.
Sequence analysis of hepatitis B virus genomes from an infant with acute severe hepatitis and a hepatitis B e antigen‐positive carrier mother
Authors: Komatsu Haruki , Inui Ayano , Morinishi Youichi , Sogo Tsuyoshi , Fujisawa Tomoo
Published: October 2004

It is well known that fulminant hepatitis B can occur in infants born to hepatitis B e antigen (HBeAg)‐negative hepatitis B virus (HBV) carrier mothers, whereas fulminant hepatitis and severe hepatitis are uncommon in infants born to HBeAg‐positive mothers. We have encountered an infant with severe acute hepatitis B born to a HBeAg‐positive mother. The aim of this study was to determine whether HBV variants contribute to the pathogenesis of fulminant hepatitis and severe hepatitis in an infant born to an HBeAg‐positive mother. The nucleotide sequence of HBV genomes from the infant and his HBeAg‐positive carrier mother was analyzed. All HBV isolated from the infant and his mother were subtype adr. The sequences of the cloned HBV genomes, each including a part of the X and precore/core regions, isolated from the infant were almost identical (homology of 99.1–99.9%) to those from his mother. There was no mutation in any of the 17 clones examined at nucleotides 1762 and 1764 in the core promoter, which is reported to be associated with fulminant hepatitis. A point mutation at nucleotide 1758 in the second AT‐rich region of the basic core promoter was present in all clones. None of the clones had a point mutation at nucleotide 1896 of the precore region. In this study, no specific HBV variants contributing to the development of neonatal severe hepatitis were found. There is a possibility that host factors rather than viral factors play an important role in some cases of severe neonatal hepatitis B. J. Med. Virol. 65:457–462, 2001. © 2001 Wiley‐Liss, Inc.
Molecular analysis of hepatitis B virus genomes isolated from black African patients with fulminant hepatitis B
Authors: Owiredu William K.B.A. , Kramvis Anna , Kew Michael C.
Published: October 2004

To investigate further the possible role of mutant hepatitis B viruses in the pathogenesis of fulminant hepatitis B, the genomic sequence of hepatitis B virus isolates from 9 South African blacks with this disease, including 5 entire genomes, was analysed. Seven of the isolates were genotype A. The mutation most often reported in patients with fulminant hepatitis B, the G1896A precore stop‐codon substitution, was, as expected, not present in the genotype A isolates with the exception of one in which it was accompanied by a compensatory C1858T substitution. G1896A was, however, present in the one genotype D isolate. No other precore‐defective mutants were detected. The other mutation commonly found in patients with fulminant hepatitis B, the paired A1762T, G1764A substitution in the basic core promoter, was present in only one patient and G1764A in one other. The pre‐surface initiation‐codon mutation documented in a number of patients with fulminant hepatitis B was not found in our isolates. An 18–amino acid deletion present in the pre‐surface region of one isolate has not previously been described in fulminant hepatitis B. Variations within the surface region were mainly genotype specific and not previously described. A relatively large number of mutations were present in the middle region of the core gene in those isolates without G1896A or A1762T, G1764A mutations, although the pattern was not consistent with those in published studies. Thus, as in other published series in which the entire genome of hepatitis B virus responsible for fulminant hepatitis was sequenced, we detected many mutations in different genes, but none was common to all the reported isolates. J. Med. Virol. 65:485–492, 2001. © 2001 Wiley‐Liss, Inc.
Hepatitis C viral genotype influences the clinical outcome of patients with acute posttransfusion hepatitis C
Authors: Hwang Shinn‐Jang , Lee Shou‐Dong , Lu Rei‐Hwa , Chu Chen‐Wei , Wu Jaw‐Ching , Lai Shiau‐Ting , Chang Full‐Young
Published: October 2004

Most patients with an acute infection of hepatitis C virus (HCV) will develop chronic hepatitis, and only about 15–20% of the cases will resolve spontaneously. The mechanism for the different outcomes in patients with acute HCV infection remains unclear. HCV genotype has been recognized as an important factor affecting the clinical course and outcome of chronic hepatitis C patients. In order to evaluate the role of HCV genotype in the clinical course and outcome of acute posttransfusion hepatitis C, 67 patients with acute posttransfusion hepatitis C from a prospective study of posttransfusion non‐A, non‐B hepatitis were enrolled. Thirty‐nine patients (58.2%) were HCV genotype 1b. Among the 67 patients with acute posttransfusion hepatitis C, 53 (79.1%) progressed to chronic hepatitis. Significantly more patients with genotype 1b than non‐1b genotypes developed chronic hepatitis (89.7% vs. 64.3%; P = 0.019). There was no significant difference in gender, mean age, amount of transfused blood, hepatitis symptoms, jaundice, incubation period, peak serum alanine transaminase, or serum HCV RNA titer between patients with HCV genotype 1b and non‐1b infections. Patients who developed chronic hepatitis had a significantly greater incidence of genotype 1b infection (66.0% vs. 28.6%; P = 0.013) and a longer incubation period (7.3 weeks vs. 5.4 weeks; P = 0.052) than patients whose infection was resolved. Patients with a genotype 1b infection that resolved itself spontaneously all had an incubation period of less than 6 weeks. Multivariate logistic regression analysis revealed that genotype 1b and an incubation period ≥ 6 weeks were significant predictive factors for the development of chronic hepatitis. Therefore, the HCV genotype can influence the outcome of patients with acute HCV infection. J. Med. Virol. 65:505–509, 2001. © 2001 Wiley‐Liss, Inc.
Ethnicity and cytokine production gauge response of patients with hepatitis C to interferon‐α therapy
Authors: Kimball Pam , Elswick R.K. , Shiffman Mitchell
Published: October 2004

Interferon is the primary treatment for hepatitis C virus (HCV). However, the long‐term success rate is low particularly for African Americans relative to Caucasians and may be due to differential immune abilities. This study compared cytokine production from PHA‐stimulated peripheral blood from 25 healthy and 40 HCV‐infected African Americans and Caucasians. HCV patients were designated as IFN responders or nonresponders based on outcome after therapy. Ethnicity and genotype were associated with IFN response. IFN responders were 100% Caucasian, whereas nonresponders were 67% Caucasian and 33% African American (P = 0.01). Genotype 1 was present in 100% nonresponders and 50% responders (P < 0.05). Age, sex, liver histology, ALT, and viral titers were equivalent (ns). Cytokine production from healthy individuals showed ethnic variation in cytokine levels. Healthy African Americans produced greater amounts of IL‐2 (P = 0.06), TNF‐α (P = 0.06) and less IL‐10 (P = 0.05) than healthy Caucasians. In contrast, IFN‐γ and TGF‐β levels were equivalent. Pretherapy cytokine production among HCV patients showed a similar pattern of ethnic variation. African American nonresponders produced more IL‐2 (P = 0.06) and TNF‐α (P = 0.02) than Caucasian nonresponders. Cytokine levels among Caucasian and African American nonresponders were equivalent (P = ns) to ethnically matched healthy individuals whereas Caucasian responders produced subnormal levels of IL‐10 (P < 0.05) and TGF‐β (P < 0.05). Since all African Americans failed IFN therapy, cytokine production could not be compared with therapeutic outcome. However, comparison of cytokine production among Caucasians showed that responders produced less IL‐10 (P < 0.001) and more TGF‐β (P = 0.06) than nonresponders and predicted Caucasian nonresponders with 83% sensitivity and 96% specificity. HCV genotype was not relevant to cytokine production (P = ns). Distribution of cytokine genetic polymorphisms (TNF‐α, TNF‐β, IL‐10, TGF‐β) was equivalent in all ethnic groups and did not predict clinical nonresponders. In summary, it appears that ethnicity may contribute to variable immune responses and therapeutic outcome. The cytokine profile among African Americans suggests a more robust immune response, hich may complicate therapy with IFN. In contrast, the subnormal cytokine production among Caucasian responders may be more permissive to IFN therapy. Pretherapy cytokine production may allow prediction of drug resistance among Caucasians. J. Med. Virol. 65:510–516, 2001. © 2001 Wiley‐Liss, Inc.
New genome type of adenovirus serotype 19 causing nosocomial infections of epidemic keratoconjunctivitis in Japan
Authors: Tanaka‐Yokogui Keico , Itoh Norihiko , Usui Norio , Takeuchi Satoshi , Uchio Eiichi , Aoki Koki , Usui Masahiko , Ohno Shigeaki
Published: October 2004

Twelve strains of adenovirus serotype 19, isolated from cases of epidemic keratoconjunctivitis in Japan in 1992, 1993, 1997, and 1998, were analyzed by DNA restriction analysis, using restriction endonucleases BamHI, BglI, BglII, EcoRI, HindIII, KpnI, PstI, SacI, SalI, SmaI, and XhoI. Among these 11 restriction endonucleases, EcoRI, PstI, SacI, and SmaI were discriminative enzymes, showing restriction patterns different from those reported previously for the prototype and the variant 19a. This new genome type was isolated in 1997 and 1998, when an increase of epidemic keratoconjunctivitis cases caused by adenovirus serotype 19 was observed for both sporadic and nosocomial infections. Strains from 1992 and 1993 showed restriction patterns similar to those of the worldwide reported variant 19a for all enzymes used. The changes detected in strains from 1997 and 1998 could be the reason for the recent epidemic. J. Med. Virol. 65:530–533, 2001. © 2001 Wiley‐Liss, Inc.
Quantification of Epstein‐Barr virus load in peripheral blood of human immunodeficiency virus‐infected patients using real‐time PCR
Authors: Dehee Axelle , Asselot Catherine , Piolot Tristan , Jacomet Christine , Rozenbaum Willy , Vidaud Michel , Garbarg‐Chenon Antoine , Nicolas Jean‐Claude
Published: October 2004

Epstein‐Barr virus (EBV) reactivation is more likely to occur in immunocompromised patients with subsequent higher susceptibility to EBV‐associated lymphoproliferations. In contrast to transplant recipients, limited data are available concerning the EBV load in HIV‐infected patients, with or without AIDS‐related non‐Hodgkin's lymphomas. We developed a TaqMan real‐time PCR assay, allowing both the EBV genome and a cellular gene to be quantified in order to obtain a reliable normalized measurement of the EBV load in peripheral blood mononuclear cells (PBMCs). With a wide 6‐log10 quantification range and inter‐assay variations of less than 24%, this quantitative PCR was sufficiently accurate and reproducible for routine follow‐up. The EBV load was determined in PBMCs from 113 HIV‐infected patients, 11 patients with primary HIV infection and 24 HIV‐seronegative healthy controls. The rates of EBV detection were similar in the three groups. However, EBV loads were higher in the HIV‐infected group (P < 0.00001) except for the patients with primary HIV infection. Unexpectedly, EBV loads were not correlated with the clinical stages of HIV infection or HIV replication, and did not depend on the degree of immunodepression, as judged by CD4+ counts. This study contributes towards the definition of the baseline EBV load during HIV infection and stresses the broad inter‐individual variability of the EBV load in HIV‐infected patients. Real‐time PCR provides a useful tool that can be used in further longitudinal studies to assess the relevance of the EBV load to identify HIV‐infected patients with a high risk of EBV‐associated lymphoproliferations. J. Med. Virol. 65:543–552, 2001. © 2001 Wiley‐Liss, Inc.
Genetic analysis of an influenza B virus isolated from a patient with encephalopathy in Japan*
Authors: Shiraishi Kyoko , Lindstrom Stephen E. , Saito Takehiko , Shinjoh Masayoshi , Nerome Reiko , Funatsumaru Sadayuki , Nerome Kuniaki
Published: October 2004

An influenza B virus, B/Saga/S172/99 (SAG99), was isolated from the nasopharynx of a patient with encephalopathy/encephalitis in Japan in 1999. To clarify the molecular characteristics of this virus, detailed analysis of the gene segments coding for the hemagglutinin (HA), neuraminidase (NA), nucleoprotein (NP), matrix protein (M) and non‐structural protein (NS) was undertaken. All five genes of SAG99 showed high nucleotide and predicted amino acid similarities with those of recent non‐encephalopathic strains isolated in the same epidemic season. Subsequent phylogenetic analysis revealed that all five gene segments of SAG99 analyzed in the present study were most similar to those of the recent Yamagata/16/88‐like viruses. The hemagglutinin and neuraminidase proteins of SAG99 were each distinguished from those of recent epidemic strains by one characteristic amino acid substitution. These substitutions were not found in the previously reported encephalopathy/encephalitis‐derived influenza B viruses, and we could not find any common characteristic amino acid changes in SAG99 and these viruses. Similarly, among the internal proteins studied, only the M2 protein of SAG99 was found to contain a single novel amino acid change when compared with other recent isolates. Thus, it was apparent that SAG99 contained very few amino acid differences when compared with other epidemic viruses. The association of recent B/Yamagata/16/88‐like viruses with encephalitis/encephalopathy observed in the present study and previously suggest that these viruses may have a higher potential for causing neurological complications in certain individuals. J. Med. Virol. 65:590–597, 2001. © 2001 Wiley‐Liss, Inc.
Paget disease of the breast—an easily overlooked disease?
Authors: Sheen‐Chen Shyr‐Ming , Chen Han‐Shiang , Chen Wei‐Jen , Eng Hock‐Liew , Sheen Chih‐Wei , Chou Fong‐Fu
Published: October 2004

Background and Objectives

Paget disease of the breast has long been recognized as a distinct clinical disease. The clinical manifestations and outcomes of Paget disease of the breast were reviewed to understand its earlier diagnostic clues and achieve an optimal treatment plan.

Patients and Methods

Thirty‐one patients with Paget disease of the breast were included in this study. The postoperative outcomes and possible related prognostic factors were reviewed and analyzed.

Results

The 5‐year overall survival was 69%. Nineteen patients (61%, Group A) did not have a palpable breast mass and 12 patients (39%, Group B) had a palpable breast mass. There was significant difference (P < 0.01) in the 5‐year overall survival between Group A (94%) and Group B (19%). Group A patients had significantly higher incidences of underlying noninvasive breast carcinoma (73% vs. 8%, P < 0.01) and n0 lymph nodes status (84%vs. 50%, P = 0.043) than those of Group B.

Conclusions

Paget disease of the breast without a palpable breast mass carries a more favorable prognosis. Patients with any nipple complaints deserve a detailed evaluation even in the absence of a palpable breast mass in order not to overlook a favorable disease. J. Surg. Oncol. 2001;76:261–265. © 2001 Wiley‐Liss, Inc.
Comparison of two methods of reconstruction for primary malignant tumors at the knee: A sequential cohort study
Authors: Wunder Jay S. , Leitch Kellie , Griffin Anthony M. , Davis Aileen M. , Bell Robert S.
Published: October 2004

Background and Objectives

The purpose of this study was to compare the complications and functional outcome associated with the use of an irradiated allograft‐implant composite or a bone‐ingrowth modular tumor prosthesis for replacement of the knee joint after resection of a bone sarcoma from the distal femur or proximal tibia.

Methods

Eleven patients initially received an allograft reconstruction, followed by 64 treated with a tumor prosthesis. The primary analysis concerned reconstructive failure, defined by the requirement for removal of the original construct. Functional outcome was assessed by using the 1987 Musculoskeletal Tumor Society rating system.

Results

Reconstructive failure occurred in 6 of 11 (55%) allograft constructs compared with 10 of 64 (16%) tumor prostheses (P = 0.009). Failures were due to infection (2 of 11 allografts versus 4 of 64 prostheses; P = 0.2) or mechanical complications (4 of 11 allograft fractures versus 5 of 64 broken prosthetic stems and 1 aseptically loose prosthesis; P = 0.03). The limb salvage rate was 95% (61 of 64) for patients with a tumor prosthesis compared with 64% (7 of 11) for those with an allograft (P = 0.007). Patients with a tumor prosthesis had a better functional outcome with a mean score of 75% compared with 57% for those with an allograft reconstruction (P = 0.006).

Conclusions

This comparative study suggests that limb salvage surgery at the knee has a better and more predictable outcome with a tumor prosthesis than with an allograft‐implant reconstruction. J. Surg. Oncol. 2001; 77:89–99. © 2001 Wiley‐Liss, Inc.
Adult perineal sarcomas
Authors: Grobmyer Stephen R. , Clary Bryan , Lewis Jonathan J. , Delgado Ruby , Woodruff James M. , Brennan Murray F.
Published: October 2004

Background and Objectives

Primary perineal sarcoma in adults is a rare disease that has only been documented to occur in isolated case reports.

Methods

To better characterize and define the natural history of perineal sarcoma in adults (≥ 18 years), we reviewed our experience with treatment of perineal sarcoma between 1982 and 1999 (nine cases).

Results

Epithelioid sarcoma (n = 4) was the most common histologic subtype. Seven cases (78%) were histologically high grade, and lesions were most commonly < 5 cm. All patients were treated with wide local excision. External beam radiation was the most commonly used form of adjuvant therapy (n = 6). Recurrences were noted in five patients, and the recurrences were most commonly local (60%). Median time to first recurrence was 21 months. Six of nine patients are alive with a median follow‐up of 54 months. Three died of recurrent/metastatic disease at 16, 51, and 54 months after initial surgery.

Conclusions

Aggressive therapy and follow‐up beginning with wide excision can be associated with long‐term survival in adults with primary perineal sarcoma. J. Surg. Oncol. 2001; 77:101–104. © 2001 Wiley‐Liss, Inc.
Diminished benefit from resection of cancer of the head of the pancreas in patients of advanced age
Authors: Bathe Oliver F. , Caldera Humberto , Hamilton Kara L. , Franceschi Dido , Sleeman Danny , Livingstone Alan S. , Levi Joe U.
Published: October 2004

Background and Objectives

The incidence of pancreatic cancer is increasing, and an increasing proportion of these patients is older than 65 years. The benefits of resection in the geriatric population, in whom major comorbidity is more likely, are poorly defined. The authors sought to determine the relative benefits of resection of cancer of the head of the pancreas in different age groups, with particular emphasis on the geriatric population.

Methods

Between 1983 and 1995, 273 patients presented to the University of Miami for evaluation of noncystic epithelial cancer of the head of the pancreas. Resection was performed in 104 patients, and these patients are the subject of this retrospective review. Mean length of follow‐up for surviving patients was 37 ± 24 months. Outcomes were compared in patients < 65 years old (group 1, n = 38), 65–74 years old (group 2, n = 47), and > 74 years old (group 3, n = 19).

Results

Total pancreatectomy was performed in 12 patients and pancreaticoduodenectomy was performed in 92 patients. The overall complication rate was similar in all groups, but major morbidity was highest in group 3 (P = 0.05). Median survival for patients in group 2 was 25.1 months. Survival was significantly shorter in patients from groups 1 and 3 (median survivals 12.4 months and 11.4 months, respectively; P = 0.02). Following control for Hispanic ethnicity, which was also a significant prognostic factor on univariate analysis, only the oldest age group had a significantly shorter survival than the other two groups. Age > 74 years and Hispanic ethnicity remained significant after multivariate analysis.

Conclusions

Long‐term survival after resection is truncated in older patients. This finding and the observation that the major complication rate is higher in the older subgroup emphasize the need to evaluate critically whether older patients should be submitted to radical resection. J. Surg. Oncol. 2001; 77:115–122. © 2001 Wiley‐Liss, Inc.