bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of new endemic areas of cutaneous leishmaniasis in Pakistan: a 6‐year study
Authors: Bhutto Abdul Manan , Soomro Rashid A. , Nonaka Shigeo , Hashiguchi Yoshihisa
Published: December 2004

Background Cutaneous leishmaniasis (CL) is endemic in Pakistan and is widely spreading. Recently, an outbreak of the disease was observed in the region. We report some new endemic areas of CL in the country.

Methods A total of 1210 cases of CL who visited our department from 1996 to 2001 are reported. Among them, 760 were residents of the Jacobabad, Larkana, and Dadu districts of Sindh province and had never previously traveled to endemic areas. These districts have never been reported/recognized as endemic for CL. Others were residents of endemic areas of Balochistan province. Diagnosis was made on clinical presentation; a giemsa‐stained smear test and histopathological results. All the cases were treated with the meglumine antimoniate 600 mg/day (adults) and 15 mg/kg/day (children) intramuscularly for 20 consecutive days.

Results All the patients were aged between 2.5 months and 65 years. Three hundred and ninety‐two patients were females and 368 were males. Duration of the disease ranged from 2 to 18 months. Most of the patients had a single lesion on the face and/or extremities. Clinically, the disease was classified as: dry papular type, 407 cases; dry ulcerative type, 335 cases; and wet ulcerative type, 18 cases. No cases of muco‐cutaneous or visceral leishmaniasis were found during this period. Smear testing was positive in 845 cases, while 365 cases were histopathologically positive. An ultrastructural study was performed using specimens of a few of the cases. Leishmania parasites were detected in the dermal tissues as well as in the macrophages.

Conclusions We propose that the Jacobabad, Larkana and Dadu districts could be considered endemic for CL. Wet‐ and dry‐type lesions indicate the presence of both Leishmania tropica and L. major in this tropical region.
Practical and experimental consideration of sun protection in dermatology
Authors: Ting William W. , Vest Cortney D. , Sontheimer Richard
Published: December 2004

Much is known regarding the deleterious effects of ultraviolet radiation (UV) on the skin. As more epidemiologic and basic research continues to characterize the impact of sun exposure and other sources of UV radiation upon the development of cutaneous neoplasm and a variety of photosensitive dermatoses, it is crucial for the dermatologist to promote sun protection among his/her patients as well as the primary care physician who has a greater reach of the community than the skin specialist. Practical steps to achieve optimal sun protection include avoidance of UV radiation, avoidance of photosensitizing drugs, use of photo‐protective clothing, and diligent application of broad‐spectrum sunscreens. In recent years, novel agents and experimental modalities with the potential to offer enhanced protective effects against deleterious sequelae of sun exposure have been elucidated, e.g. antioxidants, alpha‐MSH, polyphenol in green teas, genistein, NF‐kB decoy oligodeoxynucleotides, pTpT vaccination, and IL‐12. As these new photo‐protective tools are being developed by scientists around the world, greater concerted effort is needed to engage public health officials and the media to promote sun protection awareness throughout the general public.
Courtship behavior and sexual isolation between Drosophila auraria and D. triauraria in darkness and light
Authors: Oguma Y. , Jallon J.‐M. , Tomaru M. , Matsubayashi H.
Published: December 2004

Sexual isolation between two species of the Drosophila auraria complex, D. auraria and D. triauraria is different in darkness and light. In darkness there is complete isolation while in light it is only partial. The sensory bases of these differences were investigated by behavioral studies in darkness and light. In darkness there was no normal courtship sequence but males of both species displayed attempted copulation to homospecific and heterospecific females, as well as homospecific males. After a few hours together, homospecific copulations were observed after females displayed a characteristic posture: spreading the wings. Such an acceptance posture, also observed in other Drosophila species, was probably released by the wing vibration of a homospecific male. In light, visual signals alone are able to elicit male's orientation and following, whether flies are housed together or physically separated. Intense homosexual courtships were observed. All these data suggest that males have a low discrimination ability and females play the main role in sexual isolation.
1H‐NMR Method Enables Early Identification of Degeneration in the Quality of Sweet Potato Tubers
Authors: Iwaya‐Inoue M. , Matsui R. , Sultana N. , Saitou K. , Sakaguchi K. , Fukuyama M.
Published: December 2004

In sweet potato tuber, which is a tropical plant, long‐term storage leads to loss of water and carbohydrate, thus water mobility was investigated using1H‐NMR spectroscopy. Electrolyte leakage indicated that tubers stored at 15 °C for 1 year were partly injured and that frozen‐thawed tissues were dead. Nuclear magnetic resonance (NMR) spin–lattice relaxation time (T1) and spin–spin relaxation time (T2) clearly increased with the duration of storage, whereas these values decreased in the dead tissues. Furthermore, Arrhenius plots forT1andT2were determined at temperatures ranging from 20 to 0 °C in 2.5 °C steps. In the fresh tubers, a strong converse temperature dependency was shown in theT2measurement. On the contrary, there was no temperature dependency in theT2of the dead tissues. Thus, the existence of inverse temperature dependency reflected tissue viability. Additionally, any change in theT2of the fresh tubers occurred at about 14 °C, which virtually coincided with the storage temperature of 15 °C. The slope change inT2might have responded to a physiological change as a primary event. In conclusion, monitoring water status by NMR could provide early identification of changes in the quality of post‐harvest crops; this method shows great promise for use in environmental‐stressed crop yield research.
Natural incidence ofCladosporiumspp. as a bio‐control agent against whiteflies and aphids in Egypt
Authors: Abdel‐Baky N. F. , Abdel‐Salam A. H.
Published: December 2004

Abstract:  Five species of entomopathogenic fungi were tested against whiteflies and aphids.Cladosporiumspp. showed a high incidence on the two insect species tested (81% of the total isolated species). However,C. uridenicolawas the predominant species isolated from both insect species during the two successive seasons of 1998 and 1999. Natural infection byCladosporiumranged from 18.19 to 44.38% and 16.4 to 45.27% in 1998 and 1999, respectively, according to insect species and the host plant. Statistical analysis revealed a high correlation (R = 0.8759 ± 0.093) between the total investigated and total infected of each insect species during the two successive years of the study. The natural infection ofCladosporiumto whitefly life stages was higher on whitefly nymphs (87.8%) than adults (8.08%) and eggs (4.15%) in 1998 and 1999. The results showed that the seasonal distribution ofCladosporiumoccurred all year around, but rates were higher during the period from June until November which coincided with the high populations of whiteflies and aphids. The weather had a significant effect on infection of insects and had no effect on other fungi species. The laboratory tests showed a higher pathogenicity of the candidate onAphis gossypii,Aphis craccivoraandBemisia agrentifolliithan other reported fungi.
Differences among plant species in acceptance by the spider mite Tetranychus urticae Koch
Authors: van, den Boom C. E. M. , van Beek T. A. , Dicke M.
Published: December 2004

Abstract:  The spider mite Tetranychus urticae Koch has a broad range of host plants. However, the spider mite does not accept all plants to the same degree because of differences in nutritive and toxic constituents. Other factors, such as the induction of secondary metabolites, the morphology of a leaf surface and the presence of natural enemies, also play an important role in plant acceptance. We compared plants from various families in their degree of acceptance by the spider mite, to get an indication of the plant's direct defence. Glycine max (soybean), Humulus lupulus (hop), Laburnum anagyroides (golden chain) and Nicotiana tabacum (tobacco) were highly accepted by the spider mites. Different glandular hair densities among tobacco cultivars did not affect their suitability towards spider mites significantly. Solanum melalonga (eggplant), Robinia pseudo‐acacia (black locust), Vigna unguiculata (cowpea) and Datura stramonium (thorn apple) were accepted by the spider mites to a lesser degree. Vitis vinifera (grapevine) was poorly accepted by the spider mite. It might be that the food quality of the leaves was not high enough to arrest the spider mites. Also, Capsicum annuum (sweet pepper) and especially Ginkgo biloba (ginkgo) were poorly accepted by the spider mite, probably because of the presence and concentration of certain of the secondary metabolites in the leaves. The spider mites accepted all the plants belonging to the Fabaceae for feeding, but those belonging to the Solanaceae showed a larger variance in spider mite acceptance varying from well accepted (tobacco) to poorly accepted (sweet pepper).
Spatial and temporal pattern of colonization of Nabidae (Heteroptera) in alfalfa (Medicago sativa)
Authors: Roth S.
Published: December 2004

Abstract: Six species of Nabidae (Heteroptera) were collected by standardized sweep net sampling in alfalfa fields in Thuringia, Germany, from 1993 to 1995: Nabis pseudoferus, N. ferus, N. brevis, N. major, Nabicula flavomarginata and Aptus mirmicoides. Colonization of a newly cultivated field was studied over a 3‐year period. The density of all the studied nabid species was low (less than five individuals per 100 sweeps) and not related to time since colonization started, or to the distance from the margin of the field. Macropterous species were able to colonize the whole field within one season. The density of one macropterous species, N. pseudoferus, varied between the years of study and was mainly affected by the harvest regime. The brachypterous species reached the margin within one season but for density it took three seasons to reach satiated values also in the centre of the field. The abundance of the brachypterous N. brevis was significantly different both between years and sampling sites. This indicates the importance of the surroundings on the succession of this species. Nabis major, a fully winged species, showed a migration pattern intermediate to macropterous and brachypterous nabids. These results suggest that the total abundance of nabid predators cannot be predicted by time or distance from the expansion source (shelter belts). The abundance of brachypterous nabid individuals can be predicted from time since colonization but is best analysed at the species level.
Noninherited sterility in irradiated Phthorimaea operculella females
Authors: Makee H. , Saour G.
Published: December 2004

Newly emerged females of the potato tuber moth, Phthorimaea operculella (Zeller) (Lep., Gelechiidae), were irradiated with various doses of gamma irradiation: 50, 100, 150 and 200 Gy. Inheritance of deleterious effects in the progeny of irradiated female parents was determined. Phthorimaea operculella females became completely sterile when they were exposed to 200 Gy. Therefore, inherited effects were examined in insects exposed to doses lower than 200 Gy. Developmental time and percentage mortality of F1 progeny were higher than the control, regardless of the dose. The sex ratio of F1 progeny was not distorted in favour of either male or female. When F1 individuals were crossed with unirradiated adults, their mating success, number of matings and number of eggs were similar to those of their irradiated female parents, but lower than the control. In contrast, when F1 males and females were mated together, the mating success, number of matings and number of eggs were lower than both their irradiated female parents and the control. The fertility of F1 progeny was higher than that of their irradiated female parents, at all tested crosses. The results showed that the inherited sterility phenomenon did not occur in P. operculella females at the extent known from irradiated males. When the sterile insect technique is used against P. operculella, released females should be completely sterile to prevent any increase in the feral population.
Topographic anatomy of the male perineal structures with special reference to perineal approaches for radical prostatectomy
Authors: Matsubara Akio , Murakami Gen , Arakawa Takashi , Yasumoto Hiroaki , Mutaguchi Kazuaki , Akita Keiichi , Asano Kousuke , Mita Kouji , Usui Tsuguru
Published: December 2004

Aim: Although perineal approaches for radical prostatectomy have recently gained renewed attention as excellent methods for minimally invasive surgery, the most commonly used techniques, Belt's and Young's approaches, have inadequacies regarding the topographical relationship between the rectourethral and levator ani muscles.

Methods: Using macroscopic observations of sagittal slices of 27 male pelvises and smooth muscle immunohistochemical staining of semiserial sections of another eight pelvises, we investigated the topographical anatomy of the perineal structures and their interindividual variations in elderly Japanese men.

Results: The inferomedial edge of the levator ani was located 5–15 mm lateral to the midsagittal plane in an area between the urethra and the rectum. The rectourethral smooth muscle had a superoinferior thickness of 5–10 mm and occupied a space between the right and left levator slings. The levator was adjacent to, or continuous with, the striated anal sphincters. A thick connective tissue septum, composed of smooth muscle, was evident between the rectal smooth muscle and the anal sphincter–levator ani complex.

Conclusion: Because the connective tissue septum guides the surgeon's finger upwards towards the rectoprostatic space, Belt's approach appears relatively easy; however, rectal injury can sometimes occur if the surgeon loses this guidance. In contrast, if the levator edge is identified as the first step in Young's approach, the rectourethral muscle can be precisely divided, leaving a 3–5‐mm margin from the rectum and sphincter–levator complex. Clinical investigations are now required to modify Young's approach based on the present results.
Malignant transformation of renal angiomyolipoma
Authors: TAKAHASHI NOBUYOSHI , KITAHARA RYUJI , HISHIMOTO YASUYUKI , OHGURO AKIMITSU , HASHIMOTO YASUHIRO , SUZUKI TADASHI
Published: December 2004

In the present paper, two cases of malignant transformation of renal angiomyolipoma without tuberous sclerosis are reported. Pathological examination revealed that, in both cases, in addition to the areas affected by typical angiomyolipoma, there were areas that contained elevated numbers of perivascular epithelioid cells with prominent nuclear pleomorphism. Immunohistochemical examination revealed that both cases were negative for keratin and epithelial membrane antigen, but were positive for the melanogenesis‐related marker HMB‐45. Metastatic diseases appeared 40 months after radical nephrectomy in the first case and 18 months in the second case.
Laparoscopic antegrade continence enema procedure for fecal incontinence in a patient with spina bifida
Authors: AMEDA KANAME , KAKIZAKI HIDEHIRO , MACHINO RINTARO , TANAKA HIROSHI , SHIBATA TAKASHI , KOYANAGI TOMOHIKO
Published: December 2004

We report a laparoscopic procedure for antegrade continence enema (LACE) that was performed successfully in 39‐year‐old man patient with spina bifida suffering from severe fecal incontinence. The patient had been receiving regular follow‐up at our clinic. He desired the antegrade continence enema procedure to improve his intractable fecal incontinence with a less invasive procedure.

Following the placement of the first port at the umbilicus using an open access technique, two additional ports were introduced at the upper and lower abdomen in the midline. The appendix was laparoscopically mobilized to the right lower abdomen and brought out through another port. Next, an in situ appendicocutaneostomy was created. The patient began oral intake the day after surgery. Initial irrigation was performed on the second postoperative day. Convalescence was quick and there were no postoperative complications. Although a minor skin incision was required afterward for superficial stoma stenosis, the patient has been in a satisfactory condition with regular enemas.

Laparoscopic appendicocutaneostomy can be a reasonable surgical alternative for antegrade continence stoma procedure. LACE has a clear advantage over conventional open procedures in view of its less invasive nature and better cosmetic results.
Retrograde endoscopic laser therapy for transitional cell carcinoma of the upper urinary tract
Authors: MUGIYA SOICHI , MARUYAMA SATOSHI , NAGATA MASAO , HADANO SHINSUKE , NAGAE HIROSHI
Published: December 2004

Aim: The aim of the present study was to investigate the safety and efficacy of endoscopic laser therapy for transitional cell carcinoma (TCC) of the upper urinary tract.

Methods: Tumors of the renal pelvis and ureteropelvic junction were detected by ureteroscopy. The tumors were subjected to biopsy, and after TCC was diagnosed, endoscopic laser therapy (Neodymium‐YAG and Holmium‐YAG) was conducted using a 6.9 Fr. flexible ureterorenoscope.

Results: From January 1997 to April 2002, six patients underwent ureteroscopic treatment. Tumor grade was 1 in four patients and 2 in two patients. Average tumor size was 1.45 cm. Endoscopic treatment was chosen for two patients because of the high medical risk associated with open surgery. Another patient underwent diagnostic ureteroscopy, followed immediately by endoscopic treatment. A further three patients elected to undergo ureteroscopic treatment. One patient with large (3 cm), multifocal and incompletely treated tumors died of metastatic disease 22 months after the initial operation. One patient requested nephroureterectomy one month after endoscopic treatment, and pathological examination of the resected specimen revealed no tumor. The other four patients have been followed up for a mean period of 14 months after initial treatment. Recurrence occurred in one patient, and was successfully treated by repeat endoscopic resection. None of the patients required blood transfusion or emergency open surgery.

Conclusion: Ureteroscopic treatment of small, localized, low‐grade TCC of the upper urinary tract is now a safe and feasible alternative to nephroureterectomy in selected patients.
Misconduct in medical research: whose responsibility?
Authors: Breen K. J.
Published: December 2004

Abstract

Examples of many types of misconduct in medical research continue to be reported. The true incidence is unknown because there is strong evidence of under‐reporting as well as suggestions of increased detection. Risks to research participants may also be increasing, with contributing factors such as increased pressure on researchers to publish and to produce commercialization of their research. Institutions are perceived to typically respond slowly and inadequately to allegations of research misconduct.

More could be done to try to prevent such mis­conduct, such as: (i) educating researchers about research ethics, (ii) assisting and protecting whistleblowers and (iii) instituting processes to adequately and promptly investigate and deal with allegations. In addition, a debate needs to take place as to whether research misconduct allegations should be dealt with at the institutional level or at a national level and whether medical boards should be routinely involved in the more serious breaches of ethical standards by medical practitioners engaged in research. (Intern Med J 2003; 33: 186−191)
Counting the costs of treatment: the reproductive and gynaecological consequences of adjuvant therapy in young women with breast cancer
Authors: Friedlander M. , Thewes B.
Published: December 2004

Abstract

As the mortality rate from breast cancer decreases, the issues facing breast cancer survivors are becoming increasingly important. Survivors of all ages may face physical and psychosocial consequences of their diag­nosis and treatments. However, the long‐term fertility and menopause‐related side‐effects of adjuvant therapy uniquely affect younger premenopausal breast cancer survivors. This article provides an evidence‐based overview of the reproductive and gynaecological impact of breast cancer therapy for premenopausal women diagnosed with breast cancer. The physical and psychosocial implications of premature menopause are presented. Strategies for preserving fertility in selected patients are also discussed. Recent clinical trials strongly indicate that premenopausal women with oestrogen receptor positive tumours should receive endocrine therapy. The increased use of endocrine therapies in younger women raises important questions regarding patient information needs and treatment decision‐making. (Intern Med J 2001; 31: 372−379)
Medication use among older Australian veterans and war widows
Authors: Byles J. E. , Heinze R. , Nair B. (K.) , Parkinson L.
Published: December 2004

Abstract

This study aimed to review the medications used by a group of Australian war veterans and widows, to identify type and number of medications used and potential inappropriate prescribing. Label details of 4304 medications used by 887 participants were recorded and classified according to the Anatomical Therapeutic Chemical code. The median number of regular medications being used was four (interquartile range 2−7), with a median of one other medication (interquartile range 1−2) being taken as needed. Over half (53%) the participants were taking four or more regular medications. There were 26 potential interactions among 25 people. Polypharmacy was a considerable problem for this group of older Australians. (Intern Med J 2003; 33: 388−391)
Respiratory health effects of cannabis: Position Statement of The Thoracic Society of Australia and New Zealand
Authors: Taylor D. R. , Hall W.
Published: December 2004

Abstract

Both the gaseous and the particulate phases of tobacco and cannabis smoke contain a similar range of harmful chemicals. However, differing patterns of inhalation mean that smoking a ‘joint’ of cannabis results in exposure to significantly greater amounts of combusted material than with a tobacco cigarette. The histopathological effects of cannabis smoke exposure include changes consistent with acute and chronic bronchitis. Cellular dysplasia has also been observed, suggesting that, like tobacco smoke, cannabis exposure has the potential to cause malignancy. These features are consistent with the clinical presentation. Symptoms of cough and early morning sputum production are common (20−25%) even in young individuals who smoke cannabis alone. Almost all studies indicate that the effects of cannabis and tobacco smoking are additive and independent. Public health education should dispel the myth that cannabis smoking is relatively safe by highlighting that the adverse respiratory effects of smoking cannabis are similar to those of smoking tobacco, even although it remains to be confirmed that smoking cannabis alone leads to the development of chronic lung disease. (Intern Med J 2003; 33: 310−313)
Concealed Conduction and Dual Pathway Physiology of the Atrioventricular Node
Authors: LIU SHAOWEN , OLSSON S. BERTIL , YANG YANZONG , HERTERVIG EVA , KONGSTAD OLE , YUAN SHIWEN
Published: December 2004

Introduction: Both concealed conduction and dual pathway physiology are important electrophysiologic characteristics of the AV node. The interaction of AV nodal concealment and duality, however, is not clearly understood.

Methods and Results: The properties of AV conduction curves in the presence and absence of a conditioning blocked impulse were prospectively studied during premature atrial stimulation in 20 patients with AV nodal reentrant tachycardia before and after slow pathway ablation and in 14 control patients. AV nodal duality in the control conduction curve in the absence of a conditioning impulse was observed in 19 (95%) of 20 patients with AV nodal reentrant tachycardia. However, AV nodal duality in the modulated conduction curve in the presence of a blocked impulse was only identified in 2 (10%) of 20 patients (2/20 vs 19/20, P < 0.0001). The modulated curve was characterized by a significantly longer AV nodal effective and functional refractory periods compared to the control curve (P < 0.0001) in both patients with and without AV nodal reentry and in AV nodal reentry patients after successful slow pathway ablation. The maximum AH interval (AHmax) of the modulated curve was significantly shorter than the control curve in both patients with (217 ± 74 ms vs 347 ± 55 ms, P < 0.0001) and without AV nodal reentry (178 ± 50 ms vs 214 ± 54 ms, P = 0.02). AHmax of the control curve was significantly longer in AV nodal reentry patients than in controls (P < 0.0001). AHmax of the modulated curve, however, was not significantly different between the two groups. After slow pathway ablation, AHmax of the control curve was significantly reduced (347 ± 55 ms vs 191 ± 40 ms, P < 0.0001). Significant reduction in AHmax of the modulated curve was not observed.

Conclusion: An interaction of AV nodal concealed conduction and dual pathway physiology was demonstrated by our data. Slow pathway conduction of the AV node was prevented by the concealed beat in both patients with and without AV nodal reentry. (J Cardiovasc Electrophysiol, Vol. 15, pp. 144‐149, February 2004)
Adaptation of Cardiac Action Potential Durations to Stimulation History with Random Diastolic Intervals
Authors: CHOI BUM‐RAK , LIU TONG , SALAMA GUY
Published: December 2004

Introduction: The restitution hypothesis proposes that adaptation of cardiac action potential duration (APD) to rate changes is a predictor of ventricular fibrillation (VF). Conventional restitution kinetics plots the APD of a premature beat as a function of the previous diastolic interval (DI), and VF vulnerability is related to how rapidly APD shortens with decreasing DI. However, APD depends not only on the previous DI but also on the history of previous APDs and DIs. For a comprehensive understanding of APD restitution, we developed a random stimulation protocol and curve fitted each APD with the previous DIs and APDs using multiple autoregressive analyses.

Methods and Results: Guinea pig hearts (n = 5) were perfused and stained with di‐4 ANEPPS to record optical APs from 252 sites. Activation and repolarization times were detected in real time from one pixel and hearts were stimulated at random DIs (range 0–50 or 0–100 ms). We found that the first, second, and third previous APDs and DIs are required to obtain the best curve fit, which provides the most significant feedback control to APD and up to six previous beats contributed to curve fits (R > 0.8). The coefficients relating the previous DI to APD increased systematically in going from apex to base reflecting the intrinsic gradient of APD across the epicardium.

Conclusion: Random restitution is more comprehensive than steady‐state restitution, being based on random and dynamic DIs, and makes possible characterization of restitution in only 32 seconds to track changes in restitution during time‐varying conditions such as ischemia/reperfusion.
Safety and Feasibility of Cryothermal Ablation Within the Mid‐ and Distal Coronary Sinus
Authors: SKANES ALLAN C. , JONES DOUGLAS L. , TEEFY PATRICK , GUIRAUDON COLETTE , YEE RAYMOND , KRAHN ANDREW D. , KLEIN GEORGE J.
Published: December 2004

Introduction: The aim of this study was to assess the safety and feasibility of catheter‐based cryothermal ablation lesions in the mid‐ and distal coronary sinus.

Methods and Results: Cryothermal ablation lesions were delivered using a 7‐French catheter at the mid‐ (n = 13) and distal (n = 12) coronary sinus in 14 swine under general anesthesia. Lesions were delivered for 2 or 4 minutes in a 1:2 randomized ratio such that seven 2‐minute lesions and eighteen 4‐minute lesions were delivered to a maximum negative temperature of −70°C. Integrity of the circumflex artery was assessed by angiography before and after each lesion application. In five animals, arterial Doppler flow velocity was continuously monitored and coronary flow reserve assessed. Histologic assessment of the left AV ring was made after a 48‐hour survival period and lesions graded for depth and transmurality. Eighteen of 25 lesions were >3 mm deep: five of seven 2‐minute lesions and thirteen of eighteen 4‐minute lesions. Lesions were transmural in 18 of 25 cases. Two transmural lesions were limited in depth due to their epicardial position. One 2‐minute mid‐coronary sinus lesion was not found. Adherent thrombus was seen grossly in the coronary sinus at one site and only on microscopic examination in three other lesions. Angiography demonstrated no arterial spasm or thrombosis. Continuous‐flow Doppler remained unchanged throughout lesion production. Coronary flow reserve was unchanged (1.7 ± 0.8 preablation vs 1.7 ± 1.0 postablation, P = 0.6). The media and intima were preserved in all cases. Necrosis of the adventitia was seen in one arterial segment.

Conclusion: Catheter‐based cryoablation can produce lesions in the musculature of the adjacent atrium and ventricle when accessed from the coronary sinus without significant injury to the coronary sinus or adjacent artery. This method has potential application as the ablation method of choice when such lesions are required.
Effects of Resynchronization Therapy on Cardiac Function in Pacemaker Patients “Upgraded” to Biventricular Devices
Authors: HORWICH TAMARA , FOSTER ELYSE , DE MARCO TERESA , TSENG ZIAN , SAXON LESLIE
Published: December 2004

Introduction: Cardiac resynchronization therapy (CRT) improves echocardiographic measures of cardiac function and has a variable effect on QRS duration in patients with left bundle branch block (LBBB). How CRT affects these indices in patients with right ventricular (RV) pacing‐induced LBBB who are “upgraded” with left ventricular (LV) leads for CRT is unknown. We studied the echocardiographic effects of RV pacing and CRT in patients with prior continuous RV pacing after LV lead placement.

Methods and Results: Fifteen consecutive patients (age 73 ± 11 years, LV ejection fraction 24 ± 6%, QRS duration 190 ± 27 msec) with New York Heart Association class IIIB–IV symptoms and continuous RV pacing underwent LV lead placement for CRT. Echocardiography and ECG were performed sequentially during RV pacing and CRT. CRT was associated with significantly reduced QRS duration (190 ± 27 msec vs 165 ± 18 msec, P = 0.005) and reduced LV electromechanical delay (180 ± 33 msec vs 161± 43 msec). Baseline QRS duration correlated with CRT response. After CRT, patients had significant improvements in indices of systolic function, including LV ejection fraction, myocardial performance index (MPI), and LV ejection time. Abnormal baseline MPI was associated with greater improvement after CRT. LV end‐diastolic and systolic volumes were similarly decreased with CRT. Mitral valve deceleration time, an index of diastolic function, was not affected by CRT.

Conclusion:“Upgrading” RV paced patients with advanced heart failure to CRT improves measures of electrical and LV mechanical synchrony and improves systolic function.
Structural unemployment. An analysis of recruitment and selection mechanisms based on panel data among Danish long‐term unemployed
Authors: Larsen Christian Albrekt
Published: December 2004

The perception of structural unemployment – summarised in the notion of ‘Eurosclerosis’– became almost hegemonic during the 1990s. Policy makers all over Europe tried, by means of supply‐side policies, to counteract the lack of incentives in the developed European welfare states, the lack of qualification on the post‐industrial labour markets and the personal decay due to long‐term unemployment. However, based on the critical case of Denmark, this article challenges the perception of structural unemployment and suggests an alternative business cycle/barrier perception. At the macro level it is difficult to explain the Danish decline in unemployment from 1994 to 2000 within the structure perception. The lack of explanatory power of the structure perception is further highlighted in micro‐level analyses conducted on a panel study of long‐term unemployed. Based on the unemployed's own assessments, we find no indications of supply‐side problems. These results are supported by analyses of actual labour market integration of the long‐term unemployed in the period between 1994 and 1999, which show that education level and previous unemployment had no noteworthy influence on labour market integration, whereas age had a decisive influence. These surprising results further undermine the perception of structural unemployment and the supply‐side policies rooted in this ‘mistaken’ problem definition.
Research in the concept‐based therapeutic community – its importance to European treatment research in the drug field1
Authors: Ravndal Edle
Published: December 2004

The concept‐based therapeutic community (TC) has been more scrutinised than almost every treatment model in the drug field except for methadone maintenance treatment. Important reasons for emphasising research right from the beginning were financial and/or ideological. Because of strong, ideological reasons and because of extensive research, the American TC movement has had a great impact on the treatment field of drug abusers in Europe. However, independent of the TC movement, at the same time the European treatment field also initiated several important research projects. In particular the Scandinavian countries were active in process studies with a qualitative approach. For different reasons this research tradition in Scandinavia was never considered important in the international research society. In recent years this has changed, and there is now a consensus about the need for more process evaluation and phenomenological research to complement the large body of quantitative studies in the treatment field. Probably both American and European treatment research has contributed to the preservation of the best from the original TC models and a renunciation of the more destructive elements.
Precariousness in everyday life: homelessness in Japan
Authors: Kennett Patricia , Iwata Masami
Published: December 2004

The Japanese social structure was established and has been maintained through a mixed economy comprising a balance between the state, the market, the family and the company. Vital elements in maintaining this balance have been the traditional family, full employment and increasing prosperity. More recently, developments have seen a reversal of economic prosperity, rising unemployment, increasing pressure to restructure the employment system and a potential rise in the number of households experiencing housing difficulties. In addition, the predominance of the nuclear family, the increased employment of women and decreased fertility has put the enterprise, family and state dynamic under challenge. This article explores some of the implications of these trends as some of the certainties of the past are giving way to increasing insecurity and risk across a wider section of society. It begins by exploring the institutional and social structure of post‐war Japan, when there was little evidence of poverty and homelessness. It goes on to consider the recent rise in the number of people living on the streets of Japanese cities and the policies put in place. The article then outlines some of the processes of social change that have contributed to the growth in the numbers of homeless people in Japan.

La structure sociale japonaise a été créée et préservée grâce à une économie mixte, équilibre complexe entre É tat, marché, famille et entreprise. Les éléments essentiels à cet équilibre étaient la famille traditionnelle, le plein emploi et une prospérité croissante. Or, on a pu constaté dernièrement un revirement économique, une hausse du chômage, une accentuation des forces visant à restructurer l'emploi et une progression latente du nombre de ménages confrontés à des difficultés de logement. De plus, la prédominance de la famille nucléaire, le travail croissant des femmes et la diminution de la fertilité ont remis en question la dynamique entreprise‐famille‐É tat. L'article explore certains effets de ces évolutions, alors que nombre de certitudes passées laissent place à un renforcement de l'insécurité et du risque dans une part plus vaste de la société. L'étude débute par la structure institutionnelle et sociale du Japon de l'après‐guerre, lequel comptait peu de cas de pauvreté et de sans‐abris. Elle aborde ensuite la hausse récente du nombre de personnes vivant dans les rues des grandes villes nippones et les politiques publiques mises en place, tout en décrivant certains des processus de changement social impliqués dans la multiplication des sans‐abris au Japon.
The Committee System: Powers, Appointments and Report Allocation*
Authors: Mamadouh Virginie , Raunio Tapio
Published: December 2004

The European Parliament (EP), like the US Congress, is often depicted as a parliament with strong committees and weak parties. This article compares the powers of the EP's committees with their counterparts in national legislatures and examines the role of party groups in the committees. Analysing the principles guiding the appointments to committees, the selection of committee chairs, and the distribution of reports within the committees, we show that national party delegations inside the transnational groups are often key gatekeepers in the division of spoils within the groups, with group leaders restricted in their ability to direct the actions of their committee members. The distribution of reports between party groups and national delegations produces interesting variation, with the two largest groups (PES and EPP) largely in control of key reports, while the size of national parties inside the main groups is the primary factor in explaining the output of national delegations.
Some Information Age Techno‐Fallacies
Authors: Marx Gary
Published: December 2004

In research on computer data bases, work and electronic location monitoring, telephone identification systems and drug testing1 I encountered comments such as: “turn the technology loose and let the benefits flow”; “do away with the human interface”; “only the computer sees it”; “that has never happened”; “there is no law against this”; “the technology is neutral”. These are all examples of what can be termed information age techno‐fallacies. They are part of the cultural undergirding of routine data collection practices and an optimistic, techno‐surveillance worldview that is strongest in, but is hardly restricted to, the United States. They reflect a broader celebratory ethos of technology and commerce. To understand technologies for collecting personal information, we must understand the ideational environment in which they are nourished and in which they flourish. Before a surveillance technology is adopted, it is important to examine the broader cultural climate, the rationales for action and the accompanying empirical and value assumptions.
The knowledge brokers: venture capitalists, tacit knowledge and regional development
Authors: Zook Matthew A.
Published: December 2004

This article reviews the role of knowledge in economic development and the actors through which it is created and transferred. Unpacking the often oversimplified dichotomy between tacit and explicit knowledge, the contribution of firms, communities of practice and regions to the creation of knowledge is considered. While acknowledging the importance of global knowledge flows, it is argued that regional processes of Marshallian interaction and observation retain their relevance even within the decidedly global financial and internet industries. This argument is supported empirically through an analysis of the spatial structure of the knowledge used by venture capitalists during the development of the internet industry. The ability to create and access knowledge proves key for venture capitalists throughout their work, but particularly in (1) selecting promising industries, (2) finding and evaluating firms, and (3) assisting portfolio companies.

Cet article étudie le rôle du savoir dans l'expansion économique, ainsi que les acteurs qui permettent de le créer et le transmettre. En démêlant la dichotomie souvent simplifiée à outrance entre savoirs tacite et explicite, il examine l'apport des entreprises, communautés de pratiques et régions dans la création du savoir. Tout en reconnaissant l'importance des flux internationaux de connaissances, il soutient que les processus régionaux d'observation et d'interaction marshallienne restent pertinents même pour les secteurs de l'Internet et de la finance résolument planétaires. Cet argument est étayé empiriquement par l'analyse de la structure spatiale du savoir utilisé par les spéculateurs capitalistes pendant l'essor des activités de l'Internet. L'aptitude à créer du savoir et à y accéder est essentielle pour eux quel que soit leur travail, mais surtout pour repérer les secteurs prometteurs, trouver et évaluer des entreprises, et aider les sociétés de capital‐risque.
Social movements and globalization
Authors: Dikec Mustafa
Published: December 2004

Pierre Hamel, Henri Lustiger‐Thaler and Margit Mayer (eds.) Urban movements in a globalizing world

John Guidry, Michael Kennedy and Mayer Zald (eds.) Globalizations and social movements: culture, power, and the transnational public sphere
A group of related cDNAs encoding secreted proteins from Hessian fly [Mayetiola destructor (Say)] salivary glands
Authors: Chen M.‐S. , Fellers J. P. , Stuart J. J. , Reese J. C. , Liu X.
Published: December 2004

A group of cDNAs has been isolated and characterized from Hessian fly [Mayetiola destructor (Say)] salivary glands. Members in this group appear to encode proteins with secretion signal peptides at the N‐terminals. The mature putative proteins are small, basic proteins with calculated molecular weights that ranged from 8.5 to 10 kDa, and isoelectric points from 9.92 to 10.90. Sequence analysis indicated a strong selection for mutations that generate amino acid changes within the coding region. Northern blot analysis revealed that these genes are expressed only in the first instar larvae, a critical stage that determines if the interaction between a specific Hessian fly biotype and a specific wheat cultivar is compatible. Genomic analysis demonstrated that multiple copies of similar genes are clustered within a short region on chromosome 2A. This is the same arm in which two avirulence genes have been mapped.
Delirium: behavioural changes before and during the prodromal phase
Authors: Duppils Gill Sörensen , Wikblad Karin
Published: December 2004

Background.  Delirium is an important form of psychopathology in older people and is associated with increased morbidity and functional decline. In the prodromal phase of delirium early symptoms occur, before all criteria have been met.

Aim.  The aim of this study was to delineate behavioural changes before and during the prodromal phase of delirium. That was considered to include the time from the first behavioural change up to the point when all DSM‐IV criteria for delirium were met.

Design.  Prospective and descriptive observation study.

Methods.  One hundred and three hip surgery patients (hip fracture and hip replacement) aged ≥ 80 years participated in this study. On admission none of them was delirious or had severe cognitive decline, but 32 patients met the DSM‐IV criteria for delirium during the hospital stay. Frequent observations were performed up to delirium onset or 48 hours postoperatively. The observations included 37 items on the patient's state of mind, cognition, activity and behaviour. The first observation on admission was used as a reference and behavioural changes were defined as deviations from this first observation.

Results.  Twenty‐one patients out of the 32 who met the DSM‐IV criteria (62%, D group) demonstrated behavioural changes before delirium onset, as did 34 (48%, R group) out of the remaining 71 patients. The D group had different and more numerous behavioural changes than the R group. Anxiety was common in both groups. Disorientation and urgent calls for attention were the most frequent changes in the D group. The D group presented a pattern of behavioural changes and early symptoms of the approaching delirium. Six hours immediately before the onset of delirium, the behavioural changes were more numerous and evident.

Conclusions and relevance to clinical practice.  It is necessary to pay attention to each behavioural change in the patients and to be aware of the prodromal phase of delirium in order to prevent its onset and to maintain the patient's well‐being.
Paediatric oncology nurse education: the development of a national framework
Authors: Tomlinson Deborah
Published: December 2004

Background.  It is recognized that there is a need for specialist nursing courses in a range of paediatric nursing specialities. Paediatric oncology nurses are facing challenges with clinical advances and the need for specialized care. At present there are no available courses in Scotland offering preparation for nurses working in a paediatric oncology setting.

Aims and objectives.  This project, supported by Macmillan Cancer Relief, addresses this deficit by developing a comprehensive framework for a small and widely dispersed speciality.

Methods.  Information on the needs and expectations of nurses and service managers in this field was obtained through postal questionnaires and focus groups. Due to the need for collaboration between higher educational institutions and service colleagues the views of educators were also established through questionnaires and semi‐structured interviews.

Results.  Problematic practice issues were cited and these issues were further discussed and recognized as the main educational needs. Availability and accessibility of education were of great importance.

Conclusion.  The framework developed aims to provide ongoing opportunities for continuing professional development within this speciality. Development of the educational framework is required to provide a course accessible to a wide geographical area of nurses.

Relevance to clinical practice.  A National Framework for Paediatric Oncology Nurse Education was developed in response to views of experts working in the field, to the views of other stakeholders and to what is known about needs and preferences of children with cancer and their families.
The life situation and functional capacity of the elderly with locomotor disability in Sweden and Poland according to a model by Lawton
Authors: Jaracz Krystyna , Gustafsson Gunnel , Hamrin Elisabeth
Published: December 2004

A quadripartite concept, the Good Life for older people, was developed by the American psychologist M. P. Lawton and forms the theoretical framework of this study. Ninety Swedish and 93 Polish subjects, aged ≥ 60 years who had reported locomotor disturbances in selected samples from the two countries, took part in the study. Interviews were performed using the Philadelphia Geriatric Center Multilevel Assessment Instrument (PGCMAI) and functional testing was done using the Standardized Practical Equipment (SPE). The Polish elderly scored lower in most domains of the PGCMAI, which meant a worse life situation according to the Good Life model. On the SPE, scoring was lower in the Polish group, mainly on items related to balance and mobility. There was a logic convergent validity between the PGCMAI and the SPE in the whole group. The somewhat more complicated life situation for the Polish elderly has to be further analysed.