bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of sublingual swallow immunotherapy in children with severe grass pollen allergic symptoms: a double‐blind placebo‐controlled study
Authors: Bufe A. , Ziegler‐Kirbach E. , Stoeckmann E. , Heidemann P. , Gehlhar K. , Holland‐Letz T. , Braun W.
Published: December 2004

Background:  Local application of allergen extracts in specific immunotherapy is accompanied by increased compliance and significantly reduced side effects. However, efficacy of local immunotherapy in children has yet not been sufficiently demonstrated. This study was performed to determine clinical efficacy of high dose sublingual swallow immunotherapy (SLIT) by a double‐blind placebo‐controlled study in children with grass pollen allergy using high dose allergen extracts.

Methods:  A total of 161 children with seasonal rhinoconjunctivitis of which, 68 had also asthma symptoms were enrolled in a multicenter double‐blind placebo‐controlled study for 1 year and treated on a daily basis with sublingually applied allergen drops. After 1 year all children were given treatment for another 2 years in an open‐controlled setting. Symptom scores and medication were assessed during the pollen seasons with structured interviews. Applied allergen dosage, compliance, and side effects were documented by daily diary cards. Primary endpoint was a clinical index (CI) combining symptom scores with medication index. Titrated skin prick tests (SPT) and specific antibody measurements were performed each year.

Results:  Combining symptom with medication scores to CI was highly reliable (reliability coefficient = 0.89, standard error = 9.6%). Allergen‐specific IgE‐ and IgG‐subclass antibodies increased significantly in patients treated with SLIT indicating an activation of the immune response induced by the locally applied grass pollen extract. SPT reactivity did not change during therapy. After 1 year of SLIT in the original design we observed no significant difference in the CI between treatment and placebo analyzing all patients included in the study per intention to treat and per protocol. However, subgroup analysis in a repeated measures model revealed that patients with SLIT and severe symptoms before the beginning of treatment (CI > mean/ > 1.51) showed a significant improvement of clinical symptoms after 3 years.

Conclusion:  In this study SLIT was accompanied by a significant placebo effect. Efficacy of treatment could only be seen in children with severe clinical symptoms and this became clinically marked after 3 years of therapy.
Neuronal nitric oxide synthase gene polymorphism and IgE‐mediated allergy in the Central European population
Authors: Hollá L. I. , Schüller M. , Bučková D. , Vácha J.
Published: December 2004

Background:  Several findings suggest that nitric oxide (NO) plays a significant role in the regulation of the Th1/Th2 balance and contributes to the development of allergic diseases. Our study investigates a possible association of C/T transition located 276‐bp downstream from the translation termination site in exon 29 of the human nitric oxide synthase type 1 (NOS1) gene with immunoglobulin E (IgE)‐mediated allergic diseases in the Czech population.

Methods:  The study included 688 subjects – 368 patients with clinically manifested allergic diseases and 320 unrelated controls with negative familial history of asthma/atopy. The NOS1 genotypes were determined by polymerase chain reaction (PCR) and restriction analysis by Eco72I.

Results:  No significant differences were found for allele or genotype frequencies of the 5266 C/T polymorphism in exon 29 of the NOS1 gene between IgE‐mediated allergic diseases (or asthma alone) and healthy subjects. However, this common polymorphism showed a significant association with signs of atopy, especially with total serum IgE levels [loge IgE levels (mean ± SD): CC genotype = 4.34 ± 1.40; CT genotype = 4.58 ± 1.53; TT genotype = 5.01 ± 1.61; P < 0.05).

Conclusions:  Our findings suggest that NOS1 gene may participate in the pathogenesis of high total serum IgE levels in allergic diseases in our population. These findings provide support for NOS1 as a candidate gene for IgE‐mediated allergy.
Sensitization to house dust mites in Reykjavik, Iceland, in the absence of domestic exposure to mites
Authors: Hallas T. E. , Gislason D. , Björnsdottir U. S. , Jörundsdottir K. B. , Janson C. , Luczynska C. M. , Gislason T.
Published: December 2004

Background:  House dust mites are common sources of indoor allergens. In Reykjavik, Iceland, 9% of the young adult population had serum‐specific IgE to Dermatophagoides pteronyssinus. Sensitization to mites is usually assumed to be due to exposure to house dust mites in the indoor environment. This investigation was carried out to measure the concentrations of house dust mite allergens and to investigate which species of mites were present in beds in Iceland.

Methods:  A total of 197 randomly selected adults were visited at home using the European Community Respiratory Health Survey (ECRHS) II Indoor protocol. Dust samples were collected from mattresses for measurement of house dust mite allergen concentrations and to estimate the number and type of house dust mites. Additional samples from mattresses and floors were collected from the homes of 10 patients with positive skin prick tests (SPT) to D. pteronyssinus. House dust mite allergen concentrations were measured using ELISA and examination of mite species was carried out using microscopy. Climatic parameters were assessed using psychrometer readings in the bedrooms and outdoors.

Results:  We found two single mite specimens, both D. pteronyssinus, in two dust samples. Mite allergen analyses indicated that two other dust samples had Der f 1 results close to the cut‐off of 0.1 μg/g of dust. No samples were positive for Der p 1. In an additional collection of dust from the homes of 10 SPT‐positive patients no Dermatophagoides spp. were found.

Conclusions:  Reykjavik citizens are exposed to extremely low amounts of house dust mite allergens in their homes. Possible alternative sources for sensitization are discussed, such as bird nests, exposure from travelling abroad, or other mites or invertebrates that cross‐react with house dust mite allergens. Our findings suggest that exposures other than to house dust mites indoors are possible sources of mite allergen exposure.
Synergy between Tannerella forsythia and Fusobacterium nucleatum in biofilm formation
Authors: Sharma A. , Inagaki S. , Sigurdson W. , Kuramitsu H. K.
Published: December 2004

During dental plaque formation, the interaction of different organisms is important in the development of complex communities. Fusobacterium nucleatum is considered a ‘bridge‐organism’ that facilitates colonization of other bacteria by coaggregation‐mediated mechanisms and possibly by making the environment conducive for oxygen intolerant anaerobes. These studies were carried out to determine whether coaggregation between F. nucleatum and Tannerella forsythia is important in the formation of mixed species biofilms. Further, the role of BspA protein, a surface adhesin of T. forsythia, in coaggregation and biofilm formation was investigated. The results showed the development of synergistic mixed biofilms of F. nucleatum and T. forsythia when these bacteria were cocultured. The BspA protein was not involved in biofilm formation. Though BspA plays a role in coaggregation with F. nucleatum, presumably other adhesins are also involved. The synergistic biofilm formation between the two species was dependent on cell–cell contact and soluble components of the bacteria were not required. This study demonstrates that there is a positive synergy between F. nucleatum and T. forsythia in the development of mixed biofilms and that the cell–cell interaction is essential for this phenomenon.
Multiplex polymerase chain reaction assay for simultaneous detection of black‐pigmented Prevotella species in oral specimens
Authors: Yoshida A. , Tachibana M. , Ansai T. , Takehara T.
Published: December 2004

Prevotella species are a major component of the oral microflora and some have been implicated in various forms of periodontal disease. Despite the importance of understanding the prevalence of these organisms in the oral microflora, no rapid, simultaneous detection system for these species has been reported. This study developed a multiplex polymerase chain reaction assay for the simultaneous detection of four oral black‐pigmented Prevotella species in various oral specimens. This assay will be useful for determining the prevalence of these organisms in the oral ecosystem. Furthermore, this assay system should prove a useful tool for analyzing the role of black‐pigmented Prevotella species in the mouth.
Immunohistological analysis of Tannerella forsythia‐induced lesions in a murine model
Authors: Gosling P. T. , Gemmell E. , Carter C. L. , Bird P. S. , Seymour G. J.
Published: December 2004

Tannerella forsythia has been implicated as a defined periodontal pathogen. In the present study a mouse model was used to determine the phenotype of leukocytes in the lesions induced by subcutaneous injections of either live (group A) or nonviable (group B) T. forsythia. Control mice (group C) received the vehicle only. Lesions were excised at days 1, 2, 4, and 7. An avidin‐biotin immunoperoxidase method was used to stain infiltrating CD4+ and CD8+ T cells, CD14+ macrophages, CD19+ B cells, and neutrophils. Hematoxylin and eosin sections demonstrated lesions with central necrotic cores surrounded by neutrophils, macrophages and lymphocytes in both group A and group B mice. Lesions from control mice exhibited no or only occasional solitary leukocytes. In both groups A and B, neutrophils were the dominant leukocyte in the lesion 1 day after injection, the numbers decreasing over the 7‐day experimental period. There was a relatively low mean percent of CD4+ and CD8+ T cells in the lesions and, whereas the percent of CD8+ T cells remained constant, there was a significant increase in the percent of CD4+ T cells at day 7. This increase was more evident in group A mice. The mean percent of CD14+ macrophages and CD19+ B cells remained low over the experimental period, although there was a significantly higher mean percent of CD19+ B cells at day 1. In conclusion, the results showed that immunization of mice with live T. forsythia induced a stronger immune response than nonviable organisms. The inflammatory response presented as a nonspecific immune response with evidence of an adaptive (T‐cell) response by day 7. Unlike Porphyromonas gingivalis, there was no inhibition of neutrophil migration.
Mutacin production in Streptococcus mutans genotypes isolated from caries‐affected and caries‐free individuals
Authors: Kamiya R. U. , Napimoga M. H. , Rosa R. T. , Höfling J. F. , Gonçalves R. B.
Published: December 2004

Relationships between genetic diversity and mutacin production in Streptococcus mutans were evaluated in 319 clinical isolates from eight caries‐affected and eight caries‐free individuals. The isolates were submitted to mutacin typing and AP‐PCR (arbitrarily primed polymerase chain reaction) assay. The mutacin production was detected for 12 Streptococcus sp. indicator strains. Results showed significant variations in the mutacin production profiles and the inhibitory spectra of both groups. A possible association was seen between mutacin activity and the distinct patterns of Streptococcus sp. colonization in the two groups. Genotyping by AP‐PCR using the primers OPA‐02 and OPA‐13 revealed 101 distinct genotypes against 48 phenotypes identified by mutacin typing. No correlation was observed between the inhibitory spectra of mutacin and genotypic similarities based on AP‐PCR analyses. According to our results, strains of the same S. mutans genotype showed different mutacin profiles, suggesting a high degree of interstrain diversity. In conclusion, mutacin production seems to be of clinical importance in the colonization of S. mutans and is highly diversified in the S. mutans species.
Food allergy as a risk factor for nutritional rickets
Authors: Fox A. T. , Du Toit G. , Lang A. , Lack G.
Published: December 2004

The case of a 14‐month‐old boy with vitamin D deficiency rickets as a result of unsupervised dietary manipulation in the context of cow's milk allergy is presented. Adequate supervision by a qualified dietician, coupled with appropriate supplementation, is essential if nutritional compromise is to be avoided in children with food allergy.
Monocyte switch in neonates: high phagocytic capacity and low HLA‐DR expression in VLBWI are inverted during gestational aging
Authors: Hallwirth Ulrike , Pomberger Gerhard , Pollak Arnold , Roth Erich , Spittler Andreas
Published: December 2004

Pre‐term neonates are at high risk to develop early‐onset sepsis which possibly is caused by an immature immune system. Monocytes play a pivotal role as professional phagocytic and antigen‐presenting cells in the innate immunity. In the present study, we investigated in monocytes from cord blood the expression of human leukocyte antigen (HLA)‐DR as a marker for antigen‐presenting capability, the expression of the high‐affinity receptor for IgG (FcγRI/CD64), and the capacity to phagocytize non‐opsonized Escherichia coli. We compared 70 infants in three groups according to their gestational age (group I: 20 very low birth weight infants (VLBWI), 24–31 weeks of gestation; group II: 25 pre‐term infants, 32–36 weeks of gestation, and group III: 25 term neonates). The expression of CD64 as well as the phagocytic capacity of monocytes from cord blood were highest in VLBWI (p < 0.05 and p < 0.01, respectively). In contrast, HLA‐DR expression was significantly (p < 0.05) diminished in VLBWI, which possibly leads to a reduced antigen‐presenting capacity. We conclude that monocytes have different functional properties during gestational aging, which perhaps participate in the high incidence of infections in VLBWI.
Bronchial asthma and the short‐term quality of life: follow‐up study of childhood bronchial asthma in Hungary
Authors: Szabó Alexandra , Cserháti Endre
Published: December 2004

The aim of our study is to determine and describe the current short‐term health‐related quality of life of recent adult patients who had bronchial asthma in childhood. Our objective was to investigate if symptom control in bronchial asthma could be in conflict with general quality of life. We made a follow‐up study of 152 patients (105 male, 47 female) over the age of 30 (31–55 yr) who were allergic asthmatics in childhood. The patients’ current symptoms and short‐term quality of life were evaluated by a questionnaire. The patients developed asthmatic symptoms by age 4.4 (0.5–13) years on the average. Now 60% (91 persons) have no symptoms. They became symptom‐free between 3 and 41 yr of age (mean = 14.2 ± 8.2). Amongst the currently asthmatic patients (58 patients, 38%), 34 patients (22%) belong to the Global Initiative for Asthma (GINA) I, nine patients (6%) to the GINA II, five patients (3.3%) to the GINA III, and five patients (3.3%) to the GINA IV classification. Five patients (3.3%) did not specify their own symptoms. Three persons (2%) did not answer this question. Symptomatic patients reached 5.28 on the Juniper Asthma Quality of Life Questionnaire, while their asymptomatic peers scored statistically higher with 6.8 on the scale. Amongst the symptomatic patients, the most limited areas were: ‘bothered by heavy breathing’, ‘had to avoid a situation or environment because of dust’, ‘experienced difficulty breathing out as a result of asthma’, ‘experienced asthma symptoms as a result of the weather or air pollution outside’. They were least ‘concerned about medication’, ‘frustrated as a result of their asthma’, they were least limited in ‘going outside because of the weather or air pollution’. The most problematic areas for the symptom‐free patients were ‘had to avoid a situation or environment because of dust’, ‘had to avoid a situation or environment because of cigarette smoke’, ‘experiencing asthma symptoms as a result of being exposed to dust and the ‘need to clear throat’. It seems that having no asthma symptoms is not equal to having a good quality of life for asthmatic patients. Moreover, symptom control in bronchial asthma is in conflict with quality of life, as many prophylactic measures to prevent exposure to allergens also restrict the patient's life.
von Willebrand's disease and psychotic disorders: co‐segregation and genetic associations
Authors: Lee Yu‐Sang , Miller Mary , Hassett Andrea Cortese , Lee‐Kim Byung‐Yeon , Kim Jung Jin , Haracznak Michelle , Ranade Swati , Wood Joel , Reddy Ravinder , Kupfer David J , Bontempo Franklin , Nimgaonkar Vishwajit L
Published: December 2004

Objectives:  To evaluate co‐segregation and genetic associations between von Willebrand's disease (vWD) and psychotic disorders.

Methods:  The study was initiated following ascertainment of a nuclear family in which four members were diagnosed with vWD and psychotic/mood disorders. As co‐segregation was uncertain in the extended pedigree, we also investigated population‐based linkage and association using polymorphisms of vWF, the gene conferring susceptibility to vWD. Three common vWF polymorphisms were investigated among 194 patients with psychotic disorders (bipolar I disorder, BD I; schizoaffective disorder, SZA and schizophrenia, SZ) and their parents. The cases were also compared with unrelated population‐based controls (n = 183).

Results:  The transmission disequilibrium test and related analyses suggested nominally significant transmission distortion of one allele and related haplotypes to the probands from their parents. The most significant results were obtained among patients with BD I, and similar trends were also evident in the SZ sample. Comparisons between the cases and population‐based controls did not reveal associations, though marginally significant case–control differences were obtained in the BD I sample.

Conclusions:  These studies are consistent with association and linkage between vWF and BD I. However, given the relatively small sample, stochastic variation is an alternative explanation.
The analgesic effect of intravenous ketamine and lidocaine on pain after spinal cord injury
Authors: Kvarnström A. , Karlsten R. , Quiding H. , Gordh T.
Published: December 2004

Background:  Pain following spinal cord injury (SCI) is a therapeutic challenge. Only a few treatments have been assessed in randomized, controlled trials. The primary objective of the present study was to examine the analgesic effect of ketamine and lidocaine in a group of patients with neuropathic pain below the level of spinal cord injury. We also wanted to assess sensory abnormalities to see if this could help us to identify responders and if treatments resulted in changes of sensibility.

Methods:  Ten patients with spinal cord injury and neuropathic pain below the level of injury were included. The analgesic effect of ketamine 0.4 mg kg−1 and lidocaine 2.5 mg kg−1 was investigated. Saline was used as placebo. The drugs were infused over 40 min. A randomized, double‐blind, three‐period, three‐treatment, cross‐over design was used. Systemic plasma concentrations of ketamine and lidocaine were assessed. Pain rating was performed using a visual analogue scale (VAS). Sensory function was assessed with a combination of traditional sensory tests and quantitative measurement of temperature thresholds.

Results:  Response to treatment, defined as 50% reduction in VAS‐score during infusion, was recorded in 5/10 in the ketamine, 1/10 in the lidocaine and 0/10 in the placebo groups. Neither ketamine nor lidocaine changed temperature thresholds or assessments of mechanical; dynamic and static sensibility. Nor could these sensory assessments predict response to treatment in this setting. Lidocaine and particularly ketamine were associated with frequent side‐effects.

Conclusion:  Ketamine but not lidocaine showed a significant analgesic effect in patients with neuropathic pain after spinal cord injury. The pain relief was not associated with altered temperature thresholds or other changes of sensory function.
Analgesia and discharge following preincisional ilioinguinal and iliohypogastric nerve block combined with general or spinal anaesthesia for inguinal herniorrhaphy
Authors: Toivonen J. , Permi J. , Rosenberg P. H.
Published: December 2004

Background:  Preincisional ilioinguinal and iliohypogastric nerve block (IINB) reduces postoperative analgesics after inguinal herniorrhaphy. The effect of an IINB on postoperative pain and discharge profile was therefore studied in day‐surgery patients undergoing inguinal herniorrhaphy with general or spinal anaesthesia.

Methods:  Seventy ASA I–II adult patients scheduled for inguinal herniorrhaphy received an IINB before the surgical incision with 15 ml of 0.5% bupivacaine. In a randomized fashion half of them received general anaesthesia with spontaneous breathing via a laryngeal mask (GA‐group) and the other half received spinal anaesthesia with 5 mg of bupivacaine diluted with sterile water to 2.5‐ml volume (SPIN‐group). In the postanaesthesia care unit (PACU), pain was assessed on a scale from 0 to 10 (VAS) and ketorolac 30 mg i.v. (VAS < 5), or fentanyl 0.05 mg i.v. (VAS ≥ 5) was administered as scheduled. In the day surgery unit and at home the analgesic was a tablet of ibuprofen 200 mg + codeine 30 mg (VAS ≥ 3).

Results:  Patients in the SPIN‐group reported lower postoperative pain scores at 30, 60 min (P < 0.0001) and 120 min (P < 0.05) after surgery, and longer time to first analgesic use (P < 0.0001). Patients in the GA‐group had a shorter time to discharge without voiding (P < 0.001) and with voiding (P < 0.05). After discharge, there were no significant differences between the groups regarding pain scores at rest and at walking, or the doses of analgesic. Adverse events were rare in both groups.

Conclusion:  Only a relatively short immediate analgesic benefit could be demonstrated by a combination of IINB with spinal anaesthesia compared with IINB combined with general anaesthesia. The use of general anaesthesia facilitated an earlier postoperative discharge than spinal anaesthesia.
Effects of sodium benzoate on the complications of 1. 5% glycine solution using two different intravesical pressures during bladder irrigation
Authors: Yagmurdur H. , Ceyhan A. , Dagli G. , Yuksel U. , Altunatmaz K. , Ide T. , Unal N.
Published: December 2004

Background:  In this experimental study we researched the effects of sodium benzoate on the complications of 1.5% glycine solution using with two different intravesical pressures during bladder irrigation.

Methods:  Thirty‐six male adult New Zealand rabbits with body weight ranging from 1500 to 2800 g were used in the experiments. The rabbits were randomly allocated to four groups. In groups 1 and 2, 500 ml of 1.5% gylcine was used as irrigating fluid during 30 min, but only group 2 received 500 mg kg−1 of sodium benzoate treatment by oral route immediately after irrigation. In groups 3 and 4, 500 ml of 1.5% glycine was used as irrigating fluid during 60 min, but only group 4 received the same treatment as group 2. Ammonia, urea, sodium, potassium, hemoglobin, hemotocrit and platelet levels were studied at preirrigation and postirrigation on the 4 h and 24 h. Also electrocardiographic (ECG) changes were monitored at the same time with blood parameters.

Results:  At 4 h postirrigation, Na+ levels were decreased significantly in group 1 and non‐significantly in group 3 when compared with preirrigation levels. But these levels were not changed in groups 2 and 4. Both at 4 h and 24 h, ammonia and urea levels were significantly increased in groups 1 and 3. Ammonia level was decreased but the urea level was not changed in groups 2 and 4 at the same time points. K+ level was significantly changed only in group 1 at 4 h and 24 h. Hemoglobin and hemotocrit concentrations were decreased both at 4 h and 24 h compared with preirrigation levels in all groups. Also there were ECG changes between the treated and untreated groups.

Conclusion:  Sodium benzoate was very effective against the complications of 1.5% glycine during bladder irrigation experimentally. But this needs further investigation, especially for the applicability of this new treatment model in human TURP syndrome.
Improved application of Lidocaine/Prilocaine cream in children. A randomized and prospectively controlled study of two application regimes
Authors: Gad L. N. , Olsen K. S. , Lysgaard A. B. , Culmsee M.
Published: December 2004

Summary:  Intravenous cannulation in children aged 6–12  years is less painful after a 90‐min application of a Lidocaine/ Prilocaine cream followed by a 30‐min interval without cream, than cannulation immediately after a 60‐min application.

Background:  Sixty‐min application of an eutectic mixture of 25 mg g−1 Lidocaine and 25 mg g−1 Prilocaine cream is widely used in both adults and children to alleviate pain related to intravenous cannulation. However, studies have shown that this is not the optimal procedure in adults. Inspired by the results from these studies, the aim of the present study was to find an improved application regime for children.

Methods:  In this prospective, randomized, and single‐blind study 60 Caucasian children, aged 6–12 years, presenting for an i.v. cannulation were included. The children were allocated to either a 60‐min application of anaesthetic cream followed by i.v. cannulation (Group A) or to a 90‐min application followed by an interval of 30 min before cannulation (Group B). No sedatives or analgesics were given. The children scored their pain by a faces scale with four faces.

Results:  The i.v. cannulations in Group B were less painful than the cannulations in Group A (Mann–Whitney test, P = 0.01). There was no difference between the two groups as regards problems when performing the cannulations.

Conclusion:  I.v. cannulation after application of anaesthetic cream for 90 min followed by a 30‐min interval is less painful than the widely used 60‐min application directly followed by cannulation.
Changes in diaphragm structure following prolonged mechanical ventilation in piglets
Authors: Radell P. , Edström L. , Stibler H. , Eriksson L. I. , Ansved T.
Published: December 2004

Background:  Prolonged mechanical ventilation and inactivity negatively affect muscle function. The mechanisms for this dysfunction are unclear and clinical studies of respiratory muscle are difficult to carry out. An animal model simulating the critical care environment was used to investigate the effects of 5 days' mechanical ventilation and diaphragm inactivity on diaphragm muscle morphology.

Methods:  Twelve 2–4‐month‐old piglets weighing 23–30 kg were studied. Seven animals received controlled mechanical ventilation and sedation such that spontaneous breathing efforts were inhibited over 5 days. Five control animals were ventilated for only 4–6 h following surgical preparation. Diaphragm biopsies were obtained from the left costal region at the end of all experiments.

Results:  Morphometric, morphologic, electron microscopic and enzyme histochemical examination of costal diaphragm biopsies was carried out. Contractile properties were studied over 5 days and the results have been previously reported.

Cross‐sectional area of alI fiber types was increased compared with controls. The proportion of type IIb/x fibers increased following inactivity (P < 0,05) and the proportion of type I and IIa fibers tended to decrease although not significantly. Focal areas of diaphragm fiber regeneration were found without signs of inflammation. Increased appearance of cytoplasmic vacuoles consisting of lipid accumulation was noted in type I fibers. Several study animals developed focal areas with weak myofibrillar ATPase activity and disrupted fiber organization. There were areas of myofibrillary destruction and loss of sarcomeric pattern, without evidence of selective thick filament loss or a change in the myosin to actin ratio.

Conclusion:  Five days' mechanical ventilation with sedation and complete diaphragm inactivity resulted in changes in muscle fiber structure. A causal relationship can not be concluded but the acute changes in fiber type distribution and structure suggest that previously reported diaphragm contractile impairment occurs at the level of muscle fibers.
Spinal anesthesia for arthroscopic knee surgery
Authors: Gürkan Y. , Canatay H. , Özdamar D. , Solak M. , Toker K.
Published: December 2004

Background and objective:  The purpose of the study was to compare the effects of adding 50 µg of morphine, 25 µg of fentanyl or saline to 6 mg of hyperbaric bupivacaine on postoperative analgesia and time to urination in patients undergoing arthroscopic knee surgery under spinal anesthesia.

Methods:  The study was designed in a prospective, randomized, double‐blinded and placebo‐controlled manner. Sixty ASA I–II patients were randomized into the following three groups: Group BM: 6 mg of bupivacaine and 50 µg of morphine, Group BF: 6 mg of bupivacaine and 25 µg of fentanyl, and Group BS: 6 mg of bupivacaine and saline. Selective spinal anesthesia was performed in a lateral decubitus position, with the operative knee dependent for 10 min.

Results:  In all groups satisfactory anesthesia was provided during the operation. There was a statistically significant difference between all the groups in times to voiding [Group BM 422 ± 161 min; Group BF 244 ± 163 min; Group BS 183 ± 54 min (mean ± SD)]. The incidence of pruritus was significantly greater in Group BM (80%) and BF (65%) in comparison with Group BS (no pruritus) (P < 0.05). The incidence of nausea was significantly increased in Group BM (35%) in comparison with Group BF (10%) and Group BS (P < 0.05). Analgesic consumption was significantly greater in Group BS in comparison with Groups BM and BF (P < 0.01).

Conclusions:  We conclude that during spinal anesthesia even mini‐dose intrathecal morphine is not acceptable for outpatient surgery due to side‐effects, especially severely prolonged time to urination.
Painful neuropathy alters the effect of gabapentin on sensory neuron excitability in rats
Authors: Kanai A. , Sarantopoulos C. , McCallum J. B. , Hogan Q.
Published: December 2004

Background:  Pain following peripheral nerve injury is associated with increased excitability of sensory neurons. Gabapentin (GBP), a novel anticonvulsant with an uncertain mechanism of action, is an effective treatment for neuropathic pain. We therefore investigated the effect of GBP on dorsal root ganglion (DRG) neurons from normal rats and those with painful peripheral nerve injury.

Methods:  Dorsal root ganglions were excised from rats with neuropathic pain behaviour following chronic constriction injury (CCI) of the sciatic nerve, and from normal rats. Intercellular recordings were made from myelinated sensory neuron somata using a microelectrode technique from DRGs bathed in artificial CSF with or without GBP (100 µM).

Results:  Compared with normal neurons, injury decreased the refractory interval (RI) for repeat action potential (AP) generation increased the number of APs during sustained depolariza‐ tion, and shortened the after hyperpolarization following an AP. In normal neurons, GBP decreased the RI and increased the AP number during sustained depolarization. In an opposite fashion, the result of GBP application to injured neurons was a decreased number of APs during depolarization and no change in RI. In injured neurons only, GBP increased the time‐to‐peak for AP depolarization.

Conclusions:  Nerve injury by CCI is associated with increased sensory neuron excitability, associated with a decreased AHP. In normal peripheral sensory neurons, GBP has pro‐excitatory effects, whereas GBP decreases excitability in injured neurons, possibly on the basis of altered sodium channel function.
Biochemical markers for brain damage after carbon monoxide poisoning
Authors: Rasmussen L. S. , Poulsen M. G. , Christiansen M. , Jansen E. C.
Published: December 2004

Background:  Carbon monoxide poisoning is associated with high mortality and a substantial risk for brain damage in survivors. Evidence for acute brain dysfunction may be obtained by measuring concentrations of suitable biochemical markers. We hypothesized that increased serum concentrations of Neuron‐specific enolase (NSE) and S‐100β protein could be detected after carbon monoxide poisoning and that the concentration would correlate with the severity of intoxication.

Methods:  Prospective non‐interventional study in the university hospital. We included 20 patients admitted for hyperbaric treatment due to carbon monoxide poisoning. Serum levels of NSE and S‐100β protein were measured in all patients on admission and after 12, 24, 36 and 48 h. As a control group, we included 20 patients who underwent elective hyperbaric treatment.

Results:  Serum concentrations of NSE and S‐100β protein were not significantly different from the controls, with median values at admission being 10.6 vs. 9.7 µg l−1 and 0.15 vs. 0.13 µg l−1, respectively (P = 0.82 and P = 0.38). The concentrations did not change significantly during the sampling period. We were unable to show any significant relation to level of consciousness.

Conclusion:  Blood concentrations of NSE and S‐100β protein were not significantly increased after carbon monoxide poisoning and do not seem to be related to a history of unconsciousness.
Fiber‐type composition and fiber size of the human cricopharyngeal muscle and the pharyngeal constrictor muscle
Authors: Sundman E. , Ansved T. , Margolin G. , Kuylenstierna R. , Eriksson L. I.
Published: December 2004

Background:  Despite a similar density of nicotinic acetylcholine receptors, the upper esophageal sphincter is sensitive to partial neuromuscular block, whereas the pharyngeal constrictor muscle is more resistant. In order to postulate possible mechanisms behind this difference in pharmacological response, basic knowledge of morphological and physiological features of these muscles is needed. The aim of this study was to compare the muscle fiber‐type composition, the size and the morphology of the muscle fibers of the cricopharyngeal muscle, the main component of the upper esophageal sphincter, with that of the pharyngeal constrictor muscle.

Methods:  Muscle specimens were obtained from five patients undergoing surgery with laryngectomy. Muscle fiber type was determined by myosin heavy chain immunohistochemistry and the muscle fiber cross‐sectional area was measured for each fiber type by planimetry. Morphology of muscle fibers was evaluated by histochemistry.

Results:  The muscle fiber cross‐sectional area was generally smaller in the cricopharyngeal muscle compared with the pharyngeal constrictor muscle (P < 0.001). The composition of fiber types showed a large interindividual variability with no distinct difference between the studied muscles. Aberrant histological features were common in both the cricopharyngeal muscle and the pharyngeal constrictor muscle.

Conclusion:  The main morphological difference between the neuromuscular blocking agents sensitive cricopharyngeal muscle and the more resistant pharyngeal constrictor muscle is a uniformly smaller size of contributing fiber types in the cricopharyngeal muscle than in the pharyngeal constrictor muscle. The muscle fiber‐type composition does not differ between the two studied muscles.
Convulsions on anaesthetic induction with sevoflurane in young children
Authors: Åkeson J. , Didriksson I.
Published: December 2004

Increased worldwide use for paediatric anaesthesia of the volatile anaesthetic agent sevoflurane has mainly resulted from its low blood‐gas partition coefficient and low airway irritability, providing smooth conditions for rapid induction of anaesthesia. Nevertheless, there are several clinical and experimental reports suggesting a correlation between exposure to sevoflurane and generalized clonic or tonic seizure activity. We report two clinical episodes of convulsions associated with the induction of sevoflurane anaesthesia in young children.

Case 1: during induction of anaesthesia with sevoflurane by facemask in a 3‐year‐old healthy boy, there were symmetrical clonic seizure‐like movements of the upper extremities for 60 s. Case   2: on re‐induction of anaesthesia with sevoflurane because of profuse bleeding following nasal adenoidectomy in a 4‐year‐old healthy girl with a family history of epilepsy, there were symmetrical tonic and clonic seizure‐like movements for 30–40 s in the upper and lower extremities. Both episodes ceased spontaneously.

Although no EEG was recorded, it cannot be excluded that both episodes resulted from seizure activity within the CNS. Based on our observations and reports by others we suggest that, until further notice, sevoflurane should be avoided or at least used cautiously in patients where clinical epileptic activity has been verified or is strongly suspected.
Percutaneous tracheostomy: Ciaglia Blue Rhino versus Griggs' Guide Wire Dilating Forceps. A prospective randomized trial
Authors: Añón J. M. , Escuela Ma P. , Gómez V. , Moreno A. , López J. , Díaz R. , Montejo J. C. , Sirgo G. , Hernández G. , Martínez R.
Published: December 2004

Background:  Percutaneous tracheostomy (PT) has gained widespread acceptance to control the airway in patients requiring prolonged mechanical ventilation. Since 1985, new techniques for PT have been described. It was the aim of this investigation to compare two different PT techniques: the Ciaglia Blue Rhino (CBR) and the Guide Wire Dilating Forceps (GWDF).

Methods:  A prospective randomized trial was performed in four intensive care units. After informed consent, 53 consecutive patients were randomized to undergo CBR or GWDF. Procedural complications were evaluated and specific symptoms of the upper airway tract in survivors were assessed.

Results:  Twenty‐seven patients were randomly assigned to CBR and 26 to GWDF. Patients mean ages were 62.7 ± 15.8 years and 62.2 ± 18.3, respectively. Mean APACHE II scores were 20.6 ± 6.8 and 21.2 ± 7.2, respectively. Median duration of the procedure was 7 min (range: 4–17 min) with GWDF and 9 min (range: 5–32 min) with CBR (P = 0.16). Seven patients in the group undergoing GWDF had complications (desaturation: two; mild bleeding: one; infected stoma: one; inability to complete the procedure: three). Two patients had complications in the group undergoing CBR (mild bleeding) (P = 0.07). Survivors were followed up after discharge. Three patients (all of them having undergone GWDF) were symptomatic (two with mild hoarseness and one with a persistent foreign body sensation), but laryngotracheoscopy was negative.

Conclusions:  Our results show no differences between both techniques regarding surgical duration or procedural complications. Late symptoms were encountered in three patients undergoing GWDF, however, laryngotracheoscopy failed to document anatomical or functional abnormalities.
Temperature and phosphate effects on allosteric phenomena of phosphofructokinase from a hibernating ground squirrel (Spermophilus lateralis)
Authors: MacDonald Justin A. , Storey Kenneth B.
Published: December 2004

Temperature effects on the kinetic properties of phosphofructokinase (PFK) purified from skeletal muscle of the golden‐mantled ground squirrel, Spermophilus lateralis, were examined at 37 °C and 5 °C, values characteristic of body temperatures in euthermia vs. hibernation. The enzyme showed reduced sensitivity to all activators at 5 °C, the Ka values for AMP, ADP, NH4+ and F2,6P2 were 3–11‐fold higher at 5 °C than at 37 °C. Inhibition by citrate was not affected whereas phosphoenolpyruvate, ATP and urea became more potent inhibitors at low temperature. While typically considered an activator of PFK activity, inorganic phosphate performed as an inhibitor at 5 °C. Decreasing temperature alone causes the actions of inorganic phosphate to change from activation to inhibition. We found that Km values for ATP remained constant while Vmax dropped significantly upon the addition of phosphate. Phosphate inhibition at 5 °C was noncompetitive with respect to ATP and the Ki was 0.15 ± 0.01 mm (n = 4). The results indicate that PFK is less likely to be activated in cold torpid muscle; PFK is less sensitive to changing adenylate levels at the low temperatures characteristic of torpor, and PFK is clearly much less sensitive to biosynthetic signals. All of these characteristics of hibernator PFK would serve to reduce glycolytic rate and help to preserve carbohydrate reserves during torpor.
Detection and Localization of Two Constitutive NOS Isoforms in Bull Spermatozoa
Authors: Meiser H. , Schulz R.
Published: December 2004

Bull spermatozoa were examined for the presence and localization of constitutive Nitric Oxide Synthase (NOS), as nitric oxide (NO) is involved in calcium‐dependent capacitation. In bull spermatozoa, NO generation is enhanced by l‐arginine (3 μm) and abolished by the NOS‐inhibitor N‐nitro‐l‐arginine methyl ester (l‐NAME). In addition, presence of NOS in bull spermatozoa was verified by immunohistochemistry, revealing the existence of both neuronal NOS (nNOS) and endothelial NOS (eNOS) immunoreaction. These findings were confirmed by Western blot technique, showing immunoreactive bands at 161 kDa (nNOS) and 133 kDa (eNOS). Confocal laser microscopy localized nNOS related immunofluorescence at the acrosome cap of sperms and their flagellum‐mainpart. This technique also identified eNOS staining spread over the spermatozoan head. In conclusion, immunohistochemistry, Western blot technique, and NO generation suggest the presence of n‐ and eNOS in bull spermatozoa.
Development of the Areola in the Early Placenta of the One‐humped Camel (Camelus dromedarius): A Light, Scanning and Transmission Electron Microscopical Study
Authors: Abd‐Elnaeim M. M. M. , Saber A. , Hassan A. , Abou‐Elmagd A. , Klisch K. , Jones C. J. P. , Leiser R.
Published: December 2004

This study aimed to elucidate development of the areola in the early dromedary placenta in comparison with that of the pig and mare. Placental tissues from 25 pregnant camels were obtained from Cairo abattoir and prepared for light, scanning and transmission electron microscopy by routine methods. Vascular casts were made by injection of 4 : 1 liquid plastic mixture of mercox and methylmethacrylate. Areolar formation was first observed at 4.5 cm curved‐crown‐rump CVR length, while by 5–9 cm CVR length, the endometrial surface was uneven and studded with numerous uterine gland openings, where corresponding foetal areolae were barely detectable and the foetal areolar cells were of variable appearance and covered with long microvilli. At 10–13 cm CVR length the uterine gland openings developed irregular folds and the maternal areolar cells showed numerous apical blebs. At 14–29 cm CVR length the foetal areolae showed a great increase in height at the expense of their width. At 30–34 cm (CVR) length the maternal areolae appeared discoid and sharply demarcated from the surrounding inter‐areolar tissues and the foetal areolae were rounded to irregular in shape with well‐developed areolar rims. The vascular casts showed a widely meshed capillary network on the maternal areola, connecting with the pre‐ and post‐capillary vessels, whereas the foetal side showed a relatively dense capillary meshwork. These studies indicate that the areola in the placenta of the one‐humped camel is of the regular type like in the pig, and is poorly vascularized.
Afferent and Efferent Connections of the Nucleus Rotundus Demonstrated by WGA‐HRP in the Chick
Authors: Hu M. , Naito J. , Chen Y. , Ohmori Y. , Fukuta K.
Published: December 2004

Organization of the fibre connections in the chick nucleus rotundus (Rt) was investigated by an axonal tracing method using wheat germ agglutinin conjugated to horseradish peroxidase (WGA‐HRP). After an injection of WGA‐HRP into the Rt, labelled neurones were observed in the striatum griseum centrale (SGC) in both sides of the tectum (TO) and in the ipsilateral nucleus subpretectalis/nucleus interstito‐pretecto‐subpretectalis (SP/IPS). Labelled fibres and terminals were also found in the ipsilateral ectostriatum (Ect). These fibre connections were topographically organized rostrocaudally. In the TO‐Rt projection, the rostral and the dorsocaudal parts of the Rt received afferents from the superficial part of the SGC, the middle part of the Rt received afferents from the intermediate part of the SGC, and the ventrocaudal part of the Rt received mainly fibres from the deep part of the SGC. These topographic projections were accompanied by a considerable number of diffuse projections to the thalamic regions surrounding the Rt. In addition, the rostral and middle caudal parts of the Rt received afferents from the lateral and medial parts of the SP/IPS, respectively, and respective parts of the Rt sent efferents to the lateral and medial parts of the Ect.
Morphological and Histochemical Characterization of the Mucosa of the Digestive Tract in Engraulis anchoita (Hubbs and Marini, 1935)
Authors: Díaz A. O. , García A. M. , Devincenti C. V. , Goldemberg A. L.
Published: December 2004

The histomorphological aspects as well as the histochemical content and distribution of glycoproteins (GPs) in the mucosa of the digestive tract of the anchovy Engraulis anchoita were studied. The buccopharyngeal cavity is lined by a squamous stratified epithelium with mucous superficial cells; the oesophagus shows two zones, cranial with a squamous stratified epithelium with mucous superficial cells and caudal with a columnar secretory epithelium. Finally, the stomach presents both the cranial and pyloric portion lined with a simple columnar epithelium. Tubular branched glands, formed by a single type of glandular cell, located along the stomach, are more numerous in the cranial portion. The GPs were identified with (1) oxidizable vicinal diols; (2) sialic acids and some of their chain variants, C7 or C9; (3) sialic acid residues with O‐acyl substitution at C7 or C8; (4) carboxyl groups and (5) sulphate groups. Histochemical tests showed that the buccopharyngeal cavity presented the largest amount of the different types of mucosubstances. Epithelial secretory cells were found in the oesophagus, which synthesized a large quantity of sialosulphoglycoproteins likely to be related to a protective role. The surface epithelium of the stomach synthesizes and secretes acid and neutral GPs, probably related to the movement of fluids and to the absorption of easily digested substrates, respectively. Although great differences exist between different species, in E. anchoita as in other fish species, the wall of the digestive tract is composed of the four layers classically described for vertebrates. The GPs secreted by the epithelial cells are suggested to be important for the protection and inhibition of microorganisms. In additon, they are involved in enzymatic digestion of food, absorptive functions and lubrication of the alimentary tract.
Morphology and Comparative Anatomy of Circulus Arteriosus Cerebri in Mammals
Authors: Kapoor K. , Kak V. K. , Singh B.
Published: December 2004

The normal configuration of the arterial pattern at the base of the brain in rhesus monkeys, dogs, sheep, goats and rabbits is described. The length and diameter of all vessels of the circulus arteriosus cerebri are measured. Variations are compared in relation to that of the typical pattern present in humans. In rhesus monkeys, dogs and rabbits, the circle of Willis is almost similar to that in human beings except that in these animals, (i) the anterior cerebral arteries join each other to form a single median vessel; (ii) in dogs, rabbits, goats and sheep the anterior cerebellar artery is a branch of posterior cerebral artery, and (iii) in goats and sheep, a considerable length of the internal carotid artery contributes to the formation of circulus arteriosus while the posterior cerebral artery arises from the posterior communicating artery.