bluuebunny/crossref_metadata_2025 huggingface dataset:
Dasatinib inhibits progenitor cell proliferation from polycythaemia vera
Authors: Wappl M. , Jaeger E. , Streubel B. , Gisslinger H. , Schwarzinger I. , Valent P. , Oehler L.
Published: July 2008

Background  A mutation of Janus kinase 2 V617F is present in most patients with polycythaemia vera (PV). However, it is generally believed that JAK2V617F is not the sole molecular abnormality in PV. Since dasatinib is currently evaluated in patients with PV, it is of interest to study the effects of dasatinib on the growth of clonal progenitor cells in vitro.

Design and methods  Peripheral blood mononuclear cells from patients with PV, chronic myeloid leukaemia (CML) and controls were exposed to dasatinib (0·1 to 500 nm mL−1). Colony growth was stimulated by interleukin‐3, granulocyte‐macrophage colony‐stimulating factor and erythropoietin. Endogenous erythroid colony (EEC) growth was investigated without exogenous cytokines. Real‐time PCR was performed to assess the percentage of JAK2V617F cells.

Results  10 nm of dasatinib suppressed EEC growth from PV by 89% (P = 0·002). This inhibition was dose dependent and occurred at pharmacological concentrations. Erythroid and myeloid colony growth was also significantly suppressed in the presence of exogenous cytokines. When compared to PV the inhibition of stimulated colony growth was significantly less pronounced in controls but tended to be more vigorous in CML. Interestingly, despite the potent inhibition of PV cells real‐time PCR revealed that the numbers of JAK2V617F transcripts did not decrease upon exposure to dasatinib.

Conclusion  This study shows a marked inhibition of the proliferative capacity of progenitor cells from PV. Although JAK2V617F transcript levels did not decrease upon exposure to dasatinib, the drug might suppress PV progenitors through inhibition of a yet undefined molecular target.
Physical forces constrain the depth distribution of the abundant native mussel Elliptio complanata in lakes
Authors: CYR HÉLÈNE
Published: July 2008

1. Unionid mussels often account for a large portion of benthic biomass and contribute to nutrient cycling and sediment processes, but are thought to be limited to shallow areas (<2–3 m).

2. The depth distribution and body size of Elliptio complanata were compared in seven Canadian Shield lake basins of different sizes to test what factors determine the upper and lower limit of their depth range. Specifically, I tested whether (i) the upper range of their distribution is limited by exposure to winds and wave action and (ii) the lower range of their distribution is limited by the depth of the thermocline or by the boundary of mud deposition.

3. The average depth distribution of E. complanata shifted to greater depths in larger lake basins. When comparing individual transects, maximum mussel density was found deeper at more exposed sites. Mussel size decreased with increasing depth and was larger, on average, in larger lake basins. These results suggest that physical forces limit the upper range of mussel distribution in lakes.

4. The maximum depth at which mussels were found in different lakes was closely related to thermocline depth. However, mussels were commonly observed below the predicted depth of the mud deposition boundary. The thermocline limits the lower range of mussel distribution in lakes, probably by limiting food availability and by determining water temperature. Substratum type does not limit the lower distribution of mussels.

5. These results suggest that unionid mussels are present in the deeper parts of the littoral zone, especially in large lakes. Therefore, comparisons of mussel populations between sites and between lakes would be biased unless the full depth distribution of these mussels is considered. These results also suggest that long‐term changes in the thermal structure of lakes could affect the range of unionid mussel populations and their functional role in littoral ecosystems.
Role of hyperglycaemia in the pathogenesis of hypotension observed in type‐1 diabetic rats
Authors: Liu I‐Min , Chang Cheng Kuei , Juang Shiow‐Wen , Kou Dai‐Huang , Tong Yat‐Ching , Cheng Kai‐Chun , Cheng Juei‐Tang
Published: July 2008

The role of hyperglycaemia in the pathogenesis of hypotension in diabetic disorders was investigated using the changes in cardiac M2‐muscarinic receptor (M2‐mAChR) gene expression in type‐1‐like diabetic rats and cultured cardiomyocytes. Blood pressure was markedly decreased in diabetic rats following the intravenous injection of streptozotocin (STZ) for 8 weeks. Also, the baroreflex sensitivity (ΔHR/ΔBP), as measured by the changes in heart rate (ΔHR) and mean blood pressure (ΔBP) 1 min after the intravenous injection of phenylephrine (10 μg/kg), was significantly increased. Arecaidine propargyl ester (APE), a M2‐mAChR agonist produced a marked reduction in heart rate in these diabetic rats. Normalization of plasma glucose in diabetic rats using insulin (0.5 IU) or phlorizin (1 mg/kg) injection attenuated the blood pressure reduction and reversed the mRNA and protein levels of cardiac M2‐mAChR. A high concentration of glucose (20 mmol/l) directly influenced the increase in gene expression of M2‐mAChR in the H9c2 cardiac cell line. Hyperglycaemia induced an increase in cardiac M2‐mAChR gene expression, suggesting a role in the pathogenesis of hypotension in diabetic disorders.
Effects of urine pH modification on pharmacokinetics of phenobarbital in healthy dogs
Authors: FUKUNAGA K. , SAITO M. , MUTO M. , MISHIMA K. , FUJIWARA M. , ORITO K.
Published: July 2008

Although pH modification is one of the effective strategies for dissolving or preventing uroliths, little is known about its effects on the pharmacokinetics of phenobarbital in dogs. Five spayed, female Beagles were fed with a twice‐daily diet that included potassium citrate and ammonium chloride for urine alkalinization and acidification, respectively. After a stabilizing period of 7 days, a single clinical dose of phenobarbital (3 mg/kg) was orally administered, and time‐course changes in its serum and urine concentrations were determined by high‐performance liquid chromatography. Total amounts of unchanged phenobarbital excreted into urine for 216 h were decreased by urine acidification and increased by urine alkalinization. The elimination half‐life of serum phenobarbital in dogs with urine alkalinization was shortened andClRincreased when compared with dogs with urine acidification. Other pharmacokinetic parameters, includingCmax,Tmax,AUC0–216,Cl/F, andAe0–216were not changed by modification of the urine pH. These results suggest that the pH of urine is likely to be a determinant of the pharmacokinetics, especially urine excretion rate, of a clinical dose of oral phenobarbital. It is possible that the serum concentration of phenobarbital might be altered when a pH modifying‐diet is administered for the purpose of dissolving or preventing uroliths.
The influence of multiple dispersal mechanisms and landscape structure on population clustering and connectivity in fragmented artesian spring snail populations
Authors: WORTHINGTON WILMER J. , ELKIN C. , WILCOX C. , MURRAY L. , NIEJALKE D. , POSSINGHAM H.
Published: July 2008

Many organisms occupy heterogeneous landscapes that contain both barriers to movement as well as corridors that facilitate dispersal. The extent to which such features determine population connectivity will depend on the mechanisms utilized by organisms to disperse. Here we examined the interaction between landscape structure and dispersal in the endemic aquatic snail,Fonscochlea accepta, in the fragmented artesian spring ecosystem of arid central Australia. We used frequentist and Bayesian analyses of microsatellite data to identify population structure and immigration for 1130 snails sampled from 50 springs across an entire spring complex. We introduce a modified isolation‐by‐distance analysis to test hypotheses about how populations are clustered and to distinguish the most likely dispersal pathways within and between those clusters. Highly significant differences inFSTvalues and significant isolation‐by‐distance patterns were detected among springs across the entire complex, while Bayesian assignment tests revealed the presence of two hierarchical levels of spring clustering. Clusters were defined by the spatial aggregation of springs, dynamic aquatic habitat connections between springs and the ecology of the snails. Bayesian immigrant identification and our modified isolation‐by‐distance analysis revealed that dispersal occurs at two geographical scales via two very different mechanisms. Short range dispersal (usually ≤ 300 m) occurs via active movement facilitated by aquatic connections among springs while long‐range dispersal (≥ 3 km) is likely facilitated by an animal vector (phoresy). These results underline the importance of both dispersal mode and landscape structure in influencing connectivity rates and patterns among populations.
Population genetic structure and diversity of the Apennine endemic stream frog, Rana italica– insights on the Pleistocene evolutionary history of the Italian peninsular biota
Authors: CANESTRELLI DANIELE , CIMMARUTA ROBERTA , NASCETTI GIUSEPPE
Published: July 2008

For most species in the Western Palaearctic region, southern Mediterranean peninsulas have been identified as major Quaternary refugia and hotspots of intraspecific diversity, and thus, as areas of particular relevance for the conservation of the evolutionary potential. We analysed the patterns of geographical variation among 26 populations of the Italian stream frog, using both nuclear (allozymes) and mitochondrial (partial cytochrome b sequences) markers. Phylogenetic, phylogeographical and population genetic analyses suggested that the species survived the last glacial–interglacial cycles in two distinct refugia, one restricted to the tip of the Calabrian peninsula, at the extreme south of the species’ range, the other spanning from central Calabria to central Apennines and showing evidences for further population subdivision therein. Historical demographic tests suggested a significant population expansion from the latter, which most likely began around the last pleniglacial. This expansion would have led to the rapid colonization of the northern Apennines to the north, and to a secondary contact and population admixture with the population from the southern refugium in southern central Calabria. A comparison of the evolutionary history inferred for the Italian stream frog with the data emerging for other codistributed species suggests: (i) the generality of a multiple‐refugia scenario for the Italian peninsula, (ii) the possible occurrence of at least one suture zone in southern Italy, and (iii) that for most species, this Pleistocene refugium is not only a hotspot, but also a melting pot of intraspecific genetic diversity. Finally, the conservation implications of these results are also briefly highlighted.
Mitochondrial phylogeography of the European sprat (Sprattus sprattus L., Clupeidae) reveals isolated climatically vulnerable populations in the Mediterranean Sea and range expansion in the northeast Atlantic
Authors: DEBES P. V. , ZACHOS F. E. , HANEL R.
Published: July 2008

We examined the genetic structure of the European sprat (Sprattus sprattus) by means of a 530‐bp sequence of the mitochondrial control region from 210 fish originating from seven sampling localities of its distributional range. Phylogeographical analysis of 128 haplotypes showed a phylogenetic separation into two major clades with the Strait of Sicily acting as a barrier to gene flow between them. While no population differentiation was observed based on analysis of molecular variance and net nucleotide differences between samples of the Baltic Sea, the North Sea and the Bay of Biscay nor between the Black Sea and the Bosporus, a strong population differentiation between these samples and two samples from the Mediterranean Sea was found. Further, the biggest genetic distance was observed within the Mediterranean Sea between the populations of the Gulf of Lyon and the Adriatic Sea, indicating genetic isolation of these regions. Low genetic diversities and star‐like haplotype networks of both Mediterranean Sea populations point towards recent demographic expansion scenarios after low population size, which is further supported by negative FS values and unimodal mismatch distributions with a low mean. Along the northeast Atlantic coast, a northwards range expansion of a large and stable population can be assumed. The history of a diverse but differentiated Black Sea population remains unknown due to uncertainties in the palaeo‐oceanography of this sea. Our genetic data did not confirm the presently used classification into subspecies but are only preliminary in the absence of nuclear genetic analyses.
Light controls shoot meristem organogenic activity and leaf primordia growth during bud burst in Rosa sp.
Authors: GIRAULT TIFFANIE , BERGOUGNOUX VERONIQUE , COMBES DIDIER , VIEMONT JEAN‐DANIEL , LEDUC NATHALIE
Published: July 2008

Light controls bud burst in many plants, which subsequently affects their architecture. Nevertheless, very little is known about this photomorphogenic process. This study ascertains the effects of light on bud burst and on two of its components, i.e. growth of preformed leaves and meristem organogenesis in six cultivars from three Rosa species (R. hybrida L., R. chinensis L., R. wichurana L.). Defoliated plants were severed above the third basal bud and exposed, either to darkness or to different intensities of white light, to blue, red or to FR, at constant temperature. Bud bursting was inhibited in darkness in the six cultivars of Rosa, but not in Arabidopsis, tomato and poplar plants under the same condition. In all Rosa cultivars, bud burst, growth of preformed leaves and meristem organogenesis were triggered by blue and red lights, and extended by increasing light intensities. FR was inhibitory of bud burst. Partial shading experiments demonstrated that bud and not stem was the active site for light perception in bud burst.
Spatial aggregation in Fusarium pseudograminearum populations from the Australian grain belt
Authors: Bentley A. R. , Milgroom M. G. , Leslie J. F. , Summerell B. A. , Burgess L. W.
Published: July 2008

Previous studies have evaluated the overall structure of populations of Fusarium pseudograminearum (teleomorph, Gibberella coronicola), causal agent of cereal crown rot, but there is no information available on spatial relationships of genetic variation in field populations. Three 1‐m‐row sections in crown‐rot‐affected wheat fields in the Australian grain belt were intensively sampled to estimate population genetic parameters and the spatial aggregation, or clustering, of disease aggregates and genotypes. Estimates of population genetic parameters based on amplified fragment length polymorphisms (AFLPs) indicated that the genetic diversity in isolates from the 1‐m‐row populations described a significant portion of the diversity recorded for corresponding field and regional populations. In point pattern analysis, there was physical clustering and aggregation of F. pseudograminearum isolates from two of the three sites. Analysis of the spatial distribution of clonal haplotypes (DICE similarity ≥ 97%) indicated significant aggregation of clones in all three 1‐m‐row populations. Based on matrix comparison tests, both mating types and genetic distances had significant spatial aggregation for at least two of the three 1‐m‐row populations. This is consistent with the presence of non‐random spatial genetic structure due to clonal aggregation. High levels of genetic diversity and spatial structuring of disease and genotypes in at least two of the three 1‐m‐row populations is consistent with the hypothesis that stubble is a primary inoculum source in no‐tillage farming systems, resulting in aggregated patterns of disease and allowing for haplotypes to be maintained in the field over a number of annual cropping cycles.
Carbamazepine‐induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: report of four cases and brief review
Authors: Ganeva Maria , Gancheva Tanya , Lazarova Roumiana , Troeva Jeni , Baldaranov Ivan , Vassilev Ivan , Hristakieva Evgenya , Tzaneva Valentina
Published: July 2008

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe drug reaction, most commonly to aromatic anticonvulsants with a delayed onset, variable clinical presentation and protracted course. The exact incidence of DRESS syndrome is not known because of the variability in clinical presentation, lack of strict diagnostic criteria and universally accepted nomenclature.

We report four cases of DRESS syndrome associated with the use of carbamazepine. The clinical manifestation was similar: a maculopapular eruption progressing to exfoliative erythroderma, fever, and lymphadenopathy. Leukocytosis, atypical lymphocytes and liver injury (in 2 patients) were also observed. Assessment of causality using the Naranjo algorithm established a “probable” relationship with carbamazepine in three of the cases and a “possible” relationship in one case.

Detection of DRESS syndrome is dependent on the exclusion of a variety of diseases with similar manifestations and may be delayed in time. DRESS syndrome is a potentially life‐threatening multisystem adverse drug reaction, and accidental reexposure or drug provocation tests must be avoided.
Surgical pearl: a simple means of disarming the “locked and loaded” needle
Authors: Kunishige Joy , Wanitphakdeedecha Rungsima , Nguyen Tri H. , Chen T. Minsue
Published: July 2008

Background  Surgery, in any setting, has several inherent risks not only to the patient, but the physician and his assistants as well. Safe handling and management of the sharps to prevent inoculation injuries is one of these risks, in particular: 1) instrument hand‐off of the needle and needle driver between the physician and his assistants; 2) retrieval of instruments from the surgical tray.

Objective  The authors’ review a simple means of disarming the needle loaded in the needle driver to reduce sharps injury.

Methods  Before the needle and needle driver are either handed off to the assistant or returned to the surgical tray, pivot the needle 90 degrees toward the instrument joint. The needle's point should be directed toward and touching the needle driver, and thereby, disarming the needle. To avoid dulling the needle, the point should not be grasped by the needle driver.

Conclusions  Disarming the loaded needle may reduce the chance of sharps injury during instrument hand off and retrieving instruments from the surgical tray.
Main pigmentary features and melanocortin 1 receptor (MC1R) gene polymorphisms in the population of the Canary Islands
Authors: F.‐de‐Misa Ricardo , Pérez‐Méndez Lina I. , Hernández‐Jiménez José G. , Del Cristo Rodríguez María , Vilar María Concepción , Suárez José , Claveríe‐Martín Félix
Published: July 2008

Background  Sun exposure, light skin pigmentation, and melanocortin 1 receptor (MC1R) gene variants are independent risk factors for skin cancer. The Canary Islands have a sunny and temperate climate, but data regarding the phenotypic and genotypic risk factors among the population are lacking.

Methods  The main phenotypic features (skin color, hair color, eye color, and freckling) of 5116 healthy individuals are described. The genotypic findings of six MC1R gene variants (V60L, D84E, R150C, R160W, R163Q, and T314T) in 116 healthy individuals from a population‐based cohort with at least three generations of Canary Islands’ ancestry are evaluated. The variants were analyzed by SNaPshot.

Results  Fifty per cent of the population showed at least one phenotypic risk factor (fair skin, 34.3%; freckling, 17.4%; green or blue eyes, 16.8%; red or blonde hair, 7.8%), although brown skin (65.7%), dark eyes (83.2%), and dark hair (92.2%) prevailed. Forty‐three per cent of the individuals showed at least one of the MC1R variants studied. Allelic frequencies for V60L, D84E, R150C, R160W, R163Q, and T314T were 9.1%, 1.7%, 3.0%, 0.8%, 3.0%, and 8.2%, respectively.

Conclusion  A significant proportion of the population showed risk factors for skin cancer. The inhabitants of the Canary Islands are phenotypically and genotypically close to Mediterranean populations.
Clinicopathologic challenge
Authors: Campbell Tracy , Altman Rachel , Tharp Michael , Dy Lady
Published: July 2008

What is your diagnosis?
Cutaneous blastomycosis: a diagnostic challenge
Authors: Mason Ashley R. , Cortes Gil Y. , Cook Joel , Maize John C. , Thiers Bruce H.
Published: July 2008

Primary cutaneous inoculation blastomycosis occurs less commonly than secondary blastomycosis, in which cutaneous lesions most often originate from a primary pulmonary infection which disseminates through the blood or lymphatics to involve the skin. In secondary cutaneous blastomycosis, the primary pulmonary infection is frequently subclinical at the time cutaneous lesions manifest. Here we report two cases that illustrate the difficulty in distinguishing between primary and secondary cutaneous involvement. We also review the expanding literature on blastomycosis since its identification over a century ago.
Genetic affinities of north and northeastern populations of India: inference from HLA‐based study
Authors: Agrawal S. , Srivastava S. K. , Borkar M. , Chaudhuri T. K.
Published: July 2008

India is like a microcosm of the world in terms of its diversity; religion, climate and ethnicity which leads to genetic variations in the populations. As a highly polymorphic marker, the human leukocyte antigen (HLA) system plays an important role in the genetic differentiation studies. To assess the genetic diversity of HLA class II loci, we studied a total of 1336 individuals from north India using DNA‐based techniques. The study included four endogamous castes (Kayastha, Mathurs, Rastogies and Vaishyas), two inbreeding Muslim populations (Shias and Sunnis) from north India and three northeast Indian populations (Lachung, Mech and Rajbanshi). A total of 36 alleles were observed at DRB1 locus in both Hindu castes and Muslims from north, while 21 alleles were seen in northeast Indians. At the DQA1 locus, the number of alleles ranged from 11 to 17 in the studied populations. The total number of alleles at DQB1 was 19, 12 and 20 in the studied castes, Muslims and northeastern populations, respectively. The most frequent haplotypes observed in all the studied populations were DRB1*0701‐DQA1*0201‐DQB1*0201 and DRB1*1501‐DQA1*0103‐DQB1*0601. Upon comparing our results with other world populations, we observed the presence of Caucasoid element in north Indian population. However, differential admixturing among Sunnis and Shias with the other north Indians was evident. Northeastern populations showed genetic affinity with Mongoloids from southeast Asia. When genetic distances were calculated, we found the north Indians and northeastern populations to be markedly unrelated.
HLA‐G polymorphism and transitional cell carcinoma of the bladder in a Brazilian population
Authors: Castelli E. C. , Mendes‐Junior C. T. , Viana de Camargo J. L. , Donadi E. A.
Published: July 2008

The morphologic appearance and clinical behavior of the human urinary bladder papillary transitional cell carcinoma (TCC) probably result from a complex interaction between carcinogenic insults and host resistance during the patient’s life. While the main recognized risk factors are of environmental origin (e.g. smoking), relatively little information exists about the susceptibility to TCC development. The human leukocyte antigen G (HLA‐G) molecule plays an important role in immune response regulation and has been implicated in the inhibition of the cytolytic function of natural killer and cytotoxic T cells. Several lines of evidence indicate that HLA‐G polymorphisms influence the expression level and production of different HLA‐G isoforms. The aim of this study was to explore a possible influence of the HLA‐G polymorphism on the susceptibility to urinary bladder TCC development and progression in smokers and nonsmokers Brazilian subjects. The HLA‐G locus was found to be associated with susceptibility to TCC development and progression. The G*0104 allelic group (specially the G*010404 allele) and the G*0103 allele were associated with a tobacco‐dependent influence on TCC development. The G*0104 group was associated with progression to high‐grade tumors, irrespective of smoking habit, while the G*0103 allele was associated to high‐grade tumor only in smoking patients. Our results are an evidence that the HLA‐G locus itself, or as part of an extended haplotype encompassing this chromosome region (particularly the HLA‐A given the high linkage disequilibrium observed between them in this data series), may be associated with TCC susceptibility and tumor progression, suggesting a tobacco‐dependent influence of these polymorphisms.
A Taqman assay for high‐throughput genotyping of the multiple sclerosis‐associated HLA‐DRB1*1501 allele
Authors: Goris A. , Walton A. , Ban M. , Dubois B. , Compston A. , Sawcer S.
Published: July 2008

The human leukocyte antigen (HLA)‐DRB1*1501 allele has long been established as the main genetic risk factor for multiple sclerosis (MS), and it therefore follows that stratification of study populations for this allele could aid in the identification of novel susceptibility genes and/or in establishing interactions. To this end, we have developed a simple Taqman‐based assay allowing cost‐efficient medium‐throughput HLA‐DRB1*1501 genotyping. We have validated this assay in 444 trio families with MS and 1066 individuals from the UK 1958 birth cohort (3908 independent chromosomes). In this validation cohort, the correlation coefficient (r2) between rs3135388*A and HLA‐DRB1*1501 was >0.94. Subsequently, applying the assay to a group of MS patients and controls from Belgium confirmed the association of HLA‐DRB1*1501 and MS in this population (P = 5 × 10−21).
Short‐ and long‐time effects of pediatric liver transplantation on serum cholesterol and triglyceride levels – The Vienna Cohort
Authors: Becker Julia , Huber Wolf‐Dietrich , Aufricht Christoph
Published: July 2008

Abstract:  Hyperlipidemia is common in patients after LTX. Although immunosuppressive protocols have changed, there are only few data after pediatric LTX. Aim of our study was to evaluate short‐ and long‐time effects of LTX on serum cholesterol and triglycerides in children with different immunosuppressive regimen. We retrospectively analyzed 24 children (seven boys) who underwent LTX since 1987 and were followed for at least one yr at the Medical University of Vienna. Serum lipids, liver function and records of immunosuppressive therapy were evaluated at first referral, shortly before and three, six, nine and 12 months after LTX, and at last visit (mean 6.6 yr after LTX). At first referral, serum lipids were significantly related to underlying disease and age. Following LTX, prevalence of hypercholesterolemia was 25% and of hypertriglyceridemia 90% after the first year. Long‐term follow‐up showed an overall decrease of serum lipids. Significant decreases in serum triglycerides were directly related to discontinuation of steroids. There was no effect of calcineurin inhibitiors. Our study confirms the high prevalence of hyperlipidemia before and after pediatric LTX and suggests a major role of steroid‐withdrawal for the control of post‐transplant hypertriglyceridemia.
Stable public goods cooperation and dynamic social interactions in yeast
Authors: CRAIG MACLEAN R. , BRANDON C.
Published: July 2008

Despite long‐standing theoretical interest in the evolution of cooperation, empirical data on the evolutionary dynamics of cooperative traits remain limited. Here, we investigate the evolutionary dynamics of a simple public goods cooperative trait, invertase secretion, using a long‐term selection experiment in Saccharomyces cerevisiae. We show that average investment in cooperation remains essentially constant over a period of hundreds of generations in viscous populations with high relatedness. Average cooperation remains constant despite transient local selection for high and low levels of cooperation that generate dynamic social interactions. Natural populations of yeast show similar variation in social strategies, which is consistent with the existence of similar selective pressures on public goods cooperation in nature.
Identification of Malassezia species from pityriasis versicolor in Indonesia and its relationship with clinical characteristics
Authors: Krisanty Roro Inge Ade , Bramono Kusmarinah , Made Wisnu I.
Published: July 2008

Pityriasis versicolor (PV) is a chronic superficial fungal disease caused by Malassezia spp. The incidence is as high as 30–40% in tropical climates. Previous studies indicate that the geographic factor has influence on the main species isolated from PV. Our aim was to identify Malassezia spp. from PV patients in Indonesia and their correlation to clinical characteristics. Isolates of Malassezia were collected from 98 PV patients (62 males and 36 females). Identification was based on morphological observation and biochemical evaluation. Leeming Notman agar was used as isolation culture medium. The biochemical evaluation consisted of specimen culture onto Sabouraud dextrose agar, Cremophor EL, Esculin, Dixon’s agar at 37 °C and catalase reaction. The isolates found were Malasseziafurfur (42.9%), M. sympodialis (27.5%), M. globosa (13.3%), M. slooffiae (7.7%), M. obtusa (7.7%) and M. restricta (2.2%), and 7.14% specimens were unidentified. There was no statistically significant association between Malassezia spp. and demographic characteristics and clinical characteristics of the patients. Unlike reports from temperate climate countries, this study in Indonesia found M. furfur as the most frequently isolated Malassezia spp. in PV patients.
The scholarly work of Janice Morse: Synthesis and reflection
Authors: Porr Caroline
Published: July 2008

The author was afforded opportunity during her doctoral studies to compile and reflect upon the scholarly work of nurse researcher, Dr Janice Morse. Morse's refinement and development of patient‐centred, empirically based concepts and theories, and her mastery of a diverse research repertoire, are an indisputable contribution to nursing knowledge. The author delineates four ways by which Morse's work contributes to nursing's disciplinary body of knowledge: (i) the consistent focus on the nurse–patient domain; (ii) the multiplicity of knowledge forms; (iii) the promotion of paradigm integration and methodological pluralism; and (iv) the predominance of prescriptive theories. Additionally, conjecture is put forth regarding the philosophical assumptions underpinning Morse's work. Morse serves as an excellent role model for nurse researchers who strive to ensure that nursing theories are amenable to clinical application, to research investigation and to utilization as a pedagogical tool.
Knowledge and management of infants' pain by mothers in Ile Ife, Nigeria
Authors: Olaogun Adenike , Ayandiran Olufemi , Olalumade Oluwatoyin , Obiajunwa Perpetua , Adeyemo Florence
Published: July 2008

Mothers' knowledge and management of pain in infants were assessed in this study. A total of 130 mothers from two health centres in Ile Ife, Southwest, Nigeria were selected by systematic sampling method. Only 3.8% indicated that neonates experience pain. Malaria (46.2%) was the major cause of pain identified. Analgesic/antimalarials (56.9%) and breastfeeding (16.9%) are used in pain relief. To improve the quality of life of infants, mothers must be educated on the assessment, early detection and management of pain.
Exploring relationships in teenage pregnancy
Authors: Whitehead Elizabeth
Published: July 2008

The aim of this paper is to report a study exploring aspects of teenage pregnant women relationships with the fathers of their unborn children within the context of two contrasting demographic areas of the UK. The perceptions of teenage pregnant women on how they view their relationship with the fathers of their unborn babies has not been fully investigated. Three major categories emerged from the perspectives of 47 teenage pregnant women: (i) age of baby's father; (ii) education and employment status of baby's father; and (iii) ability of baby's father to provide financial support. Teenage pregnant women living in the south‐east were more likely to maintain the relationship with fathers of their babies than those living in the north‐west. This was found to be statistically significant. The age, employment status and education of the baby's father can influence the continuance of the partnership between the participant and of the father of her baby. The statistical difference in the maintenance of the relationship between the prospective parents may be associated with the continuing demographic and cultural characteristics of the north‐west, where teenage pregnancy remains high and the south‐east where the rates are low.
Personal resources supporting living at home as described by older home care clients
Authors: Eloranta Sini , Routasalo Pirkko , Arve Seija
Published: July 2008

This study describes the personal resources of older (≥ 75 years) home care clients in Finland and their perceptions of factors that enhance and constrain their ability to live independently at home. The data were collected by unstructured interviews with 21 older home care clients. Inductive content analysis were used to analyse the data. The resources of older people consisted of a sense of control over one's life and a determination to remain active. Factors enhancing older people's resources were their involvement in leisure activities and social networks, factors undermining their resources were conditions on living imposed by outsiders, declining health and loneliness. The results show that home care professionals do not yet have sufficient skills and abilities to identify and support older people's existing resources. As well as having access to necessary resources, it is also crucial that older people know how to use them.
The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit
Authors: Picheansathian Wilawan , Pearson Alan , Suchaxaya Prakin
Published: July 2008

This quasi‐experimental study aimed to identify the impact of a promotion programme on hand hygiene practices and its effect on nosocomial infection rates in a neonatal intensive care unit of a university hospital in Thailand. The study populations were 26 nursing personnel. After implementing a hand hygiene promotion programme, compliance with hand hygiene among nursing personnel improved significantly from 6.3% before the programme to 81.2% 7 months after the programme. Compliance rate did not correlate with the intensity of patient care. Nosocomial infection rate did not decrease after the intervention, probably because of the multifactorial nature of infections. All participants agreed that promotion programme implemented in this project motivated them to practise better hand hygiene. This study indicated that multiple approaches and persistent encouragement are key factors leading to a sustained high level of appropriate hand hygiene practices among nursing personnel.
Going the distance—Experiences of women with gynaecological cancer residing in rural remote north Queensland
Authors: Baldwin Adele E , Usher Kim
Published: July 2008

Women who are diagnosed with gynaecological cancer face a difficult journey. For women residing in areas geographically removed from major health providers the journey can be much more difficult. While they ‘make do’ and ‘struggle on’, their lived experiences can provide valuable insight into the complex issues surrounding a cancer diagnosis in rural areas. This study aimed to understand their experiences through the women's stories and sought to identify the major themes impacting on these stories. This qualitative phenomenological study undertook interviews with seven women with gynaecological cancer who reside in rural and remote north Queensland. Analysis of the data collected revealed three themes: seeking answers at a distance; sharing information within a small community; and experiences of navigating the health system. The results show the inherent difficulties in accessing support in rural areas and the difficulties associated with travelling considerable distances to undergo treatment.
Covered expandable nitinol stents for malignant gastroduodenal obstructions
Authors: Seo Eun H , Jung Min K , Park Min J , Park Kwan S , Jeon Seong W , Cho Chang M , Tak Won Y , Kweon Young O , Kim Sung K , Choi Yong H
Published: July 2008

Background and Aim:  The aim of the present study was to investigate the clinical effectiveness, safety, and outcome associated with the use of covered expandable Nitinol stents (Taewoong Medical, Seoul, Korea) for the treatment of malignant gastroduodenal obstructions.

Methods:  Between March 2001 and October 2004, covered expandable Nitinol stents were placed in 68 consecutive patients under endoscopic and fluoroscopic guidance for the following reasons: gastric carcinoma (n = 49), recurrent carcinoma after partial gastrectomy (n = 7), or another malignant neoplasm involving the duodenum (n = 12).

Results:  Technical success was achieved in 60 of the 68 patients (88.2%). After stent placement, mean dysphagia score improved from a mean of 3.5 to 1.2 (P < 0.001). The mean period of primary stent patency was 107.2 days. During follow up (mean 4.4 months; range, 1–15 months), major complications (migration [6], bleeding [3], perforation [1], ingrowth [1], overgrowth [7], fistula [1]) occurred in 19 patients (27.9%), and stent migration occurred in six (8.8%) (proximal migration into the stomach [n = 3], or distal migration [n = 3]). Recurrent dysphagia (mainly due to tumor ingrowth/overgrowth) occurred in eight patients (11.8%).

Conclusion:  Covered expandable Nitinol stents appear to offer an effective and feasible palliative therapy in patients with a malignant gastroduodenal obstruction.
Erythropoietin promotes hepatic regeneration after extended liver resection in rats
Authors: Schmeding Maximilian , Boas‐Knoop Sabine , Lippert Steffen , Ruehl Martin , Somasundaram Radjan , Dagdelen Tarkan , Neuhaus Peter , Neumann Ulf P
Published: July 2008

Background and Aim:  It has been proven in various animal studies that recombinant human erythropoietin (rHuEPO) protects renal, cardiac and neuronal, as well as hepatic, tissue from ischemia, and promotes regeneration of adult central nervous system neurons. To date, no data are available as to whether rHuEPO has the ability to stimulate liver regeneration after liver resection.

Methods:  Rats undergoing 70% or 90% hepatectomy received an intraportalvenous administration (i.p.) of rHuEPO prior to resection or a subcutaneous injection (s.c.) for 3 days postoperatively, control animals were treated with surgery and saline injection only. Regeneration capacity of remnant livers was studied over 7 days by histology and immunohistochemistry (Ki‐67, proliferating cell nuclear antigen [PCNA]). Polymerase chain reaction was carried out to measure transforming growth factor β (TGF‐β), hypoxia induced factor (HIF), signal transducing activator 3 and vascular endothelial growth factor.

Results:  Ten‐day survival in rats undergoing 90% hepatectomy significantly increased in i.p.‐pretreated animals. After 70% hepatectomy the mitotic index was significantly increased in both rHuEPO‐treated groups. These data were confirmed by PCNA and Ki‐67 expression, which was significantly increased in the treated groups 24 h and 2 days after liver resection. TGF‐β and HIF mRNA both were upregulated in control animals 3 h after surgery.

Conclusion:  rHuEPO effectively increased liver regeneration in rats after 70% liver resection and enhanced survival after 90% hepatectomy. Thus, rHuEPO may increase the regenerative capacity after major hepatectomy.
Clinical features predicting the detection of abnormalities by double balloon endoscopy in patients with suspected small bowel bleeding
Authors: Byeon Jeong‐Sik , Chung Jun‐Won , Choi Kee Don , Choi Kwi‐Sook , Kim Benjamin , Myung Seung‐Jae , Yang Suk‐Kyun , Kim Jin‐Ho
Published: July 2008

Background and Aim:  Although double balloon endoscopy (DBE) has demonstrated a high diagnostic yield in suspected small bowel bleeding, it is not known whether DBE is of equal value to all patients with suspected small bowel bleeding or of greater benefit in selected subgroups. We aimed to determine whether any clinical features predict an increased likelihood of finding a lesion in patients with suspected small bowel bleeding.

Methods:  We retrospectively analyzed clinical features of 43 consecutive patients (M : F = 26:17, age 13–82 years) who underwent DBE because of suspected small bowel bleeding. Data associated with DBE procedure were collected prospectively. Predictive factors for the detection of a lesion were determined by comparison of clinical features between patients with positive DBE findings and those with negative findings.

Results:  Potential bleeding sources were discovered in 30 patients (69.8%) out of 43. Duration of bleeding was longer in patients with positive DBE findings than in those with negative findings (195 ± 311 vs 18 ± 17 days, P = 0.015). Number of bleeding episodes was higher in patients with positive DBE findings (2.2 ± 1.2 vs 1.3 ± 0.5, P = 0.011). The odds ratio for the detection of bleeding focus on DBE for patients with two or more bleeding episodes, relative to those with only one current bleeding episode was 5.67 (95% CI: 1.12–28.81, P = 0.036) in multivariate analysis.

Conclusion:  DBE may be the most useful in patients with suspected small bowel bleeding if they have a history of frequent bleeding episodes over a long period.
Clinical significance of minimal change lesions of the esophagus in a healthy Korean population: A nationwide multi‐center prospective study
Authors: Lee Jun Haeng , Kim Nayoung , Chung Il Kwun , Jo Yun‐Ju , Seo Geom Seog , Kim Sang Wook , Im Eui Hyeog , Kim Hye Rang , Park Soo Hyun , Lee So‐Young , Cha Hyun‐Min , Lee Kyoung Soo , Hyun Dong Hyo , Kim Hyun Young , Kim Sun‐Mi , Shin Jeong Eun , Park Soo‐Heon , Chung Hyun Chae , Chung In‐Sik ,   The H. pylori and GERD Study Group of Korean College of Helicobacter and Upper Gastrointestinal Research
Published: July 2008

Background and Aim:  At least half of the patients with typical reflux symptoms have non‐erosive reflux disease (NERD). Minimal change lesions are commonly seen in the screening endoscopic examinations for individuals without clinically significant symptoms. We evaluated the correlation between minimal changes and symptoms in individuals visiting the hospital for routine health check‐up by a nationwide survey in 2006.

Methods:  Upper gastrointestinal endoscopic examinations as a health check‐up were performed for 25 536 patients. Among them, symptom questionnaires were given in 23 350 patients without mucosal break or Barrett's esophagus. Endoscopic findings of the lower esophagus were divided into normal or minimal changes. Minimal changes in the present study included white turbid discoloration and Z‐line blurring.

Results:  Among a total of 25 536 subjects, reflux esophagitis was found in 2019 subjects (7.91%) and 3043 patients (11.9%) were classified as having minimal changes. History of gastroesophageal reflux disease (GERD) was more commonly found in individuals with minimal changes. Among the reflux‐related symptoms, heartburn, acid regurgitation, globus sensation, and epigastric soreness were related to the minimal changes of the esophagus. Especially, individuals with globus sensation or epigastric soreness were more likely to have minimal changes compared to individuals without respective symptoms. Male gender, current smoker, history of H. pylori eradication, frequent stooping at work, hiatal hernia, and atrophic/metaplastic gastritis were found to be risk factors for minimal changes.

Conclusion:  The minimal changes were closely related with upper gastrointestinal symptoms and had similar risk factors for GERD, suggesting that minimal changes could be considered as early endoscopic findings of GERD.
Comparison of insulin analogue regimens in people with type 2 diabetes mellitus in the PREFER Study: a randomized controlled trial
Authors: Liebl A. , Prager R. , Binz K. , Kaiser M. , Bergenstal R. , Gallwitz B. ,   PREFER Study Group
Published: July 2008

Aims:  Insulin analogues are widely used but few data exist comparing different analogue regimens. We compared two such regimens in type 2 diabetes mellitus (T2DM) uncontrolled by oral antidiabetic agents (OADs) with or without basal insulin.

Methods:  In a 26‐week multinational, multicentre, randomized treat‐to‐target trial, OADs were discontinued and subjects randomized to analogue basal–bolus therapy (insulin detemir once daily and insulin aspart mealtimes) or biphasic insulin aspart 30 (30% rapid‐acting insulin aspart), twice daily. Insulin was titrated to targets for fasting, predinner and postprandial plasma glucose (PG), as appropriate.

Results:  Of 719 subjects, 92% completed the study; 58% achieved haemoglobin fraction A1c (HbA1c) ≤7.0%, with reductions of 1.56% (to 6.96%) with basal–bolus therapy and 1.23% (to 7.17%) with biphasic insulin aspart. Reduction with basal–bolus therapy was superior in the overall population by 0.23% (p = 0.0052), with no difference between regimens in insulin‐naive patients. Major hypoglycaemia occurred in five basal–bolus patients (0.9%) and in no patients with biphasic insulin aspart. Incidence of minor hypoglycaemia was similar in both groups. All insulin doses increased during titration, with increase in lunchtime insulin aspart dose and equal distribution of breakfast and dinner biphasic insulin aspart doses. Insulin detemir remained once daily in 87% of patients.

Conclusions:  Modern insulin analogue regimens, adjusted to PG targets, enable a majority of people with T2DM to reach HbA1c≤7.0% after failure of OADs and OAD‐basal insulin therapy. Insulin‐treated patients may benefit more from transfer to analogue basal–bolus therapy, while insulin‐naive individuals benefit equally well from the more convenient biphasic analogue regimen.
Regulation of adipose triglyceride lipase by rosiglitazone
Authors: Liu L.‐F. , Purushotham A. , Wendel A. A. , Koba K. , DeIuliis J. , Lee K , Belury M. A.
Published: July 2008

Aim:  To elucidate the mechanism by which rosiglitazone regulates adipose triglyceride lipase (ATGL).

Methods:  Male C57Bl/6 mice were treated with rosiglitazone daily (10 mg/kg body weight), and adipose tissues were weighed and preserved for mRNA and protein analysis of ATGL. In parallel, preadipocyte (3T3‐L1) cells were differentiated with insulin/dexamethasone/3‐isobutyl‐1‐methlxanthine cocktail or rosiglitazone, and ATGL levels were measured with real‐time PCR, western blotting and immunohistochemistry.

Results:  Rosiglitazone concomitantly promoted differentiation of pre‐adipocytes to functional adipocytes and induced mRNA levels of ATGL. The peroxisome proliferator‐activated receptor‐γ (PPARγ) antagonist bisphenol A diglycidyl ether significantly abrogated the induction of mRNA, but not protein levels of ATGL by rosiglitazone in differentiated 3T3‐L1 adipocytes. In the presence of epinephrine rosiglitazone stimulated free fatty acid release and increased diacylglycerol acyltransferase‐1 (DGAT‐1) mRNA suggest that ATGL and DGAT‐1 may be cooperatively involved in rosiglitazone‐stimulated triglyceride hydrolysis and fatty acid re‐esterification in 3T3‐L1 adipocytes. Treatment of 3T3‐L1 adipocytes with rosiglitazone or insulin did not appear to alter localization of ATGL staining surrounding lipid droplets. Finally, we found that rosiglitazone increased ATGL mRNA levels in 3T3‐L1 adipocytes in the presence of cycloheximide, an inhibitor of protein synthesis, suggesting that rosiglitazone regulation of ATGL occurs at the transcriptional level.

Conclusions:  Rosiglitazone directly regulates transcription of ATGL, likely through a PPARγ‐mediated mechanism.