bluuebunny/crossref_metadata_2025 huggingface dataset:
Daily Hassles Reported by Chronic Fatigue Syndrome and Fibromyalgia Patients in Tertiary Care: A Controlled Quantitative and Qualitative Study
Authors: van Houdenhove Boudewijn , Neerinckx Eddy , Onghena Patrick , Vingerhoets Ad , Lysens Roeland , Vertommen Hans
Published: April 2003

Background: This study aimed at providing insight in the frequency, emotional impact and nature of daily hassles, experienced by patients suffering from chronic fatigue syndrome (CFS) and/or fibromyalgia (FM), compared with patients with a chronic organic disease. Methods: One hundred and seventy-seven CFS/FM patients, 26 multiple sclerosis (MS) and 26 rheumatoid arthritis (RA) patients were investigated within 2–6 months after diagnosis. All patients completed a self-report questionnaire assessing daily hassles and associated distress, a visual analogue scale assessing fatigue and pain and a depression and anxiety questionnaire. Results: CFS/FM patients show a higher frequency of hassles, higher emotional impact and higher fatigue, pain, depression and anxiety levels compared with MS/RA patients. Three hassle themes dominate in the CFS/FM group: dissatisfaction with oneself, insecurity and a lack of social recognition. In contrast, hassles reported by MS/RA patients show a much larger diversity and are not focused on person-dependent problems. Conclusions: Patients recently diagnosed as suffering from CFS and/or FM are highly preoccupied and distressed by daily hassles that have a severe impact on their self-image, as well as their personal, social and professional functioning. An optimal therapeutic approach of CFS and FM should take account of this heavy psychosocial burden, which might refer to core themes of these patients’ illness experience.
Who Develops Acute Stress Disorder after Accidental Injuries?
Authors: Kjær Fuglsang Annette , Moergeli Hanspeter , Hepp-Beg Sofia , Schnyder Ulrich
Published: April 2003

Background: Acute stress disorder (ASD) is still a much discussed diagnosis, and research on predictors of ASD is sparse. The aim of this study was to assess the prevalence of ASD in a random sample of accident victims and to investigate the associations between different independent variables and ASD symptomatology with the objective to find a regression model best explaining the variance in ASD symptom level. Methods: We collected a randomized sample of hospitalized accident victims (n = 323). ASD was assessed using the Peritraumatic Dissociative Experiences Questionnaire and the Clinician-Administered Posttraumatic Stress Disorder Scale. Correlations and multiple regression analyses were computed with four groups of variables. This yielded the variables entered into a final multiple regression analysis. Results: Thirteen patients (4.0%) met all criteria for a diagnosis of ASD. Thirty-two patients (9.9%) met the criteria for a diagnosis of subsyndromal ASD. Thirty-eight percent of the variance in ASD symptom level was explained with a regression model including stay at the intensive care unit, preexisting psychiatric disorder, sense of coherence, sense of death threat, appraisal of accident severity, preventability of the accident by others, pain and appraisal of coping ability regarding physical recovery. Conclusions: This study furthers the discussion about the requirements for the ASD diagnosis. It also points to the importance of not only assessing objective accident-related variables in the aftermath of an accident but also of giving more consideration to the subjective experience and appraisal of the accident in the prevention of ASD.
Morphological Analysis of Iodoacetic Acid-Induced Cataract in the Rat
Authors: Matsumoto Miho , Morita Tetsuya , Hirayama Saori , Uga Shigekazu , Shimizu Kimiya
Published: April 2003

Purpose: To clarify the mechanism underlying the development of cataract in the rat lens after intraperitoneal administration of iodoacetic acid (IAA). Methods: (1) The 2% IAA dissolved in saline solution was injected at a dose of 40 mg/kg body weight into the rat peritoneal cavity. The retina and lens were intermittently extirpated and were examined by light and electron microscopy. (2) Two kinds of tracer, Evans blue (EB) and horseradish peroxidase (HRP), were injected into the tail veins and anterior chamber, and were observed with dissecting and electron microscopes. Results: (1) Four weeks after administration, a part of the lens epithelium at the lateral side of the lens was degenerated, and the lens nucleus developed faint turbidity after 8 weeks. After 16 weeks, the nuclear turbidity could not be observed because mild cortical opacity was developing. The epithelial degeneration recovered from around 12 weeks, and instead of spherical nuclei, elliptical nuclei appeared. (2) The EB dye injected into the tail vein significantly stained the ciliary body, where the anterior and posterior ciliary arteries anastomosed. EB injected from the lateral side of the lens was seen to move towards the lens nucleus. Electron microscopically, the epithelial degeneration of the ciliary body was observed. The incorporated HRP substance was found in the cytoplasm of the nonpigmented cells of the ciliary epithelium at an early stage after IAA administration. Conclusion: IAA injected intravenously first developed epithelial degeneration at the lateral side of the lens. This change induced swelling of the lens fibers in the lens nucleus. Recovered epithelial cells had a transformed nucleus, and in turn the cortical cataract was induced by a differentiation disorder of the lens fibers. These results indicate that the breakdown of the blood-aqueous barrier in the nonpigmented epithelium of the ciliary body is a trigger to cause the cataract. The IAA-induced cataract may be useful as an animal model of human age-related cataract.
Citicoline Treatment Increases Retinal Dopamine Content in Rabbits
Authors: Rejdak Robert , Toczołowski Jerzy , Solski Janusz , Duma Dariusz , Grieb Paweł
Published: April 2003

Citicoline (exogenous cytidine-5′-diphosphocholine) was reported to enhance dopaminergic neurotransmission in the brain. A few clinical studies showed beneficial effects of this drug on the function of the visual pathway in patients with glaucoma or amblyopia. The present study was aimed at determining whether citicoline could influence retinal catecholamine levels in adult male Albino rabbits. The animals received the drug (50 mg/kg i.p., twice daily) or vehicle for 7 days, and retinal catecholamine concentrations were determined by HPLC. Compared to vehicle-treated controls, citicoline-treated animals displayed a significantly higher retinal dopamine concentration and a tendency toward an increase in adrenaline concentration, while the noradrenaline concentration remained unchanged. It is, therefore, conceivable that citicoline reinforces dopaminergic transmission in the retina.
Transendothelial Transport of Low-Density Lipoprotein and Albumin Across the Rat Peritoneum in vivo: Effects of the Transcytosis Inhibitors NEM and Filipin
Authors: Rosengren Bert-Inge , Al Rayyes Osama , Rippe Bengt
Published: April 2003

This study was performed to investigate the mechanisms responsible for the transport of albumin and low-density lipoprotein (LDL) across capillary walls in vivo. To separate transcytosis from passive, ‘porous’ transport, we tested the effects of the transcytosis inhibitors N-ethylmaleimide (NEM) and filipin given intraperitoneally on the peritoneal capillary clearance of LDL and albumin in anesthetized rats undergoing peritoneal dialysis. Radiolabeled human albumin or LDL was given intra-arterially, and 51Cr-EDTA was infused intravenously. A 2-hour peritoneal dialysis dwell was performed using 16 ml of conventional 1.36% glucose-based dialysis fluid. The clearance of LDL and albumin to the dialysate and the peritoneal mass transfer coefficient for 51Cr-EDTA were assessed. Following intraperitoneal NEM incubations (0.5–5 mM), there were marked increases in the peritoneal transport of albumin and LDL for NEM doses exceeding 1 mM. For lower NEM doses, there were no reductions in clearance. Filipin incubations (0.2–4 µg/ml) did not affect the clearance of either macromolecule. In conclusion, neither NEM nor filipin caused reductions in albumin or LDL clearance across the peritoneal capillaries. The present data clearly show that NEM and filipin are unsuitable as transcytosis inhibitors in vivo.
Endothelin-1 and Endothelial Nitric Oxide Synthase Immunoreactivity in Lymphatic Vessels of the Uterine Broad Ligament during the Estrous Cycle in the Pig
Authors: Doboszyńska Teresa , Andronowska Aneta , Modzelewska Beata
Published: April 2003

Immunohistochemical localization and distribution of endothelin (ET-1) and nitric oxide synthase (eNOS) were investigated in precollector and collector lymphangions of lymphatic vessels leaving the ovary and were found in the vascular subovarian plexus (mesovarium) as well as in those emanating from the oviductal isthmus and uterine horn (mesosalpinx and mesometrium, respectively) forming the paraovarian lymphatic plexus in the broad ligament of the uterus during different phases of the estrous cycle in pigs. The polyclonal antibody for ET-1 and the monoclonal antibody for eNOS isoform were used for studies on the light-microscopic level. Immunoreactivities to both ET-1 and eNOS were observed in the endothelial cell cytoplasm of precollector and collector lymphangions and were not demonstrated in smooth muscle cells of the lymphatics examined. In the endothelium, the intensity of immunostaining for ET-1 and eNOS was found to be estrous phase-dependent and differed between precollector and collector lymphangions. In general, immunoreactivity to ET-1 was more intense in the endothelium of shrunken lymphangions, whereas that for eNOS was more intense in lymphangions with the large lumen. These results suggest that ET-1 and eNOS can play a role in mechanisms regulating the vascular contractile activity promoting lymph flow during the estrous cycle in the porcine broad ligament.
Muscle-Specific Effects of Hindlimb Suspension and Clenbuterol in Mature Male Rats
Authors: Wineski Lawrence E. , von Deutsch Daniel A. , Abukhalaf Imad K. , Pitts Sidney A. , Potter David E. , Paulsen Douglas F.
Published: April 2003

Anabolic agents are useful tools for probing the mechanisms by which muscle fibers perceive and respond to disuse. β2-Adrenergic agonists exert protective, and/or reparative, effects on atrophying muscle tissue. The effects of one such agent, clenbuterol (Cb), were examined on muscle mass, total protein content, and myofibrillar protein content in selected hindlimb muscles [adductor longus (ADL), extensor digitorum longus (EDL), plantaris (PLAN), soleus (SOL)] of mature male rats, under different loading conditions. Pair-fed rats were divided into four experimental groups: vehicle- and Cb-treated nonsuspended, vehicle- and Cb-treated hindlimb suspended (HLS). Experiments lasted 14 days, during which the rats received subcutaneous injections of 1 mg/kg Cb or 1 ml/kg vehicle. HLS induced significant atrophy in all muscles, except the EDL, in a generally fiber type-related pattern. However, myofibrillar protein content was affected in a more regional pattern. Cb treatment of nonsuspended rats induced hypertrophy in all muscles, in a generally uniform pattern. However, myofibrillar protein content was affected in a more fiber type-related pattern. Cb treatment of HLS rats reduced or eliminated HLS-induced atrophy in all muscles, in a muscle-specific pattern. Overall, the ADL and SOL were most susceptible to HLS-induced atrophy. The PLAN had the greatest magnitude of Cb-induced sparing of atrophy. The results show that, in mature male rats, Cb exerts anabolic effects that are load-dependent and muscle-specific. Responses to this drug cannot be reliably predicted by fiber-type composition alone.
Decorin Expression during Development of Bovine Skeletal Muscle and Its Role in Morphogenesis of the Intramuscular Connective Tissue
Authors: Nishimura T. , Futami E. , Taneichi A. , Mori T. , Hattori A.
Published: April 2003

Decorin is a small leucine-rich proteoglycan suspected of playing an important role in tissue morphogenesis. However, its role in the development of skeletal muscle is less clear. In the present study, the expression and spatial distribution of decorin in developing skeletal muscle of bovine fetuses were investigated, in order to provide a background for understanding the function of decorin in morphogenesis of the intramuscular connective tissue that supports muscle fibres. Western blot analysis showed that decorin already existed in skeletal muscle by 2.5 months of fetal development, and that decorin had a longer glycosaminoglycan chain in the early fetal stages than in later development, but its core protein was of the same size. Decorin mRNA was expressed at 1 month of fetal development, although its level was relatively low. Indirect immunofluorescence microscopy demonstrated that decorin was located in the perimysium which consisted of collagen fibres, but not in the endomysium which was composed of collagen fibril networks in fetal skeletal muscle. The relatively integrated structure of the perimysium had already formed by 2.5 months of fetal development, when muscle fibres were not tightly assembled and the surrounding endomysium was not well organized. These results suggest that decorin contributes to the formation and stabilization of collagen fibres in the perimysium that support muscle fibres assembled with myogenesis.
K+ Cycling and Its Regulation in the Cochlea and the Vestibular Labyrinth
Authors: Wangemann Philine
Published: April 2003

Potassium (K+) plays a very important role in the cochlea. K+ is the major cation in endolymph and the charge carrier for sensory transduction and the generation of the endocochlear potential. The importance of K+ handling in the cochlea is marked by the discovery of several forms of hereditary deafness that are due to mutations of K+ channels. Deafness results from mutations of KCNQ4, a K+ channel in the sensory hair cells, as well as from mutations of the gap junction proteins GJB2, GJB3 and GJB6 that may facilitate cell-to-cell movements of K+. Deafness results also from mutations of KCNQ1 or KCNE1, subunits of a K+ channel that carries K+ from strial marginal cells and vestibular dark cells into endolymph. Further, deafness results from mutations of KCNJ10, a K+ channel that generates the endocochlear potential in conjunction with the high K+ concentration in strial intermediate cells and the low K+ concentration in the intrastrial fluid spaces. This review details recent advances in the understanding of K+ transport and its regulation in the cochlea and the vestibular labyrinth.
Spectrotemporal Receptive Field Properties of Single Units in the Primary, Dorsocaudal and Ventrorostral Auditory Cortex of the Guinea Pig
Authors: Rutkowski Richard G. , Shackleton Trevor M. , Schnupp Jan W.H. , Wallace Mark N. , Palmer Alan R.
Published: April 2003

We report the spectrotemporal response properties of single units in the primary (A1) and dorsocaudal (DC) fields, and the ventrorostral belt of the urethane-anaesthetised guinea pig auditory cortex. Using reverse correlation analysis, spectrotemporal receptive fields (STRFs) were constructed and subsequently classified according to a novel qualitative scheme that was based on the duration and bandwidth of excitatory and inhibitory regions within the STRF. The STRFs of units in both A1 and DC showed either broad-band (≧1 octave) or narrow-band (<1 octave) excitatory and inhibitory regions occurring either alone or together. The excitatory regions were of short duration (lasting for <50 ms) or more sustained (up to about 100 ms) and inhibitory areas either followed excitation or were located as inhibitory sidebands along the high- and low-frequency edges of the excitatory regions. Inhibitory areas that followed excitatory regions were found to be either short lasting (10–20 ms) or longer lasting (up to 200 ms or more). The STRFs recorded from each cortical area indicated temporal response properties consistent with those shown by traditional peristimulus time histogram analysis. Overall, fields A1 and DC showed no significant differences in the distribution of STRF types. Thus, it appears that both fields display similar spectrotemporal sensitivities to auditory stimuli and therefore, appear to process such stimuli in a parallel fashion. Single units recorded in the ventrorostral belt area showed STRF types similar to those recorded in A1 and DC. However, the proportions of STRF types were significantly different, suggesting a difference in spectrotemporal processing between the ventrorostral belt and the core areas.
Herbal Diuretics Revisited: From ‘Wise Women’ to William Withering
Authors: Kinne-Saffran Eva , Kinne Rolf K.H.
Published: April 2003

This contribution summarizes the use of herbal diuretics over the period of two thousand years. After describing the role of herbs in the framework of the theory of the balance of humors for well-being, it details the contributions of Pliny the Elder (23–79), Dioscorides (40–90), Hildegard von Bingen (1098–1179), Pietro Andrea Matthioli (1500–1577), and Leonard Fuchs (1501–1566) in providing increasingly more precise descriptions and illustrations of medicinal plants. Then, William Withering’s (1741–1799) scientific analysis of the use of foxglove for the treatment of dropsy is presented, taking into account the role peasant ‘wise women’ played in his discoveries and the role of ‘folklore medicine’ before him.
Coordination of Histamine H3 Receptor Antagonists with Human Adrenal Cytochrome P450 Enzymes
Authors: Yang Richard , Hey John A. , Aslanian Robert , Rizzo Charles A.
Published: April 2003

Optical difference spectroscopy was used to identify and quantify human adrenal microsomal and mitochondrial cytochrome P450 enzyme interactions with the histamine H3 receptor antagonists thioperamide, clobenpropit and ciproxifan. Addition of these structurally diverse imidazole H3 receptor antagonists to cytochrome-P450-containing human adrenal microsomal and mitochondrial preparations resulted in concentration-dependent type II optical difference spectra. Respective spectral dissociation constants (KS) for the drug interactions with human adrenal microsomal and mitochondrial cytochrome P450 were 1.5 and 1.6 µmol/l for thioperamide, 3.1 and 0.28 µmol/l for clobenpropit and 0.10 and 0.11 µmol/l for ciproxifan. The three compounds demonstrated a similar activity profile in cytochrome-P450-containing bovine adrenal microsomal and mitochondrial preparations. Findings indicate direct coordination of these imidazole-containing H3 receptor antagonists with the heme moiety of human adrenal cytochrome P450 isozymes.
Anti-Emetic Activity of the Novel Nonpeptide Tachykinin NK1 Receptor Antagonist Ezlopitant (CJ-11,974) against Acute and Delayed Cisplatin-Induced Emesis in the Ferret
Authors: Tsuchiya Megumi , Fujiwara Yoshiko , Kanai Yoshihito , Mizutani Mayumi , Shimada Kaoru , Suga Osamu , Ueda Satoko , Watson John W. , Nagahisa Atsushi
Published: April 2003

The anti-emetic effects of a novel tachykinin NK1 receptor antagonist, ezlopitant ((2S,3S-cis)-2-diphenylmethyl)- N--1-azabicyclo- [2.2.2]octan-3-amine), were investigated in ferrets. Ezlopitant inhibited [3H]substance P ([3H]SP) binding to the human, guinea pig, ferret and gerbil NK1 receptors (Ki = 0.2, 0.9. 0.6 and 0.5 nmol/l, respectively), but had no affinity to NK2 and NK3 receptors up to 1 µmol/l. Ezlopitant also inhibited SP-induced contraction of guinea pig trachea with a pA2 value of 7.8, but had no effects on the baseline tension and maximum contractile response. In ferrets, ezlopitant, either orally (0.03–3 mg/kg) or subcutaneously (0.3–3 mg/kg), prevented acute retching and vomiting responses induced by intraperitoneal injection of cisplatin (10 mg/kg). In addition, repeated subcutaneous injection of ezlopitant significantly inhibited delayed retching and vomiting responses that occurred in ferrets treated with the lower dose of cisplatin (5 mg/kg, i.p.). Ezlopitant (0.1–1 mg/kg, s.c.) also produced a dose-dependent inhibition of hindpaw tapping induced by intracerebroventricular injection of [Sar9,Met(O2)11]SP in gerbils, which is known to be mediated by NK1 receptors in the brain. These findings indicate that ezlopitant is a potent and selective NK1 receptor antagonist, and that it inhibits both acute and delayed emetic reactions induced by cisplatin in ferrets via acting on NK1 receptors in the central nervous system.
Migratory Responses of Polymorphonuclear Leukocytes to Kinin Peptides
Authors: Paegelow I. , Trzeczak S. , Böckmann S. , Vietinghoff G.
Published: April 2003

The present study examines the influence of kinins on the migratory capacity of human polymorphonuclear leukocytes under in vitro conditions using the Boyden chamber technique. By means of checkerboard analysis the migration of neutrophils induced by bradykinin could be characterized as true chemotaxis. The stimulation of human neutrophils with bradykinin, with the nonpeptide B2 receptor agonist FR190997 as well as with des-Arg9-bradykinin and des-Arg10-kallidin results in a concentration-dependent migration. Pretreatment of the neutrophils with the B2 receptor antagonist HOE-140 (icatibant) inhibited the bradykinin-induced migration but not that induced by B1 receptor agonists, whereas the B1 receptor antagonist des-Arg10HOE-140 abolished the migration elicited by des-Arg9-bradykinin or des-Arg10-kallidin but not that evoked by bradykinin. Pretreatment of the neutrophils with the leukotriene B4 (LTB4) antagonist ZK158252 inhibited the LTB4-induced chemotaxis as well as the chemotaxis produced by bradykinin and des-Arg10-kallidin. An involvement of interleukin-1β and of the chemokine IL-8 in the bradykinin-induced migration in vitro could be excluded during the migration time of the neutrophils. In conclusion, the present study provides pharmacological evidence showing that B1 and B2 kinin receptors are involved in the migration of human neutrophils in vitro, that LTB4 participates in the downstream pathway and that the B1 kinin receptor seems to be expressed already under physiological conditions.
Michael Adducts of Palmitoylascorbic Acid: Effects on the Oxidative Burst of Neutrophils and the Production of Tumor Necrosis Factor-Alpha in Monocytes
Authors: Gütschow Michael , Hauschildt Sunna , Benard Stefan , Reichl Sabine , Witt Uta G. , Eger Kurt , Arnhold Jürgen
Published: April 2003

The effects of Michael adducts of 6-O-palmitoyl-L-ascorbic acid (compounds 1–4) on the phosphorylation-dependent response of stimulated monocytes and neutrophils was investigated. The pyranosyl derivative 3 increased the production of tumor necrosis factor-α in human monocytes stimulated with lipopolysaccharide (LPS). Compound 3 also enhanced the release of tumor necrosis factor-α from nonstimulated monocytes. Michael adducts 1–4 inhibited the formation of reactive oxygen species in fMLP-stimulated human neutrophils as measured by luminol chemiluminescence. Treatment with 6-O-palmitoyl-L-ascorbic acid (compound 5) also led to a decreased luminescence response of neutrophils. Results are discussed with respect to the inhibitory activity of Michael adducts of ascorbic acids towards protein phosphatases PP1/PP2A.
Analysis of Losses of Heterozygosity of the Candidate Tumour Suppressor Gene DMBT1 in Melanoma Resection Specimens
Authors: Deichmann M. , Mollenhauer J. , Helmke B. , Thome M. , Hartschuh W. , Poustka A. , Näher H.
Published: April 2003

Deleted in malignant brain tumours 1 (DMBT1), a candidate tumour suppressor gene located on chromosome 10q25.3-q26.1, has recently been identified and found to be deleted in several different types of human tumours. In melanomas, the chromosomal region 10q22-qter is commonly affected by losses, hence we screened primary melanoma samples for losses of heterozygosity (LOH), and acquired melanocytic naevi and melanomas for transcription of DMBT1 and protein expression. Of 38 informative melanomas, 1 nodular melanoma and 2 subcutaneous metastases showed LOH of both microsatellites flanking the gene, suggesting loss of 1 DMBT1 allele. Three further melanomas showed LOH at 1 informative locus but were heterozygous for the second marker. Applying reverse-transcription polymerase chain reaction (RT-PCR), DMBT1 transcription was not found in melanomas. However, DMBT1 transcription was also absent from the majority of naevi from which melanomas frequently arise, making down-regulation of gene transcription during transformation from naevus to melanoma unlikely. Immunohistochemistry showed nerves, sweat glands and the stratum spinosum of the epidermis to be DMBT1 protein positive, whereas the naevi and melanoma cells themselves were negative. All considered, the candidate tumour suppressor gene DMBT1 does not appear to be a major inactivation target in the development of melanomas.
Prognostic Factors of Secondary Ovarian Carcinoma
Authors: Kikkawa Fumitaka , Ino Kazuhiko , Nomura Seiji , Ishikawa Hisatake , Kuzuya Kazuo , Yamamuro Osamu , Kobayashi Iwao , Kawai Michiyasu , Mizutani Shigehiko
Published: April 2003

Objective: Although the ovaries are common sites of metastases from a variety of primary neoplasms excluding carcinomas of the genital tract, there were few reports concerning survival and prognostic factors. The objective of this study was to assess the clinical factors affecting survival. Methods: Fifty-three secondary ovarian carcinomas excluding metastases from genital tract carcinoma were registered by the Tokai Ovarian Tumor Study Group from 1989 to 1999. FIGO staging was set without considering the pathologic findings of the lymph nodes and the primary tumors. Results: Twenty-four patients were stage I, 11 were stage II, 16 were stage III, and 2 were stage IV. There were significant differences in the survival curves between the early stages (I and II) and advanced stages (III and IV). The 5-year survival rate for patients without residual tumors was 39.9%, while all patients with residual tumors after surgery died within 33 months. The most frequent primary tumor was large intestinal carcinoma, and the second was gastric carcinoma. The 5-year survival rate for patients with large intestinal primary tumors was significantly better than that with stomach tumors. Multivariate analysis demonstrated that tumor stage and primary tumor sites were significant prognostic factors. Conclusion: FIGO staging without considering lymph node involvement and the primary tumor was a significant prognostic factor, and prognostic factors for primary ovarian carcinomas can be applied to secondary ovarian carcinomas. Furthermore, the primary tumor site was also an important prognostic factor for survival.
Immunohistochemical Analysis of ZO-1 in the Duodenal Mucosa of Patients with Untreated and Treated Celiac Disease
Authors: Montalto Massimo , Cuoco Lucio , Ricci Riccardo , Maggiano Nicola , Vecchio Fabio Maria , Gasbarrini Giovanni
Published: April 2003

Background/Aim: ZO-1 is a good marker for tight junction integrity which may be damaged in many intestinal diseases. ZO-1 can also accumulate in the cellular nucleus in addition to sites of cell-cell contact, suggesting a potential role in cellular proliferation and differentiation. We evaluated the expression and distribution of ZO-1 in patients with celiac disease before and after a gluten-free diet. Methods: The ZO-1 expression was evaluated semiquantitatively by means of immunohistochemical analysis in duodenal bioptic specimens of 10 consecutive patients with celiac disease before and after a gluten-free diet and in 10 controls. Furthermore, the nuclear staining was analyzed quantitatively, evaluating 3,000 cells for each count, and it was expressed as a percentage of labeled nuclei over the total of analyzed cells. Results: The intestinal mucosa of untreated celiac disease patients shows a globally lower ZO-1 labeling than that of controls. The expression of ZO-1 in the treated celiac mucosa did not differ significantly from normal intestinal mucosa of healthy subjects. At the crypt level of untreated celiac mucosa, a low intensity of nuclear labeling (1.75 ± 0.32%) was found, while in both treated celiac disease patients and in normal subjects we observed a statistically significant higher percentage of strongly labeled nuclei (53.72 ± 6.30% and 56.79 ± 5.45%, respectively; p = 0.0002). Conclusions: Our data show a global underexpression of ZO-1 in the duodenal mucosa of active celiac disease patients. Gluten withdrawal allows a normalization of the ZO-1 expression in treated celiac disease patients. Furthermore, the particular pattern of ZO-1 resembles the cellular distribution in undifferentiated cells and may be the result of immaturity of the enterocytes in untreated celiac sprue.
Protein-Losing Cytomegalovirus Gastritis in a Patient with Stevens-Johnson Syndrome
Authors: Yoshioka Mikio , Ishiguro Nobuhisa , Ma Xiaoming , Kikuta Hideaki , Kodaira Junichi , Itoh Tomoo , Kobayashi Kunihiko
Published: April 2003

We present a case of protein-losing cytomegalovirus gastritis in a previously immunocompetent 14-year-old Japanese girl that occurred during treatment of drug (zonisamide)-induced Stevens-Johnson syndrome with hepatic failure. Her hepatic failure and symptoms of Stevens-Johnson syndrome were successfully treated with intravenous prednisolone and infusion of fresh-frozen plasma or albumin, as the occasion demanded. However, during the course of treatment, she complained of severe epigastralgia together with hypoproteinemia, and cytomegalovirus gastritis was found by endoscopic and histological examinations. The possible mechanism by which cytomegalovirus gastritis occurred in the present case and effective diagnostic procedures are discussed.
Replication of a Two-Factor Model of the Beck Depression Inventory in Alcohol Dependents and Suicide Attempters
Authors: Dunkel Dirk , Froehlich Sabine , Antretter Elfi , Haring Christian
Published: April 2003

The factor structure of the Beck Depression Inventory (BDI) is still controversial. The present study attempted to replicate a general two-factor model (cognitive-affective and somatic factors) of the BDI with a confirmatory Procrustes rotation procedure in two clinical samples of patients being treated for alcohol dependence (N1 = 243, N2 = 148) and one clinical sample of patients admitted to an acute psychiatric ward because of an act of deliberate self-harm (N3 = 144). In addition, due to the neglect of gender-specific analysis in factor-analytic studies of the BDI, the two-factor model was tested for males and females separately. The results did not support the validity of the two-factor model in the total samples. Gender-specific findings indicated a better fit of the model in male samples. Possible implications of a gender-specific factor structure of the BDI are discussed.
Personality Traits in Migraine and Tension-Type Headaches: A Five-Factor Model Study
Authors: Cao Ming , Zhang Shiyang , Wang Keyong , Wang Yehan , Wang Wei
Published: April 2003

Although abnormal personality traits have been frequently reported in patients with primary headaches, the overlaps between these domains need a clear standard definition, for example, by a five-factor personality model. Moreover, personality abnormalities in patients with episodic tension-type headache (ETH) and migraine with aura (MA) are less well studied. Therefore, we administered Zuckerman-Kuhlman’s Personality Questionnaire to 72 patients suffering from chronic tension-type headaches (CTH), 33 with ETH, 15 with MA and 57 with migraine without aura (MO), as well as 58 healthy subjects. Depressive trends were measured with Plutchik-van Praag’s Depression Inventory. Compared to healthy controls, the CTH, ETH and MO groups showed significantly greater neuroticism-anxiety and depression. In addition, the MO group scored significantly higher on aggression-hostility than healthy controls. No abnormal personality traits were found in patients with MA. This study, from the perspective of a five-factor model, confirms most previous reports about personality in patients with primary headaches and establishes elevated aggression-hostility only in MO sufferers.
Pseudotumor cerebri in a Patient with Goldenhar’s and Duane’s Syndromes
Authors: Tillman Oliver , Kaiser Hedwig J. , Killer Hanspeter E.
Published: April 2003

A 4-year-old boy presented with Goldenhar’s syndrome, Duane’s syndrome and bilateral papilledema. Magnetic resonance imaging of the brain was unremarkable. On lumbar puncture, the cerebrospinal fluid (CSF) pressure measured 36 cm H2O. CSF examination was normal. The diagnosis of pseudotumor cerebri was made, and treatment with acetazolamide was started. As the papilledema did not resolve, steroids were added to the treatment. Lumbar puncture was repeated after 1 month, and pressure was found to be 30 cm H2O. Because medical treatment was not effective in lowering the CSF pressure, optic nerve sheath fenestration was performed. Papilledema resolved over the next 2 months. To the best of our knowledge, this is the first case of Goldenhar’s syndrome associated with pseudotumor cerebri.
Serum Interleukin-6 Reflects Disease Severity and Osteoporosis in Mastocytosis Patients
Authors: Theoharides Theoharis C. , Boucher William , Spear Kathleen
Published: April 2003

Background: Systemic mastocytosis (SM) is a condition typically characterized by an increased number of mast cells in the bone marrow or in skin areas known as urticaria pigmentosa. Patients may present with flushing, itching, gastrointestinal symptoms, arrhythmias, headaches and osteoporosis. Some patients experience systemic symptoms indicative of SM in the absence of a positive bone marrow or skin biopsy, and are known as ‘clinical mastocytosis’, but are herein referred to as suspected of having systemic mastocytosis. Serum tryptase has been increasingly used as a biochemical marker of mastocytosis, but is not always elevated. Objective: To investigate the association of serum levels of two key mast cell mediators, interleukin-6 (IL-6) and tryptase, to each other and with disease severity in patients with mastocytosis. Methods: Patients responded to an announcement from the Systemic Mastocytosis Society (USA) and submitted frozen serum samples, but the precise diagnosis made by their own health providers was not known until after the assays were completed. There were 9 suspected systemic mastocytosis (SuSM), 3 cutaneous mastocytosis (CM), 11 indolent systemic mastocytosis (ISM), and 3 aggressive systemic mastocytosis (ASM). Five normal volunteers (3 females/2 males) also submitted samples, as did 33 cardiac patients without coronary artery disease. For 2 days prior to and during the collection period, mastocytosis patients were asked to abstain from any over-the-counter or food products containing biogenic amines, as well as drugs prescribed for this condition. Serum levels of IL-6 and tryptase were measured using established assays. Results: Twenty-six patients (14 females/12 males) submitted serum samples. There were 9 cases of SuSM (6 females/3 males) in whom tryptase values were borderline normal; IL-6 values were slightly elevated with one being high. In 3 cases of CM (2 females/1 male), both tryptase and IL-6 were slightly elevated. In patients with ISM (5 females/6 males), only 6/11 had any tryptase elevated significantly as compared to 9/11 with elevated serum IL-6. Three patients with ASM had significant elevations of both IL-6 and tryptase. The most consistent finding was that of IL-6 elevations in 7/7 patients (3 females/4 males) who reported symptoms of osteoporosis and/or bone pain (1 SuSM, 3 ISM, 3 ASM) in the absence of any coexisting condition involving bone pathology. Conclusion: Serum IL-6 is elevated in mastocytosis patients and correlates with severity of symptoms and the presence of osteoporosis. High serum IL-6 may not only signify disease progression, but may also participate in the pathophysiology of mastocytosis.
Imiquimod, a Topical Immune Response Modifier, in the Treatment of Cutaneous Metastases of Malignant Melanoma
Authors: Bong Anne B. , Bonnekoh Bernd , Franke Ingolf , Schön Michael P. , Ulrich Jens , Gollnick Harald
Published: April 2003

Background: Imiquimod 5% cream (Aldara®), a novel topical immune response modifier, has been approved for the topical treatment of anogenital HPV-induced warts. In addition, several studies have demonstrated antitumoral activity in solar keratoses, superficial basal cell carcinomas and Bowen’s disease. Aim: Given the convincing therapeutic results of imiquimod when used for treating selected types of epithelial skin cancer, we became interested to study imiquimod as an adjuvant for treating cutaneous metastases of malignant melanoma. Methods: Three patients with multiple, i.e. more than 15, cutaneous in-transit metastases of malignant melanoma in unilateral localization on the leg were treated topically with imiquimod 5% cream. Results: Twice daily application under occlusive conditions for a period of 21–28 weeks resulted in >90% regression of cutaneous metastases in 2 patients. The third patient showed marked response only when topical imiquimod was intermittently supplemented by intralesional interleukin (IL)-2 for 2 weeks. Unwanted side effects were mild in all patients. Conclusion: Overall, imiquimod as a single agent or in combination with intralesional IL-2 may be a promising immunomodulatory compound for the adjuvant topical treatment of patients with multiple cutaneous metastases of malignant melanoma.
The Validity of Proximal Caries Detection Using Magnifying Visual Aids
Authors: Haak Rainer , Wicht Michael J. , Hellmich Martin , Gossmann Andrea , Noack Michael J.
Published: April 2003

The purpose of this study was to determine the validity of proximal caries detection supported by a prism loupe and a surgical microscope used by examiners having different professional experience. One hundred and sixty extracted premolars and molars with varying degrees of proximal caries or sound surfaces were embedded in 10 pairs of models with proximal tooth contacts and a simulated gingiva mask. The proximal surfaces were visually evaluated by 14 observers (7 students, 7 dentists) according to a 5-point caries rating scale using a head-worn prism loupe (×4.5), a surgical microscope (×14) and without any magnifying device (control). The validity of observations was expressed as ROC curves calculated for two gold standard thresholds: (a) the presence of caries and (b) macroscopic cavitation. Repeated measures analysis of variance was used to determine the effects of ‘observer group’ and ‘diagnostic modality’. An influence of the observer group could not be demonstrated (p > 0.72), whereas significant differences were revealed between the diagnostic modalities (p < 0.002). ROC areas of caries detection with magnifying aids were smaller compared to the control group. It was concluded that the use of a prism loupe or a surgical microscope does not improve the validity of proximal caries detection if the operators, irrespective of being dental students or clinical instructors, are inexperienced in its utilisation. In general only moderate validity was achieved with visual inspection of proximal sites.
Pelvic Lipomatosis in a Child
Authors: Zaman Waheed , Singh Vishwajeet , Kumar Binay , Srivastava Aneesh , Kumar Anant , Waklu Autar Kishan
Published: April 2003

We report a 10-year-old boy with pelvic lipomatosis causing chronic urinary retention. CT scan features, therapy and review of the literature are discussed.
Primary Mucosa-Associated Lymphoid Tissue Lymphoma in the Renal Pelvis
Authors: Mita Koji , Ohnishi Yoshio , Edahiro Toru , Fujii Toshihiro , Yamasaki Akihiko , Shimamoto Fumio
Published: April 2003

A primary low-grade lymphoma of mucosa-associated lymphoid tissue arising from the renal pelvis is extremely rare. We present a 77-year-old man with this disease which was difficult to diagnose preoperatively.
MPO-ANCA-Associated Small Vessel Vasculitis Presenting as Fever of Unknown Origin
Authors: Akar Harun , Ozbaslı-Levi Cigdem , Senturk Taskın , Kadıkoylu Gurhan , Levi Edi , Bolaman Zahit
Published: April 2003

Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis which can present with various clinical manifestations, for which the mainstay of treatment is systemic corticosteroids and immunosuppressants. We report a case of a 54-year-old female admitted to the hospital because of fever during the last month, leukocytosis and elevated erythrocyte sedimentation rate. Persistence of elevated serum creatinine levels and accompanying hematuria led us to perform a renal biopsy, and MPA was diagnosed on the basis of light and immunofluorescence microscopy. Remission was induced with oral corticosteroids and cyclophosphamide therapy in conjunction with plasmapheresis (PF). The objective of this report was to assess the role of PF in the treatment of MPA and report on its utility in patients with MPA who are not responding to standard therapy or who require unacceptably high doses of steroids or immunosuppressants. In a patient presenting with fever of unknown origin, microscopic polyangiitis should also be considered in the differential diagnosis.
Impairment of Vascular Responses to Reactive Hyperemia and Nitric Oxide in Chronic Renal Failure
Authors: Nakanishi Takeshi , Ishigami Yuki , Otaki Yoshinaga , Izumi Masaaki , Hiraoka Keisuke , Inoue Toru , Takamitsu Yoshihiro
Published: April 2003

Background: Cardiovascular events are the leading cause of morbidity and mortality in patients with end-stage renal disease. The role of endothelial dysfunction, an early marker of arteriosclerosis, in patients with chronic renal failure (CRF) before the initiation of maintenance hemodialysis (HD), and the factors affecting endothelial dysfunction in the setting of chronic renal failure remain poorly understood. Methods: We evaluated endothelial function by measuring flow-mediated vasodilation (%FMD) during reactive hyperemia in healthy individuals (HCS) and patients with chronic renal failure with (HD) or without (ND) hemodialysis. Nonspecific endothelium-independent vasodilation (%NTG) was measured after the administration of sublingual glyceryl trinitrate spray (0.3 mg). Factors affecting %FMD and %NTG were also tested. Results: In ND and HD, plasma homocysteine, cysteine and stable NO metabolite (NO–3) concentrations were significantly elevated. In ND and HD, reactive hyperemia as well as %NTG and %FMD were attenuated to a similar degree. On multivariate regression analysis, NO–3 concentration was directly correlated with both %FMD and %NTG, while the glutathione (GSH) concentration correlated with only %NTG. Conclusion: Our findings indicate that chronic renal failure before the initiation of maintenance hemodialysis impairs endothelial function and/or the response to NO, which is accompanied by the attenuated reactive hyperemia. Furthermore, the impairment might be related to the decreased synthesis or the dissipation of NO.
Standard Heparin versus Low-Molecular-Weight Heparin
Authors: Stefoni Sergio , Cianciolo Giuseppe , Donati Gabriele , Colì Luigi , La Manna Gaetano , Raimondi Concettina , Dalmastri Vittorio , Orlandi Valentina , D’Addio Francesca
Published: April 2003

Background: To compare standard heparin (SH) and low molecular weight heparin (LMWH) in terms of anticoagulation, platelet activation and lipid metabolism, we selected 54 patients who had been on 4-hour hemodialysis three times weekly for at least 12 months, without bleeding disorders or dyslipidemic diseases. 28 were on hemodialysis with Polysulfone low-flux, 26 were on hemodiafiltration with Polysulfone high-flux. All patients underwent EPO. Methods: During the first 18 months, we administered SH 1,500 IU on starting dialysis and 1,500 ± 500 IU in continuous intradialytic infusion per session. In the following 18 months, we administered LMWH 64.6 IU/kg on starting dialysis in a single arterious bolus. We assessed aPTT, anti-factor Xa activity, TAT and FPA, β-TG and PF4. Blood samples were taken monthly at times 0, 30, 60, 180 and 240 min, as well as 1, 4 and 20 h after dialysis end. Predialysis cholesterol, HDL, LDL, triglycerides and lipoprotein(a) were checked monthly. Results: During both LMWH and SH sessions no clotting or major bleeding complications were observed. APTT with LMWH was lower than that found with SH (p < 0.001); aFXa using LMWH was higher than when using SH (p < 0.001); TAT and FPA were lower in LMWH sessions (p < 0.01) than in SH sessions. We also detected lower β-TG (p < 0.05) and PF4 levels (p < 0.05) using LMWH than using SH. As regards lipids, we only observed a significant decrease in triglycerides after 18 months of LMWH treatment. Conclusions: Routine use of LMWH during hemodialysis affords a safe and effective alternative to SH, and causes reduced platelet activation.
Primitive Malignant Melanoma of the Parotid Gland
Authors: Barbieri Marco , Gentile Raffaella , Cordone Maria Paola , Mora Renzo , Mora Francesco
Published: April 2003

Melanoma of the parotid gland is a very rare event: it can occur as a primary disease or as spread of the intraglandular nodes. The authors report a case and review the few cases of primary melanoma of the parotid gland reported in the literature.
Leprosy: Otolaryngologist’s Perspective
Authors: Low W.K. , Ngo R. , Qasim A.
Published: April 2003

A patient with hemi-facial erythematous swelling as a result of borderline leprosy and reversal reaction is reported. This uncommon presentation of the disease poses initial diagnostic difficulties to the otolaryngologist. The otolaryngologist must be familiar with otolaryngologic manifestations of leprosy, since early diagnosis and treatment reduces the risk of transmission of the disease and may avoid permanent nerve damage.
Thymidine Labeling Index in Laryngeal Squamous Cell Carcinoma in Correlation with pTNM, Age, Histological Grade and Recurrence
Authors: Ünal Murat , Bilir Ayhan , Karatay Mesut Can
Published: April 2003

In this study, our aim was to investigate the prognostic features of the thymidine labeling index (TLI) in laryngeal squamous cell carcinoma (SCC). The TLI values in tumor tissues and adjacent healthy tissues were assessed in 40 patients who had a pathological diagnosis of laryngeal SCC. The data were correlated with age, pTNM, histological grade and recurrence. The tissues (tumor and adjacent tumor-free tissue) obtained during surgery were labeled with 3H-thymidine. A statistically significant difference was observed between tumoral tissue and adjacent tumor-free tissue (p < 0.05), but we could not confirm any statistically significant correlation between TLI and age, pTNM, histological grade and recurrence. In conclusion, TLI in laryngeal SCC had no significant relation with the clinicopathological features, probably due to the variation in tissue sampling and for tumor-dependent reasons. TLI may assist in differentiating malignant from benign lesions.
Effect of Tonsillectomy on Serum Concentrations of Interleukins and TNF-α in Patients with Chronic Tonsillitis
Authors: Ünal Murat , Öztürk Candan , Görür Kemal
Published: April 2003

We investigated serum interleukin (IL)-1β, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF)-α levels in 17 children aged 5–12 years (mean 7) with chronic tonsillitis before and after tonsillectomy. Cytokine concentrations were measured by enzyme-linked immunosorbent assay. IL-1β and IL-6 levels were significantly higher than the control levels (p < 0.05) in preoperative serum samples. Other cytokine levels were within normal limits. After tonsillectomy, IL-1β and IL-6 levels were significantly reduced (p < 0.05). It is suggested that IL-1β and IL-6 may be mediators which have a role in chronic tonsillitis disease and that tonsillectomy has a significant effect on preoperative IL-1β and IL-6 serum levels.