bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Scrotal Pain in Children – Ten Years’ Experience
Authors: Varga J. , Zivkovic D. , Grebeldinger S. , Somer D.
Published: December 2006

Introduction: Acute scrotal pain sometimes requires prompt surgical intervention and therefore accurate diagnosis of different etiologies of acute scrotal pain has great therapeutical and prognostic significance. The aim of this study was to analyze the incidence, symptomatology and results of treatment of acute scrotal pain in children. Material and Method: The study included patients hospitalized at the Pediatric Surgery Clinic with a diagnosis of acute scrotal pain. We retrospectively analyzed anamnestic data (age of patient and duration of anamnesis prior to admission), clinical parameters obtained during physical examination, mode of treatment (operative or medical), intraoperative findings and (postoperative) treatment. Results: The study included 256 patients with acute scrotal pain, aged from several hours up to 17 years of age (average 9.73 years). The average duration of symptoms prior to admission was 56.74 h. Acute epididymitis was diagnosed in 110 patients (43.0%), torsion of the testicular appendage in 104 patients (40.6%), torsion of the testis in 30 patients (11.7%) and other pathologies in another 12 patients. 166 patients (64.8%) underwent surgery, 42 patients with orchiepididymitis (38.2%), 92 patients with torsion of the testicular appendage (88.5%), and 16.6% of the patients with other pathologies. 22 patients with torsion of the testis underwent surgery (73.3%), while the rest of the 8 patients underwent manual detorquation of the testis. Conclusion: Regardless of the etiology of the acute scrotal pain, it is of great importance that the patient seeks medical assistance promptly. It is therefore important to educate the parents and patients about the problems related to acute scrotal pain.
Multiple Intravesical Instillations of Low-Dose Resiniferatoxin in the Treatment of Refractory Interstitial Cystitis
Authors: Peng Chung-Hsin , Kuo Hann-Chorng
Published: December 2006

Background: Current medications used in the treatment of interstitial cystitis (IC) have limited efficacy. This prospective study investigated the efficacy of multiple intravesical instillations of resiniferatoxin (RTX) at the concentration of 10 nM. Methods: Patients with proven IC previously treated with traditional medications for more than 6 months without clinical benefit were enrolled. They were excluded if bladder outlet obstruction or urinary tract infection was present. Intravesical instillation of low-dose RTX (10 nM) once weekly for 4 weeks was performed at the outpatient department. International Prostate Symptom Score (IPSS), 5-Point Pain Scale, and Quality of Life Index (QOL Index) were recorded. A videourodynamic study was done at baseline and 3 months after treatment. Results: The therapeutic results and urodynamic parameters were compared between baseline and 3 months. Thirteen patients, including 10 women and 3 men, were enrolled in this study. The mean duration of IC symptoms was 4.4 ± 2.5 years. The mean duration of active treatment was 15.3 ± 8.6 months. One female patient dropped out due to severe bladder pain after RTX instillation. Among the 12 patients who completed the study treatment, subjective assessment revealed that 2 had an excellent therapeutic result, 5 had an improved result and 5 remained unchanged from baseline. The overall satisfactory rate was 58.3%. IPSS, 5-Point Pain Scale, and QOL Index were significantly decreased after RTX treatment. There was no significant increase in mean functional bladder capacity or change in urodynamic parameters. No serious adverse event occurred after RTX treatment. Conclusions: This study suggests that multiple intravesical instillations of RTX at the concentration of 10 nM are effective in relieving lower urinary tract symptoms in patients with refractory IC. The treatment is tolerable and suitable for use on an outpatient clinic basis.
Hyperbaric Oxygen Therapy Attenuates Renal Ischemia/Reperfusion Injury in Rats
Authors: Solmazgul Emrullah , Uzun Gunalp , Cermik Hakan , Atasoyu Enes M. , Aydinoz Secil , Yildiz Senol
Published: December 2006

Objective: Renal ischemia/reperfusion (I/R) injury occurs in both native and transplanted kidneys. Hyperbaric oxygen (HBO) has been shown to prevent I/R injury in different tissues. The aim of this study was to evaluate the effect of HBO on renal I/R injury in rats. Materials and Methods: Sprague-Dawley rats were randomly assigned to one of three groups. The Control group (n = 6) received right nephrectomy. The I/R (n = 6) and I/R+HBO groups (n = 6) received 30 min left renal ischemia followed by 24 h of reperfusion after right nephrectomy. The I/R+HBO group (n = 6) received additional HBO therapy for 60 min at 2.5 absolute atmospheres starting at the initial 15th minute of reperfusion. Results: In the I/R group, blood urea nitrogen (BUN) and creatinine levels increased significantly compared with the Control and I/R+HBO groups (p < 0.05). BUN and creatinine levels were similar in the Control and I/R+HBO groups. Kidney samples from I/R group rats revealed severe tubular damage and neutrophil infiltration at histopathological examination. The animals treated with HBO showed markedly improved lesions and less neutrophil infiltration compared with the I/R group (p < 0.05). Conclusions: HBO exhibited marked protection against I/R injury in this study as measured using BUN and creatinine levels and renal histopathology. However, further studies are needed to clarify the renoprotective effect of HBO on I/R injury.
Late Recurrence of a Prostatic Adenocarcinoma as a Solitary Splenic Metastasis
Authors: Compérat Eva , Azzouzi Abdel-Rahmène , Chartier-Kastler Emmanuel , Ménégaux Fabrice , Capron Frédérique , Richard François , Charlotte Frédéric
Published: December 2006

Splenic metastases of solid tumors are exceptional. We report the firstcaseof an isolated splenic metastasis from prostate carcinoma, 5 years after radical prostatectomy. The splenic tumor was revealed by a pain and progressive increase in the serum prostate-specific antigen (PSA) level. Histology of the spleen showed an adenocarcinoma immunostained with cytokeratin and PSA markers. The patient remained asymptomatic and his serum PSA level was within normal limits 17 months after the splenectomy. This case suggests that splenic metastasis might be the result of the growth of an early blood-borne micrometastasis within the spleen after a period of clinical latency.
Female Urethral Duplication: An Unusual Condition
Authors: Han R. , Helgee N. , Zammit P. , Bafaloukas N. , Buchholz N.P.N.
Published: December 2006

We present the case of a 34-year-old woman who presented with a stone fragment stuck near her distal urethra without obstruction of her urinary flow. During an attempt to explore and remove the fragment, she was discovered to have complete urethral duplication with the stone stuck in one of two distal urethral orifices. This represents an extremely rare variant of a very unusual congenital anomaly, even more so as it occurs usually in male patients. Embryology, etiology, and clinical appearance of this rare anomaly are discussed.
Giant Renal Calculus in a Solitary Functioning Kidney
Authors: Girgin Cengiz , Sezer Akif , Şahin Oğuz , Öder Mehmet , Dinçel Çetin
Published: December 2006

We report a case of giant renal calculus 230×140 mm in size and weighing 1,350 g in a solitary functioning kidney treated by nephrolithotomy. A 47-year-old man presented with right lumbar pain, abdominal mass and microscopic hematuria. Physical examination revealed a stony hard mass on the right side of the abdomen, extending from the subcostal region to the iliac crest. A giant renal calculus in his right kidney and atrophic nonfunctioning left kidney was diagnosed by ultrasonography, IVP and CT scan. Right nephrolithotomy was performed. Analysis revealed a calcium phosphate stone. This case is the largest and the heaviest stone reported in the literature in a solitary functioning kidney.
Effect of Leptin Administration on Ovulation in Food-Restricted Rhesus Monkeys
Authors: Lujan Marla E. , Krzemien Alicja A. , Reid Robert L. , Van Vugt Dean A.
Published: December 2006

A chronic negative energy balance due to low nutritional intake or increased energy expenditure alters several neuroendocrine axes. The reproductive and thyroid axes are inhibited while the adrenal axis is stimulated. In primates, anovulation resulting from a chronic negative energy balance is a condition often referred to as nutritional amenorrhea. The objective of the current study was to determine if hypoleptinemia induced by dietary restriction is responsible for these neuroendocrine changes, particularly anovulation. Five rhesus monkeys had their dietary intake gradually reduced to inhibit ovulation. Dietary restriction inhibited follicle-stimulating hormone (FSH) and triiodothyronine (T3) secretion and stimulated cortisol release. Recombinant human leptin (rhleptin) administered by continuous infusion into the lateral ventricle for 16 weeks inhibited cortisol secretion but failed to stimulate FSH, T3 or ovulation. An immune response to rhleptin was noted after 3 weeks of leptin administration. Realimentation resulted in weight gain and reversed all endocrine responses to dietary restriction, including ovulation. These results do not support a role for reduced leptin secretion in anovulation induced by dietary restriction. The inability of rhleptin to reverse anovulation induced by a negative energy balance in monkeys is in contrast to its stimulatory effect on ovulation in women with functional hypothalamic amenorrhea. Different outcomes may be attributed to the degree of negative energy balance, the immune response generated by interspecies leptin administration, and/or other experimental variables such as dose or route of administration. Attributing opposing outcomes to species differences is unwarranted until these variables can be further examined.
The Fly as a Model for Neurodegenerative Diseases: Is It Worth the Jump?
Authors: Cauchi Ruben J. , van den Heuvel Marcel
Published: December 2006

Neurodegenerative diseases are responsible for agonizing symptoms that take their toll on the fragile human life. Aberrant protein processing and accumulation are considered to be the culprits of many classical neurodegenerative diseases such as Alzheimer’s disease, tauopathies, Parkinson’s disease, amyotrophic lateral sclerosis, hereditary spastic paraplegia and various polyglutamine diseases. However, recently it has been shown that toxic RNA species or disruption of RNA processing and metabolism may be partly to blame as clearly illustrated in spinal muscular atrophy, spinocerebellar ataxia 8 and fragile X-associated tremor/ataxia syndrome. At the dawn of the twenty-first century, the fruit fly or Drosophila melanogaster has taken its place at the forefront of an uphill struggle to unveil the molecular and cellular pathophysiology of both protein- and RNA-induced neurodegeneration, as well as discovery of novel drug targets. We review here the various fly models of neurodegenerative conditions, and summarise the novel insights that the fly has contributed to the field of neuroprotection and neurodegeneration.
Hemorrhage Results in Hepatic Insulin-Sensitizing Substance-Dependent Insulin Resistance Mediated by Somatostatin in Rats
Authors: Seredycz Larissa I. , Lautt W. Wayne
Published: December 2006

Background/Aims: Acute hemorrhage results in hyperglycemia regulated in a redundant manner by adrenal catecholamines and hepatic sympathetic nerves. In addition, insulin secretion is suppressed and insulin resistance is accounted for completely by elimination of the hepatic insulin-sensitizing substance (HISS) component of insulin action. Blockade of HISS action secondary to blood loss leads to a state known as HISS-dependent insulin resistance (HDIR) which results in a decrease in the glucose disposal action of insulin by 33 ± 3%. Methods: This paper describes nine studies that have explored the neuroendocrine control of HDIR that is produced in response to the stress of blood loss. The rapid insulin sensitivity test (RIST), a transient euglycemic clamp, was used to measure insulin sensitivity. To test the role of the adrenergic system, α- and β-adrenergic receptor antagonists, phentolamine and propranolol, were tested for the ability to block HDIR produced by hemorrhage. Results: Neither intervention was effective (32 ± 6 and 36 ± 3%, respectively). Exogenous somatostatin was shown to produce HDIR that could be blocked by the somatostatin receptor antagonist, cyclosomatostatin. Cyclosomatostatin completely blocked the development of HDIR that occurred following hemorrhage (RIST index 214 ± 9 control, 218 ± 9 mg glucose/kg body weight after cyclosomatostatin plus hemorrhage). Conclusions: The adrenergic system is not involved in producing HDIR in response to hemorrhage. Somatostatin appears to be the hormonal regulator of this response and it is suggested that the somatostatin derives from a neural origin within the liver.
Characterization of Two Novel Missense Mutations in the AQP2 Gene Causing Nephrogenic Diabetes Insipidus
Authors: Iolascon Achille , Aglio Veruska , Tamma Grazia , D’Apolito Maria , Addabbo Francesco , Procino Giuseppe , Simonetti Maria Carmela , Montini Giovanni , Gesualdo Loreto , Debler Erik W. , Svelto Maria , Valenti Giovanna
Published: December 2006

Here, we report the aquaporin 2 (AQP2) mutational analysis of a patient with nephrogenic diabetes insipidus heterozygote due to two novel missense mutations. Direct sequencing of DNA in the male patient revealed that he was compound heterozygote for two mutations in the AQP2 gene: a thymine-to-adenine transversion at position 450 (c.450T>A) in exon 2 and a guanine-to-thymine at nucleotide position 643 (c.643G>T) in exon 4. The double heterozygous 450T>A and 643G>T transversion causes the amino acid substitution D150E and G215C. Direct sequencing of exons 2 and 4 of the AQP2 gene from each of the parents revealed that the c.450T>A mutation was inherited from the father while the c.643G>T mutation was inherited from the mother. Analysis of AQP2 excretion demonstrated that no AQP2 was detectable in the urine of the proband, whereas normal AQP2 levels were measured in both parents. When expressed in renal cells, both proteins were retarded in the endoplasmic reticulum and no redistribution was observed after forskolin stimulation. Of note, homology modeling revealed that the two mutations involve two highly conserved residues providing important clues about the role of the wt residues in AQP2 stability and function.
Comparison of Essential Oils from Three Plants for Enhancement of Antimicrobial Activity of Nitrofurantoin against Enterobacteria
Authors: Rafii Fatemeh , Shahverdi Ahmad R.
Published: December 2006

Background: Piperitone from plant essential oils enhancesbactericidal activities of nitrofurantoin and furazolidone against bacteria from the family Enterobacteriaceae. In this study, the essential oils of spearmint (Mentha spicata L.), dill (Anethum graveolens L.) and peppermint (Mentha piperita L.)were screened for augmentation of nitrofurantoin activity and the most active components were determined. Method: The effects of essential oils and their components on the bactericidal activity of nitrofurantoin against Enterobacter cloacae were studied using disk-diffusion and agar-dilution methods. The composition of essential oils was studied using gas chromatography-mass spectrometry. Results:M. spicata and A. graveolens oils exhibited the highest effects. Gas chromatography-mass spectrometry analysis showed that the oils of these two plants contained 40.12 and 20.32% carvone, respectively. Pure carvone and piperitone equally increased the bactericidal activity of nitrofurantoin. Other ingredients of essential oils, including camphor, limonene and menthone, were less effective.
Interactions of Antiretroviral Drugs with Anti-Infectives and Other Antiretrovirals
Authors: Pontali Emanuele
Published: December 2006

Combination antiretroviral (ARV) treatment is a potent and effective therapy for human immunodeficiency virus infection. Unfortunately, ARV drugs frequently interact among themselves, as well as with other anti-infectives. These interactions determine positive or negative consequences resulting in recommendations to avoid some combinations or to adjust the dosage of coadministered drugs. The effective clinical use of ARVs requires deep knowledge of interaction mechanisms and the consequent recommendations when coadministering interacting ARVs with other anti-infectives. A brief review of the present knowledge on interactions of ARVs with anti-infective drugs is presented.
Two-Photon Microscopy of Vital Murine Elastic and Muscular Arteries
Authors: Megens R.T.A. , Reitsma S. , Schiffers P.H.M. , Hilgers R.H.P. , De Mey J.G.R. , Slaaf D.W. , oude Egbrink M.G.A. , van Zandvoort M.A.M.J.
Published: December 2006

Understanding vascular pathologies requires insight in the structure and function, and, hence, an imaging technique combining subcellular resolution, large penetration depth, and optical sectioning. We evaluated the applicability of two-photon laser-scanning microscopy (TPLSM) in large elastic and small muscular arteries under physiological conditions. Elastic (carotid) and muscular (uterine, mesenteric) arteries of C57BL/6 mice were mounted in a perfusion chamber. TPLSM was used to assess the viability of arteries and to visualize the structural components elastin, collagen, nuclei, and endothelial glycocalyx (EG). Functionality was determined using diameter changes in response to noradrenaline and acetylcholine. Viability and functionality were maintained up to 4 h, enabling the assessment of structure-function relationships. Structural vessel wall components differed between elastic and muscular arteries: size (1.3 vs. 2.1 µm) and density (0.045 vs. 0.57 µm–2) of internal elastic lamina fenestrae, smooth muscle cell density (3.50 vs. 1.53 µm–3), number of elastic laminae (3 vs. 2), and adventitial collagen structure (tortuous vs. straight). EG in elastic arteries was 4.5 µm thick, covering 66% of the endothelial surface. TPLSM enables visualization and quantification of subcellular structures in vital and functional elastic and muscular murine arteries, allowing unraveling of structure-function relationships in healthy and diseased arteries.
Facial Expressions and Personality: A Kinematical Investigation during an Emotion Induction Experiment
Authors: Mergl Roland , Vogel Michael , Prässl Anuschka , Graf Birgit , Karner Max , Mavrogiorgou Paraskevi , Hegerl Ulrich , Juckel Georg
Published: December 2006

Background/Aims: In order to elucidate the relationship between personality traits and expression of positive emotions in healthy volunteers, standardized personality inventories and kinematical analysis of facial expressions can be helpful and were applied in the present study. Methods: Markers fixed at distinct points of the face emitting ultrasonic signals at high frequency gave a direct measure of facial movements with high spatial-temporal resolution. Forty-six healthy participants (mean age: 40.7 years; 20 males, 26 females) watching a witty movie (‘Mr. Bean’) were investigated. Results: Speed of ‘laughing’ was associated with higher scores on Zuckerman’s Sensation Seeking Scale and NEO-FFI (Openness to Experience). Conclusion: Kinematical analysis of facial expressions seems to reflect sensation seeking and related personality styles. Higher speed of facial movements in sensation seekers suggests lowered serotonergic function.
Asymmetrically Altered Integrity of Cingulum Bundle in Posttraumatic Stress Disorder
Authors: Kim Seog Ju , Jeong Do-Un , Sim Minyoung E. , Bae Soojeong C. , Chung Ain , Kim Minue J. , Chang Kee Hyun , Ryu Jeong , Renshaw Perry F. , Lyoo In Kyoon
Published: December 2006

Previously, our group reported the altered white matter tract integrity of the left anterior cingulate in posttraumatic stress disorder (PTSD) in whole-brain exploration. Current study intended to explore whether the alteration was more prominent in any specific regions of the cingulum bundle. Diffusion tensor images of 21 PTSD subjects and 21 healthy comparison subjects were acquired. Eight isocubic regions of interest (ROIs), i.e. bilateral rostral, subgenual, dorsal, and upper cingulum bundle, were selected. Fractional anisotropy values in each ROI, which indicate the white matter tract integrity, were measured and compared between groups. Relative to comparison subjects, PTSD subjects had significantly smaller fractional anisotropy values in the left side of rostral, subgenual and dorsal cingulum bundle (26.7, 25.0, 22.2% decrease, respectively), but not in the right side ROIs. We report an asymmetrical alteration of the cingulum bundle in PTSD.
Effects of Caffeine on Electrophysiological and Neuropsychological Indices after Sleep Deprivation
Authors: Deslandes Andréa , Ferreira Camila , Veiga Heloisa , Cagy Maurício , Piedade Roberto , Pompeu Fernando , Ribeiro Pedro
Published: December 2006

Caffeine is regarded as a central nervous system (CNS) stimulant. The goal of this study was to analyze electrophysiological, motor, cognitive and behavioral changes produced by caffeine ingestion after sleep deprivation. Ten subjects were evaluated after sleep deprivation, comparing the ingestion of either 400 mg of caffeine or placebo, in a double-blind randomized study. The variables analyzed were: quantitative EEG, the event-related potential (ERP-P300) and cognitive responses. The most significant quantitative EEG results, which were characterized by moment × treatment interactions, were seen in α and Θ relative power variables. A significant decrease in relative α and Θ was observed in the caffeine group after sleep deprivation. In relation to caffeine stimulant effects, there were no significant differences in the other parameters.
Increased Omega Complexity and Decreased Microstate Duration in Nonmedicated Schizophrenic Patients
Authors: Irisawa Satoshi , Isotani Toshiaki , Yagyu Takami , Morita Sachi , Nishida Keiichiro , Yamada Keizo , Yoshimura Masafumi , Okugawa Gaku , Nobuhara Kenji , Kinoshita Toshihiko
Published: December 2006

To explore brain functions in schizophrenic patients, the global analytic strategy of multichannel EEG was performed that combines measures of global complexity (Ω), total power (Σ) and generalized frequency (Φ), and EEG microstate analysis was applied to multichannel EEG data for 24 nonmedicated patients and 24 healthy subjects. The patients had higher Ω and Σ values, and lower Φ values compared with healthy subjects. Three topographical classes were obtained from all EEG data by EEG microstate analysis. The mean duration of one topographical class in the patients was shortened compared to healthy subjects. These results indicated looser cooperativity, or decreased connectivity of the active brain process and deviant brain information processing in schizophrenic patients.
Autumn Peak in Shooting Suicides of Children and Adolescents from Northern Finland
Authors: Lahti Anniina , Räsänen Pirkko , Karvonen Kaisa , Särkioja Terttu , Meyer-Rochow V. Benno , Hakko Helinä
Published: December 2006

Suicide is one of the leading causes of death among adolescents worldwide. Studies on the seasonal pattern of youth suicides are rare and the results are very contradictory and heterogeneous. Generally, suicide methods affect the pattern of suicide seasonality. Shooting is the most common suicide method among Finnish adolescents. We investigated whether shooting suicides of victims aged less than 18 years are correlated with a specific period of the year. Also, the seasonal pattern of shooting suicides in adolescents was compared with that of adult victims. Our data comprised 42 adolescent suicide victims and, for comparison, 1,926 adult suicide victims over the years 1988 to 2004 from Northern Finland.Of these, 59.5% (n = 25) of the adolescents and 28.8% (n = 554) of the adults had committed suicide by shooting.We observed that shooting suicides among the under-aged showed a significant peak in autumn (ratio 2.70, 95% CI: 1.97–3.42), while those of adult victims peaked in spring (ratio 1.19, 95% CI: 1.05–1.35). The monthly pattern of suicides correlated significantly with the mean duration of daily sunshine hours (trailing by 3 months) in the under-aged (r = 0.67, p = 0.016), but not in the adults (r = 0.06, p = 0.854). The role of firearm availability, psychosocial factors such as start of the school year, and some biological factors are discussed.
The Effect of Dietary Habits and Socioeconomic Status on the Prevalence of Iron Deficiency in Children of Northern Greece
Authors: Gompakis Nikolaos , Economou Marina , Tsantali Chaido , Kouloulias Vassilios , Keramida Maria , Athanasiou-Metaxa Miranda
Published: December 2006

Backround: Despite encouraging reports concerning the declining prevalence of iron deficiency, this easily preventable disorder is still an existing problem in presumably developed regions. Objective: To evaluate the prevalence of iron deficiency and relevant anemia in children residing in Northern Greece and to study possible associations. Design: 3,100 children aged 8 months to 15 years were evaluated. Socioeconomic status was determined based on the parents’ profession and place of residence. Nutrition habits were also evaluated. Results: The incidence of iron deficiency was found to be 14% and that of iron deficiency anemia was 2.9%, with a higher prevalence in children younger than 2 years of age. The place of residence was the most significant factor in relation to the development of iron depletion in the children studied. Additional independent factors were revealed to be breast-feeding, meat-containing meal consumption and the consumption of non-home-cooked meals. Conclusion: Iron deficiency remains prevalent in Northern Greece, mainly affecting the vulnerable toddler group. Nutritional iron deficiency is still a severe public health problem even in what are considered to be developed regions. An improvement of dietary habits and an upgrading of semiurban areas should contribute substantially to decreasing the prevalence of iron depletion in Greek children.
sCD40 Ligand Determined in Maternal and Umbilical Cord Blood in Pregnancies Complicated by Pre-Eclampsia with and without Intrauterine Growth Retardation
Authors: Laskowska Marzena , Laskowska Katarzyna , Leszczyńska-Gorzelak Bożena , Oleszczuk Jan
Published: December 2006

Objective: The aim of this study was determination and comparative analysis of the maternal and umbilical cord sCD40L serum levels in pregnancies complicated by pre-eclampsia with and without intrauterine growth retardation (IUGR) and in normotensive pregnancies. Patients and Methods: The study was carried out on 16 patients with singleton pregnancies complicated by severe pre-eclampsia with appropriate-for-gestational-age weight infants and 14 pregnant patients with severe pre-eclampsia complicated by IUGR. The control group consisted of 13 healthy normotensive delivering patients. Five milliliters of blood were taken by venipuncture from each pre-eclamptic patient and from each woman from the control group before active phase of labor and 5 ml of umbilical vein blood were taken immediately after delivery and collected in sterile tubes. Maternal and umbilical serum sCD40L concentrations were estimated using a sandwich ELISA assay. Results and Conclusions: Our results reveal the higher levels of maternal and umbilical sCD40L serum levels in pregnancy complicated by pre-eclampsia with and without IUGR. The mean maternal values were 4.022 ± 2.399 ng/ml in group P, 3.914 ± 2.824 ng/ml in group PI and 0.885 ± 0.064 ng/ml in healthy controls. The mean umbilical values were 2.633 ± 1.984 ng/ml in group P, 2.703 ± 1.996 ng/ml in group PI and 1.112 ± 0.436 ng/ml in the control group. It seems that these higher concentrations of sCD40L protect maternal immune cells bearing CD40 receptor from Fas-mediated apoptosis. Our findings may suggest also enhanced platelet activation in pre-eclamptic patients. It may be one of the factors responsible for the enhanced procoagulatory and proinflammatory properties, and increased cytokine production, and endothelial cell dysfunction in pregnancies complicated by pre-eclampsia.
Effects of Probiotics on Allergic Rhinitis Induced by Japanese Cedar Pollen: Randomized Double-Blind, Placebo-Controlled Clinical Trial
Authors: Tamura Manabu , Shikina Takashi , Morihana Tetsuo , Hayama Masaki , Kajimoto Osami , Sakamoto Akane , Kajimoto Yoshitaka , Watanabe Osamu , Nonaka Chiaki , Shida Kan , Nanno Masanobu
Published: December 2006

Background:Lactobacillus casei strain Shirota (LcS) has been found to exert antiallergic effects in animal experiments, but there is little information about its clinical effects in human patients with allergy. Methods: We performed a randomized double-blind, placebo-controlled study to investigate the effects of LcS in patients with allergic rhinitis triggered by Japanese cedar pollen (JCP). Participants were asked to drink fermented milk containing LcS (LcS group) or placebo (control group) for 8 weeks. Clinical symptoms and immunological parameters were compared between the two groups. Results: Symptom-medication scores (SMS) worsened in accordance with the increase in the amount of scattered JCP. In terms of the nasal and ocular SMS, there was no significant difference between the LcS group and the placebo group during the ingestion period. In the subgroup of patients with moderate-to-severe nasal symptom scores before starting the ingestion of test samples, supplementation with LcS tended to reduce nasal SMS. Conclusion: These results indicate that fermented milk containing LcS does not prevent allergic symptoms in patients sensitive to JCP, but may delay the occurrence of allergic symptoms in patients with moderate-to-severe nasal symptom scores.
A Simple Method for the Estimation of Peritoneal Fluid Transport
Authors: Zhe Xing-wei , Shan Yi-sheng , Cheng Lei , Wang Tao
Published: December 2006

Background: Evaluating peritoneal fluid kinetics is of great value to the adjustment of peritoneal dialysis prescription. Therefore, in the present study, we developed a simple method, based on a membrane transport model, to evaluate the fluid transport characteristics of the peritoneal membrane in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Patients’ peritoneal ultrafiltration (UF) volume was collected for 2 consecutive months. Membrane transport model and nonlinear least-squares regression analyses were applied to the pooled UF volume for the first month for fluid kinetic simulation and the data from the second month were used to evaluate the reliability and precision of simulated UF values. Results: Seventeen chronic peritoneal dialysis (PD) patients were selected for the present study. Simulated UF values based on the pooled UF volume in the first month correlated significantly with the actual measured UF values in the second month. By Bland-Atman plot, the width between the 95% limits of agreement fell within –133.3 to 154.2 ml with a mean difference of 10.5 ml. Conclusion: Our study showed that applying the fluid transport model and nonlinear least-squares regression analysis to the pooled actual UF value might be a good and simple way to predict peritoneal UF.
Angiotensin II Receptor Blockade Ameliorates Mesangioproliferative Glomerulonephritis in Rats through Suppression of CTGF and PAI-1, Independently of the Coagulation System
Authors: Liu Ning , Shimizu Shinya , Ito-Ihara Toshiko , Takagi Kuniaki , Kita Toru , Ono Takahiko
Published: December 2006

Background: Previously we observed that the coagulation system promotes matrix protein accumulation through transforming growth factor (TGF)-β and connective tissue growth factor (CTGF) expression in rat mesangioproliferative glomerulonephritis (MsPGN). Angiotensin II receptor blockers (ARBs) are known to suppress matrix accumulation in experimental MsPGN. In the present study, we investigated whether ARB suppresses MsPGN through inhibition of these profibrotic cytokines, and in relation to coagulation and fibrinolytic systems. Methods: MsPGN was induced in Wistar rats by intravenous injection of anti-Thy-1.1 monoclonal antibody, OX-7. As an ARB, olmesartan was orally administered in rat feed from the day of OX-7 injection (day 0) to day 8, when rats were sacrificed and kidney specimens were collected. The degrees of cellular proliferation, matrix production, coagulation factors, and inhibitory factor of fibrinolysis were evaluated. Results: Although blood pressure did not change in the normal, disease control, or treatment groups, the amount of urinary protein was significantly decreased in the ARB-treated groups, compared with the disease control group (p < 0.05). α-Smooth muscle actin expression was suppressed significantly in the treatment groups (p < 0.001). Blue-staining areas of trichrome, the number of proliferating cell nuclear antigen (PCNA)- or ED-1-positive cells, fibronectin and plasminogen activator inhibitor type 1 in glomeruli significantly decreased in the treatment groups (p < 0.05, respectively); however, fibrin-related antigen and factor V depositions were not suppressed in the treatment groups. Conclusions: These results suggest that the ARB drug would ameliorate MsPGN in vivo, at least partly through CTGF and plasminogen activator inhibitor type 1 suppression, and independently of the local coagulation system in glomeruli.
Pathophysiology of Stroke Rehabilitation: The Natural Course of Clinical Recovery, Use-Dependent Plasticity and Rehabilitative Outcome
Authors: Kreisel Stefan H. , Hennerici Michael G. , Bäzner Hansjörg
Published: December 2006

Even though the disruption of motor activity and function caused by stroke is at times severe, recovery is often highly dynamic. Recuperation reflects the ability of the neuronal network to adapt. Next to an unmasking of latent network representations, other adaptive processes, such as excitatory metabolic stress, an imbalance in activating and inhibiting transmission, leading to salient hyperexcitability, or the consolidation of novel connections, prime the plastic capabilities of the system. Rehabilitative interventions may modulate mechanisms of neurofunctional plasticity and influence the natural course after stroke, both positively, but potentially also acting detrimentally. Though routine rehabilitative procedures are an integral part of stroke care, evidence as to their effectiveness remains equivocal. The present review describes the natural course of motor recovery, focusing on ischemic stroke, and discusses use- and training-dependent adaptive effects. It complements a prior article which highlighted the pathophysiology of plasticity. Though the interaction between rehabilitation and plasticity remains elusive, an attempt is made to clarify how and to what extent rehabilitative therapy shapes motor recovery.
Writing Good Abstracts
Authors: Alexandrov Andrei V. , Hennerici Michael G.
Published: December 2006

Introduction: Writing an abstract means to extract and summarize (AB – absolutely, STR – straightforward, ACT – actual data presentation and interpretation). Thousands of abstracts are submitted to stroke conferences each year. The following suggestions may improve the chances of your work being selected for presentation, and to communicate results in the most efficient and unambiguous way. Title and Structure: Make the title dynamic and informative, rather than descriptive. Structure the abstract following the IMRaD (Introduction, Methods, Results and Discussion) principle for your future original paper where background would become Introduction and conclusions would enter Discussion. Select the appropriate category for submission carefully. This determines which experts grade the abstract and the session where your competitors represent their work. If selected appropriately, your abstract is more likely to be graded by peers with similar interests and familiarity with your work or field. Methods should describe the study design and tools of data acquisition shortly, not data. Results: Provide data that answer the research question. Describe most important data with numbers and statistics. Make your point with data, not speculations and opinions. Abbreviations should be avoided and only be used after they have been spelled out or defined. Common mistakes include failure to state the hypothesis, rationale for the study, sample size and conclusions. Highlight the novelty of your work by carefully chosen straightforward wording. Conclusions: Conclusions have to be based on the present study findings. Make sure your abstract is clear, concise and follows all rules. Show your draft to colleagues for critique, and if you are not a native English speaker show it to a person who can improve/correct your text. Remember that accepted abstracts of completed original research should be followed by published original papers – if this is not intended or fails, it may indicate an impaired ability to succeed in scientific writing and an academic career.
Elevated Troponin Levels Are Associated with Sympathoadrenal Activation in Acute Ischaemic Stroke
Authors: Barber M. , Morton J.J. , Macfarlane P.W. , Barlow N. , Roditi G. , Stott D.J.
Published: December 2006

Background: It has been hypothesised that elevated serum troponin levels in acute stroke are due to myocardial damage caused by sympathoadrenal activation, which, in turn, may be due particularly to insular damage. We aimed to determine the factors associated with troponin elevation in ischaemic stroke and the prognostic value of this finding. Methods: We studied 222 consecutive acute ischaemic stroke admissions. Serum troponin I and catecholamines were measured. Ischaemic damage on brain computed tomography (CT) scan was graded using the Alberta Stroke Program Early CT Score (ASPECTS). Electrocardiograms were classified using the Minnesota Code and the European Society of Cardiology/American College of Cardiology criteria for acute myocardial infarction. The Rankin scale was recorded at 30 days. Results: Forty-five patients (20%) had troponin I >0.2 µg/l. These troponin-positive patients had higher epinephrine levels (median 0.27 vs. 0.17 nmol/l; p = 0.0002) and were more likely to have electrocardiograms coded as definite or possible acute myocardial infarction (odds ratio 3.35; 95% CI 1.26–8.93), compared with those with troponin ≤0.2 µg/l, in univariate analysis. There were no significant associations between troponin I score and ASPECTS or insular damage on brain CT. In logistic regression analyses, elevated troponin was significantly associated with age, elevated serum creatinine and epinephrine; however, increased troponin was not an independent predictor of death or dependency (Rankin >2) at 30 days. Conclusions: Raised troponin I is associated with elevation of circulating epinephrine in acute ischaemic stroke. Activation of the sympathoadrenal system may be an important contributor to myocardial damage in these patients. Increased troponin is not associated with insular damage and does not independently predict poor outcome.
Anatomic Variations in the Circle of Willis in Patients with Symptomatic Carotid Artery Stenosis Assessed with Multidetector Row CT Angiography
Authors: Waaijer A. , van Leeuwen M.S. , van der Worp H.B. , Verhagen H.J.M. , Mali W.P.T.M. , Velthuis B.K.
Published: December 2006

Purpose: To assess the presence of anterior and posterior collateral pathways in the circle of Willis in patients with symptomatic carotid artery stenosis (SCAS) and to compare this to patients without carotid artery stenosis. Materials and Methods: Multislice CT angiography was performed in 91 patients and 91 control subjects. Using consensus reading, 2 observers evaluated the presence and diameter of the anterior communicating artery (AcomA), the A1 segments of the anterior cerebral arteries, the posterior communicating arteries (PcomA) and the P1 segments of the posterior cerebral arteries. Anterior or posterior pathways were assumed to be present if the diameter of continuous arterial segments was >1 mm; both A1 segments and AcomA anterior, and ipsilateral P1 segment and PcomA posterior. Comparison between patients and controls was performed using the χ2 test. Results: In the patients we found significantly more hypoplastic (<1 mm) or invisible A1 segments (16 and 14 vs. 4 and 1, respectively, p < 0.01). The AcomA was invisible in 4 patients versus 1 control. An isolated compromised anterior pathway and a combined compromised anterior and posterior pathway occurred more frequently in the patients as compared to the controls; 9 versus 1% (p < 0.01) and 26 versus 4% (p < 0.01). Conclusion: A compromised anterior collateral pathway, usually combined with a compromised posterior pathway, occurs more frequently in patients with SCAS as compared to controls, which suggests a relation between symptomatic carotid stenosis and an incomplete circle of Willis.
Mild Mechanical Traumas Are Possible Risk Factors for Cervical Artery Dissection
Authors: Dittrich R. , Rohsbach D. , Heidbreder A. , Heuschmann P. , Nassenstein I. , Bachmann R. , Ringelstein E.B. , Kuhlenbäumer G. , Nabavi D.G.
Published: December 2006

Background and Purpose: Cervical artery dissection (CAD) is a common cause of ischemic stroke in younger aged subjects. Retrospective studies suggest cervical manipulative therapy (CMT) and preceding infections as extrinsic risk factors for CAD. In a case-control study, we assessed a questionnaire with 7 mild mechanical traumas as potential trigger factors for CAD, including CMT and recent infections. Patients and Methods: Forty-seven consecutive patients with CAD were compared with 47 consecutive patients of similar age with ischemic stroke due to etiologies other than CAD. Patients underwent a standardized face-to-face interview. We assessed head or neck pain and recent infection <7 days before symptom onset, as well as the following mechanical trigger factors <24 h and <7 days prior to symptom onset: (1) heavy lifting, (2) sexual intercourse, (3) mild direct or (4) indirect neck trauma, (5) jerky head movements, (6) sports activity, and (7) CMT. Results:We found no association between any single one of the above risk factors and CAD. CMT (CAD, n = 10; non-CAD, n = 5) and recent infections (CAD, n = 18; non-CAD, n = 10) were more frequent in the CAD group but failed to reach significance. However, the cumulative analysis of all mechanical trigger factors revealed a significant association of mechanical risk factors as a whole in CAD <24 h prior to symptom onset (p = 0.01). Conclusion: Mild mechanical stress, including CMT, plays a role as possible trigger factor in the pathogenesis of CAD. CMT and recent infections alone failed to reach significance during the present investigation, presumably due to the relatively small sample size of the study cohort.
Improved Time Intervals by Implementation of Computerized Physician Order Entry-Based Stroke Team Approach
Authors: Nam Hyo Suk , Han Sang Won , Ahn Seong Hwan , Lee Jong Yun , Choi Hye-Yeon , Park In Cheol , Heo Ji Hoe
Published: December 2006

Background: The need for rapid evaluation and treatment of acute stroke patients has been well documented. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information, which may be useful for an effective team approach program targeted to reduce in-hospital time delays. Methods: To reduce the time from a patient’s arrival at the emergency department to thrombolysis, a team approach program using CPOE was developed, and its efficacy was investigated by comparing time intervals from arrival to evaluation and intravenous tissue-type plasminogen activator (tPA) treatment before and after the implementation of the program. Results: Among 379 consecutive patients who were screened as potential candidates for thrombolysis, 25 patients (6.6%) received tPA during a 1-year period after initiation of the program. Fourteen patients were treated with tPA in the previous year. After program implementation, time from arrival to computed tomography scan was reduced from 34 to 19 min (p = 0.01). Time to report of complete blood count was also shortened from 52 to 33 min (p < 0.01). Finally, time from arrival to tPA treatment was reduced by 23 min (from 79 to 56 min; p < 0.01). Onset-to-door time tended to be longer after the program implementation (from 41 to 60 min; p = 0.14). Conclusions: Implementation of the CPOE-based team approach program significantly reduced time from emergency department arrival to evaluations and treatment.
Estimating the Number of Stroke Patients Eligible for Thrombolytic Treatment if Delay Could Be Avoided
Authors: Boode Bep , Welzen Vivian , Franke Cees , van Oostenbrugge Robert
Published: December 2006

Background: Although no data are available on the potential number of patients treatable with recombinant tissue plasminogen activator, it is said that up to 20% of all stroke patients should receive this treatment. The actual percentage treated is much lower, mainly due to delays between onset and admission to hospital. The aim of this study was to estimate the potential number of patients eligible for thrombolytic therapy if such delays could be avoided. Methods: We gathered data on the time of onset, presentation and admission of stroke patients. Based on the inclusion and exclusion criteria for thrombolysis derived from the National Institute of Neurological Disorders and Stroke study, we retrospectively estimated the number of patients that would have been eligible for thrombolytic therapy. Results: A total of 263 consecutive patients were included. Forty-eight patients (18%) had symptoms upon awakening, 28 (11%) reported their symptoms at a routine follow-up visit and 19 (7%) received thrombolytic therapy. All these cases were excluded. If no delay had occurred, an additional 44 patients (17%) could have been offered thrombolytic therapy. This potential loss of treatable patients was due to patient and doctor delay in 39 and 2 patients, respectively, and to other reasons in 3 patients. Conclusion: Up to 24% of stroke patients are eligible for thrombolytic treatment if delay is avoided. As delays are mainly caused by patients themselves, the results of this study underline the need for campaigns to improve the public’s awareness of stroke symptoms as well as the awareness that stroke is an emergency situation.
Do Extracellular-Matrix-Regulating Enzymes Play a Role in Cervical Artery Dissection?
Authors: Guillon Benoît , Peynet Jacqueline , Bertrand Marion , Benslamia Lamia , Bousser Marie-Germaine , Tzourio Christophe
Published: December 2006

Background: An underlying extracellular matrix defect is suspected in patients with spontaneous cervical artery dissection (SCAD). We test the hypothesis that levels of matrix metalloproteinase (MMP) 2 and 9, and elastase, extracellular-matrix-regulating enzymes involved in the vascular wall remodeling process, are modified in SCAD. Methods: The authors prospectively and consecutively recruited 47 patients with SCAD and 52 patients with an ischemic stroke from another cause in 2 centers, and measured their plasmatic level of MMP-2, MMP-9 and elastase 3 months after the vascular event. Results: Patients with SCAD had a higher mean MMP-2 level compared with controls [379.2 (SD = 76.6) vs. 355.9 (75.1) ng/ml; p = 0.11] and had more frequently a high level of MMP-2 (>326 ng/ml) than controls (77.8 vs. 54.5%, p = 0.019). This association was stronger in patients with multiple dissection than single artery dissection or controls (84.6, 75.0 and 54.5%, respectively, p = 0.018). The levels of MMP-9 and elastase were similar in cases and controls, but more patients had a high level of these enzymes in the group with multiple dissections than in the group with single artery dissection or controls. Conclusion: Patients with SCAD have higher plasma levels of proteases, particularly MMP-2. The association is stronger in patients with multiple dissections.