bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory choroidal neovascular membrane in presumed ocular Lyme borreliosis
Authors: Amer Radgonde , Brannan Suzanne , Forrester John V. 
Published: May 2008

Abstract.Introduction:  Lyme disease is a multisystemic disease with protean ocular manifestations. We describe the occurrence of inflammatory choroidal neovascular membrane (CNVM) in two patients suffering from presumed Lyme disease.Methods:  Descriptive review of the clinical records of two patients.Results:  Patient 1: 16‐year‐old healthy male presenting with a visual acuity of counting fingers [oculus dexter (OD)] and 6/6 [oculus sinister (OS)] 3 months after a tick bite. He had papillitis and an exudative subretinal macular lesion OD. Treatment was started with intravenous (IV) ceftriaxone; a week later, IV methylprednisolone was administered with a tapering dose of oral steroids thereafter. Three months later, VA had improved to 3/60 OD. Patient 2: 38‐year‐old healthy female presenting with reduced left‐eye vision (6/24) 6 weeks after a tick bite. She also suffered from erythema migrans and arthralgias. She had left‐eye papillitis, macular haemorrhages and vascular sheathing. Treatment was started with IV ceftriaxone. One month later, there was profound loss of vision with development of CNVM. Treatment was declined by the patient and eventually retinal fibrosis developed.Conclusion:  Inflammatory CNVM has not been described previously in the setting of ocular Lyme borreliosis. We herein describe the occurrence of inflammatory CNVM in two patients whose diagnosis with Lyme disease was clinically based – both were sero‐negative. Visual outcome in the two patients was profoundly impaired because of the ensuing macular scar.
Medical treatment for combined Fusarium and Acanthamoeba keratitis
Authors: Lin Hsin‐Chiung , Hsiao Ching‐Hsi , Ma David Hui‐Kang , Yeh Lung‐Kun , Tan Hsin‐Yuan , Lin Meng‐Yin , Huang Samuel Chao‐Ming 
Published: May 2008

Abstract.Purpose:  Acanthamoeba and fungal keratitis are rare ocular infections. We report cases of combined Fusarium and Acanthamoeba keratitis and the clinical course of medical treatment.Methods:  We reviewed the medical records of patients treated for culture‐proven Acanthamoeba keratitis at a referral centre, during 2001−2006.Results:  Eleven consecutive patients were treated for culture‐proven Acanthamoeba keratitis during the 5 years, two of whom had combined fungal infections. A 29‐year‐old man presented with ground‐glass corneal oedema and epitheliopathy caused by contact lens use. The other patient, a 7‐year‐old girl, had eye trauma that led to a feathery corneal infiltrate. Both cases were treated with topical 0.02% polyhexamethylene biguanide (PHMB), 0.1% propamidine, 1% clotrimazole and 5% natamycin. Therapeutic keratoplasty was not required in either case.Conclusions:  Timely identification of the pathogen, with repeated culture and smear if necessary, as well as adequate dosage to prevent recurrence is highly recommended in order to preclude the need for therapeutic penetrating keratoplasty.
Systemic lupus erythematosus‐associated optic neuritis: clinical experience and literature review
Authors: Lin Yen‐Ching , Wang An‐Guor , Yen May‐Yung 
Published: May 2008

Abstract.Purpose:  This study aimed to evaluate the visual outcome of optic neuritis in patients with systemic lupus erythematosus (SLE).Methods:  A retrospective, case‐observational study was conducted by reviewing eight patients with SLE‐associated optic neuritis from January 1986 to October 2004. The demographic data, clinical manifestations, laboratory data, medical management and disease courses of these eight patients were retrospectively analysed. Main outcome measurements included final visual acuity (VA) and relapse of optic neuritis. Statistical analyses were made using the chi‐square test and a linear regression model. The English‐language literature on SLE‐associated optic neuritis was reviewed.Results:  Initial visual loss was severe in SLE‐associated optic neuritis. Seven patients (87%) had VA < 20/200 at onset. All patients received steroid pulse therapy followed by oral steroid tapering. Final visual outcome was highly variable, ranging from the complete recovery of VA in four patients, to partial recovery in one and poor recovery in three. Better visual recovery occurred in patients who received earlier treatment (within 10 days). However, longer duration of steroid administration was found to have no significant benefit on visual outcome.Conclusions:  Systemic lupus erythematosus‐associated optic neuritis is not common. However, it is important that ophthalmologists differentiate SLE‐associated optic neuritis from idiopathic optic neuritis because of the severe visual impairment and steroid dependence associated with the former. Early diagnosis and prompt treatment are important for restoring visual function in these patients.
Re‐examination of organ‐cultured, cryopreserved human corneal grafts after 27 years
Authors: Corydon Charlotte , Hjortdal Jesper , Ehlers Niels 
Published: May 2008

Abstract.Purpose:  To determine the long‐term fate of cryopreserved corneas. Review of 17 organ‐cultered cryopreserved corneas grafted in 1978–1979.Methods:  We measured visual acuity and refraction and performed biomicroscopy, applanation tonometry and optical pachometri (CCT). Endothelial photos were taken, cells were counted and morphology was studied.Results:  Four of 16 grafted corneas were still clear after 27 years. Mean CCT was 0.52 mm, endothelial cell density was 882 cells/mm2 and visual acuity was 0.25 or better with an average of 0.6 in the four patients. Cell morphology showed irregularity in shape and size.Conclusion:  This study shows that cryopreserved endothelium can function as well as non‐frozen corneas and that a regular hexagonal pattern is not essential for corneal clarity. The four grafts showed long‐term durability despite the irregularity in shape and size.
Constructing the Public Sphere in Compromised Settings: Environmental Governance in the Alberta Forest Sector
Authors: PARKINS JOHN R. , DAVIDSON DEBRA J. 
Published: May 2008

À une époque où l'enthousiasme se manifeste pour une gouvernance environnementale plus délibérative et participative, des études critiques sur ces activités s'avèrent grandement nécessaires. Un forum très en vue sur la gouvernance, le Comité de consultation publique, en est venu à jouer un rôle d'une importance capitale dans la réglementation législative et axée sur les forces du marché des ressources forestières. L'article présente une évaluation critique de ces milieux environnants de plus en plus privés et localisés pour le discours politique du secteur forestier de l'Alberta. Quoique la prudence soit conseillée concernant le potentiel d'engagement actif du citoyen à l'intérieur de comités financés par les entreprises, l'étude de cas révèle l'importance de la variation contextuelle sur la qualité de la délibération.At a time when enthusiasm waxes for a more deliberative and participatory environmental governance, critical inquiries into these activities are sorely needed. One prominent governance forum is the public advisory committee, which has come to play a central role in the legislative and market‐based regulation of forest resources. This paper offers a critical assessment of these increasingly privatized and localized settings for political discourse within the forest sector of Alberta. Although caution is urged regarding the potential for active citizen engagement within corporate‐sponsored committees, the case study reveals the importance of contextual variation in the quality of deliberation.
Potential of laparoscopy in chronic liver disease with hepatitis B and C viruses
Authors: Arase Yasuji , Suzuki Fumitaka , Suzuki Yoshiyuki , Akuta Norio , Sezaki Hitomi , Kobayashi Masahiro , Kawamura Yusuke , Yatsuji Hiromi , Hosaka Tetsuya , Saito Satoshi , Ikeda Kenji , Kumada Hiromitsu 
Published: May 2008

Aim:  The definitive diagnosis of chronic liver disease is made either by a histological examination of a biopsy specimen or upon visualization of the liver surface at laparoscopy. The aim of this retrospective cohort study is to assess whether histological or laparoscopic findings are associated with hepatocellular carcinoma (HCC) development.Methods:  A retrospective review of paired laparoscopy and histology reports was performed on 4124 hepatitis virus‐positive patients who underwent laparoscopy: 2804 patients had hepatitis C virus (HCV group) and 1320 patients had hepatitis B virus (HBV group). Based on the irregularities of the liver surface, the laparoscopic findings were classified into three groups in progression order: smooth, irregular, or nodular. The histological findings were classified according to the extent of fibrosis into four stages (stages 1–4) in progression order.Results:  The number of patients with HCC development was 565 in the HCV group and 115 in the HBV group. The Coxregression hazard model showed that HCC appearance in the HCV group was independently associated with laparoscopic findings (relative risk based on every progression of one rank [RR], RR = 4.31, P < 0.0001) and histological findings (RR = 2.56, P < 0.0001). In the HBV group, however, HCC appearance in was mainly associated with laparoscopic findings (RR = 2.12, P < 0.0001) compared to histological findings (RR = 1.13, P = 0.403).Conclusion:  Our data indicate that laparoscopic findings of the liver are dominant predictors for HCC development compared with histological findings in patients with HBV.
Does a late evening meal reduce the risk of hepatocellular carcinoma among patients with chronic hepatitis C?
Authors: Ohfuji Satoko , Fukushima Wakaba , Tanaka Takashi , Habu Daiki , Takeda Tadashi , Tamori Akihiro , Sakaguchi Hiroki , Seki Shuichi , Kawada Norifumi , Nishiguchi Shuhei , Shiomi Susumu , Hirota Yoshio 
Published: May 2008

Aim:  Some studies have suggested that nutritional support might protect against the recurrence of hepatocellular carcinoma (HCC) among postoperative HCC patients. However, no epidemiological studies have evaluated the effect of nutritional support on HCC incidence. This study aimed to investigate the association between a late evening meal and HCC.Methods:  We conducted a hospital‐based, case‐control study comparing 73 cases with HCC to 253 matched controls among patients with chronic hepatitis C. A questionnaire elicited information on the consumption of a late evening meal, which was defined as a snack or meal within 2 h before bedtime. The odds ratios (OR) and 95% confidence intervals (CI) were calculated by the conditional logistic regression model.Results:  After adjustment for potential confounders, patients who consumed a late evening meal had a lower OR as compared to those who did not consume one (OR, 0.08; 95% CI, 0.01–0.48). In terms of frequency of intake, a clear inverse exposure–response relationship was observed (trend P = 0.009). In addition, a negative association between a late evening meal and HCC was more pronounced among patients with an α‐fetoprotein level of less than 20 ng/mL and those with a body mass index of less than 25 kg/m2.Conclusion:  A late evening meal might protect against HCC, particularly among patients with a normal α‐fetoprotein level and who are not obese, although these relations might be accounted for other factors, including total energy intake. Further studies with larger study sizes are needed to corroborate these findings.
Stones from cancerous and benign gallbladders are different: A proton nuclear magnetic resonance spectroscopy study
Authors: Srivastava Madhulika , Sharma Ajay , Kapoor Vinay K. , Nagana Gowda Gowda A. 
Published: May 2008

Aim:  Gallbladder cancer (GBC) is frequently associated with gallstones (GS). At the same time, however, a very small number of patients with GS develop GBC. Cholesterol and metal salts are the common constituents of all GS. To understand their role in the etiopathogenesis of GBC, cholesterol, calcium, and magnesium composition in GS is compared in cancerous and benign gallbladders.Methods:  GS from patients with GBC (n = 11), chronic cholecystitis (CC; n = 23), and xanthogranulomatous cholecystitis (XGC; n = 11) undergoing cholecystectomy were analyzed using proton nuclear magnetic resonance spectroscopy. The diagnosis of the gallbladder disease was based on histopathological examinations. Cholesterol, calcium, and magnesium in the GS of GBC, XGC, and CC were analyzed, compared, and correlated using statistical methods.Results:  The quantity of cholesterol was significantly less in the GS of GBC than in benign gallbladder diseases (CC or XGC, P < 0.0001 for both). Both calcium and magnesium were significantly higher in GBC than in benign disease (calcium: P < 0.0005 and magnesium: P < 0.0001 for GBC vs CC; calcium: P < 0.02 and magnesium: P < 0.04 for GBC vs XGC). In all the GS, calcium was higher than magnesium. Calcium and magnesium were positively correlated in GBC (R = 0.69) and XGC (R = 0.75), and cholesterol and calcium were negatively correlated in CC (R =−0.61).Conclusion:  Differences in the GS composition between malignant and benign gallbladder patients may provide useful clues to the etiopathogenesis of GBC. These clues could lead to the identification of patients with GS in vivo who are at high risk of developing GBC, and advocate prophylactic cholecystectomy to prevent GBC.
Tumor necrosis factor‐α induces the aberrant expression of mucus core protein‐2 in non‐neoplastic biliary epithelial cells via the upregulation of CDX2 in chronic cholangitis
Authors: Ikeda Hiroko , Sasaki Motoko , Ohira Shusaku , Ishikawa Akira , Sato Yasunori , Harada Kenichi , Zen Yoh , Nakanuma Yasuni 
Published: May 2008

Aim:  Chronic cholangitis, such as hepatolithiasis, is frequently associated with goblet cell metaplasia and the aberrant expression of mucus core protein‐2 (MUC2). In this study, we clarified the role of inflammatory cytokines in the expression of MUC2 in lining biliary epithelial cells (BEC) in chronic cholangitis with an emphasis on CDX2, an intestine‐specific transcription factor.Methods:  We used human hepatolithiatic livers and polycystic kidney (PCK) rats, an animal model of Caroli's disease, and cultured BEC from PCK rats. As a control, extrahepatic biliary obstruction and histologically normal livers and Crj:CD rats were used.Results:  Immunohistochemically, tumor necrosis factor‐α (TNF‐α) was expressed in periductal inflammatory cells and BEC of the affected intrahepatic bile ducts with an aberrant expression of MUC2 and CDX2 in hepatolithiasis and the PCK rats. In cultured BEC, TNF‐α, interleukin (IL)‐1β, IL‐6, and interferon‐γ induced the expression of CDX2 mRNA, though only TNF‐α additionally induced the expression of MUC2 mRNA. The expression of CDX2 mRNA and the MUC2 protein induced in BEC by TNF‐α were abolished by pretreatment of nuclear factor‐κB inhibitors.Conclusion:  The aberrant expression of CDX2 and MUC2 in the affected bile ducts showing goblet cell metaplasia was closely associated with TNF‐α expressed in periductal infiltrating inflammatory cells and BEC. TNF‐α induced the expression of CDX2 and MUC2 in cultured BEC. Taken together, it seems likely that TNF‐α plays a role in MUC2 expression via CDX2 upregulation in the bile ducts with chronic cholangitis and goblet cell metaplasia.
Molecular Characterization and Epidemiology of Extended-Spectrum- β-Lactamase-Producing
Escherichia coli
and
Klebsiella pneumoniae
Isolates Causing Health Care-Associated Infection in Thailand, Where the CTX-M Family Is Endemic
Authors: Kiratisin Pattarachai , Apisarnthanarak Anucha , Laesripa Chaitat , Saifon Piyawan 
Published: May 2008

ABSTRACT

Extended-spectrum β-lactamase (ESBL)-producing
Escherichia coli
and
Klebsiella pneumoniae
have rapidly spread worldwide and pose a serious threat for health care-associated (HA) infection. We conducted molecular detection and characterization of ESBL-related
bla
genes, including
bla
TEM
,
bla
SHV
,
bla
CTX-M
,
bla
VEB
,
bla
OXA
,
bla
PER
, and
bla
GES
, among 362 isolates of ESBL-producing
E. coli
(
n
= 235) and ESBL-producing
K. pneumoniae
(
n
= 127) collected from patients who met the definition of HA infection at two major university hospitals in Thailand from December 2004 to May 2005. The prevalence of ESBL-producing
E. coli
and ESBL-producing
K. pneumoniae
, patient demographics and the susceptibilities of these bacteria to various antimicrobial agents were described. A total of 87.3% of isolates carried several
bla
genes. The prevalence of
bla
CTX-M
was strikingly high: 99.6% for ESBL-producing
E. coli
(CTX-M-14, -15, -27, -40, and -55) and 99.2% for ESBL-producing
K. pneumoniae
(CTX-M-3, -14, -15, -27, and -55). IS
Ecp1
was found in the upstream region of
bla
CTX-M
in most isolates. Up to 77.0% and 71.7% of ESBL-producing
E. coli
and ESBL-producing
K. pneumoniae
, respectively, carried
bla
TEM
; all of them encoded TEM-1. ESBL-producing
K. pneumoniae
carried
bla
SHV
at 87.4% (SHV-1, -2a, -11, -12, -27, -71, and -75) but only at 3.8% for ESBL-producing
E. coli
(SHV-11 and -12).
bla
genes encoding VEB-1 and OXA-10 were found in both ESBL-producing
E. coli
(8.5% and 8.1%, respectively) and ESBL-producing
K. pneumoniae
(10.2% and 11.8%, respectively). None of the isolates were positive for
bla
PER
and
bla
GES
. Pulsed-field gel electrophoresis analysis demonstrated that there was no major clonal relationship among these ESBL producers. This is the first study to report CTX-M-3, CTX-M-27, CTX-M-40, SHV-27, SHV-71, and SHV-75 in Thailand and to show that CTX-M ESBL is highly endemic in the country.
Quantitative Assessment of Combination Antimicrobial Therapy against Multidrug-Resistant
Acinetobacter baumannii
Authors: Lim Tze-Peng , Ledesma Kimberly R. , Chang Kai-Tai , Hou Jing-Guo , Kwa Andrea L. , Nikolaou Michael , Quinn John P. , Prince Randall A. , Tam Vincent H. 
Published: May 2008

ABSTRACT

Treatment of multidrug-resistant bacterial infections poses a therapeutic challenge to clinicians; combination therapy is often the only viable option for multidrug-resistant infections. A quantitative method was developed to assess the combined killing abilities of antimicrobial agents. Time-kill studies (TKS) were performed using a multidrug-resistant clinical isolate of
Acinetobacter baumannii
with escalating concentrations of cefepime (0 to 512 mg/liter), amikacin (0 to 256 mg/liter), and levofloxacin (0 to 64 mg/liter). The bacterial burden data in single and combined (two of the three agents with clinically achievable concentrations in serum) TKS at 24 h were mathematically modeled to provide an objective basis for comparing various antimicrobial agent combinations. Synergy and antagonism were defined as interaction indices of <1 and >1, respectively. A hollow-fiber infection model (HFIM) simulating various clinical (fluctuating concentrations over time) dosing exposures was used to selectively validate our quantitative assessment of the combined killing effect. Model fits in all single-agent TKS were satisfactory (
r
2
> 0.97). An enhanced combined overall killing effect was seen in the cefepime-amikacin combination (interactive index, 0.698; 95% confidence interval [CI], 0.675 to 0.722) and the cefepime-levofloxacin combination (interactive index, 0.929; 95% CI, 0.903 to 0.956), but no significant difference in the combined overall killing effect for the levofloxacin-amikacin combination was observed (interactive index, 0.994; 95% CI, 0.982 to 1.005). These assessments were consistent with observations in HFIM validation studies. Our method could be used to objectively rank the combined killing activities of two antimicrobial agents when used together against a multidrug-resistant
A. baumannii
isolate. It may offer better insights into the effectiveness of various antimicrobial combinations and warrants further investigations.
Effective Plague Vaccination via Oral Delivery of Plant Cells Expressing F1-V Antigens in Chloroplasts
Authors: Arlen Philip A. , Singleton Michael , Adamovicz Jeffrey J. , Ding Yi , Davoodi-Semiromi Abdolreza , Daniell Henry 
Published: May 2008

ABSTRACTThe chloroplast bioreactor is an alternative to fermentation-based systems for production of vaccine antigens and biopharmaceuticals. We report here expression of the plague F1-V fusion antigen in chloroplasts. Site-specific transgene integration and homoplasmy were confirmed by PCR and Southern blotting. Mature leaves showed the highest level of transgene expression on the third day of continuous illumination, with a maximum level of 14.8% of the total soluble protein. Swiss Webster mice were primed with adjuvant-containing subcutaneous (s.c.) doses of F1-V and then boosted with either adjuvanted s.c. doses (s.c. F1-V mice) or unadjuvanted oral doses (oral F1-V mice). Oral F1-V mice had higher prechallenge serum immunoglobulin G1 (IgG1) titers than s.c. F1-V mice. The corresponding serum levels of antigen-specific IgG2a and IgA were 2 and 3 orders of magnitude lower, respectively. After vaccination, mice were exposed to an inhaled dose of 1.02 × 106CFU of aerosolizedYersinia pestisCO92 (50% lethal dose, 6.8 × 104CFU). All control animals died within 3 days. F1-V given s.c. (with adjuvant) protected 33% of the immunized mice, while 88% of the oral F1-V mice survived aerosolizedY. pestischallenge. A comparison of splenicY. pestisCFU counts showed that there was a 7- to 10-log reduction in the mean bacterial burden in survivors. Taken together, these data indicate that oral booster doses effectively elicit protective immune responses in vivo. In addition, this is the first report of a plant-derived oral vaccine that protected animals from liveY. pestischallenge, bringing the likelihood of lower-cost vaccines closer to reality.
Temporal and Spatial Distribution of
Toxoplasma gondii
Differentiation into Bradyzoites and Tissue Cyst Formation In Vivo
Authors: Di Cristina Manlio , Marocco Daniela , Galizi Roberto , Proietti Carla , Spaccapelo Roberta , Crisanti Andrea 
Published: May 2008

ABSTRACT

During
Toxoplasma gondii
infection, a fraction of the multiplying parasites, the tachyzoites, converts into bradyzoites, a dormant stage, which form tissue cysts localized mainly in brain, heart, and skeletal muscles that persist for several years after infection. At this stage the parasite is protected from the immune system, and it is believed to be inaccessible to drugs. While the long persistence of tissue cysts does not represent a medical problem for healthy individuals, this condition represents a major risk for patients with a compromised immune system, who can develop recrudescent life-threatening
T. gondii
infections. We have investigated for the first time the dynamics and the kinetics of tachyzoite-to-bradyzoite interconversion and cyst formation in vivo by using stage-specific bioluminescent parasites in a mouse model. Our findings provide a new framework for understanding the process of bradyzoite differentiation in vivo. We have also demonstrated that complex molecules such as
d
-luciferin have access to tissue cysts and are metabolically processed, thus providing a rationale for developing drugs that attack the parasite at this developmental stage.