bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraspecific Genetic Variation in H. Irritans, a Fungal Endosymbiont of Marine Brown Algae on the North American Pacific Coast
Authors: Harvey J. B. J. 
Published: March 2003

AbstractThe marine ascomycete genus Haloguignardia occurs endophytically in members of the marine brown algal family Sargassaceae globally. This example of endosymbiosis has been morphologically described: the fungal component internally infects the algal host resulting in prolific cell growth, forming galls composed chiefly of host algal cells but containing fungal reproductive structures and vegetative hyphae. H. irritans induces the formation of galls in the brown algae Cystoseira osmundacea and Halidrys dioica along the Pacific coast from Oregon to Baja California, Mexico. Using culture‐independent molecular techniques, I sequenced the 18S rDNA gene region for H. irritans and generated a 18S‐based taxonomy consistent with the current taxonomy for this morphological species. In order to study intraspecific genetic variation in H. irritans, I have sequenced the ITS rDNA (ITS 1, 2 and the 5.8 s) regions for five separate gall‐tissue samples from Santa Rosa Island in southern California and for five samples from Monterey and Carmel in central California. Intraspecific DNA sequence variation in the ITS regions of H. irritans reveals consistent sequence divergence between sites sampled. The fungal ITS regions for H. irritans total 613 bp in length and contain 40 synapomorphic characters for a total of 6.5% variation in informative loci between southern and central Californian sites. This value is similar to those found for the ITS and other gene regions previously used by researchers investigating species boundaries at the intraspecific level in symbiotic, terrestrial fungi. In addition to ITS 1, 2 and the 5.8 s gene regions, I am currently using the 5’ end of the EF1a coding region to construct intraspecific genealogies for H. irritans. By comparing these genealogies to each other and to the geographic distribution of samples, I aim to determine if more than one genetic species is present within the morphological species H. irritans.
Phylogenetic Analysis of the Mischococcales, Tribonematales, and Vaucheriales (Xanthophyceae) Inferred from 18S rRNA Gene Sequences
Authors: McElhinney A. , Bailey J. C. , Andersen R. A. 
Published: March 2003

AbstractThe Xanthophyceae have traditionally been classified using a phenetic classification system based upon vegetative cell structure. Species belonging to the class are placed in one of six orders corresponding to amoeboid, coccoid, filamentous, flagellate, palmelloid, or siphonous organization. Nuclear 18S rRNA gene sequences were determined for 29 species and aligned with 10 previously determined sequences. Parsimony and maximum likelihood trees inferred from these data imply that the orders Mischococcales (coccoid), Tribonematales (filamentous), and Vaucheriales (siphonous) are not monophyletic. The majority of species are divided between two clades defined by the presence or absence of a bipartite cell wall. Also, several families, particularly those placed in the Mischococcales, are resolved as polyphyletic. Results indicate that coccoid and filamentous life forms may have arisen independently at least three times, and some coccoid and filamentous life forms are resolved as closely related. For example, Heterococcus (filamentous) is more closely related to Mischococcus and Pseudopleurochloris (coccoid) than it is to other members of the Tribonematales. Our data strongly support the contention that Bumilleriopsis and Pseudobumilleriopsis are congeneric with Bumilleria. The siphonous xanthophytes including Asterosiphon, Botrydium, and Vaucheria probably do not form a monophyletic group although robust bootstrap support for this conclusion is low. Our results indicate that the generic, familial, and ordinal classification of the Xanthophyceae requires major revision.
Validation of an Instrument Designed to Assess Medical Student Attitudes Toward Home Care
Authors: Boal Jeremy , Fabacher Diane , Miller Roberta , Siu Albert , Kantor Bonnie , Flaherty Joseph 
Published: March 2003

OBJECTIVES: To develop and validate an instrument to assess medical students' attitudes toward home care.DESIGN: Survey administration before and following participation in a home care training program.SETTING: Five medical schools in the United States.PARTICIPANTS: 326 third and fourth year medical students.MEASUREMENTS: Factor analysis was performed on all posttests. Domains were tested for internal reliability (Chronbach's α). Interdomain correlation was tested. One‐way analysis of variance (ANOVA) was used to determine whether the results for each domain differed among the five programs.RESULTS: Using exploratory factor analysis, the original 20‐item survey was revised to yield a 14‐item survey consisting of four domains (general attitudes, home‐based therapies, home care training, and time and reimbursement). Domain intra‐item reliability ranged from 0.60 to 0.82. Interdomain correlations were found to be significant with the exception of one comparison (time and reimbursement and home care training). One‐way ANOVA showed significant differences between the training programs for two of the four domains (home‐based therapies and home care training). For a third domain, time and reimbursement, there was a trend toward differences across the schools (P = 0.06).CONCLUSION: The instrument described in this paper is a reliable and valid instrument for assessing the impact of home care training on medical student attitudes across a series of important domains.
The Effect of Body Mass Index on Complications from Cardiac Surgery in the Oldest Old
Authors: Maurer Mathew S. , Luchsinger Jose A. , Wellner Rachel , Kukuy Eugene , Md Niloo M. Edwards 
Published: March 2003

OBJECTIVES: Overweight (body mass index (BMI)>25) and obesity (BMI>30) are associated with adverse outcomes in the general population. In older people, an increased risk of adverse events was observed in leaner and overweight older subjects. We evaluated the association between BMI and cardiac surgery complications in subjects aged 75 and older.DESIGN: Retrospective review of complication rates compiled as part of the New York State Department of Health Adult Cardiac Surgery Report.SETTING: Academic tertiary care medical center.PARTICIPANTS: One thousand four hundred forty‐eight subjects aged 75 and older who underwent cardiac surgery in an academic hospital between 1991 and 1999.MEASUREMENTS: Subjects were divided into tertiles based on their BMI. Logistic regression was used in multivariate analyses examining the association between tertiles of BMI (<23, 23–26,>26) and complications from cardiac surgery, adjusting for age and gender or using a full model adjusting for history of diabetes mellitus, hypertension, myocardial infarction (MI), congestive heart failure, smoking, chronic obstructive pulmonary disease, peripheral vascular disease, renal disease, surgical priority, age, and gender.RESULTS: Mean age was 79 (range 75–94); 58% of the subjects were male. The incidence of any postoperative complication, respiratory failure, or death was U‐shaped, with higher incidence in the first tertile of BMI, followed by the last tertile and then the middle tertile. Subjects in the lowest tertile of BMI in the full model had a higher adjusted risk of stroke (odds ratio (OR) = 1.58, 95% confidence interval (CI) = 0.96–2.59), bleeding (OR = 1.71, 95% CI = 0.79–3.67), respiratory failure (OR = 1.65, 95%CI = 0.95–2.87), cardiovascular complications (stroke, MI, arrhythmia) (OR = 1.59, 95% CI = 0.93–2.73), and all complications (OR = 1.45, 95% CI = 1.05–2.00) than subjects in the middle tertile. The risk of most complications in subjects in the highest tertile of BMI was similar to that of subjects in the middle tertile except for wound infections (OR = 3.51, 95% CI = 0.92–13.33). The risk of death was higher in subjects in the lower tertile of BMI (OR = 1.97, 95% CI = 1.12–3.44) than in subjects in the middle tertile. The association between BMI and adverse cardiac surgical outcomes was stronger in men than women and decreased with advancing age.CONCLUSIONS: In the geriatric population, subjects with lower BMI have a higher risk of complications and death from cardiovascular surgery than subjects with higher BMI. An increased BMI does not increase the risk of complications from cardiovascular surgery, with the exception of wound infections.
Serum Cystatin C Concentration Compared with Other Markers of Glomerular Filtration Rate in the Old Old
Authors: Van Den Noortgate Nele J. , Janssens Wim H. , Delanghe Joris R. , Afschrift Marcel B. , Lameire Norbert H. 
Published: March 2003

OBJECTIVES: To assess serum cystatin C, compared with other markers of renal function, as a marker of renal function in the old old (aged 85 and older).DESIGN: A cross‐sectional analysis of data obtained in medically stable people aged 70 and older in a geriatric ward at a university hospital.SETTING: University hospital in Belgium.PARTICIPANTS: Forty‐eight patients (17 men, 31 women) mean age ± standard deviation 84.4 ± 6.3 without acute illness or overt malignancy 7 days after admission were included. Twenty‐five patients were aged 85 and older.MEASUREMENTS: Blood samples and 24‐hour urine collections were obtained from each patient to determine serum creatinine, serum cystatin C levels, serum albumin, and creatinine clearance. Glomerular filtration rate (GFR) was estimated using the Cockcroft‐Gault formula and the Modification of Diet in Renal Study Group (MDRD) formula. On the same day, clearance of 51chromium ethylenediamine tetraacetic acid was performed in all patients as the criterion standard of GFR.RESULTS: Serum creatinine (r = 0.68), serum cystatin C (r = 0.62), urinary creatinine clearance (r = 0.57), the Cockcroft‐Gault formula (r = 0.82), and the MDRD‐formula (r = 0.65) correlated significantly with GFR (P < .0001). Regression analysis showed that serum cystatin C and serum creatinine were comparable markers of renal function (Y = 0.442 ± 0.007 × GFR and Y = 0.494 ± 0.01 × GFR respectively). Receiver operating characteristic analysis showed a similar area under the curve for serum cystatin C and serum creatinine (P = .5) in detecting renal impairment (GFR <80 mL/min). The Cockcroft‐Gault formula provides a good estimation of GFR when the GFR is less than 60 mL/min (Y = 1.11 ± 1.04 x GFR). When the GFR is greater than 60 mL/min, the Cockcroft‐Gault formula underestimates GFR (Y = 11.01 ± 0.66 x GFR). In patients aged 85 and older, a slight decrease in GFR (51.8 ± 21.3 mL/min vs 65.2 ± 34.3 mL/min in patients aged 70–84; P = .10) is observed. This is reflected by a nonsignificant increase in serum cystatin C (P = .06), whereas serum creatinine is identical in both groups (P = .88).CONCLUSION: Serum cystatin C, serum creatinine, the Cockcroft‐Gault formula, the MDRD formula, and urinary creatinine clearance are comparable markers of renal function in the overall older population. The Cockcroft‐Gault formula underestimates renal function in older people with GFR greater than 60 mL/min. In our study, serum cystatin C was not superior to serum creatinine in the detection of renal impairment.
Neurolysis of the Trigeminal and Sphenopalatine Ganglions
Authors: Day Miles 
Published: March 2003

Abstract: Facial pain of trigeminal and sphenopalatine ganglion origin is the bain of existence for thousands of people. Treatment protocols typically begin with oral medication, usually anticonvulsants, and may progress to percutaneous and open surgical procedures. Several new medications show promise as alternatives to carbamazepine, which has been the standard first‐line treatment (trigeminal neuralgia), while electromagnetic pulsed radiofrequency and gamma knife surgery are new options when the surgical route is warranted.This article will examine the anatomy of the trigeminal and sphenopalatine ganglions. Indications for neurolysis and neurolytic options will be discussed. Efficacy of the various neurolytic techniques will be thoroughly reviewed.
Transfusions to group O subjects of 2 units of red cells enzymatically converted from group B to group O
Authors: Lenny L.L. , Hurst R. , Goldstein J. , Galbraith R.A. 
Published: March 2003

Background: It has previously been shown that full‐unit (200 mL) transfusions of red cells (RBCs) enzymatically converted from group B to group O by treatment with α‐galactosidase (ECO RBCs) are both safe and efficacious for normal group O or A subjects.Study Design and Methods: The present study describes the results of a comprehensive clinical and serologic assessment of 2‐unit (400 mL) ECO RBC transfusions to each of four normal group O subjects (after each had donated 1 unit of whole blood).Results: Clinical (hematologic tests, chemistry analysis, urinalysis) and serologic analyses revealed no evidence of immediate or delayed transfusion reaction, despite a threefold to fivefold elevation in pre‐existing anti‐B antiglobulin titer. 51Cr‐labeled ECO RBCs were administered to one of the four subjects to allow direct measurement of ECO RBC survival in the circulation, which indicated that it was normal (24‐hour survival, 95%; t½, 29.5 days). The observed increases in hemoglobin (by 1.3 ± 0.4 g/dL [13 ± 4 g/L]) and hematocrit (by 3.2 ± 0.8% [0.032 ± 0.008]) in transfused subjects provide further evidence of the efficacy of these cells in vivo.Conclusion: These results extend those observed in our earlier 1‐unit transfusion studies and suggest that ECO RBCs pose little risk and will be useful in transfusion medicine.
Differential sensitivities of viruses in red cell suspensions to methylene blue photosensitization
Authors: Wagner S.J. , Robinette D. , Storry J. , Chen X.Y. , Shumaker J. , Benade L. 
Published: March 2003

Background: Previous studies explored the feasibility of using the photosensitizer methylene blue (MB) as a virucidal agent in red cell suspensions. Under treatment conditions (5 μM [5 μmol/L] MB, 3.4 × 10(4) J/m2) that resulted in more than 6 log10 inactivation of vesicular stomatitis virus (VSV) or of the enveloped bacteriophage φ6, red cell membrane alterations were observed. Increased red cell ion permeability and the binding of plasma proteins to the red cell surface were the most sensitive indicators, which varied in a dose‐dependent fashion.Study Design and Methods: Inactivation of three additional extracellular viruses and intracellular human immunodeficiency virus type 1 (HIV‐1) was assessed after MB phototreatment of red cell suspensions. Potassium leakage and IgG binding also were characterized in MB‐treated red cell suspensions that were exposed to low‐fluence light (6 × 103 J/m2).Results: Different viruses exhibit a wide range of sensitivities to MB photoinactivation. For example, phototreatment conditions (5 μM [5 μmol/L] MB, 3.4 × 104 J/m2) that inactivated more than 6 log10 of VSV did not inactivate the nonenveloped picornavirus, encephalomyocarditis virus. In contrast, lower fluences (6 × 103 J/m2) inactivated approximately 5 log10 or more of Sindbis virus and approximately 4log10 of extracellular HIV‐1. These less stringent phototreatment conditions (5 μM [5 μmol/L] 6 × 103 J/m2) caused lower rates of red cell potassium leakage (reduction by 6‐ fold) and little or no binding of plasma proteins to the red cell surface, compared to values observed previously with higher fluences. However, neither 6 × 103 nor 4.1 × 104 J per m2 fluences resulted in any inactivation of intracellular HIV as represented by changes in the amount of p24 antigen produced during co‐culture of actively infected H9 cells.Conclusion: MB‐based protocols would require the use of high‐efficiency (> 6log10) white cell‐reduction filters or additional inactivation steps to deplete or inactivate intracellular virus.
The effect of methylene blue phototreatment on plasma proteins and in vitro coagulation capability of single‐donor fresh‐frozen plasma
Authors: ZEILER T. , RIESS H. , WITTMANN G. , HINTZ G. , ZIMMERMANN R. , MÜLLER C. , HEUFT H.G. , HUHN D. 
Published: March 2003

BACKGROUND: Photodynamic virus inactivation of fresh‐frozen plasma (FFP) may result in its impaired coagulation capability.STUDY DESIGN AND METHODS: Double‐volume plasmapheresis samples from 11 donors were divided in pairs of 250 mL. One group underwent methylene blue (MB) phototreatment (MB‐FFP). The other group was treated according to the standards of the American Association of Blood Banks for preparation and storage of FFP. Parameters of hemostasis and clinically important plasma proteins were tested in native plasma, thawed MB‐FFP, thawed FFP, and twice‐frozen and thawed FFP (FFP‐II).RESULTS: Mean activities of factor V (73.4 vs. 94.5%; p < 0.01), factor VIII (58.1 vs. 86.7%; p < 0.001), and fibrinogen (1.8 vs. 2.8 g/L; p < 0.001) were reduced in MB‐FFP as compared to those in FFP. The comparison of MB‐FFP to FFP‐II revealed reduced activities of factor VIII (58.1 vs. 85.2%; p < 0.001) and fibrinogen (1.8 vs. 2.8 g/L; p < 0.001) but no changes in factor V. Activated partial thromboplastin time in MB‐FFP was prolonged beyond the upper normal range (+5.3 sec; p < 0.001) and prothrombin time increased in MB‐FFP versus FFP (+0.96 sec; p < 0.001). CONCLUSION: MB phototreatment reduces the in vitro coagulation capacity of FFP, most likely as a result of the effects of an additional freezing and thawing procedure and photooxidation‐induced protein damage.
Retrograde transmission of Proteus mirabilis during platelet transfusion and the use of arbitrarily primed polymerase chain reaction for bacteria typing in suspected cases of transfusion transmission of infection
Authors: Engstrand M. , Engstrand L. , Hogman C.F. , Hambraeus A. , Branth S. 
Published: March 2003

BACKGROUND: When bacteria are found, after a platelet transfusion, in the recipient's blood as well as in the platelet concentrate (PC), a causal relationship is normally suspected, with the PC as the causative agent. The other alternative, that the patient has bacteremia and contaminated the PC, is less well documented in the literature. CASE REPORT: Arbitrarily primed polymerase chain reaction (AP‐PCR) was used for testing strains of Proteus mirabilis isolated from a patient's blood before and after a platelet transfusion and from the PC. Because of a febrile reaction after a platelet transfusion, bacterial culture was performed on the PC used, showing growth of P. mirabilis. The same species was found in the patient's blood after the transfusion. Posttransfusion sepsis caused by a contaminated PC was suspected, and anti‐sepsis treatment was given to the recipient. Later, it became apparent that the patient had had bacteremia before the transfusion and that P. mirabilis was one of the species in the isolate. With AP‐PCR, the identity of the three P. mirabilis isolates could be distinguished.CONCLUSION: AP‐PCR is a useful technique for distinguishing the identity of bacterial isolates from patients and blood components. A patient with bacteremia can contaminate a PC in conjunction with a platelet transfusion. With AP‐PCR, the PC could be ruled out as the cause of the posttransfusion sepsis.
Low incidence of red cell and HLA antibody formation by bone marrow transplant patients
Authors: Abou‐Elella A.A. , Camarillo T.A. , Allen M.B. , Barclay S. , Pierce J.A. , Holland H.K. , Wingard J.R. , Bray R.A. , Rodey G.E. , Hillyer C.D. 
Published: March 2003

BACKGROUND: Bone marrow transplant (BMT) patients, although immunosuppressed, are at risk for the development of red cell (RBC) and HLA antibodies, and they often are given filtered blood in an effort to prevent the latter complication. This study attempts to determine the rate of formation and the specificity of both RBC and HLA alloantibodies in this patient population.STUDY DESIGN AND METHODS: BMT patients (148 received autologous marrow; 45 received allogeneic marrow) from an 18‐month period, including patients with leukemia (57 patients), lymphoma (54), breast cancer (68), myeloma (8), myelodysplastic syndrome (5), and aplastic anemia (1), were studied to determine the rate of alloantibody formation to RBC and HLA antigens. A total of 2,410 RBC antibody screens were performed. The patients received 3,921 packed RBCs and 5,915 single‐donor platelet units; all were irradiated and administered via white cell‐reduction filters.RESULTS: Seven (3.6%) of 193 patients had RBC antibodies upon hospital admission. Four (2.1%) of 193 developed RBC antibodies during the course of BMT: 3 patients had one RBC antibody and 1 patient had two RBC antibodies. RBC antibodies included anti‐E (n = 2), anti‐M (n = 1), anti‐Jkb (n = 1), and anti‐Lu14 (n = 1). Thus, 98 percent of patients (189/193) did not develop new (182/186) or additional (7/7) RBC antibodies during BMT. BMT patients were also screened weekly for HLA antibody formation (60‐cell panel). Upon admission, 170 (85%) patients were negative. Of these, 8 (4.7%) developed persistent HLA antibodies (mean panel‐reactive antibody score, 33 +/− 29%) and 9 (5.3%) were variably positive. Thus, in our setting and population, RBC antibody formation was 0.1 percent per unit transfused, and the HLA alloimmunization rate was 5 to 10 percent.CONCLUSION: As RBC antibody screens are done every Monday, Wednesday, and Friday on this BMT service and as RBC antibody formation is low in these patients, screening for unexpected antibodies might be possible on a more infrequent basis. Also, the rate of HLA alloimmunization in this population receiving filtered blood components is low.
Mislabeling of elutriation medium: a demonstration of the need to improve the quality control of reagents produced for cell processing
Authors: Stroncek D.F. , Fautsch S. , Burger S. , Wagner J.E. , McCullough J. 
Published: March 2003

BACKGROUND: The processing of hematopoietic cells to remove red cells, T‐lymphocytes, or malignant cells has become common. However, few of the reagents used are produced specifically for marrow processing and approved by the Food and Drug Administration. CASE REPORTS: A labeling error is reported in a commercially manufactured, research‐grade reagent used in an elutriation procedure to deplete T cells from mononuclear cells obtained from bone marrow for allogeneic transplantation. The elutriation medium used in the procedure had been labeled as containing 0.9‐percent sodium chloride, 0.1‐percent dextrose, and 0.3 mM EDTA, but it actually contained 3.0 mM EDTA. When this medium was not available from the manufacturer, it was prepared in this hospital, according to the stated formulation, with 0.3 mM EDTA. When marrows from two unrelated donors were processed with this 0.3 mM EDTA‐containing medium, cell loss due to aggregation occurred, and, in one recipient, the marrow did not engraft. After the error in the medium composition was discovered, marrow was collected a second time from the same donor. The marrow was processed with medium containing 3.0 mM EDTA, and no cell aggregation was observed.CONCLUSION: Food and Drug Administration‐approved reagents, prepared specifically for use in cell processing and produced according to good manufacturing practices, should be used whenever possible.