bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in the Elderly
Authors: ROSTOCK THOMAS , RISIUS TIM , VENTURA RODOLFO , KLEMM HANNO U. , WEISS CHRISTIAN , KEITEL ANNA , MEINERTZ THOMAS , WILLEMS STEPHAN
Published: June 2005

Introduction: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular supraventricular tachycardia in the general population as well as in elderly patients. The purpose of the study was to investigate the success and complication rate particularly regarding the induction of an atrioventricular (AV) block by radiofrequency (RF) ablation in elderly patients with and without a preexisting AV block.

Methods and Results: Between February 1998 and July 2004, all patients with symptomatic AVNRT referred for slow‐pathway ablation in our institution were included and divided into two groups: group 1 patients younger than 75 years (n = 508) and group 2 patients ≥75 years (n = 70).

A preexisting prolonged PR interval was present in 17 (3.3%) patients of group 1 and in 26 (37%, P < 0.0001) patients of group 2. Following successful slow‐pathway ablation (follow‐up time group 1: 37 ± 22, group 2: 37 ± 24 months) no induction of an AV block was observed in group 2 but in four patients of group 1 (0.79%) a complete heart block was induced requiring a pacemaker implantation. In group 1, 15 (2.95%) patients with a recurrence of AVNRT were readmitted for a repeat ablation procedure. No recurrences occurred in group 2.

Conclusion: Despite a higher incidence of preexisting prolonged PR intervals slow‐pathway ablation in elderly patients is both effective and safe and should be considered as the first line therapy also in this patient population
Ventricular Tachycardia Induced by Biventricular Pacing in Patient with Severe Ischemic Cardiomyopathy
Authors: MYKYTSEY ANDREW , MAHESHWARI PRADEEP , DHAR GAURAV , RAZMINIA MANSOUR , ZHEUTLIN TERRY , WANG TED , KEHOE RICHARD
Published: June 2005

Introduction: Cardiac resynchronization therapy (CRT) is a new alternative which affords symptomatic improvement in two‐thirds of patients who exhibit medically refractory congestive heart failure (CHF) as well as significant prolongation of the QRS duration (>135 msec). As more experience with CRT accrues, unexpected complications of this promising therapy may become apparent. Herein, we describe a patient with severe ischemic cardiomyopathy and refractory CHF who developed incessant ventricular tachycardia (VT) after the initiation of biventricular pacing.

The patient is a 75‐year‐old man who suffered an inferior myocardial infarction 6 years before presenting for CRT. He underwent a three‐vessel CABG in 1997. Subsequently, episodes of near syncopal sustained VT developed, for which he received a dual chamber ICD. In 2001 he developed refractory CHF and ECG revealed LBBB with a QRS duration of 195 msec. Shortly after the initiation of biventricular pacing, the patient developed multiple episodes of drug resistant monomorphic VT that could be terminated only transiently by ICD therapies.

Ultimately, the only intervention, which proved to be effective in eliminating VT episodes, was inactivation of LV pacing. Despite subsequent therapeutic regimen of sotalol, lidocaine, tocainide, and quinidine all subsequent attempts to reactivate LV pacing resulted in prompt VT recurrence.

Conclusion: This case represents a clear example of CRT induced proarrhythmia, which required inactivation of LV pacing for effective acute management. Such an intervention should be considered in CRT patients who exhibit a notable increase in drug refractory VT episodes.
Reduction of conjunctival bacterial flora by povidone‐iodine, ofloxacin and chlorhexidine in an outpatient setting
Authors: Barkana Yaniv , Almer Zina , Segal Ori , Lazarovitch Zipora , Avni Issac , Zadok David
Published: June 2005

Purpose:  To compare the reduction of conjunctival bacterial flora by povidone‐iodine 4%, ofloxacin 0.3%, and chlorhexidine 0.05% for endophthalmitis prophylaxis before corneal suture removal in an outpatient setting.

Methods:  In each group of 25 consecutive subjects who presented for outpatient ophthalmic evaluation, one eye was treated with either povidone‐iodine 4% (PI), ofloxacin 0.3% (Oflox) or chlorhexidine 0.05% (Chex). The other eye served as a control. Three minutes after treatment, cultures were taken from the inferior conjunctival sac in both eyes. Following incubation at 35 ° for 48 hours, the numbers of colonies were counted and compared. The difference in the numbers of colonies in each pair of treated and control eyes was assessed for each drug and compared.

Results:  The reduction in colony‐forming units was highly significant for each of the three drugs tested (Wilcoxon signed‐ranks test; p < 0.0001). There was no significant difference between percent reduction by the three drugs (Kruskal–Wallis test; p = 0.68). Sterile cultures following preparation by PI, Oflox and Chex were obtained in 52%, 68% and 52%, respectively.

Conclusions:  The regimens tested were similarly effective in reducing conjunctival commensals. They may all be considered as options for a quick prophylaxis against infection following suture removal in an outpatient setting.
Expression of basic fibroblast growth factor in rabbit corneal alkali wounds in the presence and absence of granulocytes
Authors: Gan Lisha , Fagerholm Per , Palmblad Jan
Published: June 2005

Purpose:  To study the expression of basic fibroblast growth factor (bFGF) in the early phases of corneal wound healing in the presence or absence of granulocytes.

Methods:  A central penetrating corneal alkali wound was inflicted to one eye in each of 14 rabbits under general anaesthesia. Subsequently, seven of the rabbits were given fucoidin i.v. for 36 hours in order to block the selectins on the vascular endothelium, thus preventing blood granulocytes from entering the tissues. Then, corneas were prepared, stained for bFGF and evaluated by light microscopy.

Results:  Whereas normal corneal epithelium expressed bFGF weakly, conjunctival epithelium did so strongly, particularly the goblet cells. The corneal endothelium showed medium staining, while keratocytes and vascular endothelial cells did not consistently express bFGF. After 36 hours of wound healing, a marked up‐regulation of bFGF expression was observed in the corneal epithelial and endothelial cells, as well as in the keratocytes, that were migrating into the wound. No other changes were noted. None of these features were modulated when granulocyte emigration was prevented by fucoidin administration.

Conclusions:  The difference in bFGF expression between the corneal and conjunctival epithelium suggests a role for this growth factor in the barrier function at the limbus. Moreover, the specific presence of bFGF in cells migrating into the wound indicates the participation of bFGF in corneal wound healing. Expression of bFGF was independent of granulocytes.
Dominant optic atrophy: correlation between clinical and molecular genetic studies
Authors: Puomila Anu , Huoponen Kirsi , Mäntyjärvi Maija , Hämäläinen Petra , Paananen Reetta , Sankila Eeva‐Marja , Savontaus Marja‐Liisa , Somer Mirja , Nikoskelainen Eeva
Published: June 2005

Purpose:  To assess the clinical picture and molecular genetics of 14 Finnish families with dominant optic atrophy (DOA).

Methods:  The clinical status of family members was based on the assessment of visual acuity, colour vision, visual fields and optic nerve appearance; 31 individuals were affected, two suspect and 21 unaffected. A total of 30 coding exons and exon− intron boundaries of the OPA1 gene were sequenced in order to detect mutations.

Results:  Half the patients were diagnosed at the age of ≤ 20 years. Ten out of 20 affected individuals followed up for ≥ 6 years had a progressive disease and 10 had a stable disease. According to WHO criteria, 36% of the affected patients were visually handicapped. Eight OPA1 pathogenic mutations, all but one novel, and 18 neutral polymorphisms were detected.

Conclusion:  The most sensitive indicators of DOA were optic disc pallor and dyschromatopsia. With molecular genetic analysis, asymptomatic mutation carriers and DOA cases with a mild clinical outcome were ascertained. No mutational hotspot or Finnish major mutation in the OPA1 gene could be demonstrated as most families carried a unique mutation. No obvious genotype− phenotype correlation could be detected. Detailed clinical assessment and exclusion of non‐DOA families prior to mutation screening are necessary for obtaining a high mutation detection rate.
Placing the Molteno implant in a long scleral tunnel to prevent postoperative tube exposure
Authors: Ollila Marko , Falck Aura , Airaksinen P. Juhani
Published: June 2005

Purpose:  The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a new technique where the silicone tube is inserted into a scleral tunnel instead of being covered only by the conjunctiva.

Methods:  We reviewed Molteno implants carried out at the University Hospital of Oulu, in 332 patients who underwent traditional Molteno implantation between October 1986 and October 1998 and 92 patients who underwent surgery with the new technique between November 1998 and April 2001.

Results:  With our former technique, conjunctival erosions occurred in 15 eyes of 15 patients (4.5%) after a median follow‐up of 3.5 months (range 1–72 months); no conjunctival complications were discovered in patients who underwent surgery using the new technique during a median follow‐up of 22 months (range 10–39 months). (p = 0.038, two‐sample test of proportions).

Conclusion:  Inserting the Molteno tube into a scleral tunnel prevents tube extrusion through the conjunctiva in eyes with Molteno implants. The technique for making the scleral tunnel is described.
Alpha‐1‐‐antitrypsin in aqueous humour from patients with corneal allograft rejection
Authors: Funding Mikkel , Vorum Henrik , Nexø Ebba , Ehlers Niels
Published: June 2005

Purpose:  To investigate the presence and concentration of α1‐antitrypsin in aqueous humour at the time of corneal rejection and to compare results obtained from patients with reversible and irreversible rejection.

Methods:  Samples of aqueous humour were obtained from 17 patients with acute corneal endothelial allograft rejection. The presence of α1‐antitrypsin in aqueous humour was confirmed by immunoblotting and measured employing a sandwich ELISA. Total protein concentrations in aqueous humour were measured using Bradford's method. The outcome of corneal rejection episodes was determined 1 month after diagnosing corneal rejection and described as reversible or irreversible rejection.

Results:  α1‐antitrypsin was detected in aqueous humour. Patients with reversible rejection had significantly higher α1‐antitrypsin concentration than patients with irreversible rejection (p = 0.044). There was no significant difference in total protein concentrations (p = 0.745), and no correlation was found between α1‐antitrypsin and total protein concentrations (p = 0.368).

Conclusions:  α1‐antitrypsin in aqueous humour seems to signal a favourable outcome of corneal rejection. The possible mechanism is discussed.
Ethmoidal osteoma with intraorbital extension: excision through a transcutaneous paranasal incision
Authors: Karapantzos Ilias , Detorakis Efstathios T. , Drakonaki Eleni E. , Ganasouli Dimitra L. , Danielides Vassilios , Kozobolis Vassilios P.
Published: June 2005

Purpose:  To describe a case of conjunctival hyperaemia and proptosis of the right eye.

Methods:  Three‐dimensional computed tomography (CT) was performed to reveal the size and position of a lesion of osseous density extending into the right orbit. The lesion was then excised using a right paranasal transcutaneous approach.

Results:  The pathology report suggested ethmoidal osteoma. The postoperative course was uncomplicated and the lesion did not recur during a 5‐year follow‐up period. Repeated postoperative ophthalmic examinations revealed preservation of visual acuity and visual fields postoperatively.

Discussion:  Diagnosis is based on imaging studies, especially CT and three‐dimensional CT scans. A three‐dimensional CT scan is critical in understanding the actual dimensions of the tumour and its relations with other structures. Surgical removal is indicated in cases with orbital matrix compression and displacement. A transcutaneous paranasal approach allows for increased exposure of affected structures.
Chromosomal imbalances in some benign orbital tumours
Authors: Rødahl Eyvind , Lybæk Helle , Arnes Jarle , Ness Gro Oddveig
Published: June 2005

Purpose:  To examine benign orbital tumours for chromosomal imbalances.

Methods:  Specimens obtained from orbital tumours were screened for chromosomal imbalances using high resolution comparative genomic hybridization (CGH). The imbalances detected by CGH were confirmed by using fluorescence in situ hybridization (FISH) and loss of heterozygosity (LOH) analysis.

Results:  Chromosomal gains or losses were seen in 4/6 pleomorphic adenomas (gains at 8q; losses at 4p, 5p, 8p, 11p and 14q), 2/4 schwannomas (losses at 16p and 22q), and 1/9 cavernous haemangiomas (losses at 13q). Compared to previous studies of pleomorphic adenomas using G‐band analysis, chromosomal imbalances were more frequently detected by using CGH. Gains of 8q11−q22 and losses of 4p15−pter, 11p12−p15, and 14q12−q23 in pleomorphic adenomas, losses of 16p12−p13 in schwannomas, and losses of 13q32−qter in cavernous haemangiomas have not been reported previously.

Conclusions:  A range of chromosomal imbalances was detected even within tumours of the same histological subtype. We did not observe common chromosomal gains or losses that were characteristic for orbital presentation of the tumours. The clinical relevance of the abnormalities is uncertain, but they may indicate the position of genes that could play a role in tumour development.
Duration of face‐down positioning after macular hole surgery: a comparison between 1 week and 3 days
Authors: Krohn Jørgen
Published: June 2005

Purpose:  To investigate whether shortening the duration of face‐down positioning from 1 week to 3 days affects the anatomical success rate of macular hole surgery.

Methods:  A total of 53 consecutive eyes in 50 patients with full thickness macular holes of 2–24 months' (average 10 months) duration were included in the study. In 20 eyes (37.7%) the hole had been present for more than 1 year. All patients were operated with vitrectomy, removal of the posterior hyaloid and a complete fluid‐gas exchange. Peeling of the internal limiting membrane (ILM) was not performed. Postoperatively, the duration of face‐down positioning differed between two consecutive groups of patients. The first group (29 patients) was instructed to keep their heads face‐down for 7 days, while the second group (24 patients) maintained face‐down positioning for only 3 days.

Results:  Overall, 90.6% of the macular holes closed with one operation. The macular hole closed successfully in 27 (93.1%) of the 29 eyes in the 1‐week group and in 21 (87.5%) of the 24 eyes in the 3‐day group (p > 0.05).

Conclusion:  Although the frequency of hole closure differed slightly in the two study groups, the difference was far from statistically significant. Thus, the results indicate that 3 days of strict face‐down positioning are sufficient to achieve closure of even longstanding macular holes without removal of the ILM.
The cut‐and‐paste method for primary pterygium surgery: long‐term follow‐up
Authors: Koranyi Gabor , Seregard Stefan , Kopp Eva Dafgård
Published: June 2005

Objective:  To evaluate the recurrence rate, reoperation rate and side‐effects of a novel technique for pterygium surgery.

Design:  Retrospective study.

Participants:  The study included 461 eyes of 381 patients operated for primary nasal pterygium by the same surgeon between 1994 and 2003 and followed for 23 ± 20 months (range 6–112 months).

Methods:  Autologous conjunctival grafts harvested at the superotemporal limbus were used to cover the sclera after pterygium excision. Using a retrospective chart review, the outcome after attaching the transplant to the sclera with a fibrin tissue adhesive (n = 325) was compared to the outcome after graft attachment using absorbable sutures (n = 136).

Main outcome measures:  Recurrence rate, reoperation rate and complications.

Results:  The recurrence rate was 5.3% in the glue group and 13.5% in the suture group (p = 0.01). The reoperation rates were 1.2% and 3.3%, respectively (p = 0.31). Complications, such as transient transplant oedema and persistent corneal epithelial defects, occurred equally in both groups.

Conclusion:  Using a fibrin tissue adhesive instead of sutures when attaching the conjunctival transplant in primary pterygium surgery results in a significantly lower recurrence rate.
Nordic research in ophthalmology
Authors: Heijl Anders , Algvere Peep V. , Alm Albert , Andersen Nis , Bauer Birgitta , Carlsson Jan‐Olof , Ehinger Berndt , Eide Nils , Fledelius Hans , Foerster Michael , Hjortdal Jesper , Holmström Gerd , Høvding Gunnar , Kivelä Tero , La Cour Morten , Lindblom Bertil , Møller‐Pedersen Torben , Nikoskelainen Eeva , Prause Jan Ulrik , Riise Ruth , Rosenberg Thomas , Seregard Stefan , Stefánsson Einar , Tarkkanen Ahti , Tervo Timo , Tornqvist Kristina , Zetterström Charlotta
Published: June 2005

Nordic ophthalmologists and vision scientists are active in many fields of eye research. This is most evident at the biannual Nordic Congress of Ophthalmology, most recently held in Malmö in June 2004. The authors here review some of the research in vision and ophthalmology presented at this meeting or published recently by Nordic scientists. This paper does not represent a comprehensive review of all Nordic research in the field, but attempts to give an overview of some of the activities underway in eye research in this part of the world.
Research reports on treatments for bipolar disorder: preliminary assessment of methodological quality
Authors: Soldani F. , Ghaemi S. N. , Baldessarini R. J.
Published: June 2005

Objective: To assess frequencies of types of publications about bipolar disorder (BD) and evaluate methodological quality of treatment studies.

Method: We classified 100 randomly selected articles (1998–2002) from five psychiatric journals with highest impact ratings, by topic areas, and assessed methods employed in treatment studies.

Results: Topics ranked: treatment (41%; 37% on pharmacotherapy) > biology (31%) > psychopathology (14%) = miscellaneous (14%). Of treatment studies, only 19% of original articles were randomized, 15% were relatively large (n ≥ 50) but non‐randomized, 65% were small non‐randomized, case‐series or ‐reports, and 53% relied on baseline‐to‐endpoint contrasts without a control group. Patient dropout rates were ≥40% in 43% of prospective studies. Only two reports provided confidence intervals; one included a power analysis, and 53% included no references on study design or statistical methods.

Conclusion: Even in highly respected journals, the typical methodological quality of recent reports on therapeutics for BD was unexpectedly limited, and psychopathology and psychotherapies were little studied.
Recurrent V75M mutation within the Wiskott–Aldrich syndrome protein: description of a homozygous female patient
Authors: Proust Alexis , Guillet Benoît , Pellier Isabelle , Rachieru Petronela , Hoarau Cyrille , Claeyssens Ségolène , Léonard Claude , Charrier Sabine , Vainchenker William , Tchernia Gil , Delaunay Jean
Published: June 2005

Abstract:  The Wiskott–Aldrich syndrome is a rare genetic disorder due to mutations in the WAS gene situated on chromosome X. It is comprised of microthrombocytopenia, eczema and immunodeficiency. However, the phenotypical presentation may vary as to the number and intensity of its manifestations. A milder form of Wiskott–Aldrich syndrome is known as the X‐linked thrombocytopenia. We independently found eight individual or familial cases with the V75M substitution (9.76%). This high incidence was partly accounted for by the fact that three cases turned out to be related. The V75M mutation is recurrent, however, due to a CpG island. A genuine homozygous female patient was found. She showed microthrombocytopenia and infections to the same degree as her hemizygous father and brother. The WAS protein was decreased in a comparable fashion in the hemizygotes and the homozygote as well. Its amount was about 10% and 15% of normal in platelets and mononucleated white cells, respectively. In all patients was the picture consistent with XLT.
Two β‐globin cluster‐linked polymorphic loci in thalassemia patients of variable levels of fetal hemoglobin
Authors: Bandyopadhyay Sanmay , Mondal Bama Charan , Sarkar Pabak , Chandra Sarmila , Das M. K. , Dasgupta Uma B.
Published: June 2005

Abstract:  Objective: To correlate different polymorphisms of the β‐globin cluster with fetal hemoglobin (HbF) level in β‐thalassemia and E‐β thalassemia patients. Methods: Fifteen thalassemia patients, seven with high HbF and not requiring transfusion, eight with lower HbF and requiring transfusion were studied for β‐globin mutation, concurrent inheritance of α‐thalassemia, RFLP haplotype, a C→T polymorphism at −158 of Gγ and configuration of an (AT)xTy motif at −540 of β‐globin gene. Results: Senegal 5′β‐haplotype and the polymorphism at −158 of G was (P = 0.063) was linked to the high‐HbF phenotype but the (AT)9T5 configuration of the (AT)xTy motif was not (P = 0.6). Study of 30 chromosomes revealed 7 different configurations of the (AT)xTy motif. Association of these motifs with specific β‐globin mutations of this region has also been determined. Conclusion: The senegal haplotype and the polymorphism at −158 of G was linked to the high‐HbF phenotype.
Unrelated bone marrow transplantation for high‐risk anaplastic large cell lymphoma in pediatric patients: a single center case series
Authors: Cesaro S. , Pillon M. , Visintin G. , Putti M. C. , Gazzola M. V. , D'Amore E. , Scarzello G. , Zanesco L. , Messina C. , Rosolen A.
Published: June 2005

Abstract:  Objectives: The use of allogeneic stem cell transplantation in NHL patients is not yet clearly defined, especially in children and adolescents, but this option offers the advantages of a tumor‐free graft and the possible induction of a graft‐vs.‐tumor effect. Patients and methods: We report the results of four consecutive pediatric patients affected by anaplastic large cell lymphoma (ALCL) and treated with allogeneic stem cell transplantation from an unrelated donor. The conditioning regimen was based on total body irradiation given in association with etoposide in three patients, and with thiotepa and cyclophoshamide in one patient. Graft‐vs.‐host disease (GVHD) prophylaxis consisted of cyclosporin, a short course of methotrexate and rabbit antithymocyte globulin. Results: All patients had rapid engraftment within 3–4 wk for neutrophils and platelets, and achieved a stable full donor chimerism that has been maintained to the last follow‐up visit. One patient later developed a restrictive pneumonopathy. This patient had been heavily pretreated during the course of the disease having suffered four relapses and had received a cumulative dose of bleomycin of 160 mg/m2. After a follow‐up of 11–42 months, all patients are alive in complete hematological and molecular remission; and three of them without any chronic GVHD. Conclusions: The increasing number of volunteer bone marrow donors and the reduced toxicity of unrelated stem cell transplantation, especially in children, make this therapeutic option worth more extensive investigation in the treatment of high‐risk failure ALCL, although more data is needed to evaluate the long‐term benefits. In this regard, the presence of factors predictive of worst outcome such as an early relapse (within 12 months from diagnosis), a refractory or relapsing ALCL and the persistent detection on blood or bone marrow of nucleophosmin‐anaplastic lymphoma kinase protein (NPM‐ALK) transcript may help select the patients eligible to allogeneic related or unrelated stem cell transplantation.
Immunophenotypic and genetic characterization of a CD8 positive Mantle Cell Lymphoma in a patient with concomitant Mycosis Fungoides
Authors: Schroers Roland , Hildebrandt York , Steffens Rainer , Becker Sabrina , Ohms Gudrun , von Bonin Frederike , Haase Detlef , Bertsch Hans P. , Trümper Lorenz , Griesinger Frank
Published: June 2005

Abstract:  Mantle cell lymphoma (MCL) is immunophenotypically characterized by cell surface co‐expression of CD19, CD20, CD5, IgM and FMC7. However, the concomitant presence of other antigens distinctive of a particular leukocyte subset, e.g. T‐lymphocytes, is an exceptional finding in MCL. Here, the first case of a blastic MCL in leukaemic phase with aberrant expression of the T‐cell associated antigen CD8 occurring in a patient with concomitant Mycosis fungoides is described. Comprehensive immunophenotypic analysis showed that the MCL cells expressed the typical B‐lymphocytic markers, were CD5 and CD8 positive, but did not express other T‐cell proteins, such as CD2, CD3, CD4, CD7, TCRαβ and TCRγδ. The MCL cells expressed both CD8α and CD8β chains indicating cell surface presence of CD8αβ heterodimers. Intriguingly, expression of the cytotoxic enzymes perforin and granzyme A was detected by RT‐PCR. Cytogenetic and molecular genetic analysis of the lymphoma cells confirmed cyclin D1 overexpression secondary to the t(11;14)(q13;32) chromosomal translocation. Furthermore, trisomy 11, trisomy 14 and extra copies of t(11;14) translocated chromosomes were detected in sub clones of the analyzed MCL cells. Clinically, an aggressive course of disease including cerebral lymphoma involvement was noted in the reported patient. Hence, systematic studies addressing the incidence, biology and clinical behavior of this form of MCL seem to be justified in future.
Neutropenic enterocolitis in adults: systematic analysis of evidence quality
Authors: Gorschlüter Marcus , Mey Ulrich , Strehl John , Ziske Carsten , Schepke Michael , Schmidt‐Wolf Ingo G. H. , Sauerbruch Tilman , Glasmacher Axel
Published: June 2005

Abstract:  Objective: Neutropenic enterocolitis is a life‐threatening complication occurring most frequently after intensive chemotherapy in acute leukaemias. The literature is heterogenous and a systematic review is lacking. Methods: Following a systematic search we categorised all relevant reports according to their quality and extracted evidence to answer the questions: Which diagnostic criteria are appropriate? What is the incidence of neutropenic enterocolitis? Are there good quality studies supporting specific interventions: Which empiric antimicrobial therapy is recommendable? Is neutropenic enterocolitis without surgical emergency complications an indication for bowel resection? Results: We found and analysed 145 articles of these reports: 64 were reports of single cases, 30 papers reported of two or three cases, 13 were narrative reviews, 34 were retrospective case series of more than three cases and four were prospective diagnostic studies. There were no prospective trials or case control studies on the therapy of neutropenic enterocolitis. There was no consensus on diagnostic criteria. We discuss the difficulty to define diagnostic criteria without having a disease definition. Histology is mostly not available in the living patients. We suggest applying a combination of clinical and radiological criteria: fever, abdominal pain and any bowel wall thickening >4 mm detected by ultrasonography (US) or computed tomography. We calculated a pooled incidence rate from 21 studies of 5.3% (266/5058; 95% CI: 4.7%–5.9%) in patients hospitalised for haematological malignancies, for high‐dose chemotherapy in solid tumours or for aplastic anaemia. Conclusions: This systematic review provides diagnostic criteria for neutropenic enterocolitis, presents a quantitative synthesis on its incidence and discusses its treatment recommendations. Prospective studies are clearly warranted.
Autologous stem cell transplantation in multiple myeloma: outcome in patients with renal failure
Authors: Knudsen Lene M. , Nielsen Bendt , Gimsing Peter , Geisler Christian
Published: June 2005

Abstract:  The impact of renal failure on prognosis of multiple myeloma patients treated with high‐dose chemotherapy and stem cell support is incompletely studied. A total of 137 patients received high‐dose chemotherapy with autologous transplantation at our centre. The patient population was divided into three groups based on their estimated creatinine clearance (Ccr); renal failure defined as Ccr < 60 mL/min: Group A: normal renal function both at diagnosis and at transplant (n = 78), Group B: renal failure at diagnosis but normal renal function at transplant (n = 30), Group C: renal failure both at diagnosis and at transplant (n = 29). There were no differences in the number of stem cells harvested, time to engraftment or response to transplantation between the groups. Ten of the patients in Group C had a normalisation of renal function post‐transplant. Significantly longer hospitalisation, increased use of blood products and increased number of infections were seen in Group C compared to Groups A and B. The transplant‐related mortality was 17% in Group C compared to 0% and 1% in Groups B and A respectively. Eight patients were on dialysis during transplant and four of these died within the first 100 d post‐transplant. Disease response was similar in the three groups. Overall survival was significantly longer in Group A than in Groups B and C. High‐dose chemotherapy with autologous transplantation is feasible in MM with renal failure. Whereas patients with moderate renal insufficiency seem to benefit from this treatment, patients in need for dialysis at the time of transplant must be carefully evaluated before proceeding to high‐dose chemotherapy.
Antisperm Antibodies in Semen, Sera and Follicular Fluids of Infertile Patients: Relation to Reproductive Outcome after In Vitro Fertilization
Authors: Vujisić Sanja , Lepej Snježana Židovec , Jerković Lidija , Emedi Ivana , Sokolić Božica
Published: June 2005

Problem:  Data given in the literature, regarding the influence of antisperm antibodies (ASA) in the semen and/or sera on in vitro fertilization (IVF) procedure outcome are controversial. The aim of this study was to compare the prevalence of ASA in semen, peripheral blood and follicular fluid as well as to determine total immunoglobulin concentration in the serum and follicular fluid. Selected parameters were analyzed with regard to IVF outcome.

Method of study:  The study enrolled 52 married couples. ASA in the semen was determined by direct immunobead mixed antiglobulin reaction (MAR Screen test), while in the peripheral blood and follicular fluid was determined by indirect immunobead MAR Screen test. Immunoglobulin (IgG, IgM and IgA) concentration in the follicular fluid and serum was determined by a liquid‐phase immunoprecipitation assay with nephelometric end‐point detection and analyzed with regard to IVF outcome.

Results:  Semen MAR test IgG was <20% in 38 couples, and >20% in 14 couples. Fertilization (73.2% versus 71.5%) and pregnancy rates (28.9% versus 28.57%) in both groups of patients were not significantly different. The results of direct and indirect MAR test were not associated with fertilization and pregnancy rates. Total serum IgG, IgM and IgA in infertile women were within normal ranges. Follicular fluid IgG was within normal values for serum samples, while IgA and IgM were decreased.

Conclusion:  The presence of ASA on sperm or in the serum and follicular fluid was not associated with IVF outcome in the couples with good quality semen characteristic.
The Factor V Leiden and the G20210A Prothrombin Gene Mutations are Rare in Women with Fetal Death
Authors: Sullivan Amy E. , Nelson Lesa , Rice Juhree A. , Flint Porter T. , Ware Branch D. , Silver Robert M.
Published: June 2005

Problem:  To determine if there is an association between two commonly inherited thrombophilias, the factor V Leiden and the G20210A prothrombin mutations, and fetal death.

Method of study:  We used a case–control study design to compare the frequencies of these mutations in women with fetal death and controls. Fetal death was the intrauterine death of the conceptus ≥10 weeks gestation. Controls had one live birth, no miscarriages, and no fetal death. Results were compared using chi square analysis.

Results:  One hundred and seventy‐five cases and controls were identified. There were 4.6% of cases and 3.8% of controls heterozygous for the factor V Leiden mutation (NS), and 1.3% of cases and 1.7% of controls heterozygous for the prothrombin mutation (NS).

Conclusion:  In our population, neither the factor V Leiden nor the G20210A prothrombin mutations are associated with fetal death. Further evidence is required before routine screening for these mutations can be recommended.
Maternal Cytokine Production Patterns in Women with Pre‐eclampsia
Authors: Azizieh Fawaz , Raghupathy Raj , Makhseed Ma'asoumah
Published: June 2005

Problem:  To determine the levels of cytokines produced upon mitogenic or antigenic stimulation of maternal peripheral blood mononuclear cells (PBMC) from women with pre‐eclampsia.

Method of study:  PBMC from 54 women with a history of successful pregnancy and 32 women undergoing pre‐eclamptic delivery were stimulated with a mitogen or with autologous placental cells or with trophoblast antigens, and the levels of cytokines released into the culture supernatants then assessed by enzyme‐linked immunosorbent assay.

Results:  Significantly higher levels of the Th1 cytokines, interferon‐γ, and tumor necrosis factor‐α were produced by the pre‐eclamptic group than by the normal pregnancy group, which on the contrary showed significantly greater production of the Th2 cytokines, interleukin (IL)‐4, IL‐5, IL‐6 and IL‐10. A comparison of the ratios of Th2 to Th1 cytokines indicates a higher Th1 cytokine bias in pre‐eclampsia as compared with normal pregnancy.

Conclusions:  These data are suggestive of a maternal pro‐inflammatory cytokine bias in pre‐eclampsia.
Research and theory for Nursing and Midwifery: Rethinking the Nature of Evidence
Authors: McCourt Christine
Published: June 2005

Background and Rationale: The rise in the principles of evidence‐based medicine in the 1990s heralded a re‐emerging orthodoxy in research methodologies. The view of the randomised controlled trial (RCT) as a “gold standard” for evaluation of medical interventions has extended recently to evaluation of organisational forms and reforms and of change in complex systems—within health care and in other human services. Relatively little attention has been given to the epistemological assumptions underlying such a hierarchy of research evidence.

Aims and Methods: Case studies from research in maternity care are used in this article to describe problems and limitations encountered in using RCTs to evaluate some recent policy‐driven and consumer‐oriented developments. These are discussed in relation to theory of knowledge and the epistemological assumptions, or paradigms, underpinning health services research. The aim in this discussion is not to advocate, or to reject, particular approaches to research but to advocate a more open and critical engagement with questions about the nature of evidence.

Findings and Discussion: Experimental approaches are of considerable value in investigating deterministic and probabilistic cause and effect relationships, and in testing often well‐established but unevaluated technologies. However, little attention has been paid to contextual and cultural factors in the effects of interventions, in the culturally constructed nature of research questions themselves, or of the data on which much research is based. More complex, and less linear, approaches to methodology are needed to address these issues. A simple hierarchical approach does not represent the complexity of evidence well and should move toward a more cyclical view of knowledge development.

Worldviews on Evidence‐Based Nursing 2005; 2(2):75‐83
Three Options Are Optimal for Multiple‐Choice Items: A Meta‐Analysis of 80 Years of Research
Authors: Rodriguez Michael C.
Published: June 2005

Multiple‐choice items are a mainstay of achievement testing. The need to adequately cover the content domain to certify achievement proficiency by producing meaningful precise scores requires many high‐quality items. More 3‐option items can be administered than 4‐ or 5‐option items per testing time while improving content coverage, without detrimental effects on psychometric quality of test scores. Researchers have endorsed 3‐option items for over 80 years with empirical evidence—the results of which have been synthesized in an effort to unify this endorsement and encourage its adoption.
The Quality of Local District Assessments Used in Nebraska's School‐Based Teacher‐Led Assessment and Reporting System (STARS)
Authors: Brookhart Susan M.
Published: June 2005

A sample of 293 local district assessments used in the Nebraska STARS (School‐based Teacher‐led Assessment and Reporting System), 147 from 2004 district mathematics assessment portfolios and 146 from 2003 reading assessment portfolios, was scored with a rubric evaluating their quality. Scorers were Nebraska educators with background and training in assessment. Raters reached an agreement criterion during a training session; however, analysis of a set of 30 assessments double‐scored during the main scoring session indicated that the math ratings remained reliable during scoring, while the reading ratings did not. Therefore, this article presents results for the 147 mathematics assessments only. The quality of local mathematics assessments used in the Nebraska STARS was good overall. The majority were of high quality on characteristics that go to validity (alignment with standards, clarity to students, appropriateness of content). Professional development for Nebraska teachers is recommended on aspects of assessment related to reliability (sufficiency of information and scoring procedures).
Resistance to Confounding Style and Content in Scoring Constructed‐Response Items
Authors: Schafer William D. , Gagné Phill , Lissitz Robert W.
Published: June 2005

An assumption that is fundamental to the scoring of student‐constructed responses (e.g., essays) is the ability of raters to focus on the response characteristics of interest rather than on other features. A common example, and the focus of this study, is the ability of raters to score a response based on the content achievement it demonstrates independent of the quality with which it is expressed. Previously scored responses from a large‐scale assessment in which trained scorers rated exclusively constructed‐response formats were altered to enhance or degrade the quality of the writing, and scores that resulted from the altered responses were compared with the original scores. Statistically significant differences in favor of the better‐writing condition were found in all six content areas. However, the effect sizes were very small in mathematics, reading, science, and social studies items. They were relatively large for items in writing and language usage (mechanics). It was concluded from the last two content areas that the manipulation was successful and from the first four that trained scorers are reasonably well able to differentiate writing quality from other achievement constructs in rating student responses.
An NCME Instructional Module on Developing and Administering Practice Analysis Questionnaires
Authors: Raymond Mark R.
Published: June 2005

The purpose of a credentialing examination is to assure the public that individuals who work in an occupation or profession have met certain standards. To be consistent with this purpose, credentialing examinations must be job related, and this requirement is typically met by developing test plans based on an empirical job or practice analysis. The purpose of this module is to describe procedures for developing practice analysis surveys, with emphasis on task inventory questionnaires. Editorial guidelines for writing task statements are presented, followed by a discussion of issues related to the development of scales for rating tasks and job responsibilities. The module also offers guidelines for designing and formatting both mail‐out and Internet‐based questionnaires. It concludes with a brief overview of the types of data analyses useful for practice analysis questionnaires.
SOLUBILITY OPTIMIZATION OF OIL COMPONENTS IN SUPERCRITICAL CARBON DIOXIDE
Authors: ARTZ W.E. , KINYANJUI T. , CHERYAN M.
Published: June 2005

The solubilities of oleic acid, linoleic acid and soybean oil were determined in supercritical carbon dioxide and in supercritical carbon dioxide containing added hexane (10% v/v) at eight different pressures (136–372 atm) and at each of four different temperatures (35, 40, 45 and 50C). An ISCO supercritical fluid extraction system was used to determine the solubility of selected components of crude soybean oil; triacylglycerols, oleic acid and linoleic acid. An increase in density increased the solubility for all three components up to ~306 atm and 45C. The solubility for oleic acid was 2.10 ± 0.32 mg/mL (averaged over the entire range of conditions); for soybean oil, 1.40 ± 0.29 mg/mL; and for linoleic acid, 0.93 ± 0.26 mg/mL of supercritical fluid. On average, adding 10% hexane as a cosolvent to the supercritical carbon dioxide increased component solubility by ~40% at 35C and ~240% at 50C.
PHYSICAL REFINING: ELECTROLYTE DEGUMMING OF NONHYDRATABLE GUMS FROM SELECTED VEGETABLE OILS
Authors: NASIRULLAH
Published: June 2005

A new degumming protocol has been developed which employs electrolyte solutions to remove nonhydratable gums from soybean, rice bran and mustard oils. It removes nonhydratable gums, mostly phosphatidic acid (PA) and phosphatidyl ethanolamine (PE), which is left out after water degumming, and could not be removed without the use of phosphoric or citric acid. Acid degumming is associated with oil loss (∼10%) due to the emulsifying nature and subsequent washings. However, physical degumming with electrolyte solutions, when combined with water degumming, removes nonhydratable gums with much less oil loss (∼4%). The water‐degummed vegetable oils, when treated with 2% of electrolyte solution, prepared by mixing aqueous solution of 1.5% of potassium chloride and 0.5% of sodium chloride in a ratio of 95 : 5 (v/v), yielded degummed soybean, rice‐bran and mustard oils with phospholipid contents as low a 0.05, 0.06 and 0.02%, respectively. Gums recovered through this technique can easily be regenerated and used for commercial purposes.
PREPARATION OF TOCOCHROMANOL CONCENTRATE FROM RED PALM OIL
Authors: SZULCZEWSKA‐REMI A. , NOGALA‐KALUCKA M. , KWIATKOWSKI J. , LAMPART‐SZCZAPA E. , RUDZINSKA M.
Published: June 2005

Palm oil is a rich source of tocopherols and tocotrienols (tocochromanols) that are active in cancer therapy and prevention of cardiovascular diseases. The aim of this work was to prepare a tocochromanol concentrate from red palm oil. A three‐step crystallization process of acylglycerols from crude red palm oil was employed and compared with supercritical fluid extraction (SFE) with CO

2

. Crude samples and concentrates were subjected to fatty acid and sterol analyses by GC, while tocochromanols and beta‐carotene were quantified by HPLC. The three‐step crystallization process afforded a much higher tocopherol and tocotrienol concentration as compared to the SFE procedure. The amounts of tocochromanols increased consistently compared to the initial values in red palm oil, especially for tocotrienols. The three‐step crystallization also eliminated more than 40% of saturated fatty acids present in the crude palm oil.
ANTIOXIDATIVE FLAVONOIDS FROM THE FLOWER OF INULA BRITANNICA
Authors: BAI NAISHENG , ZHOU ZHU , ZHU NANQUN , ZHANG LI , QUAN ZHENG , HE KAN , ZHENG QUN YI , HO CHI‐TANG
Published: June 2005

Eight flavonoids were identified from the flowers of Inula britannica var. chinensis as luteolin, diosmetin, chrysoeriol, kaempferol, quercetin, 6‐hydroxyluteolin‐6‐methyl ether, spinacetin and eupatin. Their structures were established by spectroscopic methods. All of the identified compounds exhibited considerable antioxidant activity in the 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) assay. Diosmetin (2) showed a strong growth inhibitory effect against P‐388 leukemia cells.
IMPROVING THE OXIDATIVE STABILITY OF SUNFLOWER OIL BY BLENDING WITH SCLEROCARYA BIRREA AND ASPONGOPUS VIDUATUS OILS
Authors: MARIOD A. , MATTHÄUS B. , EICHNER K. , HUSSEIN I.H.
Published: June 2005

Improvement of the oxidative stability of sunflower kernel oil (SKO) by blending with highly stable unconventional edible Sudanese oils was investigated. Blends (9 : 1, 8 : 2, 7 : 3, 6 : 4, w/w) of sunflower oil with Sclerocarya (Sclerocarya birrea) oil (SCO) and melon bug (Aspongopus viduatus) oil (MBO), respectively, were studied with respect to the fatty acid composition, the oxidative stability (Rancimat 120C) and stability at 70C using peroxide value. By increasing the proportion of SCO and MBO in SKO, the linoleic acid content decreased from 46.3 to 31.2% (SCO) and 30.1% (MBO), respectively, while the oleic acid content increased from 41.3 to 51.0% (SCO) and 43.9% (MBO), respectively. As a result of blending SKO with SCO and MBO, respectively, the oxidative stability in the Rancimat test was improved from 47 to 147% in (SCO) and from 5 to 68% (MBO) compared to the SKO as control, with increasing parts of SCO and MBO, respectively. Storage of the blends at 70C showed that the increase of the peroxide value as a measure of oxidation was remarkably lower for the mixtures of MBO and SCO with SKO than for pure SKO. This study demonstrated a means for improving the stability of sunflower oil by blending with SCO and MBO.
CHARACTERIZATION IN THE FATTY ACID DISTRIBUTIONS OF TRIACYLGLYCEROLS AND PHOSPHOLIPIDS IN KIDNEY BEANS (PHASEOLUS VULGARIS L.)
Authors: YOSHIDA HIROMI , TOMIYAMA YUKA , MIZUSHINA YOSHIYUKI
Published: June 2005

The fatty acid distribution of triacylglycerols (TAGs) and major phospholipids (PLs) in kidney beans (Phaseolus vulgaris L.) was investigated. The lipids extracted from five cultivars were separated by thin‐layer chromatography (TLC) into seven fractions. The major lipid components were TAGs and PLs, while hydrocarbons (HCs), steryl esters (SEs), free fatty acids (FFAs) and diacylglycerols (DAGs) (sn‐1,3 and sn‐1,2) were also present in minor proportions. With a few exceptions, the dominant phospholipid components were phosphatidylcholine (PC), followed by phosphatidylethanolamine (PE) or phosphatidylinositol (PI). Significant differences (P < 0.05) in fatty acid distributions existed when different kidney bean cultivars were examined. However, the principal characteristics of fatty acid distributions in the TAGs were evident among five cultivars; unsaturated fatty acids were predominantly concentrated in the sn‐2‐position, and saturated fatty acids primarily occupied the sn‐1‐ or sn‐3‐position in the oils of the beans.