bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of surgically placed epidural catheters for analgesia after posterior spinal surgery
Authors: Turner A. , Lee J. , Mitchell R. , Berman J. , Edge G. , Fennelly M. 
Published: July 2002

SummaryPosterior spinal fusion for correction of scoliosis is a major procedure for which the provision of satisfactory, safe postoperative analgesia is often a problem. One possible solution involves the placement of epidural catheters under direct vision by the surgeon at the end of the procedure, followed by an epidural infusion of local anaesthetic with or without an opioid. Despite its simplicity, this technique has not been reported as being consistently successful. We report an observational study of the analgesia achieved with surgically placed epidural catheters and of the reasons for the failure of the technique. Fourteen consecutive patients undergoing posterior spinal fusion had epidural catheters placed by the surgeon and had radio‐opaque dye injected down the catheter 15 min before their routine postoperative chest X‐ray. Analgesia was assessed at 0, 6, 12 and 24 h after surgery using visual analogue scores. Five patients had inadequate pain control; none of these patients had dye visible in the epidural space. Seven patients had dye visible in the epidural space; all of these cases had satisfactory analgesia. In two cases, dye was observed in the paravertebral gutters; both of these patients had satisfactory postoperative analgesia. This small pilot study suggests that correctly placed ‘surgical’ epidural catheters are capable of providing good analgesia after posterior spinal fusion and that misplaced catheters, seen in a large proportion of patients, are associated with inadequate analgesia.
The responses of seven co‐occurring woodland herbaceous perennials to localized nutrient‐rich patches
Authors: Farley R. A. , Fitter A. H. 
Published: July 2002

Summary 1 Nutrient‐rich patches can occur in soils at a wide range of spatial and temporal scales. Differences in the root proliferation response between species may be due to differing abilities of root systems to locate and recognize patches of differing size and nutrient concentration. 2 We investigated the root proliferation responses of seven co‐occurring herbaceous perennial British woodland species (Ajuga reptans, Glechoma hederacea, Oxalis acetosella, Silene dioica, Stachys sylvatica, Veronica montana and Viola riviniana) and the effect of mycorrhizal colonization on any response. 3 Plants were planted in nutrient‐poor sand in the centre of rectangular pots, with a nutrient‐rich patch to one side and a control (sand) patch on the other. Size and nutrient concentration of the patches were varied between treatments. 4 Species differed in the size of their root systems and in their ability to respond to localized nutrient‐rich patches. Oxalis acetosella and Viola riviniana, which produced the smallest root systems, showed similar root growth in nutrient‐rich and control patches. All other species responded to the presence of a nutrient‐rich patch by various combinations of root proliferation, changes in root branching pattern and by an increase in specific root length. 5 In some species the response was affected by patch attributes: Silene dioica and Veronica montana were sensitive to the nutrient concentration of the patch, and Glechoma hederacea did not respond to the smallest sized patch. 6 Mycorrhizal colonization had little effect on root proliferation. Only one species (Oxalis acetosella) could be shown to benefit from colonization by increased phosphate uptake. 7 The soil is a heterogeneous environment in terms of nutrient availability; differences between species in the ability to exploit this heterogeneity may affect their distribution, and could be a mechanism that reduces interspecific root competition.
Dietetic helpers in the community: the Bolton Community Nutrition Assistants Project
Authors: Kennedy L. A. , Ubido J. , Elhassan S. , Price A. , Sephton J. 
Published: July 2002

Summary Study objective: To explore the role of ‘Community Nutrition Assistants’ (CNAs) in helping to increase coverage, by increasing access to local community dietetic services, and to bring about positive changes in the determinants of healthy eating, within low‐income areas of Bolton, UK. Study design: A descriptive evaluation of programme development and field‐testing (1995–97) in the community. Nonexperimental design. Setting: Community, less affluent neighbourhoods in Bolton, North West England. Subjects: 1272 people in total, individuals and members of community groups, recorded as CNA contacts during two discreet monitoring periods; an opportunistic or purposive sampling strategy was used; subjects were randomly selected for group interview (n=8) and telephone interviews (n=41) out of a traceable sample of contacts (n=94) over a randomly selected 1‐month collection period. Findings: Compared with professional‐only service, CNAs efforts resulted in a four‐fold increase in coverage of community nutrition services in the local community. CNAs demonstrated unique attributes, which positively influence their ability to work well with local people, but particularly those considered hard to reach. At least half the subjects interviewed reported positive behaviour changes such as changes to foods bought, cooking methods or foods eaten in the home. Conclusions: This study has shown some benefits in training local people to work alongside existing community dietitians. This may help to reduce inequalities in health, address barriers to healthy eating experienced by low‐income families and improve cost effectiveness. Before expansion continues on an ad hoc basis, further research is needed to test its application in general, to assess health outcomes and to quantify the value of using local people. The findings here are useful in guiding further developments.
Rapid Detection of European Heterobasidion annosum Intersterility Groups and Intergroup Gene Flow Using Taxon‐specific Competitive‐Priming PCR (TSCP‐PCR)
Authors: Schulze S. 
Published: July 2002

AbstractUsing taxon‐specific competitive‐priming polymerase chain reaction (TSCP‐PCR) the intersterility groups (ISGs) S and P of the root and butt rot pathogen Heterobasidion annosum were found in an active pine mortality center in the forest region Tharandter Wald (Saxonia, Germany). All isolates from spruce were typed as S, and all isolates from pine were P, except for two isolates which were identified as hybrid 'SP’genets. These results indicate the possibility of gene flow in nature between the two ISGs in Europe.
Secretory IgA epitopes in basal tears of extended‐wear soft contact lens wearers and in non‐lens wearers
Authors: Pearce D J , Demirci G , Willcox M D P 
Published: July 2002

Purpose: To determine secretory IgA epitopes in tears of extended‐wear soft contact lens wearers and non‐wearing controls. Methods: We developed enzyme‐linked immunosorbent assays (ELISA) to determine the tear concentrations of two epitopes of secretory IgA, the IgA alpha‐chain and the secretory component. These epitopes were measured in basal tears of 20 individuals in 6 nights of extended wear of etafilcon A soft contact lenses and in 19 non‐lens‐wearing individuals. Results: Levels of IgA alpha‐chain immunoreactivity were significantly decreased in the lens‐wearing group compared to non‐lens wearers. However, the level of secretory component immunoreactivity was not significantly different between groups. IgA alpha‐chain and secretory component immunoreactvity were highly correlated; however, some samples showed a marked variation between these two values. Conclusion: Tear concentrations of sIgA epitopes are significantly reduced in extended‐wear contact lens wearers, and may contribute to the increased susceptibility to ocular infection seen in this group.
Differential effects of probucol on two distinct experimental rat nephrosis models
Authors: Nakahama H , Obata K , Sugita M 
Published: July 2002

SummaryWe compared an antiproteinuric effect of a lipid‐lowering agent probucol on two distinct types of experimental nephrosis in rats, i.e. mercuric–chloride (HgCl2)‐induced autoimmune glomerulonephritis in Brown Norway (BN) rats and puromycin aminonucleoside (PA)‐nephrosis in Wistar rats. The rats were fed either standard rat chow or chow containing 5% probucol. BN rats were treated with HgCl2 according to a standard protocol (HgCl2 1 mg/kg subcutaneously three times/week). Probucol treatment did not ameliorate proteinuria, renal histology or a strong linear staining for IgG and an intercellular adhesion molecule, ICAM‐1, in glomeruli. Wistar rats were made nephrotic with an intraperitoneal injection of PA (100 mg/kg). In this model, in contrast to the BN rat model, no glomerular deposition of IgG or ICAM‐1 was observed. Probucol treatment ameliorated proteinuria significantly. These findings suggest that the response to probucol differs in different experimental nephrosis models. As probucol only affects PA‐nephrosis, in which ICAM‐1 expression is negative, the ICAM‐1 attenuation is not likely to be involved in the antiproteinuric effect of probucol.
The relevance of parity to ureteric dilatation
Authors: Bradley  , Desai  , Mamtora  
Published: July 2002

Objective To assess whether the mild dilatation of the right ureter in women that is sometimes seen on intravenous urography (IVU) represents persistent dilatation after a previous pregnancy.Patients and methods The intravenous urograms of 71 men, 63 parous and 27 nulliparous women were evaluated prospectively. The two groups of women were divided into those with and without a confirmed history of urinary tract infection (UTI) as the indication for IVU, producing five groups in all. Measurements were taken on both the 5‐min and the compressed or release films on each side.Results There were no significant differences in ureteric diameters among the five groups for the uncompressed right ureter (P=0.23), the left ureter uncompressed (P=0.32) or compressed (P=0.87). For the compressed right ureter, the difference was significant, with the diameters in the parous women with proven UTIs being larger than in the other groups (P=0. 043).Conclusion There is a significant increase in the diameter of the compressed right ureter in the group of parous women with a history of proven UTI. Infection or parity alone do not produce this effect; the combination of the two factors is required.
LIPID‐FREE VS. LIPID‐BOUND EXPERIMENTAL ALLERGIC NEURITIS IN THE LEWIS RAT
Authors: Cavaletti G. , Celon S. , Marmiroli P. , Matà S. , Fasano A. , Lolli F. , Riccio P. , Tredici G. 
Published: July 2002

The P2 protein of the peripheral nervous system myelin is a neuritogenic protein capable to induce experimental allergic neuritis (EAN) in the Lewis rat. It has been suggested that addition of some lipids to the protein isolated in the lipid‐free form might enhance its immunogenicity. Because lipid‐bound P2, copurified with all the myelin lipids, shows a conformation that is different from that of LF‐P2, this difference might, in fact, influence its immunogenicity.In this study, we have compared lipid‐free P2 (the “EAN factor”) with the corresponding lipid‐bound form of the protein for their ability to induce EAN after sc inoculation in the Lewis rat.The timing of disease and the clinical scores of lipid‐bound P2‐induced EAN animals (n = 23) did not differ statistically from those injected with lipid‐free P2 (n = 23), with only a tendency to higher clinical scores in the former group. Accordingly, tail nerve conduction velocities did not differ in the 2 groups and were in both significantly lower in comparison to Freund adjuvant controls (n = 8). Inflammation and demyelination predominated in spinal roots and were less evident in the sciatic nerve for both groups of animals. The ELISA determination of antibodies to lipid‐free and lipid‐bound P2 revealed the development of antibodies recognizing the lipid‐free form of the protein in both groups of animals.Our results are in contrast with previous studies performed after addition of individual lipids to the P2 purified in the lipid‐free form, and indicate that native‐like, lipid‐bound P2 is not significantly more immunogenic than lipid‐depleted P2.
AN INNOVATIVE HAND BRACE FOR TREATMENT OF CARPAL TUNNEL SYNDROME (CTS): RESULTS OF A CONTROLLED STUDY
Authors: Manente G. , Torrieri F. , Di Blasio F. , Uncini A. 
Published: July 2002

We recently noticed that squeezing the distal heads of metacarpal bones (excluding the first) and stretching the III and IV finger relieved paresthesias and pain in CTS (Manente et al. 1999). This manoeuvre was the rationale to design an innovative hand brace we called “MANU” (patented) and to design a trial to assess efficacy and tolerability.Forty patients with CTS symptoms and abnormal electrophysiological tests were instructed to wear MANU during the night for 1 month. Efficacy was assessed by the Levine scale the Subject's Global Impression of Change Questionnaire. Forty CTS patients served as control.In the MANU group, the Levine score was at the entry: 2.3 ± 0.6 and 1.5 ± 0.5 at the end of the study (p < 0.001). At 1 month 27 patients (67.5%) were free of symptoms or reported pronounced improvement, and 13 (32.5%) reported moderate or mild improvement. MANU was very well tolerated by all patients. In controls, Levine score was at entry 2.4 ± 0.6 and 2.3 ± 0.6 at the end (p = 0.6). At 1 month, 7 patients (17.5%) reported mild or moderate improvement (4 patients spontaneously, 3 after change or reduction of manual activities), 33 patients (82.5%) reported no change or worsened.This short‐term study shows that MANU is highly efficient in ameliorating CTS symptoms and well tolerated.
PATHOGENESIS OF CONGENITAL HYPOMYELINATION REVEALED BY P0 OVEREXPRESSING MICE
Authors: Previtali S. , Quattrini A. , Imperiale D. , Canal N. , Trapp B. , Messing A. , Feltri M.L. , Wrabetz L. 
Published: July 2002

Extra copies of the myelin protein zero (Mpz) gene cause dysmyelinating neuropathy in transgenic mice. Clinical and pathological findings are dose dependent, ranging from transient perinatal hypomyelination (30% mRNA overexpression), to arrested nerve development with impaired sorting of axons by Schwann cells (700% mRNA overexpression). Mpz overexpression promotes inappropriate trafficking of P0 protein to surface membranes of promyelinating Schwann cells. Ultrastructural immunocytochemistry demonstrates that mistargeting of P0 to the membranes of the advancing mesaxon (the lip of Schwann cell membrane that enwraps the axon) activates P0 homophilic adhesion, arresting spiral wrapping and myelination.Severely reduced nerve conduction velocities, paucity of active myelin destruction or onion bulbs, and redundant basement membrane formation in P0‐overexpressor mice resemble those present in human congenital hypomyelination (CHN). CHN is a subtype of demyelinating neuropathy due to MPZ mutation. Although increased MPZ has not yet been described in CHN, increased myelin gene dosage (PMP22 and PLP) can cause hereditary myelinopathy in both rodent and human (Charcot‐Marie‐Tooth IA and Pelitzaus Merzbacher disease). Of note, mutations in the Krox 20 transcription factor, encoded by EGR2, are also associated with CHN. Since one of these EGR2 mutations likely disinhibits Krox 20, and Krox 20 may regulate P0 expression, it is possible that MPZ overexpression contributes to the pathogenesis of this EGR2 mutation.
PERIPHERAL NEUROPATHIES AND CHRONIC HEPATITIS C
Authors: Primavera A. , Cocito L. , Reni L. , Caponnetto C. , Abbruzzese M. 
Published: July 2002

Objectives: Recent interest has been expressed in peripheral neuropathies in hepatitis C virus (HCV) patients. The aim of this prospective study was to evaluate the prevalence of peripheral neuropathies associated with chronic hepatitis and their clinical manifestations.Patients and method: Ninety anti‐HCV‐positive patients were consecutively interviewed and examined by the same operator. Forty‐five patients with end‐stage liver disease and awaiting liver transplantation were evaluated at the Liver Transplantation Center (Group 1). Further 45 patients were referred for neurological consultation during hospitalisation in the Department of Medicine (Group 2), where they had been admitted for different clinical reasons. One patient from group 1 and 5 patients from group 2 were excluded from the study because of previous neurological diseases. All patients underwent a standardized neurological evaluation, including history, neurological examination, mini mental state examination, neuropathy symptom score, and neurological disability score. In presence of symptoms and signs of peripheral neuropathy, an electrophysiological evaluation was performed.Results: Signs or history of encephalopathy were found in 23/44 patients of group 1 (52.2%) and in 8/40 patients of group 2 (20%). Clinical manifestations of neuropathy, confirmed by electrophysiological examination, were found in 11 subjects of group 1 (25%) and in 17 patients of group 2 (42.5%). Most patients had minor symptoms; sensory disturbances occurred more frequently than motor and autonomic dysfunctions. In group 1, peripheral neuropathy was associated with systemic illness (diabetes, renal failure, liver neoplasm, previous alcohol abuse) in 4/11 patients (36.3%); conversely, in all patients from group 2, other possible etiological factors were present: alcohol abuse in 3; diabetes in 4; renal failure in 1; mixed cryoglobulinemia in 7; and neoplasm in 2.Conclusions: Symptomatic but not disabling neuropathies were found in 33% of HCV in patients. Sensory involvement was prevalent. Systemic illness and mixed cryoglobulinemia were more frequently present in Group 2 than in Group 1. This finding suggests that the metabolic dysfunctions caused by liver disease may be the primary determinant of peripheral system damage only in patients with end‐stage liver disease.
EXPANDING THE NOSOLOGY OF HYPERMYELINATING NEUROPATHIES: DESCRIPTION OF TWO NEW ENTITIES
Authors: Quaranta L. , Sabatelli M. , Madia F. , Ricci E.  , Lippi G. , Conte A. , Gazzetta F. , Tonali P. 
Published: July 2002

We describe two patients affected by encephalo‐neuro‐myopathy with partial deficiency of merosin and one patient with familial spastic paraparesis and sensory neuropathy of uncertain nosology, whose sural nerve biopsy disclosed quite unusual hypermyelination features.Both patients with merosin deficiency showed mental retardation, epilepsy, myopathy and peripheral neuropathy. Brain MRI demonstrated diffuse white matter involvement and nerve conduction studies disclosed reduction of conduction velocities, consistent with a “demyelinating” neuropathy. However nerve biopsy failed to reveal segmental demyelination. The most striking feature, in both of them, was a peculiar hypermyelination, characterized by “globular” thickening of the myelin sheath only at the paranodal regions.The third patient was affected by spastic paraparesis since early infancy; a brother was affected by similar disease and both parents were normal. In view of the above, an autosomal recessive trasmission seems likely. MRI of the brain and spinal cord was normal. Electrophysiological examination disclosed a “demyelinating” motor and sensory neuropathy. Sural nerve biopsy disclosed a normal density of myelinated fibers. At teased fibers analysis we didn't find any focal hypermyelination nor segmental demyelination. On transverse sections several fibers showed a marked thickening of the myelin sheath.Abnormal myelin proliferation is a distinctive pathological feature in HNPP and CMT4B, two hereditary neuropathies in which sausage‐shaped thickenings of the myelin sheath (tomacula) and very irregular focal outfoldings, respectively, are always associated with segmental demyelination. Our patients showed morphological changes very different from these conditions. The two patients with partial merosin deficiency showed a focal, “globular” myelin overgrowth confined to paranodal regions, while the patient with spastic paraparesis disclosed a diffuse thickening of the myelin sheath. Furthermore, no demyelination neither hypomyelination were observed in our three patients. Based on these findings it may be inferred that hypermyelination may per se be responsible for the slowing of conduction velocities.
FUNCTIONAL EVALUATION OF PATIENTS AFFECTED WITH CHARCOT‐MARIE‐TOOTH DISEASE
Authors: Vinci P. , Perelli S.L. , Esposito C. , Villa L.M. 
Published: July 2002

Charcot‐Marie‐Tooth disease is a genetic neuropathy causing progressive muscle weakness and wasting and sensory reduction, starting from the distal regions of the limbs. Typical is the variability in clinical severity, which depends on the distoproximal extension of muscle weakening and its biomechanical consequences. Since the rehabilitative intervention varies according to the disease severity, we have previously suggested to grade patients in seven levels (or stages) as to the lower limbs and four levels as to the upper limbs (1). Patients are fitted in the classification on the basis of the results of a functional evaluation, which includes:The muscle testing is to be repeated after orthotic and physiotherapeutic treatment (2), since muscle strength can improve as the result of an increased mobility and a better muscle action line.The range‐of‐motion testing is also to be repeated to monitor the efficacy of the stretching program and, in children, to discover new joint alterations as soon as they appear.This methodology is recommended not only for rehabilitative purposes but also to monitor the natural evolution of the disease in an easy and objective way.