bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of oral status: evaluation of three oral assessment guides
Authors: HOLMES SUSAN , MOUNTAIN ELIZABETH
Published: November 2007

Summary

Oral care is a basic nursing activity central to patient comfort and well‐being, the prevention of infection and the maintenance of nutritional status.

This care is particularly important in cancer when both disease and treatment cause significant destruction of oral membranes/teeth, marked decline in salivary secretion and increased risk of infection. Systemic infection, originating in the mouth, is regarded as a significant cause of death. Appropriate oral care is, therefore, an important part of cancer care.

Thorough assessment is required to: provide baseline data, monitor response to therapy, identify new problems as they arise.

Although several assessment guides have been reported, for the majority no reliability/validity data are available.

This paper describes evaluation of the reliability, validity and clinical usefulness of three such guides. All were found reliable with regard to detection of gross abnormalities although precision with regard to scoring of subcategories was less reproducible.

In terms of validity, the literature supported the assessment categories of all tools, although an expert panel, supported by the nursing observers, identified many inappropriate descriptors and omissions highlighting, in particular, the difficulty of selecting appropriate descriptors when differences were observed in different areas of the mouth.

The lack of reliability and validity limits the clinical usefulness of these tools; it also suggests that reservations must be expressed about research based on their use. Further work is required to develop suitable tool(s) for assessing oral status in cancer patients.
Assessment, prevention and monitoring of chronic leg ulcers in the community: report of a survey
Authors: ROE B. H. , LUKER K. A. , CULLUM N. A. , GRIFFITHS J. M. , KENRICK M.
Published: November 2007

Summary

A questionnaire was completed by 146 community nurses which requested information on the types of leg ulcers they managed, along with details of their nursing assessment, monitoring and prevention strategies.

Important differences in their reported clinical practice related to when they qualified as a community nurse.

It is imperative that patients with chronic leg ulcers be given the benefit of a medical diagnosis, and an in‐depth nursing assessment so that an appropriate and effective plan of management may be developed.

Community nurses could benefit from further information on the aetiology and research‐based management of patients with leg ulcers.

A creative approach to the dissemination of research evidence for the management of leg ulcers, as part of continuing education initiatives, is required.
Client and information: a literature review
Authors: LEINO‐KILPI HELENA , IIRE LIISA , SUOMINEN TARJA , VUORENHEIMO JANA , VÄLIMÄKI MARITTA
Published: November 2007

Summary

This paper gives a brief review of existing research studies concerning patient information.

The paper outlines two relevant perspectives on information giving and on the meaning of information to the individual patient: ideological and practical.

From these two perspectives the knowledge structures of four patient groups: surgical patients, cancer patients, dialysis patients and psychiatric patients are looked at more closely.
Play as therapy for the hospitalized child
Authors: CHAMBERS MARGARET A.
Published: November 2007

Summary

Play has been recognized as essential for normal growth and development.

Children use play as a medium for self‐expression and communication.

Play can be utilized therapeutically to help children to master environmental stresses, such as those encountered by hospitalization.

Play is conceptualized as an important part of holistic nursing care.

Many UK hospitals do not employ paid play specialists and paediatric nurses may have to fulfil this important role.

Evidence to support the value of therapeutic play is largely anecdotal and there is a need for empirical research in this area.
The carer‐led assessment process (CLASP): a framework for the assessment of need in dementia caregivers
Authors: KEADY JOHN , NOLAN MIKE
Published: November 2007

The initial and on‐going assessment of individuals with dementia may not always fully reflect the expert knowledge of the caring situation that carers possess. In the absence of such knowledge a comprehensive and responsive assessment is unlikely to be achieved.

This paper describes the development of a carer‐led assessment process (CLASP) which it is suggested provides a flexible framework for the assessment of need in carers of dementia sufferers.
Gram‐negative bacteria. The challenge of preventing cross‐infection in hospital wards: a review of the literature
Authors: GOULD DINAH , CHAMBERLAIN ANGELA
Published: November 2007

Gram‐negative bacteria arc responsible for a high proportion of nosocomial infections, particularly among the critically ill and those in hospital for long periods.

Colonization (asymptomatic carriage on the skin) occurs before the emergence of overt clinical infection (appearance of the signs and symptoms of disease) and is therefore worth reducing.

Spread is principally via the hands of staff, so handwashing is the chief method of prevention.

Gram‐negative bacteria survive best in a moist environment and arc more readily transferred via damp than dry surfaces; hands and equipment should therefore be kept as dry as possible.

Good skin care can also help prevent cross‐infection as Gram‐negative bacteria colonize damaged skin more readily than if it is in good condition.
Neuronal binucleation in Alzheimer disease hippocampus
Authors: Zhu X. , Siedlak S. L. , Wang Y. , Perry G. , Castellani R. J. , Cohen M. L. , Smith M. A.
Published: November 2007

Aims: The literature and teachings instruct that neurones in the adult brain are fully differentiated, quiescent cells that never divide. Somewhat surprisingly, and counter to such dogma, susceptible neurones in Alzheimer disease display an activated cell cycle phenotype. However, whether this leads to a coordinated procession through the cell cycle is unclear, particularly whether neurones enter anaphase and beyond. To begin to address this issue, in this study we sought to determine whether nuclear division occurs in these neurones. Methods: We examined a series of 101 archived, routinely stained hippocampal sections collected at post mortem for neuropathological evaluation for evidence of neuronal binucleation. Results: We report for the first time, binucleated neurones within the hippocampus in cases of Alzheimer disease but not in control cases (P < 0.05). Conclusions: While a relatively rare event, occurring once every 20 000 neurones, this morphological evidence that neuronal cells within the cortical regions of the adult human brain in Alzheimer disease contain two nuclei supports the hypothesis that neuronal cells can re‐enter into a coordinated cell cycle that culminates in nuclear division.
Psychotherapy as a Rite of Passage
Authors: BEELS C. CHRISTIAN
Published: November 2007

Some psychotherapies may work because they resemble rites of passage. To explore this idea, this article describes an “individual” case of depression in which drug, cognitive, and narrative approaches fell short of effectiveness, and change occurred in a series of experiences that resemble a rite of passage. This resemblance is illuminated by examining two apparently quite different healing processes—Alcoholics Anonymous and multifamily group therapy in schizophrenia—to explore the elements they have in common with the case described: the acceptance of what Victor Turner called a liminal experience, and the importance of witnesses to the ritual support for that acceptance. The discussion contributes to a loosening of the distinctions between the processes of individual, family, group, and other social therapies and leads to questions about the expert knowledge the therapist provides.
Parental Depression and Anxiety and Early Childhood Behavior Problems Across Family Types
Authors: Meadows Sarah O. , McLanahan Sara S. , Brooks‐Gunn Jeanne
Published: November 2007

Using the Fragile Families and Child Wellbeing Study, we examine the association between parental major depressive and generalized anxiety disorders and child behavior problems across family types: married, cohabiting, involved nonresident father, and noninvolved nonresident father. Among 3‐year‐olds in all families, maternal anxiety/depression is associated with increased odds of anxious/depressed, attention deficit, and oppositional defiant disorders (N = 2,120). Paternal anxiety/depression has no significant association with these problem behaviors; father’s illness, however, exacerbates anxious/depressed behaviors in young children if both parents are ill and he is coresident. The findings underscore the importance of maternal mental health for child well‐being and suggest that a negative interaction between parent illnesses is most likely when parents and children share the same disorder.
Can We Promote Child Well‐Being by Promoting Marriage?
Authors: Acs Gregory
Published: November 2007

This article uses data from the National Longitudinal Survey of Youth 1979 Cohort Mother‐Child files to explore the idea that child well‐being can be improved by encouraging and enhancing parental marriage. I consider how children’s living arrangements, the stability of parental marriages, and changes in living arrangements are related to children’s behavior and cognitive test scores. Although there is some evidence that children living with their married parents, even parents in unstable marriages, have better outcomes than children living in certain nonmarital arrangements, the findings vary across domains and specifications, and the effect sizes are generally small. Thus, any benefits of policies aimed improving child well‐being by encouraging and enhancing parental marriage are likely to be modest at best.
Red Cell Apheresis: New Concepts of Blood Component Processing
Authors: Matthes Gert A.
Published: November 2007

Abstract: Since red cell apheresis procedures were introduced in Europe, more than 6,000 automated blood component collections have been processed. Analyzed were results of different protocols (RBCPS, RBCP, SDP‐RBC). Quality of blood components was measured over a storage period of 42 days (red cell concentrates) versus 5 days (platelet concentrates). Processing times were <8 min for RBCPS, <22 min for RBCP, and <90 min for SDP‐RBC. All collected blood components fit the standards of the European guidelines. The results for red cell concentrate storage are as good as the results for manual collection (ATP, hemolysis parameters, glucose, lactose) or better (2, ‐DPG, rheological parameters). Storage data of platelet concentrates are similar to platelet apheresis. All apheresed blood products are sterile after storage. Red cell apheresis procedures are a challenge for blood component processing and will encourage a revision of national blood and plasma programs for self‐sufficiency.
Present Status of Apheresis Technologies: Part 1. Membrane Plasma Separator
Authors: Sueoka Akinori
Published: November 2007

Abstract: This article is the first of a 4 part series describing currently available apheresis devices and technologies. The sections will include: Part 1, Membrane Plasma Separator; Part 2, Membrane Plasma Fractionator; Part 3, Leukocyte Filter; and Part 4, Adsorbent.
Dialysis‐Related Amyloidosis and Clinical Significance of Extracorporeal Removal of β2‐Microglobulin
Authors: Gejyo Fumitake , Suzuki Satoru , Arakawa Masaaki
Published: November 2007

Abstract: Dialysis amyloidosis is a frequent complication encountered in patients receiving chronic hemodialysis. β2‐Microglobulin (β2M) is a causative protein of amyloidosis, and its deposition in the tissues has been proven to be a primary cause of the onset. As a therapeutic approach to dialysis‐related amyloidosis, high flux dialysis membranes permitting the elimination of β2M with satisfactory bio‐compatibility have been developed, and the resultant high flux membranes have been clinically introduced. Positive clinical effects have been observed both in retrospective and prospective studies of the use of high flux membranes, together with a decrease in serum β2M level. However, it cannot be concluded that amyloid deposits are decreased when the elimination of β2M is maintained by a dialysis technique with a high flux membrane for some period of time. In the present paper, we review the recent clinical studies on extracorporeal removal of β2M as a therapeutic approach to amyloidosis.—
The Steroid‐Sparing Effect of Long‐Term Plasmapheresis in Pemphigus: An Update
Authors: Søndergaard K. , Carstens J. , Zachariae H.
Published: November 2007

Abstract: Glucocorticoids and immunosuppressive agents can induce remission in most pemphigus patients, but mortality remains at 5 to 15% as a result of side effects. We reviewed the adjunctive effect of long‐term plasmapheresis in 8 pemphigus patients. Four cases had been resistant to conventional therapy. One or 2 large‐volume plasmapheresis treatments were given monthly over 5 to 141 months. All patients, were in clinical remission within 2 months. Relapses seldom occurred: the patients stayed in remission 90% (40–94) (median, ranges) of the period. In all cases the daily dose of glucocorticoid was reduced. The prednisone level could be decreased from 38 (15–80) mg/day to 7.5 (2.5–35) mg/day (p = 0.002). The overall level of other immunosuppressive agents remained unchanged, except in 1 patient for whom cyclosporine was introduced. This indicates that long‐term plasmapheresis could have a steroid‐sparing effect and clinical efficacy in pemphigus.—
Selective Removal of Plasma Components by High‐Performance Immunoaffinity Chromatography
Authors: Kojima Kohichi
Published: November 2007

Abstract: Affinity Chromatography employing immobilized antibody is a rapid and specific technique for isolating biologically active materials from different sources, and high‐performance immunoaffinity Chromatography (HPIAC) has been used to isolate antibodies and antigens for medical application. In an attempt to resolve the problem of amyloid deposition in dialysis patients, we used HPIAC to specifically remove β2‐microglobulin from human plasma. The use of a membrane as an affinity ligand support was also studied. The specific antibody immobilized on a membrane was highly effective for removal of rat immunoglobulin E passed through an extracorporeal circulation system (ECS). Then we investigated the removal of injected human serum amyloid P component from the blood of rats by means of the ECS. Biocompatibility of the specific antibody‐bearing immunoaffinity membrane was also examined in terms of nonspecific binding of other plasma components. These techniques should prove useful for medical application and may have broad applicability for the elimination of any unwanted plasma component.—
Plasmapheresis for the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid
Authors: Yamada Hiromichi , Yaguchi Hitoshi , Takamori Kenji , Ogawa Hideoki
Published: November 2007

Abstract: Forty‐two cases of pemphigus vulgaris (PV) and bullous pemphigoid (BP) were treated with plasmapheresis by one of 3 techniques: centrifugation, double filtration plasmapheresis (DFPP), or a combination of the two. Each plasmapheresis resulted in a rapid reduction in the autoantibody liter and an improvement in clinical symptoms, thereby allowing a lower dose of corticosteroid to be administered and remission to be achieved. These findings suggest that plasmapheresis is an effective treatment for PV and BP patients who have been unresponsive to conventional therapy, for those for whom conventional drugs are contraindicated due to complications, and for those who show severe clinical manifestations.—
The Familial Hypercholesterolemia Regression Study: A Randomized Comparison of Therapeutic Reduction of Both Low‐Density Lipoprotein and Lipoprotein(a) Versus Low‐Density Lipoprotein Alone
Authors: Kitano Y. , Thompson G.R.
Published: November 2007

Abstract: Lipoprotein (a) [Lp (a)] is a risk factor for coronary heart disease (CHD), especially in the presence of a raised low‐density lipoprotein (LDL)‐cholesterol (LDL‐C). To ascertain whether reduction of both LDL and Lp(a) is more advantageous than reduction of LDL alone, patients with heterozygous FH and CHD were selected randomly to receive either LDL apheresis fortnightly plus simvastatin 40 mg/day or colestipol 20 g plus simvastatin 40 mg/day. Quantitative coronary angiography was undertaken before and after 2.1 years. Changes in serum lipids were similar in both groups except for the greater reduction of LDL‐C and Lp(a) by apheresis. There were no significant differences in primary angiographic endpoints, and none of the angiographic changes correlated with Lp(a). Although LDL apheresis plus simvastatin was more effective than colestipol plus simvastatin in reducing LDL‐C and Lp(a), it was not more beneficial in influencing coronary atherosclerosis. Decreasing Lp(a) seems unnecessary if LDL‐C is reduced below 130 mg/dl.—
Changes in Donor Apheresis in Japan
Authors: Sekiguchi S. , Sato N. , Yamamoto S.
Published: November 2007

Abstract: Donor apheresis has played an important role in the Japanese blood program. Donor plasmapheresis was introduced to increase source plasma in 1986 and accounted for 20.8% of all donations in 1995. The total volume of source plasma increased from 104 times 103 L in 1989 to 636 times 103 L in 1994, and the rate of self‐sufficience of factor VIII reached 100% in 1994 (excluding recombinant products). This rate had been below 10% in 1991. The supply of platelet products has increased rapidly in Japan and reached 7.19 million units in 1995. The number of platelet products obtained with the apheresis procedure accounted for 99.99% in all supplied products in the Hokkaido Red Cross Blood Center. Thus, it can be seen that platelet apheresis has played an important role in securing a sufficiency of the products. Another advantage of platelet apheresis is the reduction of residual leukocytes in the products, which helps to avoid donor antigen exposure and prevent febrile nonhemolytic reaction. The technique of apheresis has been applied in cancer therapy. Peripheral blood stem cell (PBSC) transplantation has been performed not only in autologous but also allogeneic settings instead of bone marrow transplantation. In the authors' experience, sufficient numbers of progenitor cells could be collected in 85.7% of patients within 2 leukaphereses; thus, apheresis will become more important in this field.—
Cryofiltration Apheresis and Plasma Fractionation Causing Anaphylactoid Reactions in Patients Receiving Angiotensin Converting Enzyme Inhibitors
Authors: Siami Ghodrat A. , Siami Flora S. , Morrow Jason D. , Stone William J.
Published: November 2007

Abstract: Severe anaphylactoid reactions and even death have been reported in hemodialysis patients using certain membrane dialyzers while receiving angiotensin converting enzyme (ACE) inhibitors. We report mild to moderate anaphylactoid reactions in 4 patients receiving plasmapheresis with on‐line membrane filters after being placed on ACE inhibitors. Of 21 patients receiving 497 plasma fractionation procedures, only the 2 patients who were receiving ACE inhibitors developed anaphylactoid reactions. Of 28 patients who had 680 cryofiltration procedures, only 2 of 5 patients who were taking ACE inhibitors developed anaphylactoid reactions. All patients developed facial flushing, increased warmth, bradycardia, and hypotension after approximately 1/2 to 1 L of plasma was processed during the procedures. Only a few procedures caused severe hypotension requiring discontinuation of the procedure. We quantified vasodilatory mediators in 1 patient, who developed pronounced symptoms. Results were obtained for 6‐keto PGF1α, PGD‐M, and methyl his‐tamine in plasma. In addition, in the same patient, 2,3 dinor 6‐keto PGF1α and methyl histamine were quantified in urine samples. Our results showed that plasma and urinary metabolites were not grossly elevated although they did increase slightly. Mild to moderate anaphylactoid reactions were observed in some patients on ACE inhibitors receiving plasma fractionation or cryofiltration apheresis. This was resolved by discontinuing either the ACE inhibitor, plasma fractionation, or cryofiltration apheresis.—
Clinical Experience and Future Directions for Low‐Density Lipoprotein Apheresis in the United States
Authors: Gordon Bruce R. , Saal Stuart D.
Published: November 2007

Abstract: The United States Liposorber Study was a 22 week randomized controlled study of low‐density lipoprotein (LDL) apheresis with an optional follow‐up phase. The procedure was found to acutely lower LDL cholesterol by up to 81%, have good tolerability, and produce a reduction in the frequency of cardiovascular events. Studies outside the United States have found therapy with LDL apheresis to be associated with a favorable clinical outcome including improved myocardial perfusion, but variable regression of coronary artery disease (CAD). Improvement in blood viscosity and endothelial function may help explain the symptomatic benefits observed with relatively small changes in angiography. Based upon favorable clinical experience, LDL apheresis using dextran sulfate cellulose columns has recently received approval for commercialization in the United States in patients with inadequate responses to diet and drug therapy and LDL levels 200 mg with CAD present or LDL levels 300 mg/dl without CAD.
Therapeutic Cytapheresis for Inflammatory Bowel Disease
Authors: Sawada Koji , Shimoyama Takashi
Published: November 2007

Abstract: Cytapheresis therapy has recently been investigated as a treatment for several diseases, especially autoimmune related diseases such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease. The removal of leukocyte components has been performed by the centrifugal method; however, using fiber technology or column technology, leukocyte components can be removed simply, and these technologies are more effective than the centrifugal method in removing numbers of cells. Each of 3 types of leukocytapheresis methods removes a different kind of cell in its therapeutic principle. Thus, if we understand what kind of cells should be removed, we can choose the best method for removing leukocytes. For this reason, the authors propose an international standard for unifying names. The therapy that makes use of a centrifuge to selectively remove about 40% of neutrophils and more than 60% of lymphocytes may be called a lymphocyte removal therapy, lymphocytapheresis (LCA). Using cellulose acetate beads in a G‐l granulocyte removal column, granulocytes and monocytes are removed but not lymphocytes, so we suggest calling this granulocytapheresis (GCAP). In addition, using a leukocyte removal filter, the Cellsorba leukocyte removal filter, 99% of both granulocytes and monocytes and about 70% of lymphocytes are removed. We propose calling this leukocytapheresis (LCAP). In the near future, we hope that we will be able to select one of these methods for cytapheresis for each disease pathogenesis or cellular immune abnormality. Presently, a lot of research is on‐going to analyze how cytapheresis is effective for the immune related diseases. The mechanism of cytapheresis will be clarified by investigators. We strongly believe that cytapheresis therapies offer good news to those patients suffering from incurable diseases as well as their physicians.
Leukocytapheresis Therapy for Severe Ulcerative Colitis
Authors: Sasaki Masaya , Tsujikawa Tomonori , Fujiyama Yoshihide , Bamba Tadao
Published: November 2007

Abstract: Severe attacks of ulcerative colitis are medical emergencies, and surgical treatment is indicated when glucocorticoid therapy is not effective. We have carried out an open clinical study of patients with severe attacks of ulcerative colitis to find out whether leukocytapheresis (LCAP) therapy can improve their outcomes. Nine patients were enrolled in this study. Seven of the nine patients had failed to respond to an intensive intravenous regimen before LCAP. LCAP was performed once a week for 4–5 weeks as intensive therapy using a leukocyte apheresis filter. Six of the 9 patients had an overall improvement after intensive therapy. Three patients reached the remission stage. The percentages of HLA‐DR+, HLA‐DR+ CD3+, HLA‐DR+ CD4+, and HLA‐DR+ CD8+ cells in the peripheral blood were higher in the responders than in the nonresponders, but there were no significant differences. In conclusion, LCAP therapy is useful for patients with severe attacks of ulcerative colitis, even those patients who failed to respond to glucocorticoid therapy.
Blood Purification Therapy in Cancer Treatment
Authors: Tani Tohru , Numa Kenji , Hanasawa Kazuyoshi , Kodama Masashi
Published: November 2007

Abstract: It is well known that cancer patients have specific and nonspecific immunosuppressive substances in their sera that depress cellular immunity. Plasma exchanges have been attempted to remove these immunosuppressive factors and improve the immunity to cancer. Double infiltration plasmapheresis has also been attempted and has been found to remove the immunosuppressive substances efficiently without a large volume substitution. Using these methods, an improvement in performance status and clinical symptoms and reduction of tumor size have been observed. Cancer chemotherapy has several severe side effects. Double filtration phasmapher‐esis is also clinically applied as a surplus carcinostatic drug adsorption method to alleviate systemic adverse reactions.
The Effect of Selective Low‐Density Lipoprotein Apheresis on Plasma Lipoperoxides and Antioxidant Vitamins in Familial Hypercholesterolemic Patients
Authors: Baricchi Roberto , Pizzala Roberto , Cacciavillani Giorgio , Rivasi Paolo , Tomasi Aldo
Published: November 2007

Abstract: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by a lifelong elevation in the concentration of low‐density lipoprotein (LDL) bound cholesterol in blood by cholesterol deposits and by early coronary artery disease. The LDL apheresis technique has been introduced with the goal of reducing LDL cholesterol levels, thereby preventing the development of atherosclerosis. The literature on LDL apheresis reports 2 different facets, the therapeutic aspect associated with the lessening of LDL concentration and the initiation of a peroxidation process associated with the biocompatibility of the artificial membrane. Lipid and protein peroxidation gives rise to toxic and atherogenic hydroperoxide, mostly lipid hydroperoxides, and derivative compounds, which may offset the benefit of the procedure. In this paper, plasma hydroperoxide levels are determined along with the elevation of the serum and LDL antioxidant status in hypercholesterolemic patients before and following repeated LDL apheresis sessions. Hydroperoxide concentration has been expressed both in terms of plasma volume and LDL concentration. A highly significant increase in LDL lipid hydroperoxides is demonstrated when expressed in terms of LDL concentration and is associated with the LDL apheresis procedure. The usefulness of antioxidant supplementation in LDL apheresis is discussed.
Cryosupernatant Plasma Exchange in the Treatment of Antiphospholipid Antibody Syndrome with Lupus Nephritis
Authors: Akioka Yuko , Hattori Motoshi , Konomoto Takao , Takahashi Kazuhiro , Nagafuchi Hiroyuki , Shiraga Hiroshi , Kawaguchi Hiroshi , Ito Katsumi
Published: November 2007

Abstract: We report a case of a 22‐year‐old female with antiphospholipid antibody syndrome (APS) associated with systemic lupus erythematosus in whom cryosupernatant plasma exchange was effective and improved both the refractory venous thrombosis in her legs and relapsing thrombocytopenia. A renal biopsy specimen showed not only features of active lupus nephritis but also renal arteriolar thrombosis which is considered to be a type of thrombotic microangiopathy (TMA). Because a pathological role of unusually large von Willebrand factor (vWF) multimers has been reported in patients with TMA including thrombotic thrombocytopenic purpura, plasma exchange using replacement with cryosupernatant, which is free of unusually large vWF multimers, is likely to be an option of treatment modality for patients with refractory and chronic relapsing APS manifesting TMA.
Changes in Platelet Demand in Association with the Spread of Autologous Peripheral Blood Progenitor Cell Transplantation
Authors: Ueda Yasunori , Ikeda Yasumasa , Watanabe Sayo , Kitawaki Toshio , Matsuyama Fumio , Konishi Hiroshi , Yagiri Yoshio
Published: November 2007

Abstract: Changes in platelet demand accompanying widespread application of autologous peripheral blood progenitor cell transplantation (APBPCT) were anticipated. The differences in the transfused volume of platelet concentrate (PC) among 8 patients with malignant lymphoma who were treated with APBPCT and 10 patients with malignant lymphoma who were not treated with APBPCT, although peripheral blood progenitor cell harvests had been performed, were studied. The former was 81 Japanese PC units more than the latter. Considering the supplied volume of PC from Red Cross blood centers and the number of APBPCTs in 1996 in Japan, the Japanese demand for PC increases by 0.16% for enforced APBPCT versus 0.36%, which includes the PC demand necessary in all treatment courses. The total increment in PC demand associated with APBPCT is not large enough to threaten the PC supply of Japan even if the number of APBPCTs increases rapidly.
The Efficacy of Therapeutic Plasmapheresis for the Treatment of Fatal Hemophagocytic Syndrome: Two Case Reports
Authors: Matsumoto Yoshifuji , Naniwa Daio , Banno Shyogo , Sugiura Yoshiki
Published: November 2007

Abstract: A potentially fatal hemophagocytic syndrome (HPS) has been noted in patients with reactive HPS. We describe 2 patients with reactive HPS treated with a regimen of therapeutic plasmapheresis and evaluate the efficacy of plasmapheresis for fatal HPS. Case 1 was a 31 year‐old woman who had been treated for systemic lupus erythematosus (SLE) with corticosteroid hormones and immunosuppresants. She presented with persistent leukopenia and thrombocytopenia with spiking fever. She had an elevated level of serum ferritin, liver dysfunction, coagulopathy, and plasma inflammatory cytokines. Her bone marrow smear disclosed numerous hemophagocytosis of histiocytes. She was administered therapeutic plasmapheresis with total plasma exchange by fresh frozen plasma. There was an immediate and prominent decrease of cytokines, and she completely recovered. Case 2 was a 34 year‐old woman who had been receiving high doses of corticosteroids and plasmapheresis for severe Stevens‐Johnson's syndrome. After 18 months, she presented with physical and laboratory findings resembling lupus‐like conditions and was administered high doses of corticosteroids and immunosupressants. Human parvovirus B19 infection was detected by IgM and IgG antibodies and viral DNA from a bone marrow sample; moreover, a bone marrow smear disclosed findings of HPS. Repeated therapeutic plasmapheresis was effective for improving her symptoms and laboratory abnormalities; however, she suffered from septic methicilline resistant staphylococcus aureus infection and finally died of a brain hemorrhage resulting from disseminated intravascular coagulation (DIC).
Early increase in pulmonary vascular reactivity with overexpression of endothelin‐1 and vascular endothelial growth factor in canine experimental heart failure
Authors: Ray L. , Mathieu M. , Jespers P. , Hadad I. , Mahmoudabady M. , Pensis A. , Motte S. , Peters I. R. , Naeije R. , McEntee K.
Published: November 2007

Heart failure is a cause of pulmonary vasoconstriction and remodelling, leading to pulmonary hypertension (PH) and decreased survival. The pathobiology of PH in heart failure remains incompletely understood. We investigated pulmonary vascular function and signalling molecules in early stage PH secondary to experimental heart failure. Eight beagle dogs with overpacing‐induced heart failure underwent haemodynamic assessment and postmortem pulmonary arterial reactivity, morphometry and quantification of genes encoding for factors involved in vascular reactivity and remodelling: endothelin‐1 (ET‐1), ETA and ETB receptors, vascular endothelial growth factor (VEGF), VEGF receptors 1 and 2 (VEGFR1 and VEGFR2), endothelial nitric oxide synthase, angiopoietin‐1, bone morphogenetic protein receptors (BMPR1A and BMPR2), serotonin transporter (5‐HTT) and the 5‐HT2B receptor. Overpacing was associated with a decrease in cardiac output and an increase in pulmonary vascular pressures. However, there were no changes in pulmonary vascular resistance or in arteriolar medial thickness. There were increased expressions of genes encoding for ET‐1, ETB, VEGF and VEGFR2, while expression of the other genes analysed remained unchanged. In vitro, pulmonary arteries showed decreased relaxation and increased reactivity, while systemic mammary arteries were unaffected. Early PH in heart failure is characterized by altered vasoreactivity and increased ET‐1/ETB and VEGF/VEGFR2 signalling.
Oxygen sensing in hypoxic pulmonary vasoconstriction: using new tools to answer an age‐old question
Authors: Waypa Gregory B. , Schumacker Paul T.
Published: November 2007

Hypoxic pulmonary vasoconstriction (HPV) becomes activated in response to alveolar hypoxia and, although the characteristics of HPV have been well described, the underlying mechanism of O2 sensing which initiates the HPV response has not been fully established. Mitochondria have long been considered as a putative site of oxygen sensing because they consume O2 and therefore represent the intracellular site with the lowest oxygen tension. However, two opposing theories have emerged regarding mitochondria‐dependent O2 sensing during hypoxia. One model suggests that there is a decrease in mitochondrial reactive oxygen species (ROS) levels during the transition from normoxia to hypoxia, resulting in the shift in cytosolic redox to a more reduced state. An alternative model proposes that hypoxia paradoxically increases mitochondrial ROS signalling in pulmonary arterial smooth muscle. Experimental resolution of the question of whether the mitochondrial ROS levels increase or decrease during hypoxia has been problematic owing to the technical limitations of the tools used to assess oxidant stress as well as the pharmacological agents used to inhibit the mitochondrial electron transport chain. However, recent developments in genetic techniques and redox‐sensitive probes may allow us eventually to reach a consensus concerning the O2 sensing mechanism underlying HPV.
Experimental Study of Composting Oil Wet Drill Cuttings as a Drilling Waste Disposal Option
Authors: Sørheim Roald , Paulsen John Eirik , Saasen Arild , Leleux Jérôme , Albouy Arnaud , Haraldsen Trond Knapp , Pedersen Per Anker , Hartnik Thomas , Linjordet Roar
Published: November 2007

This paper presents the potential of composting oil wet drill cuttings as a drilling waste disposal option. The potential is substantiated by results from several laboratory and field experiments. Artificially oil wetted drill cuttings were prepared by adding commonly used base oils from Norwegian offshore operations to a representative clay. Degradation of the hydrocarbon components in the oily wet cuttings by vermicomposting was successfully accomplished. The composts were beneficially used as part of growing media for landscape plants; ryegrass, coniferous, and deciduous trees, and the fertilization effect was compared with commercial NPK fertilizers. The plant growth studies showed that the composts produced by treating artificial oily drill cuttings by vermicomposting had considerable fertilizing effect on ryegrass and trees.
Combustion Characteristics of Compression Engine Driven by Emulsified Fuel Under Various Fuel Injection Angles
Authors: Ashok M. P. , Saravanan C. G.
Published: November 2007

In this present work, the various emulsified fuel ratios of 50D:50E (50% Diesel No. 2: 50% ethanol 100% proof), 60D:40E, and 70D:30E have been prepared. Performance and emission tests are carried out for the emulsified fuel ratios and they have been compared with diesel fuel. The test results show that 50D:50E has given the best result based on the performance and less emission than the other fuel ratios. By keeping the selected fuel 50D:50E, the same performance and emission tests are conducted by varying their injection angles at 18deg, 20deg, 23deg, and 24deg. The outcome shows better performance and less emission by the fuel 50D:50E at 24deg injection angle (IA). Further, ignition delay, maximum heat release, and peak combustion pressure tests have been conducted. These results show that increase in IA decreases the delay period, thus increasing the pressure obtained at the maximum output. Also, P‐θ diagram is drawn between crank angle and cylinder pressure. The maximum value is attained by the fuel 50D:50E at 24deg IA. All the tests have been conducted by maintaining the engine speed at 1500rpm. The result shows that 50D:50E ratio fuel has been identified as a good emulsified fuel and its better operation is obtained at 24deg IA based on its best performance and less emissions.
Phenotypic and Genotypic Analysis of Amino Acid Auxotrophy in
Lactobacillus helveticus
CNRZ 32
Authors: Christiansen Jason K. , Hughes Joanne E. , Welker Dennis L. , Rodríguez Beatriz T. , Steele James L. , Broadbent Jeff R.
Published: November 2007

The conversion of amino acids into volatile and nonvolatile compounds by lactic acid bacteria in cheese is thought to represent the rate-limiting step in the development of mature flavor and aroma. Because amino acid breakdown by microbes often entails the reversible action of enzymes involved in biosynthetic pathways, our group investigated the genetics of amino acid biosynthesis in
Lactobacillus helveticus
CNRZ 32, a commercial cheese flavor adjunct that reduces bitterness and intensifies flavor notes. Most lactic acid bacteria are auxotrophic for several amino acids, and
L. helveticus
CNRZ 32 requires 14 amino acids. The reconstruction of amino acid biosynthetic pathways from a draft-quality genome sequence for
L. helveticus
CNRZ 32 revealed that amino acid auxotrophy in this species was due primarily to gene absence rather than point mutations, insertions, or small deletions, with good agreement between gene content and phenotypic amino acid requirements. One exception involved the phenotypic requirement for Asp (or Asn), which genome predictions suggested could be alleviated by citrate catabolism. This prediction was confirmed by the growth of
L. helveticus
CNRZ 32 after the addition of citrate to a chemically defined medium that lacked Asp and Asn. Genome analysis also predicted that
L. helveticus
CNRZ 32 possessed ornithine decarboxylase activity and would therefore catalyze the conversion of ornithine to putrescine, a volatile biogenic amine. However, experiments to confirm ornithine decarboxylase activity in
L. helveticus
CNRZ 32 by the use of several methods were unsuccessful, which indicated that this bacterium likely does not contribute to putrescine production in cheese.
Bifidobacteria in Feces and Environmental Waters
Authors: Lamendella Regina , Domingo Jorge W. Santo , Kelty Catherine , Oerther Daniel B.
Published: November 2007

Bifidobacteria have been recommended as potential indicators of human fecal pollution in surface waters even though very little is known about their presence in nonhuman fecal sources. The objective of this research was to shed light on the occurrence and molecular diversity of this fecal indicator group in different animals and environmental waters. Genus- and species-specific 16S rRNA gene PCR assays were used to study the presence of bifidobacteria among 269 fecal DNA extracts from 32 different animals. Twelve samples from three wastewater treatment plants and 34 water samples from two fecally impacted watersheds were also tested. The species-specific assays showed that
Bifidobacterium adolescentis
,
B. bifidum
,
B. dentium
, and
B. catenulatum
had the broadest host distribution (11.9 to 17.4%), whereas
B. breve
,
B. infantis
, and
B. longum
were detected in fewer than 3% of all fecal samples. Phylogenetic analysis of 356 bifidobacterial clones obtained from different animal feces showed that ca. 67% of all of the sequences clustered with cultured bifidobacteria, while the rest formed a supercluster with low sequence identity (i.e., <94%) to previously described
Bifidobacterium
spp. The
B. pseudolongum
subcluster (>97% similarity) contained 53 fecal sequences from seven different animal hosts, suggesting the cosmopolitan distribution of members of this clade. In contrast, two clades containing
B. thermophilum
and
B. boum
clustered exclusively with 37 and 18 pig fecal clones, respectively, suggesting host specificity. Using species-specific assays, bifidobacteria were detected in only two of the surface water DNA extracts, although other fecal anaerobic bacteria were detected in these waters. Overall, the results suggest that the use of bifidobacterial species as potential markers to monitor human fecal pollution in natural waters may be questionable.
Influence of Turning and Environmental Contamination on the Dynamics of Populations of Lactic Acid and Acetic Acid Bacteria Involved in Spontaneous Cocoa Bean Heap Fermentation in Ghana
Authors: Camu Nicholas , González Ángel , De Winter Tom , Van Schoor Ann , De Bruyne Katrien , Vandamme Peter , Takrama Jemmy S. , Addo Solomon K. , De Vuyst Luc
Published: November 2007

The influence of turning and environmental contamination on six spontaneous cocoa bean heap fermentations performed in Ghana was studied through a multiphasic approach, encompassing both microbiological (culture-dependent and culture-independent techniques) and metabolite target analyses. A sensory analysis of chocolate made from the fermented, dried beans was performed as well. Only four clusters were found among the isolates of acetic acid bacteria (AAB) identified:
Acetobacter pasteurianus
,
Acetobacter ghanensis
,
Acetobacter senegalensis
, and a potential new
Acetobacter lovaniensis
-like species. Two main clusters were identified among the lactic acid bacteria (LAB) isolated, namely,
Lactobacillus plantarum
and
Lactobacillus fermentum
. No differences in biodiversity of LAB and AAB were seen for fermentations carried out at the farm and factory sites, indicating the cocoa pod surfaces and not the general environment as the main inoculum for spontaneous cocoa bean heap fermentation. Turning of the heaps enhanced aeration and increased the relative population size of AAB and the production of acetic acid. This in turn gave a more sour taste to chocolate made from these beans. Bitterness was reduced through losses of polyphenols and alkaloids upon fermentation and cocoa bean processing.
Transcriptome Analysis of
Lactococcus lactis
in Coculture with
Saccharomyces cerevisiae
Authors: Maligoy Mathieu , Mercade Myriam , Cocaign-Bousquet Muriel , Loubiere Pascal
Published: November 2007

The study of microbial interactions in mixed cultures remains an important conceptual and methodological challenge for which transcriptome analysis could prove to be the essential method for improving our understanding. However, the use of whole-genome DNA chips is often restricted to the pure culture of the species for which the chips were designed. In this study, massive cross-hybridization was observed between the foreign cDNA and the specific
Lactococcus lactis
DNA chip. A very simple method is proposed to considerably decrease this nonspecific hybridization, consisting of adding the microbial partner's DNA. A correlation was established between the resulting cross-hybridization and the phylogenetic distance between the microbial partners. The response of
L. lactis
to the presence of
Saccharomyces cerevisiae
was analyzed during the exponential growth phase in fermentors under defined growth conditions. Although no differences between growth kinetics were observed for the pure and the mixed cultures of
L. lactis
, the mRNA levels of 158 genes were significantly modified. More particularly, a strong reorientation of pyrimidine metabolism was observed when
L. lactis
was grown in mixed cultures. These changes in transcript abundance were demonstrated to be regulated by the ethanol produced by the yeast and were confirmed by an independent method (quantitative reverse transcription-PCR).
Host-Synthesized Secondary Compounds Influence the In Vitro Interactions between Fungal Endophytes of Maize
Authors: Saunders Megan , Kohn Linda M.
Published: November 2007

Maize produces a suite of allelopathic secondary metabolites, the benzoxazinoids. 2,4-Dihydroxy-7-methoxy-2
H
-1,4-benzoxazin-3-one and 2,4-dihydroxy-2
H
-1,4-benzoxazin-3-one reside as glucosides in plant tissue and spontaneously degrade to 6-methoxy-2-benzoxazolinone (MBOA) and 2-benzoxazolinone (BOA) upon plant cell disruption. Several maize-associated fungi in the genus
Fusarium
can metabolize MBOA and BOA. BOA tolerance levels in 10 species of
Fusarium
and in the maize endophytes
Nigrospora oryzae
,
Acremonium zeae
, and
Periconia macrospinosa
were characterized. BOA tolerance ranged from 0.25 to 1.10 mg/ml among species. The influence of substrate alteration by one species on the subsequent growth of another species was assessed in the presence and absence of BOA. The colony area of the secondary colonizer in heterospecific interactions was compared to that in autospecific interactions (one isolate follows itself). In the presence of BOA, four of six secondary colonizers had greater growth (facilitation) when primary colonizers had higher BOA tolerance than the secondary colonizer. When the primary colonizer had lower tolerance than the secondary, three of six secondary colonizers were inhibited (competition) and three not significantly affected. In BOA-free medium, the number of isolates that were facilitated or inhibited was the same regardless of the tolerance level of the primary colonizer. Two of six secondary colonizers were facilitated, two inhibited, and two not significantly affected. This study provides some support for facilitation in stressful conditions under the Menge-Sutherland model. The results are not consistent with the corresponding prediction of competition in the absence of stress. The hypothesis drawn from these data is that in the presence of a toxin, fungal species that detoxify their substrate can enhance the colonization rate of less tolerant fungi.
Single-Nucleotide Primer Extension Assay for Detection and Sequence Typing of “
Dehalococcoides
” spp
Authors: Nikolausz Marcell , Chatzinotas Antonis , Palatinszky Márton , Imfeld Gwenaël , Martinez Paula , Kästner Matthias
Published: November 2007

A single-nucleotide primer extension (SNuPE) assay in combination with taxon-specific 16S rRNA gene PCR analysis was developed for the detection and typing of populations of the genus “
Dehalococcoides
”. The specificity of the assay was evaluated with 16S rRNA gene sequences obtained from an isolate and an environmental sample representing two
Dehalococcoides
subgroups, i.e., the Cornell and the Pinellas subgroups. Only one sequence type, belonging to the Pinellas subgroup, was detected in a Bitterfeld-Wolfen region aquifer containing chlorinated ethenes as the main contaminants. The three-primer hybridization assay thus provided a fast and easy-to-implement method for confirming the specificity of taxon-specific PCR and allowed rapid additional taxonomic classification into subgroups. This study demonstrates the great potential of SNuPE as a novel approach for rapid parallel detection of microorganisms and typing of different nucleic acid signature sequences from environmental samples.