bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV-related lung cancer - a growing concern?
Authors: Powles T , Nelson M , Bower M
Published: September 2003

There is an increasing awareness of the importance of non-AIDS-defining malignancies occurring in HIV-seropositive people since the introduction of highly active antiretroviral therapy (HAART). Amongst these tumours, lung cancer occurs at an increased frequency compared to age- and gender-matched populations and this increase is not accounted for by smoking alone. Moreover, the incidence of lung cancer in people with HIV is rising as overall survival improves due to HAART. The development of lung cancer is not associated with a low CD4 cell count, suggesting that immune function has a less central role in these tumours than in Kaposi's sarcoma and primary cerebral lymphomas. Most patients present with advanced stage lung cancer and the outcome is very poor. In contrast to the AIDS-defining malignancies, the prognosis in HIV-associated lung cancer does not appear to be improving in the era of HAART. Thus lung cancer and possibly other non-AIDS-defining malignancies may become an increasingly frequent problem whose prognosis has not improved in the era of HAART.
Innate and adaptive immunological insights into HIV pathogenesis
Authors: Kandil Hala , Stebbing Justin , Gazzard Brian , Portsmouth Simon
Published: September 2003

The human immunodeficiency virus is notorious for its ability to evade the immune system. As well as its ability to escape from cell-mediated and humoral immune responses, new insights are detailing its subversive, pernicious interactions with the innate immune system. The molecular mechanisms underlying these processes highlight potential therapeutic and vaccination strategies.
Medical workforce speciality review for genitourinary medicine 2002/2003: England, Wales, Northern Ireland and Scotland
Authors: Rogstad K E
Published: September 2003

This document is an updated version of that produced in October 2001 and addresses medical workforce needs for the speciality of genitourinary medicine (GUM) for the next 10 years. Data on current consultant numbers, working patterns and retirement are based on information from the Royal College of Physicians (RCP) Workforce Unit annual census undertaken on 30 September 2001. Information on specialist registrars (SpRs) is from the Joint Committee on Higher Medical Training and the GUM Specialist Registrars Group. Senior house officer data are from the RCP's General Professional Training department. Data on non-consultant career grade doctors is from the Association of Genitourinary Medicine Survey and the GUM Non-Consultants Career Grade Group. Data on incidence of sexually transmitted infections (STIs) are from KC60 returns on STIs collected from GUM clinics by the Communicable Diseases Surveillance Centre. There is considerable movement of doctors in GUM between countries in the UK both during progression from SpR to consultant and at the consultant level. Data are therefore presented as amalgamated UK data and also by country (Table 1). It is essential that workforce planning takes this lateral movement into consideration when undertaking calculations for future workforce requirements. The speciality continues to have inadequate consultant numbers and funding is also required to provide adequate number of non-consultant career grade sessions.
Chlamydia trachomatis infection in a colposcopy unit: an audit of a fast track referral system for infected patients to a genitourinary medicine department and a survey of patients' demography, clinical findings and partner details
Authors: Blackwell A , Linton D , Emery S , Calvert J
Published: September 2003

We had previously shown that screening and treating patients for Chlamydia trachomatis prior to termination of pregnancy significantly reduces postoperative morbidity. Our success led us to consider screening women attending our colposcopy unit and this was introduced in 1998. However, it became apparent that a formal protocol was needed for managing women who had positive results to ensure that all patients and their partners were adequately treated. An interdepartmental protocol was devised for fast track referral of infected patients to the Genitourinary Medicine (GUM) clinic Health Advisor who arranged immediate treatment and partner notification. A re-audit, presented here, has shown that the introduction of the protocol has resulted in all infected patients receiving adequate treatment and partner notification with minimal use of doctor time or disruption of routine GUM services. We suggest that our system is effective and could be extended to other clinics where chlamydia screening is carried out.
Do STD clinics correctly diagnose STDs? An assessment of STD management in Hefei, China
Authors: Liu H , Detels R , Yin Y , Li X , Visscher B
Published: September 2003

The main purposes of the study were to assess the accuracy of laboratory testing and the diagnosis by physicians in sexually transmitted disease (STD) clinics in Hefei, China. Among 347 men complaining of urethral discharge or dysuria, 240 tested positive at the National Centre for either Neisseria gonorrhoeae or Chlamydia trachomatis, 310 tested positive according to the clinic laboratories, and 347 were diagnosed by the physicians. For chlamydia, the sensitivity and positive predictive value (PPV) of the clinic laboratories were 55% and 26%, and for the diagnosis by the physicians were 61% and 24%. Laboratory testing and the diagnosis by the physicians had low power to detect mixed infection. The PPVs for the diagnosis by the physicians were 50% for syphilis and 43% for herpes simplex virus (HSV), indicating that both syphilis and HSV were over-diagnosed. Over half of those previously infected had not received education to prevent reinfection. Thus, the quality of clinic laboratory testing was not high and physicians often misdiagnosed STDs.
The use of complementary and alternative medicine by persons with HIV infection in Europe
Authors: Colebunders R , Dreezen C , Florence E , Pelgrom Y , Schrooten W
Published: September 2003

Between June 1996-September 1997 and December 1998-December 1999, two surveys using an anonymous questionnaire were carried out in Europe among persons living with HIV infection. The questionnaire included questions on use of antiretrovirals, complementary or alternative medicines. Vitamins/minerals were taken by 528 (58%) of the 1996-97 participants, compared to 326 (63%) of the 1998-99 participants ( P =0.06). Homeopathy was taken by respectively 176 (21%) and 55 (14%) ( P =0.003) participants and herbal products respectively by 213 (25%) and 77 (20%) ( P =0.06). In multiple regression analysis a longer time since HIV diagnosis, having a higher education level and having a lower CD+ lymphocyte count were associated with the use of homeopathy. A longer time since HIV diagnosis and a more advanced stage of the disease were associated with the use of herbal products. The study shows that despite the availability of highly active antiretroviral therapy many people with HIV infection still take complementary and alternative medicine.
A computerized reminder system improves compliance with Papanicolaou smear recommendations in an HIV care clinic
Authors: Shuter Jonathan , Kalkut Gary E , Pinon Miriam W , Bellin Eran Y , Zingman Barry S
Published: September 2003

Current guidelines call for Papanicolaou (Pap) smear screening of HIV-infected women at least annually. After the initiation of a weekly computer based Pap smear reminder list in an HIV care clinic, the prevalence of scheduled women with up-to-date Pap smears was calculated for the one-year project period and was compared to the prevalence preceding the project. The prevalence of scheduled women with up-to-date Pap smears increased from 61.4% to 73.2% ( P <0.001) during the project period. Including Pap smears that were performed elsewhere, the final up-to-date Pap smear rate was 82.7%. The improved rate of up-to-date Pap smears showed no sign of attenuation over time. A computerized report generated from data in the hospital information system increased rates of compliance with Pap smear screening recommendations. Creative utilization of hospital data environments may be an inexpensive route to improved compliance with practice guidelines.
The Bali STD/AIDS Study: human papillomavirus infection among female sex workers
Authors: Ford Kathleen , Reed Barbara D , Wirawan Dewa Nyoman , Muliawan Partha , Sutarga Made , Gregoire Lucie
Published: September 2003

Female sex workers in low priced brothel areas in Denpasar, Bali, Indonesia participated in an intervention study designed to promote condom use and sexually transmitted disease (STD)/AIDS prevention. The intervention provided educational sessions for sex workers, STD treatment for sex workers, condom distribution, and media for clients. The brothel areas were divided into high and low areas for programme effort. The high effort areas received a more intensive behavioural intervention than the low effort areas. A clinic was available for STD treatment in both areas. Behavioural surveys and STD testing were used to evaluate the programmes. About 600 were evaluated for several STDs and completed personal interviews at enrolment and at six-month intervals during the 18-month study. About 50% of women were new to the study at each round. Human papillomavirus (HPV) testing of cervical swabbed specimens, using polymerase chain reaction methodology, was performed at the beginning of the study and 18 months later.

Human papillomavirus infection was initially high in these women (38.3%) and declined to 29.7% after 18 months ( P <0.01). The prevalence of HPV infection declined with age ( P <0.01). HPV infection was associated with a number of STD symptoms that were reported in personal interviews. These associations were stronger in the first time period. Infection with Neisseria gonorrhoeae was associated with HPV infection at baseline ( P =0.03). HPV infection declined in the study area with the more intensive educational programme ( P <0.01). The prevalence of HPV infection declined over time and was associated with study area and age of woman.
Social and behavioural determinants of consistent condom use among hotel and bar workers in Northern Tanzania
Authors: Ao T , Sam N , Manongi R , Seage G , Kapiga S
Published: September 2003

Bar and hotel workers ( n=519) in Moshi, Tanzania were interviewed to obtain information about potential predictors of condom use. Samples were collected for the diagnosis of sexually transmitted diseases (STDs), including HIV. Consistent condom use was defined as always using condoms with sexual partners in the past five years. Overall consistent condom use in this population was 14.1%. In multivariate analyses, consistent condom use was inversely associated with low condom self-efficacy (adjusted odds ratio [AOR], 0.20; 95% confidence interval (CI), 0.06-0.71), low condom knowledge (AOR, 0.11; CI, 0.01-0.80), and having more than three children (AOR, 0.23; 95% CI, 0.09-0.54). Other significant predictors included perceived condom acceptability and using condoms when last exchanged sex for money or gift. These results indicate that increased specific condom knowledge, improved self-efficacy, and reduced social stigma could be effective strategies in the promotion of condom use in this population.
Estimating the prevalence of syringe-borne and sexually transmitted diseases among injection drug users in St Petersburg, Russia
Authors: Abdala Nadia , Carney John M , Durante Amanda J , Klimov Nikolai , Ostrovski Dimitri , Somlai Anton M , Kozlov Andrei , Heimer Robert
Published: September 2003

Injection drug users (IDUs) are the vanguard of the human immunodeficiency virus (HIV) epidemic in Russia. We sought a non-invasive method to estimate a point prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and risk behaviours in IDUs attending the syringe exchange programme (SEP) in St Petersburg, Russia. One hundred and one IDUs returning syringes to the St Petersburg SEP were invited to complete a questionnaire requesting demographic, knowledge, and behavioural information, and to provide their syringes for antibody testing. The median age of IDUs was 23 years. Syringe prevalences were: 10.9% for HIV, 78.2% for HCV, 15.8% for HBV, and 6.9% for syphilis. All respondents recognized drug-related risk factors for getting AIDS. Only two-thirds of subjects recognized condoms to prevent sexually transmitted infections and half knew that oil-based lubricants are not appropriate for condoms. The IDU population studied was young and requires additional interventions to encourage safer sexual behaviours.
AIDS, HIV and STD among Japanese and Japanese-Americans in San Francisco, California, USA
Authors: Komatsu R , Kamakura M , Choi K-H , McFarland W
Published: September 2003

In affluent countries, some people may go abroad specifically for HIV testing or care for greater anonymity, better treatment, and less discrimination. A secondary analysis of data from the San Francisco Department of Public Health was conducted to characterize trends in AIDS incidence, AIDS care, sexually transmitted disease (STD) incidence, and HIV counselling and testing among Japanese in San Francisco. A total of 96 AIDS cases were diagnosed among ethnic Japanese, of whom 32 were born in Japan. From 1985 to 2000, 144 gonorrhoea and chlamydia cases were identified among Japanese. Of 368 self-identified Japanese seeking HIV counselling from 1995 to 1997, three (0.9%) were HIV-positive. The HIV/AIDS and STD epidemics among Japanese in San Francisco temporally parallels, but lags behind in magnitude, the epidemics for San Francisco's population as a whole. Some persons from Japan actively seek HIV/STD services while abroad. Our study points to several areas needing further research and improvements.
Have a nice day - do a wart audit
Authors: Wildman G M , Tang A
Published: September 2003

We performed an audit of the treatment of genital warts at our clinic by reviewing the case notes of 302 patients who presented with a first episode of genital warts. 186 were suitable for inclusion, of whom over 90% were clear of warts within three months. However, even after just one month of treatment, 84.9% of men and 60.2% of women were clear of warts. On the basis of this information, we can be more optimistic when advising patients about the likely duration of treatment.
Wernicke's encephalopathy in AIDS: a preventable cause of fatal neurological deficit
Authors: Alcaide M L , Jayaweera D , Espinoza L , Kolber M
Published: September 2003

Wernicke's encephalopathy is commonly associated with chronic alcohol abuse, but may also occur in patients with poor nutritional status. We report a case of acute Wernicke's encephalopathy in a patient with AIDS without any predisposing risk factors for thiamine deficiency. In developing countries, without vitamin supplementation, this disorder may play a role in the morbidity and mortality associated with AIDS. We believe that thiamine supplementation should be considered in cachetic AIDS patients, especially where access to antiretroviral therapy is limited.
The reliability of diagnosis using store-and-forward teledermatology
Authors: Du Moulin M F M T , Bullens-Goessens Y I J M , Henquet C J M , Brunenberg D E M , de Bruyn-Geraerds D P , Winkens R A G , Dirksen C D , Vierhout W P M , Neumann H A M
Published: September 2003

We compared diagnoses made by a teledermatologist from digital photographs and patient histories sent from general practitioners using a store-and-forward technique and those made by another dermatologist in a face-to-face consultation with the same patients. A total of 117 patients (mean age 47 years) were referred by 18 general practitioners for diagnosis of a skin condition. Between one and seven digital images were transmitted per case. In 31% of the cases, three images were transmitted. There was full concordance between store-and-forward and face-to-face diagnoses in 57 of 106 cases (54%); in 10 cases (9%) there was overlap between the differential diagnoses provided by the teledermatologist and the face-to-face consultant. Diagnostic categories with relatively high concordances were eczema and follicular eruptions. General practitioners need to be trained in the making of digital images and in giving a good patient history.
Feasibility and outcome evaluation of a telemedicine application in speech–language pathology
Authors: Sicotte Claude , Lehoux Pascale , Fortier-Blanc Julie , Leblanc Yves
Published: September 2003

This evaluative study assessed the feasibility and outcome of delivering speech–language services from a distance to children and adolescents who stutter. All six patients who formed the first cohort seen in the telespeech programme were included in the study. The results demonstrated that interactive videoconferencing can provide a feasible and effective care delivery model. Patient attendance was maintained throughout the intervention. All participants showed improved fluency. Stuttering ranged from 13% to 36% before treatment and 2% to 26% after treatment. All participants maintained at least part of their improved fluency during the six-month follow-up, when stuttering ranged from 4% to 32%. The study demonstrates that full assessment and treatment of stuttering in children and adolescents can be accomplished successfully via telemedicine.
A study of a rural community's readiness for telehealth
Authors: Jennett Penny , Jackson Andora , Healy Theresa , Ho Kendall , Kazanjian Arminee , Woollard Robert , Haydt Susan , Bates Joanna
Published: September 2003

A qualitative approach was used to explore the readiness of a rural community for the implementation of telehealth services. There were four domains of interest: patient, practitioner, public and organization. Sixteen semistructured telephone interviews (three to five in each domain) were carried out with key informants and recorded on audio-tape. Two community awareness sessions were held, which were followed by five audio-taped focus groups (with five to eight people in each) in the practitioner, patient and public domains. In addition, two in-depth interviews were conducted with community physicians. Analysis of the data suggested that there were four types of community readiness: core, engagement, structural and non-readiness. The level of readiness varied across domains. There were six main themes: core readiness; structural readiness; projection of benefits; assessment of risk; awareness and education; and intra-group and inter-group dynamics. The results of the study can be used to investigate the readiness of rural and remote communities for telehealth, which should improve the chance of successful implementation.
A model of the willingness to use telemedicine for routine and specialized care
Authors: Werner Perla , Karnieli Eddy
Published: September 2003

We examined factors associated with the willingness to use telemedicine for routine and specialized care within a theoretical framework. The conceptual model proposed that willingness to use telemedicine is associated directly with attitudes to telemedicine, attitudes to the patient–physician relationship, and to satisfaction with current health-care. In addition, technology anxiety and past behaviour were both assumed to affect willingness to use telemedicine indirectly. Telephone interviews were conducted with a national sample of 1204 Jewish, non-institutionalized adults in Israel. Structural equation modelling was used to examine the hypothesized relationships. Participants were more willing to use telemedicine for routine than for specialized care. Overall, willingness to use telemedicine was affected by attitudes to telemedicine, attitudes to the patient–physician relationship and by level of technology anxiety. Educational interventions aimed at encouraging the use of telemedicine should target potential users' attitudes, as well as feelings of uneasiness and anxiety regarding technology.
Acceptance of telemedicine and new media: a survey of Austrian medical students
Authors: Moser Patrizia L , Hager Martina , Lorenz Ingo H , Sögner Peter , Schubert Heinrich M , Mikuz Gregor , Kolbitsch Christian
Published: September 2003

Telemedicine and new media (e.g. the Internet, tele-teaching and tele-learning) are increasingly being used in medicine. We surveyed the awareness and acceptance of these developments on the part of medical students ( n =750) at the University of Innsbruck. A 16-item questionnaire was handed out in randomly chosen medical classes and collected immediately after completion, which resulted in a response rate of 99.9%. Nearly all of the students used the Internet regularly (68%) or at least sometimes (30%). Telemedicine was already known to most of the students, mainly from articles in magazines and newspapers (41%), but the great majority of them (95%) reported that they did not know about the telemedicine lectures offered by the University of Innsbruck. Most students (75%) thought that they would benefit from tele-teaching or tele-learning. The survey suggested that medical schools should offer more special lectures, as well as undergraduate or postgraduate qualifications in telemedicine. The marketing of such opportunities needs to be improved.
Feasibility of and satisfaction with the use of low-bandwidth videoconferencing for examination of undergraduate students
Authors: Mattheos Nikos , Nattestad Anders , Attström Rolf
Published: September 2003

We investigated the feasibility and students' acceptance of Internet-based videoconferencing as a communications method during examinations. Thirty-nine second-year dental students took an interactive examination in periodontology, comprising self-assessment, essay writing, discussion and feedback. The students were randomly divided into two groups, which were examined through the standard classroom procedure ( n =15) or through Internet-based videoconferencing ( n =24). Students evaluated the experience using a standardized questionnaire. The technology proved to be reliable. The interactive examination technique was well accepted, although there was significantly less satisfaction in the videoconference group ( P <0.01). There were no significant differences in the performance of students between the two modalities. Interaction was stressed as one of the major strengths of the examination by students in the conventional group, but it appeared to be less appreciated by the videoconference group. Internet-based videoconferencing can successfully facilitate a highly structured assessment, although students seem to prefer classroom assessment.
Experiences of rural women with breast cancer receiving social support via audioconferencing
Authors: Solberg Shirley , Church Jon , Curran Vernon
Published: September 2003

We examined the process of social support for breast cancer survivors in rural Newfoundland and Labrador. The subjects were 11 participants in a social support programme that made use of audioconferencing. The core social psychological process by which women received social support consisted of four distinct but overlapping stages: getting connected to the network; finding a voice; connecting with others; and becoming empowered. The findings suggested that support groups facilitated via audioconferencing can transcend geographical distance and permit women living in rural areas to share experiences with each other and to learn from and teach each other. The use of telephone and audioconferencing technologies should be encouraged for the provision of information and support to people in rural settings, where such services may be especially beneficial.
A cost study of prenatal telemedicine
Authors: Ippolito Adelaide , De Falco Marianna , Triassi Maria , Di Lieto Andrea
Published: September 2003

We calculated the cost of using a telemedicine system for the cardiotocographic (CTG) recording of fetal heart rate. In a one-year study in the Campania region of Italy, 162 patients were monitored. The total cost of the telemedicine system was €344,796. A control group was retrospectively drawn from all deliveries at the university hospital in Naples during the year 2000. Patients were retrospectively assigned to a category of high or low risk, and the hospital costs of the high-risk patients were compared. In the intervention group, 11 of the 87 high-risk patients (13%) were admitted to hospital prematurely, and stayed on average 12 days. In the control group, 203 of the 813 women in the high-risk group (25%) were admitted to hospital prematurely, and stayed on average 20 days. If the women in the control group had been monitored, there would have been a notional saving, through avoided bed days, amounting to 358,280, which was similar to the cost of the telemedicine system. The study suggests that the use of telemedicine in CTG monitoring improves the quality of prenatal care.
Preliminary clinical evaluation of a video transmission system for home visits
Authors: Ogasawara Katsuhiko , Ito Kuniko , Jiang Guoqian , Endoh Akira , Sakurai Tsunetaro , Sato Hitomi , Okuhara Yoshiko , Adachi Taeko , Hori Kyoichi
Published: September 2003

A portable video transmission system based on a hand-held computer and cellular telephone was developed for use with patients undergoing rehabilitation at home. It was designed to be simple to operate, for use by nurses on home care visits. The whole system can be held in one hand, and video pictures can be recorded and transmitted with the touch of a few buttons. The quality of the transmitted pictures and the feasibility of the system were clinically evaluated by physical therapists and nurses. Three image transmission scenes were used to evaluate the system: turning over in bed; walking; and raising and lowering a shoulder. Nurses reported that the system was easy to carry and simple to use. Physiotherapists found the system to be useful in making a judgement about the patient's condition. The patients were all enthusiastic about the system. The increased interaction had the effect of improving the patients' desire to continue their in-home rehabilitation.
Tele-ophthalmology and conventional ophthalmology using a mobile medical unit in remote Greece
Authors: Labiris G , Fanariotis M , Christoulakis C , Petounis A , Kitsos G , Aspiotis M , Psillas K
Published: September 2003

We evaluated the quality of medical services delivered to remote glaucoma patients from a mobile unit. A four-wheel-drive vehicle containing the necessary equipment visited five different remote locations in Greece. During a three-year prospective study, 1205 patients were examined, of whom 230 had glaucoma. The majority of the subjects were examined by the unit's medical staff using the available instrumentation (e.g. slit-lamp and tonometer), while 56 glaucoma subjects were telemedically examined by consultants at the Patissia General Hospital, in Athens. Control data were obtained from a random sample of 260 urban glaucoma patients. A significantly greater proportion of the remote patients had an inadequate awareness of glaucoma (77%) compared with the urban patients (20%). Significantly more remote patients had poorer compliance (68%) in comparison with urban patients (23%). A significantly larger proportion of the remote patients had high intra-ocular pressure (21%) compared with the urban patients (5%). Technical difficulties occurred in the 13 of the 56 telemedical examinations. Mobile medical units can enhance access to medical services and contribute to the health-care of under-served populations.
Iridium‐Catalyzed Direct Borylation of Five‐Membered Heteroarenes by Bis(pinacolato)diboron: Regioselective, Stoichiometric, and Room Temperature Reactions
Authors: Ishiyama Tatsuo , Takagi Jun , Yonekawa Yuhei , Hartwig John F. , Miyaura Norio
Published: September 2003

An iridium(I) complex generated from 1/2[Ir(OMe)(COD)]2 and 4,4′‐di‐tert‐butyl‐2,2′‐bipyridine catalyzed the direct borylation of 2‐substituted thiophenes, furans and pyrroles in stoichiometric amounts relative to bis(pinacolato)diboron in hexane at room temperature. The heteroarylboronates from regioselective CH activation at the 5‐position were formed in high yields. Similar borylations of unsubstituted heteroarenes with an equimolar amount of the diboron regioselectively provided 2,5‐bis(boryl)heteroarenes.
C(sp2)‐C(sp) and C(sp)‐C(sp) Coupling Reactions Catalyzed by Oxime‐Derived Palladacycles
Authors: Alonso Diego A. , Nájera Carmen , Pacheco Ma Carmen
Published: September 2003

Oxime‐derived chloro‐bridged palladacycle 8a, derived from 4,4′‐dichlorobenzophenone, is an efficient pre‐catalyst for the copper‐ and amine‐free Sonogashira coupling between terminal acetylenes and aryl iodides and aryl and vinyl bromides achieving turnover numbers (TON) of up to 72000. Catalyst 8a has also been shown as a effective promoter for the sila‐Sonogashira coupling between 1‐(trimethylsilyl)alkynes and aryl iodides and bromides in the presence of CuI or Bu4NBr as co‐catalysts. This complex also catalyzes efficiently the homocoupling reaction (Glaser‐type coupling) between 1‐alkynes in NMP at room temperature with TONs of up to 1000. All the reactions can be performed under air and employing reagent‐grade chemicals under very low loading conditions, which demonstrates the versatility and high activity of oxime‐derived palladacycles.
Heterogeneous Photooxidation of Alcohols in Water by Photocatalytic Membranes Incorporating Decatungstate
Authors: Bonchio Marcella , Carraro Mauro , Scorrano Gianfranco , Fontananova Enrica , Drioli Enrico
Published: September 2003

The incorporation of decatungstate in polymeric membranes provides new heterogeneous photocatalysts for the oxidation of organic substrates performed in water under an oxygen atmosphere at 25 °C. The photooxidation of water‐soluble alcohols proceeds to completion, forming the carbonyl derivative as an intermediate, and leading to degradation products with a COD loss up to 70%. Solid state characterisation techniques (SEM, IR) together with solution UV‐VIS analysis and kinetic studies allowed us to identify, among diverse polymeric materials, the PDMS‐based system as leaching‐free under irradiation and recyclable up to>300 turnovers (4 runs) with no major loss of activity. Membrane induced discrimination of the substrate results from the oxidations of a series of alcohols, through comparison with the homogeneous reactions.
The Remote Activation of Chemical Bonds via Metal Coordination
Authors: Oh Moonhyun , Yu Kunquan , Li Huazhi , Watson Eric J. , Carpenter Gene B. , Sweigart Dwight A.
Published: September 2003

The activation of chemical bonds to cleavage by mild metal nucleophiles can be achieved by precoordination of a transition metal fragment to a site remote from the bond in question. The following bonds have been activated in this manner by η6‐coordination to an internal arene ring: CC in biphenylene, CS in benzothiophene and dibenzothiophene, CSe in benzoselenophene, CO in benzofuran, and NH in indole.
Theoretical Studies on Diastereo‐ and Enantioselective Rhodium‐Catalyzed Cyclization of Diazo Compound via Intramolecular CH Bond Insertion
Authors: Yoshikai Naohiko , Nakamura Eiichi
Published: September 2003

Theoretical studies on the stereoselectivity of the dirhodium tetracarboxylate (carboxamidate)‐catalyzed intramolecular CH insertion reaction, which gives a variety of carbo‐ or heterocyclic compounds, have been performed by the following procedure. First, the CH insertion mechanism of simple systems was studied by the hybrid density functional theory (B3LYP) calculations. On the basis of these B3LYP structures, stereoselectivities of the reactions of realistic substrates were examined by the PM3 calculations with some structural constraints. The origin of the diastereo‐ and enantioselectivities in the four‐ and five‐membered ring formation reactions with an achiral or a chiral Rh catalyst has thus been elucidated.
Genotypes from patients indicate no paternal mitochondrial DNA contribution
Authors: Taylor Robert W. , McDonnell Martina T. , Blakely Emma L. , Chinnery Patrick F. , Taylor Geoffrey A. , Howell Neil , Zeviani Massimo , Briem Egill , Carrara Franco , Turnbull Douglass M.
Published: September 2003

A cornerstone of mitochondrial genetics, strict maternal inheritance, has been challenged recently by the study of a patient with mitochondrial myopathy due to a sporadic 2bp deletion. The mitochondrial DNA (mtDNA) harboring the mutation was paternal in origin, whereas the patient's blood was identical to the maternal genotype. To determine whether this is a common phenomenon, we studied mtDNA sequence variation between muscle and blood from 35 patients with sporadic mitochondrial myopathies, but detected no evidence of paternal mtDNA transmission. Our findings suggest that paternal transmission of mtDNA is rare and should not alter our genetic advice to families.
Early recovery after cerebral ischemia risk of subsequent neurological deterioration
Authors: Johnston S. Claiborne , Leira Enrique C. , Hansen Michael D. , Adams Harold P.
Published: September 2003

Given the high short‐term risk of stroke after transient ischemic attack, we hypothesized that substantial acute neurological recovery in patients presenting with cerebral ischemia would be associated with a greater risk of subsequent neurological deterioration due to recurrent cerebral ischemia. Data from the Trial of ORG10172 in Acute Stroke Treatment, a randomized trial of the heparinoid danaparoid, were analyzed to determine whether substantial acute recovery, defined as an improvement of greater than or equal to 75% on National Institutes of Health Stroke Scale (NIHSS) between baseline and 24 hours, was associated with a greater risk of subsequent deterioration, defined as a worsening on the NIHSS between day 1 and day 90. Of 1,184 subjects meeting entry criteria, 63 (5.3%) had substantial acute recovery. Subsequent deterioration was more common in those with substantial acute recovery compared with others (48 vs 33%; p = 0.028 by Fisher's exact test). In multivariable models, substantial acute recovery remained an independent predictor of subsequent deterioration (odds ratio, 3.0; 95% confidence interval, 1.7–5.2; p < 0.001). Among patients with acute cerebral ischemia, those who recover substantially within 24 hours may be at greater risk of subsequent neurological deterioration due to causes other than hemorrhage.
Bilateral striatal necrosis associated with a novel mutation in the mitochondrial ND6 gene
Authors: Solano Abelardo , Roig Manuel , Vives‐Bauza Cristofol , Hernandez‐Peña Jose , Garcia‐Arumi Elena , Playan Ana , Lopez‐Perez Manuel J. , Andreu Antonio L. , Montoya Julio
Published: September 2003

We report the molecular findings in two independent patients presenting with progressive generalized dystonia and bilateral striatal necrosis in whom we have identified a mutation (T14487C) in the mitochondrial ND6 gene. The mutation is heteroplasmic in all samples analyzed, and it fulfills all accepted criteria of pathogenicity. Transmitochondrial cell lines harboring 100% mutant mitochondrial DNA showed a marked decrease in the activity of complex I of the respiratory chain supporting the pathogenic role of T14487C.
Subthalamic nucleus stimulation affects a frontotemporal network: A PET study
Authors: Schroeder Ulrike , Kuehler Andreas , Lange Klaus W. , Haslinger Bernhard , Tronnier Volker M. , Krause Martin , Pfister Robert , Boecker Henning , Ceballos‐Baumann Andres O.
Published: September 2003

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an effective strategy in the treatment of motor symptoms in advanced Parkinson's disease. However, clinical studies have shown that DBS can affect verbal fluency. Seven Parkinson's disease patients with bilateral DBS of the STN were studied with positron emission tomography (PET) to investigate the effects of STN stimulation on regional cerebral blood flow during a verbal fluency task. Activation of the right orbitofrontal cortex and verbal fluency‐associated activation within a left‐sided frontotemporal network were decreased during STN stimulation compared with the OFF state. Our results offer an explanation for the commonest neuropsychological side effect of STN stimulation and show that STN stimulation affects a frontotemporal network during a fluency task. Ann Neurol 2003;54:000–000
Meningitis‐associated hearing loss: Protection by adjunctive antioxidant therapy
Authors: Klein Matthias , Koedel Uwe , Pfister Hans‐Walter , Kastenbauer Stefan
Published: September 2003

Hearing loss is the most frequent long‐term complication of pneumococcal meningitis, affecting up to 40% of survivors. Unfortunately, adjuvant therapy with dexamethasone has failed to satisfactorily reduce its incidence. Therefore, we evaluated the use of antioxidants for the adjunctive therapy of meningitis‐associated deafness. Eighteen hours after intracisternal injection of 7.5 × 105colony‐forming units ofStreptococcus pneumoniae, rats were treated systemically either with ceftriaxone and the antioxidants and peroxynitrite scavengers Mn(III)tetrakis(4‐benzoic acid)‐porphyrin (MnTBAP) orN‐acetyl‐L‐cysteine (NAC) or placebo (1ml phosphate‐buffered saline) for 4 days. Hearing was assessed by auditory brainstem response audiometry. Adjunctive antioxidant therapy significantly reduced the long‐term hearing loss (14 days after infection) for square wave impulses (mean hearing loss ± SD: ceftriaxone and placebo, 45±26dB; ceftriaxone and MnTBAP, 9±23dB; ceftriaxone and NAC, 19±30dB) as well as 1kHz (ceftriaxone and placebo, 28±19dB; ceftriaxone and MnTBAP, 10±16dB; ceftriaxone and NAC, 10±17dB), and 10kHz tone bursts (ceftriaxone and placebo, 62±27dB; ceftriaxone and MnTBAP, 16±13dB; ceftriaxone and NAC, 25±26dB). Furthermore, both antioxidants attenuated the morphological correlates of meningogenic hearing loss, namely, long‐term blood‐labyrinth barrier disruption, spiral ganglion neuronal loss, and fibrous obliteration of the perilymphatic spaces. Adjuvant antioxidant therapy is highly otoprotective in meningitis and therefore is a promising future treatment option.
Contribution of the ipsilateral motor cortex to recovery after chronic stroke
Authors: Werhahn Konrad J. , Conforto Adriana B. , Kadom Nadja , Hallett Mark , Cohen Leonardo G.
Published: September 2003

It has been proposed that the intact (ipsilateral) motor cortex play a significant role mediating recovery of motor function in the paretic hand of chronic stroke patients, but this hypothesis has not been tested experimentally. Here, we evaluated the effects of transcranial magnetic stimulation (TMS) on motor performance of the paretic hand of chronic stroke patients and healthy controls. We hypothesized that, if activity in the intact hemisphere contributes to functional recovery, TMS should result in abnormal motor behavior in the paretic hand. We found that stimulation of the intact hemisphere resulted in delayed simple reaction times (RTs) in the contralateral healthy but not in the ipsilateral paretic hand, whereas stimulation of the lesioned hemisphere led to a marked delay in RT in the contralateral paretic hand but not in the ipsilateral healthy hand. RT delays in the paretic hand correlated well with functional recovery. Finger tapping in the paretic hand was affected by TMS of the lesioned but not the intact hemisphere. These results are consistent with the idea that recovered motor function in the paretic hand of chronic stroke patients relies predominantly on reorganized activity within motor areas of the affected hemisphere.
Low mutant load of mitochondrial DNA G13513A mutation can cause Leigh's disease
Authors: Kirby Denise M. , Boneh Avihu , Chow C. W. , Ohtake Akira , Ryan Michael T. , Thyagarajan Dominic , Thorburn David R.
Published: September 2003

Respiratory chain complex I deficiency is a common cause of Leigh's disease (LD) and can be caused by mutations in genes encoded by either nuclear or mitochondrial DNA (mtDNA). Most pathogenic mtDNA mutations act recessively and only cause disease when present at high mutant loads (typically >90%) in tissues such as muscle and brain. Two mitochondrial DNA mutations in complex I subunit genes, G14459A in ND6, and T12706C in ND5, have been associated with complex I deficiency and LD. We report another ND5 mutation, G13513A, in three unrelated patients with complex I deficiency and LD. The G13513A mutation was present at mutant loads of approximately 50% or less in all tissues tested, including multiple brain regions. The threshold mutant load for causing a complex I defect in cultured cells was approximately 30%. Blue Native polyacrylamide gel electrophoresis showed that fibroblasts with 45% G13513A mutant load had approximately 50% of the normal amount of fully assembled complex I. Fibroblasts with greater than 97% of the ND6 G14459A mutation had only 20% fully assembled complex I, suggesting that both mutations disrupt complex I assembly or turnover. We conclude that the G13513A mutation causes a complex I defect when present at unusually low mutant load and may act dominantly.
Predictors of neuropathological severity in 100 patients with Huntington's disease
Authors: Rosenblatt Adam , Abbott Margaret H. , Gourley Lisa M. , Troncoso Juan C. , Margolis Russell L. , Brandt Jason , Ross Christopher A.
Published: September 2003

Subjects were followed in the Longitudinal Core Study of the Baltimore Huntington's Disease Center and given annual neurological, cognitive, and psychiatric examinations. Postmortem neuropathological grade was assigned using the system of Vonsattel and colleagues. We examined the correlations between the neuropathological grade and scores on the Quantified Neurological Examination (QNE) and its chorea and motor impairment subscales, the Mini‐Mental State Examination (MMSE), the HD Activities of Daily Living (ADL) Scale, and a number of demographic variables (CAG number, age of onset, age at death, disease duration) in 100 subjects who had been examined within 1,000 days of death. All measures showed significant correlation with Vonsattel score except for chorea. The strongest effect was that of motor impairment score (r2 = 0.351, p < 0.0001). In a stepwise correlation of clinical variables, motor impairment remained significant. The largest effect for a demographic variable was for age of onset (r2 = 0.226, p < 0.0001) A partial correlation was significant between CAG number and Vonsattel grade, controlling for age at death or disease duration. Motor impairment appears to be a good clinical measure of neuronal cell loss, at least late in the course of HD and therefore may prove useful in observational and treatment studies.
Myosin storage myopathy associated with a heterozygous missense mutation in MYH7
Authors: Tajsharghi Homa , Thornell Lars‐Eric , Lindberg Christopher , Lindvall Björn , Henriksson Karl‐Gösta , Oldfors Anders
Published: September 2003

Myosin constitutes the major part of the thick filaments in the contractile apparatus of striated muscle. MYH7 encodes the slow/β‐cardiac myosin heavy chain (MyHC), which is the main MyHC isoform in slow, oxidative, type 1 muscle fibers of skeletal muscle. It is also the major MyHC isoform of cardiac ventricles. Numerous missense mutations in the globular head of slow/β‐cardiac MyHC are associated with familial hypertrophic cardiomyopathy. We identified a missense mutation, Arg1845Trp, in the rod region of slow/β‐cardiac MyHC in patients with a skeletal myopathy from two different families. The myopathy was characterized by muscle weakness and wasting with onset in childhood and slow progression, but no overt cardiomyopathy. Slow, oxidative, type 1 muscle fibers showed large inclusions consisting of slow/β‐cardiac MyHC. The features were similar to a previously described entity: hyaline body myopathy. Our findings indicate that the mutated residue of slow/β‐cardiac MyHC is essential for the assembly of thick filaments in skeletal muscle. We propose the term myosin storage myopathy for this disease.
Familial aggregation of early‐ and late‐onset Parkinson's disease
Authors: Marder Karen , Levy Gilberto , Louis Elan D. , Mejia‐Santana Helen , Cote Lucien , Andrews Howard , Harris Juliette , Waters Cheryl , Ford Blair , Frucht Steven , Fahn Stanley , Ottman Ruth
Published: September 2003

The role of heredity in early‐ versus late‐onset Parkinson's disease (PD) is controversial. We estimated the degree of increased risk of PD in first‐degree relatives of 221 PD probands with age of onset 50 years or younger and 266 PD probands with age of onset older than 50 years compared with the first‐degree relatives of 409 control probands. Risk of PD was similar among first‐degree relatives of early‐onset PD probands (risk ratio [RR], 2.9; 95% confidence interval [CI], 1.6–5.0; p = 0.0002) and late‐onset PD probands (RR, 2.7; 95% CI, 1.6–4.4; p = 0.0002) when each was compared with first‐degree relatives of controls. However, siblings of early‐onset PD probands were at markedly increased risk of PD compared with siblings of controls (RR, 7.9; 95% CI, 2.5–25.5; p = 0.0005), whereas parents of early‐onset PD probands were not at significantly increased risk compared with parents of controls (RR, 1.7; 95% CI, 0.9–3.3; p = 0.2). In late‐onset families, both siblings (RR, 3.6; 95% CI, 1.3–10.3; p = 0.02) and parents (RR, 2.5; 95% CI, 1.4–4.6; p = 0.003) were at increased risk compared with control relatives. This pattern is consistent with an autosomal recessive contribution to the inheritance of early but not late‐onset PD. Genetic factors are important in both early‐ and late‐onset PD, but specific genes and mode of inheritance may differ between the two groups. Ann Neurol 2003;54:507–513
Epilepsy in low‐grade gliomas: The impact on cognitive function and quality of life
Authors: Klein Martin , Engelberts Nadine H. J. , van der Ploeg Henk M. , Kasteleijn‐Nolst Trenité Dorotheé G. A. , Aaronson Neil K. , Taphoorn Martin J. B. , Baaijen Hans , Vandertop W. Peter , Muller Martin , Postma Tjeerd J. , Heimans Jan J.
Published: September 2003

Low‐grade gliomas frequently are associated with epilepsy. The purpose of this study is to determine the impact of epilepsy and antiepileptic drug (AED) treatment on cognitive functioning and health‐related quality of life (HRQOL) in these patients. One hundred fifty‐six patients without clinical or radiological signs of tumor recurrence for at least 1 year after histological diagnosis and with an epilepsy burden (based on seizure frequency and AED use) ranging from none to severe were compared with healthy controls. The association between epilepsy burden and cognition/HRQOL was also investigated. Eighty‐six percent of the patients had epilepsy and 50% of those using AEDs actually were seizure‐free. Compared with healthy controls, glioma patients had significant reductions in information processing speed, psychomotor function, attentional functioning, verbal and working memory, executive functioning, and HRQOL. The increase in epilepsy burden that was associated with significant reductions in all cognitive domains except for attentional and memory functioning could primarily be attributed to the use of AEDs, whereas the decline in HRQOL could be ascribed to the lack of complete seizure control. In conclusion, low‐grade glioma patients suffer from a number of neuropsychological and psychological problems that are aggravated by the severity of epilepsy and by the intensity of the treatment.
Voltage‐gated potassium channel antibodies in limbic encephalitis
Authors: Pozo‐Rosich Patricia , Clover Linda , Saiz Albert , Vincent Angela , Graus Francesc
Published: September 2003

We found voltage‐gated potassium channel (VGKC) antibodies in 4 of 15 patients with limbic encephalitis (LE). Two patients with idiopathic LE had high VGKC antibody levels (>800pM; controls <100pM), that fell in parallel with a clinical response to immunotherapy. Two patients with lower VGKC antibodies (170pM, 300pM) had lung cancer (radiological evidence only in one) and the LE improved with immunotherapy in one. The other 11 patients without VGKC antibodies had paraneoplastic LE and eight onconeural antibodies (Hu in 6; Ma2 in 2). VGKC antibodies do not unambiguously discriminate between idiopathic or paraneoplastic LE but probably indicate a good response to immunotherapy. Ann Neurol 2003;54:530‐533