bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial Patterns in the Abundance of the Coastal Horned Lizard
Authors: Fisher Robert N. , Suarez Andrew V. , Case Ted J.
Published: March 2003

Abstract: Coastal horned lizards (   Phrynosoma coronatum) have undergone severe declines in southern California and are a candidate species for state and federal listing under the Endangered Species Act. Quantitative data on their habitat use, abundance, and distribution are lacking, however. We investigated the determinants of abundance for coastal horned lizards at multiple spatial scales throughout southern California. Specifically, we estimated lizard distribution and abundance by establishing 256 pitfall trap arrays clustered within 21 sites across four counties. These arrays were sampled bimonthly for 2–3 years. At each array we measured 26 “local” site descriptors and averaged these values with other “regional” measures to determine site characteristics. Our analyses were successful at identifying factors within and among sites correlated with the presence and abundance of coastal horned lizards. These factors included the absence of the invasive Argentine ant (  Linepithema humile) (and presence of native ant species eaten by the lizards), the presence of chaparral community plants, and the presence of sandy substrates. At a regional scale the relative abundance of Argentine ants was correlated with the relative amount of developed edge around a site. There was no evidence for spatial autocorrelation, even at the scale of the arrays within sites, suggesting that the determinants of the presence or absence and abundance of horned lizard can vary over relatively small spatial scales ( hundreds of meters). Our results suggest that a gap‐type approach may miss some of the fine‐scale determinants of species abundance in fragmented habitats.
Topographic Determinants of Faunal Nestedness in Great Basin Butterfly Assemblages: Applications to Conservation Planning
Authors: Fleishman Erica , Nally Ralph Mac
Published: March 2003

Abstract: We examined factors possibly responsible for a nested distributional pattern of resident butterflies in the Toquima Range, a mountain range in the Great Basin of western North America. In related analyses, Poisson‐based modeling indicated that species richness is better explained as a function of elevation and local topographic heterogeneity than by area per se. Therefore, we explored whether area, elevation, and topographic heterogeneity affected relative degree of nestedness. Elevation and topographic heterogeneity not only explained a significant percentage of the total deviance in species richness but also may be responsible for generating nested species distributions. The species‐presence matrix ordered by the elevation‐heterogeneity model was significantly more nested than the matrix ordered by area. The matrix ordered by the elevation‐heterogeneity model also was significantly more nested than matrices ordered by three other environmental variables that did not explain significant variance in species richness, indicating that the model is unlikely to be an artifact. The influence of area on distribution patterns may be relatively slight because it was not significantly correlated with species richness or topographic heterogeneity in this system. Elevation covaried with both species richness and area, but the former correlation was positive and the latter was negative. Our results suggest that faunal richness and compositional patterns are related to independent variables that can be measured extensively—through satellite or airborne telemetry—thus reducing dependence on labor‐intensive measurements of habitat. Because nestedness analyses may help reveal causes, or at least correlates, of species composition, we believe they are a promising tool for conservation planning.
Tree‐Species Preferences of Foraging Insectivorous Birds: Implications for Floodplain Forest Restoration
Authors: Gabbe Aaron P. , Robinson Scott K. , Brawn Jeffrey D.
Published: March 2003

Abstract: The tree‐species composition of forests can be an important component of habitat selection by breeding birds. We examined tree‐species use by observing the foraging behavior of 13 species of foliage‐gleaning birds in floristically diverse floodplain forests in southern Illinois in 1997 and 1998. Twelve of 13 bird species foraged selectively with respect to tree species. The Yellow‐throated Warbler (   Dendroica dominica ) and Cerulean Warbler (   D. cerulea ) were the most selective species, whereas the Yellow‐throated Vireo, Red‐eyed Vireo, and Eastern Tufted Titmouse (    Vireo flavifrons, V. olivaceus, and Baeolophus bicolor, respectively ) were the least selective. Three tree species were strongly preferred by most of the bird community: kingnut hickory, bitternut hickory, and silver maple ( Carya laciniosa, C. cordiformis, and Acer saccharinum , respectively ). Less common bird species tended to be more selective foragers than the more abundant bird species. The four most preferred trees were relatively uncommon where we sampled. Heavy‐seeded hickories are slow to recolonize forests traditionally restored with common oak species ( Quercus spp. ). Therefore, restoring floristically diverse floodplain forests by planting preferred heavy‐seeded and uncommon trees will enhance habitat quality for birds in these forests.
Floral Diversity in Relation to Playa Wetland Area and Watershed Disturbance
Authors: Smith Loren M. , Haukos David A.
Published: March 2003

Abstract: There are 25,000–30,000 playa wetlands in the intensively cultivated Southern Great Plains of the United States. Knowledge of area and watershed influences on wetland flora are needed to guide their conservation. We surveyed plant‐community composition in 224 playas over 360,000 km2 and examined the relationships of species richness and diversity ( Shannon's) to playa area and watershed disturbance. The relationship of increasing species diversity to increasing area is most often hypothesized to be associated with an increasing number of habitats and/or larger populations as area increases. Watershed disturbance (  perennial grassland vs. annual cropland) was included to determine its relationship to floral diversity and bioinvasion by exotic species. For all (terrestrial and wetland) plant species and all playas, there were only marginal relationships (r 2 < 0.1) between area and richness and diversity. Analyses supported the hypothesis that the number of habitats affects playa plant diversity because number of habitats changed little as playa area increased. Tests on only wetland plant species suggested stronger (r 2≅ 0.2) relationships between richness and area. This relationship also was not likely related to increased population size, because large playas remain flooded longer than small playas, and therefore wetland plant species have a greater opportunity to become established. Finally, playas with cropland watersheds had more ( p < 0.05) exotic species, higher diversity, and fewer perennial species than playas with grassland watersheds. Because watershed cultivation has altered playa hydroperiod and increased frequency of disturbance, playas are associated with a flora dominated more by annuals and exotics. Conservation efforts aimed at preserving playa wetland plant diversity and native communities should focus not only on the area of the wetland but also on the condition of its watershed.
Capercaillie (Tetrao urogallus) and Avian Biodiversity: Testing the Umbrella‐Species Concept
Authors: Suter Werner , Graf Roland F. , Hess Ruedi
Published: March 2003

Abstract: Because of limited resources, biodiversity conservation practice is often reduced to measures directed at single species in the hope that this will simultaneously benefit other species in the same community. Such “umbrella species” should therefore have habitat requirements that are similar to those of the other species, whereas their spatial needs should be more extensive. The umbrella‐species concept is often applied in management yet rarely tested beforehand. The Capercaillie (   Tetrao urogallus) is a large forest grouse that is declining over much of its range in Central Europe. It is considered a good example of an umbrella species and is now widely receiving attention from forestry managers. We tested its usefulness as an umbrella species in the Swiss Prealps by analyzing relationships between Capercaillie occurrence and avian biodiversity and asked whether both were associated with the same habitat‐structure parameters. Study plots with Capercaillie did not hold significantly higher bird diversity than plots without the grouse. However, the species richness and abundance of birds that are more or less restricted to subalpine forests (mountain birds) and that at the same time are on the red list was considerably higher in Capercaillie plots than in those without Capercaillie. Both Capercaillie and mountain birds responded positively to forest structure characterized by intermediate openness, multistoried tree layer, presence of ecotonal conditions, and abundant cover of ericaceous shrubs. Capercaillie may therefore be a useful umbrella species, at least for that part of avian biodiversity of conservation interest.
Historical Progress of Biodiversity Conservation in the Protected‐Area System of Tasmania, Australia
Authors: Mendel Louise C. , Kirkpatrick J. B.
Published: March 2003

Abstract: The progress of biodiversity conservation is a function of the historic development of reserve systems, studies of which provide data on reservation gaps and direction for more systematic conservation planning. We used mapped plant communities as a surrogate for the globally significant biodiversity of Tasmania in an analysis of reservation status in relation to a range of conservation targets for 1937, 1970, and 1992. Before the 1970s the representation of plant communities in the Tasmanian National Park system was strongly biased toward the reservation of communities that are not economically valuable, typically those occurring in scenic alpine and subalpine areas. In 1970 <3% of economically valuable communities were reserved above 15% of their pre‐European area, compared with over 17% of communities without economic value. These statistics support the “worthless lands” hypothesis. Between 1970 and 1992 there was a dramatic rise in the representation of communities in the reserve system in response to a change in motivations for reserve establishment and the availability of gap analyses for many plant communities and species. This increase included large increases in the reservation of both economically valuable and noneconomically valuable plant communities. In 1992, one‐third of the plant communities in Tasmania had 15% of their pre‐European area represented in the reserve system, with over 20% of economically valuable communities and 58% of noneconomically valuable communities having over 15% of their pre‐European area reserved. Although gaps in the reservation of forest communities have been partially filled since 1992, some treeless lowland communities are still highly depleted and unreserved. The reserve system in Tasmania, however, is closer to a representative system of biodiversity than in most other countries.
Indirect Effects of Feral Horses on Estuarine Communities
Authors: Levin Phillip S. , Ellis Julie , Petrik Rachel , Hay Mark E.
Published: March 2003

Abstract: Livestock have grazed on salt marshes for centuries and have dramatic effects on marsh vegetation. Most studies examining the effects of livestock on salt marshes have focused on the effects on plants rather than on salt marsh fauna or ecological processes. However, grazers such as feral horses may have strong indirect effects on communities by altering the habitat, making it more or less suitable for species that potentially occur there. We evaluated the indirect effects of grazing by feral horses on estuarine animals that use salt marshes and adjacent subtidal communities. Surveys revealed that horse‐grazed marshes had less vegetation, a higher diversity of foraging birds, higher densities of crabs, and a lower density and species richness of fishes than marshes not grazed by horses. In addition, fish density was reduced in subtidal habitats adjacent to grazed marshes. Experiments manipulating marsh vegetation indicated that the potential for predation on fishes in ungrazed marshes was higher than in grazed marshes. Results of additional experiments in which fishes were enclosed with or without artificial Spartina suggested that the removal of shelter provided by marsh vegetation results in behavioral shifts by fishes that make them more susceptible to predation. Although large herbivores are naturally absent from extant salt marsh ecosystems, such large herbivores were common members of Pleistocene communities. Using modern horses as surrogates for extinct ungulates, we hypothesize that large herbivores could have had strong indirect effects on Pleistocene estuarine habitats. We argue that both the modern introduction of ungulates to salt marshes and the prehistoric elimination of large herbivores affected estuarine biodiversity.
A Multispecies Approach to Ecological Valuation and Conservation
Authors: Root Karen V. , Akçakaya H. Resit , Ginzburg Lev
Published: March 2003

Abstract: The conservation of ecosystems focuses on evaluating individual sites or landscapes based on their component species. To produce a map of conservation values, we developed a method to weight habitat‐suitability maps for individual species by species‐specific extinction risks. The value of a particular site reflects the importance and magnitude of the threats facing the component species of the ecological community. We applied this approach to a set of species from the California Gap Analysis Project. The resulting map of multispecies conservation values identified the areas with the best habitat for the species most vulnerable to extinction. These methods are flexible and can accommodate the quantity and quality of data available for each individual species in both the development of the habitat‐suitability maps and the estimation of the extinction risks. Additionally, the multispecies conservation value can accommodate specific conservation goals, such as preservation of local endemics, making it useful for prioritizing conservation and management actions. This approach provides an estimate of the ecological worth of a site based on habitat characteristics and quantitative models in terms of all the ecological components of a site, rather than a single threatened or endangered species.
Performance of Sub‐Saharan Vertebrates as Indicator Groups for Identifying Priority Areas for Conservation
Authors: Moore Joslin L. , Balmford Andrew , Brooks Thomas , Burgess Neil D. , Hansen Louis A. , Rahbek Carsten , Williams Paul H.
Published: March 2003

Abstract: The aim of continental and global identification of priority areas for conservation is to identify particularly valuable areas for conservation on which to focus more‐detailed effort. Often, these sets of important areas, referred to as priority sets, have been identified through use of data on a single taxon (e.g., birds), which is assumed to act as an indicator for all biodiversity. Using a database of the distributions of 3882 vertebrate species in sub‐Saharan Africa, we conducted one of very few large‐scale tests of this assumption. We used six potential indicator groups—birds, mammals, amphibians, snakes, threatened birds, and threatened mammals—to find priority sets of 200 areas that best represent the species in that group. Priority sets of grid cells designed to maximize representation of a single indicator group captured 83–93% of species in the other groups. This high degree of representation is consistent with observed high levels of overlap in the patterns of distribution of species in different groups. Those species of highest conservation interest were more poorly represented, however, with only 75–88% of other groups' threatened species and 63–76% of other groups' narrow‐range species represented in the priority sets. We conclude that existing priority sets based on indicator groups provide a pragmatic basis for the immediate assessment of priorities for conservation at a continental scale. However, complete and efficient representation—especially of narrow‐range species—will not be achieved through indicator groups alone. Therefore, priority‐setting procedures must remain flexible so that new areas important for other taxa can be incorporated as data become available.
Guidelines for Perinatal Care
Authors: Young Diony
Published: March 2003

The health care system should be oriented toward providing family centered care, the underlying assumption of which is that the family is the primary source of support for anyone receiving health care services. Family‐centered health care professionals engage parents as caregivers and partners and seek to ensure that every encounter builds on the family's strengths, preserves their dignity, and enhances their confidence and competence. These health care professionals strive to understand each family's priorities and needs, incorporating the family's perspective into an individualized plan of care for each infant. Such an approach offers families real choices and respects the decisions they make for themselves and their children. In family‐centered perinatal services, women and their families are involved in all aspects of planning, delivering, and evaluating health care services. This approach creates a climate in which decisions at all levels throughout the perinatal program and hospital are based not only on the expertise and assumptions of health care professionals, but also on the needs, values, and strengths of the newborns and their families.
Women's Experiences of Giving Birth After 35
Authors: Windridge Kate C , Berryman Julia C
Published: March 2003

Background: This research forms part of a longitudinal study comparing experiences of pregnancy, birth, and the first year of motherhood among women aged 35 years and over with women aged 20 to 29 years, in the light of the current trend toward later childbearing. Methods: Data from 107 women were collected from medical records of labor and delivery, and women themselves evaluated control and pain management in labor, satisfaction with support from professionals, labor problems, and postnatal depression. Associations between maternal age and parity and 1) obstetric outcomes, 2) women's perceptions of labor and delivery, and 3) postnatal depression were calculated. Results: Professionals were more likely to place women over 35 years than those aged 20 to 29 years in a “high‐risk” category, but medical records of labor and delivery revealed few maternal age effects. Older mothers were more likely than younger mothers to acknowledge that their baby's life might have been at risk during labor, and that they felt happy about the way staff managed labor problems. They were less likely than younger mothers to blame others for making labor pain worse. Conclusions: Older and younger women's experiences of labor differed in ways that were not mirrored by obstetric differences. Women over 35 years, even if healthy, may believe that their age makes their infants particularly vulnerable during labor. Their higher levels of concern do not necessarily have negative consequences for their experience of childbirth or for their postnatal emotional well‐being.
Maternal Attitudes to Amniotomy and Labor Duration: A Survey in Early Pregnancy
Authors: Impey Lawrence
Published: March 2003

Background:
Although maternal choice increasingly influences intrapartum care, little is known about maternal attitudes about many outcomes and interventions, particularly the length of labor. Early amniotomy decreases the length of labor and particularly the frequency of prolonged (> 12 hr) labor but is often avoided by health professionals. The objective of this survey was to assess the attitudes of women in a major Dublin teaching hospital about the length of labor, amniotomy, and epidural analgesia.
Methods:
An anonymous, structured, self‐completed questionnaire was given to 438 women at their booking visit to the hospital antenatal clinic in February 1998. Participants could ring “agree,”“disagree,”“don't know,” or “don't care” to seven different statements.
Results:
The questionnaire was returned by 398 (92%) women; demographic details were similar to those for the overall hospital population. Of these, 73.5 percent of women wanted a quick labor; 82 percent wanted it to last less than 12 hours. Nearly one‐half specifically wanted epidural analgesia. Only 13 percent wished to avoid amniotomy; significantly more multiparas disagreed with “avoiding amniotomy.”
Conclusions:
Many women want a quick and painless labor, and do not object to the interventions that help achieve this.
Postpartum Maternal Oxytocin Release by Newborns: Effects of Infant Hand Massage and Sucking
Authors: Matthiesen Ann‐Sofi , Ransjö‐Arvidson Anna‐Berit , Nissen Eva , Uvnäs‐Moberg Kerstin
Published: March 2003

Background:
Newborns placed skin‐to‐skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin‐to‐skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors.
Methods:
Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video‐recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed.
Results:
Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005). Conclusions:The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother‐infant interaction.
Breastfeeding Duration, Costs, and Benefits of a Support Program for Low‐Income Breastfeeding Women
Authors: Pugh Linda C. , Milligan Renee A. , Frick Kevin D. , Spatz Diane , Bronner Yvonne
Published: March 2003

Background: Breastfeeding can ameliorate some of the complex health issues faced by low‐income families. Women who breastfeed and their infants have lower health care costs compared with those who formula feed. Increasing the duration of breastfeeding is recognized as a national priority, particularly for low‐income women. This community‐based randomized clinical trial involving low‐income mothers compared usual care with an intervention comprising hospital and home visits, and telephone support by a community health nurse/peer counselor team for 6 months after delivery.

Methods: Forty‐one women were recruited after delivery of a full‐term singleton infant and randomly assigned to intervention or usual care groups.

Results: Women receiving the community health intervention breastfed longer than the women receiving usual care. The infants in the intervention group had fewer sick visits and reported use of fewer medications than infants in the usual care group. The intervention cost ($301/mother) was partially offset by cost savings on formula and health care.

Conclusions: Community health nurse and peer counselor support can increase breastfeeding duration in low‐income women, and has the potential to reduce total costs including the cost of support. (BIRTH 29:2 June 2002)
Satisfaction and Use of Prenatal Care: Their Relationship Among African‐American Women in a Large Managed Care Organization
Authors: Handler Arden , Rosenberg Deborah , Raube Kristiana , Lyons Sandra
Published: March 2003

ABSTRACT:Background: Although many more mothers of almost all ethnic groups began prenatal care in the first trimester during the last decade, a significant number of low‐income and minority women still fail to obtain adequate care in the United States—a failure that may be related to their dissatisfaction with the prenatal care experience. This study sought to examine the relationship between satisfaction with care and subsequent prenatal care utilization among African‐American women using prospective methods.

Methods: A sample of 125 Medicaid and 275 non‐Medicaid African‐American adult women seeking care through a large Midwest managed care organization were interviewed before or at 28 weeks’ gestation at one of two prenatal care sites. Women were interviewed about personal characteristics, prenatal care experience, and ratings of care (satisfaction). Information about subsequent use of prenatal care was obtained through retrospective medical record review after delivery. Univariate and multivariable analyses examining the relationship between women's satisfaction and prenatal care use were conducted using a dichotomous measure of satisfaction and a continuous measure of utilization.

Results: Women were highly satisfied with prenatal care, with an overall mean satisfaction score of 80.3. Non‐Medicaid women were significantly (p < 0.05) less satisfied with their prenatal care (mean score, 79.1) than Medicaid women (mean score, 82.8), and the latter had significantly fewer visits on average than the former subsequent to the interview. Analyses showed no significant difference in subsequent utilization according to whether a woman had a high versus low level of satisfaction at the prenatal care interview.

Conclusions: This study challenges the assumption that improving a woman's satisfaction with care will lead to an increase in the adequacy of her prenatal care utilization. Since this study was limited to African‐American women and is the first prospective study of women's satisfaction with care and prenatal care utilization, the negative findings do not yet settle this area of inquiry. Monitoring women's satisfaction with prenatal care in both managed care and fee‐for‐service settings and working to improve those aspects of care associated with decreased satisfaction is warranted. (BIRTH 30:1 March 2003)
Growth Inhibitory and Bactericidal Activities of Lansoprazole Compared with Those of Omeprazole and Pantoprazole against Helicobacter pylori
Authors: Nakao Masafumi , Malfertheiner Peter
Published: March 2003

Background.

Helicobacter pylori plays a role in the pathogenesis of both duodenal and gastric ulcers. The aim of this study was to evaluate the effect of the proton pump inhibitor (PPI), lansoprazole, commonly used in eradication regimens, on growth, bactericidal activity and morphology of H. pylori in vitro in comparison with other PPIs.

Materials and Methods.

Growth inhibitory activity of each of the PPIs was evaluated by determining minimum inhibitory concentrations using an agar dilution method. Bactericidal activity was determined by analysis of the viable cells in culture at various time points after incubation with different concentrations of the PPIs. Bacterial morphology was examined using scanning electron microscopy of fixed cells after exposure to the test substances. Urease activity in cell extracts of H. pylori that had been incubated with increasing concentrations of the PPIs was determined by colorimetry.

Results.

The growth inhibitory activity of lansoprazole was significantly more potent than that of omeprazole or pantoprazole (MIC90 6.25 vs. 25 and 100~μg/ml, respectively). Exposure of H. pylori to lansoprazole produced loss of viability and an aberrant bacterial morphology, which was more extensive than seen with omeprazole or pantoprazole. Lansoprazole dose dependently inhibited urease activity; its effectiveness was comparable with omeprazole but more potent than pantoprazole.

Conclusions.

The mechanism of action that leads to loss of viability of H. pylori cells appears to differ between the three PPIs investigated; lansoprazole was the most potent of the three agents in terms of growth inhibition and disruption of bacterial morphology.
Effect of Helicobacter pylori Eradication on Peptic Ulcer Disease Complicated with Outlet Obstruction
Authors: Taskin Vildan , Gurer Inanç , Ozyilkan Esin , Sare Mustafa , Hilmioglu Fatih
Published: March 2003

Background. At present, the prevalence of Helicobacter pylori (H. pylori) in complicated peptic ulcer and the effect of H. pylori eradication on complicated peptic ulcer have not been fully established. In this study, we report the prevalence of H. pylori in peptic ulcer patients complicated with gastric outlet obstruction, effectiveness of oral eradication therapy on these patients, and their long‐term follow up.

Patients and Methods. Ten consecutive patients presenting with clinically and endoscopically significant obstructed peptic ulcers were included in this study. During each endoscopy, seven gastric biopsy specimens were obtained and analyzed for H. pylori colonization.

Results. The antral mucosal biopsy specimens were positive for H. pylori in nine patients. H. pylori infection was eradicated and complete ulcer healing was observed in all patients. The mean follow‐up period was 14 (7–24) months. One patient had duodenal perforation and underwent surgical intervention following medical treatment, despite the eradication of H. pylori. Ulcer recurrence was noted in two (22.2%) of nine patients, and in one of them the recurrent ulcer was complicated with obstruction (11.1%). The mean time to ulcer recurrence was 17 months (range, 10–24 months). The biopsies and CLOtests were H. pylori negative at the time of ulcer or erosion recurrence in two patients.

Conclusion. We suggest that H. pylori eradication may improve the resolution in obstructive ulcer cases with colonization.
Inducible Nitric Oxide Synthase Expression in Gastroduodenal Diseases Infected with Helicobacter pylori
Authors: Son Hee Jung , Rhee Jong Chul , Park Dong Il , Kim Young‐Ho , Rhee Poong‐Lyul , Koh Kwang Cheol , Paik Seung Woon , Choi Kyoo Wan , Kim Jae J.
Published: March 2003

Background.

Nitric oxide (NO) is synthesized enzymatically from L‐arginine by NO synthase, which is measured by inducible NO synthase (iNOS). Helicobacter pylori (H. pylori) infection produces a state of chronic immunostimulation in the gastric epithelium. Infection with cagA+H. pylori has greater degree of gastric inflammation and epithelial cell damage. Therefore, we compared the levels of iNOS in patients with H. pylori infection in relation to cagA status and H. pylori‐related disease.

Materials and Methods.

One hundred and seven patients, including 51 patients with gastric cancer, 12 patients with gastric ulcer, 18 patients with duodenal ulcer and 26 patients with chronic gastritis, were enrolled in this study. Biopsies from the antrum and body were obtained for histologic examination, culture and reverse transcriptionase‐PCR (RT‐PCR) for detection of iNOS gene expression. The presence of H. pylori was confirmed by Giemsa staining or culture and the gene expression of cagA in H. pylori isolates was confirmed by PCR.

Results.

H. pylori infection was detected in 70.1% (75/107) and cagA was detected in 84.8% (28/33). iNOS expression was detected in 49.5% (53/107) and there was no significant difference in iNOS expression according to H. pylori infection nor the cagA status in the gastroduodenal diseases. However, iNOS expression was more frequently detected in gastric cancer than the other H. pylori‐related diseases (64.7% vs. 35.7%, p < .05).

Conclusion.

Although NO was thought be involved in the gastric carcinogenesis, the level of NO production was not related to H. pylori infection or cagA status.
Helicobacter pylori in Gastric Cancer and Peptic Ulcer Disease in a Colombian Population. Strain Heterogeneity and Antibody Profiles
Authors: Piñeros Diana M. Cittelly , Riveros Sandra C. Henao , Marin Julian D. Martinez , Ricardo Oliveros , Díaz Oscar Orozco
Published: March 2003

Background.

Helicobacter pylori infection is associated with peptic ulcer disease and gastric cancer. The aim of this work was to describe, to compare H. pylori antigenic profiles, and to characterize the antibody response against Colombian strains in gastric cancer and peptic ulcer patients.

Materials and Methods.

Liquid culture supernatants were used to determine the antigenic profiles of 35 H. pylori strains by immunoblotting using a pool of positive sera. Characterization of strains included the evaluation of cytotoxic and vacuolating activities. The serologic antibody profiles of 124 patients (54 duodenal ulcer and 70 gastric cancer) were analyzed against two native strains (Hpu24, Hpc29) and NCTC11638. Antibodies to specific antigenic bands in each strain were related with presentation.

Results.

Differences among antigenic profiles were observed between native isolates with each serum recognizing a wide range of antigens (30–120 Kd). A 68 Kd band in Hpu24 strain was recognized by 50% of sera from peptic ulcer patients but not by gastric cancer sera (p = .000). The immune profiles differed according to the strain used (i.e. a given sera did not recognize the same bands in different strains). Detection of H. pylori in gastric mucosa was associated with the presence of antibodies against low molecular weight antigenic bands.

Conclusions.

The heterogeneity in the antibody response to H. pylori and the prevalence specific anti‐H. pylori antibodies in a specific disease depend on the strain used as antigen. The results support the hypothesis that there may be a differential antibody response to carcinogenic and ulcerogenic strains and suggest that there are antigenic bands that could be useful as markers of disease.
Non‐Helicobacter pylori Related Duodenal Ulcer Disease in Children
Authors: Elitsur Yoram , Lawrence Zandra
Published: March 2003

Background.

In spite of the worldwide distribution of Helicobacter pylori infection, recent data have reported an increased rate of non‐H. pylori, non‐NSAIDs‐duodenal ulcer disease in adults. The estimated rate of these ulcers in children is unknown. We aimed to investigate the prevalence of non‐H. pylori, non‐NSAIDs‐peptic ulcer disease in our pediatric patients who undergo upper endoscopic procedures.

Methods.

A retrospective analysis of 622 upper endoscopic reports was performed. Reports that documented mucosal ulcerations were included in our study. The demographic, clinical, endoscopic, and histological data were retrieved. The H. pylori‐negative, duodenal/gastric ulcer‐positive patients were compared with H. pylori‐positive, duodenal/gastric ulcer‐positive patients.

Results.

Out of the 622 upper endoscopy reports, a total of 11 (1.8%) children with mucosal ulceration were studied. Mucosal ulceration was distributed in the following locations: stomach‐3 (27%), and duodenal bulb‐10 (91%) (two children had ulcers in both the stomach and duodenal bulb). Helicobacter pylori infection was only detected in three (27%) children with duodenal ulcer. Gastritis was more severe in patients with H. pylori infection/duodenal ulcer compared with H. pylori‐negative/duodenal ulcer group. No statistical difference in clinical symptoms or endoscopic appearance was observed between the H. pylori‐negative and H. pylori‐positive groups.

Conclusion.

‘Idiopathic’ (H. pylori‐negative, NSAIDs‐negative) duodenal/gastric ulcers are present in symptomatic children. Clinical or endoscopic characteristics are insufficient markers to identify those ‘idiopathic’ ulcers. Investigating the ‘risk factors’ for those ulcers will be helpful in reducing the morbidity in these children.
Production of Chemokines and Reactive Oxygen Species by Human Neutrophils Stimulated by Helicobacter pylori
Authors: Shimoyama Tadashi , Fukuda Shinsaku , Liu Qiang , Nakaji Shigeyuki , Fukuda Yoshihiro , Sugawara Kazuo
Published: March 2003

Background. Bacteria have different characteristics in stimulation of human neutrophils to produce reactive oxygen species (ROS) and chemokines. This study examined the ability of Helicobacter pylori to induce production of ROS and chemokines by human neutrophils.

Methods. H. pylori strains (1.5 × 108 CFU/ml) were cocultured with 5 × 104 neutrophils isolated from healthy subjects. Samples were incubated with human serum with or without IgG antibodies to H. pylori. ROS production was measured using luminol‐dependent chemiluminescence (LmCL), and the concentrations of chemokines (IL‐8, RANTES, MIP‐1α and MCP‐1) were measured by ELISA.

Results. The mean of the highest LmCL (peak height; PH) value stimulated by H. pylori was 3318 in the absence of serum. PH increased to 4687 when incubated with anti‐H. pylori antibody‐positive sera (p < .001) but antibody‐negative sera did not affect LmCL response. The mean final concentration of IL‐8 produced in the absence of serum was 142.6 pg/ml. Increased IL‐8 production was seen by addition of antibody positive serum (p < .01). IL‐8 production was not significantly correlated with production of ROS. On the other hand, H. pylori stimulation did not induce neutrophil production of RANTES, MIP‐1α or MCP‐1.

Conclusions. H. pylori was capable of inducing IL‐8 production by human neutrophils, but not C‐C chemokines. Production of C‐X‐C dominant chemokine by neutrophils is consistent with the pathological characteristics of H. pylori‐induced gastritis, where persistent neutrophil infiltration is present.
Stool Antigen Assay to Screen H. pylori Infection and to Assess the Success of 3‐Day and 7‐Day Eradication Therapy in the Patients with Partial Gastrectomy
Authors: Sheu Bor‐Shyang , Yang Hsiao‐Bai , Wang Yen‐Lin , Kao Ai‐Wen , Chuang Chiao‐Hsiung , Lin Pin‐Wen , Chang Yuh‐Chung
Published: March 2003

Background. Even after partial gastrectomy, Helicobacter pylori may persist in the residual stomach but be less abundant in the bacterial load. H. pylori stool antigen is a reliable noninvasive tool to detect H. pylori infection in patients without gastrectomy. We thus test whether [1] the course of H. pylori eradication therapy could be diminished [2]; stool antigen can effectively detect H. pylori infection for the patients with gastrectomy.

Methods. One hundred and eight patients who had undergone partial gastrectomy were enrolled to receive panendoscopy and provided stool samples for H. pylori stool antigen within 3 days after endoscopy. The H. pylori‐infected patients were then randomized to receive either a 3‐ or 7‐day triple therapy for H. pylori eradication. Six weeks later, to evaluate the success of H. pylori eradication, patients received a follow‐up endoscopy and again provided stool samples for H. pylori stool antigen.

Results. Seventy out of 108 patients, proven to have H. pylori infection, were evenly randomized into 3‐day and 7‐day therapy groups. The H. pylori eradication rates were similar between the 3‐day and 7‐day triple therapy (90.9 vs. 93.8%, p > .05). Before therapy, the H. pylori stool antigen was 93% sensitive and 100% specific to detect H. pylori. After therapy, H. pylori stool antigen remain 100% sensitive and 88.3% specific to detect the failure of eradication therapy.

Conclusion. H. pylori stool antigen is a highly reliable tool to screen H. pylori infection before therapy and to assess the success of eradication therapy in partial gastrectomy patients. To eradicate H. pylori infection for patients with partial gastrectomy, the duration of triple therapy can be shortened.
Evaluation of a Western Blot Test, Helico Blot 2.1, in the Diagnosis of Helicobacter pylori Infection in a Pediatric Population
Authors: Oleastro Mónica , Matos Rita , Cabral José , Barros Rosa , Lopes Ana Isabel , Ramalho Paulo , Monteiro Lurdes
Published: March 2003

Background. Noninvasive diagnostic tests are useful as screening tools for Helicobacter pylori infection in pediatric populations. The aim of this study was to evaluate performance of the immunoblot assay, Helico Blot 2.1, for the diagnosis of H. pylori infection in symptomatic children.

Materials and Methods. Immunoblot assay was used for detection of IgG antibodies to specific H. pylori proteins and to a recombinant H. pylori antigen, CIM marker. The study was performed on sera collected from 134 symptomatic, untreated children (mean age, 9.1 ± 3.2 years; range, 1–14 years). H. pylori infection status was determined by culture, histology and rapid urease test.

Results. Immunoblot assay yielded a positive result in 71 of the 72 infected patients (sensitivity 98.6%) and in eight of the 62 noninfected ones (specificity 87.1%). The predictive values for a positive and a negative result were 89.9% and 98.2%, respectively. The performance of the CIM band alone, as a marker for H. pylori infection status, was also evaluated. This band was present on the blot of 71 infected patients and on four of the 62 H. pylori‐negative patients. The sensitivity, specificity, PPV and NPV of the CIM antigen were 98.6%, 93.5%, 94.7% and 98.3%, respectively.

Conclusions. The immunoblot assay Helico Blot 2.1 is a suitable noninvasive test for the serodiagnosis of H. pylori infection in children. The good level of performance demonstrated by the novel recombinant antigen CIM suggests it may be a useful contribution to the qualitative and quantitative performance of the Helico Blot 2.1 in pediatric populations.
Impact of Furazolidone‐Based Quadruple Therapy for Eradication of Helicobacter pylori after Previous Treatment Failures
Authors: Treiber G. , Ammon S. , Malfertheiner P. , Klotz U.
Published: March 2003

Background. One week of quadruple therapy including metronidazole is recommended for Helicobacter pylori treatment failures after first line therapy regardless of resistance status. This study investigated whether a quadruple regimen containing furazolidone could be effective as a third‐line (salvage) therapy.

Methods. All patients with previous H. pylori treatment failure after a clarithromycin‐metronidazole ± amoxicillin combination plus acid suppression were given lansoprazole 30 mg twice a day (bid), tripotassiumdicitratobismuthate 240 mg bid, tetracycline 1 g bid, metronidazole 400 mg (PPI‐B‐T‐M) three times a day (tid) for 1 week. In the case of treatment failure with this second‐line therapy, the same regimen was applied for 1 week except for using furazolidone 200 mg bid (PPI‐B‐T‐F) instead of metronidazole (sequential study design).

Results. Eighteen consecutive patients were treated with PPI‐B‐T‐M. Eleven of those 18 remained H. pylori positive (38.9% cured). Pretherapeutic metronidazole resistance was associated with a lower probability of eradication success (10% vs. 75%, p= .04). Ten of these 11 patients agreed to be retreated by PPI‐B‐T‐F. Final cure of H. pylori with PPI‐B‐T‐F was achieved in 9/10 patients (90%) nonresponsive to PPI‐B‐T‐M.

Conclusions. In the presence of metronidazole resistance, PPI‐B‐T‐M as a recommended second‐line therapy by the Maastricht consensus conference achieved unacceptable low cure rates in our metronidazole pretreated population. In this population, metronidazole based second‐line quadruple therapy may be best suited in case of a metronidazole‐free first line‐regimen (e.g. PPI‐clarithromycin‐amoxicillin) or a low prevalence of metronidazole resistance. Furazolidone in the PPI‐B‐T‐F combination does not have a cross‐resistance potential to metronidazole and is a promising salvage option after a failed PPI‐B‐T‐M regimen.
A Novel Method for Assessing Gastritis in the Murine Model Demonstrates Genetically Determined Variation in Response to Helicobacter felis Infection
Authors: Walker M. M. , Worku M. , Coggle S. , Thursz M. R.
Published: March 2003

Background. In murine Helicobacter infection it has been demonstrated that the degree of gastric mucosal inflammation is determined by mouse strain. This is a valuable tool for investigating genetic, immunological or bacterial determinants for the outcome of human Helicobacter infection. This study aims to devise a robust method to facilitate these investigations.

Materials and Methods. C57BL/6, BALB/c and (C57BL/6 × BALB/c) F1 mice were given 108H. felis by gavage on days 1, 3 and 5 of the experiment Sections of the lesser and greater curve of stomach were examined at 12 weeks to assess active gastritis using a semi‐quantitative and a quantitative method by counting neutrophils in glands in four zones of the mucosa.

Results. Semi‐quantitative scoring for active inflammation, based on the Sydney System, was inadequate with little discrimination between strains. Quantifying the level of active inflammation, counting the number of neutrophils in inflamed gastric glands and taking the total number of neutrophils in three inflamed pits within each zone (cardia, body, transitional zone and antrum) showed clear differences between the two parental strains for the degree of active gastritis and furthermore, using this system the phenotype of the (C57BL/6 × BALB/c) F1 was found to be between the two parental extremes.

Conclusions. This novel method provides a numerical value for active inflammation in the stomach that is accurate, reproducible and discriminatory.
Helicobacter pylori Infection in Connective Tissue Disorders is Associated with High Levels of Antibodies to Mycobacterial hsp65 but not to Human hsp60
Authors: Kalabay László , Fekete Béla , Czirják László , Horváth Laura , Daha Mohamed R. , Veres Amarilla , Fónyad Gábor , Horváth Anna , Viczián Ágnes , Singh Mahavir , Hoffer Izabella , Füst George , Romics László , Prohászka Z.
Published: March 2003

Background. To investigate whether the Helicobacter pylori status influences levels of antibodies against mycobacterial heat shock protein (hsp) 65 and human hsp60 in systemic autoimmune diseases and to study the concentration of anti‐H. pylori antibodies in autoimmune patients and healthy controls.

Materials and Methods. Antibodies against human heat‐shock protein hsp60, mycobacterial heat‐shock protein hsp65 were analyzed by ELISA. Anti‐Helicobacter antibodies were determined by enzyme immunoassay.

Results. There was a markedly higher prevalence of H. pylori infection in undifferentiated connective tissue disease (82%) (n = 33) and systemic sclerosis (78%) (n = 55) but not in systemic lupus erythematosus (n = 49), polymyositis/dermatomyositis (n = 14), rheumatoid arthritis (n = 21) or primary Raynaud's syndrome (n = 26) compared with controls (59%) (n = 349). In autoimmune diseases H. pylori infection was associated with elevated levels of antihsp65 (p = .008) but not of antihsp60. Anti‐hsp65 levels were significantly higher in H. pylori‐infected (n = 129) than in uninfected patients (n = 69) (p = .0007).

Conclusions. These findings indicate that in autoimmune diseases the infection with the H. pylori bacterium is associated with increased concentration of antimycobacterial hsp65.