bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo Tolerance Assessment of Skin after Insertion of Subcutaneous and Cutaneous Microdialysis Probes in the Rat
Authors: Mathy F.-X. , Denet A.-R. , Vroman B. , Clarys P. , Barel A. , Verbeeck R.K. , Préat V.
Published: April 2003

The purpose of the study was to evaluate the trauma induced by insertion of the linear microdialysis probe in the subcutaneous and dermal tissue in the rat and to check if the microdialysis probe insertion affects transdermal drug delivery. Non-invasive bioengineering methods (TEWL, Laser Doppler Velocimeter, Chromameter) as well as histology were combined to characterize these effects. The results showed that the dermal and subcutaneous insertion of microdialysis probes did not change skin permeability, blood flow and color, confirming the safety of this technique. The probe depth did not influence the trauma. No significant physical damage after probe insertion was noticed. Thus, the present work validates the use of microdialysis in dermatopharmacokinetics studies after topical or systemic drug delivery.
Efficacy Measurement of Topical Antihistamines
Authors: Heinemann C. , Elsner P.
Published: April 2003

More and more antihistamines are used in gels or ointments for local antipruritic therapy. Among other factors, the efficacy is dependent on the penetration properties of the respective agents and the optimal choice of vehicle substances. To avoid expensive treatment with unsatisfying success, a reliable efficacy measurement would be desirable prior to the admission of new topical antihistamine preparations. Therefore we reviewed the literature for common methods to assess the efficacy of local antihistamines in healthy volunteers. The principle is to apply the test substance to marked test areas and to challenge the skin after a certain time with a standardised amount of histamine, allergens or mast-cell-degranulating substances. For the test evaluation, the areas of wheal, flare and itch are measured and compared between antihistamine-treated and control fields. Challenge models and most of the described evaluation methods are suited for the preliminary efficacy measurement of antihistamines. However, to be able to compare the results, a standardised procedure used by all investigators would be desirable.
The Alexandria Cochlear Implant Program: A Multisystem Program (1983–2001)
Authors: Belal Aziz , Morad Mona , Bassiouny Mohamed , Bassiouny Moktar , Abdel-Baki Fathi , Sobhy Ossama
Published: April 2003

Objective: This study reviews 51 cases of cochlear implantation done over a period of 18 years (1983–2001) in Alexandria, Egypt. Study Design: Retrospective case review on patients implanted in the period 1983–2001. Setting: Tertiary referral medical center, Alexandria University Hospitals. Patients: The study group consisted of 51 profoundly deaf patients, 24 adults and 27 children. Intervention: Five types of cochlear implants were used. Three types were short, single-electrode implants: 3M-House (n = 5), Med-El (n = 6) and All-Hear (n = 24). Two types were long, multiple-electrode implants: Nucleus-22 (n = 14), and Combi-40 (n = 2). Main Outcome Measures: Preoperative air conduction thresholds and speech perception tests with and without hearing aids, postoperative aided thresholds and speech perception tests repeated at 3, 6 and 12 months after implantation, then semiannually. Results: Although marked individual differences were seen in the performance of the different implants, both short and long electrode implants provided almost similar results for sound field warble tone thresholds, and patient’s satisfaction with sound alertness. The long, multiple-electrode implants provided better speech understanding than single-electrode implants, but the difference was not statistically significant due to the small number of cases. The new generation of short electrode implants (All-Hear) provided better scores of speech understanding than the older generations (3M-House and Med-El). Retrofitting an All-Hear speech processor on 1 patient with 3M-House electrode led to improvement in speech understanding scores. Preservation of residual hearing in the implanted cases was much higher with short than with long electrode implants. Functional failure of speech processor, microphone and connecting wires was higher among long electrode implants. Conclusions: We recommend long electrode implants for postlingual profoundly deaf adults who do not benefit from conventional hearing aids, who are mentally sane, whose ears are radiologically free and are committed to a long-term follow-up program. Short electrode implants are indicated particularly when preservation of hearing remnants is essential, when there is a need for a cost-effective, easily programmable and maintenance-free cochlear implant, for the fitting of prelingual adults, and in implanting some difficult cases like Mondini dysplasia and labyrinthitis ossificans.
The Effect of Oxygen Supplementation on the Arterial Ketone Body Ratio in Human Cirrhosis
Authors: Froomes Paul R. , Ghabrial Hany , Morgan Denis J. , Angus Peter W.
Published: April 2003

Background/Aims: Data from studies in experimental models have suggested that the impairment of mitochondrial function and altered redox state that occur in cirrhosis may be due to impaired hepatic oxygenation. Since interventions that improve oxygen delivery to hepatocytes may improve mitochondrial functions, we studied the effects of oxygen supplementation on the arterial ketone body ratio (AKBR) in normal volunteers and patients with cirrhosis. Methods: After a 2-hour fast, ketone bodies were measured in arterial blood taken from patients and controls while breathing room air and then after breathing oxygen via a face mask at 12 liters/min for 60 min. Results: The AKBR was reduced in cirrhotic patients compared with controls, 0.74 ± 0.23 and 1.51 ± 0.4, respectively (p = 0.002). Oxygen supplementation significantly improved the AKBR in cirrhotic patients, from 0.74 ± 0.23 to 1.04 ± 0.28 (p = 0.001) but did not affect the AKBR in controls. Conclusion: These findings suggest that reduced hepatocyte oxygenation contributes to impaired hepatic mitochondrial function in cirrhosis. Strategies at increasing hepatic oxygen delivery may improve hepatic mitochondrial function in patients with chronic liver disease.
Flow-Cytometric Cellular Allergen Stimulation Test in Latex Allergy
Authors: Sanz María L. , Gamboa Pedro M. , García-Avilés Carmen , Vila Leticia , Diéguez Isauro , Antépara Ignacio , de Weck Alain L.
Published: April 2003

Background: The use of flow-cytometric basophil activation to different allergens has been recommended in recent years. In this study, we analyzed the diagnostic reliability of the flow-cytometric allergen stimulation test (FAST) after latex-specific stimulation in vitro. The diagnostic reliability of the technique was assessed as well as its correlation with other in vitro diagnostic parameters. Methods: 43 patients allergic to latex with a positive history and skin test participated in the study. Thirty subjects (20 of them exposed to latex) with a negative history, skin tests and serum-specific IgE determination to latex were used as controls. In FAST the percentage of basophils that express CD63 as an activation marker after in vitro stimulation with allergen (latex) is determined by flow cytometry, following double labelling with the monoclonal antibodies anti-CD63-PE and anti-IgE FITC. Results: Intraclass correlation coefficient in FAST with latex was 0.995 (p < 0.0001), which demonstrates the excellent reproducibility of this technique. Taking a cutoff point of 10% by means of ROC curves, FAST yields a sensitivity of 93% and a specificity of 100%. The FAST positive predictive value in latex allergy was 100% and the negative predictive value was 99.9%. We found a positive and significant correlation between FAST and specific IgE (CAP) with the histamine release test and specific sulphidoleukotriene production [cellular allergen stimulation test (CAST); p < 0.05]. Conclusions: FAST is a highly reliable technique (93% sensitivity and 100% specificity) in the in vitro diagnosis of IgE-mediated latex allergy.
Improved mRNA Quantitation in LightCycler RT-PCR
Authors: Ball T.B. , Plummer F.A. , HayGlass K.T.
Published: April 2003

Background: Real-time polymerase chain reaction (PCR) utilizing the LightCycler and similar systems is an increasingly used technique for quantitative reverse transcription (RT)-PCR of mRNA levels from genes of immunologic interest. A commonly encountered limitation with these systems is that the fluorescence induced by SYBR® Green (a fluorophore that binds double-stranded DNA) can result from primer dimers (PDs) as well as the PCR product of interest, thus interfering with the ability to reproducibly quantitate mRNA levels. Methods: We use a modification of the LightCycler PCR strategy to overcome this problem by altering the PCR strategy to take advantage of the LightCycler’s ability to measure fluorescence at a temperature greater than the melting point of PDs. The resulting measurements determine fluorescence of only the desired PCR product. Results: We demonstrate that by using this modified PCR strategy, one can eliminate the fluorescence induced by PDs and obtain accurate product quantitation. Conclusions: This simple modification allows more precise quantitation of sample mRNA levels by eliminating the contaminating fluorescence induced by the formation of PCR PDs. This modification obviates the need to redesign PCR primers in RT-PCR experiments where this is impractical or impossible.
Inhalant Allergies in Zimbabwe: A Common Problem
Authors: Sibanda Elopy Nimele
Published: April 2003

Allergic rhinitis, allergic conjunctivitis, allergic asthma and atopic dermatitis affect a quarter of the population of the industrialised countries and are the most common symptoms of type I hypersensitivity reactions. Their prevalence has been documented in many communities, yet data from Africa are limited. In the 5-year period from September 1997 to September 2002, approximately 14,000 patients of all ages were referred to the only specialist allergy clinic in Harare, Zimbabwe, for allergy investigation, diagnosis and therapeutic management. In approximately one tenth of these patients, food allergies were diagnosed; less frequent presentations included allergic pharyngitis, bee- or wasp-induced reactions and latex allergy. An allergologic basis for the clinical conditions was established following a careful clinical and physical examination, evaluation of family history and the detection of in vivo (skin prick test) or in vitro (radio-allergo-sorbent test; RAST) allergen-specific IgE antibodies to known sources of inhalant allergens, using commercial allergen extracts and a RAST assay kit. Asthma diagnosis was supported by the clinical and laboratory findings of salbutamol-reversible airways obstruction. Case files of the first 1,046 patients are reviewed in order to define the clinical presentation of allergic patients in this region. It is highlighted that allergy in general and inhalant allergy in particular are very common, if not widely acknowledged, clinical problems in this Central African region.
Effect of Interleukin 6 on the Hepatic Metabolism of Itraconazole and Its Metabolite Hydroxyitraconazole Using Primary Human Hepatocytes
Authors: Gubbins Paul O. , Melchert Russell B. , McConnell Scott A. , Franks Amy M. , Penzak Scott R. , Gurley Bill J.
Published: April 2003

A potential cytokine-drug interaction between interleukin 6 (IL-6) and itraconazole (ITZ) was studied using human hepatocytes in primary culture. Cultures from 5 adult males (mean age 42 ± 15 years) who had not received any medicines known to interact with CYP3A4 were studied. Cultures were exposed to ITZ 500 ng/ml, and the effects of 120 µg/ml cimetidine, 50 ng/ml human IL-6, or IL-6 plus IL-6 receptor antagonist were analyzed for 2, 4, 8, and 12 h. Intracellular ITZ and hydroxyitraconazole concentrations were measured using HPLC and normalized to total cellular protein. Mean intracellular concentrations between groups were compared using one-way Anova (f test; p < 0.10) and corresponding Bonferroni versus control test for multiple comparisons (p < 0.02). Mean intracellular ITZ concentrations between the groups were similar at all time points. Human hepatocytes in primary culture can metabolize ITZ. However, IL-6 did not inhibit hydroxyitraconazole formation, but it may inhibit its subsequent metabolism.
Protein Kinase C and Phosphoinositol-3-Kinase Mediate Differentiation or Proliferation of Slice-Derived Rat Microglia
Authors: Zassler Birgit , Schermer Christine , Humpel Christian
Published: April 2003

Granulocyte-macrophage colony-stimulating factor plays an important role in the activation of microglia in the central nervous system. We have recently shown (see text) that granulocyte-macrophage colony-stimulating factor activates the proliferation and subsequent migration of microglia from organotypic cortex brain slices. The aim of this study was to investigate whether this activation is modulated by different putative intracellular pathway inhibitors. Our data show that the protein kinase C inhibitor staurosporine enhanced the proliferation as well as the differentiation of slice-derived microglia, while the phosphoinositol-3-kinase inhibitor LY294002 markedly suppressed the proliferative activity. In conclusion, proliferation, migration, as well as differentiation of rat microglia are highly regulated by intracellular signaling cascades.
High-Resolution CT Features: Prognostic Significance in Peripheral Lung Adenocarcinoma with Bronchioloalveolar Carcinoma Components
Authors: Takashima Shodayu , Maruyama Yuichiro , Hasegawa Minoru , Saito Akitoshi , Haniuda Masayuki , Kadoya Masumi
Published: April 2003

Background: Based on Noguchi’s classification, adenocarcinomas with bronchioloalveolar carcinoma (BAC) components have a heterogeneous prognosis. However, until now, the prognostic factors in this tumor category have not been clarified. Objectives: We studied the prognostic significance of high-resolution CT (HRCT) findings in this tumor subtype. Materials and Methods: HRCT findings [lesion size, percentage of ground-glass opacity (GGO) areas in the lesion, presence or absence of lobulation, coarse spiculation, pleural tag, satellite lesion, air bronchogram, and site of the lesion], clinical data (age, gender and surgical method), and pathologic findings (degree of tumor differentiation and presence or absence of nodal metastasis) were analyzed in 52 consecutive patients with adenocarcinoma with BAC components <3 cm (mean, 1.7 cm). The patients included 32 women and 20 men with a mean age of 66 years. The results correlated with survival using univariate and multivariate analysis. The mean follow-up period was 41 months. Results: Nine (17%) of the 52 patients died of lung cancer. In univariate analysis, a significant difference was found for lobulation (p = 0.018), %GGO (p = 0.043), air bronchogram (p = 0.003), site of lesion (p = 0.034), degree of tumor differentiation (p = 0.001), and nodal metastasis (p = 0.040). Multivariate analysis using the 6 factors that were significant in univariate analysis as independent variables revealed that an air bronchogram (p = 0.010) and the degree of tumor differentiation (p = 0.008) were significant independent factors for survival. Conclusion: The presence of an air bronchogram on HRCT may have an independent prognostic significance in lung adenocarcinoma with BAC components.
Predicting Chemotherapy Response to Paclitaxel-Based Therapy in Advanced Non-Small-Cell Lung Cancer with P-Glycoprotein Expression
Authors: Yeh J.J. , Hsu W.H. , Wang J.J. , Ho S.T. , Kao A.
Published: April 2003

Background: It was reported that multidrug resistance gene 1 (MDR1) encoding human P-glycoprotein (Pgp) may play an important role in multidrug resistance of lung cancer. Therefore, before initiating chemotherapy, it is important to accurately determine the presence of Pgp in lung cancer, to achieve a satisfactory chemotherapy response. Objectives: The aim of this study was to compare immunohistochemical analyses of Pgp expression and response to paclitaxel in non-small-cell lung cancer (NSCLC). Methods: Before chemotherapy with paclitaxel, 50 patients with stage IIIb or IV NSCLC were enrolled in this study. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the 3rd month after completion of treatment by clinical and radiological methods. Results: All of the 28 (100%) cases with good response had negative Pgp expression and 15 of the 22 (68%) cases with poor response had positive Pgp expression (p < 0.05). No significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between good response and poor response groups. Conclusions: Although Pgp expression in NSCLC does not fully predict chemotherapy response to paclitaxel-based therapy, detection of Pgp expression will aid in planning paclitaxel-based therapy for patients with advanced NSCLC. Further studies with a larger number of patients and a longer time of follow-up are necessary to confirm our findings.
Analysis of Chest CT in Patients with Mycobacterium avium Complex Pulmonary Disease
Authors: Fujiuchi Satoru , Matsumoto Hiroyuki , Yamazaki Yasuhiro , Nakao Shoko , Takahashi Masaaki , Satoh Kazue , Takeda Akinori , Okamoto Kiyotaka , Fujita Yuka , Fujikane Toshiaki , Shimizu Tetsuo
Published: April 2003

Background: The radiographic changes of Mycobacterium avium complex (MAC) pulmonary disease during therapy have not been studied well. Objective: To assess the efficacy of antituberculous drug therapy against MAC pulmonary disease using computed tomography (CT). Method: We analyzed chest CT scans before and after antituberculous therapy in 30 patients (21 women, 9 men) with MAC pulmonary disease. To evaluate radiographic changes during therapy, we defined a ‘degree of improvement’ (DI) that is calculated according to the CT appearance. Results: DI was better (1.35 ± 0.21) in patients who had converted sputum culture than in those who had not (0.44 ± 0.25) (p < 0.05). In patients who were diagnosed by bronchial washing, DI was better (1.60 ± 0.22) than in patients who were diagnosed by sputum (0.67 ± 0.20) (p < 0.01). We categorized the CT appearance into 6 types: small nodules, cavities, bronchial wall thickening, infiltration, pleural thickening and atelectasis. Patients who showed pleural thickening had a significantly worse DI (0.12 ± 0.40) than those who did not (1.23 ± 0.18) (p < 0.01). Most of the lesions that disappeared after therapy were small nodules. Conclusion: These results indicate that chest CT might be a useful tool for the prediction or assessment of drug therapy for MAC pulmonary disease.
Transthoracic Ultrasound
Authors: Herth F.J.F. , Becker H.D.
Published: April 2003

Sonography (US) has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, US is less expensive and more convenient than computed tomography (CT) or magnetic resonance imaging (MRI); it provides immediate information with real-time imaging, and can give information not available from a standard radiograph. This review describes the utility and limitations of US and compares US with radiography.
Cost-Effectiveness of Spinal Cord Stimulation versus Coronary Artery Bypass Grafting in Patients with Severe Angina Pectoris – Long-Term Results from the ESBY Study
Authors: Andréll P. , Ekre O. , Eliasson T. , Blomstrand C. , Börjesson M. , Nilsson M. , Mannheimer C.
Published: April 2003

The present study is a 2-year follow-up of the 104 patients participating in the ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris), a randomised prospective study including patients with increased surgical risk and no prognostic benefit from revascularisation. Hospital care costs, morbidity and causes of death after spinal cord stimulation (SCS) and coronary artery bypass grafting (CABG) were assessed, as well as the complication rate of SCS treatment. SCS proved to be a less expensive symptomatic treatment modality of angina pectoris than CABG (p < 0.01). The SCS group had fewer hospitalisation days related to the primary intervention (p < 0.0001) and fewer hospitalisation days due to cardiac events (p < 0.05). The groups did not differ with regard to causes of death. There were no serious complications related to the SCS treatment.
Cutaneous Recall Reactions with Systemic Fluorouracil
Authors: Kirkup M.E. , Narayan S. , Kennedy C.T.C.
Published: April 2003

5-Fluorouracil is used extensively to treat actinic keratoses as there is selective excessive uptake of 5-fluorouracil in rapidly dividing cells, thus causing inflammation in lesional skin. We report 2 cases of inflammation occurring on clinically normal skin after fluorouracil had been administered parenterally for carcinoma of the oesophagogastric junction and lower third of the oesophagus, respectively. In the first case, actinic keratoses had previously been treated with topical fluorouracil and in the second case, although there were no previous actinic keratoses, there was a high degree of previous solar exposure of the affected areas. In each case, there was a good response to topical steroid application. No recurrence was experienced on further doses of systemic fluorouracil when the skin was treated prophylactically with topical steroids. Recognition of these reactions is important if unnecessary discontinuation of chemotherapeutic drugs is to be avoided as a result of fear of allergic drug reactions.
Angioedema and Oral Contraception
Authors: Bouillet L. , Ponard D. , Drouet C. , Jullien D. , Massot C.
Published: April 2003

Background: Oral contraceptives can precipitate attacks of hereditary angioedema (ANE) or induce acquired forms. Objective: We studied 5 patients who had an ANE which had begun under oral contraception and disappeared after stopping the pill. Methods: We explored the clinical and biological characteristics of these patients. Results: The symptoms developed during the first year or later after starting contraception; the patients reported relapsing swelling of the lips, hands, larynx and abdomen. All women had normal serum C4 and C1 inhibitor (C1Inh) antigen levels, but a lowered C1Inh activity, with a marked protein cleavage on the immunoblot. The suppression of the pill was associated with the regression of the edema and normalization of C1Inh function. Conclusion: The mechanism of these ANE is unknown. The could be due to a modulation of C1Inh expression upon androgens or an imbalance between coagulation proteins favoring C1Inh cleavage by its target proteases.
31-Year-Old Injection Drug User with Massive Skin Necrosis and Shock
Authors: Hengge Ulrich R. , Beiderlinden Martin , Otterbach Friedrich , Groeben Harald , Nast-Kolb Dieter , Mehnert Wolfgang H. , Peters Jürgen , Schmid Kurt W.
Published: April 2003

Massive tissue necrosis and septic shock have recently been reported in a series of injection drug users in Scotland, England and Ireland. We report the first case outside the UK meeting the criteria for this new entity (septic shock without fever in an injection drug user, local and systemic inflammation, rhabdomyolysis and tissue necrosis at the injection site). Following surgical treatment and antibiotic treatment, the patient was cured and is currently well.
Treatment of Psoriatic Nails with Topical Cyclosporin: A Prospective, Randomized Placebo-Controlled Study
Authors: Cannavò S.P. , Guarneri F. , Vaccaro M. , Borgia F. , Guarneri B.
Published: April 2003

Background: Nail involvement is a frequent event in the course of psoriasis causing severe distress. While systemic cyclosporin (CsA) represents a well-established therapy of psoriasis, its topical use is limited by the difficult penetration of the molecule through the skin and the nail because of its highly lipophilic nature. Objectives: We carried out a prospective randomized placebo-controlled study in order to analyze the effectiveness and tolerability of topical oil-dissolved 70% CsA solution in nail psoriasis. Methods: Sixteen adult patients with nail psoriasis, divided randomly into two groups of 8 patients (group A and group B), were treated respectively with a 70% maize-oil-dissolved oral CsA solution and maize oil alone. To compare the therapeutic effectiveness, all patients were evaluated, before starting the treatment and after 12 weeks of therapy, by the same dermatologists. The patients were also asked to assess the severity of their nail involvement at baseline and at the end of the treatment. Results: In group A, 3 patients came to a complete resolution of nail lesions and 5 showed a substantial improvement of the overall severity score. In group B, a slight improvement was noted in only 1 patient. All the patients of group A judged positively the results of the therapy, while in group B only 1 patient reported a moderate improvement. Conclusion: Our results show that topical therapy with oral CsA solution is a safe, effective and cosmetically highly acceptable treatment modality for nail psoriasis. The ability of CsA to influence keratinocyte proliferation and T-cell lymphokine release, reducing the cornification of the upper layers of the epidermis, may prevent the typical alterations observed in nail psoriasis.
Lipid Composition of Outer Stratum corneum in Hereditary Palmoplantar Keratodermas
Authors: Küster Wolfgang , Melnik Bodo , Traupe Heiko , Hamm Henning
Published: April 2003

Background: The analysis of lipid composition of the outer stratum corneum is a promising approach to study the pathophysiology of inherited disorders of keratinization. Objective: The purpose of the study was the search for biochemical alterations of stratum corneum lipids in hereditary palmoplantar keratoderma (PPK). Methods: Using high-performance thin-layer chromatography, we performed an analysis of all major stratum corneum lipid classes in scales of 29 patients with 8 different types of hereditary PPK. Results: In comparison to the controls, slight differences in the lipid pattern were found in all keratodermas. Reduced amounts of total ceramides and increased levels of free fatty acids were noted in nearly all types. Conclusions: The study indicates that the abnormal composition of stratum corneum lipids in PPK is probably not caused by genetic defects of the epidermal lipid metabolism, but it appears to represent an epiphenomenon of a disturbed cornification.
Multifetal Pregnancies: Evolution of Methods of Initiation and Impact of REI Certification for Patients Seeking Reduction
Authors: Calhoun Byron , Evans Mark I. , Krivchenia Eric L. , Waters Thaddeus , Urban Anita J. , Morgan Patricia , Hume Roderick F. , Wapner Ronald J.
Published: April 2003

Objective: Multifetal pregnancy as a result of ovulation induction (OI) and assisted reproductive technologies (ART) correlate with Board certification in reproductive endocrinology and infertility (REI). Design: Retrospective chart analysis of 304 patients referred to Wayne State University (WSU) and Thomas Jefferson University (TJU) for multifetal pregnancy reduction (MFPR) from March 1986 to January 1995 compared to 275 patients referred from January 1 to December 31, 2000 at MCP Hahnemann University. Material and Methods: Chart review for fetal number, pregnancy generation (OI or ART) and physician REI Board certification from the American Board of Specialties Obstetrics and Gynecology. Information was available on 296 of 304 patients studied in the 1986–1995 WSU cohort and 275 patients studied from the MCP Hahnemann 2000 cohort. Results: Analysis of 296 multifetal pregnancies at WSU and TJU for REI Board status showed non-REI Board-certified (NREI) physicians generated 174 pregnancies with quadruplets or more compared to 122 quadruplets or more by REI Board-certified physicians. Board certification did not impact quadruplet or more rates for OI or ART (p < 0.368). Of 275 patients with triplets or more at MCP Hahnemann, 156 (56.7%) were from ARTs versus 41.2% from 1986–1995 (χ2 = 13.1, p < 0.001). Quintuplets or more decreased from 18.5 to 9.7% (χ2 = 8.3, p = 0.004), and for REIs from 22.1 to 9.6% (χ2 = 4.7, p < 0.01), while 14.4% of cases coming from non-REIs had quintuplets versus 9.6% from REIs (p = NS). Conclusions: Cases of MFPR from ARTs have risen, while percentage of cases with quintuplets have fallen in half. We found no difference in quintuplets between REIs and non-REIs overall, but REI quintuplets fell significantly, and NREI has not.
ABCA4 Sequence Variants in Chinese Patients with Age-Related Macular Degeneration or Stargardt’s Disease
Authors: Baum Larry , Chan Wai Man , Li Wai Ying , Lam Dennis S.C. , Wang Peng Bo , Pang Chi Pui
Published: April 2003

ABCA4 gene sequence alterations cause Stargardt’s disease (STGD) and may cause some age-related macular degeneration (AMD). We sought to shed light on these associations among Hong Kong Chinese by genotyping 140 AMD, 18 STGD and 95 normal control subjects for 15 ABCA4 exons which were reported to often contain AMD- or STGD-associated mutations. Sequence alterations R212H, T1428M, V1433I, T1572M, I2166M, IVS6–5T>G and IVS33+1G>T were found in AMD patients. T1428M and R2040X occurred in STGD patients. Control subjects displayed all the above missense alterations but no splicing or nonsense changes. Therefore, ABCA4 splicing mutations may be associated with a small proportion of AMD cases.
Evaluation of Treatment by Pulsed Electromagnetic Fields in a Rabbit Hyphema Model
Authors: Wollensak Gregor , Muchamedjarow Felix , Funk Richard
Published: April 2003

Purpose: Previous clinical studies have suggested a positive effect of low-frequency pulsed electromagnetic fields (PEMF) on wound healing and inflammation in the eye. We tried to test the value of PEMF treatment in a hyphema animal model with well-defined conditions. Methods: After injection of citrated autologous blood for the production of hyphema, 16 rabbit eyes were treated with 10 or 20 mT for 60 min on 4 days within the postoperative week. Two control groups with hyphema alone (n = 8) and PEMF irradiation without hyphema (n = 4) were also included. The rate of resorption was recorded daily. Histopathologic evaluation was performed. Results: The incidence of endothelial cell damage and fibrotic clots was markedly reduced in the 10-mT group while the resorption time of 8 days was identical with the control group. In the 20-mT group, the complication rate and the resorption time was increased versus the control group. Conclusions: The use of PEMF treatment is of some, however, limited value as it did not reduce the resorption time of hyphema but displayed a dose-dependent, beneficial influence on some serious side effects. Future clinical studies with low-dose PEMF irradiation are justified and should determine the optimal dosage and suitable indications of PEMFs as an adjunctive treatment in ocular inflammation or trauma.
Disproportionately Elevated Fasting Proinsulin Levels in Normoglycemic Patients with Thalassemia major Are Correlated to the Degree of Iron Overload
Authors: Cario Holger , Holl Reinhard W. , Debatin Klaus-Michael , Kohne Elisabeth
Published: April 2003

Objective: To analyze the secretion of the insulin precursor proinsulin in patients with β-thalassemia and its possible relation to iron overload. Methods: We assessed fasting proinsulin, insulin, C-peptide and glucose levels from 34 patients with β-thalassemia and 33 healthy controls. The correlation to age, body mass index, hepatic iron concentration, serum ferritin and serum AST was analyzed. Results: Fasting proinsulin (p < 0.002) and proinsulin-to-insulin ratio (p < 0.02) were significantly increased in patients with thalassemia irrespective of the degree of glucose tolerance. They correlated positively to serum ferritin, liver iron, patient age and serum AST (all p < 0.05). Conclusions: Disproportionately elevated proinsulin levels in thalassemic patients indicate early β-cell dysfunction due to siderosis. An additional biological significance of hyperproinsulinemia and its possible ability to predict long-term iron toxicity in these patients remain to be clarified.
One-Year Spinal Bone Change in Pre- and Perimenopausal Japanese Women
Authors: Komukai Shigeyuki , Ohta Hiroaki , Makita Kazuya , Yanamoto Shigehisa , Takamatsu Kiyoshi , Okano Hiroya , Yajima Masazumi , Nozawa Shiro
Published: April 2003

Background: This prospective observational study was designed to determine whether the bone mineral density (BMD) of the lumbar spine decreases before menopause. Methods: The change in BMD of the second through fourth lumbar vertebrae (Δ%L2–4BMD) over the course of 12 months was measured in 197 pre- and perimenopausal Japanese women aged 48.2 ± 2.3 (mean ± SD) years. Results: Overall, Δ%L2–4BMD decreased significantly, with a greater decrease seen in perimenopausal women. This group also had a significantly higher level of FSH (p < 0.05, t = 7.356), a significantly lower level of estradiol (p < 0.05, t = 4.245), and significantly higher levels of the bone metabolic markers, alkaline phosphatase (p < 0.05, t = 3.841), calcium (p < 0.05, t = 3.939), and osteocalcin (p < 0.05, t = –3.295). Overall, there was a significant positive correlation between osteocalcin and Δ%L2–4BMD (r = –0.194, p = 0.0479). Conclusion: A subset of perimenopausal women with transient decreases in ovarian function that do not respond to increased FSH may be at increased risk for abnormally low BMD, and may benefit from early management of bone mass.
Suppression of TSH in Congenital Hypothyroidism Is Significantly Related to Serum Levels and Dosage of Thyroxine
Authors: Brown J.J. , Datta V. , Sutton A.J. , Swift P.G.F.
Published: April 2003

Aim: To assess thyrotropin (thyroid-stimulating hormone; TSH) suppression and serum thyroxine (T4) concentrations in infants with congenital hypothyroidism in relation to T4 dose and pretreatment parameters. Method: A retrospective study of all cases treated in a single centre since neonatal screening began was performed. Results: In 54 infants treated with a mean daily T4 dose of 9.8 µg/kg, the TSH concentration was suppressed (<6 mU/l) in 65% of the cases by 6 months with the serum T4 level at the upper end of the infant reference range. Infants who suppressed their TSH later did not differ in pretreatment serum TSH or T4 concentration. T4 dose and serum T4 level were lower in infants whose TSH was not suppressed. Conclusions: TSH suppression in congenital hypothyroidism is significantly related to serum levels and dosage of T4. We suggest that a delay in TSH suppression is mainly due to undertreatment.
Development of Emotional Intelligence: Towards a Multi-Level Investment Model
Authors: Zeidner Moshe , Matthews Gerald , Roberts Richard D. , MacCann Carolyn
Published: April 2003

This paper examines the development of emotional intelligence (EI) in childhood. It is proposed that ambiguities in conceptualizing EI may be resolved by distinguishing multiple levels of emotion-regulation processes. Temperament, rule-based skill acquisition, and self-aware emotion regulation are differentiat-ed as potential sources of individual differences. We review empirical studies that demonstrate multiple mechanisms linked to these levels. Temperament is shaped by genes, interacting with environmental influences such as patterns of infant-caregiver interaction. Early, language-dependent skill learning is governed by reinforcement and modeling processes. Subsequent, insightful learning is influenced by emotional discourse with parents and others, and cultural factors. Cognitive abilities may also influence individual differences in emotional function. At the same time, the biological and sociocultural factors that influence EI interact in complex and interrelated ways. We conclude this article by proposing a tentative ‘investment model’ for emotional competencies in children that accommodates the multifaceted nature of EI. Lower-level competencies may provide a platform for developing more sophisticated emotion-regulation skills, with competencies becoming increasingly differentiated over time.
Distribution of Beta-Tubulin in Guinea Pig Inner Ear
Authors: Du Xiaoping , Yoo Taijune , Mora Renzo
Published: April 2003

Our previous research had suggested that β-tubulin might be an autoantigen for autoimmune inner ear disease. In this study, the expression of β-tubulin in inner ears of normal and tubulin-immunized guinea pigs was examined by immunohistochemical staining. Strong immunoreactivity to β-tubulin monoclonal antibody was found in stria vascularis, neurons of the spiral ganglion, cochlear nerve fibers and spiral ligament. Diffuse staining was found in the stria vascularis and the neurons of the spiral ganglion, while dense network staining was found in the spiral ligament, the nerve fibers and the vestibular end organs. The semicircular canals, endolymphatic duct and sac were also positively stained. In inner ears of guinea pigs challenged with β-tubulin, staining intensity was diminished in the stria vascularis, the spiral ligament, and the neurons of the spiral ganglion. The results suggest that β-tubulin is distributed to most structures of guinea pig inner ear. A challenge to the inner ear by tubulin could change the β-tubulin distribution and cause degeneration in the spiral ganglion. The results support the hypothesis that β-tubulin might be an autoantigen for autoimmune inner ear disease.
Cochlear Implantation in Mondini Dysplasia
Authors: Daneshi Ahmad , Hassanzadeh Saeid , Abasalipour Parvaneh , Emamdjomeh Hessamaddin , Farhadi Mohammad
Published: April 2003

The use of cochlear implantation to treat patients with inner ear malformations such as Mondini dysplasia has been increasingly successful. Until now, conventional hearing aids in these patients have not performed well. Consequently, the hearing problem for patients with this condition has been somewhat improved with the use of cochlear implants. Various results of cochlear implantation have been reported in these patients so far. This is a report of 5 patients with Mondini malformation who have undergone cochlear implant surgery.
Contribution of Virtual Endoscopy to the Investigation of Laryngotracheal Pathological Conditions
Authors: Schultz P. , Wiorowski M. , Million P. , Veillon F. , Debry C.
Published: April 2003

Three-dimensional CT scan imaging obtained by using helicoidal CT scan provides the basis for an endoscopic exam said to be virtual since no invasive procedure is actually performed. Compared to optical endoscopy this easily accessible exam offers additional information especially for the analysis of the infraglottic and tracheal areas, which are two anatomically rigid segments. This property facilitates their three-dimensional reconstruction. Our study encompassed 6 patients presenting with a stenosis of the laryngotracheal tract. In 5 of them it was possible to correlate optical and virtual endoscopic imaging. Coupling both exams significantly improved the diagnostic investigation and facilitated the management of the disease. However, the real contribution of virtual endoscopy to the exploration of tumoral conditions still remains to be determined given the low degree of tissue resolution. As a consequence parietal and extraparietal lesional spreading is more accurately assessed by axial scan imaging.
Pneumocystis carinii Infection of the Middle Ear and External Auditory Canal
Authors: Menger D.J. , v.d. Berg R.G.
Published: April 2003

We present a 50-year-old male with Pneumocystis carinii infection involving the middle ear and the external auditory canal as the first manifestation of a previously unknown HIV infection. In case of therapy-resistant otitis with a polypoid mass in the external auditory canal histological evaluation should be considered to rule out malignancy or pathogens, like Pneumocystis carinii, that cannot be cultured. Oral or intravenous antiprotozoal agents are the treatment in line with current practice. Exploration of the os petrosum is never required.
Malignant Ectomesenchymoma of the Nose
Authors: Brehmer D. , Overhoff H.M. , Marx A.
Published: April 2003

To the best of our knowledge, a malignant ectomesenchymoma of the nose has not yet been reported. This rare tumour is composed of a mesenchymal element – usually a rhabdomyosarcoma – and a neuroectodermal element, often a neuroblastoma or a malignant schwannoma. Most malignant ectomesenchymomas have been found in children (mainly boys), but 5 adult cases, including our case, have also been reported. A 62-year-old man presented with a nasal obstruction on the right side of the nose. Diagnostic nasal endoscopy revealed a mass in the dorsal part of the right nasal cavity, which was treated by endoscopic surgery. The postoperative course was uneventful, and subsequent radiotherapy well tolerated. Since rhabdomyosarcoma is the most common component of this neoplasm, the treatment protocol for rhabdomyosarcoma would have appeared appropriate. This report reviews the literature, summarises the pathological features and possible histogenesis of the tumour, and outlines recommended treatments for malignant ectomesenchymoma.
A Self-Controlled, Naturalistic Study of Selective Serotonin Reuptake Inhibitors versus Tricyclic Antidepressants
Authors: Faravelli C. , Cosci F. , Ciampelli M. , Scarpato M.A. , Spiti R. , Ricca V.
Published: April 2003

Objective: To compare the effectiveness of serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) for anxiety and mood disorders in a naturalistic setting. Methods: 114 of 2,000 outpatients drawn from a private facility with a diagnosis of mood or anxiety disorder had two separate episodes during which they were treated once with a SSRI and once with a TCA. The drugs had to be in monotherapy and appropriate according to the recent guidelines. Key outcome measures included several rating scales, the results of which were combined into three measures of outcome: full response (no symptom), partial response (residual symptoms), poor response. Results: TCAs produced a better response in 63 cases and SSRIs in 18 cases (p < 0.00001). When the outcome was dichotomized, TCAs were still superior (stricter criterion of full response: p = 0.0002; lower threshold: p < 0.0001). Considering depressive and anxiety disorders separately, TCAs remained superior in terms of efficacy (for depression: p < 0.0001; for anxiety: p = 0.026). Moreover, the second episode of illness showed a better outcome than the first (p = 0.0008). Conclusions: In those cases where two different antidepressants were prescribed over two different episodes of illness, TCAs were significantly more effective than SSRIs, regardless of the type of disorder and order of prescription.
Getting What You Ask For: On the Selectivity of Depression Rating Scales
Authors: Demyttenaere Koen , De Fruyt Jürgen
Published: April 2003

A large number of rating scales has been developed to assess depression severity and change during antidepressant therapy. When reviewing the literature, the choice of the rating scales used in a particular study often seems arbitrary. The most frequently used observer rating scales, the Hamilton Depression Rating Scale (HDRS) and the Montgomery-Åsberg Depression Rating Scale (MADRS), and the most frequently used self-rating scale (the Beck Depression Inventory, or BDI) were developed more than 20 years ago. Their historical background is too often forgotten and they are reflections of their origin: the HDRS and the MADRS reflect antidepressant activity while the BDI reflects psychotherapy. Moreover, the HDRS is at risk of putting ‘all depressions in one basket’, while the MADRS is at risk of putting ‘all antidepressants in one basket’. Therefore, the question whether a particular antidepressant could be more effective in a particular subtype of depression cannot be answered. Observer rating scales are more frequently used than self-rating scales, and when scales are used that do exist in an observer rating and a self-rating version, interesting differences are found. The present paper does not suggest that one scale is better than another, but suggests that a better knowledge of their differential background can help the researcher choose the correct scale for his purposes.
Depression and Folate Status in the US Population
Authors: Morris Martha S. , Fava Maurizio , Jacques Paul F. , Selhub Jacob , Rosenberg Irwin H.
Published: April 2003

Background: Folate deficiency and low folate status have been linked in clinic studies to depression, persistent depressive symptoms, and poor antidepressant response. These relationships have not been demonstrated in general populations. This study examined associations between depression and folate status indicators in an ethnically diverse general US population sample aged 15–39 years. Methods: Healthy subjects whose red blood cell (RBC) folate concentrations had been measured were determined to have no depression (n = 2,526), major depression (n = 301 ), or dysthymia (n = 121) using a diagnostic interview schedule. Serum concentrations of folate and total homocysteine (tHcy) were also measured. Results: After adjustment for sociodemographic factors, serum vitamin B12 concentration, alcohol consumption over the past year and current status as to overweight and use of vitamin/mineral supplements, cigarettes and illegal drugs, subjects who met criteria for a lifetime diagnosis of major depression had folate concentrations in serum and RBCs that were lower than those of subjects who had never been depressed. Subjects who met criteria for dysthymia alone had lower RBC folate concentrations than never-depressed subjects, but the serum folate concentrations of the two groups were comparable. Serum tHcy concentration was not related to lifetime depression diagnoses. Low folate status was found to be most characteristic of recently recovered subjects, and a large proportion of such subjects were folate deficient. Conclusions: Low folate status was detectable in depressed members of the general US population. Folate supplementation may be indicated during the year following a depressive episode.
The Water-Soluble Fraction (<10 kD) of Bee Venom (Apis mellifera) Produces Inhibitory Effect on Apical Transporters in Renal Proximal Tubule Cells
Authors: Han Ho Jae , Yoon Byeong Cheol , Oh Young Joon , Park Soo Hyun , Lee Jang Hern , Mar Woong Chon
Published: April 2003

Human envenomation caused by bee stings has been reported to cause acute renal failure and the pathogenetic mechanisms of these renal functional changes are still unclear. Bee venom is also a complex mixture of enzymes and proteins. Thus, this study was conducted to examine the effects of bee venom (BV, Apis mellifera) fractions on apical transporters’ activity and its related signal pathways in primary cultured renal proximal tubule cells. Whole BV was extracted into three fractions according to solubility [a water-soluble fraction (BVA), an ethylacetate-soluble fraction (BVE), and a hexane-soluble fraction (BVH)]. BVA fraction was further separated to three portions according to molecular weights: BF1 (>20 kD), BF2 (10–20 kD), and BF3 (<10 kD). Each fraction was treated to the PTCs to the ratio of BV (1 µg/ml). BVA (930 ng/ml) significantly decreased cell viability, but BVH (27 ng/ml) and BVE (43 ng/ml) did not. BF3 (710 ng/ml) among BVA fractions predominantly decreased cell viability and inhibited α-methyl-D-glucopyranoside (α-MG), phosphate (Pi), and Na+ uptake. In addition, BF3 increased [3H] arachidonic acid release, lipid peroxide formation, and Ca2+ uptake. These effects of BF3 were blocked by mepacrine and AACOCF3 (phospholipase A2 inhibitors) or N-acetylcysteine, vitamin C, and vitamin E (antioxidants). In conclusion, BF3 (<10 kD) among BV fractions is the most effective portion in BV-induced inhibition of α-MG, Pi, and Na+ uptake and these effects of BF3 are associated with phospholipase A2-oxidative stress-Ca2+ signal cascade in the primary cultured rabbit renal proximal tubule cells.