bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative mRNA expression analysis of neurotrophin‐receptor TrkC and oncogene c‐MYC from formalin‐fixed, paraffin‐embedded primitive neuroectodermal tumor samples
Authors: Kunz Franzisca , Shalaby Tarek , Lang Doris , Von Büren André , Hainfellner Johannes A. , Slavc Irene , Tabatabai Ghazaleh , Grotzer Michael A.
Published: September 2006

Most recent studies analyzing candidate biological prognostic factors (including neurotrophin receptor TrkC and proto‐oncogene c‐MYC) in childhood primitive neuroectodermal brain tumors (PNET) are limited by small patient numbers due to dependence on fresh‐frozen tumor material. In contrast, large archives of formalin‐fixed, paraffin‐embedded PNET samples exist from homogeneously treated patients. The ability of real‐time RT‐PCR to assay very small mRNA fragments makes this assay amenable to studies where the RNA is moderately or even highly degraded. We have optimized RNA isolation from archive PNET samples and found that TrkC and c‐MYC mRNA measurements significantly correlated with those obtained from matching fresh‐frozen tissues. Exploitation of already existing archives of formalin‐fixed paraffin‐embedded PNET samples may accelerate the building of better stratification systems for PNET patients.
Rapidly enlarging chordoid meningioma with abundant mucin production
Authors: Hasegawa Shu , Yoshioka Susumu , Urabe Shougo , Kuratsu Jun‐ichi
Published: September 2006

This 77‐year‐old woman with a rapidly enlarging chordoid meningioma first noticed a growing, non‐pulsatile, non‐painful soft mass in the left temporal region after a head trauma 2 years earlier. Neuroimaging showed a homogeneously enhanced osteolytic mass lesion in the left temporal bone. Surgery revealed an extradural tumor without significant adhesions. Histopathologically it was a meningioma with features reminiscent of chordoma. Most of the tumor cells contained mucin‐rich chordoid elements. Immunohistochemically, the lesion was positive for vimentin and epithelial membranous antigen; it was negative for cytokeratin and S‐100 protein. Based on these findings a diagnosis of chordoid meningioma was made. We posit that the rapid enlargement of the tumor over a relatively short period was attributable to its high mucin‐producing activity.
Heterogeneous inclusions in neurofilament inclusion disease
Authors: Uchikado Hirotake , Li Ang , Lin Wen‐Lang , Dickson Dennis W.
Published: September 2006

Neurofilament inclusion disease (NFID) is a rare disease, whose pathogenesis remains to be elucidated. Immunoreactivity of ubiquitin‐binding protein p62 has been reported in various neurodegenerative diseases, but it has not been studied in NFID. In this report we show p62 immunoreactivity in neuronal perikaryon of three cases of NFID. We found inclusions in NFID to be heterogenous based on immunoreactivity for α‐internexin, phosphorylated neurofilament‐H, p62 and ubiquitin. Moreover, we showed both p62‐ and α‐internexin‐immunoreactive inclusions within the perikarya of the same neuron. Electron microscopy findings support the notion that inclusions in NFID are heterogenous. The present study extends the list of proteins that have been identified as components of neuronal inclusions in NFID, and may help account for the pathogenesis of NFID.
An autopsy case of frontotemporal dementia with severe dysarthria and motor neuron disease showing numerous basophilic inclusions
Authors: Ishihara Kenji , Araki Shigeo , Ihori Nami , Shiota Jun‐ichi , Kawamura Mitsuru , Nakano Imaharu
Published: September 2006

We report a clinicopathological study of a patient suffering from frontotemporal dementia (FTD) with severe dysarthria and concomitant motor neuron disease (MND). The patient was a 52‐year‐old woman with almost simultaneous emergence of severe dysarthria and FTD. The severe dysarthria subsequently evolved into anterior opercular syndrome. Motor neuron signs then emerged, and the patient developed akinetic mutism approximately 2 years after the onset of the disease. The patient died of pneumonia after a 7‐year clinical illness. Pathologically, severe and widespread degeneration in the frontal and temporal lobes, including the anterior opercular area, limbic system, basal ganglia, spinal cord and cerebellum, and frequent ubiquitin‐ and tau‐negative basophilic inclusions were observed. The pyramidal tracts and anterior horns of the cervical cord also showed marked degeneration. Cases showing basophilic inclusions reported so far have been divided into two groups: early onset FTD and MND with basophilic inclusions. Our case presented clinicopathological features of both FTD and MND, which suggests that cases showing basophilic inclusions may constitute a clinicopathological entity of FTD/MND.
Naftopidil monotherapy vs naftopidil and an anticholinergic agent combined therapy for storage symptoms associated with benign prostatic hyperplasia: A prospective randomized controlled study
Authors: MARUYAMA OSAMU , KAWACHI YOSHIO , HANAZAWA KISABURO , KOIZUMI KAZUO , YAMASHITA RYO , SUGIMURA SOSUKE , HONDA SHIN‐ICHI , SUGIYAMA YOSHIKI , SAITOH TOSHIHIKO , NOTO KENSHO
Published: September 2006

Aim: The aim of this study was to compare the efficacy and safety of α1‐adrenoceptor (α1‐AR) antagonist monotherapy with combination therapy using α1‐AR antagonist and anticholinergic agent for benign prostatic hyperplasia (BPH) with storage symptoms as the chief complaint.

Methods: In this prospective comparative study, either 25–75 mg/day of naftopidil monotherapy (monotherapy group) or combination therapy using 25–75 mg/day of naftopidil and an anticholinergic agent (10–20 mg/day of propiverine hydrochloride or 2–6 mg/day of oxybutynin hydrochloride; cotherapy group) were administered for 12 weeks to 101 BPH patients with storage symptoms.

Results: International prostate symptom score (IPSS) and quality of life (QOL) index improved significantly in both groups, with no marked differences between groups. Maximum flow rate (Qmax) and residual urine volume (RUV) tended to improve in both groups, again with no marked differences between groups. However, median post‐therapeutic RUV was significantly worse for the cotherapy group (45.0 mL) than for the monotherapy group (13.5 mL; P = 0.0210). Ratio of patients with increased RUV was also significantly worse for cotherapy (22.9%) than for monotherapy (5.0%; P = 0.038).

Conclusions: Although the anticholinergic dosage was low, the present results suggest that naftopidil monotherapy was as useful as combination therapy of naftopidil and an anticholinergic agent. Therefore, naftopidil is a useful agent as the first choice in BPH patients with storage symptoms.
Evaluation of the duration of ureteral stenting following endopyelotomy: Animal study
Authors: SORIA FEDERICO , RIOJA LUIS A , BLAS MIGUEL , DURAN ESTHER , USON JESUS
Published: September 2006

Background: The purpose of the present paper was to evaluate whether it is possible to reduce the duration of ureteral stenting following endopyelotomy, and thus reduce side‐effects.

Methods: Seventeen pigs were used. They were distributed at random into three groups. The study was divided as follows: phase I included baseline study of the urinary system and the creation of a ureteropelvic junction obstruction (UPJO) model. Phase II, 1 month later, consisted of diagnosing UPJO, Acucise endopyelotomy of the same, and the placement of a ureteral stent. Ureteral stents were left in situ for 1 week in group I, for 3 weeks in group II and 6 weeks in group III. Phase III, 3 months after treatment, consisted of follow up and post‐mortem studies of the animals. The following procedures were carried out during each phase: ureteropelvic junction (UPJ) diameter measurement, ultrasound percutaneous and endoluminal studies, urine culture and determination of blood urea and creatinine levels.

Results: On removal of the stent, the presence of urinoma was observed in two animals in group I. There were statistically significant differences between group I and III with regard to evolution of the internal diameter of the UPJ. However, the least severe histological lesion at the UPJ level was found in group II.

Conclusions: Ureteral stent placement for 1 week is insufficient in order to assure correct healing and evolution of the UPJ following endopyelotomy. Stenting for 3 weeks is effective, and it is not necessary to extend stenting time to 6 weeks. Endoluminal ultrasound is of great use in determining the effects of endourological techniques in the ureter and the retroperitoneal space. It is also useful for deciding which therapeutic technique to use, and for inserting the Acucise in order to prevent iatrogenic problems.
Alveolar soft‐part sarcoma of the retroperitoneum
Authors: ISHIKAWA MASAKUNI , ISHIZUKA OSAMU , NAKAYAMA TSUYOSHI , KOBAYASHI SHINYA , IGAWA YASUHIKO , NISHIZAWA OSAMU , SUGIMOTO KOUJI , YAMASHITA TOSHIO , MATSUSHITA TAKAAKI
Published: September 2006

Abstract  A 33‐year‐old woman was referred to Iida Municipal Hospital because of left back pain. Computed tomography showed a tumor (17 × 11 × 10 cm) in the left retroperitoneal space. T1‐ and T2‐weighted magnetic resonance imaging showed an inhomogeneous mass with marginal blood vessels. The tumor was resected via lumbar oblique incision with the thoraco‐abdominal approach. The tumor weighed 1800 g and consisted of nests of 5–100 large, loosely arranged, polygonal cells, surrounded by capillaries, resembling alveoli. The tumor cells were rich in cytoplasm, containing periodic acid–Schiff‐ and diastase‐positive granules and typical crystals. The pathological diagnosis was alveolar soft‐part sarcoma (ASPS). Alveolar soft‐part sarcoma is a rare soft‐tissue tumor that accounts for approximately 0.5–1% of soft‐tissue sarcomas. Such tumors originating in the retroperitoneal space are extremely rare. Herein is reported a case of ASPS of the retroperitoneum with radiological and pathological findings.
Hydronephrosis caused by intra‐abdominal abscess from cecal perforation by an ingested fish bone
Authors: ISHIMURA TAKESHI , TAKENAKA ATSUSHI , SAKAI YUTAKA , FUJII TOMOHIRO , JO YOSHIMASA , FUJISAWA MASATO
Published: September 2006

Abstract  A patient was treated for hydronephrosis caused by an intra‐abdominal abscess arising from cecal perforation by an ingested fish bone. To the authors’ knowledge there is no previous report of such ureteral obstruction. Ureteral stenting, drainage of the abscess, and ileocecal resection were performed. Six months of stenting were required to attain ongoing ureteral patency following removal.
Computer simulated additional deep apical biopsy enhances cancer detection in palpably benign prostate gland
Authors: MATSUMOTO KAZUMASA , EGAWA SHIN , SATOH TAKEFUMI , KURUMA HIDETOSHI , YANAGISAWA NOBUYUKI , BABA SHIRO
Published: September 2006

Objectives: The objective of this study was to use computer simulation to investigate the optimal biopsy scheme for enhancing the detection of cancer in palpably benign prostate glands.

Methods: The predominant distribution of palpably benign prostate cancer is anterior apex to mid‐prostate. We used computer simulation to optimize apical samplings and to simulate the biopsy procedure, including angle and length. A total of 254 consecutive patients with palpably benign prostate glands underwent sextant biopsy plus two additional deep apical biopsies.

Results: Based on the computer simulation, lateral sextant and two additional medially located deep apical cores with a sagittal penetration angle of 80° had the maximum cancer detection. Of the 254 patients, 58 (22.8%) had prostate cancer: 28 (48.3%) were positive only at the standard sextant sites, 12 (20.7%) were positive exclusively at the deep apical sites, and the remaining 18 (31.0%) were positive at both sites. Patients with gray‐zone prostate‐specific antigen (PSA) ranges of 4.1–10.0 ng/mL had increased cancer detection rates of 24% compared to sextant biopsy. Enhanced cancer detection by the deep apical biopsy was also evident in patients with a prostatic volume >40 cm3 (by 36.4%) and PSA 2.1–4.0 ng/mL (by 13.3%).

Conclusions: Using a computer simulation‐based biopsy scheme with deep apical sampling cores enhanced the detection of prostate cancer in palpably benign glands, especially in men with PSA ranges of 4.1–10.0 ng/mL or a gland volume of >40 cm3. Our approach with fewer sampling cores may have been more cost‐effective than other extensive biopsy schemes, but further studies with larger samples are warranted.
How many uncomplicated male and female overactive bladder patients reveal detrusor overactivity during urodynamic study?
Authors: SEKIDO NORITOSHI , HINOTSU SHIRO , KAWAI KOJI , SHIMAZUI TORU , AKAZA HIDEYUKI
Published: September 2006

Objective: We retrospectively evaluated the incidence of detrusor overactivity (DO) in uncomplicated overactive bladder syndrome (OAB) patients.

Methods: From December 1993 to October 2003, 139 adult patients were referred to an urodynamic clinic for urodynamic evaluation of frequency and/or urinary incontinence. Of these, 50 patients (12 males and 38 females) with urgency, without any overt pathological conditions, were retrospectively evaluated in regard to patient age, storage symptoms, urodynamic parameters, and the presence or absence of DO (DO patients or no DO patients, respectively).

Results: The overall incidence of DO was 75% (nine of 12 patients) and 36.8% (14 of 38 patients) in male and female patients, respectively. Two of nine male DO patients and five of 14 female DO patients revealed DO after provocative maneuvers. In male patients, all DO patients were OAB wet. In female patients, 13 of 14 DO patients were OAB wet (92.9%), whereas 17 of 24 no DO patients were also OAB wet (70.8%). Compared with no DO patients, female DO patients revealed statistically significant lower maximum cystometric capacity (P = 0.0139) and lower vesical compliance (P = 0.0002). Although aged 60 years or more was associated with DO in univariate analysis in female patients, any symptoms, even incontinence, were not associated with DO in both sexes.

Conclusion: It is supposed that, in contrast to male OAB, DO might not be a major underlying cause of uncomplicated female OAB.
Sexuality and seeking medical help for erectile dysfunction in young adults with spina bifida
Authors: SHIOMI TSUTOME , HIRAYAMA AKIHIDE , FUJIMOTO KIYOHIDE , HIRAO YOSHIHIKO
Published: September 2006

Objectives: The objectives of this study were to evaluate the correlation between the sexual function of spina bifida (SB) patients and Sharrard classification, touch sensation on the penis, to examine if SB patients who are sexually active have erectile dysfunction (ED) on the International Index of Erectile Function‐5 (IIEF5), and to clarify if they seek medical treatment for ED.

Methods: Thirty‐six male SB patients aged over 18 years were enrolled. A questionnaire was sent to all patients that included the following items: touch sensation on the penis, psychogenic erection, rigidity at erection, ejaculation, orgasm and experience in sexual intercourse. In addition, patients who had experience in sexual intercourse were asked about ED through the use of the IIEF5 and whether or not they sought medical help for their ED.

Results: Twenty‐six patients responded. The positive rates of psychogenic erection, rigidity at erection, ejaculation and orgasm were 85%, 54%, 88% and 65% respectively. Psychogenic erection and ejaculation correlated with Sharrard classification. Rigidity at erection and orgasm correlated with touch sensation on the penis. Eleven patients had experience in sexual intercourse and six of them were diagnosed as having ED on the IIEF5. There were no factors correlating with ED. None of the patients sought medical advice and none was treated for ED.

Conclusions: Sexual function of SB patients could be predicted by Sharrard classification and touch sensation on the penis to some degree. However, ED did not correlate with sexual function. Therefore, we should not evaluate the neurological loss but instead provide adequate information.
Evaluation of a prostate biopsy strategy for cancer detection using a computer simulation system with virtual needle biopsy for three‐dimensional prostate models
Authors: NOGUCHI MASANORI , DEGUCHI DAISUKE , TORIWAKI JUNICHIRO , MORI KENSAKU , MEKADA YOSHITO , MATSUOKA KEI
Published: September 2006

Aim: We evaluated a prostate biopsy strategy for cancer detection using a computer simulation system with virtual needle biopsy for three‐dimensional (3D) prostate models.

Methods: Two 3D prostate models with a volume of 25 cc or 50 cc were constructed from computed tomographic images of radical prostatectomy specimens. The peripheral zone (PZ) and transition zone (TZ) were arranged in the prostate models according to the anatomical information. Four thousand patterns of cancer lesions were automatically inserted into each prostate model with a proportion of 75% in PZ and 25% in TZ. Average hit rates (AHR) in prostate models were evaluated both with an increased number of biopsy cores and various angles of virtual needle biopsy. The influence of adding secondary tumors for hit rates was also evaluated.

Results: For both sizes, the laterally angled biopsy in 4‐8 core biopsy schemes showed higher AHR than the vertical plane biopsy, while the vertical plane biopsy in 10‐18 core biopsy schemes showed higher AHR than the laterally angled biopsy. A higher number of biopsy cores increased the AHR of secondary tumors.

Conclusions: Our results suggest that it is important in prostate cancer detection to change the needle placement according to the number of biopsy cores and the size of the prostate.
Predation on mutualists can reduce the strength of trophic cascades
Authors: Knight Tiffany M. , Chase Jonathan M. , Hillebrand Helmut , Holt Robert D.
Published: September 2006

Ecologists have put forth several mechanisms to predict the strength of predator effects on producers (a trophic cascade). We suggest a novel mechanism – in systems in which mutualists of plants are present and important, predators can have indirect negative effects on producers through their consumption of mutualists. The strength of predator effects on producers will depend on their relative consumption of mutualists and antagonists, and on the relative importance of each to producer population dynamics. In a meta‐analysis of experiments that examine the effects of predator reduction on the pollination and reproductive success of plants, we found that the indirect negative effects of predators on plants are quite strong. Most predator removal experiments measure the strength of predator effects on producers through the antagonist pathway; we suggest that a more complete understanding of the role of predators will be achieved by simultaneously considering the effects of predators on plant mutualists.
The silver spoon effect and habitat selection by natal dispersers
Authors: Stamps Judy A.
Published: September 2006

The silver spoon effect in the context of habitat selection occurs when dispersers in good condition are more likely to settle in high‐quality habitats than dispersers in poor condition. Positive relationships between disperser condition and the quality of post‐dispersal habitats are predicted by at least two non‐exclusive ultimate hypotheses. The competition hypothesis assumes that a disperser's condition affects its chances of competing for space or joining an established group after arriving at a high‐quality habitat, while the search hypothesis assumes that a disperser's condition affects its selectivity, and hence its chances of accepting a lower‐quality habitat when it is searching for a new habitat. Thus far, silver spoon effects in the context of habitat selection have been reported in only a handful of species (several birds and marine invertebrates), but this study suggests that they may be relatively common in particular species and situations.
Enhancing tissue integration in cartilage repair procedures
Authors: Archer Charles W. , Redman Samantha , Khan Ilyas , Bishop Joanna , Richardson Kirsty
Published: September 2006

Arguably, the gold standard of biological repair of articular cartilage lesions is autologous chondrocyte transplantation. Although the clinical outcomes appear to range between good and excellent in most cases, there are, nevertheless, both clinical and biological challenges that remain to improve rehabilitation and clinical outcome. One of the major biological problems relates to tissue integration of the reparative tissue into the host tissue at a predictable level. Often within a single lesion, varying degrees of integration can be observed from total integration through to non‐integration as one passes through the defect. Here we briefly review some of the literature relating to this problem and include some of our own data drawn from questions we have posed about the biological nature of cartilage/cartilage integration. The nature and status of the tissue that comprises the wound lesion edge is central to tissue integration, and controlling aspects of trauma and free‐radical‐induced cell death together with matrix synthesis are identified as two components that require further investigation. Interestingly, there appears to be a limited ability of chondrocytes to be able to infiltrate existing cartilage matrices and even to occupy empty chondrocyte lacunae. Proliferation as a result of blunt and sharp trauma shows differential responses. As expected, blunt trauma induces a greater proliferative burst than sharp trauma and is more widespread from the lesion edge. However, in the case of sharp trauma, the basal cells enter proliferation before surface zone chondrocytes, which is not the case in blunt wounds. Regulation of these and associated processes will be necessary in order to devise strategies that can predict successful integration in biological repair procedures.
Soluble and insoluble signals and the induction of bone formation: molecular therapeutics recapitulating development
Authors: Ripamonti Ugo , Ferretti C. , Heliotis M.
Published: September 2006

The osteogenic molecular signals of the transforming growth factor‐β (TGF‐β) superfamily, the bone morphogenetic/osteogenic proteins (BMPs/OPs) and uniquely in primates the TGF‐β isoforms per se, pleiotropic members of the TGF‐β supergene family, induce de novo endochondral bone formation as a recapitulation of embryonic development. Naturally derived BMPs/OPs and gamma‐irradiated human recombinant osteogenic protein‐1 (hOP‐1) delivered by allogeneic and xenogeneic insoluble collagenous matrices initiate de novo bone induction in heterotopic and orthotopic sites of the primate Papio ursinus, culminating in complete calvarial regeneration by day 90 and maintaining the regenerated structures by day 365. The induction of bone by hOP‐1 in P. ursinus develops as a mosaic structure with distinct spatial and temporal patterns of gene expression of members of the TGF‐β superfamily that singly, synergistically and synchronously initiate and maintain tissue induction and morphogenesis. The temporal and spatial expressions of TGF‐β1 mRNA indicate a specific temporal transcriptional window during which expression of TGF‐β1 is mandatory for successful and optimal osteogenesis. Highly purified naturally derived bovine BMPs/OPs and hOP‐1 delivered by human collagenous bone matrices and porous hydroxyapatite, respectively, induce bone formation in mandibular defects of human patients. By using healthy body sites as bioreactors it is possible to recapitulate embryonic developments by inducing selected biomaterials combined with recombinant proteins to transform into custom‐made prefabricated bone grafts for human reconstruction. The osteogenic proteins of the TGF‐β superfamily, BMPs/OPs and TGF‐βs, the last endowed with the striking prerogative of inducing endochondral bone formation in primates only, are helping to engineer skeletal reconstruction in molecular terms.
Location of injury influences the mechanisms of both regeneration and repair within the MRL/MpJ mouse
Authors: Beare Alice H. M. , Metcalfe Anthony D. , Ferguson Mark W. J.
Published: September 2006

The adult MRL/MpJ mouse regenerates all differentiated structures after through‐and‐through ear punch wounding in a scar‐free process. We investigated whether this regenerative capacity was also shown by skin wounds. Dorsal skin wounds were created, harvested and archived from the same animals (MRL/MpJ and C57BL/6 mice) that received through‐and‐through ear punch wounds. Re‐epithelialization was complete in dorsal wounds in both strains by day 5 and extensive granulation tissue was present by day 14 post‐wounding. By day 21, wounds from both strains contained dense amounts of collagen that healed with a scar. The average wound area, as well as α‐smooth muscle actin expression and macrophage influx were investigated during dorsal skin wound healing and did not significantly differ between strains. Thus, MRL/MpJ mice regenerate ear wounds in a scar‐free manner, but heal dorsal skin wounds by simple repair with scar formation. A significant conclusion can be drawn from these data; mechanisms of regeneration and repair can occur within the same animal, potentially utilizing similar molecules and signalling pathways that subtly diverge dependent upon the microenvironment of the injury.
Glycaemic control throughout pregnancy and risk of pre‐eclampsia in women with type I diabetes
Authors: Temple RC , Aldridge V , Stanley K , Murphy HR
Published: September 2006

The aim of this study was to examine the influence of pre‐pregnancy care and its effect on early glycaemic control and also the effect of glycaemic control in later pregnancy on risk of pre‐eclampsia in women with type I diabetes. A prospective cohort study of 290 consecutive nonselected pregnancies in women with type I diabetes was performed from 1991 to 2002. We examined the relationship of monthly glycosylated haemoglobin (HbA1c) level, pre‐pregnancy care, parity, diabetes duration, microvascular complications, maternal age, weight and smoking with risk of pre‐eclampsia. Pre‐eclampsia developed in 31/243 singleton births (12.8%). HbA1c level at 24 weeks was significantly increased in women with pre‐eclampsia compared with women without pre‐eclampsia (6.0 versus 5.6%, P= 0.017) and was, after nulliparity, the strongest independent predictor of increased risk (OR 1.65 for each 1% increase in HbA1c; P= 0.01). In contrast, there was no relationship between pre‐pregnancy care or HbA1c level at booking and risk of pre‐eclampsia.
Cluster randomised trial of an active, multifaceted educational intervention based on the WHO Reproductive Health Library to improve obstetric practices
Authors: Gülmezoglu AM , Langer A , Piaggio G , Lumbiganon P , Villar J , Grimshaw J
Published: September 2006

Objective  We conducted a trial to evaluate the effect of an active, multifaceted educational strategy to promote the use of the WHO Reproductive Health Library (RHL) on obstetric practices.

Design  Cluster randomised trial. The trial was assigned the International Standardised Randomised Controlled Trial Number ISRCTN14055385.

Settings  Twenty‐two hospitals in Mexico City and 18 in the Northeast region of Thailand.

Methods  The intervention consisted primarily of three interactive workshops using RHL over a period of 6 months. The focus of the workshops was to provide access to knowledge and enable its use. A computer and support for using both the computer and RHL were provided at each hospital. The control hospitals did not receive any intervention.

Main outcome measures  The main outcome measures were changes in ten selected clinical practices as recommended in RHL starting approximately four to six months after the third workshop. Clinical practice data were collected at each hospital from 1000 consecutively delivered women or for a 6‐month period whichever was reached sooner.

Results  The active, multifaceted educational intervention we employed did not affect the ten targeted practices in a consistent and substantive way. Iron/folate supplementation, uterotonic use after birth and breastfeeding on demand were already frequently practiced, and we were unable to measure external cephalic version. Of the remaining six practices, selective, as opposed to routine episiotomy policy increased in the intervention group (difference in adjusted mean rate = 5.3%; 95% CI −0.1 to 10.7%) in Thailand, and there was a trend towards an increased use of antibiotics at caesarean section in Mexico (difference in adjusted mean rate = 19.0%; 95% CI: −8.0 to 46.0%). There were no differences in the use of labour companionship, magnesium sulphate use for eclampsia, corticosteroids for women delivering before 34 weeks and vacuum extraction. RHL awareness (24.8–65.5% in Mexico and 33.9–83.3% in Thailand) and use (4.8–34.9% in Mexico and 15.5–76.4% in Thailand) increased substantially after the intervention in both countries.

Conclusion  The multifaceted, active strategy to provide health workers with the knowledge and skills to use RHL to improve their practice led to increased access to and use of RHL, however, no consistent or substantive changes in clinical practices were detected within 4–6 months after the third workshop.
Cyclin‐dependent kinase 5 in synaptic plasticity, learning and memory
Authors: Angelo Marco , Plattner Florian , Giese K. Peter
Published: September 2006

Cyclin‐dependent kinase 5 (Cdk5) is a serine/threonine kinase with a multitude of functions. Although Cdk5 is widely expressed, it has been studied most extensively in neurons. Since its initial characterization, the fundamental contribution of Cdk5 to an impressive range of neuronal processes has become clear. These phenomena include neural development, dopaminergic function and neurodegeneration. Data from different fields have recently converged to provide evidence for the participation of Cdk5 in synaptic plasticity, learning and memory. In this review, we consider recent data implicating Cdk5 in molecular and cellular mechanisms underlying synaptic plasticity. We relate these findings to its emerging role in learning and memory. Particular attention is paid to the activation of Cdk5 by p25, which enhances hippocampal synaptic plasticity and memory, and suggests formation of p25 as a physiological process regulating synaptic plasticity and memory.
Population recovery and spatial dynamics of colony recruitment in a harvester ant: a case study in a park
Authors: YAMAGUCHI Takeshi
Published: September 2006

The recovery process of Messor aciculatus (Fr. Smith) harvester ant colonies from habitat disturbance by construction work in an urban park was investigated from 1989 to 1994. Colonies located in 1989 were considered to be survivors of the disturbance, and colonies located for the first time after 1990 were considered to be recruits. The colonies continuously increased in number after the disturbance, and the population size more than doubled just after the disturbance. Analyses of the nest site distribution of colonies in 1989 and 1994 suggest that landform modification destroyed some of them, and that the changed nest site distribution in 1989 affected the distribution in 1994, or, in other words, the disturbance indirectly affected the nest distribution 5 years later. Analyses of the nearest neighbor to each colony suggested that established colonies would obstruct newly recruited colonies around their nests. Construction may open up space for recruitment colonization by removing established colonies, and may also create suitable conditions by destruction of original vegetation, or returning vegetation to the early stages of plant community succession. As a result, the disturbance may facilitate the subsequent recruitment of new colonies and rejuvenate the population.
Life history strategy and taxonomic position of gall midges (Diptera: Cecidomyiidae) inducing leaf galls on Styrax japonicus (Styracaceae)
Authors: TOKUDA Makoto , NOHARA Machiko , YUKAWA Junichi
Published: September 2006

Four gall midge species (Diptera: Cecidomyiidae) that induce leaf galls on Styrax japonicus (Styracaceae) were identified to generic level based on larval morphology. Three of these gall midges, which induce whitish hemiglobular galls, flattened subglobular galls, and purple globular galls, respectively, were identified as three genetically distinct species of Contarinia, and the remaining species, which induces globular galls with dense whitish hairs, was identified as a species of Dasineura. Field surveys in Fukuoka, Japan, revealed that adults of these gall midges emerged and oviposited in late March to mid‐April at Mount Tachibana (approximately 200 m a.s.l.) and in late April to early May at Mount Sefuri (about 1050 m a.s.l.), coinciding with the leaf‐opening season of S. japonicus. Larvae of these gall midges mostly developed into third instars by June and then left their galls and dropped to the ground. These species therefore have a life history strategy that differs from that of another S. japonicus‐associated gall midge, Oxycephalomyia styraci, which overwinters as the first instar in ovate swellings, matures rapidly in spring, and emerges directly from the galls.
Taxonomy, distribution and nesting biology of species of the genus Dolichovespula (Hymenoptera, Vespidae)
Authors: ARCHER Michael E.
Published: September 2006

The genus Dolichovespula consists provisionally of 18 species. Aerial nest site characteristics have been established for seven species but most of these species show flexibility in their choice of nest sites and two species often nest in shallow subterranean situations. Colony length is usually just over 3 months to approximately 4 months, but at lower latitudes may extend to more than 5 months. Mature colony size is usually approximately 1000 cells with more large cells than small cells. Parasitized colonies have a shorter colony cycle and smaller colonies. During the production of the sexual brood the larva/worker ratio reaches its lowest value of approximately 2.5 larvae per worker. Colonies often have upper mixed combs of small and large cells. Total adult production is usually less than 2000 adults. Colonies of D. arenaria and D. norwegica may specialize in mainly producing males or queens. Variations in mature colony size and production of queens is probably a consequence of the number of workers present, particularly early in the colony cycle.
The Arhopala butterflies described by Fabricius: A. centaurus is from Java, A. democritus from Phuket (Lepidoptera: Lycaenidae)
Authors: VANE‐WRIGHT Richard I. , GAONKAR Harish
Published: September 2006

The origins and identities of two Fabrician butterfly species now included in the genus Arhopala Boisduval, 1832, are examined; the species are Papilio centaurus Fabricius, 1775, and Hesperia democritus Fabricius, 1793 (Lepidoptera: Lycaenidae). To dispel recent confusion, complete taxonomic histories are presented for both. The type locality of Arhopala centaurus is established as near Jakarta, Java, and that of Arhopala democritus as Phuket Island, south‐western peninsular Thailand. Amblypodia pseudocentaurus Doubleday, 1847, described from Java, is re‐established as a subjective synonym of Arhopala centaurus sensu stricto. The subspecies of centaurus that flies in the Malay Peninsula is re‐established as A. centaurus nakula (Felder & Felder, 1860). The distinct Australian species misidentified in recent literature as Arhopala centaurus should be known as Arhopala eupolis (Miskin, 1890). Lectotype designations are made for the nominal species Papilio centaurus, Hesperia democritus, Amblypodia pseudocentaurus and Amblypodia nakula.
A Single‐Blinded, Randomized, Controlled Clinical Trial Evaluating the Effect of Face Washing on Acne Vulgaris
Authors: Choi Joanna Mimi , Lew Vincent K. , Kimball Alexa B.
Published: September 2006

Abstract:  Despite the common recommendation to wash the face twice daily with a mild cleanser, there is little published evidence to support the practice. Indeed, while the general public believes that cleaner skin will result in fewer blemishes, dermatologists often warn that overwashing and scrubbing can exacerbate the condition. To clarify the effect of frequency of face washing on acne vulgaris, we designed a single‐blinded, randomized, controlled clinical trial to be conducted on males with mild to moderate acne vulgaris. Subjects washed their faces twice daily for 2 weeks with a standard mild cleanser before being randomized to one of three study arms, in which face washing was to be done once, twice, or four times a day for 6 weeks. At the end of the study no statistically significant differences were noted between groups. However, significant improvements in both open comedones and total noninflammatory lesions were observed in the group washing twice a day. Worsening of acne condition was observed in the study group washing once a day, with significant increases in erythema, papules, and total inflammatory lesions. We concluded that slight support exists, both in terms of efficacy and convenience, for the recommendation to wash the face twice daily with a mild cleanser. However, excessive face washing may not be as culpable as previously thought.
Pediatric Atopic Eczema: The Impact of an Educational Intervention
Authors: Grillo Marianne , Gassner Lee , Marshman Gillian , Dunn Sandra , Hudson Pamela
Published: September 2006

Abstract:  Patient education has been regarded as having a key role in the self‐management of atopic eczema. However, the relationship between the educational interventions and clinical outcomes including severity of eczema, quality of life, and family impact has not been rigorously examined. The purpose of this longitudinal randomized controlled study was to evaluate the impact of an intensive education program with a focus on dermatology and immunology designed for parents and children diagnosed with atopic eczema. The intention of this study was not to change treatment regimes prescribed by the patient's physician. The Scoring Atopic Dermatitis rating system was used for assessment of disease impact, and the impact on quality of life was quantified by using the Children's Dermatology Life Quality Index, Infants’ Dermatology Quality of Life Index, and Dermatitis Family Impact. A total of 61 pediatric patients (0–16 years) diagnosed with atopic eczema from the metropolitan area of Adelaide were randomized to either the control or intervention group. Results of the study showed that the intervention group had a significant improvement in the scoring atopic dermatitis measure when compared to the control group at week 4 and week 12. Quality of life measures did not significantly improve with decreased severity of eczema except in the group of children aged 5–16 years which, despite small numbers, showed a significant improvement in quality of life scores. These findings suggest that education provides an important role in decreasing the severity of eczema.
The Prognostic Value of Nailfold Capillary Changes for the Development of Connective Tissue Disease in Children and Adolescents with Primary Raynaud Phenomenon: A Follow‐up Study of 250 Patients
Authors: Pavlov‐Dolijanović Slavica , Damjanov Nemanja , Ostojić Predrag , Sušić Gordana , Stojanović Roksanda , Gacić Dragica , Grdinić Aleksandra
Published: September 2006

Abstract:  To assess the prognostic value of capillaroscopy findings for the development of connective tissue disease in children and adolescents with Raynaud phenomenon, we followed up a group of 250 (mean age 15 years) for 1 to 6 years after the first capillaroscopy was performed. Every 6 months they were screened for signs and symptoms of connective tissue disease. Analysis was performed on capillary changes registered 6 months before the development of connective tissue disease. Capillary changes were classified into three types: normal, nonspecific, and sclerodermatous. At the end of the follow‐up period, 191 (76%) subjects had primary Raynaud phenomenon, 27 (10.8%) were diagnosed as having undifferentiated connective tissue disease, and 32 (12.8%) fulfilled the criteria for a diagnosis of a specific connective tissue disease. Systemic lupus erythematosus was found in nine (3.6%) patients, rheumatoid arthritis in 10 (4%) patients (six of them with juvenile onset rheumatoid arthritis), and scleroderma spectrum disorders in 13 (5.2%). The mean time for the evolution of Raynaud phenomenon into undifferentiated connective tissue disease or a form of the disease was 2 years. Most of the subjects with primary Raynaud phenomenon (173/191, 91%), undifferentiated connective tissue disease (22/27, 81%), juvenile onset rheumatoid arthritis/rheumatoid arthritis (7/10, 70%), and systemic lupus erythematosus (6/9, 67%) had normal capillary findings. Nonspecific capillary changes occurred in 3 of 10 (30%) patients with rheumatoid arthritis, 2 of 9 (22%) with systemic lupus erythematosus, 4 of 27 (15%) with undifferentiated connective tissue disease, and 18 of 191 (9%) with primary Raynaud phenomenon. Of all the subjects, only 10 (4%) showed sclerodermatous disease type capillary changes 6 months before the expression of a particular disease: eight (62%) of these developed scleroderma spectrum disorders, one expressed systemic lupus erythematosus, and one had undifferentiated connective tissue disease. We concluded that there were no specific capillary changes predictive for future development of systemic lupus erythematosus, juvenile onset rheumatoid arthritis/rheumatoid arthritis, and undifferentiated connective tissue disease in children and adolescents with Raynaud phenomenon. Most of our study subjects with Raynaud phenomenon who developed these diseases had normal capillary findings or nonspecific changes. Children and adolescents who developed scleroderma spectrum disorders showed a sclerodermatous type of capillary changes 6 months before the expression of the disease, indicating that this type of capillary changes in children and adolescents with Raynaud phenomenon highly correlated with further development of scleroderma spectrum disorders.
Celiac Disease Presenting with Chilblains in an Adolescent Girl
Authors: Clair Nicole E. St. , Kim Caroline Choi , Semrin Gaith , Woodward Amy L. , Liang Marilyn G. , Glickman Jonathan N. , Leichtner Alan M. , Binstadt Bryce A.
Published: September 2006

Abstract:  Chilblains, or pernio, are cutaneous lesions that may accompany systemic illnesses including states of malnutrition and autoimmune diseases. We report an adolescent girl in whom chilblains were the chief presenting sign of celiac disease. A gluten‐free diet led to weight gain and resolution of the chilblains. We speculate that in this patient, weight loss due to celiac disease contributed to the development of chilblains.
Video Game Induced Knuckle Pad
Authors: Rushing Mary E. , Sheehan Daniel J. , Davis Loretta S.
Published: September 2006

Abstract:  Controversy and concern surround the video game playing fascination of children. Scientific reports have explored the negative effects of video games on youth, with a growing number recognizing the actual physical implications of this activity. We offer another reason to discourage children's focus on video games: knuckle pads. A 13‐year‐old black boy presented with an asymptomatic, slightly hyperpigmented plaque over his right second distal interphalangeal joint. A punch biopsy specimen confirmed knuckle pad as the diagnosis, and a traumatic etiology from video game playing was suspected. Knuckle pads can be painful, cosmetically unappealing, and refractory to treatment. They can now be recognized as yet another potential adverse consequence of chronic video game playing.
Exuberant Juvenile Hyaline Fibromatosis in Two Patients
Authors: Muniz Mariela Leão , Lobo Alice Zoghbi Coelho , Machado Maria Cecília da Matta Rivitti , Valente Neusa Yuriko Sakai , Kim Chong Ae , Lourenço Sílvia Vanessa , Nico Marcello Menta Simonsen
Published: September 2006

Abstract:  Juvenile hyaline fibromatosis and infantile systemic hyalinosis are rare autosomal recessive disorders of infancy and early childhood that are histologically characterized by deposition of hyaline material. The main clinical features are papulo‐nodular skin lesions, gingival hypertrophy, joint contractures, and bone abnormalities. However, infantile systemic hyalinosis has a more severe clinical presentation, including visceral involvement and premature death. Very recently, genetic studies identified mutations in the same gene in patients with both conditions, strongly suggesting that they belong to the same disease spectrum. We report two new nonrelated patients who met the criteria for the diagnosis of juvenile hyaline fibromatosis/infantile systemic hyalinosis. Clinical, histopathologic, immunohistochemical, and ultrastructural findings are presented, as well as an extensive review of the literature. Recent information regarding pathogenesis and treatment is discussed.
Geroderma Osteodysplastica. Report of a New Family
Authors: Boente María del Carmen , Asial Raúl A. , Winik Beatriz C.
Published: September 2006

Abstract:  We report a family in which geroderma osteodysplastica affected two male siblings. They showed the characteristic features associated with this syndrome: a prematurely aged face with wrinkly, lax skin, more prominent on the acral regions, associated with joint laxity, osteoporosis, and skeletal abnormalities. The main histologic abnormalities were fragmented elastic fibers that were diminished in number. Although collagen fibers showed changes in their orientation, they were normal in structure and number. We consider the differential diagnosis with other syndromes associated with cutis laxa using clinical, radiologic, and histopathologic criteria.
Fontana‐Positive Grains in Mycetoma Caused by Microsporum canis
Authors: Kramer Sasha C. , Ryan Michael , Bourbeau Paul , Tyler William B. , Elston Dirk M.
Published: September 2006

Abstract:  We describe mycetoma caused by Microsporum canis occurring in a 9‐year‐old African‐American girl. Pathologic evaluation showed a granulomatous dermatitis with numerous large fungal grains containing septate hyphae that were Fontana–Masson positive. Two cultures of pure grains grew M. canis. Mycetoma due to dermatophytes is very uncommon. The few instances reported have been pseudomycetoma (grains in the absence of sinus tracts). Our patient developed sinus tracts (true mycetoma). No prior reports were found of M. canis staining Fontana positive. Differentiation of dermatophyte‐induced mycetoma from kerion is important because mycetomas require a combined approach including surgical debridement in addition to oral antifungal therapy.
Mycobacterium haemophilum in an Immunosuppressed Child
Authors: Campbell Lisa B. , Maroon Michele , Pride Howard , Adams David C. , Tyler William B.
Published: September 2006

Abstract:  Mycobacterium haemophilum is an emerging cutaneous and systemic pathogen in immunosuppressed adults. Reports in the pediatric literature prior to 2004, limited to immunocompetent children with lymphadenitis, offer a different clinical presentation from that of the immunosuppressed adult. We report an instance of this atypical mycobacterial infection occurring in an immunosuppressed boy with clinical findings similar to those described in immunosuppressed adults.
Deep Morphea after Vaccination in Two Young Children
Authors: Torrelo Antonio , Suárez José , Colmenero Isabel , Azorín Daniel , Perera Antonio , Zambrano Antonio
Published: September 2006

Abstract:  A number of dermatoses have been reported to appear in close temporal or spatial relationship to the intramuscular injection of vaccines. We describe two young children who had morphea consistent with the deep morphea type (morphea profunda) that appeared at the site of a previous vaccination. Trauma has been implicated as an important trigger of morphea, both in children and in adults. Furthermore, vaccines might induce an immune response, which could lead to morphea in predisposed individuals.