bluuebunny/crossref_metadata_2025 huggingface dataset:
Profile of Pediatric Hemiparesis
Authors: Oskoui Maryam , Shevell Michael I.
Published: February 2008

Our objective was to determine the clinical spectrum of pediatric hemiparesis by identifying the relative frequency of various diagnoses and comorbid conditions seen in these children. Case records of all patients with hemiparesis in a single practice over an 11-year period were reviewed with reference to clinical features, etiologic determination, and comorbid conditions. Ninety-two children were identified: 73 (79.3%) had a congenital hemiparesis and 19 (20.7%) had an acquired hemiparesis. An abnormal perinatal history ( P = .003), prematurity ( P = .016), and younger age at onset of symptoms ( P < .001) were associated with a congenital hemiparesis. The overall etiologic yield was 83.7% (82.2% in the congenital and 89.5% in the acquired). The top four etiologic entities were cerebrovascular ischemia (40.2%), periventricular leukomalacia (18.5%), intracranial hemorrhage (16.3%), and cerebral dysgenesis (13%). Factors predictive of establishing an underlying etiology included birth prior to 34 weeks' gestation ( P = .034), global developmental delay ( P = .048), epilepsy ( P = .024), and having appropriate imaging modalities ( P = .001). Half of these children had a concurrent global developmental delay, associated epilepsy (odds ratio 3.67; 95% confidence interval 1.40-9.72), and prematurity (odds ratio 5.41; 95% confidence interval 1.56-18.80). A third of these children developed epilepsy. Multivariate predictive factors for epilepsy included global developmental delay (odds ratio 4.20; 95% confidence interval 1.44-12.27), cerebrovascular ischemia (odds ratio 5.10; 95% confidence interval 1.76-14.77), and term birth (odds ratio 3.87; 95% confidence interval 1.20-12.56). The majority of children with hemiparesis have a congenital etiology. The diagnostic yield is higher than previously reported; however, specific underlying etiologies need to be better determined. Comorbid conditions of global developmental delay and epilepsy have a high prevalence in this population, contributing to overall morbidity. ( J Child Neurol 2005;20:471-476).
Profile of Pediatric Hemiparesis
Authors: Oskoui Maryam , Shevell Michael I.
Published: February 2008

Our objective was to determine the clinical spectrum of pediatric hemiparesis by identifying the relative frequency of various diagnoses and comorbid conditions seen in these children. Case records of all patients with hemiparesis in a single practice over an 11-year period were reviewed with reference to clinical features, etiologic determination, and comorbid conditions. Ninety-two children were identified: 73 (79.3%) had a congenital hemiparesis and 19 (20.7%) had an acquired hemiparesis. An abnormal perinatal history ( P = .003), prematurity ( P = .016), and younger age at onset of symptoms ( P < .001) were associated with a congenital hemiparesis. The overall etiologic yield was 83.7% (82.2% in the congenital and 89.5% in the acquired). The top four etiologic entities were cerebrovascular ischemia (40.2%), periventricular leukomalacia (18.5%), intracranial hemorrhage (16.3%), and cerebral dysgenesis (13%). Factors predictive of establishing an underlying etiology included birth prior to 34 weeks' gestation ( P = .034), global developmental delay ( P = .048), epilepsy ( P = .024), and having appropriate imaging modalities ( P = .001). Half of these children had a concurrent global developmental delay, associated epilepsy (odds ratio 3.67; 95% confidence interval 1.40—9.72), and prematurity (odds ratio 5.41; 95% confidence interval 1.56—18.80). A third of these children developed epilepsy. Multivariate predictive factors for epilepsy included global developmental delay (odds ratio 4.20; 95% confidence interval 1.44—12.27), cerebrovascular ischemia (odds ratio 5.10; 95% confidence interval 1.76—14.77), and term birth (odds ratio 3.87; 95% confidence interval 1.20—12.56). The majority of children with hemiparesis have a congenital etiology. The diagnostic yield is higher than previously reported; however, specific underlying etiologies need to be better determined. Comorbid conditions of global developmental delay and epilepsy have a high prevalence in this population, contributing to overall morbidity. ( J Child Neurol 2005;20:471—476).
Status Epilepticus: Clinical Analysis of a Treatment Protocol Based on Midazolam and Phenytoin
Authors: Brevoord Judith C. D. , Joosten Koen F. M. , Arts Willem F. M. , van Rooij Roos W. , de Hoog Matthijs
Published: February 2008

The efficacy of a combination of midazolam and phenytoin in treating generalized convulsive status epilepticus in children was studied retrospectively. The patient group comprised all patients admitted for generalized convulsive status epilepticus to the pediatric intensive care unit over 7 years. Patients treated according to the protocol were included ( N = 122). These patients were treated with the following regimen; each subsequent step was taken if clinical evidence of epileptic activity persisted: midazolam 0.5 mg/kg rectally or 0.1 mg/kg intravenously. After 10 minutes: midazolam 0.1 mg/kg intravenously. After 10 minutes: phenytoin 20 mg/kg intravenously in 20 minutes. After phenytoin load: midazolam 0.2 mg/kg intravenously followed by midazolam 0.1 mg/kg/hour continuously, increased by 0.1 mg/kg/hour every 10 minutes to maximum 1 mg/kg/hour. Phenobarbital 20 mg/kg intravenously or pentobarbital 2 to 5 mg/kg intravenous load, 1 to 2 mg/kg/hour continuously intravenously. Patients who received initial rectal diazepam were included. Patients were categorized according to the cause of generalized convulsive status epilepticus. These categories were then related to the level of antiepileptic therapy needed. Patients' ages ranged from 0.5 to 197.4 months. The cause of generalized convulsive status epilepticus was idiopathic or febrile convulsions in two thirds of cases. Most (89%) patients were managed on midazolam and phenytoin. Generalized convulsive status epilepticus was terminated with midazolam alone in 58 patients, with the addition of phenytoin in 19 patients and with continuous midazolam in 32 patients. Thirteen patients needed additional barbiturates. The relationship between the level of antiepileptic therapy and etiology was not significant. Fifty-two patients needed artificial ventilation. Seven patients died; no deaths were directly attributable to generalized convulsive status epilepticus itself. With the use of the proposed protocol, combining midazolam and phenytoin, 89% of the cases of generalized convulsive status epilepticus could be successfully managed. ( J Child Neurol 2005;20:476-481).
Status Epilepticus: Clinical Analysis of a Treatment Protocol Based on Midazolam and Phenytoin
Authors: Brevoord Judith C. D. , Joosten Koen F. M. , Arts Willem F. M. , van Rooij Roos W. , de Hoog Matthijs
Published: February 2008

The efficacy of a combination of midazolam and phenytoin in treating generalized convulsive status epilepticus in children was studied retrospectively. The patient group comprised all patients admitted for generalized convulsive status epilepticus to the pediatric intensive care unit over 7 years. Patients treated according to the protocol were included ( N = 122). These patients were treated with the following regimen; each subsequent step was taken if clinical evidence of epileptic activity persisted: midazolam 0.5 mg/kg rectally or 0.1 mg/kg intravenously. After 10 minutes: midazolam 0.1 mg/kg intravenously. After 10 minutes: phenytoin 20 mg/kg intravenously in 20 minutes. After phenytoin load: midazolam 0.2 mg/kg intravenously followed by midazolam 0.1 mg/kg/hour continuously, increased by 0.1 mg/kg/hour every 10 minutes to maximum 1 mg/kg/hour. Phenobarbital 20 mg/kg intravenously or pentobarbital 2 to 5 mg/kg intravenous load, 1 to 2 mg/kg/hour continuously intravenously. Patients who received initial rectal diazepam were included. Patients were categorized according to the cause of generalized convulsive status epilepticus. These categories were then related to the level of antiepileptic therapy needed. Patients' ages ranged from 0.5 to 197.4 months. The cause of generalized convulsive status epilepticus was idiopathic or febrile convulsions in two thirds of cases. Most (89%) patients were managed on midazolam and phenytoin. Generalized convulsive status epilepticus was terminated with midazolam alone in 58 patients, with the addition of phenytoin in 19 patients and with continuous midazolam in 32 patients. Thirteen patients needed additional barbiturates. The relationship between the level of antiepileptic therapy and etiology was not significant. Fifty-two patients needed artificial ventilation. Seven patients died; no deaths were directly attributable to generalized convulsive status epilepticus itself. With the use of the proposed protocol, combining midazolam and phenytoin, 89% of the cases of generalized convulsive status epilepticus could be successfully managed. ( J Child Neurol 2005;20:476—481).
Neurologic, Neuropsychologic, and Electroencephalographic Findings After European Tick-borne Encephalitis in Children
Authors: Schmolck Heike , Maritz Elke , Kletzin Isabel , Korinthenberg Rudolf
Published: February 2008

Tick-borne European early summer meningoencephalitis is believed to be a benign disease in childhood. The causative RNA virus is from the same family as the West Nile virus, and the respective clinical presentations have many similarities. We studied 19 German children who had suffered from tick-borne encephalitis virus meningitis or meningoencephalitis in an endemic area and compared them with 19 matched controls. Epidemiologic data were consistent with known features of tick-borne encephalitis infection in southern Germany. None of the children studied had severe neurologic or neuropsychologic sequelae. One child developed significant clinical depression shortly after the illness. Electroencephalograms (EEGs) from children with tickborne encephalitis were significantly slower on follow-up than control EEGs. After tickborne encephalitis, children had a higher likelihood of having an impairment of attention and psychomotor speed. Using the Touwen neurologic examination, after tick-borne encephalitis, children had lower scores than control children on 4 of the 10 subsystems. Owing to the small sample size, it was difficult to identify risk factors for and predictors of adverse outcomes. ( J Child Neurol 2005;20:500—508).
Early Alteration in Bone Metabolism in Epileptic Children Receiving Carbamazepine Monotherapy Owing to the Induction of Hepatic Drug—Metabolizing Enzymes
Authors: Voudris Konstantinos A. , Attilakos Achilleas , Katsarou Eustathia , Garoufi Anastasia , Dimou Stamatia , Skardoutsou Angeliki , Mastroyianni Sotiria
Published: February 2008

The purpose of this study was to investigate, by a prospective, self-controlled method, whether early treatment with carbamazepine monotherapy can alter bone metabolism in ambulatory epileptic children with adequate sun exposure, based on the determination of total serum alkaline phosphatase and its bone isoenzyme activities. Serum total alkaline phosphatase and its bone, liver, and intestinal isoenzyme activities were evaluated in 22 epileptic ambulatory children (13 males and 9 females, aged from 5 to 12 years) before and at 3, 6, and 12 months of carbamazepine monotherapy. Serum concentrations of other biochemical markers of bone and liver metabolism, such as calcium, phosphorus, magnesium, γ-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase, were also measured in the study participants before and at 6 and 12 months of treatment. Carbamazepine was prescribed at normal dosages (16.4—20 mg/kg/day). Serum total alkaline phosphatase activities were significantly increased at 3 ( P = .000), 6 ( P = .024), and 12 ( P = .037) months of treatment; serum bone alkaline phosphatase activities at 3 ( P = .000), 6 ( P = .008), and 12 ( P = .017) months of treatment; and serum liver alkaline phosphatase activities at 3 ( P = .000), 6 ( P = .049), and 12 ( P = .008) months of treatment, whereas serum intestinal alkaline phosphatase isoenzyme activity was significantly increased only at 3 months of treatment ( P = .035). Serum γ-glutamyltransferase activities were also significantly increased at 6 ( P = .000) and 12 ( P = .000) months of treatment. No significant changes in the concentrations of serum calcium, phosphorus, magnesium, alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were noted at 6 and 12 months of treatment. There was a significant correlation between serum γ-glutamyltransferase activities and serum total alkaline phosphatase activities ( r = .689, P = .000 at 6 months; r = .493, P = .020 at 12 months), bone alkaline phosphatase activities ( r = .700, P = .000 at 6 months; r = .466, P = .029 at 12 months), and liver alkaline phosphatase activities ( r = .427, P = .047 at 6 months; r = .425, P = .048 at 12 months). These findings indicate that ambulatory children who receive carbamazepine monotherapy, even when residing in a country with adequate sunlight, can have their bone metabolism altered early in the course of treatment, as indicated by the elevated activities of serum bone alkaline phosphatase isoenzyme. This early alteration in bone metabolism is probably due to the hepatic enzyme—inducing character of carbamazepine. ( J Child Neurol 2005;20:513—516).
Proton Spectroscopic Findings in Children With Epilepsy Owing to Tuberous Sclerosis Complex
Authors: Yapici Zuhal , Dincer Alp , Eraksoy Mefkure
Published: February 2008

Tuberous sclerosis complex is an autosomal dominant disorder that often causes refractory seizures. The presence of multiple lesions makes it difficult to identify a single lesion responsible for the epilepsy. Our purpose is to assess the single-voxel proton spectroscopic findings of the tubers in 11 children with tuberous sclerosis complex. Prior to age 4 years, all of the patients had presented with epileptic seizures and multiple bilateral tubers in magnetic resonance images. Single-voxel proton spectroscopy was performed from the tubers especially showing epileptogenic activity using both the long and short echo time and in 14 controls. The results were analyzed using the Mann-Whitney U-test. Compared with the control group, the spectroscopic findings of tubers were characterized by decreased N-acetylaspartate to creatine ratios (1.43 ± 0.33 ; P < .001) in both the long and short echo time spectra, increased choline to creatine ratios (0.91 ± 0.082; P < .05), and myo-inositol to creatine ratios (0.97 ± 0.19; P < .01) in the short echo time spectra. A lactate peak was detected in the regions corresponding to an epileptic focus on electroencephalography in six patients. Single-voxel proton spectroscopy could be a useful noninvasive method to evaluate epileptogenic tubers. ( J Child Neurol 2005;20:517-522).
Familial Cognitive Impairment With Ataxia With Oculomotor Apraxia
Authors: Mahajnah Muhammad , Basel-Vanagaite Lina , Inbar Dov , Kornreich Liora , Weitz Raphael , Straussberg Rachel
Published: February 2008

Ataxia with oculomotor apraxia is an autosomal recessive inherited disease characterized by childhood onset of progressive cerebellar ataxia, oculomotor apraxia, and progressive motor peripheral neuropathy. The mean age at onset is approximately 4.7 years, with oculomotor apraxia appearing a few years later. Diagnosis is based on molecular genetic analysis for mutations of the aprataxin ( APTX) gene (chromosome 9p 13.1; ataxia with oculomotor apraxia 1). Ataxia with oculomotor apraxia 2 is caused by an unknown gene mutation at locus 9q34. We describe two siblings, born to consanguineous parents, who had clinical features of cerebellar ataxia, tremor, dysarthria, oculomotor apraxia, and motor peripheral neuropathy. Brain magnetic resonance imaging showed cerebellar atrophy and mild brainstem atrophy. Electromyography showed signs of axonal neuropathy. The molecular genetic analysis demonstrated the APTX mutation W279X at locus 9p13.3 (ataxia with oculomotor apraxia 1 disease), and psychologic studies showed mild cognitive impairment. We suggest that mentation can be compromised in ataxia with oculomotor apraxia 1. ( J Child Neurol 2005;20:523-525).
Not a New Leukodystrophy but Congenital Cytomegalovirus Infection
Authors: Tatli Burak , Ozmen Meral , Aydinli Nur , Caliskan Mine , Wertheim-van Dillen Pauline M. , van der Knaap Marjo S.
Published: February 2008

We report a 16-month-old girl who presented with global developmental delay and hearing loss. Cranial magnetic resonance imaging demonstrated a pattern that could be interpreted as a "new leukoencephalopathy " Etiologic investigations revealed a positive polymerase chain reaction for cytomegalovirus DNA using her stored Guthrie card, indicating a congenital cytomegalovirus infection. ( J Child Neurol 2005;20:525-527).
Acute Necrotizing Encephalopathy in Caucasian Children: Two Cases and Review of the Literature
Authors: Kirton Adam , Busche Kevin , Ross Catherine , Wirrell Elaine
Published: February 2008

Acute necrotizing encephalopathy is a fulminant neurologic disease seen predominantly in Japan and Taiwan. We present two cases diagnosed at a Canadian center within the same year in Caucasian children. Both were previously well, developed an acute viral illness with fever and vomiting, and progressed to brain death within 2 to 4 days. Neuroimaging and postmortem examination demonstrated the unique features of bilateral and severe necrosis of deep gray-and subcortical white-matter structures. The first case was associated with extensive, but transient, hepatic involvement, recent varicella and rotavirus infections, and detailed metabolic studies, including mitochondrial functional analysis, were normal. The second case tested positive for influenza A infection, whereas evidence of liver damage was lacking. Both children demonstrated early lymphopenia and myocardial necrosis, two features not previously associated with acute necrotizing encephalopathy. These cases are unique in their occurrence in non-Japanese children and are among the first published reports in Canada. ( J Child Neurol 2005;20:527-532).
Two Cases of Glycine Encephalopathy Accompanied by Pes Equinovarus
Authors: Zenciroğlu Ayşegul , Demirel Nihal , Aydemir Cumhur , Agτldere Muhtesem , Kalkanoglu Serap , Coskun Turgay
Published: February 2008

Glycine encephalopathy is a rare autosomal recessive metabolic disease characterized by glycine accumulation in body fluids owing to a defect in the glycine cleavage system. There are several forms of glycine encephalopathy. In the classic or neonatal form, symptoms usually develop as neurologic symptoms in the first few days of life. It characteristically presents with hypotonia, lethargy, apnea, and seizures and usually results in death by 1 year of age. In this report, we present two cases of neonatal glycine encephalopathy accompanied by isolated pes equinovarus deformity. ( J Child Neurol 2005;20:533-535).
Benign Familial Infantile Convulsions: Phenotypic Variability in a Family
Authors: Demir Ercan , Turanlτ Güzide , Yalnτzoğlu Dilek , Topcu Meral
Published: February 2008

Benign familial infantile convulsion is an autosomal dominant epilepsy syndrome characterized by seizures starting from 3 to 12 months and a favorable outcome. We present a Turkish family with benign familial infantile convulsions and report the clinical variability associated with this syndrome in three generations. All 11 affected members had benign infantile seizures, which were primarily generalized in all but one patient, who had partial seizures with secondary generalization. The seizures started within the first year and were accompanied by normal neurologic development and a good response to treatment with phenobarbital. In this family, the phenotype extended beyond infancy. The index patient had unilateral occipital spike and waves on electroencephalography (EEG), although he had no clinical seizures at 4 years of age. Follow-up EEG of this patient 1 year later showed that the discharges shifted to the occipital lobe of the other hemisphere. The grandmother of this patient had temporal lobe seizures as an adult, years after the remission of infantile convulsions. One of the patients experienced paroxysmal choreoathetosis during adolesence. Our findings highlight the intrafamilial phenotypic variability of benign familial infantile convulsions in a large pedigree with long-term follow-up. ( J Child Neurol 2005;20:535-538).
Benign Familial Infantile Convulsions: Phenotypic Variability in a Family
Authors: Demir Ercan , Turanl Güzide , Yalnzoğlu Dilek , Topcu Meral
Published: February 2008

Benign familial infantile convulsion is an autosomal dominant epilepsy syndrome characterized by seizures starting from 3 to 12 months and a favorable outcome. We present a Turkish family with benign familial infantile convulsions and report the clinical variability associated with this syndrome in three generations. All 11 affected members had benign infantile seizures, which were primarily generalized in all but one patient, who had partial seizures with secondary generalization. The seizures started within the first year and were accompanied by normal neurologic development and a good response to treatment with phenobarbital. In this family, the phenotype extended beyond infancy. The index patient had unilateral occipital spike and waves on electroencephalography (EEG), although he had no clinical seizures at 4 years of age. Follow-up EEG of this patient 1 year later showed that the discharges shifted to the occipital lobe of the other hemisphere. The grandmother of this patient had temporal lobe seizures as an adult, years after the remission of infantile convulsions. One of the patients experienced paroxysmal choreoathetosis during adolesence. Our findings highlight the intrafamilial phenotypic variability of benign familial infantile convulsions in a large pedigree with long-term follow-up. ( J Child Neurol 2005;20:535—538).
Paying Friends, Family Members, or Strangers to Be Home-Based Personal Assistants
Authors: Matthias Ruth E. , Benjamin A.E.
Published: February 2008

This study describes consumers who hire friends, family members, or strangers as paid personal assistants and compares service satisfaction among the three groups. From surveying 511 consumers of self-directed home care services, the authors found that consumers who hire friends as workers are younger and more educated than consumers who hire family members and strangers, and they are more impaired than consumers with strangers as workers. The friend cohort experiences more stability with their personal assistants than does the stranger cohort but not as much stability as the family cohort. On some dimensions of consumer satisfaction, friends as workers are perceived by consumers to be either the same as or better than strangers, but they also are perceived as either the same as or worse than family workers. Using friends as paid workers is an important resource. Researchers and policy makers should further explore this approach because the need for home-based personal assistance continues to increase.
The Potential for Multi-Modal Approaches to Reading for Students With Disabilities as Found in State Reading Standards
Authors: Johnstone Christopher , Thurlow Martha , Thompson Sandra , Clapper Ann T.
Published: February 2008

This article examines topics found in reading standards for K–12 education and then examines the standards from a perspective of accessibility for students with a variety of sensory and learning disabilities. The article begins by first determining how broad or limiting states' reading standards are in coverage and whether focus on particular standards limits options for students to use multiple methods of interaction with print (e.g., accessing print through visual, audio, tactile, or multiple modalities). A review of standards found that state standards generally fall into the following categories: the acquisition of specific skills; the knowledge of the elements or conventions in language; literacy as an interactive, thinking activity; literacy as a problem-solving tool; and literacy as a catalyst for personal growth. With the exception of specific skill standards, all standards have the potential to be accessed through different modalities.
Protecting People With Decisional Impairments and Legal Incapacity Against Biomedical Research Abuse
Authors: Noble John H. , Sharav Vera Hassner
Published: February 2008

Ethical and legal principles are provided for reviewing the ethics of recent cases of biomedical research abuse involving persons with decisional impairments or legal incapacity who were unable to understand the risks and benefits of the research to which they were subjected. Research abuse continues to occur despite guidance from the Nuremburg Code, the Declaration of Helsinki, the U.S. Belmont Report, extensive federal regulations governing human participant research, and several professional and disciplinary codes of ethics with which, the authors believe, the majority of researchers comply. Contributing to research abuse are weaknesses in the institutional review board and research ethics board review process; conflicting opinions about applicable ethical principles; mounting evidence of pervasive conflicts of interest; and dubious conflated research and marketing practices involving researchers, pharmaceutical and medical device manufacturers, and government research sponsors and regulatory agencies. Several recommendations are made to correct identifiable weaknesses and failures in the governance of biomedical research.
Acute promyelocytic leukemia: from highly fatal to highly curable
Authors: Wang Zhen-Yi , Chen Zhu
Published: February 2008

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia. Morphologically, it is identified as the M3 subtype of acute myeloid leukemia by the French-American-British classification and cytogenetically is characterized by a balanced reciprocal translocation between chromosomes 15 and 17, which results in the fusion between promyelocytic leukemia (PML) gene and retinoic acid receptor α (RARα). It seems that the disease is the most malignant form of acute leukemia with a severe bleeding tendency and a fatal course of only weeks. Chemotherapy (CT; daunorubicin, idarubicin and cytosine arabinoside) was the front-line treatment of APL with a complete remission (CR) rate of 75% to 80% in newly diagnosed patients. Despite all these progresses, the median duration of remission ranged from 11 to 25 months and only 35% to 45% of the patients could be cured by CT. Since the introduction of all-trans retinoic acid (ATRA) in the treatment and optimization of the ATRA-based regimens, the CR rate was raised up to 90% to 95% and 5-year disease free survival (DFS) to 74%. The use of arsenic trioxide (ATO) since early 1990s further improved the clinical outcome of refractory or relapsed as well as newly diagnosed APL. In this article, we review the history of introduction of ATRA and ATO into clinical use and the mechanistic studies in understanding this model of cancer targeted therapy.
Rap1B speeds up angiogenesis
Authors: Zwartkruis Fried J. T. , Bos Johannes L.
Published: February 2008

In this issue of Blood, Chrzanowska-Wodnicka and colleagues identify a regulatory role for Rap1B in angiogenesis. Although not absolutely required for angiogenesis, loss of Rap1B affects both proliferation and migration of endothelial cells.
Epigenomic repression by APL oncoprotein
Authors: Pettersson Filippa , Miller Wilson H.
Published: February 2008

In recent years, powerful technologies to globally examine epigenetic targets of transcription factors and directly link these to changes in gene expression have emerged. Acute leukemias are characterized by translocations leading to the production of chimeric transcription factors, which are perfect targets for such analyses.
Mast cells and T-cell expansion
Authors: Nakae Susumu , Oboki Keisuke , Saito Hirohisa
Published: February 2008

IgE/antigen-FcϵRI crosslinking promotes antigen internalization and apoptosis in mouse mast cells. Dendritic cells uptake the apoptotic mast cells carrying internalized antigens, and thus can efficiently present the antigens to memory T cells.
Epac1 activation and progenitor-cell homing
Authors: Ribatti Domenico
Published: February 2008

The article by Carmona and colleagues in this issue of Blood demonstrates that activation of Epac1 increases integrin activity and integrin-dependent homing functions of progenitor cells and enhances their in vivo therapeutic potential.
Evaluation of the new advanced 15-loci MIRU-VNTR genotyping tool in Mycobacterium tuberculosis molecular epidemiology studies
Authors: Alonso-Rodríguez Noelia , Martínez-Lirola Miguel , Herránz Marta , Sanchez-Benitez Marisa , Barroso Pilar ,   INDAL-TB group, Bouza Emilio , de Viedma Darío García
Published: February 2008

Background

During the last few years, PCR-based methods have been developed to simplify and reduce the time required for genotyping Mycobacterium tuberculosis (MTB) by standard approaches based on IS6110-Restriction Fragment Length Polymorphism (RFLP). Of these, MIRU-12-VNTR (Mycobacterial interspersed repetitive units- variable number of tandem repeats) (MIRU-12) has been considered a good alternative. Nevertheless, some limitations and discrepancies with RFLP, which are minimized if the technique is complemented with spoligotyping, have been found. Recently, a new version of MIRU-VNTR targeting 15 loci (MIRU-15) has been proposed to improve the MIRU-12 format.

Results

We evaluated the new MIRU-15 tool in two different samples. First, we analyzed the same convenience sample that had been used to evaluate MIRU-12 in a previous study, and the new 15-loci version offered higher discriminatory power (Hunter-Gaston discriminatory index [HGDI]: 0.995 vs 0.978; 34.4% of clustered cases vs 57.5%) and better correlation (full or high correlation with RFLP for 82% of the clusters vs 47%). Second, we evaluated MIRU-15 on a population-based sample and, once again, good correlation with the RFLP clustering data was observed (for 83% of the RFLP clusters). To understand the meaning of the discrepancies still found between MIRU-15 and RFLP, we analyzed the epidemiological data for the clustered patients. In most cases, splitting of RFLP-clustered patients by MIRU-15 occurred for those without epidemiological links, and RFLP-clustered patients with epidemiological links were also clustered by MIRU-15, suggesting a good epidemiological background for clustering defined by MIRU-15.

Conclusion

The data obtained by MIRU-15 suggest that the new design is very efficient at assigning clusters confirmed by epidemiological data. If we add this to the speed with which it provides results, MIRU-15 could be considered a suitable tool for real-time genotyping.
Individual and occupational risk factors for knee osteoarthritis – Study protocol of a case control study
Authors: Klußmann André , Gebhardt Hansjuergen , Liebers Falk , von Engelhardt Lars Victor , Dávid Andreas , Bouillon Bertil , Rieger Monika A
Published: February 2008

Background

Knee osteoarthritis (OA) is one of the frequent and functionally impairing disorders of the musculoskeletal system. In the literature, a number of occupational risk factors are discussed as being related to the development and progress of knee joint diseases, e.g. working in kneeling or squatting posture, lifting and carrying of heavy weights. The importance of the single risk factors and the possibility of prevention are currently under discussion. Besides the occupational factors, a number of individual risk factors are important, too. The distinction between work-related factors and individual factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In existing studies, the occupational stress is determined mainly by surveys in employees and/or by making assumptions about individual occupations. Direct evaluation of occupational exposure has been performed only exceptionally.

The aim of the research project ArGon is the assessment of different occupational factors in relation to individual factors (e.g. constitutional factors, leisure time activities, sports), which might influence the development and/or progression of knee (OA). The project is designed as a case control study.

Methods/Design

To raise valid data about the physical stress associated with occupational and leisure time activities, patients with and without knee OA are questioned by means of a standardised questionnaire and an interview. The required sample size was estimated to 800 cases and an equal number of controls. The degree and localisation of the knee cartilage or joint damages in the cases are documented on the basis of radiological, arthroscopic and/or operative findings in a patient record. Furthermore, occupational exposure is analysed at selected workplaces. To evaluate the answers provided in the questionnaire, work analysis is performed.

Discussion

In this research project, specific information on the correlation of occupational and individual factors on the one hand and the current state of knee OA on the other will be analysed in order to describe preventive measures. In addition, information regarding a better evaluation of various forms of physical stress in different occupations will be available. This might lead to more effective prevention strategies.
Preparing Articles on Photocatalysis—Beyond the Illusions, Misconceptions, and Speculation
Authors: Ohtani Bunsho
Published: February 2008

A growing number of papers on research subjects relating to photocatalysis have and will continue to be submitted and published in scientific journals. Some of these, published or still under review, include illusions and misconceptions that may, from a scientific point of view, adversely affect the writing of academic papers and hamper the development of scientific and technological research in this field. In the present article, the author would like to point out the problems that researchers in photocatalysis encounter when writing articles. In fact, one of the most serious concerns regarding the abstracts contained in most scientific papers is that they often include misleading speculation(s) which are not based on sound scientific evidence yet may be interpreted as truth. A fair number of readers, especially busy ones, may read only the titles and abstracts without serious consideration or analysis of the discussions. Reviewers and editors need to consider such problems, as might be expected, however, the reader community also needs to be instructed of such aspects in order to gain a more correct understanding of what is and is not acceptable. This article aims to present an analysis of such inherent problems in hopes of improving the quality of the research work and scientific papers in this field.
Asymmetric 1,3-Dipolar Cycloaddition Reaction of Azomethine Imines to Allyl Alcohol
Authors: Kato Tomomitsu , Fujinami Shuhei , Ukaji Yutaka , Inomata Katsuhiko
Published: February 2008

The asymmetric 1,3-dipolar cycloaddition of azomethine imines to allyl alcohol was achieved by utilizing diisopropyl (R,R)-tartrate as a chiral auxiliary to afford the corresponding optically active trans-pyrazolidines with excellent regio-, diastereo-, and enantioselectivities.
High Hole Mobilities in the Amorphous Films of 2,7-Di(9-carbazolyl)-9-(2-ethylhexyl)carbazole
Authors: Tomkeviciene Ausra , Grazulevicius Juozas V , Jankauskas Vygintas
Published: February 2008

2,7-Di(9-carbazolyl)-9-(2-ethylhexyl)carbazole was synthesized and investigated as new effective hole-transporting material. The synthesized compound showed high thermal stability with the initial weight loss temperature of 400 °C. It forms glass with glass-transition temperature of 88 °C. Hole drift mobilities in the amorphous films of the newly synthesized compound exceeded 10−2 cm2 V−1 s−1 at high electric field, as characterized by the xerographic time of flight technique.
Two Novel Asymmetric Eremophilane Dimers from the Roots of Ligularia virgaurea
Authors: Zhang Zhan-Xin , Wang Chun-Ming , Fei Dong-Qing , Jia Zhong-Jian
Published: February 2008

Virgaurol A (1) and B (2), two novel dimeric eremophilanes in whose structures the two asymmetric sesquiterpene units are connected by a C–C bond directly, have been isolated from the roots of Ligularia virgaurea. Their structures were determined by comprehensive spectral analysis. Compound 1 was evaluated for its in vitro cytotoxic activity against human leukemia (HL-60), human hepatoma (SMMC-7721), and human cervical carcinoma (HeLa) cells.
Synthesis and Characterization of Poly(ethylene oxide)-b-poly(4-butyltriphenylamine)-b-poly(ethylene oxide) Triblock Copolymers
Authors: Fujioka Masahiro , Sato Hisaya , Tsuchiya Kousuke , Ogino Kenji
Published: February 2008

The synthesis and characterization of poly(ethylene oxide)-b-poly(4-butyltriphenylamine)-b-(polyethylene oxide) triblock copolymers (PEO-b-PBTPA-b-PEO) with different block ratio are described. The optical properties of block copolymers were investigated by UV–vis absorption, and photoluminescence (PL) spectroscopy. From atomic force microscopy (AFM) observation of the annealed thin films of block copolymers, microphase-separated morphology was observed.
Morphological Transformation of Ultrathin Gold Nanosheets to Rounded Nanotapes in the Photomediated Reduction Process
Authors: Shiraki Tomohiro , Morikawa Masa-aki , Kimizuka Nobuo
Published: February 2008

Photoreduction of AuCl4− ions in the presence of o-phthalaldehyde (o-PA) in water provides ultrathin gold nanosheets which show surprising morphological changes to saw-edged nanosheets, multipored sheets, and rounded nanotapes depending on the reaction temperature.
The potential of digital monochrome images versus colour slides in telescreening for diabetic retinopathy
Authors: Johansen Monika Alise , Fossen Kristian , Norum Jan , Christoffersen Terje , Øritsland Håkon , Haga Daniel , Hasvold Per , Bellika Johan Gustav , Knarvik Undine , Pedersen Steinar
Published: February 2008

Summary

We explored the potential of digital monochrome images as an alternative to colour slides in screening for diabetic retinopathy. Twenty-eight patients with diabetes were recruited for the study and 20 actually participated. Using a fundus camera (Nikon 505AF) one set of three digital images and one set of three colour slides were taken per eye. Two independent ophthalmologists graded the colour slides and the digital images for diabetic retinopathy. The ophthalmologists spent about two minutes grading each set of images, suggesting that specialists could potentially screen a large number of patients. The agreement between the two screening methods was 0.95 and 0.89, with respect to disease or no disease. The agreement ( κ) between the two ophthalmologists for grade of retinopathy was 0.47 when colour slides were employed and 0.61 when digital monochrome images were employed. The results indicate that digital red-free monochrome images represent a superior screening tool for diabetic retinopathy. Tele-screening may be beneficial when patients have to travel substantial distances to visit an ophthalmologist.
Mobile teledermatology: a feasibility study of 58 subjects using mobile phones
Authors: Ebner Christoph , Wurm Elisabeth MT , Binder Barbara , Kittler Harald , Lozzi Gian Piero , Massone Cesare , Gabler Gerald , Hofmann-Wellenhof Rainer , Soyer H Peter
Published: February 2008

Summary

We investigated the diagnostic agreement between teledermatology based on images from a mobile phone camera and face-to-face (FTF) dermatology. Diagnostic agreement was assessed for two teledermatologists (TD) in comparison with FTF consultations in 58 subjects. In almost three-quarters of the cases (TD1: 71%; TD2: 76%), the telediagnosis was fully concordant with the FTF diagnosis. Furthermore, the diagnosed diseases were almost all in the same diagnostic category (TD1: 97%; TD2: 90%). If mobile teledermatology had been used for remote triage, TD1 could have treated 53% subjects remotely and 47% subjects would have had to consult a dermatologist FTF. TD2 could have treated 59% subjects remotely, whereas 41% subjects would have had to consult a dermatologist FTF. Forty-eight subjects responded to a questionnaire, of whom only 10 had any concerns regarding teledermatology. Thirty-one subjects stated that they would be willing to pay to use a similar service in future and suggested an amount ranging from €5 to €50 per consultation (mean €22) (€ = £0.7, US $1.4). These results are encouraging as patient acceptance and reimbursement represent potential obstacles to the implementation of telemedicine services.
An evaluation of second and third generation telecare services in older people's housing
Authors: Brownsell Simon , Blackburn Steven , Hawley Mark S
Published: February 2008

Summary

In a controlled study of older people living in sheltered housing (retirement housing), 24 people provided with telecare were compared with a control group of 28 people. The intervention consisted of second generation telecare equipment, such as automatic flood or falls detectors, a third generation lifestyle reassurance system and an Internet café. After a 12-month monitoring period, there was no noticeable change in the fear of falling. There was no significant difference for eight of the nine SF-36 domains. However, the Social Functioning domain showed a significant difference ( P = 0.049), with scores 8% higher in the intervention group, suggesting a beneficial effect of telecare. Positive trends were also evident in areas such as an increase in the length of time spent out of the home, improved feelings of safety during the day and night, and a reduction in the fear of crime. The Internet café was used by 25% of people for at least 20 min per week. The results suggest that second generation telecare systems and Internet facilities could be more widely used in service delivery, but that lifestyle reassurance requires further development.
Long-term treatment of obese children and adolescents using a telemedicine support programme
Authors: Schiel Ralf , Beltschikow Wadim , Radón Sandra , Kramer Guido , Schmiedel Ralf , Berndt Rolf-Dietrich , Stein Günter
Published: February 2008

Summary

A total of 140 obese patients (mean age 14 years) participated in a structured treatment and teaching programme (STTP) in hospital, with the aim of weight reduction. At both the start and finish of the STTP, patients underwent clinical and psychological examination. During an average hospital stay of 35 days, their mean bodyweight decreased from 82.4 kg to 76.0 kg ( P < 0.001). Patients were then followed up with a telemedicine support programme. During the next 12 months, the acceptance of the telemedicine support programme declined from 93% to 46%. The body mass index was 30.5 kg/m2 at admission and 27.7 kg/m2 at 12-month follow-up ( P < 0.05). In parallel, wellbeing and treatment satisfaction increased, and there was a positive effect on eating behaviour and exercise. Intervention was needed in up to 64% of the children and adolescents who participated in the programme, most frequently due to poor results in exercise. Telemedical follow-up care and counselling seemed to be highly effective, and allowed not only an initial weight reduction, but long-term stabilization as well.
The TeleGuard trial of additional telemedicine care in CAD patients. 1 Utilization of the system
Authors: Katalinic Alexander , Waldmann Annika , Schwaab Bernhard , Richardt Gert , Sheikhzadeh Abdolhamid , Raspe Heiner
Published: February 2008

Summary

Patients with established coronary artery disease (CAD) were recruited in 11 hospitals and randomized to an intervention (telemedicine system; n = 752) or a control group (usual medical care; n = 748). On the day before discharge, patients in the intervention group were equipped with a 12-lead event recorder and trained to use the device. Whenever they had symptoms, they could contact the call centre, transmit an ECG (without redialling) and consult a physician. During a 12-month study, 171 patients (23%) in the intervention group contacted the call centre, a total of 269 times. The main reasons for calling were chest pain and radiating pain. Pathological changes were seen in 24% of the transmitted ECGs. Only 23% of the calls were made in the first hour after onset of symptoms and a further 12% in the subsequent hour, suggesting that patients should be encouraged to use ECG transmission at an earlier stage. At follow-up, 157 patients (21%) had had at least one recurrent cardiac event (myocardial infarction, cardiac hospital stay, re-vascularization). The proportion was significantly higher in telemedicine users (35%) than in non-users (17%), P < 0.001. Regardless of utilization, the majority of the intervention patients considered that the telemedicine system was helpful (users = 93%, non-users = 89%; P = 0.095).
Mental health profile of callers to a telephone counselling service
Authors: Burgess Nicole , Christensen Helen , Leach Liana S , Farrer Louise , Griffiths Kathleen M
Published: February 2008

Summary

We studied the mental health profile of callers to a generalist helpline. A survey was conducted in a large telephone counselling centre over a four-week period in 2006. Telephone counsellors administered the survey at the completion of a user's call. The centre answered a total of 1404 calls in the study period. Of these, 439 calls met the inclusion criteria and 270 callers agreed to participate. The survey collected data from callers on demographic variables, anxiety, depression, panic and social phobia, alcohol use, frequency of help seeking from the service, sources of professional help, attitudes to help services and access to the Internet. Callers experienced high levels of anxiety and depression. More frequent callers were older, with very frequent callers more likely to be never married. More frequent callers were more likely to report concerns with loneliness, physical illness and anxiety. There was a significant difference on the Goldberg Anxiety Scale ( P < 0.05), with more frequent callers having higher anxiety scores. However, there was no significant difference on the Goldberg depression scores as a function of call frequency ( P > 0.05). Panic attacks were more common among more frequent callers. These results will be useful in developing new telephone-administered anxiety and depression treatment programmes.
L'imperatore Giovanni VIII Paleologo a Pistoia
Authors: Braccini Tommaso
Published: February 2008

Uno dei problemi che affliggono maggiormente lo storico che si occupi del Concilio di Ferrara-Firenze per l'Unione delle Chiese (1438–39) è, notoriamente, la perdurante scarsezza e disorganicità delle fonti, soprattutto occidentali. Nonostante la pubblicazione degli Acta e di altre importanti relazioni, restano infatti molti vuoti che attendono ancora di essere colmati, in primis riguardo agli spostamenti delle varie delegazioni, ed alle attività che furono condotte al di fuori della stretta ufficialità delle sessioni conciliari. Del resto, è emblematico che anche per un evento importante come dovette essere l'arrivo dei Greci a Firenze, con le accoglienze ed i festeggiamenti che furono organizzati per l'occasione, ci si debba rivolgere a quello che rimane sostanzialmente il diario privato di un vinaio fiorentino, Bartolomeo del Corazza, che per giunta ha avuto una tradizione piuttosto fortunosa e non è nemmeno sopravvissuto nella sua interezza. Tutto ciò deve servire da sprone per non abbassare mai la guardia, e soprattutto per non trascurare nessuna possibile fonte d'informazione.