bluuebunny/crossref_metadata_2025_split huggingface dataset:
The soluble forms of CD28, CD86 and CTLA‐4 constitute possible immunological markers in patients with abdominal aortic aneurysm
Authors: Sakthivel P. , Shively V. , Kakoulidou M. , Pearce W. , Lefvert A. K. 
Published: February 2007

Abstract.Objective.  The T cell co‐stimulatory factors CD28 and CTLA‐4 and their ligands CD80 and CD86 occur as receptors on T cells and antigen‐presenting cells and also in soluble forms in the circulation. We determined the levels of soluble co‐stimulatory molecules in patients with abdominal aortic aneurysm (AAA) and normal individuals. We further correlated these soluble co‐stimulatory molecules to other clinical parameters of importance such as age of the patient, presence of hypertension, size of the aneurysm and levels of matrix metalloproteinases‐9 and C‐reactive protein.Design, setting, subjects.  This case‐control study was designed to quantify the circulating levels of soluble co‐stimulatory molecules by an in‐house enzyme linked immunosorbent assay. A total of 314 subjects participated in the study including 100 patients and 214 normal controls. The statistical analysis was performed by Mann–Whitney test and Spearman's correlation rank test.Results.  Our results show increased plasma levels of sCD28, sCD86 (P = 0.0001) and decreased plasma levels of sCTLA‐4 (P = 0.0018) in the patients compared with normal individuals. The levels of these factors were not related to the age of the patient, size of aneurysm or levels of C‐reactive protein in plasma. There was, however, a significant inverse relationship between the concentrations of sCTLA‐4 and sCD80 with matrix metalloproteinase‐9.Conclusions.  We suggest that soluble co‐stimulatory molecules serve as biomarkers for the estimation of immune activation in AAA patients.
Copper and iron homeostasis in Arabidopsis: responses to metal deficiencies, interactions and biotechnological applications
Authors: PUIG SERGI , ANDRÉS‐COLÁS NURIA , GARCÍA‐MOLINA ANTONI , PEÑARRUBIA LOLA 
Published: February 2007

ABSTRACTPlants have developed sophisticated mechanisms to tightly control the acquisition and distribution of copper and iron in response to environmental fluctuations. Recent studies with Arabidopsis thaliana are allowing the characterization of the diverse families and components involved in metal uptake, such as metal‐chelate reductases and plasma membrane transporters. In parallel, emerging data on both intra‐ and intercellular metal distribution, as well as on long‐distance transport, are contributing to the understanding of metal homeostatic networks in plants. Furthermore, gene expression analyses are deciphering coordinated mechanisms of regulation and response to copper and iron limitation. Prioritizing the use of metals in essential versus dispensable processes, and substituting specific metalloproteins by other metal counterparts, are examples of plant strategies to optimize copper and iron utilization. The metabolic links between copper and iron homeostasis are well documented in yeast, algae and mammals. In contrast, interactions between both metals in vascular plants remain controversial, mainly owing to the absence of copper‐dependent iron acquisition. This review describes putative interactions between both metals at different levels in plants. The characterization of plant copper and iron homeostasis should lead to biotechnological applications aimed at the alleviation of iron deficiency and copper contamination and, thus, have a beneficial impact on agricultural and human health problems.
Surface Expression of Transglutaminase 2 by Dendritic Cells and its Potential Role for Uptake and Presentation of Gluten Peptides to T Cells
Authors: Ráki M. , Schjetne K. W. , Stamnaes J. , Molberg Ø. , Jahnsen F. L. , Issekutz T. B. , Bogen B. , Sollid L. M. 
Published: February 2007

AbstractCeliac disease is a chronic small intestinal inflammation driven by gluten‐reactive T cells of the intestinal mucosa. These T cells are HLA‐DQ2 or ‐DQ8 restricted, and predominantly recognize gluten peptides that are deamidated by the enzyme transglutaminase 2 (TG2). Our recent results strongly suggest that duodenal CD11c+ dendritic cells (DC) are directly involved in T cell activation in the celiac lesion. The aim of this study was to investigate whether surface‐associated TG2 could be involved in receptor‐mediated endocytosis of gluten peptides, a process that may contribute to the preferential recognition of deamidated peptides. We found that both monocyte‐derived DC and local CD11c+ DC in the duodenal mucosa expressed cell surface‐associated TG2. As phenotypic characterization of CD11c+ DC in the celiac lesion suggests that these cells may be derived from circulating monocytes, we used monocyte‐derived DC in functional in vitro studies. Using a functional T cell assay, we obtained evidence that cell surface‐associated TG2 is endocytosed by monocyte‐derived DC. However, we were unable to obtain evidence for a role of surface TG2 in the loading and subsequent generation of deamidated gluten peptides in these cells.
The Time Course of Lymphatic Routes Emanating from the Peritoneal Cavity in Rats
Authors: Shibata S. , Yamaguchi S. , Kaseda M. , Ichihara N. , Hayakawa T. , Asari M. 
Published: February 2007

SummaryThe lymph drainage routes from the abdominal cavity in rats were observed at 3 min, 1, 2 and 4 h after India ink was administered intraperitoneally. Four systems of lymph drainage routes from the peritoneal cavity were observed. Three minutes after injection, the drainage route travelled via the intrathoracic lymph vessels located along the internal thoracic artery and returned to the anterior mediastinal lymph nodes. One hour after injection, the drainage route travelled via the lymph vessel located along the left phrenic nerve in addition to the drainage route observed at 3 min. Two and four hours after injection, in addition to the above‐mentioned routes, the drainage that had travelled via the thoracic duct continued along the right side of the aorta and was also observed in the lateral lymph vessel located on the vertebra. These findings suggest that lymph or cells absorbed into the peritoneal cavity at first travel towards the anterior mediastinal lymph nodes in the thorax via the ventral lymphatic channels, and then gradually course through the dorsal lymphatic channels. These routes may serve as a route for transporting cancer cells and other cells from the peritoneal cavity.
Paving the way: Stepping stones to evidence‐based nursing
Authors: C Margaret , Shorten Allison , Russell Kenneth G 
Published: February 2007

Wallace MC, Shorten A, Russell KG. International Journal of Nursing Practice 1997;3:147–152Paving the way: Stepping stones to evidence‐based nursingEvidence‐based practice is an emerging paradigm in health care. This paper outlines the main features of this paradigm and its potential value to nursing. Evidence‐based practice is based on a conceptual framework that examines the extent of evidence available in support of particular clinical practices. The Quality of Evidence Ratings adapted by the National Health and Medical Research Council (NHMRC) from the United States Preventive Services Task Force are discussed, and the strengths and weaknesses of different categories of evidence are highlighted. Potential barriers to implementation of research into practice are identified. The authors suggest that legal, ethical, economic and humane imperatives oblige nursing to develop evidence‐based practice as one of several viable contributions to nursing knowledge. Suggestions for analysing current research and for the planning of the direction of future nursing research are made.
The acceptance of a philosophically based research culture?
Authors: Gullifer John 
Published: February 2007

Gullifer J. International Journal of Nursing Practice 1997;3:153–158The acceptance of a philosphically based research cultureThis paper addresses a trend that emerged at a nursing research conference held in New South Wales during 1996. The trend was a downplaying of the relevance of philosophical and theoretical bases for research in nursing. Such a trend would not be of concern if all research aimed to merely generate local, non‐generalizable conclusions and recommendations. However, research that aims to develop knowledge that can provide relevant knowledge on a broader, or universal scale, needs to be based on coherent and relevant philosophical and/or theoretical foundations. To adequately critique such research it should ideally be linked to a philosophy or theory that situates it in both historical and intellectual loci and consequently, theraison d’etrefor the research should arise. This paper begins with an exploration of Immanuel Kant’s philosophy and proceeds to a discussion on the philosophical underpinnings of Dorothea Orem. It is intended that such discussion will assist the clinician to see the relevance that philosophy has to clinically based research in nursing and, importantly, the critique of such research. In conclusion, two possible reasons are suggested as to why philosophy and theory in nursing research may appear to be increasingly frowned upon. It is hoped that a greater understanding of the power of philosophically based research will contribute to an increased enthusiasm and uptake of philosophically based research projects by nurses.
Relationships between demographic variables and family dynamics of childbearing families
Authors: Hakulinen Tuovi , Paunonen Marita , Laippala Pekka 
Published: February 2007

Hakulinen T, Paunonen M, Laippala P. International Journal of Nursing Practice 1997; 3: 247–254 Relationships between demographic variables and family dynamics of childbearing families In this study relationships between demographic variables and family dynamics of childbearing families in Finland were studied. The sample was 160 urban families expecting their first or second child in the third trimester of pregnancy. One‐hundred and eighteen families participated in the study. The Family Dynamics Questionnaire (FDQ) and the Family Dynamics Measure (FDM) were used in this study. Most expectant parents reported their family was well‐functioning. Mothers of higher socioeconomic status found more flexibility in their families than mothers of lower socioeconomic status. Fathers in families expecting their first baby reported more mutuality, role reciprocity and more stability than second‐time fathers. The findings contribute cues for public health nurses and midwives regarding parity, socioeconomic status and family dynamics to provide more specific family guidance during the transition to parenthood. Realistic information on the changes in family dynamics after childbirth should be given to pregnant parents.
Prevalence of trachoma in school children of remote Western Australian communities between 1992 and 2003
Authors: Kain Sam , Morgan William , Riley Delia , Dorizzi Kevin , Hogarth Geraldine , Yu Dao‐Yi 
Published: February 2007

AbstractPurpose:  To measure the prevalence and trends in childhood trachoma within remote, largely Aboriginal communities.Methods:  Children from eight remote communities of the Goldfields region of Western Australia were examined annually over 12 years from 1992 to 2003. World Health Organization trachoma grading system was used, with the data collected prospectively.Results:  In this study 2975 of 3483 child ocular examinations were analysed, 72% of whom were Aboriginal. The mean age was 8 years 9 months with a range from 1 month to 17 years 11 months. The overall prevalence of active trachoma was volatile ranging from 44% in 1993 to 5% in 1997 and 2001. The prevalence of World Health Organization grade TI disease showed a significant decline from 5% to less than 1% (P = 0.001).Conclusion:  The prevalence of active trachoma in children of these eight remote communities of the Goldfields region of Western Australia was volatile. The prevalence of intense inflammation has dropped to very low levels. A significant reservoir of less severe inflammation remains.
SEPTAL‐SUPERIOR EXPOSURE IN MITRAL VALVE SURGERY WITH RADIOFREQUENCY ABLATION
Authors: Ishikawa Susumu , Obayashi Tamiyuki , Kawasaki Akio , Suzuki Yoshitaka , Neya Kazuo , Ohki Satoshi , Kugawa Satoshi , Hayama Tamuro , Ueda Keisuke 
Published: February 2007

Background:  We review the results of surgical radiofrequency ablation of both atria in patients of mitral valve disease approached by septal‐superior exposure and discuss the availability of this approach.Methods:  Eighteen patients with a mean age of 65 years were included in this study. Thirteen patients had mitral valve regurgitation predominantly and five had mitral valve stenosis. Eleven patients underwent mitral valve plasty and valve replacement was carried out in seven. All ablation lesions were created on both atria using radiofrequency energy delivered by a unipolar malleable radiofrequency ablation catheter with seven electrodes at a minimum temperature of 80–85°C for a period of 2 min.Results:  At the time of discharge, 14 patients were showed normal sinus rhythm and one patient remained in AF. The other three patients were free from atrial fibrillation; however, they received dual‐mode, dual‐pacing, dual‐sensing pacemaker implantation because of bradycardia during the early postoperative phase. At a mean time of 7 months after surgery, all patients were free from atrial fibrillation; 13 patients showed normal sinus rhythm and five patients received dual‐mode, dual‐pacing, dual‐sensing pacemakers.Conclusion:  Septal‐superior exposure provides an excellent operative view both for mitral valve surgery and for radiofrequency ablation. However, this exposure has not been considered a first‐line approach because of the high rate of pacemaker implantation.
FACTORS AFFECTING MORTALITY OF FOURNIER’S GANGRENE: REVIEW OF 70 PATIENTS
Authors: Ersay Ahmet , Yilmaz Gulsen , Akgun Yilmaz , Celik Yusuf 
Published: February 2007

Background:  Fournier’s disease is a potentially fatal, acute, gangrenous infection of the scrotum, penis or perineum associated with a synergistic bacterial infection of the subcutaneous fat and superficial fascia.Methods:  The clinical records of 70 patients treated for Fournier’s gangrene were evaluated retrospectively to determine prognostic indices and to stress Fournier’s Severity Index (FSI), influencing outcome.Results:  The mortality rate in this study was 22.8%. Length of the hospitalization time and FSI were detected as effective factors on mortality of Fournier’s gangrene (P < 0.05) by Binary Logistic Regression analysis and the area under the receiver operating characteristic curve of these variables was also found to be significant (P < 0.001). The average FSI was determined as 4.66 ± 2.31 in survivors and 11.56 ± 2.68 in non‐survivors and 5.11 ± 2.83 in patients with primary genito‐urinary infection but 7.56 ± 4.35 in primary anorectal infection. The FSI was also found predictive of hospitalization time and number of debridements among survivors.Conclusion:  Fournier’s Severity Index is a simplified way of comparing patients with this disease and may also have some significance in predicting outcome. The FSI is a more significant and predictive tool that should be popularized to predict the prognosis in Fournier’s gangrene.
VIRTUAL PATIENTS IN UNDERGRADUATE SURGERY EDUCATION: A RANDOMIZED CONTROLLED STUDY
Authors: Vash Javad H. , Yunesian Masud , Shariati Mohammad , Keshvari Amir , Harirchi Iraj 
Published: February 2007

Background:  This study aims to clarify the effects of implementing a series of virtual patients in undergraduate surgery education on various dimensions of skills as applied to clinical problems.Methods:  In a randomized controlled trial 48 surgery clerks were assigned to an intervention group who worked on 14 simulated cases of abdominal pain during 7 weeks in a computer lab and a control group without access to software. At the end of the intervention, both groups were tested by a structured, seven‐part paper‐based exam evaluating certain areas of competence.Results:  Forty‐five students took the exam. Results showed a significant improvement in history taking (P < 0.001) and no improvement in scores related to appropriate use of radiology and lab tests, proposing differential diagnoses and management plans and factual knowledge. From the intervention group, 20 students completed a virtual case exam whose results had a poor correlation with the written exam.Conclusion:  Overall, our findings indicate that virtual patients are strong tools in enhancing history‐taking skills of students, but they do not affect other areas of competence significantly. Educators are recommended to be sceptical about enthusiastic reports on various computer applications and avoid falling into false expectations of their implementation.
ADAPTIVE BONE REMODELLING OF ALL POLYETHYLENE UNICOMPARTMENTAL TIBIAL BEARINGS
Authors: Gillies R. Mark , Hogg Michael C , Kohan Lawrence , Cordingley Rebecca L 
Published: February 2007

Background:  Failure of unicompartmental knees is either by progressive osteoarthritis or by failure of the prosthesis. Prosthesis failure can be because of either the actual component itself or its fixation method. Specifically, the tibial component may wear, loosen or subside into the tibial metaphyseal bone. We modelled all polyethylene tibial components and investigated the periprosthetic adaptive remodelling of the bone.Methods:  Computed tomography scans were used to reconstruct the tibial geometry and a 3‐D finite element mesh was created. The tibia loading was set at 45% of the gait cycle. The distal end of the tibia set as fixed. Implant orientations were in accordance with the manufacturer specifications. The bone mineral density changes at three regions of interest under the component were measured and plotted.Results:  All regions of interest became stable at the 12‐month time‐point. Predictive bone mineral changes were minimal in both resorption and deposition. Zones 1–3 for the St Georg Sled (Waldermar Link, Hamburg, Germany) presented evidence of stress shielding and a maximum loss of approximately 6% bone mineral density. The Eius (Stryker Orthopaedics, Mahwah, NJ, USA) showed increased loading and caused an increase in bone mineral density for all regions of interests; the maximum being approximately 10%.Conclusion:  These findings are consistent with the clinical experience of unicompartmental knee replacements, where the changes are small and have little effect on the outcome of the prosthesis. From a mechanical perspective, the results are also consistent when a compliant material is used to distribute loads. They do, however, support the biomechanical theory that a change in geometry influences the loading environment and as a consequence the adaptive response of the bone is also influenced.
A halothane surge phenomenon during paediatric mask induction using the Tec 4 vaporizer in the Ohmeda Modulus II Plus Anaesthesia System
Authors: MORRISON J.E. , McDONALD C. , OLIVER T. 
Published: February 2007

SummaryA prospective study of 30 paediatric patients who received a halothane inhalational induction revealed that in all 30 a brief halothane surge, i.e. an anaesthetic gas concentration greater than dialled on the vaporizer, occurred with the opening of the Tec 4 vaporizer (Ohmeda Tec 4 continuous flow vaporizer, Fluothane) dial setting to 0.25%. The surges were of brief (< 30 s) duration but ranged up to peak concentrations of 3% with a mean of 1.7% (± 0.8 SD). Measurements were made on the Ohmeda RGM 5250 respiratory gas monitor. While two of the children were crying throughout the induction and were not included in the totals, 11 (39%) of the remaining children were noted to withdraw from the mask when halothane was begun despite the use of sweet‐flavoured (e.g. strawberry) scent application. Although no physiologic parameters were changed as a result, the effect on parents present during induction and the alteration of a calm, pleasant induction into one with a crying, uncooperative child make this factor pertinent to the paediatric anaesthetist.
Peri‐operative changes in plasma C3a and C5a concentrations in infants
Authors: MIKAWA K. , MAEKAWA N. , IKEGAKI J. , GOTO R. , YAKU H. , OBARA H. 
Published: February 2007

SummaryIt is well known that complement activation plays a key role in the development of pulmonary insufficiency; it is also well known that cortisol suppresses complement activation. By measuring the plasma concentrations of C3a and C5a, we investigated peri‐operative changes in the activation of the complement system in 18 infants undergoing elective abdominal surgery. We also measured plasma cortisol concentrations to assess the peri‐operative relationship between complement activation and the stress produced by multiple peri‐operative factors following two anaesthetic techniques. Eighteen infants ranging in age from 1 to 11 months were randomly divided into two groups according to the anaesthetic technique used: Group 1 consisted of nine infants in whom general anaesthesia was maintained with halothane and nitrous oxide (N2O) in oxygen, while Group 2 consisted of nine infants in whom general anaesthesia was maintained with fentanyl and N2O in oxygen. Plasma C3a and C5a concentrations were higher in the fentanyl group than in the halothane group during the peri‐operative period. Plasma cortisol concentration, in contrast, was lower in the fentanyl group both during and after surgery. The post‐operative clinical course showed no significant intergroup differences between the two groups throughout the study. These observations suggest that the difference in peri‐operative complement activation between the halothane and the fentanyl groups may have been due, in part, to different peri‐operative stress responses. However, further studies are required to elucidate the precise causative mechanisms and the clinical implications of complement activation in infants.
The use of extracorporeal membrane oxygenation in a child with adult respiratory distress syndrome following post‐obstruction pulmonary oedema
Authors: COHEN I.T. , BAKER S.B. 
Published: February 2007

SummaryThe use of extracorporeal membrane oxygenation (ECMO) for post‐operative complications is not well described. ECMO, a partial venoarterial cardiopulmonary bypass, may permit the reversal of pulmonary insult from barotrauma and oxygen toxicity. This report concerns an 8‐year‐old girl who developed post‐obstruction pulmonary oedema and adult respiratory distress syndrome (ARDS) after a general anaesthetic for an attempted aspiration of a peritonsillar abscess and demonstrates an effective use of this technique. In this patient, the extreme levels of ventilatory support required post‐operatively caused haemodynamic instability and severe barotrauma. The institution of ECMO with accompanying decrease in ventilatory support resulted in rapid resolution of haemodynamic instability, hypoxia, and pulmonary pathology.
Anaesthesia and the lipidoses: a review of patients treated by bone marrow transplantation
Authors: MAHONEY A. , SONI N. , VELLODI A. 
Published: February 2007

SummaryThere are many potential problems associated with anaesthesia in patients with lipid storage diseases. This review covers an 8‐year period (1983–1990) during which time 13 patients presented for procedures associated with bone marrow transplantation. The case notes of 12 patients who underwent a total of 48 general anaesthetics were reviewed. Pre‐operative assessment revealed cardiorespiratory disease in six patients. Eighty per cent of the children were anaemic (haemoglobin < 95 g1‐1). Anaesthesia was tolerated well although tracheal intubation in two patients with Gaucher's disease was difficult and became progressively more difficult as they became older. Forty‐five per cent of patients with Gaucher's disease were intubated with a tracheal tube smaller than predicted from the age of the child. Few complications were encountered but those which may be anticipated are discussed.