bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrafamilial Spread of Helicobacter pylori: A Genetic Analysis
Authors: Roma‐Giannikou Eleftheria , Karameris Andreas , Balatsos Basilios , Panayiotou Joanna , Manika Zisoula , Van‐Vliet Catherina , Rokkas Theodore , Skandalis Nikolaos , Kattamis Christos
Published: March 2003

Background. A high incidence of Helicobacter pylori among family members of children with H. pylori gastritis has previously been documented on biopsy material. The main objective of this study was the genetic clarification of H. pylori strains involved in intrafamilial dispersion.

Materials and Methods. Formalin‐fixed, paraffin‐embedded material of antral mucosa from 32 members of 11 families was studied for the presence of genetic homogeneity. To achieve this goal, the entire genome of H. pylori was studied by the polymerase chain reaction (PCR)‐based random amplified polymorphic DNA (RAPD) fingerprinting method. Furthermore, the Urease A gene was analyzed using a multiplex PCR‐assay and an alternative mutation detection method based on the Hydrolink™ analysis.

Results. RAPD fingerprinting confirmed that closely related H. pylori strains were involved in the intrafamilial dispersion. Mutations and small deletions in Urease A gene were found in 22 out of 32 individuals.

Conclusions. The homology of the H. pylori genome in members of the same family strongly supports the hypothesis of transmission of H. pylori from person‐to‐person or from a common source.
Extragastric Helicobacter species
Authors: On Stephen L.W. , Hynes Sean , Wadström Torkel
Published: March 2003

The genus Helicobacter has expanded at a rapid pace and no fewer than 31 species have been named since the proposal of the genus in 1989. Of these 31 species, 22 are principally associated with extragastric niches and there is increasing interest in the role of these taxa in diseases of humans and animals. Substantial evidence attests to certain species playing a role in the pathogenesis of enteric, hepatic and biliary disorders and some taxa demonstrate zoonotic potential. The importance of extragastric Helicobacters is likely to be an important topic for research in the near future. Here, important papers published in the field this last year are reviewed.
Improving the Pain Management Standard of Care in a Community Hospital
Authors: Bell Anita , Wheeler Richard
Published: March 2003

purpose: The purpose of this article is to outline the development, implementation, and progress of one community hospital in improving the pain management standards of care and to describe why collaboration within the community and with a nationally recognized research facility, such as the City of Hope in California, is beneficial for the educational needs of a community‐based hospital and for a framework‐improvement model of pain management.

overview: Most patients with cancer receive care in community facilities. It is essential that optimal pain relief be provided to these patients. A model used by Mercy Health Center in Oklahoma demonstrates how community facilities can tap into national resources. The adaptation of research and educational information that was made available by the City of Hope National Medical Center has allowed multiple strategies to be implemented to target pain management education and clinical practice effectively to meet the American Pain Society quality improvement standards. Ongoing data collection and monitoring of pain management outcomes can provide direction and support for improved pain management patient satisfaction and other pain management outcomes. With continuous quality improvement monitoring, education, and administrative support, a pain management patient “safety net” can been developed to improve the standard of care for all patients within the organization.

clinical implications: Effective pain management according to accepted national clinical standards can be implemented and improved on by adapting national resources to guide multidisciplinary strategic planning.
A Provider Survey
Authors: Gulitz Elizabeth , Bustillo‐Hernandez Marta , Kent Ellen B.
Published: March 2003

PURPOSE
: Lack of physician recommendation is a major predictor of underutilization of breast and cervical cancer screening. The authors conducted a comprehensive two‐part study of Florida primary care providers to determine which providers were not screening their older patients and why. This article reports on the study's quantitative survey component.

DESCRIPTION OF STUDY
: After an initial mailing of surveys to 2052 randomly sampled, licensed medical and osteopathic physicians, nurse practitioners, and certified nurse midwives, a follow‐up mailing and phone calls resulted in 496 usable surveys. Outcome variables were whether or not primary care providers performed screening tests for their asymptomatic, women patients older than 50 years of age. Predictor variables included: age, race, gender, training, specialty, practice size, and location of the providers, and the percentage of older patients that they served.

RESULTS
: The best predictors of primary care providers not screening their asymptomatic women patients who were older than 50 years of age were providers also being older than 50, specializing in geriatrics or adult health, and working in a small or rural practice. An analysis of providers' responses to structured survey items related to their own and their patients' attitudes about screening indicated that providers often miss the opportunity to screen due to a combination of patient, provider, practice, and access barriers.

CLINICAL IMPLICATIONS
: The authors recommend that public health and primary care practitioners collaborate in developing strategies that address areas of potential change for overcoming these four barriers, while also considering the essential public health services of assessment, policy development, and assurance. These strategies should be designed to facilitate the breast and cervical cancer screening process for both providers and patients, so that providers feel more comfortable performing and recommending these important tests, particularly for underserved groups of older women.
Lung cancer in African Americans. A call for action.
Authors: Cooley ME , Jennings‐Dozier K
Published: March 2003

PURPOSE: The authors present information about current trends in the incidence, risk factors, types, presentation, and treatment for lung cancer common to all Americans and highlight factors that are unique to African Americans. Barriers to effective care and strategies for implementing culturally competent programs for lung cancer are outlined. OVERVIEW: Disparity in the incidence and mortality rates of cancer between African Americans and white Americans has been increasing at an alarming rate since 1950. For African‐American men and women, lung cancer accounted for the largest increase in the incidence of cancer between 1988 and 1992: African‐American men experienced an increase of 170%, and African‐American women had a dramatic increase of 464%. Lung cancer is by far the most common cause of cancer death in this population, accounting for 32% of the mortality rate in men and 20% in women. Unfortunately, lung cancer in African Americans has received little attention, and culturally competent programs are needed urgently to promote lung cancer prevention, early detection, and treatment in this population. CLINICAL IMPLICATIONS: Healthcare providers' lack of knowledge about cultural influences on care is a barrier to providing adequate healthcare to individuals of different ethnic groups. Knowledge about cultural differences, respect for individual opinions about health and illness, and ability to negotiate differences are essential qualities for health professionals who serve culturally diverse populations. Because of the morbidity and mortality rates associated with lung cancer in the African‐American population, prevention, early detection, and treatment programs are needed urgently. However, for these programs to succeed, the multidisciplinary cancer care team (nurses, physicians, social workers, psychologists, health educators, clergy) must provide information and care in culturally appropriate ways. Partnerships with family, extended kin networks, and religious and community leaders are essential. Finally, to minimize morbidity and maximize quality of life during the illness trajectory, comprehensive education and supportive care services are needed for those who have been diagnosed with lung cancer.
An Evaluation of Advisors' Activities
Authors: Earp Jo Anne L. , Flax Valerie L.
Published: March 2003

PURPOSE
: Since the 1970s, health promotion and disease prevention programs that rely on lay health advisors have proliferated, making it important to ascertain the levels and types of activity that can reasonably be expected from such advisors. This report describes the activities of lay health advisors participating in a program to increase mammography screening by older African American women and shares lessons that the authors learned about evaluating advisors' activities.

DESCRIPTION OF STUDY
: Between September 1994 and January 1996, 144 lay health advisors, associated with the North Carolina Breast Cancer Screening Program, were asked to complete, on a periodic basis, a standardized, self‐administered activity report that asked about group presentations in the past 3 months and one‐on‐one contacts in the past week. Eighty‐five advisors submitted one or more reports. The authors tabulated responses for lay health advisors overall, for those turning in one or more reports, and for those reporting a specific type of activity.

RESULTS
: The responses showed that North Carolina Breast Cancer Screening Program lay health advisors made approximately one group presentation every 3 months and had one to three individual contacts per week. Group presentations were commonly in churches and homes, and focused on who needs a mammogram, how then, and where to get one. During one‐on‐one encounters, advisors primarily encouraged women to get mammograms or discussed fears about mammograms.

CLINICAL IMPLICATIONS
: Information about lay health advisor activities serves several important purposes. Such information allows programs to identify the types of messages that lay health advisors transmit and the number of contacts they make, while also identifying the groups that are more and less difficult to reach, and the topics and locations favored by advisors and the women they contact. Activity data may indicate what resources or other support the advisors need, whether in‐service training is necessary, and how to enhance the recruitment and training of additional lay health advisors.
Multidisciplinary Care of Hepatocellular Carcinoma
Authors: Van Cleave Janet , Devine Pamela , Odom‐Ball Pam
Published: March 2003

objectives: Multidisciplinary care of cancer patients in varied settings is well described in the literature, but there is little specifically describing the multidisciplinary care of the patient with hepatocellular carcinoma (HCC). The purpose of this article is to describe HCC and the multidisciplinary approach at the Philadelphia Veterans Affairs Medical Center (PVAMC).

materials and methods: HCC is one of the most common solid tumors in the world, but it is rare in North America. It is associated with environmental carcinogens identified in animal studies, hepatitis B and C, cirrhosis of any etiology, and various metabolic diseases. No reliable therapy has been established for HCC. Surgical resection is the best treatment, but it is possible only in the patient with adequate hepatic reserve and limited‐stage cancer. From January 1995 to May 1998, 22 patients at PVAMC received a diagnosis of primary HCC. One patient was a candidate for surgery, two patients received radiation therapy, and one patient underwent chemoembolization. Eighteen patients presented with an advanced‐stage disease and comorbidities.

results: Therapy goals in these 18 patients were limited to supportive care and enhancement of quality of life. A multidisciplinary team provided care to this challenging patient population. The multidisciplinary team treating HCC at PVAMC consisted of physicians, nurses, pharmacists, social workers, and a chaplain. Most care occurred in the outpatient setting. Supportive therapy included the controlling of ascites and abdominal discomfort, hepatic encephalopathy, and pruritus. Opioids relieved abdominal pain. Psychiatric support and counseling helped patients and families cope with the poor prognosis.

conclusions: A multidisciplinary team approach helped provide care for this challenging population. Through anecdotal reports, patients and family expressed satisfaction with their care. Research is needed to systematically test interventions designed to enhance quality of life in patients with HCC.
Colorectal Cancer Screening Beliefs
Authors: Rawl Susan M. , Menon Usha , Champion Victoria L. , Foster June L. , Skinner Celette Sugg
Published: March 2003

Objectives: The purpose of this paper is to describe the perceived benefits and barriers to colorectal cancer screening reported by first‐degree relatives of colorectal cancer patients.

Materials and methods: In this study, the authors used focus groups to identify perceived benefits and barriers to colorectal cancer screening among parents and children of colorectal cancer patients. Four focus groups were conducted with relatives of colorectal cancer patients seen at two university medical centers in the Midwest. The groups ranged in size from five to eight members each and were stratified by gender.

Results: Four benefits of colorectal cancer screening were identified by participants: finding colorectal cancer early, decreasing the chances of dying from colorectal cancer, freedom from worry about colorectal cancer, and reassurance that one was cancer‐free. Four main barriers were identified that applied to all four types of colorectal cancer screening or to colorectal cancer screening in general. These included inadequate public awareness of colorectal cancer, inconsistent recommendations from healthcare providers, concerns about the efficacy of screening tests, and embarrassment. Barriers unique to each screening test also were identified.

Conclusions: Understanding individual beliefs about the benefits and barriers to colorectal cancer screening will allow clinicians and researchers to develop effective interventions to increase screening. Results from the focus groups have been used to develop an instrument to measure benefits and barriers to colorectal cancer screening, which now needs to be tested with more culturally and socioeconomically diverse groups.
Family History of Breast Cancer
Authors: Petrisek Ann , Campbell Susan , Laliberte Linda
Published: March 2003

Purpose: Family history is the most prominent risk factor, besides advanced age, for the incidence of breast cancer among women. This study investigates differences in the experiences of women in the detection, diagnosis, and treatment of early‐stage disease. The purpose of this research is to obtain a more comprehensive understanding of the impact of family history on the overall illness experience.

Description of study: Self‐report retrospective data obtained from in‐depth interviews with a convenience sample of 179 women who had recently received a diagnosis of nonrecurrent stage 0 to IIIA breast cancer are used to compare the experiences of women with and without a family history of breast cancer (FHOBC). The authors examine differences in screening behavior, method of detection, diagnostic processes, treatment decision making, and therapy receipt, and they report the results of bivariate analyses.

Results: The results suggest that women with FHOBC have a different disease experience than those without an affected relative. Women with FHOBC were more likely than their counterparts to comply with screening guidelines, to seek more timely care, to consult with specialists, to be influenced by the experiences of others, to feel comfortable with treatment decisions, and to receive adjuvant therapy.

Clinical implications: Healthcare providers should be aware that compliance with mammography and therapy guidelines may vary with FHOBC. Because the better health‐related behavior reported by women with affected relatives suggests that they may have higher perceived risk, physicians should be sensitive to potentially elevated levels of anxiety, provide accurate information about relative risk, put patient concerns in the proper perspective, and include family members in treatment discussions. Alternatively, women without an FHOBC appear to have less favorable screening, detection, diagnosis, and treatment decision‐making behavior. Because family doctors play an important role in the care of these patients, they may need to provide special education and counseling regarding the importance of adherence to screening guidelines, recognition of relevant symptoms, initiation of timely examinations, consultation with cancer specialists, and compliance with treatment recommendations.
Fears about Breast Cancer Recurrence:
Authors: Johnson Vickberg Suzanne M.
Published: March 2003

Purpose:Prior research shows that the majority of women diagnosed with breast cancer experience ongoing fears about recurrence. These studies primarily have used Likert scales to determine the extent to which women fear recurrence but have not presented details of women's experiences or addressed the nature of women's fears. This report describes a pilot study designed to capture women's diverse experiences related to the possibility of recurrence.

Description of study:Sixteen women participated in semi‐structured interviews about their thoughts and feelings regarding the possibility of breast cancer recurrence. Thematic content coding was used to categorize women's responses.

Results:Although some women indicated strong fears about recurrence, the majority expressed more moderate fears. Fears revolved around the possibility of death, further treatment (particularly chemotherapy), emotional difficulties, pain, advancement of the disease, suffering of family members, and loss of the breast. Many women spoke about life circumstances that were more salient than the possibility of recurrence. Women also described events/situations that triggered fears and strategies used for coping with fears.

Clinical implications:Results suggest that more systematic investigation of women's fears about breast cancer recurrence is warranted and that clinicians should address the multidimensional nature of women's fears as they relate to other psychological processes and events in women's lives. Moreover, women's life circumstances should be considered when attempting to determine whether a social support intervention might be beneficial or detrimental.
Perceived Cancer Causes
Authors: Maskarinec Gertraud , Gotay Carolyn C. , Tatsumura Yvonne , Shumay Dianne M. , Kakai Hisako
Published: March 2003

Purpose: The objectives of this report are to describe beliefs about general and personal cancer causes among patients with cancer who use and do not use complementary and alternative medicine (CAM), to compare these beliefs with current epidemiologic knowledge, and to explore associations between these beliefs and choice of CAMs.

Description of interviews: The authors conducted a semistructured interview with 143 patients with cancer, who were identified via the Hawaii Tumor Registry and had participated in a survey on CAM use. By design, the majority of interviewees (85%) were CAM users. A qualitative data analysis was performed.

Results: Genetics, environment, and diet were among the most common perceived general causes of cancer, whereas psychosocial factors were by far the most common perceived personal causes. CAM users were more likely than nonusers to name environment, immune system, and stress as cancer causes. Compared with the epidemiologic literature, study participants were less likely to mention tobacco use and more likely to consider environmental exposures, psychosocial factors, immunologic mechanisms, and physical injury as causes of cancer. Furthermore, the interviews suggest that causal thinking may be related to the type of CAM used.

Clinical implications: Given the discrepancy between popular cancer theories and current scientific knowledge, the challenge for the healthcare provider is to listen and try to understand the patient's beliefs about cancer etiology. Understanding the patient's beliefs about their disease is important in providing the support and information they need to make effective decisions about their medical care.
Cancer Clinical Trial Patients in the Information Age
Authors: Ehrenberger Heidi E.
Published: March 2003

Purpose:The purpose of this pilot study was to explore the cancer clinical trial patient's perception and use of electronic information and communication.

Description of study:A total of 42 participants who self‐reported they had enrolled, or were enrolled, in a cancer clinical trial completed a Web‐based clinical trials survey questionnaire linked to a cancer‐specific Web site. The questionnaire was used to obtain written responses to open‐ended questions regarding the perception and use of electronic information and communication.

Results:The pilot study findings document that more than one third of the respondents use the Internet to seek clinical trials information. Results also describe the impact of the Internet in helping these patients to identify what questions to ask their healthcare providers. The findings underscore the desire of patients to communicate not only with others on the same clinical trial, but also with their healthcare providers via the Internet.

Clinical implications:When providing care to cancer clinical trial patients in the information age, online information seeking and the desire for electronic communication must increasingly be acknowledged, understood, and supported. A proactive and comprehensive approach to addressing patient information and support needs can facilitate patient empowerment and satisfaction.
Chelicerate Hox genes and the homology of arthropod segments
Authors: Abzhanov Arhat , Popadic Aleksandar , Kaufman Thomas C.
Published: March 2003

Genes of the homeotic complex (HOM‐C) in insects and vertebrates are required for the specification of segments along the antero‐posterior axis. Multiple paralogues of the Hox genes in the horseshoe crab Limulus poliphemus have been used as evidence for HOM‐C duplications in the Chelicerata. We addressed this possibility through a limited PCR survey to sample the homeoboxes of two spider species, Steatoda triangulosa and Achaearanea tepidariorum. The survey did not provide evidence for multiple Hox clusters although we have found apparent duplicate copies of proboscipedia (pb) and Deformed (Dfd  ). In addition, we have cloned larger cDNA fragments of pb, zerknullt (zen/Hox3) and Dfd. These fragments allowed the determination of mRNA distribution by in situ hybridization. Our results are similar to the previously published expression patterns of Hox genes from another spider and an oribatid mite. Previous studies compared spider/mite Hox gene expression patterns with those of insects and argued for a pattern of segmental homology based on the assumption that the co‐linear anterior boundaries of the Hox domains can be used as markers. To test this assumption we performed a comparative analysis of the expression patterns for UBX/ABD‐A in chelicerates, myriapods, crustaceans, and insects. We conclude that the anterior boundary can be and is changed considerably during arthropod evolution and, therefore, Hox expression patterns should not be used as the sole criterion for identifying homology in different classes of arthropods.
Expression of Distal‐less in molluscan eggs, embryos, and larvae
Authors: Lee Shannon E. , Jacobs David K.
Published: March 2003

SUMMARY Distal‐less (Dll  ) is best known as a transcription factor involved with “limb patterning” in Drosophila melanogaster. Observations of both deuterostome and protostome phyla have led to the suggestion that some aspect of this gene's function in “appendage” or proximal–distal “outgrowth” development is conserved. Here we explore the possibility of other conserved roles operating earlier in development. We examine the expression of DLL protein during the early development of two molluscan classes, Polyplacophora (chiton) and Gastropoda (snail). Using an antibody approach, we find DLL expression in the oocytes of a chiton (Mopalia muscosa) and in the pregastrulae through early veliger larvae of a marine snail (Kelletia kelletii  ). We observe antibody localization in the oocyte, nuclear expression in all cells of the pregastrulae, and predominant expression in the ectoderm of postgastrulae and early veliger larvae. Comparison of our observations on spiralian taxa, thought to have conservative development with previous work, primarily on deuterostomes, suggests the possibility of an ancient role(s) for DLL in early development. Possible functions appear to include maternal and zygotic involvement in the establishment of embryonic polarity, involvement in the process of germ layer formation, and a role in the specification and/or differentiation of ectoderm/epithelia. We note that the exploration of conserved gene function in early development may be clarified by examining taxa whose early development has putatively not been subject to dramatic evolutionary change.
Genetic variation for the positioning of wing veins in Drosophila melanogaster
Authors: Birdsall Kelli , Zimmerman Erika , Teeter Katherine , Gibson Greg
Published: March 2003

SUMMARY To define the components of variation for wing shape in Drosophila in relation to what is known about the developmental control of wing patterning, we have characterized shape variation in the wings of 12 randomly chosen highly inbred lines. Despite large differences in wing size between males and females, and between flies reared at 18°C or 25°C, wing shape is remarkably unaffected by these variables and is highly line specific. The shape of each intervein region of the wing appears to be independently regulated at the genetic level, consistent with the role of secreted growth factors in establishing the locations of wing veins. Sex and temperature were found to have different effects on cell number in two intervein regions, with the result that wing shape is to a large extent independent of cell density. Dietary cholesterol was also shown to affect the breadth of the central intervein region, consistent with an effect on the strength of Hedgehog signaling during wing development. We conclude that wing shape is under tighter genetic control than wing size, and hypothesize that this control is achieved in large part by gene activity at the level of wing vein determination and differentiation.
Homology, limbs, and genitalia
Authors: Minelli Alessandro
Published: March 2003

SUMMARY Similarities in genetic control between the main body axis and its appendages have been generally explained in terms of genetic co‐option. In particular, arthropod and vertebrate appendages have been explained to invoke a common ancestor already provided with patterned body outgrowths or independent recruitment in limb patterning of genes or genetic cassettes originally used for purposes other than axis patterning. An alternative explanation is that body appendages, including genitalia, are evolutionarily divergent duplicates (paramorphs) of the main body axis. However, are all metazoan limbs and genitalia homologous? The concept of body appendages as paramorphs of the main body axis eliminates the requirement for the last common ancestor of limb‐bearing animals to have been provided with limbs. Moreover, the possibility for an animal to express complex organs ectopically demonstrates that positional and special homology may be ontogenetically and evolutionarily uncoupled. To assess the homology of animal genitalia, we need to take into account three different sets of mechanisms, all contributing to their positional and/or special homology and respectively involved (1) in the patterning of the main body axis, (2) in axis duplication, followed by limb patterning mechanisms diverging away from those still patterning the main body axis (axis paramorphism), and (3) in controlling the specification of sexual/genital features, which often, but not necessarily, come into play by modifying already developed and patterned body appendages. This analysis demonstrates that a combinatorial approach to homology helps disentangling phylogenetic and ontogenetic layers of homology.
Ontogenetic torsion in two basal gastropods occurs without shell attachments for larval retractor muscles
Authors: Page Louise R.
Published: March 2003

SUMMARY Results of this study on two species of vetigastropods contradict the long‐standing hypothesis, originally proposed by Garstang (1929), that the larval retractor muscles power the morphogenetic movement of ontogenetic torsion in all basal gastropods. In the trochid Calliostoma ligatum and the keyhole limpet Diodora aspera, the main and accessory larval retractor muscles failed to establish attachments onto the protoconch (larval shell) when the antibiotics streptomycin sulfate and penicillin G were added to cultures soon after fertilization. Defects in protoconch mineralization were also observed. Despite these abnormalities, developing larvae of these species accomplished complete or almost complete ontogenetic torsion, a process in which the head and foot rotate by 180° relative to the protoconch and visceral mass. Analysis by using phalloidin‐fluorophore conjugate and transmission electron microscopy showed that myofilaments differentiated within myocytes of the larval retractor muscles and adherens‐like junctions formed between muscle and mantle epithelial cells in both normal and abnormal larvae. However, in abnormal larvae, apical microvilli of mantle cells that were connected to the base of the larval retractor muscles failed to associate with an extracellular matrix that normally anchors the microvilli to the mineralized protoconch. If morphogenesis among extant, basal gastropods preserves the original developmental alteration that created gastropod torsion, as proposed by Garstang (1929), then the alteration involved something other than the larval retractor muscles. Alternatively, the developmental process of torsion has evolved subsequent to its origin in at least some basal gastropod clades so that the original alteration is no longer preserved in these clades.
Pitx homeobox genes inCionaand amphioxus show left–right asymmetry is a conserved chordate character and define the ascidian adenohypophysis
Authors: Boorman Clive J. , Shimeld Sebastian M.
Published: March 2003

SUMMARYAll vertebrates have directional asymmetries in the organization of their internal organs. In jawed vertebrates, development of asymmetry is controlled by a conserved molecular pathway that includesPitx2, which is expressed by lateral plate mesoderm cells on the left side of the embryo.Pitx2is a member of the Pitx homeobox gene family, the expression of which also marks stomodeal ectoderm and the adenohypophysis. Here we report the characterization of Pitx genes fromBranchiostoma floridae(an amphioxus) andCiona intestinalis(a urochordate), representatives of two basal chordate lineages and successively deeper outgroups to the vertebrates. Expression ofB. floridaePitx is similar to that reported fromB. belcheri, a different amphioxus species. Expression of theCionaPitx ortholog in the embryonic primordial pharynx and adult neural complex leads us to propose theCionaprimordial pharynx and ciliated funnel are homologous to the adenohypophyseal placode and adenohypophysis, respectively. Additionally, in both species we identify asymmetrical left‐sided expression of Pitx genes during embryonic development. This shows that asymmetrical Pitx gene expression, and by inference directional asymmetry, evolved before the radiation of living chordates and should be considered a chordate character.
Hox genes and the evolution of the arthropod body plan1
Authors: Hughes Cynthia L. , Kaufman Thomas C.
Published: March 2003

SUMMARY In recent years researchers have analyzed the expression patterns of the Hox genes in a multitude of arthropod species, with the hope of understanding the mechanisms at work in the evolution of the arthropod body plan. Now, with Hox expression data representing all four major groups of arthropods (chelicerates, myriapods, crustaceans, and insects), it seems appropriate to summarize the results and take stock of what has been learned. In this review we summarize the expression and functional data regarding the 10 arthropod Hox genes: labial, proboscipedia, Hox3/zen, Deformed, Sex combs reduced, fushi tarazu, Antennapedia, Ultrabithorax, abdominal‐A, and Abdominal‐B. In addition, we discuss mechanisms of developmental evolutionary change thought to be important for the emergence of novel morphological features within the arthropods.
Generalized norms of reaction for ecological developmental biology
Authors: Sarkar Sahotra , Fuller Trevon
Published: March 2003

SUMMARY A standard norm of reaction (NoR) is a graphical depiction of the phenotypic value of some trait of an individual genotype in a population as a function an environmental parameter. NoRs thus depict the phenotypic plasticity of a trait. The topological properties of NoRs for sets of different genotypes can be used to infer the presence of (nonlinear) genotype–environment interactions. Although it is clear that many NoRs are adaptive, it is not yet settled whether their evolutionary etiology should be explained by selection on the mean phenotypic trait values in different environments or whether there are specific genes conferring plasticity. If the second alternative is true, the NoR is itself an object of selection. Generalized NoRs depict plasticity at the level of populations or subspecies within a species, species within a genus, or taxa at higher levels. Historically, generalized NoRs have routinely been drawn though rarely explicitly recognized as such. Such generalized NoRs can be used to make evolutionary inferences at higher taxonomic levels in a way analogous to how standard NoRs are used for microevolutionary inferences.
Protochordate Zic genes define primitive somite compartments and highlight molecular changes underlying neural crest evolution
Authors: Gostling Neil J. , Shimeld Sebastian M.
Published: March 2003

SUMMARYThe vertebrate Zic gene family encodes C2H2 zinc finger transcription factors closely related to the Gli proteins. Zic genes are expressed in multiple areas of developing vertebrate embryos, including the dorsal neural tube where they act as potent neural crest inducers. Here we describe the characterization of a Zic ortholog from the amphioxusBranchiostoma floridaeand further describe the expression of a Zic ortholog from the ascidianCiona intestinalis.Molecular phylogenetic analysis and sequence comparisons suggest the gene duplications that formed the vertebrate Zic family were specific to the vertebrate lineage. InCionamaternalCiZic/Ci‐macho1transcripts are localized during cleavage stages by asymmetric cell division, whereas zygotic expression by neural plate cells commences during neurulation. The amphioxus Zic orthologAmphiZicis expressed in dorsal mesoderm and ectoderm during gastrulation, before being eliminated first from midline cells and then from all neurectoderm during neurulation. After neurulation, expression is reactivated in the dorsal neural tube and dorsolateral somite. Comparison ofCiZicandAmphiZicexpression with vertebrate Zic expression leads to two main conclusions. First, Zic expression allows us to define homologous compartments between vertebrate and amphioxus somites, showing primitive subdivision of vertebrate segmented mesoderm. Second, we show that neural Zic expression is a chordate synapomorphy, whereas the precise pattern of neural expression has evolved differently on the different chordate lineages. Based on these observations we suggest that a change in Zic regulation, specifically the evolution of a dorsal neural expression domain in vertebrate neurulae, was an important step in the evolution of the neural crest.
Comparison of even‐skipped related gene expression pattern in vertebrates shows an association between expression domain loss and modification of selective constraints on sequences
Authors: Avaron Fabien , Thaëron‐Antono Christelle , Beck Caroline W. , Borday‐Birraux Véronique , Géraudie Jacqueline , Casane Didier , Laurenti Patrick
Published: March 2003

SUMMARY The even‐skipped related genes (evx) encode homeodomain‐containing transcription factors that play key roles in body patterning and neurogenesis in a wide array of Eumetazoa species. It is thought that the genome of the last common ancestor of Chordata contained a unique evx gene linked to a unique ancestral Hox complex. During subsequent evolution, two rounds of whole genome duplication followed by individual gene losses gave rise to three paralogs: evx1, evx2, and eve1. Then, eve1 was maintained in Actinopterygii lineage but not in Tetrapoda. To explain this discrepancy, we examined the expression patterns of the evx1 homologue, Xhox3, in Xenopus laevis and that of evx1 and eve1 in Danio rerio. We show here that Xhox3 is expressed in a manner that closely reflects the inferred expression pattern of the evx1 gene in the last common ancestor of Vertebrata (i.e., in gastrula, the central nervous system, the posterior gut, and the tip of the growing tail). Zebrafish evx1 and Xenopus Xhox3 are expressed in homologous cell lineages of the central nervous system and of the posterior gut, but evx1 was undetectable in the gastrula and the tail bud. Strikingly, eve1 is the only evx gene of zebrafish to be expressed in these two latter regions. Thus, the ancestral expression pattern of evx1 in vertebrates appears to have been distributed between evx1 and eve1 in zebrafish. We propose that evx1 and eve1 underwent a complementary loss of expression domain in zebrafish that allowed the maintenance of the two paralogs in accordance with the duplication‐degeneration‐complementation model. It is important to note that, in zebrafish, Evx1 and Eve1 have lost most of the protein domain upstream of the homeodomain. In addition, Eve1 has accumulated substitutions in positions that are highly conserved in all other Evx proteins. Thus, the reduction of the expression domain of both evx1 and eve1 in zebrafish appears to be associated with the modification of constraints on the protein sequences, allowing the shortening of both genes and an accelerated substitution rate in eve1.
Comparative expression analysis of Adh3 during arthropod, urochordate, cephalochordate, and vertebrate development challenges its predicted housekeeping role
Authors: Cañestro Cristian , Godoy Laura , Gonzàlez‐Duarte Roser , Albalat Ricard
Published: March 2003

SUMMARY Gene and genome duplications in the vertebrate lineage explain the complexity of extant gene families. Among these, the medium‐chain alcohol dehydrogenase (ADH), which expanded by tandem duplications after the cephalochordate–vertebrate split, is a good model with which to analyze the evolution of gene function. Although the ancestral member of this family, ADH3, has been strictly conserved throughout animal evolution, its physiological role is still controversial. Previous evidence indicates that it contributes to formaldehyde cytoprotection, retinoic acid metabolism, and nitric oxide homeostasis. We performed in situ hybridization during Drosophila, ascidian (Ciona intestinalis), and zebrafish (Danio rerio) development. We showed that Adh3 expression was restricted to the fat body in Drosophila embryos at stage 17 and to the anterior endoderm in C. intestinalis tail bud, whereas in the zebrafish 2.5‐day larvae the signal appeared widespread. A more comprehensive expression analysis including amphioxus and mice revealed that ancestral Adh3 was tissue specific, whereas a widespread expression was later attained in vertebrates. These variations occurred concomitantly with the expansion of the ADH family and the acquisition of new functions but were unlinked to the genomic changes that led to the transition from fractional to global methylation in vertebrates. Our data challenge the housekeeping role of ADH3 and question its involvement in the prevertebrate retinoic acid pathway.
Plasmapheresis in Severe Forms of Myasthenia Gravis
Authors: Morosetti Massimo , Meloni Carlo , Iani Cesare , Caramia Maria , Galderisi Cristina , Palombo Giuditta , Gallucci Massimo Taccone , Bernardi Giorgio , Cascian Carlo Umberto
Published: March 2003

In this study we introduce a new combination treatment of plasma exchange (PE) and high daily doses of prednisone for severe forms of myasthenia gravis (MG). The clinical efficacy of the combined therapy has been tested in 18 patients suffering from severe forms of MG. The protocol included 5 sessions of PE, performed in a range of 15 days, 1 session every 3 days, with concurrent administration of oral prednisone (1 mg/kg of body weight), starting at the first session of PE and given daily for at least 3 months. At the end of the entire cycle of PE, almost complete recovery (more than 90% of the initial clinical score) was obtained in 8 of 18 patients while an improvement between 60 and 90% of the initial score was achieved in 9 of 18 patients. An early improvement was noted 24 h after the beginning of plasmapheresis in 11 of 18 patients. No recurrence of symptoms was reported after 36 months of follow‐up for 17 patients. The administration of steroid therapy was never followed by an early exacerbation of myasthenic symptoms as reported when it is administered in the absence of concomitant PE. According to our results, we can conclude that high doses of oral prednisone therapy in simultaneous association with PE lead to successful control of severe forms of MG, significantly superior to the therapeutic strategies until now adopted and reported in literature.
Soluble Interleukin 2 Receptor in Dialyzed Patients
Authors: Shu Kuo‐Hsiung , Lu Yuan‐San , Cheng Chi‐Hung , Lian Jong‐Da
Published: March 2003

Azotemic patients are usually characterized by a state of so‐called preactivation resulting in excessive expression of interleukin 2 receptors (IL‐2R) on T lymphocytes. The etiological mechanism of this preactivation is, however, still speculative. We studied the serum level of the soluble form of IL‐2R (sIL‐2R) in azotemic patients on either hemodialysis (HD) (n = 49) or continuous ambulatory peritoneal dialysis (CAPD) (n = 45). Both patient groups had significantly higher sIL‐2R levels (1,750 ± 664 U/ml in the HD group and 1,769 ± 647 U/ml in the CAPD group, respectively) p < 0.00001 as compared to the normal control group (511 ± 436 U/ml). However, there was no significant difference between the levels of the HD and CAPD group patients. When clinical parameters were studied for their influence on sIL‐2R levels, none of the following caused any significant changes; blood transfusion, type of dialyzer used, type of dialysis fluid used, treatment with erythropoietin, hepatitis B infection, or liver function profile. We conclude that chronic renal failure per se is the major cause of the preactivation of T lymphocytes. The modes of treatment and various clinical variables in these patients have no significant influence on sIL‐2R levels.
An Aortic Balloon Catheter Incorporating a Conduit for Percutaneous Cardiopulmonary Support
Authors: Watari Masanobu , Fukunaga Shintaro , Hirai Shinji , Orihashi Kazumasa , Sueda Taijiro , Matsuura Yuichiro
Published: March 2003

Circulatory support using both intraaortic balloon pumping (IABP) and percutaneous cardiopulmonary support (PCPS) can improve general hemodynamics; however, sometimes brain damage occurs caused by hypoperfusion. Such cerebral hypoperfusion is likely to be caused by PCPS when applying the conventional femoral cannulation. We have developed a new IABP catheter which incorporates a conduit for PCPS with an outlet at the catheter tip, the goal of which is the improvement of cerebral perfusion. The hemodynamic characteristics of this new IABP catheter were compared with those of the conventional combination of IABP and PCPS. Studies were performed by mock test using a pulsatile artificial heart. A polyvinyl chloride tube acted as the aorta with 2 branches at the proximal and distal portions representing the upper and lower portions of the body. The IABP balloon was positioned between the 2 branches, and changes in flow at the 2 branches were examined at varying PCPS flow rates. Flow in the proximal branch using the new device was greater than it was using the conventional PCPS device. We conclude that cerebral perfusion could be improved with the use of this new special IABP catheter.
The Ethics of Technology Introduction
Authors: Abele John E.
Published: March 2003

The rapid acceleration of technology development is outpacing our ability to assess it objectively and competently. Our challenge is to develop new assessment methods that take into account the fast moving nature of technology development while still protecting the patients' and the public interest.
It is the goal of this section to publish material that provides information regarding specific issues, aspects of artificial organ application, approach, philosophy, suggestions, and/or thoughts for the future. 5‐Lipoxygenase Gene Expression in Hemodialysis
Authors: Menegatti Elisa , Roccatello Dario , Rossi Daniela , Formica Marco , Piccoli Giuseppe , Sena Luigi M.
Published: March 2003

Leukotrienes (LTs), the end products of the eicosanoid pathway released during inflammation, are markers of polymorphonuclear cell and monocyte activation. The present study focused on the possibility that 5‐lipoxygenase (5‐LO), the key enzyme for LT synthesis, was involved in the interaction between blood and the hemodialysis (HD) membrane. 5‐LO gene expression was examined by reverse transcriptase polymerase chain reaction (RT‐PCR) in samples of mononuclear cells isolated from peripheral blood withdrawn at the start and at 15 min of HD from 10 chronic HD patients, 5 treated with Cuprophan and 5 with polymethylmethacrylate (PMMA) membrane. An increased 5‐LO gene expression was detected at 15 min in 4 of 5 patients using the Cuprophan membrane but in none of the 5 PMMA treated patients. Our results showed for the first time that the interaction between blood and the HD membrane upregulates 5‐LO messenger ribonucleic acid (mRNA).