bluuebunny/crossref_metadata_2025 huggingface dataset:
International differences in home treatment for mental health problems
Authors: Burns Tom , Catty Jocelyn , Watt Hilary , Wright Christine , Knapp Martin , Henderson Juliet
Published: October 2002

Background

It is perceived that North American home treatment studies reveal greater success in reducing days in hospital than do European studies. There are difficulties in extrapolating findings internationally.

Aims

We aimed to determine whether North American studies find greater reductions in days in hospital and whether experimental service patients in North American studies spend less time in hospital.

Method

The results of a systematic review were analysed with respect to study location. Service components ascertained through follow-up were utilised to interpret the meta-analyses conducted.

Results

Most of the 91 studies found were from the USA and UK. North American studies found a difference of one hospital day (per patient per month) more than European studies but there was no difference in experimental data between the two locations.

Conclusions

North American studies demonstrate greater differences in days in hospital but patients in their experimental services seem to spend no fewer days in hospital, implying a disparity in control services.
Social adversity and mental functions in adolescents at high risk of psychopathology
Authors: Goodyer Ian M.
Published: October 2002

Background

Social adversities are accepted as critical factors in the development of psychopathology in young people, but the precise mechanisms of this relationship are unknown.

Aims

To explore sources of evidence and suggest future lines of research to clarify the relationship between exposure to negative circumstances and development of psychopathology in young people.

Method

Selective survey of the literature to collect a series of hypotheses that might serve as a framework for future research.

Results and conclusions

Evidence to date suggests there is no simple relationship between adverse life events and the subsequent emergence of psychopathology. The interplay of acute and chronic stressors over the lifespan with affective temperament; the interrelationship of ‘sensitivity’ and ‘performance’ cognitions in response to life events; and limbic-cortical neural networks are all indicated as important avenues of future research.
Adult psychosis, common childhood infections and neurological soft signs in a national birth cohort
Authors: Leask Stuart J. , Done D. John , Crow Timothy J.
Published: October 2002

Background

Neurological soft signs preceding adult-onset schizophrenia suggest a neurodevelopmental origin and could reflect physical illness in childhood.

Aims

To investigate possible associations of adult-onset psychosis with neurological soft signs and common infectious illnesses in childhood.

Method

Using data from the UK National Child Development Study, a longitudinal general population sample, odds ratios were calculated for clinical diagnoses of common childhood viral illnesses and later adult psychotic illness, childhood epilepsy and a range of neurological soft signs.

Results

The number of illnesses per individual did not relate either to the number of soft signs, or to any particular adult outcome. Schizophrenia, affective psychosis and epilepsy were not associated with common childhood illness but were associated with neurological soft signs and an increased, but small, frequency of previous meningitis and tuberculosis.

Conclusions

Overall the data support the notion of neurological soft signs as markers of disordered neurodevelopment in schizophrenia (but the early neurological abnormalities are not caused by infectious illness) and an association between meningitis or tuberculosis in childhood and a small proportion of cases of epilepsy, affective psychosis and schizophrenia.
Survivors of the Piper Alpha oil platform disaster: long-term follow-up study
Authors: Hull Alastair M. , Alexander David A. , Klein Susan
Published: October 2002

Background

The long-term psychological effects of surviving a major disaster are poorly understood. We undertook a survey of survivors of the Piper Alpha oil platform disaster (1988).

Aims

To examine the role of factors relating to the trauma, the survivors and the survivors' circumstances.

Method

Ten years after the disaster, 78% (46/59) of the survivors were located, of whom 72% (33/46) agreed to be interviewed. A further three individuals completed postal measures.

Results

The most stringent diagnostic criteria for post-traumatic stress disorder (PTSD) were met by 21% (7/33) of the survivors over 10 years after the disaster. Features such as physical injury, personal experience and survivor guilt were associated with significantly higher levels of post-traumatic symptoms.

Conclusions

A narrow definition of factors affecting outcome will limit the potential for improving survivor well-being in the long-term after major disasters. Specific symptoms that are not included in the criteria for the diagnosis of PTSD, together with issues such as re-employment, need to be addressed.
Ten books
Authors: Oyebode Femi
Published: October 2002

This is an opportunity, but also a challenge, to write about books, especially at a time when the pre-eminence of books as the source and repository of knowledge is no longer indisputable. It is, of course, an impossible task to select merely ten books with the implication that these ten have been the most influential in my professional career, which is the same thing as saying that they have been the most influential books in my life. I have selected ten books from literature, philosophy and psychiatry, and these books, drawn from all my main interests, serve as the springboard for discussing other books. There is no principle underlying the order in which the books are discussed. In many respects, the order has been dictated by the internal logic of this essay.
The influence of patient variables on polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients
Authors: Lelliott Paul , Paton Carol , Harrington Maria , Konsolaki Maria , Sensky Tom , Okocha Chike
Published: October 2002

Aims and Method

A1-day census, involving 3576 psychiatric in-patients prescribed antipsychotic medication, was conducted as a prelude to a multi-centre audit. The aim was to explore the extent to which a number of patient variables explain antipsychotic polypharmacy and the use of high doses of these drugs.

Results

Prescriptions of more than one type of antipsychotic drug were made for 50.5% of patients. Patient factors that influenced the probability of polypharmacy were: younger age, being male, detained under the Mental Health Act and on a rehabilitation or forensic ward, and a diagnosis of schizophrenia. The effect of ethnicity was not significant. Polypharmacy was the most powerful factor influencing the probability of being prescribed a high dose. Identified patient variables accounted for only 18% of the variance in dose prescribed.

Clinical Implications

The patient and clinician factors that account for the unexplained variance need to be identified.
The results of a multi-centre audit of the prescribing of antipsychotic drugs for in-patients in the UK
Authors: Harrington Maria , Lelliott Paul , Paton Carol , Okocha Chike , Duffett Richard , Sensky Tom
Published: October 2002

Aims and Method

Forty-seven UK mental health services participated in a 1-day audit of prescribing of antipsychotic drugs. Audit standards were derived from national guidelines and consensus statements.

Results

Of the 3132 patients, 20% were prescribed a total dose of antipsychotic medication above that recommended by the British National Formulary. The majority of case notes failed to record an indication for high-dose prescribing or that the patient had been informed; only 8% had undergone an electrocardiogram. Forty-eight per cent of patients were prescribed more than one antipsychotic drug.

Clinical Implications

Antipsychotic prescribing for in-patients often runs counter to existing guideline recommendations. It is likely that many patients who are prescribed high doses or polypharmacy are unaware that their prescription is out of line with guideline recommendations and is inadequately monitored.
Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients
Authors: Harrington Maria , Lelliott Paul , Paton Carol , Konsolaki Maria , Sensky Tom , Okocha Chike
Published: October 2002

Aims and Method

A 1-day census provided an opportunity to examine the variation between 44 mental health services in the frequency of prescribing high doses and polypharmacy of antipsychotic drugs to in-patients on acute psychiatric wards.

Results

The proportion of patients prescribed a high dose ranged 0–50% and simultaneous use of more than one antipsychotic drug ranged 12–71%. A number of case-mix variables explained 26% and 40%, respectively, of the variance between services on these two indicators of prescribing practice.

Clinical Implications

Services with high rates of prescription of high dose or polypharmacy might consider a review of clinical practice and of service-level factors that might affect prescribing.
Attitudes of psychiatrists to evidence-based guidelines
Authors: Rees Harvey , Sipos Attila , Spence Matthew , Harrison Glynn
Published: October 2002

Aims and Method

We aimed to survey clinicians' attitudes on using evidence-based guidelines. A postal questionnaire based on a previous survey of general practitioners was sent to 105 psychiatrists working within Avon and Western Wiltshire Mental Health Partnership NHS Trust.

Results

There was a 91% response rate. Respondents were generally in favour of clinical guidelines, with scores indicating a positive attitude to guidelines in 13 of the 18 statements. The majority felt that guidelines were effective in improving patient care, could be used flexibly to suit individual patients and did not impinge on their clinical judgement.

Clinical Implications

Psychiatrists welcomed the increasing use of guidelines. Further research is needed to determine whether this will translate into actual use and improved outcomes for patients.
Acute wards: problems and solutions
Authors: Griffiths Hugh
Published: October 2002

This paper will outline some of the long-standing problems and new challenges facing acute in-patient care, some of the recommendations for change and various difficulties encountered in trying to improve the situation. It will describe how a collaborative approach (led by the Northern Centre for Mental Health, the Centre for Best Practice in Leicester and both the Northern and Yorkshire and the Trent regional offices) can bring about tangible and measurable change for the better and what lessons there may be for the management and delivery of mental health care in the future.
A new opportunity: three tales of training in liaison psychiatry of old age
Authors: Holmes John , Millard Jon , Waddingham Susie
Published: October 2002

Liaison psychiatry has emerged as a sub-speciality within general adult psychiatry, with specific experience and training being required to develop the skills and knowledge to address comorbid physical and psychiatric symptoms and illness (House & Creed, 1993; Lloyd, 2001). Older people often present with significant physical and psychiatric comorbidity (Ames et al, 1994; Holmes & House, 2000) and most old age psychiatry services receive one-quarter to one-third of referrals from general hospital wards (Anderson & Philpott, 1991). Despite this, there are no specific requirements for training in liaison psychiatry for old age psychiatrists at any level. The experience gained in assessing and treating general hospital referrals during basic and higher specialist training is felt to be adequate (Royal College of Psychiatrists, 1998).
Health status and health‐related quality of life associated with hemophilia
Authors: Barr Ronald D. , Saleh Mahassen , Furlong William , Horsman John , Sek Julia , Pai Mohan , Walker Irwin
Published: October 2002

The hemophilias are a group of disorders associated with a chronic burden of morbidity and early mortality. Improvements in these adverse features have been achieved by the use of clotting factor concentrates within comprehensive centers of specialized care providing home infusion programs. Offsetting effects from transfusion‐transmitted hepatitis and HIV infection are in recent decline. The net impact of these changes merits assessment. To test the a priori hypotheses that increasing severity of factor VIII deficiency would be associated with an increasing burden or morbidity and that hepatitis and HIV positivity would impair health status further, a cross‐sectional study of a population‐based cohort was undertaken in a regional hemophilia program in Ontario, Canada. A survey was made of mild, moderate, and severe hemophiliacs over 13 years of age who self‐reported their health status using a standard 15‐item questionnaire. The responses were converted to levels in the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) health status classification systems to form multi‐element vectors from which single‐attribute morbidity and overall health‐related quality of life utility scores were determined. The burden of morbidity was greater in hemophiliacs than in the general population and correlated with the category of disease (mild < moderate < severe). Hepatitis and HIV positivity conferred additional burdens of morbidity, which were mainly in the attributes of mobility (HUI2), ambulation (HUI3), and pain (HUI2/3), all of these differences reaching levels of statistical significance. Despite demonstrable improvements in the safety, effectiveness, and utilization of clotting factor concentrates, hemophiliacs continue to experience an important burden of morbidity. Measurement of this burden, as reported here, provides a basis for future economic evaluation of the costs and consequences of health care interventions provided to this population. Am. J. Hematol. 71:152–160, 2002. © 2002 Wiley‐Liss, Inc.
Danazol for the treatment of thrombocytopenia in patients with myelodysplastic syndrome
Authors: Chan Geoffrey , DiVenuti Gina , Miller Kenneth
Published: October 2002

Thrombocytopenia is a poor prognostic indicator in the myelodysplastic syndromes (MDS). Treatment options for patients with symptomatic thrombocytopenia are limited. Danazol, an attenuated androgen, may have some efficacy in increasing the platelet count of patients with MDS. We retrospectively reviewed 33 patients with primary MDS who were treated with danazol for 6 or more weeks. After 6 weeks on danazol, the mean platelet count increased from 42 × 109/L to 60 × 109/L (P < 0.015), and 25 out of 33 patients (76%) had an increase in their platelet counts. Following 12 weeks of treatment, the mean platelet count increased to 67 × 109/L (P < 0.005), and 21 out of 29 patients (72%) had an increase in their platelet counts. Seven out of nine patients no longer required platelet transfusions because bleeding stopped after 6 weeks on danazol. Mean duration of response was 10 months (range 2–68 months). Responses were seen in all French‐American‐British (FAB) subtypes and in all International Prognostic Scoring System (IPSS) scores. Therapy was well tolerated. Danazol may be effective in MDS patients who are thrombocytopenic. Am. J. Hematol. 71:166–171, 2002. © 2002 Wiley‐Liss, Inc.
Treatment of a patient with end‐stage renal disease with Rituximab: Pharmacokinetic evaluation suggests Rituximab is not eliminated by hemodialysis
Authors: Jillella Anand P. , Dainer Paul M. , Kallab Andre M. , Ustun Celalettin
Published: October 2002

The purpose of this study was to determine if therapeutic levels of Rituximab could be achieved in a patient with renal failure being dialyzed and if Rituximab is removed by hemodialysis. A 54‐year‐old man with low‐grade lymphoma and renal failure on hemodialysis received 8 weekly treatments of Rituximab at 375 mg/M2. Serum Rituximab levels were obtained before and after each treatment, before and after dialysis following each treatment, as well as in the dialysate fluid. The serum levels of Rituximab increased gradually with each treatment and were comparable to levels in patients with normal renal function. The postdialysis levels were higher than the predialysis levels as a consequence of hemo‐concentration after dialysis. Rituximab was not detected in the dialysate fluid. The patient developed life‐threatening hyperkalemia after the fourth treatment, which we believe occurred secondary to tumor lysis. Therapeutic levels of Rituximab may be maintained in patients undergoing dialysis. Rituximab is not eliminated by hemodialysis. Am. J. Hematol. 71:219–222, 2002. © 2002 Wiley‐Liss, Inc.
Severe congenital Factor VII deficiency associated with the 13q deletion syndrome
Authors: Hewson Michael P. , Carter John M.
Published: October 2002

The first reported case of clinically significant congenital Factor VII deficiency in association with the 13q deletion syndrome is presented. It illustrates the importance of knowledge of the specific genes involved in gross deletion syndromes and adds to the current clinical experience of this rare disease. Am. J. Hematol. 71:232–233, 2002. © 2002 Wiley‐Liss, Inc.
Effect of ABO blood group on the collagen‐binding assay for von Willebrand factor
Authors: Haley Erin , Babar Nadiya , Ritter Cory , Downes Katharine A. , Green Deana , Shurin Susan , Sarode Ravindra
Published: October 2002

von Willebrand disease (VWD) is the most common congenital bleeding disorder and is caused by a quantitative or qualitative abnormality of von Willebrand factor (VWF). Ristocetin cofactor (RCoF) assay is used to evaluate VWF activity, but it does not assess collagen‐binding activity. Normal values of RCoF and VWF antigen vary with ABO blood group type. The collagen‐binding assay (CBA) measures VWF activity; however, its relationship with ABO blood group has not been completely explored. We performed CBA on plasma samples from 131 healthy volunteers to determine if CBA values correlated with blood type. Individuals with blood group O had a mean CBA value of 94 ± 28%, which was significantly different from the mean of 117 ± 33% in persons with non‐O blood groups (P = 0.0001). Thus, CBA values appear to correlate with ABO blood type in a manner similar to RCoF. Am. J. Hematol. 71:229–231, 2002. © 2002 Wiley‐Liss, Inc.
On bidirectional English–Arabic search
Authors: Aljlayl M. , Frieder O. , Grossman D.
Published: October 2002

In Cross‐Language Information Retrieval (CLIR), queries in one language retrieve relevant documents in other languages. Machine‐Readable Dictionaries (MRD) and Machine Translation (MT) systems are important resources for query translation in CLIR. We investigate the use of MT systems and MRD to Arabic–English and English–Arabic CLIR. The translation ambiguity associated with these resources is the key problem. We present three methods of query translation using a bilingual dictionary for Arabic–English CLIR. First, we present the Every‐Match (EM) method. This method yields ambiguous translations because many extraneous terms are added to the original query. To disambiguate query translation, we present the First‐Match (FM) method that considers the first match in the dictionary as the candidate term. Finally, we present the Two‐Phase (TP) method. We show that good retrieval effectiveness can be achieved without complex resources using the Two‐Phase method for Arabic–English CLIR. We also empirically evaluate the effectiveness of the Arabic–English MT approach using short, medium, and long queries of TREC7 and TREC9 topics and collections. The effects of the query length to the quality of the MT‐based CLIR are investigated. English–Arabic CLIR is evaluated via MRD and English–Arabic MT. The query expansion via posttranslation approach is used to deemphasize the extraneous terms introduced by the MRD and MT for English–Arabic CLIR.
A preliminary evaluation of the differences in the glycosylation of alpha‐1‐acid glycoprotein between individual liver diseases
Authors: Anderson Nicola , Pollacchi Aileen , Hayes Peter , Therapondos George , Newsome Philip , Boyter Anne , Smith Kevin
Published: October 2002

During the acute phase response (APR) to tissue injury or infection, the liver is responsible for the level of mediators such as cytokines required at the site of inflammation and providing the essential components for wound healing and tissue repair. Additionally there are substantial alterations in the expression of plasma proteins of hepatic origin such as alpha‐1‐acid glycoprotein (AGP). The APR also results in alterations to the branching, sialylation and fucosylation of the oligosaccharide chains of AGP. This study investigated whether liver damage could be correlated with changes in AGP glycosylation in groups of patients with various liver diseases (alcoholic liver disease, hepatitis B, hepatitis C, cirrhosis). Hyperfucosylation occurred in all cases of liver disease, although the hepatitis B and C samples showed a more significant increase in comparison with the others. Additionally N‐acetylgalactosamine (GalNAc) was detected in the majority of the hepatitis C samples, which was unexpected since this monosaccharide is not a usual component of the N‐linked oligosaccharide chains. It was also determined by concanavalin (con) A chromatography that there is a shift towards the increased branching of the oligosaccharide chains in inflammatory liver diseases compared to normal serum. Copyright © 2002 John Wiley & Sons, Ltd.
Percutaneous mitral balloon valvuloplasty in pregnant women with mitral stenosis
Authors: Nercolini Deborah Christina , Bueno Ronaldo da Rocha Loures , Eduardo Guérios Ênio , Tarastchuk José Carlos , Pacheco Álvaro Luis , Andrade Paulo Mauricio Piá de , Cunha Claudio Leinig Pereira da , Germiniani Hélio
Published: October 2002

Forty‐four consecutive pregnant patients with mitral stenosis were submitted to percutaneous mitral valvuloplasty (PMV) over a period of 12 years. The mean age was 28 ± 6 years and the mean gestational age was 23 ± 6 weeks. The mean mitral valve area had a significant increase from 1.17 ± 0.26 to 2.06 ± 0.41 cm2 (P = 0.0000). The mean mitral valve gradient decreased from 16.22 ± 5.55 to 7.94 ± 3.75 mm Hg (P = 0.0001). The procedure was performed successfully in 95% of the patients and there were no major complications. Concerning labor and delivery, we evaluated 37 patients. Thirty patients (81%) reached term and delivered normal infants. Seven patients (18.9%) delivered prematurely, resulting in two fetal death; one patient delivered a stillborn. We concluded that PMV is a safe procedure for the treatment of mitral stenosis in pregnant patients, providing significant symptomatic relief and better clinical conditions for labor and delivery. Cathet Cardiovasc Intervent 2002;57:318–322. © 2002 Wiley‐Liss, Inc.
Resolution of refractory no‐reflow with intracoronary epinephrine
Authors: Skelding Kimberly A. , Goldstein James A. , Mehta Laxmi , Pica Mark C. , O'Neill William W.
Published: October 2002

Refractory no‐reflow is associated with adverse outcomes in patients undergoing percutaneous coronary intervention. Charts were reviewed to identify 29 consecutive patients in whom intracoronary epinephrine was administered for refractory no‐reflow. The effects of intracoronary epinephrine on coronary flow (TIMI grade), cardiac rhythm, and systolic blood pressure in the cardiac catheterization laboratory were assessed. Administration of intracoronary epinephrine (mean dose, 139 ± 189 μg) resulted in significant improvement in coronary flow. After administration, TIMI 3 flow was established in 69% of patients. Overall, TIMI flow significantly increased (mean TIMI flow form 1.0 ± 1.0 to 2.66 ± 0.55; P = 0.0001). Intracoronary epinephrine resulted in significant but tolerable increase in heart rate (72 ± 19 to 86 ± 26 beats/min; P = 0.009), but no cases of acute dysrhythmia. These findings indicate that intracoronary epinephrine may exert salutary effects in patients suffering refractory no‐reflow following elective or acute coronary interventions. Cathet Cardiovasc Intervent 2002;57:305–309. © 2002 Wiley‐Liss, Inc.
Prospective randomized study of N‐acetylcysteine, fenoldopam, and saline for prevention of radiocontrast‐induced nephropathy
Authors: Allaqaband Suhail , Tumuluri Ramagopal , Malik Ahmed M. , Gupta Anjan , Volkert Paul , Shalev Yoseph , Bajwa Tanvir K.
Published: October 2002

The objective of this study was to compare the efficacy of N‐acetylcysteine (NAC), fenoldopam, and saline in preventing radiocontrast‐induced nephropathy (RCIN) in high‐risk patients undergoing cardiovascular procedures. We prospectively enrolled 123 patients who were scheduled for cardiovascular procedures and had a baseline creatinine > 1.6 mg/dl or creatinine clearance of < 60 ml/min. Patients were randomly assigned to receive either saline (0.45% normal saline at 1 cc/kg) for 12 hr before and 12 hr after the procedure, or fenoldopam (0.1 μg/kg/min) plus saline for 4 hr prior and 4 hr after the procedure, or NAC orally (600 mg) plus saline every 12 hr for 24 hr prior and 24 hr after the procedure. All the patients received low‐osmolality nonionic contrast. RCIN was defined as an increase in creatinine level > 0.5 mg/dl after 48 hr. The incidence of RCIN was 17.7% in the NAC group, 15.3% in the saline group, and 15.7% in the fenoldopam group (P = 0.919). Of the 20 patients who developed RCIN, 2 required dialysis. Serum creatinine decreased after 48 hr (vs. baseline) in 38% patients in the NAC group, 18% in the fenoldopam group, and 15% in the saline group. In patients with chronic renal insufficiency, NAC or fenoldopam offered no additional benefit over hydration with saline in preventing RCIN. Cathet Cardiovasc Intervent 2002;57:279–283. © 2002 Wiley‐Liss, Inc.
Coronary artery fistula embolization in an infant with pulmonary atresia intact ventricular septum: A case report
Authors: Garabedian Carl P. , Mosca Ralph S. , Hellenbrand William E.
Published: October 2002

This report presents a case of pulmonary atresia/intact ventricular septum with right ventricular‐dependent coronary circulation. At 7 months of age, the infant underwent coil embolization of the connection between the right ventricle and the coronary circulation. The child is currently well following surgical decompression of the right ventricle. Cathet Cardiovasc Intervent 2002;57:371–373. © 2002 Wiley‐Liss, Inc.
Transcatheter patch occlusion of experimental atrial septal defects
Authors: Sideris Eleftherios B. , Sideris Chrysoula E. , Stamatelopoulos Stamatis F. , Moulopoulos Spyridon D.
Published: October 2002

The effectiveness and safety of transcatheter patch atrial septal defect (ASD) occlusion were studied in 20 piglets. Experimental atrial septal defects were created by foramen ovale dilation. ASDs were corrected by polyurethane patches of two types (flat and sleeve). Specially made balloon catheters supported the patches for periods varying from 1 to 6 days; after this period, the supporting catheters were withdrawn and the patches were released. All transcatheter patches were safely embedded in the atrial septum 48 hr or more after implantation. All defects were fully occluded. One patch became infected. The transcatheter patch experimental ASD occlusion method was found effective and safe, potentially applicable in the occlusion of human ASDs. Cathet Cardiovasc Intervent 2002;57:404–407. © 2002 Wiley‐Liss, Inc.
Transjugular approach to balloon mitral valvuloplasty helps overcome impediments caused by anatomical alterations
Authors: Joseph George , George Oommen K. , Mandalay Asishkumar , Sathe Sunil
Published: October 2002

Ten patients who had anatomic alterations that cause impediments to successful completion of conventional transfemoral balloon mitral valvuloplasty (BMV) underwent transjugular BMV. They included six patients in whom conventional BMV could not be completed due to cardiac anatomic distortion; two patients with dextrocardia (one with visceroatrial situs solitus and the other with situs inversus); two patients with venous abnormalities (one with azygous continuation of the inferior vena cava and the other with bilateral iliac/femoral vein occlusion). Transjugular BMV was successful in all 10 patients (mean mitral valve area increasing from 0.68 ± 0.17 to 1.92 ± 0.40 cm2; range, 1.56–2.76 cm2); it was quick (mean total fluoroscopy time, 10.5 ± 2.7 min; range, 7.3–15.2 min); and it was safe (no major or minor complications except one patient who developed severe mitral regurgitation that only required medical therapy). The jugular approach to BMV overcomes many of the technical problems caused by anatomic changes that are encountered in transfemoral BMV and complements the latter approach. Cathet Cardiovasc Intervent 2002;57:353–362. © 2002 Wiley‐Liss, Inc.
Balloon‐based radiation therapy for treatment of in‐stent restenosis in human coronary arteries: Results from the BRITE I study
Authors: Waksman Ron , Buchbinder Maurice , Reisman Mark , Lansky Alexandra J. , Trauthen Brett , Whiting James , Li Alexander
Published: October 2002

Catheter‐based intracoronary radiation therapy demonstrated reduction of the recurrence rate of in‐stent restenosis by 35%–50% when compared to conventional therapy. The objectives of this study were to determine the safety and feasibility of a new balloon‐shaped source design and a higher applied dose to reduce the restenosis rates. Thirty‐two patients with in‐stent restenosis who met study eligibility criteria were successfully treated with standard PCI techniques. Following a successful intervention, a P‐32 β‐balloon source was positioned to cover the angioplasty site and a dose of a 20 Gy at 1 mm from the surface of the source was administered. The primary endpoint was a composite of major adverse cardiac events (any death, MI, emergent CABG, or repeat target vessel revascularization) during 6 months of follow‐up. At 6 months, only one patient underwent repeat PTCA to the target vessel (3%). There were no instances of death, emergency surgery, late thrombosis, total occlusions, or MI. Binary restenosis measured by QCA at the stented segment was 0% and for the whole analysis vessel was 7.5%. Beta‐radiation delivered with a balloon P‐32 source design for patients with in‐stent restenosis results in lower than expected rate of angiographic and clinical restenosis and the absence of late complications. Cathet Cardiovasc Intervent 2002;57:286–294. © 2002 Wiley‐Liss, Inc.
Origin of the dopaminergic innervation of the central extended amygdala and accumbens shell: A combined retrograde tracing and immunohistochemical study in the rat
Authors: Hasue Renata H. , Shammah‐Lagnado Sara J.
Published: October 2002

The origin of the dopaminergic innervation of the central extended amygdala (EAc; i.e., the lateral bed nucleus of the stria terminalis [BSTl]‐central amygdaloid nucleus [Ce] continuum) and accumbens shell (AcSh) was studied in the rat by combining retrograde transport of Fluoro‐Gold (FG) with tyrosine hydroxylase (TH) immunofluorescence. Perikaryal profiles (PP) immunoreactive to FG and to both FG and TH were counted in A8–A14 dopaminergic districts. Our results suggest that dopaminergic inputs to the EAc and AcSh arise from the ventral tegmental area‐A10, substantia nigra, pars compacta‐A9, and retrorubral nucleus‐A8 groups as well as from the dorsal raphe nucleus and periaqueductal gray substance, housing the dorsocaudal part of A10 group (A10dc). Quantitative estimates reveal that the A10dc group contains approximately half of the total number of FG/TH double‐labeled PP projecting to Ce and BSTl. By using an anti‐dopamine serum, DR/PAG projections to Ce were confirmed to be in part dopaminergic. In contrast, modest numbers of FG/TH double‐labeled PP were seen in the A10dc group after injections in the sublenticular extended amygdala, interstitial nucleus of the posterior limb of the anterior commissure or AcSh. Ventral mesencephalic projections to the EAc display a crude mediolateral topographic organization, whereas those to the AcSh are topographically organized along a mediolateral and an inverted dorsoventral dimension. The diencephalic dopaminergic groups do not innervate the EAc or AcSh, except for the periventricular gray‐A11 which sends light dopaminergic projections to Ce and BSTl. Overall, the present results provide additional details on the organization of the mesolimbic dopaminergic system that critically controls behavioral responsiveness to salient environmental stimuli. J. Comp. Neurol. 454:15–33, 2002. © 2002 Wiley‐Liss, Inc.
Patterns of dye coupling in lumbar motor nuclei of the rat
Authors: Coleman Allison Marie , Sengelaub Dale Robert
Published: October 2002

Gap junctions exist on motoneurons of the spinal nucleus of the bulbocavernosus (SNB) and the dorsolateral nucleus (DLN), both sexually dimorphic motor nuclei in the lumbar spinal cord of the rat. In addition, messenger RNA for gap junction proteins is expressed in motoneurons of the retrodorsolateral nucleus (RDLN), a nondimorphic spinal motor nucleus that innervates a muscle of the foot. Gap junctions on SNB and DLN motoneurons are androgen sensitive; the number and size of gap junctions decrease following castration, a change that can be reversed with exogenous testosterone replacement. In contrast, RDLN gap junction mRNA levels remain constant throughout hormone manipulation. In this study, dye coupling was used to examine patterns of gap junction‐mediated connectivity in these three lumbar spinal motor nuclei. Injection of dye into single motoneurons resulted in spatially extensive labeling of neighboring cells in all three nuclei; significantly more coupling was observed in the sexually dimorphic nuclei than in the RDLN. Dye‐coupled clusters of cells included motoneurons and interneurons; coupling was bilateral in the SNB. Treatment with oleamide, a gap junction blocker, completely attenuated labeling. In all nuclei, androgen manipulation did not alter the number, identity, or distribution of coupled cells. Thus, sexually dimorphic nuclei in the spinal cord exhibit greater dye coupling than do nondimorphic populations, and the patterns of connectivity are insensitive to androgen despite modification of their number and size. J. Comp. Neurol. 454:34–41, 2002. © 2002 Wiley‐Liss, Inc.
First bite syndrome: A complication of surgery involving the parapharyngeal space
Authors: Chiu Alexander G. , Cohen James I. , Burningham Alan R. , Andersen Peter E. , Davidson Bruce J.
Published: October 2002

Introduction.

First bite syndrome (FBS) is the development of pain in the parotid region after the first bite of each meal and can be seen after surgery of the parapharyngeal space. The cause is not clear but has been proposed to involve a loss of sympathetic nerve function to the parotid, causing a denervation supersensitivity of salivary gland myoepithelial cells. The purpose of this study was to review the records of 12 patients with FBS to determine any common features of the operations performed that would support this theory of parotid “sympathectomy” as an etiologic factor of FBS.

Methods.

Retrospective review of 12 patients with FBS managed at two tertiary care centers.

Results.

Twelve patients were diagnosed with FBS after surgery involving the parapharyngeal space. All patients had most of their parotid gland preserved. Six patients exhibited a postoperative Horner's syndrome, suggesting sympathetic chain interruption. The six patients without Horner's syndrome were found to have undergone external carotid artery ligation inferior to the parotid gland, suggesting an interruption of sympathetic innervation to the parotid gland itself.

Conclusions.

Preservation of parotid gland tissue and a loss of its sympathetic nerve supply, whether by disruption of the cervical sympathetic chain as evidenced by a Horner's syndrome or more selective denervation by ligation of the external carotid artery with its accompanying sympathetic nerve plexus, were common features of all patients. This series supports the concept of parotid “sympathectomy” as an etiologic factor in FBS. © 2002 Wiley Periodicals, Inc.
Planned neck dissection after definitive radiotherapy for squamous cell carcinoma of the head and neck
Authors: Mendenhall William M. , Villaret Douglas B. , Amdur Robert J. , Hinerman Russell W. , Mancuso Anthony A.
Published: October 2002

Background.

To define the role of planned neck dissection after definitive radiotherapy for patients with node‐positive squamous cell carcinoma of the head and neck.

Methods.

Review of the pertinent literature.

Results.

Radiotherapy alone produces a relatively high likelihood of regional control for patients with early‐stage neck disease. Patients with more advanced neck disease have a higher probability of regional control if a planned neck dissection follows radiotherapy. However, for patients who have a complete response to radiotherapy, the likelihood of an isolated recurrence in the neck is low. Radiographic evaluation of the response to radiotherapy may better define the subset of patients who are likely to benefit from a neck dissection.

Conclusions.

Neck dissection after definitive radiotherapy improves regional control for patients with advanced neck disease. Patients who have a complete clinical and radiographic regional response to radiotherapy have a low probability of an isolated recurrence in the neck. It is advisable to proceed with a neck dissection for patients who have an equivocal response to radiotherapy, because the likelihood of salvage of an isolated recurrence in the neck is remote. © 2002 Wiley Periodicals, Inc. Head Neck 24: 1012–1018, 2002
Drip irrigation of corn in the Southeast Anatolia Project (GAP) Area in Turkey
Authors: Yazar Attila , Sezen Semih Metin , Gencel Burçin
Published: October 2002

This study was designed to evaluate the yield response of trickle‐irrigated corn grown on a clay‐textured soil under the arid Southeast Anatolia Project (GAP) area conditions during the 2000 growing season at Koruklu in Turkey. The effects of three different irrigation levels (100, 67 and 33% of cumulative Class‐A pan evaporation on a three‐ and six‐day basis), and two irrigation intervals (three‐ and six‐day) on yield were investigated. Trickle laterals were laid out on the soil surface at a spacing of 1.40 m. A total of 581 mm of water was applied to the full‐irrigation treatments (100%) for both irrigation intervals. Seasonal water use ranged from 358 to 562 mm across treatments. Highest average corn yield (11 920 kg ha−1) was obtained from the full‐irrigation treatment (100%) with six‐day interval. Corn grain yields varied from 7940 to 11 330 kg ha−1 and 7253 to 11 920 kg ha−1 for three‐ and six‐day irrigation intervals, respectively. Irrigation levels significantly increased yield. Maximum irrigation water use efficiency (IWUE) and water use efficiency (WUE) were 2.53 and 2.27 kg m−3 in treatment of I‐33 with six‐day interval. Both IWUE and WUE values varied with irrigation quantity and frequency. The research results revealed that the trickle irrigation system could be used successfully for irrigating corn crops under the arid climatic conditions of the Southeast Anatolia Project (GAP) area in Turkey. Copyright © 2002 John Wiley & Sons, Ltd.
A simple nitrate submodel for trickle fertigated potatoes
Authors: Narda N. K. , Chawla J. K.
Published: October 2002

A simple nitrate dynamics submodel capable of predicting the spatial distribution of NO3‐N within the soil profile following N fertigation with urea through trickle irrigation has been formulated and validated. The model utilizes a best‐fit nitrification function which, on a particular day, converts a given quantity of urea into nitrate and also incorporates the cumulative effect of previous fertigations. The daily updated values of NO3‐N of soil layers have been obtained by deducting the N‐uptake by plants calculated on the basis of root length present. The predicted values of NO3‐N have matched reasonably well with the observed data. Copyright © 2002 John Wiley & Sons, Ltd.
Irrigation and drainage systems research and development in the 21st century
Authors: Schultz Bart , De Wrachien Daniele
Published: October 2002

One critical problem confronting mankind today is how to manage the intensifying competition for water between expanding urban centres, traditional agricultural activities and in‐stream water uses dictated by environmental concerns. In the agricultural sector, the dwindling number of economically attractive sites for large‐scale irrigation and drainage projects limits the prospects of increasing the gross cultivated area. Therefore, the required increase in agricultural production will necessarily rely largely on a more accurate estimation of crop water requirements on the one hand, and on major improvements in the construction, operation, management and performance of existing irrigation and drainage systems, on the other. The failings of present systems and the inability to sustainably exploit surface and groundwater resources can be attributed essentially to poor planning, design, system management and development. This is partly due to the inability of engineers, planners and managers to adequately quantify the effects of irrigation and drainage projects on water resources and to use these effects as guidelines for improving technology, design and management.

To take full advantage of investments in agriculture, a major effort is required to modernize irrigation and drainage systems and to further develop appropriate management strategies compatible with the financial and socio‐economic trends, and the environment. This calls for a holistic approach to irrigation and drainage management and monitoring so as to increase food production, conserve water, prevent soil salinization and waterlogging, and to protect the environment. All this requires, among others, enhanced research and a variety of tools such as water control and regulation equipment, remote sensing, geographic information systems, decision support systems and models, as well as field survey and evaluation techniques. To tackle this challenge, we need to focus on the following issues:

affordability with respect to the application of new technologies;

procedures for integrated planning and management of irrigation and drainage systems;

analysis to identify causes and effects constraining irrigation and drainage system performance;

evapotranspiration and related calculation methods;

estimation of crop water requirements;

technologies for the design, construction and modernization of irrigation and drainage systems;

strategies to improve irrigation and drainage system efficiency;

environmental impacts of irrigation and drainage and measures for creating and maintaining sustainability;

institutional strengthening, proper financial assessment, capacity building, training and education.

Copyright © 2002 John Wiley & Sons, Ltd.
Expression of the gene of interest fused to the EGFP–expressing gene in transgenic mice drived from selected transgenic embryos
Authors: Kubo Jun , Yamanouchi Keitaro , Naito Kunihiko , Tojo Hideaki
Published: October 2002

The present paper describes the expression of a target fusion gene, WAP/hGH fused to the EGFP–expressing gene in transgenic mice derived from the transfer of transgenic embryos selected because of their expression of enhanced green fluorescent protein (EGFP). The 6.7–kb fusion gene was microinjected as a single cassette gene construct into the pronuclei of mouse zygotes. The surviving embryos were cultured and were classified according to the EGFP expression patterns at the morula or blastocyst stage. After the transfer of embryos with uniform–expression or mosaic–expression of EGFP, transgenesis occurred in 85.7% to 86% or 44.1% to 44% of the pups, respectively. No transgenic pups were derived from EGFP negative embryos. In the transgenic females, EGFP was ubiquitously expressed under the control of the CAG promoter, and hGH was expressed under the control of the WAP promoter in an appropriate fashion: hGH was secreted into the milk of lactating transgenic females. The presence or absence of the expression of EGFP coincided with that of the hGH gene in the transgenic mice. The present cassette gene construct is a useful example for circumventing the routine analyses of DNA and RNA required for the generation and maintenance of transgenic lines. J. Exp. Zool. 293:712–718, 2002. © 2002, Wiley‐Liss, Inc.
Studies on lipid metabolism in trout (Oncorhynchus mykiss) branchial cultures
Authors: Hansen Heinz J.M. , Kelly Scott P. , Grosell Martin , Wood Chris M.
Published: October 2002

Cultured branchial cell epithelia from freshwater rainbow trout were incubated with (32P)phosphate and (14C)acetate as lipid precursors under both symmetrical (L15 media apical/L15 media basolateral) and asymmetrical (freshwater apical/L15 media basolateral) culture conditions. Epithelia composed of pavement cells alone, or containing both pavement cells and chloride cells, were examined. Lipids (labeled with 32P and 14C) were isolated and assayed by thinlayer chromatography, and fatty acids (labeled with 14C) were isolated and assayed by paper chromatography. The main goal was to see whether the loss of a major incorporation into (32P)phosphatidylethanolamine [(32P)PE], previously seen in eel gills in vivo when the fish were transferred from an osmotic steady state to more dilute media, was the result of a hormonal regulation, i.e., did it only apply to gill tissue in vivo or could it also be seen in the absence of hormonal modulation after incorporation of (32P)phosphate in vitro? We likewise wished to see whether a major incorporation into (32P)PE was dependent upon the presence of chloride cells. Results show that it is possible to obtain a (32P)PE dominated incorporation pattern, even in the pavement cells alone, provided that (32P)phosphate is added specifically to freshwater on the apical side of epithelia bathed asymmetrically (freshwater/L15). This is identical to the pattern seen in vivo in trout adapted to freshwater. However, this pattern is not seen under symmetrical conditions (L15/L15) or when (32P)phosphate is added to the basolateral media. The shift from symmetrical (L15/L15) to asymmetrical (freshwater/L15) culture conditions thus leads to the establishment of a major incorporation into (32P)PE and not to the equivalent loss as seen in vivo in more dilute apical media. We conclude that hormonal control is not needed to change the pattern of short‐term lipid formation but, nevertheless, the responses are not altogether the same in vitro and in vivo. Furthermore, cultured trout gill epithelia, in contrast to gills in vivo, do not exhibit a marked incorporation of (14C)acetate into palmitoleic acid. J. Exp. Zool. 293:683–692, 2002. © 2002 Wiley‐Liss, Inc.