bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-Based Guidelines for the Secondary Prevention of Falls in Older Adults
Authors: Moreland Julie , Richardson Julie , Chan David H. , O’Neill John , Bellissimo Agostino , Grum Rosa Maria , Shanks Lynne
Published: April 2003

Background: Falls are a significant problem for older adults. Individuals who have sustained a fall come to the attention of health care providers and are at risk of further falls. To promote the highest quality of care and reduce variation in care, a practice guideline is needed. Summarization of evidence regarding falls may be useful to researchers in this field. Objectives: To provide evidence-based guidelines of assessment and treatment to prevent falls in older adults and to provide researchers with tables of risk factor studies and randomized controlled trials of falls prevention. Methods: A template for the development of practice guidelines from the Agency for Health Care Policy and Research was used. Evidence for risk factors was accepted from prospective studies with more than 80% follow-up. Potentially modifiable risk factors were selected and a schema for evaluating the importance of each risk factor was used. Evidence for interventions was examined from randomized controlled trials and strength of the evidence was graded. Recommendations for aspects of care where judgment was required were made by panel consensus. Results: Information was drawn from 46 risk factor studies and 37 randomized controlled trials to develop a practice guideline consisting of assessment items and recommended interventions for community-dwelling and institution-dwelling older adults separately. For clinicians, a check list is provided. Summary tables of the results of studies are given to substantiate the recommendations. Conclusions: For community-dwelling older adults, there is strong evidence for multi-factorial specific risk assessment and targeted treatment. Balance exercises are recommended for all individuals who have had a fall and there is evidence for a program of home physiotherapy for women over 80 years of age regardless of risk factor status. For institutional settings, the establishment of a falls program for safety checks, ongoing staff education and monitoring is substantiated by research. Residents who have fallen need to be assessed for specific risk factors and clinical indicators to determine relevant management options.
Endogenous Nitric Oxide Production in the Airways of Preterm and Term Infants
Authors: Condò Valentina , Pugni Lorenza , Fumagalli Monica , Mosca Fabio
Published: April 2003

Few studies have measured endogenous nitric oxide exhaled from the respiratory system of newborn infants. We measured exhaled nitric oxide (eNO) in the first 48 h of life in 24 (13 preterm, 11 term) spontaneously breathing (online method) newborns using a chemoluminescence analyzer. There was a significant difference in the eNO concentration between term and preterm healthy infants in the first 2 days of life (repeated measures analysis of variance, p < 0.05). In term infants there is a peak eNO production in the first hours of life, suggesting a potential role in postnatal adaptation, while in preterm infants eNO production is almost absent at birth, and then gradually increases.
Severe Tardive Dyskinesia in Affective Disorders: Treatment with Vitamin E and C
Authors: Michael Nikolaus , Sourgens Hildegard , Arolt Volker , Erfurth Andreas
Published: April 2003

Tardive dyskinesia caused by antipsychotic treatment is a severe problem not only in the management of schizophrenia, but also of affective disorders. Vitamin E monotherapy has been used in schizophrenic patients with tardive dyskinesia. Pharmacologists warn against high dosage of vitamin E because of its pro-oxidative effects on low-density lipoprotein with consecutive cardiac risks. Addition of vitamin C probably reduces this risk because of its interactions with vitamin E, i.e. vitamin C reduces vitamin E radicals formed when vitamin E scavenges the oxygen radicals. We have therefore tested the safety and efficacy of combining vitamin C and E in a sample of patients with affective disorders and tardive dyskinesia who had previously been treated with antipsychotics due to psychotic symptoms. In all 6 patients, a reduction of tardive symptomatology was seen. In our sample, no side effects were observed. Further studies on this combination therapy are suggested.
Renal Processing of Albumin in Diabetes and Hypertension in Rats
Authors: Russo Leileata M. , Osicka Tanya M. , Brammar Gail C. , Candido Riccardo , Jerums George , Comper Wayne D.
Published: April 2003

Background/Aims: Recent studies show that albuminuria may be the result of changes in post-glomerular cellular uptake and processing of albumin. This study aims to determine whether this processing is disrupted in diabetes and/or hypertension. Methods: Diabetes (d) was induced using streptozotocin in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) and studied after 8, 16 and 24 weeks of disease. Intact albumin excretion was determined by radioimmunoassay. Total albumin was determined by [14C]albumin. Lysosomal activity was determined by dextran sulfate desulfation. Renal TGF-β1 and transforming growth factor-β1 inducible gene-h3 mRNA (βig-h3) expression was determined by real time RT-PCR. Results: SHR-c rats exhibited an increase in intact albuminuria without significant change in total albumin excretion (intact plus albumin-derived peptides). For WKY-d rats, intact albuminuria developed initially, followed by an increase in total albumin excretion primarily in the form of albumin peptides (peptiduria). SHR-d rats exhibited both increases in peptiduria and intact albuminuria. There was no increase in glomerular permeability at 24 weeks for polydisperse [3H]Ficoll in all groups. Increased renal TGF-β1 and βig-h3 expression was correlated with a decrease in dextran sulfate desulfation and increased intact albuminuria independent of peptiduria. Conclusion: Increased albumin excretion in hypertension and/or diabetes is manifested in different forms independent of glomerular permeability.
Renal Replacement in End-Stage Renal Disease Patients over 75 Years Old
Authors: Létourneau Isabelle , Ouimet Denis , Dumont Marc , Pichette Vincent , Leblanc Martine
Published: April 2003

Background: Over the last decade, the age of dialysis patients has been increasing steadily in several units in Canada. Our main objective was to assess prevalence, co-morbidity and outcome of ESRD patients over 75 years old at the beginning of dialysis treatment in our center. As a group, they were compared to younger dialysis patients treated simultaneously. Methods: In the last 5 years, all cases beginning dialysis in our institution who were above 75 years of age were reviewed, as well as cases aged between 50 and 60 years who started dialysis during the same period. Between January 1996 and December 2000, among a total of 429 new chronic dialysis patients, 67 ESRD patients over 75 years (15.6%) and 66 patients between 50 and 60 years (15.4%) began dialysis treatment. Results – Primary and Secondary: Diabetes was present in 37% of elderly and in 56% of the younger patients. Younger patients had been referred earlier to our nephrologists than the older ones (42 vs. 27%). Elderly were more frequently treated by hemodialysis than peritoneal dialysis (81 vs. 19%) when compared to their younger counterparts (65 vs. 35%). Long-term catheters for hemodialysis were used more often in elderly patients. No renal transplantation were performed in older patients while 7 younger patients received a renal graft. Survival rates after 1 and 3 years were, respectively, 93 and 74% for patients between 50 and 60 years, whereas it decreased to 80 and 45% for those over 75 years (p = 0.002). More than 50% of patients older than 75 years died within 2 years after starting dialysis; their mean survival was 31 months; patients starting dialysis between 50 and 60 years survived on the average 44 months during the study period. According to the multivariate logistic regression model, risk factors for increased mortality in the older group were: number of hospitalization days during the past 3 months (OR 34.8, 95% CI 8.3–145.7, p < 0.001) and lower weight (OR 16.6, 95% CI 2.0–139.0, p = 0.001). Conclusion: We may conclude that, in our hands, life expectancy of patients who began dialysis above 75 years is significantly shorter than for patients for whom dialysis is initiated between age 50 and 60 years, especially if they have a low weight, lose weight and/or require hospitalization.
Evaluation of Cerebral Hemodynamics with Perfusion MRI in Childhood Moyamoya Disease
Authors: Kim Seung-Ki , Wang Kyu-Chang , Oh Chang-Wan , Kim In-One , Lee Dong Soo , Song In Chan , Cho Byung-Kyu
Published: April 2003

The purpose of our study was to evaluate the role of perfusion MRI and to compare the findings with those of conventional imaging in childhood moyamoya disease (MMD). Perfusion MRI was performed preoperatively on 13 cases of childhood MMD. Based on the perfusion MRI findings, patients were classified into four groups: those with normal regional cerebral blood volume (rCBV) and time to peak (TTP) (group 1, n = 2); those with normal rCBV and delayed TTP (group 2, n = 1); those with increased rCBV and delayed TTP (group 3, n = 5), and those with decreased rCBV and delayed TTP (group 4, n = 5). Lesion volume as determined using the rCBV map was compared with that on MRI and single photon emission computerized tomography (SPECT). The characteristics of groups 1, 2 and 3 were a high frequency of transient ischemic attacks, normal finding on MRI, early angiographic stages, decreased reserve on SPECT and favorable operative outcome. In group 3, angiography revealed abundant collateral channels. In group 4, all cases had infarction on MRI and abnormal perfusion on SPECT. Angiographic stages tended to have progressed, and operative outcome was less favorable. Perfusion MRI documented hemodynamic asymmetries in the five cases with normal MRI. Perfusion MRI is suggested to have a sensitivity intermediate between rest and acetazolamide SPECTs. We conclude that perfusion MRI may be a valuable tool for characterizing and monitoring ischemia in MMD. Perfusion MRI provides additional functional information not available from conventional MRI and has a potential role comparable to SPECT in the evaluation of MMD.
Lip Kinematics for /p/ and /b/ Production during Whispered and Voiced Speech
Authors: Higashikawa Masahiko , Green Jordan R. , Moore Christopher A. , Minifie Fred D.
Published: April 2003

In the absence of voicing, the discrimination of ‘voiced’ and ‘voiceless’ stop consonants in whispered speech relies on such acoustic cues as burst duration and amplitude, and formant transition characteristics. The articulatory processes that generate these features of whispered speech remain speculative. This preliminary investigation examines the articulatory kinematics differences between whispered /p/ and /b/, which may underlie the acoustic differences previously reported for these sounds. Computerized video-tracking methods were used to evaluate kinematic differences between voiced and voiceless stops. Seven subjects produced the target utterances ‘my papa puppy’ and ‘my baba puppy’ in voiced and whispered speech modes. The results revealed that mean peak opening and closing velocities for /b/ were significantly greater than those for /p/ during whispered speech. No differences in peak velocity for either oral closing or opening were observed during voiced speech. The maximum distance between the lips for oral opening for /b/ was significantly greater than for /p/ during whisper, whereas no difference was observed during voiced speech. These data supported the suggestion that whispered speech and voiced speech rely on distinct motor control processes.
The Interleukin-2-Deficient Mouse Model
Authors: Barmeyer C. , Horak I. , Zeitz M. , Fromm M. , Schulzke J.D.
Published: April 2003

Interleukin-2-deficient (IL-2–/–) mice develop colitis with striking clinical and morphological similarities to ulcerative colitis. Since transport and barrier properties are impaired in ulcerative colitis, we studied transport and barrier functions in IL-2–/– mice in order to gain insight for the first time into the general pathomechanisms of disturbed transport and barrier function of the intestine during inflammation. Alternating current impedance analysis was used to determine tissue conductance in the inflamed proximal colon of IL-2–/– mice and to discriminate between pure epithelial and subepithelial conductance. Surprisingly, epithelial conductance was not increased but diminished in IL-2–/– mice compared to controls (20.2 ± 1.3 versus 28.8 ± 2.8 mS/cm2). Concomitantly, conductance of the subepithelial tissue layers was decreased in IL-2–/– mice as a result of edema and infiltration with inflammatory cells. In the distal colon, electrogenic Na+ transport (JNa) mediated by the epithelial Na+ channel (ENaC) was measured 8 h after stimulation with 3·10–9M aldosterone in vitro as the drop in ISC (short circuit current) after addition of 10–4M amiloride. In controls, JNa was 6.9 ± 0.9 µmol·h–1·cm–2, whereas it was abolished in IL-2–/– mice. In conclusion, the inflamed colon of IL-2–/– mice exhibits a severe disturbance in Na+ uptake via the ENaC in the absence of a barrier defect. Thus, reduced expression of active absorptive transport and not a barrier defect is responsible for the diarrhea in this model of intestinal inflammation. This makes this model suitable for studying the general pathomechanisms of the inflammatory downregulation of intestinal transport proteins.
Interleukin-12 Antagonists as New Therapeutic Agents in Inflammatory Bowel Disease
Authors: Schmidt Carsten , Marth Thomas , Wittig Bianca M. , Hombach Andreas , Abken Hinrich , Stallmach Andreas
Published: April 2003

Inflammatory bowel diseases (IBDs; Crohn’s disease (CD) and ulcerative colitis) are chronic inflammatory diseases leading to destruction of gastrointestinal tissue. They are characterized by an exaggerated immune response. In CD, an increased expression of T-helper-1 (Th1) cytokines was observed in which interleukin-12 (IL-12) seems to play a pivotal role. Different immunosuppressive agents have been used to treat patients suffering from IBD, nevertheless remarkable side effects or treatment failure are limiting factors in this regard. Therefore, studies on more specific treatment of CD have recently been published, using recombinant anti-inflammatory cytokines or inhibitors of proinflammatory cytokines and their receptors. Beyond these principles anti-IL-12 strategies seem to play a promising role because of the central position of this Th1-inducing cytokine in the inflammatory cascade. Up to now anti-IL-12 antibodies, complement receptor-3 antibodies and IL-12p40 homodimers have been evaluated in their potential to suppress the mucosal inflammation. Based on our understanding of the pathogenesis of CD, the available data and experiences concerning these principles are presented in this review.
Experimental Dispase-Induced Retinopathy Causes Up-Regulation of P2Y Receptor-Mediated Calcium Responses in Müller Glial Cells
Authors: Francke Mike , Uhlmann Susann , Pannicke Thomas , Goczalik Iwona , Uckermann Ortrud , Weick Michael , Härtig Wolfgang , Wiedemann Peter , Reichenbach Andreas , Bringmann Andreas
Published: April 2003

During proliferative vitreoretinopathy (PVR) Müller glial cells show an up-regulation of their responsiveness to extracellular adenosine 5′-triphosphate (ATP). In the present study, we investigated if such a glial cell response is also a feature for other retinopathies besides PVR. To this aim, the proteolytic enzyme, dispase (0.1 U), was injected into the vitreous of rabbit eyes. After 3 weeks, a distinct retinopathy had developed which showed no signs of PVR. The retinopathy was characterized by strong alterations of the retinal vasculature in the medullary rays, by photoreceptor degeneration, retinal atrophy, and activation of microglial cells. Müller cells became reactive, as indicated by up-regulation of glial fibrillary acidic protein immunoreactivity and by hypertrophy involving subretinal fibrosis. Müller cell reactivity was also evidenced electrophysiologically by a down-regulation of their inwardly rectifying potassium currents and by an up-regulation of their responsiveness to extracellular ATP. Significantly more Müller cells from dispase-treated eyes showed ATP-evoked calcium (83%) and current responses (69%) when compared with cells from control eyes (13 and 9%, respectively). The results indicate that increased responsiveness to extracellular ATP may be a more general feature of Müller cell gliosis, and is also observed in retinopathies besides PVR.
Cyclic Changes of the Canine Endometrial Surface: An Electron-Microscopic Study
Authors: van Cruchten S. , van den Broeck W. , Roels F. , Simoens P.
Published: April 2003

The endometrial surface morphology of 38 dogs during different stages of the estrous cycle was investigated with scanning electron microscopy. The cell surface altered from convex in proestrus and estrus to very variable in early metestrus, flattened in late metestrus and became completely plane in anestrus. Microvilli were numerous and long in proestrus and in estrus, became short and variable in number in early metestrus, decreased further in length in late metestrus and became very short and rare in anestrus. The variable appearance in early metestrus was not influenced by changing the osmolarity of the fixative and might be a physiological process. The number of glandular openings showed little variability throughout the estrous cycle. Ciliated cells were rare but present in all cycle stages except in late metestrus. However, in the latter cycle stage and in anestrus rare single strands were noted. Transmission electron microscopy was used to determine the inner structure of these strands. Microtubuli were detected in transversal and longitudinal sections but without the 9 + 2 arrangement which is characteristic for cilia. The nature and function of these structures remain unclear.
Sarcoglycans in Human Skeletal Muscle and Human Cardiac Muscle: A Confocal Laser Scanning Microscope Study
Authors: Anastasi G. , Cutroneo G. , Trimarchi F. , Rizzo G. , Bramanti P. , Bruschetta D. , Fugazzotto D. , Cinelli M.P. , Soscia A. , Santoro G. , Favaloro A.
Published: April 2003

Sarcoglycans are a subcomplex of transmembrane proteins which are part of the dystrophin-glycoprotein complex. They are expressed in the skeletal, cardiac and smooth muscle. Although numerous studies have been conducted on the sarcoglycan subcomplex in skeletal and cardiac muscle, the manner of the distribution and localization of these proteins along the nonjunctional sarcolemma is not clear. We therefore carried out an indirect immunofluorescence study on surgical biopsies of normal human skeletal muscle and of healthy human atrial myocardium biopsies of patients affected by valvulopathy. Our results indicate that, in skeletal muscle, sarcoglycans have a costameric distribution and all colocalize with each other. Only in a few cases did the α-sarcoglycan not colocalize with other sarcoglycans. In addition, these glycoproteins can be localized in different fibers either in the regions of the sarcolemma over band I or band A. In cardiac muscle, our results show a costameric distribution of all proteins examined and, unlike in skeletal muscle, they show a constant colocalization of all sarcoglycans with each other, along with a consistent localization of these proteins in the region of the sarcolemma over band I. In our opinion, this situation seems to confirm the hypothesis of a correlation between the region of the sarcolemma occupied by costameric proteins and the metabolic type, fast or slow, of the muscular fibers. These data, besides opening a new line of research in understanding interactions between the sarcoglycans and other transmembrane proteins, could also be extended to skeletal and cardiac muscles affected by neuromuscular and cardiovascular pathologies to understand possible structural alterations.
Clinical Effects of the Nd:YAG Laser Operating in the Photodisruptive and Thermal Modes
Authors: Fankhauser Franz , Kwasniewska Sylwia
Published: April 2003

The clinical effects of the Nd:YAG laser operating in both the photodisruptive (Q-switched) and thermal (free-running, cw) modes are discussed, and their clinical applications investigated. Moreover, the physical background of the working modes is explored. When working in the photodisruptive and fundamental (TEM00) modes, it is possible to carry out delicate clinical tasks with minimally invasive effects. When the laser is being used in the multimode regime, tasks that are highly resistant to photodisruptive laser radiation can be undertaken. In the thermal mode, photocoagulation can be performed. Nd:YAG laser light (1,064 nm) has high optical tissue penetration and good hemostatic properties, particularly when it is being operated in the frequency-doubled mode (KTP laser).
Early and Late Assessment of Internal Drainage of Chronic Dacryocystitis
Authors: Mansour Khaled , Janssen Alfred G. , van Bijsterveld O. Paul
Published: April 2003

To evaluate the efficacy of internal drainage of a lacrimal abscess, we treated 10 patients with pyocele of the lacrimal sac, who did not want to undergo operative intervention. A temporary nasolacrimal stent was placed in the nasolacrimal duct, and the pussy material was collected for microbiological examination to adjust the preliminary antibiotic treatment which was given systemically and locally. The stents were removed after the infection had subsided clinically. Three years later, there was a recurrence of the infection in only 1 patient. This internal drainage of the lacrimal sac, combined with systemic and local antibiotics, was successful in 90% of the patients.
Trabeculectomy with Mitomycin C versus Trabeculectomy Alone for Juvenile Primary Open-Angle Glaucoma
Authors: Tsai Jen-Chia , Chang Hsueh-Wen , Kao Chien-Neng , Lai Ing-Chou , Teng Mei-Ching
Published: April 2003

Purpose: We compare the intermediate-term outcome of initial trabeculectomy with adjunctive mitomycin C use versus initial trabeculectomy alone for juvenile primary open-angle glaucoma. Methods: This retrospective consecutive analysis included 44 eyes from 36 patients with juvenile primary-open angle glaucoma, all of whom underwent either initial trabeculectomy with adjunctive mitomycin C use (15 eyes) or initial trabeculectomy alone without mitomycin C use (29 eyes). We compared the success rate and complications between the two groups in a three-year follow-up period following surgery. Results: Three years subsequent to surgery, the cumulative success probability was 73% for the mitomycin C group and 68% for the control group, there being no real difference between the two groups (p = 0.89). A greater incidence of hypotony maculopathy was found amongst the mitomycin C group than was the case for the control group (20 versus 0%, respectively, p = 0.034). A lower intraocular pressure amongst the mitomycin C group was noted as compared with the control group (10.8 ± 3.0 versus 13.3 ± 3.8 mm Hg, respectively, p = 0.017) amongst the successfully treated patients. Conclusions: Despite the lower intraocular pressure level for the successfully treated patients from the trabeculectomy with mitomycin C group, and a greater incidence of resultant hypotony maculopathy for this group as compared with the trabeculectomy alone group, there appeared to be no significant difference in the cumulative success probability for this group as compared with the trabeculectomy alone group. Therefore, we caution against the use of an initial trabeculectomy with mitomycin C for juvenile primary open-angle glaucoma.
Ureteral and Sigmoid Obstruction Caused by Pelvic Actinomycosis in an Intrauterine Contraceptive Device User
Authors: Nasu Kaei , Matsumoto Harunobu , Yoshimatsu Jun , Miyakawa Isao
Published: April 2003

We report herein a rare case of ureteral and sigmoid obstruction caused by pelvic actinomycosis in a patient fitted with an intrauterine contraceptive device (IUCD). A 63-year-old Japanese woman was admitted complaining of lower abdominal pain and slight fever continuing for a month. She had a history of IUCD insertion 30 years previously and had been menopausal for the past 10 years. Ultrasonography and CT scan revealed a solid pelvic mass involving the uterus, sigmoid colon, urinary bladder, and right ureter. The IUCD was detected in the uterine cavity. Right hydronephrosis and hydroureter due to an obstruction of the distal ureter and the extensive stenosis of the sigmoid colon were also observed. Blood analysis showed leukocytosis, thrombocytosis, and elevated C-reactive protein levels. Although pathological and microbiological analysis of the removed IUCD showed negative results for Actinomyces infection, these findings suggested a pelvic abscess caused by actinomycosis. Benzyl penicillin administration was started immediately. Total hysterectomy, bilateral salpingo-oophorectomy, and lysis of adhesion around the ureter were performed. Actinomycosis was diagnosed based on histologic examination. The patient’s postoperative course was uneventful except for persistent mild hydroureter and hydronephrosis. The patient is now healthy without evidence of recurrent Actinomyces infection 1 year after treatment. As shown in the present case, pelvic actinomycosis should be considered as a cause of pelvic inflammatory disease in IUCD users, even though Actinomyces was not detected on the IUCD.
Correlations between Extent and Spread of Adenomyosis and Clinical Symptoms
Authors: Sammour Aref , Pirwany Imran , Usubutun Alp , Arseneau Jocelyne , Tulandi Togas
Published: April 2003

Objective: To correlate the histopathology of adenomyosis particularly the depth and spread of adenomyosis and symptomatology. Study Design: Medical records of 94 patients who had undergone a hysterectomy and who were found to have adenomyosis on histopathologic examination were reviewed and histopathologic slides were reexamined. The symptoms were correlated with the presence of adenomyosis, the depth of penetration, and the spread of adenomyosis foci. Results: Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into the myometrium of up to 25%; group B, 26–50%; group C, 51–75%, and group D, >75%. There was a significant correlation between the depth of penetration and the number of adenomyosis foci (r = 0.3446; p = 0.0001). Hemosiderin deposition was found mainly in the specimens with penetration of >75%. The symptoms did not correlate with the degree of penetration (r = 0.088; p NS). However, the spread of adenomyosis correlated significantly with pelvic pain (r = 0.80, p = 0.02), and with dysmenorrhea (r = 0.81, p = 0.01), but not with menorrhagia or dyspareunia. Conclusions: Hemosiderin deposition and adenomyosis foci are found predominantly in specimens with deep adenomyosis penetration. It suggests that the deeper the penetration, the more extensive the adenomyosis. Symptoms of adenomyosis do not correlate with the depth of penetration, but there is a correlation between the spread of adenomyosis and pelvic pain, and dysmenorrhea.
Seed Dispersal by Sympatric Tamarins, Saguinus mystax and Saguinus fuscicollis: Diversity and Characteristics of Plant Species
Authors: Knogge Christoph , Heymann Eckhard W.
Published: April 2003

In a comparative study of Saguinus mystax and Saguinus fuscicollis, we examined the spectrum of plant species whose seeds are dispersed by these two tamarin species. We characterize these plants in terms of life form, fruit colour, pulp consistency and seed dimensions. The tamarins disperse a much broader spectrum of plant species than previously reported (88 of the total of 155 species exploited for fruit). While the distribution over plant life form, fruit colour and pulp consistency is identical between dispersed plant species and the overall spectrum of consumed plant species, clear differences exist in all seed parameters (length, width, height, volume, mass) except specific weight between dispersed and non-dispersed plant species for both tamarin species. Plant and fruit characteristics and seed parameters of dispersed plant species do not differ between S. mystax and S. fuscicollis, suggesting that their ecological and evolutionary interaction with plants is very similar or identical.
Mal de Meleda: A New Geographical Localization in Anatolia
Authors: Ergin Ş. , Erdogan B. Şanlı , Aktan Ş.
Published: April 2003

Background: Mal de Meleda (MDM) is an autosomal recessive form of palmoplantar keratoderma first described on the Dalmatian island of Meleda. MDM has been observed in many other countries so that the origin of the MDM gene may be elsewhere than in Meleda. Objective: After identification of the first MDM patient during a medical visit, a study was planned to reveal other families with MDM in the Köprüçay region in Anatolia. Methods: The patient was interviewed with a questionnaire including a pedigree drawing. All the subsequent cases reported to be of MDM were visited for clinical examination and pedigree drawings. Results: Thirty-nine patients, 8 families and 2 additional cases with MDM were identified in a 50-km2 mountainous region in Köprüçay canyon in Anatolia. The prevalent clinical features were nail involvement (80%), ‘glove-and-sock’ distribution of the keratoderma (60%), edema on the hands/feet (60%), conical tapering of the fingertips (60%) and hyperhidrosis on the palms and soles (50%). Conclusion: To our knowledge, this is the largest series reported. The relationship between the patients in Meleda and those in Anatolia awaits discovery by further researches that will be carried out with the collaboration of dermatology, genetics and medical history departments.
Non-Drug Therapies for Dementia: An Overview of the Current Situation with Regard to Proof of Effectiveness
Authors: Gräsel Elmar , Wiltfang Jens , Kornhuber Johannes
Published: April 2003

An overview will be presented of music therapy, art therapy, movement therapy and reminiscence therapy, memory training, reality orientation, validation therapy, self-maintenance therapy, behaviour therapy, milieu therapy and staff training. The overview will examine the aims of each, the principles on which procedures are based and the proof of their effectiveness. The principal aim of non-drug therapies is to influence symptomatic dementia beneficially and to improve the abilities remaining to the patient. The potential benefits are usually deduced from studies made without control groups. At the present time, proof of the effectiveness of these therapies is still lacking as controlled, randomized studies have yet to be conducted, and so a fundamental evaluation of the therapeutic benefits of non-drug therapies in the treatment of dementia cannot yet be made.
Recognition of Facial Expressions and Emotional Situations in Patients with Dementia of the Alzheimer and Vascular Types
Authors: Shimokawa Akio , Yatomi Naomi , Anamizu Sachiko , Torii Shigeo , Isono Hiroshi , Sugai Yuuichi
Published: April 2003

The aim of this study was to investigate the ability of patients with dementia to recognize facial expressions and emotional situations. We evaluated 16 patients with dementia of the Alzheimer type (DAT) and 15 with vascular dementia (VD) for general cognition, discrimination of facial expressions and individual faces, and recognition of facial expressions and emotional situations. VD patients performed significantly worse than DAT patients at recognizing facial emotions, even though there was no difference between them in their general cognition and visuoperceptual abilities. There was no significant difference between them in their ability to recognize emotional situations. The results of this and past studies suggest that caregivers in nursing homes and hospitals need to be aware that VD patients lose the ability to comprehend facial expressions.
Kinematic Analysis of Handwriting Movements in Patients with Alzheimer’s Disease, Mild Cognitive Impairment, Depression and Healthy Subjects
Authors: Schröter A. , Mergl R. , Bürger K. , Hampel H. , Möller H.-J. , Hegerl U.
Published: April 2003

A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal motor symptoms (EPMS) are common in patients with Alzheimer’s disease (AD). Several studies have reported an association of EPMS with severity, progression and poor prognosis of AD. The majority of these studies used clinical assessments for the rating of EPMS. In this study, kinematic handwriting analysis was used to quantify differences in fine hand motor function in patients with probable AD and mild cognitive impairment (MCI, as an assumed initial stage of AD) compared to depressed patients and healthy controls. Both patients with MCI and patients with probable AD exhibited loss of fine motor performance. Movements of AD patients were significantly less regular than those of healthy controls.
Associated Ischemic Lesions in Intracranial Hemorrhage: MRI Study
Authors: Kang Kyusik , Lee Yong-Seok , Kim Nam-Hee , Kim Dong-Eog , Park Seong-Ho
Published: April 2003

Cerebral small-vessel disease is an important cause of a hemorrhagic stroke (HS) or a certain type of ischemic stroke (IS). Using magnetic resonance imaging, the frequency and the pattern of ischemic lesions between an HS group and an IS group were compared. Sixty-eight patients with HS and 104 patients with IS as a control group were enrolled in this study. The rate of grade 2 and 3 periventricular white matter lesions (WML) in the HS group was similar to that in the IS group. However, grade 2 and 3 lacunes (LAC) were more frequent in the HS group. These results show that the incidence of concomitant silent LAC is different from that of WML in HS patients. This suggests that the pathophysiology of WML and that of LAC is different and that the pathophysiology of HS is closely associated with that of LAC.
Does Bone Marrow Contain Renal Precursor Cells?
Authors: Poulsom Richard
Published: April 2003

In the past few years stem cells normally present within the bone marrow have been shown to have considerable plasticity in the repertoire of the cells that they produce. They are capable of producing specific lineages of cells not only of the blood, but also contribute usefully to lineages of other organs. In the kidney, studies in humans and rodents provide evidence for the presence of bone marrow-derived ‘re-programmed’ cells, but it remains possible that the cells that arrive and re-differentiate are no longer stem cells (quiescent cells, not actively proliferating). Nevertheless, the fact that appropriately differentiated cells are delivered deep within the kidney simply by injection of bone marrow cells should make us think differently about the way these organs regenerate and repair. Migratory pathways for multipotential stem cells could be exploited to effect repair using an individual’s own stem cells, perhaps after gene therapy. It is clear also that a transplanted organ would in time become affected by the genetic susceptibilities of the recipient, because of phenotypes that are expressed when trafficking cells engraft and differentiate.
Urinary Concentration Defect and Limited Expression of Sodium Cotransporter, rBSC1, in a Rat Model of Chronic Renal Failure
Authors: Michimata Mari , Kazama Itsuro , Mizukami Kazuhiko , Araki Tsutomu , Nakamura Yohsuke , Suzuki Michiko , Wang Weihua , Fujimori Keisei , Satomi Susumu , Ito Sadayoshi , Imai Yutaka , Matsubara Mitsunobu
Published: April 2003

Background: Renal urinary concentration is associated with enhanced expression of sodium cotransporter (rBSC1) in thick ascending limb of Henle. Overexpression of rBSC1 was reported recently in hypertrophied nephrons after unilateral nephrectomy (UNX) and in kidney isografts. Since urinary concentration defect and hypertrophy of residual nephrons are major manifestations of chronic renal failure (CRF), we investigated the rBSC1 signals for RNA and protein in a rat model of CRF. Methods: Rats underwent 5/6 nephrectomy and examined 8 weeks after operation. rBSC1 mRNA was examined by competitive PCR and in situ hybridization, and rBSC1 protein signals by western blotting and immunohistochemistry. Rats that underwent sham-operation, UNX, or 5/6 nephrectomy followed by a 3-week recovery period (acute renal failure), were used as control. Water intake was restricted for 24 h in subgroups of control and CRF rats. Results: Microscopic examination showed hypertrophy of residual nephrons in both UNX and CRF rats. Signals for rBSC1 mRNA and protein were enhanced at basal condition only in rats with UNX. Under basal conditions, CRF rats demonstrated low urinary osmolality in spite of high plasma arginine vasopressin levels. Water restriction resulted in increased signals for rBSC1 mRNA and protein and concentration of urine in sham-operated rats, but such increases were absent and urinary concentration was incomplete in CRF rats. Conclusions: Compensatory overexpression and upregulation of rBSC1 expression in response to dehydration are both absent in CRF rats. These limitations are thought to be the underlying mechanisms of urinary concentrating defect seen in CRF.
Results of Anterior Chamber Clearance via the Pars plana in Pseudophakic Endophthalmitis
Authors: Patil Rajashekhar , Talwar Dinesh , Verma Lalit K. , Sharma Yog Raj , Nainiwal Sanjeev , Azad Raj Vardhan , Tewari Hem K.
Published: April 2003

Purpose: Patients with endophthalmitis have extensive fibrinous exudates in the anterior chamber. Clearance of these exudates in pseudophakic patients during vitrectomy is difficult. We evaluated the results of the pars plana approach for clearing these exudates. Material and Methods: Eighteen patients with pseudophakic endophthalmitis underwent clearance of anterior chamber exudates through the pars plana approach after initial creation of a peripheral iridectomy with a vitrectome. Results: The exudates were adequately cleared in all 18 patients with good posterior segment visualization during vitrectomy. Minor punctate iris bleeds (4 patients), intraoperative dislocation of the intraocular lens (IOL) (1 patient) and postoperative dislocation of the IOL following blunt trauma, 9 months after vitrectomy (1 patient) were the complications noted. Conclusion: This technique is simple, safe and helps clearing anterior chamber exudates. It also permits excellent visualization during vitrectomy for pseudophakic endophthalmitis.
Safety of Unoprostone Isopropyl 0.15% Ophthalmic Solution in Patients with Mild to Moderate Asthma
Authors: Gunawardena Kulasiri A. , Crame Nathan , Mertz Beat , Shams Naveed
Published: April 2003

Purpose: To assess the safety of unoprostone isopropyl 0.15% ophthalmic solution (UIOS) in patients with mild to moderate asthma. Methods: Randomized, double-masked, two-period crossover, placebo-controlled study comparing unoprostone 0.15% with vehicle-placebo. Pulmonary function tests conducted at baseline and during the 4-hour postdose observation period included forced expiratory volume in 1 s, forced vital capacity, peak expiratory flow rate, and bronchodilator response after 200 µg inhaled salbutamol. Results: There were no significant changes in pulmonary function up to 4 h postdose after treatment with 1 drop unoprostone 0.15% in each eye. Conclusion: Unoprostone 0.15% was safe for use in patients with mild to moderate asthma, without affecting the response to bronchodilator therapy.
Color Doppler Imaging of Choroidal Circulation in Patients with Asymmetric Age-Related Macular Degeneration
Authors: Üretmen Önder , Akkın Cezmi , Erakgün Tansu , Killi Refik
Published: April 2003

We aimed at evaluating the possible role of choroidal perfusion abnormalities in the development of choroidal neovascularisation (CNV) in patients with age-related macular degeneration (AMD). Twenty-six patients who had non-exudative AMD in the first eye and CNV secondary to AMD in the fellow eye were enrolled. Blood flow velocities, vessel pulsatilities and resistivities were measured from ophthalmic artery, nasal and temporal posterior ciliary arteries using colour Doppler imaging. Systolic and diastolic velocities were lower in eyes with CNV for all vessels, except for the systolic velocity of the nasal posterior ciliary artery (p >0.05). Pulsatility and resistivity indices were higher in eyes with CNV for all vessels. This difference was statistically significant for the resistivity index of the nasal and temporal posterior ciliary arteries (p = 0.032 and p = 0.021, respectively) and the pulsatility index of the nasal posterior ciliary artery (p = 0.035). We have shown that in patients with AMD choroidal blood flow is more impaired in the eyes with CNV than in the fellow eyes.
Classic Hypoglossal-Facial Nerve Anastomosis after Acoustic Neuroma Resection
Authors: Kunihiro Takanobu , Higashino Kazutaka , Kanzaki Jin
Published: April 2003

To clarify the factors contributing to patient satisfaction with facial movement after the classic hypoglossal-facial nerve anastomosis, we examined 46 such patients who consented to an interview and video-recording. No correlation was seen between the physician’s evaluation of returned function (according to Yanagihara’s 40-point scale and the grading system of House-Brackmann) and the scores (full marks: 100 points) the patients assigned to their own facial movements. Instead the scores that the patients assigned were closely related to subjective oral dysfunction, such as difficulty in masticating, articulating, and swallowing. Those scores did not correlate with eye-related functional deficits. These findings indicate that modified techniques to minimize the hypoglossal nerve deficit may enhance patient satisfaction without sacrificing recovery of facial movements.
Behavioral and Emotional Disturbances in the Offspring of Depressed Parents with Anger Attacks
Authors: Alpert Jonathan E. , Petersen Timothy , Roffi Pamela A. , Papakostas George I. , Freed Rachel , Smith Megan M. , Spector Andrew R. , Nierenberg Andrew A. , Rosenbaum Jerrold F. , Fava Maurizio
Published: April 2003

Background: To examine the emotional and behavioral characteristics of the offspring of depressed parents with and without anger attacks. Methods: Forty-three parents who met criteria for major depressive disorder (MDD) completed the Achenbach Child Behavior Checklist – Parent Report Version (CBCL) for each of their birth children (n = 58, age range 6–17 years). Unpaired t tests were used to evaluate the CBCL scale score differences between children of parents with and children of parents without anger attacks. Baseline demographics and clinical differences between the two groups of parents were also evaluated. Results: Parents with anger attacks had a significantly younger age of onset of MDD. Offspring of depressed parents with anger attacks were found to have significantly lower social and school competency scale scores and higher scores for delinquency, attention problems, and aggressive behavior. In addition, this group was found to have a significantly higher total T score (a global measure of psychopathology). Conclusions: There are some important differences between offspring of depressed parents with and without anger attacks. This finding may be important in identifying and formulating intervention strategies for childhood problems in the offspring of depressed parents.
Multifactorial Determination of Hypertensive Nephroangiosclerosis
Authors: Tylicki Leszek , Rutkowski Boleslaw , Hörl Walter H.
Published: April 2003

Essential hypertension causes renal injury. Hypertensive nephroangiosclerosis (HN) or hypertensive nephropathy are terms most commonly used to describe this renal pathology. Although specific histological lesions occurring in affected kidneys are well known, pathogenesis of hypertension-related renal scarring is not completely understood. Evidence exists to support the theory that other factors such as aging, black race or smoking, beside blood pressure, contribute to the development and progression of HN. Metabolic disturbances, cocaine and nonsteroidal anti-inflammatory drug abuse, ochratoxin A exposure, dietary salt intake, heavy metal toxicity, hantavirus infection and perinatal programming are also considered risk factors. Renal susceptibility genes may determine whether hypertension-induced progressive renal damage occurs and how severe it is. Determination of all risk factors may identify patients at high risk of renal failure and help tailor an appropriate management. In the present paper, the knowledge available on this clinically important objective is discussed.
BIA 3-202, a Novel Catechol-O-Methyltransferase Inhibitor, Reduces the Peripheral O-Methylation of L-DOPA and Enhances Its Availability to the Brain
Authors: Parada António , Soares-da-Silva Patrício
Published: April 2003

The present study aimes at determining the effects of the catechol-O-methyltransferase (COMT) inhibitor BIA 3-202 [1-(3,4-dihydroxy-5-nitrophenyl)-2-phenyl-ethanone] upon levels of L-3,4-dihydroxyphenylalanine (L-DOPA) and metabolites in peripheral circulation (jugular vein), whole brain, and striatal microdialysates in rats orally treated with L-DOPA plus benserazide. A low dose (3 mg/kg) of BIA 3-202 was relatively selective to inhibit liver COMT, being devoid of major significant inhibitory effects upon brain COMT. By contrast, a high dose (30 mg/kg) of BIA 3-202 markedly inhibited liver and brain COMT. BIA 3-202 (3 and 30 mg/kg) reduced the L-DOPA-induced rise of 3-O-methyl-L-DOPA in the peripheral circulation (jugular vein), brain tissue, and striatal dialysate, but failed to increase the levels of dopamine in striatal dialysates despite the increase in dopamine brain levels. However, the changes in brain levels of L-DOPA, 3-O-methyl-L-DOPA, and dopamine and in striatal dialysate levels of L-DOPA and 3-O-methyl-L-DOPA, obtained with 3 mg/kg BIA 3-202, were not different from those obtained with 30 mg/kg BIA 3-202. In conclusion, inhibition of peripheral COMT by BIA 3-202 may suffice to improve the availability of L-DOPA to the brain.
Atrial Fibrillation Is Associated with Severe Acute Ischemic Stroke
Authors: Dulli Douglas A. , Stanko Heather , Levine Ross L.
Published: April 2003

Atrial fibrillation (AF) is a common risk factor for disabling ischemic stroke in the elderly, but it is not clear that its severity is generally worse than that of ischemic stroke due to other etiologies. We reviewed the clinical presentations of patients with acute ischemic stroke admitted between 1990 and 2001. The etiologies of these strokes were also classified using well-established criteria. Of 1,061 patients with acute ischemic stroke, 216 (20.3%) had AF. The frequency of bedridden state was 41.2% in patients with AF, compared to 23.7% in patients without AF (p < 0.0005). Other measures of clinical stroke severity showed similar disparities between these groups. The odds ratio for bedridden state following ischemic stroke due to AF was 2.23 (95% CI = 1.87–2.59, p < 0.0005) by multivariate logistic regression. Ischemic stroke associated with AF is typically more severe than ischemic stroke due to other etiologies, and this increased severity is independent of advanced age and other stroke risk factors.
Clear Cell Sarcoma of the Kidney with Invasion of the Inferior Vena cava
Authors: Rosso D. , Ghignone G.P. , Bernardi D. , Zitella A. , Casetta G. , De Zan A. , Tizzani A.
Published: April 2003

Objective: We present a case of clear cell sarcoma of the kidney (CCSK) in 53-year-old white man who was treated with surgery. This case represents the oldest patient with CCSK published in the English literature. Methods: Right radical nephrectomy with lymphadenectomy and thrombectomy was performed. Results: Histological findings indicated a CCSK. Tumor cells showed positive vimentin staining. Conclusion: CCSK is considered a rare and highly malignant renal tumor. The malignant nature may relate not only to the biological features of these tumor cells, but also to the high resistance against radiation and chemotherapy. The treatment of CCSK has been a subject of controversy.