bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary Aquaporin-2 Excretion in Preterm and Full-Term Neonates
Authors: Nyul Z. , Vajda Zs. , Vida G. , Sulyok E. , Frokiaer J. , Nielsen S.
Published: April 2003

The study was undertaken to define the role of aquaporin-2 (AQP2) in renal concentrating performance by measuring urinary AQP2 excretion and urine osmolality in healthy preterm and full-term neonates during early postnatal life. Random urine samples were obtained from 9 full-term newborn infants (mean birth weight 3,218 g, mean gestational age 39.2 weeks) at postnatal ages of 1, 3 and 5 days. Five premature infants with a mean birth weight of 1,570 g and mean gestational age of 30.6 weeks were studied at the end of the 1st week and then weekly up to the 6th week. Urine osmolality (Knauer osmometer), creatinine (modified Jaffé’s method) and AQP2 concentrations (radioimmunoassay) were measured. In full-term neonates, urinary AQP2 excretion showed no consistent changes over the age period studied, while urine osmolality decreased significantly with advancing age. In premature infants, urinary AQP2 excretion remained practically unchanged during the first 4 weeks followed by an abrupt increase thereafter. Urine osmolality did not follow the developmental pattern of AQP2 excretion; its mean values varied only from 78 ± 39 to 174 ± 146 mosm/l during the experimental period. It is concluded that during the early postnatal period, urinary AQP2 excretion does not serve as a direct marker of the renal action of AVP and the renal capacity to concentrate urine.
Decreased Phagocytic Capacity of Cord Blood Monocytes in Second- and Third-Born Multiplets
Authors: Pomberger Gerhard , Hallwirth Ulrike , Strohmer Heinz , Spittler Andreas , Wald Martin , Zaknun Daniela
Published: April 2003

Objective: To assess the risk to second- and third-borns of developing perinatal infections based on a diminished first-line immune response in comparison to the first-born. Study Design: 11 sets of twins and 2 sets of triplets (27–39 weeks of gestation, 740–3,560 g birth weight) admitted consecutively to our neonatal care unit were investigated. All were delivered by cesarean section. Phagocytosis and the expression of TNF-α and IL-1 in cord blood were determined immediately and 72 h after birth from peripheral blood monocytes by FACS analysis and ELISA. Results: In all second- and third-borns, phagocytosis of cord blood monocytes was significantly decreased in comparison to the first-borns (p < 0.001, p < 0.015). 72 h after birth phagocytosis determined from peripheral blood showed no significant difference between the first-borns and the second- and third-borns. Cytokine expression revealed no significant differences dependent on birth order. Conclusion: We suggest that the observed temporarily diminished first-line immune response of second- and third-born multiplets might be the result of a short-term reduced cellular oxygenation during delivery, but has no influence on further immunological deficiency leading to a higher risk of perinatal infections.
The Cerebellum at Birth in Therian Mammals, with Special Reference to Rodents
Authors: Sánchez-Villagra Marcelo R. , Sultan Fahad
Published: April 2003

The stage of cerebellar development at birth was assessed in 23 species of placental mammals. Serial histological sections were examined and five stages in the differentiation of the cerebellar cortical layers were defined. A wide diversity of conditions at birth was found. The available evidence (after parsimony reconstruction) suggests that the last common ancestor of placentals was born with an altricial cerebellum in which the molecular layer was just present between the external granular layer and the prospective Purkinje cell layer. Some placental species have an even more altricial cerebellum at birth (e.g., Muscardinus avellanarius, Sorex araneus), with Mesocricetus auratus as the most altricial species among the taxa studied. In the newborn M. auratus a cerebellar anlage was present with only a loose accumulation of cells located at the dorsal cerebellar anlage above the ventricular neuroepithelial layer. The five species of caviomorph rodents examined here are relatively precocial as far as the cerebellum is concerned. The only other rodent species that has a similarly advanced state was the murid Acomys sp. Most of the life history variables examined were not strongly correlated with the cerebellar stage at birth if at all. However, a significant positive correlation (r2 = 0.67) was observed between the cerebellar stage at birth and the gestation length and a significant negative correlation (r2 = 0.31) was observed between cerebellar stage and the average litter size. The weak correlation may be due to sampling among different distantly related clades. The most mature cerebella at birth still had an external granular layer, indicating that the mossy fiber-granule cell connectivity is not yet fully developed and further indicating that this connectivity may depend on external experience to fully mature. All species that have their eyes open at birth also have the most mature cerebelli. The growth of the cortical layers was also studied in a postnatal ontogenetic series of the marsupial Monodelphis domestica. As is the case with placentals, the most advanced stage of cerebellar development coincides with the opening of the eyes.
Non-Compliance with National Guidelines in the Management of Acute Pancreatitis in the United Kingdom
Authors: Aly Emad A.H. , Milne R. , Johnson C.D.
Published: April 2003

Background: Deficiencies and lack of standardisation of the management of acute pancreatitis in the UK have been reported. National UK guidelines for the management of acute pancreatitis were published in 1998. However, implementation of national guidelines in other areas has been patchy, suggesting that evaluation of the uptake of the pancreatitis guidelines would be appropriate. Aim: Identification of current practice in the management of acute pancreatitis as reported by consultant surgeons, in order to determine how effectively the UK guidelines have been introduced into practice. Methods: A questionnaire was posted to 1,072 full members of the Association of Surgeons of Great Britain and Ireland. It consisted of 13 questions that aimed to identify the surgeon’s practice in the management of patients with acute pancreatitis in relation to key points in the UK guidelines. We compared the practice of hepatobiliary and pancreatic (HBP) vs. non-HBP specialists, and teaching vs. non-teaching hospital surgeons using the χ2 test. Results: Of 538 responses (50%), 519 were from consultant surgeons. 59 did not look after patients with acute pancreatitis and 89 (17%) had a HBP interest. There were differences between the recommendations in the guidelines and reported practice, particularly in the use of critical care resources and referral to specialist units. Of consultants looking after acute pancreatitis 371 (72%) were non-HBP specialists. There were significant overall differences between the practice of HBP specialists and non-specialists: in severity assessment (Glasgow and C-reactive protein vs. Ranson criteria); indication and timing of requesting computed tomography (routinely at 7–10 days vs. when clinically indicated); nutritional support (enteral feeding vs. no support), and in common bile duct assessment prior to cholecystectomy (intra-operative cholangiography vs. endoscopic retrograde cholangiopancreatography). There was no significant difference between practice in teaching and non-teaching hospitals. Conclusion: Implementation of national guidelines for the management of acute pancreatitis was greater in the practice of HBP specialists than non-specialists. This has implications for the rationale of creating guidelines, and for the strategies associated with their introduction.
Triad of Malnutrition, Inflammation, and Atherosclerosis in Hemodialysis Patients
Authors: Sezer Siren , Özdemir F. Nurhan , Arat Zübeyde , Turan Münire , Haberal Mehmet
Published: April 2003

Background/Aim: As chronic inflammation underlies both atherosclerosis and malnutrition, a possible link between these factors has been suggested in hemodialysis (HD) patients. We designed this study to compare nutritional indices and inflammatory parameters of HD patients with demonstrated atherosclerosis (group I) and HD patients without (group II). Methods: We included 59 and 57 patients in groups I and II, respectively. The patient groups were matched for the risk factors for atherosclerosis such as age, gender, smoking habits, hypertension, and HD duration. The nutritional status of the patients was evaluated according to laboratory parameters, normalized protein catabolic rate, anthropometric measurements, and subjective global assessment. Results: Laboratory parameters (albumin, prealbumin, total cholesterol, phosphorus, creatinine), normalized protein catabolic rate, and triceps skinfold thickness revealed a significant decline in the nutritional status of the patients with atherosclerosis. We found that the patients with atherosclerosis had significantly higher C-reactive protein, ferritin, and fibrinogen levels when we compared the patient groups for acute-phase reactants. When we assessed malnutrition as being in category B/C (B = mild to moderately malnourished, C = severely malnourished) according to subjective global assessment and inflammation on the basis of a C-reactive protein level ≧10 mg/l, among patients with atherosclerosis, there was a significantly higher proportion of them having malnutrition and inflammation. Additionally, the proportion of patients without any evidence of malnutrition and inflammation was significantly lower in group I than in group II. Conclusion: Our study gives evidence for the possible triad of malnutrition, inflammation, and atherosclerosis in HD patients.
LiCl Attenuates M1AChR-Mediated Intrathecal Pilocarpine-Induced Reciprocal Hindlimb Scratching in Mice
Authors: Martinez Rebecca P. , Raffa Robert B.
Published: April 2003

Pretreatment of mice with a subcutaneous (s.c.) injection of LiCl (1, 3, 10 mmol/kg) 18 h prior to testing produced dose-related attenuation of the reciprocal hindlimb scratching (RHS) response induced by intrathecal (i.t.) administration of pilocarpine. LiCl (10 mmol/kg, 424 mg/kg) pretreatment shifted the pilocarpine (2 µg)-induced RHS dose-response curve about 5-fold to the right compared to vehicle-injected controls (ED50 = 2.97 and 0.56  µg, respectively). Coadministration of inositol-1,4,5-trisphosphate (IP3; 5, 10, 20 µg), but not inositol hexaphosphate (0.03–3 µg), myo-inositol (10 µg) or EDTA (1.33 µg), produced dose-related reversal of the LiCl effect. IP3 administration alone neither produced RHS nor enhanced the pilocarpine-induced RHS in animals not pretreated with LiCl. These findings provide in vivo evidence for a possible link between RHS and a LiCl-sensitive, possibly phosphoinositide-related, effector pathway.
Rupture of a Renal Artery Aneurysm in Pregnancy
Authors: Meabed Ahmed H. , Onuora Vincent C. , Al Turki Mohammed , Koko Abdelmoniem H. , Al Jawini Nasser
Published: April 2003

Rupture of a renal artery aneurysm is a well-recognized phenomenon. The rupture usually occurs in late pregnancy. We report a case in whom this occurred in the first trimester of pregnancy.
Inhibitory Control of Growth Hormone Secretion by Somatostatin in Rat Pituitary GC Cells: sst2 but Not sst1 Receptors Are Coupled to Inhibition of Single-Cell Intracellular Free Calcium Concentrations
Authors: Cervia Davide , Petrucci Cristina , Bluet-Pajot Marie Thérèse , Epelbaum Jacques , Bagnoli Paola
Published: April 2003

Rat pituitary tumor cells (GC cells) exhibit spontaneous oscillations of intracellular free calcium concentration ([Ca2+]i) that allow continuous release of growth hormone (GH). Of the somatostatin (SRIH) receptor subtypes (sst receptors) mediating SRIH action, sst1 and sst2 receptors are highly expressed by GC cell membranes. In the present study, the effects of sst1 or sst2 receptor activation on single-cell [Ca2+]i were investigated in GC cells by confocal fluorescence microscopy. In addition, the effects of sst1 or sst2 receptor activation on GH secretion were also studied. Our results demonstrate that SRIH decreases [Ca2+]i baseline and almost completely blocks Ca2+ transients through activation of sst2 but not of sst1 receptors. In contrast, SRIH effectively inhibits GH secretion through activation of both sst1 and sst2 receptors. Blocking Ca2+ transients is less efficient than SRIH to inhibit GH release. The cyclic octapeptide, CYN-154806, antagonizes sst2 receptors at [Ca2+]i since it abolishes the sst2 receptor-mediated inhibition of [Ca2+]i without affecting single-cell Ca2+ signals. On the other hand, CYN-154806 alone potently inhibits GH secretion through the involvement of pertussis toxin-sensitive G proteins. In conclusion, the present results demonstrate that SRIH inhibition of GH release in GC cells involves mechanisms either dependent or independent on SRIH modulation of [Ca2+]i. The implications of CYN-154806 inhibition of GH secretion are discussed.
Identification of Differentially Expressed cDNA Clones from Gerbil Cochlear Outer Hair Cells
Authors: Zheng Jing , Long Kevin B. , Robison Donald E. , He David Z.Z. , Cheng Jennifer , Dallos Peter , Madison Laird D.
Published: April 2003

In order to identify genes that are associated with outer hair cell(OHC)-specific function, a plasmid library enriched with OHC-specific gene products was constructed using single cell-type-specific complementary DNA (cDNA) and a PCR subtractive hybridization strategy. As a first step, we created separate OHC and inner hair cell (IHC) cDNA pools from individually collected cells using a nonspecific reverse transcription polymerase chain reaction. Next, the OHC cDNA was subtracted against IHC cDNA using a PCR-based subtractive technique. IHCs and OHCs share many common features, making IHC cDNA an ideal ‘driver’ to ‘subtract away’ common hair cell gene products and enrich differentially expressed cDNAs, including OHC-specific genes. The subtracted OHC cDNAs were then cloned to generate an OHC – IHC subtracted cDNA plasmid library. Finally, a differential screening procedure was performed, resulting in 477 differentially positive clones. After analysis of these 477 clones, 50 known genes were identified, including two previously known OHC-specific proteins: oncomodulin and the recently described motor protein prestin. An additional 84 novel clones were also found. As this library of cDNA fragments represents differentially expressed genes in OHCs, it can be used as starting material for isolation and characterization of a complete set of OHC gene products, an important step in investigating normal and abnormal cochlear function.
The Decorin Gene 179 Allelic Variant Is Associated with a Slower Progression of Renal Disease in Patients with Type 1 Diabetes
Authors: De Cosmo S. , Tassi V. , Thomas S. , Piras G.P. , Trevisan R. , Cavallo Perin P. , Bacci S. , Zucaro L. , Cisternino C. , Trischitta V. , Viberti G.C.
Published: April 2003

Background genetic factors may influence the variability in the rate of progression of kidney disease in type 1 diabetes. In diabetes, progressive mesangial matrix expansion and glomerular sclerosis are, to a large extent, mediated by TGF-β1. Decorin, a proteoglycan which is a component of the extracellular matrix, regulates TGF-β1 activity and expression. We have examined the relationship between the 179/183/185 polymorphism of the Decorin gene and the progression of diabetic nephropathy. Methods: From a cohort of 175 European patients with diabetic nephropathy, we studied 79 patients who were selected because they had a follow-up of at least 2 years (average 6.5 years; range: 2.5–15 years), and regular measurements of serum creatinine on 5 or more occasions. Creatinine clearance (CrCl) calculated from serum creatinine concentration was used as a measure of derived glomerular filtration rate (dGFR). All patients were on antihypertensive therapy. Results: The rate of dGFR decline in the whole cohort was [median (range)] 4.6 (–3.8 to 18) ml/min/year. No patient with 185 allele was found. Patients with 179/183 and 179/179 genotype (n = 14), who were considered together and named 179 carriers, had a slower rate of GFR decline [2.1 (0.06–11.7) ml/min/year] as compared to patients with Decorin 183/183 genotype (n = 65) [5.6 (–3.8 to 18) ml/min/year; p < 0.001]. In addition, when considering individual data, patients carrying the 179 allele had a 3.0 (95%CI: 1.8–4.2)-fold higher probability to be slow progressors (i.e. GFR decline below the median). This difference could not be accounted for by differences in duration of disease, type and duration of antihypertensive therapy, albumin excretion rate, blood glucose or blood pressure control. In a multivariate logistic analysis albumin excretion rate (p < 0.001), mean arterial pressure (p = 0.07) and Decorin gene polymorphism (p = 0.036), but not HbA1c, were independently correlated with the rate of dGFR fall. Conclusion: The 179 allele variant of the Decorin gene is related to a slower progression of DN in type 1 diabetic patients with albuminuria and receiving antihypertensive therapy.
Renoprotection following Treatment of Secondary Hyperparathyroidism with Percutaneous Ethanol Injection in Pre-Dialysis Patients
Authors: Chen Han-Hsiang , Chen Yi-Chou , Yeh Jui-Chi
Published: April 2003

What could be done for patients with chronic renal failure are marginally beneficial. Among 58 pre-dialysis patients, we found 24 of chronic glomerulonephritis (CGN) with serum creatinine >5 mg/dl and intact parathyroid hormone (i-PTH) >200 pg/ml. In this study, we determined if the residual renal function could be preserved when hyperparathyroidism was corrected by either low-dose calcitriol treatment or ethanol injection. The 58 CGN patients were divided into three groups. The first group, which comprised 11 cases with i-PTH >200 pg/ml and had parathyroid mass, were treated by ultrasonography-guided percutaneous ethanol injection therapy (PEIT). The second study group composed of 13 cases with i-PTH >200 pg/ml without parathyroid mass were treated by calcitriol 1 µg every other day. The third group made up of 34 cases with i-PTH <200 pg/ml, who did not receive calcitriol or ethanol therapy. All patients were followed up within 2 years or until dialysis. The average rate of decline in renal function (slope of reciprocal serum creatinine vs. time) was 0.0025 ± 0.0026 dl/mg month in group 1, 0.0054 ± 0.0024 in group 2, and 0.0067 ± 0.0025 in group 3 (p = 0.018 in group 1 vs. group 2, p < 0.001 in group 1 vs. group 3). The declines of i-PTH, phosphorus, and alkaline phosphatase, and the increase of calcium were all significantly different between group 1 and group 3. Two cases of group 1, 6 cases of group 2, and 20 cases of group 3 entered into dialysis during this study. In conclusion, selective PEIT guided by color Doppler flow mapping is an effective therapy for treating hyperparathyroidism and protecting the residual renal function.
Potential of Sanguiin H-6 against Oxidative Damage in Renal Mitochondria and Apoptosis Mediated by Peroxynitrite in vivo
Authors: Yokozawa Takako , Chen Cui Ping , Rhyu Dong Young , Tanaka Takashi , Park Jong Cheol , Kitani Kenichi
Published: April 2003

Potential of sanguiin H-6, a component of Sanguisorbae Radix, to protect against oxidative damage in renal mitochondria and apoptosis mediated by peroxynitrite (ONOO–) was examined using a model in which rats were injected with lipopolysaccharide (LPS) and then subjected to renal ischemia followed reperfusion (LPS plus ischemia-reperfusion). Ischemia-reperfusion was achieved by occluding bilateral renal artery for 60 min and then releasing for 350 min. At 50 min after ischemia started, LPS was injected intravenously. LPS plus ischemia-reperfusion induced a large amount of 3-nitrotyrosine, an oxidative product of protein that is produced via ONOO– nitration, which was not detectable in normal group. Oxidative damage of mitochondria was indicated by an accumulated thiobarbituric acid (TBA)-reactive substance, glutathione (GSH) depletion and glutathione peroxidase (GSH-Px) inactivation in the mitochondria. Treatment of rats with sanguiin H-6 (10 mg/kg body weight/day) for 30 days prior to LPS plus ischemia-reperfusion attenuated the oxidative damage in the mitochondria. The amount of TBA-reactive substance was decreased and the GSH levels significantly increased as compared with that in control group. However, its effect on GSH-Px activity was much weaker. Apoptosis induced by LPS plus ischemia-reperfusion was detected by fluorescence staining, TdT-mediated dUTP-biotin nick end labeling and electrophoretic analysis. Sanguiin H-6 appeared to inhibit apoptosis, and this was associated with the suppression of caspase-3 activity. These beneficial effects of sanguiin H-6 against oxidative damage in mitochondria and apoptosis contributed to the improvement in renal function by reversing the elevated levels of blood urea nitrogen and creatinine caused by ONOO–.
Effects of Direct Current Electric Fields on Cell Migration and Actin Filament Distribution in Bovine Vascular Endothelial Cells
Authors: Li Xuefeng , Kolega John
Published: April 2003

Electric fields exceeding 1 V/cm occur during wound healing, morphogenesis, and tumor growth, and such fields have been shown to induce directional migration of a variety of different cells. However, the mechanism by which electric fields direct cell movement is not yet understood, and the effects on vascular endothelial cells are entirely unknown. We demonstrate that cultured bovine aortic endothelial cells migrate toward the cathode of an applied electric field. Time-lapse microscopic imaging shows that the field suppresses protrusive activity from anode-facing surfaces of the cells while stimulating protrusions from surfaces that face the cathode. The threshold for this response is 1–2 V/cm, similar to field strengths measured in vivo. In addition, fluorescence microscopy shows that lamellipodia projecting toward the cathode are rich in actin filaments. Using quantitative image analysis, we show that the electric field induces a transient 80% increase in the amount of filamentous actin in the cell. Comparison of the distribution of F-actin with total protein distribution indicates that F-actin is asymmetrically distributed in the cytoplasm, being selectively enriched toward the cathode. We propose that physiological electric fields direct cell migration by eliciting an intracellular signal that creates new sites for actin assembly in the cathodal cytoplasm.
Increased Coronary Vascular Resistance Cannot Be Reduced by Inhibiting Sympathetic Overactivity in Hypertension
Authors: Sundell Jan , Laine Hanna , Luotolahti Matti , Nuutila Pirjo , Knuuti Juhani
Published: April 2003

The aim of this study was to test whether increased coronary vascular resistance in hypertensive subjects can be reduced by centrally inhibiting sympathetic overactivity with dexamethasone. Coronary vascular resistance was quantitated in 11 men with untreated mild essential hypertension (RR 149 ± 13/98 ± 10 mm Hg) and 23 healthy, normotensive, otherwise matched men using positron emission tomography and [15O]H2O. The measurements were performed at baseline and during adenosine stimulation. Each subject was studied twice, with and without previous dexamethasone treatment for two days (0.5 mg × 4 per day). Before dexamethasone treatment, cardiac index and plasma norepinephrine concentration (1.9 ± 0.6 vs. 1.3 ± 0.5 nmol/l, p < 0.01) were significantly higher in hypertensive than in normotensive subjects. Additionally, both baseline and hyperemic coronary vascular resistances were higher in hypertensive than normotensive subjects (147 ± 31 vs. 113 ± 24 and 36 ± 9 vs. 25 ± 10 mm Hg·min·g·ml–1; p < 0.05). Dexamethasone treatment significantly decreased plasma norepinephrine concentrations in hypertensive subjects, leading to comparable plasma norepinephrine concentrations in hypertensive and normotensive subjects (1.4 ± 0.5 vs. 1.2 ± 0.4 nmol/l; NS). However, coronary vascular resistances remained increased in hypertensive subjects. In conclusion, hypertensive subjects are characterized by sympathetic overactivity, which can be normalized by dexamethasone. However, coronary vascular resistances remained increased in hypertensive subjects after dexamethasone treatment, suggesting that other mechanisms than sympathetic overactivity-induced vasoconstriction explain the increased coronary vascular resistance in hypertension.
Magnetic Resonance Imaging Diagnosis of a Deep Soft Tissue Leiomyoma under the Rectus Muscle
Authors: Sumi Toshiyuki , Ishiko Osamu , Ueda Kayoko , Wakasa Kenichi , Ogita Sachio
Published: April 2003

Leiomyomas of the deep soft tissue are extremely rare. We report a case of a deep soft tissue leiomyoma that was difficult to differentiate from a uterine leiomyoma. A 48-year-old woman was diagnosed with a uterine leiomyoma, but surgical and pathological findings revealed a deep soft tissue leiomyoma and normal uterus.
Repair of Vaginal Prolapse following Penoscrotal Flap Vaginoplasty in a Male-to-Female Transsexual
Authors: Loverro Giuseppe , Bettocchi Carlo , Battaglia Michele , Cormio Gennaro , Selvaggi Gennaro , Di Tonno Pasquale , Selvaggi Francesco Paolo
Published: April 2003

Penis and testicle amputation, vaginoplasty, and clitoroplasty are procedures that help male-to-female transsexuals to accept their body and to increase psychosocial well-being. We describe a successful correction of prolapse of the neovagina with abdominovaginal sacropexy in a male-to-female transsexual who had undergone penoscrotal flap vaginoplasty. Although the reasons for a neovaginal prolapse are not completely known, in our case vaginal sacropexy was successful, with good functional and cosmetic results.
Psychiatric Morbidity amongst Infertile Chinese Women Undergoing Treatment with Assisted Reproductive Technology and the Impact of Treatment Failure
Authors: Lok Ingrid Hung , Lee Dominic Tak Shing , Cheung Lai Ping , Chung Wai Sau , Lo Wing Kit , Haines Christopher John
Published: April 2003

This is a prospective study to assess the psychiatric morbidity in Chinese infertile women who underwent treatments with assisted reproductive technology and also the impact of treatment failure. The 30-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were employed before and 3 weeks after the assisted reproductive technology treatment. Data from 372 patients who completed the questionnaires and failed the treatment were analyzed. Before treatment, 33% of the participants scored above the GHQ cutoff, and 8% had a BDI score of 20 or above, signifying moderate to severe depression. Following failed treatment, 43% scored above GHQ cutoff, and 8% had BDI scores 20 or above. The posttreatment GHQ and BDI scores were significantly higher than the corresponding scores at baseline (p < 0.001). About 13% of the participants reported self-harm ideas. The severity of depression following a failed treatment was positively associated with the duration of infertility (p < 0.05), but not with the posttreatment BDI scores, age, education, and number of previous treatment episodes. Our results show that one third of the women who sought infertility treatment had an impaired psychological well-being. Following failed treatment, there was a further deterioration in mental health, and about 10% of the participants were moderately to severely depressed. Proper psychological care and counseling should be an integral part of infertility management among the Chinese population.
Could Honey Have a Place in Colitis Therapy? Effects of Honey, Prednisolone, and Disulfiram on Inflammation, Nitric Oxide, and Free Radical Formation
Authors: Bilsel Y. , Bugra D. , Yamaner S. , Bulut T. , Cevikbas U. , Turkoglu U.
Published: April 2003

Background/Aims: The purpose of this study was to investigate the potential therapeutic roles of honey, prednisolone and disulfiram in an experimental model of inflammatory bowel disease. Another aspect of the study was to find out whether these substances have any effect on nitric oxide (NO) and free radical production. Methods: After the induction of colitis with trinitrobenzene sulfonic acid in 64 male rats, physiological saline, honey, prednisolone and disulfiram enemas were applied to the rats once daily for 3 days (acute treatment groups) or 7 days (chronic treatment groups). Control groups received only saline enemas. Rats were killed on the 4th or 8th days and their colonic mucosal damage was quantitated using a scoring system. Acute and chronic inflammatory responses were determined by a mucosal injury score, histological examination and measurement of the myeloperoxidase (MPO) activity of tissues. The content of malonylaldehyde (MDA) and NO metabolites in colon homogenates was also measured to assess the effects of these substances on NO and free oxygen radical production. Results: Estimation of colonic damage by mucosal injury scoring was found to be strongly correlated with the histologic evaluation of colon specimens. On the other hand, mucosal injury scores were not correlated with MPO, MDA or NO values. There were significant differences between the MPO results of chronic-control and chronic-honey groups, as well as chronic-control and chronic-prednisolone groups (p = 0.03 and p = 0.0007). The acute honey, prednisolone, and disulfiram groups had significantly lower MDA results compared to the acute control group (p = 0.04, p = 0.02, and p = 0.04). In terms of NO, there was no significant difference between the treatment and control groups. NO was found to have a strong relationship with MDA (p = 0.03) and MPO values (p = 0.001). On the other hand, MPO results were not found to be correlated with MDA values (p > 0.05). Conclusions: MPO activity is not directly proportional to the severity of the inflammation, but it may only determine the amount of neutrophil in the tissues. Inflammatory cells are not the sole intensifying factor in colitis. Therefore, mucosal injury scores may not correlate well with MPO activities. In an inflammatory state NO and MPO levels have a strong relationship, since NO is released from the neutrophils. In an inflammatory model of colitis, intrarectal honey administration is as effective as prednisolone treatment. Honey may have some features in the treatment of colitis, but this issue requires further investigation. Honey, prednisolone and even disulfiram also have some value in preventing the formation of free radicals released from the inflamed tissues. Prednisolone may also have some possible benefits in the inhibition of NO production in colitis therapy.
Novel Candidate Genes for Atherosclerosis Are Identified by Representational Difference Analysis-Based Transcript Profiling of Cholesterol-Loaded Macrophages
Authors: Andersson Tove , Boräng Stina , Larsson Magnus , Wirta Valtteri , Wennborg Anders , Lundeberg Joakim , Odeberg Jacob
Published: April 2003

Objectives: To analyze the early gene expression in macrophages accompanying the phenotypic changes into foam cells upon exposure to oxidized low-density lipoprotein. To identify candidate genes and markers for further studies into the pathogenesis of atherosclerosis. Methods: Cells of the monocytic cell line THP-1 were activated by PMA and exposed to oxidized low-density lipoprotein. Gene expression profiles were investigated after 24 h, using a solid phase cDNA representational difference analysis (RDA) method and shotgun sequencing. Results were verified by microarray hybridization, and analyzed in the virtual chip display of a novel software tool for transcript profile exploration. Results: By comparing transcript profiles of exposed/unexposed cells, 1,984 transcript sequences, representing a total of 921 genes with altered expression levels in response to oxidized low-density lipoprotein exposure, were identified. Genes that are central to cell cycle control and proliferation, inflammatory response, and of pathways not previously implicated in atherosclerosis were identified. The data obtained is also made available on-line at http:// biobase.biotech.kth.se/thp1a for further exploration. Conclusion: The identification of new candidate genes for atherosclerotic disease through RDA-based transcript profiling facilitates further functional genomic studies in coronary artery disease. Candidate genetic polymorphism markers of potential clinical relevance can be identified by filtering information in genome variation databases through the virtual chip analysis of the transcript profiles and subsequently tested in association studies.
Factors Predisposing to a Nonadmission of Patients with Acute Myocardial Infarction
Authors: Kentsch Michael , Rodemerk Uwe , Münzel Thomas , Müller-Esch Gert , Ittel Thomas-Heinz , Mitusch Rolf
Published: April 2003

Among patients presenting at the hospital with an acute myocardial infarction (AMI), about 2–6% are mistakenly discharged by emergency physicians. The relevance of diagnostic problems in the prehospital period of an AMI is unknown. We prospectively studied 421 patients seen by a primary care physician in the prehospital period of an AMI. Using a standardized interview, data were obtained to identify factors determining nonadmission. Of 421 AMI patients, 327 (77.7%) were directly admitted to hospital after examination by the physician, whereas 94 (22.3%) were not admitted. The median prehospital delay was 240 min in admitted and 2,200 min in nonadmitted patients. Using a stepwise logistic regression model, the following factors were identified as independent contributors to nonadmission: the patient not being much affected by the symptoms (2.48; 1.40–4.39), improvement of symptoms (2.59; 1.46–4.59), the patient not thinking to suffer an AMI (2.33; 1.28–4.17) and the patient being unable to imagine having a heart disease (1.93; 1.07–3.46). Conclusion: Nonadmission of AMI patients by health care professionals is a common problem. Several aspects of AMI presentation including the often limited intensity of symptoms and the variability of the clinical course may have to be re-emphasized by cardiologists. Taking a very careful history and being circumspect about the patient’s interpretation of symptoms still are the keys to a correct diagnosis of AMI.
An Unusual Case of a Vesicovaginal Stone
Authors: Pang M.W. , Lok H. , Tsui H.Y. , Wong W.S. , Yip S.K.
Published: April 2003

We report a case of an unusual vesicovaginal stone. The dumb-bell-shaped stone created a ball valve effect in the fistula, therefore giving rise to only mild urinary leakage despite the large size of the fistula.
Determinants of Plasminogen Activator Inhibitor-1 in South Asians with Ischaemic Stroke
Authors: Kain Kirti , Young John , Bamford John , Bavington John , Grant Peter J. , Catto Andrew J.
Published: April 2003

To investigate the relationship of circulating plasminogen activator inhibitor-1 (PAI-1) levels with features of insulin resistance and genotype at a single nucleotide insertion/deletion (4G/5G) polymorphism in the promoter region of the PAI-1 gene in 101 South Asian ischaemic stroke patients and 102 symptom-free reference subjects. The allele frequencies were 4G-0.51, 5G-0.49 and 4G-0.61, 5G-0.39 in patients and reference subjects, respectively. There was a significant association between PAI-1 promoter genotype and PAI-1 antigen levels in patients. Regression analysis with significant correlates in the model demonstrated age, gender and triglycerides in patients and fasting insulin and HDL cholesterol in reference subjects as independent predictors of PAI-1 antigen.
Double-Blind Prospective Randomized Comparison of Interferon Gamma-1b versus Placebo after Autologous Stem Cell Transplantation
Authors: Koziner B. , Dengra C. , Cisneros M. , Glancszpigel R.
Published: April 2003

Thirty-eight patients, including 14 with Hodgkin’s disease, 9 with non-Hodgkin’s lymphomas, 4 with multiple myeloma and 11 with solid tumors, were enrolled in our study. Between March 1995 and March 1997, 24 of these patients had been autografted with peripheral blood, and 14 had received peripheral blood autografts plus bone marrow. The study was a double-blind, prospectively randomized comparison of interferon gamma-1b (IFN-γ), given subcutaneously at a dose of 50 µg/m2 daily for 30 days to 18 of the 38 patients, vs. placebo (20 of 38). Administration started after 2 consecutive days of >0.5 × 109 neutrophils/l following autologous stem cell transplantation. At a mean follow-up time of 536 ± 269 days, disease-free survival (DFS) for the IFN-γ and placebo groups was 728 vs. 510 days, respectively (p < 0.0750 by the Generalized Wilcoxon/Peto-Prentice test). Overall survival (OS) time for the IFN-γ and placebo groups was 830 vs. 755 days, respectively. Despite the limited number of patients included in this comparison, a trend for superior DFS was observed in the IFN-γ-treated group, a finding which merits further study.
Advanced Waldenström’s Macroglobulinemia: A Case of Possible Cure after Systemic Chemotherapy, Splenic Radiation and Splenectomy
Authors: Cavanna Luigi , Bertè Raffaella , Lazzaro Antonio , Vallisa Daniele , Moroni Carlo Filippo , Civardi Giuseppe
Published: April 2003

A 41-year-old man with advanced Waldenström’s macroglobulinemia (WM) associated with the hyperviscosity syndrome, massive splenomegaly and with IgM concentration of 10 g/dl, was treated in January 1984 with plasmapheresis, systemic chemotherapy (M2 protocol) and splenic radiotherapy. He rapidly improved and was discharged 1 month later. Fourteen months later he underwent splenectomy since a mild splenomegaly persisted though the normalization of bone marrow, peripheral blood and electrophoresis with an IgM concentration of 140 mg/dl. However, at this time immunofixation and immunoelectrophoresis showed a small IgM-ĸ monoclonal component. The histological and immunohistochemical analysis showed minimal splenic involvement by WM. Two months after splenectomy, immunofixation and immunoelectrophoresis showed no monoclonal component. The spleen was the probable site of minimal residual disease. The patient was treated with monthly chlorambucil and prednisone for 2 years. Subsequently clinical and laboratory tests persisted within normal limits. The last control performed in January 2002 showed that the patient was in good health; bone marrow examination (aspiration, biopsy with immunohistochemical analysis) and immunofixation persisted normally. This interesting case report, with advanced WM, alive, in good health and without signs of disease 18 years from diagnosis, is presented here and the role of splenectomy is debated.
Chronic Haemolytic Anaemia and Glucose-6-Phosphate Dehydrogenase Deficiency
Authors: Hundsdoerfer P. , Vetter B. , Kulozik A.E.
Published: April 2003

Deficiency in glucose-6-phosphate dehydrogenase (G6PD) is the most common enzymopathy, and more than 125 different mutations causing G6PD deficiency have been identified. Chronic haemolytic anaemia (CHA) associated with G6PD deficiency is rare, but there is a cluster of mutations causing CHA between amino acids 361–428 which are encoded by exon 10 of the G6PD gene. This region is involved in the dimer formation of the active G6PD enzyme and therefore plays an important role for enzyme stability and activity. Here, we report a 17-year-old patient with CHA, who carries a rare G → A mutation at nucleotide 1160 which causes an R387H amino acid substitution. We review the reports of the seven previously described patients with this mutation, concluding that G6PD deficiency should be considered as a rare differential diagnosis of chronic haemolytic, non-spherocytic anaemia.
Elevated Blood Levels of Dehydroepiandrosterone Sulphate Vary with Symptom Load in Posttraumatic Stress Disorder: Findings from a Longitudinal Study of Refugees in Sweden
Authors: Söndergaard Hans Peter , Hansson Lars-Olof , Theorell Töres
Published: April 2003

Background: The present study is part of a longitudinal study of recently resettled refugees with the aim of learning which factors in their daily life influence health as measured by self-report and stress-responsive hormones. Methods: In a group of recently resettled refugees with a high incidence of posttraumatic stress disorder (PTSD), diagnosed by structured interview, self-rated symptoms of PTSD were followed three times over a period of 9 months after inclusion in the study. Eighty-six individuals were included in the study and 58 subjects (67.4%) completed it. Blood samples were drawn at each examination for assessment of hormone levels. Results: After adjustment for age, dehydroepiandrosterone sulphate (DHEA-s) was observed to be higher in non-depressed PTSD cases than in non-PTSD without depression. There was an interaction between PTSD and depression regarding DHEA-s levels. DHEA-s correlated significantly with changes in self-rated symptoms of PTSD at last follow-up; the greater the increase in PTSD symptoms, the greater the increase in plasma DHEA-s. The variation of DHEA-s levels in relation to changes in self-rated health in non-PTSD showed the opposite pattern, although not reaching significance. Conclusions: The finding of changes in DHEA-s should encourage further studies of the role of altered steroid metabolism in PTSD.
Multimodal Integration in the Feeding Behaviors of Predatory Teleost Fishes
Authors: New John G.
Published: April 2003

The search for useful model systems to study sensory processing in vertebrate nervous systems has resulted in many neuroethological studies investigating the roles played by a single sensory modality in a given behavior. However, animals behaving in a complex, three-dimensional environment receive a large amount of information from external and internal receptor arrays. Clearly, the integration of sensory afference arising from different modalities into a coherent ‘gestalt’ of the world is essential to the behaviors of most animals. Over the past several years researchers in my laboratory have examined the roles played by the visual and lateral line sensory systems in organizing the feeding behavior of two species of predatory teleost fishes, the largemouth bass, Micropterus salmoides and the muskellunge, Esox masquinongy. The free-field feeding behaviors of these fishes was studied quantitatively in intact animals and compared to animals in which the lateral line and visual systems had been selectively suppressed. The data show that both bass and muskie employ similar approach and strike behaviors. Vision is crucial to the initial detection of, and orientation to, prey. Lateral line and vision together determine the optimum distance and angular deviation for the initiation of a rapid strike toward the prey. Blinded animals are able to strike accurately at prey at very close ranges and small angular deviations, indicating that this modality presents sufficient information to direct the behavior during the final phases of the strike. The results demonstrate that there is a hierarchy of senses involved in feeding behavior, with different modalities playing critical roles in succeeding phases.
Central Venous Catheter Infections in Patients with Acute Leukemia
Authors: Karthaus M. , Doellmann T. , Klimasch T. , Krauter J. , Heil G. , Ganser A.
Published: April 2003

Background: Central venous catheters (CVCs) have become an essential tool for an appropriate management of patients with acute leukemia. Infectious complications are a major concern in patients treated for acute leukemia. Although CVC-related infections are considered to be a major source of infections during neutropenia (<500/µl), data regarding the incidence of CVC-related infections are rare in acute leukemia. Patients and Methods: We analyzed nontunneled CVCs in 58 patients with acute leukemia (22 men/36 women) in 119 chemotherapy cycles from April 1996 to January 1998 in a prospective trial. Proven CVC-related infection was defined as the isolation of the same organism from peripheral blood and CVC tip. CVC infection was suspected or possible when exit site inflammation and positive blood culture or organisms typical for CVC infection were observed. Results: Mean neutropenia/cycle was 16.3 days (SD 8.0). 178 CVCs with 2,576 CVC days (mean 14.5 days, SD 7.2 days) were used in 119 cycles. Fever occurred in 87 cycles (73%). Blood stream infection was proven in 31 out of 87 febrile episodes (26.1%) with 40 isolates (8 gram-negative, 31 gram-positive, 1 Candida spp.). Colonization of the CVC tip was observed in 24 CVC lines with 28 isolates (27 gram-positive, 1 gram-negative); however, proven CVC-related infections were observed in 5 episodes only, all with coagulase-negative staphylococci. In another 6 episodes, CVC-related infection was assumed (local inflammation and gram-positive blood culture). Six further episodes had typical blood isolates (4 coagulase-negative staphylococci, 1 Candida spp.) and were considered possible CVC-related infections. In none of the remaining afebrile 32 cycles was a CVC infection observed or suspected. Conclusion: Gram-positive organisms contributed to the majority of CVC-related infections (16 out 17 CVC infections); however, the overall incidence of CVC infections in acute leukemia patients was 6.5/1,000 CVC days only (1.9 proven/2.3 suspected/2.3 possible/1,000 CVC days).
Diabetes mellitus and the Risk of Dementia, Alzheimer’s Disease and Vascular Cognitive Impairment in the Canadian Study of Health and Aging
Authors: MacKnight Chris , Rockwood Kenneth , Awalt Erin , McDowell Ian
Published: April 2003

Background: Conflicting results have been reported about the status of diabetes mellitus as a risk for Alzheimer’s disease. We investigated the relationship between diabetes and incident dementia (including Alzheimer’s disease and vascular cognitive impairment) in a 5-year longitudinal study. Methods: Secondary analysis of the Canadian Study of Health and Aging, a representative cohort study of dementia in older Canadians. Results: 5,574 subjects without cognitive impairment at baseline participated in 5-year follow-up. Diabetes mellitus at baseline was associated with incident vascular cognitive impairment (RR: 1.62; 95% CI: 1.12–2.33) and its subtypes, vascular dementia (RR: 2.03; 95% CI: 1.15–3.57), and vascular cognitive impairment not dementia (RR: 1.68; 95% CI: 1.01–2.78). Diabetes was not associated with mixed Alzheimer’s/vascular dementia (RR: 0.87; 95% CI: 0.34–2.21), incident Alzheimer’s disease (RR: 1.30; 95% CI: 0.83–2.03) or all dementias (RR: 1.26; 95% CI: 0.90–1.76). Conclusions: Despite increased recognition of the role of vascular factors in Alzheimer’s disease, we did not find an association between diabetes and incident Alzheimer’s disease, even though diabetes was associated with incident vascular cognitive impairment.