bluuebunny/crossref_metadata_2025 huggingface dataset:
Santorio Sanctorius (1561–1636) – Founding Father of Metabolic Balance Studies
Authors: Eknoyan Garabed
Published: April 2003

The intellectual renaissance of the closing decades of the sixteenth century provided the fertile ground in which the budding spirit of scientific inquiry emerged in the seventeenth century. Direct observation, soon augmented by instrumentation that allowed for quantification and, therefore, verification, became the revelatory medium for the progress of the sciences. In medicine, progress depended on the application of the exact sciences of chemistry, mathematics and physics to the study of function. One of the medical luminaries of this early scientific revolution was Santorio Sanctorius (1561– 1636), whose principal contributions were his studies on insensible perspiration and his instrumental inventions. To study insensible perspiration, he designed a movable platform attached to a steelyard scale that allowed for the quantification of changes in body weight of subjects who partook in their daily activities on the platform. After years of self-experimentation, he applied his device to the study of patients. Unfortunately, his records are lost. What survives is a summary of his observations in a series of aphorisms published under the title of Ars de statica medicina, in 1614; 3 years after he was appointed Ordinary Professor of Theoretical Medicine in Padua. To enhance the bedside evaluation of patients, he also designed instruments to quantify the pulse, temperature, and environmental humidity. For his pioneering and detailed balance studies, Sanctorius clearly deserves the title of founding father of metabolic balance studies.
Effects of Simvastatin and Pravastatin on Hyperlipidemia and Cyclosporin Blood Levels in Renal Transplant Recipients
Authors: Capone Domenico , Stanziale Pasquale , Gentile Antonio , Imperatore Paola , Pellegrino Tommaso , Basile Vincenzo
Published: April 2003

Thirty-one renal transplant recipients, submitted to treatment with cyclosporin in association with other immunosuppressive agents, were also treated for 9 months with two hydroxymethylglutaryl coenzyme A reductase inhibitors, simvastatin (10 mg/day) or pravastatin (20 mg/day), for concomitant hypercholesterolemia and hypertriglyceridemia. Both drugs significantly decreased total cholesterol and triglyceride serum levels, but they did not modify whole-blood trough concentrations of polyclonal and monoclonal cyclosporin or polyclonal/monoclonal cyclosporin ratio. No alterations of the clinical and laboratory parameters investigated were found. The results of this study show the efficacy and safety of hydroxymethylglutaryl coenzyme A reductase inhibitors in the treatment of hyperlipidemia in kidney transplant patients.
IgA-Antigliadin Antibodies in Patients with IgA Nephropathy: The Secondary Phenomenon?
Authors: Ots Mai , Uibo Oivi , Metsküla Kaja , Uibo Raivo , Salupere Vello
Published: April 2003

Circulating IgA-antigliadin antibodies (IgA-AGA) are often found in patients with IgA nephropathy (NP). IgA-AGA are sensitive markers of an abnormal immune system reaction to gluten, seen particularly in patients with celiac disease. However, a lack of IgA-antireticulin and IgA-antiendomysium antibodies and often jejunal mucosal atrophy of patients with IgA NP suggest that most patients do not have latent celiac disease. To examine the relationship between IgA-AGA and clinical data, enzyme-linked immunosorbent assays for IgA-AGA were performed in 28 patients with IgA NP and in 50 healthy persons. The results were calculated in arbitrary units (AU). The cutoff level for a negative or a positive test was found to be 60 AU, calculated according to the AGA test result (mean + 3 SD) in 50 healthy persons. The following clinical data were assessed: age, gender, disease duration, daily proteinuria, blood pressure, serum creatinine, and creatinine clearance. Control sera were negative for IgA-AGA. Positive IgA-AGA tests were observed in 14 of the 28 patients (p < 0.0001 vs. controls) and high levels of IgA-AGA (AU >90) in 6 of the 28 patients (p < 0.001 vs. controls). The mean duration of the disease of the patients with positive IgA-AGA was significantly longer as compared with the patients who had a negative antibody test. IgA-AGA correlated with age (p < 0.05, r = 0.56), disease duration (p < 0.05, r = 0.40), and blood pressure (p < 0.05, r = 0.48). Antireticulin and antiendomysium antibody tests were negative in all patient and control sera. We conclude that IgA-AGA are associated with the progression of IgA NP. Our findings support the current concept about the pathogenesis of IgA NP, where the defective IgA production itself may be the primary and intestinal lesions as well as the production of IgA-AGA the secondary phenomenon.
Efficiency of 1-Year Treatment with Fluvastatin in Hyperlipidemic Patients with Nephrotic Syndrome
Authors: Matzkies Fritz K. , Bahner Udo , Teschner Markus , Hohage H. , Heidland August , Schaefer Roland M.
Published: April 2003

The influence of fluvastatin, a liver-selective, competitive inhibitor of the 3-hydroxymethyl-glutaryl-coenzyme A reductase, on the lipoprotein metabolism was investigated in 9 patients with nephrotic syndrome. All patients had biopsy-proven renal disease as cause of their nephrotic syndrome and exhibited severe hyperlipidemia [baseline: serum cholesterol 358 ± 46 mg/dl (9.3 mmol/l), low-density lipoprotein cholesterol 236 ± 18 mg/dl (6.1 mmol/l), triglyerides 333 ± 28 mg/dl (3.8 mmol/l), and lipoprotein Lp(a) 46 ± 11 mg/dl]. After 1 year of 40 mg of fluvastatin, significant reductions of total cholesterol by 31% to 242 ± 26 mg/dl (6.3 mmol/l) and low-density lipoprotein cholesterol by 29% to 162 ± 12 mg/dl (4.2 mmol/l) were observed. Furthermore, triglyceride values were also lowered significantly by 19% to 268 ± 21 mg/dl (3.1 mmol/l). Lipoprotein Lp(a) and high-density lipoprotein-cholesterol remained unchanged by fluvastatin. These improvements in lipid profile were maintained during the entire follow-up period of 1 year. There were no adverse events, and the slight increase in serum creatinine observed during the study was considered to be due to the primary renal disease. In conclusion, long- term administration of fluvastatin in patients with nephrotic syndrome appears to be an effective and safe treatment of the hyperlipidemia associated with this disorder.
Membranoproliferative Glomerulonephritis with Subendothelial Deposits (Type 1) Associated with Hepatitis G Virus Infection in a Renal Transplant Recipient
Authors: Berthoux Patricia , Laurent Blandine , Cecillon Simone , Berthoux François
Published: April 2003

Background: Infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is a well-known etiology for membranoproliferative glomerulonephritis (MPGN) with subendothelial deposits (MPGN type 1). Material and Methods: The newly discovered hepatitis G virus (HGV) is currently under active investigation. We report the first case of de novo MPGN type 1 associated with HGV infection in a young male renal transplant recipient who manifested glomerulonephritis (GN) with proteinuria 7 years after transplant, and whose original disease was chronic obstructive pyelonephritis secondary to nephrolithiasis. Results: Serum markers for HBV and HCV infections were negative. HGV infection was detected by specific double-nested reverse transcriptase-polymerase chain reaction (RT-PCR) in sera (positive HGV viremia) 2.5 years after renal transplantation. By specific in situ RT-PCR, the presence of the HGV genome was detected in peripheral blood mononuclear cells and in the kidney biopsy (glomeruli and tubules), but not in the liver. Conclusion: This report adds new information on the role of HGV infection in the occurrence of de novo GN (MPGN type 1) in renal transplantation.
Magnetic Resonance Imaging of Pseudotumors of the Craniovertebral Junction in Long-Term Hemodialysis Patients
Authors: Maruyama Hiroki , Tanizawa Tatsuhiko , Uchiyama Seiji , Higuchi Takeshi , Ei Kyoko , Oda Mizue , Ei Isei , Oya Minoru , Kishimoto Hidefumi , Saito Takao , Miyamura Syouji , Takano Yoshiyuki , Hasegawa Shin , Kawada Kazuya , Ueki Kazuya , Iwafuchi Yoichi , Arakawa Masaaki
Published: April 2003

Background/Aims: Pseudotumors of the craniovertebral junction (PTCVJ) are observed in long-term hemodialysis (HD) patients. There are neither criteria for diagnosis nor guidelines for screening. We attempted to determine magnetic resonance imaging (MRI) findings that could be used to detect PTCVJ, to determine the prevalence of PTCVJ, and to evaluate whether destructive spondyloarthropathy (DSA) might be a yardstick for selection of patients for MRI examination for PTCVJ. Methods: MRI were examined in 19 DSA patients (8 males, 11 females, age 61.4 ± 7.3 years, HD duration 17.0 ± 4.4 years) and in 20 sex-, age-, and HD-duration-matched non-DSA patients (9 males, 11 females, age 57.5 ± 6.6 years, HD duration 17.7 ± 4.9 years). We evaluated MRI characteristics of PTCVJ according those which occur due to rheumatoid arthritis. Results: PTCVJ were characterized as follows: disappearance of fat pads in the upper region (supradental PTCVJ), intensity change of the ‘predental triangle’ in the anterior region (predental PTCVJ), and thickening of cruciform ligaments (retrodental PTCVJ). The prevalence of PTCVJ among patients undergoing HD more than 10 years was high (26 out of 39; 66.7%). The prevalence of PTCVJ was not different between DSA and non-DSA groups. Conclusion: We verified that the above MRI findings might be helpful in the detection of PTCVJ. These findings were observed frequently and independently also in patients with DSA.
Renal Reabsorption of Phosphate in Children with Sickle Cell Anemia
Authors: Al-Harbi Nafa , Annobil Samuel Hagan , Abbag Fuad , Adzaku Festus , Bassuni Wagih
Published: April 2003

It has previously been reported that in adult patients with sickle-cell anemia the serum phosphate value and the maximum tubular reabsorption of phosphate per liter of glomerular filtrate (TmP/GFR) were significantly higher than in normal controls. This does not appear to have been studied in children with sickle cell anemia (young sicklers) and this prompted us to assess renal phosphate reabsorption in this group of patients. We looked at serum phosphate level and calculated renal phosphate reabsorption (TP/GFR) in children taking random urine and blood samples at the same time and using the formula TP/GFR = Sp – Up × SCr: UCr, in 30 young sicklers all of whom had normal renal function (mean age 7.3 years) and 40 normal matching controls (mean age 6.5 years). The mean serum phosphate value in young sicklers was significantly lower than in controls (4.3 against 5.3 mg/dl) while the mean value of TP/GFR was 4.09 ± 0.74 mg/dl in young sicklers compared to 4.65 ± 0.75 mg/dl in the control group (p = 0.0026). Therefore, the TP/GFR in young sicklers was also significantly lower (p = 0.0026) than in the control group. This may be explained by the high serum level of parathyroid hormone reported previously in patients with sickle cell anemia which is expected to lower phosphate reabsorption (TmP/GFR and TP/GFR are identical in children). The lower serum phosphate value and TP/GFR in younger sicklers seems to be in contrast with the relatively high serum phosphate value and TP/GFR previously reported in adults with sickle cell anemia.
Pravastatin Treatment of Very Low Density, Intermediate Density and Low Density Lipoproteins in Hypercholesterolemia and Combined Hyperlipidemia Secondary to the Nephrotic Syndrome
Authors: Toto Robert D. , Grundy Scott M. , Vega Gloria Lena
Published: April 2003

Background/Aims: In the current study pravastatin was used in nephrotic syndrome patients with hypercholesterolemia and combined hyperlipidemia to test whether the drug decreases production of LDL and reduces levels of VLDL and IDL. Methods: Thirteen patients (7 with high LDL alone and 6 with high VLDL, IDL and LDL) were randomized in a placebo-controlled study that had a crossover design. Patients were treated 8 weeks with pravastatin (40 mg/day) (or placebo) and switched to the corresponding placebo/drug for another 8 weeks. During each phase of the trial, patients had measurement of plasma levels of lipoprotein lipids, and turnover rates of autologous LDL apo B. Results: Pravastatin increased LDL clearance by 16.7% and reduced total cholesterol content per LDL particle in patients with hypercholesterolemia. In combined hyperlipidemia, LDL clearance increased by 19% and there was no significant change in the production of LDL-apo B. Levels of VLDL+IDL apo B were not reduced significantly, while the total cholesterol content of these particles was reduced by 31.7%. Conclusion: Pravastatin effectively reduced LDL levels in both types of dyslipidemia by increasing LDL clearance. Treatment had no effect on production of LDL or on levels of VLDL+IDL-apo B. Thus, pravastatin increases LDL clearance. Statins do not seem to affect production rates of apo B-containing lipoproteins. Treatment of combined hyperlipidemia may require pravastatin and an added drug targeted to normalize levels of VLDL and IDL.
Elevation of Serum Levels of Metalloproteinase-1, Tissue Inhibitor of Metalloproteinase-1 and Type IV Collagen, and Plasma Levels of Metalloproteinase-9 in Polycystic Kidney Disease
Authors: Nakamura Tsukasa , Ushiyama Chifuyu , Suzuki Shingo , Ebihara Isao , Shimada Noriaki , Koide Hikaru
Published: April 2003

Several studies on polycystic kidney disease (PKD) have revealed a number of extracellular matrix (ECM) abnormalities, suggesting that an abnormal ECM plays a role in the development of tubular cysts. Cystic kidney tubules synthesize and secrete high levels of metalloproteinases (MMP), which may participate in the restructuring of the tubular basement membrane. The aim of the present study was to determine whether serum MMP-1, tissue inhibitor of metalloproteinase (TIMP)-1, and type IV collagen levels, and plasma MMP-9 levels were altered in patients with PKD. Sixteen patients with autosomal dominant polycystic kidney disease, and 20 healthy controls were included in this study. Specific enzyme immunoassays were used to measure MMP-1, MMP-9, TIMP-1, and type IV collagen levels. Serum MMP-1 (14.8 ± 3.6 ng/ml), TIMP-1 (288.6 ± 48.6 ng/ml), and type IV collagen (192.6 ± 38.8 ng/ml) concentrations, and plasma MMP-9 (90.2 ± 26.8 ng/ml) concentrations in patients with PKD were significantly higher than those in healthy controls (MMP-1; 6.6 ± 0.9 ng/ml, p < 0.01, MMP-9; 36.4 ± 12.2 ng/ml, p < 0.01, TIMP-1; 164.6 ± 22.8 ng/ml, p < 0.01, and type IV collagen; 86.6 ± 14.2 ng/ml, p < 0.001). The present results suggest that ECM abnormalities associated with cystic kidney may result from aberrant degradation as well as from abnormal synthesis of ECM components.
Acute Effects of Oral Calcium Load on Parathyroid Function and on Bone Resorption in Young Men
Authors: Guillemant Josette , Le Huyen-Tran , Maria Annick , Guillemant Serge
Published: April 2003

Aim: The aim of the present study was to check whether a calcium oral load was able to inhibit bone resorption as assessed by urinary excretion of a new bone marker, type 1 collagen cross-linked C-telopeptide (CrossLapsTM), in healthy young male adults. Methods: Twenty healthy young male adults (age 22 ± 2 years) were studied. In one series of assays, an oral calcium load of 1 g of elemental calcium as calcium citrate dissolved in 200 ml of low-calcium water was ingested, while in another series of assays the subjects ingested 200 ml of water alone. Blood samples were collected before and 1, 2, 3 and 4 h after the intake of calcium. Urine was collected at 2-hour intervals, i.e. before and for 4 h after the intake of calcium. Serum ionized calcium, phosphate and intact parathormone (iPTH) were measured at each time point. Urinary calcium, phosphate, creatinine and CrossLaps (as a ratio to creatinine) were measured in each urine sample. Results: Calcium intake was associated with very significant (ANOVA, p < 0.001) increases in serum ionized calcium and decreases in PTH. After calcium intake, measurements of urinary CrossLaps showed a progressive statistically significant (ANOVA, p < 0.001) decrease (–20% at 2 h and –55% at 4 h), whereas after ingestion of water, the changes were modest and not statistically significant. Conclusions: The present results show that bone resorption as assessed by urinary excretion of CrossLaps can be significantly suppressed by the ingestion of a 1-gram calcium load and attest that calcium supplementation has an acute effect on bone metabolism.
Behçet’s Disease and AA-Type Amyloidosis
Authors: Akpolat Tekin , Akpolat İlkser , Kandemir Bedri
Published: April 2003

Behçet’s disease (BD) is a multisystem disorder characterized by vasculitis. To our knowledge, 52 patients with BD and amyloidosis have previously been described in the literature. Nephrotic syndrome was the most common type of presentation of amyloidosis in these patients. The prognosis of patients with BD and amyloidosis has not been reported before. In this report, we present a patient with BD and AA-type amyloidosis and analyze the prognosis in these patients. Follow-up and prognosis have been reported in 23 patients. Ten of these 23 patients died and most of these deaths occurred within 3 months after the diagnosis of amyloidosis. End-stage renal disease developed shortly in 4 patients. BD should be considered in the differential diagnosis of AA amyloidosis. In conclusion, the cases with BD and amyloidosis carry poor prognosis.
Efficiency of Different Hollow-Fiber Hemofilters in Continuous Arteriovenous Hemodiafiltration
Authors: Morabito Santo , Pierucci Alessandro , Marinelli Rocco , Cicciarelli Angela , Guzzo Isabella , Cinotti Giulio Alberto , Marino Benedetto , Chiavarelli Roberto
Published: April 2003

Low dialysate to blood flow rate ratios are a unique characteristic of continuous arteriovenous hemodiafiltration (CAVHDF) that should allow complete saturation of dialysis fluid with small-molecular-weight blood solutes. The aim of the investigation was to evaluate the performance of different hemofilters in CAVHDF. In 10 critically ill patients with acute renal failure, the efficiency of four hollow-fiber hemofilters, polyamide 0.6 m2, polyacrylonitrile (PAN) 0.3 and 0.6 m2, acrylonitrile sodium methallylsulfonate (AN69HF) 0.6 m2, has been evaluated. For comparison, dialysate flow rates (Qdi) were standardized to 16.6 and 25 ml/min. Samples for urea nitrogen were obtained from the arterial blood line (Cbi) and from the dialysate exit port (Cdo) within 24-hour running time. Outflowing dialysate (Qdo) was also measured at the same time. Blood flow (Qb) was calculated by the bubble transit time technique. Diffusive and total urea clearances were determined. AN69HF and PAN hemofilters provided higher clearances than the polyamide hemofilter. Despite the smaller surface area, PAN 0.3 m2 had a total urea clearance comparable to that of PAN 0.6 m2 and AN69HF at Qdi = 16.6 ml/min. While at Qdi = 16.6 ml/min equilibrium between blood and dialysate (Cdo/Cbi ≅ 1) occurred with the AN69HF and PAN hemofilters, at Qdi = 25 ml/min the equilibrium was obtained only with the AN69HF hemofilter. In conclusion, almost complete urea saturation of dialysis fluid has not been obtained with all hemofilters tested here. In our experience, membrane characteristics play an important role in determining diffusive efficiency in CAVHDF.
Leptin and Serum Erythropoietin in Hemodialyzed and Peritoneally Dialyzed Uremic Patients during rHuEPO Therapy
Authors: Małyszko Jolanta , Zbroch Edyta , Wołczyński Sławomir , Małyszko Jacek S. , Hryszko Tomasz , Myśliwiec Michał
Published: April 2003

Leptin produced by fat cell has an unanticipated role in hematopoietic system development. We examined the relationships between leptinemia and requirements of erythropoietin (Epo), endogenous Epo levels as well as markers of inflammation: C-reactive protein, tumor necrosis factor α (TNFα) and interleukin-1 (IL-1) in rHuEPO-treated patients maintained on chronic hemodialyses or peritoneal dialyses. The studies were performed on 51 chronically hemodialyzed patients, 20 of them did not receive rHuEPO, 31 subjects received rHuEPO, and 22 patients on CAPD, 13 of them did not receive rHuEPO, 9 subjects were given rHuEPO. In hemodialyzed patients (Epo and Non-Epo group) leptin levels were significantly higher when compared to CAPD patients (Epo and Non-Epo group, respectively). Leptin in peritoneal fluid was significantly higher in the Non-Epo group. In ultrafiltrate, leptin levels were below the detection limit of 0.5 ng/ml. Epo levels in the HD + Epo group were significantly lower than in the HD + Non-Epo group and CAPD + Epo group. TNFα and IL-1 concentrations were significantly lower in both groups of CAPD patients when compared to respective HD groups. Treatment with rHuEPO resulted in nonsignificant decline in serum leptin (p = 0.07 in HD and p = 0.08 in CAPD) and significant leptin loss in peritoneal fluid. It may be of clinical relevance in dialyzed patients. In both groups of Epo-treated patients, positive physiological correlation between leptinemia and BMI disappeared. Leptin levels do not correlate with rHuEPO requirements and serum Epo in dialyzed patients.
Influence of Dialysis Procedure, Membrane Surface and Membrane Material on Iopromide Elimination in Patients with Reduced Kidney Function
Authors: Matzkies F.K. , Reinecke H. , Tombach B. , Kosch M. , Hegger K. , Milius M. , Hohage H. , Kisters K. , Kerber S. , Schaefer R.M.
Published: April 2003

Haemodialysis for the elimination of contrast medium in patients with advanced renal failure is a common procedure. Even though sufficient elimination with the use of regular low-flux membranes is documented, large differences in results have been reported in prior investigations. We, therefore, compared Cuprophan and polysulfone dialysers with different surface areas to haemofiltration with different amounts of substitution fluid in 40 patients with compromised renal function after coronary angiography. Plasma iodine concentrations were measured by fluorescent excitation analysis. At constant blood flow rates of 200 ml/min, Cuprophan membranes with 1.3 m2 surface area had a clearance rate of 87 ml/min, whereas polysulfone membranes of comparable size displayed a significantly higher clearance rate of 147 ml/min. Polysulfone membranes with 1.8 m2 surface area showed a small but insignificant increase in the iodine clearance (162 ml/min), while Cuprophan membranes displayed an increase in clearance rates (121 ml/min). Additional ultrafiltration led to a further increase in the plasma clearance of both membranes and reduced urinary iodine excretion. Haemofiltration was comparable to haemodialysis in terms of efficacy and thus represents an alternative method. Clearance of iopromide during haemodialysis with polysulfone membranes is higher than with Cuprophan membranes. Elimination rates can be further increased by additional ultrafiltration. Haemofiltration is comparable to haemodialysis regarding contrast medium elimination.
A Simple Estimate of the Effect of the Serum Albumin Level on the Anion Gap
Authors: Carvounis Christos P. , Feinfeld Donald A.
Published: April 2003

Background: The serum anion gap (serum [Na+]-Cl-]-[CO2]) is still the first-line approach to metabolic acidosis. However, while it is generally acknowledged that hypoalbuminemia mandates a downward adjustment of the expected anion gap, a specific correction factor for the anion gap in the face of low serum albumin has never been demonstrated. Methods: We reviewed initial laboratory data from 432 consecutive patients admitted or transferred to the medical intensive care unit at Nassau County Medical Center over a 6-month period and correlated the serum albumin with the anion gap and the serum [tCO2] using multivariate analysis. We looked at the anion gap as a function of  (albumin), the difference between normal and actual serum albumin, defined as 4.0 - measured serum albumin g/dl. We also assessed [tCO2] as an independent variable. Results: For patients with normal or high serum tCO2, the ratio of change in anion gap ( anion gap) to  (albumin) was 1.46 and 1.45, respectively. For patients with serum tCO2 <22 mEq/l this ratio was 1.89. In the latter group, anion gap was best predicted taking both  (albumin) and serum tCO2 into account: anion gap = 36.2 - serum tCO2 - 2.3* (albumin) (r = 0.71, p < 0.0001). Conclusion: For intensive care patients with normal or high serum tCO2 (>21 mEq/l) a simple bedside adjustment of the anion gap by subtracting 1.5 times the difference between measured serum albumin and the 'normal' level of 4.0 g/dl gives a close estimate of the actual anion gap. For intensive care patients with serum tCO2 <22 mEq/l, correction of the anion gap is well predicted by adding about twice the  (albumin) to the calculated gap.
Hypoalbuminemia as a Risk Factor for Progressive Left-Ventricular Hypertrophy in Hemodialysis Patients
Authors: Moon Kyoung Hyoub , Song In Suk , Yang Won Seok , Shin Young Tae , Kim Soon Bae , Song Jae Kwan , Park Jung Sik
Published: April 2003

Background: This study was performed to evaluate the changes in left-ventricular (LV) mass in the patients starting maintenance hemodialysis and the risk factors for the progression of LVH. Methods: From June 1994 to February 1997, baseline echocardiography was obtained within six months after the initiation of hemodialysis in 111 patients with end-stage renal disease. Of the patients who had LVH on baseline echocardiography, 32 patients underwent follow-up echocardiography after 15 months (range: 9-24 months). LVH was defined as a left-ventricular mass index (LVMI) greater than 131 g/m2 in males and 100 g/m2 in females. Progressive LVH was defined as a follow-up LVMI greater than 105% of the baseline value. Hemoglobin, blood urea nitrogen, creatinine, cholesterol, albumin, prealbumin, parathyroid hormone, Kt/V, nPCR, fibrinogen, homocysteine and ACE gene polymorphism were also measured. Results: LVH was detected in 91 of 111 (82%) ESRD patients starting maintenance hemodialysis. Of the 32 patients in whom follow-up echocardiography was performed, progressive LVH occurred in 19 patients (M:F = 12:7). Progressive LVH was associated with lower diastolic blood pressure (81 +/- 11 vs. 90 +/- 12 mm Hg, p = 0.036) and lower serum albumin (3.5 +/- 0.4 vs. 3.9 +/- 0.4 g/dl, p = 0.009). Serum albumin was negatively (r = -0.420, p = 0.017) correlated to  LVMI (follow-up LVMI minus baseline LVMI). Hypoalbuminemia was an independent risk factor for progressive LVH in multiple logistic regression analysis (R.R. = 1.29, p = 0.046). The association of progressive LVH with age, gender, diabetes mellitus, smoking history or other laboratory parameters was not significant. Conclusion: LVH was highly prevalent in the patients starting maintenance hemodialysis for ESRD. In the follow-up echocardiography, LVH progressed in a substantial portion of the patients, and hypoalbuminemia was a risk factor for progressive LVH.
Der Individuationsprozess im Spiegel der Chakrensymbolik
Authors: Bittlinger Arnold
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Es war im C.G.-Jung-Institut in Zürich. Zum ersten Mal betrat ich das Büro des Studienleiters – und war überrascht. Die Wände waren ringsum geschmückt mit grossen gerahmten Darstellungen der Chakrensymbole. Es waren Kopien der Bilder, die Arthur Avalon (Sir John Woodroffe) 1918 in seinem Buch «Die Schlangenkraft» veröffentlicht hat [Avalon, 1988].
Seelische Wirkung und therapeutische Wirksamkeit: Zwei Dimensionen Jungscher Therapie
Authors: Brutsche Paul
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Wir haben als heutige Jungianer Fragen. Den Internationalen Kongress in Zürich widmeten wir den «Offenen Fragen in der Analytischen Psychologie», und immer wieder wird an Tagungen die Frage gestellt, was denn das typisch Jungsche an unserem Therapieverständnis sei. Wir haben Fragen und andere fragen uns. Konzentriert auf die Arbeit mit den vielen einzelnen, die zu uns in die Analyse kommen, haben wir bisher gewohnheitsmässig und selbstverständlich das getan, was wir für sinnvoll und richtig hielten. Und plötzlich werden wir gefragt: Ja, aber ist die Welt dadurch besser geworden? Oder andere fragen uns: Seid ihr wirklich noch Jungianer oder habt ihr Jung nicht schon längst über Bord geworfen? Wieder andere fragen: Habt ihr eigentlich die letzten Entwicklungen in Psychotherapie und Forschung schon zur Kenntnis genommen?
Was wirkt in der analytischen Gruppenpsychotherapie?
Authors: Roser Martin
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Die Tatsache, dass das mehrere tausend Jahre alte «I Ging» ein Hexagramm mit der Bezeichnung «Tung Jen» («Gemeinschaft mit Menschen») aufführt, zeigt, dass die Gruppe als ein Grundarchetyp menschlichen Lebens schon seit Urzeiten einen zentralen Wirkfaktor darstellt. Interessanterweise wird in dem synchronistischen Denken der chinesischen Kultur verbundenen «I Ging» betont, dass die Gemeinschaft mit Menschen nur im Freien Gelingen hat, d.h. als Wesen die friedliche Vereinigung der Menschen mit äusserer Stärke und innerer Klarheit zum Ziel hat.
Hysterie/Anima – Vom extravertierten zum introvertierten Weiblichkeitskonzept Jungs
Authors: Czerny Michael
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Die folgenden Überlegungen beabsichtigen, die intrapsychischen Veränderungen Jungs zeitkritisch nachzuvollziehen, die es ihm ermöglichten, mit der Konzeptualisierung der Anima einen introversiven Weg zu finden, das Phänomen Weiblichkeit in seinem späteren Werk zu integrieren. Es wird nicht als Aufgabe dieser Arbeit angesehen, das Animakonzept Jungs in seiner Entwicklung und seinem ganzen Bedeutungsumfang einer kritischen Würdigung zu unterziehen. Die innerseelischen Vorgänge und äusseren Umstände, die bei Jung zur Entwicklung des Animakonzeptes führten, können nur im Zusammenhang mit seinem Wandlungsprozess gesehen werden, der sich in eindrücklicher Weise während seiner Lebenskrise im Sinne eines Initiationsgeschehens ereignete. Die Wandlung betraf nachdrücklich Jungs extravertierte Einstellung mit seiner damaligen starken Bezogenheit auf die Psychiatrie und die Psychoanalyse Freuds.
Interaktive körpertherapeutische Gruppentherapie und Gegenübertragung
Authors: Ware Robert C.
Published: April 2003

//8RIn den letzten Jahren wurde mir immer mehr das interaktive, seelische und körperliche Erleben des Analytikers innerhalb der therapeutischen Beziehung wichtig. Insbesondere interessierte ich mich für die Bedeutsamkeit des sogenannten «Vaterkörpers» [Ware, 1996] sowie für erotisch-sexuelle Übertragungen und Gegenübertragungen [Ware, 1999, Ware, in Vorbereitung]. Vor 2 oder 3 Jahren stiess ich bei meinen Recherchen auf einen Begriff des englischen Psychoanalytikers Christopher Bollas, der ein Phänomen beschrieb, das mir schon lange vertraut war, ohne dass ich es hätte benennen können, «countertransference capacity» [Bollas, 1987/1997], was ich aus später erläuterten Gründen mit «Gegenübertragungs-Kapazität» übersetze. In den unten geschilderten kasuistischenVignetten versuche ich anhand einiger gruppentherapeutischer Erfahrungen den interaktiven, beziehungsanalytisch-körpertherapeutischen Gebrauch von Gegenübertragungs-Kapazität darzustellen. Es handelt sich um einen psychischen «Raum» im Therapeuten, in dem ein Patient oder die Gruppe als Ganzes mittels unbewusst verlaufender induktiver und projektiv identifikatorischer Prozesse konflikthafte frühere Beziehungsmuster, innere Objektbeziehungen und unaussprechbare Affekte wiederholend inszeniert. Im ersten Teil schildere ich ein konkretes Beispiel konflikthafter Gegenübertragung und erläutere danach das Konzept. Im zweiten Teil erörtere ich einige mir wichtig gewordene allgemeinere Teilaspekte der Praxis interaktiver und körperorientierter analytischer Gruppentherapie. Wiederum geht es um Beziehung, Interaktion und Inszenierung. Im dritten Teil stelle ich zwei weitere Beispiele körperorientierter analytischer Gruppentherapie kurz dar, die vor allem interaktive Möglichkeiten wortloser Inszenierung und handlungssymbolischer «Deutung» von Übertragung und Gegenübertragung versinnbildlichen.
Goethe – Anmerkungen zu seinem 250. Geburtstag
Authors: Wasserziehr Gabriele
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.In meiner Schulzeit hegte ich eine starke Abneigung gegen Goethe. Er wurde uns als der «Dichterfürst», als Modell aller Dichter, hingestellt. Ich dagegen sah ihn als eingebildeten Spiesser. Bequem in seinem Ministaat lebend, den jungen Dichtern Hilfe und Anerkennung verweigernd, machte er sich mit seinen Liebeleien bis ins Alter in meinen Augen eher lächerlich. Ich schrieb einen «flammenden» Aufsatz zur Verteidigung Schillers gegen Goethe, der mir ein Ungenügend sowie eine Ohrfeige einbrachte. So etwas wurde nicht geduldet, vor 1968 schon gar nicht. In meinem Studium schrieb ich eine Fleissarbeit über seine Gedichte, ich brauchte den Seminarschein. Dann war jahrzehntelang Schweigen um ihn in mir.
High-Precision Neuromagnetic Study of the Functional Organization of the Human Auditory Cortex
Authors: Lütkenhöner Bernd , Steinsträter Olaf
Published: April 2003

Previous studies have proven that a dipole source analysis of the auditory evoked field is capable of providing evidence of the tonotopic organization of the human auditory cortex. To explore the nature of the estimated dipoles in greater detail, a single subject was extensively studied, and the estimated sources were registered in a three-dimensional reconstruction of the cortical surface derived from magnetic resonance images. The stimuli were 500-ms tone bursts with frequencies of 250, 500, 1,000, and 2,000 Hz (mean intensity of 60 dB SL). The total number of stimuli presented per condition was about 3,600 (36 independent experiments spread over 4 days). Using special postprocessing techniques, the relative localization accuracy could be enhanced to such an extent that differences in the dipole locations of 1 mm could be clearly distinguished. The results suggest that peak N1m (latency around 100 ms) arises from the planum temporale, whereas peak P2m (latency around 170 ms) appears to correspond to a center of activity in (or close to) Heschl’s gyrus. The tonotopic organization found for the generator of N1m was consistent with earlier studies (‘the higher the frequency the deeper the source’). However, additional findings (time dependence of the estimated sources; slightly different tonotopy obtained for field change; dependence of the estimated sources on the estimation technique) indicate that multiple areas are involved in the generation of N1m. Evidence of a frequency-dependent source location was found also for P2m.
Basal Cochlear Lesions Result in Increased Amplitude of Otoacoustic Emissions
Authors: Kakigi Akinobu , Hirakawa Haruo , Harel Noam , Mount Richard J. , Harrison Robert V.
Published: April 2003

We have measured the changes in transient otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) during and after ototoxic amikacin treatment in an animal (chinchilla) model. TEOAE and DPOAE were recorded from 6 adult chinchillas over a 6-week time course starting just before a 5-day or 7-day treatment period with amikacin sulphate (400 mg/kg/day, i.m.). After final recordings, cochlear morphology was assessed by scanning electron microscopy. Generally, both DPOAE and TEOAE amplitudes change during and after treatment in a systematic fashion. High-frequency components change first, followed by lower-frequency components. We note that there is often a long latency to the onset of changes in otoacoustic emissions (OAE), and that these changes can continue for weeks after treatment. Most importantly we report that when the basal region of the cochlea is damaged in the frequency region above the OAE recording bandwidth (0.6–6 kHz for TEOAE; 1–6.7 kHz for DPOAE), we often find an increase in OAE amplitudes. More specifically, we note that as a cochlear lesion progresses apically, there is often a transient increase in a frequency-specific OAE before it reduces or is lost. Our results suggest that the increase in OAE amplitudes precedes the expression of detectable cochlear pathology.
Effects of Age, Gender and Ear Side on SOAE Parameters in Infancy and Childhood
Authors: Lamprecht-Dinnesen Antoinette , Pohl Michaela , Hartmann Sabine , Heinecke Achim , Ahrens Susanne , Müller Elfriede , Riebandt Michael
Published: April 2003

We investigated 267 infants and children aged 9 days to 16.8 years to study the spontaneous otoacoustic emission (SOAE) data prevalence, number per ear, level and frequency as a function of growth. Dependence on age, gender and ear side was statistically analyzed using the method of generalized estimation equations. Except in the 1st year of life, SOAE prevalence per ear and SOAE number per ear decreased significantly with increasing age. Both SOAE parameters were significantly higher in female than in male subjects, with gender difference of SOAE prevalence per ear being more distinct in the 1st year of life. Although a clear ear side effect on SOAE prevalence per ear could already be seen in ears of female children in this age group, only SOAE number per ear was significantly higher in right ears than in left ears from the 1st year of life on. Except in the first 12 months, SOAE level and SOAE frequency decreased significantly with increasing age. Neither a significant gender difference nor a significant ear side difference could be determined. Our results found in infancy and childhood are discussed within the framework of the current literature.
Clinical Applicability of Transient Evoked Otoacoustic Emissions: Identification and Classification of Hearing Loss
Authors: Hatzopoulos S. , Prosser S. , Mazzoli M. , Rosignoli M. , Martini A.
Published: April 2003

The study aimed at the development of a clinically applicable methodology that could: (1) discriminate transient evoked otoacoustic emission (TEOAE) recordings from normal hearing or hearing impaired individuals; (2) classify the nature of the hearing loss as conductive or as cochlear, and (3) define clear-cut TEOAE clinical criteria. A classification algorithm based on a multivariate discriminant analysis of fast Fourier transform data from recordings evoked by click stimuli of 50 ± 2, 62 ± 2, 68 ± 2 and 80 ± 2 dB SPL was used to discriminate 302 normal subjects from 383 subjects suffering from mild to moderate hearing losses. The best discriminant model (QDF80) produced a sensitivity of 93.8% and a specificity of 79.4%. When extra correlation criteria were serially applied to the classification outcome, the specificity was increased to 85.3%, but the sensitivity was marginally decreased to 91.7%. The classification of the correctly identified hearing-impaired cases yielded 93.8% identification of conductive and 75.1% identification of cochlear cases. A sensitivity analysis of the misclassified hearing-impaired cases suggested that the TEOAE spectra are well correlated with the 2-kHz but poorly correlated with the 4-kHz octave frequency.
Age- and Strain-Related Differences in Dehydrogenase Activity and Glycogen Levels in CBA and C57 Mouse Cochleas
Authors: Ding Da-Lian , McFadden Sandra L. , Wang Jian , Hua Hu Bo , Salvi Richard J.
Published: April 2003

In the C57 mouse strain, loss of sensory hair cells (HCs) begins during early adulthood, starting in the base of the cochlea and progressing toward the apex as aging continues. In contrast, the CBA mouse strain exhibits no significant cochlear histopathology until relatively late in life. These strain and age differences may be related to differences in cochlear energy metabolism. To examine this possibility, we used dehydrogenase and glycogen histochemistry to evaluate the metabolic capacities of HCs and stria vascularis (SV) in cochleas of C57 and CBA mice. Reaction product density was quantified and compared as a function of strain (1.5-month-old C57 mice vs. CBA mice) and age (CBA mice, 1.5, 18 and 36 months). Young C57 mice had significantly less HC dehydrogenase activity than CBA mice of any age, lower HC glycogen levels than 18-month-old CBA mice and lower SV glycogen levels than 18- or 36-month-old CBA animals. Within the CBA strain, HC dehydrogenase activity decreased significantly between 1.5 and 18 months of age, while glycogen levels in both HCs and SV increased over the same time period. Between 18 and 36 months, HC dehydrogenase activity and SV glycogen levels remained stable. The results show that there are significant age-related changes in energy metabolism in the inner ear of CBA mice that are correlated with age-related hearing loss. Genetically determined deficits in cochlear metabolic capacity in C57 mice could be linked to the early onset of hearing loss in this strain.
Mechanical Properties of the Middle Ear System Investigated by Its Pressure-Volume Relationship
Authors: Gaihede Michael
Published: April 2003

A new method is presented for the measurement of ear canal pressure changes in response to tympanic membrane volume displacements, i.e. the pressure-volume relationship (PVR) of the middle ear system. This method has several advantages when compared to tympanometry; for example, it avoids phase delay and hysteresis can be used as a variable thanks to bidirectional recordings. Moreover, dynamic complicance is registered physically as changes in volume relative to pressure. Normative data for 39 subjects are summarized along with preliminary data from patients exhibiting various clinical conditions. The major findings are that secretory otitis media with middle ear effusion results in significantly increased hysteresis (leading to large errors when middle ear pressure is determined by tympanometry), two types of ossicular discontinuity may be distinguished by this method and that myringoplasty leads to a linear PVR in contrast to the nonlinearity found in normal subjects.
Identification of Parameters for the Middle Ear Model
Authors: Bornitz Matthias , Zahnert Thomas , Hardtke Hans-Jürgen , Hüttenbrink Karl-Bernd
Published: April 2003

This paper presents a method of parameter identification for a finite-element model of the human middle ear. The parameter values are estimated using a characterization of the difference in natural frequencies and mode shapes of the tympanic membrane between the model and the specimens. Experimental results were obtained from temporal bone specimens under sound excitation (300–3,000 Hz). The first 3 modes of the tympanic membrane could be observed with a laser scanning vibrometer and were used to estimate the stiffness parameters for the orthotropic finite-element model of the eardrum. A further point of discussion is the parameter sensitivity and its implication for the identification process.
Cutaneous-Evoked Tinnitus
Authors: Cacace Anthony T. , Cousins Joseph P. , Parnes Steven M. , Semenoff David , Holmes Timothy , McFarland Dennis J. , Davenport Charles , Stegbauer Keith , Lovely Thomas J.
Published: April 2003

Complete and acute unilateral deafferentation of the auditory periphery (auditory and vestibular afferents) can induce changes in the central nervous system that may result in unique forms of tinnitus. These tinnitus perceptions can be controlled (turned on and off) or modulated (changed in pitch or loudness) by performing certain overt behaviors in other sensory/motor systems. Clinical reports from our laboratory and several other independent sources indicate that static change in eye gaze, from a neutral head-referenced position, is one such behavior that can evoke, modulate and/or suppress these phantom auditory events. This report deals with a new clinical entity and a form of tinnitus that can be evoked directly by cutaneous stimulation of the upper hand and fingertip regions. In 2 adults, cutaneous-evoked tinnitus was reported following neurosurgery for space-occupying lesions at the base of the skull and posterior craniofossa, where hearing and vestibular functions were lost completely and acutely in one ear (unilateral deafferentation) and facial nerve paralysis (unilateral deefferentation) was present either immediately following neurosurgery or had occurred as a delayed-onset event. Herein, we focus on the phenomenology of this discovery, provide perceptual correlates using contemporary psychophysical methods and document in one individual cutaneous-evoked tinnitus-related neural activity using functional magnetic resonance imaging. In a companion paper, neuroanatomical and physiological interactions between auditory and somatosensory systems, possible mechanistic accounts and relevant functional neuroimaging studies are reviewed.
Structural Recovery from Sound and Aminoglycoside Damage in the Avian Cochlea
Authors: Cotanche Douglas A.
Published: April 2003

Hair cell regeneration in the mature avian cochlea occurs in response to trauma that causes the death of some or all of the existing hair cell population. In general, this trauma has been introduced experimentally by either sound overexposure or treatment of the bird with high doses of aminoglycoside antibiotics. When injured hair cells are ejected from the sensory epithelium, the nonsensory supporting cells respond by re-entering the cell cycle and proliferating or by transdifferentiating directly into hair cells without a mitotic event. The new hair cells mature in a manner similar to that seen during embryonic development. They make connections with the overlying tectorial membrane and the afferent and efferent cochlear nerve processes within the sensory epithelium. This structural regeneration is accompanied by a significant recovery of auditory function and thus allows the animal to regain its hearing ability. This hair cell regeneration is presumably quite beneficial to birds, whose primary means of communication is based on vocalizations and the ability to hear and comprehend them. The prevalence of hearing loss in our society and the isolating impact it has on affected individuals makes the potential for finding ways to induce a similar hair cell regeneration in humans a very tempting goal. Studies of hair cell regeneration over the last 12 years have focused on the mechanisms that regulate the process and how they could be controlled. This review will examine the structural events involved in regenerating hair cells in the avian cochlea after sound damage and aminoglycoside treatment. It will define how hair cells and nerve endings are lost and the tectorial membrane is damaged by the traumatizing stimuli and how the supporting cells and nerve fibers respond by producing new hair cells, a new tectorial membrane and new synaptic connections during recovery. Finally, it will focus on mechanisms that control the proliferation and transdifferentiation of supporting cells and the differentiation of new hair cells. This structural review is accompanied by a companion review that covers the fundamental issues concerning functional recovery in the avian cochlea associated with hair cell regeneration.