bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurogenesis and Neuronal Regeneration in the Adult Reptilian Brain
Authors: Font Enrique , Desfilis Ester , Pérez-Cañellas M. Mar , García-Verdugo Jose Manuel
Published: April 2003

Evidence accumulated over the last few decades demonstrates that all reptiles examined thus far continue to add neurons at a high rate and in many regions of the adult brain. This so-called adult neurogenesis has been described in the olfactory bulbs, rostral forebrain, all cortical areas, anterior dorsal ventricular ridge, septum, striatum, nucleus sphericus, and cerebellum. The rate of neuronal production varies greatly among these brain areas. Moreover, striking differences in the rate and distribution of adult neurogenesis have been noted among species. In addition to producing new neurons in the adult brain, lizards, and possibly other reptiles as well, are capable of regenerating large portions of their telencephalon damaged as a result of experimentally-induced injuries, thus exhibiting an enormous potential for neuronal regeneration. Adult neurogenesis and neuronal regeneration take advantage of the same mechanisms that are present during embryonic neurogenesis. New neurons are born in the ependyma lining the ventricles and migrate radially through the brain parenchyma along processes of radial glial cells. Several lines of evidence suggest that radial glial cells also act as stem cells for adult neurogenesis. Once they reach their final destination, the young neurons extend axons that reach appropriate target areas. Tangential migration of neurons alongside the ventricular ependyma has also been reported. Most of these tangentially migrating neurons seem to be destined for the olfactory bulbs and are, thus, part of a system similar to the mammalian rostral migratory stream. The proliferation and recruitment of new neurons appear to result in continuous growth of most areas showing adult neurogenesis. The functional consequences of this continuous generation and integration of new neurons into existing circuits is largely conjectural, but involvement of these phenomena in learning and memory is one likely possibility.
Idiopathic Myelofibrosis with Nodal, Serosal and Parenchymatous Infiltration
Authors: Tzankov Alexandar , Krugmann Jens , Steurer Michael , Dirnhofer Stephan
Published: April 2003

Idiopathic myelofibrosis (IMF) is a breakpoint cluster region rearrangement-negative chronic myeloproliferative disease with progressive bone marrow fibrosis. We report a female patient (65 years old) who was admitted to our hospital in 1996. Trephine bone marrow biopsy revealed diffuse fibrosis with atypical multilobulated megakaryocytes. A cellular phase of IMF was diagnosed. Three years later, despite being at intermediate risk, the patient developed generalized lymphadenopathy and multiple sclerosing tumors throughout the peritoneum and retroperitoneum. Biopsy specimens from these tumors revealed sclerosing hematopoietic infiltrates. The present case demonstrates that IMF not only can progress to acute leukemia but can also spread uncontrollably, or ‘metastasize’ with extensive sclerosing hematopoietic tumors throughout the body.
Supplemental Feeding in the First Days of Life – Effects on the Recipient Infant
Authors: Sievers Erika , Clausen Uta , Oldigs Hans-Dieter , Schaub Jürgen
Published: April 2003

Aim: Since clinical indications may necessitate the feeding of supplements to newborn infants, the effects of different supplemental feedings on the recipient infants were studied. Methods: Two groups of healthy, term newborn infants (n = 64 in each group) were investigated. The mothers breast-fed their infants, and by indication the babies were additionally fed supplement A (supplementary neonatal formula, 78 kcal/dl) or the traditionally used supplement B (glucosaccharide solution, 100 kcal/dl). The differences in volume and energy intake, weight development and rate of hyperbilirubinemia were assessed in the hospital. The frequency of breast-feeding was evaluated using a structured telephone interview at the ages of 4 and 8 weeks. Results: The energy intake of group B was higher prior to the 3rd day of study (p < 0.05). Afterwards a higher mean intake of human milk, a faster weight gain but a lower frequency of exclusive breast-feeding at discharge were observed in study group A. Hyperbilirubinemia was more frequent in the group B. Fifty-five percent (group A) and 52% (group B) of the participants were exclusively breast-fed at the age of 8 weeks. Conclusions: Despite differences in milk intake and weight gain in the early postpartum period, the breast-feeding patterns at 4 and 8 weeks were not significantly influenced by the use of different supplements.
Combination Treatment of Influenza A Virus Infections in Cell Culture and in Mice with the Cyclopentane Neuraminidase Inhibitor RWJ-270201 and Ribavirin
Authors: Smee Donald F. , Bailey Kevin W. , Morrison Ann C. , Sidwell Robert W.
Published: April 2003

Treatment of virus infections with compounds acting by different mechanisms may lead to more potent effects when these agents are used in combination. Under this premise, two known active influenza virus inhibitors, ribavirin and the novel cyclopentane influenza virus neuraminidase inhibitor (1S,2S,3R,4R)-3-[(1S)-(acetylamino)-2-ethylbutyl]-4-[(aminoiminomethyl)amino]-2-hydroxy-cyclopentanecarboxylic acid (RWJ-270201, BCX-1812) were studied. Experiments in cell culture demonstrated that RWJ-270201 plus ribavirin synergistically reduced extracellular influenza A/NWS/33 (H1N1) virus yields at low concentrations of each inhibitor. Mice were treated with ribavirin at 20 and 6.25 mg/kg/day combined with RWJ-270201 at 1, 0.32, or 0.1 mg/kg/day, or used alone. Treatments were twice daily for 5 days starting 4 h before exposure to influenza A/NWS virus. Only RWJ-270201 alone at 1 mg/kg/day significantly prevented mortality. In contrast, most drug combinations increased survival significantly compared to the placebo group. Doses of the two compounds used in combination delayed the mean day of death, and improved arterial oxygen saturation levels, as measured on day 11 of the infection. The combination of the two inhibitors produced additive to synergistic interactions in these mouse experiments with no enhancement of host toxicity. Treatment of influenza infections in the clinical setting may benefit by these two agents in combination.
Tissue Stem Cells: Definition, Plasticity, Heterogeneity, Self-Organization and Models – A Conceptual Approach
Authors: Loeffler Markus , Roeder Ingo
Published: April 2003

The classical definition of adult tissue stem cells (TSC) is fundamentally based on a functional perspective. A TSC is an undifferentiated cell, capable of proliferation, self-renewal, production of a large number of differentiated functional progeny, regenerating tissue after injury and a flexibility in the use of these options. Here, we discuss the necessity for amending this definition in the light of recent insight into stem cell biology regarding stem cell heterogeneity, lineage plasticity, clonal fluctuation and cell–environment interactions. We conclude that the definition needs amendments. A decade ago the flexibility criterion has attracted little attention but recent findings have indicated its importance. Flexibility and reversibility of tissue and lineage specification (tissue plasticity) and of properties within a tissue (within-tissue plasticity) have major implications with regard to concepts of stem cell function. We advocate to give up the view of TSC as being entities with a preprogrammed development and to replace it by a concept that makes the capabilities for flexible and regulated tissue self-organization based on cell–cell and cell–environment interactions the new paradigm. This concept would permit to incorporate the context-dependent lineage plasticity, within-lineage plasticity and generation of stem cell heterogeneity as a result of a dynamically regulated process. Such concepts need a rigorous examination by formal modeling including simulation studies. We provide some general ideas on how to proceed with such theories and illustrate this with worked models for tissue stem cells of the hematopoietic system and the intestinal epithelium.
Avian Models to Study the Transcriptional Control of Hematopoietic Lineage Commitment and to Identify Lineage-Specific Genes
Authors: Nielsen Julie S. , Doyonnas Regis , McNagny Kelly M.
Published: April 2003

E26 is an avian acute leukemia virus with a profound ability to transform multipotent hematopoietic progenitor cells both in vivo and in vitro. Progenitor cells transformed by this virus can be expanded in vitro as undifferentiated clones for up to two months and can also be induced to differentiate into cells of the erythroid, eosinophilic, thrombocytic, and myelomonocytic lineages with reproducible kinetics. Aside from the proliferative stimulus provided by the E26 oncoprotein, these cells are remarkably similar to normal hematopoietic progenitors. They therefore provide an ideal assay system for determining the influence of ectopically expressed transcription factors on both maturation and commitment to several hematopoietic lineages. Results from experiments using this system suggest that subtle shifts in the balance of lineage-restricted transcription factors can result in profound changes in phenotype and challenge the notion that lineage commitment is a uni-directional process. Analysis of the regulatory elements governing the expression of these genes has provided novel mechanistic insights into the transcriptional control of hematopoiesis. In addition to their utility in deciphering the control of lineage commitment, the ability to grow large numbers of undifferentiated and more mature hematopoietic cells has facilitated the discovery of a number of novel, lineage-restricted genes. Analysis of the proteins encoded by these genes is helping to clarify the role of a number of membrane proteins in the interaction between hematopoietic cells and their microenvironments.
Neural Stem Cells: Plasticity and Their Transdifferentiation Potential
Authors: Vescovi Angelo , Gritti Angela , Cossu Giulio , Galli Rossella
Published: April 2003

The presence of resident stem cells in adult tissues is of fundamental importance for the maintenance of their structural and functional integrity. In fact, throughout life, somatic stem cells attend to the critical function of substituting terminally differentiated cells lost to physiological turnover, injury or disease. Thence, one of the basic dogmata in tissue biology holds that the differentiation potential of an adult stem cell is restricted to the generation of the mature cell lineages found in the tissue to which the stem cell belongs. A plethora of recent evidences from many groups, including ours, is now providing evidence that adult stem cells may possess a broader differentiation repertoire than expected and that their fate potential may not be as tissue specific as once thought. The initial example of an unforeseen, trans-germ layer plasticity – that seems now to emerge as a prototypic functional trait of various somatic stem cells of different origin – has come from the reported awakening of a latent hemopoietic developmental capacity in stem cells isolated from the adult mammalian brain following their transplantation into sub-lethally irradiated mice. More recently, it has been shown that adult neural stem cells can differentiate into a wide array of bodily cells of different origin when injected into the blastocyst and into myogenic cells when transplanted into the adult regenerating skeletal muscle. Moreover, bone marrow stem cells can now give rise to skeletal muscle, hepatic and brain cells, whereas muscle precursors can generate blood cells. In this article, we review some of the basic notions regarding the functional properties of the adult neural stem cells and discuss findings in the expanding area of trans-germ layer conversion, with emphasis on the neural stem cell.
Interaction of a Muscarinic Cholinergic Agonist on Acetylcholine and Dopamine Receptors in the Monkey Brain Studied with Positron Emission Tomography
Authors: Hartvig Per , Nordberg Agneta , Torstenson Richard , Sjöberg Pernilla , Fasth Karl Johan , Långström Bengt
Published: April 2003

The effects on the binding to cholinergic and dopaminergic receptors in the brain during continuous intravenous infusion of the muscarinic cholinergic receptor agonist milameline (CI-979) were studied in the rhesus monkey by means of positron emission tomography. Binding to milameline cholinergic receptors was quantified using the muscarinic receptor antagonist [11C]-N-methyl-4-piperidinylbenzilate ([11C]NMP), and the effects on nicotine receptor binding were measured with (S)-[11C-methyl]nicotine. Changes in the binding of the D2 dopamine receptor antagonist [11C]raclopride were measured as well. The binding of [11C]NMP increased in most brain regions with the infusion of increasing doses of milameline from 0.5 to 10 µg/kg/h. (S)-[11C-methyl]nicotine binding was unchanged or increased somewhat. Binding of [11C]raclopride to the D2 dopaminergic receptors in the striatum of the brain increased by 10 ± 4% following 2 µg/kg/h of milameline. The results suggest a possible action of milameline both on presynaptic muscarinic receptor subtypes as well as dopamine levels dependent on the receptor reserve of the muscarinic receptor subtypes.
Physiological Study of pH Stability and Sensitivity to Pepsin of Human Gastric Lipase
Authors: Ville Eric , Carrière Frédéric , Renou Christophe , Laugier René
Published: April 2003

Background/Aims: The aim of this study was to exactly determine the pH stability of human gastric lipase (HGL) and to investigate the mechanism underlying the inactivation of HGL which occurs in gastric juice. Methods: Samples of human gastric juice and purified HGL were incubated at various pH values ranging from 0.5 to 8.0, and the residual HGL activity was measured as a function of time using the pHstat technique. Samples of purified HGL were also incubated in the presence of human pepsin. Electrophoresis and Western blot analysis were performed on all the samples in which HGL was inactivated. Results: HGL was found to be stable in gastric juice at pH values ranging from 2.0 to 7.0, especially between pH 3.0 and 5.0 (half-inactivation time >24 h). HGL activity decreased rapidly below pH 2.0 and above pH 7.0. The inactivation half times were only 43 ± 9 and 24 ± 18 min at pH 1 and pH 8, respectively. The pH stability of purified HGL was much lower than that of HGL in gastric juice. Acid or alkaline inactivation of HGL could occur without any prior proteolytic degradation, and this inactivation was irreversible. However, proteolytic degradation of HGL by pepsin also occurred at very low pH values, probably because the acid-denatured HGL is more sensitive to proteolytic cleavage by pepsin. An ex vivo study of HGL activity in several gastric juice samples showed that the HGL activity decreased with the pH of the sample, in both basal and pentagastrin-stimulated gastric juice. Conclusion: Although HGL is not as stable as it was previously thought to be under acidic conditions, it is nevertheless the most stable acid lipase and constitutes a good candidate tool for enzyme substitution therapy.
Tumor Necrosis Factor-Alpha Effects on Rat Gastric Enterochromaffin-Like Cells
Authors: Huber Christian , Zanner Robert , Pohlinger Agnes , Mahr Sabine , Neu Bruno , Prinz Christian
Published: April 2003

Gastric enterochromaffin-like (ECL) cells are histamine-producing cells in the gastric epithelium which are responsible for the peripheral regulation of acid secretion. The gastric mucosa is frequently infected with Helicobacter pylori, leading to increased levels of the pro-inflammatory cytokine tumor necrosis factor-α (TNF-α). The aim of our current study was to identify the effect of TNF-α on programmed cell death. ECL cells were isolated from the rat corpus mucosa to a purity >90%. TNF receptor and adapter protein presence were determined using RT-PCR, Western blot and immunocytochemistry. Apoptosis was measured by Tdt-mediated dUTP nick end labeling reaction and by DNA fragmentation based ELISA. Isolated ECL cells were found to express the TNF receptor p55 and IFN-γ receptor, but not the TNF receptor p75 or CD95. TNF-α (25 ng/ml) increased apoptosis in ECL cells approximately 4-fold, IFN-γ had no effect. Western blot analysis revealed that TNF-α caused degradation of IĸBα within 10 min. EMSA demonstrated that TNF-α led to increased DNA-binding activity of NFĸB and that proteasome inhibitors counteracted NFĸB activation. Proteasome inhibitors, specific antisense oligodeoxynucleotides against the p65 subunit of the NFĸB complex and the NO synthase inhibitor NG-monomethyl-L-arginine completely prevented TNF-α-induced apoptosis. Our data suggest that TNF-α induces apoptosis of isolated gastric ECL cells via activation of NFĸB and the generation of NO.
Antiseptic Efficacy of Local Disinfecting Povidone-Iodine (Betadine®) Therapy in Chronic Wounds of Lymphedematous Patients
Authors: Daróczy J.
Published: April 2003

In chronic wounds (ulcus cruris) of lymphedematous patients (n = 25) opportunistic infections caused by gram-negative rods and methicillin-resistant Staphylococcus aureus can be detected in 35% of cases. The healing of the wound takes a long time, which is the reason why the patients are taught how to manage the wound care. Local antibiotics must be avoided. The elimination of the wound infections is the first step of the complex decongestive physiotherapy. The infection aggravates the lymphostasis and makes the complaints of the patients (inflammation, pain, odor) more unacceptable, the systemic infections (erysipelas, lymphadenopathy, fever) more probable and the costs of the treatment higher. Betadine® solution and ointment were used locally. The clinical and bacteriological efficacy of povidone-iodine has been validated. Excellent local tolerability has also been observed. The opinion of the patients was registered on a visual analog scale and statistically analyzed. No development of resistance has been noted. For local treatment, Betadine proved to be an effective preparation tolerable for a long time in the treatment of chronic wounds.
Efficacy of Povidone-Iodine Vaginal Suppositories in the Treatment of Bacterial Vaginosis
Authors: Wewalka Günther , Stary Angelika , Bosse Bjoern , Duerr Heike E. , Reimer Karen
Published: April 2003

A prospective, randomized clinical trial was performed to study the efficacy of povidone iodine (Betadine®) suppositories for the treatment of bacterial vaginosis (BV) in comparison to capsules containing lactobacilli (Döderlein Med®). Seventy patients with BV included in the study were randomly assigned to be either treated with povidone iodine suppositories or lactobacilli. Patients were treated once a day for 5 days. Initial examinations took place on the first day of the study with follow-up examinations on days 8 and 15. The examinations included clinical parameters, patient evaluation, secretion screens, and quantitative and qualitative microbiological tests of vaginal flora. Both treatment groups showed improvement of clinical parameters, condition of secretions and subjective state of health. At day 15 there was a trend towards a better efficacy of the treatment with povidone iodine but this was not significant. However, patients with acute BV treated with povidone iodine had significantly better scores after 15 days. Both treatments were well tolerated. The microbiological examinations showed an increase of the mean number of lactobacilli in the vagina on day 8 after initiation of treatment with lactobacilli, but a decrease on day 15. Contrary to that the lactobacilli counts from patients treated with povidone iodine suppositories decreased after the first week but increased in the second one. Potentially pathogenic germs, e.g. Gardnerella, Bacteroides and Enterobacteria were reduced in a higher extent and with a longer lasting effect after treatment with povidone iodine suppositories than with capsules containing lactobacilli. The results of this study show that native lactobacilli rapidly re-colonize after the antiseptic treatment with povidone iodine. Therefore, there is no need to use lactobacilli in addition.
Contrast Transcranial Doppler Ultrasound in the Detection of Right-to-Left Shunts: Comparison of Echovist®-200 and Echovist®-300, Timing of the Valsalva Maneuver, and General Recommendations for the Performance of the Test
Authors: Droste Dirk W. , Jekentaite Ruta , Stypmann Jörg , Grude Matthias , Hansberg Tjark , Ritter Martin , Nabavi Darius , Nam Eun-Mi , Dittrich Ralf , Wichter Thomas , Ringelstein E. Bernd
Published: April 2003

Background and Purpose: Cardiac right-to-left shunts (RLS) can be identified by transesophageal echocardiography (TEE) as well as by transcranial Doppler ultrasound (TCD) using contrast agents, such as Echovist®-200 or Echovist®-300 in conjunction with a Valsalva maneuver (VM) as provocation procedure. Both Echovist preparations are in use. Currently, the appropriate timing of the VM is still under debate. Methods: Sixty-four patients were investigated by both TEE and bilateral TCD of the middle cerebral arteries. The following protocol was applied in a randomized way: (1) no VM, (2) VM for 5 s starting with the beginning of Echovist-300 injection, (3) VM for 5 s starting 5 s after the beginning of Echovist-300 injection, (4) VM for 5 s starting 10 s after the beginning of Echovist-300 injection, and (5) VM for 5 s starting 5 s after the beginning of Echovist-200 injection. Results: In 27 patients, an RLS was demonstrated by both TEE and contrast TCD (shunt-positive). Twenty-two patients were negative in both investigations, no patient was positive on TEE but negative on TCD, 15 patients were only positive on at least one TCD investigation but negative on TEE. Tests 3 and 5 were the most appropriate ones; test 3 was slightly superior to test 5. Conclusions: TCD using Echovist-300 or Echovist-200 is a sensitive method to identify TEE-proven cardiac RLS. To achieve the best diagnostic accuracy, the VM should be performed for a duration of 5 s starting at 5 s following the beginning of contrast injection.
Centenarian Stroke Treated with Tissue-Type Plasminogen Activator
Authors: Gorman Mark J. , Tanne David , Lewandowski Christopher A.
Published: April 2003

Background: Elderly patients with acute ischemic stroke often do worse than younger counterparts independent of thrombolytic therapy. Further, tissue-type plasminogen activator, (t-PA) is frequently withheld from the very old. This may be the result of comorbid conditions prohibiting its use or possibly the fear of causing more harm than good. We present a case of a 100-year-old woman who was treated with t-PA for acute ischemic stroke with rapid resolution of symptoms. Case Description: A 100-year-old woman presented to the emergency department with slurred speech, right hemiparesis and right hemisensory loss. Computed tomography revealed neither hemorrhage nor early ischemic changes. Intravenous t-PA was administered at 0.9 mg/kg 3 min prior to the 3-hour limit. She improved rapidly (NIHSS from 12 on admission to 4 at 1 month) and was discharged to the care of her family after 4 hospital days. Conclusion: Intravenous thrombolysis may be beneficial in the very elderly and should be considered in any eligible elderly patients with acute ischemic stroke, with a risk/benefit analysis individualized to each case.
Remineralization Effect of a Low-Concentration Fluoride Rinse in an Intraoral Model
Authors: Chow L.C. , Takagi S. , Frukhtbeyn S. , Sieck B.A. , Parry E.E. , Liao N.S. , Schumacher G.E. , Markovic M.
Published: April 2003

A previous study showed that a sodium hexafluorosilicate-calcium chloride-based two-solution fluoride (F) rinse containing 6 mmol/l of F was more effective than a 12 mmol/l F sodium fluoride rinse in depositing F on tooth surfaces and increasing oral F levels. The present study compared the remineralization effects of these two rinses in an intraoral de- and remineralization model. The results showed that the 6 mmol/l F two-solution rinse produced greater remineralization in increasing lesion mineral contents and reducing lesion depths. The results demonstrated that the effectiveness of an F regimen depends less on the F dose and more on the ability of the treatment to utilize F efficiently for remineralization.
Euclidean and Fractal Computer-Assisted Corneofungimetry: A Comparison of 2% Ketoconazole and 1% Terbinafine Topical Formulations
Authors: Arrese J.E. , Fogouang L. , Piérard-Franchimont C. , Piérard G.E.
Published: April 2003

Background: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. Objective: In this 2-step study performed in two groups of 15 volunteers, corneofungimetry was used to compare the effect of 5-day b.i.d. treatments with 2% ketoconazole and 1% terbinafine creams. Methods: The bioassay was performed using 10 isolates of each of the 3 fungi Trichophyton rubrum, T. mentagrophytes var. interdigitale and Candida albicans put to grow on human stratum corneum. Controls were stratum corneum either untreated or enriched in propylene glycol contained in an unmedicated vehicle. Quantitative assessments were made using both Euclidean and fractal geometry parameters. Results: In comparison with untreated stratum corneum, the fungitoxic activity of the 2% ketoconazole and 1% terbinafine formulations was obvious and similar against dermatophytes. By contrast, 2% ketoconazole was significantly more active against C. albicans than 1% terbinafine. The propylene-glycol-containing vehicle did not exhibit a significant effect upon the dermatophyte growth. Positive linear correlations were yielded between the extent area and the fractal dimension D of dermatophyte mycelia. By contrast, D appeared unrelated to the relative area of dermatophyte growth compared to controls. Conclusion: The combination of Euclidean and fractal analyses improves the information provided by the corneofungimetry bioassay. Creams containing 2% ketoconazole and 1% terbinafine appear equally effective against dermatophytes while the former is more potent against Candida albicans.
Long-Term Efficacy of Dexamethasone-Cyclophosphamide Pulse Therapy in Pemphigus
Authors: Kanwar Amrinder J. , Kaur Sukhjot , Thami Gurvinder P.
Published: April 2003

Background: Corticosteroids are used as a daily oral therapy or in a pulse form with or without various adjuvant drugs for the treatment of pemphigus. Our long-term experience with the use of dexamethasone-cyclophosphamide pulse therapy as a first-line treatment modality for pemphigus is presented. Methods: A retrospective analysis of records of pemphigus patients treated by dexamethasone-cyclophosphamide therapy was carried out. The treatment regimen consisted of the monthly administration of intravenous dexamethasone (136 mg) for 3 consecutive days with addition of intravenous cyclophosphamide (500 mg) on the second day. Oral cyclophosphamide (50 mg) daily and oral corticosteroids (low tapering doses) were given in the intervals between the pulses, till partial remission was achieved. Pulse therapy was then continued for another 6 months followed by daily oral cyclophosphamide (50 mg) for 1 year, which produced a complete remission. Results: A total of 36 patients, 32 with pemphigus vulgaris and 4 with pemphigus foliaceus, were treated with this regimen. Two to 8 pulses were required to achieve a partial remission, while the total number of pulses given for complete remission ranged from 8 to 32. The duration of pulse therapy correlated with both the disease severity and the time to achieve remission. All patients are now in complete remission with a follow-up of 0.5–12 years. Four patterns of remission were observed, related to the severity of disease. The response to pulse therapy was faster in the milder form of disease. The severe form of disease required more pulses as well as higher doses of intervening oral corticosteroids. Conclusions: Dexamethasone-cyclophosphamide pulse therapy is an effective form of treatment in pemphigus and results in long-lasting remissions.
Tumor Progression and Serum Anti-HuD Antibody Concentration in Patients with Paraneoplastic Neurological Syndromes
Authors: Rauer Sebastian , Andreou Ioanna
Published: April 2003

The aim of this study was to investigate whether there are clues for a correlation between tumor progression and serum anti-Hu antibody concentration in patients with anti-Hu-associated paraneoplastic neurological syndromes (PNS). 19 patients with anti-Hu-associated PNS were assigned to three groups according to the course of tumor progression. Group 1 corresponds to patients with rapid tumor progression [n = 5; mean survival in months/standard deviation (SD); 24/10]; in group 2 patients with a favorable tumor prognosis were included (n = 7; mean/SD 79/25, 6 patients still alive); group 3 consisted of patients in whom tumor progression could not be assessed (n = 7; mean/SD 23/20). The anti-Hu antibody concentrations in sera were measured in a recombinant HuD-ELISA. In sera from patients of group 1 the anti-Hu antibody concentration was modest (mean OD 0.56, SD 0.08) whereas a significantly higher anti-Hu antibody concentration was detected in sera from patients with a favorable tumor prognosis (group 2, mean OD 1.86, SD 0.34). These results hint at a negative correlation between tumor progression and the anti-Hu antibody concentration in sera from patients with PNS. These findings confirm and extend previous reports of more indolent tumor growth in patients with an anti-Hu immune response.
Speech-Language Pathology in Malta: Meeting Local Needs in a Global Perspective
Authors: Grech Helen
Published: April 2003

Education in logopaedics and patterns of service delivery for the communication-disordered have expanded over the past decade in the Maltese Islands to address local needs, culture and circumstances. This paper provides an overview of the expansion of trained staff, caseloads and mode of service delivery. Various strategies are reported as having been adopted by the relatively underresourced training establishment to ensure the preparation and maintenance of competent and accountable practitioners, as recommended by the International Association of Logopedics and Phoniatrics. The success in training is perceived as being the result of the collaborative approach adopted with local service providers and expatriate colleagues. Strategic plans to strengthen the profession and service provision are also discussed.
Wandlungen in der Kaiserschnittindikation
Authors: Hickl Ernst-Joachim
Published: April 2003

Die drastische Senkung des mütterlichen Letalitätsrisikos hat eine Wandlung in der Indikationsstellung zum Kaiserschnitt bewirkt. In dem Masse, in dem sich die Sterblichkeit der vaginalen Geburt und der elektiven Kaiserschnittentbindung einander nähern, erhöht sich der Stellenwert der Vermeidung von Schmerzen und von Schäden des Beckenbodens und der Prophylaxe kindlicher Schädigungen. Der Geburtshelfer muss wissen, dass er das Selbstbestimmungsrecht der Frau zu achten hat und unter welchen Voraussetzungen er ihr ein Mitbestimmungsrecht bei der Wahl des Entbindungsweges einzuräumen hat. Er muss die Risiken für Mutter und Kind kennen, und er ist verpflichtet, die Schwangere zutreffend aufzuklären, um ihr eine eigenverantwortliche Abwägung zu ermöglichen. Dies ist die Voraussetzung für eine wirksame Aufklärung. Der Wunsch der Mutter nach einer Kaiserschnittentbindung muss unter diesen Voraussetzungen je nach ihren Motiven in die medizinische Indikation mit einbezogen werden. Eine Sectio auf Wunsch ohne jede medizinische Indikation ist extrem selten. Aber auch sie darf der Arzt durchführen, wenn keine Kontraindikationen bestehen und eine sorgfältige Aufklärung erfolgt ist. Verpflichtet ist er dazu allerdings nicht.
Drug-Induced Urticaria and Angioedema: Pathomechanisms and Frequencies in a Developing Country and in Developed Countries
Authors: Greaves Malcolm W. , Hussein Suraiya H.
Published: April 2003

A careful drug history should be obtained from all patients with acute or chronic urticaria/angioedema, especially in the elderly. Although strictly comparable data are lacking, drug-induced urticaria appears to be more common in developed countries than in Malaysia, at least in a Hospital setting. Culprit drugs include antibiotics, analgesics and contrast media. Pseudoallergic drug-induced urticaria mimicks true allergic urticaria, but without an evident immunological basis, and is at least as common as the allergic type. In Malaysia, and in many other countries compulsory, ingredient labelling of ‘traditional’ medicines would do much to reduce the frequency of drug-induced urticaria.
Regulation of Cytokine Production in Human Peripheral Blood Mononuclear Cells and Allergen-Specific Th Cell Clones by 1α,25-Dihydroxyvitamin D3
Authors: Rausch-Fan Xiaohui , Leutmezer Fritz , Willheim Martin , Spittler Andreas , Bohle Barbara , Ebner Christof , Jensen-Jarolim Erika , Boltz-Nitulescu George
Published: April 2003

Background: The steroid hormone 1α,25-dihydroxyvitamin D3 (calcitriol), in addition to its crucial role in calcium homeostasis, exerts several effects on the immune system by regulating cell proliferation, differentiation, and maturation. These effects may be exerted through the control of protooncogenes and the regulation of cytokine production. Methods: The influence of calcitriol on cytokines secretion by human peripheral blood mononuclear cells (PBMC) isolated from healthy donors, and by allergen-specific T helper (Th) cell clones was studied. PBMC were cultured for 48 h with phorbol myristate acetate (PMA) and ionomycin in the presence or absence of calcitriol. Human Th cell clones were stimulated with either Bet v 1 allergen or anti-CD3 antibodies and PMA. Cytokines were measured in the supernatants by ELISA, and at single-cell level by FACS. Results: Calcitriol significantly inhibited the production of IL-2, IFN-γ and IL-12 by PBMC, as well as the percentage of CD4+ T cells containing intracytoplasmic IL-2 and IFN-γ. Interestingly, calcitriol-treated PBMC induced the production of IL-10 and IL-5, but not of IL-4. The effect of calcitriol was maximal at 10–7 to 10–9 and noneffective at 10–11M. Calcitriol diminished the secretion of IL-1, TNF-α, and MG-CSF in PBMC. Furthermore, calcitriol also decreased the secretion of IL-2 and IFN-γ by Th1 clones, and of IL-4 by Th2 clones. Conclusions: Our data strongly support the notion that calcitriol modulates the production of cytokines in a time- and concentration-dependent manner, and suggest that nonhypercalcemic derivatives of 1α,25-dihydroxyvitamin D3 may be used for new immunosuppressive therapies.
Immune Profiles of Patients with Chronic Idiopathic Urticaria
Authors: Piconi Stefania , Trabattoni Daria , Iemoli Enrico , Fusi Maria Luisa , Villa Maria Luisa , Milazzo Francesco , Clerici Mario
Published: April 2003

Background: The immunologic characterization of chronic idiopathic urticaria (CIU) is still incomplete. In particular, it is not known if positivity to the intradermal autologous serum skin test (ASST) identifies an immunologic subset of CIU patients. Methods: Nineteen CIU patients and 15 healthy controls were enrolled in the study. A diagnostic flowchart was designed to select CIU patients, who were then analyzed by ASST. Cytokine and chemokine production and the expression of adhesion molecules was measured in patients and controls. Results: In CIU patients compared to controls, it was found that (1) TNF-α, IL-10, MIP-1α and RANTES production was augmented and IL-2 and INF-γ reduced, and (2) CD44, CD11a and CD62L expression on CD4 and CD8 cells was augmented. Additionally, TNF-α and chemokine production was significantly increased in CIU patients with a negative ASST (p–; n = 10) compared to patients with a positive response to the test. Conclusions: The presence of an inflammatory process in CIU patients is suggested by the findings that the production of both TNF-α and chemokines as well as the expression of adhesion molecules is increased in these patients. Similarly to what is seen in rheumatoid arthritis, augmented IL-10 production might be secondary to the attempt to hamper the inflammatory milieu. Immune profiles are particularly altered in CIU p– patients, in whom a more aggressive therapeutic strategy might be considered.
Apolipoprotein(a) Gene Polymorphism in the Korean Population: Is There Any Relevance to Essential Hypertension?
Authors: Kang Byung Yong , Bae Joon Seol , Kim Ki Tae , Kim Jae Hyoun , Shin Jung Hee , Lee Chung Choo
Published: April 2003

Objective: To investigate the role of the apolipoprotein(a) [Apo(a)] gene in predicting essential hypertension in the Korean population, we undertook a case-control study using the TTTTA repeat and the Met/Thr polymorphisms of the Apo(a) gene. Methods: The study subjects consisted of 74 essential hypertensives and 211 normotensive individuals. For polymorphism analysis, DNA was amplified by polymerase chain reaction (PCR). In the case of the Met/Thr polymorphism, amplified PCR products were digested with the restriction enzyme KspI. Genotyping was performed by a 10% nondenaturing polyacrylamide gel. Results: There were no significant differences in the allele and genotype frequencies of these polymorphisms between normotensive and essential hypertensive subjects (p > 0.05). Furthermore, levels of lipoprotein(a) in the plasma were not significantly associated with the different genotypes of the Apo(a) gene in either group (p > 0.05). Conclusion: The polymorphisms of these two loci on the Apo(a) gene are unlikely to contribute to the etiology of essential hypertension in the Korean population.
Prevalence of Type-2 Diabetes in Patients with Hepatitis C and B Virus Infection in Jeddah, Saudi Arabia
Authors: Akbar Daad H. , Siddique Aisha M. , Ahmed Maimona M.
Published: April 2003

Objectives: To determine the prevalence of type-2 diabetes mellitus (DM) in patients with hepatitis C virus (HCV) and B virus (HBV) infections. Materials and Methods: A cross-sectional study of HCV- and HBV-positive patients admitted to King Abdul Aziz University Hospital, Jeddah, Saudi Arabia, was conducted from January 1999 to September 2000. The following data were collected and analysed: demographic data, the presence and type of DM, details of the treatment, body mass index (BMI), family history of DM, serum transaminases, thrombocytopenia, and presence of liver cirrhosis on liver biopsy. A total of 399 patients were included in the study. Results: 165 (41%) were anti-HCV positive and 234 (59%) were HBsAg positive. Type-2 diabetes was present in 35 of 165 (21.2%) patients with HCV infection, and 33 of 234 (14.1%) with HBV infection. 94% of anti-HCV-positive type-2 diabetes were older than 40 years and 6% were younger, while for nondiabetics the corresponding percentages were 55 and 45%, respectively. 76% of HBsAg-positive type-2 diabetics were older than 40 and 24% were younger, while the corresponding percentages for nondiabetics were 27 and 73%, respectively. Anti-HCV-positive type-2 diabetics, when compared to nondiabetics, had a higher BMI, a frequent family history of DM, elevated serum transaminases, thrombocytopenia, and liver cirrhosis on biopsy. HBsAg-positive type-2 diabetics had only a more frequent family history of DM than did nondiabetics. Conclusion: Our findings indicate that type-2 diabetes is more common in patients with an HCV than with an HBV infection.
Acute Pancreatitis Associated with Mycoplasma pneumoniae: A Case Report of Missed Diagnosis
Authors: Al-Abassi Abdulla
Published: April 2003

Objective:Mycoplasma pneumoniae is responsible for approximately 20% of community-acquired pneumonia. A wide variety of extrapulmonary manifestations related to M. pneumoniae infection can occur. The diagnosis of M. pneumoniae and its association with acute pancreatitis is briefly reviewed. Clinical Presentation: We describe the case of a 9-year-old boy with clinical features of acute abdomen. Intervention: A perforated appendix was suspected and the patient was accordingly operated on. The clinical, radiological and serological findings that led to the proper diagnosis are described. Conclusion: The case is presented to help increasing the awareness of M. pneumoniae infection as a potential cause of acute pancreatitis in children.
Achieving 24-Hour Control of Parkinson’s Disease Symptoms: Use of Objective Measures to Improve Nocturnal Disability
Authors: Chaudhuri K. Ray , Pal Suvankar , Bridgman K. , Trenkwalder C.
Published: April 2003

Sleep-related problems are common in Parkinson’s disease (PD) and may occur due to the disease process, alteration in sleep architecture or nocturnal motor problems such as akinesia and dystonia. Neuropsychiatric problems and nocturia can also cause significant sleep disruption in PD. Poor sleep may lead to daytime consequences such as excessive daytime sleepiness or fatigue. As there are no PD-specific sleep scales, we have devised a simple visual analogue scale – the Parkinson’s disease sleep scale (PDSS) which is aimed at formal quantification of various aspects of nocturnal sleep disturbance in PD. In this paper, we discuss the development of this scale, its clinical use and how the scale could be used to devise targeted treatment strategies for nocturnal problems in PD.
Vaginal Adenosis in a Non-Diethylstilbestrol-Exposed 6-Year-Old Patient
Authors: García Accetta Solange , Rivoire Waldemar Augusto , Mônego Heleusa Ione , Vettori Daniela Vanessa , De Oliveira Freitas Daniel Melecchi , Edelweiss Maria Isabel , Capp Edison
Published: April 2003

Vaginal adenosis is rare, and it is defined as the presence of metaplastic cervical or endometrial epithelium within the vaginal wall. It is associated with in utero exposition to diethylstilbestrol and a high risk of vaginal carcinomas. A case of vaginal adenosis arising in a non-diethylstilbestrol-exposed 6-year-old patient is presented. Few cases have been described in children and adolescents, and since the withdrawal of diethylstilbestrol from the market, this condition is rarely described in the medical literature. However, it should be considered as a possible diagnosis in girls with persistent vaginal discharge.
Interferon-α Therapy following Autologous Peripheral Blood Stem Cell Transplantation for Adult T Cell Leukemia/Lymphoma
Authors: Fujiwara Hiroshi , Arima Naomichi , Akasaki Yuichi , Ohtsubo Hideo , Ozaki Atsuo , Kukita Toshimasa , Matsushita Kakushi , Arimura Kosei , Suruga Yukio , Wakamatsu Shinichi , Matsumoto Tadashi , Hidaka Shiroh , Eizuru Yoshito , Tei Chuwa
Published: April 2003

In the present report, we describe a case of adult T cell leukemia/lymphoma (ATLL), a 58-year-old woman, successfully treated with interferon (IFN)-α following autologous peripheral blood stem cell transplantation (auto-PBSCT). The patient remains in remission with full performance status for more than 12 months. Auto-PBSCT reduced the abdominal lymphoma mass and IFN-α eliminated residual tumor cells, possibly through the induction of specific T-cell subsets expressing CD3, CD8 on their surfaces and either IFN-γ or tumor necrosis factor (TNF)-α in cytoplasm. We have treated a total of 4 ATLL patients with auto-PBSCT, including the case presented herein. All other patients treated with auto-PBSCT were not followed by adjuvant chemotherapy or cytokine therapy and relapsed within 3 months after auto-PBSCT. This evidence suggests that the therapeutic success of the present case was attributable to the administration of IFN-α immunotherapy following auto-PBSCT.
Maternal Peripheral T-Helper 1-Type and T-Helper 2-Type Immunity in Nonpreeclamptic Twin Pregnancies
Authors: Suzuki Shunji , Kuwajima Toyohiko , Yoneyama Yoshio , Sawa Rintaro , Araki Tsutomu
Published: April 2003

The percentage of T-helper (Th)1, Th2 cells and the Th1:Th2 cell ratios in peripheral blood from 14 normal nonpregnant women, 23 normal pregnant women and 9 patients with twin pregnancies without preeclampsia at 28–32 weeks’ gestation were calculated using flow cytometry. In normal pregnant women, the percentage of Th1 cells and Th1:Th2 ratios were significantly lower than those in nonpregnant women. In twin pregnancies, the percentage of Th1 cells and the Th1:Th2 ratios were significantly lower than those in nonpregnancies. In twin pregnancies; in addition, the percentage of Th1 cells was significantly lower than that in singleton pregnancies. Our findings show a markedly predominant Th2 immunity in twin pregnancies.
Development of Parafoveal Exudates and Serous Retinal Detachment in a Pregnant Woman with Tuberous Sclerosis
Authors: Lee Seok-Joon , Kim Yoon-Hee , Lee Jong-Hyuck , Rah Sang-Hoon , Shin Hyun-Woong , Han Byung-Keun
Published: April 2003

The authors describe an unusual case of a serous detachment of the fovea and decreased vision with parafoveal exudates with subsequent spontaneous resolution and return of central vision in a pregnant patient with tuberous sclerosis. To our knowledge, this is the first report of an ocular change during gestation in a patient with tuberous sclerosis.
Dialysis-Membrane-Dependent Reduction and Adsorption of Circulating Hepatitis C Virus during Hemodialysis
Authors: Mizuno Mari , Higuchi Terumi , Yanai Mitsuru , Kanmatsuse Katsuo , Esumi Mariko
Published: April 2003

Background/Aims: Patients on chronic hemodialysis (HD) are often infected with hepatitis C virus (HCV), a common cause of chronic liver disease. In some cases, however, decreases in the serum HCV load after HD have been documented. To better understand this phenomenon, we investigated the effects of various types of dialysis membrane on virus load in the circulation in vivo and in vitro. Methods: HCV RNA levels in patients’ serum, filtrate and dialyzer membranes were analyzed semiquantitatively by reverse transcription-polymerase chain reaction (RT-PCR) before and after HD treatment with two to four different types of dialysis membrane. HCV RNA was also determined from each fraction in in vitro dialysis and ultrafiltration. Results: In HD patients treated with a polysulfone (PS) membrane and a hemophan membrane, the HCV RNA titer reproducibly decreased by a factor of 10–1–10–2. In contrast, a cuprophan (CU) membrane had no detectable effect on HCV viremia, and HD with the AN69 membrane reduced HCV RNA levels in only a subset of the patients. In addition, a PS membrane, but not a CU membrane, reduced the level of circulating HCV in an in vitro assay. In both in vivo and in vitro experiments, HCV RNA was recovered from the PS membrane itself, but not from the ultrafiltrate. Conclusions: Membrane-dependent adsorption of HCV occurs during HD, causing a transient reduction in HCV in the circulation of patients.
Prevalence of TT Virus in a CAPD Population
Authors: Ozener I. Cetin , Ture Filiz , Koc Mehmet , Avsar Erol
Published: April 2003

TT virus (TTV) has recently been identified in patients with post-transfusion non-A, non-G hepatitis. It is reported to be common in patients with a variety of liver diseases and with history of transfusion. Its pathogenesis in chronic liver diseases remains unclear. In this study, we have determined the prevalence of TTV in a continuous ambulatory peritoneal dialysis (CAPD) population and related its prevalence with history of previous hemodialysis, transfusion, HCV positivity and serum alanine amino-transferase (ALT) levels. TTV was detected in 44% of 63 CAPD patients and 30% of 43 healthy controls (p = 0.15). Frequency of TTV was similar in previously hemodialysed and never hemodialysed (8/14, 57% vs. 20/40, 41%, p = 0.15) and previously transfused and non-transfused (7/19, 37% vs. 15/44, 34%) CAPD patients. Prevalence of TTV was also similar in HCV(+) and HCV(–) patients. Serum ALT levels were 19 ± 16 and 20 ± 12 U/l in TTV(+) and TTV(–) patients, respectively. These results indicate that prevalence of TTV in a CAPD population is similar to healthy controls, and other routes of transmission in addition to parenteral routes might be involved in the transmission of TTV.