bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of High-Level Aminoglycoside Resistance in Vancomycin-Sensitive and Vancomycin-Resistant Enterococcus Species
Authors: Yazgi H , Ertek M , Erol S , Ayyildiz A
Published: February 2013

The aim of this study was to investigate whether there was a significant difference in high-level aminoglycoside resistance (HLAR) between vancomycin-sensitive enterococci (VSE) and vancomycin-resistant enterococci (VRE). Vancomycin resistance was determined in 116 Enterococcus isolates using brain-heart infusion agar containing 6 μg/ml vancomycin. HLAR was determined by both standard agar screening and disk diffusion methods. Streptomycin and gentamicin were used as predictors of HLAR. Vancomycin resistance and HLAR were found in 17 (14.7%) and 41 (35.3%) of the Enterococcus strains, respectively. HLAR was found in 11 of 17 VRE and 30 of 98 VSE strains. HLAR in VRE strains was significantly higher than in VSE. More enterococcal strains were found to be resistant to both gentamicin and streptomycin (29) than to gentamicin (one) or streptomycin (11) alone. The HLAR rate in VRE was two-fold higher than in VSE. The synergistic bactericidal effect of aminoglycosides and β-lactam or glycopeptide antibiotics is lost if there is high-level resistance to aminoglycosides.
ABPM Comparison of the Anti-Hypertensive Profiles of Telmisartan and Enalapril in Patients with Mild-to-Moderate Essential Hypertension
Authors: Amerena J , Pappas S , Ouellet J-P , Williams L , O'Shaughnessy D
Published: February 2013

In this multicentre, prospective, randomized, open-label, blinded-endpoint (PROBE) study, the efficacy of 12 weeks' treatment with once-daily telmisartan 40–80 mg and enalapril 10–20 mg was evaluated using ambulatory blood pressure monitoring (ABPM) in 522 patients with mild-to-moderate essential hypertension. Patients were titrated to the higher dose of study drug at week 6 if mean seated diastolic blood pressure (DBP) was ≥ 90 mmHg. The primary endpoint was the change from baseline in ambulatory DBP in the last 6 h of the 24-h dosing interval after 12 weeks' treatment. Telmisartan and enalapril produced similar reductions from baseline in DBP and systolic blood pressure (SBP) over all ABPM periods evaluated (last 6 h, 24-h, daytime and night-time). Telmisartan produced a significantly greater reduction in mean seated trough DBP, measured unblinded with an automated ABPM device in the clinic, amounting to a difference of −2.02 mmHg ( P < 0.01). A significantly greater proportion of patients achieved a seated diastolic response with telmisartan than enalapril (59% versus 50%; P < 0.05), also measured with the same ABPM device. Both treatments were well tolerated. Compared with telmisartan, enalapril was associated with a higher incidence of cough (8.9% versus 0.8%) and hypotension (3.9% versus 1.1%). Therefore, telmisartan may provide better long-term compliance and, consequently, better blood pressure control than enalapril.
Is Neuropathic Ulceration the Key to Understanding Increased Mortality Due to Ischaemic Heart Disease in Diabetic Foot Ulcer Patients? A Population Approach Using a Proportionate Model
Authors: Chammas NK , Hill RLR , Foster AVM , Edmonds ME
Published: February 2013

Ischaemic heart disease (IHD) is the commonest cause of death in diabetic foot ulcer patients and non-ulcerated diabetic patients, yet the mortality rate of diabetic foot ulcer patients is over twice that of non-ulcerated patients. As the cause of this increased mortality is not understood, we plotted the ratio of deaths due to ischaemic heart disease (IHD n) to other causes of death (i.e. IHD n:OCD n) against age for 242 diabetic foot ulcer patients and 121 controls (non-ulcerated diabetic patients). The IHD n:OCD n ratio rose above 1.0 from age 40 years onwards for diabetic foot ulcer patients, but from age 70 years onwards for controls, demonstrating differentially increased mortalities due to IHD. A population model involving summation of IHD n:OCD n ratios for neuropathic and neuroischaemic diabetic foot ulcer patients calculated an overall increased mortality rate of 1.8 compared with that of non-ulcerated diabetics. The model predicted that a 25% reduction in neuropathic diabetic foot ulcer patients dying from IHD would eliminate the increased mortality, demonstrating that neuropathic rather than ischaemic ulceration defines the cause of increased mortality among diabetic foot ulcer patients.
Significance of p53 and bcl-2 Immunoexpression in the Prognosis of Laryngeal Squamous Cell Carcinoma
Authors: Yildirim S , Cermik H , Işitmangil T , Baloglu H , Gungor A , Pekkafali Z
Published: February 2013

This study was undertaken to determine whether p53 or bcl-2 immunoexpression has any significance in the prognosis of laryngeal squamous cell carcinoma. Eighty-four cases of laryngeal squamous cell carcinoma at different pathological stages and locations were studied. All patients were treated surgically first, and followed up for 6–96 months (mean, 35 months). p53 and bcl-2 immunoexpression in tumour cells, evaluated by image analysis and histoscore, were found in 71.4% and 46.4% of tumours, respectively. Glottic location was correlated with significantly longer survival than tumours at other locations. Pathological stage and histological grade of tumour were also significant predictors of survival. Neither p53 nor bcl-2 immunoexpression was found to be predictive of post-operative survival. Only transglottic tumours expressed significantly high levels of bcl-2. Both methods used to evaluate p53 and bcl-2 immunoexpression correlated well with each other. This study suggests that immunoexpression of p53 and bcl-2 is not a significant prognostic predictor in laryngeal squamous cell carcinoma.
Major Surgery with Guillain-Barré Syndrome: A Case Report
Authors: Koc M , Ozalp N , Zulfikaroglu B
Published: February 2013

Guillain-Barré syndrome (GBS) is an acute demyelinating polyneuropathy characterized by progressive muscle weakness and areflexia. The pathogenesis of GBS is unknown, but it is generally believed to result from aberrant humoral and cellular immune responses against components of the peripheral nervous system. The overall prognosis of GBS is quite good with approximately 85% of survivors making a good functional recovery. When a diagnosis of GBS has been made, appropriate treatment should be started as early as possible. This may include supportive care in intensive care units, ventilatory assistance, monitoring of blood pressure, fluid status, cardiac rhythm, nutritional supports and medical therapy. Our patient reached maximum deficiency 3 weeks after the onset of GBS. Full recovery took 8 months. The occurrence of GBS after major surgery is rare. We believe that major surgical stress may be the potential triggering factor for the occurrence of GBS in this case report.
Beta-Lactam Resistance: Clinical Implications for Pediatric Patients
Authors: Dajani AS
Published: February 2013

The emergence of resistance to established antibiotic agents such as beta-lactams has been reported worldwide and poses a serious challenge to the management of pediatric infections. The most common mechanism of resistance involves the production of an enzyme that inactivates the antibiotic before it can be effective. Streptococcus pneumoniae, the most common cause of pediatric respiratory tract infections, exhibits variable resistance to penicillins and aminopenicillin due to alterations in its penicillin-binding proteins (PBPs). Haemophilus influenzae and Moraxella catarrhalis show moderate and high beta-lactamase-mediated resistance to aminopenicillins, although they remain susceptible to beta-lactam/beta-lactamase inhibitor combinations. Methicillin-resistant Staphylococcus aureus, a frequent cause of skin and soft-tissue infections, has shown PBP-mediated beta-lactam resistance, prompting the widespread use of vancomycin to eradicate this pathogen. Finally, PBP-mediated resistance has been observed in a large proportion of isolates of coagulase-negative staphylococci, which account for a high proportion of nosocomial infections, particularly in neonatal intensive care units. The challenge is to control the emergence of beta-lactamase-mediated resistance by using beta-lactams judiciously. In this regard, the beta-lactam/beta-lactamase inhibitor combinations have an important role to play in extending the usefulness of established beta-lactam agents.
The Importance of Pulmonary Artery Circulation during Cardiopulmonary Bypass
Authors: Ege T , Canbaz S , Cikirikcioglu M , Arar C , Edis M , Duran E
Published: February 2013

This study sought to determine changes in transpulmonary difference in blood cells and alveolar-arterial oxygen (A-aO2) gradient when pulmonary artery circulation was obstructed in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Eighteen patients were divided into group A (control group; X-clamp placed on aorta, n = 9) and group B (pulmonary ischaemia group; X-clamp placed on aorta and pulmonary artery, n = 9). Haematological parameters were compared before CPB and up to 90 min after declamping. A-aO2 gradient differences were compared before and 2 h and 6 h after declamping. A transpulmonary increase in leucocyte levels normalized after 60 min in group A but remained higher in group B. A transpulmonary increase in neutrophils normalized after 60 min in group A and 90 min in group B. Increased lymphocyte levels normalized after 30 min in group A and 90 min in group B. A-aO2 gradient was determined as: group A (294.8 ± 74.3) and group B (321.2 ± 73.3) before X-clamping; group A (132.7 ± 22.7) and group B (236.6 ± 41.5) 2 h after declamping; and group A (72.2 ± 22.7) and group B (189.4 ± 88.9) 6 h after declamping. When pulmonary artery circulation was obstructed during the X-clamping period, leucocyte, neutrophil and lymphocyte sequestration within both lungs increased, and an increased A-aO2 gradient was observed because of tissue damage. To prevent post-operative complications, precautions to maintain normal pulmonary artery circulation are recommended.
Comparison of Immunological and Endocrinological Markers Associated with Major Depression
Authors: Jozuka H , Jozuka E , Takeuchi S , Nishikaze O
Published: February 2013

Natural-killer-(NK)-cell activity and blood levels of interleukin 2 (IL-2), dehydroepiandrosterone (DHEA), DHEA sulphate (DHEA-S) and cortisol were measured in 17 patients with major depression and 10 control subjects. Depression severity was evaluated using the Zung Self-rating Depression Scale. NK-cell activity and IL-2 levels were measured using a chromium-51 release test and an enzyme-linked immunosorbent assay, respectively. Radioimmunoassays were used to measure serum cortisol, DHEA and DHEA-S. As would be expected, patients with major depression had a higher score on the Zung Self-rating Depression Scale than healthy controls. Compared with controls, NK-cell activity and levels of cortisol and DHEA were reduced in patients with major depression, whereas IL-2 levels were increased. No difference was observed in DHEA-S levels between patients and controls. A reduction in NK-cell activity and DHEA levels, and an increase in IL-2 levels appear to be associated with major depression. Whether these changes are the cause or the consequence of the depression remains to be determined.
The Beneficial Effect of Melatonin on Chronic Cyclosporin a Nephrotoxicity in Rats
Authors: Eşrefoğlu M , Kuruş M , Şahna E
Published: February 2013

Cyclosporin A (CsA)-induced nephrotoxicity may be the consequence of oxidative stress. Anti-oxidant agents could be useful in reducing CsA toxicity. In this light microscopy study, tubular dilatation, atrophy, vacuolization and tubulointerstitial fibrosis were observed in rats given CsA, whereas in rats given CsA plus melatonin, no histological changes occurred. It is concluded that melatonin could be useful for reducing the nephrotoxic effects of CsA.
Efficacy and Safety of Azithromycin as Monotherapy or Combined with Metronidazole Compared with Two Standard Multidrug Regimens for the Treatment of Acute Pelvic Inflammatory Disease
Authors: Bevan CD , Ridgway GL , Rothermel CD
Published: February 2013

The objective of the study was to compare the efficacy of azithromycin, alone or with metronidazole, versus two standard multidrug regimens for the treatment of acute pelvic inflammatory disease (PID). Patients with PID were treated with once-daily intravenous (IV) azithromycin 500 mg for 1 day or 2 days followed by once-daily azithromycin 250 mg orally for a total of 7 days, alone or with three-times-daily metronidazole 400 mg or 500 mg IV then orally for a total of 12–14 days. The comparators were either metronidazole + doxycycline + cefoxitin + probenecid or doxycycline + amoxycillin/clavulanate given at standard recommended doses for up to 21 days. In total, 309 patients were treated for PID. The diagnosis was confirmed laparoscopically in 74.8% of patients. Rates of clinical success for azithromycin, alone (97.1%) or with metronidazole (98.1%), were comparable to those for the comparator regimens (94.6%). Eradication rates for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis and anaerobes were also comparable for each of the treatment groups. Both azithromycin regimens were well tolerated. In conclusion, azithromycin, alone or with metronidazole, provides a shorter, simpler treatment option for the successful management of acute PID.
Expression of Interleukin 6 and Its Receptor in Human Gastric and Colorectal Cancers
Authors: Matsuo K , Oka M , Murase K , Soda H , Isomoto H , Takeshima F , Mizuta Y , Murata I , Kohno S
Published: February 2013

Interleukin 6 (IL-6) is a pleiotropic cytokine with many physiological functions. The present study was designed to determine the expression of IL-6 and its receptor (IL-6R) in human gastric and colorectal cancers. Nine gastric- and nine colorectal cancer cell lines were analysed. The IL-6 gene was expressed in two gastric cancer cell lines and one colorectal cancer cell line; however, most of the cancer cell lines studied expressed the IL-6R gene. The level of IL-6 secretion in the gastric cancer cell lines correlated with the level of soluble IL-6R secretion, and was significantly higher (> ~100 pg/ml) than the level of IL-6 secretion in the colorectal cancer cell lines (> ~50 pg/ml). These results suggest that IL-6 may act in a paracrine fashion rather than an autocrine fashion in these cell lines.
Does Adenotonsillectomy Improve Growth in Children with Obstructive Adenotonsillar Hypertrophy?
Authors: Selimoğlu E , Selimoğlu MA , Orbak Z
Published: February 2013

Faltering growth may be associated with adenotonsillar hypertrophy, but its pathophysiological mechanism is unclear. This study included 29 pre-pubertal children with obstructive adenotonsillar hypertrophy, and aimed to investigate the probable difference in energy intake and serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) levels before and 6 months after adenotonsillectomy. Weight and height standard deviation scores, energy intake per kilogram and serum IGF-1 levels were found to be significantly higher 6 months after adenotonsillectomy, indicating that adenotonsillar hypertrophy is associated with poor growth.
Celecoxib is as Efficacious as Naproxen in the Management of Acute Shoulder Pain
Authors: Bertin P , Béhier J-M , Noël E , Leroux J-L
Published: February 2013

This study compared the analgesic efficacy and safety of the cyclo-oxygenase-2 specific inhibitor celecoxib with the non-specific non-steroidal anti-inflammatory drug, naproxen, in patients with acute shoulder pain. Adult patients with shoulder pain, onset within the previous 14 days and shoulder pain of ≥ 40 mm on a 100 mm visual analogue scale (VAS), were treated with oral doses of celecoxib or naproxen for 14 days and followed by a visit at day 42 in a double-blind, randomized study. The primary efficacy assessment was change in maximum pain at rest on a 100 mm VAS at day 14 compared with baseline. In addition, secondary efficacy pain and functional assessments were analysed at baseline, day 14 and day 42. A total of 202 patients were included in the trial (99 celecoxib 400 mg/day; 103 naproxen 1 g/day). The difference in change from baseline at day 14 in maximum pain at rest was not statistically significant between the two treatment groups, but was numerically higher for celecoxib than for naproxen (−47.9 ± 2.5 versus −42.3 ± 2.5, respectively). According to the limits of the 95% confidence interval of the difference between groups (−12.52; 1.38), celecoxib appeared to be at least as effective as naproxen. All secondary efficacy measures followed the same pattern, showing similarity between the two treatments with a trend in favour of celecoxib. The incidences of adverse events were similar for both groups. Fewer patients experienced epigastric pain with celecoxib (seven patients versus 14 with naproxen). This adverse event led to discontinuation in two patients receiving celecoxib and five receiving naproxen. Celecoxib 400 mg/day was at least as effective as naproxen 1 g/day in managing pain in this condition.
The Effects of Prednisolone and Serum Malondialdehyde Levels in Puppies with Experimentally Induced Meconium Aspiration Syndrome
Authors: Kirimi E , Tuncer O , Kösem M , Ceylan E , Tas A , Tasal I , Balahoroğlu R , Caksen H
Published: February 2013

The aim of this study was to investigate the effect of different doses of prednisolone in puppies experimentally induced with meconium aspiration syndrome (MAS). Meconium was collected from human babies in the first day of life and was released into the trachea of 11 newborn puppies to induce MAS. Puppies were treated with 2 mg/kg prednisolone (standard dose), 30 mg/kg prednisolone (megadose) or 0.9% saline, all administered intravenously. The study ended 20 h after meconium aspiration and the lungs were then scored for histopathology. Animals not treated with prednisolone deteriorated after 8 h while respiration rate, oxygenation, pH and partial pressure of carbon dioxide values were better in the prednisolone-treated groups. Histopathology scores were better in the treatment groups compared with the control group, with megadose giving the best result. At the end of the study, serum malondialdehyde levels were significantly higher in the megadose prednisolone group compared with the other two groups. In conclusion, we determined that prednisolone reduced physiological and histological changes in puppies with MAS and that a 30 mg/kg dose was more effective than 2 mg/kg.
A Therapy-Resistant Chronic Leg Ulcer Treated Successfully with Topical Basic Fibroblast Growth Factor
Authors: Kurokawa I , Hayami J , Kita Y
Published: February 2013

We report a patient with rheumatoid arthritis who had a chronic leg ulcer with long-standing resistance to therapy. Topical basic fibroblast growth factor (bFGF) at a dose of 30 μg/day for 3 months was clinically effective in reducing the ulcer area by promoting angiogenesis, re-epithelization, granulation and scar formation. bFGF may be an effective treatment for therapy-resistant leg ulcers.
Transient Blindness following Hysteroscopy
Authors: Karci A , Erkin Y
Published: February 2013

The potential adverse effects resulting from absorption of irrigation fluids during endoscopic procedures are well documented. Glycine, which is commonly used as an irrigation solution, has an inhibitory effect both on the central nervous system and on the retinal cells. We report the case of a woman who developed transient blindness following hysteroscopic myomectomy in which glycine was used as the irrigation solution.
Impact of Side-Effects of Atypical Antipsychotics on Non-Compliance, Relapse and Cost
Authors: Mortimer A , Williams P , Meddis D
Published: February 2013

Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of ~$530 (95% confidence interval [CI] ~$275, $800), and ~$485 (95% CI ~$235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.
Spontaneously Identified Gastric Sarcoidosis: A Report of Three Cases
Authors: Kawaura K , Takahashi T , Kusaka K , Yamakawa J , Itoh T , Kanda T
Published: February 2013

Sarcoidosis is a systemic granulomatous disease, frequently involving the lungs, lymph nodes, eyes and skin. Gastric sarcoidosis is very rare. We report three patients diagnosed initially with gastric sarcoidosis. Two had no other identified involvement, and one had involvement of the lungs and hilar lymph nodes. Gastroscopy was performed because of abdominal discomfort or as a follow-up examination for partial gastrectomy. This revealed atrophic lesions with nodular mucosal changes in the antrum and granular mucosa, and residual gastritis was found at the site of gastroduodenal anastomosis. Non-caseating epitheloid-cell granulomas were found in all patients following histological analysis. Gastroscopy and histopathological findings in gastric mucosal biopsy samples from suspicious sites are essential in establishing an accurate diagnosis of gastric sarcoidosis.
Prevalence and In-Vitro Antimicrobial Susceptibility Patterns of Acinetobacter Strains Isolated from Patients in Intensive Care Units
Authors: Aktas O , Ozbek A
Published: February 2013

Fifty-six Acinetobacter species strains (49 Acinetobacter baumanii, 5 Acinetobacter calcoaceticus, 2 Acinetobacter iwoffii) were detected using both conventional methods and gas chromatography of bacterial fatty acids with the MIDI Sherlock® Microbial Identification System. The susceptibilities of these strains to 16 antimicrobial agents were investigated by the disc-diffusion method according to the National Committee for Clinical Laboratory Standards. The production of extended-spectrum β-lactamases (ESBLs) and inducible β-lactamases (IBLs) by the strains were investigated by the double-discsynergy and disc-approximation methods, respectively. Imipenem was the most effective agent for Acinetobacter baumanii strains (95.9% of strains were sensitive), while meropenem and netilmicin showed moderate activity (87.7% and 79.6% of strains, respectively, responded). Acinetobacter baumanii strains were less sensitive to cefoperazone-sulbactam (53.1%), ofloxacin (51.0%), ciprofloxacin (42.8%), and amikacin (36.7%). Acinetobacter calcoaceticus and Acinetobacter iwoffii strains were sensitive to imipenem, meropenem and netilmicin. IBLs and ESBLs were produced, respectively, by 8.9% and 7.1% of all bacterial strains. The strains isolated were sufficiently sensitive to imipenem, but not to ofloxacin or ciprofloxacin, and were very resistant to amikacin.
Intraportal Donor Bone Marrow Transplantation Improves Intestinal Allograft Survival in Rats under FK506-Based Immunosuppression
Authors: Sun DS , Yagi T , Oyama T , Matsukawa H , Matsuda H , Sadamori H , Inagaki M , Matsuoka J , Iwagaki H , Tanaka N
Published: February 2013

Donor-specific immunosuppression is important in transplant surgery. We examined the effect of intraportal donor-specific bone marrow transplantation on heterotopic small bowel transplantation in the high responder rat combination, ACI to Lewis. The study comprised five treatment groups: untreated controls (group 1); FK506 alone (group 2); low-dose predonine + FK506 (group 3); high-dose predonine + FK506 (group 4); and intraportal donor-specific bone marrow transplantation + FK506 (group 5). Intraportal transplantation was performed pre-operatively and FK506 and predonine given post-operatively. Intestinal allograft survival and changes of intragraft cytokine expression were analysed using the reverse transcription polymerase chain reaction. Allograft survival (mean ± SD) was lowest in group 1 and greatest in group 5. The group 5 treatment regimen also down-regulated interferon-γ and interleukin-2 transcription in the transplanted intestine. Intraportal donor bone marrow transplant combined with FK506 immunosuppression was found therefore to be the most beneficial treatment regimen
Fine-Needle Aspiration as a Diagnostic Tool for Recurrent Tonsillitis
Authors: İnci E , Karakullukçu B , Aygün G , Yaşar H , Enver O , Yağiz C
Published: February 2013

Acute tonsillitis is a common childhood disease, but repeated antibiotic treatment may fail, leading to tonsillectomy. Superficial swab cultures do not sufficiently represent the core bacteria present, but fine-needle aspiration may be a promising diagnostic method. We evaluated 58 patients undergoing tonsillectomy, and took superficial and core swabs, and fine-needle aspirations. Staphylococcus aureus was the most common bacterial pathogen identified, present in 26 out of 50 (52%) positive core cultures, followed by Haemophilus influenza in 13 positive core cultures (26%), and group A β-haemolytic streptococci in 10 positive core cultures (20%). Fine-needle aspiration detected 33 out of 50 positive core cultures (66%), whereas superficial swab culture detected 18 of 50 (36%); the difference being statistically significant. All pathogens detected by superficial swabs and fine-needle aspiration were detected in core cultures. The sensitivity and specificity of fine-needle aspiration were 66% and 100%, respectively, compared with 36% and 100% for superficial swabs. Fine-needle aspiration is therefore a promising method for detecting core bacteria in patients with recurrent tonsillitis.
Clinical Experience with Subxiphoid Pericardiostomy in the Management of Pericardial Effusions: A Study of 240 Cases
Authors: Becit N , Özyazicioğlu A , Ceviz M , Karakelleoğlu Ş , Karapolat S , Koçak H
Published: February 2013

We aimed to assess the effectiveness of subxiphoid pericardiostomy for treating patients with pericardial effusions (PE), and its contribution to defining the aetiology of these effusions. We undertook retrospective analysis of 240 PE patients who underwent subxiphoid pericardiostomy and tube drainage between 1990 and 2000. Echocardiography classified PE as severe in 132 patients, moderate in 99, and mild in nine. The main causes of PE were uraemic, idiopathic and undefined, tuberculous and non-tuberculous pericarditis, malignancy and trauma. Peri-operative myocardial injury requiring sternotomy, and recurrent effusion requiring further surgical intervention, occurred in three and 24 patients, respectively. Histopathological examination assisted the diagnosis in 94% of patients with malignancy, and 96% with tuberculous pericarditis. Overall 30-day mortality was 1.3% and pericardial constriction, requiring pericardiectomy, developed in seven cases. In conclusion, we believe that adults and children with PE can be safely, effectively and quickly managed with subxiphoid pericardiostomy, irrespective of its aetiology.
Immunohistochemical Study of Surgically Excised Choroidal Neovascular Membranes
Authors: Sato T , Kanda T , Iida T , Takahashi T , Kishi S , Hoshino Y
Published: February 2013

We carried out an immunohistochemical investigation of the choroidal neovascular membranes from 12 eyes surgically excised as a result of age-related macular degeneration ( n = 6) or idiopathic choroidal neovascularization ( n = 6). Immunohistochemical staining was performed with antibodies specific for basic transcriptional element binding protein-2, actin or smooth muscle cell 1. In all membranes, the endothelial cells and stromal components around the vessels were immunoreactive for expression of basic transcriptional element binding protein-2, while immunoreactive expression of actin and smooth muscle cell type 1 was found in the surrounding stromal cells. These results suggest that basic transcriptional element binding protein-2, a zinc finger transcription factor, may contribute to the establishment of the choroidal neovascularization observed in the pathogenesis of age-related macular degeneration and idiopathic choroidal neovascularization.
Effects of Glutaraldehyde on Synovial Tissue
Authors: Tosun N , Akpinar F , Dogan A
Published: February 2013

This study investigated the effect of glutaraldehyde on the synovial tissue of rabbits. Four different concentrations of glutaraldehyde solution were injected into one knee and the contralateral glenohumeral joint of rabbits in group A to group D. The concentration levels used in group A and group B were 1000 ppm and 100 ppm, respectively. For group C and group D, samples of rinsing solutions obtained by rinsing arthroscopic equipment with ***1 l or ***2 l of isotonic saline, respectively, after immersion in 2% glutaraldehyde were used. The contralateral knee and ipsilateral glenohumeral joint of the same rabbits were injected with saline and used as control sites.

Rabbits were sacrificed after 1 day, 7 days or 15 days and the histopathological changes in the synovial tissues were compared. The most dramatic inflammatory changes were observed in group A and group B. The histopathological changes were greater after 7 days than after 1 day or 15 days. Group C and group D showed no significant differences when compared with normal synovium. A correlation between the concentration of the glutaraldehyde solution and the number of inflamed joints was observed. Very few or no inflamed joints were seen when samples from rinsing solutions of 1 l or 2 l of saline, respectively, were used.
Moxifloxacin in the Treatment of Acute Maxillary Sinusitis after First-Line Treatment Failure and Acute Sinusitis with High Risk of Complications
Authors: Gehanno P , Berche P , Perrin A
Published: February 2013

This multicentre, prospective study evaluated the efficacy and safety of 7-day oral moxifloxacin (400 mg/day) for treatment of acute maxillary sinusitis after first-line treatment failure (group 1), and acute sinusitis with high risk of complications (group 2). Two hundred and fifty-eight patients with radiologically confirmed acute sinusitis were enrolled by 52 investigators; 216 patients (83.7%) qualified for per protocol efficacy analysis (group 1, n = 175; group 2, n = 41), and 92 for bacteriological analysis. Samples were collected from the middle meatus. The clinical success rate 7-10 days post-treatment was 92.6%. Bacteriological success rates were 95.7% after 3-4 days of treatment, and 97.2% and 95.2%, in group 1 and group 2, respectively, at 7-10 days post-treatment. Drug-related adverse events, including abdominal pain (2.4%), nausea (2.4%) and diarrhoea (1.2%), were reported in 12.2% of patients. Overall, moxifloxacin therapy resulted in rapid bacteriological eradication, with a high rate of clinical success.
Acute Hyposmia in Type 2 Diabetes
Authors: Takayama S , Sasaki T
Published: February 2013

During treatment for type 2 diabetes with a diabetic diet (without medication), a 61-year-old Japanese man suddenly developed hyposmia. The fasting plasma glucose was 208 mg/dl and haemoglobin A1c was 8.6%. On investigation, there were no indications of disease of the brain, or the nasal or paranasal sinuses. The intravenous olfaction test yielded no response, indicating suspected neural hyposmia. After 6 months, the symptoms of hyposmia improved without medication, and the intravenous olfaction test results were normal. This clinical course is very similar to that seen with diabetic neuropathy of the third and sixth cranial nerves. We speculate that hyposmia in this case may have been caused by diabetic mononeuropathy of the first cranial nerve.
Comparison of Prophylactic Anti-Emetic Effects of Ondansetron and Dexamethasone in Women Undergoing Day-Case Gynaecological Laparoscopic Surgery
Authors: Yuksek MS , Alici HA , Erdem AF , Cesur M
Published: February 2013

We aimed to determine the effect of ondansetron and dexamethasone on preventing post-operative nausea and vomiting (PONV). Sixty women undergoing laparoscopic gynaecological surgery were randomized to receive ondansetron 4 mg, dexamethasone 8 mg or saline. Drugs were administered 2 min before induction of anaesthesia, and anaesthesia and post-operative analgesic regimens were standardized. The incidence of PONV in the first 24 h after the operation was 35% in the ondansetron group, 55% in dexamethasone group and 85% in the control group. A significant difference between the groups was only seen in the first 3 h post-operatively. In this period, ondansetron was significantly more effective than dexamethasone and saline, but no differences were seen between dexamethasone and saline. In all treatment groups, post-operative visual analogue scale scores, sedation scores and usage of analgesics were similar. In conclusion, ondansetron, but not dexamethasone, prevented PONV in the first 3 h after gynaecological laparoscopic surgery.
The Effect of Caudal Bupivacaine versus Tramadol in Post-Operative Analgesia for Paediatric Patients
Authors: Özkan S , Poçan S , Bahar A , Çakir O , GÖkben M
Published: February 2013

In this study 20 paediatric surgical patients were randomized to two groups after induction of general anaesthesia. Group 1 received 0.25% bupivacaine (2 mg/kg) and group 2 received 5% tramadol (2 mg/kg) both as a caudal block. Heart rate, mean arterial pressure, arterial oxygen saturation, respiratory rate and pain and sedation scores were recorded at 1, 2, 4, 6, 12 and 24 h post-operatively. Acetaminophen was administered rectally (20 mg/kg) if the pain score was > 3/10. The pain and sedation scores in group 2 were significantly lower compared with group 1. There were no significant differences in heart rate, mean arterial pressure, arterial oxygen saturation and respiratory rate between the two groups. In conclusion, caudal tramadol was superior to bupivacaine in analgesic efficacy and in reducing the need for additional analgesia during the post-operative period in paediatric patients.
Acupressure versus Oxybutinin in the Treatment of Enuresis
Authors: Yuksek MS , Erdem AF , Atalay C , Demirel A
Published: February 2013

We aimed to assess the efficacy of acupressure for treating nocturnal enuresis, compared with oxybutinin. Acupressure was administered to 12 patients by their parents, who had been taught the technique. Pressure was applied at acupuncture points Gv4, Gv15, Gv20, B23, B28, B32, H7, H9, St36, Sp4, Sp6, Sp12, Ren2, Ren3, Ren6, K3 and K5. Twelve control patients received 0.4 mg/kg oxybutinin. Parents were asked to record incidences of bed-wetting and patients and/or parents completed a questionnaire 15 days and 1, 3 and 6 months after the start of treatment. Complete and partial responses after 6 months of treatment were seen in 83.3% and 16.7%, respectively, of patients treated with acupressure, and in 58.3% and 33.3%, respectively, of children who received oxybutinin. In conclusion, nocturnal enuresis can be partially treated by oxybutinin but acupressure could be an alternative non-drug therapy. Acupressure has the advantages of being non-invasive, painless and cost-effective.
Anatomical Characteristics of the Tibial Medullary Canal and Their Implications for Intramedullary Fixation
Authors: Tosun N , Aydinlioğlu A , Akpinar F , Doğan A , Islam C
Published: February 2013

The use of intramedullary fixation methods in the tibia is limited by the anatomical characteristics of this bone. In this study, the shape and degree of axial lateral rotation of the medullary canal were determined in 45 human dry cadaver bones using X-ray and computed tomography examinations and direct measurement of rotation in inserted nails. Forty bones (88.8%) had slight and five bones (11.1%) had excessive anterior bowing along the tibial shaft. Six of the 45 bones (13.3%) had an extremely narrow medullary canal. Axial lateral rotation was demonstrated in the middle third of the medullary canal, being on average (± SD) 32.35 ± 16.25° (range 10-75°). This study revealed that extreme narrowing of the medullary canal, axial lateral rotation of the medullary canal, and extreme anterior bowing of the tibial shaft are the anatomical characteristics most likely to cause difficulties when using intermedullary fixation in the tibia.
Suppression of Alveolar Bone Resorption by Etidronate Treatment for Periodontal Disease: 4- to 5-Year Follow-up of Four Patients
Authors: Takaishi Y , Ikeo T , Miki T , Nishizawa Y , Morii H
Published: February 2013

Four women with periodontitis received intermittent cyclical etidronate (etidronate administered orally at a dose of 200 mg/day for 2 weeks, at intervals of 10-12 weeks or 6 months) for 4-5 years in addition to ordinary dental therapy. Alveolar bone density was measured using a new method comparing the percentage increase in density. Mean alveolar bone density increased significantly during intermittent cyclical etidronate treatment. Significant reductions were observed in the mobility of the teeth and the depth of periodontal pockets. There were significant correlations between alveolar bone density and both mobility of the teeth and the depth of the alveolar pockets. It is concluded that increases in alveolar bone density are associated with the clinical benefits of etidronate in the treatment of periodontitis.
Wellens' Syndrome: A Case Report
Authors: Kardesoglu E , Celik T , Cebeci BS , Cingozbay BY , Dincturk M , Demiralp E
Published: February 2013

The pattern of clinical findings and electrocardiography (ECG) changes known as Wellens' syndrome is associated with significant stenosis of the proximal left anterior descending coronary artery. Cases can be classified according to the ECG pattern into type 1 (biphasic T waves) or type 2 (deeply inverted T waves, especially in leads V2 and V3). We present here an unusual case of Wellens' syndrome in which the ECG pattern changed from type 2 to type 1 during observation, and in which the coronary lesion was in the middle rather than the proximal part of the left anterior descending artery.
Effects of Propofol Target-Controlled Infusion on Haemodynamic and Respiratory Changes with Regard to Safety
Authors: Lee YS
Published: February 2013

We investigated the haemodynamic and respiratory effects of propofol target-controlled infusion (TCI) during spontaneous ventilation. We studied 20 patients scheduled for elective orthopaedic surgery who were classified as American Society of Anesthesiologists physical status I. During spontaneous ventilation, haemodynamic, respiratory and electroencephalographic variables were measured. Oxygen flow was maintained at 5 1/min using a semi-closed system and a close-fitting face mask. All measurements were obtained before the propofol TCI and at each propofol effect-site concentration (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0 μg/ml). Changes in Bispectral Index Score, systolic blood pressure, diastolic blood pressure, end tidal carbon dioxide tension and heart rate were negatively correlated with propofol effect-site concentrations. Despite maintaining oxygen saturation (> 99%), apnoea and blood pressure reductions were abruptly induced as the propofol effect-site concentration increased. We therefore recommend careful monitoring of haemodynamic and respiratory function during spontaneous ventilation using propofol TCI.
Enhanced Effects of Combined Bu-Zhong-Yi-Qi-Tang (TJ-41) and Interleukin-18 on the Production of Tumour Necrosis Factor-α and Interferon-γ in Human Peripheral Blood Mononuclear Cells
Authors: Tamura R , Takahashi HK , Xue D , Kubo S , Saito S , Nishibori M , Iwagaki H , Tanaka N
Published: February 2013

Co-stimulatory molecules play important roles in immune responses. We investigated the effect of Bu-Zhong-Yi-Qi-Tang (TJ-41) on the expression of intercellular adhesion molecule-1 (ICAM-1), B7.1 and B7.2 by peripheral blood mononuclear cells stimulated by interleukin-18 (IL-18) using fluorescence-activated cell sorter analysis. TJ-41 increased IL-18-induced ICAM-1 and B7.2 expression, resulting in enhanced production of tumour necrosis factor-a and interferon-g. These results suggest that TJ-41 enhances IL-18-induced cell-mediated immunity and may enhance host defence mechanisms against pathogens.
Evaluation of Ion Release from Two Base-Metal Alloys at Various pH Levels
Authors: Denizoğlu S , Duymuş Z YeşLil , Akyalçin Ş
Published: February 2013

We examined the influence of salivary pH on the corrosion of two base-metal alloys. Cobalt — chromium (Co — Cr) and nickel — chromium (Ni — Cr) alloy samples were created and submerged in artificial saliva of different pH values (pH 4, pH 5 and pH 7). The amount of each ion present in solution 1 month later was measured by flame atomic absorption spectrophotometry. Statistical analysis showed that pH significantly affected total and Co ion release, but not Ni or Cr ion release. The alloy type did not affect total ion release, but was significant for Cr ion release. Alloy — pH interaction significantly affected Cr and total ion release. To prevent metal particle release, the alloys used for dental restoration should, whenever possible, be made from noble metals and corrosion-resistant alloys.
Identification of the Culprit Artery Involved in Inferior Wall Acute Myocardial Infarction Using Electrocardiographic Criteria
Authors: Bayram E , Atalay C
Published: February 2013

We tested whether particular electrocardiogram (ECG) changes can identify the right coronary (RCA) or left circumflex (LCX) artery as the responsible vessel in inferior wall acute myocardial infarction (AMI) in 73 patients. A standard 12-lead ECG was performed within 6 h of onset of chest pain. Coronary angiography was performed between 1 week and 6 weeks after the infarction. RCA and LCX lesions were detected in 53 and 20 patients, respectively.

The most useful ECG parameters for implicating the RCA were a higher ST elevation in lead III than lead II (specificity 94%, sensitivity 86%) and an S/R wave ratio > 0.33 plus ST segment depression > 1 mm in lead aVL (specificity 94%, sensitivity 92%). Absence of these criteria was associated with LCX occlusion (specificity 100%, sensitivity 87%). These results indicate that composite ECG criteria are useful in predicting the artery involved in inferior wall AMI.
Strict Fluid Volume Control and Left Ventricular Hypertrophy in Hypertensive Patients on Chronic Haemodialysis: A Cross-Sectional Study
Authors: Gunal AI , Karaca I , Aygen B , Yavuzkir M , Dogukan A , Celiker H
Published: February 2013

Left ventricular hypertrophy (LVH) is very common in haemodialysis patients. We measured left ventricular mass in three groups of haemodialysis patients: group A ( n = 40) were normotensive and receiving a strict salt-restricted diet; group B ( n = 23) were normotensive and receiving antihypertensive drugs; and group C ( n = 43) were hypertensive despite anti-hypertensive drug treatment. The interdialytic weight gain in group B and group C was significantly higher than in group A; the mean left atrial index and left ventricular end-systolic and end-diastolic diameter indices were all higher in group B than in group A. The interventricular septum and posterior wall were significantly thicker in group B and group C than group A, resulting in a higher left ventricular mass index. Left ventricular systolic and diastolic function parameters were slightly better in group A than in the other groups. These results show that strict fluid volume control decreases blood pressure, reduces dilated cardiac compartments and corrects LVH more effectively than lowering blood pressure without correcting the volume overload.
Cefepime versus Ceftazidime for Treatment of Pneumonia
Authors: Konstantinou K , Baddam K , Lanka A , Reddy K , Zervos M
Published: February 2013

Consecutive patients with pneumonia, treated with cefepime ( n = 66) or ceftazidime ( n = 132), were evaluated in a retrospective, observational study. There was no significant difference between the two treatment groups with respect to age, underlying diseases, acute physical and chronic health evaluation score, intensive care unit admission, presence of sepsis, community or hospital acquisition, causative organism, duration of therapy, death, cure or improvement in infection, adverse events, superinfections, presence of vancomycin-resistant enterococcus (VRE) and resistance to therapy. Post-therapy hospitalization (days) and vancomycin co-administration were significantly lower, and time to vancomycin initiation significantly higher, in the cefepime compared with the ceftazidime group. The results suggest a trend towards less resistance on therapy, less VRE, reduced vancomycin use and shorter post-therapy hospitalization in patients treated with cefepime compared with ceftazidime. The clinical outcomes for hospitalized patients treated for serious pneumonia were similar between the two groups.
Randomized Study of the Efficacy and Safety of Oral Elderberry Extract in the Treatment of Influenza A and B Virus Infections
Authors: Zakay-Rones Z , Thom E , Wollan T , Wadstein J
Published: February 2013

Elderberry has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have antiviral activity against influenza and herpes simplex. We investigated the efficacy and safety of oral elderberry syrup for treating influenza A and B infections. Sixty patients (aged 18-54 years) suffering from influenza-like symptoms for 48 h or less were enrolled in this randomized, double-blind, placebo-controlled study during the influenza season of 1999-2000 in Norway. Patients received 15 ml of elderberry or placebo syrup four times a day for 5 days, and recorded their symptoms using a visual analogue scale. Symptoms were relieved on average 4 days earlier and use of rescue medication was significantly less in those receiving elderberry extract compared with placebo. Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza. These findings need to be confirmed in a larger study.
Autoimmunity to Heat Shock Protein 40 in Ulcerative Colitis
Authors: Sato S , Oka M , Noguchi Y , Soda H , Tsurutani J , Nakamura Y , Kitazaki T , Mizuta Y , Takeshima F , Murase K , Murata I , Ohtsuka K , Kohno S
Published: February 2013

Autoantibodies against heat shock protein 40 (HSP40) and their clinical significance in ulcerative colitis (UC) have not been evaluated before. Twenty-six tissue specimens of inflamed areas from patients with UC, 16 from patients with Crohn's disease (CD) and 16 endoscopically normal tissues were analysed for HSP40 expression. Sera from 47 patients with UC and 44 healthy volunteers were examined for the presence of autoantibodies against HSP40 by enzyme-linked immunosorbent assay test. Immunohistochemistry showed that 17 out of 26 specimens from UC patients, one specimen from a CD patient and one normal tissue specimen were positive for HSP40. Most HSP40-positive cells expressed CD68. Higher titres of anti-HSP40 autoantibodies were detected in sera from UC patients compared with healthy volunteers. In patients with inactive disease, those with proctitis or left-sided colitis had higher titres of anti-HSP40 autoantibodies than those with total colitis. Our study suggests that autoimmunity against HSP40 may have a beneficial effect in UC patients by limiting the extent of the disease.