bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital analysis of mouthrinses’ staining characteristics on provisional acrylic resins
Authors: CAL E. , GÜNERI P. , KOSE T.
Published: March 2007

summary  Provisional restorations are expected to be both aestethically and physically durable during the preparation of permanent restorations. In this study, the staining properties of mouthrinses containing chlorhexidine gluconate, benzydamine hydrochloride and a hybrid mouthrinse were investigated on light and dark shades of a provisional acrylic resin. Totally 80 specimens were prepared and were photographed digitally to obtain the baseline L*, a*, b* values. Each sample was immersed in test solutions for 12 h which was equivalent time to 1 year of mouthrinse use, and the post‐treatment images of the test materials were acquired. All L*, a*, b* values were analysed by a graphic software, and the total colour change (ΔE*) of each specimen was calculated. Also the same colour analyses were performed on all test solutions to establish their colour parameters. Analysis of variance and Tukey's tests were used for statistical analyses and alpha was 0·05. All test solutions produced perceptible staining on the provisional material, with ΔE values over 3·7. In both shades, hybrid rinse caused the highest staining (ΔE = 5·705), and was followed by chlorhexidine gluconate rinse, with ΔE value of 4·120. The third highest staining was observed with benzydamine hydrochloride rinse (ΔE = 3·959), whereas the control caused the least staining (ΔE = 3·095). The lighter shade provisional material resulted with clinically observable staining even when immersed in distilled water; however, the dark shades showed clinically perceptible staining solely with the hybrid mouthrinse. In this study, the shade of the acrylic material was the determinator of the staining process.
Productivity of natural and artificial containers for Aedes polynesiensis and Aedes aegypti in four American Samoan villages
Authors: BURKOT T. R. , HANDZEL T. , SCHMAEDICK M. A. , TUFA J. , ROBERTS J. M. , GRAVES P. M.
Published: March 2007

Abstract Six mosquito species were identified in a survey of containers associated with 347 households in four villages in American Samoa. Aedes polynesiensis Marks (Diptera: Culicidae) and Aedes aegypti (L) were the most abundant species, representing 57% and 29% of the mosquitoes identified. Culex quinquefasciatus (Say), Culex annulirostris (Skuse), Aedes oceanicus (Belkin) and Toxorhynchites amboinensis (Doleschall) were also found. Aedes aegypti and Ae. polynesiensis showed distinct differences in their use of containers, preferring large and small containers, respectively. By contrast with previous studies, Ae. polynesiensis utilized domestic and natural containers with equal frequency, whereas Ae. aegypti continued to be found predominantly in domestic containers. Only 15% of containers holding immature mosquitoes included pupae and fewer than 10 Aedes spp. pupae were found in most containers with pupae. An estimated 2289 Ae. polynesiensis and 1640 Ae. aegypti pupae were found in 2258 containers. The presence of both species in the same container did not affect the mean density of either species for larvae or pupae. Glass jars, leaf axils, tree holes and seashells produced few Aedes spp. pupae in any of the study villages. Overall, 75% of Ae. polynesiensis pupae were found in buckets, ice‐cream containers and tyres, with <7% being produced in natural containers, whereas 82% of Ae. aegypti pupae were found in 44‐gallon (US) drums (∼166L), buckets and tyres. Source reduction efforts targeting these container types may yield significant reductions in both Ae. polynesiensis and Ae. aegypti populations in American Samoa.
Molecular characterization of the Anopheles maculipennis complex during surveillance for the 2004 Olympic Games in Athens
Authors: PATSOULA E. , SAMANIDOU‐VOYADJOGLOU A. , SPANAKOS G. , KREMASTINOU J. , NASIOULAS G. , VAKALIS N. C.
Published: March 2007

Abstract Specimens belonging to the Anopheles maculipennis complex were collected as larvae or resting adults from May 2003 to November 2004 in the area of the Athens 2004 Olympic Rowing Centre in Schinias, Attiki, Greece, and identified by morphological and molecular analyses. Of the 201 specimens collected, 199 were found to be Anopheles sacharovi Favre and two were An. maculipennis Meigen s.s. on the basis of similarity to published sequence data for the rDNA internal transcribed spacer (ITS2) region and the mitochondrial cytochrome c oxidase I gene (COI). Sequence data from a number of specimens were obtained for both genes and compared with corresponding GenBank data derived from diverse geographical areas. A high degree of homology in ITS2 sequences was found in both species, ranging from 99.5% to 100% in An. sacharovi and 99.4% to 100% in An. Maculipennis, with no intraspecific variation in either of the two species in our study. The degree of homology in the COI sequences was 94.8–99.8% in An. sacharovi and 95.0–99.8% in An. maculipennis. The 522‐bp fragment produced a rather high degree of intrapopulation polymorphism for An. sacharovi, generating nine different haplotypes, five of which were singletons. Intraspecific variation for these sequences ranged from 0.2% to 1.4%, but was much lower (0.77%) for the two An. maculipennis sequences. These findings represent the first characterization of the An. maculipennis complex in the area of Schinias.
Haemocyte population and ultrastructural changes during the immune response of the mosquito Culex quinquefasciatus to microfilariae of Wuchereria bancrofti
Authors: BRAYNER F. A. , ARAÚJO H. R. C. , SANTOS S. S. , CAVALCANTI M. G. S. , ALVES L. C. , SOUZA J. R. B. , PEIXOTO C. A.
Published: March 2007

Abstract Haemocytes circulating in the haemolymph protect insects against pathogens that enter the haemocoel. Changes in haemocyte morphology and differences in haemocyte counts during the immune response of Culex quinquefasciatus Say (Diptera: Culicidae) to microfilariae of Wuchereria bancrofti (Cobbold) (Spirurida: Onchocercidae) were investigated in the present study. The mean number of total haemocytes was significantly elevated in infected mosquitoes (P < 0.001), reaching a peak on the third day post‐infection. Differential counts show that mean numbers of prohaemocytes, plasmatocytes, granular cells and oenocytoids increased significantly after infection with microfilariae granulocytes compared to the control and näive groups of Cx. quinquefasciatus (P < 0.05). Changes in proportional counts of haemocytes were also analysed in haemolymph perfusates of Cx. quinquefasciatus infected with W. bancrofti. On the first day post‐infection, infected mosquitoes showed an increase in the proportion of prohaemocytes (18.8% compared to 9.6% for the control) and of oenocytoids (7.1% compared to 4.7% control); however, they exhibited lower levels of plasmatocytes (36.6% compared to 42.1% control) and granular cells (36.1% compared to 41.4% control). On day 14 post‐infection, similar changes were observed for these haemocyte types, except that the proportion of granular cells was significantly greater than the control (41.2% compared to 31.3% control). Although an enhancement of prohaemocyte numbers was observed, this cellular type did not show any ultrastructural alteration. On the other hand, granular cells, plasmatocytes and oenocytoids presented morphological alterations indicative of innate immunological activation in mosquitoes infected with W. bancrofti.
Differential admixture shapes morphological variation among invasive populations of the lizardAnolis sagrei
Authors: KOLBE JASON J. , LARSON ALLAN , LOSOS JONATHAN B.
Published: March 2007

The biological invasion of the lizardAnolis sagreiprovides an opportunity to study evolutionary mechanisms that produce morphological differentiation among non‐native populations. Because theA. sagreiinvasion represents multiple native‐range source populations, differential admixture as well as random genetic drift and natural selection, could shape morphological evolution during the invasion. Mitochondrial DNA (mtDNA) analyses reveal seven distinct native‐range source populations for 10 introducedA. sagreipopulations from Florida, Louisiana and Texas (USA), and Grand Cayman, with 2–5 native‐range sources contributing to each non‐native population. These introduced populations differ significantly in frequencies of haplotypes from different native‐range sources and in body size, toepad‐lamella number, and body shape. Variation among introduced populations for both lamella number and body shape is explained by differential admixture of various source populations; mean morphological values of introduced populations are correlated with the relative genetic contributions from different native‐range source populations. The number of source populations contributing to an introduced population correlates with body size, which appears independent of the relative contributions of particular source populations. Thus, differential admixture of various native‐range source populations explains morphological differences among introducedA. sagreipopulations. Morphological differentiation among populations is compatible with the hypothesis of selective neutrality, although we are unable to test the hypothesis of interdemic selection among introductions from different native‐range source populations.
Advances in our understanding of mammalian sex‐biased dispersal
Authors: LAWSON HANDLEY L. J. , PERRIN N.
Published: March 2007

Sex‐biased dispersal is an almost ubiquitous feature of mammalian life history, but the evolutionary causes behind these patterns still require much clarification. A quarter of a century since the publication of seminal papers describing general patterns of sex‐biased dispersal in both mammals and birds, we review the advances in our theoretical understanding of the evolutionary causes of sex‐biased dispersal, and those in statistical genetics that enable us to test hypotheses and measure dispersal in natural populations. We use mammalian examples to illustrate patterns and proximate causes of sex‐biased dispersal, because by far the most data are available and because they exhibit an enormous diversity in terms of dispersal strategy, mating and social systems. Recent studies using molecular markers have helped to confirm that sex‐biased dispersal is widespread among mammals and varies widely in direction and intensity, but there is a great need to bridge the gap between genetic information, observational data and theory. A review of mammalian data indicates that the relationship between direction of sex‐bias and mating system is not a simple one. The role of social systems emerges as a key factor in determining intensity and direction of dispersal bias, but there is still need for a theoretical framework that can account for the complex interactions between inbreeding avoidance, kin competition and cooperation to explain the impressive diversity of patterns.
Differentiation of sympatric populations of the band‐rumped storm‐petrel in the Galapagos Islands: an examination of genetics, morphology, and vocalizations
Authors: SMITH A. L. , FRIESEN V. L.
Published: March 2007

In each of at least two locations within the Galapagos Islands, breeding band‐rumped storm‐petrels (Oceanodroma castro) form two distinct populations that use the same colony site at separate times of the year for reproduction. Temporal segregation of these populations raises the possibility that they are reproductively isolated and represent cryptic species. We examined variation in mitochondrial DNA, morphology, and vocalizations of storm‐petrel populations nesting 6 months apart on the islet of Plaza Norte in the Galapagos. Seasonal populations displayed low but significant levels of differentiation in the mitochondrial control region, five morphological variables, and one feature of male vocalizations. Breeding populations appear to have been separated for approximately 1700 years. Given the recent divergence date and relatively high effective population sizes (4000–5600 females each), seasonal populations are unlikely to be in genetic equilibrium. As a result, the low divergence estimate probably reflects historical association and not contemporary genetic exchange. These populations are not sufficiently differentiated to be considered cryptic species. However, they are probably in the early stages of divergence. Consequently, we recommend that cool‐ and hot season populations on Plaza Norte be recognized as separate management units.
Sensing the light: photoreceptive systems and signal transduction in cyanobacteria
Authors: Montgomery Beronda L.
Published: March 2007

Photosynthetic prokaryotes have highly developed abilities to detect and react to environmental signals. Light sensing is one of the most important capabilities of organisms that use light for photosynthesis and photomorphogenesis. This review addresses photoreception in cyanobacteria from the perception of light through the physiological responses observed in response to light‐dependent signalling. Recent progress made in our understanding of the structure and function of photosensory receptors and their downstream effector molecules is discussed.
General and specific host responses to bacterial infection in Peyer's patches: a role for stromelysin‐1 (matrix metalloproteinase‐3) during Salmonella enterica infection
Authors: Handley Scott A. , Miller Virginia L.
Published: March 2007

Salmonella enterica serovar Typhimurium (S. typhimurium) and Yersinia enterocolitica are enteric pathogens capable of colonizing and inducing inflammatory responses in Peyer's patches (PPs) and mesenteric lymph nodes (MLNs). Although the tissue colonization pattern is similar between these two pathogens, their pathogenic lifestyles are quite different. For example, while S. typhimurium is primarily an intracellular pathogen, Y. enterocolitica survives primarily extracellularly. We determined and compared the transcriptional changes occurring in response to S. typhimurium and Y. enterocolitica colonization of PP using Affymetrix GeneChip technology. Both pathogens elicited a general inflammatory response indicated by the upregulation of cytokines and chemokines. However, specific differences were also observed, most notably in the transcriptional regulation of gamma interferon (IFN‐γ) and IFN‐γ‐regulated genes in response to S. typhimurium but not Y. enterocolitica. Of particular note, a group of genes encoding matrix metalloproteinases (MMPs) had increased transcript numbers in the PPs following infection with both pathogens. The experiments described here compare oral S. typhimurium or Y. enterocolitica infection in stromelysin‐1 (MMP‐3)‐deficient mice (mmp‐3–/–) with mice possessing functional MMP‐3 (mmp‐3+/+). There was little difference in the survival of MMP‐3‐deficient mice infected with Y. enterocolitica when compared with littermate controls. Surprisingly though, mmp‐3–/– mice were markedly more resistant to S. typhimurium infection than the control mice. S. typhimurium was able to colonize mmp‐3–/– mice, albeit in a delayed fashion, to equivalent levels as mmp‐3+/+ mice. Nevertheless, significantly lower levels of inflammatory cytokines were detected in tissues and serum in the mmp‐3–/– mice in comparison with mmp‐3+/+ mice. We hypothesize that MMP‐3 is involved in initiating an early and lethal cytokine response to S. typhimurium colonization.
Regulation of polar flagellum genes is mediated by quorum sensing and FlhDC in Burkholderia glumae
Authors: Kim Jinwoo , Kang Yongsung , Choi Okhee , Jeong Yeonhwa , Jeong Jae‐Eun , Lim Jae Yun , Kim Minkyun , Moon Jae Sun , Suga Hiroaki , Hwang Ingyu
Published: March 2007

The bacterium Burkholderia glumae causes rice grain rot by producing toxoflavin, whose expression is regulated by quorum sensing (QS). We report a major deviation from the current paradigm for the regulation of bacterial polar flagellum genes. The N‐octanoyl homoserine lactone (C8‐HSL)‐deficient mutant of B. glumae is aflagellate and has lost the ability to swim and swarm at 37°C. Mutagenesis of the bacterium with the mini‐Tn5rescue identified an IclR‐type transcriptional regulator, called QsmR, which is important for flagellum formation. TofR, which is a cognate C8‐HSL receptor, activated qsmR expression by binding directly to the qsmR promoter region. From the flagellum gene cluster, we identified flhDC homologues that are directly activated by QsmR. FlhDC in turn activates the expression of genes involved in flagellum biosynthesis, motor functions and chemotaxis in B. glumae. Non‐motile qsmR, fliA and flhDC mutants produced toxoflavin, but lost pathogenicity for rice. The unexpected discovery of FlhDC in a polarly flagellate bacterium suggests that exceptions to the typical regulatory mechanisms of flagellum genes exist in Gram‐negative bacteria. The finding that functional flagella play critical roles in the pathogenicity of B. glumae suggests that either QS or flagellum formation constitutes a good target for the control of rice grain rot.
Selection for functional diversity drives accumulation of point mutations in Dr adhesins of Escherichia coli
Authors: Korotkova Natalia , Chattopadhyay Sujay , Tabata Tami A. , Beskhlebnaya Viktoria , Vigdorovich Vladimir , Kaiser Brett K. , Strong Roland K. , Dykhuizen Daniel E. , Sokurenko Evgeni V. , Moseley Steve L.
Published: March 2007

Immune escape is considered to be the driving force behind structural variability of major antigens on the surface of bacterial pathogens, such as fimbriae. In the Dr family of Escherichia coli adhesins, structural and adhesive functions are carried out by the same subunit. Dr adhesins have been shown to bind decay‐accelerating factor (DAF), collagen IV, and carcinoembryonic antigen‐related cell adhesion molecules (CEACAMs). We show that genes encoding Dr adhesins from 100 E. coli strains form eight structural groups with a high level of amino acid sequence diversity between them. However, genes comprising each group differ from each other by only a small number of point mutations. Out of 66 polymorphisms identified within the groups, only three were synonymous mutations, indicating strong positive selection for amino acid replacements. Functional analysis of intragroup variants comprising the Dr haemagglutinin (DraE) group revealed that the point mutations result in distinctly different binding phenotypes, with a tendency of increased affinity to DAF, decreased sensitivity of DAF binding to inhibition by chloramphenicol, and loss of binding capability to collagen, CEACAM3 and CEACAM6. Thus, variability by point mutation of major antigenic proteins on the bacterial surface can be a signature of selection for functional modification.
Engulfment during sporulation in Bacillus subtilis is governed by a multi‐protein complex containing tandemly acting autolysins
Authors: Chastanet Arnaud , Losick Richard
Published: March 2007

The conversion of a growing cell into an endospore in Bacillus subtilis involves a phagocytic‐like process in which the developing spore (the forespore) is wholly engulfed by the adjacent mother cell. A prerequisite for engulfment is the removal of peptidoglycan from the septum that separates the forespore from the mother cell, a process that depends on the autolysin SpoIID and two proteins of unknown function, SpoIIM and SpoIIP. Here we present evidence that SpoIIP is also an autolysin, that it acts in tandem with SpoIID, and that all three proteins are in a complex with each other. We further show that the members of the complex exhibit a hierarchical relationship in which SpoIIM is responsible for localization to the septal membrane, SpoIIP localizes to the septal membrane by interacting with SpoIIM, and SpoIID, in turn, localizes by interacting with SpoIIP. Finally, we show that localization of SpoIIM depends on a fourth protein SpoIIB, raising the possibility that the complex contains an additional component and creating an overall hierarchy of the form: SpoIIB→SpoIIM→SpoIIP→SpoIID.
Evaporative enrichment and time lags between δ18O of leaf water and organic pools in a pine stand
Authors: BARNARD ROMAIN L. , SALMON YANN , KODAMA NAOMI , SÖRGEL KARIN , HOLST JUTTA , RENNENBERG HEINZ , GESSLER ARTHUR , BUCHMANN NINA
Published: March 2007

Understanding ecosystem water fluxes has gained increasing attention, as climate scenarios predict a drier environment for many parts of the world. Evaporative enrichment of 18O (Δ18O) of leaf water and subsequent enrichment of plant organic matter can be used to characterize environmental and physiological factors that control evaporation, based on a recently established mechanistic model. In a Pinus sylvestris forest, we measured the dynamics of oxygen isotopic composition (δ18O) every 6 h for 4 d in atmospheric water vapour, xylem sap, leaf water and water‐soluble organic matter in current (N) and previous year (N‐1) needles, phloem sap, together with leaf gas exchange for pooled N and N‐1 needles, and relevant micrometeorological variables. Leaf water δ18O showed strong diel periodicity, while δ18O in atmospheric water vapour and in xylem sap showed little variation. The Δ18O was consistently lower for N than for N‐1 needles, possibly related to phenological stage. Modelled leaf water Δ18O showed good agreement with measured values when applying a non‐steady state evaporative enrichment model including a Péclet effect. We determined the time lags between δ18O signals from leaf water to water‐soluble foliar organic matter and to phloem sap at different locations down the trunk, which clearly demonstrated the relevance of considering these time‐lag effects for carbon transport, source‐sink and carbon flux partitioning studies.
Phototropic bending of non‐elongating and radially growing woody stems results from asymmetrical xylem formation
Authors: MATSUZAKI JUN , MASUMORI MASAYA , TANGE TAKESHI
Published: March 2007

Active phototropic bending of non‐elongating and radially growing portion of stems (woody stems) has not been previously documented, whereas negative gravitropic bending is well known. We found phototropic bending in woody stems and searched for the underlying mechanism. We inclined 1‐year‐old Quercus crispula Blume seedlings and unilaterally illuminated them from a horizontal direction perpendicular to (‘normal’ illumination) or parallel to (‘parallel’ illumination) the inclination azimuth. With normal illumination, active phototropic bending and xylem formation could be evaluated separately from the negative gravitropic response and vertical deflection resulting from the weight of the seedlings. One‐year‐old stems with normal illumination bent significantly, with asymmetrical xylem formation towards the illuminated upper surface and side of the stem, whereas those with parallel illumination showed non‐significant lateral bending, with asymmetrical xylem formation only on the upper side. A mechanical model was built on the assumption that a bending moment resulted from the asymmetrical xylem formation during phototropic bending of the woody stems. The model fitted the relationship between the observed spatial distributions of the xylem and the observed lateral bending, and thus supported the hypothesis that phototropic bending of woody stems results from asymmetrical xylem formation, as such occurs during gravitropism.
Factors influencing glomerular filtration rate in renal transplantation after cyclosporine withdrawal using sirolimus‐based therapy: a multivariate analysis of results at five years1
Authors: Legendre Christophe , Brault Yves , Morales José M. , Oberbauer Rainer , Altieri Paolo , Riad Hany , Mahony John , Messina Maria , Pussell Bruce , Martínez Javier G. , Lelong Magali , Burke James T. , Neylan John F. ,   for the Rapamune Maintenance Regimen Study Group
Published: March 2007

Abstract:  Changes in calculated glomerular filtration rate (GFR) from baseline to five yr were analyzed in relation to risk factors among renal transplant recipients. At three months after transplantation (baseline), 430 eligible patients receiving sirolimus (SRL), cyclosporine (CsA), and steroids (ST) were randomly assigned (1:1) to continue SRL–CsA–ST or have CsA withdrawn and SRL trough levels increased (SRL–ST group). For each risk factor, changes from baseline were compared within each treatment using a t‐test and between treatments using ANCOVA. Univariate then multivariate robust linear regression analyses were also performed. In the SRL–ST group, changes from baseline were not significantly different for any risk factor. With the exception of cold ischemia time >24 h, GFR values declined significantly for all risk factors in SRL–CsA–ST patients. For all risk factors, except second transplant or cold ischemia time >24 h, renal function was significantly different between groups. By order of significance in the multivariate analysis, treatment (p < 0.001), donor age (p < 0.001), proteinuria (p < 0.001), and biopsy‐confirmed rejection (p = 0.010) were significant predictors of GFR change from baseline. In conclusion, patients with risk factors for reduced renal function benefit from SRL maintenance therapy without CsA vs. those remaining on CsA.
Using thyroid hormone in brain‐dead donors to maximize the number of organs available for transplantation
Authors: Salim Ali , Martin Matthew , Brown Carlos , Inaba Kenji , Roth Bradley , Hadjizacharia Pantelis , Mascarenhas Angela , Rhee Peter , Demetriades Demetrios
Published: March 2007

Abstract:  The aggressive management of brain‐dead (cadaveric) organ donors has been shown to increase organs available for transplantation. Some centers use hormone therapy with thyroid hormone (T4) in selected donors. The purpose of this study is to evaluate the effects of T4 on organs available for transplantation. A policy of aggressive donor management was adopted at our trauma center in 1998. T4 therapy is reserved for the hemodynamically unstable donors who require significant vasopressor support. The records of patients who successfully donated organs between January 2001 and December 2005 were reviewed. Organ donor demographics and whether T4 was used was examined for each donor. T4 was used in 96 of 123 donors (78%). Compared with donors who did not receive T4, those that did were similar in age (32 ± 14 vs. 38 ± 21, p = 0.148), had more organs donated (3.9 ± 1.7 vs. 3.2 ± 1.7, p = 0.048), and had no differences in brain‐death related complications. Despite the severe hemodynamic instability in the T4 group, the number of organs harvested from this group was significantly more than in patients who did not receive T4. The use of T4 in this group may result in the increased salvage of transplantable organs.
Renal function with delayed or immediate cyclosporine microemulsion in combination with enteric‐coated mycophenolate sodium and steroids: results of follow up to 30 months post‐transplant
Authors: Mourad Georges , Karras Alexandre , Kamar Nassim , Garrigue Valérie , Legendre Christophe , Lefrançois Nicole , Charpentier Bernard , Bourbigot Bernard , Pouteil‐Noble Claire , Bayle François , Lebranchu Yvon , Mariat Christophe , Meur Yann Le , Kessler Michèle , Moulin Bruno , Ducloux Didier , Delahousse Michel , Lang Philippe , Merville Pierre , Chaouche‐Teyara Kamel , Rostaing Lionel ,   for The French Myriade FR01 Study Group
Published: March 2007

Abstract:  Background:  In the multicenter, open‐label Myriade study, renal transplant patients were randomized to early cyclosporine microemulsion (CsA‐ME, day 0) or delayed CsA‐ME (day 6) with enteric‐coated mycophenolate sodium (EC‐MPS), steroids and interleukin‐2 receptor induction. One‐yr results have been published previously. We now report the results of an extension study in which patients were followed up for a period of three yr post‐transplant.

Methods:  All patients completing the one‐yr core study on‐treatment were eligible to enter the extension study.

Results:  Of the 203 patients, 153 completed the core trial on‐treatment; 144 (94%) entered the extension study with a minimum follow‐up of one yr (73 early CsA‐ME, 71 delayed CsA‐ME). In 75% of patients receiving EC‐MPS during the extension, the recommended dose was administered (1440 mg/d). Median creatinine clearance remained constant (57 mL/min) at 12, 24 and 30 months post‐transplant and was similar in the early and delayed CsA‐ME groups as well as in subpopulations with or without delayed graft function. One patient in the early CsA‐ME group died. No grafts were lost. The incidence of BPAR from time of transplant to the end of the extension study was 17% (24/139). Seven patients (5%) discontinued the extension study prematurely because of adverse events.

Conclusion:  These results suggest that a regimen of CsA‐ME, EC‐MPS and steroids results in excellent survival rates with stable renal function over a mean follow‐up of 30 months. Immediate introduction of CsA‐ME has no deleterious effect on long‐term renal function, even among patients with delayed graft function.
Renal transplant incision closure using new absorbable subcuticular staple device
Authors: Tellis Vivian A.
Published: March 2007

Abstract:  Closure of skin incisions has received scant attention in the transplant literature. Yet, wound healing can be an important source of morbidity after transplantation. Recently, a novel form of skin closure utilizing absorbable subcuticular staples has become available. It was used in 26 live‐related and deceased donor kidney transplant recipients. A large (no. 1) continuous absorbable suture with wide, sweeping bites was first used to attach the subcutaneous tissue to the fascia, thus removing all stress from the skin edges. There was a single minor wound separation in one patient in follow‐up ranging from one month to one yr. Cosmetic result and patient comfort were superior. Subcuticular closure can give similar results, but is more time consuming. The limited literature on this product is industry sponsored and refers to animal experience and to diverse surgical procedures; the reports are similar to our own experience. Skin staples are left in for prolonged periods in transplantation because of concerns about wound healing. This may contribute to wound discomfort and serous oozing as well as requiring an additional encounter for removal of staples. Although this experience is early and limited, we conclude that absorbable subcuticular staples are secure and effective and are preferable to metal staple closures even in renal transplant recipients receiving steroids and sirolimus.
KIR genes polymorphism in Argentinean Caucasoid and Amerindian populations
Authors: Flores A. C. , Marcos C. Y. , Paladino N. , Capucchio M. , Theiler G. , Arruvito L. , Pardo R. , Habegger A. , Williams F. , Middleton D. , Fainboim L.
Published: March 2007

In natural killer cells, killer immunoglobulin‐like receptors (KIRs) loci code for either inhibitory or activating receptors, and according to the number of genes present in each individual, it is possible to identify a high rate of polymorphism in the populations. We performed KIR typing by polymerase chain reaction–sequence‐specific oligonucleotide probing in 402 Argentinean Caucasoid and in two Amerindian populations (101 Wichis and 54 Chiriguanos) from the North of Argentina. KIR2DL4, KIR3DL2, KIR3DL3 and KIR3DP1 were always present, whereas the frequencies of KIR2DL1, KIR2DL3, KIR2DS4, KIR3DL1 and KIR2DP1 ranged between 84% and 96%. The frequencies of KIR2DS2, KIR2DL2, KIR2DL5, KIR2DS5, KIR2DS1 and KIR3DS1 ranged between 41% and 62%. The KIR2DS3 with a frequency of 29% in Argentinean Caucasoid population was present at a very low frequency in Amerindian populations. Haplotype segregation studies performed in 10 Wichi families showed the presence of only three haplotypes: A, B5 and B1. The Amerindian populations showed several similarities to Asian but not to Caucasoid populations with regard to the frequency of KIR2DS3, full‐length KIR2DS4 gene and KIR2DL4 alleles.
The challenges of using medication event monitoring technology with pediatric transplant patients
Authors: Shellmer Diana A. , Zelikovsky Nataliya
Published: March 2007

Abstract:  This study investigated the advantages and challenges of using Medication Electronic Monitoring System (MEMS) technology to examine adherence among pediatric kidney transplant patients. Twenty‐nine patients participated in the study, with a mean age of 14.03 yr (SD = 3.34, range 8–19 yr). Patients were given a MEMS bottle and cap to be used with their primary immunosuppressant medication over a three‐month period. Issues related to study eligibility, recruitment, and participant maintenance were recorded. Patients completed the Debriefing Form regarding their experiences with the MEMS. Many younger patients were on liquid medications affecting the feasibility of this technology across ages. Acceptance of this technology proved difficult, as many patients either declined upfront or dropped out because they did not want to use the MEMS. Of the final sample, 41% found transferring medication into the MEMS bottle difficult and 27.2% reported that the MEMS was a burden and/or difficult to transport. Another 22% of the patients reported that using the MEMS changed their routine, and 10.2% worried about missing their medications. Pediatric transplant centers should be cautious about solely relying on MEMS to examine adherence until more research is conducted on the feasibility, acceptance, and utility of this technology.
Adherence and medical outcomes in pediatric liver transplant recipients who transition to adult services
Authors: Annunziato Rachel A. , Emre Sukru , Shneider Benjamin , Barton Codette , Dugan Christina A. , Shemesh Eyal
Published: March 2007

Abstract:  Non‐adherence to medications is associated with poor medical outcomes in adolescent transplant recipients. It is unclear whether non‐adherence is further compromised when transplant recipients transition to the adult health care system. The purpose of the present study was to examine whether adherence changes during transition. We reviewed the medical records of 14 recently transitioned patients and compared their adherence and corresponding medical outcomes before and after transition. These outcomes were also compared with two cohorts of patients receiving care solely in pediatric or adult services. Medication adherence, measured through the use of standard deviations of tacrolimus blood levels, was examined for all patients. We found that adherence to tacrolimus significantly decreased after transition. After transitioning, patients furthermore exhibited poorer adherence than patients in the other two cohorts did over time. This small retrospective study suggests that the period of transition from pediatric to adult transplant clinics is a vulnerable one. Larger, prospective investigations of the transition process are necessary before recommendations are made regarding interventions.
Simultaneous pediatric kidney transplantation and ureterocystoplasty in a 20‐month‐old boy
Authors: Ojogho O. N. , Ben‐Youssef R. , Chen L. J. , Baron P. W. , Franco E. S. , Baldwin D. D.
Published: March 2007

Abstract: Kidney transplantation (KT) in children with end‐stage renal disease and an abnormal bladder poses a complex management challenge. Ureterocystoplasty (UC) has been previously reported in older children with non‐compliant bladders, but the timing and technique of repair are controversial. This case reports the youngest patient, a 20‐month‐old boy to undergo successful single‐stage UC and living‐related KT. UC was performed because of a fibrotic, non‐compliant bladder. A temporary vesicostomy was placed to provide adequate drainage in the presence of urethral stenosis. The patient developed a single episode of pyelonephritis within the first six months post‐operatively, but there were no other urologic complications. At 13 months, the renal function is excellent with a mean glomerular filtration rate of 100 mL/min/1.73 m2and no clinical evidence of rejection. This case demonstrates that simultaneous UC and KT can be safely performed even in infants with non‐compliant bladders and renal failure.
Effect of n‐3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients
Authors: PERUNICIC‐PEKOVIC GORDANA B , RASIC ZORICA R , PLJESA STEVA I , SOBAJIC SLADJANA S , DJURICIC IVANA , MALETIC RADOJKA , RISTIC‐MEDIC DANIJELA K
Published: March 2007

Aims:  Nutrition as an aetiological factor participates a great deal in premature atherosclerosis in haemodialysis (HD) patients. The basic mechanisms of end‐stage renal disease and premature atherosclerosis are connected with changes in cell functions at the membrane level. We investigated the red cell membrane fatty acids and the effects of fish oil supplements on nutritional status and inflammatory markers in HD patients.

Methods:  We examined 42 HD patients (mean age 55 ± 8 years). The control group consisted of 16 healthy subjects of similar age and sex to the tested group. HD patients were administered supplements with 2.4 g of n‐3 polyunsaturated fatty acids per day for 2 months. Before and after supplementation, we examined plasma lipids, cell membrane erythrocyte phospholipids content, serum albumin, haemoglobin, interleukin‐6 (IL‐6) and tumour necrosis factor alpha (TNF‐α).

Results:  Baseline values in the tested group confirmed the presence of essential fatty acids deficiency. A statistically significant negative correlation between TNF‐α and eicosapentaenoic acid (EPA) (r = −0.497; P < 0.05) and IL‐6 and EPA (r = −468; P = 0.03) was found in HD patients before supplementation. There was a significant increase in docosahexaenoic acids, high density lipoprotein cholesterol, plasma albumin, haemoglobin levels in HD patients after supplementation (P = 0.0001). There was a significant increase in EPA (P = 0.01) after treatment, and there was a significant decrease in inflammatory markers (IL‐6 and TNF‐α, P = 0.0001) after supplementation in the tested group.

Conclusion:  A dietary regime with fish oil could be used in dialysis patients to slow down the development of atherosclerosis and improve nutritional parameters.
Single meal food intake characteristics reliably predict nutrition status and body composition in patients undergoing continuous peritoneal dialysis
Authors: CHANG CHIA‐CHU , CHEN HUNG‐LIN , HUNG CHING‐HUI , HWANG KAI‐LIN , LIN CHING‐YUANG
Published: March 2007

Aim:  This study aimed to determine whether single meal food intake characteristics measured via visual analogue scales (VAS) predict appetite and have a clinical impact on continuous ambulatory peritoneal dialysis (PD) patients.

Methods:  The nutritional status of 50 continuous ambulatory PD patients (30 men, mean age 44.26 ± 13.53 years, and 20 women, mean age 48.70 ± 12.53 years) at a single tertiary referral hospital was evaluated via subjective global assessment and VAS questionnaires. The Spearman correlation coefficient was used to evaluate the linear association between continuous variables, while the two‐sample Student's t‐test was performed to compare ghrelin levels between the two groups. P‐values less than 0.05 were considered to be of statistical significance.

Results:  Subjective global assessment was correlated with VAS scores in each single patient. VAS score for fullness sensation was significantly positively correlated with age (r = 0.41, P = 0.02), triceps skin fold (r = 0.46, P = 0.01), waist‐hip ratio (r = 0.50, P = 0.005) and fat content (r = 0.37, P = 0.04), and significantly negatively correlated with daily energy (r = −0.36, P = 0.04) and protein intake (r = −0.52, P = 0.003). By contrast, serum ghrelin level and the four VAS scores were not correlated.

Conclusion:  Single meal food intake characteristics can reliably estimate nutrition status and predict body composition in patients undergoing continuous PD.
Elevated resistin is related to inflammation and residual renal function in haemodialysed patients
Authors: MALYSZKO JOLANTA , MALYSZKO JACEK S , KOZMINSKI PIOTR , PAWLAK KRYSTYNA , MYSLIWIEC MICHAL
Published: March 2007

Aim:  Resistin is an adipocytokine that recently generated much interest. Because of the fact that inflammation, endothelial cell damage or injury is invariably associated with such clinical conditions as thrombosis, atherosclerosis and their major clinical consequences, that is, cardiovascular disease and resistin play a role in linking inflammation and cardiovascular disease, the aim of the study was to assess resistin in correlation with markers of inflammation, endothelial cell injury and residual renal function in haemodialysed (HD) patients.

Methods:  We assessed resistin, markers of coagulation: thrombin‐antithrombin complexes (TAT), prothrombin fragments 1+2; fibrinolysis: tPA, plasminogen activator inhibitor type 1, plasmin‐antiplasmin complexes (PAP); endothelial function/injury: von Willebrand factor (vWF), thrombomodulin, intracellular adhesion molecule (ICAM); inflammation: high sensitivity C‐reactive protein (hsCRP), tumour necrosis factor alpha and interleukin‐6 (IL‐6).

Results:  Healthy volunteers and HD patients did not differ significantly regarding age, leucocyte count, serum iron, aspartate and alanine aminotransferases activities, calcium, cholesterol, tPA concentration. Triglycerides, CRP (assessed by high sensitivity method), phosphate, urea, creatinine, IL‐6, tumour necrosis factor alpha, vWF, prothrombin fragments 1+2, TAT, PAP, thrombomodulin, ICAM, plasminogen activator inhibitor type 1 and resistin, were elevated in HD patients when compared with the control group. Serum albumin, total protein, haemoglobin and haematocrit were significantly lower in HD patients when compared with the control group. In HD patients with hsCRP 0e; 6 mg/L, resistin, IL‐6, vWF and F1+2 were significantly higher, whereas tPA was significantly lower than in patients with hsCRP < 6 mg/L. Moreover, HD patients with residual renal function have significantly lower resistin when compared with patients without it. Resistin was significantly higher in diabetics. In HD patients, resistin correlated significantly, in univariate analysis, with calcium, phosphate, PTH, TIBC, vWF residual renal function, urea, hsCRP, IL‐6 and tended to correlate with tPA and ferritin. In the healthy volunteers, resistin was related to IL‐6 and hsCRP. In multiple regression analysis, resistin was independently related to hsCRP, IL‐6, residual renal function in HD patients.

Conclusion:  Elevated resistin related to markers of inflammation may represent a novel link between inflammation and adipocytokines in HD patients. Impaired renal function and inflammation are responsible for elevated resistin in HD patients.
Decision‐making about suitability for kidney transplantation: Results of a national survey of Australian nephrologists
Authors: CASS ALAN , CUNNINGHAM JOAN , ANDERSON KATE , SNELLING PAUL , COLMAN SAM , DEVITT JEANNIE , PREECE CILLA , ERIS JOSETTE
Published: March 2007

Aim:  This study aimed to elucidate the factors affecting nephrologists' decision‐making on patients' suitability for kidney transplantation. Given the reduced access to transplantation for Indigenous Australians, the role of patient's ethnicity was of particular interest.

Methods:  A postal survey of practising nephrologists and trainees was undertaken in Australia. Each participant was provided with a unique set of 15 hypothetical patient descriptions, with demographic, clinical and behavioural factors randomly generated to ensure an overall balance of factors across the cases. The main outcome measure was whether kidney transplantation was recommended.

Results:  Responding nephrologists and trainees were more likely to recommend transplantation for hypothetical patients who were young, of normal weight and described as compliant. They were less likely to recommend transplantation for smokers, or for people with diabetes or heart disease. No significant differences related to the patients' sex or ethnicity. The geographical location of the respondent was a significant determinant, with differences according to their State/Territory and their metropolitan/non‐metropolitan location.

Conclusion:  When all other factors were held constant, nephrologists and trainees appear to base their decision‐making regarding suitability for transplant on clinical and behavioural factors, rather than on the basis of ethnicity or sex. In practice, however, clinical and behavioural factors cluster with ethnicity, and this is likely to contribute to the current poor access to transplantation for Indigenous end‐stage kidney disease patients. Apparent differences in decision‐making according to the respondent's location may reflect variations in practice across the country.
The micro‐fascism of Plato’s good citizen: producing (dis)order through the construction of risk
Authors: O’Byrne Patrick , Holmes Dave
Published: March 2007

Abstract  The human body has come to be seen as forever susceptible to both external and internal hazards, which in many circumstances require immediate, heroic, and expensive intervention. In response to this, there has been a shift from a treatment‐based healthcare model to one of prevention wherein nurses play an integral role by identifying and assessing risks for individuals, communities, and populations. This paper uses Deborah Lupton’s outline of the spectrum of risk and applies the theoretical works of Foucault and Plato to demonstrate the means by which nurses maintain social order by identifying and counselling risk takers. It also utilizes the work of Deleuze and Guattari to illustrate how Plato’s framework for creating social order through the creation of the good citizen can be viewed as a micro‐fascist system, which has been adopted wholeheartedly by preventative health professionals. The goal of this paper is to present an alternate understanding of risk to provide nurses and other healthcare professionals with a non‐traditional appreciation of certain aspects of their practice as researchers and clinicians.
Capitalism, psychiatry, and schizophrenia: a critical introduction to Deleuze and Guattari’s Anti‐Oedipus
Authors: Roberts Marc
Published: March 2007

Abstract Published in 1972, Anti‐Oedipus was the first of a number of collaborative works between the French philosopher, Gilles Deleuze, and the French psychoanalyst and political activist, Felix Guattari. As the first of a two‐volume body of work that bears the subtitle, Capitalism and Schizophrenia, Anti‐Oedipus is, to say the least, an unconventional work that should be understood, in part, as a product of its time – created as it was among the political and revolutionary fervour engendered by the events of ‘May 1968’. However, this paper will suggest that Anti‐Oedipus – as a critique of psychoanalysis and the Oedipus complex, as well as being a study of the relationship between capitalism and schizophrenia – should also be understood in a less ‘time‐bound’ fashion. In particular, the paper will examine Deleuze and Guattari’s formulation of a concept of ‘desire’ and its employment in relation to subjectivity, time, capitalism, representation, and the radical ‘therapeutic’ practice that they refer to as ‘schizoanalysis’. Moreover, nearly 40 years after the events of May 1968 and against possible doubts concerning the contemporary relevance of psychoanalysis, it will be suggested that psychoanalysis and the Oedipus complex are to be understood as symptomatic of a wider ‘malaise’ that can be discerned within psychiatry, psychotherapy, and contemporary capitalist society itself, and that it is this that forms the broader target of the book’s critique. Accordingly, by providing an accessible and critical introduction to Anti‐Oedipus, the paper also hopes to stimulate further discussion and research regarding both the critique and the contribution that the work can make to contemporary psychiatry, psychotherapy, and mental health nursing generally.