bluuebunny/crossref_metadata_2025 huggingface dataset:
Ageing, Optimal National Saving and Future Living Standards in Australia
Authors: Guest Ross S. , McDonald Ian M.
Published: March 2003

Making allowance for the ageing structure of the population, this paper calculates the levels of optimal national saving and future living standards for Australia for the period 1999–2050. For this period, the optimal saving response to the ageing of the Australian population is for national saving to increase from its current level by 2.7 per cent of GDP by the year 2017 and then to decline to the year 2050. The implied growth of living standards is 1.20 per cent per year. Reduced immigration would reduce the rate of growth of living standards but reduced fertility would not.
Asymmetric Responses of the Underground Economy to Tax Changes: Evidence From New Zealand Data
Authors: Giles David E.A. , Werkneh Gugsa T. , Johnson Betty J.
Published: March 2003

This paper considers the relationship between taxes and the size of the New Zealand underground economy. Previous studies indicate that a positive relationship exists in this and certain other countries. This paper addresses the question: ‘Is the response of the underground economy to an increase in taxes the same as its response to a decrease in taxes?’ We find that although the effect on the underground economy of an upward movement in the effective tax rate is numerically greater than that of a downward tax movement, this difference is not statistically significant.
Economics Teaching in Australian Universities: Rewards and Outcomes
Authors: Guest Ross , Duhs Alan
Published: March 2003

This paper presents evidence from two surveys to help explain the poor ratings consistently given to the teaching of economics at Australian universities. The evidence suggests that the poor ratings of economics teaching can be attributed to two related factors: inappropriate pedagogical practices and lack of rewards for allocating additional time to teaching. The survey data on pedagogy in economics consist of 205 responses from graduates from two Queensland universities. The time elapsed since graduation ranges from 1 to 10 years. The survey data on academics' time allocation consist of 290 responses from academic economists across a wide range of Australian universities.
The Elasticity of Demand for Labour in Australia
Authors: Lewis Philip E. T. , MacDonald Garry
Published: March 2003

The elasticity of demand for labour at the aggregate level is an important parameter for macroeconomic analysis. In particular, policy issues concerning the impact of wage falls on employment and unemployment hinge on the size of this parameter. It is argued in the present paper that previous work on the elasticity of demand for labour in Australia has been unsatisfactory in a number of ways. A new set of estimates is provided that are derived using a better methodology than before.
Catching Up on Health Outcomes: The Texas Medication Algorithm Project
Authors: Kashner T. Michael , Carmody Thomas J. , Suppes Trisha , Rush A. John , Crismon M. Lynn , Miller Alexander L. , Toprac Marcia , Trivedi Madhukar
Published: March 2003

Objective. To develop a statistic measuring the impact of algorithm‐driven disease management programs on outcomes for patients with chronic mental illness that allowed for treatment‐as‐usual controls to “catch up” to early gains of treated patients.

Data Sources/Study Setting. Statistical power was estimated from simulated samples representing effect sizes that grew, remained constant, or declined following an initial improvement. Estimates were based on the Texas Medication Algorithm Project on adult patients (age≥18) with bipolar disorder (n=267) who received care between 1998 and 2000 at 1 of 11 clinics across Texas.

Study Design. Study patients were assessed at baseline and three‐month follow‐up for a minimum of one year. Program tracks were assigned by clinic.

Data Collection/Extraction Methods. Hierarchical linear modeling was modified to account for declining‐effects. Outcomes were based on 30‐item Inventory for Depression Symptomatology—Clinician Version.

Principal Findings. Declining‐effect analyses had significantly greater power detecting program differences than traditional growth models in constant and declining‐effects cases. Bipolar patients with severe depressive symptoms in an algorithm‐driven, disease management program reported fewer symptoms after three months, with treatment‐as‐usual controls “catching up” within one year.

Conclusions. In addition to psychometric properties, data collection design, and power, investigators should consider how outcomes unfold over time when selecting an appropriate statistic to evaluate service interventions. Declining‐effect analyses may be applicable to a wide range of treatment and intervention trials.
South Africa's Political Futures
Authors: Butler Anthony
Published: March 2003

Political analysts are variously divided over the prospects for South Africa's democracy. This article both explores and explains their great diversity of opinion. It investigates the implications, both positive and negative, of African National Congress one-party electoral dominance. The paper goes on to assess the reliability of the mechanisms through which an electorally dominant government can be rendered politically accountable. It then explores the implications of political challenges — concerning capital and skills flight, HIV/AIDS, and corruption — that have licensed further speculation about South Africa's future, and concludes that a cohesive ruling alliance offers the best hope of entrenching the country's imperfect democracy.
Focus on Economic Theory Keynes on the “Nature of Economic Thinking”: The Principle of Non‐Neutrality of Choice and the Principle of Non‐Neutrality of Money
Authors: Fontana Giuseppe
Published: March 2003

In the last two decades there has been a flourishing of writings on the methodological approach of Keynes. Whereas broad interpretations of Keynes’s work may have a role to play for future economics the main argument of this paper is to propose a return to the theoretical foundations of a truly Keynesian economics. In the main economic writings of Keynes it is possible to discern a body of beliefs, which is (a) consistent in its own terms and (b) susceptible of being used in the explanation of different realities. That body of beliefs is grounded on (1) the principle of non‐neutrality of choice and (2) the principle of non‐neutrality of money. Both principles were essential parts of the core of Keynes’s A Treatise on Money (1930) and The General Theory (1936), and should be used as foundation for future development of Keynesian economics at the methodological as well as at the theoretical level.
Voters, Parties, and the Endogenous Size of Government
Authors: Olters Jans‐Peter
Published: March 2003

Elections, often to a considerable degree, influence the fiscal policies of governments installed on the basis of their results. Yet, economists have tended to view politicians' behaviour either as being determined exogenously or as the result of a social planner's maximisation of a well‐defined social‐welfare function (subject to some appropriate technology and resource constraints). The latter approach— given (i) its inherent abstraction from important politico‐economic interactions, (ii) the theoretical difficulty in deriving a non‐contradictory “collective utility function” (as demonstrated by Arrow), and (iii) the inability to estimate a stable relationship that could explain political preferences with economic variables—is viewed as being an unsatisfactory tool for the joint description of a country's economy and polity. On the basis of explicit micro‐economic foundations and a democratically coordinated decision‐making mechanism over the “optimal” provision of public goods and the corresponding taxes required to finance them, this paper will introduce a simple economic model of politics that subjects individuals to a—two‐tiered—political decision‐making process over party membership and electoral participation, thereby endogenising the evolution of the competing parties' ideologies, households' electoral behaviour, and the key factors explaining the design of fiscal policies. Having the majority party's median delegate determine on the “optimal” degree of income redistribution suggests that a country's wealth distribution is a crucial explanatory variable explaining its politico‐economic development path.
Political Instability and Economic Growth: Implications of Coup Events in Sub‐Saharan Africa
Authors: Fosu Augustin Kwasi
Published: March 2003

The study examines the differential roles of various elite political instability (PI) events—successful coups d'etat, abortive coups, or coup plots—in the growth of Sub‐Saharan Africa. It analyzes World Bank economic statistics and data on the incidence of coups d'etat for 31 countries in a cross‐country augmented production function framework that incorporates PI events as well as labor and capital as arguments. It finds that abortive coups, rather than successful coups, had the greatest adverse impact on economic growth over the 1960–1986 period. Coup plots were also observed to be growth‐inhibiting. This deleterious “direct” effect of PI is observed to be channeled via the deterioration in the marginal productivity of capital, regardless of coup event. While abortive coups negatively influenced economic growth monotonically, however, the impacts of successful coups and coup plots appeared to be non‐monotonic: negative generally but positive at very low levels of investment.
Building Consensual Institutions: Networks and the National Estuary Program
Authors: Schneider Mark , Scholz John , Lubell Mark , Mindruta Denisa , Edwardsen Matthew
Published: March 2003

Currently, many approaches to solving policy problems seek to create community‐based, less coercive solutions that are creating the conditions for the birth of new regional governmental institutions. We argue that networks form the core of these emergent structures and that federal programs can play a positive role in developing local networks. Our empirical work compares networks in estuaries included in National Estuary Program with networks in comparable estuaries that were not. We find that the networks in NEP areas span more levels of government, integrate more experts into policy discussions, nurture stronger interpersonal ties between stakeholders, and create greater faith in the procedural fairness of local policy, thus laying the foundation for a new form of cooperative governance.
Tight money policies and inflation revisited
Authors: Bhattacharya Joydeep , Kudoh Noritaka
Published: March 2003

In this paper we reconsider the link between tight money policies and inflation in the spirit of Sargent and Wallace’s (1981) influential paper, ‘Some unpleasant monetarist arithmetic.’ A standard neoclassical model with capital, bonds, and return‐dominated currency is used. The potential for tight‐money policies to be inflationary (unpleasant arithmetic) exists, even when the real interest rate is below the growth rate of the economy. Additionally, the likely observability of unpleasant arithmetic in real world economies is shown to depend crucially on the type of monetary policy rule that is used. JEL Classification: E52, E63

Un autre coup d’œil sur la relation entre politiques monétaires restrictives et inflation. Ce mémoire ré‐examine la relation entre politiques monétaires restrictives et inflation dans l’esprit du travail de Sargent et Wallace (1981) ‘Some Unpleasant Monetarist Arithmetic’. Les auteurs utilisent un modèle néo‐classique standard avec capital, débentures et une monnaie dont les rendements sont dominés par ceux d’autres réservoirs de valeur. La possibilité que les politiques monétaires restrictives soient inflationnistes existe même quand le taux d’intérêt réel est plus petit que le taux de croissance de l’économie De plus on montre que l’obtention de ces résultats déplaisants dans les économies concrètes dépend fondamentalement du type de règle monétaire qu’on utilise.
Productivity performance and international competitiveness: an old test reconsidered
Authors: Choudhri Ehsan U. , Schembri Lawrence L.
Published: March 2003

A modern adaptation of the Ricardian model is used, which incorporates monopolistic competition and multiple factors to derive a MacDougall‐type relation between a country’s international competitiveness at the industry level and its productivity performance. This relation is implemented empirically for Canada and the United States, using panel data for twenty‐five years and forty industries. A key finding is that the Canadian‐U.S. productivity ratio is an important determinant of relative shares of Canadian firms in both Canadian and U.S. markets. Trade liberalization between Canada and the United States also plays a significant role in influencing market shares. JEL Classification: F11, F12

Niveau de productivité et compétitivité internationale : un autre coup d’œil à un vieux test. Ce mémoire utilise une adaptation moderne du modèle ricardien qui postule concurrence monopolistique et plusieurs facteurs pour dériver une relation à la MacDougall entre la compétitivité internationale d’un pays au niveau de l’industrie et son niveau de productivité. On calibre cette relation pour le Canada et les États‐Unis en utilisant des données pour quarantes industries sur une période de vingt‐cinq ans. Un résultat important est que le ratio de la productivité entre le Canada et les États‐Unis est un déterminant important des parts de marché des firmes canadiennes tant au Canada qu’aux États‐Unis. La libéralisation du commerce entre les deux pays joue aussi un rôle important dans la définition de ces parts de marché.
Contagion Effects from the 1994 Mexican Peso Crisis: Evidence from Chilean Stocks
Authors: Mathur Ike , Gleason Kimberly C. , Dibooglu Selahattin , Singh Manohar
Published: March 2003

The contagion, or informational spillover, effects of the 1994 peso crisis from the Mexican market to the Chilean market, and to the Chilean American Depository Receipts (ADRs) trading in the U.S., are examined. Significant excess returns are observed for Chilean stocks for the event dates of the Mexican Peso crisis, providing evidence of contagion effects. Significant excess returns on these Chilean ADRs are also observed for each of the five event dates associated with the Peso crisis, suggesting that the contagion effects spilled over to the ADRs. A multiple regression model shows that the spillover contagion effects were very efficiently transmitted from the Mexican market to the Chilean market to the Chilean ADRs. Multifactor regressions show that the most significant influence on the pricing of Chilean ADRs is the raw Chilean Index, rather than the Chilean Index expressed in U.S. dollars.
Payment For Risk: Constant Beta Vs. Dual‐Beta Models
Authors: Pettengill Glenn , Sundaram Sridhar , Mathur Ike
Published: March 2003

Fama and French’s (1992) assertion that investors receive premium payments for risk associated with the book value to market price (BE/ME) and size and not for holding beta risk has sparked a lively debate concerning risk factors that are priced in the market. Howton and Peterson (1998) use a dual‐beta model to test the Fama and French conclusions. They conclude that the significant relationship between beta and returns depends on the use of the dual‐beta model. This work, however, ignores the results reported by Pettengill, Sundaram, and Mathur (PSM, 1995). PSM find a significant relation between a constant risk beta and returns when data are segmented between up and down markets, but do not consider the impact of size and BE/ME. In this paper we show that the PSM (1995) market segmentation procedure alone provides a sufficient condition to identify a significant relation between beta and returns in the presence of size and BE/ME. Dual market betas may be relevant in explaining risk and return. However, the market segmentation procedure of PSM (1995) is the critical condition for finding a significant relationship between returns and betas.
Wealth Effects of Private Equity Placements: Evidence from Singapore
Authors: Chen Sheng‐Syan , Ho Kim Wai , Lee Cheng‐few , Yeo Gillian H.H.
Published: March 2003

We examine institutional characteristics and the wealth effects of private equity placements in Singapore. Our findings show that private placements in Singapore generally result in a negative wealth effect and a reduction in ownership concentration. We find that at high levels of ownership concentration, the relation between abnormal returns and changes in ownership concentration is significantly negative. We also show that the market reacts less favorably to placements in which management ownership falls below 50%, but more favorably to issues to single investors. We do not find evidence suggesting that our results are due to an information effect.
Seven‐dimensional considerations of Einstein′s connection. II.The recurrence relations of the second and third kind in 7‐g‐UFT
Authors: Kim Mi Ae , So Keum Sook , Cho Chung Hyun , Chung Kyung Tae
Published: March 2003

We present powerful recurrence relations of the second and third
kind which hold in 7‐dimensional Einstein′s generalized
Riemannian manifold X7. All considerations in this paper are
restricted to the first and second classes of X7 only since
the case of the third class, the simplest case, was already
studied by many authors.
Unimodal time‐symmetric dynamics
Authors: Bernhardt Chris
Published: March 2003

Time‐symmetric cycles are defined. Unimodal time‐symmetric cycles
are classified. A one‐parameter family of maps of the closed unit
interval that exhibits this classification is given.
Boundary values and the transformation problem for constantprincipal strain mappings
Authors: Gevirtz Julian
Published: March 2003

We initiate a study of homeomorphisms f with constant principal
strains (cps) between smoothly bounded planar domains D, D′.
An initial result shows that in order
for there to be such a mapping of a given Jordan domain D onto
D′, a certain condition of an isoperimetric nature must be
satisfied by the latter. Thereafter, we establish the fundamental
fact that principal strain lines (characteristics) of such
mappings necessarily have well‐defined tangents where they meet
∂D. Using this, we obtain information about the boundary
values of the Jacobian transformation of f, and finally we
determine the class of all cps‐homeomorphisms of a half‐plane
onto itself.
Resistin Is Expressed in the Human Placenta
Authors: Yura Shigeo , Sagawa Norimasa , Itoh Hiroaki , Kakui Kazuyo , Nuamah Mercy A. , Korita Daizo , Takemura Maki , Fujii Shingo
Published: March 2003

The mechanism for decreased insulin sensitivity in pregnant women is not fully clarified. Resistin, a novel peptide hormone, is specifically expressed in the adipose tissue and decreases insulin sensitivity in rodents. In the present study, we demonstrate resistin gene expression in the human placental tissue, mainly in trophoblastic cells. The resistin gene expression in term placental tissue was more prominent than was seen in the first trimester chorionic tissue. In contrast resistin gene expression in adipose tissue was rather weak and remained unchanged by pregnancy. Thus, resistin is a newly isolated placental hormone in humans which may modulate insulin sensitivity during pregnancy.
Effects on Gender Identity of Prenatal Androgens and Genital Appearance: Evidence from Girls with Congenital Adrenal Hyperplasia
Authors: Berenbaum Sheri A. , Bailey J. Michael
Published: March 2003

To address questions about sex assignment in children with ambiguous genitalia, we studied gender identity in girls with congenital adrenal hyperplasia (CAH) in relation to characteristics of the disease and treatment, particularly genital appearance and surgery. A 9-item gender identity interview was administered to 43 girls with classical CAH ranging in age from 3–18 yr, 7 tomboys, and 29 sister control girls. Groups were compared on total score and on individual items. Results showed that, on the total gender identity score, 88% of girls with CAH had scores overlapping those of control girls, but the average score was intermediate between control girls and tomboys. On individual items of gender identity (discomfort as a girl, wish to be a boy), girls with CAH were similar to control girls. Gender identity in girls with CAH was not related to degree of genital virilization or age at which genital reconstructive surgery was done. Thus, moderate androgen excess early in development appears to produce a small increase in the risk of atypical gender identity, but this risk cannot be predicted from genital virilization.
Association of Low Interleukin-10 Levels with the Metabolic Syndrome in Obese Women
Authors: Esposito Katherine , Pontillo Alessandro , Giugliano Francesco , Giugliano Giovanni , Marfella Raffaele , Nicoletti Gianfranco , Giugliano Dario
Published: March 2003

The potential role of anti-inflammatory cytokines in human obesity is unknown. We tested the hypothesis that low serum IL-10 concentrations associate with the metabolic syndrome in obese women. Compared with 50 matched nonobese women, the prevalence of the metabolic syndrome (≥3 of the following abnormalities: waist circumference, >88 cm; triglycerides, >1.69 mmol/liter; high density lipoprotein cholesterol, <1.29 mmol/liter; blood pressure, >130/85 mm Hg; glucose, >6.1 mmol/liter) was higher in 50 obese women (52% vs. 16%; P < 0.01). As a group, obese women had higher circulating levels of IL-6, C-reactive protein, and IL-10 than nonobese women. In both obese and nonobese women, IL-10 levels were lower in those with than in women without the metabolic syndrome: obese, 1.3 (0.7/2.1) pg/ml vs. 4.5 (4.3/7.4) pg/ml (median and quartiles; P < 0.01); and nonobese, 0.9 (0.7/1.3) pg/ml vs. 1.3 (0.9/3.3) pg/ml (P < 0.05). After 12 months of a lifestyle program, body weight decreased by 10.9 ± 1.7 kg and was associated with a significant decrement of IL-6, C-reactive protein, and IL-10 levels; the decrease in IL-10 levels was confined to obese women without the metabolic syndrome. These results show that circulating levels of the anti-inflammatory cytokine IL-10 are elevated in obese women and that low IL-10 levels are associated with the metabolic syndrome.
Association of ambient air‐pollution levels with acute asthma exacerbation among children in Singapore
Authors: Chew FT , Goh DYT , Ooi BC , Saharom R , Hui JKS , Lee BW
Published: March 2003

Background: Air‐pollution levels have been shown to be associated with increased morbidity of respiratory diseases.

Methods: Data for ambient air‐pollutant levels, meteorologic factors, and hospitalization or emergency room (ER) visits for acute asthma in Singapore children over a 5‐year period (1990–4) were obtained and analyzed for associations by time‐series methods.

Results: Throughout this period, the annual mean and 24‐h mean levels for sulfur dioxide (SO2), nitrogen dioxide (NO2), and total suspended particles (TSP) and maximum 1‐h daily average for ozone were generally within the air‐quality guidelines established by the World Health Organization (WHO). However, positive correlation between levels of each of these pollutants and daily ER visits for asthma was observed in children aged 3–12 years, but not among adolescents and young adults (13–21 years old). The association with SO2 and TSP persisted after standardization for meteorologic and temporal variables. An adjusted increase in 2.9 ER visits for every 20 μg/m3 increase in atmospheric SO2 levels, lagged by 1 day, was observed on days when levels were above 68 μg/m3. With TSP, an adjusted increase of 5.80 ER visits for every 20 μg/m3 increase in its daily atmospheric levels, lagged by 1 day, was observed on days with levels above 73 μg/m3. Similar results were also obtained after controlling for autocorrelation by time‐series analysis.

Conclusions: These associations were observed even though the overall levels of all pollutants were generally within the air‐quality guidelines established by the WHO. These findings suggest that asthmatic children are susceptible to increased levels of air pollutants, particularly SO2 and TSP, although the ambient levels are generally within “acceptable” ranges.
Allergy to date fruits: characterization of antigens and allergens of fruits of the date palm (Phoenix dactylifera L.)
Authors: Kwaasi A.A.A. , Parhar R.S. , Al‐Sedairy S.T. , Collison K.S. , Al‐Mohanna F.A. , Harfi H.A. , Panzani R.C.
Published: March 2003

Background: Date‐palm (Phoenix dactylifera L.) fruits are eaten daily by most inhabitants of the Middle East and the neighboring countries. Recent reports have indicated that dates are allergenic. This study aimed to investigate the antigenic and allergenic potential of date fruits.

Methods: Date‐fruit extracts from eight cultivars were evaluated in skin prick tests (SPT) in an atopic population, used to produce antisera, analyzed by SDS–PAGE, and fractionated by gel‐filtration chromatography. Sera from SPT‐positive individuals were evaluated by ELISA and RAST, and in anti‐IgE immunoblot experiments.

Results: About 13% of patients were SPT‐positive for at least two extracts. SDS–PAGE of whole extracts revealed 15–18 protein bands of 6.5–>100 kDa, and Sephacryl S‐200 fractions gave distinct peptide bands. RAST and anti‐IgE ELISA gave a range of positive results, which could be abrogated when sera were preabsorbed with fruit extracts. IgE immunoblots of different extracts with pooled positive sera revealed different anti‐IgE‐binding immunoprints. All the positive sera from fruit‐allergic and pollen‐allergic individuals bound strongly to two anti‐IgE reactive bands of 6.5 to 12–14 kDa and 28–33 kDa, respectively, and about 50% of sera bound to a 54–58‐kDa band.

Conclusions: These results strongly indicate that

date‐palm fruit is a potent allergen

sera from fruit‐allergic as well as pollen‐allergic patients recognize common fruit‐specific epitopes

there is heterogeneity in patient responses to the different extracts.
Prevalence of pollinosis in the Basque Country
Authors: Azpiri A. , Alonso E. , Gamboa P.M. , Jauregui I. , Antepara I. , Fernandez E. , Férnandez de Corres L. , Audicana M. , Muñoz D. , Escobar A.
Published: March 2003

Background: The prevalence of allergic diseases, mainly pollinosis, has increased within the last decades. Our study aimed to determine the prevalence of sensitization to Poaceae pollen in the Basque Country. This is a region of northern Spain, with an area of 7261 km2 and a population of 2109009 inhabitants. Two different climatic regions may be distinguished in the Basque Country (the Atlantic and the Oceanic).

Methods: A transversal study was carried out on 2216 subjects, aged 10–40 years. A personal interview was carried out in order to compile study data, by means of a questionnaire that had been previously validated with a clinical history and an allergy study.

Results and Conclusions: Our results show the prevalence of pollinosis in the Basque Country to be 10.6% (C.I. 95% 9.35–11.96%) without significant differences between men and women. The prevalence in the Atlantic climate area (9.71%) was lower than in the Oceanic climate area (13.61%). There were no differences between persons living in a rural environment (10.87%) and those living in an urban setting (10.51%). Pollinosis was more frequent in individuals aged 10–20 (11.41%) and 20–30 (12.54%) than those aged 30–40 years (7.43%). Three features significantly distinguished pollinic from nonpollinic patients:

a more common complaint of symptoms after ingestion of Rosaceae fruits or nuts (10.2%)

a family history of atopy (8.8%)

a greater occurrence of bronchial asthmatic symptoms (23%).
Allergy to bumblebee venom. III. Immunotherapy follow‐up study (safety and efficacy) in patients with occupational bumblebee‐venom anaphylaxis
Authors: De Jong N.W. , De Groot H. , Vermeulen A.M.
Published: March 2003

Background: The objective was to investigate whether venom immunotherapy with bumblebee venom (BBV) is safe and effective.

Methods: Eleven patients with severe occupational anaphylaxis caused by stings of bumblebees were studied. Sensitization to bumblebee venom was confirmed by skin tests and RAST. Immunotherapy was started with bumblebee venom extract by the semirush procedure, because these patients showed a primary sensitization to Bombus venom, and a low or absent degree of cross‐reactivity with honeybee venom. IgE titer and skin tests with bumblebee venom were performed yearly. Efficacy was evaluated by means of in‐hospital sting challenge and/or occupational field stings from bumblebees.

Results: All patients reached maintenance dose in 6 weeks without severe side‐effects. During the follow‐up period (1.5–5 years), three systemic reactions in two patients were seen in 20 bumblebee stings. However, these reactions were milder than the index sting.

Conclusions: Immunotherapy with bumblebee venom is safe and effective, and is comparable with honeybee and yellow‐jacket venom immunotherapy.
Immunologic response to different determinants of benzylpenicillin, amoxicillin, and ampicillin. Comparison between urticaria and anaphylactic shock
Authors: Torres M.J. , Mayorga C. , Pamies R. , Juarez C. , Blanca M. , Romano A.
Published: March 2003

Background: Subjects with IgE‐mediated allergic reactions to penicillins can develop urticaria or anaphylactic shock. Urticaria is mainly associated with positivity to the major determinant of benzylpenicillin (BPO), and anaphylactic shock with minor determinants (MDM). The presence of IgG antibodies to BPO is thought to be mainly associated with urticaria, possibly protecting from anaphylactic shock. We aimed to study the skin test response to BPO and MDM, amoxicillin (AX), and ampicillin (AMP) in a group of subjects allergic to penicillins, and to evaluate the role of specific IgG.

Methods: We studied a group of patients with immediate allergic reactions to penicillins, comparing urticaria and anaphylactic shock. Skin tests were done with BPO, MDM, AX, and AMP. Specific IgE and IgG antibodies to benzylpenicilloyl‐poly‐l‐lysine (BPO‐PLL) and amoxicilloyl‐poly‐l‐lysine (AXO‐PLL) were determined by RAST and ELISA, respectively.

Results: Fifty‐nine patients were studied (30 with anaphylactic shock and 29 with urticaria). Skin test positivity to BPO was associated with urticaria (P<0.001), and positivity to MDM, AX, and AMP with anaphylactic shock (P=0.006, P<0.001, and P=0.002, respectively). Specific anti‐BPO‐PLL and AXO‐PLL IgG values were higher in patients than controls (P<0.001), but no differences were observed between urticaria and anaphylactic shock.

Conclusions: Positivity to minor determinants of penicillins is associated more with anaphylactic shock than urticaria, but the role of IgG antibodies in helping to prevent the development of anaphylactic shock could not be confirmed.

Abbreviations: BPO: benzylpenicilloyl; MDM: minor determinant mixture; AX: amoxicillin; AMP: ampicillin; AXO‐PLL: amoxicilloyl‐poly‐l‐lysine; BPO‐PLL: benzylpenicilloyl‐poly‐l‐lysine.
Genes, factor X, and allergens: what causes allergic diseases?
Authors: Wjst M , Dold S
Published: March 2003

Genetic disposition and allergen exposure play the main roles in the development of allergic diseases. Another factor that could be involved is the nutritional intake of vitamin D.
Overexpression of CD44 on alveolar eosinophils with high concentrations of soluble CD44 in bronchoalveolar lavage fluid in patients with eosinophilic pneumonia
Authors: Katoh S. , Taniguchi H. , Matsumoto N. , Matsukura S. , Matsubara Y. , Kadota J. , Kohno S. , Fukushima K.
Published: March 2003

Background: High levels of interleukin‐5 (IL‐5) are found in the alveolar space of patients with eosinophilic pneumonia (EP). IL‐5 promotes the growth and differentiation of eosinophils, as well as activating these cells. IL‐5 also induces the expression of CD44 on eosinophils in vitro. To evaluate the contribution of CD44 to the pathogenesis of EP, we examined the expression of CD44 on eosinophils in bronchoalveolar lavage fluid (BALF) and measured the concentration of soluble CD44 (sCD44) in BALF from patients with EP.

Methods: The concentrations of IL‐5, sCD44, and hyaluronic acid (HA) were measured in BALF. The expression levels of CD44 on eosinophils in BALF and peripheral blood in patients with EP were compared.

Results: The expression of CD44 on alveolar eosinophils and the concentration of sCD44 were increased in BALF of patients with EP. There was a significant correlation between IL‐5 and sCD44 in BALF. A high concentration of HA was observed in BALF of EP patients.

Conclusions: Our results suggest that the high expression of CD44 on eosinophils probably results from upregulation by IL‐5 and could be important in the pathogenesis of EP.
Onset of action of mometasone furoate nasal spray (NASONEX®) in seasonal allergic rhinitis
Authors: Berkowitz Rb , Bernstein Di , LaForce C , Pedinoff Aj , Rooklin Ar , Damaraju Crv , Mesarina‐wicki B , Nolop Kb
Published: March 2003

Background:Mometasone furoate nasal spray (MFNS, NASONEX®), is a new synthetic corticosteroid with considerable efficacy in the treatment of seasonal and perennial rhinitis and less than 0.1% systemic absorption. This study was designed to evaluate the time of onset of action of MFNS. The subjects were evaluated over the course of 2 weeks during the spring allergy season.

Methods:The effects of MFNS 200 μg given once daily for 2 weeks were evaluated in a randomized, multicenter, double‐blind, placebo‐controlled study in 201 patients with seasonal allergic rhinitis. Clinically significant onset of action was assessed prospectively by special patient diary cards kept during the first 3 days of treatment.

Results:By 12 h after initial dosage (the earliest evaluation), 28% of patients in the MFNS group experienced clinically significant relief, compared with 13% of those given placebo (P=0.01). Median time to at least moderate symptom relief in patients who received MFNS was 35.9 h, compared with more than 72 h in patients given placebo (P<0.01). By 72 h, 64% of the patients receiving MFNS experienced at least moderate relief, compared with 40% of those treated with placebo (P<0.01). Both patient and physician ratings of symptom severity, response to treatment, and overall condition of rhinitis indicated significant (P<0.01) superiority of MFNS over placebo. MFNS was well tolerated, with adverse events comparable to placebo.

Conclusions:MFNS provided rapid onset of clinically significant symptom relief in patients with seasonal allergic rhinitis.
Cow's milk allergy: diagnostic accuracy of skin prick and patch tests and specific IgE
Authors: Majamaa H , Moisio P , Kautiainen H , Majamaa H , Turjanmaa K , Holm K
Published: March 2003

Background: The objective of the present study was to evaluate the relevance of skin tests and the concentration of cow's milk‐specific IgE antibodies in correlation with oral cow's milk challenge in infants with suspected cow's milk allergy.

Methods: The study material comprised 143 infants under the age of 2 years who had undergone a diagnostic elimination challenge because of suspected cow's milk allergy in 1996. Cow's milk‐specific IgE was measured, and skin prick and patch tests were performed.

Results: Of the 143 oral cow's milk challenges performed, 72 (50%) were positive. Of the positive reactions, 22 involved immediate‐type reactions. In 50 patients, delayed‐onset reactions of eczematous or gastrointestinal type appeared. Of the infants with challenge‐proven cow's milk allergy, 26% showed elevated IgE concentrations to cow's milk, 14% had a positive skin prick test, and 44% had a positive patch test for cow's milk. Interestingly, in most patch test‐positive patients, the prick test for cow's milk was negative.

Conclusions: Our study demonstrated that many patients with a negative prick test result had a positive patch test to cow's milk. The patch test was a more sensitive method than the prick test or RAST to detect cow's milk allergy in this study population. Our results indicate that patch testing will significantly increase the probability of early detection of cow's milk allergy. Confirmation of the diagnosis is essential in patients with negative test results but a clinical suspicion of food allergy, and in patch test‐positive patients. For this purpose, the most reliable method is the elimination‐challenge procedure.
Study of the Th1/Th2 balance, including IL‐10 production,in cultures of peripheral blood mononuclear cells frombirch‐pollen‐allergic patients
Authors: Movérare R. , Elfman L. , Stålenheim G. , Björnsson E. , Movérare R.
Published: March 2003

Background: Excessive production of interleukin (IL)‐4, IL‐5, IL‐10, and IL‐13 is thought to be important in the development of allergy and asthma. The objective of this investigation was to study Th1/Th2‐like cytokine profiles in vitro in seven patients allergic to birch pollen and six nonallergic controls during the birch‐pollen season.

Methods: Peripheral blood mononuclear cells (PBMC) were isolated and cultured with birch‐pollen extract (BPE) or tetanus toxoid (TT) for 7 days, harvested, and restimulated with the mitogens phytohemagglutinin (PHA) and phorbol 12‐myristate 13‐acetate (PMA) for 24 h. Cytokine production was determined by ELISA, and logarithmic cytokine ratios were compared between the two groups and between the antigens.

Results: In the allergic group, the cultures prestimulated with BPE had a more Th2‐like cytokine response than the TT‐prestimulated cultures; i.e., lower IFN‐γ and higher IL‐10 production (P<0.05), as well as higher IL‐5/IFN‐γ and IL‐13/IFN‐γ ratios (P<0.05). There were also significantly higher IL‐4/IFN‐γ (P<0.005) and IL‐5/IFN‐γ (P<0.05) ratios in BPE‐stimulated cultures in the allergic group than in the control group. The IL‐4 and IL‐13 production in vitro correlated with the specific serum IgE levels.

Conclusions: BPE stimulation induces a Th2‐like cytokine response by PBMC isolated during the pollen season from birch‐pollen‐allergic patients, indicating a Th2‐type immune response to birch pollen in vivo.
Evaluation of the allergenicity of tropical pollen and airborne spores in Singapore
Authors: Chew F. T. , Lim S. H. , Shang H. S. , Siti Dahlia M. D. , Goh D. Y. T. , Lee B. W. , Tan H. T. W. , Tan T. K.
Published: March 2003

Background: Sensitization to pollen and spores of the Southeast Asian tropical region is not well documented. This study evaluated the allergenicity of the tropical airspora in Singapore.

Methods: On the basis of the results of an aerobiologic survey of the airspora profile of Singapore, crude extracts of 23 main spore (fungal and fern) and pollen types were prepared. A total of 231 patients with asthma and/or allergic rhinitis and 76 healthy controls were evaluated by skin prick test (SPT). Total and specific IgE levels were also quantified by the fluorescence allergosorbent test (FAST).

Results: All 23 allergenic extracts tested elicited positive SPT responses. Among the patients with atopic diseases, extracts of oil‐palm pollen (Elaeis guineensis) were observed to have the highest frequency of positive reactions (40%), followed by extracts of resam‐fern spores (Dicranopteris linearis) (34%) and sea‐teak pollen (Podocarpus polystachyus) (33.8%). Fungal spores with the highest SPT responses were Curvularia spp. (26–32%) and Drechslera‐like spores (31%). Positive responses to these extracts correlated with total serum IgE levels of the subjects and were significantly associated with the presence of atopic disease.

Conclusions: We have documented sensitization to tropical pollen and spores in our population. Its association with atopy suggests that it has a role in allergic diseases in the tropics.
Interleukin‐4‐independent production of Th2 cytokines by nasal lymphocytes and nasal eosinophilia in murine allergic rhinitis
Authors: Okano M. , Satoskar A. R. , Abe M. , Harn D. A. , Okano M. , Nishizaki K. , Takeda Y. , Yoshino T. , Brombacher F. , Satoskar A. A.
Published: March 2003

Background: Interleukin (IL)‐4 is believed to play an important role in the atopic pathogenesis. However, the precise role of IL‐4 in the in vivo initiation of allergic rhinitis is not fully understood. We have recently found that BALB/c mice sensitized intranasally with Schistosoma mansoni egg antigen (SEA) mount a Th2 response that initiates allergic rhinitis. Thus, we sought to determine the role of IL‐4 in the initiation of allergic rhinitis in vivo with this model.

Methods: IL‐4 gene‐deficient (IL‐4−/−) BALB/c and wild‐type (IL‐4+/+) control mice were sensitized by intranasal SEA administration, and their immunologic responses were examined both in vivo and in vitro.

Results: IL‐4+/+ mice sensitized with SEA displayed significantly higher titers of SEA‐specific IgG1 and IgE antibodies than IL‐4−/− mice, while the latter produced significantly more SEA‐specific IgG2a. Antigen‐stimulated nasal lymphocytes from SEA‐sensitized IL‐4−/− and IL‐4+/+ mice produced similar amounts of IL‐5 and IL‐10, but neither produced IFN‐γ. Furthermore, the severity of nasal eosinophilia was similar in both groups.

Conclusions: These results indicate that although IL‐4 is necessary for the production of Th2‐associated antibodies – in particular, IgE – it is not required for either the production of the Th2‐associated cytokines IL‐5 and IL‐10, or the induction of nasal eosinophilia.
Usefulness of currently available methods for the diagnosis of Anisakis simplex allergy
Authors: Lorenzo S. , Iglesias R. , Leiro J. , Ubeira F. M. , Ansotegui I. , García M. , Fernández de Corres L.
Published: March 2003

Background: Serodiagnosis of anisakiosis and Anisakis allergy is difficult since many Anisakis antigens show cross‐reactivity complications. In the present study, we assess the usefulness of the major immunologic methods currently available for the diagnosis of Anisakis allergy.

Methods: Four tests (skin prick test, CAP‐FEIA system, Western blotting, and an antigen‐capture ELISA using O‐deglycosylated antigen bound by the monoclonal antibody UA3) were applied to Anisakis‐free subjects and subjects with confirmed Anisakis allergy.

Results: The skin prick test, CAP‐FEIA, and the antigen‐capture ELISA identified Anisakis allergy sera with 100% sensitivity, while Western blotting showed 96% sensitivity. The antigen‐capture ELISA also showed 100% specificity, but CAP‐FEIA showed a specificity of only 50%. In Western blotting, none of the bands detected were specific for either Anisakis‐free or Anisakis allergy subjects. The skin prick test was not applied to the Anisakis‐free subjects, so its specificity could not be determined.

Conclusions: On the basis of these results, we suggest that the most appropriate procedure for diagnosis of Anisakis allergy suspected on clinical grounds is the antigen‐capture ELISA using UA3, or, alternatively, a preliminary skin prick test with a positive result subsequently confirmed by UA3‐ELISA.
Asthma: pathophysiology of the bronchial obstruction
Authors: Maselli R. , Paciocco G.
Published: March 2003

From a pathophysiologic perspective, the changes that occur in asthma are multiple, diverse, and complex. Assessment of the mechanical properties of the ventilatory apparatus provides several different types of information, depending on the gravity of the bronchial obstruction. During asthma, or induced bronchial obstruction, the function of the muscles is altered, causing changes in respiratory timing. Expiratory duration decreases more than inspiratory duration, and the functional residual capacity (FRC) increases, due to mechanical changes within the airways that lead to air trapping. The related hypoventilation is responsible for hypoxemia and hypercapnia, but it does not severely affect the diffusion capacity of the alveolocapillary membrane. We describe the pathophysiology of the bronchial obstruction in asthmatic patients, underlining the critical function of the respiratory muscles. Moreover, we clarify the relations between the ventilatory changes and gas‐exchange alteration.
Symptoms suggestive of atopic rhinitis in children aged 6–9 years and the indoor environment
Authors: Zacharasiewicz A. , Zidek T. , Haidinger G. , Waldhör T. , Vutuc C. , Zacharasiewicz A. , Goetz M. , Pearce N.
Published: March 2003

Background: We aimed to investigate the influence of indoor factors on the prevalence of symptoms suggestive of atopic rhinitis in children aged 6–9 years in Upper Austria.

Methods: We analyzed the results from an extended ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, answered by the parents, about indoor environment and symptoms strongly suggesting atopic rhinitis. This was defined as having reported a running, obstructed, or itchy nose apart from having a cold in the last year. The overall response rate was 93.4%. After excluding 6016 children (17.1%) with changed indoor environment (due to allergies in the family), we analyzed the remaining subsample of 18606 questionnaires.

Results: The following factors were associated with an increased risk: mother's smoking during pregnancy and/or during time of breast‐feeding (OR 1.28; CI 1.07–1.52), synthetic bedding (OR 1.21; CI 1.09–1.36), dampness/mold at home (OR 1.51; CI 1.31–1.74), central heating with gas (OR 1.75; CI 1.06–2.87), and space heating (OR 1.66; CI 1.01–2.98). Cooking with wood (OR 0.62; CI 0.46–0.84) was negatively associated with symptoms.

Conclusions: The indoor environment plays a role in the symptoms of atopic rhinitis in children. However, the population‐attributable risks were not particularly high; they were between −2.7% and 9% for the various exposures considered in this study.
Hypersensitivity pneumonitis caused by Fusarium napiforme in a home environment
Authors: Lee S‐K. , Kim S‐S. , Nahm D‐H. , Park H‐S. , Oh Y‐J. , Park K‐J. , Kim S‐O. , Kim S‐J.
Published: March 2003

Background: We report a case of hypersensitivity pneumonitis (HP) in a 17‐year‐old male student caused by Fusarium napiforme found in his home environment.

Methods: The patient was diagnosed according to history, chest radiograph, spirometry, high‐resolution chest CT, and transbronchial lung biopsy. To identify the causative agent, cultured aeromolds were collected by the open‐plate method. From the main fungi cultured, fungal antigens were prepared, and immunoblot analysis with the patient's serum and each fungal antigen was performed.

Results: Five fungal species were isolated from the patient's home. Immunoblotting analysis with the patient's serum demonstrated more than 10 IgG‐binding fractions to F. napiforme extract only, while little binding was noted with the other fungal antigens.

Conclusions: We should be aware that HP may be caused by F. napiforme in the home environment.