bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Bimatoprost and Travoprost: Effect on Intraocular Pressure and Ocular Circulation in Newly Diagnosed Glaucoma Patients
Authors: Alagöz Gürsoy , Gürel Kamil , Bayer Atilla , Serin Didem , Çelebi Serdal , Kükner Şahap
Published: February 2008

Background: This study compares intraocular pressure (IOP)-lowering efficacy and retrobulbar hemodynamic effects of bimatoprost and travoprost in patients with newly diagnosed open-angle glaucoma. Methods: Patients were randomly assigned to one of two treatment groups (bimatoprost group, n = 36; travoprost group, n = 46). IOP levels were measured with Goldmann applanation tonometer. Peak systolic velocity, end-diastolic velocity and resistivity index were obtained for each vessel by color Doppler imaging. Results: Both bimatoprost and travoprost significantly lowered IOP on days 30, 90 and 180 (p < 0.001). There was no significance between the 2 drugs on all follow-up visits. End-diastolic velocity of central retinal artery on day 180 was significantly higher than the value obtained at baseline in both groups. Conclusions: Patients were likely to achieve and maintain low target IOP with both drugs. Both drugs also resulted in improvement in the central retinal artery blood flow.
Correction of Epiblepharon of the Upper Eyelid by the Buried Suture Technique: Correlation with Morphological Features of the Upper Eyelid
Authors: Lew Helen , Yu Su-Byung , Yun Young-Soo , Lee Sang-Yeul
Published: February 2008

Aims: To investigate the correlation between morphological features of the upper eyelid and surgical results of the correction of epiblepharon by the buried suture technique. Methods: This retrospective study was conducted from March 2001 to June 2005. One hundred and one patients (202 eyes) with upper eyelid epiblepharon were enrolled in this study. Surgical amount, lid thickness and height of the tarsal plate were measured. Eighty-four cases with epiblepharon were corrected by full-thickness buried sutures with 6/0 Vicryl, and 118 cases with epiblepharon were corrected by full-thickness buried sutures with 6/0 Prolene. They were followed up for a minimum of 9 months. Results: The skin crease of the upper eyelid disappeared in 18 eyes of 9 patients (8.9%). Eight patients were free from lash-cornea touch, and 1 recurrent case underwent successful reoperation. Clinical factors such as sex, age, suture material, and amount of surgery did not have an effect on the rate of recurrence. However, the thickness of lateral eyelid and height of the tarsal plate significantly contributed to the recurrence of upper eyelid epiblepharon. Conclusion: Upper eyelid thickness and height of the tarsal plate are considered as valuable factors to predict the result of the correction of upper eyelid epiblepharon by the buried suture technique.
Comparison of Fibrin Sealant and Sutures for Conjunctival Autograft Fixation in Pterygium Surgery: One-Year Follow-Up
Authors: Jiang Jin , Yang Yinghang , Zhang Mei , Fu Xiaojin , Bao Xiaoyan , Yao Ke
Published: February 2008

Aims: To evaluate the efficacy and safety of fibrin sealant in conjunctival autograft fixation in pterygium surgery. Methods: Prospective, comparative, interventional case series. 40 eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and 8 female based on the pterygium area encroaching onto the cornea. In one group the conjunctival autograft was attached to the sclera with fibrin sealant and the other group with nylon 10–0 sutures. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 2, 6 and 12. The main outcome measures included operating time, postoperative symptoms, graft success, recurrence rate and complications. Results: The average operating time was significantly shorter (p < 0.001) in the fibrin sealant group and fewer postoperative symptom complaints were received as well. By the end of 1-year follow-up, the recurrence rate was 5% in the fibrin sealant group and 10% in the suture group (p = 1.000), and there was no statistically significant difference in complications (p > 0.05) between the two groups. Conclusions: It is safe and effective to use fibrin sealant for conjunctival autograft fixation. This method causes much fewer postoperative symptoms and shortens surgery time significantly, and the long-term results are also favorable.
Transpupillary Thermotherapy in Chinese Patients with Choroidal Neovascularization Secondary to Age-Related Macular Degeneration: Emphasis on the Influence of Power Setting
Authors: Kuo Hsi-Kung , Kao Min-Tse , Chen Yung-Jen , Chen Chih-Hsin , Wu Pei-Chang , Kao Min-Lun
Published: February 2008

Purpose: To perform a safety and efficacy study of transpupillary thermotherapy (TTT) in Chinese patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (ARMD). Methods: In a prospective study, patients with subfoveal or juxtafoveal CNV secondary to ARMD underwent TTT with fixed treatment and follow-up protocols. From August 2002 to December 2004, 26 patients (27 eyes) completed ≧6 months of follow-up and were included in this report. Results: Fourteen eyes (52%) had improved or stable visual acuity (loss of <3 lines) and 13 eyes (48%) had vision loss of ≧3 lines. The serial mean visual acuity initially decreased during follow-up, then stabilized by 6 months. In the subgroup of occult or minimally classic CNV (20 eyes), 13 eyes (65%) had improved or stable vision. The major complication of TTT included laser-related retinal pigment epithelium (RPE) atrophy in 10 eyes (37%). Six eyes had mild RPE atrophy, 4 eyes had severe RPE-choroid atrophy (macular burn). Analysis of possible risk factors for macular burn showed that 3 eyes had to have the power amplified due to nuclear sclerosis, and 1 pseudophakic eye had regular power. Conclusions: TTT in Chinese ARMD patients with occult or minimally classic CNV, according to our protocol, prevented severe vision loss in the majority of patients, but power amplification due to medium lens opacity induced RPE atrophy or burn in some patients.
Meta-Analysis of Chromovitrectomy with Indocyanine Green in Macular Hole Surgery
Authors: Rodrigues Eduardo B. , Meyer Carsten H.
Published: February 2008

Purpose: To report a meta-analysis of the literature comparing internal limiting membrane (ILM) peeling with and without indocyanine green (ICG) staining in macular hole (MH) treatment. Methods: A Pubmed search was conducted from January 1999 to June 2004. Manuscripts describing the anatomical and functional outcomes of vitrectomy plus ILM peeling with and without ICG application in MH surgery were reviewed. A statistical meta-analysis was performed including studies which defined anatomical outcomes as closure of the MH and disappearance of the fluid cuff and functional outcomes as improvement of 2 or more Snellen lines. A secondary outcome was to investigate the incidence of retinal pigment epithelium (RPE) alterations with and without ICG staining in MH surgery. Results: Results including all types of MHs in 837 eyes indicated the same anatomical success but worse functional outcomes in the group with ICG application (p = 0.0008; odds ratio = 0.587, 95% confidence interval = 0.427–0.808). A higher incidence of RPE alterations in the ICG injection group was observed. The incidence of RPE alterations was found to be 1.98%, whereas RPE changes were noted in 13.83% of 201 patients with ICG application (odds ratio = 7.998). Conclusion: This meta-analysis of previous reports comparing ILM peeling with and without intravitreal ICG application in the treatment of MHs demonstrated statistically worse functional outcomes when ICG was applied (p = 0.0008). A higher number of RPE alterations were observed in the ICG-stained group.
Visual Outcomes and Associated Risk Factors of Cataract Surgeries in Highly Myopic Taiwanese
Authors: Tsai Ching-Yao , Chang Ting-Jia , Kuo Li-Lin , Chou Pesus , Woung Lin-Chung
Published: February 2008

Aims: The purposes of this study were to describe the visual outcome of highly myopic eyes undergoing cataract surgery, to investigate associated risk factors for poor postoperative vision, and to assess postoperative complication frequency among the prevalent myopic Taiwanese population. Methods: We conducted a retrospective, noncomparative case series study at the Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taiwan. High myopia was defined as axial length of 26.0 mm. Main study outcomes were visual acuity for the initial 6-month postoperative period (including visual acuities and improvement of postoperative vision), and postoperative complications (including subsequent cataract formation and postoperative retinal detachment). Results: Fifty-two highly myopic eyes were registered between January 2002 and December 2004. Mean follow-up interval was 43.3 ± 20.2 weeks (range 25–103). Thirty-two eyes (61.5%) had good postoperative visual improvement (≧4 line Snellen chart). Thirty-seven eyes (71.2%) achieved good postoperative vision (20/40 or better). Fifteen eyes (28.8%) demonstrated poor postoperative vision. Pre-existing maculopathy was an independent risk factor for failure to achieve good postoperative vision (odds ratio, OR, 6.84, 95% confidence interval, CI: 1.12–41.8) and improvement (OR 16.1, 95% CI: 2.2–119.9). Diabetic history was considered another independent risk factor for poor postoperative vision (OR 15.6, 95% CI: 0.97–267.6). Six eyes (11.5%) developed subsequent posterior capsular opacification requiring Nd:YAG laser capsulotomy. Two eyes (3.8%) developed retinal detachment during follow-up. Conclusions: Most of highly myopic eyes achieved good visual improvement and good postoperative visual acuity after cataract surgery. Pre-existing maculopathy was an independent risk factor of postoperative visual improvement and status. It is crucial to examine retinal status prior to cataract surgery to prevent poor vision improvement, poor postoperative vision, or retinal complications.
Activation of Human T Cells Induces Upregulation of Cannabinoid Receptor Type 1 Transcription
Authors: Börner Christine , Höllt Volker , Kraus Jürgen
Published: February 2008

Objective: Effects of cannabinoids are mediated by CB1 and CB2 receptors. In addition to neuronal effects, cannabinoids are potent modulators of immune functions. In this report, we investigated whether the transcription of these receptors is regulated after activation of T lymphocytes. Methods: CB1- and CB2-specific mRNA of primary human peripheral blood T cells and cells of the human T cell line Jurkat was measured by quantitative real-time RT-PCR in response to CD3/28. Using the decoy oligonucleotide approach, transcription factors involved in the regulation were determined. A promoter analysis was performed using transient transfection of chloramphenicol acetyl transferase reporter gene constructs in Jurkat cells. Results: Activation of human T cells caused an induction of CB1 mRNA expression in primary human T cells (8-fold) and Jurkat cells (29-fold). In contrast, CB2 transcription was not regulated. The CD3/28-mediated upregulation of CB1 involves the transcription factors AP-1, NFĸB and NFAT. Furthermore, 2,490 bp of the CB1 promoter mediated inducibility in response to CD3/28. Conclusions: The upregulation of CB1 in activated T cells, together with the constitutive expression of CB2, enables cellular responses to cannabinoids mediated by both receptor subtypes. It may thus contribute to the understanding of the various modulatory effects of cannabinoids on activated T cells.
Stress and Prolactin Effects on Bone Marrow Myeloid Cells, Serum Chemokine and Serum Glucocorticoid Levels in Mice
Authors: Dugan Amy L. , Schwemberger Sandy , Noel Greg J. , Babcock George F. , Ogle Cora K. , Buckley Donna J. , Horseman Nelson D. , Gregerson Karen A.
Published: February 2008

Objective: Current evidence supports the conclusion that prolactin (PRL) is not an obligate immunoregulatory hormone and influences the immune system predominantly during stress conditions. In this study, we examined the impact of PRL on the psychogenic stress-induced responses of myeloid cells. Methods: Seven-week-old PRL+/– (normal) and PRL–/– (deficient) mice were exposed to a predator for 1 h/day on 3 consecutive days. Another group of PRL-deficient mice received either 1 pituitary graft (hyperprolactinemic) or sham surgery at 5 weeks of age, while PRL-normal mice only received sham surgery. Two weeks later, these mice were also subjected to predator exposure. One day after the last predator exposure session, all mice were killed and the bone marrow and blood harvested. Results: Significant differences in the myeloid cells between PRL-normal and PRL-deficient mice only occurred in stressed conditions. The median serum corticosterone levels were consistently higher in PRL-deficient mice. The implantation of a pituitary graft lowered the corticosterone levels to those observed in PRL-normal mice. The absolute number of immature neutrophils as well as the numbers of granulocyte macrophage, monocyte/macrophage and granulocyte colonies were significantly higher in the stressed PRL-deficient mice; however, only the increased number of immature neutrophils was reversed by pituitary grafting. Conclusions: Our findings support previous observations that PRL influences myeloid cells of the bone marrow most profoundly in stressed conditions. However, the mechanism by which PRL influences bone marrow myeloid cells during stress cannot be explained solely by its effect on serum corticosterone.
Urinary IL-18 and NGAL as Early Predictive Biomarkers in Contrast-Induced Nephropathy after Coronary Angiography
Authors: Ling Wang , Zhaohui Ni , Ben He , Leyi Gu , Jianping Liu , Huili Dai , Jiaqi Qian
Published: February 2008

Background/Aims: Contrast-induced nephropathy (CIN) is at present the third leading cause of hospital-acquired acute kidney injury (AKI). Traditionally, it is diagnosed by measuring the increase of the serum creatinine concentration. However, in patients with acute changes in their glomerular filtration rate, serum creatinine is an insensitive marker. This clinical study was designed to investigate whether human urinary interleukin-18 (IL-18) and neutrophil gelatinase-associated lipocalin (NGAL) are early predictive markers for AKI after coronary angiography and their correlation with later cardiac events. Methods: Patients undergoing coronary angiography using low-osmolar contrast medium were enrolled and then followed up for at least 17 months. Urine samples were collected before and 24 h after coronary angiography and IL-18 and NGAL levels measured by using an ELISA kit. Results: CIN was diagnosed in 13 of 150 (8.7%) patients (CIN group); 27 patients without CIN served as control group. At 24 h after the procedure, the urinary IL-18 and NGAL levels were significantly increased in the CIN group, but not in the control group (p < 0.05). The predictable time of AKI onset determined by IL-18 was 24 h earlier than determined by serum creatinine (p < 0.01). Receiver operating characteristic curve analysis showed that both IL-18 and NGAL showed a good performance in early diagnosis of CIN as compared with serum creatinine (p < 0.05). We also found that IL-18 is an independent predictive marker for later major cardiac events: relative risk = 2.09 (p < 0.01). Conclusions: We conclude that urinary IL-18 or NGAL could be early biomarkers of CIN and that urinary IL-18 is well associated with the later cardiac outcomes in patients after coronary angiography.
Novel SLC12A3 Mutations in Chinese Patients with Gitelman’s Syndrome
Authors: Shao Leping , Ren Hong , Wang Weiming , Zhang Wen , Feng Xiaopei , Li Xiao , Chen Nan
Published: February 2008

Background: Inactivating mutations of the SLC12A3 gene are the most common cause of Gitelman’s syndrome (GS), a disorder inherited as an autosomal recessive trait. In a minority of cases, GS-like phenotypes are caused by mutations in the CLCNKB gene. Methods: We searched for SLC12A3 and CLCNKB gene mutations in 13 Chinese patients (9 males and 4 females, age 35 ± 14 years) from 8 unrelated families with the clinical and biochemical features of GS. All coding regions, including intron-exon boundaries, were analyzed using PCR followed by direct sequence analysis. Results: We identified 10 mutations distributed throughout the SLC12A3 gene. Seven are novel variants, including 4 missense mutations (Gly196Val, Cys430Gly, Gly439Val and Leu571Pro), 2 deletions (1384delG and 346–353delACTGATGG) and 1 in-frame insertion (997insCys). Three mutations were recurrent, including 2 missense mutations (Thr60Met and Asp486Asn) and 1 deletion (2883–2884delAG). The homozygous or heterozygous mutation Thr60Met was found in 8 of 13 patients. There were no mutations detected in the CLCNKB gene. Conclusions: Thr60Met may be the most common mutation in Chinese patients with GS. Possible specific genotype-phenotype correlations were difficult to identify.
Inhibitory Effect of a Potent and Selective Cytosolic Phospholipase A2α Inhibitor RSC-3388 on Skin Inflammation in Mice
Authors: Yamamoto Mina , Haruna Takayo , Imura Kinichi , Hikita Ichiro , Furue Yoko , Higashino Kenichi , Gahara Yoshinari , Deguchi Masashi , Yasui Kiyoshi , Arimura Akinori
Published: February 2008

Cytosolic phospholipase A2α (cPLA2α) preferentially hydrolyzes membrane phospholipids containing arachidonic acid, resulting in the biosynthesis of eicosanoids such as prostaglandins and leukotrienes. To examine the contribution of cPLA2α to skin inflammation, we evaluated the effect of (E)-N-[(2S,4R)-4-[N-(biphenyl-2-ylmethyl)-N-2-methylpropylamino]-1-[2-(2,4-difluorobenzoyl)benzoyl]pyrrolidin- 2-yl]methyl-3-[4-(2,4-dioxothiazolidin-5-ylidenemethyl) phenyl]acrylamide (RSC-3388), a potent and selective cPLA2α inhibitor, on 2,4,6-trinitro-1-chlorobenzene (TNCB)-induced ear inflammation and mite antigen-induced dermatitis in mice. Topical application of RSC-3388 showed a significant inhibitory activity against TNCB-induced ear swelling and eicosanoid production in mice. Comprehensive expression analysis using Gene-Chip technology and subsequent experiments concerning mRNA and protein expression demonstrated that RSC-3388 clearly reduced the levels of interleukin-1β, macrophage inflammatory protein-1α (MIP-1α) and MIP-1β in a TNCB-induced mouse model. In addition, RSC-3388 ointment significantly alleviated atopic dermatitis-like skin lesions induced by repeated application of mite antigen. Furthermore, increased expression of cPLA2α, assessed by anti-phospho-cPLA2α antibody, was observed in the skin lesions of mite-antigen-induced dermatitis. These results indicate that cPLA2α is involved in the development of skin inflammation in mice, and RSC-3388 is expected to be useful for the treatment of inflammatory skin disorders such as atopic dermatitis.
Increased Circulating Inflammatory Proteins Predict a Worse Prognosis with Valvular Calcification in End-Stage Renal Disease: A Prospective Cohort Study
Authors: Wang Angela Yee-Moon , Lam Christopher Wai-Kei , Wang Mei , Chan Iris Hiu-Shuen , Yu Cheuk-Man , Lui Sui-Fai , Sanderson John E.
Published: February 2008

Background: It remains unknown whether inflammation may predict a worse prognosis with valvular calcification (VC) in end-stage renal disease (ESRD) patients. Method: We prospectively performed echocardiography in 231 ESRD patients receiving chronic peritoneal dialysis treatment to detect VC and then followed them for 3 years or until death. Results: Patients with VC had higher C-reactive protein (CRP; p = 0.001), higher interleukin-6 (IL-6; p = 0.002) and lower fetuin-A (p = 0.004). Stratifying patients into 4 groups on the basis of VC, CRP, IL-6 and fetuin-A, respectively, those with VC and CRP in the upper tertile had 3.68-fold (95% confidence intervals [CI], 1.72–7.88; p = 0.001) and 3.13-fold (95% CI, 1.57–6.24; p = 0.001) respective increases in the adjusted risk of mortality and major adverse cardiovascular event (MACE) than those with no VC and CRP in the lower/middle tertiles. The adjusted hazard ratios (HR) in relation to mortality and MACE were 3.56 (95% CI, 1.53–8.26; p = 0.003) and 2.51 (95% CI, 1.24–5.11; p = 0.011), respectively, for patients with VC and IL-6 in the upper tertile compared to those with no VC and IL-6 in the lower/middle tertiles. The adjusted HR in relation to mortality and MACE were 3.56 (95% CI, 1.53–8.26; p = 0.003) and 2.51 (95% CI, 1.24–5.11; p = 0.011), respectively, for patients with VC and fetuin-A in the lower tertile compared to those with no VC and fetuin-A in the middle/upper tertiles. Conclusions: Increased circulating inflammatory proteins predict a worse prognosis of VC in chronic peritoneal dialysis patients.
Stoma-Related Complications in Inflammatory Bowel Disease
Authors: Takahashi Ken-ichi , Funayama Yuji , Fukushima Kouhei , Shibata Chikashi , Ogawa Hitoshi , Kumagai Eiko , Sasaki Iwao
Published: February 2008

Background: This study was designed to evaluate the incidence and details of stoma-related complications in patients with ulcerative colitis and Crohn’s disease who underwent permanent enterostomas, and to analyze the specific problems in these diseases. Methods: Permanent enterostomas constructed for ulcerative colitis and Crohn’s disease between 1984 and 2004 in our institution were included. The incidence and details of stoma-related complications were investigated retrospectively. The cumulative probability of complications and stoma reconstruction was also estimated by the Kaplan-Meier life-table analysis. Results: 43 patients with ulcerative colitis and 59 patients with Crohn’s disease underwent 46 and 76 stoma constructions, respectively. Stoma-related complications, including fistula, retraction and stenosis, were significantly more frequent in patients with Crohn’s disease (36.8%) than ulcerative colitis (17.4%) (p < 0.05). The cumulative risk of complications and the necessity for stoma reconstruction was significantly higher in patients with Crohn’s disease (p < 0.05). Among the patients with Crohn’s disease, colostomies were likely to receive revisional surgery earlier than ileostomies (p < 0.05). Conclusion: In the surgical therapy of inflammatory bowel disease, special attention should be paid in the high incidence of stoma-related complications in patients with Crohn’s disease, which needs revisional surgery more frequently.
Synchronous Esophageal and Renal Cell Carcinoma: Incidence and Possible Treatment Strategies
Authors: de Hingh I.H.J.T. , van Berge Henegouwen M.I. , Laguna Pes M.P. , Busch O.R.C. , van Lanschot J.J.B.
Published: February 2008

Background: The occurrence of synchronous malignancies in patients suffering from esophageal cancer is a frequent phenomenon, but the reported incidence of synchronous renal cell carcinoma (RCC) is very low. The present study investigated the incidence of synchronously detected RCC since the introduction of preoperative CT scans in a tertiary referral center for esophageal cancer patients. Methods: The medical records of 392 consecutive patients included in a prospective database of patients scheduled to undergo surgery for esophageal tumors were scrutinized for the presence of renal neoplasms. The coincidence of esophageal cancer and RCC was then estimated by analyzing only those patients who were operated on for an esophageal malignancy after a CT scan was obtained. Results: 192 patients were operated on for an esophageal malignancy after abdominal CT scanning was performed. RCC was diagnosed in 4 of these patients resulting in an incidence of synchronous esophageal and renal malignancies of 2.1%. Conclusion: Since the introduction of CT scanning the incidence of synchronous RCC in esophageal cancer patients appears to be much higher than previously reported and suggests a genetic and/or environmental association between these malignancies. Simultaneous treatment of both tumors appeared safe at our institute.
Outcome of Distal Pancreatectomy for Pancreatic Adenocarcinoma
Authors: Goh Brian K.P. , Tan Yu-Meng , Cheow Peng-Chung , Chung Yaw-Fui Alexander , Chow Pierce K.H. , Wong Wai-Keong , Ooi London L.P.J.
Published: February 2008

Objectives: To determine the outcome of patients undergoing distal pancreatectomy for pancreatic adenocarcinoma. Methods: A retrospective review of 39 patients undergoing distal pancreatectomy for adenocarcinoma. Results: Thirty patients underwent surgery for ductal adenocarcinoma, 5 for malignant intraductal papillary mucinous neoplasm and 4 for mucinous cystadenocarcinoma. Malignant cystic neoplasms were significantly less likely to demonstrate perineural invasion, more likely to be well-differentiated, of lower T stage and of lower AJCC staging compared to ductal adenocarcinoma. These had a longer median disease-specific survival (42 (3–144) vs. 15 (14–16) months, p = 0.002). Eight patients underwent extended resections. These were associated with longer operating times compared to standard resections but there was no difference in surgical morbidity or mortality, blood transfusions, length of hospitalization or long-term survival. Univariate analysis demonstrated that R2 resection, size >30 mm, lymph node involvement, need for perioperative blood transfusion, serum albumin <40 g/l and platelet count <200/µl were predictors of survival for ductal adenocarcinoma. Conclusions: Malignant cystic neoplasms have less aggressive behavior and more favorable outcome compared to ductal adenocarcinoma. R2 resection, larger tumor size, lymph node involvement, perioperative transfusion, decreased serum albumin and low platelet count are factors associated with decreased survival in patients with ductal adenocarcinoma undergoing distal pancreatectomy.
A Systematic Review of the Efficacy of Gum Chewing for the Amelioration of Postoperative Ileus
Authors: de Castro S.M.M. , van den Esschert J.W. , van Heek N.T. , Dalhuisen S. , Koelemay M.J.W. , Busch O.R.C. , Gouma D.J.
Published: February 2008

Background: Recent trials have shown promising results for the efficacy of gum chewing for the amelioration of postoperative ileus. This finding could have a major clinical impact since gum chewing is relatively harmless and cheap while postoperative ileus has a significant impact on healthcare. Methods: Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of gum chewing after colorectal surgery to a standard control for the amelioration of postoperative ileus, expressed as time to flatus, time to defecation and overall hospital stay. Results: Five randomized controlled trials with a total number of 158 patients were found. The studies were homogeneous and a meta-analysis was performed. The pooled weighted mean difference (WMD) of time to flatus was significantly shorter for the gum-chewing group (20 h with a 95% confidence interval (CI) of 13–27). The pooled WMD of time to defecation was significantly shorter (29 h, 95% CI of 19–39). There was a non-significant trend towards a shorter postoperative hospital stay (1.3 days shorter, 95% CI of 3.2 days shorter to 0.6 days longer). Conclusion: This meta-analysis shows a favorable effect of gum chewing on time to flatus and defecation but no significant effect on the hospital stay.
Direct Assessment of Thymic Reactivation after Autologous Stem Cell Transplantation
Authors: Thiel Andreas , Alexander Tobias , Schmidt Christian A. , Przybylski Gregorsz K. , Kimmig Sonja , Kohler Siegfried , Radtke Hartmut , Gromnica-Ihle Erika , Massenkeil Gero , Radbruch Andreas , Arnold Renate , Hiepe Falk
Published: February 2008

Methods to quantify Th cell reconstitution after immunosuppressive therapies such as hematopoietic stem cell transplantation are becoming a key issue since persistent Th cell deficiencies may result in severe complications and adverse events. We employed here cytometric monitoring of CD31+ thymus-naive Th cells for the direct assessment of human thymic function in 10 patients undergoing autologous stem cell transplantation for severe autoimmune diseases. High frequencies of posttransplant recurring naive Th cells coexpressed CD31 and stable long-term reconstitution with elevated absolute counts of CD31+ thymus-naive Th cells that were enriched with T cell receptor excision circles was demonstrated. Cytometric monitoring of CD31+ thymus-naive Th cells enables to directly evaluate human thymic function ex vivo.
Survival of Allogeneic Hepatocytes Transplanted into the Thymus
Authors: Mula Nieves , Cubero Francisco J. , Codesal Javier , de Andrés Socorro , Escudero Cristina , García-Barrutia Socorro , Millán Isabel , Arahuetes Rosa M. , Maganto Paloma
Published: February 2008

Background/Aim: Currently, when cell therapy is being considered instead of liver transplantation to treat terminal liver diseases, complete knowledge of the evolution and behavior of ectopically transplanted hepatocytes is a subject of utmost interest in the design of clinical trials. Hepatocytes survive in ectopic locations and have a therapeutic effect in different experimental models. Although it offers remarkable advantages over liver transplantation, hepatocyte transplantation presents several problems, among them the number of cells that can be injected at once and their rejection. Our main objective was to study the survival and functionality of hepatocytes transplanted into the thymus and, secondarily, to test whether the intrathymic transplant could induce any tolerogenic effect. Methods: Hepatocytes from F344 rats were transplanted into thymuses of Gunn rats, half of which received a unique dose of cyclosporine A. The recipients were sacrificed at different times. Light microscopy was performed and bilirubin levels were determined in serum and bile. Results/Conclusions: Transplanted hepatocytes survive for at least 6 weeks in the thymus of allogeneic animals without immunosuppressive therapy. The work provides interesting data about the behavior of hepatocytes injected into this unique ectopic site and shows that the thymus can be used as a recipient organ for cell therapy.
Mental Ability in Childhood and Cognitive Aging
Authors: Gow Alan J. , Johnson Wendy , Pattie Alison , Whiteman Martha C. , Starr John , Deary Ian J.
Published: February 2008

Background: Identifying the determinants of cognitive aging is a research priority; however, few studies are able to examine the influence of pre-morbid cognitive ability on later changes in cognitive function. Objective: To examine the association between childhood cognitive ability and cognitive change from age 79 to 83 in the presence of other demographic and lifestyle indicators. Methods: The participants took a test of mental ability when aged 11 as part of the Scottish Mental Survey 1932. Cognitive ability based on Raven’s Matrices, Verbal Fluency, and Logical Memory was assessed at ages 79 and 83. We used both linear regression and latent variable growth curve modeling to compare methods and results. Results: Using linear regression, childhood mental ability was a significant predictor of cognitive change from 79 to 83, accounting for about 1.4% of the variance. Sex, education, social class, smoking status and alcohol intake were non-significant. In contrast, using latent variable growth curve modeling, there was no association between childhood mental ability and cognitive change. Sex (male), years of education, drinking status (positive), and childhood IQ were associated with better cognitive ability at age 79. The difference in results was due to the inability of linear regression to account completely for test-specific variance. Conclusion: Within a group of non-demented older people, greater childhood mental ability was associated with level of cognitive ability at age 79, but not with change in cognitive ability to age 83. To obtain accurate results regarding covariates of change, it is important to use methodology that can appropriately allocate all measured sources of variance.
Electromyographic Activity of the Mandible Muscles at the Beginning and End of Masticatory Cycles in Patients with Complete Dentures
Authors: Goiato Marcelo Coelho , Garcia Alício Rosalino , dos Santos Daniela Micheline
Published: February 2008

The aim of this study was to assess the electrical activity of the masseter and anterior temporal muscles in subjects with severe bone resorption at two different times: (a) the initial period, with the complete dentures they had worn for over 10 years, and (b) the final period, 5 months after having new dentures put into place. Twelve asymptomatic subjects were asked to respond to the questionnaire, according to the research diagnostic criteria for temporomandibular disorders, before denture rehabilitation and 5 months after the new dentures were put in place. The electrical activity of the muscles was recorded during mastication in the initial and final period, using artificial food (Optocal). The operator monitored the 35 chewing cycles that were repeated to grind the artificial food. After wearing the new dentures for 5 months, the right anterior temporal muscle showed a statistical difference before and after denture rehabilitation at the beginning and end of mastication. Muscular capacity and ability reduced the electrical activity in the masseter muscles after rehabilitation.
Baseline in vitro Activity of Tigecycline among Key Bacterial Pathogens Exhibiting Multidrug Resistance
Authors: Draghi Deborah C. , Tench Stacy , Dowzicky Michael J. , Sahm Daniel F.
Published: February 2008

Tigecycline is the first clinically available semisynthetic glycylcycline approved for clinical use. This study was done to establish a baseline for ongoing surveillance of tigecycline’s activity as this agent’s clinical use increases. Against 1,796 Staphylococcus aureus (559 multidrug resistant), tigecycline had the lowest minimal inhibitory concentration (MIC90; 0.12 µg/ml) among all agents tested and 99.8% of the isolates were susceptible. For Acinetobacter spp., tigecycline again demonstrated the lowest MIC90 (2 µg/ml) and the highest percent susceptibility (96.9%). Among Enterobacteriaceae, the 2 most active agents were tigecycline (MIC90 = 1 µg/ml; 99% susceptible) and imipenem (MIC90 = 1 µg/ml; 99.5% susceptible). Tigecycline also demonstrated high activity against Streptococcus pneumoniae, Streptococcus pyogenes,Haemophilus influenzae and Enterococcus spp. In summary, tigecycline currently exhibits potent activity against a broad array of bacteria species. Given the dynamics of resistance development, careful monitoring of tigecycline activity against these organisms should remain a significant aspect of ongoing surveillance.
Efficacy and Safety of Percutaneous Transhepatic Portal Embolization before Right Liver Resection Using an Ethibloc/Lipiodol Mixture: A Single-Center Experience
Authors: Radeleff B. , Schawo S. , Hoffmann K. , Schemmer P. , Noeldge G. , Kauffmann G.W. , Froehlich B. , Richter G.M.
Published: February 2008

Aim: The purpose of this study was to evaluate the safety and efficacy of percutaneous transhepatic portal vein embolization of the right portal vein with an Ethibloc/Lipiodol mixture to induce hypertrophy of the left liver lobe in patients with primarily unresectable liver tumor. Methods: 15 patients (8 primary liver tumors, 7 liver metastases) underwent portal vein embolization. Liver volumetry, duration of hospitalization, complication rates, relevant laboratory values were documented. Results: In 13/15 patients (84.6%) embolization could be performed with a median of 8.8 ml (range 1.5–28 ml) Ethibloc/Lipiodol. One minor procedure-related complication (subcapsular hematoma) occurred, which did not affect the two-step liver resection. No patient developed acute liver failure after embolization or liver resection. The volume of the left liver lobe increased significantly (p = 0.0015) by 25% from a median of 750 ml (587–1,114 ml) to 967 ml (597–1,249 ml). 11/13 (81.8%) of the embolized patients underwent liver resection at a median of 49 days after embolization. Median hospitalization time was 4 days after embolization and 7 days after liver resection. Median overall survival of the 11 operated patients was 376 days. Conclusion: Percutaneous transhepatic portal vein embolization using an Ethibloc/Lipiodol mixture is a safe, feasible, and efficient interventional procedure.
Clinical Studies with Oxiracetam in Patients with Dementia of Alzheimer Type and Multi-lnfarct Dementia of Mild to Moderate Degree
Authors: Villardita C. , Grioli S. , Lomeo C. , Cattaneo C. , Parini J.
Published: February 2008

The cognitive and behavioral effects and the safety of oxiracetam therapy during a placebo-controlled trial and the relevant follow-up up to 1 year in patients with senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID) of mild to moderate degree were studied. Sixty male and female outpatients participated in the double-blind, placebo-controlled, parallel-group, randomized trial, comparing the effects of oxiracetam 800 mg b.i.d. and placebo during 90 days of treatment. At the end of therapy, statistical analysis evidenced significant improvements in the group receiving oxiracetam in respect to the placebo group on Mini Mental State Examination, Auditory Continuous Performance Test, Rey’s 15 Words Test, Block Tapping Test, Mattis Word Fluency, Luria Alternating Series and Instrumental Activities of Daily Living. Afterwards, 29 of the 30 patients who received oxiracetam, participated in the open follow-up study, receiving 800 mg b.i.d. oxiracetam for a total standard period of 1 year. Statistical improvements in comparison to baseline were again found on the same tests of the first 90 days (except for Rey’s 15 Words Test) and on the Memory item of the Inventory of Psychic and Somatic Complaints Elderly. During the late phase of the follow-up, statistically significant worsenings in comparison to baseline were observed on Digit Span Backward, Gibson’s Spiral and some non-memory items of IPSC-E. Neither severe adverse events were observed during the whole study, nor changes in routine laboratory examinations. In conclusion, in the present population of patients with mild to moderate degree dementia, the safety of 1,600 mg/day of oxiracetam also up to 1 year of treatment was confirmed. Clinical efficacy was also confirmed, although some improvements seen after the first months were not completely maintained after 12 months.
Tissue Factor in Patients With Acute Coronary Syndromes
Authors: Brambilla Marta , Camera Marina , Colnago Deborah , Marenzi Giancarlo , De Metrio Monica , Giesen Peter L. , Balduini Alessandra , Veglia Fabrizio , Gertow Karl , Biglioli Paolo , Tremoli Elena
Published: February 2008

Objective—

Activated platelets and circulating platelet-leukocyte aggregates (PLA) are significantly higher in patients with unstable angina than in those with stable angina (SA). Platelets from healthy subjects express TF on activation. The aim of this study was to investigate the expression of TF in PLA, in platelets, and in monocytes of acute coronary syndrome (ACS) patients compared to SA patients and healthy subjects (Controls).

Methods and Results—

We enrolled 26 consecutive patients with ACS, 29 patients with SA, and 25 Controls. A significantly greater number of total and TF positive platelet-monocyte aggregates was found by flow cytometry in blood of ACS patients than in either SA patients (3-fold) or Controls (5-fold). ACS patients also had a significantly higher amount of TF-positive platelets than SA or Controls (>3-fold) and significantly higher thrombin generation capacity. TF mRNA expression in platelets was significantly higher in ACS patients than in SA or Controls.

Conclusions—

In ACS patients the greater expression of TF in platelets and PLA strengthens the link between platelet activation, blood coagulation, and thrombus formation and may further contribute to the hypercoagulability associated with the disease.
Induction of CXCR2 Receptor by Peroxisome Proliferator-Activated Receptor γ in Human Macrophages
Authors: Rigamonti Elena , Fontaine Coralie , Lefebvre Bruno , Duhem Christian , Lefebvre Philippe , Marx Nikolaus , Staels Bart , Chinetti-Gbaguidi Giulia
Published: February 2008

Objective—

Macrophages play a central role in the immune response against infectious organisms. Once activated, macrophages secrete proinflammatory cytokines and chemokines. Interleukin (IL)-8 and related CXC chemokines play a role in the recruitment and activation of phagocytes acting through CXCR1 and CXCR2 receptors. The nuclear receptor peroxisome proliferator-activated receptor (PPAR) γ exerts antiinflammatory properties in macrophages, by inhibiting cytokine and CC chemokine production. In this study, we investigated whether PPAR-γ also plays a role in the regulation of the CXC chemokine pathway.

Methods and Results—

Synthetic PPAR-γ ligands increase CXCR2 but not CXCR1 gene expression in a PPAR-γ-dependent manner in primary human macrophages in vitro and in atherosclerotic plaques in vivo. The increase of CXCR2 mRNA was paralleled by an increase in membrane protein expression. EMSA, ChIP, and transient transfection assays indicate that PPAR-γ activates the CXCR2 promoter by binding to a PPAR response element (PPRE). Finally, human macrophages acquire responsiveness to the CXCR2 ligands (IL-8 and Groβ), as measured by superoxide anion production, after induction of CXCR2 expression by PPAR-γ ligands.

Conclusions—

Our results provide a novel mechanism via which PPAR-γ can enhance the immune response in human macrophages.
Mechanisms of Venous Thrombosis and Resolution
Authors: Wakefield Thomas W. , Myers Daniel D. , Henke Peter K.
Published: February 2008

Venous thromboembolism is a significant health care problem in the US. In this review, the unique role of inflammation to the venous thrombotic process is emphasized as well as the potential role of abnormalities of fibrinolytic mechanisms to the thrombotic process. Inflammation influences not only thrombogenesis but also thrombus resolution and vein wall remodeling, and these interactions are also discussed. Knowledge of molecular and immunologic mechanisms for venous thrombosis and its resolution should allow for the future development of targeted therapies.
Gas6–Axl Receptor Signaling Is Regulated by Glucose in Vascular Smooth Muscle Cells
Authors: Cavet Megan E. , Smolock Elaine M. , Ozturk Oktay H. , World Cameron , Pang Jinjiang , Konishi Atsushi , Berk Bradford C.
Published: February 2008

Objective—

The receptor tyrosine kinase Axl and its ligand Gas6 are involved in the development of renal diabetic disease. In vascular smooth muscle cells (VSMCs) Axl is activated by reactive oxygen species and stimulates migration and cell survival, suggesting a role for Axl in the vascular complications of diabetes.

Methods and Results—

We investigated the effect of varying glucose concentration on Axl signaling in VSMCs. Glucose exerted powerful effects on Gas6-Axl signaling with greater activation of Akt and mTOR in low glucose, and greater activation of ERK1/2 in high glucose. Plasma membrane distribution and tyrosine phosphorylation of Axl were not affected by glucose. However, coimmunoprecipitation studies demonstrated that glucose changed the interaction of Axl with its binding partners. Specifically, binding of Axl to the p85 subunit of PI3-kinase was increased in low glucose, whereas binding to SHP-2 was increased in high glucose. Furthermore, Gas6-Axl induced migration was increased in high glucose, whereas Gas6-Axl mediated inhibition of apoptosis was greater in low glucose.

Conclusion—

This study demonstrates a role for glucose in altering Axl signaling through coupling to binding partners and suggests a mechanism by which Axl contributes to VSMC dysfunction in diabetes.
Solid Cerebral Microemboli and Cerebrovascular Symptoms in Patients With Prosthetic Heart Valves
Authors: Skjelland Mona , Michelsen Annika , Brosstad Frank , Svennevig Jan L. , Brucher Rainer , Russell David
Published: February 2008

Background and Purpose—

Although cerebral microemboli are often detected by transcranial Doppler ultrasonography in mechanical heart valve patients, the clinical significance of such microemboli is unclear. The aim of this study was to determine the frequency and composition of cerebral microemboli in a prosthetic heart valve population and to correlate these findings to cerebrovascular symptoms, blood inflammation, and coagulation parameters.

Methods—

Seventy-six consecutive patients with a total of 81 prosthetic (54 mechanical, 27 biologic) heart valves were monitored for cerebral microemboli by multifrequency transcranial Doppler ultrasonography 1 year after valve replacement. Cerebrovascular events in the first year were recorded by a neurologist. Inflammation and coagulation markers were measured by immunoassays.

Results—

Microemboli were detected in mechanical heart valve patients only (28 patients, 56%). Twelve percent were solid, occurring in 17 (34%) of the mechanical heart valve population. The presence of solid cerebral microemboli was the only variable that was associated with cerebrovascular symptoms after a final regression analysis (
P
=0.026). The plasma monocyte chemotactic protein-1 level was raised in patients with solid microemboli (
P
=0.014).

Conclusions—

Solid cerebral microemboli were detected by multifrequency transcranial Doppler ultrasonography in 35% of a mechanical heart valve population, and the frequency was higher in patients who experienced cerebrovascular events during the first year after valve replacement. The results suggest that the detection of solid cerebral microemboli may be helpful in predicting the risk of ischemic stroke in mechanical heart valve patients.
Blocking of Platelets or Intrinsic Coagulation Pathway–Driven Thrombosis Does Not Prevent Cerebral Infarctions Induced by Photothrombosis
Authors: Kleinschnitz Christoph , Braeuninger Stefan , Pham Mirko , Austinat Madeleine , Nölte Ingo , Renné Thomas , Nieswandt Bernhard , Bendszus Martin , Stoll Guido
Published: February 2008

Background and Purpose—

Models of photochemically-induced thrombosis are widely used in cerebrovascular research. Photothrombotic brain infarctions can be induced by systemic application of photosensitizing dyes followed by focal illumination of the cerebral cortex. Although the ensuing activation of platelets is well established, their contribution for thrombosis and tissue damage has not formally been proved.

Methods—

Infarction to the cerebral cortex was induced in mice by Rose Bengal and a cold light source. To assess the functional role of platelets, animals were platelet-depleted by anti-GPIbα antibodies or treated with GPIIb/IIIa-blocking F(ab)
2
fragments. The significance of the plasmatic coagulation cascade was determined by using blood coagulation factor XII (FXII)-deficient mice or heparin. Infarct development and infarct volumes were determined by serial MRI and conventional and electron microscopy.

Results—

There was no difference in development and final size of photothrombotic infarctions in mice with impaired platelet function. Moreover, deficiency of FXII, which initiates the intrinsic pathway of coagulation and is essential for thrombus formation, or blockade of FXa, the key protease during the waterfall cascade of plasmatic coagulation, by heparin likewise did not affect lesion development.

Conclusions—

Our data demonstrate that platelet activation, factor XII–driven thrombus formation, and plasmatic coagulation pathways downstream of FX are not a prerequisite for ensuing tissue damage in models of photothrombotic vessel injury indicating that other pathomechanisms are involved. We suggest that this widely used model does not depend on platelet- or plasmatic coagulation-derived thrombosis.