bluuebunny/crossref_metadata_2025 huggingface dataset:
The locus responsible for horizontal gaze palsy/progressive scoliosis and brainstem hypoplasia is refined to a 9‐cM region on chromosome 11q23
Authors: Lo B , Faiyaz‐Ul‐Haque M , Banwell B , Blaser S , Paterson AD , Tsui L‐C , Teebi AS
Published: January 2004

Horizontal gaze palsy associated with progressive scoliosis (HGPS) is a rare autosomal recessive condition that has been recently mapped to a 30‐cM region on chromosome 11q23–25. In this report, we describe a consanguineous family in which three of five sibs are affected with HGPS. In two of the affected sibs, there was significant cognitive delay in addition to congenital horizontal gaze palsy and childhood onset scoliosis. In all three affected sibs, magnetic resonance imaging (MRI) scans revealed brainstem hypoplasia, a finding that has recently been associated with HGPS. Clinical examination of the family showed no significant dysmorphic features, while karyotyping, EMG, nerve conduction, and muscle biopsies were unrevealing. Homozygosity mapping was performed to narrow the disease locus on 11q23–25. A recombination event was observed in one affected sib between markers D11S1345 and D11S4464, which further refined the region to a 9‐cM interval. Since the MRI results provide support for the theory that maldevelopment of neurons in the abducens nuclei and caudal longitudinal fascicle is the cause for HGPS, we speculate on the existence of a gene in this 9‐cM interval on chromosome 11q23, which is critical for brainstem development.
A model for disclosing the first trimester part of an integrated Down's syndrome screening test
Authors: Maymon R , Betser M , Dreazen E , Padoa A , Herman A
Published: January 2004

This study was designed to evaluate a model for disclosing the first part of an integrated Down's syndrome (DS) test without affecting its low false‐positive results. Parturient women underwent sequential DS‐screening tests. They included nuchal translucency (NT) and biochemistry assessments in the first trimester and a mid‐gestation triple test. Although screening tests results were given following each test, fetal karyotyping was performed by means of mid‐gestation amniocentesis. The proposed approach for disclosure refers to either (a) cases picked by a statistical model (this is based on a logistic regression analysis and a receiver‐operated curve that was set to a specificity of 100% of first‐trimester markers pointing on at very high probability of aneuploidy) or (b) cases demonstrating a first trimester DS risk ≥1 : 40 (a threshold level at which the integrated test results will always be screen positive). The results of the sequential screening and pregnancy outcome were available for 372 normal and 22 chromosomal affected singletons. NT and pregnancy‐associated placental protein A emerged as the most sensitive marker combination. The statistical model picked up seven of 22 abnormal cases (32%), and a first‐trimester DS risk ≥1 : 40 was detected in 11 (50%) (there was an overlap of five cases). The combined strategy yields a 60% detection rate (13/22) of the affected pregnancies and without any increase in the false‐positive results. This can be achieved immediately following the first part of the integrated DS test. This model obviates the ethical, clinical, and financial implications of further assessing about 60% of the affected pregnancies.
Sanfilippo B syndrome: molecular defects in Greek patients
Authors: Beesley C , Moraitou M , Winchester B , Schulpis K , Dimitriou E , Michelakakis H
Published: January 2004

Sanfilippo syndrome type B [mucopolysaccharidosis IIIB (MPS IIIB] is the most prevalent type of MPS III in Greece, accounting for 81% of all MPS III cases diagnosed at the Institute of Child Health (Athens) over the last 20 years. The majority of the patients originated from East Central/Central Greece, Thessaly, and Macedonia. We present the results of mutation analysis in 21 Greek patients from 18 different families, all of whom had the severe form of the disorder. Patients were initially screened for five previously known mutations by restriction enzyme digestion of polymerase chain reaction products. Unknown mutations were identified by single‐strand conformation polymorphism analysis and DNA sequencing and were confirmed by restriction enzyme analysis. Seven previously described mutations (Y140C, R626X, 503‐512del, H414R, G292R, 334del25, and E452K) and four novel mutations (P516L, L242P, E446K, and R482Q) were identified. Expression of the latter and H414R showed that they were all null activity mutations. Considerable genetic heterogeneity has been described in MPS IIIB patients of different origins. In our population, Y140C, H414R, and R626X account for approximately 70% of the studied alleles. Our findings, especially in combination with the origin of individual patients, can improve carrier detection and genetic counseling in affected families.
HSP47 is a useful marker for skin fibroblasts in formalin‐fixed, paraffin‐embedded tissue specimens
Authors: Kuroda K. , Tajima S.
Published: January 2004

Aim:  This study was undertaken to assess whether heat‐shock protein (HSP)47 is a useful cell marker for skin fibroblasts in formalin‐fixed, paraffin‐embedded skin specimens.

Background:  HSP47, a 47‐kDa HSP, is a collagen‐specific molecular chaperone localized in the endoplasmic reticulum. HSP47 plays an essential role in collagen biosynthesis in skin fibroblasts.

Methods:  Immunohistochemistry was performed to detect HSP47 in skin fibroblast cultures and skin tissue sections.

Results:  Immunostaining for HSP47 clearly detected skin fibroblasts in paraffin tissue sections as well as in fibroblast cultures and frozen tissue sections. HSP47 staining on paraffin sections from diseased skin specimens revealed that skin ulcer, keloid, nodular fascitis, spindle cell lipoma, and dermatofibroma had strong signals for HSP47 compared with the signals obtained from normal skin. Dermatofibrosarcoma protuberans had many HSP47 positive cells, but signals on individual cells were not as strong as those seen from the above benign proliferative disease samples. In neurofibroma, a small number of faintly positive cells were detected. Our double‐immunostaining studies also demonstrated that HSP47 staining distinguished skin fibroblasts from CD68‐positive histiocytes/macrophages, factor VIII‐related antigen‐positive endothelial cells, or factor XIIIa‐positive dermal dendritic cells. CD34‐positive interstitial cells coexpressed HSP47 in spindle cell lipoma.

Conclusions:  These findings indicate that HSP47 staining can detect skin fibroblasts in routine, paraffin‐embedded specimens. A panel approach using HSP47 and other cell markers on paraffin sections may help the identification of the cell type involved with mesenchymal proliferative disorders.
Analysis of the vitamin D system in cutaneous squamous cell carcinomas
Authors: Reichrath Jörg , Rafi Leyla , Rech Martin , Mitschele Tanja , Meineke Viktor , Gärtner Barbara C. , Tilgen Wolfgang , Holick Michael F.
Published: January 2004

Background:  Increasing evidence points at an important function of vitamin D metabolites for growth regulation in various tissues, and new vitamin D analogs are interesting candidates for the treatment of malignancies, including squamous cell carcinomas (SCC).

Methods:  We have analyzed expression of vitamin D receptor (VDR), vitamin D‐25‐hydroxylase (25‐OHase), 25‐hydroxyvitamin D‐1α‐hydroxylase (1α‐OHase), and 1,25‐dihydroxyvitamin D‐24‐hydroxylase (24‐OHase) in SCC.

Results:  Intensity of VDR immunoreactivity was increased in SCCs as compared to normal human skin. VDR staining did not correlate with histological type or grading, nor with markers for proliferation, differentiation, or apoptotic cells. Incubation of SCC cell lines (SCL‐1, SCL‐2) with calcitriol resulted in a dose‐dependent suppression of cell proliferation (approximately up to 30%) in vitro, as measured by a tetrazolium salt (WST‐1)‐based colorimetric assay. RNA levels for VDR, 25‐OHase, 1α‐OHase, and 24‐OHase were significantly elevated in SCCs as compared to HS, as measured by real‐time polymerase chain reaction.

Conclusions:  Our findings demonstrate that modulation of VDR expression and local synthesis or metabolism of vitamin D metabolites may be of importance for growth regulation of SCCs. Additionally, SCCs represent potential targets for therapy with new vitamin D analogs that exert little calcemic side effects or for pharmacological modulation of calcitriol synthesis/metabolism in these tumors.
Verrucous plaque on the foot
Authors: Arroyo Martha P. , Chu David H. , Mobini Narciss , Park Henry S.
Published: January 2004

Abstract:  Amelanotic melanoma can present clinically in mutiple ways, often mimicking benign processes. This makes diagnosis more difficult and often delays proper medical attention. This case report highlights the importance of having a high suspicion of melanoma in cases that do not behave clinically as expected.
Merkel cell carcinoma: a clinicopathologic study with prognostic implications
Authors: Mott Ryan T. , Smoller Bruce R. , Morgan Michael B.
Published: January 2004

Background:  Merkel cell carcinoma (MCC) is a frequently aggressive neuroendocrine malignancy of the skin that presents in sun‐exposed areas on elderly patients. Although originally described over 30 years ago, many aspects of MCC remain to be defined. Of particular importance is the need to identify prognostic factors capable of predicting the biological behavior of these tumors. Knowledge of these factors may help in determining which patients require more aggressive treatment regimens. In this study, we examined 25 cases of MCC with an attempt to identify clinical, histopathological, or immunohistochemical features capable of predicting disease outcome.

Methods:  Features that we evaluated in each case included age, gender, race, tumor location, tumor size, depth of invasion, growth pattern, lymphocytic infiltration, mitotic activity, ulceration, necrosis, vascular invasion, and perineural invasion. In addition, we examined neural cell adhesion molecule and cytokeratin‐20 expression using immunohistochemical methods.

Results:  We found that most patients were males (84%) with an average age of 74 years. The tumors were located on the head and neck (68%) and upper extremities (32%). Overall, 64% of the patients developed metastatic disease to regional lymph nodes or distant sites (average follow‐up time of 21 months). Local recurrence was also common, occurring in 29% of the patients. The overall 1‐ and 2‐year survival rates were 80 and 53%, respectively. Histopathological examination revealed tumors with an average size of 7.2 mm. Common features included invasion into the subcutaneous adipose tissue, solid growth pattern, tumor necrosis, and vascular and perineural invasion. Findings that had a statistically significant correlation with poor outcome included tumor size ≥5 mm (p = 0.047), invasion into the subcutaneous adipose tissue (p = 0.005), diffuse growth pattern (p = 0.040), and heavy lymphocytic infiltration (p = 0.017). The remaining findings, including the immunohistochemical results, did not correlate with disease outcome. Using logistic regression models, we show that depth of invasion and degree of lymphocytic infiltration are strong predictors of disease outcome.

Conclusions:  The current controversies regarding the treatment of early‐stage MCC (i.e., localized disease) underscore the importance of identifying clinicopathological features capable of predicting tumor behavior. In this study, we have identified several prognostic features in MCC. Perhaps, these features may prove useful in identifying patients who require more aggressive treatment regimens.
Multiple familial pilomatricomas: an unusual case
Authors: Hubbard Virginia G. , Whittaker Sean J.
Published: January 2004

Although solitary pilomatricomas are relatively common, multiple pilomatricomas occur rarely, in 2–3.5% of reported cases. The majority of cases of familial multiple pilomatricomas occur in association with myotonic dystrophy. The occurrence of multiple familial pilomatricomas in patients who are otherwise well is extremely rare. We describe a 29‐year‐old man with multiple pilomatricomas whose father and brother also had similar lesions. There is no history of myotonic dystrophy.
Giant folliculosebaceous cystic hamartoma of the upper extremity
Authors: Sturtz David E. , Smith David J. , Calderon Marlene S. , Fullen Douglas R.
Published: January 2004

Background:  Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma consisting of dilated folliculosebaceous units invested in mesenchymal elements. These lesions have a striking predilection for the central face and scalp of adults. The vast majority of lesions present as 0.5–1.5‐cm papules or exophytic nodules. A single case of giant FSCH has been reported on the upper back.

Methods:  A 32‐year‐old woman presented with a (15 cm in greatest dimension) plaque‐like, multinodular lesion on her left upper arm for several years. The lesion was clinically suspected to be a nevus sebaceus.

Results:  The skin excision showed numerous dermal and subcutaneous dilated follicular structures with peripherally radiating sebaceous lobules, hair follicles, and surrounding mesenchymal elements consistent with FSCH.

Conclusion:  To our knowledge, this is the second case of giant FSCH. Our case is unique for its larger size, more plaque‐like growth, and location on an extremity when compared to the seminal case of giant FSCH.
Solute removal index correlates more with equilibrated Kt/V than with single pool Kt/V in haemodialysis patients
Authors: TANG HON LOK , TSANG WAI KAY , YEUNG SHING , CHAN HILDA WAI HAN , TONG KWOK LUNG
Published: February 2004

Background and Aims:  Solute removal index (SRI) is an adequacy index that estimates haemodialysis dose based on urea removal in the spent dialysate. We examined the SRI, single pool Kt/V (spKt/V) and equilibrated Kt/V (eKt/V) in two groups of chronic haemodialysis patients; group A, 25 patients received haemodialysis twice weekly and group B, 11 patients received haemodialysis thrice weekly.

Method and Results:  The Ing's partial dialysate collection method was used for spent dialysate collection. The SRI values of the first and second dialysis sessions in a week in group A were 68.7 ± 4.7 and 69.7 ± 4.1%, respectively, while that of the first, mid‐week and third dialysis sessions in a week in group B were 56.5 ± 5.3, 55.8 ± 5.4 and 57.5 ± 6.2%, respectively. The correlation coefficients (r) between SRI and spKt/V in the first and second dialysis sessions in a week in group A were 0.90 (P < 0.01) and 0.95 (P < 0.01), respectively, and that in the first, mid‐week and third sessions for group B were 0.96 (P < 0.01), 0.94 (P < 0.01) and 0.91 (P < 0.01), respectively. The r values between SRI and eKt/V in the first and second sessions for group A were 0.97 (P < 0.01) and 0.99 (P < 0.01), respectively, and that in the first, mid‐week and third sessions for group B were 0.98 (P < 0.01), 0.97 (P < 0.01) and 0.98 (P < 0.01), respectively. Therefore, the correlation between SRI and eKt/V (r values approaching one) was better than that between SRI and spKt/V in all dialysis sessions in a week for both group A and B patients.

Conclusion:  We conclude that the SRI, an index based on dialysate urea removal, correlates more with equilibrated Kt/V (an index that accounted for postdialysis urea rebound) than with single pool Kt/V.
Clinical features of thin basement membrane disease and associated glomerulopathies
Authors: SUE YUH‐MOU , HUANG JENG‐JONG , HSIEH RYH‐YAW , CHEN FEN‐FEN
Published: February 2004

Background:  Thin basement membrane disease (TBMD) occurs in 5–11% of renal biopsy series, and can be associated with other glomerulopathies (GNs). Data on the prevalence, clinical features, and prognosis of TBMD with other GNs are limited.

Methods and Results:  From June 1990 to May 2001, findings from 658 native kidney biopsies were retrospectively studied. The overall prevalence of TBMD was 7.9% (52 of 658). The mean glomerular basement membrane (GBM) thickness was 206 ± 30 nm. Clinicopathological features were compared for patients with TBMD only (n = 14) and in those with TBMD and GN (n = 38). Focal segmental glomerulosclerosis, mesangial proliferative GN, and minimal change disease were the most common GNs associated with TBMD. After a mean follow‐up period of 44.9 ± 42.5 months, the group who only had TBMD revealed a relatively benign disease with microscopic haematuria and trivial proteinuria, a low prevalence of hypertension, and no renal progression. In the group who had both TBMD and GN, heavy proteinuria (6.1 ± 5.2 g/day), hypoalbuminaemia (26 ± 12 g/L) and renal insufficiency (76 ± 25 mL/min) might develop.

Conclusion:  We suggested that the TBMD is a developmental abnormality of little or no significance and that it is the underlying associated GN rather than TBMD, which has the relevance to the outcome of renal disease.
Detection of gender difference and epitope specificity of IgG antibody activity against IgA1 hinge portion in IgA nephropathy patients by using synthetic hinge peptide and glycopeptide probes*
Authors: NAKAMURA IKUKO , IWASE HITOO , ARAI KENJI , NAGAI YOKO , TOMA KAZUNORI , KATSUMATA TADASHI , HIKI YOSHIYUKI , KOKUBO TOHRU , SANO TAKASHI , KOBAYASHI YUTAKA
Published: February 2004

Background and Aims:  There are many reports on the presence of an incompletely glycosylated O‐linked oligosaccharide(s) on the IgA1 hinge region in some immunoglobulin (IgA) nephropathy patients. Furthermore, the production of an antibody against the naked hinge peptide portion was reported in an IgA nephropathy patient. In this report, characterization of the IgG antibody against the hinge portion was carried out by using synthetic hinge glycopeptide probes.

Methods and Results:  The following synthetic hinge peptide and glycopeptides were prepared: 19mer peptide, V‐P‐S‐T‐P‐P‐T‐P‐S‐P‐S‐T‐P‐P‐T‐P‐S‐P‐S (designated HP), the peptide having a single α‐linked GalNAc residue at positions 4, 7, 9, 11 and 15 (4 GN − 15 GN, respectively) and the same peptide having five GalNAc residues at all five positions (GN5). The mean value of the antibody activity against these probes was compared with each other. The highest activity against the naked hinge peptide (HP) and lowest activity against the fully glycosylated hinge peptide (GN5) were obvious. As attachment of GalNAc to position 4 or 11 on the peptide brought about a significant reduction of the activity against the naked hinge peptide, the P‐S‐T‐P sequence included in both positions was thought to be the most probable site recognized by these antibodies. As an additional unexpected observation, a gender difference in this antibody activity against all the probes was found. The antibody activity in a female was significantly higher compared with that in a male.

Conclusion:  Because the frequency of incidence of IgA nephropathy is known to be slightly higher in males, this gender difference might indicate a protective meaning to remove aberrantly glycosylated molecules from the patient's serum.
Renal imaging in pyelonephritis
Authors: SHEN YVONNE , BROWN MARK A
Published: February 2004

Background:  Pyelonephritis accounts for a significant number of hospital admissions. It is unclear from existing literature whether all patients requiring admission to hospital should undergo renal imaging or if there is a subset that indicates clinical parameters for those who are more likely to have significant renal imaging abnormalities.

Method and Results:  We undertook a retrospective study of 60 consecutive patients hospitalized with pyelonephritis, the majority of whom underwent renal ultrasound at the time of admission. Clinical data collected included age, sex, fever, serum creatinine, days for resolution of fever, premorbid conditions, and results of renal imaging. Sixteen per cent were found to have new and clinically significant abnormal findings; predominantly, urinary tract obstruction. We found no significant difference between the groups with abnormal and normal renal imaging in terms of any easily detectable clinical parameter such as change in serum creatinine, premorbid conditions, age, days for fever to resolve or white cell count on admission. We found a high proportion of Escherichia coli resistant to ampicillin (46%) but not to amoxycillin/clavulinic acid.

Conclusion:  Although our study did not test whether immediate imaging is more advantageous than delaying imaging for those who fail to respond to treatment, our findings suggest that early imaging is a cost‐effective part of management. On the basis of these data, we recommend renal imaging for all patients requiring hospital admission for pyelonephritis, and suggest that initial empirical therapy should include an intravenous dose of cephalosporin but not ampicillin.
Melatonin as a new drug for improving oocyte quality
Authors: Takasaki Akihisa , Nakamura Yasuhiko , Tamura Hiroshi , Shimamura Katsunori , Morioka Hitoshi
Published: January 2004

Background:  Although recent technical advances have benefited infertile couples, inadequate embryo development as a result of poor quality oocytes still contributes to infertility. The purpose of the present study was to evaluate melatonin as a drug for improving oocyte quality in such cases.

Methods:  Twenty‐seven women from whom fewer than three fertilized embryos were grown and who failed to fall pregnant in previous treatment cycles were enrolled in the current prospective clinical study. Subjects took 1 mg or 3 mg tablets of melatonin orally at 22:00 h from the fifth day of the previous menstrual cycle to the day they were injected with human chorionic gonadotropin. The numbers of mature follicles, retrieved oocytes, degenerate oocytes, and fertilized embryos were compared to their previous data without melatonin (the control cycle).

Results:  Intrafollicular melatonin concentrations were significantly increased, and intrafollicular lipid peroxide concentrations showed a tendency towards lower levels in the 3 mg melatonin treatment cycles compared with the control cycles. The number of degenerate oocytes was significantly reduced, and the number of fertilized embryos showed a tendency towards an increase in the 3 mg cycle compared to the control cycle. Three women succeeded in falling pregnant.

Conclusion:  Melatonin is likely to become the drug of choice for improving oocyte quality in women who cannot fall pregnant because of poor quality oocytes. (Reprod Med Biol 2003; 2: 139–144)
Incidental deviation of short and long CAG repeats in the androgen receptor gene for Japanese male infertility
Authors: Nakabayashi Akira , Sueoka Kou , Matsuda Noriko , Asada Hironori , Tanigaki Reiko , Sato Kenji , Tajima Hiroto , Ogata Tsutomu , Naoaki Kuji  , Yoshimura Yasunori
Published: January 2004

Aim: The present study investigated whether the CAG repeat length in exon 1 of the androgen receptor gene on the X chromosome is associated with male infertility.

Methods: The CAG repeat length between the two groups of 143 idiopathic infertile Japanese men with severe oligozoospermia or non‐obstructive azoospermia and 100 fertile men were analyzed. The azoospermia factor deletions were also analyzed.

Results: Although there was no significant difference in the mean length between the two groups observed (P = 0.055), the distribution in the infertile men was wider than that in the fertile men. Similar results were detected in the combined data from previous Japanese reports and our present data including 261 infertile and 235 fertile men. We detected 12 and 34 CAG repeats in the present study that were the shortest and the longest repeats in Japan, respectively.

Conclusions: These results suggest that excessive expansion or reduction of CAG repeats might be related to impaired spermatogenesis. (Reprod Med Biol 2003;2: 145–150)
Accuracy of sperm velocity assessment using the Sperm Quality Analyzer V
Authors: Hirano Yuki , Shibahara Hiroaki , Shimada Kazuhiko , Yamanaka Seiji , Suzuki Tatsuya , Takamizawa Satoru , Motoyama Mitsuhiro , Suzuki Mitsuaki
Published: January 2004

Aim:  The correct diagnosis of the functional capacity of human sperm is limited. The Sperm Quality Analyzer (SQA) with the visualization system (SQA V, Medical Electronic System, Hatavorzo, Israel), an upgraded version of SQA, was recently developed to provide a rapid and low‐cost quantitative evaluation of sperm quality as well as sperm velocity assessment. The aim of the present study was to evaluate whether the SQA V's new parameters correlate with computer‐aided sperm analysis (CASA) estimates.

Methods:  Semen quality analysis of 66 fresh samples was determined using SQA V and CASA.

Results:  There were significant correlations of total sperm concentration (P < 0.001), sperm motility (P = 0.145), and percentage of progressive motile sperm (P = 0.001), between the SQA V variables and the CASA estimates. The sperm velocity assessed by SQA V was significantly correlated with some of the CASA estimates, including sperm motility (P = 0.001), the percentage of progressively motile sperm (P < 0.001), straight‐line velocity (P < 0.001), curvilinear velocity (P < 0.001) and average path velocity (P < 0.001). However, it did not correlate with amplitude of lateral head displacement, beat cross frequency, straightness, or linearity, assessed by CASA.

Conclusion:  Assessment of sperm motility has been shown as one of the important factors to predict the functional capacity of human sperm. On the basis of the present study, SQA V is considered useful for screening sperm quality in the management of male infertility. (Reprod Med Biol 2003; 2: 151–157)
Validity of trans‐rectal ultrasound‐guided embryo transfer against retroflexed uterus
Authors: Isobe Tetsuya , Minoura Hiroyuki , Kawato Hiroaki , Toyoda Nagayasu
Published: January 2004

Background:  Embryo transfer is one of the most critical steps affecting the success of in vitro fertilization/intracytoplasmic sperm injection‐embryo transfer. It has been reported that uterine contraction caused by touching the uterine fundus at the time of embryo transfer decreased the pregnancy rate. It was demonstrated that there is a significant rise in the pregnancy rate by adequate positioning of embryos. Transabdominal ultrasound‐guided embryo transfer has been reported to improve the pregnancy rate compared with the clinical touch method. The improvement of the pregnancy rate under ultrasound guidance can be attributed to the accurate positioning of the embryos aided by good visualization without touching the uterine fundus. However, sometimes difficulties are encountered when visualizing the tip of the catheter in cases where the patient has a retroflexed uterus.

Methods:  In the present study, we investigated the difference in the pregnancy rates and in the implantation rates between transabdominal ultrasound‐guided group and trans‐rectal ultrasound‐guided group in retroflexed cases.

Results and Conclusion:  We found that the pregnancy rate and the implantation rate were higher among the trans‐rectal group compared with the transabdominal group in retroflexed cases. The difference between the two groups was statistically significant. (Reprod Med Biol 2003; 2: 159–163)
Relationship between follicular fluid hormone levels, embryo quality, and maternal age during in vitro fertilization after the short or long protocol with a gonadotropin releasing hormone agonist
Authors: Yokota Yoshimasa , Yokota Mikako , Yokota Hidemi , Ishikawa Yasuko , Sato Setsuko , Araki Yasuhisa
Published: January 2004

Purpose:  To examine the relationship between embryo quality and follicular fluid hormonal level in short and long protocol gonadotrophin releasing hormone agonist treatment cycles.

Methods:  A total of 90 patients had non‐polycystic ovary syndrome (non‐PCOS) and 10 had PCOS. A total of 100 subjects underwent in vitro fertilization (IVF). Thirty‐six subjects underwent conventional IVF and 64 subjects underwent intracytoplasmic sperm injection (ICSI). The dominant follicles were initially retrieved and a hormonal assay was done. A total of 32 patients underwent a short protocol and 66 patients were treated with the long protocol. Estradiol (E2), progesterone (P4), total testosterone (TTE) and androstenedione (ASG) levels in follicular fluid (FF) were compared in the two treatment groups (short and long protocol), in regard to maternal age and oocyte/embryo quality.

Results:  The retrieval FF volume was not significantly different between the PCOS and non‐PCOS patients; however, P4 was significantly lower with PCOS (P < 0.01). Analysis of four different hormone levels was not significantly different between the short and long protocol groups. No significant relationship was found between four hormone levels in regard to oocyte morphology and embryo quality. The levels of P4 of younger women was significantly lower than that of older women; furthermore, a significantly higher TTE and ASG were found in the younger women. Progesterone was found to statistically significantly increase with FF volume.

Conclusion:  Follicular fluid P4 from the younger group was significantly lower, and TTE and ASG was significantly higher when compared to the older group. Analysis of four different hormone levels revealed no significant difference between the short and long protocol groups. No significant relationship was found between four hormone levels, oocyte morphology, and embryo quality. (Reprod Med Biol 2003; 2: 165–169)
Olfactory recognition and behavioural avoidance of angiosperm nonhost volatiles by conifer‐inhabiting bark beetles
Authors: Zhang Qing‐He , Schlyter Fredrik
Published: February 2004

Abstract  1 When searching for suitable hosts in flight, especially in mixed forests, conifer‐inhabiting bark beetles will encounter not only suitable host trees and their odours, but also unsuitable hosts and nonhost trees. Rejection of these trees could be based on an imbalance of certain host characteristics and/or a negative response to some nonhost stimuli, such as nonhost volatiles (NHV).

2 Recent electrophysiological and behavioural studies clearly indicate that conifer‐inhabiting bark beetles are not only able to recognize, but also to avoid, nonhost habitats or trees by olfactory means. Green leaf volatiles (GLV), especially C6‐alcohols, from the leaves (and partly from bark) of nonhost angiosperm trees, may represent nonhost odour signals at the habitat level. Specific bark volatiles such as trans‐conophthorin, C8‐alcohols, and some aromatic compounds, may indicate nonhosts at the tree species level. Flying bark beetles are also capable of determining whether a possible host is unsuitable by reacting to signals from conspecifics or sympatric heterospecifics that indicate old or colonized host tree individuals.

3 Combined NHV signals in blends showed both redundancy and synergism in their inhibitory effects. The coexistence of redundancy and synergism in negative NHV signals may indicate different functional levels (nonhost habitats, species, and unsuitable hosts) in the host selection process. Combinations of NHV and verbenone significantly reduced the number of mass attacked host trees or logs on several economically important species (e.g. Dendroctonus ponderosae, Ips typographus, and I. sexdentatus).

4 We suggest a semiochemical‐diversity hypothesis, based on the inhibition by NHV of bark beetle host‐location, which might partly explain the lower outbreak rates of forest insects in mixed forests. This ‘semiochemical‐diversity hypothesis’ would provide new support to the general ‘stability‐diversity hypothesis’.

5 Natural selection appears to have caused conifer‐inhabiting bark beetles to evolve several olfactory mechanisms for finding their hosts and avoiding unsuitable hosts and nonhost species. NHV and unsuitable host signals have potential for use in protecting trees from attack. The use of these signals may be facilitated by the fact that their combination has an active inhibition radius of several metres in trap test, and by the observation of area effects for several trees near inhibitor soruces in tree protection experiments. Furthermore, incorporation of negative signals (such as NHV and verbenone) and pheromone‐based mass‐trapping in a ‘push–pull’ fashion may significantly increase the options for control against outbreaks of conifer‐inhabiting bark beetles, especially in high risk areas.
Effects of bud phenology and foliage chemistry of balsam fir and white spruce trees on the efficacy of Bacillus thuringiensis against the spruce budworm, Choristoneura fumiferana
Authors: Carisey Nathalie , Bauce Éric , Dupont Alain , Miron Sylvain
Published: February 2004

Abstract  1 Efficacy of commercial formulations of Bacillus thuringiensis ssp. kurstaki (Btk) against spruce budworm Choristoneura fumiferana was investigated in mixed balsam fir‐white spruce stands. Btk treatments were scheduled to coincide with early flaring of balsam fir shoots, and later with flaring of white spruce shoots. Btk efficacy on the two host trees was compared and examined according to the foliar content of nutrients and allelochemicals and the insect developmental stage at the time of spray.

2 Larvae fed white spruce foliage were less vulnerable to Btk ingestion than larvae fed balsam fir foliage. Higher larval survival on white spruce, observed 10 days after spray, was related to higher foliage content in tannins and a lower N/tannins ratio, which might have induced inactivation of Btk toxins.

3 Larval mortality due to Btk did not depend on spruce budworm larval age.

4 Foliage protection of both host trees was similar in plots treated with Btk: larval mortality due to Btk treatment reduced insect grazing pressure on balsam fir trees; meanwhile, suitability of white spruce foliage seemed to decrease very rapidly, which induced high larval mortality among spruce budworm fed on white spruce trees. Nevertheless, following Btk sprays, 50% more foliage remained on white spruce than on balsam fir trees, because of the higher white spruce foliage production.

5 Both spray timings achieved similar protection of white spruce trees, but Btk treatments had to be applied as early as possible (i.e. during the flaring of balsam fir shoots to optimally protect balsam fir trees in mixed balsam fir‐white spruce stands).
Idiocentric and allocentric differences in emotional expression, experience, and the coherence between expression and experience
Authors: Matsumoto David , Kupperbusch Cenita
Published: January 2004

This study examined differences in emotional expression, experience, and the coherence between expression and experience in idiocentric and allocentric individuals, who participated in a study similar to Ekman (1972) and Friesen's (1972) original display rule study. Encoders, classified as idiocentric or allocentric based on a measure of psychological culture, were unobtrusively videotaped as they viewed positive and negative films in two contexts – alone, and then a second time either alone or with an experimenter present. Subjective emotional responding was assessed following each of the film viewing sessions and, using the encoders' videotaped data, their emotional expressions were judged by a separate sample of decoders. Emotional expression and coherence differed as a function of encoder culture and viewing condition; experience did not. These findings replicate and extend the only other cross‐cultural experiment of spontaneous emotional expressions in adults conducted over thirty years ago (Ekman, 1972; Friesen, 1972), and speak to the influence of culture as a socio‐psychological construct, given that all participants were European American females.
An integrative approach to leadership and social support
Authors: Suganuma Takashi , Ura Mitsuhiro
Published: January 2004

This study examined the effects of instrumental and socio‐emotional behaviors of friends on stress reactions and task performance. A 2 (presence or absence of instrumental behavior) * 2 (presence or absence of socio‐emotional behavior) * 2 (high or low legitimacy of influence) factorial design was used. Ninety‐one college‐age females as subjects and their close same‐sex friends as confederates participated together in the experiment. Dependent variables were mean blood pressure (MBP) as a physiological stress reaction, state anxiety as a psychological stress reaction, and the level of performance in a simple arithmetic task. Instrumental behavior had a facilitating effect on task performance in the high legitimacy condition. Socio‐emotional behavior showed a buffering effect on physiological stress reaction when the friend did not engage in instrumental behavior in the low legitimacy condition. These findings suggest that legitimacy of influence may be able to explain the differences between leadership and social support processes.
The Falsification of Four Popular Hypotheses About the Asian Crisis
Authors: Willett Thomas D. , Budiman Aida , Denzau Arthur , Jo Gab‐Je , Ramos Cesar , Thomas John
Published: February 2004

Various claims have been made about the causes of the Asian crisis and its spread. Here, we use data on the behaviour of capital flows during the crisis to test the strong forms of four such hypotheses, that portfolio investors and hedge funds played a dominant role in initiating and/or spreading the crisis; that moral hazard kept efficient markets from predicting the crisis; and, finally, the common lender hypothesis of Kaminsky and Reinhart. In the process we also test implications of the Calvo‐Mendoza model of rational investor ignorance. All are falsified as monocausal explanations. For example, portfolio investments that could not have been subject to substantial moral hazard continued to flow into Asia until very shortly before the crisis. Likewise, banks were a much larger source of capital outflows during the crisis than were portfolio investors. While falsified in their strongest forms, several of these hypotheses in less strong forms should play a role in a more nuanced analysis. It is necessary to move past simple single‐factor approaches in order to produce a more complete, synthetic explanation of this episode.
Foreign Direct Investment and European Integration in the 1990s
Authors: Egger Peter , Pfaffermayr Michael
Published: February 2004

This paper examines the effects of EU integration in the 1990s on the FDI relations in Europe. We find that the completion of the Single Market, the 1995 enlargement and the so‐called Eastern enlargement are characterised by a substantial, positive anticipation effect in the period between the announcement and the formal establishment of each integration step. Neither the Single Market Programme nor the previous enlargement exhibited any further positive effects on intra‐EU FDI volumes after their establishment.
Clinical effects of exposure to the White‐stemmed gum moth (Chelepteryx collesi)
Authors: Balit Corrine R , Geary Merilyn J , Russell Richard C , Isbister Geoffrey K
Published: February 2004

Background:  The White‐stemmed gum moth (Chelepteryx collesi) can be found in eastern Australia. The clinical effects of injuries caused by its many spine‐like hairs are poorly defined and concern about the numerous hairs that remain embedded following contact with the cocoon have led to heroic means of removal.

Objective:  To examine the clinical effects of injuries by the caterpillar or cocoon of the White‐stemmed gum moth.

Methods:  Prospective observational study of caterpillar injuries from calls to the New South Wales Poisons Information Centre. Cases resulting from C. collesi exposure were included for analysis. Caterpillars and cocoons were expertly identified where available and a follow‐up consultation of all patients was conducted. Information was collected on the circumstances of exposure, local and systemic effects and treatment.

Results:  From the 26 included cases, seven had confirmed caterpillar contact (all children aged 1–11), six had confirmed cocoon contact and 13 had exposures consistent with C. collesi, but no caterpillar was caught. All cases occurred in summer. Of 13 confirmed exposures there was no difference between caterpillars and cocoons, and these were considered together. Affected areas were hands, feet, or both, following C. collesi being handled or trodden on. Pain was reported in all 13 cases, one with severe pain. In 10 cases pain duration was < 60 min. Six subjects had more than 100 hairs embedded (small black dots). In three cases, the hairs were surrounded by swelling and yellow discolouration. Despite the attempted removal of multiple hairs, they remained embedded for prolonged periods but caused no sequelae.

Conclusion:  The clinical effects of the White‐stemmed gum moth were minor with local pain. Although hairs remained in all cases, they caused no problems. Complete removal of hairs is neither possible nor necessary, and painful and invasive methods should be avoided.
Emergency department management of maxillofacial trauma
Authors: Lynham Anthony J , Hirst Julian P , Cosson John A , Chapman Pat J , McEniery Paul
Published: February 2004

This paper highlights critical aspects of examination, diagnosis and early management of the maxillofacial trauma patient.
Does the presence of an emergency physician improve access based quality indicators in a rural emergency department?
Authors: O'Connor Alan E , Lockney Amanda L , Sloan Peter M , McGrail Matthew
Published: February 2004

Objective:  To assess the effect that the presence of an emergency physician in the ED has on the access indicators of the Australian Council on Healthcare Standards.

Methods:  A retrospective study was carried out in a 265 bed regional referral hospital in Victoria. The performance of the ED over a 6 month period, during which time there was incomplete emergency physician coverage, was monitored using The Australian Council on Healthcare Standards (ACHS) access indicators as the benchmark. These indicators are waiting time by triage category, and access block.

Results:  A total of 11 999 patient presentations were eligible for inclusion in the study. Emergency physicians were present for 76.5% of these presentations. All the indicators show a trend towards improvement when an emergency physician was present. However, the only indicator that shows a significant improvement is waiting time by triage category, and this is due mainly to an improvement within triage category 4.

Conclusion:  There is some evidence that the presence of an emergency physician improves performance within this group of access based indicators within a rural ED, however, the effect seen here is small. More studies are needed on this topic and also on the development of quality indicators for rural ED.
Compliance with advice and appropriateness of emergency presentation following contact with the HealthDirect telephone triage service
Authors: Sprivulis Peter , Carey Mary , Rouse Ian
Published: February 2004

Objective:  Evaluation of compliance with advice and appropriateness of emergency presentation following contact with a telephone triage service (HealthDirect).

Methods:  Compliance rates, triage distributions and admission rates were determined using linked HealthDirect and ED records for patients living within 2 km of an ED that presented during 2000.

Results:  Of 13 019 presentations, 842 (6.5%) were HealthDirect contacts. In the HealthDirect group there were a greater proportion of patients under the age of 15 (290, 34% vs 1598, 13.1%) and women (481, 57% vs 5610, 46%). The triage distributions and admission rates for HealthDirect contacts and other patients were similar (HealthDirect 37.6% admitted, 95% CI 34–41, others 38.4% admitted, 95% CI 38–39, Pχ2 = 0.67). Of 3996 callers to HealthDirect, 3167 (79%) complied with advice with 963 (61%) complying with advice to present and 212 (9%, 95% CI 8–10%) presenting despite advice to defer presentation. Triage distributions and admission rates for compliers and non‐compliers were similar (compliers 38% admitted, 95% CI 34–41, non‐compliers, 37% admitted, 95% CI 30–44, Pχ2 = 0.89).

Conclusions:  HealthDirect contacts were of similar appropriateness to non‐HealthDirect presenters and appear to attend the ED independent of HealthDirect advice. HealthDirect has a limited capacity to influence ED utilization or workload.
Vertigo: A practical approach
Authors: Stone Hilton E
Published: February 2004

Dizziness is a common symptom and a systematic method is required to make a diagnosis from its many possible causes. This article describes an approach to the problem with emphasis on true vertigo and in particular its otological aetiology. Important points in the history as well as relevant physical signs are described together with some readily identifiable conditions and their management.
Multidisciplinary assessment at triage: A new way forward
Authors: Richardson Joanna R , Braitberg George , Yeoh Michael J
Published: February 2004

Objective:  To evaluate a dual doctor and nurse triage system at a tertiary referral hospital.

Methods:  Data were compared between periods of multidisciplinary triage and periods of standard triage. Data comparison was also made between rostered multidisciplinary triage shifts and non‐multidisciplinary triage shifts. Staff satisfaction with the process was assessed.

Results:  The percentage of patients seen within Australasian Triage Scale performance indicator thresholds increased from 75% to 81% in Category 2 patients (P = 0.12) and 56% to 78% in Category 3 patients (P < 0.0001). There was a reduction of 50% in the number of patients who left prior to being seen by a doctor (P = 0.024). Surveys showed high staff satisfaction with the process.

Conclusions:  We feel that multidisciplinary triage performs a useful function in our department enabling us to reduce waiting times. The process is widely accepted amongst the staff and it ensures a senior doctor assesses most patients. It reduces the number of patients leaving prior to being seen by a doctor and it provides one way of getting around access block and a physically small department.
Management of foreign bodies in the ear, nose and throat
Authors: Kumar Sashi
Published: February 2004

This article presents a summary of the common foreign bodies (FB) and a practical approach to diagnosis and management. Removal of FB requires good lighting, a cooperative or fully restrained patient and a gentle approach by the clinician. An accurate diagnosis of the FB should be made prior to attempts to remove it and most, if not all FB could be safely removed the following day under better lighting conditions, sedation or anaesthesia in a fasted patient by a more senior clinician.
Output Feedback Fuzzy Control for Uncertain Nonlinear Systems
Authors: Chang Wook , Park Jin Bae , Joo Young Hoon , Chen Guanrong
Published: January 2004

In this paper, a fuzzy control scheme, which employs the output feedback control approach, is suggested for the stabilization of nonlinear systems with uncertainties. The uncertain nonlinear system can be represented by uncertain Takagi-Sugeno (TS) fuzzy model structure, which is further rearranged to give a set of uncertain linear systems. A switching-type fuzzy-model-based controller, which utilizes the static output feedback control strategy, is designed based on this preliminary study. Theoretical analysis guarantees that under the control of the proposed technique, the uncertain nonlinear system is stabilizable by the switching-type static output-feedback fuzzy-model-based controller. Finally, two computer simulation examples are provided to show the effectiveness and feasibility of the developed controller design method.
Numerical Analysis of the Basketball Shot
Authors: Silverberg Larry , Tran Chau , Adcock Kit
Published: January 2004

This paper numerically analyzes the dynamics of the basketball shot. The focus of the paper is on the development of a general formulation for the dynamics of the shot beginning when the ball leaves the shooter’s hand and ending when the shot is made or missed. The numerical analysis developed in this paper can be used to conduct a parametric study of the dynamics of the basketball shot, which in turn, can be used to improve individual shooting and team strategy. The individual skill level of the shooter enters the formulation through the statistical accuracy of the release. The paper then shows how to determine the shooter’s probability of making a given shot.