bluuebunny/crossref_metadata_2025 huggingface dataset:
False Negative Urea Breath Tests with H2‐Receptor Antagonists: Interactions Between Helicobacter pylori Density and pH
Authors: Graham David Y. , Opekun Antone R. , Jogi Medhavi , Yamaoka Yoshio , Lu Hong , Reddy Rita , El‐Zimaity Hala M.T.
Published: February 2004

Background.  We studied the effects of famotidine, sodium bicarbonate, and citric acid on the 13C‐urea breath test (UBT).

Methods.  Helicobacter pylori‐infected volunteers received a UBT, 40 mg of famotidine at bedtime, and a second UBT (pudding test meal, 648 mg NaHCO3 tablet then 125 mg of urea in 200 ml of water containing 650 mg of NaHCO3). Experiment 2 consisted of four UBTs. Two were standard citric acid UBTs with 75 mg of urea and 2 g citric acid and two were sequential bicarbonate‐citric acid UBTs. Sequential UBTs consisted of administration of a 648 mg bicarbonate tablet with 50 g of Polycose in 200 ml of water. Five minutes later, 125 mg of 13C‐urea was given in 75 ml of water containing 650 mg of NaHCO3. Breath samples were collected after 15 minutes. Then, to acutely acidify the stomach, 4 g of citric acid was given in 200 ml of water. A second breath sample was collected 15 minutes after the citric acid. The standard UBTs were done before and after 6 days of famotidine (40 mg b.i.d.). Sequential UBTs were done after 1 and 6 days of famotidine therapy. Gastric biopsies for histology, culture, and mucosal cytokines were assessed before and after 6 days of famotidine.

Results. Eighteen subjects participated, 10 in each experiment; seven had endoscopy with biopsy. Famotidine/bicarbonate resulted an ∼50% fall in UBT values (p = .021) with 10% becoming negative. The gastric pH increased from 5.1 ± 0.5 to 6.7 ± 0.2 (p = .03) although no pH value predicted the occurrence of false negative results. Under famotidine acid suppression, NaHCO3 reduced the delta over baseline (DOB) by 63% (p = .021). This was reversed with citric acid. Histology showed a H2‐receptor antagonist‐associated increase in the depth of gastric corpus inflammation.

Conclusions. H2‐receptor antagonists differ from proton pump inhibitors as high intragastric pH may cause a reduction in urease activity, unrelated to a reduced bacterial load and reversed by citric acid.
Evaluation of Stool Antigen Test, PCR on ORAL Samples and Serology for the Noninvasive Detection of Helicobacter pylori Infection in Children
Authors: Bonamico Margherita , Strappini Pier Michele , Bonci Enea , Ferri Mirella , Crisogianni Massimo , Guido Mirka , Thanasi Enina , Nenna Raffaella , Macchia Stefania , Luzzi Ida , Magliocca Fabio Massimo , Mastromarino Paola
Published: February 2004

Background.  Endoscopy represents the gold standard for the diagnosis of Helicobacter pylori infection. We evaluated three noninvasive tests in a group of children: the immunoassay for detection of H. pylori stool antigen, the polimerase chain reaction for identification of bacterial DNA on the oral cavity and the serum specific antibodies.

Materials and Methods.  One hundred and ninety children underwent endoscopy for various gastrointestinal symptoms. H. pylori stool antigen and anti‐H. pylori antibodies were assayed by commercial kits. The bacterial DNA on saliva and oral plaque was detected by a seminested PCR.

Results.  Based on the positivity of culture or urease rapid test and histology, infection was detected in 47 patients. The statistical analysis showed that, for the detection of the infection, stool antigen assay is more effective in sensitivity and negative predictive value (91.5% and 96.5%), whereas specificity and positive predictive values appear slightly better in serology (89.6% and 76.0%). Correlations between serum IgG both with patients’ age (r = 0.21, p < .05) and H. pylori stool antigen (r = 0.47, p < .01) were found. The search for bacterial DNA on oral samples proved to be very specific (99.1% on saliva and 98.2% on plaque), but insensitive (22.2% and 25.7%).

Conclusions.  In children H. pylori stool antigen represents a sensitive test, suitable for detecting H. pylori infection. Serum IgG proved to be more specific; the PCR on the oral cavity resulted as being a very specific, but insensitive test.
Abnormal Gastroesophageal Flap Valve is Highly Associated with Endoscopic Reflux Esophagitis after Helicobacter pylori Eradication
Authors: Takeuchi Rie , Kato Kimitoshi , Mizuno Shigeaki , Kawamura Yo , Kawamura Fumio , Iwasaki Ariyoshi , Arakawa Yasuyuki
Published: February 2004

Background.  Whether or not eradicating Helicobacter pylori worsens reflux esophagitis remains controversial. We investigated the relationship between gastroesophageal flap valve grading and endoscopic reflux esophagitis (in patients with peptic ulcer and gastritis) before and after H. pylori eradication in a case controlled study. Whether endoscopic assessment of the gastroesophageal flap valve allows prediction of endoscopic reflux esophagitis development or exacerbation was also assessed.

Materials and Methods.  A total of 220 patients with peptic ulcer or chronic gastritis, who received H. pylori eradication therapy, were followed for at least 6 months (range, 6–34 months) for endoscopic changes. Another 88 age‐ and disease‐matched H. pylori‐positive controls, without eradication therapy, were also enrolled. Gastroesophageal flap valve grade (I–IV) was assessed using the Hill classification.

Results.  Endoscopic reflux esophagitis incidence was significantly (p < .01) higher in abnormal gastroesophageal flap valve (grades III and IV) than in normal gastroesophageal flap valve (grades I and II) cases in both H. pylori eradication and control groups. The rate of new endoscopic reflux esophagitis after eradication was significantly (p < .01) higher in the abnormal than in the normal gastroesophageal flap valve group (54.5% vs. 9.1%). By contrast, the endoscopic reflux esophagitis exacerbation rate in patients with endoscopic reflux esophagitis before eradication was low (4.5%) and endoscopic reflux esophagitis improvement was observed in 40.9% of these patients.

Conclusions.  These results suggest gastroesophageal flap valve grading by endoscopy to be useful for predicting the risk of newly developing endoscopic reflux esophagitis after H. pylori eradication, in addition to predicting the presence of endoscopic reflux esophagitis.
Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients
Authors: Miwa Hiroto , Sakaki Nobuhiro , Sugano Kentaro , Sekine Hitoshi , Higuchi Kazuhide , Uemura Naomi , Kato Mototsugu , Murakami Kazunari , Kato Chieko , Shiotani Akiko , Ohkusa Toshifumi , Takagi Atsushi , Aoyama Nobuo , Haruma Ken , Okazaki Kazuichi , Kusugami Kazuo , Suzuki Masayuki , Joh Takashi , Azuma Takeshi , Yanaka Akinori , Suzuki Hidekazu , Hashimoto Hiroshi , Kawai Takashi , Sugiyama Toshiro
Published: February 2004

Objective.  Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection.

Methods.  This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori‐cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated.

Results.  Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers).

Conclusions.  Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.
The TETRA Study: A prospective evaluation of Helicobacter pylori‘Test‐and‐Treat’ Strategy on 736 Patients in Clinical Practice
Authors: Gisbert Javier P. , Badía Xavier , Roset Montserrat , Pajares José María
Published: February 2004

Aims.  To prospectively evaluate the effectiveness of the test‐and‐treat strategy in a large group of dyspeptic patients in clinical practice.

Methods.  Patients with ulcer‐like dyspepsia, < 45 years, without alarm symptoms, were prospectively studied. Helicobacter pylori infection was diagnosed with the 13C‐urea‐breath‐test, and eradication or symptomatic treatment was prescribed accordingly. ‘Symptomatic improvement’ was defined as the percentage of patients with a decrease of ≥ 2 levels in the dyspepsia‐severity‐score or with no symptoms after treatment. Health status and use of health resources were also assessed. Endoscopy was performed in therapeutic failures.

Results.  Out of 736 patients initially included, 422 received eradication, and 314 symptomatic therapy; 87% returned at 6 weeks and 67% at 6 months. At 6 months, ‘symptomatic improvement’ was achieved in 73% and 54% of the patients, in eradication and symptomatic groups, respectively (p < .001), and overall in 66%. A reduction of 78% in mean self‐assessment visual analogical score was observed at 6 months. More than 50% of patients were ‘much better’ at control visits. Endoscopy (18%) and physician's visits (13%) were the main health resources used. No gastric or oesophageal cancer was diagnosed.

Conclusion.  This large prospective study shows that the test‐and‐treat strategy is effective and safe for management of dyspeptic patients in clinical practice.
13C‐Urea Breath Test to Diagnose Helicobacter pylori Infection in Children Aged up to 6 Years
Authors: Machado Rodrigo Strehl , Da Silva Patrício Francy Reis , Kawakami Elisabete
Published: February 2004

Background.  13C‐urea breath test (13C‐UBT) is an accurate noninvasive tool for diagnosis of Helicobacter pylori infection. It is considered the best method for epidemiological studies, but there are few studies to evaluate the 13C‐UBT in infants and toddlers.

Aim.  To evaluate the 13C‐UBT performed with infrared spectroscopy in children aged up to 6 years.

Patients.  Sixty‐eight patients (6 months. to 5 years 11 months.) were evaluated prospectively and consecutively.

Methods.  Helicobacter pylori infection was detected by positive culture, or rapid urease test and histological examination, both positive. 13C‐UBT was performed with 50 mg of 13C‐urea diluted in 100 ml of commercial orange juice. Two expired air samples were collected: before and 30 minutes after tracer ingestion. Cutoff of delta over baseline (DOB) was 4.0‰ and urea hydrolysis rate 10 µg/minute.

Results.  Fifteen of 68 (22.1%) patients were H. pylori infected. Sensitivity was 93.3% (95% CI; 86.8%–99.7%) and specificity was 96.2% (95% CI; 93.6%–98.8%), and these values were equal for DOB and urea hydrolysis rate. Negative DOB values in noninfected patients ranged from −1.5‰ to 2.6‰ and positive DOB values ranged from 10.8‰ to 105.5‰. There was no relationship between DOB values and age.

Conclusion.  13C‐UBT performed with infrared spectroscopy proved to be a reliable and accurate noninvasive diagnostic tool for H. pylori infection detection in children aged up to 6 years. Results far from cutoff value can clearly distinguish positive from negative 13C‐UBT results in children up to 6 years old.
Helicobacter pylori Associated Antigastric Autoantibodies: Role in Sjögren's Syndrome Gastritis
Authors: Sorrentino Dario , Faller Gerhard , DeVita Salvatore , Avellini Claudio , Labombarda Antonella , Ferraccioli Gianfranco , Kahlow‐Toussaint S.
Published: February 2004

Background.  Previous studies have shown that Helicobacter pylori seroprevalence in Sjögren's syndrome is comparable with that of the general population. However, the origin of the chronic gastropathy associated with this syndrome and the role of local autoimmunity – possibly triggered by bacterial infection – in its pathogenesis remain unclear.

Materials and Methods.  We initially determined the prevalence of IgG anti H. pylori in dyspeptic subjects with and without Sjögren's syndrome. In subsets of both groups we then determined anti CagA and human tissue‐tested anticanalicular/antifoveolar autoantibodies. We also compared activity, atrophy and Mucosa Associated Lymphoid Tissue (MALT) scores, as well as symptoms, before and after bacterial eradication.

Results.  Prevalence of H. pylori in Sjögren's syndrome patients was similar to controls: 31/54 (57%) vs. 93/150 (62%). Anti CagA prevalence was also similar in the two groups. Twenty weeks after H. pylori eradication, histological activity decreased in both groups, however, atrophy and MALT decreased significantly only in controls. Sixteen months after H. pylori eradication, 75% of Sjögren's syndrome patients still complained of dyspepsia compared with 13% of controls. Finally, antigastric autoantibodies were present in 29% of tested Sjögren's syndrome patients vs. 28% of controls.

Conclusions.  H. pylori infection was equally prevalent among dyspeptic Sjögren's syndrome patients and dyspeptic controls. Likewise, there were no differences regarding anti CagA prevalence or antigastric autoantibodies among the two groups. The persistence of symptoms as well as of the lymphocytic infiltration and atrophy after H. pylori eradication in Sjögren's syndrome may underlie the ‘endogenous’ and still unknown nature of the gastropathy in this condition.
Genotypes of the Helicobacter pylori vacA Signal Sequence Differ with Age in Korea
Authors: Lee Jun Haeng , Choe Yon Ho , Jeon Byung Ha , Oh Yoo Joung , Kim Jae J. , Rhee Jong Chul , Kim Pum Soo , Choi Mi Sook
Published: February 2004

Background.  Studies on Helicobacter pylori genotypes have focused on adults in developed countries, and data on the genotypes of Helicobacter pylori recovered from the children are rare.

Materials and methods.  One hundred and twenty‐eight biopsy samples from patients with H. pylori infection were studied. The patients’ ages ranged from 9 to 83 years. PCR analysis for vacA genotypes was performed using DNA extracted from biopsy specimens.

Results.  Genotyping of the s‐region showed s1a in 33 (25.8%) samples and s1c in 82 (64.1%) samples. When the specimens were grouped by age, the distribution of s‐region genotype was found to be significantly different between groups (p = .002). The prevalence of s1a was 45.2% in patients < 20 years old, but 14.9% in patients ≥ 50 years old. On the other hand, the prevalence of s1c or recombinant s1a‐s1c was higher in those ≥ 50 years old. The distribution of the m‐region did not differ significantly with age (p = .110).

Conclusions.  Strain populations infecting Korean adults and children differ.
The Incidence ofHelicobacter pyloriAcquisition in Children of a Canadian First Nations Community and the Potential for Parent‐to‐Child Transmission
Authors: Sinha Samir K. , Martin Bruce , Gold Benjamin D. , Song Qunsheng , Sargent Michael , Bernstein Charles N.
Published: February 2004

Background and Aims. We have previously reported that Wasagamack, a Canadian First Nations community has a seroprevalence rate ofHelicobacter pyloriof 95% and a prevalence rate among children aged 0–12 years as measured by stool antigen testing of 56%. We aimed to determine the rate of infection acquisition and possible modes of transmission of childhoodHelicobacter pyloriinfection in this Canadian First Nations community.

Methods. Children who were previously negative forH. pyloriby stool antigen testing in August 1999 were eligible for enrollment in August 2000; 50 (77%) eligible children underwent stool collection.H. pyloristool antigen status was tested using the Premier Platinum HpSA test. Drinking water samples, maternal saliva, breast milk, local berries and flies were tested by three complementaryH. pylori‐specific PCR assays. Soothers or bottle nipples, collected from 16 children whoseH. pyloristool antigen status was determined, were bathed in sterile water and this water was tested by PCR.

Results. Stool was positive forH. pyloriin 16% (8/50) of children retested. Five had no other siblings infected and three had infected siblings. The mothers of all children infected were positive forH. pylori. The median age of newly infected children was 6 years (range 1–13 years). By PCR, 78% (18/23) mothers’ saliva samples, 69% (11/16) soother water samples and 9% (1/11) water samples from infected homes tested positive. All of 24 sequenced PCR‐produced DNA fragments from samples showed 99% homology with that from ATCC type strainH. pylori.

Conclusions. The rate of childhoodH. pyloriacquisition was 16% over 1 year, and was not dependent on number of siblings infected. The finding of homologousH. pyloriDNA in saliva and in soother water suggests the possibility of human to human transmission, particularly via an oral–oral route. Thus, there is the potential for further investigations in this population and other endemic communities that are directed at prevention of infection transmission via this modality.
The Prevalence and Incidence of Helicobacter pylori Infections Among Young Recruits During Service in the Hungarian Army
Authors: Fürész József , Lakatos Susan , Németh Krisztina , Fritz Péter , Simon László , Kacserka Katalin
Published: February 2004

Background.  A vast number of data indicate that the prevalence of Helicobacter pylori infections is positively correlated with age and is different in various countries. Although our knowledge of transmission of H. pylori is very limited, it is reasonable to assume that it could be much more contagious in closed communities, for example in garrisons, than in normal populations.

Methods.  Young male recruits (aged 19–23 years) in the Hungarian Army were tested for seropositivity at the beginning and at the end of their military service.

Results.  The prevalence of H. pylori seropositivity was found to be 23% (♦CI95%: 21–24%) among the young male recruits. Seroconversion among the formerly seronegative persons after completing either their 9‐month or 6‐month military service was 30% (CI95%: 25–35%) and 23% (CI95%: 8–45%), respectively. In those groups, where either the H. pylori infection was eradicated by antibiotics or hygienic countermeasures were introduced, the infection rate was reduced from 23% to 11% (CI95%: 3–25%) and to 0% (CI95%: 0–6%); p > .2 and p < .002, respectively.

Conclusion.  Our data suggest that, although H. pylori has a very high contagiosity in closed communities, its spread can be reduced or even prevented by medication of the infected persons and/or by improving the hygienic conditions and introducing anti‐infective sanitary regulations.
Serological Responses of FldA and Small‐Molecular‐Weight Proteins of Helicobacter pylori: Correlation with the Presence of the Gastric MALT Tissue
Authors: Yang Hsiao‐Bai , Sheu Bor‐Shyang , Wang Jin‐Town , Lin Shih‐Ting , Wu Jiunn‐Jong
Published: February 2004

Purpose.  We tested whether the serological response to Flavodoxin‐A (FldA) protein and anti‐Helicobacter pylori immunoblots correlated to the degree of mucosa‐associated lymphoid tissue (MALT) in the stomach.

Methods.  Eighty H. pylori‐infected patients with different degrees of MALT in the stomach were investigated with serum sampling and endoscopy on enrolment, the 2nd and the 12th months after anti‐H. pylori therapy. All sera were tested for the anti‐FldA protein and anti‐H. pylori immunoblots, including 19.5, 26.5, 30, 35, 89, and 116 KDa (CagA). Regression of follicular gastritis was assessed by histology.

Results.  Patients with dense lymphoid follicles had higher prevalence rates of anti‐FldA protein, 19.5, 26.5, and 30 KDa antibodies of H. pylori (p < .05). Histologic downgrade of MALT was observed in 25% (10/40) of patients in the 2nd month and in 60% (23/38) in the 12th month after H. pylori therapy. After H. pylori eradication, the patients with MALT and dense lymphoid follicles had significantly negative seroconversions of 19.5, 26.5, 30, and 35 KDa antibodies (p < .05), but not of CagA and FldA.

Conclusion.  Patients with gastric MALT and dense lymphoid follicles had different anti‐H. pylori serological responses to those with scanty or an absence of lymphoid follicles. The negative seroconversion of the smaller‐molecular‐weight proteins, but not CagA and FldA, may correlate with the regression of MALT by H. pylori eradication.
Pharmacoeconomics of Gastrointestinal Drug Utilisation Prior and Post Helicobacter pylori Eradication
Authors: Klok Rogier M. , Van Der Veen Willem Jan , Van Der Werf Ger Th , Van Den Berg Paul B. , Brouwers Jacobus R. B. J. , Postma Maarten J.
Published: February 2004

Background.  Eradication of Helicobacter pylori prevents recurrence of peptic ulcer. In pharmacoeconomic analyses it is often presumed that after successful eradication no more gastrointestinal drugs are used. We investigated this presumed positive monetary effect using General Practitioners prescribing data, including information in diagnosis.

Methods.  From the RNG‐database we identified patients with a H. pylori eradication in the years 1997–2000. H. pylori eradication was defined as a prescription of two antibiotics and one gastrointestinal drug on the same day. Patients were divided into a group with diagnosed ulcers and a group without diagnosed ulcers. Gastrointestinal drug costs were calculated for 4 months prior to eradication and 9–12 months post eradication. For comparison costs in all periods were expressed per patient per period. For statistical analysis the paired t‐test was used.

Results.  One hundred and two patients were eligible for evaluation. Of these patients 35 had a diagnosed ulcer and 67 had not. Generally the number of patients on gastrointestinal drugs decreased (61% prior vs. 33% post), however, the drug costs did not change (€33 prior vs. €34 post). Costs for proton pump inhibitors increased post eradication (€14 prior vs. €28 post). The ulcer and nonulcer group showed similar results.

Conclusion.  Helicobacter pylori eradication is thought to be cost effective, however, we did not find a decrease in costs for all gastrointestinal drugs. There may be a great pharmacoeconomical advantage when it is possible to predict which patients are more likely to ‘fail’ eradication therapy.
Biological and conformational study of β‐substituted prolines in MT‐II template: steric effects leading to human MC5 receptor selectivity*
Authors: Cai M. , Cai C. , Mayorov A. V. , Xiong C. , Cabello C. M. , Soloshonok V. A. , Swift J. R. , Trivedi D. , Hruby V. J.
Published: February 2004

Abstract:  To investigate the molecular basis for the interaction of the χ‐constrained conformation of melanotropin peptide with the human melanocortin receptors, a series of β‐substituted proline analogs were synthesized and incorporated into the Ac‐Nle‐c[Asp‐His‐d‐Phe‐Arg‐Trp‐Lys]‐NH2 (MT‐II) template at the His6 and d‐Phe7 positions. It was found that the binding affinities generally diminished as the steric bulk of the p‐substituents of the 3‐phenylproline residues increased. From (2S, 3R)‐3‐phenyl‐Pro6 to (2S, 3R)‐3‐(p‐methoxyphenyl)‐Pro6 analogs the binding affinity decreased 23‐fold at the human melanocortin‐3 receptor (hMC3R), 17‐fold at the hMC4R, and eight‐fold at the hMC5R, but selectivity for the hMC5R increased. In addition, the substitution of the d‐Phe7 residue with a (2R, 3S)‐3‐phenyl‐Pro resulted in greatly reduced binding affinity (103–105) at these melanocortin receptors. Macromodel's Large Scale Low Mode (LLMOD) with OPLS‐AA force field simulations revealed that both MT‐II and SHU‐9119 share a similar backbone conformation and topography with the exception of the orientation of the side chains of d‐Phe7/d‐Nal (2′)7 in χ space. Introduction of the dihedrally constrained phenylproline analogs into the His6 position (analogs 2–6) caused topographical changes that might be responsible for the lower binding affinities. Our findings indicate that hMC3 and hMC4 receptors are more sensitive to steric effects and conformational constraints than the hMC5 receptor. This is the first example for melanocortin receptor selectivity where the propensity of steric interactions in χ space of β‐modified Pro6 analogs of MT‐II has been shown to play a critical role for binding as well as bioefficacy of melanotropins at hMC3 and hMC4 receptors, but not at the hMC5 receptor.
The respiratory chain of blue‐green algae (cyanobacteria)
Authors: Peschek G. A. , Obinger C. , Paumann M.
Published: February 2004

Electron transport components on the way from reduced substrates to the terminal respiratory oxidase(s) are discussed in relation to analogous and/or homologous enzymes and electron carriers in the generally much better known bacteria, mitochondria and chloroplasts. The kinetic behaviour of the components, their localization within the cell and their evolutionary position are given special attention. Pertinent results from molecular genetics are also mentioned. The unprecedented role of cyanobacteria for our biosphere and our whole planet earth appears to deserve a more extended introductory chapter.
Long‐term sedation with propofol 60 mg ml−1 vs. propofol 10 mg ml−1 in critically ill, mechanically ventilated patients
Authors: Knibbe C. A. J. , Naber H. , Aarts L. P. H. J. , Kuks P. F. M. , Danhof M.
Published: February 2004

Background:  Hypertriglyceridaemia is the main cause of therapeutic failure during propofol use in long‐term sedated mechanically ventilated patients. Propofol 60 mg ml−1 has been developed to reduce fat and volume load for the critically ill patient.

The purpose of the study was to compare the effectiveness of sedation, achievability of effective concentrations and the effects on serum lipid concentrations of propofol 60 mg ml−1 vs. propofol 10 mg ml−1 for long‐term sedation in critically ill patients.

Methods:  In this randomized, open, prospective study, 20 critically ill, mechanically ventilated patients who required sedation for a minimum of 48 h received propofol 60 mg ml−1 or propofol 10 mg ml−1 in doses as required during 2–5 days.

Results:  No differences between propofol 60 mg ml−1 and propofol 10 mg ml−1 were observed in the effectiveness of sedation using the Ramsay Sedation score and the Subjective Sedation score, nor in relation to the propofol concentrations. Between the two groups, there were no significant differences in the daily propofol dose, number of daily infusion rate adjustments or need for additional sedatives.

Mean serum triglyceride concentrations were higher in the propofol 10 mg ml−1 group compared with the propofol 60 mg ml−1 group [5.26 (3.19) vs. 3.22 (2.05) mmol l−1, P > 0.05][mean (SD)]. Patients in the propofol 10 mg ml−1 group received more fat from the propofol infusion than from the propofol 60 mg ml−1 group [53.2 (29.6) vs. 10.0 (4.7) % compared with fat from nutrition, respectively]. A significant relationship was observed between the daily total fat dose and the serum triglyceride concentration (r2 = 0.32, P < 0.001), whereas there was no significant correlation between the daily propofol dose and the serum triglyceride concentration.

Conclusion:  Propofol 60 mg ml−1 is a useful alternative to propofol 10 mg ml−1 for the long‐term sedation of critically ill patients. Sedation with propofol 60 mg ml−1 reduces fat and volume load by 83%, which reduces the risk of hypertriglyceridaemia.
E‐cadherin Expression in Canine Mammary Carcinomas with Regional Lymph Node Metastases
Authors: Brunetti B. , Sarli G. , Preziosi R. , Leprotti S. , Benazzi C.
Published: February 2004

E‐cadherin (E‐cad) is a cell adhesion molecule known for its tumour invasion‐suppressor function. This study investigated the immunohistochemical expression of E‐cadherin in 19 cases of malignant mammary tumours of the dog and the relationship between E‐cadherin expression in primary tumours and in regional lymph node metastases. E‐cadherin expression is not always parallel in the primary tumour and in the lymph node metastasis. One year follow‐up was available in 12 of 19 cases. Three different patterns of expression were revealed in the lymph node metastases compared with the primary tumour: downregulation when the protein expression was weaker in the metastasis than in the primary tumour; upregulation when E‐cadherin was stronger in the lymph node than in the primary tumour, and a similarly intense expression when it was equal in the metastasis and in the tumour. The lymph node pattern revealed a prevalent upregulation or downregulation with respect to the primary tumour, whereas a similar expression of E‐cadherin was encountered in less than 50% of cases.
Acellular and Glutaraldehyde‐Preserved Tendon Allografts for Reconstruction of Superficial Digital Flexor Tendon in Bovines: Part I – Clinical, Radiological and Angiographical Observations
Authors: Ramesh R. , Kumar N. , Sharma A. K. , Maiti S. K. , Singh G. R.
Published: February 2004

Sixteen tenorrhaphies were performed at the mid‐metatarsal region in eight buffalo calves under lignocaine epidural analgesia. A 2 cm long gap was created in the superficial digital flexor (SDF) tendon and immediately repaired with acellular grafts in animals of group I, 1% glutaraldehyde‐preserved tendon allografts in group II. In group III, the defect was repaired with autografts. This group served as control. The contralateral limb in each animal was operated after an interval of 60 days and the animals underwent the same procedure according to the designed groups. Diclofenac sodium and Enrofloxacin was given post‐operatively for 5 days. Clinical examination revealed significant increase (P < 0.05) in rectal temperature, heart and respiratory rate for 3–4 post‐operative days in all the animals. Mild pain and exudation as well as early restoration of tendon gliding movements and weight‐bearing were observed earlier in group I in comparison with group II. Air‐tendograms revealed early organization, minimal adhesion formation and lesser thickening of tendon at the reconstructive site in the acellular group whereas in the glutaraldehyde group dense homogenous swelling with adhesions was seen along the flexors. Angiography on day 30 showed that the area of proximal and distal host tendon graft junction appeared hypervascularized, whereas the area occupied by the graft appeared relatively less vascularized. Normal vascularization was observed on day 90 in all the three groups.
Acellular and Glutaraldehyde‐Preserved Tendon Allografts for Reconstruction of Superficial Digital Flexor Tendon in Bovines: Part II – Gross, Microscopic and Scanning Electron Microscopic Observations
Authors: Ramesh R. , Kumar N. , Sharma A. K. , Maiti S. K. , Kumar S. , Charan K.
Published: February 2004

Sixteen tenorrhaphies were performed at mid‐metatarsal region in eight buffalo calves. A 2‐cm long gap was created in the superficial digital flexor (SDF) tendon in all animals. The gap was immediately repaired with acellular grafts in animals of group I, 1% glutaraldehyde‐preserved tendon allografts in group II, and in group III the defect was repaired with autografts (control group). The contralateral limb in each animal was operated after an interval of 60 days and the animals underwent the same procedure according to the designed groups. Gross observation revealed filling of host tendon–graft junction with fibrous connective tissue. Increased vascularity was seen in group I when compared with group II and III. Graft was resorbed in animals of group I and III, whereas partial absorption of graft was seen in group II. Histological observations on day 30 revealed restoration of cellularity in acellular graft and fragmentation and resorption of glutaraldehyde‐preserved graft. Graft was replaced by newly formed fibrous connective tissue. Tissue reaction around polygalactin suture consisted of plasma cells, lymphocytes and macrophages. On day 90, most of the acellular graft was replaced by newly formed fibrous connective tissue. In group II the majority of graft portion remained at the site and was in a state of resorption. In the control group it was difficult to distinguish between the host tendon and the graft. Scanning electron microscopical observation showed densely packed neoformed tissue at host tendon–graft junction. Hydrolysis and invasion of connective tissue between polygalactin suture filaments, resorption of graft with cavity formation and dissolution of ground substance were observed.
Cardiovascular effects of xylazine recorded with telemetry in the dog
Authors: Ilbäck N.‐G. , Stålhandske T.
Published: February 2004

Cardiovascular effects of xylazine have not been studied with telemetry in dogs. In the present study, the effects on cardiovascular parameters after intramuscular (i.m.) administration of 2.0 mg/kg xylazine were studied via telemetry in unrestrained dogs. Telemetry transmitters were implanted subcutaneously (s.c.) with a pressure catheter in the femoral artery. Cardiovascular effects and body temperature effects were assessed after i.m. administration of xylazine. Heart rate decreased for about 10 min and was continuously depressed during 60 min. Thereafter, heart rate slowly increased but had not fully reached pre‐dose values 4 h after treatment. Both systolic and diastolic blood pressure increased immediately after administration of xylazine. The systolic blood pressure showed a peak increase for about 5–10 min and then decreased below the baseline value not normalizing within 90 min. The diastolic blood pressure peaked 5–10 min after xylazine administration but did not return to baseline level until 50 min after administration. Body temperature decreased continuously for about 90 min and remained low for more than 4 h after treatment. An additional administration of xylazine to the same individuals after a recovery period of 4 weeks induced exactly the same response in systolic and diastolic blood pressure and in heart rate. By using the telemetric recording system it was possible to continuously evaluate xylazine‐induced cardiovascular responses in a way that is not possible with conventional techniques.
Treatment and Follow‐Up of Clinical Cyathostominosis in Horses*
Authors: Deprez P. , Vercruysse J.
Published: February 2004

The results of the treatment with moxidectin or ivermectin of 20 horses with clinical cyathostominosis were studied during a 3‐week observation period. Both treatments were effective in completely eliminating larvae from the faeces within 1 or 2 weeks, but no significant improvement in body weight or clinical parameters could be demonstrated over the observation period. The poor short time results of the treatment support the need for an adequate prevention of cyathostominosis in horses.
Expression of Inflammatory Cytokines (TNF‐αα, IL‐1, IL‐6 and IL‐8) in Colon of Pigs Naturally Infected withSalmonella typhimuriumandS. choleraesuis
Authors: Cho W.‐S. , Chae C.
Published: February 2004

The expression of mRNA encoding tumour necrosis factor‐α(TNF‐α), interleukin‐1 (IL‐1), IL‐6 and IL‐8 was studied, byin situhybridization with a non‐radioactive digoxigenin‐labelled probe, in formalin‐fixed, paraffin wax‐embedded colonic tissue from pigs naturally infected withSalmonella typhimuriumandS. choleraesuis. Byin situhybridization, a distinct positive signal for TNF‐α, IL‐1, IL‐6 and IL‐8 was detected in colon from all 12 infected pigs. Hybridization signals for all four inflammatory cytokines were detected primarily inflammatory cells infiltrating the lamina propria and submucosa. In comparison, expression of all four inflammatory cytokines was minimal in non‐lesional colon of infected pigs and in normal colon from control pigs. The results suggest that these cytokines play an important role in the pathophysiological processes in porcine salmonellosis.
Hepatic Effects of Halothane, Isoflurane or Sevoflurane Anaesthesia in Dogs
Authors: Topal A. , Gül N. , İlçöl Y. , Görgül O. S.
Published: February 2004

The effects of halothane, isoflurane and sevoflurane anaesthesia on hepatic function and hepatocellular damage were investigated in dogs, comparing the activity of hepatic enzymes and bilirubin concentration in serum. An experimental study was designed. Twenty‐one clinically normal mongrel dogs were divided into three groups and accordingly anaesthetized with halothane (n = 7), isoflurane (n = 7) and sevoflurane (n = 7). The dogs were 1–4 years old, and weighed between 13.5 and 27 kg (18.4 ± 3.9). Xylazine HCI (1–2 mg/kg) i.m. was used as pre‐anaesthetic medication. Anaesthesia was induced with propofol 2 mg/kg i.v. The trachea was intubated and anaesthesia maintained with halothane, isoflurane or sevoflurane in oxygen at concentrations of 1.35, 2 and 3%, respectively. Intermittent positive pressure ventilation (tidal volume, 15 ml/kg; respiration rate, 12–14/min) was started immediately after intubation and the anaesthesia lasted for 60 min. Venous blood samples were collected before pre‐medication, 24 and 48 h, and 7 and 14 days after anaesthesia. Serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma‐glutamyltransferase (GGT), lactate dehydrogenase (LDH GGT) activities and bilirubin concentration were measured. Serum AST, ALT and GGT activities increased after anaesthesia in all groups. In the halothane group, serum AST and ALT activities significantly increased all the time after anaesthesia compared with baseline activities. But in the isoflurane group AST and ALT activities increased only between 2 and 7 days, and in the sevoflurane group 7 days after anaesthesia. GGT activity was increased in the halothane group between 2 and 7 days, and in the isoflurane and sevoflurane groups 7 days after anaesthesia. All dogs recovered from anaesthesia without complications and none developed clinical signs of hepatic damage within 14 days. The results suggest that the use of halothane anaesthesia induces an elevation of serum activities of liver enzymes more frequently than isoflurane or sevoflurane from 2 to 14 days after anaesthesia in dogs. The effects of isoflurane or sevoflurane anaesthesia on the liver in dogs is safer than halothane anaesthesia in dogs.
Long‐term Effects of Dietary Anion–Cation Balance on Acid–Base Status and Bone Morphology in Reproducing Ewes
Authors: Espino L. , Guerrero F. , Suarez M. L. , Santamarina G. , Goicoa A. , Fidalgo L. E.
Published: February 2004

The beneficial effects of anionic salts on calcium metabolism have been shown by supplementing rations with such salts during the last 3 weeks of pre‐partum. However, there are few reports on the effects of anionic salts supplementation for periods of 4 weeks or longer on acid–base status, mineral metabolism and bone morphology. This study was conducted to evaluate the effects of the long‐term dietary supplementation of anionic salts on the acid–base status, plasma minerals concentrations and bone morphology in sheep. Twenty‐seven twin‐bearing sheep were assigned to two experimental groups and a control group, depending on dietary cation–anion difference (DCAD) (+272.6, −88.9 and +164.5 mEq/kg DM, respectively). Sheep assigned to each dietary treatment received their respective rations beginning 6 weeks pre‐partum and continuing until 12 days post‐partum. Diets containing anionic salts induced a mild metabolic hyperchloraemic acidosis from 1 week pre‐partum to 2 days post‐partum that was completely compensated by non‐respiratory mechanisms. These changes on acid–base status were accompanied by an increase of plasma ionized calcium levels. Plasma total calcium, phosphorus and magnesium concentrations were not affected by dietary treatment. Parathyroid hormone concentrations were related to the concentration of ionized calcium of plasma and were higher in sheep fed the cationic diet. Plasma osteocalcin levels were increased in sheep fed the anionic diet and cortical bone remodelling occurred in all the animals during late pregnancy in light and electron microscopy observation, but was particularly evident in the sheep fed the anionic diet. Bone turnover might be stimulated because of the role of the bone in buffering systemic acidosis. The data suggest that anionic salts ameliorated calcium metabolism around parturition by increasing bone resorption and the concentration of ionised calcium in plasma, possibly mediated by a mild hyperchloraemic metabolic acidosis induced by the salts.
Total Serum Alkaline Phosphatase Activity in Dogs with Mammary Neoplasms: a Prospective Study on 79 Natural Cases
Authors: Karayannopoulou M. , Koutinas A. F. , Polizopoulou Z. S. , Roubies N. , Fytianou A. , Saridomichelakis M. N. , Kaldrymidou E.
Published: February 2004

Increased total alkaline phosphatase (TALP) activity in the serum, long noticed in canine mammary tumours among other neoplasms, has not been yet associated with malignancy, osseous transformation of neoplastic tissue or histopathological typing. Therefore, the purpose of this study was to correlate this biochemical abnormality with the above‐mentioned parameters, in 79 adult to elderly female dogs with mammary neoplasms, without evidence of metastatic or any other disease. Histopathology disclosed that 64 (81%) of these neoplasms were malignant and 15 (19%) benign, belonging to various histological types. Radiology and histopathology revealed the presence of osseous tissue in 18 (22.8%) cases. The malignant neoplasms were subsequently allocated into group A including 46 (74.2%) of epithelial origin and group B with 16 (25.8%) neoplasms of both epithelial and mesenchymal origin (‘malignant mixed’ tumours). In addition, their benign counterparts were divided into group C (adenomas, fibroadenomas) and group D (benign mixed tumours) that included seven (46.7%) and eight (53.3%) tumours, respectively. Almost 55% of the dogs with malignant and 47% with benign tumours had increased serum‐TALP activity. However, no significant difference in serum‐TALP activity was found between the dogs with malignant (mean ± SE: 243.7 ± 37.4 U/l) and benign (167.9 ± 38.4 U/l) neoplasms, with (238.9 ± 45.3 U/l) and without (226.5 ± 38.3 U/l) osseous transformation, with (298.5 ± 85.6 U/l) or without (201.2 ± 30.5 U/l) myoepithelial cell proliferation and with different tumour size (T1/T2: 175.1 ± 34.9 and T3: 254.5 ± 42.5 U/l). In histopathological typing, the only difference noticed involved the malignant neoplasms of group A (190.5 ± 25.5 U/l) compared with group B (378 ± 124.6 U/l) dogs. The higher increase of serum‐TALP activity in ‘malignant mixed’ tumours could not be attributed to osseous transformation or new ALP isoenzyme production by myoepithelial cells. Increased serum‐TALP activity is of no apparent diagnostic (as to tumour type) or prognostic value.
Expression of Transforming Growth Factor‐β Isoforms in the Skin, Kidney, Pancreas and Bladder in a German Shepherd Dog affected by Renal Cystadenocarcinoma and Nodular Dermatofibrosis
Authors: Vercelli A. , Bellone G. , Abate O. , Emanuelli G. , Cagnasso A.
Published: February 2004

The present study was performed to assess the expression of isoforms 1, 2 and 3 of transforming growth factor (TGF)‐β in skin nodular dermatofibrosis lesions, kidney, bladder and pancreas from a 10‐year‐old female German shepherd dog (GSD) affected by renal cystadenocarcinoma and nodular dermatofibrosis (RCND) compared with normal GSDs (n = 2). Formalin‐fixed, paraffin‐embedded tissues obtained from the dog affected by RCND, diagnosed by renal ultrasonography and histopathological examination were analysed by immunohistochemistry using polyclonal antibodies to TGF‐β1, 2 and 3, and evaluated semiquantitatively using an immunoreactivity score. Similar expression of TGF‐β2 and TGF‐β3 was observed in all tissue specimens in both the RCND‐affected animal and normal dogs. In contrast, TGF‐β1 immunoreactivity was increased in the derma of the RCND canine. Comparable TGF‐β1 serum levels were found between the diseased and normal animals. The increased local cutaneous production of TGF‐β1 in the RCND dog, compared with the normal animals, suggests that this cytokine may play an important role in the induction of nodular dermatofibrosis associated with renal cystadenocarcinoma.
New evidence or changing population? Reviewing the evidence of a link between mental illness and violence
Authors: Paterson Brodie , Claughan Peter , McComish Sandy
Published: February 2004

ABSTRACT:  There has been an apparent shift in majority opinion within psychiatry over the last 20 years on the nature of the relationship between mental illness and violence. Where once there was perhaps widespread scepticism, research, while sometimes producing conflicting results, appears ultimately to have led to the emergence of an almost universal consensus that there is a link. This paper will review the nature of the evidence for such a link between mental illness and violence and explore some of the newer suggestions about why mental illness may sometimes be related to violence
DECREASED OXIDATIVE STRESS IN PREHEPATIC PORTAL HYPERTENSIVE RAT LIVERS FOLLOWING THE INDUCTION OF DIABETES
Authors: Evelson P , Llesuy S , Filinger E , Rodriguez RR , Lemberg A , Scorticati C , Susemihl M , Villareal I , Polo JM , Peredo H , Perazzo JC
Published: February 2004

1. Oxidative stress (OS) is a biological entity indicated as being responsible for several pathologies, including diabetes. Diabetes can also be associated with human cirrhosis. Portal hypertension (PH), a major syndrome in cirrhosis, produces hyperdynamic splanchnic circulation and hyperaemia. The present study was designed to investigate the occurrence of OS in prehepatic PH rat livers following the induction of diabetes.

2. Five groups of rats were used: control, sham operated, chronic diabetes (induced with a single dose of streptozotocin at 60 mg/kg, i.p.), prehepatic PH and chronic diabetic plus prehepatic PH. The occurrence of OS was determined in liver homogenates by measuring hydroperoxide‐initiated chemiluminescence and the activity of anti‐oxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase).

3. Prehepatic PH produced a significant increase in hydroperoxide‐initiated chemiluminescence in the liver compared with control and sham‐operated rats, whereas the liver in chronic diabetic rats showed no difference. However, chemiluminescence values decreased almost by 50% in the chronic diabetic plus prehepatic PH group. Concomitantly, the activities of the anti‐oxidant enzymes in chronic diabetes, prehepatic PH and chronic diabetic plus prehepatic PH groups were decreased (P < 0.05 vs control and sham‐operated groups).

4. Livers from the chronic diabetic group did not show any evidence of the occurrence of OS, whereas the prehepatic PH group showed the occurrence of OS. The association of PH and chronic diabetes resulted in a significant decrease in the occurrence of OS, which could be explained by an anti‐oxidant response to an OS.