bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Ehrlichia (Cytoecetes) phagocytophila on the Clinical Chemistry of Sheep and Goats
Authors: Gokce H. I. , Woldehiwet Z.
Published: April 2007

Tick‐borne fever (TBF) is a rickettsial disease of domestic and wild ruminants in temperate climates where the hard tick Ixodes ricinus is present. The disease is characterized by a high temperature and severe leukopenia. In the present study, the effects of TBF on the activity of serum alkaline phosphatase (ALP), and on the concentrations of plasma zinc, iron, total bilirubin, urea, creatinine and albumin were investigated by inoculating one group of eight sheep and one group of eight goats with the Old Sourhope (OS) strain of Ehrlichia (Cytoecetes) phagocytophila. All goats and sheep experimentally infected with E. phagocytophila reacted with fever, rickettsiaemia and leukopenia. The leukopenia was due to an acute lymphocytopenia and prolonged neutropenia. In both groups of animals, TBF was characterized by significant reductions in the activities of serum ALP and concentrations of plasma zinc, iron and albumin. However, there were significant increases in the concentrations of plasma total bilirubin, urea and creatinine in both species of animals. The reductions in ALP and iron were significantly more pronounced in sheep than in goats.
Simulated mechanisms of soil N feedback on the forest CO2 response
Authors: PEPPER DAVID A. , ELIASSON PETER E. , McMURTRIE ROSS E. , CORBEELS MARC , ÅGREN GÖRAN I. , STRÖMGREN MONIKA , LINDER SUNE
Published: April 2007

An improved understanding of the response of forest ecosystems to elevated levels of CO2 in the atmosphere is crucial because atmospheric CO2 concentration continues to increase at an accelerating rate and forests are an important sink in the global carbon cycle. Several CO2‐enrichment experiments have now been running for more than 10 years, with highly variable short‐term results after the first decade. Responses to rising [CO2] over the next few decades will depend on several plant and ecosystem feedbacks that are inadequately understood. In this study, we conduct a sensitivity analysis, within the context of the simulated CO2 response, using a new version of the G'DAY ecosystem model, with an improved decomposition submodel, applied to a nitrogen‐limited Norway spruce forest site in the north of Sweden. The new decomposition model incorporates important modifications to soil processes, including some that constitute negative feedbacks on an ecosystem's growth response to elevated [CO2]. The sensitivity analysis reveals key parameters and processes that are important for the simulated CO2 response on the short term and others that are more important on the long term. A process that has a strong impact on the short‐term response is a change in decomposer composition, potentially in response to altered litter quality. Parameters that become increasingly important in the long term are carbon allocation to root exudates that are directly or indirectly associated with atmospheric N2 fixation, and the rate of humification of soil organic matter. We identify factors intrinsic to species and site (microbes and resources) and ecosystem nutrient supply that determine the duration of the enhanced simulated growth response to elevated [CO2].
Antroduodenojejunal motor activity in untreated and treated celiac disease patients
Authors: Bassotti Gabrio , Villanacci Vincenzo , Mazzocchi Alessandro , Mariano Marina , Incardona Paolo , Clerici Carlo , Morelli Antonio
Published: April 2007

Background and Aim: Patients with celiac disease may present with abnormal upper gut motor activity. However, it is not known if these abnormalities persist after the introduction of a gluten‐free diet. The present study aimed to compare antroduodenojejunal motor variables recorded in untreated celiac patients with those of celiac patients given a gluten‐free diet and healthy volunteers.

Methods: Eleven untreated celiac disease patients, 12 age‐ and sex‐matched celiac patients on a gluten‐free diet (at least 12 months), and 33 controls entered the study. Antroduodenojejunal motility was recorded for 6 h during fasting and for 3 h after a standard meal by means of a perfused, multiple lumen catheter.

Results: More than 80% of untreated celiac patients had discrete motor abnormalities of the upper gut, in both fasting and fed recordings, compared to the other subjects. Patients on a gluten‐free diet also showed motor abnormalities, albeit to a lesser extent. In these patients histological evaluation showed the persistence of mild mucosal abnormalities.

Conclusions: Upper gut motor abnormalities are frequent in patients with celiac disease, even in those on a gluten‐free diet. In the latter group, these abnormalities may suggest an incomplete adherence to the dietary regimen.
Predicting pleural effusion and ascites following extended hepatectomy in the non‐cirrhotic liver
Authors: Shimizu Yasuhiro , Sano Tsuyoshi , Yasui Kenzo
Published: April 2007

Background:  There are cases in which intractable pleural effusion and/or ascites appear even in the non‐cirrhotic liver following extended liver resection, making postoperative management difficult. In this study we investigated the risk factors for pleural effusion and ascites following extended hepatectomy.

Methods:  Subjects were 50 patients between 1996 and 2003 who had hepatic metastasis of colorectal cancer, and who underwent extended liver resection of hemihepatectomy or greater at a time separate from the surgery for their colorectal cancer. The 50 patients were classified according to the presence or absence of pleural effusion and/or ascites, and compared for preoperative ICGR15, pre‐ and postoperative total serum protein and albumin levels, operating time, amount of blood loss, resected liver weight g/bodyweight kg (Hx ratio), intraoperative fluid replacement volume, period of surgery, operative procedure, use of serum and plasma derivatives, and use of catecholamines.

Results:  In a univariate analysis of pleural effusion and ascites, the Hx ratio, period of surgery, operative procedure, use of fresh frozen plasma and use of albumin preparations were significant factors, but in a multivariate analysis only the Hx ratio was a significant independent factor. Among patients with an Hx ratio of 8 or above, many had postoperative pleural effusion and ascites.

Conclusions:  The Hx ratio is a simple method for the evaluation of postoperative remnant liver function and is extremely useful as a predictive factor for pleural effusion and ascites following extended hepatectomy in the non‐cirrhotic liver.
Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non‐acetaminophen‐related fulminant hepatic failure
Authors: Miyake Yasuhiro , Iwasaki Yoshiaki , Makino Yasuhiro , Kobashi Haruhiko , Takaguchi Kouichi , Ando Masaharu , Sakaguchi Kohsaku , Shiratori Yasushi
Published: April 2007

Background and Aim:  Many patients continue to die due to the rapid development of cerebral edema and/or multiple organ failure prior to receiving a liver transplantation.

Methods:  We investigated the prognostic factors associated with 1‐week fatal outcomes after the diagnosis of fulminant hepatic failure, which were associated with fatal outcomes prior to receiving liver transplantation, in 104 patients with non‐acetaminophen‐related fulminant hepatic failure.

Results:  With a multivariate logistic regression analysis, age (>40 years), systemic inflammatory response syndrome (SIRS) and plasma prothrombin activities (≤10%) were significantly associated with fatal outcomes at 1 week after diagnosis in 104 patients. At the time of diagnosis, 50 patients (48%) were in a state of SIRS. Significant differences were observed between patients with and without SIRS regarding the period from the initial symptoms to the diagnosis of fulminant hepatic failure, hepatic coma grade, serum alanine aminotransferase level, serum creatinine level and plasma prothrombin activity. With a multivariate logistic regression analysis, age (>40 years), cause of fulminant hepatic failure (viral hepatitis), plasma prothrombin activity (≤10%) and no administration of protease inhibitor were significantly associated with the 1‐week fatal outcomes of 50 patients with SIRS.

Conclusions:  Patients with SIRS exhibited hepatic failure of increased severity and SIRS may reduce the probability of receiving a liver transplantation. In order to estimate the efficacy of protease inhibitor for patients with SIRS, a prospective randomized trial is required.
Serum sodium and hydration status predict transplant‐free survival independent of MELD score in patients with cirrhosis
Authors: Mathur Sachin , Gane Edward J , McCall John L , Plank Lindsay D
Published: April 2007

Background and Aim:  Serum sodium may have prognostic value in addition to the model for end‐stage liver disease (MELD) score for prediction of early mortality in patients listed for liver transplant. In patients with cirrhosis, over‐hydration is a common feature but its prognostic value has not been evaluated. This study examines the independent prognostic significance of MELD, serum sodium and hydration status on long‐term survival in patients with cirrhosis.

Methods:  Serum sodium and hydration (total body water as a percentage of fat‐free mass) were measured in 227 consecutive cirrhotic patients (146 male, 81 female; median age 49 years, range 19–73 years; median MELD score 13, range 6–36). Patients with hepatocellular carcinoma or listed for liver transplantation at the time of initial assessment were excluded. A competing risks Cox proportional hazards analysis was performed to evaluate the influence of MELD, sodium and hydration on risk of death or transplant.

Results:  Median follow‐up was 52 (range 4–93) months. Serum sodium and hydration were each associated with reduction in time to death or transplant on univariate analysis (sodium: hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.87–0.94, P < 0.0001; hydration: HR 1.20, 95% CI 1.10–1.30, P < 0.0001). On multivariate analysis, MELD, serum sodium and hydration were independently predictive of death or transplant (MELD: HR 1.12, 95% CI 1.06–1.19, P < 0.0001; sodium: HR 0.93, 95% CI 0.87–0.99, P = 0.04; hydration: HR 1.17, 95% CI 1.02–1.33, P = 0.02).

Conclusions:  In non‐waitlisted patients with cirrhosis, serum sodium is predictive of transplant or death independent of MELD score.
Hepatitis E in New Zealand
Authors: Dalton Harry R , Fellows Helen J , Gane Edward J , Wong Philip , Gerred Stephen , Schroeder Bryan , Croxson Margaret C , Garkavenko Olga
Published: April 2007

Background and Aim:  Locally acquired hepatitis E virus (HEV) infection has been described in a number of developed countries and is thought to be zoonotic from pigs. Little is known about hepatitis E in humans in New Zealand (NZ) but 90% of NZ pigs show evidence of HEV infection. The aim of this study was to investigate the epidemiology of hepatitis E infection in NZ by documenting HEV immunoglobulin (Ig) G seroprevalence in NZ blood donors, testing patients with unexplained hepatitis for HEV, and comparing genetic sequences of human HEV with local porcine isolates.

Methods:  In total, 265 blood donors were tested for HEV IgG and 77 patients with unexplained hepatitis were tested for HEV. Viral sequences were compared with known HEV isolates including those from NZ pigs.

Results:  The HEV IgG seroprevalence was 4%. HEV genotype 3 was isolated in four patients with unexplained hepatitis. Clinical and sequencing data suggest that two cases were acquired in Europe and two in NZ. All cases were in elderly patients, one of whom was asymptomatic and initially misdiagnosed as a drug reaction. The NZ‐acquired cases were most similar to HEV from Japan, and bore little sequence homology to HEV isolated from NZ pigs.

Conclusions:  Hepatitis E does occur in NZ in patients who have not traveled to endemic areas and seems to affect the elderly. The seroprevalence data suggest that subclinical/unrecognized infection is common. Sequencing data suggest that some reservoir other than pigs could be the source of HEV in NZ. It is recommend that all patients with unexplained hepatitis, whatever their age or travel history, are tested for HEV.
Factors that influence the adequacy of total mesorectal excision for rectal cancer
Authors: Jeyarajah S. , Sutton C. D. , Miller A. S. , Hemingway D.
Published: April 2007

Objective  In 1997 with the start of CRO7 trial it was agreed that adequacy of surgical resection of rectal cancer would be determined by a pathologically determined grading of the mesorectum the so called total mesorectal excision score (TME score). Scores ranged from 1–3 with 3 being a perfect specimen. The aim of this study was to investigate factors which may influence TME scores and establish if local recurrence is related to them.

Method  Data on all patients undergoing resectional surgery for rectal cancer in our unit are entered prospectively onto a database. Pathology reports of those patients who underwent total mesorectal excision were examined and the TME scores added to the database. Categorical variables were analysed using the χ2 test, continuous variables using ANOVA. Statistical significance was taken as P < 0.05.

Results  Between January 2000 and June 2005, 518 patients underwent surgery for adenocarcinoma of the rectum, of these, 287 patients had a total mesorectal excision for mid or lower third tumours under the care of seven colorectal surgeons. All resected specimens were scored by a Consultant GI pathologist. Two hundred and fourteen patients underwent anterior resection and 73 underwent abdomino‐perineal resection. The median age of the patients was 73 years (range 38–95 years). One hundred and ninety‐four patients were male. Seventy‐eight patients were treated with preoperative radiotherapy, 59 short course and 19 long course. TME scores were TME1 n = 30, TME2 n = 99, TME3 n = 158. Fifteen patients developed local pelvic recurrence at 2 years.

Total mesorectal excision scores were not statistically influenced by Dukes’ stage, width of tumour, preoperative radiotherapy or grade of surgeon. Male patients were statistically more likely to have a TME score of 2 or 3 compared with female P = 0.04. Patients undergoing an anterior resection were statistically more likely to have a TME score of 2 or 3 compared with abdomino‐perineal resection P = 0.0001.Tumours with a circumferential resection margin (CRM) of more than 1 mm were more likely to have a TME score of 2 or 3 score (P = 0.0001). There was no relationship between TME and local recurrence (P = 0.966).

Conclusion  There is no relationship between the TME score in patients undergoing resectional surgery for adenocarcinoma of the rectum and the development of local recurrence at 2 years. Other factors such as CRM involvement are more likely to have an impact on local recurrence. The factors that influence the quality of TME are the operative procedure of anterior resection, male gender and CRM positivity. There appear to be no deleterious effects on the TME score by Specialist Registrars performing the operation under Consultant supervision. While TME scores may be an index of a technical performance, they appear to have little role in predicting future outcomes.
The Euro Effect on Trade is not as Large as Commonly Thought*
Authors: Bun Maurice J. G. , Klaassen Franc J. G. M.
Published: April 2007

Existing studies on the impact of the euro on goods trade report increments between 5% and 40%. These estimates are based on standard panel gravity models for the level of trade. We show that the residuals from these models exhibit upward trends over time for the euro countries, and that this leads to an upward bias in the estimated euro effect. To correct for that, we extend the standard model by including a time trend that may have different effects across country‐pairs. This results in an estimated euro impact of only 3%.
BURNT KIMMERIDGIAN SHALE AT EARLY ROMAN SILCHESTER, SOUTH‐EAST ENGLAND, AND THE ROMAN POOLE–PURBECK COMPLEX‐AGGLOMERATED GEOMATERIALS INDUSTRY
Authors: ALLEN J.R.L. , FULFORD M.G. , TODD J.A.
Published: April 2007

Summary.  A wide range of geomaterials were worked at industrial settlements scattered over an area of c.225 km2 in the Poole Harbour–Isle of Purbeck district of modern Dorset. These materials, more than one handled at some sites, included shale (‘coal’), burnt shales (yellow, red) and cementstones from the Kimmeridge Clay Formation (Upper Jurassic), Purbeck marble from the Purbeck Group (earliest Cretaceous), hard chalk from the Chalk Group (Upper Cretaceous), and potting clays and sands from the Bracklesham Group (Palaeogene), for South‐east Dorset Black‐burnished Pottery Category 1. There was also a salt industry, which could have used pottery for packaging. The industrial products are conterminously distributed in southern and central Britain and, in the case of pottery and shale items, reached as far as the northern frontiers. Raw material of red burnt shale was exported to Silchester (Calleva Atrebatum), where it was made into mosaic tesserae. Of proven Kimmeridgian age on the evidence of fossils, the mudstone used to make it had been collected and quarried on the coast of the Isle of Purbeck before being burnt. The decline in the demand for stone products, excepting shale, in the second century AD saw an expansion of the potting industry, which persisted into the fifth century. The term complex‐agglomerative is introduced to describe this diverse and dispersed enterprise at this highest hierarchical level, examples of which occur elsewhere in the Roman world.
Intra‐individual variation in sperm tail length in murine rodents
Authors: Breed W. G. , Bauer M. , Wade R. , Thitipramote N. , Suwajarat J. , Yelland L.
Published: April 2007

In eutherian mammals, there are marked interspecific differences in sperm head shape and tail length. In a few species, sperm head variability occurs but intra‐individual variation in sperm tail length has rarely been investigated or commented upon. Here, we ask the question: Do murine rodent species that have variable sperm head shapes exhibit greater intra‐individual variation in sperm midpiece and total tail lengths than closely related species where little, or no, sperm head variability occurs? From three separate lineages, we selected three pairs of murine rodents, one of which has monomorphic, and the other variable, sperm head shape. These were from southern Asia the bandicoot rats Bandicota bengalensis and Bandicota indica, from southern Africa the veld rats, Aethomys chrysophilus and Aethomys ineptus and from Australia the fawn hopping mouse Notomys cervinus and the spinifex hopping mouse Notomys alexis. Cauda epididymal sperm smears were prepared and sperm midpiece and total tail lengths were determined. A linear mixed‐effects model was used to estimate intra‐individual variance. The results showed that in all three species where there are variable sperm head shapes (B. indica, A. ineptus and N. alexis), statistically significantly greater intra‐individual variability of sperm midpiece and total tail lengths occurs (P<0.0001 in all cases). These species all have relatively smaller testes mass compared with the closely related species with monomorphic sperm populations. This suggests that depressed levels of intermale sperm competition may result in the occurrence of variability in not only the divergent sperm head shape but also in the length of the midpiece as well as that of the total length of the sperm tail.
Living with your food: geckos in termitaria of Cantão
Authors: Vitt L. J. , Shepard D. B. , Caldwell J. P. , Vieira G. H. C. , França F. G. R. , Colli G. R.
Published: April 2007

We tested three non‐exclusive hypotheses that the lizard, Gymnodactylus carvalhoi, lives in termitaria to avoid thermal extremes, to avoid predators, or because of an abundance of food (dietary specialist). We first confirm that these geckos are restricted to termitaria in the region studied. Body temperatures (Tb) of geckos averaged below environmental temperatures during day outside of termitaria and above outside temperatures at night; Tb averaged only slightly higher than temperatures inside termitaria. We conclude that thermal constraints in Cerrado habitats lacking rocks restrict Gymnodactylus to termite nests. High frequencies of tail loss and the presence of many potential predators within termitaria suggest high encounter rates with predators, indicating that predation pressure does not restrict these geckos to termite nests. Dietary data indicate that G. carvalhoi is a termite specialist. Published data indicate that other Gymnodactylus species and populations are also termite specialists, even though several live primarily outside termitaria (in crevices and under rocks). An evolutionary history of termite specialization and low thermal requirements in the clade (Gymnodactylus) predispose them to feed on termites within the termitaria.
Proportional Feedback Stimulation for Seizure Control in Rats
Authors: Colpan Mustafa Efkan , Li Yue , Dwyer Jennifer , Mogul David Jeffrey
Published: April 2007

Summary:  Purpose: A responsive electrical brain stimulation system using control feedback was investigated for the treatment of seizures.

Methods: A proportional feedback stimulation system was designed. Penicillin‐induced episodic seizures were created in rat primary motor cortex. Both intracranial (proximal to seizure focus) and extracranial EEGs were monitored. Current stimulation was applied at the seizure focus by using the intracranial EEG as the current‐stimulus template. Different gains (H) for determining feedback stimulus amplitudes were tested.

Results: The effect of feedback stimulation on seizures was initially assessed by measuring change in variance of the amplitude histogram of the intracranial EEG before and during stimulation. Mean reduction in amplitude variance during seizure activity was significant, with variance during stimulation progressively reduced as feedback gain was increased, indicating that overall suppression of seizure amplitude depended on H. Further increases in feedback gain typically produced saturating oscillations, indicating that this level of H resulted in instability. Frequency analysis of seizure and stimulation periods for each of the effective levels of H demonstrated close correlation across a large frequency domain, suggesting that the reduction in EEG seizure amplitude during feedback stimulation was possibly because of shunting of neuronal currents near electrodes as opposed to an alteration of neuronal dynamics. Although the frequency and energy responses during seizures before or during feedback stimulation remained well correlated in the delta band, this correlation progressively decreased across the theta, alpha, and beta bands.

Conclusions: These results demonstrate that proportional feedback stimulation holds the promise of suppressing seizure activity. More‐complicated control algorithms for generating feedback stimulation may provide further improvements in seizure suppression.
Insights into the structure of plant α‐type phospholipase D
Authors: Stumpe Susanne , König Stephan , Ulbrich‐Hofmann Renate
Published: April 2007

Phospholipases D play an important role in the regulation of cellular processes in plants and mammals. Moreover, they are an essential tool in the synthesis of phospholipids and phospholipid analogs. Knowledge of phospholipase D structures, however, is widely restricted to sequence data. The only known tertiary structure of a microbial phospholipase D cannot be generalized to eukaryotic phospholipases D. In this study, the isoenzyme form of phospholipase D from white cabbage (PLDα2), which is the most widely used plant phospholipase D in biocatalytic applications, has been characterized by small‐angle X‐ray scattering, UV‐absorption, CD and fluorescence spectroscopy to yield the first insights into its secondary and tertiary structure. The structural model derived from small‐angle X‐ray scattering measurements reveals a barrel‐shaped monomer with loosely structured tops. The far‐UV CD‐spectroscopic data indicate the presence of α‐helical as well as β‐structural elements, with the latter being dominant. The fluorescence and near‐UV CD spectra point to tight packing of the aromatic residues in the core of the protein. From the near‐UV CD signals and activity data as a function of the calcium ion concentration, two binding events characterized by dissociation constants in the ranges of 0.1 mmand 10–20 mmcan be confirmed. The stability of PLDα2 proved to be substantially reduced in the presence of calcium ions, with salt‐induced aggregation being the main reason for irreversible inactivation.
Globin gene family evolution and functional diversification in annelids
Authors: Bailly Xavier , Chabasse Christine , Hourdez Stéphane , Dewilde Sylvia , Martial Sophie , Moens Luc , Zal Franck
Published: April 2007

Globins are the most common type of oxygen‐binding protein in annelids. In this paper, we show that circulating intracellular globin (Alvinella pompejana and Glycera dibranchiata), noncirculating intracellular globin (Arenicola marina myoglobin) and extracellular globin from various annelids share a similar gene structure, with two conserved introns at canonical positions B12.2 and G7.0. Despite sequence divergence between intracellular and extracellular globins, these data strongly suggest that these three globin types are derived from a common ancestral globin‐like gene and evolved by duplication events leading to diversification of globin types and derived functions. A phylogenetic analysis shows a distinct evolutionary history of annelid extracellular hemoglobins with respect to intracellular annelid hemoglobins and mollusc and arthropod extracellular hemoglobins. In addition, dehaloperoxidase (DHP) from the annelid, Amphitrite ornata, surprisingly exhibits close phylogenetic relationships to some annelid intracellular globins. We have characterized the gene structure of A. ornata DHP to confirm assumptions about its homology with globins. It appears that it has the same intron position as in globin genes, suggesting a common ancestry with globins. In A. ornata, DHP may be a derived globin with an unusual enzymatic function.
A robust metallo‐oxidase from the hyperthermophilic bacterium Aquifex aeolicus
Authors: Fernandes André T. , Soares Cláudio M. , Pereira Manuela M. , Huber Robert , Grass Gregor , Martins Lígia O.
Published: April 2007

The gene, Aquifex aeolicus AAC07157.1, encoding a multicopper oxidase (McoA) and localized in the genome as part of a putative copper‐resistance determinant, has been cloned, over‐expressed in Escherichia coli and the recombinant enzyme purified to homogeneity. The purified enzyme shows spectroscopic and biochemical characteristics typical of the well‐characterized multicopper oxidase family of enzymes. McoA presents higher specificity (kcat/Km) for cuprous and ferrous ions than for aromatic substrates and is therefore designated as a metallo‐oxidase. Addition of copper is required for maximal catalytic efficiency. A comparative model structure of McoA has been constructed and a striking structural feature is the presence of a methionine‐rich region (residues 321–363), reminiscent of those found in copper homeostasis proteins. The kinetic properties of a mutant enzyme, McoAΔP321‐V363, deleted in the methionine‐rich region, provide evidence for the key role of this region in the modulation of the catalytic mechanism. McoA has an optimal temperature of 75 °C and presents remarkable heat stability at 80 and 90 °C, with activity lasting for up to 9 and 5 h, respectively. McoA probably contributes to copper and iron homeostasis in A. aeolicus.
Managing cardiovascular collapse in severe flecainide overdose without recourse to extracorporeal therapy
Authors: Devin Ruth , Garrett Peter , Anstey Chris
Published: April 2007

Flecainide overdose can rapidly result in profound cardiovascular collapse, and is associated with a relatively high mortality. A case is described where a woman with major toxicity and high serum levels was managed without recourse to invasive modalities such as cardiopulmonary bypass or extracorporeal therapies. Hypertonic sodium bicarbonate is recognized as effective therapy for hypotension and arrhythmias. More recent case reports have concentrated on the use of cardiopulmonary bypass. In this report and other reports describing successful resuscitation, the total dose of sodium bicarbonate is conspicuously higher than in reports describing extracorporeal interventions. Sodium bicarbonate should be given early in the resuscitation, and re‐administered as frequently as required, targeting an alkaline pH and improved cardiac output, while accepting hypernatraemia. This case demonstrates the maxim that the correct dose of hypertonic sodium bicarbonate is ‘enough’. Cardiopulmonary bypass support can be considered as a salvage therapy.
Practicality, safety and accuracy of computed tomography coronary angiography in the evaluation of low TIMI‐risk score chest pain patients: A pilot study
Authors: Soon Kean H , Kelly Anne‐Maree , Cox Nicholas , MacGregor Lachlan , Chaitowitz Ivan , Bell Kevin , Lim Yean
Published: April 2007

Objectives:  The present pilot study aimed to assess the practicality, safety and accuracy of performing CT coronary angiography (CT‐CA) in the evaluation of acute chest pain of patients with low thrombolysis in myocardial infarction (TIMI) risk scores.

Methods:  The present prospective observational study was undertaken in a university teaching hospital between November 2004 and December 2005. Participants were a convenience sample of patients admitted to hospital for investigation of chest pain with TIMI risk scores <3. Consenting patients underwent CT‐CA within 48 h of presentation. Outcomes of interest were practicality (proportion of diagnostic quality scans obtained and preparation time for CT‐CA), rate of serious adverse events, and accuracy at the patient level using selective coronary angiography as the reference standard.

Results:  Thirty‐four patients were recruited. Diagnostic quality scans were obtained in 26/34 or 76% of patients (four failed CT‐CA and four non‐diagnostic scans). The median CT preparation time was 1.9 h (range 0.17–4.0). No serious adverse events were found. Fourteen of those 26 patients with diagnostic CT‐CA subsequently had selective coronary angiography, of which nine were positive. The sensitivity and specificity of CT‐CA in identifying patients with significant coronary artery disease were 9/9 (100%; 95% confidence interval 72–100%) and 4/5 (80%; 95% confidence interval 28–100%), respectively.

Conclusions:  The majority of acute chest pain patients with low TIMI risk scores were successfully scanned with a 16‐slice CT to produce CT‐CA studies with good diagnostic quality and accuracy. No major adverse events were found. The place of CT‐CA in diagnostic workup for chest pain remains to be defined.
Uncommon cause of cardiac arrest in the emergency department
Authors: Clarke Benjamin , Ryan Glenn , Fraser John , Francis Leo
Published: April 2007

A previously healthy 48‐year‐old woman presented to a peripheral ED with non‐specific signs and symptoms, including vomiting, abdominal cramping, shortness of breath, tachycardia and hypertension. Despite supportive measures the patient rapidly deteriorated, resulting in a cardiac arrest during an interhospital transfer. This required aggressive resuscitation, but without success. The case represents a diagnostic dilemma in the ED regarding the diagnosis and initial management of the patient’s presentation.
Creep-Resistant, Al
2
O
3
-Forming Austenitic Stainless Steels
Authors: Yamamoto Y. , Brady M. P. , Lu Z. P. , Maziasz P. J. , Liu C. T. , Pint B. A. , More K. L. , Meyer H. M. , Payzant E. A.
Published: April 2007

A family of inexpensive, Al
2
O
3
-forming, high–creep strength austenitic stainless steels has been developed. The alloys are based on Fe-20Ni-14Cr-2.5Al weight percent, with strengthening achieved through nanodispersions of NbC. These alloys offer the potential to substantially increase the operating temperatures of structural components and can be used under the aggressive oxidizing conditions encountered in energy-conversion systems. Protective Al
2
O
3
scale formation was achieved with smaller amounts of aluminum in austenitic alloys than previously used, provided that the titanium and vanadium alloying additions frequently used for strengthening were eliminated. The smaller amounts of aluminum permitted stabilization of the austenitic matrix structure and made it possible to obtain excellent creep resistance. Creep-rupture lifetime exceeding 2000 hours at 750°C and 100 megapascals in air, and resistance to oxidation in air with 10% water vapor at 650° and 800°C, were demonstrated.
Gametes from Embryonic Stem Cells: A Cup Half Empty or Half Full?
Authors: Daley George Q.
Published: April 2007

When first reported 4 years ago, gametogenesis from embryonic stem (ES) cells promised an accessible in vitro model to facilitate molecular analysis of the germ lineage. Formation of primordial germ cells is robust, but terminal gametogenesis remains inefficient and doubts about gamete function persist. Although useful for research, clinical use of ES cell–derived gametes appears a distant prospect.
Raman-Assisted Crystallography Reveals End-On Peroxide Intermediates in a Nonheme Iron Enzyme
Authors: Katona Gergely , Carpentier Philippe , Nivière Vincent , Amara Patricia , Adam Virgile , Ohana Jérémy , Tsanov Nikolay , Bourgeois Dominique
Published: April 2007

Iron-peroxide intermediates are central in the reaction cycle of many iron-containing biomolecules. We trapped iron(III)-(hydro)peroxo species in crystals of superoxide reductase (SOR), a nonheme mononuclear iron enzyme that scavenges superoxide radicals. X-ray diffraction data at 1.95 angstrom resolution and Raman spectra recorded in crystallo revealed iron-(hydro)peroxo intermediates with the (hydro)peroxo group bound end-on. The dynamic SOR active site promotes the formation of transient hydrogen bond networks, which presumably assist the cleavage of the iron-oxygen bond in order to release the reaction product, hydrogen peroxide.
Identification of Genotypically Diverse
Cryptococcus neoformans
and
Cryptococcus gattii
Isolates by Luminex xMAP Technology
Authors: Bovers M. , Diaz M. R. , Hagen F. , Spanjaard L. , Duim B. , Visser C. E. , Hoogveld H. L. , Scharringa J. , Hoepelman I. M. , Fell J. W. , Boekhout T.
Published: April 2007

A Luminex suspension array, which had been developed for identification of
Cryptococcus neoformans
and
Cryptococcus gattii
isolates, was tested by genotyping a set of 58 mostly clinical isolates. All genotypes of
C. neoformans
and
C. gattii
were included. In addition, cerebrospinal fluid (CSF) obtained from patients with cryptococcal meningitis was used to investigate the feasibility of the technique for identification of the infecting strain. The suspension array correctly identified haploid isolates in all cases. Furthermore, hybrid isolates possessing two alleles of the Luminex probe region could be identified as hybrids. In CSF specimens, the genotype of the cryptococcal strains responsible for infection could be identified after optimization of the PCR conditions. However, further optimization of the DNA extraction protocol is needed to enhance the usability of the method in clinical practice.
Distinct Pathotypes of O113
Escherichia coli
Strains Isolated from Humans and Animals in Brazil
Authors: dos Santos L. F. , Gonçalves E. M. , Vaz T. M. I. , Irino K. , Guth B. E. C.
Published: April 2007

Two distinct diarrheagenic
Escherichia coli
pathotypes, enteroaggregative
E. coli
(EAEC) and Shiga toxin-producing
E. coli
, were observed in association with O113 strains isolated from human and nonhuman sources in Brazil, respectively. The O113 strains from human diarrhea belonged to a diversity of serotypes, and nine (53%) of them harbored virulence traits of typical EAEC.
Development of a Serological Assay Based on a Synthetic Peptide Selected from the VP0 Capsid Protein for Detection of Human Parechoviruses
Authors: Abed Yacine , Wolf Dana , Dagan Ron , Boivin Guy
Published: April 2007

A serological enzyme-linked immunosorbent assay was developed using a synthetic peptide from the VP0 protein of human parechoviruses (HPeVs). Seroprevalence for HPeVs was 70% in children of ≤5 years of age and 95% in adults. For children from whom serial sera were sampled, seropositivity increased from 22% to 88% between 2 and 24 months of age.
Microtubule-Mediated and Microtubule-Independent Transport of Adenovirus Type 5 in HEK293 Cells
Authors: Yea Carmen , Dembowy Joanna , Pacione Laura , Brown Martha
Published: April 2007

Adenovirus serotypes 2 and 5 are taken into cells by receptor-mediated endocytosis, and following release from endosomes, destabilized virions travel along microtubules to accumulate around the nucleus. The entry process culminates in delivery of the viral genome through nuclear pores. This model is based on studies with conventional cell lines, such as HeLa and HEp-2, but in HEK293 cells, which are routinely used in this laboratory because they are permissive for replication of multiple adenovirus serotypes, a different trafficking pattern has been observed. Nuclei of 293 cells have an irregular shape, with an indented region, and virions directly labeled with carboxyfluorescein accumulate in a cluster within that indented region. The clusters, which form in close proximity to the microtubule organizing center (MTOC) and to the Golgi apparatus, are remarkably stable; a fluorescent signal can be seen in the MTOC region up to 16 h postinfection. Furthermore, if cells are infected and then undergo mitosis after the cluster is formed, the signal is found at each spindle pole. Despite the sequestration of virions near the MTOC, 293 cells are no less sensitive than other cells to productive infection with adenovirus. Even though cluster formation depends on intact microtubules, infectivity is not compromised by disruption of microtubules with either nocodazole or colchicine, as determined by expression of an enhanced green fluorescent protein reporter gene inserted in the viral genome. These results indicate that virion clusters do not represent the infectious pathway and suggest an alternative route to the nucleus that does not depend on nocodazole-sensitive microtubules.
Hepatitis B Virus Translocates across a Trophoblastic Barrier
Authors: Bhat Purnima , Anderson David A.
Published: April 2007

Mother-infant transmission of hepatitis B virus (HBV) accounts for up to 30% of worldwide chronic infections. The mechanism and high-risk period of HBV transmission from mother to infant are unknown. Although largely prevented by neonatal vaccination, significant transmission continues to occur in high-risk populations. It is unclear whether HBV can traverse an intact epithelial barrier to infect a new host. Transplacental transmission of a number of viruses relies on transcytotic pathways across placental cells. We wished to determine whether infectious HBV can traverse a polarized trophoblast monolayer. We used a human placenta-derived cell line, BeWo, cultured on membranes as polarized monolayers, to model the maternal-fetal barrier. We assessed the effects of placental maturity and maternal immunoglobulin on viral transport. Intracellular viral trafficking pathways were investigated by confocal microscopy. Free HBV (and infectious duck hepatitis B virus) transcytosed across trophoblastic cells at a rate of 5% in 30 min. Viral transport occurred in microtubule-dependent endosomal vesicles. Additionally, confocal microscopy showed that the internalized virus traverses a monensin-sensitive endosomal compartment. Differentiation of the cytotrophoblasts to syncytiotrophoblasts resulted in a 25% reduction in viral transcytosis, suggesting that placental maturity may protect the fetus. Virus translocation was also reduced in the presence of HBV immunoglobulin. We show for the first time that transcytosis of infectious hepadnavirus can occur across a trophoblastic barrier early in gestation, with the risk of transmission being reduced by placental maturity and specific maternal antibody. This study suggests a mechanism by which mother-infant transmission may occur.
Murine Gammaherpesvirus 68 Contains Two Functional Lytic Origins of Replication
Authors: Adler Heiko , Steer Beatrix , Freimüller Klaus , Haas Jürgen
Published: April 2007

A 1.25-kbp DNA fragment from the right side of the genome containing the lytic origin of replication (oriLyt) of murine gammaherpesvirus 68 (MHV-68) has been identified by a plasmid replication assay. Here we show that a mutant MHV-68 with a deletion of an essential part of this oriLyt, generated by using an MHV-68 bacterial artificial chromosome, was only slightly attenuated and still able to replicate but that a mutant containing an additional deletion on the left side of the genome was replication deficient. The newly identified region was sufficient to support plasmid replication, thus providing evidence for a second oriLyt.
Molecular Behaviors of “CH1641-Like” Sheep Scrapie Isolates in Ovine Transgenic Mice (TgOvPrP4)
Authors: Baron Thierry , Biacabe Anne-Gaëlle
Published: April 2007

Molecular analyses of the protease-resistant prion protein (PrP
res
) from a few natural scrapie isolates showed by Western blotting some partial similarities with those observed in experimental ovine bovine spongiform encephalopathy (BSE). They showed a low apparent molecular mass of unglycosylated PrP
res
, although diglycosylated PrP
res
was less abundant than in ovine BSE. The prototype of such cases is the CH1641 experimental scrapie isolate. We analyzed PrP
res
molecular features from three French natural “CH1641-like” isolates, in comparison with CH1641 and BSE, after transmission of the disease in ovine transgenic mice (TgOvPrP4). One of these isolates (TR316211) behaved like the CH1641 isolate, with PrP
res
features in mice similar to those in the sheep brain. From two other isolates (O100 and O104), two distinct PrP
res
phenotypes were identified in mouse brains, with either high (h-type) or low (l-type) apparent molecular masses of unglycosylated PrP
res
, the latter being similar to that observed with CH1641, TR316211, or BSE. Both phenotypes could be found in variable proportions in the brains of the individual mice. In contrast with BSE, l-type PrP
res
from “CH1641-like” isolates showed lower levels of diglycosylated PrP
res
. From one of these cases (O104), a second passage in mice was performed for two mice with distinct PrP
res
profiles. This showed a partial selection of the l-type phenotype in mice infected with a mouse brain with predominant l-type PrP
res
, and it was accompanied by a significant increase in the proportions of the diglycosylated band. These results are discussed in relation to the diversity of scrapie and BSE strains.
Viral Translation Is Coupled to Transcription in Sindbis Virus-Infected Cells
Authors: Sanz Miguel A. , Castelló Alfredo , Carrasco Luis
Published: April 2007

During the late phase of Sindbis virus infection, the viral subgenomic mRNA is translated efficiently in BHK cells, whereas host protein synthesis is inhibited. However, transfection of in vitro-generated Sindbis virus subgenomic mRNA leads to efficient translation in uninfected BHK cells, whereas it is a poor substrate in infected cells. Therefore, the structure of the subgenomic mRNA itself is not sufficient to confer its translatability in infected cells. In this regard, translation of the subgenomic mRNA requires synthesis from the viral transcription machinery. The lack of translation of transfected viral mRNAs in infected cells is not due to their degradation nor is it a consequence of competition between viral transcripts and transfected mRNAs, because a replicon that cannot produce subgenomic mRNA also interferes with exogenous mRNA translation. Interestingly, subgenomic mRNA is translated more efficiently when it is transfected into uninfected cells than when it is transcribed from a transfected replicon. Finally, a similar behavior was observed for other RNA viruses, such as vesicular stomatitis virus and encephalomyocarditis virus. These findings support the notion that translation is coupled to transcription in cells infected with different animal viruses.
The challenge of cross-cultural collaborative research: lessons learnt from a pilot case–crossover study of severe occupational hand trauma in the People’s Republic of China
Authors: Jin Kezhi , Lombardi David A , Courtney Theodore K , Sorock Gary S , Perry Melissa J , Chen Hong , Wang Xin , Liang Youxin
Published: April 2007

Objective:A pilot epidemiologic study was conducted in the People’s Republic of China to assess the feasibility of applying the study protocol from a US case–crossover study on transient work-related exposures and the risk of an acute occupational hand injury.

Design:Injured workers were recruited from a hand surgery center in Ningbo, Zhejiang, People’s Republic of China. A structured face-to-face interview questionnaire was administered.

Results:156 workers with hand injury completed the study (73% men). The enrollment rate was 91%. Of those who refused participation, most indicated their reluctance was due to the requirement to sign the written consent form. Considerable variability was found among interviewers in ascertaining responses from participants to important exposure questions (21.3%v97%).

Conclusions:Recommendations include the following: (1) exploring effective oral-consent protocols that reduce participant concern and still meet human participant protection requirements; (2) using non-physician interviewers; and (3) increasing the intensity and standardization of interviewer training.
Non-fatal injuries among urban and rural residents: The National Health Interview Survey, 1997–2001
Authors: Tiesman Hope , Zwerling Craig , Peek-Asa Corinne , Sprince Nancy , Cavanaugh Joseph E
Published: April 2007

Objective:Although death rates from injuries are higher in rural areas compared with large metropolitan areas, little is known about how non-fatal injury rates vary by rurality. Data from the 1997–2001 US National Health Interview Surveys were used to explore associations between rurality and non-fatal injury.

Design:A nationally representative survey.

Methods:The annual injury rates per 1000 adults and 95% CIs were computed for medically attended injuries. Counties of residence were coded according to urban influence codes into four categories: large urban, small urban, suburban and rural. A linear-by-linear trend test was used to determine whether injury rates increase monotonically with county rurality. Logistic regression was used to control potential confounders.

Results:Compared with large urban counties, small urban counties experienced 8% higher injury odds (95% CI 1% to 15%); suburban counties 20% higher injury odds (95% CI 10% to 31%); and rural counties 30% higher injury odds (95% CI 17% to 43%) after adjusting for age, gender, marital status, education and health insurance.

Conclusions:Rural residents had higher non-fatal injury rates than urban and suburban residents. Exploring this discrepancy can further contribute to new hypotheses regarding rural injury risk and ultimately lead to better suited interventions for rural residents.