bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Adhesion of Polymorphous Neutrophilic Granulocytes to Macro- and Microvascular Endothelial Cells under Flow Conditions
Authors: Otto Mike , Bittinger Fernando , Kriegsmann Jörg , Kirkpatrick Charles James
Published: April 2003

Objective: As one of the important active barriers in the human organism, endothelial cells (EC) play a central role in the biological reaction to a variety of stimuli, e.g. during the induction and regulation of inflammation, as well as in the reaction to transplantation and biomaterial implantation. In the study of endothelial function, the most widely used in vitro model is that of human umbilical vein EC (HUVEC), i.e. an EC type of embryonic and macrovascular origin. However, many of the important pathological processes occur at microvascular level, thus questioning the validity of the HUVEC model. Moreover, the morphological and functional heterogeneity of the endothelium in the various organs, e.g. kidney, liver and lung, must be taken into consideration. The purpose of the present study was to use a dynamic cell culture system to compare the reactions of HUVEC and human pulmonary microvascular EC (HPMEC) to pro-inflammatory stimulation. Methods: HUVEC and HPMEC in monolayer culture were stimulated by tumor necrosis factor-α (TNFα) in a parallel-plate flow chamber. Short- (4 h) and long-term (12 h) stimulation were compared. As a functional parameter, the adhesion of human peripheral blood polymorphonuclear granulocytes (PMN) to EC was quantitated both under venous and arterial flow conditions. Results: Short-term (4 h) TNFα stimulation and venous flow conditions elicited a 32% higher PMN adhesion to HPMEC compared with HUVEC, whereas under arterial flow conditions no statistically significant differences were found. Following longer-term (12 h) TNFα stimulation, PMN adhesion to HPMEC was 65% higher than to HUVEC under venous flow. Under arterial flow no differences were detected. Conclusion: The present results provide new data on the heterogeneity of the endothelium and affect a central element in microvascular pathology, namely granulocyte-endothelial interactions. Moreover, this paper emphasizes the necessity to evaluate the in vitro models of the endothelium with respect to the extrapolation to the situation in vivo.
The characterisation of the lymphoma cell line U937, using comparative genomic hybridisation and multi-plex FISH
Authors: Strefford J.C. , Foot N.J. , Chaplin T. , Neat M.J. , Oliver R.T.D. , Young B.D. , Jones L.K.
Published: April 2003

The cell line U937, which has been used extensively for studies of myeloid differentiation, bears the t(10;11)(p13;q14) translocation which results in a fusion between the MLLT10 (myeloid/lymphoid or mixed-lineage leukemia [trithorax, Drosophila, homolog]; translocated to 10; alias AF10) gene and the Ap-3-like clathrin assembly protein, PICALM (Clathrin assembly lymphoid myeloid leukaemia). Apart from this translocation, very little is known about the other genetic alterations in this cell line that may represent significant events in disease progression. In this study, conventional G-banding, CGH and M-FISH have been used to characterise fully all of the cytogenetic alterations present in the U937 cell line. M-FISH analysis confirmed the presence of the t(10;11) and an apparently normal copy of both chromosomes 10 and 11. A t(1;5) translocation was observed as well as several unbalanced rearrangements. CGH detected amplifications resulting from duplications of 2q, 6p and 13q. These changes could result in fusion gene products involved in carcinogenesis or the positions of putative oncogenes and tumour suppressor genes. A good correlation between conventional G-banding, CGH and M-FISH was observed.
Comparative FISH mapping in river buffalo and sheep chromosomes: assignment of forty autosomal type I loci from sixteen human chromosomes
Authors: Iannuzzi L. , Di Meo G.P. , Perucatti A. , Schibler L. , Incarnato D. , Cribiu E.P.
Published: April 2003

Forty autosomal type I loci earlier mapped in goat were comparatively FISH mapped on river buffalo (BBU) and sheep (OAR) chromosomes, noticeably extending the physical map in these two economically important bovids. All loci map on homoeologous chromosomes and chromosome bands, with the exception of COL9A1 mapping on BBU10 (homoeologous to cattle/goat chromosome 9) and OAR9 (homoeologous to cattle/goat chromosome 14). A FISH mapping control with COL9A1 on both cattle and goat chromosomes gave the same results as those obtained in river buffalo and sheep, respectively. Direct G- and R-banding comparisons between Bovinae (cattle and river buffalo) and Caprinae (sheep and goat) chromosomes 9 and 14 confirmed that a simple translocation of a small pericentromeric region occurred between the two chromosomes. Comparisons between physical maps obtained in river buffalo and sheep with those reported in sixteen human chromosomes revealed complex chromosome rearrangements (mainly translocations and inversions) differentiating bovids (Artiodactyls) from humans (Primates).
Fibroblast growth factor receptor 2 (FGFR2): genomic sequence and variations
Authors: Ingersoll R.G. , Paznekas W.A. , Tran A.K. , Scott A.F. , Jiang G. , Jabs E.W.
Published: April 2003

Fibroblast growth factor receptors (FGFRs) play an important role in development and tumorigenesis. Mutations in FGFR2 cause more than five craniosynostosis syndromes. The FGFR2 genomic structure is the largest of the FGFR family. We have refined and extended the genomic organization of the FGFR2 gene by sequencing more than 119 kb of PACs, cosmids, and PCR products and assembling a region of approximately 175 kb. Although the gene structure has been reported to include only 20 exons, we have verified the presence of at least 22 exons, some of which are alternatively spliced. The sizes of six exons differed from those reported previously. Comparison of our sequence and those in the NCBI database detected more than 300 potential single nucleotide polymorphisms (SNPs). However, sequencing regions containing 52 of these potential SNPs verified only 14 in PCR products generated from 16 CEPH alleles. In contrast, direct sequencing of the CEPH DNAs revealed 21 other polymorphisms. Only one SNP was found in the 2,926 bp of coding sequence. Twenty-seven SNPs, two insertion polymorphisms and five microsatellite polymorphisms are contained in approximately 16.6 kb of non-coding sequence. These data yield an average of one polymorphism for approximately 488 bp of non-coding sequence examined. This collection of SNP, insertion, and repeat polymorphisms will aid future association studies between the FGFR2 gene and human disease and will enhance mutation detection.
Identification and characterization of alternatively spliced murine Rgs11 isoforms: genomic structure and gene analysis
Authors: Giudice A. , Gould J.A. , Freeman K.B. , Rastan S. , Hertzog P. , Kola I. , Iannello R.C.
Published: April 2003

The RGS proteins comprise a large family of proteins which were recently identified as negative Regulators of G-protein Signaling. They have been shown to act as GTPase Activating Proteins (GAPs) towards the Gα subunits of heterotrimeric G-proteins. In addition to this GAP activity, which has been shown to occur through the RGS domain, RGS proteins are likely to possess other functions due to the existence of other domains in these molecules (De Vries and Farquhar, 1999; Hepler, 1999). Here, we report the molecular characterization of the murine Rgs11 gene. The gene encodes a protein with high homology to human RGS11 (79.9%), containing conserved DEP (Dishevelled/EGL-10/Pleckstrin) and GGL (G protein γ-like) domains. The gene is comprised of at least 13 exons, spanning 8–9 kb. Spliced transcript variants were identified which are co-expressed with 5A3, a transcript that contains the largest ORF. Expression of mouse Rgs11 was found to be restricted to specific tissues with a unique pattern of expression observed in brain.
Coeliac Disease in Patients with Autoimmune Thyroiditis
Authors: Volta Umberto , Ravaglia Giovanni , Granito Alessandro , Forti Paola , Maioli Fabiola , Petrolini Nunzio , Zoli Marco , Bianchi Francesco B.
Published: April 2003

Background and Aims: The close association between coeliac disease and autoimmunity prompted us to perform an antibody screening for gluten-sensitive enteropathy in patients with autoimmune thyroid dysfunction. Methods: Sera from 220 patients with autoimmune thyroiditis, 50 euthyroid subjects with thyroid nodules and 250 blood donors were tested for IgA anti-tissue transglutaminase (anti-tTG) and antiendomysial antibodies (EmA). Results: IgA anti-tTG was positive in 7 patients with autoimmune thyroiditis, whereas IgA EmA was found only in 6 of them. Duodenal biopsy confirmed coeliac disease diagnosis disclosing marked and mild villous atrophy in 6 and 1 of them, respectively. All but 2 of the 7 coeliacs did not show any sign of malabsorption. All euthyroid controls were negative for IgA antibodies, whereas 1 blood donor, positive for both IgA anti-tTG and EmA, was found to be coeliac. The prevalence of coeliac disease in patients with autoimmune thyroiditis (3.2%) was significantly higher than that found in blood donors (0.4%) (p = 0.022, Fisher’s exact test). Conclusions: Antibody screening for coeliac disease should be included in the work-up of patients with autoimmune thyroiditis. Either IgA anti-tTG or EmA may be used, even though the former seems to be slightly more sensitive than the latter.
Viewing the Microcirculation through the Window: Some Twenty Years Experience with the Hamster Dorsal Skinfold Chamber
Authors: Menger Michael D. , Laschke Matthias W. , Vollmar Brigitte
Published: April 2003

Intravital microscopy represents a sophisticated technique to study the microcirculation in health and disease. While most preparations used for those studies are acute in nature, the use of chamber preparations in the skinfold bear the advantage to allow for chronic studies with repeated analysis of the microcirculation over a prolonged period of time. The skinfold chamber model for microcirculatory analysis has been adapted to mice, rats and hamsters. Although the use of rats and, in particular, the use of mice has the advantage of the availability of species-specific tools, the use of the hamster as the experimental animal may be preferred due to anatomical reasons, which facilitate the microsurgical preparation and improve the quality of microscopic imaging. The use of the hamster dorsal skinfold chamber, firstly described by Endrich and coworkers in 1980, has brought out during the last two decades a considerable number of experimental studies within the fields of microcirculation physiology, inflammation and sepsis, ischemia-reperfusion, angiogenesis, and transplantation, indicating that the model has to be considered a versatile tool to study the microcirculation in health and disease.
Effects of Ultra-Purified Polymerized Bovine Hemoglobin on Local Tissue Oxygen Tension in Striated Skin Muscle – An Efficacy Study in the Hamster
Authors: Botzlar Andreas , Steinhauser Peter , Nolte Dirk
Published: April 2003

The development of hemoglobin-based oxygen carriers has been propagated for replacement of the oxygen carrying properties of red blood cells for almost one century. Using a Clark-type multi-wire oxygen surface electrode and the dorsal skin fold chamber model of the awake Syrian golden hamster, local tissue pO2 was analyzed in the thin striated skin muscle before and after administration of an ultrapurified polymerized bovine hemoglobin solution (U-PBHb®, Biopure Corp., Boston, Mass., USA) under the following experimental conditions: (a) hypervolemic infusion with U-PBHb at ∼10% of calculated blood volume, and (b) isovolemic exchange transfusion with U-PBHb by replacing ∼50% of calculated blood volume. Control animals of group a received equivalent treatment with either isotonic saline or dextran 60, control animals of group b received dextran 60. Local tissue pO2 was found slightly decreased after both hypervolemic infusion and isovolemic exchange transfusion with U-PBHb, while frequency distribution curves of local tissue pO2 were found more narrow (less values <10 mm Hg and >25 mm Hg), suggesting a more homogeneous tissue pO2 distribution. The data thus indicate that U-PBHb slightly decreases mean tissue pO2 after both hypervolemic infusion and isovolemic exchange transfusion which is accompanied by an effective homogenization of local tissue pO2 distribution as compared to dextran 60.
Comparison of the New OPS Imaging Technique with Intravital Microscopy: Analysis of the Colon Microcirculation
Authors: Biberthaler P. , Langer S.
Published: April 2003

Background: The OPS imaging technique has been introduced for in vivo assessment of microcirculation in humans. The aim of this study was to validate the new technique against intravital fluorescence microscopy (IFM) for the visualization of colon microcirculation in a murine model of inflammatory bowel disease (IBD). Method: IBD was induced in Balb/c mice by dextran sulfate sodium, controls received normal water. In each animal, both the CYTOSCANTM A/R and IFM were used to image the microcirculation (n = 7 in each group). The postcapillary venular diameter was analyzed on the colon muscularis and mucosa. Results: The venular diameter correlated significantly between both methods representing the good correspondence between both methods. Conclusion: Our study demonstrates that the new technique for visualization of microcirculation without use of fluorescent dyes, the OPS imaging, allows for quantitative measurement of a key microcirculatory parameters of the mouse colon.
Maternal Undernutrition Induces Neuroendocrine Immune Dysfunction in Male Pups at Weaning
Authors: Chisari Andrea N. , Giovambattista Andrés , Perelló Mario , Gaillard Rolf C. , Spinedi Eduardo
Published: April 2003

The present study was designed to assess the effect of maternal undernutrition, during gestation and lactation, on the neuroendocrine [hypothalamo-pituitary-adrenal (HPA)]-immune axis response to endotoxin (LPS) administration. For this purpose, 21-day-old male rats from both well-nourished (WN) and undernourished (UN) mothers were examined 2 h after injection (i.p.) of vehicle alone (VEH) or containing LPS (130 µg/kg BW). Circulating levels of glucose (GLU), ACTH, corticosterone (B), tumor necrosis factor-alpha (TNFα) and leptin were explored. The results indicate that: (a) mother body weight was significantly (p < 0.05) reduced, as a consequence of UN, at the second and third weeks of pregnancy; (b) no differences in basal glycemia were found in the two groups of pups, and LPS treatment did not induce hypoglycemia, in either group; (c) basal plasma ACTH, B and TNFα levels were similar in the two groups, and LPS-induced ACTH, B and TNFα secretions, although severalfold higher than respective VEH values (p < 0.05) in pups from WN mothers, were fully (ACTH and B) and partially (TNFα) abolished in products from UN mothers; (d) both mean body weights and basal plasma leptin levels were significantly (p < 0.05) lower in pups from UN than from WN mothers, and LPS administration did not modify plasma leptin values in products from both groups. In addition, results of dispersed total adrenal cells incubated in vitro indicate that: (a) both basal and ACTH (22 pM)-induced B secretion were significantly (p < 0.05) lower in cells from UN than WN pups, and (b) leptin (100 nM) was able to inhibit partially ACTH-stimulated B output by adrenal gland (AG) cells from WN pups; however, it failed to inhibit ACTH-stimulated glucocorticoid release by AG cells from UN pups. The present results indicate that undernutrition in mothers, during the very critical periods of gestation and lactation, induces in their male pups at weaning: (a) reduced circulating leptin levels and body weight values; (b) metabolic adaptation to normal carbohydrate metabolism; (c) hyporesponsiveness of the HPA and immune (TNFα) axes during endotoxemia, and (d) leptin resistance at the adrenocortical level. This study strongly supports that undernutrition of mothers results in neuroendocrine immune dysfunction of their pups; however, adrenal resistance to the inhibitory effect of leptin on glucocorticoid output is developed, probably as an adaptive mechanism to counteract unfavorable metabolic conditions.
Epidemiology and Clinical Significance of Chronic Hepatitis-Related Viruses Infection in Hemodialysis Patients from Taiwan
Authors: Dai Chia-Yen , Yu Ming-Lung , Chuang Wan-Long , Sung Ming-Hsing , Lin Zu-Yau , Chen Shinn-Cherng , Hsieh Ming-Yuh , Wang Liang-Yen , Tsai Jung-Fa , Chang Wen-Yu
Published: April 2003

Background/Aims: A novel DNA virus which was designated TT virus (TTV) in 1997 was considered a possible hepatitis-related virus, like hepatitis C (HCV), hepatitis B (HBV) and GB virus C/hepatitis G viruses (GBV-C/HGV). In the present study, the molecular epidemiology and clinical significance of TTV, GBV-C/HGV and HCV infection in hemodialysis patients from Taiwan are investigated. Methods: Sera of 85 patients on maintenance hemodialysis were tested for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), second-generation HCV antibody (anti-HCV), anti-envelope protein 2 antibody (anti-E2) and RNA of GBV-C/HGV, HCV RNA and TTV DNA. Sera of patients with positive TTV DNA, GBV-C/HGV RNA or HCV RNA were tested for viruses 2 years later. Results: Seven (8.2%) 29 (34.1%), 21 (24.7%), 12 (14.1%) and 9 (10.6%) hemodialysis patients were positive for HBsAg, Anti-HCV, HCV RNA, GBV-C/HGV RNA and anti-E2, respectively. TTV DNA was positive in 46 (54.1%) patients. Neither clinical nor virological factors were associated with TTV viremia. The ALT level was significantly elevated in HCV RNA-positive individuals than –negative ones (34.5 vs. 12.5%, p < 0.05). TTV DNA, GBV-C/HGV RNA and HCV RNA remained detectable in sera of 31 (86.1%), 6 (50%) and 21 (100%) patients collected 2 years after first diagnosis of viremia. Conclusion: Among Taiwanese hemodialysis patients, TTV infection is highly prevalent. No clinical or virological factor was observed to be significantly associated with TTV infection. The ALT abnormality was mainly attributable to HCV but not TTV infection in Taiwanese hemodialysis patients.
Changes in Renal Resistive Index and Urinary Albumin Excretion in Hypertensive Patients under Long-Term Treatment with Lisinopril or Nifedipine GITS
Authors: Leoncini Giovanna , Martinoli Carlo , Viazzi Francesca , Ravera Maura , Parodi Denise , Ratto Elena , Vettoretti Simone , Tomolillo Cinzia , Derchi Lorenzo E. , Deferrari Giacomo , Pontremoli Roberto
Published: April 2003

Introduction: Increased renal vascular resistance and microalbuminuria are associated with hypertensive target organ damage and may be predictors of hypertensive nephrosclerosis. Aim: We investigated changes in renal resistive index (RI) and urinary albumin excretion (UAE) in a group of patients with primary hypertension before and during long-term antihypertensive treatment. Methods: Thirty-two patients were randomized to receive antihypertensive treatment with either a calcium channel blocker (nifedipine GITS, up to 90 mg/day, n = 16) or an ACE inhibitor (lisinopril, up to 20 mg/day, n = 16), alone or in association with a diuretic (chlortalidone, 25 mg/day). Blood pressure, renal resistive index (by US Doppler) and UAE (mean of three nonconsecutive timed urinary collections, µg/min) were evaluated at baseline and over the course of 24 months of treatment. Results: Both regimens effectively lowered blood pressure (mean blood pressure from 123 ± 1.8 at baseline to 103 ± 1.5 mm Hg at 24 months in the lisinopril group and from 122 ± 1.9 at baseline to 104 ± 0.8 at 24 months in the nifedipine group, p < 0.001 for both groups). Overall, blood pressure decrease was associated with a reduction in UAE and no change in RI throughout the study. However, despite similar blood pressure reduction, the two regimens showed different specific effects. Lisinopril was associated with a significant decrease in both UAE (33.8 ± 16.2 at baseline and 9.1 ± 2.1 at 24 months, p < 0.01) and renal RI (0.61 ± 0.02 at baseline and 0.56 ± 0.04 at 24 months, p < 0.05) while nifedipine GITS did not significantly influence UAE (35.7 ± 12.2 at baseline and 31.2 ± 12.1 at 24 months, n.s.) or RI (0.61 ± 0.01 at baseline and 0.59 ± 0.02 at 24 months, n.s.). Conclusion: Effective blood pressure control over a long period of time reduces the severity of organ damage, namely UAE while maintaining renovascular resistance in patients with essential hypertension. Different classes of antihypertensive agents might convey additional specific renal protection beyond blood pressure control. These data could be useful in devising individualized therapeutic strategies in hypertensive patients at increased renal risk.
SDS-PAGE Is Underutilised as a Tool for Investigating Renal Patients
Authors: Lau Y.K. , Woo K.T.
Published: April 2003

SDS-PAGE is an excellent single test for investigating proteinuria. It can provide much useful information on the underlying renal problem. Yet the literature hardly report a SDS-PAGE result in the management of renal patients. To examine how closely SDS-PAGE results may reflect biopsy findings, we investigated 11 patients scheduled for renal biopsy. Urine samples were taken at the same time for SDS-PAGE analysis using the Phast- System (Pharmacia, Sweden). Comparing biopsy findings and SDS-PAGE results, the data show consistency in the revelation of tubular dysfunction and/or glomerular damage in all 11 patients. We concluded that the SDS-PAGE test is underutilised and suggest that its role for the management of renal patients be fully explored particularly in its potential for reducing the need for renal biopsy in certain patient groups.
Prevalence of Cryptosporidium Infection in Hemodialysis Patients
Authors: Turkcapar Nuran , Kutlay Sim , Nergizoglu Gokhan , Atli Teslime , Duman Neval
Published: April 2003

The prevalence of Cryptosporidium infection in patients who are on chronic hemodialysis due to end-stage renal failure is investigated and compared with the incidence in the healthy population. Stool specimens of 74 adult hemodialysis patients treated on an outpatient basis and 50 healthy individuals are examined for Cryptosporidium oocysts by using the modified acid-fast method. While 20.27% (15/74) of patients in the dialysis group had Cryptosporidium oocysts in their stools, none (0/50) of the controls had such an infection (p < 0.001). Ten of 15 patients who had Cryptosporidium oocysts in their stool specimens were asymptomatic and the remaining 5 had diarrhea. Four of these 5 diarrheic patients had Cryptosporidium oocysts in their stools and 1 had both Cryptosporidium oocysts and Giardia trophozoites. Since hemodialysis patients with chronic renal failure are candidates for renal transplantation, general preventive measures against infection must be taken and these patients must be screened for their carrier state before transplantation.
Endoillumination-Guided Intranasal Microscopic Dacryocystorhinostomy for Difficult Cases
Authors: May A. , Fries U. , Zubcov-Ivantscheff A. , Lüchtenberger M. , Weber A.
Published: April 2003

Purpose: This prospective study explores the efficacy of a combined approach by intranasal microsurgical dacryocystorhinostomy and fiberglass endoillumination of the tear passage for difficult cases of lacrimal sac or nasolacrimal duct obstruction. Methods: Microscopic dacryocystorhinostomy was performed in 67 patients with lacrimal obstruction and for revision of external dacryocystorhinostomy. Improved endonasal visualization by microscope and combination with endoillumination of the tear passage allows instant identification and opening of the lacrimal nasal sac without skin incision. Silicon tubes were used for bicanalicular intubation. The patients were prospectively observed for at least 1 year. Results: The operation was well tolerated by all patients. In 95%, a persistently open tear passage was successfully established. No serious complications were observed. Conclusion: Endoillumination of the lacrimal sac is useful for locating the sac precisely and refining the endonasal operation technique.
New Challenges in the Etiopathogenesis of Atherothrombosis
Authors: Badimon Lina
Published: April 2003

Atherosclerotic disease is a focal pathological event characterized by thickening and hardening of large arteries due to the accumulation of lipids, proteoglycans, blood and blood products, fibrous tissue and calcium deposits. The formation of arterial thrombi appears to be a significant factor for the occurrence of clinical acute complications in asymptomatic chronic atherosclerosis. The knowledge obtained on the mechanisms of platelet activation, signal transduction, receptor binding, zymogen activation and function, substrate recognition and adhesive events has been useful to design new intervention techniques with beneficial results and new highly promising strategies. It was initially thought that receptors were only involved in binding functions, but they have also been shown to be important factors in the transduction of information from the extracellular compartment to the inside of the cell, and that they partly control cell function, structure, proliferation and differentiation. The availability of monoclonal antibodies and the molecular biology techniques applied to the fields of thrombosis, and the interaction between blood cells and the vascular wall will provide tools to explore specific pathways of cell activation and interaction between cells. These studies, together with those aimed at finding the main agonists and substrates triggering and perpetuating an event, will be helpful to establish strategies for treatment and prevention of clinical events and to reduce the associated morbidity and mortality.
Neuropathology of White Matter Lesions in Vascular Cognitive Impairment
Authors: Englund Elisabet
Published: April 2003

The white matter is an important locus for tissue damage in vascular cognitive impairment and white matter lesions often dominate over gray matter changes. The spectrum of ischemic white matter lesions histopathologically represents focal and diffuse lesions, the most common form being the combination of both, in varying proportions. In the combined pathology, the diffuse lesion represents a gradient zone of damage towards surrounding normal tissue and may hold over 200 times the volume of an identified focal lesion, the lacunar infarct. Pathogenetically, the focal lesion results from the acute reaction to regional ischemia, while the diffuse white matter lesion represents the adjustment to altered perfusional and physiological conditions within the tissue.
Small Vessel Disease and Alzheimer’s Dementia: Pathological Considerations
Authors: Kalaria Raj N.
Published: April 2003

Current evidence suggests that the neuropathology of Alzheimer type of dementia comprises more than amyloid plaques and neurofibrillary tangles. At least a third of Alzheimer disease (AD) cases may exhibit significant cerebrovascular pathology, which constitutes distinct small vessel disease (SVD). Cerebral amyloid angiopathy, microvascular degeneration affecting the cerebral endothelium and smooth muscle cells, basal lamina alterations, hyalinosis and fibrosis are often evident in AD. These changes may be accompanied by perivascular denervation that is causal in the cognitive decline of AD. Amyloid β protein may cause degeneration of both the larger perforating arterial vessels as well as cerebral capillaries, which represent the blood-brain barrier. In addition, macro- and microinfarctions, haemorrhages, lacunes and ischaemic white matter changes are also present in AD. The development of SVD in late-onset AD may engage an interaction of perivascular mediators as well as circulation-derived factors that perturb the brain vasculature. Peripheral vascular disease such as long-standing hypertension, atrial fibrillation, coronary or carotid artery disease and diabetes could further modify the cerebral circulation such that a sustained hypoperfusion or oligaemia is impacted upon the ageing brain.
Subcortical Vascular Dementia
Authors: Erkinjuntti Timo
Published: April 2003

Vascular dementia (VaD) incorporates different vascular mechanisms and changes in the brain, and has different causes and clinical manifestations. Current criteria for VaD select an aetiologically and clinically heterogeneous group and this definitional heterogeneity has affected clinical trial results. Focus on a more homogeneous group, such as that with subcortical (ischaemic) VaD, could be an alternative in clinical drug trials. This subtype incorporates two small vessel clinical entities – ‘Binswanger’s disease’ and ‘the lacunar state’. It comprises small vessel disease as the primary vascular aetiology, lacunar infarct(s) and ischaemic white matter lesions as the primary type of brain lesions, subcortical location as the primary location of lesions, and the subcortical clinical syndrome as the primary clinical manifestation. Subcortical VaD is expected to show a more predictable clinical picture, natural history, outcome and treatment responses.
Bupropion as Add-On Strategy in Difficult-to-Treat Bipolar Depressive Patients
Authors: Erfurth Andreas , Michael Nikolaus , Stadtland Cornelis , Arolt Volker
Published: April 2003

Bupropion, a selective norepinephrine and dopamine reuptake inhibitor, has been suggested for the treatment of bipolar depression, not only because of its efficacy, but also because of a probably lower risk of inducing switches to hypomania or mania. Most studies on bupropion treatment in bipolar patients have been performed in moderately ill out-patients. In contrast, we report on a sample of difficult-to-treat, predominantly severely ill, co-morbid, psychotic or therapy-refractory bipolar depressive in-patients. In this open and prospective study, 13 patients were treated with bupropion as an add-on strategy mainly to other antidepressants and to various mood stabilizers. Our data support the idea that bupropion is a first-line antidepressant in the treatment of severe bipolar depression. Eight of 13 patients showed a >50% reduction of Montgomery-Asberg Depression Scale ratings within 4 weeks. Co-medication with drugs commonly used in treatment-resistant bipolar disorder including venlafaxine, clozapine, lithium, topiramate and sodium valproate was safe in our small sample. While adhering to the suggestion of Goren and Levin not to exceed a daily dose of 450 mg of bupropion when treating bipolar depressed patients, we did not observe any switch from depression to hypomania or mania.
Cryptococcal Meningitis: Implications for the Otologist
Authors: Low W.K.
Published: April 2003

Cryptococcal meningitis can present to the otologist with hearing loss and vestibular dysfunction. A man with cryptococcal meningitis presenting with bilateral profound sensorineural hearing loss and vestibular dysfunction is described. The difficulty in arriving at the diagnosis and consequences of misdiagnosis are discussed. Histological and clinical studies suggest that the cochlear nerve is likely to be damaged in patients who have deafness associated with this disease. Retrocochlear damage may result in cochlear implantation having a poor outcome.
Psychogenic Hearing Loss with Panic Anxiety Attack after the Onset of Acute Inner Ear Disorder
Authors: Mori Shigehito , Fujieda Shigeharu , Yamamoto Takehito , Takahashi Noboru , Saito Takehisa , Saito Hitoshi
Published: April 2003

A very rare case of a 50-year-old female showing psychogenic hearing loss with a panic anxiety attack that complicated an acute organic sensorineural hearing loss is reported. At the first visit to our clinic, the patient showed left sensorineural hearing loss with an inner ear disorder pattern. Five days after the onset, her left hearing threshold markedly increased without any subjective signs. On the next day, she suddenly experienced a severe panic attack with anxiety. After the attack, she felt mildly anxious and depressed. A combined therapy using primary corticosteroid therapy for the acute inner ear disorder, psychiatric counseling based on cognitive therapy and the administration of a minor tranquilizer was performed. Her left hearing threshold recovered to within normal ranges except in the high-frequency ranges immediately after the treatment. This case was considered very rare because: (1) the panic anxiety attack occurred in the conversion disorder as psychogenic hearing loss and (2) the psychogenic hearing loss complicated the primary sudden deafness. We suggest that otorhinolaryngologists should have psychiatric knowledge and be able to treat psychogenic hearing loss as a primary care.
A Catch-Up Study of Former Child and Adolescent Psychiatric Inpatients: Psychiatric Status in Adulthood
Authors: Brieger P. , Blöink R. , Sommer S. , Marneros A.
Published: April 2003

Background: The purpose of this study was to reassess former child and adolescent psychiatric patients as adults with regard to their further development. Methods: We used a ‘catch-up’ design. A former child and adolescent psychiatric patient cohort and controls (matched for sex and age) were assessed as adults with standardized instruments (Schedules for Clinical Assessment in Neuropsychiatry, International Personality Disorder Examination, biography, psychiatric history, Global Assessment Scale, Satisfaction with Life Scale). Results: We assessed 164 former patients and 80 controls. The mean catch-up period was 13.2 years, and the subjects had a mean age of 24.8 years. Thirty-nine percent of the former patients and 25% of the controls fulfilled criteria for an ICD-10 diagnosis (present state) at catch-up, with a clear excess of personality disorders in the former patient group (13 vs. 3%). Using a survival analysis we estimated that 38% of the former patients and 10% of the controls would undergo psychiatric treatment between the ages of 18 and 31 years. Conclusions: Most former child and adolescent psychiatric patients did not come into contact with psychiatric treatment facilities again in their twenties, although they had a higher risk for a psychiatric disorder than controls. Nevertheless, the risk of later developing a personality disorder according to ICD-10 seems to be markedly raised for former child and adolescent psychiatric patients.
A Case of Paranoia with Severe Consequences
Authors: Richartz Elke , Wormstall Henning
Published: April 2003

Following a brief resume of the history of the notion of paranoia, we present the case history of a 67-year-old female patient, who suffered from irreversible physical handicap as a result of chronic delusion. Against the background of the on-going controversy about the existence of paranoia as a distinct illness, we discuss the contemporary understanding of delusional disorders, emphasising the importance of a multidimensional therapeutic approach.
Hyperventilation in Panic Disorder and Social Phobia
Authors: Nardi Antonio E. , Valença Alexandre M. , Nascimento Isabella , Mezzasalma Marco A. , Zin Walter A.
Published: April 2003

The aim of our study was to observe the induction of panic attacks by hyperventilation in a group of panic disorder and social phobia patients (DSM-IV). We randomly selected 26 panic disorder patients, 22 social phobics and 25 normal volunteers. They were drug-free for 1 week. Hyperventilation (30 breaths/min) was induced for 3 min. Anxiety scales were taken before and after the test. 61.5% (n = 16) of panic disorder patients, 22.7% (n = 5) of social phobics and 4.0% (n = 1) of control subjects had a panic attack after hyperventilating (p < 0.01, panic disorder vs. control; p < 0.05, panic disorder vs. social phobia; p = n.s., social phobia vs. control). Both anxiety disorder groups were more sensitive to hyperventilation than normal volunteers. The induction of panic attacks by voluntary hyperventilation may be an easy and useful test for validating the diagnosis in some specific panic disorder patients.
Evaluation of the German Version of the PTSD Symptom Scale (PSS)
Authors: Stieglitz Rolf-Dieter , Frommberger Ulrich , Foa Edna B. , Berger Mathias
Published: April 2003

The psychometric properties of the PTSD Symptom Scale (PSS) were evaluated in a clinical sample of severely injured in-patients after a traffic accident (n = 123). The PSS contains 17 items which were derived from the DSM-III-R criteria of posttraumatic stress disorder (PTSD). The results indicate that the PSS has satisfactory reliability and validity (internal and external). The results are in correspondence with the results of Foa et al. using a sample of rape and non-sexual-assault patients.
Clinical Validity of ICD-10 Neurasthenia
Authors: Bankier Bettina , Aigner Martin , Bach Michael
Published: April 2003

Background: Neurasthenia was defined over a century ago. In view of a questionable clinical validity, it was omitted from the 3rd edition of the American Psychiatric Association’s DSM, while it remains as an own diagnostic category in the WHO’s ICD-10. The purpose of this study was, therefore, to examine the clinical validity of ICD-10 neurasthenia in a consecutive sample of chronic pain patients. Patients and Methods: We included 193 patients (mean age 45.1, SD ± 10.2, 63% females) in the study. Psychiatric diagnoses were established by the use of ICD-10 Diagnostic Criteria for Research. In addition, the Screening List for Somatization Symptoms was administered: self-rating of 53 medically unexplained somatic symptoms, and 11 additional screening questions concerning weakness after slight mental or physical exertion and disease conviction. Results: Thirty-three percent of the patients who fulfilled the criteria of ICD-10 neurasthenia also fulfilled the criteria of ICD-10 somatization disorder, 69% the criteria of ICD-10 undifferentiated somatoform disorder, 14% the criteria of ICD-10 hypochondriacal disorder, 66% the criteria of ICD-10 somatoform autonomic dysfunction, 85% the criteria of ICD-10 persistent somatoform pain disorder and 14% the criteria for sexual dysfunction not caused by organic disorder or disease. The symptom profile of ICD-10 neurasthenia was not clearly distinguishable from the symptom profiles of ICD-10 somatoform disorders and ICD-10 sexual dysfunction. Discussion: Due to this substantial diagnostic overlap, the clinical validity of ICD-10 neurasthenia remains questionable.
Self-Monitoring Dysfunction and the Positive Symptoms of Schizophrenia
Authors: Stirling John D. , Hellewell Jonathan S.E. , Ndlovu David
Published: April 2003

Frith has proposed that symptoms of alien control in schizophrenia result from a defect in a metarepresentational process leading to a failure to properly monitor self-willed intentions and actions. To examine this hypothesis, a group of 40 schizophrenic patients, all meeting DSM-III-R criteria, and rated for current symptoms on the basis of a detailed clinical interview, were compared with 36 non-patient controls, using a battery of tests which included measures of self-monitoring, general cognitive function and attention. In comparison with controls, patients were impaired on two tests of self-monitoring. These differences were preserved when measures of current IQ, attention, and recognition memory were entered as covariates. Amongst patients, self-monitoring performance was related to the severity and extent of positive symptoms. These findings provide further experimental support for the proposal that positive symptoms of schizophrenia arise as a result of deficiencies in self-monitoring.
The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’
Authors: Marková Ivana S. , Berrios German E.
Published: April 2003

Insight is a relational or ‘intentional’ concept, i.e., it is only understood in terms of its relation to something; and that ‘something’ is the ‘object’ of insight. In clinical practice, the ‘object’ of insight thus generally refers to a particular mental or physical state (e.g., mental illness, neuropsychological deficit) in relation to which insight is being assessed. It is argued in this paper that the ‘object’ of insight plays a crucial role in shaping or determining the sort of insight that is elicited in clinical practice (i.e., the phenomenon of insight). Three ways in which the ‘object’ of insight can shape the clinical phenomenon of insight are discussed. One concerns the conceptual background in which the ‘object’ is embedded and which is likely to impose a similar structure onto the phenomenon of insight. Another is the semantic category to which the ‘object’ of insight belongs and which will imprint its particular structure on the phenomenon of insight. Yet another concerns the specific nature of the ‘object’ which itself will shape the insight phenomenon elicited. This carries implications for research on insight, since insight tends to be explored in relation to a variety of ‘objects’. Phenomena of insight in relation to different ‘objects’ are likely to vary in structure, and this, in turn, has consequences for mechanisms underlying insight in each case. Understanding more about the nature and contribution of the ‘object’ of insight in the insight-‘object’ relationship will help to delineate separate insight phenomena and achieve consistency in empirical studies on insight.
Visual Imagery and Depersonalisation
Authors: Lambert Michelle V. , Senior Carl , Phillips Mary L. , Sierra Mauricio , Hunter Elaine , David Anthony S.
Published: April 2003

Twenty-eight people diagnosed with depersonalisation disorder (DD) were assessed using self-report measures of imagery ability in relation to a range of symptoms and in comparison with age- and sex-matched controls. It was found that symptoms of depersonalisation as well as other dissociative symptoms and depressed mood correlated with impaired ability to generate visual images. This was particularly evident with images pertaining to the self and other people as opposed to objects. A subgroup of 10 patients was tested on a neuropsychological battery of visual perception tests and found to be unimpaired compared with normal controls and patients with obsessive compulsive disorder, despite subjective impairments in imagery and high symptom scores. The findings add further weight to the distinctions made between imagery and perceptual processes.
Guilt and Depression: A Cross-Cultural Comparative Study
Authors: Stompe T. , Ortwein-Swoboda G. , Chaudhry H.R. , Friedmann A. , Wenzel T. , Schanda H.
Published: April 2003

Although nearly a century has passed since Kraepelin’s investigations in Java [Cbl Nervenheilk Psychiatr 1904; 27:468–469], one crucial question regarding guilt in the course of depression has still not been decided: Is there a more or less stable connection independent of culture, or is guilt confined to certain civilisations? This study investigated this issue in 100 Pakistani and 100 Austrian out-patients diagnosed with ‘major depression’ according to DSM-IV by means of standardised instruments (Schedule for Affective Disorders and Schizophrenia-Life Time Version, Hamilton Rating Scale for Depression, 21-item version). The experiences of guilt were subdivided into ethical feelings (ethical anxiety and feelings of guilt) and delusions of guilt. It turned out that ethical feelings could be found in both cultures regardless of age and sex. They seem to be primarily related to the extent of depressive retardation. However, the distribution of the two subsets of ethical feelings was culture dependent. Delusions of guilt were confined to patients of the Austrian sample. So, our data qualify the exclusivity of the aforementioned two points of view and support the need for a psychopathologically differentiated approach.
Stability of Memories of Parental Rearing among Psychiatric Inpatients: A Replication Based on EMBU Subscales
Authors: Richter Jörg , Eisemann Martin
Published: April 2003

With regard to information about parental rearing, retrospective data are exclusively available among adults. These data are vulnerable due to various biases. This study was performed in order to replicate the findings of overall stability of three perceived parental rearing factors of the EMBU (Swedish acronym for ‘own memories of childhood upbringing’) based on 14 rather detailed subscales. A consecutive sample of 220 depressive inpatients were investigated on admission and at discharge by means of the EMBU, the Beck Depression Inventory and the Dysfunctional Attitude Scale. Perceived parental rearing scores showed high stability despite clinically significant changes in the severity of depression, except for ‘tolerance’, ‘guilt engendering’, ‘performance orientation’ and ‘shaming’ parenting with probable gender-specific effects which were found to covary with dysfunctional attitudes. Recall of parenting should be taken as a subjective truth when it is assessed by standardised behaviour-oriented questionnaires like the EMBU.
Efficacy of Brief Dynamic Psychotherapy for Children with Emotional Disorders
Authors: Muratori Filippo , Picchi Lara , Casella Cristina , Tancredi Raffaella , Milone Annarita , Patarnello Maria Grazia
Published: April 2003

Background: Child psychiatry has enjoyed a long tradition of using brief psychotherapy with children, but research on its efficacy and effectiveness in the setting of routine clinical care is remarkably sparse; the aim of this study was to evaluate the efficacy of an original model of brief psychodynamic psychotherapy (BPP) for children with emotional disorders in a clinical outpatient setting. Methods: A sample of 30 subjects (6.3–10.9 years old) was divided into an experimental BPP group and a control group. Each subject was evaluated at the beginning, after 6 months and at an 18-months follow-up. Outcome measures were Children’s Global Assessment Scale and Child Behavior Check-List. Statistical and clinical significance of change were evaluated. Results: At the first evaluation, the experimental group showed a better improvement in global functioning; at follow-up, the two groups improved to a comparable degree, but only the mean of the experimental group moved to a functional range. The experimental group showed a significant reduction in total behavioral problems and externalizing problems at the follow-up. Conclusions: The better improvement of the experimental group in two outcome measures suggests that BPP is efficient in emotional disorders. The hypothesis that BPP introduces changes at long term (sleeper effects) is suggested. The improvement in global functioning of the two groups is discussed in relation to specific characteristics of emotional disorders. Finally, limitations of the study are discussed and in particular the bias introduced by lack of randomization.