bluuebunny/crossref_metadata_2025 huggingface dataset:
Superficial Acral Fibromyxoma: Report of Two Cases
Authors: Kazakov D.V. , Mentzel T. , Burg G. , Kempf W.
Published: April 2003

Superficial acral fibromyxoma (SAFM) is a rare soft tissue tumor that has recently been delineated as a separate entity. We report 2 cases of SAFM and discuss its pathological features and differential diagnosis. Both patients had lesions on the toe. In 1 patient, the tumor was found after nail extraction, which had been performed for the treatment of onychomycosis, whereas in the other patient the tumor itself was the reason for seeking dermatological assistance. Biopsies from both cases demonstrated similar features. There was a moderately circumscribed, non-encapsulated tumor extending through the whole dermis. The neoplasm was composed of spindle and stellate cells with slight nuclear atypia arranged in a loose storiform, partly fascicular growth pattern. In 1 case, strands of cells with rather wavy nuclei were seen at the periphery of the tumor. Mitotic figures were scarce. The neoplastic cells were embedded in a myxoid stroma with increased numbers of small blood vessels and scattered mast cells. Immunohistochemically, the tumor cells showed weak focal positivity for CD34 and stained negatively for S-100 protein and α-smooth muscle actin. In 1 case epithelial membrane antigen (EMA) was negative, whereas in the second case focal expression of EMA by neoplastic cells was seen. Alcian blue staining revealed abundant mucinous material within the stroma. In conclusion, SAFM represents a distinct entity in the spectrum of cutaneous myxoid tumors. The differential diagnosis of SAFM includes various myxoid neoplasms and tumors with a predilection for distal parts of the extremities.
Diagnosing Nonimmediate Reactions to Penicillins by in vivo Tests
Authors: Romano Antonino , Viola Marinella , Mondino Chiara , Pettinato Rosa , Di Fonso Marina , Papa Giuseppe , Venuti Alberto , Montuschi Paolo
Published: April 2003

Background: Maculopapular and urticarial rashes are nonimmediate manifestations common during penicillin treatment; the former often represent cell-mediated hypersensitivity. Our objectives were to assess the incidence of allergy in adults reporting nonimmediate manifestations during penicillin therapy and to evaluate the diagnostic potential of patch tests, delayed-reading skin tests and challenges in such cases. Methods: We used prick and intradermal tests as well as patch tests with penicillin determinants, ampicillin, amoxicillin and any other suspect penicillins. We also performed challenges with the suspect antibiotics. Results: Such antibiotics were aminopenicillins in 93.1% of 259 patients, most of whom had suffered from maculopapular rashes followed by piperacillin (4.2%). Three subjects displayed immediate skin test positivity. Ninety-four subjects showed patch test and delayed intradermal test positivity to the culprit penicillin (90 to aminopenicillins and 4 to piperacillin) and were considered as having had delayed hypersensitivity reactions. Five of the 8 subjects who displayed delayed intradermal test positivity and patch test negativity to the suspect penicillin underwent challenges, 2 reacted positively to the responsible aminopenicillin. Among the remaining 154 with negative results in allergologic tests, 125 agreed to undergo challenges; only 3 reacted. In all, 98 patients – 93 of whom had experienced maculopapular rashes – displayed delayed hypersensitivity (94 to aminopenicillins and 4 to piperacillin). Conclusions: Both patch and intradermal tests are useful in evaluating nonimmediate reactions to penicillins, particularly maculopapular rashes. Patch test and delayed intradermal positivity together indicate delayed hypersensitivity. Intradermal testing appears to be slightly more sensitive than patch testing.
Hypothermia Reduces Neurological Damage in Asphyxiated Newborn Infants
Authors: Compagnoni G. , Pogliani L. , Lista G. , Castoldi F. , Fontana P. , Mosca F.
Published: April 2003

Background: Perinatal asphyxia remains one of the most devastating neurologic processes. There is experimental and clinical evidence that cerebral cooling may suppress the biochemical cascades leading to delayed cerebral damage. Objective: To determine if hypothermia started soon after delivery reduces cerebral damage in term infants. Design/Methods: Retrospective chart analysis with historical controls. Ten asphyxiated newborns treated with hypothermia between October 1998 and October 1999 were compared to 11 asphyxiated newborns admitted from September 1997 to September 1998. Characteristics at birth of infants of the two groups (control and hypothermia) were comparable. After obtaining parental consent, whole-body hypothermia was induced before the 6th hour of life by placing a cold blanket (Polar Air, Augustine Medical Inc., model 600) around the body of the patients. Rectal temperature was maintained between 32 and 34°C for 72 h. Outcome was assessed by neurological evaluation at birth and every 3 months up to the 12th month. Brain MRI was performed in the 2nd month. We had no evidence of severe adverse events related to hypothermia. In the hypothermic group there was a significant (p < 0.05) reduction of major neurologic abnormalities at follow-up and abnormal MRI findings. Conclusions: Hypothermia appears to be safe. Our results on morphological damage evaluated by brain MRI and neurological outcome are encouraging: randomized controlled trials are needed to confirm this experience.
A Comparative Analysis of Brain Size in Relation to Foraging Ecology and Phylogeny in the Chiroptera
Authors: Hutcheon James M. , Kirsch John A.W. , Garland Jr Theodore
Published: April 2003

Variations in total brain mass and in the mass of three brain regions (main olfactory bulb, hippocampus, auditory nuclei) were examined using a data set for 63 species of bats (Chiroptera). Using both conventional and phylogenetically based analysis of covariance (log body mass as covariate), we tested several hypotheses that relate total brain mass or the size of the components to variation in foraging ecology, categorized as phytophagous, gleaner, and aerial insectivore. In some analyses, the category phytophagous was split into phytophagous pteropodid and phytophagous phyllostomid to examine differences between two distinct clades of bats. Because the Megachiroptera orient primarily by vision and olfaction, whereas all other bats rely on laryngeal echolocation to locate their prey, we hypothesized that the former would differ in size of the main olfactory bulb, as compared with all other bats. This hypothesis was supported by our analyses. Our more general prediction was that insectivorous bats, which rely heavily on echolocation for the pursuit and capture of their prey, would have larger auditory nuclei than do phytophagous species. This, too, was supported. We also compared phytophagous (fruit or nectar consuming) bats in two families, the Pteropodidae and the Phyllostomidae. We hypothesized that the phyllostomids, which use echolocation while foraging, would have larger auditory nuclei. Although statistical power is low in phylogenetically informed comparisons of the two clades, we did find weak evidence in support of this hypothesis. We conclude that bat brains show evidence of adaptation to foraging ecology.
Interpersonal Psychotherapy as Augmentation Treatment in Depressed Elderly Responding Poorly to Antidepressant Drugs: A Case Series
Authors: Scocco Paolo , Frank Ellen
Published: April 2003

Background: Medication is often the first choice in the treatment of depression, even though large numbers of depressed patients do not respond to antidepressant drugs or fail to achieve symptom remission or recovery. Generally, other drugs, rather than other therapeutic approaches such as psychotherapy, are used as augmentation treatment. This applies in particular to elderly patients. The aim of this work is to assess whether augmentation with interpersonal psychotherapy (IPT) can bring about symptom remission in depressed elderly responding poorly to medication. Method: Five cognitively intact patients aged over 60 and suffering from major depression were first treated for 6 weeks with a selective serotonin reuptake inhibitor compound. Owing to poor outcome, IPT was added to the treatment. IPT is a brief psychotherapy addressing the interpersonal problems linked to depression, and has been modified for use with elderly patients. Results: All patients achieved symptom remission after a cycle of psychotherapy lasting a minimum of 16 and a maximum of 20 weekly sessions. Conclusions: The methodological limitations of this open study do not allow us to generalize from the positive outcomes. Further studies might confirm these initial observations and establish whether an equally satisfactory therapeutic response can be attained if medication is discontinued after the start of psychotherapy.
Possible Involvement of Toll-Like Receptor 4 in Endothelial Cell Activation of Larger Vessels in Response to Lipopolysaccharide
Authors: Hijiya Naoki , Miyake Kensuke , Akashi Sachiko , Matsuura Keiko , Higuchi Yasunori , Yamamoto Shunsuke
Published: April 2003

Toll-like receptors (TLRs) serve as recognition and signaling elements for bacterial substances. To examine the role of TLRs in endothelial cells of larger vessels in lipopolysaccharide (LPS)-induced signaling, the expression and function of TLRs in human umbilical vein endothelial cells (HUVEC) were analyzed. A high level of TLR4 mRNA expression was found in HUVEC, human peripheral blood mononuclear cells (PBMC) and human monocyte cell line THP-1 cells. Little or no TLR2 mRNA expression was observed in HUVEC. In contrast, strong TLR2 mRNA expression was observed in PBMC and THP-1 cells. Moderate and high levels of TLR1 mRNA expression were found in HUVEC, PBMC and THP-1 cells, respectively. TLR3 mRNA expression was moderate in PBMC but weak in HUVEC and THP-1 cells. Little or no TLR5 and RP105 mRNA expression was observed in HUVEC, whereas a moderate level was detected in PBMC and THP-1 cells. The LPS-induced E-selectin expression in HUVEC was significantly inhibited by pretreatment with an anti-TLR4 mAb. Preincubation of HUVEC with an anti- TLR4 mAb significantly reduced the LPS-induced IL-6 production. LPS induced E-selectin and IL-6 production by HUVEC only in the presence of human serum, suggesting the involvement of soluble CD14. Anti-CD14 mAb strongly inhibited the LPS-induced E-selectin and IL-6 production by HUVEC. The inhibition with the concomitant treatment with anti-TLR4 and anti-CD14 mAbs was stronger than that with anti-CD14 mAb only, although it was slight. These results show that TLR4 in the presence of soluble CD14 plays a major role in the signaling of LPS in endothelial cells of larger vessels.
Cerebrospinal Fluid Phospho-Tau, Total Tau and β-Amyloid1–42 in the Differentiation between Alzheimer’s Disease and Vascular Dementia
Authors: Nägga Katarina , Gottfries Johan , Blennow Kaj , Marcusson Jan
Published: April 2003

The two most frequently examined biomarkers in the diagnosis of dementia are cerebrospinal fluid (CSF) tau and β-amyloid1–42 (Aβ1–42). An assay for tau phosphorylated at threonine 181 (phospho-tau) has recently been developed. We studied these three markers in patients with possible Alzheimer’s disease (AD; n = 23), probable AD (n = 50), AD with relevant cerebrovascular disease (AD with CVD; n = 14), possible vascular dementia (VaD; n = 39), probable VaD (n = 36), cognitively impaired (n = 13) and 27 neurologically healthy controls. Compared with the controls, tau levels were significantly increased in possible AD, probable AD, AD with CVD and probable VaD. Aβ1–42 was decreased in all dementia groups compared with the controls. In contrast, phospho-tau levels were increased only in probable AD compared with the controls. From the results of the present study, it is concluded that neither measurement of phospho-tau, tau nor Aβ1–42 in CSF can discriminate entirely between dementia and cognitively non-disturbed controls or between dementia of different aetiologies in the clinical diagnostic procedure.
Cochlear Dysfunction in Patients with Mitochondrial Myopathy
Authors: Korres Stavros , Balatsouras Dimitrios , Manta Panagiota , Economou Constantinos , Yiotakis Ioannis , Adamopoulos Georgios
Published: April 2003

The present study investigates cochlear function in a group of 11 patients suffering from mitochondrial myopathy with normal or near normal audiometric pure tone thresholds, in most of whom diagnosis was histologically confirmed. A complete ENT, neurologic and audiological work-up, including transiently evoked otoacoustic emissions, was performed in all patients in order to estimate cochlear function. Compared to control subjects, most patients had absent otoacoustic emissions (OAE) in spite of normal hearing, indicating cochlear dysfunction. These findings suggest that subclinical involvement of the cochlea is quite common in patients with mitochondrial myopathy. Damage of the cochlea can be explained on the grounds of its increased metabolic rate, resulting in failure of the stria vascularis and the outer hair cells. Otoacoustic emissions might provide a useful tool in the clinical work-up and follow-up of these patients.
Ultrastructural Morphology of a Middle Ear Ceruminoma
Authors: Schenk Peter , Handisurya Alessandra , Steurer Martin
Published: April 2003

The ultrastructural morphology of a ceruminous gland adenoma in the middle ear was examined electron microscopically. The epithelial tumor cells displayed apocrine caps, microvilli, cell junctions, secretory granules, vacuoles, lipid droplets and siderosomes, which are the characteristic ultrastructural features of apocrine glands. Concentric membranous bodies of the endoplasmic reticulum, phagocytic activity of the tumor cells, intracytoplasmic lumina, ciliated cells and also spiny collagen in the tumor stroma could be seen. The myoepithelial cells are an important tumor marker in the differential diagnosis between ceruminomas and adenomas of the middle ear. The ectopic origin in the modified apocrine ceruminous glands, the specific localization, the clinical features and the extremely rare occurrence of the ceruminoma makes this tumor a unique neoplastic entity.
Expression of Gap Junction Proteins (Connexin 26, 30, 32, 43) in Normal Mucosa, Hyperkeratosis and Carcinoma of the Human Larynx
Authors: Schneider Berit , Teschner Magnus , Sudermann Thomas , Pikula Branko , Lautermann Jürgen
Published: April 2003

Introduction: Gap junction proteins (connexins = Cx) form transmembrane channels and mediate the transfer of small molecules and ions between the cytoplasm of adjacent cells. Most tissues express several Cx isoforms. The precise combination might play an important role in the maintenance of cell differentiation. Human carcinogenesis is accompanied by aberrant expression and function of Cx. While the larynx is a target organ for many tumor promoters, no data on Cx expression in laryngeal mucosa are available. The goal of the study was to observe the expression of different Cx (Cx26, -30, -32 and -43) in the normal mucosa, hyperkeratoses and carcinomas of the human larynx. Method: The immunofluorescence method was performed in normal (n = 7) and dysplastic (n = 6) laryngeal mucosa and in squamous cell carcinoma (n = 7) using affinity-purified polyclonal rabbit antibodies against the 4 Cx isoforms and FITC-conjugated secondary antibodies. Results: The immunofluorescence staining of the normal human vocal fold’s epithelium showed the expression of Cx26 and Cx30 in the parabasal and intermediate layers, whereas Cx43 was localized in the basal, parabasal and lower intermediate layers. Cx epitopes could not be found in the upper layers. The precanceroses showed a similar expression of the Cx compared to normal laryngeal epithelium. Due to the higher degree of staining observed in dysplastic specimens, a hyperexpression of Cx26, -30 and -43 could be assumed. The squamous cell caricnomas were characterized by inhomogeneous staining for Cx26, -30 and -43. Regions of intensive expression alternated with regions of no expression. Cx32 could not be observed by immunofluorescence staining in laryngeal tissue. Conclusion: In immunohistochemical terms, there was no alteration of the expression of Cx isoforms during carcinogenesis in the laryngeal epithelium. These results do not exclude a loss of functional intercellular gap junction communication by posttranslational modifications of Cx isoforms or disturbed Cx integration into the gap junction channel. Further studies should investigate potential defective gap junctional intercellular communication in cancer cells based on molecular studies.
Prelingual Nonsyndromic Hearing Loss in Greece
Authors: Iliades T. , Eleftheriades N. , Iliadou V. , Pampanos A. , Voyiatzis N. , Economides J. , Leotsakos P. , Neou P. , Tsakanikos M. , Antoniadi T. , Konstantopoulou I. , Yannoukakos D. , Grigoriadou M. , Skevas A. , Petersen M.B.
Published: April 2003

Mutations in the gene encoding the gap-junction protein connexin 26 (GJB2) on chromosome 13q11 have been shown as a major contributor to prelingual, sensorineural, nonsyndromic deafness. One specific mutation, 35delG, has accounted for the majority of the mutations detected in the GJB2 gene in Caucasian populations and is one of the most frequent disease mutations identified so far with highest carrier frequency of 3,5% in the Greek population. In a collaboration with the major referral centers for childhood deafness in Greece, patients were examined by an extensive questionnaire to exclude syndromic forms and environmental causes of deafness and by allele-specific PCR for the detection of the 35delG mutation. The 35delG mutation was found in 32.1% of the alleles in 173 unrelated cases of prelingual deafness: 50 homozygotes and 11 heterozygotes. Individuals heterozygous for the 35delG mutation were further analyzed by direct genomic sequencing of the coding region of the GJB2 gene, which revealed R184P and 486insT mutations in single alleles. We conclude that the 35delG GJB2 mutation is responsible for one third of prelingual, sensorineural deafness in Greece, which is higher than the usually quoted 20% for Caucasian populations.
The Visible Ear: A Digital Image Library of the Temporal Bone
Authors: Sørensen Mads S. , Dobrzeniecki Andy B. , Larsen Per , Frisch Thomas , Sporring Jon , Darvann Tron A.
Published: April 2003

High-fidelity computer-based modeling, simulation and visualization systems for the study of temporal bone anatomy and training for middle ear surgery are based on a sequence of digital anatomical images, which must cover a large tissue volume and yet display details in high resolution and with high fidelity. However, the use of existing image libraries by independent developers of virtual models of the ear is limited by copyright protection and low image resolution. A fresh frozen human temporal bone was CT-scanned and serially sectioned at 25 µm and digital images of the block surface were recorded at 50- to 100-µm increments with a Light PhaseTM single-shot camera back attachment. A total of 605 images were recorded in 24-bit RGB resolution. After color correction and elimination of image size variation by differential cropping to 15.4 cm × 9.7 cm, all images were resampled to 3,078 × 1,942 pixels at a final resolution of 50 µm/pixel and stored as 605 one-Mb JPEG files together with a three-dimensional viewer. The resulting complete set of image data provides: (1) a source material suitable for generating computer models of the human ear; (2) a resource of high-quality digital images of anatomical cross sections from the human ear, and (3) a PC-based viewer of the temporal bone in three perpendicular planes of section.
Contact Allergy to Trimers in p-tert-Butylphenol-Formaldehyde Resin
Authors: Zimerson Erik , Sörensen Östen , Bruze Magnus
Published: April 2003

Allergy to p-tert-butylphenol formaldehyde resin (PTBP-F-R) is not rare. More knowledge about the sensitizers in the resin can contribute to the development of diagnosis and prevention. The objective was to study some trimers in PTBP-F-R. Preparative and analytical high-pressure liquid chromatography, nuclear magnetic resonance spectrometry, mass spectrometry and patch testing in patients hypersensitive to PTBP-F-R were used. Four trimers were isolated and identified: 4-tert-butyl-2,6- bis-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxy-methyl)-phenol (XIII), 4-tert-butyl-2-(5-tert-butyl-2-hydroxy-benzyloxymethyl)-6-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-phenol (XIVa), 9,17,25-tri-tert-butyl-27,28,29-trihydroxy-2,3,4,5,12,13,20,21-octahomo-3,5,13,21-tetraoxacalix[3]arene (XVIIa) and 7,15,23-tri-tert-butyl-25,26,27-trihydroxy-2,3,10,11,18,19-hexahomo-3,11,19-trioxacalix[3]arene (XVIII). Six patients hypersensitive to PTBP-F-R were patch tested with serial dilutions of XIII, XIVa, XVIIa and XVIII. Six 6, 1 and 0 patients reacted positively to XIII, XIVa, XVIIa and XVIII, respectively. No control patient reacted positively to XIII or XIVa. Positive patch test reactions were seen down to 0.025 mmol × 1–1 for XIII and XIVa. The study shows that XIII and XIVa are allergens in PTBP-F-R and strongly argues that XVIIa is also one.
Association Study for Parkinson’s Disease and a Dopamine Transporter Gene Polymorphism (1215A/G)
Authors: Lin Chien-Nan , Liu Hsiu-Chih , Tsai Shih-Jen , Liu Tsung-Yun , Hong Chen-Jee
Published: April 2003

The dopamine transporter (DAT) may play a role in the pathogenesis of Parkinson’s disease (PD) because dopamine-specific neurotoxins are taken into dopaminergic nerve terminals via the DAT. A recent study has demonstrated that a DAT polymorphism in exon 9 (1215A/G) is associated with susceptibility to PD. This finding was not replicated by another study, however. Therefore, the significance of this association was tested using a Chinese sample population consisting of 102 PD patients and 174 controls, together with the association for onset age. Comparing the two groups, neither the genotypic (p = 0.272) nor allelic frequencies (p = 0.209) were statistically different. Further, the mean onset age was not significantly different for PD patients comparing the DAT genotypes (p = 0.925). Our findings confirm those of the previous negative report and, taken together, suggest that the DAT polymorphism (1215A/G) does not play a major role in the susceptibility to PD. Other DAT genetic variants, and the association of these variants with PD symptomatology or treatment response, may merit further investigation.
Conjunctival Rotation Autograft for Primary Pterygium
Authors: Alp Banu N. , Yanyali Ates , Ay Gulten Manav , Keskin Ozcan
Published: April 2003

Purpose: To evaluate the safety and effectiveness of conjunctival rotation autograft technique in preventing the recurrence of primary pterygium. Methods: In this prospective study, 24 eyes of 24 consecutive patients with primary pterygium were evaluated. Conjunctival rotation autograft technique, which involved the removal of the underlying fibrovascular pterygium tissue and replacement of the original epithelium over the bare sclera with a 180° rotation was performed in all eyes. Results: Patients were 34–70 years of age (mean, 52.8; SD = 10.5). During the mean follow-up of 15.9 months (range, 12–23 months; SD: 4.0), 4 recurrences (16.6%) were observed. Neither intraoperative nor postoperative complications were encountered except for recurrences and 3 suture openings, which were re-sutured postoperatively without further complications. Conclusion: Conjunctival rotation autograft technique appears to be effective and safe in preventing the recurrence of primary pterygium. A prospective randomised trial comparing conjunctival rotation autografting with other adjunctive procedures in addition to simple pterygium excision is required to determine its effectiveness.
Evaluating Genetic Heterogeneity in Complex Disorders
Authors: Pal Deb K. , Greenberg David A.
Published: April 2003

Objectives: The Admixture test is routinely used in linkage analysis to take account of genetic heterogeneity, and yields an estimate of the proportion of families (α) segregating the linked disease gene. In complex disorders, the assumptions of the Admixture test are violated. We therefore explore how the estimate of α relates to the true proportion of linked families with a complex disorder in a population or dataset. Methods: We simulated a two-locus heterogeneity model and varied genetic parameters, ascertainment scheme and phenocopy frequency. Results: In this model, α is almost always overestimated, by as little as 5% to as much as 60%. The bias is largely attributable to (1) intrafamilial heterogeneity arising from ascertainment of families with many affected members or from analysis of dense pedigrees; (2) low informativeness, which occurs in the presence of reduced penetrance; and (3) differences in the evidence for linkage in linked and unlinked families. This bias is also affected by the analysis phenocopy frequency, but only if the linked locus is dominant and the unlinked locus is recessive. Conclusions: We conclude that, in complex diseases, the Admixture test has greater value in detecting linkage than in estimating the proportion of linked families in a dataset.
Log-Linear Models for Gene Mapping with Affected Sib Pair Data
Authors: Yang Yaning , Ott Jürg
Published: April 2003

In genome-wide screens of genetic marker loci, non-mendelian inheritance of a marker is taken to indicate its vicinity to a disease locus. Heritable complex traits are thought to be under the influence of multiple possibly interacting susceptibility loci yet the most frequently used methods of linkage and association analysis focus on one susceptibility locus at a time. Here we introduce log-linear models for the joint analysis of multiple marker loci and interaction effects between them. Our approach focuses on affected sib pair data and identical by descent (IBD) allele sharing values observed on them. For each heterozygous parent, the IBD values at linked markers represent a sequence of dependent binary variables. We develop log-linear models for the joint distribution of these IBD values. An independence log-linear model is proposed to model the marginal means and the neighboring interaction model is advocated to account for associations between adjacent markers. Under the assumption of conditional independence, likelihood methods are applied to simulated data containing one or two susceptibility loci. It is shown that the neighboring interaction log-linear model is more efficient than the independence model, and incorporating interaction in the two-locus analysis provides increased power and accuracy for mapping of the trait loci.
The Effect of Intrathecal Baclofen on Muscle Co-Contraction in Children with Spasticity of Cerebral Origin
Authors: Sgouros S. , Seri S.
Published: April 2003

Aim: Investigation of the effect of intrathecal baclofen administration on the time course of electrical patterns of muscle activation in patients with spasticity due to upper motor neuron syndrome. Methods: Six children with clinical signs of upper motor neuron syndrome resulting from an acquired cerebral hypoxic injury were tested. Simultaneous multichannel acquisition of surface EMG activity from flexor/extensor muscle groups of the upper and lower limbs was recorded. Investigated muscle group pairs included biceps/triceps brachii, wrist flexors/extensors, rectus/biceps femoris and tibialis anterioris/gastrocnemius. Time-frequency analysis of EMG activity at rest and while eliciting a stretch reflex was performed. The non-linear cross-correlation coefficient and time lag estimation were computed between paired channel groups both for baseline and post-intrathecal baclofen injection conditions for epochs consisting of 2 s prior to and 2 s after voluntary contraction. The effect of baclofen was assessed 3 h following single-bolus intrathecal injections of 25 or 50 µg during the baclofen trial and 6 months after baclofen pump implantation. Results: In the baseline condition, the stretch reflex resulted in a synchronous increase in spectral EMG power in both the agonist and the antagonist muscles. The mean correlation coefficient between agonist and antagonist muscles was 0.948 (SD = 0.034), and the mean time lag was 4.64 ms (SD = 1.84 ms). After intrathecal administration of baclofen, a dramatic decrease in the correlation coefficient between agonist and antagonists (mean value = 0.342) during voluntary contraction was observed. This corresponded to a significant reduction of tone and spasticity in all four limbs, and reduction of the Ashworth score by 2 points on average. Conclusion: After intrathecal baclofen administration, we observed a significant decrease in the co-contraction pattern typically associated with upper motor neuron spasticity. This was evident clinically and was quantitatively expressed by the significantly decreased degree of coupling in EMG activity of agonist/antagonist muscles. Although a relatively small sample was investigated in this study, we were able to demonstrate the efficacy of this procedure in restoring selective activation of agonists during voluntary contraction. This is one of the prerequisites of an improvement of motor function in patients with spasticity.
Investigations for Fine Mapping of Amplifications in Chromosome 3q26.3–28 Frequently Occurring in Squamous Cell Carcinomas of the Head and Neck
Authors: Riazimand Seyed H. , Welkoborsky Hans-J. , Bernauer Hubert S. , Jacob Roland , Mann Wolf J.
Published: April 2003

Objective: Overrepresentations of chromosomal material on the long arm of chromosome 3 frequently occur in squamous cell carcinoma of the head and neck. This experimental study was conducted for further fine mapping of these overrepresentations by interphase fluorescence in situ hybridization (FISH) of tumor cells in cell lines. Methods: Seven cell lines derived from squamous cell carcinomas of the head and neck were investigated by comparative genomic hybridization to analyze unbalanced chromosomal aberrations. Overrepresentations of chromosomal material on the telomeric part of the long arm of chromsome 3 were further analyzed by interphase FISH using YAC contig clones. Results: Chromosomal aberrations which frequently occurred were overrepresentations on 5p (n = 4), 7p (n = 5), 11q13 (n = 3), 15q (n = 5), 17q (n = 3), 19q (n = 2), 20q (n = 2) and 22q (n = 3). Reoccurring losses of chromosomal material were found in 3p (n = 3), 7q (n = 2), 18q (n = 3) and 19p (n = 2). Gains of chromosomal material on chromosome 3q were found in 4 out of 7 cell lines, with a high copy number of amplifications occurring in the chromosomal region of 3q26.3–28. Further experiments revealed a physical mapping of this amplification to a narrow band of 13.8 Mbp on chromosome 3q, whose amplification borders were represented by the YAC clones 754_f_3 centomeric and 955_b_2 telomeric. Conclusions: By FISH, the amplification of chromosomal material on 3q could be fine mapped on a narrow band on 3q26.3–27. This aberration can be considered as a breakpoint in tumorigenesis. Putative candidate oncogenes and tumor suppressor genes located in this region might be a target for mutations leading to tumor progression.
Symptom Structure in Schizophrenia: Two-, Three- or Four-Factor Models?
Authors: Dollfus S. , Everitt B.
Published: April 2003

Beside the syndromic dichotomy (negative-positive), other symptomatic dimensions have been described in schizophrenia. A question of interest is, therefore, to know which symptom structures can be individualized to characterize schizophrenia. Using confirmatory factor analysis in 135 patients, a two-factor model (negative-positive), a three-factor model (negative-positive-disorganization) and a four-factor model (negative-positive-disorganization-relational) were primarily identified with SANS (Scale for the Assessment of Negative Symptoms) and SAPS (Scale for the Assessment of Positive Symptoms). In contrast, no models could be identified with PANSS (Positive and Negative Syndrome Scale). The results confirm the relevance of other syndrome dimensions, beside the negative and positive ones and suggest that SANS-SAPS was more useful than PANSS in identifying an adequate dimensional factor structure of schizophrenic symptoms.
On the Validity of the Beck Depression Inventory
Authors: Richter Paul , Werner Joachim , Heerlein Andrés , Kraus Alfred , Sauer Heinrich
Published: April 2003

The present review discusses validity aspects of the Beck Depression Inventory (BDI) on the basis of meta-analyses of studies on the psychometric properties. Shortcomings of the BDI are its high item difficulty, lack of representative norms, and thus doubtful objectivity of interpretation, controversial factorial validity, instability of scores over short time intervals (over the course of 1 day), and poor discriminant validity against anxiety. Advantages of the inventory are its high internal consistency, high content validity, validity in differentiating between depressed and nondepressed subjects, sensitivity to change, and international propagation. The present paper outlines agreements and contradictions between the various studies on the BDI and discusses the potential factors (composition of the subject sample, statistical procedures, point in time of measurement) accounting for the variance in their results.
Management of Chronic Kidney Disease in an Academic Primary Care Clinic
Authors: Israni Ajay , Korzelius Cynthia , Townsend Raymond , Mesler Douglas
Published: April 2003

Background: Three million people in the United States are estimated to have chronic kidney disease (CKD). Management of these CKD patients in the outpatient primary care clinic setting has not been well studied. Hypothesis: Primary care management of CKD can be assessed and opportunities for improvement can be identified. Methods: Management of CKD based on available published literature and guidelines was assessed in a single primary care site of an academic hospital with 23,000 annual visits and 8,300 patients. Charts of patients seen between October 1, 1997 and March 25, 1999 with an elevated SCr ≧1.7 mg/dl on two separate measurements at least 6 months apart were reviewed for predefined indicators of CKD management. Results: Assessment identified several aspects of CKD management to be suboptimal: control of blood pressure, use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, assessment of proteinuria, and renal consultation. Better management was found with respect to hemoglobin A1c measurement for diabetic patients. In general, CKD care was similar for diabetic and non-diabetic patients. CKD management was also similar regardless of level of creatinine clearance (≧50 vs. 50–30 vs. ≤30 ml/min). Conclusion: CKD care can be measured in an outpatient academic primary care clinic and opportunities to improve were identified.
Association of Mannan-Binding Lectin Deficiency with Venous Bypass Graft Occlusions in Patients with Coronary Heart Disease
Authors: Limnell Vilho , Aittoniemi Janne , Vaarala Outi , Lehtimäki Terho , Laine Seppo , Virtanen Vesa , Palosuo Timo , Miettinen Ari
Published: April 2003

We investigated the effect of mannan-binding lectin (MBL) deficiency on the susceptibility to bypass graft occlusion in 62 patients with coronary heart disease. MBL deficiency appeared to be associated with occlusion (p = 0.0099). A high level of anti-cardiolipin IgG as well as the number of venous bypass grafts were also involved (p = 0.0018 and p = 0.0104, respectively). Since early occlusion (<5 years after surgery) of a venous bypass graft is considered to be caused by thrombosis or fibro-intimal hyperplasia superimposed by thrombosis, our finding also implies an association of MBL deficiency with thrombotic events. It remains unclear whether the previously confirmed effect of MBL deficiency in coronary disease is mediated through this possible thrombotic mechanism, or whether plaque formation is also involved in the process. Further studies are clearly warranted.
Morphologic Characteristics of Aortic Valve Sclerosis by Transesophageal Echocardiography: Importance for the Prediction of Coronary Artery Disease
Authors: Tolstrup Kirsten , Crawford Michael H. , Roldan Carlos A.
Published: April 2003

Aortic valve sclerosis (AVS) is associated with myocardial infarction and mortality. Since it is not cost effective to test all patients with AVS for coronary artery disease (CAD), the identification of high-risk patients is important. We developed a morphologic classification system for AVS by transesophageal echocardiography and correlated the subtypes of AVS with the presence of cardiovascular disease. AVS in general was not associated with CAD. However, among patients with mixed nodular and diffuse AVS, the prevalence of CAD and previous coronary artery bypass graft surgery were higher than among those without this mixed type (p = 0.02 and 0.008, respectively). We concluded that the finding of mixed nodular and diffuse AVS identifies patients at increased risk for CAD. Thus, the echocardiographic assessment of AVS morphology is of clinical relevance.
Influence of Uremia on Cell Viability and Cytokine Release of Human Peritoneal Mesothelial Cells
Authors: Plum J. , Fleisch M.C. , Razeghi P. , Fusshöller A. , Lordnejad M.R. , Grabensee B.
Published: April 2003

Introduction: There is still no evidence whether human peritoneal mesothelial cells (HPMC) from patients with end-stage renal failure are altered in cell viability or show a different pattern of the release of proinflammatory cytokines. Also the serum of patients with uremia may contain substances stimulating the cytokine release of HPMC. Study Design: The IL-1β-induced IL-6/IL-8 release of HPMC from healthy donors and from patients with end-stage renal disease (ESRD) were measured before the start of chronic peritoneal dialysis (PD) and during PD therapy. Additionally the influence of uremic and non-uremic serum on IL-6 and IL-8 release of normal HPMC was studied. Cell viability was assessed by MTT assay and by the measurement of intracellular ATP (chemoluminescence assay). HPMC were obtained from the following patient groups: (1) non-uremic control patients (n = 7); (2) patients with ESRD undergoing PD catheter implantation for the first time (n = 7), and (3) patients on PD undergoing catheter exchange for noninfectious reasons (n = 6). Pooled human serum from PD patients and normal controls were used for stimulation experiments. HPMC from different donors were grown to confluence (second passage) and then stimulated with IL-1β (1,000 pg/ml in M199) for 24 h. IL-6 and IL-8 concentrations were measured in the supernatant by ELISA. Additionally uremic and non-uremic sera were incubated with HPMC from normal donors for 24 h with a subsequent 24-hour IL-1β stimulation. Mesothelial cell protein mass was determined by the Bradford reagent. Results: Non-uremic patients and ESRD patients did not differ with regard to the global cell viability of HPMC according to MTT assay activity or the intracellular ATP concentration. However, HPMC from uremic patients produced more IL-8 on IL-1β stimulation than the non-uremic controls (group 2, 53.5 ± 15.7 pg/µg; group 3, 70.5 ± 27.3 pg/µg vs. group 1, 24.0 ± 11.8 pg/µg). HPMC from patients on chronic PD additionally released significantly more IL-6 (30.5 ± 13.8 pg/µg) on IL-1β stimulation than uremic patients before the onset of PD (6.2 ± 2.6 pg/µg; p < 0.01). Incubation of normal HPMC with the serum from uremic donors produced an enhanced stimulated IL-8 release compared to the exposition with normal control serum (50.6 ± 6.1 vs. 20.8 ± 2.9 pg/µg; p < 0.01). Conclusion: HPMC from uremic patients more readily release IL-8 on stimulation with IL-1β. On chronic PD treatment IL-6 release was further enhanced. Not further classified serum components in uremia also enhance IL-6 and IL-8 release of HPMC.
Chromosome banding in Amphibia
Authors: Schmid M. , Ziegler C.G. , Steinlein C. , Nanda I. , Haaf T.
Published: April 2003

The mitotic chromosomes of an Ecuadorian population of the marsupial frog Gastrotheca espeletia were analyzed by means of banding techniques and fluorescence in situ hybridization. This species is characterized by unusual supernumerary (B) chromosomes. The maximum number of B chromosomes is 9 and they occur in three different morphological types. Banding analyses show that the B chromosomes are completely heterochromatic, consist of AT base pair-rich repeated DNA sequences, replicate their DNA in very late S-phase of the cell cycle, and are probably derived from a centromeric or paracentromeric region of a standard (A) chromosome. Exceptionally, the B chromosomes carry 18S + 28S ribosomal RNA genes and the conserved vertebrate telomeric DNA sequence appears to be underrepresented. Flow cytometric measurements of the nuclear DNA content differentiate between individuals with different numbers of B chromosomes. Significantly more B chromosomes are present in female than in male animals.
Identification and characterization of murine Brunol4, a new member of the elav/bruno family
Authors: Meins M. , Schlickum S. , Wilhelm C. , Mißbach J. , Yadav S. , Gläser B. , Grzmil M. , Burfeind P. , Laccone F.
Published: April 2003

RNA-binding proteins are involved in post-transcriptional processes like mRNA stabilization, post-transcriptional modification, and transport and have been suggested to play an important role in developmental gene regulation. We report here the cloning and characterization of Brunol4, a novel mouse cDNA closely related to the elav-type family of genes encoding for RNA-binding proteins and a subfamily recently named after the bruno gene of Drosophila. Murine Brunol4 is localized near the centromere of chromosome 18. The cDNA sequence of Brunol4 is separated by 12 introns and the size of Brunol4 may be around 250 kb due to the large size of several introns. Brunol4 expression is detectable in the developing embryo and, later on becomes mainly restricted to cerebral structures, in particular the cerebellum where it persists in the adult organism. We predict a role of Brunol4 and the respective human homologue in differentiation and maintenance of neuronal structures.
APOE Genotype, Memory Test Performance, and the Risk of Alzheimer’s Disease in the Canadian Study of Health and Aging
Authors: Klages Jennifer D. , Fisk John D. , Rockwood Kenneth
Published: April 2003

Objective: This study examined the relation between two risks for Alzheimer’s disease (AD): the apolipoprotein (APOE) Ε4 allele and poor memory test performance. Methods: In the Canadian Study of Health and Aging (CSHA), a 5-year longitudinal population-based study that screened and followed over 10,000 participants, 2,914 had an initial clinical assessment and 1,624 had APOE genotype testing. All participants were categorized as having no cognitive impairment, cognitive impairment but no dementia, or dementia at both baseline and follow-up. We examined those (n = 209) with a complete neuropsychological assessment at baseline and no evidence of cognitive impairment who had either APOE Ε3/Ε3 or Ε3/Ε4 genotypes and who had a clinical consensus diagnosis of either no cognitive impairment or AD at follow-up. Delayed free recall memory was evaluated at CSHA-1 with the Buschke Cued Recall Test (BCRT). Results: The risk of AD at follow-up was increased for participants with an APOE Ε3/Ε4 genotype when memory test performance was not considered, but logistic regression demonstrated that a model which also considered baseline memory test performance was more predictive of AD. In the more complete model, reduced BCRT free recall scores were associated with an increased risk of AD, whereas the risk associated with the APOE Ε3/Ε4 genotype was no longer significant. Conclusions: For those with no evidence of cognitive impairment, drawn from a population-based sample of elderly persons, the APOE Ε3/Ε4 genotype was only associated with an increased risk of AD after 5 years if their memory test performance was relatively poor at baseline. Regardless of the APOE genotype, and in the absence of clinical evidence of cognitive impairment, reduced scores on a test of delayed free recall at baseline was associated with an increased risk of AD after 5 years.
Validity and Applicability of the Chinese Version of Community Screening Instrument for Dementia
Authors: Chan Teresa S.F. , Lam Linda C.W. , Chiu Helen F.K. , Prince Martin
Published: April 2003

The development of an educationally independent screening instrument for dementia is most valuable for epidemiological studies. The Community Screening Instrument for Dementia (CSI-D) was applied to 120 subjects, with 30 matched for age in each of the four groups of mild to moderately demented, depressed, low-education and high-education normal control subjects. The internal consistency and interrater reliability of CSI-D were satisfactory. Correlation with the ten-word-list learning task, a test sensitive to early dementia, was high. CSI-D could differentiate the demented from nondemented subjects, but not the high- from the low-education control group. Receiver operating characteristic analysis showed good test performance of CSI-D. In conclusion, the Chinese version of CSI-D is a valid, reliable and educationally independent screening instrument for dementia sensitive to detect early stage of the disease.
Knowledge and Attitudes of Hispanic Women and Their Health Care Providers about Breast Cancer Risk Factors and Screening
Authors: Strecker Michelle N. , Williams Aimee J. , Bondy Melissa , Johnston Dennis A. , Northrup Hope
Published: April 2003

Objectives: The purpose of our study was to develop and evaluate an educational program for health care providers and patients on the topics of general breast cancer risk factors, breast cancer genetics, and breast cancer screening recommendations. The program was designed with specific emphasis on addressing the needs of medically underserved Hispanic women in Southern Texas. We also identified and compared perceptions of potential barriers to breast cancer screening. Methods: The educational program was piloted with patient and health care provider focus groups. After incorporating modifications suggested by the focus groups, 103 patients and 94 health care providers (HCPs) from community health clinics in Harris County, Tex., were recruited to participate in the study. Changes in knowledge were measured through the use of pre- and postseminar questionnaires. Results: The program identified various misconceptions about breast cancer in representative groups of patients and HCPs. Comparison of pre- and post-test scores indicated that both groups made significant gains in knowledge about breast cancer and breast cancer screening. Participant evaluations indicated that the seminar was informative and interesting. Both patients and HCPs agreed that the cost of breast cancer screening and the lack of sufficient bilingual HCPs were ‘major’ barriers to obtaining breast cancer screening, but had differing opinions regarding other potential barriers. Conclusions: We have developed an effective method of education about breast cancer risk factors and screening for two groups: Hispanic women of lower educational and socioeconomic levels, and the HCPs who serve them. Based on the successful reception of our program, we propose extending it to other areas of Texas with demographics similar to those of the study population.