bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxidant/antioxidant Parameters and their Relationship with Chemotherapy in Hodgkin's Lymphoma
Authors: Kaya E , Keskin L , Aydogdu I , Kuku I , Bayraktar N , Erkut MA
Published: February 2013

This study investigated changing levels of serum oxidant/antioxidant with chemotherapy and their relation to treatment in 34 Hodgkin's lymphoma patients. The patient population consisted of 19 males and 15 females. Mean age was 30.41 ± 12.08 years. All patients received the adriamycin, bleomycin, vincristine and dexamethasone (ABVD) treatment protocol. Blood samples were taken before treatment, and on days 1 and 7 during treatment for measurement of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and enzyme activities. After ABVD treatment, mean free radical levels were increased and antioxidant levels were significantly decreased in the serum. ABVD treatment results in an increase of free radical levels and a decrease of antioxidant levels in the serum of patients with Hodgkin's lymphoma.
Effect of Pre-operative Angiotensinconverting Enzyme Inhibitors on Haemodynamic Parameters and Vasoconstrictor Requirements in Patients Undergoing Off-pump Coronary Artery Bypass Surgery
Authors: Lee YK , Na SW , Kwak YL , Nam SB
Published: February 2013

The effects of pre-operative angiotensin-converting enzyme inhibitor (ACEI) treatment on haemodynamic status and vasoconstrictor requirements during off-pump coronary artery bypass surgery (OPCAB) were studied. Eighty patients selected for OPCAB were divided into those who had been treated with ACEIs for 4 weeks or more pre-operatively (ACEI group) (n = 43) and those who had not been treated with ACEIs (control group) (n = 37). Noradrenaline was infused during the operation when the mean systemic arterial pressure (SAP) fell below 60 mmHg. No significant differences in the haemodynamic parameters measured were detected between the two groups, except for cardiac output, which was found to be significantly greater in the control group. During anastomosis of the obtuse marginal branch of the left circumflex artery (OM), a significantly larger amount of noradrenaline was required by the ACEI group compared with the control group. In conclusion, pre-operative treatment with ACEIs significantly increased the amount of vasoconstrictor necessary to maintain the target SAP during OM anastomosis during OPCAB.
Cerebral Venous Thrombosis Initially Considered as a Complication of Spinal-Epidural Anaesthesia
Authors: Karci A , Boyaci F , Yaka E , Çakmur R , Men S , Elar Z
Published: February 2013

Cerebral venous thrombosis is an unusual condition characterized by headache, nausea, vomiting, focal deficits and epileptic seizures. In this case report we describe a patient who presented with headache and focal motor deficits after an uneventful Caesarean section, performed using combined spinal-epidural anaesthesia. Magnetic resonance imaging was performed because of the pronounced neurological symptoms, and a diagnosis of cerebral venous thrombosis was made. The patient was treated with anticoagulant agents and made a complete recovery. This case emphasizes the importance of considering cerebral venous thrombosis in the differential diagnosis of headache in the post-partum period prior to instituting conventional therapy.
Pre-Clinical and Clinical Experience of Telmisartan in Cardiac Remodelling
Authors: Verdecchia P
Published: February 2013

Epidemiological studies have established that left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular and cerebrovascular morbidity and mortality. In turn, hypertension is a well-established risk factor for LVH. Ambulatory blood pressure monitoring has shown that 24-h mean ambulatory blood pressure is a particularly powerful predictor of LVH, being superior to casual clinic blood pressure measurements. The magnitude of the rise in blood pressure in the early morning correlates with the extent of LVH. Prospective studies have shown the advantageous effects of anti-hypertensive therapy on LVH in terms of regression of left ventricular mass (LVM) and subsequent reduction in overt cardiovascular disease. Meta-analysis has identified differences in the ability of different classes of anti-hypertensive agents to bring about regression of LVH, with agents that target the renin – angiotensin system (RAS) appearing superior to other agents, such as β-blockers and diuretics. The distinct pharmacological features of telmisartan suggest that it may be a suitable agent for managing hypertensive patients because it provides sustained control of blood pressure and appears to be very effective in reversing cardiac remodelling. Pre-clinical evaluation has demonstrated that telmisartan suppresses angiotensin II-induced collagen production and secretion by cultured fibroblasts, and reduces left ventricular weight in different animal models. Several clinical studies have demonstrated that, as well as reducing blood pressure (including 24-h mean ambulatory values), telmisartan brings about LVM regression in patients with hypertension, and improves left ventricular and left atrial function. Comparative studies have shown telmisartan's superiority compared with both hydrochlorothiazide and carvedilol in regressing LVM, the additional activity probably being explained by the sustained blood pressure control and the non-haemodynamic effects of targeting the RAS. The ultimate proof of the clinical value of telmisartan will be provided by the outcome trials ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in aCE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) currently being conducted in high-risk patients.
Angiotensin II Receptor Blocker Telmisartan: Effect on Blood Pressure Profile and Left Ventricular Hypertrophy in Patients with Arterial Hypertension
Authors: Ivanova OV , Fomicheva OA , Sergakova LM , Chernova NA , Rogoza AN , Karpov YA
Published: February 2013

In this open-label, non-comparative study, the anti-hypertensive efficacy and effect on left ventricular hypertrophy (LVH) of 24 weeks' treatment with once-daily telmisartan 40-80 mg was evaluated in 24 patients with mild-to-moderate hypertension and LVH. Patients were titrated to the higher dose of study drug at week 4 if they did not achieve blood pressure normalization (i.e. systolic blood pressure [SBP]/diastolic blood pressure [DBP] remained ≥ 140/90 mmHg). The anti-hypertensive action of telmisartan was assessed using clinic cuff measurements and 24-h ambulatory blood pressure monitoring, and left ventricular mass index (LVMI) was determined by two-dimensional echocardiography at baseline and after 24 weeks of therapy. Telmisartan significantly reduced mean 24-h, daytime and night-time SBP and DBP compared with baseline after 12 and 24 weeks of therapy. Target blood pressure levels, defined as SBP/DBP < 140/90 mm Hg, were achieved in 16 (69.6%) patients at the end of the treatment period. After 24 weeks of telmisartan treatment, LVMI decreased from 151.6 ± 5.4 to 135.1 ± 5.9 g/m2. In conclusion, anti-hypertensive treatment with telmisartan for 24 weeks produced significant reductions in blood pressure and regression of LVH, as assessed by LVMI, in patients with hypertension and LVH.
Safety and Tolerability of a ‘Refrigeration-free’ Formulation of Interferon Beta-1b - Results of a Double-blind, Multicentre, Comparative Study in Patients with Relapsing-Remitting or Secondary Progressive Multiple Sclerosis
Authors: Baum K ,   Mannitol Formulation Study Group
Published: February 2013

The original glucose-based formulation of Betaferon®/Betaseron® (interferon beta-1b) requires refrigerated storage. A refrigeration-free formulation of interferon beta-1b, based on mannitol, is stable at room temperature for up to 2 years, and offers a greater degree of flexibility for patients with multiple sclerosis (MS). We compared the safety and tolerability of the two formulations in a 24-week, randomized, double-blind, parallel group, Phase IV clinical study conducted in 303 patients with MS. Patients received the glucose formulation (IFNβ-1b-G) for 8 weeks, and were then randomized to receive either IFNβ-1b-G or the refrigeration-free formulation (IFNβ-1b-M) for a further 8 weeks. On completion of the double-blind phase, all patients received IFNβ-1b-M for an 8-week follow-up period. The primary outcome measure was the proportion of injection sites that developed reactions per patient during the double-blind period. In addition, a range of secondary outcomes relating to these reactions was also assessed. The difference in the proportion of injection-site reactions between the two groups was not statistically significant (59% IFNβ-1b-G versus 60% IFNβ-1b-M). There were no statistically significant differences observed between the two treatment groups in any of the secondary tolerability endpoints. The results from this study demonstrate that the tolerability and safety profiles of both formulations are extremely good, and that the refrigeration-free formulation of interferon beta-1b is comparable with that of the original glucose formulation.
The Significance of Carotid Artery Plaques in the Detection of Coronary Artery Disease in Asymptomatic Type 2 Diabetic Patients
Authors: Charvat J , Michalova K , Chlumsky J , ková M Horáč , Valenta Z , dárská D Ž
Published: February 2013

This study aimed to evaluate whether there was any association between carotid artery ultrasound parameters and the results of stress myocardial single photon emission computed tomography (SPECT) and coronarography in 126 asymptomatic type 2 diabetic patients. Thirty-three (26%) patients had an abnormal SPECT result, 33 (26%) had an intermediate result and 60 (48%) had a normal result. Carotid ultrasound demonstrated a significant association between an abnormal SPECT result and the presence of atheroma plaques and reduced distensibility of the common carotid artery, but there was no association with intima-media thickness (IMT). In 38 diabetic patients who agreed to be examined with selective coronarography, significant coronary stenosis (at least one stenosis ≥ 70%) was diagnosed in 22 (58%) patients. A significant association was demonstrated between significant coronary stenosis and the presence of atheroma plaques; however, there was no association between stenosis and reduced distensibility of the common carotid artery or IMT.
Electrophysiological Abnormalities in Type 2 Diabetic Patients with Reduced Levels of Insulin-like Growth Factor I
Authors: Godínez-Gómez R , Trujillo-Hernández B , Tene CE , Huerta M , Trujillo X , Vásquez C
Published: February 2013

This cross-sectional study investigated electrophysiological abnormalities in type 2 diabetics with normal and reduced insulinlike growth factor I (IGF-I) levels. Sixty patients and 20 non-diabetic controls were included in the study. The fasting serum glucose was measured and IGF-I levels were determined by radioimmunoassay in all patients. Nerve conduction tests were performed in all the study participants on the ulnar nerve and lower extremities. Compared with the controls, all the patients showed a reduction in the peak amplitude of the motor response, 58% showed a reduction in the motor conduction velocity and 55% showed a reduction in the sensory conduction velocity. There was no statistically significant correlation between the electrophysiological changes and the glucose or IGF-I levels. In conclusion, there does not appear to be a correlation between serum glucose or IGF-I levels and electrophysiological abnormalities in patients with type 2 diabetes mellitus.
Non-verbal Communication Method Based on a Biochemical Marker for People with Severe Motor and Intellectual Disabilities
Authors: Yamaguchi M , Takeda K , Onishi M , Deguchi M , Higashi T
Published: February 2013

This study evaluated a novel non-verbal communication method for people with severe motor and intellectual disabilities (SMID) based on a biochemical marker, salivary amylase. The physical and psychological status of 10 people with SMID was quantitatively evaluated using a hand-held salivary amylase activity monitor. Each patient needed daily gastric and/or bronchial tube exchanges and these medical procedures were thought to cause severe distress and pain. Salivary amylase activity and heart rate were simultaneously measured during 32 medical procedures. The medical procedures resulted in a significant mean increase for individuals of 70% in salivary amylase activity. The increase in salivary amylase activity was more than four-fold that observed for heart rate. The structural equation modelling analysis also demonstrated a significant correlation between pain and salivary amylase activity. Our data indicate that salivary amylase activity might be used as a non-verbal method of assessing pain in people with SMID.
Evaluation of Epoetin Alpha (rHuEPO) and Darbepoetin Alpha (DARB) on Human Burst-colony Formation (BFU-E) in Culture
Authors: Jamal NM , Krzyzanski W , Cheung W , Lau CY , Messner HA
Published: February 2013

The erythropoietic effect of recombinant human erythropoietin, epoetin alpha (rHuEPO), in promoting the growth of erythroid burst-forming units (BFU-E) was compared with darbepoetin alpha (DARB), a rHuEPO analogue obtained by site-directed mutagenesis. Human bone marrow cells derived from healthy donors were cultured with different concentrations of rHuEPO or DARB for 12-21 days and BFU-E were counted using an inverted microscope. The EC50 of rHuEPO was about 10-fold lower than DARB and the size of the colonies was significantly larger in rHuEPO-containing cultures using comparable concentrations. The maximum number of colonies obtained in some rHuEPO-containing cultures was also higher than for DARB. The number of colonies in DARB-containing cultures was increased, in part, by the addition of low concentrations of rHuEPO, but not by DARB, even at high concentrations. We conclude that DARB is not as effective as rHuEPO in supporting the in vitro growth of human BFU-E.
Decreased Immunoreactive Maspin Expression in Intermediate Thickness and Thick Primary Melanoma Lesions
Authors: Vereecken P , Reynaert S , Lalmand M-C , Zouaoui-Boudjeltia K , Heenen M , Heule B Van Den , Petein M
Published: February 2013

Maspin is a member of the serpin family of protease inhibitors. It is a 42 kDa cytoplasmic protein that is reported to have tumour suppressor activity. The loss of maspin gene expression is correlated with increased invasiveness and the risk of metastases in breast cancer. We studied maspin expression in primary melanoma lesions obtained from 76 patients. Immunostaining of 5 μm sections for maspin expression was obtained using the citrate antigen retrieval method. The extent of immunostaining was scored by recording the proportion of immunoreactive cells and the intensity of immunostaining. Our results demonstrated that maspin expression was down-regulated in intermediate thickness and thick melanoma lesions compared with thin lesions. These results suggest that loss of maspin expression might play a role in melanoma progression, invasion and metastatic dissemination. Further studies are needed to clarify the clinicopathological significance of maspin expression in melanoma.
Comparison of Letrozole and Clomiphene Citrate in Women with Polycystic Ovaries Undergoing Ovarian Stimulation
Authors: Atay V , Cam C , Muhcu M , Cam M , Karateke A
Published: February 2013

Letrozole was compared with clomiphene citrate (CC) as a first-line treatment for ovulation induction in women with polycystic ovaries (PCOs). A total of 106 women with primary infertility and a diagnosis of PCOs were randomized to receive either 100 mg CC ( n = 55) or 2.5 mg letrozole ( n = 51) daily for 5 days. Human chorionic gonadotrophin (hCG) at a dose of 10 000 IU was administered when at least one follicle with a mean diameter ≥ 18 mm was observed using transvaginal ultrasound. The number of mature follicles was significantly lower, but endometrial thickness and ovulation and pregnancy rates were significantly higher in the letrozole group than in the CC group. In conclusion, letrozole is associated with a higher pregnancy rate than CC in PCO patients and may have a role as a first-line treatment for anovulatory patients with PCOs.
Post-operative Infection by Pathogenic Micro-organisms in the Oral Cavity of Patients with Prostatic Carcinoma
Authors: Senpuku H , Tada A , Uehara S , Kariyama R , Kumon H
Published: February 2013

The aim of this study was to analyse the change in the oral cavity microflora of 14 patients who had undergone a radical prostatectomy for prostatic carcinoma. The detection of microorganisms in the oral cavity was compared before and after the surgical procedure. Post-operative infection, defined as those patients who had increased Candida species counts and/or pathogenic bacteria only at the postoperative examination, was observed in 10 patients. Six patients showed increased Candida species counts at the post-operative examination compared with the pre-operative examination. In five patients, pathogenic bacterial species were detected at the post-operative examination but not at the pre-operative examination. One patient had detectable pathogenic bacterial species only at the post-operative examination along with increased Candida species counts. Our findings suggest that pre-operative oral hygiene to remove bacterial and Candida species from patients who are scheduled for surgical procedures is important for satisfactory clinical outcomes.
Painful Neuropathy with Trigeminal Nerve Involvement in Type 2 Diabetes
Authors: Takayama S , Osawa M , Takahashi Y , Iwamoto Y
Published: February 2013

After several years of treatment for type 2 diabetes mellitus, a 69-year-old Japanese man developed an acute painful neuropathy, characterized by bilateral causalgia and dysaesthesia in his cheeks and around his eyes, typically 30 min to 3h after meals. As his glycaemic control deteriorated, his haemoglobin (Hb) A1c level gradually increased from 7-8% to 10.3% and his symptoms became more severe. The pain radiated out along the distribution of the ophthalmic and maxillary divisions of the trigeminal nerve. The patient was treated with insulin therapy and his HbA1c level decreased from 10.3% to 6.8% within 7 months. Five months after initiating insulin therapy, his symptoms showed a dramatic improvement. This was a very unusual case of bilateral acute painful neuropathy that involved the ophthalmic and maxillary divisions of the trigeminal nerve, and in which aggravation of the symptoms clearly related to poor glycaemic control.
The Effect of Pre-operative Lornoxicam and Ketoprofen Application on the Morphine Consumption of Post-operative Patient-controlled Analgesia
Authors: Karaman S , Gunusen I , Uyar M , Firat V
Published: February 2013

We compared the efficacy of preoperative intramuscular lornoxicam and ketoprofen for post-operative analgesia in patients undergoing abdominal hysterectomy. This randomized, double-blind, placebo-controlled, parallel-group study investigated 60 patients who received lornoxicam (group L, 8 mg), ketoprofen (group K, 100 mg) or saline (group C) 60 min before standard anaesthesia. All patients received patient-controlled analgesia (intravenous morphine) during the post-operative period. Visual analogue scale (VAS) scores recorded 2, 4, 6 and 12 h after surgery in groups L and K patients were significantly lower than in group C patients, and VAS scores at 2, 4 and 6 h in group L patients were significantly lower than those in group K patients. Morphine consumption in groups L and K was significantly lower than in group C. Pre-emptive administration of lornoxicam and ketoprofen effectively reduced post-operative pain and morphine consumption, and lornoxicam was more effective than ketoprofen in the early post-operative period.
Antioxidant Enzyme Activities and Lipid Peroxidation Levels in Erythrocytes of Patients with Oesophageal and Gastric Cancer
Authors: Dursun H , Bilici M , Uyanik A , Okcu N , Akyüz M
Published: February 2013

In this study, levels of lipid peroxidation and antioxidant enzyme activities were investigated in the erythrocytes of patients with oesophageal and gastric cancers. Erythrocytes were obtained from 17 patients with oesophageal cancer, 37 patients with gastric cancer and 20 healthy controls. Levels of malondialdehyde (MDA), a lipid peroxidation marker, and activities of copper- and zinc-containing superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GPx) were determined using spectrophotometric methods. MDA levels and CuZn-SOD activity were significantly higher and GPx and CAT activities significantly lower in patients with oesophageal and gastric cancer than in controls. There were no statistically significant differences in the parameters measured in relation to disease stage in either patient group. These results indicate significant changes in the antioxidant defence system in patients with oesophageal and gastric cancer. It is postulated that this may lead to enhanced action of oxygen radicals, resulting in lipid peroxidation.
Inhaled Corticosteroid Use and Asthma Hospitalization Rates in Japan
Authors: Odajima Y , Kuwabara H
Published: February 2013

This epidemiological study assessed whether the use of anti-inflammatory drugs, in particular inhaled corticosteroids, affected hospitalization rates for asthma in Japan between 1990 and 2002. Asthma hospitalization rates were calculated from the number of asthma in-patients recorded in governmental surveys. Information concerning use of anti-inflammatory drugs was extracted from the IMS prescription database. Patients were stratified into four age groups: ≤ 4 years, 5-19 years, 20-39 years and 40-64 years. Over the study period, the number of prescriptions for inhaled corticosteroids per year increased dramatically and hospitalizations for asthma decreased in all groups except those ≤ 4 years of age. Increased use of leukotriene receptor antagonists was also noted in all age groups. The use of anti-inflammatory drugs may have contributed to the observed decrease in asthma hospitalizations. Increased use of inhaled corticosteroids in infants and very young children may help prevent hospitalization in this age group.
Longitudinal Long-term Follow-up Study of Children with Vertically Acquired Hepatitis C Virus Infection
Authors: Zuccotti GV , Salvini F , Farina F , Agostoni C , Riva E , Giovannini M
Published: February 2013

Seventeen children with vertically acquired hepatitis C virus (HCV) infection were followed from birth for a mean of 104 months. Alanine aminotransferase (ALT) levels were increased significantly at 3 and 6 months of age but were stable thereafter. HCV polymerase chain reaction was positive at 3 months in 16 patients and at 12 months in one patient. Viral load remained stable during follow-up at a mean value of 5.4 ± 0.4 log10. Mild chronic hepatitis was the most common histopathological feature on liver biopsy, occurring in six of the seven children biopsied at a mean age of 4.0 ± 2.4 years. Genotype did not seem to be related to the type of liver involvement. The results of this study suggest that vertically acquired HCV infection has a benign course in children, despite the presence of viraemia and persistent alterations in ALT levels.
Clinical Correlation between Adenosine Deaminase Activity and Pre-eclampsia Severity
Authors: Kafkasli A , Karabulut AB , Atmaca R , Laurini R
Published: February 2013

This study evaluated the relationship between the activity of the inflammatory indicator adenosine deaminase (ADA) in placental tissue and maternal and fetal (umbilical cord) plasma and the severity of pre-eclampsia. Maternal and umbilical vein whole blood and placental tissue samples were collected from women with normal pregnancies ( n = 33) and patients with mild ( n = 12) or severe ( n = 17) pre-eclampsia. ADA activity was measured spectrophotometrically. Significantly increased ADA activity was detected in maternal and fetal plasma, and placental tissue in patients with mild and severe pre-eclampsia compared with normal pregnancies; there were no significant differences between the mild and severe cases. The presence of increased ADA activity in pre-eclampsia is consistent with activation of the inflammatory system in this condition. The increased ADA activity was related to the presence of the disease but not the severity of clinical symptoms. Neonatal outcome did not significantly correlate with observed ADA activity.
Association of ACE, ACE2 and UTS2 Polymorphisms with Essential Hypertension in Han and Dongxiang Populations from North-western China
Authors: Yi L , Gu YH , Wang XL , An LZ , Xie XD , Shao W , Ma LY , Fang JR , An YD , Wang F , Zhang DL
Published: February 2013

To assess the significance of polymorphisms of the genes for angiotensin-converting enzyme ( ACE), angiotensin-converting enzyme 2 ( ACE2) and urotensin II (UTS2) as risk factors for essential hypertension in two populations from north-western China, we enrolled 198 patients with essential hypertension and 131 healthy controls from the Han population and 120 patients with essential hypertension and 102 healthy controls from the Dongxiang population. Polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism were used to analyse gene polymorphisms. The results provided evidence that genetic variants of UTS2 and ACE2 may play a role in the development of essential hypertension in these populations. Polymorphisms of ACE were not associated with essential hypertension in either population. This is the first report showing that the S89N single-nucleotide polymorphism of the UTS2 gene is associated with essential hypertension.
Heart Rate Variability in Diabetes Patients
Authors: Kudat H , Akkaya V , Sozen AB , Salman S , Demirel S , Ozcan M , Atilgan D , Yilmaz MT , Guven O
Published: February 2013

Diabetes mellitus can cause cardiovascular autonomic neuropathy and is associated with increased cardiovascular deaths. We investigated cardiovascular autonomic neuropathy in diabetics and healthy controls by analysis of heart rate variability. Thirty-one diabetics and 30 age- and sex-matched controls were included. In the time domain we measured the mean R-R interval (NN), the standard deviation of the R-R interval index (SDNN), the standard deviation of the 5-min R - R interval mean (SDANN), the root mean square of successive R - R interval differences (RMSSD) and the percentage of beats with a consecutive R - R interval difference > 50 ms (pNN50). In the frequency domain we measured high-frequency power (HF), low-frequency power (LF) and the LF/HF ratio. Diabetes patients had lower values for time-domain and frequency-domain parameters than controls. Most heart rate variability parameters were lower in diabetes patients with chronic complications than in those without chronic complications.
Training in Swallowing Prevents Aspiration Pneumonia in Stroke Patients with Dysphagia
Authors: Huang JY , Zhang DY , Yao Y , Xia QX , Fan QQ
Published: February 2013

This study investigated the frequency of aspiration pneumonia in conscious stroke patients fed by a family member and examined the effect of introducing training in swallowing techniques by nurses. A total of 96 consecutive patients presenting with dysphagia due to acute stroke were included in the study. Patients presenting between January 2000 and July 2003 ( n = 48) were fed orally by a family member given general nursing information (group A), whereas those presenting between August 2003 and March 2005 ( n = 48) were fed orally by an experienced nurse trained in specific swallowing techniques (group B). All patients were examined daily for the presence of aspiration pneumonia. The incidence of aspiration pneumonia was 33.3% in group A and 6.3% in group B ( P < 0.05). The incidence of aspiration pneumonia in dysphagic stroke patients who are orally fed is still high. Training in swallowing during oral feeding offers clear protection against pneumonia in conscious stroke patients.
Psychosis or Simply a New Manifestation of Neurosyphilis?
Authors: Kararizou E , Mitsonis C , Dimopoulos N , Gkiatas K , Markou I , Kalfakis N
Published: February 2013

The widespread use of antibiotics in recent years has caused a significant reduction in the incidence of neurosyphilis and changes in its clinical features. We present a case that initially presented as persistent headache and untreatable psychosis. Neurosyphilis was diagnosed during the clinical evaluation. Blood serum analyses for syphilis were positive for rapid plasma reagin titres, the Venereal Disease Research Laboratories test and fluorescent treponemal antibody absorption. A lumbar puncture was performed and cerebrospinal fluid analysis resulted in the diagnosis of neurosyphilis. The patient completed a 2-week course of treatment with aqueous crystalline penicillin G and his symptoms subsequently improved. We suggest that neurosyphilis should always be included in the differential diagnosis of untreatable psychosis.
Plasma and Synovial Fluid Concentrations of Nimesulide and its Main Metabolite after a Single or Repeated Oral Administration in Patients with Knee Osteoarthritis
Authors: Bianchi M , Ferrario P , Balzarini P , Broggini M
Published: February 2013

The aim of this study was to evaluate plasma and synovial fluid concentrations of the non-steroidal anti-inflammatory drug nimesulide and its major metabolite (hydroxynimesulide, M1), after a single 100 mg dose of nimesulide and a repeated (14 day) administration, 100 mg twice a day, in patients with osteoarthritis of the knee and joint effusion. Nimesulide was rapidly absorbed in plasma and distributed in synovial fluid. On day 1, effective concentrations were present 30 min after the first dose and on day 14, the synovial fluid concentration of nimesulide was significantly higher than that measured on day 1; no accumulation was observed in plasma. After 14 days of treatment, both the plasma and synovial fluid concentrations of M1 were significantly higher than those measured on day 1. These data may help to explain the rapid onset of the analgesic effect of nimesulide demonstrated in several clinical conditions, including painful osteoarthritis.
Direct Detection of Bordetella pertussis and Bordetella parapertussis: Comparison of Polymerase Chain Reaction and Culture
Authors: De Donno A , Quattrocchi M , Ansaldi F , Campa A , Rollo MC , Gabutti G
Published: February 2013

We evaluated the diagnostic performance of a genomic DNA amplification method for Bordetella pertussis and Bordetella parapertussis compared with culture isolation. Aliquots from B. pertussis and B. parapertussis cultures were added to sterile physiological saline or sterile distilled water to give bacterial suspensions of 108 cells/ml and serial dilutions were prepared. Suspensions in physiological saline were cultured on charcoal agar medium; bacterial growth was observed up to dilutions of 10−7. Suspensions in distilled water were subjected to DNA extraction and nested polymerase chain reaction (PCR) was performed on the extracts; the PCR was positive up to dilutions of 10−8 for B. pertussis and 10−9 for B. parapertussis. Since the efficacy of culture isolation, regarded as the standard for the detection of B. pertussis and B. parapertussis, declines after the first stage of pertussis or with prior vaccination or antibiotic therapy, PCR, although not yet standardized, may provide an alternative diagnostic tool.
Comparison of the Effects of Sevoflurane and Propofol Anaesthesia on Regional Cerebral Glucose Metabolism in Humans using Positron Emission Tomography
Authors: Jeong Y-B , Kim J-S , Jeong S-M , Park J-W , Choi I-C
Published: February 2013

This study compared brain glucose metabolism during sevoflurane anaesthesia and propofol anaesthesia using positron emission tomography (PET) in the same eight human volunteers. All the volunteers were anaesthetized twice, with a 1-week interval. Half of the volunteers received sevoflurane on the first occasion and propofol on the second; the other half received the two anaesthetics in the reverse order. PET scans using 18F-fluorodeoxyglucose were performed after sevoflurane or propofol anaesthesia. The relative glucose metabolic rate (rGMR) in the brain was assessed with statistical parametric mapping. Propofol suppressed the rGMR of the neocortex area more than sevoflurane, and sevoflurane suppressed the rGMR of the paleocortex and telencephalon more than propofol. These findings suggest that these two anaesthetics act via different mechanisms and may provide an important clue to the relationship between anaesthesia and the brain.
Greater Development of 1, 2-Dimethylhydrazine-induced Colon Cancer in a Rat Model of Type 2 Diabetes Mellitus
Authors: Terai K , Sakamoto K , Goto M , Matsuda M , Kasamaki S , Shinmura K , Takita N , Kamano T
Published: February 2013

Several clinical cohort and case-control studies have suggested a link between diabetes and colon cancer. Otsuka Long-Evans Tokushima Fat (OLETF) rats spontaneously develop type 2 diabetes mellitus and Long-Evans Tokushima Otsuka (LETO) rats are non-diabetic. The relationship between type 2 diabetes mellitus and colon cancer was examined in these rats. The carcinogen 1, 2-dimethylhydrazine was administered subcutaneously once weekly for 10 weeks, and the animals were killed and necropsied in week 29. All OLETF rats and 80% of the LETO rats developed cancer. The number of colon cancers per rat was significantly greater in the diabetic than in the non-diabetic rats. Although the tumours tended to be larger in diabetic rats, the difference was not statistically significant. No significant differences were observed in the depth of invasion or histological type of cancer in the two groups. Type 2 diabetes mellitus may enhance the generation and growth of colon cancer.
Analysis of the Relationship between Sex and Chromosomal Aberrations in Colorectal Cancer by Comparative Genomic Hybridization
Authors: Unotoro J , Kamiyama H , Ishido Y , Yaginuma Y , Kasamaki S , Sakamoto K , Oota A , Ishibashi Y , Kamano T
Published: February 2013

Colorectal cancer is thought to be more common in men than in women. The chromosomal locations of DNA gains and losses in surgical specimens of colorectal tumours were detected by comparative genomic hybridization and were compared by gender. Five chromosomal regions, 7p, 8p, 8q, Xp and Xq, contained multiple gains that were significantly more common in males than in females, and within these regions, the differences were significant for Xp21, Xp11.3, Xp11.4 and Xq26. Regions 1p, 3q, 11q, 12p, 12q and 15q contained multiple sites of gain that were significantly more common in females than in males. Tumours from male and female patients showed significantly more losses at 11p and 15q, and at 4q and Xq, respectively. The fact that gains in X-chromosomal regions were detected with a significantly higher frequency in tumours from male patients suggests that the difference between the genders might be explained by X-chromosomal inactivation.
Plasma Oxidants and Antioxidants in Acute Ischaemic Stroke
Authors: Aygul R , Kotan D , Demirbas F , Ulvi H , Deniz O
Published: February 2013

Plasma levels of the oxidants xanthine oxidase, nitric oxide and malondialdehyde and the antioxidants superoxide dismutase, glutathione peroxidase and glutathione reductase, together with total superoxide scavenger activity and non-enzymatic superoxide scavenger activity, were determined in 19 patients with acute ischaemic stroke and 20 controls. Compared with controls, superoxide dismutase, total superoxide scavenger activity, glutathione peroxidase and glutathione reductase activities were significantly lower, and nitric oxide and malondialdehyde levels significantly higher, in acute stroke patients. Xanthine oxidase showed a slight but non-significant increase in stroke patients compared with controls. There was no significant difference in non-enzymatic superoxide scavenger activity between the two groups. There was a positive correlation between glutathione reductase levels and Glasgow Coma Scale scores, and a negative correlation between malondialdehyde levels and non-enzymatic superoxide scavenger activity. These findings suggest that oxidative stress in patients with acute ischaemic stroke may be the result of an imbalance in oxidant/antioxidant homeostasis.
Impaired Blood Rheology in Critically Ill Patients in an Intensive Care Unit
Authors: Muranaka Y , Kunimoto F , Takita J , Sumino H , Nara M , Kuwano H , Murakami M
Published: February 2013

Critically ill patients are at increased risk of thromboembolic complications. Japanese patients admitted to the intensive care unit of Gunma University Hospital were divided into critically ill (high score) and moderately ill (low score) groups according to mean Acute Physiology and Chronic Health Evaluation (APACHE) II score. White blood cell count, potassium, creatinine, immunoglobulin G and blood passage time, measured using the microchannel method, were significantly higher and the platelet aggregation score and platelet count were significantly lower in the high-score group than in the low-score group, but other haemorheological parameters did not differ significantly between the two groups. White blood cell count, potassium, creatinine, APACHE II score and levels of immunoglobulins G, A and M were positively correlated with blood passage time in all patients. Critically ill patients had impaired blood rheology, which could result from increased white blood cell count, potassium, creatinine and immunoglobulins and may be associated with the pathophysiology of the thromboembolic process.
Cardiac Arrest due to a Vagal Reflex Potentiated by Thoracic Epidural Analgesia
Authors: Park JY , Park SJ , Kim JY , Shin HW , Lim HJ , Kim J
Published: February 2013

Reflex bradycardia and cardiac arrest may be the result of a vagal reflex, which can occur during a variety of surgical procedures. We report a patient who developed cardiac arrest as a result of a vagal reflex that was potentiated by thoracic epidural analgesia during general anaesthesia. A 53-year-old man was scheduled for subtotal gastrectomy because of an early gastric adenocarcinoma. After an epidural catheter had been inserted, general anaesthesia was induced. During surgery, an abdominal self-retaining retractor was set up but bradycardia and cardiac arrest developed. The patient returned to a normal sinus rhythm after successful resuscitation. We conclude that bradycardia as a result of a vagal reflex is mediated by potent abdominal wall traction and is potentiated by epidural analgesia. Early diagnosis and proper treatment can allow a full recovery, even in high-risk patients.
Advanced Oesophageal Carcinoma in an 84-year-old Treated with Chemoradiotherapy
Authors: Kusaka K , Itoh T , Kawaura K , Moriya J , Yamakawa J , Takahashi T , Oguchi M , Tonami H , Yamamoto I , Kanda T
Published: February 2013

We present a case of advanced oesophageal cancer with cardiac invasion in an 84-year-old male presenting with dysphagia and general malaise. Histological analysis of an endoscopic biopsy specimen revealed a poorly differentiated squamous cell carcinoma. Computed tomography indicated a thickened oesophageal wall that was compressing the left atrium, suggesting invasion of the heart, and oesophagography revealed a polypoid lesion 9 cm in length. No distant metastases were seen on computed tomography. The patient was given chemotherapy with 10 mg/m2 cisplatin on days 1 and 4 every week for 5 weeks and concurrent radiotherapy at a dose of 2 Gy five times per week (total dose 52 Gy). After 4 weeks, the mass was no longer visible on oesophagography or endoscopic examination. The patient was free of recurrence and metastases for 4.5 years. In conclusion, chemoradiotherapy may be curative in elderly patients with unresectable oesophageal carcinoma.
P-wave Dispersion is Increased in Pregnancy Due to Shortening of Minimum Duration of P: Does This Have Clinical Significance?
Authors: Ozmen N , Cebeci BS , Yiginer O , Muhcu M , Kardesoglu E , Dincturk M
Published: February 2013

Most pregnant women complain of palpitation, and various kinds of arrhythmias can be observed during pregnancy. We investigated P-wave and QT dispersion during pregnancy. Healthy pregnant women ( n = 162) and healthy age-matched, non-pregnant women ( n = 150) were included. We performed electrocardiography and transthoracic echocardiography and determined serum oestradiol levels in both groups, and performed Holter monitoring in the pregnant group only. Resting heart rate, P-wave dispersion, left ventricular diastolic diameter, left atrial diameter and serum oestradiol levels in the pregnant group were significantly higher than in the control group. Minimum P-wave duration was shorter in the control group than in the pregnant group; however, there was no statistically significant difference in maximum P wavelength and corrected QT dispersion between the groups. No atrial fibrillation was detected in the pregnant group during Holter monitoring. Shortening of the minimum P-wave duration leads to increased P-wave dispersion during pregnancy. In contrast to other pathologies with increased P-wave dispersion, paroxysmal atrial fibrillation is absent in pregnant women; this may be a result of the stable maximum P wavelength that is present during pregnancy.
Cardioprotective Effect of Edaravone against Ischaemia–Reperfusion Injury in the Rabbit Heart Before, during and after Reperfusion Treatment
Authors: Fukuda A , Okubo S , Tanabe Y , Hoshiba Y , Shiobara H , Harafuji K , Kobori Y , Fujinawa M , Okubo T , Yamashina A
Published: February 2013

The free radical scavenger edaravone is able to stimulate prostacyclin release and inhibit the lipoxygenase pathway in the arachidonic acid cascade. The effect of edaravone administration on myocardial damage in rabbit hearts subjected to ischaemia–reperfusion was examined at different times relative to reperfusion. All rabbits underwent sustained coronary artery occlusion for 30 min followed by 3 h of reperfusion. Rabbits were divided into the following groups: control; early (3 mg/kg edaravone IV 10 min before reperfusion); immediate (3 mg/kg edaravone IV immediately after the start of reperfusion); and late (3, 6 or 10 mg/kg edaravone IV 5 min after the start of reperfusion). Single bolus administration of edaravone 10 min before reperfusion or immediately upon initiation of reperfusion appears to be associated with reductions in infarction size and the percentage of apoptotic cells, but treatment with edaravone 5 min after initiation of reperfusion does not appear to have this protective effect.
The Effect of Fexofenadine on Pruritus in a Mouse Model (HR-ADf) of Atopic Dermatitis
Authors: Akamatsu H , Makiura M , Yamamoto N , Yagami A , Shimizu Y , Matsunaga K
Published: February 2013

Fexofenadine, a histamine H1-receptor antagonist, is approved for the treatment of pruritus associated with atopic dermatitis. The effects of fexofenadine on scratching behaviour, and plasma levels of histamine and eotaxin were assessed in a new model of atopic dermatitis. Mice fed a diet low in Mg2+ and Zn2+ (special diet S) were compared with mice on a normal diet (N) or diet S plus fexofenadine HCl for weeks 0-10 (S + F0-10), 0-5 (S + F0-5) or 6-10 (S + F6-10) (seven mice per group). Compared with group N, group S mice showed significantly greater scratching frequency, and plasma histamine and eotaxin concentrations; these three variables were significantly lower in group S + F0-10 than in group S. Scratching frequency increased when fexofenadine was discontinued. Fexofenadine significantly reduced mast cell and eosinophil numbers. Histamine may be important in the pathological changes seen in this model of atopic dermatitis, suggesting that it might aid future development of antihistamines for the treatment of atopic dermatitis.
Acarbose, an α-Glucosidase Inhibitor, Decreases Aortic Gene Expression and Serum Levels of Monocyte Chemoattractant Protein-1 in Fructose-fed Rats
Authors: Nakamura K , Yamagishi S , Matsui T , Yoshida T , Imaizumi T , Makino T , Shimizu T , Inoue H
Published: February 2013

Insulin resistance is one of the determinants of post-prandial hyperglycaemia. Recently, acarbose, an α-glucosidase inhibitor that delays the absorption of carbohydrates from the small intestine, has been found to reduce the incidence of cardiovascular disease in patients with impaired glucose tolerance or diabetes. However, the molecular mechanism by which acarbose inhibits cardiovascular events remains unknown. In this study, we examined whether oral administration of acarbose could suppress expression of monocyte chemoattractant protein-1 (MCP-1) in fructose-fed rats, a widely used animal model of insulin resistance. Serum MCP-1 levels were elevated in fructose-fed rats after 4 weeks. Acarbose treatment for 4 weeks reduced the fructose-induced elevation of serum MCP-1 levels. Acarbose treatment for 8 weeks decreased MCP-1 mRNA levels in the aortae of fructose-fed rats. These results suggest that the cardioprotective effects of acarbose could be due, at least in part, to the suppression of MCP-1 expression.
The Effect of Gynaecological Laparoscopic Surgery on Cerebral Oxygenation
Authors: Lee J-R , Lee P-B , Do S-H , Jeon Y-T , Lee J-M , Hwang JY , Han S-H
Published: February 2013

During gynaecological laparoscopic surgery, alterations in cerebral blood flow and intracranial pressure are frequently reported. These changes affect cerebral perfusion pressure and thus may affect cerebral oxygenation. In this prospective study, the effect of gynaecological laparoscopic surgery on cerebral oxygenation was examined by following the changes in regional cerebral oxygen saturation (rSo2). Twenty-four female patients were enrolled. The mean rSo2 was 65.5 ± 5.4% at baseline before surgery, 60.8 ± 5.6% when the patient was placed in the Trendelenburg position, 57.1 ± 9.3% after creation of pneumoperitoneum, and 64.0 ± 7.3% after the completion of surgery. During the period of pneumoperitoneum, rSo2 fell below 50% in two hypercapnic patients. In comparison with baseline, rSo2 declined significantly in the Trendelenburg position. The creation of pneumoperitoneum itself did not decrease the average rSo2 value further unless the patients were hypercapnic.
Radiofrequency Ablation of Intra-articular Osteoid Osteoma of the Hip
Authors: Papagelopoulos PJ , Mavrogenis AF , Kyriakopoulos CK , Benetos IS , Kelekis NL , Andreou J , Soucacos PN
Published: February 2013

Diagnosis and treatment of intra-articular osteoid osteoma is challenging. We present 16 patients with intra-articular osteoid osteomas of the hip treated with percutaneous radiofrequency ablation. Eight osteoid osteomas were located in the femoral head, six in the femoral neck, and two in the acetabulum. Three of the 16 patients had had an incorrect previous diagnosis. Percutaneous radiofrequency ablation was a clinical and technical success in all 16 patients. Within the first 24 h after the procedure, pain improved in all patients. Five patients had pain relief within the first 3 days after the procedure, nine patients within the first week and two patients within 2 weeks. Residual or recurrent symptoms were not reported by the last follow-up. At the 12-month follow-up, computed tomography and magnetic resonance imaging showed complete ossification and bone regeneration at the site of the lesion in three patients, partial ossification in six patients and no changes in seven patients. Computed tomography-guided percutaneous radiofrequency ablation is a simple, minimally invasive, safe and effective method for the treatment of most intra-articular osteoid osteomas.