bluuebunny/crossref_metadata_2025 huggingface dataset:
Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies
Authors: Takahashi Satoshi , Iseki Tohru , Ooi Jun , Tomonari Akira , Takasugi Kashiya , Shimohakamada Yoko , Yamada Toshiki , Uchimaru Kaoru , Tojo Arinobu , Shirafuji Naoki , Kodo Hideki , Tani Kenzaburo , Takahashi Tsuneo , Yamaguchi Takuhiro , Asano Shigetaka
Published: July 2004

Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematologic malignancies who received unrelated BM transplants (n = 45) or unrelated CB transplants (n = 68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of transplantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. The time from donor search to transplantation was significantly shorter among CB transplant recipients (median, 2 months) than BM transplant recipients (median, 11 months; P < .01). Multivariate analysis demonstrated slow neutrophil (P < .01) and platelet (P < .01) recoveries in CBT patients compared with BMT patients. Despite rapid tapering of immunosuppressants after transplantation and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CB transplant recipients compared with 10 deaths of 24 among BM transplant recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P = .02 and P < .01, respectively), despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematologic malignancies.
Comparative analysis of T-cell costimulation and CD43 activation reveals novel signaling pathways and target genes
Authors: Mattioli Ivan , Dittrich-Breiholz Oliver , Livingstone Mark , Kracht Michael , Schmitz M. Lienhard
Published: July 2004

The CD43 lymphocyte surface receptor is involved in the regulation of lymphocyte adhesion and activation. Many CD43 functions remain controversial or unclear, and it is not known to which extent CD43 signaling pathways are shared with or distinct from those used by the T-cell receptor (TCR). Here, we systematically compared signaling events and target gene expression induced by CD43 or T-cell costimulation in primary human peripheral T cells. These studies identify nuclear factor-κB (NF-κB) p65 serine 468 as a novel inducible phosphorylation site strongly induced by T-cell costimulation and only weakly triggered by CD43 ligation. We also identified CD43 as a novel Jun N-terminal kinase (JNK) activator and a comprehensive analysis of further signaling events suggests that both stimuli use overlapping but also distinct signaling pathways. Microarray analysis of inflammatory genes shows 1 group of genes coregulated by both stimuli and 2 further groups of target genes affected solely by costimulation or primarily by CD43. (Blood. 2004;104:3302-3304)
Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation
Authors: Erba P. , Anastasi S. , Senn O. , Maggiorini M. , Bloch K.E.
Published: July 2004

The purpose of the study was to investigate determinants of acute mountain sickness after rapid ascent to high altitude.

A total of 21 climbers were studied ascending from <1,200 m to Capanna Regina Margherita, a hut in the Alps at 4,559 m, within <24 h. During their overnight stay at 4,559 m, breathing patterns and ventilation were recorded by calibrated respiratory inductive plethysmography along with pulse oximetry. In the following morning, acute mountain sickness was assessed.

Altogether, 11 mountaineers developed pronounced symptoms of acute mountain sickness (Lake Louise score ≥5) and 10 did not (controls). Compared to controls, subjects with acute mountain sickness had lower nocturnal oxygen saturation (mean±sd 59±13%versus73±6%), higher minute ventilation (7.94±2.35versus6.06±1.34 L·min−1), and greater mean inspiratory flow, a measure of respiratory centre drive (0.29±0.09versus0.22±0.05 L·s−1). Periodic respiration was prevalent but not significantly different among the two groups (apnoea/hypopnea index 60.1±34.6versus47.1±42.6 events per h).

The data suggest that pronounced nocturnal hypoxemia, which was not related to hypoventilation, may have promoted acute mountain sickness. Periodic breathing seems not to play a predominant role in the pathogenesis of acute mountain sickness.
Patient-physician communication about end-of-life care for patients with severe COPD
Authors: Curtis J.R. , Engelberg R.A. , Nielsen E.L. , Au D.H. , Patrick D.L.
Published: July 2004

Since patients with chronic obstructive pulmonary disease (COPD) infrequently discuss treatment preferences about end-of-life care with physicians, the goal of the present study was to identify which specific areas of communication about end-of-life care occur between patients with severe COPD and their physicians, and how patients rate the quality of this communication.

A total of 115 patients with oxygen-dependent COPD, identified in pulmonary clinics in three hospitals and through an oxygen delivery company, were enrolled in this study. A 17‐item quality of communication questionnaire (QOC) was administered to patients, along with other measures, including satisfaction with care.

The patients reported that most physicians do not discuss how long the patients have to live, what dying might be like or patients' spirituality. Patients rated physicians highly at listening and answering questions. Areas patients rated relatively low included discussing prognosis, what dying might be like and spirituality/religion. Patients' assessments of physicians' overall communication and communication about treatment correlated well with the QOC. Patients' overall satisfaction with care also correlated significantly with the QOC.

In conclusion, this study identifies areas of communication that physicians do not address and areas that patients rate poorly, including talking about prognosis, dying and spirituality. These areas may provide targets for interventions to improve communication about end-of-life care for patients with chronic obstructive pulmonary disease. Future studies should determine the responsiveness of these items to interventions, and the effect such interventions have on patient satisfaction and quality of care.
Bronchiolitis obliterans syndrome in popcorn production plant workers
Authors: Akpinar-Elci M. , Travis W.D. , Lynch D.A. , Kreiss K.
Published: July 2004

Following sentinel case recognition, an excess of fixed airways obstruction was found among current workers in a microwave popcorn plant associated with butter flavouring exposures.

In order to characterise the clinical presentation of sentinel cases, the medical records of sentinel cases were reviewed, interviews conducted and serial spirometric testing performed.

Cases worked in microwave popcorn production, and five of the nine cases had mixed flavourings. Most had never smoked or smoked minimally. Cases showed onset of cough, shortness of breath and wheezing 5 months to 9 yrs after starting work at the popcorn plant. Initial forced expiratory volume in one second ranged 14.0–66.8% of the predicted value. Eight high-resolution computed tomography scans showed marked bronchial wall thickening and mosaic attenuation with air trapping. Open lung biopsy results were consistent with, or diagnostic of, constrictive bronchiolitis in two of three cases. Five cases are on lung transplantation waiting lists. After leaving employment, nearly all cases experienced stabilisation of their lung function within 2 yrs.

Astute clinicians can help identify new causes of airways obstruction by alerting public health authorities to unexplained disease cases occurring in groups of workers.
Triggering receptor expressed on myeloid cells: role in the diagnosis of lung infections
Authors: Richeldi L. , Mariani M. , Losi M. , Maselli F. , Corbetta L. , Buonsanti C. , Colonna M. , Sinigaglia F. , Panina-Bordignon P. , Fabbri L.M.
Published: July 2004

The triggering receptor expressed on myeloid cells (TREM)‐1 is a recently described molecule, which plays an important role in myeloid cell-activated inflammatory responses. TREM‐1 is expressed on blood neutrophils and monocytes, and also on alveolar macrophages, thus suggesting a potential role in lung inflammatory responses against infections.

To investigate the differential expression of TREM‐1 in lung infections, its levels were assessed in bronchoalveolar lavage specimens from patients with community-acquired pneumonia or tuberculosis. TREM‐1 was also investigated in patients with interstitial lung diseases, as a model of noninfectious inflammatory disease of the lung.

TREM‐1 expression was significantly increased in lung neutrophils and in lung macrophages of patients with pneumonia (n=7; 387.9±61.4 and 660.5±18.3, respectively) compared with patients with pulmonary tuberculosis (n=7; 59.2±13.1 and 80.6±291.2) and patients with interstitial lung diseases (n=10; 91.8±23.3 and 123.9±22.8). In contrast, TREM‐1 expression on peripheral blood neutrophils was no different among the three groups.

In conclusion, these data suggest that triggering receptor expressed on myeloid cells‐1 is selectively expressed in the lungs of patients with pneumonia caused by extracellular bacteria and not in patients with tuberculosis, providing a potential marker for differential diagnosis.
β‐Adrenoceptor stimulation and neutrophil accumulation in mouse airways
Authors: Miyamoto M. , Tomaki M. , Lötvall J. , Lindén A.
Published: July 2004

This study characterised the effect of β‐adrenoceptor stimulation on endotoxin-induced accumulation of neutrophilic granulocytes in mouse airways, where the cytokines interleukin (IL)‐6 and macrophage inflammatory protein (MIP)‐2 are involved as mediators.

The β2‐adrenoceptor agonist salbutamol (0.025–250 fMol) was administered intranasally in mice 24 h prior to administration of endotoxin (10 µg) intranasally. Bronchoalveolar lavage (BAL) fluid and venous blood, respectively, was harvested (6 or 24 h) after administration of endotoxin.

Salbutamol substantially decreased the number of neutrophils in BAL fluid from endotoxin-exposed (6 and 24 h) mice and this effect was dose dependent (24 h). Pretreatment with the β‐adrenoceptor antagonist propranolol attenuated the inhibitory effect of salbutamol on BAL neutrophils (6 and 24 h), an attenuation that was not due to any unspecific effect of propranolol. Salbutamol also substantially decreased IL‐6, but not MIP‐2 in BAL fluid (6 h). In contrast to BAL fluid, salbutamol caused a moderate increase in blood neutrophils (24 h).

In conclusion, as indicated in mouse airwaysin vivo, β‐adrenoceptor stimulation prior to endotoxin exposure inhibits the induced accumulation of neutrophils at a time point much later than that anticipated from its bronchodilatory effect. Even though the detailed molecular mechanisms behind this sustained “anti-inflammatory” effect remain unknown, it seems likely that this effect is in part due to a decrease in the local concentration of interleukin‐6.
Heterogeneity of narrowing in normal and asthmatic airways measured by HRCT
Authors: King G.G. , Carroll J.D. , Müller N.L. , Whittall K.P. , Gao M. , Nakano Y. , Paré P.D.
Published: July 2004

Asthmatic airway narrowing is heterogeneous and contributes to airway hyperresponsiveness. The present study compared heterogeneity of narrowing during methacholine challenge in asthmatics and normal subjects using high-resolution computed tomography (HRCT).

The current authors defined heterogeneity as variability in narrowing greater than the repeatability of measurement. Airways of <2 mm diameter were compared with larger airways from baseline and postmethacholine HRCT of the right lower lung in 13 normals (seven had repeat baseline scans) and seven asthmatics. The coefficient of repeatability was calculated from repeat scans (RepAi) and was compared with heterogeneity of narrowing measured by the variability in narrowing from preversuspostmethacholine scans (VarΔAi).

Forced expiratory volume in one second decreased 27±6% and 24±8% in normals and asthmatics, respectively. Airways >2 mm narrowed more heterogeneously in asthmatics (VarΔAi=±0.85 mm) compared with normals (VarΔAi=±0.67 mm), with both being greater than the measure of repeatability (RepAi=±0.16 mm). Small airway narrowing was not heterogeneous in asthmatics (VarΔAi=±0.59 mm) or normals (VarΔAi=±0.53 mm) compared with repeatability (RepAi=0.51 mm).

It is possible to study heterogeneity of airway narrowing in small and large airways using high resolution computed tomography. Airway narrowing is heterogeneous in the large airways of asthmatics and normals, being greater in asthmatics.
Sleep-related breathing disorders: impact on mortality of cerebrovascular disease
Authors: Parra O. , Arboix A. , Montserrat J.M. , Quintó L. , Bechich S. , García-Eroles L.
Published: July 2004

The aim of the study was to analyse the impact of sleep-related breathing disorders in a 2‐yr survival follow-up of patients with a first ever stroke or transient ischaemic attack.

The study followed 161 patients. Complete neurological assessment was performed in order to determine cerebrovascular risk factors, functional disability, and parenchymatous and vascular localisation, as well as stroke subtype categorisation. A sleep study was carried out using a portable respiratory recording device. The entire cohort was followed over a mean period of 22.8 months. The main outcome event was death and time of survival since the neurological event. A multivariate Cox's model was estimated.

The patients were ages 72±9 yrs (mean±sd), and had a body mass index of 26.6±3.9 kg·m−2and apnoea/hypopnoea index (AHI) of 21.2±15.7. Overall, mortality occurred in 22 cases, and the survival rate was 86.3%. Vascular disease accounted for 63.6% of deaths. Multivariate analysis selected four independent variables associated with mortality: 1) age; 2) AHI, with an implied 5% increase in mortality risk for each additional unit of AHI; 3) involvement of the middle cerebral artery; and 4) the presence of coronary disease.

In conclusion, the findings suggest that sleep-related breathing disorders are an independent prognostic factor related to mortality after a first episode of stroke.
Automatic CPAP titration with different self-setting devices in patients with obstructive sleep apnoea
Authors: Stammnitz A. , Jerrentrup A. , Penzel T. , Peter J.H. , Vogelmeier C. , Becker H.F.
Published: July 2004

Autotitrating continuous positive airway pressure (CPAP) devices automatically adjust the pressure according to upper airway obstructions. The aim of this study was to compare the treatment effects of different automatic CPAP devices (AutoSet, Horizon and Virtuoso) with conventional CPAP in patients with obstructive sleep apnoea independently of financial manufacturer support.

Twelve male patients with obstructive sleep apnoea were submitted to a crossover study protocol with overnight polysomnography for 6 consecutive nights. After diagnostic polysomnography, the CPAP pressure was manually titrated. Over the next 4 nights, the patients were treated with any one of the three automatic CPAP devices or fixed CPAP in random order.

The apnoea/hypopnoea index on the diagnostic night was 67.3±21.7 events·h−1, and was significantly reduced to 0.7±1.2, 3.0±2.9, 2.3±2.5 and 12.0±13.6 events·h−1with the fixed CPAP, AutoSet, Horizon and Virtuoso devices respectively. An apnoea/hypopnoea index of <5 events·h−1, an indicator of optimal treatment, was achieved in all patients with fixed CPAP and in 10 patients using the Autoset and Horizon devices, but in only six of the 12 using the Virtuoso. The mean pressure was significantly lower with the AutoSet and Virtuoso devices, but not with the Horizon as compared to fixed CPAP. The maximum pressure was significantly higher with the Horizon.

It is concluded that automatic continuous positive airway pressure devices produce a significant reduction in apnoea/hypopnoea index; however, there is considerable difference in the efficacy of the various devices.
Montelukast protects against nasal lysine-aspirin challenge in patients with aspirin-induced asthma
Authors: Lee D.K.C. , Haggart K. , Robb F.M. , Lipworth B.J.
Published: July 2004

Aspirin-induced asthma (AIA) is associated with increased production of cysteinyl leukotrienes (CysLT). Although leukotriene CysLT1-receptor antagonists improve lower airway outcomes in AIA, their effects and dose-response in the upper airway is less well documented.

The present study evaluated the dose-response for montelukast (ML) against nasal lysine-aspirin challenge in patients with AIA.

A total of 12 patients with a clear-cut history of AIA were randomised in double-blind cross-over fashion to receive single doses of ML 10 mg, ML 40 mg, or placebo (PL), with nasal lysine-aspirin challenge performed 12 h after dosing. Measurements of peak nasal inspiratory flow (PNIF), nasal blockage visual analogue scale (VAS) and forced expiratory volume in one second (FEV1) were made over 120 min after nasal lysine-aspirin challenge.

Prechallenge values for mean±sem PNIF (L·min−1) were not significantly different comparing all groups: ML 10 mg (132±10), ML 40 mg (125±12) and PL (132±11). There was no significant difference comparing the maximum % PNIF fall from baseline between screening (46±6) and PL (45±6). The maximum % PNIF fall from baseline was significantly greater with PL (45±6) compared to either ML 10 mg (34±6) or ML 40 mg (32±5). There was also a significantly greater mean % PNIF response over 120 min after lysine-aspirin challenge for PL (26±7) compared to either ML 10 mg (14±6) or ML 40 mg (17±6). There were no significant differences for the maximum or mean % PNIF fall from baseline comparing ML 10 mg and ML 40 mg. A significant increase in nasal blockage VAS score was observed between baseline and 60 min or 120 min with PL but not with ML 10 mg or ML 40 mg. There were no significant differences for either the maximum or mean % FEV1over 120 min as change from baseline comparing all groups.

A single 10 mg dose of montelukast partially protected against the local effects of nasal lysine-aspirin challenge, with no further benefit at 40 mg. Nasal lysine-aspirin challenge appeared to be a reproducible and safe method in assessing patients with aspirin-induced asthma.
The use of SPECT in preoperative assessment of patients with lung cancer
Authors: Piai D.B. , Quagliatto R. , Toro I. , Cunha Neto C. , Etchbehere E. , Camargo E.
Published: July 2004

Perfusion scintigraphy is the most frequently used method for the regional assessment of pulmonary function in candidates for pulmonary resection with borderline respiratory function. This method provides two-dimensional images, and it considers all the segments of the pulmonary lobes as having the same volume and function, without considering the spatial overlapping of pulmonary areas with different function. As single-photon emission computed tomography (SPECT) provides tomographic imaging, this could be a more precise method for regional assessment.

In this study, the postoperative predicted forced expiratory volume in one second (FEV1) (FEV1,ppo) was calculated in 26 patients with lung cancer using FEV1, quantitative lung perfusion scan with planar acquisition (PA) and quantitative lung perfusion scan with tomographic imaging (SPECT).

The estimated FEV1,ppovalues obtained using both methods were compared with FEV1values measured after surgery (mean: 48±44 days; range: 15–180 days; median: 32 days). The Pearson's linear correlation coefficient was 0.8840 for FEV1,ppoestimated by PA and 0.8791 for FEV1,ppoestimated by SPECT. The linear correlation coefficient for lobectomy was greater than the coefficient for pneumonectomy using both methods.

In conclusion, both methods show good correlation for real postoperative pulmonary function without demonstrating single-photon emission computed tomography superiority over planar acquisition, and both methods were more effective for estimating postoperative predicted forced expiratory volume in one second in lobectomies than in pneumonectomies.
Efficacious pleurodesis with OK‐432 and doxorubicin against malignant pleural effusions
Authors: Kishi K. , Homma S. , Sakamoto S. , Kawabata M. , Tsuboi E. , Nakata K. , Yoshimura K.
Published: July 2004

Malignant pleural effusion develops frequently in patients with advanced lung cancer. Chemical pleurodesis is the most effective palliative treatment for these patients.

The efficacy of pleurodesis using both OK‐432, a preparation ofStreptococcus pyogenes, and doxorubicin for 20 patients with cytology-proven malignant pleural effusion associated with lung cancer was evaluated. After complete removal of pleural effusion, OK‐432 and 30 mg of doxorubicin were injectedviaan inserted chest tube. Treatment was terminated when the volume of daily drainage reached <200 mL. If the daily volume remained >200 mL, an additional OK‐432 was administered every 3 days.

In total, 16 patients (80%) revealed a complete response, two patients (10%) revealed a partial response, and no response was seen in two patients. Eighteen patients with complete or partial responses did not show subsequent reaccumulation of pleural effusion after pleurodesis. The chest tube remained in place for an average of 6.4 days, draining a mean of 2,854 mL. The main side-effects were fever and pain that were easily treated with nonsteroidal anti-inflammatory drugs.

Pleurodesis using both OK‐432 and doxorubicin showed high efficacy for controlling malignant pleural effusions caused by lung cancer.
Characterization of yeast histone H3-specific type B histone acetyltransferases identifies an ADA2-independent Gcn5p activity
Authors: Sklenar Amy R , Parthun Mark R
Published: July 2004

Background

The acetylation of the core histone NH2-terminal tails is catalyzed by histone acetyltransferases. Histone acetyltransferases can be classified into two distinct groups (type A and B) on the basis of cellular localization and substrate specificity. Type B histone acetyltransferases, originally defined as cytoplasmic enzymes that acetylate free histones, have been proposed to play a role in the assembly of chromatin through the acetylation of newly synthesized histones H3 and H4. To date, the only type B histone acetyltransferase activities identified are specific for histone H4.

Results

To better understand the role of histone acetylation in the assembly of chromatin structure, we have identified additional type B histone acetyltransferase activities specific for histone H3. One such activity, termed HatB3.1, acetylated histone H3 with a strong preference for free histones relative to chromatin substrates. Deletion of the GCN5 and ADA3 genes resulted in the loss of HatB3.1 activity while deletion of ADA2 had no effect. In addition, Gcn5p and Ada3p co-fractionated with partially purified HatB3.1 activity while Ada2p did not.

Conclusions

Yeast extracts contain several histone acetyltransferase activities that show a strong preference for free histone H3. One such activity, termed HatB3.1, appears to be a novel Gcn5p-containing complex which does not depend on the presence of Ada2p.
Calcineurin activation influences muscle phenotype in a muscle-specific fashion
Authors: Talmadge Robert J , Otis Jeffrey S , Rittler Matthew R , Garcia Nicole D , Spencer Shelly R , Lees Simon J , Naya Francisco J
Published: July 2004

Background

The calcium activated protein phosphatase 2B, also known as calcineurin, has been implicated as a cell signaling molecule involved with transduction of physiological signals (free cytosolic Ca2+) into molecular signals that influence the expression of phenotype-specific genes in skeletal muscle. In the present study we address the role of calcineurin in mediating adaptations in myosin heavy chain (MHC) isoform expression and muscle mass using 3-month old wild-type (WT) and transgenic mice displaying high-level expression of a constitutively active form of calcineurin (MCK-CN* mice).

Results

Slow muscles, e.g., soleus, were significantly larger (by ~24%), whereas fast muscles, e.g., medial gastrocnemius (MG) and tibialis anterior were significantly smaller (by ~26 and ~16%, respectively) in MCK-CN* mice compared to WT. The masses of mixed phenotype muscles, such as the plantaris and the extensor digitorum longus, were not significantly changed from WT. The soleus, plantaris, MG and diaphragm displayed shifts toward slower MHC isoforms, e.g., soleus from WT mice contained ~52% MHC-I, ~39% MHC-IIa, and ~9% MHC-IIx, whereas MCK-CN* mice had ~67% MHC-I, ~26% MHC-IIa, and ~7% MHC-IIx. The specific isoforms that were either up or down-regulated were muscle-specific. For instance, the proportion of MHC-IIa was decreased in the soleus and diaphragm, but increased in the plantaris and MG of MCK-CN* mice. Also, the proportion of MHC-IIx was unchanged in the soleus, decreased in the diaphragm and increased in the plantaris and MG of MCK-CN* relative to WT mice. Fast to slow shifts in fiber type proportions were evident for the plantaris, but not the soleus. Fast, but not slow, plantaris fibers of MCK-CN* mice had higher oxidative and lower glycolytic properties than WT.

Conclusion

These data suggest that calcineurin activation can influence muscle phenotype and that the specific influence of calcineurin activation on the phenotypic and mass characteristics of a muscle is dependent upon the original phenotypic state of the muscle.
Identification and characterization of a nontypeable Haemophilus influenzae putative toxin-antitoxin locus
Authors: Daines Dayle A , Jarisch Justin , Smith Arnold L
Published: July 2004

Background

Certain strains of an obligate parasite of the human upper respiratory tract, nontypeable Haemophilus influenzae (NTHi), can cause invasive diseases such as septicemia and meningitis, as well as chronic mucosal infections such as otitis media. To do this, the organism must invade and survive within both epithelial and endothelial cells. We have identified a facilitator of NTHi survival inside human cells, v irulence-a ssociated protein D (vapD
Hi
, encoded by gene HI0450). Both vapD
Hi
and a flanking gene, HI0451, exhibit the genetic and physical characteristics of a toxin/antitoxin (TA) locus, with VapD
Hi
serving as the toxin moiety and HI0451 as the antitoxin. We propose the name VapX
Hi
for the HI0451 antitoxin protein. Originally identified on plasmids, TA loci have been found on the chromosomes of a number of bacterial pathogens, and have been implicated in the control of translation during stressful conditions. Translation arrest would enhance survival within human cells and facilitate persistent or chronic mucosal infections.

Results

Isogenic mutants in vapD
Hi
were attenuated for survival inside human respiratory epithelial cells (NCI-H292) and human brain microvascular endothelial cells (HBMEC), the in vitro models of mucosal infection and the blood-brain barrier, respectively. Transcomplementation with a vapD
Hi
allele restored wild-type NTHi survival within both cell lines. A PCR survey of 59 H. influenzae strains isolated from various anatomical sites determined the presence of a vapD
Hi
allele in 100% of strains. Two isoforms of the gene were identified in this population; one that was 91 residues in length, and another that was truncated to 45 amino acids due to an in-frame deletion. The truncated allele failed to transcomplement the NTHi vapD
Hi
survival defect in HBMEC. Subunits of full-length VapD
Hi
homodimerized, but subunits of the truncated protein did not. However, truncated protein subunits did interact with full-length subunits, and this interaction resulted in a dominant-negative phenotype. Although Escherichia coli does not contain a homologue of either vapD
Hi
or vapX
Hi
, overexpression of the VapD
Hi
toxin in trans resulted in E. coli cell growth arrest. This arrest could be rescued by providing the VapX
Hi
antitoxin on a compatible plasmid.

Conclusion

We conclude that vapD
Hi
and vapX
Hi
may constitute a H. influenzae TA locus that functions to enhance NTHi survival within human epithelial and endothelial cells.
Geographic correlation between deprivation and risk of meningococcal disease: an ecological study
Authors: Williams Christopher J , Willocks Lorna J , Lake Iain R , Hunter Paul R
Published: July 2004

Background

Meningitis caused by Neisseria meningitidis is a serious infection which is most common in young children and adolescents. This study investigated the relationships between the incidence and age distribution of meningococcal disease, and socioeconomic environment.

Methods

An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.

Results

Incidence of meningococcal disease was highest in the most deprived wards, with a relative risk of 1.97 (1.55 – 2.51). Mapping revealed geographical coincidence of deprivation and meningococcal disease, particularly in urban areas. Two-thirds of the increased incidence was due to cases in the under fives.

Conclusions

The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.
Injuries at a Canadian National Taekwondo Championships: a prospective study
Authors: Kazemi Mohsen , Pieter Willy
Published: July 2004

Background

The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured.

Methods

Subjects (219 males, 99 females) participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury.

Results

The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E). The males (79.9/1,000 A-E) sustained significantly more injuries than the females (25.3/1,000 A-E). The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E), followed by the head and neck (18.3/1,000 A-E). Injuries to the spine (neck, upper back, low back and coccyx) were the third most often injured body region in males (13.8/1,000 A-E). All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E). However, men's most common type of injury was the sprain (22.8/1,000 A-E) followed by joint dysfunction (13.7/1,000A-E). Concussions were only reported in males (6.9/1,000 A-E). Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E).

Conclusions

Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction.
Bereavement care interventions: a systematic review
Authors: Forte Amanda L , Hill Malinda , Pazder Rachel , Feudtner Chris
Published: July 2004

Background

Despite abundant bereavement care options, consensus is lacking regarding optimal care for bereaved persons.

Methods

We conducted a systematic review, searching MEDLINE, PsychINFO, CINAHL, EBMR, and other databases using the terms (bereaved or bereavement) and (grief) combined with (intervention or support or counselling or therapy) and (controlled or trial or design). We also searched citations in published reports for additional pertinent studies. Eligible studies had to evaluate whether the treatment of bereaved individuals reduced bereavement-related symptoms. Data from the studies was abstracted independently by two reviewers.

Results

74 eligible studies evaluated diverse treatments designed to ameliorate a variety of outcomes associated with bereavement. Among studies utilizing a structured therapeutic relationship, eight featured pharmacotherapy (4 included an untreated control group), 39 featured support groups or counselling (23 included a control group), and 25 studies featured cognitive-behavioural, psychodynamic, psychoanalytical, or interpersonal therapies (17 included a control group). Seven studies employed systems-oriented interventions (all had control groups). Other than efficacy for pharmacological treatment of bereavement-related depression, we could identify no consistent pattern of treatment benefit among the other forms of interventions.

Conclusions

Due to a paucity of reports on controlled clinical trails, no rigorous evidence-based recommendation regarding the treatment of bereaved persons is currently possible except for the pharmacologic treatment of depression. We postulate the following five factors as impeding scientific progress regarding bereavement care interventions: 1) excessive theoretical heterogeneity, 2) stultifying between-study variation, 3) inadequate reporting of intervention procedures, 4) few published replication studies, and 5) methodological flaws of study design.
Gene deletion of P-Selectin and ICAM-1 does not inhibit neutrophil infiltration into peritoneal cavity following cecal ligation-puncture
Authors: Crockett Elahé T , Remelius Crystal , Hess Karen , Al-Ghawi Hayma
Published: July 2004

Background

Neutrophil infiltration is one of the critical cellular components of an inflammatory response during peritonitis. The adhesion molecules, P-selectin and intercellular adhesion molecule (ICAM)-1, mediate neutrophil-endothelial cell interactions and the subsequent neutrophil transendothelial migration during the inflammatory response. Despite very strong preclinical data, recent clinical trials failed to show a protective effect of anti-adhesion therapy, suggesting that the length of injury might be a critical factor in neutrophil infiltration. Therefore, the objective of this study was to determine the role of P-selectin and ICAM-1 in neutrophil infiltration into the peritoneal cavity during early and late phases of peritonitis.

Methods

Peritonitis was induced in both male wild-type and P-selectin/ICAM-1 double deficient (P/I null) mice by cecal ligation-puncture (CLP). Peripheral blood and peritoneal lavage were collected at 6 and 24 hours after CLP. The total leukocyte and neutrophil contents were determined, and neutrophils were identified with the aid of in situ immunohistochemical staining. Comparisons between groups were made by applying ANOVA and student t-test analysis.

Results

CLP induced a severe inflammatory response associated with a significant leukopenia in both wild-type and P/I null mice. Additionally, CLP caused a significant neutrophil infiltration into the peritoneal cavity that was detected in both groups of mice. However, neutrophil infiltration in the P/I null mice at 6 hours of CLP was significantly lower than the corresponding wild-type mice, which reached a similar magnitude at 24 hours of CLP. In contrast, in peritonitis induced by intraperitoneal inoculation of 2% glycogen, no significant difference in neutrophil infiltration was observed between the P/I null and wild-type mice at 6 hours of peritonitis.

Conclusions

The data suggest that alternative adhesion pathway(s) independent of P-selectin and ICAM-1 can participate in neutrophil migration during peritonitis and that the mode of stimuli and duration of the injury modulate the neutrophil infiltration.
Resident interest and factors involved in entering a pediatric pulmonary fellowship
Authors: Gershan William M
Published: July 2004

Background

Relatively little is known about interest in pediatric pulmonology among pediatric residents. The purpose of this study, therefore, was to determine at this institution: 1) the level of pediatric resident interest in pursuing a pulmonary fellowship, 2) potential factors involved in development of such interest, 3) whether the presence of a pulmonary fellowship program affects such interest.

Methods

A questionnaire was distributed to all 52 pediatric residents at this institution in 1992 and to all 59 pediatric residents and 14 combined internal medicine/pediatrics residents in 2002, following development of a pulmonary fellowship program.

Results

Response rates were 79% in 1992 and 86% in 2002. Eight of the 43 responders in 1992 (19%) had considered doing a pulmonary fellowship compared to 7 of 63 (11%) in 2002. The highest ranked factors given by the residents who had considered a fellowship included wanting to continue one's education after residency, enjoying caring for pulmonary patients, and liking pulmonary physiology and the pulmonary faculty. Major factors listed by residents who had not considered a pulmonary fellowship included not enjoying the tracheostomy/ventilator population and chronic pulmonary patients in general, and a desire to enter general pediatrics or another fellowship. Most residents during both survey periods believed that they would be in non-academic or academic general pediatrics in 5 years. Only 1 of the 106 responding residents (~1%) anticipated becoming a pediatric pulmonologist.

Conclusions

Although many pediatric residents consider enrolling in a pulmonary fellowship (~10–20% here), few (~1% here) will actually pursue a career in pediatric pulmonology. The presence of a pulmonary fellowship program did not significantly alter resident interest, though other confounding factors may be involved.
"A calorie is a calorie" violates the second law of thermodynamics
Authors: Feinman Richard D , Fine Eugene J
Published: July 2004

The principle of "a calorie is a calorie," that weight change in hypocaloric diets is independent of macronutrient composition, is widely held in the popular and technical literature, and is frequently justified by appeal to the laws of thermodynamics. We review here some aspects of thermodynamics that bear on weight loss and the effect of macronutrient composition. The focus is the so-called metabolic advantage in low-carbohydrate diets – greater weight loss compared to isocaloric diets of different composition. Two laws of thermodynamics are relevant to the systems considered in nutrition and, whereas the first law is a conservation (of energy) law, the second is a dissipation law: something (negative entropy) is lost and therefore balance is not to be expected in diet interventions. Here, we propose that a misunderstanding of the second law accounts for the controversy about the role of macronutrient effect on weight loss and we review some aspects of elementary thermodynamics. We use data in the literature to show that thermogenesis is sufficient to predict metabolic advantage. Whereas homeostasis ensures balance under many conditions, as a general principle, "a calorie is a calorie" violates the second law of thermodynamics.
Similar group mean scores, but large individual variations, in patient-relevant outcomes over 2 years in meniscectomized subjects with and without radiographic knee osteoarthritis
Authors: Paradowski Przemyslaw T , Englund Martin , Roos Ewa M , Stefan Lohmander L
Published: July 2004

Background

Epidemiological studies have, so far, identified factors associated with increased risk for incident or progressive OA, such as age, sex, heredity, obesity, and joint injury. There is, however, a paucity of long-term data that provide information on the nature of disease progression on either group or individual levels. Such information is needed for identification of study cohorts and planning of clinical trials. The aim of the study was, thus, to assess the variation in pain and function on group and individual level over 2 years in previously meniscectomized individuals with and without radiographic knee osteoarthritis (OA).

Methods

143 individuals (16% women, mean age at first assessment 50 years [range 27–83]) were assessed twice; approximately 14 and 16 years after isolated meniscectomy, with a median interval of 2.3 years (range 2.3–3.0). Radiographic OA (as assessed at the time of second evaluation) was present in the operated knee in 40%, and an additional 19% had a single osteophyte grade 1 in one or both of the tibiofemoral compartments. Subjects completed the self-administered and disease-specific Knee injury and Osteoarthritis Outcome Score (KOOS).

Results

There were no significant changes in the group mean KOOS subscale scores over the 2-year period. However, a great variability over time was seen within individual subjects. Out of 143 subjects, 16% improved and 12% deteriorated in the subscale Pain, and 13% improved and 14% deteriorated in the subscale ADL ≥ 10 points (the suggested threshold for minimal perceptible clinical change). Similar results were seen for remaining subscales.

Conclusion

Group mean scores for this study cohort enriched in incipient and early-stage knee OA were similar over 2 years, but pain, function and quality of life changed considerably in individuals. These results may be valid also for other at risk groups with knee OA, and motivate further careful examination of the natural history of OA, as well as properties of the OA outcome instruments used. Longitudinal outcome data in OA studies need to be analyzed both on an individual and a group level.
Ground‐roll suppression from deep crustal seismic reflection data using a wavelet‐based approach: A case study from western Canada
Authors: Welford J. Kim , Zhang Rongfeng
Published: July 2004

Seismic reflection data sets recorded on land are often contaminated by coherent ground‐roll noise generated by the propagation of dispersive waves along the free surface. For crustal‐scale investigations, this ground‐roll contamination can be particularly harmful as the higher amplitude, low‐frequency noise overwhelms low‐frequency signals coming from deep reflectors. Consequently, conventional ground‐roll suppression techniques which rely on frequency separation of ground roll from signal become ineffective for crustal studies. This paper presents the successful use of a new 2D wavelet method based on frame theory (physical wavelet frame denoising) in removing ground roll from a deep 3D reflection data set intended for the study of upper crustal Precambrian mafic sills in southwestern Alberta, Canada.
Determination of relative angles and anisotropic resistivity using multicomponent induction logging data
Authors: Zhang Zhiyi , Yu Liming , Kriegshäuser Berthold , Tabarovsky Lev
Published: July 2004

We have developed a new algorithm that retrieves information about relative dip angle, relative azimuth angle, vertical resistivity, and horizontal resistivity from multicomponent EM induction logging data. To investigate how relative dip and azimuth angles affect multicomponent induction logging data, we performed a sensitivity analysis using an anisotropic whole space model. Based upon the sensitivity analysis, we designed a two‐step procedure to recover relative dip, relative azimuth, horizontal resistivity, and vertical resistivity. In the first step, the observed data are transformed into a new data set independent of the azimuth angle; a simultaneous inversion method recovers relative dip angle, vertical resistivity, and horizontal resistivity. In the second step, a 1D line search is performed to decide relative azimuth angle. Synthetic and field data tests indicate that the new inversion algorithm can extract information about relative dip and azimuth angles as well as the anisotropic resistivity structure from multicomponent induction loggingdata.
Three‐dimensional crustal structure in central Taiwan from gravity inversion with a parallel genetic algorithm
Authors: Zhang Jian , Wang Chi‐Yuen , Shi Yaolin , Cai Yongen , Chi Wu‐Cheng , Dreger Douglas , Cheng Win‐Bin , Yuan Yen‐Horng
Published: July 2004

The genetic algorithm method is combined with the finite‐element method for the first time as an alternative method to invert gravity anomaly data for reconstructing the 3D density structure in the subsurface. The method provides a global search in the model space for all acceptable models. The computational efficiency is significantly improved by storing the coefficient matrix and using it in all forward calculations, then by dividing the region of interest into many subregions and applying parallel processing to the subregions. Central Taiwan, a geologically complex region, is used as an example to demonstrate the utility of the method. A crustal block 120 × 150 km2 in area and 34 km in thickness is represented by a finite‐element model of 76 500 cubic elements, each 2 × 2 × 2 km3 in size. An initial density model is reconstructed from the regional 3D tomographic seismic velocity using an empirical relation between velocity and density. The difference between the calculated and the observed gravity anomaly (i.e., the residual anomaly) shows an elongated minimum of large magnitude that extends along the axis of the Taiwan mountain belt. Among the interpretive models tested, the best model shows a crustal root extending to depths of 50 to 60 km beneath the axis of the Western Central and Eastern Central Ranges with a density contrast of 400 or 500 kg/m3 across the Moho. Both predictions appear to be supported by independent seismological and laboratory evidence.
Quantitative estimation of compaction and velocity changes using 4D impedance and traveltime changes
Authors: Landrø Martin , Stammeijer Jan
Published: July 2004

In some hydrocarbon reservoirs, severe compaction of the reservoir rocks is observed. This compaction is caused by production, and it is often associated with changes in the overburden. Time‐lapse (or 4D) seismic data are used to monitor this compaction process. Since the compaction causes changes in both layer thickness and seismic velocities, it is crucial to distinguish between the two effects.

Two new seismic methods for monitoring compacting reservoirs are introduced, one based on measured seismic prestack traveltime changes, and the other based on poststack traveltime and amplitude changes. In contrast to earlier methods, these methods do not require additional empirical relationships, such as, for instance, a velocity‐porosity relationship. The uncertainties in estimates for compaction and velocity change are expressed in terms of errors in the traveltime and amplitude measurements. These errors are directly related to the quality and repeatability of time‐lapse seismic data. For a reservoir at 3000‐m depth with 9 m of compaction, and assuming a 4D timeshift error of 0.5 ms at near offset and 2 ms at far offset, we find relative uncertainty in the compaction estimate of approximately 50–60% using traveltime information only.
Nonlinear distortion of signals radiated by vibroseis sources
Authors: Lebedev Andrey V. , Beresnev Igor A.
Published: July 2004

A model of nonlinearity of the contact between the vibrator baseplate and the ground is proposed to describe the distortion of vibroseis signals in the near‐field. A thin layer between the baseplate and the soil exhibits a strong nonlinear response because of the difference in its rigidity between the compression and tension phases. The model allows for a quantitative description of the transmission of seismic energy into the ground, including the observed harmonic distortion. However, the contact nonlinearity does not lead to the dependence of wave traveltimes on the amplitude of the force applied to the ground. This fact can be used in field observations to localize the source of the observed harmonic distortion.