bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental factors during seed development of narrow‐leaved bird's‐foot‐trefoil (Lotus tenuis) influences subsequent dormancy and germination
Authors: Clua A. A. , Gimenez D. O. 
Published: December 2004

AbstractNarrow‐leaved bird's‐foot‐trefoil (Lotus tenuis) is a perennial forage legume adapted to waterlogged and heavy and infertile soils and can replace alfalfa (Medicago sativa) in areas with these soils in Argentina. Its seeds are hard and water‐impermeable but the effects of environmental factors on seed dormancy and germination are not known. The objective was to evaluate the hypothesis that water availability during seed development and maturation affects the degree of hardseededness in L. tenuis by changing seed coat properties, conditioning water uptake through the seed coat; and subsequently affecting dormancy, germination and speed of germination. Seeds were harvested in December/January and in February in both 1993/1994 and 1994/1995 from a permanent pasture of L. tenuis growing in a Hapludol soil in San Miguel del Monte province of Buenos Aires. Environmental conditions of each anthesis‐harvest period were determined. Seeds of each harvest were subjected to chilling, washing and mechanical scarification. After 12 months seeds from each harvest were observed in a scanning electron microscope. The water deficit of the soil and relative humidity were greater in the second than the first anthesis‐harvest period in both seasons. In 1993/1994 the control treatment in December had a higher germination rate than the February control seeds (0·40 vs. 0·20) and a faster germination rate. Mechanical scarification and chilling significantly enhanced the germination rate (0·95) and its speed in seeds of both harvests. Low temperatures significantly enhanced germination rate, starting after 60 d for the seeds harvested in December, and 90 d for the seeds harvested in February. In 1994/1995 the results were similar but both the January and February control treatments had higher germination rates (0·60 vs. 0·40) than in the previous year. Seeds harvested in February were more dormant in both years. These differences could be explained by the conditions in February anthesis‐harvest period in both years that could have hastened the natural dehydration process of seed, changing integument structure and enhancing its impermeability.
Insights into the regulation of immunoglobulin light chain gene rearrangements via analysis of the κ light chain locus in λ myeloma
Authors: Perfetti Vittorio , Vignarelli Maurizio C. , Palladini Giovanni , Navazza Valentina , Giachino Claudia , Merlini Giampaolo 
Published: December 2004

SummaryAccumulating evidence indicates that B cells may undergo sequential rearrangements at the light chain loci, despite already expressing light chain receptors. This phenomenon may occur in the bone marrow and, perhaps, in germinal centers. As immunoglobulin (Ig)κ light chains usually rearrange before Igλ light chains, we analysed, by polymerase chain reaction, the Igκ locus of bone marrow mononuclear cells from 29 patients with Igλ myeloma to identify earlier recombinations in marrow plasma cells. The results demonstrated that Igκ alleles were inactivated via the kappa‐deleting element, presumably prior to Vκ‐Jκ rearrangement, in many cases. Eighteen alleles (16 myeloma clones, 55%) showed Vκ–Jκ rearrangements, with increased utilization of 5‵ distant Vκ and 3′ distant Jκ gene segments (Jκ4, 56%), an indication of multiple sequential rearrangements. In‐frame, potentially functional Vκ–Jκ rearrangements were found in approximately one‐third of available rearrangements (as expected by chance), each one in different myeloma clones: three were germline encoded, while one had several nucleotide substitutions, suggesting inactivation after the onset of somatic hypermutation. Three of four potentially functional Vκ–Jκ rearrangements involved Vκ4–1, a segment considered to be associated with autoimmunity. These findings provide insights into the regulation of light chain rearrangements and support the view that B cells may occasionally undergo sequential light chain rearrangements after the onset of somatic hypermutation.
Comparison of nutritional risk screening tools in patients on admission to hospital
Authors: Corish C. A. , Flood P. , Kennedy N. P. 
Published: December 2004

AbstractBackground and aims  Undernutrition has been frequently reported in patients on admission to hospital. Because this is not always detected promptly, screening for nutritional risk on admission has been widely advocated. Although there is no universally accepted ‘gold standard’ for defining undernutrition, the definition used by McWhirter, J.P. & Pennington, C.R. [(1994) Br. Med. J.308, 945] has been widely used by clinical nutrition specialists. This study aimed to compare the efficacy of two frequently used nutritional risk screening tools in detecting undernutrition according to this definition.Methods  Both the Nutrition Risk Index [Veterans Affairs Total Parenteral Nutrition Co‐operative Study Group (1991) N. Engl. J. Med.325, 525] and the Nutrition Risk Score [Reilly H.M. et al. (1995) Clin. Nutr.14, 269] were used to screen for undernutrition in 359 admissions to two acute teaching hospitals in Dublin. Undernutrition was defined as a Body Mass Index below 20 kg m−2 and a triceps skinfold thickness or mid‐arm muscle circumference below the 15th percentile. Comparison of stratification of nutritional risk by the two screening tools was carried out.Results  Both screening tools identified over 40% (Nutrition Risk Index, 44%; Nutrition Risk Score, 46%) of all patients assessed as at nutritional risk on admission. However, one‐third of the undernourished patients were classified as at no nutrition risk by the Nutrition Risk Index, while almost one‐fifth of those undernourished were classified as at low risk by the Nutrition Risk Score. The degree of nutritional risk differed with the screening tool used, the Nutrition Risk Score classifying 29% of all patients as high risk while the Nutrition Risk Index classified only 5% as in the high risk category.Conclusions  Although a large proportion of patients on admission were classified as being at nutritional risk, the degree of risk was significantly different depending on the screening tool used. Both nutritional risk screening tools evaluated in this study failed to recognize many cases of undernutrition. Evaluation of the efficacy of nutritional screening tools should be promoted as seriously as the development of such tools.
Prevalence study of the randomized controlled trials in the Journal of Intellectual Disability Research: 1957–1994
Authors: Duggan L. M. , Morris M. , Adams C. E. 
Published: December 2004

AbstractSystematic reviews of care are increasingly potent guides to clinical practice, and it is important that all relevant randomized controlled trials (RCTs) are identified by those within the speciality of learning disability who produce such works. All RCTs in the Journal of Intellectual Disability Research and its predecessor were identified by hand‐searching (1957–1994), and the frequency, origin, intervention and quality of reporting of randomization were described. Electronic searches for the trials were undertaken for the years 1974–1994, and the quality of indexing was inspected and tested. These electronic searches were then compared to a ‘gold standard’ search. Fifty‐six RCTs were identified. None contained the word ‘randomized’ in the title and only nine mentioned it in the abstract. Out of the 37 RCTs published between 1974 and 1994, 36 are in PsycLIT and 37 in MEDLINE. One MEDLINE record contained the wrong abstract. The methodological phrases used in the electronic records were poor, and thus, the precision of electronic searches, using both databases, was low. This international journal contains many relevant RCTs from around the world, involving several types of interventions. Unfortunately, these trials cannot be readily accessed electronically using methodological phrases designed to find RCTs. Improved quality of indexing would facilitate identification of RCTs and their dissemination.
The role of macrophage migration inhibition factor in toxic epidermal necrolysis
Authors: Halevy Sima , Livni Ella 
Published: December 2004

Patient A A 60‐year‐old man developed toxic epidermal necrolysis (TEN) following several weeks of treatment with two kinds of drug: co‐trimoxazole and acetazolamide. On the basis of time relationship data, both drugs could be considered as the inducers of the cutaneous reaction.1 Guide fables indicated that co‐trimoxazole is one of the most common inducers of TEN, whereas acetazolamide has been reported as a possible uncommon inducer of TEN.1–3 Drug intake was stopped, and treatment with prednisone (120 mg/day) was instituted, followed by a gradual tapering of the dosage. A month later, complete remission of the skin lesions was observed. A macrophage migration inhibition factor (MIF) test was performed towards the drugs taken, in an attempt to identify the offending drug. The macrophage migration inhibition factor (MIF) test was positive towards co‐trimoxazole and negative for acetazolamide. Positive MIF responses towards co‐trimoxazole were not recorded in ten control patients (control I) treated with the drug with no manifestations of drug eruption. Patient B TEN was diagnosed in an 84‐year‐old man treated prior to the appearance of the eruption with two kinds of drug: furosemide, which had been taken for several weeks, and nitrofurantoin, which had been taken for 3 months. On the basis of time relationship data, furosemide was suspected to be the offending drug; however, guide tables indicated nitrofurantoin as a possible inducer of TEN,3 whereas the role of furosemide (a sulfa drug) as an inducer of TEN has not yet been reported. Drug intake was stopped, and following supportive treatment, without the addition of corticosteroids, the skin lesions disappeared 3 weeks later. A MIF test was performed towards furosemide and nitrofurantoin. The MIF test was positive towards furosemide and negative for nitrofurantoin. Positive MIF responses towards furosemide were not recorded in seven control patients (control II) treated with the drug with no manifestations of drug eruption. The MIF test technique The MIF test was performed according to the modified method of Livni et al.4 A migration index of 0.80 or less at one or more of the drug concentrations was considered to be a positive MIF test. Statistical analysis Statistical analysis of MIF test results in TEN patients and controls was performed using Fisher's exact test (F.E.T.). The occurrence of positive MIF responses towards drugs recorded in TEN patients (2/4) was significantly higher (P<0.05) than that recorded in the controls (0/17). The MIF test results in TEN patients and controls are summarized in Table 1.
From melanotic to amelanotic lentigo maligna: an aggressive variant presenting as an inflammatory lesion
Authors: Kiene Petra , Christophers Enno 
Published: December 2004

A 79‐year‐old woman presented to us with an erythematous macule of the left cheek, approximately 4 cm in diameter. She reported slow enlargement of the lesion over the previous 12 months. Clinically the lesion showed irregular borders and changing erythematous discoloration, as well as slight scaling. The diagnosis at the time of presentation was rosacea‐like dermatitis. The lesion was situated besides and within the site of a skin transplant.The patient's medical history revealed a first excision of a pigmented lentigo maligna 17 years previously (Fig. 1). Multiple recurrences of the pigmented lentigo maligna had been treated surgically 13, 6, 5, and 2 years prior to the latest clinical consultation, showing the clinical and histologic features of pigmented lentigo maligna.Because of this medical history, biopsies were performed which exhibited the histologic characteristics of amelanotic lentigo maligna. To confirm the melanocytic nature of the tumor cells, immunohistochemical analyses were carried out using S‐100 protein (Dako, Germany), HMB45 (Dako, Germany), and NK/C3 (Biogenex, USA) antibodies and the ABC method (Vectastain, USA) with 3‐amino‐9‐ethylcarbazol (AEC) as the chromogen. The cells expressed all three markers (Fig. 2), while the Fontana stain for melanin pigment failed to indicate the pigment.Histologically, as seen in Fig. 3, the first lentigo maligna excised demonstrates deposits of melanin pigment in melanophages and pigmented tumor cells, as well as a lichenoid and perifollicular infiltrate of lymphocytes and some macrophages. The histologic specimen shown in Fig. 4 demonstrates the biopsy taken 17 years later, where no melanin pigment can be observed within the tumor cells, which show a pagetoid infiltrating pattern of the epidermal layers. The inflammatory infiltrate is comparable with that seen in the first specimen, while regression was not observed. The solar elastosis of the upper dermis has markedly progressed.
Atypical acropustulosis in infancy
Authors: Truong Alizabeth L. , Esterly Nancy B. 
Published: December 2004

A 20‐month‐old white girl had a 4‐month history of an intensely pruritic widespread eruption that began as crops of 1–3‐mm papules and vesicles predominantly on her hands and feet. These lesions evolved into pustules after 24–48 h. Identical lesions would then erupt over large areas of her scalp, trunk, and extremities. Her primary care physician initially interpreted this eruption as chickenpox complicated by impetigo, and also considered a diagnosis of scabies. Antiscabetics, topical steroids, oral antibiotics, and antihistamines failed to control the eruption or alleviate the pruritus which interrupted sleep and her dally activities. The lesions waxed and waned, with new crops developing every 2–3 weeks and fading slowly before the next crop appeared.There was no history of significant exposure to pets or insects. The patient was otherwise in reasonable health and without systemic symptoms. No other children in her day care center nor any family members had a similar eruption. The family history was negative for skin disorders.On physical examination, there was an extensive pustular eruption, most pronounced on the hands and feet (Fig. 1), but also involving the legs (Fig. 2), chest, and scalp, which was remarkable for the confluent, crusted lesions. There was sparing of the intertriglnous areas.Burrows were absent. Cultures of the pustules for fungi and bacteria were negative, as were KOH and scabies preparations.Our clinical impression was acropustulosis of infancy. Because of some unusual features of presentation, namely the late age of onset, the widespread distribution, and the severity of the eruption, we obtained a 3‐mm punch biopsy of an intact pustule from the right foot. Histopathologic examination of the biopsy specimen revealed a subcorneal, unilocular pustule containing small clusters of neutrophils invading the intact epithelium (Fig. 3). Hyperplasia and spongiosis of the surrounding epidermis were also noted. There was a sparse mononuclear infiltrate in the papillary dermis, occasionally in a perivascular distribution. Eosinophils were absent. Periodic acid‐Schiff (PAS) stain was negative for fungal elements. These histologic findings were considered to be representative of acropustulosis of infancy.Prior to starting dapsone therapy, initial laboratory studies, including a complete blood count with differential, platelet count, liver function tests, blood urea nitrogen, creatinine, and G‐6‐PD level, were obtained and determined to be within normal limits. Dapsone therapy was initiated at 1 mg/kg/day for 1 week and then increased to 2 mg/kg/day. She showed a dramatic response to therapy with clearing of all lesions. The dapsone dose was then slowly reduced over the next few months and discontinued after 11 months without recurrence of the disorder. She was carefully monitored and at no time experienced untoward effects from this medication.
Aggressive peripheral T‐cell lymphoma containing Epstein–Barr virus genomes
Authors: Okuyama Ryuhei , Takahashi Kazuhiro , Ohi Tomonori , Mochizuki Mamoru , Tagami Hachiro 
Published: December 2004

A 42‐year‐old woman presented in December 1995 with a half‐year history of asymptomatic erythematous plaques with firm induration on her extremities (Fig. 1). In the biopsy specimen, they were composed of medium‐ to large‐sized pleomorphic lymphoid cells with nuclear atypia and frequent mitoses, which extensively infiltrated the dermis and subcutis (Fig. 2a). There were also large phagocytic cells filled with nuclear dusts and erythrocytes (Fig. 2b). Immunohistochemlcal staining performed on paraffin‐embedded sections using the labeled streptavidine‐biotin‐immunoperoxidase technique revealed that the atypical lymphoid cells were positive for CD3, a T‐cell marker, but negative for CD20, a B‐cell marker. Large phagocytic cells were positively stained with PGM1, a macrophage marker. Unfortunately, we could not obtain further information concerning the gene rearrangement or immunostaining of the T‐cell receptor because only paraffin‐fixed samples were available.A complete blood cell count revealed mild thrombocytopenia, but it was otherwise within normal limits. Atypical cells were absent in the peripheral blood and bone marrow. The serum level of lactate dehydrogenase was elevated at 1402 lU/L. Antibodies to human T‐lymphotrophic virus (HTLV–1) were negative. The titers of antibodies to human Epstein‐Barr virus (EBV) were as follows: viral capsid antigen (VCA) IgM type, <10; VCA IgG type, 640; early antigen (EA) IgG, 40; EBV‐determined nuclear antigen (EBNA), 40.Under a diagnosis of T‐cell lymphoma, we suspected the association of the lymphoma cells with EBV infection from the moderately high titers of antibodies to EBV, and performed in situ hybridization for EBV‐encoded nuclear RNAs (EBER). After hybridization, the detection of specifically bound fluorescein (FITC)‐conjugated antisense RNA probes (Dako, Kyoto, Japan) was achieved by anti‐FITC monoclonal antibody conjugated with alkaline phosphatase. More than 90% of lymphoid cells exhibited EBER‐positive nuclei, and almost all of the infiltrating cells in the same area expressed CD3 and CD45RO. No signal was observed for sense RNA probes, and suitable control specimens from EBV‐positive and EBV‐negative cases were used as controls for EBV detection.Together with a rapid exacerbation of the skin tumors, a marked protrusion of the left eye appeared, behind which computed tomographic (CT) scan demonstrated the presence of a mass. CT scan of the abdomen also revealed large masses compatible with lymphoma. The patient was treated with cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP). However, the response to this therapeutic regimen was transient with only a brief remission interval, and the patient died of progressive disease 2 months after starting the chemotherapy.
Generalized epidermolytic hyperkeratosis in a child born to a parent with systematized epidermolytic linear epidermal nevus
Authors: Reddy Belum Siva Nagi , Thadeus Joseph , Kumar Sangeetham Krishan Ashok , Jaishanker Telanseri , Garg Bhagat Ram 
Published: December 2004

A 5‐month‐old girl was born with generalized erythematous skin covered with fine scales. Two days after she was born blisters started appearing over several places on the skin, resulting in multiple denudations. Later, over a period of 2–3 weeks, her skin started becoming rough, thickened, and covered with verrucous scales. The patient is the product of a full‐term normal delivery, is born to nonconsanguinous parents, and had normal developmental milestones. None of her family members had had similar episodes, although her father had had verrucous linear epidermal nevus since his childhood.On examination her entire skin was erythematous, thickened, and covered with rough verrucous scales arranged in a rippled pattern (Fig. 1a), more prominent in the flexural areas. Multiple erosions and a few flaccid vesicles and bullae were seen over the trunk and extremities (Fig, 1b), and islands of normal‐looking skin were seen over the recently healed erosions. Scales were less marked over the face. Mucous membranes, skin appendages, palms, and soles were not affected. The rest of her systemic examination revealed no other abnormality.Routine laboratory investigations including haemogram, Veneral Disease Research; Laboratory test (VDRL), and radiologic skeletal survey were normal. Histopathologic examination of the lesional skin and also the normal‐looking skin revealed the picture of epidermolytic hyperkeratosis showing features of hyperkeratosis and hypergranulosis with prominent vacuolar degeneration of the upper epidermis extending to the middle of the stratum spinosum (Fig. 2), Dermis was normal but for a mild edema and nonspecific perivascular inflammatory infiltrate.Dermatologic evaluation of her father revealed bilateral, asymmetric, thick, warty papules, and plaques arranged in a linear pattern following the lines of Blaschko over the trunk and extremities (Fig. 3), The rest of the skin and systemic examination was normal. A skin biopsy of the verrucous plaque over the back showed typical features of epidermolytic hyperkeratosis similar to his daughter (Fig. 4), and normal histology was observed from the skin section obtained from normal‐looking skin.
Do the British Guidelines for Asthma Management facilitate concordance?
Authors: Steven Karen , Marsden Wendy , Neville Ronald G , Hoskins Gaylor , Sullivan Frank M , Drummond Neil 
Published: December 2004

AbstractBackground  Asthma is an example of a common, chronic illness in which clinicians are encouraged to promote concordance and adhere to guidelines. Some existing research suggests that these aims may be incompatible.Objectives  To describe patient goals for life and for asthma management in order to inform concordance with people with asthma.Design  A cross‐sectional, qualitative survey.Setting and participants  A purposive sample of 47 adults with asthma from Dundee, UK. The subjects were identified from general practice asthma registers and had a range of ages and asthma severity but no significant comorbidity.Methods  Tape‐recorded semi‐structured interviews. The topic guide was based on the literature and had been piloted in a previous study.Results  The participants focussed on improving their lives, only aiming to improve their asthma as a means of improving their lives. Three aspects of asthma were reported to help or hinder improving life: the use of asthma medication, trigger avoidance and exercise. People integrated these three aspects of asthma in order to maximize life.Conclusions  The study supports the more individualized goals of the recently revised British Guidelines for Asthma Management but highlights the need to develop this further in future revisions. It also provides an explanation for patients’ acceptance of less than ‘perfect’ asthma control and it suggests that shared goals may be achieved in practice by considering the advantages and disadvantages of medication and allergen avoidance on everyday life rather than on asthma.