bluuebunny/crossref_metadata_2025 huggingface dataset:
Spiegler-Karzinome mit assoziierten Symptomen
Authors: Greither A. , Rehrmann † A.
Published: November 2009

The report concerns a southern Italian female patient of – at her death – 67 years, who developed in 1975 within several months Spiegler basaliomas of the scalp. The tumors increased in size and number, and developed immediately to dedifferentiated, relapsing, metastasizing and finally lethal tumors which resisted to each therapy. Histologically only the structural rests of Spiegler basaliomas could be seen, but the cellular picture demonstrated completely dedifferentiated carcinomas. In this observation there was no dominant inheritance, as it is known in Spiegler basaliomas. The late manifestation of the tumors with immediate malignancy, the lacking affection of other members of the family, the high familiar incidence of internal carcinomas, and, finally, the combination with other associated symptoms (brachydactyly, racket nails, the latter ones also in the mother) revealed this disorder as a new syndrome of Spiegler carcinomas with associated symptoms.
Cutaneous-Mucous Infection with Lymphadenopathy Caused by Mycobacterium chelonei
Authors: Zina A.M. , Depaoli M. , Bossano A.F.
Published: November 2009

A 61-year-old man presented with an eruption of papulonodular lesions on the glans and discharging bilateral inguinal lymphadenopathy. The lesions sprang up as a consequence of urethral dilatations. Mycobacterium chelonei was isolated from the inguinal discharge, while acid-fast bacteria were detected microscopically in a biopsied nodule. The pathogenesis of this infection is discussed.
The Content of Trace Elements (Cu, Zn, Fe, Mg) in Fingernails of Children
Authors: Alexiou D. , Koutselinis A. , Manolidis C. , Boukis D. , Papadatos J. , Papadatos C.
Published: November 2009

The concentrations of Cu, Zn, Fe and Mg in fingernails of 212 normal children, 109 males and 103 females, 6–11 years old, were determined by atomic absorption spectroscopy. A wide scatter of results in all trace element determinations in fingernails was found. Nevertheless, it was noted that the petrographical composition of the region influences the trace element concentration in fingernails. An age variation was observed for Cu and Fe. Nail concentrations of the same trace elements were significantly higher in male than in female children.
Treatment of Verruca plana with 5% 5-FIuorouraciI Ointment
Authors: Lee Sungnack , Kim Joong-Gie , Chun Soo Il
Published: November 2009

11 patients with verruca plana were treated with 5% 5-Fluorouracil ointment as a twice daily topical application with open dressing. The patients were chosen among those who failed to be cured with various topical agents such as salicylic acid, vitamin A acid and dinitrochlorobenzene (DNCB), or even with carbon dioxide cryotherapy, oral administration of methotrexate and intramuscular injection of sodium cacodylate. In 9 patients, all the treated warts completely disappeared within 3–5 weeks. 2 of these patients had recurrence after 3 weeks and 2 months, respectively. In 2 patients, some lesions disppeared while others failed to be healed. The major clinical adverse reactions were hyperpigmentation (8 cases), erythema (5 cases) and erosion (5 cases).
Two Cases of Penicillamine-Induced Pemphigus Erythematosus
Authors: Thorvaldsen Johannes
Published: November 2009

2 women, 62 and 69 years old, both suffering from rheumatoid arthritis, were treated for 1 and 1½ years, respectively, with penicillamine. Both developed a bullous eruption which according to clinical and histological picture, immunofluorescence studies and to light provocation, as well as in 1 case to antinuclear antibody findings corresponded to pemphigus erythematosus. In spite of treatment with prednisone and azathioprine, they still keep developing bullae.
Intranuclear Particles in Keratoacanthoma: Possible Association with Malignant Degeneration
Authors: van de Staak W.J.B.M. , Bergers A.M.G.
Published: November 2009

Electron microscopic investigation of 12 patients with keratoacanthoma is reported. Intranuclear virus-like particles, as described by Zelickson and Lynch, were seen in 3 cases; 2 of these subsequently underwent malignant degeneration. These findings suggest that it is particularly important to exclude the possibility of malignant change in those tumours when intranuclear particles are found.
Electron Microscopy in the Early Diagnosis of Genetic Disorders of the Skin
Authors: Anton-Lamprecht I.
Published: November 2009

Electron microscopy is shown to represent an effective tool in the early diagnosis of genetic disorders. On the basis of ultrastructural findings in various dominant and recessive types of ichthyoses and epidermolyses, defects of structural proteins of the skin proved to form the main intrinsic pathogenetic feature of some dominantly inherited types whereas quantitative impairments characterize their closely resembling recessive counterparts. Most of the diseases concerned severely disable the involved patients. Early diagnosis is therefore of high importance. In those cases where an exact diagnosis in newborn children is difficult or impossible with respect to their clinical features, electron microscopy provides the clinician with reliable and significant criteria to differentiate between closely resembling entities.
pH Effect on the Percutaneous Penetration of Lignocaine Hydrochloride
Authors: Menczel Efraim , Goldberg Sarah
Published: November 2009

(1) The percutaneous penetration of lignocaine hydrochloride is affected in vitro by the pH; alkalinity increased the portion of the unionized drug which permeated through the lipoid outer skin membrane of guinea pigs. (2) The amount of lignocaine accumulated on the dermal side of the diffusion cell containing isotonic phosphate buffer (pH 7.4) was directly proportional to the initial concentration of the applied drug at the alkaline pH. (3) The dermal transfer rates of lignocaine into the isotonic phosphate buffer (pH 7.4) of the diffusion cell decreased with the increase in the pH of the initially applied solution on the epidermal side of the diffusion cell; the simultaneous cutaneous penetration of the alkaline buffer promoted retention of the unionized drug in the dermis. (4) Percutaneous penetration of lignocaine hydrochloride represents a dual-stage process involving dissimilar rates of clearance into cutaneous tissue and transfer from dermis to body fluids. Variations in the alkaline pH of lignocaine hydrochloride solution appear to govern the rate-limiting factor of the total percutaneous penetration; the pharmacologic action of lignocaine may thus be localized.
Intradermal Triamcinolone Treatment of Psoriatic Onychodystrophy
Authors: Bedi T.R.
Published: November 2009

Intradermal injections of triamcinolone acetonide have been used in the treatment of psoriatic onychodystrophies in seven patients. The therapeutic response initially is good but relapses appear inevitable. One patient developed rather persistent periungual hypopigmentation, thereby limiting the routine recommendation of this form of treatment.
Comparative Ultrastructural Study of Mast Cells in Mastocytoma and Mastocytosis
Authors: Ludatscher R.M. , Haim S. , Gellei B. , Cohen A.
Published: November 2009

The ultrastructural aspects of mast cells from skin lesions in 2 patients with mastocytoma were compared to those from lesions in 4 patients with mastocytosis, 3 with cutaneous and 1 with systemic involvement. In mastocytoma, the mast cells accumulated in a large mass. They revealed short cytoplasmic villi and were similar, morphologically, to mast cells of normal skin and gingiva. In the diffuse types of the disease, cutaneous and systemic, the cells were arranged in small groups. In addition to normal mast cells, there were also irregular or bizarre-shaped cells presenting long and twisted cytoplasmic protrusions. In the case with the systemic involvement and in 2 of 3 cases with apparently cutaneous diffuse lesions, the villi of adjacent cells interlaced and showed a tendency to form mast cell aggregates. The pathognomonic value of the above observation seems worthy of further investigations.
Impetigo herpetiformis
Authors: Bajaj A.K. , Swarup V. , Gupta O.P. , Gupta S.C.
Published: November 2009

A case of impetigo herpetiformis with accompanying hypocalcaemia occurring in a female patient during two consecutive pregnancies is being reported. She responded dramatically to parenteral calcium and vitamin D therapy.
Poikiloderma-Like Cutaneous Amyloidosis
Authors: Ogino Atsuhiko , Tanaka Soichi
Published: November 2009

Cases of cutaneous amyloidosis which exhibit poikiloderma-like skin changes are extremely rare. There are at least two clinical forms of poikiloderma-like cutaneous amyloidosis (PCA): (1) the ordinary type, and (2) PCA syndrome. The PCA syndrome includes poikilodermatous skin manifestations which may appear early in life and lichenoid papules, both with cutaneous amyloid deposits, frequently associated with light sensitivity and short stature, occasionally with palmoplantar keratosis and blister formation. We carried out an examination of a 5-year-old girl who was compatible with the syndrome.
Immunological Properties in Staphylococcal Toxic Epidermal Necrolysis
Authors: Sarai Yasunaga , Nakahara Hideomi , Ishikawa Tomoaki , Kondo Isamu , Futaki Shohei , Ichizawa Yutaka , Hirayama Kaoru
Published: November 2009

The analysis of host defenses in 4 patients with staphylococcal toxic epidermal necrolysis revealed normal serum immunoglobulin levels, but a deficiency in cell-mediated immunity as detected by the tuberculin reactions. We suspected that the transient deficiency of cell-mediated immunity may have contributed to the development of this disease.
Mitteilungen – Communications Unterschiedliches Verhalten von menschlichen Melanomzellen aus Primärtumor und Metastasen in vitro
Authors: Meyer J.Ch. , Weiss Heidi
Published: November 2009

The morphologic differences of two melanoma cell cultures from a primary melanoma and a metastasis are described. Though both cultures looked very similar at the beginning, they developed into totally different forms. Long, thin spindle-shaped cells containing an optically dense plasma grew in the culture from the primary melanoma during its whole life span and the epithelioid cells of metastasis culture separated itself into different subcultures. The cells of both subcultures detached from the bottom of the culture flasks after 15 days of growth and began to spread again 7 days later with two very different forms. This transformation was observed three more times at monthly intervals. The possible relationship between these morphological alterations and the ability of the melanoma cells to produce metastases as well as the usefulness of melanoma cell cultures for immunodiagnostic purposes are discussed.
Objective and Quantitative Evaluation of Fetal Movement with Ultrasonic Doppler Actocardiogram
Authors: Maeda Kazuo , Tatsumura Masato , Nakajima Kazuhiko
Published: November 2009

Actocardiogram is the simultaneous recording of fetal movement (FM) and fetal heart rate (FHR) with the use of a single transducer by weak ultrasound. Fetal behavioral states, fetal hiccups, nonpathologic sinusoidal FHR pattern induced by cyclic FM were reported in the use of this technique. Computer processing of FM signals enabled automatic recognition of fetal behavior. Fetal hypoxic state preceding fetal distress was diagnosed by the actocardiogram. Cross-correlation coefficient of FHR and delayed FM was high, showing a new possibility of detailed grading of mild fetal hypoxia.
Motor Paralysis Complicating Herpes Zoster
Authors: Nord E. , Weinberger A. , Benjamin D. , Pinkhas J.
Published: November 2009

Two patients in whom transient paralysis complicated cutaneous herpes zoster infection are described. The major features of this condition are reviewed.
Paraproteinaemia in Sézary Syndrome
Authors: Kövary P.M. , Niedorf H. , Sommer G. , Breu H. , Kamanabroo P. , Büchner T. , Macher E.
Published: November 2009

We have observed non-myelomatous monoclonal hypergammaglobulinaemia in a 61-year-old man with Sézary syndrome. Similar cases have not been reported before. Sézary cells of patients studied by other investigators were found to be helper T cells. The abundant production of T-lymphocytic stimuli may possibly explain in our case the occurrence of a paraprotein.
Prolongation of Bacillus firmus Survival on Human Skin by a Spore Inoculum
Authors: Bibel D.J.J. , Lebrun Joseph R. , Lovell David J.
Published: November 2009

A case report is presented of an individual who carried vegetative cells of Bacillus firmus on multiple sites of his body for over a year. With the aim of investigating the survival mechanisms of Bacillus species on human skin, vegetative cells or spores of this microorganism were applied to the forearms of volunteers. Whereas vegetative cells were rapidly eliminated, the bacillus was recovered up to 2 weeks following an inoculum of spores. Persistence was not passive since germination, growth, and possible sporulation were demonstrated. We observed strong individual differences in the carriage of bacilli.
Generalized Pustular Psoriasis and Pustulation on the Linear Epidermal Nevus
Authors: Ogino Atsuhiko , Higuchi Takako
Published: November 2009

A 9-year-old Japanese girl with generalized pustular psoriasis (GPP) had a linear epidermal nevus (LEN) which exhibited psoriasislike features in a noneruptive phase of GPP. In advance of the exacerbation of the disease, crops of confluent pustules appeared on the linear lesions and afterwards continued during the flare-up. Although several cases of ordinary psoriasis with a LEN presenting inflammatory changes have been reported, it seems that there is only one paper in the literature concerning pustular formation on a LEN in a patient with GPP. This particular phenomenon may be interpreted as a kind of Koebner reaction in a person with active GPP.
Occupational Cobalt and Chromium Dermatitis in an Offset Printing Factory
Authors: Spruit D. , Malten K.E.
Published: November 2009

A case history of three offset printers and the atomic absorption analysis of their contact materials is described. Though the factory direction and personnel felt strongly about cooperating in order to combat the disease, it became apparent that the prescribed measures had not been effectively carried out. The chemical analysis of the materials proved to be a necessary supplement to the patch testing procedure.
Antibodies with Affinity for Epithelial Tissue in Chronic Dermatophytosis
Authors: Hopfer Roy L. , Grappel Sarah F. , Blank F.
Published: November 2009

Antibodies to dermatophytes which also had affinity for intercellular material of epithelial tissue, were detected in sera from 80% of patients with chronic dermatophytosis using an indirect fluorescent antibody test. The class of immunoglobulins reactive with both the dermatophyte and the epithelial tissue was identified as IgM. IgM antibodies with affinity for arthrospores of Trichophyton mentagrophytes and intercellular substance of epithelial tissue could be removed from sera with mycelium of Trichophyton rubrum.
The Effects of Some Hair Oils and Unsaturated Fatty Acids on Experimentally Induced Dermatophytosis
Authors: Abraham A. , Mohapatra L.N. , Kandhari K.C. , Pandhi R.K. , Bhutani L.K.
Published: November 2009

Antimycotic effect of mustard and coconut oils, oleic and palmitic acids on experimentally produced dermatophytic infection on hairy skin in the guinea pigs was studied. Mean Duration of Infection (MDI) was significantly reduced in all experiments where coconut and mustard oils or unsaturated fatty acid (oleic acid) were used. The significance of these results in relation to Tinea capitis in humans is discussed.
Peripheral Blood Lymphocyte Distribution in Scleroderma
Authors: Carapeto F.J. , Winkelmann R.K.
Published: November 2009

Determination in peripheral blood T and B lymphocytes performed in progressive systemic scleroderma (8 patients); dermatomyositis (5 patients); and inflammatory or mesenchymal scleroderma (‘mixed’ connective tissue disease) (5 patients) demonstrated a marked increase in peripheral B cells with T cell depression in patients with mesenchymal scleroderma. Patients with progressive systemic scleroderma and dermatomyositis demonstrated also a peripheral T depression, but no consistent changes in B cell population were found. The clear relationship between a B lymphocyte increase and elevated immunoglobulins, antinuclear and antiribonucleoprotein antibody and positive direct immunofluorescence of skin (basal membrane and blood vessels) defines inflammatory or mesenchymal scleroderma in which a disturbance in humoral immunity is involved. B lymphocyte determination can help to measure these changes in immunoreactivity.
Mélano-acanthome
Authors: Delacrétaz J.
Published: November 2009

A 87-year-old Caucasian women had a recurrent pigmented tumor on the back. Histologically, the lesion was interpreted as being a melanoacanthoma. It was characterized by a proliferation of unpigmented basaloid cells with aggregates of large prickle cells, forming small horn pearls; furthermore the tumor contained numerous large dendritic cells with large amounts of melanin granules. A short review of the literature is followed by the discussion of the relationship between melanoacanthoma and irritated seborrheic keratosis.
Increased Susceptibility to Infections in the Papillon-Lefèvre Syndrome
Authors: Haneke E. , Hornstein O.P. , Lex C.
Published: November 2009

This report deals with a case of Papillon-Lefèvre syndrome associated with an increased susceptibility to infections and a diminished lymphocyte stimulation by PHA in a 3-year-old girl.
Leishmania tropica Presenting Macrocheilia
Authors: Haim S.
Published: November 2009

Leishmania tropica rarely involve the mucous membrane. The only presenting symptom in the reported case was a chronic macrocheilia simulating a granulomatous cheilitis.
Corticosteroid-Sparing Effect of β-Adrenergic Blocking Agents in Pemphigus vulgaris
Authors: Singh I. , Sharma N.N. , Seth H.N. , Gaind M.L.
Published: November 2009

Beta-adrenergic blocking agents have a significant corticosteroid-sparing effect in the treatment of pemphigus vulgaris. In 18 patients, observations over a period of 8-27 months have shown that, in terms of percentage of the maintenance dose of betamethasone when administered alone, the corticosteroid-sparing effect of propranolol 120 mg was 33.3–83.3% in 17 patients and 100% in 1 patient. It is postulated that propranolol affects the vasodilator fibres as a result of which the influx of plasma in blisterformation is prevented or minimised.
Klarzellenakanthom (Degos) mit syringomatösen und naevus-sebaceus-artigen Anteilen
Authors: Cramer H.-J.
Published: November 2009

The histological details of a pale cell acanthoma (Degos) is presented. The described lesion showed marked sweat duct hyperplasia, atopical placed sebaceous glands and small epithelial formations with differentiation to sebaceous gland cells. Of this the pale cell acanthoma (Degos) is interpreted as a hamartomal tumor. The pale cells are probable differentiations of the spinal layer cells, which are given in the norm such as in the oral mucosa.
Low Leptin Concentration in the First Gestational Trimester Is Associated with Being Born Small for Gestational Age: Prospective Study in Rio de Janeiro, Brazil
Authors: Franco-Sena Ana Beatriz , Goldani Marcelo Zubaran , Tavares do Carmo Maria das Graças , Velásquez-Melendez Gustavo , Kac Gilberto
Published: November 2009

Background: Being born small for gestational age (SGA) is a known risk factor for greater neonatal mortality and disease in later life. Some determinants of the incidence of SGA newborns have been studied but little is known about the role of leptin in the beginning of pregnancy. Objectives: To investigate the effect of serum leptin concentration in the 1st gestational trimester on the incidence of SGA newborns and to identify other determining factors in the occurrence of SGA. Methods: Prospective study with 195 pairs of mothers and their children monitored in Rio de Janeiro, Brazil. The dependent variable was SGA newborns, while the independent variables were sociodemographic, reproductive, anthropometric and biochemical variables. Statistical analysis was performed by means of logistic regression. Results: The incidence of SGA was 11.3% (CI 95%: 7.31–16.46). The results showed that low concentrations (lowest tertile compared to 2nd and 3rd tertiles) of leptin (RR = 5.26; CI 95%: 1.91–9.56), insufficient gestational weight gain (RR = 3.16; CI 95%: 0.98–7.38), low stature (RR = 3.94; CI 95%: 1.22–8.57) and alcohol consumption during gestation (RR = 5.92; CI 95%: 1.44–12.92) were risk factors for SGA. Conclusions: Lower leptin concentrations were associated with a significant risk for SGA after adjusting for confounding variables. Maternal serum leptin at the beginning of gestation can be used as a marker for the early detection of SGA.
Impact of Skin to Skin Care, Prone and Supine Positioning on Cardiorespiratory Parameters and Thermoregulation in Premature Infants
Authors: Heimann K. , Vaeβen P. , Peschgens T. , Stanzel S. , Wenzl T.G. , Orlikowsky T.
Published: November 2009

Background: Skin to skin care (SSC), prone (PP) and supine (SP) positions are standard positions in daily care for premature infants. Their influence on cardiorespiratory parameters and thermoregulation is discussed controversially. Objectives: We compared SSC with PP, the recommended position for preterm infants, and SP, the safest position for term infants, and tested the hypothesis that SSC has no impact on cardiorespiratory parameters and thermoregulation. Methods: In 18 spontaneously breathing premature infants [median gestational 28 weeks (24–32); chronological age 36 days (7–64), and weight 1,543 g (750–2,100)], heart and respiratory rate, breathing pattern, episodes of desaturation (<85 but ≧80 and <80%), oxygen saturation and rectal temperature were analyzed with polygraphy (Alice 3® and 3.5®) in a 6-hour measuring cycle of three subsequent series (120 min each in SP, SSC and PP) and compared (Wilcoxon test). Results: During SSC, we found no increase in apneic attacks and bradycardic episodes and no difference in respiratory rate, breathing pattern, oxygen saturation, episodes and duration of desaturation compared to SP and PP. Episodes of desaturation <85 but ≧80 and <80% were more frequent in SP compared to PP (p = 0.0421 and p = 0.0319). Heart rate increased in SSC and PP compared to SP (154.86 bpm, SD 11.55, and 153.33 bpm, SD 15.95 vs. 150.25 bpm, SD 14.64; p = 0.0013 and p = 0.0346). Temperature level was not significantly higher during SSC and PP compared to SP except a rise between the start and the end of the 6-hour measuring cycle (37.05°C, SD 0.2 vs. 37.30°C, SD 0.3; p = 0.0436). Conclusion: We found no significant SSC-mediated changes in quality and quantity of desaturations and in body temperature compared to PP in preterm infants.
Nystagmus during Attacks of Vestibular Migraine: An Aid in Diagnosis
Authors: Polensek Sharon Hartman , Tusa Ronald J.
Published: November 2009

Introduction: An estimated one-fourth to one-third of patients with migraine will experience vertigo associated with their migraine attacks. Vestibular migraine frequently presents as a diagnostic challenge as objective neurological findings consistent with this entity have not been well described. Objective: The aim of this study is to characterize eye movements of patients presenting with nystagmus during attacks of migrainous vertigo. Design: A retrospective study of 26 patients presenting with nystagmus during an acute vestibular migraine was performed. All patients were examined while symptomatic during a migraine spell, and also while asymptomatic. All patients underwent tests of vestibular function with either bithermal water caloric or rotary chair electronystagmography. Results: The most common patient was a female of perimenopausal age. Spontaneous nystagmus was seen in 19% of patients and nystagmus provoked by horizontal headshaking was seen in 35%. Nystagmus could be provoked with positional testing in 100% of symptomatic patients with fixation blocked. The positional nystagmus most commonly was sustained, of low velocity, and could be horizontal, vertical or torsional. Bithermal water caloric or rotary chair tests obtained during symptom-free intervals were normal in all patients. Conclusions: Although nystagmus characteristics are quite variable during vestibular migraine, the finding on examination of low-velocity, sustained nystagmus with positional testing in a young to middle-aged adult patient presenting with vertigo, nausea and headache is highly suggestive of vestibular migraine as long as the nystagmus dissipates when the patient is free of symptoms.
Validation of the Telephone Interview for Cognitive Status-modified in Subjects with Normal Cognition, Mild Cognitive Impairment, or Dementia
Authors: Knopman David S. , Roberts Rosebud O. , Geda Yonas E. , Pankratz V. Shane , Christianson Teresa J.H. , Petersen Ronald C. , Rocca Walter A.
Published: November 2009

Background: The telephone assessment of cognitive functions may reduce the cost and burden of epidemiological studies. Methods: We validated the Telephone Interview for Cognitive Status-modified (TICS-m) using an extensive in-person assessment as the standard for comparison. Clinical diagnoses of normal cognition, mild cognitive impairment (MCI), or dementia were established by consensus of physician, nurse, and neuropsychological assessments. Results: The extensive in-person assessment classified 83 persons with normal cognition, 42 persons with MCI, and 42 persons with dementia. There was considerable overlap in TICS-m scores among the three groups. Receiver operating characteristic curves identified ≤31 as the optimal cutoff score to separate subjects with MCI from subjects with normal cognition (sensitivity = 71.4%; subjects with dementia excluded), and ≤27 to separate subjects with dementia from subjects with MCI (sensitivity = 69.0%; subjects with normal cognition excluded). The TICS-m performed well when subjects with MCI were pooled either with subjects with dementia (sensitivity = 83.3%) or with subjects with normal cognition (sensitivity = 83.3%). Conclusions: Although the TICS-m performed well when using a dichotomous classification of cognitive status, it performed only fairly in separating MCI from either normal cognition or dementia. The TICS-m should not be used as a free-standing tool to identify subjects with MCI, and it should be used with caution as a tool to detect dementia.
Prevalence and Correlates of Cognitive Impairment among the Elderly in a General Hospital
Authors: Mendes-Chiloff Cristiane Lara , Torres Albina Rodrigues , Lima Maria Cristina Pereira , Ramos-Cerqueira Ana Teresa de Abreu
Published: November 2009

Aims: To estimate the prevalence and correlates of cognitive impairment (CI) among the elderly in a general hospital. Methods: A cross-sectional study, including 200 Brazilian inpatients aged 60 years or over, using the Mini Mental State Examination to evaluate CI (dependent variable), and the Geriatric Depression Scale and the Katz and Lawton Index to evaluate basic (BADL) and instrumental activities of daily living (IADL). Results: 56% were women, 29% were dependent for BADL and 77.5% for IADL. The prevalence of CI was 29% and, in the logistic regression, it remained associated with higher age (>74 years old), number of previous hospitalizations (>3) and dependency for BADL (being dependent raised the odds of being cognitively impaired). Conclusions: It is essential to train the hospital staff to properly assist these patients, and to orient and support their caregivers.
Construction of Weight Gain Charts in a Low-Risk Obstetric Belgian Population
Authors: Guelinckx I. , Beckers K. , Vansant G. , Devlieger R.
Published: November 2009

Aim: To generate reference charts for weight gain during pregnancy for the different BMI categories (underweight, normal weight, overweight, obesity), based on recent data in a homogeneous, Caucasian, low-risk obstetric population. Methods: Weight gain and prepregnancy BMI were retrospectively gathered from 605 pregnant Belgian women with accurately dateable, uncomplicated singleton pregnancies. Percentile curves for the different BMI categories were constructed using the linear mixed model, based on absolute weight gain. The effect of parity on weight gain was examined. Results: Overall mean weight gain was 14.8 kg (±4.7). Weight gain differed significantly between underweight (15.4 ± 4.1 kg) and obese patients (12.0 ± 5.9 kg), between patients with normal weight (15.1 ± 4.5 kg) and overweight patients (13.7 ± 5.3 kg), and between normal-weight and obese patients. Parity had a statistical, but no clinically significant, influence on amount and evolution of weight gain. Conclusion: By using strict inclusion criteria, BMI-category-specific reference charts were generated representing, in terms of outcome, the optimal weight gain during pregnancy rather than the mean observed weight gain. This enables the weight charts to be used as a clinical tool during the counseling of pregnant women.
Antiapoptotic and Proliferative Effects of Low Concentrations of 7β-Hydroxycholesterol in Human Endothelial Cells via ERK Activation
Authors: Trevisi Lucia , Bertoldo Alessandro , Agnoletto Laura , Poggiani Chiara , Cusinato Federico , Luciani Sisto
Published: November 2009

The atherogenic potential of oxidized low-density lipoproteins (oxLDL) has been correlated to their 7β-hydroxycholesterol (7βOHC) content; oxLDLs have a dual effect on endothelial cell viability, inducing apoptosis or proliferation depending on the concentration. Considering that 7βOHC is apoptotic for endothelial cells at concentrations ≧20 µg/ml, a study on the effect of lower concentrations of 7βOHC on human umbilical vein endothelial cells (HUVECs) was undertaken. 7βOHC (1–10 µg/ml) increased 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction of growth-factor-deprived HUVECs. This effect was due to the increased cell proliferation, determined by [3H]thymidine incorporation, and the reduction of apoptosis, revealed by the decreased caspase-3 activation and annexin V staining. 7βOHC also protected against staurosporine apoptosis. 7βOHC induced an increase in intracellular ROS antagonized by N-acetylcysteine; however, HUVECs treatment with the antioxidant did not inhibit the effects of 7βOHC. 7βOHC produced an increase in extracellular signal-regulated kinase (ERK) phosphorylation that was blocked by inhibitors of store-operated calcium entry 2-aminoethoxydiphenyl borate and gadolinium. MEK inhibition with PD98059 or U0126 as well as store-operated calcium entry inhibition antagonized the effect of 7βOHC. The results suggest that 7βOHC promotes HUVECs survival and proliferation by a mechanism independent of ROS production and involving calcium-dependent activation of ERK.
Baseline Diabetic Status and Admission Blood Glucose Were Poor Prognostic Factors in the EPITHET Trial
Authors: De Silva D.A. , Ebinger M. , Christensen S. , Parsons M.W. , Levi C. , Butcher K. , Barber P.A. , Bladin C. , Donnan G.A. , Davis S.M.
Published: November 2009

Background: Previous data have suggested that diabetes and hyperglycemia predict poor outcome following stroke. We studied the prognostic impact of diabetes and admission blood glucose in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET). Methods: EPITHET was a prospective randomized placebo-controlled trial of intravenous tissue plasminogen activator (tPA) in the 3- to 6-hour time window. A preexisting diagnosis of diabetes was noted and baseline serum glucose was measured. Results: Intravenous tPA attenuated infarct growth in non-diabetics, but not in diabetics (p = 0.029). In the tPA treatment group, admission blood glucose was higher among patients with poor functional outcome (p = 0.002). Conclusions: Diabetes and hyperglycemia attenuate the effects of tPA on infarct evolution. Future thrombolytic trials should consider randomizing patients by subgroups based on diabetic status and serum glucose levels.
Case Report: Respiratory Inductance Plethysmography as a Monitor of Ventilation during Laser Ablation and Balloon Dilatation of Subglottic Tracheal Stenosis
Authors: Atkins Joshua H. , Mirza Natasha , Mandel Jeff E.
Published: November 2009

We describe a 61-year-old female who underwent KTP laser ablation and CRE balloon dilatation of symptomatic idiopathic subglottic stenosis (50% obstruction). The procedure was conducted, using our standard approach for such cases, under total intravenous general anesthesia with subglottic high-frequency jet ventilation (HFJV) via Lindholm laryngoscope. The patient was enrolled in an ongoing investigational protocol in which respiratory inductance plethysmography (RIP; Ambulatory Monitoring Inc., Ardsley, N.Y., USA) bands were used to monitor ventilation in addition to pulse oximetry and visual inspection. HFJV instituted with an Acutronic Monsoon jet ventilator (Acutronic Medical, Hirzel, Switzerland) resulted in a rapid increase in RIP signal amplitude consistent with breath stacking and inadequate expiratory flow around the tight stenosis. High pressure alarms sounded and automatic cessation of jet ventilation ensued. After successful tracheal dilation under intermittent apnea, subsequent jet ventilation produced only modest RIP amplitude changes. RIP may be an important safety monitor during jet ventilation for patients with obstructive tracheal lesions to lessen the risk of both barotrauma and hypoventilation. RIP remains under active study by our group for this purpose.
Increase in the Oxidized/Total Coenzyme Q-10 Ratio in the Cerebrospinal Fluid of Alzheimer’s Disease Patients
Authors: Isobe Chiaki , Abe Takashi , Terayama Yasuo
Published: November 2009

Background/Aim: The contribution of mitochondrial dysfunction and oxidative stress to the pathogenesis of Alzheimer’s disease (AD) has previously been described. We aimed to investigate whether the balance between the oxidized and reduced forms of coenzyme Q-10 (CoQ-10) is related to the pathogenesis of AD. Materials and Method: Thirty patients with AD (69.0 ± 4.1 years) and 30 healthy control subjects (63.8 ± 16.4 years) were enrolled in this study. Concentrations of oxidized CoQ-10 and reduced CoQ-10 were measured by high-performance liquid chromatography using an electrochemical detector. Results: The percentage of oxidized/total CoQ-10 in the cerebrospinal fluid (%CoQ-10, CSF) was significantly higher in the untreated AD group (78.2 ± 18.8%) than in the control group (41.3 ± 10.4%, p < 0.001), and there was a significant negative correlation between %CoQ-10 and the duration of the illness (rs = –0.93, p < 0.001). Conclusion: These findings in living AD patients suggest a possible role for %CoQ-10 in the pathogenesis of the early stage of AD development.
Are Electrocardiographic Changes in Patients with Acute Subarachnoid Hemorrhage Associated with Takotsubo Cardiomyopathy?
Authors: Jung Jae-Hun , Min Pil-Ki , Rim Se-Joong , Ha Jong-Won , Chung Namsik , Lee Kyu-Chang
Published: November 2009

Background: Subarachnoid hemorrhage (SAH) has been associated with electrocardiographic (ECG) changes, arrhythmias, and release of cardiac enzymes. Recently, Takotsubo cardiomyopathies, presenting typical ECG changes and left ventricular (LV) regional wall-motion abnormalities (RWMAs), have been reported and considered to be a result of high norepinephrine (NE) levels. We hypothesized that ST-T-wave changes in patients with SAH may be manifestations of Takotsubo cardiomyopathy and associated with RWMAs. Methods: We instituted consecutive echocardiographic screening of all patients with acute aneurysmal SAH. A standard 12-lead ECG and blood samples for creatine kinase (CK) MB isoenzyme and troponin-T (Tn-T) were obtained. To evaluate sympathetic nervous activity, we obtained blood samples and urine samples for NE. Results: Of 42 patients with acute aneurysmal SAH, 26 had abnormal ECG including rhythm abnormalities. Ten of 12 patients with ST-T-wave changes had severe neurologic deficits, but 1 patient had RWMAs on echocardiography. Another patient with LV dysfunction showed a normal ST-T wave. In patients with ST-T-wave changes, elevated Tn-T (8.3 vs. 3.3%), CK-MB (8.3 vs. 10.0%), plasma and urine NE (16.7 and 33.3% vs. 16.7 and 50.0%), and mortality (8.3 vs. 13.3%) were not significantly higher. All 5 deaths resulted from noncardiac causes. High plasma and urine NE levels were not related to neurologic severity or mortality. Conclusions: Although ECG abnormalities are frequently seen in SAH patients, the incidence of RWMAs is very low. Electrocardiographic manifestations in patients with SAH and Takotsubo cardiomyopathy are similar, but ECG abnormalities in patients with SAH are mostly not related to LV dysfunction.
Fragmentation of Human Erythrocyte Actin following Exposure to Hypoxia
Authors: Risso Angela , Santamaria Barbara , Pistarino Erika , Cosulich Maria Elisabetta , Pompach Petr , Bezouska Karel , Antonutto Guglielmo
Published: November 2009

In a comparative study on erythrocytes (RBCs) drawn from mountaineers before and after a high-altitude stay, we observed that upon returning to sea level, their RBCs displayed a senescent-like phenotype as indicated by their density and the partial loss of membrane proteins which are shed by ageing RBCs. The aim of this study was to investigate possible changes in the membrane skeleton of these RBCs and to compare them with pathological RBCs. We analysed the proteins of RBC ghosts obtained from our subjects before and after returning to sea level by two-dimensional electrophoresis and mass spectrometry. We observed lower expression and fragmentation of β-actin after exposure to hypoxia. This suggested an alteration in membrane skeleton structure, which was confirmed by β-actin release in cell lysates during ghost preparation. We observed a similar actin fragmentation and release in RBC lysates from β-thalassaemic patients. In conclusion, these results indicate that after exposure to hypoxia, RBCs display a modification of their actin and cytoskeleton instability.
Food Availability Affects Orexin A/ Hypocretin-1-Induced Inhibition of Pulsatile Luteinizing Hormone Secretion in Female Rats
Authors: Furuta Miyako , Mitsushima Dai , Shinohara Kazuyuki , Kimura Fukuko , Funabashi Toshiya
Published: November 2009

Orexin A/hypocretin-1 inhibits pulsatile luteinizing hormone (LH) secretion in female rats. In this study, we investigated whether this inhibition was tied to the fasting state, as suggested by our previous study. We first examined whether orexin A inhibited pulsatile LH secretion when food was available ad libitumduring blood sampling. Next, we investigated the effect of intravenous administration of glucose (400 mg/kg) or lactic acid (negative control; 400 mg/kg) on orexin A-induced inhibition of pulsatile LH secretion. We found that orexin A did not affect pulsatile LH secretion in the presence of food, although it increased feeding behavior. Injection of orexin A significantly inhibited pulsatile LH secretion when food was withheld during blood sampling (p < 0.05); this inhibitory effect was rapidly reversed by intravenous injection of glucose but not lactic acid. Because orexin A did not seem to affect pulsatile LH secretion when food was available ad libitum, we speculate that orexin A has an effect on LH secretion when orexin A-induced hunger is accompanied by stress, such as the absence of food. Furthermore, glucose as well as food may act as a satiety factor in gonadotropin-releasing hormone pulse generation.
Endoscopic Third Ventriculostomy: The Lebanese Experience
Authors: Rahme Ralph , Rahme Rudy J. , Hourani Roula , Moussa Ronald , Nohra Georges , Okais Nabil , Samaha Elie , Rizk Tony
Published: November 2009

Background: Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. Methods: Between 1998 and 2007, we performed 49 ETV procedures in 46 patients suffering from OHC. Medical records were retrospectively reviewed. Success was defined as shunt-free survival. Results: There were 29 males and 17 females with a mean age of 23 years (6 months–65 years). Aqueductal stenosis and tectal tumor were the most common etiologies (63%). Seven patients (15.6%) had early ETV failure. Of 38 patients with initial success and available follow-up, shunt independence was achieved in 29 patients (76.3%) after a mean follow-up of 37 months. Kaplan-Meier analysis yielded a 70% 5-year shunt-free survival rate. On multivariate analysis, no variables could predict early or late ETV failure. Transient complications occurred in 6 patients (13%), but there were no ETV-related deaths or permanent morbidity. Conclusion: ETV is a safe and effective treatment for OHC, resulting in a high rate of long-term shunt independence with a low risk of complications. ETV should be considered the treatment of choice for patients with OHC and its development as a substitute to shunt placement should be encouraged in neurosurgically developing countries.
Congenital Tumors of the Central Nervous System: The MCH Experience
Authors: Shamji Mohammed F. , Vassilyadi Michael , Lam Cornelius H. , Montes José L. , Farmer Jean-Pierre
Published: November 2009

Introduction: Congenital brain tumors in the younger pediatric population are rare lesions that are histologically distinct from those in the older pediatric population. Malignant histology is common, with persistently poor outcomes despite accessible neuroimaging and evolving adjuvant therapy. There remains scant literature about the natural history of these patients because of rarity and varied institutional experiences. Methods: A retrospective review was performed of congenital brain tumor patients surgically treated at the Montreal Children’s Hospital (MCH) over a 22-year period. Patients presenting in the first year of life were evaluated for demographic information, presenting symptoms, lesion location, and management. Analysis was by median rank test and χ2 statistics. Results: 13 cases of congenital brain tumors were identified: 5 supratentorial and 8 infratentorial. Median age (p = 0.93) and gender (p = 0.57) did not differ by location, and predominant histologies were choroid plexus papilloma and primitive neuroectodermal tumor. Seizure activity was exclusive to supratentorial lesions (40%, p = 0.03), with hypotonia observed only among infratentorial lesions (50%, p = 0.02). There was equal incidence of hydrocephalus (69%, p = 0.57) and increasing head circumference (38%, p = 0.27) by lesion location. Supratentorial lesions were treated by total resection (n = 3), subtotal resection (n = 1), and biopsy (n = 1). Infratentorial lesions were treated by total resection (n = 1), subtotal resection (n = 2), biopsy (n = 1), no operation (n = 2), and decompressive laminectomy for two spinal lesions. Conclusions: Congenital brain tumor patients represent fewer than 2% of patients treated at MCH. An evolving understanding of management objectives for these lesions requires understanding institutional experiences. Patients with supratentorial lesions frequently present with seizures, hydrocephalus, and macrocrania, and more frequently underwent total resection at surgery.
Clinical Trial Comparing Hydrocortisone 17-Butyrate to Betamethasone 17-Valerate in a Series of Patients with Eczematous Skin Diseases
Authors: Thormann J. , Brodthagen H.
Published: November 2009

A randomized, double-blind, left-right comparative study was carried out to compare the value of hydrocortisone 17-butyrate with that of betamethasone 17-valerate in the treatment of eczematous skin disorders. In a series of 23 patients with such disorders, no differences between the two preparations was demonstrated with regard to effectiveness.
Global and Seasonal Assessment of Interactions between Climate and Vegetation Biophysical Processes: A GCM Study with Different Land–Vegetation Representations
Authors: Xue Yongkang , De Sales Fernando , Vasic Ratko , Mechoso C. Roberto , Arakawa Akio , Prince Stephen
Published: November 2009

A global and seasonal assessment of regions of the earth with strong climate–vegetation biophysical process (VBP) interactions is provided. The presence of VBP and degree of VBP effects on climate were assessed based on the skill of simulations of observed global precipitation by two general circulation models of the atmosphere coupled to three land models with varying degrees of complexity in VBP representation. The simulated VBP effects on precipitation were estimated to be about 10% of observed precipitation globally and 40% over land; the strongest impacts were in the monsoon regions. Among these, VBP impacts were highest on the West African, South Asian, East Asian, and South American monsoons. The specific characteristics of vegetation–precipitation interactions in northern high latitudes were identified. Different regions had different primary impact season(s) depending on regional climate characteristics and geographical features. The characteristics of VBP effects on surface energy and water balance as well as their interactions were also analyzed. The VBP-induced change in evaporation was the dominant factor in modulating the surface energy and water balance. The land–cloud interaction had substantial effects in the feedback. Meanwhile, the monsoon regions, midlatitudes lands, and high-latitude lands each exhibited quite different characteristics in circulation response to surface heating changes. This study is the first to compare simulations with observations to identify and assess global seasonal mean VBP feedback effects. It is concluded that VBPs are a major component of the global water cycle.
Uncertainty in Scatterometer-Derived Vorticity
Authors: Bourassa Mark A. , McBeth Ford Kelly
Published: November 2009

A more versatile and robust technique is developed for determining area-averaged surface vorticity based on vector winds from swaths of remotely sensed wind vectors. This technique could also be applied to determine the curl of stress, and it could be applied to any gridded dataset of winds or stresses. The technique is discussed in detail and compared to two previous studies that focused on early development of tropical systems. Error characteristics of the technique are examined in detail. Specifically, three independent sources of error are explored: random observational error, truncation error, and representation error. Observational errors are due to random errors in the wind observations and determined as a worst-case estimate as a function of averaging spatial scale. The observational uncertainty in the Quick Scatterometer (QuikSCAT)-derived vorticity averaged for a roughly circular shape with a 100-km diameter, expressed as one standard deviation, is approximately 0.5 × 10−5 s−1 for the methodology described herein. Truncation error is associated with the assumption of linear changes between wind vectors. Uncertainty related to truncation has more spatial organization in QuikSCAT data than observational uncertainty. On 25- and 50-km scales, the truncation errors are very large. The third type of error, representation error, is due to the size of the area being averaged compared to values with 25-km length scales. This type of error is analogous to oversmoothing. Tropical and subtropical low pressure systems from three months of QuikSCAT observations are used to examine truncation and representation errors. Representation error results in a bias of approximately −1.5 × 10−5 s−1 for area-averaged vorticity calculated on a 100-km scale compared to vorticity calculated on a 25-km scale. The discussion of these errors will benefit future projects of this nature as well as future satellite missions.