bluuebunny/crossref_metadata_2025 huggingface dataset:
The 10‐year course of physically self‐destructive acts reported by borderline patients and axis II comparison subjects
Authors: Zanarini M. C. , Frankenburg F. R. , Reich D. B. , Fitzmaurice G. , Weinberg I. , Gunderson J. G.
Published: February 2008

Objective:  The purpose of this paper was to determine the frequency and methods of two forms of physically self‐destructive acts (i.e. self‐mutilation and suicide attempts) reported by borderline patients and axis II comparison subjects over 10 years of prospective follow‐up.

Method:  Two hundred and ninety borderline patients and 72 axis II comparison subjects were interviewed about their physically self‐destructive acts during their index admission and at five contiguous 2‐year follow‐up periods.

Results:  It was found that a high percentage of borderline patients reported multiple acts and methods of each of these two forms of physically self‐destructive behavior prior to their index admission. It was also found that the percentage of borderline patients reporting multiple acts and methods declined significantly over time. However, these acts remained significantly more common among borderline patients than axis II comparison subjects.

Conclusion:  The course of self‐mutilation and suicide attempts among borderline patients is initially more serious and ultimately more benign than previously recognized.
The introduction and perception of an OSCE with an element of self‐ and peer‐assessment
Authors: Larsen T. , Jeppe‐Jensen D.
Published: February 2008

The purpose of the present study was to encourage reflective dental students by performing an educational Objective Structured Clinical Examination (OSCE) with an element of self‐ and peer‐assessment. An interdisciplinary OSCE comprising cariology, endodontics and microbiology was set up for all third‐year students. A blueprint secured representation of the skills to be tested, i.e. knowledge, interdisciplinary knowledge, communication, clinical reasoning and practical procedures. At each station positive and constructive feedback was given to the students based on predefined criteria. Further, the students received written marks after completion of the OSCE. At one station the feedback and marks were replaced by self‐ and peer‐assessment performed by the students in groups after the OSCE. Afterwards, the 68 students and 8 teachers participating in the OSCE answered a questionnaire on their opinion and perception of the examination. The results showed good correlation between the marks given and the students' perception of task difficulty. Generally, there were no systematic variations in the marks given during the week or by individual assessors at the same station, except for one, as well as agreement with marks of the ordinary clinical assessment. The marks given during self‐ and peer‐assessment differed widely, indicating a need for training in this aspect. The questionnaires revealed a very positive perception of the OSCE from both students and teachers. Thus, the majority found the examination relevant and of educational benefit, capable of improving the learning of the students and useful for assessment purposes. Also, the self‐ and peer‐assessment was found useful by the students. In conclusion, this interdisciplinary OSCE stressing constructive feedback to the students was perceived very positively by students and teachers and recognised for its beneficial possibilities in education and assessment.
The development of a primary dental care outreach course
Authors: Waterhouse P. , Maguire A. , Tabari D. , Hind V. , Lloyd J.
Published: February 2008

The aim of this work was to develop the first north‐east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.
Attitudes of Irish dental, dental hygiene and dental nursing students and newly qualified practitioners to tobacco use cessation: a national survey
Authors: McCartan B. , McCreary C. , Healy C.
Published: February 2008

Background:  Ireland has some of the strictest smoking regulations in the world. Little is known of the attitudes of student Irish dental healthcare workers towards tobacco control and tobacco use cessation. This study aimed at determining the knowledge and attitudes of these students towards the deleterious effects of tobacco in the mouth and towards tobacco use cessation in dental practice.

Method:  A questionnaire survey was distributed to 654 students (including newly qualified) on dentistry, dental hygiene and dental nursing programmes in Irish dental schools. Information sought included college, course, year of study, sex, age, nationality, smoking status, knowledge of effects of tobacco in the mouth and attitudes towards tobacco use cessation in dental practice and towards the Irish smoking bans.

Main findings:  There was a 90% response rate. In all, 12% of dental students, 25% of dental hygiene students and 31% of dental nursing students were current smokers. Newly qualified dental hygienists were as knowledgeable about tobacco effects in the mouth as newly qualified dentists. Overall, the majority in each student category believed that all three groups could be effective tobacco counsellors and should provide tobacco use cessation counselling to patients, although less than half of evening course dental nursing students felt that dental nurses could be effective counsellors or should provide counselling. There was overwhelming support for the Irish smoking ban. Only a minority of dental students and dental nursing students had received instruction in tobacco use cessation counselling.

Conclusions:  There are strong positive attitudes to tobacco use cessation counselling in dental practice among these young dental healthcare students. This is true even amongst those who have not received specific instruction in tobacco use cessation counselling.
Fucosyltransferase VII‐positive, skin‐homing T cells in the blood and skin lesions of atopic dermatitis patients
Authors: Mizukawa Yoshiko , Takahashi Ryo , Yamazaki Yoshimi , Kimishima Momoko , Shiohara Tetsuo
Published: February 2008

Abstract: Patients with atopic dermatitis (AD) have an abnormally increased frequency of cutaneous lymphocyte antigen (CLA)+ Th2 cells responsible for local inflammation; however, this is paradoxical, given the well‐recognized defective capacity of Th2 cells to migrate to the skin sites of inflammation. These discrepant observations would stem from the ambiguity of CLA+ T cells, because CLA does not represent the epitope required for binding to E‐selectin but the epitope generated by fucosyltransferase VII (Fuc‐TVII) and because skin‐homing T cells are composed of three distinct subpopulations; Fuc‐TVII+ E‐selectin ligand (ESL)+ CLA−, Fuc‐TVII+ ESL+ CLA+ and Fuc‐TVII− ESL− CLA+ cells. We therefore asked which subpopulations of skin‐homing Th2 cells could be increased in the blood and skin lesions of AD. We analysed the frequencies of the three subpopulations in purified CD4+ peripheral blood T cells from AD patients and healthy controls by immunohistochemistry and flow cytometry. The Fuc‐TVII+ CLA+ or CLA+ ESL+ CCR4+ cells were dramatically increased in frequency not only in the blood but also in the skin lesions of AD patients and this increase was related to the severity of the clinical symptoms. Our data indicate the clinical importance of identifying skin‐homing T cells with the potent capacity to migrate into the skin by analysing their Fuc‐TVII expression and E‐selectin binding ability in patients with AD.
How best to halt and/or revert UV‐induced skin ageing: strategies, facts and fiction
Authors: Ralf Paus Lübeck , Berneburg M. , Trelles M. , Friguet B. , Ogden S. , Esrefoglu M. , Kaya G. , Goldberg D. J. , Mordon S. , Calderhead R. G. , Griffiths C. E. M. , Saurat J. H. , Thappa D. M.
Published: February 2008

Abstract:  Once considered mainly a cosmetic issue, photoageing research has long moved to the forefront of investigative dermatology. Besides obvious market pressures, increasing insight into the mechanistic overlap between UV‐induced skin cancer and UV‐induced skin ageing has contributed to this development. Also, as strategies that work to antagonize intrinsic skin ageing/senescence may also be exploited against photoageing (and vice versa!), it has become an important skin research challenge to dissect both the differences and the overlap mechanisms between these interwined, yet distinct phenomena. Finally, the current surge in putative ‘antiageing’ products, devices, and strategies – too many of which boldly promise to fight and/or repair the perils that come along with a lifetime spent in the sun in the absence of convincing evidence of efficacy – makes it particularly pertinent to critically review the available evidence to support often made antiageing claims. The current CONTROVERSIES feature, therefore, aimed to provide both guidance through, and critical voices in, the antiageing circus. Here, a panel of experts defines relevant key problems, points the uninaugurated to intriguing aspects of photoageing that one may not have considered before, highlights promising strategies for how best to halt and/or revert it, and spiritedly debates some controversially discussed approaches.
CD40 ligation during dendritic cell maturation reduces cell death and prevents interleukin‐10‐induced regression to macrophage‐like monocytes
Authors: Haenssle Holger , Buhl Timo , Knudsen Susanne , Krueger Ullrich , Rosenberger Albert , Reich Kristian , Neumann Christine
Published: February 2008

Abstract:  Dendritic cells (DCs) have become popular candidates in cancer vaccination because of their crucial role in inducing T‐cell responses. However, clinical studies greatly differ in their protocols for generating DCs and the efficacy in treating established tumors needs to be improved. We systematically analyzed DCs maturated by five different protocols for surface markers, the alloproliferative T‐cell response, the DC survival after cytokine deprivation, the stability of surface markers under the influence of interleukin‐10 (IL‐10) and the DC cytokine secretion pattern. Monocyte‐derived DCs were maturated by CD40‐ligand (CD40‐L), unmethylated cytosine–guanosine dinucleotides‐oligodinucleotides (CpG‐ODN), an inflammatory cytokine cocktail (ICC), a combination of ICC and CD40‐L, or ICC, CD40‐L and CpG‐ODN. A high co‐expression of DC maturation and costimulation markers was found after treatment with ICC plus CD40‐L (69.3 ± 9.6% CD83/CD80 double positive staining) and correlated with a significantly increased cell survival, a high expression of the antiapoptotic factor bcl‐XL, a stable CD83high/CD14low expression under the influence of IL‐10, and a strong alloproliferative T‐cell response. In conclusion, our data support the use of maturation protocols containing ICC plus CD40‐L in order to generate highly mature, phenotypically stable, cell‐death resistant, and T‐cell stimulatory DCs for clinical application in cancer patients.
Palatal zygomycosis: experience of 21 cases
Authors: Bonifaz A , Macias B , Paredes‐Farrera F , Arias P , Ponce RM , Araiza J
Published: February 2008

Objective:  To present a clinical report of palatal zygomycosis, its epidemiological, mycological features, and our treatment experience.

Design:  Retrospective report.

Subjects and methods:  This is a 25‐year long retrospective trial of clinically and mycologically proven cases of zygomycosis. Some patients underwent a biopsy of the palatal lesion and autopsy. This study reports the treatment experience with amphotericin B alone and in combination with itraconazole and fluconazole.

Results:  Twenty‐one cases (18.75%) of zygomycosis with palatal involvement were included in the study, from a total of 112 cases screened. Mean age was 36.5 years, with 18 adults and three children. The associated pre‐disposing factors were: ketoacidotic diabetes (five type‐1 and 15 type‐2), and acute leukaemia in one patient. The clinical varieties were as follows: 19 cases of rhinocerebral (RC) involvement and two disseminated cases. Palatal ulcers occurred in 3/21 early cases (14.3%) and in 16/21 cases after the nasal involvement. All patients received amphotericin B; in four patients, it was combined with itraconazole and four with fluconazole. Clinical and mycological cure was achieved in 4/21 patients (19.04%).

Conclusion:  Zygomycosis with palatal involvement occurs in around 18% of cases, usually associated with RC modalities; it has an acute and generally lethal course.
Basal cell carcinoma of the nipple – An unusual location in a male patient
Authors: Avcı Oktay , Pabuççuoğlu Uğur , Koçdor M. Ali , Ünlü Mehtat , Akin Çiler , Soyal Cüneyt , Canda Tülay
Published: February 2008

Although basal cell carcinoma is extremely common, it only rarely occurs on the nipple. Men are affected more often than women.Basal cell carcinoma of the nipple‐areola complex may be more aggressive as metastases to regional lymph nodes have been reported.We report a basal cell carcinoma of the nipple with features of a fibroepithelioma of Pinkus in a man and review the literature.
Aquatic dermatoses
Authors: Ulrich Heidi , Landthaler Michael , Vogt Thomas
Published: February 2008

Despite the fascination of the aquatic world, it can be associated with some medical risks. Natural bodies of water, swimming pools and aquariums contain many living organisms. Some of these aquatic species may cause traumatic or toxic skin reactions after contact as well as life‐threatening systemic reactions. Most frequently, the injuries include poisonous bites and stings by coelenter‐ates, worms,stinging fish,mollusks and echinoderms or skin infections. A basic knowledge regarding the flora and fauna that populate the aquatic world can help to avoid contact with such organisms,or if it happens,to promptly initiate appropriate therapy.
Emerging Christian Scholars among the Intellectual Virtues
Authors: Ream Todd C. , Seat Thomas W.
Published: February 2008

The reason why all of our students should be Thomists is that excellence among the intellectual virtues is what should come to define our aspirations for them as emerging Christian scholars. Such aspirations are formed by the design and implementation of practices of study. Such aspirations denounce any distinction between subject and object or finite and infinite. However, such aspirations are also guided by the narrative of excellence as defined by the beatific vision of God. Thomas Aquinas reminds us that this narrative is not one the academy generates on its own but is the story of Christianity as embodied by the Church. Failure to recognize such a narrative and design practices of study accordingly not only leaves our students beyond the formative influence of the intellectual virtues but also leaves them susceptible to the influences wielded by other narratives such as the narrative of the market economy.
Alpha 1‐antichymotrypsin/SerpinA3 is a novel target of orphan nuclear receptor Nur77
Authors: Zhao Yongjuan , Liu Yanxin , Zheng Dexian
Published: February 2008

Nur77 is one member of the nuclear receptor superfamily. As a transcription factor, Nur77 participates in a variety of biological processes, including T cell development, inflammatory responses, steroid hormone synthesis, and hepatic glucose metabolism. It typically acts via binding to the Nur77 responsive element (NBRE) in the promoter regions of its target genes. In the present study, we identified a novel Nur77‐regulated gene, α1‐antichymotrypsin/SerpinA3, via an approach combining computational prediction and wet‐laboratory validations. First, we identified 483 candidate genes via a human genome‐wide scan for NBREs in their proximal promoters. Three out of 14 function‐associated genes were further identified to be transactivated by Nur77 in luciferase reporter gene assays in HEK 293T cells. The transactivation assay proved that the NBRE (−182 to −175) in the SerpinA3 promoter region is a novel Nur77‐dependent functional motif in HEK 293T and HepG2 cells. Electrophoretic mobility shift and chromatin immunoprecipitation assays demonstrated that Nur77 physically associates with the SerpinA3 promoter region both in vitro and in vivo. Nur77 overexpression and RNA interference‐mediated Nur77 gene knockdown analysis confirmed that SerpinA3 is indeed a novel Nur77‐targeted gene. These data may throw light on the function of Nur77 in inflammatory responses and acute‐phase reactions as well as the development of Alzheimer’s disease.
Sulfide : quinone oxidoreductase (SQR) from the lugworm Arenicola marina shows cyanide‐ and thioredoxin‐dependent activity
Authors: Theissen Ursula , Martin William
Published: February 2008

The lugworm Arenicola marina inhabits marine sediments in which sulfide concentrations can reach up to 2 mm. Although sulfide is a potent toxin for humans and most animals, because it inhibits mitochondrial cytochrome c oxidase at micromolar concentrations, A. marina can use electrons from sulfide for mitochondrial ATP production. In bacteria, electron transfer from sulfide to quinone is catalyzed by the membrane‐bound flavoprotein sulfide : quinone oxidoreductase (SQR). A cDNA from A. marina was isolated and expressed in Saccharomyces cerevisiae, which lacks endogenous SQR. The heterologous enzyme was active in mitochondrial membranes. After affinity purification, Arenicola SQR isolated from yeast mitochondria reduced decyl‐ubiquinone (Km = 6.4 μm) after the addition of sulfide (Km = 23 μm) only in the presence of cyanide (Km = 2.6 mm). The end product of the reaction was thiocyanate. When cyanide was substituted by Escherichia coli thioredoxin and sulfite, SQR exhibited one‐tenth of the cyanide‐dependent activity. Six amino acids known to be essential for bacterial SQR were exchanged by site‐directed mutagenesis. None of the mutant enzymes was active after expression in yeast, implicating these amino acids in the catalytic mechanism of the eukaryotic enzyme.
Characterization of thermostable aminoacylase from hyperthermophilic archaeon Pyrococcus horikoshii
Authors: Tanimoto Koichi , Higashi Noriko , Nishioka Motomu , Ishikawa Kazuhiko , Taya Masahito
Published: February 2008

The gene encoding putative aminoacylase (ORF: PH0722) in the genome sequence of a hyperthermophilic archaeon, Pyrococcus horikoshii, was cloned and overexpressed in Escherichia coli. The recombinant enzyme was determined to be thermostable aminoacylase (PhoACY), forming a homotetramer. Purified PhoACY showed the ability to release amino acid molecules from the substrates N‐acetyl‐l‐Met, N‐acetyl‐l‐Gln and N‐acetyl‐l‐Leu, but had a lower hydrolytic activity towards N‐acetyl‐l‐Phe. The kinetic parameters Km and kcat were determined to be 24.6 mm and 370 s−1, respectively, for N‐acetyl‐l‐Met at 90 °C. Purified PhoACY contained one zinc atom per subunit. EDTA treatment resulted in the loss of PhoACY activity. Enzyme activity was fully recovered by the addition of divalent metal ions (Zn2+, Mn2+ and Ni2+), and Mn2+ addition caused an alteration in substrate specificity. Site‐directed mutagenesis analysis and structural modeling of PhoACY, based on Arabidopsis thaliana indole‐3‐acetic acid amino acid hydrolase as a template, revealed that, amongst the amino acid residues conserved in PhoACY, His106, Glu139, Glu140 and His164 were related to the metal‐binding sites critical for the expression of enzyme activity. Other residues, His198 and Arg260, were also found to be involved in the catalytic reaction, suggesting that PhoACY obeys a similar reaction mechanism to that proposed for mammalian aminoacylases.
Male breast cancer: Progress, prognosis and future pathways
Authors: FIELD Kathryn M , CAMPBELL Belinda , DE BOER Richard
Published: February 2008

Breast cancer is one of the most commonly treated malignancies worldwide, but is rare in males. Less than one percent of all breast cancers occur in men, and breast cancer comprises less than one percent of all male malignancies. Thus, clinical experience in managing this condition is limited. In contrast to female breast cancer, much remains unknown about breast cancer in males. While there are similarities between the two, emerging data suggest that there are perhaps more differences than previously thought. Nevertheless, much of how males with breast cancer are managed continues to be extrapolated from randomised trials performed in females, due to lack of data in the male population alone. Another poorly understood aspect is the psychological impact experienced by male patients when diagnosed with what is generally thought of as a female malignancy. This review will discuss the known epidemiology, demographics, risk factors and genetic predispositions surrounding the development of breast cancer in males; as well as current surgical and radiotherapeutic interventional techniques. Histological profiles and subtypes as well as hormone receptor and HER‐2 receptor status are also discussed, with an overview of chemotherapy and hormonal strategies in both the adjuvant and metastatic settings.
Efficacy of Granulocyte and Monocyte Adsorption Apheresis for Pustular Psoriasis
Authors: Seishima Mariko , Mizutani Yoko , Shibuya Yoshinao , Nagasawa Chikako , Aoki Takahiko
Published: February 2008

Abstract:  Granulocyte and monocyte adsorption apheresis (GCAP) has recently shown remarkable effects on ulcerative colitis, which is characterized by inflammation and neutrophil infiltration. Pustular psoriasis often shows histological findings of neutrophilic pustules in the epidermis, and in Japan is usually treated with etretinate or immunosuppressive agents. However, there are some resistant cases to these therapies. We performed GCAP on one patient with generalized pustular psoriasis (patient 1) and on one patient with acrodermatitis continua, a subtype of pustular psoriasis limited to acral lesions (patient 2). Patient 1, a 44‐year‐old woman suffering from alcoholic liver cirrhosis and osteoporosis as a result of the liver cirrhosis, received two GCAP sessions because cyclosporine was ineffective. Patient 2, a 66‐year‐old man with hypertension who had suffered from a brain infarction 4 years before, had five GCAP sessions because etretinate was ineffective. GCAP remarkably improved the skin lesions in both patients. No adverse effects were observed either during or after treatment. From these findings, GCAP could be an effective therapy for refractory cases of pustular psoriasis.
Plasma S100A12 Concentrations in Peritoneal Dialysis Patients and Subclinical Chronic Inflammatory Disease
Authors: Uchiyama‐Tanaka Yoko , Mori Yasukiyo , Kosaki Atsushi , Kimura Tatsuji , Moriishi Misaki , Kawanishi Hideki , Matsubara Hiroaki
Published: February 2008

Abstract:  S100A12 is a ligand for the receptor for advanced glycation end products. It has been shown that S100A12 induces expression of adhesion molecules, and mediates activation and migration of monocytes/macrophages. Circulating S100A12 may be involved in chronic inflammation. We previously reported increased S100A12 levels in patients with non‐insulin‐dependent diabetes mellitus and hemodialysis. A high peritoneal solute transport rate may be associated with encapsulating peritoneal sclerosis and mortality. We measured plasma S100A12 levels in peritoneal dialysis patients and evaluated a possible relation between the increased plasma S100A12 levels in peritoneal dialysis patients and the high peritoneal solute transport rate. Subjects included 36 patients (mean age ± SE, 46.0 ± 12.0 years) with no apparent infection and no malignancy who had been undergoing peritoneal dialysis for 36.5 ± 3.9 months. We developed an enzyme‐linked immunosorbent assay system to measure plasma S100A12 levels. A peritoneal equilibrium test was performed and subjects were categorized as high and high‐average (H) (n = 14) or low and low‐average (L) (n = 22) transporters. Plasma S100A12 concentrations were significantly higher in peritoneal dialysis patients (21.6 ± 3.0 ng/mL) than in control subjects (n = 42; 10.8 ± 1.0 ng/mL). Plasma S100A12 concentrations were also higher in the H group (28.2 ± 6.1 ng/mL) than in the L group (14.2 ± 2.0 ng/mL). These results suggest that S100A12 may be a sensitive marker of subclinical inflammation and that an increased S100A12 level may be related to the high peritoneal solute transport rate.
Calcium, Phosphorus, Cardiovascular Events and All‐cause Mortality in Hemodialysis Patients: A Single‐center Retrospective Cohort Study to Reassess the Validity of the Japanese Society for Dialysis Therapy Guidelines
Authors: Komaba Hirotaka , Igaki Naoya , Takashima Mototsugu , Goto Shunsuke , Yokota Kazuki , Komada Hisako , Takemoto Toshiyuki , Kohno Maki , Kadoguchi Hiraku , Hirosue Yoshiaki , Goto Takeo
Published: February 2008

Abstract:  Mineral and bone disorders frequently cause cardiovascular complications and mortality in hemodialysis patients, but few observational studies of Japanese patients have investigated this matter. A retrospective cohort study of 99 patients (53 males, 46 females; mean age: 65 ± 12 year; 38% with diabetes mellitus) on maintenance hemodialysis in our dialysis center was conducted. Mean serum Ca, P and intact parathyroid hormone (iPTH) levels were 9.2 ± 0.9 mg/dL, 6.1 ± 1.7 mg/dL, and 233 ± 333 pg/mL, respectively. The cutoff values for each of these three parameter were defined according to the target ranges recommended by the Japanese Society for Dialysis Therapy (JSDT) guidelines (Ca: 8.4–10.0 mg/dL; P: 3.5–6.0 mg/dL; iPTH: 60–180 pg/mL). During a 45‐month follow up, patients with all parameters outside the target ranges showed the highest incidence of cardiovascular events and all‐cause deaths (16.6 and 29.2 per 1000 person‐years, respectively). The relative risks of cardiovascular events and all‐cause deaths were analyzed by multivariate Cox regression models. The hazard ratio (HR) for cardiovascular events was significantly lower for patients who achieved serum Ca and P objectives compared with others (HR: 2.12; 95% CI: 1.04–4.34; P < 0.05), and similar differences were observed for all‐cause deaths (HR: 3.10; 95% CI: 1.13–8.53; P < 0.05). However, the relationship between iPTH levels and each of the endpoints was less pronounced. The results of this study provide support for the JSDT guidelines, which give priority to the control of serum Ca and P levels over the control of parathyroid function.
Carpal Tunnel Syndrome and Plasma β2‐microglobulin Concentration in Hemodialysis Patients
Authors: Shin Jeongsoo , Nishioka Masato , Shinko Satoko , Shibuya Koji , Sugiki Masahiko , Kasumoto Hiroomi , Fudo Akiko , Bito Yoshiko , Fujita Yoshikazu , Komaba Keitaro
Published: February 2008

Abstract:  As of the end of June 2005, 27 of 96 dialysis outpatients at our clinic had developed carpal tunnel syndrome (CTS). Of 19 patients who had undergone dialysis for 30 years or longer, 15 had CTS, whereas none of the 38 patients who had received dialysis for less than 10 years had CTS. These data reflect trends in CTS development: from 1983 the incidence of CTS increased for many years, but more recently there has been a decline in new cases of CTS. Comparison of the 27 CTS and 69 non‐CTS dialysis patients at our clinic showed that those in the CTS group were older and had a longer duration of dialysis. Patients in the CTS group were found to have had a high plasma β2‐microglobulin (BMG) level in the distant past (15–21 years ago), but conversely had a much lower BMG level in recent years. Simple correlation analysis and multiple logistic regression analysis showed that the presence of CTS was correlated with high BMG levels in the distant past, in addition to age and duration of dialysis. These findings suggest that reduction of the plasma BMG level due to advances in dialysis therapy in recent years has contributed to the decreased incidence of CTS.
A Case Report of Uncompensated Alkalosis Induced by Daily Plasmapheresis in a Patient With Thrombotic Thrombocytopenic Purpura
Authors: Nagai Yoshiko , Itabashi Mitsuyo , Mizutani Mayuko , Ogawa Tetsuya , Yumura Wako , Tsuchiya Ken , Nitta Kosaku
Published: February 2008

Abstract:  Plasmapheresis (PP) is widely known as the standard therapy for thrombotic thrombocytopenic purpura (TTP). Citrate is used as an anticoagulant in fresh frozen plasma, and the large amount of citrate infused during PP induces metabolic alkalosis. A 29‐year‐old woman was diagnosed with TTP associated with systemic lupus erythematosus, and was treated by daily PP in addition to a steroid, an immunosuppressant, vincristine, and cyclophosphamide. Uncompensated alkalosis caused by a combination of metabolic and respiratory alkalosis developed after artificial ventilation was discontinued. Her metabolic status improved after controlling her respiratory status and the activity of the TTP. Metabolic alkalosis is a common complication in TTP patients treated by frequent PP, but several factors that affect metabolic status may aggravate the alkalosis and induce uncompensated alkalosis.
A Case Report of a Pyogenic Liver Abscess Caused by Fusobacterium Nucleatum in a Patient With Autosomal Dominant Polycystic Kidney Disease Undergoing Hemodialysis
Authors: Cigarrán Secundino , Neches Carmen , Lamas José María , García‐Trio Gerardo , Alonso Mario , Saavedra Jesus
Published: February 2008

Abstract:  Pyogenic liver abscess (PLA) is a process with significant morbidity and mortality and is a rare complication in an aisled way in patients with autosomal dominant polycystic kidney disease (ADPKD). In addition to hepatic cyst infection, intracystic hemorrhage is another complication seen in ADPKD patients; however, the liver parenchyma itself remains normal. A PLA located in normal liver tissue in these kinds of patients has not been previously reported. Fusobacterium nucleatum is an anaerobic bacterium with rare involvement other than in periodontal infections. A 58‐year‐old Caucasian male, who was on hemodialysis treatment from July 2004 due to end‐stage renal disease secondary to ADPKD, was admitted with fever, rigor, chills, weakness, and abdominal pain of 10 days duration. During that time, ciprofloxacin 500 mg, twice daily, gentamycin 80 mg/48 h, and vancomycin 1 g/week, were prescribed, but treatment was interrupted by hospitalization. Physical examination on admission revealed that the patient had a fever of 39.8°C, pallor, chills, right upper quadrant abdominal pain, and hepatosplenomegaly. Abdominal ultrasound revealed a 5.3 cm diameter collection with irregular configuration located in the caudate lobe. Abdominal computed tomography (CT) showed a large multiloculated hepatic collection. The PLA was managed with antibiotics (metronidazole) and continuous catheter drainage (8Fr drainage catheters [Abocath‐T, Abbott, Sligo, Ireland]) into the abscess. Fluid culture was positive for F. nucleatum. Complete remission was obtained after 12 days without complications. We describe a PLA by F. nucleatum, in a very rare location in an ADPKD patient undergoing hemodialysis without complicated cysts, managed with antibiotics and percutaneous drainage with satisfactory resolution.
Partial Blood Recirculation: A New Trial for Prolonging Filter Life During Continuous Hemodiafiltration
Authors: Ikeda Yuji , Kishi Tomoya , Kishi Chie , Miyazono Motoaki , Okazaki Yukio , Nakashima Mikio , Sakemi Takanobu , Sanai Toru , Node Koichi
Published: February 2008

Abstract:  Although continuous hemodiafiltration (CHDF) has been widely accepted in the management of complicated acute renal failure, the requirement for prolonged continuous systemic anticoagulation appears to be a major drawback. We herein describe the case of a patient who developed postoperative multiple organ failure and received CHDF therapy with partial blood recirculation (PBR). PBR is a mode of extracorporeal circulation used as an anticoagulation modality. The technique accelerates the blood flow rate with the goal of extending filter life, and it was performed because the filter life had been significantly shortened (10.5 ± 5.1 h) during the CHDF process in this case. Despite increasing the dose of the anticoagulant, changing the hemofilter and changing the mode from postdilution to predilution, we did not obtain amelioration of filter life. The filter life was significantly improved (41.5 ± 1.4 h) when we performed PBR. It is difficult to minimize the bleeding risk and maintain filter life during CHDF. Our success in prolonging the filter life during this case therefore suggests that PBR might resolve one of the main problems related to CHDF, although more study is needed to clarify the advantages of this system.
ANTIFUNGAL PROPERTIES OF OLIVE LEAF EXTRACTS AND THEIR PHENOLIC COMPOUNDS
Authors: KORUKLUOGLU M. , SAHAN Y. , YIGIT A.
Published: February 2008

Olive (Olea europaea L.) leaf extracts were obtained using water or different organic solvents such as acetone, methanol and ethyl acetate. Antimicrobial activities of the extracts and some phenolic components were investigated to screen against 30 fungal strains (Alternaria alternata, Aspergillus chevalieri, A. chrysogenum, A. elegans, A. flavus [three strains], A. fumigatus, A. nidulans, A. niger [two strains], A. oryzae, A. parasiticus[four strains], A. tamari, P. verrucosum, A. versicolor, A. wentii, Fusarium oxysporum, F. semitectum, Mucor racemosus, Neurospora crassa, Penicillium citrinum, P. echinulatum, P. griseofulvum, P. italicum, P. roqueforti and Rhizopus oligosporus) using the disc diffusion method. In this study, in terms of inhibition activity, it was determined that aqueous extract was the best as it completely inhibited the growth of 10 molds, followed by acetone and methanol extracts, which were effective against eight molds, and diethyl ether extract, which was effective against 7 out of 30 test fungi. The inhibition zones ranged from 7 to 21 mm. Comparing the sensitivity of the fungi with all crude olive leaf extracts and pure phenolic compounds, we found that A. parasiticus(4) was the most resistant strain while A. wentii was the most sensitive.

PRACTICAL APPLICATIONS

Foodborne diseases are still a major problem in the world, even in well‐developed countries. Fusarium spp., Aspergillus spp., Rhizopus spp. and Penicillium spp. have been reported as the causal agents of foodborne diseases and food spoilage. Raw and processed foods are open to contamination during the production, sale and distribution. Thus, at present, it is a necessity to the food industry to use chemical preservatives to prevent the growth of fungi in foods. Because of the economic impact of spoiled foods and consumer concerns over the safety of foods containing synthetic chemicals, considerable attention has been paid to naturally derived compounds or natural products. Recently, there has been considerable interest in using extracts from plants with antimicrobial activities to control pathogens or toxin‐producing microorganisms in foods. Olive leaves have been shown to inhibit or delay the rate of growth of a range of fungi; thus, they might be useful as natural preservatives.
SENSOMINER: A PACKAGE FOR SENSORY DATA ANALYSIS
Authors: LE SEBASTIEN , HUSSON FRANÇOIS
Published: February 2008

We propose a new package for sensory data analysis, named SensoMineR. SensoMineR is implemented in the R programming environment and can be accessed at the following addresses: http://sensominer.free.fr or http://cran.r‐project.org. This package produces graphical displays of data that are simple to interpret, and it also provides syntheses of results issuing from various analysis of variance models or from various factor analysis methods accompanied with confidence ellipses.

PRACTICAL APPLICATIONS

SensoMineR is a free software intended for sensory analysts from both academic and corporate institutions. SensoMineR is an easy and powerful solution that tackles the following problems: characterization of the products, panel performance assessment, links between sensory and instrumental data, consumer's preferences, napping evaluation, optimal designs. SensoMineR is implemented in R and can be used easily with the help of a very intuitive graphical interface.
Impact of Discontinued Obstetrical Services in Rural Missouri: 1990‐2002
Authors: Sontheimer Dan , Halverson Larry W. , Bell Laird , Ellis Mark , Bunting Pamela Wilbanks
Published: February 2008

ABSTRACT: 
Purpose:

This study examines the potential relationship between loss of local obstetrical services and pregnancy outcomes.

Methods:

Missouri Hospital Association and Missouri Department of Health birth certificate records were used as sources of information. All member hospitals of the Missouri Hospital Association that were located in cities of 10,000 or less were identified and surveyed by telephone.

Results:

Frequency of low birth weight babies originating from service areas where hospitals closed services was statistically increased in the first year after service closures. This effect was transient.

Conclusions:

Transient increases in the rate of lower birth weights may reveal difficulties in service access after closure. These outcomes merit further investigation into the consequences of disruptions in access to maternity care in rural communities.
Uninsured Rural Families
Authors: Ziller Erika C. , Coburn Andrew F. , Anderson Nathaniel J. , Loux Stephenie L.
Published: February 2008

ABSTRACT: Context:Although research shows higher uninsured rates among rural versus urban individuals, prior studies are limited because they do not examine coverage across entire rural families.Purpose:This study uses the Medical Expenditure Panel Survey (MEPS) to compare rural and urban insurance coverage within families, to inform the design of coverage expansions that build on the current rural health insurance system.Methods:We pooled the 2001 and 2002 MEPS Household Component survey, aggregated to the family level (excluding households with all members 65 and older). We examined (1) differences in urban, rural‐adjacent, and rural nonadjacent family insurance coverage, and (2) the characteristics of rural families related to their patterns of coverage.Findings:One out of 3 rural families has at least 1 uninsured member, a rate higher than for urban families—particularly in nonadjacent counties. Yet, three fourths of uninsured rural families have an insured member. For 42% of rural nonadjacent families, this is someone with public coverage (Medicaid/SCHIP or Medicare); urban families are more likely to have private health insurance or a private/public mix.Conclusions:Strategies to expand family coverage through employers may be less effective among rural nonadjacent than urban families. Instead, expansions of public coverage or tax credits enabling entire families to purchase an individual/self‐employment plan would better ensure that rural nonadjacent families achieve full coverage. Subsidies or incentives would need to be generous enough to make coverage affordable for the 52% of uninsured rural nonadjacent families living below 200% of the federal poverty level.
Enhancing the Care Continuum in Rural Areas: Survey of Community Health Center–Rural Hospital Collaborations
Authors: Samuels Michael E. , Xirasagar Sudha , Elder Keith T. , Probst Janice C.
Published: February 2008

ABSTRACT: Context:Community Health Centers (CHCs) and Critical Access Hospitals (CAHs) play a significant role in providing health services for rural residents across the United States.Purpose:The overall goal of this study was to identify the CAHs that have collaborations with CHCs, as well as to recognize the content of the collaborations and the barriers and facilitators to collaborations.Methods:The target population was CAHs within 60 miles of CHCs. Surveys were mailed to 386 chief executive officers of CAHs in 41 states who met the study criteria. The response rate was 40.9%. A descriptive analysis using chi‐square tests compared the status of partnerships along with factors identified as barriers and facilitators to collaboration.Findings: Out of the 161 CAH respondents, 24 (14.9%) reported having a collaborative agreement with a CHC, and 2 indicated that they planned to develop a collaborative agreement. A common reason given for not collaborating was lack of awareness of a CHC within the service area. Other barriers identified were competition with CHCs and organizational differences. External funding to start a collaborating service was the most frequently cited factor to facilitate collaborations.Conclusions: The findings indicate that collaborations between CAHs and CHCs are a largely untapped resource. The rural health care services continuum may benefit from increased collaborations.
Migrant Farmworker Stress: Mental Health Implications
Authors: Hiott Ann E. , Grzywacz Joseph G. , Davis Stephen W. , Quandt Sara A. , Arcury Thomas A.
Published: February 2008

ABSTRACT: 
Context:

The number of Latinos in rural regions of the United States is increasing. Little is known about factors that undermine the mental health of this segment of the rural population. Purpose: The goal of this study is to determine which stressors inherent in farmwork and the farmworker lifestyle contribute to poor mental health. Methods: An interview containing the Migrant Farmworker Stress Inventory (MFWSI) and 3 mental health scales (the PAI [anxiety], CES‐D [depression], and CAGE/4M [alcohol abuse]) was administered to a sample of 125 male migrant farmworkers. Factor analysis differentiated discrete domains of stressors in the MFWSI. Regression models identified associations of the MFWSI stressor domains with mental health outcomes. Findings: Thirty‐eight percent of participants had significant levels of stress as determined by the MFWSI. The MFWSI reduced to 5 stressor domains: legality and logistics, social isolation, work conditions, family, and substance abuse by others. Some 18.4% of participants had impairing levels of anxiety, 41.6% met caseness for depression, and 37.6% answered yes to 2 or more questions on the CAGE. Social isolation and working conditions were associated with both anxiety and depressive symptoms. However, social isolation was more strongly associated with anxiety, and working conditions were more strongly linked to depression. Conclusions: Specific categories of stressors (social isolation, working conditions) inherent in farmwork and the farmworker lifestyle are associated with mental health among immigrant farmworkers. Isolating specific categories of stressors helps in designing programs and practice for the prevention and management of mental health disorders in the immigrant, farmworker population.
Cultural Perspectives Concerning Adolescent Use of Tobacco and Alcohol in the Appalachian Mountain Region
Authors: Meyer Michael G. , Toborg Mary A. , Denham Sharon A. , Mande Mary J.
Published: February 2008

ABSTRACT: 
Context:

Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and alcohol use. Methods: With 4 grants from the National Institutes of Health, 34 focus groups occurred between 1999 and 2003 in 17 rural Appalachian jurisdictions in 7 states. These jurisdictions ranged between 4 and 8 on the Rural‐Urban Continuum Codes of the Economic Research Service of the US Department of Agriculture. Of the focus groups, 25 sought the perspectives of women in Appalachia, and 9, opinions of adolescents. Findings: The family represented the key context where residents of Appalachia learn about tobacco and alcohol use. Experimentation with tobacco and alcohol frequently commenced by early adolescence and initially occurred in the context of the family home. Reasons to abstain from tobacco and alcohol included a variety of reasons related to family circumstances. Adults generally displayed a greater degree of tolerance for adolescent alcohol use than tobacco use. Tobacco growing represents an economic mainstay in many communities, a fact that contributes to the acceptance of its use, and many coal miners use smokeless tobacco since they cannot light up in the mines. The production and distribution of homemade alcohol was not a significant issue in alcohol use in the mountains even though it appeared not to have entirely disappeared. Conclusions: Though cultural factors support tobacco and alcohol use in Appalachia, risk awareness is common. Messages tailored to cultural themes may decrease prevalence.
Appalachian Women's Perceptions of Their Community's Health Threats
Authors: Schoenberg Nancy E. , Hatcher Jennifer , Dignan Mark B.
Published: February 2008

ABSTRACT: 
Context:

Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose: We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to identify the key health priorities. While Kentucky Appalachian communities are often described as suffering from substandard health, resource, and socioeconomic indicators, strong traditions of community mobilization make possible positive, home‐grown change. Methods: To assess what women, the key health gatekeepers, perceive as the most significant health threats to their rural communities, 10 focus groups were held with 52 Appalachian women from diverse socioeconomic backgrounds. Tape‐recorded narratives were content analyzed and a codebook was developed. Measures designed to increase data trustworthiness included member checks, negative case evidence, and multiple coding. Findings: The following rank‐ordered conditions emerged as posing the greatest threat to the health of rural Appalachian communities: (1) drug abuse/medication dependence; (2) cancer; (3) heart disease and diabetes (tied); (4) smoking; (5) poor diet/overweight; (6) lack of exercise; and (7) communicable diseases. These health threats were described as specific to the local environment, deriving from broad ecological problems and were connected to one another. Conclusion: Drawing on participants' community‐relevant suggestions, we suggest ways in which rural communities may begin to confront these health concerns. These suggestions range from modest, individual‐level changes to broader structural‐level recommendations.