bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental contact factors in eczema and the results of patch testing Chinese patients with a modified European standard series of allergens
Authors: Li Lin‐Feng , Guo Jing , Wang Jing
Published: August 2004

Environmental contact factors in eczema were investigated in China by clinical questionnaire and patch testing patients with a modified European standard series of allergens. 217 consecutive eczema patients were studied. Contact dermatitis (CD) was clinically diagnosed in 30% of the patients. Among the patients patch tested, 46 patients had clinically diagnosed allergic CD (ACD), 20 patients clinically had non‐ACD (NACD) (including 16 cases of irritant contact dermatitis, 1 case of phototoxic contact reaction and 3 cases of asteatotic eczema) and 115 patients had clinically suspected ACD. 45 patients (98%) in the ACD group went on to have relevant patch test results. The most common ACD was from metals, fragrance materials, cosmetics and rubber materials. The most common contact allergens identified were nickel, fragrance mix, para‐phenylenediamine (PPD), carba mix and thimerosal. No adverse reactions were observed to patch testing, except for pruritus in patch‐test‐positive patients. The positive rate of patch testing in ACD was much higher than that in NACD (98% versus 15%, P < 0.05, χ2‐test). 60 (28%) patients had facial dermatitis (FD). Among these, 20 (33%) were confirmed as having ACD. 48 (22%) patients had hand dermatitis (HD). Among these, 7 (15%) were confirmed as having ACD. Fewer patients were confirmed as having ACD in the HD group than in the FD (15% versus 33%, P < 0.05, χ2‐test). Although the difference was not significant, the total positivity rate in the HD group (55%) was lower than in the other groups. 65 (30%) patients had unclassified endogenous eczema (UEE). The total positive rate of patch testing in the UEE group (56%) was no different from that in the FD or HD groups. However, the relevance of positive patch tests was hard to determine in UEE. These results indicate that CD is common in eczema; relatively more patients with FD have ACD, while other factors, such as irritation, may play more of a role in HD. The total positive rate of patch testing in the UEE group was no different from that in the FD or HD groups, suggesting that patch testing should be stressed in UEE and the relevance of positive patch test results in UEE should be studied further. It is effective and safe to patch eczema patients with a modified European standard series of allergens in China.
The use of complementary medicine by patients referred to a contact dermatitis clinic
Authors: Nicolaou Nicolas , Johnston Graham A.
Published: August 2004

Our aim was to quantify and qualify the use of complementary medicine (CM) by patients referred to our contact dermatitis clinic in Leicester, UK. A face‐to‐face structured questionnaire study was made of 109 consecutive patients referred to the contact dermatitis clinic. 109 such questionnaires were completed. 21/109 (20%) of patients were Indo‐Asian and 86/109 (79%) white Caucasian. 33/109 (30%) had tried some form of CM to treat their skin condition. This use was higher in the Indo‐Asian group, where 13/21 (62%) had tried some form of CM. 21/33 (63%) who had used CM were happy to recommend it to other patients with skin disease, even though only 10/33 (30%) of these reported an improvement in their skin condition while using CM. The most frequently used CM treatments were herbal medicine [17/33 (51%)], Chinese herbal medicine [6/33 (18%)], traditional Indian medicine [4/33 (12%)] and aromatherapy [6/33 (18%)]. These proportions were similar in all ethnic groups. In a population of adults referred to a contact dermatitis clinic in a city‐centre teaching‐hospital dermatology department in Leicester, UK, 30% use, or intend to use, CM and this use is associated with ethnicity.
Reduplication of nominal modifiers in Singapore English: a semantic and cultural interpretation
Authors: Wong Jock
Published: August 2004

Abstract:  While the formal properties of reduplication in many languages have aroused the interest of many linguists and much appears to have been done in this area, the same cannot be said about its semantics. It seems that our understanding of the kinds of meaning associated with reduplication processes remains rather limited. This is regrettable, given that language meaning can shed a lot of light on the speech community's ways of thinking and norms of interaction. In this paper, the object of study is a widely used reduplication process in Singapore English – the reduplication of nominal modifiers. I will endeavour to identify its meaning and articulate it in the form of a reductive paraphrase. I will also try to show that its use may be linked, via meaning, with a culture‐specific norm of interaction that seems to be characteristic of Singapore English speakers.
Culture, gender, and identity in cross‐cultural personals and matrimonials
Authors: Pandey Anita
Published: August 2004

Abstract:  This paper demonstrates how different Englishes are employed in Indian matrimonials versus US personals ads. In addition to demonstrating how a knowledge of world Englishes is pertinent to interpretation of the advertisements in question, the study reported here illustrates how, on a functional‐semantic level, the two categories of ads are not as different as they may appear to be. The cultural hybridity evident in several matrimonials is also examined, and the saliency of context discussed, as the Englishes in question are not always variable on the surface.
The Reform of the UK's Auditor Independence Framework after the Enron Collapse: An Example of Evidence‐based Policy Making
Authors: Fearnley Stella , Beattie Vivien
Published: August 2004

Following the collapse of Enron, the UK government set up a high level group of regulators and ministers to co‐ordinate a review of the UK regulatory framework, including the key area of auditor independence. The Accountancy Foundation Review Board (Review Board), which was at the time responsible for the independent oversight of the UK accountancy professional bodies, took the leading role in the auditor independence review.

A programme of research was set up by the Review Board and studies were provided by other bodies. The results of the research were compiled into a paper which underpinned the Review Board's recommendations for change. This was fed into the government review process. In this paper, the research is summarised and the Review Board's evidence‐based recommendations are presented and compared with the government's final position. Few differences are found. Insights are provided into the nature of the regulatory reform process and the quality of the evidence which underpinned it.
The Market for Professional Services in Indonesia
Authors: Basioudis Ilias G. , Fifi Fifi
Published: August 2004

This paper reports the results of a study which investigates the market for professional services in Indonesia, a country which has not been investigated in the by audit fee literature prior. A well‐developed research model used in the prior literature has also been applied in this study, and the empirical findings suggest broad similarities in the pricing of professional services in Indonesia and other countries previously studied. In addition to extending the results of prior research to a country not previously studied, this paper examines whether the large auditors fee premium documented in other countries exists in Indonesia, especially after the major Asian financial crisis of 1997/98, since then almost all companies in this geographical area exercise tight budget controls. The results suggest that no audit fee premium is accrued to Indonesian Big 5 auditors, in contrast to the large audit firm fee premium documented in many other countries.
Auditors’ Perceptions of Responsibilities to Detect and Report Client Illegal Acts in Canada and the UK: A Comparative Experiment
Authors: Fraser Ian A. M. , Lin Kenny Z.
Published: August 2004

This paper investigates the theme of the role and influence of auditing standards on auditing practice by means of a comparative case study focused on two different standard setting regimes. Specifically, the Canadian and UK standards concerned with the detection and reporting of client illegal acts are considered. Fifteen short vignettes are developed each describing an illegal act and reflecting the distinctive factors highlighted by the respective auditing standards. We find that the regulation of the auditing profession through the mode of auditing standards does have an identifiable impact on auditor behavior. The impact of standards on auditors’ perceptions of their responsibilities in the area of illegal acts is clearer for detection than it is for reporting. Additionally, auditors continue to perceive a clear distinction between fraud and other illegal acts and recognize a higher degree of res‐ponsibility for illegal acts involving fraud than for others. At the other end of the spectrum auditors do recognize some degree of responsibility in connection with illegalities that do not fall within the ambit of auditing standards. Auditors are also influenced in their judgments on the general nature of an illegal act rather than on how the illegality fits the framework adopted by the appropriate auditing standard.
Tests of Control in the Audit Risk Model: Effective? Efficient?
Authors: Blokdijk J. H.
Published: August 2004

Lately, the Audit Risk Model has been subject to criticism. To gauge its validity, this paper confronts the Audit Risk Model as incorporated in International Standard on Auditing No. 400, with the real life situations faced by auditors in auditing financial statements. This confrontation exposes serious deficiencies in the Audit Risk Model, especially regarding tests of control. One conclusion is that internal controls that cannot be reperformed by an auditor, should be disregarded in assessing control risk. Another conclusion is that tests of the other internal controls are far more effective in focusing specific substantive tests, than in assessing control risk with the aim of reducing the size of a random sample. The paper concludes with a proposal for restructuring the audit process.
DNA hypermethylation in gastric cancer
Authors: Kim T. Y. , Jong H.‐S. , Jung Y. , Kim T.‐Y. , Kang G. H. , Bang Y.‐J.
Published: August 2004

Background : Transcriptional silencing of tumour suppressor genes by DNA hypermethylation plays a crucial role in the progression of gastric cancer. Many genes involved in the regulation of cell cycle, tissue invasion, DNA repair and apoptosis have been shown to be inactivated by this type of epigenetic mechanism.

Results : Recent studies have demonstrated that DNA hypermethylation begins early in cancer progression, and in some cases, may precede the neoplastic process. Ageing is associated with DNA hypermethylation, and may provide a mechanistic link between ageing and cancer. Several reports have indicated that Epstein−Barr virus‐related gastric cancer is associated with a high frequency of DNA hypermethylation, suggesting that viral oncogenesis might involve DNA hypermethylation with inactivation of tumour suppressor genes. Hypermethylation of hMLH1 with the resulting loss of its expression is known to cause microsatellite instability, which reflects genomic instability associated with defective DNA mismatch repair genes in the tumour.

Conclusions : In conclusion, recent studies demonstrate that DNA hypermethylation is a crucial mechanism of inactivation of tumour suppressor genes in gastric cancer. A better understanding of DNA hypermethylation will provide us with new opportunities in the diagnosis and therapy of gastric cancer.
Enhanced airway inflammation and decreased subepithelial fibrosis in interleukin 6‐deficient mice following chronic exposure to aerosolized antigen
Authors: Qiu Z. , Fujimura M. , Kurashima K. , Nakao S. , Mukaida N.
Published: August 2004

Background
Airway inflammation and remodelling are characteristic features of chronic asthma.

Objective
To elucidate the role of interleukin (IL)‐6 in airway responses to chronic antigen exposure.

Methods
We compared airway inflammation, subepithelial collagen deposition, cytokine mRNA expression, and airway responsiveness between IL‐6‐deficient and wild‐type (WT) mice following sensitization and repeated exposure to ovalbumin (OVA) three times a week for 8 weeks.

Results
The repeated exposure to OVA induced infiltration of eosinophils, neutrophils, and lymphocytes into the airway, and caused thickening of the basement membrane and subepithelial fibrosis. IL‐6‐deficient mice exhibited more pronounced infiltration of these cells, a thinner basement membrane, and decreased subepithelial fibrosis, compared with WT mice. The repeated OVA exposure increased expression of IL‐4, IL‐13, eotaxin, monocyte chemoattractant protein‐1 (MCP‐1), and transforming growth factor‐β1 mRNA in WT mice. Among these factors, expression of IL‐13 and MCP‐1 mRNA was further enhanced in IL‐6‐deficient mice, compared with WT mice. However, both WT and IL‐6‐deficient mice exhibited similar levels of airway responsiveness to increasing doses of methacholine, even after repeated exposure to OVA.

Conclusion
These results suggest that IL‐6 has dual roles in the chronic phase of asthma: down‐regulation of inflammatory cell infiltration and enhancement of airway remodelling.
Atopic disease and its determinants – a focus on the potential role of childhood infection
Authors: Resch A. , Schlipköter U. , Crispin A. , Behrendt H. , Heinrich J. , Wichmann H. E. , Ring J. , Schäfer T. ,   the KORA study group
Published: August 2004

Background
Atopic diseases develop on a genetic background and are modulated by environmental factors among which some infectious diseases are thought to have a protective influence.

Objective
The aim of this study was to determine the influence of infectious diseases in younger ages, bacterial and viral, on atopic diseases and sensitization to aero‐ and foodallergens in adults.

Methods
A population‐based sample of 4262 subjects aged 25–74 years were interviewed concerning their history of infectious disease within the first 18 years of life. Information about allergic disease, including atopic eczema, allergic rhinitis (AR), and asthma was obtained. A blood sample was drawn and analysed for allergen‐specific IgE antibodies against food‐ and aeroallergens.

Results
Multiple logistic regression analyses identified viral infection to be associated with AR (adjusted odds ratio (OR)=1.39; 95% confidence interval (95% CI): 1.13–1.72) and sensitization to aeroallergens (OR=1.21; 95% CI: 1.05–1.41). Bacterial disease was a negative predictor for atopy development in the subgroup of patients sensitized to nutritional allergens with concomitant atopic eczema (OR=0.34; 95% CI: 0.11–0.99), AR (OR=0.67; 95% CI: 0.42–1.07), or asthma (OR=0.41; 95% CI: 0.19–0.87). Influences of viral and bacterial infection on AR differed with regard to family history of atopic disease.

Conclusion
In our study population, history of viral infection was consistently positively associated with AR. Our data suggests that bacterial infections might be preventive for specific subgroups of atopy.
Monitoring response to treatment in asthma management: food for thought
Authors: Scichilone N. , Deykin A. , Pizzichini E. , Bellia V. , Polosa R.
Published: August 2004

Asthma is a chronic inflammatory disorder of the airways that is characterized by episodic symptoms. In this regard, asthma management has classically involved periodic re‐assessment by the health‐care provider, during which therapy is altered mainly based on clinical and physiological parameters, such as assessment of symptoms, spirometry and peak expiratory flow monitoring. In this context, various markers of airway inflammation (e.g. eosinophils in the induced sputum, nitric oxide in the exhaled air) have been proposed to assess the severity of asthma and to adjust the therapy accordingly. The evaluation of airway hyper‐responsiveness with different stimuli has also been suggested as a new tool to monitor asthma. However, the lack of definite relationships between airway inflammation and asthmatic symptoms strongly limit the use of markers of asthma severity in the clinical setting. Therefore, the need of new tools to assess the severity of asthma is raised. The ideal measurement employed to establish the proper asthmatic therapy should be safe, non‐invasive, easy to perform, reproducible and accurate, and have the capability to monitor the changes induced by the therapeutic interventions. A careful review of the available techniques, and the evaluation of their sensitivity and specificity in the clinical setting is warranted.
Resiquimod, a new immune response modifier from the family of imidazoquinolinamines, inhibits allergen‐induced Th2 responses, airway inflammation and airway hyper‐reactivity in mice
Authors: Quarcoo D. , Weixler S. , Joachim R.A. , Stock P. , Kallinich T. , Ahrens B. , Hamelmann E.
Published: August 2004

Background
Allergen‐induced sensitization and airway disease are the results of adverse immune reactions against environmental antigens that may be prevented or inhibited by immune modifying strategies.

Objective
To investigate the effects of the novel immune response modifier resiquimod (R‐848), from the family of imidazol‐derivates, in a murine model of allergen‐mediated Th2‐immune responses and concomitant airway inflammation and airway hyper‐reactivity.

Methods
BALB/c mice were systemically sensitized with ovalbumin (OVA) on days 1 and 14 and challenged with OVA aerosol on days 28 and 29. R‐848 was applied intranasally to sensitized animals once prior to the first allergen airway challenge, on day 27.

Results
A single application of R‐848 significantly reduced numbers of eosinophils and lymphocytes in bronchoalveolar lavage fluid and inhibited mucus gland hyperplasia, compared with sensitized and challenged controls. Associated with the decrease in airway inflammation, single intranasal treatment with R‐848 abolished the development of airway hyper‐reactivity after allergen sensitization and airway challenges. Additionally, Th2‐cytokine production in lung tissues from sensitized and R‐848‐treated animals was reduced, whereas IL‐12 and IFN‐γ production was increased, compared with non‐treated sensitized mice.

Conclusion
These data indicate that R‐848 effectively inhibits allergen‐induced airway inflammation and hyper‐reactivity by modulation of increased Th2‐immune responses.
Effect of mite‐impermeable mattress encasings and an educational package on the development of allergies in a multinational randomized, controlled birth‐cohort study – 24 months results of the Study of Prevention of Allergy in Children in Europe
Authors: Horak F. , Matthews S. , Ihorst G. , Arshad S. H. , Frischer T. , Kuehr J. , Schwieger A. , Forster J. ,   the SPACE study group
Published: August 2004

Background
Sensitization to house dust mite (HDM) is an important risk factor for the development of asthma and allergic disease in childhood. Higher levels of HDM allergen are linked to increased sensitization to HDM.

Objective
To study the effect of mite‐impermeable mattress encasings and an educational package on the development of allergies in a newborn cohort.

Methods
Six hundred and ninety‐six newborns at high risk of developing allergies were enrolled in three European countries (Germany, Austria, UK) in a prospective, randomized, controlled birth‐cohort study. Children were randomly assigned to an intervention and control group. Intervention measures included the use of mite‐impermeable mattress encasings for the child's bed and a simple educational package on allergen avoidance. The control group received basic information about allergies. Children were followed up at age 6, 12, 18 and 24 months.

Results
80.9% of the children were followed up to the age of 24 months. No difference in the prevalence of sensitization to HDM (control vs. intervention group: 8.4% vs. 6.1%, P=0.33) or the development of symptoms (recurrent wheezing 10.3% vs. 10.7%, nocturnal cough 12.5% vs. 12.5%) or allergic diseases (asthma 3.5% vs. 5.1%, eczema 20.0% vs. 19.6%, rhinitis 28.9% vs. 25.8%) could be found between the control and intervention group.

Conclusion
In this study, HDM avoidance did not show a protective effect on the development of sensitization to HDM or symptomatic allergy in children at age 24 months.
Cellular and molecular mechanisms in chronic obstructive pulmonary disease: an overview
Authors: Di Stefano A. , Caramori G. , Ricciardolo F. L. M. , Capelli A. , Adcock I. M. , Donner C. F.
Published: August 2004

In the last decade, the analysis of bronchial biopsies and lung parenchyma obtained from chronic obstructive pulmonary disease (COPD) patients compared with those from smokers with normal lung function and non‐smokers has provided new insights on the role of the different inflammatory and structural cells, their signalling pathways and mediators, contributing to a better knowledge of the pathogenesis of COPD. This review summarizes and discusses the lung pathology of COPD patients with emphasis on inflammatory cell phenotypes that predominate in different clinical conditions. In bronchial biopsies, a cascade of events takes place during progression from mild‐to‐severe disease. T lymphocytes, particularly CD8+ cells and macrophages are the prevalent inflammatory cells in the lung of healthy smokers and patients with mild COPD, while total and activated neutrophils predominate in severe COPD. The number of CD4+, CD8+ cells and macrophages expressing nuclear factor‐kappa B (NF‐κB), STAT‐4 and IFN‐γ proteins as well as endothelial adhesion molecule‐1 in endothelium is increased in mild/moderate disease. In contrast, activated neutrophils (MPO+ cells) and increased nitrotyrosine immunoreactivity develops in severe COPD. In bronchial biopsies obtained during COPD exacerbations, some studies have shown an increased T cell and granulocyte infiltration. Regular treatment with high doses of inhaled glucocorticoids does not significantly change the number of inflammatory cells in bronchial biopsies from patients with moderate COPD. The profile in lung parenchyma is similar to bronchial biopsies. ‘Healthy’ smokers and mild/moderate diseased patients show increased T lymphocyte infiltration in the peripheral airways. Pulmonary emphysema is associated with a general increase of inflammatory cells in the alveolar septa. The molecular mechanisms driving the lymphocyte and neutrophilic prevalence in mild and severe disease, respectively, needs to be extensively studied. Up‐regulation of pro‐inflammatory transcription factors NF‐κB and STAT‐4 in mild, activated epithelial and endothelial cells in the more severe disease may contribute to this differential prevalence of infiltrating cells.
A case–control study of dietary and erythrocyte membrane fatty acids in asthma
Authors: Broadfield E. C. , McKeever T. M. , Whitehurst A. , Lewis S. A. , Lawson N. , Britton J. , Fogarty A.
Published: August 2004

Background
Epidemiological evidence suggests that increased dietary ω‐6 and reduced ω‐3 fatty acid intake, may have contributed to the rising prevalence of asthma, but these hypotheses have not been tested in studies comparing both dietary intake and objective measures of polyunsaturated fatty acids.

Objective
To assess whether a higher intake of ω‐6 or a lower intake of ω‐3 fatty acids increases the risk of asthma, by measuring dietary fatty acid intake by a food frequency questionnaire (FFQ) and erythrocyte membrane fatty acids, as an objective biomarker of intake.

Methods
We have compared individual fatty acid intake estimated by FFQ and by mass spectrometry of fasting erythrocyte cell membranes in 89 cases of asthma and 89 community‐matched controls.

Results
The odds of asthma were increased in relation to intake of the ω‐3 fatty acids eicosapentaenoic acid (odds ratio (OR) for difference between the 25th and 75th centiles of intake=1.89, 95% CI 1.15–3.11) and docosahexaenoic acid (OR=2.11, 95% CI 1.19–3.74). There was no evidence of any difference in erythrocyte membrane levels of ω‐3 fatty acids, while the odds of asthma were reduced in relation to linoleic acid (ω‐6) membrane levels (OR=0.45, 95% CI 0.21–0.95).

Conclusion
These findings suggest that dietary ω‐3 fatty acids do not play a major role in protecting against asthma, and that higher levels of erythrocyte membrane linoleic acid are associated with a lower risk of asthma.
Increase in urinary leukotriene B4 glucuronide concentration in patients with aspirin‐intolerant asthma after intravenous aspirin challenge
Authors: Mita H. , Higashi N. , Taniguchi M. , Higashi A. , Akiyama K.
Published: August 2004

Background
Aspirin challenge of aspirin‐intolerant asthma (AIA) patients causes a significant increase in leukotriene E4 (LTE4) concentration in urine. However, knowledge on leukotriene B4 (LTB4) generation in patients with AIA is insufficient. Recent research has demonstrated that exogenously administered LTB4 is excreted as glucuronide into the urine in human healthy subjects.

Objective
The purpose of this study is to estimate urinary LTB4 glucuronide (LTBG) concentration in the clinically stable condition in healthy subjects and asthmatic patients and to investigate changes in urinary LTBG concentration in patients with AIA after aspirin challenge.

Methods
A provocation test was performed by intravenous aspirin challenge. After urine was hydrolysed by β‐glucuronidase, the fraction containing LTB4 was purified by high‐performance liquid chromatography and LTB4 concentration was quantified by enzyme immunoassay. Urinary LTBG concentration was calculated as the difference between the concentration obtained with hydrolysis and that without hydrolysis.

Results
(1) After hydrolysis, the presence of urinary LTB4 was verified by gas chromatography‐mass spectrometry‐selected ion monitoring. (2) The urinary LTBG concentration was significantly higher in the asthmatic patients than in the healthy subjects (median, 5.37 pg/mg creatinine [range 1.2–13] vs. 3.32 pg/mg creatinine [range, 0.14–10.5], P=0.0159). (3) The patients with AIA (n=7), but not those with aspirin‐tolerant asthma (n=6), showed significant increases in LTBG and LTE4 excretions after aspirin challenge. (4) When the concentrations after aspirin challenge were analysed simultaneously, a significant linear correlation was observed between urinary LTBG concentration and urinary LTE4 concentration in patients with AIA (Spearman's rank correlation test, r=0.817, P=0.0003).

Conclusion
LTBG is present in human urine, albeit at a concentration lower than urinary LTE4. In addition to a marked increase in cysteinyl‐leukotriene production, aspirin challenge induced LTB4 production in AIA patients.
An evaluation of a GP out‐of‐hours service: meeting patient expectations of care
Authors: Thompson Kate , Parahoo Kader , Farrell Brid
Published: August 2004

Background  The reorganized out‐of‐hours general practitioner (GP) service, resulting in the creation of out‐of‐hours cooperatives has been widely welcomed by the medical profession. However, GP satisfaction remains only one aspect of this reorganized service and patients’ views and levels of satisfaction must have a contribution to make to the organization and delivery of the service.

Aim  To assess patient satisfaction at two out‐of‐hours cooperatives in Northern Ireland.

Method  A sample of 4466 patients contacting the out‐of‐hours service was surveyed by postal questionnaires using a previously validated patient satisfaction instrument.

Results  Patients who initially requested to be seen at the out‐of‐hours centre were more likely to receive the contact they requested than those who requested telephone advice or a home visit. Only 41.8% of patients requesting a home visit actually received one. Patients were generally satisfied with the service provided and most satisfied with the ‘doctor's manner’ and the ‘explanation and advice’ received. Patients who received the contact they initially requested were more satisfied with all aspects of the service than other patients. The type of contact actually received had little effect on the satisfaction levels reported by patients who received the contact they initially requested.

Conclusion  The population should be made fully aware of the services provided by out‐of‐hours cooperatives to enable them to have realistic expectations. With realistic expectations, patients are more likely to receive the medical contact they request and consequently will be more satisfied with the service provided. High satisfaction level is an important outcome measure of any out‐of‐hours service as it increases patient confidence and compliance and ultimately clinical outcome.
Histopathological studies of bacterial haemorrhagic ascites of ayu, Plecoglossus altivelis (Temminck & Schlegel)
Authors: Kobayashi T , Imai M , Ishitaka Y , Kawaguchi Y
Published: August 2004

A histopathological study was carried out on ayu, Plecoglossus altivelis, with bacterial haemorrhagic ascites. The fish were obtained from culture ponds in Wakayama Prefecture in 2003. The causative agent was identified as Pseudomonas plecoglossicida by a slide agglutination test using anti‐P. plecoglossicida FPC941 serum. Histopathological studies revealed lesions in spleen, kidney, liver, intestine, heart and gills. Lesions in the spleen and haematopoietic tissue were prominent and invaded by P. plecoglossicida. Necrotic lesions accompanied by haemorrhage, fibrin deposition and oedema occurred in the splenic pulp and sheathed tissue, and in the kidney. The liver also had necrotic lesions and abscess formations. However, the intestine, heart and gills were only slightly invaded by P. plecoglossicida. No lesions or bacteria were observed in the brain.
Nodavirus infections in Israeli mariculture
Authors: Ucko M , Colorni A , Diamant A
Published: August 2004

Viral encephalopathy and retinopathy (VER) infections were diagnosed in five fish species: Epinephelus aeneus, Dicentrarchus labrax, Sciaenops ocellatus, Lates calcarifer and Mugil cephalus cultured on both the Red Sea and Mediterranean coasts of Israel during 1998–2002. Spongiform vacuolation of nervous tissue was observed in histological sections of all examined species. With transmission electron microscopy, paracrystalline arrays and pieces of membrane‐associated non‐enveloped virions measuring approximately 30 nm in diameter were observed in the brain and retina of all species. At the molecular level, the nodavirus was detected by using a primer set that amplified the T4 region of the coat protein gene. When the same set of primers was used to search for VER in an additional fish species, Sparus aurata, it was found to produce non‐specific amplicons, giving rise to false‐positive results. This problem was overcome by using a different primer set (F1/VR3), designed on a highly conserved region of the virus gene, which amplified a fragment of 254 bp, and confirmed that S. aurata was nodavirus‐free. This set was validated on all five species of infected fish, as well as clinically healthy fish. Comparison of the coat protein genes from the Israeli isolated sequences indicated that more than one viral strain was involved. No strict host‐specificity was evident. Red Sea and Mediterranean isolated sequences grouped in distinct clusters, together with several foreign isolates from the Mediterranean area and the Far East, as phylogenetically close to the Epinephelus akaara RGNNV type.
Lichen planus induced by hepatitis B vaccination: a new case and review of the literature
Authors: Calista Donato , Morri Massimo
Published: August 2004

Case Report

In May 1996, as part of his routine antihepatitis B (hepB) vaccination plan, a 28‐year‐old HbsAg‐negative man, hospital worker, received his first dose (20 µg) of a recombinant vaccine (EngerixB‐B, Smith Kline and Beecham, Belgium), administered via deltoid injection. The patient was otherwise healthy and taking no medication. Thirty days after the 2nd booster dose, several pruritic, polygonal, purple, papules appeared on the volar aspect of the patient's wrists. New lesions gradually spread to the arms and trunk (Fig. 1). The clinical diagnosis of lichen planus (LP) was confirmed by histology, which revealed hyperorthokeratosis, hypergranulosis, vacuolar degeneration of the basal layer cells and a dense, band‐like lymphocytic infiltrate in the superficial dermis. The disease started to heal after treatment with topical clobetasol propionate 0.05% and sun exposure during the following summer. Five days after the 3rd booster dose, in November 1996, the dermatosis relapsed on the forearms, trunk, and legs. On that occasion, routine laboratory tests, including a complete blood count, blood chemistry and liver function tests, were within normal limits. Screening serologic tests for autoantibodies including antinuclear antibodies, antidouble‐stranded DNA, anti‐SS‐A, anti‐SS‐B and anti‐Sm were all negative. As a result of the inadequate levels of antihepatitis B antibodies, less than 10 IU/l in May 1998, in a high‐risk patient who was frequently exposed to blood and its products, an additional booster dose was performed. Three days later a new recurrence of disseminated lichen planus occurred. The patient was successfully treated with prednisone 1 mg/kg/day for 2 weeks. There was no recurrence the following year.

Polygonal, violet, brownish papules scattered on the trunk

image
Bioavailability of betamethasone dipropionate when combined with calcipotriol
Authors: Traulsen Jette
Published: August 2004

Background  Calcipotriol and corticosteroids are commonly used treatments for psoriasis vulgaris, each with different mechanisms of action. The two agents have shown combined action, but current formulations do not permit simultaneous application. Daivobet® (LEO Pharma, Denmark) ointment contains calcipotriol and the corticosteroid, betamethasone dipropionate. Such a formulation may provide convenience and enhanced activity compared with separate applications, but it is essential that the biological activity and bioavailability of either active agent is not adversely affected by the other component.

Objective  his study was designed to determine whether the bioavailability of the corticosteroid component of Daivobet® was equivalent to that in a corticosteroid‐only formulation (Diprosone®, Schering‐Plough Laboratories, France).

Method  A vasoconstrictor assay measuring skin blanching was used to determine bioequivalence.

Result  Skin blanching measured either by objective chromametric measurement or visual assessment showed Daivobet® to be equivalent to Diprosone®.

Conclusion  The data indicate that the steroid component of Daivobet® is not unfavorably affected by the calcipotriol.
Intravascular metastatic melanoma of the vena saphena magna
Authors: Saint‐Cyr Isabelle , Boisseau‐Garsaud Anne‐Marie , Pont Frédéric , Cales‐Quist Danielle , Helenon Raymond , Chinyavong Thao
Published: August 2004

Background  Melanoma blood vessel metastases are very uncommon. We report the first recorded case of intravascular metastatic melanoma of the vena saphena magna.

Case report  A 74‐year‐old woman presented with a swelling of the upper third of her left thigh and was suspected of superficial thrombophlebitis. Two intravascular black masses were excised in the vena saphena magna. Histopathologic examination showed an endovascular metastatic melanoma positively staining for HMB45 and S‐100 proteins. Acral‐lentiginous melanoma of her big toe was then found. Subcutaneous lymph node and chest metastases were discovered and treatment with dacarbazine was initiated, followed by treatment with fotemustine. The patient died 21 months after the diagnosis was made.

Conclusions  Only a few cases of blood vessel metastatic melanoma have been reported. We here report the first recorded case, to our knowledge, of intravascular metastatic melanoma of the vena saphena magna. Surgical exploration allowed rapid diagnosis, and histological examination confirmed the intravascular nature of a hematogenous melanoma metastasis. This case clearly illustrates the need for histologic examination of any thrombotic material.
Autoimmune progesterone dermatitis
Authors: Rasi Abbas , Khatami Alireza
Published: August 2004

Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions with variable morphology occurring during the luteal phase of the menstrual cycle. We report a case of a 40‐year‐old woman with recurrent pruritic eruptions of 8 years’ duration. The possibility of autoimmune progresterone dermatitis was raised because of the cyclic nature of the exacerbations. We used oral estrogen both to confirm the diagnosis and to treat the patient. A brief review of the clinical features of the disease is also presented.
Human T lymphotropic virus 1 and hepatitis C virus as risk factors for inflammatory dermatoses in HIV‐positive patients
Authors: Bonamigo Renan Rangel , Borges Karen , Rietjens Juliana , Arenzon Simone , Blanco Luiz Felipe , Loureiro Regina
Published: August 2004

Background  Dermatoses are common in HIV‐infected patients. Infections caused by human T lymphotropic virus 1 (HTLV‐1) and hepatitis C virus (HCV) are also associated with dermatoses, and their coinfection with HIV has been described. The aim of this study was to investigate the influence of HTLV‐1 and HCV in increasing the frequency of dermatological diseases in HIV‐positive patients.

Methods  This cross‐sectional study included patients infected with HIV and dermatoses, who consulted the Service of Dermatology Outpatient Clinic of the Health Department of the State of Rio Grande do Sul, in southern Brazil. Their care included the taking of a history and a physical examination, complementary examinations for diagnostic purposes, HTLV‐1 and HCV serology, measurement of CD4 lymphocyte count and HIV viral load, and recording of the use of antiretroviral drugs.

Results  One hundred and five HIV‐positive patients with dermatoses were evaluated. Positivity for HTLV‐1 occurred in 12 patients (12.5%) and that for HCV in 35 patients (38%). The most frequently found dermatoses were infectious and inflammatory in origin. A significant statistical association was found between HIV and HTLV‐1 coinfection, with dermatoses of inflammatory origin (P = 0.03; CI = 1.14–2.83).

Conclusions  It is important to consider the high rate of positivity for HTLV‐1 and HCV in the HIV‐positive patients (12.5 and 38%, respectively). A higher risk of inflammatory dermatoses is found in patients who are simultaneously positive for HTLV‐1 and HIV, indicating the possible importance of this coinfection in the development or worsening of certain dermatological diseases.
A protocol for oral desensitization in children with IgE‐mediated cow's milk allergy
Authors: Meglio P. , Bartone E. , Plantamura M. , Arabito E. , Giampietro P. G.
Published: August 2004

Objectives: To desensitize children with severe immunoglobulin (Ig)E‐mediated cow's milk allergy in a period of 6 months by introducing increasing daily doses of cow's milk (CM) in order to enable the child to assume 200 ml of CM daily, or to induce tolerance of the highest possible CM dose.

Study design: Twenty‐one children at least 6 years old with severe IgE‐mediated CM allergy were admitted to the study. A convincing history of IgE‐mediated CM allergy or a positive double‐blind placebo‐controlled food challenge with CM confirmed the diagnosis. Oral desensitization was performed with increasing doses starting from 0.06 mg of CM proteins.

Results: Overall, 15 of 21 children (71.4%) achieved the daily intake of 200 ml during a 6‐month period; three of 21 children (14.3%) tolerated 40–80 ml/day of undiluted CM; three of 21 children (14.3%) failed the desensitization because they presented allergic symptoms after ingesting minimal amounts of diluted CM.

Conclusions: We successfully desensitized 15 of 21 children with severe IgE‐mediated CM allergy in a period of 6 months. We stress the importance of the partial outcome in those three of 21 children who could not reach the maximum amount of 200 ml/day of whole CM, but were able to tolerate 40–80 ml/day of CM. In this way we dramatically reduced the risk of severe reactions after accidental or unnoticed introduction of low quantities of CM. We do not propose generalizing this method beyond trained staff.
The relation between obesity and asthmatic airway inflammation
Authors: Leung Ting Fan , Li Chung Yi , Lam Christopher W. K. , Au Catherine S. S. , Yung Edmund , Chan Iris H. S. , Wong Gary W. K. , Fok Tai Fai
Published: August 2004

Epidemiologic studies suggest increased asthma prevalence in obese subjects. However, the relation between obesity and airway inflammation remains unclear. This cross‐sectional study aims to investigate the relation between obesity indices and exhaled nitric oxide (ENO) and leukotriene B4 (LTB4) in children with asthma. Asthmatic patients aged 7–18 yr old were recruited. Weight‐for‐height Z score was calculated from anthropometry. ENO was measured by online single‐breath method using a chemiluminescence analyzer, whereas LTB4 concentrations in exhaled breath condensate (EBC) were quantified using competitive enzyme immunoassay. Ninety‐two asthmatics and 23 controls were recruited. The mean ENO and LTB4 concentrations in EBC were higher in asthmatic patients (87 p.p.b. and 40.5 pg/ml) than controls (25 p.p.b. and 18.7 pg/ml) (p < 0.0001 for both). Obesity, as defined by weight >120% median weight‐for‐height, was not associated with any alteration in ENO or LTB4 concentrations in patients with asthma. Besides, these inflammatory markers did not differ between asthmatics in the highest and lowest quartiles of weight‐for‐height Z score. On multivariate analysis, ENO showed significant correlation with age (β = 0.511, p < 0.0001), peripheral blood eosinophil count (β = 0.222, p = 0.019), plasma total IgE concentration (β = 0.187, p = 0.050) and forced expiratory volume in 1‐s (FEV1; β = −0.221, p = 0.014). None of the factors was associated with LTB4 concentration in EBC. In conclusion, ENO and LTB4 concentration in EBC are increased in childhood asthma. However, these inflammatory markers did not differ between obese and non‐obese children with asthma.
Development of atopy and wheezing symptoms in relation to heredity and early pet keeping in a Swedish birth cohort
Authors: Sandin Anna , Björkstén Bengt , Bråbäck Lennart
Published: August 2004

The role of pet keeping during infancy for the development of allergy and asthma is still controversial. The objective of this population‐based birth cohort study was to assess the development of atopy and different wheezing phenotypes during the first 4 yr of life in relation to heredity and early pet keeping. The cohort comprised all 1228 infants living in a Swedish county who were born over a 1‐yr period. The parents replied to repeated questionnaires and 817 of the children were skin prick tested both at 1 and 4 yr. Cat keeping during the first year of life was associated with an increased risk of a positive skin prick test to cat at 1 yr of age [odds ratio (OR) 2.2, 95% confidence interval (CI) 0.9–5.6], but neither with sensitivity nor clinical symptoms of allergy at 4 yr. Dog keeping during the first year of life was associated with an increased risk of early‐onset transient wheezing, but only in children with parental asthma (adjusted OR 4.3, 95% CI 1.5–12.1). In contrast, early dog keeping had an inverse association with sensitivity to pollen allergen at 4 yr (adjusted OR 0.3, 95% CI 0.1–0.9) and late‐onset wheezing (adjusted OR 0.4, 95% CI 0.2–1.0). Thus, pet keeping during the first year of life was not associated with an increased risk of atopy at 4 yr, although a positive SPT to cat was more common at 1 yr. Our findings may even suggest that dog keeping during the first year of life might provide some protection from pollen allergy and late‐onset wheezing and increase the risk of early‐onset transient wheezing in children with heredity for asthma.
Prenatal exposure to house dust mite allergen (Der p 1), cord blood T cell phenotype and cytokine production and atopic dermatitis during the first year of life
Authors: Hagendorens Margo M. , Ebo Didier G. , Bridts Chris H. , Water Leen Van de , De Clerck Luc S. , Stevens Wim J.
Published: August 2004

This study investigated the influence of prenatal exposure to house dust mite (HDM, D. pteronyssinus) on interleukin (IL)‐2, interferon‐gamma (IFN‐γ) and IL‐4 producing CD4+ and CD8+ T lymphocytes in cord blood as well as on the development of sensitization and occurrence of atopic dermatitis (AD) as the first symptom of allergy during the first year of life. Dust samples (n = 22) were collected by vacuum cleaning the maternal mattress during early to mid‐pregnancy. In these samples, the amount of the major HDM antigen (Der p 1) was assessed by a sensitive enzyme‐linked immunosorbent assay technique (detection limit 0.004 μg/g dust). Flow cytometry was used to determine cord blood lymphocyte subtypes and to quantify the intracellular amounts of IL‐2, IFN‐γ and IL‐4 produced by cord blood CD4+ helper and CD8+ cytotoxic T lymphocytes, both spontaneously and after stimulation with phorbol‐12‐mirystate‐13‐acetate and ionomycin. Children were followed for 1 yr for the presence of symptoms associated with allergy. In addition, at the age of 1 yr specific IgE to different classical inhalant and food allergens was measured. Higher prenatal exposure to Der p 1 (>0.2 μg/g dust) was associated with a significant lower percentage of IFN‐γ producing stimulated CD4+ T lymphocytes, compared with lower prenatal Der p 1 exposure (p = 0.03). The presence of AD during the first year of life (n = 9) was associated with an increased number of naive CD4+ CD45RA+ lymphocytes (p = 0.03), with an increased spontaneous IL‐4 production by CD8+ lymphocytes (p = 0.04) and with a decreased percentage of IFN‐γ producing stimulated CD4+ lymphocytes (p = 0.04). Furthermore, exposure to HDM during pregnancy tended to be higher in mothers of children with AD during the first year of life when compared with those without AD (p = 0.08). This study shows that the level of prenatal exposure to Der p 1 influences the immune profile of cord blood T lymphocytes and the clinical outcome in early life. Therefore, the prenatal environment must be regarded as a possible early risk factors for allergic diseases in children.
Interaction of cis‐acting elements in the expression of a gene encoding cytosolic glutamine synthetase in pine seedlings
Authors: Gómez‐Maldonado Josefa , Ávila Concepción , Barnestein Pilar , Crespillo Remedios , Cánovas Francisco M.
Published: August 2004

Glutamine synthetase (GS) genes, GS1a and GS1b, in pine (Pinus sylvestris L.) are differentially regulated in tissue specificity and during seedling development. To gain insight into the regulatory mechanisms controlling their expression, we have analysed the 5′‐flanking sequences of the gene GS1a using a transient expression system in pine protoplasts. Structural analysis of this region revealed the presence of putative regulatory elements including two AT‐rich elements and a poly CT consensus sequence. A series of 5′‐ and 3′‐deletions of the untranslated region covering the three putative elements, −800 to −626, −626 to −427 and +118 to +177 were analysed to demonstrate the functional implications of these elements in gene regulation. An electrophoretic mobility‐shift assay showed that nuclear proteins prepared from pine cotyledons interact with both AT‐rich regions (−800 to −427). Interestingly, no protein binding was detected when the untranslated region (+118 to +177) was included, even if deletion of that region suppressed promoter activity in the transient expression experiments conducted. However, simultaneous deletion of both types of cis elements, A/T and CT, resulted in a recovery of promoter activity of 50%. These results suggest a key regulatory role of the CT box by the interaction with A/T stretches in the distal part of the promoter and possibly with the proximal region (−427 to −1).