bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Nocturnal Sleep and the Carryover Effects of Triazolam and Brotizolam Using Neurophysiological and Subjective Methods
Authors: Suzuki Hideaki , Yamadera Hiroshi , Asayama Kentaro , Kudo Yoshihisa , Ito Takao , Tamura Yoshiatsu , Endo Shunkichi
Published: May 2003

In the present study, the effects of short-acting benzodiazepines on nocturnal sleep and the carryover effects of these drugs were studied. The study involved 10 young, healthy male subjects who had given their written informed consent to participate. Either a placebo (PLA), 0.125 mg triazolam (TRZ), 0.25 mg TRZ or 0.25 mg brotizolam (BRZ) was administered to the subjects in a double-blind crossover design by randomized allocation with a single oral administration at 23.00 h. A polysomnography (PSG) was recorded for each subject from 23.00 to 07.00 h the following day. Then, the Stanford Sleepiness Scale (SSS) and Kwansei Gakuin Sleepiness Scale (KSS) were checked between 07.55 and 08.00 h, and the sleep latency test (SLT) was performed between 08.00 and 08.20 h. Event-related potentials (ERPs) were then recorded with an oddball paradigm; the reaction time (RT) was measured simultaneously. According to the PSG, treatment with 0.25 mg TRZ resulted in a statistically significant increase in the percentage of stage 2 sleep (p < 0.05) and a reduction in the percentage of rapid eye movement sleep (p < 0.05) compared with PLA. None of the drugs had any effect on the percentage of slow-wave sleep compared with PLA. With regard to carryover effects, although none of the drugs had any effect on SSS, KSS, RT or ERPs, BRZ did cause a statistically significant decrease in sleep latency (p < 0.05) compared with PLA. TRZ (0.125 and 0.25 mg) and 0.25 mg BRZ exerted different effects on SLT. We suggest that these different effects are attributable to differences in the half-life of these hypnotics.
Frontal Brain Hypoactivity as a Biological Substrate of Anxiety in Patients with Panic Disorders
Authors: Akiyoshi Jotaro , Hieda Keiko , Aoki Yoshinori , Nagayama Haruo
Published: May 2003

Frontal brain asymmetry is associated with differences in the basic dimensions of emotion. It seems to reflect the activation of specialized systems for avoidance-withdrawal behavior. Since patients with panic disorder are characterized by having both negative emotions and avoidance-withdrawal behavior, we expected them to show greater asymmetry in the frontal hemisphere change activation. Near-infrared reflection spectroscopy was recorded from the left and right frontal regions of 23 patients with panic disorder without depression and from 31 healthy control participants in the following conditions: confrontation at rest with neutral (mushroom), anxiety-relevant (spider and snake) or anxiety-irrelevant but emotionally relevant stimuli (erotic picture). Emotional states and traits were assessed by the State-Trait Anxiety Inventory. The left frontal oxyhemoglobin in patients was significantly lower than in control subjects when confronted with anxiety-relevant or anxiety-irrelevant but emotionally relevant stimuli. There was no frontal brain asymmetry when patients or control subjects observed any stimuli. These data suggest that patients with panic disorder are characterized by having a greater decrease in the activation of a left frontal avoidance-withdrawal system in situations with a negative valence. The findings are interpreted as biological evidence for a disturbed cortical processing in patients with panic disorder.
Single Nucleotide Polymorphism Haplotypes in the Cholesteryl-Ester Transfer Protein (CETP) Gene and Lipid Phenotypes
Authors: Bauerfeind Anja , Knoblauch Hans , Schuster Herbert , Luft Friedrich C. , Reich Jens G.
Published: May 2003

We studied the association between high (HDL) and low-density (LDL) cholesterol concentrations and family-derived haplotypes based on six common SNPs in the cholesteryl-ester transfer protein (CETP) gene. We based our analysis on 201 founders from families recruited throughout Germany. The analysis revealed one subhaplotype block with complete, pairwise, linkage disequilibrium between 5 SNPs located in the promoter and intron 1. The sixth SNP was the well known 1405V polymorphism in exon 14, close to the 3′ end of the gene. Four haplotypes accounted for 86% of the entire sample. We found that haplotype associations with HDL, LDL, and the LDL/HDL ratio were more robust than associations with individual SNPs. Moreover, the associations were robust for men, but not for women. Our data suggest an interaction between gender and genetic variation within the CETP gene.
Langage oral et écrit chez des enfants prématurés: résultats à 7½ ans
Authors: Crunelle Dominique , Le Normand Marie-Thérèse , Delfosse Marie-José
Published: May 2003

La prématurité induit des facteurs de risques de retard cognitif, particulièrement de retard dans le langage oral et écrit. Ces facteurs de risques peuvent être liés aux variables physiologiques et/ou environnementales. Cette étude a deux objectifs: (1) repérer quels sont les enfants prématurés les plus à risque de retard cognitif et de langage oral et écrit et (2) estimer l’intérêt d’un bilan précoce de langage oral proposé dès 3½ ans à ces enfants en mesurant sa prédictivité sur l’apprentissage de la lecture. Une cohorte de 50 enfants (23 garçons et 27 filles) nés prématurément ont été suivis de 2 ans à 7½ ans. Les résultats montrent que: a) 28% des enfants présentent un retard de production du langage à 3½ ans; b) 34% des enfants présentent un retard de la lecture à 7½ ans; c) la production du langage oral à 3½ ans est prédictif des capacités de lecture à 7½ et d) les enfants nés prématurément les plus à risques sont ceux qui évoluent dans un milieu défavorisé.
Inflammation versus Immunoregulation: What Is the Key to the Development of an Effective Antiallergy Vaccine?
Authors: Wohlleben G. , Erb K.J.
Published: May 2003

The incidence and severity of allergic disorders is currently increasing worldwide. The reason for this development is unclear. However, epidemiological studies and experimental data suggest that this increase may be due to a decline in infectious diseases which induce T helper type 1 (Th1) and/or T regulatory (Tr) responses. Based on these observations, antiallergy vaccines are currently being tested in animal studies aimed at inducing Th1 or Tr responses. This review focuses on novel approaches potentially leading to a vaccine protecting humans from the development of allergic disorders.
Transcription Factors: New Targets for Antiallergic Therapy
Authors: Quarcoo D. , Hamelmann E.
Published: May 2003

Due to their pivotal role in the fast transmission of signals from cell surface receptors to the nucleus, resulting in gene expression, transcriptional factors play an important part in the physiology of cells. Recently, a number of transcription factors have been identified that are involved in the pathogenesis of allergic diseases. In order to attenuate the development of allergen-mediated diseases, new strategies have been developed to influence these transcription factors in vivo. Among these, the use of oligodeoxynucleotide decoy has emerged as a new tool with promising results for therapeutical and experimental purposes.
Development of Synthetic Pan-Selectin Antagonists: A New Treatment Strategy for Chronic Inflammation in Asthma
Authors: Aydt E. , Wolff G.
Published: May 2003

Asthma is characterized by chronic inflammation of large and small airways maintained by extravasation of leukocytes from the bloodstream into the surrounding peribronchial tissue. The process of extravasation is of crucial importance in inflammation and is mediated by a sequenced and concerted action between different adhesion molecules on endothelial cells and ligands on leukocytes. In this context, initial rolling and tethering is generally considered to be the primary event which is mediated by selectins, a family of glycoproteins comprised of E-, P- and L-selectin. Their role in asthma has been demonstrated in a variety of animal models, showing that all three selectins are involved in the chronic inflammation in asthma. Therefore, selectins are an attractive target where pan-selectin antagonism is the desired treatment strategy. Here, we give an overview of the status of the preclinical and clinical development of bimosiamose, the most advanced synthetic pan-selectin antagonist as a treatment for asthma.
Point Surveillance of Staphylococcus aureus Carriage among Medical Staff in Infectious Diseases Hospital, Kuwait
Authors: Dimitrov Tz. , Udo E.E. , Grover S.
Published: May 2003

Objective: To investigate the carriage of Staphylococcus aureus among doctors and nurses in Infectious Diseases Hospital, Kuwait, following the detection of 3 cases of methicillin-resistant S. aureus (MRSA). Materials and Methods: A total of 260 nasal and throat swabs were obtained from 19 doctors and 111 nurses and cultured for the carriage of S. aureus. Forty-three S. aureus were identified based on their growth characteristics on mannitol-salt agar, catalase and tube coagulase and DNA hydrolysis. The isolates were tested for susceptibility to antibacterial agents and typed by phage typing; plasmid analysis and pulsed-field electrophoresis were carried out to determine their relatedness. Results: Of the 19 doctors, 4 (21%) had nasal carriage while only 1 of them had a throat carriage. Sixteen (14.4%) nurses carried S. aureus in their noses and 20 (18%) in their throats. The combined nasal carriage rate for both doctors and nurses was 15.8%, and combined throat carriage was 16.6%. None of them carried MRSA. The isolates were resistant to penicillin G (90%), tetracycline (23.3%), erythromycin (9.3%) and cadmium (100%). Typing of the isolates showed a variety of phage types, plasmid and pulsed-field gel electrophoresis patterns. Discussion: None of the doctors or nurses carried MRSA. Typing of the methicillin-susceptible strains that they carried demonstrated that the S. aureus were different, indicating an absence of a dominant clone capable of spreading. It is important to maintain a low carriage of S. aureus among health-care workers.
Sectorial Technetium-99m-Dimercaptosuccinic Acid Scintigraphy for Monitoring the Effect of Extracorporeal Piezoelectric Lithotripsy for Calyceal Calculi on Regional Renal Function
Authors: Al-Tawheed A. , Al-Awadi K.A. , Kehinde E.O. , Loutfi I. , Abdul-Haleem H. , Al-Mohannadi S.
Published: May 2003

Objective: To apply a semiquantitative method for analysis of technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy for monitoring the effect of extracorporeal piezoelectric lithotripsy (EPL) in patients with calyceal stones on regional kidney function and to check whether EPL had caused any deleterious effect on the target calyceal renal parenchymal function. Patients and Methods: Forty patients (mean age 35 years) suffering from calyceal stones documented by abdominal plain radiography, intravenous urogram or abdominal ultrasound were studied. All patients were treated by EPL. 99mTc-DMSA scan was performed before and 4 weeks after EPL. Sector analysis involved calculation of the relative function of the target calyx to the function of the ipsilateral kidney and the relative function of the treated kidney to global renal function. Results: The stone sizes were 6–11 mm in diameter and 11 were located in the upper, 13 in the middle and 16 in the lower calyx. After EPL, the overall stone clearance rate was 85% (100% for calculi in the upper and middle calyces, 62% for lower calyces). The sector analysis did not show statistically significant change of the relative regional (calyceal) or whole kidney function between the pre- and post-EPL 99mTc-DMSA scans. Using sector analysis, EPL appeared to be a safe modality and its usage was not associated with any untoward effect on calyceal or whole kidney function. Conclusion: Sector analysis of 99mTc-DMSA renal scan is a simple semiquantitative method for monitoring regional changes of kidney function after EPL for treatment of calyceal stone.
The Protein Polymorphism of Haptoglobin in Korean Elite Athletes
Authors: Kang Byung Yong , Kang Chin Yang , Oh Sang Duk , Bae Joon Seol , Kim Ki Tae , Lee Kang Oh
Published: May 2003

Objective: To investigate protein polymorphism of the haptoglobin (Hp) and the relationship between Hp phenotypes and anthropometric or biochemical parameters in elite Korean male athletes. Materials and Methods: Serum samples were collected from 120 Korean male elite athletes. The Hp phenotypes were determined by polyacrylamide gel electrophoresis, followed by peroxidase staining. Then anthropometric or biochemical measurements were made: body composition, blood pressures, ventilatory responses, cholesterol (total, LDL cholesterol and HDL cholesterol), triglyceride, apolipoprotein A1, lipoprotein (a), creatine phosphokinase and lactate dehydrogenase. Results: The gene frequencies of the Hp1-1, Hp2-1 and Hp2-2 phenotypes in Korean male athletes were 12, 37 and 51%, respectively; this polymorphism was significantly associated with the VO2max index in the athletes. An excess of the Hp1 allele was also observed in marathon runners compared with the other sporting activities, although it did not have any statistical significance. Conclusion: Hp polymorphism exists in elite Korean male athletes and Hp phenotype may be a useful marker for endurance performance in these male athletes.
Modified Giemsa Staining for Rapid Diagnosis of Malaria Infection
Authors: Iqbal J. , Hira P.R. , Al-Ali F. , Khalid N. , Sher A.
Published: May 2003

Objectives: To develop and evaluate a rapid method for the diagnosis of malaria infection by microscopy of stained blood films. Subjects and Methods: Blood specimens were collected from randomly selected confirmed malaria cases (n = 75) and suspected malaria cases (n = 175). The microscopy was done on each set of blood films stained by modified and the standard Giemsa staining methods. Results: All the 75 previously diagnosed malaria cases were confirmed by the microscopy of blood films stained by both methods. Forty-nine (28%) of the 175 cases suspected for malaria infection showed malarial parasites on microscopy of blood films stained by both methods. However, due to homogeneous staining and clearer background of the blood films it was possible to determine the parasite species in 65% of the cases on microscopy of the thick films stained with the modified method compared to only 20% with the standard method. Further, the turnaround time for reporting the microscopy test result was 15–20 and 45–50 min with modified and standard staining methods, respectively. Conclusion: Our data showed that performance of the modified staining method in detecting malarial parasites was comparable to that of the standard staining method. Moreover, the modified staining method was rapid, easy to use, and reliable.
Comparison of Lactose Intolerance in Healthy Kuwaiti and Asian Volunteers
Authors: Al Sanae Hala , Saldanha Winston , Sugathan T.N. , Majid Molla Abdul
Published: May 2003

Objective: To study and compare the incidence of lactose intolerance among Kuwaiti and Asian healthy volunteers as measured by breath hydrogen level following challenge with lactose drink. Subjects and Methods: The study involved 70 Kuwaiti and 79 Asian healthy volunteers. The volunteers were physicians, medical students and other hospital workers. The study was carried out prospectively at Amiri Hospital, Kuwait. None of the volunteers was sick or had taken antibiotics or any other drug that could influence breath hydrogen level 2 weeks prior to the study. After an overnight fast 20-ml baseline samples of exhaled air were collected from each volunteer prior to oral administration of 40 g of lactose drink. Following this, the same amount of exhaled air was collected at 30-min intervals for 2 h. All samples were analyzed for hydrogen level using a Quintron microlyzer. Hydrogen level of 20 ppm more than baseline value was considered positive. Results: The basal breath hydrogen levels were 12.49 ± 8.4 and 6.97 ± 6.9 for Kuwaitis and Asians, respectively. Thirty-three (47%) of the 70 Kuwaitis and 46 (58%) of the 79 Asians were positive for the breath hydrogen test. The clinical symptoms of flatulence, abdominal pain, and diarrhea were associated with high levels of breath hydrogen. Conclusion: The findings indicate that the Kuwaiti volunteers had higher breath hydrogen levels than Asians, but the incidence of lactose intolerance was similar in both groups.
Retinoids and Cancer: Antitumoral Effects of ATRA, 9-cis RA and the New Retinoid IIF on the HL-60 Leukemic Cell Line
Authors: Orlandi M. , Mantovani B. , Ammar K. , Avitabile E. , Dal Monte P. , Bartolini G.
Published: May 2003

Objective: To compare the antitumoral effects of all-trans retinoic acid (ATRA) and 9-cis retinoic acid (9-cis RA) with those of 5-OH,11-O-hydrophenanthrene (IIF), a new derivative of retinoic acid. Materials and Methods: The effect of retinoids was tested on cell line HL-60. Cell differentiation and apoptosis were evaluated by morphological and biochemical analysis as bcl-2 protein and by DNA fragmentation assay. The ability to activate retinoic acid receptors (RAR) and/or retinoid X receptors (RXR) and to modulate gene expression was determined by transactivation assay. Results: With cell line HL-60, the antiproliferative effect of IIF was stronger than that of ATRA and 9-cis RA. Following retinoid treatment, cells appeared to differentiate and apoptotic cells were observed. The appearance of DNA laddering and a decrease in the amount of bcl-2 protein confirmed apoptosis. IIF transcriptionally activated RXR-γ more than RAR-α. Conclusion: The findings indicate that IIF transcriptionally activates RXR-γ preferentially, induces apoptosis and has a more antiproliferative activity than ATRA and 9-cis RA on cell line HL-60.
A Study of Serological Markers of Hepatitis B and C Viruses in Istanbul, Turkey
Authors: Erden S. , Büyüköztürk S. , Çalangu S. , Yilmaz G. , Palanduz S. , Badur S.
Published: May 2003

Objective: This study was undertaken to investigate the prevalence of HBsAg, anti-HBs and anti-HCV positivity in Istanbul, Turkey. Subjects and Methods: The frequencies of HBsAg, anti-HBs and anti-HCV positivity were determined in 1,157 randomly selected patients attending the outpatient clinic of Istanbul University Hospital, Istanbul, Turkey, during the years 1998 and 2001. All patients underwent complete physical and various routine laboratory examinations. Results: Of the 1,157 patients, the prevalence of HBsAg, anti-HBs and anti-HCV was 6.6, 28.1 and 2.4%, respectively. It appeared that having dental and surgical procedures formed the risk factors for HBV infection. HBsAg positivity in the health care workers was not different from that of the other professions, but anti-HBs was significantly higher in this group. Conclusions: Our findings indicate that HBV infection occurs more frequently than HCV in Istanbul, and this poses an important health problem in the community.
Anticonvulsant Hypersensitivity Syndrome: Report of 2 Cases from Kuwait
Authors: Bin-Nakhi Hanan A. , Sadeq Sameera , Pinto Raimond G. , Habeeb Yousef
Published: May 2003

Objective: To illustrate the clinical features, laboratory findings, and management of anticonvulsant hypersensitivity syndrome (AHS), emphasizing the importance of recognizing its multiple clinical components and raising awareness of the cross-sensitivity among different anticonvulsants. Clinical Presentation and Intervention: Two cases of AHS due to carbamazepine and a combination of sodium valproateand lamotrigene are reported. Both patients presented within the first month of starting the new antiepileptic medication with fever, skin rashes, hematological abnormalities, and hepatitis. The offending antiepileptic drugs were immediately stopped in both cases. Skin rashes responded to intravenous immunoglobulin in case 1 and to intravenous hydrocortisone in case 2. Conclusion: AHS is a serious, life-threatening condition. This report demonstrates that the most important steps in the management of AHS are to recognize the disorder, discontinue the offending antiepileptic drug, and provide supportive care in an inpatient setting and treat with benzodiazepines if seizures occur.
Six-Year Success Rates of Occlusal Amalgam and Glass-Ionomer Restorations Placed Using Three Minimal Intervention Approaches
Authors: Mandari G.J. , Mandari G.J. , Frencken J.E. , Frencken J.E. , van’t Hof M.A. , van’t Hof M.A.
Published: May 2003

The present randomised clinical trial was aimed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material. The treatment approaches tested in parallel groups were: conventional in a university setting, modified-conventional and ultraconservative (Atraumatic Restorative Treatment, ART) approaches in a field setting. A split-mouth design was used in which the two restorative materials were randomly placed in 430 matched contralateral pairs of permanent molar teeth. A total of 152 children from five primary schools were recruited and treated by a dental therapist. The restorations were evaluated after 6 years by 2 calibrated independent examiners. The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3%, respectively. There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART (68.6%, with 95% CI = 61–76%) approach or by the conventional (74.5%, with 95% CI = 65–82%) and the modified-conventional (75.8%, with 95% CI = 67–83%) approaches after 6 years. There was also no statistically significant difference observed between the successes of occlusal ART restorations with glass-ionomer (67.1%, with 95% CI = 56–77%) and occlusal conventional restorations with amalgam (74%, with 95% CI = 61–85%) after 6 years. ‘Restoration fracture/marginal defects’ and ‘loss of material’ were the most common causes for failure. The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations. Secondary caries was observed for 2% of glass-ionomer and for 10% of amalgam restorations. This difference was statistically significant (p = 0.001). The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years.
Inflammation in Uremic Patients: What Is the Link?
Authors: Galle Jan , Seibold Stefan , Wanner Christoph
Published: May 2003

Uremic patients suffer to an extremely high degree from cardiovascular disease. Cardiovascular disease results mainly from atherosclerotic remodeling of the arterial system. Inflammation is considered to contribute significantly to development of atherosclerosis, and albeit many different factors may lead to inflammation, generation of enhanced oxidative stress is believed to be an important common feature of pro-inflammatory causes. Studies in the general population without renal disease could clearly show that markers of inflammation, in particular C-reactive protein, predict the cardiovascular risk. In this review article, we discuss the presence and the predictive value of inflammation in patients with end-stage renal disease, and analyze whether uremic patients are exposed to specific pro-inflammatory and pro-oxidative conditions. Particular emphasis is set on oxidative stress induced by oxidatively modified lipoproteins and angiotensin II. Based on pathophysiological considerations valid for uremic patients, we discuss therapeutical options that might help to reduce cardiovascular disease in uremic patients.
Treatment Options to Intensify Hemodialysis
Authors: Haag-Weber M.
Published: May 2003

At present, three methods are practiced to intensify hemodialysis (HD): 3 times weekly, 8-hour HD, short daily HD and slow daily nocturnal HD. Three times weekly 8-hour dialysis increase both the dialysis dose and time. The longest experiences are in Tassin. Five-year survival in Tassin was better in all age groups compared with the major registries – Japan, EDTA and US Medicare and more obvious for older age groups. The data of Tassin show that increasing the dialysis time provides better blood pressure control, need for no or less antihypertensive drugs, less intradialytic complications, better middle molecule and phosphate clearance, better nutritional status, less requirement for erythropoietin and increased survival. These data of Tassin could be mainly confirmed in our dialysis center. The main difference to Tassin was that in our center most of the patients still need few antihypertensive drugs. The reasons for the difference are that in Tassin the patients are on very low sodium diet (<5 g/day) and in Tassin extracellular volume (ECV) is reduced as far as possible independent of residual renal function. The concept of our center was to preserve residual renal function and accept slightly higher ECV and few antihypertensive drugs. Another concept to intensify HD is short daily HD (6 times/week for 90–180 min). This form of dialysis is offered as in-center and home HD with and without dialysis partner. All studies demonstrated significant improvement of nutritional status, quality of life, control of blood pressure, phosphate and anemia. Survival of AV fistula even with daily double punctures was excellent. The most extensive form of dialysis is slow daily nocturnal dialysis (6 times/week for 8–10 h). This form of dialysis provides excellent urea, phosphate clearance and fourfold increase of β2-microglobulin clearance. Patients discontinue phosphate binders and several patients need phosphate addition to dialysis. Blood pressure control is excellent, all patients are off antihypertensive drugs. Improvement of nutrition, anemia, blood pressure and quality of life is even more pronounced compared to short daily HD or 3 times weekly 8-hour HD. Nocturnal dialysis was able to improve sleep apnea. Nocturnal dialysis is offered only as home HD with and without dialysis partner. Any patient who could be trained for home HD was eligible. Presence of co-morbidities was not a contraindication.
Vitamin C in Chronic Kidney Disease and Hemodialysis Patients
Authors: Deicher Robert , Hörl Walter H.
Published: May 2003

Increments of oxidative stress have been addressed as one potential cause for the accelerated atherosclerosis of chronic kidney disease patients. Ascorbate represents one of the most prominent antioxidants both in plasma as well as intracellulary, exerting beneficial effects by an inhibition of lipid peroxidation and by reducing endothelial dysfunction. However, in the presence of transition metals like iron, ascorbate may give rise to an increased generation of oxidants, and ascorbylation may impose additional carbonyl stress to uremic patients. Unsupplemented dialysis patients have reportedly lower plasma levels of ascorbate in comparison to healthy controls, mostly due to a loss into the dialysate or, in case of not dialyzed patients, increased urinary losses. Currently, 60 mg of ascorbate are recommended for chronic kidney disease patients, and 1–1.5 g of oral ascorbate/week in case of suspected subclinical ascorbate deficiency or 300 mg parenteral ascorbate/dialysis session, respectively. Ascorbate’s role in modifying arterial blood pressure remains unclear, but anemic patients with functional iron deficiency might benefit from short-term, moderately dosed ascorbate supplements.
Effluent CA 125 Concentration in Chronic Peritoneal Dialysis Patients: Influence of PD Duration, Peritoneal Transport and PD Regimen
Authors: Fusshöller Andreas , Grabensee Bernd , Plum Jörg
Published: May 2003

In terms of the integrity of the peritoneal membrane in peritoneal dialysis (PD), the peritoneal mesothelial cells play a pivotal role since its monolayer constitutes the first line of the peritoneal membrane. Cancer antigen 125 (CA 125) is released by peritoneal mesothelial cells and correlates with the mesothelial cell mass in PD. Since its effluent concentration is easy to determine in chronic PD patients, CA 125 serves as an in vivo marker of biocompatibility. We performed a cross-sectional study to investigate the relation between PD duration, peritoneal transport and the PD regimen (CAPD/CCPD) on effluent CA 125 concentration in 22 chronic PD patients. We compared long-term (>6 months) with short-term PD treatment, patients with high small solute transport properties (MTAC >11 ml/min, d/p ratio of creatinine >0.72) to patients with low small solute transport and CAPD with APD patients. A peritoneal equilibration test was performed with 1.36% glucose. Dialysate/plasma (D/P) ratio and mass transfer area coefficient (MTAC) of creatinine were calculated and the 4-hour effluent concentration of CA 125 was determined. CA 125 tended to be lower in the long-term PD patients and also in APD patients, but statistical significance was missing. Effluent CA 125 was significantly increased in patients with an MTAC of creatinine >11 ml/min (40.2 ± 11.2 vs. 20.7 ± 1.2 U/ml) and in patients with a d/p ratio of creatinine >0.72 (48.2 ± 11.0 vs. 21.6 ± 1.6 U/ml). CA 125 and the d/p ratio of creatinine were positively correlated (r = 0.68). The positive correlation of CA 125 with peritoneal small solute transport especially in the early phase of PD treatment indicates an initial correlation of the mesothelial cell mass with the peritoneal surface area. A direct relation between the CA 125 concentration and peritoneal transport is unlikely. In our study the CA 125 effluent concentration tended to be lower in long-term PD patients and also in APD patients, possibly indicating a cell depletory influence of the conventional PD fluid.
Continuous Renal Replacement Therapy in Acute Renal Failure
Authors: Riegel Werner
Published: May 2003

The management of acute renal failure in the critically ill patient is extremely variable and there are no published standards for the provision of renal replacement therapy in this population. Continuous renal replacement therapy seems to be the treatment of choice because of its superior metabolic and hemodynamic control. There is better organ protection by continuous treatment but no evidence for better survival or renal recovery due to continuous treatment. The debate about optimal membrane as well as about optimal dialysis dose is ongoing. An effluent flow rate of at least 35 ml/kg/h as well as lower BUN level at treatment initiation seem to be necessary to provide better survival rate. Peritoneal dialysis is a less suitable option in continuous renal replacement of the adult intensive care patient but hybrid methods such as extended daily dialysis and sustained low efficient daily dialysis need consideration with respect to continuous hemofiltration/dialysis.
How to Calculate Clearance of Highly Protein-Bound Drugs during Continuous Venovenous Hemofiltration Demonstrated with Flucloxacillin
Authors: Meyer Brigitte , Ahmed el Gendy Salwa , Delle Karth Georg , Locker Gottfried J. , Heinz Gottfried , Jaeger Walter , Thalhammer Florian
Published: May 2003

Background: Flucloxacillin is an important antimicrobial drug in the treatment of infections with Staphylococcus aureus and therefore is often used in staphylococcal infections. Furthermore, flucloxacillin has a high protein binding rate as for example ceftriaxone or teicoplanin – drugs which have formerly been characterized as not being dialyzable. Methods: The pharmacokinetic parameters of 4.0 g flucloxacillin every 8 h were examined in 10 intensive care patients during continuous venovenous hemofiltration (CVVH) using a polyamide capillary hemofilter. In addition, the difficulty of calculating the hemofiltration clearance of a highly protein-bound drug is described. Results: Flucloxacillin serum levels were significantly lowered (56.9 ± 24.0%) even though only 15% of the drug was detected in the ultrafiltrate. Elimination half-life, total body clearance and sieving coefficient were 4.9 ± 0.7 h, 117.2 ± 79.1 ml/min and 0.21 ± 0.09, respectively. These discrepancies can be explained by the high protein binding of flucloxacillin, the adsorbing property of polyamide and the equation in order to calculate hemofiltration clearance. The unbound fraction of a 4.0 g flucloxacillin dosage facilitates time above the minimum inhibitory concentration (T > MIC) of 60% only for strains up to a minimum inhibitory concentration (MIC) of 0.5 mg/l. Conclusion: Based on the data of this study, we conclude that intensive care patients with staphylococcal infections on CVVH should be treated with 4.0 g flucloxacillin every 8 h which was safe and well tolerated. Moreover, further studies with highly protein-bound drugs are recommended to check the classical ‘hemodialysis’ equation as the standard equation in calculating the CVVH clearance of highly protein-bound drugs.
Perspectives of Evidence-Based Surgery
Authors: Wente Moritz N. , Seiler Christoph M. , Uhl Waldemar , Büchler Markus W.
Published: May 2003

The assessment of the optimal treatment option based on best current knowledge is called evidence-based medicine (EBM). Considering the cost explosion in public health systems, EBM should also incorporate proper utilization of the restricted economical resources and should enforce quality assurance in medicine. It is imperative that surgeons realize that randomized controlled trials are applicable to the operative specialties in a large scale, and are necessary to provide evidence-based surgery. So far, only 3.4% of all publications in the leading surgical journals are randomized controlled trials. Furthermore, only 44.1% of the published surgical randomized controlled studies compared different surgical procedures, whereas 55.9% of the articles compared medical therapies in surgical patients. Evidence-based surgical therapy is essential for further development of a high- quality surgical standard, which will also provide quality assurance in future surgical care. This article presents the definition of EBM and discusses specific problems involved in the introduction of its principles into the surgical discipline.
An Unusual Case of Bilateral Ureteric Obstruction after Anterior Colporrhaphy and Vaginal Hysterectomy for Pelvic Organ Prolapse
Authors: Pang M.W. , Wong W.S. , Yip S.K. , Law L.W.
Published: May 2003

We report a case of bilateral ureteric obstruction after anterior colporrhaphy. The excessive folding of the bladder trigone after anterior colporrhaphy led to occlusion of both ureteric orifices.
Role of activin A in murine mast cells: modulation of cell growth, differentiation, and migration
Authors: Funaba Masayuki , Ikeda Teruo , Ogawa Kenji , Murakami Masaru , Abe Matanobu
Published: May 2003

Activins, members of the transforming growth factor-β (TGF-β) superfamily, are potent growth and differentiation factors. Our previous studies revealed that activin A, a homodimer of inhibin/activin βA, was induced in mast cells and peritoneal macrophages in response to their activation. In the present study, we examined the roles of activin A in murine bone marrow-derived, cultured mast cell progenitors (BMCMCs), which expressed gene transcripts for molecules involved in activin signaling, suggesting that BMCMCs could be target cells of activin A. Treatment of activin A inhibited 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide uptake into BMCMCs in a dose-dependent manner. The IC50 concentration was 2.1 nM, which was less potent than 185 pM TGF-β1. Activin A treatment caused morphological changes toward the differentiated cells at 2 nM and up-regulated mRNA of mouse mast cell protease-1 (mMCP-1), a marker enzyme of mature mucosal mast cells, at 1 nM. Activin A also showed activity in inducing migration of BMCMCs; the optimal concentration for maximal migration was 10 pM, which was much lower than the concentrations to inhibit cell growth and to activate the mMCP-1 gene. Taking the present results together with our previous results, it is suggested that activin A secreted from activated immune cells recruits mast cell progenitors to sites of inflammation and that with increasing activin A concentration, the progenitors differentiate into mature mast cells. Thus, activin A may positively regulate the functions of mast cells as effector cells of the immune system.
5-Lipoxygenase knockout mice exhibit a resistance to pleurisy and lung injury caused by carrageenan
Authors: Cuzzocrea Salvatore , Rossi Antonietta , Serraino Ivana , Mazzon Emanuela , Di Paola Rosanna , Dugo Laura , Genovese Tiziana , Calabrò Barbara , Caputi Achille P , Sautebin Lidia
Published: May 2003

In the present study, by comparing the responses in wild-type (WT) mice and mice lacking [knockout (KO)] the 5-lipoxygenase (5-LO), we investigated the role played by 5-LO in the development of acute inflammation. When compared with carragenan-treated 5-LOWT mice, 5-LOKO mice, which had received carrageenan, exhibited a reduced degree of pleural exudation, polymorphonuclear cell migration. Lung myeloperoxidase activity, an index of neutrophil infiltration, was significantly reduced in 5-LOKO mice in comparison with 5-LOWT. Lung-tissue sections from carrageenan-treated 5-LOWT mice showed positive staining for intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), P-selectin, and E-selectin, which were mainly localized around vessels. The intensity and degree of ICAM-1, VCAM-1, P-selectin, and E-selectin were markedly reduced in tissue section from carrageenan-5-LOKO mice, which also improved the histological status of the inflamed lungs. Taken together, our results clearly demonstrate that 5-LO modulates neutrophil infiltration in the acute lung inflammation.
Methods of predicting urban domestic energy demand with reduced datasets: a review and a new GIS-based approach
Authors: Rylatt R M , Gadsden S J , Lomas K J
Published: May 2003

This paper reviews existing bottom-up approaches to the urban scale prediction of domestic energy demand and introduces a new approach based on Geographical Information Systems (GIS). It describes how software tools can be used to derive predictors from the plan form of dwellings extracted from digital maps and, using a new default-data system, to satisfy the large data requirements of an embedded version of the BREDEM-8 domestic energy model. Energy consumption and CO2emissions of urban dwellings can be predicted quickly and robustly without costly on-site measurements or statistically derived geometrical models. Urban areas of almost arbitrary size can be modelled and accuracy can be incrementally improved with additional data. The model is validated by comparison with results produced by the UK's National Home Energy Rating scheme software using complete site-surveyed datasets. Its ability to rapidly estimate energy demand is demonstrated for around 400 dwellings in Leicester, UK using only the dwelling age, the default data system and the GIS tools.
Synthesis, Structure and Catalytic Activity of a Seven-Coordinate Titanium(IV) Tris(pyridine-2-thiolate) Complex
Authors: Nakayama Yuushou , Miyamoto Kaoru , Ueyama Norikazu , Nakamura Akira
Published: June 2003

Reaction of TiCl4 with three equivalents of Me3SiSPy (SPy = pyridine-2-thiolate) cleanly gave a tris(thiolate) complex, TiCl(SPy)3·THF (1). The pentagonal bipyramidal geometry of 1 was revealed by X-ray crystallography. This complex showed catalytic activity for the polymerization of ethylene and styrene upon activation with methylaluminoxane.
One-Pot Formation of a Cyclobutane from the Double Photocycloaddition Reactions of 1,4-Diethynylbenzene to Some o-Quinones
Authors: Kim Sung Sik , Kim Ae Rhan , Mah Yoon Jung , Shim Sang Chul
Published: June 2003

A cyclobutane was produced in one pot, when irradiated 1,4-diethynylbenzene and some o-quinones, such as tetrahalo-1,2-benzoquinones, phenanthrenequinone and acenaphthenequinone, in dichloromethane with 300 nm UV light.
Easy Access to [60]Fulleroalkaloids via Photoinduced Reactions of Tertiary Amines with [60]Fullerene
Authors: Guo Li-Wei , Gao Xiang , Zhang Dan-Wei , Wu Shi-Hui , Wu Hou-Ming , Li Yong-Jiang
Published: June 2003

Photoinduced reactions of tertiary amines with [60]fullerene (C60) were successfully applied to the synthesis of [60]fulleroalkaloids. This method is easy and effective for constructing C60 derivatives containing natural alkaloids for the purpose of checking the influence of the carbon cage on the biological activities of the alkaloids. In this letter, the preparation and characterization of [60]fulleroscandine is reported.
Two-Dimensional Honeycomb Network Formed by Porphyrinatomanganese(III) and μ4-σ-Dimerized 7,7,8,8-Tetracyano-p-quinodimethane Dianion
Authors: Mikami Shinji , Sugiura Ken-ichi , Miller Joel S , Sakata Yoshiteru
Published: June 2003

An unprecedented layered (2-D) honeycomb supramolecular structure comprised of μ4-σ-dimerized 7,7,8,8-tetracyano-p-quinodimethane dianion bridging four S = 2 substituted Mn(III)porphyrins as demonstrated with meso-tetrakis(2,4,6-trimethylphenyl)porphyrinato has been structural characterized.
Photochemical Generation of Radical Species from α-Stannyl Ethers and Their Reaction with Conjugate Enones
Authors: Mikami Tetsuhiro , Harada Manabu , Narasaka Koichi
Published: June 2003

Photochemical reaction of α-stannyl ethers and conjugated enones proceeds in the presence of photosensitizers to give addition products of aryloxymethyl radicals to the enones.
Syntheses of Novel Cyclotriveratrylenophane Capsules and Their Supramolecular Complexes of Fullerenes
Authors: Matsubara Hiroshi , Oguri Shin-ya , Asano Kaori , Yamamoto Koji
Published: June 2003

Cyclotriveratrylenophanes were synthesized and their inclusion abilities for fullerenes were examined by UV spectroscopy. From the spectra, the association constants were determined using Rose and Drago method. Cyclotriveratrylene hosts showed shape-selective properties and large association constants up to 19400 ± 110 dm3mol−1 for C60 and 26500 ± 260 dm3mol−1 for C70
Novel Catalytic Oxidative Synthesis of Soluble Conductive Polymers of Poly(3-butoxycarbonyl-4-methylpyrrole)
Authors: Ohno Naonori , Toshima Naoki
Published: June 2003

A soluble conductive polymer, poly(3-butoxycarbonyl-4-methylpyrrole) was synthesized by catalytic oxidative polymerization of 3-butoxycarbonyl-4-methylpyrrole, where only a small amount of iron (III) chloride as a catalyst, and enough amount of oxygen as an oxidant were used. Addtion of BF3·Et2O to the reaction system can make the yield of the polymer remarkably increase.
Assembly of a Tetranuclear Mixed-Valence Manganese(II,III) Complex from a Binuclear Manganese(II) Complex by Photo-Irradiation
Authors: Tomida Shouichi , Matsushima Hideaki , Koikawa Masayuki , Tokii Tadashi
Published: June 2003

A tetranuclear mixed-valence manganese(II,III) complex, [Mn2(O)(Ph2MeCCOO)2(phen)2]2(PF6)2·10H2O (2), has been assembled from a binuclear manganese(II) complex, [Mn(Ph2MeCCOO)(phen)2]2(PF6)2·2MeCN (1) by use of a photo-induced oxidation reaction.
Preparation of Non-Stoichiometric Nd1−xMnO3−y by Coprecipitation Method
Authors: Uehara Motoki , Nagai Takuro , Yamazaki Atsushi , Takahashi Koichiro , Tsutsumi Sadao
Published: June 2003

The coprecipitate of carbonates was obtained by titrating an ammonium carbonate solution into an hydrochloric solution of MnO2 and Nd2O3 . The non-stoichiometric perovskite-type oxide, Nd1−xMnO3−y was synthesized by firing the coprecipitate in air without flowing. For the products of Nd1−xMnO3−y prepared at 1100 °C, the single phase showing the stable y/x value 1.5 was obtained in the x = 0.05 to 0.20 region, and a by-product Mn3O4 was appeared in x = 0.25.
Cyanodibenzo[1,4]dioxines: A New Family of Synthons for Substituted Dibenzo[1,4]dioxines
Authors: Eastmond Geoffrey C , Paprotny Jerzy
Published: June 2003

Cyanodibenzo[1,4]dioxines, previously unreported, are prepared quantitatively from catechols by nucleophilic fluorodisplacement from 2,3- and 3,4-difluorobenzonitriles, involving meta-fluorodisplacement, in DMF at 130 °C in the presence of potassium carbonate; the cyano-substituted dioxines can be transformed to other substituted dibenzo[1,4]dioxines.
Mixed Phthalocyaninato-Porphyrinato Europium(III) Triple-decker Sandwich Complexes Containing a Conjugated Dimeric Porphyrin Ligand
Authors: Arnold Dennis P , Jiang Jianzhuang
Published: June 2003

The first examples of triple-decker europium(III) sandwich complexes containing bis(octaethylporphyrinyl)butadiyne and phthalocyanine have been prepared by condensation of NiOEP-C4-OEPH2(H21) and Li2Pc with Eu(acac)3·H2O. The complexes (Pc)Eu(1)Eu(Pc) and (1)Eu(Pc)Eu(Pc) were characterized by NMR, IR, Raman, UV-vis, and mass spectra.
Reaction of Primary Selenoamides with Bisacyl Chlorides: Syntheses of 6-Hydroxy-1,3-selenazin-4-ones and Selenoanhydrides
Authors: Koketsu Mamoru , Hiramatsu Sohma , Ishihara Hideharu
Published: June 2003

The reaction of primary selenoamides with bisacyl chlorides in the presence of Et3N was investigated. By the reaction with malonyl chloride, 6-hydroxy-1,3-selenazin-4-ones were provided in high yield. By the reactions with succinyl chloride, glutaryl chloride, and phthaloyl chloride, the corresponding selenoanhydrides were obtained in moderate yields, respectively.
Tissue Based Enzymatic Determination of ATP in Human Erythrocyte Hemolysate Combined with Spectrophotometric Method
Authors: Kataoka Makoto , Teshima Norio , Kurihara Makoto , Kuwa Katsuhiko , Kawashima Takuji
Published: June 2003

A potato tissue based enzymatic determination of ATP combined with spectrophotometric detection is proposed. ATP can be hydrolyzed to give AMP via ADP and two moles of orthophosphate by apyrase (EC 3.6.1.5) contained in the potato tissue. The phosphate released is determined spectrophotometrically based on molybdenum blue formation (λmax = 712 nm). A linear calibration graph is obtained over the range 1.3 × 10−6–1.3 × 10−5 mol dm−3 ATP with a detection limit of 1.5 × 10−7 mol dm−3 (S/N = 3). The proposed method was successfully applied to the determination of ATP in human erythrocyte hemolysate.
Microcryoscopy of Water Employing Silver Iodide to Break Supercooling
Authors: Ogura Tetsuya , Salinas Maria Lorenza , Quiroz Cynthia Genoveva , Miyake Hiroyuki , Kojima Yoshitane
Published: June 2003

A microcryoscope for water has been successfully developed. A series of experiments using 25 μL samples were presented here. It was shown that microcryoscopes can be small sized employing a smaller thermistor and a folded Al-foil as container. AgI was employed to promote ice nucleation.
In vivo Simultaneous Monitoring by Pt-disk Microelectrodes of Intracerebral Hydrogen Peroxide and Dopamine in Rats
Authors: Yokoyama Hidekatsu , Kasai Nahoko , Matsue Tomokazu , Uchida Isamu , Ohya-Nishiguchi Hiroaki , Kamada Hitoshi
Published: June 2003

A technique was developed for simultaneous monitoring of temporal changes in hydrogen peroxide (H2O2) and dopamine (DA) levels by using Pt-disk microelectrodes (φ 30 μm). H2O2 and DA were determined by differential double-pulse amperometry (for H2O2; 1st step, 750 mV, 1000 ms; 2nd step, 1100 mV, 1000 ms: for DA; 1st step, 150 mV, 600 ms; 2nd step, 250 mV, 50 ms). The electrode for H2O2 or DA is capable of determining each target substance and these substances do not interfere with each other. For an in vivo application, the electrodes were implanted into the striatum of rats and used successfully to monitor intrastriatal changes in H2O2 and DA simultaneously after intraperitoneal injection of methamphetamine while the animals were moving freely.