bluuebunny/crossref_metadata_2025 huggingface dataset:
Response of the wasp (Cotesia glomerata) to larvae of the large white butterfly (Pieris brassicae)
Authors: SATO Yoshibumi , OHSAKI Naota
Published: June 2004

The large white butterfly (Pieris brassicae L) first invaded northernmost Japan from Siberia around 1994, and after a few years, began to expand its range. The wasp, Cotesia glomerata (L) parasitizes larvae of the small white butterfly (Pieris rapae crucivora Boisduval), a usual host in the same geographic area. Some Pieris brassicae larvae in Hokkaido have been parasitized by Cotesia glomerata, but the parasitism rate of Pieris brassicae larvae tends to be lower than that of Pieris rapae. To examine the process of parasitizing Pieris brassicae larvae, we observed how the parasitoid wasp responded to the host larvae on damaged leaves. Cotesia glomerata females tended to avoid Pieris brassicae larvae, and even when female wasps inserted their ovipositors into Pieris brassicae larvae, none laid eggs. The parasitoids obtained from Pieris rapae larvae failed to parasitize Pieris brassicae during the host‐acceptance step.
Social behaviors of all‐male proboscis monkeys when joined by females
Authors: MURAI Tadahiro
Published: June 2004

In a riverine forest along the Menanggul River, which is a tributary of the Kinabatangan River, Sabah, Malaysia, I observed an all‐male group of proboscis monkey (Nasalis larvatus) consisting of 27–30 (mean: 28.8) individuals. This large size of the all‐male group seems to be attributed to habitat fragmentation because of the expansion of oil palm plantations. A few females joined this all‐male group. Sub‐adult females copulated with subadult or large juvenile males. Since the mean male tenure period of this monkey was estimated to be longer than female maturity, and prematured females might leave their natal one‐male groups to avoid inbreeding and temporarily participate in the all‐male group where males were permissive to them. Even when females joined this group, no conflicts occurred among males.
Pilot study to determine the ability of health‐care professionals to undertake drug dose calculations
Authors: Oldridge G. J. , Gray K. M. , McDermott L. M. , Kirkpatrick C. M. J.
Published: June 2004

Abstract

Background: It is essential for health‐care professionals to calculate drug doses accurately. Previous studies have demonstrated that many hospital doctors were unable to accurately convert dilutions (e.g. 1:1000) or percentages (e.g. percentage w/v) of drug concentrations into mass concentrations (e.g. mg/mL).

Aims: The aims of the present study were to evaluate the ability of health‐care professionals to perform drug dose calculations accurately and to determine their preferred concentration convention when calculating drug doses.

Methods: A selection of nurses, medical students, house surgeons, registrars and pharmacists undertook a written survey to assess their ability to perform five drug dose calculations. Participants were also asked which concentration convention they preferred when calculating drug doses. The surveys were marked then analysed for health‐care professionals as a whole and then by subgroup analysis to assess the performance of each health‐care‐professional group.

Results: Overall, less than 14% of the surveyed health‐care professionals could answer all five questions correctly. Subgroup analysis revealed that health‐care pro­fessionals’ ability to calculate drug doses were ranked in the following order: registrars ≈ pharmacists > house surgeons > medical students >> nurses. Ninety per cent of health‐care professionals preferred to calculate drug doses using the mass concentration convention.

Conclusions: Overall, drug dose calculations were performed poorly. Mass concentration was clearly indicated as the preferred convention for calculating drug doses. (Intern Med J 2004; 34: 316−319)
Prefrontal cortical involvement in verbal encoding strategies
Authors: Bor Daniel , Cumming Nick , Scott Catherine E. L. , Owen Adrian M.
Published: June 2004

The lateral prefrontal cortex is critical for the control and organization of information in working memory. In certain situations, effective reorganization can attenuate task difficulty, suggesting a dissociation between lateral prefrontal activity and basic memory demand. In a verbal working memory task, we investigated the enhancement of performance that occurs when incoming information can be reorganized into higher‐level groups or chunks. In the fMRI scanner, volunteers heard and repeated a sequence of digits. Mathematically structured sequences, encouraging ‘chunking’, were compared with unstructured, random sequences. Though structured sequences were easier to remember, fMRI showed increased lateral prefrontal activation for these sequences. Specifically, both the dorsolateral and ventrolateral prefrontal cortices were activated preferentially for the structured sequences during encoding. When visual stimuli that can be chunked using spatial structure are used, similar results are observed. These results demonstrate that cognitively less demanding tasks may elicit greater lateral prefrontal recruitment. Thus, the lateral prefrontal cortex appears to play a general role in strategically recoding information from memory, in order to optimize performance.
Ileosigmoid knotting
Authors: Mallick I. H. , Winslet M. C.
Published: June 2004

Intestinal obstruction is a common cause of emergency surgical admission. The most frequent causes are well known and may often be safely treated conservatively in the first instance. The rarer causes of intestinal obstruction require prompt diagnosis and surgery if they are not to progress rapidly to strangulation and gangrene. One such cause is the ileosigmoid knotting, which is associated with a high morbidity and mortality. With increasing travel activity and population migration this condition is now being seen outside its original geographical sites of origin. This article focuses on the aetiology, pathophysiology, clinical features, investigations and the various surgical options for the management of the ileosigmoid knotting. Studies and case reports in English literature were identified by PubMed, ISIS, Embase and CAS searches between the years 1966–2004 using the following free text keywords: ileo‐ sigmoid knotting, ileosigmoid knot(ting), intestinal knot(ting), compound volvulus and double volvulus. All the reference lists were reviewed to retrieve additional articles. Aggressive resuscitation, prompt surgical relief of obstruction, appropriate antibiotics, accurate intra‐operative assessment of the viability of the involved loops of intestine and the use of modern postoperative intensive care will help reduce the mortality and morbidity associated with this life threatening condition.
Retrograde commercial colonic hydrotherapy
Authors: Taffinder N. J. , Tan E. , Webb I. G. , McDonald P. J.
Published: June 2004

Objective  To ascertain the current practice of commercial colonic hydrotherapy in the UK and to collect data on the profiles of both the practitioners and their clients. In addition to understand how colonic hydrotherapy is perceived by those who use it and how much economic benefit it generates for the practitioners. Information as to training and complications was sought.

Patients and methods  A questionnaire was sent to all 80 practitioners registered with the Association of Colonic Hydrotherapists (ACH) of the UK. The practitioners who responded were sent 10 questionnaires to be given to a group of consecutive clients. This client questionnaire included an SF‐36 self‐administered scoring system and a satisfaction survey. To understand the methodology and ritual of the hydrotherapy procedure a field trip was arranged and two of the authors (NJT and PJM) underwent one colonic hydrotherapy session with an experience practitioner.

Results  Thirty‐eight (48%) of practitioners responded to our practitioner survey and 242 client questionnaires were returned. One third of practitioners reported a previous clinical background and 32 (83%) were single‐handed practitioners. The average time in practice was six years and with an average age of the hydrotherapists being 50 years (22–78 years). Estimated number of sessions conducted were 3200 (range 140–10 000). Average annual income before expenses per practitioner was estimated at £45 675. The clients' ages ranged was 18 and 82 years of age (mean 44 years) and had undergone an average of 35 hydrotherapy treatments (range 1–2500). Clients had lower SF‐36 scores than the UK norm.

Conclusion  Colonic hydrotherapy is practised widely in the UK with an estimated 5600 procedures carried out by ACH practitioners monthly. It is not known how much activity is carried out by non‐ACH members. ACH practitioners appear to be well trained and a proportion have medical backgrounds. Clients, who are often unhappy with orthodox medicine seem satisfied enough with the experience of colonic hydrotherapy to undergo regular purgings. No serious side‐effects have been reported to us. Economic factors could be a driving force for the continuation of the practice as the monies earnt are not inconsiderable.
Classification of internal haemorrhoids: a discussion paper
Authors: Lunniss P. J. , Mann C. V.
Published: June 2004

In the absence of an internationally agreed classification of haemorrhoids, evaluation of the ever increasing number of therapeutic options available is impossible. A new classification is proposed which relates symptoms to our knowledge of haemorrhoidal development, the use of which should provide a more accurate way of comparing treatments and in the evaluation of new techniques. The evidence for such a classification is presented in detail.
Rates of prostate‐specific antigen testing in general practice in England and Wales in asymptomatic and symptomatic patients: a cross‐sectional study
Authors: Melia Jane , Moss Sue , Johns Louise ,   contributors in the participating laboratories
Published: June 2004

OBJECTIVE

To assess the rate of prostate‐specific antigen (PSA) testing for prostate cancer in general practice in asymptomatic and symptomatic patients.

SUBJECTS AND METHODS

The cross‐sectional study took place in England and Wales, was population‐based and covered 469 159 men aged 45–84 years. Pathology data on PSA tests requested between 19 November 1999 and 31 May 2002 by general practitioners (GPs) were provided by 28 pathology laboratories. The practices recorded reasons for the tests between 1 December 2001 and 31 May 2002. In all, 391 practices in which all GP partners participated were included in the analyses.

RESULTS

The overall annual rate of testing in men with no previous diagnosis of prostate cancer was estimated to be 6%, of which the annual rates of asymptomatic, symptomatic and re‐testing were 2.0%, 2.8% and 1.2%, respectively, after adjusting for missing values. The rate decreased with increasing social deprivation, and with increasing proportions of black and Asian populations. The overall rate of PSA testing increased significantly from 1999 to 2002.

CONCLUSIONS

If the recommendations of the National Health Service Prostate Cancer Risk Management Programme were applied, 14% of asymptomatic tests and 23% of symptomatic tests would have led to a referral. As the rate of PSA testing is increasing and there are uncertainties about the benefit of screening, the workload and costs in general practice and hospitals should be monitored.
‘Pseudospongioplasty’ in the repair of a urethral diverticulum
Authors: Radojicic Zoran I. , Perovic Sava V. , Djordjevic Miroslav L.J. , Vukadinovic Vojkan M. , Djakovic Nebijsa
Published: June 2004

OBJECTIVES

To describe a technique for repairing urethral diverticula which includes neourethral reconstruction and increasing the mechanical support of the neourethra.

PATIENTS AND METHODS

Between February 1995 and May 2000, 267 patients with proximal hypospadias underwent a one‐stage penile skin longitudinal flap urethroplasty. The overall postoperative complication rate was 20%; a diverticulum formed in 24 patients (9%) and in all it was repaired. Diverticulectomy was carried out by de‐epithelialization of excess diverticular skin, so that two subcutaneous vascularized tissue wings could be created. After re‐establishing distal urethral patency and neourethral closure, the de‐epithelialized diverticular wings were folded and overlapped to form a mechanical support for the neourethral ventral wall; this procedure was termed ‘pseudospongioplasty’.

RESULTS

There were no recurrences of diverticulum or any fistula formation. The only complication was urethral stenosis in two cases, which was successfully resolved by internal urethrotomy.

CONCLUSION

Re‐establishing patency and providing mechanical support are essential when repairing a urethral diverticulum. Our technique with pseudospongiosal tissue reconstruction during the repair represents a good alternative or addition to other techniques.
‘Vanishing’ prostate cancer in radical prostatectomy specimens: incidence and long‐term follow‐up in 38 cases
Authors: Bostwick David G. , Bostwick Kathleen C.
Published: June 2004

OBJECTIVE

To determine the incidence and long‐term follow‐up of the ‘vanishing cancer’ phenomenon, as complete sampling of some radical prostatectomy (RP) specimens reveals no residual cancer.

MATERIALS AND METHODS

The Mayo Clinic prostate cancer RP database for 1966–1995 was searched for all cases in which there was no residual adenocarcinoma (pathological stage pT0). Each case was confirmed by a review of all tissue specimen slides. Various clinical and pathological features were evaluated, and the follow‐up obtained for all patients.

RESULTS

Among 6843 RPs there were 38 in which no residual cancer was identified despite careful sampling. There was a 10‐fold decline in the incidence of this finding, from 2.1% before 1980 to 0.2% in 1993–95; this decline appeared to be caused by a decrease in the frequency of diagnosis of cancer by transurethral resection from > 10% before 1990 to < 2% in 1993–95. The mean (range) age of the patients was 63 (38–75) years. All cancers on biopsy or transurethral resection were well or moderately differentiated; clinical stages included T1a (42% of cases), T1b (45%) and T2 (13%). Six patients had a nerve‐sparing RP, all after 1990. The mean follow‐up was 9.6 (1.0–28.5) years, and there were no recurrences of cancer; the serum prostate specific antigen concentration remained at < 0.2 ng/mL in surviving patients. Six patients (16%) died from intercurrent disease.

CONCLUSIONS

The incidence of ‘vanishing cancer’ declined between 1966 and 1995, probably as a result of the decline in the use of transurethral resection, occurring in 0.2% of RPs. The prognosis in such patients is excellent, indicating that there is no apparent clinical significance to microscopic foci of cancer that remain undetected after reasonably complete pathological sampling. The inability to identify cancer in a prostate removed for biopsy‐confirmed carcinoma does not indicate technical failure.
Publication rate of abstracts presented at the annual meeting of the American Urological Association
Authors: Ng Longena , Hersey Karen , Fleshner Neil
Published: June 2004

OBJECTIVE

To determine the rate and time‐course of peer‐reviewed publication of abstracts presented at the annual meetings of the American Urological Association (AUA).

METHODS

All abstracts presented at the annual meetings of the AUA from 1998 to 2000 were searched in the PubMed database. To assess any significant predictors of ultimate peer‐reviewed publication, abstract number, meeting year, presentation type (podium vs poster), type of research (basic vs clinical), date of publication and session name (i.e. prostate cancer: advanced) were entered into a database.

RESULTS

The overall rate of publication was 37.8%. Survival analysis indicated that most abstracts were published within 2 years of their respective meetings. Univariate and multivariate techniques showed that none of the tested covariates were significant predictors of publication.

CONCLUSIONS

Information presented at the AUA annual meetings should be carefully considered by physicians before implementation into their clinical practice. Researchers are encouraged to publish their data.
Productivity improvement in Korean rice farming: parametric and non‐parametric analysis†
Authors: Kwon Oh Sang , Lee Hyunok
Published: June 2004

The published empirical literature on frontier production functions is dominated by two broadly defined estimation approaches – parametric and non‐parametric. Using panel data on Korean rice production, parametric and non‐parametric production frontiers are estimated and compared with estimated productivity. The non‐parametric approach employs two alternative measures based on the Malmquist index and the Luenberger indicator, while the parametric approach is closely related to the time‐variant efficiency model. Productivity measures differ considerably between these approaches. It is discovered that measures of efficiency change are more sensitive to the choice of the model than are measures of technical change. Both approaches reveal that the main sources of growth in Korean rice farming have been technical change and productivity improvements in regions of the country that have been associated with low efficiency.
Privatised provision of essential plant breeding infrastructure*
Authors: Lindner Bob
Published: June 2004

As private plant breeding replaces public programs, the efficient provision and utilisation of key enabling technologies for crop breeding, which are largely knowledge based and provide the foundation for variety improvement, might be at risk. Typically, such inputs are non‐rival in use and are therefore termed essential plant breeding infrastructure (EPBI). Specific threats include the possibility of wasteful duplication in production, under‐production, under‐utilisation of produced EPBI because of price rationing, and anticompetitive outcomes in plant breeding and downstream markets. The likely level of under‐investment in hypothetical molecular‐marker technology by a profit‐maximising monopoly producer, charging uniform prices for access, is analysed using results from the published literature on excludable public goods.
Prospects for the Greek Economy in the Post‐enlargement Era
Authors: Dimelis Sophia P.
Published: June 2004

This paper examines the consequences for Greece of the EU enlargement eastwards. The analysis is based on an evaluation of the Greek economy competitiveness relative to the economies of the acceding and candidate countries during the last decade. Using data disaggregated up to the third digit, the magnitude of Greek inter‐ and intra‐industry trade with the above countries is determined and contrasted to the corresponding trade with the EU. Other issues examined are the effects from factor movements such as the FDI flows and migration, and the macroeconomic effects from the reallocation of EU funds. Enlargement is expected to exert positive trade and FDI effects on the Greek economy, a negative effect on future economic growth as a result of budgetary reductions and an uncertain effect on labour markets from migration. A non‐exploited trade potential of Greece with the Balkan countries creates further opportunities for regional development.
Enlargement and the EU Periphery: The Impact of Changing Market Potential
Authors: Brülhart Marius , Crozet Matthieu , Koenig Pamina
Published: June 2004

We study the impact of changing relative market access in an enlarged EU on the economies of incumbent Objective 1 regions. First, we track the impact of external opening on internal spatial configurations in a three‐region economic geography model. External opening gives rise to potentially offsetting economic forces, but for most parameter configurations it is found to raise the locational attractiveness of the region that is close to the external market. Then, we explore the relation between market access and economic activity empirically. We simulate the impact of enlargement on EU Objective 1 regions. Predicted market‐access‐induced gains in regional GDP and manufacturing employment are up to seven times larger in regions proximate to the new accession countries than in ‘interior’ EU regions. We also find that a future Balkans enlargement could be particularly effective in reducing economic inequalities among the EU periphery, due to the positive impact on relative market access of Greek regions.
Short‐term electric power load forecasting using feedforward neural networks
Authors: Malki Heidar A. , Karayiannis Nicolaos B. , Balasubramanian Mahesh
Published: June 2004

Abstract: This paper presents the results of a study on short‐term electric power load forecasting based on feedforward neural networks. The study investigates the design components that are critical in power load forecasting, which include the selection of the inputs and outputs from the data, the formation of the training and the testing sets, and the performance of the neural network models trained to forecast power load for the next hour and the next day. The experiments are used to identify the combination of the most significant parameters that can be used to form the inputs of the neural networks in order to reduce the prediction error. The prediction error is also reduced by predicting the difference between the power load of the next hour (day) and that of the present hour (day). This is a promising alternative to the commonly used approach of predicting the actual power load. The potential of the proposed method is revealed by its comparison with two existing approaches that utilize neural networks for electric power load forecasting.
Trade unionism and partnership in practice: evidence from the Barclays–Unifi agreement
Authors: Wills Jane
Published: June 2004

This article draws on empirical evidence from Barclays Bank PLC to explore the impact of partnership on trade union organisation. It outlines the rationale, development, benefits and pitfalls of the partnership agreement between Barclays and Unifi. Particular attention is paid to the positive impact the agreement has had on systems of workplace representation and on the ways in which the partnership needs to develop to better serve the trade union side. It is argued that unions need to manage the risks of partnership, ensuring their continued legitimacy in the eyes of union members.
Fragmented in Space: The Oral History Narrative of an Arab Christian from Antioch, Turkey
Authors: Neyzi Leyla
Published: June 2004

This study uses the case of Can Kilçiksiz, an Arab Christian refugee youth from Antioch, Turkey, to argue that globalization may result in fragmented families and subjectivities and can also accelerate processes initiated by modernity and the construction of national identities. Can Kilçiksiz and his siblings now live in Turkey, Germany, France and Finland. His life history suggests that males of Arab Christian origin from Antioch who had access to schooling are more likely to be involved in politics whereas females tend to be drawn to evangelical Christian organizations. The case also suggests that sibling ties might prove more durable in the course of transnational migration than conjugal ties. The case of Can Kilçiksiz shows that the time/space linked to childhood through memory can play an important role in identity construction of subjects circulating in transnational space.
Early Treatment of Migraine With Rizatriptan: A Placebo‐Controlled Study
Authors: Mathew Ninan T. , Kailasam Jayasree , Meadors Lori
Published: June 2004

Objective.—To evaluate the efficacy of rizatriptan when administered early during a migraine attack.

Background.—Several studies indicate that triptans are more efficacious when administered early during a migraine attack, when the pain is still mild.

Methods.—One hundred and twelve rizatriptan‐naïve patients aged 20 to 64 years with a history of migraine with or without aura that progressively worsened when left untreated were instructed to treat a total of three migraine attacks with either rizatriptan 10 mg or placebo as early as possible during each attack. Seventy‐four patients (68 women and 6 men) were assigned to use the active drug and 38 (35 women and 3 men) to placebo. The primary efficacy endpoint was pain‐free response at 2 hours after administration of the study drug. Secondary efficacy measures were pain‐free response at 1 hour and sustained pain‐free response lasting between 2 and 24 hours.

Results.—A total of 216 attacks were treated in the rizatriptan group and 109 in the placebo group. Pain‐free response at 2 hours after early treatment was noted in 151 (70%) of attacks in the rizatriptan group and in 24 (22%) in the placebo group (P < .01). Pain‐free response at 1 hour occurred in 97 (45%) and 9 (8%) attacks, respectively (P < .01). When the attacks were categorized by headache severity at the time of treatment, the pain‐free response at 2 hours was higher for mild attacks than for moderate or severe attacks (P < .01). Sustained pain‐free response after treatment was significantly higher for attacks treated with rizatriptan (60%) than for those treated with placebo (17%) (P < .001). Adverse events were observed in 62 patients in the rizatriptan group and 15 in the placebo group. Only 1 patient taking rizatriptan discontinued the study because of adverse events, and no serious adverse events were reported.

Conclusions.—Rizatriptan is significantly more likely than placebo to produce a pain‐free response within 2 hours when the drug is administered early in the migraine attack, when pain is mild rather than moderate or severe.
Disability in Chronic Migraine Patients With Medication Overuse: Treatment Effects at 1‐Year Follow‐up
Authors: Grazzi Licia , Andrasik Frank , D'Amico Domenico , Usai Susanna , Kass Steven , Bussone Gennaro
Published: June 2004

Objective.—To determine (1) the clinical course of a sample of chronic migraine patients with drug overuse 6 and 12 months following in‐patient treatment and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment.

Background.—Patients with chronic migraine and medication overuse are particularly difficult to treat (prophylactic medications that otherwise are effective become ineffective; discontinuation of the offending medication can lead to withdrawal headache; physical and emotional dependence can be present, as well as increased psychological involvement; initial treatment gains can be difficult to maintain).

Methods.—Of the 106 patients meeting criteria for chronic migraine with medication overuse, 84 went on to complete a structured in‐patient treatment, consisting of medication withdrawal and then prophylactic treatment.

Results.—As a group, the patients were improved at both 6‐ and 12‐month follow‐up, with respect to two headache parameters (frequency and medication use) and three measures of functional impact extracted from the MIDAS questionnaire (Total Score, Headache Frequency, and Headache Intensity).

Conclusion.—Chronic migraine accompanied with medication overuse led to the considerable disability prior to treatment. However, notable improvement occurred coincident with the treatment. This suggests that successful treatment has more wide‐ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used prospectively as an outcome measure in patients with chronic migraine and medication overuse to assess disability subsequent to a semi‐standardized treatment program.
From Hemicrania Lunaris to Hemicrania Continua: An Overview of the Revised International Classification of Headache Disorders
Authors: Gladstone Jonathan P. , Dodick David W.
Published: June 2004

The International Headache Society's (IHS) Classification of Headache Disorders, published in 1988, is largely responsible for stimulating the rapid scientific and therapeutic advances that have revolutionized the field of headache. By establishing consistent operational diagnostic criteria for primary and secondary headache disorders, the IHS Classification has facilitated epidemiological and genetic studies as well as the multinational clinical trials that provide the basis for our present treatment guidelines. Fifteen years after its original release, a revised 2nd edition has been unveiled. Modifications are small but significant. We hope to introduce clinicians to the salient changes in the 2nd edition by highlighting the newly included headache types, acknowledging the renamed headache types, and reviewing the modifications in diagnostic criteria for existing headache types. Physicians involved in the care of headache patients need to be aware of these changes and should continue to consult the IHS criteria to ensure accurate diagnosis, to continue to refine the diagnostic criteria, and to contribute to the body of knowledge necessary to make further advances in the classification as well as in the field of headache.
Headache as a Manifestation of a Life‐Threatening Vascular Disorder
Authors: Mathys Jan , Lachat Mario , Herren Thomas
Published: June 2004

Headache is a common complaint among patients seeking medical assistance. The differentiation between a primary headache disorder versus headache as a symptom of a serious underlying disease is of crucial importance. Dissections of the carotid or vertebral arteries frequently present with headache and can result in ischemic stroke. Rarely, headache or neck pain is a presenting symptom in patients with spontaneous proximal aortic dissection. We report on a 53‐year‐old man with a history of migraine with aura, who was admitted to the hospital because of severe frontal headache and neck pain. An anterior chest pain lasting for 10 minutes the day before and a diastolic heart murmur suggested a proximal aortic dissection, which was confirmed by transesophageal echocardiography. Patients with proximal aortic dissection rarely have headache or neck pain, reflecting the low incidence of carotid artery involvement in this disease. However, differentiation between an isolated cervical artery dissection and a proximal aortic dissection extending to the carotid arteries is pivotal, since treatment options are vastly different.
Subcutaneous Sumatriptan Induces Changes in Frequency Pattern in Cluster Headache Patients
Authors: Rossi Paolo , Lorenzo Giorgio Di , Formisano Rita , Buzzi M. Gabriella
Published: June 2004

Objectives.—To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature.

Background.—Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial.

Methods.—Six CH sum‐naïve patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described.

Results.—All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache.

Conclusions.—Physicians should recognize the possibility that treatment of CH with SQ sum may be associated with an increased frequency of headache attacks.
Extracephalic Stabbing Pain Temporally Related to Cephalic Ones
Authors: Selekler Macit Hamit , Komsuoglu Sezer Sener
Published: June 2004

A 23‐year‐old woman consulted with the complaint of short‐lasting, severe stabbing headaches and mild‐to‐moderate degree near‐daily migrainous headaches. Further questioning revealed that she also had stabbing pain on both ipsilateral hand and calf. Stabs on the hand were time‐locked to cephalic ones and stabs in the calf were alternating with the ones in the hand. Dizziness and scotomas were accompanying symptoms to cephalic ones and paresthesia was the accompanying symptom in the hand. Patient's cephalic and extracephalic stabbing pains responded to indomethacine and daily headaches responded to prophylactic sodium valproate therapy. The stabs were felt in the head; hand and calf are considered as the parts of a whole. Along with its accompanying symptoms, stabbing pain may be the result of complex interactions in central nervous system.
Economic and Social Correlates of Re‐Employment Following Job Displacement
Authors: MAZEROLLE MAURICE J. , SINGH GANGARAM
Published: June 2004

Abstract.  The purpose of our study is to examine the economic and social correlates of re‐employment following job displacement. Our data are taken from 247 workers who were displaced as a result of plant closures in Ontario (Canada). Human capital did not affect re‐employment. Economic need positively affected re‐employment. Discrimination negatively affected re‐employment, and social networks positively affected re‐employment. Our conclusion falls squarely within the field of economic sociology, in that an economic outcome can have both an economic and a sociological explanation.
The Conduct of Policy Analysis: Philosophical Points of Reference
Authors: Dixon John , Dogan Rhys
Published: June 2004

This paper explicates and reviews the competing approaches to policy analysis. It does so by constructing a methodological taxonomy that enables the identification of competing philosophical methodologies that underpin contending approaches to policy analysis. This is done by reference to contesting understandings of what constitutes knowledge (an epistemological issue) and what exists that is capable of giving rise to consequences (an ontological issue). This philosophical framework is then, illustratively, applied to an examination of the concept of the underclass. Then the epistemological and ontological challenges facing policy analysts seeking to analyze and address policy problems and issues are identified. Meeting these challenges requires the adoption of a methodology that draws insights from the epistemological and ontological syntheses that have emerged within contemporary social theory.
Involving the Public: When Are Surveys and Stakeholder Interviews Effective?1
Authors: Darnall Nicole , Jolley G. Jason
Published: June 2004

Scholars and practitioners alike advocate involving stakeholders in environmental decision making, although there is uncertainty regarding the effectiveness of public involvement tools and the degree of public involvement in the decision making process. Some researchers have gone a step further to promote the use of public surveys and stakeholder interviews as preferred means to include public concerns in environmental decision making. However, there is little evidence as to whether public involvement tools are effective at representing public preferences, especially when there is a shortage of technical information to inform public opinion. This study examines the effectiveness of surveys and stakeholder interviews for assessing the District of Columbia's environmental problems in a comparative risk assessment. The findings suggest that these public involvement tools are less effective when there is a shortage of technical data. Instead, more deliberative forms of public involvement may generate greater convergence of opinion regarding environmental problems.
Same Governance, Different Day: Does Metropolitan Reorganization Make a Difference?
Authors: Reese Laura A.
Published: June 2004

This commentary focuses on three points related to the debate about urban governmental restructuring: existing conflicts in the literature regarding the outcomes of local government consolidation; insights about consolidation based on an assessment of the amalgamation of twelve municipal units creating the new city of Ottawa; and, a discussion of a variety of methodological and political factors that may well account for the continuing inconsistency in academic assessments of structural change in local government. One possible explanation for the latter conflict is that governmental reorganization does not really make things substantially different in terms of taxes and services, that is, those outcomes most directly experienced by the average citizen. Over the long term other forces, such as intergovernmental relations and the economy, will tend to negate most of the initial effects of change. While there are likely to be winners and losers related to power in government or regime, it will be argued that in large part, for most citizens, governmental reorganization produces the same governance on a different day.
Gram‐positive anaerobic bacilli in human periodontal disease
Authors: Booth V. , Downes J. , Van den Berg J. , Wade W. G.
Published: June 2004

Objective:  The uncertain taxonomy of oral anaerobic gram‐positive bacilli and their generally slow growing nature has limited the understanding of their role in periodontal disease. The current objective was to design and use species‐specific oligonucleotide probes to investigate the relationship of selected gram‐positive anaerobic bacilli to periodontal disease.

Methods:  Plaque and clinical measurements were collected from 40 patients with periodontitis and from 40 matched controls. Oligonucleotide probes were designed for Bulleidia extructa, Eubacterium nodatum, Mogibacterium timidum and Slackia exigua and used to probe nucleic acids extracted from the samples with a chemiluminescent detection method. Species were quantified as absent or present at low (approximately 103−104 cells), medium (approximately 104−105 cells) or high levels (approximately 105−106 cells).

Results:  M. timidum and B. extructa were detected in only three and four samples, respectively. The level of both E. nodatum and S. exigua was significantly higher in deep than shallow pockets (Wilcoxon, p < 0.001). The level of E. nodatum, but not S. exigua, was higher in patients than matched controls (Mann–Whitney U, p < 0.03). Using an ordered logistic regression model, the probing depth of the sampled sites had the greatest influence on the level of both species and significant variations occurred between individuals. Bleeding also influenced the levels of both species, with supragingival plaque influencing S. exigua.

Conclusion:  Both E. nodatum and S. exigua were associated with clinical indicators of periodontal disease.
Expression of human β‐defensins‐1 and ‐2 peptides in unresolved chronic periodontitis
Authors: Lu Qian , Jin Lijian , Darveau Richard P. , Samaranayake Lakshman P.
Published: June 2004

Background:  Human β‐defensins (hBDs) are antimicrobial peptides which contribute to host innate immunity by disrupting the membrane integrity of a broad spectrum of microorganisms.

Objectives:  This study aimed to determine the expression profiles of hBD‐1 and ‐2 peptides in gingiva and to assess the possible relations of these antimicrobial peptides with periodontal health and disease.

Methods:  Seven periodontally healthy subjects and 22 patients with unresolved chronic periodontitis were recruited and the gingival biopsies collected consisted of healthy tissues from the healthy subjects (HT‐C); periodontal pocket tissues (PoT) and inflamed connective tissues (ICT) from the base of pocket, i.e. granulation tissues, as well as clinically healthy tissues (HT‐P) from the adjacent clinically healthy sites from the patients. The expression of hBD‐1 and ‐2 peptides was detected by immunohistochemistry and quantitatively analyzed with a computerized image processing system.

Results:  Both hBD‐1 and ‐2 peptides were detected in all periodontally healthy subjects, while hBD‐1 was detected in all patients and hBD‐2 was found in most of the patients. Their expression was mainly confined to the granular and spinous layers of gingival epithelium, in which hBD‐1 was detected in both intercellular spaces and cytoplasm, whereas hBD‐2 was mainly observed in the cytoplasm. HT‐C expressed significantly higher levels of hBD‐2 than HT‐P (p < 0.05). Within the patients, both defensins were up‐regulated significantly in PoT as compared with the adjacent HT‐P (p < 0.05).

Conclusions:  The present study showed that hBD‐1 and ‐2 were frequently expressed in the granular and spinous layers of gingival epithelia and their expression may be associated with periodontal health and disease.
Herpesviral–bacterial interrelationships in aggressive periodontitis
Authors: Saygun Işıl , Kubar Ayhan , Özdemir Atilla , Yapar Mehmet , Slots Jørgen
Published: June 2004

Background:  Recent findings have begun to provide a basis for a causal link between herpesviruses and aggressive periodontitis. One theory is that herpesviruses cooperate with specific bacteria in the etiopathogenesis of the disease. This study examined whether the presence of herpesviruses [human cytomegalovirus (HCMV), Epstein–Barr virus (EBV) type 1, herpes simplex virus (HSV) type 1 and 2] is associated with the presence of putative pathogenic bacteria (Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Campylobacter rectus, Actinobacillus actinomycetemcomitans) in aggressive periodontitis lesions.

Methods:  The study included 18 young adults with advanced periodontitis and 16 periodontally healthy subjects from Ankara, Turkey. Subgingival specimens pooled from two sites in each subject were collected by a periodontal curette. Qualitative polymerase chain reaction methodology was used to identify herpesviruses and bacteria. Chi‐square tests were employed to determine statistical associations among herpesviruses, bacteria and periodontal disease.

Results:  HCMV, EBV‐1 and HSV‐1 were each detected in 72–78% of the aggressive periodontitis patients. HSV‐2 occurred in 17% of the periodontitis patients. EBV‐1 was detected in one periodontally healthy subject. The study bacteria occurred in 78–83% (P. gingivalis, T. forsythia, C. rectus) and in 44% (P. intermedia, A. actinomycetemcomitans) of the periodontitis samples, and in 0–19% of the samples from healthy periodontal sites. HCMV, EBV‐1 and HSV‐1 were positively associated with P. gingivalis, P. intermedia, T. forsythia and C. rectus, but not with A. actinomycetemcomitans. HSV‐2 was not associated with any test bacteria.

Conclusions:  These results support the notion that the clinical outcome of some types of severe periodontal infection depends on the presence of specific herpesviruses and bacterial pathogens. Our findings open the door to testing a variety of hypotheses regarding the deleterious aspects of combined herpesviral‐bacterial infections in periodontal sites.
Serum antibodies against the hemoglobin‐binding domain (HA2) of Porphyromonas gingivalis
Authors: DeCarlo Arthur A. , Nadkarni Mangala , Paramaesvaran Mayuri , Yun Peter W. , Collyer Charles A. , Hunter Neil
Published: June 2004

Background: 
The hemoglobin‐binding domain (HA2) of the Porphyromonasgingivalis gingipains and hemagglutinins strongly binds hemoglobin and hemin and is thought to play a key role in acquisition of this essential metabolite by the microorganism.

Methods:  In this report, we partially characterized human anti‐HA2 humoral antibodies and their relationship to periodontal disease in an analysis of titer and function.

Results:  Overall, serum anti‐HA2 antibodies were relatively low and dominated by the immunoglobulin M (IgM) isotype. Pre‐therapy titers had a direct association with periodontal health. Levels of P. gingivalis in the plaque were directly related to pre‐therapy anti‐HA2 IgG levels, and were an important covariant in a significant direct relationship between pre‐ and post‐therapy anti‐HA2 titers. Post‐therapy anti‐HA2 IgG antibody titers were directly related to the capacity of serum IgG fractions to neutralize hemoglobin binding by Lys‐gingipain (Kgp). Further, lower levels of neutralizing activity post‐therapy were directly related to severe periodontitis within the patient cohort.

Conclusions:  These data suggest that anti‐HA2 IgG antibodies correspond directly with periodontal health, possibly through their ability to neutralize P. gingivalis hemoglobin capture. The data also suggest that inadvertent or therapeutic inoculation of P. gingivalis in the plaque may contribute to generation of neutralizing anti‐HA2 IgG and improvement of periodontal prognosis.
Periodontal disease and C‐reactive protein‐associated cardiovascular risk
Authors: D'Aiuto Francesco , Ready Derren , Tonetti Maurizio S.
Published: June 2004

Background:  Periodontitis has been associated with a moderate systemic inflammatory response. Successful periodontal therapy could decrease serum inflammatory parameters. The aim of this report was to explore the outcomes of periodontal therapy in terms of changes in C‐reactive protein (CRP)‐associated cardiovascular disease (CVD) risk as defined in a recent American Heart Association (AHA) consensus conference.

Methods:  Ninety‐four systemically healthy subjects suffering from severe generalized periodontitis received standard non‐surgical periodontal therapy. Periodontal parameters and serum inflammatory responses [interleukin‐6 (IL‐6) and CRP] were monitored 2 and 6 months after therapy.

Results:  At baseline, subjects with more severe and widespread periodontitis had a higher chance of having high CRP‐associated CVD risk (OR 5.6, 95% CI 1.2–27.4). Age and body mass index were also significant in the analysis. After therapy, a significant decrease in number of subjects associated with a medium and high CRP‐associated risk was observed (p < 0.001 χ2), with 40 of 94 subjects displaying a decrease in their class of risk. Patients who had a better oral response to periodontal therapy were also more likely to have decreased their inflammatory risk category (OR 4.8, 95% CI 1.4–15.8) after correcting for age, gender, ethnicity and cigarette smoking.

Conclusions:  This study indicated that periodontitis may add to the inflammatory burden of the individual and may result in increased levels of cardiovascular risk based on serum CRP concentrations. These observations will need to be confirmed in a definitive trial. Given the high prevalence of periodontitis in the population, these data would caution physicians to be aware of the possible oral source of an increased inflammatory burden.
Local expression of lipopolysaccharide‐binding protein in human gingival tissues
Authors: Ren Lei , Jin Lijian , Leung W. Keung
Published: June 2004

Background:  Lipopolysaccharide‐binding protein (LBP) functions as a crucial molecule in innate host defense responses to bacterial challenge through neutralization of bacterial lipopolysaccharide (LPS) and activation of cellular responses.

Objectives:  This study was to investigate the expression profile and levels of LBP in gingival tissues and their associations with periodontal health and disease.

Methods:  Gingival biopsies were collected from 44 chronic periodontitis patients, including periodontal pocket tissues (PoTs) and the adjacent healthy gingival tissues (HT‐Ps), as well as from 15 periodontally healthy subjects as controls (HT‐Cs). The peptide and mRNA of LBP were detected by semi‐quantitative immunohistochemistry and reverse transcription‐polymerase chain reaction (RT‐PCR), respectively.

Results:  LBP peptide was detected in 90.9% of PoTs (20/22), 84.6% of HT‐Ps (11/13) and all HT‐Cs (7/7). The expression of LBP was mainly confined to the cytoplasm of granular and keratinized layers of gingival epithelium, spreading from the oral sulcular epithelium to oral epithelium with the expression density decreasing gradually from coronal to apical portion. LBP peptide was also found on endothelial surfaces and/or inside the lumens of blood vessels in connective tissues. The mean LBP expression levels in HT‐Cs were significantly higher than those in HT‐Ps and PoTs. LBP mRNA was detected in 55% of PoTs (11/20), 55% of HT‐Ps (11/20) and 75% of HT‐Cs (6/8).

Conclusions:  We for the first time found the expression of LBP peptide and mRNA in human gingival tissues. Local expression of LBP in gingival tissues might contribute to periodontal homeostasis.