bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolongation of corneal xenotransplant survival by T‐cell vaccination‐induced T‐regulatory cells
Authors: Wang Jing , Jiang Shibo , Shi Haiming , Lin Ying , Wang Jufang , Wang Xiaoning 
Published: July 2008

Abstract:  Background:  Corneal xenotransplantation is an alternative approach for overcoming shortage of allograft in clinics. However, the mechanism of acute corneal xenograft rejection and the method of prolonging xenograft survival have not been well defined.Methods:  In this study, we used an orthotopic corneal guinea pig‐to‐rat xenotransplantation model to study the effects of CD4 and CD8 T cells, T‐cell vaccination (TCV) and TCV‐induced T‐regulatory (Treg) cells on xenograft survival.Results:  The acute rejection of xenografts occurred in untreated rats as early as 6 days post‐transplantation, while TCV significantly prolonged xenograft survival from 6–12 to 21–27 days. The lymph node cells of the TCV‐treated rats exhibited significant response to the anti‐guinea pig T cells and the responding cell populations contained two Treg cell subsets, CD4+ CD25− and CD8+ CD28− T cells, both of which lack expression of Foxp3. Adoptive transfer of CD8+ CD28− T cells resulted in profound inhibition of corneal xenograft rejection, while transfer of CD4+ CD25− T cells alone exhibited no significant inhibition. However, transfer of the CD4+ CD25− and CD8+ CD28− T‐cell mixture remarkably enhanced the in vivo protective activity against xenograft rejection.Conclusions:  These data suggest that TCV induces the activation of specific Treg cell subsets, CD4+ CD25− and CD8+ CD28− T cells, which may act cooperatively to mediate prolongation of corneal xenograft survival. Therefore, TCV can be used as immunotherapy for suppression of acute xenograft rejection.
Autoantibodies to basement membrane proteins BP180 and BP230 are commonly detected in normal subjects by immunoblotting
Authors: Desai Nemesha , Allen Jill , Ali Iaisha , Venning Vanessa , Wojnarowska Fenella 
Published: July 2008

SUMMARYAutoantibodies to basement membrane proteins BP180 and BP230 are characteristic of bullous pemphigoid and other subepidermal immunobullous disorders. These antibodies are, however, reported in other pruritic dermatoses, non‐bullous disorders and non‐cutaneous disease. Few studies have assessed basement membrane antibodies in normal subjects; antibody prevalence in this population is not clear. This study aims to examine basement membrane zone antibodies in normal middle‐aged to elderly subjects. Sera from 61 healthy subjects (majority age 50–70 years) were assessed by immunoblot, indirect immunofluorescence and enzyme‐linked immunosorbent assay. Ninety‐one bullous pemphigoid patients acted as positive controls. Antigenic target, antibody class and titre were examined; sera binding BP180 were assessed for reactivity to the non‐collagenous 16A (NC16A) domain. Thirty‐six normal subjects (59%) had antibodies to either BP180 or BP230 on immunoblot analysis. BP180 was the commonest target antigen, detected in 35 subjects; binding to the immunodominant NC16A domain was not detected. Immunofluorescence was positive in three subjects. Of the bullous pemphigoid sera, 88% were positive on immunoblot or immunofluorescence; a higher frequency had antibodies against BP230. In conclusion, significant numbers of normal healthy subjects have circulating autoantibodies to basement membrane proteins, chiefly BP180 detectable by immunoblot, but these do not bind the NC16A domain.
From biologic to biologic to biologic: Lessons to learn for erythrodermic and recalcitrant chronic plaque psoriasis
Authors: Yip Leona , Harrison Shannon , Foley Peter 
Published: July 2008

SUMMARYDifferences in mode of action between biologic agents could explain why one agent is more efficacious than another in the treatment of recalcitrant and erythrodermic flares of chronic plaque psoriasis. Here, we present our experience using a case series of three patients with chronic plaque psoriasis who showed consistent and similar responses to three different biologic agents. All three patients who were refractory to efalizumab developed erythrodermic flares 2–12 weeks after a direct switch to etanercept. Switching from efalizumab to etanercept could provoke paradoxical flaring of psoriasis, which might be prevented by transitioning to systemic agents. The erythrodermic flares in all three patients responded dramatically to infliximab with marked and maintained improvements in Psoriasis Area and Severity Index scores.
Public support for anti‐smoking legislation varies with smoking status
Authors: Dwyer Trudy , Bradshaw Julie , Mummery William K. , Searl Kerry R. , Rossi Dolene , Broadbent Marc 
Published: July 2008

AbstractObjective:  Rural Australians have higher rates of smoking than their urban counterparts, contributing to poorer health outcomes. In 2004, the Queensland Government introduced legislation to reduce the impact of environmental tobacco smoke on the community. The aims of the study were to describe smoking behaviours and associations between smoking behaviour and agreement with current anti‐smoking laws. Participants:  A total of 1208 people over the age of 18 years and living in rural, remote and very remote central Queensland participated in this telephone survey. Results:  About 22% (n = 130) of female and 21% of male (n = 125) participants identified themselves as smokers. No difference existed between the mean age of smokers (47.3 years) and non‐smokers (47.1 years). While there is high level of support for smoking restrictions in public places (75%), attitudes vary with smoking status. Smokers were less likely than smokers to agree that the legislation would create a healthier environment, reduce exposure to passive smoking or agree that ‘it is right to ban smoking in public places’. Smokers were significantly more likely to agree that the legislation had gone too far.Conclusion:  The gradual implementation of the anti‐smoking legislation is changing social beliefs on what are acceptable smoking practices. It is likely that the legislation within Queensland and the subsequent forced changes in social conditions for smokers will continue to reduce the number of people smoking and reduce exposure to environmental tobacco smoke.
Rural inpatient rehabilitation by specialist outreach: Comparison with a city unit
Authors: Bowman Malcolm , Faux Steven , Wilson Stephen 
Published: July 2008

AbstractObjective:  To examine the effectiveness of a rural inpatient rehabilitation service provided by specialist outreach, and to compare outcomes with a large inner city unit. Design:  Descriptive study using health service outcome data. Setting:  Rural base hospital and inner city tertiary referral centre. Participants:  A total of 329 patients (234 city and 95 rural) admitted for inpatient rehabilitation. Main outcome measures:  Length of hospital stay, Functional Independence Measure, discharge destination. Results:  Functional Independence Measure gain per week was 5.4 for the rural outreach unit, compared with 5.5 for the city unit. Length of stay was shorter for the rural unit, with a higher proportion of patients discharged to nursing home. Conclusions:  Similar rates of functional improvement are achievable with rural inpatient rehabilitation provided by specialist outreach compared with a large inner city unit. Local factors probably account for the shorter length of stay in the rural unit.
Creating a database to facilitate multilevel analyses of mental health determinants and outcomes in rural and remote areas
Authors: Lane Philip , Stain Helen J. , Kelly Brian , Lewin Terry J. , Higginbotham Nick 
Published: July 2008

AbstractObjective:  The lack of consistent findings regarding comparisons of mental health between rural and urban areas has been attributed in part to methodological shortcomings, including poor conceptualisation of ‘rurality’. To address the diversity of rural and remote communities, an interdisciplinary collaboration sought to establish a database incorporating a range of domains hypothesised to be major influences on the mental health of individuals, families and communities. Design:  The database domains included health (physical and mental), health service utilisation, sociodemographic characteristics, climate patterns, agricultural activity and primary industry. Important steps in the development of the database were addressing issues related to ethics, ownership, accessing data sources, sustainability of the database and integration of differing outcomes sought by the collaborators. Results:  The paper describes the database while an illustrative example of analysis demonstrates its application. The potential for multilevel analyses between the database and other datasets is discussed as well as challenges for the future development of this valuable resource for rural mental health research. Conclusion:  The Centre for Rural and Remote Mental Health database will be a valuable resource for rural mental health research.
Real‐time polymerase chain reaction quantification of specific butyrate‐producing bacteria, Desulfovibrio and Enterococcus faecalis in the feces of patients with colorectal cancer
Authors: Balamurugan Ramadass , Rajendiran Ethendhar , George Sarah , Samuel G Vijay , Ramakrishna Balakrishnan S 
Published: July 2008

AbstractBackground and Aim:  Bacterial metabolites produced in the bowel are potentially related to the genesis of colorectal cancer. Butyrate is protective against cancer, whereas hydrogen sulfide and oxygen free radicals can be toxic to the epithelium. The present study was designed to quantitate Eubacterium rectale, Faecalibacterium prausnitzii (both butyrate‐producing bacteria), Desulfovibrio (sulfate‐reducing bacteria), and Enterococcus faecalis (that produces extracellular superoxide) in the feces of patients with colorectal cancer.Methods:  DNA was extracted from feces of 20 patients with colorectal cancer, nine patients with upper gastrointestinal cancer and 17 healthy volunteers. Real‐time polymerase chain reaction using primers aimed at 16S rDNA was used to quantitate the above bacterial species or genus, and this was expressed relative to amplification of universal sequences conserved among all bacteria.Results:  Levels of E. rectale and F. prausnitzii were decreased approximately fourfold (P = 0.0088 and 0.0028, respectively) in colorectal cancer patients compared to healthy control volunteers. Levels of Desulfovibrio were not significantly different between the three groups. E. faecalis populations were significantly higher in colorectal cancer patients compared to healthy volunteers (P = 0.0294).Conclusions:  Butyrate producers were decreased and E. faecalis increased in the feces of colon cancer patients. These shifts in the colonic bacterial population could potentially lead to epithelial cell damage and increased turnover and may be a factor leading to colon cancer.
Clinical features and survival in Chinese patients with hepatitis B e antigen‐negative hepatitis B virus‐related cirrhosis
Authors: Ma Hui , Wei Lai , Guo Fang , Zhu Sainan , Sun Yan , Wang Hao 
Published: July 2008

AbstractAim:  To compare the clinical features of hepatitis B e antigen (HBeAg)‐negative and HBeAg‐positive cirrhosis, and to define the survival and prognostic indicators of Chinese HBeAg‐negative hepatitis B virus (HBV)‐related cirrhosis.Methods:  Two hundred and seventeen patients with chronic hepatitis B cirrhosis were studied. Survival was calculated using the Kaplan–Meier method. Proportional hazards Cox regression procedure was used to identify independent predictors of survival. The relationship between HBV‐DNA viral load and prognosis was also investigated.Results:  The mean follow‐up time was 35 months (3–47 months). HBeAg‐negative liver cirrhosis patients comprised the greatest number of cirrhosis patients. Median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, median total leukocytes (WBC), hemoglobin (Hb), platelet (Plt) and HBV‐DNA levels and the proportion of HBV‐DNA > 105 copies/mL were lower in HBeAg‐negative patients. There were fewer complications in patients treated with lamivudine than in other patients. Survival rates were significantly reduced in patients with HBeAg‐negative cirrhosis (P = 0.0024). The baseline Child–Pugh scores and more than one decompensation during follow up were independent variables correlated with survival of HBeAg‐negative liver cirrhosis patients (P = 0.006 and P = 0.001, respectively). The HBV‐DNA viral load did not correlate with any complications or mortality rates of HBeAg‐negative patients.Conclusions:  The clinical features of HBeAg‐negative and ‐positive liver cirrhosis differ. Survival was significantly reduced for Chinese patients with HBeAg‐negative than ‐positive cirrhosis. Factors contributing to the prognosis were baseline Child–Pugh scores and the presence of more than one decompensation during follow up.
Discussing withholding and withdrawing of life‐sustaining medical treatment in paediatric inpatients: Audit of current practice
Authors: Stark Zornitza , Hynson Jenny , Forrester Mike 
Published: July 2008

Aim:  To understand the circumstances of inpatient deaths at a tertiary paediatric hospital and current practices regarding the timing and documentation of discussions concerning the withholding and withdrawing of life‐sustaining medical treatment (WWLSMT).Methods:  Retrospective review of the medical records of 50 consecutive inpatient deaths.Results:  In total, 84% of inpatient deaths occurred in an intensive care setting. In all, 74% of patients had an underlying life‐limiting or life‐threatening condition and death was documented as having been expected in the short term in 88% of patients. Life‐sustaining treatment was either withdrawn or limited prior to death in 84% of cases. There was documented family involvement in the decision‐making process in 98% of cases. A total of 83% of discussions first took place on the day of death itself or in the week leading up to the child's death. Although medical staff frequently documented the outcome of these discussions, the content, clarity and accessibility of documentation varied widely.Conclusions:  The majority of inpatient deaths at The Royal Children's Hospital occur in acute circumstances and involve patients with chronic conditions. In most cases, death follows WWLSMT. Discussions with families are documented as first occurring relatively late in the course of the final admission although opportunities for earlier discussions may exist. Further research is needed to understand more about how and when discussions actually take place, what the barriers to communication are and to what extent opportunities exist for discussions to be initiated earlier in the illness course.
Ghrelin and leptin modulate immunity and liver function in overweight children
Authors: Okamatsu Yuki , Matsuda Kentaro , Hiramoto Ikue , Tani Hidekazu , Kimura Koichi , Yada Yoichi , Kakuma Tatsuyuki , Higuchi Sadanobu , Kojima Masayasu , Matsuishi Toyojiro 
Published: July 2008

AbstractBackground:  The rising prevalence of obesity represents a growing worldwide public health problem. Interactions of adipocytokines and low‐grade systemic inflammation presently are considered important in the development of obesity, as well as associated chronic disease including bronchial asthma, obesity‐related liver disease and type 2 diabetes mellitus. The purpose of the present study was to investigate metabolic, hormonal, immunologic and inflammatory factors in overweight children and to further clarify possible immunomodulatory effects of obesity‐related hormones and cytokines.Methods:  Forty‐nine prepubertal overweight children and 49 age‐matched controls of normal weight without underlying disease were enrolled. Levels of plasma ghrelin and serum leptin, cytokines (interleukin [IL]‐4, IL‐10, IL‐12, 1L‐13), C‐reactive protein, immunoglobulin, and insulin were measured, and liver function tests were done to better understand their status in the setting of obesity.Results:  Overweight subjects had significantly higher measures of adiposity (body mass indexI, % body fat) and had significantly higher serum levels of IgG, IgA and IgE than non‐obese children (P = 0.038, 0.0043, 0.0034, respectively); the opposite was true for IgM (P = 0.025). The incidence of presumed non‐alcoholic fatty liver disease was 28.6% in overweight children. In overweight children, serum leptin levels were associated with liver function index (aspartate aminotransferase/alanine aminotransferase ratio) and serum insulin levels. Some elevated immunoglobulin levels significantly correlated with plasma ghrelin levels and liver function index.Conclusions:  It is possible that appetite‐regulating hormones modulate both humoral immunity and liver function. Further studies with a larger number of subjects are needed to clarify the precise mechanisms of this association.
Detection of a novel silent deletion, a missense mutation and a nonsense mutation in TCOF1
Authors: Fujioka Hirotaka , Ariga Tadashi , Horiuchi Katsumi , Ishikiriyama Satoshi , Oyama Kimie , Otsu Makoto , Kawashima Kunihiro , Yamamoto Yuhei , Sugihara Tsuneki , Sakiyama Yukio 
Published: July 2008

AbstractBackground: Treacher Collins syndrome (TCS) is a disorder of craniofacial development, that is caused by mutations in the TCOF1 gene. TCS is inherited as an autosomal dominant trait, and haploinsufficiency of the TCOF1 gene product treacle is proposed to be etiologically involved.Methods: Mutational analysis of the TCOF1 gene was done in 10 patients diagnosed with TCS using single‐strand conformation polymorphism and direct sequencing.Results: Among these 10 patients, a novel 9 bp deletion was found, together with a previously reported 2 bp deletion, a novel missense mutation and a novel nonsense mutation in three different families. Familial studies allowed judgment of whether these abnormal findings were responsible for the TCS phenotype, or not. The 9 bp deletion of three amino acids Lys‐Glu‐Lys (1378–1380), which was located in the nuclear localization domain of treacle, seemed not essential for the treacle function. In contrast, the novel mutation of Ala26Val is considered to affect the LisH domain, an important domain of treacle. All of the mutations thus far detected in exon 5 have resulted in frameshift, but a nonsense mutation was detected (Lys159Stop).Conclusion: The information obtained in the present study provides additional insights into the functional domains of treacle.
Anatomic relationship between the internal jugular vein and the carotid artery in preschool children – an Ultrasonographic Study
Authors: ROTH BENJAMIN , MARCINIAK BRUNO , ENGELHARDT THOMAS , BISSONNETTE BRUNO 
Published: July 2008

SummaryBackground:  Central venous cannulation in young children is technically difficult and may lead to potentially serious complications especially when performed blindly or using anatomical landmarks only.Aim:  The aim of this study was to determine the anatomical relationship of the internal jugular vein (IJV) and the common carotid artery (CA) in preschool children using ultrasound.Methods:  Forty five children aged 60 months and under were included prospectively and divided into three groups: group 1: <6 months, group 2: 7–18 months and group 3: 19–60 months. With the head in neutral position the location of the left and right IJV was noted as anterior (A), anterolateral (AL), lateral (L) or medial (M) in relation to the CA at the level of the cricoid cartilage. Depths of IJV and CA as well as time taken to locate the vessels were recorded.Results:  The IJV was more commonly found in the AL position in all groups. The mean depth was 0.96 cm in group 1, 0.95 cm in group 2 and 3. Mean duration for localization of the vessels was 4.2 s in group 1, 4 s in group 2 and 4.3 s in group 3. The differences between the groups were not significant.Conclusion:  This study demonstrates that the IJV cover the CA in the majority of young children. Depth of the IJV is rarely more than 1 cm deep to the skin. Ultrasound location of the IJV and CA is easy and does not necessarily delay the procedure. The findings of this study support the use of ultrasound guidance for CVC in children.
Ketamine anesthesia in children – exploring infusion regimens
Authors: DALLIMORE DANIEL , ANDERSON BRIAN J. , SHORT TIMOTHY G. , HERD DAVID W. 
Published: July 2008

SummaryAim:  We aimed to produce a racemic ketamine manual infusion regimen capable of maintaining a steady‐state blood concentration associated with anesthesia in children aged 1.5–12 years.Method:  The literature was searched for a ketamine blood concentration associated with anesthesia in humans. Pharmacokinetic parameter estimates were taken from published studies of infusion data in children and used in a pharmacokinetic simulation program to predict likely ketamine blood concentrations during infusions. A variability of 10% was allowed about the chosen target concentration.Results:  A target concentration of 3 mg·l−1 was chosen for simulation modeling. This target is greater than that associated with anesthesia when supplemented by nitrous oxide or midazolam in adults. Arousal to light touch or voice appears to occur at a mean plasma concentration of 0.5 mg·l−1 in both children and adults. A loading dose of 2 mg·kg−1 followed by an infusion rate of 11 mg·kg−1·h−1 for the first 20 min, 7 mg·kg−1·h−1 from 20 to 40 min, 5 mg·kg−1·h−1 from 40 to 60 min and 4 mg·kg−1·h−1 from 1 to 2 h resulted in a steady‐state target concentration of 3 mg·l−1 in children 1.5–12 years. Arousal, either spontaneous or to speech, is anticipated 3 h 47 min after a 2 h infusion in an average 6‐year‐old child. The context sensitive half‐time in children was shorter than in adults after 1.5 h, rising from 30 min at 1 h to 55 min at 5 h after an infusion of 3 mg·kg−1·h−1 in a 10 kg child.Conclusion:  Children require higher infusion rates than adults to maintain steady‐state concentrations of 3 mg·l−1 and have shorter context sensitive half‐times than adults after prolonged infusion. These differences can be attributed to age‐related pharmacokinetics. We anticipate slow return to full consciousness after prolonged infusion, suggesting that a lower target concentration with supplementation from adjuvant short acting anesthetic drugs may be advantageous.
Beneficial acclimation and the Bogert effect
Authors: Marais Elrike , Chown Steven L. 
Published: July 2008

AbstractFew studies have examined the extent to which phenotypic plasticity in a given trait might be influenced by behavioural responses to an environmental cue. Regulatory behaviour might eliminate environmental variation such that little selection for physiological change would take place. Here, to test this Bogert effect on acclimation, we use two life‐stages of a kelp fly that inhabit the same habitat, but differ profoundly in their behaviour. We predicted that when denied opportunities for behavioural regulation, mobile, though brachypterous adults would show a performance advantage in most thermal environments following acclimation to their preferred temperature(s). By contrast, in the less mobile larvae, that have a broader thermal preference, beneficial acclimation would be more evident. Ordered factor anova with orthogonal polynomial contrasts revealed that adults recovered faster from chill coma following any one of six short‐term temperature treatments if they had been acclimated at low temperature, whilst larvae showed beneficial acclimation.