bluuebunny/crossref_metadata_2025 huggingface dataset:
Herlitz Junctional Epidermolysis Bullosa Presenting at Birth with Anonychia: A Case Report and Review of H‐JEB
Authors: Parsapour Kourosh , Reep Michael D. , Mohammed Layla , Church Annamaria , Shwayder Tor
Published: March 2003

Abstract: A 15‐day‐old Yemeni boy presented with anonychia and granulomatous nail beds and white patches in the mouth. Biopsy specimens from the nail beds were nondiagnostic. Shortly thereafter the child developed multiple tense bullae, a hoarse voice, and poor appetite. Hematoxylin and eosin staining along with monoclonal antibody studies of a skin biopsy specimen revealed subepidermal bullae through the lamina lucida and a marked decrease in laminin 5. A diagnosis of junctional epidermolysis bullosa Herlitz variant was made. His course was complicated by multiple nonhealing wounds, oral pharyngeal involvement, sepsis, anemia, and poor nutrition, leading to his eventual death. This report emphasizes the unusual presentation of Herlitz junctional epidermolysis bullosa with anonychia as the initial finding and a relatively prolonged period before cutaneous blister formation, resulting in delay of diagnosis.
Congenital Plaquelike Glomus Tumor in a Child
Authors: Carvalho V. O. , Taniguchi K. , Giraldi S. , Bertogna J. , Marinoni L. P. , Fillus J. N. , Filho J. S. Reis
Published: March 2003

Abstract: An 8‐year‐old girl was seen in our outpatient clinic with a history of an angiomatous plaque on the chest since birth. She had complained of pain at the site of the lesion for 1 month. Histopathologic examination and immunohistochemical analysis led to the diagnosis of glomangioma, a rare congenital plaquelike glomus tumor. We review the literature and discuss the clinical presentation and evolution of this rare entity.
New‐Onset Ichthyosis and Diabetes in a 14‐Year‐Old
Authors: Scheinfeld Noah , Libkind Miriam , Freilich Stephanie
Published: March 2003

Diabetes has not been linked to acquired ichthyosis or ichthyosis vulgaris. We report a newly diagnosed diabetic 14‐year‐old girl with bilateral tibial and sacral ichthyosiform plaques and a hemoglobin A1c of 20.1%. The patient had no personal or family history of atopy or ichthyosis and lacked keratosis pilaris or hyperlinear palms. A biopsy specimen of an ichthyosiform plaque showed compact lamellar orthohyperkeratosis and hypogranulosis, histopathology consistent with either ichthyosis vulgaris or acquired ichthyosis. We speculate that our patient’s new‐onset diabetes induced acquired ichthyosis.
Pityriasis Lichenoides in a Girl with the Granulomatous Form of Common Variable Immunodeficiency
Authors: Pasic Srdjan , Pavlovic Milos , Vojvodic Danilo , Abinun Mario
Published: March 2003

Pityriasis lichenoides (PL) is a cutaneous disease of unknown origin. In our 8‐year‐old female patient with the granulomatous form of common variable immunodeficiency (CVID), PL occurred together with massive splenomegaly and intra‐abdominal lymphadenopathy. Prednisone was efficient for treatment of her splenomegaly and autoimmune cytopenias. However, PL was resistant to both topical and systemic steroid treatment. Healing of PL was achieved with the use of a superpotent topical steroid, clobetasol propionate. A defect of T‐cell function in CVID may contribute to development of PL. In the granulomatous form of CVID, sarcoidlike granulomas are the most commonly reported cutaneous lesions. PL has not been previously reported.
Congenital Generalized Terminal Hypertrichosis with Gingival Hyperplasia
Authors: Guevara‐Sanginés Esther , Villalobos Alejandra , Vega‐Memije Ma. Elisa , Mosqueda‐Taylor Adalberto , Canún‐Serrano Sonia , Lacy‐Niebla Rosa Ma.
Published: March 2003

Congenital generalized terminal hypertrichosis is a rare disease, especially when associated with gingival hyperplasia. Congenital hypertrichosis can be a clinical feature of several syndromes, so these patients must be studied by a multidisciplinary team that should include a dermatologist, geneticist, psychologist, odontologist, and an endocrinologist. We report a 7‐year‐old girl with congenital generalized hypertrichosis and gingival hyperplasia, and analyze the clinical approach, differential diagnosis, and treatment.
Dexpanthenol cream significantly improves mucocutaneous side effects associated with isotretinoin therapy
Authors: Romiti Ricardo , Romiti Ney
Published: March 2003

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Giant Nevoid Hypertrichosis in an Iranian Girl
Authors: Vergani Raffaella , Betti Roberto , Martino Patrizia , Crosti Carlo
Published: March 2003

A 12‐year‐old Iranian girl and her father had an extensive congenital nevus consisting of long, black terminal hair involving the entire back and the posterior surface of the arms without pigmentary changes of the underlying skin. A physical examination revealed no other abnormalities. In this study the possibility of a genetically determined etiology is considered.
Changes in CD4+ T Lymphocyte Subsets in Circulating Blood and Synovial Fluid Following Filtration Leukocytapheresis Therapy in Patients with Rheumatoid Arthritis
Authors: Hidaka Toshihiko , Suzuki Kimihiro , Matsuki Yasunori , Takamizawa‐Matsumoto Mitsuyo , Okada Makoto , Ishizuka Toshiaki , Kawakami Makoto , Ohsuzu Fumitaka
Published: March 2003

The purpose of this study is to determine the changes in CD4+ T lymphocyte subsets in the circulating blood and synovial fluid following filtration leukocytapheresis (LCP) therapy for patients with rheumatoid arthritis (RA). A Cellsorba column packed with polyester fibers was used for the removal of circulating leukocytes. For patients with RA, filtration LCP or sham procedures were performed 3 times with 1 week intervals between procedures. T lymphocyte surface markers in the peripheral blood and synovial fluid were measured by flow cytometry. The proportions of activated CD4+ T cells (CD4+DR+, CD4+CD25+, and CD4+CD71+) and CD4+CD29+ T cells increased significantly in the peripheral blood, but the counts of these cells were significantly reduced in the synovial fluid after 2 treatment sessions in the LCP group. No significant changes were observed in the proportion of these cells in the control group. Our findings suggest that filtration LCP may cause a redistribution of activated T cells from affected joints into the circulating blood.
Influence of Atorvastatin Versus Simvastatin on Fibrinogen and Other Hemorheological Parameters in Patients with Severe Hypercholesterolemia Treated with Regular Low‐Density Lipoprotein Immunoadsorption Apheresis
Authors: Otto Carsten , Geiss H. Christian , Donner Markus G. , Parhofer Klaus G. , Schwandt Peter
Published: March 2003

Abstract: Low‐density lipoprotein (LDL) apheresis is a treatment option in patients with coronary artery disease and elevated LDL cholesterol concentrations if maximal drug therapy fails to achieve adequate LDL cholesterol reduction. This therapy is more effective when combined with strong lipid‐lowering drugs, such as atorvastatin. However, conflicting data have been published concerning the effect of atorvastatin on fibrinogen concentration. Therefore, we investigated the effect of atorvastatin compared to simvastatin on fibrinogen concentration and other hemorheological parameters in patients treated by weekly LDL apheresis. Hemorheological parameters were, studied twice in 9 patients (4 female, 5 male, 54.0 ± 8.9 years) with coronary artery disease treated by weekly LDL immunoadsorption, once during concomitant simvastatin therapy (40 mg daily) and once during atorvastatin therapy (40 mg daily). Fibrinogen concentration, plasma and blood viscosity at different shear rates, parameters of red cell aggregation at stasis and shear rate 3/s, and erythrocyte filterability were determined 7 days after the last LDL apheresis after each drug had been given for a minimum for 8 weeks. Fibrinogen concentration did not show any statistically significant difference during therapy with atorvastatin (3.09 ± 0.36 g/L) compared to simvastatin (3.13 ± 0.77 g/L). Plasma and blood viscosity as well as erythrocyte filterability were also unchanged. The increase in red cell aggregation at stasis during atorvastatin treatment (5.82 ± 1.00 U versus 4.89±0.48 U during simvastatin; p < 0.05) was inversely correlated with a lower high‐density liprotein (HDL) cholesterol concentration (1.17 ± 0.21 mmol/L versus 1.31 ± 0.30 mmol/L during simvastatin; p < 0.05). LDL cholesterol showed a strong trend to lower concentrations during atorvastatin (4.14 ± 0.61 mmol/L versus 4.56 ± 0.66 mmol/L during simvastatin; p = 0.07), despite a reduced plasma volume treated (3,547 ± 1,239 ml during atorvastatin versus 3,888 ± 1,206 mL during simvastatin; p < 0.05). In conclusion, fibrinogen concentration and other hemorheological parameters were unchanged during atorvastatin compared to simvastatin therapy with the exception of a higher red cell aggregation at stasis. Therefore, with respect to hemorheology, we conclude that atorvastatin should not be withheld from hypercholesterolemic patients regularly treated with LDL immunoadsorption.
Effects of Low‐Density Lipoprotein Apheresis on Coronary and Carotid Atherosclerosis and Diabetic Scleredema in Patients with Severe Hypercholesterolemia
Authors: Koga Nobuhiko
Published: March 2003

Abstract: Correlations between serum cholesterol levels and progression of coronary and peripheral atherosclerosis have been found in many recent studies. It has also been demonstrated that aggressive cholesterol‐lowering therapy with low‐density lipoprotein (LDL) apheresis, a method of LDL elimination by extracorporeal circulation, is effective not only for coronary artery disease, but also for systemic circulatory disturbance in severe hypercholesterolemic patients with familial hypercholesterolemia (FH) in particular. We found that LDL apheresis treatment with medical therapy improved coronary atherosclerotic lesions, based on coronary angiography evaluation and histopathological observation, suppressed progression of early carotid atherosclerotic lesions on annual B‐mode ultrasonography, and improved diabetic scleredema in FH patients. This effectiveness of LDL apheresis appears to be due to recovery of vascular endothelial function and improvement of blood rheology. For diseases that are possibly due to circulation disturbance and that are intractable with drugs alone, LDL apheresis may be worth trying, particularly for patients complicated by hyperlipemia.
Development of Affinity Microparticles for Extracorporeal Blood Purification Based on Crystalline Bacterial Cell Surface Proteins
Authors: Weber Viktoria , Weigert Stefan , Sára Margit , Sleytr Uwe B. , Falkenhagen Dieter
Published: March 2003

Abstract: In this article, the development of specific adsorbents for extracorporeal blood purification are described. Affinity microparticles were prepared by linking Protein A to crystalline cell surface layers (S‐layers) from Thermoanaerobacter thermohydrosulfuricus l111‐69. S‐layers were used in the form of cell wall fragments obtained by breaking whole cells by ultrasonification, resulting in cup‐shaped structures (average size 0.5 × 1μm) completely covered with S‐layer protein. Protein A was covalently bound to carboxylic acid groups of the S‐layer protein after activation with 1‐ethyl‐3,3'(dimethylamino)‐propylcarbodiimide. In batch adsorption experiments with fresh frozen human plasma, the resulting S‐layer based affinity microparticles showed a high adsorption capacity for IgG (40 mg IgG were bound per g wet pellet of S‐layer based affinity microparticles). Fractions eluted from the microparticles were subjected to sodium dodecyl sulfate‐polyacrylamide gel electrophoresis. They contained only IgG demonstrating that adsorption was specific. In biocompatibility tests, preparations of the S‐layer microparticles showed no low‐density lipoprotein‐reactivity, no cytotoxicity, and no cytokine inducing activity.
Use of Human Preconditioned Phagocytes for Extracorporeal Immune Support: Introduction of a Concept
Authors: Mitzner Steffen R. , Freytag Jens , Sauer Martin , Kleinfeldt Tilo , Altrichter Jens , Klöhr Sven , Koball Sebastian , Stange Jan , Ringel Bruno , Nebe Barbara , Schmidt Heidrun , Podbielski Andreas , Noeldge‐Schomburg Gabriele , Schmidt Reinhard
Published: March 2003

Abstract: Neutrophils are critical effector cells in humoral and innate immunity and play a vital role in phagocytosis and bacterial killing. If they and/or their specific functions are lacking, then immunoparalysis may occur, and severe diseases like systemic inflammatory response syndrome (SIRS) or sepsis can take a fatal course. In this paper, we discuss the possibility of using preconditioned cells in an extracorporeal biohybrid immune support system. A human promyelocytic cell line was stimulated for different times with all‐trans retinoic acid. The resulting cells displayed major signs and functions of mature neutrophilic granulocytes including oxygen radical production, phagocytosis of living and dead Escherichia coli, Staphylococcus aureus, Candida albicans, intracellular killing, and interleukin production. The cells can be expanded to yield a sufficient cell mass, and subsequent prestimulation results in an expression of specific neutrophil functions. Extracorporeal bioreactor experiments seem to be feasible to test the benefit in immunoparalysis‐associated diseases like SIRS or sepsis.
Effects of Operating Conditions on Selectivity of a Plasma Fractionator in Double Filtration Plasmapheresis
Authors: Mineshima Michio , Yokoi Ryo , Horibe Koji , Eguchi Kei , Kaneko Iwakazu , Agishi Tetsuzo , Akiba Takashi
Published: March 2003

Abstract: In a typical double filtration plasmapheresis treatment, plasma fractionation between albumin and some immunoglobulins associated with toxins is limited because none of the currently available plasma fractionators has a strict cutoff property for these proteins. Selectivity of immunoglobulins over albumin depends not only on the cutoff properties of the membrane but on the operating conditions such as the flow rate of the supplied plasma (Qp) and retained plasma to be discarded (Qd) in the plasma fractionator. We carried out an in vitro study using human plasma harvested by single plasma exchange treatments to assess the selectivity of a plasma fractionator, Evaflux 2A‐F (Kawasumi Laboratories, Inc., Tokyo, Japan), under various operating conditions. The results of rate‐constant filtration experiments showed that the concentrations in the feed tank and the sieving coefficient (SC) values of every protein were decreased slightly within 2 h after the start of the experiment because of membrane trapping, adsorption, and/or plugging. The time‐averaged SC value of albumin increased with flow rate ratio (Qp/Qd) due to increasing filtration fraction (FF), but relative removal efficiency (mD/mP*) for albumin decreased with Qp/Qd due to decreasing Qd. For immunoglobulins, on the other hand, the SC values were almost unchanged, and the mD/mP* values increased with Qp/Qd due to an increase in FF. Both increasing Qp and decreasing Qd are effective means of improving selectivity between these proteins in the plasma fractionator. Membrane fouling is, however, obvious beyond a Qp/Qd value that is thought to be a critical point. Operation should be conducted below the critical Qp/Qd value, which depends on the patient's plasma components and the cutoff property of the membrane.
Patterns of Disease‐Modifying Antirheumatic Drug Use, Medical Resource Consumption, and Cost Among Rheumatoid Arthritis Patients
Authors: Griffiths Robert I. , Bar‐Din Miriam , MacLean Catherine , Sullivan Erin M. , Herbert Robert J. , Yelin Edward H.
Published: March 2003

Abstract: We compared medical resource use and costs among rheumatoid arthritis (RA) patients receiving alternative disease‐modifying antirheumatic drugs (DMARDs). The cohort study used data from a managed care organization. Health plan members who were prescribed DMARD therapy for at least 2 consecutive months, were age 18 years or older, had at least 6 months of DMARD‐free enrollment prior to the first DMARD, and had a diagnosis of RA before or during the first month of DMARD were eligible. Median duration of initial DMARD therapy was 10 months overall: 11 months for hydroxychloroquine (n = 252), 15 months for methotrexate (n = 185), 5 months for sulfasalazine (n = 49), and 5 months for other mono/combination therapy (n = 85) (p < 0.0001). The average monthly cost of care was $853, of which $294 (34%) was for RA‐coded medical services. In multivariate analyses, monthly RA‐coded costs varied significantly by initial DMARD. RA costs and duration of initial therapy varied significantly by initial DMARD.
Performance Evaluation of Plasma Fractionation Membrane
Authors: Zhao Changsheng , Zhang Xiaohua , Yue Yi‐lun
Published: March 2003

Abstract: Membrane plasma fractionation is an important part of double filtration plasmapheresis. We evaluated a newly developed polyethersulfone (PES) hollow‐fiber plasma fractionation membrane, using 3 parameters: abnormal protein ratio (APRR), different protein ratio (DPR), and plasma filtration efficiency, except sieving coefficients. The APRR of the fractionation membrane was over 0.90, and the DPR changed after the plasma fractionation. We also compared the sieving coefficients of the PES hollow membrane with some commercial plasma fractionation membranes. The data were significant for the clinical use of the PES hollow‐fiber fractionation membrane.
The Beneficial Effects of Lymphocytapheresis for Treatment of Nephrotic Syndrome
Authors: Yokoyama Hitoshi , Shimizu Miho , Wada Takashi , Yoshimoto Keiichi , Iwata Yasunori , Shimizu Kazuaki , Sakai Norihiko , Furuichi Kengo , Hisada Yukimasa , Takakuwa Hiroshi , Kobayashi Ken‐ichi
Published: March 2003

Abstract: A considerable permeability factor (or factors) derived from circulating T cells has a crucial role in proteinuria of nephrotic syndrome (NS). We attempted to remove pathogenic T cells through lymphocytapheresis (LCAP) in 6 patients with primary NS, 2 patients with minimal change nephrotic syndrome (MCNS), 2 patients with focal segmental glomerulosclerosis (FSGS), 1 patient with membranous nephropathy (MN), and 1 patient with MN and FSGS using Cellsorba (Asahi Medical Co., Osaka, Japan). LCAP was performed 2 times in 2 consecutive weeks and was followed with corticosteroid therapy with or without cyclosporine A in 5 patients. Two patients with MCNS, 1 with FSGS, and 1 with MN and FSGS showed a dramatic decrease of proteinuria (−30% and −94%) in their urine protein/creatinine ratio. Three out of 4 patients had a complete or partial remission (proteinuria <1g/day) within 8 weeks following immunosuppressive therapy. During the LCAP, T cells, especially activated T cells, decreased significantly in the response group. The other 2 patients, 1 with FSGS and 1 with MN, however, had no response to LCAP and following immunosuppressive therapy or low‐density lipoprotein apheresis and suffered from end‐stage renal failure or death by pneumonia. These results suggested that LCAP might have a beneficial effect on the treatment of NS, especially MCNS and in some patients with FSGS, despite varying responses to LCAP and concomitant immunosuppressive therapy.
Reactive Hemophagocytic Syndrome Associated with Thrombotic Thrombocytopenic Purpura During Therapeutic Plasma Exchange
Authors: Baz Elizabeth M. Kfoury , Mikati Abdel Razzak A. , Kanj Nadim A.
Published: March 2003

Abstract: Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, cytopenia, splenomegaly, and lymphohistiocytic proliferation with hemophagocytosis. Sporadic, familial, and reactive HLH varieties exist. The latter, also termed the reactive hemophagocytic syndrome (RHS), has been associated with a variety of infectious and noninfectious etiologies. Activation of monocytes in RHS is due to stimulation by high levels of activating cytokines. RHS has not been associated previously with thrombotic thrombocytopenic purpura (TTP). TTP is a multisystem disorder characterized by consumptive thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, renal impairment, and fever. We report on a 33 year old male patient with a classic picture of TTP who initially responded to therapeutic plasma exchange but then became refractory to treatment and developed RHS. It is likely that a specific pathophysiology involving the activation of neutrophils during TPE is present for the development of cytokine‐induced hemophagocytosis during TTP treatment. The consequent development of RHS possibly caused early TTP relapse.
Myasthenia Gravis and Lambert‐Eaton Syndrome
Authors: Pascuzzi Robert M.
Published: March 2003

Abstract: Myasthenia gravis is a common autoimmune disorder characterized by the presence of pathogenic antibodies directed against the acetylcholine receptor. Patients present with variable degrees and distribution of fluctuating weakness at times life threatening. Clinical manifestations, establishment of diagnosis, the natural history of myasthenia gravis, and therapeutic options are herein reviewed. Far less common is Lambert‐Eaton syndrome (the myasthenic syndrome), another autoimmune disorder due to the presence of antibodies directed against the PQ‐type voltage‐gated calcium channels. Clinical features and treatment options are summarized.
Designing an Integrated Extracorporeal Therapy Service Quality System
Authors: Riley Jeffrey B. , Justison George A. , Povrzenic Darinka , Zabetakis Paul A.
Published: March 2003

Abstract: Reorganization in clinical operations of a national service provider organization, Fresenius Medical Care Extracorporeal Alliance (FMC‐EA), provided the opportunity to overhaul and integrate quality systems. Under the new structure, the management of acute dialysis, apheresis, open‐heart perfusion, and intraoperative autotransfusion services were combined into an integrated service portfolio supported by a multidisciplinary team of nurses, perfusionists, and technicians. This communication is intended to be a concise review of the literature that establishes the foundation for the new quality system as well as a discussion of the five clinical policies and clinical procedure guidelines that govern clinical behavior in mobile, point of care, acute extracorporeal therapy services. The clinical policy standards are based on recognized essentials and guidelines published by professional organizations, federal and state government agencies, and accreditation groups. The standards list the essential behaviors that clinicians should exhibit during the provision of extracorporeal therapy procedures such as acute therapeutic apheresis. Compliance with the redesigned procedure guidelines and policies will provide the clinical practice platform for continuous quality improvement (CQI) activities, benchmarking, and self‐improvement. These practices can lead to improvements in the quality of care, a decrease in medical errors, and a reduction in overall health care costs.
In Vitro Evaluation of Newly Developed Adsorbent for Selective Removal of Glycosylated Low‐Density Lipoprotein
Authors: Murabayashi Shun , Nishide Takuji , Mitamura Yoshinori
Published: March 2003

Abstract: Chronic hyperglycemia leads to the accumulation of nonenzymatically derived glycosylation products on proteins. Such glycosylation products, especially glycosylated low‐density lipoprotein (glc‐LDL), have been increasingly recognized as factors in the pathogeneses of diabetic complications. A new adsorbent was developed for the selective removal of glc‐LDL from plasma. The adsorbent has dual ligands in order to improve the specific binding affinity for glc‐LDL that consisted of boronic acid moiety for the glycosylated site and acrylic acid (AA) moiety for the apolipoprotein B of LDL. The adsorbent was synthesized by copolymerization of 4‐vinyl phenyl boronic acid and AA. Five kinds of copolymers having different compositions were prepared and evaluated in terms of glc‐LDL in vitro adsorption in human plasma. The adsorption behaviors were different depending on the polymer composition. The adsorbent having the AA composition from 50% to 90% showed very high selectivity for glc‐LDL adsorption. The capability of selective adsorption was not impaired in human plasma. These results suggested that the adsorbent would be a promising material for glc‐LDL apheresis.
Yellow Bush Lupine Invasion in Northern California Coastal Dunes I. Ecological Impacts and Manual Restoration Techniques
Authors: Pickart Andrea J. , Miller Linda M. , Duebendorfer Thomas E.
Published: March 2003

We studied the ecological effects of the invasion of coastal dunes by Lupinus arboreus (yellow bush lupine), an introduced species, and used the results to develop manual restoration techniques on the North Spit of Humboldt Bay. Vegetation and soil data were collected in five vegetation types representing points along a continuum of bush lupine's invasive influence. We collected data on the number and size of shrubs, vegetation cover, and soil nutrients. One set of plots was subjected to two restoration treatments: removal of lupine shrubs only, or removal of all nonnative vegetation and removal of litter and duff. Treatments were repeated annually for four years, and emerging lupine seedlings were monitored for three years. Prior to treatment, ammonium and nitrate were found to increase along the lupine continuum, but organic matter decreased at the extreme lupine end. Yellow bush lupine was not the most significant variable affecting variation in soil nutrients. After four years, nonnative grasses, including Vulpia bromoides, Holcus lanatus (velvet grass), Bromus spp. (brome), and Aira spp. (European hairgrass), were significantly reduced in those restoration plots from which litter and duff was removed. Native species increased significantly in vegetation types that were less influenced by lupine. By the third year, soil variables differed among vegetation types but not by treatment. Bush lupine seedling emergence was higher, however, in plots receiving the litter and duff removal treatment. Based on these results, we conclude that bush lupine invasion results in both direct soil enrichment and indirect enrichment as a result of the associated encroachment of other nonnative species, particularly grasses. Although treatment did not affect soil nutrients during the period of this study, it did reduce establishment of nonnative grasses and recruitment of new bush lupine seedlings. Restoration should therefore include litter and duff removal. In areas that are heavily influenced by lupine and contain few native propagules, revegetation is also required.
Development and N2‐Fixing Activity of the Benthic Microbial Community in Transplanted Spartina alterniflora Marshes in North Carolina
Authors: Piehler M. F. , Currin C. A. , Cassanova R. , Paerl H. W.
Published: March 2003

Growth and maturation of transplanted salt marshes is often limited by the availability of nitrogen (N). We examined the role of N2‐fixing benthic microbial assemblages (microalgae and associated bacteria) in two restored marshes (1‐year‐old and 6‐year‐old marsh) and a natural salt marsh in the Newport River Estuary, North Carolina. Benthic N2 fixation (nitrogenase activity, NA), chlorophyll a (Chl a) concentration, Spartina alterniflora (smooth cordgrass) stem counts, and sediment organic matter content were determined in the three marshes. Significant differences were observed between sites for both Chl a and NA. The 1‐year‐old marsh always exhibited the highest levels of NA and Chl a. Sediment organic matter content was lowest in the 1‐year‐old marsh (∼2%), intermediate in the 6‐year‐old marsh (∼5%), and highest in the natural marsh (∼10%). Carbon and nitrogen analyses were also performed on the 1‐year‐old marsh sediments, which were depleted in N. A positive correlation was observed between surface sediment N and Chl a. Remineralized, microbially derived N may provide growth‐limiting inorganic N to Spartina transplants. N2‐fixing microbial assemblages in the 1‐year‐old marsh may also be an important food source for marsh infauna. Benthic N2‐fixing microbial assemblages play a key role in the N economy of restored salt marshes.
The Role of Thermal Regime in Tundra Plant Community Restoration
Authors: Shirazi M. A. , Haggerty P. K. , Hendricks C. W. , Reporter M.
Published: March 2003

Mineral extraction activities in the Arctic regions of the world produce long‐lasting ecological disturbances. Assisted recovery from such disturbances may require restoration of the tundra thermal regime. We transplanted plugs of entire root zone and live tundra plants to a disturbed site in Alaska oil fields. The dominant species were Carex aquatilis, Eriophorum angustifolium, Dupontia fisheri, Poa glauca, Festuca rubra, Salix ovalifolia, S. reticulata, and Sphagnum spp. We studied plant responses in the plugs to thermal regime manipulations by means of greenhouse and of single‐ or double‐plug treatments. All plugs continued to produce new plants with time and expanded in area and canopy volume. Plants responded differently to treatments and generally reversed those responses when we reversed the greenhouse treatment the third year after transplant. Our small‐scale experiment showed that the native thermal regime of a plant community is vital in revegetating a disturbed tundra. But large‐scale restoration using transplants requires resources of modern extraction technology, engineering, and planning to salvage the extensive live tundra mats now routinely destroyed under gravel fills of roads, structures, and mine‐site stockpiles.
Defining the Limits of Restoration: The Need for Realistic Goals
Authors: Ehrenfeld Joan G.
Published: March 2003

The search for a universal statement of goals for ecological restoration continues to generate discussion and controversy. I discuss the diverse roots of restoration ecology, and show how the complex lineages within the field have led to diverse, and divergent, sets of goals. I then review the three major themes that currently are used to develop statements of goals: restoration of species, restoration of whole ecosystems or landscapes, and the restoration of ecosystem services, and point out both the advantages and the limitations and problems associated with each category. Finally, I suggest that restoration ecology would be better served by recognizing that the diversity of conditions requiring restoration demands much flexibility in goal setting, and that restorationists should seek to develop guidelines for defining the sets of conditions under which different kinds of goals are appropriate. I further suggest that goals would be more easily and more appropriately set if restorationists would set forth at the outset the true scope and limitations of what is possible in a given project.

Key words: goal‐setting, wetlands, conservation biology, ecosystem management, ecosystem services, landscape management.
Effects of Prescribed Fire on Shinnery Oak ( Quercus havardii) Plant Communities in Western Oklahoma
Authors: Boyd Chad S. , Bidwell Terrence G.
Published: March 2003

Changes in structural and compositional attributes of shinnery oak (Quercus havardii Rydb.) plant communities have occurred in the twentieth century. These changes may in part relate to altered fire regimes. Our objective was to document effects of prescribed fire in fall (October), winter (February), and spring (April) on plant composition. Three study sites were located in western Oklahoma; each contained 12, 60 × 30‐m plots that were designated, within site, to be seasonally burned, annually burned, or left unburned. Growing season canopy cover for herbaceous and woody species was estimated in 1997–1998 (post‐treatment). At one year post‐fire, burning in any season reduced shrub cover, and spring burns reduced cover most. Winter and annual fires increased cover of rhizomatous tallgrasses, whereas burning in any season decreased little bluestem cover. Perennial forbs increased with fall and winter fire. Shrub stem density increased with fire in any season. Communities returned rapidly to pre‐burn composition with increasing time since fire. Fire effects on herbaceous vegetation appear to be manifested through increases in bare ground and reduction of overstory shrub dominance. Prescribed fire can be used as a tool in restoration efforts to increase or maintain within and between community plant diversity. Our data suggest that some plant species may require or benefit from fire in specific seasons. Additional research is needed to determine the long‐term effects of repeated fire over time.
Effects of Initial Site Treatments on Early Growth and Three‐Year Survival of Idaho Fescue
Authors: Ewing Kern
Published: March 2003

Prairies in the Pacific Northwest have been actively restored for over a decade. Competition from non‐native woody and herbaceous species has been presumed to be a major cause for the failure of restoration projects. In this research, plugs of the native prairie bunchgrass, Festuca idahoensis Elmer var. roemeri (Pavlick), were grown from seed in a nursery and transplanted into a grassland site dominated by non‐native pasture grasses. The growth of the plants was followed for three years, and biomass of all volunteer plants was measured. Before planting, five treatments were applied to the plots: removal of vegetation by burning, removal of vegetation by an herbicide‐and‐till procedure, soil impoverishment by removal of organic matter, fertilizer application, and compost mulch application. Initial growth of Idaho fescue plugs was greatest with fertilizer and compost mulch. Plants grown in mulched plots were also able to photosynthesize later into the dry summer season. After the first year, plots initially fertilized or composted had the lowest survival rate of Idaho fescue. Impoverished and herbicide‐and‐till plots had the greatest 3‐year survival. Mulched plots supported the greatest weed growth after three years. Stressful environments give a competitive advantage to Idaho fescue in prairie restoration projects. As weedy species increase, growth and survival of Idaho fescue decreases.
Mounding as a Technique for Restoration of Prairie on a Capped Landfill in the Puget Sound Lowlands
Authors: Ewing Kern
Published: March 2003

Closed landfills create large open spaces that are often proposed as sites for restored or created ecosystems. Grasslands are probably prescribed most often because of the presumption that grass root systems will not breach the landfill cap. Capped landfills have a number of soil degradation problems, including compaction, decreased permeability, lack of organic material, diminished soil fauna, inappropriate texture, and lack of structure. In this study in the Puget Sound lowlands, Washington, U.S.A., mounding (low sandy‐loam mounds, about 20 cm high and 2 m in diameter), addition of fertilizer, and mulching with yard‐waste compost were applied to landfill sites as treatments in a factorial‐design experiment. Prairie plants (1,344 individuals, 7 species) were planted into 4‐m2 plots (n = 48), and plant growth and survival and the increase in weed biomass were monitored for 3 years. Mulching had no effect on plant survival or growth. Fertilization had a negative effect on Lupinus lepidus, a nitrogen‐fixing species. Mounding had a positive effect on growth and survival of Eriophyllum lanatum, Festuca idahoensis, and Aster curtus. Potentilla pacifica was indifferent to mounding, and Carex inops responded negatively. Mounds should probably be used as one element of a complex of habitats on restored landfills.
Topsoil Stockpiling Versus Exposure to Traffic: A Case Study on In situ Uranium Wellfields
Authors: Stahl Peter D. , Perryman Barry L. , Sharmasarkar Shankar , Munn Larry C.
Published: March 2003

Management of soils on areas subjected to planned disturbance, such as surface mine sites, is crucial to post‐disturbance restoration. We conducted a study to determine which of the following two topsoil management strategies resulted in less of a negative impact to the soil and vegetation resources and better promoted site restoration on in situ uranium wellfields: (1) removal of topsoil from an entire wellfield and stockpiling until mining activity is complete; or (2) leaving the majority of topsoil on the wellfield and allowing it to be exposed to disturbance associated with wellfield development activity (primarily heavy vehicle traffic). Our study compared selected soil properties from areas on in situ uranium wellfields managed by the two strategies stated above and with adjacent, relatively undisturbed sites. Vegetation reestablishment was assessed on sites where topsoil was left in place. Results indicated that levels of vehicular traffic on wellfields did not cause significant soil compaction and that removal and stockpiling of topsoil results in more negative impacts than disturbance inflicted when topsoil is left in place.
Hydraulic Geometry: A Geomorphic Design Tool for Tidal Marsh Channel Evolution in Wetland Restoration Projects
Authors: Williams Philip B. , Orr Michelle K. , Garrity Nicholas J.
Published: March 2003

Empirical hydraulic geometry relationships for tidal marsh channels are a practical geomorphically based design tool that can assist in the planning of tidal wetland restoration projects. This study provides hydraulic geometry relationships for predicting the depth, width, and cross‐sectional area of mature tidal channels as functions of contributing marsh area or tidal prism. The relationships are based on data from San Francisco Bay coastal salt marshes ranging in size from 2 to 5,700 ha. These hydraulic geometry relationships refine and expand on earlier relationships. Relationships for mature marshes can be used to predict the direction and rate of evolution of a channel in an immature or perturbed marsh system. Channel evolution data for three youthful tidal channels, ages 4 to 13 years, suggest that the channels are converging on their predicted equilibrium morphology. Two channels are eroding in response to significant increases in upstream tidal prism. They have enlarged first by deepening, in one case after 13 years to beyond the predicted equilibrium depth, and then widening through slumping of the channel banks. The third channel, a new one forming in a depositional mudflat, is converging on its equilibrium morphology after 13 years but will likely take several decades to equilibrate.
Response of a Tree Weta Population (Hemideina crassidens) After Eradication of the Polynesian Rat from a New Zealand Island
Authors: Rufaut Catherine G. , Gibbs George W.
Published: March 2003

Abstract A population of Hemideina crassidens (the Wellington tree weta) was monitored over a 4‐year period after the eradication of Rattus exulans (the Polynesian rat kiore) and Gallirallus australis australis (the South Island weka) from Nukuwaiata (Chetwode Islands), Pelorus Sound, New Zealand. A novel survey technique (entrance scores) was used in combination with a conventional technique (random searches for active weta) to measure changes in weta population parameters after the removal of predation pressure and to investigate impacts of exotic predators on tree weta. Tree weta density did not increase markedly over the 4‐year period, but the proportion of active adults did increase. Weta were observed to move into larger and more crowded galleries (refuges), to occupy galleries closer to the ground, and to spend less time sitting in gallery entrances. It was concluded that endemic tree weta are well adapted to withstand some introduced vertebrate predators but are able to live a more “relaxed” lifestyle in the absence of this predation. The most significant change detected was in weta age structure, with adults increasing their proportion of the population.
Peroneal neuropathy after weight loss
Authors: Cruz‐Martinez Antonio , Arpa Javier , Palau Francesc
Published: March 2003

Abstract  The objectives of this study were to evaluate the clinical and electrophysiological findings in peroneal mononeuropathies following a weight‐reduction diet. Thirty patients with acute peroneal palsy and weight loss were studied. Complete nerve conduction studies (NCS) were performed in upper and lower limbs. NCS showed conduction block (CB) of the peroneal nerve at the fibular head that recovered in 29 patients within 3 weeks to 3 months. Severity of CB was correlated with clinical weakness. Three patients had abnormalities consistent with polyneuropathy (PNP). NCS in asymptomatic relatives confirmed familial neuropathy. Nerve biopsy and molecular study were consistent with hereditary neuropathy with liability to pressure palsies (HNPP). One of these peroneal palsies (6 months) recovered after neurolysis. Weight loss might be a risk factor in peroneal mononeuropathies. NCS is a tool in the diagnosis of the site and severity of the nerve injury. Testing should be considered for relatives of patients with PNP because peroneal mononeuropathies may be the first expression of HNPP.
Contribution of cranial nerve ganglia to innervation of the walls of the rat external acoustic meatus
Authors: Folan‐Curran Jean , Cooke Fiachra J.
Published: March 2003

Abstract  The retrograde neuronal tracer, fluorogold, was used to determine the relative contributions of neurons in selected cranial nerve ganglia to the somatosensory innervation of the external acoustic meatus in the rat. Frozen sections from the trigeminal (semilunar), facial (geniculate), glossopharyngeal (superior petrosal) and vagal (jugular) nerve ganglia were examined by epifluoresence microscopy 10 to 14 days after application of the tracer dye fluorogold to the superior, inferior, anterior and posterior walls of the external acoustic meatus. The anterior wall of the canal makes a large contribution to the trigeminal ganglion and a lesser contribution to the other 3 ganglia. The trigeminal ganglion is also a major recipient from the posterior wall with smaller contributions from that wall to the geniculate and vagal ganglia. The superior wall projects a relatively constant supply to all 4 ganglia while the inferior wall primarily relays to the trigeminal and geniculate ganglia sending smaller contributions to the vagal and glossopharyngeal ganglia. In conclusion, neurons in these 4 cranial nerve ganglia contribute an overlapping supply to the 4 walls of the external ear meatus, and there is no evidence of a preferential distribution of nerve supply from one particular ganglion or nerve to specific walls of the external acoustic meatus.
Clinical versus quantitative vibration assessment: improving clinical performance
Authors: Burns Ted M. , Taly Anisya , O'Brien Peter C. , Dyck Peter J.
Published: March 2003

Abstract  In 3 large cohorts (total of 787 patients), clinical vibration impairment (CVI) of the great toe using a tuning fork was compared with quantitative vibration threshold (QVT). Using a stepwise multivariate analysis, we assessed demographic and anthropomorphic patient characteristics associated with the difference between CVI and QVT for the various cohorts and the chosen QVT ranges of percentile abnormality. We also compared CVI or QVT abnormality with a composite score of nerve conduction abnormality to confirm that QVT is a valid measure of severity of neuropathy.

Highly significant associations between CVI and QVT were found in all 3 cohorts studied, regardless of the chosen QVT percentile level of abnormality. However, in the 2 cohorts evaluated by many different physicians, CVI overestimated QVT much more often than underestimated it. The discordance between CVI and QVT in all QVT abnormality percentile levels was associated with age, height and body surface area (BSA) in 1 cohort, with age and BSA in another cohort, and with age in the third cohort. In the third cohort, the correlation between QVT and the composite score of nerve conduction abnormality was significantly higher than the correlation between CVI and the composite score.

Using a tuning fork, neuromuscular physicians overestimate vibration sensation loss more often than when QVT testing is done, which employs quantitative stimuli, a broad range of stimulus magnitudes, null stimuli, validated algorithms of testing and validated reference values. To improve assessment of vibration sensation, physicians should take into account age, height and weight (or body surface area) when judging vibration abnormalities. Applying some useful approaches to quantitative sensory testing might improve the accuracy of clinical sensory testing.
IDENTIFICATION OF THE REGULATORY REGION OF THE PERIPHERAL MYELIN PROTEIN 22 (PMP22) GENE THAT DIRECTS TEMPORAL AND SPATIAL EXPRESSION IN DEVELOPMENT AND REGENERATION OF PERIPHERAL NERVES
Authors: Maier M , Berger P , Nave KA , Suter U
Published: March 2003

Minor changes in PMP22 gene dosage have profound effects on the development and maintenance of peripheral nerves. This is evident from the genetic disease mechanisms in Charcot‐Marie‐Tooth disease type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsies (HNPP) as well as transgenic animals with altered PMP22 gene dosage. Thus, regulation of PMP22 is a crucial aspect in understanding the function of this protein in health and disease. In this study, we have generated transgenic mice containing 10 kb of the 5′‐flanking region of the PMP22 gene, including the two previously identified alternative promoters, fused to a lacZ reporter gene. We show that this part of the PMP22 gene contains the necessary information to mirror the endogenous expression pattern in peripheral nerves during development and regeneration and in mouse models of demyelination due to genetic lesions. Transgene expression is strongly regulated during myelination, demyelination, and remyelination in Schwann cells, demonstrating the crucial influence of neuron‐Schwann cell interactions in the regulation of PMP22. In addition, the region of the PMP22 gene present on this transgene confers also neuronal expression in sensory and motor neurons. These results provide the crucial basis for further dissection of the elements that direct the temporal and spatial regulation of the PMP22 gene and to elucidate the molecular basis of the master program regulating peripheral nerve myelination.
BEDSIDE SCORING PROCEDURE FOR THE DIAGNOSIS OF DIABETIC PERIPHERAL NEUROPATHY IN YOUNG PATIENTS WITH TYPE 1 DIABETES MELLITUS
Authors: Shalitin S , Josefsberg Z , Lilos P , De‐Vries L , Phillip M , Weintrob N
Published: March 2003

Objective: To test the applicability of a bedside scoring method for screening for diabetic peripheral neuropathy (DPN) in patients with type 1 diabetes mellitus (DM) in an ambulatory clinic. The prevalence of DPN was estimated and its risk factors identified. Methods: A total of 217 patients (102 males) with type 1 DM, median age 23.4 years (7.5–49 years) and median duration of DM 13.2 years (1–34 years) were evaluated for DPN using the bedside Neuropathy Disability Score (NDS). A score of 3–5 indicated mild DPN, 6‐8 moderate DPN and 9–10 severe DPN. The presence of DPN was correlated with possible predictive factors. Results: The NDS was reliable and highly reproducible. The overall prevalence of DPN was 17.1%: mild in 14.3%, moderate in 2.3%, and severe in 0.5% of patients. The prevalence and severity of DPN were significantly related to long‐term glycemic control (p<0.001), DM duration (p<0.005), age (p=0.005), and duration of pubertal DM duration (p=0.03). The prevalence of DPN was significantly associated with the presence of retinopathy (p<0.002) and overt proteinuria (p<0.005). Conclusions: The NDS is a simple, reliable and reproducible screening method for use in the ambulatory clinic to identify the early signs of DPN, leading to early institution of intensive diabetes control measures and preventive foot care.
MINIREVIEW—THE FIRST KISS: ESTABLISHMENT AND CONTROL OF INITIAL ADHESION BY RAPHID DIATOMS
Authors: Wetherbee Richard , Lind Jan L. , Burke Jo , Quatrano Ralph S.
Published: March 2003

Minireviews do not have abstracts.