bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels of dyslipidaemia and improvement in its management in England: results from the Health Survey for England 2003
Authors: Primatesta Paola , Poulter Neil R.
Published: February 2006

Objective  To evaluate blood lipid levels in the adult English population and to report changes in the use and efficacy of lipid‐lowering treatment between 1998 and 2003.

Design  Cross‐sectional surveys.

Participants  Nationally representative sample of 8269 non‐institutionalized adults (≥ 16 years) living in England, taking part in the Health Survey for England 2003.

Measurements  Mean levels of total, HDL, non‐HDL and total : HDL cholesterol ratio; prevalence of hypercholesterolaemia; use of lipid‐lowering agents and lipid levels among those on treatment; blood pressure. Information on smoking and history of cardiovascular events and diabetes were recorded by the interviewer.

Results  In 2003 69·9% of adults had a total cholesterol ≥ 5 mmol/l and 6·2% reported lipid‐lowering treatment. Treatment rates among those with a total cholesterol ≥ 5 mmol/l and a history of coronary heart disease or stroke, hypertension or diabetes were 71·1%, 32·7% and 50·9%, respectively in men; and 55·8%, 22·4% and 50·0% in women. In all these groups, more than half of those treated were controlled (< 5 mmol/l).

Only small changes in levels of dyslipidaemia were seen since 1998 (when 67·5% of adults had a total cholesterol ≥ 5 mmol/l), but use of lipid‐lowering treatment has more than doubled and control rates have increased by approximately fourfold.

Conclusions  Treatment and control rates of lipids have improved importantly between 1998 and 2003 but remain suboptimal. Reductions in major cardiovascular events are likely to result from these changes and may be further enhanced by adherence to the new general practitioner contract.
The treatment with cabergoline for 24 month normalizes the quality of seminal fluid in hyperprolactinaemic males
Authors: De Rosa Michele , Ciccarelli Antonio , Zarrilli Stefano , Guerra Ermelinda , Gaccione Maria , Di Sarno Antonella , Lombardi Gaetano , Colao Annamaria
Published: February 2006

Background  Alterations of sperm number and motility are found in hyperprolactinaemic men. Cabergoline treatment reverses alterations in semen. No information is currently available on the quality of seminal tests in hyperprolactinemia in response to cabergoline treatment.

Objective  To further investigate the effect of hyperprolactinaemia and its treatment with cabergoline on semen quality.

Patients  Forty‐three men with hyperprolactinaemia (32 macro‐ and 11 micro‐prolactinomas); 60 healthy men served as control.

Methods  Live spermatozoa count, sperm membrane function, kinetic index, nuclear DNA integrity, sperm curvilinear and linear velocity and amplitude of lateral movement of the sperm head were investigated before and after 6 and 24 months of treatment with cabergoline.

Study design  Open prospective.

Results  At study entry, semen functional tests were severely and similarly impaired both in patients with macro‐ and micro‐prolactinomas compared to controls. After 6 and 12 months of treatment there was a significant improvement of semen quality in patients achieving normalization of prolactin levels, although most of the parameters remained lower than in controls. After 24 months of treatment, seminal fluid characteristics were similar to the controls except for live spermatozoa count, sperm membrane function, sperm kinetic index and sperm nuclear DNA integrity, which remained abnormal in 9·3–53% of the patients.

Conclusions  Twenty‐four months of cabergoline treatment restored gonadal function in 66·7% of men with hyperprolactinaemia.
Personality characteristics and quality of life in patients treated for Cushing's syndrome
Authors: Sonino Nicoletta , Bonnini Stefano , Fallo Francesco , Boscaro Marco , Fava Giovanni A.
Published: February 2006

Objective  Psychological distress does not always disappear upon proper endocrine treatment of Cushing's syndrome, and quality of life may still be compromised. Little is known on the personality correlates that may be involved. The aim of this study was to provide a controlled assessment of personality characteristics and quality of life in patients successfully treated for Cushing's syndrome.

Design  A single‐centred, controlled, prospective study.

Patients  Twenty‐four consecutive outpatients who were in remission upon proper treatment of Cushing's syndrome for at least 1 year and no more than 3 years (20 with pituitary‐dependent Cushing's disease and four with a cortisol‐secreting adrenal adenoma; 5 M/19 F; mean age 34·5, SD = 10·6; range 18–57 years) were compared with 24 healthy control subjects matched for sociodemographic variables.

Measurements  Both patients and controls were administered two self‐rating scales:

tridimensional personality questionnaire (TPQ), a 100‐item inventory that yields three scales: novelty seeking, harm avoidance and reward dependence.

symptom rating test (SRT), a 46‐item scale for assessing psychological distress and quality of life with six subscales (anxiety, depression, somatic symptoms, anger‐hostility, cognitive symptoms, psychotic symptoms).

Results  There were no significant differences in personality dimensions, as measured by the TPQ, between patients and controls. The results did not change when the four patients with an adrenal adenoma were excluded and only the 20 with pituitary‐dependent Cushing's disease were considered. As to the SRT scale, patients with Cushing's syndrome displayed significantly higher scores in anxiety (P= 0·046), depression (P= 0·013), and psychotic symptoms (P= 0·006), with a generalized compromised quality of life (P= 0·02). Again, no differences were found in evaluating the 20 patients with Cushing's disease separately.

Conclusions  Even though personality traits other than those explored here may be involved, the results seem to exclude the presence of latent dysfunctional attitudes and beliefs contributing to long‐standing psychological disturbances, even in the pituitary‐dependent form of Cushing's syndrome. Data from larger populations might provide further insight in this field. The findings of a compromised quality of life are in agreement with the recent literature and have implications for the long‐term management of patients.
Frequent occurrence of pituitary apoplexy in patients with non‐functioning pituitary adenoma
Authors: Nielsen E. Husted , Lindholm J. , Bjerre P. , Christiansen J. Sandahl , Hagen C. , Juul S. , Jørgensen J. , Kruse A. , Laurberg P.
Published: February 2006

Background and objective  There is agreement in the literature that pituitary apoplexy is a rare disorder. As our experience differs from this view, we analysed the incidence in patients operated on for a nonfunctioning pituitary adenoma.

Patients and design  One hundred ninety‐two consecutive patients with a suprasellar, clinically inactive adenoma operated on during the period 1985–1996 were retrospectively reviewed. A diagnosis of pituitary apoplexy was made from relevant neurological symptoms together with pertinent findings at operation.

Results  Pituitary apoplexy occurred in 41 patients (21%), in 23 patients within 12 days prior to the operation. The male/female ratio was 1·9. Median follow‐up time was 13·7 years (range 8·9–19·9). During this period, 12 patients had died, yielding a standard mortality ratio of 1·09 (95% CI 0·62–1·92), similar to that in the patients who had not sustained pituitary apoplexy. Postoperatively, 24% of the patients had normal pituitary function, 38% were panhypopituitary and partial pituitary insufficiency was present in 38%. Subnormal GH secretion was present in virtually all patients tested. Two patients died within 60 days of surgery and in two no or incomplete data were available, although they most likely were panhypopituitary.

Conclusion  Most of our findings add little to what is known about pituitary apoplexy. On one point, however, they are contrary to previously presented data. We found a much higher incidence of pituitary apoplexy despite rather rigorous criteria for the diagnosis. The outcome as regards survival and endocrine function was not different from that in patients with a nonfunctioning adenoma who did not suffer pituitary apoplexy.
High variability in CYP21A2 mutated alleles in Spanish 21‐hydroxylase deficiency patients, six novel mutations and a founder effect
Authors: Loidi Lourdes , Quinteiro Celsa , Parajes Silvia , Barreiro Jesús , Lestón Domingo G. , Cabezas‐Agrícola José M. , Sueiro Aurelio M. , Araujo‐Vilar David , Catro‐Feijóo Lidia , Costas Javier , Pombo Manuel , Domínguez Fernando
Published: February 2006

Objective To detect common as well as rare and novel CYP21A mutations in 21‐hydroxylase deficiency patients. To estimate the distribution of mutations and compare them with other European studies. To construct haplotypes linked to a recurrent novel mutation.

Design Genetic analysis by sequencing the entire CYP21A2 gene plus Southern blot.

Patients A total of 138 unrelated Spanish patients: 122 nonclassical forms (NCF) and 16 classical forms (CF) were studied.

Results Among the 266 nonrelated mutated alleles; CYP21A2 deletions/conversions and a spectrum of 27 different mutated alleles were found: 15 different single point mutations, 8 nucleotide deletions in exon 3, 3 mutation clusters in exon 6, 9 alleles with more than one mutation, one 21‐nucleotide duplication in exon 10, and one allele with CYP21A2 duplicated and both copies mutated. The most frequent mutation in NCF alleles is V281L (71·8%). Among CFs, the most common is I2 g (20%) and Q318X (16%) and rare alleles (21·9%). Six novel causative mutations were found, four associated with CF: I46+1nt, R444X, P463L and M473_R479dup and two associated with NCF: W302 and D322G. The R444X mutation was found in seven unrelated patients and it appeared only once in an ancestral haplotype. In addition, we found a novel single nucleotide polymorphism with a 31·5% frequency for the rare allele.

Conclusion A great diversity of haplotypes with a large spectrum of mutated alleles was found. The frequency of the V281L mutation was the highest reported and the relatively high frequency of R444X was the result of a founder effect.
First‐line octreotide‐LAR therapy induces tumour shrinkage and controls hormone excess in patients with acromegaly: results from an open, prospective, multicentre trial
Authors: Colao Annamaria , Pivonello Rosario , Rosato Francesca , Tita Patrizia , De Menis Ernesto , Barreca Antonina , Ferrara Roberto , Mainini Franco , Arosio Maura , Lombardi Gaetano
Published: February 2006

Background  The majority of patients with acromegaly have large tumours and the outcome of conventional management remains poor.

Objective  To investigate the clinical application of octreotide‐LAR as primary treatment in newly diagnosed patients with GH‐secreting pituitary tumours.

Design  Open, prospective, multicentre, 24‐week follow‐up study.

Patients  Thirty‐four patients were enrolled (20 men, 14 women; mean age, 50 years); 13 had microadenoma [median tumour volume 327 mm3 (range 31–629 mm3)], 21 had macroadenoma [median tumour volume 1325 mm3 (range 503–11583 mm3)].

Interventions  Octreotide‐LAR at the dosage of 20 mg every 28 days for the first 12 weeks increased to 30 mg every 28 days to control GH and/or IGF‐I excess in 20 patients (64·7%).

Main outcome measures  Primary endpoints were control of GH (fasting < 2·5 µg/l) and IGF‐I secretion (gender‐ and age‐normalized) and presence and entity of tumour mass shrinkage. Secondary endpoint was improvement of symptoms score.

Results  In patients with micro‐ and macroadenomas GH levels decreased to < 2·5 µg/l in 84·6% and 45%, serum IGF‐I levels normalized for age and gender in 61·5% and 35% of cases. Failure in achieving either GH < 2·5 µg/l or normal IGF‐I levels was found in none of the patients with micro‐ and in 45% of patients with macroadenoma. Median tumour volume was reduced by 54% (range: −90% to +350%) in micro‐ and by 49% (range −94% to −14%) in macroadenomas. Headache, perspiration and osteo‐arthralgias disappeared in 21%, paresthesias in 38%, fatigue in 26% and carpal tunnel syndrome in 15%. The treatment was well tolerated: more frequent adverse events were gastrointestinal (in 44%).

Conclusions  In both patients with micro‐ or macroadenoma, primary octreotide‐LAR treatment controls hormone excess, induces tumour shrinkage and improves symptoms of acromegaly with limited side effects and can be therefore successfully employed in patients with contraindications for surgery or in those who refuse surgery.
Soil moisture, carbon and nitrogen dynamics following incorporation and surface application of labelled crop residues in soil columns
Authors: Coppens F. , Garnier P. , De Gryze S. , Merckx R. , Recous S.
Published: February 2006

One way to increase the amount of carbon sequestered in agricultural land is to convert conventional tillage into no‐tillage systems. This greatly affects the location of crop residues in soil. To investigate the impact of the location of residues on soil physical and biological properties and how the interactions between those properties influence the fate of carbon and nitrogen in soil, we did a laboratory experiment with repacked soil in columns. Doubly labelled 13C15N oilseed rape residues were incorporated in the 0–10 cm layer or left on the soil surface. The columns were incubated for 9 weeks at 20°C and were submitted to three cycles of drying and wetting, each of them induced by a rain simulator. The location of the residues affected the water dynamics and the distribution of C and N in the soil, which in turn influenced microbial activity and the decomposition rate of the added residues. After 9 weeks of’incubation, 18.4 ± 1.5% of the surface applied residue‐C and 54.7 ± 1.3% of the incorporated residue‐C was mineralized. We observed a nitrate accumulation of 10.7 mg N kg−1 with residues at the soil surface, 3.6 mg N kg−1 with incorporated residues and 6.3 mg N kg−1 without addition of fresh organic matter, which entailed net N mineralization in soil under mulch and immobilization of N with residue incorporation compared with the control soil. We concluded that application of oilseed rape residues at the soil surface increased the storage of fresh organic C in soil in the short term, compared with the incorporation treatment, but increased the risk of nitrate leaching.
A pattern‐based approach for multiple removal applied to a 3D Gulf of Mexico data set
Authors: Guitton Antoine
Published: February 2006

Surface‐related multiples are attenuated for one sail line and one streamer of a 3D data set (courtesy of Compagnie Générale de Géophysique). The survey was carried out in the Gulf of Mexico in the Green Canyon area where salt intrusions close to the water‐bottom are present. Because of the complexity of the subsurface, a wavefield method incorporating the full 3D volume of the data for multiple removal is necessary. This method comprises modelling of the multiples, where the data are used as a prediction operator, and a subtraction step, where the model of the multiples is adaptively removed from the data with matching filters. The accuracy of the multiple model depends on the source/receiver coverage at the surface. When this coverage is not dense enough, the multiple model contains errors that make successful subtraction more difficult. In these circumstances, one can either (1) improve the modelling step by interpolating the missing traces, (2) improve the subtraction step by designing methods that are less sensitive to modelling errors, or (3) both. For this data set, the second option is investigated by predicting the multiples in a 2D sense (as opposed to 3D) and performing the subtraction with a pattern‐based approach. Because some traces and shots are missing for the 2D prediction, the data are interpolated in the in‐line direction using a hyperbolic Radon transform with and without sparseness constraints. The interpolation with a sparseness constraint yields the best multiple model. For the subtraction, the pattern‐based technique is compared with a more standard, adaptive‐subtraction scheme. The pattern‐based approach is based on the estimation of 3D prediction‐error filters for the primaries and the multiples, followed by a least‐squares estimation of the primaries. Both methods are compared before and after prestack depth migration. These results suggest that, when the multiple model is not accurate, the pattern‐based method is more effective than adaptive subtraction at removing surface‐related multiples while preserving the primaries.
The origin and nature of seismic reflections of sharp‐based shoreface deposits (upper Jurassic Siliciclastics, northern France)
Authors: Braaksma H. , Drijkoningen G.G. , Filippidou N. , Kenter J.A.M. , Proust J.N.
Published: February 2006

In order to advance understanding of the relationship between geological properties and their physical expression in reflection images, this study has focused expertise in reflection geophysics, petrophysics and sedimentology on the same geological object, in this case a succession of Upper Jurassic sharp‐based shoreface deposits embedded in offshore marine shales in northern France. This integrated approach to determine firstly the origin and nature of seismic reflections (calibration) and secondly to provide a means of extracting geological information from seismic imagery (inverse calibration) was built on the following analytical steps.

Firstly, detailed and extensive petrophysical analyses of outcrop (plug) samples, continuous core and sonic well logs, in combination with a quantification of mineralogical and textural properties, allowed a direct conversion of acoustic properties (impedance) into sedimentological properties, resulting in a quantitative physical sequence stratigraphic model.

Secondly, the integration of scale‐dependent acoustic measurements, ranging from 0.01 m and 320 kHz on cores up to the wavelength of field seismic data was established using an averaging algorithm (an effective‐medium‐theory type) as an upscaling approach. This alternative to a VSP or check shot allows an optimized depth–time conversion and hence determination of the origin of the seismic reflections with previously unattainable accuracy.

Finally, the shape and scale dependence of impedance contrasts were integrated into so‐called singularity parameters that directly link depositional changes with information from seismic reflections: depositional changes in the shallow‐water domain are generally characterized by step functions, whereas those in more distal depositional environments are represented by spiky functions. This approach allows the recognition of the associated reflection events and, vice versa, it provides a unique opportunity to extract the character of impedance changes, and thus changes in depositional environment, from seismic reflection records in general.

This integrated and multiscale characterization of sharp‐based shoreface deposits calibrates the typical reflection patterns for such sedimentary units. These include continuous high‐amplitude smooth and flat tops, discontinuous sharp basal reflections with variable amplitude, and complex sigmoidal high‐amplitude reflections within the compound shoreface deposits. In addition, the results of this study, by detailing the effects of scale and frequency on impedance changes, improve the identification of similar deposits in subsurface seismic data and the extraction of maximum amounts of geological information beyond seismic resolution.
Assessing the impact of Impatiens glandulifera on riparian habitats: partitioning diversity components following species removal
Authors: HULME PHILIP E. , BREMNER ELEANOR T.
Published: February 2006

Attempts to quantify the impact of non‐native plants on the vegetation of invaded habitats have often been criticized because of the frequent use of observational assessments (invaded/uninvaded comparisons) focused on local‐ rather than community‐level effects. This study highlights how removal experiments combined with partitioning of diversity components across spatial scales can provide key insights into invasive species’ impacts.

Impatiens glandulifera (Balsaminaceae) is a widespread invasive riparian weed, yet few quantitative assessments of its impact on natural vegetation exist. Thus replicated experiments were used to compare the impact of Impatiens removal on α, β, γ components of species richness, diversity and evenness in open riparian habitats in north‐east England.

Plant community response to Impatiens removal was rapid, with a significant increase in seedling recruitment resulting in an average increase of four species m−2. The impact of Impatiens invasion was most marked for light‐demanding species. Eight non‐native species (in addition to Impatiens) occurred in the community and these responded proportionally more to Impatiens removal than native species. As a result the proportion of non‐native species in removal plots was higher than in invaded plots.

The increase in α richness and diversity following Impatiens removal was matched by a similar increase in the γ components. Thus the effect of Impatiens was significant at both the local plot scale and at the scale of the riparian community, although the former effect was more marked. Species accumulation curves suggested that extensive Impatiens stands may reduce species richness by as much as 25%.

Synthesis and applications. Removal experiments appear particularly well suited to assess the impacts of herbaceous non‐native plants on ruderal communities. By partitioning diversity components, impacts were consistently assessed at local and community scales and, when combined with analysis of species accumulation curves, provided a comprehensive assessment of impact on the plant community. The approach adopted in this study highlights that although Impatiens reduces native species diversity in open and frequently disturbed riparian vegetation, many of the species negatively influenced by Impatiens are widespread ruderal species. Furthermore, management may lead to a compensatory increase in the abundance of other non‐native species and thus fail to achieve desired conservation goals.
Correlates of biological soil crust abundance across a continuum of spatial scales: support for a hierarchical conceptual model
Authors: BOWKER MATTHEW A. , BELNAP JAYNE , DAVIDSON DIANE W. , GOLDSTEIN HARLAND
Published: February 2006

Desertification negatively impacts a large proportion of the global human population and > 30% of the terrestrial land surface. Better methods are needed to detect areas that are at risk of desertification and to ameliorate desertified areas. Biological soil crusts are an important soil lichen‐moss‐microbial community that can be used toward these goals, as (i) bioindicators of desertification damage and (ii) promoters of soil stability and fertility.

We identified environmental factors that correlate with soil crust occurrence on the landscape and might be manipulated to assist recovery of soil crusts in degraded areas. We conducted three studies on the Colorado Plateau, USA, to investigate the hypotheses that soil fertility [particularly phosphorus (P), manganese (Mn) and zinc (Zn)] and/or moisture limit soil crust lichens and mosses at four spatial scales.

In support of the soil fertility hypothesis, we found that lichen–moss crusts were positively correlated with several nutrients [Mn, Zn, potassium (K) and magnesium (Mg) were most consistent] at three of four spatial scales ranging from 3·5 cm2 in area to c. 800 km2. In contrast, P was negatively correlated with lichen–moss crusts at three scales.

Community composition varied with micro‐aspect on ridges in the soil crust. Three micro‐aspects [north‐north‐west (NNW), east‐north‐east (ENE) and TOP] supported greater lichen and moss cover than the warmer, windward and more xeric micro‐aspects [west‐south‐west (WSW) and south‐south‐east (SSE)]. This pattern was poorly related to soil fertility; rather, it was consistent with the moisture limitation hypothesis.

Synthesis and application. Use of crusts as desertification bioindicators requires knowledge of a site's potential for crust cover in the absence of desertification. We present a multi‐scale model of crust potential as a function of site properties. Future quantitative studies can use this model to guide sampling efforts. Also, our results suggest new directions in restoration research: enhancement of moisture residence time and fertilization with key nutrients (Mn, Zn, K and Mg). Re‐establishment of soil crusts in desertified lands will help regain lost soil stability and fertility, and facilitate plant re‐establishment.
Using spatial heterogeneity to extrapolate species richness: a new method tested on Ecuadorian cloud forest birds
Authors: O'DEA NIALL , WHITTAKER ROBERT J. , UGLAND KARL I.
Published: February 2006

For most ecological assemblages, compiling complete inventories of species is difficult, if not impossible. Various methods have been developed to estimate total species richness based on the pattern of richness and relative abundance reflected in a limited sample.

We assessed the performance of a recently developed technique, the total‐species (T‐S) accumulation method, in estimating bird species richness for cloud forest reserves in north‐west Ecuador. This technique explicitly integrates the spatial heterogeneity of samples into the estimate of species richness for large areas by grouping samples into subsets based on shared environmental characteristics.

We compared the technique's performance with that of more traditional methods of species richness estimation: non‐parametric estimators and extrapolations from species‐accumulation curves. Existing bird species records for the Ecuadorian cloud forest reserves served as the independent measure of total species richness.

Non‐parametric estimators of species richness significantly underestimated total species richness. In contrast, extrapolation from the semi‐log approximation of T‐S curves, using subdivision by habitat type, altitude and first axis detrended correspondence analysis scores, overestimated total species richness, while extrapolation from null T‐S models and the standard species‐accumulation curve produced the most accurate results.

The T‐S method overestimated species richness for our ‘hyper‐diverse’ assemblage. This was probably because it adjusted the estimates upwards to account for beta‐diversity, when this diversity was already captured in the design of the site selection scheme. Nevertheless, it provided a quantitative measure of the beta‐diversity produced by environmental and compositional gradients. Moreover, our test indicated that factors such as sampling effort and species abundance distributions may be more important for accurate species richness estimation than heterogeneity in the spatial distribution of species.

Synthesis and applications. Our analysis demonstrates significant differences in the accuracy of different methods for estimating total species richness from a limited sample. Our work highlights the importance of knowing what an estimator is estimating so that when we characterize or compare sites, whether in ecological or conservation research, we do so with explicit knowledge of the potential biases in our chosen methodology.
Development of gastric slow waves and effects of feeding in pre‐term and full‐term infants
Authors: Zhang J. , Ouyang H. , Zhu H. B. , Zhu H. , Lin X. , Co E. , Hayes J. , Chen J. D. Z.
Published: February 2006

Abstract The aims of this study were to investigate the difference in developmental process of gastric slow waves and the effects of feeding in pre‐term and full‐term infants. Twenty‐six pre‐term and 31 full‐term infants were enrolled in the study. Gastric myoelectrical activity was recorded using electrogastrography (EGG) from birth to month 6. (1) An increase in the % of 2–4 cpm slow waves was noted in both pre‐term (P < 0.01) and full‐term infants (P < 0.04) from birth to month 4. (2) The pre‐term infants showed a reduced dominant EGG power at certain points of the study. (3) Breast or formula feeding resulted in no difference in the EGG in the full‐term infants and showed a difference in the postprandial dominant power of the EGG in the pre‐term infants only at month 2 after birth (P < 0.05) but not at other times. The gastric slow wave in pre‐term infants is of a significantly reduced amplitude but similar rhythmicity. The method of feeding has no effects on the EGG in full‐term infants and minimal effects (may be of non‐clinical significance) on the EGG in pre‐term infants as the difference was noted only at one time point during the 6‐month follow‐up study.
Characterization of cortical potentials evoked by oesophageal balloon distention and acid perfusion in patients with functional heartburn
Authors: Yang M. , Li Z‐s. , Xu X‐r. , Fang D‐c. , Zou D‐w. , Xu G‐m. , Sun Z‐x. , Tu Z‐x.
Published: February 2006

Abstract  Oesophageal visceral hypersensitivity is thought to be important in generating symptoms in functional heartburn (FH). However, the neurophysiological mechanisms involved are poorly understood. The aim of this study was to compare the characteristics of oesophageal cortical evoked potentials (CEPs) induced by balloon distension and acid perfusion in FH and controls. We studied 21 FH patients and 12 healthy volunteers. Oesophageal mechanical stimulation was performed using the specially constructed mechanical pump. CEPs were recorded using the 10–20 international system of electroencephalogram recording. Oesophageal distention elicited recognizable, reproducible and muti‐peak CEPs. CEP latencies for N1, P1 and N2 components were significantly shorter (P = 0.016, P = 0.003 and P = 0.031, respectively) in FH than in controls before perfusion. Acid perfusion significantly decreased the latencies of N1, P1 and N2 (P = 0.022, P = 0.007 and P = 0.041, respectively) and significantly increased the amplitude of P1–N2 components (P = 0.020) in FH patients, but not in controls. In conclusion, cortical evoked potential responses evoked by oesophageal distention and acid perfusion were greater in FH than in controls, suggesting that dysfunction of visceral neural pathways and/or alterations in cortical processing may produce and mediate oesophageal hypersensitivity in FH. These findings provide the evidence that central sensitization contributes to the development and maintenance of oesophageal hypersensitivity.
Characterization of depolarization‐evoked ERG K+ currents in interstitial cells of Cajal
Authors: Mckay C. M. , Ye J. , Huizinga J. D.
Published: February 2006

Abstract  Interstitial cells of Cajal (ICC) harbour the ether‐a‐go‐go related gene (ERG) channel as shown by its characteristic rapidly deactivating current upon hyperpolarization. This property, however, does not explain the marked increase in cell excitability by ERG channel blockers, namely an increase in slow wave plateau duration and action potential generation. The objective of the present study was to characterize the depolarization‐activated, E4031‐sensitive ERG currents in murine ICC within a range of physiologically relevant membrane potentials. Whole cell currents were recorded from ICC isolated from murine neonatal jejunum, superfused with a physiological salt solution and with high intracellular Cs+ to block most other K+ currents. Upon depolarizing the cell from the resting membrane potential (∼−60 mV) towards the region of the slow wave plateau (∼−30 mV), significant sustained (window) current was generated between the potentials of −40 to 0 mV (maximal at −30 mV) and inhibited by the ERG specific blocker E4031. Channel activation followed by rapid inactivation produced a steady state conductance at −30 mV which was 51.6 ± 11% of the hyperpolarization‐evoked peak conductance value at −100 mV. When the cell repolarized from −30 mV, again, significant currents were generated, indicating recovery from inactivation, a typical characteristic of ERG channels. These data provide evidence that the ERG channel is of significance in the regulation of ICC excitability and provide the mechanism by which ERG channel blockade increases the slow wave duration.
Mannan‐Binding Lectin in Children with Chronic Gastritis
Authors: Ba̧k‐Romaniszyn L. , Cedzyński M. , Szemraj J. , St. Świerzko A. , Zeman K. , Kałuz̊yński A. , Płaneta‐Małecka I.
Published: February 2006

The involvement of mannan‐binding lectin (MBL) insufficiency in the pathogenesis of chronic gastritis (CG) in children was investigated. Blood samples were collected from 78 paediatric patients suffering from CG associated with Helicobacter pylori infection (group Hp+) and from 41 with the disease not associated with such an infection (group Hp–). Control group consisted of 77 children. The frequency of mbl‐2 gene mutations and serum protein concentrations did not differ significantly in both groups as compared with controls. An expression of mbl‐2 gene in gastric biopsies of CG patients was demonstrated. It was found to be stronger in H. pylori‐infected children. The results presented in this paper suggest that MBL deficit/dysfunction probably does not contribute to an increased risk of CG (both associated and not associated with H. pylori infection) in children. However, MBL opsonic effect and/or the lectin pathway of complement activation may be taken into account as possible host defence mechanisms in gastric patients.
Enhanced arsenate reduction by a CDC25‐like tyrosine phosphatase explains increased phytochelatin accumulation in arsenate‐tolerant Holcus lanatus
Authors: Bleeker Petra M. , Hakvoort Henk W.J. , Bliek Mattijs , Souer Erik , Schat Henk
Published: February 2006

Decreased arsenate [As(V)] uptake is the major mechanism of naturally selected As(V) hypertolerance in plants. However, As(V)‐hypertolerant ecotypes also show enhanced rates of phytochelatin (PC) accumulation, suggesting that improved sequestration might additionally contribute to the hypertolerance phenotype. Here, we show that enhanced PC‐based sequestration in As(V)‐hypertolerant Holcus lanatus is not due to an enhanced capacity for PC synthesis as such, but to increased As(V) reductase activity. Vacuolar transport of arsenite‐thiol complexes was equal in both ecotypes. Based on homology with the yeast As(V) reductase, Acr2p, we identified a Cdc25‐like plant candidate, HlAsr, and confirmed the As(V) reductase activity of both HlAsr and the homologous protein from Arabidopsis thaliana. The gene appeared to be As(V)‐inducible and its expression was enhanced in the As(V)‐hypertolerant H. lanatus ecotype, compared with the non‐tolerant ecotype. Homologous ectopic overexpression of the AtASR cDNA in A. thaliana produced a dual phenotype. It improved tolerance to mildly toxic levels of As(V) exposure, but caused hypersensitivity to more toxic levels. Arabidopsis asr T‐DNA mutants showed increased As(V) sensitivity at low exposure levels and enhanced arsenic retention in the root. It is argued that, next to decreased uptake, enhanced expression of HlASR might act as an additional determinant of As(V) hypertolerance and As transport in H. lanatus.
Outcome after anaesthesia and emergency surgery in patients over 100 years old
Authors: Konttinen N. , Rosenberg P. H.
Published: February 2006

Background:  Deteriorated organ function and reduced stress response in very old patients may cause post‐operative morbidity and mortality. We wanted to identify immediate and longer‐term outcome after anaesthesia and surgery in the oldest of the old patients.

Methods:  We analysed retrospectively anaesthesia and hospital records of patients who were over 100 years old when undergoing major emergency surgery in our hospital during 1990–2004.

Results:  Altogether, 12 patients (median age 101 years) underwent 14 operations (nine for hip fracture, four for lower extremity circulatory problems and one for peritonitis). During anaesthesia, invasive arterial pressure was monitored in eight patients while central venous pressure (CVP) was monitored in only one patient. Spinal anaesthesia with bupivacaine was given as a continuous technique in six and as single‐shot spinal anaesthesia in five cases. Both spinal (11) and general (3) anaesthesias were characterized by marked drops in arterial pressure. Haemodynamics was managed with intravenous (i.v.) fluids and vasopressors. Five patients had post‐operative delirium. Mortality at 30 days, 6 months and 1 year was 25%, 42% and 50%, respectively. Within 15 days of the operation, three patients had died (pneumonia, cerebral infarction and myocardial infarction). Nine patients returned home and six of them lived in their pre‐operative mental and physical state for at least a year.

Conclusion:  Independently of the anaesthetic method, marked drops in blood pressure occurred, requiring pharmacological intervention. We assume that in most of the patients, hypovolaemia explains the intra‐operative haemodynamic instability. A 25%, 30‐day mortality may be regarded as acceptable and, overall, these very old patients tolerated emergency surgery quite well.
Regional pulmonary pressure volume curves in mechanically ventilated patients with acute respiratory failure measured by electrical impedance tomography
Authors: Hinz J. , Moerer O. , Neumann P. , Dudykevych T. , Frerichs I. , Hellige G. , Quintel M.
Published: February 2006

Background:  We hypothized, that in mechanically ventilated patients with acute respiratory failure, regional pressure volume curves differ markedly from conventional global pressure volume curves of the whole lung.

Methods:  In nine mechanically ventilated patients with acute respiratory failure during an inspiratory low‐flow manoeuvre, conventional global pressure volume curves were registered by spirometry and regional pressure volume curves in up to 912 regions were assessed simultaneously using electrical impedance tomography. We compared the lower (LIP) and upper (UIP) inflection points obtained from the conventional global pressure volume curve and regional pressure volume curves.

Results:  We identified from the conventional global pressure volume curves LIP [3–11 (8) cmH2O] in eight patients and UIP [31–39 (33) cmH2O] in three patients. Using electrical impedance tomography (EIT), LIP [3–18 (8) cmH2O] in 54–264 (180) regions and UIP [23–42 (36) cmH2O] in 149–324 (193) regions (range and median) were identified. Lung mechanics measured by conventional global pressure volume curves are similar to the median of regional pressure volume curves obtained by EIT within the tomographic plane. However, single regional pressure volume curves differ markedly with a broad heterogeneity of lower and upper inflection points.

Conclusion:  Lower and upper inflection points obtained from conventional global pressure volume curves are not representative of all regions of the lungs.
Qualitative analysis of unanticipated difficult airway management
Authors: Rosenstock C. , Hansen E. G. , Kristensen M. S. , Rasmussen L. S. , Skak C. , Østergaard D.
Published: February 2006

Background:  Unanticipated difficult airway management (DAM) is a major challenge for the anaesthesiologist and is associated with a risk of severe patient damage. We analysed 24 cases of unanticipated DAM for actual case management and anaesthesiologists knowledge, technical and non‐technical skills. Anaesthesiologists' opinions, as well as environmental factors of importance for DAM proficiency, were also assessed.

Methods:  Departments of Anaesthesiology in three Copenhagen University Hospitals participated in a prospective study of unanticipated DAM. Anaesthesiologists recorded the details of the cases on a data sheet. Qualitative data were collected in a semi‐structured interview if the value of the Intubation Difficulty Score (IDS) was more than five, if the value of the visual analogue scale score for mask ventilation was more than five or in the case of a registered complication. Transcripts were theme analysed independently by two analysts. Data sheets and interviews were used in the final evaluation.

Results:  All 24 cases concerned difficult tracheal intubation, and this was associated with difficult mask ventilation on four occasions. Management in three cases demonstrated strict adherence to a DAM practice guideline. Anaesthesiologists lacked standards for DAM. Inadequate knowledge, training and training facilities were documented. Sudden re‐allocation of personnel and change of anaesthetic technique were potential risk factors for DAM. Insufficient airway assessment, insufficient patient information and registration of difficulties were demonstrated. Ethical issues were raised concerning the use of patients for skills practice.

Conclusions:  Both personal and system failures resulted in unanticipated DAM. There was insufficient knowledge of DAM and anaesthesiologists lacked DAM training. Standards for DAM and curricula for continuing education in DAM are needed.
Individuality in Problem Solving: String Pulling in TwoCarduelisSpecies (Aves: Passeriformes)
Authors: Seibt Uta , Wickler Wolfgang
Published: February 2006

The research reported here was designed to study the individual peculiarities of birds in solving a problem. GoldfinchesCarduelis carduelisand siskinsC. spinuswere tested with the string‐pulling task: sitting on a perch from which a small food container is suspended by a string the test bird had to lift the container, using the bill to pull the string stepwise up and a foot to hold it, and repeat that until they could reach the food. Fifty‐two goldfinches and 29 siskins raised under controlled conditions were tested individually. Three groups became apparent: ‘inventors’ (23% of goldfinches; 62% of siskins) solved the problem by themselves; ‘imitators’ (25% of goldfinches; 10% of siskins) succeeded after seeing a performing conspecific; ‘duffers’ (52% of goldfinches, 28% of siskins) did not succeed either way. The species – but not the sexes – differed significantly in string‐pulling ability. The results of our experiments indicate that string pulling is an acquired combination of innate behaviour elements. An individual's string‐pulling competence may depend on prior experience of handling branchlets, on trial‐and‐error learning and on social learning (emulation). However, some individuals succeeded without these facilitating factors, while others did not succeed at all despite all of them present. Although functionally and motivationally related to feeding, the learned string pulling is often shown as a playful activity without an obvious reward.
Ontogeny of Anti‐Predator Behavioral Habituation in Cottonmouths (Agkistrodon piscivorus)
Authors: Glaudas Xavier , Winne Christopher T. , Fedewa Luke A.
Published: February 2006

Few studies of venomous snakes have addressed how anti‐predator behavior may be affected by experience with a potential predator. Because defensive strikes may be costly to snakes, individuals with the ability to learn to discriminate among potentially harmful and non‐harmful predatory stimuli should be favored by natural selection. In large venomous snakes, adults are capable of successfully defending themselves against most potential predators, whereas neonates suffer higher predator‐induced mortality and are faced with a large diversity of predators. Consequently, we hypothesized that the relative costs of habituation to potential predatory stimuli should vary ontogenetically. This hypothesis predicts that adults should habituate rapidly to non‐harmful predatory stimuli, whereas neonates should consistently employ active defensive displays (e.g. striking) because they are at higher risk. To test this prediction, we examined daily changes in the defensive behavior of adult and neonate cottonmouths (Agkistrodon piscivorus) towards a standardized non‐harmful predatory stimulus. As predicted, adults and neonates differed in their tendencies to habituate: adults decreased defensiveness over days while neonates did not. Adults showed habituation of striking components but not of warning displays. Our results support the hypothesis that there may be ontogenetic differences in predator perception.
Mating Strategies in Relation to Sexually Selected Infanticide in a Non‐Social Carnivore: the Brown Bear
Authors: Bellemain Eva , Swenson Jon E. , Taberlet Pierre
Published: February 2006

Based on the sexually selected infanticide (SSI) hypothesis, infanticide can be an adaptive mating strategy for males, but this is has rarely been documented in non‐social mammals. This phenomenon should not benefit females, so one would expect females to evolve mating counter strategies in order to protect their infants from infanticidal males. Cases of SSI are extremely difficult to document in the field, especially for non‐social species. Using field observations and genetic methods, we describe mating strategies employed by both sexes of brown bears (Ursus arctos) in relation to SSI. We present evidence for the first time suggesting that infanticide is an adaptive male mating strategy in this non‐social carnivore, as all requirements for SSI are fulfilled (1) infanticide shortens the time to the mother's next estrus, (2) the perpetrator is not the father of the killed infants, and (3) putative perpetrators sire the next litter. Moreover, all infanticide cases occurred during the mating season. We expected that primarily immigrant males were infanticidal, as in social species. However, we found that resident adult males commonly committed infanticide. Perhaps they recognize females they have mated with previously. Moreover, we used DNA‐based parentage testing to demonstrate a minimum of 14.5% of multiple paternities (up to 28% for litters with at least three young). Female promiscuity to confuse paternity may be an adaptive counter strategy to avoid infanticide.
Effect of eggplant transformed withoryzacystatingene onMyzus persicaeandMacrosiphum euphorbiae
Authors: Ribeiro A. P. O. , Pereira E. J. G. , Galvan T. L. , Picanço M. C. , Picoli E. A. T. , da Silva D. J. H. , Fári M. G. , Otoni W. C.
Published: February 2006

Abstract: The effect of a genetically modified eggplant line expressingoryzacystatinonMyzus persicae(Sulzer) andMacrosiphum euphorbiae(Thomas) was examined. The transgenic eggplant reduced the net reproductive rate (R0), the instantaneous rate of population increase (r), and the finite rate of population increase (λ) of both aphids species compared with a control eggplant line. The mean generation time (T) of the aphids was unaffected by the transgenic plants. Age‐specific mortality rates ofM. persicaeandM. euphorbiaewere higher on transgenic plants. These results indicate that expression oforyzacystatinin eggplant has a negative impact on population growth and mortality rates ofM. persicaeandM. euphorbiaeand could be a source of plant resistance for pest management of these aphids.