bluuebunny/crossref_metadata_2025 huggingface dataset:
AGE‐STANDARDISED MORTALITY AND PROPORTIONAL MORTALITY ANALYSES OF ABORIGINAL AND NON‐ABORIGINAL DEATHS IN METROPOLITAN, RURAL AND REMOTE AREAS
Authors: Peach Hedley G. , Pearce Dora C. , Farish Stephen J.
Published: March 2008

ABSTRACT: The study's aim was to assess how much of the variation in disease‐specific mortality between metropolitan, rural and remote areas is specific to those diseases or reflects the all‐cause mortality pattern. The ranges and variances of disease‐specific standardised proportional mortality ratios between geographical areas were compared to those of the corresponding standardised mortality ratios. For most chapters in the International Classification of Diseases, the ranges and variances of the standardised proportional mortality ratios were less than 40% of those of the corresponding standardised mortality ratios. Only a small proportion of the variation in mortality can therefore be attributed to a specific disease component; the remainder must be attributed to an underlying force of mortality. Research, programs and policies addressing the socio‐economic disadvantages of living in remote areas may lead to a greater improvement in mortality than those targeting specific diseases.
PSYCHOLOGICAL SYMPTOMS IN RURAL ROAD TRAUMA VICTIMS
Authors: Jeavons Sue , Greenwood Kenneth M. , Horne David J. de L.
Published: March 2008

ABSTRACT: There is limited research into the psychological aftermath for people who have experienced road accidents, especially outside major cities. This study by postal survey used the General Health Questionnaire‐28, the Impact of Events Scale, the Post‐Traumatic Stress Disorder Interview, and the Late Effects of Accidental Injury Questionnaire to assess the psychological effects on a sample of 80 people who had attended a hospital in a regional Australian centre following road accidents. Results showed that there were marked effects on many people and that these had not always been diagnosed or treated.
International Perspective: RURAL NURSING IN THE UNITED STATES: WHERE DO WE STAND AS WE ENTER A NEW MILLENNIUM?
Authors: Bushy Angeline
Published: March 2008

ABSTRACT: Approximately one‐fourth of all Americans live in rural communities; and, of the 50 States, 31 have more than 60% of their counties designated as rural. No matter what indicator is used, United States residents in non‐metropolitan areas have less than metropolitan counterparts (e.g. per capita income, health status, access to care, level of education and employment opportunities) and are more likely to need help from human services and health professionals. Additionally, rural people often must confront unique obstacles not experienced by most urban residents to access those services. As nurses live and work in rural communities they, too, must be aware of and contend with similar factors in their practice settings. In some ways rural nursing practice has changed dramatically over the last decade but in other ways things remain much the same. This article will examine common nursing issues associated with caring for clients in a rural environment. The information in this article is based on a review of the literature and the author's personal and professional nursing experiences.
UNDERTAKING RESEARCH FOR THE BENEFIT OF THE RURAL COMMUNITY
Authors: McMurray Anne
Published: March 2008

ABSTRACT: This paper discusses the importance of disseminating clinical research findings to improve nursing practice and, ultimately, the health of rural Australia. It is argued that nursing in all settings must be practised within the context of changing healthcare trends. Currently, these changes include the restructuring of health services toward a greater emphasis on community‐based services, a redirection of the focus of care toward population health rather than hospital‐based service provision, multidisciplinary clinical decision‐making with the community as partner, and the need for all health professionals to maintain fiscal and clinical accountability. To chart the process and outcomes of care in these changing circumstances requires ongoing, systematic research. The global movement toward evidence‐based healthcare practice is thus timely and necessary. In order to provide a foundation for evidence‐based practice that will demonstrate quality, efficiency, effectiveness and community acceptability, employers must address both infrastructure and educational needs. Educators must be responsive to changes in the organisation and funding of care. Also both groups must work collaboratively toward ensuring dissemination of research information that will make a difference to patient and community outcomes. The key to success is ongoing communication between employers, educators, practitioners in the field, community members and professional organisations so that research findings can be analysed in simple language that increases utility and that provides a forum for valuing information from all sources.
WHY DOCTORS WOULD STAY IN RURAL PRACTICE IN THE NEW ENGLAND HEALTH AREA OF NEW SOUTH WALES
Authors: Alexander Christian
Published: March 2008

ABSTRACT: Retention of rural doctors is a critical factor in effectively addressing the well‐documented maldistribution of the medical workforce. The present study explores the reasons why rural doctors working in northwestern New South Wales left their previous practice, moved to their current practice and have considered moving to another practice. In addition, these doctors were also asked as to the most effective strategies in retaining rural doctors and which organisations could make a valuable contribution in making rural general practice more attractive. As the doctors' choices concerning their practice locations involve judgements relating to a complex array of factors, there are a great number of priority actions involving many stakeholders that can impact positively on the retention of rural doctors. In addition to strictly professional issues, such as access to hospitals, a reasonable work load and a good level of procedural work, other issues, such as the availability of good social and cultural facilities, work opportunities for one's partner and good educational facilities for one's children, have a great bearing on the doctor's decision where to practise. Put differently, while the professional environment needs to be conducive to good rural practice, rural doctors are also human beings, requiring appropriate facilities to meet their ‘quality of life’ needs.
TELEMEDICINE IN NEONATOLOGY: LESSONS FROM NORTH QUEENSLAND
Authors: Whitehall John , Bliganault Ilse , French Colleen , Carson Vicki , Patole Sanjay
Published: March 2008

ABSTRACT: Using videoconferencing technology, educational programs in neonatology were provided for staff at rural hospitals. The technology was also used to reunite babies with their families and its usefulness in long‐distance diagnosis was assessed. Eighty‐two educational sessions were delivered over a 9 month period and, despite problems with technology, operation and presentation, were considered worthwhile by the audiences. Family reunions were very successful. Neonatal diagnosis was impossible at the narrow bandwidth used (128 kilobits/s). Valuable lessons were learned regarding optimum use of this medium.
RURAL PALLIATIVE CARE VOLUNTEER EDUCATION AND SUPPORT PROGRAM
Authors: Freeman Merlin , Ramanathan Shanthi , Aitken Ann , Dunn Peter , Aird Judy
Published: March 2008

ABSTRACT: The present paper looks at the challenges of palliative care delivery in rural and remote areas and proposes the establishment, education and coordination of a network of palliative care volunteers to assist in the delivery of non‐clinical services. The development of a rural palliative care volunteer education and support training package is documented, together with details of the trialling of the package and its evaluation. Possible benefits of the program and some key issues to be considered when establishing a volunteer network are raised.
EVALUATION OF THE PROVISION OF FIELD WORK TRAINING THROUGH A RURAL STUDENT UNIT
Authors: Barney Tania , Russell Mary , Clark Michael
Published: March 2008

ABSTRACT: A Rural Student Unit was established as a pilot project to trial a model of rural fieldwork placement provision. The Unit aimed to increase the number of student placements available in rural areas and provide undergraduate students with a positive fieldwork experience. The results indicate that the Unit was successful in overcoming some of the barriers to rural fieldwork, for both students and supervisors, and substantially increased the number of students undertaking fieldwork in this area. The results support the further trialling and expansion of the model.
ROLE OF Ca2+ STORES IN ACETYLCHOLINE‐INDUCED ALL‐OR‐NONE SHORTENING OF SMOOTH MUSCLE CELLS FROM GUINEA‐PIG TAENIA CAECUM
Authors: Mita Mitsuo , Toguchi‐Senrui Natsuko
Published: March 2008

We have reported previously that isolated single smooth muscle cells from guinea‐pig taenia caecum respond to acetylcholine (ACh) in an all‐or‐none manner.

To clarify the roles of intracellular Ca2+ stores in the all‐or‐none response of isolated smooth muscle cells from guinea‐pig taenia caecum to ACh, we examined the inositol 1,4,5‐trisphosphate (IP3)‐induced contractile response in Staphylococcus aureus a‐toxin‐permeabilized smooth muscle cells and the effect of depletion of intracellular Ca2+ stores on the all‐or‐none response to ACh in intact smooth muscle cells.

a‐Toxin‐permeabilized smooth muscle cells responded to 3–30 nmol/L or 0.3–3 nmol/L IP3 in the presence of 0.2 mmol/L Ca2+ with 1 mmol/L EGTA or 0.1 mmol/L EGTA, respectively, in an all‐or‐none manner. These results suggest that Ca2+ release induced by IP3 is Ca2+ dependent and is evoked in an all‐or‐none manner.

In the presence of the Ca2+ ionophore A23187 (0.1 mmol/L) or the sarcoplasmic reticulum Ca2+‐ATPase inhibitor cyclopiazonic acid (1 mmol/L), the shortening of intact smooth muscle cells induced by increasing concentrations of ACh showed a graded response, but not an all‐or‐none response.

In conclusion, the results suggest that Ca2+ release from Ca2+ stores induced by IP3 plays an important role in the all‐or‐none response of intact smooth muscle cells to ACh.
METFORMIN, ARTERIAL FUNCTION, INTIMA–MEDIA THICKNESS AND NITROXIDATION IN METABOLIC SYNDROME: THE MEFISTO STUDY
Authors: Meaney Eduardo , Vela Agustín , Samaniego Virginia , Meaney Alejandra , Asbún Juan , Zempoalteca Juan‐Carlos , Elisa Zárate N , Emma Mendoza N , Guzman Martin , Hicks Juan , Ceballos Guillermo
Published: March 2008

Metabolic syndrome (MS) is one of the greatest public health problems in Mexico, where more than 75% of adults in urban populations are overweight or obese. Metabolic syndrome has several comorbidities, which result in a high cardiometabolic risk.

Some of the vasopathogenic phenomena in MS are caused by nitroxidant stress, secondary to cardiometabolic dysfunction.

The action of metformin to diminish or control MS remains a matter of debate.

In the present study, 60 patients with at least three diagnostic criteria for MS were divided into two groups. Both groups received similar dietary counselling, but one group was given 850 mg metformin daily.

The variables assessed were body mass index, waist circumference, systolic and diastolic blood pressures (SBP and DBP, respectively), total cholesterol (TC), high‐ and low‐density lipoprotein–cholesterol, triglycerides (TG), fasting glucose, nitroxidant metabolites (free carbonyls, malondialdehyde, dityrosines and advanced oxidative protein products (AOPP)), nitric oxide (NO), carotid vascular stiffness, carotid intima–media thickness (IMT) and C‐reactive protein (CRP).

After 1 year follow up, both groups reported weight loss, as well as decreases in waist circumference, SBP and DBP.

Patients on metformin exhibited reductions in TC and IMT and there were marked changes in nitroxidation: levels of carbonyls, dityrosines and AOPP were reduced, whereas those of NO were increased, indicating better endothelial function. In addition, in patients given metformin, CRP levels decreased.

In conclusion, metformin has a considerable beneficial effect on nitroxidation, endothelial function and IMT in patients with MS.
LIMITATION OF INFARCT SIZE BY ERYTHROPOIETIN IS ASSOCIATED WITH TRANSLOCATION OF Akt TO THE MITOCHONDRIA AFTER REPERFUSION
Authors: Kobayashi Hironori , Miura Tetsuji , Ishida Hideyuki , Miki Takayuki , Tanno Masaya , Yano Toshiyuki , Sato Takahiro , Hotta Hiroyuki , Shimamoto Kazuaki
Published: March 2008

The aim of the present study was to determine the critical timing of Akt activation and its interaction with the mitochondrial permeability transition pore (mPTP) in the mechanism of infarct size limitation by erythropoietin (Epo).

In an isolated, buffer‐perfused preparation, rabbit hearts were subjected to 30 min ischaemia/2 h reperfusion. Infusion of Epo (1 unit/mL) before ischaemia reduced infarct size from 36.6 ± 2.6% of the risk area to 15.4 ± 3.2%, whereas a 10‐fold higher dose of Epo infused for 65 min commencing 5 min before reperfusion failed to afford significant cardioprotection. The protection afforded by Epo pretreatment was abolished by coinfusion of 5 mmol/L LY294002, a phosphatidylinositol 3‐kinase (PI3‐K) inhibitor. Infusion of Epo induced phosphorylation of Akt, extracellular signal‐regulated kinase, glycogen synthase kinase 3b and p70s6 kinase before ischaemia and tended to enhance reperfusion‐induced phosphorylation of these protein kinases. Erythropoietin increased phospho‐Akt in the mitochondria and induced complex formation of Akt with adenine nucleotide translocase (ANT), a major subunit of mPTP, upon reperfusion.

In another series of experiments, cardiomyocytes were isolated from rat hearts and loaded with Rhod‐2 to determine mitochondrial Ca2+ levels. Increases in mitochondrial Ca2+ levels following exposure to 1 mmol/L ouabain for 30 min were similar in untreated and Epo‐pretreated cells. However, ouabain‐induced hypercontracture was significantly suppressed from 45.1 ± 1.6 to 39.2 ± 1.9% by Epo.

In conclusion, activation of PI3‐K–Akt signalling before ischaemia is crucial for Epo‐induced myocardial protection and this protection may be achieved by complex formation of activated Akt with mPTP components upon reperfusion, leading to elevation of the threshold for opening of mPTP.
Histamine: Correlative studies in nucleus accumbens
Authors: Chronister R. B. , Palmer G. C. , Defrance J. F. , Sikes R. W. , Hubbard J. I.
Published: March 2008

The role of histamine as a neurotransmitter has been the subject of considerable controvery. Recent evidence suggests it to be involved in such complex activities as arousal and affect. The purpose of the present study is to examine the possible source, function, and pharmacology of histamine in the nucleus accumbens, an area of the brain also implicated in complex activities such as affect. The anatomical studies suggest that the most probable source of the histamine in nucleus accumbens is the complex region lateral to the mammillary nuclei. These areas are the intercalated nucleus and the tuberomammillary nucleus (nuclei gemini hypothalami). To a lesser degree, the supramammillary complex may also contribute histamine‐containing axons to the accumbens area. Adenylate cyclase in the rabbit nucleus accumbens displayed activation in response to histamine agonists (histamine, 2‐Me‐histamine, and 4‐Me‐histamine). The action of the H1 antagonist promethazine was greater than the H2 antagonist metiamide in reducing enzyme activation by histamine and 2‐Me‐histamine. In contrast, metiamide was more potent than promethazine toward antagonism of the action of 4‐Me‐histamine. However, no additive effects were noted when agonists were added in combination. Based upon these data, it is suggested that activation of adenylate cyclase in the rabbit nucleus accumbens is mediated in part by mixed H1 and H2 receptors or cellular disruption reflects the loss of receptor specificity. Physiological studies demonstrated that the H2 agonist 4‐Me‐histamine had an inhibitory effect on the activity of neurons driven by stimulation of the fimbria. The magnitude of the effect was frequency dependent. The H1 agonist 2‐Me‐histamine had no significant effect. Iontophoretic application of 4‐Me‐histamine had minimal effect upon low frequency volleys (0.5 Hz) but had a pronounced effect upon higher frequency volleys (6.0 Hz). These effects were antagonized by metiamide. Iontophoretic application of metiamide alone produced an effect only upon the P component of the field response, which is also bicuculline sensitive. Bicuculline coadministration was also effective in antagonizing the 4‐Me‐histamine effect. The physiological data suggest that histamine works through H2 receptors in nucleus accumbens, perhaps by potentiating the effects of gamma‐aminobutyric acid (GABA). Thus histamine in nucleus accumbens appears to function as a modulatory substance whose effect is dependent upon the activity of other transmitter and afferent systems.
Thalamic center for the lateral line system in the catfish Ictalurus nebulosus: Evoked potential evidence
Authors: Finger T. E. , Bullock T. H.
Published: March 2008

By means of evoked potential methods, a lateral line center in the thalamus of the bullhead catfish is here identified. The locus of this lateral line center corresponds to the mechanoreceptive thalamic zone and/or torothalamic tract identified by anatomical means. The thalamic lateral line area responds to acoustic stimuli as well as lateral line nerve shock but fails to respond to electroreceptor inputs that do cause responses in their special part of the midbrain torus semicircularis. The latency of the first peak of response to lateral line nerve shock, which is also the main response peak, is 30 ms for the thalamic zone compared to 15 ms for the earliest peak response in the mechanoreceptive part of the torus semicircularis. The thalamic response fatigues much more quickly than the toral response and has different dynamic properties to closely spaced stimulus pairs as well.
Whole‐blood interferon‐γ assay for the diagnosis of tuberculosis infection in an unselected Greek population
Authors: GEROGIANNI Irini , PAPALA Maria , KLAPSA Dimitra , ZINZARAS Elias , PETINAKI Efi , GOURGOULIANIS K. I.
Published: March 2008

Background and objective:  Although QuantiFERON‐TB Gold (QFT‐G) has been approved for the diagnosis of latent tuberculosis infection (LTBI), there are limited data regarding its performance in routine clinical practice. The aim of this study was to compare QFT‐G ‘In Tube’ results, based on stimulation with Mycobacterium tuberculosis‐specific antigens, with tuberculin skin test (TST) results in an unselected hospital‐based Greek population.

Methods:  This was a prospective study of inpatients and outpatients in the University Hospital of Larissa, Greece. Demographic, clinical and microbiological data were collected and correlated to the QFT‐G ‘In Tube’ results. Agreement was tested using the Q‐test; kappa coefficient and confounding factors were adjusted for by univariate and multivariable logistic regression.

Results:  Among the 191 patients with valid results for both tests, the concordance between the TST and the QFT‐G was 68.5%, with a kappa value of 0.38 (95% CI 0.2–0.5). In 27 (14.1%) patients with active tuberculosis, QFT‐G ‘In Tube’ yielded 85.1% positive results compared with 74% for the TST (P = 0.45).

Conclusions:  Overall agreement between the QFT‐G ‘In Tube’ assay and the TST in this unselected hospital population was low, mainly due to discordant TST‐positive/QFT‐negative results.
Evaluation of enzyme‐linked immunosorbent assay for Chlamydophila pneumoniae‐specific immunoglobulin M in acute respiratory tract infection
Authors: MIYASHITA Naoyuki , OUCHI Kazunobu , KAWASAKI Kozo , KOMURA Hayashi , KAWAI Yasuhiro , OBASE Yasushi , KOBASHI Yoshihiro , OKA Mikio
Published: March 2008

Background and objective:  The study evaluated a newly developed ELISA (Hitazyme Chlamydophila pneumoniae) for detecting anti‐C. pneumoniae‐specific IgM antibody, by comparing the ELISA assay to a microimmunofluorescence (MIF) test and immunoblotting.

Methods:  One hundred patients with acute respiratory tract infections (58 children and 42 adults) were enrolled in the study. Paired sera were obtained from all subjects for serological testing of C. pneumoniae.

Results:  C. pneumoniae IgM positivity was observed in 36 (62.0%) children and 11 (26.1%) adults. However, MIF test or immunoblot revealed only four positive reactions in these patients. These four IgM‐positive patients were also positive by ELISA. A significant increase in IgG and/or IgA antibody titres in paired sera was observed in three of the four patients. Of the remaining 96 patients, no significant increase in IgG or IgA antibody titre in the paired sera was observed. To confirm the positive reactivity of ELISA, positive sera were also analysed by recombinant enzyme immunoassay. Forty‐three cases that were IgM‐positive only by ELISA were all negative by recombinant enzyme immunoassay and the ELISA results were considered to be false‐positives.

Conclusions:  These results indicate that a newly developed ELISA for detecting anti‐C. pneumoniae‐specific IgM antibody frequently generates false‐positive findings in patients with acute respiratory tract infections, at the current cut‐off level. Further studies are needed to determine an appropriate cut‐off level and the possible causes of the false‐positive results in the ELISA.
Effect of vitamin E and selenium supplementation on oxidative stress status in pulmonary tuberculosis patients
Authors: SEYEDREZAZADEH Ensiyeh , OSTADRAHIMI Alireza , MAHBOOB Soltanali , ASSADI Yagoob , GHAEMMAGAMI Jamal , POURMOGADDAM Masood
Published: March 2008

Background and objective:  Increased production of reactive oxygen species secondary to phagocyte respiratory burst occurs in pulmonary tuberculosis (TB). The present study evaluated the efficacy of vitamin E–selenium supplementation on oxidative stress in newly diagnosed patients treated for pulmonary TB.

Methods:  A double‐blind, placebo‐controlled trial including patients with newly diagnosed TB was conducted. The intervention group (n = 17) received vitamin E and selenium (vitamin E: 140 mg α‐tocopherol and selenium: 200 μg) and the control group (n = 18) received placebo. Both groups received standard anti‐TB treatment. Assessment of micronutrient levels, oxidative markers and total antioxidant capacity were carried out at baseline and 2 months after the intervention.

Results:  Malondialdehyde levels were significantly reduced in the intervention group (P = 0.01), while there was minimal reduction in the control group. The mean plasma level of total antioxidants was increased significantly (P = 0.001) in both the intervention and the control groups.

Conclusion:  A 2‐month intervention with vitamin E and selenium supplementation reduces oxidative stress and enhances total antioxidant status in patients with pulmonary TB treated with standard chemotherapy.
Symptomatic ocular metastases in lung cancer
Authors: SU Hsuan‐Tsung , CHEN Yuh‐Min , PERNG Reury‐Perng
Published: March 2008

Background and objective:  A survey was carried out of ocular manifestations of lung cancer.

Methods:  A retrospective analysis was performed of all lung cancer patients diagnosed between 1991 and 2005 at Taipei Veterans General Hospital, Taipei, Taiwan.

Results:  Sixteen lung cancer patients with symptomatic ocular metastases were identified. The incidence was less than 1%. The low incidence among these patients contrasts with previous reports of an incidence of about 6–7%, and suggests that most patients with ocular metastasis may be asymptomatic and remain undiagnosed. The most frequent ocular symptoms were changes in visual acuity. Metastases most frequently originated from adenocarcinomas and the choroids were the most common sites of metastases. Ten of the 16 ocular metastases were early events, identified prior to or at the initial diagnosis of the lung cancer. Only three of the 16 ocular metastatic events presented as solitary distant metastases.

Conclusion:  Although symptomatic ocular metastases are rare, they should be considered in lung cancer patients presenting with alterations in visual acuity.
Analysis of gene expression in human bronchial epithelial cells upon influenza virus infection and regulation by p38 mitogen‐activated protein kinase and c‐Jun‐N‐terminal kinase
Authors: HAYASHI Shinichi , JIBIKI Itsuro , ASAI Yasukiyo , GON Yasuhiro , KOBAYASHI Tomoko , ICHIWATA Toshio , SHIMIZU Kazufumi , HASHIMOTO Shu
Published: March 2008

Background and objective:  Airway epithelial cells, which are the initial site of influenza virus (IV) infection, participate in the inflammatory process through the expression of various genes. In this process, mitogen‐activated protein kinase (MAPK) may be associated with the expression of many genes, but its precise role remains unknown.

Methods:  A comprehensive analysis was performed of gene expression in human bronchial epithelial cells upon IV infection, using an Affymetrix gene chip containing 12 000 genes. Regulation of gene expression by MAPK was also analysed.

Results:  A total of 5998 genes were detected. Upon IV infection, 165 genes were upregulated and 49 of these were interferon‐stimulated genes. The functions of 129 genes, including 14 apoptosis‐related genes and 6 antiviral genes, were well characterized; however, those of 36 genes were unknown. The expression of 29 genes was inhibited either by SB 203580, a specific inhibitor of p38 MAPK, or by CEP‐11004, a specific inhibitor of the c‐Jun‐N‐terminal kinase (JNK) cascade, and the percentage inhibition by SB 203580 correlated with that by CEP‐11004, suggesting that p38 and JNK participate in a common downstream pathway involved in the regulation of gene expression. p38 MAPK‐ or JNK‐dependent genes were functionally classified into diverse categories.

Conclusions:  Although further studies are needed to obtain a more complete understanding of gene expression and the role of MAPK in gene expression, the present results are important in understanding the molecular mechanisms involved in the response of bronchial epithelial cells to IV infection.
Prognostic factors of tracheobronchial mucoepidermoid carcinoma—15 years experience
Authors: CHIN Chien‐Hung , HUANG Chao‐Cheng , LIN Meng‐Chih , CHAO Tung‐Ying , LIU Shih‐Feng
Published: March 2008

Background and objectives:  Mucoepidermoid carcinoma of the tracheobronchial tree is a rare tumour which displays a variable degree of clinical aggressiveness and malignancy. The relationship between the patient's prognosis and the tumour's histological features and clinical behaviour is uncertain. The aim of this study was to identify the clinicopathological features and analyse the outcomes of patients with this type of cancer.

Methods:  A retrospective analysis of the medical records of patients diagnosed with mucoepidermoid carcinoma of the lung between 1991 and 2006 was conducted.

Results:  The study comprised 15 patients. Higher histological grade tumours had a higher proportion of squamoid cells (P = 0.019); the tumours of patients with lymph node metastases also had a higher proportion of squamoid cells than did the tumours of patients without lymph node metastases (P = 0.015). Patients with early stage tumours (stage IA, IB, IIB) had better outcomes (10‐year survival rate = 87.5%), than did patients with late‐stage tumours (stage IIIB, IV) (1‐year survival rate = 28.6%; 2‐year survival rate = 0%, P = 0.001). Patients with lower‐grade tumours (grade 1 and grade 2) had better outcomes (1‐year survival rate = 80%; 5‐year survival rate = 57.1%) than did patients with higher‐grade tumours (grade 3) (1‐year survival rate = 20%, P = 0.035). Tumour staging was a significant independent predictor of survival on Cox proportional hazards analysis.

Conclusions:  The proportion of squamoid cells on tumour histology may be an indicator of the level of tumour malignancy. Tumour, node, metastasis staging is a significant determinant of prognosis in patients with tracheobronchial mucoepidermoid carcinoma.
Pulmonary coccidioidomycosis found in healthy Japanese individuals
Authors: KISHI Kazuma , FUJII Takeshi , TAKAYA Hisashi , MIYAMOTO Atsushi , KUROSAKI Atsuko , KOHNO Tadasu , YOSHIMURA Kunihiko
Published: March 2008

Background and objective:  Coccidioidomycosis is endemic in the south‐western USA. This study described the clinicopathological features of pulmonary coccidioidomycosis found in otherwise healthy Japanese individuals.

Methods:  Four male patients with pulmonary coccidioidomycosis were assessed by clinical examination, serology, PCR assay, high‐resolution computed tomography and histopathological findings.

Results:  All patients had returned to Japan from the USA and all presented with an abnormal CXR during routine assessment; two of the patients were symptomatic. High‐resolution computed tomography showed a well‐defined homogenous nodule or mass adjacent to the pleura. All patients underwent surgical wedge resection. Histopathological examination revealed encapsulated caseating epithelioid cell granulomas containing spherules and endospores. Serum IgG antibody was negative in all patients, but PCR assay using DNA from resected specimens demonstrated the presence of coccidioides‐specific DNA.

Conclusions:  Pulmonary coccidioidomycosis is very rare in Japan, but it can be found incidentally during routine evaluation. The main high‐resolution computed tomography findings are a well‐defined homogenous nodule adjacent to the pleura, reflecting the histological feature of encapsulated granulomas. PCR assay is useful for confirming the presence of coccidioides.
Effects of independent lung ventilation and lateral position on cytokine markers of inflammation after unilateral lung acid injury in dogs
Authors: BU XiaoNing , WANG Chen , CAO ZhiXin , PANG BaoSen , WANG Shuo
Published: March 2008

Background and objective:  The aim of this study was to compare the effects of conventional ventilation, lateral (non‐injured lung‐dependent) position, asynchronous and synchronous independent lung ventilation on inflammatory markers in an animal model of unilateral lung acid injury.

Methods:  Twenty‐eight dogs underwent unilateral endobronchial instillation with hydrochloric acid and randomly received (n = 7 in each group) conventional ventilation in the supine (group I) or lateral position (group II), and independent lung ventilation in asynchronous (group III) or synchronous (group IV) modes. Arterial blood gases and serum cytokine levels were assessed at baseline, and 5 min and 4 h after mechanical ventilation. At the end of the study, cytokine levels were measured in individual lung lavage fluid. In three animals per group, differential lung perfusion was detected using a dual‐head gamma camera.

Results:  Unilateral acid injury alone worsened oxygenation as determined by the ratio of PaO2 to fraction of inspired oxygen (PaO2/FiO2) and increased serum cytokine levels. Mean oxygenation (SD) was significantly preserved in group II, 338 (26); group III, 396 (28); and group IV, 395 (22) compared with group I, 173 (18) (all P < 0.01). Serum IL‐8, left‐lung lavage IL‐8 and matrix metalloproteinase‐9 levels were significantly lower in groups II–IV (all P < 0.05). Only group I showed significantly different left and right lung lavage fluid cytokine levels. Groups III and IV showed slightly decreased left lung perfusion. Cytokine levels and oxygenation were similar in groups III and IV.

Conclusions:  In this model of unilateral lung acid injury, lateral position and independent lung ventilation preserved oxygenation and attenuated the inflammatory response in serum and injured lung BAL fluid.
Pulmonary mucormycosis (Cunninghamella bertholletiae) with cavitation diagnosed using ultra‐thin fibre‐optic bronchoscopy
Authors: YAGI Shin‐ichi , MIYASHITA Naoyuki , FUKUDA Minoru , OBASE Yasushi , YOSHIDA Koichiro , MIYAUCHI Ayaka , KAWASAKI Kouzou , SODA Hiroshi , OKA Mikio
Published: March 2008

Abstract:  Recently, ultra‐thin bronchoscopy has made it possible to observe smaller bronchi not visualized using standard techniques. We describe a case of pulmonary mucormycosis with cavitation, diagnosed using an ultra‐thin bronchoscope. A 15‐year‐old girl with acute myeloid leukaemia had taken oral prednisolone, 60 mg/day, for graft versus host disease after haematopoietic stem cell transplantation. She was admitted to our hospital with fever and a large cavitary lesion in the right hilum. Using an ultra‐thin bronchoscope, the interior of the cavity in the superior segment of the right lower lobe was observed. The bronchoscopic findings revealed debris adhering to the cavity wall with a small volume of effusion. Cunninghamella bertholletiae was isolated from the effusion specimen obtained using the bronchoscope. Pulmonary mucormycosis (C. bertholletiae) complicating an immunocompromised state was diagnosed. Ultra‐thin bronchoscopy is useful to diagnose complex pulmonary infections and more research is needed to verify its clinical indications and utility.
Association of β2‐adrenoreceptor genotypes with bronchodilatory effect of tiotropium in COPD
Authors: UMEDA Nobuaki , YOSHIKAWA Takahiro , KANAZAWA Hiroshi , HIRATA Kazuto , FUJIMOTO Shigeo
Published: March 2008

Background and objective: Recently, there has been interest in interactions of β2adrenergic receptors (β2‐AR) and muscarinic acetylcholine receptors (mAChR), which share intracellular signal transduction systems. The aim of the present study was to investigate whether bronchodilator response to tiotropium is influenced by β2‐AR genotype in patients with COPD who show poor responsiveness to inhaled β2‐agonists.

Methods: After a 4‐week run‐in period, patients with COPD were treated with inhaled tiotropium bromide (18 μg once daily) for 8 weeks. Spirometric measurements and reversibility testing with inhaled β2‐AR agonists were performed and health‐related quality of life was assessed using the St George's respiratory questionnaire (SGRQ) before and after treatment. Genomic DNA was prepared from peripheral blood and individual genotypes at amino acid 16 of the β2‐AR were examined.

Results: Forty‐four patients with COPD completed the study. COPD patients with the Arg/Arg genotype (n = 22) had a significant increase in FEV1during treatment compared with those without the Arg/Arg genotype (n = 22) (FEV1,P = 0.009; FEV1%,P = 0.006). While all component and total scores on the SGRQ improved significantly in both genetic groups, changes in impact and total scores were significantly greater in patients with Arg/Arg compared with those without (total scores,P = 0.005; impact scores,P < 0.001).

Conclusions: These findings indicate that the homozygous Arg/Arg genotype at amino acid 16 of the β2‐AR could affect bronchodilator response to tiotropium in patients with COPD with significant effects on health‐related quality of life.
Feasibility of functional magnetic resonance lung imaging in Australia with long distance transport of hyperpolarized helium from Germany
Authors: THIEN Francis , FRIESE Marlies , COWIN Gary , MAILLET Donald , WANG Deming , GALLOWAY Graham , BRERETON Ian , ROBINSON Philip J. , HEIL Werner , THOMPSON Bruce
Published: March 2008

Background and objective:  MRI of the lung using hyperpolarized helium as an inhaled contrast agent has important research applications and clinical potential. Owing to the limited availability of hyperpolarized helium, this type of imaging has not been performed in the human lung outside of North America or Europe. The objective of this study was to test the feasibility of imaging human lungs in Australia using hyperpolarized helium gas imported from Germany.

Methods:  A Bruker 2‐Tesla whole‐body magnetic resonance scanner located in Brisbane, Australia was adapted with a helium‐3 radiofrequency transceiver coil. Helium‐3 was hyperpolarized to 72% in Mainz, Germany and airfreighted to Brisbane. The time taken for the journey was 32 h and scanning was performed 36–40 h after departure from Mainz, with an estimated polarization level of 44%. Procedures were developed to transfer 300 mL of the hyperpolarized helium to Tedlar bags filled with 700 mL of nitrogen. Healthy volunteers inhaled the 1 L helium/nitrogen mixture from FRC, and imaging was performed with a 10 s breathhold.

Results:  Imaging showed very detailed and even ventilation of all regions of the lung with a good signal‐to‐noise ratio. No adverse effects of inhaling the gas mixture were noted.

Conclusions:  This report of MRI of the human lung using hyperpolarized helium demonstrates the feasibility of long distance gas transport from Germany to Australia. This will help to facilitate research and clinical application of this innovative functional lung imaging technique.
Prognostic factors of renal cell carcinoma with extension into inferior vena cava
Authors: Tanaka Masahiro , Fujimoto Kiyohide , Okajima Eijiro , Tanaka Nobumichi , Yoshida Katsunori , Hirao Yoshihiko
Published: March 2008

Objective:  To evaluate the prognosis of our series of patients with renal cell carcinoma (RCC) and tumor thrombus involving inferior vena cava (IVC) treated with nephrectomy and thrombectomy.

Methods:  In 46 patients with unilateral RCC extending into IVC who underwent nephrectomy and thrombectomy (T3b in 38 patients, T3c in 6, T4 in 2, N+ in 15, M1 in 21), overall and cancer‐specific survival rates were estimated, and the univariable and multivariable analysis were carried out to determine the prognostic factors among age, gender, performance status, fever, inflammatory laboratory parameters, nodal and distant metastasis, tumor thrombus level, pathological parameters and postoperative interferon‐α administration.

Results:  The median age was 66.5 (range 35–79) years. The median follow‐up was 18.0 (mean 36.7 ± 38.7) months. The overall and cancer‐specific 5‐year survival rates were 32.9% and 40.0%, respectively. The univariate analysis revealed that fever (hazard ratio: HR 4.03), C‐reactive protein (HR 4.89), grade of tumor cell (HR 3.83), and lymph node metastasis (HR 5.99) were independent prognostic factors of cause‐specific survival in all patients. The multivariate analysis demonstrated that lymph node metastasis (HR 4.13) was the only independent prognostic factor of cause‐specific survival. The extension level or postoperative interferon‐α administration did not influence the prognosis of patients with tumor thrombus involving IVC.

Conclusions:  Aggressive surgery should be considered first in RCC patients with any levels of tumor thrombus. However, patients with both IVC involvement and nodal metastasis showed significantly poor prognosis, and development of novel intensive multidisciplinary therapies will be needed.
Testing the assumptions of chronosequences in succession
Authors: Johnson Edward A. , Miyanishi Kiyoko
Published: March 2008

Many introductory ecology textbooks illustrate succession, at least in part, by using certain classic studies (e.g. sand dunes, ponds/bogs, glacial till, and old fields) that substituted space for time (chronosequence) in determining the sequences of the succession. Despite past criticisms of this method, there is continued, often uncritical, use of chronosequences in current research on topics besides succession, including temporal changes in biodiversity, productivity, nutrient cycling, etc. To show the problem with chronosequence‐based studies in general, we review evidence from studies that used non‐chronosequence methods (such as long‐term study of permanent plots, palynology, and stand reconstruction) to test the space‐for‐time substitution in four classic succession studies. In several cases, the tests have used the same locations and, in one case, the same plots as those in the original studies. We show that empirical evidence invalidates the chronosequence‐based sequences inferred in these classic studies.
Polysaccharide hydrolysis in aggregates and free enzyme activity in aggregate‐free seawater from the north‐eastern Gulf of Mexico
Authors: Ziervogel Kai , Arnosti Carol
Published: March 2008

Marine snow aggregates represent hotspots of carbon remineralization in the ocean. Various aspects of bacterial dynamics have been investigated on marine snow. To date, extracellular enzymatic activities in aggregates have been measured using small substrate proxies that do not adequately reflect the complexity of biomacromolecules such as polysaccharides, proteins and lipids. To address this issue, we used six structurally distinct, fluorescently labelled polysaccharides to measure enzymatic hydrolysis on aggregates formed with a roller table and in aggregate‐free (ambient) seawater from two near‐coast sites, north‐eastern Gulf of Mexico. A single polysaccharide was incubated in aggregates and ambient seawater. Changes in polysaccharide molecular weight were monitored over time to measure the course of enzymatic hydrolysis. All six polysaccharides were hydrolysed in aggregates, indicating a broad range of enzyme activities in aggregate‐associated bacteria. Four substrates were also hydrolysed in ambient waters. Epifluorescence microscopy revealed that nearly all of the bacteria present in original waters were incorporated into aggregates. Therefore hydrolytic activities in ambient waters were presumably due to enzymes spatially disconnected from cells and aggregates. Our results show substantial enzymatic activity in cell/aggregate‐free seawater, suggesting a significant role of free enzymes in hydrolytic activity in waters from the north‐eastern Gulf of Mexico.
Manure‐amended soil characteristics affecting the survival of E. coli O157:H7 in 36 Dutch soils
Authors: Franz Eelco , Semenov Alexander V. , Termorshuizen Aad J. , De Vos O. J. , Bokhorst Jan G. , Van Bruggen Ariena H. C.
Published: March 2008

The recent increase in foodborne disease associated with the consumption of fresh vegetables stresses the importance of the development of intervention strategies that minimize the risk of preharvest contamination. To identify risk factors for Escherichia coli O157:H7 persistence in soil, we studied the survival of a Shiga‐toxin‐deficient mutant in a set of 36 Dutch arable manure‐amended soils (organic/conventional, sand/loam) and measured an array of biotic and abiotic manure‐amended soil characteristics. The Weibull model, which is the cumulative form of the underlying distribution of individual inactivation kinetics, proved to be a suitable model for describing the decline of E. coli O157:H7. The survival curves generally showed a concave curvature, indicating changes in biological stress over time. The calculated time to reach the detection limit ttd ranged from 54 to 105 days, and the variability followed a logistic distribution. Due to large variation among soils of each management type, no differences were observed between organic and conventional soils. Although the initial decline was faster in sandy soils, no significant differences were observed in ttd between both sandy and loamy soils. With sandy, loamy and conventional soils, the variation in ttd was best explained by the level of dissolved organic carbon per unit biomass carbon DOC/biomC, with prolonged survival at increasing DOC/biomC. With organic soils, the variation in ttd was best explained by the level of dissolved organic nitrogen (positive relation) and the microbial species diversity as determined by denaturing gradient gel electrophoresis (negative relation). Survival increased with a field history of low‐quality manure (artificial fertilizer and slurry) compared with high‐quality manure application (farmyard manure and compost). We conclude that E. coli O157:H7 populations decline faster under more oligotrophic soil conditions, which can be achieved by the use of organic fertilizer with a relatively high C/N ratio and consequently a relatively low rate of nutrient release.
Unexpected co‐occurrence of six bacterial symbionts in the gills of the cold seep mussel Idas sp. (Bivalvia: Mytilidae)
Authors: Duperron Sébastien , Halary Sébastien , Lorion Julien , Sibuet Myriam , Gaill Françoise
Published: March 2008

Bathymodioline mussels occur in chemosynthesis‐based ecosystems such as cold seeps, hydrothermal vents and organic debris worldwide. Their key adaptation to these environments is their association with bacterial endosymbionts which ensure a chemosynthetic primary production based on the oxidation of reduced compounds such as methane and sulfide. We herein report a multiple symbiosis involving six distinct bacterial 16S rRNA phylotypes, including two belonging to groups not yet reported as symbionts in mytilids, in a small Idas mussel found on carbonate crusts in a cold seep area located north to the Nile deep‐sea fan (Eastern Mediterranean). Symbionts co‐occur within hosts bacteriocytes based on fluorescence in situ hybridizations, and sequencing of functional genes suggests they have the potential to perform autotrophy, and sulfide and methane oxidation. Previous studies indicated the presence of only one or two symbiont 16S rRNA phylotypes in bathymodioline mussels. Together with the recent discovery of four bacterial symbionts in the large seep species Bathymodiolus heckerae, this study shows that symbiont diversity has probably been underestimated, and questions whether the common ancestor of bathymodioline mussels was associated with multiple bacteria.
Diversity of the active methanotrophic community in acidic peatlands as assessed by mRNA and SIP‐PLFA analyses
Authors: Chen Yin , Dumont Marc G. , McNamara Niall P. , Chamberlain Paul M. , Bodrossy Levente , Stralis‐Pavese Nancy , Murrell J. Colin
Published: March 2008

The active methanotroph community was investigated for the first time in heather (Calluna)‐covered moorlands and Sphagnum/Eriophorum‐covered UK peatlands. Direct extraction of mRNA from these soils facilitated detection of expression of methane monooxygenase genes, which revealed that particulate methane monooxygenase and not soluble methane monooxygenase was probably responsible for CH4 oxidation in situ, because only pmoA transcripts (encoding a subunit of particulate methane monooxygenase) were readily detectable. Differences in methanotroph community structures were observed between the Calluna‐covered moorland and Sphagnum/Eriophorum‐covered gully habitats. As with many other Sphagnum‐covered peatlands, the Sphagnum/Eriophorum‐covered gullies were dominated by Methylocystis. Methylocella and Methylocapsa‐related species were also present. Methylobacter‐related species were found as demonstrated by the use of a pmoA‐based diagnostic microarray. In Calluna‐covered moorlands, in addition to Methylocella and Methylocystis, a unique group of peat‐associated type I methanotrophs (Gammaproteobacteria) and a group of uncultivated type II methanotrophs (Alphaproteobacteria) were also found. The pmoA sequences of the latter were only distantly related to Methylocapsa and also to the RA‐14 group of methanotrophs, which are believed to be involved in oxidation of atmospheric concentrations of CH4. Soil samples were also labelled with 13CH4, and subsequent analysis of the 13C‐labelled phospholipid fatty acids (PLFAs) showed that 16:1ω7, 18:1ω7 and 18:1ω9 were the major labelled PLFAs. The presence of 13C‐labelled 18:1ω9, which was not a major PLFA of any extant methanotrophs, indicated the presence of novel methanotrophs in this peatland.