bluuebunny/crossref_metadata_2025 huggingface dataset:
Migraine and Anti‐Phospholipid Antibodies
Authors: Shuaib Ashfaq , Barklay Lynn , Lee Mary Anne , Suchowersky Oksana
Published: June 2005

SYNOPSIS

Anti‐phospholipid antibodies (APA), initially described with SLE, have in recent years received much attention because of an associated increased risk of thrombo‐embolic disease, recurrent abortion and thrombocytopenia. Although commonly seen with SLE or other collagen vascular diseases, the antibodies frequently occur in the absence of any such disease. Neurologic complications include transient or permanent ischemic episodes, migraine or related phenomena, myelopathy and a Guillain‐Barré type syndrome.

In this report we describe the presenting features and clinical course of six patients with anti‐phospholipid antibodies where migraine was an early and prominent symptom. All six patients, however, were recognized only after a second more serious event had occurred. As this entity becomes more widely recognized and better treatments evolve an earlier diagnosis of patients with migraine as the only manifestation of APA may prevent the development of other serious complications.
Cardiovascular Sympathetic Hypofunction in Muscle Contraction Headache and Migraine
Authors: Mikamo Katsuaki , Takeshima Takao , Takahashi Kazuro
Published: June 2005

SYNOPSIS

There have been some recent reports proposing that muscle contraction headache (MCH) and migraine are similar and may have a common etiology. It has been hypothesized that derangement of the autonomic nervous system (ANS) plays an important role in the pathogenesis of migraine. However, reports on the ANS function in MCH have rarely been submitted. Therefore, in this report, MCH patients were investigated as well as migraine patients. The cardiovascular reflex responses by orthostatic test, isometric work test and the pulse rate (R‐R interval) variation in fifteen MCH patients and fifteen migraine patients were recorded during headache‐free intervals. The plasma norepinephrine (NE) levels were also measured throughout the orthostatic tests. Fifteen healthy subjects served as the age‐matched control group. In the MCH group and the migraine group, blood pressure immediately after going from the supine to the erect position decreased more significantly than in the control group. The basal NE level was significantly low in both the MCH group and the migraine group, in comparison with the control group. MCH patients as well as migraine patients showed cardiovascular sympathetic hypofunction.
Long‐Term Effects of Training in Relaxation and Stress‐Coping in Patients with Migraine: A 3‐Year Follow‐Up
Authors: Sorbi Marjolijn , Tellegen Bert , Long Arnoud Du
Published: June 2005

SYNOPSIS

Research on the short‐term effects of psychological interventions in migraine indicates improvement rates of 50 percent. Yet long‐term follow‐ups are scarce: the studies extending to three years provide evidence for the maintenance of effects, but these studies evaluate the benefits of rather complex psychological treatments and the samples include other types of headache.

We compared the effects of single‐method psychological interventions upon migraine. The study reports results obtained from 24 patients three years after completion of relaxation training, which is a psychophysiological regimen, and stress‐coping training, which is a cognitive‐behavioral regimen. Results for the complete sample, excluding data biased by confounding factors, provide clear evidence of the preservation of effects in migraine. Relaxation training (RT) and stress‐coping training (SCT) were equally effective and both groups exhibited little medication consumption since completion of training. Among the secondary effects, SCT was found to improve assertiveness and active problem solving, and to decrease depressive reaction. The study yielded two predictor variables‐little external stress for relaxation training, and high self motivation for stress‐coping training‐that accounted for more than 50 percent of the effect variance in the respective groups.

Although more research is needed to substantiate our findings, the results suggest that, thus far, there is little reason to favor multimodal training or more complex psychological treatments over single‐method psychological interventions in migraine. Also, our results do not support the assumed superiority of cognitive‐behavioral treatment over psychophysiological treatment. Research on factors predicting long‐term effects of psychological interventions in migraine may profit from considering separate variables on skill rehearsal and skill employment (instead of employing a global measure of home practice), and from a measure for post‐training external stress.
The Effectiveness of Physical Therapy in the Treatment of Chronic Daily Headaches
Authors: Jay Gary W. , Brunson Janel , Branson Suzanne Jeffers
Published: June 2005

SYNOPSIS

We investigated the adjunctive use of physical therapy, with the more standard modalities of medication and/or biofeedback‐enhanced neuromuscular re‐education, in patients with chronic daily headaches who had palpable muscle spasm in the neck and shoulder regions.

Patients in group one received medication detoxification (when necessary), amitriptyline and (in some cases), biofeedback. Patients in group two received detoxification (when necessary), amitriptyline (in somecases) and physical therapy, including TENS (trans‐cutaneous electrical nerve stimulation). Patients in group three received detoxification (when necessary), amitriptyline in (some cases), and TENS without other modalities of physical therapy.

Patients in groups two and three, as judged by changes in Headache Index, showed a significantly faster and greater decline in headaches than patients in group one, and maintained this excellent relief through the six month follow‐up period. From a biochemical perspective, this improvement may be related to the demonstrable increase in serotonin levels that attends TENS. From a behavioural perspective, improvement may be related to the change in “locus of control” from the headache to the patient that attends the more “active” modalities of TENS and physical therapy, as opposed to the more “passive” modality of medication alone.
Prophylactic Treatment of Cluster Headache with Verapamil
Authors: Gabai Ivy J. , Spierings Egilius L. H.
Published: June 2005

SYNOPSIS

An open study of verapamil in cluster headache is reported. Forty‐eight patients participated in the study of whom 33 (=69%) improved more than 75%. No significant differences in response were observed between episodic and chronic cluster headache.
Hyperperfusion of Cerebral Cortex, Thalamus and Basal Ganglia During Spontaneously Occurring Migraine Headaches
Authors: Kobari Masahiro , Meyer John Stirling , Ichijo Makoto , Imai Akira , Oravez William T.
Published: June 2005

SYNOPSIS

Color‐coded, cross‐sectional imaging of local cerebral blood flow (LCBF) was made in a prospective manner among 22 patients with well‐established common or classic migraine utilizing the stable xenon‐enhanced computed tomographic (Xe CT‐CBF) method. LCBF in patients during spontaneously occurring headaches (N = 12) were significantly higher compared to patients without headache (N = 10) by 25–35%. The hyperperfusion involved not only cerebral cortex but also sub‐cortical structures including thalamus, basal ganglia, and sub‐cortical white matter. LCBF increases were bilateral and sometimes asymmetrical, but LCBF increases were not consistently related to the preponderant side of headache. No significant differences were observed in the degree or pattern of cerebral hyperperfusion during headaches compared among common (N = 6) and classic (N = 6) migraineurs.

Results suggest a common etiology for both common and classic migraine. Results are not consistent with spreading oligemia or spreading cortical depression as a cause of migraine. The cerebral hyperperfusion appears to be mediated by various neurogenic and chemical changes accompanying migraine. The unilateral nature of migraine head pain is more likely due to dilation of extracranial vessels.
The Role of Psychopathology in Chronic Headache: Cause or Effect?
Authors: Blanchard Edward B. , Kirsch Cynthia A. , Appelbaum Kenneth A. , Jaccard James
Published: June 2005

SYNOPSIS

The psychological test results (BDI, STAI, PSC, and MMPI Scales 1, 2, 3, and 7) of 492 chronic headache patients were subjected to five analyses in order to test two hypotheses about the relation of headache activity and psychopathology/ personality: (H‐1), that psychopathology “causes” headache; and (H‐2), that headache “causes” psychopathology. No support was found for H‐2. There was modest support for H‐1.
Brain Imaging with 123I‐IMP‐SPECT in Migraine Between Attacks
Authors: Schlake H.‐P. , Böttger I.G. , Grotemeyer K.‐H. , Husstedt I.W.
Published: June 2005

SYNOPSIS

123I‐IMP‐SPECT brain imaging was performed in patients with classic migraine (n=5) and migraine accompagnée (n =18) during the headache‐free interval. A regional reduction of tracer uptake into brain was observed in all patients with migraine accompagnée, while in patients with classic migraine only one case showed an area of decreased activity. The most marked alteration was found in a patient with persisting neurological symptoms (“complicated migraine”). In most cases the areas of decreased tracer uptake corresponded to headache localization as well as to topography of neurologic symptoms during migraine attacks. It may be concluded that migraine attacks occur in connection with exacerbations of preexisting changes of cerebral autoregulation due to endogenous or exogenous factors.
Menstrual Migraine and Intermittent Ergonovine Therapy
Authors: Gallagher R. Michael
Published: June 2005

SYNOPSIS

The treatment of patients suffering with menstrual migraine is sometimes a difficult and frustrating problem for the physician. As many menstrual migraine headaches are refractory to abortive therapy, prophylactic therapy is often needed. Ergonovine maleate, an ergot derivative with vasoconstrictive properties, has been used with some success in migraine headache patients. Forty patients who were treated with intermittent prophylactic ergonovine were studied over six months. The patients ranged in age from 22 to 40 years, and all suffered with menstrual migraine headaches which were refractory to abortive therapy. Each patient took ergonovine maleate 0.2 mg three to four times daily during menses and recorded headache occurrence and severity. After three months, 24 patients (60%) reported significantly less severe attacks, six patients (15%) reported less frequent headaches and 14 patients (35%) reported no improvement. After six months there was a decrease in effectiveness with 20 patients (50%) reporting significantly less severe headaches and two patients (5%) reporting less frequent headaches. This limited study suggests that ergonovine maleate may be of value in the treatment of difficult menstrual migraine patients.
Regional Cerebral Blood Flow in Childhood Headache
Authors: Roach E.S. , Stump David A.
Published: June 2005

SYNOPSIS

Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non‐invasive Xenon‐133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whoseheadache is atypical.
Acute Demyelination Mimicking Vascular Hemicrania
Authors: Nager Benjamin J. , Lanska Douglas J. , Daroff Robert B.
Published: June 2005

SYNOPSIS

A 29‐year‐old woman presented with acute hemicrania, trigeminal neuropathy and posterior fossa dysfunction. The admission differential diagnosis included vertebral artery dissection, posterior circulation aneurysm, vascular malformation and brainstem infarction. However, radiographic and CSF studies indicated demyelination. Acute demyelination should be in the differential diagnosis of vascular hemicrania with signs of posterior fossadysfunction.
Pituitary Adenoma Presenting as Painful Intermittent Third Nerve Palsy
Authors: Cano M. , Lainez J.M. , Escudero J. , Barcia C.
Published: June 2005

SYNOPSIS

We report the case of a woman with short nocturnal attacks of peri‐ and retro‐orbital pain, diplopia, ptosis, rhinorrhea and lacrimation of five months evolution. Neurological examination was normal between attacks. The latter presented with partial third nerve palsy, which finally became complete and permanent. Brain CT showed a sellar and supraseller tumor with parasellar extension to the right side. We stress the atypical clinical presentation and evolution of this case, and discuss its pathophysiology.
Longterm Prognosis of Analgesic Withdrawal in Patients with Drug‐Induced Headaches
Authors: Baumgartner Christoph , Wessely Peter , Bingöl Cicek , Maly Joachim , Holzner Felix
Published: June 2005

SYNOPSIS

We studied long‐term prognosis and prognostic variables for therapeutic outcome of analgesic withdrawal in 54 patients with drug‐induced headaches. The duration of headache history was 21.9 ± 12.8 years. Each patient took an average of 38.8±22.8 tablets or suppositories a week and an average of 2.5 distinct drugs. Most patients used drugs containing several components. Caffeine was contained in at least one drug in all cases, ergotamine in 80.0% and pyrazolon in 77.1%. All patients were admitted to the hospital for two weeks. The analgesics were discontinued abruptly and the withdrawal symptoms were alleviated by neuroleptics and neurotropics. During the second week of hospital stay we started a basic therapy with calcium antagonists or beta blockers in patients suffering from migraine initially and with tricyclic antidepressants, physical therapy or biofeedback in patients suffering from tension type headaches initially. At the end of the study (mean follow‐up period = 16.8±13.6 months) 38 patients (70.1%) were evaluated. 76.3% of these patients had significantly reduced their analgesic intake, 60.5% had experienced a significant relief of headache both in intensity and frequency, and 23.7% were therapeutic failures. Analysis of the time course of relapse revealed the first six month after hospital discharge as the critical period determining long‐term success. The variables tested for prognostic relevance (age, sex,duration of headache history, number of tablets or suppositories taken a week, organic mental syndrome, and type of initial headaches) were not statistically significant.
Failure of Mexiletine to Control Trigeminal Neuralgia
Authors: Pascual Julio , Berciano José
Published: June 2005

SYNOPSIS

The analgesic effects of lidocaine and tocainide on trigeminal neuralgia have been established. However, both drugs are unpractical: lidocaine can only be used intravenously, and tocainide may exhibit serious haematological side effects. Mexiletine, a structural analogue of lidocaine that can be safely administered by the oral route, was given, as the sole drug, to four patients with active trigeminal neuralgia. After at least seven days on mexiletine they had no clear benefit. The four patients subsequently improved with carbamazepine or phenytoin. Our observations suggest that mexiletine alone is not of value in trigeminal neuralgia.
Adverse Reactions to Iopamidol and Iohexol Myelography with Special Attention to Headache: Role of Myelographic Technique
Authors: Sobel David F. , Rowe Rekarda , Zyroff Jack , Koziol James A. , Frost Francine , Krupsaw Jean
Published: June 2005

SYNOPSIS

In order to identify those myelographic risk factors associated with a higher incidence of adverse effects, myelographic technique, patient variables and post‐myelographic symptoms were prospectively recorded in a group of 152 patients studied with iopamidol and in a second group of 28 patients studied with iohexol.

None of the technical factors studied were identified to have a statistically significant relationship with the incidence of adverse reactions. Older patients fared better than younger patients in both groups. Overall, there was a lower incidence of side effects in the iopomidol group (29%) than in the iohexol group (50%). Headache, nausea, and vomiting were the most frequent reactions seen.
Migraine ‐ A Risk Factor for Dissection of Cervical Arteries
Authors: D'Anglejan‐Chatillon J. , Ribeiro V. , Mas J.L. , Youl B.D. , Bousser M.G.
Published: June 2005

SYNOPSIS

A case control study technique was employed to test for an association between non‐traumatic cervical artery dissection and several possible risk factors. A significant positive association was shown with migraine, independent of type and treatment regimen. No such relationship was found with smoking history, hypertension or past oral contraceptive use. There was, however a significant and independent association with current oral contraceptive use.
Prevalence and Clinical Features of Migraine: A Community Survey in Bangkok, Thailand
Authors: Phanthumchinda Kammant , Sithi‐Amorn Chitr
Published: June 2005

SYNOPSIS

The authors probed the extent and clinical features of migraine through a community survey in the Bangkokslum. A total population of 540 individuals of both sexes were randomly selected from available subjects. They were interviewed using questionnaires. The response rate was 100%. The prevalence of migraine in the previous year in 135 men and 405 women was 10.4% and 35.3% respectively. The overall prevalence of migraine in this community was 29.1%. In both sexes, the prevalence declined with increasing age and in women, the effect of age was significant (p<.005). The clinical features of migraine (age of onset, headache profile, neurological symptoms, severity and frequency of headache, familial history, precipitating factors and medications for headache) were analyzed. We concluded that migraine is not uncommon in a low socioeconomic group in Thailand, and that this type of headache is a burden to patients and may have some economic effect. Thus, strategy in prevention and control of migraine should be critically considered.
Epidural Blood Patch in the Treatment of Post Dural Puncture Headache: A Double Blind Study
Authors: Seebacher J. , Ribeiro V. , LeGuillou J. L. , Lacomblez L. , Henry M. , Thorman F. , Youl B. , Bensimon G. , Darbois Y. , Bousser M.G.
Published: June 2005

SYNOPSIS

A randomised double blind controlled trial of ‘epidural blood‐patch’ as treatment for post‐dural puncture headache is presented. The method was successful in 11 out of 12 cases on its first application, the twelfth patient being relieved by a second procedure. None of six patients reported benefit from a ‘sham’ procedure. The rationale for the use of the technique is discussed.
European Multicenter Trial of Nimodipine in the Prophylaxis of Common Migraine (Migraine Without Aura)
Authors:   Migraine‐Nimodipine European Study Group (MINES)
Published: June 2005

SYNOPSIS

This double blind, randomized study of the calcium antagonist Nimodipine 40 mg t.i.d. vs placebo in the prophylaxis of common migraine (migraine without aura) included 192 patients. Patients with 2–8 migraine days/4 weeks, age 18–60, who had no other types of recurring headaches except up to 6 interval headaches/4 weeks were included. The study was carried out at 11 European centers. After a 4 week run‐in period, patients were randomly allocated to Nimodipine or placebo for 12 weeks (parallel groups). There were 19 drop‐outs, 12 on Nimodipine and 7 on placebo, A gradual and marked improvement was seen both with Nimodipine and with placebo amounting to approximately 60% during the last 4 weeks. Statistical analysis on all included patients (intention to treat) revealed no difference between Nimodipine and placebo for migraine days (P = 0.69) or migraine index (p = 0.91). In patients “valid for analysis of efficacy” there were also no significant differences. Due to a very marked placebo effect and use of the parallel groups design, the present trial was not very powerful despite the large number of patients and a satisfactory compliance. We cannot rule out that Nimodipine might have up to 30% effect on a single main outcome parameter, but the uniform lack of response in all tested parameters makes this unlikely. Therefore Nimodipine probably has only a small or no effect in common migraine (migraine without aura).
European Multicenter Trial of Nimodipine in the Prophylaxis of Classic Migraine (Migraine With Aura)
Authors:   Migraine‐Nimodipine European Study Group (MINES)
Published: June 2005

SYNOPSIS

This double‐blind, randomized study of the Nimodipine 40 mg t.i.d. vs placebo in the prophylaxis of classic migraine (migraine with aura) included 89 patients. Required migraine frequency was 2–8 migraine days/4 weeks and at least two of the attacks within the last 6 months had to be with aura. The study was carried out at 11 European centers. After a 4 week run‐in period, patients were randomly allocated to nimodipine or placebo for 12 weeks (parallel groups). There were 7 dropouts, 3 on Nimodipine, and 4 on placebo. A gradual and verymarked improvement was seen both with Nimodipine and placebo amounting to between 60 and 90 per cent during the last 4 weeks. Statistical analysis on all included patients (intention to treat) revealed no difference between Nimodipine and placebo for migraine days or migraine index. In patients “valid for analysis of efficacy” there were also no significant difference. Due to a very marked placebo effect and use of the parallel groups design, the present trial is relatively weak despite a fairly large sample size. It cannot rule out the possibility of an important effect of Nimodipine in classic migraine with a high degree of certainty.
Assessing the effectiveness of whole blood–derived platelets stored as a pool: a randomized block noninferiority trial
Authors: Heddle N.M. , Cook R.J. , Blajchman M.A. , Barty R.L. , Sigouin C.S. , Boye D.M. , Nelson E.J. , Kelton J.G.
Published: June 2005

BACKGROUND: Prestorage pooling of whole blood–derived platelets (PLTs) would simplify bacterial detection. This study evaluated the in vivo effect of the prestorage pooling of PLTs stored for up to 5 days, by assessing the corrected count increment (CCI) 18 to 24 hours after transfusion of the product.

STUDY DESIGN AND METHODS: A randomized block noninferiority design was used. Eligible patients had chemotherapy‐induced thrombocytopenia and were considered likely to need at least six PLT transfusions. For every block of two transfusion events, one consisted of PLTs stored individually and then pooled before transfusion, and the other was a product pooled before storage. The primary outcome was categorized as a successful (>4.5) or unsuccessful (≤4.5) 18‐ to 24‐hour posttransfusion CCI analyzed with a matched pair score test. A mixed‐effect linear model estimated the mean difference in CCI between the two types of storage.

RESULTS: Twenty‐three eligible patients received a total of 189 PLT transfusions. The median number of PLT transfusions was 7 (range, 0‐27). Eighty‐five complete transfusion pairs were used in the primary analysis. The proportions of transfusions leading to a CCI of greater than 4.5 was identical for both routine and PLTs pooled before storage (45/85 = 52.9%; relative risk, 1.00; lower limit of the one‐sided 95% confidence interval [CI], 0.83). The estimate of the mean difference in CCI between pooled and routine storage (pooled − routine) was −0.45 (95% CI, −2.23 to 1.33; p = 0.63).

CONCLUSION: These results provide evidence that storage of PLTs as a pool for up to 5 days results in posttransfusion CCIs that are not inferior to PLTs stored individually.
Delayed platelet engraftment in group O patients after autologous progenitor cell transplantation
Authors: Hoffmann Sandra , Zhou Lan , Gu Yuan , Davenport Robertson , Cooling Laura
Published: June 2005

BACKGROUND: Fucosylated glycans, including H‐antigen, play critical roles in hematopoietic progenitor cell homing, adhesion, growth, and differentiation. H‐active antigens are strongly expressed on CD34+ progenitor cells and committed megakaryocytic progenitors and may mediate adhesion to marrow stromal fibroblasts. We examined the possible influence of donor ABO type on platelet (PLT) engraftment after autologous peripheral blood progenitor cell transplant (PBPCT).

STUDY DESIGN AND METHODS: A retrospective analysis of all patients who underwent a single autologous PBPCT between 1996 and 2000 were reviewed. Neutrophil and PLT engraftment were compared by patient ABO type and CD34+ cell dose by t test, chi‐square test, analysis of variance, Kaplan‐Meier probability, and log‐rank test.

RESULTS: Engraftment data was available in 195 patients. PLT engraftment was delayed in all patients, regardless of ABO type, at CD34+ PBPC doses of 2 × 106 to 3 × 106 per kg (p < 0.001). When examined by ABO type, late PLT engraftment (PLT count > 50 × 109/L) was significantly delayed in group O patients relative to all non‐group O patients (32.4 days vs. 19.6 days, p < 0.001). Approximately 50 percent of group O patients required more than 40 days to achieve late PLT recovery (p < 0.005).

CONCLUSIONS: A group O phenotype may be associated with delayed PLT engraftment at lower CD34 doses.
Parvovirus B19 transmission by a high‐purity factor VIII concentrate
Authors: Wu Chuan‐ging , Mason Bobby , Jong Julia , Erdman Dean , McKernan Laurel , Oakley Meredith , Soucie Mike , Evatt Bruce , Yu Mei‐ying W.
Published: June 2005

BACKGROUND: Parvovirus B19 (B19) is known to cause a variety of human diseases in susceptible individuals by close contact via the respiratory route or by transfusion of contaminated blood or blood products. In this study, whether a case of B19 transmission was causally related to the infusion of implicated lots of a solvent/detergent (S/D)‐treated, immunoaffinity‐purified factor VIII concentrate (antihemophilic factor [human][AHF]) was investigated.

STUDY DESIGN AND METHODS: Anti‐B19 (both immunoglobulin M [IgM] and immunoglobulin G [IgG]) and B19 DNA (by a nucleic acid testing [NAT] procedure) were assayed in two implicated product lots, a plasma pool, and a recipient's serum sample. Analysis of the partial B19 sequences obtained from sequencing clones or direct sequencing of the samples was performed.

RESULTS: Only one of the two implicated lots was B19 DNA–positive. It contained 1.3 × 103 genome equivalents (geq or international units [IU]) per mL. The negative lot was derived from plasma screened for B19 DNA by NAT in a minipool format to exclude high‐titer donations, whereas the positive lot was mostly from unscreened plasma. This high‐purity AHF product had no detectable anti‐B19 IgG. A 4‐week postinfusion serum sample from a recipient, who received both lots and became ill, was positive for the presence of B19 antibodies (both IgM and IgG) as well as B19 DNA. The B19 sequences from the positive lot, its plasma pool, and the recipient's serum sample were closely related.

CONCLUSION: These findings and the recipient's clinical history support a causal relationship between the implicated AHF product and B19 infection in this recipient. The seronegative patient became infected after receiving 2 × 104 IU (or geq) of B19 DNA, which was present in this S/D‐treated, high‐purity AHF product.
Characterization of banked umbilical cord blood hematopoietic progenitor cells and lymphocyte subsets and correlation with ethnicity, birth weight, sex, and type of delivery: a Cord Blood Transplantation (COBLT) Study report
Authors: Cairo Mitchell S. , Wagner Elizabeth L. , Fraser John , Cohen Geoff , Van De Ven Carmella , Carter Shelly L. , Kernan Nancy A. , Kurtzberg Joanne
Published: June 2005

BACKGROUND: The Cord Blood Transplantation (COBLT) Study banking program was initiated in 1996. The study goals were to develop standard operating procedures for cord blood (CB) donor recruitment and banking and to build an ethnically diverse unrelated CB bank to support a transplantation protocol.

STUDY DESIGN AND METHODS: The hematopoietic progenitor cell (HPC) and lymphocyte subset (LS) content of approximately 8000 CB units were characterized, and these results were correlated with donor ethnicity, birth weight, gestational age, sex, and type of delivery.

RESULTS: There was a significant correlation of CD34+ cell count with colony‐forming unit (CFU)–granulocyte‐macrophage (r = 0.68, p < 0.001), CFU–granulocyte‐erythroid‐macrophage‐megakaryocyte (r = 0.52, p < 0.001), burst‐forming unit–erythroid (BFU‐E; r = 0.61, p < 0.001), and total CFUs (r = 0.67, p < 0.001). Nucleated red blood cell count was significantly correlated with total CD34+ (r = 0.56, p < 0.001), total CFU (r = 0.50, p < 0.001), BFU‐E (r = 0.48, p < 0.001), and counts of CD34+ subsets (p < 0.001). Caucasian ethnicity was significantly correlated with higher CD3+/CD4+, CD19+, and CD16+/CD56+ LSs. Furthermore, CD34+/CD38– and CD34+/CD61+ CB units (HPC‐C) were significantly lower in African American and Asian persons compared to Caucasian and Hispanic persons. Male sex was associated with significantly fewer CD3+/CD4+, CD19+, and CD16+/CD56+ but increased CD3+/CD8+ LSs (p < 0.001). Finally, cesarean section was associated with significantly higher total CFU and CD16+/CD56+ but lower CD3+/CD4+, CD3+/CD8+, and CD19+ LSs.

CONCLUSION: These results provide a standard and range for uniformly processed HPC‐C progenitor cells and LSs. CB progenitor cells and/or LSs may in the future predict for rapidity of engraftment, incidence of graft‐versus‐host disease, speed and quality of immunore‐ constitution, graft‐versus‐tumor effects, and/or success of gene transfection after CB transplantation.
Quantification of Annular Dilatation and Papillary Muscle Separation in Functional Mitral Regurgitation: Role of Anterior Mitral Leaflet Length as Reference
Authors: Jorapur Vinod , Voudouris Apostolos , Lucariello Richard J.
Published: June 2005

Background: We hypothesized that anterior mitral leaflet length (ALL) does not differ significantly between normal subjects and patients with functional mitral regurgitation (FMR) and hence may be used as a reference measurement to quantify annular dilatation and papillary muscle separation. Methods and Results: We prospectively studied 50 controls, 15 patients with systolic left ventricular dysfunction (LVD) with significant FMR, and 15 patients with LVD without significant FMR. Significant MR was defined as an effective regurgitant orifice area ≥ 0.2 cm2 as measured by the flow convergence method. Annular diameter, interpapillary distance, and ALL were measured, and the following ratios were derived: annular diameter indexed to ALL (ADI) and interpapillary distance indexed to ALL (IPDI). There was no significant difference in ALL among the three groups. The mean ADI was 1.26 times controls in patients with LVD without significant FMR compared to 1.33 times controls in patients with LVD with significant FMR (P = 0.06, no significant difference between groups). The mean IPDI was 1.42 times controls in patients with LVD without significant FMR compared to 2.1 times controls in patients with LVD with significant FMR (P < 0.0001, significant difference between groups). Conclusion: There was no significant difference in ALL between controls and patients with LVD. ALL can be used as a reference measurement to quantify annular dilatation and papillary muscle separation in patients with FMR. Interpapillary distance but not annular diameter indexed to ALL correlates with severity of FMR.
Evaluation of Safety of Warfarin in Combination with Antiplatelet Therapy for Patients Treated with Coronary Stents for Acute Myocardial Infarction
Authors: MATTICHAK STEPHEN J. , REED PAMELA S. , GALLAGHER MICHAEL J. , BOURA JUDITH A. , O'NEILL WILLIAM W. , KAHN JOEL K.
Published: June 2005

The safety and efficacy of treating recently stented patients on combination antiplatelet therapy with warfarin for clinical indications in unknown. Therefore, we examined the use of warfarin in a population of patients with myocardial infarction (MI) treated with coronary stenting. We performed a retrospective analysis comparing patients who underwent successful coronary stenting for acute MI and were discharged on either warfarin and combination platelet therapy for clinical indications or combination antiplatelet therapy alone. There was a nonsignificant trend toward reinfarction at 6 and 12 months in warfarin‐treated patients. Warfarin‐treated patients had significantly higher rates of transfusion compared to nonwarfarin‐treated patients at 12 months (21% vs 0%, P = 0.028). There were no significant predictors of reinfarction in 6 and 12 months in multivariate analysis. These data demonstrate that warfarin anticoagulation, in combination with successful coronary stenting for acute MI and antiplatelet therapy, does not reduce risk of reinfarction but is associated with increased rates of transfusion.
Ischemia‐Driven Target Vessel Revascularization After‐Primary Percutaneous Coronary Intervention: Patients At Risk and Their Outcomes
Authors: MEHTA RAJENDRA H. , HARJAI KISHORE J. , BOURA JUDY , O'NEILL WILLIAM , GRINES CINDY L. ,   On Behalf of Primary Angioplasty in Myocardial Infarction (PAMI)‐Investigators
Published: June 2005

Clinical and angiographic correlates of ischemia‐driven target vessel revascularization (ITVR) in patients undergoing primary percutaneous coronary interventions (PCI) are currently less well known. Accordingly, we examined 2,981 patients enrolled in different Primary Angioplasty in Myocardial Infarction trials, who underwent primary PCI to evaluate risk factors and outcomes of individuals requiring subsequent ITVR. At 6 months, ITVR was required in 321 patients (11%). Compared to the cohort without ITVR, patients requiring ITVR were younger (P = 0.036), females (P = 0.018), and more likely to have systolic blood pressure >100 mmHg on presentation (P = 0.022), family history of premature coronary artery disease (P = 0.035), and postprocedure dissection (P = 0.001). In contrast, Killip Class >I on presentation (P = 0.05), left circumflex as infarct‐related artery (P = 0.022), and the use of ticlopidine (P = 0.044) and stents (p = 0.057) were less frequent among ITVR patients. Multivariate analysis identified younger age (for each 10‐year decrease, odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06–1.32), female gender (OR: 1.41, 95% CI: 1.05–1.89), and final dissection (OR: 1.69, 95% CI: 1.23–2.33) as independent risk factors for ITVR. In‐hospital reinfarction (P < 0.001) was increased and at 6 months remained higher in ITVR patients; in‐hospital and 6‐month mortality did not differ between the two groups. Our study identifies the incidence, risk factors, and outcomes of patients requiring ITVR after primary PCI. Importantly, our data suggest that no increase in mortality occur, if ITVR is promptly performed to treat recurrent ischemia after primary PCI.
Science and Technology for What?
Authors: Krone Robert M.
Published: June 2005

In 1939 American scholar Robert S. Lynd first published his classic book Knowledge for What? (Lynd, 1948). It provided statements on the requirement for social science knowledge to serve policymaking. This paper addresses the requirement for science and technology education policy to undergo changes dictated by the 21st‐century environment. It also identifies the inseparable links between political governance and educational policymaking.

Views of 50 global professionals were solicited for their answers to the fundamental question: Science and technology for what? Experience of the respondents was in science, technology, education, religion, defense, engineering, space, business, and government. This paper classifies and summarizes those responses, then provides the author's analysis and conclusion that humanity has reached the point in history where its long‐term future is doubtful if both policymaking and education fail to formally conclude that the answer to the question, Science and technology for what? . . . is determined to be: Global humanity.

The paper, therefore, is more concerned with the strategic answers to the meta question of Science and technology for what? than the precise answers for individual science disciplines. The paper data‐reduces focus group responses into 18 categories (Figure 1), and provides only illustrative discrete uses of what education for science and technology within those categories should do. The reader will grasp the complexities of moving from strategic decisions to changes within the disciplines of science and the applications of technology.

. What 50 Professionals Think about “Science & Technology for What?”: Challenges for Education Policy

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Response of Danaus plexippus to pollen of two new Bt corn events via laboratory bioassay
Authors: Mattila Heather R. , Sears Mark K. , Duan Jian J.
Published: June 2005

Laboratory bioassays were conducted to evaluate the response of first instar larvae of the monarch butterfly, Danaus plexippus L. (Lepidoptera: Danaidae), a non‐target species, to pollen from corn, Zea mays L. (Commelinales: Poaceae), from two new corn hybrids genetically modified to express different types of insecticidal proteins derived from the bacterium Bacillus thuringiensis Berliner (Bacillales: Bacillaceae) (Bt). One hybrid expresses both Cry1Ab and Cry2Ab2 proteins (MON 810 × MON 84006), active against lepidopteran pests, and the other expresses Cry3Bb1 protein (MON 863), targeted against coleopteran pests. First instar larvae were placed on milkweed leaves (Asclepias syriaca L.) (Gentianales: Asclepiadaceae) dusted with doses of either Bt pollen or its nonexpressing (isoline) pollen counterpart ranging from 50 to 3200 grains cm−2 of milkweed leaves, or no pollen at all. Larvae were exposed to pollen for 4 days, then moved to pollen‐free leaves and observed for another 6 days. Survival was observed after 2, 4, and 10 days. Weight gain was estimated after 4 and 10 days, leaf consumption after 2 and 4 days, and larval development after 10 days. Exposure to pollen of the Cry1Ab/Cry2Ab2‐Bt expressing hybrid reduced larval survival approximately 7.5–23.5% at the dose ranges tested relative to a no pollen control. Larval weight gain and consumption were reduced for larvae exposed to pollen of this hybrid and a small minority of larvae (3.1%) never developed past the third instar after 10 days of observation. Exposure to pollen of the Cry3Bb1‐Bt expressing hybrid had no negative effects on larval mortality, weight gain, consumption, or development relative to the consumption of Bt‐free corn pollen. The relevance of these findings to the risk that these Bt corn hybrids pose to monarch populations is discussed.
Variability in response specificity of apple, hawthorn, and flowering dogwood‐infesting Rhagoletis flies to host fruit volatile blends: implications for sympatric host shifts
Authors: E. Linn Charles , Dambroski Hattie , Nojima Satoshi , Feder Jeffrey L. , Berlocher Stewart H. , Roelofs Wendell L.
Published: June 2005

Rhagoletis pomonella Walsh (Diptera: Tephritidae) originating from domesticated apple (Malus pumila), hawthorn (Crataegus mollis) (Rosaceae), and flowering dogwood (Cornus florida) (Cornaceae) were tested sequentially in flight‐tunnel assays to volatile blends previously identified from the three fruit types. The majority of flies flew to odor sources containing their natal blend (68–83%). Some flies from each fruit type also flew to non‐natal fruit blends (11–39%), but of these non‐natal responders the vast majority were flies that responded to their natal blend as well. The results indicate that individual flies within R. pomonella populations infesting different host types have different degrees of specificity with respect to discriminating among fruit volatile blends, and that a moderate proportion of apple, hawthorn, and dogwood flies (10–30%) are broad responders, with the capacity to recognize and orient to more than one blend. The observed variability in response specificity could facilitate sympatric shifts to new host plants.
Clinical attachment loss produced by curettes and ultrasonic scalers
Authors: Alves Renato Vasconcelos , Machion Luciana , Casati Màrcio Zaffalon , Nociti Francisco Humberto , Sallum Enilson Antonio , Sallum Antonio Wilson
Published: June 2005

Objectives: The aim of this study was to clinically detect the immediate effect of root instrumentation with curettes and ultrasonic scalers on clinical attachment level.

Material and Methods: Twelve subjects with moderate chronic periodontitis, presenting probing depths of 3.5–6.5 mm on anterior teeth, upper and/or lower, were selected. Teeth were randomly assigned to one of the following groups: US group – scaled with an ultrasonic scaler; and CC group – scaled and planed with 5–6 Gracey curettes. The selected teeth were probed with a computerized electronic probe, guided by an occlusal stent and subjected to scaling and root planing. Immediately following instrumentation, teeth were probed again. The difference between relative attachment level (RAL) immediately before and after instrumentation was considered trauma from instrumentation.

Results: Intra‐group analysis revealed statistically significant differences between RAL immediately before and after instrumentation in both groups (0.77±0.51 for US group; and 0.73±0.41 for CC group, p<0.0001). However, inter‐group analysis did not show statistically significant difference in trauma from instrumentation caused by the two different instruments (p=0.816).

Conclusions: Within the limits of this study, it was concluded that root instrumentation causes a mean immediate attachment loss of 0.75 mm, and that instrumentation with either curettes or ultrasonic scalers do not seem to reduce significantly the trauma from of instrumentation produced.
Factors related to utilization of dental services during pregnancy
Authors: Al Habashneh Rola , Guthmiller Janet M. , Levy Steven , Johnson Georgia K. , Squier Christopher , Dawson Deborah V. , Fang Qian
Published: June 2005

Objectives: The purposes of this study were to investigate factors related to utilization of dental services during pregnancy and to assess the extent of mothers' knowledge regarding oral health during pregnancy and its effect on pregnancy outcomes.

Materials and Methods: Cross‐sectional data were collected from 625 women using a structured questionnaire mailed to mothers who had given birth in Johnson County, Iowa from August 2001 to March 2002. The survey assessed knowledge, behaviours, attitudes toward dental care during pregnancy, and personal, demographic and pregnancy‐related factors. Variables which showed associations in bivariate analysis (p0.1) were considered as candidates for building logistic regression models separately by domain (demographics, dental health care behaviours, lifestyle, financial variables, pregnancy‐related variables, and knowledge of the possible association between oral health and pregnancy). Significant domain‐specific regression results (p0.05) were used to develop a final model using forward stepwise logistic regression analyses.

Results: The overall response rate was 69%. Dental visits during pregnancy were reported by 49% of respondents. Forty‐three percent were aware of the possible connection between oral health and pregnancy outcomes. In the final logistic regression analysis, factors significantly associated with reporting dental visits during pregnancy were: (1) personal factors (being married, greater frequency of visiting the dentist when not pregnant and use of inter‐proximal cleaning aids); (2) financial factors (dental insurance); and (3) knowledge of the possible connection between oral health and pregnancy outcomes.

Conclusions: There was limited knowledge of the possible relationships between oral health and pregnancy outcomes in a fairly homogeneous population of women who were of relatively high socioeconomic standing. This study suggests that better education of the importance of dental care before and during pregnancy is needed.
Reducing variability and choosing ideal subjects for experimental gingivitis studies
Authors: Shearer Barbara , Hall Peter , Clarke Peter , Marshall Graeme , Kinane Denis F.
Published: June 2005

Introduction: This study was undertaken to test the hypothesis that male, non‐smokers, aged 25–50 years, with a proven track record of developing gingivitis would provide suitable subjects for experimental gingivitis studies because the inter‐subject variation would be greatly reduced.

Materials and Methods: Subjects were required to be men aged between 25 and 50 years, in good general health with at least four sound teeth in one posterior quadrant of the mandible. Subjects who were smokers, taking antibiotics, anti‐inflammatory drugs or had any other medical, surgical or social condition making participation in the study inadvisable, were excluded. Subjects had previously participated in a 21‐day experimental gingivitis study. Subjects with the most gingivitis at the end of the previous study were invited to participate first, moving down the list until the required number of subjects had been achieved. Subjects were randomly assigned to one of three toothpastes: Crest Gum Care, Mentadent P or a placebo (UK Signal). Subjects were asked to brush their teeth twice daily for 1 min., with the tooth‐shield in place and containing 1 ml of their assigned toothpaste.

Results: Thirty‐five subjects completed the study using the placebo, 36 used Mentadent P and 39 completed the study using Crest Gum Care. Both toothpastes containing active gum health ingredients (Triclosan and Zinc Citrate in Mentadent P and Stannous Fluoride in Crest Gum Care) resulted in statistically significant reductions in gingival bleeding and inflammation. Although a directional reduction, there was no statistically significant reduction in plaque scores. No significant differences between the two active groups were established.

Conclusion: The factors that were controlled or measured and analyzed in these studies were: gender, smoking status, age and chronic gingivitis level. The results add support to the hypothesis that male subjects show less variation, however there is limited evidence linking the female menstrual cycles to variations in gingivitis status. Further research in this area is required before definitive conclusions can be made. Selecting a subject population in order to decrease variation must be undertaken with caution. A subject population selected for particular attributes can be extremely valuable when assessing the anti‐gingivitis potential of new agents, but this population would be as biased if used for large efficacy clinical trials. The data obtained will not necessarily be able to be generalized, that is, applicable to the whole population. However there is sufficient evidence to justify balancing for (or excluding) smokers from subject populations in experimental gingivitis studies.