bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Newer Echocardiographic Modalities in the Elderly
Authors: Mankad Sunil , Nanda Navin C.
Published: December 2007

The emerging role novel echocardiographic techniques play in the practice of cardiology and how they can specifically impact care of the elderly patient are reviewed. Newer echocardiographic modalities including Doppler tissue and strain/strain rate imaging, contrast echocardiography, 3‐dimensional echocardiography, and velocity vector imaging are described. Examples illustrating how these newer echocardiography modalities enhance our ability to make a variety of cardiovascular diagnoses are shown. The way in which these novel echocardiographic techniques allow for improved noninvasive estimation of left ventricular filling pressure, better diagnosis of cardiomyopathy and complications of acute myocardial infarction, better quantification of valvular heart disease, and enhance our understanding of myocardial contractile processes are reviewed. These newer echocardiographic modalities will continue to play an increasing role in the future as applications identifying ways in which they enhance cardiovascular diagnosis are discovered.
Isolation of cDNAs encoding 6‐phosphogluconate dehydrogenase and glucose‐6‐phosphate dehydrogenase from the mediterranean fruit fly Ceratitis capitata: correlating genetic and physical maps of chromosome 5
Authors: Scott M. J. , Kriticou D. , Robinson A. S.
Published: December 2007

We have isolated and determined the nucleotide sequences for cDNA clones encoding glucose‐6‐phosphate dehydrogenase (G6PD) and 6‐phosphogluconate dehydrogenase (6PGD) from the medfly Ceratitis capitata. The derived amino acid sequences for G6PD and 6PGD are presented and compared with G6PDs and 6PGDs from other species. The codon usage of the cDNA clones has little bias with the notable exceptions of arginine, glycine and leucine.

The chromosomal location of the genes for 6PGD and G6PD were determined by in situ hybridization to salivary gland polytene chromosomes. This localization orients a genetic map of enzymatic loci and illustrates a remarkable similarity in the intra chromosomal order of homologous genes between Drosophila melanogaster and medfly.
Transfection of cultured cells of the cotton boll weevil, Anthonomus grandis, with a heat‐shock‐promoter‐chloramphenicol‐acetyltransferase construct*
Authors: Stiles B. , Heilmann J. , Sparks R. B. , Santoso A. , Leopold R. A.
Published: December 2007

Expression of heat shock proteins (hsp) in the BRL‐AG‐3C cell line from the cotton boll weevil was examined. It was determined that the maximal expression of endogenous hsp occurred at 41°C. Various transfection methods were then compared using this cell line in conjunction with a transiently expressed bacterial gene marker (chloramphenicol acetyltransferase) which was under the control of the Drosophila hsp 70 gene promoter. The cationic lipid preparation Lipofectin was found to be very efficient at transfecting the boll weevil cells. Polylysine and 20‐hydroxyecdysone‐conjugated polylysine were moderately effective, whereas polybrene and electroporation, under the conditions reported herein, were ineffective at transfecting this cell line.
Modulation of DNA‐binding proteins in Locusta migratoria in relation to juvenile hormone action
Authors: Braun R. P. , Wyatt G. R.
Published: December 2007

Using a gel mobility shift assay, protein factors have been identified that may participate in the transcriptional regulation of the juvenile hormone (JH) induced vitellogenin A (VgA) gene of the migratory locust. Two DNA‐binding proteins were found that were modulated in correlation with VgA gene activity during normal reproductive cycles and experimental stimulation by an active JH analogue (pyriproxyfen). One of these, JH factor (JHF), may be a regulator of VgA and perhaps other JH‐responsive genes. The second, mobile factor (MF), appears to have a more general role in cellular responses to external stimuli such as JH and wounding. JHF and MF may represent factors that act together with the JH receptor to regulate VgA gene transcription.
Cloning and sequencing of the blood meal‐induced late trypsin gene from the mosquito Aedes aegypti and characterization of the upstream regulatory region
Authors: Barillas‐Mury C. , Wells M. A.
Published: December 2007

A 4.1 kb genomic clone of the late trypsin gene from the mosquito Aedes aegypti was isolated, mapped and subcloned. A1.6 kb subclone, corresponding to 1.1 kb of upstream regulatory region and 0.5 kb of coding region, was sequenced. The gene has no introns within the coding region. The 5 end of the mature mRNA was mapped using primer extension analysis. A TATA box consensus sequence (TATAAA) was found at position —31 from the 5 end of the mature mRNA. A cluster of five repeat sequences homologous to the yeast GCN4 DNA binding site was found within 200 nucleotides upstream of the cap site. GCN4 is required for derepression mediated control of general amino acid biosynthesis in response to amino acid starvation in yeast. It activates the transcription of at least twenty different genes coding for enzymes involved in amino acid biosynthesis. The presence of this cluster of consensus sequences suggests that a protein similar to GCN4 might regulate expression of the late trypsin gene in the mosquito. Southern blot analysis of genomic DNA indicates that late trypsin is a single copy gene.
Different modes of hypervariability in (GATA)n simple sequence repeat loci
Authors: Rohwedel J. , Weichenhan D. , Meier C. , Traut W.
Published: December 2007

Only a few prominent simple sequence repeat (SSR) loci of the type (GATA)n are found in the genome of the mealmoth Ephestia kuehniella Zeller. Therefore this moth was chosen as a model organism for the genetic and molecular analysis of hypervariability of SSR loci. We characterized alleles of (GATA)n loci in different Ephestia strains by cloning and genomic restriction mapping. Some variants appeared to be mere variable number of tandem repeat (VNTR) alleles, others showed considerable changes in the sequence neighbourhood of the GATA repeats. These may be produced by major rearrangements or by transposition of the (GATA)n block together with flanking sequences into a different sequence environment.
Excretory/secretory chymotrypsin from Lucilia cuprina: purification, enzymatic specificity and amino acid sequence deduced from mRNA
Authors: Casu R. E. , Pearson R. D. , Jarmey J. M. , Cadogan L. C. , Riding G. A. , Tellam R. L.
Published: December 2007

Two chymotrypsin‐like proteases were purified from the secretory and excretory material of first‐instar larvae of Lucilia cuprina. The hydrolysis of N‐succinyl‐L‐phenylalanine‐nitroanilide was used to monitor the purification of these proteases which was achieved by affinity chromatography on soybean trypsin inhibitor‐Sepharose followed by anion exchange and hydrophobic interaction chromatographies. The enzymatic specificity of the most abundant protease {Lucilia chymotrypsin b; LCTb) was further defined by determining the amino acid sequence of peptides released from insulin B chain after incubation with LCTb. Peptide amino acid sequences obtained from LCTb were used to design degenerate oligonucleotide primers which, in conjunction with the polymerase chain reaction, enabled cDNA coding for LCTb to be cloned and sequenced. The deduced amino acid sequence of LCTb showed many of the structural features of serine proteases as well as significant amino acid sequence homology with chymotrypsins from a diverse range of species. It is probable that LCTb plays an important role in establishing the myiasis‐causing larvae of L. cuprina on host skin as well as providing nutrients for the rapidly growing larvae.
Detection of Buchnera, the primary prokaryotic endosymbiont of aphids, using the polymerase chain reaction
Authors: Rouhbakhsh D. , Moran N. A. , Baumann L. , Voegtlin D. J. , Baumann P.
Published: December 2007

Members of the genus Buchnera constitute a distinct prokaryotic lineage containing the primary endosym‐bionts of aphids (Homoptera: Aphidoidea). Using synthetic oligonucleotides in conjunction with the polymerase chain reaction, we propose three approaches for the identification of members of this genus. The first is based on unique sequences within rrs (gene coding for 16S ribosomal RNA). The second is based on a different and unique organization of the ribosomal RNA operons of Buchnera and the close proximity of aroEupstream of rr/(gene coding for 23S rRNA). The third is based on the linkage relationship of argS which is upstream of rrs. Validation of these three approaches requires their more extensive application.
Ribosomal spacer length variability in the large raspberry aphid, Amphorophora idaei (Aphidinae: Macrosiphini)
Authors: Birch A. N. E. , Fenton B. , Malloch G. , Jones A. T. , Phillips M. S. , Harrower B. E. , Woodford J. A. T. , Catley M. A.
Published: December 2007

The large raspberry aphid, Amphorophora idaei, has several biotypes described by their abilities to overcome plant resistance genes. Bioassays of field populations showed a strong shift towards A, resistance‐breaking biotypes since the 1960s. RFLP analysis of the rDNA cistron was used to study variation found within and between standard clones of three A. idaei biotypes and twenty‐nine field populations collected over 3 years. Probing genomic DNA with the ribosomal DNA probe pBG 35 produced consistent differences in RFLPs between standard clones of biotypes. However, analysis of field populations gave more complex RFLP patterns that were not biotype‐specific, unlike characteristic intergenic spacer (IGS) patterns reported for Schizaphis graminum biotypes. All but one sample collected from separate fields showed considerable genetic diversity within populations, attributed to alate migrations of parthenogenetic females in summer and males in autumn.
Molecular analysis of the endosymbionts of tsetse flies: 16S rDNA locus and over‐expression of a chaperonin
Authors: Aksoy S.
Published: December 2007

Based on 16S rDNA sequence comparison, intracellular mycetome‐associated endosymbionts (P‐endosymbionts) of tsetse flies (Diptera: Glossinidae) form a distinct lineage within the γ‐3 subdivision of proteobacteria, related to the free‐living bacterium Escherichia coli, midgut S‐endosymbionts of various insects including tsetse flies, and to the P‐endosymbiont lineage of aphids, Buchnera aphidicola. Gene organization and expression of several loci in intracellular microorganisms have revealed differences from free‐living bacteria. This study analyses two of these characteristics in tsetse endosymbionts; the copy number and gene organization of rDNA operons and the nature of the abundant protein(s) synthesized by these microorganisms. Results indicate that Glossina morsitans morsitans S‐endosymbionts have multiple (seven) rDNA operons coding for 16S (rrs) followed by 23S (rrl) gene sequences, whereas tsetse P‐endosymbionts have a single, similarly organized rDNA operon. In tsetse mycetocytes in vitro, P‐endosymbionts synthesize a predominant protein of 60 kDa in size (p60) which by Western blot analysis shows immunological cross‐reactivity with the abundant 63 kDa (p63) protein of B. aphidicola. p63 (also referred to as symbionin) has been characterized as a molecular chaperone, structurally and functionally similar to the groEL protein of E. coli. Under in vitro conditions, tsetse S‐endosymbionts synthesize high levels of a similarly‐sized protein that cross‐reacts with p63 chaperonin. Antisera against the tsetse p60 protein also recognizes p63 protein of B. aphidicola, suggesting that the abundant tsetse endosymbiont protein is a chaperonin.
Primary sequence, copy number, and distribution of mariner transposons in the honey bee
Authors: Ebert P. R. , Hileman J. P. , Nguyen H. T.
Published: December 2007

A single honey bee mariner transposon (TnM1a) was sequenced, revealing a transpositionally non‐autonomous element of 937 bp delimited by 30 bp perfect inverted terminal repeats. The element is flanked by the TA duplication typical of mariner elements in general. There are approximately 435 copies of TnM1a homologous elements per haploid genome. These elements appear, by Southern blot analysis, to be dispersed throughout the genome. Thirteen individual genomic clones with an average size of 15 kb, were found to contain only a single element each, which also suggests that the elements are not tightly clustered. Finally, mariner elements are neither inactivated by methylation nor sequestered into a methylated fraction of the genome.
U1 snRNA variants coexist in Bombyx mori cells
Authors: Gao Jian‐Ping , Herrera R. J.
Published: December 2007

Evidence for at least four U1 snRNA variants were obtained from a U1 cDNA library using U1 snRNA from Bombyx mori BmN cells in culture. Sequence analysis of thirty cDNA clones showed that: (1) the nucleotide changes are in the hairpin structures I, II and III; (2) the majority of the base changes in stem structures between a posterior silk gland (PSG) U1 RNA and the BmN U1 clones, as well as among the BmN U1 clones, are compensatory; (3) although the base differences between PSG U1 and BmN U1 clones, and among the BmN U1 clones, are not the same, they are located in similar positions in moderately conserved sites, frequently at the bases of loops; (4) when comparing the PSG U1 with the BmN U1 clones, twelve out of nineteen stem differences generate stronger pairing resulting in a more stable hairpin II in the BmN U1 clones; and (5) the Sm and 70K proteins binding site sequences are highly conserved among these U1 clones. Although a comparison of sequence changes associated with U1 isoforms from different species indicate that there are no common base changes with the B. mori U1 clones reported here, similarities in the multitude and location of base differences in hairpins I, II and III are observed in mouse and/or Xenopus. It is possible that U1 variants like the ones reported here play a role in alternative pre‐mRNA splicing by way of different RNA‐protein factor interactions.
A model of clinical supervision for nurses undertaking short placements in mental health care settings
Authors: RITTER SUSAN , NORMAN IAN J , RENTOUL LYNETTE , BODLEY DENISE
Published: December 2007

This paper presents a model of supervision developed from the experience of supervising undergraduate general nursing students undertaking clinical experience in psychiatric wards.

Supervision structures and methods are presented and the theoretical underpinnings of the supervision model are discussed.

Our experience of using the model over the past 5 years suggests that it has the potential to allow students to gain a good understanding of individual patients within a short time span and to engage with them as active collaborators in care.

The supervision model can also assist students to develop the knowledge and insights needed to gain the respect of senior colleagues, and the confidence to challenge the professional conservatism that often characterizes psychiatric wards.
Striving to prevent falls in an acute care setting — action to enhance quality
Authors: MITCHELL ANN , JONES NEVILLE
Published: December 2007

Although most falls do not result in serious physical injury, they can contribute to a loss of confidence and mobility which can culminate in a significant reduction in quality of life. Furthermore, the potential to fall is often increased when an individual is institutionalized because of frailty or confusion.

The purpose of the study was, therefore, to establish whether a structured intervention would assist in preventing falls in an acute setting.

This pre‐test/post‐test study was carried out over a 12‐month period. Interventions included risk assessment, an alert system, reinforcing preventive actions, staff education and ongoing audits and feedback. Initial analysis of the data and comparison of fall rates indicated a significant reduction in the rate of falls between the pre‐ and post‐intervention phases, although subsequent statistical analysis did not identify any significant relationships.

It must be noted that no controls existed for extraneous variables, although patient profiles varied minimally during the period of the study.

Outcomes include: a reduction in fall numbers and rates, enhanced staff morale with ownership of the programme, provision of a learning experience for staff (on which to build), and the fostering of a professional approach to improving the quality of patient care.
Nurses achieve quality with pre‐assessment clinics
Authors: CLINCH CHRISTINE A.
Published: December 2007

Nurses in a group of Wolverhampton Hospitals carried out a local research study to identify not only the level of patient satisfaction with pre‐assessment clinics (PAC), but also what care nurses delivered in these clinics.

Data were collected using both ethnographic and survey methods.

Patients found the PAC visit valuable: it reduced stress and provided much needed information about the coming surgery.

The skills nurses used and the tasks carried out were consistent throughout the Trust, and reflected the provision of a high standard of care.
Clinical supervision
Authors: GOORAPAH DAVID
Published: December 2007

The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view.

Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations.

This paper examines the potential for its success amidst the scepticism that exists.

One important question raised is whether clinical supervision will replace or run alongside other support systems.
Anticipating and experiencing post‐operative pain: the patients' perspective
Authors: CARR ELOISE C.J. , THOMAS V.J.
Published: December 2007

This study uses a qualitative approach to explore patients' expectations and experiences of pain, factors contributing to the effective/ineffective management of their pain and strategies patients reported as helpful when experiencing pain. Ten patients on a mixed surgical ward at a District General Hospital in the south of England participated in the study.

Pain scores, using a visual analogue scale, were obtained for ‘expected’ pain pre‐operatively and ‘worst pain experienced’. A taped in‐depth interview exploring patients' experience of pain after surgery took place on the fifth post‐operative day.

Details of analgesia were also collected for the 5 days following surgery.

Patients expected pain after surgery but the intensity of the pain they experienced was often significantly greater than anticipated.

Lack of information, inadequate pain assessment and ineffective pain control contributed to this finding.

It is suggested that new pain technology, such as epidural and patient‐controlled analgesia, may not change the prevalence and incidence of pain unless the systems these technologies are placed within also change.
The emotional work of caring, with a focus on gynaecological nursing
Authors: MCQUEEN ANNE
Published: December 2007

In this paper the author briefly reviews the concept of caring

Emphasis is given to the emotional component and its management in caring relationships. This is illustrated with reference to a study of gynaecological nursing.

Analysis of nurses' perceptions and experiences revealed situations particularly relevant to empathy and emotional work in caring for gynaecological patients.
Empathy: a literature review and concept analysis
Authors: WHITE SUZANNE J.
Published: December 2007

Empathy appears to be an important concept in the interpersonal repertoire of the nurse. There are a number of definitions and models of empathy available in the literature.

These definitions and models are explored and analysed using Walker & Avant's (1983) approach to concept analysis. A model case of the concept is described and the relevant defining attributes identified. A borderline case and an example of ‘not the case’ are also examined.

This concept analysis may assist practitioners to develop the behavioural skills of empathy and to recognize and coach it in their students and colleagues.
‘Effective’ Australian gerontology nurses: a repertory grid analysis
Authors: RETSAS ANDREW , WILSON JANICE
Published: December 2007

Repertory grids were completed by gerontological nurses (N= 60) to elicit the personal constructs they used to characterize gerontological nurses, effective gerontological nurses and the extent to which participants believed themselves to be effective as nurses working in this specialist field.

Analysis of pooled repertory grids indicated that the personal construct ‘caring, compassionate, empathetic’ was rated most highly as characteristic of gerontological nurses in general and of effective gerontological nurses.

Cluster analysis of individual repertory grids showed no significant difference between self‐perceptions of participants as effective gerontological nurses and the ideal gerontological nurses they would like to become.

Other findings of this research indicate that a variety of aspects of gerontological nursing need improvement if negative perceptions of this area of nursing practice are to be altered.
The nature of expert psychiatric nurse practice: a grounded theory study
Authors: CUTCLIFFE JOHN R.
Published: December 2007

This study examines what psychiatric nurses regard as the nature of expert psychiatric nurse practice.

The study focuses on the beliefs and principles of psychiatric nurses currently working within a psychiatric unit.

Using grounded theory methodology, data were coded and analysed, producing an integrated framework of expert psychiatric nurse practice comprised of four core variables: ‘attitudes/philosophy’, ‘knowledge’, ‘skills’ and ‘roles’.

It is suggested that the nature of expert psychiatric practice is an evolutionary concept and that as this practice develops the integrated theory presented will need to develop in parallel.
Evidence‐based practice in primary care: past, present and future
Authors: Benech Irene , RGN Allson E. Wilson , Dowell Anthony C.
Published: December 2007

As in other health care specialities, evidence‐based practice is beginning to have an impact on the philosophy and workings of primary care. Some practising clinicians, however, may wish to question its relevance to their everyday work, and whether general practitioners and other members of the primary health care team can realistically adopt a new approach to clinical decision making, at a time of such high workload and competing priorities.

Major changes have taken place during the last 20 years as a result of the National Health Service (NHS) reforms, the development of general practice and primary care research, and other health service innovations such as the introduction of new technologies, which have had an important impact on primary care. Issues such as the availability and use of different research methods, the role of experts, and the development of guidelines, audit and evaluation of care, are becoming subject to renewed scrutiny.

Within this context, this article explores the potential of an evidence‐based approach in the primary care setting, and discusses possible strategies for change to assist the dissemination of research into practice and the implementation of evidence‐based health care.
The burden of waiting for hip and knee replacements in Ontario*
Authors: Williams J. Ivan , Llewellyn‐Thomas Hilary , Arshinoff Rena , BScPT Nancy Young , Naylor C. David
Published: December 2007

The objectives of this study were to assess the impact of major joint replacements in reducing pain and disability and to describe the burden of pain and disability that could be avoided by ordering the queues with respect to severity of disease. A secondary goal was to compare the uses of a general health status measure, the Short Form Health Survey (SF‐36), and a disease‐specific measure, the Western Ontario McMaster Osteoarthritis Index (WOMAC), for accomplishing the objectives.

The results are based on interviews with 209 patients before and after they had surgery. Only 15.9% of the patients had surgery within 3 months' waiting time, 19.2% waited 4–6 months, 30.7% waited 7–9 months, and the remaining 34.1 % waited a year or more. The waiting times were unrelated to the seventy of pain or disability reported in the initial interview.

Following surgery, there were large reductions in the WOMAC scores for pain, stiffness and difficulty in functioning. The SF‐36 showed substantial improvements in relief from pain and in physical functioning, and reductions in role limitation due to physical problems, but not for scores related to mental health. The WOMAC scores were more responsive to the benefits of surgery than the SF‐36 scores.

Queuing systems keyed on burden of symptoms could reduce the burden of pain and disability suffered by patients awaiting surgery. The improvements from hip and knee replacements suggest that equitable access for these procedures should be a priority in Ontario.
Including practice data to improve evidence‐based guidelines. Example of guidelines on the management of thyroid nodules
Authors: MPH Lionel H. Pazart MD , PhD Jacques Massol MD , PhD Yves Matillon MD
Published: December 2007

Although clinical guidelines are based on the best evidence available, their proliferation has often failed to change actual practice. One of the many explanations suggested is that there is a gap between the expectations of the targeted professionals and the recommendations in the guidelines. In this study, we attempted to take into account the state of current practice and the physicians' priorities. Using the example of guidelines on the management of thyroid nodules, three different surveys have been conducted: (1) an analysis of physicians' expectations and practice through a postal questionnaire to define appropriate questions; (2) a survey of the professionals' expert opinions, and (3) a prospective study of the use of these guidelines in the management of 253 patients. The results of these surveys have modified the development of the guidelines, and helped us to adapt the content of the guidelines to match physicians' practices more closely.
The ends of outcomes assessment
Authors: PhD Richard Gunderman MD
Published: December 2007

Outcomes assessment holds great promise to improve the quality and efficiency of health care. By subjecting practices to rigorous and systematic analysis, we should be in a position to make judgments about what does and does not work in clinical practice. However, the outcomes of outcomes assessment themselves should be approached with the same critical eye. Among the many sorts of criteria by which to evaluate outcomes assessment are several key parameters: foremost among them are cognitive outcomes, ethical outcomes, and economic outcomes. Only when these outcomes are thoroughly explored and taken into account will the fullest potential of outcomes assessment be realized.
Sequence variability of hepatitis C virus and its clinical relevance
Authors: Dusheiko G. , Simmonds P.
Published: December 2007

SUMMARY. Chronic type C hepatitis is a potentially serious disease that can lead to cirrhosis and hepatocelluler carcinoma. This complex disease is caused by the hepatitis C virus (HCV), a positive sense, single‐stranded RNA virus. HCV has been assigned to a separate genus within the Flaviviridae, and shares a close relationship to the pestiviruses. Nucleotide sequence variation has been observed in genomes amplified from serum of patients with HCV infection, and cloning of RNA amplified from patients infected with HCV has confirmed the heterogeneity of the agent responsible for post‐transfusion and sporadic hepatitis C. The variability of HCV is structured in a way that immediately suggests a two tiered classification: this nomenclature comprises ‘types’ corresponding to the major branches in a phylogenetic tree of sequences from genomic or subgenomic regions of the genome, and ‘subtypes’, corresponding to the more closely related sequences within some of the major groups. This genotyping designation has provided an epidemiological tool for studying geographical differences in hepatitis C infection. Clearly discernible patterns of genotype distribution have been found in those countries that have been studied so far. In many European countries genotype distributions vary with the age of patients, reflecting rapid changes in genotype distribution with time within a single geographical area. Unfortunately we know very little about modes of transmission within different communities. There is considerable interest in the clinical significance of different HCV genotypes, and the intriguing question of whether these differences may affect the spectrum of the disease associated with hepatitis C. These data also have implications for diagnosis and treatment of acute and chronic hepatitis C. A uniform typing scheme and nomenclature will facilitate our understanding of the disease caused by this virus worldwide.
Long‐term titrated recombinant interferon‐α2a in chronic hepatitis C: a randomized controlled trial
Authors: Rumi M. G. , Del Ninno E. , Parravicini M. L. , Romeo R. , Soffredini R. , Donate M. F. , Zahm F. , Colombo M.
Published: December 2007

Summary. The efficacy and tolerability of 12‐month treatment with titrated doses of recombinant interferon‐α2a (IFN‐α2a) in chronic hepatitis C were studied in 67 consecutively recruited patients randomly assigned either to a starting dose of IFN‐α2a 6 MU, subsequently adjusted to the serum alanine aminotransferase (ALT) response (n= 35), or to no therapy (n= 32; controls). End‐of‐treatment ALT levels were normal and hepatitis C virus (HCV) RNA was negative by nested polymerase chain reaction (PCR) in 17 (49%) treated patients compared to none of the controls (P < 0.001). During the 12 months after stopping treatment the number of patients who remained in remission was eight (23%) and one respectively (4%) (P= 0.031). Follow‐up liver biopsy showed reduced hepatic inflammation in 80% of treated patients and in 29% of controls (P < 0.001). The eight sustained responders and 2 7 non‐responders or relapsers received similar mean total doses of IFN (565 MU vs 545 MU) and had a similar incidence of anti‐IFN neutralizing anti‐bodys (13% vs 19%). Absence of cirrhosis was the only independent pretreatment parameter that predicted a sustained response. In conclusion, a mean cumulative dose of IFN 549 MU, titrated over 12 months, was well tolerated, and resulted in the long‐term clearance of HCV RNA and normal ALT levels in 23% of patients.
Hepatitis C virus RNA and long‐term response to recombinant interferon‐α2b in patients with chronic hepatitis C
Authors: Tanno H. , Fernández J. L. , Rendo P. , del Pino N. , Viola L. , Terg R. , Pérez V.
Published: December 2007

Summary. The effectiveness of recombinant interferon‐α2b (rIFN‐α2b) in eradicating hepatitis C virus (HCV) RNA from serum has not been completely assessed. We studied 39 patients with compensated chronic hepatitis C diagnosed by liver biopsy and positive HCV RNA measured by polymerase chain reaction (PCR). Group I consisted of 26 patients treated with 3 MU of rIFN‐α2b for 6 months; group II, 13 control patients observed for six months; and group III, 12 out of 13 patients from group n who subsequently received 5 MU of rIFN‐α2b for 6 months. In group I, 11 out of 23 (47.8%) patients who completed treatment had an immediate response and five (21.7%) had a sustained response to therapy six months after treatment. No response was observed in patients from group II. In group III, 7 out of 12 (58.3%) patients who completed treatment had an immediate response and none had a sustained response. Considering all patients who completed rIFN‐α2b treatment, HCV RNA remained positive at the end of therapy in three of five sustained responders (60%), six of 13 patients who relapsed (46.1%), and in all non‐responders (100%). HCV RNA was positive 6 months after therapy in four (80%), 13 (100%). and 17 (100%) patients respectively. All patients with a sustained response had normal aminotransferase levels 18 months after therapy. We conclude that in chronic hepatitis C rIFN‐α2b causes a significant immediate response but this is not sustained, only 2.8% of treated patients had a sustained loss of HCV RNA. Normal aminotransferase persist in the long term, despite persistence of HCV RNA.
Re‐treatment of interferon‐resistant patients with chronic hepatitis C with interferon‐α
Authors: Bresci G. , Parisi G. , Banti S. , Capzia A.
Published: December 2007

Summary. Non‐responders to 6‐months treatment with recombinant interferon (rIFN)‐α, 3 MU thrice weekly (primary non‐responders) were treated for 6 further months with the same therapy or with a double dose of rIFN‐α or with a different type of IFN (L‐IFN). 112 primary non‐responders were randomly enrolled into four groups of 28 patients each over a period of 4 years and were followed up for 6 months: group A continued the same dose of rIFN‐α, group B was treated with the same rIFN‐α but received a double dose (6 MU thrice weekly), group C received L‐IFN, 3 MU thrice weekly, and group D stopped IFN therapy and did not receive any treatment. Patients were examined at monthly intervals and response was defined as a complete normalization of alanine amino transferase (ALT). The four groups were homogeneous as to age, sex, duration of the disease, probable source of infection, histological diagnosis, ALT and γ glutamyl transferase (γGT) levels. No patient discontinued therapy for side‐effects. Further treatment with rIFN‐α 3MU thrice weekly (group A) induced normalization of ALT levels in four patients (14%); treatment with double‐dosed rIFN‐α (group B) induced normalization of liver enzymes in six cases (21%); a different type of interferon (L‐IFN) (group C) achieved normalization of serum ALT in five patients (18%). None of 28 primary non‐responders who did not receive any treatment (group D) showed normalization of ALT levels. None of the patients was anti‐HCV negative at the end of the study and no statistically significant difference was noted between responders and non‐responders to the second course of IFN therapy as to age, sex, duration of the disease, ALT and γGT levels at the end of the trial. Overall at the end of the study the primary non‐responders with normal levels of ALT were 15/112 (13%), with a therapeutic advantage of 7%. No statistically significant difference in the response rate was found among patients who continued IFN therapy, but prolongation of rIFN‐α treatment at double dosage seems to be the best therapeutic regimen.
Comparative study of two high doses of lymphoblastoid interferon in the treatment of chronic hepatitis C: influence on the levels of ALT, viraemia and histologic activity
Authors: Enríquez J. , Torras X. , Miralles F. , Cerezo F. J. Martinez , Poch F. J. Sancho , Buenestado J. , Madoz P. , Howe I. , Vilardell F.
Published: December 2007

Summary. Ninety consecutive patients with chronic hepatitis C were included in a randomized, uncontrolled trial to compare the efficacy of two treatment regimens, 10 MU (group A) vs 5 MU (group B), of lymphoblastoid interferon, in a step‐down schedule for 24 weeks. All of the patients had antibodies against the hepatitis C virus, and all but one were HCV RNA positive in serum. The origin of the infection was attributed to blood transfusion in 30 patients and classified as sporadic in 60 patients. During treatment reduction in the ALT levels as well as the elimination of viraemia was observed in both treated groups, although these changes did not correlate significantly with the interferon dose. Nine months after the end of therapy, a sustained response was achieved in 13.6% (12/88) of the patients. Relapse in group B (87.5%) was significantly higher than in group A (59.1%). The percentage of cases which remained with undetectable HCV RNA was significantly higher for the sustained responders (66.7%) than for the non‐responders (11.8%) and relapser patients (2.4%). Repeated liver biopsies showed an overall significant reduction of all the subindices of histological activity from patients with sustained response, except for fibrosis. In short: the 10 MU dosing regimen of lymphoblastoid interferon was as efficient as the 5 MU dose as it brought about a similar improvement in ALT levels, histological activity and elimination of viraemia, albeit 10 MU proved significantly more effective in the prevention of a relapse among the responders after 24 weeks therapy.
The use of deferoxamine infusions to enhance the response rate to interferon‐α treatment of chronic viral hepatitis B
Authors: Bayraktar Y. , Koseoglu T. , Somner C. , Kayhan B. , Temizer A. , Uzunalimoglu B. , Maria N. De , Thiel D. H. Van
Published: December 2007

Summary An individual's iron status may affect the response rate achieved with the use of interferon (IFN) as therapy for chronic viral hepatitis. A total of 27 patients with chronic hepatitis B viral infection, who had elevated serum ferritin levels, were randomized to receive either IFN 5 MU, three times weekly by subcutaneous injection alone (n= 14) or in combination with cycles of deferoxamine at a dose of 80 mg kg‐1 per cycle (n= 13) administered over 3 consecutive days, to reduce their iron and maintain a serum ferritin level less than 250 ng ml‐1. All deferoxamine‐treated patients were on a low iron‐containing diet. An IFN response was defined as a normalization of the serum alanine aminotransferase (ALT) level and seroconversion from hepatitis B e antigen (HBeAg) positivity to hepatitis B e antibody (HBeAb) positivity. The deferoxamine‐treated group experienced a reduction in their serum ferritin level to 226 ± 73 ng ml‐1 as a result of the deferoxamine treatment. Six of the 13 (46%) deferoxamine‐treated patients and two of the 14 (14%) control patients normalized their ALT levels. Seven of the 13 (54%) deferoxamine but only 14% of the IFN‐treated group seroconverted to HBeAb positivity. A greater rate of histological improvement and loss of hepatitis B virus (HBV) DNA was seen in the deferoxamine‐treated group. Two of the deferoxamine‐treated patients were treated only once, two were treated twice, seven were treated three times and two were treated four times to achieve a ferritin level below 250 ng ml‐1.
Rare pre‐core stop‐codon mutant nt. 1897 predominates over wide‐spread mutant nt. 1896 in an unusual course of chronic hepatitis B
Authors: Protzer U. , Trippler M. , Ohl J. , Knolle P. , Duchmann R. , zum Büschenfelde K.‐H. Meyer , Gerken G.
Published: December 2007

Summary We present a patient with an unusual course of hepatitis B e antigen (HBeAg)‐negative chronic hepatitis B who had repeated reactivations of his disease progressing to cirrhosis with terminal liver failure. Each flare up presented like an acute hepatitis with very high titres of hepatitis B virus (HBV) and high inflammatory activity followed by rapid clearance of viraemia. The pre‐core genome of HBV isolated from sera during 5 years of follow up was analysed. Direct sequencing of polymerase chain reaction (PCR) products derived from consecutive sera showed a rare pre‐core stop‐codon mutation at nucleotide (nt.) 1897 G→A with an accompanying mutation nt. 1857 C→T as well as a stop‐codon mutation nt. 1896 G→A. By cloning and sequencing of PCR products the mutant strain with mutation nt. 1897 was shown to predominate over viral strains with a mutation nt. 1896 during the course of disease, although the stop‐codon mutation nt. 1896 in general is observed more frequently. Both mutations allow viral replication by stabilizing the encapsidation signal ε. This allowed HBV replication at a very high level as observed during flare ups. The absence of HBeAg may be responsible for the massive cytotoxic T‐cell response towards hepatocytes which might explain the rapid progression to liver cirrhosis although no, or very little, HBV replication was observed for long periods. However, there is no clear explanation as to why the nt. 1897 mutant strain overwhelmed the other virus strains.
Combination low‐dose lymphoblastoid interferon and thymosin α1 therapy in the treatment of chronic hepatitis B
Authors: Rasi G. , Mutchnick M. G. , Virgilio D. Di , Sinibaldi‐Vallebona P. , Pierimarchi P. , Colella F. , Favalli C. , Garaci E.
Published: December 2007

SUMMARY. This open label study was initiated to assess the safety and efficacy of lymphoblastoid interferon‐α (IFN‐α) and thymosin α1 (Tα1) in the treatment of 11 patients with chronic hepatitis B, who had failed to respond to standard IFN‐α2b therapy, and in four interferon naive patients. These fifteen hepatitis B surface antigen (HBsAg) positive and serum hepatitis B virus (HBV) DNA positive patients were given Tα1 (1 mg) subcutaneously (sc) on 4 consecutive days. Low‐dose lymphoblastoid IFN‐α (3 MU) was administered intramuscularly (IM) on the fourth day. Beginning with the second and for the subsequent 25 weeks, patients self‐administered Tα1 twice weekly in the morning followed, 12 h later, by 3 million units (MU) lymphoblastoid IFN‐α. Patients were followed‐up for 12 months. Nine (60%) of the 15 patients, including six (55%) of the 11 patients previously treated with IFN‐α2b, responded by losing serum HBV DNA and normalizing alanine aminotransferase (ALT) values. Six of the nine responders seroconverted to HBsAg negativity. Significant improvements in the Knodell histological activity index were observed in the responders and no significant adverse effects were observed. Combination low‐dose lymphoblastoid IFN‐α and Tα1 treatment may provide a safe and potentially effective therapeutic approach in chronic hepatitis B. These results require confirmation in future randomized controlled studies.
Stability of hepatitis C virus RNA in serum from samples collected in a closed‐tube system for serum separation and transport, as measured by a quantitative competitive PCR assay
Authors: Trabaud M‐A. , Bailly F. , Colucci G. , Trepo C.
Published: December 2007

SUMMARY. Recovery of hepatitis C virus (HCV) RNA, after variable time intervals from collection, was assessed using a closed‐tube system for collection, separation and transport (SST(tm) tubes). Blood from four hepatitis C‐infected patients was collected in 12 SST(tm) tubes and centrifuged within 1 to 3 h of collection. Tubes were then left 0, 8, 12, 24. 48 and 72 h at room temperature and at 4°C before removing serum. Hepatitis C virus RNA levels were measured by quantitative polymerase chain reaction (PCR) using the AMPLICOR HCV MONITOR(tm) assay. Hepatitis C virus RNA levels in these samples were stable for at least three days at both temperatures. Polymerase chain reaction signals never decreased by more than 0.5 log. The reproducibility of the assays showed that the quantitative PCR method can be used with the storage conditions tested here. Our data suggests that processing blood in SST(tm) tubes may be very useful in following hepatitis C virus RNA titres in infected patients, especially those receiving treatment.
Sampling of cariogenic microorganisms in human populations
Authors: Keene Harris J.
Published: December 2007

The sampling of cariogenic microorganisms such as Streptococcus mutans is performed in etiologic studies of dental caries, in obtaining estimates of microbial prevalence in human populations and in monitoring the results of various dental and antimicrobial therapies. Although the selection of a sampling methodology is primarily dependent upon the specific objectives of the study, considerations pertaining to validity, sensitivity, and reliability are also important. A general knowledge of the ecology and primary oral reservoirs of infection of the cariogenic bacteria is essential in the sampling of dental plaque as well as saliva and each sampling method is associated with certain strengths as well as weaknesses and limitations. A proposal is made for a simple universal oral sampling method, based on a 15–sccond saline rinse, which gives results which correlate strongly with total plaque load levels of 5. mutans as well as salivary S. mutans levels.
The identification of bacteria associated with periodontal disease and dental caries by enzymatic methods
Authors: Loesche Walter J.
Published: December 2007

This brief review describes the potential usefulness of enzymatic reagents for the diagnosis of dental caries and periodontal disease. The cultural tests for salivary S. mutans levels should soon become commercially available in the U.S. and their success may preclude the immediate development of enzymatic diagnostic reagents for this group of organisms. However, in regards to periodontal disease, these enzyme reagents offer great promise, particularly those which measure the trypsin‐like activity of plaque. The BANA hydrolytic activity of plaque, while not due exclusively to the spirochetes, nevertheless seems to reflect the spirochetal load of the plaque. Of even greater interest is the possibility that this and other enzymes can also be measured in the saliva. This would lend itself to routine screening for these enzymes in the saliva.
Extracellular proteinaceous substances from Haemophilus actinomycetemcomitans induce mitogenic responses in murine lymphocytes
Authors: Nishihara Tatsuji , Koga Toshihiko , Hamada Shigeyuki
Published: December 2007

An extracellular proteinaceous substance (ES) and lipopolysaccharide (LPS) were prepared from culture supernatants and whole cells of Haemophilus actinomycetemcomitans Y4, respectively. In addition, extracellular LPS (E‐LPS) was isolated from the ES preparation by the phenol‐water procedure. Both the ES and LPS induced Limulus amebocyte lysate clotting and the local Shwartzman reaction. LPS and E‐LPS from the strain were mitogenic for BALB/c, BALB/c (nu/nu) and C3H/HeN mouse spleen cells, but not for C3H/HeJ spleen cells and BALB/c thymocytes. On the other hand, ES was also mitogenic for C3H/HeJ spleen cells. Polymyxin B suppressed to a lesser extent the mitogenicity of ES than that of LPS and E‐LPS. The mitogenicity of ES was markedly inhibited by pronase treatment. These results suggest that H. actinomycetemcomitans produces extracellularly proteinaceous mitogenic substances as well as LPS.
Inhibition of the activity of glucosyltransferase from Streptococcus mutans by glycyrrhizin
Authors: Sela M. N. , Steinberg D. , Segal R.
Published: December 2007

We have previously shown that the natural sweetener glycyrrhizin (glyc) inhibits in vitro adherence of Streptococcus mutans in the presence of sucrose. In order to further examine the mechanism of adherence inhibition, extracellular glucosyltransferase of S. mutans was obtained, and its ability to produce glucans from sucrose in the presence of glyc was tested. These results indicate that glyc inhibits bacterial adherence by affecting the activity of glucosyltransferase.
Penicillin‐induced lysis in related species of oral streptococci
Authors: Norys J. W. , Kral T. A.
Published: December 2007

Treatment of 10 strains representing 5 species of related oral streptococci with penicillin G resulted in measurable levels of cellular lysis. This lysis was dependent on penicillin concentration and cell density. At similar penicillin concentrations and cell densities, the 10 strains demonstrated appreciable differences in their lytic responses. Lysis values for Streptococcus mutans (GS‐5 and Ingbritt) and Streptococcus rattus (BHT and FA‐1) were greater than those for Streptococcus sobrinus (01 and B13), Streptococcus cricetus (HS6 and AHT), and Streptococcus ferus(8S1 and HD3).