bluuebunny/crossref_metadata_2025 huggingface dataset:
B‐1 cells are pivotal for in vivo inflammatory giant cell formation
Authors: Bogsan Cristina Stewart Bittencourt , Brito Ronni Rômulo Novaes e , Palos Maiko da Cruz , Mortara Renato Arruda , Almeida Sandro Rogério , Lopes José Daniel , Mariano Mario
Published: July 2005

The mechanisms that govern giant cell (GC) formation in inflammatory, neoplastic and physiologic conditions are far from being understood. Here, we demonstrate that B‐1 cells are essential for foreign‐body GC formation in the mouse. GCs were analysed on the surface of glass cover slips implanted into the subcutaneous tissue of the animals. It was demonstrated that GCs are almost absent on cover slips implanted into the subcutaneous tissue of BALB/c or CBA/N X‐linked immunodeficient mice. As these animals do not have B‐1 cells in the peritoneal cavity, they were reconstituted with B‐1 cells obtained from cultures of adherent mouse peritoneal cells. Results showed that in B‐1‐reconstituted animals, the number of GCs on the implant surface surpassed the values obtained with preparations from wild animals. In animals selectively irradiated (pleural and peritoneal cavities) to deplete these cavities of B‐1 cells, GCs were also not formed. Enriched suspensions of B‐1 cells grown in culture were labelled with [3H]‐tymidine and injected into the peritoneal cavity of naive mice before implantation of glass cover slips. After 4 days, about 17% of mononuclear cells had their nuclei labelled, and almost 70% of GCs had one or more of their nuclei labelled when analysed by histoautoradiographic technique. A few GCs expressed an immunoglobulin M when analysed by immunostaining and confocal microscopy. Overall, these data demonstrate that B‐1 cells are pivotal in the mechanisms of foreign‐body GC formation in the mouse.
Strategic Supply Management and Dyadic Quality Performance: A Path Analytical Model
Authors: Paulraj Antony , Chen Injazz J.
Published: July 2005

A number of studies have addressed the critical role of strategic purchasing and its impact on buyer–supplier relationships. Most studies, however, treat buyer–supplier relationships as a single construct. Recognizing that buyer–supplier relationships are a much more complex phenomenon, this study first identifies three critical constructs including supply base reduction, communication and long‐term relationships for a broader conceptualization of buyer–supplier relationships. It then explores the effects of strategic purchasing on these three constructs, along with their impacts on dyadic quality performance. The proposed path analytical model was tested using structural equation modeling. Results provide robust support for the notion that strategic supply management improves the quality performance of both supplier and buyer firms.
Supply Management Strategies for the Future: A Delphi Study
Authors: Ogden Jeffrey A. , Petersen Kenneth J. , Carter Joseph R. , Monczka Robert M.
Published: July 2005

As supply management becomes more involved in strategic decisions, an understanding of the various strategies that it can employ is crucial. This research uses a multiround Delphi study of key procurement and supply management executives to better understand which procurement and supply management strategies may lead to significant improvements over the next 5–10 years. The results indicate that strategies such as increased integration, information sharing and collaboration among supply chain members are most likely to be implemented and will have the largest impact on organizations. However, this integration will not include joint investment or asset sharing, will be limited to one tier in the supply chain, and will not heavily involve e‐markets and electronic auctions.
CREM activator and repressor isoform expression in human male germ cells
Authors: BLÖCHER SONJA , FINK LUDGER , BOHLE RAINER M. , BERGMANN MARTIN , STEGER KLAUS
Published: July 2005

The transcription factor cAMP‐responsive element modulator (CREM) is known to play a vital role for male fertility as it has been demonstrated that male mice lacking a functional CREM gene are infertile. The CREM gene consists of 14 exons. Owing to alternative exon splicing, CREM gene expression results in the production of functionally different CREM proteins with either activating or repressing potential on target gene expression. Infertile men have been reported to reveal a substantial reduction of CREM activators and additional inaccurately spliced CREM transcripts. In the present study, we analysed the expression of CREM transcripts with the recently reported leader exons θ1 and θ2 and identified a new putative CREM repressor, namely θ1‐F‐H, in patients with impaired spermatogenesis. In addition, we applied single cell microdissection followed by RT‐PCR with leader exons B, θ1 and θ2 to assign the expressed CREM activator and repressor isoforms to specific germ cell types within the seminiferous epithelium. Contrary to dogma, we demonstrated CREM activator and repressor isoforms in all germ cell types, but not in Sertoli cells. However, the percentage of germ cell samples that revealed positive RT‐PCR signals for these CREM activators was higher in spermatocytes and round spermatids than in spermatogonia and elongated spermatids. It remains unknown whether these activator transcripts are physiologically active. Our data suggest a fine‐tuning between CREM activator and repressor isoforms in normal germ cells that might be disturbed during impaired spermatogenesis.
Altered melatonin secretion in hypogonadal men: clinical evidence
Authors: KUMANOV PHILIP , TOMOVA ANALIA , ISIDORI ALDO , NORDIO MAURIZIO
Published: July 2005

The pineal gland, through the rhythmic production of melatonin, seems to play an important role in the control of the reproductive function of many vertebrate species. In contrast, the effects of the pineal gland in humans and the relationship between gonadotropins and melatonin secretion are not yet clarified. On the basis of these considerations, the aim of the present study was to clarify whether melatonin serum concentrations were altered in males with different hypothalamo‐pituitary–gonadal disturbances, in comparison to normal individuals.

We have studied 36 individuals divided into three groups according to their gonadotropin status: normals, hypogonadotropic hypogonadism and hypergonadotropic hypogonadism. They were submitted to blood sample withdrawal at 03.00, 11.00 and 19.00 h for melatonin determination according to a radioimmunological method, without extraction of the sample.

The results obtained in the present study suggest the existence of an interaction between the pituitary and the pineal gland. In fact, in the case of hypersecretion of gonadotropins, nocturnal melatonin release is reduced, while night melatonin secretion is increased in the opposite situation (hypogonadotropic hypogonadism). Both these endocrine pathologies are characterized by a reduced sexual steroid secretion; for that reason, this reduction cannot be regarded as responsible for the two opposite dysfunctions of melatonin release.

In conclusion, our study shows that darkness‐dependent release of melatonin in males with hypogonadotropic hypogonadism is significantly higher in comparison with the healthy men, while it is significantly reduced in patients with hypergonadotropic hypogonadism. A strong significant negative correlation is also found between gonadotropins and melatonin release.
The cryptorchidism prevalence among infants in the general population of Rotterdam, the Netherlands
Authors: PIERIK FRANK H. , BURDORF ALEX , KEIZER‐SCHRAMA SABINE M. P. F. DE MUINCK , WOLFFENBUTTEL KATJA P. , RIEN NIJMAN J. M. , JUTTMANN RIKARD E. , WEBER ROBERTUS F. A.
Published: July 2005

Published trends and geographical differences in cryptorchidism rates are almost exclusively derived from hospital‐based birth defect registers, which are sensitive to selection bias and incomplete reporting. This study aimed to accurately assess the cryptorchidism prevalence in the general population of Rotterdam. Of 7652 consecutive male live births, 7292 (95%) were examined for cryptorchidism at Child Healthcare Centres around the age of 1 month. In a subgroup of cases, the persistence of cryptorchidism was re‐assessed during a follow‐up examination by expert specialists. The cryptorchidism rate at the median age of 35 days was 1.2% (89/7292). In the re‐examined subgroup (median age 95 days) 69% of the boys (24/35) had persistent cryptorchidism, of which 20 were unilateral and four bilateral. The population rate of 1.2% falls within the range of 0.9–9% reported by others. Differences in case ascertainment and population characteristics probably explain part of the differences between studies. Our cross‐sectional design does not allow for analysis of a temporal trend, but provides a baseline for future trend studies. To study cryptorchidism rates, trends, and risk factors, a systematic case ascertainment is warranted.
Human mtDNA haplogroups and reduced male fertility: real association or hidden population substructuring
Authors: PEREIRA LUÍSA , GONÇALVES JOÃO , GOIOS ANA , ROCHA TIAGO , AMORIM ANTÓNIO
Published: July 2005

A mitochondrial DNA (mtDNA) haplogroup association study carried out in 101 southern Portuguese males with oligozoospermia showed to be negative when comparing with a geographically matching control sample. Misleading positive association signs were however obtained when using other control samples from the same country. This shows that mtDNA population substructure can also introduce spurious signs in haplogroup association studies, as previously reported for Y‐chromosome. However, our data do not exclude the probability that a particular mtDNA mutation contributes significantly to the reduction of sperm production, but indeed precludes the hypothesis of a significant association between such a mutation and specific haplogroup.
Biochemical Characterisation and Immunohistochemical Localisation of the Secretogranin II‐Derived Peptide EM66 in the Hypothalamus of the Jerboa (Jaculus orientalis): Modulation by Food Deprivation
Authors: Boutahricht M. , Guillemot J. , Montero‐Hadjadje M. , Bellafqih S. , El Ouezzani S. , Alaoui A. , Yon L. , Vaudry H. , Anouar Y. , Magoul R.
Published: July 2005

The neuroendocrine protein secretogranin II is the precursor of several neuropeptides, including secretoneurin and a novel 66‐amino acid peptide, EM66, the sequence of which has been highly conserved across the vertebrae phylum. The presence of EM66 has been detected in the adult and fetal human adrenal gland, as well as the rat pituitary and adrenal glands. The present study aimed to explore a possible neuroendocrine role of EM66 by analysing its occurrence and distribution within the jerboa hypothalamus, and its potential implication in the control of feeding behaviour. High‐performance liquid chromatography analysis of jerboa hypothalamic extracts combined with a radioimmunoassay of EM66 revealed a single peak of immunoreactive material exhibiting the same retention time as recombinant EM66. Immunocytochemical labelling showed that EM66‐producing neurones are widely distributed in several hypothalamic regions, including the preoptic area, the suprachiasmatic, supraoptic, parvocellular paraventricular and arcuate nuclei, and the lateral hypothalamus. Food deprivation for 5 days induced a significant increase in the number of EM66‐containing neurones within the arcuate nucleus (105% increase) and the parvocellular aspect of the paraventricular nucleus (115% increase), suggesting that EM66 could be involved in the control of feeding behaviour and/or the response to stress associated with fasting. Altogether, these data reveal the physiological plasticity of the EM66 system in the hypothalamus and implicate this novel peptide in the regulation of neuroendocrine functions.
Arcuate Nucleus Transcriptome Profiling Identifies Ankyrin Repeat and Suppressor of Cytokine Signalling Box‐Containing Protein 4 as a Gene Regulated by Fasting in Central Nervous System Feeding Circuits
Authors: Li J.‐Y. , Kuick R. , Thompson R. C. , Misek D. E. , Lai Y.‐M. , Liu Y.‐Q. , Chai B.‐X. , Hanash S. M. , Gantz I.
Published: July 2005

The arcuate nucleus of the hypothalamus is a primary site for sensing blood borne nutrients and hormonal messengers that reflect caloric status. To identify novel energy homeostatic genes, we examined RNA extracts from the microdissected arcuate nucleus of fed and 48‐h fasted rats using oligonucleotide microarrays. The relative abundance of 118 mRNA transcripts was increased and 203 mRNA transcripts was decreased during fasting. One of the down‐regulated mRNAs was ankyrin‐repeat and suppressor of cytokine signalling box‐containing protein 4 (Asb‐4). The predicted structure of Asb‐4 protein suggested that it might encode an intracellular regulatory protein, and therefore its mRNA expression was investigated further. Reverse transcription quantitative polymerase chain reaction was used to validate down‐regulation of Asb‐4 mRNA in the arcuate nucleus of the fasted Sprague‐Dawley rat (relative expression of Asb‐4 mRNA: fed = 4.66 ± 0.26; fasted = 3.96 ± 0.23; n = 4, P < 0.01). Down‐regulation was also demonstrated in the obese fa/fa Zucker rat, another model of energy disequilibrium (relative expression of Asb‐4 mRNA: lean Zucker = 3.91 ± 0.32; fa/fa = 2.93 ± 0.26; n = 5, P < 0.001). In situ hybridisation shows that Asb‐4 mRNA is expressed in brain areas linked to energy homeostasis, including the arcuate nucleus, paraventricular nucleus, dorsomedial nucleus, lateral hypothalamus and posterodorsal medial amygdaloid area. Double in situ hybridisation revealed that Asb‐4 mRNA colocalises with key energy homeostatic neurones. In the fed state, Asb‐4 mRNA is expressed by 95.6% of pro‐opiomelanocortin (POMC) neurones and 46.4% of neuropeptide Y (NPY) neurones. By contrast, in the fasted state, the percentage of POMC neurones expressing Asb‐4 mRNA drops to 73.2% (P < 0.001). Moreover, the density of Asb‐4 mRNA per fasted POMC neurone is markedly decreased. Conversely, expression of Asb‐4 mRNA by NPY neurones in the fasted state is modestly increased to 52.7% (P < 0.05). Based on its differential expression, neuroanatomical distribution and colocalisation, we hypothesise that Asb‐4 is a gene involved in energy homeostasis.
Distribution analyses of Meloidogyne spp. and Pratylenchus coffeae sensu lato in coffee plots in Costa Rica and Guatemala
Authors: Herve G. , Bertrand B. , Villain L. , Licardie D. , Cilas C.
Published: July 2005

The distribution of the plant‐parasitic nematodes Pratylenchus coffeae sensu lato and Meloidogyne spp. were studied in two plots, one in Guatemala (P. coffeae and M. paranaensis) and the other in Costa Rica (P. coffeae and M. exigua). The quantity of nematodes per g fresh weight root were counted for each coffee tree sampled. The distributions were aggregated, and generally fitted well to negative binomial distributions. Population aggregation was greater when a smaller number of nematodes were involved, suggesting that initial colonization develops in foci. Analyses of the relationships between population levels of the species suggested that there was competition between Pratylenchus coffeae and Meloidogyne spp. This competition was expressed differently depending on the relative population density of the different species.
Systemic Potato virus YNTN infection and levels of salicylic and gentisic acids in different potato genotypes
Authors: Krečič‐Stres H. , Vučak C. , Ravnikar M. , Kovač M.
Published: July 2005

Endogenous levels of free and conjugated salicylic (SA) and gentisic (GA) acids, both putative signal molecules in plant defence, were analysed in order to investigate their involvement in the resistance of four potato (Solanum tuberosum) genotypes with different susceptibilities to Potato virus YNTN (PVYNTN) infection: the highly susceptible cv. Igor and its extremely resistant transgenic line, the extremely resistant cv. Sante and the tolerant cv. Pentland Squire. The lowest levels of free and conjugated SA were observed in the extremely resistant cv. Sante, while free GA, which was detected in all the other varieties, was absent. The extremely resistant transgenic cv. Igor contained the highest basal total SA level and the lowest level of total GA of all four cultivars. In susceptible cv. Igor, but not in resistant transgenic cv. Igor, a systemic increase of free SA was measured 1 day postinfection (dpi). Even more significant increases of free and conjugated SA and GA were detected 11 dpi when systemic symptoms appeared. In inoculated but not in upper noninoculated leaves of resistant transgenic cv. Igor, significant increase of SA conjugates occurred, but not before 11 dpi. The increase of SA and GA in susceptible cv. Igor could contribute to the general elevated levels of phenolic compounds as a response to stress caused by virus infection. It appears that basal levels of SA and GA do not correlate with resistance to PVYNTN in potato plants.
Evaluation of cacao (Theobroma cacao) clones against seven Colombian isolates of Moniliophthora roreri from four pathogen genetic groups
Authors: Phillips‐Mora W. , Castillo J. , Krauss U. , Rodríguez E. , Wilkinson M. J.
Published: July 2005

Artificial pod inoculation was used to compare the relative aggressiveness of seven Colombian isolates of Moniliophthora roreri (the causal agent of moniliasis or frosty pod disease), representing four major genetic groupings of the pathogen in cacao (cocoa), when applied to five diverse cacao genotypes (ICS‐1, ICS‐95, TSH‐565, SCC‐61 and CAP‐34) at La Suiza Experimental Farm, Santander Department, Colombia. The following variables were evaluated 9 weeks after inoculation of 2‐ to 3‐month‐old pods with spore suspensions (1·2 × 105 spores mL−1): (i) disease incidence (DI); (ii) external severity (ES); and (iii) internal severity (IS). IS was found to be of greatest value in classifying the reaction of the host genotype against M. roreri. Genetic variation reported between isolates and cacao genotypes was not matched by similar diversity in their aggressiveness. All isolates were generally highly aggressive against most cacao genotypes, with only two isolates showing reduced IS and ES reactions. There was considerable variation between clones in the IS and ES scores, but one cultivated clone (ICS‐95) displayed a significant level of resistance against all seven isolates. This clone may be useful in cacao breeding initiatives for resistance to moniliasis of cacao.
Genetic diversity and mixed infections of begomoviruses infecting tomato, pepper and cucurbit crops in Nicaragua
Authors: Ala‐Poikela M. , Svensson E. , Rojas A. , Horko T. , Paulin L. , Valkonen J. P. T. , Kvarnheden A.
Published: July 2005

Begomoviruses were detected in Nicaraguan fields of tomato (Lycopersicon esculentum) and adjacently growing plants of pepper (Capsicum annuum), chilli pepper (C. baccatum), cushaw (Cucurbita argyrosperma) and Mexican fireplant (Euphorbia heterophylla) using polymerase chain reaction (PCR) and universal begomovirus primers. All tomato and Mexican fireplant plants showing symptoms were infected with begomoviruses, while only 30–46% of the pepper, chilli pepper and cushaw plants showing symptoms tested virus‐positive. No begomoviruses were found in potato. The virus species were provisionally identified by sequencing 533 bp of the viral coat protein gene (AV1). Tomato severe leaf curl virus (ToSLCV), Tomato leaf curl Sinaloa virus (ToLCSinV) and Pepper golden mosaic virus (PepGMV) were found to infect both tomato and pepper. A new provisional species designated Tomato leaf curl Las Playitas virus (ToLCLPV) was detected in a tomato plant. Squash yellow mottle virus (SYMoV) and PepGMV were found in cucurbits, the latter for the first time in this host. Euphorbia mosaic virus (EuMV) was detected in Mexican fireplant. Sequencing of a larger number of PCR‐amplified clones from selected plants revealed intraspecific viral sequence variability, and also multiple begomovirus infections which could represent up to three species in a single tomato or cushaw plant. Phylogenetic grouping of virus sequences did not correlate with the host of origin.
Relationships between health of Quercus robur, occurrence of Phytophthora species and site conditions in southern Sweden
Authors: Jönsson U. , Jung T. , Sonesson K. , Rosengren U.
Published: July 2005

The effect of Phytophthora species, soil chemistry, precipitation and temperature on the vitality of oak was evaluated in 32 oak stands in southern Sweden. In addition, the relationship between the occurrence of Phytophthora species and soil conditions was determined. The results showed that there was a weak association between the presence of P. quercina, the most frequently recovered Phytophthora species in southern Sweden, and the vitality of the oak stands (determined from estimates of crown defoliation of individual trees). The pathogens occurred more frequently in clayey and loamy soils that were less acidic and which had higher base saturation. However, they were found in all but the most acidic soils (pH < 3·5). In stands where Phytophthora species were not present, positive correlations between the average crown defoliation and proportion of damaged trees with average summer precipitation and average annual precipitation were found. There were no significant differences in soil chemistry between healthy and declining stands included in this study, and no significant correlations were found between any soil parameter and crown vitality. Based on the results from these 32 oak stands, it is likely that the decline of oaks in southern Sweden can be attributed to several different site‐specific factors, such as infection by P. quercina or unusual weather events, which interact with a number of biotic and abiotic factors, leading to oak decline.
Explaining variation in the effects of take‐all (Gaeumannomyces graminis var. tritici) on nitrogen and water uptake by winter wheat
Authors: Pillinger C. , Paveley N. , Foulkes M. J. , Spink J.
Published: July 2005

Two field experiments, in 1999 and 2000, were used to test whether reductions in root growth and function explained the effects of take‐all on crop water and nitrogen uptake. The fungicide silthiofam was used to manipulate take‐all independently of other factors. Soil water content was manipulated from heading to determine effects on disease progress and resource capture. Epidemic progress was significantly delayed in the presence of silthiofam, leading to reductions in disease in both experiments. Effects of silthiofam were reduced by increasing soil water late in the season, although only in 2000 did increased soil water content have a direct effect, leading to a higher rate of disease increase. Higher levels of disease in the absence of silthiofam did not affect root growth as measured by total root length density (TRLD), but did lead to significantly reduced healthy root length density (HRLD, a measure of functional roots) in both experiments. Only in 2000 were there any significant effects of increased take‐all on water and nitrogen uptake. This was attributed to the higher TRLD in the (1999) crop, which allowed HRLDs to be maintained above a critical threshold (where water and nitrogen uptake start to be severely affected) despite loss of functional root to disease. The effects of take‐all on nitrogen uptake were more likely to affect crop canopy size and duration than the relatively small effects observed on water uptake. Increasing soil water content allowed the crop to take up more water in absolute terms despite, in 2000, increasing levels of disease and reducing HRLD.
Hypersensitive‐like reaction conferred by the Mex‐1 resistance gene against Meloidogyne exigua in coffee
Authors: Anthony F. , Topart P. , Martinez A. , Silva M. , Nicole M.
Published: July 2005

The response of a susceptible coffee cultivar (Caturra) to infection by the root‐knot nematode Meloidogyne exigua was compared histologically with that of cv. Iapar 59 possessing the recently identified Mex‐1 resistance gene. The reproductive behaviour of the nematode was also compared in the two cultivars. Penetration and development in resistant plants were reduced in comparison with susceptible plants. Several cell features, including dark‐stained cytoplasm and altered organelle structure, were observed in the resistant cultivar, indicating a hypersensitive‐like (HR) response of the infested host cells. Features of giant cells were sometimes found beside necrotic‐like areas, but the corresponding feeding sites were frequently associated with nematodes displaying abnormal shape. Six weeks after inoculation, root systems of cv. Caturra contained significantly more nematodes than those of cv. Iapar 59 (mean values 1574 and 41, respectively). The susceptible cultivar presented a minimum of 11 galls per plant, compared with only one or two galls per plant in the resistant cultivar. The findings are discussed in the context of plant–pathogen interactions.
Factorial design provides evidence to guide practice of anaesthesia
Authors: Korttila K. , Apfel C. C.
Published: July 2005

Many scientific articles are written merely to get something published, neglecting the clinician who would like the medical literature to guide their practice. Evidence‐based medicine is expected to help in clinical decision‐making. Systematic reviews of the literature followed by a meta‐analysis of randomized, controlled trials (RCT) have claimed to represent the highest strength of evidence. However, the results published in meta‐analyses have not always been confirmed in subsequent large RCTs. An analysis of 12 large RCTs and 19 meta‐analyses addressing the same questions found that the outcomes of these large RCTs were not predicted accurately 35% of the time by previously published meta‐analyses. Therefore, meta‐analyses of several small RCTs do not obviate the need for large, multicentre RCTs, which can still be considered as a gold standard for the development of clinical guidelines or practice plans. Moreover, large RCTs using a factorial design can be highly efficient because they can answer several clinical questions at the same time and offer the only systematic approach to investigate an interaction of combinations in multimodal approaches.
Helicopter transport of sick neonates: a 14‐year population‐based study
Authors: Berge S. D. , Berg‐Utby C. , Skogvoll E.
Published: July 2005

Background:  The Norwegian Helicopter Emergency Medical Service (HEMS) employs anesthesiologists and paramedics who are not formally trained in neonatology to provide stabilization and transport of sick neonates. We describe neonatal transport by HEMS in central Norway and report the outcome.

Methods:  Retrospective analysis of HEMS missions during the 14‐year period 1988–2001.

Results:  A total of 252 neonates were transported, indicating a prevalence of 0.90 per 100 newborn. Median response time was 42 min, on‐scene stabilization time 38 min and transportation time 30 min. Median gestational age (GA) was 38 weeks and 4.8% of the neonates were <1000 g and/or <28 weeks. Main clinical problems were respiratory disease, asphyxia and malformations; 30 neonates (12%) died within 1 year. No deaths were transport‐related. Tube or ventilator problems were noted in seven out of 66 transports of ventilated neonates. Other technical problems were few. Regarding ventilation, oxygenation and circulation, the clinical condition of most neonates improved during transport and the median temperature rose from 36.5°C to 37.0°C. Hypoglycemia (<2 mmol l−1) was documented in 19 missions after transport; of these, eight received a glucose infusion. Four neonates might have profited from HEMS‐delivered surfactant therapy.

Discussion:  Helicopter Emergency Medical Service in central Norway provides rapid medical assistance in a wide spectrum of neonatal problems, but more attention should be paid to proper ventilation and prevention of hypothermia and hypoglycemia.
Renal effects of hypotensive anaesthesia in combination with acute normovolaemic haemodilution with hydroxyethyl starch 130/0.4 or isotonic saline
Authors: Fenger‐Eriksen C. , Hartig Rasmussen C. , Kappel Jensen T. , Anker‐Møller E. , Heslop J. , Frøkiær J. , Tønnesen E.
Published: July 2005

Background:  Hypotensive anaesthesia (HA) and acute normovolaemic haemodilution (ANH) are used separately to decrease per‐operative blood loss. Reducing blood viscosity by adding ANH to HA may appear profitable in a situation with lowered perfusion pressure and concern about organ ischemia. The aim of this study was to clarify the influence of HA in combination with ANH using crystalloid or colloid as replacement fluid on renal function.

Methods:  Hypotensive anaesthesia was induced in 11 patients referred to major spine surgery using sevoflurane in combination with fentanyl/remifentanil. Acute normovolaemic haemodilution was carried out by drawing venous blood into standard blood bags and replacing it by isotonic saline 0.9% (Group S) or HES 130/0.4 (Group V). Renal function was evaluated before, during and up to 8 h after hypotension as the glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) by means of 51Cr‐EDTA and 125I‐Hippuran clearances.

Results:  Lowering mean arterial blood pressure decreased GFR and ERPF in both groups. During hypotension ERPF was lower in Group S (n = 5) than Group V (n = 6). Renal function was normalized postoperatively. We found a positive but non‐significant correlation between the relative GFR change and the duration of hypotension.

Conclusion:  In conclusion, our study demonstrated that renal function, assessed by GFR and ERPF, is transiently reduced during the combination of hypotensive anaesthesia and acute normovolaemic haemodilution. A colloid‐based fluid regime (HES 130/0.4) used for haemodilution may preserve renal function to a greater extent than a crystalloid‐based regime (0.9% saline).
Fluid shift is moderate and short‐lived during acute crystalloid hemodilution and normothermic cardiopulmonary bypass in piglets
Authors: Farstad M. , Haugen O. , Rynning S. E. , Onarheim H. , Husby P.
Published: July 2005

Background:  Crystalloids are commonly used as priming solutions during cardiopulmonary bypass (CPB). Consequently, hemodilution is a regular occurrence at the start of a CPB. This study describes the time‐course variations of hemodynamic parameters, plasma volume (PV) and fluid exchange following crystalloid hemodilution at start of normothermic CPB.

Methods:  Forty‐five anesthetized piglets were given 60‐min normothermic CPB. Ringer's solution was used as priming solution and maintenance fluid. Fluid input/losses, PV, colloid osmotic pressures (plasma/interstitium), hematocrit, and s‐proteins were measured, and fluid extravasation rates (FER) and intravascular protein‐masses calculated.

Results:  Start of CPB resulted in a 25–30% hemodilution. To keep the fluid level of the CPB‐reservoir constant after start of bypass, fluid addition [2.08 ± 0.36 (mean ± SEM) ml kg−1 min−1] was necessary during the first 5 min. Thereafter the fluid needs to be leveled off [0.17 ± 0.03 ml kg−1 min−1 (10–60 min), P < 0.001]. Fluid extravasation rate increased immediately following hemodilution from a baseline value of 0.08 ± 0.01 to 1.75 ± 0.34 ml kg−1 min−1 with a delayed decrease compared to fluid additions, to reach a ‘steady‐state’ level of 0.22 ± 0.03 ml kg−1 min−1 after 30 min (P < 0.001). Differences in time‐course variations between fluid added and fluid extravasated were accompanied by changes in PV and mean arterial pressure. The colloid osmotic gradient decreased about 50% throughout the study and could partly explain the increased FER.

Conclusion:  Acute crystalloid hemodilution contributes to fluid overload during normothermic CPB. The resulting increase in fluid extravasation is, however, moderate, short‐lived and levels off to baseline values within 30 min.
Inflammatory response during hyperglycemia and hyperinsulinemia in a porcine endotoxemic model: the contribution of essential organs
Authors: Brix‐Christensen V. , Gjedsted J. , Andersen S. K. , Vestergaard C. , Nielsen J. , Rix T. , Nyboe R. , Andersen N. T. , Larsson A. , Schmitz O. , Tønnesen E.
Published: July 2005

Background:  During euglycemia acute hyperinsulinemia diminishes the cytokine response to endotoxin [Lipopolysaccharide (LPS)] exposure. In this study we elucidated whether acute hyperglycemia and hyperinsulinemia modify the cytokine content in several organs during LPS challenge in a porcine model.

Methods:  Pigs (35–40 kg) were randomized to either normoglycemia (group 1, n = 8) or hyperglycemia and hyperinsulinemia (group 2, n = 8), anesthetized and mechanically ventilated. Both groups received a 180‐min intravenous infusion of LPS (total 10 µg kg−1). Groups 1 and 2 were clamped at plasma glucose concentrations of 5 mM and 15 mM, respectively. Group 1 maintained a baseline insulin level while the hyperglycemic group exhibited increased insulin levels.

Results:  Circulating cytokines, cytokine mRNA and cytokine protein content were examined in the heart, liver, kidneys, lungs, spleen, adipose and muscle tissue. After LPS exposure, in both groups vast and equal plasma cytokines were elicited by approximately 70–5000‐fold. A 10‐fold higher level of IL‐10, IL‐6 and TNF‐α protein was found in kidney tissue compared to the other organs together with a 3–10‐fold increase of TNF‐α in adipose tissue. However, cytokine mRNAs as well as organ function were without statistical difference between the groups.

Conclusion:  Endotoxemia elicited a pronounced cytokine response in both plasma and at organ level. The kidneys and adipose tissue showed the highest cytokine protein content. Acute hyperglycemia apparently counteracts the well‐established anti‐inflammatory effects of insulin on the inflammatory response in a LPS challenged porcine model. Whether the observation can be extrapolated to more long‐term stress‐exposure remains to be clarified.
Comparison of two different techniques for brachial plexus block: infraclavicular versus axillary technique
Authors: Ertug Z. , Yegin A. , Ertem S. , Sahin N. , Hadimioglu N. , Dösemecİ L. , Erman M.
Published: July 2005

Background:  Brachial plexus block via the axillary approach is problematic in patients with limited arm mobility. In such cases, the infraclavicular approach may be a valuable alternative. The purpose of our study was to compare axillary and infraclavicular techniques for brachial plexus block in patients undergoing arm or forearm surgery.

Methods:  After institutional approval and informed consent were obtained, 30 patients (ASA physical status I or II) scheduled for forearm and hand surgery under brachial plexus anesthesia were included in the study. Patients were randomly allocated into two groups. Brachial plexus block was performed via the axillary approach in the Group A patients and via the infraclavicular approach in the Group I patients using a peripheral nerve stimulator. All blocks were performed with a total dose of 40 ml 0.375% bupivacaine.

Results:  In each nerve territory (radial, ulnar, median, and musculocutaneous), the mean values of the degree and the duration of the sensory block and motor block were not significantly different between the two groups (P > 0.05). Inadvertent vessel puncture was significantly more frequent in the axillary approach (P < 0.05).

Conclusion:  Brachial plexus block performed via the infraclavicular approach is as safe and effective as the axillary approach. Infraclavicular approach may be preferred to the axillary approach when the upper arm mobility is impaired or not desired.
Genetic variability and clinical efficacy of morphine
Authors: Klepstad P. , Dale O. , Skorpen F. , Borchgrevink P. C. , Kaasa S.
Published: July 2005

The individual variability of opioid pharmacology suggests that the patients' genetic disposition influences the response to opioids. Given the complexity of morphine pharmacology, variability may be caused by several genes. We review data which shows that variability in genes coding the enzyme metabolizing morphine (UGT2B7 gene), mu‐opioid receptors (OPRM gene) and blood‐brain barrier (BBB) transport of morphine by multidrug resistance transporters (MDR1 gene) influences the clinical efficacy of morphine. Furthermore, variability in an enzyme degrading catecholamines (COMT gene) alters the efficacy of morphine demonstrating that genetic variability in non‐opioid systems may indirectly influence the clinical efficacy from morphine. Thus, results obtained so far strongly argue that opioid efficacy is partly related to inborn properties caused by genetic variability.
Future of regional anaesthesia
Authors: Rosenberg P. H.
Published: July 2005

The development and refinement of regional anaesthetic techniques for various types of surgery, mainly obstetric, ophthalmic and orthopaedic surgery, and of continuous regional analgesia continues. Suitable analgesic drug mixtures, and concentrations, will be further tested in order to find the ideal analgesic regimen for each type of surgery and for the individual patient. No new local anaesthetics or equipment for clinical use are expected in the near future. Improvement therefore depends much on how the anaesthesiologists use the present drugs, needles, nerve detection devices, catheters and pumps. During training in regional anaesthesia for the speciality of anaesthesiology and intensive care medicine, it may suffice to concentrate only on certain common techniques such as epidural block, spinal block, axillary brachial plexus block, intravenous regional anaesthesia and femoral nerve block. Rare regional anaesthetic blocks and invasive techniques should be mastered and taught by specially trained regional anaesthesiology experts. In chronic pain, regional anaesthetic blocks with local anesthetics are not expected to play any major therapeutic role. However, nerve blocks can be useful for diagnostic purposes and in order to facilitate rehabilitation in chronic pain syndromes.
Is there a relationship between herbaceous species richness and buffel grass (Cenchrus ciliaris)?
Authors: JACKSON JANICE
Published: July 2005

Abstract  Cenchrus ciliaris L. (buffel grass) (Poaceae) is recognized as one of Australia's most serious environmental weeds. This introduced grass has been associated with loss of native species and alteration of fire regimes. However, it is also highly valued as a pasture species for arid and semiarid zones and its weed status is highly controversial. Quantitative studies are needed to determine its ecological effects. The relationship between C. ciliaris and herbaceous species richness was investigated in two studies at a range of scales up to 64 m2 in open woodlands in the Dalrymple Shire, north‐eastern Queensland. In the first study, the herbaceous species composition of sites with and without C. ciliaris were compared. Cenchrus ciliaris‐dominated sites had fewer herbaceous species than non‐C. ciliaris sites at all scales investigated and this pattern was found for the major plant groups (perennial grasses, legumes and other forbs) present. In the second study, the relationship between varying levels of C. ciliaris biomass and species richness was investigated. The relationship between varying levels of a dominant native grass, Bothriochloa ewartiana (Domin) C.E. Hubb. (Poaceae), and species richness was also determined for comparison with the C. ciliaris biomass‐richness relationship. In this study, species richness was negatively associated with increasing C. ciliaris biomass at some scales and it appeared that C. ciliaris had a greater effect on richness than B. ewartiana. The negative association between C. ciliaris and species richness is consistent with the view that invasion by C. ciliaris poses a threat to biodiversity. However, the precise cause of the relationship has yet to be determined.
Floristic richness of three perhumid New Zealand alpine plant communities in comparison with other regions
Authors: ONIPCHENKO VLADIMIR , MARK ALAN F. , WELLS GUDRUN
Published: July 2005

Abstract  Results are presented on vascular species richness in three representative alpine plant communities at 1040–1410 m on Mt Burns in the perhumid Fiordland region, a hotspot of alpine plant diversity, in south‐western South Island, New Zealand. Overall species richness was not dissimilar between the three communities in any of the eight plot sizes (mean values of 20.8–24.4 species in the largest plots of 100 m2), even though coefficients of floristic similarity were small (17.9; 23.5) between both low‐alpine communities (snow tussock‐shrubland and snow tussock grassland) and the high‐alpine cushion fellfield. Vascular species richness was generally similar to that in the few other oceanic New Zealand alpine communities for which data are available. The decline in richness from the low‐alpine to high‐alpine zones, revealed in more comprehensive records from two other regions with generally similar oceanic environments, was not recorded, indeed was reversed, on Mt Burns. Whether the recognized biodiversity hotspot of Fiordland has a generally richer high‐alpine flora than other regions in New Zealand needs further examination. The general pattern of alpine floristic richness in relation to elevation, in New Zealand, also prevails in most alpine regions abroad, usually under much more extreme continental environments. This pattern is usually ascribed to the associated decrease in temperature. Both the small size of the land mass and/or associated environmental conditions may be implicated but clarification awaits further data, preferably collected with standardized procedures.
Regrowth or dispersal? Recovery of a freshwater red alga following disturbance at the patch scale
Authors: DOWNES BARBARA J. , STREET JODIE L.
Published: July 2005

Abstract  Disturbance is an important factor in species coexistence. Disturbance models require knowledge about whether disturbed patches must be colonized anew from dispersal or whether species left behind can dominate, hence altering recovery trajectories of patches. The red, filamentous alga Audouinella hermannii Roth is a common macroalgal species present at sites in the Steavenson River, a stony, upland stream in south‐eastern Australia. We conducted an experiment in which we contrasted the recovery trajectory of the alga on overturned rocks compared with those that were not overturned, and for rocks that had remnants of the alga left behind compared with others where the alga was scrubbed off completely. Rocks had either a rough or smooth texture. Experimental rocks were set out in riffles and algal recovery monitored in 8 × 8 cm quadrats at approximately 4–6 weekly intervals for 8 months. We found that overturning caused a lasting impact on A. hermannii cover, whereas rocks that were abraded by scrubbing recovered very quickly, suggesting that this alga can re‐grow quickly from fragments (a result confirmed by a second experiment). Both surface texture and resident algae affected recovery on abraded substrata. Quadrats surrounded by resident algae on rough‐textured rocks had lower algal cover compared with all other treatments. We hypothesize this effect is caused by higher densities and grazing intensities of herbivorous macroinvertebrates on those sorts of substrata, analogous to findings for marine habitats. Abrasion does not kill A. hermannii, whereas overturning likely does, necessitating new colonization. Floods often create a mix of abrasion and overturning, producing a mosaic of patches, the complexity of which is not represented well by measures of average disturbance intensity over a whole site. The use of the latter may explain some recent contradictory results among stream disturbance studies. A patch‐level perspective is needed when disturbance creates mosaics over the landscape.
Geographical distributions, relative abundance and coexistence of Drosophila aldrichi and Drosophila buzzatii in Australia
Authors: BARKER J. S. F. , KREBS ROBERT A. , DAVIES H. I.
Published: July 2005

Abstract  Climatic data and collection records for the cactophilic Drosophila aldrichi and Drosophila buzzatii for 97 localities were used to examine the effects of geographical location, season, host plant species and climatic factors on their range and relative abundance. Temporal variation in relative abundance was assessed from monthly collections over 4 years at one locality. Effects of weather variables over the 28 days before each collection were examined. A generalized linear model of the spatial data showed significant geographical variation in relative abundance, and significant climatic effects, with the proportion of D. aldrichi higher in the warm season, and increasing as temperature variation decreased and moisture indices increased. The temporal data gave generally concordant results, as D. aldrichi proportion was higher in summer and autumn, and increased as maximum and minimum temperatures increased, and as variation in maximum temperature decreased. In a laboratory competition experiment, D. aldrichi eliminated D. buzzatii at 31°C, but was itself eliminated at 18°C and 25°C. The range of D. buzzatii is constrained only by availability of its host plant, Opuntia species, although its relative abundance is reduced in the northern part of its distribution. The range of D. aldrichi, from central Queensland to northern NSW, Australia, is entirely within that of D. buzzatii, and its relative abundance decreases from north to south. Both climate and weather, particularly temperature variability, have direct effects on the relative abundances of the two species, and both likely act indirectly by influencing the outcome of interspecific competition.
Which diabetic patients should receive podiatry care? An objective analysis
Authors: McGill M. , Molyneaux L. , Yue D. K.
Published: July 2005

Abstract

Introduction:  Diabetes is the leading cause of lower limb amputation in Australia. However, due to limited resources, it is not feasible for everyone with diabetes to access podiatry care, and some objective guidelines of who should receive podiatry is required.

Methods:  A total of 250 patients with neuropathy (Biothesiometer; Biomedical Instruments, Newbury, Ohio, USA) (>30, age <65)) but no active foot lesion, and 222 without neuropathy matched for age, type of diabetes, gender and duration, was followed prospectively for 2 years. Sensation was also tested using a 10 g Semmes Weinstein monofilament (Royal Prince Alfred Hospital Diabetes Centre). After the baseline examination, patients were contacted at 6 months and thereafter yearly to determine ulcer status. Incidence of foot ulceration across different risk categories was calculated using Kaplan–Meier survival curve. Log‐rank test and Cox's proportional model were used to compare groups. The Number Needed to Treat (NNT) to prevent one ulcer per year was calculated using the standard formulae.

Results:  During the follow‐up period, 34 new ulcers occurred in the neuropathy group and three ulcers in the control group (χ21df = 21.3; P < 0.0001), equating to an annual incidence of 6.3% and 0.5%, respectively. Fifty‐four per cent of the ulcers were due to trauma from footwear. Further stratification of the neuropathy group showed annual incidence of ulceration to be 4% for those with abnormal biothesiometer reading, but who could still feel the monofilament, 10% for those who cannot feel the monofilament and 26% for those with previous ulceration or amputation. Predictors of ulceration were past history of ulceration/amputation (χ2 = 27.8; P < 0.0001) and the presence of neuropathy (χ2 = 4.7; P = 0.03). Assuming a 55% relative risk reduction in ulceration from podiatry care (mean of estimates from 10 reports), the NNT to prevent one foot ulcer per year was: no neuropathy (vibration perception threshold (VPT) <30)), NNT = 367; neuropathy (VPT >30) alone, NNT = 45; +cannot feel monofilament, NNT = 18; +previous ulcer/amputation, NNT = 7.

Conclusion: Provision of podiatry care to diabetic patients should not be only economically based, but should also be directed to those with reduced sensation, especially where there is a previous history of ulceration or amputation. (Intern Med J 2005; 35: 451–456)