bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric emptying in diabetic and non‐diabetic patients on continuous ambulatory peritoneal dialysis
Authors: TANG Sydney , LO Wai Kei , HUI Wai Mo , YEUNG Henry , LAI Kam Chuen , Po CHENG Ignatius Kum
Published: August 2010

Summary:As anorexia is common in continuous ambulatory peritoneal dialysis (CAPD) particularly in diabetic patients, we conducted this study to investigate gastric motility and the effect of 2 L of intraperitoneal dialysate in diabetic (DM) and non‐diabetic (NDM) CAPD patients. A standard test meal labeled with technetium‐99m was given after an overnight fast to 11 DM and 10 asymptomatic NDM CAPD patients (matched for age and sex) on two occasions, each 1 week apart, with an empty (postdrainage) and 2 L dialysate‐lilled (pre‐drainage) peritoneal cavity. Serial anterior images of the abdomen were taken in a standard manner for up to 2 h. the percentage of radioactivity retained at the end of 2 h (%2h), half emptying time (ET1/2), and emptying rate (ER) were determined. These three parameters were also obtained from six normal individuals matched for age and sex. the mean age was 53.9 for NDM and 54 for DM patients; the mean dialysis duration was 37.9 and 22.3 months, respectively. the mean age in the control group was 49.5. Comparing the DM and NDM groups individually and with the control group, there were no statistical differences in the three gastric emptying parameters, but the latter were slightly more often abnormal in DM (8) than in NDM (6) patients. There was also a significant difference in the fractional changes of all three parameters pre‐ and postdrainage in the DM group, but not in the NDM group. We conclude that gastric emptying is impaired in the presence of peritoneal dialysate in DM but not in NDM patients. These findings may explain the higher prevalence of anorexia among DM CAPD patients.
Hypertension in stroke patients: Relationship with hyperinsulinaemia
Authors: WIDIANA I Gde Raka , WIYONO Paulus , RAHARDJO Poerwono , PURNAMA
Published: August 2010

Summary: In an attempt to determine the presence of hypertension in stroke patients and its relationship with hyperinsulinaemia, a case‐control study was carried out in the outpatients clinic, Department of Neurology, Sardjito General Hospital, Yogyakarta. Patients included in the study were those who had survived a stroke at least 3 months after the first attack. the exclusion criteria included: diabetes mellitus, renal failure, heart failure, malignancy, myocardial infarction, current antihypertensive and hypolidaemic treatment. Controls were selected from non‐stroke patients at the same department matching for sex and age. During the study 51 stroke patients (39 male and 12 female, aged 58.7 ± 10.3 years) and 51 controls (40 male and 11 female, aged 58.6 ± 9.8 years). There were no significant differences in baseline clinical characteristics; namely, smoking, body mass index, blood sugar and blood lipids except triglyceride (169 ± 61 vs 141 ± 60 P<0.05) of cases and controls. Although there was no significant difference of fasting plasma insulin levels (9.3 ± 8.3 vs 8.3 ± 2.6 mU/L, P= >0.05), significantly higher levels of postprandial insulin (94.8 ± 86.7 vs 55.2 ± 49.1 mU/L, P<0.05) were found in cases than controls. There were a significantly higher levels of blood pressure, both systolic (160 ± 24 vs 131 ± 11 mmHg, P<0.05) and diastolic (101 ± 13 vs 79 ± 4 mmHg, P<0.05), and more frequent hypertension defined as BP ± 140/90 mmHg (72.5 vs 2.0%, P<0.05) in cases than controls. No significant difference of plasma insulin levels (94.9 ± 82.3 vs 94.3 ± 119.2 mU/L, P>0.05) between hypertensive and normotensive stroke patients. However, significantly higher levels of insulin (94.3 ± 119.2 mU/L vs 55.2 ± 49.1 mU/L, P<0.05) were found in normotensive stroke patients than controls. the relationship between 2 h post‐prandial blood sugar levels and post‐prandial insulin levels was positive and nearly significant relationship (r=0.62, P=0.05). the relationship between mean arterial pressure (MAP) and post‐prandial insulin levels of the whole patients (cases and controls) were poor but significant (r = 0.22, P<0.05). the relationship between MAP and post‐prandial insulin levels are poor and not significant both in stroke patients (r = 0.00, P>0.05) and controls (r = 0.17, P>0.05). the slope of both curves in both scattered diagrams seemed to be slightly different. We conclude that hypertension and post prandial hyperinsulinaemia may play a role in the genesis of stroke, while hyperinsulinaemia may an independent factor.
Low‐density lipoprotein subfraction profiles in dialysis patients
Authors: BOFINGER Andrew , WESTHUYZEN Justin , SALTISSI David , MORGAN Colleen , HEALY Helen
Published: August 2010

Summary: Uraemic dyslipidaemia is a major risk factor for cardiovascular disease in end‐stage renal failure patients. In patients without renal failure, high levels and qualitative abnormalities of low‐density lipoprotein (LDL) are known to be atherogenic. Recently, LDL subfraction analysis has associated premature coronary artery disease with a high prevalence of small, dense LDL particles characterizing the LDL subclass phenotype B. We therefore examined the lipid profiles, LDL subfraction distribution and phenotypes in our population of haemodialysis (HD; n= 30) and peritoneal dialysis patients (PD; n= 17), and compared them to 40 asymptomatic, non‐uraemic volunteers. Dialysis patients had significantly higher triglyceride and VLDL cholesterol concentrations and lower HDL cholesterol and smaller LDL peak particle diameters. PD patients had significantly higher total cholesterol, glycated haemoglobin and fasting blood glucose levels with smaller LDL peak particle diameters (24.4 [0.1] vs 24.8 [0.1 nm] than HD. Both groups showed significant negative correlations between plasma triglyceride and LDL peak particle diameter, and positive correlations between HDL cholesterol and LDL peak particle diameter. All the PD patients expressed the B phenotype (LDL peak diameter ± 25.5 nm) compared to 73% of HD patients. This study demonstrates that HD and especially PD patients have atherogenic lipid profiles which are associated with a predominance of small dense LDL particles and the highly atherogenic LDL subclass phenotype B.
Sodium modelling and profiled ultrafiltration in conventional haemodialysis
Authors: PARSONS Darren S , YUILL Elizabeth , LLAPITAN Myrna , HARRIS David CH
Published: August 2010

Summary: Previous controlled studies have shown that sodium modelling may reduce intradialytic hypotension and symptoms (particularly cramp, headache and nausea) in patients on maintenance haemodialysis, and it has been proposed that decremental profiled ultrafiltration may improve haemodynamic stability. Those controlled studies of sodium modelling were flawed because sodium modelling programmes were compared to a constant sodium dialysate concentration lower than the overall mean sodium concentration during sodium modelling (the ‘true mean’). to compare sodium modelling to its true mean constant dialysate concentration and also to compare profiled ultrafiltration with constant ultrafiltration, 12 patients on conventional haemodialysis were dialysed by four regimens in random order each for 3 weeks: (i) sodium modelling (exponential decline from 150 to 140 mmol/L) and conventional (linear) ultrafiltration; (ii) sodium modelling and profiled (65% of target loss in first 2 h) ultrafiltration; (iii) constant sodium (143 mmol/L, the true mean) and conventional ultrafiltration; and (iv) constant sodium and profiled ultrafiltration. Weight gain and pre‐dialysis blood pressure were no different between the four regimens. Sodium modelling had no effect on the frequency of intradialytic hypotension or need for saline administration when compared to a constant sodium dialysate of 143 mmol/L, nor improved frequency or severity of thirst, cramp, nausea and lethargy. Interdialytic headache was less severe (P<0.05) but no less frequent with sodium modelling. Profiled ultrafiltration increased the frequency of intradialytic hypotension (odds ratio 2.44, P<0.05) and did not improve symptoms except interdialytic thirst, which occurred less frequently than with linear ultrafiltration (odds ratio 0.55, P<0.05). the haemodynamics and symptoms were no better with sodium modelling and profiled ultrafiltration than with constant sodium dialysis and linear ultrafiltration, respectively. Thus, there is no justification for the routine use of sodium modelling or profiled ultrafiltration in conventional haemodialysis on the grounds of haemodynamic stability or symptom control.
Vascular disease in type II diabetes: Progression before and after commencing haemodialysis
Authors: BIESENBACH Georg , ZAZGORNIK Jan
Published: August 2010

Summary: In 20 nephropathic type II‐diabetic patients (nine women, 11 men, mean age 56 ± 7 years) we compared the progression of macroangiopathic damages and the incidence rates of angiopathic complications during the pre‐dialysis phase (mean observation period 70 ± 26 months) and after start of dialysis treatment (observation period 29 ± 21 months). the following parameters were measured at 2‐ month intervals: HbA1c, serum cholesterol and triglycerides, systolic and diastolic blood pressure and bodyweight. A fundoscopy, resting electrocardiogram, carotid Duplex sonography and Doppler sonographic investigations of the lower extremities were performed yearly. In special cases a thallium scintigraphy and/ or coronary angiography were also performed. the prevalence of all cerebrovascular damages increased from 5% at the begin of the study to 50% at the start of haemodialysis and to 70% at the end of the study. During the same period the prevalence of stroke increased from 0 to 10% and to 50%, respectively. Coronary heart disease was present in 40% of patients at the beginning of the study, in 80% of patients at the start of dialysis treatment, and in 95% patients at the end of observation period. During this time the prevalence of myocardial infarction increased from 5 to 25% and at least to 60% at the end of the study. Peripheral vascular disease was be observed in 20% of the patients at the time of entry into study, in 65% of patients at the start of haemodialysis and 85% patients at the end of the study. During the same time the prevalence of amputations of the lower legs increased from 10 to 15% and to 35%, respectively. the incidence of complications in both observation periods (pre‐dialysis and dialysis phase) was: 0.09 vs 0.08 for cerebrovascular damages (0.02 vs 0.16 for strokes), 0.08 vs 0.06 for cardiovascular diseases (0.04 vs 0.14 for myocardial infarctions) and 0.09 vs 0.08 for peripheral vascular diseases (0.01 vs 0.08 for amputations). the increase in the incidence rate of stroke and myocardial infarction was significantly (P<0.05) higher during the haemodialysis period. In conclusion, the progression of macroangiopathic diseases in type II diabetic patients is approximately the same during the pre‐dialysis and dialysis phase, but the incidence rates of the severe macroangiopathic complications stroke and myocardial infarction are significantly higher during the period of haemodialysis. This increase can be explained by the typical dialysis‐induced effects on the heart and the intravascular volume.
Avascular necrosis of bone after renal transplantation
Authors: JAGOSE Jinni T , BAILEY Ross R
Published: August 2010

Summary: Avascular necrosis (AVN) of bone is the most debilitating musculoskeletal complication that can follow renal transplantation, and has been reported in 3‐41% of patients. In this unit 351 renal transplants have been done on 285 recipients. Five (1.8%) of these patients (mean age 41.6 years; range 22‐57 years; four female; all cadaveric kidneys) developed AVN which affected both hip joints. the mean duration of renal failure before dialysis was 18.2 months (range 5‐36). All five were on dialysis for a mean of 16.2 months (range 4‐29) pre‐transplant. No patient had radiological evidence of renal osteodystrophy prior to transplantation. the first 116 patients were immunosuppressed with prednisone/azathioprine and four (3.5%) developed AVN. the subsequent 169 patients were treated with prednisone/azathioprine/ cyclosporine and one (0.6%) developed AVN. Only two of the five patients needed treatment for acute rejection (methylprednisolone 3 g and 6 g). the mean time from transplantation to onset of joint pain was 45.4 months (range 6‐108). Total hip replacement (THR) was undertaken on all 10 joints with the first side being operated on after a mean of 73.2 months (range 23‐124) from transplantation and the contralateral side after 88.4 months (range 24–144). Total hip replacement resulted in relief of pain in all joints: three surgical revisions were required, two for dislocation and one for a fractured prosthesis. This study has shown a low prevalence of AVN after renal transplantation. Possible explanations include careful control of renal osteodystrophy while on dialysis and the use of low dose prednisone in the immunosuppressive regimen.
Provision of optimal dialysis for peritoneal dialysis patients
Authors: IBELS Lloyd S , GARCHOW Stephen , MORAN John
Published: August 2010

SUMMARY: Prescription of optimal dialysis is of major importance in determining the overall prognosis and nutritional status of patients receiving chronic peritoneal dialysis (PD). A mathematical model of peritoneal dialysis kinetics was used to examine typical dialysis prescriptions for patients receiving continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD), and using a new automatic night‐time dialysis machine. Based on the recommendations of the CANUSA and other studies, a creatinine clearance delivery target of 70 L per week (the equivalent of 6.9 mL/min) was selected. At the start of dialysis, creatinine clearances of greater than 70 L/week are achieved in most patients on PD, but by 2 years deterioration of residual renal function (RRF) results in standard dialysis prescriptions of 4 × 2 L exchanges per day providing adequate solute clearance to only a minority of patients. Prescriptions of 4 × 2.5 or 4 × 3.0 L exchanges per day may be required to provide optimal solute clearance to most patients without RRF. Automated peritoneal dialysis, especially when prescribed without day‐time fluid, often delivers inadequate solute clearance. In order to achieve optimal solute clearance with APD it is essential that patients have dialysate in the abdomen by day, and most need to perform a mid‐day exchange. Five exchanges per day can be easily achieved, using the new technology that performs a night‐time exchange, and this often results in optimal solute clearance. Optimization of dialysis prescriptions may be expected to result in improvement in objective measures of morbidity and mortality. For. the individual patient, it is essential to take into account the creatinine clearances achieved with the dialysis prescribed, the body surface area, peritoneal transport rates and the contribution of measured residual renal function.
Primary focal sclerosing glomerulonephritis: A clinicopathological analysis
Authors: IBELS Lloyd S , GYORY Akos Z , MAHONY John F , CATERSON Robyn J , POLLOCK Carol A , WAUGH David A , COULSHED Susan
Published: August 2010

SUMMARY:The clinical and laboratory features, renal biopsy findings, and outcome of 68 patients with primary focal sclerosing glomerulonephritis were studied. the cumulative probability of not progressing to end‐stage renal failure (ESRF) was 0.92 at 5 years and 0.73 at 10 years after presentation, and was significantly worse in patients with hypertension or severe renal impairment (serum creatinine >0.24 mmol/L) at presentation. Proteinuria of up to 1gm/day was associated with an excellent prognosis, whereas proteinuria of 1–3 gm/day and >3 gm/day had similar and poorer survivals. an adverse outcome was associated with, at presentation, age less than 30 years, hypertension, a family history of glomerulonephritis, cigarette smoking, impaired renal function, and heavy proteinuria. Renal biopsy findings which correlated with progressive renal failure included a higher percentage of glomeruli with global or segmental sclerosis, and the degrees of tubular atrophy, interstitial fibrosis, interstitial inflammation and arterial thickening. During follow‐up the degrees of renal impairment and proteinuria, persistence or development of hypertension, transient decreases of renal function of >10%, and the total number of red cells and casts on centrifuged urine microscopy were all predictive of progressive renal disease. Multivariate analysis demonstrated that the indices with adverse effects on outcome induced all of the above except tubulointerstitial and vascular changes on renal biopsy. It is concluded that the prognosis may be better than has been suggested in the literature. It is possible to predict which patients are likely to have an adverse outcome, and this should assist with therapeutic decisions likely to retard progression of disease.
A randomized prospective comparison of nadolol, captopril with or without ticlopidine on disease progression in IgA nephropathy
Authors: CHENG Ignatius KP , FANG GX , WONG MC , JI YL , CHAN KW , YEUNG Henry WD
Published: August 2010

SUMMARY: To determine if angiotensin converting enzyme inhibitors (ACEI) and antiplatelet agents have any added advantages over beta‐blockers in preventing disease progression in IgA nephropathy (IgAN), 52 patients with IgAN with at least two features suggestive of progressive disease, namely, proteinuria >1 gm/day, mean blood pressure (MBP) >107 mmHg, serum creatinine 0.12‐0.4 mmol/L and the presence of glomerulosclerosis and/or tubulointerstitial fibrosis on initial biopsy were randomized to receive nadolol (N), captopril (C) and captopril plus ticoplidine (CT). In hypertensive subjects, the dose N and C was adjusted to normalize MBP. In normotensive subjects the dose was adjusted to achieve a reduction of MBP of 5–10mmHg. Five patients withdrew prematurely before reaching the end of the study period. the results after a minimal period of 3 years follow‐up were available in the remaining 47 patients (n=16, 12 and 19 in groups N, C and CT, respectively). Target of blood pressure (BP) treatment was achieved in all patients and the post‐treatment MBP was comparable among the three groups. In C and CT, peripheral blood renin increased significantly while in CT, in vitro platelet aggregation decreased significantly following treatment. Urinary protein and albumin excretion decreased significantly in all treatment groups but there was no difference among the three groups. Progression of renal failure as measured by life table analysis of the percentage of patients with doubling of serum creatinine and by the slope of the reciprocal of serum creatinine (mean ± SEM: −0.021 ± 0.014; −0.016 ± 0.010 and −0.017 ± 0.008 for N, C and CT, respectively) and of glomerular filtration rate as measured by plasma disappearance of injected Cr51EDTA over time (mean ± SEM: −0.556 ± 0.157, −0.739 ± 0.304 and −0.543 ± 0.274 for N, C and CT) were similar among the three groups. In this small comparative study, ACEI does not appear to be better than long‐acting beta‐blocker in retarding disease progression in patients with IgAN and ticlopidine confers no additional benefit.
Retinitis pigmentosa associated with autosomal dominant polycystic kidney disease
Authors: PERNG Chan T , SEGASOTHY Murugasu
Published: August 2010

SUMMARY: We report a case of a 35‐year‐old man with autosomal dominant polycystic kidney disease (ADPKD) who presented for the first time with end‐stage renal failure. He had a long history of blurred vision and on examination had retinitis pigmentosa. to our knowledge, this is the second report on the association of retinitis pigmentosa with polycystic kidney disease.
Effect of Sairei‐to on irreversible glomerular sclerotic lesions in rats
Authors: LI Ping , KAWACHI Hiroshi , ORIKASA Michiaki , SHI Zhen Sheng , SHIMIZU Fujio
Published: August 2010

SUMMARY: The effects of Sairei‐to and its active components on a model of irreversible mesangial proliferative glomerulonephritis induced by injecting monoclonal antibody (MoAb) 1‐22‐3 into uninephrectomized rats were examined. the significant suppressive effects of Sairei‐to and its active components on proteinuria were demonstrated on days 7, 14, 21 after MoAb 1‐22–3 injection compared with phosphate‐buffered saline (PBS)‐treated controls. On day 21, light microscopy revealed that the drugs reduced mesangial cell proliferation, mesangial matrix expansion (matrix score: 84.5 ± 41.6 for Sairei‐to, 76.1 ± 31.9 for Syo‐saiko‐to, 66.7 ± 46.3 for its three components vs 162.4 ± 26.1 for PBS, P<0.005) and crescent formation (mean percentage: 2.25% for Sairei‐to, 1.71% for Syo‐saiko‐to, 1.43% for its three components vs 18.86% for PBS, P<0.005). the kidney weights of the groups given the drugs were significantly lower than the PBS group value (1.03 ± 0.08 g with Sairei‐to, 1.11 ± 0.12 g with Syo‐saiko‐to, 1.06 ± 0.12 g with its three components vs 1.39 ± 0.20 g with PBS, P<0.01 or P<0.05). Immunofluorescence analysis revealed that the drugs suppressed the expression of transforming growth factor‐β (TGF‐β), α‐smooth muscle actin (α‐SMA) and collagen type I in the glomeruli, and reduced the numbers of ED1‐positive cells in the glomeruli and OX8‐positive cells in the glomeruli and in the tubular interstitium. the blood biochemistry results revealed significant differences between the total cholesterol levels (70.0 ± 5.9 mg/dL with Sairei‐to, 66.0 ± 6.4 mg/dL with Syo‐saiko‐to, 76.6 ± 8.4 mg/dL with its three components vs 104.3 ± 26.6 mg/dL with PBS, P<0.05). We conclude that Sairei‐to and its active components have suppressive effects on proteinuria and mesangial matrix expansion in rats with irreversible renal sclerosis. Transforming growth factor‐β, collagen type I and α‐SMA expression and infiltration by ED1‐ and OX8‐positive cells were also suppressed by these drug preparations.
Stimulation of PAI‐1 in rabbit anti‐GBM glomerulonephritis
Authors: GALLICCHIO Marisa , McFARLANE Jim , HUFNAGL Peter , HOLDSWORTH Stephen , TIPPING Peter
Published: August 2010

SUMMARY: It has previously been shown in human disease and animal models of glomerulonephritis (GN) that fibrin deposition is associated with a net reduction of glomerular fibrinolytic activity as a result of reduced expression of plasminogen activators and increased expression of plasminogen activator inhibitor type 1 (PAI‐1). Conditioned media (CM) prepared from cultured glomeruli of normal rabbits and rabbits 24 (Day 1) and 96 (Day 4) h after induction of anti‐GBM GN were compared for their effects on the synthesis of fibrinolytic molecules in human endothelial cells (EC). Only CM from Day 4 GN rabbits showed PAI‐1 protein stimulatory activity of up to 148% (P<0.05; n= 3) above that of untreated EC. This was also seen at the mRNA level. Glomerulonephritis Day 4 CM showed significantly higher amounts of tumour necrosis factor (TNF) and thrombin and transforming growth factor‐β (TGF‐β) bioactivity in comparison to glomerular CM from normal rabbits. After high performance liquid chromatography (HPLC) of Day 4 GN CM, PAI‐1 stimulatory activity was found to correlate with the presence of interleukin 1 (IL‐1), TNF and TGF‐β. These results suggest a correlation between severity of anti‐GBM GN in a rabbit model, increased PAI‐1 synthesis and increased expression of TNF and TGF‐β. This may potentiate glomerular fibrin and extracellular matrix deposition in anti‐GBM GN, leading to glomerular crescent formation and eventual renal failure.
Prevalence of hepatitis B and hepatitis C in haemodialysis patients
Authors: SANTOS MARISA G , DANGUILAN Romina A , QUE Ernesto T , BALMACEDA Rene P , PADILLA Benita S
Published: August 2010

SUMMARY: The prevalence of hepatitis B surface antigen (HBsAg), hepatitis B exposure and antibodies against the hepatitis C virus (anti‐HCV) was assessed in 86 haemodialysis patients at the National Kidney and Transplant Institute (NKTI) using the commercial radioimmunoassay and ortho HCV ELISA assay. of the 86 patients included in the study, 42 were male with a mean age of 44.9 years and a mean duration of dialysis of 2.4 years. Forty‐four were female with a mean age of 48.4 years and a mean duration of dialysis of 2.3 years. Hepatitis B exposure was 57% and 12.8% of haemodialysis patients were positive for HBsAg, whereas 39.8% of patients were positive for anti‐HCV. There was a significant correlation (P= 0.00007) between anti‐HCV positivity and the length of time on haemodialysis. However, there was no significant correlation found between the number of blood transfusions received and anti‐HCV positivity. There was also no significant correlation found between HBsAg and antibodies to hepatitis B core antigen (anti‐HBc) positivity and the number of blood transfusions or the length of time on haemodialysis, nor between hepatitis B and C exposure and elevated aminotransferase levels.
Malaysian Dialysis and Transplant Registry Report
Authors: LIM TO , LIM YN , TAN CC , LEE DG , MORAD Zaki
Published: August 2010

SUMMARY: This report summarizes data for dialysis and transplant patients up to the end of 1995. We estimate coverage to be about 30% of dialysis patients and near complete ascertainment of transplant patients. On the 31 December 1995, there were 2224 patients on renal replacement therapy (RRT), comprising 50% on haemodialysis (HD), 12% on continuous ambulatory peritoneal dialysis (CAPD) and 38% with functioning transplants. the prevalence rate for dialysis was 68 per million population (p.m.p.) and that of transplant 42 p.m.p. the new dialysis acceptance rate was 15 p.m.p. and transplant 5 p.m.p. Forty‐seven per cent of new patients had unknown primary renal disease and 30% was due to non‐insulin dependent diabetes mellitus. Mean age of prevalent HD patients was 42 years, CAPD 46 years and 34 years for transplant. Patient survival on CAPD was 85% at 1 year and for HD was 88%. One year transplant patient survival was 94% and graft survival 91%.
Systolic time intervals in haemodialysis patients with normal ejection fraction: an echocardiographic study
Authors: TUKEK Tufan , YILDIZ Alaattin , AKKAYA Vakur , GÖRÇTIN Bilal , SEVER Mehmet S , ATILGAN Dursun , KORKUT Ferruh
Published: August 2010

SUMMARY: In this controlled study, systolic time intervals (STI) and diastolic functions were investigated in haemodialysis patients (HDp) with ejection fraction (EF) within normal limits. Echocardiographic findings in 86 HDp (M:F, 47:39, mean age 36 ± 13 years) and 51 healthy controls (M:F, 22:29, mean age 37±10 years) were compared for STI parameters (projection period (PEP), left ventricular ejection time (LVET) and STI index (PEP/LVET)) and diastolic dysfunction (isovolumetric relaxation time (IVRT) and E/A ratio and deceleration time). the pre‐ejection period (114±21 vs 94±4 msec, P < 0.001) and STI index (0.41 ±0.11 vs 0.34 ±0.02, P < 0.001) were higher in the HDp compared with controls. Increased STI index and prolonged PEP in HDp were independent of left ventricular (LV) hypertrophy and hypertension. Diastolic dysfunction was present in 61% of the patients. the IVRT were also found to be longer in HDp compared with controls (97±16 vs 75±16 msec, P < 0.001), independent of the presence of LV hypertrophy or hypertension. Diastolic dysfunction indicated by IVRT >100 msec and latent systolic dysfunction (STI index >0.4) were randomly distributed, with nearly half (48%) of the patients with prolonged IVRT having an STI index within the normal limits and the other half of the patients with deteriorated STI index having a normal IVRT. the combined systolic and diastolic dysfunction was observed in 30% of the patients. It was concluded that STI indexes deteriorate before an overt systolic dysfunction (normal EF), and that systolic and/or diastolic dysfunction of the myocardium may appear singly or simultaneously because of a common pathogenetic mechanism of myocardial fibrosis.
Primary vesicoureteral reflux mediated renal scarring after urinary tract infection in Thai children
Authors: VACHVANICHSANONG PRAYONG , DISSANEEWATE PORNSAK , THONGMAK SUCHITRA , LIM APIRADEE
Published: August 2010

Aim:  To evaluate the association between primary vesicoureteral reflux (VUR) and renal scarring in children using 99 m Technetium‐labelled dimercaptosuccinic acid (DMSA).

Methods:  Children attending at Songklanagarind Hospital from 1987 to 2002 were evaluated.

Results:  Ages at diagnosis of VUR in 46 boys and 52 girls were 1.1 ± 1.6 and 2.9 ± 2.5 years, median 0.6 and 2.3 years, respectively (P < 0.001). DMSA scans were performed at 4.1 ± 3.6 years. Renal parenchymal damage was detected in 34 kidneys (22%) of 154 demonstrated refluxing ureters, and one kidney (2%) of 42 non‐refluxing ureters (P = 0.002). Of 79 refluxing ureters in boys and 75 refluxing ureters in girls, there were 25 and nine renal scars, respectively (32% and 12%, P = 0.003). Renal scars in VUR grades I–V were 11%, 7%, 12%, 44% and 64%, respectively (P < 0.001). Multivariate analysis revealed that high grade VUR (P < 0.001), age of diagnosis of VUR greater than 5 years (P = 0.001), and male gender (P = 0.002) were the most significant risk factors for renal scarring.

Conclusion:  High‐grade VUR, age of diagnosis of VUR greater than 5 years and male gender were the most significant risk factors for renal scarring.
Structural Power and Public Policy: A Signaling Model of Business Lobbying in Democratic Capitalism
Authors: Bernhagen Patrick , Bräuninger Thomas
Published: August 2010

This paper develops a signaling model of corporate lobbying in democratic capitalist societies to analyze the conditions that lead to a powerful political position of business. Proceeding from the traditional dichotomy of structural economic determinants versus business' political action, our model predicts the conditions under which elected political decisionmakers modify their policy pledges to accommodate business' political preferences, or override business' lobbying messages and honor their pledges. Our results show that the structural power of business over public policy is contingent on two variables: the size of reputation costs of business in relation to its material costs of lobbying; and the ratio of the policymaker's reputation constraints from policy commitments and campaign pledges to the electoral costs arising from adverse effects of policy. We evaluate our model using case studies of business lobbying on environmental and financial services regulation in Britain and Germany.
Understanding Public Support for British Membership of the Single Currency
Authors: Gabel Matthew , Hix Simon
Published: August 2010

There has been much public debate about whether a referendum on British membership of the European single currency could be won despite opinion polls showing a widening gap between those opposed to membership and those in favour. However, academic research provides little insight into why British attitudes towards the Euro vary at an individual level, and hence what factors might be crucial in a referendum campaign. Existing studies suggest, among other things, that British political parties can shape voters' preferences on important public policy issues. We explore this and other explanations using data from recent Eurobarometer and British Elections Study surveys. We find that general evaluations of the EU, British national identity and concerns over the democratic character of EU governance are stronger predictors of support for the single currency than which party a person supports. However, we also find that the influence of these factors varies with a citizen's level of information about the Euro, which suggests that the supply and use of information might be crucial in a referendum campaign.
Monomaniacs or Schizophrenics?: Responsible Governance and the EU's Independent Agencies
Authors: Williams Garrath
Published: August 2010

This paper examines the creation of independent agencies within the EU, such as the European Environment Agency (EEA) and the European Central Bank (ECB). Majone and others have argued the case for European regulatory agencies. Such agencies can provide for continuity, expertise, accountability and effective authority – in short, an institutionalisation of responsibility. Against this optimism, I argue that a dilemma of institutional design naturally arises from the agencies' situation in the EU. On the one side, we risk creating powerful agencies that institutionalise monomania – that is, agencies that single-mindedly and all-too-effectively pursue narrow agendas, inadequately checked by other bodies. On the other, we are also likely to encounter relatively impotent agencies which institutionalise schizophrenia — that is, agencies that must scout around for audience and support, and hence are unable to act effectively.
Crooked Timber or Bent Twig? Isaiah Berlin's Nationalism
Authors: Miller David
Published: August 2010

Isaiah Berlin is often regarded as one of the sources of contemporary liberal nationalism. Yet his own attitude to nationalism, and its relation to his liberalism, remains unexplored. He gave conflicting definitions of nationalism in different places, and although he frequently contrasts more benign with more malign forms of nationalism, the terms in which he draws the contrast also vary. In Berlin's most explicit account, nationalist doctrine is presented as political, unitary, morally unrestricted and particularist, but these four dimensions are separate, and on each of them alternative nationalist positions are available. Berlin's account of the sources of nationalism is also ambiguous: his analysis of the Jewish condition in European societies and his support for Zionism contrasts with his diagnosis of the origins of German nationalism. Comparing Berlin with later liberal nationalists, we see that his liberalism prevented him from presenting a normative political theory in which liberal and nationalist commitments were successfully combined. Such a theory can indeed be developed, but the challenge that emerges from Berlin's writing is to explain how real-world nationalism can be kept within liberal limits.
Gender Ghosts in McGarry and O'Leary and Representations of the Conflict in Northern Ireland
Authors: Zalewski Marysia
Published: August 2010

This article focuses on how ideas about gender function in academic analyses of the conflict in Northern Ireland. Part of the reason for doing this is to explore the paradox afflicting contemporary feminism, namely that in the midst of apparent success feminism still seems largely irrelevant to matters of political significance. A second reason involves a demonstration of the political value of poststructural feminism. To achieve these aims, I first consider the use and political aims of poststructuralist analyses, partly through an analysis of the use of poetry in social scientific analyses. The main site used to demonstrate the functions of gender and the political possibilities of poststructural feminism is John McGarry and Brendan O'Leary's book Explaining Northern Ireland: Broken Images. The sub-title of this book refers to a Robert Graves' poem, ‘In Broken Images’, a poem the authors use to explain their desire to ‘break images’ when explaining the conflict in Northern Ireland. I next reflect on and illustrate how ideas about gender function by focusing primarily on Explaining Northern Ireland: Broken Images. The final section re-considers the paradox of contemporary feminism, suggesting that feminism's own methodologies contribute towards its persistent marginalisation.
Deliberative Democracy and the Politics of Recognition
Authors: McBride Cillian
Published: August 2010

It is commonly supposed that deliberative democracy and the politics of recognition are natural allies, as both demand a more inclusive politics. It is argued here that this impression is misleading and that the politics of recognition harbours significant anti-deliberative tendencies. Deliberative politics requires a public sphere which is maximally inclusive of diverse beliefs and perspectives, including those which dissent from orthodox understandings of group indentities. By contrast, the politics of recognition typically seeks to insulate such identities from challenge, both from within and without. Devices such as special group representation, while apparently inclusive, risk incentivising an anti-deliberative culture of deference to identity claims. An alternative model of inclusive politics, which involves a more contestatory political culture and a multiplication of deliberative opportunities, is sketched.
Incivility: The Politics of ‘People on the Margins’ in Jamaica
Authors: Johnson Hume N.
Published: August 2010

This paper employs and scrutinizes Asef Bayat's theory of [the] ‘quiet encroachment’ of the ‘informal people’ in the Middle East to reflect on civility and governance in Jamaica. The central argument is that while the practices of the economically dispossessed represent rational ways to survive hardships and improve their lives, the alliance of members of Jamaica's informal sphere with ‘community dons’ flies in the face of civility and civic engagement, engendering destructive, criminal behaviour, which undermines the state's capacity to regulate the space and uphold the rule of law. The essay recognises the validity of the episodic mobilization of ‘people on the margins’ in Jamaica as a useful, autonomous aspect of civil society, without romanticising it or abstracting it from its counterpoint to the state. It however maintains that such a collectivity, operating vicariously, exerts a burden on social stability and cohesion with dire consequences for democratic governance.
A Reconceptualisation of the Antecedents of Party Activism: A Multidisciplinary Approach
Authors: Granik Sue
Published: August 2010

Leading researchers are questioning the continued use of competitive model testing to explain participation within British political parties. This paper argues that difficulties with this approach have not arisen out of the use of model testing per se, but because of the shortcomings of the models currently in use. A multidisciplinary approach towards accounting for participation exposes some of the theoretical and analytical shortcomings in previous research into political party members, and identifies relevant factors underlying participation that merit investigation in greater detail. In particular, analytical frameworks derived from the disciplines of marketing, nonprofit management and organisational behaviour provide appropriate and robust instruments for measuring factors underlying participation that are generally ignored in the political science literature. Alternative models comprising appropriately theorized variables drawn from a number of disciplines are presented, and the implications of a multidisciplinary approach towards explaining party activism are discussed.
Magnification characteristics of the Optical Coherence Tomograph STRATUS OCT 3000
Authors: Sanchez‐Cano Ana , Baraibar Begoña , Pablo Luis E. , Honrubia Francisco M.
Published: August 2010

Purpose:  To evaluate the magnification characteristics of an Optical Coherence Tomograph (STRATUS OCT 3000) used to measure optic disc size.

Methods:  An eye model was designed, built and used to measure changes in the magnification of the Optical Coherence Tomograph (OCT) with variation in the axial length of the eye and OCT correction lenses. Theoretical calculations using ray‐tracing were used to compare the experimental and theoretical results.

Results:  OCT‐performed fundus measurements have a magnification that depends on two factors: eye axial length and optical correction with the focusing dial of the OCT. Theoretical calculations showed that the size of the optic disc image for greater axial lengths of the eye model (myopic eye) was less than that for smaller axial lengths (hyperopic eye). The disc diameter measurements of the image obtained with the OCT did not agree with the real disc size. By focussing with the focusing dial of the OCT, the power of the optics can be varied from −12.0 D to +12.0 D and the image size is decreased for all axial lengths. The maximum variation of the disc area was 2.1%. Differences in area measured at intervals of 2.0 D after correcting the eye refraction for measurements with the OCT were equivalent to the repeatability error at that point.

Conclusions:  Our results confirm that any variation in the optical system of the eye, in the OCT, and/or in the distance between them, induces a change in the magnification of the tomograph images. These variations will affect the measurements of any of the structures in the retinal plane.
Accommodation in emmetropic and myopic young adults wearing bifocal soft contact lenses
Authors: Tarrant Janice , Severson Holly , Wildsoet Christine F.
Published: August 2010

Purpose:  To assess the effect of bifocal soft contact lenses on the accommodative errors (lags) of young adults. Recent studies suggest that bifocal soft contact lenses are an effective myopia control treatment although the underlying mechanism is not understood.

Methods:  Accommodation responses were measured for four target distances: 100, 50, 33 and 25 cm in 35 young adult subjects (10 emmetropes and 25 myopes; mean age, 22.8 ± 2.5 years). Measurements were made under both monocular and binocular conditions with three types of lenses: single vision distance soft contact lenses (SVD), single vision near soft contact lenses (SVN; +1.50 D added to the distance prescription) and bifocal soft contact lenses (BF; +1.50 D add).

Results:  For the SVD lenses, all subjects exhibited lags of accommodation, with myopes accommodating significantly less than emmetropes for the 100 and 50 cm target distances (p < 0.05). With the SVN lenses, there was no significant difference in accommodative responses between emmetropes and myopes. With the BF lenses, both emmetropic and myopic groups exhibited leads in accommodation for all target distances, with emmetropes showing significantly greater leads for all distances (p < 0.005).

Conclusions:  Overall, myopes tended to accommodate less than emmetropes, irrespective of the contact lens type, which significantly affected accommodation for both groups. The apparent over‐accommodation of myopes when wearing the BF contact lenses may explain the reported efficacy as a myopia control treatment, although further studies are required to elucidate the mechanism underlying this accommodative effect.
Accommodation‐ presbyopia: mechanism etiology
Authors: Schachar Ronald A.
Published: August 2010

The purpose of the presentation is to elucidate the mechanism of accommodation and etiology of the age‐related decline in accommodative amplitude that results in presbyopia in the fifth decade of life. Multiple physical, mathematical, clinical, in vitro, and in vivo experiments demonstrate that the human crystalline lens develops an unusual shape during accommodation. Central lens thickness increases; the curvatures of the central surfaces of the lens steepen; while the peripheral surfaces of the lens flatten. This ‘steep profile’ also occurs in other biconvex objects that have an aspect ratio ≤ 0.6 (minor axis to major axis ratio) in response to a small equatorial displacement when the volume of the object only minimally changes. The ‘steep profile’ even occurs when the major axis of an ellipse with an aspect ratio ≤ 0.6 is increased and the area enclosed by the ellipse is held constant or permitted to decrease by 2%. The universality of the occurrence of a ‘steep profile’ implies that the lens is under increased tension during accommodation. This hypothesis was confirmed by using high‐resolution anterior segment optical coherence tomography (OCT) to measure the change of stress on the anterior lens capsule in patients who had undergone a phakic refractive intraocular lens (PRL) at least 1 year prior to the study. The PRL served as an internal control. It was found that during a mean of 8‐diopters of in vivo accommodation, the stress on the lens was increased during accommodation, p < 0.001. The increased stress on the lens capsule during accommodation occurs as a consequence of increased equatorial zonular tension. Normal equatorial lens growth predicts both the age‐related decline in accommodative amplitude and the age‐related increase in intraocular pressure (IOP). The rapid decline in accommodative amplitude and rapid increase in IOP that occur during childhood and their slower changes thereafter, both match the logarithmic pattern of equatorial lens growth, R2 = 0.90. In summary, the lens is under increased stress during accommodation as a consequence of increased equatorial zonular tension. Normal equatorial lens growth is the etiology of both the age‐related decline in accommodative amplitude that results in presbyopia in the fifth decade of life and the increase in IOP that occurs with age.
Just how useless is an amblyopic eye?
Authors: Panesar Eve , Pacey Ian , Barrett Brendan
Published: August 2010

Purpose:  The extent to which individuals with amblyopia are visually disadvantaged has generated renewed research interest. Investigation of the contribution of the amblyopic eye to visual performance under habitual conditions is a key component of this issue. This study aims to evaluate the contribution of each eye to a simple light detection task when both eyes are open and in their habitual motor position.

Methods:  A custom program on the Humphrey Field Analyzer (Carl Zeiss Meditec Inc., Dublin, CA, USA) was used to measure detection thresholds for a blue light on a yellow background along the horizontal meridian at two degree intervals to an eccentricity of 25 degrees either side of fixation. Three viewing conditions were used: (1) both eyes open, (2) a yellow filter in front of the amblyopic eye and (3) a yellow filter in front of the fellow eye. The purpose of the yellow filter was to produce minimal dissociation as it only prevented the eye behind the filter from seeing the blue stimulus; the fixation mark and the background remained visible to both eyes. Participants included 10 visual normals and 16 volunteers with amblyopia.

Results:  Within the sample of amblyopes there were three basic patterns of results, and each applied to around one third of the group: (1) habitual sensitivity governed by the sensitivity of the fellow eye at each stimulus location, (2) habitual sensitivity exceeding the sensitivities of either eye at each stimulus location and (3) a pattern of contribution that varied across the range of eccentricities. Surprisingly, in one amblyope the habitual sensitivity appeared to be governed by the sensitivity of the amblyopic eye. The pattern of contribution of each eye to the habitual sensitivity did not vary in a manner that was predictable by the visual acuity deficit or the presumed aetiology of the amblyopia. The control sample showed either pattern 2 (70%) or pattern 3 (30%).

Conclusions:  The amblyopic eye did not contribute to the habitual performance in approximately one‐third of cases in this simple detection task. Thus, in many cases the amblyopic eye may be a useful contributor to visual performance in the binocular field. This challenges the traditional view that an amblyopic eye is useful only for peripheral vision.