bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and phenomenological comparisons of delusional and non‐delusional major depression in the Chinese elderly
Authors: Lee Tien‐Wen , Tsai Shih‐Jen , Yang Cheng‐Hung , Hwang Jen‐Ping 
Published: May 2003

AbstractObjectiveDistinct clinical entities, with and without delusions, have been reported for depressed patients. This study explores the clinical and phenomenological aspects of delusional and non‐delusional major depression in elderly Chinese patients.MethodsA total of 156 depressed patients (105 males and 51 females) admitted to our geriatric psychiatry ward were investigated. Sociodemographic and clinical characteristics were compared between patients divided into two groups—according to presence or absence of delusions.ResultsOn admission, higher risk of suicide attempt, higher chance of guilt feelings, and greater daily functional impairment were observed for the deluded group. Further, the score of Hamilton Depression Rating Scale was higher and the score of Mini‐Mental State Examination was lower for delusional depressives.ConclusionOur findings were grossly concordant with previous Western reports, and highlight the importance of identifying the delusional subgroup of depressive patients because of the higher risk of suicide attempt. Copyright © 2003 John Wiley & Sons, Ltd.
Factors associated with antipsychotic drug use in residential care: changes between 1990 and 1997
Authors: Lindesay James , Matthews Ruth , Jagger Carol 
Published: May 2003

AbstractBackgroundThere is limited information from population‐based studies about the rates of antipsychotic drug use in residential and nursing homes in the UK, and associated adverse effects.ObjectivesTo examine the relationship between antipsychotic drug prescription, cognitive impairment and disturbed behaviour in this population over time, and to identify possible adverse consequences of their use.MethodsTwo censuses of the residential and nursing home population aged 65 years and older in Leicestershire, carried out in 1990 and 1997. A questionnaire was completed by care staff for each resident, including information on demographic details, physical functioning, cognitive impairment, behaviour disturbance, urinary incontinence, falls, mobility, daytime alertness (1997 only), and prescribed medication.ResultsThe prevalence of staff‐rated moderate or severe cognitive impairment increased from 38.0% in 1990 to 44.3% in 1997. The prevalence of staff‐rated disturbed behaviour decreased from 11.8% in 1990 to 10.4% in 1997. Cognitive impairment was strongly associated with disturbed behaviour in both years. The prescription rate of antipsychotic drugs increased from 17.8% in 1990 to 21.9% in 1997. There was no significant change in the prescription rates to cognitively impaired residents between 1990 and 1997 (29.1% vs 30.7%). In residents without cognitive impairment, the prescription rate rose from 10.7% to 15.0%. Antipsychotic drug use was independently associated with: younger age, type of home (1990 only), cognitive impairment, offensive behaviour, lower ADL dependency (1990 only), antidepressant drug use, reported urinary incontinence and greater mobility. There was no association with increased liability to falls or drowsiness. In the cognitively unimpaired residents, antipsychotic drug use was not associated with urinary incontinence in 1997, and there was an association with increased drowsiness in that year.ConclusionsThe only significant change in antipsychotic drug prescribing practice in this population over the period covered by this study was an increase in the prescription rate in cognitively unimpaired residents in 1997, possibly related to mental hospital closures. Urinary incontinence was the principal adverse effect of antipsychotic drug use observed in the group as a whole. Changes in the adverse effects associated with antipsychotic drug use may be a function of the increasing frailty. Copyright © 2003 John Wiley & Sons, Ltd.
Screening for late life depression: cut‐off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects
Authors: Schreiner Andrea S. , Hayakawa Hiroshi , Morimoto Tomoko , Kakuma Tatsuyuki 
Published: May 2003

AbstractBackgroundProper screening of depression among older adults depends on accurate cut‐off scores. Recent articles have recommended the Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD) for this screening. However, there has been no investigation of the sensitivity and specificity of either scale using Japanese subjects. The purpose of the present study was to identify appropriate GDS and CSDD cut‐offs for Japanese older adults.MethodsThe GDS and the CSDD were interview‐administered to nondepressed Japanese older adults (n = 74) and to Japanese older adults with a SCID‐IV diagnosis of major or minor depression (n = 37). Depressed subjects were also administered the Hamilton Depression Rating Scale (HDRS). Data were also collected on demographic variables, mental status, health status, and medication use.ResultsROC curve analysis identified a cut‐off score of 6 for the GDS which had a sensitivity of 0.973, a specificity of 0.959, a False Positive Rate (FPR) of 0.894, and a False Negative Rate (FNR) of 0. A cutoff score of 5 for the CSDD yielded a sensitivity of 1, a specificity of 0.919, a FPR of 0.942, and a FNR of 0. Comparisons indicate current HDRS cut‐offs may overlook subthreshold depression. The GDS cut‐off score identified among Japanese subjects was the same as that reported for Western subjects.ConclusionsDue to the substantial prevalence of psychiatric disorders found in false‐negative subjects, the above cut‐off scores were chosen to optimize the potential for true positives. These scores are recommended for alerting physicians and other caregivers as to when more intensive depression evaluation is needed. Copyright © 2003 John Wiley & Sons, Ltd.
Use of constraints and surveillance in Norwegian wards for the elderly
Authors: Kirkevold Øyvind , Laake Knut , Engedal Knut 
Published: May 2003

AbstractObjectiveTo describe the use of constraints and surveillance and their correlates in a nationwide sample of wards in institutions for the elderly in Norway.MethodsQuestionnaires were sent to 975 institutions and returned by 623 (64%) with 1398 wards. The wards' head nurses were asked whether any patient was currently subjected to physical restraints, electronic surveillance, force or pressure in medical examination or treatment, and force or pressure in ADL. The reporting of constraints was found reliable.ResultsIn all, 79% of the head nurses reported daily or occasional use of constraints in their wards. Most frequently reported were force or pressure in the performing of activities of daily living (reported by 61%, 95% Confidence Intervals (CI) 59–64), use of force or pressure in medical treatment or examination (49%, 95% CI 47–53) and use of physical restraints (38%, 95% CI 36–41). Electronic surveillance was used less frequently (14%, 95% CI 13–16). All classes of constraints, except physical constraints, were used significantly more frequently in special care units for persons with dementia than in ordinary nursing home units. The methodology does not allow conclusions to be drawn regarding the role of ward size and person characteristics. The staffing was unrelated to the use of constraints which varied significantly across the counties.ConclusionConstraints are widely used in Norwegian institutions for the elderly. A different pattern in use of constraints was found between special care units for demented patients and ordinary units in nursing homes. Copyright © 2003 John Wiley & Sons, Ltd.
External auditory canal eccrine spiradenocarcinoma: A case report and review of literature
Authors: Meyer Tanya K. , Rhee John S. , Smith Michelle M. , Cruz Michael J. , Osipov Vladamir O. , Wackym Phillip A. 
Published: May 2003

AbstractBackground.Eccrine spiradenocarcinoma is a rare dermal appendage carcinoma believed to arise from transformation of a long‐standing benign spiradenoma. This tumor demonstrates highly malignant biologic behavior with a high recurrence rate, frequent lymph node metastases, and overall poor survival.Methods.We report the first case of eccrine spiradenocarcinoma arising in the external auditory canal. The management of this tumor, its histopathologic characteristics, and a review of literature are presented.Results.A literature review identified 17 cases of eccrine spiradenocarcinoma in the head and neck region. Local recurrence occurred in 58.8% of patients, with an average of 23 months from diagnosis. Lymph node metastasis occurred in 35.3%, with an average of 31 months from diagnosis. Other metastatic sites included skin, bone, and lung. Disease‐specific mortality was 22.2%.Conclusions.Eccrine spiradenocarcinoma is an aggressive tumor with a poor prognosis. Primary treatment should include wide local excision with or without regional lymphadenectomy. Isolated successful treatments have been documented with adjuvant hormonal manipulation, chemotherapy, and radiation therapy. © 2003 Wiley Periodicals, Inc. Head Neck 25: 505–510, 2003
Vascular endothelial growth factor C and vascular endothelial growth factor receptor 3 expression in squamous cell carcinomas of the head and neck
Authors: Neuchrist Csilla , Erovic Bohan M. , Handisurya Allesandra , Fischer Michael B. , Steiner Georg E. , Hollemann David , Gedlicka Claudia , Saaristo A. , Burian Martin 
Published: May 2003

AbstractBackground and Methods.VEGF proteins and their receptors are involved in tumor vessel neoformation. The third VEGF receptor, VEGFR3 (flt‐4) is important during both blood vessel development and lymphatic vessel formation. Because HNSCC preferentially metastasizes to regional lymph nodes, we investigated the expression of VEGFR3 and its ligand VEGF‐C in head and neck squamous cell carcinomas by semiquantitative RT‐PCR (4 HNSCC cells lines and 6 HNSCC specimens) and by immunohistochemistry (18 HNSCC specimens). VEGFR3 protein expression was confirmed by Western blotting in four HNSCC cell lines and six HNSCC specimens.Results.Semiquantitative mRNA analysis showed VEGF‐C mRNA expression in three (SCC9, SCC25, LFFR) of four HNSCC cell lines and all six HNSCC specimens. VEGFR3 mRNA was found in two HNSCC cell lines (JPPA and SCC25) and only weakly detected in the other two HNSCC cell lines (SCC9 and LFFR). High amounts of VEGFR3 mRNA were shown in all six patients' tumor specimens. VEGFR3 Western blot analysis yielded a distinct band at the predicted size of 210 kD in JPPA and SCC9 and hardly detectable bands in SCC25 and LFFR cell lines. All six HNSCC specimens displayed strong VEGFR3 protein bands. Immunohistochemistry in 18 HNSCC specimens assigned strong to mediate VEGF‐C IR and minor VEGFR3 IR to tumor cells and strong VEGF‐C and VEGFR3 IR to tumor surrounding vessels. In addition, intense VEGF‐C immunostaining was observed on perivascular and mononuclear cells in the tumor surrounding stroma. Subtyping of VEGFR3+ microvascular tumor vessels revealed partially double immunolabeling with CD34 and flk‐1, indicating a common origin of blood and lymphatic vessels. The expression of VEGF‐C on tumor cells could be correlated with recurrences, and larger primary tumors had more VEGF‐C–positive vessels.Conclusions.The broad expression of VEGF C and VEGFR3 in HNSCC suggests involvement in tumor lymph angiogenesis and vascular angiogenesis, promoting tumor growth and propagation of cancer cells. This implies that inhibitors of lymph angiogenesis could become effective therapeutic options similar to classical angiogenesis inhibitors. © 2003 Wiley Periodicals, Inc. Head Neck 25: 464–474, 2003
Medical malpractice and the thyroid gland
Authors: Lydiatt Daniel D. 
Published: May 2003

AbstractBackground.A medical malpractice litigation “crisis” exists in this country. Analyzing litigation trends through verdict summaries may help understand causes.Methods.Jury verdict reviews from 1987–2000 were obtained from a computerized database. Reviews compile data on defendants, plaintiffs, allegations of wrongdoing, and verdict summaries.Results.Thirty suits from nine states occurred. Plaintiffs were women in 80% of the cases, with a median age of 41. Fifty percent of patients (15 of 30) had a bad outcome, (9 of 30 dead, 4 of 30 with neurologic deficits, 1 blind, and 1 alive with cancer). Thirty percent alleged surgical complications, mostly recurrent laryngeal nerve injury, and 75% of cancer patients alleged a delay, either through falsely negative biopsies or no biopsy taken. Respiratory events occurred in 43% and frequently resulted in large awards.Conclusions.The liberal use of fine‐needle aspiration and documentation of surgical risks may help reduce litigation. Complications and bad outcomes do not indicate negligence. Analysis may contribute to risk management strategies or litigation reform. © 2003 Wiley Periodicals, Inc. Head Neck 25: 429–431, 2003
Stage‐dependent effects of 20‐hydroxyecdysone on DNA synthesis of corpus allatum cells in the silkworm, Bombyx mori
Authors: Gu Shi‐Hong , Chow Yien‐Shing 
Published: May 2003

AbstractDNA synthesis in cells of the corpus allata (CA) of the silkworm, Bombyx mori, was studied immunocytochemically after in vivo labeling with 5‐bromo‐2'‐deoxyuridine (BrdU); developmental changes during the 3rd, 4th, and last larval instars and effects of 20‐hydroxyecdysone treatment were examined. During both the 3rd and 4th larval instars, the number of DNA‐synthesizing cells fluctuated, and relatively low levels were observed during the middle stages. On day 0 of the last larval instar, the number of DNA‐synthesizing cells per gland was 9.2, which then increased on day 1 and remained at levels ranging from 12.9 and 16.9 cells per gland. A major peak level (28 BrdU‐labeled cells per gland) occurred on day 8, two days after larvae entered the wandering stage. When last instar larvae were fed 20‐hydroxyecdysone‐supplemented mulberry leaves starting on day 0 or 1, the number of DNA‐synthesizing cells dramatically decreased to very low levels and these low levels were maintained throughout the remainder of the instar. However, no effect was observed when last instar larvae were fed 20‐hydroxyecdysone‐supplemented mulberry leaves starting on day 3, indicating the stage‐specific action of 20‐hydroxyecdysone. The mechanism by which 20‐hydroxyecdysone treatment inhibits DNA synthesis of CA cells was further examined by using continuous in vitro BrdU labeling for a 2‐day incubation. It was found that the decrease in responsiveness of DNA synthesis of CA cells of 20‐hydroxyecdysone‐treated larvae to stimu‐lation by growth factors from hemolymph may have been, at least in part, responsible for the indirect inhibitory effects of 20‐hydroxyecdysone. J. Exp. Zool. 297A:138–146, 2003. © 2003 Wiley‐Liss, Inc.
Presence of putative histidine‐rich proteins in the amphibian epidermis
Authors: Alibardi Lorenzo , Spisni Enzo , Toni Mattia 
Published: May 2003

AbstractIn amphibian epidermis mucus is thought to constitute the matrix material that links keratin filaments present in cells of the corneous layer. As contrast in mammals, and perhaps in all amniotes, histidine‐rich proteins form the matrix material. In order to address the study of matrix molecules in the epidermis of the first tetrapods, the amphibians, an autoradiographic and electrophoretic study has been done after administration of tritiated histidine. Histological analysis of amphibian epidermis shows that histidine is taken up in the upper intermediate and replacement layers beneath the corneous layer. Ultrastructural autoradiographic analysis reveals that electron‐dense interkeratin material is labeled after administration of tritiated histidine. Electrophoretic analysis of the epidermis shows labeled proteic bands at 58–61, 50–55, 40–45, and some only weakly labeled at 30 and 24–25 kDa at 4–48 hours after injection of tritiated histidine. Keratin markers show that bands at 40–61 kDa contain keratins. Most histidine is probably converted into other amino acids such as glutamate and glutamine that are incorporated into newly synthetized keratins. However, non‐keratin histidine‐incorporating proteins within the keratin range could also be formed. The bands at 30 and 24–25 kDa suggest that these putative histidine‐rich proteins are not keratins. In fact, their molecular weigh is below the range of that for keratins. In contrast with the mammalian condition, but resembling reports for lizard epidermis, putative histidine‐rich proteins in amphibians have no high molecular weight precursor. Although filaggrin is not detectable by immunofluorescence in sections of amphibian epidermis, protein extraction, electrophoresis and immunoblotting are more sensitive. In the epidermis of toad and frog, but only occasionally in that of newt, filaggrin cross‐reactive proteic bands are seen at 50–55, 40–45, and sometimes at 25 kDa. This suggests that after extraction and unmasking of reactive sites in the epidermis of more terrestrial amphians (anurans), some HRPs with filaggrin‐like cross‐reactivity are present. The overlap that exists at 50–55 kDa between filaggrin‐positive and AE2‐positive keratins, but not that at 40–45 kDa further indicate that non‐keratin, filaggrin‐like proteins may be present in anuran epidermis. The present study suggests for the first time that very small amounts of histidine‐rich proteins are produced among keratin filaments in upper intermediate, replacement and corneous layers of amphibian epidermis. Although the molecular composition of these proteins is unknown, precluding understanding of their relationship to those of mammals and reptiles, these cationic proteins might have originated in conjunction with the formation of a horny layer during the adaptation to land during the Carboniferous and were possibly refined later in the epidermis of amniotes. J. Exp. Zool. 297A:105–117, 2003. © 2003 Wiley‐Liss, Inc.
Molecular cloning of zebrafish (Danio rerio) MutS homolog 6(MSH6) and noncoordinate expression of MSH6 gene activity and G‐T mismatch binding proteins in zebrafish larvae
Authors: Yeh Fu‐lung , Yan Hwei‐ling , Wang Shi‐ya , Jung Ting‐yi , Hsu Todd 
Published: May 2003

AbstractEukaryotic MutS homolog 6(MSH6) is a DNA mismatch recognition protein associated with mismatch repair of simple base‐base mispairs and small insertion‐deletion loops. As replication or recombination errors generated during embryonic development of living organisms should be efficiently corrected to maintain the integrity of genetic materials, we attempted to study MSH6 gene expression in developing zebrafish (Danio rerio) and the influence of MSH6 expression on the production of mismatch binding factors. A full‐length cDNA encoding zebrafish MSH6 (zMSH6) was first obtained by rapid amplification of cDNA ends (RACE). The deduced amino acid sequence of zMSH6 shares 57% and 56% identity with human and mouse MSH6, respectively. The 190‐kDa recombinant zMSH6 containing 1,369 amino acids bound preferentially to a heteroduplex than to a homoduplex DNA. Northern blot and semiquantitative RT‐PCR analysis detected apparent levels of zMSH6 mRNA expression in 12 and 36‐hr‐old zebrafish embryos, while this expression in 84‐hr‐old larvae was dramatically reduced to 23% of that in 12‐hr‐old embryos when β‐actin mRNA was constitutively synthesized. Incubation of G‐T and G‐G heteroduplex probes with 12 to 60‐hr‐old zebrafish extracts produced predominantly high‐shifting binding complexes with very similar band intensity. Although low in zMSH6 mRNA production, the extracts of 84‐hr‐old larvae interacted significantly stronger than the embryonic extracts with both G‐T and G‐G mispairs, producing high and low‐shifting complexes. Heteroduplex‐recognition proteins in 108‐hr‐old larvae gave a similar pattern of mismatch binding. The intensities of G‐T complexes produced by 84 and 108‐hr‐old zebrafish extracts were 2.5 to 3‐fold higher than those of G‐G complexes. Our data indicate that the production of efficient MSH6‐independent binding factors, particularly G‐T‐specific recognition proteins, is upregulated in zebrafish at the larval stage when MSH6 gene activity is downregulated. J. Exp. Zool. 297A:118–129, 2003. © 2003 Wiley‐Liss, Inc.
Effects of ionomycin and thapsigargin on ion currents in oocytes of Bufo arenarum
Authors: Cavarra M. Soledad , Assef Yanina A. , Kotsias Basilio A. 
Published: May 2003

AbstractIn this study, two electrode voltage clamp technique was used to assess the ionic current of oocytes of the South American toad Bufo arenarum and to study the dependence of these currents on the extracellular and intracellular Ca2+ concentrations. Ca2+ chelators, ionomycin –a calcium ionophore‐ and thapsigargin, a blocker of the Ca2+ pump of the sarcoplasmic reticulum, were used. The main results were the following: Most oocytes showed a voltage activated rectifying conductance. Ionomycin (1μM) increased inward and outward currents in control solution. The effect of ionomycin was blocked partially at negative potentials and was blocked completely at positive potentials in absence of extracellular Ca2+. When the oocytes were treated with thapsigargin (2 μM) or BAPTA‐am, a membrane‐permeant intracellular chelator in control solution (10 μM), ionomycin did not increased either inward nor outward currents. The conclusion of our experiments is that there are two sources of Ca2+ for activation of the current induced by ionomycin, the cytoplasmic stores and the extracellular space. We believe ionomycin directly translocates Ca2+ from the SER into the cytoplasm but not from the extracellular medium. Ca2+ entry probably occurs through store‐operated‐Ca‐channels. J. Exp. Zool. 297A:130–137, 2003. © 2003 Wiley‐Liss, Inc.
Phenotypic plasticity of reproductive effort in a colonial ascidian, Botryllus schlosseri
Authors: Newlon Arthur W. , Yund Philip O. , Stewart‐Savage J. 
Published: May 2003

AbstractPhenotypic plasticity is the capability of a genotype to produce different phenotypes in different environments. Previous studies have indicated phenotypic variability in asexual, male, and female reproduction in Botryllus schlosseri, a hermaphroditic, colonial ascidian, but not explicitly tested for genotype by environment interactions that indicate genetic variation in plastic responses. Consequently, clones derived from an estuarine population were deployed at their native site and a warmer, higher productivity site 10km up‐river. Male reproduction was assayed by testis size, female reproduction by the number of eggs produced, and asexual reproduction by colony growth rate. To test for ontogenetic effects, data were collected from two different generations of zooids born in the field. Analyses of variance indicated plasticity in asexual and female reproduction during the first zooid generation and plasticity in all three traits during the third zooid generation. Reaction norms varied significantly among genotypes in direction and magnitude for asexual reproduction at both times, implying that selection on asexual reproduction is weak. Sperm production during the third zooid generation was significantly lower at the nonnative site, but there was no genotype by environment interaction. The reaction norms for female reproduction varied significantly among genotypes in direction and magnitude during the first zooid generation, but only varied in magnitude during the third generation, with egg production being higher in all genotypes at the nonnative site. Comparisons of weighted frequency distributions between sites demonstrated that differences in egg production in the third generation were due to increases in the proportion of reproductive zooids within a colony. The greater emphasis on female reproduction at a site associated with higher food availability and temperature, and the greater emphasis on male reproduction at a colder, food‐limited site, supports predictions from sex allocation theory. J. Exp. Zool. 297A:180–188, 2003. © 2003 Wiley‐Liss, Inc.