bluuebunny/crossref_metadata_2025 huggingface dataset:
Does a history of peritoneal dialysis result in an impaired gastrointestinal life quality?
Authors: HEINE Gunnar H. , KASTNER Chantal Y. , JAHNKE Thomas , KÖHLER Hans , KUHLMANN Martin K.
Published: October 2007

Peritoneal dialysis (PD) invariably induces sclerotic changes in the peritoneal membrane. The impact of these changes on the well‐being of PD patients has not been studied sufficiently. In a matched‐pair analysis, the gastrointestinal life quality of patients with a history of PD was compared with end‐stage renal disease patients who never performed PD, using a standardized questionnaire (gastrointestinal life‐quality index [GLQI]). We identified all patients in our dialysis unit who underwent PD between 1989 and 2001 and who were alive in October 2001 (PD patients; n=53). Patients who were treated by hemodialysis (HD patients) were recruited as pairs. Hemodialysis and PD patients did not differ in gastrointestinal life quality (GLQI: HD 106.0±16.4 points; PD 104.0±16.7 points; p=0.70). Gastrointestinal life quality was neither correlated with the number of peritonitis episodes, nor with the duration of PD treatment. Peritoneal dialysis treatment is not associated with a long‐term impairment of gastrointestinal life quality.
Challenges and limitations of maintenance hemodialysis in urban South India
Authors: SANKARASUBBAIYAN Suresh , RAJKUMAR Avinash , TANGALVADI Tausif Ahmed , DAWOOD Ubaidullah Shaik , KAUR Prabhdeep
Published: October 2007

Maintenance hemodialysis is a treatment modality available to few patients reaching end‐stage renal disease in India. However, the morbidity and outcome of such treatment remains largely unknown. A retrospective cohort of patients commencing hemodialysis in a secondary care institution in India between January 1, 2002 and December 31, 2004 was studied. Patient demographics, cardiac status, access, hospitalizations, and emergency room visits were assessed and outcomes determined. During the study period, 95 patients (66 males, 29 females) commenced maintenance hemodialysis. The underlying cause of chronic kidney disease was diabetic nephropathy in 66.3% of patients. Cumulative follow‐up was 676+9.1 patient months. The mean serum creatinine (+SD) at initiation of dialysis was 8.39+3.28 mg%. Thirty‐six percent of patients had a functioning arteriovenous fistula at commencement of dialysis, while the remaining 64% of patients required temporary access. The mean number of comorbidities was 1.9+1.0/patient; diastolic dysfunction was deemed to be present in 20.4% of the patients. The hospitalization rate was 3.9/patient year; the number of visits to the emergency room was 4.9/patient year. Cardiac pathology was the most common cause leading to hospitalization and emergency room visits. Diabetic patients were older and had higher cardiac morbidity (p<0.01). The outcome was as follows: 39% transferred to other units; 27% died; 9% switched to CAPD; 8% lost to follow‐up; 1% transplantation: Kaplan‐Meier survival analysis showed a median survival of 410 days. Patients commencing hemodialysis in an urban dialysis center in South India are predominantly male and have significant comorbidity including diabetes and cardiac disease. Outcome is generally poor. Hence, a huge opportunity for improvement exists.
A comparison of center‐based vs. home‐based daily hemodialysis for patients with end‐stage renal disease
Authors: KRAUS Michael , BURKART John , HEGEMAN Rebecca , SOLOMON Richard , COPLON Norman , MORAN John
Published: October 2007

Home hemodialysis has been a therapeutic option for almost 4 decades. The complexity of dialysis equipment has been a factor‐limiting adoption of this modality. We performed a feasibility study to demonstrate the safety of center‐based vs. home‐based daily hemodialysis with the NxStage System One portable hemodialysis device. We also performed a retrospective analysis to determine if clinical effects previously associated with short‐daily dialysis were also seen using this novel device. We conducted a prospective, 2‐treatment, 2‐period, open‐label, crossover study of in‐center hemodialysis vs. home hemodialysis in 32 patients treated at 6 U.S. centers. The 8‐week In‐Center Phase (6 days/week) was followed by a 2‐week transition period and then followed by the 8‐week Home Phase (6 days/week). We retrospectively collected data on hemodialysis treatment parameters immediately preceding the study in a subset of patients. Twenty‐six out of 32 patients (81%) successfully completed the study. Successful delivery of at least 90% of prescribed fluid volume (primary endpoint) was achieved in 98.5% of treatments in‐center and 97.3% at home. Total effluent volume as a percentage of prescribed volume was between 94% and 100% for all study weeks. The composite rate of intradialytic and interdialytic adverse events per 100 treatments was significantly higher for the In‐Center Phase (5.30) compared with the Home Phase (2.10; p=0.007). Compared with the period immediately preceding the study, there were reductions in blood pressure, antihypertensive medications, and interdialytic weight gain. Daily home hemodialysis with a small, easy‐to‐use hemodialysis device is a viable dialysis option for end‐stage renal disease patients capable of self/partner‐administered dialysis.
What is a surrogate marker for optimal dialysis?
Authors: ISHIZAKI Makoto , MATSUNAGA Tomohito , ITAGAKI Ichiro
Published: October 2007

To find a surrogate marker to obtain optimal dialysis delivery from the viewpoint of nutrition, 180 maintenance hemodialysis patients (109 males/71 females) were enrolled between October 1999 and June 2006 at our kidney center. In the 449 hemodialysis treatments, ultrapure dialysis solutions and high‐flux synthetic membranes were utilized. Parameters were measured by Kt/Vurea and postdialysis urea rebound, Kc (the cellular membrane clearance for urea), urea clear space (CS), %creatinine generation rate, %lean body mass, total body water, and so on. We examined the correlation between dialysis delivery and nutritional parameters: Kt/Vurea and postdialysis urea rebound were found to be strongly and negatively correlated with nutritional parameters. However, Kc and CS have shown positive and strong correlations with nutritional parameters such as %creatinine generation rate, %lean body mass, and total body water as well. In addition, the age factor was correlated with Kt/Vurea positively, and it influenced Kc and CS negatively. As a conventional dialysis parameter, Kt/Vurea did not reflect nutrition, but Kc was found to improve nutrition due to the increase of the dialysis delivery. Therefore, Kc might be a reliable surrogate marker for optimal dialysis.
High‐Temperature Structural Phase Transition in Ca0.7Ti0.7La0.3Al0.3O3: Investigation by Synchrotron X‐Ray Diffraction
Authors: Ravi Guttamindapalli A. , Azough Feridoon , Freer Robert , Cernik Robert J. , Bell Anthony M. T.
Published: October 2007

Mixed‐oxide prepared Ca0.7Ti0.7La0.3Al0.3O3(CTLA) ceramics (≈96% dense), grain size 6–7 μm, with dielectric properties (at 4 GHz) of ɛr≈46,Q×f≈38 000 GHz, and τf+13 ppm/°C, were studied at 25°–1300°C using synchrotron X‐ray powder diffraction. At room temperature, CTLA exhibits a distorted orthorhombic structure, with two tilt systems:a=5.40383 (4) Å,b=5.41106 (6) Å, andc=7.64114 (7) Å with space groupPbnm. At 1050°±25°C, there is a transition from orthorhombic (Pbnm) to tetragonal (I4/mcm), with a simpler tilt arrangement. The lattice parameters at 1100°C were:a=5.44285 (4) Å andc=7.68913 (8) Å.
SEM/EDX Characterization of the Hydration Products of Belite Cements from Class C Coal Fly Ash
Authors: Goñi Sara , Guerrero Ana
Published: October 2007

This paper presents the microscopic characterization of two types of fly ash belite cements and their hydration products by means of scanning electron microscopy, energy‐dispersive X‐ray microanalysis, and X‐ray diffraction analysis. The cements were obtained from ASTM class C coal fly ash by the hydrothermal–calcination route in water (FABC‐2‐W) and NaOH 1M solution (FABC‐2‐N). The hydration was studied during a period of 180 days at 21°C and >95% RH. The results showed significant incorporation of aluminum (Al) into the C–S–H gel and other minor elements, with a presumable composition close to that of aluminum‐tobermorite. The C–S–H composition of the FABC‐2‐W is more stable over the hydration time than that of the FABC‐2‐N cement. Portlandite is scarcely formed during hydration.
Evidence for male‐ and juvenile‐specific contact pheromones of the common bed bug Cimex lectularius
Authors: Siljander Eric , Penman Dan , Harlan Harold , Gries Gerhard
Published: October 2007

Males and females of the common bed bug, Cimex lectularius L. (Heteroptera: Cimicidae), have been shown to produce and respond to an aggregation pheromone. We tested whether juvenile C. lectularius also produce and respond to aggregation pheromone, and whether the pheromone is perceived by contact chemoreception. In dual‐choice laboratory experiments, juveniles, but not males or females, preferred juvenile‐exposed paper discs to control discs. Unlike juveniles, males and females preferred male‐exposed paper discs to control discs. Neither juveniles, males, nor females preferred female‐exposed discs to control discs. When test stimuli were inaccessible, C. lectularius failed to show any preference. Male‐ and juvenile‐specific contact pheromones may have contrasting functions of marking shelters as safe refugia for development and growth (juveniles) or mate encounter (adults), but result in the same phenomenon, the aggregation of conspecifics.
Stable isotopes as markers to investigate host use by Rhyzopertha dominica
Authors: Mahroof Rizana M. , Phillips Thomas W.
Published: October 2007

Rhyzopertha dominica (F.) (Coleoptera: Bostrichidae) is a serious worldwide pest of stored cereal grains that also has the ability to breed in non‐agricultural host plant material. Stable isotope signatures (concentrations of isotopes) were used as internal tissue markers to determine dietary differences among adult R. dominica and to make inferences about source habitats of field‐trapped insects. Adult R. dominica collected near granaries or from non‐agricultural forested sites near Stillwater, OK, USA, and insects reared on selected hosts under laboratory conditions were studied to determine the carbon and nitrogen isotope signatures. Laboratory‐reared R. dominica showed δ13C (stable isotope ratio of carbon) values similar to the host on which they developed with an enrichment of about 1 in the insect body. Insects reared on seeds of wheat and oak, which have C3 photosynthetic pathways, showed much depleted δ13C values (–23.7 and –26.2, respectively) in comparison to insects reared on seeds of corn, a C4 photosynthetic plant (–11.3). A majority of the field‐collected R. dominica showed δ13C values similar to expectations for a C3 host. However, a few field‐collected insects had δ13C signatures similar to the C4 plant‐reared insects in the laboratory experiment. Stored grain of C4 crops were lacking at many of the sample field sites. These results suggest that R. dominica occurs on either C3‐ or C4‐based hosts in the field, and point to utilization of non‐grain C4 plants as hosts. Our studies indicated that 13C isotope is a reliable marker to infer types of hosts used in the feeding history of R. dominica.
The additional therapeutic effect of group music therapy for schizophrenic patients: a randomized study
Authors: Ulrich G. , Houtmans T. , Gold C.
Published: October 2007

Objective:  Schizophrenia is one of the most serious mental disorders. Music therapy has only recently been introduced as a form of treatment. The aim of this study was to examine the effect of music therapy for schizophrenic in‐patients needing acute care.

Method:  Thirty‐seven patients with psychotic disorders were randomly assigned to an experimental group and a control group. Both groups received medication and treatment indicated for their disorder. Additionally, the experimental group (n = 21) underwent group music therapy.

Results:  Significant effects of music therapy are found in patients’ self‐evaluation of their psychosocial orientation and for negative symptoms. No differences were found in the quality of life.

Conclusion:  Musical activity diminishes negative symptoms and improves interpersonal contact. These positive effects of music therapy could increase the patient’s abilities to adapt to the social environment in the community after discharge from the hospital.
Physical illness and schizophrenia: a review of the literature
Authors: Leucht S. , Burkard T. , Henderson J. , Maj M. , Sartorius N.
Published: October 2007

Objective: The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation.

Method: We searched MEDLINE (1966 – May 2006) combining the MeSH term of schizophrenia with the 23 MeSH terms of general physical disease categories to identify relevant epidemiological studies.

Results: A total of 44 202 abstracts were screened. People with schizophrenia have higher prevalences of HIV infection and hepatitis, osteoporosis, altered pain sensitivity, sexual dysfunction, obstetric complications, cardiovascular diseases, overweight, diabetes, dental problems, and polydipsia than the general population. Rheumatoid arthritis and cancer may occur less frequently than in the general population. Eighty‐six per cent of the studies came from industrialized countries limiting the generalizability of the findings.

Conclusion: The increased frequency of physical diseases in schizophrenia might be on account of factors related to schizophrenia and its treatment, but undoubtedly also results from the unsatisfactory organization of health services, from the attitudes of medical doctors, and the social stigma ascribed to the schizophrenic patients.
IgG against extracellular subdomains of desmoglein 3 relates to clinical phenotype of pemphigus vulgaris
Authors: Müller Ralf , Svoboda Vera , Wenzel Elke , Müller Hans‐Helge , Hertl Michael
Published: October 2007

Abstract:  Pemphigus vulgaris (PV) is associated with autoantibodies against desmoglein (Dsg) 3 inducing epidermal loss of adhesion. The major pathogenic epitopes of Dsg3 are presumably dependent of their conformation. The aim of this study was to characterize the IgG reactivity of sera from a cohort of clinically well‐characterized PV patients against presumably non‐conformational subdomains of the Dsg3 ectodomain including recently described NH2‐terminal immunodominant epitopes. By ELISA, IgG reactivity against distinct subdomains of Dsg3 was related to disease activity and the clinical phenotype of PV patients. Our findings suggest that (i) autoantibody from PV sera react with non‐conformational epitopes of Dsg3; (ii) IgG reactivity against the NH2‐terminus and the extracellular domains (EC) 2‐4 of Dsg3 was associated with active PV, while IgG titres were not strictly correlated with disease activity and (iii) IgG reactivity against the EC1‐4 was associated with mucosal dominant PV and was decreased in cutaneous dominant PV. The findings may help to define more refined serological disease markers of PV.
Ultraviolet B‐induced alterations of the skin barrier and epidermal calcium gradient
Authors: Jiang Shao Jun , Chu Ai Wu , Lu Zhen Feng , Pan Min Hong , Che Dun Fa , Zhou Xiao Jun
Published: October 2007

Abstract:  Ultraviolet irradiation induces a variety of cutaneous changes, including epidermal permeability barrier disruption. In the present study, we assessed the effects of ultraviolet B (UVB) irradiation in epidermal barrier function and calcium distribution in murine epidermis. Adult hairless mice were exposed to a single dose of UVB (0.15 J/cm2). Barrier function was evaluated by transepidermal water loss (TEWL), lanthanum perfusion. The morphological alterations were examined by histology, immunohistochemistry and electron microscopy using ruthenium tetroxide (RuO4) postfixation. For evaluation of the effect on epidermal calcium distribution, the ion‐capture cytochemistry was employed. UVB irradiation caused a significant increase in TEWL, which peaked at day 4. In parallel, the increased number of sunburn cells and the changes in epidermal hyperplasia and proliferation were observed. Electron microscopic observation demonstrated that the water‐soluble lanthanum tracer was present in the extracellular stratum corneum domains, and the increased intercellular permeability was correlated with defective organization of the extracellular lipid lamellar bilayers of the stratum corneum. Moreover, UVB irradiation also caused an appearance of calcium precipitates in the stratum corneum and transitional cell layers as well as the increased cytosolic calcium in the lower epidermis, reflecting the alterations of the epidermal calcium gradient. These results suggest that the changes of the epidermal calcium distribution pattern may correlate with the perturbation of the epidermal barrier induced by UVB irradiation.
Transdermal delivery of proteins mediated by non‐covalently associated arginine‐rich intracellular delivery peptides
Authors: Hou Yu‐Wun , Chan Ming‐Huan , Hsu Hui‐Ru , Liu Betty Revon , Chen Chung‐Pin , Chen Hwei‐Hsien , Lee Han‐Jung
Published: October 2007

Abstract: Plasma membranes of animal cells are generally impermeable to macromolecules. Protein transduction mediated by protein transduction domains (PTDs) covalently cross‐linked to cargoes for cellular internalization has previously been demonstrated. Peptides with PTDs could be an effective way to deliver proteins into living cells or tissuesin vitro. In this report, we demonstrate that arginine‐rich intracellular delivery (AID) peptides are able to facilitate the delivery of proteins into animal cells and to penetrate skin tissues rapidly. This cellular internalization and transdermal delivery of proteins is mediated by non‐toxic AID peptides in a non‐fusion protein and non‐conjugation dependent manner. The efficiency of intracellular transport is further increased in the presence of chemical enhancer oleic acid. The mechanism of the AID‐mediated cellular entry may involve macropinocytosis and actin rearrangement. Thus, we confirm that direct delivery of bioactive proteins into living cells and tissues mediated by non‐covalent actions of AID peptides represents a useful strategy in pharmaceutics, therapeutics and cosmetics.
Targeting of Sp1 transcription factor: a novel therapeutic approach for Keloids, an in vitro analysis
Authors: Mukhopadhyay A. , Khoo A. , Cheong H. H. , Chan S. Y. , Aalami O. , Lim I. J. , Phan T. T.
Published: October 2007

Abstract:  Keloid scars are fibroproliferative disorders characterized by the accumulation of extracellular matrix (ECM) components resulting in a fibrotic condition. Several ECM promoters are regulated by Sp1. Thus, our aim was to investigate the role of Sp1 in keloid pathogenesis and investigate the antiproliferative and antifibrotic effects of Wp631 and mitoxantrone, potent inhibitors of Sp1‐activated transcription. An elevated level of Sp1 was observed in tissue extracts obtained from keloid tissue. Serum stimulation elevated Sp1 levels in keloid fibroblasts (KF). Under coculture conditions Sp1 seemed to be downregulated. Wp631 and mitoxanthrone in serum growth factors resulted in a reduced expression of ECM components in KF. Both Wp631 and mitoxanthrone were also able to inhibit the proliferation of normal and keloid keratinocytes and fibroblasts significantly. As Wp631 seems to be potent in downregulating the ECM components in KF and also inhibiting the proliferation of these cells it could be explored as a possible therapeutic agent in the treatment of keloids.
High genetic introgression in alpine brown trout (Salmo trutta L.) populations from Hardangervidda, Norway
Authors: Sønstebø J. H. , Borgstrøm R. , Heun M.
Published: October 2007

Abstract –  We studied the effect of stocking brown trout in three alpine lakes (Skavatn, Midtre Grøndalsvatn and Nordmannslågen) of the Hardangervidda mountain plateau by comparing microsatellite data from historical (1933 and 1967) and contemporary (2003) population samples. Historical and contemporary samples from a control lake (Krokavatn) and a contemporary sample from Gjuvsjå (suspected donor lake) were included as well. A total of 331 brown trout were genotyped with 11 microsatellites. Very low level of genetic diversity is observed in the historical samples from Nordmannslågen and Midtre Grøndalsvatn but not in the contemporary samples. In Skavatn historical and contemporary samples show similar genetic diversity as in the other contemporary samples. Admixture analyses with the structure program indicate high levels of introgression by nonnative brown trout in all three lakes. The stocking source for two lakes (i.e. from Gjuvsjå) is partially verifiable via our analyses. The high introgression in these lakes is discussed and the management issues are briefly addressed.
Bone sialoprotein and its transcriptional regulatory mechanism
Authors: Ogata Y.
Published: October 2007

Background and Objective:  Bone sialoprotein is a mineralized tissue‐specific noncollagenous protein that is glycosylated, phosphorylated and sulfated. The temporo‐spatial deposition of bone sialoprotein into the extracellular matrix of bone, and the ability of bone sialoprotein to nucleate hydroxyapatite crystal formation, indicates a potential role for bone sialoprotein in the initial mineralization of bone, dentin and cementum. Bone sialoprotein is also expressed in breast, lung, thyroid and prostate cancers.

Material and Methods:  We used osteobast‐like cells (rat osteosarcoma cell lines ROS17/2.8 and UMR106, rat stromal bone marrow RBMC‐D8 cells and human osteosarcoma Saos2 cells), and breast and prostate cancer cells to investigate the transcriptional regulation of bone sialoprotein. To determine the molecular basis of the transcriptional regulation of the bone sialoprotein gene, we conducted northern hybridization, transient transfection analyses with chimeric constructs of the bone sialoprotein gene promoter linked to a luciferase reporter gene and gel mobility shift assays.

Results:  Bone sialoprotein transcription is regulated by hormones, growth factors and cytokines through tyrosine kinase, mitogen‐activated protein kinase and cAMP‐dependent pathways. Microcalcifications are often associated with human mammary lesions, particularly with breast carcinomas. Expression of bone sialoprotein by cancer cells could play a major role in the mineral deposition and in preferred bone homing of breast cancer cells.

Conclusion:  Bone sialoprotein protects cells from complement‐mediated cellular lysis, activates matrix metalloproteinase 2 and has an angiogenic capacity. Therefore, regulation of the bone sialoprotein gene is potentially important in the differentiation of osteoblasts, bone matrix mineralization and tumor metastasis. This review highlights the function and transcriptional regulation of bone sialoprotein.
Comparative analysis of putative periodontopathic bacteria by multiplex polymerase chain reaction
Authors: Morikawa M. , Chiba T. , Tomii N. , Sato S. , Takahashi Y. , Konishi K. , Numabe Y. , Iwata K. , Imai K.
Published: October 2007

Background and Objective:  The polymerase chain reaction (PCR) has been applied for the rapid and specific detection of periodontopathic bacteria in subgingival plaque and is potentially of clinical benefit in the diagnosis and treatment of periodontitis subjects. However, several technical points need to be modified before the conventional PCR detection system can be used by clinicians.

Material and Methods:  To develop a PCR‐based technique more applicable for clinical use than conventional PCR, we established a multiplex PCR for five putative periodontopathic (Treponema denticola, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia) and two nonperiodontopathic (Streptococcus sanguinis and Streptococcus salivarius) species of bacteria using whole‐plaque suspension as templates, and detected bacteria in subgingival plaque taken from 85 subjects at the supportive periodontal therapy stage after active periodontal treatments.

Results:  Among putative periodontopathic bacteria, the detection frequency of T. denticola and P. gingivalis was elevated in parallel with higher probing pocket depth and clinical attachment loss, and had 4.2–14.1 times increasing odds of the clinical parameters tested. Detection of any of the five species of putative periodontopathic bacteria markedly increased the odds ratio of a higher probing pocket depth, clinical attachment loss and bleeding on probing.

Conclusion:  The multiplex PCR system developed in this study enabled the detection of all the bacteria under investigation in one reaction tube in a less time‐ and labor‐intensive manner than conventional PCR. These results support the potential clinical use of multiplex PCR for detecting periodontopathic bacteria and for evaluating therapeutic strategies and predicting the prognosis for each subject.
Heritability of specific language impairment depends on diagnostic criteria
Authors: Bishop D. V. M. , Hayiou‐Thomas M. E.
Published: October 2007

Heritability estimates for specific language impairment (SLI) have been inconsistent. Four twin studies reported heritability of 0.5 or more, but a recent report from the Twins Early Development Study found negligible genetic influence in 4‐year‐olds. We considered whether the method of ascertainment influenced results and found substantially higher heritability if SLI was defined in terms of referral to speech and language pathology services than if defined by language test scores. Further analysis showed that presence of speech difficulties played a major role in determining whether a child had contact with services. Childhood language disorders that are identified by population screening are likely to have a different phenotype and different etiology from clinically referred cases. Genetic studies are more likely to find high heritability if they focus on cases who have speech difficulties and who have been referred for intervention.
Particularities in managing melanoma patients with tattoos:case report and review of the literature
Authors: Gall Natalie , Bröcker Eva‐Bettina , Becker Jürgen C.
Published: October 2007

Assessing pigmented lesions within or covered by tattoos is difficult, both at a clinical and dermatoscopic level. Patients with tattoos may provide a challenge in the early recognition and follow‐up of melanoma.
Prehospital analgesia in adults using inhaled methoxyflurane
Authors: Buntine Paul , Thom Ogilvie , Babl Franz , Bailey Michael , Bernard Stephen
Published: October 2007

Objective:  For many years, ambulance services throughout Australia have been administering methoxyflurane as a first‐line analgesic agent. However, there is a paucity of literature regarding its efficacy, safety and usage profile. The present study was designed to examine the efficacy of methoxyflurane in adults.

Methods:  An observational case series was conducted over a 10 month period. Adults to whom methoxyflurane was administered while traveling by ambulance to an urban teaching hospital were enrolled. Data analysed included indications for use, verbal numerical pain scores, depth of sedation and adverse effects. Data were collected via paramedic, patient and ED staff surveys.

Results:  Eighty‐three adult patients were enrolled over a 10 month period. A mean reduction in verbal numerical rating scale (VNRS) scores of 2.47 ± 0.24 (on a 10‐point scale) was recorded 5 min post methoxyflurane, with a total reduction of 3.21 ± 0.24 at time of arrival at the ED. Both VNRS scores were significantly different from baseline (P < 0.0001). Fifteen patients (18.1%, 95% CI 9.8–26.4%) reported mild side‐effects either during or shortly after administration. A total of 68 (81.9%, 95% CI 72.0–89.5%) of the paramedics and 60 (72.3%, 95% CI 61.4–81.6%) of the patients interviewed said that they felt satisfied with the level of analgesia provided by methoxyflurane.

Conclusion:  The use of methoxyflurane as a prehospital analgesic significantly reduced pain in patients, with no significant side‐effects attributed to its use. The majority of patients and paramedics interviewed were satisfied with its effects and indicated a willingness to use it again.
Use of information technology in New Zealand emergency departments
Authors: Tan Eunicia , Yates Kim M
Published: October 2007

Objectives:  To determine previous computer training and current computer confidence of emergency medicine (EM) specialists and trainees, and to determine the accessibility of computer and Internet resources in New Zealand ED.

Methods:  A prospective, cross‐sectional study of all New Zealand EM specialists and trainees between July 2005 and October 2005, using a 47‐item postal questionnaire. Descriptive statistics with 95% confidence intervals were compiled. Fisher's exact test was used to compare proportions, with t‐test and Mann–Whitney U‐test to compare continuous variables.

Results:  A total of 226 EM specialists and trainees were sent questionnaires. In total, 144 (62 specialists and 82 trainees) out of 224 were analysed (response rate 64.3%). The majority of respondents (136, 94.4% (95% CI 89.4–97.6)) had access to a computer at home. Almost all respondents (143, 99.3% (95% CI 96.2–100.0)) also had computer access in the ED 24 h/day. The vast majority (140, 97.2% (95% CI 93.0–99.2)) had access to medical educational materials via the Internet in the ED 24 h/day. Most respondents had limited prior computer training. Respondents felt most confident using word processing and e‐mail/communications applications, and least confident using statistical and graphics programs. Compared with specialists, trainees were significantly less confident with spreadsheets (P = 0.002), literature searching (P = 0.034), and e‐mail/communications (P = 0.040).

Conclusions:  Increased access to computer technology has not been parallelled by increased confidence in the use of computers among EM specialists and trainees. Training must address gaps in computer literacy if computer technology is to be used to its full potential.
Efficient Use of the Iron Ortho‐Nitrophenylporphyrin Chloride to Mimic Biological Oxidations of Dimethylaminoantipyrine
Authors: Bazin Marc J. , Shi Helen , Delaney Jeannine , Kline Billie , Zhu Zhendong , Kuhn Cyrille , Berlioz Francoise , Farley Kathleen A. , Fate Gwen , Lam Wing , Walker Gregory S. , Yu Linning , Pollastri Michael P.
Published: October 2007

Major metabolites of dimethylaminoantipyrine have been synthesized using iron ortho‐nitrophenylporphyrin chloride as biomimetic catalyst. Reactivity of iron tetrakis‐ortho‐nitrophenylporphyrin chloride [Fe(TNO2PP)Cl] has been compared with iron tetrakis‐pentafluorophenylporphyrin chloride and iron tetrakis‐2,6‐dichlorophenylporphyrin chloride using various oxidants such as hydrogen peroxide, iodosobenzene, and cumene hydroperoxide in either protic or aprotic solvent. Effect of imidazole has been showed on the reactivity of Fe(TNO2PP)Cl/cumene hydroperoxide system.
Dihydropyridine Derivatives to Overcome Atypical Multidrug Resistance: Design, Synthesis, QSAR Studies, and Evaluation of Their Cytotoxic and Pharmacological Activities
Authors: Mehdipour Ahmad R. , Javidnia Katayoun , Hemmateenejad Bahram , Amirghofran Zahra , Miri Ramin
Published: October 2007

Multidrug resistance (MDR) is defined as resistance of tumor cells to the cytotoxic action of multiple structurally dissimilar and functionally divergent drugs commonly used in chemotherapy. Until now, there is no evidence for the effect of 1,4‐dihydropyridines (DHPs) on atypical MDR, although there are some indications about the effect of DHPs on p‐glycoprotein‐mediated MDR. However, it was reported that a DHP derivative (Dexniguldipine) inhibited human DNA topoisomerase I through a non‐competitive mechanism. Therefore, some derivatives of DHP were synthesized and their effect in reversing atypical MDR was evaluated. The results showed that two compounds were the potent reversals of atypical MDR. In addition, the intrinsic cytotoxicity of compounds was determined on four different cell lines. Furthermore, their Ca2+ channel blocking activity was evaluated and showed a clear structure‐activity relationship (SAR) trend according to the moieties in C‐4 position which confirmed the importance of C‐4 moiety on Ca2+ channel blocking.
Signposts of Docking and Scoring in Drug Design
Authors: Gani Osman A .B. S. M.
Published: October 2007

Docking and scoring tools are often used in the early stages of drug discovery projects today. Because the language of this field of drug design often includes intermingled terms of physics, chemistry, biology, and medicine, the significant developments of docking and scoring are challenging to follow for non‐experts. In this Science Philosophy article, I attempt to clarify the concepts used in docking and scoring to help articulate the successes and limitations of this multidisciplinary field in more comprehensible manner.
Evaluation of the root dentine cutting effectiveness of the HERO 642®, HERO Apical® and HERO Shaper® Rotary Systems
Authors: Câmara Andréa Cruz , Aguiar Carlos Menezes , De Figueiredo Jose Antonio Poli
Published: October 2007

Different HERO rotary systems were evaluated by pre‐ and postoperative images of a cross‐section of their mesiobuccal root thirds with a stereoscopic magnifier (45×). Fifty mesiobuccal canals of human mandibular first molars were divided into five groups: 1 – HERO 642®; 2 – HERO 642® and HERO Apical®; 3 – HERO Shaper®; 4 – HERO Shaper® and HERO Apical®; 5 – NitiFlex files. The perimeter of the canal was calculated using Image Tool software (UTHSCA). Final, post‐instrumentation perimeters were compared by Kruskal–Wallis test (P = 0.05). The distribution of the values of the final canal perimeter for each instrumentation method was not statistically significant in any of the thirds (P = 0.174, cervical third; P = 0.874, middle third; and P = 0.631, apical third). An increase in canal perimeter was observed in all groups. In the cervical third the greatest increase was Group 5; in the middle third, Group 4, and in the apical third, Group 2.
Flare‐ups in endodontics and their relationship to various medicaments
Authors: Ehrmann Ernest H. , Messer Harold H. , Clark Robert M.
Published: October 2007

The purpose of this research is to investigate the frequency of endodontic flare‐ups using a visual analogue scale. Definitions of flare‐ups vary widely as does their reported frequency. A flare‐up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare‐ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare‐up rates at both the 4‐h and 24‐h periods between the three modalities. Further research is required using the above definition of a flare‐up and standardising treatment protocols.
Computed tomography assessment of three techniques for removal of filling material
Authors: Barletta Fernando Branco , De Sousa Reis Magda , Wagner Márcia , Borges Janusa Casali , Dall'Agnol Cristina
Published: October 2007

In this study, computed tomography (CT) was used to assess three techniques for root canal filling removal. Seventy‐five roots of extracted human lower incisors were filled with zinc oxide‐eugenol sealer and gutta‐percha and separated into three groups before gutta‐percha removal (group 1, Gates Glidden burs + K‐type hand instrumentation; group 2, K‐type reciprocating instrumentation + NSK TEP E16R; group 3, ProTaper rotary instrumentation + NSK NAC E16R). Specimens were CT‐scanned before and after filling removal. The mean rate of filling removal was 94.88%. Reciprocating instrumentation was the most effective and manual instrumentation associated with Gates Glidden burs was the least effective technique. Removal rate was significantly different for the three groups according to one‐way anova (P = 0.049). The Tukey test showed a significant difference between groups 1 and 2 (P = 0.039) only. CT proved to be a reliable method for assessing root filling removal techniques.
The effects of hypoxia and hypercapnia on renal and heart function, haemodynamics and plasma hormone levels in stable COPD patients*
Authors: Hemlin Mats , Ljungman Susanne , Carlson Jan , Maljukanovic Svetlana , Mobini Reza , Bech‐Hanssen Odd , Skoogh Bengt‐Eric
Published: October 2007

Background:  Fluid retention with oedema is an important clinical problem in advanced chronic obstructive pulmonary disease (COPD).

Objective:  The aim of this study was to investigate cardiovascular, hormonal, renal and pulmonary function data and their possible relation to fluid retention in COPD.

Methods:  The study group consisted of 25 stable outpatients with COPD. The presence of oedema was assessed by clinical examination and the intake of diuretics was recorded. Glomerular filtration rate (GFR) and the renal blood flow (RBF) were measured. Lung function was assessed with standard spirometry. Cardiac function and haemodynamic variables were studied using echocardiography and equilibrium radionucleotide angiography. The plasma levels of noradrenaline, plasma renin activity, angiotensin II, aldosterone, atrial natriuretic peptide, brain natriuretic peptide and antidiuretic hormone were measured.

Results:  Systolic and diastolic cardiac functions were found to be well preserved in the patients. Hypercapnia and impaired lung function, but not hypoxia, were clearly associated with oedema/intake of diuretics, low diuresis, low GFR, low RBF and high renal vascular resistance. These effects had no significant relationship to central haemodynamics or the measured plasma hormone levels.

Conclusions:  In stable COPD, renal fluid retention and oedema are enhanced by hypercapnia‐induced renal vasoconstriction and antidiuresis. In contrast to some earlier reports, this effect does not seem to be mediated via the central haemodynamic reflex systems or the measured plasma hormones. In addition, hypoxia had no significant effect on fluid retention in this group of patients.

Please cite this paper as: Hemlin M, Ljungman S, Carlson J, Maljukanovic S, Mobini R, Bech‐Hanssen O and Skoogh B‐E. The effects of hypoxia and hypercapnia on renal and heart function, haemodynamics and plasma hormone levels in stable COPD patients. The Clinical Respiratory Journal 2007; 1:80–90.
Neural drive to human genioglossus in obstructive sleep apnoea
Authors: Saboisky Julian P. , Butler Jane E. , McKenzie David K. , Gorman Robert B. , Trinder John A. , White David P. , Gandevia Simon C.
Published: October 2007

One postulated mechanism for obstructive sleep apnoea (OSA) is insufficient drive to the upper‐airway musculature during sleep, with increased (compensatory) drive during wakefulness. This generates more electromyographic activity in upper airway muscles including genioglossus. To understand drives to upper airway muscles, we recorded single motor unit activity from genioglossus in male groups of control (n= 7, 7 ± 2 events h−1) and severe OSA (n= 9, 54 ± 4 events h−1) subjects. One hundred and seventy‐eight genioglossus units were recorded using monopolar electrodes. Subjects were awake, supine and breathing through a nasal mask. The distribution of the six types of motor unit activity in genioglossus (Inspiratory Phasic, Inspiratory Tonic, Expiratory Phasic, Expiratory Tonic, Tonic and Tonic Other) was identical in both groups. Single unit action potentials in OSA were larger in area (by 34%, P < 0.05) and longer in duration (by 23%, P < 0.05). Inspiratory units were recruited earlier in OSA than control subjects. In control subjects, Inspiratory Tonic units peaked earlier than Inspiratory Phasic units, while in OSA subjects, Inspiratory Tonic and Phasic units peaked simultaneously. Onset frequencies did not differ between groups, but the peak discharge frequency for Inspiratory Phasic units was higher in OSA (22 ± 1 Hz) than control subjects (19 ± 1 Hz, P= 0.003), but conversely, the peak discharge frequency of Inspiratory Tonic units was higher in control subjects (28 ± 1 Hz versus 25 ± 1 Hz, P < 0.05). Increased motor unit action potential area indicates that neurogenic changes have occurred in OSA. In addition, the differences in the timing and firing frequency of the inspiratory classes of genioglossus motor units indicate that the output of the hypoglossal nucleus may have changed.
Properties of the major classes of mechanoreceptors in the guinea pig bladder
Authors: Zagorodnyuk Vladimir P. , Gibbins Ian L. , Costa Marcello , Brookes Simon J. H. , Gregory Sarah J.
Published: October 2007

Sensory neurons represent an attractive target for pharmacological treatment of various bladder disorders. However the properties of major classes of mechano‐sensory neurons projecting to the bladder have not been systematically established. An in vitro bladder preparation was used to examine the effects of a range of mechanical stimuli (stretch, von Frey hair stroking and focal compression of receptive fields) and chemical stimuli (1 mmα,β‐methylene ATP, hypertonic solutions (500 mm NaCl) and 3 μm capsaicin) during electrophysiological recordings from guinea pig bladder afferents. Four functionally distinct populations of bladder sensory neurons were distinguished by these stimuli. The first class, muscle mechanoreceptors, were activated by stretch but not by mucosal stroking with light (0.05–0.1 mN) von Frey hairs or by hypertonic saline, α,β‐methylene ATP or capsaicin. Removal of the urothelium did not affect their stretch‐induced firing. The second class, muscle‐mucosal mechanoreceptors, were activated by both stretch and mucosal stroking with light von Frey hairs or by hypertonic saline and by α,β‐methylene ATP, but not by capsaicin. Removal of the urothelium reduced their stretch‐ and stroking‐induced firing. The third class, mucosal high‐responding mechanoreceptors, were stretch‐insensitive but could be activated by mucosal stroking with light von Frey hairs or by hypertonic saline, α,β‐methylene ATP and capsaicin. Stroking‐induced firing was significantly reduced by removal of the urothelium. The fourth class, mucosal low‐responding mechanoreceptors, were stretch insensitive but could be weakly activated by mucosal stroking with light von Frey hairs but not by hypertonic saline, α,β‐methylene ATP or capsaicin. Removal of the urothelium reduced mucosal stroking‐induced firing. All four populations of afferents conducted in the C‐fibre range and showed class‐dependent differences in spike amplitude and duration. At least four functional classes of bladder mechanoreceptors can be readily distinguished by different mechanisms of activation and are likely to transmit different types of information to the central nervous system.
Kinetics of both synchronous and asynchronous quantal release during trains of action potential‐evoked EPSCs at the rat calyx of Held
Authors: Scheuss V. , Taschenberger H. , Neher E.
Published: October 2007

We studied the kinetics of transmitter release during trains of action potential (AP)‐evoked excitatory postsynaptic currents (EPSCs) at the calyx of Held synapse of juvenile rats. Using a new quantitative method based on a combination of ensemble fluctuation analysis and deconvolution, we were able to analyse mean quantal size (q) and release rate (ξ) continuously in a time‐resolved manner. Estimates derived this way agreed well with values of q and quantal content (M) calculated for each EPSC within the train from ensemble means of peak amplitudes and their variances. Separate analysis of synchronous and asynchronous quantal release during long stimulus trains (200 ms, 100 Hz) revealed that the latter component was highly variable among different synapses but it was unequivocally identified in 18 out of 37 synapses analysed. Peak rates of asynchronous release ranged from 0.2 to 15.2 vesicles ms−1 (ves ms−1) with a mean of 2.3 ± 0.6 ves ms−1. On average, asynchronous release accounted for less than 14% of the total number of about 3670 ± 350 vesicles released during 200 ms trains. Following such trains, asynchronous release decayed with several time constants, the fastest one being in the order of 15 ms. The short duration of asynchronous release at the calyx of Held synapse may aid in generating brief postsynaptic depolarizations, avoiding temporal summation and preserving action potential timing during high frequency bursts.
Antioxidant administration attenuates mechanical ventilation‐induced rat diaphragm muscle atrophy independent of protein kinase B (PKB–Akt) signalling
Authors: McClung J. M. , Kavazis A. N. , Whidden M. A. , DeRuisseau K. C. , Falk D. J. , Criswell D. S. , Powers S. K.
Published: October 2007

Oxidative stress promotes controlled mechanical ventilation (MV)‐induced diaphragmatic atrophy. Nonetheless, the signalling pathways responsible for oxidative stress‐induced muscle atrophy remain unknown. We tested the hypothesis that oxidative stress down‐regulates insulin‐like growth factor‐1–phosphotidylinositol 3‐kinase–protein kinase B serine threonine kinase (IGF‐1–PI3K–Akt) signalling and activates the forkhead box O (FoxO) class of transcription factors in diaphragm fibres during MV‐induced diaphragm inactivity. Sprague–Dawley rats were randomly assigned to one of five experimental groups: (1) control (Con), (2) 6 h of MV, (3) 6 h of MV with infusion of the antioxidant Trolox, (4) 18 h of MV, (5) 18 h of MV with Trolox. Following 6 h and 18 h of MV, diaphragmatic Akt activation decreased in parallel with increased nuclear localization and transcriptional activation of FoxO1 and decreased nuclear localization of FoxO3 and FoxO4, culminating in increased expression of the muscle‐specific ubiquitin ligases, muscle atrophy factor (MAFbx) and muscle ring finger‐1 (MuRF‐1). Interestingly, following 18 h of MV, antioxidant administration was associated with attenuation of MV‐induced atrophy in type I, type IIa and type IIb/IIx myofibres. Collectively, these data reveal that the antioxidant Trolox attenuates MV‐induced diaphragmatic atrophy independent of alterations in Akt regulation of FoxO transcription factors and expression of MAFbx or MuRF‐1. Further, these results also indicate that differential regulation of diaphragmatic IGF‐1–PI3K–Akt signalling exists during the early and late stages of MV.