bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical efficacy and safety of oral terbinafine in fungal mycetoma
Authors: N'Diaye Bassirou , Dieng Mame T. , Perez Antonio , Stockmeyer Marlies , Bakshi Rajesh
Published: January 2006

Objectives  An open‐label study was performed to assess the efficacy and safety of terbinafine in the treatment of eumycetoma.

Methods  Single‐center, open‐label study, including 27 patients with signs and symptoms of eumycetoma which had developed within 5 years and was confirmed by mycological examination. The intention‐to‐treat population (n = 23) received 500 mg of terbinafine bid for 24–48 weeks.

Efficacy evaluations included clinical signs and symptoms (e.g. sinuses open or closed, degree of tumefaction, and emission of grains either present or absent); mycological examinations from Week 24 onwards; and investigators’ overall assessment of efficacy (cure, improved since baseline, unchanged since baseline, or deterioration since baseline). Safety evaluations included monitoring of adverse events, laboratory assessments, vital signs and physical examinations.

Results  Good clinical improvement was seen in patients who completed the study (n = 20). Tumefaction was absent or improved in 80% of patients; sinuses were closed in 50% of patients, and grain emissions were absent in 65% of patients. Of the 16 patients who had repeat mycological assessment, four (25%) were mycologically cured. In the investigators’ overall opinion at the end of the study, five (25%) were cured and 11 (55%) were clinically improved. The majority of adverse events reported were mild to moderate, and consistent with the known tolerability profile of terbinafine.

Conclusion  High‐dose terbinafine (1000 mg/day) is well tolerated and clinically effective in patients with eumycetoma, a difficult‐to‐treat subcutaneous mycoses.
Efficacy of autologous transplantation of noncultured epidermal suspension in two different dilutions in the treatment of vitiligo
Authors: Tegta Geeta R. , Parsad Davinder , Majumdar Subroto , Kumar Bhushan
Published: January 2006

Background  Previous reports have shown the effectiveness of a basal layer cell suspension in the treatment of stable vitiligo; however, there has been no mention in the literature until now of the optimal number of melanocytes required in an autologous noncultured epidermal suspension for transplantation to obtain early and acceptable results.

Methods  In this randomized prospective study, we compared the efficacy of two different dilutions to determine the optimum density of melanocytes required for transplantation to achieve early and cosmetically acceptable results. We enrolled 20 patients with stable vitiligo with a body surface area involvement of < 10%.

Results  Fifty per cent of patients in Group A (where the recipient area transplanted was approximately three times the size of the donor area, and the density of melanocytes transplanted per square millimeter was approximately 231.60 ± 27.03) showed marked (> 75%), 20% moderate, 10% mild, and 20% minimal repigmentation (or no response). In Group B (where the recipient area was increased to five‐fold the donor area), none of the patients showed marked, 10% showed moderate, 20% showed mild, and 70% showed either minimal or no repigmentation. The density of melanocytes transplanted in this group was 154.90 ± 27.65/mm2. The extent of repigmentation was significantly greater (P < 0.05) in Group A than in Group B, and the density of melanocytes in the suspension was also significantly greater (P < 0.01) in Group A than in Group B.

Conclusion  We contend that the minimum number of melanocytes required to produce satisfactory repigmentation is probably in the range of 210–250/mm2.
Primary cutaneous coccidiodomycosis: case report and review of the literature
Authors: Gildardo Jaramillo Moreno , Leobardo Velázquez Arenas , Nora Mendez Olvera , Jorge Ocampo Candiani
Published: January 2006

Background  Coccidiodomycosis is a systemic infection caused by Coccidioides immitis, a dimorphic fungus endemic in the south of the USA and the north of Mexico. The disease usually affects the lungs. Primary cutaneous infection is extremely rare. We present a report of a patient with primary cutaneous infection located on the nose. To our knowledge, such a presentation has never previously been reported in the literature.

Observations  The patient had a 3‐cm‐diameter elevated nodule with a verrucous aspect located on the tip of her nose. The histopathologic features of the lesion were consistent with coccidioidomycosis.

Conclusions  To our knowledge, this is the first report of primary cutaneous coccidioidomycosis located on the tip of nose.
Leg ulcer in a patient associated with hydroxyurea therapy
Authors: Dissemond Joachim , Hoeft Daniela , Knab Julia , Franckson Tom , Kroger Knut , Goos Manfred
Published: January 2006

Hydroxyurea is a hydroxylated derivate of urea commonly used in the treatment of various hematologic disorders. Cutaneous side‐effects such as alopecia, diffuse hyperpigmentation, scaling, poikiloderma, atrophy of the skin and subcutaneous tissues or nail changes can develop after long‐term treatment with hydroxyurea. Painful leg ulcers in association with hydroxyurea have only rarely been reported.

We present a report of a 52‐year‐old patient with essential thrombocythemia suffering from painful leg ulcers 3 years after starting therapy with hydroxyurea. We decided to treat the leg ulcers following a modern phase‐adapted wound‐healing strategy and continued hydroxyurea therapy until complete healing of the ulcers.

In conclusion, cutaneous ulceration of the leg is one adverse effect in patients with essential thrombocythemia during hydroxyurea therapy. Healing does not necessarily require discontinuation of the drug. Therefore, therapists should first optimize a conservative and systematic wound‐healing strategy. If these interventions fail, discontinuation of hydroxyurea therapy is advisable.
Cutaneous protothecosis: report of a third Brazilian case
Authors: Zaitz Clarisse , Godoy Andrea Miranda , Colucci Fabiana Márcia , De Sousa Valéria Maria , Ruiz Ligia Rangel B. , Masada Andréa S. , Nobre Márcia Valéria , Muller Helena , Muramatu Laura Hitomi , Arrigada Giovanna Letícia Hernandez , Heins‐Vaccari Elisabeth Maria , Martins José Eduardo Costa
Published: January 2006

The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a nonimmunocompromised Brazilian female. Dermatological examination revealed a 15‐cm diffusely infiltrated eczema‐like plaque recovered with many pustule‐like lesions on the right forearm. We emphasize the mycological and pathological aspects of this infection that can lead to misdiagnosis. The patient was successfully treated with itraconazole.
Leishmaniasis recidiva cutis due to Leishmania (Viannia) panamensis in subtropical Ecuador: isoenzymatic characterization
Authors: Calvopina Manuel , Uezato Hiroshi , Gomez Eduardo A. , Korenaga Masataka , Nonaka Shigeo , Hashiguchi Yoshihisa
Published: January 2006

Background  Information regarding leishmaniasis recidiva cutis (LRC), a clinical variant of cutaneous leishmaniasis, in the New World is scarce. LRC is characterized by slowly progressing lesion(s) that appear after a variable period of time, from months to years, in or around the scar of an apparently clinically healed sore.

Patients and methods  Six patients are reported who presented with crusted, papular lesions located on the edge of a healed scar, with a mean of 18.2 months of slowly progressive evolution. The isolated strains of Leishmania parasites were characterized by enzyme electrophoresis. Eleven enzyme systems were assayed. Skin biopsies from the active border of the lesions were taken for histopathology.

Results  Tissue sections showed a granulomatous, lymphohistiocytic, dermal infiltrate containing Langhans’ giant cells. The anamnestic data, together with the clinical and histopathologic findings, support the diagnosis of LRC. The isoenzyme profile of Leishmania parasites isolated from five of the six patients identified them as Leishmania (Viannia) panamensis.

Conclusions  These findings are the first reported evidence of LRC within the clinical spectrum of American tegumentary leishmaniasis in Ecuador, and of its causative agent. The existence of LRC has future implications for both disease treatment and vaccine development.
Neonatal eosinophilic pustulosis*
Authors: Asgari Maryam , Leiferman Kristin M. , Piepkorn Michael , Kuechle Melanie K.
Published: January 2006

A pre‐term, 7‐week‐old male infant presented with a recurrent pustular eruption involving his face and scalp with associated peripheral blood eosinophilia. Skin biopsy revealed spongiosis with numerous dermal and epidermal eosinophils without predominant follicular involvement. Immunohistology showed deposition of eosinophil granule major basic protein and eosinophil derived neurotoxin in the dermis and epidermis. He responded to conservative management. We discuss the differential diagnosis of neonatal eosinophilic pustular eruptions and suggest the term ‘neonatal eosinophilic pustulosis’ to best describe our case.
Eccrine porocarcinoma arising in two African American patients: distinct presentations both treated with Mohs micrographic surgery
Authors: Cowden Alissa , Dans Michael , Militello Giuseppe , Junkins‐Hopkins Jacqueline , Van Voorhees Abby S.
Published: January 2006

Background  Eccrine porocarcinoma (EPC) is a rare, malignant adnexal tumor that has been reported only three times specifically in African American individuals. Diagnosis and treatment of EPC is important, given the 20% local recurrence and regional metastatic rates. However, no standard of care has been developed to guide effective treatment.

Methods  We report two distinct clinical presentations of EPC, both in African Americans, and discuss a review of the literature.

Results  The neoplasms were successfully removed from both patients by Mohs micrographic surgery.

Conclusions  These two cases illustrate that EPC can have a variety of presentations and can occur in African Americans. Although there is no standard of care for treating EPC, Mohs is becoming a common technique of removing these lesions.
Clinical features of Behçet's disease in children
Authors: Borlu Murat , Ukşal Ümit , Ferahbaş Ayten , Evereklioglu Cem
Published: January 2006

Background  Behçet's disease (BD) is a systemic inflammatory vasculitis of young adults with unknown etiology.

Objective  The aim of this study was to determine the clinical features and outcome of BD in childhood.

Patients and methods  Seventeen patients with BD within a pediatric age group were studied since 1997.

Results  Boys : girls ratio was 12:5. Familial cases were very frequent (45%). Oral aphthous ulcers were present in all patients (100%), genital aphthous ulcers were present in 16 (94%), ocular lesions in 4 (24%), erythema nodosum in 3 (18%), papulopustules in 8 (47%), joint symptoms in 13 (76%), mild gastrointestinal symptoms in 2 (12%), neurological involvement in 2 (12%), positive pathergy reactions in 13 (76%), and thrombophlebitis in 1 (6%). We used colchicine, systemic corticosteroids, cyclosporine, nonsteroidal anti‐inflammatory drugs, sulfasalazine, and topical agents for the treatment of children with BD.

Conclusion  The findings of BD in children are similar as in adults, but the frequency of familial cases is significantly higher.
Diagnostic accuracy in skin cancer clinics: the Australian experience
Authors: Moffatt Cameron R. M. , Green Adèle C. , Whiteman David C.
Published: January 2006

Background  Australia, with the world's highest incidence of skin cancer, has witnessed the emergence of “open access” skin cancer clinics during the past decade. These clinics are becoming increasingly popular destinations for the diagnosis and treatment of skin cancers, yet little is known about the diagnostic performance of practitioners in this setting. We sought to measure the accuracy of clinical diagnosis in this setting.

Methods  Clinical and histological data were obtained from 199 consecutive patients undergoing biopsy or excision for 287 skin lesions. We measured the sensitivity, specificity and predictive value of the clinical diagnoses compared with histological diagnoses.

Results  Of 287 biopsied or excised lesions, the most common were benign nevi (24%) and basal cell carcinomas (22%), followed by actinic keratoses (11%), dysplastic nevi (11%) and squamous cell carcinomas (7%). Sensitivity was highest for diagnosing BCC (0.89, 95%CI 0.78–0.95) and dysplastic nevi (0.80, 95%CI 0.61–0.93), and lowest for actinic keratoses and the group of benign lesions. Specificity was greater than 0.93 for all diagnoses except BCC (0.76, 95%CI 0.70–0.81). Treating clinicians perceived moderate to strong pressure to excise 49% of lesions overall, but in particular for benign nevi (73%).

Conclusions  Australian family practitioners in open access skin cancer clinics diagnose a wide range of skin lesions with high specificity and moderate to high sensitivity. Benign nevi are accurately diagnosed and often excised because of patient pressure.
Genital lymphangioma with recurrent cellulitis in men
Authors: Swanson David L.
Published: January 2006

Background  Lymphangioma circumscriptum rarely occurs on the penis. This report describes a patient observed in private practice who presented with recurrent unexplained cellulitis of the penis for whom this diagnosis was not initially apparent.

Methods  Diagnosis of lymphangioma in this patient resulted in a retrospective records review of the Mayo Clinic experience with patients who had genital lymphangioma and cellulitis.

Results  Six other male patients with recurrent cellulitis complicating genital lymphangioma were identified. Five of these six patients were managed with antibiotic prophylaxis.

Conclusions  Compromised lymphatic drainage should be suspected in male patients with otherwise unexplained penile swelling or cellulitis. These patients usually require long‐term antibiotic prophylaxis for recurrent infection.
Nehushtan: the pressing need
Authors: Goihman‐Yahr Mauricio
Published: January 2006

Nehushtan was a bronze serpent that cured those bitten by snakes, made by Moses during the Exodus. Nevertheless, centuries later, King Hezekiah had it destroyed because it had become an object of idol worship. This striking contrast led us to choose this name to illustrate issues germane to medicine and dermatology, which are not necessarily straightforward. They require special analysis to be fully grasped. To explain, we have begun with a biblical, historical, or literary selection from which we build a point of view. The following is an example of this technique.
A bibliometric study of dermatology in central Europe 1991–2002
Authors: Jemec Gregor B. E. , Nybæk Hanne
Published: January 2006

Background  Bibliometric studies have gained interest in recent years, although most analyses are limited to simple use of average citations rates for journals, also known as the “impact factor”. Central Europe has a long tradition of dermatological research which has been negatively impacted by general political developments for a long period. This study was undertaken in order to describe the progress made in recent years.

Methods  The study was conducted in two parts: First the annualised national output for the period 1991–2002 was identified for each country by MEDLINE® searches. In the second part of the study a sample was drawn from the papers identified in the first part and the number of citations for each paper noted.

Results  The annualised national output showed great variation between countries and from year to year. The mean citation rates were found to vary between 0–5 citations/year, and some underlying publications were 10 years old. Countries with national indexed journals appear to hold a bibliometric advantage over countries without indexed journals.

Conclusions  Throughout the last decade of the 20th century the number of publications has grown with an average of 21.7% per year, and publication rates have only suffered in countries directly involved in war or similar disturbances. The mean citation rates were low, with a varying age of the underlying publications. Some cited publications were however old suggesting a persistent relevance. A national or regional indexed journal appears to confer a bibliometric advantage.
The evolution of family interventions for schizophrenia. A tribute to Gianfranco Cecchin
Authors: Bertrando Paolo
Published: January 2006

Family intervention for schizophrenia has informed the whole history of family therapy, although in different fashions. This presentation will deal with the main phases of such intervention, outlining the characteristic features of each one. We can roughly divide the history of family intervention for schizophrenia into four phases: Phase 1 – Conjoint family therapy (1955–1965). Family interventions were aimed at modifying family communication patterns, implying the possibility of a definitive resolution of psychopathology. Phase 2 – Antipsychiatry (1965–1975). This, rather than a treatment model, was a philosophy of psychiatry, which considered schizophrenia as an epiphenomenon of the distortions of Western society. Family treatment was aimed at promoting the awareness of such a dynamic. Phase 3 – Milan systemic therapy (1975–1985). The systemic model was aimed at helping people with schizophrenia to recognize their position within their families (and other significant systems), giving all family members a new sense of their relationships to each other. Phase 4 – Psychoeducation (1985–2005). In most psychoeducational models, schizophrenia was conceived of as a biologically determined disorder. Psychoeducation was a way of helping the not diagnosed family members to cope with problems brought about by the illness, eliciting consensus towards psychiatric treatments such as medication and rehabilitation. A fifth phase of family intervention for schizophrenia is probably developing right now. If this is happening it should probably be an integrative phase, in which different approaches to family dynamics might be bridged and blended, in order to give more effective help to all members of families with schizophrenia.
Training and disseminating family interventions for schizophrenia: developing family intervention skills with multi‐disciplinary groups
Authors: Fadden Gráinne
Published: January 2006

Family interventions for psychosis are not routinely available, in spite of a robust evidence base, clear policies and guidelines, and requests from service recipients. The reasons for this are complex involving three key groups: service recipients, clinicians and organizations. This paper first of all identifies barriers to implementation in relation to each of these groups. It then outlines a range of strategies that may be employed at a number of levels to bring about change in each of these systems. The strategies are drawn from current research in the area, and from experiences over a seven‐year period in the Meriden West Midlands Family Programme.
Psychosis and multiple family group therapy
Authors: Asen Eia , Schuff Heiner
Published: January 2006

Despite the growing evidence base for the effectiveness of family intervention in the treatment of individuals suffering from a psychotic disorder, in practice only relatively few mental health teams use family approaches when treating and managing those with schizophrenia or other psychoses. This paper describes a pragmatic model, which may be used in addition to other ongoing treatments, such as medication, CBT or single family therapy. It was developed jointly by clinicians and service users over the past few years. It consists of regular multiple family group work, with six to eight families attending simultaneously, and aims to involve families directly in the treatment, rehabilitation and recovery of their members suffering from psychotic disorder.
Family interventions in schizophrenia: evidence for efficacy and proposed mechanisms of change
Authors: Kuipers Elizabeth
Published: January 2006

Family intervention for psychosis developed from empirical work on the role of emotion in families of those caring for someone with schizophrenia. The level of expressed emotion (EE) has been shown to be a robust predictor of subsequent outcome for service users returning to live in family settings. There is also evidence that staff have similar attitudes. This has led to the development of specific family interventions for schizophrenia. NICE Guidelines for Schizophrenia (2003) confirm that family intervention is effective at reducing service user relapse rates and recommends it for those in contact with carers. Exactly how family intervention improves outcome is less clear. A recent model of psychosis proposes a primarily emotional rather than cognitive route for family factors, and some evidence is presented which supports this. Implications for family interventions are discussed.
The Economics of Child Custody
Authors: RASUL IMRAN
Published: January 2006

I develop a model of marriage in which spouses decide on investments in child quality during marriage, and on the allocation of child custody should they divorce. The custodial allocation determines the share of the marital surplus each spouse appropriates, which in turn influences spouses' investment incentives. The custodial allocation therefore has both distributional and efficiency consequences. I derive the equilibrium investments and optimal custodial allocation, and identify three channels through which making divorce easier affects child welfare: investments in child quality during marriage, the likelihood of divorce, and the allocation of custody if divorce occurs.
A Simple Test of Friedman's Permanent Income Hypothesis
Authors: DEJUAN JOSEPH P. , SEATER JOHN J.
Published: January 2006

Friedman's Permanent Income Hypothesis (PIH) predicts that the income elasticity of consumption should be higher for households for which a large fraction of the variation of their income is permanent than for households facing more transitory variations in income. We test this prediction using modern household data from the US Consumer Expenditure Survey. The results offer some support for the PIH.
Estimating Workers' Marginal Willingness to Pay for Safety using Linked Employer–Employee Data
Authors: DALE‐OLSEN HARALD
Published: January 2006

In this study, Norwegian linked employer–employee panel data covering 1994–96 are used to estimate workers' marginal willingness to pay (MWP) for safety, thus providing unique comparisons between estimates of MWPs from hedonic wage, quit and job duration models. Hedonic wage regressions show that higher injury hazards imply higher wages. Quit and duration regressions show that higher injury hazards imply higher job exit probabilities, while higher wages reduce the job exit probabilities. Differences in the estimated MWP figures indicate that search frictions cause sizeable bias in MWP figures from hedonic wage models, and that MWP issues should be addressed from a dynamic perspective.
Large aberrant Mongolian spots coexisting with cutis marmorata telangiectatica congenita (phacomatosis pigmentovascularis type V or phacomatosis cesiomarmorata)
Authors: Torrelo A , Zambrano A , Happle R
Published: January 2006

A 1‐month‐old boy showed cutis marmorata telangiectatica congenita (CMTC) involving a block‐like pattern on his left leg and thigh and on the left side of his trunk, along with bilateral greyish‐blue hyperpigmentation involving the buttocks and thighs and being in part intermingled with CMTC. This association of CMTC with Mongolian spots has been reported as a distinct type of phacomatosis pigmentovascularis (PPV), namely PPV type V. More recently, the term phacomatosis cesiomarmorata (cesius = blue) has been proposed. We believe phacomatosis cesiomarmorata is another example of twin spotting or didymosis.
High‐resolution epiluminescence colorimetry of striae distensae
Authors: Hermanns J‐F , Piérard GE
Published: January 2006

Background  Colours of striae distensae are often different from that of the surrounding skin. A close look using dermoscopy discloses distinct patterns of melanized networks at these sites. The aim of the study was to design a method of high‐∖resolution analytical analysis of the skin colours using the combination of photographic dermoscopy and small field reflectance colorimetry.

Methods  Clinical photographs were taken from striae distensae and their surrounding skin using a Dermaphot® (Heine Optotechnik, Hersching, Germany). A final magnification of 125× was obtained on paper photographs. The reflectance colorimeter Visi‐Chroma VC‐100 (Biophotonics, Lessines, Belgium) was used to measure colours of the pigmentary networks in the L*a*b* system. Differential colour parameters (ΔE*ab, ΔL*, Δa*, Δb*) were calculated for each case between the lesional and the surrounding normal skin, and between the melanized reticulated pattern and the enclosed lighter areas.

Results  Objective colorimetric assessments distinguished four distinct types, namely striae albae, striae rubrae, striae caeruleae and striae nigrae. The latter peculiar hyperpigmented type of striae distensae was specifically identified by epiluminescence examination in dark‐skinned subjects. The fine‐melanized honeycomb network present on the adjacent intact skin was reshaped inside striae in a streaky pattern perpendicular to the striae axis. Strong linear correlations were found between all combinations of ΔL* and Δb* evaluating colours of the reticulated and the honeycomb alveolar patterns both inside and outside the striae distensae. By contrast, no correlations were found between Δa* and the other colorimetric parameters.

Conclusion  The direct and/or indirect influences of melanocyte mechanobiology appear to have a prominent effect on the various colours of striae distensae.
Matting of hair: what is the role of conditioners?
Authors: Rigopoulos D , Kontochristopoulos G , Kalogirou O , Gregoriou S , Katsambas A
Published: January 2006

Matting of the hair is a very rare and multifactorial condition affecting usually women. We present three female patients with matting of the hair as a result of the shampoo used. In all three cases, cutting of the affected hair was unavoidable.
A set of microsatellite markers for Heliconius melpomene and closely related species
Authors: MAVÁREZ J. , GONZÁLEZ M.
Published: January 2006

The butterflies in the genus Heliconius offer an exceptional opportunity for the study of the ecology and genetics of an adaptive radiation due to their extensive intra‐ and interspecific variation in wing colour patterns and mimetic associations. Here, we characterize 22 polymorphic microsatellite loci in Heliconius melpomene that have been shown to be useful for linkage mapping and population studies in this and other species. Levels of variation were high, although heterozygosity deficiencies were found in most loci, probably due to null alleles. The loci showed broad amplification success on six other species across the genus.
Being seen by others as we see ourselves: the congruence between the ingroup and outgroup perceptions of health and social care students
Authors: Hean Sarah , Clark Jill Macleod , Adams Kim , Humphris Debra , Lathlean Judith
Published: January 2006

This article examines intergroup processes amongst neophyte health and social care students who are about to embark on an interprofessional education (IPE) programme. Positive relationships between students of the different professions must be optimized to promote student learning of each other, a central objective of these courses. It has been proposed that to reduce conflict and promote harmonious intergroup relations during this IPE activity, students from each professional group should feel their own group (the ingroup) to be distinctive from other professional groups (the outgroup) on some key characteristics (intergroup differentiation). Good relations are further promoted if the characteristics they see as distinctive to their identities are also recognized as distinctive by other professional groups (mutual intergroup differentiation). The current article considers the incidence of these two factors in neophyte health and social care students and identifies sources of potential intergroup conflict. The findings of the study suggest that all groups of neophyte health and social care students perceived their ingroup as distinct from other professional groups, with the exception of audiology students. The implications of this finding to the relationships between students participating in IPE are discussed. Furthermore, in certain groups there was evidence that students of these groups were seen by others as they saw themselves. This was particularly the case for doctors and social workers and implies that these professions will suffer least from a threat to their group distinctiveness. However, there were instances where characteristics, seen as distinctive by the professional group itself, were not recognized by other groups. For example, physiotherapy students believe that being a team player, and decision making and practical skills were all distinctive characteristics of their profession. However, these features were not recognized as distinctive by other professional groups. The implications of matches/mismatches in how students see themselves, and how they may be viewed by others, are discussed in terms of their impact on student learning experiences and relationships during IPE.
Self‐assessment as a strategy to provoke integrative learning within a professional degree programme
Authors: Fitzpatrick Jane
Published: January 2006

Self‐assessment is advocated as a means of encouraging learners to develop critical thinking skills. This article examines how self‐assessment has been used within a community nursing programme to provoke learners’ integration of personal and professional development and thus extend their critical perspectives on their developing practice. The article explores how self‐assessment, combined with a culture of reflective dialogue within learner‐led discussion groups, enhances learners’ emotional engagement with learning. It suggests that self‐assessment, used as the focus of interactive learning experiences, can provoke integrative learning within a professional degree programme. By legitimately bringing personal and professional knowledge and skills acquisition to the fore, learners engage in challenging reflective dialogue with tutors, peers and mentors in practice. The article argues that this provides a pivot for transformative learning. This report draws on the evaluation of the self‐assessment strategy within a community nursing programme to illuminate the discussion. The evaluation draws on Joyes’ model of evaluation to include a review of both the process of, and stakeholder perspectives on, the development and implementation of the initiative. The community nursing case study suggests that self‐assessment can help harness emotion to benefit learning.
‘Sy excellente pasture’: Guillaume Briçonnet's mysticism and the Pseudo‐Dionysius
Authors: Corrie Cathleen Eva
Published: January 2006

In order to understand the theology of reformists like Guillaume Briçonnet, bishop of Meaux and central figure in early 16th‐century French ecclesiastical circles, one must concentrate on Briçonnet's relationship to mysticism. Briçonnet's theology comes in the main from his study of Pseudo‐Dionysius, and thus concentrates on a mystical understanding of Christianity and the Christian's path toward God. By looking also at Briçonnet's interest in the reinvigoration of Scripture and Hebrew mysticism, one can understand Briçonnet's theology as both reformist and in keeping with medieval tradition.
Pawns of international finance and politics: Florentine sculptors at the court of Henry VIII
Authors: Sicca Cinzia Maria
Published: January 2006

The aim of this paper is to place the projected tomb of Henry VIII and Catherine of Aragon within a wider context of events that are specifically of a political and economic nature. The artists are at once pawns in the hands of diplomats and financiers motivated by their inner rationale, as well as actors in their own right, discovering in a somewhat tentative way that, though not entirely free from the system of patronage of either institutions or princely families, they could jostle for position on the international stage, relying almost entirely on their own enterprising skills. The episode of the tomb, far from being a footnote in the history of the competition between Michelangelo and Bandinelli, offers an unusual insight into the workings of Medici patronage at a very delicate time in the history of both Leo X and Cardinal Giulio de’ Medici. The favour accorded to Baccio Bandinelli precluded, during Leo's lifetime, the possibility that any other sculptor would be offered even a chance of being a candidate for this commission. The death of the pontiff left the Cardinal not only in a political quandary but also in dire financial straits. Yet the support and loyalty of the English monarch were crucial to Giulio de’ Medici's success in his own endeavours to ascend the papal throne and, perhaps more importantly, to preserve Medici control over Florence. The trusted members of the Medici entourage representing both Florence and the family's interests at the court of Henry VIII, prevented the tomb project from dying altogether. The involvement of Giovanni Cavalcanti and his business partners Pierfrancesco de’ Bardi and Zanobi Girolami, as well as that of Giovanni Gaddi, was financial since each partner bought stakes in the models prepared by a number of artists, but at the same time aesthetic judgement had to be exercised by one if not all the investors in selecting the authors of the models sent to London in 1521–1523. This opened the way for sculptors who had previously suffered from Bandinelli's overbearing dominance: namely Baccio da Montelupo, and Jacopo Sansovino.
Artificial Matrix Helps Neonatal Cardiomyocytes Restore Injured Myocardium in Rats
Authors: Zhang Pingchuan , Zhang Hao , Wang Hao , Wei Yingjie , Hu Shengshou
Published: January 2006

Abstract:  The purpose of this study was to investigate whether an artificial matrix can help neonatal cardiomyocytes restore an injured heart in a rat model of myocardial infarction (MI). The left coronary arteries of female Sprague Dawley (SD) rats were ligated to create MI models. Ventricular cardiomyocytes from 1‐ to 3‐day‐old SD rats (both sexes) were isolated, cultured, and labeled. Three weeks after MI, the animals were randomized into four groups: (i) group cell plus matrix (n = 12); (ii) group cell (n = 12); (iii) group matrix (n = 12); and (iv) group control (n = 11). Four weeks after transplantation, echocardiography and the Langerdoff model were used to assess heart function. Immunohistochemical staining and polymerase chain reaction (PCR) were performed to track the implanted cardiomyocytes and detect the sex‐determining region Y gene on the Y chromosome. Histology study and PCR showed that transplanted cardiomyocytes survived, formed condensed tissue, and produced connected protein in group cell plus matrix. Heart function assessment indicated transplantation of cardiomyocytes plus matrix preserved left ventricle wall thickness, fraction shortening, and end‐systolic internal diameter most effectively.
In Vivo Experimental Testing of a Microaxial Blood Pump for Right Ventricular Support
Authors: Christiansen Stefan , Perez‐Bouza Alberto , Reul Helmut , Autschbach Rüdiger
Published: January 2006

Abstract:  The incidence of isolated right ventricular (RV) failure is rare in postcardiotomy patients, but high in patients undergoing implantation of a left ventricular assist device or cardiac transplantation. Therefore, we have developed a new microaxial flow device and report on our first in vivo animal trials. Six healthy adult female sheep weighing 80–90 kg underwent implantation of the microaxial blood pump for partial unloading of the right ventricle. This pump is a miniaturized rotary blood pump with a diameter of only 6.4 mm and a weight of 11 g. The inner volume of the pump is limited to 12 mL, and the inner artificial blood contacting surface is 65 cm2. The pump consists of a rotor driven by an incorporated brushless direct current motor, the housing of the rotor, the inflow cage, the outflow cannula, and the driveline. At the maximum speed of 32 500 rotations/min, a flow of 6 L/min can be delivered. The inflow and outflow conduit were anastomosed to the right atrium and the main pulmonary artery, respectively. Hemodynamic and echocardiographic data as well as blood samples were measured over the whole test period of 7 days. The hearts and lungs as well as the pump were explanted for a thorough examination at the end of the trial. Systemic arterial blood pressures remained unchanged during the entire test period. RV cardiac output was diminished significantly as demonstrated by the echocardiographic studies. The number of platelets decreased perioperatively, but recovered within the test period. The free hemoglobin was not enhanced postoperatively indicating no significant hemolysis. Liver function was only slightly impaired due to operative reasons (increase in bilirubin on the first postoperative day but normalization within the test period). The pathologic examination revealed some clots at the inflow cage and fibrin depositions on the impeller as well as on the inner surface of the outflow graft without an impairment of pump function. Our results demonstrate that this newly developed microaxial blood pump is a promising device for RV support, but it cannot be driven without any anticoagulation.
Activation of Coagulation During Hemodialysis: Effect of Blood Lines Alone and Whole Extracorporeal Circuit
Authors: Lucchi Leonardo , Ligabue Giulia , Marietta Marco , Delnevo Annalisa , Malagoli Marcello , Perrone Salvatore , Stipo Lucia , Grandi Fabio , Albertazzi Alberto
Published: January 2006

Abstract:  Activation of coagulation during hemodialysis (HD) is a relevant clinical problem, especially when patients at risk of bleeding are treated. However, little is known about the relative contribution of the various components of the circuit to the thrombotic process. Thus, an experimental model was developed that is aimed at evaluating biochemical markers of coagulation activation at different times and sites throughout the HD circuit. A HD blood‐tubing set with integrated arterial and venous chambers (cartridge‐line set) was used, which was added with the following sampling points: at the beginning of the arterial line (P1), before the blood pump (P2), after the blood pump (P3), and at the end of the venous line (P4). A bypass system allowed us to circulate the blood only into the blood lines for the first 20 min of the extracorporeal circulation. The extracorporeal circuit was rinsed with 1.7 L of heparinized saline (2500 IU/L) that was completely discarded before patient connection. A continuous administration of unfractionated heparin (500–800 IU/h) without a starting bolus was adopted as a low heparin extracorporeal treatment. Samples were collected before the start of the extracorporeal circulation from the fistula needle (T0P0), after 5 (T1), 10 (T2), and 20 min (T3) from P1, P2, P3, and P4. After 20 min, the blood was returned to the patient using only saline and HD was then started, circulating the blood through the dialyzer. Further samples were obtained from P1 and P4 after 5 (T4) and 210 min (T5). Plasma levels of coagulation activation markers—thrombin–antithrombin complex (TAT) and prothrombin fragment 1 + 2 (F1 + 2)—were evaluated in all the samples in 12 stable HD patients. In each patient, the activated partial thromboplastin time (APTT) was measured at T0P0 and T1–T5 from P1. No significant changes were found at any time as far as F1 + 2 is concerned. However, TAT levels increased over time only after the start of HD, suggesting that the latter test could be more useful in order to detect coagulation activation during HD. The same experiments performed with nonheparin‐primed extracorporeal circuit showed similar results. The blood lines used did not significantly activate coagulation during the first 20 min, whereas only 5 min of blood circulation throughout the whole circuit increased TAT values, which still remained lower than previous reports, even after 210 min of treatment.
Clearance Studies During Subsequent Sessions of Double Filtration Plasmapheresis
Authors: Yeh Jiann‐Horng , Chen Wei‐Hung , Chiu Hou‐Chang , Bai Chyi‐Huey
Published: January 2006

Abstract:  To evaluate the optimal session of double filtration plasmapheresis (DFP) in terms of the maximal clearance rates for various serum substances, the laboratory parameters of 152 consecutive patients treated with different sessions of DFP following a standard protocol on an alternate‐day basis was studied. Immunoglobulin M (IgM) and lipoprotein cholesterol had the most effective clearance by a minimum of two sessions of DFP treatment, and the clearance rates remained relatively constant despite the increase in the number of treatment sessions, while the clearance rates for other serum proteins increased steadily with further treatments. Using the clearance rate of the 2‐session group as reference, the highest slopes for clearance of albumin, globulin, and triglyceride were found in the 4‐session group, while the slopes for IgA and IgG were highest in the 5‐session group. In conclusion, for the clearance of IgM and lipoprotein cholesterol, two sessions of DFP treatment are adequate. However, the best clearance of IgG and other globulins cannot be achieved until the fourth session of DFP treatment. Therefore, a minimum of 4 sessions of DFP treatment at 2‐day intervals is needed for most immunological diseases.
Tissue Engineering Approach to the Treatment of Bone Tumors: Three Cases of Cultured Bone Grafts Derived From Patients’ Mesenchymal Stem Cells
Authors: Morishita Toru , Honoki Kanya , Ohgushi Hajime , Kotobuki Noriko , Matsushima Asako , Takakura Yoshinori
Published: January 2006

Abstract:  A novel approach to the treatment of bone tumors using tissue‐engineered implants is reported in this study. The number of mesenchymal stem cells (MSCs) obtained from each patient's bone marrow cells was first increased, and the MSCs were forced to differentiate into osteoblasts followed by bone matrix formation on hydroxyapatite (HA) ceramics. The strong osteogenic ability of the implants, as evidenced by high osteoblastic activity, was confirmed. Consequently, the HA surface was covered with the patient's derived cultured osteoblast/bone matrix. The tissue‐engineered HA was used to fill the patient's bone cavity after tumor curettage. Immediate healing potential was found by serial plain radiographs and computed tomograhy images, and no adverse reactions were noted in these patients. The results indicate that tissue‐engineered osteogenic ceramics might be an alternative to autologous bone grafts.
Vasoconstrictor Administration During Cardiopulmonary Bypass Affects Acid–Base Balance in Infants and Children
Authors: Sato Koichi , Watanabe Hiroshi , Sogawa Masakazu , Takahashi Masashi , Namura Osamu , Takekubo Masaru , Hayashi Jun‐ichi
Published: January 2006

Abstract:  Background: In experimental reports, blood flow redistribution occurred during cardiopulmonary bypass (CPB) and perfusion pressure was restored by vasoconstrictor administration without improving splanchnic perfusion. The influence of vasoconstrictor administration during CPB was clinically examined.

Materials and Methods: Twenty‐two consecutive pediatric CPB cases of ventricular septal defect without blood transfusion were divided into two groups, depending upon whether a vasoconstrictor was administered during CPB or not (n = 7 vs. 15). Bypass flow and systemic perfusion pressure during CPB were maintained at 2.5 L/m2/min and not lower than 30 mm Hg by vasoconstrictor administration, respectively.

Results: Although preoperative state and CPB conditions were comparable between the two groups, more sodium bicarbonate was administered (P < 0.05); duration from the operation to extubation was longer (P < 0.05); and bowel movement occurred later in the vasoconstrictor‐administered group than in the control group. Conclusions: Vasoconstrictor administration during CPB may deteriorate the acid–base balance and the postoperative state in infants and children.
MOLECULAR PHYLOGENY OF SELECTED MEMBERS OF THE ORDER THALASSIOSIRALES (BACILLARIOPHYTA) AND EVOLUTION OF THE FULTOPORTULA1
Authors: Kaczmarska Irena , Beaton Margaret , Benoit Anita C. , Medlin Linda K.
Published: January 2006

Recent phylogenetic studies of the diatoms indicate that members of the order Thalassiosirales occupy an interesting position in the diatom evolutionary tree. Despite their radial morphology and scaly auxospores, they are consistently recovered in molecular analyses as a member of subdivision Bacillariophytina and a sister clade to non‐fultoportulate and non‐radial lithodesmioids. This study included 46 species from nine traditionally accepted extant genera, and analyzed 43 nuclear small subunit (SSU) rRNA sequences in parallel with a survey of the variation in fultoportula structure. Three possible scenarios leading to the evolution of the fultoportula are discussed in the context of molecular and morphological similarities between the examined Thalassiosirales and their SSU rRNA sister clade Lithodesmiales. We speculate that the fultoportula might be derived by a modification of either a cribrum in an areola (fultoportula within an areola), or structures similar to marginal ridges now seen in lithodesmioids around a cluster of poroids (fultoportula in a tube), or finally, that the central fultoportula may have an origin different from the marginal fultoportulae. Our data confirm that fultoportula‐bearing diatoms constitute a natural phylogenetic group. The families Thalassiosiraceae, Skeletonemaceae, and Stephanodiscaceae and the genus Thalassiosira Cleve were unexpectedly found to be paraphyletic. Further, Cyclotella Kutz. and Stephanodiscus Ehr. may not be closely related and some species of these genera are more closely allied to other species of Thalassiosira. The generitype, T. nordenskioeldii, is embedded within a large poorly structured cluster of species that includes several members of Thalassiosira, Planktoniella sol, Minidiscus trioculatus, and two members of Stephanodiscus. An emendment of the order Lithodesmiales and the family Lauderiaceae are proposed.
COASTAL DIATOM–ENVIRONMENT RELATIONSHIPS FROM THE GULF OF FINLAND, BALTIC SEA1
Authors: Weckström Kaarina , Juggins Steve
Published: January 2006

Eutrophication of the Baltic Sea has become a serious concern in recent decades. To provide a potential means for quality assessments of coastal waters in this area, we collected a data set of 49 embayments in the Gulf of Finland, and explored the relationship between surface sediment diatom assemblages and 15 environmental variables, with special emphasis on nutrients. Total dissolved nitrogen, total phosphorus, depth, and salinity all accounted for significant and independent fractions of variation in the diatom data and explained 34% of the total variation. There were clear changes in diatom assemblage structures along the nutrient gradients. Although these changes were gradual, we could identify a number of taxa that were more abundant in a particular nutrient environment. These taxa could be used as potential indicators of the quality of coastal waters in the Baltic Sea. Diatom assemblages that were least affected by nutrient enrichment included a variety of benthic species and a relatively high species richness. Small planktonic taxa such as Cyclotella atomus Hustedt, Cyclotella meneghiniana Kützing and Thalassiosira pseudonana Hasle and Heimdal were good indicators of highly elevated nutrient concentrations (>600 lg·L−1 total dissolved nitrogen and 60 lg·L−1 total phosphorus) together with low species richness. The first appearance of these small planktonic taxa in regular monitoring could be used as an early warning sign for deteriorating water quality. Diatoms could be applied to water quality classification and monitoring purposes in the coastal waters of the Baltic Sea area using techniques such as weighted‐averaging regression and calibration.