bluuebunny/crossref_metadata_2025 huggingface dataset:
Late‐onset Rothmund–Thomson syndrome
Authors: Kumar Pramod , Sharma Prafulla Kumar , Gautam Ram Krishan , Jain Rakesh Kumar , Kar Hemanta Kumar
Published: May 2007

A 43‐year‐old woman presented with complaints of exfoliation of the skin and mottled pigmentation all over the body, intolerance to sunlight for the last 14 years, and swelling on the lower one‐third of the neck for 15 years. She was apparently well until the age of 29 years when she noticed redness on her shins which later progressed to involve the upper limbs, chest, and face. Three months later, she observed multiple, small, brownish plaques over the erythematous areas, which gradually spread to the sun‐exposed areas, namely the face, forearms, hands, and nape of the neck. The erythema disappeared within 5 months of onset. The patient experienced redness of the face, intolerance to the sun, and reduced sweating, particularly during the summer. There was no history of bullous eruption, difficulty during deglutition, tremors, or pedal edema. She suffered five miscarriages and, ultimately, was successful in delivering a normal boy who is now 16 years of age.

She had menarche at the age of 14 years and her menstrual cycle was regular. There was no history of similar illness in the family.

On cutaneous examination, the skin on the face, neck, trunk, buttocks, and limbs was found to be dry, lusterless, thin, and covered with fine scales. Mottled hyperpigmentation was observed all over the body. Atrophy and telangiectasia were seen over the neck (Fig. 1), face (Fig. 2), nape of the neck, upper and lower limbs, back, and chest. Mild erythema was observed over the face, nose, ears, and forearms. The hair on the scalp, eyebrows, axillae, and pubic area was sparse and thin. The teeth were loose and discolored due to caries, and a foul odor emanated from the mouth. The nails were lusterless and centrally depressed. The thyroid gland was enlarged, smooth, nontender, and moved with deglutition. No bruit was heard over it. No ocular abnormality was detected.

Atrophy and telangiectasia over the neck

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Poikiloderma over the face

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The patient had a haemoglobin level of 7.6 g%, total serum iron binding capacity of 70 µmol/L (normal, 45–66 µmol/L), and serum ferritin level of 10 µg/L (normal, 15–200 µg/L). Peripheral blood smear showed hypochromic microcytic red blood cells. Total and differential leukocyte counts, erythrocyte sedimentation rate (ESR), blood glucose, serum electrolytes, total and differential serum proteins, liver function tests, blood urea, and microscopic examination of urine and stools were within normal limits. The thyroid profile and complement C3 and C4 levels were within normal limits. Rheumatoid factor, antinuclear factor and LE cells were absent. Abdominal ultrasonogram was normal.

Fine needle aspiration cytology from the thyroid gland showed features suggestive of colloid goiter. Skin biopsy revealed thinning of the epidermis, flattening of the rete ridges, and hydropic degeneration of the basal cell layer. The dermis was edematous with dilated capillaries, melanophages, and a band‐like mononuclear infiltrate. The sweat glands were reduced in number.
Nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis: a case series of nine patients and review of the literature
Authors: Introcaso Camille E. , Hivnor Chad , Cowper Shawn , Werth Victoria P.
Published: May 2007

Background  Nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis (NFD/NSF) is a fibrosing cutaneous disorder recently recognized to have systemic manifestations. The disease is characterized clinically by an acute onset of hardening and thickening of the skin of the extremities and trunk, often resulting in flexion contractures, and histologically by an increase in spindle‐shaped cells, collagen, and sometimes mucin deposition in the dermis. The only common exposure amongst patients is acute or chronic renal failure. The pathophysiology of the disease remains to be elucidated, and there is currently no consistently effective treatment for this unremitting disease.

Methods  We report a case series of nine patients seen at the University of Pennsylvania between 1998 and mid‐2004. The clinical, laboratory, and pathologic data of these patients are reviewed.

Results  All patients had renal disease, received peritoneal or hemodialysis, and five had received at least one renal transplant. All patients had characteristic fibrotic cutaneous lesions involving the trunk, extremities, or both, and eight of the nine patients had scleral plaques. There were no other common findings amongst the histories, medications, or laboratory results of the patients.

Conclusion  Our report confirms the clinical and histologic characteristics of NFD that have been described previously, and raises new issues regarding the possible subtypes. A review of the current literature stresses that further basic science and translational studies are necessary to understand the disease mechanism and to propose effective therapy, and emphasizes the importance of recognizing the systemic effects of NFD.
Clinical relevance of autoantibodies after pediatric liver transplantation
Authors: Richter Andrea , Grabhorn Enke , Helmke Knut , Manns Michael P. , Ganschow Rainer , Burdelski Martin
Published: May 2007

Abstract:  Background:  The presence of autoantibodies and development of autoimmune hepatitis after liver transplantation has recently been reported as one of the causes for chronic graft dysfunction. The pathogenesis and clinical significance of this disease still remains unclear.

Methods:  We evaluate 96 patients for the prevalence of autoantibodies and autoimmune hepatitis after pediatric liver transplantation and review their clinical follow‐up including virus serologies, ultrasound examination and liver biopsies.

Results:  Positive autoantibodies were detected in 74% of the patients after pediatric OLT. Graft dysfunction was observed in 46% of these children, and in 35% of the transplant recipients seronegative for autoantibodies. None of the patients showed histological signs or fulfilled clinical criteria for de novo autoimmune hepatitis. One child with negative autoantibodies was diagnosed to have a histologically proven de novo AIH two yr following OLT.

Conclusions:  There is a high prevalence of autoantibodies after pediatric OLT, but the incidence of de novo AIH is very rare. In transplant recipients showing elevated liver function tests de novo autoimmune hepatitis has to be excluded by liver biopsy even if the patient is seronegative for autoantibodies.
Influence of KIR gene diversity on the course of HSV‐1 infection: resistance to the disease is associated with the absence of KIR2DL2 and KIR2DS2
Authors: Estefanía E. , Gómez‐Lozano N. , Portero F. , De Pablo R. , Solís R. , Sepúlveda S. , Vaquero M. , González M. A. , Suárez E. , Roustán G. , Vilches C.
Published: May 2007

Herpes simplex virus type 1 (HSV‐1) causes lifelong latent infections in most humans. Periodical virus reactivations from latency in the neurons of sensitive ganglia lead to transport to mucocutaneous regions and productive replication, which results in recurrent inflammatory herpetic lesions or in asymptomatic virus shedding. The medical consequences of such lesions and the frequency of recurrences vary greatly in different subjects. Furthermore, many infected individuals never suffer manifestations of the disease, even when exposed to stimuli that trigger clinical recurrences in other humans. The origin of the variability in the clinical course of HSV‐1 infection remains unexplained. Herpesviruses and other pathogens sabotage the expression of major histocompatibility complex class I molecules by infected cells, thus subverting T‐cell‐mediated immunity. Subversion of antigen presentation is counteracted by natural killer cells, which survey the human leukocyte antigen (HLA) expression by specific receptors. These include the killer cell immunoglobulin‐like receptors (KIRs), which are encoded by a complex of extremely diverse and rapidly evolving genes. Here, we analyze the contribution of KIR gene diversity to the variable clinical course of HSV‐1 infection by comparing the distribution of these genes in humans with clinical manifestations of the disease with that in asymptomatically infected donors. This study provides preliminary evidence that the receptors KIR2DL2 and KIR2DS2 predispose to symptomatic HSV‐1 infection and favor the frequently recurring forms of the disease. Possible contribution of the ‘HLA‐C1’ ligand to HSV‐1 disease was not statistically supported. Because of an absolute genetic linkage between KIR2DL2 and KIR2DS2, we could not determine which receptor was primarily responsible for the observed association, but our results suggest that presence in the genome of KIR2DL2 and KIR2DS2 hinders an effective cellular response to HSV‐1.
Surveillance renal transplant biopsies and subclinical rejection at three months post‐transplant in pediatric recipients
Authors: Hymes Leonard C. , Greenbaum Laurence , Amaral Sandra G. , Warshaw Barry L.
Published: May 2007

Abstract:  Subclinical acute rejection (SCR) has been increasingly recognized in adult renal transplant recipients with the advent of surveillance biopsies. However, in children, surveillance biopsies are not routinely performed at most centers. Therefore, the incidence, predisposing factors, treatment, and clinical outcomes of SCR remain unclear in children. From August 2004 to December 2005, we performed 36 protocol biopsies at three months post‐transplantation. All patients had received induction therapy with basiliximab and were maintained on prednisone, MMF, and tacrolimus. Sixteen cases of SCR were detected by biopsy (44%). Age, gender, race, donor source, or serum creatinine did not discriminate between children with SCR and those with normal biopsies. All cases of SCR were treated with high doses of methylprednisolone. At one yr post‐transplant, renal function was similar in children with SCR to those with normal surveillance biopsies (p = 0.62). Because of the high incidence of SCR, the maintenance dose of MMF was increased by 50% in 20 children transplanted after December 2005. This resulted in a significant decline in the incidence of SCR from 44 to 15% (p < 0.05). However, the incidence of polyomavirus (BK) viremia also increased significantly in these children (p < 0.005). Conclusion: A high incidence of SCR was found on surveillance biopsies at three months post‐transplant and could not be predicted by age, gender, race, donor source, or serum creatinine. The occurrence of SCR declined significantly by increasing the dose of MMF, but resulted in an increase in BK viremia. We conclude that surveillance biopsies provide valuable information in the management of pediatric renal transplant recipients. Increasing immunosuppression to avoid SCR should be weighed against the risk for infection.
Living donor liver transplantation for acute liver failure in infants: The impact of unknown etiology
Authors: Sakamoto Seisuke , Haga Hironori , Egawa Hiroto , Kasahara Mureo , Ogawa Kohei , Takada Yasutsugu , Uemoto Shinji
Published: May 2007

Abstract:  Infants with ALF occasionally have the most urgent need for a liver transplant. In urgent situations for liver transplantation, LDLT has been advocated. Between July 1995 and April 2004, medical records of 15 infants undergoing LDLT for ALF of unknown etiology were reviewed and their outcomes were compared with infants undergoing LDLT for other liver diseases. They received LLS (n = 9), MS (n = 3), and RMS (n = 3) grafts. Eight technical complications occurred, with a similar incidence for LDLT and the other liver diseases. On the other hand, the liver biopsies after LDLT showed a significantly higher incidence of ACR with centrilobular injuries. Ten patients died after primary LDLT because of refractory rejection (n = 6), rotavirus infection (n = 2), chronic rejection (n = 1), and surgical complications (n = 1). With a median follow‐up of 7.0 months, five‐yr graft and patient survival rates were 17.8% and 26.7%, respectively. In conclusion, the outcome of LDLT for ALF in infants, especially cases with unknown etiology, was unsatisfactory and refractory rejection often led to liver failure. From our observation the centrilobular changes were characteristics of ACR in infantile LDLT for cryptogenic ALF.
Diversity of spiders after spring sowing – influence of farming system and habitat type
Authors: Öberg S.
Published: May 2007

Spiders contribute considerably to diversity in agroecosystems and are important components of natural pest control. Farming system and adjacent habitats may influence spider diversity. In this study, diversity of the spider families Lycosidae and Linyphiidae was studied after spring sowing until the time when a common pest (Rhopalosiphum padi) colonizes cereal fields. The spiders were collected with pitfall traps at eight organically or conventionally managed farms around Uppsala, Sweden, in three different habitats at each site: field margin, crop field and the edge between the two. The effects of farming system and habitat type on diversity of lycosids and linyphiids were considered using three different measures (activity density, species richness and composition). The most dominant species of each spider family, Pardosa agrestis (Lycosidae) and Oedothorax apicatus (Linyphiidae), had higher activity density at organic sites, and farming systems also contained different species compositions of both lycosid and linyphiid spiders. Also, linyphiid species richness was higher on conventional sites and linyphiid species composition was influenced by habitat type, in contrast with lycosids. Activity density and species richness of lycosid spiders were, on the other hand, more associated with field margins than linyphiid spiders.
Differential expression of Candida albicans secreted aspartyl proteinase in human vulvovaginal candidiasis
Authors: Lian Cui Hong , Liu Wei Da
Published: May 2007

The opportunistic pathogen Candida albicans secretes aspartic proteinases (Saps), which raises a particular interest because of their role as virulence factors. Candida albicans possesses at least 10 members of a SAP gene family, all of which have been sequenced. Although the expression of the SAP genes has been extensively characterised under laboratory growth conditions and Saps contribute to the virulence of C. albicans in animal models of infection, few studies have analysed the difference of the in vivo expression of these proteinases in recurrent vulvovaginal candidiasis (RVVC), vulvovaginal candidiasis (VVC) and asymptomatic Candida carriers. The RT‐PCR protocol was used to determine which of the SAP1 to SAP7 genes are expressed by C. albicans during asymptomatic Candida carriage, VVC and RVVC infection in this study. We found SAP2, the SAP4–6 and SAP7 were the predominant proteinase genes expressed in the sample of both Candida carriers and patients with VVC and RVVC. SAP2 and SAP4–6 mRNA were detected in all subjects. SAP1 and SAP3 transcripts were observed only in patients with VVC and RVVC. SAP7 mRNA expressions were detected in several of the patients and carriers samples. All seven SAP genes were simultaneously expressed in some patients with VVC and RVVC. This study demonstrates the differential expression of the secreted aspartic proteinases (Saps) genes during colonisation and VVC and RVVC infection in humans and correlates the expression of specific Candida species virulence genes with active disease and anatomical location.
Oral Candida colonization of human immunodeficiency virus infected subjects in Turkey and its relation with viral load and CD4+ T‐lymphocyte count
Authors: Erköse Gonca , Erturan Zayre
Published: May 2007

The association of asymptomatic oral Candida colonization with the markers of immunodeficiency and HIV is not clear yet. In addition, the prevalence of different Candida species colonizing the oral cavity of HIV‐infected patients in Turkey remains unknown. To evaluate these subjects, oral rinse samples were taken from 64 HIV‐positive individuals who have come to the department of Microbiology and Clinical Microbiology, Istanbul Medical Faculty for viral load and CD4+ T‐lymphocyte count measurement. The specimens were plated quantitatively on CHROMagar Candida. Oral Candida colonization was detected in 53 (82.8%) patients. The species isolated most frequently from carriers was Candida albicans (83%), followed by Candida glabrata (22.6%) and Candida dubliniensis (11.3%). More than one Candida spp. was isolated from 16 (30%) colonized patients. The status of yeast carriage and Candida load was not associated with the number of CD4+ cells or the viral load. Similarly, there was no statistical relation between the use of protease inhibitors, age, gender, smoking and the oral carriage of Candida. Other factors, which may be responsible for the high oral carriage of Candida spp. in this patient group, need to be researched.
Size Distribution of Dispersed Luteal Cells During Oestrous Cycle in Angora Goats
Authors: Kalender H , Arikan Ş
Published: May 2007

Contents

The present study examines the size distribution of the goat steroidogenic luteal cells throughout the oestrous cycle. Corpora lutea (CL) were collected after laparatomy on days 5, 10 and 16 of the oestrous cycle. Luteal cells were isolated from CL by collagenase digestion. Steriodogenic luteal cells were identified by staining of the cells for 3β‐hydroxysteroid dehydrogenase activity, a marker for steroidogenic cells. Luteal cells having steroidogenic capacity covered a wide spectrum of sizes, ranging from 5 to 37.5 μm in diameter. There was a significant increase in mean cell diameters (p < 0.01) as CL aged. The mean cell diameter on day 5 was 11.55 ± 0.12 μm, which was significantly increased and reached up to 19.18 ± 0.24 μm by day 16 of the oestrous cycle. The ratio of large to small luteal cells was 0.06:1.0 on day 5 of the oestrous cycle. This ratio increased to 0.78:1.0 by day 16 of the oestrous cycle. Luteal cell size on days 5, 10 and 16 of the oestrous cycle reached its maximum at 7.5, 10 and 35 μm in diameter, respectively. Development of CL is associated with an increase in luteal cell size in goats. It is likely that small luteal cells could develop into large luteal cells as CL becomes older during oestrous cycle in goats.
Psychotic disorder in a patient with central and extrapontine myelinolysis
Authors: LIM LESLIE , KRYSTAL ANDREW
Published: May 2007

Abstract  Central pontine and extrapontine myelinolysis (CPEM) are rare conditions usually associated with rapid correction of hyponatremia. Neurologic complications are the usual sequelae although neuropsychiatric features are rare. Described herein are unusual psychotic symptoms following CPEM and discussion of the likely pathogenesis and implications for treatment.
Effectiveness of kamishoyosan for premenstrual dysphoric disorder: Open‐labeled pilot study
Authors: YAMADA KAZUO , KANBA SHIGENOBU
Published: May 2007

Abstract  The purpose of the present paper was to investigate the efficacy of kamishoyosan (TJ‐24), a traditional Japanese herbal formula (kampo), for outpatients with premenstrual dysphoric disorder (PMDD) as an alternative treatment. Thirty patients with PMDD were treated with TJ‐24 for six menstrual cycles. Nineteen patients (63.3%) had >50% improvement in the total score of the Hamilton Depression Rating Scale (HAM‐D) Scale (17 items) in the late luteal phase. Fourteen patients (46.7%) went into remission (total HAM‐D score <7). In the present study many patients with PMDD were successfully treated with TJ‐24.
Hyperactivity and comorbidity in Japanese children with attention‐deficit/hyperactivity disorder
Authors: TAKAHASHI KAZUHIRO , MIYAWAKI DAI , SUZUKI FUTOSHI , MAMOTO AKIKO , MATSUSHIMA NORIAKI , TSUJI HISASHI , HORINO AKEMI , BALLAS PAUL A. , KIRIIKE NOBUO
Published: May 2007

Abstract  No previous study about comorbidity of attention‐deficit/hyperactivity disorder (ADHD) in Japan have carried out both a comprehensive investigation using a structured interview and a comparison between ADHD subtypes. The aim of the present study was to clarify the relationship between hyperactivity and disruptive behavior disorder (DBD) in ADHD by comparing a hyperactivity group (HG) with a non‐hyperactivity group (non‐HG). After diagnosis was carried out by strict exclusion, the 41 ADHD subjects (6–14 years old; IQ, 70–121) diagnosed according to DSM‐IV were divided into HG (n = 24) and non‐HG (n = 17), and compared for comorbidities and psychopathologies. This was done via semistructured interview with children and parents and questionnaires to parents and teachers. The results demonstrate that (i) most ADHD children had comorbidity (e.g. DBD or anxiety disorder); (ii) the HG had a significantly higher rate of DBD than the non‐HG, but the total number of anxiety disorders was not different between subgroups, and (iii) the HG generally had more serious psychopathologies both at home and at school than the non‐HG. Both groups had more serious externalizing and internalizing problems at home than at school. The present study provides evidence of a strong relationship between hyperactivity and DBD.
Clinical importance of caffeine dependence and abuse
Authors: OGAWA NAOSHI , UEKI HIROFUMI
Published: May 2007

Abstract Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder–fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in ‘eutrophic’ (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder–fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long‐term use of caffeine carry health risks.
Application of the Cockcroft–Gault method to estimate lithium dosage requirement
Authors: CHIU CHIH‐CHIANG , SHEN WINSTON W. , CHEN KUN‐PO , LU MONG‐LIANG
Published: May 2007

Abstract  The aim of the present study was to assess the precision and bias of a priori methods in the estimation of lithium dosage requirement among bipolar patients. The charts of 82 Diagnostic and Statistical Manual of Mental Disorder–fourth edition bipolar patients with previous history of lithium intoxication were reviewed. After excluding patients who had discontinued lithium treatment, 69 patients were entered to the study. Another 60 bipolar patients without history of lithium intoxication were also included in the study. The demographic data regarding factors thought to affect serum lithium concentrations, including gender, weight, and renal function, was retrospectively collected. Predicted daily lithium doses were calculated by using the new equation derived by the present authors and a priori methods proposed by Pepin et al., Zetin et al., Terao et al. and Keck et al. Mean error was calculated to assess the precision and bias of each a priori method. The Zetin method, the Terao method, and the Keck method had a significant tendency to overpredict dosage requirement. The Pepin method significantly underpredicted dosage. Only the 95% confidence interval of mean error of the present authors' equation was across zero. The present authors' equation represents a precise approach to estimate the lithium dose requirement and is easy to calculate. Regardless of the accuracy of each a priori method in predicting a patient's drug dosage, there is no substitute for proper serum drug concentration monitoring and good clinical judgment. Predictions made by any method should always be assessed clinically before applying its use in a patient.
Detecting mental disorders in dental patients with occlusion‐related problems
Authors: MIYACHI HIDEO , WAKE HIROYUKI , TAMAKI KATSUSHI , MITSUHASHI AKIRA , IKEDA TATSUNORI , INOUE KATSUO , TANAKA SATOMI , TANAKA KATSUTOSHI , MIYAOKA HITOSHI
Published: May 2007

Abstract  Dentists often treat patients who may be suffering from comorbid mental disorders without paying attention to their symptoms. This leads to a delay in starting the treatment of mental disorders and to inappropriate dental treatments for physical symptoms originating from mental disorders. In the present study, the ways in which dentists can easily detect mental disorders in dental patients with occlusion‐related problems were examined. Fifty‐three patients who visited the Occlusion Clinic of Kanagawa Dental College were interviewed by a psychiatrist and a dentist specialized in psychosomatic medicine. Thirty‐five patients (66.0%) were diagnosed as having DSM‐IV Axis I disorders. The demographic and psychological factors that correlate with the presence of mental disorders are duration of chief complaint, number of clinics and hospitals visited for the current symptom, total score of the General Health Questionnaire (GHQ), the scores of the anxiety and insomnia and social dysfunction subscales in the GHQ and the scores of the confusion–bewilderment and fatigue–inertia subscales in the Profile of Mood States (POMS). A logistic regression analysis indicated that number of clinics and hospitals visited markedly correlated with cormobidity of a mental disorder. This information may be useful for screening mental disorder patients. Dental patients having comorbid mental disorders should be treated both odontologically and psychologically.
Cerebellar volumes in men with schizophrenia and alcohol dependence
Authors: VARNÄS KATARINA , OKUGAWA GAKU , HAMMARBERG ANDERS , NESVÅG RAGNAR , RIMOL LARS M. , FRANCK JOHAN , AGARTZ INGRID
Published: May 2007

Abstract  The aim of the present study was to investigate the variation in cerebellar morphology in schizophrenia and alcohol dependence. Volumetric measurements of cerebellar structures were performed using magnetic resonance imaging in 17 men with schizophrenia, nine men with alcohol dependence, and 18 healthy men. Schizophrenia patients had smaller volumes of the posterior superior vermis, while alcohol‐dependent patients had smaller volumes of both the anterior and the posterior superior vermis compared with controls. The groups were not significantly different with respect to cerebellar hemisphere volumes. The results provide indications for differential morphological abnormalities of the cerebellar vermis in patients with schizophrenia and alcohol dependence.
Diagnostic classification and demographic features in 283 patients with somatoform disorder
Authors: KUWABARA HIDEKI , OTSUKA MICHITO , SHINDO MASANOBU , ONO SHIN , SHIOIRI TOSHIKI , SOMEYA TOSHIYUKI
Published: May 2007

Abstract  A total of 283 patients with somatoform disorder (SFD) seen in a psychiatry clinic were surveyed and their diagnostic subtypes, demographic features, and comorbidities, analyzed. The results indicate that: (i) SFD comprises 5.8% of first‐visit outpatients; (ii) undifferentiated SFD (USFD) and SFD not otherwise specified (SFD‐NOS) account for the majority of patients; (iii) there are 1.7‐fold more women than men; (iv) age of onset is lower in patients with somatization disorder or body dysmorphic disorder and higher in patients with hypochondriasis or pain disorder; (v) the mean number of years of education was 11.2 years; and (vi) comorbid illness were seen in 24.8% of patients, and included mood disorder, anxiety disorder, and personality disorder, as well as borderline intellectual functioning and mental retardation. The data indicate that the majority of patients with SFD are given a diagnosis of residual category, such as USFD or SFD‐NOS, and that the age of onset varies depending on the diagnostic subtype. SFD was more frequently seen in women, associated with comorbidities.
Postictal cardiovascular response predicts therapeutic efficacy of electroconvulsive therapy for depression
Authors: AZUMA HIDEKI , FUJITA AKIKO , SATO KIYOE , ARAHATA KEIKO , OTSUKI KAZUYUKI , HORI MIKI , MOCHIDA YOSHIHITO , UCHIDA MEGUMI , YAMADA TOMOKO , AKECHI TATSUO , FURUKAWA TOSHI A.
Published: May 2007

Abstract  Physiological parameters such as blood pressure (BP) and heart rate (HR) reflect autonomic response after seizure and may correlate with therapeutic efficacy in electroconvulsive therapy (ECT). However, the literature has been inconclusive with regard to the relationship between the effectiveness of ECT and physiological markers without atropine. In a consecutive sample of 24 patients with a drug‐resistant major depressive episode who underwent modified sine or pulse wave ECT without atropine, the correlation was examined between BP and HR before, and 2 min after electrical stimulation and therapeutic efficacy on depressive symptoms. When mode of stimulation (sine wave or pulse wave) and baseline Hamilton Rating Scale for Depression (HRSD) were controlled for, postictal diastolic BP, systolic BP, HR and rate pressure product (RPP) were all found to be significant predictors of post‐treatment HRSD. When these predictors were entered into stepwise regression, both postictal systolic BP and HR remained as significant predictors. The higher these postical physiological parameters, the more effective the course of ECT. It may be useful to examine such sensitive physiological parameters as BP, HR or RPP to determine effective or non‐effective electrical seizure.
Tobacco smoking habits among a complete cross‐section of Australian nursing students
Authors: Smith Derek R. , Leggat Peter A.
Published: May 2007

Abstract  This study was undertaken as a complete cross‐sectional survey of tobacco smoking habits among 270 undergraduate students at an Australian nursing school (response rate: 84.6%). An anonymous, self‐reporting questionnaire survey was used to gather the data. The overall prevalence of current smoking was 15.9%, with a further 8.5% being ex‐smokers. The nursing students consumed an average of 11.5 cigarettes per day, they began smoking at 20.8 years of age, and had an average smoking duration of 7.2 years. The students who had previously worked as a nurse were twice as likely to be current smokers. This study suggests that although tobacco smoking remains fairly common among Australian nursing students, its prevalence and distribution vary according to the individual demographics of the group under study. Future researchers will need to consider the changing demographic base from which the new generation of nursing students are drawn.
Childbirth overseas: The experience of Japanese women in Hawaii
Authors: Taniguchi Hatsumi , Baruffi Gigliola
Published: May 2007

Abstract  The purpose of this study is to investigate which kinds of stress women experience during childbirth in a foreign country and to explore whether childbirth in a foreign country influences women’s mental health. The study was a quantitative and qualitative mixed study. Forty‐five Japanese women, born and raised in Japan and who gave birth in Hawaii, USA, were telephone‐interviewed within 1 year after childbirth. The stress factors that emerged were: language barrier, distance from family and friends, different culture, and health‐care attitude about childbirth. Half of the participants experienced emotional dysfunction during their pregnancy. All primiparas experienced postpartum depression. The participants who had the maternity blues tended to have postpartum depression. Help from the participants’ mothers after childbirth decreased postpartum depression. The importance of mental health for foreign‐born primiparas emerges during the perinatal period.
The expertise of Finnish occupational health nurses
Authors: Naumanen Paula
Published: May 2007

Abstract  This study describes the self‐assessed activities, features, prerequisites, and consequences of occupational health nurses’ expertise. The quantitative data were gathered from 468 Finnish occupational health nurses, of whom 373 (80%) returned the completed questionnaire. The data were analyzed by using one‐way‐anova, the Kruskal–Wallis or the χ2‐tests. The activities of the occupational health nurses included working with employees, workplaces, and collaborative partners, administrative and office work, and other duties. The most important expert features were the holistic perspective and listening to clients. Continuing training and a positive attitude were the most necessary prerequisites for expertise. The main benefits of expertise, from the perspective of the occupational health nurses, were improved health and a decreased number of work‐related health risks. Support by the work community and good educational possibilities were important for expert practice. Occupational health nurses need to develop their expertise continually because they play a key role in promoting workers’ health.
Taiwanese adolescents’ gender differences in knowledge and attitudes towards menstruation
Authors: Cheng Ching‐Yu , Yang Kyeongra , Liou Shwu‐Ru
Published: May 2007

Abstract  The purpose of the study was to explore gender differences in knowledge and attitudes towards menstruation among Taiwanese adolescents. This study was a secondary data analysis of a cross‐sectional comparison study conducted in Taiwan. A total of 287 female and 269 male students at a junior high school participated in the study. The results showed that almost all the students had heard about menstruation and most of them had received menstrual information at school. However, their knowledge about menstruation was not accurate. Moreover, the male students expressed more negative attitudes towards menstruation than the female students. Taboos were heard by most students and, although many female students doubted the reality of the taboos they had heard, they observed them anyway. The study calls for an evaluation of sex education and suggests more open discussions about menstruation among young people in those education sessions. In addition, school nurses and obstetrical/gynecological nurses should be involved more in adolescents’ sexual education.
Care dependency among school‐aged children: Literature review
Authors: Tork Hanan , Lohrmann Christa , Dassen Theo
Published: May 2007

Abstract  Many disabilities and chronic illnesses of children result in those children being dependent on their caregivers. The higher dependence of children in their daily tasks undoubtedly places a greater burden on their caregivers and on care‐providers in the health‐care system, especially nurses. The objectives were to gain an overview of the literature dealing with care dependency among children and the factors possibly influencing their dependency on care, and to obtain instruments for measuring children’s care dependency. MEDLINE, CINAHL, and PsychINFO were searched for different publications from 1995 to 2005. The literature reveals four categories of factors associated with care dependency of the child. With respect to instruments, a variety of instruments were identified but most of them were restricted to children with specific health conditions. For this reason, the paper suggests the development of a new instrument for assessing children’s care dependency that is applicable to healthy children.
Effects of a diabetes self‐management program on glycemic control, coronary heart disease risk, and quality of life among Thai patients with type 2 diabetes
Authors: Wattana Chodchoi , Srisuphan Wichit , Pothiban Linchong , Upchurch Sandra L.
Published: May 2007

Abstract Uncontrolled diabetes is a major health problem in Thailand. The objective of this study was to determine the effects of a diabetes self‐management program on glycemic control, coronary heart disease (CHD) risk, and quality of life in 147 diabetic patients (aged 56.8 ± 10.2 years). Type 2 diabetic patients who met the research criteria were randomized into two groups for a period of 6 months: the experimental group received the diabetes self‐management program and the control group received the usual nursing care. The findings indicated that the experimental group demonstrated a significant decrease in the hemoglobin A1clevel and CHD risk, with an increase in quality of life (QOL) compared to the control group. The diabetes self‐management program was effective for improving metabolic control and the QOL for individuals with diabetes. Further studies should be replicated using larger groups over a longer time frame.
Serum gamma glutamyl‐transferase is a sensitive but unspecific marker of metastatic renal cell carcinoma
Authors: Simic Tatjana , Dragicevic Dejan , Savic‐Radojevic Ana , Cimbaljevic Slavica , Tulic Cane , Mimic‐Oka Jasmina
Published: May 2007

Objective:  To address the role of serum γ‐glutamyl transferase (GGT) as a marker of metastases in patients with renal cell carcinoma.

Methods:  Serum alkaline phosphatase and GGT were determined in 156 patients with localized renal cell carcinoma and 60 patients with metastases as proven by echosonography, computerized tomography and bone scan. The control group consisted of 50 healthy subjects matched for sex and age. Sensitivity and specificity of both enzymes as markers of metastatic disease were compared. In metastatic patients, enzyme activities were analyzed according to the site of metastases.

Results:  Both alkaline phosphatase and GGT activities were normal in majority of patients with localized renal cell carcinoma and increased in most of the patients with metastatic disease (80% and 70%, respectively). GGT did not significantly differ from alkaline phosphatase in terms of sensitivity (70% vs 80%) and specificity (89% vs 92%). Concerning the site of metastases, high frequencies of increased GGT and alkaline phosphatase were found in patients with liver‐only metastases (80% and 90%, respectively). All of the patients with both liver and bone metastases exhibited increased activity of both enzymes. Despite the fact that bone cells do not express GGT, increased activity was found in patients with bone metastases‐only (45%), suggesting that enzymes might be released from tumor cells.

Conclusions:  Our data provided evidence that GGT is a sensitive marker of metastatic renal cell carcinoma. However, findings of abnormal GGT activity cannot specify the site of involvement.
Nested variant of transitional cell carcinoma with osseous metaplasia of the urinary bladder: A case report and review of published reports
Authors: Neşe Nalan , Kandiloğlu Ali Rıza , Atesçi Yusuf Z
Published: May 2007

Abstract:  Nested variant of transitional cell carcinoma (NV‐TCC) of the bladder is a rare and relatively new entity. The tumor is aggressive contrasted by its benign histopathologic appearance, and characterized by irregular urothelial nests and/or tubules. Herewith, a case with exceptional osseous metaplasia is presented emphasizing its diagnostic difficulties, because it can be confused with benign diseases or conventional TCC.
Hematospermia associated with congenital arteriovenous malformation of internal iliac vessels
Authors: Suzuki Kuri , Nishimi Daisuke , Morioka Hajime , Takanami Masaharu
Published: May 2007

Abstract:  The presence of blood in the ejaculate is called hematospermia or hemospermia. While often perceived as a symptom of little significance, hematospermia can cause great concern to men who experience it. We report an unusual case of hematospermia associated with pelvic arteriovenous malformation (AVM). A 60‐year‐old man who visited our hospital complaining of hematospermia and pollakisuria was found to have AVM and aneurysmal changes in the left side of the pelvis using computed tomography (CT). The patient was treated with steel coil embolization of the left inferior gluteal artery, and after the procedure the hematospermia and pollakisuria remained absent without flare‐ups.
Case of acute urinary retention as a result of non‐steroidal anti‐inflammatory drugs
Authors: Minami Hidero , Matsutani Ryo , Mizokami Atsushi , Namiki Mikio
Published: May 2007

Abstract:  A 19‐year‐old woman presented at our hospital with acute urinary retention in September 2005. She had experienced the same chief complaint twice previously. She had used non‐steroidal anti‐inflammatory drugs before acute urinary retention. The results of physical examinations were unremarkable, and her neurologic signs were not remarkable. The basic laboratory test values were all normal and a psychiatric assessment indicated that her symptoms were not psychogenic. Magnetic resonance imaging was carried out, but revealed only a slight bulging in the L3/L4/L5 disk. Water cystometry showed acontractile detrusor. We made a diagnosis of acute urinary retention as a result of non‐steroidal anti‐inflammatory drugs because of her use of such drugs before the development of symptoms on multiple occasions. This patient was regularly followed up as an outpatient, and she could void smoothly in February 2006. This is the first report which acute urinary retention associated with non‐steroidal anti‐inflammatory drugs in Japan.
Could the tree diversity pattern in Europe be generated by postglacial dispersal limitation?
Authors: Svenning Jens‐Christian , Skov Flemming
Published: May 2007

The relative importance of contemporary climate and history as controls of geographical diversity patterns is intensely debated. A key example is the controversy over the extent to which temperate tree distributions and diversity patterns reflect postglacial dispersal limitation. Here, we focus on Central and Northern Europe, and show that recent estimates of tree migration rates < 100 m year−1 imply that many species have probably not reached equilibrium with climate in this region. We then demonstrate that geographical accessibility from glacial refuges explains 78% of the geographical variation in the region's tree diversity and is a much stronger diversity predictor than climate. Finally, we show that realistic estimates of migration rates can be derived from the observed tree diversity pattern by assuming it to be purely dispersal driven. In conclusion, the tree diversity pattern in Central and Northern Europe could, to a large extent, be a result of postglacial dispersal limitation.
Within‐plant signalling via volatiles overcomes vascular constraints on systemic signalling and primes responses against herbivores
Authors: Frost Christopher J. , Appel Heidi M. , Carlson John E. , De Moraes Consuelo M. , Mescher Mark C. , Schultz Jack C.
Published: May 2007

Plant volatiles play important roles in signalling between plants and insects, but their role in communication among plants remains controversial. Previous research on plant–plant communication has focused on interactions between neighbouring plants, largely overlooking the possibility that volatiles function as signals within plants. Here, we show that volatiles released by herbivore‐wounded leaves of hybrid poplar (Populus deltoides × nigra) prime defences in adjacent leaves with little or no vascular connection to the wounded leaves. Undamaged leaves exposed to volatiles from wounded leaves on the same stem had elevated defensive responses to feeding by gypsy moth larvae (Lymantria dispar L.) compared with leaves that did not receive volatiles. Volatile signals may facilitate systemic responses to localized herbivory even when the transmission of internal signals is constrained by vascular connectivity. Self‐signalling via volatiles is consistent with the short distances over which plant response to airborne cues has been observed to occur and has apparent benefits for emitting plants, suggesting that within‐plant signalling may have equal or greater ecological significance than signalling between plants.
Basin‐scale distribution patterns of picocyanobacterial lineages in the Atlantic Ocean
Authors: Zwirglmaier Katrin , Heywood Jane L. , Chamberlain Katie , Woodward E. Malcolm S. , Zubkov Mikhail V. , Scanlan Dave J.
Published: May 2007

Marine picocyanobacteria of the genera Prochlorococcus and Synechococcus are major contributors to oceanic primary production. The genera are genetically diverse, comprising several known ecotypes or lineages. However, little is known of the distribution of these lineages over large geographic areas. Here, we analysed the relative abundance of Prochlorococcus ecotypes and Synechococcus lineages at the ocean basin scale along an Atlantic Meridional Transect (AMT) using dot blot hybridization and fluorescence in situ hybridization (FISH) techniques. The transect covered several contrasting oceanic provinces (gyres, upwelling, temperate regions) as well as environmentally ‘equivalent’ regions in the northern and southern hemisphere (northern and southern gyres and temperate regions). Flow cytometric data revealed a discrete separation in abundance of major picocyanobacterial genera. Prochlorococcus reached highest abundance in oligotrophic regions, while more mesotrophic waters were dominated by Synechococcus. Individual genetic lineages of both Prochlorococcus and Synechococcus showed highly similar distributions in corresponding regions in the northern and southern hemisphere. In addition, Prochlorococcus showed a distinctive depth distribution, with HLI and HLII ecotypes near the surface and co‐occurring LL ecotypes further down in the water column. Conversely, Synechococcus generally revealed no obvious depth preference, but did show highly specific distribution at the horizontal scale, with clades I and IV particularly dominating temperate, mesotrophic waters in both the northern and southern hemispheres. The data clearly reveal that specific picocyanobacterial lineages proliferate in similar oceanic provinces separated by large spatial scales. Furthermore, comparison with an earlier AMT dataset suggests that basin scale distribution patterns for Prochlorococcus ecotypes are remarkably reproducible from year to year.
Flow cytometric identification and enumeration of photosynthetic sulfur bacteria and potential for ecophysiological studies at the single‐cell level
Authors: Casamayor Emilio O. , Ferrera Isabel , Cristina Xavier , Borrego Carles M. , Gasol Josep M.
Published: May 2007

We show the potential of flow cytometry as a fast tool for population identification and enumeration of photosynthetic sulfur bacteria. Purple (PSB) and green sulfur bacteria (GSB) oxidize hydrogen sulfide to elemental sulfur that can act as storage compound to be further oxidized to sulfate generating the reducing power required for growth. Both groups have different elemental sulfur allocation strategies: whereas PSB store elemental sulfur as intracellular inclusions, GSB allocate sulfur globules externally. We used well‐characterized laboratory strains and complex natural photosynthetic populations developing in a sharply stratified meromictic lake to show that PSB and GSB could be detected, differentiated and enumerated in unstained samples using a blue laser‐based flow cytometer. Variations in cell‐specific pigment content and the dynamics of sulfur accumulation, both intra‐ and extracellularly, were also detected in flow cytometric plots as sulfur accumulation changed the light scatter characteristics of the cells. These data were used to show the potential for studies on the metabolic status and the rate of activity at the single‐cell level. Flow cytometric identification and enumeration resulted in faster and more precise analyses than previous approaches, and may open the door to more complex ecophysiological experiments with photosynthetic sulfur bacteria in mixed cultures and natural environments.