bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic lupus erythematosus in Asia: is it more common and more severe?
Authors: THUMBOO Julian , WEE Hwee‐Lin
Published: November 2006

Aim:  We summarized published data on prevalence and comparative disease manifestations of systemic lupus erythematosus (SLE) to determine if SLE is more common or more severe in Asians compared with Caucasians.

Methods:  A PubMed search was used to identify studies reporting prevalence or clinical manifestations (limited to comparative studies in multi‐ethnic Asian populations or between Asians and Caucasians) of SLE among Asians.

Results:  We identified 18 studies of prevalence and six studies of comparative disease manifestations and/or prevalence (from 1725 retrieved abstracts). Prevalence (per 100,000) of SLE in community‐based studies ranged from 3.2 to 70.4 in Asian studies and 46.7–161.0 in Asian migrant studies compared with 20.6–78.5 in North America and 24.6–91.0 in Europe. Studies in Asian migrants showed double the prevalence of SLE among Indians (2/2 studies) and Chinese (1/2 studies) as compared with Caucasians. Two studies found differences in clinical manifestations of SLE among Chinese, Malays and Indians living in the same country. Four comparative studies variously found more renal, central nervous system or other major organ involvement among Asians and Asian migrants than Caucasians with SLE over the disease course.

Conclusions:  SLE is generally not more prevalent in Asian than Caucasian populations, although it is more prevalent among Asian migrants. SLE has more severe clinical manifestations among Asians compared with Caucasians.
An 18‐year follow‐up study of a lupus cohort in Shanghai
Authors: CHEN Sheng , GU Yue‐Ying , BAO Chun‐De , CHEN Shun‐Le
Published: November 2006

Aim:  To investigate the long‐term prognosis of systemic lupus erythematosus (SLE) and its risk factors.

Methods:  An 18‐year (1980–1998) clustering follow‐up study of 50 patients with SLE was performed.

Results:  The overall survival rate at 1, 5, 10, 15 and 18 years after the onset of illness was 98%, 98%, 84%, 76%, and 70%, respectively. The two major causes of death were infection and renal failure. Cox proportional hazard regression analysis showed that the presence of ≥ 7 of the American College of Rheumatology criteria for SLE at diagnosis and vasculitis were associated with worse survival. Thirteen (26%) patients were in remission with complete discontinuation of drugs, with the mean remission duration being 12 years (range: 2–17 years).

Conclusion:  It is possible for patients with SLE to get long‐term remission through timely and effective treatment. Prevention of infection and renal failure and reducing dosage of corticosteroids by combined treatment with immunosuppressive drugs may enhance prognosis and survival in SLE.
Molecular abnormalities of T‐cells in systemic lupus erythematosus
Authors: TAKEUCHI Tsutomu , TSUZAKA Kensei , KAMEDA Hideto , AMANO Kouichi
Published: November 2006

Substantial evidence supports that T‐cells play a central role in the pathogenesis of systemic lupus erythematosus (SLE). To explore the molecular basis of the defective function of SLE T‐cells, we focused on the signal transduction system via T‐cell antigen receptor (TCR) in peripheral blood T‐cells from SLE patients. Comprehensive analysis to identify the molecules responsible for the defects showed the expression of the TCR ζ chain was attenuated, or absent in more than half of SLE patients. Moreover, the aberrant transcripts of the TCR ζ chain, including spliced variants lacking exon 7 and with a short 3′‐UTR, were detected in SLE T‐cells. Although attenuated expression of the TCR ζ chain is also observed in patients with cancers, infections, and other autoimmune diseases, sustained attenuation of TCR ζ expression and aberrant transcripts are only observed in SLE. In this review we discuss the unique features of the TCR ζ defects in SLE.
Management of systemic lupus erythematosus in the coming decade: potentials and challenges
Authors: CHNG Hiok Hee
Published: November 2006

The management of systemic lupus erythematosus (SLE) has improved in the past 50 years, but there is still a 3–5‐fold increased mortality compared to the general population, with major organ failure due to active disease, infection and cardiovascular disease as the major challenges for the coming decade. Research advances at cellular, molecular and genetic levels enhance our understanding of the immunopathogenic mechanisms of SLE, leading to the development of drugs targeting specific sites of immune dysregulation – with therapies directed at cytokines, B‐ and T‐cells, and their interactions showing promise. Advances are expected in the field of haematopoietic stem cell transplant (HSCT) as a therapeutic option for a subset of patients. Furthermore, some non‐traditional immunomodulating therapies like statins, leflunomide and tacrolimus may prove useful as alternative or adjunct treatment in some patients. A better understanding of how current immunosuppressants act at the cellular and molecular level should guide the re‐evaluation of the indications, doses and duration of therapy in clinical trials using these agents, many of which have not been subjected to proper double‐blinded placebo‐controlled studies. Research on triggers of SLE onset and flare of activity continues to yield information helpful in prevention. The evidence on the impact of psychosocial and economic factors on the outcome of SLE is overwhelming and the rheumatology community should enlist the assistance of other healthcare professionals, patient advocates and local health authorities to address these issues pertinent to good patient care and outcome.
PROPOSAL OF THE GRACILARIALES ORD. NOV. (RHODOPHYTA) BASED ON AN ANALYSIS OF THE REPRODUCTIVE DEVELOPMENT OF GRACILARIA VERRUCOSA1
Authors: Fredericq Suzanne , Hommersand Max H.
Published: November 2006

The mode of division of vegetative cells, formation of spermatangial parent cells, initiation of the carpogonial branch apparatus, and formation of tetrasporangial initials are homologous developmental processes that are documented for the first time in the type species of the economically important family Gracilariaceae, Gracilaria verrucosa (Hudson) Papenfuss from the British Isles. G. verrucosa is characterized by a supporting cell of intercalary origin that bears a 2‐celled carpogonial branch flanked by two sterile branches, direct fusion of cells of sterile branches onto the carpogonium, formation of an extensive carpogonial fusion cell through the incorporation of additional gametophytic cells prior to gonimoblast initiation, gonimoblast initials produced from fusion cell lobes, schizogenous development of the cytocarp cavity, inner gonimoblast cells producing tubular nutritive cells that fuse with cells of the pericarp or floor of the cystocarp, absence of cytologically modified tissue in the floor of the cystocarp, and carposporangial initials produced in clusters or irregular chains. Spermatangial parent cells are generated in flaments from intercalary cortical cells that line an intercellular space forming a ‘pit’ or ‘conceptacle’. Tetrasporangial initials are transformed from terminal cells derived through division of an outer cortical cell. Tetrasporangia are cruciately divided.

The Gracilariaceae is removed from Gigartinales and transferred to the new order Gracilariales. Their closest living relatives appear to be agarophytes belonging to the Gelidiales and Ahnfeltiales.
VEGETATIVE REPRODUCTION OF THE FRESHWATER DINOFLAGELLATE GLOEODINIUM MONTANUM1
Authors: Kelley Ingrid , Pfiester Lois A.
Published: November 2006

The vegetative life cycle of Gloeodinium montanum Klebs was examined. In unialgal cultures G. montanum divided predominantly by binary fission once every 2‐3 weeks. Nuclear division was followed by a delayed cytokinesis producing non‐motile G. montanum cells. When placed in fresh media 2‐4 biflagellated swarmers were formed. The swarmers, although similar in appearance to those of Hemidinium ochraceum Levander (1900), differ from that species in their dimensions. During vegetative reproduction swarmers developed directly into non‐motile vegetative cells.
EFFECTS OF ENVIRONMENTAL VARIATION ON SINKING RATES OF MARINE PHYTOPLANKTON1
Authors: Culver Mary E. , Smith Walker O.
Published: November 2006

The effects of environmental variables, particularly irradiance, on the sinking rates of phytoplankton were investigated using cultures of Chaetoceros gracilis Schütt and C. flexuosum Mangin in laboratory experiments; these data were compared with results from assemblages in the open ocean and marginal ice zone of the Greenland Sea. In culture experiments both the irradiance under which the diatom was grown and culture growth rate were positively correlated with sinking rates. Sinking rates (ψ) in the Greenland Sea were smallest when determined from chlorophyll (mean ψchl= 0.14 m · d−1) and biogenic silica (ψsi= 0.14 m · d−1) and greatest when determined from particulate carbon (ψc= 0.55 m · d−1) and nitrogen (ψN= 0.64 m · d−1). Field measurements indicated that variations in sinking may be associated with changes in irradiance and nitrate concentrations. Because these factors do not directly affect water density, they must be inducing physiological changes in the cell which affect buoyancy. Although a direct response to a single environmental variable was not always evident, sinking rates were positively correlated with growth rates in the marginal ice zone, further indicating a connection to physiological processes. Estimats of carbon flux at stations with vertically mixed euphotic zones indicated that approximately 30% of the daily primary production sank from the euphotic zone in the form of small particulates. Calculated carbon flux tended to increase with primary productivity.
DESCRIPTIONS OF FOUR NEW MALLOMONAS TAXA (MALLOMONADACEAE, CHRYSOPHYCEAE)1
Authors: Nicholls Kenneth H.
Published: November 2006

Three new species and one new variety of Mallomonas (Mallomonadaceae, Chrysophyceae) were discovered in Ontario, Canada. Descriptions based on electron microscopy of silica scale structure are provided for Mallomonas inornata sp. nov., Mallomonas perfossa sp. nov., Mallomonas sexangularis sp. nov. and Mallomonas guttata var. simplex var. nov. The relationships of the scale structures of the new taxa with those known for other similar species are discussed. About 80 Mallomonas species and subspecies now are known from North America.
MODULATION OF PHOTOSYNTHETIC CARBON ASSIMILATION IN SELENASTRUM CAPRICORNUTUM (CHLOROPHYCEAE) BY cAMP: AN ELECTROGENIC MECHANISM?1
Authors: Francko David A.
Published: November 2006

Laboratory batch cultures of the unicellular alga Selenastrum capricornutum Printz (Chlorophyceae) were used as a model system to test the hypothesis that the regulatory molecule cAMP may alter algal photo synthetic carbon assimilation (PCA) rates via an electrogenic mechanism. In one series of experiments, cells were resuspended in cAMP‐free media subsequently augmented with 0.5 nmol·L−1to 0.1 μmol·L−1of added cAMP, concentrations paralleling dissolved cAMP levels in lake water and culture filtrates but insufficient to result in short‐term increases in intracellular cAMP content. cAMP‐treated cells were moderately and transiently hypopolarized concomitant with a reduction in PCA capacity. Media and intracellular pH and quinacrine fluorescence quenching rates were also altered, with similar effects on PCA, but specific effects appeared to be associated with diel cycles. Higher concentrations of added cAMP (10 μmol·L−1to 10 mmol·L−1) further hypopolarized the transmembrane potential, greatly enhanced PCA rates, acidified the cell interior, and enhanced quinacrine quenching rates. With the exception of cGMP, no nucleotide derivative examined elicited the same effects. Inhibitors of plasmalemma ATPase and NADH oxidase activity also hypopolarized the membrane potential but inhibited PCA rates. Collectively, the data support the cAMP‐electrogenic thesis, but the mechanism, although resembling features of H+/ ion‐cotrans‐port, may in fact be more complex.
INFRAGENERIC TAXONOMY OF AHNFELTIA (AHNFELTIALES, RHODOPHYTA)1
Authors: Maggs Christine A. , McLachlan Jack L. , Saunders Gary W.
Published: November 2006

Ahnfeltia plicata (Hudson) Fries, the type species of Ahnfeltia Fries, is reported to be a widespread alga which is an important source of agar. However, after characterizing type material and representative populations of A. plicata, we found that several taxa usually considered to be synonyms of A. plicata instead represent separate species with differing geographic distributions. Ahnfeltia plicata sensu stricto is characterized by the development of external carposporophytes on female sori that are present only on mature axes. Pseudocarposporophytes bearing monosporangia and cortical monosporangial sori occur on both young and old axes. Characteristic vegetative features include long medullary cells and cortical growth rings. Ahnfeltia plicata s.s. is circumpolar in both hemispheres and is harvested for agar in the White Sea. Ahnfeltia setacea (Kútzing) Schmitz from the Falkland Islands, Gymnogongrus comosus Kützing from Chile and Gymnogongrus filiformis Kützing from southern Argentina appear to be synonymous with A. plicata. Ahnfeltia fastigiata (Postels et Ruprecht) Makienko, from the North Pacific, differs from A. plicata principally in the development of female sori and carposporophytes only near apices; medullary cells are shorter and cortical growth rings, cortical monosporangia and pseudocarposporophytes are not formed. It is dioecious and its life history involves the development from carpospores of a crustose Porphyrodiscus tetrasporophyte. We suggest that A. plicata var. tobuchiensis Kanno et Matsubara, the principal form of Ahnfeltia utilized for agar production in the North Pacific, represents an unattached ecad of A. fastigiata. Ahnfeltia elongata Montagne, known only from Chile and with carposporophytes restricted to main axes, is more closely related to A. plicata than to A. fastigiata. Thalli are large and regularly dichotomous, with long medullary cells, and do not form pseudocarposporophytes or monosporangia.
FURTHER EVIDENCE FOR ANOMALOUS SIZE SCALING OF RESPIRATION IN PHYTOPLANKTON1
Authors: Lewis William M.
Published: November 2006

Respiration per unit mass decreases as organism size increases among metazoans and heterotrophic unicells. The rate of decrease is described by a power function of organism mass; the exponent of the power function is 0.75 (Three‐fourths Rule). Previously unanalyzed respiration rates for 11 species of phytoplankton ranging in size over four orders of magnitude show a size‐scaling exponent of 1.13 (SE, ±0.15), which is statistically different from 0.75. This result confirms the result of an earlier study of eight phytoplankton species indicating that size scaling of respiration is absent or minimal in phytoplankton, in contrast to the pattern of heterotrophic unicells. The size‐related range of respiration rates per unit mass across the full size spectrum of phytoplankton would be approximately 18–fold if respiration were scaled according to the Three‐fourths Rule. If respiration does not scale with size or scales minimally with size, as suggested by present evidence, the size‐related range of rates will be much smaller or negligible. The apparent anomaly of size scaling for phytoplankton respiration is potentially of great ecological and adaptive significance in unicellular algae.
PHOTOACCLIMATION AND GROWTH RATE RESPONSES OF ULVA ROTUNDATA (CHLOROPHYTA) TO INTRADAY VARIATIONS IN GROWTH IRRADIANCE1
Authors: Henley William J. , Ramus J.
Published: November 2006

A vegetative clone of the chlorophyte macroalga Ulva rotundata was maintained in an outdoor continuous flow system under nutrient sufficient conditions and various light regimes. Step changes between 9 and 100% incident irradiance (Io) were employed to simulate cloud passage. Temporary (1–4 h) midday (Io)perturbations evoked net changes in growth rate (μ) and chlorophyll (chl) content. Under Io alternating at various periodicities from 15 min to 7 h, net μ was the average of the μ under steady state 9 and 100% Io, regardless of periodicity. However, the μ in alternating light was considerably less than μ under steady state 55% Io(≃ 9%+ 100%/2), as expected based on the nonlinear shape of the μ‐I relationship. Unlike μ, chl content depended primarily on the total daily irradiance, probably clue to the slower response of chl compared to photosynthetic rate. On time scales ≥ one day, chl was linearly correlated with light‐regulated daily μ under both steady state and intraday fluctuating irradiance, consistent with photosynthetic feedback regulation of chl concentration.
LUXURY PHOSPHATE UPTAKE AND VARIATION OF INTRACELLULAR METAL CONCENTRATIONS IN HETEROSIGMA AKASHIWO (RAPHIDOPHYCEAE)1
Authors: Watanabe MasatMaka , Takamatsu Takejiro , Kohata Kunio , Kunugi Masayuki , Kawashima Munetsugu , Koyama Mutsuo
Published: November 2006

The effectr of phosphate starvation and subsequent uptake on distribution and concentration of phosphate metabolic intermediates and metals were studied in Heterosigma akashiwo (Hada) Hada by 31P‐NMR spectroscopy, neutron activation analysis and ESR spectroscopy. Excess orthophosphate (4.5 μM Pi, as NaH2PO4) added to a medium with P‐depleted H. akashiwo cells was rapidly taken up resulting in an increase in P cell quota (qp)from 68.2 to 99.6 fmol. cell‐1in 2 h and to 156.3 fmol. cell‐1in 6 h. After three days, qp approached about 190 fmol. cell−1. Polyphosphate (PPi) rapidly increased from 0 to 11.4 fmol· cell−1in 2 h and to 24.7 fmol·cell−1in 6 h. Diel variation of cell quota indicated that cellular Pi increase was synchronized with cellular PPi decrease and vice versa. The average chain length of PPi increased from ca. 0 to ca. 10.2 phosphate residues in 2 h after addition of Pi and one day later, from ca. 9.8 to ca. 12.5.

The cell quota of Mn (qMn), and to a lesser extent Co, increased rapidly from 4.87 fg. cell−1in the P‐ starved condition to 50.48 fg·cell−12 h afer addition of Pi but decreased to 8.63 fg. Cell−1by 6 h. Concentrations of Zn, As, Hf, Cu and sometimes Al, Mg, K, and Ca changed in a manner opposite to that of Mn and Co. The excretion of these cations, which was synchronized with the uptake of Mn and Co, may be important for a charge balancing in the cells. The ESR spectra showed that the high cellular Mn observed at 2 h after P addition was Mn2+which was taken up by the cells rather than adsorbed on the cell surface. These data combined with PPi data suggested that the behavior of qMn is synchronized with the behavior of average chain length of PPi.
COMPETITION BETWEEN STAURASTRUM LUETKEMUELLERII (CHLOROPHYCEAE) AND MICROCYSTIS AERUGINOSA(CYANOPHYCEAE) UNDER VARYING MODES OF PHOSPHATE SUPPLY1
Authors: Olsen Yngvar , Vaddtein Olav , Andersen Tom , Jensen Arne
Published: November 2006

The desmid Staurastrum luetkemuellerii Donat et Ruttner and the cyanobacterium Microcystis aeruginosa Kütz. were grown in mixed cultures with various phosphate (Pi) additions. One pulse of Pi each day (semi‐continuous cultures) favored M. aeruginosa whereas S. luetkemuellerii was favored when the same quantity of Pi was supplied continuously (chemostats). Both species coexisted under P limitation provided that the nutrient was supplied in an appropriate mode.

The ability of each species to compete for P depended on their Pi uptake characteristics and their capability to retain the accumulated Pi. High affinity in uptake at low Pi concentrations contributed considerably to the growth eficiency of S. luetkemuellerii under continuous supply of PiM. aeruginosa was, however, consistently superior to S. luetkemuellerii in accuniulatiug the newly added P, but had a high rate of Pi release. In both ‐types of cultures, a net high of P went from M. aeruginosa to S. luetkemuellerii.

The kinetic characteristics of the two species were used to simulate the outcome of competition experiments. Simulations agreed with the experimental data f both uptake and Pi release were considered in the model.

The zlariable P*(the concentration of Pi at which the net uptake is equal to μ·QP is a function of uptake and release of Pi but could not explain the chemostat results. S. luetkemuellerii was the winner in many experiments even if its P*was higher thou that of M. aeruginosa. Thus, in the present case Pc (the concentration at which the net uptake is zero) was a better predictor of the ability to compete for Pi under steady state as well as transient conditions in the Pi supply.
RESPONSES OF THE ACIDOPHILIC ALGA EUGLENA MUTABILIS (EUGLENOPHYCEAE) TO CARBON ENRICHMENT AT pH 31
Authors: Olaueson Mary M. , Stokes Pamela M.
Published: November 2006

A defined medium (MAM) simulating acid mine drainage waters was developed which supported reproducible growth rates of three axenic strains of Euglena mutabilis Schmitz. Growth responses to various pHs and carbon sources were examined under defined culture conditions. A lab strain and two 5eld isolates, tested over pH range 1.5‐9.0, grew best under acidic conditions (pH < 5.5) with highest growth rates at pH 3‐4. Photoauxotrophic growth rates of all strains at pH 3 were improved significantly over unstirred batch controls by bubbling with air and even more by enrichment with 5% CO2 in air. These results confirmed inorganic carbon limitation in batch culture. Organic carbon substrates were tested as possible carbon supplements in batch culture at pH 3. None of the strains survived in the dark on any of the twenty organic sources added. In the light, the lab strain exhibited some photoheterotrophic growth potential on glucose, sucrose, ethanol, and amino acids but growth was inhibited by acetate. Field strains showed little or no growth improvement with any organic substrate addition. Under simultaneous enrichment with acetate and 5% CO2 acetate continued to be inhibitory. Simultaneous enrichment with glucose and 5% CO2 gave higher yields of the lab strain than with CO2 alone but did not enhance growth of the field strain. We conclude that E. mutabilis is an acidophilic photoauxotroph which appears unable to use organic carbon supplements for growth even under conditions of carbon limitation.
NITRITE UPTAKE TRANSIENTS AND CONSEQUENCES FOR IN VIVO ALGAL NITRATE REDUCTASE ASSAYS
Authors: Brinkhuis Boudewijn H. , Renzhi Li , Chaoyuan Wu , Xun‐sen Jiang
Published: November 2006

We conducted in vivo nitrate reductase (NR) assays with the commercially important brown seaweed, Laminaria japonica Aresch., and present evidence that significant, sustained nitrite uptake can occur under typical assay conditions. Thus, we caution investigators to determine the importance of nitrite uptake prior to conducting similar in vivo NR assays in this and other algal species. Further, we observed high initial nitrite uptake from sea‐water medium supplemented with nitrite at concentrations found in coastal seawater of Qingdao, People's Republic of China. The pattern of initial uptake was unlike that described previously as “surge uptake” or “rapid uptake” in seaweeds, but it was similar to that recently reported for rapid ammonium uptake in phytoplankton. A high initial uptake rate lasted for a few minutes, followed by a rapid decline, a transient increase and a subsequent decline to stable uptake rates after ca. 1 h. This is the first report of such initially high inorganic nitrogen uptake in seaweeds. The significance of nitrite uptake in seaweeds may have been underestimated. Seaweeds may be able to exploit short‐duration nitrite pulses, as has been observed for ammonium in phytoplankton populations.
THE RED ALGAL EPIPHYTESMICROCLADIA COULTERIANDM. CALIFORNICA(RHODOPHYCEAE, CERAMIACEAE). II. BASIPHYTE SPECIFICITY1
Authors: Gonzalez Mariela A. , Goff Lynda J.
Published: November 2006

The phenomenon of basiphyte specificity in the settlement and growth of the red algal epiphytesMicrocladia californicaFarl. andM. coulteriHarv. was examined by studying the interface with their respective basiphytes and by cross‐inoculation experiments.Microcladia californicaattaches only to the surface of its single basiphyteEgregia menziesii(Aresch.) Turn. whereasM. coulteripenetrates the tissue of a wide range of basiphytes. The pattern of primary rhizoid development in both epiphytes determines the mode of attachment and may influence the range of basiphytes possible for each epiphyte. Cross‐inoculation experiments show thatMicrocladia californicais not able to colonize the basiphytes ofM. coulteri, IridaeaandPrionitis, orUlva.The mechanisms by which these algae restrict the growth of epiphytes include short life‐span, “cuticle peeling” and chemical defense.Microcladia coulteri, which naturally colonizesIridaeaandPrionitis, has evolved mechanisms to counteract the antifouling effects of those basiphytes. The question of whyEgregiais the exclusive substratum forM. californicaremains undetermined. However, Egregia may provide the appropriate ecological conditions and a surface topography conductive toM. californicaspore settlement and growth.
Retrospective Cost‐Effectiveness Analyses for Polio Vaccination in the United States
Authors: Thompson Kimberly M. , Tebbens Radboud J. Duintjer
Published: November 2006

The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost‐effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately $35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately $1.4 billion (1955 net present value, or $6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately $180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost‐saving public health program. Observed changes in the cost‐effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost‐effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of population and other dynamics, and shows the importance of dynamic modeling.
Anatomic Characteristics of the Left Atrial Isthmus in Patients with Atrial Fibrillation: Lessons from Computed Tomographic Images
Authors: CHIANG SHUO‐JU , TSAO HSUAN‐MING , WU MEI‐HAN , TAI CHING‐TAI , CHANG SHIH‐LIN , WONGCHAROEN WANWARANG , LIN YENN‐JIANG , LO LI‐WEI , CHEN YI‐JEN , SHEU MING‐HUEI , CHANG CHENG‐YEN , CHEN SHIH‐ANN
Published: November 2006

Introduction: Left atrial (LA) isthmus ablation was reported to improve the success rate of catheter ablation of paroxysmal atrial fibrillation (AF). LA isthmus ablation could also cure a subset of LA flutter. Therefore, understanding the anatomy of the LA isthmus is important for performing the ablation effectively.

Methods and Results: Group I included 45 patients (40 male, mean age = 50 ± 13 years) with paroxysmal AF who underwent catheter ablation. Group II included 45 patients (37 male, mean age = 54 ± 10 years) without a history of AF. They underwent a 16‐slice multidetector computed tomography (MDCT) scan to delineate the LA structures before the ablation procedure. The average length of the LA isthmus was longer in group I than in group II (lateral isthmus: 3.30 ± 0.68 vs 2.71 ± 0.60 cm, P < 0.001; medial isthmus: 5.12 ± 0.94 vs 4.45 ± 0.63 cm, P < 0.001), and morphological patterns of lateral and medial isthmus were similar between groups. In addition, the average depth of lateral isthmus was similar between groups (0.62 ± 0.32 vs 0.55 ± 0.33 cm, P = 0.41), but the average depth of medial isthmus was larger in group I than in group II (0.60 ± 0.32 vs 0.44 ± 0.25 cm, P = 0.01). The medial isthmus had more ridges, as compared to the lateral isthmus (13% vs 0%, P = 0.026). Furthermore, the distances between esophagus and lateral isthmus were longer in group I than in group II (at the middle of isthmus and mitral annulus level: 21.0 ± 4.8 vs 18.4 ± 6.0 mm, P < 0.001; and 37.1 ± 5.7 vs 29.6 ± 8.1 mm, P < 0.001, respectively).

Conclusion: The LA isthmus was longer in the AF patients. The morphology of the isthmus was variable. Compared with the lateral isthmus, the medial isthmus was longer and had more ridges. A peculiar configuration of the isthmus provided by CT images could influence the ablation strategy.
Successful Catheter Ablation of Two Types of Ventricular Tachycardias Triggered by Cardiac Resynchronization Therapy: A Case Report
Authors: PEICHL PETR , MLČOCHOVÁ HANKA , KAUTZNER JOSEF
Published: November 2006

We report a case of a patient with nonischemic dilated cardiomyopathy and implantable cardioverter‐defibrillator, in whom an upgrade to biventricular pacing triggered multiple episodes of ventricular tachycardias (VTs) of two morphologies. First VT presented as repetitive nonsustained arrhythmia of the same morphology as isolated ectopic beats, suggesting its focal origin. Second VT was reentrant and was triggered by the former ectopy, leading to a therapy from the device. Electroanatomical mapping of the left ventricle revealed relatively small low voltage area in the left ventricular outflow tract and identified both an arrhythmogenic focus as well as critical isthmus for reentrant VT. Radiofrequency catheter ablation successfully abolished both VTs. After the procedure, biventricular pacing was continued without any recurrences during a period of 24 months. The report emphasizes the role of catheter ablation in management of VTs triggered by cardiac resynchronization therapy.
Polymers, Drug Release, and Drug‐Eluting Stents
Authors: COMMANDEUR SUZAN , VAN BEUSEKOM HELEEN M.M. , VAN DER GIESSEN WIM J.
Published: November 2006

Implantable biomaterials mainly serve as physical support devices, carriers for bioactive molecules and guidance for tissue growth. For any application within or outside the cardiovascular area, biomaterials are subject to an extended set of requirements in order to establish safe application. These requirements mainly include acceptable biocompatibility and, if the material is to be degraded within the body, safe degradation characteristics. During degradation, biocompatible polymers are broken down into molecules that are metabolized and removed from the body via normal metabolic pathways. Major applications of these polymers include targeted drug delivery systems, resorbable sutures and orthopedic fixation devices. In the cardiovascular area they include biodegradable cardiovascular stents and drug‐eluting stent (DES) coatings. This review focuses on general aspects of local drug delivery by implantable polymeric devices, with special emphasis on drug‐eluting stents.
Multislice Computer Tomography for Detection of Coronary Artery Disease
Authors: ROPERS DIETER
Published: November 2006

Multislice computer tomography has undergone substantial technological progress during the past years. Current 64‐slice scanners with gantry rotation speeds of as little as 330 ms, and particularly the recently introduced dual source CT equipped with two X‐ray tubes, provide a temporal and spatial resolution that is sufficient to allow reliable imaging of cardiac morphology and coronary arteries. Especially the ability to noninvasively visualize the coronary arteries, including the assessment and quantification of calcifications, as well as the detection of luminal obstruction and atherosclerotic plaque, constitutes an attractive addition to currently available diagnostic tools for the work‐up of patients with known or suspected coronary artery disease. Besides the evaluation of coronary artery calcium and atherosclerotic plaques, this review focuses on the contrast‐enhanced CT visualization of the coronary vessels, including native coronary arteries, bypass grafts, and coronary stonts. Thereby detailed information concerning the scan protocol, clinical data, possible indications, and limitations using up‐to‐date 64‐slice technology is provided. Finally, the overview includes design and initial image examples of dual source CT technology as the newest development in the field.
Clinical Applications of Optical Coherence Tomography
Authors: PINTO TINA L. , WAKSMAN RON
Published: November 2006

Rupture of vulnerable plaque (VP) is responsible for most coronary events. Optical coherence tomography (OCT) is a high‐resolution imaging method that allows excellent characterization of atherosclerotic plaque. While this technique is limited by the need to interrupt blood flow and a shallow depth of penetration, its resolution is an order of magnitude greater than possible with intravascular ultrasound (IVUS), and it has demonstrated better sensitivity and specificity for accurately determining plaque composition. Early in vitro and in vivo experiences have affirmed the excellent quality of these images making it an attractive technology for the analysis of VP. Its high resolution likely renders it the best imaging modality currently available for the evaluation of proper stent deployment and of intracoronary pathology in the setting of percutaneous coronary interventions (PCI). Our institution is currently involved in a multicenter trial to evaluate the effectiveness of OCT when compared to IVUS in this setting. Ongoing technological improvements aim to permit rapid scanning which should alleviate its current major limitation of needing to scan in a blood‐free space. OCT is a promising new technology in the evaluation of atherosclerotic plaque and coronary microstructure.
Complex Coronary Interventions: Unprotected Left Main and Bifurcation Lesions
Authors: BARLIS PETER , TANIGAWA JUN , KAPLAN SAHIN , DI MARIO CARLO
Published: November 2006

Percutaneous coronary intervention has moved forward with great speed since the advent of stents and now more recently the introduction of drug‐eluting technologies. This has seen the modern interventional cardiologist tackle more and more complex coronary lesions, of which unprotected left main (ULM) and bifurcations still remain challenging and controversial. ULM coronary artery stenosis traditionally remains a surgical indication although there have been recent reports and studies demonstrating the feasibility of a percutaneous strategy in select patient groups. Furthermore, drug‐eluting stents have shown great benefit in reducing the problem of restenosis and have also become the mainstay treatment modality for bifurcation lesions with a choice between one‐ or two‐stent strategies determined by the extent of disease burden in the main vessel and side branch and the response of the side branch ostium following treatment of the main vessel. This article will provide a contemporary review of percutaneous intervention for these two lesion subsets and describe the relative merits of each of the different strategies in current use with a glimpse into what the future may hold.
Marked Improvements in Outcomes of Contemporary Percutaneous Coronary Intervention in Patients with Diabetes Mellitus
Authors: FREEMAN ANDREW M. , ABBOTT J. DAWN , JACOBS ALICE K. , VLACHOS HELEN A. , SELZER FAITH , LASKEY WARREN K. , DETRE KATHERINE M. , WILLIAMS DAVID O.
Published: November 2006

We sought to determine if advances in percutaneous coronary intervention (PCI) are associated with better outcomes among patients with diabetes mellitus (DM). Patients with DM enrolled in the National Heart, Lung, and Blood Institute (NHLBI) early PTCA Registry (1985–1986) were compared to those in the subsequent contemporary Dynamic Registry (1999–2002) for in‐hospital and one‐year cardiovascular outcomes. The study population included 945 adults with DM, 325 from the PTCA Registry and 620 from the Dynamic Registry. Multivariable Cox regression models were built to estimate the risk of clinical events. Dynamic Registry patients were older, had more noncardiac comorbidities, and a lower mean ejection fraction (50.5% vs 57.8%, P ≤ 0.001) compared to the PTCA Registry patients. The incidence of in‐hospital mortality (1.9% vs 4.3%, P ≤ 0.05), myocardial infarction (MI) (1.0% vs 7.4%, P ≤ 0.001), and coronary artery bypass grafting (CABG) (0.8% vs 6.2%, P ≤ 0.001) were all significantly lower and independent of the use of stents. One‐year adverse events including MI (4.9% vs 11.0%, P ≤ 0.001), CABG (6.4% vs 15.0%, P ≤ 0.001), and need for repeat revascularization (18.7% vs 33.3%, P ≤ 0.001) were all lower in the Dynamic Registry. The relative risk of death at 1 year was significantly less for patients in the Dynamic Registry (RR 0.56, 0.34; 0.92, P = 0.02). Although Dynamic Registry patients with diabetes had more advanced coronary disease, in‐hospital and late adverse events were lower. A combination of the use of stents and an increase in adjunctive medical therapy are likely responsible for the observed improvements in outcomes in contemporary PCI.
In SituObservation of Metastable Rare‐Earth Iron Garnet Formed at the Melt/Substrate Interface by Splat Quenching
Authors: Nagashio K. , Kuribayashi K. , Yamaguchi O. , Hibiya T.
Published: November 2006

The Nd substitution limit in the NdxSm3−xFe5O12garnet can be metastably extended fromx=0.375 up tox=2.0 by splat quenching combined with containerless processing. To understand the rapid solidification process at the melt/substrate interface, a droplet with NdxSm3−xFe5O12composition (x=0.43) was dropped by free fall on a Si wafer having relatively high thermal conductivity. The sequence of dropping, impacting, spreading, and solidification of the droplet was monitored using an infrared high‐speed video camera through the Si wafer from the bottom. When the droplet impinged on the Si wafer, an amorphous layer was formed at the initial impact. Then, the metastable garnet nucleated on it, resulting in the first recalescence. Subsequently, the second recalescence of the perovskite, which is stable above the peritectic temperature and identified as a high‐temperature phase, was observed ∼3 ms later. This time lag may be ascribed to the considerably low growth rate of the metastable garnet and the difficulty of nucleation of the perovskite on the metastable garnet. This is the first time that the phase transition at the melt/substrate interface during rapid quenching was observedin situ.
Adapted preparation technique for screw‐type implants: explorative in vitro pilot study in a porcine bone model
Authors: Beer Andreas , Gahleitner André , Holm Anders , Birkfellner Wolfgang , Homolka Peter
Published: November 2006

Objective: The aim of this study was to quantify the effect of adapted preparation on the insertion torque of self‐tapping implants in cancellous bone. In adapted preparation, bone condensation – and thus, insertion torque – is controlled by changing the diameter of the drilling.

Material and methods: After preparation of cancellous porcine vertebral bone with drills of 2.85, 3, 3.15 or 3.35 mm final diameters, Brånemark sytem® Mk III implants (3.75 × 11.5 mm) were inserted in 141 sites. During implantation, the insertion torque was recorded. Prior to implant insertion, bone mineralization (bone mineral density (BMD)) was measured with dental quantative computed tomography. The BMD values measured at the implant position were correlated with insertion torque for varying bone condensation.

Results: Based on the average torque recorded during implant insertion into the pre‐drilled canals with a diameter of 3 mm, torque increased by approximately 17% on reducing the diameter of the drill by 5% (to 2.85 mm). On increasing the diameter of the osteotomy to 3.15 mm (5%) or 3.35 mm (12%), torque values decreased by approximately 21% and 50%, respectively.

Conclusion: The results demonstrate a correlation between primary stability (average insertion torque) and the diameter of the implant bed on using a screw‐shaped implant. Thus, using an individualized bone mineralization‐dependent drilling technique, optimized torque values could be achieved in all tested bone qualities with BMDs ranging from 330 to 500 mg/cm3. The results indicate that using a bone‐dependent drilling technique, higher torque values can also be achieved in poor bone using an individualized drilling resulting in higher bone condensation. As immediate function is dependent on primary stability (high insertion torque), this indicates that primary stability can be increased using a modified drilling technique in lesser mineralized bone.
UNDERSTANDING RESPONSE BEHAVIOR TO AN ONLINE SPECIAL TOPICS ORGANIZATIONAL SATISFACTION SURVEY
Authors: ROGELBERG STEVEN C. , SPITZMÜELLER CHRISTIANE , LITTLE IAN , REEVE CHARLIE L.
Published: November 2006

In this study we sought to better understand response intentions and response behavior to an online special topics university satisfaction survey to not only advance theory but to better inform practice on the meaning and implications of nonresponse to their efforts. Using the Rogelberg, Luong, Sederburg, and Cristol (2000) response behavior model, data collected in this 2‐wave field study (394 students, 50% men) supported most of the framework's major assertions, supported our proposed extensions, and resulted in a few unexpected findings. Overall, to understand response behavior to an online special topics organizational survey, one must take into consideration factors related to technology, attitudes toward surveys in general, satisfaction with the specific topic in question, and response intentions.
Study of Safe Usage of High‐Flow Three‐Way Stopcocks in a Blood Circuit
Authors: Nakae Hajime , Omokawa Susumu , Asanuma Yoshihiro , Igarashi Toshiko , Tajimi Kimitaka
Published: November 2006

Abstract:  To examine the safety of using a high‐flow three‐way stopcock in a blood circuit during extracorporeal blood purification therapy, we studied the risk of development of hemolysis and clot formation in both ex vivo and in vivo extracorporeal circulation. In the ex vivo study, no significant difference was observed in the decrease in hematocrit (HCT) or increase in the potassium level between the three‐way stopcock group and the control group. Nor was there a significant difference in the change in inlet pressure between the two groups. Thus, it was shown that the risk of hemolysis caused by the use of a high‐flow three‐way stopcock on both the outlet side and inlet side would be small. In the in vivo cases, there was no significant difference in the decrease in HCT or the increase in inlet pressure between the three‐way stopcock group and control group, suggesting that it is clinically possible to incorporate a high‐flow three‐way stopcock into a blood circuit.
Judicial diversity, the woman judge and fairy tale endings
Authors: Rackley Erika
Published: November 2006

The story of the woman judge as one of exclusion and isolation plagued with allegations of bias is well documented. Interestingly, despite significant differences in time and place, a common theme unites these tales: the woman judge is a dangerous outsider, a threat to the aesthetic norm. The judicial climate, at least in most of the common law world, is somewhat chilly: reactions to her presence on the bench vary from the largely indifferent to the downright hostile. Why is this? After all, most people, perhaps acknowledging the political and democratic gains underlying calls for a more representative judiciary, would wish to encourage – or at least not discourage – judicial diversity.

Taking the stories of the woman judge as its starting point, this paper contends that underlying these tales is an image of the judge that is as much intuitive as it is reasoned; that our understanding of the judge and judging is as much derived from the imagination as from what is conventionally considered as rational thought. Thus, the paper deploys the narrative strategies of fairy tales in an attempt to disrupt the imaginative hold of familiar yet particular images that infuse and distort current discourses on adjudication. It suggests that despite the Department for Constitutional Affairs’ ongoing quest to increase diversity within the judiciary, current initiatives do not confront fully these instinctive images. As a result, their narrative of inclusiveness and difference fails. In response, the paper appeals to the imagination as a route toward engendering new conceptions on the judge and judging, the possibility of truly diverse judiciaries and, perhaps, a fairy tale ending to the woman judge’s story.
Calcium regulation in individual peripheral sensory nerve terminals of the rat
Authors: Gover Tony D. , Moreira Thaís H. V. , Kao Joseph P. Y. , Weinreich Daniel
Published: November 2006

Ca2+ is vital for release of neurotransmitters and trophic factors from peripheral sensory nerve terminals (PSNTs), yet Ca2+ regulation in PSNTs remains unexplored. To elucidate the Ca2+ regulatory mechanisms in PSNTs, we determined the effects of a panel of pharmacological agents on electrically evoked Ca2+ transients in rat corneal nerve terminals (CNTs) in vitro that had been loaded with the fluorescent Ca2+ indicator, Oregon Green 488 BAPTA‐1 dextran or fura‐2 dextran in vivo. Inhibition of the sarco(endo)plasmic reticulum Ca2+‐ATPase, disruption of mitochondrial Ca2+ uptake, or inhibition of the Na+–Ca2+ exchanger did not measurably alter the amplitude or decay kinetics of the electrically evoked Ca2+ transients in CNTs. By contrast, inhibition of the plasma membrane Ca2+‐ATPase (PMCA) by increasing the pH slowed the decay of the Ca2+ transient by 2‐fold. Surprisingly, the energy for ion transport across the plasma membrane of CNTs is predominantly from glycolysis rather than mitochondrial respiration, as evidenced by the observation that Ca2+ transients were suppressed by iodoacetate but unaffected by mitochondrial inhibitors. These observations indicate that, following electrical activity, the PMCA is the predominant mechanism of Ca2+ clearance from the cytosol of CNTs and glycolysis is the predominant source of energy.