bluuebunny/crossref_metadata_2025 huggingface dataset:
Cocaine Use in Europe – A Multi-Centre Study: Patterns of Use in Different Groups
Authors: Prinzleve Michael , Haasen Christian , Zurhold Heike , Matali Josep Lluis , Bruguera Eugeni , Gerevich József , Bácskai Erika , Ryder Niamh , Butler Shane , Manning Victoria , Gossop Michael , Pezous Anne-Marie , Verster Annette , Camposeragna Antonella , Andersson Pia , Olsson Börje , Primorac Andjela , Fischer Gabriele , Güttinger Franziska , Rehm Jürgen , Krausz Michael
Published: September 2004

Aim: The study investigates patterns of cocaine powder and crack cocaine use of different groups in nine European cities. Design, Setting, Participants: Multi-centre cross-sectional study conducted in Barcelona, Budapest, Dublin, Hamburg, London, Paris, Rome, Vienna, and Zurich. Data were collected by structured face-to-face interviews. The sample comprises 1,855 cocaine users out of three subgroups: 632 cocaine users in addiction treatment, mainly maintenance treatment; 615 socially marginalized cocaine users not in treatment, and 608 socially integrated cocaine users not in treatment. Measurements: Use of cocaine powder, crack cocaine and other substances in the last 30 days, routes of administration, and lifetime use of cocaine powder and crack cocaine. Findings: The marginalized group showed the highest intensity of cocaine use, the highest intensity of heroin use and of multiple substance use. 95% of the integrated group snorted cocaine powder, while in the two other groups, injecting was quite prevalent, but with huge differences between the cities. 96% of all participants had used at least one other substance in addition to cocaine in the last 30 days. Conclusions: The use of cocaine powder and crack cocaine varies widely between different groups and between cities. Nonetheless, multiple substance use is the predominating pattern of cocaine use, and the different routes of administration have to be taken into account.
Outcome Expectancies and Ecstasy Use in Visitors of Rave Parties in the Netherlands
Authors: Engels Rutger C.M.E. , ter Bogt Tom
Published: September 2004

The aim of this study was to examine the associations between outcome expectancies and ecstasy use in a sample of visitors of raves. The type of expectancies that people endorse were explored, as well as the differences between users and nonusers in expected outcomes of ecstasy use, and the associations between expectancies and quantity of ecstasy use within the group of users. Questionnaires were administered to 844 young visitors of 7 parties in the Netherlands, of which 543 reported to be users. Drug use on these parties was high: 65% reporting ecstasy use. Factor analyses showed 7 factors: negative consequences, enhancement, euphoria, sexiness, dancing, communication and self-insight. These factors strongly discriminated between users and nonusers. In particular those who scored high on self-insight and low on negative effects were most likely to use ecstasy. The expected outcomes of ecstasy are related to ecstasy use and patterns of use providing information for health education directed on long-term negative and positive effects of ecstasy use. Longitudinal research on random samples of visitors of raves is warranted.
Comparison between Self-Report and a Dipstick Method (NicCheck 1®) to Assess Nicotine Intake
Authors: Bernaards Claire M. , Twisk Jos W.R. , van Mechelen Willem , Snel Jan , Kemper Han C.G.
Published: September 2004

The purpose of this study was to investigate the agreement between self-reported tobacco consumption and NicCheck 1® (Dynagen Inc. Cambridge, Mass., USA) regarding smoking status and nicotine intake in a population of smokers (20.8%) and non-smokers. NicCheck 1 is a dipstick that changes colour in the presence of urinary nicotine metabolites. Smoking was assessed by self-report and NicCheck 1 in 169 males and 191 females (mean age 36.0 SD 0.7). Self-report and NicCheck 1 agreed highly on smoking status, especially in moderate to heavy smokers. With regard to nicotine intake, there was a large overlap in self-reported tobacco consumption between NicCheck 1 levels, despite a relatively high correlation coefficient between self-report and NicCheck 1 in smokers (i.e. 0.74). No effect modification by gender or BMI was found. When both methods were validated against two blood lipid parameters, self-report seemed to do equally well as NicCheck 1 in assessing nicotine intake.
Alcohol and Non-Fatal Drug Overdoses
Authors: Ødegård Einar , Rossow Ingeborg
Published: September 2004

The purpose of this study was to explore to what extent alcohol is a factor in non-fatal overdoses on the basis of records of ambulance emergencies, and to what extent this varies across gender and age. Furthermore, we wanted to investigate whether alcohol intake, in relation to an overdose, is associated with the risk of recurrent overdoses, and if so, whether such an association varies across gender and age. To investigate the role of alcohol intake in non-fatal overdoses, analyses were conducted both at the event level and at the individual level. Bivariate associations were explored in table analyses and by comparisons of means. To determine whether alcohol intake was associated with experiencing recurrent overdoses, survival analyses were conducted applying Kaplan-Meier estimation and Cox regression models. Furthermore, a linear regression model was estimated to assess the impact of gender age and number of overdoses on the proportion of overdoses in which alcohol was involved. Between groups of clients who had overdosed once, several times or many times, we found that there was a U-shaped relationship. The proportion of overdoses with alcohol involved was highest among those who had overdosed once and those who had overdosed more than ten times. The probability for a recurrent overdose was higher among those who were reported with no alcohol intake in the first overdose. Being female and having alcohol involved in the first overdose registered during our observation period reduced the risk for a recurrent overdose. However, age seemed to be a gradient with respect to alcohol’s association with recurrent overdoses. While alcohol was associated with a significantly lower risk for recurrence in the two youngest age groups, this is not the case in the oldest age group. A possible explanation might be that it is a change in the pattern of drug use as an effect of aging where infrequent heroin use in combination with frequent alcohol intake increases with increasing age. For this type of drug users the individual’s risk of recurrent overdoses may be lower due to fewer events of heroin intake.
French Version of the Addiction Severity Index (5th Edition): Validity and Reliability among Swiss Opiate-Dependent Patients
Authors: Krenz Sonia , Dieckmann Sarah , Favrat Bernard , Spagnoli Jacques , Leutwyler Joëlle , Schnyder Christiane , Daeppen Jean-Bernard , Besson Jacques
Published: September 2004

Objective: The aim of the study was to validate a French adaptation of the 5th version of the Addiction Severity Index (ASI) instrument in a Swiss sample of illicit drug users. Participants and Setting: The participants in the study were 54 French-speaking dependent patients, most of them with opiates as the drug of first choice. Procedure: Analyses of internal consistency (convergent and discriminant validity) and reliability, including measures of test-retest and inter-observer correlations, were conducted. Results: Besides good applicability of the test, the results on composite scores (CSs) indicate comparable results to those obtained in a sample of American opiate-dependent patients. Across the seven dimensions of the ASI, Cronbach’s α ranged from 0.42 to 0.76, test-retest correlations coefficients ranged from 0.48 to 0.98, while for CSs, inter-observer correlations ranged from 0.76 to 0.99. Conclusions: Despite several limitations, the French version of the ASI presents acceptable criteria of applicability, validity and reliability in a sample of drug-dependent patients.
Outpatient Alcohol Detoxification: Implementation Efficacy and Outcome Effectiveness of a Model Project
Authors: Soyka Michael , Horak Michael
Published: September 2004

Background: The aim of the study was to examine the practicability and implementation efficacy of an alcohol outpatient detoxification model and the concomitant ‘motivational’ psychotherapeutic approach. Method: This was an open prospective study to examine the implementation efficacy, practicability and medical safety of a novel psychotherapy-based, integrated outpatient detoxification model in alcohol-dependent patients. Patients were carefully screened for relevant neuropsychiatric disorders and other exclusion criteria and then seen on a daily outpatient basis for 5–7 days. Patients received psychotropic or other medication, if necessary (CIWA-A score >16). Beside management of withdrawal symptoms, psychotherapeutic interventions were conducted to motivate the patient for further alcohol therapy. Results: Of 557 patients screened 331 entered the program. For medical reasons 226 patients had to be admitted for inpatient detoxification, 122 patients in a special alcohol unit, 101 patients in a general hospital. 198 (60%) of the outpatients received psychotropic medication during treatment. 312 (94%) of these patients successfully completed treatment. 301 (91% of the initial sample) patients entered a consecutive 3-month motivational phase of a two-phase alcohol treatment program. 139 (46%) patients successfully completed the 1-year consecutive outpatient treatment. Conclusions: Outpatient detoxification, at least in a highly structured frame, can be considered as a safe and efficient therapeutic approach. The data of this study also indicate that psychotherapeutic interventions and motivation for further abstinence and treatment may work in alcohol-dependent patients on an outpatient basis. Further controlled trials are necessary to compare the effects of outpatient versus inpatient withdrawal.
Surgical Outcomes of Ulnar Nerve Lesions in Children
Authors: Baysefer Alper , Izci Yusuf , Akay Kamil Melih , Kayali Hakan , Timurkaynak Erdener
Published: September 2004

The ulnar nerve provides the major motor innervation of the interosseous muscles of the hand and the flexor muscles of the wrist and the fourth and fifth digits. Injury is most common at the wrist, forearm or elbow, secondary to trauma or entrapment. Pediatric ulnar nerve lesions differ from adult lesions by their quicker axonal regeneration. Neural plasticity is also greater in children. We analyzed 21 pediatric patients with ulnar nerve lesion who underwent surgical treatment between 1995 and 2002 to determine if there were differences in the neurological outcome in terms of the type of lesion and surgery. Data showed that excellent results were found in 100% of the lesions treated by simple decompression and nearly 58% of the lesions treated by neurolysis. Good results were obtained in 33% of lesions treated by neurolysis. There were fair results for surgery performed in discontinuous lesions.
Endocrinological Outcome of Different Treatment Options in Children with Craniopharyngioma: A Retrospective Analysis of 66 Cases
Authors: Gonc E. Nazli , Yordam Nursen , Ozon Alev , Alikasifoglu Ayfer , Kandemir Nurgun
Published: September 2004

Craniopharyngioma is one of the leading causes of hypothalamic-pituitary dysfunction in childhood, caused either by the tumor itself or the consequences of treatment. Tumor management in terms of recurrence rate, quality of life and complications is still controversial. Sixty-six patients with craniopharyngioma at pediatric age were reviewed for symptoms, signs, types of treatment, recurrence rates, complications, and endocrinological outcome. The majority of symptoms was related to the neurological system. Complaints only affecting the endocrinological system were seen in 6% of patients. The most frequent complaints were headache and vomiting (74.2%). The main endocrinological complaints were polyuria and polydipsia (15%), and lassitude (10.6%). Although short stature was a symptom in 9.1% of patients, it was a finding in 39.7% of patients. Plain skull X-rays raised the suspicion of intracranial tumor in more than 90% of children with craniopharyngioma. Recurrence rates were independent of the extent of tumor removal (total or subtotal). The frequency of endocrine dysfunction increased significantly after treatment. The most frequent hypothalamic-pituitary dysfunction was growth hormone deficiency (100%) and gonadotropin deficiency (80%). Hypothyroidism was diagnosed in 74% of patients. The frequency of hypothalamic-pituitary dysfunction was not affected by the extent of tumor removal. Radiotherapy did not increase the frequency of endocrine dysfunctions further. In conclusion, growth follow-up in childhood seems to be an important indicator of craniopharyngioma in early diagnosis. Radiotherapy and extent of tumor removal – either total or subtotal – did not influence endocrine outcome.
Congenital Cystic Hemangioblastomas of the Cerebral Hemisphere in a Neonate without Alteration in the VHL Gene
Authors: Johnson Mahlon D. , Mitchell Alex R. , Troup E. Christopher , Bhowmick Deb A. , Wait Scott D. , Aulino Joseph , Zhuang Zhengping , Weil Robert J.
Published: September 2004

A 4-week-old child presented with lethargy, emesis, decreased spontaneous movements, and a bulging fontanelle. Neuroimaging demonstrated a large, hemispheric, multicystic lesion with multiple enhancing nodules, which, on pathological examination, proved to be multiple, distinct hemangioblastomas. Careful molecular analysis failed to reveal alterations of the VHL gene. This represents an uncommon presentation for these tumors and suggests that genes other than VHL may be important in the genesis of these tumors.
Minimally Invasive Management of a Traumatic Artery Aneurysm Resulting from Shaken Baby Syndrome
Authors: Levine Nicholas B. , Tanaka Tomoko , Jones Blaise V. , Crone Kerry R.
Published: September 2004

Based on our review of the literature, we present the first use of coiling in an infant with a traumatic artery aneurysm that resulted from shaken baby syndrome. Computed tomography (CT) scans showed a skull fracture, hemorrhagic subdural collections, multiple parenchymal contusions, and intraventricular and subarachnoid hemorrhages in a 3-week-old infant who presented with lethargy, poor feeding, and seizure. These multiple injuries were consistent with shaken baby syndrome. After closed-head injury medical management, including subdural taps, the baby was discharged home. When increasing seizures and hydrocephalus developed 8 months later, CT angiographic scans showed a pseudoaneurysm of the anterior cerebral artery. We successfully occluded the aneurysm with pushable coils placed via a microcatheter and treated the obstructive hydrocephalus with endoscopic third ventriculostomy. We show that minimally invasive radiological and surgical techniques may be effective in managing the sequelae of trauma in children.
Exclusive Lower Extremity Mirror Movements and Diastematomyelia
Authors: Tubbs R. Shane , Smyth Matthew D. , Dure Leon S. , Oakes W. Jerry
Published: September 2004

Mirror movements usually seen in the Klippel-Feil syndrome are most commonly appreciated in the upper extremities. Lower extremity involvement is seen rarely and when observed, is found in conjunction with upper extremity mirror movements. We report what we believe to be the first case of mirror movements found exclusively in the lower extremities in a female patient presenting with tethered cord syndrome. Our hopes are that this report will help elucidate mechanisms involved with these anomalous movements, as currently there is no commonly accepted etiology.
Nasal Chondromesenchymal Hamartoma of Infancy Clinically Mimicking Meningoencephalocele
Authors: Kim Bomi , Park Sung-Hye , Min Hye Sook , Rhee Jae Suh , Wang Kyu Chang
Published: September 2004

We report a typical case of nasal chondromesenchymal hamartoma (NCMH) of infancy, which extended to the orbit and intracranium through the skull base. The nasal mass was incidentally found in a 5-month-old otherwise healthy boy who had recently developed ptosis of the left eye. On neuroimaging, there were defects in the left ethmoid bone of the anterior cranial fossa and medial orbital wall. A round heterogeneous mass was found in the left nasal cavity. Solid portions were strongly enhanced. The preoperative diagnosis was nasal glioma or encephalocele. After frontal craniotomy, the mass was separated from the cranial basal dura. Through the transnasal approach, the mass was dissected from the left orbital content and removed. NCMH is a rare benign lesion and histopathological analogue of the mesenchymal hamartoma of the chest wall, having unique pathology: islands of hyaline cartilage, somewhat calcified or ossified hyalinized collagenous trabeculae and abundant myxoid stroma. Its occurrence in the nasal cavity was identified in 1998. The recognition of this entity is necessary to avoid misdiagnosis of the frozen section and for appropriate surgery.
On-Line Electrical Impedance Measurement for Monitoring Blood Viscosity during On-Pump Heart Surgery
Authors: Pop G.A.M. , de Backer T.L.M. , de Jong M. , Struijk P.C. , Moraru L. , Chang Z. , Goovaerts H.G. , Slager C.J. , Bogers A.J.J.C.
Published: September 2004

Background: The viscosity of blood (η) as well as its electrical impedance at 20 kHz at high shear rate depends on hematocrit, temperature, concentration of macromolecules and red cell deformability. The aim of our study was to investigate the relation between viscosity and electrical impedance in a heart-lung machine-like set-up, because during on-pump heart surgery considerable viscosity changes occur. Methods: Blood of 10 healthy volunteers was examined under temperature variation between 18.5 and 37°C at four different levels of hemodilution. Blood viscosity was examined with a golden-standard technique, i.e. a Contraves LS 30 Couette viscometer, and the results were compared with measurements of the electrical resistivity (R) at 20 kHz by a specially designed device in series with the tubing system of a heart-lung machine. All measurements were performed at a shear rate of 87 s–1. Results: Using stepwise multiparameter regression analysis (SPSS) a highly significant correlation was found (r2 = 0.882) between viscosity (η) and resistivity (R). Adding the variables sodium ([Na+]) and fibrinogen ([Fibr]) concentration the coefficient of correlation further improved to r2 = 0.928 and the relation became: η = –0.6844 + 0.038 R + 0.038 [Na+] + 0.514 [Fibr]. All coefficients showed a statistical significance of p < 0. 001. Conclusions: Electrical impedance measurement is feasible in a heart-lung machine-like set-up and allows accurate continuous on-line estimation of blood viscosity; it may offer an adequate way to record and control viscosity changes during on-pump heart surgery.
Aortic Aneurysm Repair Is Associated with a Lower Inflammatory Response Compared with Surgery for Inflammatory Bowel Disease
Authors: Oldenburg H.S.A. , Siroen M.P.C. , Boelens P.G. , Sluijter B.J.R. , Pruitt J.H. , Naseri A.H. , Rauwerda J.A. , Meijer S. , Cuesta M.A. , van Leeuwen P.A.M. , Moldawer L.L.
Published: September 2004

Background: Since the plasma cytokine profile reflects the body’s inflammatory response to injury, this study was designed to prospectively observe the plasma cytokine levels in response to the degree of different sorts of abdominal surgical trauma. Methods: Plasma levels of TNF-α, type I TNF receptor (p55), type II TNF receptor (p75), IL-6, IL-8, IL-10, phospholipase A2 (PLA2), and haptoglobin were measured peri-operatively in patients undergoing bowel resection for inflammatory bowel disease or diverticulitis (IBD) (n = 9), elective repair of abdominal aortic aneurysm (AAA) (n = 9), or laparoscopic cholecystectomy (lap chole) (n = 9). Results: The IBD patients showed a significant (p < 0.05) post-operative elevation in plasma IL-6, p55, p75, and PLA2 levels, but no significant change in TNF-α, IL-8, IL-10 or haptoglobin levels. The AAA patients had a significant post-operative rise in IL-10 levels and a significant decrease in plasma haptoglobin levels, but no significant change of TNF-α, IL-6, IL-8, p55, p75, or PLA2 concentrations. The lap chole patients demonstrated no significant change in any of these parameters. Conclusion: These data show that IL-6, IL-10, p55, and p75 are markers to measure the degree of inflammatory stress associated with abdominal operative procedures and demonstrate the relative lack of a cytokine response to laparoscopic cholecystectomy.
Comparison of Morphological and Functional Alterations of Human Saphenous Veins after Seven and Fourteen Days of ex vivo Perfusion
Authors: Paroz A. , Probst H. , Saucy F. , Mazzolai Lucia , Rizzo Elena , Ris H.-B. , Corpataux J.-M.
Published: September 2004

Intimal hyperplasia (IH) is a vessel wall remodeling process responsible of early failure after vascular surgery or endovascular interventions. An ex vivo perfusion was used to study human venous segments regarding functional, histomorphological, immunohistochemical and molecular alterations after 7 (group 1, n = 6) and 14 days (group 2, n = 6) of ex vivo perfusion. All vessel segments showed preserved smooth muscle function before and after perfusion. Histomorphometry revealed IH development which was more pronounced after 14 days rather than 7 days (p < 0.05). Expression of CD34, factor VIII, α-actin and MIB-1 was demonstrated in all segments from both groups indicating that muscular and endothelial integrity was preserved after ex vivo perfusion of up to 14 days. PAI-1 mRNA expression was significantly increased after perfusion (p < 0.05), suggesting that the endothelial fibrinolytic function may be modulated in this ex vivo perfusion model of human saphenous veins.
Intraosseous Hypertonic Saline Solution for Resuscitation of Uncontrolled, Exsanguinating Liver Injury in Young Swine
Authors: Carrera R.M. , Pacheco Jr. A.M. , Caruso J. , Mastroti R.A.
Published: September 2004

Fluid resuscitation administered before hemorrhage control for trauma victims sustaining blunt abdominal injury is controversial. Prehospital fluid resuscitation is limited by difficulty in delivering large volumes of fluid in the field and time delays associated with gaining vascular access. Venous access is often a clinical dilemma in severely hypovolemic children. Intraosseous infusion is considered a useful technique for the administration of fluids in emergency situations when peripheral intravascular access is not possible. This study investigated the effectiveness of intraosseous versus intravenous infusion of hypertonic saline solution in an uncontrolled hemorrhagic shock swine model. We also tested the effect of the different sites of infusion on the intra-abdominal bleeding. Relevant hemodynamic parameters were monitored and blood samples were collected. After liver injury, 20 anesthetized immature pigs were randomized to three groups: intraosseous access, intravenous access and control. After 20 min of uncontrolled hemorrhage, the hypertonic saline solution begins in the intraosseous access and intravenous access groups of animals. Thirty minutes later, the animals were killed and intra-abdominal blood loss was measured. All the pigs presented lower pressures and lower cardiac output after 20 min of hemorrhagic shock. The intravenous and intraosseous access groups did not show a better hemodynamic performance after 10 min of fluid resuscitation. At the end of the experiment, all animals were hemodynamically similar without an improved answer to a fluid resuscitation. There were no significant differences between groups regarding intra-abdominal blood loss. It was concluded that the hypertonic saline solution in this experimental model did not promote hemodynamic improvement and there were no differences between the two sites of fluid resuscitation regarding intra-abdominal blood loss.
Portosystemic Shunt Prevents Apoptosis in Rat Intestinal Mucosa Caused by Total Hepatic Ischemia
Authors: Bedirli A. , Sakrak O. , Soyuer I. , Muhtaroglu S.
Published: September 2004

Background: Prolonged splanchnic congestion due to total hepatic ischemia (THI) has been shown to induce damage to the intestinal mucosa. The present study was conducted to examine whether the protective effect of portosystemic shunt (PSS) can be seen on apoptosis of intestinal mucosa in a rat model of THI. Methods:Adult male Wistar rats were divided into the following 3 groups: control group; the THI group underwent THI for 30 min, and the PSS group was subjected to THI for 30 min with PSS. Rats were killed after 1, 2, and 6 h of reperfusion. For each time point, levels of serum liver enzymes, intestinal morphology, malondialdehyde (MDA) contents and DNA fragmentation in intestinal tissue were determined. In addition, the 7-day survival rate was measured. Results: The 7-day survival rate of THI group remained at 50%, whereas that of PSS group was significantly higher at 90% (p < 0.01). Serum AST and ALT levels of the THI and PSS groups rapidly increased after reperfusion, reaching peak values at 2 h. MDA levels after 1 and 2 h of reperfusion in the THI group were significantly increased as compared with the control group (p < 0.001). Increases in the percentage of fragmented DNA peaked 1 h after reperfusion in the THI group. PSS resulted in the reduction of DNA fragmentation and preserved the macroscopic and microscopic appearance of the intestinal mucosa. Conclusions: Splanchnic congestion due to portal occlusion increased apoptosis in the rat intestinal mucosa. PSS is very effective in counteracting the principal negative effects of total hepatic ischemia.
Effects of Human Hepatocyte Growth Factor on the Proliferation of Human Hepatocytes and Hepatocellular Carcinoma Cell Lines
Authors: Efimova E.A. , Glanemann M. , Liu L. , Schumacher G. , Settmacher U. , Jonas S. , Langrehr J.M. , Neuhaus P. , Nüssler A.K.
Published: September 2004

Background: Hepatocyte growth factor (HGF) has been suggested to initiate both hepatocyte and tumor cell proliferation after partial hepatectomy, thereby supporting local tumor recurrence. The aim of this study was to clarify the role of HGF in the regeneration of human hepatocyte and the growth of residual hepatocellular carcinoma cells after liver resection. Patients/Methods: 36 patients who underwent partial hepatectomy for hepatocellular carcinoma (HCC) or living liver donation have been analyzed for HGF serum levels at day –1 through day 5 following surgery using an enzyme-linked immunosorbent assay. Isolated human hepatocytes and HCC cell lines (Hep 3B, Hep G2) were treated either with recombinant human (rh)-HGF, or sera from the 36 patients in the presence or absence of anti-HGF in order to measure their proliferative capacity using 3H-thymidine incorporation. Results: Basal HGF levels were significantly higher in HCC than in healthy patients (1,573 ± 131 vs. 778 ± 64 pg/ml; p < 0.001), however, the postoperative rise of HGF in healthy patients was higher (9,608 ± 3111 vs. 2,060 ± 148 pg/ml) than in HCC patients. Incubation of human hepatocytes and Hep 3B cells with rh-HGF revealed a dose-dependent increase in DNA synthesis, while anti-HGF partially abolished this effect. Sera from normal and resected HCC patients stimulated DNA synthesis only in human hepatocytes, whereas it was inhibited in HCC cell lines. Conclusion: HGF plays an important role in hepatocyte proliferation but contrary to in vitro results, HGF does not play a major role for the progression of hepatocarcinoma cells in vivo.
Electromotor Activity of the Cecum and Ascending Colon: The Concept of ‘Individual Pacemakers’
Authors: Shafik A. , Mostafa Randa M. , El-Sibai O. , Shafik I.A.
Published: September 2004

Background/Aims: The cecum is described as differing anatomically from the ascending colon (AC); yet their similarity or difference in terms of motile activity has not been studied sufficiently. The cecum is separated from the AC by the cecocolonic junction (CCJ) which contains a cecocolonic sphincter. We assumed that the motile activity of the AC is different from that of the cecum and hypothesized that both the AC and the cecum might have different pacemakers which initiate the motile activity. This hypothesis was investigated in the current study. Methods: The study was performed in 10 subjects (mean age 41.6 ± 12.8 SD years; 7 women) during the repair of huge abdominal incisional hernias. The electric activity was recorded from 2 monopolar electrodes applied each to the cecum, CCJ and AC. The CCJ was then anesthetized by xylocaine and the electric waves of the cecum, CCJ and AC were registered after 10 and 90 min. The test was repeated using normal saline instead of xylocaine. Results: Electric waves were recorded from the cecum, CCJ and AC in the form of monophasic pacesetter (PPs) and action potentials (APs). The PPs occurred regularly and the APs randomly. The frequency, amplitude and conduction velocity of the waves recorded from the CCJ and AC had higher readings than those from the cecum (p < 0.05). The CCJ and AC showed similar frequency and conduction velocity (p > 0.05). Ten minutes after CCJ anesthetization, electric waves were recorded from the cecum but not from the CCJ or AC; however, electric activity returned after 90 min. Saline injection did not affect the electric activity of the cecum, CCJ and AC. Conclusion: The electric wave parameters of the cecum differed from those of the CCJ and AC, suggesting that the motile activity of the CCJ and AC is not a continuation of the motile activity of the cecum and that it might be evoked by 2 different pacemakers. The similarity in frequency and conduction velocity of electric waves of the CCJ and AC, however, most likely denotes that the AC waves are a continuation of those of the CCJ, and that both are evoked by the same pacemaker probably located in the CCJ. The higher amplitude of cecal waves might be due to the thicker cecal musculature compared to that of the AC.
Influence of Titanium Coating on the Biocompatibility of a Heavyweight Polypropylene Mesh
Authors: Scheidbach H. , Tannapfel A. , Schmidt U. , Lippert H. , Köckerling F.
Published: September 2004

Introduction: In light of the fact that, to date, no information is available about titanium relative to its application in prosthetic material employed for hernial repair, the aim of the present work was to evaluate the fundamental possibilities of titanium-coated polypropylene meshes. Materials and Methods: In experiments with animals, two groups, each containing 11 pigs, received either a heavyweight polypropylene mesh (Atrium®) or an identical but titanium-coated mesh (titanium-coated Atrium) implanted into the left groin using the totally endoscopic extraperitoneal patchplasty technique. Results: A significant difference in the shrinkage behavior between conventional Atrium and titanium-coated Atrium was found (14.9 vs. 8.8%, p < 0.05). Furthermore, the partial volume of the inflammatory infiltrate also proved to be smaller with the titanium-coated mesh (14.9 vs. 12.4%). In addition, Ki-67 expression was lower in the group implanted with titanium-coated mesh (21.0 vs. 15.0%). No difference was observed with regard to the apoptosis index (7.6 vs. 6.5). Conclusions: Heavyweight titanium-coated polypropylene meshes induce a less pronounced foreign body reaction in comparison with identical meshes with no titanium coating, which, since the amount of material implanted is identical, must be attributed solely to the titanium coating.
Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?
Authors: Berndsen F.H. , Bjursten L.-M. , Simanaitis M. , Montgomery A.
Published: September 2004

Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas deferens and s-testosterone from the spermatic vein were measured using the contralateral side as control. Light microscopy of the inguinal canal was performed and inflammation and fibrosis were graded. Results: Vasography revealed patent vas deferens in all animals. In group III, there was a lower s-testosterone in the spermatic vein and a reduced cross-sectional area of the vas deferens on the operated compared to the control side. However, there was no difference in the other groups and there was no significant difference in s-testosterone levels between the groups. There was significantly more inflammation and fibrosis after mesh repair compared to suture repair, but there was no difference between the two mesh groups. Unexpectedly, polyglactin fibres were still seen in specimens in group III after 90 days. Conclusion: In conclusion, the only effect on the spermatic cord structures in a rat model is seen as an impaired s-testosterone production and a reduced cross-sectional area of the vas deferens after use of a low-weight composite mesh compared to the control side. No difference in inflammation or fibrosis was found between heavyweight polypropylene mesh and low-weight composite mesh.
Construction of a Transplantable Tissue-Engineered Artificial Peritoneum
Authors: Kuga H. , Morisaki T. , Nakamura K. , Onishi H. , Matsuda T. , Sueishi K. , Tanaka M. , Katano M.
Published: September 2004

Background: Peritoneal defects lead to serious postoperative problems. Thus the development of physiological material to cover peritoneal defects is very desirable. Aim: The aim of this study was to develop a transplantable artificial peritoneum. Method: The artificial peritoneum consisted of collagen gel, fibroblasts, and mesothelial cells, and histological features were analyzed. The artificial peritoneum at the site of a peritoneal defect in the rat was transplanted to the abdominal wall. Results: Histological examination revealed that the artificial peritoneum consisted of a flat mesothelial monolayer upon a stromal matrix. All transplanted artificial peritoneums adapted well to the host and prevented severe adhesion. Conclusion: Our artificial peritoneum may be a useful transplantable bioengineered material for repair of surgical peritoneal defects.
Hypertension but Not Sodium Intake Determines Progression of Renal Failure in Experimentally Uremic Rats
Authors: Weissgarten Joshua , Modai David , Berman Sylvia , Efrati Shai , Golik Ahuva , Cohen Natan , Cohn Mirel , Galperin Elena , Averbukh Zhan
Published: September 2004

Background/Aims: High sodium intake is implicated in contributing to progression of chronic renal failure. We studied the effect of high sodium consumption on progression of rat experimental renal failure while sodium-induced hypertension was pharmacologically controlled. Methods: 64 Sprague-Dawley rats underwent 5/6 nephrectomy. Subsequently, they were divided in three groups which were fed either low, normal, or high sodium diet. Only the high sodium-consuming group developed hypertension. This group was further divided in two subgroups in which hypertension was either untreated or titrated to normotension by hydralazine alone or with propranolol. Results: Sequential GFR values did not differ between the respective normotensive groups. Survival downslopes of all three normotensive groups (including the pharmacologically treated, high sodium-consuming subgroup) were also similar, extending over 10 weeks. By contrast, pharmacologically untreated animals exhibited severe hypertension and 100% mortality within 3 weeks. In all experimental groups, 24-hour urinary sodium excretion paralleled sodium intake. Proteinuria rose similarly and significantly in all animals on high sodium. A significant correlation between 24-hour sodium and proteinuria was evident throughout the experimental period. Conclusions: (1) In 5/6 nephrectomized rats, renal function deterioration was not affected by dietary sodium, provided hypertension was pharmacologically controlled. (2) Enhanced proteinuria secondary to high sodium consumption had no adverse effect on progression of renal failure in this model.
Endocrine Response to Surgical Stress and Postoperative Confusion in Depressed Patients with Alcohol Abuse
Authors: Kudoh Akira , Katagai Hiroshi , Takase Hajime , Takazawa Tomoko
Published: September 2004

Both alcohol drinking and depression are risk factors for postoperative confusion and are associated with alteration of pituitary-adrenal function. We investigated the incidence of postoperative confusion, plasma cortisol and ACTH response to surgical stress in depressed patients with alcohol abuse. We studied sixty depressed patients with and without alcohol abuse who underwent abdominal surgery. Postoperative confusion occurred in 4 of 30 patients (13%) in depressed patients without alcohol abuse, 10 of 30 patients (33%) in depressed patients with alcohol abuse. Plasma cortisol concentrations (27.2 ± 7.0, 28.3 ± 8.2, 29.2 ± 4.1, 28.0 ± 6.3 and 27.9 ± 5.7 µg dl–1) 15, 60 min after the skin incision, 60 min after the end of surgery, the next day and the third day after surgery in depressed patients with alcohol abuse were significantly higher than that (20.1 ± 6.4, 21.7 ± 9.6, 22.3 ± 8.0, 21.9 ± 6.7 and 20.3 ± 5.4 µg dl–1) in depressed patients without alcohol abuse. In depressed patients with alcohol abuse, plasma cortisol concentrations (34.9 ± 7.1, 33.2 ± 5.8 and 33.4 ± 5.5 µg dl–1) 60 min after the end of surgery, the next day and third day after surgery in postoperatively confused depressed patients were significantly higher than those (26.4 ± 6.3, 25.4 ± 5.0 and 25.2 ± 4.9 µg dl–1) of nonconfused depressed patients. In conclusion, the incidence of postoperative confusion was significantly higher in depressed patients with alcohol abuse than in depressed patients without alcohol abuse. Increased plasma cortisol concentrations after surgery were associated with postoperative confusion in depressed patients with alcohol abuse.
Serotonergic Dissection of Obsessive Compulsive Symptoms: A Challenge Study with m-Chlorophenylpiperazine and Sumatriptan
Authors: Gross-Isseroff Ruth , Cohen Rivka , Sasson Yehuda , Voet Hillary , Zohar Joseph
Published: September 2004

We have conducted a pharmacological challenge experiment in 10 medication-free obsessive compulsive (OC) disorder (OCD) patients. We used a placebo-controlled paradigm for m-chlorophenylpiperazine (mCPP) and sumatriptan challenges. Endocrine, physiological and behavioral variables were assessed at baseline and over a 3-hour period after the challenge. Both cortisol and prolactin were significantly elevated in OCD patients following mCPP administration. Both mCPP and sumatriptan caused significant OC symptom exacerbation with the response to sumatriptan being more robust. We conclude that the 5-HT1Dβ receptor may play a role in the pathophysiology of OCD.
Analysis of Enhancer Activity of a Dinucleotide Repeat Polymorphism in the Neurotrophin-3 Gene and Its Association with Bipolar Disorder
Authors: Tadokoro K. , Hashimoto R. , Tatsumi M. , Kamijima K. , Kunugi H.
Published: September 2004

Growing evidence has implicated the possible involvement of neurotrophins in the pathogenesis of functional psychoses such as schizophrenia and bipolar disorder. Previous studies reported a significant association of a dinucleotide repeat polymorphism of the neurotrophin-3 (NTF3) gene with schizophrenia. The aims of the present study were to examine whether this polymorphism is associated with bipolar disorder and whether the polymorphic region has an enhancer/silencer effect on transcriptional activity in an allele-dependent manner. In an association analysis between the polymorphism and bipolar disorder in a Japanese sample of 88 patients and 98 controls matched for age, sex, and ethnicity, the distribution of alleles did not differ significantly between the two groups. pGL3-promoter luciferase reporter vectors containing the polymorphic region increased luciferase activity relative to empty pGL3-promoter vector in HeLa, IMR-32 (neuroblastoma) and Hs683 (glioma) cell lines; however, no significant difference was detected between alleles for either cell line. Our results suggest that the examined polymorphism has no major role in giving susceptibility to bipolar disorder. Although the polymorphic region may have an enhancer-like effect on transcriptional activity, we obtained no evidence for allele-dependent differential effects.
Neuronal Dysfunction of the Frontal Lobe in Schizophrenia
Authors: Pae Chi-Un , Choe Bo-Young , Joo Ra-Hyeong , Lim Hyun-Kook , Kim Tae-Suk , Yoo Seung-Schik , Choi Byung-Gil , Kim Jung-Jin , Lee Soo-Jung , Lee Chul , Paik In-Ho , Lee Chang Uk
Published: September 2004

Localized in vivo proton magnetic resonance spectroscopy (MRS) was performed to evaluate metabolic alterations in the right and left frontal lobe before and after antipsychotic treatment of schizophrenic patients (n = 24) and a group of healthy normal subjects (n = 20). Proton metabolic ratios obtained from the 8 cm3 voxels in the right and left frontal lobes were compared with the clinical assessment for each subject. There was no significant difference in the metabolic ratios between the right and the left frontal lobes in either the schizophrenic group or the control group, indicating no laterality. Compared with those of the normal control group, NAA/Cr ratio of the schizophrenic patients showed significantly lower value. The NAA/Cr ratio of the schizophrenic patients was not changed after antipsychotic treatment. The present study supports the ‘hypofrontality’ hypothesis of schizophrenia.
Familial Aggregation of Suicidal Ideation in Psychiatric Patients: Influence of Gender
Authors: Dikeos Dimitris G. , Papadimitriou George N. , Soldatos Constantin R.
Published: September 2004

To investigate the role of familial factors for suicidal ideation, 48 psychiatric patients belonging to 20 nuclear and three-generation families were personally interviewed. The effect of familiality on suicidal ideation was estimated through the use of mixed model analysis with family as random effect and gender, age and depressive score as fixed effects (covariates). The effect of family was found to be statistically significant (p = 0.024) for the whole group of patients and for the subgroup of males (p = 0.048), but not female patients; significance persisted for the whole group (p = 0.030) and was reduced to indicative level for males (p = 0.069), when psychiatric diagnosis was also considered as an additional potentially confounding factor. These results show that the occurrence of suicidal ideation has a familial component, stronger among males than females. This may be an additional explanation (besides those related to various other biological and sociocultural factors) for gender differences in suicidal behavior.
Absence of NK1 Receptors in Human Blood Lymphocytes and Granulocytes
Authors: Marazziti Donatella , Giannaccini Gino , Baroni Stefano , Betti Laura , Giusti Laura , Lucacchini Antonio , Cassano Giovanni B.
Published: September 2004

Substance P is a peptide that exerts its activity through the interaction with specific receptors that are distributed in different brain areas. Given the potential of NK1 receptor antagonists as antidepressants, the availability of a peripheral model of NK1 receptors would be particularly relevant for the possibility to perform studies in samples of patients. Therefore, with the present study we aimed to explore the possible existence of NK1 receptors by means of [3H]SR140333 and [125I]BHSP that behave as, respectively, antagonist and agonist, at this level, in human blood lymphocytes and granulocytes of healthy donors. The results of the present study failed to detect the presence of a high-affinity and saturable binding of [3H]SR140333 and [125I]BHSP in human blood cells, whereas a specific binding for both compounds was found in rat cerebral cortex that was used as the control tissue. These findings would question the presence of NK1 receptors in human circulating cells.
Replication Test for Association of the IL-1 Receptor Antagonist Gene, IL1RN, with Attention-Deficit/Hyperactivity Disorder
Authors: Misener Virginia L. , Schachar Russell , Ickowicz Abel , Malone Molly , Roberts Wendy , Tannock Rosemary , Kennedy James L , Pathare Tejaswee , Barr Cathy L.
Published: September 2004

Attention-deficit/hyperactivity disorder (ADHD) has a strong genetic basis, and aberrant brain dopaminergic and noradrenergic activity is implicated in its etiology. Interleukin-1 (IL-1), its antagonist, IL-1Ra, and IL-1 receptors are all present in the brain, and IL-1 has been shown to influence both dopaminergic and noradrenergic function. Recently, Segman et al. [1] tested the IL-1Ra gene, IL1RN, as a candidate for involvement in ADHD.Using the transmission/disequilibrium test (TDT) to examine 77 nuclear ADHD families for the inheritance of alleles of an intronic 86-bp VNTR polymorphism, they found significant evidence for biased transmission of the 4-repeat allele (p = 0.04) and non-transmission of the 2-repeat allele (p = 0.03). Here, we sought to replicate this in an independent sample of families. In contrast to the previous findings, our analysis of 178 ADHD families showed no evidence for biased transmission of these alleles (p = 0.81 and p = 1.00, respectively). Our lack of evidence for association of this IL1RN polymorphism with ADHD, based on a much larger sample of families, suggests that the original finding may have been a spurious (i.e. false-positive) result. These findings highlight the need for further investigations of this marker, in additional independent ADHD samples, in the future.
Association Study of Serotonin 1B Receptor (A-161T) Genetic Polymorphism and Suicidal Behaviors and Response to Fluoxetine in Major Depressive Disorder
Authors: Tsai Shih-Jen , Hong Chen-Jee , Yu Younger W.-Y. , Chen Tai-Jui , Wang Ying-Chieh , Lin Wen-Kuo
Published: September 2004

Serotonin 1B receptors (5-HT1B) are autoreceptors involved in the local inhibitory control of serotonin release, and have been suggested to play a role in the pathogenesis of major depressive disorder (MDD) and the antidepressant effects of the selective serotonin reuptake inhibitors in patients. We genotyped the 5-HT1B A-161T polymorphism in 160 patients with MDD and 160 normal controls. We then tested the hypothesis that the allelic variant, A-161T, of the 5-HT1B gene confers susceptibility to MDD or is associated with suicide attempt. We also examined the association of this polymorphism with therapeutic response in 116 of the MDD patients who received fluoxetine treatment for 4 weeks. No significant difference was found in the A-161T genetic polymorphism between MDD patients and controls. The genotype distribution between patients with and without suicide attempt, or between fluoxetine treatment responders and nonresponders were also similar. Our findings suggest that 5-HT1B A-161T genetic polymorphism does not play a major role in the susceptibility to MDD, nor is it related to suicidal attempt or the therapeutic response to fluoxetine in MDD.
Neuropeptide Y in Euthymic Lithium-Treated Women with Bipolar Disorder
Authors: El Khoury Aram , Mathé Aleksander A.
Published: September 2004

Plasma neuropeptide Y-like immunoreactivity (NPY-LI) and platelet cyclic AMP (cAMP) activity were determined in 13 women with bipolar disorder stabilized on lithium (Li) and 12 matched healthy controls. No differences in plasma NPY-LI were found between the two groups. In euthymic Li-treated bipolar patients, there was an inverse correlation between plasma NPY-LI levels and intracellular cAMP in prostaglandin E1-stimulated platelets. A positive correlation was found between plasma NPY-LI levels and age in both the patient and the control group. Our findings support earlier findings that NPY is capable of inhibiting adenylyl cyclase and that aging is a physiological factor in regulating NPY-LI levels.